Medicine and Health Sciences Commons^™

Potret Kebijakan Pengendalian Demam Berdarah Dengue Di Kabupaten Indramayu, Henri Peranginangin, Hasim Hasim, Bambang Pramudya, Sri Budiarti

Kesmas

Penyakit demam berdarah dengue (DBD) masih menjadi masalah di Kabupaten Indramayu. Penelitian ini bertujuan mengidentifikasi elemen-elemen prioritas kebijakan pengendalian penyakit DBD di Kabupaten Indramayu menurut pakar berdasarkan metode Analytical Hierarchy Process (AHP). Hasil penelitian menunjukkan “strategi utama” pengendalian penyakit DBD di Kabupaten Indramayu adalah peningkatan kesehatan lingkungan permukiman; “aktor utama pengendalian” ialah Pemerintah Kabupaten Indramayu; “faktor utama pengendalian” adalah lingkungan; “tujuan utama pengendalian” ialah Kabupaten Indramayu bebas penyakit DBD; dan “kriteria utama pengendalian” adalah jumlah dan mutu sumber daya manusia. Agar implementasi strategi pengendalian itu efektif maka Pemerintah Kabupaten Indramayu perlu meningkatkan kerja sama lintas program dan sektoral; dukungan teknologi, …

Kesehatan Jiwa Yang Terabaikan Dari Target Milenium, Sri Idaiani

Kesmas

Millenium Development Goals (MDG) yang dicanangkan pada tahun 2000 sangat didominasi oleh penyakit menular serta kesehatan ibu dan anak, tetapi mengabaikan berbagai masalah penyakit tidak menular. Tidak sedikitpun terlintas dalam benak para pemimpin dunia itu target dan indikator yang menyentuh atau berhubungan dengan masalah kesehatan jiwa. Tulisan ini bertujuan membahas posisi kesehatan jiwa di seluruh dunia yang cenderung semakin memprihatinkan, tetapi justru terabaikan dari target MDG. Pencapaian target milenium tampaknya tidak memperhitungkan beban penyakit akibat berbagai masalah kejiwaan. Padahal, jika dibiarkan, pada masa mendatang masalah kesehatan jiwa akan menjadi besar seperti yang tengah dihadapi oleh berbagai negara maju. Berdasarkan prediksi …

Examining The Association Of Fruit And Vegetable Intake And Breast And Prostate Cancer Screening, Mark Yu

Theses and Dissertations

Breast and prostate cancer incidence and mortality have been steadily decreasing. Reasons for these reductions may be related to increased rates of cancer screening and other factors such as improvements in diet, including consumption of fruits and vegetables. We wanted to determine if individuals who get screened for breast and prostate cancer are more or less likely to consume adequate servings of fruit and vegetables. A cross-sectional study using the BRFSS survey was conducted. Individuals included in this study (n=26,222), were asked about their breast or prostate cancer screening history. They were also asked about their servings per day of …

The Association Between Lead Exposure And Respiratory Health In Children, Colleen Coleman

Theses and Dissertations

Purpose: The substantial impact of indoor air quality and environmental hazards in the home on one’s health has long been recognized in the field of public health. This cross-sectional study investigates the risk between home based hazards, specifically lead, and respiratory health in children. The objective of this study is to examine the extent to which children testing positive for blood lead exposure are at an increased risk for having poor respiratory health. Methods: A nationally representative sample of 977 children ages 1- 6 years was obtained from the 2005-2006 National Health and Nutrition Examination Survey (NHANES). Information from the …

Strategies For Recruiting Hispanic Women Into A Prospective Cohort Study Of Modifiable Risk Factors For Gestational Diabetes Mellitus, Lisa Chasan-Taber, Renee T. Fortner, Valerie Hastings, Glenn Markenson

Lisa Chasan-Taber

Background The purpose of this article was to describe effective strategies for recruitment of Hispanic women into a prospective cohort study of modifiable risk factors for gestational diabetes mellitus (GDM). Although Hispanic women have two to four times the risk of developing GDM compared with non-Hispanic white women, few GDM prevention studies have included Hispanic women. Methods The study was conducted in the ambulatory obstetrical practices of Baystate Medical Center located in a socioeconomically and ethnically diverse city in Massachusetts. The study employed a range of strategies to recruit Hispanic women based on a review of the literature as well …

Community Voice: Taking It To The People, Guidelines For Conducting A Process Evaluation, Tiffany Mcghee

Theses and Dissertations

Background The Community Voice program is designed for African-Americans and explores key factors that can contribute to African-American infant mortality. This program was implemented in Henrico County based on Virginia Health Statistics that the White infant mortality rate average during the years of 2001-2005 was 5.3 deaths per 1,000 live births and in the same time period the infant mortality rate for African-Americans was 13.7 deaths per 1,000 live births. At the time of implementation of the program, no plans to evaluate the program had been made. Objective This evaluation was designed to develop guidelines regarding the evaluation process of …

Association Between Preconception Multivitamin Use And The Risk Of Preeclampsia/High Blood Pressure In Pregnant Women, Krisandra Allen

Theses and Dissertations

Gestational Hypertension and Preeclampsia are significant causes of morbidity and mortality among pregnant women and neonates. This study examined the relationship between multivitamin use and incidence of reported high blood pressure or preeclampsia using data from the 2007 Oregon State Pregnancy Risk Assessment Monitoring System (PRAMS). Overall there were n=1894 women included in the study. Women were asked two to four months after delivery to report their multivitamin or prenatal vitamin usage in the month prior to conception and were categorized as daily users, or less than daily users. The unadjusted prevalence of high blood pressure or preeclampsia was 13.4% …

Developing A Comprehensive Youth Obesity Initiative For The State Of Virginia, Jennifer Thompson

Theses and Dissertations

The 2009 Virginia General Assembly Session unanimously voted to change the legislation governing the Virginia Tobacco Settlement Foundation to create the Virginia Foundation for Healthy Youth (VFHY) and incorporate childhood overweight and obesity prevention and reduction in its mission. In order to successfully meet the requirements of this legislation, VFHY needed assistance developing a strategic plan for the obesity initiative and a knowledge base to draw from. A comprehensive assessment of the status of Virginia’s childhood obesity problem was conducted, including the prevalence of the illness, the barriers existing to and the benefits to obesity prevention programs, the need for …

The 2009 H1n1 Influenza A “Swine Flu” Virus Presentation In Virginia 2009, Tammie Smith

Theses and Dissertations

Objective: 2009 H1N1 influenza was first detected in the Northern Hemisphere in April 2009. National data have suggested that the novel influenza virus disproportionately causes severe illness in children and young adults, a somewhat different presentation from traditional seasonal flu which normally strikes hardest in the very young and older adults. This may or may not be the case in Virginia, which, if it is different, may suggest a need to alter flu prevention messages and vaccine policy as the outbreak continues through the fall 2009-10 influenza season. This report examined the early presentation of the new influenza virus in …

Use Of Oral Chemotherapeutic Medications In Non-Traditional Ambulatory Settings, Sameer Arora

Theses and Dissertations

Background: Cancer is the second leading cause of death in economically developed countries. The use and availability of oral treatment for cancer has increased dramatically in the past 10 years. Few studies have described the use of oral chemotherapy in non-traditional ambulatory settings by health care professionals across different specialties. Objective: The purpose of this study is to describe the usage of oral chemotherapeutic medications in ambulatory settings. Methods: Cross sectional study of 2007 NAMCS Survey analysis involving 21,761 subjects aged 18 years and above with cancer who participated in the 2007 National Ambulatory Medical Survey (NAMCS). Main Outcome Measure: …

Client Perceptions And Working Alliance: Predictors Of Outcome?, Theresa Do

Theses and Dissertations

BACKGROUND In recent years, there has been a push to measure and monitor the quality of health care and the delivery of effective services. Substance use disorders are debilitating and in order to better understand this facet of substance abuse, it is important for organizations and providers to assess the quality of services, client satisfaction, and the relationships that exist between clients and treatment providers. PURPOSE The purpose of the study was to (1) assess the extent of the relationship between measures of client perceptions of satisfaction and treatment outcomes and (2) to assess the relationship between measures of therapeutic …

Intimate Partner Violence And Pregnancy: Data From The Chicago Women's Health Risk Study, Anne Zehner

Theses and Dissertations

Background: Intimate partner violence (IPV) during pregnancy increases the risks of adverse outcomes for both mothers and their unborn children, including maternal and fetal death. However, more research is needed to determine if IPV increases in frequency or severity during pregnancy and to determine what the risk factors are for IPV during pregnancy. Objectives: To use data from the Chicago Women’s Health Risk Study to determine (1) if abuse is more prevalent during the pregnancy period, 2) if abuse during the pregnancy period increases in frequency or severity, 3) if pregnant women who are abused are at increased risk for …

Association Between Obesity And Depression And Anxiety Disorders: Results From The 2008 National Health Interview Survey, Monica Gaidhane

Theses and Dissertations

Introduction: Obesity is one of the most important medical problems in the U.S. and is considered to be an epidemic with over 30% of the population being obese. Obesity is associated with increased risk of hypertension, diabetes, cardiovascular diseases, certain cancers and a shorter life expectancy. Recent studies have shown that higher BMI levels are also significantly associated with several lifetime mental disorders such as major depressive disorder, anxiety disorders as well as panic attacks and panic disorders. Purpose: The purpose of this study was to quantify the extent to which higher BMI increased the likelihood of Depression, Anxiety Disorder …

Income Inequality And Homicide Rates In Sao Paulo, Brazil., Paulo A. Lotufo, Isabela M. Bensenor

Paulo A Lotufo

Description of the epidemic of homicide among poor people in Brazil. In Sao Paulo, Brazil, homicides to men aged 15-44 years increased with an annual percentage change (APC) of 4.7% from 1996 to 2001, and then decreased from 2001 to 2007 with an APC of -14.6%. Analyzing the intra-urban distribution according to family income, the increase in the homicide rate was restricted to men living in the poorest neighbourhoods. In contrast, the decline in homicide rates was observed to men living in all districts. The reasons for this 'up and down' trend are not clear.

Survival Analysis With Error-Prone Time-Varying Covariates: A Risk Set Calibration Approach, Xiaomei Liao, David M. Zucker, Yi Li, Donna Spiegelman

Harvard University Biostatistics Working Paper Series

No abstract provided.

Post-Operative Extended Volume External Beam Radiation Therapy Is Safe For High Risk Esophageal Cancer Patients, Edward Yu, Patricia Tai, Jawaid Younus, Richard Malthaner, Larry Stitt, Pauline Truong, George Rodrigues, Robert Ash, Rashid Dar, Anna Tomiak, Mark Vincent, Walter Kocha, Brian Dingle, Richard Inculet

Edward Yu

Post-operative radiation therapy (RT) (1) and post-operative chemoradiation (2) have been used for esophageal cancer patients deemed high risk for recurrence after esophagectomy. Defining opitmal RT target volume after esophagectomy is difficult due to significant changes in patient anatomy and function. Some radiationon cologists advocated the inclusion of the anastomotic site within the irradiation volume due to concerns for potential increased relapse risk, while others did not subscribe to this practice due to concerns for increased treatment related toxicity. We have previously reported patient outcome benefit using extended volume RT In management with high risk esophageal cancer patients underwent esopagectomy(3). …

Extended Vs. Small Field Irradiation In High Risk Post Esophagectomy Patients Receiving Combined Chemoradiation Therapy: A Decade Experience In Treatment Of Esophageal Cancer, Edward Yu, Patricia Tai, George Rodrigues, Robert Ash, Larry Stitt, Rashid A. Dar, Pauline Truong, Gregory M. Videtic, Richard Malthaner, Richard Inculet, Anna Tomiak, Jawaid Younus, Brian Dingle, Walter Kocha, Mark Vincent

Edward Yu

OBJECTIVE: To assess the impact of extended field irradiation with anastomotic coverage on local recurrence in high risk resected esophageal cancerpatients. METHODS: From 1989-1999, high risk resected esophageal cancer cases receiving post-resection chemoradiation were reviewed. Adjuvant chemotherapy consisted of four cycles of fluorouracil-based regimens. Loco-regional irradiation with or without coverage of anastomotic site had radiation a dose range from 45-60 Gyat 1.8-2.0 Gy/fraction given with initial anterior-posterior/posterior-anterior arrangement with either extended (with anastomotic coverage), or small (without anastomotic coverage) field followed by oblique fields for boost. RESULTS: One hundred eighty-eight charts were reviewed. Seventy-two patients were eligible for post-resection chemoradiation. …

Tailoring Messages To Individual Differences In Monitoring- Blunting Styles To Increase Fruit And Vegetable Intake, Pamela Williams-Piehota, Amy E. Latimer, Nicole A. Katulak, Ashley Cox, Stephanie A. Navarro Silvera, Linda Mowad, Peter Salovey

Department of Public Health Scholarship and Creative Works

Objective

To examine whether messages matched to individuals' monitoring-blunting coping styles (MBCS) are more effective in increasing fruit and vegetable intake than mismatched messages. MBCS refers to the tendency to either attend to and amplify, or distract oneself from and minimize threatening information.

Design/Setting

Randomly assigned messages were tailored to resonate with either monitors or blunters and delivered at baseline, 1 week, 2 months, and 3 months later. Surveys were conducted at baseline and 2 and 4 months later.

Participants

531 callers to a cancer information hotline who did not meet the 5 A Day guideline.

Intervention

A brief telephone-delivered …

Prevalence Of Copd Among Symptomatic Patients In A Primary Care Setting, Barbara Yawn, David M. Mannino, Thomas Littlejohn, Gary Ruoff, Amanda Emmett, Ibrahim Raphiou, Glenn Crater

David M. Mannino

Objective: Spirometry is recognized as the gold standard assessment for the diagnosis of COPD. However, spirometry continues to be underused, perpetuating the underdiagnosis of COPD. The aim of this study was to evaluate the prevalence of COPD in a primary care setting in patients with a smoking history and self-reported chronic bronchitis symptoms.

Research design and methods: This was a multi-center, cross-sectional study. The primary assessment was the percentage of patients with airway obstruction (post-bronchodilator FEV1/FVC ratio ≤ 0.70) compared to those without obstruction (post-bronchodilator FEV1/FVC ratio > 0.70).

Results: Airflow obstruction consistent with COPD was confirmed in 26% of patients …

Effect Of Interval To Definitive Breast Surgery On Clinical Presentation And Survival In Early-Stage Invasive Breast Cancer, Olga Vujovic, Edward Yu, Anil Cherian, Francisco Perera, A. Dar, Larry Stitt, A. Hammond

Edward Yu

Purpose: To examine the effect of clinical presentation and interval to breast surgery on local recurrence and survival in early-stage breast cancer. Methods and materials: The data from 397 patients with Stage T1-T2N0 breast carcinoma treated with conservative surgery and breast radiotherapy between 1985 and 1992 were reviewed at the London Regional Cancer Program. The clinical presentation consisted of a mammogram finding or a palpable lump. The intervals from clinical presentation to definitive breast surgery used for analysis were 0-4, >4-12, and >12 weeks. The Kaplan-Meier estimates of the time to local recurrence, disease-free survival, and cause-specific survival were determined …

The Black, African And Caribbean Canadian Health (Blacch) Study: Phase I Preliminary Findings, Shamara Baidoobonso, Roxanne Longman, Greta Bauer, Mercy Nleya-Ncube, Daniel Pugh, Erica Lawson, Monica Abdelkader, Jan Jasnos, Sherin Hussien

Shamara M Baidoobonso, PhD

The Challenge: Most studies of HIV and health in African, Caribbean and Black (ACB) communities have taken place in large urban centres and rarely examine how the interactions between racism, gender, HIV-related stigma and multiple forms of oppression affect health and HIV vulnerability. This lack of information negatively impacts HIV prevention and health promotion efforts for ACB communities. Our Approach: The BLACCH Study uses a community-based approach to collect extensive information about the health of ACB communities in Middlesex County, Ontario. The first stage of the project consists of semi-structured interviews to collect information about the breadth of health-related experiences …

Gangguan Akibat Kekurangan Iodium Di Indonesia: Tinjauan Epidemiologis Dan Kebijakan Kesehatan, Laurentius Aswin Pramono

Kesmas

Gangguan Akibat Kekurangan Iodium (GAKI) merupakan penyebab retardasi mental terbesar di seluruh dunia yang dapat dicegah. Dewasa ini, GAKI masih merupakan masalah kesehatan masyarakat yang penting di Indonesia karena belum mampu mencapai kondisi eliminasi seperti yang diharapkan. Hasil survei tahun 2003 dan Riskesdas 2007 menunjukkan bahwa pencapaian program penanggulangan GAKI di Indonesia masih jauh dari target Universal Salt Iodization dan Indonesia Sehat 2010. Artikel ini bertujuan mengevaluasi berbagai eviden epidemiologi yang berhubungan dengan kebijakan GAKI di Indonesia. Pada masa mendatang, berbagai komitmen lintas sektoral sangat diperlukan bagi pencapaian kondisi eliminasi GAKI. Perhatian klinisi dan ahli epidemiologi terhadap permasalahan GAKI di …

Causal Inference In Epidemiological Studies With Strong Confounding, Kelly L. Moore, Romain S. Neugebauer, Mark J. Van Der Laan, Ira B. Tager

U.C. Berkeley Division of Biostatistics Working Paper Series

One of the identifiabilty assumptions of causal effects defined by marginal structural model (MSM) parameters is the experimental treatment assignment (ETA) assumption. Practical violations of this assumption frequently occur in data analysis, when certain exposures are rarely observed within some strata of the population. The inverse probability of treatment weighted (IPTW) estimator is particularly sensitive to violations of this assumption, however, we demonstrate that this is a problem for all estimators of causal effects. This is due to the fact that the ETA assumption is about information (or lack thereof) in the data. A new class of causal models, causal …

Sleep Disorders In Parkinson's Disease, Israt Jahan, Robert A. Hauser, Kelly L. Sullivan, Amber M. Miller, Theresa A. Zesiewicz

Kelly L. Sullivan

Sleep disorders occur commonly in Parkinson’s disease (PD), and reduce quality of life. Sleep-related problems in PD include insomnia, restless legs syndrome, rapid eye movement sleep behavior disorder, sleep apnea, parasomnias, excessive daytime sleepiness, and sleep attacks. This article reviews sleep disorders and their treatment in PD.

Developing A School Functioning Index For Middle Schools, Amanda Birnbaum, Leslie A. Lytle, Cheryl L. Perry, David Murray, Mary Story

Department of Public Health Scholarship and Creative Works

Despite widespread recognition of schools' role in the healthy development of youth, surprisingly little research has examined the relationships between schools' overall functioning and the health‐related behavior of students. School functioning could become an important predictor of students' health‐related behavior and may be amenable to intervention. This paper describes the development and testing of the School Functioning Index (SFI) as a first step in investigating this question. The index was developed for use with middle schools and conceived as a predictor of students' violent behavior, with the potential for extending research applications to additional health and social behaviors. Using social …

Peer-Led, School-Based Nutrition Education For Young Adolescents: Feasibility And Process Evaluation Of The Teens Study, Mary Story, Leslie A. Lytle, Amanda Birnbaum, Cheryl L. Perry

Department of Public Health Scholarship and Creative Works

Peer education has become a popular strategy for health promotion interventions with adolescents, but it has not been used widely in school‐based nutrition education. This paper describes and reports on the feasibility of the peer leader component of school‐based nutrition intervention for young adolescents designed to increase fruit and vegetable intakes and lower-fat foods. About 1,000 seventh‐grade students in eight schools received the nutrition intervention. Of these, 272 were trained as peer leaders to assist the teacher in implementing the activities. Results from a multicomponent process evaluation based on peer leader and classroom student feedback, direct classroom observation, and teacher …

What Factors Predict Outcome At Relapse After Previous Esophagectomy And Adjuvant Therapy In High-Risk Esophageal Cancer?, Edward Yu, Patricia Tai, Richard Malthaner, Larry Stitt, George Rodrigues, Rashid Dar, Brian Yaremko, Jawaid Younus, Michael Sanatani, Mark Vincent, Brian Dingle, Dalilah Fortin, Richard Inculet

Oncology Presentations

Management of patients who have disease relapse after completion of surgery and adjuvant chemo-radiation (CRT) is controversial.

Some oncologists would advocate intensive therapeutic intervention due to promising experience on treatment for recurrence disease while others would recommend palliative support due to the concerns for poor patient outcome post disease recurrence.

In Addition, it is not clear if patient outcome is improved post adjuvant CRT when patients at risk have resection margin involvement and if time interval to recurrence can affect patient survival post relapse.

The present study was conducted to determine what factors will affect patient outcome at relapse after …

Association Of Ambient Ozone Exposure With Airway Inflammation And Allergy In Adults With Asthma, Sumita B. Khatri, Fernando C. Holguin, P. Barry Ryan, David M. Mannino, Serpil C. Erzurum, W. Gerald Teague

David M. Mannino

Rationale

Previous studies have demonstrated associations of high ozone levels with increased epidemiologic as well as lung function measures of asthma activity.

Objectives

In an observational study during the summer months, we hypothesized that higher ambient ozone levels are associated with more frequent symptoms, higher airway and systemic inflammation, as well as worse lung function in asthmatics as compared with non-asthmatic individuals.

Methods

Thirty-eight asthmatics and thirteen healthy control subjects residing in metropolitan Atlanta were enrolled during peak ozone season. Medical histories, quality-of-life questionnaires, spirometry, serum immunoglobulin (IgE), peripheral eosinophil counts, and exhaled nitric oxide (NO) were obtained during study …

What Factors Predict Outcome At Relapse After Previous Esophagectomy And Adjuvant Therapy In High-Risk Esophageal Cancer?, Edward Yu, Patricia Tai, Richard Malthaner, Larry Stitt, George Rodrigues, Rashid Dar, Brian Yaremko, Jawaid Younus, Michael Sanatani, Mark Vincent, Brian Dingle, Dalilah Fortin, Richard Inculet

Edward Yu

Management of patients who have disease relapse after completion of surgery and adjuvant chemo-radiation (CRT) is controversial. Some oncologists would advocate intensive therapeutic intervention due to promising experience on treatment for recurrence disease while others would recommend palliative support due to the concerns for poor patient outcome post disease recurrence. In Addition, it is not clear if patient outcome is improved post adjuvant CRT when patients at risk have resection margin involvement and if time interval to recurrence can affect patient survival post relapse. The present study was conducted to determine what factors will affect patient outcome at relapse after …

Community Empowerment Through An Academic Product: Implications For The Social-Justice, Tamara Leech, Edrose Potts Jr.

Department of Public Health Scholarship and Creative Works

Often, African American community organizations are distanced from government institutional practices. In response, they may approach local academics to help bridge the divide. This think piece explores lessons that one academic scholar learned during the process of writing and distributing an applied report that ultimately helped a community organization to gain access to the governmental decision-making process. In exploring the project, we first focus on the process and value of shifting from a charity orientation to a social justice orientation. Second, we use the report itself to provide examples of essential, concrete aspects of social justice-oriented products. In the end, …