Medicine and Health Sciences Commons^™

Hiv Symptom Burden And Anemia Among Hiv-Positive Individuals: Cross-Sectional Results Of A Community-Based Positive Living With Hiv (Polh) Study In Nepal, Catherine Martin, Kalpana Poudel-Tandukar, Krishna C. Poudel

Krishna C. Poudel

Primary Health Centres And Patients Satisfaction Level In Haripad Community Development Block Of Kerala, India, Sarath Chandran

SARATH CHANDRAN

The main objectives of the present study were to show the spatial distribution of Primary Health Centres in the Haripad Block of Kerala and to investigate the patients’ perception regarding the services provided by the Primary Health Centres. Spatial distribution of Primary Health centres was shown with the help of GIS mapping. Out of eight Primary Health Centres of the Block, five of them were selected by lottery method of simple random sampling for the present study. A pre designed schedule was used for t tabulated and analysed by using of primary health care services in Haripad The major problems …

An Evaluation Of The Us High Production Volume (Hpv) Chemical-Testing Programme: A Study In (Ir)Relevance, Redundancy And Retro Thinking, Andrew Nicholson, Jessica Sandler, Troy Seidle

Troy Seidle, PhD

Under the US Environmental Protection Agency (EPA) High Production Volume (HPV) Challenge Programme, chemical companies have volunteered to conduct screening-level toxicity tests on approximately 2800 widely-used industrial chemicals. Participating companies are committed to providing available toxicity information to the EPA and presenting testing proposals for review by the EPA and posting on the EPA Web site as public information. People for the Ethical Treatment of Animals (PETA) and a coalition of animal protection organisations have reviewed all the test plans submitted by the participating chemical companies for compliance with the original HPV framework, as well as with animal welfare guidelines …

A Modular One-Generation Reproduction Study As A Flexible Testing System For Regulatory Safety Assessment, Richard Vogel, Troy Seidle, Horst Spielmann

Troy Seidle, PhD

The European Union’s Registration, Evaluation and Authorisation of Chemicals (REACH) legislation mandates testing and evaluation of approximately 30,000 existing substances within a short period of time, beginning with the most widely used “high production volume” (HPV) chemicals. REACH testing requirements for the roughly 3000 HPV chemicals specify three separate tests for reproductive toxicity: two developmental toxicity studies on different animal species (OECD Test Guideline 414) and a two-generation reproduction toxicity study (OECD TG 416). These studies are highly costly in both economic and animal welfare terms. OECD TG 416 is a fertility study intended to evaluate reproductive performance of animals …

What Future Democracy?, Aziz Rana

Aziz Rana

The threat posed by Aids to the development of democracy in Africa plays no part in current discussions of the impact of the disease.

Create Workshop 2014: Leveraging Mobile Technology And Social Media In Behavioral Research, Andre M. Müller

Andre M Müller

The 2014 CREATE workshop brought together some forty young health behavior researchers from thirteen different countries, all sharing an interest in mobile technology and social media research. The three- day workshop was held in Innsbruck, Austria,...

Making Women's Health Connections: Between Researchers And To Resources, Martha E. Meacham, Len L. Levin, Lisa A. Palmer, Elaine Martin

Lisa A. Palmer

The Lamar Soutter Library at the University of Massachusetts Medical School has recently completed the second year of a National Library of Medicine grant funded project; the Women’s Health Resources Dissemination Outreach Project. The goals include assisting women’s health researchers by providing them with access to information and making them more aware of opportunities and available resources. This, ultimately, enables both an improvement in women’s health and the advancement of women in academic medicine. Moreover, by supporting women’s health research and women researchers through the objectives of this project, women researchers build connections, knowledge, and skills. This facilitates meaningful contributions …

A State And Territorial Survey Regarding Utilization Of Environmental Health Shelter Assessments During Disasters, And A Secondary Analysis Of Available Shelter Assessment Data, Miguel A. Cruz

Miguel A. Cruz

Disasters are complex events characterized by damage to key infrastructure and population displacements into disaster shelters. Assessing the living environment in shelters during disasters is a crucial health security concern. Until now, jurisdictional knowledge and preparedness on those assessment methods, or types of deficiencies found in shelters is limited. A cross-sectional survey (STUSA survey) ascertained knowledge and preparedness for those assessments in all 50 states, DC, and 5 US territories. Descriptive analysis of overall knowledge and preparedness was performed. Fisher’s exact statistics analyzed differences between two groups: jurisdiction type and population size. Two logistic regression models analyzed earthquakes and hurricane …

In Search Of Justification For The Unpredictability Paradox, Jeremy Howick, Alexander Mebius

Alexander Mebius

A 2011 Cochrane Review found that adequately randomized trials sometimes revealed larger, sometimes smaller, and often similar effect sizes to inadequately randomized trials. However, they found no average statistically significant difference in effect sizes between the two study types. Yet instead of concluding that adequate randomization had no effect the review authors postulated the “unpredictability paradox”, which states that randomized and non-randomized studies differ, but in an unpredictable direction. However, stipulating the unpredictability paradox is problematic for several reasons: 1) it makes the authors’ conclusion that adequate randomization makes a difference unfalsifiable—if it turned out that adequately randomized trials had …

The Economics Of Implementing Population Health Strategies, Glen P. Mays

Glen Mays

Successful strategies to scale up and spread complex community-level interventions require an understanding of the resources required for implementation, how best to distribute them among supporting institutions, and how resource consumption and distribution varies across settings. This session reviews methods and early findings from the RWJF’s Public Health Delivery and Cost Studies (DACS) Initiative, which includes 12 inter-related studies examining the causes and consequences of variation in the costs of delivering complex community-level prevention strategies across more than 300 community settings in 12 states. Findings from these studies highlight the value of studying the economics of implementation, the measurement and …

Ideas For A Healthy Baby--Reducing Disparities In Use Of Publicly Reported Quality Data: Study Protocol For A Randomized Controlled Trial, Sarah L. Goff, Penelope S. Pekow, Katharine O. White, Tara Lagu, Kathleen M. Mazor, Peter K. Lindenauer

Peter Lindenauer MD

BACKGROUND: Publicly reported performance on quality measures is intended to enable patients to make more informed choices. Despite the growing availability of these reports, patients' use remains limited and disparities exist. Low health literacy and numeracy are two barriers that may contribute to these disparities. Patient navigators have helped patients overcome barriers such as these in other areas, such as cancer care and may prove useful for overcoming barriers to using publicly reported quality data. METHODS/DESIGN: The goals of this study are: to determine the efficacy of a patient navigator intervention to assist low-income pregnant women in the use of …

Clear: Conversations: A Collaborative Regional Project To Help Patients Improve Their Health Visits, Michelle L. Eberle, Margot Malachowski, Alberta Richetelle, Monina Lahoz, Linda Mcintosh, Bradley Moore, Jen Searl, Judy Kronick

Margot G Malachowski, MLS, AHIP

Objective: The National Network of Libraries of Medicine, New England Region’s Clear: Conversations project aimed to teach health literacy skills to help patients communicate better with their health care providers including how to: ask for simple language and slow down the provider, use teach-back, bring medications and supplements for a brown bag review, and get need-to-know information. Methods: Five organizations were awarded with Clear: Conversations materials that were adapted from a program created by Health Literacy Missouri. A highlight of the workshop was a role play between a health care provider and patient. Awardees were required to offer the workshop …

What Makes Orphans In Kigali, Rwanda, Non-Adherent To Antiretroviral Therapy? Perspectives Of Their Caregivers, Kimiyo Kikuchi, Krishna C. Poudel, John Muganda, Tomoko Sato, Vincent Mutabazi, Ribakare Muhayimpundu, Adolphe Majyambere, Simon P. Ngyonsenga, Eriko Sase, Masamine Jimba

Krishna C. Poudel

Health Professionals’ Roles In Animal Agriculture, Climate Change, And Human Health, Aysha Z. Akhtar, Michael Greger, Hope Ferdowsian, Erica Frank

Michael Greger, MD, FACLM

What we eat is rapidly becoming an issue of global concern. With food shortages, the rise in chronic disease, and global warming, the impact of our dietary choices seems more relevant today than ever. Globally, a transition is taking place toward greater consumption of foods of animal origin, in lieu of plantbased diets. With this transition comes intensification of animal agriculture that in turn is associated with the emergence of zoonotic infectious diseases, environmental degradation, and the epidemics of chronic disease and obesity. Health professionals should be aware of these trends and consider them as they promote healthier and more …

Opportunities And Future Directions For The National Health Security Preparedness Index, Glen P. Mays

Glen Mays

This presentation examines options and opportunities for future development of the National Health Security Preparedness Index, created through a partnership of national public health and health care organizations led by the U.S. Centers for Disease Control and Prevention (CDC) and the Association of State and Territorial Health Officials (ASTHO).

How We Eat What We Eat: Identifying Meal Routines And Practices Most Strongly Associated With Healthy And Unhealthy Dietary Factors Among Young Adults, Mary Hearst, Melissa N. Laska, Katherine Lust, Leslie A. Lytle

Mary Hearst

No abstract provided.

Community Health Worker Interventions For Latinos With Type 2 Diabetes: A Systematic Review Of Randomized Controlled Trials, Tariana V. Little, Monica L. Wang, Eida M. Castro, Julio Jiménez, Milagros C. Rosal

Tariana V. Little

This systematic review aimed to synthesize glucose (HbA1c) outcomes of community health worker (CHW)-delivered interventions for Latinos with type 2 diabetes that were tested in randomized controlled trials and to summarize characteristics of the targeted populations and interventions, including the background, training, and supervision of the CHWs. Searches of PubMed and Google Scholar databases and references from selected articles identified 12 studies that met the inclusion criteria. Of these, seven reported statistically significant improvements in HbA1c. Study participants were largely low-income, female, and Spanish-speaking and had uncontrolled diabetes. The CHWs led the interventions alone, in pairs, or as part of …

Background On The Program Management Office For The National Health Security Preparedness Index At The University Of Kentucky, Glen P. Mays

Glen Mays

The University of Kentucky’s National Health Security and Preparedness Index (NHSPI) Program Management Office is a consortium of four of the university’s leading research centers that collaborate in producing, translating, and disseminating data and analyses to mobilize improvements in health and wellbeing: (1) the National Coordinating Center for Public Health Services & Systems Research (PHSSR) within the College of Public Health, (2) the Center for Business and Economic Research (CBER) within the College of Business and Economics; (3) the Division of Risk Sciences within the College of Communication and Information; and (4) the campus-wide Dissemination and Implementation Sciences Consortium (DISC). …

Impact Of A Rapid Response System In A Children's Hospital, Erich C. Maul Do, Mph

Erich C. Maul DO MPH

My capstone project demonstrating the impact for a rapid response system in a children's hospital within a larger general hospital.

Resilience : An Independent Psychobiological Mental Health Construct (Guest Editorial), Amresh Srivastava

Amresh Srivastava

Survival against trauma is a unique characteristic of all human beings. While a number of factors contribute in building this capacity, resilience appears to be the most important one. Interest in studying resilience arises from number of areas which are of utmost clinical significance such as such as exploring the possibility of at-risk individuals who developing a mental illness]. Resilience is a human capacity to adapt swiftly and successfully to stressful or traumatic events and revert back to a positive state. It is commonly conceptualized as the ability to thrive despite experiencing adversity

Development Of A Self-Report Measure Of Dual Diagnosis Capability For Addiction And Mental Health Programs, Kenneth E. Fletcher, Anna Kline, Tara Zandi, Gregory Seward, Sun Kim, Douglas M. Ziedonis

Douglas M. Ziedonis

The purpose of this study is to develop and test the psychometrics of a self-report version of a measure of the capacity of addiction and mental health programs to deliver dual-diagnosis treatment, that is, to provide treatment for both addiction problems and mental health problems. Traditionally these services are provided by very different service providers that did not until recently interact very well, if at all. The increasing recognition that patients who suffer from both kinds of problems – who are dually diagnosed – would benefit from integrated delivery of addiction and mental health services has led to efforts to …

Implementing The Massachusetts Child Trauma Project (Mctp) To Improve Services For Children With Complex Trauma In Child Welfare: Phase I Needs And Readiness Assessment, Charmaine B. Lo, Melodie Wenz-Gross, Jessica L. Griffin

Melodie Wenz-Gross

MCTP seeks to improve placement stability and outcomes for children with complex trauma in the care of the Massachusetts Department of Children and Families (DCF) by creating a sustainable capacity for providing evidence-based trauma interventions within provider agencies, and trauma-informed practices within DCF.

Outpatient Commitment: A Competency Based Justification, Albert J. Grudzinskas, Jeffrey L. Geller, Jonathan C. Clayfield, William H. Fisher

Jeffrey L. Geller

A recent survey of state statutes for outpatient commitment (Torrey and Kaplan, 1995) indicates that while thirty-five states and the District of Columbia have laws permitting outpatient commitment, Massachusetts is not one of them. Rather, Massachusetts uses a competency-based, substituted-decision-making model for the involuntary administration of medication in the community. To appreciate the Massachusetts model, it is important to understand how this court-ordered involuntary outpatient treatment fits into the overall scheme of outpatient commitment and how it is structured. A review of involuntary outpatient treatment (IOT) literature indicates that it is prudent to distinguish between outpatient commitment, conditional release, and …

The Family Options Project: Implementing An Innovative Intervention For Parents With Mental Illnesses And Their Families, Joanne Nicholson, Kathleen Biebel, Valerie F. Williams, Elizabeth A. Aaker, Karen Albert, Bernice Gershenson, Brenda Warren, Katherine Woolsey

Kathleen Biebel

The Family Options Project reflects a productive partnership between researchers and providers at the UMMS Center for Mental Health Services Research and Employment Options, Inc., Marlborough, MA The Family Options Intervention is an evidence-informed psychiatric rehabilitation intervention, developed and tested within the context of a community-based agency setting.

Promoting Global Health Awareness Through Hands-On Training, Christina B. Gunther

Christina B. Gunther

Christina Gunther, Director, Global Programs & Assessment at Sacred Heart University, discusses her work with students in global health awareness through service learning and mission trips, study abroad and international clincal experiences.

The Dynamics Of Medicaid & Public Health Spending: Implications For Aca Implementation, Glen P. Mays

Glen Mays

We estimate the dynamics and interactions of governmental spending on Medicaid and other public health services in all 50 states over a 15 year period. Using a quasi-experimental design with instrumental variables estimation, we find evidence that increased Medicaid spending leads to reduced governmental spending on other public health services, consistent with a crowd-out effect. Over 10 years, such crowd-out has the potential to diminish the health status improvements generated through health insurance coverage expansions.

Aca Implementation In Kentucky: Experiences Of An Expansion State, Glen P. Mays

Glen Mays

Kentucky's implementation of the Affordable Care Act has included early successes with insurance coverage expansion through Medicaid and a state-operated health insurance exchange. Signals of improvements in health care accessibility and delivery of preventive services are evident in the first year after coverage expansions. Challenges associated with political opposition, delivery system transformation, and public health financing remain on the state's policy agenda.

Geographic Variation In The Delivery Of High-Value Public Health Services:Exploring Causes & Consequences, Glen P. Mays

Glen Mays

OBJECTIVES: A growing body of evidence indicates that the delivery of public health activities varies widely across states and communities, creating missed opportunities for prevention as well as inequities in health protection. Measures of quality in public health are needed to guide public health improvement initiatives and to support research on the comparative effectiveness of alternative public health strategies. The Multi-network Practices and Outcomes Variation Examination Study (MPROVE), uses the infrastructure of six Public Health Practice-Based Research Networks (PBRNs) across the U.S. to develop and validate a “starter set” of measures and to analyze geographic variation delivery across diverse public …

Cost Estimates Of Foundational Public Health Services:Results From Piloting An Expert Consensus Methodology, Cezar B. Mamaril, Glen P. Mays

Glen Mays

We review preliminary estimates from pilot testing a cost estimation methodology developed to identify the resources required to implement a set of Foundational Public Health Services as recommended by the Institute of Medicine and defined by the Public Health Leadership Forum.

Medicaid Expansions & Public Health Spending: Cross-Subsidies, Complementarities, And Crowd-Out, Glen Mays

Glen Mays

In this paper we estimate the causal impact of state Medicaid enrollment expansions and expenditures on state and local resources allocated to other public health programs and services. Using a quasi-experimental design with instrumental variables estimation, we find evidence that increased Medicaid spending leads to reduced governmental spending on other public health services, consistent with a crowd-out effect. Over 10 years, such crowd-out has the potential to diminish the health status improvements generated through health insurance coverage expansions.