Reducing perinatal HIV transmission among HIV-infected pregnant women.

BACKGROUND: In 1995, Help Understand and Guide-Me (HUG-Me) began planning the implementation of Protocol 076, a treatment that aids in the reduction of perinatal transmission of human immunodeficiency virus (HIV). A program coordinator and a social worker worked with a 1572 bed-hospital system to successfully implement the protocol. METHODS: Program effectiveness was tracked through monitoring of client outcomes. HIV test results of infants born to HIV-infected mothers were tracked for nine years. In addition, chart audits were conducted on all patients to ensure that testing and counseling were documented for every pregnant woman who delivered at the hospital. RESULTS: From 1996 to 2005, among 434 births to HIV-infected women enrolled in the clinic, only one HIV-infected infant was born. Chart audits revealed that HIV testing and counseling were not being performed and/or documented by all physicians. Therefore, in-service training was initiated for providers on a regular basis. In addition, other factors were addressed to aid patient adherence to treatment. DISCUSSION: The initiative's success in virtually eliminating perinatal transmission has had a major impact in reducing rates of pediatric HIV/AIDS for the community.

Comparison of stage at diagnosis of melanoma among Hispanic, black, and white patients in Miami-Dade County, Florida.

OBJECTIVE: To compare stage at diagnosis of melanoma between non-Hispanic white, non-Hispanic black, and Hispanic patients. DESIGN: Retrospective analysis. SETTING: Melanoma cases reported to the Florida Cancer Data System, with known stage and race/ethnicity information, for residents of Miami-Dade County, Florida, from 1997 to 2002. PATIENTS: Those diagnosed as having melanoma according to the Florida Cancer Data System. MAIN OUTCOME MEASURE: Stage of melanoma at diagnosis. RESULTS: Of the 1690 melanoma cases reported with both stage and race/ethnicity information, 1176 (70%) were among non-Hispanic white patients, 485 (29%) were among Hispanic patients of any race, and 29 (2%) were among non-Hispanic black patients. Late-stage (regional and distant) diagnosis was more common among Hispanic (26%) and non-Hispanic black patients (52%) compared with non-Hispanic white patients (16%) (P < .001). CONCLUSION: Advanced stage of melanoma diagnosis among Hispanic and black patients suggests suboptimal secondary prevention efforts in minority populations.

Accuracy of parental and youth reporting of secondhand smoke exposure: the Florida youth cohort study.

The accuracy of adolescent and parental reports of youth secondhand smoke exposure has received limited attention in the research literature. Florida Youth Cohort Study participants provided saliva samples during the fifth round of interviews for determination of cotinine levels. After exclusion of admitted or likely youth smokers with cotinine levels>14.7 ng/ml, there were 341 youth ages 13-17 who completed a telephone interview; 304 parents of these participants completed a similar secondhand smoke exposure interview. Adolescents with cotinine levels above the threshold of detection (> 0.10 ng/ml) were considered exposed. Specificity ranged from 87.1-97.8. Positive predictive value, negative predictive value, sensitivity, and kappa values varied considerably by the reporting source (e.g., youth, parent, or a combination of responses), and the age and gender of the youth respondent. Agreement between youth and parent that at least one parent smoked inside the home yielded the best combination of sensitivity (85.0) and specificity (89.8) and was least affected by the age and gender of the youth respondent.

Tobacco Use Prevention Education (TUPE) Programs in the State of Florida: correlates and predictors of teachers' perceptions of program effectiveness.

In Florida, data from telephone surveys were used to identify correlates and predictors of teachers' perceptions of the effectiveness of tobacco use prevention education (TUPE) prior to the implementation of the Tobacco Pilot Project (TPP). A 40% random sample of public middle and high schools yielded 296 middle school teachers (MST) and 282 high school teachers (HST). Higher perceived program effectiveness ratings were associated with: using peer leaders, frequent evaluations, parental involvement, few barriers, high student interest, and low tolerance norms for tobacco use. The importance of program features and implementation contexts to teachers' perceived program effectiveness ratings is highlighted.

Amenability and implementation in secondary school antitobacco programs.

OBJECTIVES: To describe relationships between teachers' amenability to implement antitobacco programs and features of implementation settings. METHODS: A telephone random survey was administered to middle school and high school teachers in Florida. Data were analyzed via cluster analysis and other multivariate techniques. RESULTS: Teachers were classified by their amenability to implement tobacco-use-prevention education (TUPE). Cluster membership was associated with key contextual variables. Hierarchical multiple regression identified significant predictors of teachers' perceptions of program success. CONCLUSION: After controlling for other school and community factors, classroom activities remained significant predictors of program effectiveness. Findings may have implications for the design of secondary interventions to promote teacher efficacy related to delivery of antitobacco programs.

Diverticulitis cecal aguda. Presentación de un caso / Acute cecal diverticulitis. Report of a case

Se revisa brevemente la diverticulitis cecal aguda y se destacan: su historia, etiopatogenia, frecuencia, cuadro clínico y diagnóstico. Se realiza la presentación del caso de un paciente y se llega a conclusiones con respecto a dicha enfermedad(AU)