Medicine and Health Sciences Commons^™

The Public Health Pbrn Program: A Summative Report, Glen P. Mays

Glen Mays

This report provides a six-year summary of the work of the Public Health Practice-Based Research Networks Program, supported by the Robert Wood Johnson Foundation.

Socioeconomic-Status And Mental Health In A Personality Disorder Sample: The Importance Of Neighborhood Factors, Zach Walsh, M. Tracie Shea, Shirley Yen, Emily B. Ansell, Carlos M. Grilo, Thomas H. Mcglashan, Robert L. Stout, Donna S. Bender, Andrew E. Skodol, Charles A. Sanislow, Leslie C. Morey, John G. Gunderson

Charles A. Sanislow, Ph.D.

This cross-sectional study examined the associations between neighborhood-level socioeconomic-status (NSES), and psychosocial functioning and personality pathology among 335 adults drawn from the Collaborative Longitudinal Personality Disorders Study. Participants belonged to four personality disorder (PD) diagnostic groups: Avoidant, Borderline, Schizotypal, and Obsessive Compulsive. Global functioning, social adjustment, and PD symptoms were assessed following a minimum two-year period of residential stability. Residence in higher-risk neighborhoods was associated with more PD symptoms and lower levels of functioning and social adjustment. These relationships were consistent after controlling for individual-level socioeconomic-status and ethnicity; however, the positive association between neighborhood-level socio-economic risk and PD symptoms was …

Addressing The Persistence Of Tuberculosis Among The Canadian Inuit Population: The Need For A Social Determinants Of Health Framework, Kassandra C. Kulmann Ma Candidate, Chantelle Am Richmond Professor

Chantelle Richmond

Canadian Aboriginal people have poorer levels of health than the general population. A serious issue is the high rate of tuberculosis (TB) among the Inuit population; rates are much higher than those of the general Canadian population. Several social determinants of health (SDOH), including household crowding and poverty, are strongly correlated with TB prevalence. In this paper, we describe the medical and social determinants of TB, and critically examine the TB literature specific to the Inuit population. The majority of studies recommend biomedical interventions for the treatment of TB. Few researchers have employed the social determinants of health theory to …

The Impact Of Worksite Weight-Related Social Norms On Associated Behaviors, Stephenie C. Lemon, Qin Liu, Robert P. Magner, Kristin L. Schneider, Lori Pbert

Qin Liu

Objective: To assess the association between descriptive social norms for weight and weight-related behaviors and associated behaviors at the worksite. Design and Sample: Baseline data from site-randomized trial of a worksite ecological intervention for weight control; 12 public high schools in central Massachusetts; Sample of 844 employees enrolled (~ 2/3 of all employees). Conclusions: Associations of weight loss and eating social norms with behavior; Unique from social support; No association of physical activity social norms with physical activity; May be little opportunity for and therefore little exposure to physical activity during the workday; Results support the development of weight loss …

Increasing Fruit And Vegetable Consumption And Offerings To Somali Children: The Fav-S Pilot Study, Mary Hearst, Rebecca Kehm, Shelley Sherman, Kate E. Lechner

Mary Hearst

No abstract provided.

The National Longitudinal Survey Of Public Health Systems: Selected Findings And Applications For Monitoring The Affordable Care Act, Glen P. Mays

Glen Mays

This presentation reviews the National Longitudinal Survey of Public Health Systems and its applicability for monitoring the effects of the Affordable Care Act on public health delivery within the U.S.

Early Chronic Low-Level Lead Exposure Produces Glomerular Hypertrophy In Young C57bl/6j Mice, Christina Sobin, John Basgen

Christina Sobin, Ph.D.

Early chronic lead exposure continues to pose serious health risks for children, particularly those living in lower socioeconomic environments. This study examined effects on developing glomeruli in young C57BL/6J mice exposed to low (30 ppm), higher (330 ppm) or no lead via dams’ drinking water from birth to sacrifice on post-natal day 28. Low-level lead exposed mice [BLL mean (SD); 3.19 (0.70) µg/dL] had an increase in glomerular volume but no change in podocyte number compared to control mice [0.03 (0.01) µg/dL]. Higher-level lead exposed mice [14.68 (2.74) µg/dL] had no change in either glomerular volume or podocyte number. The …

2012 Año Europeo Del Envejecimiento Activo Y La Solidaridad Intergeneracional Una Mirada Multidimensional A Un Fenómeno Global, Diego A. Bernardini

Diego Bernardini MD, PhD

No abstract provided.

Integration Of Health Protection And Health Promotion: Rationale, Indicators, And Metrics, Glorian Sorenson, Deborah Mcclellan, Jack Dennerlein, Nicolaas Pronk, Jennifer Allen, Leslie Boden, Cassadra Okechukwu, Dean Hashimoto, Anne Stoddard, Gregory Wagner

Dean M. Hashimoto

Objective: To offer a definition of an “integrated” approach to worker health and operationalize this definition using indicators of the extent to which integrated efforts are implemented in an organization.

Methods: Guided by the question—How will we know it when we see it?—we reviewed relevant literature to identify available definitions and metrics, and used a modified Delphi process to review and refine indicators and measures of integrated approaches.

Results: A definition of integrated approaches to worker health is proposed and accompanied by indicators and measures that may be used by researchers, employers, and workers.

Conclusions: A shared understanding of what …

Results Of A Pilot Intervention To Improve Health And Safety For Health Care Workers, Caitlin Caspi, Jack Dennerlein, Christopher Kenwood, Anne Stoddard, Karen Hopcia, Dean Hashimoto, Glorian Sorensen

Dean M. Hashimoto

Objective: To test the feasibility of a multicomponent pilot intervention to improve worker safety and wellness in two Boston hospitals. Methods: A 3-month intervention was conducted on seven hospital units. Pre- (374 workers) and postsurveys (303 workers) assessed changes in safety/ergonomic behaviors and practices, and social support. Wellness outcomes included self-reported pain/aching in specific body areas (musculoskeletal disorders or MSDs) and physical activity (PA). Results: Pain was reported frequently (81%), and PA averaged 4 hours per week. There was a postintervention increase in safe patient handling (P < 0.0001), safety practices (P = 0.0004), ergonomics (P = 0.009), and supervisor support (P = 0.01), but no changes in MSDs or PA. Conclusions: Safe patient handling, ergonomics, and safety practices are good targets for worker safety and wellness interventions; longer intervention periods may reduce the risk of MSDs.

Glutathione Redox Dynamics And Expression Of Glutathione-Related Genes In The Developing Embryo, Alicia R. Timme-Laragy, Jared V. Goldstone, Barry R. Imhoff, John J. Stegemana, Mark E. Hahn, Jason M. Hansen

Alicia R. Timme-Laragy

Embryonic development involves dramatic changes in cell proliferation and differentiation that must be highly coordinated and tightly regulated. Cellular redox balance is critical for cell fate decisions, but it is susceptible to disruption by endogenous and exogenous sources of oxidative stress. The most abundant endogenous non-protein antioxidant defense molecule is the tri-peptide glutathione (γ-glutamyl-cysteinylglycine, GSH), but the ontogeny of GSH concentration and redox state during early life stages is poorly understood. Here, we describe the GSH redox dynamics during embryonic and early larval development (0–5 days post-fertilization) in the zebrafish (Danio rerio), a model vertebrate embryo. We measured reduced and …

La Situación De Personas Con Discapacidades Intelectuales En Santiago De Chile (The Situation Of Persons With Intellectual Disabilities In Santiago, Chile), Elizabeth Ramsey

Elizabeth Ramsey

Background: Chile has among the highest rates in the world of appearance of cognitive disability. The population of adults with disabilities can be defined as any person over the age of 18 with a congenital intellectual difficulty. Additionally, the specific population of this study includes only individuals who are partially autonomous, those who require some degree of support in their everyday lives. To serve this population, diverse services and opportunities are necessary to support a vibrant and fulfilling lifestyle. This includes workplaces, programs of social inclusion, appropriate health access, and protection and support from the government. Objectives: This study aims …

Social Foundations For A Community-Based Public Health Cholera Campaign In Borgne, Haiti, John Mazzeo

John Mazzeo, Ph.D.

The rapid and widespread progression of cholera in rural Haiti can be attributed to a “perfect storm” of conditions including the widespread use of unprotected water sources, rudimentary sanitation, the lack of means to afford simple necessities, and the near absence of basic health services to treat the sick. Accessibility of essential health care and reliable sources of clean water in remote areas of rural Haiti are fundamental barriers to addressing acute public health emergencies including the ongoing cholera epidemic. This article explores the notion that positive health outcomes for hard to reach populations can be achieved through community mobilization. …

Intention To Seek Professional Psychological Help Among College Students In Turkey: Influence Of Help-Seeking Attitudes, Feyza Seyfi, Krishna C. Poudel, Junko Yasuoka, Keiko Otsuka, Masamine Jimba

Krishna C. Poudel

Risk Factors For Becoming Homeless Among A Cohort Of Veterans Who Served In The Era Of The Iraq And Afghanistan Conflicts, Stephen Metraux, Limin X. Clegg, John D. Daigh, Dennis P. Culhane, Vincent R. Kane

Dennis P. Culhane

Community-Level Characteristics Associated With Variations In Rates Of Homelessness Among Families And Single Adults, Jamison D. Fargo, Ellen A. Munley, Thomas H. Byrne, Ann Elizabeth Montgomery, Dennis P. Culhane

Dennis P. Culhane

Relationship Among Adverse Childhood Experiences, History Of Active Military Service, And Adult Outcomes: Homelessness, Mental Health And Physical Health, Ann Elizabeth Montgomery, J J. Cutuli, Michelle Evans-Chase, Dan Treglia, Dennis P. Culhane

Dennis P. Culhane

Homelessness Research: Shaping Policy And Practice, Now And Into The Future, Dennis P. Culhane, Vince R. Kane, Mark Johnston

Dennis P. Culhane

Universal Screening For Homelessness And Risk For Homelessness In The Veterans Health Administration, Ann Elizabeth Montgomery, Jamison D. Fargo, Thomas H. Byrne, Vincent R. Kane, Dennis P. Culhane

Dennis P. Culhane

Core Competencies For Clinical Supervisors, David Kalman, Stephanie Rodrigues

Stephanie Rodrigues

This chapter provides useful strategies that will help guide clinical supervisors who oversee and support the work of MISSION-VET Case Managers and Peer Support Specialists. It includes an overview of the MISSION-VET supervisor’s role and a description of each team member’s primary area of responsibility within the MISSION-VET program. The remainder of the chapter describes key strategies that MISSION-VET supervisors will need in order to establish productive working relationships with MISSION Case Managers and Peer Support Specialists. These strategies, which are designed to foster a strong supervisory alliance and assure that services are being delivered with fidelity to the MISSION-VET …

Estimating The Costs Of Public Health Services: Progress On The Institute Of Medicine Recommendations, Glen P. Mays

Glen Mays

The National Academy of Sciences Institute of Medicine recommended in 2012 that the federal government undertake work to identify the components and costs of a "minimum package" of public health programs, services, and capabilities that should be available in every American community. This presentation summarizes work that is currently underway through the Robert Wood Johnson Foundation-supported Public Health Practice-Based Research Networks (PBRN) Program to estimate the costs of public health delivery.

Elders With Serious Mental Illness: Lost Opportunities And New Policy Options, Darlene O'Connor, Faith Little, Richard Mcmanus

Richard H. McManus

This article reviews key federal Medicaid policies affecting older adults with serious, long-term mental illness: (a) the Medicaid exclusion of coverage for Institutions for Mental Diseases, (b) the Preadmission Screening and Resident Review Process, and (c) the Medicaid Home and Community Based Services waiver policy. Documenting the incentives and restrictions in these policies provides an historical context for understanding the current gaps in treatment for elders with mental illness. New federal options under the Deficit Reduction Act may provide opportunities for reducing the institutional bias for older adults with mental illness and for improving mental health services for elders under …

Increase In The Proportion Of Patients Hospitalized With Acute Myocardial Infarction With Do-Not-Resuscitate Orders Already In Place Between 2001 And 2007: A Nonconcurrent Prospective Study, Jane Saczynski, Ezra Gabbay, David Mcmanus, Richard Mcmanus, Joel Gore, Jerry Gurwitz, Darleen Lessard, Robert Goldberg

Richard H. McManus

BACKGROUND AND OBJECTIVE: Shared decision making and advance planning in end-of-life decisions have become increasingly important aspects of the management of seriously ill patients. Here, we describe the use and timing of do-not-resuscitate (DNR) orders in patients hospitalized with acute myocardial infarction (AMI). STUDY DESIGN AND SETTING: The nonconcurrent prospective study population consisted of 4182 patients hospitalized with AMI in central Massachusetts in four annual periods between 2001 and 2007. RESULTS: One-quarter (25%) of patients had a DNR order written either prior to or during hospitalization. The frequency of DNR orders remained constant (24% in 2001; 26% in 2007). Among …

Transitions, Risks, And Actions In Coronary Events--Center For Outcomes Research And Education (Trace-Core): Design And Rationale, Molly Waring, Richard Mcmanus, Jane Saczynski, Milena Anatchkova, David Mcmanus, Randolph Devereaux, Robert Goldberg, Jeroan Allison, Catarina Kiefe

Richard H. McManus

Background: Cardiovascular disease continues to cause significant morbidity, mortality, and impaired quality of life, with unrealized health gains from the underuse of available evidence. The Transitions, Risks, and Actions in Coronary Events Center for Outcomes Research and Education (TRACE-CORE) aims to advance the science of acute coronary syndromes by examining the determinants and outcomes of the quality of transition from hospital to community and by quantifying the impact of potentially modifiable characteristics associated with decreased quality of life, rehospitalization, and mortality. Methods and Results: TRACE-CORE comprises a longitudinal multiracial cohort of patients hospitalized with acute coronary syndromes, 2 research projects, …

Elders With Serious Mental Illness: Lost Opportunities And New Policy Options, Darlene O'Connor, Faith Little, Richard Mcmanus

Richard H. McManus

This article reviews key federal Medicaid policies affecting older adults with serious, long-term mental illness: (a) the Medicaid exclusion of coverage for Institutions for Mental Diseases, (b) the Preadmission Screening and Resident Review Process, and (c) the Medicaid Home and Community Based Services waiver policy. Documenting the incentives and restrictions in these policies provides an historical context for understanding the current gaps in treatment for elders with mental illness. New federal options under the Deficit Reduction Act may provide opportunities for reducing the institutional bias for older adults with mental illness and for improving mental health services for elders under …

Increase In The Proportion Of Patients Hospitalized With Acute Myocardial Infarction With Do-Not-Resuscitate Orders Already In Place Between 2001 And 2007: A Nonconcurrent Prospective Study, Jane Saczynski, Ezra Gabbay, David Mcmanus, Richard Mcmanus, Joel Gore, Jerry Gurwitz, Darleen Lessard, Robert Goldberg

Richard H. McManus

BACKGROUND AND OBJECTIVE: Shared decision making and advance planning in end-of-life decisions have become increasingly important aspects of the management of seriously ill patients. Here, we describe the use and timing of do-not-resuscitate (DNR) orders in patients hospitalized with acute myocardial infarction (AMI). STUDY DESIGN AND SETTING: The nonconcurrent prospective study population consisted of 4182 patients hospitalized with AMI in central Massachusetts in four annual periods between 2001 and 2007. RESULTS: One-quarter (25%) of patients had a DNR order written either prior to or during hospitalization. The frequency of DNR orders remained constant (24% in 2001; 26% in 2007). Among …

Transitions, Risks, And Actions In Coronary Events--Center For Outcomes Research And Education (Trace-Core): Design And Rationale, Molly Waring, Richard Mcmanus, Jane Saczynski, Milena Anatchkova, David Mcmanus, Randolph Devereaux, Robert Goldberg, Jeroan Allison, Catarina Kiefe

Richard H. McManus

Background: Cardiovascular disease continues to cause significant morbidity, mortality, and impaired quality of life, with unrealized health gains from the underuse of available evidence. The Transitions, Risks, and Actions in Coronary Events Center for Outcomes Research and Education (TRACE-CORE) aims to advance the science of acute coronary syndromes by examining the determinants and outcomes of the quality of transition from hospital to community and by quantifying the impact of potentially modifiable characteristics associated with decreased quality of life, rehospitalization, and mortality. Methods and Results: TRACE-CORE comprises a longitudinal multiracial cohort of patients hospitalized with acute coronary syndromes, 2 research projects, …

Return On Investment In Prevention And Public Health: Overview And Opportunity, Cezar Brian C. Mamaril

Cezar Brian C Mamaril

No abstract provided.

Get The Word Out: Utilizing Traditional And Emerging Tools To Disseminate And Measure The Impact Of Your Research, Sally A. Gore

Sally A. Gore

Publishing articles and presenting at conferences are tried and true ways for promoting your research within academic and professional circles, but with changes to scholarly communications and the emergence of many new forms that allow individuals to disseminate information more freely, openly, and quickly, researchers have a host of opportunities to both promote their work to a larger audience and track the impact of their research in a more accurate manner. From article-level metrics (altmetrics) to open access publications to the use of social media, this poster gives an introduction to some of the vehicles available today, how to use …

New Health Delivery Networks: Merging Public Health And Health Care Systems, Glen P. Mays

Glen Mays

Incomplete coordination between medical care and public health delivery systems can result in significant missed opportunities for improving population health and constraining overall resource use. This lecture uses insight from the field of public health services and systems research (PHSSR) to examine: (1) why medical care and public health systems often fail to connect; (2) what are the potential health and economic consequences of these failures; and (3) what are the opportunities for connecting medical care and public health delivery to improve population health.