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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 …

Cancer Information Seeking Preferences Among Health Professionals Serving American Indians In Minnesota, North Dakota, And Wisconsin, K. Knutsen, R. Strickland, J. Matloub, P. Remington, J. Kaur

Native Health Database Full Text

This article identifies cancer information resources used by health professionals in tribal health departments or Indian Health Service clinics serving American Indian communities in Wisconsin, Minnesota and North Dakota.

The Effectiveness Of Back Belts As A Control Measure For Occupational Low Back Pain In A Retail Hardware Chain, Nick Merdith

Theses: Doctorates and Masters

The objective of this study was to examine the effect of the mandatory introduction of back belts on the incidence, days lost and cost of occupational low back injuries resulting from manual handling in 11 retail hardware chain. The study was of a non-experimental before-and-after design with all retail employees in Western Australia being included in a retrospective cohort. The pre-intervention period extended for 21 months and included 2,265,933 work hours with 647 full-time equivalent positions, while the intervention period was 32 months for 4,411,352 hours worked and 827 full-time equivalent positions. Workers' compensation claims for all occupational injuries occurring …

Assessing The Relationship Between Socioeconomic Variables And Risk Of Overweight Among Children 6 Years Of Age, Marilyn Cochon Batan

Theses and Dissertations

Background: The percentage of overweight children has tripled in the last thirty years. Inconsistent findings are published regarding the relationship between socioeconomic variables and being overweight in childhood.Objective: To determine whether socioeconomic variables are associated with risk of being overweight among six year olds. Methods: Six year olds with BMI data were selected from the National Survey of Children's Health (n=4,362). Variables were coded and a low socioeconomic index was created. Using population weights, descriptive statistics were generated and regression was utilized to assess the relationship between socioeconomic variables and being 'at risk' for overweight. Socioeconomic variables were also compared …

Predictors Of Sun Protection Practices Among Adult Women In The United States, Anne Ridgely Minter

Theses and Dissertations

Background. Skin cancer is the most common form of cancer in the United States. The main modifiable risk factor for skin cancer is exposure to excessive sun and UV radiation. More than 90% of all skin cancers are known to be caused by sun exposure. However, studies on excessive sun and UV exposure are limited. The purpose of this study was to examine risk and protective factors affecting sun protection behaviors of adult women in the United States. Methods. Data on U.S. adult women (n=17,425) from the 2003 National Health Information Survey (NHIS) was analyzed. Sun protection behaviors were assessed …

Blood Lead And Decision Speed In Working Age Adults, S. W. Harkins

Theses and Dissertations

Lead is a central nervous system poison. Healthy People 2010 established a target blood lead level (BLL) for children of 0 μg/dL by 2010, but is silent with regard to any changes in BLLs standards for working age adults. In this paper, the relation of BLL to performance on two neurobehavioral tests was assessed in working age adults (N = 4909; Age 20 to 59 years; 51.4% Female) employing data from the Third National Health and Nutrition Survey (NHANES 111). Multiple linear regression analyses indicated a significant effect of BLL on time taken to complete an attention demanding cognitive task …

Trends In Canine Lyme Disease On The Eastern Shore Of Virginia, 2000-2005, Ellen Garrett Hillyer

Theses and Dissertations

Introduction: Lyme disease is caused by the tick-borne spirochete Borrelia burgdorferi. Research has shown that dogs can be used as sentinels for human infection of Lyme disease. The purpose of this 5-year, retrospective study was to determine if there was any evidence that the incidence of canine Lyme disease has increased between 2000 and 2005 in Accomack and Northampton counties. An increased incidence in Lyme disease in dogs may indicate an increased present or future risk of Lyme disease in humans.Methods: Cases of canine Lyme disease were identified via practice invoicing systems and dogs that received doxycycline were entered into …

Age At Sexual Assault And Posttraumatic Stress Disorder In Females Residents Of Virginia, Ahmed Gasmelseed Babiker

Theses and Dissertations

Background Post Traumatic Stress Disorder (PTSD) is a psychiatric debilitating condition that can occur in individuals who experience extremely stressful or traumatic life events. Sexual assault is considered as one of the most traumatic stressor in life. Although few studies investigated the association between history of sexual assault and PTSD, no studies have examined the impact of age at sexual assault on PTSD.Method A cross-sectional telephone survey was conducted among adult female residents of Virginia from November 2002 to February 2003. A total of 1,769 women aged 18 and older were interviewed using a random digit dialing method. Detailed screening …

Effect Of Medicaid/Schip And Wic On Oral Health Of Low-Income Children, Dahlia Naqib

Theses and Dissertations

Oral caries is the most prevalent chronic disease among US children, and disproportionately impacts those of low socioeconomic status. Studies have shown that the Special Supplemental Nutrition Program for Women Infants and Children (WIC) improves access to dental care among Medicaid children. This study investigated the impact of WIC, Medicaid, and the State Children's Health Insurance Program (SCHIP) on the prevalence of dental caries among low-income children. The 1999-2000 and 2001-2002 NHANES data were utilized for this analysis. Children 2-4 years old who participated in WIC, Medicaid, or SCHIP, or who were uninsured, and for whom both interview and complete …

The Association Between Eating Habits And Hypertension Among African American Women Compared To Other Women, Anike N. Clark

Theses and Dissertations

Background: Hypertension is a major public health concern for African American women. Many studies have shown a greater prevalence of hypertension, as well as physical inactivity, excess weight, and diabetes, in African Americans. Objective: To determine if differences in eating patterns, as measured by Healthy Eating Index (HEI) scores, between African American women and other women in the United States are associated with hypertension. Methods: Data were extracted from the Third National Health and Nutrition Examination Survey (NHANESIII). The sample included 31,189,534 women aged 45 years or greater after survey weights were applied. The majority was White (86.1 %); minority …

Long-Term Consequences Of West Nile Virus In Virginia., Diana Cruz Ocampo

Theses and Dissertations

Objective: The purpose of this investigation was to describe the long-term effects and functional outcomes of patients in Virginia who were reported to the Virginia Department of Health with West Nile virus (WNV) non-neuroinvasive and neuroinvasive disease. The study identified the duration of symptoms after initial illness, the number of persons who fully recovered versus the number who continue to be symptomatic and how patients' quality of life differed after illness.Methods: The study population was drawn from 60 human cases that met the surveillance case definition for non-neuroinvasive and neuroinvasive WNV illness in Virginia between 2002-2004. Information was collected during …

Analysis Of The Impact Of A Social Norms Campaign On The Alcohol Use Of Undergraduate Students At A Public, Urban University, Amanda B. Wattenmaker

Theses and Dissertations

Purpose: To conduct a secondary analysis of survey data collected at a large, urban university assessing for change in students' alcohol use perceptions and behaviors between 2002 and 2004. After the baseline data collection in 2002, the campus launched an intensive media intervention to normalize low-risk drinking. Simultaneously, the campus shifted from being a primarily commuter to primarily residential. Methods: This cross-sectional analysis used data collected from students in randomly selected undergraduate classes in February 2002 (n= 662) and 2004 (n=1334). The survey instrument used was the National College Health Assessment. Variables were categorized as demographic, alcohol perception, and alcohol …

Development Of Dose Conversion Coefficients For Radionuclides Produced In Spallation Neutron Sources: Quarterly Progress Report 9/1/04 – 12/31/04, Phillip W. Patton, Mark Rudin

Transmutation Sciences Physics (TRP)

The research consortium comprised of representatives from several universities and national laboratories has successfully generated internal and external dose conversion coefficients for twenty radionuclides produced in spallation neutron sources. In addition, the group has identified twenty radionuclide that are missing electron capture files and eighteen additional radionuclides missing substantial physical data.

Public Health Abstracts 2004

Florida Public Health Review

No abstract provided.

Public Health, Primary Care, And Privatization

Florida Public Health Review

No abstract provided.

Estimating Percentile-Specific Causal Effects: A Case Study Of Micronutrient Supplementation, Birth Weight, And Infant Mortality, Francesca Dominici, Scott L. Zeger, Giovanni Parmigiani, Joanne Katz, Parul Christian

Johns Hopkins University, Dept. of Biostatistics Working Papers

In developing countries, higher infant mortality is partially caused by poor maternal and fetal nutrition. Clinical trials of micronutrient supplementation are aimed at reducing the risk of infant mortality by increasing birth weight. Because infant mortality is greatest among the low birth weight infants (LBW) (• 2500 grams), an effective intervention may need to increase the birth weight among the smallest babies. Although it has been demonstrated that supplementation increases the birth weight in a trial conducted in Nepal, there is inconclusive evidence that the supplementation improves their survival. It has been hypothesized that a potential benefit of the treatment …

A Hybrid Newton-Type Method For The Linear Regression In Case-Cohort Studies, Menggang Yu, Bin Nan

The University of Michigan Department of Biostatistics Working Paper Series

Case-cohort designs are increasingly commonly used in large epidemiological cohort studies. Nan, Yu, and Kalbeisch (2004) provided the asymptotic results for censored linear regression models in case-cohort studies. In this article, we consider computational aspects of their proposed rank based estimating methods. We show that the rank based discontinuous estimating functions for case-cohort studies are monotone, a property established for cohort data in the literature, when generalized Gehan type of weights are used. Though the estimating problem can be formulated to a linear programming problem as that for cohort data, due to its easily uncontrollable large scale even for a …

Public Health Nursing Acceptance Of The 5 A’S Protocol For Prenatal Smoking Cessation, Jihong Liu

Faculty Publications

Oregon’s efforts in tobacco cessation have historically focused on the general population and have depended on quit line services as the primary intervention. The Oregon Smoke Free Mothers and Babies Program (SFMB) was developed in 2002 to focus on public health nurses and prenatal care providers who work with high risk pregnant women. It seeks to increase smoking cessation among low income and other high risk pregnant women by disseminating the U.S. Public Health Service best practices, the 5 A’s (Ask, Advise, Assess, Assist, Arrange) tobacco brief intervention protocol, to public health nurses and prenatal care providers. Interventions included teaching …

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 …

Quality Improvement In Maryland: Partnerships And Progress, Judith D. Moore, Lisa Sprague

National Health Policy Forum

This one-and-a-half-day site visit to Easton, Maryland, explored the activities of the Delmarva Foundation, the Quality Improvement Organization (QIO) for Maryland and the District of Columbia. The program reviewed Delmarva’s responsibilities under their Medicare contract and the initiatives they have undertaken with hospitals and other providers to improve health care outcomes and to define, collect, and report quality data. Local hospital officials added their perspective on quality programs and working with Delmarva. Topics of particular interest were health information technology, patient safety, and quality reporting both to government agencies and to consumers.

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 …

West Nile Virus Blood Transfusion-Related Infection Despite Nucleic Acid Testing, Alexandre Macedo De Oliveira, Brady D. Beecham, Susan P. Montgomery, Robert S. Lanciotti, Jeffrey M. Linnen, Cristina Giachetti, Larry A. Pietrelli, Susan L. Stramer, Thomas J. Safranek

United States Public Health Resources

BACKGROUND: A case of West Nile virus (WNV) encephalitis associated with transfusion of blood that did not react when tested for WNV by minipool (MP) nucleic acid testing (NAT) is described. A Nebraska man developed clinical encephalitis 13 days after surgery and transfusion of 26 blood components. Antibody testing confirmed WNV infection. An investigation was initiated to determine the source of this infection.
STUDY DESIGN AND METHODS: The patient’s family members were interviewed to identify risk factors for WNV infection. Residual samples were retested for WNV RNA using transcription-mediated amplification (TMA) assay and two polymerase chain reaction (PCR) assays. Blood …

Comparison Of Two Approaches To Structured Physical Activity Surveys Of Adolescents, Robert G. Mcmurray, Kimberly B. Ring, Margarita S. Treuth, Gregory J. Welk, Russell R. Pate, Kathryn H. Schmitz, Julie L. Pickrel, Vivian Gonzalez, Maria João C. A. Almeida, Deborah Rohm Young, James F. Sallis

Faculty Publications

Purpose - To compare the test-retest reliability, convergent validity, and overall feasibility/usability of activity-based (AB) and time-based (TB) approaches for obtaining self-reported moderate-to-vigorous physical activity (MVPA) from adolescents.

Methods - Adolescents (206 females and 114 males) completed two 3-d physical activity recalls using the AB and TB surveys, which contained identical lists of physical activities. The participants wore an MTI Actigraph^® accelerometer for the same period.

Results - The TB instrument took about 3 min longer to complete (P=0.022). Overall 2-d test-retest correlations for MVPA were similar for the two surveys (r=0.676 and 0.667), but the girls …

Perceptions And Practices Of Indiana School Superintendents In Response To The Problem Of Sick Building Syndrome, Janet Elaine Hiller

All-Inclusive List of Electronic Theses and Dissertations

The purpose of this study was to compare the perceptions and practices of Indiana public school superintendents who represent two groups, those who had experienced building exposure to mold and those who had not experienced building exposure to mold. Seventy-five Indiana public school superintendents responded to the opinionnaire with a return rate of 81.5%. Results indicate that: (1) Indiana public school superintendents who had not experienced building exposure to mold had higher mean values than those who had experienced building exposure to mold relative to closing only classrooms affected by mold and to relocating staff and students exposed to mold; …

Metal Fabrication Shop Owner Dies When Crushed By Falling Steel Plate, Kentucky Injury Prevention And Research Center

Fatality Case Reports--Other

On December 15, 2003, a metal fabrication shop owner died when a 4,000 pound steel base plate fell on him. While inside the shop building, the work crew of least three men, including the owner, fabricated a 10’x 20’ steel base plate to be used at a water treatment plant. The base plate was to house or serve as a bas anchor a large water pump. After welding connectors and channel iron beams to one side of the plate, the crew pushed the plate through a bay door with a forktruck to an outside area in back of the shop. …

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 …