Medicine and Health Sciences Commons^™

Culture, Caregiving, And Health: Exploring The Influence Of Culture On Family Caregiver Experiences, Jennifer Pharr, Carolee Dodge Francis, Christine Terry, Michele Clark

Public Health Faculty Publications

Ethnic minorities are expected to experience a greater demand for family caregiving than non-Latino Whites due to their projected population growth. Although the consensus of researchers on caregiving and culture finds that the caregiving experience differs significantly among cultural/ethnic groups, the question remains as to how cultural values and norms influence the caregiver experiences. We conducted an interpretative, phenomenological qualitative analysis of focus group transcripts from four groups (African American, Asian American, Hispanic American, and European American) for cultural influences on caregiving. Data were collected in Nevada between December 7, 2009, and August 20, 2010. Thirty-five caregivers participated in this …

Health Effects Associated With Foreclosure: A Secondary Analysis Of Hospital Discharge Data, Nancy N. Menzel, Sheniz Moonie, Melva V. Thompson-Robinson

Public Health Faculty Publications

Objectives. The purpose of this study was to assess the health effects of high home foreclosure rates in an area of the United States of America and the utility of hospital discharge data for this purpose. Methods.We analyzed hospital discharge data from three postal zip codes using the principal diagnosis for 25 Diagnostic Related Groups associated with stress. Descriptive statistics were used to characterize hospital discharge rates for each condition by year and zip code. To test for differences across time, the Cochran-Armitage trend test was performed. Results. Most conditions did not demonstrate a statistical change between 2005 and 2008. …

Health Disparities Experienced By People With Disabilities In The United States: A Behavioral Risk Factor Surveillance System Study, Jennifer Renee Pharr, Timothy J. Bungum

Public Health Faculty Publications

The Americans with Disabilities Act became law in 1990; since then research has shown that people with disabilities continue to experience barriers to health care. The purpose of this study was to compare utilization of preventive services, chronic disease rates, and engagement in health risk behaviors of participants with differing severities of disabilities to those without disabilities. This study was a secondary analysis of 2010 data collected in the Behavioral Risk Factor Surveillance System national survey in the United States. Rao Chi square test and logistic regression were employed. Participants with disabilities had significantly higher adjusted odds ratios for all …

Analysis Of Primary Risk Factors For Oral Cancer From Us States With Increasing Rates, Anthony Bunnell, Nathan Pettit, Nicole Reddout, Kanika Sharma, Susan O'Malley, Michelle Chino, Karl Kingsley

Public Health Faculty Publications

Objectives

To examine the primary risk factor for oral cancer in the US, smoking and tobacco use, among the specific US states that experienced short-term increases in oral cancer incidence and mortality.

Methods

Population-based data on oral cancer morbidity and mortality in the US were obtained from the National Cancer Institute's (NCI) Surveillance, Epidemiology, and End Results (SEER) database for analysis of recent trends. Data were also obtained from the Centers for Disease Control and Prevention (CDC) Behavioral Risk Factor Surveillance System (BRFSS) to measure current and former trends of tobacco usage. To comprehensive measures of previous state tobacco use …

Acquired Immuno-Deficiency Syndrome (Aids) And Human Immuno-Deficiency Virus (Hiv) In Nevada – Annual Surveillance Report (1999), Mary Guinan, Nancy Kreher, Drew Mather, Wei Yang

Public Health Faculty Publications

Background:

Acquired Immuno-Deficiency Syndrome (AIDS) is the most severe manifestation of Human Immunodeficiency Virus (HIV) infection. AIDS was first reported in the world in 1981 by the Centers for Disease Control and Prevention. Statewide surveillance for AIDS was begun in 1982. Because the cause of AIDS was unknown at that time, the surveillance case definition included many opportunistic infections and tumors. Persons with AIDS were noted to have abnormalities in their immune system that left them susceptible to certain infections. As more information became available, the AIDS surveillance case definition was modified.

In 1984, HIV was found to be the …

Special Report On Children Born To Hiv Positive Parents In Nevada, 1991-1999, Drew Mather, Mary Guinan, Richard Whitley, Wei Yang

Public Health Faculty Publications

Background:

This report encompasses an effort to look at the number of children born to HIV (Human Immunodeficiency Virus) and/or AIDS (Acquired Immunodeficiency Syndrome) infected parents during the years 1991 to 1999 in Nevada.

According to the Healthy People 2000 (HP 2000) Review for the years 1998- 1999, infants of untreated or undetected HIV positive women have been identified as a distinct population at risk for contracting the virus that causes AIDS.

The State of Nevada’s Bureau of Disease Control and Intervention Services in collaboration with the Bureau of Health Planning and Statistics has taken the initial step to “cross …

Counseling And Testing For Hiv Prevention: Costs, Effects, And Cost-Effectiveness Of More Rapid Screening Tests, P. G. Farnham, Robin D. Gorsky, D. R. Holtgrave, Wanda K. Jones, Mary Guinan

Public Health Faculty Publications

New rapid human immunodeficiency virus (HIV) antibody tests permit many individuals to receive test results and appropriate counseling at one clinic visit. Because currently used tests require significant time for processing, all individuals must return for a second visit for test results and counseling. Since return rates for the second visit are low, the more rapid tests present an opportunity to improve the efficiency of HIV counseling and testing.

The authors compared the costs and effectiveness of the currently used counseling and testing procedure and a streamlined procedure made possible by the new, more rapid screening tests. When test-positive clients …

Behavioral Science And Public Health: A Necessary Partnership For Hiv Prevention, Martin Fishbein, Mary Guinan

Public Health Faculty Publications

We are now in the second decade of the AIDS epidemic in the United States. As of October 31, 1995, a total of 311,381 U.S. citizens had t died from AIDS, another 189,929 had been diagnosed with AIDS (1), and it is estimated that nearly l million persons are infected with HIV, the virus that causes AIDS (CDC). Despite the best efforts of biomedical researchers, we still have neither a cure nor a vaccine to prevent this deadly disease. Yet AIDS is a preventable disease; AIDS is first and foremost a consequence of behavior. It is not who you are, …

Preventing Perinatal Transmission Of Hiv Costs And Effectiveness Of A Recommended Intervention, Robin D. Gorsky, P G. Farnham, Walter L. Straus, Blake Caldwell, D R. Holtgrave, R. J. Simonds, M F. Rogers, Mary Guinan

Public Health Faculty Publications

In the United States, nearly all new human immunodeficiency virus (HIV) infections in children are acquired through perinatal (mother-to-infant) transmission. Each year, approximately 7000 infants are born to HIV-infected women in the United States.¹ Without intervention, an estimated 15-30% of these infants would become infected.² In 1994, results of the AIDS Clinical Trial Group (ACTG) Protocol 076 showed that treatment of infected pregnant women and their infants with zidovudine (ZDV) reduced the rate of perinatal HIV transmission from 25% to 8%.^3,4 Following these findings, the Public Health Service (PHS) issued recommendations for ZDV therapy to prevent perinatal …

An Overview Of The Effectiveness And Efficiency Of Hiv Prevention Programs, D. R. Holtgrave, Noreen L. Qualls, J. W. Curran, Ronald O. Valdiserri, Mary Guinan, William C. Parra

Public Health Faculty Publications

Because of the enormity of the HIV-AIDS epidemic and the urgency for preventing transmission, HIV prevention programs are a high priority for careful and timely evaluations. Information on program effectiveness and efficiency is needed for decision-making about future HIV prevention priorities. General characteristics of successful HIV prevention programs, programs empirically evaluated and found to change (or not change) high-risk behaviors or in need of further empirical study, and economic evaluations of certain programs are described and summarized with attention limited to programs that have a behavioral basis. HIV prevention programs have an impact on averting or reducing risk behaviors, particularly …

Finding Hiv-Infected Women - The Clinician's Role, Mary Guinan

Public Health Faculty Publications

An estimated 100,000 women are currently infected with the human immunodeficiency virus (HIV) in the United States, and a great majority of them are unaware of their condition. Approximately 20,000 HIV-infected women were identified through publicly funded HIV screening programs in 1989 and 1990, and an unknown number through private screening. Because most HIV-infected women are believed to be in the lower socioeconomic strata, it is unlikely that a significant number were identified in the private sector. Therefore, up to 80% of HIV-positive women may not know they are infected.

What Is The Health Impact Of Day Care Attendance On Infants And Preschoolers?, Ruth L. Berkelman, Mary Guinan, Phen B. Thacker

Public Health Faculty Publications

The impact of various child care arrangements on the health of infants and preschool children is not known in any systematic way, yet by 1990 more than 10 million of these children may be receiving their care in day care facilities (1). Concerns over the health of these children and health practices within day care facilities have already led some States to place regulation of day care facilities under the jurisdiction of the department of health (2,3), and others are presently considering such legislation. In addition, the American Academy of Pediatrics has recently published "Health in Day Care," a manual …

Women And Aids: The Future Is Grim, Mary E. Guinan, Ann Hardy

Public Health Faculty Publications

Recently, we analyzed the reported cases of acquired immunodeficiency syndrome (AIDS) in women in the United States.1 We found two areas of great concern: first, women are more likely than men to acquire AIDS through heterosexual intercourse, and second, women are the source of disease for about 80% of children with AIDS. In this column we will discuss the source and distribution of AIDS in women, and in a future piece we will discuss women as the source of infection for pediatric AIDS cases.

Women, Children And Aids, Mary Guinan

Public Health Faculty Publications

More than 500 cases of acquired immune deficiency syndrome (AlDS) in children (ages I3 and under) had been reported to the Centers for Disease Control as of August , 1987. Of these children, 78% were infected perinatally by their mothers. The ratio of AIDS cases among women to AIDS cases among ; i children has remained stable at approximately 5:1 for several years. So, for the foreseeable future, we can expect that for every five reports of women with AIDS, one child with AIDS will be reported. As is the CMe with other sexually transmitted diseases, AIDS causes a disproportionately …

Letter To The Editor (Human Immunodeficiency Virus In Costa Rica), Mark W. Oberle, Charles A. Schable, Mary Guinan, Luis Rosero

Public Health Faculty Publications

Recent reports of 12 confirmed cases of acquired immunodeficiency syndrome (AIDS) in Costa Rica have generated interest in the extent of spread of human T-lymphotropic virus type III/LAV (HTLV-III) in Latin America (1). To date, all cases of AIDS in Costa Rica have occurred in members of previously identified, high-risk groups, chiefly hemophiliacs. To examine the possibility of heterosexual transmission in Costa Rica, we utilized sera collected in a population-based case-control study of cervical cancer, conducted by the Costa Rican Demographic Association and other institution.

Heterosexual And Homosexual Patients With The Acquired Immunodeficiency Syndrome: A Comparison Of Surveillance, Interview, And Laboratory Data, Mary Guinan, Pauline A. Thomas, Paul F. Pinksy, James T. Goodrich, Richard M. Selik, H W. Jaffe, H W. Haverkos, Gary Noble, J W. Curran

Public Health Faculty Publications

Homosexual and heterosexual patients with the acquired immunodeficiency syndrome were compared by risk group. Race; diagnoses; history of sexually transmitted diseases, sexual behavior, and drug use; and socioeconomic indicators differed considerably among the risk groups, suggesting different risk factors for acquisition of the syndrome. Patients in the homosexual, intravenous drug user, and Haitian risk groups differed in their serologic response to cytomegalovirus and syphilis testing, presumably due to lifestyle-related exposures. Differences in the rate of recovery of cytomegalovirus, serum levels of IgA and IgG, and antibody titers to Epstein-Barr virus were noted among patients with different diagnoses. We conclude that …

National Case-Control Study Of Kaposi's Sarcoma And Pneumocystis Carinii Pneumonia In Homosexual Men: Part 1. Epidemiologic Results, Harold W. Jaffe, Keewhan Choi, Pauline A. Thomas, Harry W. Haverkos, David M. Auerbach, Mary E. Guinan, Martha F. Rogers, Thomas J. Spira, William W. Darrow, Mark A. Kramer, Stephen M. Friedman, James M. Monroe, Alvin E. Friedman-Kien, Linda J. Laubenstein, Michael Marmor, Bijan Safai, Selma K. Dritz, Salvatore J. Crispi, Shirley L. Fannin, John P. Orkwis, Alexander Kelter, Wilmon R. Rushing, Stephen B. Thacker, James W. Curran

Public Health Faculty Publications

To identify risk factors for the occurrence of Kaposi's sarcoma and Pneumocystis carinii pneumonia in homosexual men, we conducted a case-control study in New York City, San Francisco, Los Angeles, and Atlanta. Fifty patients (cases) (39 with Kaposi's sarcoma, 8 with pneumocystis pneumonia, and 3 with both) and 120 matched homosexual male controls (from sexually transmitted disease clinics and private medical practices) participated in the study. The variable most strongly associated with illness was a larger number of male sex partners per year (median, 61 for patients; 27 and 25 for clinic and private practice controls, respectively). Compared with controls, …