Medicine and Health Sciences Commons^™

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 …

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.

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 …

E-Therapy As A Means For Addressing Barriers To Substance Use Disorder Treatment For Persons Who Are Deaf, Dennis Moore, Debra Guthmann, Nikki Lynn Rogers, Susan Fraker, Jared A. Embree

Population and Public Health Sciences Faculty Publications

Persons who are deaf face a number of challenges with regard to vulnerability for substance use disorders. Moreover, accessible treatment for this condition can be difficult to establish and maintain. The Deaf community may be one of the most disenfranchised groups in America in regard to appropriate access to substance use disorder (SUD) prevention and treatment services. This article reviews
findings related to substance use disorder and treatment for this condition among persons who are deaf. It also reviews a promising approach for addressing treatment needs via e-therapy, and it highlights the challenges and concerns regarding e-therapy for this population. …

Evening Primrose Oil, Bryan Bayles, Richard Usatine

Public Health

Evening primrose oil (Oenothera biennis) is a commonly used alternative therapy and a rich source of omega-6 essential fatty acids. It is best known for its use in the treatment of systemic diseases marked by chronic inflammation, such as atopic dermatitis and rheumatoid arthritis. It is often used for several women’s health conditions, including breast pain (mastalgia), menopausal and premenstrual symptoms, cervical ripening, and labor induction or augmentation. However, there is insufficient evidence to make a reliable assessment of its effectiveness for most clinical indications. The current evidence suggests that oral evening primrose oil does not provide clinically significant improvement …

Analogical Reasoning: A Process For Fostering Learning Transfer From The Classroom To Clinical Practice, Timothy E. Speicher, Marijke Kehrhahn

All PTHMS Faculty Publications

In 2001, the Institute of Medicine (IOM), a committee of physicians and health policy experts charged to improve the health of the United States by the National Academy of Science, identified a gap in the area of education of health care practitioners as one of the reasons for medical error. However, one of the most common instructional methods in medical education to promote transfer and problem solving is examination of a single patient case (Shine, 2002), a pedagogical practice shown to be ineffective (Gentner, Loewenstein & Thompson, 2003; Norman et al., 2007). Therefore, adult learners in health care may be …

A Descriptive Review Of Health Care Providers Perspective On Stigmatization Of Hiv/Aids Patients: United States And South Africa, Ana I. Fonseca

Honors Projects

Compares the issue of social stigma affecting people with HIV/AIDS in the United State and in South Africa. Posits that stigma is more of an interpersonal problem in the United States, while it is a huge barrier to access to care in South Africa. Data was compiled through personal conversations and experiences in South Africa during June 2009, interviews with health professional and community members in Rhode Island during the fall of 2009, and reading of the professional literature.

Association Of Various Reproductive Rights, Domestic Violence And Marital Rape With Depression Among Pakistani Women, Faridah A. Ali, Syed M. Israr, Badar S. Ali, Naveed Z. Janjua

Community Health Sciences

Background: Depression among women is common in developing countries. Gender inequality can contribute to women's risk for depression. Lack of reproductive and sexual rights is an important marker of gender inequality and women do not have the freedom to express their reproductive and sexual needs in many parts of the world. Therefore we designed this study to determine the association of depression with lack of various reproductive rights and domestic violence among married women in Karachi, Pakistan. Methods: A case-control study with 152 cases and 152 controls, which included women 15-48 years, recruited from two teaching hospitals from 1(st) June …

Maternal Morbidity In The First Year After Childbirth In Mombasa Kenya; A Needs Assessment, Matthew F. Chersich, Nicole Kley, Stanley Luchters, Carol Njeru, Elodie Yard, Mary J. Othigo, Marleen Temmerman

Population Health, East Africa

Background: In sub-Saharan Africa, few services specifically address the needs of women in the first year after childbirth. By assessing the health status of women in this period, key interventions to improve maternal health could be identified. There is an underutilised opportunity to include these interventions within the package of services provided for woman-child pairs attending child-health clinics.

Methods: This needs assessment entailed a cross-sectional survey with 500 women attending a child-health clinic at the provincial hospital in Mombasa, Kenya. A structured questionnaire, clinical examination, and collection of blood, urine, cervical swabs and Pap smear were done. Women's health care …

Direct Healthcare Costs Of Hip, Vertebral, And Non-Hip, Non-Vertebral Fractures., Nianwen Shi, Kathleen Foley, Gregory Lenhart, Enkhe Badamgarav

College of Population Health Faculty Papers

Limited data exist regarding the cost of non-hip, non-vertebral (NHNV) fractures. Although NHNV fractures may be less expensive than hip and vertebral fractures, they have a higher incidence rate. The objective of this study was to quantify first-year healthcare costs of hip, vertebral, and NHNV fractures. This was a claims-based retrospective analysis using a case-control design among patients with commercial insurance and Medicare employer-based supplemental coverage. Patients were > or =50 years old with a closed hip, vertebral, or NHNV fracture between 7/1/2001 and 12/31/2004, and continuous enrollment 6 months prior to and 12 months after the index fracture. Adjusted mean …

The Lyme Disease Spirochete, Borrelia Burgdorferi, In Tick Species Collected From Raccoons (Procyon Lotor) And Opossums (Didelphis Virginiana) Trapped In The Warren And Barren Counties Of South Central Kentucky, Kristina Tackett

Masters Theses & Specialist Projects

The incidence of tick-borne zoonoses such as Ehrlichiosis, Rocky Mountain Spotted Fever, and Lyme disease has steadily increased in the southeastern United States in recent years. According to the Centers for Disease Control and Prevention (CDC), the southeastern states accounted for 1,200 of the 27,000 total cases of Lyme disease reported in the U.S. in 2007. Although Ixodes scapularis is the most commonly recognized vector for the Lyme disease spirochete Borrelia burgdorferi, Dermacentor variabilis (a common vector for Rocky Mountain Spotted Fever) also has been shown to be a viable host for this pathogen. The purpose of the present …

Prospective Associations Between Objective Measures Of Physical Activity And Fat Mass In 12-14 Year Old Children: The Avon Longitudinal Study Of Parents And Children (Alspac), Chris J. Riddoch, Sam D. Leary, Andy R. Ness, Steven N. Blair, Kevin Deere, Calum Mattocks, Alex Griffiths, George Davey Smith, Kate Tilling

Faculty Publications

Objective: To investigate associations between physical activity at age 12 and subsequent adiposity at age 14.

Design: Prospective birth cohort study with data collected between 2003 and 2007.

Setting: Original recruitment in 1991-2 of 14,541 pregnant women living in the former County of Avon (United Kingdom).

Participants: At age 12, 11,952 children were invited to attend the research clinic. Of these, 7159 attended, and 4150 (1964 boys, 2186 girls) provided sufficient data on exposure, outcome, and confounding variables.

Main outcome measure: Fat mass at age 14, measured by dual emission x ray absorptiometry, associated with physical activity at age 12, …

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 …

Survival Analysis With Error-Prone Time-Varying Covariates: A Risk Set Calibration Approach, Xiaomei Liao, David M. Zucker, Yi Li, Donna Spiegelman

Harvard University Biostatistics Working Paper Series

No abstract provided.

Validation Of A Commercial Geographical Information Systems Database Of Walking And Bicycling Destinations, Heather A. Whitcomb, Ellen K. Cromley, Kosuke Tamura, Steven J. Melly, Sayali Kale, Francine Laden, Peter James, Robin Puett, Eran Ben-Joseph, Philip J. Troped

GIS Day

Background: Recent interdisciplinary studies in public health, transportation, and urban planning have shown that stores and other destinations such as banks, post offices, and physical activity facilities within close proximity to residences are positively related to recreational and transportation physical activity. The built environment has been measured several different ways, including conducting field audits and by surveying individuals’ perceptions of their neighborhood. Increasingly researchers are also using geographic information systems (GIS) software and commercially available data sources to create objective measures of the built environment. The advantages of commercial data are that they are relatively easy to access and are …

Environmental Health Service Learning And Water Quality In Gales Point, Belize, Ritchie D. Taylor, Shabbar Ranapurwala, Matthew Hill

Impact Belize

Belize is a country in Central America, formerly British Honduras, located south of Mexico and east of Guatemala on the Yucatan Peninsula. As part of the WKU International Health and Human Service Learning Program, an assessment of the local water supply in Gales Point, Belize was conducted. Gales Point is a small rural village located on the Caribbean Sea coast of Belize. Belize is a developing country thus access to safe drinking water can be problematic, as was observed on the local scale. The lack of technical, managerial and financial capacity coupled with the rural location of the village, create …

A Comparison Of Frequentist And Bayesian Approaches To The Estimation Of Long-Stay Per-Diems, Jeff Hatcher, Jason M. Sutherland

Dartmouth Scholarship

Within many diagnosis related group (DRG) systems, there is recognition that a single cost weight per DRG is not suitable, and that cost weights should take into account extremely lengthy hospital stays. Long lengths of stay are considered to be due to factors largely beyond the control of the hospital, and a single weight per DRG would potentially place hospitals under financial risk.

Within Canada's acute-care, inpatient grouping methodology - Case Mix Groups (CMG+) - long-stay episodes represent approximately 4.5% of all discharges. Within a CMG (analogous to DRG), the cost weight assigned to long-stay cases consists of the typical …

Lot Quality Assurance Sampling (Lqas) And The Mozambique Malaria Indicator Surveys, Caitlin Biedron, Marcello Pagano, Bethany L. Hedt, Albert Kilian, Amy Ratcliffe, Samuel Mabunda, Joseph J. Valadez

Harvard University Biostatistics Working Paper Series

No abstract provided.

Victims Of Violence Among Indigenous Mothers Living With Dependent Children, Kyllie Cripps, Catherine M. Bennett, Lyle C. Gurrin, David M. Studdert

Aboriginal Policy Research Consortium International (APRCi)

Objective: Toidentifyindividualandhouseholdfactorsassociatedwithviolenceamong Australian Indigenous women with dependent children. Design and participants: Univariate and multivariable analysis of data from the 2002 National Aboriginal and Torres Strait Islander Social Survey, stratified by area.

Main outcome measure: Self-reported experience of being a victim of violence in the previous year. Results: OneinfourIndigenouswomenlivingwithdependentchildrenyoungerthan 15 years reported being victims of violence in the previous year; this corresponds to an estimated 24 221 Indigenous mothers (95% CI, 21 507–26 935) nationwide. Violence was more prevalent in regional areas and cities than remote areas. In remote areas, mothers who had been removed from their natural families during childhood …

Tailoring Messages To Individual Differences In Monitoring- Blunting Styles To Increase Fruit And Vegetable Intake, Pamela Williams-Piehota, Amy E. Latimer, Nicole A. Katulak, Ashley Cox, Stephanie A. Navarro Silvera, Linda Mowad, Peter Salovey

Department of Public Health Scholarship and Creative Works

Objective

To examine whether messages matched to individuals' monitoring-blunting coping styles (MBCS) are more effective in increasing fruit and vegetable intake than mismatched messages. MBCS refers to the tendency to either attend to and amplify, or distract oneself from and minimize threatening information.

Design/Setting

Randomly assigned messages were tailored to resonate with either monitors or blunters and delivered at baseline, 1 week, 2 months, and 3 months later. Surveys were conducted at baseline and 2 and 4 months later.

Participants

531 callers to a cancer information hotline who did not meet the 5 A Day guideline.

Intervention

A brief telephone-delivered …

State Medicaid Coverage Of Perinatal Services: Summary Of State Survey Findings, Usha Ranji, Alina Salganicoff, Alexandra M. Stewart, Marisa A Cox, Lauren Doamekpor

Health Policy and Management Faculty Publications

No abstract provided.

Helping Immigrant And Refugee Students Succeed: It's Not Just What Happens In The Classroom, Eileen Kugler, Olga Acosta Price

Center for Health and Health Care in Schools

No abstract provided.

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 …

Analysis Of Subgroup Data In Clinical Trials, Kao-Tai Tsai, Karl E. Peace

Biostatistics Faculty Presentations

This conference abstract was published in the Proceedings of the Sixteenth Annual Biopharmaceutical Applied Statistics Symposium.

Selected Comparison Of Global Health Organizations, Steven C. Mccullar

Scholarship in Medicine - All Papers

Due to a potential, worldwide adverse impact on health, transnational dependencies, and the need for effective response, global cooperation is imperative (Buchanan & Decamp, 2006). There are more than 100 global health agencies, including the World Health Organization. As the number of organizations increases, each with their own agendas, so does the concern for lack of coherence and collaboration among organizations in the effort of disease eradication and development of health systems (Beaglehole & Bonita, 2008). The focus of this study is on comparing the effectiveness of selected global health organizations in efforts to detect a need to either establish …

Health Insurance Patterns Among Latinos In Comparative Perspective 2004 — 2007, Rachael Varra

Center for Latin American, Caribbean, and Latino Studies

Introduction: This report examines the rates at which the four major racial/ethnic groups in the United States — Latinos, non-Hispanic Whites, non-Hispanic Blacks and Asians — lacked health insurance from 2004- 2006 in the U.S. overall and in the ten states with the largest Latino populations: California, Texas, Florida, New York, Illinois, Arizona, New Jersey, Colorado, New Mexico and Georgia.

Methods: The “lack of insurance data” in this report were derived from Health Statistics Data obtained by the Center for Disease Control from 2004 to 2006. In September 2008 these data became available by race, age and ethnicity/race on a …

A National Physical Activity Plan For The United States, Russell R. Pate

Faculty Publications

No abstract provided.

A Review Of The National Physical Activity Plans Of Six Countries, Daniel B. Bornstein, Russell R. Pate, Michael Pratt

Faculty Publications

Background: Architects of the United States national physical activity plan can benefit from a thorough understanding of national physical activity plans from other nations. The purpose of this paper was to search for and analyze comprehensive national physical activity plan documents that can best inform the development of the U.S. plan. Methods: Electronic databases were searched for national physical activity plan documents, yielding 252 documents from 56 countries. After eliminating documents that were not written in English, did not address physical activity primarily, and did not meet our definition of a national physical activity plan, we were left with physical …

A Cost Analysis Of A Physical Activity Intervention For Older Adults, Erik J. Groessl, Robert M. Kaplan, Steven N. Blair, W. Jack Rejeski, Jeffrey A. Katula, Abby C. King, Roger A. Fielding, Nancy W. Glynn, Marco Pahor

Faculty Publications

We examined the costs of a physical activity (PA) and an educational comparison intervention. 424 older adults at risk for mobility disability were randomly assigned to either condition. The PA program consisted of center-based exercise sessions 3x weekly for 8 weeks, 2x weekly for weeks 9 to 24 and weekly behavioral counseling for 10 weeks. Optional sessions were offered during maintenance weeks (25-52). The comparison intervention consisted of weekly education meetings for 24 weeks, and then monthly for 6 months. Cost analyses were conducted from the "payer's" perspective, with a 1-year time horizon. Intervention costs were estimated by tracking personnel …