Faculty Bibliography

This study describes the severity, alcohol consumption, consequences, readiness to change, and coping behaviors of African-American and white primary care patients enrolled in a trial of brief interventions for problem drinking. In multivariate analysis, unemployment but not race was associated with clinical indicators of alcohol problems. African-Americans reported no difference in alcohol consumption and similar quality of life scores. African-American race and unemployment were both associated with increased identification and resolution of alcohol problems. There was no difference in readiness to change, but African-Americans reported more problems related to alcohol and greater use of coping behaviors to avoid drinking. African-Americans may be better equipped to manage drinking problems when they do occur due to increased familiarity with coping mechanisms.

Quality in women's health care has been assessed with preventive measures such as mammograms and pap smears, and obstetrical measures, such as prenatal care. Although awareness about sex and gender differences among researchers, health professionals, and women themselves has grown dramatically over the last 10 years, health care policy and medical education have not been influenced to any significant degree. Sex and gender differences have not been developed for a wider range of services, such as diagnosis and treatment of acute or chronic conditions, outside of reproductive health. This article reviews contemporary women's health issues and discusses the need for collaboration among multiple stakeholder groups within the health care industry to address quality in women's health care

OBJECTIVE: To assess genetic diversity and drug resistance of Mycobacterium tuberculosis isolates collected at Christian Medical College Hospital (CMCH), Vellore, India, between July 1995 and May 1996. MATERIALS AND METHODS: Isolates were subjected to IS6110-based restriction fragment length polymorphism (RFLP) analysis and tested for resistance to isoniazid, rifampin, ethambutol, streptomycin, and pyrazinamide, and DNA from selected strains was sequenced in regions associated with drug resistance. RESULTS: One hundred and one M. tuberculosis isolates were collected from 87 patients with pulmonary tuberculosis. Charts of 69 patients were reviewed for history of tuberculosis illness and treatment. DNA from 29 strains was sequenced in katG, rpoB, and gyrA, and sometimes pncA regions. Analysis by RFLP revealed a high degree of genetic diversity, with no identifiable clusters of infection. Of the strains tested, 51% were resistant to at least one antibiotic, and 43% were resistant to more than one drug. There was a high rate of resistance observed in patients whose charts indicated a history of improperly administered tuberculosis treatment, whereas little drug resistance was observed in patients never previously treated for tuberculosis. Sequencing of genes associated with drug resistance revealed several previously unreported mutations in resistant strains. CONCLUSIONS: This analysis suggests that the cases of tuberculosis in the sample are largely reactivation of long-standing infections and that the drug resistance among patients in CMCH is largely acquired or secondary rather than attributable to the spread of drug-resistant strains

How does one maneuver through this information logjam? A new book, "The Civil War on the Web" (Scholarly Resources, $18.95 paperback), offers much needed help. After exhaustive investigation, the authors - William Thomas, director of the Virginia Center for Digital History at the University of Virginia, and Alice Carter, project manager for education at New York Times Digital - recommend 95 sites based on the richness of sources, ease of navigation and visual appeal. These criteria are flexible, they say, because most sites were not made by professional Web designers but by "librarians and archivists, reenactors and preservationists, students and educators - people more interested in the Civil War than in slick appearances or sophisticated menus." Put simply, most sites are stronger on content than on aesthetics.