Public Health Commons^™

Leaving Home Care: Decision Making, Risk Scenarios & Services Gaps In The Home Care System, Jacey J. Vaughan, Nina M. Silverstein

Gerontology Institute Publications

Home and community-based services (HCBS) enable older and disabled adults to age-in-place in their homes and communities by helping them function independently for as long as possible (Grabowski et al., 2010; Wong & Silverstein, 2011). Previous studies well document that older adults prefer receiving HCBS rather than institutional care at a nursing home (e.g., Walker, 2010; Fox-Grage, Coleman, & Freiman, 2006). Medicaid is a major source of funding for long-term care. Currently, a large proportion of Medicaid funds in most states has been spent on institutional care (National Conference of State Legislatures & AARP, 2009), and older adults and their …

Determining The Factors Associated With Unmet Need For Family Planning: A Cross-Sectional Survey In 49 Districts Of Pakistan, Waqas Hameed, Syed Khurram Azmat, Mohsina Bilgrami, Muhammad Ishaqe

Community Health Sciences

Introduction & Background: Around 137 million women in the developing world who would like to avoid childbearing are unable to do so, despite a huge increase in contraceptive access and use globally. Ironically, the prevalence of unmet need in Pakistan is among the highest in the world despite being one of the first countries in South Asia to launch national family planning program. The aim of this paper is to estimate the prevalence of unmet need for contraception and to indentify the factors associated with it.
Methods: A cross-sectional survey was conducted in forty nine districts of Pakistan across all …

Gender Roles And Their Influence On Life Prospects For Women In Urban Karachi, Pakistan: A Qualitative Study, Tazeen S. Ali, Gunilla Krantz, Raisa Gul, Nargis Asad, Eva Johansson, Ingrid Mogren

School of Nursing & Midwifery

BACKGROUND: Pakistan is a patriarchal society where men are the primary authority figures and women are subordinate. This has serious implications on women's and men's life prospects.
OBJECTIVE: The aim was to explore current gender roles in urban Pakistan, how these are reproduced and maintained and influence men's and women's life circumstances.
DESIGN: Five focus group discussions were conducted, including 28 women representing employed, unemployed, educated and uneducated women from different socio-economic strata. Manifest and latent content analyses were applied.
FINDINGS: TWO MAJOR THEMES EMERGED DURING ANALYSIS: 'Reiteration of gender roles' and 'Agents of change'. The first theme included perceptions …

Cervical Cancer Screening Outcomes In A Refugee Population, Sarah Pickle, Md, Marc Altshuler, Md, Kevin Scott, Md, Christina Hillson, Md, R. Patrick Mcmanus, Md, Mazvita Nyamukapa, Michael Walker

Department of Family & Community Medicine Presentations and Grand Rounds

The purpose of our study was to determine the prevalence of abnormal Pap smears and high-risk HPV genotypes within our refugee population.

Advances In Information And Communication Technology (Ict): Issues, Challenges And Opportunities For Health Care Professionals, Waris Qidwai

Department of Family Medicine

No abstract provided.

The Association Between Parity, Infant Gender, Higher Level Of Paternal Education And Preterm Birth In Pakistan: A Cohort Study, Kiran Shaikh, Shahirose Sadrudin Premji, Marianne S. Rose, Ambreen Kazi, Shaneela Khowaja, Suzanne Tough

School of Nursing & Midwifery

Background:

High rates of antenatal depression and preterm birth have been reported in Pakistan. Self reported maternal stress and depression have been associated with preterm birth, however findings are inconsistent. Cortisol is a biological marker of stress and depression, and its measurement may assist in understanding the influence of self reported maternal stress and depression on preterm birth.

Methods:

In a prospective cohort study pregnant women between 28 to 30 weeks of gestation from the Aga Khan Hospital for Women and Children completed the A-Z Stress Scale and the Centre for Epidemiology Studies Depression Scale to assess stress and depression …

Beverage Consumption And Bmi Of British Schoolchildren Aged 9-13 Years, Tara Coppinger, Y. M. Jeanes, M. Mitchell, S. Reeves

Publications

Objective Adequate fluid intake has been well documented as important for health but whether it has adverse effects on overall energy and sugar intakes remains under debate. Many dietary studies continue to refrain from reporting on beverage consumption, which the present study aimed to address. Design A cross-sectional survey investigated self-reported measures of dietary intake and anthropometric measurements. Setting Primary and secondary schools in south-west London, UK. Subjects Boys and girls (n 248) aged 9-13 years. Results Boys consumed 10 % and girls consumed 9 % of their daily energy intake from beverages and most children had total sugar intakes …

Poor Women With Sexually Transmitted Infections: Providers’ Perspectives On Diagnoses, Genevieve R. Cox

Sociology

This article presents results from a study of health care providers, mainly nurses and nurse practitioners, who routinely diagnose sexually transmitted diseases (STDs) in rural low-income populations in West Virginia (WV). A qualitative analysis of eighteen semi-structured interviews reveals that providers who consistently work with low-income populations believe patients undergo a negative change in self-image in response to a chronic STD diagnosis. Providers express concerns about a number of issues related to low-income, rural women’s access to sexual health care and see the need for more sexuality education, more funding for free and reduced cost clinics, and more available health …

A Silent Storm: Hepatitis C In Pakistan, Noureen Jiwani, Raisa B. Gul

School of Nursing & Midwifery

No abstract provided.

Doulas Going Dutch: The Role Of Professional Labor Support In The Netherlands, Monica He

Independent Study Project (ISP) Collection

This study uses a mixed method approach and medicalization theory to explore the new role of professional doulas in the Netherlands through the perspectives of women who have had doula-attended births. Survey data from the Dutch doula association is first analyzed in order to quantify women’s experiences with doula care and characterize their demographic information and birth outcomes. Simulatenously, nine in-depth interviews are conducted with Dutch and non- Dutch mothers who have recently had doula-attended births. The interviews focus on experiences with doula care in the context of the Dutch maternity care system. Quantitative analysis finds women who had doulas …

Infectious Disease As A Security Threat, With Particular Application To The Migration Context, Marielena Faria

Independent Study Project (ISP) Collection

This paper analyzes the threat infectious diseases impose on global security, specifically in the migration context. Infectious diseases can threaten security through a variety of areas, and this paper aims to identify the global spread of infectious diseases through migration, international crises, humanitarian emergencies, HIV/AIDS, and emerging and re-emerging infectious diseases. This paper explores global health, security, and migration in an attempt to determine if combining these three areas can be meaningful. Generally, studies approach only two of the three areas to examine a topic, but this paper will assess and point out when combining all three fields is relevant. …

Use Of Dried-Blood-Spot Samples And In-House Assays To Identify Antiretroviral Drug Resistance In Hiv-Infected Children In Resource-Constrained Settings, Carrie Ziemniak, Yohannes Mengistu, Andrea Ruff, Ya-Hui Chen, Leila Khaki, Abubaker Bedri, Birgitte B. Simen, Paul Palumbo

Dartmouth Scholarship

Monitoring HIV drug resistance is an important component of the World Health Organization's global HIV program. HIV drug resistance testing is optimal with commercially available clinically validated test kits using plasma; however, that type of testing may not be feasible or affordable in resource-constrained settings. HIV genotyping from dried blood spots (DBS) with noncommercial (in-house) assays may facilitate the capture of HIV drug resistance outcomes in resource-constrained settings but has had varying rates of success. With in-house assays for HIV reverse transcriptase, we evaluated the yield of genotyping DBS samples collected from HIV-infected children who were enrolled in two clinical …

Hiv And Concurrent Sexual Partnerships: Modelling The Role Of Coital Dilution, Larry Sawers, Alan G. Isaac, Eileen Stillwaggon

Economics Faculty Publications

Background: The concurrency hypothesis asserts that high prevalence of overlapping sexual partnerships explains extraordinarily high HIV levels in sub-Saharan Africa. Earlier simulation models show that the network effect of concurrency can increase HIV incidence, but those models do not account for the coital dilution effect (nonprimary partnerships have lower coital frequency than primary partnerships).

Methods: We modify the model of Eaton et al (AIDS and Behavior, September 2010) to incorporate coital dilution by assigning lower coital frequencies to non-primary partnerships. We parameterize coital dilution based on the empirical work of Morris et al (PLoS ONE, December …

Elderly Patients And Their Health In Pakistan: Current Status, Issues, Challenges And Opportunities, Waris Qidwai, Tabinda Ashfaq

Department of Family Medicine

No abstract provided.

Setting Research Priorities To Reduce Global Mortality From Childhood Pneumonia By 2015, Igor Rudan, Shams El Arifeen, Zulfiqar Ahmed Bhutta, Robert E. Black, Abdullah Brooks, Kit Yee Chan, Mickey Chopra, Trevor Duke, David Marsh, Antonio Pio, Eric A. F. Simoes, Giorgio Tamburlini, Evropi Theodoratou, Martin W. Weber, Cynthia G. Whitney, Harry Campbell, Shamim A. Qazi

Department of Paediatrics and Child Health

No abstract provided.

The Referral Process: Rural Primary Care Physicians' Perspectives On Providing Counseling Referrals, Casey N. Tallent

College of Education and Human Sciences: Dissertations, Theses, and Student Research

The advantages to collaborative care between physicians and mental health care providers have been known for many decades. Rural primary care physicians (RPCPs) are the first professionals that most patients contact when they have a mental health concern, particularly in rural communities. It is therefore important to understand the process that occurs when a referral for counseling is made from a RPCP and the subsequent collaboration that occurs. The purpose of this qualitative study was to generate a model that provides a better understanding of the counseling referral process from the perspective of RPCPs in private practice in the Midwest. …

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]) …

Obesity And Other Predictors Of Absenteeism In Philadelphia School Children., Elizabeth B Rappaport, Constantine Daskalakis, Jocelyn Andrel

Department of Family & Community Medicine Faculty Papers

BACKGROUND: Limited data indicate that obese children are absent from school more than their normal-weight peers. We analyzed administrative data from a large urban school district to investigate the association of obesity and student sociodemographic characteristics with absenteeism.

METHODS: We analyzed 291,040 records, representing 165,056 unique students (grades 1-12). Obesity status was classified according to Centers for Disease Control and Prevention age- and sex-specific percentiles for body mass index (BMI) and analyses were based on negative binomial regression.

RESULTS: Overall rates of overweight and obesity were 17% and 20%, respectively, and the estimated absence rate was 17 absences per 180 …

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

Gerontology Institute Publications

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 …

Primary School Vision Screening Involving Teachers In Nampula, Mozambique, Aoife Phelan, Lisa O'Donoghue, Kathryn Saunders, Stephen Thompson, Vivien Ocampo, Kevin Naidoo, James Loughman

Conference Papers

Purpose: There is no plan for a national child eye care programme or existing human resource infrastructure to address the immediate challenge of child eye health in Mozambique.This study aims to design, implement and evaluate a school based pediatric vision screening service, to identify those in need of eye care services, among Mozambique’s 11,561,000 children.

Methods: Primary School Screening took place in three schools in Nampula, Mozambique in September 2010 and March 2011. The children’s vision was screened by an optometry student, optometrist or teacher with Log MAR ETDRS letters at 4 Meters. Ophthalmoscopy was performed on all children by …

Oral Ingestion Of Hexavalent Chromium Through Drinking Water And Cancer Mortality In An Industrial Area Of Greece - An Ecological Study, Athena Linos, Athanassios Petralias, Costas A. Christophi, Eleni Christoforidou, Paraskevi Kouroutou, Melina Stoltidis, Afroditi Veloudaki, Evangelia Tzala, Konstantinos C. Makris, Margaret R. Karagas

Dartmouth Scholarship

Background: Hexavalent chromium is a known carcinogen when inhaled, but its carcinogenic potential when orally ingested remains controversial. Water contaminated with hexavalent chromium is a worldwide problem, making this a question of significant public health importance.

Methods: We conducted an ecological mortality study within the Oinofita region of Greece, where water has been contaminated with hexavalent chromium. We calculated gender, age, and period standardized mortality ratios (SMRs) for all deaths, cancer deaths, and specific cancer types of Oinofita residents over an 11-year period (1999 - 2009), using the greater prefecture of Voiotia as the standard population.

Results: A total of …

Baseline Data For Maine Pediatric And Family Practices From Arra-Funded Hit Ambulatory Practice Survey Data, Kimberley S. Fox Mpa

Population Health & Health Policy

No abstract provided.

Eat, Drink And Be Wary, Robert Lannigan

Pathology Presentations

The diversity of foods available and the way we produce, process and distribute them can have consequences in terms of infectious illnesses. This talk by Dr. Robert Lannigan, professor in Western’s Schulich School of Medicine & Dentistry, explores some of these concerns.

Racial/Ethnic Disparities In Survival Among Men Diagnosed With Prostate Cancer In Texas, Arica L. White, Ann L. Coker, Xianglin L. Du, Katherine S. Eggleston, Melanie Williams

CRVAW Faculty Journal Articles

BACKGROUND:

To the authors' knowledge, few studies to date have examined racial differences in prostate cancer survival while controlling for socioeconomic status (SES). No such studies have examined this association in Texas, a large state with significant ethnic and racial diversity. The objective of this analysis was to determine whether racial disparities in survival for men diagnosed with prostate cancer in Texas from 1995 through 2002 remained after adjusting for SES, rural residence, and stage of disease.

METHODS:

A cohort of 87,449 men who were diagnosed with prostate cancer was identified from the Texas Cancer Registry. The SES measure was …

Understanding The Context Of Balanced Scorecard Implementation: A Hospital-Based Case Study In Pakistan., F Rabbani, Sabrina Nh Lalji, Farhat Abbas, Sm Wasim Jafri, Junaid A. Razzak, Naheed Nabi, Firdous Jahan, Agha Ajmal, Max Petzold, Mats Brommels, Goran Tomson

Section of Urology

Background: As a response to a changing operating environment, healthcare administrators are implementing modern management tools in their organizations. The balanced scorecard (BSC) is considered a viable tool in high-income countries to improve hospital performance. The BSC has not been applied to hospital settings in low-income countries nor has the context for implementation been examined. This study explored contextual perspectives in relation to BSC implementation in a Pakistani hospital. Methods: Four clinical units of this hospital were involved in the BSC implementation based on their willingness to participate. Implementation included sensitization of units towards the BSC, developing specialty specific BSCs …

Involvement Of Medical Students And Fresh Medical Graduates Of Karachi, Pakistan In Research, Kiran Ejaz, Muhammad Shahid Shamim, Muhammad Shahzad Shamim, Syed Abid Hussain

Department of Emergency Medicine

OBJECTIVE: To study the involvement in research, of final year medical students and fresh graduates of Karachi, Pakistan and to identify the factors influencing their interest in medical research.

METHODS: A cross-sectional, questionnaire based study was conducted in 2007-2008. Five institutes representing the private and public hospitals in the city were selected by cluster sampling. Final year medical students and fresh graduates were included. Descriptive statistics were charted using SPSS v.16 after double data entry.

RESULTS: Out of 378, 186 (49%) participants had journal reading habits due to the requirement of their institution. Mostly, 157 (41%) undergraduates had already participated …

Massachusetts’ Home Care Programs And Reasons For Discharge Into Nursing Homes, Cathy M. Wong, Nina M. Silverstein

Gerontology Institute Publications

Home and community-based services (HCBS) are a range of long-term care services intended to enable older adults and persons with disabilities to “age in place” in their own homes and communities. Previous studies well document that older adults prefer receiving HCBS rather than institutional care at a nursing home. One study concluded that 84 percent of older Americans, aged 50 years and older, want to remain in their homes for as long as possible. Medicaid is a major source of funding for long term care. Currently, a large proportion of Medicaid funds in most states has been spent on institutional, …

Female Genital Mutilation Practices In Kenya: The Role Of Alternative Rites Of Passage. A Case Study Of Kisii And Kuria Districts, Habil Oloo, Monica Wanjiru, Katy Newell-Jones

Reproductive Health

This research was undertaken by the Population Council to better understand female genital mutilation (FGM) as currently practiced by the Kuria and Kisii communities in Kenya. The study investigated current attitudes and practices in relation to FGM, awareness and attitudes toward the alternative rite of passage (ARP), and factors which encourage individuals to make decisions to abandon FGM. The findings show that FGM is still a celebrated public event among the Kuria, whereas in Kisii, it is a private family affair. The study suggests that the success of ARP as an approach to abandoning FGM is strongly dependent on the …

Chemotherapy-Induced Cognitive Impairment Is Associated With Decreases In Cell Proliferation And Histone Modifications, Teresita L. Briones, Julie Woods

Wayne State University Associated BioMed Central Scholarship

Abstract

Background

In this study, we examined the effects of cyclophosphamide, methothrexate, and 5-Fluorouracil (CMF) drug combination on various aspects of learning and memory. We also examined the effects of CMF on cell proliferation and chromatin remodeling as possible underlying mechanisms to explain chemotherapy-associated cognitive dysfunction. Twenty-four adult female Wistar rats were included in the study and had minimitter implantation for continuous activity monitoring two weeks before the chemotherapy regimen was started. Once baseline activity data were collected, rats were randomly assigned to receive either CMF or saline injections given intraperitoneally. Treatments were given once a week for a total …

Fetal Erap2 Variation Is Associated With Preeclampsia In African Americans In A Case-Control Study, Lori D. Hill, Dashaunda D. Hilliard, Timothy P. York, Sindhu Srinivas, Juan P. Kusanovic, Ricardo Gomez, Michal A. Elovitz, Roberto Romero, Jerome F. Strauss Iii

Wayne State University Associated BioMed Central Scholarship

Abstract

Background

Preeclampsia affects 3-8% of pregnancies and is a major cause of maternal and perinatal morbidity and mortality worldwide. This complex disorder is characterized by alterations in the immune and vascular systems and involves multiple organs. There is strong evidence for a genetic contribution to preeclampsia. Two different single nucleotide polymorphisms (SNPs) in the endoplasmic reticulum aminopeptidase 2 (ERAP2) gene were recently reported to be associated with increased risk for preeclampsia in two different populations. ERAP2 is expressed in placental tissue and it is involved in immune responses, inflammation, and blood pressure regulation; making it is an attractive preeclampsia …