Digital Commons Network^™

Barriers To Lesbian Health Care, Paula Bowles

Masters Theses & Specialist Projects

The primary purpose of this research was to examine a sample of sixteen lesbian women regarding the barriers to lesbian health-care. From this information several interpretive findings regarding lesbian health-care are made. Data were gathered via indepth interviews with each individual lesbian. The data suggest that most lesbian women do not reveal their sexual orientation to their primary-care physician for fear of reprisal. Most of the women interviewed do feel they receive adequate health-care from their physician. The women who participated in this project did so confidentially and were assigned pseudonyms. They were asked questions on a variety of topics, …

Time-Series Studies Of Particulate Matter, Michelle L. Bell, Jonathan M. Samet, Francesca Dominici

Johns Hopkins University, Dept. of Biostatistics Working Papers

Studies of air pollution and human health have evolved from descriptive studies of the early phenomena of large increases in adverse health effects following extreme air pollution episodes, to time-series analyses and the development of sophisticated regression models. In fact, advanced statistical methods are necessary to address the many challenges inherent in the detection of a small pollution risk in the presence of many confounders. This paper reviews the history, methods, and findings of the time-series studies estimating health risks associated with short-term exposure to particulate matter, though much of the discussion is applicable to epidemiological studies of air pollution …

A Corrected Pseudo-Score Approach For Additive Hazards Model With Longitudinal Covariates Measured With Error, Xiao Song, Yijian Huang

UW Biostatistics Working Paper Series

In medical studies, it is often of interest to characterize the relationship between a time-to-event and covariates, not only time-independent but also time-dependent. Time-dependent covariates are generally measured intermittently and with error. Recent interests focus on the proportional hazards framework, with longitudinal data jointly modeled through a mixed effects model. However, approaches under this framework depend on the normality assumption of the error, and might encounter intractable numerical difficulties in practice. This motivates us to consider an alternative framework, that is, the additive hazards model, under which little has been done when time-dependent covariates are measured with error. We propose …

Rural Health Care In The Electronic Age (Danville, Pa), Lisa Sprague, Nora Super

National Health Policy Forum

This site visit to the Geisinger Health System in central Pennsylvania explored the use of technology in providing health care to an aging, rural population with a high index of chronic-care needs. The agenda included an in-depth examination of Geisinger’s electronic medical record and its use in various domains of care, including outpatient clinics, disease management, and non-Geisinger medical practices and community hospitals. The program also highlighted specific care management initiatives in the areas of radiology, stroke, and obesity. Geisinger’s advantages as an integrated system dominant in its market, with the resources to invest in technology were weighed in considering …

Ua61/6 Newsletter, Issue 2, 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:

• College of Health & Human Services Has New Dean – John Bonaguro
• Simpson, Staci. Institute Aims to Improve Oral Health of Children
• Whitfield, Beth. WKU Mobile Unit KICS Off Dental Event with Webster County – Kentucky Interdisciplinary Community Screening
• Stone, Glynda. TEACH KY: Teachers Exploring & Advocating Careers in Health in Kentucky
• Institute Sponsors Hispanic Health Fair
• HIV Prevention Counseling & Testing Training Program Initiated at WKU
• New Web-based Course Offered Through Communications Disorders Department at WKU
• Lashley, Donita. Child Passenger Safety Training
• Handy, …

Multijurisdictional Approach To Biosurveillance, Kansas City., Mark A Hoffman, Tiffany H Wilkinson, Aaron Bush, Wayne Myers, Ron G Griffin, Gerald L Hoff, Rex Archer

Manuscripts, Articles, Book Chapters and Other Papers

No abstract provided.

Medical Response For Terrorist And Public Health Threats: One Region's Experience (Pittsburgh), Eileen Salinsky, Lisa Sprague

National Health Policy Forum

This site visit, planned and convened in conjunction with the Agency for Healthcare Research and Quality’s User Liaison Program, examined the efforts underway in the greater Pittsburgh area to develop emergency medical response capabilities for mass causality events. The site visit explored efforts to improve infectious disease surveillance capabilities and looked at the Region 13 collaborative’s development of a regionalized approach to emergency management planning and response. Hospital preparedness activities were also studied, including a discussion of lessons learned from a recent drill to test response to a radiological event and an exploration of conceptual frameworks to guide hospital planning …

The Benefits Of Breastfeeding: An Introduction For Health Educators, Sheila G. J. Clark, Timothy J. Bungum

Environmental & Global Health Faculty Research

Currently 16% of Americans breastfeed their children for at least 12 months as recommended by the AAP, which is well below the HP 2010 goal of 25%. Breastfed infants receive benefits that can improve their health throughout their lives. The benefits of breastfeeding for children include increased resistance to infectious diseases, such as gastroenteritis, respiratory tract infections, and ear infections. Breastfed children also display lower rates of chronic diseases including diabetes, obesity, asthma, and leukemia. The choice to breastfeed results in economic benefits from lower health care costs and from reduced spending on infant formula. The Healthy People 2010 targets …

Multiple Psychosocial Factors As Predictors In The Progression Of Hiv-1 To Aids, Robert Louis Dutile

Loma Linda University Electronic Theses, Dissertations & Projects

Nearly 3.1 million individuals have died of AIDS as of December 2002 and more than 38.6 million individuals were identified as being infected with HIV (Joint United Nations Programme on HIV/AEDS (UNAIDS) and World Health Organization (WHO) 2002). Psychoneuroimmunology is a discipline that increases our understanding of the relationships between psychosocial factors, the central nervous system, the immune system, and disease. From this perspective, this study reviews the biopsychosocial medical model and components of the stress-immunity-health (SET) model. The constructs of stress and social support are discussed and defined referencing current theory and research. In addition, physiological mechanisms of stress …

All The News That’S Fat To Print: The American "Obesity Epidemic" And The Media, Natalie Boero

Faculty Publications, Sociology

Increasingly the term epidemic is being used to describe the current prevalence of fatness in the United States. Skyrocketing rates of obesity among all groups of Americans, particularly children, the poor, and minorities, have become a major public health concern. Indeed, it is difficult to open a newspaper or magazine without encountering a discussion of the expanding American waistline and the health problems associated therewith. In this paper I use 751 New York Times articles on obesity to examine the media construction of the obesity epidemic. I show that there is not one dominant discourse (i.e. medicine) constructing this epidemic, …

Dose Coefficients For Radionuclides Produced In A Spallation Neutron Source, John P. Shanahan

Transmutation Sciences Physics (TRP)

Internal and external dose coefficient values have been calculated for 14 anthropogenic radionuclides which are not currently presented in Federal Guidance Reports No. 11, 12, and 13 or Publications 68 and 72 of the International Commission on Radiological Protection. Internal dose coefficient values are reported for inhalation and ingestion of 1 μm and 5 μm particulates along with the f1 values and absorption types for the adult worker. Internal dose coefficient values are also reported for inhalation and ingestion of 1 μm particulates as well as the f1 values and absorption types for members of the public. Additionally, external dose …

Obesity In America: A Growing Threat, Eileen Salinsky, Wakina Scott

National Health Policy Forum

This background paper seeks to clarify the nature and causes of the obesity epidemic in the United States and provides an overview of the associated economic and health costs. The paper summarizes existing federal programs and policies that address obesity and examines new and emerging policy strategies to battle the bulging American silhouette. Topics explored include population-based prevention, federal food- and nutrition-assistance programs, Medicare and Medicaid payment policies, school health initiatives, and publicly funded biomedical research.

Sibling Death In Childhood: An Evaluation Of The Literature Regarding Inclusion Of Minority Cultures, 1990–2002, Joyce Kay L. Cherry

Community & Environmental Health Theses & Dissertations

This evaluation seeks to determine the extent to which the professional literature concerning bereaved children in the United States includes African American, Hispanic American, and Asian American children whose siblings have died in childhood.

A literature search identifies 58 articles, published between 1990 and 2002, concerning children under age 19 living in the United States whose siblings have died. Articles are sorted by time frame and classified by type. There are 31 descriptive articles consisting of five literature reviews, five commentaries, five case studies, and 16 narratives; there are 27 research articles. Analysis determines the extent to which race, culture, …

Psychosocial Stress And Cervical Neoplasia Risk, Ann L. Coker, Sharon M. Bond, Margaret M. Madeleine, Kathryn J. Luchok, Lucia Pirisi

CRVAW Faculty Journal Articles

OBJECTIVE: We assessed the association between psychosocial stress and preinvasive cervical neoplasia development controlling for HR-HPV infection.

METHODS: This case-control study enrolled low-income women receiving family planning services at health department clinics. There were 59 cases with biopsy confirmed HSIL and 163 with low-grade SIL and 160 controls with normal cervical cytology. A modified SLE scale was used to measure stressful events and the perceived impact of the event in the prior 5 years. Unconditional logistic regression was used to assess SIL risk and stressful events scores and by subscales.

RESULTS: After adjusting for age, HR-HPV infection, and lifetime number …

Prediction Of 1976 Diabetes Incidence From 1960 Animal Product Consumption Among California Seventh-Day Adventists, Arnold Vang

Loma Linda University Electronic Theses, Dissertations & Projects

The prevalence of diagnosed and undiagnosed diabetes in the US has been estimated at more than 16 million individuals (King, 1998). This has led to research into lifestyle practices (Astrup, 2001; Touomilehto, 2001), which has identified several of primary prevention. High fat diet and type 2 diabetes has been attributed to the wellareas known mechanisms of hyperglycemia, hyperinsulinaemia and insulin resistance (Ferrannini, 1999; Reaven, 1988).

We examined the association between all animal product consumption, specific animal product consumption and diabetes incidence among California Seventh-day Adventists who were cohort members of the Adventist Mortality Study (Kahn, 1984) and the Adventist Health …

On David Koplow's Smallpox: The Fight To Eradicate A Global Scourge, Lisa Donovan, David Alan Sapp

Reconstruction: Studies in Contemporary Culture

[First paragraph]

The world is free from the variola virus, more commonly known to us as the virus responsible for smallpox -- or at least it is almost free from it. Since the World Health Organization's (WHO) successful eradication campaign ended officially on December 9, 1979, smallpox no longer exists in its natural state, yet it does remain in securely isolated freezers in two locations: the Centers for Disease Control and Prevention facility in Atlanta, Georgia, and the Russian State Research Center of Virology and Biotechnology near Novosibirsk. In Smallpox: The Fight to Eradicate a Global Scourge, David Koplow …

Exercise And Physical Activity In The Prevention And Treatment Of Atherosclerotic Cardiovascular Disease: A Statement From The Council On Clinical Cardiology (Subcommittee On Exercise, Rehabilitation, And Prevention) And The Council On Nutrition, Physical Activity, And Metabolism (Subcommittee On Physical Activity), Paul D. Thompson, David Buchner, Ileana L. Piña, Gary J. Balady, Mark A. Williams, Bess H. Marcus, Kathy Berra, Steven N. Blair, Fernando Costa, Barry Franklin, Gerald F. Fletcher, Neil F. Gordon, Russell R. Pate, Beatriz L. Rodriguez, Antronette K. Yancey, Nanette K. Wenger

Faculty Publications

No abstract provided.

Temporal Stability And Geographic Variation In Cumulative Case Fatality Rates And Average Doubling Times Of Sars Epidemics, Alison P. Galvani, Xiudong Lei, Nicholas P. Jewell

U.C. Berkeley Division of Biostatistics Working Paper Series

We analyze temporal stability and geographic trends in cumulative case fatality rates and average doubling times of severe acute respiratory syndrome (SARS). In part, we account for correlations between case fatality rates and doubling times through differences in control measures. We discuss factors that may alter future estimates of case fatality rates. We also discuss reasons for heterogeneity in doubling times among countries and the implications for the control of SARS in different countries and parameterization of epidemic models.

Commencement Program 2003, Loma Linda University

Commencement Programs

CONTENTS

2 | 2003 Events of Commencement

3 | The Academic Procession

4 | Significance of Academic Regalia

5 | The Speakers

12 | The University Honorees

21 | The School Honorees

29 | The Programs

• School of Medicine, 30
• School of Dentistry, 37
• Graduate School, 45
• School of Nursing, 55
• School of Allied Health Professions - Physical Therapy, 60
• School of Allied Health Professions, 68
• School of Public Health, 77

Identifying Target Populations For Screening Or Not Screening Using Logic Regression, Holly Janes, Margaret S. Pepe, Charles Kooperberg, Polly Newcomb

UW Biostatistics Working Paper Series

Colorectal cancer remains a significant public health concern despite the fact that effective screening procedures exist and that the disease is treatable when detected at early stages. Numerous risk factors for colon cancer have been identified, but none are very predictive alone. We sought to determine whether there are certain combinations of risk factors that distinguish well between cases and controls, and that could be used to identify subjects at particularly high or low risk of the disease to target screening. Using data from the Seattle site of the Colorectal Cancer Family Registry (C-CFR), we fit logic regression models to …

Development Of Dose Coefficients For Radionuclides Produced In Spallation Neutron Sources, Phillip W. Patton

Transmutation Sciences Physics (TRP)

A research consortium comprised of representatives from several universities and national laboratories has been established as part of this on-going project to generate internal and external dose conversion coefficients for radionuclides produced in spallation neutron sources. Information obtained from this multi-year study will be used to support the siting and licensing of future accelerator-driven nuclear initiatives within the U.S. Department of Energy complex, including the Spallation Neutron Source (SNS) and the Advanced Fuel Cycle Initiative (AFCI) Projects. Determination of these coefficients will also fill data gaps for several hundred radionuclides that exist in Federal Guide Report No. 11 and in …

The Ignored Disease: The Aids Epidemic 1981–1987, Heather L. Graff, Heather Graff Bloom

College of Journalism and Mass Communications: Theses

Less than six months after Ronald Reagan was inaugurated as the 40th president of the United States, the federal Centers for Disease Control in Atlanta reported pneumocystis carinii pneumonia, in five gay men. In the United States, AIDS was first diagnosed among gay men in New York City and San Francisco. There were several media trends for AIDS coverage in the 1980s. In the early 1980s, AIDS was mainly thought of as a gay-related disease. In the mid- l 980s, AIDS cases were found in hemophiliacs, intravenous drug users and "celebrities." Coverage in the late 1980s focused on heterosexuals and …

Association Of Borrelia Garinii And B. Valaisiana With Songbirds In Slovakia, Klara Hanincova, Veronika Taragelova, Juraj Koci, Stefanie M. Schafer, Rosie Hails, Amy J. Ullmann, Joseph Piesman, Milan Labuda, Klaus Kurtenbach

United States Public Health Resources

In Europe, 6 of the 11 genospecies of Borrelia burgdorferi sensu lato are prevalent in questing Ixodes ricinus ticks. In most parts of Central Europe, B. afzelii, B. garinii, and B. valaisiana are the most frequent species, whereas B. burgdorferi sensu stricto, B. bissettii, and B. lusitaniae are rare. Previously, it has been shown that B. afzelii is associated with European rodents. Therefore, the aim of this study was to identify reservoir hosts of B. garinii and B. valaisiana in Slovakia. Songbirds were captured in a woodland near Bratislava and investigated for engorged ticks. Questing I. ricinus ticks …

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

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 …

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 …

Child Rearing Practices In Eastern Nigeria: Implications For Social Work In The United States, Chinyelu B. Okafor

International Journal of Global Health

This qualitative study describes the childrearing practices among the Igbos of Eastern Nigeria, and offers implications for social work and educational services for African immigrants raising families in the United States. First objective for the study was to ascertain how rural Igbos of Eastern Nigeria raise their children from birth to age eight years of age. Second objective was to determine parent's concept of reward and punishment, how gender role is communicated, and what constitutes parental expectations from successful parenting. Method: Focus group discussions with 400 men and women in 20 villages from five rural Local Government Areas (counties) of …

Increased Morbidity And Mortality In Single Parent Families: A Review, Katie Steneroden

International Journal of Global Health

American families have changed dramatically in composition in recent decades. Increasing proportions of children are being raised in single parent households, reflecting both rising divorce rates, the growing percentage of births to unmarried women and adoption by single parents. As fewer children grow up in traditional families, there is increasing concern about the impact of alternative family structures on children's health and well-being. Many believe that there is a vital connection between family structure and youth well-being, with the nuclear family constituting the optimal structure for fostering "normal" development. Some say the change in the typical nuclear family is one …