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Pay-to-play fees in public schools place more support for sport participation in the hands of parents; this may disproportionately affect the ability of girls to garner the benefits of sports. Using an online survey of a national sample of parents (N = 814), we examined the relationship between parents' gender role beliefs, parents' beliefs about the benefits and monetary value of sports, and the types of sports their daughters play. The results indicate that parents placed somewhat greater value on sport for sons, than for daughters, both ideologically and financially. Gender role beliefs played a small, but significant role, in shaping parents' beliefs about their daughters' involvement in sport, and the types of sports their daughters play.

Purpose: Many older patients with common chronic conditions also experience chronic pain. We examined how chronic pain affects patients' difficulty with recommended self-management activities and the potential intervening role of self-efficacy (the level of confidence in one's own ability to perform a specific task). Design and Methods: We obtained data from a cross-sectional nationwide survey of older patients, primarily older men, with chronic health conditions (N = 543). We defined chronic pain as pain present most of the time for 6 months or more during the past year. We assessed ability to follow self-management recommendations by asking respondents to rate their level of difficulty in performing three commonly recommended activities as suggested by their doctor. Results: More than 60% of survey respondents reported chronic pain. Chronic pain was significantly associated with difficulty exercising regularly (odds ratio [OR] = 1.57, 95% confidence interval [Cl] = 1.04-2.37) and taking prescribed medications (OR = 3.08, 95% Cl = 1.10-8.59) but not with following a recommended eating plan (OR = 1.16, 95% Cl = 0.76-1.76). However, when we took self-efficacy into account, chronic pain was no longer significantly associated with either exercise or taking medications. Implications: Chronic pain is a prevalent condition among older patients and is associated with greater reported difficulty performing certain essential self-management activities. Self-efficacy, however, plays an important intervening role. Specifically, higher self-efficacy negated or reduced the association between chronic pain and reported difficulty exercising and taking medications. Promoting self-efficacy among older adults with multiple chronic health problems is a promising strategy to improve their ability to follow self-management recommendations. Key Words: Self-efficacy, Multimorbidity, Mediator, Chronic conditions, Adherence

An alcohol misuse prevention study (AMPS) was applied as a curriculum-based program for fifth- and sixth-graders numbering 5,000. The program trained students to combat socially related pressures that force individuals to misuse alcohol. It was evaluated after 26 months of implementation using measures such as peer pressure, curriculum understanding and the actual use of alcohol. Results vary according to grade level and prior drinking experience.

Differential Effectiveness of an Elementary School-based Alcohol Misuse Prevention Program Recent studies indicate children are beginning to use alcohol earlier [1] and are drinking more heavily at earlier ages. [2,3] [...]

Objective To explore public opinion regarding insurance coverage for obesity treatment among severely obese adolescents. Design and Methods The National Poll on Children's Health was fielded to a nationally representative sample of US adults, January 2011. Respondents ( n = 2150) indicated whether insurance should cover specific weight management services for obese adolescents and whether private insurance and Medicaid should cover bariatric surgery. Sampling weights were applied to generate nationally representative results. Linear and logistic regression analyses were performed to assess associations. Results More respondents endorsed insurance coverage for traditional healthcare services (mental health 86%, dietitian 84%) than for services generally viewed as outside the healthcare arena (exercise programs 65%, group programs 60%). For bariatric surgery, 81% endorsed private insurance coverage; 55% endorsed Medicaid coverage. Medicaid enrollees, black, Hispanic, and low-income respondents had greater odds ( P < 0.05) of endorsing bariatric surgery coverage by Medicaid, compared to the referent groups (non-Hispanic white, income ≥$60K, private insurance). Conclusion Although public support for insurance coverage of traditional weight management services appears high, support for Medicaid coverage for bariatric surgery is lower and varies by demographics. If public opinion is a harbinger of future coverage, low-income adolescents could experience disparities in access to treatments like bariatric surgery. [ABSTRACT FROM AUTHOR]

Context In the United States, levels of public participation in medical research in the era of Clinical and Translational Science Awards (CTSAs) are unknown. Methods In 2011, a household survey was administered to a sample of U.S. adults, asking whether they (and children <18 years old) had participated, or were aware of opportunities to participate, in medical research. Respondents living within 100 miles of CTSA sites were identified. Regression analyses of participation and awareness (PA) were performed, applying sampling weights to permit nationally representative inferences. Results Overall, 2,150 individuals responded (completion rate = 60%); 65% of adults and 63% of families with children resided within 100 miles of ≥1 CTSA location. Research participation rates were 11% among adults and 5% among children. Among nonparticipants, awareness rates were 64% among adults and 12% among parents of children. PA among adults was associated with higher income and education, older age, presence of chronic conditions, and living within 100 miles of four specific CTSA locations. For children, PA was associated with higher household income and parents' chronic health conditions. Conclusions PA of medical research opportunities is substantially higher for adults than children. Higher PA levels near specific CTSAs merit investigation to identify their successful approaches. [ABSTRACT FROM AUTHOR]

Abstract: Successful launches of recently licensed vaccines contrast with pharmaceutical industry concerns about unfavorable market conditions, making the status and future of vaccine development uncertain. We assessed trends in private-sector vaccine research and development for the period 1995–2008, using a global pharmaceutical database to identify prophylactic vaccines in preclinical, Phase I, Phase II, or Phase III stages of development. We counted companies that research and/or manufacture vaccines (“vaccine originators”) and their vaccine products in each year. The global number of vaccine originators doubled (to 136), as did the number of prophylactic vaccine products in development (to 354); the majority of this growth was in preclinical and early phase clinical research. Because rapid growth in earlier research phases has not yet led to growth in Phase III, it is not yet clear whether recent industry expansion will translate to an increase in the number of available vaccines in the near future. [Copyright &y& Elsevier]

Abstract: Research and development of prophylactic vaccines carries a high risk of failure. In the past, industry experts have asserted that vaccines are riskier to produce than other pharmaceuticals. This assertion has not been critically examined. We assessed outcomes in pharmaceutical research and development from 1995 to 2011, using a global pharmaceutical database to identify prophylactic vaccines versus other pharmaceuticals in preclinical, Phase I, Phase II, or Phase III stages of development. Over 16 years of follow-up for 4367 products (132 prophylactic vaccines; 4235 other pharmaceuticals), we determined the failure-to-success ratios for prophylactic vaccines versus all other products. The overall ratio of failures to successes for prophylactic vaccines for the 1995 cohort over 16 years of follow-up was 8.3 (116/14) versus 7.7 (3650/475) for other pharmaceuticals. The probability of advancing through the development pipeline at each point was not significantly different for prophylactic vaccines than for other pharmaceuticals. Phase length was significantly longer for prophylactic vaccines than other pharmaceuticals for preclinical development (3.70 years vs 2.80 years; p <.0001), but was equivalent for all 3 human clinical trial phases between the two groups. We conclude that failure rates, phase transition probabilities, and most phase lengths for prophylactic vaccines are not significantly different from those of other pharmaceutical products, which may partially explain rapidly growing interest in prophylactic vaccines among major pharmaceutical manufacturers. [Copyright &y& Elsevier]

In the US, birth has become a carefully planned experience for those with the greatest access to resources. Pregnancy preparations, including prenatal care, childbirth education, and peer interactions, encourage women to act as informed consumers, to communicate their own values, beliefs, and preferences in labor and delivery, and to challenge healthcare systems and medical providers. Simultaneously, there has been a growth in the number of mothers who reject medical recommendations for infant vaccination and newborn interventions. These challenges are presented by women with higher levels of education and resources, a group that is also most likely to insist on control over birth. In this article, I draw on qualitative data from mothers who reject vaccination recommendations for their children to highlight the interconnected experiences of childbirth self-advocacy and vaccine refusal. I suggest prenatal education toward self-advocacy may serve as a pedagogical process that mirrors the rhetoric of vaccine refusal. I conclude by showing how this new pedagogy of patient empowerment is nurtured and respected by pediatricians who administer vaccines and provide wellness care, even as they struggle with mothers who reject this core public health intervention. [ABSTRACT FROM AUTHOR]

Parents who confidently reject vaccines and other forms of medical intervention often seek out pediatric care, medical treatments, and prescription medications for their children in ways that seem to contradict these views. Drawing on in-depth interviews with 34 parents who rejected some or all vaccines for their children, this article examines the strategies they use to pharmaceutically manage their children's health, even when espousing a larger rejection of pharmaceutical interventions like childhood vaccines. Rather than treating decision-making as solely an internal process, this article shows how medication use results from individual, interactional, and institutional contexts, with different mechanisms of encouragement and enforcement. Using three illustrative cases, I show how parents manage ambivalence, which allows them to accept medication for their children as a tool to be deployed as deemed necessary in particular contexts while at the same time communicating their rejection of it. I conclude with suggestions for how to engage parents around healthcare decision-making. [ABSTRACT FROM AUTHOR]

An index of authors featured in the November 2, 2011 issue of "Obesity" journal, is presented.

This article explores secondary education in its historical aspects. The term "secondary education" is a historical and more specific reality. The term appeared by the turn of the eighteenth and nineteenth centuries, when several European states started to build public, and more or less secularized, educational systems, including schools for the general education of the future elite. The nineteenth-century secondary education itself was based on a type of school dating from the Renaissance. They were also characterized by the division of pupils into classes according to their educational level. One of the main evolutions of this form of schooling over a period of five centuries is about its connection with religion. The college soon proved to he a major weapon in the ideological fight that had started in the sixteenth century between Catholic and Reformed churches.