Medicine and Health Sciences Commons^™

The Effectiveness Of Needle Exchange Programs In The United States And West Virginia, Margie J. Phillips, Alberto Coustasse, Sara Johnson, Briana Washington

Alberto Coustasse, DrPH, MD, MBA, MPH

Needle Exchange Programs (NEPs) have been controversial aspects of public health care due to conflicting beliefs and opinions for public policies. NEPs have allowed Injection Drug Users the ability to exchange their used equipment for clean, unused supplies. Research into the effectiveness of needle exchange programs and the impact it has had on the reduction of HIV and viral hepatitis infections in people who inject drugs. Injection Drug Users have accounted for 10% of HIV transmission cases in West Virginia, and this state has been ranked as the highest in the whole United States for incidents of Hepatitis C. NEPs …

The Effectiveness Of Needle Exchange Programs In The United States And West Virginia, Margie J. Phillips

Margie J. Phillips

Needle Exchange Programs (NEPs) have been controversial aspects of public health care due to conflicting beliefs and opinions for public policies. NEPs have allowed Injection Drug Users the ability to exchange their used equipment for clean, unused supplies. Research into the effectiveness of needle exchange programs and the impact it has had on the reduction of HIV and viral hepatitis infections in people who inject drugs. Injection Drug Users have accounted for 10% of HIV transmission cases in West Virginia, and this state has been ranked as the highest in the whole United States for incidents of Hepatitis C. NEPs …

The Emerging Issue Of Hepatitis C Virus In The United States And In West Virginia, Alberto Coustasse Dr.Ph. Md,Mba, Mph, Maggie Phillips Rn, Bsn, Mha, Jumana Abboud Mha, Neha Botre Mha, David P. Paul Iii

Alberto Coustasse, DrPH, MD, MBA, MPH

Introduction:

Hepatitis C virus (HCV) is one of the most significant public health problems currently facing the U.S., Especially in West Virginia. If it is undetected and left untreated, the likelihood of sustaining a treatment response decreases. While early identification has been identified as a critical focus in trying to obtain better health outcomes, new drug treatments appear promising, although somewhat expensive. West Virginia, a predominantly rural state, is beginning to face a mounting financial crisis due to HCV.

Purpose of the Study:

The purpose of this study was to examine the effects of early identification and treatment for patients …

Ethnic Differences In Risk Factors For Obesity Among Adults In California, The United States, Liang Wang, Jodi L. Southerland, Kesheng Wang, Beth A. Bailey, Arsham Alamian, Marc A. Stevens, Youfa Want

Arsham Alamian

Little attention has been given to differences in obesity risk factors by racial/ethnic groups. Using data from the 2011-2012 California Health Interview Survey, we examined differences in risk factors for obesity among Whites, Latinos, Asians, and African Americans among 42,935 adults (24.8% obese). Estimates were weighted to ensure an unbiased representation of the Californian population. Multiple logistic and linear regression analyses were used to examine the differences in risk factors for obesity. Large ethnic disparities were found in obesity prevalence: Whites (22.0%), Latinos (33.6%), African Americans (36.1%), and Asians (9.8%). Differences in risk factors for obesity were also observed: Whites …

Influence Of Sense Of Coherence, Spirituality, Social Support And Health Perception On Breast Cancer Screening Motivation And Behaviors In African American Women, Regina Conway-Phillips, Linda W. Janusek

Regina Conway-Phillips

Despite formidable barriers, some African American women (AAW) engage in breast cancer screening (BCS) behaviors. Understanding individual characteristics that allow AAW to overcome barriers to BCS is critical to reduce breast cancer mortality among AAW. A salutogenic model of health was used to evaluate the influence of sense of coherence, social support, spirituality and health perception on BCS motivation and behaviors in AAW, and to determine differences in these factors in AAW who participate in free BCS programs compared to AAW who do not. Findings revealed that greater levels of spirituality were significantly associated with greater motivation to practice BCS. …

Measuring Nurse Caring Behaviors In The Acute Hospitalized Geriatric Patient, Susan A. Goncalves

Susan A. Goncalves

The number of older adults in the United States is increasing substantially with the highest impact of the baby boomers phenomenon turning 65 in the year 2011, and the number projected to keep growing until the year 2030. The rapid growth of older adults inherently requires expert physicians and nurses to care for this population. The art of simple basic communication between the nurse and patient is essential to nursing.

Successful Aging In The United States And China : A Theoretical Basis To Guide Nursing Research, Practice, And Policy., Valerie Lander Mccarthy, Hong Ji, Jiying Ling

Valerie L. McCarthy

Successful aging is an idea gaining increasing attention given the exponential growth in the older adult population. Criteria and definitions within multiple disciplines vary greatly in Western literature, with no consensus on its meaning. Moreover, sociocultural, economic and political differences between the Western view of successful aging and its use in China – with the world’s largest older adult population – add to the confusion. Similarities and differences in the meaning of successful aging in the United States and China are examined and the potential for a common definition that is useful to nursing in both countries is explored. Using …

Hospitalist Involvement In Family Medicine Residency Training: A Cera Study, Robert A. Baldor, Judith A. Savageau, Navkiran Shokar, Stacy E. Potts, Joseph Gravel Jr., Kimberly Eisenstock, James Ledwith

Judith A. Savageau

BACKGROUND AND OBJECTIVES: Little is known about the impact of hospitalists on family medicine residencies. We surveyed family medicine residency directors to assess attitudes about hospitalists and their involvement in residency teaching.

METHODS: Questions were included in the 2012 Council of Academic Family Medicine Educational Research Alliance (CERA) survey of family medicine residency directors. Univariate statistics were used to describe programs, directors, and our questions on the use of hospitalists. Bivariate statistics were used to examine relationships between the use of hospitalists to teach and program characteristics.

RESULTS: Forty-one percent (n=175) of residency directors completed the hospitalist section of the …

Postoperative Glycemic Variability In Diabetic And Non Diabetic Patients, Boris Mraovic, Md, Brian Hipszer, Md, Zvi Grunwald, Md, David Gratch, Do, Charles J. Yeo, Md, Jennifer Lessin, Rn, Kathleen O'Malley, Rn, Angela Gulino, Md, Peter Simpson, Meng, Jeffrey Joseph

David Gratch, DO

Objectives: Glycemic variability increases oxidative stress and may trigger the inflammation and coagulation cascades. Variability may be associated with increase morbidity and mortality in ICU patients. We analyzed glycemic variability after major surgery in diabetic (DM) and non-diabetic (NDM) patients using an automated intravenous blood glucose monitor (IVBG).

A Comparison Of Pharmacist Travel-Health Specialists' Versus Primary Care Providers' Recommendations For Travel-Related Medications, Vaccinations, And Patient Compliance In A College Health Setting, Melissa J. Durham, Jeffery A. Goad, Lawrence S. Neinstein, Mimi Lou

Jeff Goad

Background. Pretravel medication and vaccination recommendations and receipt were compared between primary care providers (PCPs) without special training and clinical pharmacists specializing in pretravel health. Methods. A retrospective chart review of patients seen for pretravel health services in a pharmacist-run travel clinic (PTC) compared to PCPs at a University Student Health Center. Vaccine/medication recommendations were assessed for consistency with national/international guidelines. Medical/pharmacy records were queried to determine the receipt of medications/vaccinations. Results. The PTC recommended antibiotics for travelers' diarrhea were given more often when indicated (96% vs 50%, p < 0.0001), and patients seen in the PTC received their medications more …

Prenatal Oral Health Education In U.S. Dental Schools And Obstetrics And Gynecology Residencies, Megan Curtis, Hugh Silk, Judith A. Savageau

Judith A. Savageau

Prenatal oral health (POH) is an important health issue, but dental and obstetrical clinicians are not meeting the oral health needs of pregnant patients. This study evaluates how training contributes to this paradox with a national survey of sixty dental school deans and 240 obstetrics and gynecology residency program directors. Response rates were 53 percent and 40 percent for deans and program directors, respectively. According to the respondents, 94 percent of responding dental schools provided POH education, only 39 percent of responding residencies taught POH, and 65 percent of responding deans and 45 percent of responding program directors were aware …

Friends Of Nursing: A Community Of Caring To Promote Excellence In Nursing Practice, Education, And Research, Kim S. Hitchings Msn, Rn, Nea-Bc, Terry Capuano Rn, Svp, Clinical Services, Mary Ellen Herzog Med, Cfre, Cgms

Terry A Capuano MBA, MSN, RN, FACHE, NE-BC

More than 25 years ago, the name "Friends of Nursing" was adopted by an academic, community Magnet(®) hospital to signify a model for community support of nursing. From inception, the intent was to recruit philanthropic dollars to promote recognition of and excellence in nursing practice, education, and research. Although philanthropy in health care settings is common, what is unique about this program is the long-standing, dedicated conceptual framework for nursing philanthropy and the very significant number of philanthropic dollars from literally thousands of donors to support a diverse range of activities to affect and advance the professional excellence of nurses …

Initial Multicenter Experience With Double Nucleoside Therapy For Human Immunodeficiency Virus Infection During Pregnancy, Neal S. Silverman, D. Heather Watts, Joseph Hitti, D. M. Money, E. Livingston, J. Axelrod, J. M. Ernest, Douglas Robbins, M. M. Divito

Neal Silverman

OBJECTIVE: To study maternal and neonatal effects of combination nucleoside analog therapy administered to human immunodeficiency virus (HIV)-infected pregnant women for maternal indications. METHODS: A multicenter, prospective observational study was undertaken at six perinatal centers in the United States and Canada that supported regional referral programs for the treatment of HIV-infected pregnant women. Demographic, laboratory, and pregnancy outcome data were collected for 39 women whose antiretroviral treatment regimens were expanded to include more than one nucleoside analog for maternal indications. The 40 newborns were monitored at pediatric referral centers through at least three months of age to ascertain their HIV …

Analysis United Kingdom And United States Healthcare, Joyce K. Kutin

Joyce K Kutin RN, MSN, MOL

United Kingdom and the United States are two dissimilar health systems each having uniquely differing focuses, where the primary differences are a parliamentary verses a republic government application toward the socioeconomic requirements of the populace. The United Kingdom’s National Health Service interprets health care as a public service rather than the commodity. The United States healthcare system is riddled with disparities regarding quality, access and cost. The socioeconomic poor and or homeless are less likely to utilize the healthcare system when compared to others who are more fortunate. Health care systems are facing the same challenges around the world with …

Clopidogrel Hypersensitivity: Clinical Challenges And Options For Management., Kimberly L Campbell, John R Cohn, Michael P Savage

Michael P Savage M.D.

Over 90 million patients have been prescribed clopidogrel since its US FDA approval in 1997. Clopidogrel hypersensitivity affects up to 6% of patients, most commonly in the form of a pruritic rash. Symptoms are severe enough to result in drug discontinuation in 1.5% of patients. Premature discontinuation of clopidogrel is problematic following percutaneous coronary intervention because of the risk of stent thrombosis leading to myocardial infarction and death. Accordingly, the management of patients with clopidogrel hypersensitivity is of significant clinical importance. Conventional clopidogrel desensitization protocols, while successful in most patients, employ a washout period off medication to enable accurate detection …

A Compact Guide To The Diagnosis And Management Of Neurofibromatosis Type 1, Timothy Beer, David Strayer, Md, Phd

Timothy C Beer

Brief Introduction Neurofibromatosis type 1 (NF-1) is a multisystem neurocutaneous disorder resulting from mutations in the NF-1 gene on chromosome 17 (q11.2). Mutations in NF-1 result in deficient activity of the tumor suppresor protein neurofibromin, allowing for uncontrolled constitutive activity of the proliferative Raspathway in several neural cell types, including neurons, oligodendrocytes, astrocytes and Schawnn cells. Half of NF-1 cases are inherited in autosomal dominant fashion, while half develop sporadically. The syndrome has 100% penetrance but highly variable expressivity. The prevalence of this syndrome is 1/3,000, making it common enough to warrant YOU, the physician, taking a moment to learn …

Neighborhood Socioeconomic Deprivation And Mortality: Nih-Aarp Diet And Health Study, Jacqueline M. Major, Chyke A. Doubeni, Neal D. Freedman, Yikyung Park, Min Lian, Albert R. Hollenbeck, Arthur Schatzkin, Barry I. Graubard, Rashmi Sinha

Chyke A. Doubeni

PURPOSE: Residing in deprived areas may increase risk of mortality beyond that explained by a person's own SES-related factors and lifestyle. The aim of this study was to examine the relation between neighborhood socioeconomic deprivation and all-cause, cancer- and cardiovascular disease (CVD)-specific mortality for men and women after accounting for education and other important person-level risk factors. METHODS: In the longitudinal NIH-AARP Study, we analyzed data from healthy participants, ages 50-71 years at study baseline (1995-1996). Deaths (n = 33831) were identified through December 2005. Information on census tracts was obtained from the 2000 US Census. Cox models estimated hazard …

The Clinical Gaze In The Practice Of Migrant Health: Indigenous Mexican Migrants In The United States, Seth M. Holmes Phd, Md

Seth M. Holmes PhD, MD

This paper utilizes eighteen months of ethnographic and interview research undertaken in 2003 and 2004 as well as follow-up fieldwork from 2005 to 2007 to explore the sociocultural factors affecting the interactions and barriers between U.S. biomedical professionals and their unauthorized Mexican migrant patients. The participants include unauthorized indigenous Triqui migrants along a transnational circuit from the mountains of Oaxaca, Mexico, to central California, to northwest Washington State and the physicians and nurses staffing the clinics serving Triqui people in these locations. The data show that social and economic structures in health care and subtle cultural factors in biomedicine keep …

Bapcap2-1 Does Preoperative Aspirin Improve Outcomes In Cardiac Surgery Patients?, Jian-Zhong Sun, L. Cao, H. Liu, W. Sun, S Silvestry, J. Diehl

Hua Kun Liu

Best Abstracts - Runner-up Session 2 presented at Euroanaesthesia 2011 in the Netherlands.

Background and Goal of Study: The effects of preoperative aspirin on major cardiocerebral and renal outcomes and mortality remain uncertain.

Challenges And Opportunities For Medical Institutional Repositories, Dan Kipnis, Msi, Ann E. Koopman, Am, Lisa Palmer, Msls, Ahip

Lisa A. Palmer

Description Thomas Jefferson University Library and University of Massachusetts Medical School Library have two important things in common: successful institutional repositories and experienced library leaders that developed them. Please join Dan Kipnis and Ann Koopman of Thomas Jefferson University, and Lisa Palmer of University of Massachusetts Medical School for a free webinar on institutional repositories (IRs) at medical schools. Speakers will explore how each organization decided to start an IR, how the IRs have evolved, unique IR collections, successful partnerships, challenges and opportunities, and the future of medical IRs.

In Vitro And In Vivo Models Of Acute Alcohol Exposure, Angela Dolganiuc, Gyongyi Szabo

Gyongyi Szabo

Alcohol abuse is a global problem due to the financial burden on society and the healthcare system. While the harmful health effects of chronic alcohol abuse are well established, more recent data suggest that acute alcohol consumption also affects human wellbeing. Thus, there is a need for research models in order to fully understand the effect of acute alcohol abuse on different body systems and organs. The present manuscript summarizes the interdisciplinary advantages and disadvantages of currently available human and non-human models of acute alcohol abuse, and identifies their suitability for biomedical research.

The Effect Of A Global Multiculturalism Track On Cultural Competence Of Preclinical Medical Students, Michael A. Godkin, Judith A. Savageau

Judith A. Savageau

BACKGROUND: We evaluated the effect of an elective (the Global Multiculturalism Track), including international and domestic immersion experiences, on the cultural competence of preclinical medical students. METHODS: A self-assessment instrument was used to measure cultural competence, and it was administered to Track participants and nonparticipating class cohorts at the beginning and the end of the preclinical years. RESULTS: Track participants (n=26) had a higher level of cultural competence both at the beginning and at the end of the program. At the end of their second year, students participating in the Track had, for the first time, greater knowledge of certain …

Chronic Disease Medication Use In Managed Care And Indemnity Insurance Plans, Randall S. Stafford, Stephen M. Davidson, Harriet Davidson, Heidi Miracle-Mcmahill, Sybil L. Crawford, David Blumenthal

Sybil L. Crawford

OBJECTIVE: To evaluate the impact of managed care on the use of chronic disease medications. DATA SOURCE: Claims data from 1997 from two indemnity and three independent practice association (IPA) model managed care insurance plans. RESEARCH DESIGN: Cross-sectional analysis of claims data. DATA COLLECTION: Adult patients with diabetes mellitus (DM, n = 26,444), congestive heart failure (CHF, n = 7,978), and asthma (n = 9,850) were identified by ICD-9 codes. Chronic disease medication use was defined through pharmacy claims for patients receiving one or more prescriptions for drugs used in treating these conditions. Using multiple logistic regression we adjusted for …

Health Hazards Manual For Autobody Shop Workers, Nellie J. Brown

Nellie J. Brown, MS., C.I.H.

[Excerpt] We will look at the principal occupational health hazards and exposures themselves and some of the related issues. We will look closely at the chemical composition of autobody shop products to see what components appear to be particularly hazardous, how you are exposed to them, and what you can do to minimize exposure. The health effects discussed for these products are based upon the exposure of the professional, not the consumer. This manual deals with chemical exposure only; other issues of interest to the autobody shop worker may include occupational exposure to noise and neuromuscular problems such as Raynaud’s …

Obesity And Diabetes In Vulnerable Populations: Reflection On Proximal And Distal Causes, Lucy M. Candib

Lucy M. Candib

Around the world obesity and diabetes are climbing to epidemic proportion, even in countries previously characterized by scarcity. Likewise, people from low-income and minority communities, as well as immigrants from the developing world, increasingly visit physicians in North America with obesity, metabolic syndrome, or diabetes. Explanations limited to lifestyle factors such as diet and exercise are inadequate to explain the universality of what can be called a syndemic, a complex and widespread phenomenon in population health produced by multiple reinforcing conditions. Underlying the problem are complex factors-genetic, physiological, psychological, familial, social, economic, and political-coalescing to overdetermine these conditions. These interacting …

Parce Qu'ils Sont Plus Pres Sol: L'Invisibilisation De La Souffrance Sociale Des Cueilleurs De Baies, Seth M. Holmes Phd, Md

Seth M. Holmes PhD, MD

No abstract provided.

An Ethnographic Study Of The Social Context Of Migrant Health In The United States, Seth M. Holmes Phd, Md

Seth M. Holmes PhD, MD

Background

Migrant workers in the United States have extremely poor health. This paper aims to identify ways in which the social context of migrant farm workers affects their health and health care.

Methods and Findings

This qualitative study employs participant observation and interviews on farms and in clinics throughout 15 months of migration with a group of indigenous Triqui Mexicans in the western US and Mexico. Study participants include more than 130 farm workers and 30 clinicians. Data are analyzed utilizing grounded theory, accompanied by theories of structural violence, symbolic violence, and the clinical gaze. The study reveals that farm …