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Down-Regulation Of Natural Killer Cell Activation In Response To Influenza Virus In Older Adults, Yu Jing

Theses and Dissertations in Biomedical Sciences

Immune senescence contributes to influenza-associated high mortality and morbidity and reduced vaccine efficacy in elderly people. Type I T cell (Thl)-mediated immunity plays a significant role in Immune responses to influenza infection and vaccination. Natural killer (NK) cells secrete significant amount of IFN-7 , a hallmark Thl cytokine, in response to influenza infection. How aging influences human NK cell IFN-7 production in response to influenza virus has not been well documented. In this study we employed human peripheral blood mononuclear cells (PBMC) and performed intracellular cytokine staining and flow cytometry primarily to investigate how aging influences NK cell activation with …

Cost Effectiveness Of Screening Of All Newly Recruited Employees For Diabetes At A Tertiary Care Hospital, Niloufer Sultan Ali, Ali Khan Khuwaja

Department of Anaesthesia

Diabetes Mellitus is a disease which remains asymptomatic for long duration of time and usually diagnosed either when gets complicated or by routine or opportunistic screening. The practice of universal screening is not recommended, particularly in constraint resources . However, we embarked with a study to assess the yield of recommended screening for Type 2 diabetes in all the newly recruited employees at a tertiary care hospital in Karachi. Methods: All the information required for this study was collected from medical records of all newly recruited employees of nursing services department of a tertiary care hospital of Karachi, Pakistan, over …

Modifying And Validating A Quality Of Life Measure To Fit Your Patient Population, Michelle R. Johnson, J Ross Maclean, Rebecca L. Rogers, Donna M. Fick, Andre Kallab

Journal of the Georgia Public Health Association

Introduction: A well-developed quality of life (QoL) instrument is valuable in identifying the burden of illness. We were interested in exploring whether existing QoL instruments were suitable for patients in our medical setting and, if not, whether this could be rectified by adapting an existing valid and reliable instrument to meet the specific needs of our patient population. For the purposes of this study, we chose to evaluate the quality of life of patients with breast cancer. Specifically, we were interested in two aspects of QoL in women with breast cancer. The first was whether existing instruments were pertinent to …

The Breast And Cervical Cancer Prevention And Treatment Act (Bccpta) In Georgia: Women Covered And Medicaid Costs In 2003, E. Kathleen Adams, Sarah C. Blake, Cheryl Raskind-Hood, Linien Chien, Mei Zhou, Jonathan Liff, William Eley

Journal of the Georgia Public Health Association

The Breast and Cervical Cancer Prevention and Treatment Act (BCCPTA) provided states with an optional Medicaid eligibility category for uninsured women with breast and/or cervical cancers. The BCCPTA is the first and only such effort to use a population-based public health screening program, the National Breast and Cervical Cancer Early Detection Program (NBCCEDP) to provide a pathway to publicly funded health insurance for otherwise uninsured low-income women. Georgia was one of the first states to adopt the BCCPTA and was one of only twelve states that provided Medicaid eligibility to women screened by non-NBCCEDP providers. We use 2003 Georgia Medicaid …

Relationship Of Fruit And Vegetable Servings And Self-Reported Diabetics In The Southeast And Northeast, Marylen Rimando, Faye Lopez, Haritha Battula

Journal of the Georgia Public Health Association

According to the American Diabetes Association, most diabetic patients are not consuming the recommended 3-5 servings of vegetables and 2-4 servings of fruits a day. This study examined fruit and vegetable servings of self-reported diabetics (N=35,407) in select southeastern and northeastern states using Behavioral Risk Factor Surveillance System (BRFSS) 2005 data. The estimate for both fruit and vegetable servings and self-reported diabetes was determined using multivariate logistic regression, adjusting for sociodemographics and geographic region. The results indicated a significant difference between fruit and vegetable servings for diabetics and non-diabetics (p<0.0001). A higher percentage of diabetics in the northeast consumed more than three servings of fruit and vegetables when compared to diabetics in the southeast. Respondents in the northeast were 21% more likely to consume five or more servings of fruit and vegetables and 16% less likely to be diabetic than those in the southeast after adjusting for age, race, sex, and geographic region. In conclusion, diabetics in the northeast consumed more servings of fruit and vegetables than did those in the southeast. Multiple factors influence fruit and vegetable consumption and diabetes and should be considered when developing targeted nutritional interventions. Diabetes educators, nurses, and physicians can encourage diabetic patients to consume more fruit and vegetables and motivate them to continue eating fruit and vegetables.

Ambulatory Care Adverse Events And Preventable Adverse Events Leading To A Hospital Admission, Donna M Woods, Eric J Thomas, Jane L Holl, Kevin B Weiss, Troyen A Brennan

Faculty, Staff and Student Publications

BACKGROUND: Most healthcare in the US is delivered in the ambulatory care setting, but the epidemiology of errors and adverse events in ambulatory care is understudied.

METHODS: Using the population-based data from the Colorado and Utah Medical Practices Study, we identified adverse events that occurred in an ambulatory care setting and led to hospital admission. Proportions with 95% CIs are reported.

RESULTS: We reviewed 14,700-hospital discharge records and found 587 adverse events of which 70 were ambulatory care adverse events (AAEs) and 31 were ambulatory care preventable adverse events (APAEs). When weighted to the general population, there were 2608 AAEs …

Clinicians’ Perception Of Inmates’ Satisfaction With Mental Health Services, Jerry B. Daniel, Wynne S. Korr

Journal of the Georgia Public Health Association

A growing body of literature addresses the mental health needs of prison inmates; however, very little research has examined mental health services among this population. Based on the Behavioral Model of Health Services Use (Andersen Model), the current study examined clinicians’ perception of inmates’ satisfaction with mental health services. The study’s main objective was to identify the effect of three major groups of predictor variables (predisposing, enabling, and need) on clinicians’ perception with inmates’ satisfaction with mental health services. The study utilized an exploratory, survey methodology. Although only a few variables were found to be statistically significant in the multivariate …

Multi-Level Evaluation Of A Perinatal Health Program In Rural Southeast Georgia, Swati Raychowdhury, Stuart H. Tedders, Greta O'Steen, Sarah Jones

Journal of the Georgia Public Health Association

Problem: Infant mortality has declined steadily in the past decade, however, significant disparities associate with lack of adequate perinatal health services and barriers to access disproportionately impact women residing in rural areas. In Georgia, data suggest significant challenges with respect to birth outcomes, and this problem seems to be exacerbated in rural regions of state. The objective of this presentation is to report on the impact of a regional perinatal health care collaborative implemented in rural southeast Georgia.

Method: Analysis of pre-intervention and post-intervention birth outcomes (gestational age, birth weight and infant mortality) served as the focal point programmatic evaluation. …

Trends In Particulate Matter And Mortality: An Approach To The Assessment Of Unmeasured Confounding, Holly Janes, Francesca Dominici, Scott Zeger

Johns Hopkins University, Dept. of Biostatistics Working Papers

We propose a method for diagnosing confounding bias under a model which links a spatially and temporally varying exposure and health outcome. We decompose the association into orthogonal components, corresponding to distinct spatial and temporal scales of variation. If the model fully controls for confounding, the exposure effect estimates should be equal at the different temporal and spatial scales. We show that the overall exposure effect estimate is a weighted average of the scale-specific exposure effect estimates.

We use this approach to estimate the association between monthly averages of fine particles (PM2.5) over the preceding 12 months and monthly mortality …

Caring For People With Alzheimer's Disease Or Dementia In Maine, Stuart Bratesman Mpp, Julie T. Fralich Mba, Catherine Mcguire Bs, Louise Olsen, Romaine Turyn

Disability & Aging

It is clear that caring for people with Alzheimer’s disease and dementia is a growing public health issue. Alzheimer’s is a progressively deteriorating disease that can last anywhere from 1 to 15 years. Families are the primary caregivers and will continue to need support to manage the care of their loved ones, to coordinate services within the long term care system and to maintain their own health and well-being.

Food Facilities, Food Service Workers And The Flow Of Food: Food-Borne Illnesses In Taiwan's Preschools, Shu-Chen Lin

Graduate Student Dissertations, Theses, Capstones, and Portfolios

This study examined food-borne illnesses in Taiwan's preschools which are a major cause of personal distress and preventable death. They are of particular concern in preschools as very young children are highly susceptible to food-borne illnesses. Previous studies that comprehensively investigated the factors impacting food-borne illnesses in Taiwan were not found in the literature. The development of a universal food safety model is necessary as a means to measure relevant constructs. Application of the model should be able to prevent the occurrence of food-borne illnesses in organizations. This explanatory (correlational) study examined the relationships among food facilities, food service workers, …

Health Care Price Transparency And Price Competition, Mark Merlis

National Health Policy Forum

Growing numbers of consumers are in health plans that give them incentives to be more cost-conscious. Yet complex pricing systems and limited information may make it hard to choose among providers and treatment options. This report examines steps that insurers and others have taken to make better price information available, possible government measures to further promote price transparency or to simplify price comparisons, and the likely effects on consumer behavior and provider competition.

Finding The Fastest Way To Her Heart: Linking Clinical And Policy Pathways, Paula Johnson, Brian R. Schuetz, Shelley M. Stark, Dora Tovar

New England Journal of Public Policy

The Mary Horrigan Connors Center for Women’s Health and Gender Biology at Brigham and Women’s Hospital in Boston, integrates research, clinical practice, and policy analysis with practical application to emerging women’s health issues. Recently, an interdisciplinary team of practitioners examined pathways to improving women’s heart health. Beginning with the evidence that a heart-healthy diet leads to improved health outcomes for women with cardiovascular disease, the Connors Center team charted a course of intellectual exploration that culminated in a broader community dialogue on how to improve access to healthy and affordable food. Through clinical experiences, research activities, and an ongoing interchange …

Effects Of Residence And Race On Burden Of Travel For Care: Cross Sectional Analysis Of The 2001 Us National Household Travel Survey, Janice C. Probst, Sarah B. Laditka, Jong-Yi Wang, Andrew O. Johnson

Faculty Publications

Background: Travel burden is a key element in conceptualizing geographic access to health care. Prior research has shown that both rural and minority populations bear disproportionate travel burdens. However, many studies are limited to specific types of patient or specific locales. The purpose of our study was to quantify geographic and race-based differences in distance traveled and time spent in travel for medical/dental care using representative national data.

Methods: Data were drawn from 2001 National Household Travel Survey (NHTS), a nationally representative, cross-sectional household survey conducted by the US Department of Transportation. Participants recorded all travel on a designated day; …

Condition Reporting And Resolution, J. M. Pesek, S. A. Wade

Publications (YM)

This procedure facilitates a safety conscious work environment by providing a mechanism for employees to make management aware of existing and potential conditions. This procedure establishes the responsibilities and process to be used to ensure that conditions related to, but not limited to, the environment, safety, health, waste isolation, operations, security, or quality of items and services associated with Office of Civilian Radioactive Waste Management (OCRWM) work activities are promptly identified, controlled, evaluated, and corrected as soon as practical. This procedure describes the process flow, controls, interfaces, and requirements for condition identification and resolution. This includes adverse conditions as well …

Fairfax County's Commitment: A Housing And Health Continuum For Seniors, Judith D. Moore, Lisa Sprague

National Health Policy Forum

This one-day site visit focused on the range of services made available to seniors by Fairfax County, Virginia, including senior centers, adult day health care, and assisted living and independent housing. Services to low-income residents were emphasized. Participants were introduced to the different agencies and funding streams involved and were able to observe how county officials have acted on a stated commitment to help seniors who wish to age in place, staying in the county and in their own homes rather than in a nursing home or other institution. The day included tours of two Fairfax County multiservice sites, in …

Patient Advocacy Resource Manual, Jeff Hope

Student Organizations

Patient Advocacy began as a freestanding group, formed by medical students who wanted to help homeless men and women with their psychosocial needs, such as finding a job, obtaining health insurance, and joining a drug and alcohol rehabilitation program. Later, we merged with Jeff HOPE to form an organization that can address all of the needs of our patients. This combination of energies and talents has proven quite beneficial, especially because our patients often need services that are beyond the scope of what the Jeff HOPE medical clinic can provide. Thus, one of our most important responsibilities is to link …

Medical Malpractice Reform: A Societal Crisis Or Fear Marketing?, Phil Rutsohn, Andrew Sikula Sr.

Management Faculty Research

This paper explores the primary issues surrounding the malpractice crisis currently facing the healthcare system and asks the question ‘is it truly a crisis or is it an effective marketing campaign waged by interested parties?’ The authors discuss the primary issues presented by both the supporters of tort reform and the opposition to tort reform. As is true for many issues in healthcare, final analysis suggests that tort reform is needed or not needed depends on the analysts' role in the system. The authors argue that the evidence suggests malpractice reform will produce desired results if the goal is to …

Adequacy Of Communicating Results From Screening Mammograms To African American And White Women, Beth Jones, Kam Reams, Lisa Calvocoressi, Amy B. Dailey, Stanislav V. Kasl, Nancy M. Liston

Health Sciences Faculty Publications

Objective. We examined whether African American women were as likely as White women to receive the results of a recent mammogram and to self-report results that matched the mammography radiology report (i.e., were adequately communicated). We also sought to determine whether the adequacy of communication was the same for normal and abnormal results.

Methods. From a prospective cohort study of mammography screening, we compared self-reported mammogram results, which were collected by telephone interview, to results listed in the radiology record of 411 African American and 734 White women who underwent screening in 5 hospital-based facilities in Connecticut between October 1996 …

Download Full Pdf Issue Of Thomas Jefferson University Mph Public Health Link Newsletter, Vol. 3, Iss.2, Marchl 2007

Public Health Link

The Dean of Jefferson College of Graduate Studies (JCGS) announced recently that the public health program has been given a new name and will make several other important changes beginning in September of 2007. The public health program is no longer a Master of Science in Public Health (MSPH) program. It is a Master of Public Health Program and will issue MPH degrees.

Medicare And P4p, David B. Nash

Selected Works of David B. Nash, MD, MBA

No abstract provided.

Fatal Aerial Lift Injuries, Kentucky Injury Prevention And Research Center

Kentucky Haz Alerts--Motor Vehicle

To prevent injuries while working in aerial lifts:

• A “pre-job safety plan” should be developed for each job site and reviewed prior to each day on the job site.
• Mechanical checks should be performed on all equipment at each job site prior to each use.
• There should be communication between the worker in the elevated lift and ground control crew.
• Ensure that appropriate fall protection equipment is available and correctly used when working from elevations.
• Employees should work within job qualifications and job limits.

Use Of Complementary And Alternative Medicine For Weight Control In The United States, Patricia A. Sharpe, Heidi M. Blanck, Joel E. Williams, Barbara E. Ainsworth, Joan M. Conway

Faculty Publications

Objectives: The purpose was to assess the prevalence and correlates of complementary and alternative medicine use for weight control.

Design: A list-assisted random-digit-dialed telephone survey of adults was conducted in the fall of 2002 (n = 11,211). The focus of the study was complementary and alternative medicine (CAM) use, other than dietary supplements, in the previous 12 months.

Settings/location: The sample of respondents was drawn from the total noninstitutionalized U.S. adult population residing in telephone-equipped locations.

Subjects: The sampling procedures were designed to obtain adequate representation of Hispanic and non-Hispanic black respondents. Data from the total sample of 11,211 …

Staphylococcal Cassette Chromosome Mec And Panton-Valentine Leukocidin Characterization Of Methicillin-Resistant Staphylococcus Aureus Clones, Shannon M. Moroney, Loree C. Heller, Jesse Arbuckle, Monica Talavera, Ray H. Widen

Bioelectrics Publications

Staphylococcal cassette chromosome mec (SCCmec) types and Panton-Valentine leukocidin (PVL) gene carriage were compared among suspected community-associated methicillin-resistant Staphylococcus aureus MRSA (CA-MRSA) and health care-associated MRSA (HA-MRSA) isolates. CA-MRSA isolates carried the SCCmec type IV complex, and most were PVL positive. The HA-MRSA isolates carried the SCCmec type II complex and did not harbor the PVL genes.

The Association Between Lifestyle Factors And Inflammatory Markers, Kerry Ann Stonebrook

Loma Linda University Electronic Theses, Dissertations & Projects

Background: Cardiovascular disease (CVD) is the leading cause of death for both men and women in the United States. While smoking, high blood pressure, and elevated cholesterol levels are established risk factors for CVD, inflammation is being evaluated as a potential independent risk factor. A key cytokine regulator of the inflammatory response, interleukin-1 (IL-1), has emerged as playing a particularly important role at the genetic level in determining the degree to which the inflammation pathway is turned on. How an individual’s genetic make-up affects inflammation, CVD risk, and response to lifestyle intervention is an area of research that is in …

Objectively Measured Physical Activity And Fat Mass In A Large Cohort Of Children, Andy R. Ness, Sam D. Leary, Calum Mattocks, Steven N. Blair, John J. Reilly, Jonathan Wells, Sue Ingle, Kate Tilling, George Davey Smith, Chris J. Riddoch

Faculty Publications

Background: Previous studies have been unable to characterise the association between physical activity and obesity, possibly because most relied on inaccurate measures of physical activity and obesity.

Methods and Findings: We carried out a cross sectional analysis on 5,500 12-year-old children enrolled in the Avon Longitudinal Study of Parents and Children. Total physical activity and minutes of moderate and vigorous physical activity (MVPA) were measured using the Actigraph accelerometer. Fat mass and obesity (defined as the top decile of fat mass) were measured using the Lunar Prodigy dual x-ray emission absorptiometry scanner. We found strong negative associations between MVPA and …

Seaweed And Soy: Companion Foods In Asian Cuisine And Their Effects On Thyroid Function In American Women, Jane Teas, Lewis E. Braverman, Mindy S. Kurzer, Sam Pino, Thomas G. Hurley, James R. Hébert

Faculty Publications

Seaweeds and soy are two commonly eaten foods in Asia. Both have been reported to affect thyroid function, seaweed because of its iodine content and soy because of its goitrogenic effect. Twenty-five healthy postmenopausal women (mean age 58 years) completed a double-blinded randomized crossover study. Ten capsules (5 g/day) of placebo or seaweed (Alaria exculenta), providing 475 ug of iodine/day, were consumed daily for 7 weeks. A powdered soy protein isolate (Solae Co., St. Louis, MO) providing 2 mg of isoflavones/kg of body weight, was given daily during the last week of each treatment arm. On average, …

Characterization Of Alanine Aminotransferase And Transaldolase In T. Brucei, Diana Spitznagel

Doctoral

T. brucei is the causative agent of sleeping sickness in humans and nagana in cattle. The parasite is transmitted by the tsetse fly, which is endemic in many areas of Africa. Considerable metabolic changes occur between the two life cycle stages, the procyclic fly form (PCF) and the mammalian bloodstream form (BSF). This work focuses on two enzymes of T. brucei (1) Transaldolase (TbTA) is part of the pentose phosphate pathway. The pathway is complete in the PCFS, but show abnormalities in the BSF. In particular, the enzymes preceding and succeeding the TbTA reaction are not detectable in BSF. This …

Assessing The Unreliability Of The Medical Literature: A Response To "Why Most Published Research Findings Are False", Steven Goodman, Sander Greenland

Johns Hopkins University, Dept. of Biostatistics Working Papers

A recent article in this journal (Ioannidis JP (2005) Why most published research findings are false. PLoS Med 2: e124) argued that more than half of published research findings in the medical literature are false. In this commentary, we examine the structure of that argument, and show that it has three basic components:

1)An assumption that the prior probability of most hypotheses explored in medical research is below 50%.

2)Dichotomization of P-values at the 0.05 level and introduction of a “bias” factor (produced by significance-seeking), the combination of which severely weakens the evidence provided by every design.

3)Use of Bayes …

Kekerasan Pada Setiap Tahap Penempatan Tki Asal Propinsi Sumatera Barat Tahun 2006, Helfi Agustin

Kesmas

Peningkatan jumlah tenaga kerja Indonesia yang diberangkatkan keluar negeri seiring dengan kebijakan nasional diikuti oleh peningkatan berbagai masalah yang mengarah pada pelanggaran hak azasi manusia. Penelitian ini bertujuan mengetahui berbagai kekerasan yang menyertai setiap tahap penempatan tenaga kerja Indonesia dan dampaknya terhadap kesehatan. Penelitian ini menggunakan metoda kualitatif dengan metode pengumpulan data wawancara mendalam dan metoda analisis tema. Penelitian diadakan di Propinsi Sumatera Barat, pada bulan April-Mei 2006. Hasil penelitian menemukan semua TKI berangkat pada usia muda. TKI dengan tingkat pendidikan/akses informasi terbatas mudah terjebak dalam pemberangkatan ilegal. Semua TKI mengalami beberapa bentuk kekerasan secara bersamaan dan berulang dan besar …