American journal of preventive medicine
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The ethical problems that surrounded the Tuskegee Syphilis Study prompted widespread public criticism when they first surfaced in 1972; the Tuskegee Study remains an important case in bioethics. We recently examined public health student knowledge of the ethical significance of the Tuskegee Study as part of an ethics curriculum needs assessment at Tulane University. A brief questionnaire was administered to 236 graduate students currently enrolled in seven epidemiology courses. ⋯ However, this important case stands as an exemplar of the potential for ethical abuses in human subjects research. Such cases ought to be highlighted in public health curricula. Medical Subject Headings (MeSH): blacks, African Americans, educational curriculum, epidemiology, ethics, public health, racism.
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During the last decade, the decline in cardiovascular disease mortality slowed among African Americans, compared to the general population. Hypertension control is likely to play an important role in determining these trends. The Maywood Cardiovascular Survey provides estimates of the prevalence, awareness, treatment, and control of hypertension among African Americans. ⋯ Rates of hypertension awareness, pharmacologic treatment, and control on pharmacologic treatment are higher in this sample of African Americans than among African Americans in NHANES II and are comparable to those in NHANES III. The impact of nonpharmacologic treatments on control needs further consideration. Medical Subject Headings (MeSH): hypertension, nonpharmacologic treatment, African-American males.
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The population of uninsured and underinsured individuals in the United States continues to grow, compounding problems of adequate access to medical care. Some of the medical needs of this population are met by community health centers (CHCs). However, CHCs often have difficulty recruiting and retaining physicians, especially those with skills in community medicine. ⋯ Thus far, all graduates have remained involved in community-based medical care and preventive medicine activities for medically underserved populations. This training arrangement can serve as a model for other preventive medicine residency programs and for CHCs interested in enhancing physician recruitment and retention. Medical Subject Headings (MeSH): community-oriented preventive medicine, medically uninsured, preventive medicine residency training, community health centers.
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In the majority of episodes of fatal interpersonal violence, the weapon used is a firearm. Amid frequent reports of youths carrying weapons, including firearms, we conducted a case-control study to identify risk factors for being charged with gun-carrying and gun-carrying, per se, among adolescents in Jefferson Parish, Louisiana. Cases were defined as incidents of gun-carrying among adolescents < 19 years of age, legally charged in the Jefferson Parish, Louisiana, juvenile court from January 1, 1992, through April 15, 1993. ⋯ Gun-carrying control subjects were significantly more likely than non-gun-carrying control subjects to report their school not safe, having seen a shooting, using marijuana, and having fired a gun (OR = 9, 95% CI = 1, 82.1; OR = 7, 95% CI = 1.3, 38.2; OR = 6.8, 95% CI = 1.8, 25.5; and OR = 17, 95% CI = 1.8, 156.6, respectively). We found that gun-carrying was very common, and that adolescent youths who carry guns were more likely to have familiarity with guns and experience with or perception of an unsafe environment. Together, these lead to the conclusion that gun-carrying is a common response of youths who live in a risky environment, who do not have the social support to learn how to deal effectively with that risk, and who have access to guns, which they think may provide them with some protection.