Public Health Commons^™

Lowering The Risk Of Spreading Hiv Among Heterosexual Men In Africa, Richard Wamai

Richard G. Wamai

No abstract provided.

Coronary Heart Disease Knowledge And Risk Factors Among Filipino-Americans Connected To Primary Care Services, Alona N. Dalusung-Angosta

Nursing Faculty Publications

Coronary heart disease (CHD) is the leading cause of death of Filipino-Americans (FAs). Despite the growing numbers of FAs in the United States, little is known about their CHD knowledge and risk factors.

The purposes of this study were to examine the baseline knowledge and risk factors of CHD among FAs and to describe the relationships between knowledge, sociodemographic, and socioeconomic characteristic variables of FAs between the ages of 35-75 years.

The study sample consisted of 120 FAs (N = 120) who were connected to primary care services. Data were collected from three primary care clinics in Las Vegas, …

The Affordable Care Act, Medical Homes, And Childhood Asthma: A Key Opportunity For Progress, Meagan Lyon, Anne Rossier Markus, Sara J. Rosenbaum

Geiger Gibson/RCHN Community Health Foundation Research Collaborative

The medical homes provisions of the Affordable Care Act offer a major opportunity to advance high quality, cost-efficient health care for children with asthma. This policy brief examines evolving national medical homes policy in a childhood asthma context. Following a brief background that examines childhood asthma and explores the origins and evolution of medical homes policy (a concept developed with children in mind), the brief then describes how the Affordable Care Act can advance the implementation of medical homes policies to improve health outcomes for children with asthma.

Coronary Heart Disease Mortality And Long-Term Exposure To Ambient Particulate Air Pollutants In Elderly Nonsmoking California Residents, Lie Hong Chen

Loma Linda University Electronic Theses, Dissertations & Projects

The purpose of this study is to assess the effect of long-term concentrations of ambient PM on risks of all causes, cardiopulmonary, coronary heart disease (CHD), total cancer, and any mention of nonmalignant respiratory disease (NMRD) mortality.

The health effects of long-term ambient air pollution have been studied with up to 30 years of follow-up in the AHSMOG cohort, a cohort of 6,338 nonsmoking white California adults. Monthly concentrations of ambient air pollutants [particulate matter(PMio), Ozone (O3), sulfur dioxide (SO2), nitrogen dioxide (NO2) or particulate matter

In the AHSMOG cohort, each increment of 10 |ig/m3 in PMio in two-pollutant models …

Vertical Transmission Of West Nile Virus In Culex Spp. Mosquitoes Of Clark County, Nevada, Vivek K. Raman

UNLV Theses, Dissertations, Professional Papers, and Capstones

West Nile Virus (WNV) is an RNA arbovirus that cycles between mosquitoes and birds, but also infects and causes disease in humans, horses and other vertebrate species. Although most infections are asymptomatic, WNV has emerged as the most common cause of epidemic meningoencephalitis in North America and the leading cause of arboviral encephalitis in the United States.

Mosquitoes of the genus Culex are the most active vectors of WNV in North America. Approximately 85% of human WNV infections in the United States occur in late summer with a peak number of cases in August and September. Vertical transmission is defined …

Effects Of Acculturation On Hiv/Aids Sexual Risk Behaviors Among Asian And Pacific Islander (Api) Women, Margaret Cabotage Salud

Loma Linda University Electronic Theses, Dissertations & Projects

Background. In the US women are the fastest growing group for sexually transmitted infections (STIs), including HIV and AIDS. In addition, the estimated AIDS cases among female adults and adolescents, aged 13-19, increased from 7% in 1985 to approximately 26% in 2002. Most infections occur by heterosexual transmission with 53% occurring through contact with a high-risk sexual partner. While overall HIV/AIDS rates in the Asian Pacific Islander (API) community remain low, they are rising and HIV testing rates, one of the major prevention strategies for HIV, are lower than that of other populations. Furthermore, very little is known about APIs …

Battling Hiv/Aids And The Healthcare Crisis In Africa, Richard Wamai

Richard G. Wamai

No abstract provided.

Hiv Prevention Cost-Effectiveness: A Systematic Review, Omar Gálarraga, M. Arantxa Colchero, Richard G. Wamai, Stefano Bertozzi

Richard G. Wamai

Background: After more than 25 years, public health programs have not been able to sufficiently reduce the number of new HIV infections. Over 7,000 people become infected with HIV every day. Lack of convincing evidence of cost-effectiveness (CE) may be one of the reasons why implementation of effective programs is not occurring at sufficient scale. This paper identifies, summarizes and critiques the CE literature related to HIV-prevention interventions in low- and middle-income countries during 2005-2008. Methods: Systematic identification of publications was conducted through several methods: electronic databases, internet search of international organizations and major funding/implementing agencies, and journal browsing. Inclusion …

Pufa And Vitamin D And Type 2 Diabetes Inflammatory Markers, Paulo A. Lotufo

Paulo A Lotufo

No abstract provided.

A Conversation On African Diaspora, Richard Wamai

Richard G. Wamai

No abstract provided.

Physical Interventions To Interrupt Or Reduce The Spread Of Respiratory Viruses: Systematic Review, Tom Jefferson, Chris Del Mar, Liz Dooley, Eliana Ferroni, Lubna A. Al-Ansary, Shaikh Abdullah S. Bahamdam, Ghada A. Bawazeer, Mieke L. Van Driel, Ruth Foxlee, Alessandro Rivetti

Liz Dooley

Objective: To review systematically the evidence of effectiveness of physical interventions to interrupt or reduce the spread of respiratory viruses. Data sources: Cochrane Library, Medline, OldMedline, Embase, and CINAHL, without restrictions on language or publication. Data selection: Studies of any intervention to prevent the transmission of respiratory viruses (isolation, quarantine, social distancing, barriers, personal protection, and hygiene). A search of study designs included randomised trials, cohort, case-control, crossover, before and after, and time series studies. After scanning of the titles, abstracts and full text articles as a first filter, a standardised form was used to assess the eligibility of the …

The Efficacy Of Spirometry As A Screening Tool In Detection Of Air Flow Obstruction, Nabeel Manzar, A. Suleman Haque, Bushra Manzar, Muhammad Irfan

Section of Pulmonary & Critical Care

Background/Objectives: In developing countries, spirometry has not been considered a part of routine medical check-up. The purpose of the study was to establish the usefulness of spirometry as a primary screening tool in detecting air flow obstruction (AFO) during routine medical check-up (RMC). Methods: This was a hospital based, retrospective, non-randomized case series study of 3696 participants, who presented to hospital for routine medical check-up. All subjects were assisted at the Pulmonary Medicine Department, from January 2003 till December 2008 who, having met other inclusion criteria, underwent spirometry. Data were analyzed using proportion, group means, standard deviations and …

Perfil Dos Acidentes De Trabalho No Brasil, 2004-2007 / Analysis Of Labor Accidents In Brazil, 2004 - 2007, Everton Fernando Alves

Everton Fernando Alves

Neste estudo sintetizam-se achados epidemiológicos de morbi- mortalidade decorrentes de acidentes de trabalho napopulação brasileira. O objetivo do estudo é descrever o perfil dos acidentes de trabalho no Brasil entre 2004 e 2007. Trata-se de um estudo descritivoexploratório utilizando como fonte de dados a estatística anual de acidentes do trabalho da Previdên- cia Social. Foram notificados 465.700 mil acidentesem 2004 e 653.090 em 2007, mostrando uma tendência ascendente nos acidentes com trabalhado- res formais no Brasil. Evidenciou-se que o estado de residência com maior acidentabilidade foi Santa Catarina com uma média de 577,3 acidentes para cada 100.000 trabalhadores. O aumento …

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 …

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, & …

Body Mass Index, Treatment Practices, And Mortality In Patients With Acute Heart Failure, Timothy Fitzgibbons, Olga Hardy, Darleen Lessard, Joel Gore, Jorge Yarzebski, Robert Goldberg

Jorge L. Yarzebski

OBJECTIVES: Obesity is associated with an increased risk of heart failure (HF). Among patients presenting with acute HF, however, differences in clinical characteristics, treatment regimens, and short-term prognosis of varying weights are largely unknown, particularly from a broader population-based perspective. METHODS: A total of 3722 patients admitted with acute HF to 11 greater Worcester (Massachusetts, USA) hospitals during 1995 and 2000 were categorized as being lean (n = 216), normal weight (n = 1465), overweight (n = 1007), or obese (n = 1034) at the time of hospitalization. RESULTS: Obese patients with decompensated HF were significantly younger (mean age = …

Differences In Discharge Medication After Acute Myocardial Infarction In Patients With Hmo And Fee-For-Service Medical Insurance, Danny Mccormick, Jerry Gurwitz, Judith Savageau, Jorge Yarzebski, Joel Gore, Robert Goldberg

Jorge L. Yarzebski

OBJECTIVE: To assess the impact of fee-for-service (FFS) versus HMO medical insurance coverage on receipt of aspirin, beta-blockers, and calcium channel blockers at the time of hospital discharge following an acute myocardial infarction. DESIGN: Prospective, population-based study. SETTING: All 16 community and tertiary care hospitals in the metropolitan area of Worcester, Massachusetts. PATIENTS: The study population consisted of patients under 65 years of age hospitalized with a validated acute myocardial infarction in all hospitals in the Worcester (Massachusetts) Standard Metropolitan Statistical Area (1990 census estimate, 437,000) during 1986, 1988, 1990, 1991, and 1993. MEASUREMENTS AND MAIN RESULTS: After adjustment for …

Multidecade-Long Trends (1986-2005) In The Utilization Of Coronary Reperfusion And Revascularization Treatment Strategies In Patients Hospitalized With Acute Myocardial Infarction: A Community-Wide Perspective, Jared Wasser, Robert Goldberg, Frederick Spencer, Jorge Yarzebski, Joel Gore

Jorge L. Yarzebski

OBJECTIVES: The objectives of our community-wide investigation were to describe multidecade-long trends (1986-2005) in the utilization of thrombolytic therapy, percutaneous coronary interventions, and coronary artery bypass graft surgery in patients hospitalized with acute myocardial infarction (AMI). METHODS: The study sample consisted of 9422 greater Worcester (MA) residents hospitalized with confirmed AMI at all metropolitan Worcester medical centers in 11 annual periods between 1986 and 2005. RESULTS: Increases in the utilization of percutaneous coronary interventions were observed between 1986 (2.0%) and 2005 (50.7%) with the most rapid increases beginning in the late 1990s. Utilization of coronary artery bypass graft surgery during …

Long-Term Trends In The Use Of Coronary Reperfusion Strategies In Acute Myocardial Infarction: A Community-Wide Perspective, Robert Goldberg, Frederick Spencer, Joseph Okolo, Darleen Lessard, Jorge Yarzebski, Joel Gore

Jorge L. Yarzebski

BACKGROUND: The objectives of our study were to examine long-term (1986-2003) trends in the use of percutaneous coronary interventions (PCI) and thrombolytic therapy in the management of patients hospitalized with acute myocardial infarction (AMI) while our secondary study goal was to examine factors associated with use of these coronary reperfusion strategies. While there have been considerable changes in the management of patients hospitalized with AMI over time, limited contemporary data are available about changing trends in the use of different coronary reperfusion strategies, particularly from the more generalizable perspective of a population-based investigation. METHODS: The study sample consisted of 9,422 …

Use Of Do-Not-Resuscitate Orders In Patients With Kidney Disease Hospitalized With Acute Myocardial Infarction, Joline Chen, Jonathan Sosnov, Darleen Lessard, Jorge Yarzebski, Joel Gore, Robert Goldberg

Jorge L. Yarzebski

BACKGROUND: Patients with kidney disease are at increased risk for adverse health outcomes in comparison to patients without kidney disease. Therefore, patients with kidney disease may have greater use of do-not-resuscitate (DNR) orders than patients without kidney disease in the setting of an acute illness. We examined the association between advanced kidney disease and use of DNR orders in patients admitted with an acute myocardial infarction (AMI) to all greater Worcester, MA, hospitals as part of an epidemiological study.

METHODS: Use of DNR orders in 4,033 Worcester residents hospitalized with AMI at 11 greater Worcester medical centers during 1997, 1999, …

Treatment Practices And Outcomes Of Patients With Established Peripheral Arterial Disease Hospitalized With Acute Myocardial Infarction In A Community Setting, Frederick Spencer, Darleen Lessard, Chyke Doubeni, Jorge Yarzebski, Joel Gore, Robert Goldberg

Jorge L. Yarzebski

BACKGROUND: There are little contemporary data available describing the hospital and long-term outcomes of patients with peripheral arterial disease (PAD) who are hospitalized with acute myocardial infarction (AMI). The objectives of our population-based study were to examine the hospital and long-term outcomes, as well as the use of different treatment practices, among patients with established PAD who were hospitalized with AMI. METHODS: The study sample consisted of 4480 patients hospitalized with AMI at all Worcester, Mass, medical centers in 4 alternate years between 1997 and 2003. RESULTS: Among the metropolitan Worcester residents hospitalized with AMI, 13.5% had a history of …

Excess Body Weight, Clinical Profile, Management Practices, And Hospital Prognosis In Men And Women After Acute Myocardial Infarction, Robert Goldberg, Jiang Cui, Barbara Olendzki, Frederick Spencer, Jorge Yarzebski, Darleen Lessard, Joel Gore

Jorge L. Yarzebski

BACKGROUND: Excess body weight is increasingly being recognized as a major health problem in American men and women. It is unclear, however, whether body weight is associated with the demographic and clinical profile, treatment of, and hospital prognosis after acute myocardial infarction (AMI).

METHODS: Nonconcurrent prospective epidemiologic investigation of Worcester (Massachusetts) metropolitan residents hospitalized at all 11 greater Worcester medical centers with validated AMI in 1997, 1999, 2001, and 2003.

RESULTS: A total of 2008 men and 1505 women were hospitalized with confirmed AMI during the 4 study periods. Approximately 41% of men and 29% of women were classified as …

Perfil Dos Atendimentos Ambulatoriais Realizados Em Uma Clínica De Cirurgia Plástica No Sul Do Brasil / Outpatient Service Profile In A Plastic Surgery Clinic In Southern Brazil, Everton Fernando Alves

Everton Fernando Alves

Objetivo: Descrever o perfil dos atendimentos ambulatoriais realizados em uma clínica de cirurgia plástica no sul do Brasil. Materiais e Métodos: Foi realizado um estudo descritivo, exploratório e de caráter quantitativo com o intuito de analisar a totalidade de atendimentos ambulatoriais (consultas e cirurgias) realizadas em uma clínica privada de cirurgia plástica no período de 01 de janeiro a 31 de dezembro de 2010. Resultados: Observou-se que, das 671 (60,5%) consultas novas, apenas 205 (18,5%) cirurgias foram realizadas. Março foi o mês com mais consultas (10%) e cirurgias (11,7%). Do total de consultas novas, as reparadoras foram predominantes em 55,6% …

Validation Of A Stroke Symptom Questionnaire For Epidemiological Surveys., Paulo A. Lotufo

Paulo A Lotufo

CONTEXT AND OBJECTIVE:Stroke is a relevant issue within public health and requires epidemiological surveillance tools. The aim here was to validate a questionnaire for evaluating individuals with stroke symptoms in the Stroke Morbidity and Mortality Study (Estudo de Mortalidade e Morbidade do Acidente Vascular Cerebral, EMMA), São Paulo, Brazil.DESIGN AND SETTING:This was a cross-sectional study performed among a sample of the inhabitants of Butantã, an area in the western zone of the city of São Paulo.METHODS:For all households in the coverage area of a primary healthcare unit, household members over the age of 35 years answered a stroke symptom questionnaire …

Socioeconomic Status And Coronary Heart Disease Mortality In The City Of Sao Paulo, Brazil (1996 To 2007), Paulo A. Lotufo

Paulo A Lotufo

No abstract provided.

Cardiovascular Risk Assessment - From Individual Risk Prediction To Estimation Of Global Risk And Change In Risk In The Population, John A. Batsis, Francisco Lopez-Jimenez

Dartmouth Scholarship

Cardiovascular disease is the most common cause of death and risk prediction formulae such as the Framingham Risk Score have been developed to easily identify patients at high risk that may require therapeutic interventions. Using cardiovascular risk formulae at a population level to estimate and compare average cardiovascular risk among groups has been recently proposed as a way to facilitate surveillance of net cardiovascular risk and target public health interventions. Risk prediction formulas may help to compare interventions that cause effects of different magnitudes and directions in several cardiovascular risk factors, because these formulas assess the net change in risk …

Non-Inferiority Trials [In Portuguese], Paulo A. Lotufo

Paulo A Lotufo

No abstract provided.

Evaluating The Impact Of The Guatemalan Nursing Program On Staff, Organizational, And Clinical Outcomes, Sara Williamson Day

Theses and Dissertations (ETD)

There is great disparity between the outcome of childhood cancer in developed and developing countries. Nurses, who comprise the largest group of health care professionals globally, are essential to successful treatment. Pediatric oncology education is generally unavailable for nurses in developing countries. This lack of education is likely to contribute to the disparity in survival rates, as undereducated nurses are unable to meet the demands of pediatric cancer care. A second critical problem in developing countries is the workload of the nurse, with a patient nurse ratio reported as high as 30 patients per one nurse.

In 2006, the quality …

Cardiovascular And Cancer Mortality In Brazil, Paulo A. Lotufo

Paulo A Lotufo

Cancer are not surpassing Cardiovascular Diseases. Here you have an evaluation of mortality in Brazil. The debate was ignited by paper from IARC (International Agency for Research on Cancer) that forecasts cancer deaths surpassing heart diseases rates during de 2020’s. There is no dispute about the fact that - at least in the US and other countries - the decline of mortality deaths for heart diseases presenting a faster pace compared to cancer death rates. It is an epidemiological evidence that must be analyzed and some headline fueling hype as “heart diseases as an old agenda of public health and …

Glycan Shielding Of The Influenza Virus Hemagglutinin Elicits Evasion Of The Adaptive Immune Response And T-Cell-Driven Pathology, Keith C. Wanzeck

Theses and Dissertations (ETD)

Three separate influenza pandemics have emerged in the human population since 1918, each characterized by viruses that lack N-linked glycosylation sites on the globular head of the hemagglutinin protein. In contrast, recent non-pandemic isolates have acquired such sites. Here we constructed isogenic viruses containing differing numbers of additional N-linked glycosylation sites to assess the impact on the host immune response. These studies show that mice infected with a glycosylated virus remain susceptible to challenge with a non-glycosylated virus, glycosylated viruses elicit an inferior immune response, and in this context T-cell pathology and death may occur. We conclude from these data …