Digital Commons Network^™

Prescriptions For Excellence In Health Care Spring 2010 Dowload Full Pdf

Prescriptions for Excellence in Health Care Newsletter Supplement

No abstract provided.

Intellectual Propriety: Compulsory Licenses Through The Trips Agreement And The Doha Declaration On Public Health, Samuel Mintzer Fuchs

Independent Study Project (ISP) Collection

The Agreement on Trade Related Aspects of Intellectual Property (TRIPS), part of the Uruguay Round of trade negotiations led to the creation of the World Trade Organization (WTO) in 1995, has led to a variety of interpretations and opinions. Though its application goes beyond matters of public health, it is this area that has come under the most scrutiny in the last fifteen years as the gaps between developed and developing countries have widened and exposed the health disparities between the two groups. Tensions over intellectual property and access to newly developed medicines to treat diseases such as HIV and …

Birth Order Modifies The Effect Of Il13 Gene Polymorphisms On Serum Ige At Age 10 And Skin Prick Test At Ages 4, 10 And 18: A Prospective Birth Cohort Study, Ikechukwu U. Ogbuanu, Wilfried J. Karmaus, Hongmei Zhang, Tara Sabo-Attwood, Susan L. Ewart, Graham Roberts, Syed Hasan Arshad

Faculty Publications

Background: Susceptibility to atopy originates from effects of the environment on genes. Birth order has been identified as a risk factor for atopy and evidence for some candidate genes has been accumulated; however no study has yet assessed a birth order-gene interaction.

Objective: To investigate the interaction of IL13 polymorphisms with birth order on allergic sensitization at ages 4, 10 and 18 years.

Methods: Mother-infant dyads were recruited antenatally and followed prospectively to age 18 years. Questionnaire data (at birth, age 4, 10, 18); skin prick test (SPT) at ages 4, 10, 18; total serum IgE and specific inhalant screen …

Associations Between Polycyclic Aromatic Hydrocarbon-Related Exposures And P53 Mutations In Breast Tumors, Irina Mordukhovich, Pavel Rossner Jr., Mary Beth Terry, Regina M. Santella, Yu-Jing Zhang, Hanina Hibshoosh, Lorenzo Memeo, Mahesh Mansukhani, Chang-Min Long, Gail Garbowski, Meenakshi Agrawal, Mia M. Gaudet, Susan E. Steck, Sharon K. Sagiv, Sybil M. Eng, Susan L. Teitelbaum, Alfred I. Neugut, Kathleen Conway-Dorsey, Marilie D. Gammon

Faculty Publications

BACKGROUND: Previous studies have suggested that polycyclic aromatic hydrocarbons (PAHs) may be associated with breast cancer. However, the carcinogenicity of PAHs on the human breast remains unclear. Certain carcinogens may be associated with specific mutation patterns in the p53 tumor suppressor gene, thereby contributing information about disease etiology.

OBJECTIVES: We hypothesized that associations of PAH-related exposures with breast cancer would differ according to tumor p53 mutation status, effect, type, and number.

METHODS: We examined this possibility in a population-based case–control study using polytomous logistic regression. As previously reported, 151 p53 mutations among 859 tumors were identified using Surveyor nuclease and …

An Analysis Of Restaurant Food Safety Violations: Human Factors, Non-Human Factors, And Food-Borne Illness, Jai Choung

UNLV Theses, Dissertations, Professional Papers, and Capstones

An estimated 76 million food-borne illnesses occur in the United States each year, causing 325,000 hospitalizations and 5,000 deaths, according to the U.S. Food and Drug Administration. Food safety is an increasingly important topic to governmental food regulators, not only in trying to reduce the number of illnesses from contaminated food. Governmental regulators also are becoming aware of the vulnerability of the food supply chain as a target for bioterrorism. Recommendations have been developed to protect the U. S. food supply from terrorism, but little of the research and recommendations relate to the food-service level.

Eighty percent of reported cases …

Policies That Restrict Sweetened Beverage Availability May Reduce Consumption In Elementary-School Children, Sonya J. Jones, Wendy Gonzalez, Edward A. Frongillo Jr.

Faculty Publications

Objective:We investigated whether having a policy regarding the availability of sweetened beverages in school was associated with children's purchase of total weekly and daily consumption of sweetened beverages.

Design: Data were obtained in the Early Childhood Longitudinal Study-Kindergarten cohort. Multilevel logistic regression was used to determine the magnitude and significance of relationships between the availability of different beverages and purchase of sweetened beverages at school and overall consumption of beverages.

Results: The purchase of sweetened beverages by children in school was strongly associated with the administrative policy of sweetened beverage availability. Compared with children in schools without an administrative …

Outcomes Associated With A Unlv Outdoor Adventures' Women's Wilderness Canoe Trip, Joanna Leigh Libby

UNLV Theses, Dissertations, Professional Papers, and Capstones

The purpose of this study was to examine the outcomes associated with a short term women's canoe trip. Short debriefings, field observations and in-depth interviews were used to capture women's experiences and the processes that take place to achieve these experiences.

Eight females from the University of Nevada, Las Vegas participated in a three day canoeing trip led by the University's outdoor program. Their ages range from 18 to 40 and are all affiliated with the University of Nevada, Las Vegas in some way.

Results from the participant's interviews highlighted four major themes. These themes are the disengagement from traditional …

Who Guidelines For Antimicrobial Treatment In Children Admitted To Hospital In An Area Of Intense Plasmodium Falciparum Transmission: Prospective Study, Behzad Nadjm, Ben Amos, George Mtove, Jan Ostermann, Semkini Chonya, Hannah Wangai, Juma Kimera, Walii Msuya, Frank Mtei, Denise Dekker, Rajabu Malahiyo, Raimos Olomi, John A. Crump, Christopher J. M. Whitty, Hugh Reyburn

Faculty Publications

Objectives To assess the performance of WHO’s “Guidelines for care at the first-referral level in developing countries” in an area of intense malaria transmission and identify bacterial infections in children with and without malaria.

Design Prospective study.

Setting District hospital in Muheza, northeast Tanzania.

Participants Children aged 2 months to 13 years admitted to hospital for febrile illness.

Main outcome measures Sensitivity and specificity of WHO guidelines in diagnosing invasive bacterial disease; susceptibility of isolated organisms to recommended antimicrobials.

Results Over one year, 3639 children were enrolled and 184 (5.1%) died; 2195 (60.3%) were blood slide positive for Plasmodium falciparum …

Latino Family Variables And Sexual Activity In Latino Adolescents, Brittany Nicole Barber

Counselor Education and Counseling Psychology Research Exchange Conference

Researchers’ focused examination of Latino adolescents’ cultural values and sexual activity has yielded questions regarding the cultural- and gender-specific attitudes and practices of these youth (Deardorff, Tschann, & Flores, 2008). Cultural values include family-related variables such as different aspects of familism, parent-adolescent communication, and parental monitoring, which have been found to decrease adolescents’ engagement in other negative activities such as aggressive behavior, (Dishion & McMahon, 1998), substance use (Estrada, Rabow, & Watts, 1982), and delinquency (Clark & Shields, 1997). Research investigating these risk behaviors has often implicated Latino adolescents’ level of assimilation to White, mainstream society as a potential risk …

Is Uncompensated Care Affecting Quality Assurance Of Rural Hospitals?, Doohee Lee, Chris Dixon, Paul Kruszynski, Alberto Coustasse

Management Faculty Research

Healthcare disparities in rural areas remain significant in the U.S. healthcare industry. Uncompensated care makes healthcare disparities in rural areas worse and rural hospitals are unfavorably positioned to compete with urban hospitals in the economic downturn marketplace. How uncompensated care affects quality care among rural hospitals has been lightly investigated. As many rural residents experience difficulty accessing high quality care and the importance of establishing quality care practice standards in a rural setting, we conducted a systematic literature review to identify some quality care barriers and opportunities, suggested strategies to strengthen the position of rural hospitals in response to uncompensated …

Management Of Kawasaki Disease In Texas: Policy Implications, Alberto Coustasse, Doohee Lee, Cody Arvidson, Julius J. Larry Iii, Witold Migala

Management Faculty Research

Kawasaki Disease (KD) is the leading cause of acquired cardiovascular disease among children, but KD has received little attention on its management from a policy perspective. The core objective of this paper is to review the literature, identify problems related to KD, and evaluate and offer some policy alternatives to effectively prevent and treat KD epidemiologically in Texas. Policy options suggested in this paper include, among others, (1) establishing a mandatory national KD registry system (along with active surveillance), (2) introducing sentinel providers, (3) requiring mandatory reporting of KD by hospitals, and (4) sponsoring policy KD research and practice.

Climate Change, Environmental Justice, And Vulnerability: An Exploratory Spatial Analysis, Sacoby M. Wilson, Roland Richard, Lesley Joseph, Edith M. Williams

Faculty Publications

Research has demonstrated that vulnerable populations including disadvantaged populations of color live in areas that may place them at higher risk of exposure to social and environmental hazards. Due to climate change, these populations may experience worse health outcomes and environmental health disparities. The purpose of this project was to explore the use of Geographic Information Systems (GIS) to assess areas that may be vulnerable to climate change across the United States. We employed ArcGIS 9.3 to create vulnerability scores for areas across the country that may be that may be impacted by climate change at the county level in …

Campaigns To Change Health Damaging Corporate Practices, Nicholas Freudenberg

Publications and Research

When corporations claim the same citizenship rights as human citizens, they exercise an undue influence on health policy and democratic processes. Surprisingly, the same basic repertoire of tactics has been found to be employed by corporations to effect this influence, regardless of the specific industry at work. In this book, authors from around the world reveal the range of tactics used across the corporate world that ultimately favor the bottom line over the greater good.

The Bottom Line or Public Health deconstructs some of the most ubiquitous tactics at play, including public relations, political influence, legal maneuvering, and financial power, …

Conceptions Regarding Children’S Health: An Examination Of Ethnotheories In A Sending And Receiving Community, Maria Rosario De Guzman, Jennifer Deleon, Gloria Gonzalez-Kruger, Rodrigo Cantarero

Department of Child, Youth, and Family Studies: Faculty Publications

Ethnotheories are beliefs that adults hold about children and the factors that impact upon their development. Scholars suggest that “ethnotheories” serve as cultural models that underlie motivations for parenting practices and the way adults organize children’s early experiences. This study examines Mexican adults’ ethnotheories about children’s health in two communities that are linked by transnational migrants and serve as sending and receiving communities for workers. Forty-four Mexican adults in six focus groups discussed well-being issues affecting children in their communities. Qualitative analyses using grounded theory revealed a complex conception of children’s health issues that included physical, psychological, and behavioral components …

Residential Tree Trimmers Killed While Working, Kentucky Injury Prevention And Research Center

Kentucky Haz Alerts--Falls

To prevent tree trimmer injuries:

• Tree trimming or cutting should not be performed without appropriate safety training.
• Appropriate personal protective equipment should be worn at all times while removing trees.
• All trees and limbs should be inspected for structural weakness before work commences.
• Safe work procedures should be used for climbing, felling, topping, and pruning trees.
• A jobsite hazard assessment should be performed to identify hazards so that hazards can be controlled for.

Correlates Of Physical Activity In Black, Hispanic, And White Middle School Girls, Evelyn B. Kelly, Deborah Parra-Medina, Karin A. Pfeiffer, Marsha Dowda, Terry L. Conway, Larry S. Webber, Jared B. Jobe, Scott Going, Russell R. Pate

Faculty Publications

Background: A need exists to better understand multilevel influences on physical activity among diverse samples of girls. This study examined correlates of moderate-to-vigorous physical activity (MVPA) among adolescent girls from different racial/ethnic backgrounds. Methods: 1,180 6th grade girls (24.5% black, 15.7% Hispanic, and 59.8% white) completed a supervised self-administered questionnaire that measured hypothesized correlates of PA. MVPA data were collected for 6 days using the ActiGraph accelerometer. Hierarchical regression analysis was used to examine correlates of PA in each racial/ethnic group. Results: Hispanic girls (n=185) engaged in 21.7 minutes of MVPA per day, black girls (n=289) engaged in 19.5 minutes …

Maternal And Neonatal Outcomes By Labor Onset Type And Gestational Age, Judith U Hibbard, Shoshana Haberman, Christos G Hatjis, Matthew K Hoffman, Michelle Kominiarek, Helain J Landy, Lee A Learman, James Troendle, Paul Van Veldhuisen, Isabelle Wilkins, Liping Sun, Jun Zhang

Faculty, Staff and Student Publications

OBJECTIVE: We sought to determine maternal and neonatal outcomes by labor onset type and gestational age.

STUDY DESIGN: We used electronic medical records data from 10 US institutions in the Consortium on Safe Labor on 115,528 deliveries from 2002 through 2008. Deliveries were divided by labor onset type (spontaneous, elective induction, indicated induction, unlabored cesarean). Neonatal and maternal outcomes were calculated by labor onset type and gestational age.

RESULTS: Neonatal intensive care unit admissions and sepsis improved with each week of gestational age until 39 weeks (P < .001). After adjusting for complications, elective induction of labor was associated with a lower risk of ventilator use (odds ratio [OR], 0.38; 95% confidence interval [CI], 0.28-0.53), sepsis (OR, 0.36; 95% CI, 0.26-0.49), and neonatal intensive care unit admissions (OR, 0.52; 95% CI, 0.48-0.57) compared to spontaneous labor. The relative risk of hysterectomy at term was 3.21 (95% CI, 1.08-9.54) with elective induction, 1.16 (95% CI, 0.24-5.58) with indicated induction, and 6.57 (95% CI, 1.78-24.30) with cesarean without labor compared to spontaneous labor.

CONCLUSION: Some neonatal outcomes improved until 39 weeks. Babies born with elective induction …

Identifikasi Penyebab Diare Di Kabupaten Karangasem, Bali, I N. Sujaya, N.P. Desy Aryantini, N.W. Nursini, S.G. Purnama, N.M.U. Dwipayanti, I G. Artawan, I M. Sutarga

Kesmas

Pada Februari hingga Maret 2008 terjadi kejadian luar biasa muntah berak (diare) di Kabupaten Karangasem Bali. Tercatat sekitar 600 orang mengalami muntaber dan 5 orang meninggal dunia. Ini merupakan kejadian KLB muntaber pertama kali di Bali serta belum diketahui patogen penyebab diare tersebut. Tujuan penelitian ini adalah mengidentifikasi penyebab diare di Karangasem serta kemungkinan rantai penularannya. Penelusuran penyebab KLB dilakukan dengan menganalisis sampel air yang diambil dari sumber air umum, cubang/sumur penduduk, bahan makanan, serta rectal swab penderita dengan kombinasi teknik pemupukan kuman dan PCR spesifik dengan target gen pembentuk toksin pada Escherichia coli. Dengan melakukan kultur pada sampel makanan …

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

School of Public Health Faculty Research

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 use …

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 invest …

Traveling Exhibit: The Lives They Left Behind: Suitcases From A State Hospital Attic, Laura J. Hall

Posters and Presentations

The Lives They Left Behind: Suitcases from a State Hospital Attic was a traveling exhibit that explored the stories of patients from the Willard Psychiatric Center in New York, whose personal belongings were discovered after the institution closed in 1995. The exhibit highlighted the intersection of mental health, poverty, and systemic failures in care. Through a series of public events including panel discussions on homelessness, health equity, and mental health policy, the exhibit aimed to raise awareness and promote dialogue on mental health issues. Curated locally by Laura J. Hall and funded by the New Mexico Humanities Council, it was …

Using A Participatory Research Process To Address Disproportionate Hispanic Cancer Burden, Pamela C. Hull, Juan R. Canedo, Michelle C. Reece, Irma Lira, Francisco Reyes, Erandi Garcia, Paul Juarez, Elizabeth Williams, Baqar A. Husaini

Public Health, Health Administration, and Health Sciences Faculty Research

Community-based participatory research (CBPR) offers great potential for increasing the impact of research on reducing cancer health disparities. This article reports how the Community Outreach Core (COC) of the Meharry–Vanderbilt–Tennessee State University (TSU) Cancer Partnership has collaborated with community partners to develop and implement CBPR. The COC, Progreso Community Center, and Nashville Latino Health Coalition jointly developed and conducted the 2007 Hispanic Health in Nashville Survey as a participatory needs assessment to guide planning for subsequent CBPR projects and community health initiatives. Trained community and student interviewers surveyed 500 Hispanic adults in the Nashville area, using a convenience sampling method. …

Risky Business: Effectiveness Of State Market-Based Health Programs, Christopher Stream, Nathan Myers

Public Policy and Leadership Faculty Research

Since the 1990s, state governments have been leaders of health care reform. Today, approximately 47 million people are without health insurance. As health care costs and uninsurance levels continue to rise, states are pursuing a variety of government- and market-based strategies to address this growing social problem. Health care research has indicated that state-based programs have proven to be successful in extending access to coverage. However, the question remains as to whether the market-based programs have had a positive impact on state health care. Advocates for market-based state health programs argue that the reforms benefit the greater good because they …

An Integrated Intervention To Reduce Intimate Partner Violence In Pregnancy: A Randomized Trial, Michele Kiely, Ayman El-Mohandes, M. Nabil El-Khorazaty, Marie G. Gantz

Publications and Research

OBJECTIVE: We estimated the efficacy of a psycho-behavioral intervention in reducing intimate partner violence (IPV) recurrence during pregnancy and postpartum, and in improving birth outcomes in African-American women

METHODS: We conducted a randomized controlled trial in which 1,044 women were recruited. Individually-tailored counseling sessions were adapted from evidence-based interventions for IPV and other risks. Logistic regression was used to model IPV victimization recurrence, to predict minor, severe, physical and sexual IPV.

RESULTS: Women randomized to the intervention were less likely to have recurrent episodes of IPV victimization (OR=0.48, 95%CI=0.29-0.80). Women with minor IPV were significantly less likely to experience further …

Culturally-Adapted And Audio-Technology Assisted Hiv/Aids Awareness And Education Program In Rural Nigeria: A Cohort Study, Ighovwerha Ofotokun, Jose Nilo G. Binongo, Eli S. Rosenberg, Michael Kane, Rick Ifland, Jeffrey L. Lennox, Kirk A. Easley

Faculty Articles

Background: HIV-awareness programs tailored toward the needs of rural communities are needed. We sought to quantify change in HIV knowledge in three rural Nigerian villages following an integrated culturally adapted and technology assisted educational intervention.

Methods: A prospective 14-week cohort study was designed to compare short-term changes in HIV knowledge between seminar-based education program and a novel program, which capitalized on the rural culture of small-group oral learning and was delivered by portable digital-audio technology.

Results: Participants were mostly Moslem (99%), male (53.5%), with no formal education (55%). Baseline HIV knowledge was low (< 80% correct answers for 9 of the 10 questions). Knowledge gain was higher (p < 0.0001 for 8 of 10 questions) in the integrated culturally adapted and technology-facilitated (n = 511) compared with the seminar-based (n = 474) program.

Conclusions: Baseline HIV-awareness was low. Culturally …

Explaining Low Rates Of Autism Among Hispanic Schoolchildren In Texas, Raymond F. Palmer, Tatjana Walker, David Mandell, Bryan Bayles, Claudia S. Miller

Public Health (Archived)

In data from the Texas Educational Agency and the Health Resources and Services Administration, we found fewer autism diagnoses in school districts with higher percentages of Hispanic children. Our results are consistent with previous reports of autism rates 2 to 3 times as high among non-Hispanic Whites as among Hispanics. Socioeconomic factors failed to explain lower autism prevalence among Hispanic schoolchildren in Texas. These findings raise questions: Is autism underdiagnosed among Hispanics? Are there protective factors associated with Hispanic ethnicity?

Cultural Competency: A Growing Need To Better Serve Our Diverse Populations, Rob Simmons Drph, Mph, Ches, Cph, Nancy L. Chernett Mph, Elain Yuen Phd, Susan Toth-Cohen Phd, Otr/L

Population Health Matters (Formerly Health Policy Newsletter)

No abstract provided.

End Of Life Decision Making, Susan Parks Md

Population Health Matters (Formerly Health Policy Newsletter)

No abstract provided.

Health Policy Newsletter Dec. 09 Download Full Pdf

Population Health Matters (Formerly Health Policy Newsletter)

No abstract provided.

The Effects Of Cognitive Reserve On The Rate Of Cognitive Decline In Persons With Mild Cognitive Impairment, Nicholas Adams

UCHC Graduate School Masters Theses 2003 - 2010

No abstract provided.