Digital Commons Network^™

Mainecare Managed Care Performance Report 2003, Catherine Ormond, Stuart Bratesman

Disability & Aging

No abstract provided.

Ua61/6 Newsletter Issue 4, Wku Institute For Rural Health Development & Research

WKU Administration Documents

Newsletter created by and about the Institute for Rural Health Development & Research. This issue contains:

• Simpson, Staci. Letter from the Director
• Institute for Rural Health Development & Research Impact Statement
• Mobile Health Unit Conference Attended
• WKU Mobile Health & Wellness Unit
• Kentucky State Fair Project
• Health House of Horrors
• Wilson, Richard. Faculty Presents at American Public Health Association Conference
• New Interdisciplinary Program: WellWorks
• Health Fair Event for Migrant Workers Held
• Local Interventions to Encourage the Enhancement of the Health of the Rural Elderly
• Jones, Susan. Predicting the Use of Personal Respiratory Protection Among Workers in Swine Confinement Buildings
• The …

Assessment Of A Body Composition-Focused Approach To Obesity Treatment, Beverly D. Hall

Loma Linda University Electronic Theses, Dissertations & Projects

Obesity is a significant United States’ public health concern. However, high relapse rates continue to be a problem for obesity treatment programs while the focus remains on weight loss, not body composition change. This study examined whether a clinic-based obesity treatment program, focused on body composition change through resistance training, lead to improved body composition, exercise behaviors, and attitude change from focus on weight loss to body composition change. Improvements in self efficacy, outcome expectations and stages of change were also examined. Forty-eight physician-referred overweight or obese adult women (mean body fat 41%, SD = 6.65%), completed assessments and questionnaires …

Lower Extremity Muscle Strength And Risk Of Self-Reported Hip Or Knee Osteoarthritis, Jennifer M. Hootman, Shannon J. Fitzgerald, Carol A. Macera, Steven N. Blair

Faculty Publications

Purpose: The purpose of this study was to investigate the gender-specific longitudinal association between quadriceps strength and self-reported, physician-diagnosed hip or knee osteoarthritis (OA).

Methods: Subjects were 3081 community-dwelling adults who were free of OA, joint symptoms and injuries, completed a maximum treadmill exercise test, had isokinetic knee extension and flexion and isotonic leg press strength measurements taken at baseline and returned at least one written follow-up survey. Multivariate logistic regression was used to estimate odds ratios and 95% confidence intervals.

Results: Women with moderate or high isokinetic quadriceps strength had a significantly reduced risk (55% to 64%) of hip …

Descriptive And Comparative Study Of The Nutritional Knowledge And Behavior Of Mothers Of Young Children Who Have Received Targeted Nutritional Education And Those Who Have Not As A Method To Ascertain The Effectiveness Of The Little Tree Nutritional And Educational Centre In Combating Malnutrition In The Pienaarsig Township Of Nieu Bethesda, Eastern Cape Province, South Africa, Amelia Peterson

Independent Study Project (ISP) Collection

No abstract provided.

Indigenous Healing Practices And Their Effect On Tb And Hiv/Tb Patients’ Utilization And Compliance With Anti-Tb Medication, Josephine Thinwa

Independent Study Project (ISP) Collection

A sample of 27 Tuberculosis patients attending New Brighton Clinic in small urban community for treatment were surveyed and interviewed on their use of alternative treatments and interpretation of TB. This study specifically focused on TB patients’ use of traditional medicine in treating TB and whether this use had an effect on the patients’ willingness to utilize and adherence to anti-TB treatment from the clinic. Investigations were also done to characterize if an HIV positive status influenced TB patients’ inclination to utilize traditional medicine. Through a focus group discussion with three traditional healers, information was provided on traditional medicine and …

Cervical Cancer Screening In Rural South Africa: An Analysis Of The Awareness, Attitudes, And Practices Of Women Served By The Masincedane Clinic, Jordan Schneider

Independent Study Project (ISP) Collection

The aim of this study was to conduct a brief investigation into the awareness, attitudes and practices regarding cervical cancer among women living in Keiskammahoek, a rural area in the Eastern Cape of South Africa. The objectives of this study were to:

• Determine if screening is available within a localized rural community and the methods that are being used.

• Determine if women are coming in for screening, the demographics of these women, and the circumstances that bring them into PHC clinics.

• Investigate the level of knowledge and education about cervical cancer and prevention among women within the …

Pediatric Obesity: Intervention Outcomes, Kristy Anne Kuehfuss

Loma Linda University Electronic Theses, Dissertations & Projects

Childhood obesity is a national epidemic with serious medical and psychological implications. Almost one-fourth of children in the United States are overweight. Children do not typically grow out of obesity and without intervention the majority of overweight children become overweight adults. Further, childhood obesity results in numerous chronic medical conditions. Thus, the prevention and treatment of childhood obesity are paramount to the avoidance of resultant physical and psychological risk factors. Loma Linda University’s Growing Fit Program seeks to serve the critical and urgent needs of the ever-increasing population of obese children with a multi-disciplinary approach to pediatric weight management. Evaluating …

Fundamentals Of Community Health Centers, Jessamyn Taylor

National Health Policy Forum

This background paper examines the dominant model of federal grant funding for primary care in the health care safety net: the community health center. It describes the history of the health center program and highlights key policy issues influencing health centers, such as Medicaid payment policies and medically underserved area designations. The paper also examines the recent presidential initiative to expand health centers, including a review of the process used to identify new grantees, an assessment of remaining gaps in capacity, an exploration of continuing challenges, and a discussion of unresolved policy questions.

Tick-Tock: Preparing For The Next Influenza Pandemic, Eileen Salinsky

National Health Policy Forum

This paper describes the nature of pandemic influenza and highlights key challenges for responding to this disease threat. It explains how an influenza pandemic would differ from annual influenza outbreaks and examines how a pandemic virus could emerge. It also explores important issues involved in pandemic preparedness capabilities, including disease surveillance, vaccine production and distribution, antiviral stockpiling, health care system readiness, and public health containment measures. The national pandemic preparedness plan is briefly reviewed, and unresolved policy issues related to the plan’s implementation are identified.

Body Image, Emotional Regulation, And Binge Eating In Obese Females, Courtney D. Stahl

All-Inclusive List of Electronic Theses and Dissertations

Individuals with binge eating disorder (BED) tend to endorse significant overconcerns with weight and shape and a greater propensity to eat in response to negative mood states. The primary aim of this study was to examine the impact of body image disturbance on the self-regulation of affect in female obese non-binge (n=46) and binge eaters (n=l09). Groups were similar in age (M=46.3) and race (84% Caucasian). Obese non-binge eaters were significantly less obese (BMI=35.50) than their binge eating counterparts (BMI=38.60). On the Multidimensional Body Self-Relations Questionnaire (MBSRQ), obese binge eaters endorsed significantly higher levels of body dissatisfaction, greater feelings of …

Health Education’S New Frontier In Addressing Corporate Influences On Health: An Interview With Nicholas Freudenberg, Nicholas Freudenberg, Ellen Jones, Lori Dorfman

Publications and Research

Nick Freudenberg is Distinguished Professor of Public Health at Hunter College, City University of New York. For the past 25 years, he has worked with community organizations to develop, implement, and evaluate community interventions to improve the well-being of low-income urban communities. He has also worked for many years in the New York City jail, running programs to improve the transition from jail to the community, and advocating for policy changes related to jail conditions and postrelease drug treatment, health care, and housing. More recently, he has turned his attention to the role of corporate policies and practices on the …

Living Well And Medicaid: Better Health For Consumers -- Lower Costs For States, Craig Ravesloot Ph.D., University Of Montana Rural Institute

Health and Wellness

The United States has the world’s most expensive healthcare system. In 2002, health spending rose to nearly 15 percent of U.S. Gross Domestic Product. Healthcare policymakers charged with balancing cost containment with quality healthcare for consumers are desperate for solutions (Levit, Smith, Cowan, Sensenig, and Catlin, 2004).

Defining Accelerometer Thresholds For Activity Intensities In Adolescent Girls, Margarita S. Treuth, Kathryn H. Schmitz, Diane J. Catellier, Robert G. Mcmurray, David M. Murray, Maria João C. A. Almeida, Scott Going, James E. Norman, Russell R. Pate

Faculty Publications

Purpose - To derive a regression equation that estimates metabolic equivalent (MET) from accelerometer counts, and to define thresholds of accelerometer counts that can be used to delineate sedentary, light, moderate, and vigorous activity.

Methods - Seventy-four healthy 8th grade girls, age 13-14 yr, were recruited from urban areas of Baltimore, MD, Minneapolis/St. Paul, MN, and Columbia, SC, to participate in the study. Accelerometer and oxygen consumption (VO₂) data for 10 activities that varied in intensity from sedentary (e.g., TV watching) to vigorous (e.g., running) were collected. While performing these activities, the girls wore two accelerometers, a heart …

Cancer Esophagus Karachi 1995-2002:Epidemiology, Risk Factors And Trends, Y. Bhurgri, N. Faridi, L. A.G. Kazi, S. K. Ali, H. Bhurgri, A. Usman, J. Malik, A. Bhurgri, R. Ahmed, S. Muzaffar, N. Kayani, Shahid Pervez, S. H. Hasan

Department of Pathology and Laboratory Medicine

Objective: To study the trends of cancer esophagus in Karachi South during 1995-2002 and identify risk factors.

Methods: Incident esophageal cancer cases recorded at the Karachi Cancer Registry for Karachi South, during 1st January 1995 to 31st December 2003 were reviewed. For maximum completion of data, incident cases registered from 1st January 1995 to 31st December 2002 were included for final analyses.

Results: The Age Standardized Incidence Rates (ASIRs) of cancer esophagus in Karachi South for males were 6.5/100,000 (1995-1997) and 6.4/100,000 (1998-2002). In females the observed rates were 7.0/100,000 (1995-1997) and 8.6/100,000 (1998-2002).

Conclusion: In the moderately high incidence, …

Anemia And Blood Transfusion In The Critically Ill Patient: Role Of Erythropoietin, Howard L. Corwin

Dartmouth Scholarship

Critically ill patients receive an extraordinarily large number of blood transfusions. Between 40% and 50% of all patients admitted to intensive care units receive at least 1 red blood cell (RBC) unit during their stay, and the average is close to 5 RBC units. RBC transfusion is not risk free. There is little evidence that 'routine' transfusion of stored allogeneic RBCs is beneficial to critically ill patients. The efficacy of perioperative recombinant human erythropoietin (rHuEPO) has been n demonstrated in a variety of elective surgical settings. Similarly, in critically ill patients with multiple organ failure, rHuEPO therapy will also stimulate …

Effects Of A Tailored Follow-Up Intervention On Health Behaviors, Beliefs, And Attitudes, Alissa D. Jacobs, Alice S. Ammerman, Susan T. Ennett, Marci K. Campbell, Katherine W. Tawney, Semra Aytur, Stephen W. Marshall, Julie C. Will, Wayne D. Rosamond

Health Management & Policy

Background: The high rates of relapse that tend to occur after short-term behavioral interventions indicate the need for maintenance programs that promote long-term adherence to new behavior patterns. Computer-tailored health messages that are mailed to participants or given in brief telephone calls offer an innovative and time-efficient alternative to ongoing face-to-face contact with healthcare providers.

Methods: Following a 1-year behavior change program, 22 North Carolina health departments were randomly assigned to a follow-up intervention or control condition. Data were collected from 1999 to 2001 by telephone-administered surveys at preintervention and postintervention for 511 low-income, midlife adult women enrolled …

The Association Of Blood Type On The Five Factors Of Personality In Chinese Adolescents, Kunher Wu

Loma Linda University Electronic Theses, Dissertations & Projects

The purpose of this study was to identify the number of personality factors in Chinese adolescents using the Chinese Revised NEO Personality Inventory (NEO-PI-R) and to determine whether blood type is associated with personality. It is widely accepted by psychologists that the five-factor model can provide an adequate representation of adult personality dimensions, but there is less agreement on the number of factors observable in adolescence. A total of 3,396 11^th graders from the city of Kaohsiung, Taiwan completed the Chinese NEO-PI-R. Principle component analysis with varimax rotation showed five factors of personality in these Taiwanese adolescents, which clearly …

The Anti-Proliferation Effects Of Lycopene On Breast Cancer Cells, Tixieanna Dissmore

Loma Linda University Electronic Theses, Dissertations & Projects

Background: The incidence and deaths from breast cancer represent the most cause of all cancer deaths among women. Lycopene, the carotenoid in tomatoes has been associated with decreasing risk of prostate, breast, and digestive tract cancers. Various mechanisms of lycopene action have been proposed, including antioxidant activity and pro-differentiation activities. Identifying changes in the expression of proteins modified by lycopene can provide information to study the modulating effects of lycopene carcinogenesis and tumorigenesis development.

Objective: The objective was to study the anti-proliferative effects of lycopene on MCF- 7 human breast cancer cells and to identify changes in protein expression patterns. …

The Economics Of Quality: Changing Incentives In Cincinnati, Lisa Sprague, Nora Super

National Health Policy Forum

This site visit focused on private market dynamics and quality improvement initiatives. Cincinnati is characterized by strong players in all sectors of the market: employers such as Procter and Gamble and General Electric, hospital systems, health plans, and physician groups with the power to “push back” in contract negotiations. The city is a pilot site for Bridges to Excellence, a pay-for-performance initiative spearheaded by GE. Cincinnati Children’s Hospital Medical Center is a grantee under the Robert Wood Johnson Foundation’s Pursuing Perfection program. Among the issues explored were physician supply, incentive structures, specialty hospitals, and information technology.

Medicare's Chronic Care Improvement Pilot Program: What Is Its Potential?, Nora Super

National Health Policy Forum

This paper describes the voluntary chronic care improvement program under traditional fee-for-service Medicare as authorized by the Medicare Prescription Drug, Improvement, and Modernization Act (MMA) of 2003 (Public Law 108-173; section 721). This brief analyzes the emerging issues raised by this new program, including which chronic conditions and regional areas will be targeted, the types of entities that may participate, the physician’s role in care management, and the adoption and use of health information technology and evidence-based clinical guidelines.

Cost Analysis Of The Built Environment: The Case Of Bike And Pedestrian Trials In Lincoln, Neb, Guijing Wang, Caroline A. Macera, Barbara Scudder-Soucie, Tom Schmid, Michael Pratt, David Buchner, Gregory Heath

United States Public Health Resources

We estimated the annual cost of bike and pedestrian trails in Lincoln, Neb, using construction and maintenance costs provided by the Department of Parks and Recreation of Nebraska. We obtained the number of users of 5 trails from a 1998 census report. The annual construction cost of each trail was calculated by using 3%, 5%, and 10% discount rates for a period of useful life of 10, 30, and 50 years. The average cost per mile and per user was calculated.
Trail length averaged 3.6 miles (range=1.6–4.6 miles). Annual cost in 2002 dollars ranged from $25 762 to $248479 (mean=$124927; …

Monitoring Physical Activity: Uses And Measurement Issues With Automated Counters, Michelle L. Granner, Patricia A. Sharpe

Faculty Publications

Background: Promotion of physical activity is a public health priority, and environmental factors influence physical activity behavior. Valid and reliable automated measurement tools of physical activity for assessment and evaluation within public settings are needed. Methods: Searches of the research literature and governmental reports from physical activity, transportation, and recreation fields were conducted to identify methods of automated counting and validation studies. The article provides a summary of (a) current methods and uses of automated counters, (b) information about validity and reliability where available, (c) strengths and limitations of each methods, and (d) measurement issues. Results: Existing automated counting technology …

The Florida Legislature’S Physical Activity And Nutrition Bills And Florida’S Youth: A Health Professional’S Call To Action

Florida Public Health Review

No abstract provided.

Perceptions Of Access To U.S. Health Care Of Haitian Immigrants In South Florida

Florida Public Health Review

No abstract provided.

School Health Is Public Health

Florida Public Health Review

No abstract provided.

Use Of Hospitals, Physician Visits, And Hospice Care During Last Six Months Of Life Among Cohorts Loyal To Highly Respected Hospitals In The United States, J. E. Wennberg, Elliot S. Fisher, Therese A. Stukel, Jonathan S. Skinner

Dartmouth Scholarship

Objective: To evaluate the use of healthcare resources during the last six months of life among patients of US hospitals with strong reputations for high quality care in managing chronic illness.

The Health Care Safety Net In South Carolina: A Test Of Tenacity, Jennifer Ryan, Randy Desonia

National Health Policy Forum

This site visit to the state of South Carolina provided an opportunity to experience and understand the unique makeup of the health care safety net in a southern state. Site visitors had the opportunity to interact with health care providers, state officials, faith-based organizations and leaders of provider-driven volunteer initiatives. They also learned about the challenges of access to care in rural areas and among diverse population groups. The group visited the Sea Island Medical Center and Our Lady of Mercy Community Outreach and Wellness House; a migrant farm worker camp on Johns Island; and a “medical home” site, Medical …

Living Well With A Disability: An Update, Tom Seekins Ph.D., University Of Montana Rural Institute

Health and Wellness

As many as one of every five Americans has a disability or chronic health condition. In rural areas, that proportion (23%) is even higher. As the U.S. population ages, the numbers of people with disability and chronic conditions will predictably increase, which accounts for a growing national interest in the health and wellness of individuals with disabilities. While composing about 20% of the population, individuals with disabilities account for nearly half of all medical expenditures.

The Frank J. Manning Certificate In Gerontology Alumni Survey: 21 Years Of Service To Elders, Nina M. Silverstein, Jenai Murtha, Donna Sullivan, May Jawad

Gerontology Institute Publications

The Certificate Program in Gerontology at the University of Massachusetts Boston, a large urban university, was established in 1979 as part of an Administration on Aging (AoA) grant to develop and expand services to the elderly citizens of the Commonwealth of Massachusetts. In 1984, a line item was added to the state budget by the legislature and governor establishing the Gerontology Institute at the University of Massachusetts Boston and ensuring the continuation of training, research, and policy and advocacy work on behalf of and with Massachusetts’ elders (O’Brien, 1996). Upon Frank J. Manning’s death in 1986, the program was renamed …