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Rubin's 'taking-in' and 'taking-hold' model has been a dominant paradigm for postpartum nursing. To determine whether 'taking-in' and 'taking-hold' apply to contemporary hospitalized postpartum women, I conducted a repeated measures survey of 95 women with uncomplicated postpartum courses after vaginal births during their hospital stay. 'Taking-in' and 'taking-hold' were measured with the Martell Postpartum Questionnaire-Revised (MPQ-R), a paper-and pencil instrument. An expert panel established the content validity of the MPQ-R in this study. Cronbach's alpha for the two subscales ranged from .40 to .60, a result of skewed distribution of items or lack of variability in scores. The participants were neither 'taking-in' nor 'taking-hold.' The distribution of the participants' responses was similar to each others' and indicated that their postpartum experiences included some aspects of both 'taking-in' and 'taking-hold.' Despite the limitations of the MPQ-R and the research methods, the findings suggest that Rubin's theory has limited usefulness for postpartum nursing of contemporary women. [ABSTRACT FROM AUTHOR]

Development and initial validation of the Infant Reactions Inventory (IRI), a parent-report instrument for assessing distress to sensory stimulation in early infancy, is reported. The final version of the scale contains 15 sets of questions, three items in each set, with all items averaged for a single Distress to Sensory Stimulation score. Evidence for convergent validity is provided by correlations with some scales of the Infant Behaviour Questionnaire. The IRI provides a useful tool for the assessment and identification of individual differences in response to sensory stimulation during early infancy. [ABSTRACT FROM AUTHOR]

This paper examines whether a woman's level of attachment to her unborn child varies according to her age, parity and the stage of pregnancy. Cranley's (1981) Maternal -- Fetal Attachment Scale (MFAS) was completed at mid-pregnancy by 104 women. Women of 35 and over (26 nulliparas and 26 multiparas) were compared with two equivalent groups of women in their twenties. Parity, occupational and educational status were controlled in the two age groups. At late pregnancy 96 of these women again completed the MFAS. It was hypothesized that the sample of older women would be more `tentative' than the younger ones in admitting to feelings of attachment to the fetus (because the former are likely to be aware that raised maternal age can be associated with increased risk to the fetus of conditions such as Down's syndrome) and that this effect would change as the pregnancy progressed. Examination of the MFAS scores revealed that there was a significant tendency for increased age to be associated with decreased levels of attachment at mid-pregnancy but this age effect disappeared by late pregnancy. [ABSTRACT FROM AUTHOR]

The effect of tulasi (Ocimum sanctum) powder supplementation on glycaemic control, lipidaemic control, total amino acids and uronic acid was studied in 27 non-insulin-dependent diabetes mellitus subjects. All the patients were on hypoglycaemic drugs. The above parameters were monitored at the start and on the thirtieth day. After 1 month of supplementation, a significant lowering of the blood glucose (20.8%), glycated proteins (11.2%), total amino acids (13.5%) and uronic acid (13.7%) was observed. A significant reduction was also noticed in the levels of total cholesterol (11.3%), low-density lipoprotein-cholesterol (14.0%), very low-density lipoprotein-cholesterol (16.3%) and triglycerides (16.4%). No appreciable change was noticed in high-density lipoprotein-cholesterol. [ABSTRACT FROM AUTHOR]

Postnatal depression carries a significant health burden for mothers and their offspring. However, the majority of screening or treatment studies for postnatal depression have been carried out on white or European populations and clinicians have been appropriately cautious about applying these findings to different cultural groups. This study describes the development and use of a Bengali version of the Edinburgh Postnatal Depression Scale (EPDS). Forty-eight Bangladeshi postnatal women in both Bangladesh and England were interviewed by a Syhletti/Bengali-speaking psychologist. The translated version of the EPDS was presented in the usual way, along with a standardized interview about the degree of social support and a translated version of the General Health Questionnaire (GHQ). Although one item of the EPDS presented some translation difficulties, the majority of items obtained reasonable semantic equivalence and were successfully rated by the women in the study. Preliminary examination of the psychometric properties of the scale suggested adequate reliability for the scale. Higher EPDS scores had both a significant positive association with less social support and higher scores on the GHQ. While this is not a screening validation study of the Bengali version of the EPDS, the findings do provide preliminary evidence that postnatal depression screening programmes may be an appropriate and inexpensive method of identifying postnatal distress in Bangladeshi women. [ABSTRACT FROM AUTHOR]

Those with low income, especially women of African American and Hispanic heritage have the greatest risk of inactivity and obesity. A 4-session (Internet and video) intervention with healthy snack and gym labs was tested in 2 (gym lab in 1) urban low-middle-income middle schools to improve low fat diet and moderate and vigorous physical activity.1 The gym lab was particularly beneficial (p =.002). Fat in diet decreased with each Internet session in which students participated. Percentage of fat in food was reduced significantly p =.018 for Black, White, and Black/Native American girls in the intervention group. Interventions delivered through Internet and video may enable reduction of health disparities in students by encouraging those most at risk to consume 30% or less calories from fat and to engage in moderate and vigorous physical activity. [ABSTRACT FROM AUTHOR]

Presents information on a study that evaluated hearing aid fitting from a societal viewpoint. Methods of the study; Results of the study; Discussion on the study.

In this paper we discuss middle-to-late life issues of the transgender and intersex communities. We demonstrate that these mid-to-late life issues are richly complex, full of courage, coping, risk, and resilience, and are grounded in a socio-ecological landscape of systemic actual and perceived violence and abuse. We examine how this socio-ecological environment affects the 'normative' mid-life cycle processes. Practical examples are drawn from the author's field interviews and survey research over the past decade. We close by examining the effects of such a landscape on the middle-age life stage and examine its potential ramifications for old age as well. [ABSTRACT FROM AUTHOR]

Social discourses regarding gender are responsible for molding people's cognitions, perceptions, behaviors, and interactions with others. Approaching and understanding gender socialization is an important strategy that must be included in the development of HIV/AIDS prevention interventions efforts targeting male-to-female (MTF) transgender people. This paper represents an effort to identify the influence of gender construction among a group of MTF transgenders in Puerto Rico. Using combined methodology, authors examined results from a questionnaire and in-depth interviews with a convenience sample of MTF transgenders living in the San Juan metropolitan area. Quantitative analysis demonstrated that this sample is composed of young, unemployed, and under educated population. Many participated in the sex industry. Participants reported need for basic health and social services and alienation from social networks. Qualitative analysis confirmed their traditional social construction of the 'feminine.' Their discourse underlines their need to reinforce their identity by the construction of a female self which undermine their possibilities for negotiating safer sex, as happens to most females in Latino societies. Social vulnerability, institutional exclusion, and gender construction issues are obstacles for the HIV prevention efforts among these communities. [ABSTRACT FROM AUTHOR]

Objective. To describe determinants of diet-related behavior and physical activity in First Nations for development of culturally appropriate diabetes prevention programs. Design. Cross-sectional 24-hour dietary recalls (n=129), random household risk factor surveys of primary food preparers/shoppers (n=133), and accelerometry (n=81) were assessed in First Nations adults. Setting. Nine Anishinaabe (Ojibwe and Oji-Cree) First Nations in northwestern Ontario, Canada. Results. Descriptive statistics (mean, SD, range) were calculated for all outcomes (dietary intake, psychosocial determinants of diabetes risk factors, dietary behaviors, physical activity, and body mass index, BMI) and t-tests were performed to examine differences in means between remote and semi-remote communities. Regression models adjusting for sociodemographic factors were also fit for the outcome measures. Respondents reported high-energy intake (2676 and 2060 kcal/day for men and women, respectively) and acquired higher fat/higher sugar/lower fiber foods up to 30 times more often than healthier alternatives. Over 80% of respondents were overweight or obese (BMI >25 kg/m2) with no significant difference between remote and semi-remote communities. Employment and having diabetes or impaired glucose tolerance were positively associated with BMI. Food intention scores were positively associated with healthy food acquisition scores. Younger respondents in semi-remote communities were more likely to have higher knowledge scores. Food intention scores were predicted by outcome expectations; outcome expectations by self-efficacy. Conclusions. Diabetes prevention programs for First Nations should focus on improving physical activity and dietary intake by targeting specific risk group needs. Food knowledge, self-efficacy, outcome expectations, and intention are important factors in understanding those needs. [ABSTRACT FROM AUTHOR]

The way Togolese people estimate the risk of becoming HIV-infected as a result of sexual contact was examined. The participants were presented with scenarios depicting a number of sexual acts, use of protective devices, and the probability that the partner is infected. Findings support the appropriate use of protective behavior information, as well as the appropriate use of probability information. Number of sexual acts was, however, perceived to have minimal impact on risk. Togolese people should be made aware, through systematic information campaigns, of the relationship between number of sexual acts and risk. [ABSTRACT FROM AUTHOR]

Exposure to the butter-flavoring compound diacetyl was assessed in four microwave popcorn manufacturing plants in the United States during multiple surveys from 2005-2007. Personal, breathing zone samples were collected and analyzed using NIOSH Method 2557. Samples were collected at the lapel, outside the powered air-purifying respirator used by any worker entering the slurry room. The data were evaluated for similarity of exposure across job duties and resulted in two exposure groups: (1) Mixers, those who routinely work in the slurry room mixing vegetable oil, salt, and flavorings, and (2) Non-mixers (all other production jobs). From 639 samples collected during surveys, summary estimates of exposures were calculated as the arithmetic mean and median of the data and by the geometric mean of lognormally distributed results. For Mixers, the range of the arithmetic mean exposures across the four plants was 0.057-0.860, and geometric means ranged from 0.029 to 0.231. For Non-mixers, the range of arithmetic mean exposures was 0.014-0.074 ppm, and geometric means ranged from 0.001-0.018. Because of concerns regarding reliability of the method with increasing humidity, mean exposures were also calculated for samples collected when relative humidity was 30% or less. For this restricted set of measurements, geometric statistics always produced higher summary metrics, compared with the full data set; the direction of change using arithmetic statistics was not uniform, being higher at two plants and lower at two plants. Overall, 49.1% of the 639 values were below the limit of detection; in the lower humidity analysis, 25.6% of 246 results were below the limit of detection. At one plant, ventilation changes were made in the slurry room; based on 39 additional samples (not included in the 639 values reported here) collected using the same protocol after the engineering change, exposure decreased from 0.614 to 0.061 ppm. Further work at these facilities to better characterize diacetyl exposure was not possible, as substitution resulted in diacetyl being removed from the product. [ABSTRACT FROM AUTHOR]

Popular interest in online communities has grown rapidly in recent years as a result of the widespread diffusion of Web 2.0 applications. However, the full values and potential of online communities cannot be realised without users' ongoing participation. Thus, this study aims at developing and empirically testing a research model to examine users' continuance intention to participate in an online community based on an extended information systems (IS) continuance model. Specifically, entertainment value and affective commitment are included in the IS continuance model and empirically examined in the context of online communities. A total of 240 returns collected from an online survey, which was conducted among users of a website bulletin board-based community in China, were analysed using partial least squares. The results reveal that users' continuance intention to participate in an online community is determined by both satisfaction and affective commitment. Satisfaction and affective commitment are, in turn, influenced by positive disconfirmations of purposive and entertainment values. The findings of this study contribute not only to theory building in online community continuance but also inform online community moderators in their effort to develop strategies for retaining their users. [ABSTRACT FROM AUTHOR]

This study investigated the functional brain organization of 68 male-to-female (MtF) transwomen and 26 female-to-male (FtM) transmen by comparing their performance with 36 typical male and 28 typical female controls on two indicators of cerebral lateralization: dichotic listening and handedness. A sex-differentiating dichotic test and a handedness questionnaire were administered. It was hypothesized that the MtF participants' dichotic performance would be significantly different from the control males and resemble the control female pattern. This hypothesis was supported. It was also hypothesized that the FtM dichotic pattern would be significantly different from the control females and would resemble the control male pattern. This hypothesis was not supported. Finally, it was hypothesized that there would be significantly more nonexclusive right-handers in both trans-groups. This hypothesis was supported. Taken together, the dichotic and handedness data reported here indicate that the MtF and FtM conditions are not mirror images in terms of the verbal-auditory aspects of their brain organization and neurobiology plays an important role, particularly in the development of the male-to-female trans-condition. [ABSTRACT FROM AUTHOR]

Empirical research on multi-disciplinary health care teams has yet to explore the development of mutual understanding between team members in the course of their collective clinical decision-making. This paper addresses this gap in the literature directly by examining changes in mutual understanding and the extent to which its facilitation is shared by individual members of multi-disciplinary health care teams. A Habermasian theoretical framework is used to operationalize mutual understanding. Social network analysis is used to analyze survey data on team-based clinical decision-making collected from multi-disciplinary health care teams in a Canadian province. The results of the study indicate that mutual understanding between team members ebbs and flows over the course of their collective clinical decisions. Further, as the extent of mutual understanding within the team increases, its facilitation becomes more equally shared among team members. The paper closes by specifying a practical outcome of the future work: a typology of clinical decisions that health care teams are able to use as an evaluation tool to assess how effectively they are making collective clinical decisions. As an evaluation tool, the typology would foster open and deliberative discussion, enable critical self-reflection, and thereby further enhancing mutual understanding within the teams. [ABSTRACT FROM AUTHOR]

Objective. General practitioner (GP) involvement may be instrumental in obtaining successful palliative cancer trajectories. The aim of the study was to examine associations between bereaved relatives’ evaluation of palliative cancer trajectories, place of death, and GP involvement. Design. Population-based, cross-sectional combined register and questionnaire study. Setting. The former Aarhus County, Denmark. Subjects. Questionnaire data on GPs’ palliative efforts and relatives’ evaluations of the palliative trajectories were obtained for 153 cases of deceased cancer patients. Main outcome measures. A successful palliative trajectory as evaluated retrospectively by the relatives. Results. Successful palliative trajectories were statistically significantly associated with home death (PR 1.48 (95% CI 1.04; 2.12)). No significant associations were identified between the evaluations of the palliative trajectory at home and GP involvement. “Relative living with patient” (PR 1.75 (95% CI: 0.87; 3.53)) and “GP having contact with relatives” (PR 1.69 (95% CI 0.55; 5.19)) were not significantly associated, but this may be due to the poor number of cases included in the final analysis. Conclusion. This study indicates that home death is positively associated with a higher likelihood that bereaved relatives will evaluate the palliative trajectory at home as successful. No specific GP services that were statistically significantly associated with higher satisfaction among relatives could be identified, but contact between GPs and relatives seems important and the impact needs further investigation. [ABSTRACT FROM AUTHOR]

This paper reports on an investigation into the skills and competencies of forensic learning disability nurses in the United Kingdom. The two sample populations were forensic learning disability nurses from the high, medium, and low secure psychiatric services and non-forensic learning disability nurses from generic services. An information gathering schedule was used to collect the data; of 1200 schedules, 643 were returned for a response rate of 53.5%. The data identified the 'top ten' problems that forensic learning disability nurses may encounter, the skills and competencies necessary to overcome them, and the areas that need to be developed in the future. The results indicated that the forensic learning disability nurses tended to focus on the physical aspects to the role whilst the non-forensic learning disability nurses tended to perceive the forensic role in relational terms. This has implications for practice, policy, and procedures. [ABSTRACT FROM AUTHOR]

Tobacco-related conditions contribute significantly to the health gap between Indigenous and non-Indigenous Australians. Smoking rates in Australia's Indigenous population has failed to decline even though smoking rates in Australia have declined in general. In some Indigenous communities, smoking rates remain very high. This paper outlines a project to investigate appropriate strategies to assist Indigenous smokers to quit and the important role nurses can play. [ABSTRACT FROM AUTHOR]

Objective. Several studies indicate that ethnicity may be a strong predictor of poor self-rated health (SRH). The aims of the present study were to investigate whether there was an association between ethnicity and poor SRH in subjects with type 2 diabetes and to determine if the association remained after adjusting for possible confounders such as age, gender employment, marital status, and education. Design. A cross-sectional study based on a patient population in the town of Södertälje. An unconditional logistic regression was performed to estimate the odds ratios (ORs) and 95% confidence intervals (95% CIs). Setting. Four primary health care centers. Subjects. A total of 354 individuals were included: Assyrian/Syrian-born (n = 173) and Swedish-born (n = 181). Results. The odds ratio for rating poor SRH for Assyrian/Syrian subjects with type 2 diabetes was 4.5 times higher (95% CI = 2.7-7.5) than for Swedish patients in a crude model. After adjusting for possible confounders, unemployed/retired people had 5.4 times higher odds for reporting poor SRH than employees (OR = 5.4; 95% CI = 2.3-12.5). Women had 1.8 times higher odds (95% CI = 1.0-3.0) for reporting poor SRH than men. In the final model poor SRH among Assyrians/Syrians decreased but still remained significant (OR=3.7; 95% CI = 2.5-6.6). Conclusions. The findings in this study are important for planning primary health care services. They highlight the crucial importance of being aware of the subjective health status of immigrants fleeing from war in the Middle East and resettling in Sweden. [ABSTRACT FROM AUTHOR]

As in many other parts of the world, young people in Papua New Guinea (PNG) are considered particularly vulnerable to HIV infection. Young Papua New Guineans' understanding of health and HIV form the basis of their interactions with HIV-prevention programmes, yet literature documenting their views is limited. Participatory research was conducted with 31 youth in two different settings in the Highlands of PNG to analyse their perceptions of factors influencing young people's health in a local context. The participants perceived social and structural factors to have a dominant influence on their health outcomes, in contrast to prevention programmes' focus on individuals. Youth perceived HIV to be less pressing than other everyday health concerns not currently addressed by national programmes, with their resultant frustration undermining the potential of existing HIV-prevention interventions. The young participants' experience of the social spaces developed through Photovoice, the research approach used, demonstrates the potential and limitations of participatory initiatives to support young people's actions to reduce their vulnerability to poor health outcomes. Findings point to the importance of youth-focused intervention programmes engaging influential adults in a community, and supporting “in-between” spaces where young people and community leaders can connect in order to affect the health-related contexts in which young people live. [ABSTRACT FROM PUBLISHER]

Neonatal mortality is a major health problem in low and middle income countries and the rate of improvement of newborn survival is slow. This article is a review of the PhD thesis by Mats Målqvist, titled 'Who can save the unseen -- Studies on neonatal mortality in Quang Ninh province, Vietnam', from Uppsala University. The thesis aims to investigate structural barriers to newborn health improvements and determinants of neonatal death. The findings reveal a severe under-reporting of neonatal deaths in the official health statistics in Quang Ninh province in northern Vietnam. The neonatal mortality rate (NMR) found was four times higher than what was reported to the Ministry of Health. This underestimation of the problem inhibits adequate interventions and efforts to improve the survival of newborns and highlights the invisibility of this vulnerable group. The findings of the thesis also point at an inequity in survival chances based on ethnicity of the mother. Newborns of ethnic minority mothers were at a twofold risk of dying within the first 4 weeks of life compared to their peers belonging to the hegemonic group of Kinh (OR 2.08, 95% CI: 1.393.10). This increased risk was independent of maternal education and household economic status. Neonatal mortality was also associated with home deliveries, non-attendance to antenatal care and distance to the health care facilities. However, ethnic minority mothers still had an increased risk of experiencing a neonatal death even if they attended antenatal care, delivered at, or lived close to a health facility. This example of ethnic inequity highlights the importance to target those most in need. [ABSTRACT FROM AUTHOR]

Background: The number of injured far exceeds those dead and the average injury to mortality ratio in earthquakes stands at 3:1. Immediate effective medical response significantly influences injury outcomes and thus the overall health impact of earthquakes. Inadequate or mismanagement of injuries may lead to disabilities. The lack of precise data from immediate aftermath is seen as a remarkable weak point in disaster epidemiology and warrants evidence generation. Objective: To analyze the epidemiology of injuries and the treatment imparted at a secondary rural hospital in the Kutch district, Gujarat, India following the January 26, 2001 earthquake. Design/Methods: Discharge reports of patients admitted to the hospital over 10 weeks were analyzed retrospectively for earthquake-related injuries. Results: Orthopedic injuries, (particularly fractures of the lower limbs) were predominant and serious injuries like head, chest, abdominal, and crush syndrome were minimal. Wound infections were reported in almost 20% of the admitted cases. Surgical procedures were more common than conservative treatment. The most frequently performed surgical procedures were open reduction with internal fixation and cleaning and debridement of contaminated wounds. Four secondary deaths and 102 transfers to tertiary care due to complications were reported. Conclusion: The injury epidemiology reported in this study is in general agreement with most other studies reporting injury epidemiology except higher incidence of distal orthopedic injuries particularly to the lower extremities. We also found that young males were more prone to sustaining injuries. These results warrant further research. Inconsistent data reporting procedures against the backdrop of inherent disaster data incompleteness calls for urgent standardization of reporting earthquake injuries for evidence-based response policy planning. [ABSTRACT FROM AUTHOR]

Background: Research on reproductive health in developing countries focuses mostly on the role of economic development on various components of reproductive health. Cross-sectional and empirical research studies in particular on the effects of non-economic factors such as reproductive rights remain few and far between. Objective: This study investigates the influence of two components of an empowerment strategy, gender equality, and reproductive rights on women's reproductive health in developing countries. The empowerment strategy for improving reproductive health is theoretically situated on a number of background factors such as economic and social development. Design: Cross-national socioeconomic and demographic data from a number of international organizations on 142 developing countries are used to test a model of reproductive rights and reproductive health. Results: The findings suggest that both economic and democratic development have significant positive effects on levels of gender equality. The level of social development plays a prominent role in promoting reproductive rights. It is found that reproductive rights channel the influences of social structural factors and gender equality on reproductive health. [ABSTRACT FROM AUTHOR]

The recent increase in international multicenter epidemiologic studies of occupational hazards and the current development of risk analysis tools based on multinational exposure data provide an incentive to evaluate the extrapolation of exposure data across countries. We compared formaldehyde measurements in the French (COLCHIC) and U.S. (IMIS) occupational exposure databases for 1986-2001 using multimodel inference. In this approach, conclusions are based on a set of plausible models rather than on a single model. Modeled variables included data source, industry, year, and sample type (short-term or long-term). The model set included 72 models corresponding to testing all variables and 5 interactions and estimation of 93 coefficients. As it is impossible to classify non-detects (ND) as short-term or long-term samples, they were removed from IMIS prior to analysis. Respectively, 3143 and 2646 IMIS and COLCHIC data, spread across 28 common industries, were analyzed. The full model explained 21% of the total variability. All fixed effects and the source-industry interaction were shown as strong predictors of exposure. The temporal trend (5% yearly decrease) and difference between short-term and long-term data (short-term greater than long-term by two-fold) were similar across the two databanks. Industry-specific differences between IMIS and COLCHIC were detected only for health-related activities for which COLCHIC levels were higher (∼ four-fold). Sensitivity analyses were conducted to assess the impact of excluding NDs from IMIS. They showed initial predicted industry-specific geometric means for IMIS data potentially multiplied by factors from 0.42 to 0.98 (long-term data) and from 0.11 to 1.4 (short-term data) when NDs were included with various distributions across the short-term and long-term categories. The most realistic scenario yielded 0.82 for long-term (18% overestimation) data and 1.05 (5% underestimation) for short-term data. Although tempered by a probable non-detect bias, our analysis showed that both databanks provide a similar multi-industry portrait of formaldehyde exposure despite a potential for very different occupational settings. Our results offer encouraging insight about extrapolation of exposure data across countries. [ABSTRACT FROM AUTHOR]

As the HIV/AIDS epidemic and the spread of sexually transmitted infections (STIs) in China has come to the forefront of public health attention, female sex workers (FSWs) and their clients (CFSWs) are becoming increasingly important to HIV/STI prevention efforts. This secondary analysis uses data abstracted from the Chinese Health and Family Life Survey 1999-2000 to report prevalence rates of two STIs as well as sexual risk behaviors for CFSWs - men who paid for sex with FSWs in the past 12 months - in comparison with men who had not patronized FSWs. Among 1879 Chinese CFSWs who completed anonymous interviews and urine testing, 152 (6.3%, weighted) said they had paid for sex in the past 12 months and 18.8% of CFSWs (weighted) tested positive for gonorrhea. CFSWs were 10 times more likely to have an STI (either self-reported or tested) than non-client Chinese men, and they were equally likely to use condoms inconsistently with their spouses. This study highlights the importance of studying CFSWs who use condoms inconsistently and do not practice safe sex with their spouse as a potential bridge population. Prevention and intervention efforts should target this bridge population and include education on HIV/AIDS and STI transmission, condom promotion, marriage counseling, destigmatization of HIV and STIs, and promotion of STI diagnosis and treatment. [ABSTRACT FROM AUTHOR]

This article aims to address female sex workers at high risk for contracting HIV in China by recommending evidence-based socio-structural interventions and policies at the national level that have yielded effective outcomes in other countries. National governments such as the Philippines and Hong Kong have utilized the Social Hygiene Clinic (SHC) model. A similar national policy can be highly effective in China. Evidence-based research study results indicate significant reductions in STI and consistent condom use among female sex workers in both China and the Philippines. Consistent condom use in both countries continues to be significantly associated with interpersonal- and venue-level factors. Individuals who had higher appointment-keeping ratios in the Philippines had higher rates of consistent condom use (OR = 2.7, 95% CI = 1.6-3.7) and significantly lower rates of STI (OR = 0.43, 95% CI = 0.26-0.57). By beginning with provinces, which already have a good relationship between establishment venues and the local Health Department, China can develop city ordinances and establishment regulations that begin to require regular examinations of female sex workers and entertainers in the local STI clinic. [ABSTRACT FROM AUTHOR]

The sexual transmission of HIV and STI is becoming a major public health concern in China. However, studies on sexuality in China remain scant, particularly those that analyze female sexuality. This study is to investigate the prevalence of multiple sexual partnerships (MSP) among adult women, and to examine trends and correlates for having more than one lifetime sexual partner. MSP, coded as having one or none vs. two or more lifetime sexual partners, was the key binary outcome measure. The data were from two national probability surveys on sexual behaviors in China carried out in 2000 and 2006. The sample size of adult women was 1899 in 2000 (total sample n=3812), and 2626 in 2006 (n=5404). Overall prevalence of MSP increased from 8.1% in 2000 to 29.6% in 2006 (chi-square test, significance = 0.000). The most rapid changes took place among women with less education, those who worked in blue-collar jobs and lower social-status positions, and those living in rural areas or small towns. Women who were better educated, lived in big cities, and held management-level occupations exhibited less change but had a higher baselines prevalence of MSP, suggesting that changes in MSP behavior may occur initially among women of higher socioeconomic status. Based on the 2006 data-set, significant positive correlates of MSP included more years of education, being in a long-term relationship, being middle aged, having a lower-status job, going out dancing at entertainments venues, and being a state of overall health in the past 12 months. The significant recent increase in MSP among women reinforces the need to examine China's sexual revolution in the context of a rapidly transitioning society. Findings regarding female sexuality also raise new questions to be explored in further sexuality studies, in order to better understand population sexual behaviors and to inform future HIV-prevention efforts. [ABSTRACT FROM AUTHOR]

Background: Diarrhea is an important problem among the under-five children in India. Objective: The paper examines long-term impacts of recurrent floods on diarrhea among under-five children in Uttar Pradesh, India. Design: A two stage stratified cluster survey was conducted in flood affected (exposed) and non-flood affected areas (unexposed). Results: The long-term impact of the floods was not clearly marked in the overall prevalence of diarrhea with the exposed group having prevalence of 55.1% as against 56.2% in the unexposed group of children under five. Economic condition of the household is associated with the prevalence of diarrhea in both exposed and unexposed strata. Anemia was found to be a significant risk factor for diarrhea among children in both the flood exposed and non-flood exposed populations. The recurrent floods did not have any significant effect on the prevalence of diarrhea in relation to gender, religion, caste, and household size. Conclusions: The study indicates that the long-term impacts of floods are very differently manifested than the immediate impacts. [ABSTRACT FROM AUTHOR]

The demographics of the United States are rapidly changing as a result of immigration from Latin America. Predictions indicate that by the year 2050, one of every four persons in the United States will be of Hispanic ethnicity. If health disparities relating to substance abuse and related mental health conditions among Hispanics are not fully understood and addressed, these will continue grow along with this population. The purpose of this pilot study was to describe the relationships among acculturation, depression, self-esteem, and substance abuse among a community sample of Hispanic men in South Florida ( N = 164, 82 heterosexual men and 82 men who have sex with men). Standardized instruments measuring acculturation, depression, self-esteem, and substance abuse were administered in English or Spanish in a face-to-face interview format. Descriptive statistics and multiple logistic regression were used to illustrate participant characteristics and test relationships among the variables. Despite the fact that the majority of participants were more acculturated to the Hispanic culture than US culture, reported low levels of education and income, were depressed, and used substances, this group of men reported high levels of self-esteem. However, age and depression were the only predictors of substance abuse. Acculturation and self-esteem were not predictors of substance abuse. Clinicians need to be aware of the high rates of depression and substance abuse in this population and screen frequently for signs and symptoms of depression and substance abuse during health care encounters. [ABSTRACT FROM AUTHOR]

Consumer participation in all aspects of mental health service delivery, including the education of mental health professionals, is now a policy expectation in Australia. Whether education programs introducing nurses to mental health nursing lead to more favourable attitudes towards consumer participation is yet to be examined in pre-registration nursing programs in Australia. The current evaluation examined changes in scores for the Consumer Participation Survey for undergraduate nursing students ( n = 68) in an Australian University. Data were analysed, using repeated measures t-test, to compare the pre- and post-test scores. There was a significant improvement in views on consumers participating as staff members. There were no statistically significant changes in attitudes towards consumer capacity and consumer involvement in care processes. Consumer participation in mental health care is now clearly articulated in Australian Government policy. For this to be successfully implemented a more comprehensive understanding of the ability of education to influence attitudes is required. [ABSTRACT FROM AUTHOR]

This study explored the relationships between Korean American parental depressive symptoms and parenting in 64 mothers and 35 fathers of adolescents 11 to 17 years of age. Using multiple regression after controlling for family income, both parents' depressive symptoms were found to significantly influence their acceptance and rejection behaviors, explaining 14% of variance in the mother model and 47% of variance in the father model. Specifically, maternal depressive symptoms were found to significantly positively influence their hostility. Paternal depressive symptoms were found to significantly negatively influence their affection and positively influence their hostility, neglect, and undifferentiated rejection. Educating Korean American parents, especially fathers, regarding the possible influence of their depressive symptoms on their acceptance and rejection of their adolescents could be helpful. [ABSTRACT FROM AUTHOR]

Empathy is one of the fundamental concepts in nursing, and it is an ability that can be learned. Various education models have been tested for improving empathic skills. Research has focused on using oral presentations, videos, modeling, practiced negotiation based on experiences, and psychodrama methods, such as role playing, as ways to improve empathy in participants. This study looked at the use of expressive arts to improve empathic skills of nursing students. The study was conducted with 48 students who were separated into five different groups. All groups lasted for two hours, and met for 12 weeks. Expressive art and psychodrama methods were used in the group studies. The Scale of Empathic Skill was administered to participants before and after the group studies. Before the group study took place, the average score for empathic skill was 127.97 ( SD = 21.26). After the group study, it increased to 138.87 ( SD = 20.40). The average score for empathic skill increased after the group (t = 3.996, p = .000). Results show that expressive methods are easier, more effective, and enjoyable processes in nursing training. [ABSTRACT FROM AUTHOR]

In 2008, a company using multiple buttermilk flavorings in the production of dry bakery mixes replaced one liquid flavoring containing 15-20% diacetyl with a proprietary substitute meant to lower occupational risk for diacetyl-related bronchiolitis obliterans. Subsequently, the National Institute for Occupational Safety and Health (NIOSH) evaluated buttermilk flavoring-related exposures at this company's facility, with a focus on measuring ketones by several methods. Volatile organic compounds (VOCs) were evaluated in the headspaces of six bulk flavorings samples, including the substitute buttermilk flavoring. Ketones were evaluated in workplace air via area and personal samples collected during batch preparation of the substitute buttermilk flavoring and production of a bakery mix containing the same flavoring. Air samples were evaluated using five different methods: NIOSH 2549, Modified OSHA PV2118, OSHA 1013, NIOSH Draft Procedure SMP2, and evacuated canisters. Of five buttermilk flavorings from five different flavorings manufacturers, diacetyl was present in four, including the substitute flavoring; acetoin in two; 2,3-pentanedione in four; 2,3-hexanedione in one; and 2,3-heptanedione in three. Among material safety data sheets (MSDS) for four flavorings, only one listed a hazardous ingredient, which was acetoin. The predominant flavoring ingredient identified in the headspace of the substitute flavoring was 2,3-pentanedione; all other chemicals noted above were also present. Diacetyl and 2,3-pentanedione were measured in workplace air via evacuated canisters. In one area and one personal air sample, 2,3-pentanedione was measured by OSHA Method 1013 at concentrations of 78 and 91 ppb, respectively. Without their or the employer's knowledge, workers who used buttermilk flavorings were exposed to substitute ketones from many flavorings manufacturers. Because 2,3-pentanedione, 2,3-hexanedione, and 2,3-heptanedione all share the same functional α-diketone group as diacetyl, these compounds also may share diacetyl's mechanism of toxicity. Until more is known about 2,3-pentanedione and other α-diketone compounds, they should not be assumed to be safe. Companies using artificial buttermilk flavorings should use a precautionary approach that assumes these flavorings pose a health risk and limit exposures through engineering and administrative controls and use of personal protective equipment. [ABSTRACT FROM AUTHOR]

In 2001, letters filled with a powder containing anthrax (Bacillus anthracis) spores were delivered by mail to a number of governmental and media locations within the United States. In response, the U.S. Centers for Disease Control and Prevention (CDC) provided guidelines for office personnel who might encounter a letter containing suspicious powder. These guidelines were developed during the crisis and in the absence of experimental data from laboratory or field investigations. An obvious need thus exists for quantitative and scientific verification for validation of these guidelines. This study attempts to address this need, adapting earlier work that used a multiple small office test site to create a model system in an open office test site in a vacated office building in which Bacillus atrophaeus spores (as a simulant for B. anthracis spores) were released by opening a letter. Using SF6 as a tracer gas, smoke tubes (containing stannic chloride) to visualize airflow, culturable aerosol sampling, and aerosol spectrometry we were able to characterize airflow and unmitigated spore aerosol dissemination within the office test site. Subsequently, two scripted test scenarios were used to reproduce selected portions of the existing CDC response guidelines and a modified version where the contaminated letter opener warned co-workers to evacuate then waited 5 min before doing so himself. By not leaving together with other co-workers, the risk of the letter opener cross-contaminating others was eliminated. The total potential spore aerosol exposure of the letter opener was not affected by remaining still and waiting 5 min to allow co-workers to escape first before leaving the office. Closing office doors and quickly deactivating the heating, ventilation, and air conditioning system significantly reduced spore aerosol concentrations outside the main open office in which they had been released. [ABSTRACT FROM AUTHOR]

The physiological and perceptual demands together with match notation of a four-set tennis match were studied in two elite professional players during the preparation for the 2008 Davis Cup. The design of this case report is unique in that it is the first to describe the demands of prolonged match-play (197 min) over four sets in ecologically valid conditions. The variables measured before and after each set included blood lactate and glucose concentrations, body mass, and perception of effort. Stroke count for each rally and heart rate were recorded during each set while salivary cortisol concentration was determined before and after the match. The rally length decreased as the match progressed. The results showed significant physiological stress, with each player losing greater than 2.5% of body mass (as fluid) and having elevated salivary cortisol concentrations after the match. Heart rate and perception of effort were also increased following each set indicating increasing stress. However, blood lactate decreased following the fourth set while blood glucose was maintained. The results also suggest that elite players may adjust work rates or tactics to cope with the increased perception of effort. This report shows that four sets of tennis are associated with increasing stress and fatigue. [ABSTRACT FROM AUTHOR]

Peroxisome proliferator activated receptor (PPARα) is a main regulator of energy metabolism, as it regulates the expression of genes encoding several key muscle enzymes involved in fatty acid oxidation. Importantly for power sports, it may affect pathways of glucose metabolism, which can be critical in power-based sports. The aim of this study was to analyse the distribution of the PPARα gene polymorphisms in mixed power/endurance athletes. The study was carried out on elite combat athletes and sedentary individuals, in an attempt to determine possible relationships between genotype and physical performance. We tested 60 male elite Polish combat athletes. Control samples came from 181 unrelated sedentary volunteers. The G/C polymorphic site in PPARα intron 7 was scanned using the polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) protocol with TaqI enzyme. Differences in the distribution frequency of this polymorphism were assessed by chi-square analysis. The results revealed that frequencies of the PPARα GG genotype (73.33% vs. 54.70%; P=0.04) and G allele (82.50% vs. 70.17%; P=0.01) were significantly higher in the elite combat athletes compared with sedentary controls. The results confirm the significance of the PPARα gene as a useful genetic marker in combat athletes. However, these results should be supported with more experimental data on PPARα polymorphisms with larger groups of elite athletes. [ABSTRACT FROM AUTHOR]

The linear driving force (LDF) model is applied to predict the service life of activated carbon cartridges. It is compared with the currently used Wheeler-Jonas equation, which results from a model of chemical reaction kinetics. The LDF model is based on a mass transfer model of adsorbate into the particle. The two models are studied in constant-pattern conditions. The properties of the two models are first clarified and then compared. It is shown that the Wheeler-Jonas equation leads to symmetrical breakthrough curves, whereas the constant-pattern LDF equation results in asymmetrical curves. Thus, the curvature of the isotherm has no influence on the shape of the Wheeler-Jonas curve. For the LDF breakthrough curve, it is shown that the asymmetry increases with the curvature of the isotherm. Wheeler-Jonas can be used with a Dubinin-Raduskevitch isotherm, whereas the LDF model analytical solution is valid for a Langmuir isotherm only. The LDF model can be used with the DR isotherm, but a numerical solution is required. At very low concentrations where the isotherm is linear, the constant pattern no longer exists and both models fail. The Dubinin-Raduskevitch isotherm must be fitted with a Langmuir isotherm to use the analytical solution of the LDF model. [ABSTRACT FROM AUTHOR]

This study was conducted to verify the performance of a recently developed subjective rating (SR) exposure assessment technique and to compare estimates made using this and two other techniques (trade mean, or TM, and task-based, or TB, approaches) to measured exposures. Subjects (n = 68) each completed three full-shift noise measurements over 4 months. Individual measured mean exposures were created by averaging each subject's repeated measurements, and TM, TB, and SR estimates were created using noise levels from worksites external to the current study. The bias, precision, accuracy, and absolute agreement of estimates created using the three techniques were evaluated by comparing estimated exposures with measured exposures. Trade mean estimates showed little bias, while neither the TM nor the SR techniques produced unbiased estimates, and the SR estimates showed the greatest bias of the three techniques. Accuracy was essentially equivalent among the three techniques. All three techniques showed poor agreement with measured exposures and were not highly correlated with each other. Estimates from the SR technique generally performed similarly to the TM and TB techniques. Methods to incorporate information from each technique into exposure estimates should be explored. [ABSTRACT FROM AUTHOR]

The aim of the study described was to capture student experiences in postgraduate clinical programmes across Australian universities. The data collected from the Directors of clinical programmes was used to further illustrate the training practices and constraints within the current Australian context. The data were collected through two survey instruments and were analysed by deriving themes via Leximancer as well as quantitative content analysis of percentage response to direct questions. The results indicate that while many students are happy with the training received, there are also many areas open to significant improvement both in the teaching and assessment of clinical skills and course content more generally. Students overwhelmingly prefer practical, interactive, and competency-based teaching and assessment to didactic, written and exam-based alternatives that are still used in most programmes. The responses from programme Directors further illustrate the concerns currently faced by clinical staff engaged in training programmes, with insufficient training places available in the community, fewer clients accessing training clinics, and concerns related to adequate supervision and the competency of students exited from programmes. The findings are discussed in light of limitations to the study and suggestions for future research directions. [ABSTRACT FROM AUTHOR]

Training in clinical psychology in Australia has become increasingly popular after coverage for psychological services under national Medicare was introduced. All regional universities in Australia offer clinical psychology training at the master's level, but little is known about how such training at these universities compares with training in larger, urban universities. Here, we report on results of surveys of clinical students and training directors at regional universities across Australia in order to contrast the perceived quality of training and various aspects of the nature of training. Responses from 190 students and all 35 directors of training show little difference in the perceived quality of training on several indices, with differences limited to the use of staff clinical research. Students at urban universities were less disposed to undertake a placement in a rural setting than those at regional universities. [ABSTRACT FROM AUTHOR]

The increased use of information technology in health care allows researchers to generate data on rates of medication use among population groups, raising questions as to whether these rates are too high or too low. This paper presents findings from a study of records of all prescription medication dispensed in one New Zealand region (Te Tāirawhiti) over a one year period. The study examined patterns of psychotropic medication use amongst older people, by age, gender, ethnicity and socio-economic position. It concludes that the chances of being defined as needing psychotropic medication, that is, of being 'medicalised', are not evenly spread through the elderly population. Gender, age and ethnicity impacted significantly on whether prescriptions were received. Our results suggest the need for a nuanced understanding of the medicalisation of unhappiness and deviant behaviour amongst the elderly which takes into account barriers to treatment for some social groups. [ABSTRACT FROM AUTHOR]

Airborne formaldehyde concentrations can be measured using several different techniques, including laboratory-based methods and direct-reading instruments. Two commercially available direct-reading instruments, an RKI Instruments Model FP-30 and a PPM Technology Formaldemeter htV, were compared with National Institute for Occupational Safety and Health Method 2016 in different test environments to determine if these direct-reading instruments can provide comparable results. The methods yielded the following mean concentrations for 47 samples: NIOSH Method 2016, 0.37 ppm; FP-30, 0.29 ppm; and htV, 0.34 ppm. Results from both of the direct-reading instruments were correlated with the laboratory-based method (R2 = 0.78 for FP-30, and 0.902 for htV). Comparison of the means of the three methods showed that on average the FP-30 instrument (p < 0.001) differed statistically from NIOSH Method 2016, whereas the htV (p = 0.15) was not statistically different from the NIOSH method. Sensitivity and specificity tests demonstrated that the FP-30 had sensitivity above 60% to detect formaldehyde concentrations at all the cutoff levels tested, whereas the htV appeared to have greater sensitivity above 88% for the levels evaluated. [ABSTRACT FROM AUTHOR]

This study compared workplace protection factors (WPFs) for five different contaminants (endotoxin, fungal spores, (1→3)-β-D-glucan, total particle mass, and total particle number) provided by an N95 elastomeric respirator (ER) and an N95 filtering facepiece respirator (FFR). We previously reported size-selective WPFs for total particle numbers for the ER and FFR, whereas the current article is focused on WPFs for bioaerosols and total particle mass. Farm workers (n = 25) wore the ER and FFR while performing activities at eight locations representing horse farms, pig barns, and grain handling facilities. For the determination of WPFs, particles were collected on filters simultaneously inside and outside the respirator during the first and last 15 min of a 60-min experiment. One field blank per subject was collected without actual sampling. A reporting limit (RL) was established for each contaminant based on geometric means (GMs) of the field blanks as the lowest possible measurable values. Depending on the contaminant type, 38-48% of data points were below the RL. Therefore, a censored regression model was used to estimate WPFs (WPFcensored). The WPFcensored provided by the two types of respirators were not significantly different. In contrast, significant differences were found in the WPFcensored for different types of contaminants. GMs WPFscensored for the two types of respirators combined were 154, 29, 18, 19, and 176 for endotoxin, fungal spore count, (1→3)-β-D-glucan, total particle mass, and total particle number, respectively. The WPFcensored was more strongly associated with concentrations measured outside the respirator for endotoxin, fungal spores, and total particle mass except for total particle number. However, when only data points with outside concentrations higher than 176×RL were included, the WPFs increased, and the association between the outside concentrations and the WPFs became weaker. Results indicate that difference in WPFs observed between different contaminants may be attributed to differences in the sensitivity of analytical methods to detect low inside concentrations, rather than the nature of particles (biological or non-biological). [ABSTRACT FROM AUTHOR]

The clinical use of lasers in surgery began in 1973 with applications of the carbon dioxide laser in otolaryngology, and since then the use of lasers has become commonplace in many medical and surgical specialties. Nonetheless, when biological tissue is subjected to laser radiation, the target cells can be vaporized, resulting in the aerosolization of their contents and the subsequent exposure of health care workers to laser-generated air contaminants (LGACs). The purpose of our analysis was to summarize and present all of the published literature pertaining to the laser-induced plume chemical and physical composition, health effects, and methods of control. The objective was to identify knowledge gaps within exposure science to set a research agenda for the protection of health care personnel exposed to LGACs. A literature search was performed using the PubMed database using a variety of search strategies and keyword combinations. To locate additional studies, we systematically searched the reference lists of all studies identified by our search, as well as key review papers. To date, researchers have identified roughly 150 chemical constituents of plume, as well as fine and ultrafine particulate matter, which has been shown to include viable cellular material, viruses, and bacteria. However, very few studies have attempted to characterize the effects of laser system type, power, and tissue treated, as it relates to LGAC exposure. Furthermore, current control strategies do not appear to be adequate in preventing occupational exposure to LGACs. [ABSTRACT FROM AUTHOR]

Background: Although skills-lab training is widely used for training undergraduates in technical procedures, the way in which clinical skills are to be used and instructed remains a matter of debate. Purpose: We conducted a randomized controlled trial to evaluate the learning outcome of two different instructional approaches in the context of acquiring procedural–technical skills. Methods: Volunteer 2nd- and 3rd-year medical students were randomly assigned to an intervention group receiving instruction according to Peyton's Four-Step Approach (IG; n = 17) or to a control group receiving standard instruction (CG; n = 17). Both groups were taught gastric-tube insertion using a manikin. Following each of the two forms of instruction, participants’ first independent gastric-tube insertions were video recorded and scored by two independent video assessors using binary checklists and global rating forms. The time required for each instructional approach and for the first independent performance of the skill was measured. Results: A total of 34 students agreed to participate in the trial. There were no statistically significant group differences with regard to age, sex, completed education in a medical profession, or completed medical clerkships. The groups did not differ in terms of correct stepwise performance of the procedure as assessed by a binary checklist (p < .802). However, ratings based on global rating scales assessing professionalism and accompanying patient-doctor communication proved significantly better in IG (both ps < .001). The length of the different instructional approaches did not differ significantly between the two groups (IG: 605 ± 65 s; CG: 572 ± 79 s; p < .122), but the time needed for the first independent performance of gastric-tube placement on the manikin was significantly shorter in IG (IG: 168 ± 30 s; CG: 242 ± 53 s; p < .001). Conclusions: Peyton's Four-Step Approach is superior to standard instruction with respect to professionalism and accompanying doctor–patient communication and leads to faster performance when trainees perform the learned skill for the first time. [ABSTRACT FROM AUTHOR]

The purposes of this study were to derive nasalance norms for monolingual Greek speakers, to examine nasalance scores as a function of gender and to draw cross-linguistic comparisons based on normative data. Participants read aloud a corpus of linguistic material, consisting of (1) a nasal text, an oral text and a balanced text; (2) a set of nasal sentences and four sets of oral sentences and (3) repetitions of each of 12 syllable types (8 oral and 4 nasal). The last two sets of material corpus were based on an adaptation of the Simplified Nasometric Assessment Procedures Test (SNAP test) test (MacKay and Kummer, 1994) in Greek, called the G-SNAP test. Eighty monolingual healthy young adult speakers of Greek, 40 males (mean age = 21 years) and 40 females (mean age = 20.5 years), with normal hearing and speech characteristics and unremarkable history were included in the study. The Nasometer (model 6200-3) was used to derive nasalance scores. Mean normative nasalance for spoken Greek was 25.50%, based on the G-oronasal text (with 8.6% nasals). Nasalance scores did not differ significantly with respect to gender. Finally, spoken Greek consistently yielded lower nasalance scores than other languages examined in past work. The aforementioned normative data on nasalance of young adult speakers of Greek are valid across gender and have direct clinical utility as they provide valuable reference information for the diagnosis and management of Greek adults with resonance disorders caused by velar dysfunction. [ABSTRACT FROM AUTHOR]

This work investigates the developmental aspects of the duration of point vowels in children with normal hearing compared with those with hearing aids and cochlear implants at 4 and 5 years of age. Younger children produced longer vowels than older children, and children with hearing loss (HL) produced longer and more variable vowels than their normal hearing peers. In this study, children with hearing aids and cochlear implants did not perform differently from each other. Test age and HL did not interact, indicating parallel but delayed development in children with HL compared with their typically developing peers. Variability was found to be concentrated among the high vowels , / but not in the low vowels , /. The broad findings of this work are consistent with previous reports and contribute a detailed description of point vowel duration not in the literature. [ABSTRACT FROM AUTHOR]

We examined children's productions of mainstream and non-mainstream relative clause markers (e.g. that, who, which, what, where, Ø) in African American English (AAE) and Southern White English (SWE) as a function of three linguistic variables (syntactic role of the marker, humanness of the antecedent and adjacency of the noun phrase head). The data were language samples from 99 typically developing 4-6-year-olds: 61 spoke AAE and 38 spoke SWE. The majority of the children's relative clauses included mainstream markers. Non-mainstream markers were rare, with 3-6% involving Ø subjects and 2% involving what. The children produced who exclusively as subjects and with human antecedents, where exclusively as locatives and with non-human antecedents and Ø and what primarily as direct objects or objects of prepositions and with non-human antecedents. Although AAE- and SWE-speaking children produce some non-mainstream relative markers, the majority of their markers are mainstream. Their use of relative markers is also influenced by linguistic variables in ways that are consistent with a wide range of mainstream and non-mainstream English dialects. These findings show across-dialect similarity in children's relative clauses, even though characterisation of relative clauses as a contrastive dialect structure remains justified. [ABSTRACT FROM AUTHOR]

Objectives. Sickle cell disease (SCD) has a distinctive social history that continues to influence research and clinical practice related to the disease. Despite the historical link between SCD and concepts of 'race', there is limited empirical information on the relationships among SCD patients' 'race'/ancestry/ethnicity/nationality, their beliefs and attitudes associated with these identities, and their SCD experiences and outcomes. We conducted a preliminary study to explore some of these relationships. Design. This US-based study comprised 46 adults with SCD, 20 males and 26 females, with an average age of 32.04 (18-59) years. Using US Census 'race' categories, 42 participants identified themselves as 'Black or African American', two as 'Hispanic/Latino', and two as 'Other'. All participants completed a computer-based questionnaire that included measures of sociodemographics and 'racial' identity. Indicators of disease severity and frequency of hospitalizations were obtained from their medical records. Two open-ended questions explored the impact of SCD and 'race' on participants' experiences and another probed their understanding of the term 'race'. Results. Overall, participants had positive regard for their 'race' and endorsed assimilation and humanist ideologies. 'Racial' identity was not related to disease severity or hospitalizations. Participants with non-US-born parents had higher levels of minority ideology than those with US-born parents (p<.01). Public regard beliefs were negatively associated with participants' perspective that SCD influenced how others perceived and treated them (r=-.35; p=.02). Centrality of 'race' and a nationalist ideology were positively associated with participants' belief that their 'race' influenced their experience with SCD (r=.31; p=.04 and r=.45; p=.001, respectively). The open-ended responses reveal that SCD and 'race' had varied effects on participants' experiences. Conclusion. This study illustrates the complexity of the interplay between 'racial' identity beliefs and patients' experiences with SCD, as well as the role of 'race' in these experiences. Implications of the findings are discussed. [ABSTRACT FROM AUTHOR]