Factors Associated with Physician Discussion of Health Behaviors with Adolescents

Behaviors developed in adolescence influence health later in life. The purpose of this study was to investigate the frequency of health care provider's discussion of health behaviors with overweight and non-overweight adolescents and identify demographic and health behaviors related to exercise, hours of television viewing, and weight issues associated with these discussions. A Cross sectional survey of urban adolescents was conducted. Trained interviewers administered surveys over a three month period in 2001 at an urban academic pediatric and adolescent clinic. The 252 adolescents surveyed had a mean age of 15 with 49% categorized as being at risk for overweight/overweight and 51% as normal weight using the CDC percentiles for BMI. While 16% of the adolescents reported that their physician or nurse discussed the amount of television they watched, rates of discussion related to exercise (58%), and weight (54%) were much higher. In multivariate analyses, health care provider discussions with adolescents regarding exercise were more common for overweight (O.R.=2.42, 95% C.I. [1.28–4.57]) and at risk for overweight (O.R.=1.98, 95% C.I. [1.03–3.81]) adolescents, whereas physician discussion of television viewing was not associated with weight. Discussions of weight were more common for female (O.R.=2.18, 95% C.I. [1.21–3.95]), African-American (O.R.=2.53, 95% C.I. [1.40–4.57]), and overweight (O.R.=3.92, 95% C.I. [1.97–7.81]) adolescents. Even after adjusting for weight, race and gender strongly influenced the frequency of discussions about weight in physician offices. Although health care providers frequently address weight and exercise with adolescents, more discussions related to sedentary behaviors such as television viewing may be warranted to address adolescent obesity.Received PhD in Epidemiology from University of California, San Diego. Research interests include smoking prevention and cessation among adolescents and health promotion interventions.Received MD from University of Missouri-Kansas City and MPH from Johns Hopkins University. Research interests include health services research and research in support of measurable, systematic improvements in the quality of medical care.Received medical degree from Christian Medical College, Punjab, India and Master of Public Health from University of Kansas School of Medicine. Research interests include diet and physical activity behaviors, role of the environment in obesity and obesity prevention, especially among children and adolescents.Received MBBS from Allama Iqbal Medical College, Punjab University, Lahore, Pakistan and MPH from University of Kansas Medical Center. Research interests include smoking cessation, database design, implementation, data management and analysis, and use of information technology in health care settings.Director, Cancer Prevention, Control, and Population Sciences, Kansas Cancer Institute. Received MD/MPH from Tulane University and MS from Harvard School of Public Health. Research interests include disparities in healthcare; smoking cessation among underserved populations, specifically African Americans; diet, nutrition, obesity, and physical activity.     

Assessing the Impact of Bureaucracy Bashing by Electoral Campaigns

The literature on the implications of electoral "bureaucracy bashing" for public management is thin. This is partly because of the difficulty of defining basic terms and measuring results in meaningful ways. Using focus group data, this article explores how senior federal managers perceive campaign bureaucracy bashing and assess its consequences. The participants perceive that candidate-based bashing affects federal management on two levels: one emotional, the other programmatic. The emotional impact is pronounced, producing frustration and hostility from senior managers toward political candidates, political appointees, and the media. Senior managers report that bashing adversely affects policy implementation through low morale, poor recruitment, and training and by fostering an environment of distrust toward bureaucracy. Grounded in a diverse literature relating to public administration, the presidency, campaigns and elections, and political communication, this inquiry finds that senior managers confirm many of the speculations these works raise about how bashing affects public employees and public policy.     

Locke on the Moral Basis of International Relations

This article aims to focus analysis of Locke's theory of international relations away from the familiar discourse of sovereignty and natural law and toward a different discourse involving self-government and international society. It argues that Locke's conception of international society balanced interrelated, overlapping, and even competing claims about sovereignty and natural law in a normative framework in which the right of self-government replaced the principle of sovereignty as the moral basis of international relations. Thus, for Locke the norms deduced from the law of nature govern the international state of nature even as independent societies remain the primary executors of the law of nature in international society. The article concludes by considering how Locke's reflections on international relations may contribute to our understanding of contemporary debates about sovereignty, the use of force, and the ethics of intervention.     

State Poverty Rates: Do the New Welfare Policies Make a Difference?

This article uses four models to identify the best predictors of state poverty levels and changes in state poverty rates since the implementation of welfare reform. The policy decisions based on the Personal Responsibility and Work Opportunity Reconciliation Act (PRWORA) by the states are tested along with more traditional variables identified in the literature. Using several measures of state poverty, the analysis finds that those states with the lowest poverty rates are those with the healthiest economies, and the most generous state spending on Temporary Assistance for Needy Families (TANF). States with the highest percentage of their TANF rolls made up of black citizens tend to have the highest rates of poverty. Initial poverty rates are found to be important in that states with higher initial poverty levels are capable of generating a larger reduction in poverty than states with lower initial rates. With the exception of limited evidence on sanctions, none of the PRWORA–based policies were found to have any effect on poverty rates.     

Intersectoral differences in public affairs: the duty of public reporting in public administration

Public reporting is a requirement for public affairs practitioners in public administration because of the democratic context in which government operates. By reporting to the public‐at‐large on agency activities, government agencies contributed to an informed citizenry, the essential foundation of a democracy. For public affairs in business administration and non‐profit administration, public reporting is desirable rather than mandatory. Public reporting was traditionally accomplished indirectly, through news media coverage of government. However, recent research suggests a diminution of interest by the media in fulfilling its role as an instrument of democracy. This means that the public reporting obligation of public affairs professionals in public administration needs to shift to direct reporting, through such products as annual reports, newsletters, TV programmes, Internet websites etc. Copyright © 2002 Henry Stewart Publications.     

Pharmacopoeia – a collaboration between the textile artist Susie Freeman and the general practitioner Liz Lee

In this article I describe the development of my collaboration with the textile artist Susie Freeman in the production of the visual arts project Pharmacopoeia. Over the last 3 years we have created a body of work that aims to provide information about common medical treatments in a way that engages the public imagination. The work is dominated by the use of active pharmaceuticals, both pills and capsules, which are incorporated into dramatic fabrics by a process known as pocket knitting. These fabrics are then made into clothing and accessories, making their individual messages easier to ‘read’. The work aims to encourage people to think about their own medical and pharmacological history, and to reflect on their relationship with commonly prescribed drugs. It also reveals how dependent our society is on pharmaceuticals, how ambivalent we feel about them and yet how casually we use them.     

Dimensions of self-esteem and psychological symptoms among chinese adolescents in Hong Kong

Self-esteem and psychological symptoms were assessed in a sample of 1082 Chinese adolescents who responded to the Chinese versions of Coopersmith's Self-Esteem Inventory and the General Health Questionnaire. Three dimensions of self-esteem, interpreted as Family Acceptance/Rejection, Self-Depreciation, and Peer Affirmation/Disaffirmation, were found to relate substantially to general psychological symptoms and particularly to specific symptoms of anxiety, social dysfunction, and depression as reported by these adolescents. The implications of the relative importance of appraisal from internal feedback as sources of self-esteem as opposed to the external feedback from family and peers were discussed in relation to self-esteem enhancement in adolescents.Received his Ph.D. from the University of Western Ontario in 1978. His research interests include self-esteem, stress, coping, health and psychopathology.Received her Ph.D. from the University of South Dakota in 1983. Her research interests include stress, coping and health, and geriatric psychology.     

Age estimation by occlusal tooth wear

The purpose of the present investigation was to test the accuracy of a new scoring system in recording tooth wear for age estimation. The material consisted of dental stone casts of 383 volunteers who had sound premolars and molars with normal occlusion. The degree of occlusal wear for all premolar and molar teeth was scored with the new system. The high intra- and inter-examiner concordances showed that the new score system was very reliable. The degree of tooth wear showed a significant positive correlation with age in each and every examined tooth of both males and females. Tooth wear scores of males were higher than those of females. Calculating tables for age estimation were designed and the accuracy of age estimation was obtained with the General Linear Models procedures. Our system could provide estimation of an individual's age within +/-3 years in 42.4% of males and 49.4% of females, within +/-5 years in 61.8% of males and 63.3% of females. When the subjects were divided into two age groups and data were re-treated, the accuracy of age estimation was increased. Collectively, it was shown that our new system for scoring tooth wear is a reliable and accurate method for age estimation.