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.     

Organizing for Homeland Security after Katrina: Is Adaptive Management What’s Missing?

This article analyzes performance and organizational issues revealed by the governmental response to Hurricane Katrina. It reviews and analyzes the organizational changes made in the federal government to address homeland security and presents several proposals for reorganization suggested by policy makers in the aftermath of Katrina. A management approach rooted in adaptive management is presented for use in the ongoing process of organizing for homeland security.     

The Israel and Palestine land settlement problem, 1948–2005: An analytical history

This paper traces the history of the current conflict between Israel and Palestine from 1948–2005 C.E. It focuses on the frontier conflict between Israel and Palestine, a conflict that has resulted in four major wars during the post-Second World War period, and that has left Israel as the occupying power over a large swathe of territory not allocated to it by the United Nations in 1947. It outlines the nature of the refugee problem in Palestine and neighboring Arab states, and defines the political problems posed both by relative Israel-Palestine population growth, and by the `right to return’ claim by ousted Palestinian Arabs. It reviews the political problems posed by religious extremism and theocratic government both in Israel and Palestine. It concludes with a brief discussion of the unpleasant alternatives left as the road map to peace disintegrates and outlines a preferred solution from the perspective of the advanced western nations.     

A Good Place to Bury Bad News? Hiding the Detail in the Geography on the Labour Party’s Website

But actually, he thought as he re–adjusted the Ministry of Plenty's figures, it was not even forgery. It was merely the substitution of one piece of nonsense for another. Most of the material that you were dealing with had no connexion with anything in the real world, not even the kind of connexion that is contained in a direct lie. Statistics were just as much a fantasy in their original version as in their rectified version.