An Infection Control Program for a 2009 Influenza A H1N1 Outbreak in a University-Based Summer Camp

Abstract

Objectives: Describe two 2009-H1N1 influenza outbreaks in university-based summer camps and the implementation of an infection control program. Participants: 7,906 campers across 73 residential camps from May 21–August 2, 2009. Methods: Influenza-like-illness (ILI) was defined as fever with cough and/or sore throat. Influenza A was identified using PCR or rapid-antigen testing. We implemented an infection control program consisting of education, hand hygiene, disinfection, symptom screening, and ILI case management. Results: An initial ILI cluster involved 60 cases across 3 camps from June 17–July 2. Academic Camp-1 had the most cases (n = 45, 14.9% attack rate); influenza A was identified in 84% of those tested. Despite implementation of an infection control program, a second ILI cluster began on July 12 in Academic Camp-2 (n = 47, 15.0% attack rate). Conclusions: ILI can spread rapidly in a university-based residential camp. Infection control is an important aspect of the medical response but is challenging to implement.     

Relative Efficacy of a Pregnancy,Sexually Transmitted Infection,or Human Immunodeficiency Virus Prevention–Focused Intervention on Changing Sexual Risk Behavior Among Young Adults

Abstract

Objectives: Despite findings suggesting that young adults are more concerned about experiencing an unplanned pregnancy or contracting a sexually transmitted infection (STI) than becoming human immunodeficiency virus (HIV) infected, no empirical work has investigated whether the specific focus of an intervention may be more or less efficacious at changing sexual behavior. Participants: Participants were 198 college students randomized to 1 of 4 conditions: pregnancy intervention, STI intervention, HIV intervention, or a control condition during 2008–2009. Methods: The authors compared the efficacy of 3 theory-based, sexual risk–reduction interventions that were exactly the same except for an exclusive focus on preventing pregnancy, STI, or HIV. Condom use and risky sexual behavior were assessed at baseline and 4-week and 8-week follow-up. Results: Participants exposed to the pregnancy or STI interventions reported greater condom use and less risky sexual behavior than those exposed to the HIV intervention. Conclusions: The focus of sexual risk–reduction interventions may lead to differential behavior change among young adults.     

The Paradox of Risk: Historically Black College/University Students and Sexual Health

Abstract

Objective: This literature review provides an analysis of the current state of the empirical research on sexual health among students attending historically black colleges and universities (HBCUs). Methods: Several electronic databases were used to identify 24 empirical studies that met criteria for inclusion in this review. Results: The results indicated that perceived human immunodeficiency virus (HIV) risk, religiosity, HIV testing, condom use, and substance use were as high or higher for black HBCU students in comparison with students of other racial/ethnic groups. Comment: Consistent with past findings, sexually transmitted infections continue to be of concern among HBCU students, as seen in the general black population. Limitations: This review only examined cross-sectional studies published between 2000 and 2013. Conclusions: The findings in this review suggest the importance of moving beyond individual risk models to examining structural barriers and assets related to promoting sexual health on HBCU campuses.     

Human Immunodeficiency Virus and Chlamydia/Gonorrhea Testing Among Heterosexual College Students: Who Is Getting Tested and Why Do Some Not?

Abstract

Objective: This study explored college students’ reported history of human immunodeficiency virus (HIV) and chlamydia/gonorrhea and characteristics of students reporting testing. Additionally, it assessed their motivation regarding future testing and reasons for lack of motivation. Participants: The sample consisted of 292 sexually experienced college students self-identifying as heterosexual at a midwestern university. Methods: Participants completed a 26-item survey during the 2010–2011 academic year. Results: Demographics (sex, age, race/ethnicity), behaviors (higher numbers of sex partners, currently not using condoms), and motivation for future testing distinguished those who had been tested ever and those who had not. Half of participants were not motivated to seek testing in the next 3 months; the most common reason for no motivation being perceived lack of risk. Conclusions: Interventions promoting testing can use these findings to target those likely to never have been tested. These results also highlight the need to find ways to motivate students to get tested.     

Association between hand-grip strength and erectile dysfunction in older men

Abstract

Objectives: To evaluate the association between handgrip strength and erectile dysfunction (ED) in community-dwelling older men.

Methods: This cross-sectional study included 1771 participants of the Dong-gu Study. Handgrip strength was measured with a handheld dynamometer. ED was assessed with the Korean version of the International Index of Erectile Function (IIEF). ED was categorized as none to mild (IIEF-EF scores of 13–30) and moderate to severe (IIEF-EF scores of 0–12). Multivariable logistic regression was conducted with adjustment for potential confounders.

Results: The proportion of men with moderate to severe ED was 48.8%. The age-adjusted ED score increased with increasing quartile of handgrip strength (11.0, 12.4, 13.4, and 14.0 in the lowest, second, third, and highest quartiles, respectively). After adjustment for potential confounders, greater handgrip strength was associated with a lower risk of ED (odds ratio (OR): 0.82 per 5?kg; 95% confidence interval (CI): 0.74–0.90). In addition, a high level of moderate to vigorous physical activity was associated with a lower risk of ED (OR: 0.75; 95% CI: 0.61–0.93).

Conclusion: In this study, aging men with greater handgrip strength had a lower risk of ED. This result suggests that reduced physical functioning may contribute to ED.     

A/H1N1 Vaccine Intentions in College Students: An Application of the Theory of Planned Behavior

Abstract

Objective: To test the applicability of the Theory of Planned Behavior (TPB) in college students who have not previously received the A/H1N1 vaccine. Participants: Undergraduate communication students at a metropolitan southern university. Methods: In January–March 2010, students from voluntarily participating communication classes completed a hardcopy survey assessing TPB and clinically significant constructs. Hierarchical regression equations predicted variance in vaccine intentions of students who had not received a flu shot (N = 198; 70% Caucasian). Results: The TPB model explained 51.7% (p < .001) of variance in vaccine intentions. Controlling for side effects, self-efficacy and perceived comparative susceptibility predicted intentions when entered in the first block, whereas attitudes, subjective norms, and perceived behavioral control significantly contribute when entered in the second block. Conclusions: For students who have not previously received a flu vaccine, vaccine communication should utilize self-efficacy and perceived comparative susceptibility to employ the TPB to promote vaccine intentions.     

The Effects of Student Satisfaction and Attitudes on Staffing and Policy Decisions: A Case Study and Empirical Support

Abstract

Increased interest in the University of Mississippi (U.M.) Student Health Service (S.H.S.) indicated dissatisfaction among its users. Complaints about the service in general and one physician in particular suggested an evaluation to identify the causes of the complaints and areas where improvements could be made. Because patient satisfaction can exert a strong influence on factors such as utilization of services, compliance with treatment regimens, and recovery and wellness, a study of user satisfaction was conducted.

A 16-statement patient satisfaction questionnaire was constructed and administered to students reporting a visit to the health service during the semester the study was conducted. The physician conducting the examination was identified at the end of the questionnaire. Simple frequency analyses for the physicians identified specific elements of dissatisfaction, and comparisons showed a distinctly greater amount of dissatisfaction with one physician.

A report to the university administration brought a promise of improvements without an indication of what they would be. Several months later the physician in question resigned. Even though appointments were suspended and waiting time increased with the loss of the physician, comparisons of utilization with the previous period showed little change.     

Mental Health and Clinical Correlates in Lesbian,Gay, Bisexual,and Queer Young Adults

Abstract

Objective: This study examined the prevalence of mental health disorders and their clinical correlates in a university sample of lesbian, gay, bisexual, and queer (LGBQ) students. Participants: College students at a large public university. Methods: An anonymous, voluntary survey was distributed via random e-mail generation to university students during April and May of 2011. LGBQ students were compared with their heterosexual counterparts on psychological and physical status as well as academic performance. Results: LGBQ students reported worse depressive symptoms, higher levels of perceived stress, considered themselves less attractive, and were more likely to be overweight. LGBQ students were significantly more likely to report histories of affective, substance use, and certain anxiety disorders as well as compulsive sexual behavior and compulsive buying. Conclusions: The higher rates of many psychiatric conditions among LGBQ students underscore the need for universities to provide LGBQ students a nonjudgmental environment to discuss sexual orientation and health issues.     

Presence and Visibility of Outdoor and Indoor Physical Activity Features and Participation in Physical Activity Among Older Adults in Retirement Communities

Abstract

In this paper we examine how the presence and visibility of outdoor and indoor physical activity resources (e.g., walking path/ trail, outdoor tennis courts, gardens, etc.) influences participation in physical activity among elderly residents in non-profit continuing care retirement communities and other senior housing communities. This paper reports findings from a survey of 800 such communities. A social ecological model was used to study the relationships between the environment and physical activity behavior. A fifty-two percent response rate (n = 398) was obtained. Campuses with more attractive outdoor and indoor physical activity facilities had more residents participating in different types of physical activity.     

Styles of Physician Advice About Smoking Cessation in College Students

Abstract

Objective: To examine whether young adult cigarette smokers who were in the precontemplation and contemplation stages of change for smoking cessation would differ in their evaluations of vignettes depicting 2 types of physician advice. Participants: Fifty-seven young adult cigarette smokers who were undergraduate students (49.1% female, mean age = 20.4 years) attending an urban university. Methods: Participants evaluated 2 written vignettes. Both vignettes depicted physicians using patient-centered communication styles. One vignette depicted a physician giving a patient direct advice to quit smoking and the other a physician using a motivational style of advice. Data were collected from September 2004 through May 2005. Results: Participants rated the motivational advice vignette as significantly more favorable compared to the direct advice vignette on all assessed dimensions (global satisfaction, general satisfaction, physician affective style, physician technical style, and physician communication style). Conclusion: Smokers preferred the motivational advice style to simple patent-centered advice.     

Antibiotics

Abstract

This study of a college population showed that group A streptococcal pharyngitis accounted for 0.6%–2.5% of total visits to the student health service for the academic years 1977–78, 1978–79, and 1979–80. Streptococcal pharyngitis accounted for 4.0%–13.6% of all throat cultures performed. The prevalence of reported acute rheumatic fever (ARF) in this population was virtually nonexistent.

Review of medical records for 346 cases of streptococcal pharyngitis for academic year 1979–80 revealed that 253 (73%) were treated with oral penicillin V potassium. Nine (4.8%) repeat positive cultures occurred in 188 persons presenting for reculture after completing their course of therapy. All of the repeat positive cases had been treated with oral antibiotics, and almost all responded to a second course of oral treatment. It appeared that oral penicillin was adequate as primary prevention of ARF in this population.

Despite pitfalls of the bacitracin disc method, results of negative cultures prevented unnecessary antibiotic treatment in a population at low risk for ARF. The incidence of penicillin allergy approached 1%, supporting other studies that the risk of penicillin allergy is greater than the risk of ARF.     

An Evaluation of Behavioral Health Compliance and Microbial Risk Factors on Student Populations Within a High-Density Campus

Abstract

Objective: The aim of this Canadian study was to assess student behavioral response to disease transmission risk, while identifying high microbial deposition/transmission sites. Participants: A student survey was conducted during October 2009. Methods: The methods included a survey of students to assess use of health services, vaccination compliance, and hygiene along with a microbial analysis of potential transmission sites targeting specific residence buildings on campus. Results: Results indicated that most students maintained that they were worried about H1N1 and reported making changes in hygienic behavior, with the majority not planning to be vaccinated. The microbial analysis indicated contamination of fomites in co-ed residences to be higher than either male or female student residences. Conclusions: A consideration of physical space along with behavioral factors is required in order to properly assess risk pathways in the establishment of an evidence-based infection control plan for universities and their contiguous communities.     

Eating Disorder Risk and Body Dissatisfaction Based on Muscularity and Body Fat in Male University Students

Abstract

Objective: To investigate the relationship between risk of eating disorders, body dissatisfaction, and perceptual attractiveness in male university students. Participants: Research was conducted January–April 2012 and involved 339 male and 441 female students. Methods: Eating disorder risk was assessed with the Eating Attitudes Test (EAT) and body dissatisfaction and perceptual attractiveness determined with the Bodybuilder Image Grid (BIG). Results: There was a positive correlation (r = .16, p < .01) between the EAT and fat dissatisfaction and a negative correlation (r = ?.14, p < .05) for muscle dissatisfaction, 28% of the males had an EAT score indicating that they were at risk for an eating disorder. Males chose a significantly more muscular and leaner body type than what females chose to be attractive. Conclusion: College-aged males may be at risk for eating disorders based on distortions in their perceived ideal body image, both for fat and muscle.     

Taking a Leap Forward: Adult Protective Services and the Elder Justice Act

ABSTRACT

The author outlines factors in the current environment for Adult Protective Services programs in the United States of America in the spring of 2003 and the significance of the Elder Justice Act to those programs. The commentary notes key strengths and challenges in the bill and warns against relying on legislation alone to address the root causes of elder abuse.     

Exploring the Association Between Dispositional Cancer Worry,Perceived Risk,and Physical Activity Among College Women

Abstract

Objective: In this study, the authors explored the association between dispositional cancer worry (DCW), risk perceptions (RP), and physical activity (PA) among college females. Participants: Four hundred fifty-one females from a midwestern university completed an online survey in September/October 2012. Methods: DCW severity, DCW frequency, RP, and PA were measured along with qualitative data about PA as cancer prevention. Results: Sixty-nine percent of participants did not meet PA recommendations. DCW severity was a significant predictor of meeting PA recommendations (odds ratio = 1.2, 95% confidence interval [1.00, 1.38]; p = .05). Qualitative data revealed a lack of knowledge about breast cancer risk and PA as cancer prevention. Conclusions: College women do not engage in enough PA nor feel at risk for developing breast cancer. A lack of knowledge exists about the cancer prevention benefit of PA. Results indicate a need for PA interventions that both educate breast cancer risk and motivate health protective behaviors.     

Associations between backache and stress among undergraduate students

Abstract

Objective: Low back pain (LBP) is a very common symptom. It occurs in all age groups from children to the elderly population. Globally, years lived with disability caused by LBP increased by 54% between 1990 and 2015. Our objective was to investigate measures that associate with LBP in students. Participants: A structured, anonymous, self-report questionnaire was distributed in two study years, 2009 and 2015. Participants included 1,026 students, 57.7% of them female, with a mean age of 27.2 (SD?=?6.4). Methods: The questionnaire included validated questions on various subjects related to health status and health behaviors. Results: The associated factors of undergraduate students experiencing backaches are higher if they engage in smoking (AOR?=?2.15; p<.01), report study-based stress (AOR?=?2.39; p<.01), and show depressive symptoms (AOR?=?2.69; p<.000). Conclusions: Smoking, stress, and depression are strong measures associated with backache in undergraduate students, significantly more than BMI, physical activity, or sedentary behaviors.     

Estrogen receptor alpha single nucleotide polymorphism as predictor of diabetes type 2 risk in hypogonadal men

Abstract

Estradiol (E2) is, apart from its role as a reproductive hormone, also important for cardiac function and bone maturation in both genders. It has also been shown to play a role in insulin production, energy expenditure and in inducing lipolysis. The aim of the study was to investigate if low circulating testosterone or E2 levels in combination with variants in the estrogen receptor alpha (ESR1) and estrogen receptor beta (ESR2) genes were of importance for the risk of type-2 diabetes. The single nucleotide polymorphisms rs2207396 and rs1256049, in ESR1 and ESR2, respectively, were analysed by allele specific PCR in 172 elderly men from the population-based Tromsø study. The results were adjusted for age. In individuals with low total (≤11?nmol/L) or free testosterone (≤0.18?nmol/L) being carriers of the variant A-allele in ESR1 was associated with 7.3 and 15.9 times, respectively, increased odds ratio of being diagnosed with diabetes mellitus type 2 (p?=?0.025 and p?=?0.018, respectively). Lower concentrations of E2 did not seem to increase the risk of being diagnosed with diabetes. In conclusion, in hypogonadal men, the rs2207396 variant in ESR1 predicts the risk of type 2 diabetes.     

Abstract

Abstract

Edmunds M W: Structure and nurse practitioner performance. The Nurse Practitioner 4: (3)42, May/June 1979

Are you a “new” nurse practitioner (NP) returning to your “old” practice setting? Are you a staff nurse, physician, receptionist in the “old” setting, wondering how to cope with this “new” nurse? This article is a MUST.

Simply and clearly, Ms. Edmunds illustrates the ingredients necessary to facilitate successful role transition.

Structural aspects requiring consideration are drawn from A. Donabedian and include:

1. adequacy of physical structure, facilities and equipment—office, exam room and equipment, telephone;

2. staff qualifications and organization-different mixes and levels of staff and/or reallocation of functions may be required;

3. fiscal arrangements—economic contributions to the practice should be recognized financially;

4. administrative, organization and/or programatic structures need to be reevaluated. Daily routine, patient assignment, collaboration-consultation time, development of new modes of health care delivery are examples.

Problems that may prove to be barriers to the role transition must be assessed and defined. Solutions potentiated should include attending to the structural aspects of the practice milieu. Ms. Edmunds offers valuable suggestions to avert or resolve “reentry” problems.     

Prevalence of Human Immunodeficiency Virus Testing and Associated Risk Factors in College Students

Abstract

Objective: This study documents the prevalence of human immunodeficiency virus (HIV) testing in a sample of college students and examines associated demographic and behavioral characteristics. Participants: College students aged 18 or older were randomly selected to participate in a health behavior survey at a southeastern university in September 2011. Methods: Only sexually active students were included (N = 905). Relationships between demographic and sexual behavior characteristics were explored using logistic regression and classification regression tree (p ≤.05). Results: Only 36.2% reported having been tested for HIV. Age was the most significant factor associated with testing. Factors associated with those least likely to be tested were race and anal sexual activity. Unsafe sexual behaviors were also associated with lower rates of HIV testing. Conclusions: Findings support the need for targeted HIV interventions on college campuses. Such interventions need to be tailored for at-risk students and take into consideration factors likely to contribute to HIV testing.     

Genetic variants in 5p13.2 and 7q21.1 are associated with treatment for benign prostatic hyperplasia with the α-adrenergic receptor antagonist

Background: The etiology of benign prostatic hyperplasia (BPH) has not been well established. The preferred medical treatment for many men with symptomatic benign prostatic hyperplasia is either an α-adrenergic receptor antagonist (α-blocker), or a 5α-reductase inhibitor. Single nucleotide polymorphism (SNP) is a powerful tool for successful implementation of individualized treatment.

Methods: Eighteen SNPs associated with drug efficacy in a Chinese population were genotyped in 790 BPH cases (330 aggressive and 460 non-aggressive BPH cases) and 1008 controls. All BPH patients were treated with α-adrenergic blockers for at least 9 months. We tested the associations between tagging single nucleotide polymorphism and BPH risk/aggressiveness, clinical characteristics at baseline, including the International Prostate Symptom Score (IPSS) and total prostate volume, and changes in clinical characteristics after treatment.

Results: There were nine SNPs associated with BPH risk, clinical progression and therapeutic effect. (1) There were nine tSNPs been chosen in CYP3A4, CYP3A5 and RANBP3L genes. (2) The SNP, rs16902947 in RANBP3L at 5p13.2 (p?=?.01), was significantly associated with BPH. (3) We found two SNPs, rs16902947 in RANBP3L at 5p13.2 (p?=?.0388) and rs4646437 in CYP3A4 at 7q21.1 (p?=?.0325), associated with drug effect. (4) Allele “G” for rs16902947 was found to be risk alleles for BPH risk (OR=?2.357, 95%CI 1.01–1.48). The “A” allele of rs4646437 was associated with lower IPSS at baseline (β=??0.4232, p=?.03255).

Conclusions: rs16902947, rs16902947 and rs4646437 single nucleotide polymorphisms are significantly associated with the clinical characteristics of benign prostatic hyperplasia and the efficacy of benign prostatic hyperplasia treatment.