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 …

Awareness, Acceptability And Uptake Of Human Papilloma Virus Vaccine Among Cameroonian School-Attending Female Adolescents, Claudine Ayissi, Richard Wamai, Geofrey Oduwo, Stacey Perlman, Edith Welty, Simon Manga, Javier Ogembo

Richard G. Wamai

The purpose of this study is to assess awareness, knowledge and beliefs about HPV, cervical cancer HPV vaccine and willingness to vaccinate among adolescent females aged 12-26 years at clinics and schools in the North West Region of Cameroon where the Cameroon Baptist Convention Health Services (CBCHS) conducted a sensitization and education campaign. A questionnaire survey was administered among female adolescents in schools and clinics. Descriptive statistics including frequencies, percentages and proportions were generated for independent variables and bivariate analyses (Chi square test) were used to assess the relationship between independent and outcome variables. Data were analyzed using SAS Version …

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 …

Commentary: The Role Of Food Culture And Marketing Activity In Health Disparities, Jerome Williams, David Crockett, Robert Harrison, Kevin Williams

David Crockett

Marketing activities have attracted increased attention from scholars interested in racial disparities in obesity prevalence, as well as the prevalence of other preventable conditions. Although reducing the marketing of nutritionally poor foods to racial/ethnic communities would represent a significant step forward in eliminating racial disparities in health, we focus instead on a critical-related question. What is the relationship between marketing activities, food culture, and health disparities? This commentary posits that food culture shapes the demand for food and the meaning attached to particular foods, preparation styles, and eating practices, while marketing activities shape the overall environment in which food choices …

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 …

Factors Associated With Inadequate Colorectal Cancer Screening With Flexible Sigmoidoscopy, Adeyinka Laiyemo, Chyke Doubeni, Paul Pinsky, V. Paul Doria-Rose, Andrew Sanderson, Robert Bresalier, Joel Weissfeld, Robert Schoen, Pamela Marcus, Phillip Prorok, Christine Berg

Chyke A. Doubeni

BACKGROUND AND STUDY AIM: Inadequate colorectal cancer screening wastes limited endoscopic resources. We examined patients factors associated with inadequate flexible sigmoidoscopy (FSG) screening at baseline screening and repeat screening 3-5 years later in 10 geographically-dispersed screening centers participating in the ongoing Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial.

METHODS: A total of 64,554 participants (aged 55-74) completed baseline questionnaires and underwent FSG at baseline. Of these, 39,385 participants returned for repeat screening. We used logistic regression models to assess factors that are associated with inadequate FSG (defined as a study in which the depth of insertion of FSG was …

Contribution Of Behavioral Risk Factors And Obesity To Socioeconomic Differences In Colorectal Cancer Incidence, Chyke Doubeni, Jacqueline Major, Adeyinka Laiyemo, Mario Schootman, Ann Zauber, Albert Hollenbeck, Rashmi Sinha, Jeroan Allison

Chyke A. Doubeni

BACKGROUND:Health behaviors are known risk factors for colorectal cancer and are more common in low socioeconomic status (SES) populations. We evaluated the extent to which behavioral risk factors and body mass index (BMI) explain SES disparities in colorectal cancer incidence, overall and by tumor location.

METHODS: We analyzed prospective National Institutes of Health-AARP Diet and Health Study data on 506 488 participants who were recruited in 1995-1996 from six US states and two metropolitan areas and followed through 2006. Detailed baseline data on risk factors for colorectal cancer, including health behaviors, were obtained using questionnaires. SES was measured by self-reported …

Socioeconomic Status, Healthcare Density, And Risk Of Prostate Cancer Among African American And Caucasian Men In A Large Prospective Study, Jacqueline Major, M. Oliver, Chyke Doubeni, Albert Hollenbeck, Barry Graubard, Rashmi Sinha

Chyke A. Doubeni

OBJECTIVES: The purpose of this study was to separately examine the impact of neighborhood socioeconomic deprivation and availability of healthcare resources on prostate cancer risk among African American and Caucasian men. METHODS: In the large, prospective NIH-AARP Diet and Health Study, we analyzed baseline (1995-1996) data from adult men, aged 50-71 years. Incident prostate cancer cases (n = 22,523; 1,089 among African Americans) were identified through December 2006. Lifestyle and health risk information was ascertained by questionnaires administered at baseline. Area-level socioeconomic indicators were ascertained by linkage to the US Census and the Area Resource File. Multilevel Cox models were …

Variation Of Adenoma Prevalence By Age, Sex, Race, And Colon Location In A Large Population: Implications For Screening And Quality Programs, Douglas Corley, Christopher Jensen, Amy Marks, Wei Zhao, Jolanda De Boer, Theodore Levin, Chyke Doubeni, Bruce Fireman, Charles Quesenberry

Chyke A. Doubeni

BACKGROUND and AIMS: Reliable community-based colorectal adenoma prevalence estimates are needed to inform colonoscopy quality standards and to estimate patient colorectal cancer risks; however, minimal data exist from populations with large numbers of diverse patients and examiners. METHODS: We evaluated the prevalence of adenomas detected by sex, age, race/ethnicity, and colon location among 20,792 Kaiser Permanente Northern California members >/=50 years of age who received a screening colonoscopy exam (102 gastroenterologists, years 2006-2008). RESULTS: Prevalence of detected adenomas increased more rapidly with age in the proximal colon (adjusted odds ratio [OR], 2.39; 95% confidence interval [CI], 2.05-2.80; 70-74 vs 50-54 …

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 …

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

Chyke A. Doubeni

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 …

Assessing The Effectiveness Of A Community-Based Sensitization Strategy In Creating Awareness About Hpv, Cervical Cancer And Hpv Vaccine Among Parents In North West Cameroon, Richard Wamai, Claudine Ayissi, Geofrey Oduwo, Stacey Perlman, Edith Welty, Simon Manga, Javier Ogembo

Richard G. Wamai

In 2010, the Cameroon Baptist Convention Health Services (CBCHS) received a donation of HPV vaccine (Gardasil(A (R))) to immunize girls of ages 9-13 years in the North West Region of Cameroon. We evaluated the effectiveness of the CBCHS campaign program in sensitizing parents/guardians to encourage HPV vaccine uptake, identified factors that influence parents' decisions to vaccinate girls, and examined the uptake of cervical cancer screening among mothers. We conducted a cross-sectional survey in four healthcare facilities run by CBCHS, churches and other social settings. A total of 350 questionnaires were distributed and 317 were used for the analysis. There were …

Hiv Testing Behaviors Of A Cohort Of Hiv-Positive Racial/Ethnic Minority Ymsm, Sheldon Fields

Sheldon D. Fields

The HIV epidemic in the United States has disproportionately affected young racial/ethnic minority men who have sex with men (YMSM). However, HIV testing rates among young men of color remain low. Within this sample of racial/ethnic minority YMSM (n = 363), the first HIV test was a median of 2 years after men who have sex with men sexual debut. Individuals with less than 1 year between their first negative and first positive HIV test were significantly more likely to identify the reason for their first negative test as being sick (OR = 2.99; 95 % CI 1.23-7.27). This may …

Patterns Of Hiv Disclosure And Condom Use Among Hiv-Infected Young Racial/Ethnic Minority Men Who Have Sex With Men., Sheldon Fields

Sheldon D. Fields

Recent findings highlight the continued rise in cases of HIV infection among racial/ethnic minority young men who have sex with men (YMSM). In adults, disclosure of HIV status has been associated with decreased sexual risk behaviors but this has not been explored among YMSM. In this study of 362 HIV-infected racial/ethnic minority YMSM, rates of disclosure were high, with almost all disclosing their status to at least one person at baseline. The majority had disclosed to a family member, with higher disclosure rates to female relatives compared with males. After adjustment for site, disclosure to sex partners and boyfriends was …

Integrating Health Literacy And Esl : An Interdisciplinary Curriculum For Hispanic Immigrants, Francisco Soto Mas

Francisco Soto Mas

Adult Hispanic immigrants are at a greater risk of experiencing the negative outcomes related to low health literacy, as they confront cultural and language barriers to the complex and predominately monolingual Englishbased U.S. health system. One approach that has the potential for simultaneously addressing the health, literacy, and language needs of Hispanics is the combination of health literacy and English as a second language (ESL) instruction. The purpose of the project was to evaluate the feasibility of using ESL instruction as a medium for improving health literacy among Hispanic immigrants. Objectives included the development, implementation, and evaluation of an interdisciplinary …

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 …

Criticisms Of African Trials Fail To Withstand Scrutiny: Male Circumcision Does Prevent Hiv Infection, Richard Wamai, Brian Morris, Jake Waskett, Edward Green, Joya Banerjee, Robert Bailey, Jeffrey Klausner, David Sokal, Catherine Hankins

Richard G. Wamai

A recent article in the JLM (Boyle GJ and Hill G, "Sub-Saharan African Randomised Clinical Trials into Male Circumcision and HIV Transmission: Methodological, Ethical and Legal Concerns" (2011) 19 JLM 316) criticises the large randomised controlled trials (RCTs) that scientists, clinicians and policy-makers worldwide have concluded provide compelling evidence in support of voluntary medical male circumcision (VMMC) as an effective HIV prevention strategy. The present article addresses the claims advanced by Boyle and Hill, demonstrating their reliance on outmoded evidence, outlier studies, and flawed statistical analyses. In the current authors' view, their claims portray misunderstandings of the design, execution and …

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 …

Hiv Rages Among Black Gay Men, Sheldon Fields

Sheldon D. Fields

No abstract provided.

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 …

Environmental Health And Service Learning, Kelly Tuohig, Dale Stephenson, Dean Lillquist, Justin Bird, Stephen Adler, Mark Babitz

Dale J. Stephenson

In developing curriculum for a Salt Lake City, Utah High School's Advance Placement--Environmental Studies class, one goal was a module on air quality/air pollution. University of Utah graduate students and faculty presented on air pollution topics. Community exposure to school bus emissions was identified and students developed a study design, performed air sampling, learned to interpret results, and communicate results and recommendations to various audiences. This project emphasized health impacts, public awareness, and policy recommendations to promote change.

An Analysis Of Vdt Monitor Placement And Daily Hours Of Use For Female Bifocal Users, J. Lyon, Dean Lillquist, S. Alder, Dale Stephenson, D. Bloswick

Dale J. Stephenson

A population of 72 bifocal wearers was studied to determine the relationship between VDT (video display terminal) placement for those who reported musculoskeletal pain and those who did not. The mean hours worked was 50.4 minutes (p=0.003) greater for those who reported head/neck pain versus those who did not and 48.6 minutes (p=0.004) greater for those who reported shoulder/arm pain that those who did not. There was no statistically significant difference between the means of monitor height, distance, or angle for those who reported pain symptoms versus those who did not. This study indicates that, self reported pain symptoms are …

Comparison Of Sampling Methods To Measure Exposure To Diesel Particulate Matter In An Underground Metal Mine, Dale Stephenson, T. Spear, M. Lutte

Dale J. Stephenson

Diesel particulate matter (DPM) continues to be scrutinized as an adverse occupational exposure agent. Currently, the air sampling protocol approved by the U.S. Mine Safety and Health Administration (MSHA) to quantify exposure to DPM in mines designates an SKC impactor as the sample collection device and limits exposure to the total carbon faction of a DPM aerosol. Because use of this impactor requires submission of the sample to an analytical laboratory, it inherently includes a lag time before workplace exposures can be determined. Thus, mine operators who use this MSHA-approved sampling device to monitor personal DPM exposures are faced with …

Side-By-Side Comparison Of Three Sampling Methods For Aerosolized Endotoxin In A Wastewater Treatment Facility, Dale Stephenson, F. Derosso, Dean Lillquist, D. Greene, G. White

Dale J. Stephenson

Research studies have established the occurrence of adverse health effects in individuals exposed to organic dusts and water aerosols laden with endotoxin. To determine what exposure levels cause these health effects, it is necessary to quantity airborne endotoxin. Several scientific studies have demonstrated that the quantification of detectable endotoxin is affected by differences in sampling media, analytical method, and aerosol composition, The study reported here performed side-by-side endotoxin sampling using a liquid impinger, a glass fiber filter, and a polycarbonate filter in a wastewater treatment plant. Results show levels of detected endotoxin appear to be highest with the impinger. Coefficients …

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 …