Public Health Commons^™

Male Circumcision For Hiv Prevention: Current Evidence And Implementation In Sub-Saharan Africa, Richard G. Wamai, Brian J. Morris, Stefan A. Bailis, David Sokal, Jeffrey D. Klausner, Ross Appleton, Nelson Sewankambo, David A. Cooper, John Bongaarts, Guy De Bruyn, Alex D. Wodak, Joya Banerjee

Richard G. Wamai

Heterosexual exposure accounts for most HIV transmission in sub-Saharan Africa, and this mode, as a proportion of new infections, is escalating globally. The scientific evidence accumulated over more than 20 years shows that among the strategies advocated during this period for HIV prevention, male circumcision is one of, if not, the most efficacious epidemiologically, as well as cost-wise. Despite this, and recommendation of the procedure by global policy makers, national implementation has been slow. Additionally, some are not convinced of the protective effect of male circumcision and there are also reports, unsupported by evidence, that non-sex-related drivers play a major …

Geographic Disparities Associated With Stroke And Myocardial Infarction In East Tennessee, Ashley Pedigo Golden

Doctoral Dissertations

Stroke and myocardial infarction (MI) are serious conditions whose burdens vary by socio-demographic and geographic factors. Although several studies have investigated and identified disparities in burdens of these conditions at the county and state levels, little is known regarding their geographic epidemiology at the neighborhood level. Both conditions require emergency treatments and therefore timely geographic accessibility to appropriate care is critical. Investigation of disparities in geographic accessibility to stroke and MI care and the role of Emergency Medical Services (EMS) in reducing treatment delays are vital in improving health outcomes. Therefore, the objectives of this work were to: (i) classify …

Spatial Distribution Of Obesity Among West Virginia 5th Grade Children: Analysis Of The Socioeconomic, Physical, And Personal Environment, Sherry Roper

Theses and Dissertations (ETD)

Childhood obesity defined as a body mass index (BMI) at or above the 95th percentile for children of the same age and sex, is considered an epidemic in the United States. Biology and lifestyle behaviors have been identified as important factors in the development of childhood obesity; however, researchers are beginning to place more emphasis upon the impact that continual environmental exposures have upon obesity development. Environmental risk factors associated with obesity are distributed continuously over space, yet evidence suggests that burden of risk may not be evenly dispersed across a community. West Virginia (WV), a rural Appalachian community has …

Evaluation Of The Pilot Program, Pediatric Early Warning Sentinel Surveillance Program (Pewss), And Its Efficacy In Monitoring Pediatric Illness In Clark County, Nevada, Michelle Lee Lutman

UNLV Theses, Dissertations, Professional Papers, and Capstones

The influenza outbreak that occurred during 2009 stimulated the formation of several surveillance programs throughout the country. The majority monitor only influenza; however, there are several other circulating respiratory pathogens, especially within the pediatric community. These other respiratory pathogens cause a variety of illnesses, such as bronchitis, pneumonia, croup, etc. Prior research has provided the medical community with valuable information about respiratory illnesses, especially those which afflict pediatric patients. Areas of knowledge including seasonality, demographics, signs and symptoms, prevention measures, and pathogenicity, have been greatly expanded over the years. This information has been of tremendous help to the medical community …

Elsa-Brasil: Historico [In Portuguese], Paulo A. Lotufo

Paulo A Lotufo

No abstract provided.

Vigilância Em Doença Cerebrovascular [Portuguese], Paulo A. Lotufo

Paulo A Lotufo

No abstract provided.

Living With Alzheimer’S Disease: A Study Of Adult Day Health Services In Massachusetts, Nina M. Silverstein, Cathy M. Wong, Kristen E. Brueck

Nina Silverstein

The role of adult day health care (ADHC) is gaining increased attention as the nation prepares for the large cohort of baby boomers entering their later years. Many boomers are aging with physical and cognitive impairments, including Alzheimer's disease and related dementias. Projections indicate that Massachusetts, along with the nation as a whole, is experiencing an increasing rate of older persons as baby boomers enter late-life. The Commonwealth can expect that persons with Alzheimer's disease and their care partners will need community-based services that are specifically designed for adults with cognitive impairments. However, a report by the Robert Wood Johnson …

Chronic Disease Self-Management Programs: Relevance For Persons With Dementia, Nina M. Silverstein, Alison S. Gottlieb

Nina Silverstein

The context for this study is the work of the Healthy Brain Initiative. The CDC has established a cooperative agreement with the Alzheimer’s Association to develop and implement a multifaceted approach to look at cognitive health as a public health issue. Late in 2010, the Association commissioned a review of the major chronic disease prevention programs from a systems approach to begin to understand the source of findings that Medicare beneficiaries with Alzheimer’s and related disorders are much higher cost than those simply with a single chronic disease and no AD. This led to the conclusion that Chronic Disease Self‐Management …

Characterization Of Street Food Consumption In Palermo: Possible Effects On Health, Silvio Buscemi, Annamaria Barile, Vincenza Maniaci, John A. Batsis

Dartmouth Scholarship

Background: Street Food (SF) consists of out-of-home food consumption and has old, historical roots with complex social-economic and cultural implications. Despite the emergence of modern fast food, traditional SF persists worldwide, but the relationship of SF consumption with overall health, well-being, and obesity is unknown.

Methods: This is an observational, cross-sectional study. The study was performed in Palermo, the largest town of Sicily, Italy. Two groups were identified: consumers of SF (n = 687) and conventional restaurant food (RES) consumers (n = 315). Study subjects answered a questionnaire concerning their health conditions, nutritional preferences, frequency of consumption of SF and …

With His Hands, David J. Malebranche

David J Malebranche

No abstract provided.

Long-Term Trends In Short-Term Outcomes In Acute Myocardial Infarction, Hoa Nguyen, Jane Saczynski, Joel Gore, Molly Waring, Darleen Lessard, Jorge Yarzebski, George Reed, Frederick Spencer, Shu-Xia Li, Robert Goldberg

Jorge L. Yarzebski

BACKGROUND: The objectives of this study were to examine the magnitude of, and 20-year trends in, age differences in short-term outcomes among men and women hospitalized with acute myocardial infarction (AMI) in central Massachusetts.

METHODS: The study population consisted of 5907 male and 4406 female residents of the Worcester, MA, metropolitan area hospitalized at all greater Worcester medical centers with AMI between 1986 and 2005.

RESULTS: Overall, among both men and women, older patients were significantly more likely to have developed atrial fibrillation, heart failure, and to have died during hospitalization and within 30 days after admission compared with patients …

Targeting Diseases Beyond Our Borders, Richard Wamai

Richard G. Wamai

No abstract provided.

A Reappraisal Of Stroke Mortality Trends In Brazil (1979 To 2009), Paulo A. Lotufo

Paulo A Lotufo

Background: Brazil has the highest cerebrovascular death rate in the Western Hemisphere. We investigated temporal trends according to gender and stroke subtypes. Methods: We analysed mortality rates between 1979 and 2009 for different stroke subtypes. Data were stratified by sex and age (35–74 y). The annual percent change (APC) and significant changes in the trends were identified with joinpoint Poisson regression. The average annual percent change (AAPC) for 2005-09 was presented because that period had the best quality of information. Results: After excluding deaths due to stroke sequels, for men, the APCs (95% confidence intervals) were: 1979-84: 0.7 (-0.8 to …

Use Of Optimal Control Models To Predict Treatment Time For Managing Tick-Borne Disease, Holly D. Gaff, Elsa Schaefer, Suzanne Lenhart

Biological Sciences Faculty Publications

Tick-borne diseases have been on the rise recently, and correspondingly, there is an increased interest in implementing control measures to decrease the risk. Optimal control provides an ideal tool to identify the best method for reducing risk while accounting for the associated costs. Using a previously published model, a variety of frameworks are assessed to identify the key factors influencing mitigation strategies. The level and duration of tick-reducing efforts are key metrics for understanding the successful reduction in tick-borne disease incidence. The results show that the punctuated nature of the tick's life history plays a critical role in reducing risk …

Assessment Of Organic And Inorganic Phosphorus In Soils Derived From Cretaceous Sediments And Basement Complex Soils Of Guinea Savannah Of Kogi State, North Central Nigeria, Sunday I. Amhakhian, H H. Isitekhale, Charles I. Oyewole

Confluence Journal Environmental Studies (CJES), Kogi State University, Nigeria

A pot experiment was carried out using 20 surface soils (0-15cm depth) in 2008 to assess soil organic phosphorus and some fraction of inorganic phosphorus in other to know their availability in the soils of the studied area and also work have not been done in this areas in respect to organic and in-organic phosphorus. The experiment was conducted using 20 soils 10 from each geological formation (Cretaceous sediments and Basement complex soils), respectively. The mean organic phosphorus of 63.51 mgkg 1 soil was obtained for Cretaceous sediment soils and 158.54 mgkg 1 soil for the basement complex soils respectively. …

Development Of Functional Indices Of Facility Occurrence Towards The Distribution Of Social Services In Lagos Island Nigeria., Augustus O. Atubi

Confluence Journal Environmental Studies (CJES), Kogi State University, Nigeria

Proper coordination of transport and public facilities provision is vital to any balanced regional development strategy. The central aim of this study, therefore, is to find out what the relationship is between access to the transport network and the provision of functional indices of facility occurrence towards the distribution of social services in Lagos Island, Nigeria. In particular it seeks to find out areas that have below or above average level of facility occurrences relative to the level of accessibility. However, a pair wise correlation matrix of the eleven (11) variables employed in the index construction was carried out. The …

Neighborhood Disparities In Stroke And Myocardial Infarction Mortality: A Gis And Spatial Scan Statistics Approach, Agricola Odoi

Agricola Odoi

Background: Stroke and myocardial infarction (MI) are serious public health burdens in the US. These burdens vary by geographic location with the highest mortality risks reported in the southeastern US. While these disparities have been investigated at state and county levels, little is known regarding disparities in risk at lower levels of geography, such as neighborhoods. Therefore, the objective of this study was to investigate spatial patterns of stroke and MI mortality risks in the East Tennessee Appalachian Region so as to identify neighborhoods with the highest risks. Methods: Stroke and MI mortality data for the period 1999-2007, obtained free …

Aids/Hiv Denialism: Patients' Privacy Rights, Fadia Abdullah, Guadalupe Medrano

Undergraduate Research Opportunities Program (UROP)

HIV is a sexually transmitted disease that develops into AIDS. There is no cure for it, only treatment. In this poster, we look at the pros and cons of disclosing this type of information. People who decide to disclose their HIV status may have various reasons for doing so, but most do it for emotional support and for prevention of spreading the disease. Those who decide to keep it private primarily do it to not face rejection, discrimination, degradation, and loss of respect. (Petronio Page 72) The problem with creating a public database is that many organizations are against the …

Regulation Of The Shigella Flexneri Icsp Gene And H-Ns Dependent Repression, Rosa Ojeda, Amanda Wigley, Dustin Harrison, Helen Wing

Undergraduate Research Opportunities Program (UROP)

The gram negative bacterium Shigella flexneri is known to cause dysentery in humans and primates. In order to help prevent the spread of shigellosis, gene regulation must be understood. Studies show that the virulence genes in S .flexneri are thermo regulated. At 30°C histone-like nucleoid structuring protein (H-NS) represses transcription of virulence genes and at 37°C VirB derepresses virulence genes. One of the genes that contribute to the virulence of S. flexneri is icsP. My project focuses on the regulation of the S. flexneri icsP gene and has two main goals. The first is to identify the sequence of H-NS …

Gene By Bmi Interactions Influencing C-Reactive Protein Levels In European-Americans, Sarah Tudor

Dissertations & Theses (Open Access)

C-Reactive Protein (CRP) is a biomarker indicating tissue damage, inflammation, and infection. High-sensitivity CRP (hsCRP) is an emerging biomarker often used to estimate an individual’s risk for future coronary heart disease (CHD). hsCRP levels falling below 1.00 mg/l indicate a low risk for developing CHD, levels ranging between 1.00 mg/l and 3.00 mg/l indicate an elevated risk, and levels exceeding 3.00 mg/l indicate high risk. Multiple Genome-Wide Association Studies (GWAS) have identified a number of genetic polymorphisms which influence CRP levels. SNPs implicated in such studies have been found in or near genes of interest including: CRP, APOE, APOC, IL-6, …

Sexual Health And Life Experiences: Voices From Behaviourally Bisexual Latino Men In The Midwestern Usa, Omar Martinez, Brian Dodge, Michael Reece, Phillip W. Schnarrs, Scott D. Rhodes, Gabriel Goncalves, Miguel Munoz-Laboy, David J. Malebranche, Barbara Van Der Pol, Ryan Nix, Guadalupe Kelle, J Dennis Fortenberry

David J Malebranche

Research on behaviourally bisexual Latino men in the USA has not yet examined sexual health issues among men living in diverse areas of the nation, including the Midwest. A community-based participatory research approach was used to engage a diverse sample of 75 behaviourally bisexual men (25 White, 25 Black and 25 Latino). Semi-structured interviews were conducted and standard qualitative analysis procedures were used to explore data from the 25 Latino participants. Men described their unique migration experiences as behaviourally bisexual men in this area of the USA, as well as related sexual risk behaviours and health concerns. Lack of culturally …

Urban Climate And Challenges Of Tropical Cities, B E. Omogbai

Confluence Journal Environmental Studies (CJES), Kogi State University, Nigeria

This study examines the nature of urban climate, features and the challenges on the developing tropical cities in the 21st century. It argues that the use of principles of urban climate would help in providing comfortable living conditions and problem immune working environments for the inhabitants of tropical cities. The findings reveal that owing to poor environmental planning, inadequate geotechnical landscape surveys prior to the development of urban infrastructures, and non-adherence to the principles of urban climate, challenges of landscape degradation, excessive flooding of the built infrastructures, heat-island effects, and collapse of buildings have emerged. Suggested measures to avert these …

Detecting Changes In Landuse/Cover Of Umuahia, South-Eastern Nigeria Using Remote Sensing And Gis Techniques, Fanan Ujoh, Olarewaju Oluseyi Ifatimehin, Adams Ndalai Baba

Confluence Journal Environmental Studies (CJES), Kogi State University, Nigeria

Since 1991 when it became the capital city of Abia State, Umuahia has undergone tremendous transformation in its land use and land cover due to rapid urbanization. The main materials employed for this study are a land use map (1991) and Landsat ETM+satellite image (2007) of the study area. These, combined with field survey/checks, were brought into a GIS environment using ILWIS 3.2 Academic image classification software to map the land use/land cover and to estimate the rate of urban expansion and loss of rural land at the peri-urban fringes of Umuahia between 1991 and 2007. The study revealed significant …

Appalachian Regional Model For Organizing And Sustaining County-Level Diabetes Coalitions, Richard Crespo, Molly Shrewsberry, Darrlyn Cornelius-Averhart, Henry B. King Jr.

Family and Community Health

This article describes a model for developing diabetes coalitions in rural Appalachian counties and presents evidence of their sustainability. The rural Appalachian coalition model was developed through a partnership between two federal agencies and a regional university. Coalitions go through a competitive application process to apply for one-time $10,000 grants. The project has funded 7 to 9 coalitions annually since 2001, reaching 66 total coalitions in 2008. Sustainability of the coalitions is defined by the number of coalitions that voluntarily report on their programs and services. In 2008, 58 of 66 (87%) coalitions in the Appalachian region continue to function …

Early Diagnosis Of Pulmonary Embolism: Review And Cost-Effectiveness Analysis, Efstathios Polychronopoulos

Health Services Research Dissertations

Pulmonary embolism (PE) is a serious, life-threatening thrombotic disease, which results in considerable health and economic consequences each year for the United States. These consequences include a toll of 83,000 deaths and an economic impact between 1,5 and 5 billion. Approaches to strategy selection by physicians and other health-care specialists are based mainly upon cost, technology availability, and cultural tolerance regarding radiation exposure. The purpose of this study was to determine the most cost-effective diagnostic strategy with patients suspected of PE among several strategies currently used by examining their detection failure rates. This objective was met by (a) assessing parameter …

'How To Contain Generalized Hiv Epidemics' Article Misconstrues The Evidence, Richard Wamai, B. Morris

Richard G. Wamai

No abstract provided.

Real-World Comparison Of Two Molecular Methods For Detection Of Respiratory Viruses, Syed Asad Ali, James E. Gern, Tina V. Hartert, Kathryn M. Edwards, Marie R. Griffin, E Kathryn Mille, Tebeb Gebretsadik, Tressa Pappas, Wai Ming Lee, John V. Williams

Department of Paediatrics and Child Health

Background: Molecular polymerase chain reaction (PCR) based assays are increasingly used to diagnose viral respiratory infections and conduct epidemiology studies. Molecular assays have generally been evaluated by comparing them to conventional direct fluorescent antibody (DFA) or viral culture techniques, with few published direct comparisons between molecular methods or between institutions. We sought to perform a real-world comparison of two molecular respiratory viral diagnostic methods between two experienced respiratory virus research laboratories.
Methods: We tested nasal and throat swab specimens obtained from 225 infants with respiratory illness for 11 common respiratory viruses using both a multiplex assay (Respiratory MultiCode-PLx Assay [RMA]) …

Emotional Climate, Feeding Practices, And Feeding Styles: An Observational Analysis Of The Dinner Meal In Head Start Families, Sheryl O Hughes, Thomas G Power, Maria A Papaioannou, Matthew B Cross, Theresa A Nicklas, Sharon K Hall, Richard M Shewchuk

Faculty Publications

BACKGROUND: A number of studies conducted with ethnically diverse, low-income samples have found that parents with indulgent feeding styles had children with a higher weight status. Indulgent parents are those who are responsive to their child's emotional states but have problems setting appropriate boundaries with their child. Because the processes through which styles impact child weight are poorly understood, the aim of this study was to observe differences in the emotional climate created by parents (including affect, tone of voice, and gestures) and behavioral feeding practices among those reporting different feeding styles on the Caregiver's Feeding Styles Questionnaire. A secondary …

Gender Participation In The Management Of Tricycle Transport For Youth Empowerment And Sustainable Development In Kano State, Nigeria, Nuratu Muhammed

Confluence Journal Environmental Studies (CJES), Kogi State University, Nigeria

The research examined gender participation in the management of tricycle for youth empowerment and sustainable development in Kano state, Nigeria. Stratified random sampling technique was used to select samples of drivers(150), passengers (150) and owners/managers the female tricycle owners fell under this category and they numbered(65).All together a total of 365 samples were selected for the study. Data obtained from the primary data was analyzed using simple statistical techniques and chi square test to ascertain whether there was any significant differences in some of the variables tested. The results of the analysis revealed that the main difference was found in …

Addressing The Challenges Of Reporting On Childhood Asthma In A Changing Health Care System: Building Better Evidence For High Performance, Meagan Lyon, Anne Rossier Markus, Maya Tuchman Gerstein, Sara J. Rosenbaum

Geiger Gibson/RCHN Community Health Foundation Research Collaborative

Childhood asthma is a serious and costly chronic disease that burdens children and families as well as the health care systems that serve them. A key element to improving asthma outcomes is access to timely and useful data that can improve the quality of care and inform programs and policies to best serve those communities most burdened by asthma. This Policy Brief examines the nation’s data collection framework for childhood asthma and considers steps that might be taken to strengthen it, including the development, collection and refinement of community-level data to inform local health care systems. Through a review of …