Digital Commons Network^™

Traditional Practices And Governmental Responsibilities: An Investigation Into The Evolving Partnership Between Indigenous Brazilian Midwives And State-Provided Maternal Healthcare Services, Caitlin Canfield

Independent Study Project (ISP) Collection

Traditional midwives play important roles in the provision of maternal healthcare services in developing countries. Especially in rural, marginalized communities, traditional midwives help to provide obstetric care when local governmental health services fail to do so. The healthcare provision that traditional midwives “should” undertake is a subject debated by public health and development policy makers who seek to reduce maternal mortality rates and improve maternal health in rural communities in developing countries. This study examines the practices of traditional midwives in indigenous Tupinambá communities located in Southern Bahia, Brazil. It seeks to define the contemporary role of traditional midwives within …

La Ley De Maternidad Gratuita En Intag: Su Aplicación, Educación Y Uso, Stephanie Lewis

Independent Study Project (ISP) Collection

The country of Ecuador has a high rate of infant and maternal mortality, as well as problems with malnutrition. The Minister of Public Health responded to these problems with a law to provide the public with different types of free medical attention. The Minister’s hope is to reduce these problems with the law. The law is called the Law of Free Motherhood and Attention for Infants (Ley de Maternidad Gratuita y Atención a la Infancia), and includes free attention and vitamins for pregnant women, free birth and post-birth care, and vitamins, attention and vaccinations for children under 5 years of …

“Sou Doméstica:” Construções De Identidade E Saúde Das Trabalhadoras Domésticas Salvador, Bahia Brasil, Jenny Fauci

Independent Study Project (ISP) Collection

O mundo do trabalho doméstico é um mundo invisível de discriminação, desvalorização e exploração. No Brasil, existem milhões de trabalhadoras domésticas, na sua maioria mulheres, negras e que vêm de histórias pobres. Essas trabalhadoras domésticas enfrentam uma agressão profunda contra a dignidade, direitos, saúde, e identidade delas.

Nesta pesquisa, perguntamos sobre a relação entre identidade e saúde. Como é que a identidade afeta a saúde? Qual é a natureza desta relação? A motivação para esta pergunta vem da invisibilidade das condições de saúde—como uma expressão do corpo e da mente-- desta população e também o reconhecimento que a identidade duma …

Individual Responsibility Concerning Hiv Transmission Among Msm: A Comparative Study Of The Effectiveness Of Ngo Intervention Policies And Their Practical Applications Within The United Kingdom, Australia, And The Netherlands, Martha Kienbaum

Independent Study Project (ISP) Collection

This study investigates the complexities involved in utilizing the terms of individual responsibility for the construction of HIV prevention campaigns that target men who have sex with men. Four health workers in the Netherlands were interviewed about their personal opinions regarding HIV intervention, and these interviews were analyzed qualitatively for their points of comparison and contrast. Then, campaign materials from organizations in the United Kingdom and Australia were analyzed for their use of the language of responsibility, their portrayal of MSM, their balance between promoting disclosure and communication, their focus on individual groups within the MSM community, and their overall …

Environmental Equity Is Child's Play: Mapping Public Provision Of Recreation Opportunities In Urban Neighbourhoods, Jason Gilliland, Martin Holmes, Jennifer D. Irwin, Patricia Tucker

Geography & Environment Publications

This paper examines the spatial distribution of recreational opportunities for children and youth in a mid-sized Canadian city (London, Ontario), in relation to the socioeconomic status of neighbourhoods and estimated local need for publicly provided recreation spaces. Public recreation facilities (N = 537) throughout the city were identified, mapped and analysed in a geographic information system. To explore potential socio-environmental inequities, neighbourhoods (N = 22) were characterized by socioeconomic and environmental variables, an index of neighbourhood social distress, a neighbourhood play space needs index, and measures of the prevalence and density of recreational opportunities. The results of the …

Annual Report To The Nation On The Status Of Cancer, 1975–2003, Featuring Cancer Among U.S. Hispanic/ Latino Populations, Holly L. Howe, Xiao-Cheng Wu, Lynn A. G. Ries, Vilma Cokkinides, Faruque Ahmed, Ahmedin Jemal, Barry A. Miller, Melanie Williams, Elizabeth Ward, Phyllis A. Wingo, Amelie Ramirez, Brenda K. Edwards

United States Public Health Resources

BACKGROUND. The American Cancer Society, Centers for Disease Control and Prevention, National Cancer Institute, and North American Association of Central Cancer Registries collaborate annually to provide U.S. cancer information, this year featuring the first comprehensive compilation of cancer information for U.S. Latinos.

METHODS. Cancer incidence was obtained from 90% of the Hispanic/Latino and 82% of the U.S. populations. Cancer deaths were obtained for the entire U.S. population. Cancer screening, risk factor, incidence, and mortality data were compiled for Latino and non-Latino adults and children (incidence only). Long-term (1975– 2003) and fixed-interval (1995–2003) trends and comparative analyses by disease …

Download Full Pdf Issue Of Thomas Jefferson University Mph Public Health Link Newsletter, Vol. 2, Iss. 7, October 2006

Public Health Link

Vol. 2, Iss. 7 includes a description of the The Albert Schweitzer Fellowship, a faculty spotlight on the Thomas Jefferson University and the Rwanda Healing Project and new course offerings for the spring.

Stress, Coping, Social Support, And Prostate Cancer Risk Among Older African American And Caucasian Men, Ann L. Coker, Maureen Sanderson, Gary L. Ellison, Mary Kay Fadden

CRVAW Faculty Journal Articles

Objectives: While psychosocial stress and high effort coping have been associated with reduced immune function, no epidemiologic study has addressed psychological stress and risk of prostate cancer. The purpose of this analysis was to investigate the association between stress, coping, social support, and risk of prostate cancer among older men (age 65–79 years). Design: Population-based case-control study in South Carolina.

Participants: Cases were 400 incident, histologically confirmed prostate cancer cases identified through the South Carolina Central Cancer Registry between 1999 and 2001 (70.6% response rate). Controls were 385 men identified through the 1999 Health Care Financing Administration Medicare beneficiary file …

Victims Struck Out By Logging, Kentucky Injury Prevention And Research Center

Kentucky Haz Alerts--Tractors/Logging

To prevent injuries while felling trees:

• Loggers should attend the Kentucky Master Logger program for training and education regarding Occupational Safety and Health Administration logging standards and safety procedures.
• A “pre-job safety plan” should be developed for each job site and the plan should be reviewed prior to each day on the site.
• Proper notching and directional felling techniques should be utilized when felling trees.
• Develop a felling plan for each tree prior to felling that includes escape route, dead or hanging branches, vines, and nearby trees.

Health And Needs Assessment Of Geriatric Patients: Results Of A Survey At A Teaching Hospital In Karachi, Syed Nabeel Zafar, Hammad Ashraf Ganatra, Sarah Tehseen, Waris Qidwai

Department of Family Medicine

Objective: To study the health and needs of geriatric patients

Methods: A questionnaire based survey of patients visiting the out-patient department of Aga Khan University was carried out. Ethical requirements were met and included administration of informed consent and provision of confidentiality to patients. Convenience sampling was used without any randomization for interviews. Epi-info and SPSS software were used for data management.

Results: Four hundred and two (402) subjects above the age of 65 were surveyed. Most of the subjects were retired (40.5%) married (76.4%) men (69.7%). Ages ranged from 65 to 90 years, the mean being 70.57 years and …

Physical Activities In Adolescent Girls: Variability In Energy Expenditure, Karin A. Pfeiffer, Kathryn H. Schmitz, Robert G. Mcmurray, Margarita S. Treuth, David M. Murray, Russell R. Pate

Faculty Publications

Background - Understanding interindividual variability of energy expended in common activities is important for determining precise estimates of energy expenditure in surveillance studies and clinical trials. The purpose of this study was to describe the variability in energy expenditure for selected physical activities among adolescent girls.

Methods - Seventy-four adolescent girls (aged 13 to 14 years) participated in this cross-sectional investigation. Data were collected in 2001 and analyzed in 2004. Energy expenditure was measured by indirect calorimetry for ten activities and during a submaximal cycle ergometer test, which was used to estimate cardiorespiratory fitness. Variability in energy expended for the …

A Focused Telephonic Nursing Intervention Delivers Improved Adherence To A1c Testing, Patty M. Orr, Matthew A. Mcginnis, Laurel R. Hudson, Sadie S. Coberley, Albert Crawford, Janice L. Clarke, Neil I. Goldfarb

College of Population Health Faculty Papers

Compliance with hemoglobin A1c (A1c) testing is suboptimal despite the clear national recommendations and guidelines established for care of patients with diabetes. Recent studies have demonstrated a relationship between participation in a diabetes disease management (DM) program and improved adherence to A1c testing. A focused intervention study was initiated to investigate the ability of a DM program to drive improvement in A1c testing. A cohort of 36,327 members experienced a statistically significant increase (29%) in A1c testing while participating in the 6-month focused intervention. This finding demonstrated that a focused DM intervention is able to deliver improvement in a clinical …

Frequency And Characteristics Of Breast Lymphomas Presenting To A Tertiary Care Hospital, Pakistan, Nausheen Yaqoob, Shahid Pervez, Naila Kayani, Rashida Ahmed, Zubair Ahmed, Sheema Hasan

Department of Pathology and Laboratory Medicine

Objective: To assess the relative frequency of (primary and secondary) mammary lymphomas presenting to a tertiary care hospital, Pakistan and its categorization according to WHO classification of lymphoid neoplasms.

Methods: All NHLs (nodal and extra nodal) diagnosed in the section of histopathology during 1992-2004 were retrieved and reviewed. All patients (n=30) diagnosed with lymphomatous involvement of the breast were selected. Distinction between primary and secondary breast lymphomas was not made owing to lack of availability of clinical information.

Results: A total of 5637 breast malignancies were diagnosed in our department during the study period of 10 years and the total …

What Is Available Vs. What Is Accessible: An Evaluation Of Resources For Kwazulu Natal Diabetics Based On The Data Of Kwazulu Natal Experts And Cato Manor Diabetics, Mollie Gurian

Independent Study Project (ISP) Collection

The objective of this study was to learn about the resources available to a diabetic and the actual ability of diabetics to access these resources. I found that two ideal paradigms of care were consistently mentioned by experts in KwaZulu Natal and at the World Diabetes Congress (WDC), the international conference on diabetes that I attended in Cape Town. The first is self-management of the disease and a patient centered approach to care. The second is a collaborative team approach to treating diabetics which involves a number of experts besides a physician. These two concepts are connected in that a …

The Complex Realities Of Indigenous Health Care Delivery, Megan Waterman

Independent Study Project (ISP) Collection

The indigenous population of Australia faces a life expectancy that is eighteen years lower than the general population. This study addresses this incredible disparity by exploring the historical, cultural and social forces that impact on health status, focussing especially on health care service utilisation. Qualitative methods of interviewing and participant observation have been used to examine the two sectors of Aboriginal health service delivery in urban Victoria: Aboriginal community controlled health organisations (ACCHOs) and mainstream organisations. Accounting for the complex forces and realities in health service delivery, this is a discussion of the important components of the current realities for …

Treatment Evolution In High-Risk Congenital Diaphragmatic Hernia: Ten Years' Experience With Diaphragmatic Agenesis, Kevin P Lally, Pamela A Lally, Krisa P Van Meurs, Desmond J Bohn, Carl F Davis, Bradley Rodgers, Jatinder Bhatia, Golde Dudell

Faculty, Staff and Student Publications

OBJECTIVE: The objective of this study was to evaluate the impact of newer therapies on the highest risk patients with congenital diaphragmatic hernia (CDH), those with agenesis of the diaphragm.

SUMMARY BACKGROUND DATA: CDH remains a significant cause of neonatal mortality. Many novel therapeutic interventions have been used in these infants. Those children with large defects or agenesis of the diaphragm have the highest mortality and morbidity.

METHODS: Twenty centers from 5 countries collected data prospectively on all liveborn infants with CDH over a 10-year period. The treatment and outcomes in these patients were examined. Patients were followed until death …

Historical Critique Of The Leading Causes Of Death In The United States, Mckinley Thomas

Journal of the Georgia Public Health Association

Historical Critique of the Leading Causes of Death in the United States

A Needs Assessment Of Hypertension In Georgia, Faye Lopez, Marylen Rimando, Harshali Khapekar

Journal of the Georgia Public Health Association

Hypertension is a leading cause of stroke, coronary artery disease, heart attack, and heart and kidney failure in the United States. In Georgia, the percentage of those with hypertension and related diseases remain above the national average. The aim of this paper is to offer a basic review of hypertension including physical complications of the disease and to provide statistics regarding the scope of hypertension in the state of Georgia. Additionally, the paper provides insights on current hypertension programs such as the National High Blood Pressure Education Program (NHBPEP) and Dietary Approaches to Stop Hypertension (DASH). In conclusion, a statewide …

Racial Differences In Perception Of Breast Cancer Risk In Rural Southeast Georgia, Stuart H. Tedders, Anthony V. Parrillo, Karl E. Peace, Jannell R. Knight

Journal of the Georgia Public Health Association

A university-public health collaborative was formed to more fully understand cancer risk among rural women in Georgia. Objectives: This study sought to gain an understanding of racial differences with regard to behavioral risk, perception of breast cancer risk, and perception of barriers to screening. Design: Differences in subjects’ risk and risk perception were assessed by creating, piloting, and administering a written survey at local health departments. Sample: A purposive sample of females enrolled in breast and cervical cancer screening programs in four rural counties in southeast Georgia (n = 147) were surveyed. Subjects were randomly invited to participate. Incentives were …

Care Quality For Adult Medicaid Beneficiaries With Type 2 Diabetes Varies By Primary Care Provider Subspecialty, Robert M. Mayberry, Rita Finley, Ernest Alema-Mensah, Trobiand A. Davis

Journal of the Georgia Public Health Association

The Georgia Medicaid primary care case management (PCCM) program, phased in over the 1994-1997 period, has now given way to a capitated managed care model of regional care management organizations (CMOs). Using Georgia Medicaid eligibility and provider claim data for 1996-1998, this study investigated diabetes care quality and whether it varied by primary care provider subspecialty in a longitudinal follow-up of newly diagnosed adults with type 2 diabetes during the early phase of the PCCM program. Results indicated that the quality of diabetes care was suboptimal and varied significantly by PCP subspecialty, with patients seen by generalists least likely to …

Pregnancy And Delivery Costs In Georgia Medicaid: Pccm Versus Fee-For-Service Enrollees, Chery Raskind-Hood, Kathleen E. Adams, Ernest Alema-Mensah, Robert M. Mayberry

Journal of the Georgia Public Health Association

This study examines the enrollment, resource utilization, and prenatal care cost patterns among pregnant black and white women in Georgia’s PCCM program, Georgia Better Health Care (GBHC), compared with those acquiring pregnancy and delivery services through Georgia’s Fee for Service (FFS) sector. Birth certificate data from 1998 were linked with Medicaid enrollment and claims data from 1997 and 1998 to construct a retrospective pregnancy history for each Medicaid woman giving birth in Georgia hospitals in 1998. Total payments for pregnancy and delivery services and on the total number of prenatal care visits were derived for each woman in the sample. …

Biologic Interaction And Their Identification, Tyler J. Vanderweele, James Robins

COBRA Preprint Series

The definitions of a biologic interaction and causal interdependence are reconsidered in light of a sufficient-component cause framework. Various conditions and statistical tests are derived for the presence of biologic interactions. The conditions derived are sufficient but not necessary for the presence of a biologic interaction. Through a series of examples it is made evident that in the context of monotonic effects, but not in general, the conditions which are derived are closely related but not identical to effect modification on the risk difference scale.

A Theory Of Sufficient Cause Interactions, Tyler J. Vanderweele, James M. Robins

COBRA Preprint Series

Sufficient-component causes are discussed within the potential outcome framework so as to formalize notions of sufficient causes, synergism and sufficient cause interactions. Doing so allows for the derivation of counterfactual conditions and statistical tests for detecting the presence of sufficient cause interactions. Under the assumption of monotonic effects, more powerful statistical tests for sufficient cause interactions can be derived. The statistical tests derived for sufficient cause interactions are compared with and contrasted to interaction terms in standard statistical models.

Exploiting Gene-Environment Independence For Analysis Of Case-Control Studies: An Empirical Bayes Approach To Trade Off Between Bias And Efficiency , Bhramar Mukherjee

The University of Michigan Department of Biostatistics Working Paper Series

Standard prospective logistic regression analysis of case-control data often leads to very imprecise estimates of gene-environment interactions due to small numbers of cases or controls in cells of crossing genotype and exposure. In contrast, modern ``retrospective'' methods, including the celebrated ``case-only'' approach, can estimate the interaction parameters much more precisely, but they can be seriously biased when the underlying assumption of gene-environment independence is violated. In this article, we propose a novel approach to analyze case-control data that can relax the gene-environment independence assumption using an empirical Bayes (EB) framework. In the special case, involving a binary gene and a …

Girls' Perception Of Physical Environmental Factors And Transportation: Reliability And Association With Physical Activity And Active Transport To School, Kelly R. Evenson, Amanda Birnbaum, Ariane L. Bedimo-Rung, James Sallis, Carolyn C. Voorhees, Kimberly Ring, John P. Elder

Department of Public Health Scholarship and Creative Works

Background

Preliminary evidence suggests that the physical environment and transportation are associated with youth physical activity levels. Only a few studies have examined the association of physical environmental factors on walking and bicycling to school. Therefore, the purpose of this study was (1) to examine the test-retest reliability of a survey designed for youth to assess perceptions of physical environmental factors (e.g. safety, aesthetics, facilities near the home) and transportation, and (2) to describe the associations of these perceptions with both physical activity and active transport to school.

Methods

Test and retest surveys, administered a median of 12 days later, …

Spatial Cluster Detection For Censored Outcome Data, Andrea J. Cook, Diane Gold, Yi Li

Harvard University Biostatistics Working Paper Series

No abstract provided.

Extending Marginal Structural Models Through Local, Penalized, And Additive Learning, Daniel Rubin, Mark J. Van Der Laan

U.C. Berkeley Division of Biostatistics Working Paper Series

Marginal structural models (MSMs) allow one to form causal inferences from data, by specifying a relationship between a treatment and the marginal distribution of a corresponding counterfactual outcome. Following their introduction in Robins (1997), MSMs have typically been fit after assuming a semiparametric model, and then estimating a finite dimensional parameter. van der Laan and Dudoit (2003) proposed to instead view MSM fitting not as a task of semiparametric parameter estimation, but of nonparametric function approximation. They introduced a class of causal effect estimators based on mapping loss functions suitable for the unavailable counterfactual data to those suitable for the …

Assessing The Adequacy Of Variance Function In Heteroscedastic Regression Models, Lan Wang, Xiao-Hua Andrew Zhou

UW Biostatistics Working Paper Series

Heteroscedastic data arise in many applications. In a heteroscedastic regression model, the variance is often taken as a parametric function of the covariate or the regression mean. This paper presents a kernel-smoothing based nonparametric test for checking the adequacy of such a postulated variance structure. The test does not need to specify a parametric distribution for the random errors. It has an asymptotical normal distribution under the null hypothesis and is powerful against a large class of alternatives. Numerical simulations and an illustrative example are provided.

Download Full Pdf Issue Of Thomas Jefferson University Mph Public Health Link Newsletter, Vol. 2, Iss. 6, September 2006

Public Health Link

Vol. 2, Iss. 6 of the MPH Public Health Link highlights faculty member Vic Spain, the formal announcement of national accreditation for Jefferson Master of Science Program in Public Health and new course offerings for the Spring.

Amputation Injuries Due To Forklifts, Kentucky Injury Prevention And Research Center

Kentucky Haz Alerts--Other

To prevent injuries from forklifts while working:

• Before you operate a forklift, make sure that you are trained and certified.
• Remember if you are on a sit-down type forklift, and it starts to over-turn, lean in the opposite direction, stay with the forklift; don’t jump.
• When operating a forklift on site, slow the truck and sound the horn at cross aisles, exits, and other employee traverse points.
• Before dismounting, set the parking brake, lower the forks or lifting carriage, and neutralize controls.