Medicine and Health Sciences Commons^™

Adherence To Accelerometer Protocols Among Women From Economically Disadvantaged Neighborhoods, Patricia A. Sharpe, Sarah Wilcox, Laura J. Rooney, Donna Strong, Rosie Hopkins-Campbell, Jean Butel, Barbara E. Ainsworth, Deborah Parra-Medina

Faculty Publications

Background: Objective measurement of physical activity with accelerometers is a challenging task in community-based intervention research. Challenges include distribution of and orientation to monitors, nonwear, incorrect placement, and loss of equipment. Data collection among participants from disadvantaged populations may be further hindered by factors such as transportation challenges, competing responsibilities, and cultural considerations. Methods: Research staff distributed accelerometers and provided an orientation that was tailored to the population group. General adherence strategies such as follow-up calls, daily diaries, verbal and written instructions, and incentives were accompanied by population-specific strategies such as assisting with transportation, reducing obstacles to wearing the accelerometer, …

Early Diagnosis Of Pulmonary Embolism: Review And Cost-Effectiveness Analysis, Efstathios Polychronopoulos

Health Services Research Dissertations

Pulmonary embolism (PE) is a serious, life-threatening thrombotic disease, which results in considerable health and economic consequences each year for the United States. These consequences include a toll of 83,000 deaths and an economic impact between 1,5 and 5 billion. Approaches to strategy selection by physicians and other health-care specialists are based mainly upon cost, technology availability, and cultural tolerance regarding radiation exposure. The purpose of this study was to determine the most cost-effective diagnostic strategy with patients suspected of PE among several strategies currently used by examining their detection failure rates. This objective was met by (a) assessing parameter …

Using Modeling And Simulation To Improve Oral Health Services Delivery In Hampton Roads, Virginia, Mohammad J. Alzahrani

Health Services Research Dissertations

The purpose of this study is to examine the system performance in delivering oral health services in a public health district based on the Conceptual Framework to Measure Performance of the Public Health System (PHS). Using modeling and simulation, a predictive model based on the conceptual framework dimensions: mission, structural capacity, processes, and outcomes was developed to predict the performance of public health district in delivering oral health services.

This is a retrospective longitudinal study. The main objective of this study is to use a modeling and simulation approach to predict the performance of public health district dental clinic in …

Prenatal Smoking And Drinking Implications For Subsequent Child Maltreatment, Nicholas Alexander Adams

Sociology & Criminal Justice Theses & Dissertations

Prenatal smoking and drinking are very serious problems that have continued to plague society. They have multiple negative effects on the child both physically and cognitively. This study explored the relationship between prenatal abuse, i.e., prenatal smoking and prenatal drinking, and subsequent child physical abuse and official reports of child maltreatment. It was hypothesized that mothers who smoked or drank prenatally would be more likely to physically abuse their child postnatally and have official reports of child maltreatment. The sample included women participating in Wave III of the National Longitudinal Survey of Adolescent Health. N = 620 women who answered …

Real-World Comparison Of Two Molecular Methods For Detection Of Respiratory Viruses, Syed Asad Ali, James E. Gern, Tina V. Hartert, Kathryn M. Edwards, Marie R. Griffin, E Kathryn Mille, Tebeb Gebretsadik, Tressa Pappas, Wai Ming Lee, John V. Williams

Department of Paediatrics and Child Health

Background: Molecular polymerase chain reaction (PCR) based assays are increasingly used to diagnose viral respiratory infections and conduct epidemiology studies. Molecular assays have generally been evaluated by comparing them to conventional direct fluorescent antibody (DFA) or viral culture techniques, with few published direct comparisons between molecular methods or between institutions. We sought to perform a real-world comparison of two molecular respiratory viral diagnostic methods between two experienced respiratory virus research laboratories.
Methods: We tested nasal and throat swab specimens obtained from 225 infants with respiratory illness for 11 common respiratory viruses using both a multiplex assay (Respiratory MultiCode-PLx Assay [RMA]) …

Mentoring: Combating Vulnerabilities Of Homeless Children, Julia Lane Mitchell

Florida Public Health Review

Homeless children are at risk for numerous health maintenance, academic performance, job preparedness, and emotional well- being issues. The effects of poverty multiply with time, posing greater risks the longer children are entrenched in homelessness. Expansive, holistic programming can address the special needs ofhomeless children. One-on-one mentoring offers a viable strategy to prevent morbidity emanating from homelessness by providing personal attention, encouragement, and affirmation to these vulnerable children, who with time, may develop a more defined self-identity that results in motivation and success.

Pedestrian Safety In Hillsborough County, Florida: A Proposed Policy Approach, Alyssa B. Mayer

Florida Public Health Review

Despite the resurgence of interest in policy implementation, communities, community-based coalitions, and other community- based groups have had mixed success in effecting state and local health policy changes. However, policy changes have been deemed more effective than individual behavior change programs. The creation of a policy advocacy framework may simplify the policy analysis process and arm community groups with practical tools to select, modify, and promote effective public health policies. This paper applies a hypothetical framework for equipping community groups to apply an evidence base to focus policy advocacy efforts systematically.

Perbandingan Rapid Diagnostic Test Dan Pemeriksaan Mikroskopik Pada Diagnosis Malaria, Lombok Siahaan

Kesmas

Penelitian ini dilakukan untuk membandingkan penggunaan Rapid diagnostic test dengan pemeriksaan mikroskopik (apusan darah) dalam menegakkan diagnosis malaria. Penelitian uji diagnostik ini dilakukan di Kabupaten Nias Selatan dan Kotamadya Sabang, Sumatera Utara. Apusan darah diwarnai dengan larutan Giemsa 10% dan dibaca oleh pemeriksa yang sudah terlatih. Rapid diagnostic test dilakukan dengan menggunakan parascreen. Uji diagnostik rapid diagnostic test secara umum diperoleh hasil yaitu sensitivitas 63,8%; spesifisitas 100%; Positive Predictive Value (PPV) 100%; dan negative predictive value (NPV) 93,5%. Kepadatan parasit pada rapid diagnostic test (+) dan mikroskopik (+) adalah 1.483 ± 583 parasit/μl. Sementara, kepadatan parasit pada pemeriksaan rapid diagnostic …

Pengembangan Instrumen Sumber Daya Rumah Sakit Dengan Pendekatan Systematic Review Terintegrasi Manajemen Bencana Dan Pandemi Influenza, Agus Suswandono, Wiku Adisasmito, Dewi Nur Aisyah

Kesmas

Pandemi influenza yang terjadi sejak tahun 2009 dan berbagai kejadian bencana karena kondisi geografis Indonesia membutuhkan integrasi komponen sumber daya rumah sakit terintegrasi untuk mengatasi bencana. Penelitian ini bertujuan untuk mengembangkan instrumen sumber daya rumah sakit menggunakan data Riset Fasilitas Kesehatan (Risfaskes) 2011 yang memuat komponen terkait manajemen bencana dan pandemi influenza. Instrumen ini dikembangkan dengan prinsip Client Oriented Research Activity, studi literatur serta diskusi pakar dan tim ahli di tingkat lokal dan nasional. Instrumen ini kemudian diintegrasikan ke dalam manajemen bencana dan pandemi influenza dengan pendekatan systematic review. Dalam integrasi ini, instrumen asli mengalami beberapa modifikasi menghasilkan 49 halaman …

Sistem Pembiayaan Dan Skema Kelembagaan Jaminan Kesehatan Daerah Kota Yogyakarta, Sunarto Sunarto

Kesmas

Negara menyelenggarakan Sistem Jaminan Sosial Nasional sebagai sistem penyelenggara program negara dan pemerintah untuk memberikan perlindungan sosial agar setiap penduduk dapat memenuhi kebutuhan dasar hidup layak. Jaminan sosial kesehatan bertujuan memberi kepastian perlindungan kesejahteraan sosial kesehatan agar setiap penduduk dapat memenuhi kebutuhan hidupnya menuju terwujudnya kesejahteraan sosial bagi seluruh masyarakat Indonesia. Penelitian ini bertujuan untuk mengidentifikasi masalah, hambatan, dan tantangan yang berkaitan dengan sistem pembiayaan dan skema kelembagaan Jaminan Kesehatan Daerah (Jamkesda) yang sudah dikembangkan selama ini. Penelitian ini merupakan desain studi kasus menggunakan metode kualitatif dengan pendekatan analisis kebijakan retrospektif. Analisis kebijakan ini berorientasi pada aplikasi dengan melakukan identifikasi …

Faktor Risiko Kanker Serviks Di Rumah Sakit Umum Pemerintah Dr. Wahidin Sudirohusodo Makassar, Sulawesi Selatan, Sri Syatriani

Kesmas

Kanker serviks adalah tumor ganas terbanyak pada perempuan di seluruh dunia termasuk Indonesia. Jumlah penderita kanker serviks di Rumah Sakit Umum Pemerintah Dr. Wahidin Sudirohusodo pada tahun 2007 sebanyak 231 kasus, menurun menjadi 220 kasus tahun 2008 dan menurun sebanyak 167 kasus pada tahun 2009. Tujuan penelitian ini adalah untuk melihat besar risiko kejadian kanker serviks terhadap penggunaan pembalut, penggunaan sabun, status ekonomi, dan pasangan pria yang tidak disirkumsisi. Jenis penelitian adalah penelitian observasional analitik dengan desain kasus kontrol. Sampel adalah pasien yang berkunjung ke bagian ginekologi yang diambil secara accidental sampling sebanyak 213 orang. Pengumpulan data dilakukan dengan wawancara …

Studi Kematian Ibu Dan Kematian Bayi Di Provinsi Sumatera Barat: Faktor Determinan Dan Masalahnya, Ulvi Mariati, Z Agus, D Sulin, Masrul Masrul, Z Amri, F Arasy, Muslim Muslim, H Hanum, Mohanis Mohanis, F Arma

Kesmas

Salah satu tujuan yang hendak dicapai oleh World Health Organization pada tahun 2000 adalah health for all by year 2000. Beberapa indikator digunakan untuk mengukur pencapaian tersebut, diantaranya angka kematian bayi (AKB) dan angka kematian ibu (AKI). Dinas Kesehatan Sumatera Barat telah berhasil menurunkan AKB dan AKI selama 5 tahun terakhir, akan tetapi angka-angka tersebut tidak menggambarkan angka yang sebenarnya karena hanya diperoleh berdasarkan prediksi perhitungan statistik kependudukan. Angka tersebut juga tidak dapat memperlihatkan disparitas antarwilayah dan kelompok sosial ekonomi di Sumatera Barat. Penelitian ini dilakukan untuk mendapatkan AKB dan AKI yang tepat serta mengetahui faktor determinan dan permasalahannya di …

Perilaku Masyarakat Dan Masalah Pelayanan Kesehatan Ibu Dan Anak Di Provinsi Riau, Zahtamal Zahtamal, Tuti Restuastuti, Fifia Chandra

Kesmas

Status kesehatan masyarakat yang rendah di Indonesia ditandai oleh angka kematian ibu dan angka kematian bayi yang tinggi sebagaimana terlihat pada indikator pelayanan KIA yang belum ideal. Penelitian ini bertujuan untuk mengetahui situasi pelayanan KIA dan mengkaji faktor perilaku sebagai penyebab masalah KIA di Provinsi Riau. Riset ini menggunakan rancangan studi deskriptif dengan data kuantitatif dan kualitatif mengenai indikator keberhasilan pelayanan KIA. Hasil penelitian ini menunjukkan bahwa indikator-indikator kinerja pelayanan KIA ada yang tercapai, ada pula yang tidak. Sementara itu, perilaku masyarakat terhadap pengetahuan tentang kehamilan ibu tergolong baik, sikap netral, dan praktek baik. Seseorang yang berpengaruh besar terhadap pengambilan …

Formalizing Education About Public Health Leadership During Professional Preparation, Robert J. Mcdermott

Florida Public Health Review

This year is the fourth year that the Florida Public Health Review (FPHR) has published student essays that attempt to illustrate how the application of specific leadership paradigms might, in theory, be responsive in addressing challenging and historically unresponsive problems in public health. Other public health students, faculty, and practitioners from throughout Florida are invited to contribute ideas that foster leadership skills and the development ofdynamic leaders.

Addressing Colon Cancer Screening Disparities Among Overweight And Obese Women, Sara M. Kennedy

Florida Public Health Review

Colon cancer is the third most common cancer in women and 60% ofdeaths from colon cancer could be prevented ifpersons 50 and older were screened regularly. Whereas physician recommendation has been identified as critical to increasing colon cancer screening, this factor may be insufficient for increasing colon cancer screening adherence among overweight and obese women. Despite having more physician visits, this population tends to receive fewer preventative services. Women who delay routine cancer screening have the highest rates ofdieting. An intervention utilizing the recommendation for screening from a weight loss advisor at an organization like may prove to be effective. …

Failures In The Veterans Administration And New Strategies For Leadership, Jarrett Nathaniel Brunny

Florida Public Health Review

World news organizations have criticized the United States Department of Veterans Affairs for endangering patient safety through negligence. Several VA medical centers - including prominent centers operating in Florida - failed to sterilize endoscopy and colonoscopy equipment. Through improper sterilization, a pathway for infection is created resulting in potential disease exposures to patients. In response, the Department of Veterans Affairs Office of Inspector General investigated the reports and found that facilities did not adhere to protocol concerning reusable medical equipment (RME) problems during the practice ofperforming endoscopies and colonoscopies. The Office ofInspector General noted that the incidents reflected flaws in …

Childhood Obesity In America: The Leadership Role Of Schools In Prevention, Daphnee A. Guillaume

Florida Public Health Review

Childhood obesity is a major public health concern; children are being diagnosed with adult type diseases and health conditions, such as type 2 diabetes, hypertension, cardiovascular disease, etc. Still, over the past decade there have been many attempts by schools, and even the federal government to address the situation, yet there hasn’t been an effective model that has been able to do so. The schools in this country are not consistent when it comes to addressing the issue of childhood obesity. Out of the 50 states in this country, only 19 have nutritional standards for school meals, though all 50 …

Using Leadership To Address The Problem Of Obesity In The Workplace, Amber Colston

Florida Public Health Review

Obesity is a growing epidemic that affects more and more Americans every year. With the majority ofAmerican adults in the workforce, obesity plays a large part in healthcare costs, absenteeism, and “presenteeism.” Because ofthe large amount oftime adults spend in the workplace, using this setting as an intervention point for healthy lifestyle change could greatly reduce the prevalence of obesity. This paper will review factors that have contributed to the problem of obesity in the workplace, namely the factors at each ofthe five levels ofthe Social Ecology ofHealth Model. Then using leadership frameworks, such as that of Transformational Leadership, this …

Lead The Way Florida! Raising Nutrition Awareness To Lower Obesity, Bethany M. Brunny

Florida Public Health Review

Rising obesity rates increase the potential for many chronic diseases and lower quality of life. Strong leadership in the practice ofnutrition awareness and knowledge needs to be established to reduce obesity in the state ofFlorida. Most Americans do not eat the recommended daily amounts offruits and vegetables, which partially accounts for increased obesity rates. Interventions that raise nutritional knowledge and awareness may increase fruit and vegetable intake and lower fat intake. Having nutritional knowledge is the first step to living a healthy lifestyle with a healthy weight. Changes in policy like requiring restaurants to report calorie and fat contents offood …

A Leadership Solution To Workplace Stress, Monica L. Rousseau

Florida Public Health Review

Sources of stress can be found nearly everywhere: in school, at home, in traffic, and maybe most importantly –in the workplace. Chronic workplace stress, also known as “burnout”, has been linked with both psychological and physiological illnesses. As most Americans spend about halfoftheir waking hours at work, the workplace is an excellent location to evaluate specific risk factors and implement stress reducing programs. Although a number ofsuch programs are currently in practice, the majority ofthem only offer techniques and coping mechanisms to individuals already exhibiting some, or several, ofthe many severe symptoms ofchronic stress. The purpose ofthis paper is to …

Prostate Cancer Screening: Leadership Implications, Dorothy D. Zeviar

Florida Public Health Review

TheepidemiologyofprostatecancerintheAfricanAmericanpopulationiswell-knowntohealthcarepractitioners; prostate cancer disproportionately impacts African American men 2:1 compared to Caucasian men. The Prostate Cancer Foundation hypothesizes that the increased mortality risk may be due to delayed diagnosis, poor work-up, and less complete treatment, indicating inequitable use of the health care system. The National Cancer Institute suggests that availability of health insurance and physician contact may increase screening and thus, reduce cancer mortality. Because health behaviors and health outcomes are impacted at five different levels according to the Social Ecology Model ofhealth – intrapersonal, interpersonal, organizational, community and social/policy levels – this report proposes that a Collaborative Leadership model …

Health Initiatives By Indigenous People In Australia, Stephanie Clark

Aboriginal Policy Research Consortium International (APRCi)

No abstract provided.

Perflurorochemical (Pfc) Exposure In Children: Associations With Impaired Response Inhibition, Brooks B. Gump, Qian Wu, Amy K. Dumas, Kurunthachalam Kannan

Falk College Research Center

Background: Perfluorinated chemicals (PFCs) have been used widely in consumer products since the 1950s and are currently found at detectable levels in the blood of humans and animals across the globe. In stark contrast to this widespread exposure to PFCs, there is relatively little research on potential adverse health effects of exposure to these chemicals.Objectives: We performed this cross-sectional study to determine if specific blood PFC levels are associated with impaired response inhibition in children. Methods: Blood levels of 11 PFCs were measured in children (N = 83) and 6 PFCs: perfluorooctane sulfonate (PFOS), perfluorohexane sulfate (PFHxS), perfluorooctanoic acid (PFOA), …

Media Attention On African Americans With Human Immunodeficiency Virus, Charles S. Beverley Jr., Edith M. Williams, Saundra H. Glover

Faculty Publications

Human immunodeficiency virus (HIV) is a disease that has captured the attention of the media in various ways and to varying degrees. One of the ongoing debates and areas of research in HIV that provide many opportunities for discovery is the disproportionate number of African Americans infected with HIV compared to the amount of attention they receive in the media. This manuscript addresses the question that has preoccupied the minds of many people: Why have African Americans infected with HIV received so little media attention? Analysis of this question suggests that there are many reasons for this lack of media …

Caractérisation Des Poussières Dans Le Secteur Des Assaisonnements Alimentaires, Brigitte Roberge, Simon Aubin, Yves Cloutier

Rapports de recherche scientifique

Les épices et les herbes aromatiques contiennent des substances organiques - nommées également substances actives - pouvant causer des irritations ou ayant un potentiel allergène pour la peau et pour le système respiratoire. De 1995 à 2007, la CSST a indemnisé 9 cas d’asthme survenus dans le secteur des autres industries de produits alimentaires qui comprennent notamment la production d’assaisonnements. Les auteurs ont caractérisé les poussières dans l’air d’établissements de fabrication de mélanges d’assaisonnement à base d’épices et d’herbes aromatiques en termes de poussières totales, de fractions inhalable et respirable ainsi que la granulométrie des poussières générées lors de diverses …

Patterns Of Fetal Heart Rate Response At ∼30 Weeks Gestation Predict Size At Birth, C. Sandman, C. J. Cordova, E. P. Davis, Laura M. Glynn, C. Buss

Psychology Faculty Articles and Research

There is evidence that fetal exposure to maternal stress is associated with adverse birth outcomes. Less is known about the association between fetal responses to a stressor and indicators of fetal maturity and developmental outcomes. The purpose of the present study was to determine whether fetal heart rate (FHR) patterns in response to a startling stimulus at ∼30 weeks of gestation were associated with gestational age at birth and birth weight. FHR was measured in 156 maternal–fetal dyads following a vibroacoustic stimulus. All pregnancies were singleton intrauterine pregnancies in English-speaking women who were primarily married, middle class, White and at …

Addressing The Challenges Of Reporting On Childhood Asthma In A Changing Health Care System: Building Better Evidence For High Performance, Meagan Lyon, Anne Rossier Markus, Maya Tuchman Gerstein, Sara J. Rosenbaum

Geiger Gibson/RCHN Community Health Foundation Research Collaborative

Childhood asthma is a serious and costly chronic disease that burdens children and families as well as the health care systems that serve them. A key element to improving asthma outcomes is access to timely and useful data that can improve the quality of care and inform programs and policies to best serve those communities most burdened by asthma. This Policy Brief examines the nation’s data collection framework for childhood asthma and considers steps that might be taken to strengthen it, including the development, collection and refinement of community-level data to inform local health care systems. Through a review of …

Smoking Cessation And Relapse Among Pregnant African-American Smokers In Washington, Dc, Ayman El-Mohandes, M. Nabil El-Khorazaty, Michele Kieley, Marie G. Gantz

Publications and Research

Smoking is the single most preventable cause of perinatal morbidity. This study examines smoking behaviors during pregnancy in a high risk population of African Americans. The study also examines risk factors associated with smoking behaviors and cessation in response to a cognitive behavioral therapy (CBT) intervention. This study is a secondary analysis of data from a randomized controlled trial addressing multiple risks during pregnancy. Five hundred African-American Washington, DC residents who reported smoking in the 6 months preceding pregnancy were randomized to a CBT intervention. Psycho-social and behavioral data were collected. Self-reported smoking and salivary cotinine levels were measured prenatally …

Research On Healthcare Worker Personal Protective Equipment: Minimum Requirements For Isolation Gowns, F.Selcen Kilinc-Balci, Phd

Building the Chain of Safety: Stakeholders Summit

F. Selcen Kilinc-Balci, PhD, is a Senior Service Fellow at the National Personal Protective Technology Laboratory (NPPTL) of Centers for Disease Control and Prevention (CDC)/National Institute for Occupational Safety and Health (NIOSH). She works in the area of protective clothing and ensembles, including personal protective equipment for healthcare workers, mine rescue ensembles, fire fighter turnout gear, and chemical protective garments. Prior to joining NIOSH in February 2010, she worked as a senior engineer at DuPont Protection Technologies. Her work at DuPont focused on product development, product testing and certification, and promotional claim validation in personal protective clothing. She has more …

Adoption Of Protective Uniforms, Thomas J. Walsh, Md, Facp, Fccp, Faam, Fidsa

Building the Chain of Safety: Stakeholders Summit

Thomas J. Walsh, MD, FACP, FCCP, FAAM, FISDA, is Professor of Medicine (appointment pending) and Director of the new Transplantation-Oncology Infectious Diseases Program at Weill Medical College of Cornell University. Following graduation from Johns Hopkins University School of Medicine, Dr. Walsh completed ten post-doctoral years of laboratory investigation, clinical research and patient care leading to boards in Medicine, Infectious Diseases and Oncology and laboratory expertise in pharmacology, innate host defenses, and medical mycology.

Following a distinguished career in the Pediatric Oncology Branch of the National Cancer Institute, Dr. Walsh was recruited to direct the new Transplantation-Oncology Infectious Diseases Program of …