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PURPOSE: This formative research study describes the development and preliminary evaluation of a theory-guided, online multimedia psycho-educational program (PROGRESS) designed to facilitate adaptive coping among prostate cancer patients transitioning from treatment into long-term survivorship. METHODS: Guided by the Cognitive-Social Health Information Processing Model (C-SHIP) and using health communications best practices, we conducted a two-phase, qualitative formative research study with early stage prostate cancer patients (n = 29) to inform the Web program development. Phase 1 included individual (n = 5) and group (n = 12) interviews to help determine intervention content and interface. Phase 2 employed iterative user/usability testing (n = 12) to finalize the intervention. Interview data were independently coded and collectively analyzed to achieve consensus. RESULTS: Survivors expressed interest in action-oriented content on (1) managing treatment side effects, (2) handling body image and comorbidities related to overweight/obesity, (3) coping with emotional and communication issues, (4) tips to reduce disruptions of daily living activities, and (5) health skills training tools. Patients also desired the use of realistic and diverse survivor images. CONCLUSIONS: Incorporation of an established theoretical framework, application of multimedia intervention development best practices, and an evidence-based approach to content and format resulted in a psycho-educational tool that comprehensively addresses survivors' needs in a tailored fashion. IMPLICATIONS FOR CANCER SURVIVORS: The results suggest that an interactive Web-based multimedia program is useful for survivors if it covers the key topics of symptom control, emotional well-being, and coping skills training; this tool has the potential to be disseminated and implemented as an adjunct to routine clinical care.

Rural communities, compared with their urban counterparts, have higher rates of disease and adverse health conditions, fueling disparities in health outcomes. This encourages the need for effective curricula to engage students and enable them to address such disparate health outcomes as imminent health professionals. Incorporating learner-centered teaching strategies, such as collaboration and power-sharing, into public health (PH) courses can enhance student learning and help faculty enable future health professionals to address needs of rural, underserved populations. Successfully engaging students to explore issues related to rural health disparities in their education, research, and training can thereby advance PH practice. This paper describes the collaborative efforts of five PH faculty, an instructional designer, and administrators to develop a learner-centered curriculum for a newly launched PH program in a rural Midwestern United States (US) university.

Book Reviews 125 All of the above and more are detailed by Claerbaut. He also covers Michigan State’s program as it went into decline in the late 1960s. Daugherty began to miss on the recruiting trail. At the same time, African American students and athletes on campuses across the nation more vocally joined the civil rights protest movement. It was a difficult period for Daugherty, who never sought credit for his progressive attitudes of providing black athletes equal opportunities. One of his responses was to break more barriers with black assistant coaches. Sherman Lewis, Daugherty’s first Underground Railroad All-American as a halfback from Louisville, Kentucky, joined the MSU staff in 1969. Raye was hired part time in 1971 and full time in 1972. Raye and Lewis went on to the National Football League as assistant coaches and offensive coordinators. A consequence of Daugherty doing what was right without seeking credit allowed myths surrounding a 1970 game matching USC and the University of Alabama to usurp his far more significant role. That is reason to link Daugherty with the words of David Maraniss, the Pulitzer Prizewinning biographer, who wrote, “History writes people out of the story. It’s our job to write them back in.” Thus, until that national trip-wire is no longer stepped over and subsequently triggered, the more the merrier to rightly place Daugherty’s story back into history. Tom Shanahan Author, Raye of Light Anna Clark. The Poisoned City: Flint's Water and the American Urban Tragedy. New York: Metropolitan Books, 2018. Pp. 305. Index. Notes. Cloth: $30.00. Journalist Anna Clark provides a gripping, thought-provoking, and comprehensive account of the people who caused, suffered from, and exposed the Flint water crisis. Clark’s brilliant story reminds us of the farreaching , devastating effects of lead exposure and that safe, high-quality drinking water is essential to good health. Clark meticulously details how corruption, recklessness, and arrogance of public officials, prejudice, and greed characterized the crisis in Flint. The Poisoned City is divided into three parts, each subdivided into several chapters. Part one reviews how water that blessed the indigenous Ojibwa people would eventually curse Flint residents. We learn how industrialization coincided with mistreatment and development of waterways. Vast, ferocious Lake Huron served as Flint’s freshwater 126 The Michigan Historical Review source for nearly 50 years. Amid financial distress, Flint switched to the Flint River water system in April 2014. The new water treatment program lacked corrosion control, breaking federal law. Adding to Flint’s woes were exorbitant water and sewer bills, an aging water infrastructure, and decreased federal funding. Clark also describes the federal government’s alarming apartheid approach to city building. Vicious, systematic tactics prolonged residential segregation and created multigenerational housing inequalities. Desegregation triggered a large-scale departure of whites. In 2014, General Motors (GM) workers noticed water-corroded engine parts. People wondered what it did to the inside of humans. Part two discusses the damaging health effects of and countless sources of exposure to lead. We meet longtime GM research director and leaded gasoline creator Charles Kettering. We gain insight into leaded gasoline’s profitability, Flint’s re-engineering to favor automobiles, fierce rebuttals to decries of lead hazards, ethical burdens of proving lead toxicity, the lead industry’s massive lobbying, and victim-blaming in response to residents’ concerns. Clark discusses loopholes in lead restriction policies, manipulation of lead testing, and a trend of childhood lead poisoning in shrinking cities. We learn how biochemist Marc Edwards, veteran journalist Curt Guyette, regulations manager Miguel Del Toral, pediatrician Mona Hanna-Attisha, and local residents rallied to spur a movement to urge governmental action. We also see effects of a very expansive law signed in 2011 that gave emergency managers unyielding power. Part three details the switch back to Detroit water in October 2015 and the flawed, hasty decision-making of untrustworthy leaders. Governor Rick Snyder declares a state of emergency in January 2016 and announces a two-year Legionnaire’s disease outbreak. Declaration of a federal emergency in Flint follows. A myriad of lawsuits, rebuttals, indictments, and pushbacks ensues. Apologies are offered, promises are made, and secrecy and injustices proliferate. Sadly, accountability...

Objective: To describe faculty efforts to deliver and evaluate health disparities–related education in US online undergraduate and graduate public health courses. Design: A pre- and post-survey was given to a cohort of 46 US college students in three public health courses taught asynchronously online over an 8-week period in 2017. This study took place at a mid-sized, public, rural, midwestern US university. Method: Faculty received professional development and online training and were assigned to develop courses for a new public health programme. Following the receipt of ethical approval, students completed anonymous, online pre- and post-surveys to assess effect of intentional instructional approaches on their knowledge and attitudes about health disparities. Curricula incorporated various assessment methods and teaching strategies. Descriptive statistics were used to compare pre- and post-survey scores and analyse demographic data. Paired t-tests and one-way analysis of variance were used to analyse pre- and post-survey test scores. Results: At post-survey, students demonstrated a positive change in mean scores for several items, including for ability to discuss the role of theory in understanding health behaviour and disparities in health status (3.20 vs 4.06; p < .001) and ability to discuss strategies health promotion programmes can use to reduce health disparities (3.47 vs 4.40; p < .001). Post-survey response rate was 87%. Conclusion: Results suggest an effective way to increase health disparities knowledge among online college students. Additional research is encouraged to expand upon these findings.

Preventable differences in health outcomes between U.S. population subgroups, related to factors such as race or ethnicity, income, and geographic location, are troubling. Geographically, rural American communities experience higher rates of adverse health conditions when compared with urban areas, further widening disparities in health outcomes. Such disparities necessitate the creation of effective curricula to enable students to address the health needs of underserved populations. By intentionally incorporating health disparities awareness content into the curricula, undergraduate and graduate public health programs can play an integral role in developing conscious health practitioners to help close gaps in health outcomes. Moreover, rural health courses may increase students’ interest in rural health careers. This article presents the process and results of faculty efforts to design and deliver health disparities–related education in undergraduate and graduate public health courses at a rural Midwestern U.S. university. Various teaching development programs inspired faculty to use intentional instructional approaches to teach students about health disparities. Consequently, faculty incorporated a variety of assessment methods and teaching styles to infuse health disparities awareness content into public health courses. Results from students’ course evaluations and reflections are discussed along with lessons learned and implications for future pedagogical directions.

Abstract It is clear that there is an increasing proportion of the United Kingdom (UK) population who are suffering with food allergies and this combined with an increase in the frequency of eating away from home (where there is less control over the content of food) poses a significant risk. In December 2014, the European Union (EU) introduced legislation which aimed to ensure that customers with food allergens could make informed choices and safely consume food, without the risk of a potentially life-threatening reaction. The research used semi-structured interviews with staff from a BCB, located in the North West of the UK, as the aim of the research was to explore food handlers’ knowledge, attitudes and understanding of food allergens. The findings of the semi-structured interviews identified five themes: E-learning training programmes: the staff felt that these were ineffective and did not take into account individual learning styles. Responsibility: there is a lack of clarity as to who is responsible, with staff believing the key responsibility lies with the customer. Communication: similarly, communication, both within the kitchen and within the company was not clear and likely to give rise to confusion. Need to make a profit: the staff felt that the drive for profit meant that customer safety was being compromised, especially when staff numbers were reduced. Staff awareness: the staff felt confident in their own ability to prepare a safe meal but indicated that staff may be dismissive towards claims of allergen sufferers. In conclusion, these themes illustrate that a significant risk exists for allergen suffers, who rely upon the knowledge, attitudes and understanding of BCB staff to ensure their meals are safely prepared.

The sabbatical focus was a qualitative study with sexual assault survivors related to current health status.

Objectives: Assess the association of helmet use with motorcycle crash mortality and identify characteristics of riders who do not wear helmets in Connecticut crashes. Methods: Police crash data for Connecticut motorcycle crashes 2001-2007 were analyzed. Bivariate analysis and multivariable logistic regressions were performed including age, gender, seating position, road type, season, time of day, and recklessness. Results: Of the 9,214 crashes with helmet use data available, helmets were worn in 4,072 (44.2%). Non-helmeted riders, age > 18, riding interstate or state roads, in the evening or at night, and whowereridingrecklesslywere associated withhigher odds of fatality. Predictors of nonhelmet use included males, passengers, age <18 or 30 to 59, and riding in the summer, evening or at night, and on US, state, and local roads. Conclusion: Current crash data affirm that helmets reduce fatal crashes in Connecticut. A set of factors help predictnon helmeted riders to whom safety training could be targeted.

Introduction: Like medicine, public health practitioners seek to understand causes of mortality, practices of humans and issues that can change population conditions, in order to preserve and care for life. The murder pandemic has been such in Jamaica that the World Bank sponsored a qualitative study on crime in urban areas in Jamaica in the late 1990s to provide a platform to guide policy intervention and programmes. As a result this study will fill the gap in the literature by providing the evidence to support that divorce and marriage are public health concerns from the perspective of murders. Objective: To evaluate the role of divorce and marital relationships on murders. Materials and methods: The data for this study are taken from various Jamaica Government Publications. The period for this work is from 1950 through 2013. Data were recorded, stored and retrieved using the Statistical Packages for the Social Sciences (SPSS) for Windows, Version 21.0. The level of significance that is used to determine statistical significance is less than 5% (0.05). Ordinary least square (OLS) regression analyses and curve estimations were used to determine models and best fitted models. Results: On average, annually, 523 Jamaicans are murdered (± 484), with there being 9,531 marriages (±22,747) and 904 divorces (±468). Logged marriage rate and divorce rate are factors of murder rate, with both independent factors accounting for 82.2% of the variability in the murder rate. Both factors are positively correlated with the murder rate, with the divorce rate accounting for most of the variance in the murder rate (R2 = 79.2%). Conclusion: Death can be extremely devasting to families, however, murder among married couples can severely disrupt the lives of both families along with any children from such relationship. © 2014, Chevron Publishing Corporation. All rights reserved.

Purpose: Evaluate five different recruitment strategies for their capacity to enroll and retain both healthy and vulnerable older adults as part of a multiyear influenza vaccination study. Methods: We analyzed recruitment methods and other characteristics of individuals who participated in or were considered for five sequential one-year studies. Results: Of 940 screened individuals, 820 met eligibility criteria with 795 enrolled over the five-year study (307 primary participants). Among these enrollees, 63.4% were female and 95.5% were white, with mean ages of 75.3 (older group) and 30.6 (younger group). More than a half (56.7%) of the participants enrolled more than once, participating an average of 2.56 (SD=1.6) times. The majority (81.9%) of individuals recruited each year were return participants identified during earlier recruitments. Physician referrals resulted in only 5.3% recruitments. Conclusions: Recruitment and retention of study subjects, especially older adults, was facilitated by the existence of a database listing past participants.

Introduction: The educational system of Jamaica is designed whereby performance is assessed based on formal evaluation (or test). This test culture places immense pressure on students at the primary level to successful complete some examinations in order for placement into select schools. Objectives: The present study seeks to evaluate psychological stress among students who take the G.S.A.T examination in the Corporate Area schools in Jamaica and assess whether psychological stressors influence academic performance. Methods: For this research, mixed methodology was employed to investigate the phenomenon of stressors among students who took the 2013 G.S.A.T examination. For the survey instrument (questionnaire), the large volume of data were stored, retrieved and analyzed using the Statistical Packages for the Social Sciences (S.P.S.S) for Windows version 21.0 (SPSS Inc; Chicago, IL, USA). Findings: The overall academic performance of the surveyed respondents was high (75.8 ± 19.4; 95% CI: 72.4- 79.2), with students in the preparatory school (92.4 ± 4.1) outperformed those in the primary school (71.0 ± 19.4)- t-test =10280, P < 0.0001. The level of stress experienced by those in the public school was greater (29.9 ± 6.0; 95% CI: 28.9 - 30.1) than those in the private school (26.0 ± 3.9; 95% CI: 24.5- 27.4- t-test=-3.300, P=0.001). Five factors determine overall academic performance: 1) stress level, 2) parental involvement, 3) school type, 4) nervous on taking the first G.S.A.T examination and 5) school choice (traditional or non-traditional high school). The five factors accounted for 35.8 percentage points of the variance in overall academic performance (Adjusted R2). Conclusion: Parental involvement is crucial in academic performance among students who took the 2013 G.S.A.T examination and students experienced moderately high stress, which offers some insight in the examination and the information can be used to better guide policy formulation. © 2015 Bourne PD, et al.

Background: For millennia, women with multiple sexual partners have been labeled and stigmatized as whores, prostitutes, promiscuous and commercial sex workers. However, there is little literature comprehensively addressing factors related to reproductive health in this group. Aim: The aim of the current study is to elucidate the reproductive health matters of women who have multiple sexual partners. Setting and design: The data use for this research is taken from the Jamaica Reproductive Health Survey, 2007. Stratified random sampling is used to design the sampling frame. Materials and Methods: The current study extracts a sample of 225 respondents (from 7,168 women ages 15-49 years) who indicate having had multiple sex partners. Statistical analysis used: Data are analyzed using the Statistical Packages for the Social Sciences for Windows, Version 21.0. Multiple logistic regressions were used to analyze factors that explained current method of contraception. Results: Women with multiple sex partners on average are involved with men at least 9.5 years their senior, and 72% of them have become pregnant. Currently, contraception use can be explained by social class (middle class, Odds ratio (OR) = 0.08, 95% CI= 0.01 – 0.59); age at first sexual intercourse (OR = 0.90, 95% CI = 0.68 – 1.21); employment status (employed, OR = 5.07, 95% CI = 1.06 – 24.36); and marital status (married or common-law, OR = 0.09, 95% CI = 0.02 – 0.38). Conclusion: The early sexual initiation among young women is a public health problem because of the increased incidence of teenage pregnancy and increased incidence of sexually transmitted diseases, which must be addressed with the same intensity and resource allocation used to fight against Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome (HIV/AIDS). © 2015, Chevron Publishing Corporation. All rights reserved.

Background: The bullying phenomenon, an aspect of aggression, has gained attention in many countries thus making it a very important issue in schools. Many studies have been done on this issue resulting in deeper analysis and review on the matter because the matter covers physical, verbal or psychological acts of aggression that may be intentional, and, which may occur once or repeated over time. Objectives: This study seeks to examine the following research questions: 1) How is bullying manifested in grades 4-6 in primary schools identified for this study?; 2) What are the specific bullying behaviours exhibited by class bullies in grades 4-6?; 3) How does the behavior of bullies affect the conduct of classes?; 4) What are the characteristics of the students who are targeted by in-class bullies?, and 5) What strategies are currently used by the teachers to deal with bullying in class? Materials and Methods: Two hundred students were conveniently identified (n = 200) for the study in the three schools of which 153 participated in the survey (i.e., response rate of 76.5%). The sample comprises of pupils in grades 4, 5 and 6, which 67 pupils in grades 4 and 5, and 66 in the 6th grade. Likewise 50 students ages 9, 10, 11 and 12 years were recruited for participation, with the least respondents being ages 9 years (46%) and the most being 11 years old (94%). Results: The principals and guidance counselor reported that the bullying phenomenon is a daily occurrence at their schools and that on a daily basis they are called upon to address at least 3 cases and a maximum of 10 cases of bullying. All the parents in this study noted that the bullying phenomenon is widespread in primary schools in St. Thomas and that schools are now considered an unsafe environment. Of the 26 surveyed parents in this research, 92.3% indicated that ‘schools are no longer fun for children to be anymore because of the bullying phenomenon. Conclusion: Now there is empirical evidence that the bullying phenomenon is creating psychological issues that extend beyond the aggressor to those around him/her. The psychology of the bullying phenomenon is far-reaching more than a social issue and as such clearly the psychology of the matter is crying out for public health efforts and/or intervention in Jamaica. © 2015, Chevron Publishing Corporation. All rights reserved.

Since the advent of medical treatments for HIV, the promotion of adherence to these difficult treatment regimens has proven critical to disease management. Three Connecticut state-funded HIV medication adherence programs were evaluated. The purpose of this process evaluation was to explore and compare the goals and modality of each adherence program, assess client and staff satisfaction, and provide recommendations for the improvement of these programs. Focus group interviews with clients and individual interviews with staff were conducted at each of the programs. Interviews were transcribed, coded, and analyzed with a code-and-retrieve method of theme identification. Focus group themes included the importance of social support on medication adherence and the “lifesaving” effect the program has had. The staff expressed that although complete adherence should be the long-term objective, more intermediate objectives should be considered (e.g., behavioral changes to increase clients’ ability, selfesteem, and self-efficacy to take medications). © 2014, 2011, 2008, 2005, 2003, 2001 by Taylor & Francis.