Medicine and Health Sciences Commons^™

Stark Voluntary Self-Referral Disclosure Protocol (Srdp) And Stark Law, Kip Klingman

Kip Klingman

When you’ve made a serious mistake, sometimes it is best to step forward and confess before the government regulators find out on their own. The federal Stark Law, governing physician self-referral, provides a mechanism for voluntary disclosing a violation, but using that option requires a carefully crafted game plan.

Evaluating “Not In Mama's Kitchen” Second-Hand Smoke Campaign In Georgia, Jonathan B. Vangeest, Verna L. Welch

Journal of Health Disparities Research and Practice

In 2003-2005, the Association of Black Cardiologists, Inc. initiated the Not in Mama’s Kitchen (NIMK) second-hand smoke (SHS) prevention campaign in Georgia as part of their effort to reduce exposure to SHS in African American communities statewide. This initiative was evaluated using baseline data from pledge cards as well as data from a self-administered mail survey of 1,000 campaign participants. 14,770 Georgians participated in NIMK, signing pledges to make their homes and cars smoke free. Majorities of those surveyed followed through with their pledge, banning tobacco use in their homes (76.1%) and cars (80.2%). The program was cited by 65.4% …

African American Adults’ Experiences With The Health Care System: In Their Own Words, Keri A. Jupka, Nancy L. Weaver, Vetta L. Sanders-Thompson, Nicole M. Caito, Matthew W. Kreuter

Journal of Health Disparities Research and Practice

African Americans suffer a disproportionate burden of death and illness from a number of different chronic diseases. Inequalities in health care practices and poor patient and provider communication between African American patients and health care professionals contribute to these disparities. We describe findings from focus groups with 79 urban African Americans in which the participants discussed their interactions with the healthcare system as well as beliefs and opinions of the healthcare system and professionals. Analysis revealed five major themes: (1) historical and contextual foundations; (2) interpersonal experiences with physicians and other health care workers; (3) discrimination; (4) trust, opinions and …

Pastors’ Influence On Research-Based Health Programs In Church Settings, Shirley M. Timmons

Journal of Health Disparities Research and Practice

Churches, in the United States, are recognized essential players in addressing our mounting health and social service needs. Yet, even though they implement a relatively large number of programs, few are research-based. Focus groups were conducted with pastors from 11 Baptist churches in a small Southeastern town to explore factors that influence the implementation of research-based health programs. Transcripts were coded for domains resulting in four themes: congregant needs, shared programming ethics, common understanding of programming processes, and care for the church and congregation. Pastors value research and seek church-based programs that enhance the health of congregants. Yet, future study …

Differential Effects Of Race And Poverty On Ambulatory Care Sensitive Conditions, Farrukh B. Hakeem, Daniel L. Howard, Timothy S. Carey, Yhenneko J. Taylor

Journal of Health Disparities Research and Practice

This study is a continuation of an earlier study that examined hospitalization rates for ambulatory care sensitive (ACS) conditions, as a proxy for quality of care, and found evidence of a racial disparity among African American and White Medicare beneficiaries. The current study sought to determine whether neighborhood socioeconomic status (SES) explained this disparity. Differences in rates of ACS hospitalizations by race were assessed using Cochran-Mantel Haenszel tests and Poisson regression. Unadjusted rate ratios for ACS hospitalization for African Americans vs. Whites were found to be higher in low poverty areas (rate ratio (RR)=1.13; 95% CI (1.08, 1.17)) than in …

Race/Ethnicity As A Risk Factor Of Mother To Child Transmission Among Hiv Infected Mothers, Wei Yang, Fares Qeadan, Mona L. Brown, Michelle Chino, Scott Hall, Mary Guinan

Journal of Health Disparities Research and Practice

Objectives: African American women, living with HIV, exhibit a higher percentage of giving birth as compared to other race/ethnicity groups. The aim of this study is to understand the apparent black and non-black differences (health disparities) among the HIV Infected Mothers group and examine whether race/ethnicity can explain the high variation in different prenatal and HIV mother-to-child-transmission (MTCT) risk factors.

Methods: Data-Linkage was conducted on all women HIV+ cases, who delivered a child during the time period and reported to the Nevada state HIV with the live birth registries. Demographic and social data, separated into black and Non-black groups, were …

Hipaa - What Rns Need To Know, Kip Klingman

Kip Klingman

“HIPAA regulations were instituted to protect the privacy of individuals by safeguarding individually identifiable healthcare records, including those housed in electronic media.”

An Outline Of Contraceptive Use In Mali, Lillie Carlile

Independent Study Project (ISP) Collection

The global community continues to increase at alarming rates. October 2011 marked the world’s population at a record high of 7 billion people, and counting. This population growth is linked to many complex factors, an important one of which is maternal health. The World Bank reports that over 99% of maternal deaths occur in developing countries, more than half of which occurred in Sub-Saharan Africa.^[1] The term “maternal health” refers to the health of women before, during, and after pregnancy. A crucial factor in maternal health is contraception, as its use allows women to avoid or space pregnancies, effectively …

Lo Personal Es Político: La Lucha Por La Legalización Del Aborto En Chile, A Través De La Organización Feminista, Católicas Por El Derecho A Decidir, Gavin Odabashian

Independent Study Project (ISP) Collection

This paper investigates the work of a small collective of women—Católicas por el Derecho a Decidir—and the practice of their activism in Valparaíso, Chile. I focus on the ways in which these women are strategically mobilizing as an organization to fight for justice for women in Chile—more specifically, for gender equality, access to reproductive rights, and the legalization of abortion in all cases. I examine the history of the organization, its form and structure, the projects and campaigns they are currently working on, the individual experiences of the women working within the organization, their perspectives on their work, …

Indicadores De Maduracion Sexual Y Su Relacion Con Indices De Masa Corporal (Imc) Y Habitos De Alimentacion En Escolares Femeninas De Arica, Chile, Melissa Colden

Independent Study Project (ISP) Collection

The basis of this investigation came from recent evidence that the age of puberty, specifically with respect to young girls, has fallen notably in the past decade. This trend exists in Chile, as well as other countries such as the United States, and has presented itself alongside a portentous epidemic of obesity and malnutrition. Knowing the risks of both disorders, and how their affects have already been manifested in the adolescent population in Chile and the city of Arica, this study sought to develop a relationship between body mass index (BMI) and pubertal development, including the appearance of secondary sexual …

Connecting Cultures: Msmcbj’S Alternative Methods To Mental Health Therapy Within The Aldeia Indigenous Reserve And The Bom Jardim Favela, Emily Rasowsky

Independent Study Project (ISP) Collection

For my Independent Research Project I observed how community integration and connecting individuals back to the indigenous cultural idea of community work together to improve upon the mental health of individuals in the Favela of Bom Jardim, Fortaleza and the Pitaguary Indigenous Reserve or Aldeia. I examined how the Movimento de Saude Mental Comunitara do Bom Jardim (MSMCBJ) organization provides individuals within Bom Jardim a space to build a supportive community, based in indigenous ideals, while simultaneously providing professional and social opportunities for the Pitaguary tribe to create a sense of cultural valorization and how both of these aspects lead …

Conocimientos Y Conductas Sexuales En Trabajadores Migrantes (Arica, Chile), Anna Conley

Independent Study Project (ISP) Collection

Background: The HIV/AIDS epidemic continues to be prevalent and to expand in Chile, as in many other regions of Latin America and around the world. Furthermore, it continues to concentrate in distinct, vulnerable populations. Migrant workers represent one such vulnerable population. The HIV/AIDS epidemic disproportionately impacts migrant workers because of the social, economic, and psychological factors that are involved in both migratory behaviors and disease construction.

Aim: This study identified sexual health knowledge and sexual health behavior in the migrant laborer population of Arica, Chile. More specifically, it identified risk factors for HIV/AIDS and explored possible strategies for a preventative …

Conflict Situation For Health Care Workers: A Case Study Of The Occupational Challenges In Kasangati Health Centre Iv And Their Implications For Patient Care., Shannon Mcdowell

Independent Study Project (ISP) Collection

Many factors influence a country’s ability to provide quality health services for its people. Particularly, quality health care hinges upon the availability of properly trained and equipped health care workers (HCWs) to deliver effective care. Resource-strained countries committed to the Millennium Development Goals are confronting the reality that shortages and uneven distribution of HCWs threaten their capacities to encourage and establish healthy communities. A scarcity in HCWs is one challenge of public health initiatives and places stress on existing HCWs. Other challenges faced by HCWs severely affect performance, motivation, and overall care-giving ability.

This study aims to examine the particular …

Curative Care As The Access Point To Rural Social Transformation A Case Study Of The Comprehensive Rural Health Project, Nancy Liu

Independent Study Project (ISP) Collection

Health inequities based on geographic differences and between rural and urban populations in modern India demonstrate the stark differences in health access and community development throughout the country. More than 70% of the Indian population lives in rural areas, and yet a greater proportion of health care spending is devoted to urban populations. In 2004-5, 29.2% of both central and state public expenditures were allocated to urban allopathic services while 11.8% went to rural allopathic services (Balarajan, Selvaraj, and Subramanian 2011, 508). There are more than twice as many government beds in urban than in rural areas and geographic distribution …

Access To Healthcare For The Poor: Will The Affordable Care Act Address Income-Related Health Disparities In The United States?, Sonya Fabricant

Independent Study Project (ISP) Collection

Background: Low-income populations live shorter and less healthy lives in the United States due to a complexity of social, environmental and behavioral factors. These populations also face significant barriers in accessing health services. In 2010, the Patient Protection and Affordable Care Act (PPACA) passed, marking the first major reform of the American healthcare system since the 1960s. This paper evaluates its potential to address health disparities through changes to medical care delivery. Methodology: Results were compiled from government documents, reports from research institutes, journal articles, and an expert interview. A section-analysis was also performed, evaluating the strengths and weaknesses of …

Un Compromiso Al Parto Culturalmente Sensible: Una Evaluación De La Interculturalidad En Salud Reproductiva En El Norte De Chile, Kalin J. Gregory-Davis

Independent Study Project (ISP) Collection

Este investigación observa, explora, y describe la interculturalidad en la salud reproductiva en la región de Arica y Parinacota en el norte de Chile durante el mes de mayo, 2012. A causa de la diversidad étnica de la región y las diferencias en las tradiciones y creencias acerca del parto aymara, natural y medicalizado, existe una necesidad de atención alternativa en el sistema de salud. El estudio describe la atención alternativa ofrecida a las mujeres aymara durante el embarazo y el parto. Empleando las perspectivas y las percepciones culturales de parteras aymaras, profesionales médicos occidentales y mujeres involucradas, el estudio …

Social Capital And Violence Across Racial And Ethnic Samples Of Adolescents, Darlene R. Haff, Kevin M. Fitzpatrick, H. H. Floyd

Journal of Health Disparities Research and Practice

Using a national sample of adolescents, results of this study demonstrate the important role family and school social capital plays in protecting both White and selected non- White students against violent outcomes. For example, parent-child relationship was associated with reduced violence for Black and White adolescents but not for Hispanics. School affiliation was significant in models for Hispanic and White adolescents but not in models for Black students. Sports participation was associated with greater violence among Hispanics and Whites, but not Blacks. Interestingly, club participation was significant for Whites, but, like sports, it was associated with greater violence. Parental monitoring …

Living Wills In Kansas, Debra M. Sellers, Erin J. Dittman

Debra M. Sellers

A living will allows you to record in writing, what type of care you want at the end of your life, if you have a terminal illness.

Durable Power Of Attorney For Health Care In Kansas, Debra M. Sellers, Erin J. Dittman

Debra M. Sellers

Name a person authorized to make your health care decisions for you, when you are not capable of making decisions for yourself, with a Durable Power of Attorney.

Advanced Directives In Kansas, Debra M. Sellers, Erin J. Dittman

Debra M. Sellers

Advance directives are documents to state how you want to be cared for at the end of your life: durable power of attorney for health care and living will.

Lithium Treatment Of Appswdi/Nos2−/− Mice Leads To Reduced Hyperphosphorylated Tau, Increased Amyloid Deposition And Altered Inflammatory Phenotype, Tiffany L. Sudduth, Joan G. Wilson, Angela Everhart, Carol A. Colton, Donna M. Wilcock

Sanders-Brown Center on Aging Faculty Publications

Lithium is an anti-psychotic that has been shown to prevent the hyperphosphorylation of tau protein through the inhibition of glycogen-synthase kinase 3-beta (GSK3β). We recently developed a mouse model that progresses from amyloid pathology to tau pathology and neurodegeneration due to the genetic deletion of NOS2 in an APP transgenic mouse; the APPSwDI/NOS2-/- mouse. Because this mouse develops tau pathology, amyloid pathology and neuronal loss we were interested in the effect anti-tau therapy would have on amyloid pathology, learning and memory. We administered lithium in the diets of APPSwDI/NOS2-/- mice for a period of eight months, followed by water maze …

Conformational Altered P53 As An Early Marker Of Oxidative Stress In Alzheimer's Disease, Laura Buizza, Giovanna Cenini, Cristina Lanni, Giulia Ferrari-Toninelli, Chiara Prandelli, Stefano Govoni, Erica Buoso, Marco Racchi, Maria Barcikowska, Maria Styczynska, Aleksandra Szybinska, D. Allan Butterfield, Maurizio Memo, Daniela Uberti

Sanders-Brown Center on Aging Faculty Publications

In order to study oxidative stress in peripheral cells of Alzheimer's disease (AD) patients, immortalized lymphocytes derived from two peculiar cohorts of patients, referring to early onset AD (EOSAD) and subjects harboured AD related mutation (ADmut), were used. Oxidative stress was evaluated measuring i) the typical oxidative markers, such as HNE Michel adducts, 3 Nitro-Tyrosine residues and protein carbonyl on protein extracts, ii) and the antioxidant capacity, following the enzymatic kinetic of superoxide dismutase (SOD), glutathione peroxidase (GPx) and glutathione reductase (GRD). We found that the signs of oxidative stress, measured as oxidative marker levels, were evident only in ADmut …

Providers' And Key Opinion Leaders' Attitudes, Beliefs, And Practices Regarding Emergency Contraception In India: Final Survey Report, M.E. Khan, Deepthi S. Varma, Isha Bhatnagar, Anvita Dixit, Martha Brady

Reproductive Health

The Population Council undertook this study to assess the knowledge, attitudes, and practices regarding emergency contraception (ECPs) among providers in public and private facilities and pharmacies in India. This study’s objectives were: 1) to assess providers’ knowledge of ECP’s biological mechanism; 2) to understand providers’ knowledge and attitudes about ECP’s safety, effectiveness, and availability as an over-the-counter drug; and 3) to identify providers’ definitions of “repeated use” and profiling of women who are “repeated users” of ECP. The study recommends intervention programs and advocacy strategies to increase knowledge and access to ECP.

Expanding Access To Comprehensive Reproductive Health And Hiv Information And Services For Married Adolescent Girls In Nyanza Province, Chi-Chi Undie, Harriet Birungi, Francis Obare, Ben Ochieng, Wilson Liambila, Erick Oweya, Ian Askew, Rob Burnet, Bridget Deacon, Aisha Mohamed

Reproductive Health

The objectives of this operations research study, conducted by the Population Council’s APHIA II Operations Research Project in Kenya, were to: 1) identify and design a set of interventions that promote the uptake of comprehensive reproductive health (RH)/family planning (FP) and HIV prevention services and information among married adolescent girls; and 2) expand access to comprehensive RH/FP and HIV prevention services and information among this population. The study demonstrated that the combined use of interactive media and community health worker visitation, health information provision, and referrals, is an effective means of reinforcing RH/FP and HIV messages, and of increasing access …

Évaluation De Processus : Programme Filles Eveillées Pour Adolescentes Migrantes Employées De Maison Au Burkina Faso Urbain 2012, Leah Jarvis, Gisele Kaboré

Poverty, Gender, and Youth

Le programme «Filles Éveillées» a été conçu pour apporter aux adolescentes migrantes employées de maison les compétences, les connaissances et le capital social qui leur permettent de réduire leurs vulnérabilités et de s’ouvrir de nouveaux débouchés. Les observations tirées de la collecte de données quantitatives et qualitatives ont révélé le succès considérable du programme: il est largement apprécié et a été bien reçu par les participantes, les mentors, les membres de la communauté et tous les autres intéressés. En sa qualité de programme pilote, les obstacles à une mise en œuvre sans incidents auraient été inévitables, mais par leur détermination …

Function-­Preserving Filters For Sampling In Biological Networks, Kathryn Dempsey Cooper, Sanjukta Bhowmick, Hesham Ali

Interdisciplinary Informatics Faculty Publications

Assays created to study systems of disease and aging can offer a whole new set of therapeutic targets. However, with experiments of this immense volume, data becomes unmanageable for many traditional analyses. Enter the biological network, a tool for modeling relationships among high-throughput data that is quickly rising in popularity. Small networks (in the order of hundreds to few thousands of nodes) use relationships between network structure to infer biological function; this relationship has been confirmed and used in many studies to advance the study of model organisms. Networks built for assessing entire genomes, or entire protein repertoires, however, tend …

Le Consensus De Bellagio : Recommandations Pour Améliorer L'Accès Aux Méthodes De Contraception Efficaces, Réversibles À Longue Durée D'Action, Population Council

Reproductive Health

Ce communiqué et cette déclaration proposent des recommandations pour améliorer l'accès aux méthodes de contraception efficaces, réversibles à longue durée d'action (LARC) et accélérer les progrès vers la réalisation de l'Objectif du Millénaire pour le développement relatif à l'accès universel aux services de santé reproductive.

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This brief and statement offers recommendations for action to increase access to highly effective, long-acting, reversible contraception (LARCs) and accelerate progress toward meeting the Millennium Development Goal of universal access to reproductive health services.

Repositioning Community-Based Family Planning In Ghana: A Case Study Of Community-Based Health Planning And Services (Chps), Stephen Ntsua, Placide Tapsoba, Gloria Quansah Asare, Frank K. Nyonator

Reproductive Health

The Population Council conducted a diagnostic appraisal of delivering family planning services using the community-based health planning and services (CHPS model) in Ghana. This study’s results indicate that the CHPS program is well appreciated by rural communities where it is operational. However, the study identified several developments with implications for service delivery: increased community health officer (CHO) workloads and concomitant reductions in outreach services and home visits by community health visitors (CHVs) have weakened the CHO-CHV working relationship, leaving both cadres working in isolation. CHPS has significantly improved health indices but its contribution to increasing family planning is limited and …

Routine Screening For Intimate Partner Violence In Public Health Care Settings In Kenya: An Assessment Of Acceptability, Chi-Chi Undie, Catherine Maternowska, Margaret Mak'anyengo, Harriet Birungi, Jill Keesbury, Ian Askew

Reproductive Health

Most research on intimate-partner violence (IPV) screening has been conducted in developed countries, so this study in Kenya serves as one of the first in a developing-country context to assess the acceptability of IPV screening from the perspective of providers and clients in public healthcare settings. The study conducted in Kenyatta National Hospital in Nairobi found that routine screening for IPV is acceptable to providers and clients at that location. However, to be effective as a routine service, the system needs to be reinforced in specific ways, including greater assurance of confidentiality, more positive provider attitudes, and higher respect for …

Belize Coverage Exercise Study: Assessing The Status To Build A Portfolio Of Targeted Interventions For Vulnerable Girls, Joint Un Programme Of Adolescent Girls

Poverty, Gender, and Youth

The United Nation Children Fund, the United Nations Population Fund, and Population Council staff collaborated on a number of activities to generate evidence on the lives and experiences of adolescent girls in Belize. The goal of the collaboration was to establish targeted, evidence-based policies and programs sensitive to the unique needs of girls. The information presented in this report is of particular interest to program planners, policymakers, and decisionmakers from a wide range of institutions seeking to designate resources for programs and policies for vulnerable or marginalized subgroups of young people, particularly girls, in Belize. The report presents empirical evidence …