Digital Commons Network^™

How Does A Riverine Setting Affect The Lifestyle Of Shellmound Builders In Brazil?, Sabine Eggers, C. C. Petronilho, K. Brandt, C. Jericó-Daminello, J. Filippini, Karl Reinhard

Karl Reinhard Publications

The contact of inland and coastal prehistoric groups in Brazil is believed to have been restricted to regions with no geographical barrier, as is the case in the Ribeira de Iguape valley. The inland osteological collection from the riverine shellmound Moraes (5800–4500 BP) represents a unique opportunity to test this assumption for this region. Despite cultural similarities between riverine and coastal shellmounds, important ecological and site distribution differences are expected to impact on lifestyle. The purpose of this study is thus to document and interpret health and lifestyle indicators in Moraes in comparison to coastal shellmound groups. Specifically we test …

The Std – Hiv Connection: Deficiencies In Knowledge And Practice Patterns Among Family Physicians And Gynecologists

Florida Public Health Review

Previous studies have shown suboptimal compliance with the Centers for Disease Control and Prevention recommendations for HIV testing in patients with sexually-transmitted disease (STDs). However, the literature is especially sparse with respect to family physicians and gynecologists in private practice. Further, there are no data regarding knowledge among these physicians of the causative relationship between STDs and HIV. All family physicians (238) and gynecologists (131) in private practice in Broward County, Florida were anonymously surveyed for their knowledge of the connection between STDs and HIV and to determine if they translated this into practice. Responses from 57 family physicians and …

College Students’ Knowledge About Meningococcal Disease And Preferences For Health Information

Florida Public Health Review

The purpose of this study was to measure college students’ knowledge about meningococcal disease, preferred sources of health information, and vaccine intentions. Participants included 519 students taking online undergraduate courses in public health. We developed and administered a brief, ten-question online survey, which was posted on BlackBoard®. Students demonstrated a high level of knowledge about risk factors for meningococcal disease, but reported a need for more information, preferably delivered through electronic media. About a third of students had received the meningococcal vaccine prior to the survey; students who lived on campus were more likely to be vaccinated. Further research is …

A Concentrated Look At Hiv/Aids: Transmission To Low Risk Women Through Intravenous Drug Users And Female Sex Workers In Da Nang City, Vietnam, Danielle A. Depeau

Independent Study Project (ISP) Collection

Female sex workers (FSW) and intravenous drug users (IDU) whom were living in Da Nang City, Vietnam, along with the women and children associated with these individuals, were interviewed to study the effects of Human Immunodeficiency Virus (HIV) and Acquired Immune Deficiency Syndrome (AIDS). In addition, an understanding how the epidemic was spreading from high-risk populations to the general population was explored. This was achieved by learning the history of sexual behaviors in regards to sexual partners and regularity of condom use, as well as drug injection practices, HIV/AIDS education, treatment, gender status and socio-demographic characteristics.

Informal interviews were conducted …

Economics, Epidemics & Eradication: A Case Study Of Malaria In Madagascar, Kathleen Minton

Independent Study Project (ISP) Collection

Despite effective techniques for preventing and treating malaria, the malaria burden in Madagascar remains quite high, particularly in rural areas where poor villagers are more isolated from health services, and less likely to be able to afford prevention methods or treatment. In response to this challenge, Madagascar’s government has made malaria eradication a high priority, stating that it hopes to reduce the incidence of malaria from its current level of 1,234,520 to 320,000 by 2012, and to eliminate the disease entirely by 2018. Ultimately, though, it remains to be seen if their efforts will be sufficient to meet these ambitious …

The Integration Of Traditional And Western Medicine In Ngaoundéré, Cameroon, Alison Hardy

Independent Study Project (ISP) Collection

The purpose of this study was to examine how patients in Ngaoundéré Cameroon integrate traditional and Western medicine, and how they perceive such integration on the part of their health care providers. Interviews were conducted with thirty-five patients of the Hôpital Provincial and of traditional medical practitioners in the neighbourhood of Yarmbang. Both modern and traditional health care providers were also interviewed. Patients generally believe that the two types of medicine have different strengths related to cost, accessibility, accuracy of diagnosis and treatment, ability to treat certain illnesses, and practitioners’ understanding of patients’ culture. Patients decide whether to use modern …

Outcomes Of Safety And Effectiveness In A Multicenter Randomized, Controlled Trial Of Whole-Body Hypothermia For Neonatal Hypoxic-Ischemic Encephalopathy, Seetha Shankaran, Athina Pappas, Abbott R Laptook, Scott A Mcdonald, Richard A Ehrenkranz, Jon E Tyson, Michelle Walsh, Ronald N Goldberg, Rosemary D Higgins, Abhik Das

Faculty, Staff and Student Publications

BACKGROUND: Whole-body hypothermia reduced the frequency of death or moderate/severe disabilities in neonates with hypoxic-ischemic encephalopathy in a randomized, controlled multicenter trial.

OBJECTIVE: Our goal was to evaluate outcomes of safety and effectiveness of hypothermia in infants up to 18 to 22 months of age.

DESIGN/METHODS: A priori outcomes were evaluated between hypothermia (n = 102) and control (n = 106) groups.

RESULTS: Encephalopathy attributable to causes other than hypoxia-ischemia at birth was not noted. Inotropic support (hypothermia, 59% of infants; control, 56% of infants) was similar during the 72-hour study intervention period in both groups. Need for blood transfusions …

Impact Of Chlamydia And Gonorrhea In Georgia: An Urban / Rural Comparison (2000-2004), Swati Raychowdhury, Stuart H. Tedders, Sarah K. Jones

Journal of the Georgia Public Health Association

Background: In 2005, 33,562 cases of chlamydia and 15,860 cases of gonorrhea were reported in the State of Georgia, respectively corresponding to 3.4% and 4.7% of all cases reported nationally (CDC, 2005). Disparities of infection with respect to race and gender are evident for both diseases. The objective of this study was to determine the magnitude of chlamydia and gonorrhea in rural Georgia compared to urban areas of the state.

Methods: County level data necessary for analysis were acquired using the Georgia Division of Public Health’s Online Analytical Statistical Information System database (GDHR, 2007). Rates of infection by gender and …

Assessing The Validity Of Statistical Inferences In Public Health Research: An Evidence-Based, ‘Best-Practices’ Approach, Karl E. Peace, Anthony V. Parrillo, Charles J. Hardy

Journal of the Georgia Public Health Association

Like many fields, public health has embraced the process of evidence-based practice to inform practice decisions and to guide policy development. Evidence-based practice is typically dependent upon generalizations made on the bases of the existing body of knowledge – assimilations of the research literature on a particular topic. The potential utility of scientific evidence for guiding policy and practice decisions is grounded in the validity of the research investigations upon which such decisions are made. However, the validity of inferences made from the extant public health research literature requires more than ascertaining the validity of the statistical methods alone; for …

Impact Of Haemophilus Influenzae Type B Conjugate Vaccine On Bacterial Meningitis In The Dominican Republic, Ellen H. Lee, Miriam Corcino, Arelis Moore De Peralta, Zacarias Garib, Chabela Peña, Jacquelin Sánchez, Josefina Fernández, Jesús M. Feris-Iglesias, Brendan Flannery

Publications

OBJECTIVES:

Widespread use of Haemophilus influenzae type b (Hib) vaccines has dramatically reduced the burden of Hib disease throughout the Americas. Few studies have evaluated the impact of Hib vaccination on non-culture-confirmed disease. This study analyzed trends in probable bacterial meningitis before and after the introduction of Hib vaccine in the Dominican Republic and estimated vaccine effectiveness against Hib meningitis.

METHODS:

Meningitis cases among children < 5 years of age were identified from admission records of the main pediatric hospital in Santo Domingo during 1998-2004. Laboratory criteria were used to classify meningitis cases with probable bacterial etiology; confirmed cases had positive bacterial culture or antigen detection in cerebrospinal fluid. Cumulative incidence rates of confirmed and probable bacterial meningitis were calculated for children living in the National District. Confirmed cases of Hib meningitis were enrolled in a case-control study with age- and neighborhood-matched control children to calculate vaccine effectiveness.

RESULTS:

Before vaccine introduction, annual rates of meningitis with probable bacterial etiology were 49 cases per 100 000 children < 5 years old; Hib accounted for 60% of confirmed bacterial cases. During 2002-2004, after vaccine introduction, annual rates of probable bacterial meningitis were 65% lower at 16 cases per 100 000, and Hib accounted for 26% of confirmed cases. Rates of Hib meningitis and probable bacterial meningitis with no determined etiology declined by 13 and 17 cases per 100 000, respectively.

CONCLUSIONS:

Introduction of Hib vaccine substantially reduced the incidence of confirmed and probable bacterial meningitis in …

Gastric Cancer Among American Indians And Alaska Natives In The United States, 1999–2004, Charles Wiggins, David G. Perdue, Jeffrey A. Henderson, Michael G. Bruce, Anne P. Lanier, Janet J. Kelly, Brenda F. Seals, David K. Espey

United States Public Health Resources

BACKGROUND. Gastric cancer incidence rates for American Indians and Alaska Natives (AI/ANs) historically have exceeded those for non-Hispanic whites (NHWs). Previous reports may have underestimated the true burden of gastric cancer in AI/AN populations because of misclassification of AI/AN race in cancer registries.

METHODS. Population-based cancer registry data from 1999 through 2004 were used to describe gastric cancer incidence in AI/ANs and NHWs in the US. To address misclassification of race, registry data were linked with Indian Health Service administrative records, and analyses were restricted to residents of Contract Health Service Delivery Areas (CHSDA). Disease patterns were assessed …

Shea/Apic Guideline: Infection Prevention And Control In The Long-Term Care Facility, Philip W. Smith, Gail Bennett, Suzanne Bradley, Paul Drinka, Ebbing Lautenbach, James Marx, Lona Mody, Lindsay Nicolle, Kurt Stevenson

United States Department of Veterans Affairs: Publications

Long-term care facilities (LTCFs) may be defined as institutions that provide health care to people who are unable to manage independently in the community.¹ This care may be chronic care management or short-term rehabilitative services. The term nursing home is defined as a facility licensed with an organized professional staff and inpatient beds that provides continuous nursing and other services to patients who are not in the acute phase of an illness. There is considerable overlap between the 2 terms.

More than 1.5 million residents reside in United States (US) nursing homes. In recent years, the acuity of illness …

Gender Differences In The Risk Of Hiv Infection Among Persons Reporting Abstinence, Monogamy, And Multiple Sexual Partners In Northern Tanzania, Keren Z. Landman, Jan Ostermann, John A. Crump, Anna Mgonja, Meghan K. Mayhood, Dafrosa K. Itemba, Alison C. Tribble, Evaline M. Ndosi, Helen Y. Chu, John F. Shao, John A. Bartlett, Nathan M. Thielman

Faculty Publications

Background: Monogamy, together with abstinence, partner reduction, and condom use, is widely advocated as a key behavioral strategy to prevent HIV infection in sub-Saharan Africa. We examined the association between the number of sexual partners and the risk of HIV seropositivity among men and women presenting for HIV voluntary counseling and testing (VCT) in northern Tanzania.

Methodology/ Principal Findings: Clients presenting for HIV VCT at a community-based AIDS service organization in Moshi, Tanzania were surveyed between November 2003 and December 2007. Data on sociodemographic characteristics, reasons for testing, sexual behaviors, and symptoms were collected. Men and women were categorized by …

Strong As The Weakest Link: Medical Response To A Catastrophic Event, Eileen Salinsky

National Health Policy Forum

Natural disasters and acts of terrorism have placed a spotlight on the ability of health care providers to surge in response to catastrophic conditions. This paper reviews the status of efforts to develop the capacity and capabilities of the health care system to respond to disasters and other mass casualty events. Strategies for adapting routine medical practices and protocols to the demands posed by extraordinary circumstances and scarce resources are summarized. Existing federal roles, responsibilities, and assets relative to the contributions of state and local government and the private sector are described, including specific programmatic activities such as the Strategic …

The Association Of Maternal Intention To Breastfeed, Early Skin-To-Skin Mother/Infant Contact, And Exclusive Breastfeeding During The Maternity Hospital Stay, Leslie Mary Bramson

Loma Linda University Electronic Theses, Dissertations & Projects

Breastfeeding is the optimal method to nourish and nurture an infant. Exclusive breastfeeding rates in the United States have reached the goal of Healthy People 2010 that 75% of mother's breastfeed in the immediate postpartum period. Yet, less than 35% of San Bernardino county mothers and 47.7% of Riverside county mothers are exclusively breastfeeding during their maternity hospital stays, with as many as 50% of the infants being weaned from the breast in the first 14 days of life.

This prospective study examined archived data collected by Perinatal Services Network (PSN) of Loma Linda University Medical Center/Children's Hospital for the …

Knowledge, Awareness And Practices Regarding Dengue Fever Among The Adult Population Of Dengue Hit Cosmopolitan., Ahmed Itrat, Abdullah Khan, Sunniya Javaid, Mahwash Kamal, Hassan Khan, Sannia Javed, Saira Kalia, Adil Haleem Khan, Muhammad Imran Sethi, Imtiaz Jehan

Community Health Sciences

Background: The World health Organization (WHO) declares dengue and dengue hemorrhagic fever to be endemic in South Asia. Despite the magnitude of problem, no documented evidence exists in Pakistan which reveals the awareness and practices of the country's adult population regarding dengue fever, its spread, symptoms, treatment and prevention. This study was conducted to assess the level of knowledge, attitudes and practices regarding dengue fever in people visiting tertiary care hospitals in Karachi, Pakistan.
Methods: A cross-sectional pilot study was conducted among people visiting tertiary care hospitals in Karachi. Through convenience sampling, a pre-tested and structured questionnaire was administered through …

Thomas Jefferson University-Annual Report-2008, Robert L. Barchi, Md, Phd, Brian G. Harrison

Thomas Jefferson University Administrative Documents and Reports

No abstract provided.

Cities Of Consumption: The Impact Of Corporate Practices On The Health Of Urban Populations, Nicholas Freudenberg, Sandro Galea

Publications and Research

The increasing concentration of the world's population in cities and the growing accumulation of political and economic power by corporations create new threats to health and opportunities for improving global health. By considering the intersection of these two fundamental social determinants of well-being, we elucidate some of the mechanisms by which they influence the health of urban populations. After reviewing the changing historical impact of corporations on cities, we focus on the growth of consumption as a leading cause of mortality and morbidity and describe how the food, tobacco, automobile, and other industries promote unhealthy behaviors and lifestyles in urban …

Profile And Trends Of Hiv-Infected Patients Who Use Health Department Services In Hillsborough County, Florida

Florida Public Health Review

The Hillsborough County Health Department (HCHD) provides care for one-third of persons living with HIV/AIDS in Hillsborough County, Florida, who relied on public assistance for medical treatment. This study describes the demographic profile and trends for these patients. Data were obtained retrospectively from the HCHD’s electronic database for 2,298 patients who enrolled for HIV/AIDS care between January 1, 2000 and December 31, 2006. The patient sample included 32.6% women, 48.7% African Americans, 19.0% Hispanics, and 30.9% Whites, with mean age 39.7 ± 9.6 years. The proportion of Hispanic enrollees increased annually (p<0.001), exceeding the Hispanic population growth rate in Hillsborough county during that same period (p=0.006). African Americans and Hispanics were more likely to have AIDS at enrollment (p<0.001). Minority women were much more likely to rely on this public-assisted HIV care compared with White female patients. Minority enrollees were also more likely to have AIDS at enrollment to the service. Nearly 98% of patients depended on government-funded health insurance. Whereas the coverage of the Ryan White increased, Medicaid and Medicare decreased for all ethnic groups (p<0.001). The rapid increase in Hispanic enrollment, the increasing dependence on the Ryan White funding, and ethnicity-gender disparities require further investigations. Monitoring demographic profiles and trends of this underserved patient cohort helps the health department assess service needs and effectively allocate existing resources to better serve this HIV-infected population.

Papanicolaou Test In An Urban Std Clinic: The Good And Bad News

Florida Public Health Review

The objective of the study was to review Pap test results and follow-ups in an urban sexually transmitted disease clinic in Miami, Florida. We reviewed the results of all Pap tests conducted in the clinic during 2005. All the samples were processed by a single commercial laboratory. We attempted to contact clients with abnormal results other than inflammation to return to the clinic. Results: of the 849 samples, 622 (73.3%) were normal, 211 (24.8%) were abnormal (inflammation 76 (9.0%), ASCUS 68 (8%), and LGSIL or higher 64 (7.5%), and 16 (1.9%) were considered unsatisfactory for cytological interpretation. We were able …

Hiv Risk Among Nursing Students In Rwanda : Self-Efficacy, Knowledge And Attitudes, Jacqueline Wosinski

Loma Linda University Electronic Theses, Dissertations & Projects

Acquired immune deficiency syndrome (AIDS) is the leading cause of death in sub-Saharan Africa. With a prevalence rate of 3.1% in 2006, Rwanda is one of the hardest hit countries. Nurses are often the leading health professionals in rural communities and at the forefront of the fight against the HIV pandemic. Little has been written on how nurses are prepared to intervene successfully along the continuum of HIV prevention and care. A mixed-methods sequential exploratory approach was used to explore this question.

In the first phase, cognitive, socio-psychological, and environmental factors of nursing education in Rwanda in regard to HIV …

Partner Communication And Factors Associated With The Decision To Obtain An Hiv Test Among Chinese/Chinese American Community College Students In Northern California, Sang Leng Trieu

Loma Linda University Electronic Theses, Dissertations & Projects

HIV testing and counseling is considered the cornerstone of a comprehensive approach to HIV prevention and education. Little is known, however, about HIV prevention, including HIV testing rates for Asian Pacific Islander (API) women, because data for this ethnic group is aggregated, thus limiting specific data for Chinese/Chinese American population or other API subgroups. This dissertation research examined factors associated with the decision to obtain an HIV test among Chinese/Chinese American community college women and explored the association among relationship status, partnership communication, and discussions of HIV testing.

Using constructs of the health belief model, an online and paper-pencil, crosssectional …

Doubly Robust Ecological Inference, Daniel B. Rubin, Mark J. Van Der Laan

U.C. Berkeley Division of Biostatistics Working Paper Series

The ecological inference problem is a famous longstanding puzzle that arises in many disciplines. The usual formulation in epidemiology is that we would like to quantify an exposure-disease association by obtaining disease rates among the exposed and unexposed, but only have access to exposure rates and disease rates for several regions. The problem is generally intractable, but can be attacked under the assumptions of King's (1997) extended technique if we can correctly specify a model for a certain conditional distribution. We introduce a procedure that it is a valid approach if either this original model is correct or if we …

The Changing Role Of Physicians In Disaster Management And Hospital Incident Command, F. Matthew Mihelic, M. David Stockton, Stephen A. Cole, Gregory H. Blake

Faculty Publications

Recent changes in governmental policy toward disaster medicine and hospital incident command foreshadow a significant change in the role that physicians will play in disaster preparedness and response. The distinct discipline of Disaster Medicine has received authoritative recognition and promotion in the recent Homeland Security Presidential Directive 21, and recently established guidelines for incident command within hospitals have included a new position designated as “Medical/Technical Specialist(s)” that will assist the Incident Commander in disaster-related decision-making. This is a multidisciplinary position, and its functions can be filled by one or more individuals. As physician training and competency in Disaster Medicine increases, …

Socioeconomic Determinants Of Hiv Status In Kenya, Kimberly Fletcher

Masters Theses & Specialist Projects

The spread of Human Immunodeficiency Virus (HIV) is one of the greatest threats to stability and development in Kenya. The country's infection rate is estimated between seven and eight percent, making it one of the highest in the world. Several studies have been done that examine subpopulations such as truck drivers, sex workers, and migrants. However, to date there is little research that examines who, across the country, is contracting HIV. Kenya's 2003 Demographic and Health Survey includes data that make it possible to determine which groups have the highest odds of being infected. The question of who is contracting …

Predictors Of Depressive And Anxiety Symptoms Among African American Hiv-Positive Women, Nina Katherine Sublette

Theses and Dissertations (ETD)

This descriptive correlation study had four purposes: describe depressive and anxiety symptom levels in pregnant and non-pregnant African American (AA) HIV-positive women, examine the association between underlying vulnerabilities and depressive symptoms in HIV-positive AA women, determine the association between underlying vulnerabilities and anxiety symptoms in AA HIV-positive women, and determine the predictors of depressive and anxiety symptoms among African American HIV-positive women. A convenience sample of 80 African American HIV-positive women was recruited from university-based obstetrics/-gynecology and infectious disease practices in a large metropolitan city in the Mid-South. Depressive symptoms were measured with the Center for Epidemiologic Studies Depression Scale …

The Complexity Of Re-Evaluating Antiretroviral Therapy Eligibility Guidelines For Hiv/Aids Patients In Uganda, Jennifer Klein

Independent Study Project (ISP) Collection

When I first learned that the eligibility criteria for Antiretroviral Drugs (ARVs) in Uganda is to have a CD4 cell count of 200 or below, I was shocked. Actually, I think my exact response was, “So patients must have full-blown AIDS, severely weakened immune systems, and may be on their deathbeds before they can receive the drugs?” I knew little of the subject, other than that in the United States HIV-positive patients who are on drugs may avoid many of the opportunistic infections and complications that come from delaying treatment until the CD4 count is low. My initial confusion over …

Taming The Mind: Current Mental Health Treatments And Obstacles To Expanding The Western-Model In A Tibetan Exile Community, Dylan Brock

Independent Study Project (ISP) Collection

No abstract provided.

Tetanus And Rabies Eradication In Pakistan; A Mission Not Impossible, Mohammad Wasay, Ismail A. Khatri, Naseem Salahuddin

Department of Medicine

No abstract provided.

Basis For Treatment Of Tuberculosis Among Hiv-Infected Patients In Tanzania: The Role Of Chest X-Ray And Sputum Culture, Muhammad Bakari, Robert D. Arbeit, Lillian Mtei, Johnson Lyimo, Richard Waddell, Mecky Matee, Bernard F. Cole, Susan Tvaroha

Dartmouth Scholarship

Active tuberculosis (TB) is common among HIV-infected persons living in tuberculosis endemic countries, and screening for tuberculosis (TB) is recommended routinely. We sought to determine the role of chest x-ray and sputum culture in the decision to treat for presumptive TB using active case finding in a large cohort of HIV-infected patients. Ambulatory HIV-positive subjects with CD4 counts ≥ 200/mm3 entering a Phase III TB vaccine study in Tanzania were screened for TB with a physical examination, standard interview, CD4 count, chest x-ray (CXR), blood culture for TB, and three sputum samples for acid fast bacillus (AFB) smear and culture.