Specificity of the Tuberculin Skin Test and the T-SPOT.TB Assay Among Students in a Low–Tuberculosis Incidence Setting

Abstract

Objective: Interferon-γ release assays (IGRAs) are an important tool for detecting latent Mycobacterium tuberculosis infection (LTBI). Insufficient data exist about IGRA specificity in college health centers, most of which screen students for LTBI using the tuberculin skin test (TST). Participants: Students at a low–TB incidence college health center. Methods: TST and T-SPOT.TB were performed on prospectively recruited students. TB exposure risk was assessed using a questionnaire: Those at low risk were assumed to not have LTBI in order to calculate test specificity. Results: Of 184 students enrolled, 143 had results available for both TST and T-SPOT.TB. Agreement of the tests was 97% (kappa statistic 0.717; 95% confidence interval, 0.399–1.00). Among 124 low-risk students, specificity for TST and T-SPOT.TB were 98.4% and 100%, respectively. Conclusions: T-SPOT.TB specificity was high among low-risk students. Additional studies such as cost-effectiveness analyses using T-SPOT.TB as a single or confirmatory test to TST are needed to contribute to LTBI screening policy decisions.     

A Culturally Competent Family Enhancement and Empowerment Model for African American Parents

The National Association of Social Worker's Standards for Cultural Competence (2002 National Association of Social Workers. 2002. NASW standards for cultural competence in social work practice, Washington, DC: Author.  [Google Scholar]) mandates social work practices that recognize the cultural preferences of different groups in the United States. The NASW Code of Ethic (1996 National Association of Social Workers. 1996. Code of ethics, Washington, DC: NASW Press.  [Google Scholar]) states that social workers have a responsibility to understand culture and its function and to further recognize the strengths that exist in all cultures. This article addresses the void in the social work literature on culturally based and strengths‐oriented family interventions for African American parents. The article describes a culturally competent intervention model developed by the MAAT Center for Human and Organizational Enhancement, Inc. in Washington, D.C. for parents of African American male youths who live in high‐risk environments. The family enhancement and empowerment model (FEEM) is based on Africentric social work principles that are grounded in a strengths perspective. The article describes the FEEM program, including a discussion of practical strategies for building trust and offering support to African American parents and families.     

Seeking Justice: The Strategy of the National Social Action Program

Past efforts at law reform have taken years of consciousness raising. The resulting legislation has been ineffective in reducing men’s sexual violence against women and children, in large part because most women are understandably reluctant to go to court. This reluctance comesfrom recognition of the fundamental failures of the legal doctrine. The judicial response to men’s sexual violence can be reformed through the use of existing procedures (e.g., prosecution objections and appeals). This paper describes 3 local actions to start a fast and effective reform of the legal doctrine: Documenting the Outrageous, Challenging the Legal System, and Supporting Victims.     

Family Divorce and Romantic Relationships in Early Adolescence

Prior research has indicated that family experiences, including parental divorce, family conflict, and parental monitoring, play an important role in adolescent relationships (e.g., Mahl, 2001 Mahl, D. 2001. The influence of parental divorce on the romantic relationship beliefs of young adults. Journal of Divorce & Remarriage, 34: 89–118. [Taylor & Francis Online] , [Google Scholar]). Research on how these family experiences affect romantic relationships during early adolescence is lacking. Because pubertal maturation has been linked with earlier dating, it is also important to consider its role when studying adolescent relationships. This study compared 1,765 young adolescents (grades 5–8) from intact (n = 1,315) and divorced (n = 379) families on their dating patterns, susceptibility to romantic influence, and romantic relationship quality. The findings show that adolescents from divorced families, compared to adolescents from intact families, report more dating, report more susceptibility to romantic influence, and do not differ in their romantic relationship quality. In line with the hypotheses, both family conflict and puberty mediated the relationship between family structure and dating stage, as well as family structure and susceptibility to romantic influence. Parental monitoring, however, did not mediate between family structure and the romantic relationship variables. Finally, differences, regardless of family structure, were found between males and females, where males indicated being at a higher dating stage than females.     

Planning to Plan: A Process to Involve Child Welfare Agencies in Disaster Preparedness Planning

In the aftermath of Hurricane Katrina when child welfare officials in Louisiana reported they did not know the whereabouts of all their children in foster care, disaster planning in public child welfare became a new area of concern. This article reports on a process of engaging seven public child welfare agencies in planning for disasters that could affect child safety and service delivery. The Washington Metropolitan Area Disaster Planning Project used a strengths-based approach to help agencies responsible for protecting and serving children in foster care and families at risk of abuse and neglect develop plans to augment and continue service delivery and responsiveness in the aftermath of a natural or man-made disaster. The processes of gathering information on disaster responsiveness, interviewing community and professional informants, developing a template to guide disaster planning within the agencies, and implementing a tabletop exercise are described. As a result of this consultation effort agencies became aware that disaster planning at the state and county levels had proceeded without child welfare at the table, that the increase in need for child welfare services during a disaster was not recognized by disaster professionals, and that practicing disaster responsiveness is necessary to assure readiness.     

Ageing Lesbians: Marginalising Discourses and Social Exclusion in the Aged Care Industry

The provision of services for ageing lesbians in Victoria, Australia, appears, at an initial reading, to be equitable and inclusive. Government polities suggest recognition and respect for diversity, with a focus on equitable provision of all social services. The reality, however, turns out to be both problematic and exclusionary. The researchers explored how dominant discourses around aged care facilities fail to take into account the identities and needs of ageing lesbians. The advertising brochures of aged care facilities were subjected to a critical and feminist discourse analysis, which was then compared with the perceived needs of a group of ageing lesbians from the same region as the aged care facilities. The data revealed marginalizing of non-heterosexual identities through the absence of representation in the brochures and their exclusion in the construction of aged care space. Further, a review of aged care policies that underpin the provision of services found that lesbian needs and identities were not included or mentioned in the special need groups. This limits the potential of the aged care industry to provide services that are culturally sensitive, safe, and inclusive.