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Referral Patterns Between Allopathic Physicians And Complementary And Alternative Medicine Practitioners: A Followup Study, Molly Hubbard, Hany Khattab, Matthew LeComte, Lindsay Peet, Meghan Small, Khine Win, Asha Zimmerman, Margaret Eppstein, Helene Langevin, Phil Trabulsy 2010 University of Vermont

Referral Patterns Between Allopathic Physicians And Complementary And Alternative Medicine Practitioners: A Followup Study, Molly Hubbard, Hany Khattab, Matthew Lecomte, Lindsay Peet, Meghan Small, Khine Win, Asha Zimmerman, Margaret Eppstein, Helene Langevin, Phil Trabulsy

Public Health Projects, 2008-present

Introduction: • Despite the high prevalence of Complementary and Alternative Medicine (CAM) usage, several recent surveys suggest that the vast majority of patient visits to CAM practitioners are self-referred and that communication between conventional and CAM practitioners is limited. • There is a need for a better understandingof factors influencing referral patterns across these two groups of practitioners. • Network analysis provides a useful tool to quantify relationships between members of an interrelated social network. • The goal of this follow up study was to quantify the cross-class referral patterns between conventional and CAM classes of practitioners in Chittenden County Vermont as well as ...


Are Mandates The Answer? Improving Palliative Care And Pain Management In Vermont, Patrick O. Butsch, Laura C. DePouli, Nicholas A. Larochelle, Mckalyn G. Leclerc, Michael A. Maccini, Michael P. Morwood, Andrea M. Steely, Virginia Hood, George Phillips, William Wargo, Tom Delaney, Jan Carney 2010 University of Vermont College of Medicine

Are Mandates The Answer? Improving Palliative Care And Pain Management In Vermont, Patrick O. Butsch, Laura C. Depouli, Nicholas A. Larochelle, Mckalyn G. Leclerc, Michael A. Maccini, Michael P. Morwood, Andrea M. Steely, Virginia Hood, George Phillips, William Wargo, Tom Delaney, Jan Carney

Public Health Projects, 2008-present

Background: The Vermont legislature (bill H.435, Sec. 19) has tasked the Vermont Board of Medical Practice (VBMP) with making a formal recommendation on improving Vermont health professionals’ knowledge and practice of Palliative Care and Pain Management (PC/PM). In collaboration with the VBMP, our group set out to answer the following questions: • How confident/competent are VT physicians in the practice of PC/PM? • What are the barriers to achieving optimal patient care in PC/PM? • Do VT physicians believe mandatory CME would improve the overall quality of care in PC/PM? • What are the best methods of providing ...


Physician Screening For Intimate Partner Violence In Vermont, Aleksey Androsov, Jessica Chao, Kira Fiset, Erin Hickman, Amy Huckins-Noss, Daniel Kim, Amy Kravetz, Makeda Semma, Scott Warhit 2010 University of Vermont

Physician Screening For Intimate Partner Violence In Vermont, Aleksey Androsov, Jessica Chao, Kira Fiset, Erin Hickman, Amy Huckins-Noss, Daniel Kim, Amy Kravetz, Makeda Semma, Scott Warhit

Public Health Projects, 2008-present

Introduction: The term intimate partner violence (or IPV) refers to a threat of abuse or actual psychological, physical, and/or sexual abuse perpetrated by a former or current intimate partner. IPV is an important public health issue that crosses socioeconomic lines. Approximately 4.8 million women experience physical or sexual assault perpetrated by their intimate partner each year in the US. There are no reliable statistics for how many women suffer psychological abuse, but the numbers are likely much higher. Physical, psychological, or sexual injuries can have wide ranging effects, including increased mortality. Although it has been firmly established that ...


Assessing Barriers To Utilization Of Adult Day Care Centers In A Rural County, William Ares, Michael Hart, Derek Huang, Laurel Karian, Maria Michael, Auna Otts, Donna LaFromboise-Perretta, Jill Jemison 2010 University of Vermont

Assessing Barriers To Utilization Of Adult Day Care Centers In A Rural County, William Ares, Michael Hart, Derek Huang, Laurel Karian, Maria Michael, Auna Otts, Donna Lafromboise-Perretta, Jill Jemison

Public Health Projects, 2008-present

Introduction: Adult Day Care programs provide cognitively or functionally impaired adults with medical, social, and therapeutic services as well as offer valuable respite and education to family caregivers. The Visiting Nurse Association’s Adult Day program manages three centers that offer these services and are located in Colchester, Williston, and South Burlington. We have explored the underutilization of these centers by comparing variables such as demographics, services provided, referrals, transportation constraints, and satisfaction surveys between centers and to national success guidelines for adult day services.


Emergency And Scheduled Respite Care For Caregivers Of Persons With Dementia: A Model, Piyush Gupta, Benjamin King, Katherine McBride, Damoon Rejaei, Jennifer Springer, Tyler Stewart, Diana Swett, William Pendlebury, Linda Martinez 2010 University of Vermont

Emergency And Scheduled Respite Care For Caregivers Of Persons With Dementia: A Model, Piyush Gupta, Benjamin King, Katherine Mcbride, Damoon Rejaei, Jennifer Springer, Tyler Stewart, Diana Swett, William Pendlebury, Linda Martinez

Public Health Projects, 2008-present

Background: As the population of elderly citizens in the U.S. continues to expand paralleled by an increase in the prevalence of dementia, the role of respite care within the healthcare system will increase in importance. Respite care is defined as providing the primary caregiver with relief, or a reprieve, from care commitments on a short-term or emergency basis. The need for caregiver respite is well-documented; has been shown to decrease emotional stress,burnout, anxiety and depression; and is considered vital to the overall well-being of the caregiver. While studies have shown that respite care is effective, there is an ...


Assessing Health Concerns & Obstacles To Diesel Exposure Reduction In Vermont Diesel Vehicle Operators, Melissa Marotta, Renee Bratspis, Maria Furman, Brett Porter, Joseph Yared, William Timbers, Quillan Huang, Rebecca Ryan, Gerald S. Davis, Jan Carney 2010 University of Vermont College of Medicine

Assessing Health Concerns & Obstacles To Diesel Exposure Reduction In Vermont Diesel Vehicle Operators, Melissa Marotta, Renee Bratspis, Maria Furman, Brett Porter, Joseph Yared, William Timbers, Quillan Huang, Rebecca Ryan, Gerald S. Davis, Jan Carney

Public Health Projects, 2008-present

Background and Objectives: Diesel vehicle idling reduction is an important national environmental and legislative issue. Exposure to diesel exhaust is associated with significant morbidity and mortality, including: • Lung & esophageal cancer • Asthma • Cardiovascular disease • Neurotoxicity • Decreased sperm count & testosterone deficiency Drivers of diesel vehicles have specifically been shown to have increased incidence and death from lung cancer. Diesel engines emit a number of known hazardous chemicals, including carbon monoxide, nitric oxide, sulfur dioxide, benzene, formaldehyde, and acrolein, into the air supply. While public health efforts to reduce diesel idling in Vermont and elsewhere have identified employers’ significant financial incentives in fuel ...


Analysis Of Primary Risk Factors For Oral Cancer From Us States With Increasing Rates, Anthony Bunnell, Nathan Pettit, Nicole Reddout, Kanika Sharma, Susan O'Malley, Michelle Chino, Karl Kingsley 2010 University of Nevada, Las Vegas

Analysis Of Primary Risk Factors For Oral Cancer From Us States With Increasing Rates, Anthony Bunnell, Nathan Pettit, Nicole Reddout, Kanika Sharma, Susan O'Malley, Michelle Chino, Karl Kingsley

Public Health Faculty Publications

Objectives

To examine the primary risk factor for oral cancer in the US, smoking and tobacco use, among the specific US states that experienced short-term increases in oral cancer incidence and mortality.

Methods

Population-based data on oral cancer morbidity and mortality in the US were obtained from the National Cancer Institute's (NCI) Surveillance, Epidemiology, and End Results (SEER) database for analysis of recent trends. Data were also obtained from the Centers for Disease Control and Prevention (CDC) Behavioral Risk Factor Surveillance System (BRFSS) to measure current and former trends of tobacco usage. To comprehensive measures of previous state tobacco ...


Prescriptions For Excellence In Health Care Winter 2009 Download Pdf Of Full Issue, 2010 Thomas Jefferson University

Prescriptions For Excellence In Health Care Winter 2009 Download Pdf Of Full Issue

Prescriptions for Excellence in Health Care Newsletter Supplement

No abstract provided.


Foreclosure And Health Status, Craig Evan Pollack, Julia Lynch, Dawn Alley, Carolyn Cannuscio 2010 University of Pennsylvania

Foreclosure And Health Status, Craig Evan Pollack, Julia Lynch, Dawn Alley, Carolyn Cannuscio

Issue Briefs

In 2009, more than 2.8 million housing units in the U.S. received a foreclosure notice. That represents about 1 in every 45 properties and a 120% increase in the number of foreclosed properties since 2007. Real estate experts predict even more foreclosures in 2010 as high unemployment continues. The cascading effects of the foreclosure crisis on the U.S. economy are all too clear; the effects on individuals’ health status are less obvious. This Issue Brief summarizes two studies that examine the health implications of foreclosure and reveal a vulnerable population that may benefit from coordinated health and ...


Arborist Dies After Fall From Tree, Kentucky Injury Prevention and Research Center 2010 University of Kentucky

Arborist Dies After Fall From Tree, Kentucky Injury Prevention And Research Center

Fatality Case Reports--Falls

A 30-year old arborist was hired by a private resident to remove trees from a yard. At approximately 5:00 PM, the arborist, along with a ground person, arrived at the residence. The arborist donned climbing spurs, and a tree climbing saddle then spoke briefly with the homeowner. With the climbing line and spurs, the arborist climbed the first tree. After trimming limbs from the tree trunk, the arborist began cutting the tree trunk one section at a time. There was a power line near the trees. The arborist was working at the fork of the tree and had cut ...


Development Of The Lung Function Questionnaire (Lfq) To Identify Airflow Obstruction, Barbara P. Yawn, Douglas W. Mapel, David M. Mannino, Fernando J. Martinez, James F. Donohue, Nicola A. Hanania, Mark Kosinski, Regina Rendas-Baum, Matthew Mintz, Steven Samuels, Anand A. Dalal 2010 Baylor College of Medicine

Development Of The Lung Function Questionnaire (Lfq) To Identify Airflow Obstruction, Barbara P. Yawn, Douglas W. Mapel, David M. Mannino, Fernando J. Martinez, James F. Donohue, Nicola A. Hanania, Mark Kosinski, Regina Rendas-Baum, Matthew Mintz, Steven Samuels, Anand A. Dalal

David M. Mannino

Objective:

To describe the item-selection and item-reduction for the Lung Function Questionnaire (LFQ), being developed to help clinicians identify patients appropriate for diagnostic evaluation for chronic obstructive pulmonary disease (COPD) using spirometry.

Methods:

Item selection and reduction were based on information from 387 ≥40-year-old respondents to the third National Health and Nutrition Examination Survey who had self-reported chronic bronchitis. Item reduction involved stepwise logistic regression. The accuracy of the final subset of items for identifying individuals with airflow obstruction (forced expiratory volume in one second/forced vital capacity <0.70) versus those without it was assessed with receiver operating characteristic analysis. Content and face validity were assessed using focus groups of primary care physicians (n = 16) and interviews with COPD patients (n = 16).

Results:

The model with all five items (age; smoking history; the presence ...


The Medical Education Of Physicians, Jonathan Saxton 2010 George Washington University

The Medical Education Of Physicians, Jonathan Saxton

National Health Policy Forum

This background paper provides a descriptive overview of the process of education, licensing, certification, and continuing education involved in becoming and continuing to practice as a physician.


Team Semi Driver Dies After Rig Is Struck By Impaired Driver, Kentucky Injury Prevention and Research Center 2010 University of Kentucky

Team Semi Driver Dies After Rig Is Struck By Impaired Driver, Kentucky Injury Prevention And Research Center

Fatality Case Reports--Motor Vehicle

During the early hours one fall morning, a husband and wife driving team were traveling west on a divided interstate highway. A concrete barrier separated the four east bound lanes from the four west bound lanes. The wife was driving while the husband was asleep in the sleeper berth. Driving conditions were dark and the pavement dry. They were traveling in the second lane from the median and there was a passenger car to the right of the semi in the third lane from the median traveling next to the front wheel well and bumper. The passenger car driver veered ...


The Economic Stimulus: Gauging The Early Effects Of Arra Funding On Health Centers And Medically Underserved Populations And Communities, Peter Shin, Brian K. Bruen, Emily Jones, Leighton C. Ku, Sara J. Rosenbaum 2010 George Washington University

The Economic Stimulus: Gauging The Early Effects Of Arra Funding On Health Centers And Medically Underserved Populations And Communities, Peter Shin, Brian K. Bruen, Emily Jones, Leighton C. Ku, Sara J. Rosenbaum

Geiger Gibson/RCHN Community Health Foundation Research Collaborative

During times of economic crisis, community health centers and other health care safety net providers become even more vital to the communities they serve. The current downturn, with its high levels of unemployment and enormous impact on family incomes, carries major implications for health insurance coverage. The American Recovery and Reinvestment Act (ARRA), signed into law on February 17, 2009, provided slightly more than two billion dollars to community health centers for capital improvements, expansion (or retention) of personnel and services, and adoption of health information technology. All of these uses not only support health centers' mission to serve populations ...


Comparative Efficacy Versus Effectiveness Of Initial Antiretroviral Therapy In Clinical Trials Versus Routine Care, Justin S. Routman, James H. Willig, Andrew O. Westfall, Sarah R. Abroms, Mohit Varshney, Sunil Adusumilli, Jeroan J. Allison, Karen G. Savage, Michael S. Saag, Michael J. Mugavero 2010 University of Alabama at Birmingham

Comparative Efficacy Versus Effectiveness Of Initial Antiretroviral Therapy In Clinical Trials Versus Routine Care, Justin S. Routman, James H. Willig, Andrew O. Westfall, Sarah R. Abroms, Mohit Varshney, Sunil Adusumilli, Jeroan J. Allison, Karen G. Savage, Michael S. Saag, Michael J. Mugavero

Population and Quantitative Health Sciences Publications

BACKGROUND: The applicability of clinical trial findings (efficacy) to the routine care setting (effectiveness) may be limited because of study eligibility criteria and volunteer bias. Although well-chronicled in many conditions, the efficacy versus effectiveness of antiretroviral therapy (ART) remains understudied.

METHODS: A retrospective study of the University of Alabama at Birmingham 1917 Clinic Cohort evaluated ART-naive patients who started ART from 1 January 2000 through 31 December 2006. Patients received ART through clinical trials or routine care. Multivariable logistic and linear regression models were fit to evaluate factors associated with virological failure (virological failure was defined as a viral load ...


Smart Density: A More Accurate Method Of Measuring Rural Residential Density For Health-Related Research, Peter M. Owens, Linda Titus-Ernstoff, Lucinda Gibson, Michael L. Beach, Sandy Beauregard, Madeline A. Dalton 2010 Smart Mobility, Inc.

Smart Density: A More Accurate Method Of Measuring Rural Residential Density For Health-Related Research, Peter M. Owens, Linda Titus-Ernstoff, Lucinda Gibson, Michael L. Beach, Sandy Beauregard, Madeline A. Dalton

Open Dartmouth: Faculty Open Access Articles

Studies involving the built environment have typically relied on US Census data to measure residential density. However, census geographic units are often unsuited to health-related research, especially in rural areas where development is clustered and discontinuous. We evaluated the accuracy of both standard census methods and alternative GIS-based methods to measure rural density.


Findings From The Nevada Business Summit On Early Childhood Investment, Nevada Institute for Children’s Research and Policy, The United Way of Southern Nevada, The Nevada Head Start State Collaboration, Early Childhood Comprehensive Systems Office, The Agassi Foundation, The Children’s Cabinet, Denise Tanata Ashby, Amanda Haboush 2010 Nevada Institute for Children’s Research and Policy

Findings From The Nevada Business Summit On Early Childhood Investment, Nevada Institute For Children’S Research And Policy, The United Way Of Southern Nevada, The Nevada Head Start State Collaboration, Early Childhood Comprehensive Systems Office, The Agassi Foundation, The Children’S Cabinet, Denise Tanata Ashby, Amanda Haboush

Nevada Institute for Children's Research and Policy Reports

On February 10, 2010, a partnership of the United Way of Southern Nevada, the UNLV Nevada Institute for Children’s Research and Policy, the Agassi Foundation for Education and the State of Nevada Head Start State Collaboration Office, with support from The Lincy Foundation, hosted the Nevada Business Summit on Early Childhood Investment. The summit met to discuss effective ways to invest in early childhood education and health, in hopes of creating solutions that would provide long term human capital development through early intervention. The summit tied issues of employment opportunities, job readiness and economic trends with the need to ...


Seasonal And Sex Variation Of High-Sensitivity C-Reactive Protein In Healthy Adults: A Longitudinal Study, David Chiriboga, Yunsheng Ma, Wenjun Li, Edward Stanek, James Hébert, Philip Merriam, Eric Rawson, Ira Ockene 2010 University of Massachusetts - Amherst

Seasonal And Sex Variation Of High-Sensitivity C-Reactive Protein In Healthy Adults: A Longitudinal Study, David Chiriboga, Yunsheng Ma, Wenjun Li, Edward Stanek, James Hébert, Philip Merriam, Eric Rawson, Ira Ockene

Edward J. Stanek

BACKGROUND

Cross-sectional studies have reported seasonal variation in high-sensitivity C-reactive protein (hsCRP). However, longitudinal data are lacking. METHODS

We collected data on diet, physical activity, psychosocial factors, physiology, and anthropometric measurements from 534 healthy adults (mean age 48 years, 48.5% women, 87% white) at quarterly intervals over a 1-year period between 1994 and 1998. Using sinusoidal regression models, we estimated peak-to-trough amplitude and phase of the peaks. RESULTS

At baseline, average hsCRP was 1.72 mg/L (men, 1.75 mg/L; women, 1.68 mg/L). Overall seasonal variation amplitude was 0.16 mg/L (95% CI 0 ...


Factor Vii Deficiency And Pregnancy: A Case Report And Review Of Literature, Syed Mohammad Asad Zaidi, Rahat Qureshi, Salman Naseem Adil 2010 Aga Khan University

Factor Vii Deficiency And Pregnancy: A Case Report And Review Of Literature, Syed Mohammad Asad Zaidi, Rahat Qureshi, Salman Naseem Adil

Department of Obstetrics & Gynaecology

Factor VII deficiency is one of the 'rare inherited disorders of coagulation.' Few cases of Factor VII deficiency have been reported during pregnancy, a state which could potentially cause fatal haemorrhage. Here we report a case of a pregnant lady with a history of heavy menorrhagia and multiple first pregnancy failures. Delivery was carried out via Caesarean section due to non-reassuring foetal heart monitoring. Patient was treated with Fresh Frozen Plasma (FFPs) and Factor VII concentrates, however, the patient developed bleeding postoperatively. Literature indicates that whilst Factor VII levels rise during pregnancy in normal women, no increase is seen in ...


Input Constraints And The Efficiency Of Entry: Lessons From Cardiac Surgery, David M. Cutler, Robert S. Huckman, Jonathan T. Kolstad 2010 University of Pennsylvania

Input Constraints And The Efficiency Of Entry: Lessons From Cardiac Surgery, David M. Cutler, Robert S. Huckman, Jonathan T. Kolstad

Health Care Management Papers

Prior studies suggest that with elastically supplied inputs free entry may lead to an inefficiently high number of firms in equilibrium. Under input scarcity, however, the welfare loss from free entry is reduced. Further, free entry may increase use of high-quality inputs, as oligopolistic firms underuse these inputs when entry is constrained. We assess these predictions by examining how the 1996 repeal of certificate-of-need (CON ) legislation in Pennsylvania affected the market for cardiac surgery in the state. We show that entry led to a redistribution of surgeries to higher quality surgeons, and that this entry was approximately welfare neutral.


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