Predictors of depression among refugees from Vietnam: a longitudinal study of new arrivals.

The present study examined the impact of prearrival traumatic experiences and sociodemographic characteristics on future depression among Vietnamese and Chinese refugees from Vietnam. This is a longitudinal study of newly arrived refugees from Vietnam undergoing a mandatory health screening. A stratified consecutive sample of ethnic Chinese and ethnic Vietnamese refugees was drawn.

Social dominance and 22-year all-cause mortality in men.

Objective: Research findings suggest that, in addition to hostility, social dominance-related variables may be related to morbidity and mortality. The purposes of the present study were to evaluate a) whether pressured social dominance (defined as a pattern of structured-interview-defined characteristics of verbal competition, immediateness of response, and fast speaking rate) was related to long-term health outcomes, namely, all-cause mortality, and b) whether individuals characterized by other patterns of structured-interview-derived characteristics also varied in terms of mortality.

Method: The present study represents an analysis of the data from the 22-year mortality follow-up of 750 men from the Western Collaborative Group Study.

Depressive affect and survival among gay and bisexual men infected with HIV.

Background: Although depression has been related to chronic disease processes and outcomes, studies examining the relationship between depression and disease progression in persons with human immunodeficiency virus (HIV) infection have produced inconsistent results.

Objective: To investigate whether depressive affect is associated with HIV mortality.

Methods: This was a prospective cohort study (San Francisco Men's Health Study) using a population based probability sample of single men living in areas of San Francisco, Calif, with high case rates of acquired immunodeficiency syndrome.

Lack of independent relationships between left ventricular mass and cardiovascular reactivity to physical and psychological stress in the Coronary Artery Risk Development in Young Adults (CARDIA) Study.

The objective of this study was to determine whether exaggerated blood pressure (BP) reactivity to stress and psychosocial characteristics are related to left ventricular mass (LVM) in a large cohort of young adults. Analyses were conducted with 3,742 participants of the CARDIA study (945 white men, 1,024 white women, 781 black men, and 992 black women), evaluated in 1990 to 1091 with echocardiographic measurement of LVM. Analyses were stratified by gender and race.

Psychosocial factors and plasma lipids in black and white young adults: the Coronary Artery Risk Development in Young Adults Study data.

These analyses examined the relationship between fasting plasma lipids and several psychosocial factors in a healthy cohort of 5115 black and white men and women between the ages of 18 and 30. Primary analyses were performed within race/gender subgroups and were supplemented with analyses examining consistency of associations across these groups. After controlling for age, high density lipoprotein (HDL) decreased, triglycerides increased, low density lipoprotein (LDL) increased, and the total cholesterol/HDL cholesterol ratio increased with increasing level of education in black men.

See one, do one, teach one? House staff experience discussing do-not-resuscitate orders.

Background: Medical residents commonly discuss resuscitation decisions with hospitalized patients. Previous studies suggest that the quality of these discussions is poor.

Objective: To learn about residents' experience with do-not-resuscitate (DNR) discussions and their attitudes toward them.

Television viewing and cardiovascular risk factors in young adults: the CARDIA study.

Cross-sectional associations between self-reported hours of television (TV) viewing per day and cardiovascular risk factors were assessed in a biracial (black and white) study population of 4280 men and women, ages 23 to 35 years, undergoing the year-5 follow-up examination for the Cardiovascular Risk Development in Young Adults (CARDIA) study in 1990 to 1991. Number of hours of TV viewing per day was higher in blacks than in whites and was inversely associated with education and income. Relative to "light" TV viewers (0 to 1 h/d), "heavy" TV viewers (> or = 4 h/d) had a higher prevalence (P < 0.

Resilience and vulnerability among preschool children: family functioning, temperament, and behavior problems.

Objective: To examine the effects of child temperament and stressful family functioning on child behavior problems among preschool children.

Method: One hundred forty-five preschool children, aged 2 to 5 years, were evaluated by teachers, mothers, and independent observers. Teachers reported on child temperament; from these ratings, two dimensions of temperament were derived: difficult/easy and approachability.

Postbereavement depressive mood and its prebereavement predictors in HIV+ and HIV- gay men.

Prebereavement predictors of the course of postbereavement depressive mood were examined in 110 gay men who were their partner's caregiver until the partner's death of AIDS. In all, 37 HIV+ and 73 HIV- bereaved caregiving partners were assessed bimonthly throughout a 10-month period beginning 3 months before and ending 7 months after the partner's death. Throughout the 10 months, mean Centers for Epidemiology Scale-Depression (CES-D) scores on depressive mood were above the cutoff for being at risk for major depression.

Dimensions of psychobiologic reactivity: Cardiovascular responses to laboratory stressors in preschool children.

Individual differences in children's physiologic responses to environmental stressors may be responsible for significant, but modest, associations found in past studies between stress and various morbidities. Because no standardized approach currently exists for eliciting and measuring cardiovascular reactivity (CVR) to laboratory stressors in preschool children, we developed a laboratory-based reactivity protocol that derives three dimensions of CVR-intensity, variability, and attenuation-and collected reliability data for each. A sample of 137 children between the ages of three and five years completed a series of seven devel-opmentally challenging tasks, comprising interpersonal, cognitive, and fine motor problems.

Relationship of optimism, knowledge, attitudes, and beliefs to use of HIV antibody testing by at-risk female adolescents.

This study's purpose was to examine the extent to which optimism, knowledge, attitudes, and beliefs predict use of HIV testing services in a group of at-risk female adolescents. We prospectively interviewed 124 consecutive girls engaging in risky behaviors before regularly scheduled pediatric clinic appointments at a large urban HMO. Subjects completed a self-report questionnaire assessing optimism (Scheier's Life Optimism Test, or LOT), HIV-related knowledge, beliefs, and behaviors before their regular visit.

The consequences of a positive prenatal HIV antibody test for women.

As more women of childbearing age are affected by the human immunodeficiency virus (HIV), many providers have demanded routine perinatal HIV screening, arguing that the medical benefits of testing outweigh the socioeconomic, medical, and psychological risks of a positive HIV test for women. In this primarily urban poor population, we used a semistructured interview to evaluate differences in health care discrimination, economic losses, risk behaviors, relationships changes, and psychological status in 20 HIV-positive and 20 HIV-negative mothers matched for HIV risk, race, income, and delivery date. Many (35%) seropositive and no seronegative women cited health care discrimination due to HIV status.

Psychobiologic reactivity to stress and childhood respiratory illnesses: results of two prospective studies.

Psychological stress is thought to undermine host resistance to infection through neuroendocrine-mediated changes in immune competence. Associations between stress and infection have been modest in magnitude, however, suggesting individual variability in stress response. We therefore studied environmental stressors, psychobiologic reactivity to stress, and respiratory illness incidence in two studies of 236 preschool children.

How do medical residents discuss resuscitation with patients?

Objective: To describe how medical residents discuss do-not-resuscitate (DNR) orders with patients.

Design: Prospective observational study.

Setting: Inpatient medical wards of one university tertiary care center, one urban city public hospital, and one Veterans Affairs medical center.

Clinical, immunologic, and virologic observations related to human immunodeficiency virus (HIV) type 1 infection in a volunteer in an HIV-1 vaccine clinical trial.

A vaccine breakthrough occurred in a phase 1 clinical trial of a human immunodeficiency virus (HIV) type 1 candidate subunit vaccine. The vaccine antigen, gp120SF2, is a fully glycosylated protein produced in mammalian cells from the HIVSF2 isolate. After 4 immunizations, the subject developed neutralizing antibodies and lymphoproliferative responses to the gp120 protein.

Women and health: in search of a paradigm.

The growing interest in women and health is resulting in an expanding number of important issues and invested disciplines. In this article, we propose a framework to serve as a guide for organizing themes and integrating competing approaches to the field of women's health. Our framework is illustrated through a multilevel circular model that graphically represents the evolving nature of the field.

Adherence to zidovudine (AZT) among HIV-infected methadone patients: a pilot study of supervised therapy and dispensing compared to usual care.

Twenty-seven HIV-infected methadone maintenance patients who demonstrated problems adhering to zidovudine (AZT) were randomly assigned to a group that received eight weeks of weekday supervised therapy and dispensing of AZT or a group that received usual care of the clinic. Adherence was assessed by self-report, erythrocyte mean corpuscular volume (MCV), Medication Event Monitoring Systems (MEMS), and pill counts. Subjects in the intervention group demonstrated significantly higher MCV levels during the intervention period than usual care subjects, with similar but non-significant trends for the three other adherence measures.

Perseverance pays off: health care providers' impact on HIV testing decisions by adolescent females.

Background And Objective: Although HIV counseling and testing of adolescents has increased rapidly in recent years due to increasing HIV seroprevalence rates, little is known about adolescents' use of HIV testing services. The aims of this study were to determine what proportion of high risk adolescent girls would use confidential HIV testing services linked to primary care and to explore the characteristics, beliefs, and experiences that distinguish those teenage girls who obtain HIV testing in this setting from those who do not.

Design: Prospective cohort study.