He said/She said; Shaming, Blaming Reframing: Impacts and Implications of Childlessness on Relationships in an Ancient Text.

Describing the terms of "shaming, blaming, naming, claiming, and reframing" as the possible changing dynamics in some human relationships to achieve a resolution, is a fairly recent insight. Through analyzing a short section of an ancient text, Biblical Antiquities, we show how those matters, although not named as dynamics, were recognized as stages in human interactions millennia ago. They were played out in the announcement and subsequent birth of the biblical judge Samson.

Patients' attitudes toward electronic health information exchange: qualitative study.

BACKGROUND: In many countries, there has been substantial progress in establishing the electronic transmission of patients' health information between health care providers, but little is known about how best to engage patients in the process. OBJECTIVE: We explored patients' views about sharing of electronic health information and their preferences for learning about and participating in this process. METHODS: Patients in one Massachusetts community in the northeastern United States were recruited to participate in focus-group discussions. Prior to discussion, participants completed a written questionnaire that captured their reactions to draft educational materials and a consent form. The discussion moderator and two physicians analyzed the moderator's detailed notes from each session and participants' written comments, using an immersion-crystallization approach. RESULTS: Three dominant themes emerged: (1) concerns about privacy and security, (2) the potential benefit to a person's health, and (3) the desire for more information about the consent process. On the pre-discussion questionnaire, 55 out of 62 participants (88%) indicated that they would provide consent for their information to be shared electronically among their health care providers, given the materials they had reviewed. CONCLUSIONS: Patients are enthusiastic about electronic health information exchange, recognizing its capacity to improve the quality and safety of health care; however, they are also concerned about its potential to result in breached privacy and misuse of health data. As the exchange of electronic health information becomes more widespread, policy makers will need to ensure that patients have access to concise educational materials and opportunities to engage in conversations about the risks and benefits of participation.

Acute effects of ambient particulate matter on blood pressure: differential effects across urban communities.

Recent studies have suggested a link between exposure to ambient particulate matter <2.5 microm in diameter (PM(2.5)) and adverse cardiovascular outcomes. The objective of this study was to examine the effects of differing community-level exposure to PM(2.5) on daily measures of blood pressure (BP) among an adult population. During the period May 2002 through April 2003, BP was examined at 2 time points for 347 adults residing in 3 distinct communities of Detroit, Michigan. Exposure to PM(2.5) was assessed in each community during this period, along with multivariate associations between PM(2.5) and BP. In models combining all 3 of the communities, PM(2.5) was significantly associated with systolic blood pressure; a 10-microg/m(3) increase in daily PM(2.5) was associated with a 3.2-mm Hg increase in systolic blood pressure (P=0.05). However, in models that added a location interaction, larger effects were observed for systolic blood pressure within the community with highest PM(2.5) levels; a 10-microg/m(3) increase in daily PM(2.5) was associated with a 8.6-mm Hg increase in systolic blood pressure (P=0.01). We also found young age (<55 years) and not taking BP medications to be significant predictors of increased BP effects. Among those taking BP medications, the PM(2.5) effect on BP appeared to be mitigated, partially explaining the age effect, because those participants <55 years of age were less likely to take BP medications. Short-term increases in exposure to ambient PM(2.5) are associated with acute increases in BP in adults, especially within communities with elevated levels of exposure.

A community-based participatory approach to personalized, computer-generated nutrition feedback reports: the healthy environments partnership.

BACKGROUND: Computer tailoring and personalizing recommendations for dietary health-promoting behaviors are in accordance with community-based participatory research (CBPR) principles, which emphasizes research that benefits the participants and community involved. OBJECTIVE: To describe the CBPR process utilized to computer-generate and disseminate personalized nutrition feedback reports (NFRs) for Detroit Healthy Environments Partnership (HEP) study participants. METHODS: The CBPR process included discussion and feedback from HEP partners on several draft personalized reports. The nutrition feedback process included defining the feedback objectives; prioritizing the nutrients; customizing the report design; reviewing and revising the NFR template and readability; producing and disseminating the report; and participant follow-up. LESSONS LEARNED: Application of CBPR principles in designing the NFR resulted in a reader-friendly product with useful recommendations to promote heart health. CONCLUSIONS: A CBPR process can enhance computer tailoring of personalized NFRs to address racial and socioeconomic disparities in cardiovascular disease (CVD).