|| Organ Donation: Attitudes, Intentions, and Barriers of Filipino American Youth in Hawaii
|| Using a Geographical Information System to Assess Physical Environmental Influences on Walking in New Orleans
||Impact of an Enhanced Contact Isolation Policy on Rates of Health Care Associated Infections
||Indoor Air Pollution Due to Hookah Smoking: Particulate Concentrations in a Lexington, Kentucky Hookah Lounge
||Tailored Education in a Novel Multimedia Diabetes Education Program
||Correlates of Fall-Related Mortality in U.S. Elderly
||Preventing the Spread of Seasonal Flu: Measuring the Impact of a Voluntary Program on Influenza Immunization Coverage among Long Term Care Facility Residents and Employees
||Examining barriers associated with differential use of mammography within Latina communities
||Psychosocial Correlates of Cancer Screening Adherence in a Community Sample of Appalachian Adults: An Application of the Health Belief Model
||Socio-demographic Correlates of Obstructive Genitourinary Defects
||Role of CD4 Count in the Development of Immunity after Hepatitis A and B Vaccination in HIV/AIDS Infected Patients
||Using Structural Equation Modeling to Test the Theory of Reasoned Action: Predicting Sexual Behavior
||Correlates with Concurrent HIV/AIDS Diagnoses in the District of Columbia, 1997-2006
||Longitudinal Association of Anthropometry with Mammographic Breast Density
||Effect of breastfeeding duration on lung function is modified by maternal history of asthma and atopy
||Campus Life and Overall Wellness: An Online Survey
||Sexual mixing patterns among social networks of HIV-infected Beijing men who have sex with men: A sociocentric study
||A longitudinal analysis of factors contributing to long-term abstinence from cigarettes among Oklahoma Tobacco Helpline participants
||Appropriate Prophylactic Antibiotics (Prophy-Abx) in Reducing Surgical Site Infections (SSIs) in Pediatric Patients Undergoing Cardiovascular Surgery (CVS) at Children's National Medical Center (CNMC) in Washington, DC
Organ Donation: Attitudes, Intentions, and Barriers of Filipino American Youth in Hawaii
May Rose I. Dela Cruz, University of Hawaii
There is a shortage of organ donors in the U.S. Recent studies have focused on increasing awareness about organ donation (OD) in ethnic minority adolescents. Health education interventions for adolescents have demonstrated improvements in knowledge and attitudes about organ donation; however, ethnic minority adolescents, especially Filipinos, have been underrepresented in such studies. Filipinos account for 48% of hemodialysis patients, and are least likely to be organ donors, due to cultural and religious beliefs regarding going to heaven whole and lack of organ donation awareness. The purpose of this study was to collect information about the awareness, attitudes, barriers, and intentions of Filipino youth to become a designated donor (DD) on their first driver's license/state-issued ID card. Filipino teens in Hawaii were recruited from church youth groups & high school clubs, and completed a survey or participated in a focus group (n=208). Forty-three percent currently had a Hawaii driver's license or ID card, and 18% reported they were a DD on it. Twenty-one percent supported the concept of organ donation, and 46% were willing to talk to their parents about becoming a designated donor on their driver's license. Key barriers to becoming a DD included lack of knowledge about OD (41.4%), uncertainty about OD (93%), and not wanting their body cut up (64.3%). Recommended actions include educating Filipino-American teens about how and why they should become designated organ donors, encouraging high schools to include organ donation education and establish guidelines on how to initiate family discussions about OD and cultural issues.
Using a Geographical Information System to Assess Physical Environmental Influences on Walking in New Orleans
Yaolin Weng, Tulane University
In New Orleans, only 39% of adults meet physical activity recommendations. In spite of being the simplest form of physical activity, walking is very effective. However, only few studies have explored the impact of physical environment on walking behavior. This study aimed to examine the relationship of crime rates and food store density with walking - both exercise-related and utility-related. Data on exercise/utility walking for 3116 participants in the New Orleans BRFSS and residence by census tract was extracted and analysed. Two crime databases provided information on reported violent crime and police complaint locations. A health department permit database provided information about retail food store locations. These data were geocoded to create census tract-level objective measures of crime rates and food store density. Other variables included in the analyses at the census tract level were socioeconomic status and household vehicle ownership. Additional variables at the individual level were demographics, socioeconomic status, attitudes toward exercise and walking, perceived neighborhood safety, and perceived neighborhood barriers to walking. Hierarchical modeling was used to study the relationships between tract-level crime and food store density and both exercise-related walking and utility-related walking, while controlling for individual covariates, such as gender, race, age and income. Several models were fitted for utility-related walking. After controlling for individual covariates, we found that people living in a neighborhood with higher food store density were more likely to engage in utility walking even when the crime rate was high. Motivation for walking seems to be necessity-driven, despite high crime rates.
Impact of an Enhanced Contact Isolation Policy on Rates of Health Care Associated Infections
Nitin Bhanot (not pictured) and Professor Michael Joseph, SUNY Downstate Medical Center
Health care associated infections are a serious public health problem. In 2004 our hospital implemented an enhanced contact isolation policy (Contact P). Using a quasi-experimental design, we compared rates before and after the implementation of Contact P of (1) patient infection or colonization, (2) compliance with hand hygiene policy. We targeted multi-drug resistant Gram negatives (MDRGN), methicillin-resistant Staphylococcus aureus (MRSA), Clostridium difficile (C. diff) , and vancomycin resistant enterococcus (VRE). Contact P mandated use of gowns on entering the room of an infected or a colonized patient. CDC at the time recommended gowns only if ‘substantial' contact was anticipated. Contact P also mandated the use of dedicated medical equipment and cohorting of infected/colonized patients, while CDC recommended these measures ‘when possible.' Rates of infection or colonization were determined from laboratory reports. Relative risks and associated 95% CI's were calculated to assess change in infection rates before and after Contact P implementation. Compliance with hand hygiene policy was determined by anonymous monthly observations. Rates of infection/ colonization dropped 18% for MDRGN (RR=0.82; 95% CI = 0.75, 0.90), 38% for MRSA (RR = 0.62; 95% CI = 0.52, 0.75), and 36% for C. diff (RR = 0.64; 95% CI = 0.53, 0.78). The rate of VRE infection/colonization did not change significantly (RR = 0.93; 95% CI = 0.77, 1.10). Hand hygiene compliance rates increased from 68% to 79% (p<0.05). Enhanced contact precautions for MDRGN, MRSA, andC. difficile in a hospital are associated with reduced transmission to patients.
Indoor Air Pollution Due to Hookah Smoking: Particulate Concentrations in a Lexington, Kentucky Hookah Lounge
Chloe Buchholtz, University of Kentucky
A trend of hookah tobacco smoking poses a potential health concern that has yet to be fully investigated. The increasing popularity of hookah smoking in U.S. populations, despite the historic trends seen internationally, raises questions about the environmental quality impact of hookah smoking. The aim of this study was to quantify the association between smoking density and fine particle concentration in a college campus-located hookah tobacco smoking lounge. Indoor air quality samples were collected between September 2007 and January 2008 in a Lexington, Kentucky hookah smoking lounge. The measured concentration levels of PM 2.5 were 1.1 and 2.7 times higher than the National Ambient Air Quality Standard (NAAQS) for 24 hours (35 µg/m 3 ). The detected levels of PM 2.5 were also higher than the concentrations detected inside Lexington venues following the implementation of a Lexington-wide smoke-free ordinance in 2002. We conclude that indoor air quality is negatively impacted by hookah smoking, and second-hand smoke from hookahs can cause high fine particulate concentrations exceeding the NAAQS. When considering the positive health impact of the Lexington smoke-free ordinance, there should be no exemption provided to hookah lounges. Concerns over the potential ill-health effects of hookahs should not be minimized due to a lack of a clear understanding of this emerging health threat.
Tailored Education in a Novel Multimedia Diabetes Education Program
Tiffany Leung, Northwestern University
The study objective was t o evaluate the effectiveness of Teach To Goal (TTG) as an adjunct to a novel multimedia diabetes educational program (MDEP), an educational intervention targeted to populations with low literacy. Subjects included patients with and without diabetes from 35 to 75 years of age visiting general medicine clinics at an academic institution or a federally qualified health center. A pretest-posttest model for the MDEP-TTG intervention included a 17-item knowledge assessment and the Short Test of Functional Health Literacy in Adults (S-TOFHLA). The posttest was conducted via telephone 2-6 weeks later. A comparison group acquired earlier from the same patient population received the MDEP only. The primary endpoints compared posttest knowledge scores and changes in knowledge. In both the MDEP-TTG (n=19) and comparison groups (n=193), subjects tended to be in the sixth decade of life, female, African American, and have a high school diploma. Demographic characteristics between groups were not significantly different. Follow-up posttests were completed for 68% of MDEP-TTG subjects and 60% of comparison subjects. Two subjects in the MDEP-TTG and 21 in the comparison group had less than adequate literacy. Decrease in knowledge over the follow-up period (p=0.18) and overall increase in knowledge (p=0.39) were not significantly different between study groups. TTG alone may be inadequate to achieve desired knowledge goals. Small sample size of the MDEP-TTG group may limit the study. Further recruitment is in progress. Additional research is needed to investigate the usefulness of TTG in effecting behavior change, improving health outcomes, and overcoming health literacy barriers.
Correlates of Fall-Related Mortality in U.S. Elderly
Darcy McMaughan Moudouni, Texas A&M Health Science Center
Fall mortality is rising among U.S. elderly. Understanding the associated risk factors is essential to addressing this rise. The study objectives included exploring the relationship between age, common fall injuries and in-hospital death. Elder adults who died from fall-related injuries were identified through hospital discharge records in the 2005 Health Cost Utilization Project (HCUP) Nationwide Inpatient Sample (NIS). Health and socioeconomic status indicators significantly associated with death were modeled using logistic regression analysis. After controlling for covariates (such as health status) increased age was associated with an increased odds of death ( 75-84 OR 1.22; 85-94 OR 1.70; 95 and older OR 2.59). Out of fractures only intracranial fracture (OR 4.42) resulted in higher odds of death. Being female (OR 0.59), Hispanic (OR 0.70) and cognitively impaired (OR 0.61) lowered the risk of death compared to being male, white and cognitively intact. Increased age at admission was significantly associated with increased risk of fall death. This relationship remained unchanged after controlling for socio-demographic and health status indicators and questions the concept that age as a risk factor is due to increasing disease burden from increasing years of life. This study found men more likely to die from falls than women. The cognitively impaired were less likely to die from falls than the cognitively intact. These findings highlight the need for refinement of falls prevention programs and consideration of whether risk factors associated with fall deaths are different from the risk factors for falling and fall-related injuries.
Preventing the Spread of Seasonal Flu: Measuring the Impact of a Voluntary Program on Influenza Immunization Coverage among Long Term Care Facility Residents and Employees
Jessica A. Nadeau, University at Albany, SUNY
Over 200,000 individuals are hospitalized for influenza annually, a disproportionate number are over 65 and more likely to reside in long-term care facilities (LTCFs). On April 1, 2000, New York State enacted the Long-Term Care Resident and Employee Immunization Act for LTCFs. This law requires LTCFs to provide optional influenza vaccines to all residents and employees and report coverage to the New York State Department of Health (NYSDOH). Without a mandate for immunization of healthcare workers and residents, there is a need to monitor trends in vaccination coverage rates and to determine whether the current law is sufficient to improve immunization coverage. Annual immunization report data from 2000-2007 was analyzed to identify trends in immunization coverage for employees and residents of NYS LTCFs. Site visits were made to LTCFs to provide educational resources on adult immunizations and methods for immunization coverage and reporting improvement. The mean influenza vaccination coverage for residents reported in NYS LTCFs during 2000-2007 was 84.0% (Range: 82 - 86%). Immunization levels for employees fall far below that of residents at only 36% (Range: 32 - 42%). Despite efforts to improve immunization coverage, there have been no major increases in immunization levels since 2000. Continued low influenza immunization coverage of LTCF employees is evidence that optional immunization programs have not been effective and that residents are continually put at risk. The results of this analysis will contribute objective data to assess the need fo r an influenza vaccine mandate for healthcare workers in LTCFs and other settings.
Examining barriers associated with differential use of mammography within Latina communities
Kassandra Alcaraz, Saint Louis University
Mammography use is lower in low-income populations than other groups, and rarely- and never-screened populations bear a disproportionately high late-stage breast cancer burden. This study sought to identify barriers associated with differential use of mammography. Data were obtained from the Mujer Latina project, which placed computerized breast cancer education kiosks in low-income Latino communities during 2006-2007. The touch-screen kiosks collected information from users to create and print each person a tailored mammography magazine. Data from kiosk users aged 40 and over (n=146) were analyzed. Multinomial logistic regression was used to compare the influence of self-reported barriers across three categories: current (screened within the past year), not current (last screened more than a year ago), and never screened. The current group served as the referent group, and odds ratios were adjusted for age and insurance status. Overall, 46% of individuals were current, 24% were not current, and 30% had never been screened. The only barrier associated with not being current was not receiving a provider recommendation for mammography in the past year (aOR=3.4, 95% CI: 1.1-10.4). Three barriers were associated with having never been screened: not knowing where to go to get a mammogram (aOR=13.1, 95% CI: 2.1-29.7), not having a close friend or relative who has had a mammogram (aOR=4.2, 95% CI: 1.6-10.9), and unwillingness to get a mammogram from non-Spanish speaking providers (aOR=2.9, 95% CI: 1.1-8.6). Findings can aid in developing targeted education and outreach strategies to increase mammography use among Latinas.
Psychosocial Correlates of Cancer Screening Adherence in a Community Sample of Appalachian Adults: An Application of the Health Belief Model
Travis I. Lovejoy, Consortium of Eastern Ohio
In the U.S., cancer disproportionately affects residents of Appalachia. These disparities may be due to high rates of advanced-stage cancer at initial diagnosis due to non-engagement in preventive activities such as recommended cancer screening. The Health Belief Model (HBM) guided this research. Random-digits-dialing procedures were used to survey a community sample of Appalachian Ohio adults. Respondents provided information on current screening behaviors for breast, cervical, colorectal, and prostate cancers, as well as socio - demographic data. In addition, nine questions were asked about respondents' beliefs about cancer and cancer screening. Factor analyses indicated that questions loaded on three HBM constructs: perceived susceptibility to cancer, perceived benefits of cancer screening, and perceived barriers to cancer screening. Only one-third (36%) of respondents had been screened for cancer as recommended. After controlling for age, gender, and education, greater perceived benefits of ( OR =1.35, p <.05), and fewer perceived barriers to ( OR =.74, p<.10), cancer screening were associated with an increased likelihood of having been adherent to all screening recommendations. A significant interaction between gender and perceived susceptibility to cancer was also observed ( p <.05). Among non-susceptible respondents, women were 5.35 times more likely than men to be adherent to screening recommendations; the opposite was true among susceptible respondents, with men being 2.33 times more likely than women to meet all screening recommendations. Interventions to increase rates of screening in this population should focus not only on mitigating financial and structural barriers (e.g., lack of health insurance), but should also address the psychosocial needs of Appalachians.
Socio-demographic Correlates of Obstructive Genitourinary Defects
Nasir Mushtaq, University of Oklahoma
Obstructive genitourinary defects are congenital anomalies that occur when there is a narrowing or absence of a normal opening in the urinary tract. . According to CDC data, unlike various other birth defects, COGUD prevalence had an upward trend from 1996 to 2003. In severe cases, COGUD may lead to poor lung maturity due to reduced amniotic fluid, renal failure or even fetal death. Little is known about maternal, paternal or pregnancy characteristics that may be associated with COGUD. The aim of this study is to identify socio-demographic factors that may be associated with an increased prevalence of COGUD. Birth and fetal death records were linked with birth defects registry data for 260,889 deliveries occurring in a 13 county area of Texas between 2000-2002. Logistic regression methods were used to estimate odds ratios and 95% Confidence Intervals for socio-demographic factors including maternal and paternal age, education, race-ethnicity, parity, area of residence, and prenatal care. The prevalence of COGUD in this population was 18 per 10,000 deliveries. Maternal age = 40 was associated with an increased odds of COGUD as compared to mother 25-29 years old (adjusted OR 1.93; 95% CI 1.09, 3.45). Similarly, nulliparity and Hispanic paternal ethnicity were observed to have associations of similar magnitude. Advanced maternal age, pregnancy order and Hispanic paternal ethnicity are associated with COGUD Socio-demographic correlates of COGUD is a fertile area for further epidemiological research.
Role of CD4 Count in the Development of Immunity after Hepatitis A and B Vaccination in HIV/AIDS Infected Patients
Kia E. Armstrong (not pictured) and Professor Glyn Caldwell, University of Kentucky
The aim of the study was t o determine if lower pre-vaccination CD4 counts affect the odds of immune development against Hepatitis A (HAV) or B (HBV) post-completion of vaccination. In addition to the main objective, the secondary objective was to determine if immune development is associated with gender, a racially classified social group, health insurance status, tobacco use, substance use or co-morbidities. This case-control study was performed on HIV/AIDS patients attending the Bluegrass Care Clinic, a part of the University of Kentucky Medical Center in Lexington, KY between 2002 and 2007. All patients that received a HAV or HBV vaccine and had pre- and post-vaccination Hepatitis B Surface antibody or Hepatitis A antibody titers were included in the analysis. Of the 451 patients that were vaccinated at the clinic 76 met the inclusion criteria. The development of immunity to HAV and/or HBV in the patients did increase as CD4 count increased. In this sample males had greater odds for the development of immunity than females. Whites were observed to have higher rates of immunity than other races. When looking at insurance in this sample, more patients with private insurance were observed to develop immunity to HAV and/or HBV that those on Medicaid, Medicare, or those that had no insurance. More patients without AIDS (CD4< 200/mm 3 ) were able to develop immunity than patients with AIDS. In addition, patients without AIDS, hypertension, and hyperlipidemia were observed to develop immunity more often than patients with these co-morbidities. Substance abuse and tobacco use were also found to be indicators of immunity development. Based on this sample, an increased CD4 count was associated with increases in immunity development. Patients with CD4 counts greater than 400/mm 3 were typically more likely to develop immunity to Hepatitis A and/or B, when compared to those with CD4 counts below 400/mm 3 . Racially classified social groups, insurance status, and co-morbidities did impact immunity development. However; due to the small sample that was available for this study more research needs to be completed on larger samples to truly understand the extent to which these variables impact immune development in HIV/AIDS infected patient .
Using Structural Equation Modeling to Test the Theory of Reasoned Action: Predicting Sexual Behavior
Teri Malo, University of South Florida
This study examined proximal, intrapersonal factors associated with delaying first sexual intercourse in a national sample of adolescents. Specifically, this research investigated the utility of the Theory of Reasoned Action (TRA) as a plausible model for predicting whether an adolescent engages in sexual intercourse. This analysis used data from Waves I and II of the National Longitudinal Study of Adolescent Health to test the applicability of the TRA (n = 3,395). Structural equation modeling (SEM) tested the TRA constructs simultaneously and accounted for measurement error. With the exception of the path from intention to behavior at Wave II, the standardized regression weight and all probit regression coefficients were statistically significant (p<.05): path between attitude and subjective norm = -.301, from attitude to intention = .328, subjective norm to intention = -.415, intention to behavior at Wave I = -.557, and behavior at Wave I to behavior at Wave II = .854. The modification indices suggested the addition of a path from subjective norm to behavior at Wave I (.186). The TRA may be useful for predicting whether an adolescent engages in sexual intercourse. All measured variables for subjective norm concerned one's perception of parental approval or disapproval of engaging in sexual intercourse. Researchers should continue to explore the importance of perceived norms, particularly parental perceptions. Educators and other practitioners should continuously reevaluate theoretical models on which programs and interventions are based, and SEM is a useful statistical technique for examining the practical utility of theory.
Correlates with Concurrent HIV/AIDS Diagnoses in the District of Columbia, 1997-2006
Jennifer Beal, George Washington University
This study explored correlates of concurrent HIV/AIDS diagnoses (one month or less between diagnoses) in the District of Columbia. Cases from the HIV/AIDS Reporting System (HARS) database that were reported to the District HIV/AIDS Administration from 1997-2006 were analyzed using logistic regression to determine correlates of concurrent diagnoses. A total of 7,778 AIDS cases were reported from 1997-2006, of which 4,137 (53.2%) were concurrently diagnosed. Among men, blacks and Hispanics were significantly more likely than whites to be diagnosed concurrently (OR 1.44, 95% CI: 1.21-1.73; OR 1.47, 95% CI: 1.08-2.00; respectively). Among women, blacks were significantly less likely to be diagnosed concurrently than whites (OR=0.41, 95% CI 0.22-0.76). Those with no identified risk (59.1%) or infected through heterosexual contact (56.8%) were significantly more likely to have concurrent diagnoses compared to men who have sex with men (MSM) (OR 1.46, 95% CI: 1.24-1.73; OR 1.36, 95% CI: 1.18-1.57, respectively). Individuals lacking insurance were significantly more likely to have a concurrent diagnosis compared to individuals with public insurance (OR 1.94, 95% CI: 1.65-2.28). Patients with an opportunistic infection as the AIDS defining measure were more likely to have a concurrent diagnosis than patients with a low CD4 count (OR 1.48, 95% CI: 1.30, 1.69). More than half of all AIDS cases in the District from 1997 to 2006 were diagnosed concurrently. Concurrent diagnoses represent missed opportunities for HIV prevention and treatment. Implementation of routine HIV screening in the District may reduce testing stigma and ensure earlier HIV diagnoses.
Longitudinal Association of Anthropometry with Mammographic Breast Density
Katherine W. Reeves, University of Pittsburgh
In cross-sectional studies body mass index (BMI) is negatively associated with percent breast density, a strong risk factor for breast cancer. We sought to evaluate longitudinal associations between BMI and mammographic breast density. We studied a prospective cohort of 834 women enrolled in an ancillary study to the Study of Women's Health Across the Nation (SWAN). Height and weight were measured at annual clinic visits. Routine screening mammograms were collected and read for breast density using manual planimetry. Longitudinal associations between BMI and changes in dense breast area and percent density were evaluated with random effects regression models. Mean follow-up was 4.8 years (SD 1.8), and the mean number of observations per participant was 5.6 (range 1-8). Mean annual weight change was +0.22 kg/year. In fully adjusted models, BMI and weight were not associated with changes in dense breast area (ß=-0.0105, p=0.34 and ß=-0.0055, p=0.20, respectively), but were strongly negatively associated with changes in percent density (ß=-1.18, p<0.001 and ß=-0.44, p<0.001, respectively). This longitudinal study demonstrates that BMI and weight are not associated with the dense area, yet are negatively associated with percent density. Effects of anthropometry on percent breast density may reflect effects on non-dense tissue, rather than on the dense tissue where cancers arise. These results improve our understanding of how increased BMI acts to promote breast cancer, and may lead to opportunities for disease prevention and early detection in the future.
Effect of breastfeeding duration on lung function is modified by maternal history of asthma and atopy
Ikechukwu Ogbuanu, University of South Carolina
Despite its known beneficial effects, there have been conflicting reports on whether breastfeeding confers protection from asthma in late childhood. In the Isle of Wight birth cohort (n=1456), breastfeeding practices and duration were prospectively assessed at birth and at the 1 and 2 year visits. Breastfeeding duration was categorized as “not breastfed” (n=196); “<2 months” (243); “2 and <4 months” (142) and “>=4 months” (374). Lung function was assessed at age 10 (n=1033): forced vital capacity (FVC); forced expiratory volume in 1 second (FEV 1 ); FEV 1 /FVC ratio; and peak expiratory flow (PEF). Maternal history of asthma and allergy were assessed at birth. Birthweight, sex, and current height and weight were adjusted for. FVC was increased by 53.0 +/- 20.1ml (p=0.008); FEV 1 by 37.5 +/- 19.0ml (p=0.049); and PEF by 160.3 +/- 62.9ml (p=0.01) in those who were breastfed for at least 4 months compared to those who were not. Stratification showed that this effect was modified by maternal history of asthma and atopy. Compared to those who were not breastfed, children of non-atopic non-asthmatic mothers who were breastfed for at least 4 months showed a significantly increased FVC (60.0 +/- 23.3ml; p=0.01) and PEF (164.6 +/- 75.9ml; p=0.03). This positive effect on lung function was not found in children with atopic non-asthmatic and atopic asthmatic mothers.Breastfeeding for at least 4 months enhances lung growth in children. Maternal history of asthma and atopy abolishes this effect. Future studies need to elucidate the mechanisms that drive these findings.
Campus Life and Overall Wellness: An Online Survey
DeAnnah Byrd, University of California, Los Angeles
The objective of the study was t o improve mental health and social functioning of students, the 2006 UCLA Ashe Center Student Survey examined the influence of overall mental health and associated behaviors on campus life An online cross-sectional survey of 2,203 students currently enrolled at UCLA. Mental health was ascertained using six mental health scales adopted from RAND. Focus areas included: overall mental health, anxiety, depression, positive affect, psychological distress and well-being. Campus life refers to a set of 25-items related to different dimensions of students' wellness, including social, physical, emotional, spiritual, and intellectual. Most (70%) respondents were female and undergraduates (72%). Most students were Caucasian (38%) and Chinese or Chinese American (20%). 27% of students were foreign born and 34% reported that English was not their first language. Over 20% of students reported feeling tense, “high strung,” anxious or worried a good bit of the time. 27% of students reported feeling depressed at times. Using multivariate regression analysis, preliminary findings indicate that overall mental health and number of days students could not perform their normal activities due to physical illness or injuries positively predicts their wellness; however, the average hours of sleep per night during the week does not. Our sample resembles the increasingly diverse demographic of today's college students: 30% minorities, 20% foreign born or first generation, and 55% female (Choy, 2002). Thus, these factors should be considered in the students' mental health needs. Findings indicate that students are experiencing mental health problems, which in turn is affecting their wellness in various ways.
Sexual mixing patterns among social networks of HIV-infected Beijing men who have sex with men: A sociocentric study
Stephen W. Pan, University of Alabama at Birmingham
The objective of the study was to describe sexual mixing patterns among Beijing men who have sex with men (MSM) and sexual behavior differences between social networks (SN) of HIV-positive and HIV-negative MSM. Twenty-two MSM SN were recruited through two-stage cross-sectional convenience sampling. Twenty-two first-stage recruits, 11 HIV-negative MSM matched with 11 HIV-positive MSM based on age, race, education, and residency, were sampled from a longitudinal study. One hundred eleven second-stage recruits, MSM social contacts of first-stage recruits, were sampled at first-stage recruits' discretion. SN were defined as a first-stage recruit and their social contacts. Each SN convened and completed surveys concerning personal sexual behavior and their relationships with other SN members. Individual and network differences were assessed with Chi-square tests and bootstrap t-tests, respectively. Associations between dyad characteristics and sexual partnerships were assessed with logistic regressions. Likelihood of sexual partnerships among MSM social dyads was independent of age disparity (odds ratio, 95% confidence interval: 1.47, 0.70 to 3.09) and residency status (1.56, 0.80 to 3.04). Likelihood of sexual partnerships was higher among MSM social dyads where both lacked college education (3.90, 1.76 to 8.62) and where both engaged in group sex (4.13, 1.74 to 9.81). Compared to SN members of HIV-positive MSM, SN members of HIV-negative MSM were likelier to disclose ‘homosexual' identity (p=0.01) and had wider age ranges (p=0.05). Overall, HIV-positive and HIV-negative MSM SN differed little. Sexual mixing patterns are potentially fueling HIV transmission and complicating prevention efforts. SN-based strategies should be developed to supplement China's existing MSM programs.
A longitudinal analysis of factors contributing to long-term abstinence from cigarettes among Oklahoma Tobacco Helpline participants
Mary B. Williams, University of Oklahoma
Reductions in tobacco use prevalence could have a major impact on the public's health and potentially on healthcare costs. Telephone counseling for tobacco cessation has emerged as an effective smoking cessation intervention. Identifying factors associated with abstinence can help program planners modify programs to be more effective. The goal of this study was to identify factors associated longitudinally with 30-day abstinence at the 4- and 7-month follow-up among smokers who participated in the multiple call intervention of the Oklahoma Tobacco Helpline (OTH). General Estimating Equation (GEE) longitudinal techniques were used to evaluate 30-day abstinence at 4-months and 7-months post-registration among OTH multiple call program participants who registered between March 2005 and May 2006. These techniques were used to identify factors associated with the outcome and to develop a model to estimate 30-day abstinence. The GEE techniques identified OTH provision of NRT, Hispanic ethnicity, time to first cigarette of the day, the number of completed intervention calls, and non-smoking home policy as factors that were associated with 30-day abstinence at 4-months and 7-months post-registration. Ten other factors were assessed and found not to be associated longitudinally with 30-day abstinence. The provision of NRT and the number of completed calls may be important program planning factors for quitlines that were associated with 30-day abstinence. And non-smoking home policies may need to be emphasized more by quitline coaches to improve quit rates among participants.
Appropriate Prophylactic Antibiotics (Prophy-Abx) in Reducing Surgical Site Infections (SSIs) in Pediatric Patients Undergoing Cardiovascular Surgery at Children's National Medical Center in Washington, DC
Cary Chen, George Washington University
Appropriate Prophy-Abx has demonstrated favorable results in reducing SSIs among adult patients, but its impact on pediatric patients remains unclear. To evaluate the association between Prophy-Abx and SSIs, a 1:4 matched case-control study was conducted in children with congenital anomalies undergoing CVS repair at CNMC between 1/1/2005 and 9/31/2006. Each case with SSI occurring during the surgical admission period was individually matched to 4 controls with no diagnosed SSI at time of discharge. Controls were randomly selected among candidate patients based on the surgery date as close to that of case as possible and type of surgery as defined by the NHSN. SSI was identified based on physician diagnosis, clinical symptoms, and/or wound culture(s). Appropriate Prophy-Abx was defined as administering 1st dose of cefazolin within 1 hour or 1st dose of vancomycin within 2 hours prior to the initial surgical incision. During the study period, 21 SSIs were identified and were matched to 84 controls. Of 17 cases with a positive wound culture, 8 (47%) recovered S. aureus (including 1 MRSA). Compared to controls, cases were younger at surgery (average age: 16.9 vs. 30.4 months), disproportionately male (76% vs. 43%), and less likely to undergo CVS surgery within 1 day following admission (48% vs. 69%). Of 27 newborns (¡Ü28 days) at time of surgery, 41% had delayed primary sternal closure of the surgical wound. 86% and 7% of patients received cefazolin and vancomycin, respectively, as the 1st dose of Prophy-Abx, but only 78% were administered within the appropriate pre-operative period. Unadjusted analysis revealed that appropriate Prophy-Abx was not associated with reduced risk of SSI (OR=0.66, p>0.05). Delayed sternal closure independently increased patient risk for SSI by 15 times (OR=15.33, p=0.013). Findings from this study suggest that enforcing appropriate prophylactic antibiotics alone in children undergoing CVS is not sufficient to reduce SSI. Further studies are warranted to determine if a bundle approach including both Prophy-Abx and post-operative wound management reduces the risk of SSI in this population.