bluuebunny/crossref_metadata_2025 huggingface dataset:
Medical Care and Alcohol Use after Testing Hepatitis C Antibody Positive at STD Clinic and HIV Test Site Screening Programs
Authors: Mark Karen E. , Murray Paula J. , Callahan David B. , Gunn Robert A.
Published: July 2017

Objectives.

The Centers for Disease Control and Prevention recommend screening individuals at risk for hepatitis C virus (HCV) infection. However, few published data describe outcomes of individuals with antibody to HCV (anti-HCV) identified through screening programs. The purpose of this study was to assess rates of medical evaluation and HCV treatment, change in alcohol consumption, and barriers to medical care after testing anti-HCV positive through a public screening program.

Methods.

Anti-HCV positive individuals identified through San Diego sexually transmitted disease (STD) clinics and an HIV test site screening program were informed of positive test results, provided education and referral, and contacted by telephone three, six, and ≥12 months later.

Results.

From September 1, 1999, to December 31, 2001, 411 anti-HCV positive individuals were newly identified, of whom 286 (70%) could be contacted ≥ three months after receipt of test results (median length [range] of follow-up 14 [3–35] months). Of these 286, 156 (55%) reported having received a medical evaluation, of whom 19 (12%) began HCV treatment. Of 132 who reported drinking alcohol before diagnosis, 100 (76%) reported drinking less after diagnosis. Individuals with medical insurance at diagnosis were more likely than those without insurance to obtain a medical evaluation during follow-up (75 [68%] of 111 vs. 70 [45%] of 155; p<0.001). Among those who did not obtain an evaluation, the most commonly reported reason was lack of insurance.

Conclusions.

Only about half of newly identified anti-HCV positive individuals received a medical evaluation, although 76% reported drinking less alcohol. Identifying ways to improve medical access for those who are anti-HCV positive could improve the effectiveness of screening programs.
Vaccination in Juvenile Correctional Facilities: State Practices, Hepatitis B, and the Impact on Anticipated Sexually Transmitted Infection Vaccines
Authors: Tedeschi Sara K. , Bonney Loida E. , Manalo Rosario , Mayer Kenneth H. , Shepardson Susan , Rich Josiah D. , Lally Michelle A.
Published: July 2017

Objectives.

Juvenile correctional facilities are an ideal setting to provide preventive vaccines to adolescents who are at risk. In many instances of incarceration, facilities overcome the need for parental consent by making young people wards of the state and the state providing consent. The authors investigated current state practices for administering hepatitis B vaccine to incarcerated adolescents. These may impact the delivery of anticipated sexually transmitted infection (STI) vaccines to incarcerated adolescents.

Methods.

From June to August 2004, interviews were conducted with state Immunization Program Managers by telephone about hepatitis B vaccination and consent policies in juvenile correctional facilities.

Results.

Forty-five states were able to provide information about hepatitis B immunization in publicly funded juvenile correctional facilities. Forty-one of the 45 states offered hepatitis B vaccine to adolescents who were sentenced and thereby considered to be wards of the state. Of those 41 states, 20 also made hepatitis B vaccine easily accessible to detained adolescents (no parental consent required). Those 20 states considered detained adolescents as wards of the state ( n=13), or allowed them to self-consent for the vaccine ( n=7).

Conclusions.

Most states offer hepatitis B vaccination to sentenced adolescents in correctional facilities. Just over half of these states also vaccinate detained adolescents. Juvenile correctional facilities have experience administering vaccines, and this might allow for expansion of vaccination services when new STI vaccines become available. Still, there are major barriers to universal vaccination of incarcerated adolescents, including the issue of consent.
Limited Spending: An Analysis of Correctional Expenditures on Antiretrovirals for HIV-Infected Prisoners
Authors: Zaller Nick , Thurmond Portia , Rich Josiah D.
Published: July 2017

Objective.

Correctional facilities provide a critical opportunity to treat and manage human immunodeficiency virus (HIV) and HIV-related complications among inmates. Inmates bear a higher HIV burden than the general population, and many have never received HIV care prior to incarceration. The standard of care in the community and in corrections for the treatment of HIV is highly active antiretroviral therapy (HAART). This study evaluated U.S. correctional expenditures for antiretrovirals (ARVs) and compared them to the estimated need for ARVs among HIV-infected prisoners in the U.S. to treat this population successfully.

Methods.

The total number of HIV-infected prisoners in the United States was estimated using Bureau of Justice Statistics data. The National Sales Perspectives Audit, Combined Retail and Nonretail, July 1999 to December 2004 was used to estimate correctional ARV expenditures in 2004. Both measures were used to calculate treatment costs for ARV therapy.

Results.

The analysis demonstrates that, in 2004, total ARV sales represented only 29% of the total necessary to treat all HAART eligible inmates with known HIV infection.

Conclusion.

There is a substantial unmet need for ARVs in correctional health care. Although many barriers exist to treating all eligible HIV-infected prisoners, treatment reduces costs associated with HIV-related complications and may encourage linkage to HIV care in the community. Treatment of all eligible HIV-infected inmates should be a public health priority.
The National down Syndrome Project: Design and Implementation
Authors: Freeman Sallie B. , Allen Emily G. , Oxford-Wright Cindy L. , Tinker Stuart W. , Druschel Charlotte , Hobbs Charlotte A. , O'Leary Leslie A. , Romitti Paul A. , Royle Marjorie H. , Torfs Claudine P. , Sherman Stephanie L.
Published: July 2017

Objective.

The National Down Syndrome Project (NDSP), based at Emory University in Atlanta, Georgia, represents a multi-site, population-based, case-control study with two major aims: ( 1) to identify molecular and epidemiological factors contributing to chromosome nondisjunction and the consequent packaging of an extra chromosome into an egg or sperm, and ( 2) to identify risk factors for Down syndrome-associated birth defects.

Methods.

The six national sites represent approximately 11% of U.S. births. Cases were newborns with Down syndrome (trisomy 21), and controls were infants without major birth defects randomly selected from the same birth populations. Biological samples were collected from case infants and their parents, and genetic markers were typed to determine the parental origin of chromosome 21 nondisjunction. Each site interviewed parents of case and control infants addressing pregnancy, medical and family history, occupation, and exposures. Sites collected medical information on case infants.

Results.

The NDSP enrolled 907 infants as cases and 977 infants as controls (participation rates: 60.7% for cases; 56.9% for controls). Participation rates varied widely by site as did important demographic factors such as maternal age, race, and education. Nondisjunction during oogenesis accounted for 93.2% of the cases. Errors in spermatogenesis were found in 4.1%, and 2.7% were post-zygotic errors.

Conclusions.

This exceptional compilation of questionnaire, clinical, and molecular data makes the NDSP a unique resource for ongoing studies of the etiology and phenotypic consequences of trisomy 21. The combined approach increases study power by defining subgroups of cases by the origin of nondisjunction. This report describes the design and successful implementation of the NDSP.
Growth Promoting Antibiotics in Food Animal Production: An Economic Analysis
Authors: Graham Jay P. , Boland John J. , Silbergeld Ellen
Published: July 2017

Objective.

Considerable controversy persists regarding the use of human antibiotics to promote growth in animals raised for food. The authors examined the economic effect of removing antibiotics used for growth promotion in commercial broiler chickens.

Methods.

The authors utilized data published by the Perdue company, the fourth largest poultry producer in the United States, in which a non-randomized controlled trial of growth-promoting antibiotic (GPA) use was conducted with seven million broiler chickens to evaluate the impact of removing GPAs on production.

Results.

Positive production changes were associated with GPA use, but were insufficient to offset the cost of the antibiotics. The net effect of using GPAs was a lost value of $0.0093 per chicken (about 0.45% of total cost). Based upon these data, the authors found no basis for the claim that the use of GPAs lowers the cost of production. Note that this study does not include veterinary cost changes or changes in performance variability associated with the removal of GPAs.

Conclusions.

This economic analysis is the first study to the authors' knowledge utilizing large-scale empirical data collected by U.S. industry, in which it is demonstrated that the use of GPAs in poultry production is associated with economic losses to the producers. These data are of considerable importance in the ongoing national debate concerning the continued use of antibiotics for growth promotion of food animals. Based on the industry study and the resulting economic impact, the use of GPAs in U.S. poultry production should be reconsidered.
Childhood Lead Poisoning Prevention Activities within Michigan Local Public Health Departments
Authors: Kemper Alex R. , Uren Rebecca L. , Hudson Sharon R.
Published: July 2017

Objective.

Local public health departments have a wide array of responsibilities, including coordinating childhood lead poisoning prevention activities. This study was conducted in an effort to understand how local public health officers prioritized lead poisoning prevention activities and the barriers to the delivery of childhood lead poisoning prevention services delivered through local health departments.

Methods.

A telephone survey was conducted of health officers in Michigan, a state with a high burden of environmental lead. Analysis included Spearman rank correlation and Fisher's exact test.

Results.

No association was found between the local risk of lead poisoning and the priority placed by local health departments on lead poisoning prevention activities. Similarly, there was no association between the local risk of lead poisoning and the availability of services. Only 60% of local health departments offered blood lead testing, environmental investigation, and case management. Most (74%) believed that lead poisoning is inadequately addressed within the area served by their local health department.

Conclusion.

New strategies of providing lead poisoning prevention activities are needed to achieve the federal and state goals of eliminating childhood lead poisoning over the next decade.
Veterans Using and Uninsured Veterans Not Using Veterans Affairs (VA) Health Care
Authors: Nelson Karin M. , Starkebaum Gordon A. , Reiber Gayle E.
Published: July 2017

Objectives.

The objectives of this study were to: ( 1) examine veteran reliance on health services provided by the Veterans Health Administration (VA), ( 2) describe the characteristics of veterans who receive VA care, and ( 3) report rates of uninsurance among veterans and characteristics of uninsured veterans.

Methods.

The authors analyzed data from the 2000 Behavioral Risk Factor Surveillance System. Using bivariate and multivariate analyses, the association of veteran's demographic characteristics, health insurance coverage, and use of VA services were examined. Veterans not reporting VA coverage and having no other source of health insurance were considered uninsured.

Results.

Among veteran respondents, 6.2% reported receiving all of their health care at the VA, 6.9% reported receiving some of their health care at the VA, and 86.9% did not use VA health care. Poor, less-educated, and minority veterans were more likely to receive all of their health care at the VA. Veterans younger than age 65 who utilized the VA for all of their health care also reported coverage with either private insurance (42.6%) or Medicare (36.3%). Of the veterans younger than age 65, 8.6% (population estimate: 1.3 million individuals) were uninsured. Uninsured veterans were less likely to be able to afford a doctor or see a doctor within the last year.

Conclusions.

Veterans who utilized the VA for all of their health care were more likely to be from disadvantaged groups. A large number of veterans who could use VA services were uninsured. They should be targeted for VA enrollment given the detrimental clinical effects of being uninsured.
Epidemiology Core Competencies for Master of Public Health Students
Authors: Moser Michael , Ramiah Kalpana , Ibrahim Michel
Published: July 2017

Competency-based education for public health professionals has been recommended by the Institute of Medicine. The Association of Schools of Public Health has developed a set of academic core competencies that it recommends that all Master of Public Health (MPH) students should possess prior to graduation. This article discusses the processes and reasoning used by the workgroup that prepared the epidemiology subset of MPH core competencies that appear in the association's 2006 report. These academic core competencies are complementary to but distinct from the specialist competencies that students should develop in their major field. The authors emphasize the importance of ongoing refinement of the core competency model with participation from both public health academics and public health practitioners.
Developing Competencies for Applied Epidemiology: From Process to Product
Authors: Birkhead Guthrie S. , Davies Jac , Miner Kathleen , Lemmings Jennifer , Koo Denise
Published: July 2017

Objectives.

We developed competencies for applied epidemiologic practice by using a process that is based on existing competency frameworks, that engages professionals in academic and applied epidemiology at all governmental levels (local, state, and federal), and that provides ample opportunity for input from practicing epidemiologists throughout the U.S.

Methods.

The model set of core public health competencies, consisting of eight core domains of public health practice, developed in 2001 by the Council on Linkages Between Academia and Public Health Practice, were adopted as the foundation of the Competencies for Applied Epidemiologists in Governmental Public Health Agencies (AECs). A panel of experts was convened and met over a period of 20 months to develop a draft set of AECs. Drafts were presented at the annual meetings of the Council of State and Territorial Epidemiologists (CSTE) and the American Public Health Association. Input and comments were also solicited from practicing epidemiologists and 14 national organizations representing epidemiology and public health.

Results.

In all, we developed 149 competency statements across the eight domains of public health practice and four tiers of applied epidemiologic practice. In addition, sub- and sub-subcompetency statements were developed to increase the document's specificity. During the process, >800 comments from all governmental and academic levels and tiers of epidemiology practice were considered for the final statements.

Conclusions.

The AECs are available for use in improving the training for and skill levels of practicing applied epidemiologists and should also be useful for educators, employers, and supervisors. Both CDC and CSTE plan to evaluate their implementation and usefulness in providing information for future competency development.
The Free Condom Initiative: Promoting Condom Availability and Use in New York City
Authors: Renaud Tamar C. , Bocour Angelica , Irvine Mary K. , Bernstein Kyle T. , Begier Elizabeth M. , Sepkowitz Kent A. , Kellerman Scott E. , Weglein Daniel
Published: July 2017

In 2005, the New York City Department of Health and Mental Hygiene (DOHMH) made free condoms available to organizations through a Web-based ordering system. In 2006, we interviewed managers and patrons about free condom availability, acquisition, and use in venues where people at high risk for human immunodeficiency virus congregate. DOHMH condom distribution increased from 5.8 million in 2004 to 17.3 million in 2006. Overall, managers reported making condoms available at 76% (309/409) of high-priority venues, but only at 40% of gay bars. Among patrons who saw free condoms, 80% (280/351) reported taking them; 73% (205/280) of those who reported taking them also reported using them. A simple, Web-based ordering system dramatically increased condom distribution. In the venues we sampled, the majority of patrons acquired and used free condoms when available and visible, suggesting that increasing free condom availability may increase use. Special efforts are needed to ensure availability at gay bars.
Measuring Health Behaviors and Landline Telephones: Potential Coverage Bias in a Low-Income, Rural Population
Authors: Shebl Fatma , Poppell Carolyn F. , Zhan Min , Dwyer Diane M. , Hopkins Annette B. , Groves Carmela , Reed Faye , Devadason C. , Steinberger Eileen K.
Published: July 2017

Objectives.

Population-based landline telephone surveys are potentially biased due to inclusion of only people with landline telephones. This article examined the degree of telephone coverage bias in a low-income population.

Methods.

The Charles County Cancer Survey (CCCS) was conducted to evaluate cancer screening practices and risk behaviors among low-income, rural residents of Charles County, Maryland. We conducted face-to-face interviews with 502 residents aged 18 years and older. We compared the prevalence of health behaviors and cancer screening tests for those with and without landline telephones. We calculated the difference between whole sample estimates and estimates for only those respondents with landline telephones to quantify the magnitude of telephone coverage bias.

Results.

Of 499 respondents who gave information on telephone use, 80 (16%) did not have landline telephones. We found differences between those with and without landline telephones for race/ethnicity, health-care access, insurance coverage, and several types of cancer screening. The absolute coverage bias ranged up to 6.5 percentage points. Simulation scenarios showed the magnitude of telephone coverage bias decreases as the percent of the population with landline telephone coverage increases, and as landline telephone coverage increases, the estimates from a landline telephone survey would approximate the estimates from a face-to-face survey.

Conclusions.

Our findings highlighted the need for targeted face-to-face surveys to supplement telephone surveys to more fully characterize hard-to-reach subpopulations. Our findings also indicated that landline telephone-based surveys continue to offer a cost-effective method for conducting large-scale population studies in support of policy and public health decision-making.
Postpartum Smoking Relapse and Secondhand Smoke
Authors: Ashford Kristin B. , Hahn Ellen , Hall Lynne , Rayens Mary Kay , Noland Melody
Published: July 2017

Objective.

There has been an abundance of research evaluating prenatal and postnatal smoking abstinence programs. However, few researchers have tested postpartum relapse interventions that address secondhand smoke (SHS) exposure. Pregnant women exposed to SHS are more likely to relapse. This article explores the similarities and differences among postpartum interventions that incorporate SHS education. Generating knowledge about the components of postpartum relapse prevention interventions that do and do not achieve prolongation of abstinence is integral to the development of effective SHS interventions that help women achieve lifelong abstinence.

Methods.

We used a methodological review of 11 randomized, controlled trials testing the efficacy of relapse prevention interventions that address SHS exposure. We compared intervention strength, biomarker validation of home smoking and SHS, as well as abstinence and relapse rates. We examined three predictors of postpartum relapse: ( 1) partner smoking in the home, ( 2) adoption of home smoking restrictions, and ( 3) motivation/confidence to remain abstinent.

Results.

Findings revealed a need for more comprehensive SHS interventions and a clear delineation of abstinence/relapse terminology. Biomarker validation of home smoking and SHS was primarily measured by self-report, passive nicotine monitors, and hair nicotine levels. Furthermore, studies using nurse- and pediatrician-led interventions resulted in the lowest relapse rates.

Conclusion.

A comprehensive intervention that specifically prioritizes parental education on the health effects of SHS on the family, empowerment of the mother and family members to remain abstinent and adopt a smoke-free home smoking policy, and partner influence on smoking could result in a significant reduction in postpartum relapse rates.
Infant Bed-Sharing Practices and Associated Risk Factors among Births and Infant Deaths in Alaska
Authors: Blabey Margaret H. , Gessner Bradford D.
Published: July 2017

Objective.

The Alaska Division of Public Health has stated that infants may safely share a bed for sleeping if this occurs with a nonsmoking, unimpaired caregiver on a standard, adult, non-water mattress. Because this policy is contrary to recent national recommendations that discourage any bed sharing, we examined 13 years of Alaskan infant deaths that occurred while bed sharing to assess the contribution of known risk factors.

Methods.

We examined vital records, medical records, autopsy reports, and first responder reports for 93% of Alaskan infant deaths that occurred between 1992 and 2004. We examined deaths while bed sharing for risk factors including sleeping with a non-caregiver, prone position, maternal tobacco use, impairment of a bed-sharing partner, and an unsafe sleep surface. We used Pregnancy Risk Assessment Monitoring System data to describe bed-sharing practices among all live births in Alaska during 1996–2003.

Results.

Thirteen percent ( n=126) of deaths occurred while bed sharing; 99% of these had at least one associated risk factor, including maternal tobacco use (75%) and sleeping with an impaired person (43%). Frequent bed sharing was reported for 38% of Alaskan infants. Among these, 60% of mothers reported no risk factors; the remaining 40% reported substance use, smoking, high levels of alcohol use, or most often placing their infant prone for sleeping.

Conclusions.

Almost all bed-sharing deaths occurred in association with other risk factors despite the finding that most women reporting frequent bed sharing had no risk factors; this suggests that bed sharing alone does not increase the risk of infant death.
Colorectal Cancer Screening among Users of County Health Centers and Users of Private Physician Practices
Authors: Messina Catherine R. , Lane Dorothy S. , Colson Roberto C.
Published: July 2017

Objective.

We examined use of colorectal cancer (CRC) screening exam modalities among county health centers and private physician offices, where both were located in the same geographic area.

Methods.

We surveyed 500 county health center registrants and 570 private physician patients, aged 52–75 years. We administered telephone surveys during 2004 to examine relationships among sociodemographic characteristics; perceived barriers to screening with fecal occult blood test (FOBT), sigmoidoscopy, and colonoscopy; and self-reported receipt of each exam.

Results.

FOBT was more frequent among county health center registrants; sigmoidoscopy and colonoscopy were more frequent among private physician patients ( p<0.001). County health center registrants less frequently cited no physician recommendation as a barrier to FOBT, but more frequently cited no recommendation as a barrier to sigmoidoscopy and colonoscopy, compared with private physician patients ( p ≤0.02). Among county health center registrants, better health insurance coverage was associated with lower odds of FOBT and higher odds of screening endoscopy; perceived barriers were associated with lower odds of screening ( p<0.02). Among private physician patients, we noted an association between perceived barriers to screening and lower odds of any screening ( p<0.001).

Conclusions.

Overall, CRC screening among county health center and private physician patient samples compared favorably with overall New York and U.S. rates. Although prior studies using national data suggested that screening rates were equivalent in county health center and private physician primary care settings, we found exam-specific differences in patient-reported screening endoscopy among our two patient samples. Understanding factors that contribute to differences in CRC screening between primary care settings is important for ensuring equal access to CRC screening options for all patients.
Longevity Disparities in Multiethnic Hawaii: An Analysis of 2000 Life Tables
Authors: Park Chai Bin , Braun Kathryn L. , Horiuchi Brian Y. , Tottori Caryn , Onaka Alvin T.
Published: July 2017

Objective.

We examined differences among seven major ethnic groups in Hawaii in life expectancy at birth ( e[0]) and mortality at broad age groups.

Methods.

We constructed life tables for 2000 for Caucasian, Chinese, Filipino, Hawaiian, Japanese, Korean, and Samoan ethnic groups in Hawaii. We partitioned overall mortality into broad age groups: <15 (representing premature mortality), 15–65 (representing working age), and 66–84 and ≥85 (representing senescent mortality).

Results.

The overall e(0) in Hawaii was 80.5 years, but the difference between the longest-living group (Chinese) and the shortest-living group (Samoan) was 13 years. Chinese had the lowest mortality rates in each age group except the ≥85 category. In this last age group, we observed anomalously low rates for some new immigrant groups (especially Samoan males) suggesting, as a cause, that elders in these immigrant groups may return to natal countries in their old age and die there. In the <15 age group, mortality rates for Samoans and Koreans were highest, especially for Korean girls, suggesting some continuance in the U.S. of a preference for boy children. Outside of these anomalies, ethnic differences in e(0) were likely explained by socioeconomic and behavioral variables known to affect mortality levels, which are closely associated with ethnicity in Hawaii.

Conclusions.

These findings confirm the need to disaggregate Asian and Pacific Islander data, to conduct ethnic-specific research, and to address socioeconomic disparities.
Managing Multiple Chronic Conditions: A Strategic Framework for Improving Health Outcomes and Quality of Life
Authors: Parekh Anand K. , Goodman Richard A. , Gordon Catherine , Koh Howard K. ,   The HHS Interagency Workgroup on Multiple Chronic Conditions
Published: July 2017

The escalating problem of multiple chronic conditions (MCC) among Americans is now a major public health and medical challenge, associated with suboptimal health outcomes and rising health-care expenses. Despite this problem's growth, the delivery of health services has continued to employ outmoded “siloed” approaches that focus on individual chronic diseases. We describe an action-oriented framework—developed by the U.S. Department of Health and Human Services with additional input provided by stakeholder organizations—that outlines national strategies for maximizing care coordination and for improving health and quality of life for individuals with MCC. We note how the framework's potential can be optimized through some of the provisions of the new Patient Protection and Affordable Care Act, and through public-private partnerships.
Occupational Lung Disease Risk and Exposure to Butter-Flavoring Chemicals after Implementation of Controls at a Microwave Popcorn Plant
Authors: Kanwal Richard , Kullman Greg , Fedan Kathleen B. , Kreiss Kathleen
Published: July 2017

Objectives.

After an outbreak of severe lung disease among workers exposed to butter-flavoring chemicals at a microwave popcorn plant, we determined whether or not lung disease risk declined after implementation of exposure controls.

Methods.

National Institute for Occupational Safety and Health staff performed eight serial cross-sectional medical and industrial hygiene surveys at the plant from November 2000 through August 2003. Medical surveys included standardized questionnaires and spirometry testing. Industrial hygiene surveys measured levels of production-related air contaminants, including butter-flavoring chemicals such as diacetyl. All diacetyl concentrations above detectable limits were corrected for the effects of absolute humidity and days to sample extraction.

Results.

Ventilation and isolation of the production process resulted in one to three orders of magnitude reductions in diacetyl air concentrations in different areas of the plant. Workers with past high exposures had stable chest symptoms over time; nasal, eye, and skin irritation symptoms declined. New workers had lower symptom prevalences and higher lung function than workers with past high exposures, and they did not worsen over time. In workers who had at least three spirometry tests, those with past high exposures were more likely to experience rapid declines in lung function than new workers.

Conclusions.

Implemented controls lowered exposures to butter-flavoring chemicals and decreased lung disease risk for much of the plant workforce. Some workers with continuing potential for intermittent, short-term peak and measurable time-weighted exposures remain at risk and should use respiratory protection and have regularly scheduled spirometry to detect rapid lung function declines that may be work-related. Close follow-up of such workers is likely to yield additional information on risks due to peak and time-weighted exposure levels.
Disparities in Infectious Disease Hospitalizations for American Indian/Alaska Native People
Authors: Holman Robert C. , Folkema Arianne M. , Singleton Rosalyn J. , Redd John T. , Christensen Krista Y. , Steiner Claudia A. , Schonberger Lawrence B. , Hennessy Thomas W. , Cheek James E.
Published: July 2017

Objectives.

We described disparities in infectious disease (ID) hospitalizations for American Indian/Alaska Native (AI/AN) people.

Methods.

We analyzed hospitalizations with an ID listed as the first discharge diagnosis in 1998–2006 for AI/AN people from the Indian Health Service National Patient Information Reporting System and compared them with records for the general U.S. population from the Nationwide Inpatient Survey.

Results.

The ID hospitalization rate for AI/AN people declined during the study period. The 2004–2006 mean annual age-adjusted ID hospitalization rate for AI/AN people (1,708 per 100,000 populiation) was slightly higher than that for the U.S. population (1,610 per 100,000 population). The rate for AI/AN people was highest in the Southwest (2,314 per 100,000 population), Alaska (2,063 per 100,000 population), and Northern Plains West (1,957 per 100,000 population) regions, and among infants (9,315 per 100,000 population). ID hospitalizations accounted for approximately 22% of all AI/AN hospitalizations. Lower-respiratory-tract infections accounted for the largest proportion of ID hospitalizations among AI/AN people (35%) followed by skin and soft tissue infections (19%), and infections of the kidney, urinary tract, and bladder (11%).

Conclusions.

Although the ID hospitalization rate for AI/AN people has declined, it remains higher than that for the U.S. general population, and is highest in the Southwest, Northern Plains West, and Alaska regions. Lower-respiratory-tract infections; skin and soft tissue infections; and kidney, urinary tract, and bladder infections contributed most to these health disparities. Future prevention strategies should focus on high-risk regions and age groups, along with illnesses contributing to health disparities.
Administration Time between Seasonal Live-Attenuated Influenza Vaccine and Trivalent Influenza Vaccine during the “Stop Flu at School” Campaign—Hawaii, 2009
Authors: Sreenivasan Meera V. , He Hua H. , Park Sarah Y.
Published: July 2017

Objectives.

We determined whether the administration time differed between seasonal intranasal live-attenuated influenza vaccine (LAIV) and seasonal injectable trivalent inactivated influenza vaccine (TIV) during Hawaii's 2009 school-located influenza vaccination clinics. This information is useful for public health response and allows further investigation into possible differences between the two vaccines.

Methods.

We conducted a prospective cohort study in 15 public schools to determine mean times to administer LAIV and TIV to students. We performed group analyses to control for various clinic characteristics and conducted a stratified, weighted analysis.

Results.

A total of 4,701 students were enrolled in the study, and administration time was obtained for 3,869 (82%) students (1,492 [39%] LAIV and 2,377 [61%] TIV). The mean administration time for LAIV was 62 seconds and for TIV was 90 seconds, a difference of 28 seconds ( p<0.01). This finding remained significant in the stratified analysis.

Conclusions.

Although results indicated that both LAIV and TIV can be administered rapidly among school-aged populations, LAIV was faster to administer. This finding, in addition to the greater immunogenicity of LAIV compared with TIV among children, may be an important consideration for public health administrators in planning school-located mass vaccination clinics and encouraging patient acceptance of this vaccine.
Accuracy of Parental Reports of Children's HPV Vaccine Status: Implications for Estimates of Disparities, 2009–2010
Authors: Attanasio Laura , McAlpine Donna
Published: July 2017

Objectives.

Since the introduction of the human papillomavirus (HPV) vaccine in 2006, there have been considerable efforts at the national and state levels to monitor uptake and better understand the individual and system-level factors that predict who gets vaccinated. A common method of measuring the vaccination status of adolescents is through parental recall. We examined how the accuracy of parents' reports of their daughters' HPV vaccination status varied by social characteristics.

Methods.

Data were taken from the 2009–2010 National Immunization Survey (NIS)-Teen, which includes a household interview and a provider-completed immunization history. We evaluated concordance between parents' and providers' reports of teens' HPV vaccine initiation (≥1 dose) and completion (≥3 doses). We assessed bivariate associations of sociodemographic characteristics with having a concordant, false-positive (overreporting) or false-negative (underreporting) report, and used multinomial logistic regression to estimate the independent impact of each characteristic.

Results.

In bivariate analyses, concordance of parent-reported HPV vaccine initiation was associated with each of the sociodemographic characteristics investigated. In regression models, self-reported nonwhite race, lower household income, and lower education level of the teen's mother were associated with a higher likelihood of having a false-negative parental report than a concordant report.

Conclusion.

Our results indicate that, while estimates of overall coverage based on parental report may be unbiased, the differences in the accuracy of parental report could result in misleading estimates of disparities in HPV vaccine coverage.
Persistent Racial/Ethnic Disparities in AIDS Diagnosis Rates among People Who Inject Drugs in U.S. Metropolitan Areas, 1993–2007
Authors: Pouget Enrique R. , West Brooke S. , Tempalski Barbara , Cooper Hannah L.F. , Hall H. Irene , Hu Xiaohong , Friedman Samuel R.
Published: July 2017

Objectives.

We estimated race/ethnicity-specific incident AIDS diagnosis rates (IARs) among people who inject drugs (PWID) in U.S. metropolitan statistical areas (MSAs) over time to assess the change in disparities after highly active antiretroviral therapy (HAART) dissemination.

Methods.

We compared IARs and 95% confidence intervals (CIs) for black/African American and Hispanic/Latino PWID with those of white PWID in 93 of the most populous MSAs. We selected two three-year periods from the years immediately preceding HAART (1993–1995) and the years with the most recent available data (2005–2007). To maximize stability, we aggregated data across three-year periods, and we aggregated data for black/African American and Hispanic/Latino PWID for most comparisons with data for white PWID. We assessed disparities by comparing IAR 95% CIs for overlap.

Results.

IARs were significantly higher for black/African American and Hispanic/Latino PWID than for white PWID in 81% of MSAs in 1993–1995 and 77% of MSAs in 2005–2007. MSAs where disparities became non-significant over time were concentrated in the West. Significant differences were more frequent in comparisons between black/African American and white PWID (85% of MSAs in 1993–1995, 79% of MSAs in 2005–2007) than in comparisons between Hispanic/Latino and white PWID (53% of MSAs in 1993–1995, 56% of MSAs in 2005–2007). IARs declined modestly across racial/ethnic groups in most MSAs.

Conclusions.

AIDS diagnosis rates continue to be substantially higher for black/African American and Hispanic/Latino PWID than for white PWID in most large MSAs. This finding suggests a need for increased targeting of prevention and treatment programs, as well as research on MSA-level conditions that may serve to maintain the disparities.
Gender-Role Stereotyping in Zimbabwean Television Advertisements
Authors: Furnham Adrian , Pallangyo Akunda E. , Gunter Barrie
Published: July 2017

The present study examined the portrayal of men and women in a sample of Zimbabwean television advertisements. A sample of 110 advertisements was content analysed to catalogue the gender of the central figure, mode of presentation, credibility basis, role, location, age, argument, reward type, product type, background, and end comment. The main aim was to establish whether men and women were depicted differently in advertisements. Significant gender differences were present in all coding categories, except in the preferred gender of the central figure. Gender-role stereotyping was found to be stronger in Zimbabwean advertisements when compared with both Asian and British advertisements.
Antonovsky's Sense of Coherence Scale and Job Attitudes: Three Studies
Authors: Strümpfer D.J.W. , Mionzi Ezra N.
Published: July 2017

Sense of coherence (SOC; Antonovsky, 1987) is a key concept in a theoretical model of salutogenesis and fortigenesis, which attempts to explain the origins of psychological strength. Since working provides important endpoints of well-being, SOC's relationships to job satisfaction, job involvement, organizational commitment and conscientiousness were investigated. Study 1, on 92 insurance consultants (all males, M age 39 y.), revealed significant relations of SOC with job satisfaction (3 global items, also total) and commitment (Mowday, Steers & Porter, 1979) but not job involvement (Kanungo, 1982). Study 2, on 141 working adults (72 females; M age = 34 y.), showed significant relations with job satisfaction (Andrews & Witney, 1976), commitment and conscientiousness (Goldberg, 1992). Study 3, on 118 university teachers (41 female; M age = 41 y.), revealed significant relations with the Job Descriptive Index's (Smith, P.C., Kendall, L.M. & Hulin, C.L. 1969) Work, Co-workers and Total scores, as well as the Minnesota Satisfaction Questionnaire's (Weiss, D.J., Dawis, R.V., England, G.W. & Lofquist, L.H. 1967) Intrinsic, Extrinsic and Total scores. The-probably bi-directional-job satisfaction relations were of practical significance, explaining 15–35% common variance; in line with previous findings, these findings, across a variety of measures and samples, confirm a relationship that could by now probably be taken for granted.
The Relationship between Sense of Coherence and Indicators of Secondary Traumatic Stress in Non-Professional Trauma Counsellors
Authors: Ortlepp Karen , Friedman Merle
Published: July 2017

Personality disposition is consistently noted in the literature as a critical component in the dynamics of stress — strain relationships. However, the precise nature of the role played by personality dispositions is still open to debate. In this study personality disposition is operationalised as a form of global perceptual disposition, namely, Antonovsky's Sense of Coherence. The role of Sense of Coherence in the potential experience of secondary traumatic stress forms the focus of this study. Data were collected on a sample of 130 trained non-professional trauma counsellors in the South African banking sector. Sense of Coherence was found not to be a consistent moderator of the relationship between the work-related experiences of the trauma counsellors and the indicators of secondary traumatic stress. Instead Sense of Coherence emerged as having a statistically strong main effect on the indicators of secondary traumatic stress.
Traditional African1 Beliefs and Customs: Implications for AIDS Education and Prevention in Africa
Authors: van Dyk Alta C
Published: July 2017

Many Western-based AIDS education and prevention programmes have failed dismally in Africa and they may only succeed if traditional African beliefs and customs are taken into account. This article discusses relevant aspects of the traditional African worldview by explaining what health, sickness and sexuality mean in traditional Africa. Traditional African perceptions of causes of illness (including AIDS), perceptions of sexuality, and cultural beliefs inhibiting the usage of condoms are described in terms of the influence of the macro-cosmos (the ancestors), the meso-cosmos (witches and sorcerers) and the micro-cosmos (everyday life). The implications for AIDS education and prevention in Africa are discussed and suggestions are offered for the development of such programs.
African Psychology: Myth and Reality
Authors: Moll Ian
Published: July 2017

There is in Africa (not least in South Africa) an important debate amongst psychologists, as amongst philosophers, concerning the possibility of an indigenous African psychology. One version of the debate engages the proposition that “African psychology” is a myth, in the sense that there is no domain of knowledge that is unique to a particular geographical region and its people. Another version regards it as an obvious reality, in that there is a substantial body of psychological literature that originates in the African context and is engaged with African issues and problems. This paper enters the debate by suggesting that African psychology is both myth and reality, conceived in the above terms. In doing this, it takes its lead from the West African philosopher of the human sciences, Hountondji. It goes on to explore the work of Fanon, the Algerian psychoanalytic theorist of colonialism, and Nsamenang, the developmental psychologist from Cameroon, as instances of psychologists whose work demonstrates that psychology in Africa should not be conceived of as unique to the continent, but rather as universal psychology engaged with the problems and issues of Africa. Above all else, the paper stresses that the debate is an African debate, actively engaged in by psychologists and philosophers in Africa, rather that one between Africans and some other, non-African tradition.
Deconstructive Discourse Analysis: Extending the Methodological Conversation
Authors: Macleod Catriona
Published: July 2017

Discourse analysis is increasingly becoming a methodology of preference amongst qualitative researchers. There is a danger, however, of it being viewed as a bounded and uncontested domain of research practice. As discourse analysis is inextricably linked with theoretical issues, it is a dynamic practice that is constantly in a process of revision. In this paper I reflect on some of the conceptualisations undergoing the notion of discourse – conceptualisations that have important implications in terms of how the practice of discourse analysis proceeds. I highlight some of the dualisms that may plague discourse analysis, and offer some solutions to these. Finally, I outline the deconstructive discourse analysis that I utilised in my doctoral work. The purpose of the latter is not to provide a recipe of methodology, but to illustrate how elements of various theorists' work (in this case Foucault, Derrida and Parker) may be profitably drawn together to perform specific discourse analytic work.
Empirical Clarification of the Nature of Psychological Well-Being
Authors: Wissing Marié P. , van Eeden Chrizanne
Published: July 2017

An analysis of the literature revealed that conceptualizations of the nature of psychological well-being are very diverse, and that it is still unclear what the nature and/or dimensions of psychological well-being are. Scales based on several models and constructs from diverse theoretical traditions were completed by a multicultural group of 550 participants. The validity of the scales for use in this particular group was determined. The manifestations of psychological well-being in different gender, cultural and age groups were compared. Similarities and differences were found. In a factor analysis on the data of the total group, a general psychological well-being factor was identified. Psychological well-being seems to be multidimensional with regard to facets of self that are involved ( e.g., affect, cognition, behaviour), as well as with regard to the domains of life in which these facets manifest themselves ( e.g., intra- and interpersonal, social and contextual, in love and work). A sense of coherence, satisfaction with life and affect-balance are strong indicators of general psychological well-being. Findings from this perspective may point to new directions for capacity building.
Ethical Complaints and Disciplinary Action against South African Psychologists
Authors: Scherrer R. , Louw D.A. , Möller A.T.
Published: July 2017

This study investigated the scope and nature of complaints, related to unethical behaviour, that have been lodged against South African psychologists with the Health Professions Council of South Africa (HPCSA) between 1990 and 1999. Certain biographical characteristics of the complainants and their accused also received attention. During this period, complaints were lodged annually against approximately 1% of South African psychologists, of which approximately 15% resulted indisciplinary inquiries. Only 5% of the total number of complaints and 34% of the disciplinary inquiries led to convictions. However, almost 50% of the disciplinary inquiries had not yet been concluded at the time of this investigation. Most complaints (21.3%) involved neglect to renew annual registration. As far as the rendering of services to the public is concerned, most complaints were related to accounts (16%). Other complaints included, among others, problems with psychologists' reports (13.1%), incompetence (12.9%) and improper behaviour (11.5%). It appears that complainants were family members (34%) rather than the clients/patients themselves (26%). The two penalties imposed most often were either a warning or a suspension in the form of a suspended sentence. Recommendations for reducing complaints of unethical behaviour are made.