Medicine and Health Sciences Commons^™

Correcting Instrumental Variables Estimators For Systematic Measurement Error, Stijn Vansteelandt, Manoochehr Babanezhad, Els Goetghebeur

Harvard University Biostatistics Working Paper Series

No abstract provided.

Medicare's Use Of Risk Adjustment, Gerald F. Kominski

National Health Policy Forum

Medicare accounts for expected differences in resource needs of patients or health plan enrollees by risk-adjusting the payments it makes to health care facilities, such as hospitals, skilled nursing facilities, and home health agencies, and the premiums it pays to health plans. Risk adjustment is intended to ensure that payments or premiums are adequate for patients or plan enrollees who require more resources than average in order to protect beneficiary access as well as the financial condition of the provider or plan. At the same time, risk adjustment lowers payments or premiums for beneficiaries who are expected to use fewer …

Medicaid And State Budgets: Clearing Storm, Foggy Forecast, Courtney Burke

National Health Policy Forum

This issue brief examines the recent history and trends in state budgets and considers how those trends have influenced the role of the Medicaid program. The paper offers several indicators for predicting the future of states’ fiscal standing, cautioning that, although the “stormy” period from 2001 to 2003 is over, states face many challenges in the near future. This issue brief also poses several questions regarding the appropriate roles of state and federal governments in administering the Medicaid program. These questions become particularly important as the population ages and states increasingly take the lead in developing solutions for covering the …

Community-Based Long-Term Care: Wisconsin Stays Ahead, Judith D. Moore, Carol O'Shaughnessy, Lisa Sprague

National Health Policy Forum

This report describes a site visit to Wisconsin in August 2007 that focused on the use of home and community-based services, both public and private, to delay or avoid the need for institutional care. Wisconsin was chosen because it has long been a leader among states in developing such services for the elderly and persons with disabilities. At the time of the visit, a managed long-term care program, Family Care, was operating on a pilot basis in five counties. The Partnership Program, a four-site demonstration integrating acute and long-term care for the dual eligible population (both frail elderly and younger …

Estimating The Prevalence Of Disease Using Relatives Of Case And Control Probands, Kristin N. Javaras, Nan M. Laird, James I. Hudson, Brian D. Ripley

COBRA Preprint Series

We introduce a method for estimating the prevalence of disease using data from a case-control family study performed to investigate the aggregation of disease in families. The families are sampled via case and control probands, and the resulting data consist of information on disease status and covariates for the probands and their relatives. We introduce estimators for overall prevalence and for covariate stratum-specific prevalence (e.g., sex-specific prevalence) that yield approximately unbiased estimates of their population counterparts. We also introduce corresponding confidence intervals that have good coverage properties even for small prevalences. The estimators and intervals address the over-representation of diseased …

Emergency Roadside Technician Dies When Struck By A Single-Unit Truck On An Interstate Shoulder, Kentucky Injury Prevention And Research Center

Fatality Case Reports--Motor Vehicle

In the winter of 2005 a 52-year-old male emergency roadside technician (ERT), (providing traffic control support for police), died when he fell approximately 75 – 80 feet from a bridge after being struck by a single-unit truck. A policeman had responded to a call from a semi-truck driver on the interstate who had blown a tire while driving on an interstate. After the tire blew, the driver immediately pulled the semi onto the right shoulder and called police for assistance. This section of the shoulder was on a bridge on the blind side of a hill, and was too narrow …

Shrinking Inpatient Psychiatric Capacity: Cause For Celebration Or Concern?, Eileen Salinsky, Christopher Loftis

National Health Policy Forum

This issue brief examines reported capacity constraints in inpatient psychiatric services and describes how these services fit within the continuum of care for mental health treatment. The paper summarizes the type and range of acute care services used to intervene in mental health crises, including both traditional hospital-based services and alternative crisis interventions, such as mobile response teams. It reviews historical trends in the supply of inpatient psychiatric beds and explores the anticipated influence of prospective payment for inpatient psychiatric services under Medicare. The paper also considers other forces that may affect the need for and supply of acute mental …

Relationships Between Landscape Pattern And Land Surface Temperature And Their Applications To The Study Of West Nile Virus: As Case Studies In Cities Of Indianapolis And Chicago, United States, Hua Liu

All-Inclusive List of Electronic Theses and Dissertations

A new synthesis of remote sensing and landscape ecology approaches was developed to establish relationships between the landscape patterns and land surface temperatures (LST) in the city of Indianapolis, Indiana, United States. Land use and land cover (LULC) and LST images were derived from Terra Satellite's Advanced Spaceborne Thermal Emission and Reflection Radiometer (ASTER) imagery. An analytical procedure using landscape metrics was developed, applying configuration analysis oflandscape patterns and land surface temperature zones. Detailed landscape pattern analyses at the landscape and class scales were conducted using landscape metrics in the City of Indianapolis. The effects of spatial resolution on the …

Bupropion And Nicotine Patch As Smoking Cessation Aids In Alcoholics, Kathleen M. Grant, Stephanie Sinclair Kelley, Lynette M. Smith, Sangeeta Agrawal, James R. Meyer, Debra J. Romberger

United States Public Health Resources

This is a double blind placebo controlled study of sustained release bupropion as a smoking cessation aid in alcoholics undergoing treatment for their alcoholism. Participants (N=58) were enrolled within one week of entry into alcohol treatment from community and Veterans Affairs Substance Use Disorder programs. All participants received nicotine patch and were invited to attend a smoking cessation lecture and group. Cigarette smoking and alcohol outcomes were measured at six months. Bupropion when added to nicotine patch did not improve smoking outcomes. One-third of participants on bupropion reported discontinuing the drug during weeks 1-4. Participants reported cigarette outcomes with nicotine …

Repeat Organic Dust Exposure–Induced Monocyte Inflammation Is Associated With Protein Kinase C Activity, Jill A. Poole, Todd A. Wyatt, Susanna G. Von Essen, John Hervert, Conrad Parks, Tracy Mathisen, Debra J. Romberger

United States Public Health Resources

Background: Organic dust exposure results in an inflammatory response that attenuates over time, but repetitive exposures can result in chronic respiratory diseases. Mechanisms underlying this modulated response are not clear.
Objective: This study investigated the effects of repeat versus single organic dust exposure–induced inflammatory mediators and protein kinase C (PKC) activity in monocytes.
Methods: Settled organic dust was obtained from swine confinement facilities. Promonocytic THP-1 cells and human peripheral blood monocytes were pretreated with or without dust extract and then restimulated. Culture supernatants were evaluated for TNF-α, IL-6, CXCL8, and IL-10. Responses were compared with endotoxin-depleted dust, LPS, and peptidoglycan. …

Jefferson Medical College Annual Report, 2007, Thomas J. Nasca

Jefferson Medical College Administrative Documents and Reports

No abstract provided.

Not Again!, David B. Nash

Selected Works of David B. Nash, MD, MBA

No abstract provided.

Workers Struck By Trains While Driving, Kentucky Injury Prevention And Research Center

Kentucky Haz Alerts--Motor Vehicle

To prevent injuries while driving vehicles across railroad tracks:

• A hazard assessment should be performed before crossing railroad tracks.
• Safety belts should be used while driving.
• Commercial vehicles should not be stopped on railroad tracks.
• Braking mechanism checks should be performed before commercial vehicles enter roadways.
• Cell phones should not be utilized while driving.
• Employers should provide employees training on railway traffic safety.

Preps Surveillance: Summary Of Existing Survey Measures And Recommendations For Ongoing Efforts, Lois Biener, Karen Bogen, Catherine A. Garrett

Center for Survey Research Publications

Over the past decade or more, tobacco companies have introduced cigarettes with lower content of some toxins than regular and light cigarettes. These new cigarettes, referred to as a class as Potential Reduced Exposure Products (PREPs), have typically been introduced into test markets, not nationwide, which means they are not yet widely known or recognized by name or description by most consumers. However, the introduction of these products is of great concern to public health advocates, who do not believe that enough research, particularly long term research, has been done to know whether or not the PREPs, even if proven …

Agreement Between Student-Reported And Proxy-Reported Physical Activity Questionnaires, Marsha Dowda, Russell R. Pate, James F. Sallis, Patty S. Freedson, Wendell C. Taylor, John R. Sirard, Stewart G. Trost

Faculty Publications

Parents and 531 students (46% males, 78% white) completed equivalent questionnaires. Agreement between student and parent responses to questions about hypothesized physical activity (PA) correlates was assessed. Relationships between hypothesized correlates and an objective measure of student's moderate-to-vigorous physical activity (MVPA) in a subset of 177 students were also investigated. Agreement between student and parent ranged from r=.34 to .64 for PA correlates. Spearman correlations between MVPA and PA correlates ranged from -.04 to .21 for student report and -.14 to .32 for parent report, and there were no statistical differences for 8 out of 9 correlations between parent …

Insights From The 2007 Disease Management Colloquium., David B Nash, Tine Hansen-Turton, Tracey Moorhead, Harry Leider, Donald F Wilson

College of Population Health Faculty Papers

No abstract provided.

Predictors Of Emotional Reactions In Women Treated For Breast Cancer, Erin E. Ramirez

Loma Linda University Electronic Theses, Dissertations & Projects

Breast cancer can be a devastating disease that impacts a woman in all spheres of her life (Ingram, 1989). Previous studies have examined the impact of breast cancer on body satisfaction, as well as the impact on emotional well-being. Studies have also examined the role of the coping style that a woman engages in response to the diagnosis and treatment of breast cancer in the woman's psychological adjustment to the disease. However, to date, no research has introduced and tested a multifaceted model.

The purpose of this study was to develop a model predicting psychological maladjustment in women treated for …

A Model For Preventing Anorexia In College Students, Laura Ann Negin

Loma Linda University Electronic Theses, Dissertations & Projects

The prevalence of anorexia nervosa in the general population is relatively low, but anorexia is at the forefront of health concerns because of its seriousness. Unhealthy weight loss has numerous physical, psychological, and social consequences. Most seriously, the mortality rate for people with eating disorders is the highest of all the major psychiatric disorders.

This dissertation presents a model for preventing anorexia nervosa in a population of college students that includes a comprehensive institutional approach, psychoeducational software, a high-risk population, a holistic approach that identifies an individual’s personal risk factors and protective factors, and individual therapy.

The model is built …

Predictors Of Emotional Reactions In Women Treated For Breast Cancer, Erin E. Ramirez

Loma Linda University Electronic Theses, Dissertations & Projects

Breast cancer can be a devastating disease that impacts a woman in all spheres of her life (Ingram, 1989). Previous studies have examined the impact of breast cancer on body satisfaction, as well as the impact on emotional well-being. Studies have also examined the role of the coping style that a woman engages in response to the diagnosis and treatment of breast cancer in the woman's psychological adjustment to the disease. However, to date, no research has introduced and tested a multifaceted model.

The purpose of this study was to develop a model predicting psychological maladjustment in women treated for …

Predictors Of Female Sexual Dysfunction, Julie M. Merrell

Loma Linda University Electronic Theses, Dissertations & Projects

Tiefer, Hall, and Tavris (2002) described factors comprising four categories of female sexual dysfunction. They suggested that unique factors need to be examined to understand sexual dysfunction in women. Socio-cultural, political, or economic factors, partner and relationship factors, psychological factors, and medical factors described as aspects of women’s lives that can be the source of sexual dysfunction. The current study examined indicators of the above factors-body shame, relationship satisfaction, sexual self-schema, positive and negative affect, and overall health-as predictors of female sexual dysfunction. The hypotheses were: Body shame and negative affect will be negatively associated with sexual function; and relationship …

Consider The Source : The Effects Of Adult Sources Of Human Immunodefciency [Sic] Virus And Sexually Transmitted Infection Prevention Information On Teen Risk Behaviors For Sexually Transmitted Infection, Janet E. Flores

Loma Linda University Electronic Theses, Dissertations & Projects

Sexually transmitted infections (STIs), including the Human Immunodeficiency Virus (HIV), are major health problems for adolescents, who represent over 26% of new cases of STIs diagnosed annually in the United States. Half of all HIV cases in people under age 25 result from sexual transmission during adolescence. Adolescent STI prevention is a national priority for the United States, and parents, schools, and medical providers, among others, are expected to have the greatest impact on adolescent STI risk reduction in teens.

This study used secondary Youth Risk Behavior Surveillance Survey (YRBS) data to explore the prevalence of high school students with …

Empirical Efficiency Maximization, Daniel B. Rubin, Mark J. Van Der Laan

U.C. Berkeley Division of Biostatistics Working Paper Series

It has long been recognized that covariate adjustment can increase precision, even when it is not strictly necessary. The phenomenon is particularly emphasized in clinical trials, whether using continuous, categorical, or censored time-to-event outcomes. Adjustment is often straightforward when a discrete covariate partitions the sample into a handful of strata, but becomes more involved when modern studies collect copious amounts of baseline information on each subject.

The dilemma helped motivate locally efficient estimation for coarsened data structures, as surveyed in the books of van der Laan and Robins (2003) and Tsiatis (2006). Here one fits a relatively small working model …

Health Information Technology Adoption Among Health Centers: A Digital Divide In The Making?, Adil Moiduddin, Daniel S. Gaylin

National Health Policy Forum

This background paper describes the current status of efforts to implement health information technology in community health centers. It summarizes the benefits experienced by health centers that have pioneered the use of information technology and examines the challenges that have hindered wider adoption. The paper identifies a range of policy options that have been considered to promote broader use of information technology by health centers.

Correlates Of Home Smoking Bans Among Young Adults

Florida Public Health Review

Multivariable regression in 1,858 young adults 18-25 years of age was carried out to identify correlates of household smoking bans. Knowledge of tobacco health effects, higher educational attainment, and no reported cigarette smoking were independently associated with smoking bans. Educational interventions to increase household smoking bans in young adults are needed.

Parent Derogation And Family Bonding Among African American And Non-Hispanic White Males During Middle School

Florida Public Health Review

The purpose of this study was to explore longitudinal relationships between parent derogation and family bonding in a sample of African American and non-Hispanic White males during middle school. While statistically controlling race, regression analyses indicated that parent derogation levels reported in sixth, seventh and eighth grades were statistically highly significant predictors of eighth grade family bonding. However, sixth grade parent derogation was not as strong a predictor as seventh grade parent derogation, and seventh grade was not as strong a predictor as eighth grade parent derogation. These results suggest that improving parent-child communication patterns at any point during middle …

Sustainable Antenatal Care Services In An Urban Indigenous Community: The Townsville Experience, Kathryn S. Panaretto, Melvina R. Mitchell, Lynette Anderson, Sarah L. Larkins, Vivienne Manessis, Petra G. Buettner, David Watson

Aboriginal Policy Research Consortium International (APRCi)

Objective: To evaluate the impact of a sustained, community-based collaborative approach to antenatal care services for Indigenous women.

Design: Prospective quality improvement intervention, the Mums and Babies program, in a cohort of women attending Townsville Aboriginal and Islanders Health Service, 1 January 2000 – 31 December 2005 (MB group), compared with a historical control group (PreMB group), 1 January 1998 – 30 June 1999.

Main outcome measures: Proportion of women having inadequate antenatal care and

screening; perinatal indicators. Results: Thenumberofantenatalvisitsperpregnancyincreasedfromthree

(interquartilerange[IQR],twotosix)inthePreMBgrouptosix(IQR,fourtoten)inthe MB group (P < 0.001). There were significant improvements in care planning, completion of cycle-of-care, and antenatal education activities throughout the study period. About 90% of all women attending for antenatal care were screened for sexually transmitted diseases, 89% had measurement of haemoglobin level, and serological tests for hepatitis B and syphilis (minimum antenatal screening). There was increased attendance for dating and morphology scans. In the MB group compared with the PreMB group, there was a significant reduction in perinatal mortality (14 v 60 per 1000 births; P=0.014). Conclusion: Sustained access to a community-based, integrated, shared antenatal service has improved perinatal outcomes among Indigenous women in Townsville.

Redefining Healthcare Education: Perspectives And Accomplishments, Brian G. Harrison, Robert L. Barchi

Thomas Jefferson University Administrative Documents and Reports

2007 Annual report of Thomas Jefferson University.

Rural Women With Disabilities And Depression, Part One: Characteristics And Treatment Patterns, Rosemary Hughes, University Of Montana Rural Institute

Health and Wellness

Depression is a common mental health problem in which a person may experience persistent sadness, be unable to enjoy formerly pleasurable activities, and feel worthless or hopeless. Undetected and untreated depression causes substantial physical and social limitation and may lead to suicidal thoughts or actions. More than 80% of people with depression improve with appropriate treatment (National Institute of Mental Health [NIMH], 2005).

A Relationship Between Us Healthcare Worker Smallpox Vaccination Rates In 2003 And Presidential Election Results In 2004, F. Matthew Mihelic, David G. Schultz Jr., Melinda R. Mihelic

Faculty Publications

A statistical relationship exists between state per capita smallpox vaccination rates of healthcare workers in 2003 and state presidential election results in 2004. The potential implications of political influence on national biosecurity decision making are discussed.

Download Full Pdf Issue Of Thomas Jefferson University Mph Public Health Link Newsletter, Vol. 3, Iss. 6, July 2007

Public Health Link

This issue includes an article written by Dr. James Plumb on "Public Health Perspective: Linking Public Health and Medical Education at Jefferson" along with thesis presenters and other program announcements.