Medicine and Health Sciences Commons^™

Associations Between Polycyclic Aromatic Hydrocarbon-Related Exposures And P53 Mutations In Breast Tumors, Irina Mordukhovich, Pavel Rossner Jr., Mary Beth Terry, Regina M. Santella, Yu-Jing Zhang, Hanina Hibshoosh, Lorenzo Memeo, Mahesh Mansukhani, Chang-Min Long, Gail Garbowski, Meenakshi Agrawal, Mia M. Gaudet, Susan E. Steck, Sharon K. Sagiv, Sybil M. Eng, Susan L. Teitelbaum, Alfred I. Neugut, Kathleen Conway-Dorsey, Marilie D. Gammon

Faculty Publications

BACKGROUND: Previous studies have suggested that polycyclic aromatic hydrocarbons (PAHs) may be associated with breast cancer. However, the carcinogenicity of PAHs on the human breast remains unclear. Certain carcinogens may be associated with specific mutation patterns in the p53 tumor suppressor gene, thereby contributing information about disease etiology.

OBJECTIVES: We hypothesized that associations of PAH-related exposures with breast cancer would differ according to tumor p53 mutation status, effect, type, and number.

METHODS: We examined this possibility in a population-based case–control study using polytomous logistic regression. As previously reported, 151 p53 mutations among 859 tumors were identified using Surveyor nuclease and …

75 Hours, 18 Babies, Dozens Of Women, And Me: Exploring Gynecological And Obstetrical Care In Bamako, Minnie Yordon

Independent Study Project (ISP) Collection

Mali has the third highest total fertility rate in the world, with each woman having an average of 6.62 children in the year 2009. Gynecological and obstetrical care, therefore, plays a large role in the lives of these women; 70% of women attend at least one prenatal consultation over the course of their pregnancy, and a skilled attendant is present at approximately 50% of all births. In this paper, I seek a better understanding of gynecological and obstetrical care in Bamako, the capital, from the perspective of an Ob/Gyn, which often centers on pregnancy and childbirth. Based on real experiences …

Intellectual Propriety: Compulsory Licenses Through The Trips Agreement And The Doha Declaration On Public Health, Samuel Mintzer Fuchs

Independent Study Project (ISP) Collection

The Agreement on Trade Related Aspects of Intellectual Property (TRIPS), part of the Uruguay Round of trade negotiations led to the creation of the World Trade Organization (WTO) in 1995, has led to a variety of interpretations and opinions. Though its application goes beyond matters of public health, it is this area that has come under the most scrutiny in the last fifteen years as the gaps between developed and developing countries have widened and exposed the health disparities between the two groups. Tensions over intellectual property and access to newly developed medicines to treat diseases such as HIV and …

Patient Centered Care Approach To Adherence With Cardiovascular Medications: Self-Determination Theory Integration, David S. Li

Health Services Research Dissertations

Problem statement. Behavioral intervention is used to improve adherence with medication in patients with cardiovascular diseases (CVD), but the effect was not sustainable. Patient-centered care (PCC) as a consumer movement has gained acceptance, but it lacks a theoretical framework. Self-determination theory (SDT) may provide an alternative to improve patients' adherence to chronic cardiovascular medication, as well as a theoretical framework for PCC. Both approaches to CVD management have not been evaluated.

Methods. The study was a quasi-experimental pretest posttest comparison design with consecutive sampling of a hospitalized cardiac patient population. Sixty patients each for the usual care (UC) …

An Analysis Of Continuous Chest Compression Cpr For Ems Providers During Out Of Hospital Cardiac Arrest, Megan L. Gleason

Honors Projects

A significant amount of research has been done in an attempt to improve the outcomes of patients found in cardiac arrest outside the hospital. The American Heart Association has long advocated Advanced Cardiac Life Support (ACLS), a procedure that encompasses cycles of chest compressions with advanced airway maintenance and defibrillation. Recent evidence has suggested that these current guidelines are ineffective due to prolonged “hands off” time. New research suggests utilizing a technique known as continuous chest compression CPR that delays advanced airway management and instead focuses on defibrillation and continuous chest compressions. Across the country, research has demonstrated that when …

A Gis Analysis Of The Environmental Variables Related To Rift Valley Fever Outbreaks, Jacqueline Florette Jackson

Health Services Research Dissertations

Rift Valley fever is a mosquito-borne disease that causes widespread febrile illness and mortality in domestic animals as well as humans (Gaff, 2007). Rift Valley fever virus was first isolated in 1931 (Daubney, 1931), and since then, outbreaks have occurred in sub-Saharan Africa, southern Africa, Egypt, Saudi Arabia, Yemen and Madagascar, proving it to be a virus able to invade ecologically diverse regions (Gaff, 2007). The potential introduction of Rift Valley fever into the United States suggests the potential for human infection and major economic disruption. It is important to understand the role environmental variables have played in historical outbreaks …

Anticipated Effects Of The U.S. Mexico City Policy On The Attainability Of The Millennium Development Goals And Future Development Efforts In Sub-Saharan Africa, Katherine Clare Alexander

Anthós

In the low-income countries of sub-Saharan Africa, the performance of pyramidal reproductive health and family planning services with public outreach initiatives has not met the expectations or the needs of the communities they serve. Insufficient case management, limited management capacity and referral and communication failures are challenges faced on the delivery level, while on the policy level these health clinics face insufficient coordination among organizations and weak links between programs (Schneider, 2006). The Mexico City Policy, first introduced by President Reagan in 1984, only exacerbated these challenges for organizations that offer comprehensive contraception and family planning programs by denying any …

Effects Of Perceived Fitness Level Of Exercise Partner On Intensity Of Exertion, Thomas G. Plante, Meghan Madden, Sonia Mann, Grace Lee

Psychology

Problem statement: Social comparison theory was used to examine if exercising with a research confederate posing as either high fit or low fit would increase the exertion in exercising. Approach: 91 college students were randomly assigned to one of three conditions: Biking alone, biking with a high fit confederate, or biking with a low fit confederate. All participants were instructed to complete 20 min of exercise at 60-70% of their maximum target heart rate. Results: Results indicated that participants in the high fit condition exercised harder than those in the low fit condition. However, no mood differences emerged between conditions. …

Les Risques De Troubles Musculo-Squelettiques Aux Membres Supérieurs Dans Le Secteur Des Services À L’Automobile : Étude Exploratoire, Denis Marchand, Denis Giguère

Rapports de recherche scientifique

Les troubles musculosquelettiques aux membres supérieurs (TMS-MS) comptaient en moyenne au Québec, entre 1998 et 2002, pour 8,7 % de l’ensemble des lésions compensées du secteur des Services à l’automobile, mais représentaient 14,9 % des jours d’arrêt de travail et 13,8 % des déboursés totaux de compensation. Une analyse de l’activité de travail réalisée sur quatre postes au Québec et dans cinq garages aux États-Unis, ainsi qu’une étude sur les postures dans 42 garages en Europe, faisait état de la présence de plusieurs des facteurs de risque associés à ce type de lésion, dont la répétition des gestes, le travail …

Improving Health Outcomes For Children (Ihoc) In Maine Logic Model For Primary Care Practice Improvement, Cutler Institute Of Health And Social Policy

Population Health & Health Policy

Improving Health Outcomes for Children (IHOC) is a 5-year demonstration grant from the Centers for Medicare & Medicaid Services, and authorized by 401 (d) of the Children's Health Insurance Program Reauthorization Act of 2009 (CHIPRA).

IHOC works with doctors' offices, practices and other agencies who want to improve health care in Maine and Vermont to:

• Collect and report on the use of evidenced-based child health quality measures
• Expand the Health Information Technology to improve the flow of child health data
• Promote a collaborative child health learning environment

Who Guidelines For Antimicrobial Treatment In Children Admitted To Hospital In An Area Of Intense Plasmodium Falciparum Transmission: Prospective Study, Behzad Nadjm, Ben Amos, George Mtove, Jan Ostermann, Semkini Chonya, Hannah Wangai, Juma Kimera, Walii Msuya, Frank Mtei, Denise Dekker, Rajabu Malahiyo, Raimos Olomi, John A. Crump, Christopher J. M. Whitty, Hugh Reyburn

Faculty Publications

Objectives To assess the performance of WHO’s “Guidelines for care at the first-referral level in developing countries” in an area of intense malaria transmission and identify bacterial infections in children with and without malaria.

Design Prospective study.

Setting District hospital in Muheza, northeast Tanzania.

Participants Children aged 2 months to 13 years admitted to hospital for febrile illness.

Main outcome measures Sensitivity and specificity of WHO guidelines in diagnosing invasive bacterial disease; susceptibility of isolated organisms to recommended antimicrobials.

Results Over one year, 3639 children were enrolled and 184 (5.1%) died; 2195 (60.3%) were blood slide positive for Plasmodium falciparum …

The State Health Insurance Assistance Program (Ship), Carol O'Shaughnessy

National Health Policy Forum

The State Health Insurance Assistance Program (SHIP), created by section 4360 of the Omnibus Budget Reconciliation Act (OBRA) of 1990 and administered by the Centers for Medicare & Medicaid Services (CMS), supports grants to states and jurisdictions to provide information, counseling, and assistance to Medicare beneficiaries and their families on Medicare and other health insurance questions. This publication describes the program and presents its funding history.

Oral Health Checkup: Progress In Tough Fiscal Times?, Cynthia Shirk

National Health Policy Forum

Almost ten years after the surgeon general’s report designating dental disease as the “silent epidemic,” the nation continues to struggle with adequate access to and utilization of dental services. This is particularly true for low-income individuals, who experience more than twice the amount of untreated dental disease as their higher-income peers. This issue brief reviews sources of dental coverage for low-income children and adults and the challenges these programs face. It highlights some examples of state Medicaid initiatives to improve access and utilization for children and the progress of these initiatives. Finally, it examines the potential effects of the economy …

School Food Services And Childhood Obesity: Is There A Link?, Christine M. Spiker

Florida Public Health Review

Childhood overweight and obesity have increased three-fold since 1980, and there is minimal evidence of any leveling off. Research has found that many school food programs are not sufficiently providing adequate nutrients and providing far too many calories and fat. Competitive foods are widely available in many schools which may possibly contribute to increased weight and body mass index (BMI) in students. This has put school food programs under scrutiny as a contributor to the childhood obesity crisis being faced. Schools can promote healthier eating by improving school meals, but most are forced to sell competitive foods to support their …

Application Of A Leadership Approach To Address Suicide Among Gay, Lesbian And Bisexual Youth, Katherine Davis

Florida Public Health Review

Suicide, esepcially among youth, is a significant public health issue, ranking as the third leading cause of death among youth and young adults between the ages of 10 and 24. Suicide attempts and successful suicides are more frequent occurrences in the gay, lesbian,and bisexual (GLB) population. Despite this heightened risk, sexual orientation is omitted from important documents that detail suicide risk factors. Moreover, few schools have programs that address the unique needs of GLB youth that could create a more receptive or tolerant, and less threatening environment for them. In this paper, Kotter’s eight-stage framework for leadership is explored for …

Hiv Prevention And Education: Leadership And Implications For African-American Churches, Khaliah F. Fleming

Florida Public Health Review

This paper illustrates use of John Kotter’s eight-stage process for creating change through leadership its potential for aiding African-American churches in addressing rising HIV/AIDS rates. The focus is on churches due to their large influence on the African-American community. Knowing that there are multiple influences surrounding HIV/AIDS, it is useful to highlight how certain ideological and theological factors are contributing to the current state of African-American churches work to increase HIV/AIDS awareness, prevention, and education.

Leadership, Leadership Paradigms, And Leadership Training In 2010 And Beyond, Robert J. Mcdermott

Florida Public Health Review

Since 2008, 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 applied to address some nagging and ongoing problems in public health and related endeavors. The current volume of the FPHR continues that tradition. Other public health students, faculty, and practitioners from around the state are invited to contribute ideas that foster leadership skills and the development of dynamic leaders.

Latino Family Variables And Sexual Activity In Latino Adolescents, Brittany Nicole Barber

Counselor Education and Counseling Psychology Research Exchange Conference

Researchers’ focused examination of Latino adolescents’ cultural values and sexual activity has yielded questions regarding the cultural- and gender-specific attitudes and practices of these youth (Deardorff, Tschann, & Flores, 2008). Cultural values include family-related variables such as different aspects of familism, parent-adolescent communication, and parental monitoring, which have been found to decrease adolescents’ engagement in other negative activities such as aggressive behavior, (Dishion & McMahon, 1998), substance use (Estrada, Rabow, & Watts, 1982), and delinquency (Clark & Shields, 1997). Research investigating these risk behaviors has often implicated Latino adolescents’ level of assimilation to White, mainstream society as a potential risk …

Is Uncompensated Care Affecting Quality Assurance Of Rural Hospitals?, Doohee Lee, Chris Dixon, Paul Kruszynski, Alberto Coustasse

Management Faculty Research

Healthcare disparities in rural areas remain significant in the U.S. healthcare industry. Uncompensated care makes healthcare disparities in rural areas worse and rural hospitals are unfavorably positioned to compete with urban hospitals in the economic downturn marketplace. How uncompensated care affects quality care among rural hospitals has been lightly investigated. As many rural residents experience difficulty accessing high quality care and the importance of establishing quality care practice standards in a rural setting, we conducted a systematic literature review to identify some quality care barriers and opportunities, suggested strategies to strengthen the position of rural hospitals in response to uncompensated …

Management Of Kawasaki Disease In Texas: Policy Implications, Alberto Coustasse, Doohee Lee, Cody Arvidson, Julius J. Larry Iii, Witold Migala

Management Faculty Research

Kawasaki Disease (KD) is the leading cause of acquired cardiovascular disease among children, but KD has received little attention on its management from a policy perspective. The core objective of this paper is to review the literature, identify problems related to KD, and evaluate and offer some policy alternatives to effectively prevent and treat KD epidemiologically in Texas. Policy options suggested in this paper include, among others, (1) establishing a mandatory national KD registry system (along with active surveillance), (2) introducing sentinel providers, (3) requiring mandatory reporting of KD by hospitals, and (4) sponsoring policy KD research and practice.

Consumer Consent Options For Electronic Health Information Exchange: Policy Considerations And Analysis, Melissa M. Goldstein, Alison L. Rein

Health Policy and Management Faculty Publications

The issue of whether, to what extent, and how individuals should have the ability to exercise control over their health information represents one of the foremost policy challenges related to the electronic exchange of health information. The current landscape of possible consent models is varied, and the factors involved in choosing among them are complex. States and other entities engaged in facilitating the exchange of electronic health information are struggling with a host of challenges, chief among them the establishment of policies and procedures for patient participation in their exchange efforts. While some have adopted policies enabling patients to exercise …

Climate Change, Environmental Justice, And Vulnerability: An Exploratory Spatial Analysis, Sacoby M. Wilson, Roland Richard, Lesley Joseph, Edith M. Williams

Faculty Publications

Research has demonstrated that vulnerable populations including disadvantaged populations of color live in areas that may place them at higher risk of exposure to social and environmental hazards. Due to climate change, these populations may experience worse health outcomes and environmental health disparities. The purpose of this project was to explore the use of Geographic Information Systems (GIS) to assess areas that may be vulnerable to climate change across the United States. We employed ArcGIS 9.3 to create vulnerability scores for areas across the country that may be that may be impacted by climate change at the county level in …

Using The Stages Of Change Model To Choose An Optimal Health Marketing Target, Paula Diehr, Peggy A. Hannon, Barbara Pizacani, Mark Forehand, Jeffrey Harris, Hendrika Meischke, Susan J. Curry, Diane P. Martin, Marcia R. Weaver

UW Biostatistics Working Paper Series

Background: In the transtheoretical model of behavior change, “stages of change” are defined as Precontemplation (not even thinking about changing), Contemplation, Preparation, Action, and Maintenance (maintaining the behavior change). Marketing principles suggest that efforts should be targeted at persons most likely to “buy the product.”

Objectives: To examine the effect of intervening at different stages in populations of smokers, with various numbers of people in each “stage of change.” One type of intervention would increase by 10% the probability of a person moving to the next higher stage of change, such as from Precontemplation to Contemplation. The second type would …

The Prevalence And Causes Of Vision Loss In Indigenous Australians: The National Indigenous Eye Health Survey, Hugh R. Taylor, Jing Xie, Sarah Fox, Ross A. Dunn, Anna-Lena Arnold, Jill E. Keeffe

Aboriginal Policy Research Consortium International (APRCi)

Aim: To determine the prevalence and causes of vision loss in Indigenous Australians. Design, setting and participants: A national, stratified, random cluster sample was drawn from 30 communities across Australia that each included about 300 Indigenous people of all ages. A sample of non-Indigenous adults aged 􏱄 40 years was also tested at several remote sites for comparison. Participants were examined using a standardised protocol that included a questionnaire (self-administered or completed with the help of field staff), visual acuity (VA) testing on presentation and after correction, visual field testing, trachoma grading, and fundus and lens photography. The data were …

The Ryan White Hiv/Aids Program, Jessamyn Taylor

National Health Policy Forum

This publication describes the basics of the Ryan White HIV/AIDS Program, the largest federal program solely focused on treating people living with HIV/AIDS in the United States. The program funds cities, states, and community-based organizations to provide primary care, prescription drugs, and support services to low-income, uninsured, and underinsured people living with HIV/AIDS.

The Responsibility To Protect Haiti, Linda A. Malone

Popular Media

No abstract provided.

Particulate Characterization And Control Evaluation For Carbon Fiber Composite Aircraft Crash Recovery Operations, Matthew R. Ferreri

Theses and Dissertations

Within the United States Air Force (USAF) Advanced Composite Material (ACM) is gaining an increasing use in military aircraft. With the number of aircraft that have increasingly large amounts of ACM materials, the probability of an incident with one of these aircraft also increases. When such an incident occurs the aircraft needs to be disassembled, removed, and later inspected as part of the accident investigation process. This disassembly process is termed “Crash Recovery Operations.” Carbon fibers have been shown to be hazardous to human health and a pilot study raised the suspicion that nanosized aerosol may be generated during the …

High Volume Air Sampling For Viral Aerosols: A Comparative Approach, Casey W. Cooper

Theses and Dissertations

The United States Air Force has high volume biological air sampling equipment available including the XMX/2L-MIL and DFU-1000. Neither system has been evaluated for effectiveness in the collection of viruses. Furthermore, decontamination methods have not been evaluated for these systems after use in sampling for a viral agent. MS2 bacteriophage was used as a surrogate virus. Aerosolized MS2 was released into a 12 m3 exposure chamber. High and moderate airborne concentrations of MS2 were evaluated. Low volume impingers were used for comparative purposes as well. Samples were analyzed using plaque assay and polymerase chain reaction (PCR). At high viral loads …

Development Of A Novel Noise Delivery System For Jp-8 Ototoxicity Studies, John E. Stubbs

Theses and Dissertations

Numerous chemicals with ototoxic properties may cause hearing loss directly, potentiate noise-induced hearing loss, or produce additive effects. Of interest to the US Air Force are studies showing ototoxic effects of JP-8 jet fuel and its hydrocarbon constituents. The Naval Health Research Center (NHRC) at Wright-Patterson AFB, Ohio, in conjunction with the USAF, is studying the ototoxic effects of JP-8 in rats. The study requires a white noise source that is one octave band wide, centered at 8 kHz frequency, delivered from outside of exposure chambers. Sound pressure levels must be within ± 2 dB at all exposure points within …

Hip Fracture Types In Men And Women Change Differently With Age, David A. Tanner, Marita Kloseck, Richard G. Crilly, Bert Chesworth, Jason Gilliland

Health Studies Publications

BACKGROUND: Hip fractures are expensive and a frequent cause of morbidity and mortality in the elderly. In most studies hip fractures have been viewed as a unitary fracture but recently the two main types of fracture (intertrochanteric and subcapital) have been viewed as two fractures with a different etiology and requiring a different approach to prevention. The relative proportion of intertrochanteric fractures increases with age in women. In previous studies no particular pattern in men has been noted. In this study, we explored changes in the relative proportion of the two fracture types with age in the two genders. METHODS: …