Overlap of HIV and low health literacy in the southern USA

exterior, view of facade, ca. 198

Effect of Media Use on HIV/AIDS-Related Knowledge and Condom Use in Sub-Saharan Africa: A Cross-Sectional Study

<div><p>It is known that the level of HIV/AIDS-related knowledge and the degree of condom use varies by socioeconomic status (SES). However, there is limited research on the effect of mass media use on HIV/AIDS-related cognitive and behavioral outcomes in low-income countries and how it might influence the association between SES and HIV-related outcomes. We investigated the moderating effect of media use on the relationship between SES and HIV/AIDS-related knowledge and condom use in sub-Saharan Africa in terms of communication inequalities. Cross-sectional data from the Demographic Health Surveys from 13 sub-Saharan countries (2004–10) were pooled. Gender-stratified multivariable poisson regression of 151,209 women and 68,890 men were used to calculate adjusted relative ratios and 95% confidence intervals for the associations between SES, media use, HIV-related outcomes, and condom use. We found significant disparities in mass media use among people from different SES groups as well as among countries. Education and wealth are strongly and positively associated with awareness of HIV/AIDS and knowledge about transmission and prevention of HIV/AIDS and are significantly associated with condom use. These associations are attenuated when the use of various types of mass media is added to the models, with newspapers showing the strongest effect. The findings of this study suggest that media use has the potential to blunt the impact of socioeconomic status though not completely eliminate it. Thus, we need to pay attention to reducing communication inequalities among social groups and countries to moderate the effect of wealth and SES on HIV/AIDS.</p></div

Distribution of HIV/AIDS-related knowledge and condom use by sub-Saharan African countries (%).

<p>Note: Sample weight % used; unweighted count data (n) presented.</p

General characteristics of the sample.

<p>Note: Sample weight % used; unweighted count data (n) presented.</p

Relative risk (RR) and 95% confidence interval (CI) of socioeconomic and media use characteristics with HIV/AIDS-related knowledge and condom use among sub-Saharan Africa countries in the 2004∼2010 Demographic Health Survey (Women).

<p>Note: All models are additionally adjusted for age, gender, marital status, rural/urban location, literacy level, occupation, countries and survey year.</p><p>All the figures in bold have a p-value of <0.01.</p

Neurocircuitry of disgust and anxiety in obsessive-compulsive disorder : a positron emission tomography study

Background: Disgust and fear are basic emotions that have different elicitors and expressions, and that appear to be mediated by different neurocircuits. Although obsessive-compulsive disorder (OCD) is classified as an anxiety disorder, disgust may be involved in its pathogenesis. Functional magnetic resonance imaging (fMRI) studies of disgust-inducing visual stimuli in OCD have suggested disorder specific alterations in brain activation during these tasks. Methods: Subjects with OCD and healthy controls (HC) underwent positron emission tomography (PET) brain scanning after injection of H2 15O. During PET, subjects either watched slides designed to evoke feelings of disgust (OCD = 5, HC = 11), expected the delivery of an electrical shock (OCD = 11, HC = 13), or rested (OCD = 11, HC = 14). After the anticipatory anxiety and resting tasks, anxiety ratings, heart rate, and electrodermal measures were obtained. Statistical parametric mapping (SPM) was used to analyze regional cerebral blood flow (rCBF) data. Results: Comparison of OCD subjects with controls on differences in rCBF across the disgust-inducing and resting tasks showed that OCD was characterized by greater rCBF in the left insula. In OCD the disgust-inducing task increased right lateral orbitofrontal cortex rCBF compared to resting, whereas in controls there was no difference in rCBF between these tasks. Anxiety ratings, heart rate, and electrodermal activity increased during anticipatory anxiety in both groups, and comparison of rCBF in OCD subjects with controls in anticipatory anxiety versus resting state also found no significant differences. Conclusions: OCD may be characterized by a disruption in disgust processing, such that there is a decrease in appropriate disgust (such as that evoked by observing disgust in others) and an increase in inappropriate disgust (such as that evoked by contamination stimuli). The insula may play a particularly important role in mediating such putative disruptions. The sample studied here was small, and further work is required to determine whether disgust-induced activation patterns in OCD are more apparent in specific subtypes of this disorder, whether they are specific to OCD, and whether they are normalized by treatment

Antibiotic Prescribing for Uncomplicated Acute Bronchitis Is Highest in Younger Adults

Reducing inappropriate antibiotic prescribing is currently a global health priority. Current guidelines recommend against antibiotic treatment for acute uncomplicated bronchitis. We studied antibiotic prescribing patterns for uncomplicated acute bronchitis and identified predictors of inappropriate antibiotic prescribing. We used the Epic Clarity database (electronic medical record system) to identify all adult patients with acute bronchitis in family medicine clinics from 2011 to 2016. We excluded factors that could justify antibiotic use, such as suspected pneumonia, COPD or immunocompromising conditions. Of the 3616 visits for uncomplicated acute bronchitis, 2244 (62.1%) resulted in antibiotic treatment. The rates of antibiotic prescribing were similar across the years, p value for trend = 0.07. Antibiotics were most frequently prescribed in the age group of 18–39 years (66.9%), followed by the age group of 65 years and above (59.0%), and the age group of 40–64 years (58.7%), p value &lt; 0.001. Macrolides were significantly more likely to be prescribed for younger adults, while fluoroquinolones were more likely to be prescribed for patients 65 years or older. Duration of antibiotic use was significantly longer in older adults. Sex and race were not associated with antibiotic prescribing. Our findings highlight the urgent need to reduce inappropriate antibiotic use for uncomplicated acute bronchitis, particularly in younger adults

The potential of smartphone apps in informing protobacco and antitobacco messaging efforts among underserved communities : longitudinal observational study

People from underserved communities such as those from lower socioeconomic positions or racial and ethnic minority groups are often disproportionately targeted by the tobacco industry, through the relatively high levels of tobacco retail outlets (TROs) located in their neighborhood or protobacco marketing and promotional strategies. It is difficult to capture the smoking behaviors of individuals in actual locations as well as the extent of exposure to tobacco promotional efforts. With the high ownership of smartphones in the United States-when used alongside data sources on TRO locations-apps could potentially improve tobacco control efforts. Health apps could be used to assess individual-level exposure to tobacco marketing, particularly in relation to the locations of TROs as well as locations where they were most likely to smoke. To date, it remains unclear how health apps could be used practically by health promotion organizations to better reach underserved communities in their tobacco control efforts.Published versio