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Issue 113 - 9 October 2009


1. Screening for Colorectal Cancer: The Glass Is Half Full.
by Neugut, Alfred I & Lebwohl, Benjamin. American Journal of Public Health, Apr 2009, Vol 99 Issue 4: p582-584
The authors express their opinion regarding reports indicating that almost half of adults over 50 years old in the U.S. have been screened for colorectal cancer. They note the public health benefits of the increase in screening, explaining that death rates due to colorectal cancer have declined. They discuss the need for more screening options and suggest offering patients a hierarchy of screening options.

2. Medicaid coverage of circumcision spreads harm to the poor
by Lawrence W.; McAllister et al. American Journal of Public Health, Apr 2009, Vol 99 Issue 4: p584-585
A letter to the editor is presented in response to the article "Determinants and Policy Implications of Male Circumcision in the United States, by A.A. Leibowitz, K. Desmond, and T. Belin.

3. Bold Steps for the Health of Americans: Yes We Can.
by Bassett, Mary T. American Journal of Public Health, Apr 2009, Vol 99 Issue 4: p587-587
The author expresses her opinion that more investment in public health agencies is needed to improve public health in the U.S. She explains the importance of taking an environmental approach to health. She offers suggestions to improve public health, including attention to school fitness programs to combat obesity and public works approaches such as construction of protected bicycle paths and walkways.

4. Reforming Health Care or Reforming Health?
by Farley, Thomas A. American Journal of Public Health, Apr 2009, Vol 99 Issue 4: p588-590
The author expresses his opinion that the U.S. system of health will need to be reformed to make major improvements in health. He comments on upcoming health care reform during the administration of U.S. President Barack Obama. He discusses the limits of medical care, noting the need to focus on behaviors and environments that make people sick. He believes public health professionals need to become activists.

5. Why Education and Choice Won't Solve the Obesity Problem
by Walls, Helen L et al. American Journal of Public Health, Apr 2009, Vol 99 Issue 4: p590-592
The authors express their opinion that governments must consider the environment that led to the obesity epidemic when proposing obesity prevention measures. They believe that proposals that focus on the willpower, knowledge, or decision-making ability of individuals will not be successful. They note that changing behavior is a challenge and that increasing levels of knowledge and awareness does not always result in change of behavior.

6. ElderSmile: A Comprehensive Approach to Improving Oral Health for Seniors.
by Marshall, Stephen et al. American Journal of Public Health, Apr 2009, Vol 99 Issue 4: p595-599
Societal changes, including the aging of the US population and the lack of routine dental service coverage under Medicare, have left many seniors unable to afford any dental care whatsoever let alone the most advanced treatments.[1] In 2004, the Columbia University College of Dental Medicine and its partners instituted the ElderSmile program in the largely impoverished communities of Harlem and Washington Heights/Inwood in New York City. The long-term goal of this program is to improve access to and delivery of oral health care for seniors; the short-term goal is to establish and operate a network of prevention centers surrounding a limited number of treatment centers. Preliminary results indicate substantial unmet dental needs in this largely Hispanic and Black elderly population [ABSTRACT FROM AUTHOR]

7. Core Competencies for Injury and Violence Prevention
by Songer, Thomas et al. American Journal of Public Health, Apr 2009, Vol 99 Issue 4: p600-606
Efforts to reduce the burden of injury and violence require a workforce that is knowledgeable and skilled in prevention. However, there has been no systematic process to ensure that professionals possess the necessary competencies. To address this deficiency, we developed a set of core competencies for public health practitioners in injury and violence prevention programs. The core competencies address domains including public health significance, data, the design and implementation of prevention activities, evaluation, program management, communication, stimulating change, and continuing education. Specific learning objectives establish goals for training in each domain. The competencies assist in efforts to reduce the burden of injury and violence and can provide benchmarks against which to assess progress in professional capacity for injury and violence prevention. [ABSTRACT FROM AUTHOR]

8. Public Health Legal Preparedness in Indian Country
by Bryan, Ralph T et al. American Journal of Public Health, Apr 2009, Vol 99 Issue 4: p607-614
American Indian/Alaska Native tribal governments are sovereign entities with inherent authority to create laws and enact health regulations. Laws are an essential tool for ensuring effective public health responses to emerging threats. To analyze how tribal laws support public health practice in tribal communities, we reviewed tribal legal documentation available through online databases and talked with subject-matter experts in tribal public health law. Of the 70 tribal codes we found, 14 (20%) had no clearly identifiable public health provisions. The public health-related statutes within the remaining codes were rarely well integrated or comprehensive. Our findings provide an evidence base to help tribal leaders strengthen public health legal foundations in tribal communities. [ABSTRACT FROM AUTHOR]

9. The Culture of Food
by Kropf, Aleisha. American Journal of Public Health, Apr 2009, Vol 99 Issue 4: p615-615
The article examines food preparation. The author explains that westernized food preparation, such as that associated with processed food and solitary eating, is detrimental to public health and well-being. She comments on the need to return to traditional cultures that focus on creating meals together. Photographs of families engaging in food preparation are presented.

10. The Moral Justification for a Compulsory Human Papillomavirus Vaccination Program
by Balog, Joseph E. American Journal of Public Health, Apr 2009, Vol 99 Issue 4: p616-622
Compulsory human papillomavirus (HPV) vaccination of young girls has been proposed as a public health intervention to reduce the threat of the disease. Such a program would entail a symbiotic relationship between scientific interests in reducing mortality and morbidity and philosophical interests in promoting morality. This proposal raises the issue of whether government should use its police powers to restrict liberty and parental autonomy for the purpose of preventing harm to young people. I reviewed the scientific literature that questions the value of a HPV vaccination. Applying a principle-based approach to moral reasoning, I concluded that compulsory HPV vaccinations can be justified on moral, scientific, and public health grounds.[ABSTRACT FROM AUTHOR]

11. Legal Barriers to Second-Trimester Abortion Provision and Public Health Consequences
by Jones, Bonnie Scott & Weitz, Tracy A. American Journal of Public Health, Apr 2009, Vol 99 Issue 4: p623-630
Many women need access to abortion care in the second trimester. Most of this care is provided by a small number of specialty clinics, which are increasingly targeted by regulations including bans on so-called partial birth abortion and requirements that the clinic qualify as an ambulatory surgical center. These regulations cause physicians to change their clinical practices or reduce the maximum gestational age at which they perform abortions to avoid legal risks. Ambulatory surgical center requirements significantly increase abortion costs and reduce the availability of abortion services despite the lack of any evidence that using those facilities positively affects health outcomes. Both types of laws threaten to further reduce access to and quality of second-trimester abortion care.[ABSTRACT FROM AUTHOR]

12. Preventing Mother-to-Child Transmission of HIV in Resource-Limited Settings: The Elizabeth Glaser Pediatric AIDS Foundation Experience
by Spensley, Allison et al. American Journal of Public Health, Apr 2009, Vol 99 Issue 4: p631-637
In September 1999, the Elizabeth Glaser Pediatric AIDS Foundation initiated a multicountry, service-based programmatic effort in the developing world to reduce perinatally acquired HIV infection. We review 6½ years of one of the world's largest programs for the prevention of mother-to-child transmission (PMTCT) of HIV.
Methods. Each PMTCT facility records patient data in antenatal clinics and labor and delivery settings about counseling, testing HIV status, and antiretroviral prophylaxis and submits the data to foundation staff. Results. More than 2.6 million women have accessed foundation-affiliated services through June 2006. Overall, 92.9% of women who received antenatal care or were eligible for PMTCT services in labor and delivery have been counseled and 82.8% of those counseled accepted testing. Among women identified as HIV positive, 75.0% received antiretroviral prophylaxis (most a single dose of nevirapine), as did 45.6% of their infants.
Conclusions. The foundation's experience has demonstrated that opt-out testing, supplying mothers with medication at time of diagnosis, and providing the infant dose early have measurably improved program efficiency. PMTCT should be viewed as an achievable paradigm and an essential part of the continuum of care. [ABSTRACT FROM AUTHOR]

13. Trends in Perinatal and Infant Health Disparities Between Rural American Indians and Alaska Natives and Rural Whites
by Baldwin, Laura-Mae et al. American Journal of Public Health, Apr 2009, Vol 99 Issue 4: p638-646
We examined disparities in perinatal care, birth outcomes, and infant health between rural American Indian and Alaska Native (AIAN) persons and rural Whites over time.
Methods. We compared perinatal and infant health measures for 217064 rural AIAN births and 5032533 rural non-Hispanic White births.
Results. Among American Indians and Alaska Natives, unadjusted rates of inadequate prenatal care (1985-1987, 36.3%; 1995-1997, 26.3%) and postneonatal death (1985-1987, 7.1 per 1000; 1995-1997, 4.8 per 1000) improved significantly. However, disparities between American Indians and Alaska Natives and Whites in adjusted odds ratios (AORs) of postneonatal death (1985-1987, AOR = 1.55; 95% confidence interval [Cl] = 1.41, 1.71; 1995-1997, AOR = 1.46; 95% CI = 1.31, 1.64) and adjusted risk ratios (ARRs) of inadequate prenatal care (1985-1987, ARR = 1.67; 95% CI = 1.65, 1.69; 1995-1997, ARR = 1.84; 95% CI = 1.81, 1.87) persisted.
Conclusions. Despite significant decreases in inadequate prenatal care and postneonatal death among American Indians and Alaska Natives, additional measures are needed to close persistent health gaps for this group. [ABSTRACT FROM AUTHOR]

14. The Role of Emotional Abuse in Intimate Partner Violence and Health Among Women in Yokohama, Japan
by Yoshihama, Mieko et al. American Journal of Public Health, Apr 2009, Vol 99 Issue 4: p647-653

Objectives. As part of the World Health Organization's cross-national research effort, we investigated the relationship between various health indicators and the experience of intimate partner violence (IPV), which included emotional, physical, and sexual abuse, among women in Yokohama, Japan. Methods. We used multivariate logistic and negative binomial regression to examine the relationship between health status and IPV in a stratified cluster sample of 1371 women aged 18 to 49 years.
Results. In 9 of 11 health indicators examined, the odds of experiencing health-related problems were significantly higher (P<.05) among those that reported emotional abuse plus physical or sexual violence than among those that reported no IPV, after we controlled for sociodemographic factors, childhood sexual abuse, and adulthood sexual violence perpetrated by someone other than an intimate partner. For most health indicators, there were no significant differences between those that reported emotional abuse only and those that reported emotional abuse plus physical or sexual violence.
Conclusions. The similarity of outcomes among those that reported emotional abuse only and those that reported emotional abuse plus physical or sexual violence suggests the need for increased training of health care providers about the effects of emotional abuse.[ABSTRACT FROM AUTHOR]

15. Psychosocial Care for Women Survivors of the Tsunami Disaster in India
by Becker, Susan M. American Journal of Public Health, Apr 2009, Vol 99 Issue 4: p654-658
I investigated the effectiveness of Psychosocial Care, a community-based mental health initiative for survivors of the 2004 tsunami disaster in India.
Methods. Mental health teams from the National Institute of Mental Health and Neurosciences (NIMHANS) in India implemented a train-the-trainer model of psychosocial care in one of the worst tsunami-affected areas of south India. Three months of psychosocial care was provided for an intervention group of women, but not for a control group recruited from an exposed neighboring village. Impact of Event Scale (IES) scores — both total scores and scores for subscales on hypervigilance, avoidance, and intrusion — were compiled for both the intervention and control groups and used as outcome measures.
Results. For the intervention group, posttest total IES and subscale scores were significantly lower than pretest scores (P < .001), indicating improvement in symptoms. Posttest total IES and subscale scores were significantly lower for the intervention group than for the control group (P<.001).
Conclusions. Psychosocial care is an effective mental health strategy for women survivors of disasters and should be an integral component of disaster response in resource-poor countries. [ABSTRACT FROM AUTHOR]

16. Structural and Environmental Barriers to Condom Use Negotiation With Clients Among Female Sex Workers: Implications for HIV-Prevention Strategies and Policy by Shannon, Kate et al. American Journal of Public Health, Apr 2009, Vol 99 Issue 4: p659-665.

17. The Health and Health Care of US Prisoners: Results of a Nationwide Survey
by Wilper, Andrew P et al. American Journal of Public Health, Apr 2009, Vol 99 Issue 4: p666-672
We analyzed the prevalence of chronic illnesses, including mental illness, and access to health care among US inmates. Methods. We used the 2002 Survey of Inmates in Local Jails and the 2004 Survey of Inmates in State and Federal Correctional Facilities to analyze disease prevalence and clinical measures of access to health care for inmates.
Results. Among inmates in federal prisons, state prisons, and local jails, 38.5% (SE = 2.2%), 42.8% (SE = 1.1%) and 38.7% (SE = 0.7%), respectively, suffered a chronic medical condition. Among inmates with a mental condition ever treated with a psychiatric medication, only 25.5% (SE=7.5%) of federal, 29.6% (SE = 2.8%) of state, and 38.5% (SE = 1.5%) of local jail inmates were taking a psychiatric medication at the time of arrest, whereas 69.1% (SE = 4.8%), 68.6% (SE = 1.9%), and 45.5% (SE = 1.6%) were on a psychiatric medication after admission.
Conclusions. Many inmates with a serious chronic physical illness fail to receive care while incarcerated. Among inmates with mental illness, most were off their treatments at the time of arrest. Improvements are needed both in correctional health care and in community mental health services that might prevent crime and incarceration.

18. Mexican Americans and Frailty: Findings From the Hispanic Established Populations Epidemiologic Studies of the Elderly
by Ottenbacher, Kenneth J et al. American Journal of Public Health, Apr 2009, Vol 99 Issue 4: p673-679
We examined the prevalence of frailty among Mexican American older adults and explored the correlates associated with becoming frail to determine their affect on disability and morbidity in this population.
Methods. We studied the trajectory of frailty over 10 years in 2049 Mexican Americans participating in the Hispanic Established Populations Epidemiologic Studies of the Elderly. We constructed a frailty index based on weight loss, exhaustion, grip strength, walking speed, and physical activity and collected data on sociodemographic and health status, comorbidities, and functional measures of performance.
Results. The sample was 58% female, with a mean age of 74.43 years (SD = 6.04) at baseline. Fifty-five percent of participants at baseline and 75% of the surviving sample at follow-up (n = 777) were classified as prefrail or frail. Of persons identified as frail at baseline, 84% died by the end of follow-up. Baseline age, diabetes, arthritis, smoking status, body mass index, cognition, negative affect, and number of comorbid conditions were predictors of frailty at follow-up (R² = 0.29; P<.05).
Conclusions. Further research into ways to reduce the number of Mexican American older adults who become frail and disabled and therefore lose their independence is needed. Future studies should continue to examine the trajectory of frailty as a dynamic process that
includes psychosocial and cognitive components. [ABSTRACT FROM AUTHOR]

19. Monitoring Inequities in Self-Rated Health Over the Life Course in Population Surveillance Systems
by Chittleborough, Catherine R et al. American Journal of Public Health, Apr 2009, Vol 99 Issue 4: p680-689
To investigate the effect of social mobility and to assess the use of socioeconomic indicators in monitoring health inequities over time, we examined the association of self-rated health with socioeconomic position over the life course. Methods. Data came from a cross-sectional telephone survey (n = 2999) that included life-course socioeconomic indicators and from a chronic disease and risk factor surveillance system (n = 26400). Social mobility variables, each with 4 possible intergenerational trajectories, were constructed from family financial situation and housing tenure during childhood and
Results. Low socioeconomic position during both childhood and adulthood and improved financial situation in adulthood were associated with a reduced prevalence of excellent or very good health. Trends over time indicated that socioeconomic disadvantage in adulthood was associated with poorer self-rated health.
Conclusions. Our results support policies aiming to improve family financial situation during childhood and housing tenure across the life
course. Inclusion of life-course socioeconomic measures in surveillance systems would enable monitoring of health inequities trends among socially mobile groups. [ABSTRACT FROM AUTHOR]

20. Contribution of Race/Ethnicity and Country of Origin to Variations in Lifetime Reported Asthma: Evidence for a Nativity Advantage
by Subramanian, S. V et al. American Journal of Public Health, Apr 2009, Vol 99 Issue 4: p690-697
We assessed the relative contribution of Hispanic ethnicity, country of origin, and nativity to lifetime prevalence of asthma among mothers and children enrolled in the Project on Human Development in Chicago Neighborhoods.
Methods. We used multilevel models to analyze data from wave 3 of the Project on Human Development in Chicago Neighborhoods study (2000 to 2001 ). Mothers reported physician-diagnosed asthma for themselves and their children. Maternal race, ethnicity, country of origin, and nativity were the predictors of interest.
Results. We found substantial heterogeneity in lifetime asthma within Hispanic subgroups for mothers and children. Hispanics of non-Mexican origin had greater odds of having asthma than did non-Hispanic Whites; respondents of Mexican origin did not differ from non-Hispanic Whites. Odds of experiencing asthma were more strongly related to nativity than to race, Hispanic ethnicity, or country of origin. Only immigrant Mexicans reported asthma prevalence lower than that of native non-Hispanic Whites.
Conclusions. Nativity is a strong predictor of lifetime asthma prevalence, suggesting the importance of potential interactions between genetic susceptibilities and environmental factors in both the native and the host countries. [ABSTRACT FROM AUTHOR]

Journals – Table of Contents

21. From New Zealand Doctor, 09/09/2009
And what about those Canadians [by Fountain, Barbara]
21B. DHB pulls up GP over fifty cents [by Cameron, Amanda]
21C. Lab complaints made to HDC.[by Ratcliffe, Lucy]
21D. First word [The article features Ros Rowarth, director of Rotorua Area Primary Health Services]
21E. Minister asks to see PHO bank balances [by Cameron, Amanda]
21F. GPs work after hours for no pay [by Topham-Kindley, Liane]
21G. PHO reels from 'hostile takeover [by Topham-Kindley, Liane]
21H. Aoraki PHO ditched, replacement unclear
21I. 'Expressions of interest' please
21J. Meanwhile…[The article discusses the Wairoa Primary Healthcare Organisation being able to immunise ninety three per cent of under two-year-olds as of July 1, 2009, and fortification of bread with folic acid will be put off until May 2012]
21K. Dr Fox farewells his submarine [by Ratcliffe, Lucy]
21L. Heart forecast tool weathers CVD storm [by Topham-kindley, Liane]
21M. Practices walk the talk
21N. PHO scores finally out in the open [by Cameron, Amanda]
21O. Major drug switch averted
21P. Trans-Tasman agency back on
21Q. Temuka GPs in court challenging DHB
21R. HDC finds no legal right to compassion [by Yeats, Jodi]
21S. Quitting just got cheaper [by Ratcliffe, Lucy]
21T. Futuristic decision paid dividends [by Yeats, Jodi]
21U. Time to get out & about minister [by Ratcliffe, Lucy]
21V. Need to scotch fee for service mentality [by Ratcliffe, Lucy]
21W. Sign of the times -- 18 PHOs to work together
21X. Boost to medical student numbers confirmed
21Y. Devolution [The article focuses on the changes in New Zealand healthcare since the start of capitation and primary health organisations]
21Z. Army doc multi tasks in Bamyan province [by Ratcliffe, Lucy]
21AA. PHO still keen to get funding back from DHB
21BB. CTA to offer new practice payments
21CC. Horn report gives nod to QI4GP
21DD. When beliefs conflict with good practice
21EE. Check-ups, diet & tips on walking
21FF. Dr Doctor [medical news briefs in New Zealand]
21GG. Letter [A letter is presented from Peter Fitzgerald, a director at Southern Community Laboratories, concerning the viability of Diagnostic Medlab, a provider of cervical cytology services in New Zealand, in sustaining its operations after losing an Auckland regional contract]
21HH. College costs not so bad
21II. Blog bits
21JJ. Workshop writes script for pharmacy
21KK. MSD donated Lipex to Fijian hospital
21LL. Aussie GPs to tread well worn path
21MM. Patient meeting a viable solution
21NN. Clinical Briefs
21OO. Cause of muscle cramps elusive
21PP. Tricyelic antidepressants and selective serotonin reuptake inhibitors effective for depression in primary care
21QQ. Watch elderly for anorexia of ageing
21RR. Dermatology Update [The article discusses the different kinds of eczema]
21SS. Medications to help beat booze [The article provides options of medications for heavy drinkers]
21TT. Heat signal early cancer marker
21UU. Heat signal physiological marker only
21VV. Shifting PHOs? Confused?
21WW. Healthy finances
21XX. Waitemata GPs keen on SafeRx
21YY. Future for Golden Bay services debated
21ZZ. Radical overhaul for health IT proposed
22. From Australasian Journal of Dermatology, 01/08/2008, Vol 49 Issue 3
22A. Systemic therapy of paediatric atopic dermatitis: An update
22B. Select the most correct answers – multiple answers possible for questions 1–11 [A quiz concerning the treatment of atopic dermatitis is presented]
22C. Autoantibodies to basement membrane proteins BP180 and BP230 are commonly detected in normal subjects by immunoblotting
22D. Knowledge and perceptions about sunburn and solar keratoses in Australia
22E. Black heel, talon noir or calcaneal petechiae?
22F. From biologic to biologic to biologic: Lessons to learn for erythrodermic and recalcitrant chronic plaque psoriasis
22G. Erythema induratum in a Kenyan child
22H. Eosinophilic annular erythema: A subset of Wells' syndrome or a distinct entity?
22I. Spontaneous resolution of facial papular mucinosis in a transplant patient
22J. Poliosis circumscripta associated with neurofibromatosis
22K. Histopathological evolution of a cutaneous myxofibrosarcoma
22L. Letter to the editor [A letter to the editor is presented that features a patient who responded to the combination of adalimumab and narrowband ultraviolet B (UVB). 

Conferences, training and seminars

23. Contracting in the Health Sector
19th and 20th October 2009
Venue: Mercure Hotel, Auckland
Date: 23rd and 24th November 2009
Venue: Museum Hotel, Wellington

24. The Paediatric Society of New Zealand
61st Annual Scientific Meeting

"Starving in the age of recession: The ecology of child health"
Date: 24 to 27 November 2009
Venue: WEL Energy Academy of Performing Arts, The University of Waikato, Hamilton
More information:

25. The International Orthodontic Congress 2010
The Congress of the World Federation of Orthodontists - held internationally every 5 years.

Date:  6-9 February 2010
Venue: Sydney Convention & Exhibition Centre on Darling Harbour, close to the centre of Sydney.
More information:

26. WCIM 2010 Melbourne in conjunction with Physicians Week
World Medicine for the Next Decade: 2010 to 2020
20 – 25 March 2010
Venue: Melbourne Convention and


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