Safety of Reiki Therapy for Newborns at Risk for Neonatal Abstinence Syndrome.

The incidence of opioid abuse and subsequent drug withdrawal is exponentially on the rise in the United States for many populations including newborns who are born to drug-addicted mothers. These newborns often exhibit symptoms of neonatal abstinence syndrome (NAS) within 24 to 72 hours of birth. Treatment of NAS includes monitoring of withdrawal symptoms, managing physiological parameters, and the use of supportive and pharmacologic treatments. Although a few randomized controlled trials exist, studies on supportive intervention are generally limited by small sample sizes, case study reports, expert opinions, and descriptive design. Few studies address the safety of Reiki for newborns at risk for NAS using neonatal parameters. This pilot study addresses feasibility and demonstrates that Reiki is safe when administered to this high-risk population. Considerations for future studies are discussed.

Schistosomiasis and Infertility in East Africa.

Case reports and pathology series suggest associations of female genital schistosomiasis (Schistosoma haematobium) with infertility and ectopic pregnancy. Differential geographic distribution of infertility is not explained by analyses of known risk factors. In this cross-sectional multilevel semi-ecologic study, interpolated prevalence maps for S. haematobium and Schistosoma mansoni in East Africa were created using data from two open-access Neglected Tropical Diseases Databases. Prevalence was extracted to georeferenced survey sample points for Demographic and Health Surveys for Ethiopia, Kenya, Tanzania, and Uganda for 2000 and 2010. Exploratory spatial analyses showed that infertility was not spatially random and mapped the clustering of infertility and its co-location with schistosomiasis. Multilevel logistic regression analysis demonstrated that women living in high compared with absent S. haematobium locations had significantly higher odds of infertility (2000 odds ratio [OR] = 1.5 [confidence interval95 = 1.3, 1.8]; 2010 OR = 1.2 [1.1, 1.5]). Women in high S. haematobium compared with high S. mansoni locations had significantly higher odds of infertility (2000 OR 1.4 [1.1, 1.9]; 2010 OR 1.4 [1.1, 1.8]). Living in high compared with absent S. mansoni locations did not affect the odds of infertility. Infertility appears to be associated spatially with S. haematobium.

Hansen disease among Micronesian and Marshallese persons living in the United States.

An increasing proportion of Hansen disease cases in the United States occurs among migrants from the Micronesian region, where leprosy prevalence is high. We abstracted surveillance and clinical records of the National Hansen's Disease Program to determine geographic, demographic, and clinical patterns. Since 2004, 13% of US cases have occurred in this migrant population. Although Hawaii reported the most cases, reports have increased in the central and southern states. Multibacillary disease in men predominates on the US mainland. Of 49 patients for whom clinical data were available, 37 (75%) had leprosy reaction, neuropathy, or other complications; 17 (37%) of 46 completed treatment. Comparison of data from the US mainland with Hawaii and country-of-origin suggests under-detection of cases in pediatric and female patients and with paucibacillary disease in the United States. Increased case finding and management, and avoidance of leprosy-labeled stigma, is needed for this population.

Randomized trial on the 5 a day, the Rio Grande Way Website, a web-based program to improve fruit and vegetable consumption in rural communities.

The Internet is a new technology for health communication in communities. The 5 a Day, the Rio Grande Way website intended to increase fruits and vegetables (FV) consumption was evaluated in a rural region enrolling 755 adults (65% Hispanic, 9% Native American, 88% female) in a randomized pretest-posttest controlled trial in 2002-2004. A total of 473 (63%) adults completed a 4-month follow-up. The change in daily intake on a food frequency questionnaire (control: mean = - 0.26 servings; intervention: mean = 0.38; estimated difference = 0.64, SD = 0.52, t(df = 416) = 1.22, p = 0.223) and single item (13.9% eating 5 + servings at pretest, 19.8% posttest for intervention; 17.4%, 13.8% for controls; odds ratio (OR) = 1.84, 95% CI = 1.07, 3.17) was in the expected direction but significant only for the single item. Website use was low and variable (logins: M = 3.3, range = 1 to 39.0; total time: M = 22.2 minutes, range = 0 to 322.7), but it was associated positively with fruit and vegetable intake (total time: Spearman r = 0.14, p = 0.004 for food frequency; Spearman r = 0.135, p = 0.004 for single item). A nutrition website may improve FV intake. The comparison on the food frequency measure may have been undermined by its high variability. Websites may be successful in community settings only when they are used enough by adults to influence them.

Randomized trials on consider this, a tailored, internet-delivered smoking prevention program for adolescents.

The Internet may be an effective medium for delivering smoking prevention to children. Consider This, an Internet-based program, was hypothesized to reduce expectations concerning smoking and smoking prevalence. Group-randomized pretest-posttest controlled trials were conducted in Australia (n = 2,077) and the United States (n = 1,234) in schools containing Grades 6 through 9. Australian children using Consider This reported reduced 30-day smoking prevalence. This reduction was mediated by decreased subjective norms. The amount of program exposure was low in many classes, but program use displayed a dose-response relationship with reduced smoking prevalence. American children only reported lower expectations for smoking in the future. Intervening to prevent smoking is a challenge, and this data suggest small benefits from an Internet-based program that are unlikely to be of practical significance unless increased by improved implementation. Implementation remains the major challenge to delivering interventions via the Internet, both for health educators and researchers.