Linda L. Hill

The journey to wellness: stages of refugee health promotion and disease prevention.

Refugees experience a threefold challenge to their health and well-being: 1) psychiatric disorders precipitated by the refugee experience, 2) infectious and parasitic diseases endemic to countries of origin, and 3) chronic diseases endemic to host countries. This paper documents the “journey to wellness” in which these challenges are faced in stages by the refugees themselves and by the array of health and social service agencies committed to providing refugee assistance. Using the experience of a consortium of agencies in San Diego as an example, we examine the interaction between these challenges and the mobilization of organizations to develop a program of health promotion and disease prevention for Somali and other East African refugees. This mobilization involves a series of steps designed to facilitate refugee confidence, comprehension, and compliance with prevention efforts through community-provider partnerships and negotiation between refugee and organizational explanatory models of disease causation and prevention.

Does Proximity to Retailers Influence Alcohol and Tobacco Use Among Latino Adolescents

Despite decades of research surrounding determinants of alcohol and tobacco (A&T) use among adolescents, built environment influences have only recently been explored. This study used ordinal regression on 205 Latino adolescents to explore the influence of the built environment (proximity to A&T retailers) on A&T use, while controlling for recognized social predictors. The sample was 45% foreign-born. A&T use was associated with distance from respondents’ home to the nearest A&T retailer (−), acculturation (+), parents’ consistent use of contingency management (−), peer use of A&T (+), skipping school (+), attending school in immediate proximity to the US/Mexico border (+), and the interaction between the distance to the nearest retailer and parents’ consistent use of contingency management (+). The association between decreasing distance to the nearest A&T retailer and increased A&T use in Latino adolescents reveals an additional risk behavior determinant in the US–Mexico border region.

American college of preventive medicine policy statement: Screening for skin cancer

Abstract Based on a review of current literature and recommendations, the American College of Preventive Medicine presents a practice policy statement on screening for skin cancer.

Occupational needlestick injuries in a metropolitan police force

OBJECTIVES Police officers are at risk of bloodborne diseases through needlestick injuries but few studies have addressed this problem. The purpose of this study was to assess the risk of needlestick injuries in law enforcement officers and to determine predictors of injuries and reporting rates. DESIGN An anonymous, voluntary questionnaire was distributed to 1738 active-duty, metropolitan police officers. The survey included the number of needlestick injuries ever experienced, how often these were reported, activities at the time of injury and attitudes toward injuries. RESULTS Of the 803 respondents (46.2% of survey population), 29.7% had at least one needlestick injury, and 27.7% of this group had two or more. Risk factors included evening shifts, pat-down searches, patrol duties, male gender and less experience. Only 39.2% sought medical attention for these injuries. CONCLUSIONS Needlestick injuries occur with considerable frequency in this group of law enforcement personnel, suggesting an increased risk of becoming infected with bloodborne pathogens, including hepatitis B, hepatitis C and HIV.

Skin cancer prevention and screening: Summary of the American College of Preventive Medicine's practice policy statements

Ca—A cancer Journal for Clinicians Background As part of an overall evaluation of preventive measures, the American College of Preventive Medicine assessed the efficacy of skin cancer prevention and screening strategies. Their findings were published in American Journal of Preventive Medicine in 1998.1,2 The practice policy statements generated by the College are intended to provide guidelines for physicians and public health practitioners in optimizing preventive health strategies for individuals and populations. In policy statement development, the published medical literature is searched comprehensively. The authors critically review the available literature with an attempt to evaluate the quality of the research. When available, prospective, randomized clinical trials with a study population that can be generalized and a large sample size are given the most weight. Evaluation criteria are similar to those used by the US Preventive Services Task Force, which also issues recommendations.3 The author’s analysis is reviewed by experts in the field and by the Board of the American College of Preventive Medicine. The College’s impartial, evidence-based reviews attempt to balance benefits—to both individuals and populations—with risks of interventions to assist clinicians and others in making the best possible decisions about preventive measures and screening tests. In the area of skin cancer, the prevention strategies analyzed included sun protection and sunscreen use; screening recommendations focused on total cutaneous examination. The findings are summarized in this article.

Pokémon GO—A New Distraction for Drivers and Pedestrians

Pokemon GO, an augmented reality game, has swept the nation. As players move, their avatar moves within the game, and players are then rewarded for collecting Pokemon placed in real-world locations. By rewarding movement, the game incentivizes physical activity. However, if players use their cars to search for Pokemon they negate any health benefit and incur serious risk. Motor vehicle crashes are the leading cause of death among 16- to 24-year-olds, whom the game targets. Moreover, according to the American Automobile Association, 59% of all crashes among young drivers involve distractions within 6 seconds of the accident. We report on an assessment of drivers and pedestrians distracted by Pokemon GO and crashes potentially caused by Pokemon GO by mining social and news media reports. Language: en

The Alexandria Digital Library Architecture

Since 1994, the Alexandria Digital Library Project has developed three prototype digital libraries for georeferenced information. This paper describes the most recent of these efforts, a three-tier client-server architecture that relies heavily on a middleware layer to present a single uniform set of interfaces to multiple heterogeneous servers. These standard interfaces, all of which are implemented in HTTP, support session management, collection discovery and evaluation, metadata searching, metadata retrieval, and online holding retrieval. An XML-based metadata encoding scheme and a simple boolean query language have also been developed. The architecture described by these interfaces has been implemented at UCSB.

Prevalence of and attitudes about distracted driving in college students

Objective: To identify current distracted driving (DD) behaviors among college students, primarily those involving cell phone use, and elucidate the opinions of the students on the most effective deterrent or intervention for reducing cell phone use. Methods: Students enrolled at 12 colleges and universities were recruited to participate in an online, anonymous survey. Recruitment was done via school-based list-serves and posters. School sizes ranged from 476 to over 30,000. The validated survey included 38 questions; 17 were specifically related to distracted driving. Results: Four thousand nine hundred sixty-four participants completed the surveys; the average age was 21.8, 66% were female, 82.7% were undergraduates, and 47% were white/non-Hispanic. Additionally, 4,517 (91%) reported phoning and/or texting while driving; 4,467 (90%) of drivers said they talk on the phone while driving; 1,241 (25%) reported using a hands-free device “most of the time”; 4,467 (90%) of drivers reported texting while driving; 2,488 (50%) reported sending texts while driving on the freeway; 2,978 (60%) while in stop-and-go traffic or on city streets; and 4,319 (87%) at traffic lights. Those who drove more often were more likely to drive distracted. When asked about their capability to drive distracted, 46% said they were capable or very capable of talking on a cell phone and driving, but they felt that only 8.5% of other drivers were capable. In a multivariate model, 9 predictors explained 44% of the variance in DD, which was statistically significant, F (17, 4945) = 224.31; P <.0001; R2 = 0.44. The four strongest predictors (excluding driving frequency) were self-efficacy (i.e., confidence) in driving while multitasking (β = 0.37), perception of safety of multitasking while driving (β = 0.19), social norms (i.e., observing others multitasking while driving; β = 0.29), and having a history of crashing due to multitasking while driving (β = 0.11). Conclusions: Distracted driving is a highly prevalent behavior among college students who have higher confidence in their own driving skills and ability to multitask than they have in other drivers’ abilities. Drivers’ self-efficacy for driving and multitasking in the car, coupled with a greater likelihood of having witnessed DD behaviors in others, greatly increased the probability that a student would engage in DD. Most students felt that policies, such as laws impacting driving privilege and insurance rate increases, would influence their behavior.

Koreans' use of medical services in Seoul, Korea and California.

This study assessed the types of health care services used by Korean immigrants, and differences in use between different countries, genders, health insurance status, acculturation status, and cardiovascular risk. Participant selection used probability sampling to represent the adult populations of California, United States, and Seoul, Republic of Korea. A telephone survey was administered to 2830 adult Korean-Californians and 500 adult Koreans living in Seoul. Female gender was significantly associated with higher use of outpatient services, ER usage, and hospitalization. Californian residence was significantly associated with higher outpatient usage and lower hospitalization rates. Health insurance was associated with higher allopathic health care utilization, and lower traditional health care usage, and acculturation with lower traditional health care usage. Higher self-reported cardiac risk factors were associated with lower allopathic and higher traditional health care. This suggests barriers to allopathic health care, but not traditional health care, for Koreans living in California without health insurance.

Multi-Level Barriers to LTBI Treatment: A Research Note

Background This study describes the barriers to effective and timely LTBI treatment encountered in a research study on INH adherence in Latino adolescents. Method Participant study logs were reviewed, results of continuing medical education pretests for medical providers were examined, and participating medical facilities were contacted in order to construct a profile of multi-level barriers to LTBI treatment. Results A total of 285 TST positive Latino (96%) high school students were recruited into the trial. We encountered a lack of understanding of the gravity of tuberculosis infection among both the public and providers of health care. Parents and adolescents cited competing priorities, transportation problems and financial constraints as reasons for non-compliance. Discussion Improved education of the public and physicians is needed regarding the gravity of the disease and the value of treatment, as well as public and financial support for LTBI treatment by both the government and the medical community.