bluuebunny/crossref_metadata_2025 huggingface dataset:
Re-Visiting the Web Cam and the Promises and Perils of the Fully Networked Age
Authors: Kitzmann Andreas
Published: August 2015

This essay reflects on my now ten year old investigation of the impact of web cams on the nature of life writing and the self. Despite the many changes that have occurred since that time, the trajectories of these older technologies and practices continue to have relevance today and provide us with a reasonable ground from which to continue our explorations into current and emerging technological practices.
Life Writing Versus Automedia: The Sims 3 Game as a Life Lab
Authors: Rak Julie
Published: August 2015

Online environments are rapidly changing our understanding of what it means to construct a life story and what identity itself might come to mean in virtual worlds. This essay poses a direct challenge to the field of life writing by asking us to rethink “life” and “writing” as automedia.
Coda: Data Generation
Authors: Arthur Paul Longley
Published: August 2015

It may be that the digital revolution has had a more profound effect on biography than any other branch of the arts. At the intersection of life writing and digital humanities, key questions can be posed: In what ways does the Web act to co-shape identities? How permanent are digital records of lives? Will we soon remember differently?
The Rhetorical Situations that Invite Us Online
Authors: Killoran John B.
Published: August 2015

This article probes behind familiar self-presentational genres to inquire into how distinct rhetorical situations that converge on websites complicate how people present themselves on those sites. It reports on a sample of businesspeople who present aspects of their personal lives on their professional sites.
Victim/Victor: Stalking the Subject of Online Life Writing
Authors: Pulda Molly
Published: August 2015

This essay notes an intersection between extreme acts of online stalking and everyday acts of online identity construction: both are marked by repetition. I propose an “ethics of interruption” to address the relational stakes of constructing and consuming online lives, broadening the scope of what counts as an act of life writing.
Designing a Theatre of Recollection for the Digital Age: Shifting Perspectives and the Autobiographical Eye
Authors: Zalis Elayne
Published: August 2015

Elayne Zalis discusses how “At Home in Cyberspace: Staging Autobiographical Scenes,” the essay that she published in the 2003 Online Lives issue of Biography , influenced a novel that she later wrote, Arella’s Repertoire , in which the narrator stages autobiographical scenes of her own in cyberspace. Like the websites that Zalis examined in her essay, Arella’s Repertoire explores new ways to share personal and cultural memories in the digital age.
Hoax Politics: Blogging, Betrayal, and the Intimate Public of A Gay Girl in Damascus
Authors: Cardell Kylie , Maguire Emma
Published: August 2015

Blogs can connect disparate “others,” or focus attention on certain events, moments, or histories, but to what extent does the blog function within (or trouble) the paradigms of identity politics that also frame autobiographical narration in online contexts? This paper is a close analysis of A Gay Girl in Damascus, a fast moving case of online imposture that emerged in conjunction to the “Arab Spring” and catalyzed a host of issues connected to the representation, articulation, and circulation of marginal identity in online spaces.
Pictures in the Stars: 88 Constellations For Wittgenstein and the Online “Biography”
Authors: Clark David
Published: August 2015

The author discusses his Internet artwork 88 Constellations for Wittgenstein , which uses a non-linear, hyperlinking structure to create a kind of metabiography anchored by Wittgenstein’s life and philosophy. Clark uses the constellations both as a navigation device as well as metaphor for how we make meaning (or pictures of meaning, as Wittgenstein would say), using the facts of Wittgenstein’s life to address the external relations of his life to the outside world, as digital media provides an opportunity to create a new kind of textuality that examines the relations of exteriority a life story has to our current situation.
“An Encyclopedia, Not an Experiment in Democracy”: Wikipedia Biographies, Authorship, and the Wikipedia Subject
Authors: Graham Pamela
Published: August 2015

Wikipedia biography is a culturally significant, yet overlooked form of digital life narrative. Through an examination of Wikipedia’s policies and discussion forums, and a number of its most popular and controversial biographies, this essay explores the politics of biographical practice and representation on the site.
Vlogging Toward Digital Literacy
Authors: Lange Patricia G.
Published: August 2015

The author traces her journey into the exotic, early world of video blogging, in which participants used video to share the self, develop empathy for others, and exchange knowledge. Moving from modest video blogs to an internationally-screened film demonstrated in a direct way that under the right circumstances participatory cultures work. Peer-to-peer mentorship and connected learning can open new forms of digital and participatory literacies in media cultures.
The Hospitality of Cyberspace: Mobilizing Asylum Seeker Testimony Online
Authors: Whitlock Gillian
Published: August 2015

This article focuses on maritime voyages filmed and narrated by asylum seekers, where they become “produsers” of their own testimonial narratives that are then disseminated through both conventional and new media. Social media offers new venues and opportunities for the dissemination of testimony generated by the asylum seekers, from within the boats, trucks, and planes that transport them. Asylum seekers are not citizens seeking democracy in the public spaces of their own homelands; on the contrary, they are stigmatized as the barbarians at our gates, and as a threat to the security of the nation. In their hands, however, smartphones and social media enable new forms of testimonial narrative, from within spaces of detention. Can we speak of the hospitality of cyberspace on behalf of the dispossessed?
A Call to Action: John Courtney Murray, S.J., and the Renewal of American Democracy
Authors: Cadeddu Francesca
Published: August 2015

As a Jesuit and an American intellectual, John Courtney Murray believed that U.S. society in the post–World War II era lacked a public philosophy and that intellectuals could reformulate the societal consensus so crucial to the early Republic. Invoking St. Thomas Aquinas, Murray formulated the concept of a city composed of democratic ideals and believed that Catholics could challenge the academy to preserve this city and the consensus that built it. Murray committed his life to work within Catholic and other intellectual circles and to the interpretation of U.S. democracy that could reveal the truths held by Americans.
Ubiquitously Useful: The Jesuit College of St. Francis Xavier, New York City, 1847–1912
Authors: Shelley Thomas J.
Published: August 2015

For sixty-five years the College of St. Francis Xavier was one of the largest and most important Jesuit colleges in the United States. It made a much greater contribution to Catholic higher education in New York City than St. John’s College (the future Fordham University), producing hundreds of clergy, lawyers, doctors, and businessmen. The Jesuits who ran the college also staffed a busy parish church; served as chaplains in many of the city’s hospitals, prisons, and asylums; and founded the Catholic Club of the City of New York, the most important lay Catholic social organization in New York City.
Decolonization, Language, and Identity: The Francophone Islands of the Pacific
Authors: Yan Léopold Mu Si , Saura Bruno
Published: August 2015

This article is both an introduction to this special issue of The Contemporary Pacific and a more general reflection about francophone research in the Pacific Islands and about their cultures and populations. The common topic of the essays selected here is the difficulty of maintaining an indigenous identity within the French colonial system in the French or francophone islands of the Pacific (New Caledonia, French Polynesia, and Wallis and Futuna). Four contributions from contemporary scholars of New Caledonia and French Polynesia bring their research on the cultural, social, and political struggles of their interlocutors to better visibility for a broad, largely anglophone audience in Pacific studies. The Resources section, produced by the chief librarians of the University of New Caledonia and the University of French Polynesia, provides a very useful overview of bibliographic and research materials about these two territories. Putting things in broader perspective, this introduction discusses what may be a common denominator in research work produced by francophone scholars that makes it distinctly different from the work of Anglophones. As well, it raises the epistemological issue of the political commitment of researchers born in the francophone Pacific Islands or living there on a permanent basis.
Remembrance of the Colonial Past in the French Islands of the Pacific: Speeches, Representations, and Commemorations
Authors: Saura Bruno
Published: August 2015

Beginning with an attempt to define “colonial times” and the “colonial past,” this article examines the question of indigenous remembrance or remembrances of the past in the Pacific region—a subject that lies at the heart of the collaboration between disciplines of history and anthropology. The situations of the two main French colonies in the region—New Caledonia and French Polynesia—are quite different. What is similar is that, in both cases, indigenous peoples do not seem very interested in the period of first contact with Western navigators, and both tend to cast the evangelical work of nineteenth-century missionaries in a positive light. But colonial experiences in the two places are given distinctly different representations. New Caledonia has a violent past, with opposition between Kanak groups and French settlers as well as between some groups of Kanak. For this reason, it is necessary for work of remembrance to take place before a strong path toward the future, in the spirit of the Matignon and Nouméa accords, can be developed. In French Polynesia, on the other hand, the colonial wars of the nineteenth century have only recently begun to be a subject of public interest, but the period of nuclear tests (1966–1996) is still fresh in the collective memory. This period is the main reason for the tension in French Polynesia’s relations with the French State, which, for members of the independence movement (and others), makes it impossible to forget and difficult to forgive.
Brave New Words: The Complexities and Possibilities of an “Indigenous” Identity in French Polynesia and New Caledonia
Authors: Gagné Natacha
Published: August 2015

In French Polynesia and New Caledonia, the “indigenous strategy” in reference to the world indigenous movement and UN indigenous rights instruments is a relatively new one in the struggle to recover sovereignty. Individuals and volunteer associations only began to explore the possibilities of this strategy in the mid-1990s, and it continues to hold a marginal place in the political field of the French territories in Oceania. This article explores how indigeneity and indigenous rights are understood and enacted locally, drawing on local voices and actions within a local and national context. It shows how the framework for the struggles of the indigenous peoples in the French territories in Oceania differs radically from those of other peoples who have been seen as emblematic of the category “indigenous peoples.”
Imagining the Body in Pacific Francophone Literature
Authors: Porcher-Wiart Titaua
Published: August 2015

This article deals with the central position of the body in Polynesian and Kanak imaginary, ancestral myths, and language. In the collective imagination, the body is akin to a particle of the cosmos. The author probes into major primordial images in order to understand the peculiar role of the body in the Oceanic “anthropological structures of the imaginary” (Gilbert Durand’s term) and asks whether the vision proposed by archaic myths finds its way into modern autochthonous Polynesian and Kanak indigenous literature, especially in the writings of Déwé Gorodé, Chantal Spitz, Flora Devatine, and Moetai Brotherson. Indeed, in keeping with the theories of Michel Foucault, the Oceanic body as it appears in modern poetic or novelistic narrations bears witness in its maimed flesh to a collective history and bears the scars of colonialism. Through its transhistorical dimension as well, this brand of francophone literature constitutes an original way to introduce some sort of counter-discourse into narrative strategies shaped by Western colonial history. In reclaiming the body, these writers are also reviving an ancestral voice.
Linguistic Ideologies: Teaching Oceanic Languages in French Polynesia and New Caledonia
Authors: Vernaudon Jacques
Published: August 2015

Though traditionally reluctant to teach languages other than French, the national idiom, schools in French Polynesia and New Caledonia have gradually made way for vernacular languages in response to the rise of indigenous identity claims, first articulated in the 1970s. The decentralization policy of France and especially the transfer of jurisdiction over primary and secondary education to local administrations have contributed to this linguistic and cultural acknowledgment, at least at an institutional level. However, territorial education practice remains strongly homologous with the metropolitan teaching model and, because of demographic, sociolinguistic, and political factors, the two French overseas collectivities display contrasting situations with different conditions of resistance to the “all in French” ideology. Following a presentation of their contemporary sociolinguistic contexts, this dialogue piece traces the main phases of education and language policy implemented in these two countries from the missionary period to today and identifies their ideological underpinnings. It details the current major differences between the two territories in their promotion of local languages in schools. As institutional recognition of local languages is not enough, in itself, to revitalize their practice and transmission, it also uses quantitative indicators to consider the role of families in language transmission. The essay concludes with a reflection on the ultimate objectives of teaching indigenous languages.
Resources for Research in French Polynesia and New Caledonia
Authors: Aymonin David , Heutte Isabelle
Published: August 2015

French Polynesia and New Caledonia library and archives collections are typically in French and tend to be organized according to French institutional and scientific methods. Recent transfers of power from the French State toward certain territorial institutions have not significantly changed this fact. This particular situation is, on the one hand, a source of enrichment because it creates diversity within the Pacific region and because these sources of documentation and the way they are organized link these territories to larger repositories of knowledge in France and elsewhere in Europe. On the other hand, it is also an isolation factor in the expanse of the Pacific Ocean, whose inhabitants are mainly anglophone, and in an academic world that is also dominated by the growing use of English. After a listing and presentation of all the libraries and media centers existing in French Polynesia and New Caledonia, the focus of this essay moves on to the question of partnerships to be built between the various institutions of these two territories, metropolitan French libraries and networks, and English-language institutions of the Pacific region.
Perceptions of Community HIV/STI Risk Among U.S Women Living in Areas with High Poverty and HIV Prevalence Rates
Authors: Blackstock Oni J. , Frew Paula , Bota Dorothy , Vo-Green Linda , Parker Kim , Franks Julie , Hodder Sally L. , Justman Jessica , Golin Carol E. , Haley Danielle F. , Kuo Irene , Adimora Adaora A. , Rompalo Anne , Soto-Torres Lydia , Wang Jing , Mannheimer Sharon B.
Published: August 2015

Although studies have consistently demonstrated that women at high risk for HIV and non-HIV sexually transmitted infections (STIs) tend to underestimate their individual risk, little is known about how women at risk perceive their community’s HIV/STI risk. We explored perceptions of community HIV/STI risk among U.S. women living in areas with high poverty and HIV prevalence rates as part of a qualitative substudy of the Women’s HIV SeroIncidence Study. Semi-structured focus groups were conducted. Data were coded and analyzed using the constant comparative method. Participants expressed the perception that their communities were at elevated HIV/STI risk, mostly due to contextual and structural factors such as lack of access to health care and education. Findings suggest that HIV prevention messages that target U.S. women at high risk for HIV may be strengthened by addressing the high perceived community HIV/STI risk driven by structural factors.
Vision Problems in Homeless Children
Authors: Smith Natalie L. , Smith Thomas J. , DeSantis Diana , Suhocki Marissa , Fenske Danielle
Published: August 2015

Background . Vision problems in homeless children can decrease educational achievement and quality of life. Purpose . To estimate the prevalence and specific diagnoses of vision problems in children in an urban homeless shelter. Methods . A prospective series of 107 homeless children and teenagers who underwent screening with a vision questionnaire, eye chart screening (if mature enough) and if vision problem suspected, evaluation by a pediatric ophthalmologist. Glasses and other therapeutic interventions were provided if necessary. Results . The prevalence of vision problems in this population was 25%. Common diagnoses included astigmatism, amblyopia, anisometropia, myopia, and hyperopia. Glasses were required and provided for 24 children (22%). Conclusions . Vision problems in homeless children are common and frequently correctable with ophthalmic intervention. Evaluation by pediatric ophthalmologist is crucial for accurate diagnoses and treatment. Our system of screening and evaluation is feasible, efficacious, and reproducible in other homeless care situations.
Race/Ethnicity and Primary Language: Health Beliefs about Colorectal Cancer Screening in a Diverse, Low-Income Population
Authors: Brenner Alison Tytell , Ko Linda K. , Janz Nancy , Gupta Shivani , Inadomi John
Published: August 2015

Colorectal cancer (CRC) is an important cause of cancer death in adults in the U.S.; screening is effective but underutilized, particularly among minorities. The purpose of this paper was to explore whether health belief model (HBM) constructs pertaining to CRC screening differ by race/ethnicity and primary language. Data were from the baseline surveys of 933 participants (93.5%) in a randomized trial promoting CRC screening in San Francisco. Composite scores for each construct were created from multiple items, dichotomized for analysis, and analyzed using multivariate logistic regression. Most participants were Asian (29.7%) or Hispanic (34.3%), and many were non-English speakers. Non-English speaking Hispanics (p<.001) and English-speaking Asians (p=.002) reported lower perceived susceptibility than non-Hispanic Whites (NHW). Non-English speaking Hispanics reported more and non-English speaking Asians fewer perceived barriers (psychological and structural) than NHW. Understanding how different populations think about CRC screening may be critical in promoting screening in diverse populations.
Needing Primary Care But Not Getting It: The Role of Trust, Stigma and Organizational Obstacles reported by Homeless Veterans
Authors: O’Toole Thomas P. , Johnson Erin E. , Redihan Stephan , Borgia Matthew , Rose Jennifer
Published: August 2015

We describe data from a multi-center community-based survey of homeless veterans who were not accessing available primary care to identify reasons for not getting this care as well as for not seeking health care when it was needed. Overall, 185 homeless veterans were interviewed: The average age was 48.7 years (SD 10.8), 94.6% were male, 43.2% were from a minority population. The majority identified a recent need for care and interest in having a primary care provider. Reasons for delaying care fell into three domains: 1) trust; 2) stigma; and 3) care processes. Identifying a place for care (OR 3.3; 95% CI: 1.4–7.7), having a medical condition (OR 5.5; 95% CI 1.9–15.4) and having depression (OR 3.4; 95% CI: 1.4–8.7) were associated with receiving care while not being involved in care decisions was associated with no care (OR 0.7; 95% CI 0.5–0.9). Our findings support the importance of considering health access within an expanded framework that includes perceived stigma, inflexible care systems and trust issues.
Expanding Telemedicine to Include Primary Care for the Urban Adult
Authors: Markwick Laura , McConnochie Kenneth , Wood Nancy
Published: August 2015

This article describes the effective use of telemedicine for the urban adult patient. A successful pediatric telemedicine program was expanded to include care for adults. The pilot program resulted in high levels of patient satisfaction, decreased loss of work time, and decrease in inappropriate use of the emergency department.
Characteristics of Frequent Users of the Emergency Department with Psychiatric Conditions
Authors: Buhumaid Rasha , Riley Jessica , Sattarian Mehdi , Bregman Benjamin , Blanchard Janice
Published: August 2015

Study objective . The goal of this study was to evaluate demographic factors associated with increased emergency department use among people with psychiatric conditions. Methods . This was a retrospective cohort study of all patients presenting to an urban, academic emergency department with a history of at least one mental health-related final diagnosis. Results . A total of 569 people with psychiatric conditions were included in the study. Of this group, 22.1% had four or more visits within 2009. People with more than four annual visits were more likely to be over age 40, to have at least one chronic condition, to have Medicaid, and to be Black compared with those with fewer than four annual visits. Discussion . The frequent-user group had fewer visits with a final psychiatric diagnosis, lower rate of psychiatric admissions, and higher rate of visits resulting in a medical admission than the infrequent-user group.
The Effect of Community Health Center (CHC) Density on Preventable Hospital Admissions in Medicaid and Uninsured Patients
Authors: Evans Christopher S. , Smith Sunny , Kobayashi Leslie , Chang David C.
Published: August 2015

Community health centers (CHCs) are expected to play a major role in expanding primary care access under the Affordable Care Act (ACA). Although benefits of such health centers among Medicaid populations have been documented, little is known about their impact on the uninsured. Additionally, the effect of health center density on preventable hospitalizations is unknown. This study calculated health center density within five miles of California hospitals using geocoding and Haversine distance formula. Using the 2010 California inpatient dataset, rates of preventable hospitalizations were classified by Prevention Quality Indicators (PQIs). After adjusting for patient and community covariates, we found that as health center density increased, the odds ratio of preventable hospitalizations decreased in both Medicaid and uninsured patients. (OR 0.79 and 0.86 for Medicaid and uninsured respectively p<.001,.044) These findings suggest health centers are contributing to lowering preventable hospitalizations and supports plans to expand such health centers.
Blacks Smoke Less (and More) than Whites: Simpson’s Paradox in U.S. Smoking Rates, 2008 to 2012
Authors: Persoskie Alexander , Leyva Bryan
Published: August 2015

In what is known as Simpson’s Paradox, a statistical association present within different groups becomes reversed when the groups are aggregated. Because race is confounded with socioeconomic status (SES) in the U.S., the overall smoking rate among Blacks may exceed that among Whites, even while the reverse is true within SES strata (or when adjusting for SES). Indeed, in the most recent five iterations of the Behavioral Risk Factor Surveillance System (2008–2012), a nationwide dataset, unadjusted models found that non-Hispanic Blacks were more likely than non-Hispanic Whites to report current smoking (e.g., in 2012: OR=1.14, p<.0001). However, Blacks were less likely than Whites to report smoking across all five years when models adjusted for income (e.g., in 2012: OR=0.85, p<.0001) and in 2008–2010 when models adjusted for education. This reversal of association reflects racial disparities in SES, which cause Black Americans to be disproportionately affected by smoking risk factors associated with low income and education.
Adolescents Who Visit the Emergency Department Are More Likely to Make Unhealthy Dietary Choices: An Opportunity for Behavioral Intervention
Authors: Chandler Iris , Rosenthal Lisa , Carroll-Scott Amy , Peters Susan M. , McCaslin Catherine , Ickovics Jeannette R.
Published: August 2015

To identify health behaviors that may be amenable to brief screening and intervention among children in the emergency department (ED), we described the prevalence of health behaviors known to contribute to childhood obesity among middle school students who used the ED recently. Participants included 1590 5th, 7th, and 8th grade students who completed health surveys in 2011. Multivariate logistic regression was used to examine the association between health behaviors and ED use. Children who used the ED reported more unhealthy dietary behaviors, including greater consumption of energy-dense foods such as fried chicken, french fries, and ice cream (OR 1.20, 95% CI 1.06–1.37), fast food (OR 1.07, 95% CI 1.00–1.14) and sugar-sweetened beverages (OR 1.24, 95% CI 1.14–1.35). There was no association with fruit and vegetable consumption, physical activity, or screen time. Unhealthy dietary behaviors are associated with ED use in a low-resource urban population of middle school students.
Attitudes towards Living Donor Kidney Transplantation among Urban African American Hemodialysis Patients: A Qualitative and Quantitative Analysis
Authors: Gillespie Avrum , Hammer Heather , Bass Sarah Bauerle , Ouzienko Vladimir , Obradovic Zoran , Urbanski Megan , Browne Teri , Silva Patricio
Published: August 2015

While living donor kidney transplantation (LDKT) is the treatment of choice for end-stage renal disease patients (ESRD), the potential barriers to LDKT are not well understood, especially among African American patients who have higher rates of ESRD but lower LDKT than Whites. To address this gap, a cross-sectional survey (n=101) identified LDKT experiences and attitudes among urban African American adults receiving hemodialysis at two outpatient clinics in Philadelphia. Most patients (72.3%) were interested in LDKT but only 34.2% had asked someone for a donation. Concerns about the donor (33.3%), asking for a kidney (28.1%), and their own health (24.6%) were major barriers. Patients also expressed guilt (56.3%) and fear (37.2%). About half (49.5%) had an unsolicited offer, regardless of whether or not they asked. The survey results suggest that interventions should focus on overcoming reluctance to ask for a kidney donation or to accept unsolicited offers.
A National Long-term Outcomes Evaluation of U.S. Premedical Postbaccalaureate Programs Designed to Promote Health care Access and Workforce Diversity
Authors: McDougle Leon , Way David P. , Lee Winona K. , Morfin Jose A. , Mavis Brian E. , Matthews De’Andrea , Latham-Sadler Brenda A. , Clinchot Daniel M.
Published: August 2015

The National Postbaccalaureate Collaborative (NPBC) is a partnership of Postbaccalaureate Programs (PBPs) dedicated to helping promising college graduates from disadvantaged and underrepresented backgrounds get into and succeed in medical school. This study aims to determine long-term program outcomes by looking at PBP graduates, who are now practicing physicians, in terms of health care service to the poor and underserved and contribution to health care workforce diversity. Methods . We surveyed the PBP graduates and a randomly drawn sample of non-PBP graduates from the affiliated 10 medical schools stratified by the year of medical school graduation (1996–2002). Results . The PBP graduates were more likely to be providing care in federally designated underserved areas and practicing in institutional settings that enable access to care for vulnerable populations. Conclusion . The NPBC graduates serve a critical role in providing access to care for underserved populations and serve as a source for health care workforce diversity.
Trends and Patterns of Late and Unstaged Lung, Colorectal, Female Breast, and Prostate Cancers among American Indians in the Northern Plains, 2002–2009
Authors: Watanabe-Galloway Shinobu , Watkins Kate , Duran Tinka
Published: August 2015

Introduction . We investigated incidence and staging patterns of prostate, female breast, lung, and colorectal cancer among American Indians/Alaska Natives (AI/ANs) and non-Hispanic Whites (NHWs) in the Northern Plains. Methods . Cancer registry data (2002–2009) from Nebraska, North Dakota, and South Dakota were analyzed. Incidence rates were calculated and multivariate logistic regression analyses identified factors associated with unstaged versus staged and late-stage cancer cases versus early. Results . The incidence rate was higher among AI/ANs than NHWs for lung cancer (92.2 vs. 60.6 per 100,000). Compared with NHWs, AI/ANs were 2.0 times more likely to receive an unstaged diagnosis and 1.2 times more likely to receive a late-stage diagnosis. AI/ANs were significantly more likely than NHWs to receive an unstaged diagnosis. Discussion . Increased efforts are needed to reduce unstaged and late-stage diagnoses among Northern Plains AIs. Efforts to promote early detection of cancer should target younger AI/ANs.
Service Delivery Model and Experiences in a Cancer Genetics Clinic for an Underserved Population
Authors: Woodson Ashley H , Profato Jessica L , Rizvi Sarah H , Elsayegh Nisreen , Rieber Alyssa G , Arun Banu K
Published: August 2015

This report describes a genetics clinic for hereditary breast and ovarian cancer (HBOC) in an underserved population. Genetic counseling was provided to 151 patients, and 131 underwent BRCA genetic testing. This was a unique, group-based establishment of an HBOC genetics clinic, which to our knowledge had not previously been reported.
The Prevalence and Presumed Etiology of Elevated Aminotransferase Levels in a Pacific Northwest Tribal Community
Authors: Scott John , Kowdley Kris V. , Ioannou George N. , Krantz Elizabeth , Lallemand Odile , Tsosie Ursula , Buchwald Dedra
Published: August 2015

American Indians and Alaska Natives (AI/ANs) die from chronic liver disease at high rates, but little data exist on the etiology of liver disease in AI/ANs. Adult participants from a tribal health clinic in the Pacific Northwest completed an alcohol consumption survey and underwent laboratory testing, and anthropometric measurements. Participants with abnormal serum alanine aminotransferase (ALT) levels, positive hepatitis B surface antigen, or hepatitis C antibody were invited for follow-up visit. Then, they received a limited liver ultrasound, additional liver function tests, and confirmatory hepatitis tests. Among 71 participants, 26 (37%) had sustained elevation of ALT over six months. Two patients (8%) had chronic hepatitis C virus and 19 (73%) had ultrasonographic steatosis suggesting nonalcoholic fatty liver disease (NAFLD). Elevated aminotransferase levels were common, with NAFLD and hepatitis C accounting for most cases. Few participants were aware of their liver condition, indicating the need for increased awareness, screening, and intervention.
Exploring the Impact of the New WIC Food Package on Low-Fat Milk Consumption Among WIC Recipients: A Pilot Study
Authors: Meiqari Lana , Torre Lindsey , Gazmararian Julie A.
Published: August 2015

Objective . To examine if the mothers and their eldest child participating in WIC would accept the 2009 new Women, Infants, and Children (WIC) program package and drink more low-fat milk. Methods . Mothers and their eldest child at two Atlanta WIC clinics were recruited. Data were collected at baseline (before the new WIC package), at one week and four weeks. Results . The percentage of children consuming low-fat milk significantly increased: 41.3% at baseline, 58.8% at week one, and 79.5% at week four (p<.001). After four weeks, the mothers reported increased child’s consumption of low-fat milk vs. whole milk (AOR = 7.36; CI: 1.44–37.52). Mothers’ consumption of low-fat milk did not significantly change after introduction of the new package. Conclusions . Policy changes for WIC vouchers were implemented to encourage mothers to reduce fat calories in dairy products for them and their children. This represents a powerful, low-resource intervention to change health behaviors among low-income families.
Who’s Aware of and Using Public Reports of Provider Quality?
Authors: Greene Jessica , Fuentes-Caceres Veronica , Verevkina Nina , Shi Yunfeng
Published: August 2015

Public reporting of health care provider quality is intended to spark consumer informed decision-making, yet there is concern that it might exacerbate disparities. This study explores the extent to which people with chronic conditions are aware of and using comparative quality information (CQI) on hospitals and doctors, and how awareness and use of the information differs by individuals’ socio-demographic characteristics. Using a large 2011/2012 survey of adults with chronic conditions, we find low awareness of hospital and doctor CQI (26% and 16% respectively), and lower CQI use (8% and 6% respectively). Findings related to equity in awareness and use by socio-demographic subgroups was mixed. Higher education and income were related to greater CQI awareness, however Whites were less likely to be aware of and use CQI than African Americans and Latinos. The magnitudes of these differences, however, were not large; all groups had modest levels of CQI awareness and use.
Lessons Learned: Implementation of a Culturally Focused Psychiatric Consultation Service for Latino Americans and Asian Americans
Authors: Trinh Nhi-Ha , Hails Katherine , Flaherty Katherine , Chang Trina , Fava Maurizio , Yeung Albert
Published: August 2015

Novel interventions have been developed to bridge disparities in accessing mental health care for minority populations. However, challenges arise when trying to implement and study novel interventions in real-world community settings. Our objective is to describe the challenges implementing the Culturally Focused Psychiatric (CFP) Consultation Program for depressed Latino and Asian Americans in four urban primary care practices. Issues discussed at regular on-site meetings were used to inform improvements in the program’s implementation, and interviews were conducted with intervention and practice staff at the end of the program to address additional avenues for improvement. Despite thoughtful planning, multiple challenges arose, highlighting the need for extended time piloting the intervention, additional staffing of the intervention, and maintaining flexibility when working with busy primary care sites to implement mental health interventions. The CFP program highlights the challenges of implementing mental health interventions for minority populations in primary care.
Placing a Health Equity Lens on Non-communicable Diseases in sub-Saharan Africa
Authors: Dagadu Helena E. , Patterson Evelyn J.
Published: August 2015

Deaths from non-communicable diseases are increasing worldwide. Low and middle-income countries, particularly those in sub-Saharan Africa (SSA), are projected to see the most rapid increase over the next two decades. While non-communicable diseases such as diabetes and cardiovascular disease increasingly contribute to mortality in SSA, communicable diseases such as malaria and HIV/AIDS remain major causes of death in this region, leading to a double burden of disease. In this paper, we use World Health Organization data and life table techniques to: (1) delineate the magnitude and toll of the double burden of disease in four SSA countries: Ghana, Gabon, Botswana, and Kenya, and (2) scrutinize assumptions linking changes in disease patterns to economic development and modernization. Our findings suggest that non-communicable and communicable diseases warrant equal research attention and financial commitment in pursuit of health equity.
Comparison of Inadequate Nutrient Intakes in non-Hispanic Blacks vs. non-Hispanic Whites: An Analysis of NHANES 2007–2010 in U.S. Children and Adults
Authors: Papanikolaou Yanni , Brooks James , Reider Carroll , Fulgoni Victor L.
Published: August 2015

Using total nutrient intake from the National Health and Nutrition Examination Survey 2007–2010, we determined usual nutrient intakes in non-Hispanic Black and non-Hispanic White children and adults. Mean usual intakes for calcium; phosphorus; magnesium; and vitamins A, C, and D for non-Hispanic Black children and adults were significantly lower across ages compared with their non-Hispanic White counterparts. A greater percentage of non-Hispanic Blacks were below the Estimated Average Requirement for calcium, phosphorus and magnesium relative to non-Hispanic Whites across all ages. Similarly, a greater percentage of non-Hispanic Black children and adults had a greater percentage below the EAR for vitamins A and D compared with non-Hispanic Whites. These data demonstrate that U.S. children and adults are falling short of reaching nutrient recommendations, with non-Hispanic Blacks being particularly vulnerable. As dietary and nutrient recommendations evolve, specific strategies to increase consumption of vitamins and minerals in the U.S. non-Hispanic Black population should be considered.
The Waponahki Tribal Health Assessment: Successfully Using CBPR to Conduct a Comprehensive and Baseline Health Assessment of Waponahki Tribal Members
Authors: Johansson Patrik , Knox-Nicola Patricia , Schmid Kendra
Published: August 2015

Objective . Describe a community-based participatory research effort between Tribal Health Departments in Maine and the University of Nebraska Medical Center (UNMC), College of Public Health to conduct a modified behavioral risk factors surveillance system with five Tribal communities in Maine. Methods . The study incorporated a long-distance community-based participatory research approach where Tribal Health Directors selected domains for the survey, modified the questions as needed, and advertised/recruited for the survey. Tribal interviewers trained via UNMC College of Public Health webinars conducted the surveys via computer assisted personal interviews at Tribal health centers or other Tribal facilities. Tribal interviewers uploaded surveys from the sites into a UNMC firewall protected data base. Results . 1,127 Tribal members completed the survey. Conclusions . The methodology of this study can be adapted to other communities who wish to work longdistance with academic institutions to conduct community-based participatory research.
Impact of an Intervention to Minimize Overdiagnosis of Malaria Cases in a Low Risk Kenyan sub-County
Authors: Njuguna John , Menge Daniel , Nzou Joseph , Chege Charles
Published: August 2015

Introduction . Overdiagnosis of malaria cases hampers malaria control in developing countries. Due to lack of diagnostics, febrile cases are treated using signs and symptoms. We evaluated an intervention to minimize overdiagnosis in Ijara sub-County, Kenya. Methods . Health workers were trained on case management and rapid diagnostic tests provided in late 2011. Malaria outpatient morbidity was assessed a year before and after the intervention coupled with data on rapid diagnostic tests consumption. Results . The number of diagnosed malaria cases decreased from 15,615 in 2011 to 1,892 in 2012. This represents an 87.8% decrease. There was a significant difference in number of diagnosed monthly malaria cases during the pre-intervention (Mean = 1,299, SD = 550.4) and post-intervention periods (Mean = 158, SD = 160.9, t (12.9) = 6.9, p =.000, two tailed). Mean monthly consumption of rapid diagnostic tests was 730, with 5.2% testing positive. Conclusion . This intervention reduced overdiagnosis and overtreatment of malaria cases.
Mexican Immigrant Health: Health Insurance Coverage Implications
Authors: Brown Henry Shelton , Wilson Kimberly J. , Angel Jacqueline L.
Published: August 2015

A key facet of the Patient Protection and Affordable Care Act (PPACA) is the expansion of health insurance coverage. However, even with the PPACA, an estimated 11.2 million undocumented immigrants will remain uncovered. The majority of the remaining uncovered immigrant population is of Mexican origin. We assess the long-term benefits and short-term costs of providing coverage to male migrants from Mexico, employing data from the 2007–2011 Mexican Migration Project (MMP) and the 2009 Medical Expenditures Panel (MEPS) survey. Our results show that health status prior to migration, age at time of interview, emigrating from Central Mexico, and use of health services in the U.S. all predict declines in health at a significant level. We also find that having spent more than 10 cumulative years in the U.S. has borderline significance in predicting health decline (p=.052). Estimated coverage costs for health insurance for largely undocumented immigrants increase over time, but remain lower than those of comparable U.S.-born individuals. We conclude with several policy implications.
Parent and African American Daughter Obesity Prevention Interventions: An Integrative Review
Authors: Reed Monique , Wilbur JoEllen , Schoeny Michael
Published: August 2015

Background . In the U.S., overweight/obesity among African American (AA) girls has become epidemic. Since parental factors may be associated with improved weight status, it is important to understand the empirical evidence for including parents in obesity prevention interventions with AA girls. The purpose of this integrative review was to identify effectiveness and characteristics of obesity prevention interventions for AA girls (6–17 years) and their parent. Methods . Included interventions addressed physical activity (PA), dietary/eating behaviors, and body composition. Results . Of 708 studies published through March 2014, eight met inclusion criteria. Though effects were in the intended direction for most, statistically significant effects were found only for dietary intake and eating behavior. Discussion . Interventions were characterized by exclusion of girls ages 13–17, failure to link parent involvement to child outcomes, the absence of family systems theory, and modest effects. Further research is needed to ascertain the effectiveness of daughter/parent obesity prevention interventions.
Comparative Analysis of Health Care Needs among Children with Special Health Care Needs in Ohio’s Metropolitan and Appalachian Counties
Authors: Earley Elizabeth , Asti Lindsey , Chisolm Deena
Published: August 2015

The study assessed whether children with special health care needs (CSHCN) living in Appalachian Ohio have differential health care utilization, unmet needs, and health outcomes compared with CSHCN in Ohio’s metropolitan counties using a statewide Ohio survey. Based on this survey, an estimated 28% of children in Appalachian Ohio counties have special health care needs compared with 25% of children in metropolitan counties. In Appalachia, CSHCN are poorer and more likely to have Medicaid than their metropolitan counterparts, but had no reported significant differences in health outcomes or unmet needs. Data suggested a trend toward higher use of emergency department care and inpatient services and lower use of well-child visits but these differences did not reach significance. We conclude that CSHCN in Appalachian and metropolitan areas face similar levels of health status and unmet needs but results suggest a need for additional research on access to primary care services.
Financing investment in sub-Saharan Africa: Savings, human development, or institutions?
Authors: Caceres Luis Rene , Caceres Susan Ann
Published: August 2015

The role of national and external savings on economic growth in developing countries has received considerable attention in Economics. Recent research has investigated the roles of human capital and institutions in promoting economic growth, with results that show that human development and solid institutions exert important impacts on growth during the process of socio-economic development in developing countries. The question that arises is which variable is of more significance, be it savings, human capital or institutional strength, and whether these variables complement each other. To shed light on this matter this paper presents the results of a Vector Auto-regressive Model, VAR, consisting of the variables: the human development index, a governance indicator, rule of law, net development assistance, national savings, and public and private investment. The VAR is estimated with panel data from a sample of 24 Sub-Saharan African countries, with data from the 2003-2006 period. The results indicate that the human development index and the governance indicator are the main determinants of savings and investment, and both exert negative impacts on external assistance. As well, external savings exert negative impacts on human development and rule of law. These two variables are complementary and both support public and private investment. It is argued that by virtue of its positive impact on the mobilization of savings, human development can decrease developing countries’ external vulnerability. It is postulated that the attention to early childhood education and health can result in a more dynamic economy, one that generates larger tax revenues, such that the additional tax revenues can offset the initial expenditures incurred in promoting social development. The paper ends with a series of considerations on the need to expand the financing of human development as a means to attain social and economic stability and promote dynamic economic growth.