Medicine and Health Sciences Commons^™

Immigrant Granite Installer Killed After Falling With Homemade Construction Box, Kentucky Injury Prevention And Research Center

Fatality Case Reports--Falls

On a summer day in 2009, a 50-year-old granite installer and his two sons were working alone at a construction site when the granite installer fell out of a second story window and was killed. The three granite installers worked for a subcontractor hired to install granite vanity tops and sinks in a newly constructed hotel. Work had commenced at 7:00 AM that morning. They were installing the second set of ten vanities for the day. All ten vanities, with back and side splash pieces, had been loaded onto a homemade three-sided construction box and lifted via a forklift to …

Truck Drivers Killed After Exiting Semi Tractors And Being Struck By Other Semi Tractors In Distribution Center, Kentucky Injury Prevention And Research Center

Kentucky Haz Alerts--Motor Vehicle

To prevent truck driver injuries while traversing distribution facilities:

• Drivers of yard tractors should ensure that a clear path is visible before moving the vehicle. Truck drivers should not approach such vehicles on foot until acknowledgment of contact has been made between both drivers.
• Do not enter behind the trailer until other vehicle drivers behind have come to a complete stop and parked the vehicle.
• Always wear reflective vests while traversing a distribution facility.
• Employers should develop and implement a comprehensive safety plan that addresses truck driver pedestrian traffic in freight distribution facilities.
• All air lines and electrical connections should …

Ethnic Disparities In Cervical Cancer Survival Among Texas Women, Ann L. Coker, Christopher P. Desimone, Katherine S. Eggleston, Arica L. White, Melanie Williams

CRVAW Faculty Journal Articles

Objective: The aim of this work was to determine whether minority women are more likely to die of cervical cancer. A population-based cohort study was performed using Texas Cancer Registry (TCR) data from 1998 to 2002.

Methods: A total of 5,166 women with cervical cancer were identified during 1998–2002 through the TCR. Measures of socioeconomic status (SES) and urbanization were created using census block group-level data. Multilevel logistic regression was used to calculate the odds of dying from cervical cancer by race, and Cox proportional hazards modeling was used for cervical cancer-specific survival analysis.

Results: After adjusting for age, SES, …

Workers Killed While Working With Granite, Kentucky Injury Prevention And Research Center

Kentucky Haz Alerts--Other

To prevent injuries while working with granite:

• A job hazard analysis should be conducted each day before work commences.
• Employees should be trained in proper material handling procedures that include handling and transport of granite slabs.
• Use slab carts or slab racks to transport granite slabs and use tie-downs to secure the granite slabs to the forklift.
• Work should only be performed when the general contractor has a competent person on the job site.

Workers Killed While Working With Granite, Kentucky Injury Prevention And Research Center

Kentucky Haz Alerts--Falls

To prevent injuries while working with granite:

• A job hazard analysis should be conducted each day before work commences.
• Employees should be trained in proper material handling procedures that include handling and transport of granite slabs.
• Use slab carts or slab racks to transport granite slabs and use tie-downs to secure the granite slabs to the forklift.
• Work should only be performed when the general contractor has a competent person on the job site.

Bridging The Care Continuum: Patient Information Needs For Specialist Referrals., Carol L. Ireson, Svetla Slavova, Carol L. Steltenkamp, F. Douglas Scutchfield

Preventive Medicine and Environmental Health Faculty Publications

BACKGROUND: Information transfer is critical in the primary care to specialist referral process and has been examined extensively in the US and other countries, yet there has been little attention to the patient's perspective of the information transfer process. This cross-sectional study examined the quality of the information received by patients with a chronic condition from the referring and specialist physician in the specialist referral process and the relationship of the quality of information received to trust in the physicians.

METHODS: Structured telephone interviews were conducted with a random sample of 250 patients who had experienced a referral to a …

Workers Electrocuted While Working In Elevated Buckets, Kentucky Injury Prevention And Research Center

Kentucky Haz Alerts--Motor Vehicle

To prevent worker electrocutions while working near over-head power lines:

• Employers should implement and enforce a formal written electrical safety training program that includes work around overhead lines.
• An observer should be designated by the employer to perform an electrical hazard
• evaluation prior to commencing new work activities.
• A hazard assessment of the job site and route of travel, including aerial and ground hazards and obstacles, within the job site should be performed by a competent person before work commences.

Solid Waste Driver Dies After Single Vehicle Rollover, Kentucky Injury Prevention And Research Center

Fatality Case Reports--Motor Vehicle

On the morning of a fall day in 2008, a 59 year-old male solid waste worker (Driver 1) entered the cab of a company solid waste truck parked in his driveway and drove to a restaurant a few miles away. After leaving the restaurant, the driver was observed weaving by another solid waste driver (Driver 2) at least two times in the northbound lane of a two-lane state highway. After he had driven 1.8 miles in a little over 2 minutes away from the restaurant, the driver entered a right-hand curve in the highway. While in the curve, the driver …

Opportunities For Comparative Research In Public Health Pbrns : A Baseline Analysis Of Local Practice Settings, Glen P. Mays, Sharla A. Smith, Elaine B. Wootten, Sylvia J. Porchia

Health Management and Policy Presentations

This analysis describes the organizational and operational characteristics of local public health agencies participating in an initial cohort of five (5) public health PBRNs in the U.S. We examine variation in practice settings within and between PBRNs; compare practice settings to state and national norms; and identify opportunities for comparative research that can be conducted through PBRNs.

Bridging The Gaps: Biomedicine, Complementary And Alternative Medicine In A Holistic Approach, Hatim A. Omar, Joav Merrick

Pediatrics Faculty Publications

The 4^th international conference on holistic health and medicine was held during September 24-26, 2008 in Lexington, Kentucky in the United States of America. This conference brought many participants from 23 countries, both mainstream health care providers as well as holistic health practitioners to address the latest in knowledge and research, and in turn to find ways to collaborate and work together to provide the best possible care for their patients and clients. These conferences are held to build bridges between the various fractions of medicine and health care providers. The scientific program included plenary sessions, keynotes, workshops and …

Cancer Information-Seeking Experiences: The Implications Of Hispanic Ethnicity And Spanish Language, Robin C. Vanderpool, Julie Kornfeld, Lila Finney Rutten, Linda Squiers

Health, Behavior & Society Faculty Publications

BACKGROUND: Strategies to support cancer information-seeking among Hispanics are needed.

METHODS: We analyzed data from the 2005 Health Information National Trends Survey (HINTS) to explore cancer information-seeking experiences among respondents according to ethnicity and language of interview.

RESULTS: Over 80% of Spanish-speaking Hispanics had never looked for cancer information. Compared to English-speaking respondents, Spanish-speaking Hispanics who sought cancer information indicated their search took a lot of effort (67%), was hard to understand (54%), and frustrating (42%). Spanish-speaking Hispanics noted minimal confidence in obtaining cancer information.

CONCLUSIONS: Language and cultural differences must be considered in the design, implementation, and dissemination of …

Driver Of A Semi-Tractor Pulling Twin Trailers Fatally Injured In Single Vehicle Crash, Kentucky Injury Prevention And Research Center

Fatality Case Reports--Motor Vehicle

In the spring of 2008, a 40-year-old tractor-trailer driver died after his vehicle left the interstate highway, crashed, and was engulfed in flames. The tractor drifted over the fog line and rumble strip onto the right shoulder, began to skid and left the highway. The tractor slid through the grass beside the roadway, struck a concrete culvert, sideswiped a small tree and then hit a large tree head-on. The tractor and trailers then skidded back down the embankment toward the highway where the entire unit came to rest. The tractor and lead trailer overturned onto the driver’s side. The second …

Coal Truck Driver Dies In Rollover After Tire On Trailer Fails, Kentucky Injury Prevention And Research Center

Fatality Case Reports--Motor Vehicle

In the fall of 2006, a twenty-three year old male tractor-trailer driver who was hauling coal, died when a rear outer tire on the trailer failed. After the tire failed, the trailer slipped off the right side of the road, overturned, and went over an embankment. The trailer remained attached to the tractor as both went over the embankment, flipping the entire unit upside down. A witness called emergency medical services who arrived and called the county coroner. The coroner arrived and declared the driver dead at the scene. It was determined by Kentucky State Police that the driver was …

Public Health Systems And Services Research: Dataset Development, Dissemination, And Use, F. Douglas Scutchfield, Nikki Lawhorn, Rick Ingram, Debra Joy Pérez, Rick Brewer, Michelyn Bhandari

Preventive Medicine and Environmental Health Faculty Publications

Public health systems and services research (PHSSR) is defined as "a field of study that examines the organization, financing, and delivery of public health services within communities and the impact of those services." PHSSR is a relatively young field and suffers from a paucity of research resources. In this article, we describe the development and utility of a data resource, housed on the Health Services and Sciences Research Resources website maintained by the National Library of Medicine, which provides easy access to instruments, indices, and datasets that are relevant to PHSSR researchers. We also investigate efforts to promote the use …

Semi-Truck Driver Dies After Striking A Bridge Abutment, Kentucky Injury Prevention And Research Center

Fatality Case Reports--Motor Vehicle

At approximately 11:45 PM on a spring night in 2008, a semi-tractor driver accompanied by a driver trainee began his route from a warehouse loading dock in Kentucky. The driver departed with a single axle day cab pulling a 28’ refrigerated trailer loaded with detergent, refrigerated and frozen foods.

An hour later, the semi driver was driving in the right hand northbound lane on a four-lane interstate when he came upon a crash scene. A southbound mini-van had been struck by another vehicle, crossed the median, and had come to rest across the right hand northbound lane. To avoid striking …

Retrofitting Tractors With Rollover Protective Structures: Perspective Of Equipment Dealers, Shalome M. Tonelli, Kelley J. Donham, Kerry Leedom-Larson, Wayne Sanderson, Mark A. Purschwitz

Biosystems and Agricultural Engineering Faculty Publications

This study was one of a cluster of studies that originated via requests for proposals from the NIOSH National Agricultural Tractor Safety Initiative. The present study design consisted of several steps: (1) formation of an advisory group, (2) development and testing of a standard paper self-responding survey instrument, (3) sample selection of farm equipment dealers, (4) administration of the survey, (5) assessment and analysis of the survey, and (6) in-person response panel of dealers (n = 80) to review results of the questionnaire for further definition and sharpening of the recommendations from the survey. A key finding is that most …

Early Activities For Public Health Pbrns, Glen P. Mays

UKCPHSSR Research Briefs and Reports

Launching a successful public health practice-based research network requires a planned approach to developing the necessary infrastructure, relationships, and scientific direction.

Concepts Of Contraception For Adolescents With Obesity: Pathways Of Judicial Moderation, Donald E. Greydanus, Hatim A. Omar, Artemis Tsitsika

Pediatrics Faculty Publications

All sexually active youth, whether obese or normal weight, should be offered counseling regarding contraception and appropriate contraceptive methods. However, obese youth who are sexually active may be less likely than their normal weight peers to use contraceptives correctly. Methods of contraception for obese adolescents are reviewed in this discussion. Combined oral contraceptives (COCs) and the contraceptive patch have higher failure rates in obese versus normal weight females, though failure rates are lower than noted with barrier contraceptives. The risk for venous thrombosis is higher in obese youth on COCs. Progestin-only pills and the levonorgestrel intrauterine system appear to be …

Hyperandrogenism And Obesity: Ominous Co-Morbidities, Amit M. Deokar, Shawn J. Smith, Amanda J. Goodwin, Hatim A. Omar

Pediatrics Faculty Publications

This review has a two-fold objective. One, it addresses the association of hyperandrogenism and obesity and the complex metabolic derangements that are part of the problem. Clinical management of these co-morbidities is challenging and complex. Second, this article will aid health care providers with the key features to an early diagnosis and intervention to decrease the morbidities in the short as well as long term. Method: Systematic review of articles and information on the topic of interest that were published in the last 15 years. Conclusion: Obesity and hyperandrogenism are integral parts of Metabolic Syndrome/Polycystic Ovarian Syndrome (PCOS)/Hyperandrogenism, Insulin resistance, …

Obesity And Contraception, Donald E. Greydanus, Hatim A. Omar, Artemis Tsitsika

Pediatrics Faculty Publications

All sexually active youth, whether obese or normal weight, should be offered counseling regarding contraception and appropriate contraceptive methods. However, obese youth who are sexually active may be less likely than their normal weight peers to use contraceptives correctly. Methods of contraception for obese adolescents are reviewed in this discussion. Combined oral contraceptives (COCs) and the contraceptive patch have higher failure rates in obese versus normal weight females, though failure rates are lower than noted with barrier contraceptives. The risk for venous thrombosis is higher in obese youth on COCs. Progestin-only pills and the levonorgestrel intrauterine system appear to be …

Obesity And Hyperandrogenism, Amit M. Deokar, Shawn J. Smith, Amanda J. Goodwin, Hatim A. Omar

Pediatrics Faculty Publications

This chapter has a two-fold objective. One, it addresses the association of hyperandrogenism and obesity and the complex metabolic derangements that are part of the problem. Clinical management of these co-morbidities is challenging and complex. Second, this article will aid health care providers with the key features to an early diagnosis and intervention to decrease the morbidities in the short as well as long term. Method: Systematic review of articles and information on the topic of interest that were published in the last 15 years. Conclusion: Obesity and hyperandrogenism are integral parts of Metabolic Syndrome/Polycystic Ovarian Syndrome (PCOS)/Hyperandrogenism, Insulin resistance, …

Obesity And Lack Of Physical Activity, Hatim A. Omar, Efrat Merrick-Kenig, Joav Merrick

Pediatrics Faculty Publications

Lack of physical activity and overweight status continues to be a significant health problem in the United States. To assess the actual prevalence of these problems, we reviewed data from the School-based Health Promotion Centers in one middle school, and one high school in central Kentucky. A total of 232 6th graders and 607 9th graders were included. A total of 92% of 6th graders and 45% of 9th graders reported complete lack of regular exercise. 37% of 9th graders and 59% of 6th graders had inappropriate nutrition, 47% of 9th graders and 33% of 6th graders had Body Mass …

Breast Cancer Screening In Women Exposed In Utero To Diethylstilbestrol, Elizabeth A. Camp, Ann L. Coker, Stanley J. Robboy, Kenneth L. Noller, Karen J. Goodman, Linda T. Titus-Ernstoff, Elizabeth E. Hatch, Arthur L. Herbst, Rebecca Troisi, Raymond H. Kaufman, Ervin Adam

CRVAW Faculty Journal Articles

Purpose: To determine if women exposed in utero to diethylstilbestrol (DES) are more likely than unexposed women to receive recommended or additional breast cancer screening examinations.

Methods: 1994 Diethylstilbestrol-Adenosis (DESAD) cohort data are used to assess the degree of recommended compliance of breast cancer screenings found in 3140 DES-exposed and 826 unexposed women. Participants were enrolled at four sites: Houston, Boston, Rochester, and Los Angeles. Logistic regression modeling was used to analyze mailed questionnaire data that included reported frequency over the preceding 5 years (1990–1994) of breast-self examinations (BSEs), clinical breast examinations (CBEs), and mammograms.

Results: DES-exposed women exceeded annual …

Hpv Vaccine Acceptance Among Latina Mothers By Hpv Status, Maureen Sanderson, Ann L. Coker, Katherine S. Eggleston, Maria E. Fernandez, Concepcion D. Arrastia, Mary Kay Fadden

CRVAW Faculty Journal Articles

Objective: We investigated whether Latina mothers who were and were not human papillomavirus (HPV) positive differed in their knowledge and acceptance of the HPV vaccine for their children.

Methods: We conducted a cross–sectional survey among women aged 18–64 years between April 2007 and April 2008. Data collectors conducted in-person interviews in community clinics with 215 HPV-negative women and 190 HPV-positive women (with respective response rates of 64% and 84%). Most (83%) HPV-positive women were recruited at dysplasia clinics. Although no HPV-negative women were recruited at dysplasia clinics, they were recruited at other low-income public and private clinics.

Results: After adjustment …

Violence Against Women Raises Risk Of Cervical Cancer, Ann L. Coker, Claudia Hopenhayn, Christopher P. Desimone, Heather M. Bush, Leslie Crofford

CRVAW Faculty Journal Articles

Background: An emerging literature suggests that violence against women (VAW), particularly sexual violence, may increase the risk of acquiring a sexually transmitted infection (STI) and, therefore, may be associated with cervical cancer development. The purpose of this cross-sectional analysis was to determine if women who had experienced violence had higher prevalence rates of invasive cervical cancer.

Methods: Women aged 18–88 who joined the Kentucky Women’s Health Registry (2006–2007) and completed a questionnaire were included in the sample. Multivariate logistic regression analyses were used to adjust odds ratio (OR) for confounders (e.g., age, education, current marital status, lifetime illegal drug use, …

Ethnic Disparities In Cervical Cancer Survival Among Medicare Eligible Women In A Multiethnic Population, Ann L. Coker, Katherine S. Eggleston, Xianglin L. Du, Lois Ramondetta

CRVAW Faculty Journal Articles

To determine predictors of cervical cancer survival by socioeconomic status (SES), urbanization, race/ethnicity, comorbid conditions, and treatment among elderly Medicare-eligible women whose conditions were diagnosed with cervical cancer in a multiethnic population.

Methods: A total of 538 women with cervical cancer aged 65 years or older were identified from 1999 to 2001 from the Texas Cancer Registry and were linked with the state Medicare data and Texas Vital Records to determine survival times. All women had similar access to care through Medicare fee-for-services insurance. A composite measure of SES was created using census tract-level data as was urbanization. Treatment and …