Medicine and Health Sciences Commons^™

Children At Risk For Suicide Attempt And Attempt-Related Injuries: Findings From The 2007 Youth Risk Behavior Survey, Bethany A. West, Monica H. Swahn, Frances Mccarty

Public Health Faculty Publications

Purpose: The current study examines the associations between a range of risk factors and reports of suicide attempts and attempts requiring medical care in a nationally representative study of high school students. The goal is to examine sex differences in the risk factors associated with suicide attempts and attempt-related injuries requiring treatment by a health-care provider.

Methods: We used data from the 2007 Youth Risk Behavior Survey for students in grades 9-12 to assess the prevalence and risk factors for suicidal behavior, as well as differences in these for boys and girls. Cross-sectional multivariate logistic regression analyses were computed to …

Biomonitoring Studies Should Be Used By Regulatory Agencies To Assess Human Exposure Levels And Safety Of Bisphenol A, Laura Vandenberg, Ibrahim Chahoud, Vasantha Padmanabhan, Francisco Paumgartten, Gilbert Schoenfelder

Laura Vandenberg

BACKGROUND: Within the past 3 years, four major evaluations of bisphenol A (BPA) safety have been undertaken. However, these assessments have arrived at quite different conclusions regarding the safety of BPA at current human exposure levels. OBJECTIVES: We compared the reasons provided by the European Food Safety Authority (EFSA) BPA risk assessment panel for their conclusion that human exposures are negligible with the conclusions reached by the other panels, with all panels having the same body of literature at their disposal. DISCUSSION: The EFSA panel dismissed > or = 80 biomonitoring studies that documented significant levels of BPA exposure in humans, …

A Stepwise Approach To Stroke Surveillance In Brazil: The Emma (Estudo De Mortalidade E Morbidade Do Acidente Vascular Cerebral) Study, Paulo A. Lotufo

Paulo A Lotufo

Background: Stroke mortality rates in Brazil are the highest in the Americas. Deaths from cerebrovascular disease surpass coronary heart disease. Aim: To verify stroke mortality rates and morbidity in an area of Sa˜o Paulo, Brazil, using the World Health Organization Stepwise Approach to Stroke Surveillance. Methods: We used the World Health Organization Stepwise Approach to Stroke Surveillance structure of stroke surveillance. The hospital-based data comprised fatal and nonfatal stroke (Step 1). We gathered stroke-related mortality data in the community using World Health Organization questionnaires (Step 2). The questionnaire determining stroke prevalence was activated door to door in a family-healthprogramme neighbourhood …

2009 Annual Report Of Child Deaths In Clark County, Nevada, Nevada Institute For Children’S Research And Policy

Nevada Institute for Children's Research and Policy Reports

In an effort to identify risk factors and prevent future child deaths, in 1992 the State of Nevada joined many other states in mandating Child Death Review Teams. Since that time, both the law and the regional teams throughout Nevada have evolved to facilitate the growing need for collaborative efforts to identify interventions necessary to reduce the rate of child deaths in Nevada. While the primary legislative focus of Nevada Child Death Review Teams has been on addressing fatalities related to child maltreatment and/or involvement with the child welfare system, the teams have expanded their focus to address risk factors …

Chhs September Enewsletter, Dr. John Bonaguro, Dean, Vashon S. Wells, Editor, Wku College Of Health & Human Services

College of Health & Human Services Publications

No abstract provided.

Chhs August Enewsletter, Dr. John Bonaguro, Dean, Vashon S. Wells, Editor

College of Health & Human Services Publications

No abstract provided.

Young Women’S Responses To Smoking And Breast Cancer Risk Information, Joan L. Bottorff, Stephanie Barclay Mckeown, Joanne Carey, Rebecca Haines, Chizimuzo T.C. Okoli, Kenneth C. Johnson, Julie Easley, Roberta Ferrence, Lynne Baillie, Erin Ptolemy

Chizimuzo T.C. Okoli

Current evidence confirms that young women who smoke or who have regular long-term exposure to secondhand smoke (SHS) have an increased risk of developing premenopausal breast cancer. The aim of this research was to examine the responses of young women to health information about the links between active smoking and SHS exposure and breast cancer and obtain their advice about messaging approaches. Data were collected in focus groups with 46 women, divided in three age cohorts: 15–17, 18–19 and 20–24 and organized according to smoking status (smoking, non-smoking and mixed smoking status groups). The discussion questions were preceded by information …

The Role Of Unrealistic Optimism In Explaining Preventive Behaviors In High Versus Low Endemic Malaria Settings In Belize, Daniel G. Handysides

Loma Linda University Electronic Theses, Dissertations & Projects

Background: Of all the diseases an individual can encounter in the world, malaria is one of the most destructive. Simple measures like sleeping under a bednet would greatly reduce the burden (Abeku, 2007). When people estimate their risk relative to others, they are most often unrealistically optimistic, which may explain why those at risk often fail to perform behaviors, such as using a bednet that will reduce their risk. However, one study showed that people at high risk for malaria held pessimistic perceptions of their risk for the disease, but the reasons for this finding are unclear (Morrison, Ager, & …

Program Evaluation Of A Community-Based Door-Through-Door Medical Escort Service, Lauren A. Martin

Gerontology Institute Publications

This report summarizes the program evaluation findings of a Boston-based organization’s Medical Escort program. This “door-through-door” service strives to provide medical transportation, physical assistance, and emotional support to elders on their way to the doctor’s office, during medical appointments and on the way back home again. By offering added assistance the program attempts to remove environmental barriers associated with access to health care. This evaluation combines previously collected program statistics with surveys (32) from program volunteers and phone interviews (78) with recipients.

Counselor Preferences Of White University Students: Ethnicity And Other Important Characteristics, Yi-Ying Lin

Masters Theses

In the last several decades, multiculturalism has became the one of the most popular research topics in psychology and counseling, and the counselor preferences of ethnic minority clients has been well researched. However, in the history of research on counselor preferences, the needs and preferences of ethnic majority clients have been neglected. This study investigated the counselor preferences of White university students.

This study examined three primary research questions: whether counselor ethnicity influenced White university students’ initial counselor preferences, what were White university students’ preferences for various counselor characteristics, and whether White university students preferred specific counseling styles for different …

Religiosity, Spirituality And Attendance At Religious Services Among Recreational Drug Users: A Sub-Analysis Of The Drugnet Survey, Sohini Dhar

Masters Theses & Specialist Projects

This study is a sub-analysis ofthe previously collected cross-sectional DRUGNET survey data. The sample included 1,178 current users of illicit drugs and 389 former users. This study was delimited to U.S. citizens, aged 18 years and older, who completed the DRUGNET survey (n =1,567). DRUGNET was a descriptive online survey of self - reported attitudes and behaviors among a group of adult, self - identified drug users (i.e., not drug abusers). The purpose of the sub-analysis was to explore the importance of religion, spirituality, and religious service attendance in the context of an otherwise normal healthy adult life. Moreover, it …

Body Image In Middle-Aged Mormon Women: A Comparative Case Study, Janette Olsen

Faculty Publications

Body image is a multifaceted construct developed from perceived experiences and personal and cultural attitudes towards the body. Women are more vulnerable than men to internal and external influences regarding negative body image. A qualitative comparative case study design was utilized to explore how 10 lifelong, middle-aged LDS women, either married (n=5) with children or single, never married (n=5), experienced body image through their perceptions of religiosity and spirituality. The participants lived along the Wasatch Front in Utah and were recruited through known LDS gatekeepers. Each participant completed three in-person interviews and three audio or paper journals, which were transcribed …

Contextualizing The Health Belief Model And The Social Epidemiology Theories In The Study Of Aids In Malawi, Kumbirai Madondo

All Theses

The association between HIV/AIDS knowledge, risk perception and risky sexual behavior remains a valuable area of study among scholars seeking to understand the AIDS epidemic in Africa. Past research has focused only on either the Health Belief Model or social epidemiology ideas to understand AIDS but never combined the two. The current study is unique and adds to the body of knowledge by making use of both the Health Belief Model and social epidemiology ideas to understand these relationships more clearly and, more importantly, to explore the role that keeping AIDS a secret has in the contexts of risk perception, …

Metabolic Syndrome And Risk Of Death From Cancers Of The Digestive System, Charles E. Matthews, Xuemei Sui, Michael J. Lamonte, Swann A. Adams, James R. Hébert, Steven N. Blair

Faculty Publications

We tested the hypothesis that risk of early mortality from cancers of the digestive system will be greater in men with, compared to men without, the metabolic syndrome (MetS). Participants were 33,230 men who were seen at the Cooper Clinic in Dallas, Texas and followed for 14.4 (SD=7.0) yrs. MetS was defined as having at least three of the following risk factors: abdominal obesity, fasting hypertriglyceridemia, low high-density lipoprotein cholesterol, high blood pressure, or high fasting glucose level or diabetes. MetS was associated with higher mortality (HR=1.90 [95% Confidence Interval=1.42-2.55]), and there was a graded positive association for the addition …

Perceived Stigma Among Patients Receiving Antiretroviral Treatment: A Prospective Randomised Trial Comparing An M-Dot Strategy With Standard-Of-Care In Kenya, Susan Kaai, Sandra Bullock, Avina Sarna, Matthew Chersich, Stanley Luchters, Scott Geibel, Kishorchandra Mandaliya, Marleen Temmerman, Naomi Rutenberg

Population Health, East Africa

HIV and AIDS remain highly stigmatised. Modified directly observed therapy (m-DOT) supports antiretroviral treatment (ART) adherence but little is known about its association with perceived stigma in resource-constrained settings. In 2003, 234 HIV-infected adults enrolled in a two-arm randomised trial comparing a health centre-based m-DOT strategy with standard self-administration of ART. Data on perceived stigma were collected using Berger's HIV stigma scale prior to starting ART and after 12 months. This was a secondary analysis to examine whether perceived stigma was related to treatment delivery. Perceived stigma scores declined after 12 months of treatment from a mean of 44.9 (sd=7.6) …

Drive Alive: Teen Seat Belt Survey Program, Katie M. Burkett, Steve Davidson, Carol Cotton, James Barlament, Laurel Loftin, James H. Stephens, Martin Dunbar, Ryan Butterfield

Health Policy and Management Faculty Publications

Objective: To increase teen seat belt use among drivers at a rural high school by implementing the Drive Alive Pilot Program (DAPP), a theory-driven intervention built on highway safety best practices.

Methods: The first component of the program was 20 observational teen seat belt surveys conducted by volunteer students in a high school parking lot over a 38-month period before and after the month-long intervention. The survey results were published in the newspaper. The second component was the use of incentives, such as gift cards, to promote teen seat belt use. The third component involved disincentives, such as increased police …

Public Health In Georgia, An Internet Advocacy Tool: A Capstone Project, Patricia B. Garcia

Public Health Theses

Local Public Health programs are at the frontline of Georgia’s struggle to prevent disease, prolong citizens’ lives, and promote health. In recent history it has been observed that both Georgia’s citizens and state government do not completely understand the breadth of the Public Health system and all it beneficiaries. Unfortunately this lack of comprehension about the scope of Public Health programs has lead to a significant decrease in support and funding. This capstone project describes the systematic development of an online educational portal that is a central tool used in the Public Health advocacy campaign in Georgia, “Partner-Up for Public …

Assessing Mississippians’ Preparedness For Disasters Using The Citizen Corps National Survey 2009, Carl Huston Mangum Ii

Dissertations

Disaster preparedness, a shared responsibility of all citizens and disaster agencies, is the most critical component in minimizing risk and damage from disaster. Mississippi has been affected by some of the most devastating disasters in American history, both in terms of physical destruction and human life. The purpose of this study was to assess Mississippians’ disaster preparedness by replicating The 2009 Citizen Corps National Survey (CCNS). The 65 question 2009 CCNS was slightly modified to survey 678 randomly selected Mississippians about the Citizen Corps Personal Disaster Preparedness Model: Demographics, Volunteering, Drills/Exercises, Community Plan, Household Plan, Disaster Supplies, Prevention, Self-efficacy, Reliance, …

The Influence Of Perspective And Gender On The Processing Of Narratives, Jeremy A. Houska

UNLV Theses, Dissertations, Professional Papers, and Capstones

The overarching aim of this research was to examine potential boundary conditions to situation model construction (Experiment 1) and narrative-based persuasion (Experiment 3). Variables such as narrative perspective (i.e., 2nd or 3rd person) and matched characteristics with the reader (i.e., participant-protagonist gender match) were first examined using situation model updating (Experiment 1) and behavioral measures (Experiment 3) as dependent measures. It was expected that situation model updating would be more likely for narratives written in the 2nd person perspective and with a participant-protagonist gender match. It was uncertain, however, for health promotion narratives, whether these manipulations would increase the likelihood …

Controle De Infecção Em Clínicas De Cirurgia Plástica / Infection's Control In Plastic Surgery Clinics, Everton Fernando Alves

Everton Fernando Alves

A infecção é a mais frequente e grave complicação que acomete pacientes que procuram serviços estéticos e/ou funcionais em clínicas de cirurgia plástica. Uma infecção hospitalar eleva os custos do processo, tanto para o paciente quanto para a empresa. Diante disso, torna-se importante a instalação de uma comissão de controle de infecção hospitalar, tendo como responsável um enfermeiro. A importância deste profissional se dá por meio da organização da Central de Material Estarilizado (CME), bem como do estabelecimento de outras medidas efetivas para a prevenção e controle de infecções nas clínicas apresentadas ao longo desse artigo.

Urinary, Circulating, And Tissue Biomonitoring Studies Indicate Widespread Exposure To Bisphenol A, Laura Vandenberg, Ibrahim Chahoud, Jerrold J. Heindel, Vasantha Padmanabhan, Francisco J.R. Paumgartten, Gilbert Schoenfelder

Laura Vandenberg

BACKGROUND: Bisphenol A (BPA) is one of the highest-volume chemicals produced worldwide, and human exposure to BPA is thought to be ubiquitous. Thus, there are concerns that the amount of BPA to which humans are exposed may cause adverse health effects. Importantly, results from a large number of biomonitoring studies are at odds with the results from two toxicokinetic studies. OBJECTIVE: We examined several possibilities for why biomonitoring and toxicokinetic studies could come to seemingly conflicting conclusions. DATA SOURCES: We examined > 80 published human biomonitoring studies that measured BPA concentrations in human tissues, urine, blood, and other fluids, along with …

Epidemiology Of Adiposity In Childbearing Ghanaian Women, Emma Roselyne Konan Mrs

Public Health Theses

ABSTRACT BACKGROUND: The prevalence of adiposity (overweight and obesity) is increasing in among Ghanaian women. The disparity between urban and rural Ghanaian women in adiposity is seldom described due to data paucity. The purpose of this study was to provide a comparative analysis between urban and rural women in regards to the socio-demographic factors associated with adiposity. METHODS: The analyses used cross-sectional data from the Ghana Demographic Health Survey involving child bearing women ages14 to 49 years old. The eligible population comprised 4848 non-pregnant women (2023 from urban and 2825 from rural areas). Residence-specific (urban versus rural) associations between selected …

Examining The Interrater Reliability Of The Comprehensive Inventory Of Mental Health And Recovery And Rehabilitation Services (Cimhrrs), Robert W. Johnson

Department of Psychology: Dissertations, Theses, and Student Research

This dissertation is one step in the continuing development, evaluation, and validation of the Comprehensive Inventory of Mental Health and Recovery and Rehabilitation Services (CIMHRRS). The CIMHRRS is an instrument to guide comprehensive assessment of programs that provide integrated services to people with serious mental illness (SMI).

The project described in this dissertation evaluated three key aspects of its performance in real world application: practical feasibility, internal consistency and reliability, and ability to distinguish between different programs. Investigators utilized a combination of principles and methods, associated with psychometric scale development, field methods, and program evaluation. Using a structured site review …

Changes In The Viral Distribution Pattern After The Appearance Of He Novel Influenza A H1n1 (Ph1n1) Virus In Influenza-Like Illness Patients In Peru, Gerardo Chowell, Victor Alberto Laguna-Torres, Jorge Gomez, Patricia V. Aguilar, Julia Ampuero, C V. Munayco, Victor Ocana, Juan Perez, Maria Gamero, Juan Arrasco, Irmia Paz, Edward Chavez, Rollin Cruz, Jaime Chavez, Silvia Mendocilla, Elizabeth Gomez, Juana Antigoni, Sofia Gonzalez, Cesar Tejada, Tadeusz Kochel

Public Health Faculty Publications

Background: We describe the temporal variation in viral agents detected in influenza like illness (ILI) patients before and after the appearance of the ongoing pandemic influenza A (H1N1) (pH1N1) in Peru between 4-January and 13-July 2009. Methods: At the health centers, one oropharyngeal swab was obtained for viral isolation. From epidemiological week (EW) 1 to 18, at the US Naval Medical Research Center Detachment (NMRCD) in Lima, the specimens were inoculated into four cell lines for virus isolation. In addition, from EW 19 to 28, the specimens were also analyzed by real time-polymerase-chainreaction (rRT-PCR).

Results: We enrolled 2,872 patients: 1,422 …

Injection Safety Patient Notification Communication Toolkit, Brian J. Panasuk

Public Health Theses

Unsafe injection practices put patients and healthcare providers at risk of infectious disease and have been associated with a wide variety of procedures and settings. Safe Injection Practices are part of Standard Precautions and are aimed at maintaining basic levels of patient safety and provider protections. However, from 1999 - 2009, more than 30 outbreaks of Hepatitis B or Hepatitis C from unsafe injection practices have occurred resulting in more than 150,000 patients being notified of potential exposure.

Breaches in injection safety have the potential to be high profile and sensitive, and although individual incidents may vary, the actions that …

A Comparison Of Methods To Assess Practitioner Fidelity In A Parent-Training Program, Ashwini Tiwari

Public Health Theses

As evidence-based programs are implemented in real world settings, there is a strong need to effectively and efficiently monitor fidelity, or adherence to a program, in order to maintain the expected effects demonstrated in research settings. The purpose of this study was to compare two methods of assessing fidelity to an evidence-based, parent-training model (SafeCare®) as implemented by community service providers. Specifically, analyses compared fidelity assessed via video versus audio recordings. SafeCare modules often require mobility and high interaction, thus, video recordings may provide a more accurate view of home visitor and family interactions for scoring fidelity. However, videos are …

Medicare Physician Fees: The Data Behind The Numbers, Laura A. Dummit

National Health Policy Forum

Medicare’s physician fee schedule distributes nearly $60 billion annually and is a critical determinant of individual physicians’ incomes, beneficiaries' access to health care services, and Medicare spending, as well as the basis for physician fees used by many private payers. The Centers for Medicare & Medicaid Services (CMS) relies on data derived from expert judgment and other sources to update the fee schedule. Although CMS’s methods and data for maintaining the fee schedule have improved over the years, concerns remain about medical specialty society involvement and the lack of an effective ”counterweight” to vested interests in establishing and updating the …

Corticosteroids For Pain Relief In Sore Throat: Systematic Review And Meta-Analysis, Gail Hayward, Matthew J. Thompson, Carl J. Heneghan, Rafael Perera, Paul P. Glasziou, Chris B. Del Mar

Paul Glasziou

Objective: To evaluate whether systemic corticosteroids improve symptoms of sore throat in adults and children. Design: Systematic review and meta-analysis. Data sources: Cochrane Central, Medline, Embase, Database of Reviews of Effectiveness (DARE), NHS Health Economics Database, and bibliographies. Outcome measures: Percentage of patients with complete resolution at 24 and 48 hours, mean time to onset of pain relief, mean time to complete resolution of symptoms, days missed from work or school, recurrence, and adverse events. Results: We included eight trials, consisting of 743 patients in total (369 children, 374 adults). 348 (47%) had exudative sore throat, and 330 (44%) were …

Corticosteroids For Pain Relief In Sore Throat: Systematic Review And Meta-Analysis, Gail Hayward, Matthew J. Thompson, Carl J. Heneghan, Rafael Perera, Paul P. Glasziou, Chris B. Del Mar

Christopher Del Mar

Objective: To evaluate whether systemic corticosteroids improve symptoms of sore throat in adults and children. Design: Systematic review and meta-analysis. Data sources: Cochrane Central, Medline, Embase, Database of Reviews of Effectiveness (DARE), NHS Health Economics Database, and bibliographies. Outcome measures: Percentage of patients with complete resolution at 24 and 48 hours, mean time to onset of pain relief, mean time to complete resolution of symptoms, days missed from work or school, recurrence, and adverse events. Results: We included eight trials, consisting of 743 patients in total (369 children, 374 adults). 348 (47%) had exudative sore throat, and 330 (44%) were …

Excluding Serious Illness In Feverish Children In Primary Care: Restricted Rule-Out Method For Diagnosis, Matthew J. Thompson, Anthony Harnden, Chris Del Mar

Christopher Del Mar

Extract: The list of possible diagnoses for febrile children seen in primary care is long. Identifying children who may have a serious illness can be difficult and is at the heart of decisions to prescribe, investigate, and refer to hospital. Serious infections (including pneumonia, meningitis, septicaemia, appendicitis) account for less than 1% of children presenting to primary care, yet they are leading causes of morbidity and mortality in children. One of the key challenges for primary care practitioners is trying to balance the risk of missing a serious disease against unnecessary investigation or referral. The diagnostic process hinges on the …