Where is Rural? Examining the Effect of Rural Classification Method on Disparities in HIV and STI Testing Uptake Among Men Who Have Sex with Men in the United States

AIDS and Behavior - Men who have sex with men (MSM) account for the majority of new HIV diagnoses in the United States, including in rural areas, and MSM in rural areas face additional barriers to...     

Hilbert series,Howe duality,and branching rules

Let lambda be a partition, with l parts, and let F(lambda) be the irreducible finite dimensional representation of GL(m) associated to lambda when l < or = m. The Littlewood Restriction Rule describes how F(lambda) decomposes when restricted to the orthogonal group O(m) or to the symplectic group Sp(m2) under the condition that l < or = m2. In this paper, this result is extended to all partitions lambda. Our method combines resolutions of unitary highest weight modules by generalized Verma modules with reciprocity laws from the theory of dual pairs in classical invariant theory. Corollaries include determination of the Gelfand-Kirillov dimension of any unitary highest weight representation occurring in a dual pair setting, and the determination of their Hilbert series (as a graded module for p(-)). Let L be a unitary highest weight representation of sp(n, R), so*(2n), or u(p, q). When the highest weight of L plus rho satisfies a partial dominance condition called quasi-dominance, we associate to L a reductive Lie algebra g(L) and a graded finite dimensional representation B(L) of g(L). The representation B(L) will have a Hilbert series P(q) that is a polynomial in q with positive integer coefficients. Let delta(L) = delta be the Gelfand-Kirillov dimension of L and set c(L) equal to the ratio of the dimensions of the zeroth levels in the gradings of L and B(L). Then the Hilbert series of L may be expressed in the form H(L)(q)=c(L) P(q)(1-q)(delta). In the easiest example of the correspondence L --> B(L), the two components of the Weil representation of the symplectic group correspond to the two spin representations of an orthogonal group.     

Sex differences in acute energy intake regulation

The purpose of this investigation was to determine if energy intake compensation is more accurate in males compared to females matched for age, habitual physical activity, cardiorespiratory fitness, and dietary cognitive restraint. Healthy, nonobese young men (n=12) and women (n=12) were provided with an ad libitum lunch meal on two occasions. Thirty minutes prior to the lunch meals, subjects were given either a yogurt preload (YP; 500 mL, 1988 kJ, men; 375 mL, 1507 kJ, women) or no preload (NP). Energy intake at the two lunch meals was measured. Visual analog scales were used to assess changes in hunger and fullness. Blood glucose concentrations were also determined. Energy intake compensation for the YP was significantly more accurate in the male compared to the female subjects (86.2+/-5.0 vs. 73.6+/-4.8% compensation). There were no sex differences in perceptions of hunger and satiety. In the pooled sample, hunger ratings were significantly higher in the NP condition, but there were no significant differences in fullness ratings between test meals. In the YP condition, glycemic response to the preload and the ad libitum meal was significantly higher in males compared to females. These results suggest that under acute test meal conditions, energy intake regulation is more accurate in males. Relative inability to regulate energy intake may predispose females to gain weight over time.     

Low-literacy interventions to promote discussion of prostate cancer: a randomized controlled trial

BACKGROUND: Professional organizations recommend that physicians discuss prostate cancer with patients to make individual screening decisions. However, few studies have tested strategies to encourage such discussions, particularly among high-risk populations. We examined the effects of two low-literacy interventions on the frequency of prostate cancer discussion and screening. DESIGN: Randomized, blinded, controlled trial with concealed allocation. SETTING/PARTICIPANTS: Inner-city primary care clinic, serving a predominately African-American population. Participants were men aged 45-70 with no history of prostate cancer, presenting for a regular appointment. INTERVENTIONS: While waiting to see their physician, patients received a patient education handout on prostate cancer screening (PtEd), a handout simply encouraging patients to talk to their doctor about prostate cancer (Cue), or a control handout. The interventions did not advocate for or against screening. MEASURES: Patient-reported discussion of prostate cancer with the physician and chart reviews determine prostate-specific antigen (PSA) test orders and performance of digital rectal examination (DRE). Adjusted odds ratios (aOR) and 95% confidence intervals (CI) were computed. Data were collected in 2003, and analyses were completed in 2006. RESULTS: Most of the 250 subjects (90.4%) were African American and 78.8% read below the ninth grade level. Overall, 48.4% reported discussing prostate cancer during the appointment. Compared to the control group (37.3%), discussions were significantly more common in the Cue group (58.0%, aOR=2.39 [1.26-4.52]), as well as in the PtEd group (50.0%, aOR=1.92 [1.01-3.65]). When prostate cancer was discussed, patients in the intervention groups more commonly initiated the conversation (47.6% PtEd and 40.0% Cue, vs 9.7% control, p<0.01 for each comparison to control). Compared to the control group (2.4%), PSA test orders increased in the PtEd group (14.1%, aOR=7.62 [1.62-35.83]) and in the Cue group (12.3%, aOR=5.86 [1.24-27.81]). Documentation of DRE did not change significantly (4.7% PtEd, 6.2% Cue, and 6.0% control). CONCLUSIONS: Two simple low-literacy interventions significantly increased discussion of prostate cancer and PSA test orders but not performance of DRE. Both interventions were effective in empowering low-literacy patients to initiate conversations about prostate cancer with their physician.