Digital Commons Network^™

Student Vollunteers In The Hospice Setting, Sarah Brugger

Senior Honors Projects

The purpose of this study was to determine the frequency of use of student volunteers in the hospice setting across the country. Hospice agencies were asked to answer a questionnaire regarding their use of student volunteers and the disadvantages or benefits that they have experienced. One hundred percent of the participants indicated that they use students as volunteers in their agency. The student’s youthful outlook, fresh perspective, and enthusiasm were the most frequently cited benefits. The main disadvantage of using students centered around commitment issues, such as the unavailability of students during school breaks. The results of this study suggest …

Pyemotes Herfsi (Acari: Pyemotidae), A Mite New To North America As The Cause Of Bite Outbreaks, Alberto B. Broce, Ludek Zurek, James A. Kalisch, Robert Brown, David L. Keith, David Gordon, Janis Goedeke, Cal Welbourn, John Moser, Ronald Ochoa, Eduardo Azziz-Baumgartner, Fuyuen Yip, Jacob Weber

Department of Entomology: Faculty Publications

High incidences of red, itching, and painful welts on people in the midwestern United States led to the discovery of a European species of mite, Pyemotes herfsi (Oudemans) (Acari: Pyemotidae), preying on gall-making midge larvae on oak leaves. The mites' great reproductive potential, small size, and high capacity for dispersal by wind make them difficult to control or avoid.

A Coprological View Of Ancestral Pueblo Cannibalism, Karl Reinhard

Karl Reinhard Publications

As the object of my scientific study, I’ve chosen coprolites. It’s not a common choice, but to a paleonutritionist and archaeoparasitologist, a coprolite—a sample of ancient feces preserved by mineralization or simple drying—is a scientific bonanza. Analysis of coprolites can shed light on both the nutrition of and parasites found in prehistoric cultures. Dietary reconstructions from the analysis of coprolites can inform us about, for example, the origins of modern Native American diabetes. With regard to parasitology; coprolites hold information about the ancient emergence and spread of human infectious disease. Most sensational, however, is the recent role of coprolite analysis …

Semiparametric Latent Variable Regression Models For Spatio-Temporal Modeling Of Mobile Source Particles In The Greater Boston Area, Alexandros Gryparis, Brent A. Coull, Joel Schwartz, Helen H. Suh

Harvard University Biostatistics Working Paper Series

Traffic particle concentrations show considerable spatial variability within a metropolitan area. We consider latent variable semiparametric regression models for modeling the spatial and temporal variability of black carbon and elemental carbon concentrations in the greater Boston area. Measurements of these pollutants, which are markers of traffic particles, were obtained from several individual exposure studies conducted at specific household locations as well as 15 ambient monitoring sites in the city. The models allow for both flexible, nonlinear effects of covariates and for unexplained spatial and temporal variability in exposure. In addition, the different individual exposure studies recorded different surrogates of traffic …

La Story: Improving Care Management For The Chronically Ill And Chronically Underserved, Eileen Salinsky, Jessamyn Taylor

National Health Policy Forum

This Los Angeles-based site visit examined safety net and private sector efforts to improve care coordination for underserved and vulnerable populations, including the homeless, the uninsured, the undocumented, and individuals with chronic conditions like diabetes, asthma, and severe mental illness. The visit highlighted challenges and innovations in the use of disease management programs, information systems, performance incentives, and managed care as tools for improving care coordination.

Simple Records Matching Method For Diagnostic And Clinical Datasets Of Patient’S Records, Salvo Reina, Vito M. Reina, Eugenio A. Debbia

COBRA Preprint Series

Several statistical packages, either commercials or open-source, provide many methods for multi-factorial and discriminant analysis; such a software is poorly used by physicians. Appropriate models and tests have to be used pending on the kind of experiment scheme, adequate distribution assumption are needed for variables and parameters and proper data validation have to be verified for historical records. These are but a few of many critical aspects for a robust and trustable data interpretation needed in the Evidence Based Medicine era. Clinicians always wish to be able to quickly interpreter diagnostic records to discriminate, or alternatively correlate, coherent groups of …

Acute Health Effects Of The Tasman Spirit Oil Spill On Residents Of Karachi, Pakistan, Naveed Zafar Janjua, Pashtoon Murtaza Kasi, Haq Nawaz, Sadia Zohra Farooqui, Urooj Bakht Khuwaja, Najam-Ul-Hassan, Syed Nadim Jafri, Shahid Ali Lutfi, Muhammad Masood Kadir, Nalini Sathiakumar

Community Health Sciences

Background: On July 27 2003, a ship carrying crude oil ran aground near Karachi and after two weeks released 37,000 tons of its cargo into the sea. Oil on the coastal areas and fumes in air raised health concerns among people. We assessed the immediate health impact of oil spill from the tanker Tasman Spirit on residents of the affected coastline in Karachi, Pakistan.Methods: We conducted a study consisting of an exposed group including adults living in houses on the affected shoreline and two control groups (A and B) who lived at the distance of 2 km and 20 km …

Cultural/Interpersonal Values And Smoking In An Ethnically Diverse Sample Of Southern California Adolescents, C. Anderson Johnson, Paula Palmer, Jennifer B. Unger, Sohaila Shakib, Peggy Gallaher, Anamara Ritt-Olson, Michele Mouttapa

CGU Faculty Publications and Research

In ethnically diverse school contexts, values from multiple cultures might influence adolescents' attitudes and behaviors. This study developed scales to assess cultural values among Southern California 6- grade adolescents (N=2281) and evaluated the associations between values and smoking. The scales assessed values salient in many Hispanic and Asian cultures: Respect for Adults (e.g., filial piety, respeto). Interpersonal Harmony (e.g., saving face, simpatia), and Differentiated Gender Roles (e.g., machismo). In cross-sectional and one-year longitudinal models. Respect for Adults and Interpersonal Harmony were associated with a lower risk of lifetime smoking. The associations were significant even after controlling for demographic characteristics, friends' …

Intellectual Property Management Strategies To Accelerate The Development And Access Of Vaccines And Diagnostics: Case Studies On Pandemic Influenza, Malaria And Sars, Anatole Krattiger, Stanley P. Kowalski, Robert Eiss, Anthony Taubman

Law Faculty Scholarship

Achieving global access to vaccines, diagnostics, and pharmaceuticals remains a challenge. Throughout the developing world, intellectual property (IP) constraints complicate access to critically essential medical technologies and products. Vaccines for malaria and pandemic strains of influenza, as well as diagnostic and vaccine technologies for SARS, are not only relevant to global public health but are particularly critical to the needs of developing countries. A global access solution is urgently needed. This article offers a timely case‐by‐case analysis of preliminary patent landscape surveys and formulates options via patent pools and other forms of creative IP management to accelerate development and access. …

Creating Progam Logic Models: A Toolkit For State Flex Programs, John A. Gale Ms, Andrew F. Coburn Phd, Stephanie Loux Ms

Population Health & Health Policy

A logic modeling toolkit developed by the Flex Monitoring Team is available for use by state Medicare Rural Hospital Flexibility Programs (Flex Programs) in planning for and managing their Flex programs. The use of the Program Logic Model (PLM) Toolkit will provide states with a tool to assist in:

Planning, managing, reporting on, and assessing their Flex Program goals, activities, and accomplishments;

• Developing buy-in among key Flex Program stakeholders;
• Clarifying the underlying program assumptions;
• Identifying and defining measurable outcomes;
• Linking state-level Flex Program strategies and activities to specific and measurable outcomes; and
• Reporting program results to both internal and external …

Data Integration And Storage: Managing And Using Home And Community-Based Services Data For Quality Improvement, Carolyn E. Gray Mph, Maureen Booth Mrp, Ma

Disability & Aging

This paper reports on data integration from a program manager’s perspective. The paper is not meant to be an exhaustive research document, nor does it single out any one correct approach. The paper is meant to facilitate communication between program units and analytic staff and serve as one reference for states as they continue to improve upon data collection techniques and use this information for ongoing quality management and improvement.

Download Full Pdf Issue Of Thomas Jefferson University Public Health Link, Vol. 2, Iss.3, April 2006

Public Health Link

Vol. 2, Iss. 3 of Public Health Link includes spotlight on Richard Wender, MD from the Department of Family and Community Medicine at Thomas Jefferson University. Also includes National Public Health Week and thesis presentations.

Working With The Tabu: Hiv/Aids Education Strategies In Fiji, Amanda Butts

Independent Study Project (ISP) Collection

The focus of this paper is the cultural tabu, or taboo, in Fiji that prevents the open discussion of sex and therefore complicates education efforts towards HIV/AIDS awareness and prevention. Specific factors perpetuate the tabu including using it as an excuse to simply ignore a complex issue such as HIV/AIDS and using it to keep sex off social agendas in a predominantly Christian nation. Where organizations have taken strides to work with or break the tabu, the author examines and analyzes various education strategies employed by a variety of sectors including schools, health care facilities, faith-based organizations, the HIV positive …

How To Bridge The Gap: An Analysis Of The Coverage And Efficacy Of Volunteer Counseling And Testing Centers In Suba District, Kenya, Joseph Lippi

Independent Study Project (ISP) Collection

The Suba District of western Kenya is one of the areas most affected by the HIV/AIDS epidemic. According to Kenyan Ministry of Health publications, at the end of 2005, Suba District had an HIV/AIDS prevalence of 30%. This paper focuses on the numerous volunteer counseling and testing centers (VCTs) in Suba District that test and educate members of the community in effort to curb the spread of HIV/AIDS. Great efforts have been made to attack the problem of HIV/AIDS in Suba district. This paper seeks to illuminate the numerous factors that keep people in the community from seeking VCT center …

Loaning Health: The Effectiveness Of Microfinance As An Hiv/Aids Intervention Method In Kibera Slums, Lara Berlin

Independent Study Project (ISP) Collection

Three of the major societal issues facing Kenya are poverty, gender inequalities, and HIV/AIDS, each of which acts as a catalyst for the others. In the last twenty years, microfinance has been used as an intervention method combating poverty and women’s disempowerment. As such, this study examines the effectiveness of using microfinance as an HIV/AIDS intervention method in the Kibera slums of Nairobi, Kenya. The research is primarily based upon interviews with Kibera residents and members of microfinance organizations. The findings indicate that most Kibera residents believe microfinance is the best method of reducing the spread of AIDS, especially when …

Current Issues In Healthcare In Samoa “Making-Do With What Is Available”, Veronica Braden

Independent Study Project (ISP) Collection

The objective of this research was to look at the current issues in healthcare in present day Samoa. The research was conducted over a four week period, two of which were spent observing and interviewing in the public hospital, Tupua Tamasese Meaole, and in the private hospital, MedCen. This research was conducted to look at issues such as cleanliness of facilities, the shortage of supplies and technology in the hospitals, the demand for higher salaries made by the doctors, and the reasons for the trend towards the privatization of medicine. Also researched, was the role of the government in terms …

The Human Ecology Of A Disease: Dissemination Of Resources And Information On Hiv And Aids In Can Tho City And An Giang Province, Lucas Thornblade

Independent Study Project (ISP) Collection

HIV has spread worldwide. This virus, resulting in as-of-yet incurable destruction of the human immune system, has caused the death of millions in the last two decades through opportunistic infections manifest as AIDS. Though development of prevention and treatment measures have greatly improved in recent years, because of lack of resources, incidence of infection continues to increase annually in nearly all parts of the world including southeast Asia. This paper looks at how the disease has affected people’s lives in Can Tho City and An Giang Province in Vietnam’s southern Mekong Delta. This paper offers an epidemiological and biological argument …

Sex-Education And Preventative And Contraceptive Services: Educação-Sexual E Serviços Contraceptivos E Preventativos, Elizabeth M. Ortiz

Independent Study Project (ISP) Collection

Maternal morbidity is one of the leading causes of death amongst women in Latina America. Lack of access to Reproductive Health services has incited a continental epidemic amongst adolescent women - and should be considered a public health crisis. Yet, there is little being done by the governing male bodies to secure access and the Right to Reproductive Health services. This is not only a means of re-enforcing gendered inequalities- but also class, and racial disparities. Reproductive Health in Brazil and Northeastern Brazil in particular, serves as an allegory for socio-economic, gender, ethnic, and racial inequality in the region. The …

Seasonal Variation In Food Intake, Physical Activity, And Body Weight In A Predominantly Overweight Population, Yunsheng Ma, Barbara C. Olendzki, W. Li, Andrea R. Hafner, David E. Chiriboga, James R. Hébert, Mary Jane Campbell, M. Sarnie, Ira S. Ockene

Faculty Publications

OBJECTIVE:

To describe seasonal variation in food intake, physical activity, and body weight in a predominantly overweight population.

DESIGN:

A longitudinal observational study.

SETTING:

Most of the study participants were recruited from a health maintenance organization (HMO) in central Massachusetts, USA. Additional individuals of Hispanic descent were recruited from outside of the HMO population to increase the ethnic diversity of this sample.

SUBJECTS:

Data from 593 participants, aged 20-70, were used for this investigation. Each participant was followed quarterly (five sampling points: baseline and four consecutive quarters) for 1-year period. Body weight measurements and three 24-h dietary and physical activity …

Socio-Demographic Correlates Of Betel, Areca And Smokeless Tobacco Use As A High Risk Behavior For Head And Neck Cancers In A Squatter Settlement Of Karachi, Pakistan, Samia Mazahir, Rabia Malik, Maria Maqsood, Kanwal Aliraza Merchant, Farida Malik, Atif Majeed, Zafar Fatmi, Muhammad Rizwanulhaq Khawaja, Shehzad Ghaffar

Community Health Sciences

Background

Head and neck cancers are a major cancer burden in Pakistan. They share a common risk factor profile including regular consumption of products of betel, areca and tobacco. Use of paan, chaalia, gutka, niswar and tumbaku is acceptable in Pakistan and is considered a normal cultural practice. This cross-sectional study was carried out to understand the relation of socio-demographic factors for the consumption of paan, chaalia, gutka, niswar and tumbaku in Pakistani population. Through systematic sampling, 425 subjects from a squatter settlement in Karachi were interviewed using a structured questionnaire. High risk behavior was defined as Daily use of …

Perceived Smoking Environment And Smoking Initiation Among Multi-Ethnic Urban Girls, Tracy R. Nichols, Amanda Birnbaum, Sara Birnel, Gilbert J. Botvin

Department of Public Health Scholarship and Creative Works

Purpose

To examine associations between the perceived smoking environment and smoking initiation among urban multi-ethnic adolescent girls in New York City.

Methods

Self-report surveys completed in grades 7, 8, and 9 assessed girls’ (n = 858) smoking initiation, and perceived smoking environment (family smoking, friends’ smoking, smoking norms, and cigarette availability). Carbon monoxide breath samples were collected from girls using a variation of the bogus pipeline procedure.

Results

Differences were found in smoking prevalence with white girls reporting the highest prevalence of smoking at baseline and the greatest increase in smoking prevalence from seventh to eighth grade. Black girls reported …

Meeting Public Health Challenges, Mckinley Thomas

Journal of the Georgia Public Health Association

Meeting Public Health Challenges

A Worldwide Crisis: Inappropriate Antibiotic Use And Resistant Bacterial Infections, P. Anna Vickery, James Wilde

Journal of the Georgia Public Health Association

A Worldwide Crisis: Inappropriate Antibiotic Use and Resistant Bacterial Infections

Sexually Transmitted Infections: Perceived Knowledge Versus Actual Knowledge, Heather Ferguson, Richard Topolski, Marc Miller

Journal of the Georgia Public Health Association

Sexually transmitted infections (STIs) continue to be a serious problem, with potentially severe consequences. Past research has found that people may not seek out treatment for STIs because they do not know what symptoms to look for (Greenberg et al., 2002). The present study investigated many aspects of STI knowledge, including perceived knowledge and actually knowledge. Moreover, this study added a novel and applied aspect to the assessment of STI knowledge: visual knowledge. Overall, participants performed poorly on the actual STI knowledge, however, those who rated their knowledge as high performed significantly better than those who rated their knowledge as …

An Examination Of Adolescents’ Knowledge And Attitudes Related To Heart Disease, Nutrition, Physical Activity, And Media Influences And The Adoption Of A Healthy Lifestyle, Melissa Schenkman, Randolph Martin, Susan Butler

Journal of the Georgia Public Health Association

The present pilot study aimed to determine the attitudes, beliefs, behaviors, and degree of knowledge among adolescents related to healthy eating, exercise, heart disease, the influence of television, and possible factors in modifying their attitudes toward adopting a healthy lifestyle. Juniors and seniors from two private high schools (N=62) in metro Atlanta were surveyed. The study was based on the Social Cognitive Theory and the Health Belief Model. The research questions examined the impact of nutrition and heart disease knowledge on physical activity behavior, and the impact of television media exposure on eating habits. A 36-question cross-sectional survey compiled from …

Knowledge And Attitudes Of Restaurant Operators Concerning The Requirements Of The Georgia Smoke-Free Air Act, Jeffrey B. Fountain

Journal of the Georgia Public Health Association

The State of Georgia enacted the Georgia Smoke-Free Air Act (GSAA) in 2005 to limit smoking in public places including restaurants. The purpose of this study was to determine if a correlation exists between restaurant operators’ attitude toward smoking regulation and prevention and their knowledge of requirements of the GSAA. Participants from Atkinson, Bacon, and Jeff Davis counties, three of the smaller populated rural counties of the Southeast Health District, completed questionnaires for this study (n = 41). The correlation was weak and not determined to be statistically significant (r = -.251) but did indicate restaurant operators agree they have …

Medicaid In 2006: A Trip Down The Yellow Brick Road?, Jennifer Ryan

National Health Policy Forum

This issue brief explores the continuing evolution of the Medicaid program on several fronts. It discusses the benefits and cost-sharing flexibility that is included in the Deficit Reduction Act of 2005 (DRA) and examines the implications of these provisions for states, beneficiaries, and providers. The paper also explores recent trends in section 1115 waiver development and considers the use of waivers as a vehicle for restructuring Medicaid financing systems and for testing completely new approaches to health care delivery. The role of section 1115 waivers in the context of the DRA and as a mechanism for continued state innovation is …

Reliability, Effect Size, And Responsiveness And Intraclass Correlation Of Health Status Measures Used In Randomized And Cluster-Randomized Trials, Paula Diehr, Lu Chen, Donald L. Patrick, Ziding Feng, Yutaka Yasui

UW Biostatistics Working Paper Series

Background: New health status instruments are described by psychometric properties, such as Reliability, Effect Size, and Responsiveness. For cluster-randomized trials, another important statistic is the Intraclass Correlation for the instrument within clusters. Studies using better instruments can be performed with smaller sample sizes, but better instruments may be more expensive in terms of dollars, lost opportunities, or poorer data quality due to the response burden of longer instruments. Investigators often need to estimate the psychometric properties of a new instrument, or of an established instrument in a new setting. Optimal sample sizes for estimating these properties have not been studied …

Sensitivity Of The Hazard Ratio To Non-Ignorable Treatment Assignment In An Observational Study, Nandita Mitra, Daniel F. Heitjan

UPenn Biostatistics Working Papers

In non-randomized studies, estimation of treatment effects generally requires adjustment for imbalances in observed covariates. One such method, based on the propensity score, is useful in many applications but may be biased when the assumption of strongly ignorable treatment assignment is violated. Because it is not possible to evaluate this assumption from the data, it is advisable to assess the sensitivity of conclusions to violations of strong ignorability. Lin et al [1] have implemented this idea by investigating how an unmeasured covariate may affect the conclusions of an observational study. We extend their method to assess sensitivity of the treatment …

Association Between Tobacco Use And Body Mass Index In Urban Indian Population: Implications For Public Health In India, Mangesh S. Pednekar, Prakash C. Gupta, Heema C. Shukla, James R. Hébert

Faculty Publications

Background: Body mass index [BMI, weight (kg)/height (m2)], a measure of relative weight, is a good overall indicator of nutritional status and predictor of overall health. As in many developing countries, the high prevalence of very low BMIs in India represents an important public health risk. Tobacco, smoked in the form of cigarettes or bidis (handmade by rolling a dried rectangular piece of temburni leaf with 0.15–0.25 g of tobacco) or chewed, is another important determinant of health. Tobacco use also may exert a strong influence on BMI.

Methods: The relationship between very low BMI (< 18.5 kg/m2) and tobacco use was examined using data from a representative cross-sectional survey of 99,598 adults (40,071 men and 59,527 women) carried out in the city of Mumbai (formerly known as Bombay) in western India. Participants were men and women aged ≥ 35 years who were residents of the main city of Mumbai.

Results: …