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Delayed Childbearing, Pregnancy Spacing And Impact On Subsequent Pregnancy Outcomes: Missouri Resident Mothers 1978-1997, Sarah K. Nabukera

All ETDs from UAB

Introduction The main objective of the study was to examine reproductive health issues among women delaying initiation of childbearing until age 30 or older. Specifically, it examined pregnancy spacing patterns, relationship between pregnancy spacing and subsequent perinatal outcomes as well as racial differences in spacing and adverse perinatal outcomes. Methods A retrospective cohort study was conducted using the Missouri maternally linked live birth, fetal death and infant death files 1978-1997. The study sample was limited to mothers residing in Missouri during the study period, having first pregnancy at age 20-50 years, as well as a subsequent second pregnancy. Final study …

Association Between The Exposure To Aflatoxin And Micronutrient Status Of Hiv Infected Adults In Ghana, Francis Ayodele Obuseh

All ETDs from UAB

Aflatoxins, found naturally in some foods are toxic metabolites of some Aspergillus species.They constitute the most potent hepatocarcinogens known and are also mutagenic and hepatotoxic. The preponderance of evidence indicates that aflatoxin is the major cause of hepatocellular cancer. In studies conducted in Africa, food-borne aflatoxin exposure is common (Oyelami et al. 1996; Egal et al. 2005). There is a critical need for additional information on health outcomes associated with exposure to aflatoxin in humans, especially in developing countries with a higher degree of malnutrition and likelihood of HIV infections. We sought to test the hypothesis that aflatoxin B1 and …

Maximising Parent Involvement In The Pedestrian Safety Of 4 To 6 Year Old Children: Final Report, Child Health Promotion Research Centre

Research outputs pre 2011

In Australia pedestrian injury is the leading specific cause of death among 5-9 year old children, and pedestrian injuries among 0-14 year old children in 1999-20000 were the second highest cause of hospitalisation. This mortality and morbidity can be attributed largely to unsafe road environments and under 10 year old children's significant deficits in cognitive and perceptual abilities when crossing roads. For all children under 10 years learning to cross the road needs to be taught by parents in the same way that children learn to swim i.e. under close adult supervision and in the 'real' environment where the skills …

Knowledge And Beliefs Of Adolescents Regarding Sexually Transmitted Infections And Hiv/Aids In A Rural District In Pakistan, Hafsa Raheel, Franklin White, Muhammad Masood Kadir, Zafar Fatmi

Community Health Sciences

Objective:

To assess the knowledge and beliefs of adolescents (15-19 years girls and boys) regarding sexually transmitted infections (STIs) and HIV/AIDS.

Methods:

A community based cross-sectional survey was conducted in October 2002 in a rural district (Mirpurkhas) of Sindh province, Pakistan.

Results:

A total of 428 adolescent girls and boys were interviewed. Only 44% correctly named at least one STI, while 55% knew at least two modes of transmission for HIV/AIDS. Adolescents with education greater than or equal to secondary level, those who were able to read the newspaper, possessed electricity in their homes and were allowed to meet their …

Tracking Of Carbon Monoxide Poisoning Using Michigan Emergency Department And Hospital Records, Noreen Hughes, Kenneth D. Rosenman, Joseph Gardiner, Corinne Miller, Mary Jo Reilly

Michigan Journal of Public Health

Objectives: Among all deaths due to poisonings, carbon monoxide (CO) is the leading cause. Development of a surveillance system to track CO poisoning is a recommended public health activity. Initial steps to develop such a system are discussed. Methods: Michigan hospitals provided face sheets and discharge summaries of hospitalized and emergency department visits for CO poisonings. Reports were divided into three categories; intentional poisoning, non-work-related poisoning, and work related poisoning. The characteristics of the three groups, including demographics, sources of exposure, carboxyhemoglobin levels, and time of year were described. Results: There were 847 cases of CO poisoning reported. Another 312 …

Changes In Formal-Informal Caregiving In Elderly Stroke Survivors, Holly Anne Beard

Health Services Research Dissertations

The purpose of this study is to determine the extent to which the Andersen and Aday Model of Health Services Use to predict cross-sectional and longitudinal differences in the caregiving source among stroke survivors (n=477) over a six-year period. This study involves a secondary analysis of a longitudinal panel study focusing upon three waves of interview data from the HAS/AHEAD study spanning 1998 through 2002. Multinomial logistic regression was utilized to examine caregiving source cross-sectionally at each wave. Clustered multinomial logistic regression was used to examine relationships between predictor variables in the model and caregiving source across waves while holding …

Book Review: Social Justice: The Moral Foundations Of Public Health And Health Policy, Robin West

Georgetown Law Faculty Publications and Other Works

This essay is a review of Social Justice: The Moral Foundations of Public Health and Health Policy by Madison Powers & Ruth Faden (2006).

In this pathbreaking book, senior bioethicists Powers and Faden confront foundational issues about health and justice. How much inequality in health can a just society tolerate? In a world filled with inequalities in health and well-being, which inequalities matter most and are the most morally urgent to address? In order to answer these questions, Powers and Faden develop a unique theory of social justice that, while developed for the specific contexts of public health and health …

Adults' Perceived Prevalence Of Enteric Fever Predicts Laboratory-Validated Incidence Of Typhoid Fever In Children, Xinguang Chen, Bonita Stanton, Al Pach, Andrew Nyamete, R. Leon Ochiai, Linda Kaljee, Baiqing Dong, Dipika Sur, S.K. Bhattacharya, Siti Sapardiyah Santoso, Magdarina Agtini, Zahid Memon, Zulfiqar Ahmed Bhutta, Canh Gia Do, Lorenz Von Seidlein, John Clemens

Centre of Excellence in Women and Child Health

This study was undertaken to develop a model to predict the incidence of typhoid in children based on adults’ perception of prevalence of enteric fever in the wider community. Typhoid cases among children, aged 5-15 years, from epidemic regions in five Asian countries were confirmed with a positive Salmonella Typhi culture of the blood sample. Estimates of the prevalence of enteric fever were obtained from random samples of adults in the same study sites. Regression models were used for establishing the prediction equation. The percentages of enteric fever reported by adults and cases of typhoid incidence per 100,000, detected through …

Cigarette Smoking As A Public Health Hazard: Crafting Common Law And Legislative Strategies For Abatemen, George P. Smith Ii

Scholarly Articles

The debate over when, and to what extent, the government may regulate public smoking, is a contentious one of great moment. The point at which the line will be drawn with regard to an individual's right to smoke in public is narrowing. This right may stop at public restaurants and the workplace; or it may reach as far as public stadia, outdoor gathering spots and public streets. In 2006, one report showed 461 municipalities in thirty-three states and the District of Columbia, had adopted one-hundred percent smoke-free coverage in restaurants, bars or workplaces; and 135 municipalities had one-hundred percent coverage …

Effects Of Family Factors On The Development Of Alcohol-Related Problems Among Males From Pre-Adolescence To Adulthood

Florida Public Health Review

Alcohol use is a leading risk factor in suicides, homicides and unintentional injuries (including motor vehicle crashes and drownings) among adolescents, and is associated with adolescent health risk behaviors such as cigarette smoking, illicit drug use, and risky sexual behavior. The purpose of this study was to determine if family factors would predict alcohol-related problems as the study cohort transitioned into young adulthood, and to determine if early alcohol use remained a significant influence on the development of alcohol-related problems in young adulthood. Results of the analyses indicate that three of the family factors measured in mid-adolescence were statistically significant …

Be Headsmart® Seniors! -- The Effectiveness Of A Psychoeducational Fall And Consequential Injury Prevention Program

Florida Public Health Review

This study tested the utility of the Be HeadSmart® Seniors! fall prevention intervention, HeadSmartz, a Cranium Challenge, in the promotion of safety improvement behavior change. It employed a quasi-experimental two-group design. Of the 106 individuals included in this study, 64 received the intervention and 42 only received the safety brochure. The Cranium Challenge is an interactive, visual, and auditory program based upon the popular board game CraniumTM. This game stimulated various parts of the participant’s brain verbally, through trivia questions and word games, visually, or by humming, whistling, or playing charades. The presentation included trivia questions created in a PowerPoint …

A Likelihood Based Method For Real Time Estimation Of The Serial Interval And Reproductive Number Of An Epidemic, Laura Forsberg White, Marcello Pagano

Harvard University Biostatistics Working Paper Series

No abstract provided.

The Influence Of Age On Knowledge And Medication Usage By Persons Attending Rural North Florida Clinics

Florida Public Health Review

Medication therapy is an important component of the comprehensive treatment plan designed to maintain or improve health. If patients do not take prescribed medications correctly or are non-adherent, less successful therapy occurs. Reasons given for noncompliance include cost, misunderstanding the therapy, side effects, forgetfulness, or a belief that the medication is not effective or necessary. This study had two goals, the first was to evaluate medication use while simultaneously assessing knowledge, compliance, tolerance, and perceived efficacy. Drug-related problems, if any, were also identified. The second goal was to develop methods to improve patient outcomes based upon identified problems. For eight …

A Report From The Forum Session "Complexity, Coordination And Compromise: States And The Medicare Drug Benefit" (August 4, 2006), Lee Partridge

National Health Policy Forum

This National Health Policy Forum meeting report reviews a technical session that took place on August 4, 2006. The invitation-only meeting was designed to discuss implementation issues related to the new Medicare drug benefit, with special consideration of state activities, problems, and concerns. This meeting followed similar ones sponsored by the Forum in 2004 and 2005 in which the state perspective was the primary focus of conversation. Participants, including current and former state Medicaid directors, other state officials and experts, federal officials, Medicare drug plan representatives, and beneficiary advocates, described their experiences during the implementation process and addressed continuing challenges. …

Personal Health Records: The People's Choice?, Lisa Sprague

National Health Policy Forum

Information technology (IT), especially in the form of an electronic health record (EHR), is touted by many as a key component of meaningful improvement in health care delivery and outcomes. A personal health record (PHR) may be an element of an EHR or a stand-alone record. Proponents of PHRs see them as tools that will improve consumers’ ability to manage their care and will also enlist consumers as advocates for widespread health IT adoption. This issue brief explores what a PHR is, the extent of demand for it, issues that need to be resolved before such records can be expected …

The Nevada Institute For Children’S Research And Policy: Final Report, The Nevada Institute For Children’S Research And Policy

Nevada Institute for Children's Research and Policy Reports

On November 16, 2005, the Legislative Commission unanimously voted to approve hiring the Nevada Institute for Children’s Research and Policy (NICRP), School of Public Health, UNLV to study and evaluate governmental entities and private facilities that have physical custody of children pursuant to a court order and other public entities that provide for the care and supervision of children in the State of Nevada. The study included three primary components. The first component involved an analysis of the guidelines, protocols, policies and procedures of these entities/facilities which affect the health, safety, welfare, treatment and civil or other rights of children …

Epsdt: Medicaid's Critical But Controversial Benefits Program For Children, Christie Provost Peters

National Health Policy Forum

The Early and Periodic Screening, Diagnosis and Treatment (EPSDT) program under Medicaid provides the most comprehensive set of health benefits for children and adolescents in the public or private sector. A cornerstone of early childhood preventive and treatment services in the nation’s health care “safety net,” the EPSDT program serves nearly 30 million low-income children, including children with disabilities and special needs. Over the years, states have expressed frustration with the administrative burdens of EPSDT requirements. Rising Medicaid costs have put all Medicaid benefits, including the EPSDT program, in the budgetary crosshairs. This issue brief reviews the fundamental characteristics of …

The Nuts And Bolts Of Pdps, Mary Ellen Stahlman

National Health Policy Forum

This issue brief provides an overview of Medicare prescription drug plans (PDPs), with a focus on fundamentals such as enrollment, premiums, formularies, cost sharing, prices, payment, cost management, and appeals and grievance processes. It also highlights major changes to the PDP landscape between 2006 and 2007.

Community Mobility And Dementia: A Review Of The Literature, Nina M. Silverstein, Megan Vanderbur

Gerontology Institute Publications

By the year 2030, 70 million Americans will be 65 or older. Approximately 80 percent of this population will likely be driving themselves. And without appropriate and timely interventions, many are likely to be driving with Alzheimer’s disease (AD). Current estimates suggest that 2 percent of the population 65 to 74, 19 percent of the population 75 to 84, and 47 percent of the population 85 and older are likely to suffer from Alzheimer’s disease or a related disorder. By the year 2050, the number of Americans with Alzheimer’s disease could range from 11.3 million to 16 million. This significant …

Knowledge And Attitudes About Health Research Amongst A Group Of Pakistani Medical Students, Hassan Khan, Muhammad Rizwanulhaq Khawaja, Abdul Waheed, Muhammad Ameen Rauf, Zafar Fatmi

Community Health Sciences

Background

Health research training is an important part of medical education. This study was conducted to assess the level of knowledge and attitudes regarding health research in a group of Pakistani medical students at Aga Khan University, Karachi.

Methods

It was a cross-sectional pilot study conducted among a group of Pakistani medical students. Through stratified random sampling, a pre-tested, structured and validated questionnaire was administered to 220 medical students. Knowledge and attitudes were recorded on a scale (graduated in percentages).

Results

Mean scores of students were 49.0% on knowledge scale and 53.7% on attitude scale. Both knowledge and attitudes improved …

Jmc Students’ Knowledge Of The U.S. Healthcare System, Daniel Z. Louis

Population Health Matters (Formerly Health Policy Newsletter)

No abstract provided.

Statistical Analysis Of Air Pollution Panel Studies: An Illustration, Holly Janes, Lianne Sheppard, Kristen Shepherd

UW Biostatistics Working Paper Series

The panel study design is commonly used to evaluate the short-term health effects of air pollution. Standard statistical methods for analyzing longitudinal data are available, but the literature reveals that the techniques are not well understood by practitioners. We illustrate these methods using data from the 1999 to 2002 Seattle panel study. Marginal, conditional, and transitional approaches for modeling longitudinal data are reviewed and contrasted with respect to their parameter interpretation and methods for accounting for correlation and dealing with missing data. We also discuss and illustrate techniques for controlling for time-dependent and time-independent confounding, and for exploring and summarizing …

What Is Available Vs. What Is Accessible: An Evaluation Of Resources For Kwazulu Natal Diabetics Based On The Data Of Kwazulu Natal Experts And Cato Manor Diabetics, Mollie Gurian

Independent Study Project (ISP) Collection

The objective of this study was to learn about the resources available to a diabetic and the actual ability of diabetics to access these resources. I found that two ideal paradigms of care were consistently mentioned by experts in KwaZulu Natal and at the World Diabetes Congress (WDC), the international conference on diabetes that I attended in Cape Town. The first is self-management of the disease and a patient centered approach to care. The second is a collaborative team approach to treating diabetics which involves a number of experts besides a physician. These two concepts are connected in that a …

Individual Responsibility Concerning Hiv Transmission Among Msm: A Comparative Study Of The Effectiveness Of Ngo Intervention Policies And Their Practical Applications Within The United Kingdom, Australia, And The Netherlands, Martha Kienbaum

Independent Study Project (ISP) Collection

This study investigates the complexities involved in utilizing the terms of individual responsibility for the construction of HIV prevention campaigns that target men who have sex with men. Four health workers in the Netherlands were interviewed about their personal opinions regarding HIV intervention, and these interviews were analyzed qualitatively for their points of comparison and contrast. Then, campaign materials from organizations in the United Kingdom and Australia were analyzed for their use of the language of responsibility, their portrayal of MSM, their balance between promoting disclosure and communication, their focus on individual groups within the MSM community, and their overall …

The Complex Realities Of Indigenous Health Care Delivery, Megan Waterman

Independent Study Project (ISP) Collection

The indigenous population of Australia faces a life expectancy that is eighteen years lower than the general population. This study addresses this incredible disparity by exploring the historical, cultural and social forces that impact on health status, focussing especially on health care service utilisation. Qualitative methods of interviewing and participant observation have been used to examine the two sectors of Aboriginal health service delivery in urban Victoria: Aboriginal community controlled health organisations (ACCHOs) and mainstream organisations. Accounting for the complex forces and realities in health service delivery, this is a discussion of the important components of the current realities for …

Treatment Evolution In High-Risk Congenital Diaphragmatic Hernia: Ten Years' Experience With Diaphragmatic Agenesis, Kevin P Lally, Pamela A Lally, Krisa P Van Meurs, Desmond J Bohn, Carl F Davis, Bradley Rodgers, Jatinder Bhatia, Golde Dudell

Faculty, Staff and Student Publications

OBJECTIVE: The objective of this study was to evaluate the impact of newer therapies on the highest risk patients with congenital diaphragmatic hernia (CDH), those with agenesis of the diaphragm.

SUMMARY BACKGROUND DATA: CDH remains a significant cause of neonatal mortality. Many novel therapeutic interventions have been used in these infants. Those children with large defects or agenesis of the diaphragm have the highest mortality and morbidity.

METHODS: Twenty centers from 5 countries collected data prospectively on all liveborn infants with CDH over a 10-year period. The treatment and outcomes in these patients were examined. Patients were followed until death …

Care Quality For Adult Medicaid Beneficiaries With Type 2 Diabetes Varies By Primary Care Provider Subspecialty, Robert M. Mayberry, Rita Finley, Ernest Alema-Mensah, Trobiand A. Davis

Journal of the Georgia Public Health Association

The Georgia Medicaid primary care case management (PCCM) program, phased in over the 1994-1997 period, has now given way to a capitated managed care model of regional care management organizations (CMOs). Using Georgia Medicaid eligibility and provider claim data for 1996-1998, this study investigated diabetes care quality and whether it varied by primary care provider subspecialty in a longitudinal follow-up of newly diagnosed adults with type 2 diabetes during the early phase of the PCCM program. Results indicated that the quality of diabetes care was suboptimal and varied significantly by PCP subspecialty, with patients seen by generalists least likely to …

Spatial Cluster Detection For Censored Outcome Data, Andrea J. Cook, Diane Gold, Yi Li

Harvard University Biostatistics Working Paper Series

No abstract provided.

Assessing The Adequacy Of Variance Function In Heteroscedastic Regression Models, Lan Wang, Xiao-Hua Andrew Zhou

UW Biostatistics Working Paper Series

Heteroscedastic data arise in many applications. In a heteroscedastic regression model, the variance is often taken as a parametric function of the covariate or the regression mean. This paper presents a kernel-smoothing based nonparametric test for checking the adequacy of such a postulated variance structure. The test does not need to specify a parametric distribution for the random errors. It has an asymptotical normal distribution under the null hypothesis and is powerful against a large class of alternatives. Numerical simulations and an illustrative example are provided.

Promoting Physical Activity In Children And Youth: A Leadership Role For Schools: A Scientific Statement From The American Heart Association Council On Nutrition, Physical Activity, And Metabolism (Physical Activity Committee) In Collaboration With The Councils On Cardiovascular Disease In The Young And Cardiovascular Nursing, Russell R. Pate, Michael G. Davis, Thomas N. Robinson, Elaine J. Stone, Thomas L. Mckenzie, Judith C. Young

Faculty Publications

No abstract provided.