Caregiver Decision-Making: Household Response to Child Illness in Sub-Saharan Africa

We draw upon a framework outlining household recognition and response to child illness proposed by Colvin et al. (Soc Sci Med 86:66–78, 2013) to examine factors predictive of treatment sought for a recent child illness. In particular, we model whether no treatment, middle layer treatment (traditional healer, pharmacy, community health worker, etc.), or biomedical treatment was sought for recent episodes of diarrhea, fever, or cough. Based on multinomial, multi-level analyses of Demographic and Health Surveys from 19 countries in sub-Saharan Africa, we determine that if women have no say in their own healthcare, they are unlikely to seek treatment in response to child illness. We find that women in sub-Saharan Africa need healthcare knowledge, the ability to make healthcare decisions, as well as resources to negotiate cost and travel, in order to access biomedical treatment. Past experience with medical services such as prenatal care and a skilled birth attendant also increases the odds that biomedical treatment for child illness is sought. We conclude that caregiver decision-making in response to child illness within households is critical to reducing child morbidity and mortality in sub-Saharan Africa.     

Intensity of Interaction in Supply of Business Advice and Client Impact: A Comparison of Consultancy,Business Associations and Government Support Initiatives for SMEs

This paper assesses the supply of business advice using new empirical evidence from a large-scale survey of SMEs. The chief focus of the paper is on a comparison of suppliers that operate in different environments of regulation, contract and reputation. The paper argues that interaction intensity varies with the level of information asymmetry of these different environments, between different types of service supplier and their clients. Interaction intensity between suppliers also varies as a result of the level of trust they enjoy: for example, the low trust enjoyed by consultants appears to encourage higher intensity of interaction which improves the tailoring of the service to the client's needs and enhances impact. The paper assesses interaction intensity using the existence of site visits and/or a written brief/contract as indicators. Although these measures have limitations, the paper demonstrates clear and significant differences between suppliers in terms of interaction intensity, use of contracts and impact in three broad categories: private-sector consultancy (low trust, high intensity, high impact), business associations (high trust, low intensity, moderate impact) and government support agencies (moderate trust, moderate to high intensity, moderate or low impact). Multivariate estimation methods demonstrate that significant differences in interaction intensity, use of contracts and impact by client type are much less important than differences in supplier type. This indicates that suppliers generally develop more into niche service fields or groups of services rather than niches related to types of firm.     

Improving OpenURL Menus: User Testing of Revisions to SFX® Menus

Twenty-one volunteers tested the usability of revisions to the Texas A&M University Libraries' SFX® OpenURL link resolver menus, including the addition of Ex Libris' new bX™ recommendation service and a plug-in which pulls additional information about the journal into the menu. The volunteers also evaluated the quality and desirability of the bX recommendations and discussed their preferences for help options and full-text format. Results of the usability testing are reported along with the resultant menu changes. This study will be of interest to librarians implementing or redesigning OpenURL menus as well as those interested in the user experience.     

The Patient Profile Pharmacy Filing System

Abstract

“Herpes Simplex Virus Proctitis in Homosexual Men: Clinical, Sigmoidoscopic, and Histopathological Features,” Steven E. Goodell, Thomas C. Quinn, Emmanuel Mkrtichian, Michael D. Schuffler, King K. Holmes, and Lawrence Corey. Acute herpes simplex virus (HSV) infection was detected in 23 of 102 consecutively examined, sexually active male homosexuals who presented with anorectal pain, discharge, tenesmus, or hematochezia, as compared with 3 of 75 homosexual men without gastrointestinal symptoms (P < 0.01). Findings that were significantly more frequent in men with HSV proctitis than in men with proctitis due to other infectious causes included fever (48 per cent), difficulty urinating (48 per cent), sacral paresthesias (26 per cent), inguinal lymphadenopathy (57 per cent), severe anorectal pain (100 per cent), tenesmus (100 per cent), constipation (78 per cent), perianal ulcerations (70 per cent), and the presence of diffuse ulcerative or discrete vesicular or pustular lesions in the distal 5 cm of the rectum (50 per cent). Serologic evidence indicated that 85 per cent of the men with symptomatic HSV proctitis were having their first episode of HSV-2 infection. The diagnosis of HSV proctitis is suggested by the presence of severe anorectal pain, and diffuse ulceration of the distal rectal mucosa. (New England Journal of Medicine 1983;308:868–71.)     

Exposure to Community Violence,Suicidality, and Psychological Distress Among African American and Latino Youths: Findings From the CDC Youth Violence Survey

The present investigation explored risk and protective factors for suicidal ideation and behavior in a sub-sample of African American and Latino adolescents (n = 2,626) who participated in the 2004 Centers for Disease Control Youth Violence Survey. Structural equation modeling was used to explore exposure to violence at the community level as a contextual factor that could potentially influence depressive symptomatology, substance abuse, parental support, social support, and suicidality among study participants. Findings indicated that exposure to violence at the community level was not directly related to suicidality among this population of urban adolescents. However, it was directly related with several other variables under study in the model, which in turn were directly related with suicidality. Tests of invariance revealed several across-group differences, particularly by race and gender, in how the identified risk and protective factors in the model related to suicidality. Implications for research and practice with urban, ethnic minority, adolescent populations are discussed.     

Ain’t no love in the heart of the city: Compensatory quasi-adaptive coping among African American males

ABSTRACT

The social and developmental challenges associated with the normative transition from adolescence to young adulthood for young African American males is quite difficult. These challenges are often further complicated when social, environmental, and even psycho-dynamic factors impinge on these developmental processes. Neighborhood disorder along with chronic exposure to urban stressors represent a quiet danger for this population that entrenches them in a milieu characterized by angst, hopelessness, fear, and nihilism. For many young African American males, this creates a seemingly intractable chasm that often relegates them to truncated life course trajectories. The current article explores these areas and the implications for research and practice with this vulnerable population.     

Pathways to Pathological Gambling: Component Analysis of Variables Related to Pathological Gambling

Research examining cognitive perceptions among children has suggested the importance of perceived skill and luck in initiating and maintaining gambling behavior. Using an experimentally manipulated gambling paradigm modifying rates of reinforcement the results suggest, in general, that one can modify these cognitions. More importantly, the results from the gambling task were found to generalize to multiple forms of gambling and were maintained over a relatively short period of time. The modifications of these perceptions appear to be easier for younger children (age 10 vs 12), with differential effects being found for boys and girls. The results are discussed in light of our current prevention initiatives and programs.     

Adolescent Independence across Immigrant Generations: Age and Ethnic Variations

Abstract

This study examines differences in the level of independence in decision-making experienced by three generations of immigrants and the moderating effects of age, sex, and ethnicity. Data for this study were obtained from the National Longitudinal Study of Adolescent Health. Results indicate generally less independence in decision-making among first-generation immigrants relative to their higher-generation counterparts; however, the relationship varies significantly with ethnicity and age. Among Latinos, adolescents' level of independence increases across successive immigrant generations to a much greater degree than among other ethnic groups. Age further contributes to this interaction, with evidence of greater increases in independence with age among first-generation immigrant Latinos. Findings demonstrate that cultural traditions with regard to parenting and adolescent socialization are important not only within ethnic groups but also within immigrant generations.