Medicine and Health Sciences Commons^™

Prevalence Of Colorectal Cancer Screening Among A Multimorbid Rural Appalachian Population, Steven T. Fleming, Nancy E. Schoenberg, Yelena N. Tarasenko, Kevin A. Pearce

Yelena N. Tarasenko

Objectives: The purpose of this study was to determine the relation among multiple morbidities and the prevalence of colorectal cancer (CRC) screening among older adult Appalachian residents of Kentucky. This is the first known study to address multiple morbidities exclusively with a health-disparities population.

Methods: This was a cross-sectional study of 1153 subjects, aged 50 to 76 years, from Appalachian Kentucky.

Results: White race, post-high school education, and perception of having more than enough income on which to survive were associated with higher rates of any guideline concordant CRC screening. Statistically significant trends in the outcome of …

Key Findings From A Council On Linkages Survey Of Public Health Workers, Vincent Francisco, Jeffery A. Jones, Robin Pendley

Jeffery A Jones

The US governmental public health workforce is dwindling while the need for additional workers is increasing. In an historic effort to address this issue, in March 2010 the Council on Linkages Between Academia and Public Health Practice (Council on Linkages) surveyed over 70,000 public health workers across the US to determine how, when, and why they entered the governmental public health workforce and reasons they have remained in the workforce. Key survey findings were released in the spring of 2011 and have informed the development by the Council on Linkages of evidence-assisted recruitment and retention strategies for the US public …

The Role Of Social Support In Multiple Morbidity Self-Management Among Rural Residents, Shoshana Bardach, Yelena N. Tarasenko, Nancy E. Schoenberg

Yelena N. Tarasenko

Social support generally is considered a valuable asset that may compensate for health service deficiencies among rural populations. Employing a mixed methods approach, we explored how vulnerable rural residents described social support in the context of self-management for multiple chronic conditions. Participants generally felt support was available, though emotional/ informational support was perceived as less available than other types of support. Participants did not rely heavily on informal support to help them manage their multiple morbidities, preferring to call on their doctor and their own resources. We discuss implications of these findings for meeting this vulnerable population’s self-management needs.

Quantitative Tremor Analysis In Welders: Comparison With Idiopathic Parkinson's Disease And Essential Tremor, Juan Sanchez-Ramos, Dacy Reimer, Theresa A. Zesiewicz, Kelly L. Sullivan, Paul A. Nausieda

Kelly L. Sullivan

Background: Workers chronically exposed to manganese in welding fumes may develop an extra-pyramidal syndrome with postural and action tremors.
Objectives: To determine the utility of tremor analysis in distinguishing tremors among workers exposed to welding fumes, patients with Idiopathic Parkinson’s Disease (IPD) and Essential Tremor (ET).
Methods: Retrospective study of recorded tremor in subjects from academic Movement Disorders Clinics and Welders. Quantitative tremor analysis was performed and associated with clinical status.
Results: Postural tremor intensity was increased in Welders and ET and was associated with visibly greater amplitude of tremor with arms extended. Mean center frequencies (Cf) of welders and …

The Emergency Department As A Potential Intervention Recruitment Venue Among Vulnerable Rural Residents, Yelena N. Tarasenko, Nancy E. Schoenberg, Keisa L. Bennett

Yelena N. Tarasenko

Meeting the health care needs of rural residents is complicated by their substantial medical burdens that frequently outstrip patient and community resources. Nowhere is this more evident than in central Appalachia. Preventive procedures are often sacrificed as patients and providers attend to more pressing medical issues. We report the results of a pilot study designed to explore the need for and appropriateness of a potential intervention placed in an emergency department (ED), with the eventual goal of using the ED to link traditionally underserved patients to preventive services. We used a convenience sample of 49 ED patients to explore their …

Eschar-Associated Spotted Fever Rickettsiosis, Bahia, Brazil, Nanci Silva, Marina Eremeeva, Tatiana Rozental, Guilherme S. Ribeiro, Christopher D. Paddock, Eduardo Antonio G. Ramos, Alexsandra R.M. Favacho, Mitermayer G. Reis, Gregory A. Dasch,, Elba R.S. De Lemos, Albert I. Ko

Marina E. Eremeeva

In Brazil, Brazilian spotted fever was once considered the only tick-borne rickettsial disease. We report eschar-associated rickettsial disease that occurred after a tick bite. The etiologic agent is most related to Rickettsia parkeri, R. africae, and R. sibirica and probably widely distributed from São Paulo to Bahia in the Atlantic Forest.

Emergence Of A Novel Human Ehrlichia-Muris Like Organism In North America – Wisconsin And Minnesota, Bobbi S. Pritt, Lynne M. Sloan, Diep K. Hoang-Johnson, Ulrike G. Munderloh, Susan M. Paskewitz, Kristina M. Mcelroy, Jevon D. Mcfadden, Matthew J. Binnicker, David F. Neitzel, Gongping Liu, William L. Nicholson, Curtis M. Nelson, Joni J. Franson, Scott A. Martin, Scott A. Cunningham, Christopher R. Steward, Kay Bogumill, Mary E. Bjorgaard, Jeffrey P. Davis, Jennifer H. Mcquiston, David M. Warshauer, Mark P. Wilhelm, Robin Patel, Vipul A. Trivedi, Marina Eremeeva

Marina E. Eremeeva

Background: Ehrlichiosis is a clinically important, emerging zoonosis. Only Ehrlichia chaffeensis and E. ewingii have been thought to cause ehrlichiosis in humans in the United States. Patients with suspected ehrlichiosis routinely undergo testing to ensure proper diagnosis and to ascertain the cause.

Methods: We used molecular methods, culturing, and serologic testing to diagnose and ascertain the cause of cases of ehrlichiosis.

Results: On testing, four cases of ehrlichiosis in Minnesota or Wisconsin were found not to be from E. chaffeensis or E. ewingii and instead to be caused by a newly discovered ehrlichia species.

All patients had fever, …

Creating Community-Academic Partnerships For Cancer Disparities Research And Health Promotion, John S. Luque, Cathy D. Meade, Janelle M. Menard, Dinorah Martinez Tyson, Clement K. Gwede

John S. Luque

To effectively attenuate cancer disparities in multiethnic, medically underserved populations, interventions must be developed collaboratively through solid community-academic partnerships and driven by community-based participatory research (CBPR). The Tampa Bay Community Cancer Network (TBCCN) has been created to identify and implement interventions to address local cancer disparities in partnership with community-based nonprofit organizations, faith-based groups, community health centers, local media, and adult literacy and education organizations. TBCCN activities and research efforts are geared toward addressing critical information and access issues related to cancer control and prevention in diverse communities in the Tampa Bay area. Such efforts include cross-cultural health promotion, screening, …

Rocky Mountain Spotted Fever In Panama: A Cluster Description, Maribel Tribaldos, Yamitzel Zaldivar, Sergio Bermudez, Franklyn Samudio, Yaxelis Mendoza, Alexander A. Martinez, Rodrigo Villalobos, Marina Eremeeva, Christopher D. Paddock, Kathleen Page, Rebecca E. Smith, Juan Miguel Pascale

Marina E. Eremeeva

Rocky Mountain spotted fever (RMSF) is a tick-borne infection caused by Rickettsia rickettsii. We report a cluster of fatal cases of RMSF in 2007 in Panama, involving a pregnant woman and two children from the same family. The woman presented with a fever followed by respiratory distress, maculopapular rash, and an eschar at the site from which a tick had been removed. She died four days after disease onset. This is the second published report of an eschar in a patient confirmed by PCR to be infected with R. rickettsii. One month later, the children presented within days of one …