Medicine and Health Sciences Commons^™

Primary Health Centres And Patients Satisfaction Level In Haripad Community Development Block Of Kerala, India, Sarath Chandran

SARATH CHANDRAN

The main objectives of the present study were to show the spatial distribution of Primary Health Centres in the Haripad Block of Kerala and to investigate the patients’ perception regarding the services provided by the Primary Health Centres. Spatial distribution of Primary Health centres was shown with the help of GIS mapping. Out of eight Primary Health Centres of the Block, five of them were selected by lottery method of simple random sampling for the present study. A pre designed schedule was used for t tabulated and analysed by using of primary health care services in Haripad The major problems …

A State And Territorial Survey Regarding Utilization Of Environmental Health Shelter Assessments During Disasters, And A Secondary Analysis Of Available Shelter Assessment Data, Miguel A. Cruz

Miguel A. Cruz

Disasters are complex events characterized by damage to key infrastructure and population displacements into disaster shelters. Assessing the living environment in shelters during disasters is a crucial health security concern. Until now, jurisdictional knowledge and preparedness on those assessment methods, or types of deficiencies found in shelters is limited. A cross-sectional survey (STUSA survey) ascertained knowledge and preparedness for those assessments in all 50 states, DC, and 5 US territories. Descriptive analysis of overall knowledge and preparedness was performed. Fisher’s exact statistics analyzed differences between two groups: jurisdiction type and population size. Two logistic regression models analyzed earthquakes and hurricane …

In Search Of Justification For The Unpredictability Paradox, Jeremy Howick, Alexander Mebius

Alexander Mebius

A 2011 Cochrane Review found that adequately randomized trials sometimes revealed larger, sometimes smaller, and often similar effect sizes to inadequately randomized trials. However, they found no average statistically significant difference in effect sizes between the two study types. Yet instead of concluding that adequate randomization had no effect the review authors postulated the “unpredictability paradox”, which states that randomized and non-randomized studies differ, but in an unpredictable direction. However, stipulating the unpredictability paradox is problematic for several reasons: 1) it makes the authors’ conclusion that adequate randomization makes a difference unfalsifiable—if it turned out that adequately randomized trials had …

The Economics Of Implementing Population Health Strategies, Glen P. Mays

Glen Mays

Successful strategies to scale up and spread complex community-level interventions require an understanding of the resources required for implementation, how best to distribute them among supporting institutions, and how resource consumption and distribution varies across settings. This session reviews methods and early findings from the RWJF’s Public Health Delivery and Cost Studies (DACS) Initiative, which includes 12 inter-related studies examining the causes and consequences of variation in the costs of delivering complex community-level prevention strategies across more than 300 community settings in 12 states. Findings from these studies highlight the value of studying the economics of implementation, the measurement and …

Role Of Imaging In Rhinology, Balasubramanian Thiagarajan

Balasubramanian Thiagarajan

This E book discusses the role of imaging in rhinology. Since this book has been authored by an otolaryngologist it goes without saying that a surgeon's perspective will be evident throughout the book. It contains about 250 CT scan images with succinct description.

Opportunities And Future Directions For The National Health Security Preparedness Index, Glen P. Mays

Glen Mays

This presentation examines options and opportunities for future development of the National Health Security Preparedness Index, created through a partnership of national public health and health care organizations led by the U.S. Centers for Disease Control and Prevention (CDC) and the Association of State and Territorial Health Officials (ASTHO).

Video Streaming Application: Image Quality Analysis Of Wireless Ad-Hoc Network Routing Protocols, Innovative Research Publications Irp India, Mr.Thinaharan R Amachandran, Dr.P. Rajamohan, Dr.R Leelavathi

Innovative Research Publications IRP India

Wireless sensor ad-hoc network usually applied in a monitoring system like monitoring temperature, humidity or even any triggering inputs from a connected peripheral device. The approach of wireless ad hoc network for monitoring video data is under preliminary investigation and development because video streaming requires larger storage, quality channel, less jittering and low packet loss. The mobility of IEEE 802.11 in ad-hoc network increases packet loss due to high link breakages. An efficient routing protocol can diagnose, reduce and improves ad-hoc network for video streaming activity. In this paper the Optimized Link State Routing protocol (OLSR), Better Approach To Mobile …

Dynamic Channel Allocation Technique For Distributed Multi-Radio Multichannel Multi-Path Routing Protocol In Wireless Mesh Networks, Innovative Research Publications Irp India, Shreenidhi. P.L, Ranganath H R, Puttamadappa C, Basavaraju T G

Innovative Research Publications IRP India

Wireless Mesh Networks (WMNs) have gained main attraction in providing flexible network services and support to the end users. There are many efforts seen to design robust routing protocol for WMNs and solutions are proposed to standardized channel allocation techniques. There are various approaches dedicated to maximize the network though put and minimize network interface. Existing multi radio multi channel routing protocols utilize only single channel situation and static channel allocation degrades the performance of the WMNs. The challenge is to allocate channel without link interference and to improve end-to-end throughput efficiency in multipath routing for WMNs. In this paper, …

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 …

Evaluation Of The Effect Of Orally Administered Acid Suppressants On Intragastric Ph In Cats, S Parkinson, M Katherine Tolbert, K Messenger, A. Odunayo, M. Brand, G. Davidson, E. Peters, A. Reed, M. G. Papich

M Katherine Tolbert DVM, PhD, DACVIM

Background Acid suppressant drugs are a mainstay of treatment for cats with gastrointestinal erosion and ulceration. However, clinical studies have not been performed to compare the efficacy of commonly PO administered acid suppressants in cats.

Hypothesis/Objectives To compare the effect of PO administered famotidine, fractionated omeprazole tablet (fOT), and omeprazole reformulated paste (ORP) on intragastric pH in cats. We hypothesized that both omeprazole formulations would be superior to famotidine and placebo.

Animals Six healthy adult DSH colony cats.

Methods Utilizing a randomized, 4-way crossover design, cats received 0.88–1.26 mg/kg PO q12h fOT, ORP, famotidine, and placebo (lactose capsules). Intragastric pH …

Background On The Program Management Office For The National Health Security Preparedness Index At The University Of Kentucky, Glen P. Mays

Glen Mays

The University of Kentucky’s National Health Security and Preparedness Index (NHSPI) Program Management Office is a consortium of four of the university’s leading research centers that collaborate in producing, translating, and disseminating data and analyses to mobilize improvements in health and wellbeing: (1) the National Coordinating Center for Public Health Services & Systems Research (PHSSR) within the College of Public Health, (2) the Center for Business and Economic Research (CBER) within the College of Business and Economics; (3) the Division of Risk Sciences within the College of Communication and Information; and (4) the campus-wide Dissemination and Implementation Sciences Consortium (DISC). …

The Dynamics Of Medicaid & Public Health Spending: Implications For Aca Implementation, Glen P. Mays

Glen Mays

We estimate the dynamics and interactions of governmental spending on Medicaid and other public health services in all 50 states over a 15 year period. Using a quasi-experimental design with instrumental variables estimation, we find evidence that increased Medicaid spending leads to reduced governmental spending on other public health services, consistent with a crowd-out effect. Over 10 years, such crowd-out has the potential to diminish the health status improvements generated through health insurance coverage expansions.

Aca Implementation In Kentucky: Experiences Of An Expansion State, Glen P. Mays

Glen Mays

Kentucky's implementation of the Affordable Care Act has included early successes with insurance coverage expansion through Medicaid and a state-operated health insurance exchange. Signals of improvements in health care accessibility and delivery of preventive services are evident in the first year after coverage expansions. Challenges associated with political opposition, delivery system transformation, and public health financing remain on the state's policy agenda.

Geographic Variation In The Delivery Of High-Value Public Health Services:Exploring Causes & Consequences, Glen P. Mays

Glen Mays

OBJECTIVES: A growing body of evidence indicates that the delivery of public health activities varies widely across states and communities, creating missed opportunities for prevention as well as inequities in health protection. Measures of quality in public health are needed to guide public health improvement initiatives and to support research on the comparative effectiveness of alternative public health strategies. The Multi-network Practices and Outcomes Variation Examination Study (MPROVE), uses the infrastructure of six Public Health Practice-Based Research Networks (PBRNs) across the U.S. to develop and validate a “starter set” of measures and to analyze geographic variation delivery across diverse public …

Cost Estimates Of Foundational Public Health Services:Results From Piloting An Expert Consensus Methodology, Cezar B. Mamaril, Glen P. Mays

Glen Mays

We review preliminary estimates from pilot testing a cost estimation methodology developed to identify the resources required to implement a set of Foundational Public Health Services as recommended by the Institute of Medicine and defined by the Public Health Leadership Forum.

Medicaid Expansions & Public Health Spending: Cross-Subsidies, Complementarities, And Crowd-Out, Glen Mays

Glen Mays

In this paper we estimate the causal impact of state Medicaid enrollment expansions and expenditures on state and local resources allocated to other public health programs and services. Using a quasi-experimental design with instrumental variables estimation, we find evidence that increased Medicaid spending leads to reduced governmental spending on other public health services, consistent with a crowd-out effect. Over 10 years, such crowd-out has the potential to diminish the health status improvements generated through health insurance coverage expansions.

Estimating The Costs Of Foundational Public Health Services: Pilot Results Of An Expert Consensus Methodology, Cezar B. Mamaril, Glen P. Mays

Glen Mays

We developed a methodology for estimating the resources required to deliver a set of foundational public health capabilities as recommended in the 2012 Institute of Medicine report on public health financing. The capabilities are based on IOM recommendations and defined by a national expert panel convened as part of the Public Health Leadership Forum. This paper presents preliminary estimates from a pilot test of the cost estimation methodology in Kentucky, and outlines plans for the national estimation strategy.

Optimizing Public Health Systems For Population Health Improvement: Institutions, Economics, And Metrics, Glen P. Mays

Glen Mays

This lecture reviews the evidence concerning the institutional and economic characteristics of public health delivery systems and their impact on population health. Emerging findings from these studies suggest promising pathways for transforming the U.S. public health system in ways that strengthen its effectiveness, efficiency and equity in producing health. .

Comparative Report Of Results From The Multi-Network Practice And Outcome Variation Examination Study (Mprove), Glen P. Mays, Lava Timsina

Glen Mays

This comparative report displays results from the Multi-Network Practice and Outcome Variation Examination (MPROVE) Study. Funded by the Robert Wood Jonhson Foundation and conducted through Public Health Practice-Based Research Networks (PBRNs) in 6 states, this study profiles geographic variation in the implementation of public health activities for chronic disease prevention, communicable disease control, and environmental health protection. The report shown here was customized for each local public health setting participating in the study.

Associations Of Controlling Behavior, Physical And Sexual Violence With Health Symptoms, Tazeen Saeed Ali Dr, Fazal Ather Dr, Aamir Abbas Dr

Tazeen S Ali Dr

Controlling behavior is often manifested as monitoring, coercing or threatening the partner. Globally, it has been experienced by the women (in range of 5.2% to 56.6%) and often results in their physical and mental ill health. To the best of our knowledge there is no published research on controlling behaviors. Therefore, a cross sectional study was conducted to measure the magnitude of the controlling behaviors and its association to some physical stress symptoms of women. The study was conducted in urban settings of Karachi, Pakistan, using simple random sampling technique. The data was collected by trained midwifes from the 759 …

Annual Bibliography Of The National Coordinating Center For Public Health Services & Systems Resesarch, Year Four, Glen P. Mays, Anna G. Hoover, Lizeth Fowler, Ann Kelly

Glen Mays

The National Coordinating Center for Public Health Services and Systems Research (PHSSR), together with the Public Health Practice-Based Research Networks (PBRN) Program, works to expand the production and application of evidence on how best to organize, finance and deliver public health strategies that improve population health. The Center designs and conducts research studies, provides technical assistance and direction for other researchers across the U.S., develops methodological advances in measurement and analysis, and accelerates the translation and dissemination of research findings for policy and practice stakeholders. This report inventories the research products produced during the Center's fourth program year of funding …

Annual Report Of The National Coordinating Center For Public Health Services & Systems Research, Year Four, Glen P. Mays, Anna G. Hoover, Lizeth Fowler, Ann Kelly

Glen Mays

The National Coordinating Center for Public Health Services and Systems Research (PHSSR), together with the Public Health Practice-Based Research Networks (PBRN) Program, works to expand the production and application of evidence on how best to organize, finance and deliver public health strategies that improve population health. The Center designs and conducts research studies, provides technical assistance and direction for other researchers across the U.S., develops methodological advances in measurement and analysis, and accelerates the translation and dissemination of research findings for policy and practice stakeholders. This report summarizes activities completed during the Center's fourth program year of funding from the …

Value And Cost-Effectivess Of Community Health Worker Programs: Implications For Home Care Workers, Glen P. Mays

Glen Mays

This presentation reviews studies on the health and economic value of strategies to improve the coordination of medical care, public health, and social support services for high-need and high-risk populations. Community health worker (CHW) programs feature prominently in these strategies, particularly for rural and low-resource community settings. Home care workers have the potential to function as CHWs in many settings, and as such present powerful opportunities for scaling up CHW programs that connect medical care, public health, and social services delivery.

Block Scheduling Social Skills Groups: An Intensive And Inclusive Model, Jennifer K. Schoffer Closson, Anisa Goforth

Jennifer K Schoffer Closson

This intensive model for providing social skills intervention suggests using block scheduling. This model allows for direct instruction as well as coaching in the inclusive environment. It also strongly suggests a team approach for facilitation.

Animal Models And Therapeutic Molecular Targets Of Cancer: Utility And Limitations., Maria Cekanova Ms, Rndr, Phd, Kusum Rathore

Maria Cekanova MS, RNDr, PhD

Cancer is the term used to describe over 100 diseases that share several common hallmarks. Despite prevention, early detection, and novel therapies, cancer is still the second leading cause of death in the USA. Successful bench-to-bedside translation of basic scientific findings about cancer into therapeutic interventions for patients depends on the selection of appropriate animal experimental models. Cancer research uses animal and human cancer cell lines in vitro to study biochemical pathways in these cancer cells. In this review, we summarize the important animal models of cancer with focus on their advantages and limitations. Mouse cancer models are well known, …

Cost Estimates Of Foundational Public Health Capabilities: Pilot Test Results Of An Expert Consensus Methodology, Cezar B. Mamaril, Glen Mays

Glen Mays

The Institute of Medicine's 2012 report on U.S. public health financing recommended research to identify the components and costs of a "minimum package" of public health services and foundational capabilities to be made available in every U.S. community. We present results from pilot testing of a proposed methodology for estimating the costs and resource requirements for a set of foundational public health capabilities identified by the Public Health Leadership Forum. Using pilot data from Kentucky public health settings, we estimate both current and projected costs under a range of assumptions about the resources required to fully implement the capabilities at …

Ending Failures, Showing Results, Improving Population Health:Insights From Research & Reform In The U.S., Glen P. Mays

Glen Mays

A growing body of empirical research supports the value of aligning the delivery systems for public health, medical care, and social services for populations with shared needs and risk factors. This presentation reviews selected studies from the field of public health services & systems research (PHSSR) in the U.S. that suggest pathways for achieving greater system alignment in the Canadian context.

How Can Public Health Economics Help Health Systems Focus Upstream?, Glen P. Mays

Glen Mays

Research on the health and economic impact of public health strategies can help newly evolving health care delivery systems focus on upstream health determinants and make evidence-informed decisions about resource allocation across the prevention-treatment spectrum. Examples from research underway in the U.S. have particular relevance for Canada's evolving regional health authorities and their integrated approaches to medical care and public health delivery.

Tougher Than Rocket Science, Or Just Messier? Using Research To Improveu.S. Public Health Delivery, Glen P. Mays

Glen Mays

Advances in the field of public health services & systems research (PHSSR) are incorporating complexity in theory and methods to derive strong inferences about the health and economic effects attributable to public health strategies. Opportunities for comparative international research in Canada and the U.S. promise to strengthen these avenues of inquiry.

Public Health Services Research: Informing Public Health Practice & Policy, Glen P. Mays

Glen Mays

Heterogeneity in the mechanisms used for organizing and financing public health strategies creates opportunities for comparative effectiveness research (CER) in public health that examine which organization and financing mechanisms work best, for whom, and under what circumstances. Findings from these types of studies have direct utility in shaping public health policy and practice decisions.