Digital Commons Network^™

Post-Acute Care Payment Reform Demonstration: Final Report Volume 3 Of 4, Barbara Gage, Melissa Morley, Laura Smith, Melvin Ingber, Anne Deutsch, Tracy Kline, Jill Dever, Richard Miller, Brieanne Lyda-Mcdonald, Cynthia Mckeller, Danielle Garfinkel, Joshua Manning, Christopher M. Murtaugh, Margaret Stineman, Trudy Mallinson

Clinical Research and Leadership Faculty Publications

This is the Final Report for the Post-Acute Care Payment Reform Demonstration (PAC-PRD), authorized by section 5008 of the Deficit Reduction Act of 2005, Public Law 109-171. The report has 12 sections, which are divided into four volumes: Volume 1: Executive Summary. Volume 2: Sections 1-4 (Section 1: Introduction; Section 2: Underlying Issues of the PAC-PRD Initiating Legislation; Section 3: Developing Standardized Measurement Approaches: The Continuity Assessment Record and Evaluation (CARE); Section 4: Demonstration Methods and Data Collection) Volume 3: Sections 5-6 (Section 5: Framework for Analysis; Section 6: Factors Associated with Hospital Discharge Destination) Volume 4: Sections 7-12; References …

Does Secondary Inflammatory Breast Cancer Represent Post-Surgical Metastatic Disease?, Salman Hashmi, Ladan Zolfaghari, Paul H. Levine

Epidemiology Faculty Publications

The phenomenon of accelerated tumor growth following surgery has been observed repeatedly and merits further study. Inflammatory breast carcinoma (IBC) is widely recognized as an extremely aggressive malignancy characterized by micrometastasis at the time of diagnosis, with one interesting subgroup defined as secondary IBC where pathologically identifiable IBC appears after surgical treatment of a primary non-inflammatory breast cancer. One possible mechanism can be related to the stimulation of dormant micrometastasis through local angiogenesis occurring as part of posttraumatic healing. In this report, we review cases of secondary IBC and others where localized trauma was followed by the appearance of IBC …

Sexual Behavior Of Hiv-Positive Adults Not Accessing Hiv Treatment In Mombasa, Kenya: Defining Their Prevention Needs, Avina Sarna, Stanley Luchters, Melissa Pickett, Matthew Chersich, Jerry Okal, Scott Geibel, Nzioki Kingola, Marleen Temmerman

Population Health, East Africa

Background: HIV spread continues at high rates from infected persons to their sexual partners. In 2009, an estimated 2.6 million new infections occurred globally. People living with HIV (PLHIV) receiving treatment are in contact with health workers and therefore exposed to prevention messages. By contrast, PLHIV not receiving ART often fall outside the ambit of prevention programs. There is little information on their sexual risk behaviors. This study in Mombasa Kenya therefore explored sexual behaviors of PLHIV not receiving any HIV treatment.

Results: Using modified targeted snowball sampling, 698 PLHIV were recruited through community health workers and HIV-positive …

School Racial Composition And Race/Ethnic Differences In Early Adulthood Health, Bridget J. Goosby, Katrina M. Walsemann

Faculty Publications

We investigate whether school racial composition is associated with racial and ethnic differences in early adult health. We then examine whether perceived discrimination, social connectedness, and parent support attenuates this relationship. Using U.S. data from Wave I and IV of the National Longitudinal Survey of Adolescent Health, we found that black adolescents attending predominantly white schools reported poorer adult health while Asians reported better health. Further research is warranted to understand whether there are qualitative differences in the treatment of racial and ethnic minorities within certain school contexts and how that differential treatment is related to adult health outcomes.

Heart Rate Variability And Exercise In Aging Women, Conrad P. Earnest, Steven N. Blair, Timothy S. Church

Faculty Publications

Background: Our group has shown a positive dose-response in maximal cardiorespiratory exercise capacity (VO_2max) and heart rate variability (HRV) to 6 months of exercise training but no improvement in VO_2max for women ≥60 years. Here, we examine the HRV response to exercise training in postmenopausal women younger and older than 60 years.

Methods: We examined 365 sedentary, overweight, hypertensive, postmenopausal women randomly assigned to sedentary control or exercise groups exercising at 50% (4 kcal/kg/week, [KKW]), 100% (8 KKW) and 150% (12 KKW) of the National Institute of Health (NIH) Consensus Development Panel physical activity guidelines. Primary outcomes …

Gifts Of The Heart… And Other Tissues: Legalizing The Sale Of Human Organs And Tissues, J. Randall Boyer

BYU Law Review

No abstract provided.

The Affordable Care Act Of 2010: A Brief Summary, Jim P. Stimpson

Reports: Center for Health Policy

In March 2010, the Patient Protection and Affordable Care Act (ACA, P.L. 111-148) as amended by the Health Care and Education Reconciliation Act of 2010 (HCERA, P.L. 111-152) (referred to hereafter as the ACA) was signed into law as the most comprehensive piece of legislation since the passage of Medicare and Medicaid legislation in 1965 aimed at creating sweeping health care reform. This brief provides a summary of the titles contained in the law, the implementation of the provisions, and the estimated financial impact.

Identifikasi Bahaya Keselamatan Dan Kesehatan Kerja Pada Penangkapan Ikan Nelayan Muroami, Dimas Ari Dharmawirawan, Robiana Modjo

Kesmas

Kelautan Kepulauan Seribu pada tahun 2009 terdapat 1.722 penduduk berprofesi sebagai nelayan. Sebanyak 299 orang berprofesi nelayan muroami yang menghadapi bahaya keselamatan dan kesehatan kerja tinggi dan hingga saat ini mereka belum mengetahui bahaya pekerjaan tersebut. Penelitian deskriptif dengan analisis kualitatif ini, bertujuan mendapatkan gambaran bahaya kegiatan penangkapan ikan nelayan muroami di Kelurahan Pulau Panggang, Kabupaten Kepulauan Seribu. Penelitian ini hanya mengamati para penyelam kompresor sebagai subjek penelitian dengan mengunakan metode identifikasi bahaya yaitu Job Hazard Analysis. Bahaya keselamatan dan kesehatan kerja pada tahapan aktivitas penangkapan ikan terdiri atas tahapan persiapan, tahapan penyelaman, dan tahapan penanganan hasil penangkapan. Bahaya yang …

Dog Ownership During Pregnancy, Maternal Activity, And Obesity: A Cross-Sectional Study, Carri Westgarth, Jihong Liu, Jon Heron, Andrew R. Ness, Peter Bundred, Rosalind M. Gaskell, Alexander J. German, Sandra Mccune, Susan Dawson

Faculty Publications

The Avon Longitudinal Study of Parents and Children (ALSPAC) is an observational study of 14273 UK pregnant singleton mothers in 1990/1991. We examined outcomes of self report of strenuous activity (hours per week) at 18 and 32 weeks of gestation, hours spent in leisure-time physical activities and types, and pre-pregnancy body mass index (BMI); overweight status was defined as pre-pregnancy BMI$25 and obesity BMI$30. Pet ownership and activity data were reported for 11,466 mothers. Twenty-five percent of mothers owned at least one dog. There was a positive relationship between participation in activity at least once a week and dog ownership …

Differences In Immunity Offered By The Influenza Vaccination Among Active Duty Us Air Force Personnel From 2007-2011, Billy D. Pruett

Master of Public Health Program Student Publications

OBJECTIVE: To investigate the potential difference in vaccine effectiveness among Active Duty Air Force (ADAF) personnel vaccinated against influenza from 2007-2011. Particularly, to determine if any difference in the protection offered is based on sex, vaccine type, or both.

METHODS: The proposed study incorporated a cross-sectional design using the Department of Defense’s (DoD) comprehensive databases. Laboratory-confirmed influenza and other Influenza-Like Illness (ILI) cases were identified for each of the four influenza seasons of interest, vaccination status and history was then verified, and 2x2 tables were constructed in order to calculate odds ratios.

RESULTS: No consistent difference in vaccine effectiveness in …

Does Place Of Residence Affect Risk Of Suicide? A Spatial Epidemiologic Investigation In Kentucky From 1999 To 2008, Daniel M. Saman, Sabrina Walsh, Anna Borówko, Agricola Odoi

Epidemiology and Environmental Health Faculty Publications

BACKGROUND: Approximately 32,000 people take their own lives every year in the United States. In Kentucky, suicide mortality rates have been steadily increasing since 1999. Few studies in the United States have assessed spatial clustering of suicides. The purpose of this study was to identify high-risk clusters of suicide at the county level in Kentucky and assess the characteristics of those suicide cases within the clusters.

METHODS: A spatial epidemiological study was undertaken using suicide data for the period January 1, 1999 to December 31, 2008, obtained from the Kentucky Office of Vital Statistics. Descriptive analyses using Pearson's chi-square test …

Environmental Drivers Of Ross River Virus In South-East Tasmania, Australia: Towards Strengthening Public Health Interventions, Angela Werner, Sarah Goater, Scott Carver, Greg Robertson, Philip Weinstein

Global Health Faculty Publications

In Australia, Ross River virus (RRV) is predominantly identified and managed through passive health surveillance. Here, the proactive use of environmental datasets to improve community-scale public health interventions in southeastern Tasmania is explored. Known environmental drivers (temperature, rainfall, tide) of the RRV vector Aedes camptorhynchus are analysed against cumulative case records for five adjacent local government areas (LGAs) from 1993 to 2009. Allowing for a 0- to 3-month lag period, temperature was the most significant driver of RRV cases at 1-month lag, contributing to a 23. 2% increase in cases above the long-term case average. The potential for RRV to …

Association Of Hexachlorobenzene (Hcb), Dichlorodiphenyltrichloroethane (Ddt), And Dichlorodiphenyldichloroethylene (Dde) With In Vitro Fertilization (Ivf) Outcomes., Shruthi Mahalingaiah, Stacey A. Missmer, Arnab Maity, Paige L. Williams, John D. Meeker, Katharine Berry, Shelley Ehrlich,, Melissa J. Perry, Daniel W. Cramer, Russ Hauser

Environmental and Occupational Health Faculty Publications

Background: Hexachlorobenzene (HCB), dichlorodiphenyltrichloroethane (DDT), and dichlorodiphenyldichloroethylene (DDE) are persistent chlorinated pesticides with endocrine activity that may adversely affect the early stages of human reproduction.

Objective: Our goal was to determine the association of serum levels of HCB, DDT, and DDE with implantation failure, chemical pregnancy, and spontaneous abortion in women undergoing in vitro fertilization (IVF) from 1994 to 2003.

Methods: Levels of HCB and congeners of DDT and DDE were measured in serum collected during the follicular phase. Multivariable-adjusted statistical models accommodating multiple outcomes and multiple cycles per woman were used to estimate the relation between serum pesticide levels …

The Impact Of A 3-Year After-School Obesity Prevention Program In Elementary School Children, Zenong Yin, Justin B. Moore, Maribeth H. Johnson, Marlo M. Vernon, Bernard Gutin

Faculty Publications

Background: Children tend to be sedentary during the after-school hours, and this has deleterious effects on their health. The objective of the present study was to determine the effects of a 3-year after-school physical activity (PA) program, without restriction of dietary energy intake, on percent body fat (%BF), cardiorespiratory fitness (CRF), and cardiometabolic markers in children.

Methods: A cluster randomization design was employed. A total of 574 3^rd grade children from 18 elementary schools in the south-eastern United States participated. The intervention consisted of 80 minutes of age-appropriate moderate-to-vigorous PA each school day. The main outcomes of interest were …

Hiv And Aids Education: The Tanzanian Case, Katherine Ellison

Social Sciences

This project takes a look at the cultural, religious, and socio-economic roles that affect the spread of education regarding HIV/AIDS in Tanzania. A personal experience in Zanzibar, Tanzania was the incentive to spark interest in teaching. HIV/AIDS is a powerful epidemic that has taken the lives away from millions. This article takes a deeper look at the transmission, stigmas, and pathways for change.

A Structural Equation Modeling Analysis Of The Effects Of School, Community And Individual Factors On Substance Use Among Girls In Rural Counties, Taniesa Moore

Theses and Dissertations

Substance use among adolescent girls in the United States is increasing. In some regions substance use by rural adolescent girls exceeds that of its urban and suburban counterparts. The purpose of this study is to investigate the adequacy of constructs within Catalano, Hawkins, and the Social Development Research Group's (1996) social development model (SDM) as an empirical-based model pertaining to early adolescent girls' pathways to substance use by examining school, community, and individual risk and protective factors. Risk factors are defined as those traits, variables, or vulnerabilities that, if present for a particular individual, increase the likelihood of those individual …

Alternate Estrogen Receptors Promote Invasion Of Inflammatory Breast Cancer Cells Via Non-Genomic Signaling, Kazufumi Ohshiro, Arnold M. Schwartz, Paul H. Levine, Rakesh Kumar

Epidemiology Faculty Publications

Although Inflammatory Breast Cancer (IBC) is a rare and an aggressive type of locally advanced breast cancer with a generally worst prognosis, little work has been done in identifying the status of non-genomic signaling in the invasiveness of IBC. The present study was performed to explore the status of non-genomic signaling as affected by various estrogenic and anti-estrogenic agents in IBC cell lines SUM149 and SUM190. We have identified the presence of estrogen receptor α (ERα) variant, ERα36 in SUM149 and SUM190 cells. This variant as well as ERβ was present in a substantial concentration in IBC cells. The treatment …

Review Of Civil-Military Coordination In Local Disaster Response, Wilfredo J. Nieves

Master of Public Health Program Student Publications

Background: Globally, disasters affect over 200 million people annually. Governments at all levels attempt to mitigate the effects of disasters by providing training and resources to responders in the event of a disaster. When the disaster is of sufficient magnitude, those that respond will require additional resources to adequately attend to disaster victims. County emergency managers assist in making needed additional resources available. Department of Defense (DoD) installations are sources where emergency management agency (EMA) directors may request assistance. The purpose of this research is to understand the resources legal authority available to civilian emergency managers of Ohio Counties in …

Atrazine Exposure In Public Drinking Water And Preterm Birth, Jessica L. Rinsky, Claudia Hopenhayn, Vijay Golla, Steven R. Browning, Heather M. Bush

Epidemiology and Environmental Health Faculty Publications

Objectives

Approximately 13% of all births occur prior to 37 weeks gestation in the U.S. Some established risk factors exist for preterm birth, but the etiology remains largely unknown. Recent studies have suggested an association with environmental exposures. We examined the relationship between preterm birth and exposure to a commonly used herbicide, atrazine, in drinking water.

Methods

We reviewed Kentucky birth certificate data for 2004–2006 to collect duration of pregnancy and other individual-level covariates. We assessed existing data sources for atrazine levels in public drinking water for the years 2000–2008, classifying maternal county of residence into three atrazine exposure groups. …

The Cyclin-Like Protein Spy1/Ringo Promotes Mammary Transformation And Is Elevated In Human Breast Cancer, Mohammad Al Sorkhy, Rosa-Maria Ferraiuolo, Espanta Jalili, Agnes Malysa, Andreea R. Fratiloiu, Bonnie F. Sloane, Lisa A. Porter

Wayne State University Associated BioMed Central Scholarship

Abstract

Background

Spy1 is a novel 'cyclin-like' activator of the G1/S transition capable of enhancing cell proliferation as well as inhibiting apoptosis. Spy1 protein levels are tightly regulated during normal mammary development and forced overexpression in mammary mouse models accelerates mammary tumorigenesis.

Methods

Using human tissue samples, cell culture models and in vivo analysis we study the implications of Spy1 as a mediator of mammary transformation and breast cancer proliferation.

Results

We demonstrate that this protein can facilitate transformation in a manner dependent upon the activation of the G2/M Cdk, Cdk1, and the subsequent inhibition of the anti-apoptotic regulator FOXO1. …

Fusion, 2012, George Washington University, William H. Beaumont Medical Research Honor Society

Fusion

No abstract provided.

Quality Of Life Of Families With Children Who Have Severe Developmental Disabilities: A Comparison Based On Child Residence, Joni Taylor Mcfelea, Sharon Raver

Communication Disorders & Special Education Faculty Publications

This study measured the quality of life of two groups of families with children who had severe developmental disabilities-families whose child lived at home and families whose child lived in a residential facility. Participants were 54 primary caregivers of children who had severe intellectual disabilities and who lacked the ability to both ambulate without assistance and communicate conversationally. Participants completed the "Family Quality of Life Scale" (Hoffman, Marquis, Poston, Summers, & Turnbull, 2006). Analyses revealed that both groups rated their family quality of life (FQOL) as exemplary. FQOL was higher in the family home group than in the residential facility …

Patent Landscape Of Influenza A Virus Prophylactic Vaccines And Related Technologies, Jon R. Cavicchi, Stanley P. Kowalski, David L. Pflugh, Jeremy Barton, Jeffrey Janovetz, John Schroeder

Law Faculty Scholarship

Executive Summary: This report focuses on patent landscape analysis of technologies related to prophylactic vaccines targeting pandemic strains of influenza. These technologies include methods of formulating vaccine, methods of producing of viruses or viral subunits, the composition of complete vaccines, and other technologies that have the potential to aid in a global response to this pathogen. The purpose of this patent landscape study was to search, identify, and categorize patent documents that are relevant to the development of vaccines that can efficiently promote the development of protective immunity against pandemic influenza virus strains.

The search strategy used keywords which the …

Best Practice For Casualty Simulation - Role-Playing Actor, High Fidelity Mannequin Simulation, Or Virtual Reality?, Robert Sarlay

Master of Public Health Program Student Publications

Objective: The purpose of this systemic review of the literature is to determine the best practice with regards to simulating casualties during a disaster response exercise.

Methods: MEDLINE was searched from 1950 till present for the key terms of disaster, simulation, and emergency preparedness. Articles were included which met the following criteria: English language, human subjects, original research using any research design (with or without intervention), and primary focus of disaster preparedness using simulation, virtual reality, or role playing actors.

Results: Of the 386 articles reviewed only 18 met inclusion criteria. The literature is primarily descriptive in nature with regards …

A Descriptive Analysis Of Lung Cancer In Montgomery County, Ohio, Catherine Klose

Master of Public Health Program Student Publications

Background: Lung cancer statistics are alarming, especially when it is considered by many to largely be a preventable disease. Lung cancers are the leading cause of all cancer deaths, more than breast cancer, prostate cancer, and colon cancer combined. Cancers of the bronchus and lung make up the greatest percentage of the newly diagnosed cancers reported to the Ohio Cancer Incidence Surveillance System (OCISS). The stage of diagnosis of lung and bronchus cancers is an important determinant of survival. Smoking is the primary cause of lung cancer. Race and gender disparities also exist with lung cancer, and socioeconomic factors have …

Tropical Medicine Training In The Department Of Defense, Rodney L. Coldren, David Brett-Major, Patrick W. Hickey, Eric Garges, Peter J. Weina, Paula Corrigan, Gerald Quinnan

Journal Articles: Epidemiology

No abstract provided.

Montgomery County Prostate Cancer Study: A Descriptive Study Of Prostate Cancer Incidence & Mortality In Montgomery County, Ohio, 2000-2009, Anthony F. Greaves

Master of Public Health Program Student Publications

Background: Prostate cancer is the most common cancer diagnosed among adult males in the United States. The prognosis of prostate cancer is related to the stage, with a five year relative survival rate of 100% among men diagnosed with early stage prostate cancer. Modifiable risk factors associated with the disease include lifestyle, marital status, tobacco and alcohol history, physical activity, weight, diet, and geographic location. Non-modifiable risk factors include family history and genetic factors, race/ethnicity and nationality, age, and hormonal factors.

Methods: A descriptive study of prostate cancer primary prevention and early detection factors was conducted on men living in …

A Case–Control Study Of Occupation/Industry And Renal Cell Carcinoma Risk, Sara Karami, Joanne S. Colt, Kendra Schwartz, Faith G. Davis, Julie J. Ruterbusch, Stella S. Munuo, Sholom Wacholder, Patricia A. Stewart, Barry I. Graubard, Nathanial Rothman, Wong-Ho Chow, Mark P. Purdue

Wayne State University Associated BioMed Central Scholarship

Abstract

Background

The role of occupation in the etiology of renal cell carcinoma (RCC) is unclear. Here, we investigated associations between employment in specific occupations and industries and RCC, and its most common histologic subtype, clear cell RCC (ccRCC).

Methods

Between 2002 and 2007, a population-based case–control study of Caucasians and African Americans (1,217 cases; 1,235 controls) was conducted within the Detroit and Chicago metropolitan areas to investigate risk factors for RCC. As part of this study, occupational histories were ascertained through in-person interviews. We computed odds ratios (ORs) and 95% confidence intervals (CIs) relating occupation and industry to RCC …

The Role Of Medications In Predicting Activity Restriction Due To A Fear Of Falling, Dawn M. Guthrie, Paula C. Fletcher, Evelyn Williams, Nicole Boumans, John P. Hirdes

Kinesiology and Physical Education Faculty Publications

Objectives: To examine the role of medication use and other factors in predicting activity restriction due to a fear of falling (AR/FF). Methods: Older adults were assessed twice with the interRAI Community Health Assessment and the Berg Balance Scale (BBS). The main outcome was limiting going outdoors due to an AR/FF. Medications were recorded by trained assessors. Results: Participants (n=441) had a mean age of 80.3 (sd=7.1) years, most were aged 65+ (96.8%) and 29.3% reported activity restriction. Taking nervous system active or cardiovascular medications was associated with AR/FF. In a multivariate model, the main predictors were having 3+ comorbid …

Culture Ontogeny: Lifespan Development Of Religion And The Ethics Of Spiritual Counselling, Glen Milstein, Amy Manierre

Publications and Research

The counsellor has an ethical obligation to treat the whole person. Humans are cultural beings and the foundation of most cultures is religion. Religion and culture are received from our early relation~ ships and modified through later relationships across the lifespan. The paper introduces the term "culture ontogeny" to emphasize that this is a biological process wherein abstract ideas of culture and religion become material in the developing neurophysiology of each brain. A framework and methods are offered to examine the changing roles of religion in clients' emotional self~ structure, inclusive of those who describe themselves as spiritual, not religious. …