Gender,Racial, and Ethnic Disclosure in NIH K-Award Funded Diabetes and Obesity Clinical Trials∗

In 1993, the National Institutes of Health (NIH) passed The Revitalization Act (Subtitle B) which mandated that all NIH funded clinical trials have “appropriate representation” of minority and women subjects. Our aim was to evaluate the impact of the mandate by examining the reporting and inclusion of minority and female subjects into NIH K-Award funded clinical trials, addressing the minority predominant diagnoses of diabetes and clinical obesity. Using the CRISP search engine and PUBMED, we selected publications published by the National Institute on Aging (NIA) and National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) K-grant recipients during 1989–2004, associated with all the diabetes and obesity clinical trials. Studies were stratified into three timeline categories (1989–1993, pre-mandate; 1993–1996, post-mandate, and 1997–present, well past mandate) to evaluate trends in the recruiting of minorities and women before, during, and after the passing of the Revitalization Act. Of the 165 papers, only 37% disclosed race, a number that did not improve over time (p = .15), whereas 92% disclosed gender. Clinical trials that focused on females increased across the 3 timeframes (p < .001) for diabetes studies but not obesity studies. Overall, disclosure of race declined over the 3 timeframes whereas individually, the disclosure of African Americans improved.     

Evaluation of school‐based AIDS education curricula in San Francisco

Students in 3 middle (n=385) and 3 high schools (n=254) in the San Francisco Unified School District participated in the evaluation of an AIDS education curriculum. Classes within‐schools were designated as either intervention classes or nonintervention classes. Students in intervention classes received 3 class periods of AIDS instruction with a newly developed curriculum. Students in nonintervention classes did not receive any special AIDS instruction. All students completed a pretest and posttest AIDS knowledge and attitude survey. The results indicated that AIDS instruction classes demonstrated a significant knowledge‐advantage, as well as change in attitudes (e.g., reflecting greater tolerance for attending class with students who may have AIDS or HIV infection).     

Sexual behaviour in aids‐related research: Reliability and validity of recall and diary measures

In order to assess the reliability and validity of two data collection instruments for measuring sexual practices in homosexual men, we administered a recall data collection instrument to 30 sexually active men, and a diary instrument to a subset of 19 participants. Each instrument covered a period of one month. For the recall instrument, the correlation coefficients between the test‐retest showed a good level of reliability for a number of infrequent sexual practices but was poor for frequent sexual practices. Correlation coefficients were calculated for sexual practices recorded in the first two and the second two weeks for both the recall and the diary. Generally, the level of agreement between the first and second two weeks for sexual practice data recorded in the diary was lower than the recall questionnaire. While the reliability of the recall method was found to be limited to certain sexual practices, it was concluded to be the most reliable and efficient method presently available for the collection of important high‐risk AIDS‐related sexual activities for a one‐month period.     

Adaptation and Coping in Childhood and Adolescence for those at Risk for Depression in Emerging Adulthood

Emerging adulthood is a time of great possibility and of considerable risk. This qualitative study explored the adaptation and coping strategies used over time by twenty-five emerging adults. Respondents were selected from a longitudinal community study cohort of 26-year-olds and had experienced adversity in early life. Participants mentioned using a variety of strategies, such as active evasion, seeking support, and “letting go,” in order to cope with difficulties. These strategies varied by context and according to respondents’ developmental level at the time of the adversity. Flexibility in understanding life circumstances and in choosing coping strategies to deal with specific adversities was noted as beneficial through childhood, adolescence, and emerging adulthood.     

A Comparison of Older Informal Caregivers and Non-Caregivers Living in Non-Metropolitan Areas

The primary purpose of this study was tocompare the quality of life, health, and socialsupport of caregivers and non-caregivers age 65or older. A secondary purpose was to examineage identity in these two groups. This samplewas taken from a large quality of life surveyof 875 individuals age 55 or older living incommunities in northern British Columbia,Canada (Michalos et al.,2001). We restricted our sample to (a)individuals 65 years or older because we wereparticularly interested in seniors, and (b)married individuals because preliminaryanalyses indicated that marital status was apotentially confounding variable in thecaregiver/non-caregiver comparisons. Thus, oursample consisted of 239 married,community-dwelling respondents ranging in agefrom 65 to 86 years, with an average age of71.8 years. Of these respondents, 48.5% werefemales and 26.4% were caregivers. Generallyspeaking, caregivers and non-caregivers werenot significantly different in terms of qualityof life, self-reported health, and most aspectsof social support and age identity. Seniors,whether they were caregivers or not, reportedpositive levels of quality of life and healthstatus. Caregivers and non-caregivers, however,did differ in terms of: (a) their satisfactionwith their romantic relationships, withcaregivers being less satisfied, and (b) theage they felt mentally with caregivers feelingslightly older mentally than non-caregivers.Thus, caregiver status alone does not appear toresult in lower levels of quality of life,poorer mental and physical health, lower levelsof social support, or older age identitiesoverall in older, married adults living innon-metropolitan areas.     

Interactions That Trigger Self‐Labeling: The Case of Older Undergraduates

Deviant or stigmatizing labels are associated with various negative outcomes. Although self‐labeling theory proposes that one can self‐label as deviant without first being labeled by others, most labeling research focuses on people whom others have already labeled. Using the case of undergraduates aged twenty‐five and older, I identify three subtle forms of interaction—contextual dissonance, reminder cues, and third‐party communication—that trigger self‐labeling and are associated with negative reactions, even absent others' direct negative feedback or prior labeling. I also show that each form of interaction may systematically relate to specific kinds of negative reactions. I discuss possible reasons for these patterns, as well as how these findings may affect self‐labeling theory and policymaking decisions in higher education.     

Medical Complications of Female Genital Mutilation

Abstract

More than 130 million women are subjected to genital mutilation. Despite increasing efforts to reduce the practice, there are many obstacles to eliminating this 2,000-year-old practice, which is based on strong cultural traditions. As college health clinicians provide care to more international students from countries where female genital mutilation is performed, increased awareness and knowledge of the procedure will enable clinicians to understand and manage its complications. We report a case of obstructive uropathy resulting in hydronephrosis secondary to female genital mutilation and review the medical literature regarding this and other complications of genital mutilation “surgery.”