Low Self-esteem: A Medical Dictionary, Bibliography, And Annotated Research Guide To Internet References

LOW SELF-ESTEEM A M EDICAL D ICTIONARY , B IBLIOGRAPHY , AND A NNOTATED R ESEARCH G UIDE TO I NTERNET R E FERENCES J AM...

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LOW SELF-ESTEEM A M EDICAL D ICTIONARY , B IBLIOGRAPHY , AND A NNOTATED R ESEARCH G UIDE TO I NTERNET R E FERENCES

J AMES N. P ARKER , M.D. AND P HILIP M. P ARKER , P H .D., E DITORS

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ICON Health Publications ICON Group International, Inc. 4370 La Jolla Village Drive, 4th Floor San Diego, CA 92122 USA Copyright 2004 by ICON Group International, Inc. Copyright 2004 by ICON Group International, Inc. All rights reserved. This book is protected by copyright. No part of it may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise, without written permission from the publisher. Printed in the United States of America. Last digit indicates print number: 10 9 8 7 6 4 5 3 2 1

Publisher, Health Care: Philip Parker, Ph.D. Editor(s): James Parker, M.D., Philip Parker, Ph.D. Publisher's note: The ideas, procedures, and suggestions contained in this book are not intended for the diagnosis or treatment of a health problem. As new medical or scientific information becomes available from academic and clinical research, recommended treatments and drug therapies may undergo changes. The authors, editors, and publisher have attempted to make the information in this book up to date and accurate in accord with accepted standards at the time of publication. The authors, editors, and publisher are not responsible for errors or omissions or for consequences from application of the book, and make no warranty, expressed or implied, in regard to the contents of this book. Any practice described in this book should be applied by the reader in accordance with professional standards of care used in regard to the unique circumstances that may apply in each situation. The reader is advised to always check product information (package inserts) for changes and new information regarding dosage and contraindications before prescribing any drug or pharmacological product. Caution is especially urged when using new or infrequently ordered drugs, herbal remedies, vitamins and supplements, alternative therapies, complementary therapies and medicines, and integrative medical treatments. Cataloging-in-Publication Data Parker, James N., 1961Parker, Philip M., 1960Low Self-Esteem: A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References / James N. Parker and Philip M. Parker, editors p. cm. Includes bibliographical references, glossary, and index. ISBN: 0-497-00677-4 1. Low Self-Esteem-Popular works. I. Title.

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Disclaimer This publication is not intended to be used for the diagnosis or treatment of a health problem. It is sold with the understanding that the publisher, editors, and authors are not engaging in the rendering of medical, psychological, financial, legal, or other professional services. References to any entity, product, service, or source of information that may be contained in this publication should not be considered an endorsement, either direct or implied, by the publisher, editors, or authors. ICON Group International, Inc., the editors, and the authors are not responsible for the content of any Web pages or publications referenced in this publication.

Copyright Notice If a physician wishes to copy limited passages from this book for patient use, this right is automatically granted without written permission from ICON Group International, Inc. (ICON Group). However, all of ICON Group publications have copyrights. With exception to the above, copying our publications in whole or in part, for whatever reason, is a violation of copyright laws and can lead to penalties and fines. Should you want to copy tables, graphs, or other materials, please contact us to request permission (E-mail: [email protected]). ICON Group often grants permission for very limited reproduction of our publications for internal use, press releases, and academic research. Such reproduction requires confirmed permission from ICON Group International, Inc. The disclaimer above must accompany all reproductions, in whole or in part, of this book.

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Acknowledgements The collective knowledge generated from academic and applied research summarized in various references has been critical in the creation of this book which is best viewed as a comprehensive compilation and collection of information prepared by various official agencies which produce publications on low self-esteem. Books in this series draw from various agencies and institutions associated with the United States Department of Health and Human Services, and in particular, the Office of the Secretary of Health and Human Services (OS), the Administration for Children and Families (ACF), the Administration on Aging (AOA), the Agency for Healthcare Research and Quality (AHRQ), the Agency for Toxic Substances and Disease Registry (ATSDR), the Centers for Disease Control and Prevention (CDC), the Food and Drug Administration (FDA), the Healthcare Financing Administration (HCFA), the Health Resources and Services Administration (HRSA), the Indian Health Service (IHS), the institutions of the National Institutes of Health (NIH), the Program Support Center (PSC), and the Substance Abuse and Mental Health Services Administration (SAMHSA). In addition to these sources, information gathered from the National Library of Medicine, the United States Patent Office, the European Union, and their related organizations has been invaluable in the creation of this book. Some of the work represented was financially supported by the Research and Development Committee at INSEAD. This support is gratefully acknowledged. Finally, special thanks are owed to Tiffany Freeman for her excellent editorial support.

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About the Editors James N. Parker, M.D. Dr. James N. Parker received his Bachelor of Science degree in Psychobiology from the University of California, Riverside and his M.D. from the University of California, San Diego. In addition to authoring numerous research publications, he has lectured at various academic institutions. Dr. Parker is the medical editor for health books by ICON Health Publications. Philip M. Parker, Ph.D. Philip M. Parker is the Eli Lilly Chair Professor of Innovation, Business and Society at INSEAD (Fontainebleau, France and Singapore). Dr. Parker has also been Professor at the University of California, San Diego and has taught courses at Harvard University, the Hong Kong University of Science and Technology, the Massachusetts Institute of Technology, Stanford University, and UCLA. Dr. Parker is the associate editor for ICON Health Publications.

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About ICON Health Publications To discover more about ICON Health Publications, simply check with your preferred online booksellers, including Barnes&Noble.com and Amazon.com which currently carry all of our titles. Or, feel free to contact us directly for bulk purchases or institutional discounts: ICON Group International, Inc. 4370 La Jolla Village Drive, Fourth Floor San Diego, CA 92122 USA Fax: 858-546-4341 Web site: www.icongrouponline.com/health

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Table of Contents FORWARD .......................................................................................................................................... 1 CHAPTER 1. STUDIES ON LOW SELF-ESTEEM .................................................................................... 3 Overview........................................................................................................................................ 3 The Combined Health Information Database................................................................................. 3 Federally Funded Research on Low Self-Esteem............................................................................ 7 E-Journals: PubMed Central ......................................................................................................... 9 The National Library of Medicine: PubMed .................................................................................. 9 CHAPTER 2. DISSERTATIONS ON LOW SELF-ESTEEM...................................................................... 15 Overview...................................................................................................................................... 15 Dissertations on Low Self-Esteem................................................................................................ 15 Keeping Current .......................................................................................................................... 16 CHAPTER 3. BOOKS ON LOW SELF-ESTEEM .................................................................................... 17 Overview...................................................................................................................................... 17 Book Summaries: Federal Agencies.............................................................................................. 17 Book Summaries: Online Booksellers........................................................................................... 19 CHAPTER 4. MULTIMEDIA ON LOW SELF-ESTEEM ......................................................................... 21 Overview...................................................................................................................................... 21 Video Recordings ......................................................................................................................... 21 Audio Recordings......................................................................................................................... 22 CHAPTER 5. PERIODICALS AND NEWS ON LOW SELF-ESTEEM ...................................................... 25 Overview...................................................................................................................................... 25 News Services and Press Releases................................................................................................ 25 Newsletter Articles ...................................................................................................................... 26 Academic Periodicals covering Low Self-Esteem ......................................................................... 28 APPENDIX A. PHYSICIAN RESOURCES ............................................................................................ 31 Overview...................................................................................................................................... 31 NIH Guidelines............................................................................................................................ 31 NIH Databases............................................................................................................................. 33 Other Commercial Databases....................................................................................................... 35 APPENDIX B. PATIENT RESOURCES ................................................................................................. 37 Overview...................................................................................................................................... 37 Patient Guideline Sources............................................................................................................ 37 Finding Associations.................................................................................................................... 41 APPENDIX C. FINDING MEDICAL LIBRARIES .................................................................................. 43 Overview...................................................................................................................................... 43 Preparation................................................................................................................................... 43 Finding a Local Medical Library.................................................................................................. 43 Medical Libraries in the U.S. and Canada ................................................................................... 43 ONLINE GLOSSARIES.................................................................................................................. 49 Online Dictionary Directories ..................................................................................................... 49 LOW SELF-ESTEEM DICTIONARY............................................................................................ 51 INDEX ................................................................................................................................................ 65

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FORWARD In March 2001, the National Institutes of Health issued the following warning: "The number of Web sites offering health-related resources grows every day. Many sites provide valuable information, while others may have information that is unreliable or misleading."1 Furthermore, because of the rapid increase in Internet-based information, many hours can be wasted searching, selecting, and printing. Since only the smallest fraction of information dealing with low self-esteem is indexed in search engines, such as www.google.com or others, a non-systematic approach to Internet research can be not only time consuming, but also incomplete. This book was created for medical professionals, students, and members of the general public who want to know as much as possible about low self-esteem, using the most advanced research tools available and spending the least amount of time doing so. In addition to offering a structured and comprehensive bibliography, the pages that follow will tell you where and how to find reliable information covering virtually all topics related to low self-esteem, from the essentials to the most advanced areas of research. Public, academic, government, and peer-reviewed research studies are emphasized. Various abstracts are reproduced to give you some of the latest official information available to date on low self-esteem. Abundant guidance is given on how to obtain free-of-charge primary research results via the Internet. While this book focuses on the field of medicine, when some sources provide access to non-medical information relating to low self-esteem, these are noted in the text. E-book and electronic versions of this book are fully interactive with each of the Internet sites mentioned (clicking on a hyperlink automatically opens your browser to the site indicated). If you are using the hard copy version of this book, you can access a cited Web site by typing the provided Web address directly into your Internet browser. You may find it useful to refer to synonyms or related terms when accessing these Internet databases. NOTE: At the time of publication, the Web addresses were functional. However, some links may fail due to URL address changes, which is a common occurrence on the Internet. For readers unfamiliar with the Internet, detailed instructions are offered on how to access electronic resources. For readers unfamiliar with medical terminology, a comprehensive glossary is provided. For readers without access to Internet resources, a directory of medical libraries, that have or can locate references cited here, is given. We hope these resources will prove useful to the widest possible audience seeking information on low self-esteem. The Editors

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From the NIH, National Cancer Institute (NCI): http://www.cancer.gov/cancerinfo/ten-things-to-know.

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CHAPTER 1. STUDIES ON LOW SELF-ESTEEM Overview In this chapter, we will show you how to locate peer-reviewed references and studies on low self-esteem.

The Combined Health Information Database The Combined Health Information Database summarizes studies across numerous federal agencies. To limit your investigation to research studies and low self-esteem, you will need to use the advanced search options. First, go to http://chid.nih.gov/index.html. From there, select the “Detailed Search” option (or go directly to that page with the following hyperlink: http://chid.nih.gov/detail/detail.html). The trick in extracting studies is found in the drop boxes at the bottom of the search page where “You may refine your search by.” Select the dates and language you prefer, and the format option “Journal Article.” At the top of the search form, select the number of records you would like to see (we recommend 100) and check the box to display “whole records.” We recommend that you type “low self-esteem” (or synonyms) into the “For these words:” box. Consider using the option “anywhere in record” to make your search as broad as possible. If you want to limit the search to only a particular field, such as the title of the journal, then select this option in the “Search in these fields” drop box. The following is what you can expect from this type of search: •

Self-Esteem Key in Bulimia Source: Healthy Weight Journal. p.50. July/August 2000. Contact: B.C. Decker, Inc. 4 Hughson St. South, O.O. Box 620, LCD1, Hamilton, Ontario L8N 3K7, Canada. 800-568-7281. 905-522-7017. [email protected]. Summary: According to a University of Wisconsin study, the interaction of three factors-low self-esteem, perfectionism, and perceived overweight--drives bulimic symptoms. Highly perfectionist women with low self-esteem are at risk; but perfectionist women with high self-esteem, even when they consider themselves overweight, do not develop bulimic symptoms. These findings are based on a study of 342 women who were tested in the spring of their senior year in high school and during their first year of college. The

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study suggests that bulimic symptoms may be reduced by increasing self-esteem and/or reducing perfectionism and perceived overweight. •

Hearing in the Elderly: Relation of Hearing Loss, Loneliness, and Self-Esteem Source: Journal of Gerontological Nursing. 20(6): 22-28. June 1994. Summary: In this article, the author considers the relationships between hearing, loneliness, and self-esteem in the elderly population. Topics covered in the introduction include the differences between hearing loss and hearing handicap; determining the level of hearing impairment; and what the author terms the impact of hearing loss on interpersonal communication. The author stresses that this analysis of the relations among hearing impairment, self-esteem, and loneliness will help nurses better understand the social needs of elders with hearing loss. She then reports on a descriptive correlational study undertaken with 88 subjects (aged from 65 to 90 years). Data analysis revealed that hearing impairment has a significant correlation with loneliness and that loneliness has a significant correlation with low self-esteem. Social difficulties caused by hearing loss was the only factor that affected psychosocial outcome or feelings of loneliness in men; emotional and social difficulties related to hearing loss affected self-esteem in women. The author concludes with a discussion of the nursing implications of this study. 1 figure. 2 tables. 27 references.

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Obesity and Weight Management: Current Perspectives Source: American Journal of Bariatric Medicine--The Bariatrician. 16(3):18-20. Fall/Winter 2001. Summary: Obesity is a chronic disease affecting one in three Americans. It is the second leading cause of preventable death in the country after cigarette smoking. Obesity is linked with numerous diseases including high blood pressure, heart disease, type 2 diabetes, some cancers, osteoarthritis, high blood cholesterol and blood fat, and sleep apnea. People with obesity frequently struggle with depression, low self-esteem, and anxiety. The author reviews the causes, assessment, and treatment of obesity. She encourages primary care providers to play a 'pivotal role' in caring for obese patients and improving their outcomes. Since obesity is a chronic condition, long-term care and support are crucial.

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Tormented Source: Shape. p.112,114-16. July 1998. Summary: Tarkan discusses how body images formed during adolescence can influence individuals throughout their lives. She focuses on three appearance factors that often become a body image issue: height, acne, and weight. Ann Kearney-Cooke, director of the Cincinnati Psychotherapy Institute and an expert on eating disorders, says that poor body image as an adolescent can be a factor on the development of eating disorders and low self-esteem. A sidebar offers ideas on ways to improve self-image and self- esteem. Some of these include: distinguishing past teasing from present feedback; working out; focusing less on the appearance of others; and cultivating a variety of interests. Tarkan concludes with the stories of three women who suffered from low self-esteem because of body images formed during adolescence.

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The Ethics of Promoting Weight Loss Source: Healthy Weight Journal. 14(2):25-26. March/April 2000.

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Summary: The authors discuss the consequences of health education efforts to reduce obesity. Too often, they say, such efforts focus on individual responsibility, without taking into account genetic, social, and environmental factors. As a result, this approach may lead to low self-esteem, eating disorders, exercise disorders, and societal rejection. Hawks and Gast suggest that more attention be paid to the social environment, such as fast foods available in mall food courts and schools, scheduling of food-related ads on television, increased numbers of exercise trails in parks, and employee exercise centers. Another contributor to the social environment is the media portrayal of extremely thin women as beautiful and large women as unattractive. Rather, the relationship between activity level, healthy eating, spiritual and emotional health should be emphasized. With an emphasis on overall health rather than a focus on weight, the negative consequences of current weight loss efforts can be avoided. The profit motive may also be a powerful reason for some individuals to promote a weight-loss agenda, including some physicians, according to the authors. If weight loss is seen as an individual responsibility, then it becomes easier to discriminate against the obese in health insurance, employment, and a host of other areas. Hawks and Gast call for an understanding of healthy weight as the weight the body adopts with a healthy diet and useful amounts of physical activity. •

Self-Esteem Source: Diabetes Forecast. 43(10): 51-53. September 1990. Summary: The issue of self-esteem and how it relates to people who have diabetes is addressed in this article. Low self-esteem becomes a factor for many people with diabetes because of the feeling that their condition is self-inflicted or that they feel abnormal compared to others. Individuals can help themselves reverse feelings of low self-esteem by focusing on positive points and what they like about themselves as individuals; accepting diabetes as their particular limitation (everyone has some); learning that diabetes is controllable; and attaining the abilities to do so. Finally, raising self-esteem requires people to act as if they deserved good health care. This can be accomplished through strict adherence to the diabetes control program. A selfsatisfaction scale is also provided to assist in measuring self-esteem.

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Breaking Free Source: Diabetes Forecast. 49(4): 32-35. April 1996. Contact: Available from American Diabetes Association. 1701 North Beauregard Street, Alexandria, VA 22311. (800) 232-3472. Website: www.diabetes.org. Summary: This article encourages readers to develop a positive self-image as the first step toward good health. The author includes a brief discussion of the emphasis placed by society on good health and then describes five thoughts that point to low selfesteem, including coping with the diagnosis of diabetes, societal values, interpersonal relationships, self-denigration for out-of-control blood glucose values, and martyrdom. The author stresses that everyone can learn to be at peace with themselves and the disease.

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Wholeness of Self Workshops: A New Approach to HIV Prevention for Gay and Bisexual Men Source: Journal of Gay & Lesbian Social Services; Vol. 4, no. 3, 1996. Contact: Haworth Press, 10 Alice Street, Binghamton, NY, 13904-9981, (800) 342-9678.

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Summary: This article presents a review of risk-taking behavior of gay and bisexual men from the perspective of a clinical psychologist who specializes in HIV issues and prevention. The psychologist conducts workshops that help participants address the individual and societal issues that can override a person's HIV knowledge-base and increase the likelihood of unsafe sexual practices. Feedback from workshop participants reveals that the causes of unprotected sexual behavior are not limited to low selfesteem. Confusing educational guidelines in regard to oral sex, desire for natural sex, and inclusion in a monogamous relationship also contribute. Innovative strategies that help this population increase their self-acceptance, desire to survive in society, and ability to cope with widespread death and grief are put forth as strategies for preventing the further spread of HIV. •

Depression, Self-Esteem, and Life Events in Adolescents with Chronic Diseases Source: Journal of Adolescent Health Care. 11(6): 501-504. November 1990. Summary: This article reports on a study that assesses whether nonhospitalized adolescents with chronic diseases differ from their healthy peers on standardized measurements of depression, self-esteem, and life events. The study group consisted of 80 patients (20 with sickle cell disease, 40 with asthma, and 20 with diabetes). All patients had been admitted to a hospital at least twice in the preceding year, had their disease for at least 2 years, and were between the ages of 12 and 18. All subjects completed a questionnaire compiled from the Beck Depression Inventory, the Rosenberg Scale of Self-Esteem, and the McCutcheon Life Events Checklist. Results indicated that adolescents with chronic disease had higher depression scores and lower self-esteem than their healthy age-matched controls. There was no statistically significant difference in life events between the chronic disease and control groups. Depression, self-esteem, and life events did not differ significantly among the three disease groups. The authors conclude that their findings suggest a need for intervention strategies to address depression and low self-esteem in adolescents with chronic disease. 2 tables. 18 references. (AA-M).

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Sexual Risk for HIV Transmission Among Gay/Bisexual Men in Substance - Abuse Treatment Source: AIDS Education and Prevention; Vol. 5, No. 1, Spring 1993. Contact: University of California San Francisco, Center for AIDS Prevention Studies, Collaborative HIV Prevention Research Program, 74 New Montgomery, Ste 600, San Francisco, CA, 94105, (415) 597-9175, http://www.caps.ucsf.edu/projects/ISindex.html. Summary: This journal article discusses sexual risk for HIV transmission among gay/bisexual men in substance abuse treatment. It describes a quantitative analysis comparing levels of sexual behaviors that are high risk for HIV transmission in a sample of San Francisco gay/bisexual men in substance abuse treatment and the cohort of gay/bisexual men followed in the San Francisco Men's Health Study (SFMHS). The methods for recruiting the substance-abuse treatment population are explained, the considerations regarding the choice of SFMHS cohort are described, and the measures of sexual behavior and alcohol/drug use are defined. The results indicate a significantly higher risk for HIV transmission among gay/bisexual men in substance abuse treatment than among the community-based SFMHS sample of gay/bisexual men. The article supplements the quantitative findings with an inductive analysis of the focus group data, the reasons the respondents themselves found to be relevant to their continued high risk for HIV transmission. It discusses the relationship between substance abuse

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and unsafe sex. The article cites impaired judgement from drug use/perceived release from inhibitions; patterns of alcohol and drug use to enhance activities in sexual contexts; and the difficulties in following risk-reduction guidelines due to perceived powerlessness, lack of self-assertion, and low self-esteem as causes of continued high risk for HIV transmission among gay/bisexual men in substance abuse treatment. The article concludes that AIDS prevention strategies aimed specifically at substance abusing gay/bisexual men are necessary and should be incorporated into conventional substance-abuse treatment programs.

Federally Funded Research on Low Self-Esteem The U.S. Government supports a variety of research studies relating to low self-esteem. These studies are tracked by the Office of Extramural Research at the National Institutes of Health.2 CRISP (Computerized Retrieval of Information on Scientific Projects) is a searchable database of federally funded biomedical research projects conducted at universities, hospitals, and other institutions. Search the CRISP Web site at http://crisp.cit.nih.gov/crisp/crisp_query.generate_screen. You will have the option to perform targeted searches by various criteria, including geography, date, and topics related to low self-esteem. For most of the studies, the agencies reporting into CRISP provide summaries or abstracts. As opposed to clinical trial research using patients, many federally funded studies use animals or simulated models to explore low self-esteem. The following is typical of the type of information found when searching the CRISP database for low self-esteem: •

Project Title: ANTECEDENTS AND CONSEQUENCES OF BELIEF CERTAINTY Principal Investigator & Institution: Swann, William B.; Professor; Psychology; University of Texas Austin 101 E. 27Th/Po Box 7726 Austin, Tx 78712 Timing: Fiscal Year 2002; Project Start 01-JAN-1999; Project End 31-DEC-2004 Summary: The proposed research examines the links between belief certainty and several important phenomena, including error in person perception, stereotyping, and low self-esteem. Section I follows up on preliminary studies of dating couples and college roommates indicating that as time and involvement in their relationships increase, they become increasingly certain of their beliefs about their partners with no concomitant increase in the accuracy of these beliefs. It is proposed that these effects exemplify a more general set of phenomena in which factors that make our beliefs richer foster confidence but not necessarily accuracy. The proposed studies will test this hypothesis and identify its range of applicability. Section II focuses on whether or not the model of belief certainty developed in Section I applies to social stereotypes. One study attempts to resolve an apparent contradiction between my model and past research on the certainty of social stereotypes. Another study will test the hypothesis that unmitigated losses of belief certainty increase prejudice. Yet another study will consider the counter-intuitive notion that providing prejudiced people with support for a stereotype may increase their tendency to individuate a member of a stereotyped

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Healthcare projects are funded by the National Institutes of Health (NIH), Substance Abuse and Mental Health Services (SAMHSA), Health Resources and Services Administration (HRSA), Food and Drug Administration (FDA), Centers for Disease Control and Prevention (CDCP), Agency for Healthcare Research and Quality (AHRQ), and Office of Assistant Secretary of Health (OASH).

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group. The final study in this series will test the hypothesis that temporary loses in selfcertainty within some domains will make people more likely to confirm the stereotypebased expectancies of perceivers. The third and final set of studies will examine the antecedents and consequences of self-certainty. Two studies will examine the cognitive and motivational antecedents of self-certainty. Another study will follow up on preliminary evidence that self-uncertainty and the low self-esteem it theoretically fosters can be eliminated by bolstering people's sense of self-certainty through confirmation of their negative as well as positive self-views. Studies are proposed to examine more directly the hypothesized confidence-bolstering effects of information that confirms people's self-views and specify how increasing self- certainty bolsters selfesteem. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: MENTAL HEALTH AND BEHAVIOR IN ADOLESCENT STD PREVENTION Principal Investigator & Institution: Shrier, Lydia A.; Children's Hospital (Boston) Boston, Ma 021155737 Timing: Fiscal Year 2002; Project Start 28-SEP-1999; Project End 31-AUG-2004 Summary: (Adapted from the Applicant's Abstract): Lydia A. Shrier, M.D., M.P.H., is an Adolescent Medicine specialist committed to a career in patient-oriented clinical research. Her research goals are to develop and evaluate adolescent-specific interventions to reduce sexual risk behavior and sexually transmitted diseases (STDs), including human immunodeficiency virus (HIV) infection. Adolescents are the population at highest risk for STD/HIV. Studies have suggested that mental health problems, including depression, low self-esteem, and low self-efficacy, may play an important role in the development of sexual risk behaviors and influence the effectiveness of STD/HIV prevention interventions. To develop effective STD/HIV risk reduction interventions for adolescents, it is critical to understand the impact of poor mental health on sexual risk behavior. A K23 Award would provide Dr. Shrier with the funding and time to pursue intensive training in health behavior and interventional trial design, implementation, and analysis, as well as to acquire new knowledge and experience in the study of mental health and sexual risk behavior. The superb clinical, research, and teaching faculties of Children's Hospital, Boston, Harvard Medical School, and Harvard School of Public Health will support Dr. Shrier in meeting the objectives of the career development and research plans. The Career Development Plan includes (1) coursework in biostatistics and research design, (2) a fellowship with the Behavioral Interventions and Research Branch of the Division of STD Prevention at the Centers for Disease Control and Prevention, (3) mentoring in mental health research, prevention/intervention theory and methodology, and health behavior research, and (4) on-going access to consultation and support during the planning, implementation, and evaluation of the proposed research. The Research Plan proposes 3 linked studies to evaluate the hypothesis that depression, low self-esteem, negative mood, and low selfefficacy to use condoms are related to condom nonuse and STD acquisition among sexually active adolescents. Study 1 will use data from the National Longitudinal Survey of Adolescent Health to evaluate associations of depressive symptoms and selfesteem with condom nonuse and STD acquisition. Informed by Study 1, Studies 2 and 3 will prospectively examine associations of these mental health risk factors, as well as mood and self-efficacy to use condoms, with outcomes of inconsistent condom use and STD acquisition in a randomized clinical trial of an interactive video-plus-counseling safer sex intervention. An objective biologic measure, Chlamydia trachomatis infection,

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as well as self-reported condom use will be used to assess intervention effectiveness. Study 2 will use the control group to elucidate temporal relationships among the mental health factors and the outcomes of condom nonuse and Chlamydia acquisition over one year. Study 3 will evaluate whether poor mental health alters response to the intervention, as measured by a reduction in Chlamydia incidence. If mental health is found to influence intervention effectiveness, the results of the study will be used to develop a program that systematically incorporates mental health evaluation and treatment into the prevention of HIV and other STDs in adolescents. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

E-Journals: PubMed Central3 PubMed Central (PMC) is a digital archive of life sciences journal literature developed and managed by the National Center for Biotechnology Information (NCBI) at the U.S. National Library of Medicine (NLM).4 Access to this growing archive of e-journals is free and unrestricted.5 To search, go to http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=Pmc, and type “low self-esteem” (or synonyms) into the search box. This search gives you access to full-text articles. The following is a sample of items found for low self-esteem in the PubMed Central database: •

Low self-esteem and psychiatric patients: Part I -- The relationship between low selfesteem and psychiatric diagnosis. by Silverstone PH, Salsali M.; 2003; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=151271

The National Library of Medicine: PubMed One of the quickest and most comprehensive ways to find academic studies in both English and other languages is to use PubMed, maintained by the National Library of Medicine.6 The advantage of PubMed over previously mentioned sources is that it covers a greater number of domestic and foreign references. It is also free to use. If the publisher has a Web site that offers full text of its journals, PubMed will provide links to that site, as well as to sites offering other related data. User registration, a subscription fee, or some other type of fee may be required to access the full text of articles in some journals. To generate your own bibliography of studies dealing with low self-esteem, simply go to the PubMed Web site at http://www.ncbi.nlm.nih.gov/pubmed. Type “low self-esteem” (or synonyms) into the search box, and click “Go.” The following is the type of output you can expect from PubMed for low self-esteem (hyperlinks lead to article summaries): 3 4

Adapted from the National Library of Medicine: http://www.pubmedcentral.nih.gov/about/intro.html.

With PubMed Central, NCBI is taking the lead in preservation and maintenance of open access to electronic literature, just as NLM has done for decades with printed biomedical literature. PubMed Central aims to become a world-class library of the digital age. 5 The value of PubMed Central, in addition to its role as an archive, lies in the availability of data from diverse sources stored in a common format in a single repository. Many journals already have online publishing operations, and there is a growing tendency to publish material online only, to the exclusion of print. 6 PubMed was developed by the National Center for Biotechnology Information (NCBI) at the National Library of Medicine (NLM) at the National Institutes of Health (NIH). The PubMed database was developed in conjunction with publishers of biomedical literature as a search tool for accessing literature citations and linking to full-text journal articles at Web sites of participating publishers. Publishers that participate in PubMed supply NLM with their citations electronically prior to or at the time of publication.

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Adult attachment security and symptoms of depression: the mediating roles of dysfunctional attitudes and low self-esteem. Author(s): Roberts JE, Gotlib IH, Kassel JD. Source: Journal of Personality and Social Psychology. 1996 February; 70(2): 310-20. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8636884

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Characteristics of high and low self-esteem in the elderly. Author(s): Hunter KI, Linn MW, Harris R. Source: International Journal of Aging & Human Development. 1981-82; 14(2): 117-26. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7343513

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Complex partial epileptic-like signs contribute differential sources of variance to low self-esteem and imaginings. Author(s): Persinger MA. Source: Percept Mot Skills. 1995 April; 80(2): 427-31. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7675574

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Depression-proneness, low self-esteem, unhappy outlook, and narcissistic vulnerability. Author(s): Zemore R, Bretell D. Source: Psychological Reports. 1983 February; 52(1): 223-30. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6844491

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Do boys with a low-average I.Q. actually have a low self-esteem? Author(s): Opie N, Lemasters G. Source: The Journal of School Health. 1975 September; 45(7): 381-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1041501

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Do people with low self-esteem really want to feel better? Self-esteem differences in motivation to repair negative moods. Author(s): Heimpel SA, Wood JV, Marshall MA, Brown JD. Source: Journal of Personality and Social Psychology. 2002 January; 82(1): 128-47. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11811630

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Does low self-esteem predict health compromising behaviours among adolescents? Author(s): Mcgee R, Williams S. Source: Journal of Adolescence. 2000 October; 23(5): 569-82. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11073698

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Is chronic low self-esteem the cause of eating disorders? Author(s): Silverstone PH. Source: Medical Hypotheses. 1992 December; 39(4): 311-5. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1494317

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Is low self-esteem an inevitable consequence of stigma? An example from women with chronic mental health problems. Author(s): Camp DL, Finlay WM, Lyons E. Source: Social Science & Medicine (1982). 2002 September; 55(5): 823-34. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12190273

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Low self-esteem and hopelessness in childhood and suicidal ideation in early adulthood. Author(s): McGee R, Williams S, Nada-Raja S. Source: Journal of Abnormal Child Psychology. 2001 August; 29(4): 281-91. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11523834

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Low self-esteem in different psychiatric conditions. Author(s): Silverstone PH. Source: The British Journal of Clinical Psychology / the British Psychological Society. 1991 May; 30 ( Pt 2): 185-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2059753

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Low self-esteem in differentiating fearful and self-conscious forms of shyness. Author(s): Schmidt LA, Robinson TN Jr. Source: Psychological Reports. 1992 February; 70(1): 255-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1565729

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Low self-esteem in eating disordered patients in the absence of depression. Author(s): Silverstone PH. Source: Psychological Reports. 1990 August; 67(1): 276-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2236408

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Mania and low self-esteem. Author(s): Winters KC, Neale JM. Source: Journal of Abnormal Psychology. 1985 August; 94(3): 282-90. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4031225

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Negative cognitive errors in children: questionnaire development, normative data, and comparisons between children with and without self-reported symptoms of depression, low self-esteem, and evaluation anxiety. Author(s): Leitenberg H, Yost LW, Carroll-Wilson M. Source: Journal of Consulting and Clinical Psychology. 1986 August; 54(4): 528-36. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3745607

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Neuroticism and low self-esteem as risk factors for incident eating disorders in a prospective cohort study. Author(s): Cervera S, Lahortiga F, Martinez-Gonzalez MA, Gual P, de Irala-Estevez J, Alonso Y. Source: The International Journal of Eating Disorders. 2003 April; 33(3): 271-80. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12655623

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Neuroticism and low self-esteem as risk factors for psychosis. Author(s): Krabbendam L, Janssen I, Bak M, Bijl RV, de Graaf R, van Os J. Source: Social Psychiatry and Psychiatric Epidemiology. 2002 January; 37(1): 1-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11924745

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Night eating syndrome is associated with depression, low self-esteem, reduced daytime hunger, and less weight loss in obese outpatients. Author(s): Gluck ME, Geliebter A, Satov T. Source: Obesity Research. 2001 April; 9(4): 264-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11331430

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Occupational factors contributing to low self-esteem in registered nurses and licensed practical nurses: a multivariate analysis. Author(s): Imai K. Source: J Uoeh. 2001 March 1; 23(1): 13-22. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11279837

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Psychodynamic approach to low self-esteem related to developmental deviations: growing up incompetent. Author(s): Aleksandrowicz DR, Aleksandrowicz MK. Source: Journal of the American Academy of Child and Adolescent Psychiatry. 1987 July; 26(4): 583-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2443477

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Right hemisphericity and low self-esteem in high school students: a replication. Author(s): Lazure CL, Persinger MA. Source: Percept Mot Skills. 1992 December; 75(3 Pt 2): 1058. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1484764

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Right hemisphericity, low self-esteem, and unusual experiences: a response to Vingiano. Author(s): Persinger MA. Source: Percept Mot Skills. 1992 October; 75(2): 568-70. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1408622

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Screening for psychiatric distress and low self-esteem in patients presenting for excimer laser surgery for myopia. Author(s): Kidd B, Stark C, McGhee CN. Source: Journal of Refractive Surgery (Thorofare, N.J. : 1995). 1997 January-February; 13(1): 40-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9049934

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Self-consistency for low self-esteem in dissonance processes: the role of selfstandards. Author(s): Stone J. Source: Pers Soc Psychol Bull. 2003 July; 29(7): 846-58. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=15018673

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Self-esteem maintenance processes: why low self-esteem may be resistant to change. Author(s): Josephs RA, Bosson JK, Jacobs CG. Source: Pers Soc Psychol Bull. 2003 July; 29(7): 920-33. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=15018679

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Smoking behaviour in youth: the problem of low self-esteem? Author(s): Glendinning A, Inglis D. Source: Journal of Adolescence. 1999 October; 22(5): 673-82. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10527538

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Stability and change in low self-esteem: the role of psychosocial factors. Author(s): Andrews B, Brown GW. Source: Psychological Medicine. 1995 January; 25(1): 23-31. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7792358

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Strategies of social comparison among people with low self-esteem: self-protection and self-enhancement. Author(s): Wood JV, Giordano-Beech M, Taylor KL, Michela JL, Gaus V. Source: Journal of Personality and Social Psychology. 1994 October; 67(4): 713-31. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7965616

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The cognitive-behavioural treatment of low self-esteem in psychotic patients: a pilot study. Author(s): Hall PL, Tarrier N. Source: Behaviour Research and Therapy. 2003 March; 41(3): 317-32. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12600402

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The effects of inconsistent reinforcement on the negative self-reinforcing behavior of high and low self-esteem individuals. Author(s): Neistein S, Katkovsky W. Source: Journal of Personality. 1974 March; 42(1): 78-92. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4814121

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The high cost of low self-esteem. Author(s): Borth B. Source: Occup Health Nurs. 1985 June; 33(6): 289-90. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3846859

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The prevalence of major depressive disorder and low self-esteem in medical inpatients. Author(s): Silverstone PH, Lemay T, Elliott J, Hsu V, Starko R. Source: Canadian Journal of Psychiatry. Revue Canadienne De Psychiatrie. 1996 March; 41(2): 67-74. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8705965

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Validation of the MMPI-2 Low Self-Esteem Content Scale. Author(s): Brems C, Lloyd P. Source: Journal of Personality Assessment. 1995 December; 65(3): 550-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8609587

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Who are we? Low self-esteem and marital identity. Author(s): Watson WL, Bell JM. Source: Journal of Psychosocial Nursing and Mental Health Services. 1990 April; 28(4): 15-20. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2332840

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CHAPTER 2. DISSERTATIONS ON LOW SELF-ESTEEM Overview In this chapter, we will give you a bibliography on recent dissertations relating to low selfesteem. We will also provide you with information on how to use the Internet to stay current on dissertations. IMPORTANT NOTE: When following the search strategy described below, you may discover non-medical dissertations that use the generic term “low self-esteem” (or a synonym) in their titles. To accurately reflect the results that you might find while conducting research on low self-esteem, we have not necessarily excluded nonmedical dissertations in this bibliography.

Dissertations on Low Self-Esteem ProQuest Digital Dissertations, the largest archive of academic dissertations available, is located at the following Web address: http://wwwlib.umi.com/dissertations. From this archive, we have compiled the following list covering dissertations devoted to low selfesteem. You will see that the information provided includes the dissertation’s title, its author, and the institution with which the author is associated. The following covers recent dissertations found when using this search procedure: •

A COMPARISON OF FEELINGS OF PARENTAL REJECTION AND LOW SELFESTEEM IN LATENCY AGE BOYS WHO ARE RATED HYPERACTIVE OR NONHYPERACTIVE BY THEIR PARENTS by HICKEY, JOHN KENNEDY, JR., DSW from ADELPHI UNIVERSITY, SCHOOL OF SOCIAL WORK, 1980, 157 pages http://wwwlib.umi.com/dissertations/fullcit/8027383

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A GROUP COUNSELING PROGRAM FOR LOW SELF-ESTEEM PREADOLESCENT FEMALES IN THE FIFTH-GRADE. by SHUR, M. SHARON, PHD from UNIVERSITY OF PITTSBURGH, 1975, 182 pages http://wwwlib.umi.com/dissertations/fullcit/7605475

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DOES FACE-TO-FACE CONTACT REDUCE COUNSELEE RESPONSIVENESS WITH LOW SELF-ESTEEM YOUTH? by SIMS, GREGORY KNOX, PHD from STANFORD UNIVERSITY, 1971, 163 pages http://wwwlib.umi.com/dissertations/fullcit/7211664

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EFFECTS OF CROSS-AGE TUTORING ON SELF-ESTEEM AND READING ACHIEVEMENT OF LOW SELF-ESTEEM FIFTH-GRADE MALES. by DIAMOND, BARBARA, PHD from FORDHAM UNIVERSITY, 1976, 138 pages http://wwwlib.umi.com/dissertations/fullcit/7617895

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IDENTITY DIFFUSION, MORAL CONFLICT, AND LOW SELF-ESTEEM AS CONTRIBUTING FACTORS TO THE POST-TRAUMATIC STRESS DISORDER SYMPTOMS IN VIETNAM COMBAT VETERANS by MARTIN, LELAND KARL, PhD from LOYOLA UNIVERSITY OF CHICAGO, 1986, 263 pages http://wwwlib.umi.com/dissertations/fullcit/8616194

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OPINION CHANGE IN HIGH, MIDDLE, AND LOW SELF-ESTEEM SUBJECTS UNDER TWO CONDITIONS OF DISSONANCE AROUSAL by DIXON, MICHAEL CURTIS, PHD from THE UNIVERSITY OF TEXAS AT AUSTIN, 1970, 121 pages http://wwwlib.umi.com/dissertations/fullcit/7018224

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PSYCHOLOGICAL BARRIERS TO PERSONAL RESPONSIBILITY: A COMPARATIVE ANALYSIS OF MIDDLE MANAGERS WITH EXCESSIVE, GENUINE, AND LOW SELF-ESTEEM (ORGANIZATIONAL DYNAMICS, HUMAN RELATIONS, JOB STRESS) by SINKIEWICZ, ANTHONY THOMAS, DBA from UNITED STATES INTERNATIONAL UNIVERSITY, 1986, 168 pages http://wwwlib.umi.com/dissertations/fullcit/8606168

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THE RELATIONSHIP BETWEEN INTERNALIZED HOMOPHOBIA AND DEPRESSION AND LOW SELF-ESTEEM IN GAY MEN (HOMOSEXUALITY) by ALEXANDER, RONALD ADEN, PhD from UNIVERSITY OF CALIFORNIA, SANTA BARBARA, 1986, 156 pages http://wwwlib.umi.com/dissertations/fullcit/8703645

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THE USE OF ART THERAPY TO DEAL WITH LOW SELF-ESTEEM AMONG THE AGED: SELECTED CASE STUDIES by EICHELBAUM, ELIZABETH, EdD from THE UNIVERSITY OF TENNESSEE, 2000, 90 pages http://wwwlib.umi.com/dissertations/fullcit/9973447

Keeping Current Ask the medical librarian at your library if it has full and unlimited access to the ProQuest Digital Dissertations database. From the library, you should be able to do more complete searches via http://wwwlib.umi.com/dissertations.

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CHAPTER 3. BOOKS ON LOW SELF-ESTEEM Overview This chapter provides bibliographic book references relating to low self-esteem. In addition to online booksellers such as www.amazon.com and www.bn.com, excellent sources for book titles on low self-esteem include the Combined Health Information Database and the National Library of Medicine. Your local medical library also may have these titles available for loan.

Book Summaries: Federal Agencies The Combined Health Information Database collects various book abstracts from a variety of healthcare institutions and federal agencies. To access these summaries, go directly to the following hyperlink: http://chid.nih.gov/detail/detail.html. You will need to use the “Detailed Search” option. To find book summaries, use the drop boxes at the bottom of the search page where “You may refine your search by.” Select the dates and language you prefer. For the format option, select “Monograph/Book.” Now type “low self-esteem” (or synonyms) into the “For these words:” box. You should check back periodically with this database which is updated every three months. The following is a typical result when searching for books on low self-esteem: •

Youth at Risk: A Prevention Resource for Counselors, Teachers, and Parents Contact: American Counseling Association, 5999 Stevenson Ave, Alexandria, VA, 223043300, (703) 823-9800, http://www.counseling.org. Summary: This book is a resource guide for individuals working on the prevention of the human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) with at-risk youth. A revision of the original 1989 text, this guide includes case studies that explore prevention efforts from individual, family, school, and community perspectives. Part One presents information regarding population definition, identification, and behaviors and causal factors descriptive of youth at risk. Information is provided that serves as a foundation for understanding the parameters of the prevention-intervention paradigm. Part Two deals with parameters that often serve as causal factors for the development of at-risk behaviors. Included are chapters dealing with the effects of a dysfunctional family, physical and sexual abuse, low self-esteem,

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depression, and stress. Part Three addresses prevention and intervention to change behaviors most often associated with placing youth at risk. Topics covered include substance abuse, homelessness, gangs, dropouts, suicide, pregnancy, and eating disorders. Each chapter in this section provides information related to specific behaviors, includes a case study to illustrate the information, and provides approaches to prevention from a variety of perspectives. Chapter 10 is on adolescents and AIDS. •

Helping Men in Grief. Reprint Source: Colorado Springs, CO: Bereavement Publishing, Inc. 1992. 4 p. Contact: Available from Bereavement Publishing, Inc., 8133 Telegraph Drive, Colorado Springs, CO 80920-7169. (719) 282-1948, (719) 282-1850 (Fax), [email protected] (Email). 1-25 copies, $2.00 each; 26-99 copies, $1.50 each; 100 or more copies, $1.00 each plus shipping and handling. Order No. 1103. Summary: This booklet presents two articles from Bereavement magazine on male bereavement. The first article, 'How's Your Wife?,' by W.P. Macaux, examines some aspects of the male role that inhibit the grieving process. To the extent that a man identifies with the role of 'competitor,' 'problem solver,' and 'controller,' he is likely to have difficulty expressing the full range of his feelings. Loss of control may fighten him and being unable to fix the problem may make him feel impotent. Many men cope with grief by keeping busy, intellectualizing the grief, and angrily placing blame. Society often sees bereaved fathers as having lost less than mothers. The bonding that occurs between father and child is often discounted. The question 'How's Your Wife?,' even from a friend, may be perceived as a negation of the father's loss and his need for support. If he feels that the question implies a privileged position for his wife, he could begin to resent her. The characteristics and behaviors of family and friends that are most helpful to bereaved men are described. The second article, 'Men in Grief: A Naturally Complicated Experience,' by A.D. Wolfelt, discusses how boys are conditioned to be 'masculine' and what this conditioning does to their ability to grieve. Boys learn that certain feelings are acceptable for them and others are not. Men who fit society's image of masculinity often have the most difficulty facing loss. Men have a tendency to repress their grief and are often unable to depend on other people during grief, even though this is a normal part of the healing process. The need to be self-sufficient prevents many men from seeking or accepting support. The result of this denial of grief is a near epidemic of complicated grief among males in our culture. Complicated grief can result in chronic depression, withdrawal, low self-esteem, deterioration in relationships, physical complaints, chronic anxiety, difficulty concentrating, substance abuse, indifference toward others, and workaholism. As a culture we need to begin to teach the little boy in childhood the freedom to be open to pain and loss.

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Great Shape: The First Fitness Guide for Large Women Source: Palo Alto, CA: Bull Publishing Company, 242 p., 1990. Contact: Bull Publishing Company, PO Box 208, Palo Alto, CA 94302. (800) 676-2855. Call for price information. Summary: This consumer education book offers exercise and healthy lifestyle suggestions for large women. The book urges women to pursue physical activity and a healthy lifestyle instead of concentrating on weight loss. The authors explain that large women often avoid physical activity because they have a poor self-image and low selfesteem. The authors describe and encourage a healthy lifestyle program for this audience, including walking, swimming, dancing, aerobic activities, martial arts,

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bicycling, and other exercise and sports programs that are safe and healthy. The appendices include an annotated bibliography, activities and exercise classes, clothing suppliers, and tips for starting an exercise class for large women. The first chapter offers an overview of the program. Chapter 2 offers tools for assessing ones own preference in physical activity. Chapter 3 provides an explanation of the research on weight and exercise. The fourth chapter concentrates on physical activities, and Chapter 5 covers the We Dance program. The sixth chapter discusses walking, hiking, running, and swimming. Chapter 7 covers information on sports. Chapter 8 offers topics for the field of sports psychology, and the ninth chapter discusses the barriers large women face when implementing and maintaining an exercise program.

Book Summaries: Online Booksellers Commercial Internet-based booksellers, such as Amazon.com and Barnes&Noble.com, offer summaries which have been supplied by each title’s publisher. Some summaries also include customer reviews. Your local bookseller may have access to in-house and commercial databases that index all published books (e.g. Books in Print). IMPORTANT NOTE: Online booksellers typically produce search results for medical and non-medical books. When searching for “low self-esteem” at online booksellers’ Web sites, you may discover non-medical books that use the generic term “low self-esteem” (or a synonym) in their titles. The following is indicative of the results you might find when searching for “low self-esteem” (sorted alphabetically by title; follow the hyperlink to view more details at Amazon.com): •

Drugs and Low Self-Esteem (Drug Abuse Prevention) by Kenneth Shepherd; ISBN: 0823928268; http://www.amazon.com/exec/obidos/ASIN/0823928268/icongroupinterna

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Laying the Foundation: The Roots of Low Self-Esteem (A Tools-for-Coping Series Book) by James J. Messina; ISBN: 084037190X; http://www.amazon.com/exec/obidos/ASIN/084037190X/icongroupinterna

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Little Sugar Addicts : End the Mood Swings, Meltdowns, Tantrums, and Low SelfEsteem in Your Child Today by Kathleen DesMaisons; ISBN: 1400051649; http://www.amazon.com/exec/obidos/ASIN/1400051649/icongroupinterna

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Made in His Image: Overcoming Low Self-Esteem by Discovering the Real You! by Kenneth D. Phelps; ISBN: 1591602076; http://www.amazon.com/exec/obidos/ASIN/1591602076/icongroupinterna

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CHAPTER 4. MULTIMEDIA ON LOW SELF-ESTEEM Overview In this chapter, we show you how to keep current on multimedia sources of information on low self-esteem. We start with sources that have been summarized by federal agencies, and then show you how to find bibliographic information catalogued by the National Library of Medicine.

Video Recordings An excellent source of multimedia information on low self-esteem is the Combined Health Information Database. You will need to limit your search to “Videorecording” and “low selfesteem” using the “Detailed Search” option. Go directly to the following hyperlink: http://chid.nih.gov/detail/detail.html. To find video productions, use the drop boxes at the bottom of the search page where “You may refine your search by.” Select the dates and language you prefer, and the format option “Videorecording (videotape, videocassette, etc.).” Type “low self-esteem” (or synonyms) into the “For these words:” box. The following is a typical result when searching for video recordings on low self-esteem: •

She Didn't Know Contact: California Department of Health Services, Office of AIDS, California AIDS Clearinghouse, 1443 N Martel Ave, Los Angeles, CA, 90046, (323) 845-4180, http://www.hivinfo.org. Summary: This video presents the stories of three women who are living with HIV disease. The women are Caucasian and are from rural communities. In their own words, the women describe how they became infected; how they happened to get tested for HIV; and how HIV infection has impacted their lives, careers, families, and future aspirations. The women explain how low self-esteem, ignorance of HIV, and alcohol contributed to the risky sexual encounters that resulted in their HIV infections. One of the women has died since the video was recorded.

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Soft Smoke: AIDS in the Rural West Contact: Fanlight Productions, 47 Halifax St, Boston, MA, 02130, (617) 524-0980.

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Summary: This video, for adolescents and individuals in rural areas, provides information about the impact of the human immunodeficiency virus (HIV)/acquired immune deficiency syndrome (AIDS) on individuals' lives. The video contains an interview with an employee of the Colorado Health Department's Partner Notification Program who states that low self-esteem contributes to high-risk behaviors including unprotected sex and substance abuse and that this can lead to HIV transmission. The video tells the story of three rural residents, Claudia, Laurie, and Robert who are HIVpositive. Laurie indicates that she is still afraid to openly discuss her condition, while Robert and Claudia discuss how they have been discriminated against. The video emphasizes the importance of avoiding substance abuse, building self-esteem, and practicing lower- or no-risk behaviors such as safer sex with condoms or sexual abstinence. •

Cultural Sensitivity Contact: University of Washington, Seattle STD Prevention/Training Center, 1001 Broadway Ste 101, Seattle, WA, 98122, (206) 720-4222. Summary: This videorecording contains a training session for health care professionals and educators to inform them on issues and problems regarding cultural and ethnic differences that need to be understood in order to provide effective education on HIV and other sexually transmitted diseases (STD's). The speaker, Patricia A. Woods, begins by defining culture as a learned pattern of beliefs, customs, behaviors, and values (lifestyles) that are shared by a group of individuals. She continues with a brief overview of the elements of cultural sensitivity, relevance, and specificity that are essential to understanding the issues. Woods then enumerates a number of barriers to STD service provision: lack of client education about STDs and HIV; language barriers; a fear of authority and history of bad experiences; anger; high relapse rates; access; lack of insurance; poverty; and low self-esteem and self image. She concludes the presentation by recommending solutions to these problems, which include a commitment to implementation, experience, a willingness to learn, respect, and resourcefulness.

Audio Recordings The Combined Health Information Database contains abstracts on audio productions. To search CHID, go directly to the following hyperlink: http://chid.nih.gov/detail/detail.html. To find audio productions, use the drop boxes at the bottom of the search page where “You may refine your search by.” Select the dates and language you prefer, and the format option “Sound Recordings.” Type “low self-esteem” (or synonyms) into the “For these words:” box. The following is a typical result when searching for sound recordings on low self-esteem: •

Self - Esteem & Social Support - #28: 17th National Lesbian & Gay Health Conference; Minneapolis, MN, June 17-21, 1995 Contact: NORCOM, PO Box 26172, St. Louis Park, MN, 55426, (612) 927-0050. Summary: This audiotape contains the proceedings of a symposium on self- esteem and emotional distress as it relates to gay and lesbian youth. The speakers discuss the research study they conducted to determine the level of self-esteem, social support, and overall well-being of urban gay and lesbian adolescents. They researched issues of social isolation, verbal and physical abuse, societal prejudice, family relations, stigmatization, and homophobia. They recruited 90 gay male and lesbian youth volunteers, with a mean

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age of 17 years, for the study. Study methods, research instruments, measurements, and participant demographics are described in detail. The researchers found greater amounts of emotional distress in this population of adolescents than in their heterosexual counterparts. They also determined that gay and lesbian adolescents have a significant incidence of low self-esteem.

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CHAPTER 5. PERIODICALS AND NEWS ON LOW SELFESTEEM Overview In this chapter, we suggest a number of news sources and present various periodicals that cover low self-esteem.

News Services and Press Releases One of the simplest ways of tracking press releases on low self-esteem is to search the news wires. In the following sample of sources, we will briefly describe how to access each service. These services only post recent news intended for public viewing. PR Newswire To access the PR Newswire archive, simply go to http://www.prnewswire.com/. Select your country. Type “low self-esteem” (or synonyms) into the search box. You will automatically receive information on relevant news releases posted within the last 30 days. The search results are shown by order of relevance. Reuters Health The Reuters’ Medical News and Health eLine databases can be very useful in exploring news archives relating to low self-esteem. While some of the listed articles are free to view, others are available for purchase for a nominal fee. To access this archive, go to http://www.reutershealth.com/en/index.html and search by “low self-esteem” (or synonyms). The following was recently listed in this archive for low self-esteem: •

Common beliefs on low self-esteem are myths: study Source: Reuters Health eLine Date: November 28, 2001

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The NIH Within MEDLINEplus, the NIH has made an agreement with the New York Times Syndicate, the AP News Service, and Reuters to deliver news that can be browsed by the public. Search news releases at http://www.nlm.nih.gov/medlineplus/alphanews_a.html. MEDLINEplus allows you to browse across an alphabetical index. Or you can search by date at the following Web page: http://www.nlm.nih.gov/medlineplus/newsbydate.html. Often, news items are indexed by MEDLINEplus within its search engine. Business Wire Business Wire is similar to PR Newswire. To access this archive, simply go to http://www.businesswire.com/. You can scan the news by industry category or company name. Market Wire Market Wire is more focused on technology than the other wires. To browse the latest press releases by topic, such as alternative medicine, biotechnology, fitness, healthcare, legal, nutrition, and pharmaceuticals, access Market Wire’s Medical/Health channel at http://www.marketwire.com/mw/release_index?channel=MedicalHealth. Or simply go to Market Wire’s home page at http://www.marketwire.com/mw/home, type “low selfesteem” (or synonyms) into the search box, and click on “Search News.” As this service is technology oriented, you may wish to use it when searching for press releases covering diagnostic procedures or tests. Search Engines Medical news is also available in the news sections of commercial Internet search engines. See the health news page at Yahoo (http://dir.yahoo.com/Health/News_and_Media/), or you can use this Web site’s general news search page at http://news.yahoo.com/. Type in “low self-esteem” (or synonyms). If you know the name of a company that is relevant to low self-esteem, you can go to any stock trading Web site (such as http://www.etrade.com/) and search for the company name there. News items across various news sources are reported on indicated hyperlinks. Google offers a similar service at http://news.google.com/. BBC Covering news from a more European perspective, the British Broadcasting Corporation (BBC) allows the public free access to their news archive located at http://www.bbc.co.uk/. Search by “low self-esteem” (or synonyms).

Newsletter Articles Use the Combined Health Information Database, and limit your search criteria to “newsletter articles.” Again, you will need to use the “Detailed Search” option. Go directly

Periodicals and News

27

to the following hyperlink: http://chid.nih.gov/detail/detail.html. Go to the bottom of the search page where “You may refine your search by.” Select the dates and language that you prefer. For the format option, select “Newsletter Article.” Type “low self-esteem” (or synonyms) into the “For these words:” box. You should check back periodically with this database as it is updated every three months. The following is a typical result when searching for newsletter articles on low self-esteem: •

Eating Disorders and Borderline Personality Disorder Source: American Anorexia/Bulimia Association Newsletter. p.1-3. Summer 1998. Contact: American Anorexia/Bulimia Association, 165 West 46 Street, Suite 1108, New York, NY 10036. (212) 575- 6200. Summary: Dennis suggests that some eating- disordered patients may be suffering from Borderline Personality Disorder (BPD), as recognized in the American Psychiatric Association's `Diagnostic and Statistical Manual 4th ed.' (DSM-IV). According to Dennis, the behaviors associated with eating disorders serve adaptive functions for an individual with BPD. These include: reinforcement of their feelings of low self-esteem, since they can never be thin enough; allowing them to soothe themselves through food, which they find difficult otherwise; and purging to allow them to feel a sense of selfcontrol. Finally, the behaviors associated with eating disorders are self- destructive and may be used as self-punishment by the BPD patient, and these behaviors may also serve as a numbing agent against the emotional pain they feel. As a result, says Dennis, treatment should be different, more intensive and lengthy.

•

Treatment Complexities of the Turner's Syndrome Patient Source: Oral-B Case Studies in Dental Hygiene. 1(1): 1-4,6-8. Summer 2003. Contact: Available from Oral-B Case Studies in Dental Hygiene, Professional Audience Communications, Inc. P.O. Box 243, Yardley, PA 19067. (800) 446-7252. Website: www.oralb.com/dentalpros. Summary: Effective patient assessment is critical to the delivery of high quality dental hygiene care. This article helps dental hygienists understand the treatment complexities of working with patients with Turner's syndrome, a complex medical condition characterized by oral, physical, and psychological features. Common physical characteristics of Turner's syndrome patients include short stature, webbed neck, and hypoplastic pinna (underdeveloped outer ears), underdeveloped or shield chest with wide-spaced nipples, and edema of the hands and feet. Oral features associated with Turner's syndrome include high arched and narrow palate, occurrence of cleft palate at higher-than-normal frequency, significantly smaller mesio-distal dimensions of the teeth, bifurcated roots and reduced root length, particularly in the maxilla (upper jaw), premature tooth eruption, increased molarization of premolars, and the presence of hypoplasia. The article then describes a case of the management of a patient diagnosed with Turner's syndrome. The young woman (age 21 years) presented with severe retrognathia, posterior open bite, crossbite on the right side, generalized enamel hypoplasia, shortened roots, thin dentin, compromised dexterity, osteoporosis, mitral valve prolapse, and low self-esteem. The dentist and dental hygienist provided this patient with comprehensive care in consultation with the patient's physician and other dental specialists. A posttest with which readers can obtain continuing education credit is appended to the article. 5 figures. 2 tables. 29 references.

28

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Low Self-Esteem

Healthy Mouth, Healthy Life Source: Harvard Women's Health Watch. 10(7): 4-5. March 2003. Contact: Available from Harvard Women's Health Watch. P.O. Box 420300, Palm Coast, FL 32142-0300. (800) 829-9045. Website: www.health.harvard.edu/newsletters/subinfo.html. Summary: Research conducted in recent decades has uncovered potential links between chronic gum infection and conditions as serious as diabetes, stroke, heart disease, and pregnancy complications. Also, oral diseases may contribute to malnutrition and create a variety of psychosocial difficulties, including low self-esteem and discrimination in work or social settings. This article, from a health newsletter, describes the new understanding of the relationship between oral health and general health. Topics include the pathology of dental decay, including plaque and the development of cavities (dental caries); periodontal disease, including gingivitis and periodontitis; and the fundamentals of toothbrushing and flossing, including the use of electric toothbrushes, different types of toothpaste, and mouthrinses. 2 figures.

Academic Periodicals covering Low Self-Esteem Numerous periodicals are currently indexed within the National Library of Medicine’s PubMed database that are known to publish articles relating to low self-esteem. In addition to these sources, you can search for articles covering low self-esteem that have been published by any of the periodicals listed in previous chapters. To find the latest studies published, go to http://www.ncbi.nlm.nih.gov/pubmed, type the name of the periodical into the search box, and click “Go.” If you want complete details about the historical contents of a journal, you can also visit the following Web site: http://www.ncbi.nlm.nih.gov/entrez/jrbrowser.cgi. Here, type in the name of the journal or its abbreviation, and you will receive an index of published articles. At http://locatorplus.gov/, you can retrieve more indexing information on medical periodicals (e.g. the name of the publisher). Select the button “Search LOCATORplus.” Then type in the name of the journal and select the advanced search option “Journal Title Search.”

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APPENDICES

31

APPENDIX A. PHYSICIAN RESOURCES Overview In this chapter, we focus on databases and Internet-based guidelines and information resources created or written for a professional audience.

NIH Guidelines Commonly referred to as “clinical” or “professional” guidelines, the National Institutes of Health publish physician guidelines for the most common diseases. Publications are available at the following by relevant Institute7: •

Office of the Director (OD); guidelines consolidated across agencies available at http://www.nih.gov/health/consumer/conkey.htm

•

National Institute of General Medical Sciences (NIGMS); fact sheets available at http://www.nigms.nih.gov/news/facts/

•

National Library of Medicine (NLM); extensive encyclopedia (A.D.A.M., Inc.) with guidelines: http://www.nlm.nih.gov/medlineplus/healthtopics.html

•

National Cancer Institute (NCI); guidelines available at http://www.cancer.gov/cancerinfo/list.aspx?viewid=5f35036e-5497-4d86-8c2c714a9f7c8d25

•

National Eye Institute (NEI); guidelines available at http://www.nei.nih.gov/order/index.htm

•

National Heart, Lung, and Blood Institute (NHLBI); guidelines available at http://www.nhlbi.nih.gov/guidelines/index.htm

•

National Human Genome Research Institute (NHGRI); research available at http://www.genome.gov/page.cfm?pageID=10000375

•

National Institute on Aging (NIA); guidelines available at http://www.nia.nih.gov/health/

7

These publications are typically written by one or more of the various NIH Institutes.

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•

National Institute on Alcohol Abuse and Alcoholism (NIAAA); guidelines available at http://www.niaaa.nih.gov/publications/publications.htm

•

National Institute of Allergy and Infectious Diseases (NIAID); guidelines available at http://www.niaid.nih.gov/publications/

•

National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS); fact sheets and guidelines available at http://www.niams.nih.gov/hi/index.htm

•

National Institute of Child Health and Human Development (NICHD); guidelines available at http://www.nichd.nih.gov/publications/pubskey.cfm

•

National Institute on Deafness and Other Communication Disorders (NIDCD); fact sheets and guidelines at http://www.nidcd.nih.gov/health/

•

National Institute of Dental and Craniofacial Research (NIDCR); guidelines available at http://www.nidr.nih.gov/health/

•

National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK); guidelines available at http://www.niddk.nih.gov/health/health.htm

•

National Institute on Drug Abuse (NIDA); guidelines available at http://www.nida.nih.gov/DrugAbuse.html

•

National Institute of Environmental Health Sciences (NIEHS); environmental health information available at http://www.niehs.nih.gov/external/facts.htm

•

National Institute of Mental Health (NIMH); guidelines available at http://www.nimh.nih.gov/practitioners/index.cfm

•

National Institute of Neurological Disorders and Stroke (NINDS); neurological disorder information pages available at http://www.ninds.nih.gov/health_and_medical/disorder_index.htm

•

National Institute of Nursing Research (NINR); publications on selected illnesses at http://www.nih.gov/ninr/news-info/publications.html

•

National Institute of Biomedical Imaging and Bioengineering; general information at http://grants.nih.gov/grants/becon/becon_info.htm

•

Center for Information Technology (CIT); referrals to other agencies based on keyword searches available at http://kb.nih.gov/www_query_main.asp

•

National Center for Complementary and Alternative Medicine (NCCAM); health information available at http://nccam.nih.gov/health/

•

National Center for Research Resources (NCRR); various information directories available at http://www.ncrr.nih.gov/publications.asp

•

Office of Rare Diseases; various fact sheets available at http://rarediseases.info.nih.gov/html/resources/rep_pubs.html

•

Centers for Disease Control and Prevention; various fact sheets on infectious diseases available at http://www.cdc.gov/publications.htm

Physician Resources

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NIH Databases In addition to the various Institutes of Health that publish professional guidelines, the NIH has designed a number of databases for professionals.8 Physician-oriented resources provide a wide variety of information related to the biomedical and health sciences, both past and present. The format of these resources varies. Searchable databases, bibliographic citations, full-text articles (when available), archival collections, and images are all available. The following are referenced by the National Library of Medicine:9 •

Bioethics: Access to published literature on the ethical, legal, and public policy issues surrounding healthcare and biomedical research. This information is provided in conjunction with the Kennedy Institute of Ethics located at Georgetown University, Washington, D.C.: http://www.nlm.nih.gov/databases/databases_bioethics.html

•

HIV/AIDS Resources: Describes various links and databases dedicated to HIV/AIDS research: http://www.nlm.nih.gov/pubs/factsheets/aidsinfs.html

•

NLM Online Exhibitions: Describes “Exhibitions in the History of Medicine”: http://www.nlm.nih.gov/exhibition/exhibition.html. Additional resources for historical scholarship in medicine: http://www.nlm.nih.gov/hmd/hmd.html

•

Biotechnology Information: Access to public databases. The National Center for Biotechnology Information conducts research in computational biology, develops software tools for analyzing genome data, and disseminates biomedical information for the better understanding of molecular processes affecting human health and disease: http://www.ncbi.nlm.nih.gov/

•

Population Information: The National Library of Medicine provides access to worldwide coverage of population, family planning, and related health issues, including family planning technology and programs, fertility, and population law and policy: http://www.nlm.nih.gov/databases/databases_population.html

•

Cancer Information: Access to cancer-oriented databases: http://www.nlm.nih.gov/databases/databases_cancer.html

•

Profiles in Science: Offering the archival collections of prominent twentieth-century biomedical scientists to the public through modern digital technology: http://www.profiles.nlm.nih.gov/

•

Chemical Information: Provides links to various chemical databases and references: http://sis.nlm.nih.gov/Chem/ChemMain.html

•

Clinical Alerts: Reports the release of findings from the NIH-funded clinical trials where such release could significantly affect morbidity and mortality: http://www.nlm.nih.gov/databases/alerts/clinical_alerts.html

•

Space Life Sciences: Provides links and information to space-based research (including NASA): http://www.nlm.nih.gov/databases/databases_space.html

•

MEDLINE: Bibliographic database covering the fields of medicine, nursing, dentistry, veterinary medicine, the healthcare system, and the pre-clinical sciences: http://www.nlm.nih.gov/databases/databases_medline.html

8

Remember, for the general public, the National Library of Medicine recommends the databases referenced in MEDLINEplus (http://medlineplus.gov/ or http://www.nlm.nih.gov/medlineplus/databases.html). 9 See http://www.nlm.nih.gov/databases/databases.html.

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•

Toxicology and Environmental Health Information (TOXNET): Databases covering toxicology and environmental health: http://sis.nlm.nih.gov/Tox/ToxMain.html

•

Visible Human Interface: Anatomically detailed, three-dimensional representations of normal male and female human bodies: http://www.nlm.nih.gov/research/visible/visible_human.html

The NLM Gateway10 The NLM (National Library of Medicine) Gateway is a Web-based system that lets users search simultaneously in multiple retrieval systems at the U.S. National Library of Medicine (NLM). It allows users of NLM services to initiate searches from one Web interface, providing one-stop searching for many of NLM’s information resources or databases.11 To use the NLM Gateway, simply go to the search site at http://gateway.nlm.nih.gov/gw/Cmd. Type “low self-esteem” (or synonyms) into the search box and click “Search.” The results will be presented in a tabular form, indicating the number of references in each database category. Results Summary Category Journal Articles Books / Periodicals / Audio Visual Consumer Health Meeting Abstracts Other Collections Total

Items Found 3337 88 413 155 10 4003

HSTAT12 HSTAT is a free, Web-based resource that provides access to full-text documents used in healthcare decision-making.13 These documents include clinical practice guidelines, quickreference guides for clinicians, consumer health brochures, evidence reports and technology assessments from the Agency for Healthcare Research and Quality (AHRQ), as well as AHRQ’s Put Prevention Into Practice.14 Simply search by “low self-esteem” (or synonyms) at the following Web site: http://text.nlm.nih.gov.

10

Adapted from NLM: http://gateway.nlm.nih.gov/gw/Cmd?Overview.x.

11

The NLM Gateway is currently being developed by the Lister Hill National Center for Biomedical Communications (LHNCBC) at the National Library of Medicine (NLM) of the National Institutes of Health (NIH). 12 Adapted from HSTAT: http://www.nlm.nih.gov/pubs/factsheets/hstat.html. 13 14

The HSTAT URL is http://hstat.nlm.nih.gov/.

Other important documents in HSTAT include: the National Institutes of Health (NIH) Consensus Conference Reports and Technology Assessment Reports; the HIV/AIDS Treatment Information Service (ATIS) resource documents; the Substance Abuse and Mental Health Services Administration's Center for Substance Abuse Treatment (SAMHSA/CSAT) Treatment Improvement Protocols (TIP) and Center for Substance Abuse Prevention (SAMHSA/CSAP) Prevention Enhancement Protocols System (PEPS); the Public Health Service (PHS) Preventive Services Task Force's Guide to Clinical Preventive Services; the independent, nonfederal Task Force on Community Services’ Guide to Community Preventive Services; and the Health Technology Advisory Committee (HTAC) of the Minnesota Health Care Commission (MHCC) health technology evaluations.

Physician Resources

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Coffee Break: Tutorials for Biologists15 Coffee Break is a general healthcare site that takes a scientific view of the news and covers recent breakthroughs in biology that may one day assist physicians in developing treatments. Here you will find a collection of short reports on recent biological discoveries. Each report incorporates interactive tutorials that demonstrate how bioinformatics tools are used as a part of the research process. Currently, all Coffee Breaks are written by NCBI staff.16 Each report is about 400 words and is usually based on a discovery reported in one or more articles from recently published, peer-reviewed literature.17 This site has new articles every few weeks, so it can be considered an online magazine of sorts. It is intended for general background information. You can access the Coffee Break Web site at the following hyperlink: http://www.ncbi.nlm.nih.gov/Coffeebreak/.

Other Commercial Databases In addition to resources maintained by official agencies, other databases exist that are commercial ventures addressing medical professionals. Here are some examples that may interest you: •

CliniWeb International: Index and table of contents to selected clinical information on the Internet; see http://www.ohsu.edu/cliniweb/.

•

Medical World Search: Searches full text from thousands of selected medical sites on the Internet; see http://www.mwsearch.com/.

15 Adapted 16

from http://www.ncbi.nlm.nih.gov/Coffeebreak/Archive/FAQ.html.

The figure that accompanies each article is frequently supplied by an expert external to NCBI, in which case the source of the figure is cited. The result is an interactive tutorial that tells a biological story. 17 After a brief introduction that sets the work described into a broader context, the report focuses on how a molecular understanding can provide explanations of observed biology and lead to therapies for diseases. Each vignette is accompanied by a figure and hypertext links that lead to a series of pages that interactively show how NCBI tools and resources are used in the research process.

37

APPENDIX B. PATIENT RESOURCES Overview Official agencies, as well as federally funded institutions supported by national grants, frequently publish a variety of guidelines written with the patient in mind. These are typically called “Fact Sheets” or “Guidelines.” They can take the form of a brochure, information kit, pamphlet, or flyer. Often they are only a few pages in length. Since new guidelines on low self-esteem can appear at any moment and be published by a number of sources, the best approach to finding guidelines is to systematically scan the Internet-based services that post them.

Patient Guideline Sources The remainder of this chapter directs you to sources which either publish or can help you find additional guidelines on topics related to low self-esteem. Due to space limitations, these sources are listed in a concise manner. Do not hesitate to consult the following sources by either using the Internet hyperlink provided, or, in cases where the contact information is provided, contacting the publisher or author directly. The National Institutes of Health The NIH gateway to patients is located at http://health.nih.gov/. From this site, you can search across various sources and institutes, a number of which are summarized below. Topic Pages: MEDLINEplus The National Library of Medicine has created a vast and patient-oriented healthcare information portal called MEDLINEplus. Within this Internet-based system are “health topic pages” which list links to available materials relevant to low self-esteem. To access this system, log on to http://www.nlm.nih.gov/medlineplus/healthtopics.html. From there you can either search using the alphabetical index or browse by broad topic areas. Recently, MEDLINEplus listed the following when searched for “low self-esteem”:

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Child Behavior Disorders http://www.nlm.nih.gov/medlineplus/childbehaviordisorders.html Eating Disorders http://www.nlm.nih.gov/medlineplus/eatingdisorders.html Mental Health http://www.nlm.nih.gov/medlineplus/mentalhealth.html Teen Mental Health http://www.nlm.nih.gov/medlineplus/teenmentalhealth.html Vision Impairment and Blindness http://www.nlm.nih.gov/medlineplus/visionimpairmentandblindness.html You may also choose to use the search utility provided by MEDLINEplus at the following Web address: http://www.nlm.nih.gov/medlineplus/. Simply type a keyword into the search box and click “Search.” This utility is similar to the NIH search utility, with the exception that it only includes materials that are linked within the MEDLINEplus system (mostly patient-oriented information). It also has the disadvantage of generating unstructured results. We recommend, therefore, that you use this method only if you have a very targeted search. The Combined Health Information Database (CHID) CHID Online is a reference tool that maintains a database directory of thousands of journal articles and patient education guidelines on low self-esteem. CHID offers summaries that describe the guidelines available, including contact information and pricing. CHID’s general Web site is http://chid.nih.gov/. To search this database, go to http://chid.nih.gov/detail/detail.html. In particular, you can use the advanced search options to look up pamphlets, reports, brochures, and information kits. The following was recently posted in this archive: •

Healthy Body Weight: Thinking About a Healthy Weight Source: Midland, MI: Health Enhancement Systems. 1998. [2 p.]. Contact: Available from Health Enhancement Systems. P.O. Box 1035, Midland, MI 48641-1035. (800) 326-2317 or (517) 839-0852. Fax (517) 839-0025. E-mail: [email protected]. Website: www.hesonline.com. PRICE: $.68 each; discounts available in bulk orders; Item number: HESHW-1. Summary: Being overweight can lead to lack of energy, poor performance, and low selfesteem. The risks for disease are also high; rates of diabetes, high blood pressure, gallstones, and heart disease rise with increasing weight. This simple brochure asks readers to consider their current body weight and to think about making weight loss choices as part of an overall prescription for better health. The brochure outlines the benefits of maintaining a healthy weight. The brochure also has blank space for readers to record their thoughts about healthier weight maintenance and how to overcome the typical obstacles to making changes in one's habits. The brochure concludes with a brief list of resources for readers wanting additional information.

Patient Resources

•

39

10 Ways to Help Someone Prevent HIV : A Short List of Strategies for Helping Patients, Clients, Students, Customers or Friends in Their Efforts to Prevent HIV : California Partners Study Contact: University of California San Francisco, Center for AIDS Prevention Studies, 74 New Montgomery St Ste 600, San Francisco, CA, 94105, (415) 597-9100, http://www.caps.ucsf.edu/capsweb. Summary: This brochure provides information concerning the prevention of the human immunodeficiency virus (HIV)/acquired immune deficiency syndrome (AIDS). The brochure discusses why a person might not protect him- or herself from HIV (e.g., low self-esteem, depression) and provides suggestions for improving communication between partners about sex. The brochure examines possible reasons why individuals practice high-risk behaviors that can lead to the transmission of HIV/AIDS, identifies and describes the various means by which the virus is spread, and categorizes sexual activities by level of safety. The brochure explains how to construct an effective condom display to show the many different types of condomns and lubricants that are available as a way of promoting safer sex. It states that HIV-testing is not HIV-prevention, and briefly describes post-exposure prevention (PEP). Resources for additional information are provided.

•

About Speech and Language Disorders Source: South Deerfield, MA: Channing L. Bete Company, Inc. 1997. 16 p. Contact: Available from Channing L. Bete Company, Inc. 200 State Road, South Deerfield, MA 01373. (800) 628-7733 or (413) 665-7611; Fax (800) 499-6464; http://www.channing.bete.com. PRICE: $1.25 for 1-24 copies; bulk rates available. Item Number 12542F-3-96. Summary: This health education booklet familiarizes readers with speech and language disorders. Defined as difficulties in understanding or expressing thoughts, the booklet explains speech and language disorders and how they can affect learning, independence, relationships, and emotional well-being. The booklet outlines the three aspects of normal communication: hearing, interpreting, and speaking. Communication disorders can result from physical problems, health problems, learning problems, and other problems such as mental retardation, low self-esteem, or emotional disturbances. Specific speech and language disorders outlined include stuttering, poor voice control, articulation disorders, aphasia, learning disabilities, dysarthria, and loss of voice. The early warning signs of speech and language disorders in children include slow development, speech problems, learning disabilities, and behavioral problems; the brochure emphasizes the importance of early identification. The brochure concludes with information about the role of the speech language pathologist, treatment options, where to get additional information about speech and language problems, and the important role of the school. The brochure is illustrated with simple cartoon drawings of families and children.

•

What You Should Know About a Healthy Weight for Your Child Source: South Deerfield, MA: Channing L. Bete Co., Inc. 1999. 15 p. Contact: Available from Channing L. Bete, Co., Inc. 200 State Road, South Deerfield, MA 01373-0200. (800) 628-7733. Fax (800) 499-6464. PRICE: $1.05 each; plus shipping and handling; quantity discounts available. Order number 39891A-11-97.

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Summary: This illustrated booklet discusses healthy body weight for children. A child who has the right amount of body fat is considered to be at a healthy weight. Being overweight is a health risk. Children who are overweight may have high blood pressure, high cholesterol, and problems with blood sugar. In addition, a child who is overweight may be treated unkindly, feel isolated, and develop low self-esteem. A health care provider can check a child's weight, consider risk factors, and recommend changes for the whole family. Parents need to team up with their child to build healthy eating habits, increase activity, and boost the child's self-esteem. The Food Guide Pyramid can be used to help ensure proper nutrition. Although changing family eating habits may take time, parents can serve healthy meals and snacks. A healthy weight also depends on exercise, so all family members should fit exercise into their daily routine and plan special times to exercise. In addition, working with the child's caregivers, health care provider, and a nutritionist or registered dietitian can help ensure healthy eating habits. •

Is My Weight Healthy? Source: ETR Associates. 8 pages. Title No. R338. 1999. (Reviewed 2002). Contact: 4 Carbonero Way, Scotts Valley, CA 95066-4200. (831)438-4080. www.etr.org. Summary: This pamphlet makes the case that most people, no matter what their body size or shape is, feel pressure about weight. Being unhappy with one's weight can lead to anxiety, depression, and low self-esteem. It reviews methods for assessing weight based on height, weight tables, body mass index (BMI), and waist-to-hip ratio. A chart is provided for determining one's BMI. It gives tips for healthy eating and advocates taking steps to improve or maintain one's health, regardless of one's weight. A sidebar discusses the need for physical activity. A self- assessment quiz helps one gauge personal readiness to make lifestyle changes to improve health. Healthfinder™

Healthfinder™ is sponsored by the U.S. Department of Health and Human Services and offers links to hundreds of other sites that contain healthcare information. This Web site is located at http://www.healthfinder.gov. Again, keyword searches can be used to find guidelines. The following was recently found in this database: •

The Story on Self-Esteem Summary: Explains what self-esteem is, why self-esteem is important and what to do if you have low self-esteem and don't feel very good about yourself. Source: Nemours Foundation http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=5847 The NIH Search Utility

The NIH search utility allows you to search for documents on over 100 selected Web sites that comprise the NIH-WEB-SPACE. Each of these servers is “crawled” and indexed on an ongoing basis. Your search will produce a list of various documents, all of which will relate in some way to low self-esteem. The drawbacks of this approach are that the information is not organized by theme and that the references are often a mix of information for professionals and patients. Nevertheless, a large number of the listed Web sites provide useful background information. We can only recommend this route, therefore, for relatively

Patient Resources

41

rare or specific disorders, or when using highly targeted searches. To use the NIH search utility, visit the following Web page: http://search.nih.gov/index.html. Additional Web Sources A number of Web sites are available to the public that often link to government sites. These can also point you in the direction of essential information. The following is a representative sample: •

AOL: http://search.aol.com/cat.adp?id=168&layer=&from=subcats

•

Family Village: http://www.familyvillage.wisc.edu/specific.htm

•

Google: http://directory.google.com/Top/Health/Conditions_and_Diseases/

•

Med Help International: http://www.medhelp.org/HealthTopics/A.html

•

Open Directory Project: http://dmoz.org/Health/Conditions_and_Diseases/

•

Yahoo.com: http://dir.yahoo.com/Health/Diseases_and_Conditions/

•

WebMDHealth: http://my.webmd.com/health_topics

Finding Associations There are several Internet directories that provide lists of medical associations with information on or resources relating to low self-esteem. By consulting all of associations listed in this chapter, you will have nearly exhausted all sources for patient associations concerned with low self-esteem. The National Health Information Center (NHIC) The National Health Information Center (NHIC) offers a free referral service to help people find organizations that provide information about low self-esteem. For more information, see the NHIC’s Web site at http://www.health.gov/NHIC/ or contact an information specialist by calling 1-800-336-4797. Directory of Health Organizations The Directory of Health Organizations, provided by the National Library of Medicine Specialized Information Services, is a comprehensive source of information on associations. The Directory of Health Organizations database can be accessed via the Internet at http://www.sis.nlm.nih.gov/Dir/DirMain.html. It is composed of two parts: DIRLINE and Health Hotlines. The DIRLINE database comprises some 10,000 records of organizations, research centers, and government institutes and associations that primarily focus on health and biomedicine. To access DIRLINE directly, go to the following Web site: http://dirline.nlm.nih.gov/. Simply type in “low self-esteem” (or a synonym), and you will receive information on all relevant organizations listed in the database.

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Health Hotlines directs you to toll-free numbers to over 300 organizations. You can access this database directly at http://www.sis.nlm.nih.gov/hotlines/. On this page, you are given the option to search by keyword or by browsing the subject list. When you have received your search results, click on the name of the organization for its description and contact information. The Combined Health Information Database Another comprehensive source of information on healthcare associations is the Combined Health Information Database. Using the “Detailed Search” option, you will need to limit your search to “Organizations” and “low self-esteem”. Type the following hyperlink into your Web browser: http://chid.nih.gov/detail/detail.html. To find associations, use the drop boxes at the bottom of the search page where “You may refine your search by.” For publication date, select “All Years.” Then, select your preferred language and the format option “Organization Resource Sheet.” Type “low self-esteem” (or synonyms) into the “For these words:” box. You should check back periodically with this database since it is updated every three months. The National Organization for Rare Disorders, Inc. The National Organization for Rare Disorders, Inc. has prepared a Web site that provides, at no charge, lists of associations organized by health topic. You can access this database at the following Web site: http://www.rarediseases.org/search/orgsearch.html. Type “low selfesteem” (or a synonym) into the search box, and click “Submit Query.”

43

APPENDIX C. FINDING MEDICAL LIBRARIES Overview In this Appendix, we show you how to quickly find a medical library in your area.

Preparation Your local public library and medical libraries have interlibrary loan programs with the National Library of Medicine (NLM), one of the largest medical collections in the world. According to the NLM, most of the literature in the general and historical collections of the National Library of Medicine is available on interlibrary loan to any library. If you would like to access NLM medical literature, then visit a library in your area that can request the publications for you.18

Finding a Local Medical Library The quickest method to locate medical libraries is to use the Internet-based directory published by the National Network of Libraries of Medicine (NN/LM). This network includes 4626 members and affiliates that provide many services to librarians, health professionals, and the public. To find a library in your area, simply visit http://nnlm.gov/members/adv.html or call 1-800-338-7657.

Medical Libraries in the U.S. and Canada In addition to the NN/LM, the National Library of Medicine (NLM) lists a number of libraries with reference facilities that are open to the public. The following is the NLM’s list and includes hyperlinks to each library’s Web site. These Web pages can provide information on hours of operation and other restrictions. The list below is a small sample of

18

Adapted from the NLM: http://www.nlm.nih.gov/psd/cas/interlibrary.html.

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libraries recommended by the National Library of Medicine (sorted alphabetically by name of the U.S. state or Canadian province where the library is located)19: •

Alabama: Health InfoNet of Jefferson County (Jefferson County Library Cooperative, Lister Hill Library of the Health Sciences), http://www.uab.edu/infonet/

•

Alabama: Richard M. Scrushy Library (American Sports Medicine Institute)

•

Arizona: Samaritan Regional Medical Center: The Learning Center (Samaritan Health System, Phoenix, Arizona), http://www.samaritan.edu/library/bannerlibs.htm

•

California: Kris Kelly Health Information Center (St. Joseph Health System, Humboldt), http://www.humboldt1.com/~kkhic/index.html

•

California: Community Health Library of Los Gatos, http://www.healthlib.org/orgresources.html

•

California: Consumer Health Program and Services (CHIPS) (County of Los Angeles Public Library, Los Angeles County Harbor-UCLA Medical Center Library) - Carson, CA, http://www.colapublib.org/services/chips.html

•

California: Gateway Health Library (Sutter Gould Medical Foundation)

•

California: Health Library (Stanford University Medical Center), http://wwwmed.stanford.edu/healthlibrary/

•

California: Patient Education Resource Center - Health Information and Resources (University of California, San Francisco), http://sfghdean.ucsf.edu/barnett/PERC/default.asp

•

California: Redwood Health Library (Petaluma Health Care District), http://www.phcd.org/rdwdlib.html

•

California: Los Gatos PlaneTree Health Library, http://planetreesanjose.org/

•

California: Sutter Resource Library (Sutter Hospitals Foundation, Sacramento), http://suttermedicalcenter.org/library/

•

California: Health Sciences Libraries (University of California, Davis), http://www.lib.ucdavis.edu/healthsci/

•

California: ValleyCare Health Library & Ryan Comer Cancer Resource Center (ValleyCare Health System, Pleasanton), http://gaelnet.stmarysca.edu/other.libs/gbal/east/vchl.html

•

California: Washington Community Health Resource Library (Fremont), http://www.healthlibrary.org/

•

Colorado: William V. Gervasini Memorial Library (Exempla Healthcare), http://www.saintjosephdenver.org/yourhealth/libraries/

•

Connecticut: Hartford Hospital Health Science Libraries (Hartford Hospital), http://www.harthosp.org/library/

•

Connecticut: Healthnet: Connecticut Consumer Health Information Center (University of Connecticut Health Center, Lyman Maynard Stowe Library), http://library.uchc.edu/departm/hnet/

19

Abstracted from http://www.nlm.nih.gov/medlineplus/libraries.html.

Finding Medical Libraries

45

•

Connecticut: Waterbury Hospital Health Center Library (Waterbury Hospital, Waterbury), http://www.waterburyhospital.com/library/consumer.shtml

•

Delaware: Consumer Health Library (Christiana Care Health System, Eugene du Pont Preventive Medicine & Rehabilitation Institute, Wilmington), http://www.christianacare.org/health_guide/health_guide_pmri_health_info.cfm

•

Delaware: Lewis B. Flinn Library (Delaware Academy of Medicine, Wilmington), http://www.delamed.org/chls.html

•

Georgia: Family Resource Library (Medical College of Georgia, Augusta), http://cmc.mcg.edu/kids_families/fam_resources/fam_res_lib/frl.htm

•

Georgia: Health Resource Center (Medical Center of Central Georgia, Macon), http://www.mccg.org/hrc/hrchome.asp

•

Hawaii: Hawaii Medical Library: Consumer Health Information Service (Hawaii Medical Library, Honolulu), http://hml.org/CHIS/

•

Idaho: DeArmond Consumer Health Library (Kootenai Medical Center, Coeur d’Alene), http://www.nicon.org/DeArmond/index.htm

•

Illinois: Health Learning Center of Northwestern Memorial Hospital (Chicago), http://www.nmh.org/health_info/hlc.html

•

Illinois: Medical Library (OSF Saint Francis Medical Center, Peoria), http://www.osfsaintfrancis.org/general/library/

•

Kentucky: Medical Library - Services for Patients, Families, Students & the Public (Central Baptist Hospital, Lexington), http://www.centralbap.com/education/community/library.cfm

•

Kentucky: University of Kentucky - Health Information Library (Chandler Medical Center, Lexington), http://www.mc.uky.edu/PatientEd/

•

Louisiana: Alton Ochsner Medical Foundation Library (Alton Ochsner Medical Foundation, New Orleans), http://www.ochsner.org/library/

•

Louisiana: Louisiana State University Health Sciences Center Medical LibraryShreveport, http://lib-sh.lsuhsc.edu/

•

Maine: Franklin Memorial Hospital Medical Library (Franklin Memorial Hospital, Farmington), http://www.fchn.org/fmh/lib.htm

•

Maine: Gerrish-True Health Sciences Library (Central Maine Medical Center, Lewiston), http://www.cmmc.org/library/library.html

•

Maine: Hadley Parrot Health Science Library (Eastern Maine Healthcare, Bangor), http://www.emh.org/hll/hpl/guide.htm

•

Maine: Maine Medical Center Library (Maine Medical Center, Portland), http://www.mmc.org/library/

•

Maine: Parkview Hospital (Brunswick), http://www.parkviewhospital.org/

•

Maine: Southern Maine Medical Center Health Sciences Library (Southern Maine Medical Center, Biddeford), http://www.smmc.org/services/service.php3?choice=10

•

Maine: Stephens Memorial Hospital’s Health Information Library (Western Maine Health, Norway), http://www.wmhcc.org/Library/

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•

Manitoba, Canada: Consumer & Patient Health Information Service (University of Manitoba Libraries), http://www.umanitoba.ca/libraries/units/health/reference/chis.html

•

Manitoba, Canada: J.W. Crane Memorial Library (Deer Lodge Centre, Winnipeg), http://www.deerlodge.mb.ca/crane_library/about.asp

•

Maryland: Health Information Center at the Wheaton Regional Library (Montgomery County, Dept. of Public Libraries, Wheaton Regional Library), http://www.mont.lib.md.us/healthinfo/hic.asp

•

Massachusetts: Baystate Medical Center Library (Baystate Health System), http://www.baystatehealth.com/1024/

•

Massachusetts: Boston University Medical Center Alumni Medical Library (Boston University Medical Center), http://med-libwww.bu.edu/library/lib.html

•

Massachusetts: Lowell General Hospital Health Sciences Library (Lowell General Hospital, Lowell), http://www.lowellgeneral.org/library/HomePageLinks/WWW.htm

•

Massachusetts: Paul E. Woodard Health Sciences Library (New England Baptist Hospital, Boston), http://www.nebh.org/health_lib.asp

•

Massachusetts: St. Luke’s Hospital Health Sciences Library (St. Luke’s Hospital, Southcoast Health System, New Bedford), http://www.southcoast.org/library/

•

Massachusetts: Treadwell Library Consumer Health Reference Center (Massachusetts General Hospital), http://www.mgh.harvard.edu/library/chrcindex.html

•

Massachusetts: UMass HealthNet (University of Massachusetts Medical School, Worchester), http://healthnet.umassmed.edu/

•

Michigan: Botsford General Hospital Library - Consumer Health (Botsford General Hospital, Library & Internet Services), http://www.botsfordlibrary.org/consumer.htm

•

Michigan: Helen DeRoy Medical Library (Providence Hospital and Medical Centers), http://www.providence-hospital.org/library/

•

Michigan: Marquette General Hospital - Consumer Health Library (Marquette General Hospital, Health Information Center), http://www.mgh.org/center.html

•

Michigan: Patient Education Resouce Center - University of Michigan Cancer Center (University of Michigan Comprehensive Cancer Center, Ann Arbor), http://www.cancer.med.umich.edu/learn/leares.htm

•

Michigan: Sladen Library & Center for Health Information Resources - Consumer Health Information (Detroit), http://www.henryford.com/body.cfm?id=39330

•

Montana: Center for Health Information (St. Patrick Hospital and Health Sciences Center, Missoula)

•

National: Consumer Health Library Directory (Medical Library Association, Consumer and Patient Health Information Section), http://caphis.mlanet.org/directory/index.html

•

National: National Network of Libraries of Medicine (National Library of Medicine) provides library services for health professionals in the United States who do not have access to a medical library, http://nnlm.gov/

•

National: NN/LM List of Libraries Serving the Public (National Network of Libraries of Medicine), http://nnlm.gov/members/

Finding Medical Libraries

47

•

Nevada: Health Science Library, West Charleston Library (Las Vegas-Clark County Library District, Las Vegas), http://www.lvccld.org/special_collections/medical/index.htm

•

New Hampshire: Dartmouth Biomedical Libraries (Dartmouth College Library, Hanover), http://www.dartmouth.edu/~biomed/resources.htmld/conshealth.htmld/

•

New Jersey: Consumer Health Library (Rahway Hospital, Rahway), http://www.rahwayhospital.com/library.htm

•

New Jersey: Dr. Walter Phillips Health Sciences Library (Englewood Hospital and Medical Center, Englewood), http://www.englewoodhospital.com/links/index.htm

•

New Jersey: Meland Foundation (Englewood Hospital and Medical Center, Englewood), http://www.geocities.com/ResearchTriangle/9360/

•

New York: Choices in Health Information (New York Public Library) - NLM Consumer Pilot Project participant, http://www.nypl.org/branch/health/links.html

•

New York: Health Information Center (Upstate Medical University, State University of New York, Syracuse), http://www.upstate.edu/library/hic/

•

New York: Health Sciences Library (Long Island Jewish Medical Center, New Hyde Park), http://www.lij.edu/library/library.html

•

New York: ViaHealth Medical Library (Rochester General Hospital), http://www.nyam.org/library/

•

Ohio: Consumer Health Library (Akron General Medical Center, Medical & Consumer Health Library), http://www.akrongeneral.org/hwlibrary.htm

•

Oklahoma: The Health Information Center at Saint Francis Hospital (Saint Francis Health System, Tulsa), http://www.sfh-tulsa.com/services/healthinfo.asp

•

Oregon: Planetree Health Resource Center (Mid-Columbia Medical Center, The Dalles), http://www.mcmc.net/phrc/

•

Pennsylvania: Community Health Information Library (Milton S. Hershey Medical Center, Hershey), http://www.hmc.psu.edu/commhealth/

•

Pennsylvania: Community Health Resource Library (Geisinger Medical Center, Danville), http://www.geisinger.edu/education/commlib.shtml

•

Pennsylvania: HealthInfo Library (Moses Taylor Hospital, Scranton), http://www.mth.org/healthwellness.html

•

Pennsylvania: Hopwood Library (University of Pittsburgh, Health Sciences Library System, Pittsburgh), http://www.hsls.pitt.edu/guides/chi/hopwood/index_html

•

Pennsylvania: Koop Community Health Information Center (College of Physicians of Philadelphia), http://www.collphyphil.org/kooppg1.shtml

•

Pennsylvania: Learning Resources Center - Medical Library (Susquehanna Health System, Williamsport), http://www.shscares.org/services/lrc/index.asp

•

Pennsylvania: Medical Library (UPMC Health System, Pittsburgh), http://www.upmc.edu/passavant/library.htm

•

Quebec, Canada: Medical Library (Montreal General Hospital), http://www.mghlib.mcgill.ca/

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•

South Dakota: Rapid City Regional Hospital Medical Library (Rapid City Regional Hospital), http://www.rcrh.org/Services/Library/Default.asp

•

Texas: Houston HealthWays (Houston Academy of Medicine-Texas Medical Center Library), http://hhw.library.tmc.edu/

•

Washington: Community Health Library (Kittitas Valley Community Hospital), http://www.kvch.com/

•

Washington: Southwest Washington Medical Center Library (Southwest Washington Medical Center, Vancouver), http://www.swmedicalcenter.com/body.cfm?id=72

49

ONLINE GLOSSARIES The Internet provides access to a number of free-to-use medical dictionaries. The National Library of Medicine has compiled the following list of online dictionaries: •

ADAM Medical Encyclopedia (A.D.A.M., Inc.), comprehensive medical reference: http://www.nlm.nih.gov/medlineplus/encyclopedia.html

•

MedicineNet.com Medical Dictionary (MedicineNet, Inc.): http://www.medterms.com/Script/Main/hp.asp

•

Merriam-Webster Medical Dictionary (Inteli-Health, Inc.): http://www.intelihealth.com/IH/

•

Multilingual Glossary of Technical and Popular Medical Terms in Eight European Languages (European Commission) - Danish, Dutch, English, French, German, Italian, Portuguese, and Spanish: http://allserv.rug.ac.be/~rvdstich/eugloss/welcome.html

•

On-line Medical Dictionary (CancerWEB): http://cancerweb.ncl.ac.uk/omd/

•

Rare Diseases Terms (Office of Rare Diseases): http://ord.aspensys.com/asp/diseases/diseases.asp

•

Technology Glossary (National Library of Medicine) - Health Care Technology: http://www.nlm.nih.gov/nichsr/ta101/ta10108.htm

Beyond these, MEDLINEplus contains a very patient-friendly encyclopedia covering every aspect of medicine (licensed from A.D.A.M., Inc.). The ADAM Medical Encyclopedia can be accessed at http://www.nlm.nih.gov/medlineplus/encyclopedia.html. ADAM is also available on commercial Web sites such as drkoop.com (http://www.drkoop.com/) and Web MD (http://my.webmd.com/adam/asset/adam_disease_articles/a_to_z/a).

Online Dictionary Directories The following are additional online directories compiled by the National Library of Medicine, including a number of specialized medical dictionaries: •

Medical Dictionaries: Medical & Biological (World Health Organization): http://www.who.int/hlt/virtuallibrary/English/diction.htm#Medical

•

MEL-Michigan Electronic Library List of Online Health and Medical Dictionaries (Michigan Electronic Library): http://mel.lib.mi.us/health/health-dictionaries.html

•

Patient Education: Glossaries (DMOZ Open Directory Project): http://dmoz.org/Health/Education/Patient_Education/Glossaries/

•

Web of Online Dictionaries (Bucknell University): http://www.yourdictionary.com/diction5.html#medicine

51

LOW SELF-ESTEEM DICTIONARY The definitions below are derived from official public sources, including the National Institutes of Health [NIH] and the European Union [EU]. Acne: A disorder of the skin marked by inflammation of oil glands and hair glands. [NIH] Acquired Immunodeficiency Syndrome: An acquired defect of cellular immunity associated with infection by the human immunodeficiency virus (HIV), a CD4-positive Tlymphocyte count under 200 cells/microliter or less than 14% of total lymphocytes, and increased susceptibility to opportunistic infections and malignant neoplasms. Clinical manifestations also include emaciation (wasting) and dementia. These elements reflect criteria for AIDS as defined by the CDC in 1993. [NIH] Adjunctive Therapy: Another treatment used together with the primary treatment. Its purpose is to assist the primary treatment. [NIH] Adolescence: The period of life beginning with the appearance of secondary sex characteristics and terminating with the cessation of somatic growth. The years usually referred to as adolescence lie between 13 and 18 years of age. [NIH] Aerobic: In biochemistry, reactions that need oxygen to happen or happen when oxygen is present. [NIH] Agar: A complex sulfated polymer of galactose units, extracted from Gelidium cartilagineum, Gracilaria confervoides, and related red algae. It is used as a gel in the preparation of solid culture media for microorganisms, as a bulk laxative, in making emulsions, and as a supporting medium for immunodiffusion and immunoelectrophoresis. [NIH]

Age of Onset: The age or period of life at which a disease or the initial symptoms or manifestations of a disease appear in an individual. [NIH] Airway: A device for securing unobstructed passage of air into and out of the lungs during general anesthesia. [NIH] Algorithms: A procedure consisting of a sequence of algebraic formulas and/or logical steps to calculate or determine a given task. [NIH] Alternative medicine: Practices not generally recognized by the medical community as standard or conventional medical approaches and used instead of standard treatments. Alternative medicine includes the taking of dietary supplements, megadose vitamins, and herbal preparations; the drinking of special teas; and practices such as massage therapy, magnet therapy, spiritual healing, and meditation. [NIH] Ambulatory Care: Health care services provided to patients on an ambulatory basis, rather than by admission to a hospital or other health care facility. The services may be a part of a hospital, augmenting its inpatient services, or may be provided at a free-standing facility. [NIH]

Anal: Having to do with the anus, which is the posterior opening of the large bowel. [NIH] Anatomical: Pertaining to anatomy, or to the structure of the organism. [EU] Antibody: A type of protein made by certain white blood cells in response to a foreign substance (antigen). Each antibody can bind to only a specific antigen. The purpose of this binding is to help destroy the antigen. Antibodies can work in several ways, depending on the nature of the antigen. Some antibodies destroy antigens directly. Others make it easier for white blood cells to destroy the antigen. [NIH]

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Antigen: Any substance which is capable, under appropriate conditions, of inducing a specific immune response and of reacting with the products of that response, that is, with specific antibody or specifically sensitized T-lymphocytes, or both. Antigens may be soluble substances, such as toxins and foreign proteins, or particulate, such as bacteria and tissue cells; however, only the portion of the protein or polysaccharide molecule known as the antigenic determinant (q.v.) combines with antibody or a specific receptor on a lymphocyte. Abbreviated Ag. [EU] Anxiety: Persistent feeling of dread, apprehension, and impending disaster. [NIH] Aphasia: A cognitive disorder marked by an impaired ability to comprehend or express language in its written or spoken form. This condition is caused by diseases which affect the language areas of the dominant hemisphere. Clinical features are used to classify the various subtypes of this condition. General categories include receptive, expressive, and mixed forms of aphasia. [NIH] Apnea: A transient absence of spontaneous respiration. [NIH] Applicability: A list of the commodities to which the candidate method can be applied as presented or with minor modifications. [NIH] Arrhythmia: Any variation from the normal rhythm or rate of the heart beat. [NIH] Art Therapy: The use of art as an adjunctive therapy in the treatment of neurological, mental, or behavioral disorders. [NIH] Arteries: The vessels carrying blood away from the heart. [NIH] Articular: Of or pertaining to a joint. [EU] Articulation: The relationship of two bodies by means of a moveable joint. [NIH] Articulation Disorders: Disorders of the quality of speech characterized by the substitution, omission, distortion, and addition of phonemes. [NIH] Atrium: A chamber; used in anatomical nomenclature to designate a chamber affording entrance to another structure or organ. Usually used alone to designate an atrium of the heart. [EU] Bacteria: Unicellular prokaryotic microorganisms which generally possess rigid cell walls, multiply by cell division, and exhibit three principal forms: round or coccal, rodlike or bacillary, and spiral or spirochetal. [NIH] Bacteriophage: A virus whose host is a bacterial cell; A virus that exclusively infects bacteria. It generally has a protein coat surrounding the genome (DNA or RNA). One of the coliphages most extensively studied is the lambda phage, which is also one of the most important. [NIH] Bereavement: Refers to the whole process of grieving and mourning and is associated with a deep sense of loss and sadness. [NIH] Biochemical: Relating to biochemistry; characterized by, produced by, or involving chemical reactions in living organisms. [EU] Biotechnology: Body of knowledge related to the use of organisms, cells or cell-derived constituents for the purpose of developing products which are technically, scientifically and clinically useful. Alteration of biologic function at the molecular level (i.e., genetic engineering) is a central focus; laboratory methods used include transfection and cloning technologies, sequence and structure analysis algorithms, computer databases, and gene and protein structure function analysis and prediction. [NIH] Blood Glucose: Glucose in blood. [NIH] Blood pressure: The pressure of blood against the walls of a blood vessel or heart chamber.

Dictionary 53

Unless there is reference to another location, such as the pulmonary artery or one of the heart chambers, it refers to the pressure in the systemic arteries, as measured, for example, in the forearm. [NIH] Blood vessel: A tube in the body through which blood circulates. Blood vessels include a network of arteries, arterioles, capillaries, venules, and veins. [NIH] Body Image: Individuals' personal concept of their bodies as objects in and bound by space, independently and apart from all other objects. [NIH] Body Mass Index: One of the anthropometric measures of body mass; it has the highest correlation with skinfold thickness or body density. [NIH] Cardiac: Having to do with the heart. [NIH] Caudal: Denoting a position more toward the cauda, or tail, than some specified point of reference; same as inferior, in human anatomy. [EU] Causal: Pertaining to a cause; directed against a cause. [EU] Cell: The individual unit that makes up all of the tissues of the body. All living things are made up of one or more cells. [NIH] Chin: The anatomical frontal portion of the mandible, also known as the mentum, that contains the line of fusion of the two separate halves of the mandible (symphysis menti). This line of fusion divides inferiorly to enclose a triangular area called the mental protuberance. On each side, inferior to the second premolar tooth, is the mental foramen for the passage of blood vessels and a nerve. [NIH] Cholesterol: The principal sterol of all higher animals, distributed in body tissues, especially the brain and spinal cord, and in animal fats and oils. [NIH] Chronic: A disease or condition that persists or progresses over a long period of time. [NIH] Chronic Disease: Disease or ailment of long duration. [NIH] Cleft Palate: Congenital fissure of the soft and/or hard palate, due to faulty fusion. [NIH] Clinical trial: A research study that tests how well new medical treatments or other interventions work in people. Each study is designed to test new methods of screening, prevention, diagnosis, or treatment of a disease. [NIH] Cloning: The production of a number of genetically identical individuals; in genetic engineering, a process for the efficient replication of a great number of identical DNA molecules. [NIH] Collapse: 1. A state of extreme prostration and depression, with failure of circulation. 2. Abnormal falling in of the walls of any part of organ. [EU] Computational Biology: A field of biology concerned with the development of techniques for the collection and manipulation of biological data, and the use of such data to make biological discoveries or predictions. This field encompasses all computational methods and theories applicable to molecular biology and areas of computer-based techniques for solving biological problems including manipulation of models and datasets. [NIH] Conception: The onset of pregnancy, marked by implantation of the blastocyst; the formation of a viable zygote. [EU] Concomitant: Accompanying; accessory; joined with another. [EU] Condoms: A sheath that is worn over the penis during sexual behavior in order to prevent pregnancy or spread of sexually transmitted disease. [NIH] Consultation: A deliberation between two or more physicians concerning the diagnosis and the proper method of treatment in a case. [NIH]

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Contraindications: Any factor or sign that it is unwise to pursue a certain kind of action or treatment, e. g. giving a general anesthetic to a person with pneumonia. [NIH] Control group: In a clinical trial, the group that does not receive the new treatment being studied. This group is compared to the group that receives the new treatment, to see if the new treatment works. [NIH] Coronary: Encircling in the manner of a crown; a term applied to vessels; nerves, ligaments, etc. The term usually denotes the arteries that supply the heart muscle and, by extension, a pathologic involvement of them. [EU] Coronary Thrombosis: Presence of a thrombus in a coronary artery, often causing a myocardial infarction. [NIH] Degenerative: Undergoing degeneration : tending to degenerate; having the character of or involving degeneration; causing or tending to cause degeneration. [EU] Delusions: A false belief regarding the self or persons or objects outside the self that persists despite the facts, and is not considered tenable by one's associates. [NIH] Dementia: An acquired organic mental disorder with loss of intellectual abilities of sufficient severity to interfere with social or occupational functioning. The dysfunction is multifaceted and involves memory, behavior, personality, judgment, attention, spatial relations, language, abstract thought, and other executive functions. The intellectual decline is usually progressive, and initially spares the level of consciousness. [NIH] Density: The logarithm to the base 10 of the opacity of an exposed and processed film. [NIH] Dental Caries: Localized destruction of the tooth surface initiated by decalcification of the enamel followed by enzymatic lysis of organic structures and leading to cavity formation. If left unchecked, the cavity may penetrate the enamel and dentin and reach the pulp. The three most prominent theories used to explain the etiology of the disase are that acids produced by bacteria lead to decalcification; that micro-organisms destroy the enamel protein; or that keratolytic micro-organisms produce chelates that lead to decalcification. [NIH]

Dental Hygienists: Persons trained in an accredited school or dental college and licensed by the state in which they reside to provide dental prophylaxis under the direction of a licensed dentist. [NIH] Depressive Disorder: An affective disorder manifested by either a dysphoric mood or loss of interest or pleasure in usual activities. The mood disturbance is prominent and relatively persistent. [NIH] Dexterity: Ability to move the hands easily and skillfully. [NIH] Diagnostic procedure: A method used to identify a disease. [NIH] Dietitian: An expert in nutrition who helps people plan what and how much food to eat. [NIH]

Direct: 1. Straight; in a straight line. 2. Performed immediately and without the intervention of subsidiary means. [EU] Discrimination: The act of qualitative and/or quantitative differentiation between two or more stimuli. [NIH] Distal: Remote; farther from any point of reference; opposed to proximal. In dentistry, used to designate a position on the dental arch farther from the median line of the jaw. [EU] Dorsal: 1. Pertaining to the back or to any dorsum. 2. Denoting a position more toward the back surface than some other object of reference; same as posterior in human anatomy; superior in the anatomy of quadrupeds. [EU]

Dictionary 55

Dysarthria: Imperfect articulation of speech due to disturbances of muscular control which result from damage to the central or peripheral nervous system. [EU] Dysphoric: A feeling of unpleasantness and discomfort. [NIH] Eating Disorders: A group of disorders characterized by physiological and psychological disturbances in appetite or food intake. [NIH] Edema: Excessive amount of watery fluid accumulated in the intercellular spaces, most commonly present in subcutaneous tissue. [NIH] Efficacy: The extent to which a specific intervention, procedure, regimen, or service produces a beneficial result under ideal conditions. Ideally, the determination of efficacy is based on the results of a randomized control trial. [NIH] Emaciation: Clinical manifestation of excessive leanness usually caused by disease or a lack of nutrition. [NIH] Enamel: A very hard whitish substance which covers the dentine of the anatomical crown of a tooth. [NIH] Environmental Health: The science of controlling or modifying those conditions, influences, or forces surrounding man which relate to promoting, establishing, and maintaining health. [NIH]

Enzymatic: Phase where enzyme cuts the precursor protein. [NIH] Epidemic: Occurring suddenly in numbers clearly in excess of normal expectancy; said especially of infectious diseases but applied also to any disease, injury, or other healthrelated event occurring in such outbreaks. [EU] Erection: The condition of being made rigid and elevated; as erectile tissue when filled with blood. [EU] Excimer laser: An ultraviolet laser used in refractive surgery to remove corneal tissue. [NIH] Exogenous: Developed or originating outside the organism, as exogenous disease. [EU] Family Planning: Programs or services designed to assist the family in controlling reproduction by either improving or diminishing fertility. [NIH] Family Relations: Behavioral, psychological, and social relations among various members of the nuclear family and the extended family. [NIH] Fat: Total lipids including phospholipids. [NIH] Fathers: Male parents, human or animal. [NIH] Fetus: The developing offspring from 7 to 8 weeks after conception until birth. [NIH] Fissure: Any cleft or groove, normal or otherwise; especially a deep fold in the cerebral cortex which involves the entire thickness of the brain wall. [EU] Forearm: The part between the elbow and the wrist. [NIH] Gene: The functional and physical unit of heredity passed from parent to offspring. Genes are pieces of DNA, and most genes contain the information for making a specific protein. [NIH]

Gingivitis: Inflammation of the gingivae. Gingivitis associated with bony changes is referred to as periodontitis. Called also oulitis and ulitis. [EU] Governing Board: The group in which legal authority is vested for the control of healthrelated institutions and organizations. [NIH] Handicap: A handicap occurs as a result of disability, but disability does not always constitute a handicap. A handicap may be said to exist when a disability causes a substantial and continuing reduction in a person's capacity to function socially and vocationally. [NIH]

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Health Behavior: Behaviors expressed by individuals to protect, maintain or promote their health status. For example, proper diet, and appropriate exercise are activities perceived to influence health status. Life style is closely associated with health behavior and factors influencing life style are socioeconomic, educational, and cultural. [NIH] Health Education: Education that increases the awareness and favorably influences the attitudes and knowledge relating to the improvement of health on a personal or community basis. [NIH] Health Status: The level of health of the individual, group, or population as subjectively assessed by the individual or by more objective measures. [NIH] Hemorrhage: Bleeding or escape of blood from a vessel. [NIH] Hypoplasia: Incomplete development or underdevelopment of an organ or tissue. [EU] Immune response: The activity of the immune system against foreign substances (antigens). [NIH]

Immunodeficiency: The decreased ability of the body to fight infection and disease. [NIH] Impairment: In the context of health experience, an impairment is any loss or abnormality of psychological, physiological, or anatomical structure or function. [NIH] Impotent: Unable to have an erection adequate for sexual intercourse. [NIH] Infarction: A pathological process consisting of a sudden insufficient blood supply to an area, which results in necrosis of that area. It is usually caused by a thrombus, an embolus, or a vascular torsion. [NIH] Infection: 1. Invasion and multiplication of microorganisms in body tissues, which may be clinically unapparent or result in local cellular injury due to competitive metabolism, toxins, intracellular replication, or antigen-antibody response. The infection may remain localized, subclinical, and temporary if the body's defensive mechanisms are effective. A local infection may persist and spread by extension to become an acute, subacute, or chronic clinical infection or disease state. A local infection may also become systemic when the microorganisms gain access to the lymphatic or vascular system. 2. An infectious disease. [EU]

Inflammation: A pathological process characterized by injury or destruction of tissues caused by a variety of cytologic and chemical reactions. It is usually manifested by typical signs of pain, heat, redness, swelling, and loss of function. [NIH] Inpatients: Persons admitted to health facilities which provide board and room, for the purpose of observation, care, diagnosis or treatment. [NIH] Insulin: A protein hormone secreted by beta cells of the pancreas. Insulin plays a major role in the regulation of glucose metabolism, generally promoting the cellular utilization of glucose. It is also an important regulator of protein and lipid metabolism. Insulin is used as a drug to control insulin-dependent diabetes mellitus. [NIH] Intermittent: Occurring at separated intervals; having periods of cessation of activity. [EU] Interpersonal Relations: The reciprocal interaction of two or more persons. [NIH] Intoxication: Poisoning, the state of being poisoned. [EU] Intracellular: Inside a cell. [NIH] Kb: A measure of the length of DNA fragments, 1 Kb = 1000 base pairs. The largest DNA fragments are up to 50 kilobases long. [NIH] Keratolytic: An agent that promotes keratolysis. [EU] Language Disorders: Conditions characterized by deficiencies of comprehension or expression of written and spoken forms of language. These include acquired and

Dictionary 57

developmental disorders. [NIH] Licensed practical nurse: One skilled in the care of the sick, but who has not graduated from a regular nursing school or passed an examination to qualify as a graduate nurse. [NIH] Localized: Cancer which has not metastasized yet. [NIH] Loneliness: The state of feeling sad or dejected as a result of lack of companionship or being separated from others. [NIH] Long-Term Care: Care over an extended period, usually for a chronic condition or disability, requiring periodic, intermittent, or continuous care. [NIH] Lubricants: Oily or slippery substances. [NIH] Lymphatic: The tissues and organs, including the bone marrow, spleen, thymus, and lymph nodes, that produce and store cells that fight infection and disease. [NIH] Lymphocyte: A white blood cell. Lymphocytes have a number of roles in the immune system, including the production of antibodies and other substances that fight infection and diseases. [NIH] Lymphocyte Count: A count of the number of lymphocytes in the blood. [NIH] Malignant: Cancerous; a growth with a tendency to invade and destroy nearby tissue and spread to other parts of the body. [NIH] Malnutrition: A condition caused by not eating enough food or not eating a balanced diet. [NIH]

Mammary: Pertaining to the mamma, or breast. [EU] Manic: Affected with mania. [EU] Meatus: A canal running from the internal auditory foramen through the petrous portion of the temporal bone. It gives passage to the facial and auditory nerves together with the auditory branch of the basilar artery and the internal auditory veins. [NIH] MEDLINE: An online database of MEDLARS, the computerized bibliographic Medical Literature Analysis and Retrieval System of the National Library of Medicine. [NIH] Membrane: A very thin layer of tissue that covers a surface. [NIH] Mental: Pertaining to the mind; psychic. 2. (L. mentum chin) pertaining to the chin. [EU] Mental Disorders: Psychiatric illness or diseases manifested by breakdowns in the adaptational process expressed primarily as abnormalities of thought, feeling, and behavior producing either distress or impairment of function. [NIH] Mental Health: The state wherein the person is well adjusted. [NIH] Mental Processes: Conceptual functions or thinking in all its forms. [NIH] Mental Retardation: Refers to sub-average general intellectual functioning which originated during the developmental period and is associated with impairment in adaptive behavior. [NIH]

MI: Myocardial infarction. Gross necrosis of the myocardium as a result of interruption of the blood supply to the area; it is almost always caused by atherosclerosis of the coronary arteries, upon which coronary thrombosis is usually superimposed. [NIH] Micro-organism: An organism which cannot be observed with the naked eye; e. g. unicellular animals, lower algae, lower fungi, bacteria. [NIH] Mitral Valve: The valve between the left atrium and left ventricle of the heart. [NIH] Mitral Valve Prolapse: Abnormal protrusion of one or both of the leaflets of the mitral valve into the left atrium during systole. This may be accompanied by mitral regurgitation,

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systolic murmur, nonejection click, or cardiac arrhythmia. [NIH] Molecular: Of, pertaining to, or composed of molecules : a very small mass of matter. [EU] Multivariate Analysis: A set of techniques used when variation in several variables has to be studied simultaneously. In statistics, multivariate analysis is interpreted as any analytic method that allows simultaneous study of two or more dependent variables. [NIH] Myocardium: The muscle tissue of the heart composed of striated, involuntary muscle known as cardiac muscle. [NIH] Myopia: That error of refraction in which rays of light entering the eye parallel to the optic axis are brought to a focus in front of the retina, as a result of the eyeball being too long from front to back (axial m.) or of an increased strength in refractive power of the media of the eye (index m.). Called also nearsightedness, because the near point is less distant than it is in emmetropia with an equal amplitude of accommodation. [EU] Nearsightedness: The common term for myopia. [NIH] Necrosis: A pathological process caused by the progressive degradative action of enzymes that is generally associated with severe cellular trauma. It is characterized by mitochondrial swelling, nuclear flocculation, uncontrolled cell lysis, and ultimately cell death. [NIH] Neoplasms: New abnormal growth of tissue. Malignant neoplasms show a greater degree of anaplasia and have the properties of invasion and metastasis, compared to benign neoplasms. [NIH] Nervous System: The entire nerve apparatus composed of the brain, spinal cord, nerves and ganglia. [NIH] Nipples: The conic organs which usually give outlet to milk from the mammary glands. [NIH]

Nuclear: A test of the structure, blood flow, and function of the kidneys. The doctor injects a mildly radioactive solution into an arm vein and uses x-rays to monitor its progress through the kidneys. [NIH] Nuclear Family: A family composed of spouses and their children. [NIH] Opportunistic Infections: An infection caused by an organism which becomes pathogenic under certain conditions, e.g., during immunosuppression. [NIH] Oral Health: The optimal state of the mouth and normal functioning of the organs of the mouth without evidence of disease. [NIH] Osteoarthritis: A progressive, degenerative joint disease, the most common form of arthritis, especially in older persons. The disease is thought to result not from the aging process but from biochemical changes and biomechanical stresses affecting articular cartilage. In the foreign literature it is often called osteoarthrosis deformans. [NIH] Osteoporosis: Reduction of bone mass without alteration in the composition of bone, leading to fractures. Primary osteoporosis can be of two major types: postmenopausal osteoporosis and age-related (or senile) osteoporosis. [NIH] Outer ear: The pinna and external meatus of the ear. [NIH] Outpatient: A patient who is not an inmate of a hospital but receives diagnosis or treatment in a clinic or dispensary connected with the hospital. [NIH] Overweight: An excess of body weight but not necessarily body fat; a body mass index of 25 to 29.9 kg/m2. [NIH] Palate: The structure that forms the roof of the mouth. It consists of the anterior hard palate and the posterior soft palate. [NIH]

Dictionary 59

Pathologist: A doctor who identifies diseases by studying cells and tissues under a microscope. [NIH] Patient Education: The teaching or training of patients concerning their own health needs. [NIH]

Penis: The external reproductive organ of males. It is composed of a mass of erectile tissue enclosed in three cylindrical fibrous compartments. Two of the three compartments, the corpus cavernosa, are placed side-by-side along the upper part of the organ. The third compartment below, the corpus spongiosum, houses the urethra. [NIH] Perception: The ability quickly and accurately to recognize similarities and differences among presented objects, whether these be pairs of words, pairs of number series, or multiple sets of these or other symbols such as geometric figures. [NIH] Periodontal disease: Disease involving the supporting structures of the teeth (as the gums and periodontal membranes). [NIH] Periodontal disease: Disease involving the supporting structures of the teeth (as the gums and periodontal membranes). [NIH] Periodontitis: Inflammation of the periodontal membrane; also called periodontitis simplex. [NIH]

Pharmacologic: Pertaining to pharmacology or to the properties and reactions of drugs. [EU] Phospholipids: Lipids containing one or more phosphate groups, particularly those derived from either glycerol (phosphoglycerides; glycerophospholipids) or sphingosine (sphingolipids). They are polar lipids that are of great importance for the structure and function of cell membranes and are the most abundant of membrane lipids, although not stored in large amounts in the system. [NIH] Pilot study: The initial study examining a new method or treatment. [NIH] Plaque: A clear zone in a bacterial culture grown on an agar plate caused by localized destruction of bacterial cells by a bacteriophage. The concentration of infective virus in a fluid can be estimated by applying the fluid to a culture and counting the number of. [NIH] Pneumonia: Inflammation of the lungs. [NIH] Posterior: Situated in back of, or in the back part of, or affecting the back or dorsal surface of the body. In lower animals, it refers to the caudal end of the body. [EU] Postmenopausal: Refers to the time after menopause. Menopause is the time in a woman's life when menstrual periods stop permanently; also called "change of life." [NIH] Practice Guidelines: Directions or principles presenting current or future rules of policy for the health care practitioner to assist him in patient care decisions regarding diagnosis, therapy, or related clinical circumstances. The guidelines may be developed by government agencies at any level, institutions, professional societies, governing boards, or by the convening of expert panels. The guidelines form a basis for the evaluation of all aspects of health care and delivery. [NIH] Pregnancy Complications: The co-occurrence of pregnancy and a disease. The disease may precede or follow conception and it may or may not have a deleterious effect on the pregnant woman or fetus. [NIH] Prejudice: A preconceived judgment made without adequate evidence and not easily alterable by presentation of contrary evidence. [NIH] Prevalence: The total number of cases of a given disease in a specified population at a designated time. It is differentiated from incidence, which refers to the number of new cases in the population at a given time. [NIH]

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Progressive: Advancing; going forward; going from bad to worse; increasing in scope or severity. [EU] Proneness: Susceptibility to accidents due to human factors. [NIH] Prophylaxis: An attempt to prevent disease. [NIH] Protein S: The vitamin K-dependent cofactor of activated protein C. Together with protein C, it inhibits the action of factors VIIIa and Va. A deficiency in protein S can lead to recurrent venous and arterial thrombosis. [NIH] Psychiatric: Pertaining to or within the purview of psychiatry. [EU] Psychiatry: The medical science that deals with the origin, diagnosis, prevention, and treatment of mental disorders. [NIH] Psychic: Pertaining to the psyche or to the mind; mental. [EU] Psychoactive: Those drugs which alter sensation, mood, consciousness or other psychological or behavioral functions. [NIH] Psychology: The science dealing with the study of mental processes and behavior in man and animals. [NIH] Psychosis: A mental disorder characterized by gross impairment in reality testing as evidenced by delusions, hallucinations, markedly incoherent speech, or disorganized and agitated behaviour without apparent awareness on the part of the patient of the incomprehensibility of his behaviour; the term is also used in a more general sense to refer to mental disorders in which mental functioning is sufficiently impaired as to interfere grossly with the patient's capacity to meet the ordinary demands of life. Historically, the term has been applied to many conditions, e.g. manic-depressive psychosis, that were first described in psychotic patients, although many patients with the disorder are not judged psychotic. [EU] Public Policy: A course or method of action selected, usually by a government, from among alternatives to guide and determine present and future decisions. [NIH] Publishing: "The business or profession of the commercial production and issuance of literature" (Webster's 3d). It includes the publisher, publication processes, editing and editors. Production may be by conventional printing methods or by electronic publishing. [NIH]

Pulmonary: Relating to the lungs. [NIH] Pulmonary Artery: The short wide vessel arising from the conus arteriosus of the right ventricle and conveying unaerated blood to the lungs. [NIH] Punishment: The application of an unpleasant stimulus or penalty for the purpose of eliminating or correcting undesirable behavior. [NIH] Randomized: Describes an experiment or clinical trial in which animal or human subjects are assigned by chance to separate groups that compare different treatments. [NIH] Randomized clinical trial: A study in which the participants are assigned by chance to separate groups that compare different treatments; neither the researchers nor the participants can choose which group. Using chance to assign people to groups means that the groups will be similar and that the treatments they receive can be compared objectively. At the time of the trial, it is not known which treatment is best. It is the patient's choice to be in a randomized trial. [NIH] Reality Testing: The individual's objective evaluation of the external world and the ability to differentiate adequately between it and the internal world; considered to be a primary ego function. [NIH]

Dictionary 61

Refer: To send or direct for treatment, aid, information, de decision. [NIH] Refraction: A test to determine the best eyeglasses or contact lenses to correct a refractive error (myopia, hyperopia, or astigmatism). [NIH] Refractive Power: The ability of an object, such as the eye, to bend light as light passes through it. [NIH] Regimen: A treatment plan that specifies the dosage, the schedule, and the duration of treatment. [NIH] Regurgitation: A backward flowing, as the casting up of undigested food, or the backward flowing of blood into the heart, or between the chambers of the heart when a valve is incompetent. [EU] Relapse: The return of signs and symptoms of cancer after a period of improvement. [NIH] Retina: The ten-layered nervous tissue membrane of the eye. It is continuous with the optic nerve and receives images of external objects and transmits visual impulses to the brain. Its outer surface is in contact with the choroid and the inner surface with the vitreous body. The outer-most layer is pigmented, whereas the inner nine layers are transparent. [NIH] Risk factor: A habit, trait, condition, or genetic alteration that increases a person's chance of developing a disease. [NIH] Risk-Taking: Undertaking a task involving a challenge for achievement or a desirable goal in which there is a lack of certainty or a fear of failure. It may also include the exhibiting of certain behaviors whose outcomes may present a risk to the individual or to those associated with him or her. [NIH] Schizoid: Having qualities resembling those found in greater degree in schizophrenics; a person of schizoid personality. [NIH] Schizophrenia: A mental disorder characterized by a special type of disintegration of the personality. [NIH] Schizotypal Personality Disorder: A personality disorder in which there are oddities of thought (magical thinking, paranoid ideation, suspiciousness), perception (illusions, depersonalization), speech (digressive, vague, overelaborate), and behavior (inappropriate affect in social interactions, frequently social isolation) that are not severe enough to characterize schizophrenia. [NIH] Screening: Checking for disease when there are no symptoms. [NIH] Senile: Relating or belonging to old age; characteristic of old age; resulting from infirmity of old age. [NIH] Sex Characteristics: Those characteristics that distinguish one sex from the other. The primary sex characteristics are the ovaries and testes and their related hormones. Secondary sex characteristics are those which are masculine or feminine but not directly related to reproduction. [NIH] Sexual Abstinence: Refraining from sexual intercourse. [NIH] Sexually Transmitted Diseases: Diseases due to or propagated by sexual contact. [NIH] Shyness: Discomfort and partial inhibition of the usual forms of behavior when in the presence of others. [NIH] Signs and Symptoms: Clinical manifestations that can be either objective when observed by a physician, or subjective when perceived by the patient. [NIH] Skull: The skeleton of the head including the bones of the face and the bones enclosing the brain. [NIH]

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Sleep apnea: A serious, potentially life-threatening breathing disorder characterized by repeated cessation of breathing due to either collapse of the upper airway during sleep or absence of respiratory effort. [NIH] Social Environment: The aggregate of social and cultural institutions, forms, patterns, and processes that influence the life of an individual or community. [NIH] Social Isolation: The separation of individuals or groups resulting in the lack of or minimizing of social contact and/or communication. This separation may be accomplished by physical separation, by social barriers and by psychological mechanisms. In the latter, there may be interaction but no real communication. [NIH] Social Support: Support systems that provide assistance and encouragement to individuals with physical or emotional disabilities in order that they may better cope. Informal social support is usually provided by friends, relatives, or peers, while formal assistance is provided by churches, groups, etc. [NIH] Somatic: 1. Pertaining to or characteristic of the soma or body. 2. Pertaining to the body wall in contrast to the viscera. [EU] Specialist: In medicine, one who concentrates on 1 special branch of medical science. [NIH] Specificity: Degree of selectivity shown by an antibody with respect to the number and types of antigens with which the antibody combines, as well as with respect to the rates and the extents of these reactions. [NIH] Spinal cord: The main trunk or bundle of nerves running down the spine through holes in the spinal bone (the vertebrae) from the brain to the level of the lower back. [NIH] Statistically significant: Describes a mathematical measure of difference between groups. The difference is said to be statistically significant if it is greater than what might be expected to happen by chance alone. [NIH] Stimulus: That which can elicit or evoke action (response) in a muscle, nerve, gland or other excitable issue, or cause an augmenting action upon any function or metabolic process. [NIH] Stress: Forcibly exerted influence; pressure. Any condition or situation that causes strain or tension. Stress may be either physical or psychologic, or both. [NIH] Stroke: Sudden loss of function of part of the brain because of loss of blood flow. Stroke may be caused by a clot (thrombosis) or rupture (hemorrhage) of a blood vessel to the brain. [NIH] Subacute: Somewhat acute; between acute and chronic. [EU] Subclinical: Without clinical manifestations; said of the early stage(s) of an infection or other disease or abnormality before symptoms and signs become apparent or detectable by clinical examination or laboratory tests, or of a very mild form of an infection or other disease or abnormality. [EU] Subcutaneous: Beneath the skin. [NIH] Systemic: Affecting the entire body. [NIH] Systole: Period of contraction of the heart, especially of the ventricles. [NIH] Systolic: Indicating the maximum arterial pressure during contraction of the left ventricle of the heart. [EU] Temporal: One of the two irregular bones forming part of the lateral surfaces and base of the skull, and containing the organs of hearing. [NIH] Thrombosis: The formation or presence of a blood clot inside a blood vessel. [NIH] Tissue: A group or layer of cells that are alike in type and work together to perform a specific function. [NIH]

Dictionary 63

Toxic: Having to do with poison or something harmful to the body. Toxic substances usually cause unwanted side effects. [NIH] Toxicology: The science concerned with the detection, chemical composition, and pharmacologic action of toxic substances or poisons and the treatment and prevention of toxic manifestations. [NIH] Toxins: Specific, characterizable, poisonous chemicals, often proteins, with specific biological properties, including immunogenicity, produced by microbes, higher plants, or animals. [NIH] Transfection: The uptake of naked or purified DNA into cells, usually eukaryotic. It is analogous to bacterial transformation. [NIH] Type 2 diabetes: Usually characterized by a gradual onset with minimal or no symptoms of metabolic disturbance and no requirement for exogenous insulin. The peak age of onset is 50 to 60 years. Obesity and possibly a genetic factor are usually present. [NIH] Vaccines: Suspensions of killed or attenuated microorganisms (bacteria, viruses, fungi, protozoa, or rickettsiae), antigenic proteins derived from them, or synthetic constructs, administered for the prevention, amelioration, or treatment of infectious and other diseases. [NIH]

Vascular: Pertaining to blood vessels or indicative of a copious blood supply. [EU] Ventricle: One of the two pumping chambers of the heart. The right ventricle receives oxygen-poor blood from the right atrium and pumps it to the lungs through the pulmonary artery. The left ventricle receives oxygen-rich blood from the left atrium and pumps it to the body through the aorta. [NIH] Veterinary Medicine: The medical science concerned with the prevention, diagnosis, and treatment of diseases in animals. [NIH] Virus: Submicroscopic organism that causes infectious disease. In cancer therapy, some viruses may be made into vaccines that help the body build an immune response to, and kill, tumor cells. [NIH] Withdrawal: 1. A pathological retreat from interpersonal contact and social involvement, as may occur in schizophrenia, depression, or schizoid avoidant and schizotypal personality disorders. 2. (DSM III-R) A substance-specific organic brain syndrome that follows the cessation of use or reduction in intake of a psychoactive substance that had been regularly used to induce a state of intoxication. [EU]

65

INDEX A Acne, 4, 51 Acquired Immunodeficiency Syndrome, 17, 51 Adjunctive Therapy, 51, 52 Adolescence, 4, 10, 13, 51 Aerobic, 18, 51 Agar, 51, 59 Age of Onset, 51, 63 Airway, 51, 62 Algorithms, 51, 52 Alternative medicine, 26, 51 Ambulatory Care, 51 Anal, 51, 58 Anatomical, 51, 52, 53, 55, 56 Antibody, 51, 52, 56, 62 Antigen, 51, 52, 56 Anxiety, 4, 12, 18, 40, 52 Aphasia, 39, 52 Apnea, 52 Applicability, 7, 52 Arrhythmia, 52, 58 Art Therapy, 52 ART THERAPY, 16 Arteries, 52, 53, 54, 57 Articular, 52, 58 Articulation, 39, 52, 55 Articulation Disorders, 39, 52 Atrium, 52, 57, 63 B Bacteria, 52, 54, 57, 63 Bacteriophage, 52, 59 Bereavement, 18, 52 Biochemical, 52, 58 Biotechnology, 9, 26, 33, 52 Blood Glucose, 5, 52 Blood pressure, 4, 38, 40, 52 Blood vessel, 52, 53, 62, 63 Body Image, 4, 53 Body Mass Index, 40, 53, 58 C Cardiac, 53, 58 Caudal, 53, 59 Causal, 17, 53 Cell, 6, 52, 53, 56, 57, 58, 59 Chin, 53, 57 Cholesterol, 4, 40, 53 Chronic, 4, 6, 11, 18, 28, 53, 56, 57, 62

Chronic Disease, 4, 6, 53 Cleft Palate, 27, 53 Clinical trial, 7, 33, 53, 54, 60 Cloning, 52, 53 Collapse, 53, 62 Computational Biology, 33, 53 Conception, 53, 55, 59 Concomitant, 7, 53 Condoms, 8, 22, 53 Consultation, 8, 27, 53 Contraindications, ii, 54 Control group, 6, 9, 54 Coronary, 54, 57 Coronary Thrombosis, 54, 57 D Degenerative, 54, 58 Delusions, 54, 60 Dementia, 51, 54 Density, 53, 54 Dental Caries, 28, 54 Dental Hygienists, 27, 54 Depressive Disorder, 14, 54 Dexterity, 27, 54 Diagnostic procedure, 26, 54 Dietitian, 40, 54 Direct, iii, 54, 61 Discrimination, 28, 54 Distal, 27, 54 Dorsal, 54, 59 Dysarthria, 39, 55 Dysphoric, 54, 55 E Eating Disorders, 4, 5, 11, 12, 18, 27, 38, 55 Edema, 27, 55 Efficacy, 8, 55 Emaciation, 51, 55 Enamel, 27, 54, 55 Environmental Health, 32, 34, 55 Enzymatic, 54, 55 Epidemic, 18, 55 Erection, 55, 56 Excimer laser, 13, 55 Exogenous, 55, 63 F Family Planning, 33, 55 Family Relations, 22, 55 Fat, 4, 40, 55, 58 Fathers, 18, 55

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Fetus, 55, 59 Fissure, 53, 55 Forearm, 53, 55 G Gene, 52, 55 Gingivitis, 28, 55 Governing Board, 55, 59 H Handicap, 4, 55 Health Behavior, 8, 56 Health Education, 5, 39, 56 Health Status, 56 Hemorrhage, 56, 62 Hypoplasia, 27, 56 I Immune response, 52, 56, 63 Immunodeficiency, 8, 17, 22, 39, 51, 56 Impairment, 4, 38, 56, 57, 60 Impotent, 18, 56 Infarction, 54, 56, 57 Infection, 8, 21, 28, 51, 56, 57, 58, 62 Inflammation, 51, 55, 56, 59 Inpatients, 14, 56 Insulin, 56, 63 Intermittent, 56, 57 Interpersonal Relations, 5, 56 Intoxication, 56, 63 Intracellular, 56 K Kb, 32, 56 Keratolytic, 54, 56 L Language Disorders, 39, 56 Licensed practical nurse, 12, 57 Localized, 54, 56, 57, 59 Loneliness, 4, 57 Long-Term Care, 4, 57 Lubricants, 39, 57 Lymphatic, 56, 57 Lymphocyte, 51, 52, 57 Lymphocyte Count, 51, 57 M Malignant, 51, 57, 58 Malnutrition, 28, 57 Mammary, 57, 58 Manic, 57, 60 Meatus, 57, 58 MEDLINE, 33, 57 Membrane, 57, 59, 61 Mental, iv, 7, 8, 11, 14, 32, 34, 38, 39, 52, 53, 54, 57, 60, 61 Mental Disorders, 57, 60

Mental Health, iv, 7, 8, 11, 14, 32, 34, 38, 57 Mental Processes, 57, 60 Mental Retardation, 39, 57 MI, 38, 40, 49, 57 Micro-organism, 54, 57 Mitral Valve, 27, 57 Mitral Valve Prolapse, 27, 57 Molecular, 33, 35, 52, 53, 58 Multivariate Analysis, 12, 58 Myocardium, 57, 58 Myopia, 13, 58, 61 N Nearsightedness, 58 Necrosis, 56, 57, 58 Neoplasms, 51, 58 Nervous System, 55, 58 Nipples, 27, 58 Nuclear, 55, 58 Nuclear Family, 55, 58 O Opportunistic Infections, 51, 58 Oral Health, 28, 58 Osteoarthritis, 4, 58 Osteoporosis, 27, 58 Outer ear, 27, 58 Outpatient, 58 Overweight, 3, 38, 40, 58 P Palate, 27, 53, 58 Pathologist, 39, 59 Patient Education, 38, 44, 46, 49, 59 Penis, 53, 59 Perception, 7, 59, 61 Periodontal disease, 28, 59 Periodontitis, 28, 55, 59 Pharmacologic, 59, 63 Phospholipids, 55, 59 Pilot study, 14, 59 Plaque, 28, 59 Pneumonia, 54, 59 Posterior, 27, 51, 54, 58, 59 Postmenopausal, 58, 59 Practice Guidelines, 34, 59 Pregnancy Complications, 28, 59 Prejudice, 7, 22, 59 Prevalence, 14, 59 Progressive, 54, 58, 60 Proneness, 10, 60 Prophylaxis, 54, 60 Protein S, 52, 60 Psychiatric, 9, 11, 12, 13, 27, 57, 60

67

Psychiatry, 12, 14, 60 Psychic, 57, 60 Psychoactive, 60, 63 Psychology, 7, 10, 11, 12, 13, 19, 60 Psychosis, 12, 60 Public Policy, 33, 60 Publishing, 9, 18, 60 Pulmonary, 53, 60, 63 Pulmonary Artery, 53, 60, 63 Punishment, 27, 60 R Randomized, 8, 55, 60 Randomized clinical trial, 8, 60 Reality Testing, 60 Refer, 1, 60, 61 Refraction, 58, 61 Refractive Power, 58, 61 Regimen, 55, 61 Regurgitation, 57, 61 Relapse, 22, 61 Retina, 58, 61 Risk factor, 8, 12, 40, 61 Risk-Taking, 6, 61 S Schizoid, 61, 63 Schizophrenia, 61, 63 Schizotypal Personality Disorder, 61, 63 Screening, 13, 53, 61 Senile, 58, 61 Sex Characteristics, 51, 61 Sexual Abstinence, 22, 61 Sexually Transmitted Diseases, 8, 22, 61 Shyness, 11, 61 Signs and Symptoms, 61 Skull, 61, 62

Sleep apnea, 4, 62 Social Environment, 5, 62 Social Isolation, 22, 61, 62 Social Support, 22, 62 Somatic, 51, 62 Specialist, 8, 41, 62 Specificity, 22, 62 Spinal cord, 53, 58, 62 Statistically significant, 6, 62 Stimulus, 60, 62 Stress, 18, 62 Stroke, 28, 32, 62 Subacute, 56, 62 Subclinical, 56, 62 Subcutaneous, 55, 62 Systemic, 53, 56, 62 Systole, 57, 62 Systolic, 58, 62 T Temporal, 9, 57, 62 Thrombosis, 60, 62 Tissue, 52, 55, 56, 57, 58, 59, 61, 62 Toxic, iv, 63 Toxicology, 34, 63 Toxins, 52, 56, 63 Transfection, 52, 63 Type 2 diabetes, 4, 63 V Vaccines, 63 Vascular, 56, 63 Ventricle, 57, 60, 62, 63 Veterinary Medicine, 33, 63 Virus, 8, 17, 22, 39, 51, 52, 59, 63 W Withdrawal, 18, 63

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Low Self-esteem: A Medical Dictionary, Bibliography, And Annotated Research Guide To Internet References

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