Medicine and Health Sciences Commons^™

Improving Health Outcomes For Foster Care Children In Maine Draft Conceptual Model, Culter Institute Of Health And Social Policy

Population Health & Health Policy

Improving Health Outcomes for Children (IHOC) is a 5-year demonstration grant from the Centers for Medicare & Medicaid Services, and authorized by 401 (d) of the Children's Health Insurance Program Reauthorization Act of 2009 (CHIPRA).

IHOC works with doctors' offices, practices and other agencies who want to improve health care in Maine and Vermont to:

• Collect and report on the use of evidenced-based child health quality measures
• Expand the Health Information Technology to improve the flow of child health data
• Promote a collaborative child health learning environment

Political Competition, Relative Deprivation, And Perceived Threat: A Research Note On Anti- Christian Violence In India, Chad Bauman, Tamara Leech

Department of Public Health Scholarship and Creative Works

A preliminary subnational statistical analysis of violence against Christians in contemporary India, this article suggests that whereas the data provide very little support for simple, demographic explanations of this violence, they do more robustly support theories emphasizing the relative status of ethnic and religious minorities (vis-à-vis majorities) and the perception, among Hindus, that Christians (and other minorities) represent a threat to their numerical, political and economic strength.

Rice Consumption Contributes To Arsenic Exposure In Us Women, Diane Gilbert-Diamond, Kathryn L. Cottingham, Joann F. Gruber, Tracy Punshon, Vicki Sayarath, A. Jay Gandolfi, Emily R. Baker, Brian P. Jackson, Carol L. Folt, Margaret R. Karagas

Dartmouth Scholarship

Emerging data indicate that rice consumption may lead to potentially harmful arsenic exposure. However, few human data are available, and virtually none exist for vulnerable periods such as pregnancy. Here we document a positive association between rice consumption and urinary arsenic excretion, a biomarker of recent arsenic exposure, in 229 pregnant women. At a 6-mo prenatal visit, we collected a urine sample and 3-d dietary record for water, fish/seafood, and rice. We also tested women's home tap water for arsenic, which we combined with tap water consumption to estimate arsenic exposure through water. Women who reported rice intake (n …

The Murine Caecal Microrna Signature Depends On The Presence Of The Endogenous Microbiota, Natasha Singh, Elize A. Shirdel, Levi Waldron, Regan-Heng Zhang, Igor Jurisica, Elena M. Comelli

Publications and Research

The intestinal messenger RNA expression signature is affected by the presence and compo-sition of the endogenous microbiota, with effects on host physiology. The intestine is also characterized by a distinctive micronome. However, it is not known if microbes also impact intestinal gene expression epigenetically. We investigated if the murine caecal microRNA expression signature depends on the presence of the microbiota, and the potential implica-tions of this interaction on intestinal barrier function. Three hundred and thirty four mi-croRNAs were detectable in the caecum of germ-free and conventional male mice and 16 were differentially expressed, with samples from the two groups clustering …

Obesity: The Anthropometric And Demographic Characteristics Of Insured And Uninsured Individuals, Terra Fox Williams

Master of Public Health Program Student Publications

Objectives. This study evaluates the association between Body Mass Index (BMI) and health insurance status in attendees at a local health fair. BMI was also compared among ages, gender, and races.

Methods. Descriptive analysis conducted using data collected at the “Celebrating Life and Health” health fairs between the years 2008 and 2011. Data for this study were collected at the BMI booth staffed by Wright State Boonshoft School of Medicine students.

Results. The results of this particular study do not demonstrate a statistical difference between obesity and health insurance status. Consistent with other research articles this study does show that …

Flexible Distributed Lag Models Using Random Functions With Application To Estimating Mortality Displacement From Heat-Related Deaths, Roger D. Peng

Johns Hopkins University, Dept. of Biostatistics Working Papers

No abstract provided.

The Aging Services Network: Serving A Vulnerable And Growing Elderly Population In Tough Economic Times, Carol O'Shaughnessy

National Health Policy Forum

In 1965, Congress enacted the Older Americans Act, establishing a federal agency and state agencies to address the social services needs of the aging population. The mission of the Older Americans Act is broad: to help older people maintain maximum independence in their homes and communities and to promote a continuum of care for the vulnerable elderly. In successive amendments, the Act created area agencies on aging and a host of social support programs. The "aging services network," broadly described, refers to the agencies, programs, and activities that are sponsored by the Older Americans Act. The Act’s funding for services …

Driving Qi With Research: Findings From Public Health Pbrns, Glen P. Mays

Health Management and Policy Presentations

Public health agencies are increasingly experimenting with quality improvement (QI) strategies designed to enhance the effectiveness and efficiency of their efforts. Does QI work in public health, and if so for whom and under what circumstances? What QI strategies work best for which types of public health process failures, and at what cost? Research underway through the Public Health Practice-Based Research Networks (PBRN) Program is examining these types of questions to build an evidence base for public health QI.

Health Policy & Management News, Georgia Southern University

Health Policy & Management Department News (2011-2018)

• Georgia Southern University’s Jiann-Ping Hsu College of Public Health receives grant from the Robert Wood Johnson Foundation

College Of Public Health News, Georgia Southern University

Jiann-Ping Hsu College of Public Health News (2011-2023)

• Georgia Southern University's Jiann-Ping Hsu College of Public Health receives grant from the Robert Wood Johnson Foundation

Attempting To Close The Food Gap: An Evaluation Of The 2011 Fair Share Program In Gettysburg, Pa, Lisa M. Martin

Student Publications

Background: Families in Adams County with an income between 160% and 250% of the Federal Poverty Income Guidelines and ineligible for federal food assistance programs were determined to be in the “food gap.” In collaboration with Adams County Farm Fresh Markets and the Center for Public Service at Gettysburg College, the Adams County Food Policy Council developed the Fair Share Program to provide monthly food vouchers and educational sessions to a group of families in the food gap to use at farmers markets in Gettysburg, PA. The goals of the program were to provide families not eligible for federal food …

Effects Of Prenatal Food And Micronutrient Supplementation On Child Growth From Birth To 54 Months Of Age: A Randomized Trial In Bangladesh, Ashraful Islam Khan, Iqbal Kabir, Eva-Charlotte Ekström, Kajsa Åsling-Monemi, Dewan Shamsul Alam, Edward A. Frongillo Jr., Md Yunus, Shams Arifeen, Lars-Åke Persson

Faculty Publications

Background: There is a lack of information on the optimal timing of food supplementation to malnourished pregnant women and possible combined effects of food and multiple micronutrient supplementations (MMS) on their offspring's growth. We evaluated the effects of prenatal food and micronutrient interventions on postnatal child growth. The hypothesis was that prenatal MMS and early invitation to food supplementation would increase physical growth in the offspring during 0-54 months and a combination of these interventions would further improve these outcomes.

Methods: In the large, randomized MINIMat trial (Maternal and Infant Nutrition Interventions in Matlab), Bangladesh, 4436 pregnant women were enrolled …

Components Of The Indirect Effect In Vaccine Trials: Identification Of Contagion And Infectiousness Effects, Tyler J. Vanderweele, Eric J. Tchetgen, M. Elizabeth Halloran

COBRA Preprint Series

Vaccination of one person may prevent the infection of another either because (i) the vaccine prevents the first from being infected and from infecting the second or because (ii) even if the first person is infected, the vaccine may render the infection less infectious. We might refer to the first of these mechanisms as a contagion effect and the second as an infectiousness effect. In this paper, for the simple setting of a randomized vaccine trial with households of size two, we use counterfactual theory under interference to provide formal definitions of a contagion effect and an infectiousness effect. Using …

On The Definition Of A Confounder, Tyler J. Vanderweele, Ilya Shpitser

COBRA Preprint Series

The causal inference literature has provided a clear formal definition of confounding expressed in terms of counterfactual independence. The causal inference literature has not, however, produced a clear formal definition of a confounder, as it has given priority to the concept of confounding over that of a confounder. We consider a number of candidate definitions arising from various more informal statements made in the literature. We consider the properties satisfied by each candidate definition, principally focusing on (i) whether under the candidate definition control for all "confounders" suffices to control for "confounding" and (ii) whether each confounder in some context …

Long-Term Effects Of Changes In Cardiorespiratory Fitness And Body Mass Index On All-Cause And Cardiovascular Disease Mortality In Men: The Aerobics Center Longitudinal Study, Duck-Chul Lee, Xuemei Sui, Enrique G. Artero, I-Min Lee, Timothy S. Church, Paul A. Mcauley, Fatima C. Stanford, Harold W. Kohl Iii, Steven N. Blair

Faculty Publications

Background - The combined associations of changes in cardiorespiratory fitness and body mass index (BMI) with mortality remain controversial and uncertain.

Methods and Results - We examined the independent and combined associations of changes in fitness and BMI with all-cause and cardiovascular disease (CVD) mortality in 14,345 men (mean age 44 years) with at least 2 medical examinations. Fitness, in metabolic equivalents (METs), was estimated from a maximal treadmill test. BMI was calculated using measured weight and height. Changes in fitness and BMI between the baseline and last examinations over 6.3 years were classified into loss, stable, or gain groups. …

A Theater-Based Approach To Primary Prevention Of Sexual Behavior For Early Adolescents, Lisa D. Lieberman, Cydelle Berlin, Lori-Ann Palen, Olivia Silber Ashley

Department of Public Health Scholarship and Creative Works

Early adolescence is a crucial period for preventing teen pregnancy and sexually transmitted infections. This study evaluated STAR LO, a theater-based intervention designed to affect antecedents of sexual activity among urban early adolescents (N = 1,143). Public elementary/middle schools received the intervention or served as a wait-listed comparison group in a quasi-experimental study. Students completed pretest and posttest questionnaires. Multivariate regression models were used to examine treatment effects. Comparison students showed significantly greater increases in sexual intentions and decreases in pro-abstinence attitudes and intended age of first sex than treatment group adolescents. Comparison girls showed significantly greater increases in …

Understanding The Association Of Biomedical, Psychosocial And Behavioral Risks With Adverse Pregnancy Outcomes, Michele Kiely, Ayman El-Mohandes, Marie G. Gantz, Dhuly Chowdhury, Jutta S. Thornberry, M. Nabil El-Khorazaty

Publications and Research

Objectives: This study investigates the relationship between diabetes, hypertension, preeclampsia, and Body Mass Index (BMI) -- the most common and interrelated medical conditions occurring during pregnancy; sociodemographic and behavioral risk factors; and adverse pregnancy outcomes in high-risk urban African American women in Washington, DC.

Methods: Data are from a randomized controlled trial conducted in 6 prenatal clinics. Women in their 1^st or 2^nd trimester were screened for behavioral risks (smoking, environmental tobacco smoke exposure, depression, and intimate partner violence) and demographic eligibility. 1,044 were eligible, interviewed and followed through their pregnancies. Classification and Regression Trees (CART) methodology was …

Sexuality Education, Eva Goldfarb, Norman A. Constantine

Department of Public Health Scholarship and Creative Works

Sexuality education comprises the lifelong intentional processes by which people learn about themselves and others as sexual, gendered beings from biological, psychological, and sociocultural perspectives. It takes place through a potentially wide range of programs and activities in schools, community settings, religious centers, as well as informally within families, among peers, and through electronic and other media. Sexuality education for adolescents occurs in the context of the biological, cognitive, and social-emotional developmental progressions and issues of adolescence. Formal sexuality education falls into two main categories: behavior change approaches, which are represented by abstinence-only and abstinence-plus models, and healthy sexual development …

Chhs December 2011 E-Newsletter, Dr. John Bonaguro, Dean, Vashon S. Wells, Editor, College Of Health And Human Services, Western Kentucky University

College of Health & Human Services Publications

No abstract provided.

College Student Reactions To Health Warning Labels: Sociodemographic And Psychosocial Factors Related To Perceived Effectiveness Of Different Approaches, Carla J. Berg, James F. Thrasher, J. Lee Westmaas, Taneisha Buchanan, Erika A. Pinsker, Jasjit S. Ahluwalia

Faculty Publications

Objective. To examine factors associated with perceiving different types of pictorial cigarette health warning labels as most effective in motivating smokers to quit or preventing smoking initiation among college students.

Method. We administered an online survey to 24,055 students attending six Southeast colleges in Fall, 2010. We obtained complete data for the current analysis from 2600.

Results. Current smoking prevalence was 23.5%. The largest majority (78.6%) consistently rated gruesome images as most effective, 19.5% rated testimonial images as most effective, and only a small proportion rated either standard (1.6%) or human suffering images (0.3%) as most effective. Subsequent analyses focused …

Leaving Home Care: Decision Making, Risk Scenarios & Services Gaps In The Home Care System, Jacey J. Vaughan, Nina M. Silverstein

Gerontology Institute Publications

Home and community-based services (HCBS) enable older and disabled adults to age-in-place in their homes and communities by helping them function independently for as long as possible (Grabowski et al., 2010; Wong & Silverstein, 2011). Previous studies well document that older adults prefer receiving HCBS rather than institutional care at a nursing home (e.g., Walker, 2010; Fox-Grage, Coleman, & Freiman, 2006). Medicaid is a major source of funding for long-term care. Currently, a large proportion of Medicaid funds in most states has been spent on institutional care (National Conference of State Legislatures & AARP, 2009), and older adults and their …

Effect Of Environmental Conditions On Perceived Psychological Restorativeness Of Coastal Parks, J. Aaron Hipp, Oladele A. Ogunseitan

Brown School Faculty Publications

We investigated the hypothesis that perception of psychological restorativeness during visits to coastal parks is modified by objective and perceived environmental conditions. Visitors (n=1,153) to California beaches completed a survey on perceived weather, environmental quality, and perceived restorativeness. We used generalized ordinal logistic models to estimate the association between environmental parameters and odds of perceiving higher levels of restorativeness. Visitors perceived greater restorativeness at beaches when ambient temperatures were at or below mean monthly temperatures and during low tides. The odds of perceiving the environment as more psychologically restorative were three times greater when visiting on days defined by government …

Prevalence And Risk Of Polypharmacy Among The Elderly In An Outpatient Setting: A Retrospective Cohort Study In The Emilia-Romagna Region, Italy, S. Lane Slabaugh, Vittorio Maio, Megan Templin, Safiya Abouzaid

College of Population Health Faculty Papers

Background: Polypharmacy, the simultaneous taking of many medications, has been well documented and is a topic of much concern for those looking to improve the quality of care for the elderly. Elderly patients often develop complicated and multi-factorial health states that require extensive pharmacotherapy, leaving this population at risk for exposure to drug-drug interactions and other adverse events. Previous literature supports an association between an increase in the rate of adverse events as the number of drugs taken by a patient increases.

Objective: We sought to evaluate the prevalence of polypharmacy, and to determine patient characteristics that are predictive of …

Current And Future Directions In Frailty Research., Anita Mohandas, Joanne Reifsnyder, Mimi Jacobs, Tim Fox

College of Population Health Faculty Papers

The concept of frailty has been evolving dramatically for the past 30 years. Through its evolution, a variety of single and multidimensional models have been used to describe frailty. This article reviews the current literature related to the defining dimensions of frailty and identifies the gaps in the literature requiring additional research. A detailed literature review was performed to identify key dimensions and models currently being used to define frailty, classify interventions that have been developed to reverse frailty, and identify potential areas for future research within this field. Despite the large body of research defining the dimensions of frailty, …

Determining The Factors Associated With Unmet Need For Family Planning: A Cross-Sectional Survey In 49 Districts Of Pakistan, Waqas Hameed, Syed Khurram Azmat, Mohsina Bilgrami, Muhammad Ishaqe

Community Health Sciences

Introduction & Background: Around 137 million women in the developing world who would like to avoid childbearing are unable to do so, despite a huge increase in contraceptive access and use globally. Ironically, the prevalence of unmet need in Pakistan is among the highest in the world despite being one of the first countries in South Asia to launch national family planning program. The aim of this paper is to estimate the prevalence of unmet need for contraception and to indentify the factors associated with it.
Methods: A cross-sectional survey was conducted in forty nine districts of Pakistan across all …

The Triumph And Tragedy Of Tobacco Control: A Tale Of Nine Nations, Eric A. Feldman, Ronald Bayer

All Faculty Scholarship

The use of law and policy to limit tobacco consumption illustrates one of the greatest triumphs of public health in the late twentieth and early twenty-first centuries, as well as one of its most fundamental failures. Overall decreases in tobacco consumption throughout the developed world represent millions of saved lives and unquantifiable suffering averted. Yet those benefits have not been equally distributed. The poor and the undereducated have enjoyed fewer of the gains. In this review, we build on existing tobacco control scholarship and expand it both conceptually and comparatively. Our focus is the social gradient of smoking both within …

Exploration And Comparison Of Methods For Combining Population- And Family-Based Genetic Association Using The Genetic Analysis Workshop 17 Mini-Exome, David W. Fardo, Anthony R. Druen, Jinze Liu, Lucia Mirea, Claire Infante-Rivard, Patrick Breheny

Biostatistics Faculty Publications

We examine the performance of various methods for combining family- and population-based genetic association data. Several approaches have been proposed for situations in which information is collected from both a subset of unrelated subjects and a subset of family members. Analyzing these samples separately is known to be inefficient, and it is important to determine the scenarios for which differing methods perform well. Others have investigated this question; however, no extensive simulations have been conducted, nor have these methods been applied to mini-exome-style data such as that provided by Genetic Analysis Workshop 17. We quantify the empirical power and false-positive …

Associations Between Physical Activity And Submaximal Cardiorespiratory And Pulmonary Responses In Men, John C. Sieverdes, Xuemei Sui, Steven N. Blair

Faculty Publications

Background: Habitual physical activity (PA) is associated with higher cardiorespiratory fitness values, but additional information is needed on the contributions of specific types and amounts of PA. Therefore the main aim of this study was to analyze the heart and lung function of a large cohort of men and compare these outcomes with various modes and volumes of PA.

Methods: We used data from 30,594 men from the Aerobics Center Longitudinal Study who were categorized into sedentary, swimmer, walker, and runner groups using self-report PA data collected during 1970-2005. Additional PA categories using MET-minutes/week were used to group men into …

The Role Of Supermarkets In Community Nutrition, Staci Gruber

Master of Public Health Program Student Publications

Background: Chronic diseases related to nutrition are a serious threat to public health. Supermarkets offer an important and promising venue to improve diet quality and overall health. The purpose of this study is to evaluate the supermarkets’ community nutrition focus and interest in public health.

Methods: This study emphasis’s a triangulated qualitative study design. It employs various methods and taps various sources for data. Twenty face-to-face, semi-structured key informant interviews were conducted with five full service supermarket chains in Montgomery County, Ohio; Wal-Mart, Kroger, Meijer, Cub Foods, and Dorothy Lane Market. Qualitative sources of information collected include store observation and …

Relationship Of Serum Fatty Acid Composition And Desaturase Activity To C-Reactive Protein In Japanese Men And Women, Kalpana Poudel-Tandukar, Masao Sato, Yuko Ejima, Akiko Nanri, Yumi Matsushita, Katsumi Imaizumi, Tetsuya Mizoue

Elaine Marieb College of Nursing Faculty Publication Series

Background: Although fatty acid composition in serum and desaturase activity, which alters serum fatty acid composition, has been associated with C-reactive protein (CRP) concentration in Western populations, no study has been carried out in non-Western populations. We examined the association of serum fatty acids and estimated desaturase activity with CRP concentrations in Japanese men and women. Methods: Subjects were 489 Japanese municipal employees aged 21–67 yearswhoparticipated in a survey at the time of a periodic health check-up. Serum high-sensitivity CRP concentrations were measured using the latex agglutination nephelometry method. Fatty acid composition was measured in serum cholesteryl esters and desaturase …