Community Health Commons^™

E-Therapy As A Means For Addressing Barriers To Substance Use Disorder Treatment For Persons Who Are Deaf, Dennis Moore, Debra Guthmann, Nikki Lynn Rogers, Susan Fraker, Jared A. Embree

Population and Public Health Sciences Faculty Publications

Persons who are deaf face a number of challenges with regard to vulnerability for substance use disorders. Moreover, accessible treatment for this condition can be difficult to establish and maintain. The Deaf community may be one of the most disenfranchised groups in America in regard to appropriate access to substance use disorder (SUD) prevention and treatment services. This article reviews
findings related to substance use disorder and treatment for this condition among persons who are deaf. It also reviews a promising approach for addressing treatment needs via e-therapy, and it highlights the challenges and concerns regarding e-therapy for this population. …

Few And Far Away: Detoxification Services In Rural Areas, Jennifer D. Lenardson Mhs, Melanie M. Race Ms, John A. Gale Ms

Mental Health / Substance Use Disorders

Based on Working Paper #41: Availability, Characteristics, and Role of Detoxification Services in Rural Areas. Findings: Few rural detox providers exist; 82% of rural residents live in a county without a detox provider. More than half of all rural detox providers serve a 100 mile radius. Travel distances are a barrier to outpatient detox models. Referral options to substance abuse treatment are limited, especially in isolated rural areas.

The Emergent Generation Gap In Attitudes Toward Khat Use In Urban Ethiopia, Nikki Lynn Rogers, Jared A. Embree, Yigzaw Kebede, Josephine Wilson, Mary J. Huber, Dennis Moore

Population and Public Health Sciences Faculty Publications

No abstract provided.

Athletics & Recreation Master Plan Sub‐Committee Final Report, Charlie Titus, Terry Condon, Chris Fitzgerald, Ken Mcbryde, Robert Burgess, Shaun Curry, Laurie Milliken, Chris Sweeney, Pavel Braude, Ryan Norton, Jack Looney, Susan Wolfson, Jain Ruvidich‐Higgins

Campus Master Planning Publications

In 2000 the Athletics & Recreation Department at UMass Boston Implemented a five year strategic plan that would more realistically align sports sponsorship with available financial and facility resources. We reduced the number of sports sponsored from 20 to 14 maintaining 7 sports for women and 7 sports for men. The only sports maintained without a facility were Men’s baseball and Cross Country Track. We eliminated football, swimming and indoor & outdoor track and field for men and women.

Since 2005 The Athletics & Recreation Department has been focused on University wide transition and planning efforts. In that period we …

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, …

Attachment: The Antidote To Trauma, Joshua Straub

Faculty Publications and Presentations

Trauma and loss in life are inevitable. And all too often the traumatic experience itself can be enough to paralyze the mental, emotional, and spiritual state of any given person. Unable to interpret the traumatic experience, many instead are left defined by it. Helping clients discern the objective experience and their subjective reactions to it will help free them from the emotions and beliefs that subsequently control their lives. Based on the most relevant attachment theory research and clinical techniques, this workshop teaches the attentional strategies necessary to helping clients overcome trauma.

Quality Of Life Estimation With Structural Equation Modeling In School Aged Children With Asthma, Sheniz Moonie, Xuan Huang, David A. Sterling

Environmental & Occupational Health Faculty Publications

Significant increases in childhood asthma prevalence and mortality has prompted federal and regulatory agencies to work towards a national framework to address childhood asthma. Quality of life is an important component of chronic disease, and the evaluation of healthcare outcomes. There is little discussion in the literature regarding the implications of QoL as a theoretical construct. This study determined the effect of asthma on the QoL of our study population and caregiver’s missed workdays on the child’s QoL scores. A negative relationship was found between the child’s QoL and the caregiver’s missed workdays due to their child’s asthma. The use …

Issues For Dsm-V: The Role Of Culture In Psychiatric Diagnosis, Renato D. Alarcón, Anne E. Becker, Roberto Lewis-Fernández, Robert C. Like, Prakash Desai, Edward Foulks, Junius Gonzales, Helena Hansen, Alex Kopelowicz, Francis G. Lu, María A. Oquendo, Annelle Primm

Publications from Provost Junius J. Gonzales

No abstract provided.

Anas, Mias And Wannas: Authenticity And Embodiment In Pro-Anorexia Discussion Groups, Natalie Boero, C. Pascoe

Faculty Publications, Sociology

This paper details the making of community and bodies in online environments, specifically the online pro-anorexia community. Building community among members of these groups is particularly fraught because tensions over claims to authenticity permeate these groups. Because these are embodied practices and online spaces are presumably disembodied, participants constantly grapple with authenticity, largely through the threat of the "wannarexic." This paper documents the way in which tensions around authenticity and embodied practices are managed through treatment of the wannarexic, participating in group rituals, and deployment of individual tools. Participants grapple with these tensions through engaging in offline bodily rituals that …

Is Chaalia/Pan Masala Harmful For Health? Practices And Knowledge Of Children Of Schools In Mahmoodabad And Chanesar Goth, Karachi, Sameena Shah, Riaz Qureshi, Iqbal Azam Syed

Department of Family Medicine

OBJECTIVE: To determine the practices and knowledge of harmful effects regarding use of Chaalia and Pan Masala in three schools of Mahmoodabad and Chanesar Goth, Jamshed Town, Karachi, Pakistan.

METHODS: To achieve the objective a cross-sectional design was used in three government schools of Mahmoodabad and Chanesar Goth, Jamshed Town, Karachi. Students of either gender drawn from these schools fulfilling the inclusion and exclusion criteria were interviewed using a pre-coded structured questionnaire. Along with demographic data, questions regarding frequency of Chaalia and Pan Masala use, practices of this habit in friends and family and place of procurement of these substances, …

Analysis And Evaluation Of Participation By Prescibers And Dispensers In The Maine State Prescription Monitoring Program, Marcella H. Sorg, Sharon Labrie, William Parker

Anthropology Faculty Scholarship

As part of a Department of Justice, U.S. Attorneys Office grant for the analysis and evaluation of participation in the Prescription Monitoring Program (PMP), the Margaret Chase Smith Policy Center mapped and analyzed spatial patterns of prescriber and pharmacy locations as well as PMP participation, and conducted a survey of licensed prescribers and dispensers of controlled substances in Maine. The PMP, implemented beginning July 1, 2004, monitors all drugs in Schedules II, II, and IV, and any pharmacy that is licensed to dispense prescriptions in or into the state of Maine is required by law to report to the program. …

State Experiences With Affordable Housing Plus Services: Report To Seniors And Persons With Disabilities, On The Move, Paula C. Carder, Erika Zoller

Institute on Aging Publications

Housing developers, providers, policy makers, and advocates, increasingly recognize that for some groups of individuals, access to affordable housing alone is "not enough." That is, some individuals require more than shelter. Examples include individuals who have chronic health conditions (e.g., HIV/AIDS), those with physical or cognitive limitations (e.g., persons with developmental disabilities, adults with physical disabilities), and those who have a combination of health conditions or who cannot thrive in traditional housing (e.g., persons who have been homeless, individuals with chronic mental illness). Increasingly, housing providers, social service agencies, advocates, states, and federal agencies have recognized the need to combine …

Consanguinity Among The Risk Factors For Underweight In Children Under Five: A Study From Rural Sindh, S. F. Hasnain, S. K. Hashmi

Community Health Sciences

BACKGROUND: Malnutrition is a common problem, especially in developing countries. Of the 11 million children under 5 who die each year in the developing countries mainly from preventable causes, the death of about 54% are either directly or indirectly attributable to malnutrition. The objectives of this study were to assess the prevalence and associated factors for underweight in rural Sindh.METHODS: A cross-sectional survey was conducted in Jhangara Town, located in District Dadu, Sindh. Eight hundred children under 5 years of age were enrolled. A questionnaire was used to elicit required information and anthropometric measurements were made.RESULTS: The overall prevalence for …

Improving The Health Of Diabetic Patients Through Resident-Initiated Group Visits, Chris Wheelock, Judith A. Savageau, Hugh Silk, Scott Lee

Judith A. Savageau

BACKGROUND AND OBJECTIVES: Group visits have the potential to benefit patients with chronic illnesses. Our objective was to implement resident-run diabetic group visits that would improve patient education and help patients become more involved in their care. METHODS: We developed systems to promote, coordinate, and lead the visits. Residents' responsibilities were delegated through a preparation checklist. A standardized progress note was developed to encourage patient goal setting and to track relevant laboratory test results. To evaluate our program, we conducted surveys to determine patients' behavioral changes and satisfaction levels and assessed the effect on group visit participants' glycated hemoglobin (HbA1c) …

Symptoms Of Diminished Autonomy Over Cigarettes With Non-Daily Use, Judith A. Savageau, Paul D. Mowery, Joseph R. Difranza

Judith A. Savageau

Data from a nationally representative sample of smokers (ages 12-22 years, n=2,091) was examined to investigate the prevalence of symptoms of diminished autonomy over cigarettes. Six symptoms were assessed: failed cessation, smoking despite a desire to quit, and a need or urge to smoke, irritability, restlessness, or disrupted concentration attributed to nicotine withdrawal. One or more of the six symptoms were present in 18.9% of subjects who smoked less often than once per week. Among subjects who had not smoked 20 cigarettes in their lifetime, 12.6% had symptoms of nicotine withdrawal, and 25% had made an unsuccessful quit attempt.

Community Dimensions And Hpsa Practice Location: 30 Years Of Family Medicine Training, Suzanne B. Cashman, Judith A. Savageau, Warren J. Ferguson, Daniel H. Lasser

Judith A. Savageau

BACKGROUND AND OBJECTIVES: Our objective was to assess practicing family physicians' confidence and participation in a range of community-related activities. Additionally, we assessed the strength of the relationship between the physicians' reported medical school and residency training in community-related activities and their current community activities, as well as whether they were practicing in an underserved location. METHODS: All 347 graduates of the University of Massachusetts Family Medicine Residency were surveyed about practice location and type, involvement and training in community work, confidence in community-related skills, and sociodemographic characteristics. Analyses were conducted by residency graduation decade (1976-1985, 1986-1995, and 1996-2005). RESULTS: …

Family Medicine Residency Characteristics Associated With Practice In A Health Professions Shortage Area, Warren J. Ferguson, Suzanne B. Cashman, Judith A. Savageau, Daniel H. Lasser

Judith A. Savageau

BACKGROUND AND OBJECTIVES: While some family medicine residency programs are designed to train residents in community health centers (CHCs) for future careers serving underserved populations, there are few outcome studies on such programs. Our residency program provides three options for ambulatory health center training, but otherwise residents participate in the same curriculum. We analyzed relationships between ambulatory training site and likelihood of practice in health professions shortage areas (HPSAs).

METHODS: We sent a mail survey to all graduates of one family medicine residency about practice locations, types, and populations; influences on practice choice; and sociodemographic characteristics.

RESULTS: Training in a …

Lesson In A Pill Box: Teaching About The Challenges Of Medication Adherence, Darlene M. O'Connor, Judith A. Savageau, David B. Centerbar, Kimberly N. Wamback, Jennifer S. Ingle, Nicole J. Lomerson

Judith A. Savageau

BACKGROUND AND OBJECTIVES: Medication mismanagement is a serious health issue affecting elders and people with disabilities, who often manage multiple medications. This project's goal was to educate medical and nursing students about the challenges patients face when managing complex medication regimens.

METHODS: A total of 104 first-year medical students and 40 second-year nursing students were randomly assigned to participate in a 1-week regimen of mock prescriptions or to read a description of the regimen and make predictions about what the experience would be like had they participated.

RESULTS: Quantitative results in combination with qualitative information suggest that the students taking …

Enforcement Of Underage Sales Laws As A Predictor Of Daily Smoking Among Adolescents: A National Study, Joseph R. Difranza, Judith A. Savageau, Kenneth E. Fletcher

Judith A. Savageau

BACKGROUND: With a goal to reduce youth smoking rates, the U.S. federal government mandated that states enforce laws prohibiting underage tobacco sales. Our objective was to determine if state compliance with tobacco sales laws is associated with a decreased risk of current daily smoking among adolescents.

METHODS: Data on tobacco use were obtained from a nationally representative sample of 16,244 adolescents from the 2003 Monitoring the Future survey. The association between merchant compliance with the law from 1997-2003 and current daily smoking was examined using logistic regression while controlling for cigarette prices, state restaurant smoking policies, anti-tobacco media, and demographic …

Ageing Population: Status, Challenges And Opportunities For Health Care Providers In Pakistan, Waris Qidwai Dr

Department of Family Medicine

No abstract provided.

Acetabular Morphometry And Prevalence Of Hip Dysplasia In The South Asian Population, Masood Umer, Yasir J. Sepah, Sharjeel Asif, Iqbal Azam Syed, Muhammad Umar Jawad

Section of Orthopaedic Surgery

We carried out a cross-sectional study to measure the association of the seven acetabular parameters with pelvic morphometry and prevalence of hip dysplasia in our population. Convenience sampling was carried out and 250 consecutive patients who came to AKUH for intravenous pyelogram and had no complaints in the region of the hip joint were enrolled in the study. Post-micturition standardized plain antero-posterior pelvic radiographs of 250 asymptomatic adults (500 hip joints) was studied. There were 136 males (54.4%) and 114 females (45.6%). Mean age of our study population was 38 years (15-78 years). The average center edge angle was 35.5±6.6° …

Table For Four, Fenelon And Balthasar, Megan Levy

Megan Levy

No abstract provided.

An Autoregressive Integrated Moving Average Model For Short-Term Prediction Of Hepatitis C Virus Seropositivity Among Male Volunteer Blood Donors In Karachi, Pakistan, Saeed Akhtar, Shafquat Rozi

Community Health Sciences

Aim: To identify the stochastic autoregressive integrated moving average (ARIMA) model for short term forecasting of hepatitis C virus (HCV) seropositivity among volunteer blood donors in Karachi, Pakistan.
Methods: Ninety-six months (1998-2005) data on HCV seropositive cases (1000(-1) x month(-1)) among male volunteer blood donors tested at four major blood banks in Karachi, Pakistan were subjected to ARIMA modeling. Subsequently, a fitted ARIMA model was used to forecast HCV seropositive donors for 91-96 mo to contrast with observed series of the same months. To assess the forecast accuracy, the mean absolute error rate (%) between the observed and predicted HCV …

Appropriate Practices In College/University Physical Activity Instructional Programs, Bridget F. Melton, Michele M. Sweeney, Jared A. Russel, Carrie L. Moore

Community Health Faculty Presentations

This session will introduce the audience to a new NASPE document that supports basic instructional programming at the college and university level. Based on NASPE’s former K-12 Appropriate Practice documents, this document will serve as an advocacy document for the importance of quality programming at the college/university level. Come and preview this new document!

Reliability (Internal Consistency) Of The Job Content Questionnaire On Job Stress Among Office Workers Of A Multinational Company In Kuala Lumpur, Retneswari Masilamani, Husna Maizura, Tahir Aris

Retneswari Masilamani

This small, cross-sectional study assessed the reliability of 3 scales from the Job Content Questionnaire (JCQ)-decision latitude, psychological job demand, and social support-in a group of office workers in a multinational company in Kuala Lumpur. A universal sample of 30 white-collar workers from a department of the company self-administered the English version of the JCQ comprising 21 core items selected from the full recommended version of 49 items onsite. Reliability (internal consistency) was evaluated using Cronbach's alpha coefficients for each scale. Corrected item-total correlation was presented for each and every item. Cronbach's alpha coefficients were acceptable for decision latitude (. …

Eligibility, Recruitment, And Retention Of African Americans With Severe Mental Illness In Community Research, Michelle Hampton, Mary White, Linda Chafetz

Faculty Publications

Data that addresses severely mentally ill (SMI) African Americans (AAs) likelihood to participate in clinical research is limited. This study’s purpose was to determine if differences exist between races regarding eligibility, recruitment, and retention in a community-based clinical trial. The sample included 293 participants. Data sources included clinical records and interviews. Logistic regression was used for analysis. AAs were as likely to participate and to complete followup interviews as Whites. In contrast to studies about non-mentally ill AAs, AAs with SMI appeared to be as willing to consent to and to remain in clinical research studies as Whites.

Prevalence Of Obesity In School-Going Children Of Karachi., Haider Javed Warraich, Faisal Javed, Mohammed Faraz-Ul-Haq, Fariha Batool Khawaja, Sarah Saleem

Community Health Sciences

Background: Obesity is an emerging problem in Pakistan. The authors sought to determine prevalence of obesity and malnutrition in school-going children, from grades 6(th) to 8(th) of different schools of Karachi and assess associations that affect the weight of the children.
Methodology/Principal Findings: A cross sectional Study Design with children studying in grades 6(th) to 8(th) grade, in different schools of Karachi. We visited 10 schools of which 4 consented, two subsidized government schools and two private schools. A questionnaire was developed in consultation with a qualified nutritionist. Height and weight were measured on calibrated scales. A modified BMI criterion …

Public Private Mix Model In Enhancing Tuberculosis Case Detection In District Thatta, Sindh, Pakistan, Jameel Ahmed, Mubashir Ahmed, A Laghari, Wasdev Lohana, Sajid Ali, Zafar Fatmi

Community Health Sciences

To enhance the TB case detection through Public Private Mix (PPM) model by involving private practitioners in collaboration with National TB Control Program, (NTP) in district Thatta. Private practitioners (PPs) of district Thatta involved in treatment of TB cases were requested to participate in the study. All consenting physicians were provided with training on Directly Observed Treatment Short course (DOTS) module. In addition to routine cases, TB cases diagnosed by private practitioners through sputum microscopy were also registered with the district TB control program and medicines were provided by NTP. After intervention of PPM-DOTS change in Case Detection Rate (CDR) …

The Health Seeking Behaviour Of Elderly Population In A Poor-Urban Community Of Karachi, Pakistan, Abdullah Ladha, Romaisa Shamim Khan, Awais Amjad Malik, Sana Farooq Khan, Beenish Khan, Irum Nawaz Khan, Samiullah, Waleed Tallat Kayani, Sarah Saleem

Community Health Sciences

OBJECTIVES: To presents socio-demographic characteristics and health seeking behaviour of elderly and to determine frequency of Diabetes Mellitus and Hypertension in elderly population of a poor peri-urban community in Karachi, Pakistan.

METHODS: A cross-sectional study was conducted, targeting population aged 65 or above. A total of 438 respondents were interviewed after taking informed consent, between November 2005 and December 2005. Frequencies and Chi square values were calculated for different variables using SPSS 13.0.

RESULTS: Total population surveyed comprised of 438 elderly, 158 (36%) women and 280 (63.9%) men. Mean age for the population was 71.44 +/- 7.74. A total of …

General Practitioner's Knowledge Regarding The Diagnosis And Drug Therapy For Acute Myocardial Infarction, Zaman Shah, Munsif Ali, Islam Hussain, Saadia Zohra Farooqui, Anita Naushir Akbar Ali, Ailia Welayat Ali, Fazal Manzoor Arain, Salman Saleem Allana, Shadmeen Rafique Aarabi, Salman Fasih Khan, Mansoor Arif, Saad Siddique, Majid Shafiq, Amyn B Lakhani

Community Health Sciences

OBJECTIVE: To assess the general practitioners (GP) knowledge regarding the diagnosis and initial drug therapy for acute myocardial infarction (AMI).

METHODS: A questionnaire-based survey was conducted in randomly selected GPs of Karachi. Doctors working in community as GPs who were registered medical practitioners having a Bachelor of Medicine & Bachelor of Surgery degree were included in the study. Doctors working at tertiary care facilities or having a post graduate degree or post graduate training in a specialty other than family medicine were excluded from the study.

RESULTS: A total of 186 GPs participated in our study. GPs who studied research …