Medicine and Health Sciences Commons^™

Health-Related Quality Of Life And Chronic Obstructive Pulmonary Disease In North Carolina, David Brown, Roy Pleasants, Jill Ohar, Monica Kraft, James Donohue, David Mannino, Winston Liao, Harry Herric

David C. Brown

Background:

Comparisons of health-related quality of life (HRQOL) between persons with chronic obstructive pulmonary disease (COPD) and adults in the general population are not well described.

Aims:

To examine associations between COPD and four measures of HRQOL in a population-based sample.

Patients & Methods:

These relationships were examined using data from 13,887 adults aged >18 years who participated in the 2007 Behavioral Risk Factor Surveillance System (BRFSS) conducted in North Carolina (NC). Logistic regression was used to obtain adjusted relative odds (aOR).

Results:

The age-adjusted prevalence of COPD among NC adults was 5.4% (standard error 0.27). Nearly half of adults …

Chapter 5. Chronic Obstructive Pulmonary Disease (Copd), David Mannino, Janet Croft, David Brown

David C. Brown

No abstract provided.

Motivational Interviewing (Mi) Using Co-Active Life Coaching Skills As A Treatment For Obesity, Courtney Newnham-Kanas, Jennifer Irwin, Don Morrow

Donald Morrow

No abstract provided.

Retention In Care Among Hiv-Infected Patients In Resource-Limited Settings: Emerging Insights And New Directions, Elvin Geng, Denis Nash, Andrew Kambugu, Yao Zhang, Paula Braitstein, Katerina Christopoulos, Winnie Muyindike, Mwebesa Bwana, Constantin Yiannoutsos, Maya Petersen, Jeff Martin

Elvin H Geng

In resource-limited settings—where a massive scale up of HIV services has occurred in the last 5 years—both understanding the extent of and improving retention in care presents special challenges. First, retention in care within the decentralizing network of services is likely higher than existing estimates that account only for retention in clinic, and therefore antiretroviral therapy services may be more effective than currently believed. Second, both magnitude and determinants of patient retention vary substantially and therefore encouraging the conduct of locally relevant epidemiology is needed to inform programmatic decisions. Third, socio-structural factors such as program characteristics, transportation, poverty, work/child care …

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

Richard G. Wamai

No abstract provided.

Risk Factors For Ductal And Lobular Breast Cancer: Results From The Nurses' Health Study, Joanne Kotsopoulos, Wendy Chen, Margaret Gates, Shelley Tworoger, Susan Hankinson, Bernard Rosner

Susan E. Hankinson

Introduction Ductal and lobular carcinomas are the two most common types of invasive breast cancer. Whether well-established risk factors are differentially associated with risk on the basis of histologic subtype is not clear. We prospectively investigated the association between a number of hormonal and nonhormonal exposures and risk defined by histologic subtype among 4,655 ductal and 659 lobular cases of postmenopausal breast cancer from the Nurses' Health Study. Methods Multivariate Cox proportional hazards regression stratified by histologic subtype and time period was used to examine the association between risk factors and the incidence of ductal and lobular subtypes. For each …

Application Of Quantum Cascade Lasers To High-Precision Atmospheric Trace Gas Measurements, Ezra Wood, J. Barry Mcmanus, Mark S. Zahniser, David D. Nelson, Joanne H. Shorter, Scott Herndon, Rick Wehr

Ezra Wood

We review our recent results in development of high-precision laser spectroscopic instrumentation using midinfrared quantum cascade lasers (QCLs). Some of these instruments have been directed at measurements of atmospheric trace gases where a fractional precision of 10−3 or better of ambient concentration may be required. Such high precision is needed in measurements of fluxes of stable atmospheric gases and measurements of isotopic ratios. Instruments that are based on thermoelectrically cooled midinfrared QCLs and thermoelectrically cooled detectors have been demonstrated that meet the requirements of high-precision atmospheric measurements, without the need for cryogens. We also describe the design of and results …

Seguridad, Salud Y Percepción De Factores Personales Y Organizacionales En La Industria Manufacturera, José G. Salazar-Estrada, Carolina Aranda-Beltran, Manuel Pando-Moreno, Luis G. Gómez-Azpeitia, Raquel González-Baltazar

José G. Salazar Estrada

The aim of this study is to examine working conditions of manufacturing industry workers in order to identify factors such as safety, organizational risk and workers’ perception of their employment relationship, and organizational matters. A descriptive cross-sectional study was conducted by two questionnaires. First questionnaire was circulated to 24 small, medium and large sized industries, and the second one was filled out by a sample of 329 workers having at least six months of seniority and pertaining to these 24 industries. Only 25% of the small industries was identified to have health personnel for their employees. 8,3% has a committee …

Pengelolaan Perbatasan Ditinjau Dari Sisi Sosial, Ekonomi Dan Ekologi, Dr. Zulkifli Rangkuti

Zulkifli Rangkuti

No abstract provided.

Accessibility Of Primary Health Care Settings For People With Disabilities, Nancy R. Mudrick, Mary Lou Breslin, Mengke Liang, Silvia Yee

Nancy R. Mudrick

People with disabilities report physical barriers in doctors’ offices that affect the quality of care. The analysis seeks to describe overall primary care office physical accessibility and identify (1) in which areas offices meet access criteria, (2) which accessibility criteria are most often not met, and (3) whether there are urban/non-urban differences.

Treatment Outcomes From The Tdc: A Look At Smoking Cessation Among Patients With Co-Occurring Disorders, Chizimuzo T.C. Okoli

Chizimuzo T.C. Okoli

Summary of Key Findings •Smoking abstinence at end of program:

–Intent to treat analysis: 32.2%(83/258) –Among program completers: 41.3%(83/201)

•Significant predictors of abstinence : –Having an alcohol, heroin (or other opioid) or marijuana use history was a significant predictor of being less likely to quit smoking when compared to having no history of substance use disorder. –Having a lower CO level at program enrolment was a significant predictor of being more likely to quit –Attending the TDC program for a longer duration was a significant predictor of being more likely to quit.

Aflatoxin B1 Albumin Adducts In Plasma And Aflatoxin M1 In Urine Are Associated With Plasma Concentrations Of Vitamins A And E, Francis A. Obuseh, Pauline E. Jolly, Yi Jiang, Faisal M. B. Shuaib, John Waterbor, William O. Ellis, Chandrika J. Piyathilake, Renee A. Desmond, Evans Afriyie-Gyawu, Timothy D. Phillips

Evans Afriyie-Gyawu

Background: Although aflatoxin exposure has been shown to be associated with micronutrient deficiency in animals, there are few investigations on the effects of aflatoxin exposure on micronutrient metabolism in humans.
Objective: To examine the relationship between aflatoxin B1 (AFB1) albumin adducts (AF-ALB) in plasma and the aflatoxin M1 (AFM1) metabolite in urine and plasma concentrations of retinol (vitamin A) and α-tocopherol (vitamin E) in Ghanaians.
Methods: A cross-sectional study of 147 adult participants was conducted. Blood and urine samples were tested for aflatoxin and vitamins A and E levels.
Results: Multivariable analysis showed that participants with high AF-ALB (≥ 0.80 …

Using Emerging Informatics Techniques To Evaluate The Delivery Of National Minority Aids Education And Training Center Training Programs In Addressing Hiv/Aids Disparities, Chiehwen Ed Hsu

Chiehwen Ed Hsu

Many AIDS education and training programs have developed techniques to better target and recruit providers most in need of training. Given the infusion of federal and state resources invested in training of the providers in recent years, whether the delivery of training activities are closely aligned with high minority AIDS prevalence geographic areas remains unknown. This present study discusses an informatics system to identify the relationships between AIDS intervention programs and geographic areas of minority populations adversely affected by HIV/AIDS to help determine whether resources are being expended appropriately (as evidenced by the alignment of training activities) in areas where …

Battling Hiv/Aids And The Healthcare Crisis In Africa, Richard Wamai

Richard G. Wamai

No abstract provided.

Adiposity And The Development Of Premenstrual Syndrome, Elizabeth Bertone-Johnson, Susan Hankinson, Walter Willett, Susan Johnson, Joann Manson

Elizabeth R. Bertone-Johnson

Background Moderate to severe premenstrual syndrome (PMS) affects 8%–20% of premenopausal women and causes substantial levels of impairment, but few modifiable risk factors for PMS have been identified. Adiposity may impact risk through the complex interaction of hormonal and neurochemical factors, but it is not known if adiposity increases a woman's risk of developing PMS. We have addressed these issues in a prospective study nested within the Nurses' Health Study 2. Methods Participants were a subset of women aged 27–44 and free from PMS at baseline, including 1057 women who developed PMS over 10 years of follow-up and 1968 controls. …

Health Impacts Of Pesticide Exposure In A Cohort Of Outdoor Workers, John R. Beard, Tim Sladden, Geoffrey Morgan, Geoffrey Berry, Lyndon O. Brooks, Anthony Mcmichael

Dr Lyndon O Brooks

We compared mortality of 1,999 outdoor staff working as part of an insecticide application program during 1935-1996 with that of 1,984 outdoor workers not occupationally exposed to insecticides, and with the Australian population. Surviving subjects also completed a morbidity questionnaire. Mortality was significantly higher in both exposed and control subjects compared with the Australian population. The major cause was mortality from smoking-related diseases. Mortality was also significantly increased in exposed subjects for a number of conditions that do not appear to be the result of smoking patterns. Compared with the general Australian population, mortality over the total study period was …

What Are The Basic Self-Monitoring Components For Cardiovascular Risk Management?, Alison M. Ward, Carl Heneghan, Rafael Perera, Dan Lasserson, David Nunan, David Mant, Paul P. Glasziou

Paul Glasziou

Background: Self-monitoring is increasingly recommended as a method of managing cardiovascular disease. However, the design, implementation and reproducibility of the self-monitoring interventions appear to vary considerably. We examined the interventions included in systematic reviews of self-monitoring for four clinical problems that increase cardiovascular disease risk.

Methods: We searched Medline and Cochrane databases for systematic reviews of self-monitoring for: heart failure, oral anticoagulation therapy, hypertension and type 2 diabetes. We extracted data using a pre-specified template for the identifiable components of the interventions for each disease. Data was also extracted on the theoretical basis of the education provided, the rationale given …

Hiv Prevention Cost-Effectiveness: A Systematic Review, Omar Gálarraga, M. Arantxa Colchero, Richard G. Wamai, Stefano Bertozzi

Richard G. Wamai

Background: After more than 25 years, public health programs have not been able to sufficiently reduce the number of new HIV infections. Over 7,000 people become infected with HIV every day. Lack of convincing evidence of cost-effectiveness (CE) may be one of the reasons why implementation of effective programs is not occurring at sufficient scale. This paper identifies, summarizes and critiques the CE literature related to HIV-prevention interventions in low- and middle-income countries during 2005-2008. Methods: Systematic identification of publications was conducted through several methods: electronic databases, internet search of international organizations and major funding/implementing agencies, and journal browsing. Inclusion …

Pufa And Vitamin D And Type 2 Diabetes Inflammatory Markers, Paulo A. Lotufo

Paulo A Lotufo

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 …

A Medical Student's Perspective Of Participation In An Interprofessional Education Placement: An Autoethnography, Jennifer Gallé, Lorelei Lingard

Lorelei Lingard

Interprofessional education (IPE) has emerged as a critical pedagogy for promoting interprofessional collaboration (IPC) within healthcare. However, the literature includes few reports of students' perspectives on IPE experiences. Understanding students' experiences is critical, as they are the crux of IPE's culture change agenda. This paper presents an autoethnographic account of my experiences as a medical student participating in an IPE placement within a Canadian academic hospital. During the five-week placement, I collected data using participant observation and reflective journaling on all placement experiences. I expanded my notes using the emotional recall technique and conducted thematic analysis. Using a series of …

Similarities And Differences In Health Care Use And Hiv-Related Concerns Based On Immigration Profile: Findings From The Blacch Study Interviews, Shamara M. Baidoobonso, Harina Mokanan, Monica Abdelkader, Greta Bauer

Shamara M Baidoobonso, PhD

Background and Objectives: Most HIV and health studies in African, Caribbean and Black (ACB) communities occur in large urban centres and rarely examine how the interactions between race, migration, gender, HIV-related stigma, service use and multiple dimensions of social position interact and act individually to affect health and HIV vulnerability. This lack of information negatively impacts HIV prevention efforts for ACB communities. This analysis explores the HIV-related experiences of people from different immigration classes. Methods: Using a community-based approach, a purposive sample of 22 ACB community members were interviewed to collect information about health-related experiences in London, Ontario. Respondents represented …

Introducing The Black, African And Caribbean Canadian Health (Blacch) Study, Shamara M. Baidoobonso, Harina Mokanan, Mercy Nleya-Ncube, Greta Bauer

Shamara M Baidoobonso, PhD

Background and Objectives: African, Caribbean and other Black (ACB) persons account for an increasing proportion of new HIV cases in Canada, and are 12.6 times more likely to acquire HIV than the rest of Canada’s population. Few studies have fully acknowledged the ethnic, religious and socioeconomic diversity in ACB communities. Also, studies have rarely considered the social determinants of health and broader context in which ACB persons live and access health services, and how these may potentially impact HIV vulnerability. This lack of information negatively impacts HIV prevention and care efforts. The Black, African and Caribbean Canadian Health (BLACCH) Study …

Highlighting The Social Determinants Of Health As They Pertain To Africans In London, Ontario, Shamara M. Baidoobonso

Shamara M Baidoobonso, PhD

No abstract provided.

Developing Constructs For Psychopathology Research: Research Domain Criteria, Charles A. Sanislow, Daniel S. Pine, Kevin J. Quinn, Michael J. Kozak, Marjorie A. Garvey, Robert K. Heinssen, Philip Sung-En Wang, Bruce N. Cuthbert

Charles A. Sanislow, Ph.D.

There exists a divide between findings from integrative neuroscience and clinical research focused on mechanisms of psychopathology. Specifically, a clear correspondence does not emerge between clusters of complex clinical symptoms and dysregulated neurobiological systems, with many apparent redundancies. For instance, many mental disorders involve multiple disruptions in putative mechanistic factors (e.g., excessive fear, deficient impulse control), and different disrupted mechanisms appear to play major roles in many disorders. The Research Domain Criteria (RDoC) framework is a heuristic to facilitate the incorporation of behavioral neuroscience in the study of psychopathology. Such integration might be achieved by shifting the central research focus …

What Are The Factors That Predict Outcome At Relapse After Previous Esophagectomy And Adjuvant Therapy In High-Risk Esophageal Cancer?, Edward Yu, P. Tai, R. Malthaner, L. Stitt, G. Rodrigues, R. Dar, B. Yaremko, J. Younus, M. Sanatani, M. Vincent, B. Dingle, D. Fortin, R. Inculet

Edward Yu

OBJECTIVES: The present study investigated factors affecting outcome at relapse after previous surgery and adjuvant chemoradiation (crt) in high-risk esophageal cancer patients. PATIENTS AND METHODS: From 1989 to 1999, we followed high-risk resected esophageal cancer patients who had completed postoperative crt therapy. Patients who relapsed with a disease-free interval of less than 3 months were treated with palliative crt when appropriate. Patients with a disease-free interval of 3 months or more were treated with best supportive care. Post-recurrence survival was estimated using the Kaplan-Meier technique, and statistical comparisons were made using log-rank chi-square tests and Cox regression. RESULTS: Of the …

A Conversation On African Diaspora, Richard Wamai

Richard G. Wamai

No abstract provided.

Update On The Management Of Chronic Obstructive Pulmonary Disease, Andrea K. Maas, David M. Mannino

David M. Mannino

Chronic obstructive pulmonary disease is a highly prevalent, underdiagnosed, and undertreated chronic lung disease. Early and appropriate treatment may help modify the course of the disease with respect to exacerbation timing and frequency, quality of life, and mortality. Steady progress continues to be made in understanding the disease pathogenesis and treatment modalities, and there is some evidence that outcomes are improving.

Parent Support Project: Evaluation Report, Anna D. Huddy, Sallie Newell, Anne Graham

Professor Anne Graham

What is the Parent Support Project? The Parent Support Project (PSP) was a pilot project developed by the Northern Rivers Division of General Practice (NRDGP), with funding from the Early Childhood – Invest to Grow arm of the Australian Government’s Stronger Families and Communities Strategy. This 12-month project involved expanding the parenting support services delivered through the NRDGP’s Family Care Centre, in Lismore. Planned activities included: compiling a directory of locally-available resources and services to support early child development; developing a PSP web page for inclusion on the NRDGP website; producing age-specific parenting newsletters; developing and running training sessions for …

Expect Respect Television Advertising Campaign: Evaluation Report, Chris White, Sallie Newell, Anne Graham

Professor Anne Graham

The Expect Respect project was a social marketing campaign to increase young people’s knowledge of the dynamics of healthy and unhealthy relationships. It represented the latest stage in an ongoing campaign by the Kids Really Count interagency committee (a collaboration between the Ballina Byron Family Centre, the NSW Strategy to Reduce Violence Against Women, Lismore & District Women’s Health Centre, Mullumbimby Community Health and Lismore City Council) to raise public awareness about the impact of domestic violence on children and young people. The Expect Respect television advertisement was developed following consultations with young people from diverse geographical environments and cultural …