Medicine and Health Sciences Commons^™

Transportation And Retention In Outpatient Drug Abuse Treatment Programs, Peter Friedmann, Stephenie Lemon, Michael Stein

Peter D. Friedmann MD

To determine whether certain types of transportation assistance improve outpatient treatment retention beyond thresholds shown to have therapeutic benefits, we analyzed data from 1,144 clients in 22 outpatient methadone maintenance (OMM) programs and 2,031 clients in 22 outpatient drug-free (ODF) programs in the Drug Abuse Treatment Outcomes Study (DATOS), a national, 12-month, longitudinal study of drug abuse treatment programs. Directors' surveys provided information about provision of car, van, or contracted transportation services or individual vouchers/payment for public transportation. Chart-abstracted treatment retention was dichotomized at 365 days for OMM and 90 days for ODF. Separate multivariate hierarchical linear models revealed that …

Perceived Harm Of Secondhand Electronic Cigarette Vapors And Policy Support To Restrict Public Vaping: Results From A National Survey Of Us Adults, Susan Mello, Cabral Bigman, Ashley Sanders-Jackson, Andy Tan

Andy SL Tan

Introduction: There is ongoing debate over banning electronic cigarette (e-cigarette) use (vaping) in public places. Many people perceive secondhand e-cigarette vapors (SHV) to be relatively harmless, which may affect their support for policies to restrict vaping in public places. Given that awareness of secondhand cigarette smoke risks predicts public support for clean air policies, we hypothesized that greater perceived harm of SHV to personal health would be associated with stronger support for vaping restrictions.

Methods: Data from 1449 US adults in a national online panel was collected from October to December 2013. Using multiple regressions, we predict a three-item scale …

Municipal Officials' Participation In Built Environment Policy Development In The United States, Stephenie C. Lemon, Karin V. Goins, Kristin L. Schneider, Ross Brownson, Cheryl A. Valko, Kelly R. Evenson, Amy A. Eyler, Katie M. Heinrich, Jill Litt, Rodney Lyn, Hannah L. Reed, Nancy O'Hara Tompkins, Jay Maddock

Stephenie C. Lemon

Purpose. This study examined municipal officials' participation in built environment policy initiatives focused on land use design, transportation, and parks and recreation. Design. Web-based cross-sectional survey. Setting. Eighty-three municipalities with 50,000 or more residents in eight states. Subjects. Four hundred fifty-three elected and appointed municipal officials. Measures. Outcomes included self-reported participation in land use design, transportation, and parks and recreation policy to increase physical activity. Independent variables included respondent position; perceptions of importance, barriers, and beliefs regarding physical activity and community design and layout; and physical activity partnership participation. Analysis. Multivariable logistic regression models. Results. Compared to other positions, public …

Community Health Education Methods: A Practical Guide, Robert Bensley, Jodi Brookins-Fisher

Robert J Bensley

The Third Edition Of Community Health Education Methods: A Practical Guide Teaches Students To Effectively Communicate Health Education Messages And Positively Influence The Norms And Behaviors Of Both Individuals And Communities. This Text Explores The Methods Used By Health Educators, Including Didactic Techniques Designed To Guide Others Toward The Pursuit Of A Healthy Lifestyle. The Authors Explain The Essential Tools Involved In Communicating Messages To Specific Audiences, Providing Readers With A Full Grasp Of The Skills Necessary In Making A Difference.

Meaning Of The Family-Cap Policy For Poor Women: Contraceptive And Fertility Decision-Making, Diana Romero, Hannah Fortune-Greely, Jorge Verea, Debbie Salas-Lopez

Debbie Salas-Lopez MD, MPH

In 1996 the US Congress enacted welfare reform legislation. In addition to new lifetime time limits and work requirements for those receiving cash and other forms of social assistance, the states could impose policies pertaining to reproductive-related behaviors of poor women. One such policy is the so-called “family-cap,” which denies additional income support to poor women who have a baby while receiving cash assistance; 24 states have implemented such policies. The ostensible goal of the policy is to limit fertility among current cash assistance recipients. This pilot study sought to explore whether poor women in a family-cap state (NJ) base …

Examining The Influence Of Farmers' Market Managers’ Perceived Roles On Access To Healthful Foods For Low-Income Households And Business Opportunities For Small- And Moderate-Size Farms, Rachel K. Ward

Rachel K Ward

Farmers’ markets are increasingly promoted as mechanisms for improving access to healthful foods for low-income households, as they are relatively inexpensive to establish and they can provide affordable food for low-income households by offering Supplemental Nutrition Assistance Program Electronic Benefit Transfer (SNAP/EBT). SNAP/EBT at markets also expands revenue opportunities for participating farmers. Market mangers provide a critical role in overseeing SNAP/EBT at markets and influencing business opportunities for farmers. Using a mixed-method approach, this study aimed to evaluate how managers’ motivations influence SNAP/EBT availability and participation at markets, and business opportunities for small- and moderate- sized farms. To develop a …

Imagining Possibilities For Healthy Appalachian Communities In An Emerging Postindustrial Landscape, Brian Hoey

Brian A. Hoey, Ph.D.

This paper explores how community might be re-imagined to promote incipient social and economic agendas born increasingly of broad-minded citizen initiatives within the Appalachian region aimed at what is generally understood as “development,” but of a form distinct from the prevailing models of a more industrial age. I would like to ask whether a city like Huntington, West Virginia can emerge as a progressive example of what we might term postindustrial, urban regeneration and perhaps what we might call community healing—specifically through grassroots movement now finding local governmental support in collective attempts to transform this place from one defined primarily …

Hungry And Overweight, Jody Vogelzang

Jody L Vogelzang PhD, RDN, FAND, CHES

With the recent cut in the Supplemental Nutrition Assistance Program (SNAP) funding, food availability in low income households may not meet family needs. In addition, neighborhoods in low-income urban areas generally have fewer quality, low-cost food outlets in which to spend their limited food dollars. These facts help answer the paradox of how can hungry kids be overweight? This presentation explores the bio-social-pycho aspects of hunger and obesity in America.

Re-Hospitalization Of Psychiatric Patients: The Patients, Or The Illness And Treatment?, Amresh Srivastava, Robbie Campbell, Megan Johnston, Ruth Mooser, Larry Stitt

Amresh Srivastava

Purpose: The goal of this project was to find out why psychiatric patients get hospitalised repeatedly. Studies have found that repeated hospitalization leads to economic drain, disability, poor outcome, stigma and discrimination. Hospitalization consumes more than 90% of mental health budgets. Identifying the potential risk factors for repeated hospitalization, interrelationships between risk factors, and vulnerability will help us take the appropriate measures to prevent hospitalization and promote care in the community. Logistically, there are three possible factors which may lead to repeated hospitalization: (1) Characteristics of the patient; (2) Nature of the illness; and (3) The management of the illness …

Commentary: The Role Of Food Culture And Marketing Activity In Health Disparities, Jerome Williams, David Crockett, Robert Harrison, Kevin Williams

David Crockett

Marketing activities have attracted increased attention from scholars interested in racial disparities in obesity prevalence, as well as the prevalence of other preventable conditions. Although reducing the marketing of nutritionally poor foods to racial/ethnic communities would represent a significant step forward in eliminating racial disparities in health, we focus instead on a critical-related question. What is the relationship between marketing activities, food culture, and health disparities? This commentary posits that food culture shapes the demand for food and the meaning attached to particular foods, preparation styles, and eating practices, while marketing activities shape the overall environment in which food choices …

Criticisms Of African Trials Fail To Withstand Scrutiny: Male Circumcision Does Prevent Hiv Infection, Richard Wamai, Brian Morris, Jake Waskett, Edward Green, Joya Banerjee, Robert Bailey, Jeffrey Klausner, David Sokal, Catherine Hankins

Richard G. Wamai

A recent article in the JLM (Boyle GJ and Hill G, "Sub-Saharan African Randomised Clinical Trials into Male Circumcision and HIV Transmission: Methodological, Ethical and Legal Concerns" (2011) 19 JLM 316) criticises the large randomised controlled trials (RCTs) that scientists, clinicians and policy-makers worldwide have concluded provide compelling evidence in support of voluntary medical male circumcision (VMMC) as an effective HIV prevention strategy. The present article addresses the claims advanced by Boyle and Hill, demonstrating their reliance on outmoded evidence, outlier studies, and flawed statistical analyses. In the current authors' view, their claims portray misunderstandings of the design, execution and …

Environmental Health And Service Learning, Kelly Tuohig, Dale Stephenson, Dean Lillquist, Justin Bird, Stephen Adler, Mark Babitz

Dale J. Stephenson

In developing curriculum for a Salt Lake City, Utah High School's Advance Placement--Environmental Studies class, one goal was a module on air quality/air pollution. University of Utah graduate students and faculty presented on air pollution topics. Community exposure to school bus emissions was identified and students developed a study design, performed air sampling, learned to interpret results, and communicate results and recommendations to various audiences. This project emphasized health impacts, public awareness, and policy recommendations to promote change.

An Analysis Of Vdt Monitor Placement And Daily Hours Of Use For Female Bifocal Users, J. Lyon, Dean Lillquist, S. Alder, Dale Stephenson, D. Bloswick

Dale J. Stephenson

A population of 72 bifocal wearers was studied to determine the relationship between VDT (video display terminal) placement for those who reported musculoskeletal pain and those who did not. The mean hours worked was 50.4 minutes (p=0.003) greater for those who reported head/neck pain versus those who did not and 48.6 minutes (p=0.004) greater for those who reported shoulder/arm pain that those who did not. There was no statistically significant difference between the means of monitor height, distance, or angle for those who reported pain symptoms versus those who did not. This study indicates that, self reported pain symptoms are …

Comparison Of Sampling Methods To Measure Exposure To Diesel Particulate Matter In An Underground Metal Mine, Dale Stephenson, T. Spear, M. Lutte

Dale J. Stephenson

Diesel particulate matter (DPM) continues to be scrutinized as an adverse occupational exposure agent. Currently, the air sampling protocol approved by the U.S. Mine Safety and Health Administration (MSHA) to quantify exposure to DPM in mines designates an SKC impactor as the sample collection device and limits exposure to the total carbon faction of a DPM aerosol. Because use of this impactor requires submission of the sample to an analytical laboratory, it inherently includes a lag time before workplace exposures can be determined. Thus, mine operators who use this MSHA-approved sampling device to monitor personal DPM exposures are faced with …

Side-By-Side Comparison Of Three Sampling Methods For Aerosolized Endotoxin In A Wastewater Treatment Facility, Dale Stephenson, F. Derosso, Dean Lillquist, D. Greene, G. White

Dale J. Stephenson

Research studies have established the occurrence of adverse health effects in individuals exposed to organic dusts and water aerosols laden with endotoxin. To determine what exposure levels cause these health effects, it is necessary to quantity airborne endotoxin. Several scientific studies have demonstrated that the quantification of detectable endotoxin is affected by differences in sampling media, analytical method, and aerosol composition, The study reported here performed side-by-side endotoxin sampling using a liquid impinger, a glass fiber filter, and a polycarbonate filter in a wastewater treatment plant. Results show levels of detected endotoxin appear to be highest with the impinger. Coefficients …

Bungy Jump Into The Unknown - Women Escaping Domestic Violence, Megan Levy

Megan Levy

What happens to those women coming out of a women’s refuge? Can they live away from Domestic Violence? Do they have parenting skills? To answer these questions a case study methodology combined with theories from Humanistic, Social and Community Psychology was implemented to analyse the contents of the meetings held by the refuge’s Self-Help Group,. This group consisted of 11 women, ages 29 to 48 yo: Five of them still in domestic violence; and the rest escaping DV: two, in the refuge, and four who had left 12 to 36 months ago. The first finding: When a woman is still …

Kenya Keen On Achieving Targets On Neglected Diseases, Richard Wamai

Richard G. Wamai

No abstract provided.

'So It's Always A Dance': The Politics Of Gifts And Governance At A Drop-In Centre For Vulnerable Women In London, Ontario, Treena Orchard, Sara Farr, Susan Macphail

Dr. Treena Orchard

No abstract provided.

Brief Report: Need For Autonomy And Other Perceived Barriers Relating To Adolescents’ Intentions To Seek Professional Mental Health Care., Coralie J. Wilson, Frank P. Deane

Coralie J Wilson

The current study examined the relationship between belief-based barriers to seeking professional mental health care and help-seeking intentions in a sample of 1037 adolescents. From early adolescence to adulthood, for males and females, the need for autonomy was a strong barrier to seeking professional mental health care. Help-seeking fears were weaker in the older age groups. Having lower perceived need for autonomy and believing that prior mental health care was helpful was significantly associated with higher intentions to seek future professional mental health care. Implications for prevention and overcoming barriers to seeking mental health care are suggested.

Carbon Monoxide Poisonings And Fatalities Associated With Recreational Watercraft, Dale Stephenson

Dale J. Stephenson

Carbon monoxide (CO) is a colorless and odorless gas generated from the incomplete combustion of hydrocarbon-based fuels. Medical research has shown that human exposure to elevated concentrations of CO can cause serious injury or death. Of increasing concern are CO-related poisonings and fatalities associated with the use of recreational watercraft. Currently there is a lack of awareness of this health hazard among the general public. This presentation summarizes the risks and dangers recreational watercraft users may face from carbon monoxide exposure.

'What's The Use Of Getting A Cow If You Can't Make Any Money From It?': The Reproduction Of Inequality Within Contemporary Social Reforms Of Devadasis, Treena Orchard

Dr. Treena Orchard

No abstract provided.

Evaluation And Control Of Noise And Airborne Chemical Agents, Dale Stephenson

Dale J. Stephenson

This course will cover the fundamentals of evaluation and control of noise and airborne chemical agents encountered in the workplace. Topics will include basic sampling techniques, interpretation of sampling results, compliance with occupational exposure limits, and practical application of ventilation and noise control measures.

Predicting Adolescents’ Future Intentions To Seek Help For Mental Health Problems., Coralie J. Wilson

Coralie J Wilson

This study examined whether high school students’ current symptoms of general psychological distress, self-rated social problem-solving skills, and recent help-seeking experiences predict their future intentions to seek help for a mental health problem. At Time 1, 98 high school students, aged 12-17 years, completed the study self-report survey that included measures of psychological distress, social problem-solving skill, and recent help-seeking behaviour. At Time 2, three weeks later, the same students completed measures of help-seeking intentions. Students with more severe levels of distress symptoms at Time 1 had lower intentions to seek help for a mental health problem at Time 2. …

Early Access And Help Seeking: Practice Implications And New Initiatives., Coralie J. Wilson

Coralie J Wilson

Seeking appropriate help for early signs and symptoms of psychological distress can reduce the long-term impact of many mental disorders. This article describes practice implications and new initiatives for promoting early access and help-seeking among young people. Relevant help-seeking research is reviewed, and prominent help-seeking barriers are discussed. Prominent barriers for young people include: incomplete mental health and emotional literacy, beliefs about having little need for help versus having a need for autonomy, and the process of help-negation for different symptoms of psychological distress. To improve early access to appropriate help and mental health services, barriers that can be reduced, …

Lowering The Risk Of Spreading Hiv Among Heterosexual Men In Africa, Richard Wamai

Richard G. Wamai

No abstract provided.

Status Of Epa’S Proposed Rule To Strengthen The Ozone Standard, Dale Stephenson

Dale J. Stephenson

On January 6, 2010 the EPA rolled out a proposal to reduce the 8-hour primary standard for tropospheric (ground level) ozone from its current level of 0.075 ppm to somewhere between 0.060 ppm and 0.070 ppm. This reduction has the potential for many US airsheds to be declared as nonattainment with the new standard (including many in the Rocky Mountain West). Such a declaration will require state regulatory agencies to initiate implementation plans to bring affected airsheds back into attainment. This presentation will summarize the current status of and reasoning for EPA’s proposed reduction to the primary ozone standard and …

Effect Of Elevated Leukocyte Count On In-Hospital Mortality Following Acute Myocardial Infarction, Mark Furman, Richard Becker, Jorge Yarzebski, Judith Savageau, Joel Gore, Robert Goldberg

Jorge L. Yarzebski

The peripheral white blood cell count on presentation with acute myocardial infarction directly correlates with short-term in-hospital mortality. This association is independent of other prognostic factors, including extent and size of the acute myocardial infarction.

Differences In Discharge Medication After Acute Myocardial Infarction In Patients With Hmo And Fee-For-Service Medical Insurance, Danny Mccormick, Jerry Gurwitz, Judith Savageau, Jorge Yarzebski, Joel Gore, Robert Goldberg

Jorge L. Yarzebski

OBJECTIVE: To assess the impact of fee-for-service (FFS) versus HMO medical insurance coverage on receipt of aspirin, beta-blockers, and calcium channel blockers at the time of hospital discharge following an acute myocardial infarction. DESIGN: Prospective, population-based study. SETTING: All 16 community and tertiary care hospitals in the metropolitan area of Worcester, Massachusetts. PATIENTS: The study population consisted of patients under 65 years of age hospitalized with a validated acute myocardial infarction in all hospitals in the Worcester (Massachusetts) Standard Metropolitan Statistical Area (1990 census estimate, 437,000) during 1986, 1988, 1990, 1991, and 1993. MEASUREMENTS AND MAIN RESULTS: After adjustment for …

Age-Related Trends (1986-1993) In The Use Of Thrombolytic Agents In Patients With Acute Myocardial Infarction. The Worcester Heart Attack Study, Harish Chandra, Jorge Yarzebski, Robert Goldberg, Judith Savageau, Colleen Singleton, Jerry Gurwitz, Joel Gore

Jorge L. Yarzebski

OBJECTIVE: To examine age-related differences and temporal trends in the use of thrombolytic therapy in a community-wide study of patients hospitalized with acute myocardial infarction (AMI) between 1986 and 1993. METHODS: All hospitals in the Worcester, Mass, metropolitan area (1990 census population, 4370000) were included. A total of 3824 patients with validated AMI categorized according to age comprised the study sample: younger than 55 years (n = 577), 55 to 64 years (n = 758), 65 to 74 years (n = 1143), and 75 years or older (n = 1346). RESULTS: Use of thrombolytic therapy increased during the period under …

Health Insurance Coverage And Outcome Following Acute Myocardial Infarction. A Community-Wide Perspective, Silvia Kreindel, Ronald Rosetti, Robert Goldberg, Judith Savageau, Jorge Yarzebski, Joel Gore, Arthur Russo, Carol Bigelow

Jorge L. Yarzebski

BACKGROUND: Several studies have suggested that type of medical insurance coverage is associated with hospital utilization rates and receipt of selected diagnostic or treatment approaches. To our knowledge no studies, however, have examined the relation between medical insurance coverage and short-term outcomes following acute myocardial infarction (AMI) from a multihospital, community-wide perspective. OBJECTIVE: To examine the association between medical insurance coverage and in-hospital case-fatality rates as well as length of hospital stay following AMI. METHODS: The study sample consisted of 3735 residents of the Worcester, Mass, metropolitan area hospitalized with validated AMI during 1986, 1988, 1990, 1991, and 1993 at …