When acculturation hurts: the case of immunization

The study examined the relationship between the acculturation of Mexican American mothers in Texas and immunization status of their children between 3 and 24 months of age. Mothers' acculturation, demographic characteristics, and immunization status of their children were assessed in in-person interviews with a sample of Mexican American respondents representative for Texas (n = 2193). Acculturation was measured with ten scales assessing oral and written language use, proficiency, and preference, music and TV viewing preferences, ethnic identity, place where a person was reared, and contacts with Mexico. Immunization status, defined according to the recommendation of the CDC Advisory Committee on Immunization Practices, was determined from official shot records obtained directly from respondents or, for respondents without records, obtained from their health care providers. Regression analysis revealed that acculturation significantly contributed to inadequate immunization status, even when socioeconomic status and other demographic covariates of acculturation were statistically controlled. Mediational analysis revealed that acculturation contributed to inadequate immunization through less positive attitudes toward immunization, a diminished sense of parental responsibility for children's immunization, and more perceived barriers to immunization. It is concluded that culture-specific beliefs encouraging childhood immunization should be fostered among Mexican Americans.     

George Bush: tell me where it hurts

During his first three-and-one-half years in office President Bush has compiled some impressive achievements in the areas of disease prevention and protection for the disabled. But for much of his first term, Bush ignored the twin perils of health care inflation and a rising number of uninsured Americans. Late in his term, the President put forward a plan combining tax credits for the uninsured and a greater emphasis on managed care to control costs.     

When religion hurts: Supervising cases of religious abuse

ABSTRACT

Clients who present in therapy having experienced abuse at the hands of a religious leader or religious community present a unique set of challenges for a therapist. Therapists treating such cases benefit from trauma-informed supervision that recognizes the power of the sacred to support client care and their own professional development. In this article, we define religious abuse, explore nuanced challenges of working with clients who present as survivors of religious abuse, and discuss ways in which supervisors, operating within a trauma-informed framework, can best support supervisees working with cases of religious abuse.     

CA-MRSA lesions: what works, what doesn't

Community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) abscesses are best managed surgically; postprocedure antibiotics do not substantially improve outcomes. Cure rates with incision and drainage alone are at least 90%. If incision and drainage fail to promote healing within 7 days, the oral antibiotics of choice are trimethoprim-sulfamethoxazole and tetracycline.     

OR integration: what it is--and what it isn't

Integrated operating rooms are generating much interest, and they are often considered an essential, or at least very beneficial, component of OR design. But there are some common misunderstandings about the technology. This article provides information you can use to determine whether you need an integrated OR and dispels the myths frequently associated with the topic.     

Helping hospital patients quit: what the evidence supports and what guidelines recommend

OBJECTIVE: The study aimed to critically appraise the extent and strength of systematic review evidence for, and guideline recommendations regarding hospital smoking cessation interventions. METHODS: Systematic reviews of smoking cessation interventions were identified via an electronic search of the Cochrane Library. Meta-analyses from Cochrane reviews were categorised as those that incorporated only studies of hospital based interventions, and those which incorporated interventions which were not hospital based. Smoking cessation guidelines for hospital health professionals were identified via a search of the World Wide Web. RESULTS: The review found that evidence from meta-analyses restricted to hospital studies was insufficient to evaluate a number of specific intervention strategies and at times conflicted with the findings of meta-analyses without such restrictions. The majority of guidelines recommended the provision of brief advice, counseling, nicotine replacement therapy despite the absence of clear supporting evidence. CONCLUSIONS: Further hospital-based research addressing specific cessation strategies is required. Furthermore, smoking cessation guidelines for hospital based health professionals should more specifically reflect evidence from this setting.     

Joint care: what the parents want

No-one knows better than the parents of mentally handicapped children what facilities should be available for their short-term care, but they are not often asked. The North Tyneside Planning Group for the Mentally Handicapped did ask. Dave Bromley, senior administrative assistant, North Tyneside AHA and Tim Lister, clinical psychologist, Northumberland AHA explain that the results indicate the need for a flexible service.     

Clinical governance: what it is, what it isn't and what it should be

Clinical governance is as much about setting standards and putting in place management systems to achieve them as it is about poorly performing doctors. Medical Royal Colleges are well placed to support individual hospital doctors in setting and monitoring clinical standards appropriate to their specialty.