Does a history of trauma contribute to HIV risk for women of color? Implications for prevention and policy. (73/994)

OBJECTIVES: We investigated history of abuse and other HIV-related risk factors in a community sample of 490 HIV-positive and HIV-negative African American, European American, and Latina women. METHODS: Baseline interviews were analyzed, and logistic regressions were used to identify predictors of risk for positive HIV serostatus overall and by racial/ethnic group. RESULTS: Race/ethnicity was not an independent predictor of HIV-related risk, and few racial/ethnic differences in risk factors for HIV were seen. Regardless of race/ethnicity, HIV-positive women had more sexual partners, more sexually transmitted diseases, and more severe histories of abuse than did HIV-negative women. Trauma history was a general risk factor for women, irrespective of race/ethnicity. CONCLUSIONS: Limited material resources, exposure to violence, and high-risk sexual behaviors were the best predictors of HIV risk.  (+info)

Role of Black churches in health promotion programs: lessons from the Los Angeles Mammography Promotion in Churches Program. (74/994)

OBJECTIVES: This article assesses pastor-level factors that affect the successful recruitment and implementation of community-based health promotion programs in Black churches. METHODS: Semistructured interviews with 16 pastors of Black churches were analyzed for content. RESULTS: We found that although the involvement of Black pastors in an array of secular activities makes them open to participate in health programs, their overcommitment to other issues can negatively influence their ability to participate. Second, although Black pastors appreciate being included in and benefiting from health research, minorities' history of being underserved and exploited can lead to suspiciousness and reluctance to participate. CONCLUSIONS: Our findings suggest that those interested in developing church-based health programs in the Black community must be attuned to how the same factors can both facilitate and hinder a program's development.  (+info)

Cancer risk behaviors and screening rates among homeless adults in Los Angeles County. (75/994)

The homeless encounter many barriers to health care and preventive services, while having an increased prevalence of most risk factors for cancer. A group of homeless adults (221) at nine different locations within Los Angeles County were surveyed during the summers of 1998 and 1999. A portion (71%) reported that they had had at least one rectal exam, 42% had a fecal occult blood test, 24% had a skin exam, and 23% had an endoscopy (flexible sigmoidoscopy or colonoscopy), and of the men aged 50+, only 19% had a prostate-specific antigen test in their lifetime. For women aged 40+, 55% had received a Pap smear, and 53% had a breast exam, but only 32% had a mammogram within the prior year. Among the sampled homeless population, 77% believed in the benefits of cancer screening, 79% were not fatalistic about cancer, 63% believed that early detection was efficacious, and 83% did not think it would be difficult to get screened. The majority of this population demonstrated accurate knowledge of cancer screening guidelines with the exception of endoscopy. Cancer screening rates of those surveyed were lower than the rates in California for endoscopy, prostate-specific antigen, mammography, and Pap smears. Given the lower cancer screening rates compounded by higher cancer risk factors, homeless populations need increased access to cancer screening tests, as well as education on the availability of free services. Additionally, facilities for the homeless and their staff should reinforce the purposes of cancer screening, provide more screening services, and implement institutional efforts, such as providing nutritious meals and sun protection products, to reduce high-risk behaviors and increase further access to cancer screening tests.  (+info)

Medical care capacity for influenza outbreaks, Los Angeles. (76/994)

In December 1997, media reported hospital overcrowding and "the worst [flu epidemic] in the past two decades" in Los Angeles County (LAC). We found that rates of pneumonia and influenza deaths, hospitalizations, and claims were substantially higher for the 1997-98 influenza season than the previous six seasons. Hours of emergency medical services (EMS) diversion (when emergency departments could not receive incoming patients) peaked during the influenza seasons studied; the number of EMS diversion hours per season also increased during the seasons 1993-94 to 1997-98, suggesting a decrease in medical care capacity during influenza seasons. Over the seven influenza seasons studied, the number of licensed beds decreased 12%, while the LAC population increased 5%. Our findings suggest that the capacity of health-care systems to handle patient visits during influenza seasons is diminishing.  (+info)

Binocular visual acuity summation and inhibition in an ocular epidemiological study: the Los Angeles Latino Eye Study. (77/994)

PURPOSE: To characterize binocular visual acuity summation and inhibition in participants of a population-based ocular epidemiologic study. METHODS: A complete ophthalmic examination of Latinos, aged 40 or more years, measured binocular and monocular distance visual acuities by a standard early-treatment diabetic retinopathy study (ETDRS) protocol. The proportions of participants who demonstrated binocular summation (i.e., binocular visual acuity was better than the better eye visual acuity by five or more letters), binocular inhibition (i.e., binocular visual acuity was worse than the better eye visual acuity by five or more letters), and visual impairment (visual acuity worse than 20/40) were calculated. RESULTS: In 1831 individuals, on average, binocular visual acuity was better than better eye visual acuity. Prevalence rates of binocular summation and inhibition were 21% and 2%, respectively. Compared with participants less than 65 years old or those with equivalent interocular visual acuity, older participants (> or =65 years) and those with interocular differences in visual acuity were more likely to demonstrate binocular inhibition (P < 0.01). The rate of visual impairment was significantly lower, when using binocular visual acuity than when using better eye or the American Medical Association (AMA) algorithm (5.2% vs. 6.9% and 9.5%, respectively P < 0.01). Participants with binocular inhibition had greater self-reported problems with driving activities (P < 0.05). CONCLUSIONS: The large proportion of individuals demonstrating binocular summation and inhibition suggests that in clinical or research settings, binocular visual acuity should be considered a primary measure of visual impairment, because it better equates the state in which the person usually functions.  (+info)

Mentoring future dental educators through an apprentice teaching experience. (78/994)

To address concerns about the growing shortage of dental educators, the UCLA School of Dentistry initiated an elective course to introduce fourth-year students to issues in academic dentistry and to provide an apprentice teaching experience. Participants in the elective (referred to as student teachers) developed a microcourse entitled "Welcome to Dental Anatomy," presented to incoming first-year students during orientation week. Under the guidance of faculty mentors, the student teachers were responsible for development of course content, teaching aids, and evaluation methodology. Two cycles of the elective have been completed reaching a total of twenty-one fourth-year students to date. The positive impact on student teachers and incoming first-year students indicates that this approach has great potential for encouraging more graduates to pursue careers in academic dentistry. In addition, the program has the potential to be expanded by adaptation to other foundational courses in the dental and dental hygiene curricula.  (+info)

Association of dairy products, lactose, and calcium with the risk of ovarian cancer. (79/994)

Epidemiologic findings have been inconsistent regarding the association of dietary fat, dairy products, and lactose with risk of ovarian cancer. The authors conducted a case-control study in Hawaii and Los Angeles, California, to examine several dietary hypotheses regarding the etiology of ovarian cancer in a population with a broad range of dietary intakes. A total of 558 patients with ovarian cancer diagnosed in 1993-1999 and 607 controls were interviewed regarding their diet. Consumption of all dairy products, all types of milk, and low-fat milk, but not consumption of whole milk, was significantly inversely related to the odds of ovarian cancer. Similar inverse gradients in the odds ratios were obtained for intakes of lactose and calcium, although these nutrients were highly correlated (r = 0.77). The odds ratio for ovarian cancer was 0.46 (95% confidence interval: 0.27, 0.76) among women in the highest quartile of dietary calcium intake versus the lowest (p for trend = 0.0006). The significant dietary association was limited to dairy sources of calcium (p for trend = 0.003), although a nonsignificant inverse gradient in risk was also found in relation to calcium supplement intake. These results suggest that intake of low-fat milk, calcium, or lactose may reduce the risk of ovarian cancer.  (+info)

The nature of newspaper coverage of homicide. (80/994)

OBJECTIVES: Previous research has shown that some homicides are more likely than others to receive newspaper coverage (for example, homicides by strangers). The present investigation examined whether, once the decision has been made to report on a homicide, the nature of the coverage (that is, how much visibility is given to a story, what information is included, and how a story is written) differs according to two key variables, victim ethnicity, and victim-suspect relationship. SETTING: Los Angeles, California (USA). METHODS: Homicide articles from the 1990-94 issues of the Los Angeles Times were stratified according to the predictors of interest (victim ethnicity and victim-suspect relationship) and a sample was drawn. Data that characterized two primary aspects of newspaper coverage, prominence and story framing (including background information, story focus, use of opinions, story tone, and "hook" or leading introductory lines) were abstracted from the articles. Descriptive statistics and cross tabulations were generated. Multivariate analyses were conducted to examine the predictive value of victim ethnicity and victim-suspect relationship on the nature of the newspaper coverage. RESULTS: Newspaper coverage of homicide was generally factual, episodic, and unemotional in tone. Victim-suspect relationship, but not victim ethnicity, was related to how a story was covered, particularly the story frame. Homicides by intimates were covered consistently differently from other types of homicides; these stories were less likely to be opinion dominated, be emotional, and begin with a "hook". CONCLUSION: Victim-suspect relationship was related to the nature of coverage of homicides in a large, metropolitan newspaper. Given the agenda setting and issue framing functions of the news media, these findings have implications for the manner in which the public and policy makers perceive homicides and, consequently, for the support afforded to various types of solutions for addressing and preventing violence.  (+info)