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 …

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 …

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.

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 …

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

Richard G. Wamai

No abstract provided.

What Does It Take To Be A Man? What Is A Real Man?': Ideologies Of Masculinity And Hiv Sexual Risk Among Black Heterosexual Men, David J. Malebranche, Lisa Bowleg, Michelle Teti, Jenne S. Massie, Aditi Patel, Jeanne M. Tschann

David J Malebranche

Research documents the link between traditional ideologies of masculinity and sexual risk among multi-ethnic male adolescents and White male college students, but similar research with Black heterosexual men is scarce. This exploratory study addressed this gap through six focus groups with 41 Black, low- to middle-income heterosexual men aged 19 to 51 years in Philadelphia, PA. Analyses highlighted two explicit ideologies of masculinity: that Black men should have sex with multiple women, often concurrently, and that Black men should not be gay or bisexual. Analyses also identified two implicit masculinity ideologies: the perception that Black heterosexual men cannot decline sex, …

Virtual Reality In Stroke Rehabilitation: A Meta-Analysis And Practical Implications For Clinicians, Gustavo Saposnik

Gustavo Saposnik

No abstract provided.

Circumcision Denialism Unfounded And Unscientific, Joya Banerjee, Jeffrey Klausner, Daniel Halperin, Richard Wamai, Edgar Schoen, Stephen Moses, Brian Morris, Stefan Bailis, Francois Venter, Neil Martinson, Thomas Coates, Glenda Gray, Kasonde Bowa

Richard G. Wamai

No abstract provided.

Advising Patients To Increase Fluid Intake For Treating Acute Respiratory Infections, Michelle Guppy, Sharon Mickan, Chris Del Mar, Sarah Thorning

Sarah Thorning

Background
Acute respiratory infection is a common reason for people to present for medical care. Advice to increase fluid intake is a frequent treatment recommendation. Attributed benefits of fluids include replacing increased insensible fluid losses, correcting dehydration from reduced intake and reducing the viscosity of mucus. However, there are theoretical reasons for increased fluid intake to cause harm. Anti-diuretic hormone secretion is increased in lower respiratory tract infections of various aetiologies. This systematic examination of the evidence sought to determine the benefit versus harm from increasing fluid intake.

Objectives
To answer the following questions.
(1)Does recommending increased fluid intake as …

Iscore: A Risk Score To Predict Stroke Mortality, Gustavo Saposnik

Gustavo Saposnik

Stroke is a leading cause of death and adult disability. The ability to estimate prognosis in acute stroke patients directly affects treatment decisions for patients. It may also guide supportive care plans, facilitate patient and/or family counseling or discussions pertaining to end-of-life decisions. At the population level, prognostic estimations may assist policymakers in conducting fair comparisons when evaluating stroke fatality among different facilities for hospital outcomes and performance assessment. Clinicians usually rely on their own personal experience or average mortality reported in observational studies, which do not account for valuable information available at the time of the hospital presentation. Unfortunately, …

30-Year Trends In Heart Failure In Patients Hospitalized With Acute Myocardial Infarction, David Mcmanus, Marcello Chinali, Jane Saczynski, Joel Gore, Jorge Yarzebski, Frederick Spencer, Darleen Lessard, Robert Goldberg

Jorge L. Yarzebski

Despite significant advances in its treatment, acute myocardial infarction (AMI) remains an important cause of heart failure (HF). Contemporary data remain lacking, however, describing long-term trends in incidence rates, demographic and clinical profiles, and outcomes of patients who develop HF as a complication of AMI. Our study sample consisted of 11,061 residents of the Worcester (Massachusetts) metropolitan area hospitalized with AMI at all greater Worcester hospitals in 15 annual study periods from 1975 to 2005. Overall, 32.4% of patients (n = 3,582) with AMI developed new-onset HF during their acute hospitalization. Patients who developed HF were generally older, more likely …

Recent Trends In The Incidence, Treatment, And Outcomes Of Patients With Stemi And Nstemi, David Mcmanus, Joel Gore, Jorge Yarzebski, Frederick Spencer, Darleen Lessard, Robert Goldberg

Jorge L. Yarzebski

BACKGROUND: despite the widespread use of electrocardiographic changes to characterize patients presenting with acute myocardial infarction, little is known about recent trends in the incidence rates, treatment, and outcomes of patients admitted for acute myocardial infarction further classified according to the presence of ST-segment elevation. The objectives of this population-based study were to examine recent trends in the incidence and death rates associated with the 2 major types of acute myocardial infarction in residents of a large central Massachusetts metropolitan area. METHODS: We reviewed the medical records of 5383 residents of the Worcester (MA) metropolitan area hospitalized for either ST-segment …

Declining Length Of Stay For Patients Hospitalized With Ami: Impact On Mortality And Readmissions, Jane Saczynski, Darleen Lessard, Frederick Spencer, Jerry Gurwitz, Joel Gore, Jorge Yarzebski, Robert Goldberg

Jorge L. Yarzebski

BACKGROUND: Length of hospital stay after acute myocardial infarction decreased significantly in the 1980s and 1990s. Whether length of stay has continued to decrease during the 2000s, and the impact of decreasing length of stay on rehospitalization and mortality, is unclear. We describe decade-long (1995-2005) trends in length of stay after acute myocardial infarction, and examine whether declining length of stay has impacted early rehospitalization and postdischarge mortality in a population-based sample of hospitalized patients.

METHODS: The study sample consisted of 4184 patients hospitalized with acute myocardial infarction in a central New England metropolitan area during 6 annual periods (1995, …

Management And Outcomes Of Renal Disease And Acute Myocardial Infarction, Paul Santolucito, Dennis Tighe, David Mcmanus, Jorge Yarzebski, Darleen Lessard, Joel Gore, Robert Goldberg

Jorge L. Yarzebski

BACKGROUND: Contemporary trends in the management and outcomes of chronic kidney disease patients who develop an acute myocardial infarction have not been adequately described, particularly from the more generalizable perspective of a population-based investigation. METHODS: The study population consisted of 6219 residents of the Worcester, Massachusetts, metropolitan area who were hospitalized with acute myocardial infarction in 6 annual periods between 1995 and 2005. Patients were categorized as having preserved kidney function (n=3154), mild to moderate chronic kidney disease (n=2313), or severe chronic kidney disease (n=752) at the time of hospital admission. RESULTS: Patients with chronic kidney disease were more likely …

Spatial Distribution Of Commercial Banks In Ilorin Metropolis, Kwara State, Nigeria, I B. Abdullahi, M A. Ijaiya, A Abdulraheem, R I. Abdulkadir, R O. Ibrahim

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

The spatial distribution of banks in any geographic entity determines the level of accessibility to its services by the public. This study examined the pattern of banks distribution in Ilorin metropolis. Field survey was employed in determining the number of available commercial banks and their respective distances between each other. The spatial analysis technique such as the nearest neighbour analysis as used ascertain the degree of clustering, density and the average distance taken to access these services. The study revealed that about 96% of the total number of banks are situated in the Central Business District which exhibited a very …

How Do We ‘See’ Occupations? An Examination Of Visual Research Methodologies In The Study Of Human Occupation, L. Hartman, A. Mandich, L. Magalhaes, Treena Orchard

Dr. Treena Orchard

This article argues that visual research methodologies have potential to contribute to the study of occupation. The use of visual research methodologies is quickly growing in a number of disciplines and can help researchers to access information and reasoning not accessible through interview, log or survey. The reflexive, reflective, engaged process of creating and analysing visual materials allows for rich representations on behalf of participants, and immersion in the data on the part of researchers. This paper explores photovoice, body mapping and textual analysis of visual materials to understand how they can contribute to occupational science research. These methods were …

'What's The Use Of Getting A Cow If You Can't Make Any Money From It?': The Reproduction Of Inequality Within Contemporary Social Reforms Of Devadasis, Treena Orchard

Dr. Treena Orchard

No abstract provided.

Retention In Care And Connection To Care Among Hiv-Infected Patients On Antiretroviral Therapy In Africa: Estimation Via A Sampling-Based Approach, Elvin Geng

Elvin H Geng

No abstract provided.

Retention In Care For Hiv-Infected Patients In Resource-Limited Settings: Challenges And Opportunities, Elvin Geng

Elvin H Geng

No abstract provided.

Trends In Hiv-Infected Patients Accessing Antiretroviral Therapy In Kenya, Uganda And Tanzania Between 2002 And 2009, Elvin Geng

Elvin H Geng

No abstract provided.

Correcting Mortality For Loss To Follow-Up: A Nomogram Applied To Antiretroviral Treatment Programmes In Sub-Saharan Africa, Elvin Geng

Elvin H Geng

No abstract provided.

Health Development Experiences In Haiti: What Can Be Learned From The Past To Find A Way Forward?, Richard Wamai, Colleen Larkin

Richard G. Wamai

Haiti’s history is marred by neo colonialism, structural violence, dictatorial politics, and severe natural disasters. These social political and geo-ecological factors have played a strong role in shaping the country’s past and current experiences in health and development. This paper overviews Haiti’s recent developments in health in light of the country’s tragic and complex history and comments on the health impact of the 2010 earthquake. In light of this information we draw some general conclusions and recommendations for going forward.

The Relationship Between Gender Role Conflict And Condom Use Among Black Msm, David J. Malebranche, Roman Gvetadze, Gregorio A. Millett, Madeline Y. Sutton

David J Malebranche

Gender role conflict may influence condom use among black MSM. We examined relationships between the Gender Role Conflict Scale (GRCS), social/demographic variables and condom use among 456 black MSM. Higher total GRCS scores did not predict unprotected insertive anal intercourse (UIAI) or unprotected receptive anal intercourse (URAI) with men, but were associated with unprotected vaginal or anal intercourse (UVI/UAI) with women among bisexually active participants (n = 69). Higher perceived HIV risk reduced the likelihood of both UIAI and URAI with men. Internet recruitment venues, sexual discrimination experiences, higher numbers of sex partners and UVI/UAI with women all increased the …

Hiv Risk And Perceptions Of Masculinity Among Young Black Men Who Have Sex With Men, Errol L. Fields, Laura M. Bogart, Katherine C. Smith, David J. Malebranche, Jonathan Ellen, Mark A. Schuster

David J Malebranche

Purpose: Young black men who have sex with men (YBMSM) are known to have the highest rates of HIV infection in the United States. Although reported rates of unprotected anal intercourse are similar to the rates ofmen who have sex with men of other racial/ethnic backgrounds, YBMSM aged 15–22 years are five times more likely to be HIV-infected than the comparably aged white men who have sex with men. We explored contextual social-environmental factors that may influence how YBMSM assess risk, choose partners, and make decisions about condom use.

Methods: We analyzed semi-structured interviews with 35 YBMSM (age: 18–24 years) …

Organized Outpatient Stroke Care, Gustavo Saposnik

Gustavo Saposnik

Background and Purpose—Organized inpatient stroke care decreases mortality and morbidity irrespective of patient age, stroke severity, or stroke subtype. Limited information is available on whether organized outpatient care models such as stroke prevention clinics (SPC) improve outcomes after a transient ischemic attack or ischemic stroke. We compared 1-year mortality and stroke readmission in patients with transient ischemic attack or ischemic stroke referred versus not referred to an SPC. Methods—This was a retrospective cohort study including 16 468 consecutive patients with ischemic stroke or transient ischemic attack who were seen in the emergency department or admitted to a hospital between July …

Penumonia: Risk Factors And Outcomes After Stroke, Gustavo Saposnik

Gustavo Saposnik

No abstract provided.

Vitamin B In Stroke Prevention: A Journey From Observational Studies To Rct's., Gustavo Saposnik

Gustavo Saposnik

No abstract provided.