Digital Commons Network^™

The Relative Risk Of Mortality Associated With The 10th Percentile Of Birth Weight For Gestational Age Among Singleton Infants Born To United States Resident Mothers, 1995-1999., Sheree L. Boulet

All ETDs from UAB

No abstract provided.

Population Variables And Self-Reported Barriers That Influence Receipt Of Dental Care By Arizona's Children., Carol H. Danielson

All ETDs from UAB

No abstract provided.

Mandated Healthcare Will It Work?, Anna Vira

Seton Hall University Dissertations and Theses (ETDs)

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Healthcare Practitioners' Perspectives On The Use Of E-Health Applications To Support Overweight And Obese Adolescents, Rachel J. Mahncke

Theses : Honours

The aim of this research was to investigate, from an Australian healthcare practitioners' perspective, whether online and e-health applications could provide support for and be beneficial to overweight and obese adolescents. This research has investigated whether diet and exercise related environmental causes of obesity could be positively affected by using e-health applications to re-educate adolescents about healthy eating and exercise behaviours the research identified what online and electronic resources healthcare practitioners' recommended to their patients, in order to understand how information systems· solutions could better assist these patients in achieving healthier lifestyle outcomes. Additionally, the research investigated what content, features …

From International Sanitary Conventions To Global Health Security: The New International Health Regulations, David P. Fidler

Articles by Maurer Faculty

In May 2005, the World Health Organization adopted the new International Health Regulations (IHR), which constitute one of the most radical and far-reaching changes to international law on public health since the beginning of international health cooperation in the mid-nineteenth century. This article comprehensively analyses the new IHR by examining the history of international law on infectious disease control, the IHR revision process, the substantive changes contained in the new IHR and concerns regarding the future of the new IHR. The article demonstrates why the new IHR constitute a seminal event in the relationship between international law and public health …

Changes In Beliefs Identify Unblinding In Randomized Controlled Trials: A Method To Meet Consort Guidelines, Judy R. Rees, Timothy J. Wade, Deborah A. Levy, John M. Colford, Joan F. Hilton

Journal Articles: Epidemiology

Double-blinded trials are often considered the gold standard for research, but significant bias may result from unblinding of participants and investigators. Although the CONSORT guidelines discuss the importance of reporting "evidence that blinding was successful", it is unclear what constitutes appropriate evidence. Among studies reporting methods to evaluate blinding effectiveness, many have compared groups with respect to the proportions correctly identifying their intervention at the end of the trial. Instead, we reasoned that participants' beliefs, and not their correctness, are more directly associated with potential bias, especially in relation to self-reported health outcomes. During the Water Evaluation Trial performed in …

Obesity And The Struggle Within Ourselves, Maxwell Gregg Bloche

Georgetown Law Faculty Publications and Other Works

The author argues that we ought to treat our eating, exercise habits, and girth as personal matters, for the most part, but that law can and should make a contribution, as an ally of our longer-term will against our immediate cravings. Law can be our ally in this fashion without command-and-control intrusion into our private lives. Such intrusion is at odds with our core beliefs and unlikely to produce public health success. It is more likely to provoke popular backlash--one reason why some who stand to gain from our unhealthy dining choices try to cast government efforts to inform these …

The Search For An Effective International Regime For The Long-Term Safety And Security Of High Level Radioactive Waste: Pangea And Beyond, Vincent Cusack

Theses: Doctorates and Masters

This thesis is a study of public policy issues relating to multinational geological repositories for high-level radioactive waste disposal (HLW). Nuclear states have attempted for decades to implement effective radioactive waste policies, though with limited success. The safe disposal of HLW has proven particularly troublesome and, thus far, a solution has eluded all states. A review of radioactive waste policy in the UK, the US and Switzerland reveals some of the underlying themes behind community opposition to repository siting and the reasons for a broader global search. The failure to achieve HLW repositories at a national level has led to …

Ranking Usrds Provider-Specific Smrs From 1998-2001, Rongheng Lin, Thomas A. Louis, Susan M. Paddock, Greg Ridgeway

Johns Hopkins University, Dept. of Biostatistics Working Papers

Provider profiling (ranking, "league tables") is prevalent in health services research. Similarly, comparing educational institutions and identifying differentially expressed genes depend on ranking. Effective ranking procedures must be structured by a hierarchical (Bayesian) model and guided by a ranking-specific loss function, however even optimal methods can perform poorly and estimates must be accompanied by uncertainty assessments. We use the 1998-2001 Standardized Mortality Ratio (SMR) data from United States Renal Data System (USRDS) as a platform to identify issues and approaches. Our analyses extend Liu et al. (2004) by combining evidence over multiple years via an AR(1) model; by considering estimates …

Referent Selection Strategies In Case-Crossover Analyses Of Air Pollution Exposure Data: Implications For Bias, Holly Janes, Lianne Sheppard, Thomas Lumley

UW Biostatistics Working Paper Series

The case-crossover design has been widely used to study the association between short term air pollution exposure and the risk of an acute adverse health event. The design uses cases only, and, for each individual, compares exposure just prior to the event with exposure at other control, or “referent” times. By making within-subject comparisons, time invariant confounders are controlled by design. Even more important in the air pollution setting is that, by matching referents to the index time, time varying confounders can also be controlled by design. Yet, the referent selection strategy is important for reasons other than control of …

Semi-Parametric Single-Index Two-Part Regression Models, Xiao-Hua Zhou, Hua Liang

UW Biostatistics Working Paper Series

In this paper, we proposed a semi-parametric single-index two-part regression model to weaken assumptions in parametric regression methods that were frequently used in the analysis of skewed data with additional zero values. The estimation procedure for the parameters of interest in the model was easily implemented. The proposed estimators were shown to be consistent and asymptotically normal. Through a simulation study, we showed that the proposed estimators have reasonable finite-sample performance. We illustrated the application of the proposed method in one real study on the analysis of health care costs.

A Bjs Statistical Profile, 1992-2002: American Indians And Crime, Steven W. Perry

United States Public Health Resources

This report represents a compilation and new analysis of data on the incidents, prevalence, and consequences of violent crime among American Indians. The report uses data from a wide variety of sources, including statistical series maintained by the Bureau of Justice Statistics (BJS), the Federal Bureau of Investigation (FBI), the Bureau of Prisons (BOP), and the U.S. Census Bureau.
The findings reveal a disturbing picture of the victimization of American Indians and Alaska Natives. The rate of violent crime estimated from self reported victimizations for American Indians is well above that of other U.S. racial or ethnic groups and is …

Evaluation Of The Biological Sampling Kit (Biskit) For Large-Area Surface Sampling, Mark P. Buttner, Patrica Cruz, Linda Stetzenbach, Amy Klima-Comba

Environmental & Global Health Faculty Research

Current surface sampling methods for microbial contaminants are designed to sample small areas and utilize culture analysis. The total number of microbes recovered is low because a small area is sampled, making detection of a potential pathogen more difficult. Furthermore, sampling of small areas requires a greater number of samples to be collected, which delays the reporting of results, taxes laboratory resources and staffing, and increases analysis costs. A new biological surface sampling method, the Biological Sampling Kit (BiSKit), designed to sample large areas and to be compatible with testing with a variety of technologies, including PCR and immunoassay, was …

Live Smoke Free Or Die: The Battle For Smoke Free Restaurants In New Hampshire, Jody Hodgdon

The University of New Hampshire Law Review

[Excerpt] "The need for a strict statutory scheme prohibiting or effectively segregating tobacco smoke in restaurants and public buildings in New Hampshire is compelling. One evening, during the summer of 2003, I took my wife and daughter to a restaurant in New Hampshire for dinner. When the time came to be seated, the waiter asked if we preferred to be seated in the smoking or non-smoking section. At our request, he led us to the non- smoking section. Over the course of dinner, I considered the irony of why the restaurant even had a non-smoking section. Smoke was coming over …

Diagnosing Crohn's Disease: An Economic Analysis Comparing Wireless Capsule Endoscopy With Traditional Diagnostic Procedures, Neil I. Goldfarb, Laura T. Pizzi, Joseph P. Fuhr Jr., Christopher Salvador, Vanja Sikirica, Asher Kornbluth, Blair Lewis

College of Population Health Faculty Papers

The purpose of this study was to review economic considerations related to establishing a diagnosis of Crohn's disease, and to compare the costs of a diagnostic algorithm incorporating wireless capsule endoscopy (WCE) with the current algorithm for diagnosing Crohn's disease suspected in the small bowel. Published literature, clinical trial data on WCE in comparison to other diagnostic tools, and input from clinical experts were used as data sources for (1) identifying contributors to the costs of diagnosing Crohn's disease; (2) exploring where WCE should be placed within the diagnostic algorithm for Crohn's; and (3) constructing decision tree models with sensitivity …

38 Year-Old Construction Laborer Dies When Trench Walls Collapse, Kentucky Injury Prevention And Research Center

Fatality Case Reports--Other

On November 3, 2003, a 38-year-old male construction laborer died when the unprotected 8-foot high walls of the trench he was working in collapsed. The decedent was working for a subcontractor who was contracted by a construction company to remove old gas, storm and sanitary sewer lines and install similar new lines. The old abandoned 6-inch diameter gas line was a high pressure, 300 – 320 psi gas line in 10-inch steel casing and was 600 feet long. There were five employees at the job site employed by the subcontractor; a foreman who was a certified competent person, a lab …

Licensed Electrician Dies When Electrocuted By 480volts, Kentucky Injury Prevention And Research Center

Fatality Case Reports--Other

On July 4, 2003, a 36-year-old male lead electrician died after being electrocuted with 480 volts of electricity. A crew of five licensed electricians were working at an automotive supply manufacturing facility running wires to connect service for two air conditioning units (3-phase; 480 volts; 30 amp and 35 amp) and service for a lighting panel (3-phase; 277/480 volts and 200 amps). The manufacturing facility had been shut down for the holiday, and besides a facilities office worker in the facilities main office, the five men were the only workers at the site and had complete control of the facility …

Data Adaptive Estimation Of The Treatment Specific Mean, Yue Wang, Oliver Bembom, Mark J. Van Der Laan

U.C. Berkeley Division of Biostatistics Working Paper Series

An important problem in epidemiology and medical research is the estimation of the causal effect of a treatment action at a single point in time on the mean of an outcome, possibly within strata of the target population defined by a subset of the baseline covariates. Current approaches to this problem are based on marginal structural models, i.e., parametric models for the marginal distribution of counterfactural outcomes as a function of treatment and effect modifiers. The various estimators developed in this context furthermore each depend on a high-dimensional nuisance parameter whose estimation currently also relies on parametric models. Since misspecification …

Workers Crushed By Vehicles, Kentucky Injury Prevention And Research Center

Kentucky Haz Alerts--Motor Vehicle

To prevent motor vehicle repair injuries:

• Ensure that vehicles are positively restrained from moving with chocks.
• Do not place jack stands under potential moving vehicle parts.
• The space under a jack-suspended vehicle should not be entered unless suitable vehicle support stands are utilized.

Assessment Of A Body Composition-Focused Approach To Obesity Treatment, Beverly D. Hall

Loma Linda University Electronic Theses, Dissertations & Projects

Obesity is a significant United States’ public health concern. However, high relapse rates continue to be a problem for obesity treatment programs while the focus remains on weight loss, not body composition change. This study examined whether a clinic-based obesity treatment program, focused on body composition change through resistance training, lead to improved body composition, exercise behaviors, and attitude change from focus on weight loss to body composition change. Improvements in self efficacy, outcome expectations and stages of change were also examined. Forty-eight physician-referred overweight or obese adult women (mean body fat 41%, SD = 6.65%), completed assessments and questionnaires …

Cervical Cancer Screening In Rural South Africa: An Analysis Of The Awareness, Attitudes, And Practices Of Women Served By The Masincedane Clinic, Jordan Schneider

Independent Study Project (ISP) Collection

The aim of this study was to conduct a brief investigation into the awareness, attitudes and practices regarding cervical cancer among women living in Keiskammahoek, a rural area in the Eastern Cape of South Africa. The objectives of this study were to:

• Determine if screening is available within a localized rural community and the methods that are being used.

• Determine if women are coming in for screening, the demographics of these women, and the circumstances that bring them into PHC clinics.

• Investigate the level of knowledge and education about cervical cancer and prevention among women within the …

Descriptive And Comparative Study Of The Nutritional Knowledge And Behavior Of Mothers Of Young Children Who Have Received Targeted Nutritional Education And Those Who Have Not As A Method To Ascertain The Effectiveness Of The Little Tree Nutritional And Educational Centre In Combating Malnutrition In The Pienaarsig Township Of Nieu Bethesda, Eastern Cape Province, South Africa, Amelia Peterson

Independent Study Project (ISP) Collection

No abstract provided.

Lower Extremity Muscle Strength And Risk Of Self-Reported Hip Or Knee Osteoarthritis, Jennifer M. Hootman, Shannon J. Fitzgerald, Carol A. Macera, Steven N. Blair

Faculty Publications

Purpose: The purpose of this study was to investigate the gender-specific longitudinal association between quadriceps strength and self-reported, physician-diagnosed hip or knee osteoarthritis (OA).

Methods: Subjects were 3081 community-dwelling adults who were free of OA, joint symptoms and injuries, completed a maximum treadmill exercise test, had isokinetic knee extension and flexion and isotonic leg press strength measurements taken at baseline and returned at least one written follow-up survey. Multivariate logistic regression was used to estimate odds ratios and 95% confidence intervals.

Results: Women with moderate or high isokinetic quadriceps strength had a significantly reduced risk (55% to 64%) of hip …

Nonparametric Confidence Intervals For The One- And Two-Sample Problems, Xiao-Hua Zhou, Phillip Dinh

UW Biostatistics Working Paper Series

Confidence intervals for the mean of one sample and the difference in means of two independent samples based on the ordinary-t statistic suffer deficiencies when samples come from skewed distributions. In this article, we evaluate several existing techniques and propose new methods to improve coverage accuracy. The methods examined include the ordinary-t, the bootstrap-t, the biased-corrected acceleration (BCa) bootstrap, and three new intervals based on transformation of the t-statistic. Our study shows that our new transformation intervals and the bootstrap-t intervals give best coverage accuracy for a variety of skewed distributions; and that our new transformation intervals have shorter interval …

Medicaid's Disproportionate Share Hospital Program: Complex Structure, Critical Payments, Robert E. Mechanic

National Health Policy Forum

This background paper describes the history and political evolution of Medicaid’s disproportionate share hospital (DSH) program and examines DSH as it exists today. It highlights the importance of DSH payments for the viability of safety net hospitals and considers the consequences of states’ creative financing strategies for maximizing federal Medicaid matching funds. Finally, this paper reviews several options for improving the structure and effectiveness of the DSH program.

Estimation Of Treatment Effects In Randomized Trials With Noncompliance And A Dichotomous Outcome , Mark J. Van Der Laan, Alan E. Hubbard, Nicholas P. Jewell

U.C. Berkeley Division of Biostatistics Working Paper Series

We propose a class of estimators of the treatment effect on a dichotomous outcome among the treated subjects within covariate and treatment arm strata in randomized trials with non-compliance. Recent articles by Vansteelandt and Goethebeur (2003) and Robins and Rotnitzky (2004) have presented consistent and asymptotically linear estimators of a causal odds ratio, which rely, beyond correct specification of a model for the causal odds ratio, on a correctly specified model for a potentially high dimensional nuisance parameter. In this article we propose consistent, asymptotically linear and locally efficient estimators of a causal relative risk and a new parameter -- …

Pediatric Obesity: Intervention Outcomes, Kristy Anne Kuehfuss

Loma Linda University Electronic Theses, Dissertations & Projects

Childhood obesity is a national epidemic with serious medical and psychological implications. Almost one-fourth of children in the United States are overweight. Children do not typically grow out of obesity and without intervention the majority of overweight children become overweight adults. Further, childhood obesity results in numerous chronic medical conditions. Thus, the prevention and treatment of childhood obesity are paramount to the avoidance of resultant physical and psychological risk factors. Loma Linda University’s Growing Fit Program seeks to serve the critical and urgent needs of the ever-increasing population of obese children with a multi-disciplinary approach to pediatric weight management. Evaluating …

Psychological Factors Associated With Anticipatory Nausea And Vomiting, Melinda L. Nielsen

Loma Linda University Electronic Theses, Dissertations & Projects

Many cancer patients experience adverse chemotherapy-related side effects. The present study examined the relationships among disease variables (i.e. stage of cancer, type of breast cancer), medical treatment variables (i.e. toxicity of chemotherapy regimen, strength of antiemetic treatment), psychological variables (i.e. health locus of control, anxiety sensitivity, desire for control, coping strategies), and anticipatory nausea and vomiting in women with breast cancer. One hundred women with breast cancer completed the Multidimensional Health Locus of Control Scale - Form C, the Anxiety Sensitivity Index, the Krantz Health Opinion Survey, the Coping Inventory for Stressful Situations, and the Morrow Assessment of Nausea and …

Cultural Value Orientations, Attributions, And Breast Cancer Screening Behaviors, Patricia M. Flynn

Loma Linda University Electronic Theses, Dissertations & Projects

Discrepancies in breast cancer screening behavior exist among various ethnic groups in the United States (Jacobs & Lauderdale, 2001), with Latino American women reporting particularly low screening rates in comparison to Anglo American women (ACS, 2002). Research indicates that behavior is in part influenced by aspects of culture and relevant psychological processes (Betancourt & Lopez, 1993; Betancourt & Fuentes, 2001). This study was designed to investigate the relations among cultural values, attributional processes, and breast cancer screening behavior among Anglo and Latino women. This study also investigated the influence of acculturation among Latino women in relation to the other study …

A Report From The Forum Session "Implementing The New Medicare Drug Benefit: Challenges And Opportunities For States", Judith D. Moore

National Health Policy Forum

The National Health Policy Forum convened a meeting on July 22, 2004 to discuss state-based challenges associated with implementing the Medicare Prescription Drug, Improvement, and Modernization Act (MMA). The meeting brought together an extremely insightful and experienced group of current and former state officials and other experts to discuss key issues. In keeping with its tradition of promoting a frank, off-the-record exchange on health policy issues, NHPF does not normally prepare written summaries or reports of meetings. However, because this meeting provided vivid illustrations of the importance of state-federal collaboration for the successful implementation of the new Medicare drug benefit, …