bluuebunny/crossref_metadata_2025 huggingface dataset:
Association of Aortic Stiffness With Left Ventricular Remodeling and Reduced Left Ventricular Function Measured by Magnetic Resonance Imaging
Authors: Ohyama Yoshiaki , Ambale-Venkatesh Bharath , Noda Chikara , Chugh Atul R. , Teixido-Tura Gisela , Kim Jang-Young , Donekal Sirisha , Yoneyama Kihei , Gjesdal Ola , Redheuil Alban , Liu Chia-Ying , Nakamura Tetsuya , Wu Colin O. , Hundley W. Gregory , Bluemke David A. , Lima Joao A.C.
Published: June 2016

Background—

This study sought to assess cross-sectional associations of aortic stiffness assessed by magnetic resonance imaging with left ventricular (LV) remodeling and myocardial deformation in the Multi-Ethnic Study of Atherosclerosis (MESA).

Methods and Results—

Aortic arch pulse wave velocity (PWV) was measured with phase contrast cine magnetic resonance imaging. LV circumferential strain (Ecc), torsion, and early diastolic strain rate were determined by tagged magnetic resonance imaging. Multivariable linear regression models were used to adjust for demographics and cardiovascular risk factors. Of 2093 participants, multivariable linear regression models demonstrated that higher arch PWV was associated with higher LV mass index (
B
=0.53 per 1 SD increase for log-transformed PWV,
P
<0.05) and LV mass to volume ratio (
B
=0.015,
P
<0.01), impaired LV ejection fraction (LVEF;
B
=−0.84;
P
<0.001), Ecc (
B
=0.55;
P
<0.001), torsion (
B
=−0.11;
P
<0.001), and early diastolic strain rate (
B
=−0.003;
P
<0.05). In sex stratified analysis, higher arch PWV was associated with higher MVR (
B
=0.02;
P
<0.05), impaired Ecc (
B
=0.60;
P
<0.001), and LVEF (
B
=−0.45;
P
<0.05), but with maintained torsion in women. Higher PWV was associated with impaired Ecc (
B
=0.49;
P
<0.001) and LVEF (
B
=−1.21;
P
<0.001), with lower torsion (
B
=−0.17;
P
<0.001) in men.

Conclusions—

Higher arch PWV is associated with LV remodeling, and reduced LV systolic and diastolic function in a large multiethnic population. Greater aortic arch stiffness is associated with concentric LV remodeling and relatively preserved LVEF with maintained torsion in women, whereas greater aortic arch stiffness is associated with greater LV dysfunction demonstrated as impaired Ecc, torsion, and LVEF, with less concentric LV remodeling in men.
Tissue-Type Plasminogen Activator-A
296–299
Prevents Impairment of Cerebral Autoregulation After Stroke Through Lipoprotein-Related Receptor–Dependent Increase in cAMP and p38
Authors: Armstead William M. , Riley John , Yarovoi Serge , Higazi Abd Al-Roof , Cines Douglas B.
Published: June 2016

Background and Purpose—

The sole Food and Drug Administration–approved treatment for stroke is tissue-type plasminogen activator (tPA), but its brief therapeutic window and complications of treatment constrain its use. One limitation may be its potential to exacerbate impairment of cerebral autoregulation after stroke. Vasodilation is maintained by elevations in cAMP. However, cAMP levels fall after stroke because of overactivation of N-methyl-
d
-aspartate receptors by toxic levels of glutamate, an effect that is exacerbated by tPA. Binding of wild-type (wt) tPA to the low-density lipoprotein–related receptor (LRP) mediates dilation. We propose that binding of wt-tPA to N-methyl-
d
-aspartate receptor reduces cAMP and impairs vasodilation. We hypothesize that tPA-A
296–299
, a variant that is fibrinolytic but cannot bind to N-methyl-
d
-aspartate receptor, preferentially binds to LRP and increases cAMP and p38, limiting autoregulation impairment after stroke.

Methods—

Stroke was induced by photothrombosis in pigs equipped with a closed cranial window, cerebral blood flow determined by microspheres, and cerebrospinal fluid cAMP and p38 determined by ELISA.

Results—

Stroke decreased cerebral blood flow. Cerebral blood flow was reduced further during hypotension, indicating impairment of autoregulation. Autoregulation was further impaired by wt-tPA, which was prevented by MK801 and tPA-A
296–299
. Protection by tPA-A
296–299
was blocked by anti-LRP Ab, the LRP antagonist receptor-associated protein, and the p38 inhibitor SB 203580, but not by control IgG. Stroke reduced cerebrospinal fluid cAMP, which was reduced further by wt-tPA, but augmented by tPA-A
296–299
. Cerebrospinal fluid p38 was unchanged by wt-tPA, increased by tPA-A
296–299
, and decreased by anti-LRP Ab and receptor-associated protein.

Conclusions—

tPA-A
296–299
prevents impairment of cerebral autoregulation after stroke through an LRP-dependent increase in cAMP and p38.
AEFP at Forty: Looking Back and Thinking Forward
Authors: Brewer Dominic J. , Miranda Chandler P.
Published: June 2016

Founded in 1975, the Association for Education Finance and Policy (AEFP) has evolved into a professional and academic association representing a variety of disciplines and perspectives on a growing array of education finance and education policy issues. On the occasion of the organization's fortieth anniversary, the authors look at the organization's evolution and consider how its future will be shaped by economic and social trends, as well as the evolution of education finance and policy.
Discriminating the Mineralogical Composition in Drill Cuttings Based on Absorption Spectra in the Terahertz Range
Authors: Miao Xinyang , Li Hao , Bao Rima , Feng Chengjing , Wu Hang , Zhan Honglei , Li Yizhang , Zhao Kun
Published: June 2016

Understanding the geological units of a reservoir is essential to the development and management of the resource. In this paper, drill cuttings from several depths from an oilfield were studied using terahertz time domain spectroscopy (THz-TDS). Cluster analysis (CA) and principal component analysis (PCA) were employed to classify and analyze the cuttings. The cuttings were clearly classified based on CA and PCA methods, and the results were in agreement with the lithology. Moreover, calcite and dolomite have stronger absorption of a THz pulse than any other minerals, based on an analysis of the PC1 scores. Quantitative analyses of minor minerals were also realized by building a series of linear and non-linear models between contents and PC2 scores. The results prove THz technology to be a promising means for determining reservoir lithology as well as other properties, which will be a significant supplementary method in oil fields.
Theoretical dimensions for interrogating the intersection of disability, immigration and social work
Authors: El-Lahib Yahya
Published: June 2016

This article proposes theoretical dimensions to examine the intersection of disability and immigration. These dimensions bring together knowledge from critical disability studies and postcolonial theories to inform a social justice orientation to social work practice on issues of immigration and disability. The article describes three interrelated themes that bring these theoretical dimensions together: (a) knowledge production and dominance in terms of North/South power dynamics and relations, (b) the construction and processes of Othering and how these shape the experiences of people with disabilities in immigration and (c) resistance to these constructions of Othering.
Toponymic Inscription as an Instrument of Power in Africa: The case of colonial and post-colonial Dakar and Nairobi
Authors: Njoh Ambe J
Published: June 2016

This study analyses toponymic inscription, the exercise of street/place naming, as a tool for articulating power in Anglophone and Francophone Africa. The focus is on Dakar, Senegal and Nairobi, Kenya, which were respectively indispensable for the colonial projects of France and Britain in Africa. Dakar was for France’s West African Federation what Nairobi was for Britain’s colonial East Africa. It is shown that toponymic inscription was used with equal zeal by French and British colonial authorities to express power in built space. Thus, both authorities used the occasion to christen streets and places as an opportunity to project Western power in Africa. With the demise of colonialism, indigenous authorities in Kenya inherited the Western vocabulary of spatiality but speedily moved to supplant Eurocentric with Afrocentric street/place-names. In contrast, post-colonial authorities in Senegal remain wedded to the colonial tradition of drawing most important street- and place-names from the Eurocentric cultural lexicon. Consequently, although the vocabulary of spatiality in Nairobi projects African nationalism and power, that of Dakar continues to express mainly Western power.
Hepatitis A Infections among Food Handlers in the United States, 1993–2011
Authors: Sharapov Umid M. , Kentenyants Karine , Groeger Justina , Roberts Henry , Holmberg Scott D. , Collier Melissa G.
Published: June 2016

We reviewed news reports of hepatitis A virus (HAV)-infected food handlers in the United States from 1993 to 2011 using the LexisNexis® search engine. Using U.S. news reports, we identified 192 HAV-infected food handlers who worked while infectious; of these HAV-infected individuals, 34 (18%) transmitted HAV to restaurant patrons. News reports of HAV-infected food handlers declined from 1993 to 2011. This analysis suggests that universal childhood vaccination contributed to the decrease in reports of HAV-infected food handlers, but mandatory vaccination of this group is unlikely to be cost-effective.
Shifting Resources and Focus to Meet the Goals of the National HIV/AIDS Strategy: The Enhanced Comprehensive HIV Prevention Planning Project, 2010–2013
Authors: Flores Stephen A. , Purcell David W. , Fisher Holly H. , Belcher Lisa , Carey James W. , Courtenay-Quirk Cari , Dunbar Erica , Eke Agatha N. , Galindo Carla A. , Glassman Marlene , Margolis Andrew D. , Neumann Mary Spink , Prather Cynthia , Stratford Dale , Taylor Raekiela D. , Mermin Jonathan ,   For the ECHPP Project Team
Published: June 2016

In September 2010, CDC launched the Enhanced Comprehensive HIV Prevention Planning (ECHPP) project to shift HIV-related activities to meet goals of the 2010 National HIV/AIDS Strategy (NHAS). Twelve health departments in cities with high AIDS burden participated. These 12 grantees submitted plans detailing jurisdiction-level goals, strategies, and objectives for HIV prevention and care activities. We reviewed plans to identify themes in the planning process and initial implementation. Planning themes included data integration, broad engagement of partners, and resource allocation modeling. Implementation themes included organizational change, building partnerships, enhancing data use, developing protocols and policies, and providing training and technical assistance for new and expanded activities. Pilot programs also allowed grantees to assess the feasibility of large-scale implementation. These findings indicate that health departments in areas hardest hit by HIV are shifting their HIV prevention and care programs to increase local impact. Examples from ECHPP will be of interest to other health departments as they work toward meeting the NHAS goals.
Systematic Review and Meta-Analysis of Inhaled Toxicants from Waterpipe and Cigarette Smoking
Authors: Primack Brian A. , Carroll Mary V. , Weiss Patricia M. , Shihadeh Alan L. , Shensa Ariel , Farley Steven T. , Fine Michael J. , Eissenberg Thomas , Nayak Smita
Published: June 2016

Objective.

Waterpipe tobacco smoking (WTS) is an emerging trend worldwide. To inform public health policy and educational programming, we systematically reviewed the biomedical literature to compute the inhaled smoke volume, nicotine, tar, and carbon monoxide (CO) associated with a single WTS session and a single cigarette.

Methods.

We searched seven biomedical bibliographic databases for controlled laboratory or natural environment studies designed to mimic human tobacco consumption. Included studies quantified the mainstream smoke of a single cigarette and/or single WTS session for smoke volume, nicotine, tar, and/or CO. We conducted meta-analyses to calculate summary estimates for the inhalation of each unique substance for each mode of tobacco consumption. We assessed between-study heterogeneity using chi-squared and I-squared statistics.

Results.

Sufficient data from 17 studies were available to derive pooled estimates for inhalation of each exposure via each smoking method. Two researchers working independently abstracted measurement of smoke volume in liters, and nicotine, tar, and CO in milligrams. All numbers included in meta-analyses matched precisely between the two researchers (100% agreement, Cohen's κ=1.00). Whereas one WTS session was associated with 74.1 liters of smoke inhalation (95% confidence interval [CI] 38.2, 110.0), one cigarette was associated with 0.6 liters of smoke (95% CI 0.5, 0.7). One WTS session was also associated with higher levels of nicotine, tar, and CO.

Conclusions.

One WTS session consistently exposed users to larger smoke volumes and higher levels of tobacco toxicants compared with one cigarette. These computed estimates may be valuable to emphasize in prevention programming.
The Public Health Nurse Workforce in U.S. State and Local Health Departments, 2012
Authors: Beck Angela J. , Boulton Matthew L.
Published: June 2016

Objective.

Public health nurses (PHNs) represent the single largest group of public health practitioners working in U.S. state and local health departments. Despite the important role of PHNs in the delivery and administration of public health services, little research has been conducted on this group and relatively little is known about PHN education, training, and retirement intentions. We describe the findings of a nationally representative survey of PHNs working in state and local health departments by characterizing their educational background and plans for retirement.

Methods.

An advisory committee convened by the University of Michigan Center of Excellence in Public Health Workforce Studies developed the Public Health Nurse Workforce Survey and disseminated it in 2012 to 50 U.S. state and 328 local health departments.

Results.

The 377 responding state and local health departments reported an estimated 34,521 full-time equivalent registered nurses in their employ, with PHNs or community health nurses as the largest group of workers (63%). Nearly 20% of state health department PHNs and 31% of local health department PHNs were educated at the diploma or associate's degree level. Approximately one-quarter of PHNs were determined to be eligible for retirement by 2016. Professional development and promotion opportunities, competitive benefits and salary, and hiring procedures were among the recruitment and retention issues reported by health departments.

Conclusion.

PHNs were reported to have highly variable occupational classifications and educational backgrounds in health departments. Additional training opportunities are needed for PHNs with diploma and associate's degrees. A shortage of PHNs is possible due to retirement eligibility and administrative barriers to recruitment and retention.
The Impact of the Affordable Care Act on Funding for Newborn Screening Services
Authors: Costich Julia F. , Durst Andrea L.
Published: June 2016

Objective.

The Affordable Care Act requires most health plans to cover the federal Recommended Uniform Screening Panel of newborn screening (NBS) tests with no cost sharing. However, state NBS programs vary widely in both the number of mandated tests and their funding mechanisms, including a combination of state laboratory fees, third-party billing, and other federal and state funding. We assessed the potential impact of the Affordable Care Act coverage mandate on states' NBS funding.

Method.

We performed an extensive review of the refereed literature, federal and state agency reports, relevant organizations' websites, and applicable state laws and regulations; interviewed 28 state and federal officials from August to December 2014; and then assessed the interview findings manually.

Results.

Although a majority of states had well-established systems for including laboratory-based NBS tests in bundled charges for newborn care, billing practices for critical congenital heart disease and newborn hearing tests were less uniform. Most commonly, birthing facilities either prepaid the costs of laboratory-based tests when acquiring the filter paper kits, or the facilities paid for the tests when the kits were submitted. Some states had separate arrangements for billing Medicaid, and smaller facilities sometimes contracted with hearing test vendors that billed families separately.

Conclusion.

Although the Affordable Care Act coverage mandate may offset some state NBS funding for the screenings themselves, federal support is still required to assure access to the full range of NBS program services. Limiting reimbursement to the costs of screening tests alone would undermine the common practice of using screening charges to fund follow-up services counseling, and medical food or formula, particularly for low-income families.
Health Department HIV Prevention Programs That Support the National HIV/AIDS Strategy: The Enhanced Comprehensive HIV Prevention Planning Project, 2010–2013
Authors: Fisher Holly H. , Hoyte Tamika , Purcell David W. , Van Handel Michelle , Williams Weston , Krueger Amy , Dietz Patricia , Stratford Dale , Heitgerd Janet , Dunbar Erica , Wan Choi , Linley Laurie A. , Flores Stephen A.
Published: June 2016

Objective.

The Enhanced Comprehensive HIV Prevention Planning project was the first initiative of the Centers for Disease Control and Prevention (CDC) to address the goals of the National HIV/AIDS Strategy (NHAS). Health departments in 12 U.S. cities with a high prevalence of AIDS conducted comprehensive program planning and implemented cost-effective, scalable HIV prevention interventions that targeted high-risk populations. We examined trends in health department HIV prevention programs in these cities during the project.

Methods.

We analyzed the number of people who received partner services, condoms distributed, and people tested for HIV, as well as funding allocations for selected HIV prevention programs by year and by site from October 2010 through September 2013. We assessed trends in the proportional change in services and allocations during the project period using generalized estimating equations. We also conducted thematic coding of program activities that targeted people living with HIV infection (PLWH).

Results.

We found significant increases in funding allocations for HIV testing and condom distribution. All HIV partner services indicators, condom distribution, and HIV testing of African American and Hispanic/Latino populations significantly increased. HIV tests associated with a new diagnosis increased significantly among those self-identifying as Hispanic/Latino but significantly decreased among African Americans. For programs targeting PLWH, health department activities included implementing new program models, improving local data use, and building local capacity to enhance linkage to HIV medical care, retention in care, and treatment adherence.

Conclusions.

Overall, these findings indicate that health departments in areas with a high burden of AIDS successfully shifted their HIV prevention resources to scale up important HIV programs and make progress toward NHAS goals.
Characteristics of Local Health Departments Associated with Implementation of Electronic Health Records and other Informatics Systems
Authors: Shah Gulzar H. , Leider Jonathon P. , Castrucci Brian C. , Williams Karmen S. , Luo Huabin
Published: June 2016

Objective.

Assessing local health departments' (LHDs') informatics capacities is important, especially within the context of broader, systems-level health reform. We assessed a nationally representative sample of LHDs' adoption of information systems and the factors associated with adoption and implementation by examining electronic health records, health information exchange, immunization registry, electronic disease reporting system, and electronic laboratory reporting.

Methods.

We used data from the National Association of County and City Health Officials' 2013 National Profile of LHDs. We performed descriptive statistics and multinomial logistic regression for the five implementation-oriented outcome variables of interest, with three levels of implementation (implemented, plan to implement, and no activity). Independent variables included infrastructural and financial capacity and other characteristics associated with informatics capacity.

Results.

Of 505 LHDs that responded to the survey, 69 (13.5%) had implemented health information exchanges, 122 (22.2%) had implemented electronic health records, 245 (47.5%) had implemented electronic laboratory reporting, 368 (73.0%) had implemented an electronic disease reporting system, and 416 (83.8%) had implemented an immunization registry. LHD characteristics associated with health informatics adoption included provision of greater number of clinical services, greater per capita public health expenditures, health information systems specialists on staff, larger population size, decentralized governance system, one or more local boards of health, metropolitan jurisdiction, and top executive with more years in the job.

Conclusion.

Many LHDs lack health informatics capacity, particularly in smaller, rural jurisdictions. Cross-jurisdictional sharing, investment in public health informatics infrastructure, and additional training may help address these shortfalls.
Defining Sickle Cell Disease Mortality Using a Population-Based Surveillance System, 2004 through 2008
Authors: Paulukonis Susan T. , Eckman James R. , Snyder Angela B. , Hagar Ward , Feuchtbaum Lisa B. , Zhou Mei , Grant Althea M. , Hulihan Mary M.
Published: June 2016

Objective.

Population-based surveillance data from California and Georgia for years 2004 through 2008 were linked to state death record files to determine the all-cause death rate among 12,143 patients identified with sickle cell disease (SCD).

Methods.

All-cause death rates, by age, among these SCD patients were compared with all-cause death rates among both African Americans and the total population in the two states. All-cause death rates were also compared with death rates for SCD derived from publicly available death records: the compressed mortality files and multiple cause of death files.

Results.

Of 12,143 patients identified with SCD, 615 patients died. The all-cause mortality rate for the SCD population was lower than the all-cause mortality rate among African Americans and similar to the total population all-cause mortality rates from birth through age 4 years, but the rate was higher among those with SCD than both the African American and total population rates from ages 5 through 74 years. The count of deceased patients identified by using population-based surveillance data ( n=5615) was more than twice as high as the count identified in compressed mortality files using SCD as the underlying cause of death alone ( n=5297).

Conclusion.

Accurate assessment of all-cause mortality and age at death requires long-term surveillance via population-based registries of patients with accurately diagnosed SCD.
Scaling up HIV Testing in an Academic Emergency Department: An Integrated Testing Model with Rapid Fourth-Generation and Point-of-Care Testing
Authors: Signer Danielle , Peterson Stephen , Hsieh Yu-Hsiang , Haider Somiya , Saheed Mustapha , Neira Paula , Wicken Cassie , Rothman Richard E.
Published: June 2016

Objective.

We evaluated two approaches for implementing routine HIV screening in an inner-city, academic emergency department (ED). These approaches differed by staffing model and type of HIV testing technology used. The programmatic outcomes assessed included the total number of tests performed, proportion of newly identified HIV-positive patients, and proportion of newly diagnosed individuals who were linked to care.

Methods.

This study examined specific outcomes for two distinct, successive approaches to implementing HIV screening in an inner-city, academic ED, from July 2012 through June 2013 (Program One), and from August 2013 through July 2014 (Program Two). Program One used a supplementary staff-only HIV testing model with point-of-care (POC) oral testing. Program Two used a triage-integrated, nurse-driven HIV testing model with fourth-generation blood and POC testing, and an expedited linkage-to-care process.

Results.

During Program One, 6,832 eligible patients were tested for HIV with a rapid POC oral HIV test. Sixteen patients (0.2%) were newly diagnosed with HIV, of whom 13 were successfully linked to care. During Program Two, 8,233 eligible patients were tested for HIV, of whom 3,124 (38.0%) received a blood test and 5,109 (62.0%) received a rapid POC test. Of all patients tested in Program Two, 29 (0.4%) were newly diagnosed with HIV, four of whom had acute infections and 27 of whom were successfully linked to care. We found a statistically significant difference in the proportion of the eligible population tested—8,233 of 49,697 (16.6%) in Program Two and 6,832 of 46,818 (14.6%) in Program One. These differences from Program One to Program Two corresponded to increases in testing volume ( n = 1,401 tests), number of patients newly diagnosed with HIV ( n=13), and proportion of patients successfully linked to care (from 81.0% to 93.0%).

Conclusion.

Integrating HIV screening into the standard triage workflow resulted in a higher proportion of ED patients being tested for HIV as compared with the supplementary staff-only HIV testing model. New rapid fourth-generation testing technology allowed the identification of acute HIV infection and same-visit confirmation of a positive diagnosis.
A Comparison of Parallel and Integrated Models for Implementation of Routine HIV Screening in a Large, Urban Emergency Department
Authors: Hankin Abigail , Freiman Heather , Copeland Brittney , Travis Natasha , Shah Bijal
Published: June 2016

Objective.

This study compared two approaches for implementation of nontargeted HIV screening in the emergency department (ED): ( 1) designated HIV counselors screening in parallel with ED care and ( 2) nurse-based screening integrated into patient triage.

Methods.

A retrospective analysis was performed to compare parallel and integrated screening models using data from the first 12 months of each program. Data for the parallel screening model were extracted from information collected by HIV test counselors and the electronic medical record (EMR). Integrated screening model data were extracted from the EMR and supplemented by data collected by HIV social workers during patient interaction. For both programs, data included demographics, HIV test offer, test acceptance or declination, and test result. A Z-test between two proportions was performed to compare screening frequencies and results.

Results.

During the first 12 months of parallel screening, approximately 120,000 visits were made to the ED, with 3,816 (3%) HIV tests administered and 65 (2%) new diagnoses of HIV infection. During the first 12 months of integrated screening, 111,738 patients were triaged in the ED, with 16,329 (15%) patients tested and 190 (1%) new diagnoses. Integrated screening resulted in an increased frequency of HIV screening compared with parallel screening (0.15 tests per ED patient visit vs. 0.03 tests per ED patient visit, p<0.001) and an increase in the absolute number of new diagnoses (190 vs. 65), representing a slight decrease in the proportion of new diagnoses (1% vs. 2%, p=0.007).

Conclusion.

Non-targeted, integrated HIV screening, with test offer and order by ED nurses during patient triage, is feasible and resulted in an increased frequency of HIV screening and a threefold increase in the absolute number of newly identified HIV-positive patients.
Integrating Routine HIV Testing into Family Planning Clinics That Treat Adolescents and Young Adults
Authors: Buzi Ruth S. , Madanay Farrah L. , Smith Peggy B.
Published: June 2016

Objective.

Adolescents and young adults remain at high risk for new HIV infections and for unknowingly transmitting the virus to others. Yet, they have demonstrated low rates of testing due to barriers such as stigma and difficulty accessing testing services. Few existing programs have successfully integrated family planning and HIV care services to improve testing and diagnosis rates among young adults and adolescents, particularly those of minority groups. This study describes the process of implementing HIV services into family planning clinics and how to train staff in routine, opt-out testing.

Methods.

This study used HIV screening data from 10 family planning clinics serving adolescents and young adults in Houston, Texas. A total of 34,299 patients were tested for HIV during a 48-month study period, from January 2010 through December 2014.

Results.

Patients tested included minors <18 years of age (25.5%), males (22.8%), and individuals who had missed opportunities for HIV testing at other health-care settings. From the opt-in period (2006–2007) to the routine, opt-out period (2008–2010), the yearly average number of tests administered more than doubled; the yearly average increased again by 50% from the routine, opt-out period to the routine, rapid period (2011–2014). Eighty-eight (0.3%) patients were diagnosed with HIV, a higher seropositivity rate than CDC's recommended threshold of 0.1% for settings where routine screening is warranted.

Conclusion.

Routine, opt-out HIV testing integrated into family planning clinics increased rates of testing acceptance, receipt of test results, and HIV-positive diagnoses among adolescents and young adults.
“Know Hepatitis B:” A Multilingual Communications Campaign Promoting Testing for Hepatitis B Among Asian Americans and Pacific Islanders
Authors: Jorgensen Cynthia , Chen Sherry , Carnes C. Amanda , Block Joan , Chen Daniel , Caballero Jeffrey , Moraras Kate , Cohen Chari
Published: June 2016

The “Know Hepatitis B” campaign was the first national, multilingual communications campaign to promote testing for hepatitis B virus (HBV) among Asian Americans and Pacific Islanders (AAPIs). This population comprises fewer than 5% of the total U.S. population but accounts for more than half of the up to 1.4 million Americans living with chronic HBV infection. To address this health disparity with a national campaign, CDC partnered with Hep B United, a national coalition of community-based partners working to educate AAPIs about hepatitis B and the need for testing. Guided by formative research, the “Know Hepatitis B” campaign was implemented in 2013 with a two-pronged communications strategy. CDC used available Chinese, Korean, and Vietnamese media outlets on a national level and relied on Hep B United to incorporate campaign materials into educational efforts at the local level. This partnership helped facilitate HBV testing among the priority population.
High-Yield Birth-Cohort Hepatitis C Virus Screening and Linkage to Care among Underserved African Americans, Atlanta, Georgia, 2012–2013
Authors: Miller Lesley S. , Rollin Francois , Fluker Shelly-Ann , Lundberg Kristina L. , Park Brandi , Quairoli Kristi , Niyibizi Nyiramugisha K. , Spaulding Anne C.
Published: June 2016

Objective.

Hepatitis C virus (HCV) infection disproportionately affects certain populations, including those born between 1945 and 1965 (i.e., baby boomers) and African Americans. As part of the Hepatitis Testing and Linkage to Care initiative, which promoted hepatitis B and hepatitis C screening, posttest counseling, and linkage to care at 34 U.S. sites, we conducted routine HCV screening to identify previously undiagnosed, primarily African American baby boomers with chronic hepatitis C infection and link them to care.

Methods.

We launched the Internal Medicine Trainees Identifying and Linking to Treatment for Hepatitis C (TILT-C) initiative at the Grady Memorial Hospital Primary Care Center and Grady Liver Clinic in Atlanta, Georgia, in October 2012, and present results from the first year. TILT-C faculty implemented an electronic medical record prompt and conducted educational sessions to boost HCV screening. A project coordinator tracked testing outcomes and linked HCV-positive patients to care.

Results.

Of 2,894 patients tested for anti-HCV, 201 (6.9%) tested positive. Men had a significantly higher ( p<0.001) prevalence of HCV infection than women, with 106 of 1,091 (9.7%) men compared with 95 of 1,803 (5.3%) women testing anti-HCV positive. A total of 174 of 201 (86.6%) anti-HCV-positive patients received HCV ribonucleic acid (RNA) testing. Of 124 patients with a positive HCV RNA test, 122 were referred to care and 120 attended the first appointment.

Conclusion.

The TILT-C screening program was feasible and effective in detecting previously undiagnosed HCV infection and linking patients to care. The unexpectedly high prevalence of HCV infection in this primarily African American, baby boomer population underscores the need for aggressive HCV screening efforts in similar populations.
Cognitive-behavioural therapy versus psychodynamic psychotherapy for the treatment of depression: a critical review of evidence and current issues
Authors: Goldstone Daniel
Published: June 2016

Two of the most popular psychotherapeutic approaches to treat depression are cognitive-behavioural therapy and psychodynamic psychotherapy, yet little consensus has been reached concerning which therapy is most beneficial for the treatment of depression. A review of the literature revealed that, while cognitive-behavioural therapy and psychodynamic psychotherapy are the most effective psychotherapeutic modalities for the treatment of depression, evidence suggests that neither of these modalities is superior to the other. Furthermore, multiple issues plague the studies investigating these treatments. Efficacy and effectiveness are often confounded, while rates of remission and response are often far less than might be expected from such highly regarded and widely used treatments. Severity of depression appears to moderate treatment outcomes, yet many studies overlook this, while the impact that the aetiology of a patient’s depression has on treatment outcomes is largely ignored in the literature. Additionally, a majority of studies have focused on therapies of short duration, which often have poor follow-up results. Finally, mechanisms of change in the treatment of depression have been ignored to a large extent, but there is some evidence that non-specific therapeutic factors may be more important than specific therapeutic techniques in producing positive treatment outcomes. These issues need to be closely examined and resolved if researchers and clinicians are serious about optimising treatments, improving outcomes, and adequately addressing the serious problem of depression.
Evaluation of the Measurement Properties of Self-reported Medication Adherence Instruments Among People at Risk for Metabolic Syndrome
Authors: Kim Chun-Ja , Schlenk Elizabeth A. , Ahn Jeong-Ah , Kim Moonsun , Park Eunyoung , Park JeeWon
Published: June 2016

Purpose

The purpose of this study was to present a systematic review of available published studies that evaluated the measurement properties of self-reported instruments assessing global medication adherence in adults at risk for metabolic syndrome.

Methods

The authors searched PubMed, EMBASE, PsycINFO, and CINAHL in January 2015 for appropriate studies. The methodological quality (based on reliability, validity, responsiveness, and interpretability) of selected studies was assessed with the COSMIN checklist (Consensus-Based Standards for the Selection of Health Measurement Instruments).

Results

Of the 44 studies reviewed, 32 used classical test theory, and 14 used self-reported medication adherence instruments. More than half the studies included patients with hypertension, followed by diabetes, dyslipidemia, and increased body mass index. Among the measurement properties, internal consistency, hypothesis testing, and structural validity were frequently assessed items, whereas only 1 study evaluated responsiveness, and none evaluated measurement error. The MMAS-8 (Morisky Medication Adherence Scale–8 items) and the Hill-Bone scale were the most frequently used instruments. They were found to be well validated, with strong evidence for internal consistency and strong positive evidence for reliability, structural validity, hypothesis testing, and criterion validity.

Conclusions

The MMAS-8 and Hill-Bone scale seem to be well-validated instruments for assessing medication adherence in adults at risk for metabolic syndrome. These findings may assist clinicians with selecting the appropriate instruments for assessing medication adherence in this population. However, further studies might be needed to define concepts to better understand the dimensions of each medication adherence instrument.
Social Support and Cognition
Authors: Kang Duck-Hee , Boss Lisa , Clowtis Licia
Published: June 2016

Cognitive development in early childhood and cognitive preservation in older adulthood are critical for leading healthy life. Social engagement can significantly affect cognition, but their relationships are unclear. The purpose of this review was to synthesize current findings on the relationship between social engagement and cognition in early childhood and older adulthood. PubMed, Web of Science, Ovid Medline, and PsycINFO were searched for studies published in 1995-2015 for a comprehensive review. Included in this review were 42 articles written in English, published in peer-reviewed journals with participants’ age being 2 to 6 or ≥65 years, and measurement of social engagement and cognition. Overall, greater social engagement was associated with higher levels of cognition across the life span, association of which seemed more prominent in populations at risk of cognitive impairment. Additional research is needed to elucidate biobehavioral mechanisms underlying these relationships and to test the efficacy of new interventions.
Medical Information Exchange
Authors: Siegal Gil , Dagan Elad , Wolf Michael , Duvdevani Shay , Alon Eran E.
Published: June 2016

Objective

Information technology has revolutionized health care. However, the development of dedicated mobile health software has been lagging, leading to the use of general mobile applications to fill in the void. The use of such applications has several legal, ethical, and regulatory implications. We examined the experience and practices governing the usage of a global mobile messenger application (WhatsApp) for mobile health purposes in a national cohort of practicing otolaryngologists in Israel, a known early adaptor information technology society.

Methods

Cross‐sectional data were collected from practicing otolaryngologists and otolaryngology residents via self‐administered questionnaire. The questionnaire was composed of a demographic section, a section surveying the practices of mobile application use, mobile health application use, and knowledge regarding institutional policies governing the transmission of medical data.

Results

The sample included 22 otolaryngology residents and 47 practicing otolaryngologists. Of the physicians, 83% worked in academic centers, and 88% and 40% of the physicians who worked in a hospital setting or a community clinic used WhatsApp for medical use, respectively. Working with residents increased the medical usage of WhatsApp from 50% to 91% (P =. 006). Finally, 72% were unfamiliar with any institutional policy regarding the transfer of medical information by personal smartphones.

Discussion

Mobile health is becoming an integral part of modern medical systems, improving accessibility, efficiency, and possibly quality of medical care.

Implications for Practice

The need to incorporate personal mobile devices in the overall information technology standards, guidelines, and regulation is becoming more acute. Nonetheless, practices must be properly instituted to prevent unwanted consequences.
Head and Neck Manifestations of Eosinophilic Granulomatosis with Polyangiitis
Authors: Goldfarb Jared M. , Rabinowitz Mindy R. , Basnyat Shristi , Nyquist Gurston G. , Rosen Marc R.
Published: June 2016

Objective

To conduct the first and only systematic review of the existing literature on head and neck manifestations of eosinophilic granulomatosis with polyangiitis to guide clinical decision making for the otolaryngologist.

Data Sources

PubMed, Cochrane Library, Scopus, and LILACS.

Review Methods

A systematic review of the aforementioned sources was conducted per the PRISMA guidelines.

Results

From an initial 574 studies, 28 trials and reports were included, accounting for a total of 1175 patients with eosinophilic granulomatosis with polyangiitis. Among clinical and cohort studies, 48.0% to 96.0% of all included patients presented with head and neck manifestations. In a distinct group of patients detailed in case reports describing patients presenting with head and neck manifestations, patients on average fulfilled 4.6 diagnostic criteria per the American College of Rheumatology. Furthermore, 95.8% of reported cases were responsive to steroids, and 60% required additional therapy.

Conclusion

Otolaryngologists are in a unique position for the early diagnosis and prevention of late complications of eosinophilic granulomatosis with polyangiitis. The American College of Rheumatology criteria should be relied on in the diagnostic workup. Close surveillance of these patients in a multidisciplinary fashion and with baseline complete blood counts, chest radiographs, and autoimmune laboratory tests is often necessary. Such patients with head and neck manifestations of the disease are nearly always responsive to steroids and often require additional immunosuppressive therapy or surgical intervention in cases of cranial neuropathies, temporal bone involvement, and refractory symptoms.
Collagen Content Limits Optical Coherence Tomography Image Depth in Porcine Vocal Fold Tissue
Authors: Garcia Jordan A. , Benboujja Fouzi , Beaudette Kathy , Rogers Derek , Maurer Rie , Boudoux Caroline , Hartnick Christopher J.
Published: June 2016

Objective

Vocal fold scarring, a condition defined by increased collagen content, is challenging to treat without a method of noninvasively assessing vocal fold structure in vivo. The goal of this study was to observe the effects of vocal fold collagen content on optical coherence tomography imaging to develop a quantifiable marker of disease.

Study Design

Excised specimen study.

Setting

Massachusetts Eye and Ear Infirmary.

Subjects and Methods

Porcine vocal folds were injected with collagenase to remove collagen from the lamina propria. Optical coherence tomography imaging was performed preinjection and at 0, 45, 90, and 180 minutes postinjection. Mean pixel intensity (or image brightness) was extracted from images of collagenase‐ and control‐treated hemilarynges. Texture analysis of the lamina propria at each injection site was performed to extract image contrast. Two‐factor repeated measure analysis of variance and t tests were used to determine statistical significance. Picrosirius red staining was performed to confirm collagenase activity.

Results

Mean pixel intensity was higher at injection sites of collagenase‐treated vocal folds than control vocal folds (P <. 0001). Fold change in image contrast was significantly increased in collagenase‐treated vocal folds than control vocal folds (P =. 002). Picrosirius red staining in control specimens revealed collagen fibrils most prominent in the subepithelium and above the thyroarytenoid muscle. Specimens treated with collagenase exhibited a loss of these structures.

Conclusion

Collagen removal from vocal fold tissue increases image brightness of underlying structures. This inverse relationship may be useful in treating vocal fold scarring in patients.
European Commission, trade agreements and diversity of cultural expressions: Between autonomy and influence
Authors: Vlassis Antonios
Published: June 2016

The Convention on diversity of cultural expressions – adopted by United Nations Educational, Scientific and Cultural Organization in 2005 – is a main international instrument within the global governance of cultural and audiovisual industries. For its part, the European Commission played a critical role in the negotiation, leading to the Convention on Diversity of Cultural Expressions’ adoption. In this respect, the article aims to explore why and how the Commission uses the Convention on Diversity of Cultural Expressions throughout the recent European Union trade negotiations, for which purposes and how the Convention on Diversity of Cultural Expressions influences the European Union foreign policy and its objectives. The article is more concerned with analysing the policy process through which the Commission’s strategy is formulated in light of the Convention on Diversity of Cultural Expressions and of the place of cultural and audiovisual industries within the European Union trade agreements and also concerned with understanding whether the Commission’s autonomy is transformed into influence within the policy process.
When efficiency meets clientelism: Spectrum management policy and broadcasting model – The Spanish case
Authors: Bonet Montse , Guimerà i Orts Josep Àngel
Published: June 2016

According to the predominating discourse, the radio spectrum has been converted into a technological platform of strategic importance for the economic development of countries. Wireless Internet and the promises of access at ‘any time, in any place’ add political and economic pressure to a platform, which has been an almost exclusive monopoly of radio and television for years. The main aim of this article is to study the radio spectrum management in Spanish broadcasting from its origins until the present day. The article also seeks to show the existing relationship between how frequencies are managed and the resulting broadcast model.
Sustainability and small enterprises in Scotland’s remote rural ‘margins’
Authors: Burnett Kathryn A , Danson Mike
Published: June 2016

A critical yet timely commentary is offered on the nature of sustainability narratives in reference to current small business enterprise in remote Scotland with a key focus on ‘place context’ and the complex interplay of social and material resources. A review of the academic and policy literature supports an interpretative, qualitative approach to examining the digital media texts of various small island small and medium enterprises (SMEs) in Scotland that are most especially championing the localness and placeness of their product, and most especially using this as a coded referencing of sustainability, localness, community ethics and trust. The extent of ‘co-production’ narratives of sustainability informed by ‘localness’ in areas that are typically ‘rural’ yet particularly ‘remote’ – where ‘margin’ as an idea and as practice is appropriated and deployed to entrepreneurial effect – are demonstrated. ‘Survival’ is revisited and reflections on its place within enterprise narrative as ‘margins’ are redefined; remoteness is increasingly celebrated as a sustainable reality.