A Model Program for Increasing Treatment Access for African American Women Who Use Crack Cocaine and Are at Risk of Contracting HIV

ABSTRACT

In the United States, the threat of HIV/AIDS to African-American women's health has become the focus of much concern. This article describes a federally funded community-based program that provides services to African-American women at risk for HIV/AIDS in Nashville, TN. This program provides a culturally relevant set of interventions specific to crack cocaine users aimed at reducing substance use and HIV/AIDS risk behaviors. The model is important to the continued development of culturally relevant interventions that are vital to stemming the disproportionate rates of HIV/AIDS within the African-American community by ensuring treatment access to all populations.     

Sexual Offenses Against Elderly People: Forensic Evaluation and Judicial Outcome

Forensic evaluation reports and judicial outcomes regarding older victims of suspected sexual offenses were retrospectively reviewed. During this period, a total of 14 cases were registered, corresponding to 0.3% of nonfatal crimes against elderly and 0.6% of the total of sexual crimes reported. All the victims were female. The majority lived alone and did not have limitations in communication, orientation, ambulation, or autonomy. The offenders were all male (17 to 81 years old); most were known to the victims and had history of previous disruptive behaviors. The majority of the sexual offenses occurred in the victims’ homes, and the offenders tended to use physical violence. Forensic evaluation was crucial for the identification of physical and biological evidence, and forensic conclusions were positively correlated with the judicial outcome of each case. High prosecution and conviction rates were also observed.     

Social Norms Research in College Health

Abstract

The authors report findings from the first national survey of gambling among college students. They collected information from 10,765 students attending 119 scientifically selected colleges included in the 2001 Harvard School of Public Health College Alcohol Study (CAS), which indicated that 42% of responding students gambled in the last school year and 2.6% gambled weekly or more frequently. These findings contradict the widely held opinion based on previous studies that gambling is prevalent among college students. Previous studies used convenience samples that might have overestimated the risk for gambling problems. Male students and students of legal age (> 21 y) were more likely than others to gamble. Availability of gambling, measured by the number of types of gambling venues located in the schools' states, influenced their decisions to gamble. The concordance of characteristics associated with both gambling and binge drinking suggested a disposition to take risks that is independent of the risk objects.     

Incremental Change: The Pace of Progress in Health

Abstract

In a prospective study of acute diarrheal illness among college students, during one academic year, the incidence of Campylobacter enteritis was 5.57 per 1,000. Approximately 17% of all patients with acute diarrheal illness had Campylobacter enteritis. Campylobacter enteritis is briefly discussed. The value of the stool wet-mount examination is emphasized. It can serve as a guide to which stools to culture and often can lead to a presumptive diagnosis of Campylobacter enteritis. Student health center labs are urged to perform stool wet-mount exams and to provide cultures for isolating the Campylobacter organism.     

Binge Drinking and the College Environment

Abstract

The author surveyed 788 undergraduates at a large public university (overall response rate 54%) to (1) estimate the proportion of college students who cease engaging in a pattern of episodic heavy drinking (EHD) and (2) identify individual and contextual factors associated with early cessation. He used a staging algorithm to classify respondents into 4 stages of EHD cessation. Of the 60% who had engaged in EHD, 64% continued to drink heavily with no intention of stopping, 12% continued to drink heavily but were thinking about stopping, 14% had ceased temporarily, and 9% had ceased permanently. Students who had stopped EHD perceived more risks and fewer benefits associated with alcohol misuse, but they did not differ in their perceptions of normative alcohol use on campus. Many collegiate heavy drinkers cease EHD before graduation, and others may be predisposed to moderate their alcohol use. Tailored interventions that alter alcohol expectancies may facilitate early cessation from EHD.     

Screening and Brief Intervention for Tobacco Use by Student Health Providers on College Campuses

Abstract

Objective: This study assessed college students’ reports of tobacco screening and brief intervention by student health center providers. Participants: Participants were 3,800 students from 8 universities in North Carolina. Methods: Web-based survey of a stratified random sample of undergraduates. Results: Fifty-three percent reported ever visiting their student health center. Of those, 62% reported being screened for tobacco use. Logistic regression revealed screening was higher among females and smokers, compared to nonsmokers. Among students who were screened and who reported tobacco use, 50% reported being advised to quit or reduce use. Brief intervention was more likely among current daily smokers compared to current nondaily smokers, as well as at schools with higher smoking rates. Screening and brief intervention were more likely at schools with lower clinic caseloads. Conclusions: Results highlight the need to encourage college health providers to screen every patient at every visit and to provide brief intervention for tobacco users.     

County Government Resources Associated with Dependent-Adult Abuse Investigations in Iowa

ABSTRACT

This study evaluated on a county level the association of Iowa's domestic dependent-adult abuse investigations with the location of adult protective services (APS) offices, rurality, government resources, felony charges and prosecutions, child abuse reports, and census demographics. In 2003, the rate of dependent-adult abuse investigations for Iowa was 0.70 per 1,000 population age 18 and older. Higher rates of child abuse investigations, felony prosecutions, sheriff's annual salary, and lower rates of child abuse substantiations are associated with higher rates of dependent-adult abuse investigations and substantiations.     

Development and Validation of a Tool to Improve Physician Identification of Elder Abuse: The Elder Abuse Suspicion Index (EASI)©

ABSTRACT

This study aimed to develop and validate a brief tool for physician use to improve suspicion about the presence or absence of elder abuse. A literature review on elder abuse, obstacles to its identification, limitations of detection tools, and characteristics of screeners employed by physicians were used to generate elder abuse detection questions for critique by 31 doctors, nurses, and social workers in focus groups. Six resulting questions became the Elder Abuse Suspicion Index (EASI) administered by 104 family doctors to 953 cognitively intact seniors in ambulatory-care settings. Findings were compared to a recognized, detailed elder abuse Social Work Evaluation (SWE) later administered to participants by social workers blinded to the results of the EASI. The EASI had an estimated sensitivity and specificity of 0.47 and 0.75, usually took less than 2 minutes to ask, and 97.2% of doctors felt it would have some or big practice impact. This research is a first phase in the development and validation of a user-friendly tool that might sensitize physicians to elder abuse and promote referrals of possible victims for in-depth assessment by specialized professionals.     

Nursing Home Deficiency Citations for Safety

Deficiency citations for safety violations in U.S. nursing homes from 2000 to 2007 are examined (representing a panel of 119,472 observations). Internal (i.e., operating characteristics of the facility), organizational factors (i.e., characteristics of the facility itself), and external factors (i.e., characteristics outside of the influence of the organization) associated with these deficiency citations are examined. The findings show that nursing homes increasingly receive deficiency citations for resident safety issues. Low staffing levels, poor quality of care, and an unfavorable Medicaid mix (occupancy and reimbursement) are associated with the likelihood of receiving deficiency citations for safety violations. In many cases, this likely influences the quality of life and quality of care of residents.