"There are still broken or fragmented systems": Qualitative assessment of needs to strengthen adolescent mental health services in American Samoa.

Mental health challenges appear common among adolescents in American Samoa. There is a community-identified need to better understand the health burden and identify opportunities to strengthen the mental health system to better meet adolescent mental health needs. The goal of this qualitative study was to gather community stakeholders' perceptions of common mental health problems among adolescents in American Samoa, identify existing services for adolescent mental health, and highlight strength-based opportunities to enhance care. Using the Fa'afaletui research framework, semi-structured in-depth interviews (n = 28) were conducted between October 2020 and February 2021 using Zoom. Key informants were adults living in American Samoa, sampled for diversity in profession, age, gender, education, and region of residence. Transcripts were coded in duplicate and analysed using deductive thematic analysis. Participants reported that suicide, depression, anxiety, and post-traumatic stress disorder are the conditions of highest burden. Participants identified an impressive amount of infrastructure and community mobilization, but also limitations in these services in addressing adolescents' health needs. Four themes arose related to the need to: (1) strengthen existing infrastructure; (2) reduce barriers to treatment access; (3) improve sustainability; and (4) encourage collaboration among leaders. Policymakers should prioritize the allocation of resources to strengthen infrastructure, public education, and stakeholder collaboration to improve adolescent mental health in American Samoa.

Technical note: Determination of acidity in whole raw milk: comparison of results obtained by two different analytical methods.

In Argentina, one analytical method is usually carried out to determine acidity in whole raw milk: the Instituto Nacional de Racionalización de Materiales standard (no. 14005), based on the Dornic method of French origin. In a national and international regulation, the Association of Official Analytical Chemists International method (no. 947.05) is proposed as the standard method of analysis. Although these methods have the same foundation, there is no evidence that results obtained using the 2 methods are equivalent. The presence of some trends and discordant data lead us to perform a statistical study to verify the equivalency of the obtained results. We analyzed 266 samples and the existence of significant differences between the results obtained by both methods was determined.

Investigations of patients of health care workers infected with HIV. The Centers for Disease Control and Prevention database.

OBJECTIVE: To assess the risk for transmission of the human immunodeficiency virus (HIV) from an infected health care worker to patients. DESIGN: Survey of investigators from health departments, hospitals, and other agencies who had elected to notify patients who had received care from health care workers infected with HIV. MEASUREMENTS: Information was collected about infected health care workers, their work practices, their patients' HIV test results, procedures that they did on those of their patients who were tested for HIV, and patient notification procedures. RESULTS: As of 1 January 1995, information about investigations of 64 health care workers infected with HIV was reported to the Centers for Disease Control and Prevention; HIV test results were available for approximately 22,171 patients of 51 of the 64 health care workers. For 37 of the 51 workers, no seropositive patients were reported among 13,063 patients tested for HIV. For the remaining 14 health care workers, 113 seropositive patients were reported among 9108 patients. Epidemiologic and laboratory follow-up did not show any health care worker to have been a source of HIV for any of the patients tested. CONCLUSION: Despite limitations, these data are consistent with previous assessments that state that the risk for transmission of HIV from a health care worker to a patient is very small. These data also support current recommendations that state that retrospective patient notification need not be done routinely.

HIV transmission in the health-care setting. Risks to health-care workers and patients.

Transmission of HIV from patients to health care workers (HCWs) has been documented. Data from surveillance projects and epidemiologic studies provide the basis for evaluation of the risk of HIV transmission in health care settings. Strategies to further reduce this risk should focus on prevention of blood contacts between HCWs and patients through the use of universal precautions and implementation of new or modified medical devices, techniques, and personal protective equipment.