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This study describes the results of an online social support intervention, called 'Thrive with Me' (TWM), to improve antiretroviral therapy (ART) adherence. HIV-positive gay or bisexually-identified men self-reporting imperfect ART adherence in the past month were randomized to receive usual care ( n = 57) or the eight-week TWM intervention ( n = 67). Self-reported ART outcome measures (0-100 % in the past month) were collected at baseline, post-intervention, and 1-month follow-up. Follow-up assessment completion rate was 90 %. Participants rated (1-7 scale) the intervention high in information and system quality and overall satisfaction (Means ≥ 5.0). The intervention showed modest effects for the overall sample. However, among current drug-using participants, the TWM (vs. Control) group reported significantly higher overall ART adherence (90.1 vs. 57.5 % at follow-up; difference = 31.1, p = 0.02) and ART taken correctly with food (81.6 vs. 55.7 % at follow-up; difference = 47.9, p = 0.01). The TWM intervention appeared feasible to implement, acceptable to users, and demonstrated greatest benefits for current drug users. [ABSTRACT FROM AUTHOR]

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Purpose: To report a case of transvaginal small intestinal hernia following abdominal sacrocolpopexy and review this clinical presentation in the current literature. Methods: A review of our case and a literature review of vaginal evisceration were carried out. Results: The patient underwent sacrocolpopexy and a Burch procedure. Six months later, a recurrent enterocele through a 1 cm defect in the vaginal vault was diagnosed. Several weeks later she presented with an incarcerated and strangulated loop of small intestine extending beyond the introitus. This required an urgent exploratory laparotomy, ileocecal resection, and vaginal vault closure. Postoperatively, she experienced gradual prolapse recurrence and is currently successfully managed with a pessary. Risk factors that include vaginal atrophy, chronic constipation, and previous pelvic surgery may have contributed to the evisceration, mesh erosion, and may have caused the breakdown in the vaginal vault mucosa ultimately responsible for the evisceration. In addition, placement of the sacrocolpopexy mesh without tension, and utilization of an interposition graft to reinforce the weakened vaginal vault tissue, are aspects of the surgical procedure that may influence outcomes. At the time of evisceration repair, the best approach to resuspend the vaginal vault, and prevent recurrent prolapse or evisceration, is currently unknown. Conclusion: Vaginal evisceration is a potential complication of abdominal sacrocolpopexy. Early recognition and treatment of this complication is critical, and prolapse recurrence may occur even after surgical repair. [ABSTRACT FROM AUTHOR]

This study aimed to develop an empirically based description of relapse in Electronic Gaming Machine problem gambling. In this paper the authors describe part one of a two part, linked relapse process: the 'push' towards relapse. In this two-part process, factors interact sequentially and simultaneously within the problem gambler to produce a series of mental and behavioural events that ends with relapse when the 'push' overcomes 'pull' (part one); or as described in part two, continued abstinence when 'pull' overcomes 'push'. In the second paper, the authors describe how interacting factors 'pull' the problem gambler away from relapse. This study used four focus groups comprising thirty participants who were gamblers, gamblers' significant others, therapists and counsellors. The groups were recorded, recordings were then transcribed and analysed using thematic, textual analysis. With the large number of variables considered to be related to relapse in problem gamblers, five key factors emerged that 'push' the gambler towards relapse. These were urge, erroneous cognitions about the outcomes of gambling, negative affect, dysfunctional relationships and environmental gambling triggers. Two theories emerged: (1) each relapse episode comprised a sequence of mental and behavioural events, which evolves over time and was modified by factors that 'push' this sequence towards relapse and (2) a number of gamblers develop an altered state of consciousness during relapse described as the 'zone' which prolongs the relapse. [ABSTRACT FROM AUTHOR]

This study aimed to develop an empirically based description of relapse in Electronic Gaming Machine (EGM) problem gambling (PG) by describing the processes and factors that 'pull' the problem gambler away from relapse contrasted with the 'push' towards relapse. These conceptualisations describe two opposing, interacting emotional processes occurring within the problem gambler during any relapse episode. Each relapse episode comprises a complex set of psychological and social behaviours where many factors interact sequentially and simultaneously within the problem gambler to produce a series of mental and behaviour events that end (1) with relapse where 'push' overcomes 'pull' or (2) continued abstinence where 'pull' overcomes 'push'. Four focus groups comprising thirty participants who were EGM problem gamblers, gamblers' significant others, therapists and counsellors described their experiences and understanding of relapse. The groups were recorded, recordings were then transcribed and analysed using thematic textual analysis. It was established that vigilance, motivation to commit to change, positive social support, cognitive strategies such as remembering past gambling harms or distraction techniques to avoid thinking about gambling to enable gamblers to manage the urge to gamble and urge extinction were key factors that protected against relapse. Three complementary theories emerged from the analysis. Firstly, a process of reappraisal of personal gambling behaviour pulls the gambler away from relapse. This results in a commitment to change that develops over time and affects but is independent of each episode of relapse. Secondly, relapse may be halted by interacting factors that 'pull' the problem gambler away from the sequence of mental and behavioural events, which follow the triggering of the urge and cognitions to gamble. Thirdly, urge extinction and apparent 'cure' is possible for EGM gambling. This study provides a qualitative, empirical model for understanding protective factors against gambling relapse. [ABSTRACT FROM AUTHOR]

Background The prevalence of overweight and obesity in the US population has risen dramatically in recent years. To try to explain this, some studies have examined the association between the built environment and obesity (measured using the body mass index (BMI)). Most of these studies have not sought to identify causal effects, but rather correlations. Methods Data from the Twin Cities Walking Study were used to examine the effect of population density and block size on BMI. Although the Twin Cities Walking Study is a cross-sectional observational study, the matched-sampling design is novel in that it maximises environmental variance while minimising person variance to enhance exchangeability of subjects and more closely mimic an experimental study. Results Contrary to expectations, the hypothesised most walkable neighbourhood (high density, small block stratum) had the greatest mean and median BMI. After adjusting for demographic covariates, physical activity and clustering due to neighbourhood, no conclusive effect of population density by block size on BMI was found (β=1.024, 95% CI -2.408 to 0.359). Conclusion There is no evidence of an effect of population density by block size on BMI. [ABSTRACT FROM AUTHOR]

Online social media and mobile technologies hold potential to enhance adherence to antiretroviral therapy (ART), although little is known about the current use of these technologies among people living with HIV (PLWH). To address this gap in understanding, 312 PLWH (84% male, 69% White) US adults completed an online survey in 2009, from which 22 persons accepted an invitation to participate in one of two online focus groups. Results showed that 76% of participants with lower ART adherence used social networking websites/features at least once a week. Their ideal online social networking health websites included one that facilitated socializing with others (45% of participants) and ones with relevant HIV informational content (22%), although privacy was a barrier to use (26%). Texting (81%), and to a lesser extent mobile web-access (51%), was widely used among participants. Results support the potential reach of online social networking and text messaging intervention approaches. [ABSTRACT FROM AUTHOR]

Achieving satisfactory retention in online HIV prevention trials typically has proven difficult, particularly over extended timeframes. The overall aim of this study was to assess factors associated with retention in the Men's INTernet Study II (MINTS-II), a randomized controlled trial of a sexual risk reduction intervention for men who have sex with men. Participants were recruited via e-mails and banner advertisements in December, 2007 to participate in the MINTS-II Sexpulse intervention and followed over a 12-month period. Retention across the treatment and control arms was 85.2% at 12 months. Factors associated with higher retention included: randomization to the control arm, previous participation in a study by the research team, e-mail and telephone reminders to complete a survey once it was available online, and fewer e-mail contacts between surveys. The results provide evidence that achieving satisfactory retention is possible in online HIV prevention trials, and suggest best practices for maximizing retention. [ABSTRACT FROM AUTHOR]

Background: Strategies to increase fruit and vegetable consumption of preschool aged children are needed. Objectives: Evaluate the independent effects of the following meal service strategies on intake of fruits and vegetables of preschool children: 1.) Serving fruits and vegetables in advance of other menu items as part of traditional family style meal service; and 2.) Serving meals portioned and plated by providers. Methods: Fifty-three preschool aged children completed a randomized crossover experiment conducted at a Head Start center in Minneapolis, MN. Over a six week trial period each of the experimental meal service strategies (serving fruits and vegetable first and serving meals portioned by providers) was implemented during lunch service for two one-week periods. Two one-week control periods (traditional family style meal service with all menu items served at once) were also included over the six week trial period. Children's lunch intake was observed as a measure of food and nutrient intake during each experimental condition. Results: Fruit intake was significantly higher (p<0.01) when fruits and vegetables were served in advance of other meal items (0.40 servings/meal) compared to the traditional family style meal service control condition when they were served in tandem with other menu items (0.32 servings/meal). Intakes of some nutrients found in fruits (vitamin A and folate) were concomitantly higher. In contrast, fruit and vegetable intakes were significantly lower and energy intake significantly higher during the provider portioned compared with control condition. Conclusions: Serving fruits in advance of other meal items may be a low cost easy to implement strategy for increasing fruit intake in young children. However, serving vegetables first does not appear to increase vegetable intake. Results provide support for current recommendations for traditional family style meal service in preschool settings. [ABSTRACT FROM AUTHOR]

The Irvine Minnesota Inventory (IMI) was designed to measure environmental features that may be associated with physical activity and particularly walking. This study assesses how well the IMI predicts physical activity and walking behavior and develops shortened, validated audit tools. A version of the IMI was used in the Twin Cities Walking Study, a research project measuring how density, street pattern, mixed use, pedestrian infrastructure, and a variety of social and economic factors affect walking. Both bivariate and multivariate analyses were used to assess the predictive value of the IMI. We find that while this inventory provides reliable measurement of urban design features, only some of these features present associations with increased or decreased walking. This article presents two versions of shortened scales—a prudent scale, requiring association with two separate measures of a physical activity or walking behavior, and a moderate scale, requiring association with one measure of physical activity or walking. The shortened scales provide built environment audit instruments that have been tested both for inter-rater reliability and for associations with physical activity and walking. The results are also useful in showing which built environment variables are more reliably associated with walking for travel—characteristics of the sidewalk infrastructure, street crossings and traffic speeds, and land use are more strongly associated with walking for travel, while factors that measure aesthetics are typically less strongly associated with walking for travel. [ABSTRACT FROM AUTHOR]

The article analyzes the future of Internet-based human immunodeficiency virus (HIV) prevention. It stresses the need for technology-based HIV prevention interventions, as Internet gay sex sites, Internet porn sites, and gay virtual communities continue to exist to serve as venue for men who have sex with men (MSM) to meet. The identification of computer-assisted survey interviews (CASI) is regarded a key development in behavioral research. However, there are concerns about human subjects protections, data security and access to technologies.

Confounding associated with social stratification or other selection processes has been called structural confounding. In the presence of structural confounding, certain covariate strata will contain only subjects who could never be exposed, a violation of the positivity or experimental treatment effect assumption. Thus, structural confounding can prohibit the exchangeability necessary for meaningful causal contrasts across levels of exposure. The authors explored the presence and magnitude of structural confounding by estimating the independent effects of neighborhood deprivation and neighborhood racial composition (segregation) on rates of preterm birth in Wake and Durham counties, North Carolina (1999–2001). Tabular analyses and random-intercept fixed-slope multilevel logistic models portrayed different structural realities in these counties. The multilevel modeling results suggested some nonsignificant effect of residence in tracts with high levels of socioeconomic deprivation or racial residential segregation on adjusted odds of preterm birth for white and black women living in these counties, and the confidence limit ratios indicated fairly consistent levels of precision around the estimates. The results of the tabular analysis, however, suggested that many of these regression modeling findings were off-support and based on no actual data. The implications for statistical and public health inference, in the presence of no data, are considered. [ABSTRACT FROM PUBLISHER]

Research into the effects of neighborhood environments on social and behavioral characteristics is threatened by inattention to some methodological obstacles, including the recruitment of a representative sample of resident participants. Although sampling is relatively straightforward, actual recruitment is not. The authors present the recruitment experience of the Twin Cities Walking Study addressing two questions: (a) Are randomly selected participants different from those selected by convenience? and (b) How well does the realized sample match known demographic characteristics of target neighborhoods? Of 716 total participants nested in 36 neighborhoods, 74% were randomly recruited. Socioeconomic status was positively correlated with random recruitment; nonrandom volunteers were more likely to be non-White females of lower socioeconomic status. Multivariate analyses, using propensity scores, show randomly selected and volunteer participants to be similar. The final mixed sample represented the target neighborhoods well. Supplementing a random sample with volunteers may yield a representative sample exchangeable at the group level. [ABSTRACT FROM AUTHOR]

Virtually all quantitative microdata used by social scientists derive from samples that incorporate clustering, stratification, and weighting adjustments (Kish 1965, 1992). Such data can yield standard error estimates that differ dramatically from those derived from a simple random sample of the same size. Researchers using historical U.S. census microdata, however, usually apply methods designed for simple random samples. The resulting p values and confidence intervals could be inaccurate and could lead to erroneous research conclusions. Because U.S. census microdata samples are among the most widely used sources for social science and policy research, the need for reliable standard error estimation is critical. We evaluate the historical microdata samples of the Integrated Public Use Microdata Series (IPUMS) project from 1850 to 1950 in order to determine (1) the impact of sample design on standard error estimates, and (2) how to apply modern standard error estimation software to historical census samples. We exploit a unique new data source from the 1880 census to validate our methods for standard error estimation, and then we apply this approach to the 1850-1870 and 1900-1950 decennial censuses. We conclude that Taylor series estimation can be used effectively with the historical decennial census microdata samples and should be applied in research analyses that have the potential for substantial clustering effects. [ABSTRACT FROM AUTHOR]

This study sought to identify the magnitude of HIV risk in a diverse sample of Men who use the Internet to seek Sex with Men (MISM), and test if specific subpopulations are at sufficiently increased risk to warrant tailored interventions. A sample of 2,716 American MISM, stratified by race/ethnicity, completed an Internet survey of online and offline sex seeking behavior during the last 3 months. Across most demographics, a minority of MISM reported unprotected anal intercourse with male partners (UAIMP). Across all demographics, risk of UAIMP substantially increased with partners met online. Other predictors of increased online partner risk include being 30–39 years old, having children, not living in the Northeast, and low income. HIV-positive men and African Americans reported increased online and offline partner risk. To address higher risk of UAIMP, online HIV interventions should prioritize the needs of MISM, especially HIV-positive men, with content focused on online-mediated liaisons. [ABSTRACT FROM AUTHOR]

This paper considers the media research with children from a social epidemiological perspective. I am especially concerned with comparing the types of research designs, standard measures and modeling frameworks used in media studies to those used in (social) epidemiology and prevention research more generally. Overall, the state of research on the effect of various media on outcomes in children is robust and promises to be on par with the best epidemiological research. The principal measurement deficiency lies in the measurement of potential confounders and effect modifiers. With respect to research designs, the principal deficiencies include neglect of effectmodification by recognized social groupings, contextual influences and social interaction. Substantial practical benefits may come from the implementation and evaluation of intervention programs, especially group-randomized trials. As for analyses, the principal weakness appears to be in extending causal inference into observational field studies. [ABSTRACT FROM AUTHOR]

This study documents our experience in designing, testing, and refining human subjects' consent protocol in 3 of the first NIH-funded online studies of HIV/STI sexual risk behavior in the USA. We considered 4 challenges primary: a) designing recruitment and enrollment procedures to ensure adequate attention to subject considerations; b) obtaining and documenting subjects' consent; c) establishing investigator credibility through investigator-participant interactions; d) enhancing confidentiality during all aspects of the study. Human consent in online studies appears more relative, continuous, inherent, tenuous, and diverse than in offline studies. Reasons for declining consent appear related to pragmatic concerns not human subjects' risks. Reordering the consent process, and short, chunked, stepwise, tailored consent procedures may enhance communicating information and documenting consent. [ABSTRACT FROM AUTHOR]

Abstract: We examine whether specific types of people are more sensitive to the built environment when making a decision to walk or engage in other physical activity. Over 700 participants from 36 environmentally diverse, but equivalent-sized neighborhoods or focus areas responded to a survey, kept a travel diary, and wore an accelerometer for seven days. Subgroups defined by demographic and socioeconomic variables, as well as self reported health and weight status demonstrate that most subgroups of people walk more for transportation in high density areas. However, only the less healthy walked more overall in high density areas after controlling for sociodemographic characteristics and physical activity was remarkably similar among the groups and across different kinds of environments. While environmental interventions may not increase physical activity population wide, some populations – including some for whom interventions may be important such as the less healthy and the unemployed or retired – are more affected by these neighborhood environmental characteristics. [Copyright &y& Elsevier]

As part of a study to develop effective Internet-based HIV prevention interventions for Men who use the Internet to seek Sex with Men (MISM), we sought information from the target population on; (a) acceptability of sexually explicit media; (b) interest in specific content areas; and (c) identification of credible sources of information. A cross-sectional stratified Internet-based survey design was employed. Between September and November 2005, we recruited 2,716 MISM through Gay.com stratified across race/ethnicity to ensure adequate racial/ethnic diversity. Sixteen Likert-type items assessed acceptability of sexual explicitness, 24 items identified topics for inclusion, and two assessed sources of information. There was near universal acceptability for highly sexually explicit education. Over 75% reported high interest in 10 sexual health topics. HIV positive MISM and MISM engaged in unprotected anal sex with multiple male partners reported significantly less interest in HIV prevention specific content. Differences across age, race/ethnicity and education were identified. Idiosyncratic searches and gay sites were frequently cited sources of information; however blogs, government, and media sites were not. It is acceptable for web-based HIV prevention for MISM to be highly sexually explicit and to provide detailed content relevant to men’s sexual health. Since demographic differences in acceptability and content were minor, it is appropriate for interventions to target across demographics. Interventions to re-engage men engaging in high risk and HIV + MISM should be considered. Leading health agencies should review whether their web information is retrievable, credible and useful to those most at risk. [ABSTRACT FROM AUTHOR]

Do people walk more, or less, depending on the physical character of their residential areas rather than merely their individual characteristics? This paper reports findings for the Twin Cities, Minnesota, about how walking and total physical activity are affected by street pattern, 'pedestrian-oriented' infrastructure and amenities, and mixed use or destinations—in shorthand, design and destinations. The effects of density are dealt with in less depth. Like earlier studies, it finds that walking for specific purposes (i.e. travel or leisure) varies in relation to the physical characteristics of places. However, this study using multiple measures of overall walking and physical activity suggests that socially similar people do the same total amount of physical activity in different kinds of places and that level of activity is, on average, low. [ABSTRACT FROM AUTHOR]

To assess youth's ability to purchase alcohol in a city previously not assessed—Chicago, Illinois—we hired individuals aged 21 and older who appeared to be aged 18-20 (i.e., pseudo-underage buyers) to make alcohol purchase attempts without age identification in off-premise licensed alcohol establishments. We conducted two purchase attempts at each establishment across 44 community areas, resulting in a total of 652 purchase attempts. Our dependent variable was purchase attempt outcome (purchase, no purchase) and we used four categories of independent variables: characteristics of sellers, establishments, purchase attempts, and community areas. We analyzed our data using a logistic regression model, with purchase attempt outcome regressed on the independent variables. The overall purchase rate was 35.1%, ranging from 0% to 72% across community areas. Buyers were less likely to purchase alcohol in community areas that had populations with higher percentages of Hispanics (OR = 0.99; CI = 0.98, 1.0), and more likely to purchase alcohol in establishments that had more expensive beer (OR = 2.0; CI = 1.50, 2.67) and in areas with higher percentages of unemployed individuals (OR = 1.1; CI = 1.07, 1.14). Although progress has been made since the early 1990s in reducing sales to underage youth, youth still have relatively easy access to alcohol from licensed establishments. We recommend increased use of compliance checks—underage youth attempt to purchase alcohol under the supervision of enforcement agents; if alcohol is sold, the server/seller and/or license holder are penalized-which scientific studies have shown to be the most effective strategy in reducing sales to minors. [ABSTRACT FROM AUTHOR]

As part of a larger study, we investigated the feasibility of using Internet research to capture the demographic characteristics of a largely closeted sexual minority and to report such characteristics in the first national study of transgender persons ever attempted in the United States. To achieve a nonclinical national sample, online convenience sampling was used. Of 1,373 surveys received, 1,229 (90%) were deemed complete and from unique individuals self-identifying as transgender, 18 years or older, and U.S. residents. Participation approximated that predicted by the U.S. Census (2000). Comparison with census data identified the sample as younger, White (non-Hispanic), single, more educated but with less household income, living in smaller towns to medium-sized cities, and less affiliated with traditional Christian denominations. Demographic characteristics differed significantly by both gender and transgender status. The challenge of achieving demographically representative sampling online, as well as implications for future research and policy, are discussed. [ABSTRACT FROM AUTHOR]

Many agree that increasing physical activity will improve public health. This paper reports on empirical findings on the relationship between the density of the residential environment, walking and total physical activity. Using multiple objective and self-reported measures for 715 participants in the US, and improved techniques for sampling and analysis, it finds that density is associated with the purpose of walking (travel, leisure) but not the amount of overall walking or overall physical activity, although there are sub-group differences by race/ethnicity. Overall, higher densities have many benefits in terms of efficient use of infrastructure, housing affordability, energy efficiency and possibly vibrant street life. But higher densities alone, like other built environment features, do not appear to be the silver bullet in the public health campaign to increase physical activity. [ABSTRACT FROM AUTHOR]

A growing body of health and policy research suggests residential neighborhood density and street connectivity affect walking and total physical activity, both of which are important risk factors for obesity and related chronic diseases. The authors report results from their methodologically novel Twin Cities Walking Study; a multilevel study which examined the relationship between built environments, walking behavior and total physical activity. In order to maximize neighborhood-level variation while maintaining the exchangeability of resident-subjects, investigators sampled 716 adult persons nested in 36 randomly selected neighborhoods across four strata defined on density and street-connectivity - a matched sampling design. Outcome measures include two types of self-reported walking (from surveys and diaries) and so-called objective 7-day accelerometry measures. While crude differences are evident across all outcomes, adjusted effects show increased odds of travel walking in higher-density areas and increased odds of leisure walking in low-connectivity areas, but neither density nor street connectivity are meaningfully related to overall mean miles walked per day or increased total physical activity. Contrary to prior research, the authors conclude that the effects of density and block size on total walking and physical activity are modest to non-existent, if not contrapositive to hypotheses. Divergent findings are attributed to this study's sampling design, which tends to mitigate residual confounding by socioeconomic status. [ABSTRACT FROM AUTHOR]

This article cites a study, determining the association of the timing of prognostic information delivery by physicians with care giver satisfaction with communication or decision making in intensive care units (ICUs). The objective of this longitudinal survey-based study was two-fold: first, to determine the congruity between surrogates' desired frequency of communication and the actual frequency, and second, to determine whether surrogates' comprehension of substituted judgment was associated with decision-making satisfaction. Subjects of the study were surrogate decision makers of patients in the Medical or Surgical ICU at Fairview University Medical Center or Methodist Hospital in Minnesota. A total of 57 caregivers received prognostic information during the ICU stay. The study suggests that the capacity of physicians and other ICU personnel to manage families' communication expectations may positively influence caregiver satisfaction.

Purpose: To estimate the prevalence of metabolic syndrome in persons with a history of cancer from a population-based sample of adults, and compare that prevalence to persons without a history of cancer. Methods: Data from the Third National Health and Nutrition Examination Survey were analyzed to compare prevalence and prevalence differences of the metabolic syndrome, as defined by Adult Treatment Panel III criteria, between 486 persons with a reported history of cancer and 12,526 persons with no reported history of cancer. Results: The prevalence of metabolic syndrome was 258/1000 persons for those with a cancer history and 184/1000 persons among those without, resulting in a prevalence difference of 74/1000 persons (95% CI, 38–110). Prevalence differences varied substantially by age at interview. The prevalence difference was highest among those aged 40 to 49 years (112/1000 persons) and 50 to 59 years (73/1000 persons), while those in younger (18–39 years) and older (: 60 years) age groups had a moderately higher prevalence among those without a cancer history. Conclusion: These results add to the emerging concern that metabolic syndrome and associated risks for cardiovascular disease and type 2 diabetes may be an adverse late effect of cancer and/or its treatment. [Copyright &y& Elsevier]

In an effort to inform the ongoing discussion about the purpose, purview, theoretical orientation, and viability of epidemiology, this paper considers the contemporary epistemological foundations of the discipline by analyzing article citations. Two principal questions are the following: 1) What research do American Journal of Epidemiology (AJE) authors rely on to support, inform, and frame their investigations? and 2) to what extent do such authors use social scientific and statistical citations? The data used appear to be superior to those used in previous efforts because they contain complete citations for all articles published, along with complete within-article citations, for all AJE articles published from January 1981 to December 2002. The most frequent AJE citations are statistically oriented works. About 9% of citations are to AJE articles, 15% are to a larger set of eight epidemiologic journals, 15% are to a select set of eight medical journals, 3% are to (bio)statistics journals, and just 0.2% are to social science journals. Trend analysis reveals little change during the 22-year study period. The principal implication is that AJE authors are overlooking a vast literature that could inform their understanding of how exposures emerge and are maintained. [ABSTRACT FROM PUBLISHER]

Objectives. We assessed long-term trends in ethylene oxide (EtO) worker exposures for the purposes of exposure surveillance and evaluation of the impacts of the Occupational Safety and Health Administration (OSHA) 1984 and 1988 EtO standards. Methods. We obtained exposure data from a large commercial vendor and processor of EtO passive dosimeters. Personal samples (87 582 workshift [8-hr] and 46097 short-term [15-min] samples) from 2265 US hospitals were analyzed for time trends from 1984 through 2001 and compared with OSHA enforcement data. Results. Exposures declined steadily for the first several years after the OSHA standards were set. Workshift exposures continued to taper off and have remained low and constant through 2001. However, since 1996, the probability of exceeding the short-term excursion limit has increased. This trend coincides with a decline in enforcement of the EtO standard. Conclusions. Results indicate the need for renewed intervention efforts to preserve gains made following the passage and implementation of the 1984 and 1988 EtO standards. (Am J Public Health. 2004;94:1614-1619). [ABSTRACT FROM AUTHOR]

The resurgence of interest in the effect of neighborhood contexts on health outcomes, motivated by advances in social epidemiology, multilevel theories and sophisticated statistical models, too often fails to confront the enormous methodological problems associated with causal inference. This paper employs the counterfactual causal framework to illuminate fundamental obstacles in the identification, explanation, and usefulness of multilevel neighborhood effect studies. We show that identifying useful independent neighborhood effect parameters, as currently conceptualized with observational data, to be impossible. Along with the development of a dependency-based methodology and theories of social interaction, randomized community trials are advocated as a superior research strategy, one that may help social epidemiology answer the causal questions necessary for remediating disparities and otherwise improving the public''s health. [Copyright &y& Elsevier]

Background: Many young people at highest risk for chla-mydial infection do not use chlamydia screening services. Objectives: To describe young people's beliefs and opinions about obstacles to and motivators for obtaining testing and to provide recommendations for how to improve youth participation in chlamydia screening programs. Methods: Eight focus group interviews (4 male and 4 female groups) were conducted with young people using a semistructured interview guide. Thirty-two male and 23 female volunteers (mean age, 18.2 years; age range, 15-24 years) were recruited from Job Corps and Department of Youth Services sites. The main outcome measure was categorization of textual data using content analysis techniques. Data were coded by 2 investigators into categories of responses based on research questions and spontaneously offered comments. Satisfactory interco-der agreement was achieved. Results: Participants described many obstacles to testing, including concern that someone will know they were tested or tested positive, fear about discovering they have a sexually transmitted disease, and fear of acquired im-munodeficiency syndrome. Many participants were unsure what physical effects chlamydia produced or thought it was possible to die of a chlamydial infection. Participants recommended providing more information about the effects of chlamydia, availability of urine testing, and ease of treatment to motivate more young people to seek testing. They also emphasized the need to make sexually transmitted disease screening services more private and confidential. There was an overwhelming interest in using a home Chlamydia test (much like a home pregnancy test) if one were available. Conclusions: To increase youth participation in screening programs, it will be necessary to address their concerns, dispel misconceptions, and provide more information about chlamydia. A home Chlamydia test might be one way to increase screening. [ABSTRACT FROM AUTHOR]

The resurgence of social epidemiology has yet to induce corresponding research into basic measurement issues. This paper aims to motivate investigators to refocus attention on the measurement of socioeconomic status (SES). With a primarily American focus, we document striking paucity of basic research in SES, review the history of SES measurement, highlight the central limitations of current measurement approaches, sketch a new theoretical perspective, present new pilot results, and outline areas for future research. We argue (1) that lack of conceptual clarity and the bypassing of standard psychometric techniques have retarded SES measurement. And (2) social epidemiologists should revisit the measurement of SES and consider whether a richer, psychometrically induced, approach would be more useful. Our pilot study suggests a great deal of uniformity between existing SES measures and that a new approach may be worthy of pursuit. [Copyright &y& Elsevier]

Having an Institutional Review Board (IRB) review and monitor the use of human subjects is now fundamental to ethical research. Yet social scientists appear increasingly frustrated with the process. This article aims to assist evaluators struggling to understand and work with IRBs. The author theorizes why IRBs frustrate and insists there is only one remedy: We must accept the legitimacy of IRB review and (a) learn more about IRB regulations, imperatives, and the new pressures on them; and (b) educate IRBs about social scientific methodologies and empirically demonstrable risks. A research agenda and tips are offered. [ABSTRACT FROM AUTHOR]

ABSTRACT: This study evaluated "All's Well That Eats Well," a theater production performed in 20 schools in the Twin Cities, Minn., metropolitan area in winter 2000. The production sought to change food-related knowledge and food choices concerning fruits and vegetables among children in grades 1-6. The study used a pretest-posttest design with two randomly-assigned, sequential intervention-control groups (N = 4,093). All students completed surveys prior to and then following the theater production and the classroom and home activities. No differences existed between the groups at pretest. Significant differences occurred in food-related knowledge, food choices, and food recall from pretest to posttest for all students. Significant differences also occurred between intervention groups in food-related knowledge and food choices. The study indicates that professional theater productions in schools can create at least a short-term effect on children's nutrition knowledge and behavior. (J Sch Health. 2002;72(6):256-261) [ABSTRACT FROM AUTHOR]

Nonequivalent controlled pretest-posttest designs are central to evaluation science, yet no practical and unified approach for estimating power in the two most widely used analytic approaches to these designs exists. This article fills the gap by presenting and comparing useful, unified power formulas for ANCOVA and change-score analyses, indicating the implications of each on sample-size requirements. The authors close with practical recommendations for evaluators. Mathematical details and a simple spreadsheet approach are included in appendices. [ABSTRACT FROM AUTHOR]