Pharmacy Students’ Use of and Beliefs About Traditional Healthcare

Health professional students come from many different cultural backgrounds, and may be users of traditional healthcare (also known as ethnomedicine or folk medicine). This study aimed to explore New Zealand pharmacy students’ knowledge and beliefs about traditional healthcare, and to examine whether these changed during the course. A questionnaire was administered to students in 2011 and again in 2013. Students were from a wide range of ethnic groups. Their reported use of traditional healthcare increased (from 48 % in 2011 to 61 % in 2013) and was usually for minor illness or prevention. Non New Zealand European students were more likely to use traditional healthcare. Use of traditional healthcare was relatively common, and after exposure to a biomedical curriculum students seemed to be more, rather than less likely to report using traditional healthcare. Education about traditional healthcare should not be based on the assumption that all healthcare students are unfamiliar with, or non-users of, traditional healthcare.     

GIS and Its Use

1 Brief introduction of GISGISisthe abbreviationof Geographic Information Systems.As organized data can be accessed bypointingtoa regionon a map,GIS has become useful in a wide variety of applications.Information systems that support this type of appli-ca…     

Koreans’ Use of Medical Services in Seoul, Korea and California

This study assessed the types of health care services used by Korean immigrants, and differences in use between different countries, genders, health insurance status, acculturation status, and cardiovascular risk. Participant selection used probability sampling to represent the adult populations of California, United States, and Seoul, Republic of Korea. A telephone survey was administered to 2830 adult Korean-Californians and 500 adult Koreans living in Seoul. Female gender was significantly associated with higher use of outpatient services, ER usage, and hospitalization. Californian residence was significantly associated with higher outpatient usage and lower hospitalization rates. Health insurance was associated with higher allopathic health care utilization, and lower traditional health care usage, and acculturation with lower traditional health care usage. Higher self-reported cardiac risk factors were associated with lower allopathic and higher traditional health care. This suggests barriers to allopathic health care, but not traditional health care, for Koreans living in California without health insurance.     

A Longitudinal Study of Adolescents’ Pornography Use Frequency,Motivations, and Problematic Use Before and During the COVID-19 Pandemic

Archives of Sexual Behavior - Since the beginning of the COVID-19 pandemic, an increase in pornography use has been reported based on cross-sectional findings, raising concerns about associated...     

Calories in Context: Conceptual Metaphors and Consumers’ Perception and Use of Calorie Information

The U.S. Food and Drug Administration (FDA) recently made changes to the nutrition facts label so that calories will be emphasized over all other nutrient information (U.S. Food and Drug Administration (FDA), 2016a, August 3). In light of calories’ increased visibility, strategic health communicators need to understand both how individuals perceive calorie information and how calories influence consumption decisions. Therefore, a qualitative study was conducted to analyze the metaphors that structure consumers’ thoughts about calorie information and food choices. In-depth interviews were conducted with 34 women from diverse racial/ethnic and socioeconomic backgrounds. Through the interviews and subsequent thematic analysis, metaphors were gathered that explained perceptions of different kinds of calories and how calories function in the diet. Five conceptual metaphors were uncovered. The metaphors individuals used varied based on their eating paradigms, and the metaphors were related to different approaches to consumption decisions. The implications of using these different calorie metaphors for translational communication interventions are further discussed.     

Interactions Between Drinking Motives and Friends in Predicting Young Adults’ Alcohol Use

While drinking motives are well-established proximal predictors of alcohol use, less is known about their role in event-level drinking behavior. The present study examines whether the interaction between individuals’ drinking motives and the number of friends present at a given moment can predict alcohol consumption over the course of the evening. Using the Internet-based cell phone-optimized assessment technique (ICAT), 183 young adults (53.0 % female, mean age?=?23.1) in French-speaking Switzerland completed cell phone questionnaires every Thursday, Friday, and Saturday evening over five weekends. A total of 7205 questionnaires completed on 1441 evenings were analyzed. Drinking motives and gender were assessed at baseline, while the hourly alcohol consumption rate and number of friends present were assessed at 8 p.m., 9 p.m., 10 p.m., 11 p.m., and midnight. Multilevel growth curve models with time-invariant and time-varying covariates were estimated for men and women separately. Among women, enhancement motives were associated with an increase in the hourly alcohol consumption rate over the course of the evening (b?=?.025; p?<?.05). The impact of the number of friends present on the hourly consumption rate was stronger among those women who scored high on coping motives at baseline (b?=?.028; p?<?.05). Among men, drinking motives were found to have no moderating effects. Results highlight the role of drinking motives and their interactions with situational characteristics in determining event-level drinking, especially among women. Strategies to prevent risky weekend drinking should focus on both the social environment in which drinking takes place (e.g., the drinking group) and individual drinking motives.     

Medicaid Expansion’s Impact on Emergency Department Use by State and Payer

ObjectivesThe Affordable Care Act’s Medicaid Expansion Program influences healthcare use by increasing insurance coverage. Of particular interest is how this will affect inefficient and expensive emergency department (ED) visits. We estimated the impact of the Medicaid expansion on ED use by states and payer (Medicaid, private insurance, and uninsured) 5 years after the implementation of the Medicaid expansion and illustrated the use of the generalized synthetic control method.MethodsIn this quasi-experiment study, we implemented the generalized synthetic control method to compare states with Medicaid expansion and states without Medicaid expansion. Data were from the Healthcare Cost Utilization Project Fast Stats, which cover >95% of all ED visits. We included states with complete data from 2010 to 2018.ResultsOverall, the Medicaid expansion increased Medicaid share of ED visits (average treatment effect on the treated [ATT] 11.39%; 95% confidence interval [CI] 8.76-14.02) and decreased private share of ED visits (ATT ?5.80%; 95% CI ?7.40 to ?4.12) and uninsured share of ED visits (ATT ?6.66%; 95% CI ?9.78 to ?3.55).ConclusionsMedicaid Expansion Program shifted ED payer mix to Medicaid ED visits from private insurance and uninsured ED visits for adults at age of 19 to 64 years, whereas its effect on total ED volume is mixed among states. States that experienced the largest increase in Medicaid enrollment seem to experience an increase in ED visits although such results did not reach statistical significance.     

Use of cellular or cordless telephones and the risk for non-Hodgkin’s lymphoma

Objectives: To evaluate the use of cellular and cordless telephones as the risk factor for non-Hodgkin’s lymphoma (NHL). Methods: Male and female subjects aged 18–74 years living in Sweden were included during a period from 1 December 1999 to 30 April 2002. Controls were selected from the national population registry. Exposure to different agents was assessed by questionnaire. Results: In total, 910 (91%) cases and 1016 (92%) controls participated. NHL of the B-cell type was not associated with the use of cellular or cordless telephones. Regarding T-cell NHL and >5 year latency period, the use of analogue cellular phones yielded: odds ratio (OR) = 1.46, 95%; confidence interval (CI) = 0.58–3.70, digital: OR=1.92, 95%; CI=0.77–4.80 and cordless phones: OR=2.47; CI=1.09–5.60. The corresponding results for certain, e.g. cutaneous and leukaemia, T-cell lymphoma for analogue phones were: OR=3.41, 95%; CI=0.78–15.0, digital: OR=6.12, 95%; CI=1.26–29.7 and cordless phones: OR=5.48, 95%; CI=1.26–23.9. Conclusions: The results indicate an association between T-cell NHL and the use of cellular and cordless telephones, however based on low numbers and must be interpreted with caution. Regarding B-cell NHL no association was found.     

Obstetric Providers’ Knowledge, Awareness, and Use of CDC’s HIV Testing Recommendations and One Test. Two Lives.™

This study examined the impact of the Centers for Disease Control and Prevention’s (CDC’s) One Test. Two Lives.? (OTTL) campaign on key outcomes related to CDC’s revised HIV testing recommendations and the use of the campaign materials. Data from three cross-sectional surveys were used to assess the effect of OTTL on Obstetricians/Gynecologists’ (OB/GYN) HIV knowledge and practice. A 2-year combined sample of 500 OB/GYNs completed DocStyles, a Web-based survey for physicians, and 575 American College of Obstetricians and Gynecologists (ACOG) Fellows completed an ACOG survey. The surveys were similar in focus but did not contain the same items. Data were analyzed using cross-tabulations, χ² analyses, and logistic regression. There was a 20% recall of exposure to OTTL with DocStyles and 25% with ACOG. DocStyles respondents reporting having seen OTTL materials were significantly more likely to report awareness of CDC’s recommendations [χ²(1) = 25.43, P < .001] and include HIV testing as a regular screening test for all patients [χ²(1) = 4.98, P < .05]. ACOG respondents not using the materials indicated high levels of willingness to use the materials—63.0 to 71.5%, depending on the material. Of the ACOG sample, 68.1% correctly answered the knowledge items regarding the recommendations. However, a significant relationship between correct knowledge and campaign exposure was not found. Overall, results suggest that OTTL is instrumental in raising awareness and implementation of the testing recommendations and plays an important role in facilitating HIV testing practices with obstetric providers and their patients.     

Mother-Perceived Social Capital and Children’s Oral Health and Use of Dental Care in the United States

Objectives. We examined the association between mother-perceived neighborhood social capital and oral health status and dental care use in US children.Methods. We analyzed data for 67 388 children whose mothers participated in the 2007 National Survey of Children’s Health. We measured mothers’ perceived social capital with a 4-item social capital index (SCI) that captures reciprocal help, support, and trust in the neighborhood. Dependent variables were mother-perceived ratings of their child’s oral health, unmet dental care needs, and lack of a previous-year preventive dental visit. We performed bivariate and multivariable logistic regression analyses for each outcome.Results. After we controlled for potential confounders, children of mothers with high (SCI = 5–7) and lower levels (SCI ≥ 8) of social capital were 15% (P = .05) and about 40% (P ≤ .02), respectively, more likely to forgo preventive dental visits than were children of mothers with the highest social capital (SCI = 4). Mothers with the lowest SCI were 79% more likely to report unmet dental care needs for their children than were mothers with highest SCI (P = .01).Conclusions. A better understanding of social capital’s effects on children’s oral health risks may help address oral health disparities.It is well established that children living in families with low income and low educational attainment have poorer oral health and access to dental care than children with more affluent and educated families.1,2 Previous research has rigorously described oral health disparities by sociodemographic characteristics of individuals over the years, but only more recently have investigations begun to study the influence of larger contextual, environmental, and societal factors on the population’s oral health.3–6As part of this broader interest in the social determinants of health, the social connections that people have within their communities are receiving growing interest in public health research. This interest is rooted, in part, in the potential for people’s social connections to reduce health inequities through the mobilization of resources in society to better facilitate access to horizontally and vertically available social capital. Furthermore, social capital in the neighborhood may be particularly important for children’s well-being because the neighborhood is usually a central context for children’s psychosocial development. Children learn many of their social skills and values from within their neighborhood social networks.7 Especially in the absence of different kinds of support for children within the family,8 adult intervention on behalf of children in the neighborhood could serve as an important buffer against stressors and social risk factors embedded in the context of children’s lives.Although there is no consensus definition or a standardized approach to measuring social capital, it usually is thought of as consisting of some aspect of social structure and actions of individuals embedded in that structure.7 In social cohesion theory, social capital is conceptualized as the collective resources, such as trust, norms, and reciprocity, available to members of social groups, usually defined by geographic locales.9,10 This “social cohesion” school of social capital has been criticized for overlooking some aspects of social capital such as differences in residents’ abilities to access social capital and its potential negative effects on health.9,11 Nevertheless, greater social capital, measured by various features of social organizations in the community, has been linked to lower mortality and morbidity as well as self-reported better health outcomes.12 The hypothesized mechanisms are that social capital can influence health through (1) the diffusion of knowledge about health promotion, (2) maintenance of healthy behavioral norms or prevention of deviant health-related behaviors through informal social control, (3) promotion of access to local services and amenities, and (4) psychosocial processes that provide effective support, build self-esteem, and foster mutual respect.13It has been reported in the dental literature that a greater number of churches in neighborhood clusters was associated with the reduced severity of dental caries among low-income African American preschool children residing in Detroit, Michigan.3 Bramlett et al. previously examined various child-, family-, and neighborhood-level factors available in the 2003 National Survey of Children’s Health (NSCH) along with state-level factors from a variety of surveillance and census databases to test a multilevel conceptual model of determinants of young children’s oral health.5 Factors related to neighborhood cohesiveness and physical safety were correlated with parent-rated oral health status in children aged 1 through 5 years.5 Lower neighborhood social capital and community empowerment opportunities were also linked to higher rates of dental injuries14 and more dental caries among Brazilian adolescents.15Hypothesized sociobehavioral mechanisms linking social capital to health, empirical evidence on the association of social capital and general health, and initial evidence on the association of social capital–related variables and oral health strongly support further study of its potential impact on children’s oral health. It is evident from the literature that maternal oral health status, knowledge, and self-efficacy have a significant influence on children’s oral health behaviors and outcomes.16–19 In addition, gender may affect one’s perception of neighborhood social capital, patterns, and levels of social engagement and community participation.20,21 Little is known, however, about how social capital is perceived by female caregivers of children and how it might influence their behaviors and their children’s oral health. The purposes of this study were, therefore, to (1) describe the distribution of perceived social capital, using population-based data of self-reported neighborhood social cohesion among US mothers of children younger than 18 years, and (2) determine the association between neighborhood social capital and children’s oral health status and use of dental care.     

Parental Depressive Symptoms and Children’s School Attendance and Emergency Department Use: A Nationally Representative Study

We sought to assess the association between parental depressive symptoms and school attendance and emergency department (ED) use among children with and without chronic health conditions. Secondary analysis of the 1997–2004 National Health Interview Survey, a nationally representative survey. Parental depressive symptoms were measured by three questions assessing sadness, hopelessness, or worthlessness in the past month. Children with and without asthma or attention-deficit/hyperactivity disorder (ADHD) were identified, and their school attendance and ED visits were reported by adult household respondents. Children with information on parental depressive symptoms, health conditions, and services use were eligible. We incorporated weights available in the survey for each eligible child to reflect the complex sampling design. 104,930 eligible children were identified. The point prevalence of parental depressive symptoms was low (1.8 %, 95 % CI 1.7–2.0), but greater among children with asthma (2.7 %, 95 % CI 2.4–3.0) and ADHD (3.8 %, 95 % CI 3.2–4.4) than among other children (1.6 %, 95 % CI 1.5–1.7). After adjustment for potential confounders, children whose parents reported depressive symptoms most or all of the time were more likely to report an ED visit (adjusted incident rate ratio [IRR] 1.18, 95 % CI 1.06–1.32) or school absence (adjusted IRR 1.36, 95 % CI 1.14–1.63) than children whose parents did not. The effect of parental depressive symptoms was not modified by child health conditions. Parental depressive symptoms were adversely associated with school attendance and ED use in children. These results suggest the importance of measuring depressive symptoms among adult caregivers of children.     

System-Level Factors Affecting Clinicians’ Perceptions and Use of Interpreter Services in California Public Hospitals

Professional language interpreters are skilled in the nuances of interpretation and are less likely to make errors of clinical significance but clinicians infrequently use them. We examine system-level factors that may shape clinicians’ perceptions and use of professional interpreters. Exploratory qualitative study in 12 California public hospitals. We conducted in-person key informant interviews with hospital leadership, clinical staff, and administrative staff. Five emergent themes highlight system-level factors that may influence clinicians’ perceptions and use of professional interpreters in hospitals: (1) organization-wide commitment to improving language access for LEP patients; (2) organizational investment in remote interpreter technologies to increase language access; (3)training clinicians on how to access and work with interpreters; (4) hospital supports the training and certification of bilingual staff to serve as interpreters to expand in-person, on-site, interpreter capacity; and (5)organizational investment in readily accessible telephonic interpretation. Multiple system-level factors underlie clinicians’ use of professional interpreters. Interventions that target these factors could improve language services for patients with limited English proficiency.     

Gestational Women’s Perceptions About the Harms of Cigarette and E-Cigarette Use During Pregnancy

Objectives

The purpose of this study was to examine differences between perceived harm of cigarette and electronic cigarette (e-cigarette) use while pregnant and differences between healthcare providers’ communication about these products during pregnancy.

Methods

A convenience sample of gestational women (n?=?218; ages 18–45) living in the US completed an online survey between May and December 2017. Participants reported perceived likelihood of adverse health outcomes (e.g., low birth weight, sudden infant death syndrome) among infants/children born to mothers who used cigarettes/e-cigarettes. T-tests and two-way ANOVAs examined differences between risk perceptions of using cigarettes/e-cigarettes while pregnant based on pregnancy status (previously pregnant, currently pregnant, future pregnant). Chi-square analyses examined differences between healthcare provider communication about cigarette/e-cigarette use during pregnancy.

Results

Overall, participants believed adverse health outcomes were significantly more likely to be caused by maternal use of cigarettes than e-cigarettes. Participants who planned to be pregnant reported higher endorsement that smoking combustible cigarettes would cause a miscarriage (p?<?.05) or increased blood pressure (p?<?.05) for a child than currently pregnant participants. Participants reported healthcare providers asked about (p?<?.05), advised them not to use (p?<?.001), and talked to them about health effects of smoking combustible cigarettes while pregnant (p?<?.001) significantly more than e-cigarettes.

Conclusions for Practice

Healthcare providers working with pregnant women should perform the 5As behavioral intervention method to provide pregnant women with tobacco cessation care. They should also discuss the absolute harm nicotine exposure (via cigarettes or e-cigarettes) can have on fetal health and development.

     

Pregnant and Postpartum People with Substance Use Disorders: Understanding the Obstetrical Care Provider’ s Roles and Responsibilities

Maternal and Child Health Journal - Peripartum individuals with substance misuse are a high-risk population that challenge clinicians and child welfare specialists alike. Federal legislation was...     

Older Adults’ Use of Online and Offline Sources of Health Information and Constructs of Reliance and Self-Efficacy for Medical Decision Making

We know little about older adults' use of online and offline health information sources for medical decision making despite increasing numbers of older adults who report using the Internet for health information to aid in patient–provider communication and medical decision making. Therefore we investigated older adult users and nonusers of online and offline sources of health information and factors related to medical decision making. Survey research was conducted using random digit dialing of Florida residents' landline telephones. The Decision Self-Efficacy Scale and the Reliance Scale were used to measure relationships between users and nonusers of online health information. Study respondents were 225 older adults (age range = 50?92 years, M = 68.9, SD = 10.4), which included users (n = 105) and nonusers (n = 119) of online health information. Users and nonusers differed in frequency and types of health sources sought. Users of online health information preferred a self-reliant approach and nonusers of online health information preferred a physician-reliant approach to involvement in medical decisions on the Reliance Scale. This study found significant differences between older adult users and nonusers of online and offline sources of health information and examined factors related to online health information engagement for medical decision making.     

Children’s Media Use and Self-Regulation Behavior: Longitudinal Associations in a Nationwide Japanese Study

Objective The effect of media use on child behavior has long been a concern. Although studies have shown robust cross-sectional relations between TV viewing and child behavior, longitudinal studies remain scarce. Methods We analyzed the Longitudinal Survey of Babies, conducted by Japan’s Ministry of Health, Labour and Welfare since 2001. Among 53,575 families, 47,010 responded to the baseline survey; they were followed up every year for 8 years. Complete data were available for longitudinal analysis among 32,439 participants. Daily media use (TV viewing and video game-playing hours at ages 3, 4, and 5 years) was used as the main exposure. We employed an index of the children’s self-regulatory behavior as the outcome variable. Odds ratios and 95 % confidence intervals (CIs) were estimated. Results Among boys, longer TV-viewing times at ages 4 and 5 were related to problematic self-regulatory behavior. Compared with boys who watched just 1–2 h of TV a day, those who watched it 4–5 h had a 1.79-fold greater risk (CI 1.22–2.64) of problematic self-regulatory behavior, according to parental report. Among girls, similar results were evident at ages 4 and 5 (e.g., adjusted odds ratios for 4–5 h daily viewing versus 1–2 h at age 4: 2.59; 95 % CI 1.59–4.22). Video games may have a protective effect on the risk of problematic self-regulatory behavior at ages 3 and 5. Conclusion Longer daily exposure to TV during early childhood (age 4–5) may be associated with subsequent problematic child self-regulatory behavior.     

Incongruence Between Trauma Center Social Workers’ Beliefs About Substance Use Interventions and Intentions to Intervene

This study explored trauma centers social workers' beliefs regarding four evidence-based interventions for patients presenting with substance abuse issues. Previous research has indicated that health care providers' beliefs have prevented them from implementing non-abstinence based interventions. Study results indicated that the majority of social workers believed in the 12-step approach and were least comfortable with the harm reduction approach. However, results showed that in some cases, social workers may have negative personal beliefs regarding non-abstinence based interventions, but do not let their personal beliefs get in the way of utilizing these interventions if they are viewed as appropriate for the client’s situation.     

Tweeting as Health Communication: Health Organizations’ Use of Twitter for Health Promotion and Public Engagement

This study examined how major health organizations use Twitter for disseminating health information, building relationships, and encouraging actions to improve health. The sampled organizations were the American Heart Association, American Cancer Society, and American Diabetes Association. A content analysis was conducted on 1,583 tweets to examine these organizations’ use of Twitter's interactive features and to understand the message functions and topics of their tweets. The numbers of retweets and favorites were also measured as engagement indicators and compared by different message functions. The results revealed that all of the organizations posted original tweets most, but they differed in the degree to which they used the retweet and reply functions. Hashtags and hyperlinks were the most frequently used interactive tools. The majority of the tweets were about organization-related topics, whereas personal health–related tweets represented a relatively small portion of the sample. Followers were most likely to like and retweet personal health action-based messages.     

Young Women’s Use of a Microbicide Surrogate: The Complex Influence of Relationship Characteristics and Perceived Male Partners’ Evaluations

Currently in clinical trials, vaginal microbicides are proposed as a female-initiated method of sexually transmitted infection prevention. Much of microbicide acceptability research has been conducted outside of the United States and frequently without consideration of the social interaction between sex partners, ignoring the complex gender and power structures often inherent in young women’s (heterosexual) relationships. Accordingly, the purpose of this study was to build on existing microbicide research by exploring the role of male partners and relationship characteristics on young women’s use of a microbicide surrogate, an inert vaginal moisturizer (VM), in a large city in the United States. Individual semi-structured interviews were conducted with 40 young women (18–23 years old; 85% African American; 47.5% mothers) following use of the VM during coital events for a 4 week period. Overall, the results indicated that relationship dynamics and perceptions of male partners influenced VM evaluation. These two factors suggest that relationship context will need to be considered in the promotion of vaginal microbicides. The findings offer insights into how future acceptability and use of microbicides will be influenced by gendered power dynamics. The results also underscore the importance of incorporating men into microbicide promotion efforts while encouraging a dialogue that focuses attention on power inequities that can exist in heterosexual relationships. Detailed understanding of these issues is essential for successful microbicide acceptability, social marketing, education, and use.