Medicine and Health Sciences | Open Access Articles

Health Information Access

The Southeastern Librarian

The National Network of Libraries of Medicine, Southeastern Atlantic Region, wishes to remind libraries in the region that they provide training and assistance with health information access to the public.

Go to article

Redesigning Practice To Improve Care Delivery (Boston), Laura A. Dummit, Lisa Sprague

National Health Policy Forum

This site visit focused on how the practice of medicine is changing or can be changed to improve care delivery across the spectrum of patient populations. Regarded as a “medical Mecca,” Boston is home to the academic health centers and teaching hospitals where many of the nation’s physicians are trained. As a center of innovation, Boston prides itself on its high bar with respect to standards of care. Panels addressed the used of clinical information technology (IT) in the physician’s office, in the hospital, and community-wide. Participants observed how IT is being used to further the mission of community health …

Go to article

What Is Comprehensive Sexuality Education Really All About? Perceptions Of Students Enrolled In An Undergraduate Human Sexuality Course, Eva Goldfarb

Department of Public Health Scholarship and Creative Works

The purpose of this study was to use qualitative evaluation techniques to explore the perceptions of students enrolled in undergraduate human sexuality classes regarding their expectations for the course as well as outcomes. One hundred forty-eight students were surveyed at the beginning and again at the end of the semester-long course. While pregnancy and STI prevention were considered important components of their courses, other outcomes associated with positive, healthy sexuality were given greater emphasis. Results suggest that while primary and secondary level sexuality education have been increasingly focused on abstinence-only education with a focus on pregnancy and STI reduction, this …

Go to article

Medicare Advantage Snps: A New Opportunity For Integrated Care?, Christie Provost Peters

National Health Policy Forum

Medicare Advantage special needs plans (SNPs) are a new type of coordinated care plan established by the Medicare Prescription Drug, Improvement and Modernization Act. SNPs were created to encourage greater access to Medicare managed care for certain special needs populations: the institutionalized, persons dually eligible for Medicare and Medicaid, and the chronically ill. Some view SNPs as a new opportunity to integrate acute and long-term care services as well as Medicare and Medicaid financing. Others, however, question the degree to which full integration will become a widespread reality. This issue brief examines the SNP option and the promises and challenges …

Go to article

Oral Contraceptive Use And Risk Of Breast Cancer Among Women With A Family History Of Breast Cancer: A Prospective Cohort Study, Stephanie A. Navarro Silvera, Anthony B. Miller, Thomas E. Rohan

Department of Public Health Scholarship and Creative Works

Family history of breast cancer is an established risk factor for breast cancer. In addition, there is evidence that oral contraceptive use may be associated with a moderate increase in breast cancer risk. The three cohort studies that have investigated the relationship between oral contraceptive use and breast cancer risk among women with a family history of breast cancer have yielded mixed results, possibly due to the relatively small sample sizes employed and/or differences in the selection of covariates for inclusion in multivariate models. Therefore, we examined the association between oral contraceptive use and breast cancer risk in a large …

Go to article

Cigarette Smoking And Risk Of Glioma: A Prospective Cohort Study, Stephanie A. Navarro Silvera, Anthony B. Miller, Thomas E. Rohan

Department of Public Health Scholarship and Creative Works

The etiology of glioma, the most commonly diagnosed malignant brain tumor among adults in the United States, is poorly understood. N‐nitroso compounds are known carcinogens, which are found in cigarette smoke and can induce gliomas in rats. On this basis, it has been hypothesized that cigarette smoking may be associated with an increased risk of glioma. We investigated the association between cigarette smoking and glioma risk in the National Breast Screening Study, which included 89,835 Canadian women aged 40–59 years at recruitment between 1980 and 1985. Linkages to national cancer and mortality databases yielded data on cancer incidence and deaths …

Go to article

Cigarette Smoking And Risk Of Glioma: A Prospective Cohort Study, Stephanie A. Navarro Silvera, Anthony B. Miller, Thomas E. Rohan

Department of Public Health Scholarship and Creative Works

The etiology of glioma, the most commonly diagnosed malignant brain tumor among adults in the United States, is poorly understood. N‐nitroso compounds are known carcinogens, which are found in cigarette smoke and can induce gliomas in rats. On this basis, it has been hypothesized that cigarette smoking may be associated with an increased risk of glioma. We investigated the association between cigarette smoking and glioma risk in the National Breast Screening Study, which included 89,835 Canadian women aged 40–59 years at recruitment between 1980 and 1985. Linkages to national cancer and mortality databases yielded data on cancer incidence and deaths …

Go to article

El Vih En La Ciudad De Buenos Aires: Obstáculos En El Acceso Al Tratamiento En El Sector Público, Erica Tai-Le Bliss

Independent Study Project (ISP) Collection

The focus of my research is the access to HIV treatment in the public health sector in Buenos Aires. HIV testing and treatment are guaranteed, by law, financed completely by the government for patients in the public health sector who do not have any private insurance or social work insurance plan. Over three quarters of the registered cases of HIV are patients in the public sector. Although health care is free in the Capital, many patients don’t take HIV tests, seek treatment or eventually stop taking their medication. To investigate the motivations of the patients, I interviewed three sectors that …

Go to article

A Report From The Forum Session “Implementing The Medicare Prescription Drug Benefit: Continuing Challenges For States”, Lee Partridge

National Health Policy Forum

This National Health Policy Forum Meeting Report provides an overview and discussion of a technical session that took place on July 12, 2005. The meeting was designed to re-visit issues discussed at a similar meeting in July 2004, which was intended to offer a state perspective on the implementation of the Medicare Prescription Drug, Improvement, and Modernization Act (MMA) of 2003 and the new Medicare prescription drug benefit. This report provides an update on the implementation issues identified in 2004—including outreach, education and enrollment; coordination of care for individuals who are “dually eligible” for Medicare and Medicaid; and the cost …

Go to article

One Pill, Many Prices: Variation In Prescription Drug Prices In Selected Government Programs, Dawn Gencarelli

National Health Policy Forum

This paper updates a June 2002 National Health Policy Forum Issue Brief, "Average Wholesale Price for Prescription Drugs: Is There a More Appropriate Pricing Mechanism?" Since the release of that paper, Congress enacted the Medicare Prescription Drug, Improvement, and Modernization Act (MMA) of 2003, which created a new, comprehensive outpatient prescription drug benefit and reduced Medicare’s reliance on the average wholesale price (AWP) in paying for prescription drugs. This paper discusses the continued use of AWP as well as other pricing benchmarks that pertain to prescription drugs. It explains the relevance of these pricing mechanisms to different government programs and …

Go to article

Clinical Preventive Services: When Is The Juice Worth The Squeeze?, Eileen Salinsky

National Health Policy Forum

This paper provides an overview of clinical preventive services, including a definition of such services and the role of the U.S. Preventive Services Task Force in recommending which services should be routinely offered to patients. It also describes efforts to analyze the cost effectiveness of clinical preventive services and reviews the insurance coverage policies of private and public payers. Barriers to increased uptake of appropriate services are discussed and policy relevant issues are summarized.

Go to article

Caring For "Ryan White": The Fundamentals Of Hiv/Aids Treatment Policy, Jessamyn Taylor

National Health Policy Forum

This background paper provides an overview of the HIV/ AIDS epidemic in the United States and discusses how treatment of the disease and the populations most affected by it have changed over time. The federal government’s domestic and global efforts in prevention, research, and treatment of the disease are highlighted. The paper outlines the Ryan White Comprehensive AIDS Resources Emergency (CARE) Act, a set of programs that fund treatment services for uninsured and underinsured individuals living with HIV/AIDS, and places it in the context of other federal programs that fund treatment for HIV/AIDS. Policy issues for Ryan White’s potential congressional …

Go to article

Keeping Track Of Care: Quality And Technology At Lifebridge Health System (Baltimore), Judith Moore

National Health Policy Forum

This one-day site visit focused on quality and technology in acute, post-acute and long-term care at Sinai Hospital and Levindale Hebrew Geriatric Center and Hospital, both components of LifeBridge Health System in Baltimore. Participants traced the treatment paths of hypothetical cardiac and cancer patients through the hospital and explored the range of home- and community-based as well as institutional care available through the geriatric center. The role of clinical information technology was highlighted in both settings.

Go to article

Development And Validation Of An Anthropometrically Based Prediction Equation For Estimating The Percent Body Fat Of Post-Menopausal Black Females, Leanne Petry, Lloyd L. Laubach, Peter W. Hovey, Nikki Lynn Rogers, Bradford Towne, William Cameron Chumlea

Population and Public Health Sciences Faculty Publications

Anthropometric equations developed specifically for the estimation of body composition parameters in Black females are limited. Data from the Lifespan Health Research Center were used to develop a new, easy to use equation to estimate the percent body fat of post-menopausal Black females using simple and easy to collect anthropometrics. The body composition of 72 post-menopausal Black females was measured by Dual Energy X-ray Absorptiometry (DXA). Validation (N=55) and cross-validation groups (N=17) were randomly assigned. Prediction models were developed using stepwise multiple regression analyses with percent body fat as the dependent variable and various anthropometrics as the independent variables. The …

Go to article

Dietary Folate, Alcohol Consumption, And Risk Of Ovarian Cancer In An Italian Case-Control Study, Claudio Pelucchi, Monia Mereghetti, Renato Talamini, Eva Negri, Maurizio Montella, Valerio Ramazzotti, Silvia Franceschi, Carlo La Vecchia

Department of Public Health Scholarship and Creative Works

An increasing number of studies are focusing on the potential association between dietary folate intake and risk of various cancers (1), particularly of the colorectum and breast (2, 3). A low folate status can induce misincorporation of uracil into DNA, leading to chromosome breaks in humans and hence increasing cancer risk (4). Alcohol may increase folate requirements in the body and cause relative folate deficiencies (2). Although several findings on the relation between folate intake and ovarian cancer risk are inconsistent (5-9), recent results from two prospective …

Go to article

Mental Health And Juvenile Justice: Moving Toward More Effective Systems Of Care, Jane Koppelman

National Health Policy Forum

This issue brief discusses the mental health needs of youth who are involved with the juvenile justice system, how they come into contact with the system, and the evidence of the availability and quality of mental health services for such youth. The paper also explores public policy options for avoiding dependence on the juvenile justice system as a last resort for treating youth with mental disorders.

Go to article

Specialty Hospitals: Can General Hospitals Compete?, Laura A. Dummit

National Health Policy Forum

The rapid increase in specialty cardiac, surgical, and orthopedic hospitals has captured the attention of general hospitals and policymakers. Although the number of specialty hospitals remains small in absolute terms, their entry into certain health care markets has fueled arguments about the rules of “fair” competition among health care providers. To allow the smoke to clear, Congress effectively stalled the growth in new specialty hospitals by temporarily prohibiting physicians from referring Medicare or Medicaid patients to specialty hospitals in which they had an ownership interest. During this 18-month moratorium, which expired June 8, 2005, two mandated studies of specialty hospitals …

Go to article

Local Coverage Initiatives: Solution Or Band-Aid For The Uninsured?, Jennifer Ryan

National Health Policy Forum

This issue brief surveys health coverage expansion initiatives that are operating on the county or local level, often without the benefit of federal funding. The paper explores the circumstances that have made these initiatives possible and considers the ongoing barriers that local policymakers face in sustaining the programs. Descriptions of four initiatives illustrate the range and variety of programs in operation today and offer both best practices and lessons learned for other communities. The paper also includes a brief analysis of the key elements that make up a successful coverage initiative. Finally, this issue brief considers the role of local …

Go to article

Children With Special Health Care Needs: Minding The Gaps, Christie Provost Peters

National Health Policy Forum

This background paper examines the issue of children with special health care needs and their interaction with the health care system. Results from recent national and state surveys and studies were used to review the medical expenditures, utilization, and insurance coverage of these children. The paper also discusses weaknesses within the private and public delivery and financing systems that may hinder the access of certain families with children with special health care needs to important services.

Go to article

Risk Factors For Thyroid Cancer: A Prospective Cohort Study, Stephanie A. Navarro Silvera, Anthony B. Miller, Thomas E. Rohan

Department of Public Health Scholarship and Creative Works

Given the higher incidence rate of thyroid cancer among women compared to men and evidence that smoking and alcohol consumption may be inversely related to thyroid cancer risk, we examined thyroid cancer risk in association with menstrual, reproductive, and hormonal factors, and cigarette and alcohol consumption, in a prospective cohort study of 89,835 Canadian women aged 40–59 at recruitment who were enrolled in the National Breast Screening Study (NBSS). Linkages to national cancer and mortality databases yielded data on cancer incidence and deaths from all causes, respectively, with follow-up ending between 1998 and 2000. Cox proportional hazards models (using age …

Go to article

Stimulant Abuse In Ohio And The Rural South, Robert G. Carlson

Population and Public Health Sciences Faculty Publications

This paper summarizes the methods and findings from two NIDA-supported studies of methamphetamine (MA) abuse in rural Ohio, Kentucky, and Arkansas, conducted by researchers at the Wright State University Boonshoft School of Medicine, the University of Arkansas for Medical Sciences, and the University of Kentucky. In addition, patterns of MA abuse among young adult MDMA/ecstasy users in urban central Ohio are described. Finally, preliminary findings from the Ohio Substance Abuse Monitoring Network on trends in methamphetamine abuse in Dayton, Ohio, are presented.

Go to article

Public Health Advocacy To Change Corporate Practices: Implications For Health Education Practice And Research, Nicholas Freudenberg

Publications and Research

Corporate practices, such as advertising, public relations, lobbying, litigation, and sponsoring scientific research, have a significant impact on the health of the people in the United States. Recently, health professionals and advocates have created a new scope of practice that aims to modify corporate practices that harm health. This article describes how corporate policies influence health and reviews recent health campaigns aimed at changing corporate behavior in six industries selected for their central role in the U.S. economy and their influence on major causes of mortality and morbidity. These are the alcohol, automobile, food, gun, pharmaceutical, and tobacco industries. The …

Go to article

Rural Methamphetamine Abuse: An Ethnographic Perspective, Rocky L. Sexton, Robert G. Carlson

Population and Public Health Sciences Faculty Publications

No abstract provided.

Go to article

Hospital Oversight In Medicare: Accreditation And Deeming Authority, Lisa Sprague

National Health Policy Forum

To be eligible to receive payment from Medicare, hospitals must be certified to meet certain conditions. Hospitals may gain such credentials by choosing to be reviewed by a state certification agency under contract to the Centers for Medicare & Medicaid Services or to be accredited by either the Joint Commission on Accreditation of Healthcare Organizations or the American Osteopathic Association. This issue brief looks at how accreditation of hospitals developed and how it continues to change. It considers the legal and practical reasons that a majority of hospitals choose accreditation and why some hospitals do not, along with broader consideration …

Go to article

Evaluation Of Over-The-Counter Sales As A Syndromic Surveillance Method For Waterborne Disease In New Mexico, Camilla M. Bustamante

Health, Exercise, and Sports Sciences ETDs

This research evaluates the use of Over-the-Counter anti-diarrheal medications as a potential syndromic indicator and surveillance mechanism for waterborne disease in New Mexico. The purpose was to determine the usefulness of such data for either supplemental or stand alone use in a system for waterborne disease surveillance. The use of syndromic indicators for waterborne disease was elevated in 1993 after an outbreak of cryptosporidium was detected in Milwaukee Wisconsin by an alert pharmacist who noticed increased sales of over-the-counter medications over a period of time. In 2001, terrorist threats for anthrax exposure to U.S. populations further prompted funding and research …

Go to article

Parents' Perception Of Their Children's Asthma, 2002-2008: A Community-Based Study, John M. Pascoe, William Spears, Shalini Forbis, Jessica L. Saunders

Population and Public Health Sciences Faculty Publications

Childhood asthma is a chronic health condition that is one of the leading causes of hospitalizations and missed school days for children. It also affects the lives of both asthmatic children and their families.

Go to article

Glycemic Index, Glycemic Load, And Pancreatic Cancer Risk (Canada), Stephanie A. Navarro Silvera, Thomas E. Rohan, Meera Jain, Paul D. Terry, Geoffrey R. Howe, Anthony B. Miller

Department of Public Health Scholarship and Creative Works

There is some evidence that plasma insulin and post-load plasma glucose may be associated with the risk of pancreatic cancer. Glycemic index and glycemic load are measures, which allow the carbohydrate content of individual foods to be classified according to their postprandial glycemic effects and hence their effects on circulating insulin levels. Therefore, we examined pancreatic cancer risk in association with a glycemic index (GI), glycemic load (GL), and intake of dietary carbohydrate and sugar in a prospective cohort of 49,613 Canadian women enrolled in the National Breast Screening Study (NBSS) who completed a self-administered food frequency questionnaire between 1980 …

Go to article

Scale Development For Perceived School Climate For Girls’ Physical Activity, Amanda Birnbaum, Kelly R. Evenson, Robert W. Motl, Rod K. Dishman, Carolyn C. Voorhees, James F. Sallis, John P. Elder, Marsha Dowda

Department of Public Health Scholarship and Creative Works

Objectives: To test an original scale assessing perceived school climate for girls' physical activity in middle school girls. Methods: Confirmatory factor analysis (CFA) and structural equation modeling (SEM). Results: CFA retained 5 of 14 original items. A model with 2 correlated factors, perceptions about teachers' and boys' behaviors, respectively, fit the data well in both sixth and eighth-graders. SEM detected a positive, significant direct association of the teacher factor, but not the boy factor, with girls' self-reported physical activity. Conclusions: School climate for girls' physical activity is a measurable construct, and preliminary evidence suggests a relationship with physical activity.

Go to article

Glycemic Index, Glycemic Load, And Pancreatic Cancer Risk (Canada), Stephanie A. Navarro Silvera, Thomas E. Rohan, Meera Jain, Paul D. Terry, Geoffrey R. Howe, Anthony B. Miller

Department of Public Health Scholarship and Creative Works

There is some evidence that plasma insulin and post-load plasma glucose may be associated with the risk of pancreatic cancer. Glycemic index and glycemic load are measures, which allow the carbohydrate content of individual foods to be classified according to their postprandial glycemic effects and hence their effects on circulating insulin levels. Therefore, we examined pancreatic cancer risk in association with a glycemic index (GI), glycemic load (GL), and intake of dietary carbohydrate and sugar in a prospective cohort of 49,613 Canadian women enrolled in the National Breast Screening Study (NBSS) who completed a self-administered food frequency questionnaire between 1980 …

Go to article

Health Insurance Coverage For Small Employers, Dawn Gencarelli

National Health Policy Forum

For workers of small employers, access to affordable health insurance coverage is a growing concern. This paper examines the problems these firms and their employees face in obtaining health insurance coverage they can afford. The degree to which these challenges become obstacles varies greatly, depending on, for instance, the size of the employer and the characteristics of its employees. Reviewed here are these challenges to access, as well as some of the efforts made through state and federal reforms to address them, including rules regarding guaranteed issue and guaranteed renewability. This paper also explores some of the more recent initiatives …

Go to article

Full-Text Articles in Medicine and Health Sciences

Health Information Access

The Southeastern Librarian

Redesigning Practice To Improve Care Delivery (Boston), Laura A. Dummit, Lisa Sprague

National Health Policy Forum

What Is Comprehensive Sexuality Education Really All About? Perceptions Of Students Enrolled In An Undergraduate Human Sexuality Course, Eva Goldfarb

Department of Public Health Scholarship and Creative Works

Medicare Advantage Snps: A New Opportunity For Integrated Care?, Christie Provost Peters

National Health Policy Forum

Oral Contraceptive Use And Risk Of Breast Cancer Among Women With A Family History Of Breast Cancer: A Prospective Cohort Study, Stephanie A. Navarro Silvera, Anthony B. Miller, Thomas E. Rohan

Department of Public Health Scholarship and Creative Works

Cigarette Smoking And Risk Of Glioma: A Prospective Cohort Study, Stephanie A. Navarro Silvera, Anthony B. Miller, Thomas E. Rohan

Department of Public Health Scholarship and Creative Works

Cigarette Smoking And Risk Of Glioma: A Prospective Cohort Study, Stephanie A. Navarro Silvera, Anthony B. Miller, Thomas E. Rohan

Department of Public Health Scholarship and Creative Works

El Vih En La Ciudad De Buenos Aires: Obstáculos En El Acceso Al Tratamiento En El Sector Público, Erica Tai-Le Bliss

Independent Study Project (ISP) Collection

A Report From The Forum Session “Implementing The Medicare Prescription Drug Benefit: Continuing Challenges For States”, Lee Partridge

National Health Policy Forum

One Pill, Many Prices: Variation In Prescription Drug Prices In Selected Government Programs, Dawn Gencarelli

National Health Policy Forum

Clinical Preventive Services: When Is The Juice Worth The Squeeze?, Eileen Salinsky

National Health Policy Forum

Caring For "Ryan White": The Fundamentals Of Hiv/Aids Treatment Policy, Jessamyn Taylor

National Health Policy Forum

Keeping Track Of Care: Quality And Technology At Lifebridge Health System (Baltimore), Judith Moore

National Health Policy Forum

Development And Validation Of An Anthropometrically Based Prediction Equation For Estimating The Percent Body Fat Of Post-Menopausal Black Females, Leanne Petry, Lloyd L. Laubach, Peter W. Hovey, Nikki Lynn Rogers, Bradford Towne, William Cameron Chumlea

Population and Public Health Sciences Faculty Publications

Dietary Folate, Alcohol Consumption, And Risk Of Ovarian Cancer In An Italian Case-Control Study, Claudio Pelucchi, Monia Mereghetti, Renato Talamini, Eva Negri, Maurizio Montella, Valerio Ramazzotti, Silvia Franceschi, Carlo La Vecchia

Department of Public Health Scholarship and Creative Works

Mental Health And Juvenile Justice: Moving Toward More Effective Systems Of Care, Jane Koppelman

National Health Policy Forum

Specialty Hospitals: Can General Hospitals Compete?, Laura A. Dummit

National Health Policy Forum

Local Coverage Initiatives: Solution Or Band-Aid For The Uninsured?, Jennifer Ryan

National Health Policy Forum

Children With Special Health Care Needs: Minding The Gaps, Christie Provost Peters

National Health Policy Forum

Risk Factors For Thyroid Cancer: A Prospective Cohort Study, Stephanie A. Navarro Silvera, Anthony B. Miller, Thomas E. Rohan

Department of Public Health Scholarship and Creative Works

Stimulant Abuse In Ohio And The Rural South, Robert G. Carlson

Population and Public Health Sciences Faculty Publications

Public Health Advocacy To Change Corporate Practices: Implications For Health Education Practice And Research, Nicholas Freudenberg

Publications and Research

Rural Methamphetamine Abuse: An Ethnographic Perspective, Rocky L. Sexton, Robert G. Carlson

Population and Public Health Sciences Faculty Publications

Hospital Oversight In Medicare: Accreditation And Deeming Authority, Lisa Sprague

National Health Policy Forum

Evaluation Of Over-The-Counter Sales As A Syndromic Surveillance Method For Waterborne Disease In New Mexico, Camilla M. Bustamante

Health, Exercise, and Sports Sciences ETDs

Parents' Perception Of Their Children's Asthma, 2002-2008: A Community-Based Study, John M. Pascoe, William Spears, Shalini Forbis, Jessica L. Saunders

Population and Public Health Sciences Faculty Publications

Glycemic Index, Glycemic Load, And Pancreatic Cancer Risk (Canada), Stephanie A. Navarro Silvera, Thomas E. Rohan, Meera Jain, Paul D. Terry, Geoffrey R. Howe, Anthony B. Miller

Department of Public Health Scholarship and Creative Works

Scale Development For Perceived School Climate For Girls’ Physical Activity, Amanda Birnbaum, Kelly R. Evenson, Robert W. Motl, Rod K. Dishman, Carolyn C. Voorhees, James F. Sallis, John P. Elder, Marsha Dowda

Department of Public Health Scholarship and Creative Works

Glycemic Index, Glycemic Load, And Pancreatic Cancer Risk (Canada), Stephanie A. Navarro Silvera, Thomas E. Rohan, Meera Jain, Paul D. Terry, Geoffrey R. Howe, Anthony B. Miller

Department of Public Health Scholarship and Creative Works

Health Insurance Coverage For Small Employers, Dawn Gencarelli

National Health Policy Forum