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The purpose of this study is to further understanding of the association between distrust in the healthcare system and written and verbal expressions of donation intentions among African Americans. We hypothesize that distrust in the healthcare system will be significantly, positively associated with both verbal and written donation intentions. Five hundred and eighty five participants completed a 98-item survey that included scales on distrust in the healthcare system and donation intentions. Bivariate analyses ( t-tests, ANOVA, chi-square tests and odds ratios) were used to explore the extent to which donation intentions and distrust in the healthcare system varied by demographic characteristics and the association between the distrust in the healthcare system scale and verbal and written donation intentions. Separate logistic regressions were performed with each of the dependent variables to see if significant associations remained while controlling for confounders. Findings based on the multiple regression indicate that when controlling the participant's education level, distrust in the healthcare system was not significantly related to written donation intentions (OR = 1.04; P = .12). When controlling for education level, health insurance status, Community Health Advocates group and marital status, distrust in the healthcare system was significantly associated with verbal donation intentions (OR = 1.08; P < 0.05). Our results suggest that distrust in the healthcare system varies in the way that it is associated with donation intentions. Future organ donation studies should be conducted to determine the pathways through which distrust in the healthcare system impacts different types of organ donation intentions. [ABSTRACT FROM AUTHOR]

The availability of tobacco and alcohol products in community pharmacies contradicts the pharmacists' Code of Ethics and presents challenges for a profession that is overwhelmingly not in favor of the sale of these products in its practice settings. The primary aim of this study was to estimate the proportion of pharmacies that sell tobacco products and/or alcoholic beverages and to characterize promotion of these products. The proportion of pharmacies that sell non-prescription nicotine replacement therapy (NRT) products as aids to smoking cessation also was estimated. Among 250 randomly-selected community pharmacies in Los Angeles, 32.8% sold cigarettes, and 26.0% sold alcohol products. Cigarettes were more likely to be available in traditional chain pharmacies and grocery stores than in independently-owned pharmacies (100% versus 10.8%; P < 0.001), and traditional chain drug stores and grocery stores were more likely to sell alcoholic beverages than were independently-owned pharmacies (87.5% vs. 5.4%; P < 0.001). Thirty-four (41.5%) of the 82 pharmacies that sold cigarettes and 47 (72.3%) of the 65 pharmacies that sold alcohol also displayed promotional materials for these products. NRT products were merchandised by 58% of pharmacies. Results of this study suggest that when given a choice, pharmacists choose not to sell tobacco or alcohol products. [ABSTRACT FROM AUTHOR]

Seasonal influenza vaccination is recommended for all persons aged ≥50 years to reduce influenza related morbidity and mortality, but vaccination coverage among community-dwelling elderly remains low. Homebound elderly receiving home-based primary care (HBPC) have fewer barriers to vaccination than other community-dwelling elderly. The Mount Sinai Visiting Doctors (MSVD) program provides HBPC to homebound elderly in New York City. This study assessed seasonal influenza vaccination coverage within an urban HBPC program and identified factors associated with vaccine refusal. A cross-sectional analysis of data from the 2008-2009 influenza season was completed and influenza vaccination coverage was assessed. The association between social, demographic and health-related characteristics and vaccine refusal was evaluated using bivariate analysis and multivariable logistic regression. Of 689 people aged >65 eligible for influenza vaccination, 578 (84%) accepted and 111 (16%) refused vaccination. In multivariable analysis, vaccine refusal was positively associated with female gender (adjusted odds ratio [AOR] = 1.85, 95% confidence interval [CI] 1.02, 3.35), black race (AOR = 2.04, 95% CI 1.28, 3.25), and living alone (AOR = 1.71, 95% CI 1.10, 2.67), and negatively associated with dementia (AOR = 0.59, 95% CI 0.37, 0.91). Seasonal influenza vaccine coverage in the MSVD program was high compared to nursing home and community-dwelling elderly. Offering patients vaccination at home without additional expense will likely improve vaccine coverage among urban homebound elderly. Understanding why vaccine refusal rates are higher among females, black patients, and those living alone should guide interventions to increase vaccine acceptance among this population. [ABSTRACT FROM AUTHOR]

The military community is considered a high-risk environment for HIV transmission. In this study, a total of One hundred and fifty military personnel aged between 20 and 55 years attending the Nigerian army Hospital, Air Force Clinic and Police Clinic in the Niger Delta of Nigeria were randomly recruited for the study. Samples were tested for HIV using an immunochromatographic assay. The CD4 cell count was estimated using the Partec Cyflow Counter (Partec, Germany). Results of the study showed an overall HIV prevalence rate of 14.67%. The prevalence of HIV was significantly higher among subjects in the ≥40 years age group ( P = 0.03). The HIV prevalence was higher among female subjects compared to male military personnel ( P = 0.05). Also, there was a significant negative correlation between the CD4 count and HIV positivity (r = −0.443, P<0.01). Out of the 22 subjects positive for HIV, 9.1% were severely immune compromised with CD4 count below<200 cells/μL while 72.7 and 18.2% had CD4 count of 200-350 and 350-500 cells/μL respectively. There is need for the development of a strategic plan that integrates HIV/AIDS and other STIs programs into existing systems and structures to foster behavior change through information dissemination. Policies should be instituted to make condoms regularly available and freely distributed, with the goal of achieving a 100%-condom-use rate. There is the need for an effective voluntary counseling and testing (VCT) and sentinel surveillance survey in the Nigerian military. Also critical is the establishment of a fully integrated and comprehensive care and support system including universal access of antiretroviral treatment for infected people. [ABSTRACT FROM AUTHOR]

Lack of helmet use while bicycling can have deleterious effects on health. Despite evidence that helmets can greatly reduce the risk of head injury, the prevalence of helmet use among riders, including those in urban bicycle-share programs, has been shown to be very low. Building upon the authors' previous work, this study's aim was to assess prevalence of helmet use among cyclists riding on widely used New York City (NYC) bike lanes. Across a 2-month period, cyclists were filmed in five NYC locations with bike lanes. Filming took place at two separate time periods (recreation and commute) at each location. Helmet use was coded for each cyclist. A total of 1,921 riders were observed across 10 h. Overall, half (50.0 %) of all riders were observed wearing a helmet. Rates of using a helmet were consistent across all five locations. In addition, only 21.7 % of Citi Bike users and 15.3 % of other bicycle rentals were observed wearing helmets while cycling. The prevalence of helmet use was significantly higher among males than females (z = 4.48, p < .001). Cyclists observed during the recreational time period were also less likely than those observed during the commuting time period to be wearing a helmet (z = 7.17, p < .001). The results of this study contribute to the growing literature about cyclist helmet use in urban areas. [ABSTRACT FROM AUTHOR]

To examine common reasons for utilization of health care services at a free homeless youth clinic. This is a retrospective chart review for visits over a 1 year period. Data on age, gender, and up to 3 chief complaints per visit were collected from the electronic medical record. Of the 744 clinical encounters, the mean age of youth was 18.8 years and 53.2 % involved female patients. The most common reasons for utilizing services include screening and treatment of sexually transmitted infections (STI) 14.3 %, physical exam for housing 13.7 %, dermatologic complaints 13.5 %. Chief complaints were different for males and females ( p ≤ 0.001). Females were more likely to receive laboratory testing for STI than males ( p ≤ 0.001). Females were most likely to seek care for sexual and reproductive health needs and males were more likely to come for acute concerns. These differences can inform providers working with this vulnerable population. [ABSTRACT FROM AUTHOR]