Biomedical subjects

J Galbraith

Publications and source records attributed to J Galbraith.

At least 19 recordsLinked to original sources

PubMed1996

Sexually transmitted diseases, human immunodeficiency virus, and pregnancy prevention. Combined contraceptive practices among urban African-American early adolescents.

OBJECTIVE: To evaluate the success of efforts to educate youth not only to use prescription contraceptives to avoid pregnancy, but also to use condoms to avoid sexually transmitted diseases, including infection with the human immunodeficiency virus. METHODS: Longitudinal study of 383 African-American youth aged 9 to 15 years enrolled in a randomized, controlled trial of an acquired immunodeficiency syndrome (AIDS) risk reduction intervention. Data about contraceptive practices were obtained at baseline and 6, 12, and 18 months later using a culturally and developmentally appropriate risk assessment tool administered with "talking" computers (Macintosh, Apple Computer Inc, Cupertino, Calif). RESULTS: Approximately three fourths of sexually active youth used some form of contraception in each 6-month round, with almost half of the youth using combinations of contraceptives. Among all youth at baseline and among control youth throughout the study, more than half used condoms and more than two thirds who used oral contraceptives also used condoms. Receipt of an AIDS education intervention was associated with use of more effective contraceptive practices (eg, condoms and another prescription or nonprescription method of birth control). After receiving the intervention, more than 80% of the youth who used oral contraceptives also used condoms. Contraceptive practices showed considerable stability. Knowledge about AIDS was positively associated with use of more effective contraceptive methods. CONCLUSIONS: Many youth are using condoms and prescription birth control simultaneously, and these use rates can be increased through AIDS education interventions.

Adolescent↗

PubMed1995

Development of a culturally, theoretically and developmentally based survey instrument for assessing risk behaviors among African-American early adolescents living in urban low-income neighborhoods.

The creation of developmentally and culturally appropriate data-gathering instruments is necessary as health researchers and interventionists expand their investigations to community-based minority adolescent populations. The creation of such instruments is a complex process, requiring the integration of multiple data-gathering and analytic approaches. Recent efforts have delineated several issues to be considered in survey design for minority populations: community collaboration; problem conceptualization; application of the presumed model of behavioral change; and dialect and format of delivery. This paper describes the process of creating a culturally and developmentally appropriate, theoretically grounded instrument for use in monitoring the impact of an AIDS educational intervention on the behavior and health outcomes of urban African-American pre-adolescents and early adolescents. Three phases of research were involved: preliminary (and ongoing) ethnographic research including extensive participant observation, as well as, focus group and individual interviews with 65 youths; construction and testing of the preliminary instrument involving two waves of pilot testing (N1 = 57; N2 = 45); and, finalization of the instrument including reliability testing and assessment of tool constructs and selection of the mode of delivery (involving 2 additional waves of pilot testing (N3 = 91; N4 = 351). The essential role played by the community in all phases of instrument development is underscored.

Adolescent↗

PubMed1994

Anal intercourse among preadolescent and early adolescent low-income urban African-Americans.

OBJECTIVE: The purpose of this study, which was conducted as part of a larger study on adolescent risk behaviors, was to determine the frequency of anal intercourse among preadolescent and early adolescent youths. DESIGN: Survey. SUBJECTS: Three hundred fifty-one low-income urban African-American youths aged 9 to 15 years. MAIN OUTCOME MEASURES: A questionnaire assessing self-reported acquired immunodeficiency syndrome-risk behaviors was administered via a "talking" computer. The outcome measure was anal intercourse. RESULTS: Of the 137 youths (39%) who had engaged in any sexual intercourse (vaginal or anal), 50 (36%) had engaged in anal intercourse, including 41 (35%) sexually active boys and nine (43%) sexually active girls. Youths who had engaged in anal intercourse were significantly more likely to report having been sexually molested and having engaged in several delinquent behaviors than were virgins or youths who had engaged in coitus only. CONCLUSIONS: Efforts at preventing acquired immunodeficiency syndrome that target low-income urban African-American early adolescents should include the high-risk nature of anal intercourse.

Acquired Immunodeficiency Syndrome↗

PubMed1994

Social influences on the sexual behavior of youth at risk for HIV exposure.

OBJECTIVES: Adolescents are increasingly at risk for infection with human immunodeficiency virus (HIV) and other sexually transmitted diseases, especially in poor urban minority communities. To aid the design of interventions in these communities, this study investigated the role of knowledge, attitudes, perceived parental monitoring, and peer behavior in the onset and progression of sexual behavior in children at risk for exposure to HIV. METHODS: A computerized personal interview was administered to 300 African-American 9- to 15-year-old children living in six public housing developments in a large US city. RESULTS: Although children's knowledge about the hazards of sex increased with age, their sexual activity also increased (from 12% sexually experienced at 9 years of age to more than 80% experienced at 15 years of age). Parental monitoring appeared able to influence sexual activity. However, the perceived behavior of friends was associated with the rate at which sexual activity progressed with age and the degree to which condom use was maintained with age. CONCLUSIONS: The early onset and prevalence of sexual behavior and the importance of peer group influence call for early interventions that simultaneously influence the parents and peers in children's social networks.

Adolescent↗

PubMed1994

Sexual practices and intentions among preadolescent and early adolescent low-income urban African-Americans.

OBJECTIVE: To assess the sexual practices and the social and intrapersonal influences on sexual practices and intentions which have an impact on the risk for acquired immunodeficiency syndrome among pre- and early adolescent, low-income African-American youths. DESIGN: Cross-sectional cohort study conducted in nine recreation centers serving three public housing developments in an eastern city. PARTICIPANTS: Three hundred fifty-one African-American youths 9 to 15 years of age. OUTCOME MEASURES: Past and intended sexual intercourse, and past and intended condom use determined by a risk assessment instrument delivered aurally and visually via a "talking" MacIntosh computer. RESULTS: The median age was 11 years; 35% of youths had had sexual intercourse and 20% of virgins thought it likely that they would become sexually active in the next six months. Age and male gender were correlated with sexual activity. Of sexually active youths 62% had used a condom during their last episode of coitus and 60% expected to do so at the next episode. Among sexually active youths, 24% of boys and 35% of girls had had anal intercourse. Rates of foreplay (nonpenetrative sex) were low even among sexually active youths. The median number of sexual partners in the past six months was two. Social influences from parents, peers, and partners in an intimate relationship were important for all four sexual outcomes both by univariate analysis and after logistic regression. IMPLICATIONS: A high percentage of the low-income, urban African-American pre- and early adolescents in this study are engaging or intending to engage in high-risk sexual behaviors. Acquired immunodeficiency syndrome reduction interventions for early adolescents should incorporate the importance of social influences from multiple sources.

Acquired Immunodeficiency Syndrome↗

PubMed1994

Drug trafficking among African-American early adolescents: prevalence, consequences, and associated behaviors and beliefs.

OBJECTIVE/METHODOLOGY: Drug trafficking by minority youths in low-income, urban areas has received considerable publicity from the mass media in the past half-decade. However, there has been corresponding little exposition of this problem in the medical literature. This review was undertaken to provide an overview of the epidemiology and consequences of drug trafficking among urban youths and to describe factors associated with drug trafficking. RESULTS: Existing data indicate that approximately 10% of male, urban, African-American early adolescents report having engaged in drug trafficking, with a higher percent of youths reporting having been asked to sell drugs and/or indicating that they expect to become involved in drug trafficking. Rates increase with advancing age. Reported rates of drug trafficking are comparable with rates of tobacco and alcohol use among early adolescents and are substantially higher than use rates of illegal drugs. Drug trafficking is associated with increased mortality, accounting for one third to one half of homicide-related deaths in some studies. The practice is also associated with other health-risk behaviors, including nonfatal violence, substance use, and incarceration. Perceived social pressures by family members and/or peers to engage in drug trafficking and the belief that a youth's wage-earning potential is limited to drug trafficking are highly correlated with involvement in this activity. CONCLUSIONS: Drug trafficking is a prevalent risk behavior among adolescents that has several negative health consequences.

Adolescent↗

PubMed1993

Salivary protein interactions with oral bacteria: an electrophoretic study.

The relatively low levels of human salivary proteins in whole saliva as compared to the ductal secretions may be related to their interaction with oral bacteria. These interactions are thought to play an important role in the microbial colonisation of the mouth, and salivary proteins adsorbed to oral surfaces have been implicated in adherence. In this study we attempted to investigate the prevalence of interactive strains by screening a range of oral bacteria. Parotid saliva was incubated with bacterial suspensions and consequent alterations to the salivary protein profile determined by sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE). A number of salivary components were found to be preferentially removed, particularly by those species known to be primary colonizers of clean tooth surfaces.

Animals↗

PubMed1993

Perceptions of vaccine efficacy, illness, and health among inner-city parents.

A resurgence of measles in the past decade has focused attention on the limitations of current immunization programs, particularly for inner-city, low-income populations. As part of a larger study of immunization rates, we discussed perceptions of disease severity and vaccine efficacy, as well as the prioritization of the tasks of parenthood, with 40 parents of infants living in inner-city Baltimore to discover their beliefs about immunization. Vaccines were considered only partly successful; susceptibility to chickenpox after vaccination was repeatedly cited as evidence of vaccine failure. Fever was seen as a primary indicator of illness; thus, vaccines were believed to cause, rather than prevent, illness. Immunization was not considered a high-priority parental responsibility. These findings suggest future interventions be aimed at changing parental perceptions of vaccines as ineffective and of fever after immunization as an indicator of illness. Finally, immunizations should be made easily available, even during clinic visits for a child's illness.

Baltimore↗

PubMed1993

Urban adolescent high-risk sexual behavior: corroboration of focus group discussions through pile-sorting. The AIDS Youth Research Team.

Risk activities for acquisition of the human immunodeficiency virus (HIV) remain prevalent among urban adolescents. While interdisciplinary approaches to examine the variables contributing to risk/protective behaviors have been promoted, strategies for such explorations require further formulation. Recently we employed focus group discussions to explore factors placing urban adolescents at risk for engaging in HIV risk behaviors. The focus group format enables substantial interaction on a topic in a limited time period, but does not always provide expression of the full range of behavioral options. In this study we investigated the use of pile-sorts for confirmation of impressions from focus group discussions among 57 urban youths aged 10-14. The pile-sorts revealed some support for most of the views expressed in the group discussions. However, the sorts revealed more variability in views than was expressed in the group discussions. Substantial gender and age-based differences in perceptions were revealed with potentially important intervention implications.

Adolescent↗

PubMed1993

Early initiation of sex and its lack of association with risk behaviors among adolescent African-Americans.

OBJECTIVE: High rates of adolescent homicide, pregnancy, substance abuse, and sexually transmitted diseases underscore the importance of interventions designed to reduce problem behaviors. However, the definition of "problem" behavior and the association with other activities may change between youth cultures. Therefore, greater attention to defining the "problem" behaviors to be targeted will permit more effective utilization of primary vs secondary intervention strategies and identification of high-risk individuals. DESIGN: Two studies of African-American adolescents regarding sexual intercourse, school truancy, substance abuse, and drug trafficking are presented. The first study involved 57 youths (10 to 14 years of age) from a pediatric primary health center and gathered data through pile-sorting. The second study of 300 youths (9 to 15 years of age) from six public housing sites used a questionnaire administered by a "talking" computer. Both studies assessed different self-reported behaviors, feelings about engaging in specific behaviors, and perceptions of friends' behaviors. RESULTS: While 40% of subjects reported having had sex, substantially smaller proportions reported school truancy (14%), illicit drug use (2% to 6%), or drug trafficking (6%). Analyses of reported behaviors, feelings, and perceived peer norms revealed that sex was consistently depicted as forming a different domain from other problem behaviors. CONCLUSIONS: Interventions that rely on primary prevention strategies for sexual intercourse and that identify sexually active youths as at risk for problem behaviors may not be appropriate for African-American adolescents growing up in resource-depleted urban areas.

Adolescent↗

PubMed1992

Cerebral phaeohyphomycosis caused by Xylohypha bantiana, with a review of the literature.

A 76-year-old male with chief complaints of back and right leg sciatica was hospitalized. His abdominal CT scan revealed lumber spondylitic stenosis. A laminectomy was performed. Postoperatively, he became febrile, aphasic and had grand mal seizure. A left craniotomy of the front abscess, seen in the CT scan, was performed. H and E stained smears of drainage revealed dematiaceous, septate hyphae. Cultures of the abscess drainage grew an olivaceous-grey fungus. Based on macro- and micro-morphological characters, growth at 42 degrees C, and exoantigenic analysis, the patient's fungus was identified as Xylohypha bantiana. Treatment with amphotericin B and 5-fluorocytosine was initiated. Despite surgical procedures and antifungal therapy, the patient's condition deteriorated and he died a few weeks later due to cerebral edema. The case reported here is the first microscopically, culturally, histopathologically and exoantigenically proven case of phaeohyphomycosis caused by X. bantiana in the province of Alberta and from Canada. A review of the literature on cases of X. bantiana infections has also been presented.

Adolescent↗

PubMed1991