Digital Commons Network^™

Two Sessions Of Sleep-Focused Mind–Body Bridging Improve Self-Reported Symptoms Of Sleep And Ptsd In Veterans: A Pilot Randomized Controlled Trial, Yoshio Nakamura, David L. Lipschitz, Richard Landward, Renee Kuhn, Gavin West

United States Public Health Resources

Objective: Sleep disturbance is highly prevalent among veterans. As an alternative to sleep medications with their undesirable side effects, nonpharmacological mind–body interventions may be beneficial for sleep management in primary care. The aim of this pilot study was to investigate whether a novel mind–body intervention, mind–body bridging (MBB), focusing on sleep, could improve self-reported sleep disturbance and comorbid symptoms in veterans.

Methods: This pilot study was a randomized controlled trial at the Veterans Affairs Salt Lake City Health Care System in which 63 veterans with self-reported sleep disturbance received MBB or an active sleep education control. Both interventions …

Cerebrocerebellar Hypometabolism Associated With Repetitive Blast Exposure Mild Traumatic Brain Injury In 12 Iraq War Veterans With Persistent Post-Concussive Symptoms, Elaine R. Peskind, Eric C. Petrie, Donna J. Cross, Kathleen Pagulayan, Kathleen Mccraw, David Hoff, Kim Hart, Chang-En Yu, Murray A. Raskind, David G. Cook, Satoshi Minoshima

United States Public Health Resources

Disagreement exists regarding the extent to which persistent post-concussive symptoms (PCS) reported by Iraq combat Veterans with repeated episodes of mild traumatic brain injury (mTBI) from explosive blasts represent structural or functional brain damage or an epiphenomenon of comorbid depression or posttraumatic stress disorder (PTSD). Objective assessment of brain function in this population may clarify the issue. To this end, twelve Iraq war Veterans (32.0±8.5 [mean±standard deviation (SD)] years of age) reporting one or more blast exposures meeting American Congress of Rehabilitation Medicine criteria for mTBI and persistent PCS and 12 cognitively normal community volunteers (53.0±4.6 years of age) without …

Electroconvulsive Therapy For Major Depression Within The Veterans Health Administration, Paul N. Pfeiffer, Marcia Valenstein, Katherine J. Hoggatt, Dara Ganoczy, Dan Maixner, Erin M. Miller, Kara Zivin

United States Public Health Resources

Objectives: Electroconvulsive therapy (ECT) is the most effective treatment for severe or treatment resistant depression; however, the lack of widely accepted methods for determining when ECT is indicated may contribute to disparities and variation in use. We examined receipt of ECT among depressed patients in the largest coordinated health system in the US, the Veterans Health Administration.

Methods: Using administrative data, we conducted a multivariable logistic regression to identify individual clinical and sociodemographic predictors of receiving ECT, including variables of geographic accessibility to ECT, among patients diagnosed with major depressive disorder between 1999 and 2004.

Results: 307 (0.16%) …

Veterans Affairs General Surgery Service: The Last Bastion Of Integrated Specialty Care, Stephen Poteet, Margaret Tarpley, John L. Tarpley, A. Scott Pearson

United States Public Health Resources

BACKGROUND: In a time of increasing specialization, academic training institutions provide a compartmentalized learning environment that often does not reflect the broad clinical experience of general surgery practice. This study aimed to evaluate the contribution of the Veterans Affairs (VA) general surgery surgical experience to both index Accreditation Council for Graduate Medical Education (ACGME) requirements and as a unique integrated model in which residents provide concurrent care of multiple specialty patients.

METHODS: Institutional review board approval was obtained for retrospective analysis of electronic medical records involving all surgical cases performed by the general surgery service from 2005 to …

Substance Use Disorders In Iraq And Afghanistan Veterans In Va Healthcare, 2001–2010: Implications For Screening, Diagnosis And Treatment, Karen H. Seal, Greg Cohen, Angela Waldrop, Beth E. Cohen, Shira Maguen, Li Ren

United States Public Health Resources

Background: The prevalence and correlates of alcohol use disorder (AUD) and drug use disorder (DUD) diagnoses in Iraq and Afghanistan veterans who are new users of Department of Veterans Affairs (VA) healthcare nationwide has not been evaluated.

Methods: VA administrative data were used in retrospective cross-sectional descriptive and multivariable analyses to determine the prevalence and independent correlates of AUD and DUD in 456,502 Iraq and Afghanistan veterans who were first-time users of VA healthcare between October 15, 2001 and September 30, 2009 and followed through January 1, 2010.

Results: Over 11% received substance use disorder diagnoses: AUD, …

Motivational Interview Improves Treatment Entry In Homeless Veterans, R. Morgan Wain, Paula L. Wilbourne, Keith W. Harris, Heather Pierson, Jasmine Teleki, Thomas A. Burling, Steven Lovett

United States Public Health Resources

Motivational Interviewing (MI) has successfully been used to facilitate entry and compliance in drug and alcohol treatment programs. Some questions have been raised as to the effectiveness of MI in severely distressed populations. This study aims to assess the effectiveness of MI in a population of homeless, unemployed, and substance dependent veterans who are being wait-listed for entry into a residential treatment program. Seventy-five veterans placed on a wait-list were randomized to receive a single MI or standard (Std) intake interview. Outcomes assessed were entry, and length of stay (LOS). Secondary outcomes assessed included program completion and rates of graduation. …

Insomnia Characteristics And Clinical Correlates In Operation Enduring Freedom/Operation Iraqi Freedom Veterans With Post-Traumatic Stress Disorder And Mild Traumatic Brain Injury: An Exploratory Study, D. M. Wallace, S. Shafazand, A.R. Ramos, D.Z. Carvalho, H. Gardener, D. Lorenzo, W.K. Wohlgemuth

United States Public Health Resources

Background: There is limited data on chronic insomnia in Operation Enduring Freedom/Operation Iraqi Freedom (OEF/OIF) veterans, in whom post-traumatic stress disorder (PTSD) and mild traumatic brain injury (mTBI) often co-exist. Our aim was to compare sleep characteristics of three groups of OEF/OIF veterans: (1) healthy sleepers (HS), (2) those with insomnia associated with PTSD and mTBI (PTSD–mTBI), and (3) those with insomnia associated with PTSD alone.

Methods: Consecutive veterans with insomnia complaints (>6 months) were recruited over 6 months from the Miami VA Post Deployment clinic. Participants completed a sleep disorders clinical interview, medical history, and questionnaires …

Factors Influencing Receipt Of Outpatient Rehabilitation Services Among Veterans Following Lower Extremity Amputation, Jianxun Zhou, Barbara E. Bates, Jibby E. Kurichi, Pui L. Kwong, Dawei Xie, Margaret G. Stineman

United States Public Health Resources

Objective: To determine patient-, treatment-, and facilitylevel characteristics associated with receiving outpatient rehabilitation services after lower extremity amputation within the Veterans Affairs (VA) system.

Design: Observational study.

Setting: All Veterans Affairs Medical Centers (VAMCs).

Participants: Veterans (N=4165) with lower extremity amputation discharged from VAMCs between October 1, 2002, and September 20, 2004. Interventions: Not applicable.

Main Outcome Measures: Receipt of outpatient rehabilitation services up to 1 year postdischarge. A Cox proportional hazards model was used to determine the adjusted hazard ratio and 95% confidence interval of veterans to receive outpatient services.

Results: …

Angiogenic Biomarkers For Risk Stratification In Women With Suspected Preeclampsia, Andreea Balan, Heather Young, Linda Ojo, Jennifer Keller, Sharon Maynard

Epidemiology Faculty Posters and Presentations

This poster presents the results of a single-center prospective cohort study of 315 pregnant women who presented to George Washington University Hospital Labor and Delivery service with a clinical suspicion of preeclampsia between February 2007 and November 2011. Informed consent was obtained. Baseline demographic information and medical history was collected on each patient including maternal age, ethnicity, body mass index, tobacco and other substance use, gestational age, medical problems and obstetric history. Serum samples were obtained from each enrolled subject within 24 hours of admission, and sFlt1, PlGF and sEng ELISA assays were performed in duplicate by a blinded laboratory …

The Risk Of Pedestrian Injury And Fatality In Collisions With Motor Vehicles: A Social Ecological Study Of State Routes And City Streets In King County, Washington, Anne Vernez Moudon, Lin Lin, Junfeng Jiao, Philip Hurvitz, Paula Reeves

Research Collection College of Integrative Studies

This study examined the correlates of injury severity using police records of pedestrian-motor-vehicle collisions on state routes and city streets in King County, Washington. Levels of influence on collision outcome considered (1) the characteristics of individual pedestrians and drivers and their actions; (2) the road environment; and (3) the neighborhood environment. Binary logistic regressions served to estimate the risk of a pedestrian being severely injured or dying versus suffering minor or no injury. Significant individual-level influences on injury severity were confirmed for both types of roads: pedestrians being older or younger; the vehicle moving straight on the roadway. New variables …

Situation Assessment Of The Hiv Response Among Young People In Zambia, Sam Kalibala, Drosin Mulenga

HIV and AIDS

The main objective of this situational assessment is to compile and synthesize existing recent information on HIV and young people together with the current AIDS response for young people in Zambia—including programs, policies, and key partners—and to document gaps and challenges in the response. The assessment aims to further strengthen this response by all stakeholders including the Government of the Republic of Zambia, the UN, faith-based organizations, civil society organizations, donors, young people, and youth-led organizations. Recommendations include: amending and strengthening laws related to HIV programming for young people and involving them in design and implementation; offering health services, life …

Migration And Hiv In India: Study Of Select Districts, Niranjan Saggurti, Bidhubhusan Mahapatra, Suvakanta N. Swain, Madhusudana Battala, Alka Narang, Umesh Chawla

HIV and AIDS

Report of a study assessing the important role of migration in the spread of HIV in districts with high out-migration in India. The study suggests a considerable spread of HIV linked to migrants’ extramarital sexual behaviors, and subsequent delay in treatment for infected spouses. In order to control the spread of HIV, the study provides programmatic recommendations made by the study participants and the counselors from ICTCs and ART centers. These suggestions include village-level mapping of at-risk persons, mainstreaming HIV prevention interventions within current health resources, improving various village level HIV prevention programs, and involving women left behind by migrant …

Hiv Transmission Among Married Men And Women In Districts With High Out-Migration In India: Study Brief, Niranjan Saggurti, Bidhubhusan Mahapatra, Suvakanta N. Swain, Madhusudana Battala, Umesh Chawla, Alka Narang

HIV and AIDS

This brief describes a study examining the links between male out-migration and HIV transmission among married men and women and other mechanisms by which HIV is transmitted within marital relationships in districts with high out-migration.

Facilitating Regulatory Approval Of Multipurpose Prevention Technologies For Sexual And Reproductive Health, Martha Brady

HIV and AIDS

This brief describes multipurpose prevention technologies (MPTs) that address women's sexual and reproductive health (SRH) needs, and how to go about facilitating regulatory approval of this technology. It outlines a strategic framework to examine current regulatory guidance, as well a product development pathway to bring MPTs to market.

What Regulatory Guidance Exists For Multipurpose Prevention Technologies (Mpts)? A Review Of Key Guidance Documents And Their Applicability To Mpts, Martha Brady, Heeyoung Park

HIV and AIDS

This brief reviews regulatory guidance documents and how they may apply to multi-purpose technologies (MPTs). It examines guidance documents from the Food and Drug Administration (FDA), the European Medicines Agency (EMA) and the International Conference on Harmonization of Technical Requirements for Registration of Pharmaceuticals for Human Use (ICH). The brief concludes by anticipating increased interactions with US regulatory agencies in hopes of finding new regulatory pathways that address MPTs specifically.

Evaluation Of The Informed Consent Process For Male Circumcision Scale-Up In Swaziland, Barbara Friedland, Louis Apicella, Katie D. Schenk, Meredith Sheehy, Paul C. Hewett

HIV and AIDS

This report evaluates the informed consent process for male circumcision conducted through the Male Circumcision Partnership for Swaziland, led by Population Services International, in partnership with Jhpiego, Marie Stopes International, and the Population Council. The study assesses participants' comprehension of the circumcision process, the informed consent process, as well as the affect of male circumcision counseling on their experience.

Education During Humanitarian Emergencies: The Situation Of Displaced Children And Youth In Darfur, Sudan, Safaa El-Kogali

Poverty, Gender, and Youth

More than 39 million children and youth who live in conflict-affected fragile states do not have access to education. With an increase in the average duration of refugee displacement from 9 years in the early 1990s to 17 years today, whole generations of children have little chance to recoup the potential educational investment lost during their years living in the midst of a humanitarian emergency. The Population Council and the Women’s Refugee Commission launched a research project to identify the link between education and children’s protection and well-being in Darfur, Sudan. The objective was to document the educational environment in …

Female Wages In The Egyptian Textiles And Clothing Industry: Low Pay Or Discrimination?, Amirah El-Haddad

Poverty, Gender, and Youth

This Population Council working paper analyzes data collected from a survey of firms and workers in the textiles and clothing sector in Egypt. These data allow for the explanation of the sector’s gender wage gap by poorer endowments, and relegation of women to low-paying firms and occupations; and by within-firm and within-occupation differential in returns. There is a pay gap in this sector, with men receiving an hourly wage 29 percent higher than that of women, partly because women are concentrated in the lower paid occupations, with a clear glass ceiling in effect, and outright discrimination occurs. The largest of …

The Effects Of Racially-Motivated Emotional Arousal On The Eating Behaviors Of African American Women, Lenwood W. Hayman

Wayne State University Dissertations

Disparities between African Americans and Caucasians remain vast across a wide variety of health indicators. Chronic stress has been identified as a risk factor for a variety of chronic illnesses and poor health outcomes. One type of chronic stress that has been linked to health disparities is the stress associated with experiences of racial discrimination. The stress African Americans encounter as a result of their racist experiences contributes to a chronic elevation of their physiological stress response. In addition to stress, a major risk factor for coronary heart disease and diabetes is obesity, which has been established as a major …

An Investigation On Hiv Related Stigma To Improve Hiv Prevention Efforts In North Dakota, Krissie Lynn Mayer-Guerard

All Graduate Theses, Dissertations, and Other Capstone Projects

This study examines HIV stigma to improve HIV prevention in North Dakota. A survey was administered to North Dakotan adults between January 15 and February 15, 2011, in eight selected towns. The study focused on North Dakotan perceptions of HIV in their state. Research found that most North Dakotans do not view HIV as a problem in their state. There is, however, a belief that there is stigma associated with HIV in North Dakota, as 65 percent of survey respondents believe that. The study also shows that there is a need for education regarding the transmission of HIV. Sixty percent …

Evaluation Of Health Newsletter Effectiveness On Dietary Habits In Low-Income Middle-Aged Women, Nichole Jennifer Hassebroek

All Graduate Theses, Dissertations, and Other Capstone Projects

There is little known about the effectiveness of the SagePlus newsletters at motivating dietary habit changes. The purpose of this study was to determine the effectiveness of the SagePlus newsletter in motivating low-income, middle-aged women who are participating in the SagePlus program to adopt healthier eating habits, specifically to eat more fruits and vegetables. A nonexperimental, descriptive correlational design was used in this study. Phone calls were placed to current SagePlus participants who had been enrolled in the program between six and 12 months. Forty English-speaking participants were contacted and agreed to participate in the telephone survey from a potential …

Barriers To Using Motivational Interviewing For Lifestyle Counseling, Heidi June Sannes

All Graduate Theses, Dissertations, and Other Capstone Projects

The Minnesota Department of Health has sponsored Motivational Interviewing Continuing Education sessions for SagePlus providers to increase their knowledge and skill in the utilization of MI in their clinical practice. The impact of these educational sessions on skill development as well as utilization of MI by these providers is unknown. The purpose of this study was to determine if healthcare providers perceive any barriers in utilizing MI techniques to do lifestyle counseling with SagePlus program particiants. A descriptive quantitative design was used for this study. Of the 22 healthcare providers that were doing lifestyle counseling 16 completed the questionnaires. The …

Motivational Interviewing Training And Provider Proficiency, Jeremy Jay Waldo

All Graduate Theses, Dissertations, and Other Capstone Projects

The purpose of this descriptive study was to determine if there was a relationship between the amount and type of Motivational Interviewing (MI) training a SagePlus provider receives, motivation to utilize MI training, and the proficiency of the provider in using MI in lifestyle counseling in clinical practice. This study was comprised of 16 healthcare professionals who provide SagePlus lifestyle counseling interventions in clinics that participated in the Minnesota Department of Health (MDH) funded SagePlus program. A demographic questionnaire, modified Preventative Medicine Attitudes and Activities Questionnaire (PMAAQ) and Behaviour Change Counseling Index tool (BECCI) were utilized to assess provider's amount …

Assessing Students' Risk Factors For Type Ii Diabetes At A Midwest Public University, Nicole Decourcy Ferrian

All Graduate Theses, Dissertations, and Other Capstone Projects

The purpose of this study was to assess students' risk factors for type II diabetes at a Midwest public university. It further examined students' perceived susceptibility, perceived severity, and self-efficacy of the disease. The design of the cross-sectional study was based on risk factors for type II diabetes listed by the American Diabetes Association and the Health Belief Model's constructs of perceived susceptibility, perceived seriousness, and self-efficacy. A survey was distributed to non-diabetic college students aged 18 and older enrolled in general education courses at a Midwest public university. A purposive sampling of 432 students enrolled in Health 101 and …

Increasing Organ Donation In Ireland : Social Marketing And Infrastructural Improvements., Ronan O'Sullivan

Theses

There were over 600 patients on the organ waiting list in Ireland in November 2010. This is a substantial increase on the 414 patients on the waiting list in 2008. Ireland also witnessed a dramatic decline in the number of donors from 90 donors in 2009 to 58 donors in 2010. This thesis focuses on investigating the current state of organ donation in the Republic of Ireland, with the eventual goal of recommending alterations to improve the system. In depth- interviews were conducted with eleven leading personnel from the fields of organ donation and social marketing in Ireland as well …

Front Matter

Michigan Journal of Public Health

No abstract provided.

Kriged And Modeled Ambient Air Levels Of Benzene In An Urban Environment: An Exposure Assessment Study, Kristina W. Whitworth, Elaine Symanski, Dejian Lai, Ann L. Coker

CRVAW Faculty Journal Articles

Background. There is increasing concern regarding the potential adverse health effects of air pollution, particularly hazardous air pollutants (HAPs). However, quantifying exposure to these pollutants is problematic. Objective. Our goal was to explore the utility of kriging, a spatial interpolation method, for exposure assessment in epidemiologic studies of HAPs. We used benzene as an example and compared census tract-level kriged predictions to estimates obtained from the 1999 U.S. EPA National Air Toxics Assessment (NATA), Assessment System for Population Exposure Nationwide (ASPEN) model. Methods. Kriged predictions were generated for 649 census tracts in Harris County, Texas using estimates of annual benzene …

Determinants Of Multimethod Contraceptive Use In A Sample Of Adolescent Women Diagnosed With Psychological Disorders, Delia L. Lang, Jessica M. Sales, Laura F. Salazar, Ralph J. Diclemente, Richard A. Crosby, Larry K. Brown, Geri R. Donenberg

Health, Behavior & Society Faculty Publications

OBJECTIVE: Despite recommendations for concurrent use of contraceptives and condoms to prevent unintended pregnancy and STIs, multimethod contraceptive use among women is poor. This study examined individual-, interpersonal-, and environmental-level factors that predict multimethod use among sexually active adolescent women diagnosed with psychological disorders.

METHODS: This multisite study analyzed data from 288 sexually active adolescent women who provided sociodemographic, psychosocial, and behavioral data related to birth control and condom use.

RESULTS: 34.7% of the participants reported multimethod use in the past three months. Controlling for empirically and theoretically relevant covariates, a multivariable logistic regression identified self-efficacy, multiple partners, pregnancy history, …

Examining The Relationship Among Physical And Psychological Health, Parent And Peer Attachment, And Cyberbullying In Adolescents In Urban And Suburban Environments, Jemica Monique Carter

Wayne State University Dissertations

Cyberbullying is a new phenomenon that has received substantial attention via media. An extensive review of the literature revealed limited nursing research on this topic. The purpose of this study was to examine the impact of cyberbullying on adolescents' physical (e.g., headache, stomachache, etc.) and psychosocial (e.g., self-esteem, depression, post traumatic stress syndrome, etc.) outcomes. Individuals who experience repeated traditional bullying are at increased risk for experiencing repeated incidents of cyberbullying. Research has shown that effects of cyberbullying may be more traumatic than traditional bullying because victims can be bullied 24 hours and 7 days a week, on and off …

Constructing A Critical Path For Product Development, Commercialization, And Access, Martha Brady

HIV and AIDS

This brief discusses the Council's health technologies development and the product development path from conceptualization to market. It defines the steps in the Critical Path Framework, and examines activities at the preclinical and clinical stage.