PubMed · 10111059
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1991. A Chinese volunteer program.. https://pubmed.ncbi.nlm.nih.gov/10111059/
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Asian and Pacific Islander (API) children in the United States have high rates of hepatitis B virus (HBV) infection (1-3). To prevent these infections, hepatitis B vaccination has been recommended for these children since the vaccine was first licensed by the Food and Drug Administration in 1981 (4). Recommendations have included universal hepatitis B vaccination of API infants beginning in 1990 and catch-up vaccination for API children aged <7 years (5). These recommendations were reinforced in 1991 when hepatitis B vaccination was recommended for all infants, particularly in populations such as API children with high rates of early childhood HBV infection (6). In 1995, vaccination was recommended for unvaccinated API children aged <11 years and catch-up vaccination for children aged 11-12 years who had not received hepatitis B vaccine (HepB) (7). Series completion among API children aged 19-35 months increased from 39% in 1994 to 88% in 1997 (8). However, among older API children, hepatitis B vaccination coverage was 10% in 1995 (7). In 1998, to examine trends in hepatitis B vaccination catch-up coverage among API children born before 1994, surveys were conducted in six U.S. cities. This report summarizes the results of the surveys, which indicate varying coverage among API children and suggest a need for continued focused vaccination programs for this population.
This study examined cultural differences in the expression and meaning of physical closeness. Findings indicated that immigrant-Chinese parents, as compared with Euro-American parents, sleep in closer proximity with their children; more often view independence as children growing with the family; are more likely to emphasize the family unit; and place greater importance on inhibition of expression, adherence to correct values, and hierarchy of relations. Euro-Americans, by contrast, are more accepting of nudity; place more emphasis on psychological benefits of physical closeness and on the child's expression of wants and feelings; more often view independence as celebrating the child's distinctiveness; and place greater importance on intimacy, pleasure, and spousal exclusiveness. The authors suggest that closeness is characterized by an overarching theme of harmony in immigrant-Chinese families and by an overarching theme of romance in Euro-American families.
OBJECTIVE: To determine patient and provider characteristics associated with increased risk of nondetection of mental health problems by primary care physicians. DESIGN: Cross-sectional patient and physician surveys conducted as part of the Medical Outcomes Study. PARTICIPANTS: We studied 19,309 patients and 349 internists and family physicians. MEASUREMENTS AND MAIN RESULTS: We counted "detection" of a mental health problem whenever physicians reported, in a postvisit survey, that they thought the patient had a mental health problem or that they had counseled or referred the patient for mental health. Key independent variables included patient self-reported demographic characteristics, health-related quality of life (HRQOL), depression diagnoses according to the Diagnostic and Statistical Manual of Mental Disorders, and physician demographics and proclivity to provide counseling for depression. Logistic regression analysis, adjusted for HRQOL, revealed physicians were less likely to detect mental health problems in African Americans (odds ratio [OR], 0.63; 95% confidence interval [CI], 0.46 to 0.86), men (OR, 0.64; 95% CI, 0.54 to 0.75), and patients younger than 35 years (OR, 0.61; 95% CI, 0.44 to 0.84), and more likely to detect them in patients with diabetes (OR, 1.4; 95% CI, 1.0 to 1.8) or hypertension (OR, 1.3; 95% CI, 1.1 to 1.6). In a model that included DSM-III diagnoses, odds of detection remained reduced for African Americans as well as for Hispanics (OR, 0.29; 95% CI, 0.11 to 0.71), and patients with more-severe DSM-III diagnoses were more likely to be detected. Physician proclivity toward providing counseling for depression influenced the likelihood of detection. CONCLUSIONS: Patients' race, gender, and coexisting medical conditions affected physician awareness of mental health problems. Strategies to improve detection of mental health problems among African Americans, Hispanics, and men should be explored and evaluated.