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Research indicates that women remain less financially prepared for retirement than are men. Little research has examined the gender difference in use of retirement plans. The present research assessed the gender difference in use of employer-sponsored and private retirement plans, and sought to account for this difference. Social status and human capital factors, occupation and industry of employment, and sense of financial self-efficacy were expected to account for gender differences. Findings indicated gender has no relationship with use of private retirement plans. However, females were found to be less likely to use an employer-sponsored plan, and this was largely accounted for by gender differences in occupation. [ABSTRACT FROM AUTHOR]

The attitudes of 111 ninth and eleventh graders and both of their biological parents were independently assessed for prejudice against people with HIV/ AIDS, homosexuals, Blacks, and fat people, as well as for male and female sex role stereotyping. This study corrected for two shortcomings in previous research: neglecting to assess both parents and assessing only a single domain of prejudice. We addressed the intergenerational transmission of prejudice and stereotyping using three competing models: same-sex, parent equivalent, and differential effects. Using multiple regressions in which parents' scores were entered separately, along with control variables, different maternal and paternal influences were detected. Mothers were the primary influence for prejudice regarding HIV/AIDS, fatness, and race, and fathers were the primary influence for male and female stereotyping and prejudice against homosexuals, supporting the differential effects model. We also established that prejudice and stereotyping in specific domains reflected a more general proclivity to be intolerant. In contrast to prejudice and stereotyping in specific domains, fathers and mothers about equally shaped the adolescents' intolerance, supporting the parent equivalent model. [ABSTRACT FROM AUTHOR]

Congregations are well positioned to address HIV in their communities, but their response to HIV has been mixed. An emerging literature describes HIV programming in urban, predominantly black congregations, but population-based data remain limited. This study examined the levels of HIV prevention and counseling programs and associated factors (e.g., religious, organizational) by using data from a phone census of congregations in the Greater Cincinnati area (N = 447). Over 10 % of congregations (36 % of Black Protestant and 5-18 % of other types of congregations) offered HIV education/prevention alone or in combination with counseling or with counseling and testing. Path analysis results showed notable significant (p < 0.05) total effects of theology-polity on HIV prevention/counseling programs, but these effects were fully mediated by other factors, including other community work and racial composition. The levels of HIV programming in this study were high by national standards, but further outreach is needed in high-risk African American communities.

A decade ago, an expert panel developed a framework for measuring spirituality/religion in health research (Brief Multidimensional Measure of Religiousness/Spirituality), but empirical testing of this framework has been limited. The purpose of this study was to determine whether responses to items across multiple measures assessing spirituality/religion by 450 patients with HIV replicate this model. We hypothesized a six-factor model underlying a collective of 56 items, but results of confirmatory factor analyses suggested eight dimensions: Meaning/Peace, Tangible Connection to the Divine, Positive Religious Coping, Love/Appreciation, Negative Religious Coping, Positive Congregational Support, Negative Congregational Support, and Cultural Practices. This study corroborates parts of the factor structure underlying the Brief Multidimensional Measure of Religiousness/Spirituality and some recent refinements of the original framework.

Objective: To examine the role of blame as a mediator of the relationships between perceiver age and gender and children's acceptance of an overweight peer., Design: Cross-sectional study of children's perceptions of their overweight peers using structural equation modeling., Participants: Two hundred and ninety-one children between the ages of 3 and 11 years., Measurements: Children viewed a videotape of a same-sex peer, dressed to appear overweight, interacting with an adult. After viewing the videotape, children responded to items assessing their perceptions of the child's social and emotional traits and how much the child was to blame for being overweight.Results:Confirmatory factor analysis indicated that the traits loaded on a single factor, acceptance., Results: of analyses for our structural equation model indicated that as blame increased, acceptance of the peer decreased. The relationships between gender and blame and gender and acceptance were not significant. Children were categorized into three age groups (3-4, 5-8 and 9-11 years) to examine the influence of age. Children between 5 and 8 years of age were less likely to blame the model compared with younger and older children., Conclusion: Preschoolers reported the lowest acceptance, indicating a need for intervention for children in this age range. Furthermore, it will be important to conduct longitudinal studies to determine the influence of interventions as the child passes through different developmental stages.

The extent to which measures of working memory, cognitive speed, and verbal retrieval are associated with performance on tests of olfaction was evaluated in a sample of 138 older adults. Structural equation modeling techniques indicated that verbal retrieval difficulties significantly affect performance on the University of Pennsylvania Smell Identification Test (UPSIT). Further, poor working memory and slow cognitive speed significantly affect performance on the UPSIT and the phenyl ethyl alcohol threshold test. The Sniff Magnitude Test was not influenced by any of the cognitive variables. Odor threshold and identification tasks may overestimate olfactory loss when cognitive impairment is not taken into account.

Background: Spirituality/religion is an important factor in health and illness, but more work is needed to determine its link to quality of life in patients with HIV/AIDS., Objective: To estimate the direct and indirect effects of spirituality/religion on patients' perceptions of living with HIV/AIDS., Design: In 2002 and 2003, as part of a multicenter longitudinal study of patients with HIV/AIDS, we collected extensive demographic, clinical, and behavioral data from chart review and patient interviews. We used logistic regression and path analysis combining logistic and ordinary least squares regression., Subjects: Four hundred and fifty outpatients with HIV/AIDS from 4 sites in 3 cities., Measures: The dependent variable was whether patients felt that life had improved since being diagnosed with HIV/AIDS. Spirituality/religion was assessed by using the Duke Religion Index, Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being-Expanded, and Brief RCOPE measures. Mediating factors included social support, self-esteem, healthy beliefs, and health status/health concerns., Results: Approximately one-third of the patients felt that their life was better now than it was before being diagnosed with HIV/AIDS. A 1-SD increase in spirituality/religion was associated with a 68.50% increase in odds of feeling that life has improved--29.97% due to a direct effect, and 38.54% due to indirect effects through healthy beliefs (29.15%) and health status/health concerns (9.39%). Healthy beliefs had the largest effect on feeling that life had improved; a 1-SD increase in healthy beliefs resulted in a 109.75% improvement in feeling that life changed., Conclusions: In patients with HIV/AIDS, the level of spirituality/religion is associated, both directly and indirectly, with feeling that life is better now than previously. Future research should validate our new conceptual model using other samples and longitudinal studies. Clinical education interventions should focus on raising awareness among clinicians about the importance of spirituality/religion in HIV/AIDS.

Objectives: To describe a method for quantifying headache symptoms/features in family practice charts for patients diagnosed with headache NOS (not otherwise specified, ICD-9: 784) and to determine the share of NOS headache diagnoses with clinical data strongly suggestive of migraine or probable migraine headache., Background: Headache is one of the most common pain symptoms that brings patients to a family physician. However, the majority of headache sufferers do not receive a specific headache diagnosis when they visit physicians., Methods: We examined the chart notes of 454 patients exclusively diagnosed with one or more ICD-9 coded headache NOS diagnoses from July 1, 1995 through December 31, 1999 at a large suburban, university-affiliated practice. We developed a template containing 20 headache items combining International Headache Society diagnostic criteria and additional headache symptoms/features, and decision rules for coding symptoms/features and collected data from patient charts. We then developed decision rules and reclassified NOS headaches into categories strongly suggestive of migraine, probable migraine headache, or other diagnosis. Our main outcome measure is the consistency in the application of decision rules and diagnostic criteria., Results: With this method we estimate 3 in 10 (29%) headache NOS patients may have had migraine (8%) or probable migraine headache (21%). Reclassified migraine visits averaged 6.5 migraine symptoms and reclassified probable migraine headache visits 4.7 migraine symptoms. Logistic regression analysis supports the consistency of diagnostic criteria for classifying headache based on coded symptoms/features--our model correctly predicted 96% of visits. Evidence of physical examination was recorded at 75% of visits suggesting that physician attention is focused on elimination of secondary headache., Conclusions: We think the use of our rigorous procedures reveals that a substantial amount of migraine and probable migraine headache may be missed in everyday practice. We hope our findings will provide a basis for the development of diagnostic methods more closely suited to the needs of nonspecialists, and contribute to a better standard of care for headache patients seen in primary care practice. Finally, we are hopeful that other researchers will consider using our template and guideline procedures in their efforts to identify diagnostic patterns and study headache and other health problems.

Because alcohol is a known teratogenic substance that negatively affects the fetus, screening for alcohol use is included in maternal child texts for nurses. They present no standard screening approach, however. In the general literature, a multitude of screening instruments exist for the purpose of detecting maternal alcohol dependence but few allow the nurse to detect fetal alcohol exposure in the absence of maternal alcohol dependence. After a comparative analysis of existing screening instruments, we concluded that the Timeline Followback method has the most utility as a screening instrument to detect fetal exposure to alcohol. The purpose of this article is to present a critical review of current screening instruments related to alcohol consumption in pregnant women and to propose the use of the Timeline Followback method as the preferred approach.

The food neophobia scale [FNS; Appetite 19 (1992) 105] has been used to assess willingness to try new foods in studies conducted around the world. Although it is tempting to compare FNS scores across these studies, appropriate psychometric analyses are required to validate the scale and allow cross-cultural comparisons. These analyses were pursued in the current study using confirmatory factor analysis in conjunction with a data analysis strategy described by Steenkamp and Baumgartner [J. Consumer Res. 25 (1998) 78] and random, representative samples drawn from the United States, Sweden and Finland. A unidimensional scale was constructed using eight of the original 10 items from the FNS, and this model provided an excellent fit to the data from the US and Swedish samples. An acceptable fit was achieved for six items when data from the US, Sweden and Finland were used. Based on these analyses, we recommend that two items from the original FNS be dropped (items 5 and 9). Elimination of additional items may be premature given the potential contributions of difference in sampling and testing methodology associated with data collection from the three samples. Future efforts to develop a FNS for cross-national comparisons should target the development of a scale with 14-16 items so that dropping several items from a model (due to translation or other problems) allows retention of a sufficient number of items to insure a robust test. However, even with only six items, our results supported the conclusion that people from Sweden are generally more willing to try novel foods as compared to people from the US and Finland. Future studies should focus on the source of this enhanced willingness to try novel foods among the Swedes and the potential use of this information in the development of programs aimed at facilitating dietary change.

Alcohol is a known teratogenic substance that operates under a dose-response mechanism. Before we conducted a larger study that examines the use of alcohol both before pregnancy and during pregnancy, it was important to pilot our method for measuring a pregnant mother's alcohol use that would allow us to capture the number of drinks consumed per day while addressing recall bias. The purpose of this study was 1) to pilot the Time Line Followback (TLFB) method developed by Sobell and Sobell (1992, Measuring Alcohol Use. Totowa, NJ: Humana Press) as a method for examining alcohol use during pregnancy and 2) to determine if the use of a study protocol that included biological markers of alcohol use would affect our ability to recruit subjects. Using a descriptive design, we tested our protocol for collecting alcohol use data with 10 mothers receiving prenatal care. We measured alcohol use using the TLFB method (Sobell and Sobell, 1992, Measuring Alcohol Use. Totowa, NJ: Humana Press, 1996). We also collected collected biological blood markers for heavy alcohol use. Of the 10 maternal subjects we recruited, 5 mothers (50%) reported alcohol use during pregnancy. We successfully recruited 10 out of 11 mothers approached and had a 100% retention rate for the second interview. The TLFB method is viable for measuring fetal alcohol exposure over the pregnancy, and the collection of blood samples did not impact our ability to recruit or retain mothers.

Objectives: To examine the number of visits involving a headache diagnosis among patients to four family practice sites between July 1, 1995 and December 31, 1998., Background: Although the majority of care-seeking headache sufferers are seen in the primary care setting, few studies have attempted to document the relationship between type of headache as diagnosed by the family practice physician, and number of the patient's headache visits. Design.-Secondary analysis of administrative claims data., Methods: We compared headache visits per person-year by the age and sex of patient among patients classified according to headache diagnosis received: tension-type only; headache not otherwise specified (NOS) only; migraine only; tension-type and headache NOS; tension-type and migraine; headache NOS and migraine, and migraine, tension-type, and headache NOS. Patients with an International Classification of Diseases (version 9) code of 346 were considered to have a diagnosis of migraine, with 307.81 representing tension-type headache, and 784 representing headache NOS. Age was measured from date of birth to initial visit in the study period and patients were subdivided into 5-year age groups. Person-years "at risk" for each diagnosis was measured from the time of initial visit during the study period to December 31, 1998., Results: We examined data from 4112 patients who made 9322 visits with a headache diagnosis. We found that the average number of visits per person-year increases as the number of different types of headache diagnoses increased and were greatest for patients having migraine as opposed to headache NOS and tension-type diagnoses., Conclusions: Headache type is an important predictor of the number of office visits involving a headache diagnosis in family practice. Patients with multiple headache diagnoses have more visits. Patients with combinations of headache diagnoses involving migraine are the most frequent visitors.

Purpose: To construct and estimate a model that contains a reciprocal relationship between smoking and drinking and to test whether the gateway drug thesis or the cumulative risk behaviors thesis best fits the data., Methods: Data (n = 630) are from a survey of all students (50% female; aged 16.2 years on average; 2.4 grade point average; and 57% residing in homes with both mother and father present) in a rural, tobacco-growing county's two high schools, one public (85%) and one private, in 1993. The survey was conducted by the schools as part of their alcohol and other drugs (AOD) prevention programs and was coordinated by the county AOD Council. Students completed the questionnaires in their homerooms. Endogenous predictors of drinking and smoking include student's perception of adult drug behavior, peer pressure to drink, degree to which their friends' drink, and attitudes toward drinking and smoking. Path coefficients were estimated by using LISREL., Results: The strong correlation between smoking and drinking resulted from shared causes, rather than from the effects of one type of drug use on the other. Approval of drinking had the strongest association with being a drinker (beta =.57) and with being a smoker (beta =.37). Those who found smoking offensive were less likely to be a smoker (beta = -.25). However, attitude toward smoking was not associated with being a drinker. Having drinking friends increased both the likelihood of being a drinker (beta =.29) and of being a smoker (beta =.23). Peer pressure to drink increased the likelihood of being a smoker (beta =.14) and of being a drinker (beta =.12). Students with lower grade point averages, males, older students, students in public school, and students with family structures other than both parents living in the same household were more likely to be a drinker and were more likely to be a smoker., Conclusions: Our results support the cumulative risk behaviors thesis. The link between both high-risk behaviors, smoking and drinking, results from common causes rather than from drinking leading to smoking.

Migration adds a complex dimension to the task of those who plan and allocate resources for health care. The authors offer a methodology for estimating the contribution of migration to the incidence of cancer, allow for age- and sex-specific cancer risks, and estimate, by country, the impact of recent migration on the annual incidence of cancer in Florida. Cancer and migration data were used to develop estimates of the number of cancer cases for Florida counties that were attributable to recent migrants. A net gain and loss ratio was calculated for new cancer cases in 1980 resulting from the 1975-80 migration pattern. Florida data was used because that State has one of the highest crude cancer incidence rates in the nation, is one of the most populous States, and has a population growth from migration rather than from natural increase. Preliminary findings on the relationship between cancer health services resources and net cancer rates from migration are discussed. County cancer health services resources had a strong positive relationship to population size, but the impact of migration on cancer incidence was in a curvilinear relationship to population size.