Is family medicine meeting the HIV/AIDS challenge? A national survey of family physicians' beliefs, clinical competence, and experience regarding HIV disease

A national sample of family physicians was surveyed to (1) assess family physicians' beliefs about the human immunodeficiency virus (HIV) and individuals at risk for infection, their clinical competence regarding HIV-related issues, and their experiences with HIV disease; (2) present conclusions to the American Academy of Family Physicians (AAFP) to effect the development of an early clinical care protocol and a continuing medical education curriculum; and (3) collect base-line data for use in the evaluation of an early clinical care protocol and a continuing medical education curriculum, in the case that such programs are developed and disseminated. After considering retired or deceased respondents, of the 2,660 physicians surveyed, 1,678 (63.7%) responded. The resulting sample was representative of the active members of the AAFP. About 77% of the respondents were unable to accurately identify the universal precautions for blood and body fluids to prevent occupational transmission of HIV or hepatitis B virus (HBV). Residency trained and board certified physicians expressed fewer "external constraints," such as fear of losing patients, obviating them from providing treatment to individuals with HIV disease (p =.004 and p $<$.001, respectively). These physicians also manifested fewer "internal constraints" to the provision of HIV treatment, such as fear of becoming infected (p $<$.001 and p =.012, respectively). Residency trained physicians also expressed a greater comfort with discussing sexually-related topics with their patients than did non-residency trained physicians (p $<$.001). There were 67.1% of the physicians surveyed who reported never providing treatment to an individual with HIV disease. Residency trained and board certified physicians expressed a greater likelihood to provide treatment to HIV-infected patients (p $<$.001) than non-residency trained and non-board certified physicians.^ Among the various primary care specialties, family medicine is especially vulnerable to the current challenges of HIV/AIDS. These challenges are augmented by the epidemiologic pattern that characterizes AIDS. For the past several years, we have seen AIDS in this country assume a similar pattern to that seen in most other countries; HIV is becoming increasingly prevalent in the heterosexual population as well as in locations removed from metropolitan centers. This current phase of the epidemic generates greater pressures upon primary care physicians, particularly family physicians, to become better acquainted with the means to provide early care to HIV/AIDS patients and to prevent HIV/AIDS among their patients. Family medicine is especially appropriate for providing care to HIV patients because family medicine involves treatment to all age groups and conditions; other primary care specialties focus on limited patient populations or specific conditions. Family physicians should be armed with the expertise to confront HIV/AIDS. However, family physicians' clinical competence and experience with HIV is not known. The data collected in this survey describes their competencies, attitudes, and experiences. ^

AN EMPIRICAL ESTIMATION OF MEDICAL AND NON-MEDICAL INPUTS IN THE PRODUCTION OF CARDIO-RESPIRATORY PHYSICAL HEALTH STATUS

The purpose of this study was to examine, in the context of an economic model of health production, the relationship between inputs (health influencing activities) and fitness.^ Primary data were collected from 204 employees of a large insurance company at the time of their enrollment in an industrially-based health promotion program. The inputs of production included medical care use, exercise, smoking, drinking, eating, coronary disease history, and obesity. The variables of age, gender and education known to affect the production process were also examined. Two estimates of fitness were used; self-report and a physiologic estimate based on exercise treadmill performance. Ordinary least squares and two-stage least squares regression analyses were used to estimate the fitness production functions.^ In the production of self-reported fitness status the coefficients for the exercise, smoking, eating, and drinking production inputs, and the control variable of gender were statistically significant and possessed theoretically correct signs. In the production of physiologic fitness exercise, smoking and gender were statistically significant. Exercise and gender were theoretically consistent while smoking was not. Results are compared with previous analyses of health production. ^

Internet sex among non-gay identifying men who have sex with men

The aim of this study was to examine the role of the Internet in Internal Homonegativity (IH) among Non gay identifying men who have sex with men (NGI-MSM). This study at University of Texas School of Public Health (UTSPH) had a mixed method research design and consisted of men 18 years of age and older who were residents of the US and Canada. The data were collected using an online survey called 'Men's Sexual Health Survey' which was developed in collaboration with Boston University School of Public Health and Denver Public Health. These surveys were administered in English, which took 30-minutes to complete, and were placed on gay oriented websites and chat rooms. 141 participants were presented with the module relating to IH. A Principal Component Analysis with varimax rotation on the nine questions that asked the participants about their feelings about gay men produced three factors of IH identified as (1) public identification as gay; (2) perception of stigma associated with being gay; and (3) social comfort with gay men. The factors significantly correlated with age, grade completed in school, income, openness about being gay and socializing with gay people, meeting partners online, dating on the Internet, attitude toward condom usage, alcohol and drug use before sex and having unprotected sex with Internet partners. These findings point toward the role of the Internet in determining IH and sexual behavior. Despite the risks, the Internet's popularity and outreach in NGI-MSM makes it an effective medium to spread public health programs.^

Prevalence and risk factors of asthma and work -related asthma among U.S. adults: Data from the Third National Health and Nutrition Examination Survey, 1988--1994

This cross-sectional analysis of the data from the Third National Health and Nutrition Examination Survey was conducted to determine the prevalence and determinants of asthma and wheezing among US adults, and to identify the occupations and industries at high risk of developing work-related asthma and work-related wheezing. Separate logistic models were developed for physician-diagnosed asthma (MD asthma), wheezing in the previous 12 months (wheezing), work-related asthma and work-related wheezing. Major risk factors including demographic, socioeconomic, indoor air quality, allergy, and other characteristics were analyzed. The prevalence of lifetime MD asthma was 7.7% and the prevalence of wheezing was 17.2%. Mexican-Americans exhibited the lowest prevalence of MD asthma (4.8%; 95% confidence interval (CI): 4.2, 5.4) when compared to other race-ethnic groups. The prevalence of MD asthma or wheezing did not vary by gender. Multiple logistic regression analysis showed that Mexican-Americans were less likely to develop MD asthma (adjusted odds ratio (ORa) = 0.64, 95%CI: 0.45, 0.90) and wheezing (ORa = 0.55, 95%CI: 0.44, 0.69) when compared to non-Hispanic whites. Low education level, current and past smoking status, pet ownership, lifetime diagnosis of physician-diagnosed hay fever and obesity were all significantly associated with MD asthma and wheezing. No significant effect of indoor air pollutants on asthma and wheezing was observed in this study. The prevalence of work-related asthma was 3.70% (95%CI: 2.88, 4.52) and the prevalence of work-related wheezing was 11.46% (95%CI: 9.87, 13.05). The major occupations identified at risk of developing work-related asthma and wheezing were cleaners; farm and agriculture related occupations; entertainment related occupations; protective service occupations; construction; mechanics and repairers; textile; fabricators and assemblers; other transportation and material moving occupations; freight, stock and material movers; motor vehicle operators; and equipment cleaners. The population attributable risk for work-related asthma and wheeze were 26% and 27% respectively. The major industries identified at risk of work-related asthma and wheeze include entertainment related industry; agriculture, forestry and fishing; construction; electrical machinery; repair services; and lodging places. The population attributable risk for work-related asthma was 36.5% and work-related wheezing was 28.5% for industries. Asthma remains an important public health issue in the US and in the other regions of the world. ^

Seagrass and associated benthic community data derived from field surveys at Low Isles, Great Barrier Reef, conducted July-August, 1997

The distribution of seagrass and associated benthic communities on the reef and lagoon of Low Isles, Great Barrier Reef, was mapped between the 29 July and 29 August 1997. For this survey, observers walked or free-dived at survey points positioned approximately 50 m apart along a series of transects. Visual estimates of above-ground seagrass biomass and % cover of each benthos and substrate type were recorded at each survey point. A differential handheld global positioning system (GPS) was used to locate each survey point (accuracy ±3m). A total of 349 benthic survey points were examined. To assist with mapping meadow/habitat type boundaries, an additional 177 field points were assessed and a georeferenced 1:12,000 aerial photograph (26th August 1997) was used as a secondary source of information. Bathymetric data (elevation below Mean Sea Level) measured at each point assessed and from Ellison (1997) supplemented information used to determine boundaries, particularly in the subtidal lagoon. 127.8 ±29.6 hectares was mapped. Seagrass and associated benthic community data was derived by haphazardly placing 3 quadrats (0.25m**2) at each survey point. Seagrass above ground biomass (standing crop, grams dry weight (g DW m**-2)) was determined within each quadrat using a non-destructive visual estimates of biomass technique and the seagrass species present identified. In addition, the cover of all benthos was measured within each of the 3 quadrats using a systematic 5 point method. For each quadrat, frequency of occurrence for each benthic category was converted to a percentage of the total number of points (5 per quadrat). Data are presented as the average of the 3 quadrats at each point. Polygons of discrete seagrass meadow/habitat type boundaries were created using the on-screen digitising functions of ArcGIS (ESRI Inc.), differentiated on the basis of colour, texture, and the geomorphic and geographical context. The resulting seagrass and benthic cover data of each survey point and for each seagrass meadow/habitat type was linked to GPS coordinates, saved as an ArcMap point and polygon shapefile, respectively, and projected to Universal Transverse Mercator WGS84 Zone 55 South.

Abundance estimates of diatoms in ODP Leg 207 sediments

Twenty-eight core catcher samples were provided to the author by the shipboard party for evaluation of fossil diatoms. Samples are from Ocean Drilling Program Leg 207 Holes 1257A, 1257B, 1257C, and 1258A. The samples range from 50 to 112 meters below the seafloor (mbsf) at Site 1257 and from ~22 to 60 mbsf at Site 1258. At Site 1257, samples range in age from middle Eocene (foraminifer Zone P14-13) to late Paleocene (mid-foraminifer Zone P4). At Site 1258, the samples range from middle Eocene (foraminifer Zone P11) to early Eocene (foraminifer Zone P5) according to the preliminary biostratigraphic reports (Erbacher, Mosher, Malone, et al., 2004, doi:10.2973/odp.proc.ir.207.2004). All samples were processed at Florida State University Antarctic Research Facility. Treatment included acidization and sieving through stacked 38- and 63-µm sieves. Strew slides were made from each fraction and the catcher pan. A Zeiss Photoscope II microscope was used for examination of the prepared slides. Samples from Holes 1257A, 1257B, and 1257C showed that most of the samples are barren of siliceous microfossils. Only a few radiolarians and fragments of radiolarians were observed.

Urban forest health survey on Roznik in Ljubljana in 2013 by two methods

Urban forest health was surveyed on Roznik in Ljubljana (46.05141 N, 14.47797 E) in 2013 by two methods: ICP Forests and UFMO. ICP Forests is most commonly used monitoring programme in Europe - the International Co-operative Programme on the Assessment and Monitoring of Air Pollution Effects on Forests, which is based on systematic grid. UFMO method - Urban Forests Management Oriented method was developed in the frame of EMoNFUr Project - Establishing a monitoring network to assess lowland forest and urban plantations in Lombardy and urban forest in Slovenia (LIFE10 ENV/IT/000399). UFMO is based on non-linear transects (GPS tracks). ICP forests monitoring plots were established in July 2013 in the urban forest Roznik in Ljubljana .The 32 plots are located on sampling grid 500 × 500 m. The grid was down-scaled from the National Forest Monitoring survey, which bases on national sample grid 4 × 4 km. With the ICP forests method the following parameters for each tree within the 15 plots were gathered according to the ICP forests manual for Visual assessment of crown condition and damaging agents: tree species, percentage of defoliation, affected part of the tree, specification of affected part, location in crown, symptom, symptom specification, causal agents / factors, age of damage, damage extent, and damage extent on the trunk. With the UFMO method, the following parameters for each tree that needed sylviculture measure (felling, pruning, sanitary felling, thinning, etc.) were recorded: tree species, breast diameter, causal agent / damaging factor, GPS waypoint and GPS track. For overall picture in the urban forest health problems, also other biotic and abiotic damaging factors that did not require management action were recorded.

MTurk Survey on "Mood and Personality". Documentation

Social desirability and the fear of negative consequences often deter a considerable share of survey respondents from responding truthfully to sensitive questions. Thus, resulting prevalence estimates are biased. Indirect techniques for surveying sensitive questions such as the Randomized Response Technique are intended to mitigate misreporting by providing complete concealment of individual answers. However, it is far from clear whether these indirect techniques actually produce more valid measurements than standard direct questioning. In order to evaluate the validity of different sensitive question techniques we carried out an online validation experiment at Amazon Mechanical Turk in which respondents' self-reports of norm-breaking behavior (cheating in dice games) were validated against observed behavior. This document describes the design of the validation experiment and provides details on the questionnaire, the different sensitive question technique implementations, the field work, and the resulting dataset. The appendix contains a codebook of the data and facsimiles of the questionnaire pages and other survey materials.

Non-tariff barriers, integration and the transatlantic economy

We examine the potential impact of TTIP through trade-cost reductions, applying a mix of econometric and computational methods to develop estimates of the benefits (and costs) for the EU, United States, and third countries. Econometric results point to an approximate 80% growth in bilateral trade with an ambitious trade agreement. However, at the same time, computable general equilibrium (CGE) estimates highlight distributional impacts across countries and factors not evident from econometrics alone. Translated through our CGE framework, while bilateral trade increases roughly 80%, there is a fall of about 2.5% in trade with the rest of the world in our central case. The estimated gains in annual consumption range between 1% and 2.25% for the United States and EU, respectively. A purely discriminatory agreement would harm most countries outside the agreement, while the direction of third-country effects hinges critically on whether NTB reductions end up being discriminatory or not. Within the United States and EU, while labour gains across skill categories, the impact on farmers is mixed.

Sensitive Questions in Online Surveys: Experimental Results for the Randomized Response Technique (RRT) and the Unmatched Count Technique (UCT)

Gaining valid answers to so-called sensitive questions is an age-old problem in survey research. Various techniques have been developed to guarantee anonymity and minimize the respondent's feelings of jeopardy. Two such techniques are the randomized response technique (RRT) and the unmatched count technique (UCT). In this study we evaluate the effectiveness of different implementations of the RRT (using a forced-response design) in a computer-assisted setting and also compare the use of the RRT to that of the UCT. The techniques are evaluated according to various quality criteria, such as the prevalence estimates they provide, the ease of their use, and respondent trust in the techniques. Our results indicate that the RRTs are problematic with respect to several domains, such as the limited trust they inspire and non-response, and that the RRT estimates are unreliable due to a strong false "no" bias, especially for the more sensitive questions. The UCT, however, performed well compared to the RRTs on all the evaluated measures. The UCT estimates also had more face validity than the RRT estimates. We conclude that the UCT is a promising alternative to RRT in self-administered surveys and that future research should be directed towards evaluating and improving the technique.

Linked versus Non-linked Firms in Innovation: The Effects of Economies of Network in Agglomeration in East Asia

This paper proposes a new mechanism linking innovation and network in developing economies to detect explicit production and information linkages and investigates the testable implications of these linkages using survey data gathered from manufacturing firms in East Asia. We found that firms with more information linkages tend to innovate more, have a higher probability of introducing new goods, introducing new goods to new markets using new technologies, and finding new partners located in remote areas. We also found that firms that dispatched engineers to customers achieved more innovations than firms that did not. These findings support the hypothesis that production linkages and face‐to‐face communication encourage product and process innovation.

Restoration of micro data of John Lossing Buck's survey and analysis of the inverse relationship between yield and farm size in rural China in the 1930's

A large scale Chinese agricultural survey was conducted at the direction of John Lossing Buck from 1929 through 1933. At the end of the 1990’s, some parts of the original micro data of Buck’s survey were discovered at Nanjing Agricultural University. An international joint study was begun to restore micro data of Buck’s survey and construct parts of the micro database on both the crop yield survey and special expenditure survey. This paper includes a summary of the characteristics of farmlands and cropping patterns in crop yield micro data that covered 2,102 farmers in 20 counties of 9 provinces. In order to test the classical hypothesis of whether or not an inverse relationship between land productivity and cultivated area may be observed in developing countries, a Box-Cox transformation test was conducted for functional forms on five main crops of Buck’s crop yield survey. The result of the test shows that the relationship between land productivity and cultivated areas of wheat and barley is linear and somewhat negative; those of rice, rapeseed, and seed cotton appear to be slightly positive. It can be tentatively concluded that the relationship between cultivated area and land productivity are not the same among crops, and the difference of labor intensity and the level of commercialization of each crop may be strongly related to the existence or non-existence of inverse relationships.

Income disparity among persons with disabilities assessed by education and sex : findings from a field survey conducted in Metro Manila, the Philippines

How do persons with disabilities (PWDs) earn a living? From the view point of poverty reduction, this question is quite critical in developing countries. This paper presents an investigation of economic activities of PWDs in the Philippines where, among developing countries, disability-related legislation is relatively progressive. In 2008, a field survey was conducted in cooperation with Disability People’s Organizations (DPOs) using a tailor-made questionnaire in four representative cities of Metro Manila. The level and determinants of income of PWDs were examined with Mincer regression. Conclusions are as follows: (1) The incidence and depth of poverty are greater among sample PWDs than that of the total population in Metro Manila. (2) There is remarkable income disparity among PWDs which is associated with education and sex. (3) After controlling individual, parental, and environmental characteristics, it was found that female PWDs are likely to earn less than male PWDs due to fewer opportunities to participate in economic activities. It is suggested that female PWDs are doubly handicapped in earning income.

Caste, land, and migration : a preliminary analysis of a village survey in an underdeveloped state in India

This paper explores migration from Bihar, one of the most underdeveloped states in India, by paying particular attention to social class (caste) and landholdings. After describing details of individual migrants, we present our preliminary findings on the determinants of migration, based on our field survey of 200 households in four villages in 2011. In terms of social class, Muslims are more likely to migrate, but Scheduled Castes do not show a high propensity to migrate as is stated in some of the existing literature where the underclass is said to be more mobile. In terms of landholdings, the probability that someone will migrate is high among the landless and smaller landholders but it decreases as the size of the landholding increases. However, as the size of the landholding increases still further, a reverse effect of landholding on decisions regarding migration moves in, with the decline in probability becoming less and less. This result confirms a non-linear relationship between landholdings and the decision to migrate. Some further research questions are raised in the paper.