Medicine and Health Sciences Commons^™

Messages Of Maternity: The Relationship Of State And Ngo Institutions To Reproductive Health Services And The Construction Of Family In Jordan, Julia Shatz

Independent Study Project (ISP) Collection

This project examines the ways in which family planning and reproductive health services and the institutions that provide them contribute to constructing definitions of family and motherhood in Jordan. The study is based on personal interviews conducted with representatives at six institutions – the Ministry of Health, the Higher Population Council, the Jordanian Association for Family Planning and Protection, Queen Zein Al Sharaf Institute for Development, the Arab Women’s Organization, and the Jordanian Women’s Union. This paper addresses the issues of family planning as a method of population control, the integrated medical and educational approach currently popular in family planning …

Biomass Combustion And Ari In Kiwengwa, Unguja, Eric Fournier, Nicole Poepping

Independent Study Project (ISP) Collection

A study was undertaken investigating the relationship between biomass cook stove usage practices in Kiwengwa, Unguja and the incidence of acute respiratory infections (ARI) amongst individuals participating in household cooking activities. In each household, the incidence of ARI was determined via semi-structured interviews conducted with the primary cooker. Additionally, measurements and observations of: biomass cook stove efficiency, stove usage behaviors, and the physical cooking environment were obtained. Statistical analysis was then performed to assess the nature and significance of relationships between variables in the three cook stove usage categories and the stated incidence of ARI within the sample households. Data …

Where The Sky Is High And The Hospital Is Faraway: Strategies For Rural Public Health Education In Yunnan, China, Michael Frick

Independent Study Project (ISP) Collection

The young seller sits on a low stool behind a canvas advertising his product and speaks quickly into a microphone headset. Gathered around him, a small crowd watches as he spreads a modest amount of his curative skin potion on the underarm of a willing volunteer. As the vendor dabs the liquid on the local man’s arm, he gestures toward pictures on the canvas to explain and market his medicine, a red liquid stored in small elixir bottles. Several streets away, thirty government health workers dressed in the blue and black uniforms of officialdom unfold a carnival of public health, …

Bridging The Critical Chasm Between Service And Research: The Cancer Information Service’S Collaboratory, Linda Squiers, Nigel Bush, Robin C. Vanderpool, Ludmila Cofta-Woerpel, Cecilia Fabrizio

Health, Behavior & Society Faculty Publications

As a collaboratory for cancer communication and education research, the National Cancer Institute's (NCIs) Cancer Information Service (CIS) is in an ideal position to bridge the critical chasm that exists between service and research. This article describes the CIS' current research program as well as the CIS Research Agenda launched in 2005. The CIS' progress in developing and supporting recently funded studies that address this agenda is detailed. The unique resources and opportunities available to researchers, public health practitioners, health care providers, and community-based organizations interested in developing collaborative cancer communication and cancer education studies with the CIS are identified …

Defining Programmatic Access To Healthcare For People With Disabilities, Nancy R. Mudrick, Silvia Yee

Social Work - All Scholarship

People with disabilities face disability-related barriers that affect their receipt of health care. These often are discussed in terms of three categories: financial, structural, and programmatic barriers. Financial barriers may involve the lack of insurance, inability to pay for care, or coverage limitations for such items as durable medical equipment and medication. Structural barriers primarily arise from the architectural characteristics of health care delivery settings, such as parking location, building entrances, stairs and ramps, and bathrooms. Programmatic barriers are barriers involving the processes used to deliver health care. This category is the least understood, yet an important factor for access …

A Case Study Of Pediatric Diarrhea At Murchison District Hospital In Port Shepstone, Kwazulu-Natal, South Africa, T. Smith

Independent Study Project (ISP) Collection

This study investigates pediatric diarrhea in children under 5 years old at Murchison District Hospital in Port Shepstone, South Africa. Hospital Child Pip data was used to determine the number of admissions to the hospital for pediatric diarrhea and its mortality rate. Characteristics of deceased patients including age, malnutrition, and HIV status, were then synthesized with information on patients’ access to clean water and improved sanitation obtained through 20 interviews of mothers of patients as well as caregivers’ infant feeding practices and hygiene practices, such as handwashing with soap. Treatment and prevention of diarrhea was also explored. Murchison’s management of …

Healthcast 2020, David B. Nash

Selected Works of David B. Nash, MD, MBA

No abstract provided.

Parental Views Of Otitis Media And Antibiotic Treatment, Courtney Leigh Ross

Doctoral Dissertations

Antibiotic resistance is a rapidly growing problem throughout the world. Antibiotic resistance can be due to a number of factors, including unnecessary antibiotic prescriptions, antibiotic misuse, and transmission of resistant bacteria.

Otitis media is the most often diagnosed childhood illness and accounts for the majority of the United States' annual antibiotic prescriptions. Both parents and physicians can contribute to unnecessary antibiotic treatment for otitis media. Understanding parental views of otitis media and antibiotic treatment may help reduce unnecessary antibiotic prescriptions and lead to the subsequent reduction in antibiotic resistance.

The purpose of this capstone project is to develop a questionnaire …

Preps Surveillance: Summary Of Cognitive Interviews And Recommendations For Preps Surveillance Measures, Lois Biener, Karen Bogen

Center for Survey Research Publications

A review of existing research on population awareness of potentially reduced exposure tobacco products (PREPs) as well as results of cognitive interviews suggest that awareness of PREPs is quite low at this time, except in active test-markets. In order to monitor changes in awareness and perceptions of, and receptivity to these products over time, we have proposed using a set of questions as well as coding conventions that appear to result in reasonably accurate estimates of awareness of a particular group of products. The recommended items, which performed will in cognitive interviews, are presented in Appendix D of this report. …

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

Public Health Link

This issue includes a faculty spotlight on Dr. Brawer, a recap of the 4th annual SAPHE awards luncheon and a list of Public Health Thesis presenters.

Well Child Health Care In Wales: A Change Of Setting, A Shift Of Power, Jennifer Herman

Inquiry Journal 2007

No abstract provided.

A Case Study Of School Age Female Minority Athletes Who Became Pregnant, Floyd Jones Phd, Jennifer Y. Mak, Phyllis A. Jones Ed

Management Faculty Research

The purpose of this study is to provide an in-depth understanding of ''What had happened to the urban minority female athletes who became pregnant while playing high school basketball?'' The study wanted to provide a qualitative analysis of rich narrative data collected from questionnaire interviews of two separate groups (one in Pittsburgh, the other in New York City). The findings of this study suggest that in fact urban female African-Americans athletes still received benefits from sports participation.

Gstm1, Gstt1, Gstp1, And Gsta1 Polymorphisms And Urinary Isothiocyanate Metabolites Following Broccoli Consumption In Humans, Susan E. Steck, Marilie D. Gammon, James R. Hébert, Denise E. Wall, Steven H. Zeisel

Faculty Publications

Isothiocyanates (ITC) are potentially anticarcinogenic phytochemicals formed from the metabolism of glucosinolates and are found in cruciferous vegetables as well as a select number of other foods. ITC are both substrates for and inducers of glutathione S-transferase (GST) phase II metabolizing enzymes involved in carcinogen detoxification as well as effectors of phase I pathways. Previous studies report mixed results on the interaction between cruciferous vegetable intake, GST polymorphisms, and risk of cancer. We conducted a study of 114 healthy human subjects between 18 and 50 y of age to examine the biologic mechanism underlying the associations, specifically, to assess …

Repeatability Of Serial Carotid Intima Media Thickness Scanning On Individual Subjects, Judi Nightingale

Loma Linda University Electronic Theses, Dissertations & Projects

Background. Heart disease affects millions of Americans each year. In order to improve primary prevention, early risk identification is essential. B-mode ultrasound of the common carotid artery (CCA) intima-media thickness (IMT) assesses risk of a coronary event early in the process of plaque development. Because IMT changes are so small over time, in order to determine clinically significant versus clinically insignificant changes in IMT over a 12 month time period, a protocol is needed which can detect the least significant difference (LSD) of at least 0.030 mm.

Purpose. The purpose of this study was to develop and test a well-defined …

Dental Hygienists' Contributions To Improving The Nation's Oral Health Through School-Based Initiatives From 1970 Through 1999: A Historical Review, Gayle B. Mccombs, Cynthia C. Gadbury-Amyot, Rebecca S. Wilder, Karen O. Skaff, Margaret Lappan Green

Dental Hygiene Faculty Publications

PURPOSE: The purpose of this literature review is to document the contributions dental hygienists have made over the past 3 decades to improve the nation's oral health. This historical review encompasses selected literature that acknowledged dental Hygienists' direct involvement in U.S. school-based or school-linked oral health programs from 1970-1999.

METHODS: Five researchers independently searched MEDLINE, PubMed, and other electronic databases to identify relevant literature for the years 1970-1999. The search aimed to locate articles authored by or that documented dental Hygienists' involvement as "service provider" in U.S. school-based oral health programs. For the purpose of this review, service provider was …

Cost Effectiveness Of Screening Of All Newly Recruited Employees For Diabetes At A Tertiary Care Hospital, Niloufer Sultan Ali, Ali Khan Khuwaja

Department of Anaesthesia

Diabetes Mellitus is a disease which remains asymptomatic for long duration of time and usually diagnosed either when gets complicated or by routine or opportunistic screening. The practice of universal screening is not recommended, particularly in constraint resources . However, we embarked with a study to assess the yield of recommended screening for Type 2 diabetes in all the newly recruited employees at a tertiary care hospital in Karachi. Methods: All the information required for this study was collected from medical records of all newly recruited employees of nursing services department of a tertiary care hospital of Karachi, Pakistan, over …

Modifying And Validating A Quality Of Life Measure To Fit Your Patient Population, Michelle R. Johnson, J Ross Maclean, Rebecca L. Rogers, Donna M. Fick, Andre Kallab

Journal of the Georgia Public Health Association

Introduction: A well-developed quality of life (QoL) instrument is valuable in identifying the burden of illness. We were interested in exploring whether existing QoL instruments were suitable for patients in our medical setting and, if not, whether this could be rectified by adapting an existing valid and reliable instrument to meet the specific needs of our patient population. For the purposes of this study, we chose to evaluate the quality of life of patients with breast cancer. Specifically, we were interested in two aspects of QoL in women with breast cancer. The first was whether existing instruments were pertinent to …

The Breast And Cervical Cancer Prevention And Treatment Act (Bccpta) In Georgia: Women Covered And Medicaid Costs In 2003, E. Kathleen Adams, Sarah C. Blake, Cheryl Raskind-Hood, Linien Chien, Mei Zhou, Jonathan Liff, William Eley

Journal of the Georgia Public Health Association

The Breast and Cervical Cancer Prevention and Treatment Act (BCCPTA) provided states with an optional Medicaid eligibility category for uninsured women with breast and/or cervical cancers. The BCCPTA is the first and only such effort to use a population-based public health screening program, the National Breast and Cervical Cancer Early Detection Program (NBCCEDP) to provide a pathway to publicly funded health insurance for otherwise uninsured low-income women. Georgia was one of the first states to adopt the BCCPTA and was one of only twelve states that provided Medicaid eligibility to women screened by non-NBCCEDP providers. We use 2003 Georgia Medicaid …

Relationship Of Fruit And Vegetable Servings And Self-Reported Diabetics In The Southeast And Northeast, Marylen Rimando, Faye Lopez, Haritha Battula

Journal of the Georgia Public Health Association

According to the American Diabetes Association, most diabetic patients are not consuming the recommended 3-5 servings of vegetables and 2-4 servings of fruits a day. This study examined fruit and vegetable servings of self-reported diabetics (N=35,407) in select southeastern and northeastern states using Behavioral Risk Factor Surveillance System (BRFSS) 2005 data. The estimate for both fruit and vegetable servings and self-reported diabetes was determined using multivariate logistic regression, adjusting for sociodemographics and geographic region. The results indicated a significant difference between fruit and vegetable servings for diabetics and non-diabetics (p<0.0001). A higher percentage of diabetics in the northeast consumed more than three servings of fruit and vegetables when compared to diabetics in the southeast. Respondents in the northeast were 21% more likely to consume five or more servings of fruit and vegetables and 16% less likely to be diabetic than those in the southeast after adjusting for age, race, sex, and geographic region. In conclusion, diabetics in the northeast consumed more servings of fruit and vegetables than did those in the southeast. Multiple factors influence fruit and vegetable consumption and diabetes and should be considered when developing targeted nutritional interventions. Diabetes educators, nurses, and physicians can encourage diabetic patients to consume more fruit and vegetables and motivate them to continue eating fruit and vegetables.

Ambulatory Care Adverse Events And Preventable Adverse Events Leading To A Hospital Admission, Donna M Woods, Eric J Thomas, Jane L Holl, Kevin B Weiss, Troyen A Brennan

Faculty, Staff and Student Publications

BACKGROUND: Most healthcare in the US is delivered in the ambulatory care setting, but the epidemiology of errors and adverse events in ambulatory care is understudied.

METHODS: Using the population-based data from the Colorado and Utah Medical Practices Study, we identified adverse events that occurred in an ambulatory care setting and led to hospital admission. Proportions with 95% CIs are reported.

RESULTS: We reviewed 14,700-hospital discharge records and found 587 adverse events of which 70 were ambulatory care adverse events (AAEs) and 31 were ambulatory care preventable adverse events (APAEs). When weighted to the general population, there were 2608 AAEs …

Clinicians’ Perception Of Inmates’ Satisfaction With Mental Health Services, Jerry B. Daniel, Wynne S. Korr

Journal of the Georgia Public Health Association

A growing body of literature addresses the mental health needs of prison inmates; however, very little research has examined mental health services among this population. Based on the Behavioral Model of Health Services Use (Andersen Model), the current study examined clinicians’ perception of inmates’ satisfaction with mental health services. The study’s main objective was to identify the effect of three major groups of predictor variables (predisposing, enabling, and need) on clinicians’ perception with inmates’ satisfaction with mental health services. The study utilized an exploratory, survey methodology. Although only a few variables were found to be statistically significant in the multivariate …

Multi-Level Evaluation Of A Perinatal Health Program In Rural Southeast Georgia, Swati Raychowdhury, Stuart H. Tedders, Greta O'Steen, Sarah Jones

Journal of the Georgia Public Health Association

Problem: Infant mortality has declined steadily in the past decade, however, significant disparities associate with lack of adequate perinatal health services and barriers to access disproportionately impact women residing in rural areas. In Georgia, data suggest significant challenges with respect to birth outcomes, and this problem seems to be exacerbated in rural regions of state. The objective of this presentation is to report on the impact of a regional perinatal health care collaborative implemented in rural southeast Georgia.

Method: Analysis of pre-intervention and post-intervention birth outcomes (gestational age, birth weight and infant mortality) served as the focal point programmatic evaluation. …

Down-Regulation Of Natural Killer Cell Activation In Response To Influenza Virus In Older Adults, Yu Jing

Theses and Dissertations in Biomedical Sciences

Immune senescence contributes to influenza-associated high mortality and morbidity and reduced vaccine efficacy in elderly people. Type I T cell (Thl)-mediated immunity plays a significant role in Immune responses to influenza infection and vaccination. Natural killer (NK) cells secrete significant amount of IFN-7 , a hallmark Thl cytokine, in response to influenza infection. How aging influences human NK cell IFN-7 production in response to influenza virus has not been well documented. In this study we employed human peripheral blood mononuclear cells (PBMC) and performed intracellular cytokine staining and flow cytometry primarily to investigate how aging influences NK cell activation with …

Trends In Particulate Matter And Mortality: An Approach To The Assessment Of Unmeasured Confounding, Holly Janes, Francesca Dominici, Scott Zeger

Johns Hopkins University, Dept. of Biostatistics Working Papers

We propose a method for diagnosing confounding bias under a model which links a spatially and temporally varying exposure and health outcome. We decompose the association into orthogonal components, corresponding to distinct spatial and temporal scales of variation. If the model fully controls for confounding, the exposure effect estimates should be equal at the different temporal and spatial scales. We show that the overall exposure effect estimate is a weighted average of the scale-specific exposure effect estimates.

We use this approach to estimate the association between monthly averages of fine particles (PM2.5) over the preceding 12 months and monthly mortality …

Caring For People With Alzheimer's Disease Or Dementia In Maine, Stuart Bratesman Mpp, Julie T. Fralich Mba, Catherine Mcguire Bs, Louise Olsen, Romaine Turyn

Disability & Aging

It is clear that caring for people with Alzheimer’s disease and dementia is a growing public health issue. Alzheimer’s is a progressively deteriorating disease that can last anywhere from 1 to 15 years. Families are the primary caregivers and will continue to need support to manage the care of their loved ones, to coordinate services within the long term care system and to maintain their own health and well-being.

Food Facilities, Food Service Workers And The Flow Of Food: Food-Borne Illnesses In Taiwan's Preschools, Shu-Chen Lin

Graduate Student Dissertations, Theses, Capstones, and Portfolios

This study examined food-borne illnesses in Taiwan's preschools which are a major cause of personal distress and preventable death. They are of particular concern in preschools as very young children are highly susceptible to food-borne illnesses. Previous studies that comprehensively investigated the factors impacting food-borne illnesses in Taiwan were not found in the literature. The development of a universal food safety model is necessary as a means to measure relevant constructs. Application of the model should be able to prevent the occurrence of food-borne illnesses in organizations. This explanatory (correlational) study examined the relationships among food facilities, food service workers, …

Health Care Price Transparency And Price Competition, Mark Merlis

National Health Policy Forum

Growing numbers of consumers are in health plans that give them incentives to be more cost-conscious. Yet complex pricing systems and limited information may make it hard to choose among providers and treatment options. This report examines steps that insurers and others have taken to make better price information available, possible government measures to further promote price transparency or to simplify price comparisons, and the likely effects on consumer behavior and provider competition.

Finding The Fastest Way To Her Heart: Linking Clinical And Policy Pathways, Paula Johnson, Brian R. Schuetz, Shelley M. Stark, Dora Tovar

New England Journal of Public Policy

The Mary Horrigan Connors Center for Women’s Health and Gender Biology at Brigham and Women’s Hospital in Boston, integrates research, clinical practice, and policy analysis with practical application to emerging women’s health issues. Recently, an interdisciplinary team of practitioners examined pathways to improving women’s heart health. Beginning with the evidence that a heart-healthy diet leads to improved health outcomes for women with cardiovascular disease, the Connors Center team charted a course of intellectual exploration that culminated in a broader community dialogue on how to improve access to healthy and affordable food. Through clinical experiences, research activities, and an ongoing interchange …

Effects Of Residence And Race On Burden Of Travel For Care: Cross Sectional Analysis Of The 2001 Us National Household Travel Survey, Janice C. Probst, Sarah B. Laditka, Jong-Yi Wang, Andrew O. Johnson

Faculty Publications

Background: Travel burden is a key element in conceptualizing geographic access to health care. Prior research has shown that both rural and minority populations bear disproportionate travel burdens. However, many studies are limited to specific types of patient or specific locales. The purpose of our study was to quantify geographic and race-based differences in distance traveled and time spent in travel for medical/dental care using representative national data.

Methods: Data were drawn from 2001 National Household Travel Survey (NHTS), a nationally representative, cross-sectional household survey conducted by the US Department of Transportation. Participants recorded all travel on a designated day; …

Condition Reporting And Resolution, J. M. Pesek, S. A. Wade

Publications (YM)

This procedure facilitates a safety conscious work environment by providing a mechanism for employees to make management aware of existing and potential conditions. This procedure establishes the responsibilities and process to be used to ensure that conditions related to, but not limited to, the environment, safety, health, waste isolation, operations, security, or quality of items and services associated with Office of Civilian Radioactive Waste Management (OCRWM) work activities are promptly identified, controlled, evaluated, and corrected as soon as practical. This procedure describes the process flow, controls, interfaces, and requirements for condition identification and resolution. This includes adverse conditions as well …