Digital Commons Network^™

Toward A Better Understanding Of The Comparatively High Prostate Cancer Incidence Rates In Utah, Ray M. Merrill, Sterling C. Hilton, Jared D. Sturgeon, Charles L. Wiggins

Faculty Publications

This study assesses whether comparatively high prostate cancer incidence rates among white men in Utah represent higher rates among members of the Church of Jesus Christ of Latter-day Saints (LDS or Mormons), who comprise about 70% of the state's male population, and considers the potential influence screening has on these rates. Methods: Analyses are based on 14,693 histologically confirmed invasive prostate cancer cases among men aged 50 years and older identified through the Utah Cancer Registry between 1985 and 1999. Cancer records were linked to LDS Church membership records to determine LDS status. Poisson regression was used to derive rate …

Reauthorizing Head Start: The Future Federal Role In Preschool Programs For The Poor, Jane Koppelman

National Health Policy Forum

This paper describes the implications of President Bush’s proposal to devolve authority for running the Head Start program to the states and to alter the organization and funding of all government early childhood programs—with the goal of improving the school readiness skills of low-income children. The administration plan to allow states to mix Head Start funds with state-funded preschool money and, if desired, child care monies to create a more uniform early childhood care system with an educational focus raises numerous questions. This paper addresses questions raised by this plan, including the potential quality of these new systems, the extent …

The U.S. Health Workforce: Definitions, Dollars, And Dilemmas, Karen Matherlee

National Health Policy Forum

This background paper provides a comprehensive view of the structure of the health workforce. It explores public and private insurance coverage and payment policies, as well as discretionary grant programs, that govern it. The paper also looks at health workforce concerns: supplies of certain types of physicians, health workforce mix, challenges from complementary and alternative medicine, shortages of nurses and pharmacists (and some other practitioners), maldistribution issues, and lack of diversity in response to demographic changes. It presents proposals that are on the table to reform the health workforce, at a time when it is demanding greater attention from health …

Ua61/6 Newsletter, Issue 1, Wku Institute For Rural Development

WKU Administration Documents

Newsletter created by and about the Institute for Rural Development. This issue contents:

• Mobile Health & Wellness Unit
• The New Hazard & Emergency Awareness Training (HEAT) Mobile Unit Arrives at WKU
• Gardner, Marilyn. Emergency Medical Services Monograph Coming
• A Nursing Student’s Perspective
• Enhancing Rural Student Postsecondary Decisions
• Lu, Ning & Richard Wilson. Kentuckian Socioecomic Status, Health Behavior, Access to Medical Care, & Health Status
• Austin, Lynn. School-based Dental Sealant Program
• The Institute for Rural Health Development & Research

La Prévention Du Trouble De Stress Posttraumatique Chez Les Employés De Dépanneurs Victimes De Vols À Main Armée, André Marchand, Richard Boyer

Rapports de recherche scientifique

No abstract provided.

Spiritual Function And Its Relationship To Health-Related Quality Of Life In A Population With Chronic Illness, Holly B. Orozco

Loma Linda University Electronic Theses, Dissertations & Projects

The purpose of this study was to determine the association between different aspects of spiritual function (intra- and interpersonal relationships, connectedness to God, and practices) and health-related quality of life, and to determine if perceived spirituality and perceived religiosity were significantly related to spiritual function and health-related quality of life. The study analyzed secondary data collected in the third year of a three year (1997-1999) Ambulatory Care Quality Improvement Project (ACQUIP) of the Veteran's Administration. A sample of 500 male veterans were randomly selected from a larger sub- sample of six Veterans Hospital Administration facilities across the U.S., having one …

Application Of The Traditional Epidemiological Model To Predict Occupational Injury Rates In Manufacturing Industries, Gary A. Morris

Health Services Research Dissertations

This study was designed to test the usefulness of the Traditional Epidemiological Model of disease causation in modeling occupational injury rates and the presence of occupational illness in the manufacturing industry. More specifically, this research involved use of the agent, host, and environment constructs of the Traditional Epidemiological Model to examine the effects of five environmental-related workplace health and safety practices on occupational injury and illness. Data from the National Occupational Exposure Survey (NOES), conducted by the National Institute for Occupational Safety and Health (NIOSH) in 1981–1983, were used to ascertain the presence of specific workplace characteristics and to calculate …

Population Mobility High-Risk Environments And The Diffusion Of Hiv/Stds: A Community Based Study In Southwest China, Hongyun Fu

Sociology & Criminal Justice Theses & Dissertations

Globally, population migration has been associated with the spread ofHIV/STDs in many countries. A similar trend has been observed in China from the very beginning of the HIV epidemic, but empirical research is very limited. Furthermore, the previous studies mainly focused on the micro impact of migration on individual migrant's risky behaviors. The impact of population mobility on the general population, especially on non-migrant residents, has been ignored. Using data collected from a specially designed community level survey, which was conducted in a province in the Southwest of China, this study examines the macro-level association between temporary migration and the …

Predictors Of Oral Health Behaviors: Examining The Effect Of Patient Perceived Humanistic Attitude In The Context Of The Health Belief Model, Linda Leigh Hawkins Carroll

Health Services Research Dissertations

The purpose of this study was to test the explanatory power of The Health Belief Model with the added environmental condition of perceived humanistic attitude of a dental hygienist in its ability to predict individual's performance of oral disease prevention behaviors. A cross section survey of an intact group of 1,943 full time employees of Old Dominion University was conducted. The response rate was 52% (n = 1001). An exclusionary rule eliminated respondents who did not have a dental hygienist provide preventive services during dental visits. Seven hundred and fifty four were included in the study analyses. The study participants …

Transmission Of Mycobacterium Tuberculosis Associated With Failed Completion Of Treatment For Latent Tuberculosis Infection - Chickasaw County, Mississippi, June 1999-March 2002, T. Chamblee, D. Hartley, M. Holcombe, K. Parham, P. Upchurch, R. M. Webb, Alyssa G. Robillard, L. Diem, B. Metchock, N. Deluca, P. D. Mcelroy, T. Navin, W. Walton, P. K. Dewan

Faculty Publications

During June 1999-March 2002, a total of 16 tuberculosis (TB) cases were reported from Chickasaw County, Mississippi (2000 population: 19,440), corresponding to annual TB incidences of 20.5-27.6 cases per 100,000 population. In comparison, annual TB incidences for Mississippi during the same period decreased from 7.8 to 5.4 cases per 100,000 population. This report summarizes the results of an investigation of the patients and their contacts and demonstrates the need for strategies to increase the proportion of infection contacts that successfully complete treatment for latent TB infection (LTBI).

Estimating The Accuracy Of Polymerase Chain Reaction-Based Tests Using Endpoint Dilution, Jim Hughes, Patricia Totten

UW Biostatistics Working Paper Series

PCR-based tests for various microorganisms or target DNA sequences are generally acknowledged to be highly "sensitive" yet the concept of sensitivity is ill-defined in the literature on these tests. We propose that sensitivity should be expressed as a function of the number of target DNA molecules in the sample (or specificity when the target number is 0). However, estimating this "sensitivity curve" is problematic since it is difficult to construct samples with a fixed number of targets. Nonetheless, using serially diluted replicate aliquots of a known concentration of the target DNA sequence, we show that it is possible to disentangle …

Trends. A Casualty Of War: Suicide As A Response To An American-Led Invasion Of Iraq, Ibpp Editor

International Bulletin of Political Psychology

This Trends article discusses the political psychology of suicide as protest.

Political Authority And Social Cognitions On The War On Terrorism With Global Reach: Airport Security, Terrorism Contingent On A United States-Led Attack On Iraq, Smallpox Vaccinations, Ibpp Editor

International Bulletin of Political Psychology

This article presents analyses of three common social cognitions embraced by many representatives of political authority concerning aspects of the war on terrorism with global reach.

Is Community Care A Civil Right? The Unfolding Saga Of The Olmstead Decision, Randy Desonia

National Health Policy Forum

This paper lays the groundwork for understanding the implications of the historic U.S. Supreme Court decision in the case of Olmstead v. L.C., which has far-reaching consequences for the long-term care of people with disabilities. The paper reviews the critical components influencing the case: the Medicaid program’s role in funding community-based long-term care; the Americans with Disabilities Act, which serves as the statutory basis for the decision; and the Court’s legal reasoning. The paper also describes the federal and state responses to the ruling and concludes with a brief discussion of some legal issues that will be debated in the …

Who Will Pay For The Adverse Events Resulting From Smallpox Vaccination? Liability And Compensation Issues, Robin J. Strongin, Eileen Salinsky

National Health Policy Forum

This paper summarizes liability and compensation concerns surrounding the smallpox vaccination program announced by President Bush on December 13, 2002. The paper examines the nature of adverse health events that are likely to occur in connection with the smallpox vaccine, assesses the liability protections that have been established for organizations and individuals participating in the vaccination program, and discusses the compensation mechanisms being considered to address the damages incurred by volunteers who may suffer from adverse vaccine reactions. Specifically, the implications of the Federal Tort Claims Act, workers’ compensation programs, and the creation of a new no-fault compensation fund are …

Two Laborers Die From A Scaffolding Fall Inside A Water Tank, Kentucky Injury Prevention And Research Center

Fatality Case Reports--Falls

Two 20 year-old laborers died after falling approximately 25 feet from suspension scaffolding while preparing the inside of a municipal water tank for painting. Neither laborer was wearing fall personal protection equipment at the time of the fatal incident. The laborers were preparing the inside of a 200,000-gallon water tank for painting when one end of the scaffolding dropped after a support cable slipped. The job foreman arrived at the job site and entered the tank to check on the laborers. He found both laborers on the tank floor. Laborer 1 had respiratory vital signs but Laborer 2 did not. …

Hispanic Worker Dies Due To Trench Cave-In, Kentucky Injury Prevention And Research Center

Fatality Case Reports--Other

On December 3, 2002, a 30-year old Hispanic laborer died when an unsupported 8-foot wall of a trench collapsed on him. Three laborers were working in an unsupported trench when one side caved in, burying one laborer (decedent) and partially burying another Hispanic worker. The third laborer managed to escape the trench unharmed. Two of the laborers were Hispanic, the third was a brother to the owner of the company digging the trench. The coroner pronounced the 30-year old laborer dead at the scene due to asphyxiation.

To prevent similar incidents from occurring, Kentucky Fatality Assessment and Control Evaluation personnel …

Persistence Of Virus-Reactive Serum Immunoglobulin M Antibody In Confirmed West Nile Virus Encephalitis Cases, John T. Roehrig, Denis Nash, Beth Maldin, Anne Labowitz, Denise A. Martin, Robert S. Lanciotti, Grant L. Campbell

Publications and Research

Twenty-nine laboratory-confirmed West Nile virus (WNV) encephalitis patients were bled serially so that WNV-reactive immunoglobulin (Ig) M activity could be determined. Of those patients bled, 7 (60%) of 12 had anti-WNV IgM at approximately 500 days after onset. Clinicians should be cautious when interpreting serologic results from early season WNV IgM-positive patients.

A Cost-Effectiveness Analysis Of A Community-Based Health Promotion Intervention For Adults With Mobility Impairments: Living Well With A Disability, Craig Ravesloot Ph.D., Tom Seekins Ph.D., Catherine Ipsen M.A., Steve Seninger Ph.D., Colleen Murphy-Southwick Ph.D., Lisa Brennan M.L.S., Rita K. Fjeld M.A., Glen W. White Ph.D., Ann Branstetter Ph.D., Vivian Chapman M.A., Amanda Jay M.A., James A. Bovaird M.A., Janet Marquis Ph.D., University Of Montana Rural Institute

Health and Wellness

This document reports on research conducted by the University of Montana and the University of Kansas for the Office of Disability and Health at the Centers for Disease Control and Prevention. The research project, conducted between August 1,1997 and July 31, 2001, was conducted in four separate but related studies. The research was conducted in eight States. We contracted with nine centers for independent living (CIL) to conduct 34 Living Well with a Disability health promotion workshops and to collect outcome measures. These programs included 246 individuals. In the first study, we evaluated the effectiveness and cost outcomes of the …

Introduction Of A Waterless Alcohol-Based Hand Rub In A Long-Term Care Facility, Lona Mody, Mcneil A. Shelly, Rongjun Sun, Bradley Suzanne, Carol A. Kauffman

Sociology & Criminology Faculty Publications

OBJECTIVE:

To examine the impact of introduction of an alcohol-based hand rub on hand hygiene knowledge and compliance and hand colonization of healthcare workers (HCWs) in a long-term-care facility (LTCF).

METHODS:

Two floors of an LTCF participated. Ward A used the hand rub as an adjunct to soap and water; ward B was the control. HCWs' hands were cultured using the bag-broth technique for Staphylococcus aureus, gram-negative bacilli (GNB), Candida, and vancomycin-resistant enterococci (VRE). HCWs completed a questionnaire at baseline and after an educational intervention and introduction of rub.

RESULTS:

Hand hygiene practices, knowledge, and opinions did not change after …

The Jeffcare Preceptor Model For Asthma: A Primary Care Physician Tutorial Training Model, Jeffrey L. Lenow, Robert Bales, Stanton N. Smullens

College of Population Health Faculty Papers

The societal and economic impact of asthma is a well-documented phenomenon in this country. Despite improved knowledge and techniques of care, there have been signs of worsening morbidity/mortality and a seeming disconnect between physician and patients as regards communication of care strategies. In an attempt to fashion innovative educational strategies to enhance primary care physician (PCP) and caregiver efficiencies in improving patient outcomes (clinical and financial), the "Preceptor" model of one-to-one PCP/asthma specialist has been developed. Review of utilization and prescribing data demonstrates a clear pattern of statistically significant cost improvement in the aggregate care setting, as well as improved …

Breast Diseases: A Histopathological Analysis Of 3279 Cases At A Tertiary Care Center In Pakistan, M. S. Siddiqui, Naila Kayani, Shahid Pervez, S. A. Aziz, S. Muzaffar, Z. Setna, M. Israr, S. H. Hasan, M. S. Gill

Department of Pathology and Laboratory Medicine

Objective: To know the frequency of breast diseases in Pakistani females.

Methods: A retrospective analysis of 3279 breast specimens received over a period of 4 years (1 993-1996) at the department of pathology, the Aga Khan University Hospital.

Results: Out of a total of 3279 breast specimens, common breast lesions included infiltrating duct carcinoma 37%, followed by fibro adenoma 16.95%, fibrocystic change13.96%, mastitis 6.83% and duct ectasia 5.33%. Majority of the cases of infiltrating duct carcinoma were encountered in the 5th and 6th decades of life. Tumour size was 2 or >2 cms. in 93% of cases and 40% of …

A Comparative History Of Aids In Latin America: Brazil And Cuba, Shawn Smallman

International & Global Studies Faculty Publications and Presentations

According to a joint report of the World Health Organization and the Pan American Health Organization in September 2002 there were approximately 1.4 million HIV+ people in Latin America, and a further 420,000 HIV+ people in the Caribbean. The number of infections had increased by nearly 10% from the previous year in Latin America, and 16% in the Caribbean. While striking, these figures may obscure the diversity of the HIV epidemic in the region. Latin America has a varied pattern of infections, which means that the experience of Bolivia, Ecuador and Mexico is quite different from that of Honduras, Haiti …

Reasonable Modification Or Fundamental Alteration? Recent Developments In Ada Caselaw And Implications For Behavioral Health Policy, Sara J. Rosenbaum, Joel B. Teitelbaum, D. Richard Mauery, Alexandra M. Stewart

Center for Integrated Behavioral Health Policy

No abstract provided.

Utilization Of Algal And Bacterial Extracellular Polymeric Secretions (Eps) By The Deposit-Feeding Brittlestar Amphipholis Gracillima (Echinodermata), D. L. Hoskins, S. E. Stancyk, Alan W. Decho

Faculty Publications

Like many deposit-feeding organisms, the burrowing brittlestar Amphipholis gracillima feeds on particulate organic matter in surface sediments. Microbial exopolymeric secretions (EPS) are carbohydrate-enriched polymers produced by microalgae and bacteria that bind aggregates and form dense biofilms near the sediment-water interface. EPS are assimilable by some benthic infauna and may be utilized as a significant carbon source. EPS are absorbed by some deposit-feeders, including a holothurian, and may be supplemental sources of nutrition. The burrowing brittlestar A. gracillima is a deposit-feeder that was used in a mass balance approach to model the incorporation of radiolabeled EPS by bottom feeders. Brittlestars were …

Selecting Differentially Expressed Genes From Microarray Experiments, Margaret S. Pepe, Gary M. Longton, Garnet L. Anderson, Michel Schummer

UW Biostatistics Working Paper Series

High throughput technologies, such as gene expression arrays and protein mass spectrometry, allow one to simultaneously evaluate thousands of potential biomarkers that distinguish different tissue types. Of particular interest here is cancer versus normal organ tissues. We consider statistical methods to rank genes (or proteins) in regards to differential expression between tissues. Various statistical measures are considered and we argue that two measures related to the Receiver Operating Characteristic Curve are particularly suitable for this purpose. We also propose that sampling variability in the gene rankings be quantified and suggest using the “selection probability function”, the probability distribution of rankings …

Semiparametric Receiver Operating Characteristic Analysis To Evaluate Biomarkers For Disease, Tianxi Cai, Margaret S. Pepe

UW Biostatistics Working Paper Series

The receiver operating characteristic (ROC) curve is a popular method for characterizing the accuracy of diagnostic tests when test results are not binary. Various methodologies for estimating and comparing ROC curves have been developed. One approach, due to Pepe, uses a parametric regression model with the baseline function specified up to a finite-dimensional parameter. In this article we extend the regression models by allowing arbitrary nonparametric baseline functions. We also provide asymptotic distribution theory and procedures for making statistical inference. We illustrate our approach with dataset from a prostate cancer biomarker study. Simulation studies suggest that the extra flexibility inherent …

Semi-Parametric Regression For The Area Under The Receiver Operating Characteristic Curve, Lori E. Dodd, Margaret S. Pepe

UW Biostatistics Working Paper Series

Medical advances continue to provide new and potentially better means for detecting disease. Such is true in cancer, for example, where biomarkers are sought for early detection and where improvements in imaging methods may pick up the initial functional and molecular changes associated with cancer development. In other binary classification tasks, computational algorithms such as Neural Networks, Support Vector Machines and Evolutionary Algorithms have been applied to areas as diverse as credit scoring, object recognition, and peptide-binding prediction. Before a classifier becomes an accepted technology, it must undergo rigorous evaluation to determine its ability to discriminate between states. Characterization of …

Partial Auc Estimation And Regression, Lori E. Dodd, Margaret S. Pepe

UW Biostatistics Working Paper Series

Accurate disease diagnosis is critical for health care. New diagnostic and screening tests must be evaluated for their abilities to discriminate disease from non-diseased states. The partial area under the ROC curve (partial AUC) is a measure of diagnostic test accuracy. We present an interpretation of the partial AUC that gives rise to a new non-parametric estimator. This estimator is more robust than existing estimators, which make parametric assumptions. We show that the robustness is gained with only a moderate loss in efficiency. We describe a regression modelling framework for making inference about covariate effects on the partial AUC. Such …

Converging On Nursing Home Quality, Lisa Sprague

National Health Policy Forum

This paper looks at nursing home quality initiatives, built around public reporting of quality data, that have been inaugurated by the Centers for Medicare and Medicaid Services and the California HealthCare Foundation. How the projects were developed is explored, along with preliminary indicators of their impact on consumers and providers and likely next steps in their evolution.