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Purpose: This preliminary investigation examined speech-language pathologists' (SLPs') use of contextualized practices (i.e., functional, personally relevant, nonhierarchical, and collaborative) compared with traditional practices (i.e., clinical, generic, hierarchical, and expert driven) with school-age children and adolescents with traumatic brain injury (TBI). Methods: An electronic survey asked SLPs about their use of clinical activities described as more or less contextualized. Research questions focused on frequency of using contextualized practices and factors associated with their use or nonuse. Results: Seventy responses met criteria for analysis; 98% of these participants reported using at least 1 contextualized practice. Higher use of contextualized practices was associated with working in schools compared to health care settings, access to experts, and greater experience with TBI. Most frequently cited reasons for not using contextualized practices included not fitting the student and scheduling issues. Conclusions: Factors associated with using contextualized practices suggest that access to experts and experience with TBI are critical components for facilitating contextualized practice recommendations. Reasons for not using certain contextualized practices highlight the need to address scheduling issues and to increase education about practices that may best meet the unique needs of students with TBI.

The objective of this study was to examine food selectivity in children with autism spectrum disorders longitudinally. Additionally explored were the stability of the relationship between food selectivity and sensory over-responsivity from time 1 to time 2 and the association between food selectivity and restricted and repetitive behavior at time 2. A total of 52 parents of children with autism were surveyed approximately 20 months after completing an initial questionnaire. First and second surveys each contained identical parent-response item to categorize food selectivity level and a scale to measure sensory over-responsivity. A new scale to measure restricted and repetitive behaviors was added at time 2. Results comparing time 1 to time 2 indicated no change in food selectivity level and a stable, significant relationship between food selectivity and sensory over-responsivity. The measure of restrictive and repetitive behavior (time 2) was found to significantly predict membership in the severe food selectivity group. However, when sensory over-responsivity and both restricted and repetitive behaviors were included in the regression model, only sensory over-responsivity significantly predicted severe food selectivity. These results support conclusions about the chronicity of food selectivity in young children with autism and the consistent relationship between food selectivity and sensory over-responsivity.

The article focuses on the Overdose Data to Action – Care Coordination and Capacity Building (OD2A-C3) Project in Hawaiʻi, which was initiated to combat the opioid crisis. It mentions that the project aimed to train social workers, allied health and human service professionals, provide a 12-week intensive, paid internship for social work, public health, and psychology students and develop and disseminate prevention materials to enhance public awareness.

This article presents the findings of a secondary analysis of the National Longitudinal Transition Study 2 that explored the predictive association between training in access technology and performance on the Woodcock-Johnson Tests of Academic Achievement: III. The results indicated that the use of access technology had a limited predictive relationship to performance on tests. Practical implications are discussed. (Contains 4 tables.)

Researchers report the case of a nine-year-old child who apparently transmitted tuberculosis to many people. This is very unusual because children with tuberculosis are usually not infectious. He was identified after tuberculosis was diagnosed in his female guardian. The child had originally come from the Republic of the Marshall Islands two years before and was the only possible source of the woman's infection. Further testing revealed that he had transmitted the bacterium that caused tuberculosis to three other household members, 16 classmates, 10 children who rode the same school bus, and 9 day-care providers.

Objectives. This report examined whether job strain (or its components, decision latitude and job demands) was associated with elevated blood pressure levels in a community-based sample of 726 African-American adults. Methods. Blood-pressure, anthropometric, behavioral, demographic, and psychosocial data were collected for the current cross-sectional analyses during home interviews conducted for the second wave (1993) of the Pitt County Study (North Carolina), a prospective cohort study of hypertension among African Americans. Results. Job strain was not associated with blood pressure among men or women in this study. However, men in the 80th percentile of decision latitude had more than a 50% decrease in the prevalence of hypertension compared with men in the 20th percentile (odds ratio = .46, 95% confidence interval = .22, .96). Conclusions. These results indicate that decision latitude may be important for hypertension risk among African-American men. More research is needed on African Americans to determine why job strain and its two component variables differ in their associations with blood pressure for men and women. (Am J Public Health. 1997;87:1297-1302)

Postpartum depression (PPD) affects an estimated 10% to 20% of women in the United States, but little is known about the risk factors for PPD in Hawai'i. This study sought to identify PPD risk factors and examine whether disparities exist in Hawai'i. Aggregated 2012-2015 Hawai'i Pregnancy Risk Assessment Monitoring System (PRAMS) data from 5572 women with a recent live birth were analyzed. Two questions on the PRAMS survey about mood and interest in activities were used to create a brief measure of Self-Reported Postpartum Depression Symptoms (SRPDS). Multivariate generalized logit analysis was conducted to identify risk factors associated with SRPDS or possible SRPDS, adjusting for maternal race and age, intimate partner violence (IPV), prenatal anxiety, prenatal depression, illicit drug use before pregnancy, and stressful life events (SLEs). About 10.0% of women surveyed had SRPDS and 27.7% had possible SRPDS. SRPDS was more common among Native Hawaiians (adjusted odds ratios=1.77; 95% confidence interval: 1.17-2.70), Filipinos (2.16; 1.33-3.50), Japanese (2.88; 1.67-4.98), and other Pacific Islanders (OPI; 3.22; 1.78-5.82), when compared to white. Women aged 20-29 years (0.39; 0.24-0.65) and 30-52 years (0.41; 0.24-0.69) were less likely to have SRPDS than those 19 years and younger. SRPDS was highest among women who experienced IPV (2.65; 1.37-5.13), prenatal anxiety (2.10; 1.28-3.42), prenatal depression (2.78; 1.47-5.25), or used illicit drugs before pregnancy (1.97; 1.21-3.20). There was an upward trend in SRPDS based on the number of SLEs. Possible SRPDS had similar but smaller effects, suggesting the importance of clinical screening and appropriate follow-up for these high-risk groups. [ABSTRACT FROM AUTHOR]

Objective: We modelled individual vulnerability to STI using personal history of infection and neighbourhood characteristics.Methods: Retrospective chlamydia and gonorrhoea data of reported confirmed cases from Kalamazoo County, Michigan for 2012 through 2014 were analysed. Unique IDs were generated from the surveillance data in collaboration with local health officials to track the individual STI histories. We then examine the concept that individuals with similar STI histories form a 'peer' group. These peer group include: (1) individuals with a single chlamydia; (2) individuals with single gonorrhoea; (3) individuals with repeated cases of one type of STI and (4) individuals that were diagnosed with both infections during the study period. Using Kernel density estimation, we generated densities for each peer group and assigned the intensity of the infection to the location of the individual. Finally, the individual vulnerability was characterised through ordinary least square regression (OLS) using demographics and socioeconomic variables.Results: In an OLS regression adjusted for frequency of infection, individual vulnerability to STI was only consistently significant for race and neighbourhood-level socioeconomic status (SES) in all the models under consideration. In addition, we identified six areas in three townships in Kalamazoo County that could be considered for unique interventions based on overlap patterns among peer groups.Conclusions: The results provide evidence that individual vulnerability to STI has some dependency on individual contextual (race) and exogenous factors at the neighbourhood level such as SES, regardless of that individual's personal history of infection. We suggest place-based intervention strategies be adopted for planning STI interventions instead of current universal screening of at-risk populations. [ABSTRACT FROM AUTHOR]

Background Multimorbidity, the presence of two or more chronic diseases, is a public health concern. The measurement of grip strength has been proposed as a measure of overall body strength and is reliable and easy to measure. The purpose of this study was to investigate the relationship between the number of chronic diseases and common co-occurring chronic diseases with grip strength. Methods A cross-sectional analysis was conducted of 5877 respondents (2744 = male, 3103 = female) from the 2008 Health and Retirement Study (HRS) who completed grip strength measurements (kg). Results As the number of chronic diseases increased, an incremental decrease in grip strength occurred and became more pronounced with ≥3 chronic diseases present ( b = 3.1, 95% CI = 2.3–3.9, p < 0.001). No statistically significant relationship was identified between specific chronic diseases (except for stroke) and grip strength. Conclusion Multimorbidity has a statistically significant negative relationship on grip strength. Grip strength should be considered as a physical performance measure to incorporate into the care of patients with multimorbidity. [ABSTRACT FROM AUTHOR]

Purpose: This preliminary investigation examined speech-language pathologists' (SLPs') use of contextualized practices (i.e., functional, personally relevant, nonhierarchical, and collaborative) compared with traditional practices (i.e., clinical, generic, hierarchical, and expert driven) with school-age children and adolescents with traumatic brain injury (TBI). Methods: An electronic survey asked SLPs about their use of clinical activities described as more or less contextualized. Research questions focused on frequency of using contextualized practices and factors associated with their use or nonuse. Results: Seventy responses met criteria for analysis; 98% of these participants reported using at least 1 contextualized practice. Higher use of contextualized practices was associated with working in schools compared to health care settings, access to experts, and greater experience with TBI. Most frequently cited reasons for not using contextualized practices included not fitting the student and scheduling issues. Conclusions: Factors associated with using contextualized practices suggest that access to experts and experience with TBI are critical components for facilitating contextualized practice recommendations. Reasons for not using certain contextualized practices highlight the need to address scheduling issues and to increase education about practices that may best meet the unique needs of students with TBI. [ABSTRACT FROM AUTHOR]

Introduction: Adults with vision loss often have difficulties reading prescription drug labels. An aspect of label readability that has not been well explored is the effect of container shape on the readability of the label. The research question addressed is: Does container shape affect the readability of prescription drug labels for persons with reduced visual acuity? Methods: A repeated-measure, single-factor design with within-subject control was used with 23 adults with visual acuity of 20/60 or less. Individuals were recruited from southwest Michigan. Participants read 3 unique prescription drug labels on 4 differently shaped containers (flat, box, small cylinder, large cylinder) in block randomized order, for a total of 12 trials. The amount of time needed to locate and read aloud 6 pieces of label information and number of errors made in reading were measured, as well as each participant's preference in container shapes. Results: A statistically significant difference was found between the mean number of seconds required to read flat container labels (flat and box shape, M = 54.62 seconds, SD = 23.8) and round containers (small and large cylinder shape, M = 64.46 seconds, SD = 36.3). No statistically significant effect of container type was found on the number of mistakes made in reading the label information, Wald χ2(3) = .71, p = 0.871. Seventy-eight percent of the participants chose the flat container as their preferred shape. Only 1 participant selected the box as his or her top choice. Discussion: Containers with flat surfaces (flat and box) were easier to read, measured by speed, compared to containers with round surfaces (small and large cylinders). Although the study participants overwhelmingly preferred flat containers to the boxes, little difference was found between the two shapes in the amount of time that was needed to read labels affixed to them. Implications for practitioners: Individuals with vision loss may need more time to read prescription drug labels affixed to the more typical cylindrical containers compared to flat ones. [ABSTRACT FROM AUTHOR]

The article reports on the stratification of grip strength value by age, gender, and chronic disease status in adults aged 50 years and older. Topics discussed include grip strength, multimorbidity, and population-based values. Also being discussed include impact of single chronic diseases like coronary heart disease, stroke, and chronic obstructive pulmonary disease.

The objective of this study was to examine food selectivity in children with autism spectrum disorders longitudinally. Additionally explored were the stability of the relationship between food selectivity and sensory over-responsivity from time 1 to time 2 and the association between food selectivity and restricted and repetitive behavior at time 2. A total of 52 parents of children with autism were surveyed approximately 20 months after completing an initial questionnaire. First and second surveys each contained identical parent-response item to categorize food selectivity level and a scale to measure sensory over-responsivity. A new scale to measure restricted and repetitive behaviors was added at time 2. Results comparing time 1 to time 2 indicated no change in food selectivity level and a stable, significant relationship between food selectivity and sensory over-responsivity. The measure of restrictive and repetitive behavior (time 2) was found to significantly predict membership in the severe food selectivity group. However, when sensory over-responsivity and both restricted and repetitive behaviors were included in the regression model, only sensory over-responsivity significantly predicted severe food selectivity. These results support conclusions about the chronicity of food selectivity in young children with autism and the consistent relationship between food selectivity and sensory over-responsivity. [ABSTRACT FROM PUBLISHER]

This article presents the findings of a secondary analysis of the National Longitudinal Transition Study 2 that explored the predictive association between training in access technology and performance on the Woodcock-Johnson Tests of Academic Achievement: III. The results indicated that the use of access technology had a limited predictive relationship to performance on tests. Practical implications are discussed. [ABSTRACT FROM AUTHOR]

Background. As infection with vancomycin-resistant enterococci (VRE) increases in hospitals, knowledge about VRE reservoirs and improved accuracy of epidemiologic measures are needed. Many assessments underestimate incidence by including prevalent carriers in at-risk populations. Routine surveillance cultures can substantially improve prevalence and incidence estimates, and assessing the range of improvement across diverse units is important. Methods. We performed a retrospective cohort study using accurate at-risk populations to evaluate the range of benefit of admission and weekly surveillance cultures in detecting unrecognized VRE in 14 patient-care units. Results. We assessed 165 unit-months. The admission prevalence of VRE was 2.2%-27.2%, with admission surveillance providing 2.2-17-fold increased detection. Medical units were significantly more likely to admit VRE carriers than were surgical units. Monthly incidence was 0.8%-9.7%, with weekly surveillance providing 3.3-15.4-fold increased detection. The common practice of reporting incidence using the total number of patients, rather than patients at risk, underestimated incidence by one-third. Overall, routine surveillance prevented the misclassification of 43.0% (unit range, 0%-85.7%) of "incident" carriers on the basis of clinical cultures alone and increased VRE precaution days by 2.4-fold (unit range, 2.0-2.6-fold). Conclusions. Routine surveillance markedly increases the detection of VRE, despite variability across patient-care units. Correct denominators prevent the substantial underestimation of incidence. [ABSTRACT FROM AUTHOR]

The Pitt County Study is a longitudinal investigation of anthropometric, psychosocial, and behavioral predictors of hypertension in African Americans who were aged 25–50 years at baseline in 1988. At baseline, a strong dose-response gradient was observed for alcohol consumption and blood pressure for both sexes. The current study investigated whether baseline alcohol consumption or, alternatively, changes in drinking status predicted 5-year changes in blood pressure among the 652 women and 318 men who satisfied all inclusion criteria for the longitudinal analyses. In multivariate regression analyses, baseline alcohol consumption was not significantly associated with changes in blood pressure or hypertension incidence (systolic/diastolic blood pressure ≥160/95 mmHg) by 1993. Change in drinking status, however, was significantly associated with changes in systolic pressure. The systolic pressure increase among individuals who initiated alcohol consumption was 6.2 mmHg (95% confidence interval (Cl) 1.1–6.4) greater than abstainers, while that for individuals who reported drinking at both time points was 3.8 mmHg (95% Cl 1.3–11.1) greater. Blood pressure increases for persons who discontinued drinking were comparable to those of abstainers. Results were independent of baseline age, body mass index, blood pressure, and sex. Social and economic disadvantage in 1988 was significantly associated with continuation and initiation of alcohol consumption by 1993. [ABSTRACT FROM AUTHOR]

Latinos, now the largest U.S. ethnic minority, have a high risk for type 2 diabetes. The Latino population is a heterogeneous group of individuals from many countries with a variety of beliefs and cultures. The purpose of this study was to explore similarities and differences in beliefs and attitudes related to health and healthcare practices across four Latino subgroups (Mexican, Colombian, Puerto Rican, and Mayan). The study used a qualitative research design employing focus groups and participant questionnaires. Data analysis revealed four themes: 1) View of health; 2) Access to care; 3) Acculturation; and 4) Stress and worry. [ABSTRACT FROM AUTHOR]