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Human immunodeficiency virus and migrant labor in South Africa.

The authors investigate the impact of the migrant labor system on heterosexual relationships on South African mines and assess the implications for the future transmission of human immunodeficiency virus (HIV) infection. The migrant labor system has created a market for prostitution in mining towns and geographic networks of relationships within and between urban and rural communities. A section of the migrant workforce and a group of women dependent on prostitution for economic support appear especially vulnerable to contracting HIV infection since they are involved in multiple sexual encounters with different, changing partners, usually without condom protection. Furthermore, sexually transmitted disease morbidity is extensive in the general and mineworker populations. Historically, migration facilitated the transmission of sexually transmitted diseases and may act similarly for HIV. Problems of combating the HIV epidemic in South Africa are discussed.

Acquired Immunodeficiency Syndrome↗

Malaria, agriculture, and development: lessons from past campaigns.

The author presents in this article a historical-epidemiological evaluation of several anti-malaria campaigns and of the relative contribution of various direct measures employed and indirect factors operating during these campaigns. Approaches and factors that may be essential or at least useful for successful malaria control are identified. The malaria story in Palestine/Israel and the experience of the Tennessee Valley Authority are analyzed in some detail. In both cases, direct anti-malaria measures were versatile and based mostly on reduction of mosquito breeding and elimination of Anopheles larvae. Efficient organization and coordination of anti-malaria efforts, strenuous research and understanding of the vector biology, and accompanying socioeconomic and agricultural development contributed to successful campaigns. Malaria control in other parts of the United States and in Italy is also considered. The World Health Organization global anti-malaria campaign is discussed in the light of these earlier experiences. The study concludes that no single measure is sufficient to control malaria and that future anti-malaria campaigns need to adopt strategies that are flexible, incorporated into local health services, and interrelated with agricultural practices. Moreover, a certain threshold of socioeconomic development, health services infrastructure, and educational level may have to be reached for the successful application and maintenance of direct anti-malaria measures.

Agriculture↗

Challenging the collegiate rite of passage: a campus-wide social marketing media campaign to reduce binge drinking.

A social marketing media campaign, based on a normative social influence model and focused on normative messages regarding binge drinking, on a large, southwestern university campus has yielded positive preliminary results of an overall 29.2 percent decrease in binge drinking rates over a three-year period. The Core Alcohol and Drug Survey and the Health Enhancement Survey provided information on student knowledge, perceptions, and behaviors regarding alcohol and binge drinking. This study represents the first in-depth research on the impact of a media approach, based on a normative social influence model, to reduce binge drinking on a large university campus and has yielded promising initial results.

Adolescent↗

Ratings of speech naturalness of children ages 8-16 years.

The focus of this cross-sectional study was the investigation of Speech Naturalness (speech that sounds normal or natural to the listener) of 60 normal speaking children and adolescents between the ages of 8 and 16 years. 26 naive adult listeners rated the naturalness of videotaped and computer-presented speech samples, using a 9-point-Likert rating scale (1: highly natural sounding speech and 9: highly unnatural sounding speech). The children and adolescents who participated as speakers were distributed among 5 age groups (8, 10, 12, 14, and 16 yr.) with 6 boys and 6 girls in each group. Each child demonstrated normal articulation, language, voice, and speech fluency skills. Age and sex comparisons indicated boys' and girls' speech was rated comparably; however, 8-yr.-olds' speech was rated as significantly less natural than those of 12-, 14-, and 16-yr.-olds. Preliminary ratings of Speech Naturalness for normal speaking children were presented. Suggestions for the clinical application of the findings as a target criterion in treatment programs with communicatively impaired children were suggested. Replication with a larger and more representative sample is in order.

Adolescent↗

Ambivalence among women applying for abortion.

BACKGROUND: Our purpose was to characterize women expressing ambivalence when applying for abortion. MATERIAL AND METHODS: Data were collected, by self-administered questionnaires, from 339 women. Thirty percent were in doubt about the decision when the abortion was due. Socio-economic factors more often influenced the choice among ambivalent women than among those not in any doubt. RESULTS: Ambivalent women more often felt exposed to social pressure and some felt that the abortion was not their own choice. Their decision-making was marked by doubt during the entire process. CONCLUSIONS: There is a need for professional support during this decision-making process. Many of the ambivalent women stated that their decision might not have been the same under different personal circumstances.

Abortion Applicants↗

Benefits of the National Dairy Council to the dairy processing industry.

The National Dairy Council and its affiliated units have had a vital role in presenting the nutritional qualities of US dairy products to a variety of audiences. Established in 1915, National Dairy Council has been the segment of the dairy industry that initiates and administers nutrition research, implements cutting-edge educational programs, and communicates about the nutritional merits of dairy products to educators, health professionals, consumers, and other important groups. The grassroots structure of National Dairy Council allows it to communicate these important messages at both the national and local levels.

Dairy Products↗

Special school teachers require more goal-oriented collaboration with psychiatric professionals in Northern Finland.

BACKGROUND: The problems of children and adolescents have increased in number and severity during the last years. OBJECTIVE: The purpose of this study was to elicit the views of special school teachers in the Oulu Province in Finland concerning their pupils' problems and the need, use and adequacy of relevant psychiatric services. METHODS: The information was collected from the Northern Ostrobothnia Hospital District in 1998 in Finland and responses were obtained from the 37 (97.4%) special schools. The data were analysed using the content analysis method. RESULTS: Special-needs pupils had various behavioural and emotional problems that made it difficult for them to learn and for the teachers to teach. According to the teachers, the major obstacles in the process of helping special-needs pupils were the delayed admission for treatment and the lack of information necessary for the pupils' school work and goal-oriented aftercare, although there were also favourable experiences of functional co-operation and availability of useful information. Some schools lacked a reliable network for helping pupilsand supporting teachers. The Finnish legislation on basic education obliges the providers of education to provide rehabilitation in connection with special education and to arrange relevant development, counselling and support services. CONCLUSION: The rehabilitation of special-need pupils and the collaboration between school and mental health authorities is not optimally realised in spite of the legislation.

Adolescent↗

The impact of the "grim reaper" national AIDS educational campaign on the Albion Street (AIDS) Centre and the AIDS Hotline.

The national educational programme on the acquired immunodeficiency syndrome (AIDS) caused a dramatic increase in the number of heterosexual persons who presented for human immunodeficiency virus (HIV) antibody testing at the Albion Street (AIDS) Centre. There was also a marked increase in the number of intravenous drugs abusers who presented, although the proportion of this high-risk group that has been tested remains low. There was no increase in the number of homosexual men who presented for testing. The increase in the number of telephone calls that were received by the Centre's AIDS Hotline was due to an interest in HIV-antibody testing, rather than an interest in information about safer sexual practices. The campaign was seen to have achieved its primary objective, namely, to alert sexually-active persons of the potential spread of the virus from the high-risk groups. However, it is clear that future educational campaigns need to target specific high-risk groups such as intravenous drug abusers.

Acquired Immunodeficiency Syndrome↗

Tobacco and alcohol use outcomes of a school-based intervention in New Delhi.

OBJECTIVE: To reduce tobacco use among adolescents. METHODS: Thirty schools in New Delhi, India, were randomly assigned to 3 conditions: school-based and family-based intervention, school-based intervention only, or control group. Students were in the seventh grade at pretest (N = 4,776). The smoking intervention included posters, booklets, classroom activities, debates, and a signature campaign. The family intervention involved home activities. The survey measured tobacco knowledge, attitudes, offers, use, and intentions. RESULTS: Intervention students were significantly less likely than controls to have been offered, received, experimented with, or have intentions to use tobacco. CONCLUSION: The project had a significant impact on tobacco use.

Child↗

Mass media strategies targeting high sensation seekers: what works and why.

OBJECTIVES: To examine strategies for using the mass media effectively in drug prevention campaigns targeting high sensation seekers. METHODS: Both experimental lab and field studies were used to develop a comprehensive audience segmentation strategy targeting high sensation seekers. RESULTS: A 4-pronged targeting strategy employed in an antimarijuana media campaign yielded significant drops in 30-day marijuana use by adolescents. Other research demonstrates how high and low sensation seekers process antidrug ads differently. CONCLUSIONS: Mass mediated anti-drug campaigns aimed at high sensation seekers are effective tools for drug prevention.

Adolescent↗

Quality assurance in home care: a diversified organization's approach.

The rapid growth of home care brings with it greater risks and liabilities, making quality assurance increasingly more important. Home Health Services Foundation, Inc., a diverse, multi-corporate structure, developed an effective quality assurance program through communication and information sharing.

Communication↗

Special report on reimbursement. Medicare and Medicaid false claims prosecutions: your clerk's mistake can subject you to criminal penalties!

A number of steps are available to individual and institutional providers to minimize exposure under the new wave of enforcement activity. The first is education: learn what rules apply in your setting and share that knowledge with management and line employees. Second, undertake an independent compliance review to identify and resolve any existing exposure, including voluntary disclosure to the authorities, if appropriate. Third, institute an ongoing program to communicate to all employees not only the content of applicable rules, but also the genuine commitment of management to ensure continuing compliance above other concerns.

Fraud↗

The brave new world of Medicare and Medicaid fraud and abuse enforcement: whistle-blowers, pre-filing agreements, and voluntary disclosure.

Providers participating in the recent wave of mergers, acquisitions, and affiliations may have unwittingly expanded their false claims exposure because many false claim-type situations are difficult, if not impossible, to identify in pre-closing due diligence. In addition, the possibility of retrospective characterization of ordinary billing mistakes as "false claims" increasingly introduces significant uncertainty to the average provider's financial future. To date, the single most effective approach to this problem is an independent compliance review to identify and resolve any existing exposure, including voluntary disclosure if appropriate, and an ongoing compliance program to communicate to all employees not only the content of applicable rules but also the genuine commitment of management to ensure continuing compliance above other concerns.

Fraud↗

Exploring partner communication and patterns of sexual networking: qualitative research to improve management of sexually transmitted diseases.

This ethnographic research among rural South African men and women seeking care for STDs explores constraints to communication among partners and defines predominant patterns of sexual networking. A series of fifteen open-ended interviews explored topics related to sexual networking and partner communication. Patterns of sexual networking showed clear gender variation, with men more likely to discuss multiple partners. Both men and women believed they should tell one partner about their STD, most often a steady partner. Strong distinctions were made between regular and casual partners, with an emphasis on the role of trust in a steady relationship. Men and women expressed anxiety about telling their partners of their illness, but women more often expressed fear whereas men felt embarrassed. Multi-partnered sexuality is common and is widely accepted for men. While the importance of regular partnerships is clear for both men and women, sexual relationships appear to be highly unstable. Communication among partners could be facilitated by stronger health promotion messages, such as the importance of telling a partner about an STD. Prevailing patterns of communication and sexual networking have profound implications for the STD epidemic.

Adult↗