Voluntary rapid human immunodeficiency virus (HIV) testing in jails.

OBJECTIVES: To provide human immunodeficiency virus (HIV) rapid testing to persons in jails, identify previously undiagnosed cases of HIV infection, and refer HIV-infected inmates to care, treatment, and prevention services. DESIGN: Four state health departments (Florida, Louisiana, New York, and Wisconsin) collaborated with jails to implement stand-alone voluntary rapid HIV testing programs. Inmates requested or were referred by medical staff for rapid HIV testing. HIV testing was provided by the health department, correctional facility, or a community-based organization. Inmates whose rapid test was reactive were offered confirmatory testing, medical evaluation, prevention services, and discharge planning. RESULTS: From December 2003 through May 2006, rapid HIV testing was provided to 33,211 inmates, more than 99.9% of whom received their test results. Most of the inmates tested were male (79%), black (58%), and less than 35 years of age (60%). A total of 440 (1.3%) rapid HIV tests were reactive, and 409 (1.2%) of the results were confirmed positive. The testing programs identified 269 (0.8%) previously undiagnosed cases of HIV infection. In the multivariate analyses, new HIV diagnoses were associated with race/ethnicity, report of risky behaviors, and with no report of HIV risk behavior. Almost 40% of diagnoses were for inmates whose only reported risk was heterosexual contact. CONCLUSIONS: Rapid HIV testing in jails identified a considerable number of previously undiagnosed cases of HIV infection. Rapid HIV testing should be available to all inmates, regardless of whether inmates reported HIV risky behaviors.

Evaluation of an HIV prevention intervention adapted for Black men who have sex with men.

OBJECTIVES: We assessed the efficacy of an HIV behavioral intervention adapted for Black men who have sex with men (MSM). METHODS: We conducted serial cross-sectional surveys, 1 baseline measurement followed by initiation of an intervention and 3 follow-up measurements, among Black MSM in 3 North Carolina cities over 1 year. RESULTS: We observed significant decreases in unprotected receptive anal intercourse at 4 months (by 23.8%, n=287) and 8 months (by 24.7%, n=299), and in unprotected insertive anal intercourse (by 35.2%), unprotected receptive anal intercourse (by 44.1%), and any unprotected anal intercourse (by 31.8%) at 12 months (n=268). Additionally, at 12 months, the mean number of partners for unprotected receptive anal intercourse decreased by 40.5%. The mean number of episodes decreased by 53.0% for unprotected insertive anal intercourse, and by 56.8% for unprotected receptive anal intercourse. The percentage of respondents reporting always using condoms for insertive and receptive anal intercourse increased by 23.0% and 30.3%, respectively. CONCLUSIONS: Adapting previously proven interventions designed for other MSM can significantly reduce HIV risk behaviors of Black MSM.

Frequency of hepatitis B surface antigen variants (HBsAg) in hepatitis B virus genotype B and C infected East- and Southeast Asian patients: Detection by the Elecsys® HBsAg II assay.

BACKGROUND: To avoid false negative results, hepatitis B surface antigen (HBsAg) assays need to detect samples with mutations in the immunodominant 'a' determinant region, which vary by ethnographic region. OBJECTIVE: We evaluated the prevalence and type of HBsAg mutations in a hepatitis B virus (HBV)-infected East- and Southeast Asian population, and the diagnostic performance of the Elecsys® HBsAg II Qualitative assay. STUDY DESIGN: We analyzed 898 samples from patients with HBV infection from four sites (China [Beijing and Guangzhou], Korea and Vietnam). HBsAg mutations were detected and sequenced using highly sensitive ultra-deep sequencing and compared between the first (amino acids 124-137) and second (amino acids 139-147) loops of the 'a' determinant region using the Elecsys® HBsAg II Qualitative assay. RESULTS: Overall, 237 distinct amino acid mutations in the major hydrophilic region were identified; mutations were present in 660 of 898 HBV-infected patient samples (73.5%). Within the pool of 237 distinct mutations, the majority of the amino acid mutations were found in HBV genotype C (64.8%). We identified 25 previously unknown distinct mutations, mostly prevalent in genotype C-infected Korean patients (n = 18) followed by Chinese (n = 12) patients. All 898 samples were correctly identified by the Elecsys® HBsAg II Qualitative assay. CONCLUSIONS: We observed 237 distinct (including 25 novel) mutations, demonstrating the complexity of HBsAg variants in HBV-infected East- and Southeast Asian patients. The Elecsys® HBsAg II Qualitative assay can reliably detect HBV-positive samples and is suitable for routine diagnostic use in East and Southeast Asia.

Process evaluation of an effective church-based diet intervention: Body & Soul.

Body & Soul has demonstrated effectiveness as a dietary intervention among African American church members. The process evaluation assessed relationships between program exposure and implementation factors and study outcomes and characterized factors important for adoption, implementation, and maintenance. Data sources included participant surveys and qualitative interviews with program staff, church liaisons, and volunteer advisors who conducted motivational interviewing (MI) calls. Outcomes included changes in dietary intake and psychosocial variables. Process variables included program exposure, participation, and dose and perceptions about MI calls. Results showed that attendance at project events, receiving educational materials, and self-reported quality of the MI calls were associated with significantly (p < .05) greater fruit and vegetable intake, decreased fat consumption, and other secondary outcomes. Interviews indicated implementation and sustainability issues and needs including more training to enhance MI implementation as well as ongoing support and resources. The results have implications for future dissemination efforts of Body & Soul.

Surface Engineering of Polycrystalline Silicon for Long-Term Mechanical Stress Endurance Enhancement in Flexible Low-Temperature Poly-Si Thin-Film Transistors.

The surface morphology in polycrystalline silicon (poly-Si) film is an issue regardless of whether conventional excimer laser annealing (ELA) or the newer metal-induced lateral crystallization (MILC) process is used. This paper investigates the stress distribution while undergoing long-term mechanical stress and the influence of stress on electrical characteristics. Our simulated results show that the nonuniform stress in the gate insulator is more pronounced near the polysilicon/gate insulator edge and at the two sides of the polysilicon protrusion. This stress results in defects in the gate insulator and leads to a nonuniform degradation phenomenon, which affects both the performance and the reliability in thin-film transistors (TFTs). The degree of degradation is similar regardless of bending axis (channel-length axis, channel-width axis) or bending type (compression, tension), which means that the degradation is dominated by the protrusion effects. Furthermore, by utilizing long-term electrical bias stresses after undergoing long-tern bending stress, it is apparent that the carrier injection is severe in the subchannel region, which confirms that the influence of protrusions is crucial. To eliminate the influence of surface morphology in poly-Si, three kinds of laser energy density were used during crystallization to control the protrusion height. The device with the lowest protrusions demonstrates the smallest degradation after undergoing long-term bending.

Psychosocial mediation of fruit and vegetable consumption in the body and soul effectiveness trial.

In this study the authors examined psychosocial variables as mediators for fruit and vegetable (FV) intake in a clustered, randomized effectiveness trial conducted in African American churches. The study sample included 14 churches (8 intervention and 6 control) with 470 participants from the intervention churches and 285 participants from the control churches. The outcome of FV intake and the proposed mediators were measured at baseline and at 6-month follow-up. Structural equation modeling indicated that the intervention had direct effects on social support, self-efficacy, and autonomous motivation; these variables also had direct effects on FV intake. Applying the M. E. Sobel (1982) formula to test significant mediated effects, the authors confirmed that social support and self-efficacy were significant mediators but that autonomous motivation was not. Social support and self-efficacy partially mediated 20.9% of the total effect of the intervention on changes in FV intake. The results support the use of strategies to increase social support and self-efficacy in dietary intervention programs.

Results of the healthy body healthy spirit trial.

Healthy Body Healthy Spirit was a multicomponent intervention to increase fruit and vegetable (F & V) consumption and physical activity (PA) delivered through Black churches. Sixteen churches were randomly assigned to 3 intervention conditions. At baseline, 1,056 individuals were recruited across the 16 churches, of which 906 (86%) were assessed at 1-year follow-up. Group 1 received standard educational materials, Group 2 received culturally targeted self-help nutrition and PA materials, and Group 3 received the same intervention as did Group 2 as well as 4 telephone counseling calls based on motivational interviewing (MI) delivered over the course of 1 year. At 1-year follow-up, Groups 2 and 3 showed significant changes in both F & V intake and PA. Changes were somewhat larger for F & V. For F & V, but not PA, there was a clear additive effect for the MI intervention.

Body and soul. A dietary intervention conducted through African-American churches.

OBJECTIVES: Body and Soul was a collaborative effort among two research universities, a national voluntary agency (American Cancer Society), and the National Institutes of Health to disseminate and evaluate under real-world conditions the impact of previously developed dietary interventions for African Americans. METHODS: Body and Soul was constructed from two successful research-based interventions conducted in African-American churches. Components deemed essential from the prior interventions were combined, and then tested in a cluster randomized-effectiveness trial. The primary outcome was fruit and vegetable intake measured with two types of food frequency questionnaires at baseline and 6-month follow-up. RESULTS: At the 6-month follow-up, intervention participants showed significantly greater fruit and vegetable (F&V) intake relative to controls. Post-test differences were 0.7 and 1.4 servings for the 2-item and 17-item F&V frequency measures, respectively. Statistically significant positive changes in fat intake, motivation to eat F&V, social support, and efficacy to eat F&V were also observed. CONCLUSIONS: The results suggest that research-based interventions, delivered collaboratively by community volunteers and a health-related voluntary agency, can be effectively implemented under real-world conditions.

Validity of a modified CHAMPS physical activity questionnaire among African-Americans.

PURPOSE: Valid methods for assessing physical activity (PA) patterns are essential for accurate evaluation of intervention programs and population surveillance. Numerous self-report PA instruments have been validated in white adults; however, few studies have reported validity in African-Americans. METHODS: Data are from the Healthy Body/Healthy Spirit Trial, a study to increase fruit and vegetable intake and physical activity among adults in 17 black churches. Participants completed a modified version of the CHAMPS activity recall as well as components of the Yale Physical Activity Survey and the Paffenberger Activity Questionnaire. The modified CHAMPS was scored to yield four indices: moderate to vigorous physical activities (MET value > or = 3.0), vigorous activities (MET value > or = 5.0), "Sports and Recreational Activities," and all activities. Estimated V(O2) maximum was obtained by submaximal treadmill test in 138 participants, 109 females and 29 males. RESULTS: With the exception of moderate to vigorous activities, the modified CHAMPS indices were significantly correlated with estimated maximum VO(2). Highest correlations were observed for the index of vigorous and sports-related activities, 0.19 and 0.32, respectively. Activity measures were generally uncorrelated with blood pressure, body mass index, or total cholesterol. For the CHAMPS indices, correlations with VO(2max) and other physiologic variables were generally higher for males than females as well as those with income < 30,000 US Dollars and for those participants who did not complete college. CONCLUSION: Responses from the modified CHAMPS were moderately correlated with estimated VO(2max), with higher correlations for vigorous activity and recreational sports indices. The instrument may be useful for assessing physical activity among African-Americans. Stronger correlations for individuals with lower income and educational attainment was an unexpected finding that merits further examination.

Accumulation of behavioral validation evidence for physical activity stage of change.

OBJECTIVE: The purpose of this study was to accumulate behavioral validity evidence for physical activity Stage of Change (SOC). DESIGN: Nine studies used a common physical activity SOC measure and examined self-report, objective, and performance physical activity indicators to accumulate behavioral validity evidence for SOC. Type of measure, the strength of the expected relationship between the measure and SOC, and the predicted SOC differences were examined. Validity evidence for the SOC was also examined by population and sampling method. MAIN OUTCOME MEASURES: Validity evidence for physical activity SOC was classified with respect to the type of measurement instrument and the hypothesized magnitude of the relationship between the measure and the SOC. RESULTS: Physical activity SOC was found to be behaviorally valid as evidenced by self-reported physical activity, self-reported exercise, self-reported sedentary behaviors, pedometers, and physical functioning. Physical activity SOC does not appear to be related to physical fitness or weight indicators. CONCLUSIONS: This study highlights a successful multi-site collaboration. Physical activity data from nine large-scale, health trials was combined and accumulated behavioral validation evidence for the physical activity SOC.