Multilevel community health promotion: How can we make it work?

The need for multilevel, comprehensive health promotion programmeshas become widely accepted, as has the importance of communityapproaches. However, many health promotion programmes focuson change at the individual level, no doubt partly due to thedifficulty of implementing all-inclusive health promotion. Thispaper discusses two strategies for guiding multilevel projects:multiple methods for community assessment and charting projectactivities by level of change (a possibility framework). Thesestrategies help ensure a multilevel focus and provide valuableinformation that can assist with the implementation of multilevelhealth promotion research projects in specific community contexts.Our primary purpose, therefore, is not to focus on theory orresearch findings. Rather, our goal is to make visible two strategiesthat have been helpful in one health promotion research projectin Victoria, British Columbia, Canada.     

Generalized Youden designs: construction and tables

Generalized Youden Designs are generalizations of the class of two-way balanced block designs which include Latin squares and Youden squares. They are used for the same purposes and in the same way that these classical designs are used, and satisfy most of the common criteria of design optimality.We explicitly display or give detailed instructions for constructing all these designs within a practical range: when υ, the number of treatments, is ?25; and b₁ and b₂, the dimensions of the design array, are each ?50.     

PARENTS,PEERS, PERCEIVED PRESSURE,AND ADOLESCENT SELF-CONCEPT: IS A DAUGHTER A DAUGHTER ALL OF HER LIFE?

Data collected in 1981 from 316 high-SES junior and senior high students suggest support for traditional perspectives regarding sex-differentiated self-esteem. While a significant proportion of the variance in self-esteem level is predicted by perceived approval and support from family for both girls and boys in junior high school, high school females and males drawn from the same community differ substantially. Cues of family approval continue to predict a large proportion of the variance in high school girls' self-concept, but are no longer significant for high school boys. Acceptance by friends is an important element for males at all school levels, and accounts for a small but significant proportion of the variance in high school but not junior high school girls' self-esteem scores. Daughters may not "be daughters' all of their lives, but our data suggest that young females still going to school and living at home are much more dependent on family approval and support than are young males in the same situation.     

Child Welfare Workers' Adoption of Decision Support Technology

Child welfare workers must process complex information in deciding to refer clients to appropriate mental health services. Decision support systems have been demonstrated in other fields to be an important tool, yet little research has been done in child welfare. This study focused on the adoption of a specific decision support system into child welfare practice. Quantitative analysis was used to demonstrate the diffusion of innovation process among a sample of state child welfare workers, while qualitative analysis was used to explain the facilitators and barriers to decision support systems adoption. Results indicate that for decision support systems to be widely adopted in child welfare practice, they should be integrated into the referral system and include workers' knowledge and experiences with referral resources. For successful adoption, decision support systems need to respect the natural logic and flow of worker interaction as well as organizational constraints.     

Invisible landscapes: students’ constructions of the social and the natural in an engineering course in South Africa

This paper examines the discourses that students draw on and propagate in a course on rural development in a first‐year engineering foundation programme. It looks at the way ‘rural’ is often constructed as ‘lack’ and therefore ‘other’, the dangers of constructing development as linear, the ways nostalgia and utopianism feed into discourses of development and how ‘propriety’ serves to maintain boundaries between nature and people, society and individuals. Different modes and media, coupled with the degree of regulation in the classroom, may enable alternate discourses to emerge or to be suppressed. This paper argues that the curriculum needs to engage with students’ views in order to understand, interrogate and critique the kinds of realities they feed into.     

PREDICT-1 (CNA106030): the first powered, prospective trial of pharmacogenetic screening to reduce drug adverse events

Pharmacogenetics (PGx) – the study of DNA variation in the human genome and the way this impacts the efficacy and safety of medicines – is becoming an increasingly important research tool as physicians, patients, regulatory authorities and payers look for innovative ways to improve the risk:benefit ratio of medicines. While scientific knowledge about PGx is rapidly increasing, implementation of PGx findings to patient care has yet to be fully achieved. One area where significant progress has been made is in the identification of PGx markers associated with variable response to antiretroviral medicines. For example, the major histocompatibility complex HLA‐B*5701 allele has been associated with hypersensitivity to abacavir (ABC) by several independent researchers. While PGx associations have been identified largely through retrospective examination, the clinical utility of these PGx markers in patient care has not been prospectively determined in a randomized study. This paper outlines the design of a study to evaluate the utility of prospective screening for HLA‐B*5701 to reduce the incidence of ABC hypersensitivity in an ABC‐naïve population of HIV‐infected subjects. This represents the first fully powered, randomized, blinded, prospective study to determine the clinical utility of PGx screening to reduce drug‐associated adverse events in any patient population. This type of trial design may have utility for other important medicines which have treatment‐limiting side effects. Copyright © 2007 John Wiley & Sons, Ltd.     

Perceptions of nonreciprocal touch in romantic relationships

College students attributed meaning on a questionnaire to 31 types of nonreciprocal touch occurring in opposite-sex romantic relationships. Subject sex and origin of touch (self vs. partner) had minor effects on attributed meanings. Subjects most often perceived these touches as expressing warmth/love, and rarely as expressing dominance/control.The authors are grateful to Richard Heslin and Jeffrey Fisher for their assistance in designing the study, and to C. Van Nelson for assistance in data analysis.