This publication consists of papers prepared for a conference held at the Academy for Contemporar... more This publication consists of papers prepared for a conference held at the Academy for Contemporary Problems in Columbus Ohio March 22-29 1974. The main topic of the conference was the migration of over three million people from the Appalachian region of the United States to the cities of the South East and Midwest (ANNOTATION)
It is probable that humans were first infected with HIV in the Kinshasa region of the Democratic ... more It is probable that humans were first infected with HIV in the Kinshasa region of the Democratic Republic of the Congo in the 1950s and yet many decades later we are still studying and discovering how best to control what has become a global epidemic. One of the epicenters of the disease was in Miami when people with symptoms that were inexplicable in their particular populations became of interest to clinicians and scientists. This was occurring in other major cities, which also became the epicenters for this strange and destructive disease. This chapter highlights the history of one local region of the United States, Miami-Dade County, Florida and exemplifies the global problem. This chapter will indicate how local teams of scientists were called into action to address the impending epidemic. This is an example of how modern science can mobilize scientific teams that discover the origins and consequences of a highly complex disease. Eventually from that, scientific and medical foundations began to develop interventions for the control of HIV/AIDS and its related consequences.
Prevalence rates of HIV infection acquired through heterosexual contacts have risen steadily sinc... more Prevalence rates of HIV infection acquired through heterosexual contacts have risen steadily since 1982. Crack cocaine smokers are at particular risk of HIV infection due to heterosexual exposure. HIV risk reduction interventions seeking to increase condom use among drug users have met with minimal success, and there is a need for interventions to be strongly grounded in psychosocial models of behaviour change. This study presents the results of an investigation of predictors of intention to use condoms and related therapy processes among heterosexual drug users. Data were analyzed from 586 crack smokers recruited in Washington, DC, Miami, Florida, and Collier County, Florida who reported having both primary and casual sex partners. Participants responded to items derived from the theory of reasoned action, the theory of planned behaviour and the transtheoretical model of change. Condom use beliefs and therapy processes used to initiate and maintain condom use were assessed. Outcome expectancies and normative beliefs were the strongest predictors of intention to use condoms with a primary sexual partner. In turn, beliefs that condoms inhibit sexual romance and decrease sexual pleasure strongly predicted outcome expectancies. Therapy processes found to be associated with these constructs included: self-liberation, counter conditioning and stimulus control/reinforcement. Results suggest that HIV risk reduction interventions using a group format and targeting condom beliefs related to sexual romance and pleasure will decrease negative outcome expectancies about condom use. Also, reinforcing attempts to use condoms with intimate partners should increase positive outcome expectancies and intention to initiate or maintain condoms with a primary sexual partner.
Abstract 1. Describes a demonstration project in Miami that uses an experimental research design ... more Abstract 1. Describes a demonstration project in Miami that uses an experimental research design to evaluate an acquired immune deficiency syndrome (AIDS) intervention program among iv drug users and the sexual partners of iv drug users. At the time of the initial ...
The authors provide a review of the economic evaluation literature of breast cancer screening and... more The authors provide a review of the economic evaluation literature of breast cancer screening and identify important trends and gaps in the literature. Healthcare resources are limited and economic evaluation plays a critical role in resource allocation, healthcare policy, and clinical decisions. Many economic evaluations of medical practice, however, are unreliable and do not use appropriate analytic techniques. Three important trends were observed. First, two economic evaluation methods are dominant. Second, a wide range of cost estimates exists across studies. Third, a lack of standardization exists across studies with regard to basic economic evaluation principles. These findings should be considered when conducting future research, analyzing economic evaluations of breast cancer screening, and developing clinical guidelines. Concerns about cost containment in healthcare make it necessary for physicians and clinical administrators to take an active role in resource allocation de...
Archivum immunologiae et therapiae experimentalis, 1995
In the United States, a major federally-funded approach to HIV-1 prevention for injecting drug us... more In the United States, a major federally-funded approach to HIV-1 prevention for injecting drug users (IDUs) includes teaching them to always rinse their needles/syringes with household bleach and water before use. This report describes interdisciplinary studies of the extent to which HIV-1 can be found in injection equipment and the efficacy of bleach as a disinfectant, under simulated field conditions. Bloody needle/syringe units collected from Miami, Florida, shooting galleries or from community outreach prevention participants were selected for these studies. Groups of needle/syringe units were cleansed with bleach using a standard technique taught to IDUs in community outreach programs. Cleansed and uncleansed groups of needles/syringe units were then tested for the presence of HIV-1. The data demonstrate the efficacy of bleach rinses in reducing the risks of HIV-1 infection from needle/syringe units and indicate that the teaching of a bleach cleansing method to IDUs should be p...
In Florida, prostate cancer continues to be an increasing public health problem, especially among... more In Florida, prostate cancer continues to be an increasing public health problem, especially among the elderly and medically underserved. Bilingual, random-digit-dialed telephone interviews were conducted with 897 men who were 65 years and older in Dade and Hillsborough counties, with the sample stratified along racial and ethnic lines. The purpose of the survey was to obtain information regarding knowledge, attitudes, practices, and beliefs about prostate cancer, its prevention, and early detection. More than 60% of the 897 respondents believed that a person with prostate cancer had an 80% or greater chance for cure, yet only 67% reported ever having a digital rectal examination. Black (35.7%) and Hispanic respondents (42.5%) were twice as likely to have never had a digital rectal examination than were their white counterparts (19.8%). When asked why they had never had this examination or had not had one in the past 2 years, 38.5% replied that it was "not needed/not necessary&q...
This publication consists of papers prepared for a conference held at the Academy for Contemporar... more This publication consists of papers prepared for a conference held at the Academy for Contemporary Problems in Columbus Ohio March 22-29 1974. The main topic of the conference was the migration of over three million people from the Appalachian region of the United States to the cities of the South East and Midwest (ANNOTATION)
It is probable that humans were first infected with HIV in the Kinshasa region of the Democratic ... more It is probable that humans were first infected with HIV in the Kinshasa region of the Democratic Republic of the Congo in the 1950s and yet many decades later we are still studying and discovering how best to control what has become a global epidemic. One of the epicenters of the disease was in Miami when people with symptoms that were inexplicable in their particular populations became of interest to clinicians and scientists. This was occurring in other major cities, which also became the epicenters for this strange and destructive disease. This chapter highlights the history of one local region of the United States, Miami-Dade County, Florida and exemplifies the global problem. This chapter will indicate how local teams of scientists were called into action to address the impending epidemic. This is an example of how modern science can mobilize scientific teams that discover the origins and consequences of a highly complex disease. Eventually from that, scientific and medical foundations began to develop interventions for the control of HIV/AIDS and its related consequences.
Prevalence rates of HIV infection acquired through heterosexual contacts have risen steadily sinc... more Prevalence rates of HIV infection acquired through heterosexual contacts have risen steadily since 1982. Crack cocaine smokers are at particular risk of HIV infection due to heterosexual exposure. HIV risk reduction interventions seeking to increase condom use among drug users have met with minimal success, and there is a need for interventions to be strongly grounded in psychosocial models of behaviour change. This study presents the results of an investigation of predictors of intention to use condoms and related therapy processes among heterosexual drug users. Data were analyzed from 586 crack smokers recruited in Washington, DC, Miami, Florida, and Collier County, Florida who reported having both primary and casual sex partners. Participants responded to items derived from the theory of reasoned action, the theory of planned behaviour and the transtheoretical model of change. Condom use beliefs and therapy processes used to initiate and maintain condom use were assessed. Outcome expectancies and normative beliefs were the strongest predictors of intention to use condoms with a primary sexual partner. In turn, beliefs that condoms inhibit sexual romance and decrease sexual pleasure strongly predicted outcome expectancies. Therapy processes found to be associated with these constructs included: self-liberation, counter conditioning and stimulus control/reinforcement. Results suggest that HIV risk reduction interventions using a group format and targeting condom beliefs related to sexual romance and pleasure will decrease negative outcome expectancies about condom use. Also, reinforcing attempts to use condoms with intimate partners should increase positive outcome expectancies and intention to initiate or maintain condoms with a primary sexual partner.
Abstract 1. Describes a demonstration project in Miami that uses an experimental research design ... more Abstract 1. Describes a demonstration project in Miami that uses an experimental research design to evaluate an acquired immune deficiency syndrome (AIDS) intervention program among iv drug users and the sexual partners of iv drug users. At the time of the initial ...
The authors provide a review of the economic evaluation literature of breast cancer screening and... more The authors provide a review of the economic evaluation literature of breast cancer screening and identify important trends and gaps in the literature. Healthcare resources are limited and economic evaluation plays a critical role in resource allocation, healthcare policy, and clinical decisions. Many economic evaluations of medical practice, however, are unreliable and do not use appropriate analytic techniques. Three important trends were observed. First, two economic evaluation methods are dominant. Second, a wide range of cost estimates exists across studies. Third, a lack of standardization exists across studies with regard to basic economic evaluation principles. These findings should be considered when conducting future research, analyzing economic evaluations of breast cancer screening, and developing clinical guidelines. Concerns about cost containment in healthcare make it necessary for physicians and clinical administrators to take an active role in resource allocation de...
Archivum immunologiae et therapiae experimentalis, 1995
In the United States, a major federally-funded approach to HIV-1 prevention for injecting drug us... more In the United States, a major federally-funded approach to HIV-1 prevention for injecting drug users (IDUs) includes teaching them to always rinse their needles/syringes with household bleach and water before use. This report describes interdisciplinary studies of the extent to which HIV-1 can be found in injection equipment and the efficacy of bleach as a disinfectant, under simulated field conditions. Bloody needle/syringe units collected from Miami, Florida, shooting galleries or from community outreach prevention participants were selected for these studies. Groups of needle/syringe units were cleansed with bleach using a standard technique taught to IDUs in community outreach programs. Cleansed and uncleansed groups of needles/syringe units were then tested for the presence of HIV-1. The data demonstrate the efficacy of bleach rinses in reducing the risks of HIV-1 infection from needle/syringe units and indicate that the teaching of a bleach cleansing method to IDUs should be p...
In Florida, prostate cancer continues to be an increasing public health problem, especially among... more In Florida, prostate cancer continues to be an increasing public health problem, especially among the elderly and medically underserved. Bilingual, random-digit-dialed telephone interviews were conducted with 897 men who were 65 years and older in Dade and Hillsborough counties, with the sample stratified along racial and ethnic lines. The purpose of the survey was to obtain information regarding knowledge, attitudes, practices, and beliefs about prostate cancer, its prevention, and early detection. More than 60% of the 897 respondents believed that a person with prostate cancer had an 80% or greater chance for cure, yet only 67% reported ever having a digital rectal examination. Black (35.7%) and Hispanic respondents (42.5%) were twice as likely to have never had a digital rectal examination than were their white counterparts (19.8%). When asked why they had never had this examination or had not had one in the past 2 years, 38.5% replied that it was "not needed/not necessary&q...
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