A randomized controlled trial of the impact of the Teen Council peer education program on youth development.

This paper presents results of an impact evaluation of Teen Council, a program that trains youth as peer educators. Teen Council is designed to help peer educators make healthy sexual and reproductive decisions, increase their confidence and abilities to educate their peers and inspire them to advocate for just sexual policies. The program's impact on these educators was evaluated using a randomized controlled trial. Over 5 years, interested high school students in seven states were randomly assigned to a study condition. An intent-to-treat framework using ordinary least square (OLS) regression was employed to measure program effects. Relative to control, Teen Council youth showed enhanced comfort with their own sexuality, greater comfort with and more frequent communication with parents about sexuality and more positive sexual health behaviors, including accessing reproductive health care and adopting more effective means of contraception. Teen Council youth also reported greater confidence in talking with peers about sexuality and more confidence in their civic engagement skills.

A clinical study of root surface conditioning with an EDTA gel. I. Nonsurgical periodontal treatment.

The present study was undertaken to investigate if subgingival administration of an EDTA gel has any adjunctive effect to subgingival and supragingival root debridement. The investigation was performed in one study center involving 6 clinical investigators and 91 patients. The patients were selected from 2 patient populations: 41 were included from a consecutive referral material on a voluntary basis, and 50 were included from a maintenance care material at the clinic. No significant differences were found between the EDTA-treated and control groups with respect to clinical attachment gain or probing pocket depth reduction. The referral patients showed a significant improvement of pocket depth and attachment gain compared to maintenance care patients at the clinic. In multiple regression analyses, it was found that patients with small attachment losses at baseline responded better to treatment than patients with severe periodontitis. Also, in multivariate analyses, referral patients responded better than maintenance patients when controlling for other predictors.

The necessary subjectivity of bodymind medicine: Candace Pert's molecules of emotions.

This article discusses the relevance of Candace Pert's Molecules of Emotions (1997) to the development of bodymind medicine and argues that Pert's research and conceptual analysis provide the missing link connecting the messages of the mind to physiological effects in the body. The research and analysis also present a fundamental challenge to both the reigning body of medicine and the scientific commitment to so-called objectivity by positing a human organism that can act upon itself with thoughts and feelings--that is, through subjectivity. The contention is twofold: The only adequate medical science is one in which the patient's subjectivity is written into the health and disease equation. But for this to happen the classical/modern concept of science needs to be dramatically reconfigured.

The Nobel Prize and the biomedical paradigm: is it time for a change?

An examination of the early history of Nobel Committee deliberations, coupled with a survey of discoveries for which prizes have been awarded to date--and, equally revealing, discoveries for which prizes have not been awarded--reveals a pattern. This pattern suggests that Committee members may have internalized the received, biomedical model and conferred awards in accord with the physicalistic premises that ground this model. I consider the prospect of a paradigm change in medical science and the possible repercussions of such a change on the distribution of Nobel prizes "within the domain of physiology or medicine." For expository purposes, I contrast a model based on a science of pathophysiology with one based on a science of pathopsychophysiology. I propose a means whereby members might minimize the potentially blinding effects of model-dependence and come to evaluate medical discoveries from an inter-model rather than an exclusively intra-model perspective. By bringing to light questions rarely asked and proposing answers, I seek to open a dialogue and furnish a vehicle by which the putative delimiting effects of model-dependence might be overcome.

Interactory effect between marginal plaque and subgingival proximal restorations on periodontal pocket depth.

The purpose of the present study was to investigate the influence of plaque on periodontal pocket depth adjacent to proximal amalgam restorations after non-surgical periodontal treatment. From 120 randomly selected patients 200 proximal premolar- or molar sites with subgingival restorations (test sites) and 200 contralateral unrestored sites within the same patient (control sites) were included if plaque was present on test as well as on control sites. At baseline the periodontal mean pocket depth adjacent to subgingival restorations were found to be significantly deeper (0.25 mm) than for control sites. After treatment, 24% of the initially subgingivally located restorations were registered as supragingival restorations. The differences according to mean pocket depth between supragingival restorations and corresponding control sites after treatment were found to be statistically non-significant. At reexamination mean pocket depth adjacent to proximal restorations with plaque were significantly deeper than their contralateral unrestored sites (mean difference 0.34 mm), while a non-significant difference was calculated for subgingival restorations without plaque. Subgingival restorations with their apical borders still located subgingivally after periodontal treatment should be regarded as a risk factor in periodontitis progression. Consequently, placement of the restoration margin supragingivally is recommended, especially in periodontitis-prone patients with an insufficient plaque control.

Care of the abused woman. A hospital's educational program assesses values and beliefs.

To answer questions about staff's ability to identify, assess, and support victims of woman abuse, St. Joseph's Hospital, Hamilton, Ontario, Canada, organized a task group that included a cross section of staff and representatives of a local women's shelter. A comprehensive literature review strongly confirmed the need for a program that would provide staff with relevant information about abused women and challenge them to examine their values and beliefs. The task group constructed a questionnaire that included six different scales measuring various aspects of respondents' beliefs and attitudes about woman assault. The educational program for the pilot units included a training video, in-service workshops, a resource training manual, and an assessment tool to assist staff in screening female patients. The survey identified some key areas of concern, including some widely held misconceptions about the causes of abuse. After the educational program, test scores showed significant changes, particularly on scales that measured belief in popular myths and the degree to which respondents held perpetrators responsible for their actions. Overall, the project demonstrated that values and beliefs related to woman assault can be significantly affected by an educational approach that combines information sharing with the opportunity for dialogue and questions.

Putting the mind back into the body. A successor scientific medical model.

This paper examines today's received scientific medical model with respect to its ability to satisfy two conditions: (1) its explanatory adequacy relative to the full range of findings in the medical literature, including those indicating a correlation between psychosocial variables and disease susceptibility; and (2) the fit between its physicalist patient and disease concepts and what today's basic sciences, so-called sciences of complexity, tell us about the way matter, notably complex systems (e.g. patients), behave and the nature of scientific explanation. I conclude that the received (biomedical) model falls short on both counts and to satisfy these conditions is to articulate a formal successor model. This successor must be guided by premises consistent with the findings and methods of today's basic sciences on which an applied science like medicine depends for its validity. Additionally, the successor model must be able to explain (and predict) the full range of clinical findings, both those that its predecessors explains and at least some of those that it does not. The aim of the paper is to identify such a model.

The challenge to biomedicine: a foundations perspective.

The basic premise of today's scientific medicine is that the 'book of man' is written in the language of the biological sciences, ultimately molecular genetics and biochemistry. The patient is a complex biological organism and disease is a deviation from the norm of somatic parameters. At the same time, many major contemporary diseases are reported to have psychosocial and environmental components in their etiology. Hence the challenge: how can a medical model be both scientific and conceptually well-suited to today's disease burden? I argue that certain contemporary "postmodern" sciences support alternative, non-reductionist (self-organizational) premises. So doing, they offer an infrastructure for a medical model at once scientific and responsive to the diseases at hand.