Human Capital Development Factors and Black Adolescent Tobacco and Cannabis Use.

INTRODUCTION: This study examined the association of four domains of human capital development (cognitive development, social and emotional development, physical health, and mental health) and exclusive and concurrent tobacco and cannabis use (TCU) among black youth. AIMS AND METHODS: Nationally representative annual cross-sectional data for black adolescents (12-17 years; N = 9017) in the National Survey on Drug Use and Health 2015-2019 were analyzed. Analyses examined the influence of human capital factors (cognitive development, social and emotional development, physical health, and mental health) on exclusive and concurrent TCU. RESULTS: In total, 50.4% were males; prevalence of 12-month tobacco use fluctuated insignificantly between 5.6% and 7.6% across survey years. Similarly, prevalence of 12-month cannabis use remained relatively stable around 13%, with no significant linear change. Prevalence of concurrent TCU also fluctuated insignificantly between 3.5% and 5.3%. Investment in cognitive development decreased the odds of tobacco (aOR = 0.58, p < .001), cannabis (aOR = 0.64, p < .001), and concurrent tobacco and cannabis (aOR = 0.58, p < .001) use. Similarly, investment in social and emotional development reduced the odds of tobacco (aOR = 086, p < .001), cannabis (aOR = 0.83, p < .001), and concurrent tobacco and cannabis (aOR = 0.81, p < .001) use. Good physical health reduced the odds of tobacco (aOR = 0.52, p < .1), cannabis (aOR = 0.63, p < .05), and concurrent TCU (aOR = 0.54, p < .05). Major depressive episodes increased the likelihood of cannabis use (aOR = 1.62, p < .001). CONCLUSIONS: Investment in cognitive, social, and emotional aspects of human capital development, and physical health among black youth is protective against TCU. Efforts to sustain human capital development among black adolescents may contribute to reducing TCU disparities. IMPLICATIONS: This is one of few studies to examine human capital development factors and their associations with TCU among black youth. Efforts to eliminate tobacco/cannabis-related disparities among black youth should also invest in social, emotional, cognitive, and physical health development opportunities.

Integrating the Principles of Socioecology and Critical Pedagogy for Health Promotion Health Literacy Interventions.

While health literacy research has experienced tremendous growth in the last two decades, the field still struggles to devise interventions that lead to lasting change. Most health literacy interventions are at the individual level and focus on resolving clinician-patient communication difficulties. As a result, the interventions use a deficit model that treats health literacy as a patient problem that needs to be fixed or circumvented. We propose that public health health literacy interventions integrate the principles of socioecology and critical pedagogy to develop interventions that build capacity and empower individuals and communities. Socioecology operates on the premise that health outcome is hinged on the interplay between individuals and their environment. Critical pedagogy assumes education is inherently political, and the ultimate goal of education is social change. Integrating these two approaches will provide a useful frame in which to develop interventions that move beyond the individual level.

Trends in Helicobacter pylori infection among Maori, Pacific, and European Birth cohorts in New Zealand.

BACKGROUND: The aim of this paper is to estimate the seroprevalence of Helicobacter pylori infection in the New Zealand population by ethnicity and year of birth. METHODS: A systematic search identified seven studies in New Zealand that reported prevalence of H. pylori infection among 4463 participants. Prevalence data were pooled to estimate the Maori, Pacific, and European seroprevalence of H. pylori in four birth cohorts (1926-40, 1941-55, 1956-70, and 1971-85), by assuming that infection is acquired in childhood and seroprevalence is stable with aging. The best estimates of national seroprevalence were obtained by geographic regional weighting and corrections for selection and measurement bias. RESULTS: Infection rates among all ethnic groups declined in more recent birth cohorts. Prevalence was highest among Pacific peoples (ranging from 39-83%) followed by Maori (18-57%) and then European (7-35%). The absolute ethnic differences in seroprevalence decreased in subsequent cohorts, but the relative ethnic differences increased. CONCLUSIONS: There is scope to much further reduce Maori and especially Pacific people's risk of H. pylori infection. Solutions to reduce H. pylori prevalence and its sequelae should focus on people at greatest risk of the infection. Further evaluation of strategies to address H. pylori infection is warranted. Interventions to be evaluated could include household crowding reduction and eradication therapy for asymptomatic infected persons to reduce their risk of noncardia stomach cancer.

How twins differ: multiple pregnancy and the use of health care in the 2008 Nigeria Demographic and Health Survey.

OBJECTIVES: To (i) document the incidence of multiplicity in Nigeria, (ii) compare healthcare utilization during pregnancy and at delivery for singleton and multiple pregnancies (iii)and investigate whether antenatal care modifies the relationship between multiplicity and likelihood of having skilled attendance. METHODS: This observational study was a secondary analysis of the 2008 Nigeria Demographic and Health Survey and included 17,635 women who gave birth to a live infant between 2003 and 2008. Multivariate logistic regression with adjustment for weighting, clustering and confounding was used to investigate associations and look for effect modification. RESULTS: There were 18.5 multiple pregnancies per 1000 maternities. Multiple births had nearly six times the chance of neonatal mortality (AOR 5.74). Mothers with multiple births had more skilled attendance (AOR 1.75), but similar antenatal care utilization (AOR 0.95) as women with a singleton pregnancy. Women with multiple pregnancies attending antenatal care had more visits (mean 9.0 vs. 8.2), blood pressure checks (OR 1.52) and urine tests (OR 1.51). Although antenatal care was strongly associated with skilled attendance, there was no evidence that this was more so for twins than singletons. CONCLUSIONS: Multiplicity in Nigeria is not just a common occurrence, but an indicator of a high-risk pregnancy. The fact that the use of antenatal care by women with a multiple pregnancy is not associated with a disproportionately greater use of skilled delivery care raises questions about the quality of antenatal services. Services should encourage and link all women and especially high-risk women to skilled attendance at delivery.

Registrar interest in academic obstetrics and gynaecology: a cross-sectional survey.

BACKGROUND: New Zealand has an urgent need to train and retain obstetrics and gynaecology academics, and postgraduate training pathways are being considered. AIMS: To gauge registrar interest in an academic training position and an academic career; analyse the importance of various encouraging factors; and investigate how demographics, experience and encouragers may be associated with academic interest. METHODS: All obstetric and gynaecology registrars working in New Zealand were invited by their clinical directors to participate in an online survey in March-June 2011. Statistical analysis, using Fisher's Exact and chi-squared tests, was used to investigate how demographic, experience and encourager variables were associated with academic interest. RESULTS: Of the 58 participants, 46 were women, 32 were New Zealand medical graduates and 43 were on the training program. Over half (54%) indicated they would consider a 1-year rotating research/teaching position and 45% an academic career. The most important encouraging factors for academic work were interest, opportunity to balance clinical and academic roles, job flexibility (lifestyle and family) and a supportive academic environment. Women were nearly nine times more likely to consider academic training (OR 8.75, P = 0.007), and trainees were one-third as likely to consider it compared to non-trainees (OR 0.31, P = 0.073). CONCLUSIONS: New Zealand has the unique ability to approach retention and training issues in a flexible and innovative manner which utilises international links. Clinical academic training positions should be set-up with quality supervision and support similar pay scales and the opportunity for simultaneous part-time clinical practice.

A lanthanide-based chemosensor for bioavailable Fe3+ using a fluorescent siderophore: an assay displacement approach.

The measurement of trace analytes in aqueous systems has become increasingly important for understanding ocean primary productivity. In oceanography, iron (Fe) is a key element in regulating ocean productivity, microplankton assemblages and has been identified as a causative element in the development of some harmful algal blooms. The chemosenor developed in this study is based on an indicator displacement approach that utilizes time-resolved fluorescence and fluorescence resonance energy transfer as the sensing mechanism to achieve detection of Fe3+ ions as low as 5 nM. This novel approach holds promise for the development of photoactive chemosensors for ocean deployment.

Integrating IT into the radiology environment.

Rather than perpetuating the struggle, "who controls the PACS, Radiology or Information Technology (IT)," Community Hospital of the Monterey Peninsula (CHOMP) took the approach of incorporating IT support within the Radiology Department. CHOMP faced the challenge of staffing Radiology computer systems and networks by using a two-pronged approach; promoting and training clinical staff in IT functions and transferring an experienced IT person into the Radiology Department. Roles and responsibilities are divided. CHOMP's IT Department supports the Radiology Department's desktop devices, PCs, printers, and standard peripherals; while the department's DICOM print and archive network, specialized hardware (e.g., Merge DICOM interface computers), and applications are supported by the Radiology Department. The IT Department provides operating system support for multi-user VMS, Unix, and NT-based systems, e.g. Sun Solaris for the DICOM archive, and Windows NT for Mitra PACS Broker, the HL7/DICOM interface engine. IT also supports network communications, i.e., network electronics (routers, switches, etc.), TCP/IP communications, and network traffic analysis; and OS operations support for major Radiology systems, e.g. back-ups and off-site tape storage. Radiology staff provides applications support and troubleshooting, including analyst functions for RIS; and are the first point of contact with the Radiology systems vendors, e.g., GE Medical, or Siemens. The Radiology Department's senior IT person, the Clinical Technology Coordinator, transferred from CHOMP's IT Department after 7 years in that department. She performs analysis and design associated with Radiology's computer systems, coordinates development of the department's strategic plan, evaluates vendor proposals, and assists the department with product and application selection. Her IT experience and growing knowledge of Radiology's clinical tasks enhances communications between the Radiology and IT departments. Formal meetings between the two departments are held monthly; informal and project-related meetings and discussion are frequent and vital to the continued good relationship between them. When CHOMP either upgrades or replaces its DICOM archive, and Radiology becomes completely filmless, the vendor's contract will include an on-site vendor-supplied picture archiving and communications systems support person for at least 6 months after deployment, to insure a better knowledge transfer. Having an on-site support person would have reduced the number of technical challenges the Radiology Department has faced over the past 2 years. Finding and maintaining qualified staff versed in both IT and Radiology has been and will continue to be difficult. A blend of IT and Radiology support staff and open communication between the departments is working for CHOMP.