An analysis of the effects of a peer mentor program and other factors on HIV patients' retention in care and clinical outcomes at Thomas Street Health Clinic, Houston Texas

Research examining programs designed to retain patients in health care focus on repeated interactions between outreach workers and patients (Bradford et al. 2007; Cheever 2007). The purpose of this study was to determine if patients who are peer-mentored at their intake exam remain in care longer and attend more physicians' visits than those who were not mentored. Using patients' medical records and a previously created mentor database, the study determined how many patients attended their intake visit but subsequently failed to establish regular care. The cohort study examined risk factors for establishing care, determined if patients lacking a peer mentor failed to establish care more than peer mentor assisted patients, and subsequently if peer mentored patients had better health outcomes. The sample consists of 1639 patients who were entered into the Thomas Street Patient Mentor Database between May 2005 and June 2007. The assignment to the mentored group was haphazardly conducted based on mentor availability. The data from the Mentor Database was then analyzed using descriptive statistical software (SPSS version 15; SPSS Inc., Chicago, Illinois, USA). Results indicated that patients who had a mentor at intake were more likely to return for primary care HIV visits at 90 and 180 days. Mentored patients also were more likely to be prescribed ART within 180 days from intake. Other risk factors that impacted remaining in care included gender, previous care status, time from diagnosis to intake visit, and intravenous drug use. Clinical health outcomes did not differ significantly between groups. This supports that mentoring did improve outcomes. Continuing to use peer-mentoring programs for HIV care may help in increasing retention of patients in care and improving patients' health in a cost effective manner. Future research on the effects of peer mentoring on mentors, and effects of concordance of mentor and patient demographics may help to further improve peer-mentoring programs. ^

The association of peer victimization and/or bullying perpetration and body dissatisfaction in elementary students from the healthy passages baseline study

This is the first U.S. study to investigate the association between peer victimization and/or bullying perpetration and body image dissatisfaction in American elementary school students. The study used data collected from the Healthy Passages baseline cohort of 5152 ethnically diverse fifth grade students from Alabama, Texas, and California. The overall prevalence of body dissatisfaction in our fifth grade sample was 50%. Students who were dissatisfied with their bodies were 23% more likely to be involved in peer victimization than students who were satisfied with their bodies (OR = 1.23; 95% CI = 1.02, 1.48). No significant associations were found between bullying status or bully-victim status and body dissatisfaction. Other factors that contributed significantly to a student's body image status were BMI, level of self-worth, level of household income, gender, pubertal timing and support received from adults (other than parents). It is noteworthy that those who were dissatisfied were heavier, came from lower income homes and were more likely to be male. Additional longitudinal studies are needed to confirm these associations, especially among large ethnically and socio-economically diverse samples. ^

Young Jewish adults sexual behaviors Peer, parental and surrounding influences

A qualitative study was conducted on young Jewish adults to determine cultural sexual health patterns with in the Jewish adolescent community. The young Jewish adults were recruited through Jewish social settings, such as Hillel Student Centers in Austin and Houston, Texas. Jewish was self-defined. A young adult, for this study, was defined as being between the ages of 18 and 23. Both female and males are needed in the study group. Individual interviews revealed 35 themes identifying the cultural, parental, peer, and surrounding factors that affect sexual behaviors during Jewish adolescence. Overall, this research demonstrates the need to further study and understand the culture and behaviors with in the Jewish community to then create a tailored intervention on healthy sexuality.^

Mistreatment and self-neglect in community dwelling older adults: Studies of construct validity, measurement invariance and latent classes

Mistreatment and self-neglect significantly increase the risk of dying in older adults. It is estimated that 1 to 2 million older adults experience elder mistreatment and self-neglect every year in the United States. Currently, there are no elder mistreatment and self-neglect assessment tools with construct validity and measurement invariance testing and no studies have sought to identify underlying latent classes of elder self-neglect that may have differential mortality rates. Using data from 11,280 adults with Texas APS substantiated elder mistreatment and self-neglect 3 studies were conducted to: (1) test the construct validity and (2) the measurement invariance across gender and ethnicity of the Texas Adult Protective Services (APS) Client Assessment and Risk Evaluation (CARE) tool and (3) identify latent classes associated with elder self-neglect. Study 1 confirmed the construct validity of the CARE tool following adjustments to the initial hypothesized CARE tool. This resulted in the deletion of 14 assessment items and a final assessment with 5 original factors and 43 items. Cross-validation for this model was achieved. Study 2 provided empirical evidence for factor loading and item-threshold invariance of the CARE tool across gender and between African-Americans and Caucasians. The financial status domain of the CARE tool did not function properly for Hispanics and thus, had to be deleted. Subsequent analyses showed factor loading and item-threshold invariance across all 3 ethnic groups with the exception of some residual errors. Study 3 identified 4-latent classes associated with elder self-neglect behaviors which included individuals with evidence of problems in the areas of (1) their environment, (2) physical and medical status, (3) multiple domains and (4) finances. Overall, these studies provide evidence supporting the use of APS CARE tool for providing unbiased and valid investigations of mistreatment and neglect in older adults with different demographic characteristics. Furthermore, the findings support the underlying notion that elder self-neglect may not only occur along a continuum, but that differential types may exist. All of which, have very important potential implications for social and health services distributed to vulnerable mistreated and neglected older adults.^

Beyond Bullying: Transforming the Culture of Peer Abuse

Bullying needs to be understood and positioned as a form of child abuse – peer abuse. For too many people, bullying is a benign term. This article will include information collected from a wide-range of researchers and discussions with over 50,000 students that I have facilitated during the past twenty years. The content will focus on new morbidities related to bullying such as depression and suicide, obesity, eating disorders, food allergies, juvenile diabetes, truancy, and substance and alcohol abuse. Making a cultural change in our society will require identified Change Agents, along with recommendations for collaboration, policies, projects and legislation.

Two historical maps from nineteenth-century Palestine, with links to digitized maps in shapefile format

Reconstructing past landscapes from historical maps requires quantifying the accuracy and completeness of these sources. The accuracy and completeness of two historical maps of the same period covering the same area in Israel were examined: the 1:63,360 British Palestine Exploration Fund map (1871-1877) and the 1:100,000 French Levés en Galilée (LG) map (1870). These maps cover the mountainous area of the Galilee (northern Israel), a region with significant natural and topographical diversity, and a long history of human presence. Land-cover features from both maps, as well as the contours drawn on the LG map, were digitized. The overall correspondence between land-cover features shown on both maps was 59% and we found that the geo-referencing method employed (transformation type and source of control points) did not significantly affect these correspondence measures. Both maps show that in the 1870s, 35% of the Galilee was covered by Mediterranean maquis, with less than 8% of the area used for permanent agricultural cropland (e.g., plantations). This article presents how the reliability of the maps was assessed by using two spatial historical sources, and how land-cover classes that were mapped with lower certainty and completeness are identified. Some of the causes that led to observed differences between the maps, including mapping scale, time of year, and the interests of the surveyors, are also identified.

Questões sobre Classes, Dominação e Conflitos Sociais na Alta Idade Média

Except for a History that is mobilized, nowadays, much more by the supposedly continuities than the changes, the periods of major transitions continue to demand interpretative effort from specialists. It is long the list of those who have been dedicated to the transitional problem between the Antiquity and the Middle Ages, focused on a period of poor and unequally distributed sources, trying to shed light and establish various interpretative means for this phenomenon. Albeit having overcome some of the catastrophic perspectives hindering the pioneer analyses within this context, the current approaches have also eliminated the recognition of both the contradictory manifestations and the social struggles acting as central and fundamental engines of the social transformations within the discussed context. When supported by an adequate theoretical background, documents from the period lead us to a process resulting from contradictions and a scenario of actions and reactions that eventually materialized the conflicts and moved History forward. The transition from the Antiquity to the Middle Ages was encompassed by diverse social antagonist manifestations, which allows us to consider that the arena of disputes were, therefore, that of the society itself.

Questões sobre Classes, Dominação e Conflitos Sociais na Alta Idade Média

Except for a History that is mobilized, nowadays, much more by the supposedly continuities than the changes, the periods of major transitions continue to demand interpretative effort from specialists. It is long the list of those who have been dedicated to the transitional problem between the Antiquity and the Middle Ages, focused on a period of poor and unequally distributed sources, trying to shed light and establish various interpretative means for this phenomenon. Albeit having overcome some of the catastrophic perspectives hindering the pioneer analyses within this context, the current approaches have also eliminated the recognition of both the contradictory manifestations and the social struggles acting as central and fundamental engines of the social transformations within the discussed context. When supported by an adequate theoretical background, documents from the period lead us to a process resulting from contradictions and a scenario of actions and reactions that eventually materialized the conflicts and moved History forward. The transition from the Antiquity to the Middle Ages was encompassed by diverse social antagonist manifestations, which allows us to consider that the arena of disputes were, therefore, that of the society itself.

Questões sobre Classes, Dominação e Conflitos Sociais na Alta Idade Média

Except for a History that is mobilized, nowadays, much more by the supposedly continuities than the changes, the periods of major transitions continue to demand interpretative effort from specialists. It is long the list of those who have been dedicated to the transitional problem between the Antiquity and the Middle Ages, focused on a period of poor and unequally distributed sources, trying to shed light and establish various interpretative means for this phenomenon. Albeit having overcome some of the catastrophic perspectives hindering the pioneer analyses within this context, the current approaches have also eliminated the recognition of both the contradictory manifestations and the social struggles acting as central and fundamental engines of the social transformations within the discussed context. When supported by an adequate theoretical background, documents from the period lead us to a process resulting from contradictions and a scenario of actions and reactions that eventually materialized the conflicts and moved History forward. The transition from the Antiquity to the Middle Ages was encompassed by diverse social antagonist manifestations, which allows us to consider that the arena of disputes were, therefore, that of the society itself.