Medicine and Health Sciences Commons^™

Stem Cell Matching For Patients Of Mixed Race, Ted C. Bergstrom

Ted C Bergstrom

Patients with leukemia and other blood diseases stand a good chance of recovery and a return to normal life if they receive a stem cell transplant from a living donor. In the absence of a transplant, their survival prospects are grim. For a transplant to be successful, the human leukocyte antigens (HLA) of the donor and recipient must be a close genetic match. To facilitate non-sibling matches, the developed nations of the world have set up national volunteer registries. The larges such registry is the NMDP (National Marrow Donor Program). We estimate the distribution of HLA types for individuals of …

Model Mitigasi Kebakaran Berbasis Masyarakat : Kajian Kualitatif Pada Aparat Pemerintah Dan Lsm, Fatmah Fatmah

Kesmas

Lingkungan masyarakat kota yang bebas kebakaran dapat tercipta melalui upaya pencegahan dan pemadaman kebakaran dini. Penelitian ini bertujuan mengembangkan model mitigasi kesiapsiagaan kebakaran berbasis masyarakat. Metoda kualitatif wawancara mendalam dilakukan terhadap 30 informan terpilih di Jabodetabek meliputi aparat kecamatan, kelurahan, Lembaga Swadaya Masyarakat, dan Suku Dinas Pemadam Kebakaran. Mayoritas informan mengenal organisasi Barisan Sukarelawan Kebakaran, tetapi dalam pelaksanaan ditemukan beberapa kendala antara lain meliputi tidak ada honorarium, status pekerjaan, dan anggota penduduk musiman. Hal tersebut berakibat banyak anggota yang berhenti dan sulit merekrut anggota baru. Bentuk upaya pencegahan kebakaran yang dilakukan masyarakat meliputi simulasi, penyuluhan, dan pelatihan bahaya kebakaran, serta …

Potret Kebijakan Pengendalian Demam Berdarah Dengue Di Kabupaten Indramayu, Henri Peranginangin, Hasim Hasim, Bambang Pramudya, Sri Budiarti

Kesmas

Penyakit demam berdarah dengue (DBD) masih menjadi masalah di Kabupaten Indramayu. Penelitian ini bertujuan mengidentifikasi elemen-elemen prioritas kebijakan pengendalian penyakit DBD di Kabupaten Indramayu menurut pakar berdasarkan metode Analytical Hierarchy Process (AHP). Hasil penelitian menunjukkan “strategi utama” pengendalian penyakit DBD di Kabupaten Indramayu adalah peningkatan kesehatan lingkungan permukiman; “aktor utama pengendalian” ialah Pemerintah Kabupaten Indramayu; “faktor utama pengendalian” adalah lingkungan; “tujuan utama pengendalian” ialah Kabupaten Indramayu bebas penyakit DBD; dan “kriteria utama pengendalian” adalah jumlah dan mutu sumber daya manusia. Agar implementasi strategi pengendalian itu efektif maka Pemerintah Kabupaten Indramayu perlu meningkatkan kerja sama lintas program dan sektoral; dukungan teknologi, …

Program Langit Biru : Kontribusi Kebijakan Pengendalian Pencemaran Udara Kota Terhadap Penurunan Penyakit Pernapasan Pada Anak, Laila Fitria

Kesmas

Pencemaran udara perkotaan yang berdampak buruk terhadap kesehatan masyarakat sering dikaitkan dengan PM 10, NO2, dan ozon, polutan reaktif yang memicu kerusakan jaringan dalam saluran napas melalui mekanisme stres oksidatif dan inflamasi saluran napas. Pajanan jangka panjang polutan tersebut berpengaruh terhadap gangguan pernapasan, penurunan fungsi paru, asma, serta penyakit sistem pernapasan kronik lain seperti penyakit paru-paru obstruktif kronik. Program Langit Biru merupakan salah satu upaya mengurangi pencemaran udara dari sektor transportasi yang dicanangkan sejak tahun 1996. Hingga kini, kontribusi Program Langit Biru terhadap penurunan kasus gangguan pernapasan pada anak belum dapat diperkirakan, antara lain disebabkan oleh karena pelaksanaan program melalui …

Kesehatan Jiwa Yang Terabaikan Dari Target Milenium, Sri Idaiani

Kesmas

Millenium Development Goals (MDG) yang dicanangkan pada tahun 2000 sangat didominasi oleh penyakit menular serta kesehatan ibu dan anak, tetapi mengabaikan berbagai masalah penyakit tidak menular. Tidak sedikitpun terlintas dalam benak para pemimpin dunia itu target dan indikator yang menyentuh atau berhubungan dengan masalah kesehatan jiwa. Tulisan ini bertujuan membahas posisi kesehatan jiwa di seluruh dunia yang cenderung semakin memprihatinkan, tetapi justru terabaikan dari target MDG. Pencapaian target milenium tampaknya tidak memperhitungkan beban penyakit akibat berbagai masalah kejiwaan. Padahal, jika dibiarkan, pada masa mendatang masalah kesehatan jiwa akan menjadi besar seperti yang tengah dihadapi oleh berbagai negara maju. Berdasarkan prediksi …

Corticosteroids For Pain Relief In Sore Throat: Systematic Review And Meta-Analysis, Gail Hayward, Matthew J. Thompson, Carl J. Heneghan, Rafael Perera, Paul P. Glasziou, Chris B. Del Mar

Christopher Del Mar

Objective: To evaluate whether systemic corticosteroids improve symptoms of sore throat in adults and children. Design: Systematic review and meta-analysis. Data sources: Cochrane Central, Medline, Embase, Database of Reviews of Effectiveness (DARE), NHS Health Economics Database, and bibliographies. Outcome measures: Percentage of patients with complete resolution at 24 and 48 hours, mean time to onset of pain relief, mean time to complete resolution of symptoms, days missed from work or school, recurrence, and adverse events. Results: We included eight trials, consisting of 743 patients in total (369 children, 374 adults). 348 (47%) had exudative sore throat, and 330 (44%) were …

Neuraminidase Inhibitors For Preventing And Treating Influenza In Healthy Adults: Systematic Review And Meta-Analysis, Tom Jefferson, Mark Jones, Peter Doshi, Chris Del Mar

Christopher Del Mar

Objectives: To update a 2005 Cochrane review that assessed the effects of neuraminidase inhibitors in preventing or ameliorating the symptoms of influenza, the transmission of influenza, and complications from influenza in healthy adults, and to estimate the frequency of adverse effects. Search strategy: An updated search of the Cochrane central register of controlled trials (Cochrane Library 2009, issue 2), which contains the Acute Respiratory Infections Group’s specialised register, Medline (1950-Aug 2009), Embase (1980-Aug 2009), and post-marketing pharmacovigilance data and comparative safety cohorts. Selection criteria: Randomised placebo controlled studies of neuraminidase inhibitors in otherwise healthy adults exposed to naturally occurring influenza. …

Transparent Development Of The Who Rapid Advice Guidelines, Holger J. Schunemann, Suzanne R. Hill, Meetali Kakad, Gunn E. Vist, Richard Bellamy, Lauren Stockman, Torbjorn Fosen Wisloff, Chris Del Mar, Frederick Hayden, Timothy M. Uyeki, Jeremy Farrar, Yazdan Yazdanpanah, Howard Zucker, John Beigel, Tawee Chotpitayasunondh, Tran Tinh Hien, Bulent Ozbay, Norio Sugaya, Andrew D. Oxman

Christopher Del Mar

Emerging health problems require rapid advice. We describe the development and pilot testing of a systematic, transparent approach used by the World Health Organization (WHO) to develop rapid advice guidelines in response to requests from member states confronted with uncertainty about the pharmacological management of avian influenza A (H5N1) virus infection. We first searched for systematic reviews of randomized trials of treatment and prevention of seasonal influenza and for nontrial evidence on H5N1 infection, including case reports and animal and in vitro studies. A panel of clinical experts, clinicians with experience in treating patients with H5N1, influenza researchers, and methodologists …

Comparison Of Ammonia And Particulate Matter Air Sample Concentrations At Task-Locations Within Swine Confinement Buildings., Earl Dan Bembry

Electronic Theses and Dissertations

Introduction: A task-associated analysis of ammonia and particulate matter concentrations was conducted on swine farms in breeding and gestation barns. The purpose of this study was to determine if specific tasks performed by workers increase concentrations of ammonia and particulate matter exposure.

Methods: An exploratory, descriptive design was used to determine if swine confinement workers have increased ammonia and particulate matter exposure when performing assigned tasks in breeding and gestation barns. A convenience sample of 8 workers volunteered from among all breeding and gestation workers (n=24). Data collection occurred in the morning at each of the 8 farms …

A Comparison Of The Wellbeing Of Orphans And Abandoned Children Ages 6–12 In Institutional And Community-Based Care Settings In 5 Less Wealthy Nations, Kathryn Whetten, Jan Ostermann, Rachel A. Whetten, Brian W. Pence, Karen O'Donnell, Lynne C. Messer, Nathan M. Thielman, The Positive Outcomes For Orphans (Pofo) Research Team

Faculty Publications

Background

Leaders are struggling to care for the estimated 143,000,000 orphans and millions more abandoned children worldwide. Global policy makers are advocating that institution-living orphans and abandoned children (OAC) be moved as quickly as possible to a residential family setting and that institutional care be used as a last resort. This analysis tests the hypothesis that institutional care for OAC aged 6–12 is associated with worse health and wellbeing than community residential care using conservative two-tail tests.

Methodology

The Positive Outcomes for Orphans (POFO) study employed two-stage random sampling survey methodology in 6 sites across 5 countries to identify 1,357 …

Whose Duty Is It Anyway?: The Kennedy Krieger Opinion And Its Implications For Public Health Research, Diane E. Hoffmann, Karen H. Rothenberg

Karen H. Rothenberg

In this article, the authors discuss the Maryland Court of Appeals decision in the case of Grimes v. Kennedy Krieger Institute, Inc. and its implications for the tort duty owed by researchers, in particular public health researchers, to their subjects. The Opinion resulted from two lawsuits alleging lead poisoning of children enrolled in a study conducted by the Kennedy Krieger Institute, a world renown pediatric research and treatment facility. The opinion shocked the research establishment with its scathing characterization of researchers and its apparent holding that in Maryland a parent cannot consent to the participation of a child in "nontherapeutic …

Colloquium - Gender, Law And Health Care: New Perspectives For Teaching And Scholarship: The Role Of Gender In Law And Health Care, Karen H. Rothenberg

Karen H. Rothenberg

No abstract provided.

Bisphenol-A And The Great Divide: A Review Of Controversies In The Field Of Endocrine Disruption, Laura Vandenberg, Maricel V. Maffini, Carlos Sonnenschein, Beverly S. Rubin, Ana M. Soto

Laura Vandenberg

In 1991, a group of 21 scientists gathered at the Wingspread Conference Center to discuss evidence of developmental alterations observed in wildlife populations after chemical exposures. There, the term “endocrine disruptor” was agreed upon to describe a class of chemicals including those that act as agonists and antagonists of the estrogen receptors (ERs), androgen receptor, thyroid hormone receptor, and others. This definition has since evolved, and the field has grown to encompass hundreds of chemicals. Despite significant advances in the study of endocrine disruptors, several controversies have sprung up and continue, including the debate over the existence of nonmonotonic dose …

Got Junk? The Federal Role In Regulating “Competitive” Foods, Eileen Salinsky

National Health Policy Forum

A wide variety of food and beverage items are available in schools in addition to the school meals provided through the National School Lunch Program and School Breakfast Program. A long-standing source of controversy, the need for stronger federal restrictions on foods that compete with school meals is again under debate. This issue brief examines the availability and consumption of competitive foods, explores the regulation of these foods at the federal level, considers trends in state and local restrictions, and summarizes perceived barriers to improving the nutritional quality of competitive food options.

No Free Lunch? Current Challenges Facing The National School Lunch And School Breakfast Programs, Eileen Salinsky

National Health Policy Forum

This background paper describes important characteristics of the National School Lunch Program and the School Breakfast Program, reviews U.S. Department of Agriculture rules regarding the nutritional content of school meals, and examines compliance with current nutrition standards. It also considers the dietary status and obesity risk of meal program participants, discusses proposed improvements to nutritional standards and meal requirements, and highlights key legislative issues.

Examining The Association Of Fruit And Vegetable Intake And Breast And Prostate Cancer Screening, Mark Yu

Theses and Dissertations

Breast and prostate cancer incidence and mortality have been steadily decreasing. Reasons for these reductions may be related to increased rates of cancer screening and other factors such as improvements in diet, including consumption of fruits and vegetables. We wanted to determine if individuals who get screened for breast and prostate cancer are more or less likely to consume adequate servings of fruit and vegetables. A cross-sectional study using the BRFSS survey was conducted. Individuals included in this study (n=26,222), were asked about their breast or prostate cancer screening history. They were also asked about their servings per day of …

The Association Between Lead Exposure And Respiratory Health In Children, Colleen Coleman

Theses and Dissertations

Purpose: The substantial impact of indoor air quality and environmental hazards in the home on one’s health has long been recognized in the field of public health. This cross-sectional study investigates the risk between home based hazards, specifically lead, and respiratory health in children. The objective of this study is to examine the extent to which children testing positive for blood lead exposure are at an increased risk for having poor respiratory health. Methods: A nationally representative sample of 977 children ages 1- 6 years was obtained from the 2005-2006 National Health and Nutrition Examination Survey (NHANES). Information from the …

Strategies For Recruiting Hispanic Women Into A Prospective Cohort Study Of Modifiable Risk Factors For Gestational Diabetes Mellitus, Lisa Chasan-Taber, Renee T. Fortner, Valerie Hastings, Glenn Markenson

Lisa Chasan-Taber

Background The purpose of this article was to describe effective strategies for recruitment of Hispanic women into a prospective cohort study of modifiable risk factors for gestational diabetes mellitus (GDM). Although Hispanic women have two to four times the risk of developing GDM compared with non-Hispanic white women, few GDM prevention studies have included Hispanic women. Methods The study was conducted in the ambulatory obstetrical practices of Baystate Medical Center located in a socioeconomically and ethnically diverse city in Massachusetts. The study employed a range of strategies to recruit Hispanic women based on a review of the literature as well …

Community Voice: Taking It To The People, Guidelines For Conducting A Process Evaluation, Tiffany Mcghee

Theses and Dissertations

Background The Community Voice program is designed for African-Americans and explores key factors that can contribute to African-American infant mortality. This program was implemented in Henrico County based on Virginia Health Statistics that the White infant mortality rate average during the years of 2001-2005 was 5.3 deaths per 1,000 live births and in the same time period the infant mortality rate for African-Americans was 13.7 deaths per 1,000 live births. At the time of implementation of the program, no plans to evaluate the program had been made. Objective This evaluation was designed to develop guidelines regarding the evaluation process of …

Association Between Preconception Multivitamin Use And The Risk Of Preeclampsia/High Blood Pressure In Pregnant Women, Krisandra Allen

Theses and Dissertations

Gestational Hypertension and Preeclampsia are significant causes of morbidity and mortality among pregnant women and neonates. This study examined the relationship between multivitamin use and incidence of reported high blood pressure or preeclampsia using data from the 2007 Oregon State Pregnancy Risk Assessment Monitoring System (PRAMS). Overall there were n=1894 women included in the study. Women were asked two to four months after delivery to report their multivitamin or prenatal vitamin usage in the month prior to conception and were categorized as daily users, or less than daily users. The unadjusted prevalence of high blood pressure or preeclampsia was 13.4% …

Developing A Comprehensive Youth Obesity Initiative For The State Of Virginia, Jennifer Thompson

Theses and Dissertations

The 2009 Virginia General Assembly Session unanimously voted to change the legislation governing the Virginia Tobacco Settlement Foundation to create the Virginia Foundation for Healthy Youth (VFHY) and incorporate childhood overweight and obesity prevention and reduction in its mission. In order to successfully meet the requirements of this legislation, VFHY needed assistance developing a strategic plan for the obesity initiative and a knowledge base to draw from. A comprehensive assessment of the status of Virginia’s childhood obesity problem was conducted, including the prevalence of the illness, the barriers existing to and the benefits to obesity prevention programs, the need for …

The 2009 H1n1 Influenza A “Swine Flu” Virus Presentation In Virginia 2009, Tammie Smith

Theses and Dissertations

Objective: 2009 H1N1 influenza was first detected in the Northern Hemisphere in April 2009. National data have suggested that the novel influenza virus disproportionately causes severe illness in children and young adults, a somewhat different presentation from traditional seasonal flu which normally strikes hardest in the very young and older adults. This may or may not be the case in Virginia, which, if it is different, may suggest a need to alter flu prevention messages and vaccine policy as the outbreak continues through the fall 2009-10 influenza season. This report examined the early presentation of the new influenza virus in …

Use Of Oral Chemotherapeutic Medications In Non-Traditional Ambulatory Settings, Sameer Arora

Theses and Dissertations

Background: Cancer is the second leading cause of death in economically developed countries. The use and availability of oral treatment for cancer has increased dramatically in the past 10 years. Few studies have described the use of oral chemotherapy in non-traditional ambulatory settings by health care professionals across different specialties. Objective: The purpose of this study is to describe the usage of oral chemotherapeutic medications in ambulatory settings. Methods: Cross sectional study of 2007 NAMCS Survey analysis involving 21,761 subjects aged 18 years and above with cancer who participated in the 2007 National Ambulatory Medical Survey (NAMCS). Main Outcome Measure: …

Client Perceptions And Working Alliance: Predictors Of Outcome?, Theresa Do

Theses and Dissertations

BACKGROUND In recent years, there has been a push to measure and monitor the quality of health care and the delivery of effective services. Substance use disorders are debilitating and in order to better understand this facet of substance abuse, it is important for organizations and providers to assess the quality of services, client satisfaction, and the relationships that exist between clients and treatment providers. PURPOSE The purpose of the study was to (1) assess the extent of the relationship between measures of client perceptions of satisfaction and treatment outcomes and (2) to assess the relationship between measures of therapeutic …

Intimate Partner Violence And Pregnancy: Data From The Chicago Women's Health Risk Study, Anne Zehner

Theses and Dissertations

Background: Intimate partner violence (IPV) during pregnancy increases the risks of adverse outcomes for both mothers and their unborn children, including maternal and fetal death. However, more research is needed to determine if IPV increases in frequency or severity during pregnancy and to determine what the risk factors are for IPV during pregnancy. Objectives: To use data from the Chicago Women’s Health Risk Study to determine (1) if abuse is more prevalent during the pregnancy period, 2) if abuse during the pregnancy period increases in frequency or severity, 3) if pregnant women who are abused are at increased risk for …

Association Between Obesity And Depression And Anxiety Disorders: Results From The 2008 National Health Interview Survey, Monica Gaidhane

Theses and Dissertations

Introduction: Obesity is one of the most important medical problems in the U.S. and is considered to be an epidemic with over 30% of the population being obese. Obesity is associated with increased risk of hypertension, diabetes, cardiovascular diseases, certain cancers and a shorter life expectancy. Recent studies have shown that higher BMI levels are also significantly associated with several lifetime mental disorders such as major depressive disorder, anxiety disorders as well as panic attacks and panic disorders. Purpose: The purpose of this study was to quantify the extent to which higher BMI increased the likelihood of Depression, Anxiety Disorder …

The Role Of Ombudsmen In Assuring Quality For Residents Of Long-Term Care Facilities: Straining To Make Ends Meet, Carol O'Shaughnessy

National Health Policy Forum

Assuring quality of care for residents in long-term care facilities has been a serious and continuing concern of policymakers for decades. The Older Americans Act’s long-term care ombudsman program is a consumer advocacy model intended to improve quality of care by helping the 2.5 million residents of almost 67,000 nursing and other residential care facilities resolve complaints about their care and protect their rights. Despite broad recognition of its value in assisting residents and its efforts to complement federal and state oversight of long-term care facilities, some observers are concerned about the program’s ability to meet its legislative mandates. Limited …

Impact Of Parent’S Hiv Status On Their Uninfected Child—A Comparative Analysis Of The Child’S Healthcare Utilization, Access And Health Outcomes, Arijit Ganguli

Theses and Dissertations (ETD)

With the advent of effective antiretroviral medication and increased expectancy of life span among HIV-infected individuals has lead to an increase in the at-risk population of uninfected children living with their HIV-infected parent(s). The purpose of this study was to investigate the impact of parent’s HIV status on their child’s access to healthcare resources, healthcare utilization and health outcomes.

This was a cross-sectional study in which the information on the children of HIV seropositive parent(s) was collected through a face-to-face interview of the HIV-infected parents having children currently residing with them. The comparative group comprising of children of HIV seronegative …

Public Policy On Alcohol In The United Kingdom: Towards A Safety Net For The Alcohol-Dependent, Laura Williamson

Dr Laura Williamson

Public policy on alcohol in the United Kingdom fails to support, and may even undermine, the wellbeing of those with the worst alcohol misuse problems, the alcohol-dependent. This is partly because it evades the thorny issue of impaired control that characterises dependence. In addition, until recently, all United Kingdom alcohol policy focused on improving individualised treatment for the dependent, rather than attending to the wider social and environmental factors that influence the condition. The efforts of policy to normalise "sensible" drinking, while stigmatising drunkenness, also risk exacerbating the social vulnerability of the alcohol-dependent. The article examines these issues and concludes …

Income Inequality And Homicide Rates In Sao Paulo, Brazil., Paulo A. Lotufo, Isabela M. Bensenor

Paulo A Lotufo

Description of the epidemic of homicide among poor people in Brazil. In Sao Paulo, Brazil, homicides to men aged 15-44 years increased with an annual percentage change (APC) of 4.7% from 1996 to 2001, and then decreased from 2001 to 2007 with an APC of -14.6%. Analyzing the intra-urban distribution according to family income, the increase in the homicide rate was restricted to men living in the poorest neighbourhoods. In contrast, the decline in homicide rates was observed to men living in all districts. The reasons for this 'up and down' trend are not clear.