Search

It is an assumption that physically active adults lead an overall healthy lifestyle. To examine this assumption, we administered a cross-sectional, web-based survey to a sample of young-to-middle-aged US adults between 18 and 49 who self-reported participation in at least one recreational sporting event in the past month. Logistic regressions were conducted to examine demographic characteristics associated with cancer risk and protective behaviors. Gender was represented equally (N = 938), and the average age was 32 years (SD: 8.4). Most participants reported >three days of moderate- to high-intensity physical activity (79%), but not meeting fruit and vegetable consumption guidelines (78%). Many reported current tobacco use (32%), binge drinking at least once in the past 30 days (62%), and suboptimal sun protection use (67%). Participation in lifestyle-related cancer risk and protective behaviors varied based on age, sex, education, routine doctor visits, perceived overall health, health-information-seeking behavior (how participants obtained health information), or team-based sport participation in regression models. Future interventions should be tailored to address varied cancer risk profiles among even physically active adults to encourage multiple healthy behavior changes.

Ideal efforts for cancer prevention would include lifestyle modifications along with routine, age-eligible cancer screening. Employing an asset-based approach within vulnerable populations already engaging in at least one healthy behavior (i.e., physical activity) may be an ideal way to further reduce cancer risk across peer groups with low cancer screening rates. Guided by the theory of planned behavior (TPB), the aim of this study was to identify constructs associated with cancer screening intentions among young to middle aged adults for influencing educational and behavioral interventions designed to promote cancer prevention. A cross-sectional, web-based survey was utilized to assess attitudes, subjective norms, perceived behavioral control, and intention to screen for cancer among physically active adults aged 18-49 years. Descriptive and bivariate analyses were conducted to characterize the sample, and hierarchical linear regression analyses were conducted to assess the influence of sociodemographic variables and TPB constructs on cancer screening intentions. Age, female sex, reporting a routine doctor's visit, reported knowledge of physical activity as a lifestyle behavior to reduce cancer risk, and an increased number of motivating factors for engaging in physical activity were significantly associated with higher cancer screening intention (P < 0.001). With the addition of TPB constructs (i.e., subjective norms and perceived behavioral control), the final analytic model accounted for 31% of the variance in intention to screen for cancer. Findings suggest that the TPB could be used to tailor or design asset-based, cancer education interventions to effectively promote age-eligible cancer screenings among physically active adults. Educational content to increase social support for cancer screening and enhance perceived behavioral control to complete screening is essential in this population., (© 2022. The Author(s) under exclusive licence to American Association for Cancer Education.)

Community-based organizations (CBOs) must have the capacity to adopt, implement, and sustain evidence-based practices (EBPs). However, limited research exists examining CBOs' ability/capacity to implement EBPs. The purpose of this preliminary study was to investigate how staff of CBOs perceive implementation practice capacity, determine factors needed for adequate capacity for implementing EBPs, and examine which perspectives of capacity are shared across organizational levels. Ninety-seven administrators and practitioners of CBOs were surveyed using the Implementation Capacity Survey, which examines perceived importance, presence, and organizational capacity of the CBO in nine implementation practice areas (IPAs) (e.g., leadership). Results revealed participants rated IPAs on the importance scale higher than IPAs on the present scale. Presence and organizational capacity scales were strongly correlated, and results showed significant differences between administrators and practitioners on ratings of presence and organizational capacity. Implications for future research aimed at examining/building implementation practice capacity in community settings will be discussed., (© 2021 Wiley Periodicals LLC.)

Exposure to earthquake has previously been associated with adverse mental health outcomes, however, evidence is limited among youth in resource-limited settings. This study explored the association of retrospective extent of exposure on current day depressive symptoms and post-traumatic stress disorder (PTSD) symptoms among 125 youth attending a college in Kathmandu, Nepal. A self-administered survey including socio-demographic variables, scale for earthquake exposure and Nepali language validated standardized scales for depressive and PTSD symptoms was used. Prevalence estimates for depressive symptoms was 43.2% and PTSD symptoms was 19.2%. For each increasing unit of the extent of earthquake exposure, the odds of having depressive symptoms increased by a factor of 1.26 (p = 0.001) and PTSD symptoms increased by a factor of 1.26 (p = 0.002). Being in a complicated romantic relationship increased the odds of both depressive symptoms and PTSD symptoms. Exposure to earthquake is an important factor to consider while assessing depressive and PTSD symptoms among youth earthquake survivors in Kathmandu. It is important that programs or policies aimed at youth mental health concurrently address disaster exposures., (© 2021. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Background and Objectives: Despite increasing drug use in rural communities, potentially life-saving harm reduction interventions, such as needle exchange programs (NEPs), remain underutilized. Religion is an integral component of the rural culture that has been shown to influence health, yet no studies to date have explored rural faith leaders' perceptions of harm reduction strategies., Methods: An online cross-sectional survey was conducted among rural faith leaders (n = 133) in the rural Illinois Delta Region., Results: While most of the respondents felt that drug abuse was an issue in their communities, support was mixed regarding whether they were in favor of NEPs with the majority of respondents having never heard of an NEP before this survey. While the majority believed that NEPs would help decrease bloodborne disease transmission, it was also perceived that NEPs would increase drug use. Significant differences in perceptions based on race, marital status, and political party also exist., Conclusion and Scientific Significance: Congruent with previous harm reduction literature, many rural faith leaders have varied perceptions of NEPs. Rural faith leaders could benefit from education about NEPs, including the possible positive and negative impacts they can have on the community. Future studies should explore contextual differences among rural faith leaders. To date, no studies have examined faith-based organizations' perceptions of NEPs. The findings have the potential to increase the current body of knowledge and provide data to support recommendations for engaging faith-based organizations in behavioral health service delivery., (© 2021 American Academy of Addiction Psychiatry.)

Background: While some research training programs have considered the importance of mentoring in inspiring professionals to engage in translational research, most evaluations emphasize outcomes specific to academic productivity as primary measures of training program success. The impact of such training or mentoring programs on stakeholders and local community organizations engaged in translational research efforts has received little attention. The purpose of this evaluation is to explore outcomes other than traditional academic productivity in a translational research graduate certificate program designed to pair graduate students and behavioral health professionals in collaborative service-learning projects., Methods: Semi-structured qualitative interviews with scholars, community mentors, and academic mentors were conducted regarding a translational research program to identify programmatic impacts. Interviews were transcribed and coded by the research team to identify salient themes related to programmatic outcomes., Results: Results are framed using the Translational Research Impact Scale which is organized into three overarching domains of potential impact: (1) research-related impacts, (2) translational impacts, and (3) societal impacts. This evaluation demonstrates the program's impact in all three domains of the TRIS evaluation framework. Graduate certificate participants (scholars) reported that gaining experience in applied behavioral health settings added useful skills and expertise to their present careers and increased their interest in pursuing translational research. Scholars also described benefits resulting from networks gained through participation in the program, including valuable ties between the university and community behavioral health organizations., Conclusions: This evaluation of the outcomes of a graduate certificate program providing training in translational research highlights the need for more community-oriented and practice-based measures of success. Encouraging practitioner involvement in translational research is vital to translate knowledge into practice and to enable practice-based needs to inform research and policy. A more flexible approach to measuring programmatic success in research training programs can help bridge the knowledge translation gap.

Many adults with intellectual and/or developmental disabilities (IDD) can access health and long-term services and supports (LTSS) through Medicaid. States are reforming their Medicaid LTSS programs from a fee-for-service model to a Medicaid managed LTSS (MLTSS) approach, anticipating improved quality of care and reduced costs, although there is limited evidence of MLTSS effectiveness. This study's objective was to contribute to the growing MLTSS research literature by describing MLTSS implementation in Kansas for adults with IDD. Thirty-one stakeholders completed in-depth semi-structured interviews, representing state or regional groups, service coordination providers, and family caregivers. Findings identify key aspects of the Centers for Medicare and Medicaid Services' new MLTSS regulations in the design and implementation of MLTSS programs.

The 5, 10 methylenetetrahydrofolate reductase (MTHFR) enzyme is a catalyst in the folate metabolism pathway, the byproducts of which are involved in the remethylation of homocysteine to methionine. Methionine is a precursor for a major DNA methyl donor and is important for DNA methylation and gene regulation. Rare mutations in the MTHFR gene have been associated with autosomal recessive MTHFR deficiency leading to homocystinuria. In addition, two polymorphic variants in this gene (C677T and A1298C) have been implicated in a mild form of MTHFR deficiency associated with hyperhomocysteinemia. Mild to moderate hyperhomocysteinemia has been previously implicated as a risk factor for cardiovascular disease. Further, the presence of these variants, with and without mildly elevated levels of homocysteine, has been studied in relation to several multifactorial disorders including recurrent pregnancy loss, neural tube defects and congenital anomalies, cancer, and neurodevelopmental disorders. Given this wide spectrum of purported clinical implications and the prevalence of these polymorphisms, genetic counselors may encounter questions regarding the significance of MTHFR polymorphisms in a variety of settings. Here we present a brief background of the MTHFR polymorphisms, review of the literature regarding clinical considerations, and discussion of relevant genetic counseling aspects through case vignettes. Educational resources for patients and providers are also included.

An innovative approach to research education that integrates the theory and principles of implementation science, participatory research, and service learning in the area of adolescent behavioral health is presented. Qualitative interviews and surveys of program participants have been conducted to assess the program's curricula, service-learning partnerships, student (scholar) satisfaction, and views of community partnerships and academic mentors. The Institute has experienced the successful completion of its first and second cohorts and enrollment of a third cohort of scholars. Community partners are utilizing results of service-learning projects to influence agency operations. Institute scholars have identified research and service learning experiences as key factors in the decision to apply to the Institute graduate certificate program. The availability of tuition support is identified as valuable but not ranked as the most important reason for scholar interest in the program. Academic mentors report positive relationships with community agencies. Future iterations of the program will expand options for distance learning and alternatives to traditional graduate education for community-based scholars. Community partner agency capacity for participation is expected to change over time. Methods are being identified to both sustain existing partnerships and develop new community partnership relationships.

Community-university partnerships are frequently used to enhance translational research efforts while benefiting the community. However, challenges remain in evaluating such efforts. This article discusses the utility of applying the contextual and interactive model of community-university collaboration to a translational research education program, the Institute for Translational Research in Adolescent Behavioral Health, to guide programmatic efforts and future evaluations. Institute stakeholders from academia and the community completed in-depth interviews querying their expectations and experiences in this collaboration. Key quotes and themes were extracted and analyzed based on the constructs within the 3 phases of the model. The findings note specific themes for future evaluations. Overall, the contextual and interactive model of community-university collaboration proved a useful framework to guide the process evaluation of the Institute. Findings suggest possible strategies for the successful development, evaluation, and sustainability of community-university partnerships.

Background: Translational research seeks to build bridges between research and practice to address public health issues efficiently and effectively. The purpose of this paper was to evaluate a newly formed Institute that provided graduate students and adolescent behavioral health community professionals with a translational research service-learning opportunity through the creation of a community-university mentoring partnership. Goals of the team-based research mentorship approach included: 1) providing students the skills for implementing translational research; 2) providing research opportunities for community agencies to enhance operations and to encourage ongoing research involvement; and 3) developing relationships between university faculty and community agency professionals for further research collaborations., Methods: The Institute used the National Institute on Drug Abuse's Mentoring Mosaic to select a diverse group of Community and Academic Mentors. The research mentorship experience of the initial cohort was evaluated based upon the Research Mentorship Conceptual Framework and Self-Assessment Tool., Results: As a direct result of the research mentorship, outcomes for the Academic and Community Mentors and Scholars (i.e., those seeking a graduate certificate) included improved working relationships/networking and research experience. Through experiential learning, Scholars also discovered career trajectory clarity, the need for community collaboration in research, opportunities for continuing professional development, a greater understanding of public health competencies and how they align with community-based research, and skill development in best practices for translational research., Conclusion: The team mentoring approach is a form of pedagogy that holds promise to enhance translational research and community-based research efforts while developing public health competencies.

The introduction of new technology, such as a Clinical Information System (CIS), requires hospitals to re-evaluate the roles of the Biomedical Maintenance Branch, Automation Management, and Informatics departments. This paper describes the process a 400-bed hospital underwent to resolve role ambiguity among the three activities. The institution's goal was to reach an optimal solution to using the resources offered by each activity through redrawing lines of responsibilities. This experience demonstrated that relationships among departments are dynamic and vary depending on the stage of the CIS life cycle.

The results are reported of a statewide survey of 309 physicians practicing at least part-time in public mental health agencies in Florida. Sixty-one percent (189) completed and returned the self-administered mail questionnaire. More than two-thirds received their medical degree outside the United States. Nearly one-half practiced primarily in community mental health centers. More than two-fifths reported total annual income between $75,000 and $100,000. Nearly one-fourth noted community service as an important factor in attracting them to their practice location. One-fifth reported a variety of regulations as important obstacles in their practice. Survey results are compared to other statewide and national psychiatric studies.

This paper describes the organizational characteristics, benefit coverage, referral pathways, utilization rates, and costs of substance abuse services within 17 HMOs belonging to The HMO Group in 1990. All 17 health plans responded to the questionnaire. Responses to the survey reflected the complexity of HMO substance abuse services. Overall, The HMO Group members provided substance abuse service coverage partly dependent upon state mandates, employer group priorities, and local competitive benefit structures. The HMOs reported that service utilization rates and the productivity of their substance abuse providers were critical information needs currently not fully reported. Overall, the survey responses reflected the need for improvement of clinical information systems and expansion of the aggregate substance abuse database.

This paper describes the organizational characteristics, benefits, referral, utilization, and costs of mental health services within 17 health maintenance organization (HMOs) comprising The HMO Group in 1990. All 17 health plans responded to the questionnaire, resulting in a 100% response rate. Responses to the survey reflected the complexity of the HMO mental health services field. Overall, The HMO Group members provided mental health service coverage, partly dependent upon state mandates, employer group priorities, and local competitive benefit structures. HMOs reported that service utilization rates and the productivity of their mental health providers were critical information needs. Overall, the responses reflected the need for continued information sharing between The HMO Group members, the modification of management information systems, and continuation of establishing a mental health aggregate data base.

To study the fear of driving phenomenon the authors contacted 48 subjects who, in response to a newspaper article, had expressed an intense fear of driving in the city of Houston and compared them with an age- and sex-matched control group. The information elicited from the subjects suggested the existence of a driving phobia. No significant differences emerged between the phobic subjects and the controls on relevant driving history and background. Although the phobic subjects reported significantly higher levels of anxiety while driving in normal and difficult situations, most of them reported anxiety of phobic intensity only about difficult driving situations, such as driving on freeways and in congested traffic.

States have funded psychiatric research through a variety of mechanisms, including psychiatric research institutes. The authors identified and surveyed 33 such institutes to obtain information on their organizational characteristics. Twenty-nine institutes responded; more than half were organizationally located within a university setting, and a similar number were involved in research, education, and direct services. Clinical research was the most prevalent type of research conducted, and annual state revenue appropriations were the major source of funding. Because budgetary problems have threatened their future funding in some states, the authors believe the institutes should increase efforts to demonstrate their relevance to state mental health needs.

This 1982 national survey of all operational health maintenance organizations (HMOs) provides information on the current status of mental health services, benefits, costs, and utilization within HMOs, updating and augmenting a 1978 study. Approximately 94 per cent of the responding HMOs offered mental health service coverage; over one-half (54 per cent) offered alcohol and drug abuse service coverage. The present coverage benefits and utilization of mental health services within HMOs continue to reflect greater variability vis-a-vis other health services within HMOs. Over one-half (57 per cent) of the HMOs provided for 30 days of inpatient mental health coverage (per member per year). Three out of four (77 per cent) of the health plans provided for 20 ambulatory visits (per member per year). The mean mental health hospital utilization rate was 32 days (per 1,000 members per year). The mean mental health ambulatory utilization rate was 0.33 encounters (per member per year). Further studies should investigate the combined influence of organization characteristics, mental health service organization characteristics, and service benefits on the costs and utilization of HMO mental health services.

Total body opacification with high doses of a urographic contrast agent demonstrated dilated intrahepatic biliary ducts as branching or rounded lucencies in all of 18 patients with obstructive jaundice. Dilated extrahepatic ducts were seen as tubular lucencies in 11 of 16 patients with distal common bile duct obstruction. In seven patients with nonobstructive jaundice and in a control group of 25, the biliary ducts were either normal or not seen. Gallbladder size was also evaluated. The site of obstruction could be predicted by the size of the gallbladder and visualization of the biliary ducts.

This study reports the results of a 1986 national survey of mental health, alcohol, and substance abuse services within health maintenance organizations in the United States. Ninety-seven percent of responding health maintenance organizations (HMOs) offered mental health service coverage and two-thirds of responding HMOs offered alcohol and substance abuse service coverage. Annual mean mental health hospitalization was 36.90 days per 1,000 members and annual mean ambulatory mental health utilization was 0.29 physician encounters per member.

This 1978 national survey of all operating Health Maintenance Organizations (HMOs) provided information on the current status of mental health services utilization and service coverage within HMOs. It achieved a 68 per cent response rate. Approximately 90 per cent (108) of the HMOs offered mental health services through basic or supplemental coverage plans; HMO organization characteristics reflected relative heterogeneity; the mean monthly costs for basic health plan coverage (physical and mental health services) were $33.85 (for individuals) and $95.15 (for families); HMOs reported lower physical and mental health hospital utilization and higher ambulatory utilization when compared to more traditional forms of health insurance coverage. The present coverage and uitlization of mental health services within HMOs reflect greater variability of benefits and utilization within HMOs. There is need for further studies of mental health utilization in relation to organizational structure and delivery pattern relationships within HMOs.

Two cases of Crohn's disease involving the esophagus are described. Both patients had Crohn's disease elsewhere. Multiple intramural fistulous tracts are seen in both patients, and this is a characteristic feature of Crohn's disease. One patient developed a spontaneous esophago-bronchial fistula. Even though the esophageal involvement of Crohn's disease is rare, it should be suspected when a chronic esophageal inflammatory lesion develops in a patient who has Crohn's disease elsewhere, especially without hiatus hernia or other chronic disease.

The authors conducted an assessment of mental health training, consultation, and research needs in Florida. The purpose was to document the current training, consultation, and information needs within the mental health care delivery system. The data collection included a six-page, self-administered mail questionnaire and a structured telephone interview of selected key informants throughout the state. The questions on the survey instrument asked for background information on the respondents as well as their training and research priorities for mental health services. Accountability procedures, financing issues, and clinical diagnostic and assessment techniques were among the most frequently rated priorities for training and research. Results are discussed with emphasis on the statewide dissemination of study findings, a national standardization of the needs assessment process, and the importance of systematic decision-making for administrators in the mental health service delivery system.

Detailed angiographic findings in 2 cases of proved sprue are described. There are dilatation of the superior mesenteric artery and its small bowel branches selectively, and increased capillary blush. Early draining into dilated veins is also noted. These findings are similar to those of the superior mesenteric arteriogram performed with pharmacological vasodilators. This similarity suggests that the dilated vessels in non-tropical sprue may be due to capillary dilatation.

The degree to which mental health services and coverage have been integrated into prepaid health plans (PHPs) on a national level is unknown. Using two self-administered mail questionnaires, the authors obtained descriptive data on the organization and delivery of mental health services within 205 PHPs throughout the United States and Guam. After discussing the growth of PHPs in the United States and the development of prepaid mental health services, the authors analyze the survey data using the PHP as the unit of analysis. Although 94 percent of the PHPs in the survey offered mental health benefits as part of their basic health plan, the authors found that the varied organizational characteristics of both the PHPs and their mental health components may have affected the specific mental health services provided as well as their costs, utilization, and referral patterns. The authors believe that further analysis of the various PHP organizational models is necessary to understand the utilization and costs of prepaid mental health services.