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PubMed2006

Exploring the discourse between genetic counselors and Orthodox Jewish community members related to reproductive genetic technology.

OBJECTIVE: Genetic technology is complex, relatively new and involves sensitive issues pertaining to personhood and reproduction. While ethno cultural barriers to genetic care are well documented, little attention has been devoted to understanding religious beliefs pertaining to genetic services. This study evaluated the discourse between genetic counselors and Orthodox Jewish community members' perceptions of reproductive genetic technology. METHODS: A cross section of the Orthodox Jewish community was sampled through purposeful and snowball recruitment for in-depth interviews with key informants. RESULTS: Genetic counselors felt apprehensive about serving the Orthodox Jewish population and were unaware of social norms, religious and cultural practices unique to this population. Similarly, Orthodox Jewish consumers exhibited major misgivings about genetic testing. Importantly, stereotypic expectations by both counselors and consumers exacerbated existing communication difficulties. CONCLUSION: Cultural differences and poor communication between genetic counselors and Orthodox Jewish community members impeded the ability of the Orthodox Jewish community to utilize genetic services. PRACTICE IMPLICATIONS: This work illuminates complex issues pertaining to medical encounters between providers and patients with ideological, social and cultural differences. In particular, issues of access to care and transcultural competence in serving religious minority groups, such as Orthodox Jews are presented. On the whole, this group is largely unrecognized in the minority health literature in spite of barriers and challenges that they face. Findings of this study may have application to other cloistered and highly observant religious groups when dealing with reproductive technology and other populations with diverse values, beliefs and behaviors pertaining to reproductive health.

Attitude of Health Personnel↗

PubMed2003

Severe Staphylococcus aureus infections caused by clonally related community-acquired methicillin-susceptible and methicillin-resistant isolates.

We investigated the genetic relatedness of 5 community-acquired (CA) Staphylococcus aureus isolates obtained from 4 consecutive pediatric patients presenting with sepsis syndrome and severe pneumonia during a 3-week period in 2000. Two patients were infected with methicillin-susceptible S. aureus (MSSA), and 2 were infected with methicillin-resistant S. aureus (MRSA). The pulsed-field gel electrophoresis patterns for the 2 CA-MRSA isolates were identical to each other, as were the patterns for the 3 CA-MSSA isolates. A 2-band difference reflecting the presence of a staphylococcal cassette chromosome mec (SCCmec) element distinguished the CA-MRSA isolates from the CA-MSSA isolates. The small, mobile type IV SCCmec element was present in the CA-MRSA isolates. These data suggest that an insertion or, less likely, a deletion of the SCCmec type IV element occurred in a highly virulent S. aureus background. Staphylococcal toxin genes sea, seh, lukS-PV, and lukF-PV were detected in all isolates. Also, in all isolates, was a partial homolog of seo (seo'). The relationship among these patient isolates strengthens the assumption that CA-MRSA infections may be caused by isolates closely related to MSSA isolates.

Adolescent↗

PubMed1990

Adult root caries survey of two similar communities with contrasting natural water fluoride levels.

For a comparative study of root caries, 502 adult lifelong residents of a naturally fluoridated community (1.6 ppm F) and 465 such residents of a nearby, comparable nonfluoridated community (0.2 ppm F) were examined. Substantially fewer carious lesions were found among adults in the fluoridated community relative to the nonfluoridated community. This was observed in virtually all age- and gender-specific groups. Given a cross-sectional design and considering only exposed root surfaces, root caries was related to age. In addition, the data from this study show that the number of root caries lesions is underestimated but that root caries prevalence is overestimated by the standard Root Caries Index (RCI). A less restrictive form of the RCI may lead to more valid estimation of root caries prevalence.

Adolescent↗

PubMed1978

Halfway house and family involvement as related to community adjustment for ex-residents of a psychiatric halfway house.

What variables are highly correlated with successful community adjustment? A group of ex-patients who left a halfway house to return to the community were interviewed around their active involvement and perceived support from the staff members of the halfway house, while living on their own or with their families. There was a highly positive relationship between continuing contact with the halfway house and the level of adjustment in the community. The implications for understanding the nature, continuity, and purpose of social supports for this group are discussed.

Aftercare↗

PubMed1996

Changes in the prevalence of psychiatric disorder in a community are related to changes in the mean level of psychiatric symptoms.

The paper of Anderson et al. (1993), based on cross-sectional data, showed that minor psychiatric disorder in a population is linearly related to the mean number of psychiatric symptoms in the population. The present investigation asks whether the same relationship holds longitudinally as well as cross-sectionally. Data from a 7-year follow-up of a general population sample demonstrate, for the first time, that a relationship exists between changes in prevalence of psychiatric disorder and changes in the mean number of psychiatric symptoms in a given population. Moreover, the relationship is linear; a one-point decrease in mean scores on the GHQ-30 is associated with a 6% decrease in prevalence of disorder.

Adolescent↗

PubMed2004

Caries experience among schoolchildren in relation to community fluoridation status and town size.

The objective of the present study was to determine the caries experience of schoolchildren aged 7-12 years from the Southeast area of São Paulo State, Brazil, in 1998, according to town size and fluoridation status. Data for this cross-sectional study were based on the data bank from the Epidemiological Survey of São Paulo State provided by the State Health Department. After stratification by fluoridation status and town size, 29 towns were randomly selected to represent the Southeast area of São Paulo State, Brazil, and a total of 13,480 schoolchildren were randomly selected for this study. Calibrated dentists performed dinical examinations according to the WHO criteria. Caries experience and prevalence were significantly lower in fluoridated areas (1.9 DMFT, 2.1 dmft, 20% caries free) than in non-fluoridated areas (2.4 DMFT, 2.4 dmft, 13% caries free). According to town size, DMFT and caries prevalence were significantly higher in small towns (2.3 DMFT, 13% caries free), followed by medium-sized (2.1 DMFT, 17% caries free) and large cities (1.6 DMFT, 27% caries free). Among 12-year-old children, caries prevalence was predominantly moderate or high in small and medium-sized municipalities, whereas in large cities it was moderate or low. The results suggest that water fluoridation is an essential public health measure and that town size may affect caries distribution in the Southeast area of São Paulo State.

Age Factors↗

PubMed1984