Medicine and Health Sciences Commons^™

A Comparison Of The Wellbeing Of Orphans And Abandoned Children Ages 6–12 In Institutional And Community-Based Care Settings In 5 Less Wealthy Nations, Kathryn Whetten, Jan Ostermann, Rachel A. Whetten, Brian W. Pence, Karen O'Donnell, Lynne C. Messer, Nathan M. Thielman, The Positive Outcomes For Orphans (Pofo) Research Team

Faculty Publications

Background

Leaders are struggling to care for the estimated 143,000,000 orphans and millions more abandoned children worldwide. Global policy makers are advocating that institution-living orphans and abandoned children (OAC) be moved as quickly as possible to a residential family setting and that institutional care be used as a last resort. This analysis tests the hypothesis that institutional care for OAC aged 6–12 is associated with worse health and wellbeing than community residential care using conservative two-tail tests.

Methodology

The Positive Outcomes for Orphans (POFO) study employed two-stage random sampling survey methodology in 6 sites across 5 countries to identify 1,357 …

The 600-Step Program For Type I Diabetes Self-Management In Youth: The Magnitude Of The Self-Management Task, Ronald D. Coffen

Faculty Publications

This article demonstrates the complexity of the type 1 diabetes regimen and describes the physician's role in safely promoting self-management of diabetes by youth. Literature describing type 1 diabetes and the required regimen, issues related to regimen adherence by youth, demonstration of the magnitude of the regimen, and implications for physicians are addressed. A task analysis and tool for physicians is presented that contains over 600 tasks. Given the magnitude of the regimen, issues related to the physician's promotion of the gradual transfer of regimen control to youth are illustrated. The importance of understanding broad areas of the regimen (eg, …

Prospective Associations Between Objective Measures Of Physical Activity And Fat Mass In 12-14 Year Old Children: The Avon Longitudinal Study Of Parents And Children (Alspac), Chris J. Riddoch, Sam D. Leary, Andy R. Ness, Steven N. Blair, Kevin Deere, Calum Mattocks, Alex Griffiths, George Davey Smith, Kate Tilling

Faculty Publications

Objective: To investigate associations between physical activity at age 12 and subsequent adiposity at age 14.

Design: Prospective birth cohort study with data collected between 2003 and 2007.

Setting: Original recruitment in 1991-2 of 14,541 pregnant women living in the former County of Avon (United Kingdom).

Participants: At age 12, 11,952 children were invited to attend the research clinic. Of these, 7159 attended, and 4150 (1964 boys, 2186 girls) provided sufficient data on exposure, outcome, and confounding variables.

Main outcome measure: Fat mass at age 14, measured by dual emission x ray absorptiometry, associated with physical activity at age 12, …

Current Substance Use Behavior Among Severely Mentally Ill Individuals Diagnosed With Hiv And Hcv, Michelle Hampton, Linda Chafetz, Carmen Portillo

Faculty Publications

BACKGROUND: Infection with HIV and HCV is higher among severely mentally ill (SMI) individuals than the general population. The literature addressing prevention focuses primarily on sexual risk, though substance-related risk is significant. Insufficient data is available about substance use behavior in this population to formulate effective secondary prevention interventions. METHODS: This cross-sectional study was a secondary analysis of a RCT. Subjects reporting a diagnosis of HIV/HCV (reporters) were compared to non-reporters. Data were extracted from interviews that included the Addiction Severity Index (ASI). Data were analyzed using logistic regression. RESULTS: Of 275 subjects, 64(23.3%) reported a HIV/HCV diagnosis. Compared to …

Barriers Influencing Minority Clients’ Access To Speech Language Pathology Services. Poster, Nidhi Mahendra, Katie Schoneman, Nisha Engineer

Faculty Publications

No abstract provided.

Computer-Based Cognitive Interventions For Persons With Dementia: Feasibility And Outcomes, Nidhi Mahendra, Allegra Apple, Susan Carroll, Adithya Chandregowda

Faculty Publications

No abstract provided.

A National Physical Activity Plan For The United States, Russell R. Pate

Faculty Publications

No abstract provided.

A Review Of The National Physical Activity Plans Of Six Countries, Daniel B. Bornstein, Russell R. Pate, Michael Pratt

Faculty Publications

Background: Architects of the United States national physical activity plan can benefit from a thorough understanding of national physical activity plans from other nations. The purpose of this paper was to search for and analyze comprehensive national physical activity plan documents that can best inform the development of the U.S. plan. Methods: Electronic databases were searched for national physical activity plan documents, yielding 252 documents from 56 countries. After eliminating documents that were not written in English, did not address physical activity primarily, and did not meet our definition of a national physical activity plan, we were left with physical …

A Cost Analysis Of A Physical Activity Intervention For Older Adults, Erik J. Groessl, Robert M. Kaplan, Steven N. Blair, W. Jack Rejeski, Jeffrey A. Katula, Abby C. King, Roger A. Fielding, Nancy W. Glynn, Marco Pahor

Faculty Publications

We examined the costs of a physical activity (PA) and an educational comparison intervention. 424 older adults at risk for mobility disability were randomly assigned to either condition. The PA program consisted of center-based exercise sessions 3x weekly for 8 weeks, 2x weekly for weeks 9 to 24 and weekly behavioral counseling for 10 weeks. Optional sessions were offered during maintenance weeks (25-52). The comparison intervention consisted of weekly education meetings for 24 weeks, and then monthly for 6 months. Cost analyses were conducted from the "payer's" perspective, with a 1-year time horizon. Intervention costs were estimated by tracking personnel …

Role Of Lifestyle And Aging On The Longitudinal Change In Cardiorespiratory Fitness, Andrew S. Jackson, Xuemei Sui, James R. Hébert, Timothy S. Church, Steven N. Blair

Faculty Publications

Background - Cardiorespiratory fitness (CRF) in adults decreases with age and is influenced by lifestyle. Low CRF is associated with risk of diseases and the ability of older persons to function independently. We defined the longitudinal rate of CRF decline with aging and the association of aging and lifestyle with CRF.

Methods - We studied a cohort of 3429 women and 16,889 men, aged 20 to 96 years, from the Aerobics Center Longitudinal Study who completed 2 to 33 health examinations from 1974 to 2006. The lifestyle variables were body mass index, self-reported aerobic exercise, and smoking behavior. Cardiorespiratory fitness …

Quality Health Information On The Internet: Developing A Diabetes Pathfinder For The Chinese Population, Ana D. Cleveland, Jodi Philbrick, Xuequn Pan, Xinyu Yu, Jiangping Chen, Marty O'Neill, Lisa Smith

Faculty Publications

A Web-based bilingual diabetes information pathfinder was created to help the Chinese population access quality health information on the Internet as part of a collaborative outreach project in the Dallas-Fort Worth area. A survey was conducted to identify the demographics, Internet usage, health information needs, and preferences for training sessions of the Chinese population. Breast cancer, diabetes, and hepatitis B were the top three diseases of interest. The process of developing the pathfinder is described from start to finish, and it can serve as a model for the development of others. Pathfinder training sessions also were held. Taylor & Francis …

Designing A Simulation For Student Evaluation Using Scriven's Key Evaluation Checklist, Shelly Jensen Reed

Faculty Publications

Human patient simulation use has increased dramatically in nursing education over the past 10 years, with many benefits. One advantage is that it allows students to learn by practicing skills in a risk-free environment, with immediate faculty feedback. Another benefit is that it prepares and ensures the competence of student nurses, leading to improved patient safety outcomes. Student opinions gathered in a survey of nursing schools and simulator centers favored use of competency evaluation using simulation in at least some circumstances. As little research concerning use of simulation to evaluate student competency can be found, an established guide such as …

Acoustic And Spectral Patterns In Young Children's Stop Consonant Productions, Shawn L. Nissen, Robert Allen Fox

Faculty Publications

The aim of this study was to examine the acoustic and spectral patterns of stop articulation in the speech of pre-pubescent children. A set of voiceless stop consonants, /ptk/, produced by a group of adults and typically developing children 3-5 years of age were examined in terms of multiple acoustic and spectral parameters. Findings indicated that, with the exception of spectral kurtosis, the acoustic and spectral characteristics of the stop productions varied significantly as a function of place of articulation and vowel context. Sex-specific differences in spectral slope, mean, and skewness were found for the 5-year-old and adult speakers. Such …

Student Satisfaction With Simulation Experiences, Angeline Abdo, Patricia K. Ravert

Faculty Publications

Background: Some nursing schools use patient simulators to simulate patient scenarios.

Methods: Nursing students participated in five sessions using a patient simulator and then completed a questionnaire related to their experiences.

Results: Participants felt the experiences recreated real-life situations, tested their clinical decision-making, prepared them for the “real-life” clinical setting, and increased their confidence when in the clinical setting.

Conclusions: Patient simulator experiences enhance learning. Further research regarding student perceptions and instrument validation would contribute to an increased understanding of the use of patient simulators in nursing education.

Sedentary Behavior And Obesity In A Large Cohort Of Children, Jonathan A. Mitchell, Calum Mattocks, Andy R. Ness, Sam D. Leary, Russell R. Pate, Marsha Dowda, Steven N. Blair, Chris Riddoch

Faculty Publications

The purpose of this study was to examine the association between sedentary behavior and obesity among 12-year-old children, while adjusting for moderate-to-vigorous physical activity (MVPA) and other potential confounding variables.

Cross-sectional analyses were carried out with data from 5434 children who participated in the Avon Longitudinal Study of Parents and Children (ALSPAC). Fat mass was derived using dual x-ray emission absorptiometry (DXA), and height and weight measurements were used to calculate body mass index (BMI; kg/m²). The children wore an accelerometer for seven days. The cut points for sedentary behavior and MVPA were ≤199 cpm and ≥3600 cpm, …

Food Insecurity Among Homeless And Marginally Housed Individuals Living With Hiv/Aids In San Francisco, Sheri D. Weiser, David R. Bangsberg, Susan Kegeles, Kathleen Ragland, Margot B. Kushel, Edward A. Frongillo Jr.

Faculty Publications

Food insecurity is a risk factor for both HIV transmission and worse HIV clinical outcomes. We examined the prevalence of and factors associated with food insecurity among homeless and marginally housed HIV-infected individuals in San Francisco recruited from the Research on Access to Care in the Homeless Cohort. We used multiple logistic regression to determine socio-demographic and behavioral factors associated with food insecurity, which was measured using the Household Food Insecurity Access Scale. Among 250 participants, over half (53.6%) were food insecure. Higher odds of food insecurity was associated with being white, low CD4 counts, recent crack use, lack of …

Association Between Community Health Center And Rural Health Clinic Presence And County-Level Hospitalization Rates For Ambulatory Care Sensitive Conditions: An Analysis Across Eight Us States, Janice C. Probst, James N. Laditka, Sarah B. Laditka

Faculty Publications

Background: Federally qualified community health centers (CHCs) and rural health clinics (RHCs) are intended to provide access to care for vulnerable populations. While some research has explored the effects of CHCs on population health, little information exists regarding RHC effects. We sought to clarify the contribution that CHCs and RHCs may make to the accessibility of primary health care, as measured by county-level rates of hospitalization for ambulatory care sensitive (ACS) conditions.

Methods: We conducted an ecologic analysis of the relationship between facility presence and county-level hospitalization rates, using 2002 discharge data from eight states within the US (579 counties). …

Book Review Of Unspeakable: The Story Of Junius Wilson, Michael Ashley Stein, Aviam Soifer

Faculty Publications

No abstract provided.

Carbohydrate Intake And Overweight And Obesity Among Healthy Adults, Anwar T. Merchant, Hassanali Vatanparast, Shahzaib Barlas, Mahshid Dehghan, Syed Mahboob Ali Shah, Lawrence De Koning, Susan E. Steck

Faculty Publications

Background - Little is known about the dietary habits of people with optimal body weight in communities with high overweight and obesity prevalence.

Objective - To evaluate carbohydrate intake in relation to overweight and obesity in healthy, free-living adults

Design - We used a cross-sectional analysis

Subjects/setting - The Canadian Community Health Survey Cycle 2.2 is a cross-sectional survey of Canadians conducted in 2004-2005. There were 4,451 participants aged 18 years and older with anthropometric and dietary data and no comorbid conditions in this analysis.

Main outcome measures - Outcome variables were body mass index (BMI; calculated as kg/m^{2 …}

Reasons Why Women Do Not Initiate Breastfeeding: A Southeastern State Study, Chinelo A. Ogbuanu, Janice C. Probst, Sarah B. Laditka, Jihong Liu, Jongdeuk Baek, Saundra Glover

Faculty Publications

Purpose - Despite the increase in breastfeeding initiation and duration in the United States, only five states have met the three Healthy People 2010 breastfeeding objectives. Our objectives are to study women's self-reported reasons for not initiating breastfeeding and to determine whether these reasons vary by race/ethnicity, and other maternal and hospital support characteristics.

Methods - Data are from the 2000-2003 Arkansas Pregnancy Risk Assessment Monitoring System, restricting the sample to women who did not initiate breastfeeding (unweighted n = 2,917). Reasons for not initiating breastfeeding are characterized as individual reasons, household responsibilities, and circumstances. Analyses include the χ^{2 …}

Oncology Nurses' Perceptions Of Obstacles And Supportive Behaviors At The End Of Life, Renea L. Beckstrand, Josie Moore, Lynn Callister, A. Elaine Bond

Faculty Publications

Purpose/Objectives: To determine the magnitude of selected obstacles and supportive behaviors in providing end-of-life (EOL) care to patients with cancer as perceived by oncology nurses.

Design: Cross-sectional survey.

Setting: National survey sample.

Sample: A geographically dispersed national random sample of 1,000 Oncology Nursing Society members who had cared for inpatient patients with cancer, could read English, and had experience in EOL care.

Methods: Eligible respondents received a 68-item questionnaire in the mail adapted from previous studies and were asked to rate the size of obstacles and supportive behavior items in caring for patients with cancer at the EOL.

Main Research …

Employed Parents' Satisfaction With Food Choice Coping Strategies: Influence Of Gender And Structure, Christine E. Blake, Carol M. Devine, Elaine Wethington, Margaret M. Jastran, Tracy J. Farrell, Carole A. Bisogni

Faculty Publications

This study aimed to understand parents' evaluations of the way they integrated work-family demands to manage food and eating. Employed, low/moderate-income, urban, U.S., Black, White, and Latino mothers (35) and fathers (34) participated in qualitative interviews exploring work and family conditions and spillover, food roles, and food-choice coping and family-adaptive strategies. Parents expressed a range of evaluations from overall satisfaction to overall dissatisfaction as well as dissatisfaction limited to work, family life, or daily schedule. Evaluation criteria differed by gender. Mothers evaluated satisfaction on their ability to balance work and family demands through flexible home and work conditions, while striving …

Association Between Plasma 25-Hydroxyvitamin D And Breast Cancer Risk, Katherine D. Crew, Marilie D. Gammon, Susan E. Steck, Dawn L. Hershman, Serge Cremers, Elzbieta Dworakowski, Elizabeth Shane, Mary Beth Terry, Manisha Desai, Susan L. Teitelbaum, Alfred I. Neugut, Regina M. Santella

Faculty Publications

Vitamin D has been associated with decreased risk of several cancers. In experimental studies, vitamin D has been shown to inhibit cell proliferation and induce differentiation and apoptosis in normal and malignant breast cells. Using a population-based case-control study on Long Island, New York, we examined the association of breast cancer with plasma 25-hydroxyvitamin D (25-OHD) levels, a measure of vitamin D body stores. In-person interviews and blood specimens were obtained from 1,026 incident breast cancer cases diagnosed in 1996 to 1997 and 1,075 population-based controls. Plasma 25-OHD was measured in batched, archived specimens by Diasorin RIA. The mean (SD) …

Mapping Cancer Mortality-To-Incidence Ratios To Illustrate Racial And Sex Disparities In A High-Risk Population, James R. Hébert, Virginie Daguise, Deborah M. Hurley, Rebecca C. Wilkerson, Catishia M. Mosley, Swann Arp Adams, Robin C. Puett, James B. Burch, Susan E. Steck, Susan Bolick-Aldrich

Faculty Publications

Background - Comparisons of incidence and mortality rates are the metrics used most commonly to define cancer-related racial disparities. In the US, and particularly in South Carolina, these largely disfavor African Americans (AAs). Computed from readily available data sources, the mortality-to-incidence rate ratio (MIR) provides a population-based indicator of survival.

Methods - South Carolina Central Cancer Registry incidence data and Vital Registry death data were used to construct MIRs. ArcGIS 9.2 mapping software was used to map cancer MIRs by sex and race for 8 Health Regions within South Carolina for all cancers combined and for breast, cervical, colorectal, lung, …

Associations Between Cardiorespiratory Fitness And Health-Related Quality Of Life, Robert A. Sloan, Susumu S. Sawada, Corby K. Martin, Timothy S. Church, Steven N. Blair

Faculty Publications

Background: There is limited data examining the association between cardiorespiratory fitness (CRF) and health related quality of life (HRQOL) in healthy young adults. We examined the association between CRF and HRQOL Physical Component Summary (PCS) and Mental Component Summary (MCS) scores in apparently health males in the United States Navy.

Methods: A total of 709 males (18-49 yr) performed a submaximal exercise test and HRQOL assessment (SF-12v2^TM) between 2004-2006. CRF level was classified into fourths depending on age distribution with the lowest fitness quartile serving as the referent group. PCS and MCS scores ≥ 50 were defined as …

Developing And Implementing A Simulation Program: Baccalaureate Nursing Education, Patricia K. Ravert

Faculty Publications

Brigham Young University (BYU) is a private university (owned by the Church of Jesus Christ of Latter-day Saints), established in 1875. The main campus is located in Provo, Utah, 45 miles south of Salt Lake City at the base of the Wasatch Mountains and serves approximately 33,000 students. The College of Nursing (CON) was founded in 1952. The CON offers two programs, the undergraduate Bachelor of Science and the Master of Science; the latter program prepares family nurse practitioners. The CON programs are approved by the Utah State Board of Nursing and are accredited by the National League for Nursing …

Can We Apply The Mendelian Randomization Methodology Without Considering Epigenetic Effects?, Ikechkwu U. Ogbuanu, Hongmei Zhang, Wilfried J. Karmaus

Faculty Publications

Introduction: Instrumental variable (IV) methods have been used in econometrics for several decades now, but have only recently been introduced into the epidemiologic research frameworks. Similarly, Mendelian randomization studies, which use the IV methodology for analysis and inference in epidemiology, were introduced into the epidemiologist's toolbox only in the last decade.

Analysis: Mendelian randomization studies using instrumental variables (IVs) have the potential to avoid some of the limitations of observational epidemiology (confounding, reverse causality, regression dilution bias) for making causal inferences. Certain limitations of randomized controlled trials, such as problems with generalizability, feasibility and ethics for some exposures, and high …

Modelling Optimal Location For Pre-Hospital Helicopter Emergency Medical Services, Nadine Schuurman, Nathaniel Bell, Randy L'Heureux, Syed M. Hameed

Faculty Publications

BACKGROUND: Increasing the range and scope of early activation/auto launch helicopter emergency medical services (HEMS) may alleviate unnecessary injury mortality that disproportionately affects rural populations. To date, attempts to develop a quantitative framework for the optimal location of HEMS facilities have been absent. METHODS: Our analysis used five years of critical care data from tertiary health care facilities, spatial data on origin of transport and accurate road travel time catchments for tertiary centres. A location optimization model was developed to identify where the expansion of HEMS would cover the greatest population among those currently underserved. The protocol was developed using …

Factors Related To Objectively Measured Physical Activity In Preschool Children, Karin A. Pfeiffer, Marsha Dowda, Kerry L. Mciver, Russell R. Pate

Faculty Publications

This study examined correlates of objectively measured physical activity (PA) in a diverse sample of preschool children (age 3-5 years; n=331). Accelerometer min∙hr^-1 of moderate-to-vigorous physical activity (MVPA) and nonsedentary activity (NSA) were the outcome measures. Correlations among potential correlates and PA ranged from r=-0.12-0.26. Correlates in the final MVPA model were age, race, sex, BMI Z score, and parent perception of athletic competence, explaining 37% of the variance. The NSA model included the latter two variables, explaining 35% of the variance. Demographic factors were correlates of PA; parent perceptions of children's competence may be important regarding …

Identification Of Single Nucleotide Polymorphisms In The P21 (Cdkn1a) Gene And Correlations With Longevity In The Italian Population, Silvia Gravina, Francesco Lescai, Gregory Hurteau, Graham J. Brock, Anna Saramaki, Stefano Salvioli, Claudio Franceschi, Igor Roninson

Faculty Publications

Longevity in humans is determined by multiple environmental and genetic factors. We have investigated possible associations between longevity and Single Nucleotide Polymorphisms (SNPs) in the p21 (CDKN1A) gene, a stress-inducible senescence-associated cell cycle inhibitor, expression of which upregulates genes implicated in several age-related diseases. By sequencing the promoter and exons of p21 in genomic DNA of ten individuals over 90 years old, we have identified 30 SNPs, many of which had not been previously characterized. A cluster of minor alleles within the -4547/-3489 bp region did not alter the basal activity or p53 responsiveness of the p21 promoter. We then …