Medicine and Health Sciences Commons^™

What Aspect Of Dependence Does The Fagerström Test For Nicotine Dependence Measure?, Joseph R. Difranza, Robert J. Wellman, Judith A. Savageau, Ariel Beccia, W. W. Sanouri A. Ursprung, Robert Mcmillen

Judith A. Savageau

Although the Fagerström Test for Nicotine Dependence (FTND) and the Heaviness of Smoking Index (HSI) are widely used, there is a uncertainty regarding what is measured by these scales. We examined associations between these instruments and items assessing different aspects of dependence. Adult current smokers ( , mean age 33.3 years, 61.9% female) completed a web-based survey comprised of items related to demographics and smoking behavior plus (1) the FTND and HSI; (2) the Autonomy over Tobacco Scale (AUTOS) with subscales measuring Withdrawal, Psychological Dependence, and Cue-Induced Cravings; (3) 6 questions tapping smokers’ wanting, craving, or needing experiences in response …

Incorporating Digital Health Literacy Into Adult Esl Education On The Us-Mexico Border, Erika Mein, Francisco Soto Mas

Francisco Soto Mas

The increasing digitization of information and communication has undoubtedly impacted the ways in which people in the United States access and interpret health information. Although the traditional emphasis of health literacy research has been the comprehension of health-related texts such as patient information forms, prescriptions, and medicine labels, the increased use of electronic means to locate health information requires more critical engagement with texts beyond basic comprehension. In accessing electronic health information, patients need to be able to navigate the vast amount of online health information and to interpret and synthesize health information across multiple sources (i.e. websites) while also …

A 'Snip' In Time: What Is The Best Age To Circumcise?, Brian J. Morris, Jake H. Waskett, Joya Banerjee, Richard G. Wamai, Aaron A. R. Tobian, Ronald H. Gray, Stefan A. Bailis, Robert C. Bailey, Jeffrey D. Klausner, Robin J. Willcourt, Daniel T. Halperin, Thomas E. Wiswell, Adrian Mindel

Richard G. Wamai

Background Circumcision is a common procedure, but regional and societal attitudes differ on whether there is a need for a male to be circumcised and, if so, at what age. This is an important issue for many parents, but also pediatricians, other doctors, policy makers, public health authorities, medical bodies, and males themselves. Discussion We show here that infancy is an optimal time for clinical circumcision because an infant's low mobility facilitates the use of local anesthesia, sutures are not required, healing is quick, cosmetic outcome is usually excellent, costs are minimal, and complications are uncommon. The benefits of infant …

Introduction Of A Waterless Alcohol-Based Hand Rub In A Long-Term Care Facility, Lona Mody, Mcneil A. Shelly, Rongjun Sun, Bradley Suzanne, Carol A. Kauffman

Rongjun Sun

OBJECTIVE: To examine the impact of introduction of an alcohol-based hand rub on hand hygiene knowledge and compliance and hand colonization of healthcare workers (HCWs) in a long-term-care facility (LTCF). METHODS: Two floors of an LTCF participated. Ward A used the hand rub as an adjunct to soap and water; ward B was the control. HCWs' hands were cultured using the bag-broth technique for Staphylococcus aureus, gram-negative bacilli (GNB), Candida, and vancomycin-resistant enterococci (VRE). HCWs completed a questionnaire at baseline and after an educational intervention and introduction of rub. RESULTS: Hand hygiene practices, knowledge, and opinions did not change after …

Self-Reported Colorectal Cancer Screening Of Medicare Beneficiaries In Family Medicine Vs. Internal Medicine Practices In The United States: A Cross-Sectional Study, Angela (Young) Higgins, Anna R. B. Doubeni, Karon L. Phillips, Adeyinka O. Laiyemo, Becky A. Briesacher, Jennifer Tjia, Chyke A. Doubeni

Jennifer Tjia

BACKGROUND: The benefit of screening for decreasing the risk of death from colorectal cancer (CRC) has been shown, yet many patients in primary care are still not undergoing screening according to guidelines. There are known variations in delivery of preventive health care services among primary care physicians. This study compared self-reported CRC screening rates and patient awareness of the need for CRC screening of patients receiving care from family medicine (FPs) vs. internal medicine (internists) physicians.

METHODS: Nationally representative sample of non-institutionalized beneficiaries who received medical care from FPs or internists in 2006 (using Medicare Current Beneficiary Survey). The main …

Environmental Health Information Systems: More Than Just Gigabytes, Christopher R. Cook

Christopher Cook

Environmental health professionals are concerned about bites. Animal bites, mosquito bites, and tick bites to name a few. But what about bytes of data? Environmental health information systems (EHIS) are often the "silent partners" in an environmental health (EH) department's daily protection of public health. By Webster's dictionary definition, a silent partner is a cohort that does not have the right to participate in an organization's management process. The purpose of this study was to encourage public health officials to make EHIS full partners in their EH departments. Through the use of five surveys, this study was designed to increase …

Environmental Health Information Systems: More Than Just Gigabytes, Christopher R. Cook

Christopher Cook

Environmental health professionals are concerned about bites. Animal bites, mosquito bites, and tick bites to name a few. But what about bytes of data? Environmental health information systems (EHIS) are often the "silent partners" in an environmental health (EH) department's daily protection of public health. By Webster's dictionary definition, a silent partner is a cohort that does not have the right to participate in an organization's management process. The purpose of this study was to encourage public health officials to make EHIS full partners in their EH departments. Through the use of five surveys, this study was designed to increase …

The Boston Puerto Rican Health Study, A Longitudinal Cohort Study On Health Disparities In Puerto Rican Adults: Challenges And Opportunities, Katherine L. Tucker, Josiemer Mattei, Sabrina E. Noel, Bridgette M. Collado, Jackie Mendez, Jason Nelson, John Griffith, Jose M. Ordovas, Luis M. Falcon

Katherine L. Tucker

Background The Boston Puerto Rican Health Study is an ongoing longitudinal cohort study designed to examine the role of psychosocial stress on presence and development of allostatic load and health outcomes in Puerto Ricans, and potential modification by nutritional status, genetic variation, and social support. Methods Self-identified Puerto Ricans, aged 45-75 years and residing in the Boston, MA metro area, were recruited through door-to-door enumeration and community approaches. Participants completed a comprehensive set of questionnaires and tests. Blood, urine and salivary samples were extracted for biomarker and genetic analysis. Measurements are repeated at a two-year follow-up. Results A total of …

Social Determinants Of Health In Canada: Are Healthy Living Initiatives There Yet? A Policy Analysis, Dana Gore, Anita Kothari

Anita Kothari

Introduction: Preventative strategies that focus on addressing the social determinants of health to improve healthy eating and physical activity have become an important strategy in British Columbia and Ontario for combating chronic diseases. What has not yet been examined is the extent to which healthy living initiatives implemented under these new policy frameworks successfully engage with and change the social determinants of health. Methods: Initiatives active between January 1, 2006 and September 1, 2011 were found using provincial policy documents, web searches, health organization and government websites, and databases of initiatives that attempted to influence to nutrition and physical activity …

Inquiring Into Our Past: When The Doctor Is A Survivor Of Abuse, Lucy M. Candib, Judith A. Savageau, Linda F. Weinreb, George W. Reed

Judith A. Savageau

BACKGROUND: Health care professionals like other adults have a substantial exposure to childhood and adult victimization, but the prevalence of abuse experiences among practicing family physicians has not been examined. Also unclear is the impact of such personal experiences of abuse on physicians' screening practices for childhood abuse among their patients and the personal and professional barriers to such screening. METHODS: We surveyed Massachusetts family physicians about their screening practices of adult patients for a history of childhood abuse and found that 33.6% had some experience of personal trauma, with 42.4% of women and 24.3% of men reporting some kind …

Hepatitis C Screening And Testing: A Call For A National Response., Donna M. Zucker Rn, Phd, Faan

Donna M. Zucker

The purpose of this brief is to convey the immediate need to coordinate and integrate hepatitis C virus (HCV) screening and testing for HIV co-infected and HCV infected clients, into primary care. In 2000, 1.25 million persons were estimated to be chronically infected with hepatitis B virus (HBV), and 2.7 million are chronically infected with HCV. Furthermore, 55% to 85% of new HCV infections become chronic. Of the 1.0 million people chronically infected with HIV, 250,000 also have HBV, and ~50,000 also have HCV, the leading cause of hepatocellular carcinoma. Liver disease is now the leading cause of death in …

Help-Negation For Suicidal Thoughts In Sub-Clinical Samples Of Young People, Coralie Joy Wilson

Coralie J Wilson

Across the popular and academic literature, it is widely recognised that young people with persistent suicidal thoughts are at high risk for suicide completion. It is also accepted that seeking and receiving appropriate help offers protection against the development of acute forms of suicidality, along with suicide completion. Yet, as promising as appropriate help-seeking appears for suicide prevention, a growing number of studies suggest that suicidal ideation itself may impede the help-seeking process. There is evidence that acutely suicidal samples will negate or avoid available help, and there are indications that the help-negation process may occur in samples before levels …

Report On Sanitary Shoreline Survey Within The Tanbi Wetlands National Park And Other Shellfish Harvesting Communities, The Gambia

Michael A Rice

Emphasis is placed on the sanitary control of shellfish because of the direct relationship between pollution of shellfish growing areas and the transmission of diseases to humans. Shellfish borne infectious diseases are generally transmitted via a fecal - oral route. To accurately assess waters for shellfish harvesting, an evaluation of the pollution sources that are likely to affect the area is required by the NSSP. The shoreline survey is conducted of the shellfish growing area shoreline and estuary to locate pollution sources that could have an effect on the water quality of the area. The shoreline survey team visited 15 …

Why Match In Individually And Cluster Randomized Trials?, Laura B. Balzer, Maya L. Petersen, Mark J. Van Der Laan

Laura B. Balzer

The decision to match individuals or clusters in randomized trials is motivated by both practical and statistical concerns. Matching protects against chance imbalances in baseline covariate distributions and is thought to improve study credibility. Matching is also implemented to increase study power. This article compares the asymptotic efficiency of the pair-matched design, where units are matched on baseline covariates and the treatment randomized within pairs, to the independent design, where units are randomly paired and the treatment randomized within pairs. We focus on estimating the average treatment effect and use the efficient influence curve to understand the information provided by …

Assessing Patient-Provider Collaboration In Subjects With Type 2 Diabetes In Jamaica And Effects On Glycemic Control, Paul E. Daniel Jr., Michael A. Godkin, Judith A. Savageau, Rosemarie Wright-Pascoe, Michael G. Lee

Judith A. Savageau

Background: Type 2 Diabetes Mellitus is a growing health problem worldwide that places patients at increased risk of morbidity and mortality from microvascular and macrovascular complications. Research suggests that a patient-centered approach which focuses on patient-physician communication and collaboration in the management of chronic diseases such as diabetes may improve clinical outcomes in a glycemic parameter such as HbA1c. We measured the degree of this patient-centered approach in a sample population of subjects with Type 2 Diabetes in Jamaica with the use of the Patient Assessment of Care for Chronic Illness (PACIC) questionnaire and assessed the relationship between patient-centered care …

Evaluating The Efficacy Of Training Programs For Community Health Workers In Rural Uganda, Elizabeth Butler, Edward O’Neil, Zachary Tabb, Edward Mwebe, John Mukadde, Prossy Jim, Michael A. Godkin, Judith A. Savageau, Safi Ahmed, Arwen Wolfe

Judith A. Savageau

Background: The Ministry of Health and Omnimed, a non-profit U.S.-based organization that works with international communities to provide basic health education, have partnered to provide health training to community health workers (henceforth referred to as village health workers or VHWs) in rural villages in Uganda. The training is provided via an intensive five-day long session that introduces a wide variety of themes in basic health education taught by experts in the respective fields. The participants are selected by the local government based on their age, reliability, level of education and availability. On the first day, the participants are given a …

Exposing Racial Discrimination: Implicit & Explicit Measures – The My Body, My Story Study Of 1005 Us-Born Black & White Community Health Center Members, Nancy Krieger, Pamela D. Waterman, Anna Kosheleva, Jarvis T. Chen, Dana R. Carney, Kevin W. Smith, Gary G. Bennett, David R. Williams, Elmer Freeman, Beverley Russell, Gisele Thornhill, Kristin Mikolowsky, Rachel Rifkin, Latrice Samuel

Elmer Freeman

Background: To date, research on racial discrimination and health typically has employed explicit self-report measures, despite their potentially being affected by what people are able and willing to say. We accordingly employed an Implicit Association Test (IAT) for racial discrimination, first developed and used in two recent published studies, and measured associations of the explicit and implicit discrimination measures with each other, socioeconomic and psychosocial variables, and smoking. Methodology/Principal Findings: Among the 504 black and 501 white US-born participants, age 35-64, randomly recruited in 2008-2010 from 4 community health centers in Boston, MA, black participants were over 1.5 times more …

Hospital Collaboration With A Public Library [Poster], Margot Malachowski Mls

Margot G Malachowski, MLS, AHIP

The Use Of Tacit And Explicit Knowledge In Public Health: A Qualitative Study, Anita Kothari, Debbie Rudman, Maureen Dobbins, Michael Rouse, Shannon Sibbald, Nancy Edwards

Anita Kothari

Background Planning a public health initiative is both a science and an art. Public health practitioners work in a complex, often time-constrained environment, where formal research literature can be unavailable or uncertain. Consequently, public health practitioners often draw upon other forms of knowledge.

Methods Through use of one-on-one interviews and focus groups, we aimed to gain a better understanding of how tacit knowledge is used to inform program initiatives in public health. This study was designed as a narrative inquiry, which is based on the assumption that we make sense of the world by telling stories. Four public health units …

Neighborhood Socioeconomic Deprivation And Mortality: Nih-Aarp Diet And Health Study, Jacqueline M. Major, Chyke A. Doubeni, Neal D. Freedman, Yikyung Park, Min Lian, Albert R. Hollenbeck, Arthur Schatzkin, Barry I. Graubard, Rashmi Sinha

Chyke A. Doubeni

PURPOSE: Residing in deprived areas may increase risk of mortality beyond that explained by a person's own SES-related factors and lifestyle. The aim of this study was to examine the relation between neighborhood socioeconomic deprivation and all-cause, cancer- and cardiovascular disease (CVD)-specific mortality for men and women after accounting for education and other important person-level risk factors. METHODS: In the longitudinal NIH-AARP Study, we analyzed data from healthy participants, ages 50-71 years at study baseline (1995-1996). Deaths (n = 33831) were identified through December 2005. Information on census tracts was obtained from the 2000 US Census. Cox models estimated hazard …

Communicating H1n1 Risk To University Students: A Regional Cross-Sectional Survey-Study, Francisco Soto Mas

Francisco Soto Mas

The purpose of this study was to assess university students’ self-reported knowledge, behavior, and behavioral intention regarding H1N1 influenza. Participants included students at a major university in the southwestern US. Data were collected in early spring 2010 through a 24-item selfadministered survey. Outcome variables included knowledge, behavior and intention. A total of 483 students participated. Most reported trying to prevent H1N1 influenza though specific behaviors. Many lacked knowledge about symptoms and treatment; a few (10%) had been vaccinated; and half had no intention of getting vaccinated or practicing self-isolation. Gender and age were significantly associated with the three outcome variables. …

Motivational Factors Related To Female Participation In Collegiate Sports, Francisco Soto Mas

Francisco Soto Mas

Despite the many health benefits, physical activity trends in females have been consistently reported to be lower than that of males. Other demographic variables may also be related to sport participation. The purpose of this study was to explore the factors that motivate college females to participate in sports. This was a cross sectional, causal-comparative survey study. Eight motivational factors were explored: fitness, skill/mastery, enjoyment, affiliation/recognition, team factors, ego/competition, parental support, and external rewards. Female college athletes (N=82) from two post-secondary institutions were surveyed using the 35-item Modified Sports Motivation Survey. Results indicated that all factors were important to participants …

Application Of The Self-Care Deficit Nursing Theory To The Care Of Children With Special Health Care Needs In The School Setting, Rebecca D. Green

Rebecca D. Green

The purpose of this article is to describe how practicing school nurses can apply the basic tenets of Orem’s Self-Care DeficitNursing Theory to children with special health care needs and demonstrate its applicability in the school setting. Children with disability are identified as individual members of a vulnerable population whose status is considered within a framework of self-care. Keywords: Orem, children with special health care needs, self-care, school health

Are Podcasts Effective At Educating African American Men About Diabetes, Jarrett Johnson, Levi Ross, Walter Iwanenko, Judith Schiffert, Arup Sen

Levi Ross

Education is a critical component of the National Blueprint to eliminate racial disparities in diabetes. Research indicates that traditional methods of diabetes education has had limited effectiveness with minority populations and suggests that different educational approaches be explored. The purpose of the research was to explore the effectiveness of an emergent technology (podcast) for use in educating inner-city, African American men about diabetes prevention. Thirty African American men participated in self-administered, pretest-posttest surveys in August 2009. Surveys collected information on demographic characteristics, perceptions of diabetes, and diabetes knowledge. Paired samples t test was computed to evaluate pretest-posttest changes in overall …