"It Was as Though My Spirit Left, Like They Killed Me": The Disruptive Impact of an HIV-Positive Diagnosis among Women in the Dominican Republic.

An HIV diagnosis may be associated with severe emotional and psychological distress, which can contribute to delays in care or poor self-management. Few studies have explored the emotional, psychological, and psychosocial impacts of an HIV diagnosis on women in low-resource settings. We conducted in-depth interviews with 30 women living with HIV in the Dominican Republic. Interviews were audio-recorded, transcribed, and analyzed using the biographical disruption framework. Three disruption phases emerged (impacts of a diagnosis, postdiagnosis turning points, and integration). Nearly all respondents described the news as deeply distressful and feelings of depression and loss of self-worth were common. Several reported struggling with the decision to disclose-worrying about stigma. Postdiagnosis turning points consisted of a focus on survival and motherhood; social support (family members, friends, HIV community) promoted integration. The findings suggest a need for psychological resources and social support interventions to mitigate the negative impacts of an HIV diagnosis

Which literacy skills are associated with smoking?

Background Research has demonstrated associations between smoking and reading skills, but other literacy skills such as speaking, listening and numeracy are less studied despite our dependence on the use of numbers and the oral exchange to deliver information on the risks of smoking. Methods We used multivariable logistic regression to examine the effects of reading, numeracy, speaking and listening skills on 1) becoming a regular smoker and 2) smoking cessation. Further, multivariable linear regression was used to examine the relation between literacy skills and amount smoked among current smokers. Models controlled for education, gender, age, race/ethnicity, income, and, when relevant, age they became a regular smoker. Results For each grade equivalent increase in reading skills, the odds of quitting smoking increased by about 8% (OR=1.08, 95%CI: 1.01–1.15). For every point increase in numeracy skills, the odds of quitting increased by about 24% (OR=1.24, 95%CI: 1.06 – 1.46). No literacy skills were associated with becoming a regular smoker or current amount smoked. Conclusion The ability to locate, understand and use information related to the risks of smoking may impact one’s decision to quit. Messaging should be designed with the goal of being easily understood by all individuals regardless of literacy level

Patients' Literacy Skills: More Than Just Reading Ability

Limited literacy contributes to suboptimal care and outcomes for patients. The Institute of Medicine noted that future work in health literacy should consider multiple literacy skills. However, lacking empirical evidence of the relationship between different literacy skills, reading skills are often used as proxies of literacy in research and practice. Using a community-based sample of 618 individuals residing in Boston, MA and Providence, RI, we conducted a principal component analysis on measures of four literacy skills: reading, numeracy, oral (speaking) and aural (listening) to examine whether and to what extent literacy can, or should, be represented by a single measure. The first principal component represented overall literacy and could only explain 60% of the total variation in literacy skills within individuals. The second principal component differentiated between numeracy/reading and the oral/aural exchange. While reading and numeracy best represent overall literacy, patients’ relative strengths may vary. Those with moderate reading ability may have high oral and aural language skills. Conversely, people who have difficulties speaking with or understanding a provider may read well. Effective communication with patients should rely on both the oral exchange and written health information, and not rely on a single literacy skill

"It Was as Though My Spirit Left, Like They Killed Me": The Disruptive Impact of an HIV-Positive Diagnosis among Women in the Dominican Republic.

An HIV diagnosis may be associated with severe emotional and psychological distress, which can contribute to delays in care or poor self-management. Few studies have explored the emotional, psychological, and psychosocial impacts of an HIV diagnosis on women in low-resource settings. We conducted in-depth interviews with 30 women living with HIV in the Dominican Republic. Interviews were audio-recorded, transcribed, and analyzed using the biographical disruption framework. Three disruption phases emerged (impacts of a diagnosis, postdiagnosis turning points, and integration). Nearly all respondents described the news as deeply distressful and feelings of depression and loss of self-worth were common. Several reported struggling with the decision to disclose-worrying about stigma. Postdiagnosis turning points consisted of a focus on survival and motherhood; social support (family members, friends, HIV community) promoted integration. The findings suggest a need for psychological resources and social support interventions to mitigate the negative impacts of an HIV diagnosis

Understanding the Public Health Implications of Prisoner Reentry in California: Phase I Report

Analyzes the healthcare needs of released state prisoners, their geographic distribution, the healthcare services available locally, and counties' capacity to meet returning prisoners' needs, including for mental health care and substance abuse treatment

Top occupations of study participants, % (n).

1<p>Refers to housework for one's own household, not domestic household work for others. Women tended to report this occupation as being an “<i>ama de casa</i>”, or housewife. Men tended to report this occupation as “<i>labores de casa</i>”, or housework.</p>2<p>Includes work as a domestic employee, food and drink service, gardening, sewing, washing clothes, childcare, transportation, etc.</p>3<p>Includes both entrepreneurial or employer-based commerce.</p>4<p>Includes construction, recycling, laborer-for-hire, etc.</p>5<p>Includes medical/nursing positions, as well as being an HIV peer counselor.</p>6<p>Includes artisans, painters, and actors.</p>7<p>Includes industrial mechanic, garment manufacturer, factory worker, etc.</p