Validation of a substance and alcohol use assessment instrument among orphans and vulnerable children in Zambia using Audio Computer Assisted Self-Interviewing (ACASI).

BACKGROUND: Substance and alcohol misuse is a global problem that increases the risk of HIV infection. This is a concern among orphans and vulnerable children (OVC) in sub-Saharan Africa who may have elevated substance use rates. The Alcohol, Smoking, and Substance Involvement Screening Test (ASSIST) is a reliable and valid instrument of substance use among adults in primary care high-income settings. This study examined psychometric properties of the ASSIST among OVC in Zambia using Audio Computer Assisted Self-Interviewing (ACASI). METHODS: Baseline data from an ongoing randomized trial of interventions to reduce HIV risk behaviors were analyzed. The analysis included 502 OVC ages 13-17 living in low-income, high-density neighborhoods in Lusaka, Zambia. Internal consistency of the ASSIST was assessed and discriminant validity was measured using items from the Youth Self Report as criterion variables. RESULTS: Internal reliability was strong with a Cronbach's alpha of ≥0.80 for each of the specific substance scales and total substance involvement. For all substances except tobacco and sedatives, discriminant validity was demonstrated in distinguishing between low risk use and moderate use. Sensitivity and specificity analysis indicated adequate area under the curve across substance types (AUC range: 0.68-0.80). Discrimination between moderate and high risk was demonstrated for alcohol and total substance involvement. CONCLUSIONS: ASSIST administered via ACASI is a reliable instrument and an appropriate tool for distinguishing between low and hazardous substance use among adolescent OVC populations in sub-Saharan Africa. Additional examination is warranted to determine its ability to measure gradations of severity within hazardous use.

Surveillance as cultural practice.

This special section of The Sociological Quarterly explores research on "surveillance as cultural practice," which indicates an orientation to surveillance that views it as embedded within, brought about by, and generative of social practices in specific cultural contexts. Such an approach is more likely to include elements of popular culture, media, art, and narrative; it is also more likely to try to comprehend people's engagement with surveillance on their own terms, stressing the production of emic over etic forms of knowledge. This introduction sketches some key developments in this area and discusses their implications for the field of "surveillance studies" as a whole.

Advertising media and cigarette demand.

Using state-level panel data for the USA spanning three decades, this research estimates the demand for cigarettes. The main contribution lies in studying the effects of cigarette advertising disaggregated across five qualitatively different groups. Results show cigarette demand to be near unit elastic, the income effects to be generally insignificant and border price effects and habit effects to be significant. Regarding advertising effects, aggregate cigarette advertising has a negative effect on smoking. Important differences across advertising media emerge when cigarette advertising is disaggregated. The effects of public entertainment and Internet cigarette advertising are stronger than those of other media. Anti-smoking messages accompanying print cigarette advertising seem relatively more effective. Implications for smoking control policy are discussed.

Ghettos and enclaves in the cross-place realm: mapping socially bounded spaces across cities.

Since the early Chicago School, urban researchers have used residential proximity to assess contacts within and between racial and ethnic groups. This approach is increasingly limited. Diverse groups use email, social networking sites, instant messaging and mobile phones to communicate across urban zones and distant cities. These practices enable mutual support among far-flung family members and co-ethnics as they engage with an array of institutions throughout their day. Through interviews and observations that include women and men of diverse occupations, races and national origins, the author explores how and why cross-place enclosures of sociality and resources develop. Rather than framing the residential area as the locus of racial/ethnic concentration, the author focuses on cross-place concentrations in the technologically mediated workspace. This study enhances theorization of the structural negotiations, interpersonal pressures and group preferences that produce separate lifeworlds in globalizing cities.

Multimedia campaign on a shoestring: promoting 'Stay Active - Stay Independent' among seniors.

ISSUE ADDRESSED: This paper describes a multimedia campaign implemented in rural New South Wales on a budget smaller than that typical of many published campaigns. The 'To Be Young at Heart - Stay Active Stay Independent' (SASI) campaign was one arm of a multi-strategic program to reduce falls among seniors by promoting physical activity. METHODS: This 18-month campaign used social marketing techniques. Central to this campaign was strong formative research, significant use of corporate, community and media partnerships and a detailed, strategic distribution plan. Campaign reach was evaluated by a community intercept survey. RESULTS: A variety of high-quality information, education and communication (IEC) resources were developed. Overall, the campaign cost was calculated at USD 191,000. The actual cost of USD 42,000 (excluding staff time) was used to generate almost double this amount in sponsorship (USD 82,000). In the mid-campaign reach survey, 36% recognised the campaign and attributed this to television (58%), newspaper (33%), poster (13%) and bus-back advertising (8%). Of these respondents, 21% reported seeking information about physical activity, 33% reported increased intention to be more active, and 22% reported becoming more active as a result of the campaign. CONCLUSIONS: It is possible to develop and deliver a well-designed, multi-media campaign on a limited budget by using sound formative research and engaging community and corporate partners to generate sponsorship. An effective distribution strategy is crucial and may require additional partnerships at State or national level.

Through hell and high water: New Orleans, August 29 - September 15, 2005.

In October of 2005 the Historic New Orleans Collection initiated an oral history project entitled "Through Hell and High Water: New Orleans, August 29 - September 15, 2005." The intent of the project was to capture the stories of first responders who worked in the New Orleans metropolitan area during the storm and the weeks that followed. The interview process has been linked with the after-action studies done by some of the local first-responding agencies and has provided a much-needed outlet for first responders. To date over three hundred subjects have been interviewed, and our work thus far has shown us that top-down methods of documentation do not work with an event like Katrina. The almost total loss of communications made it impossible for high-ranking members of the different agencies to control or even know what lower-ranking members were doing. As a result it will be necessary to cast a wide net in our documentation effort.

La auditoría de comunicación. Una herramienta para las organizaciones sanitarias / Communication audit. A tool for health organizations

La función comunicativa se ha incorporado como un elemento de desarrollo de la gestión y dirección de las organizaciones sanitarias. Los objetivos, la misión, la visión y los valores deben estar adecuadamente definidos en cualquier organización. A pesar de que en el ámbito de la salud suelen estar definidos estos parámetros, se constata una desviación entre la formulación de la finalidad institucional y los valores intrínsecos de los profesionales que trabajan en la organización. Lo que se comunica institucionalmente no suele corresponder con el proceso de aculturación de la práctica asistencial de las organizaciones sanitarias. En este sentido, es necesario que las organizaciones de la salud empleen la auditoría de la comunicación como una herramienta que les permita establecer una estrategia organizativa coherente, adecuada y proclive a proceder a los cambios y a las transformaciones pertinentes para adaptarse continuamente al entorno interno y externo. La auditoría de la comunicación, a través de unas fases determinadas (preparación, encuesta preliminar, observación evaluativa e interpretación de resultados) y con la debida participación de los profesionales, contribuye a disminuir la incoherencia y la desviación existente entre lo que se comunica oficialmente y lo que se percibe en el desarrollo cotidiano de la asistencia

The communicative function has been incorporated as an element of the development of management of health organizations. Purposes, mission, views and values must be well-defined in all organizations. Despite this, there is a deviation between the formal expressions of main purpose of health organizations and the intrinsic values of health professionals. Official communication from institutions does not generally correlate with the socialization process in the everyday health care practice. In this sense, health organizations must make use of audit communication as a tool for a coherent, adequate and proclive organizational strategy. Communication audit contributes to the achievement of changes and appropriate transformations in order to continuously adapt to the internal and external environment. Audit communication, through different phases (preparation, preliminary survey, evaluative observation and results interpretation) and adequate participation of health professionals, contributes to decrease incoherence and deviation between official communication and everyday health care perception

Print news and health psychology: some observations.

This commentary overviews the look of health news in American print journalism and the research that suggests how health news creates influence at both the individual and policy levels. Crime and violence are argued to be public health issues, but unfortunately they are often not treated as such. There is clearly room for improvement in all areas of health news, but unfortunately the extreme stress that newspapers are under to maintain their high profit margins suggests that the resources for such improvement are unlikely to be available. Examination of the Minneapolis Star Tribune's coverage of health, crime and violence exemplifies problematic aspects.

Understanding financing options for PACS implementation. Picture archiving and communication systems.

The acquisition of expensive equipment such as picture archiving and communication systems (PACS) becomes increasingly difficult as capital budgets become tighter. Traditional ownership financing options in the form of direct purchase or financing (loan) have several limitations including technology obsolescence, higher fixed pricing, limited options for equipment disposal, and the need to tie up valuable capital. Alternative financing options, in the form of conventional lease and risk sharing arrangements, offer several theoretical advantages including technology obsolescence protection in the form of built-in upgrades, preservation of borrowing power, multiple end-of-term options, and payment flexibility (which can be directly tied to realized productivity and operational efficiency gains). These options are discussed, with emphasis on the acquisition of PACS.

El papel de los medios de información en la asistencia social / The role of information media in the social assitance

Análisis de la evolución social de los medios de comunicación y de la función que han desempeñado en cada fase evolutiva de las sociedades. Se describen hechos relevantes en torno a que cada forma de sociedad, con sus peculiaridades culturales y materiales, desarrollan medios de información que responden a esas formas sociales. De esta manera, entre más compleja y extensa es una sociedad más complejos son los medios de información, dado que crece la necesidad no sólo de desarrollar dichos medios sino también su alcance y cobertura. Aunque todos los medios de información cumplen una función social, ésta se realiza de manera específica, determinada por las características técnicas de cada medio informativo así como de las características concretas de la información a transmitir y del alcance de dichos medios de información; por ejemplo, la radio es de amplia cobertura, se vale de la palabra hablada; la televisión es también de amplio alcance y se vale, principalmente, de la imagen; en tanto que la prensa, de la palabra escrita. La importancia que todos los medios de comunicación tienen para la asistencia social radica en que son un vehículo eficaz, de amplia cobertura y de bajo costo, mediante los cuales se pueden y se dan a conocer programas y acciones sociales de beneficio colectivo, así como despertar el interés e inducir la participación social de los diferentes grupos sociales