Medicine and Health Sciences Commons^™

Motivational Interview (Mi) Using Co-Active Life Coaching Skills As A Treatment For Obesity, Courtney Newnham-Kanas, Jennifer Irwin, Don Morrow

Donald Morrow

No abstract provided.

Change-Ing Obesity: A Methodological Account Of A Comprehensive Study For Obese University Students, Erin Pearson, Jennifer Irwin, Don Morrow

Donald Morrow

No abstract provided.

Motivational Interviewing For Special Populations Within Dentistry, Don Morrow, Jennifer Irwin

Donald Morrow

No abstract provided.

Qualitative Assessment Of Motivational Interviewing (Mi) Using Co-Active Life Coaching Skills As A Treatment For Obesity, Courtney Newnham-Kanas, Jennifer Irwin, Don Morrow

Donald Morrow

No abstract provided.

Improving Prenatal Education In A Health Center: A Pilot Study, Marcy Keddy Boucher, Hugh Silk, Judith A. Savageau, Katharine C. Barnard, Mary Flynn

Judith A. Savageau

Background: Currently, the timing and variety of health education topics that are covered during prenatal visits are decided upon by the individual physician caring for the patient. Consequently, some patients do not gain exposure to important subject matter that could potentially improve their satisfaction and pregnancy outcomes. Previously reported studies have found evidence that improved patient education may increase rates of breastfeeding (as well as duration), seat belt use during pregnancy, and decrease preterm low birth weight infants. In addition, one study has shown that when prenatal visits are targeted to specific objectives, the number of prenatal visits can …

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

Nina Silverstein

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 …

Male Circumcision For Hiv Prevention: Current Evidence And Implementation In Sub-Saharan Africa, Richard G. Wamai, Brian J. Morris, Stefan A. Bailis, David Sokal, Jeffrey D. Klausner, Ross Appleton, Nelson Sewankambo, David A. Cooper, John Bongaarts, Guy De Bruyn, Alex D. Wodak, Joya Banerjee

Richard G. Wamai

Heterosexual exposure accounts for most HIV transmission in sub-Saharan Africa, and this mode, as a proportion of new infections, is escalating globally. The scientific evidence accumulated over more than 20 years shows that among the strategies advocated during this period for HIV prevention, male circumcision is one of, if not, the most efficacious epidemiologically, as well as cost-wise. Despite this, and recommendation of the procedure by global policy makers, national implementation has been slow. Additionally, some are not convinced of the protective effect of male circumcision and there are also reports, unsupported by evidence, that non-sex-related drivers play a major …

Adjusting Medicare Capitation Payments Using Prior Hospitalization Data, Arlene Ash, Frank Porell, Leonard Gruenberg, Eric Sawitz, Alexa Beiser

Frank Porell

The diagnostic cost group approach to a reimbursement model for health maintenance organizations is presented. Diagnostic information about previous hospitalizations is used to create empirically determined risk groups, using only diagnoses involving little or no discretion in the decision to hospitalize. Diagnostic cost group and other models (including Medicare's current formula and other prior-use models) are tested for their ability to predict future costs, using R2 values and new measures of predictive performance. The diagnostic cost group models perform relatively well with respect to a range of criteria, including administrative feasibility, resistance to provider manipulation, and statistical accuracy.

Promoting Adherence And Retention To Clinical Trials In Special Populations: A Women's Health Initiative Workshop, Sara Wilcox, Sally Shumaker, Deborah Bowen, Michelle Naughton, Milagros Rosal, Shari Ludlam, Elizabeth Dugan, Julie Hunt, Stephanie Stevens

Elizabeth Dugan

This paper describes a Women's Health Initiative workshop on promoting adherence and retention in randomized clinical trials among ethnic minority women, participants of lower socioeconomic status, and older women. Workshop objectives were: (1) to increase knowledge of demographic and cultural characteristics of diverse groups, (2) to increase awareness of how diversity can affect interactions in clinical research, (3) to explore how research staff behavior can influence adherence and retention, and (4) to increase knowledge of strategies to enhance adherence and retention in special populations. The workshop emphasized the importance of understanding beliefs, values, and experiences that are common in diverse …

Patient Education About Anticoagulant Medication: Is Narrative Evidence Or Statistical Evidence More Effective?, Kathleen Mazor, Joann Baril, Elizabeth Dugan, Frederick Spencer, Pamela Burgwinkle, Jerry Gurwitz

Elizabeth Dugan

OBJECTIVE: To determine the relative impact of incorporating narrative evidence, statistical evidence or both into patient education about warfarin, a widely used oral anticoagulant medication.

METHODS: 600 patients receiving anticoagulant therapy were randomly assigned to view one of three versions of a video depicting a physician-patient encounter where anticoagulation treatment was discussed, or usual care (no video). The videos differed in whether the physician used narrative evidence (patient anecdotes), statistical evidence, or both to highlight key information. 317 patients completed both the baseline and post-test questionnaires. Questions assessed knowledge, beliefs and adherence to medication and laboratory monitoring regimens.

RESULTS: All …

Maternal B Vitamin Supplementation From Preconception Through Weaning Suppresses Intestinal Tumorigenesis In Apc1638n Mouse Offspring, Eric D. Ciappio, Zhenhua Liu, Ryan S. Brooks, Joel B. Mason, Roderick T. Bronson, Jimmy W. Croft

Zhenhua Liu

Objective—Variations in the intake of folate are capable of modulating colorectal tumorigenesis; however, the outcome appears to be dependent on timing. This study sought to determine the effect of altering folate (and related B vitamin) availability during in-utero development and the suckling period on intestinal tumorigenesis. Design—Female wildtype mice were fed diets either mildly deficient, replete or supplemented with vitamins B2, B6, B12 and folate for 4 weeks before mating to Apc1638N males. Females remained on their diet throughout pregnancy and until weaning. After weaning, all Apc1638N offspring were maintained on replete diets for 29 weeks. Results—At 8 months of …

Associations Of Daily Eating Episodes, And Eating Away-From-Home With Blood Level Of Total Cholesterol, Yunsheng Ma, Elizabeth R. Bertone-Johnson, Edward J. Stanek, Dr. Nancy L. Cohen, Ira S. Ockene

Nancy L. Cohen

The objective of this investigation is to describe the associations of number of eating episodes and proportion of meals eaten away from home with total serum cholesterol. Data from 499 participants, recruited from a health maintenance organization in central Massachusetts, aged 20-70, were used for this analysis. Dietary information and total blood cholesterol were obtained at five sampling points (baseline and four consecutive quarters) during the one-year follow-up. A cross-sectional study was conducted. The results from the study do not support the hypothesis that the number of eating episodes per day is associated with total blood cholesterol. However, we noted …

Pepfar’S Declining Investment In Treatment, Matthew Kavanagh, Marguerite Thorp

Matthew M. Kavanagh

Since its inception in 2003, the President’s Emergency Plan for AIDS Relief (PEPFAR) has saved millions of lives through providing anti-retroviral (ARV) treatment to people living with HIV/AIDS. However, our analysis of publicly available PEPFAR operational plans shows that funding to AIDS treatment has actually fallen significantly since 2008 in both absolute dollars and as a portion of total budgets—just at a pivotal moment when investment could change the course of the epidemic.

Suburban Poverty: Barriers To Services And Injury Prevention Among Marginalized Women Who Use Methamphetamine, Miriam W. Boeri, Benjamin Tyndall, Denise R. Woodall

Miriam W. Boeri

Objective: This paper aims to identify the needed healthcare and social services barriers for women living in suburban communities who are using or have used methamphetamine. Drug users are vulnerable to injury, violence and transmission of infectious diseases, and having access to healthcare has been shown to positively influence prevention and intervention among this population. Yet little is known regarding the social context of suburban drug users, their risks behaviors, and their access to healthcare. Methods: The data collection involved participant observation in the field, face-to-face interviews and focus groups. Audio-recorded in-depth life histories, drug use histories, and resource needs …

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

Kalpana Poudel-Tandukar

Undernutrition Among Hiv-Positive Children In Dar Es Salaam, Tanzania: Antiretroviral Therapy Alone Is Not Enough, Bruno F. Sunguya, Krishna C. Poudel, Keiko Otsuka, Junko Yasuoka, Linda B. Mlunde, David P. Urassa, Namala P. Mkopi, Masamine Jimba

Krishna C. Poudel

Community Mobility And Dementia: A Review Of The Literature, Nina M. Silverstein, Megan Vanderbur

Nina Silverstein

By the year 2030, 70 million Americans will be 65 or older. Approximately 80 percent of this population will likely be driving themselves. And without appropriate and timely interventions, many are likely to be driving with Alzheimer’s disease (AD). Current estimates suggest that 2 percent of the population 65 to 74, 19 percent of the population 75 to 84, and 47 percent of the population 85 and older are likely to suffer from Alzheimer’s disease or a related disorder. By the year 2050, the number of Americans with Alzheimer’s disease could range from 11.3 million to 16 million. This significant …

Massachusetts’ Home Care Programs And Reasons For Discharge Into Nursing Homes, Cathy M. Wong, Nina M. Silverstein

Nina Silverstein

Home and community-based services (HCBS) are a range of long-term care services intended to enable older adults and persons with disabilities to “age in place” in their own homes and communities. Previous studies well document that older adults prefer receiving HCBS rather than institutional care at a nursing home. One study concluded that 84 percent of older Americans, aged 50 years and older, want to remain in their homes for as long as possible. 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, …

Caffeinated Coffee, Decaffeinated Coffee And Endometrial Cancer Risk: A Prospective Cohort Study Among Us Postmenopausal Women, Ayush Giri, Susan R. Sturgeon, Nicole Luisi, Elizabeth Bertone-Johnson, Raji Balasubramanianemail, Katherine Reeves

Katherine Reeves

There is plausible biological evidence as well as epidemiologic evidence to suggest coffee consumption may lower endometrial cancer risk. We evaluated the associations between self-reported total coffee, caffeinated coffee and decaffeinated coffee, and endometrial cancer risk using the Women’s Health Initiative Observational Study Research Materials obtained from the National Heart, Lung, and Blood Institute Biological Specimen and Data Repository Coordinating Center. Our primary analyses included 45,696 women and 427 incident endometrial cancer cases, diagnosed over a total of 342,927 person-years of follow-up. We used Cox-proportional hazard models to evaluate coffee consumption and endometrial cancer risk. Overall, we did not find …

Transforming Lives -- Public Health Partners For A Global Community (Poster), Luanne Linnard-Palmer

Luanne Linnard-Palmer

Pathological Personality Traits Among Patients With Absent, Current, And Remitted Substance Use Disorders, Christopher J. Hopwood, Leslie C. Morey, Andrew E. Skodol, Charles A. Sanislow, Carlos M. Grilo, Emily B. Ansell, Thomas H. Mcglashan, John C. Markowitz, Anthony Pinto, Shirley Yen, M. Tracie Shea, John G. Gunderson, Mary C. Zanarini, Robert L. Stout

Charles A. Sanislow, Ph.D.

Personality traits may provide underlying risk factors for and/or sequelae to substance use disorders (SUDs). In this study Schedule for Nonadaptive and Adaptive Personality (SNAP) traits were compared in a clinical sample (N=704, age 18–45) with current, past, or no historical alcohol or non-alcohol substance use disorders (AUD and NASUD) as assessed by DSM-IV semi-structured interview. Results corroborated previous research in showing associations of negative temperament and disinhibition to SUD, highlighting the importance of these traits for indicating substance use proclivity or the chronic effects of substance use. Certain traits (manipulativeness, self-harm, disinhibition, and impulsivity for AUD, and disinhibition and …

Self-Harm Subscale Of The Schedule Of Nonadaptive And Adaptive Personality (Snap): Predicting Suicide Attempts Over 8 Years Of Follow-Up, Shirley Yen, M. Tracie Shea, Zach Walsh, Maria O. Edelen, Christopher J. Hopwood, John C. Markowitz, Emily B. Ansell, Leslie C. Morey, Carlos M. Grilo, Charles A. Sanislow, Andrew E. Skodol, John G. Gunderson, Mary C. Zanarini, Thomas H. Mcglashan

Charles A. Sanislow, Ph.D.

Objective: We examined the predictive power of the self-harm subscale of the Schedule for Nonadaptive and Adaptive Personality (SNAP) to identify suicide attempters in the Collaborative Longitudinal Study of Personality Disorders (CLPS).

Method: The SNAP, a self-report personality inventory, was administered to 733 CLPS participants at baseline, of whom 701 (96%) had at least 6 months of follow-up data. Cox proportional hazards regression analyses were performed to examine the SNAP–self-harm subscale (SNAP- SH) in predicting the 129 suicide attempters over 8 years of follow-up. Possible moderators of prediction were examined, including borderline personality disorder, major depressive disorder (MDD), and substance …

Collaboration With A Public Library, Margot G. Malachowski

Margot G Malachowski, MLS, AHIP

Spatial Cluster Of Female Breast Cancer In Missouri, Faustine Williams, Jeanette Jackson-Thompson, David O'Brien, Stephen C. Jeanetta, Chris Barnett

Faustine Williams

The Frank J. Manning Certificate In Gerontology Alumni Survey: 21 Years Of Service To Elders, Nina M. Silverstein, Jenai Murtha, Donna Sullivan, May Jawad

Nina Silverstein

The Certificate Program in Gerontology at the University of Massachusetts Boston, a large urban university, was established in 1979 as part of an Administration on Aging (AoA) grant to develop and expand services to the elderly citizens of the Commonwealth of Massachusetts. In 1984, a line item was added to the state budget by the legislature and governor establishing the Gerontology Institute at the University of Massachusetts Boston and ensuring the continuation of training, research, and policy and advocacy work on behalf of and with Massachusetts’ elders (O’Brien, 1996). Upon Frank J. Manning’s death in 1986, the program was renamed …

Living With Alzheimer’S Disease: A Study Of Adult Day Health Services In Massachusetts, Nina M. Silverstein, Cathy M. Wong, Kristen E. Brueck

Nina Silverstein

The role of adult day health care (ADHC) is gaining increased attention as the nation prepares for the large cohort of baby boomers entering their later years. Many boomers are aging with physical and cognitive impairments, including Alzheimer's disease and related dementias. Projections indicate that Massachusetts, along with the nation as a whole, is experiencing an increasing rate of older persons as baby boomers enter late-life. The Commonwealth can expect that persons with Alzheimer's disease and their care partners will need community-based services that are specifically designed for adults with cognitive impairments. However, a report by the Robert Wood Johnson …

Aging In Place At Harbor Point: Outreach Follow-Up Of Older Adults Living In Independent Mixed-Income Apartments, Judith M. Conahan, Nina M. Silverstein, Kelly Fitzgerald

Nina Silverstein

Most older people, despite functional impairments, plan to stay in their homes and/or communities as long as possible. According to an AARP survey, 82% of adults 65+ reported that they believe that they are “very likely” or “somewhat likely” to stay in their current homes or apartments for the rest of their lives. With increasing age, housing and community characteristics and services gain importance in meeting the challenges of “aging in place.” Staying in their homes maximizes elder’s independence, sustains their social connections, and reaffirms their identity and value.

Seniors Count Follow-Up Study, Nina M. Silverstein, Heather Connors, May Jawad

Nina Silverstein

Seniors Count is an ongoing outreach initiative under the direction of Boston Mayor Thomas M. Menino with the leadership and support of Joyce Williams, Boston's Commissioner on Affairs of the Elderly. The program's purpose is to "identify and reach out to those members of the city's elderly population who live in private housing arrangements and help provide them with the information and services they [may] need" (Boston Commission on Affairs of the Elderly, 2002). Since the program's inception in 1999, it has reached over 5,500 community-dwelling elders in the City of Boston (Boston Commission on Affairs of the Elderly, 2002). …

Chronic Disease Self-Management Programs: Relevance For Persons With Dementia, Nina M. Silverstein, Alison S. Gottlieb

Nina Silverstein

The context for this study is the work of the Healthy Brain Initiative. The CDC has established a cooperative agreement with the Alzheimer’s Association to develop and implement a multifaceted approach to look at cognitive health as a public health issue. Late in 2010, the Association commissioned a review of the major chronic disease prevention programs from a systems approach to begin to understand the source of findings that Medicare beneficiaries with Alzheimer’s and related disorders are much higher cost than those simply with a single chronic disease and no AD. This led to the conclusion that Chronic Disease Self‐Management …

With His Hands, David J. Malebranche

David J Malebranche

No abstract provided.