Medicine and Health Sciences Commons^™

The "Crossroads" And Beyond, David B. Nash

College of Population Health Faculty Papers

No abstract provided.

Report On The U.S. Summit: "Chronic Care At The Crossroads: Exploring Solutions For Chronic Care Management", Janice L. Clarke

College of Population Health Faculty Papers

On Tuesday, July 17, 2007 in Washington, DC, Intel Corporation assembled a group of the nation’s most respected health leaders to discuss the issues surrounding chronic care and an aging population and explore solutions to these highly complex and increasingly urgent challenges for the US health care system. The highlevel summit, hosted by Intel Chairman Craig Barrett, was held in the auditorium of the National Museum for Women in the Arts and attended, either in person or via the simultaneous webcast, by presidents, chairmen, and executive directors of influential organizations including the National Business Coalition on Health, the National Medical …

Healing The Health Care System: Summaries From The Department Of Health Policy Summer Seminar, David B. Nash, Nora Dowd Eisenhower, Rosemarie Greco, Deborah C. Meiris

College of Population Health Faculty Papers

Editorial Introduction:
The disease management field continues to evolve. The range of chronic diseases treated has expanded to include such conditions as obesity and pain management, and the care continuum now encompasses wellness, prevention, and population health. One population that is an ideal candidate for our collective efforts is that of older adults. Global and national population projections reveal the impending staggering increase in the age 65+ cohort, which will cause a sharp increase in the demand for health care and other services due to such age-related issues as multiple chronic conditions, falls, and depression.

To begin to address these …

Periodontal Disease And Diabetes: Knowledge And Attitudes Assessment Project

Florida Public Health Review

There is a growing body of evidence showing that periodontal disease is more prevalent among diabetic patients than among non-diabetic patients. This same evidence also shows that the more poorly controlled the diabetes, the more severe the periodontal disease. However, it is unclear if the increased risk of periodontal disease is known by the diabetes community. Two hundred diabetic patients voluntarily participated in an intervention to increase the diabetic patient’s knowledge of and attitudes toward periodontal disease. The study was conducted at the University of Miami-Jackson Memorial Hospital’s Diabetes Research Institute (DRI) during the month of May 2005. The purpose …

How Does Quality Enter Into Health Care Purchasing Decisions?, Neil I. Goldfarb, Vittorio Maio, Chureen T. Carter, Laura Pizzi, David B. Nash

College of Population Health Faculty Papers

A number of employers, business consortia, and public purchasers are promoting "value-based purchasing" as a way to improve the quality of patient care. Some purchasers are using publicly available information on health plan and provider performance to make their health plan and provider choices, while others are using their market power to drive improvements in patient care and safety. This article examines six key strategies used by purchasers.

Determinan Kematian Neonatal Dini Di Rsud Dr. Achmad Mochtar Bukittinggi, Efriza Efriza

Kesmas

Berdasarkan data SDKI 2002-2003 angka kematian neonatal di Indonesia adalah 20 per 1000 kelahiran hidup. Sebagian besar kematian neonatal terjadi pada saat neonatal dini ketika bayi berumur 0-7 hari. Penelitian ini bertujuan untuk mengetahui berbagai faktor yang mempengaruhi kematian neonatal dini di RSUD Dr. Achmad Mochtar Bukittinggi tahun 2001-2005. Penelitian yang dilakukan pada sumber data sekunder rekam medik ibu dan bayi ini menggunakan disain studi kasus kontrol. Sampel dihitung dengan rumus ukursan sampel minimal kasus kontrol. Kasus. adalah bayi yang lahir hidup dan meninggal pada periode neonatal dini (0-7 hari) dan kontrol adalah bayi yang lahir hidup dan bertahan hidup …

Faktor Risiko Tuberculosis Paru Di Kabupaten Rejang Lebong, Demsa Simbolon

Kesmas

Di Kabupaten Rejang Lebong, sejak tahun 1995 telah dilaksanakan kegiatan pemberantasan TB Paru dengan strategi DOTS, tetapi penderita baru tetap di temukan dan memperlihatkan trend yang meningkat dari tahun ke tahun. Penelitian ini bertujuan untuk mengetahui faktor risiko yang berhubungan dengan kejadian TB paru BTA (+) di Kabupaten Rejang Lebong. Desain penelitian yang digunakan adalah disain kasus kontrol. Kelompok kasus adalah penderita TB Paru BTA (+) berumur >15 tahun yang berobat pada Oktober 2005 sampai Mei 2006. Kontrol adalah tetangga kasus yang tidak mempunyai tanda-tanda gejala klinis TB paru dengan golongan umur >15 tahun. Jumlah sampel sebanyak 50 kasus dan …

Ketahanan Hidup Setahun Pasien Stroke Di Rs Cipto Mangunkusumo Jakarta, Sri Mulyani

Kesmas

Di Indonesia, penyebab utama kematian di rumah sakit adalah stroke. Penelitian ini bertujuan untuk mengetahui ketahanan hidup 1 tahun pasien stroke yang dirawat di RS Cipto Mangunkusumo Jakarta tahun 2003 dan faktor yang mempengaruhinya. Rancangan penelitian ini adalah kohort retrospektif. Sampelnya adalah total populasi, yaitu 275 pasien yang didiagnosa mengalami serangan stroke pertama dan dirawat di RS Cipto Mangunkusumo Jakarta, yang masuk tanggal 1 Januari sampai 31 Desember 2003. Hasil penelitian menunjukkan bahwa probabilitas ketahanan hidup pasien stroke berbeda beda, tergantung pada tipe stroke, ruang rawat, dan penyakit jantung. Masing-masing probabilitas ketahanan hidup setahun pasien stroke adalah sebagai berikut: 63,7% …

Outcomes Of Care By Hospitalists, General Internists, And Family Physicians, Peter K. Lindenauer, Michael B. Rothberg, Penelope Susan Pekow, Christopher Kenwood, Evan M. Benjamin, Andrew D. Auerbach

Penelope Susan Pekow

Background: The hospitalist model is rapidly altering the landscape for inpatient care in the United States, yet evidence about the clinical and economic outcomes of care by hospitalists is derived from a small number of single-hospital studies examining the practices of a few physicians.

Methods: We conducted a retrospective cohort study of 76,926 patients 18 years of age or older who were hospitalized between September 2002 and June 2005 for pneumonia, heart failure, chest pain, ischemic stroke, urinary tract infection, acute exacerbation of chronic obstructive pulmonary disease, or acute myocardial infarction at 45 hospitals throughout the United States. We used …

Outcomes Of Care By Hospitalists, General Internists, And Family Physicians, Peter K. Lindenauer, Michael B. Rothberg, Penelope Susan Pekow, Christopher Kenwood, Evan M. Benjamin, Andrew D. Auerbach

Peter Lindenauer MD

Background: The hospitalist model is rapidly altering the landscape for inpatient care in the United States, yet evidence about the clinical and economic outcomes of care by hospitalists is derived from a small number of single-hospital studies examining the practices of a few physicians.

Methods: We conducted a retrospective cohort study of 76,926 patients 18 years of age or older who were hospitalized between September 2002 and June 2005 for pneumonia, heart failure, chest pain, ischemic stroke, urinary tract infection, acute exacerbation of chronic obstructive pulmonary disease, or acute myocardial infarction at 45 hospitals throughout the United States. We used …

Towards An Understanding Of Salient Neighborhood Boundaries: Adolescent Reports Of An Easy Walking Distance And Convenient Driving Distance, Natalie Colabianchi, Marsha Dowda, Karin A. Pfeiffer, Dwayne E. Porter, Maria João C. A. Almeida, Russell R. Pate

Faculty Publications

Numerous studies have examined the association between the surrounding neighborhood environment and physical activity levels in adolescents. Many of these studies use a road network buffer of Euclidean distance buffer around an adolescent's home to represent the appropriate geographic area for study (i.e., neighborhood). However, little empirical research has examined the appropriate buffer size to use when defining this area and there is little consistency across published research as to the buffer size used. In this study, 909 12^th grade adolescent girls of diverse racial and geographic backgrounds were asked to report their perceptions of an easy walking distance …

Barriers To Medicare Hospice Utilization: A Qualitative Study Of Maine's Medicare Hospice Providers, Judith B. Tupper Dhed, Ches, Cpps

Disability & Aging

This report, prepared for the Maine Hospice Council and funded by the Carpenter Foundation, presents findings of a qualitative study of barriers to hospice utilization. This study includes the perspectives of all 26 Medicare certified hospice providers in Maine. Significant findings of the qualitative study include: A continuing need to educate the general public about hospice and the Medicare benefit. Maine health care providers have low referral rates to the hospice programs and often misunderstand the regulations and guidelines of the hospice benefit. The referral process to hospice programs is based on fragile systems of communication, fraught with potential miscues, …

Public Health Campaigns To Change Industry Practices That Damage Health: An Analysis Of 12 Case Studies, Nicholas Freudenberg, Sarah Picard Bradley, Monica Serrano

Publications and Research

Industry practices such as advertising, production of unsafe products, and efforts to defeat health legislation play a major role in current patterns of U.S. ill health. Changing these practices may be a promising strategy to promote health. The authors analyze 12 campaigns designed to modify the health-related practices of U.S. corporations in the alcohol, automobile, food and beverage, firearms, pharmaceutical, and tobacco industries. The objectives are to examine the interactions between advocacy campaigns and industry opponents; explore the roles of government, researchers, and media; and identify characteristics of campaigns that are effective in changing health-damaging practices. The authors compared campaigns …

Human Papillomavirus Vaccine Policy In The U.S., Jennifer C. Jarrell

Public Health Theses

HPV vaccine school entry mandates and vaccine funding by state was examined using the Diffusion of Innovations (DOI) theory. The DOI was applied to HPV immunization policy to evaluate the rate of vaccine adoption and to determine whether associations existed between an empirical need for vaccine adoption and action by the states. State-level data on political characteristics, health and policy were collected from several secondary sources. Data analyses were performed utilizing SPSS logistic regression models. Odds rations were used to evaluate the associations between the independent and dependent variables to determine whether there was a statistical significance level of .05. …

Adolescent Knowledge, Attitudes, And Beliefs Toward Vaccination, Richard Brendan Noggle

Public Health Theses

Vaccination, one of public health’s greatest disease prevention tools, is broadening to focus on adolescents. Now that there are more vaccines targeted specifically for adolescents, it is time to give more focus to vaccine delivery in this population. This research will increase the knowledge base to support informed changes in adolescent vaccine delivery by identifying knowledge and attitudes of adolescents toward vaccination within the context of barriers and solutions. Perceived susceptibility to disease, benefits and barriers to vaccination and other constructs were collected through a survey to 1368 high school students. In this population, a scheduled adolescent healthcare visit is …

Intake Of Coffee And Tea And Risk Of Ovarian Cancer: A Prospective Cohort Study, Stephanie A. Navarro Silvera, Meera Jain, Geoffrey R. Howe, Anthony B. Miller, Thomas E. Rohan

Department of Public Health Scholarship and Creative Works

There is some evidence from case-control studies that coffee consumption might be positively associated with ovarian cancer risk, whereas the epidemiologic evidence regarding tea consumption and ovarian cancer is inconsistent. To date, there have been few prospective studies of these associations. Therefore, we examined ovarian cancer risk in association with both coffee and tea intake in a prospective cohort study of 49,613 Canadian women enrolled in the National Breast Screening Study (NBSS) who completed a self-administered food frequency questionnaire between 1980 and 1985. Linkages to national mortality and cancer databases yielded data on deaths and cancer incidence, with follow-up ending …

Pregnancy Intentions And Happiness Among Pregnant Black Women At High Risk For Adverse Infant Health Outcomes, Susan M. Blake, Michele Kiely, Charlotte C. Gard, Ayman El-Mohandes, M. Nabil El-Khorazaty, Nih-Dc Initiative

Publications and Research

CONTEXT:Unintended pregnancy is associated with risk behaviors and increased morbidity or mortality for mothers and infants, but a woman's feelings about pregnancy may be more predictive of risk and health outcomes than her intentions.

METHODS: A sample of 1,044 black women who were at increased risk were enrolled at prenatal care clinics in the District of Columbia in 2001-2003. Bivariate and multivariate analyses assessed associations between pregnancy intentions or level of happiness about being pregnant and multiple psychosocial and behavioral risk factors, and identified correlates of happiness to be pregnant.

RESULTS: Pregnancy intentions and happiness were strongly associated, but …

A Study Of Disaster Preparedness Of Rural Hospitals In The United States, Barbara Cliff

Dissertations

This dissertation examines disaster preparedness in the U.S. and explores the relationships between risk perception, funding from the Health Resources and Services Administration (HRSA), and preparedness. Secondary data analysis was conducted using the National Study of Rural Hospitals from Johns Hopkins University. The study, based on a random sample of rural hospitals, consisted of a mail questionnaire and a follow-up phone interview with the hospital's Chief Executive Officer (n = 134).

A model of disaster preparedness was utilized to examine seven elements of preparedness. Risk perception was examined by seven risk threats, and HRSA funding was examined as a …

Breast Cancer In Pakistan - Awareness And Early Detection, Saba Sohail, Shams Nadeem Alam

Department of Radiology

No abstract provided.

Effect Of Endothelin 1 Genotype On Blood Pressure Is Dependent On Physical Activity Or Fitness Levels, Tuomo Rankinen, Timothy S. Church, Treva Rice, Nathan Markward, Arthur S. Leon, Dabeeru C. Rao, James S. Skinner, Steven N. Blair, Claude Bouchard

Faculty Publications

Contributions of the DNA sequence variation at the endothelin 1 locus to the risk of hypertension and to endurance training-induced changes in blood pressure were investigated in the Aerobics Center Longitudinal Study and the Health, Risk Factors, Exercise Training and Genetics Family Study cohorts. We identified 586 normotensive control subjects and 607 incident hypertensive case subjects from the Aerobics Center Longitudinal Study cohort (all whites) who were normotensive and healthy at their first clinical visit. The case subjects were diagnosed with hypertension during an average follow-up of 9.5 years, whereas the control subjects remained normotensive. The allele and genotype frequencies …

Addressing Potential Conflicts Of Interest Arising From The Multiple Roles Of Colorado’S Community Centered Boards, Maureen Booth Mrp, Ma, Eileen Griffin Jd

Disability & Aging

This document summarizes the information we gathered, our analysis of potential conflicts of interest, and recommendations for addressing opportunities for improvement. The information we gathered is based on document review, input from stakeholders, and a review of practices in four other states.

Objectively Assessed Associations Between Physical Activity And Body Composition In Middle-School Girls: The Trial Of Activity For Adolescent Girls, June Stevens, David M. Murray, Chris C. Baggett, John P. Elder, Timothy G. Lohman, Leslie A. Lytle, Russell R. Pate, Charlotte A. Pratt, Margarita S. Treuth, Larry S. Webber, Deborah Rohm Young

Faculty Publications

Declining levels of physical activity probably contribute to the increasing prevalence of overweight in US youth. In this study, the authors examined cross-sectional and longitudinal associations between physical activity and body composition in sixth- and eighth-grade girls. In 2003, girls were recruited from six US states as part of the Trial of Activity for Adolescent Girls. Physical activity was measured using 6 days of accelerometry, and percentage of body fat was calculated using an age- and ethnicity-specific prediction equation. Sixth-grade girls with an average of 12.8 minutes of moderate-to-vigorous physical activity (MVPA) per day (15th percentile) were 2.3 times (95% …

Interprofessional Information Work: Innovations In The Use Of The Chart On Internal Medicine Teams, Lorelei Lingard, Lesley Conn, Ann Russell, Scott Reeves, Karen-Lee Miller, Chris Kenaszchuk, Merrick Zwarenstein

Lorelei Lingard

An abundance of evidence suggests that communication in interprofessional healthcare teams is a complex endeavour. Even relatively simple communication processes involving information work - the gathering, storage, retrieval and discussion of patient information - may be fraught with pitfalls, and yet teams manage to conduct their daily information work, often with a high degree of effectiveness. In this article, we explore one commonplace dimension of information work - the use of patient charts to foster collaborative decision-making and care enactment - towards building an elaborated understanding of how teams innovate in the face of daily complexities in their information work …

Synergistic Induction Of Ahr Regulated Genes In Developmental Toxicity From Co-Exposure To Two Model Pahs In Zebrafish, Alicia R. Timme-Laragy, Crystal J. Cockman, Cole W. Matson, Richard T. Di Giulio

Alicia R. Timme-Laragy

Polycyclic aromatic hydrocarbons (PAHs) are pollutants created by the incomplete combustion of carbon, and are increasing in the environment largely due to the burning of fossil fuels. PAHs occur as complex mixtures, and some combinations have been shown to cause synergistic developmental toxicity in fish embryos, characterized by pericardial edema and craniofacial malformations. Previous studies have indicated that in the zebrafish model, this toxicity is mediated by the aryl hydrocarbon receptor 2 (AHR2), and enhanced by inhibition of CYP1A activity. In this study, we further examined this interaction of the model PAH and AHR agonist β-naphthoflavone (BNF) with and without …

Ethnicity And Mental Health Treatment Utilization By Patients With Personality Disorders, Donna S. Bender, Andrew E. Skodol, Ingrid R. Dyck, John C. Markowitz, M. Tracie Shea, Shirley Yen, Charles A. Sanislow, Anthony Pinto, Mary C. Zanarini, Thomas H. Mcglashan, John G. Gunderson, Maria T. Daversa, Carlos M. Grilo

Charles A. Sanislow, Ph.D.

The authors examined the relationship between ethnicity and treatment utilization by individuals with personality disorders (PDs). Lifetime and prospectively determined rates and amounts of mental health treatments received were compared in over 500 White, African American, and Hispanic participants with PDs in a naturalistic longitudinal study. Minority, especially Hispanic, participants were significantly less likely than White participants to receive a range of outpatient and inpatient psychosocial treatments and psychotropic medications. This pattern was especially pronounced for minority participants with more severe PDs. A positive support alliance factor significantly predicted the amount of individual psychotherapy used by African American and Hispanic …

Correction: Using Participatory Design To Develop (Public) Health Decision Support Systems Through Gis, S. Michelle Driedger, Anita Kothari, Jason Morrison, Michael Sawada, Eric J. Crighton, Ian D. Graham

Anita Kothari

Background: Organizations that collect substantial data for decision-making purposes are often characterized as being 'data rich' but 'information poor'. Maps and mapping tools can be very useful for research transfer in converting locally collected data into information. Challenges involved in incorporating GIS applications into the decision-making process within the non-profit (public) health sector include a lack of financial resources for software acquisition and training for nonspecialists to use such tools. This on-going project has two primary phases. This paper critically reflects on Phase 1: the participatory design (PD) process of developing a collaborative web-based GIS tool.

Methods: A case study …

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 …

Biological Variability Dominates And Influences Analytical Variance In Hplc-Ecd Studies Of The Human Plasma Metabolome, Yevgeniya I. Shurubor, Wayne R. Matson, Walter C. Willett, Susan E. Hankinson, Bruce S. Kristal

Susan E. Hankinson

Background Biomarker-based assessments of biological samples are widespread in clinical, pre-clinical, and epidemiological investigations. We previously developed serum metabolomic profiles assessed by HPLC-separations coupled with coulometric array detection that can accurately identify ad libitum fed and caloric-restricted rats. These profiles are being adapted for human epidemiology studies, given the importance of energy balance in human disease. Methods Human plasma samples were biochemically analyzed using HPLC separations coupled with coulometric electrode array detection. Results We identified these markers/metabolites in human plasma, and then used them to determine which human samples represent blinded duplicates with 100% accuracy (N = 30 of 30). …

Ua12/2/1 College Heights Herald, Vol. 83, No. 19, Wku Student Affairs

WKU Archives Records

WKU campus newspaper reporting campus, athletic and Bowling Green, Kentucky news

Understanding Barriers For Adherence To Follow-Up Care For Abnormal Pap Tests, Katherine S. Eggleston, Ann L. Coker, Irene Prabhu Das, Suzanne T. Cordray, Kathryn J. Luchok

CRVAW Faculty Journal Articles

Objective: Approximately 4000 women annually will die from preventable and treatable cervical cancer. Failure to adhere to follow-up recommendations after an abnormal Pap test can lead to development of cervical cancer. This paper summarizes the body of literature on adherence to follow-up after an abnormal Pap test in order to facilitate development of interventions

to decrease morbidity and mortality due to cervical cancer.

Methods: We conducted a comprehensive search of published literature addressing risk factors for adherence or interventions to improve adherence following an abnormal Pap test as the outcome. We included peer-reviewed original research conducted in the …