Organophosphorus pesticide urinary metabolite levels of children in farmworker households in eastern North Carolina

BACKGROUND: Organophosphorus (OP) pesticide urinary metabolite levels in a sample of farmworker children in North Carolina are documented and compared to national reference data. The relative importance of para-occupational, residential, and environment risk factors are delineated. METHODS: Urine samples were collected from 60 farmworker children 1-6 years of age, and interviews were completed by their mothers. Urine samples were analyzed for the dialkylphosphate (DAP) metabolites of OP pesticides. Summed molar concentrations of the diethyl and dimethyl DAP metabolites provided summary measures. RESULTS: The farmworker children had relatively high levels of OP pesticide urinary metabolites compared to national reference data; for example, participating children had higher geometric means for diethylphosphate (DEP), diethylthiophosphate (DETP), and the summed diethyl metabolites. However, analyses found no pattern of significant associations between predictors and metabolite levels. CONCLUSIONS: Future research requires greater precision in sampling and measurement to determine the risk factors for pesticide exposure among farmworker children.     

Testing to Prevent Colon Cancer: Results From a Rural Community Intervention

PURPOSE

Colon cancer is the second leading cause of cancer death in the United States. Despite tests that can detect and enable removal of precancerous polyps, effectively preventing this disease, screening for colon cancer lags behind other cancer screening. The purpose of this study was to develop and test a community-based participatory approach to increase colon cancer screening.

METHODS

Using a community-based participatory research approach, the High Plains Research Network and their Community Advisory Council developed a multicomponent intervention—Testing to Prevent Colon Cancer—to increase colon cancer screening. A controlled trial compared 9 intervention counties in northeast Colorado with 7 control counties in southeast Colorado. We performed a baseline and postintervention random digit–dial telephone survey and conducted both intent-to-treat and on-treatment analyses.

RESULTS

In all, 1,050 community members completed a preintervention questionnaire and 1,048 completed a postintervention questionnaire. During the study period, there was a 5% absolute increase in the proportion of respondents who reported ever having had any test in the intervention region (from 76% to 81%) compared with no increase in the control region (77% at both time points) (P = .22). No significant differences between these groups were found in terms of being up to date generally or on specific tests. The extent of exposure to intervention materials was associated with a significant and cumulative increase in screening.

CONCLUSIONS

This community-based multicomponent intervention engaged hundreds of community members in wide dissemination aimed at increasing colorectal cancer screening. Although we did not find any statistically significant differences, the findings are consistent with an intervention-related increase in screening and provide preliminary evidence on the effectiveness of such interventions to improve colon cancer screening.     

Mounting a community-based alcohol and drug abuse prevention effort in a multicultural urban setting: Challenges and lessons learned

This article is designed to help planners and community groups anticipate challenges in implementing community based prevention programs in multicultural urban environments. Empowerment and public health goals are described as essential elements. Methods are recommended for capacity-building with inexperienced participants and balancing long and short term goals in embattled communities.     

Evaluating food stamp nutrition education: a view from the field of program evaluation

The purpose of this paper is to review current approaches and issues in the field of program evaluation that apply to the effort of improving the evaluation of Food Stamp Nutrition Education (FSNE). As nutrition educators respond to increasing demands for accountability and measuring results, there are challenges to consider, as well as opportunities to capture. This paper includes a focus on the internal and external functions of evaluation, with attention given to evaluation's internal use and value in improving practice. A list of 10 building blocks is offered as essential for planning useful and credible evaluation of FSNE.     

Ambient temperature and pesticide poisoning: a time-series analysis

ABSTRACT

Limited studies have explored the association between ambient temperature and the disease burden of pesticide poisoning. Our study aims to estimate associations between daily mean temperature and pesticide poisoning incidence with lag effect. A distributed lag nonlinear model with Poisson distribution was used to examine the nonlinear lagged effects of ambient temperature on pesticide poisoning incidence. Overall, the estimated effects of temperature on pesticide poisoning incidence were non-linear, with higher relative risks (RRs) at hotter temperatures. It was found that the high temperature had acute and short-term effects and then declined rapidly along the lag days with the maximum risk occurring 0 day of exposure. Considering the 5-day cumulative RR for daily mean temperature, the temperature generally showed a positive association with the pesticide poisoning incidence, achieving the maximum risk at 31°C. In general, pesticide poisoning incidence increased with higher temperatures, with the strongest effects occurring shortly.     

Peer education in HIV prevention: an evaluation in schools

BACKGROUND: In recent years a number of publications have come out about the peer education method used as a tool in HIV prevention for young people. Our survey aimed at testing the effectiveness of the peer education method in HIV prevention in high school settings through a pilot intervention. METHODS: A peer education intervention took place in 10 high schools in Athens over a 1 year period. A cohort of 702 students was surveyed (n = 493 intervention group, n = 209 control group) from 13 high schools through anonymous questionnaires based on the KABPs model, pre- and post-intervention. The statistical package used was SPSS using the chi(2)-test. RESULTS: Compared with control students, the intervention students were slightly empowered: (i) to increase their personal responsibility; and (ii) to adopt a safer behaviour in sexual practice. Knowledge did not show any significant modification between the two groups. However, discrimination about certain groups of people, the attitude about condoms and initiation of sexual relations did not appear to be influenced. CONCLUSIONS: The peer education approach can influence the behaviour of young people regarding their personal protection from HIV infection. In order to test its effectiveness, peer education should be further evaluated as a health education method in HIV prevention in high schools, other youth settings and community interventions, where the aim is behavioural change.     

Estimating dietary consumption patterns among children: a comparison between cross-sectional and longitudinal study designs

Estimating dietary intake for children is an essential component of conducting pesticide exposure assessments given the fact that children are predominantly exposed to certain pesticides, such as organophosphorus pesticide, through dietary intake. Different study designs and their respective sampling methodology utilized to estimate food consumption patterns can significantly alter the parameter estimates and the variability in the values obtained. This study investigated the impacts of study design on overall estimates of dietary intake by applying the temporal sampling characteristics used in cross-sectional approaches, as in The Continuing Survey of Food for Intakes by Individuals (CSFII), to food consumption data collected in a longitudinal manner via a bootstrap sampling technique. We examined the precision of time-averaged dietary intake estimates under various sampling schemes and explored the contribution of seasonality toward the dietary patterns. A comparison between the estimates of food consumption obtained from the bootstrap replicates and the longitudinal study estimates indicate that variability is significantly decreased when employing a longitudinal study design. Moreover, both between and within-subject variability decreases when individuals are followed over an increasing number of days. Finally, within the longitudinal study cohort, we observed a seasonal component to dietary intake for fruits and grains. Our findings suggest that longitudinal dietary surveys offer substantial improvements for exposure assessment compared to a standard cross-sectional design.     

Program evaluation in sex education: Outcome assessment of sexual awareness weekend workshops

The results of an outcome assessment of a growth-oriented sex education program are reported. The evaluation project attempted to overcome flaws of existing sex education research by explicitly delineating goals and by incorporating both a rigorous experimental control group design and quasiexperimental cohort comparisons. A Sex Questionnaire (covering sexual knowledge, attitudes, and behavior) was administered to the participants of three weekend workshops at the time of registration and 1 month later. Overflow registration for one workshop permitted the random selection of a no-program control group. Results supported inferences of workshop effectiveness in meeting program goals in the areas of attitude and behavior change, but not with regard to increasing sexual knowledge. Implications for development and evaluation of sex education programs are discussed.Requests for additional information should be sent to Jacqueline Voss, Ph.D., Counseling Center, University of California at Irvine, Irvine, California 92716. The paper is based on research taken from the senior author's dissertation. We would like to thank the staff of Human Sexuality Services and the workshop's Task Force at Southern Illinois University at Carbondale for their support and cooperation in the evaluation project.     

Medical education and medical education research and development activities in modern China

The development of medical education in China occurred quite differently to medical education in the rest of the world. A review of the literature has been presented regarding the historical development and the evolution of medical education research and development (MERAD) units in modern China. The history of medical education in modern China has been divided into three periods: (1) the 17 years before the 'Cultural Revolution' (1949-1966); (2) the period of the 'Cultural Revolution' (1966-1976); (3) the post 'Cultural Revolution' period (1976 onwards). Although a number of MERAD activities had existed on China's medical campuses since 1949, there was no formal organizational structure for MERAD before 1978. The change of the political situation in 1978 led China to seek modernization, with education as its basis. In the process of health care system modernization, medical education was given priority, and the Western model of establishing MERAD units as a means of improving the training of health professionals was introduced. The evolution of medical education research and development in modern China appears to be following the Western pattern due to the multitude of Western consultants and fellowships in Western countries provided to Chinese medical education leaders. A group of people from medicine is gathering in the MERAD field and MERAD units are beginning to take shape in modern China.     

The development of a taste education program for preschoolers and evaluation of a program by parents and childcare personnel

The change in people''s dietary life has led to an increase in an intake of processed foods and food chemicals, raising awareness about taste education for preschoolers whose dietary habits start to grow. This study aims to evaluate the effectiveness and satisfaction of parents and childcare personnel after developing a taste education program and demonstrating it in class. A part of the curriculum developed by Piusais and Pierre was referred for the program. After educating 524 preschoolers in child care facilities in Seoul, a satisfaction survey was conducted on the program. The data in this study were analyzed using SPSS 14.0. Statistical analysis was conducted based on the frequency after collecting the data. Mean ± SD used to determine satisfaction with taste education, with preferences marked on a five-point scale and the alpha was set at 0.05. The program includes five teachers'' guides with subjects of sweetness, saltiness, sourness, bitterness and harmony of flavor, and ten kinds of teaching tools. For the change in parents'' recognition of the need for taste education based on five-point scale, the average of 4.06 ± 0.62 before the program has significantly increased to 4.32 ± 0.52 (P < 0.01). Regarding the change in the preferences for sweetness, saltiness, sourness, and bitterness, the average has increased to 3.83 ± 0.61, 3.62 ± 0.66, 3.64 ± 0.66, and 3.56 ± 0.75 respectively. In an evaluation of instructors in child care facilities, the average scores for education method, education effect, education contents and nutritionists, and teaching tools were at 4.15 ± 0.63, 3.91 ± 0.50, 4.18 ± 0.50, and 3.80 ± 0.56 respectively. In addition, the need for a continuous taste education scored 4.42 ± 0.67. This program has created a positive change in preschoolers'' dietary life, therefore the continuation and propagation of the taste education program should be considered.     

Measuring the success of community science: the northern California Household Exposure Study

Background: Environmental health research involving community participation has increased substantially since the National Institute of Environmental Health Sciences (NIEHS) environmental justice and community-based participatory research (CBPR) partnerships began in the mid-1990s. The goals of these partnerships are to inform and empower better decisions about exposures, foster trust, and generate scientific knowledge to reduce environmental health disparities in low-income, minority communities. Peer-reviewed publication and clinical health outcomes alone are inadequate criteria to judge the success of projects in meeting these goals; therefore, new strategies for evaluating success are needed.Objectives: We reviewed the methods used to evaluate our project, “Linking Breast Cancer Advocacy and Environmental Justice,” to help identify successful CBPR methods and to assist other teams in documenting effectiveness. Although our project precedes the development of the NIEHS Evaluation Metrics Manual, a schema to evaluate the success of projects funded through the Partnerships in Environmental Public Health (PEPH), our work reported here illustrates the record keeping and self-reflection anticipated in NIEHS’s PEPH.Discussion: Evaluation strategies should assess how CBPR partnerships meet the goals of all partners. Our partnership, which included two strong community-based organizations, produced a team that helped all partners gain organizational capacity. Environmental sampling in homes and reporting the results of that effort had community education and constituency-building benefits. Scientific results contributed to a court decision that required cumulative impact assessment for an oil refinery and to new policies for chemicals used in consumer products. All partners leveraged additional funding to extend their work.Conclusions: An appropriate evaluation strategy can demonstrate how CBPR projects can advance science, support community empowerment, increase environmental health literacy, and generate individual and policy action to protect health.     

West African youth initiative: outcome of a reproductive health education program

Purpose: To describe the implementation and evaluation of an adolescent reproductive health peer education program in West Africa. The program, known as the West African Youth Initiative (WAYI), was developed to improve knowledge of sexuality and reproductive health, and promote safer sex behaviors and contraceptive use among sexually active adolescents in Nigeria and Ghana.

Methods: Between November 1994 and April 1997, two organizations, the Association for Reproductive and Family Health (ARFH), based in Nigeria, and Advocates for Youth, based in Washington D.C., supported community-based youth-serving organizations in the two countries to implement peer education projects. Consultants from the African Regional Health Education Centre (ARHEC) in Nigeria provided technical assistance in designing and conducting a quasi-experimental process and outcome evaluation of the projects.

Results: There were significant differences over time and between intervention and control groups concerning reproductive health knowledge, use of contraceptives in the previous 3 months, willingness to buy contraceptives, and self-efficacy in contraceptive use.

Conclusions: Overall, the project provides evidence that peer education is most effective at improving knowledge and promoting attitudinal and behavior change among young people in school settings.