Medicine and Health Sciences Commons^™

Analytic Approaches For Causal Inferences With Complex Multi-Component Interventions: Project Achieve's Study Of Managing Care Transitions, Glen P. Mays

Glen Mays

Estimating the causal effects of complex, multi-component health interventions is a task with many challenges in measurement and methodology. This presentation profiles the methods being used as part of the PCORI-funded Project Achieve, a national study to estimate the comparative effectiveness of heterogeneous care transition programs designed to help hospitalized patients and their caregivers navigate care delivery systems effectively and return back to the community with optimal health and wellbeing.

The National Health Security Preparedness Index: Harnessing Evidence & Experience To Drive Improvement, Glen P. Mays

Glen Mays

This presentation profiles the National Health Security Preparedness Index as a mechanism for measuring preparedness and resiliency levels across the U.S. Forthcoming enhancements in measurement and analytic methodologies will allow the Index to play heightened roles in informing policies and practices that protect the U.S. population from a broad range of hazards.

Orientation To The National Health Security Preparedness Index, Glen P. Mays, Anna Goodman Hoover, Michael Childress

Glen Mays

Refining the measures and methodologies used within the National Health Security Preparedness Index will allow users to make more meaningful comparisons of preparedness levels across U.S. geographic areas and to assess changes in preparedness over time.

Public Act 231 Of 2008: Proposed Policy Reform To Address The Ever-Increasing Obesity Rates In Michigan, Rachele M. Hendricks-Sturrup

Rachele M Hendricks-Sturrup

In order to address the growing problem of obesity in the state of Michigan, Michigan implemented Public Act 231 of 2008 (Senate Bill 294, Amendment to the Commercial Rehabilitation Act) (hereinafter referred to as “Public Act 231”). Public Act 231 introduces a property tax incentive that seeks to increase access to affordable, healthful foods in rural and low-income urban areas (S. 294, 2008). Given recent facts stating that obesity rates in Michigan have steadily increased between years 2008-2013, it is apparent that the tax incentive under Public Act 231 has had very little impact in effectively tackling the obesity problem …

Community Health Worker Interventions For Latinos With Type 2 Diabetes: A Systematic Review Of Randomized Controlled Trials, Tariana V. Little, Monica L. Wang, Eida M. Castro, Julio Jiménez, Milagros C. Rosal

Tariana V. Little

This systematic review aimed to synthesize glucose (HbA1c) outcomes of community health worker (CHW)-delivered interventions for Latinos with type 2 diabetes that were tested in randomized controlled trials and to summarize characteristics of the targeted populations and interventions, including the background, training, and supervision of the CHWs. Searches of PubMed and Google Scholar databases and references from selected articles identified 12 studies that met the inclusion criteria. Of these, seven reported statistically significant improvements in HbA1c. Study participants were largely low-income, female, and Spanish-speaking and had uncontrolled diabetes. The CHWs led the interventions alone, in pairs, or as part of …

Is Food Marketing Making Us Fat? Fat Cats Vs Dogmatists., Stephen S. Holden

Stephen S Holden

For many, it seems obvious that food marketing is making us fat. The anger and outrage that was once evoked by tobacco companies is now being repackaged and aimed at ‘Big Food’ (Hennessy, 2014). But is it justified, is food marketing the cause of obesity? And in any case, does outrage and dogmatism help solve the problem? This paper suggests that blaming the marketers, both Big Food and "lazy leisure", is a disputable claim, and dangerously shifts responsibility from individuals to external agents.

How Will Public Health And Primary Care Come Together In Massachusetts?

Javier Crespo

The Patient Protection and Affordable Care Act aims to place public health and prevention practice closer to the clinical care delivery system by mandating basic preventive services and creating a national prevention plan. The Massachusetts health care system has a number of elements that can help foster closer linking of public health practices in the primary care setting. This research set out to examine whether the current healthcare system in Massachusetts will enable public health and primary care integration as intimated upon by the Affordable Care Act. This study will assess the current connection between public health and primary care …

The Qigong And Quality Of Life Trial: Implications For Women In Cancer Survivorship Phase, Siew Yim Loh Assoc Prof

Siew Yim Loh

Background: Qigong is widely acknowledged by Asian breast cancer survivors as a potent health-promoting physical activity. This study investigated the hypothesis that quality of life (QoL) in the Qigong group is better than the placebo (aerobic) or usual care group. Methods: 197 participants were randomly assigned to either the 8-week Qigong, Placebo or Usual care (control) group. Measurement taken at baseline and post-intervention included QoL, distress and fatigue. Analysis of Covariance (ANCOVA) and Kruskal Wallis were used to examine for differences between groups of the measurements. Results: 95 consented participants completed the 8 week trial. The adherence rate for Qigong …

Text 4 Health: Addressing Consumer Health Information Needs Via Text Reference Service, Van M. Ta Park

Van M. Ta Park

This study seeks to provide empirical evidence about how health-related questions are answered in text reference service in order to further the understanding of how to best use texting as a reference service venue to fulfill people’s health information needs. Two hundred health reference transactions from My Info Quest, the first nation-wide collaborative text reference service, were analyzed identify the types of questions, length of transactions, question-answering behavior, and information sources used in the transactions. Findings indicate that texting-based health reference transactions are usually brief, and cover a wide variety of topics. The most popular questions are those seeking general …

Providing Pathways To Coverage: A Case-Evaluation Of The Outreach And Enrollment Model At A Federally Qualified Health Center Network In South Central Florida., Jodi Ray, Margeaux A. Chavez

Margeaux A Chavez

Objectives: Assess the outreach and enrollment strategies implemented by Florida Community Health Centers, Inc. (FCHC) to enroll eligible but not insured community members in Medicaid and other benefits programs.

Methods: Researchers conducted semi-structured interviews with 24 staff members and patients, conducted ethnographic observations, administered a short staff survey, and collected outreach related print materials for analysis. FCHC, Inc. provided enrollment numbers to compliment qualitative interview data about the program’s impact. Data were analyzed using Atlas.ti.

Results: Results suggest that FCHC’s outreach and enrollment model increases healthcare access for eligible, low-income and hard-to-reach patients in their service area who face barriers …

Environmental, Human, And Socioeconomic Characteristics Of Pedestrian Injury And Death In Las Vegas, Nv, Courtney Coughenour, Jennifer Pharr, Tim Bungum

Courtney Coughenour

No abstract provided.

Harnessing The Power Of Public Health Systems For Injury Prevention And Control, Glen P. Mays

Glen Mays

Efforts to improve population health hinge on a vast yet diffuse constellation of government agencies, health care providers, and community organizations that assume responsibilities in implementing prevention programs and policies across the U.S. Realizing the full health and economic benefits of injury prevention and control initiatives requires mobilizing and managing these complex and heterogeneous public health delivery systems. This session will explore the emerging science of public health delivery systems and what it tells us about improving injury prevention and control amid policy and economic change.

Decline In Health For Older Adults: Five-Year Change In 13 Key Measures Of Standardized Health, Paula Diehr, Stephen Thielke, Anne Newman

Paula Diehr

BACKGROUND: The health of older adults declines over time, but there are many ways of measuring health. It is unclear whether all health measures decline at the same rate or whether some aspects of health are less sensitive to aging than others. METHODS: We compared the decline in 13 measures of physical, mental, and functional health from the Cardiovascular Health Study: hospitalization, bed days, cognition, extremity strength, feelings about life as a whole, satisfaction with the purpose of life, self-rated health, depression, digit symbol substitution test, grip strength, activities of daily living, instrumental activities of daily living, and gait speed. …

An Assessment Of The Effects Of Desertification In Yobe State, Nigeria, Jibril Musa Phd

Confluence Journal Environmental Studies (CJES), Kogi State University, Nigeria

Desertification is one of the most serious environmental and socio-economic problems of our time. Desertification describes circumstances of land degradation in arid, semi-arid and dry sub-humid regions resulting from the climatic variation and human activities. The fundamental goal of this thesis was to assess the effects of desertification in Yobe State, Nigeria. The present threat of desertification in the sahel has reached an alarming stage where crops cultivation and animal rearing/grazing are no more productive, soil has lost its nutrient/fertility, various infrastructure had given way because of windstorm from the neighbouring Niger Republic and sand dunes had taken over. The …

Using Remote Sensing Data To Improve Rice Production In Kutigi, Niger State, Nigeria, Jibril Musa Phd, M B. Yunusa

Confluence Journal Environmental Studies (CJES), Kogi State University, Nigeria

This research work looked in the used of Remote Sensing to improve Agricultural production in Kutigi, Niger State. The aim of the study is to use remote sensing to improve rice farming activities in Kutigi, Niger State. It is very important to identify such methods to improve Agricultural production because experts are always interested in new researches and findings to better the standard of living in any environment. In view of this, Remotely-sensed data could be used or employed to elevate most of these agricultural problems in Kutigi through the following objectives: Using Landsat imagery to assess the present landuse …

Variations In Climatic Parameters And Food Crop Yields: Implications On Food Security In Benue State, Nigeria., Emmanuel Adamgbe, Fanan Ujoh

Confluence Journal Environmental Studies (CJES), Kogi State University, Nigeria

Agricultural production in Nigeria like in other developing countries is highly vulnerable to variations in climatic parameters which may have inverse or direct effect on the performance of food crops. This paper examines the patterns and trends of the variations in the climatic parameters and the implications of such variations on efficient yield rates of some food crops in Benue State using data on climatic variables (rainfall, temperature, sunshine) and the yield of some crops per hectare for 25 years (1986-2010). Data on the climatic variables were collected from the Nigerian Meteorological Agency, AirForce Base, Makurdi while the data on …

Timing And Risk Factors Associated With Relapse Among Smokers Attempting To Quit In Malaysia, Retneswari Masilamani

Retneswari Masilamani

BACKGROUND: Many smokers attempt to quit smoking, but very few succeed. OBJECTIVE: To identify the timing and risk factors involved in smoking relapse. METHODS: We conducted a prospective cohort study among staff in two public universities in Malaysia. Behavioural therapy with free nicotine replacement therapy was given as treatment. Participants were followed up for 6 months. Relapse was defined as returning to smoking after having quit for at least 24 h. RESULTS: Of 185 smokers who volunteered to participate, 120 achieved at least 24-h abstinence, and 80% of these relapsed within 2 months. Compared to participants who attended a single …

Designing An Information-Experience Using Creativity Science & Tools, Stephanie Belhomme

Stephanie Belhomme

An “information-experience” encapsulated by a technological/digital audio-visual tool presents data and potentially meaningful information to prompt actionable knowledge concerning: “unspoken creative process elements;” their profound impacts on both how well our “physiology of creativity” functions but also; how well foundational creative thinking and behavioral prerequisites (energy, motivation, imagination, and ownership) are leveraged.

The product: 1) introduces the user to one component of the CPS (Creative Problem Solving) Facilitation Process - Exploring the Challenge; 2) features a content specific component which prompts exploration of the many correlations between societal, organizational / community, human physiological / behavioral data, and the direct relationships …

Dynamics Of Land Use/Land Cover Changes And Its Implication On Food Security In Anyigba, North Central, Nigeria, Tokula E. Arome, Sunday P. Ejaro (Phd)

Confluence Journal Environmental Studies (CJES), Kogi State University, Nigeria

This study assessed land use/land cover changes and its effect on Agricultural land in Anyigba. The objectives were to identify and delineate different land use / land cover categories, assess the rate of change that occurred and examine the impact of land use/land cover change on food security using satellite remote sensing data collected at three different years (1987 Land sat TM, 2001 Land Sat TM and 2011 Land Sat ETM). The study utilized GIS software such as Idrisi Andes academic and ArcGIS 9.3. The study area covers approximately 31.8km2, and four major land use/cover classes were utilized (built up, …

La Comercialización De Cigarrillos En Colombia Y El “Problema Del Autocontrol”: La Restricción De Venta Al Menudeo, Daniel Monroy

Daniel A Monroy C

La “Teoría de la Adicción Racional” y el denominado “Modelo de Inconsistencia Temporal de la Adicción” son los enfoques teóricos dominantes en la economía que tratan de explicar la dinámica del consumo de cigarrillo entendido este como un producto que genera adicción. Aunque la estructura de estos dos enfoques son ciertamente similares, las implicaciones de utilizar uno u otro modelo son bien diferentes, particularmente en lo relativo al criterio normativo relativo a la intervención del Estado respecto de la conducta individual en el mercado. El artículo se concentra en el segundo enfoque indicado, particularmente en el denominado “problema de autocontrol” …

Bridging The Gap Between Lady Health Workers And Traditional Birth Attendants For Reducing Maternal Mortality In Rural Pakistan, Anushka Aqil

Anushka Aqil

Background A woman’s social status affects her mortality; Pakistani women have one of the highest maternal mortality rates in the world. Due to rural and urban divides along with difficulties in access to health services, it is not surprising that maternal health of rural Pakistani women suffers greatly. In fact, 82.5% of all hospital beds exist in urban hospitals, while 70% of the population lives in rural areas. In this context, the role of the Lady Health Worker (LHW) and traditional birth attendants (TBAs) become crucial for providing health promotion and delivery services, respectively. However, there are tensions between these …

Brazilian Longitudinal Study Of Adult Health (Elsa-Brasil): Objectives And Design., Paulo A. Lotufo

Paulo A Lotufo

The Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) aims to contribute relevant information with respect to the development and progression of clinical and subclinical chronic diseases, particularly cardiovascular diseases and diabetes. In this report, the authors delineate the study's objectives, principal methodological features, and timeline. At baseline, ELSA-Brasil enrolled 15,105 civil servants from 5 universities and 1 research institute. The baseline examination (2008-2010) included detailed interviews, clinical and anthropometric examinations, an oral glucose tolerance test, overnight urine collection, a 12-lead resting electrocardiogram, measurement of carotid intima-media thickness, echocardiography, measurement of pulse wave velocity, hepatic ultrasonography, retinal fundus photography, and an …

Socio-Economic Effects Of Demolishing Squatter Settlements And Illegal Structures In Abuja Metropolis, Federal Capital Territory, Nigeria, Ishaku Iy Mallo Phd, Victor G. Obasanya

Confluence Journal Environmental Studies (CJES), Kogi State University, Nigeria

Abuja the Federal Capital Territory and study area is located between latitudes 8o25’ and 9o25’ North of the Equator and longitudes 6o45’ and 7o45’ East of the Greenwich Meridian. The study was carried out in Abuja Phase 1, and it is aimed at highlighting various socioeconomic effects of demolition of illegal structures and informal or squatter settlements on the people within the study area. Data was collected through reconnaissance survey, personal interviews with respondents, and a well laid out questionnaire. The results indicate that the demolition exercise embarked upon by the authorities in the Federal Capital Territory was a response …

Rainfall Variability And Crop Zones Classification For The Federal Capital Territory, Nigeria, Shaibu M. Hassan Phd

Confluence Journal Environmental Studies (CJES), Kogi State University, Nigeria

This study aims at analyzing agro-climatological parameters and establishing a link between some selected agro-climatological indices and sustainability of agricultural production in the Federal Capital Territory (FCT). Two sets of data, climatic and crop yield data were collected and subjected to various agro-climatological analyses. Agro-climatological analyses include the derivation of Onset, Cessation and Length of Rainy Season (LRS), Seasonality Index, Drought Index and Precipitation Periodicity Index. The statistical analyses include monthly and annual means, deviation from the mean, trend line. The result of moisture index in line with crops optimum moisture requirement was used to classify the Territory into agro-climatic …

Prevalence And Correlates Of Low Fundamental Movement Skill Competency Inchildren, Louise L. Hardy Dr

Louise L Hardy Dr

No abstract provided.

Weight Status And Weight-Related Behaviors Of Children Commencing School, Louise L. Hardy Dr

Louise L Hardy Dr

No abstract provided.

A Reappraisal In São Paulo, Brazil (2008) Of "The Ecology Of Medical Care:" The "One Per Thousand's Rule"., Adriana Roncoletta, Gustavo D. Gusso, Isabela M. Bensenor, Paulo A. Lotufo

Paulo A Lotufo

This paper reassessed in Brazil, the concept of "Medical ecology" i introduced in 1961 to describe the relationship and utilization of health care services by a given population. This was a cross-sectional telephone survey among a random sample of people enrolled in a private HMO. We interviewed a random sample of non-pregnant adults over age 18 using 10 questions about symptoms and health care use during the month prior to interview. The final sample consisted of 1,065 participants (mean age 68 years, 68% female). From this sample, 424 (39.8%) reported the presence of symptoms, 311 (29.2%) had a medical office …

Hypothyroidism In The Elderly, Paulo A. Lotufo

Paulo A Lotufo

An overview adressing observational and randomized clinical trials about hypothyroidism in the elderly.

Chronic Non-Communicable Diseases In Brazil: Priorities For Disease Management And Research, Bruce B. Duncan, Dora Chor, Estela M. Aquino, Isabela M. Bensenor, J.Geraldo Mill, M.Ines Schmidt, Paulo A. Lotufo, Alvaro Vigo, Sandhi M. Barreto

Paulo A Lotufo

Chronic Non-Communicable Diseases are the main source of disease burden in Brazil. In 2011, the Brazilian Ministry of Health launched the Strategic Plan of Action for Management of Chronic Non-Communicable Diseases focusing on population-based interventions to manage cardiovascular diseases, diabetes, cancer, and chronic respiratory diseases mainly through fi ghting tobacco use, unhealthy diets, physical inactivity and the harmful use of alcohol. Although a signifi cant number of scientifi c studies on chronic diseases and their risk factors have been undertaken in Brazil, few are of cohort design. In this context, the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil), a cohort …

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 …