The preliminary measurement properties of the person-centred community care inventory (PERCCI)

Quality of Life Research - Researchers investigating person-centredness in older people’s long-term community care are hindered by the lack of appropriate measures. Studies have tended to...     

HIV infection among Uganda women with cervical cancer: a retrospective study

OBJECTIVE: To assess whether there is an association between HIV and invasive cervical cancer (ICC). METHODOLOGY: A case-control study was conducted in Kampala between 1993 and 1995. 116 women with ICC were matched by age and parity with 116 hospital controls. Participants were tested for HIV and interviewed to assess risk factors for ICC and HIV. The association between HIV and ICC was assessed by conditional logistic regression. RESULTS: HIV prevalence was 18% among cases and 15% among controls. The odds of having ICC for HIV-infected patients was 1.27 (95% CI 0.58-2.80) when compared to controls, and the odds of being infected with HIV was higher in ICC patients aged <33 years (OR = 3.81) when compared to controls of similar age. HIV-infected ICC patients were younger (mean age 35.8 years) compared to 46.5 years in the ICC HIV-negative group (p = 0.021). CONCLUSION: HIV is associated with an earlier onset of ICC.     

Survivorship of Anopheles gambiae sensu stricto (Diptera: Culicidae) larvae in western Kenya highland forest

The western Kenya highland has been experiencing dramatic landuse changes in the past three decades. Landuse change has been hypothesized to be one of the mechanisms for malaria epidemics in African highlands because it can alter the physical and chemical characteristics of mosquito breeding habitats. One important landuse change in western Kenya highland is deforestation. The current study examined the effects of forestation or deforestation on the survivorship of Anopheles gambiae larvae and colonization of other aquatic insects in larval habitats in Kakamega forest (elevation 1,500-1,700 m above sea level), western Kenya. We found that the survivorship of An. gambiae larvae was reduced from 55 to 57% in habitats fully exposed to sunlight (open habitats) to 1-2% in habitats with full forest canopy coverage (forest habitats) and partial canopy coverage (forest edge habitats) in two out of three trials. The average daily water temperature of the open habitats was approximately 3-3.4 degrees C higher than the forest habitats. Insect species in the orders of Diptera, Coleoptera, and Odonata colonized the larval habitats, but the three habitat types differed greatly in the animal assemblage. Canonical correspondence analysis found that water temperature and amount of leaf litter were the significant variables associated with animal assemblages. Redundancy analysis revealed that openness and the presence of predatory animals were significantly related to An. gambiae survivorship. This result suggests that deforestation facilitates the survival of the immature stage of An. gambiae in the highland.     

Comparing United States versus international medical school graduate physicians who serve African- American and White elderly

OBJECTIVE: To examine the relationship that international medical school graduates (IMGs) in comparison with United States medical school graduates (USMGs) have on health care-seeking behavior and satisfaction with medical care among African-American and white elderly. DATA SOURCES: Secondary data analysis of the 1986-1998 Piedmont Health Survey of the Elderly, Established Populations for the Epidemiological Study of the Elderly, a racially oversampled urban and rural cohort of elders in five North Carolina counties. STUDY DESIGN: Primary focus of analyses examined the impact of the combination of elder race and physician graduate status across time using a linear model for repeated measures analyses and chi2 tests. Separate analyses using generalized estimating equations were conducted for each measure of elder characteristic and health behavior. The analytic cohort included 341 physicians and 3,250 elders (65 years old and older) in 1986; by 1998, 211 physicians and 1,222 elders. DATA COLLECTION/EXTRACTION METHODS: Trained personnel collected baseline measures on 4,162 elders (about 80 percent responses) through 90-minute in-home interviews. PRINCIPAL FINDINGS: Over time, IMGs treated more African-American elders, and those who had less education, lower incomes, less insurance, were in poorer health, and who lived in rural areas. White elders with IMGs delayed care more than those with USMGs. Both races indicated being unsure about where to go for medical care. White elders with IMGs were less satisfied than those with USMGs. Both races had perceptions of IMGs that relate to issues of communication, cultural competency, ageism, and unnecessary expenses. CONCLUSION: IMGs do provide necessary and needed access to medical care for underserved African Americans and rural populations. However, it is unclear whether concerns regarding cultural competency, communication and the quality of care undermine the contribution IMGs make to these populations.