Medicine and Health Sciences Commons^™

Medicaid In 2006: A Trip Down The Yellow Brick Road?, Jennifer Ryan

National Health Policy Forum

This issue brief explores the continuing evolution of the Medicaid program on several fronts. It discusses the benefits and cost-sharing flexibility that is included in the Deficit Reduction Act of 2005 (DRA) and examines the implications of these provisions for states, beneficiaries, and providers. The paper also explores recent trends in section 1115 waiver development and considers the use of waivers as a vehicle for restructuring Medicaid financing systems and for testing completely new approaches to health care delivery. The role of section 1115 waivers in the context of the DRA and as a mechanism for continued state innovation is …

Rebalancing Long-Term Care: The Role Of The Medicaid Hcbs Waiver Program, Cynthia Shirk

National Health Policy Forum

This paper reviews the history and background of the Medicaid home and community-based services (HCBS) waiver program. It describes the eligibility, benefits, and financing structure, as well as the trends in program expenditures over time. The paper considers the contribution of the HCBS waiver program toward improving access to community-based care for Medicaid beneficiaries who are elderly and disabled and discusses the barriers that remain. This paper also summarizes the provisions included in the recently enacted Deficit Reduction Act of 2005 that may further expand Medicaid HCBS and considers how it may continue the process of redefining the concept of …

Hormonal And Reproductive Factors And Risk Of Glioma: A Prospective Cohort Study, Stephanie A. Navarro Silvera, Anthony B. Miller, Thomas E. Rohan

Department of Public Health Scholarship and Creative Works

The etiology of glioma, the most commonly diagnosed malignant brain tumor among adults in the United States, is poorly understood. Given the lower incidence rate of glioma in women than in men, it has been hypothesized that reproductive and hormonal factors may be involved in the etiology of glioma. We conducted a secondary analysis of data from the National Breast Screening Study, which included 89,835 Canadian women, aged 40–59 years at recruitment between 1980 and 1985. Linkages to national cancer and mortality databases yielded data on cancer incidence and deaths from all causes, respectively, with follow‐up ending between 1998 and …

Fitness, Knowledge, Progress: Assessing Physician Qualification, Lisa Sprague

National Health Policy Forum

The informed and empowered consumer is an ideal invoked by many would-be health care reformers. An actual consumer wishing to don the mantle of power may be hindered by the scarcity of information available, particularly with respect to choosing among physicians. How is one to know who is best qualified? This issue brief looks at the basics of physician qualification and the processes by which physicians are licensed, credentialed, and board-certified. It examines how the evolution of these processes (for example, the move from lifetime certification to ongoing maintenance of certification) affects clinicians and their patients. The rise of quality …

Health Benefits In Retirement: Set For Extinction?, Mark Merlis

National Health Policy Forum

Nearly 18 million people rely on employer-provided retiree health benefits to fill gaps in Medicare’s coverage or to provide basic insurance until they reach Medicare age. Rising costs have led many employers to limit benefits, require participants to pay a larger share of the costs, or stop offering coverage at all for workers who have not yet retired. This background paper describes recent developments in retiree health benefits, possible future trends, and policy options for slowing the erosion of coverage or providing alternative ways for retirees to meet their expected medical expenses.

Carotenoid, Vitamin A, Vitamin C, And Vitamin E Intake And Risk Of Ovarian Cancer: A Prospective Cohort Study, Stephanie A. Navarro Silvera, Meera Jain, Geoffrey R. Howe, Anthony B. Miller, Thomas E. Rohan

Department of Public Health Scholarship and Creative Works

It is thought that oxidative stress resulting to repeated ovulation may increase the risk of ovarian cancer by inducing DNA damage (1). Consumption of antioxidants may, therefore, decrease ovarian cancer risk by counteracting oxidative stress and the resultant DNA damage (2, 3). Currently, the epidemiologic evidence regarding associations between antioxidants and risk of ovarian cancer is mixed (4-12). Of the two prospective studies, Kushi et al. (4) and Fairfield et al. (7) both reported no association between β-carotene and ovarian cancer risk. In addition, Fairfield et al. …

Commentary: Community Partnered Research: Driving Sensemaking, Managing Knowledge, And Moving Mental Health Care To New Heights, Junius J. Gonzales, Carmen Moten

Publications from Provost Junius J. Gonzales

No abstract provided.

The Vaccine Industry: Does It Need A Shot In The Arm?, Eileen Salinsky, Cole Werble

National Health Policy Forum

This paper broadly examines the scientific, regulatory, and economic factors that contribute to constrained vaccine production capacity, periodic vaccine shortages, and perceptions of inadequate investment in new vaccine product development. It describes the vaccine development and production processes and summarizes how regulatory requirements influence these activities. Market dynamics related to vaccine supply and demand are also explored, including an examination of the industry’s cost structure, potential market size, and purchaser price sensitivity. A broad range of policy interventions designed to address shortcomings of the vaccine market are considered.

Improving The Health Literacy Of Rural Elders: An Interdisciplinary Approach, M. Susan Jones, Marilyn M. Gardner, Janelle A. Peeler, Serena Merry Britt, Marilyn Lewis Graves

Nursing Faculty Publications

No abstract provided.

Community Participation In Tribal Diabetes Programs, Carolyn Smith-Morris

Anthropology Research

No abstract provided.

Attention-Deficit Hyperactivity Disorder And Substance Use Disorders: Prevalence And Treatment Outcomes, Carole J. Huddleston

Master of Public Health Program Student Publications

Attempts to improve substance use disorder (SUDs) treatment outcomes have been made by identifying subgroups of clients with psychoactive comorbidities and tailoring treatment approaches accordingly. This study sought to determine the prevalence of Attention-deficit Hyperactivity Disorder (ADHD) among admittees to a 28-day, residential program. It was hypothesized that ADHD screening and assessment would result in a higher prevalence rate when compared to the clinical record. It was further hypothesized that clients with ADHD would have higher, earlier unsuccessful terminations and higher overall unsuccessful terminations than non-ADHD clients. The differences in the prevalence rates (3.44% clinical record and 43.68% study psychologist) …

Community Health Outcomes Report: Phase 1, Bexar County Community Health Collaborative, William Spears, David W. Smith

Population and Public Health Sciences Faculty Publications

The 2006 Bexar County Community Health Assessment is a major initiative of The Health Collaborative, a cutting-edge, public-private model for solving community health issues. The mission of the organization is to improve the health status of the community through collaborative means. Partners include the major health systems in San Antonio, the YMCA of Greater San Antonio, Community First Health Plans, Methodist Healthcare Ministries, San Antonio Metropolitan Health District, and a community representative. Major health systems represented are Baptist Health System, CHRISTUS Santa Rosa Health Care, Methodist Healthcare, and University Health System.

The Health Collaborative began informally in 1997 when several …

Need For Cognition And Message Complexity In Motivating Fruit And Vegetable Intake Among Callers To The Cancer Information Service, Pamela Williams-Piehota, Judith Pizarro, Stephanie A. Navarro Silvera, Linda Mowad, Peter Salovey

Department of Public Health Scholarship and Creative Works

This field experiment examined the impact of an individual's need for cognition (NFC; the tendency to enjoy thinking deeply about issues), complex versus simple messages, and the interaction of NFC and message type on encouraging fruit and vegetable consumption. Callers to the Cancer Information Service of the National Cancer Institute (N = 517) were asked to participate in the experiment at the end of their call. Individual NFC was assessed, and participants were assigned randomly to receive a telephone message promoting fruit and vegetable consumption that was either complex and multifaceted or simple and straightforward. Similarly constructed brochures were …

Air Pollutants And Respiratory Symptoms Among Adults, Paulo A. Lotufo

Paulo A Lotufo

Air pollutants are associated with adverse respiratory effects mainly in susceptible groups such as children, elderly people and people with pre-existent respiratory disease. This study was designed to assess the impact of the inorganic composition of particulate matter on 33 adult asthmatics respiratory functions in São Paulo city, Brazil. From May to July 2002, fine and coarse particulate matter fractions were collected and trace metals (Fe2+, Mn2+, Zn2+, Pb2+, Cu2+) and major ions (Na+, Mg2+, K+, Ca2+, NH4 +, Cl-, NO3-, SO42-) composition was determined in each aqueous-extract fraction by Atomic Absorption Spectrometry with Graphite Furnace (AAS-GF) and Ion Chromatography, …

The Acute-Phase Proteins Serum Amyloid A And C Reactive Protein In Transudates And Exudates, Paulo A. Lotufo

Paulo A Lotufo

The distinction between exudates and transudates is very important in the patient management. Here we evaluate whether the acute-phase protein serum amyloid A (SAA), in comparison with C reactive protein (CRP) and total protein (TP), can be useful in this discrimination. CRP, SAA, and TP were determined in 36 exudate samples (27 pleural and 9 ascitic) and in 12 transudates (9 pleural and 3 ascitic). CRP, SAA, and TP were measured. SAA present in the exudate corresponded to 10% of the amount found in serum, that is, the exudate/serum ratio (E/S) was 0.10±0.13. For comparison, the exudate/serum ratio for CRP …

Epidemiological Studies In The Information And Genomics Era: Experience Of The Clinical Genome Of Cancer Project In São Paulo, Brazil, V Wunsch, Jose Eluf-Neto, Paulo A. Lotufo, Marco A. Zago

Paulo A Lotufo

No abstract provided.

Social Medicine In The Twenty-First Century, Scott Stonington Phd, Md, Seth M. Holmes Phd, Md, The Plos Medicine Editors

Seth M. Holmes PhD, MD

No abstract provided.

Health Is Still Social: Contemporary Examples In The Age Of The Genome, Timothy Holtz Md, Seth M. Holmes Phd, Md, Scott Stonington Phd, Md, Leon Eisenberg Md

Seth M. Holmes PhD, MD

No abstract provided.

Parce Qu'ils Sont Plus Pres Sol: L'Invisibilisation De La Souffrance Sociale Des Cueilleurs De Baies, Seth M. Holmes Phd, Md

Seth M. Holmes PhD, MD

No abstract provided.

Barriers For Latino Immigrants Seeking Health Care Services, Jennier Ng'andu

2006 Latino Health Summit

At the time of the presentation Ms. Ng'andu was Health Policy Analyst, National Council of La Raza.

This presentation was part of a larger track "Immigrants, Refugees, Asylees and the Undocumented: Understanding Laws that Impact their Health and Well-Being"

From the brochure:

Participants will gain a better understanding of the various status types (e.g., immigrants, refugees) of Latinos residing in the United States and learn how these status types impact individual legal rights. Specific areas to be addressed include employment, bad debt and collections, domestic violence, human trafficking, access to culturally and linguistically appropriate health care services, and access to …

Brochure And Schedule Of Events, Latino Health Summit, Virginia Commonwealth University

2006 Latino Health Summit

Brochure and Schedule of Events, including abstracts for the Latino Health Summit, November 16-17, 2006

Metro Richmond Latino Health Services & Resource Guide – 2006, Virginia Commonwealth University

2006 Latino Health Summit

This Guide was produced by the VCU Institute for Women’s Health, VCU Center on Health Disparities, and CLAS Act Virginia as a resource for the fall 2006 Latino Health Summit: Latino Cultures and Beliefs in Health Care. The purpose of this Guide is to provide a practical tool for community health care professionals to use in their work by assisting in cataloguing key provider and patient resources and services. The guide will be posted on the VCU Institute for Women’s Health and VCU Center on Health Disparities websites, which will be updated on a regular basis.

Retrospective Comparative Analysis Of The Socio-Demographic Characteristics Of Pregnant Abortion-Minded Clients Versus Pregnant Non-Abortion-Minded Clients In A Crisis Pregnancy Center In Montgomery County, Ohio, Betsy Liliana Cote

Master of Public Health Program Student Publications

Purpose: The purpose of this study is to compare socio-demographic characteristics of pregnant abortion-minded women versus pregnant non-abortion minded women who had consulted a crisis pregnancy center in Montgomery County, Ohio. The findings will be used to help develop public health prevention programs for unintended pregnancies.

Methods: A database sample of 581 records collected by a crisis pregnancy center in t Montgomery County was used for this study. Criteria for inclusion were women obtaining a positive pregnancy test, whose pregnancy intentions were assessed as being either abortion-minded or non-abortion-minded. Socio-demographic characteristics such as age, marital status, household income, education, religious …

Motivational Interviewing With Adolescents And Young Adults For Drug-Related Problems, Jerry L. Grenard, Susan L. Ames, Mary Ann Pentz, Steve Sussman

CGU Faculty Publications and Research

This article reviews studies of brief motivational interviewing (MI) interventions applied to adolescents (ages 13 to 18 years) and young adults )ages 19 to 25 years) using alcohol or other psychoactive substances. An overview of the principles of MI is provided followed by a review of 17 clinical studies reported in the literature. This review revealed mixed findings for the efficacy of brief MI among these populations. However, in 29% of the studies (5 of 17), there was a clear advantage of the brief MI demonstrated compared to standard care or other programming. Components common to successful brief MI interventions …

An Assessment Of Obese And Non Obese Girls’ Metabolic Rate During Television Viewing, Reading, And Resting., Theodore V. Cooper, L. M. Klesges, M. W. Debon, R. C. Klesges, M. L. Shelton

Theodore V. Cooper

No abstract provided.

General And Smoking Cessation Related Weight Concerns In Veterans., Theodore V. Cooper, M. Dundon, B. M. Hoffman, C. J. Stoever

Theodore V. Cooper

No abstract provided.

Strategies For Encouraging The Abandonment Of Female Genital Cutting In West Africa: Experiences From Senegal, Burkina Faso, And Mali, Nafissatou J. Diop, Ian Askew

Reproductive Health

This article explores efforts to encourage abandonment of female genital cutting (FGC) in Senegal, Burkina Faso, and Mali. The strategy of encouraging traditional practitioners to stop performing FGC is not effective as community-level support for the practice remains high. Training health staff significantly improved healthcare providers' levels of knowledge about FGC and its complications. Consequently, it was recommended that such training be incorporated into preservice medical training. The use of community-based strategies like the Village Education Program (VEP) showed the most promise, as their multifaceted approach addresses knowledge, attitudes, actions, and communal support in an integrated manner. The way forward …

Analyse De L'Evolution De La Pratique De L'Excision Au Burkina Faso: L'Environment Institutionel, Politique Et Programmatique De La Lutte Contre La Pratique De L'Excision, Nafissatou J. Diop, Zakari Congo, Aina Ouedraogo, Alphosine Sawadogo, Lydia Saloucou, Ida Tamini

Reproductive Health

La présente analyse du projet Frontiers du Population Council fait un tour historique des événements majeurs de la lutte contre la pratique de l’excision au Burkina Faso avant d’aborder les conventions internationales auxquelles le pays a adhéré ainsi que les textes nationaux adoptés en ce qui concerne les droits de l’homme, spécifiquement le droit des femmes et des enfants. Elle analyse également l’application de la loi à travers l’évolution des cas de condamnation depuis l’adoption de la loi. Enfin, elle s’intéressera à quelques programmes d’intervention mis en place en identifiant les acquis et les limites. Ce travail fait partie d’une …

Oral Cancer Prevalence In Virginia, Karin C. Loftin, Michele Darby, Stacey Plichta, Sophie Thompson, Shreeram Kumar, Louis Abbey

Dental Hygiene Faculty Publications

Purpose. Oral and pharyngeal cancer affects 30,000 Americans a year and kills one fourth of those diagnosed. The primary risk factors for oral cancer are past or present cigarette and tobacco usage, and alcohol consumption in conjunction with tobacco use. Even though the prevalence of oral cancer is relatively low in the younger age groups, this group is most likely to benefit from intervention programs designed to change risky behavior such as smoking, and to prevent oral cancer in the later years. The goal of the study was to identify high-risk target areas for an oral cancer prevention program in …

'Science Of Trivalency', Kwaku L. Carlisle Woods Rn Md Metd1, Dr. Kwaku L Carlisle Woods Rn Md Metd1

Walden Faculty and Staff Publications

Due to mine cross cultural living, (I was born in the U.S. but grew in Southeast Asia), I became very interested in the Anthological, Social and Scientific difference between cultures. This led to a historical meta evaluation of humanity in general. Using the principals of Noetic Science, this evaluation reviled the ignorance and down right absence of any educational opportunities to learn the true functional abilities of mankind.