Medicine and Health Sciences Commons^™

Primary Care Use Among Hiv Positive Inpatients At An Inner City Public Hospital: The Impact Of Crack Cocaine Use, Toye H. Brewer, Lisa R. Metsch, Marsha Mullings, Gabriel Cardenas, Margaret Pereyra

Florida Public Health Review

We studied factors associated with HIV care utilization in symptomatic HIV-positive crack-using and non-using patients at a public hospital in Miami, Florida. A bedside survey conducted with 89 HIV-positive crack-users and 93 HIV-positive non-users examined health care knowledge, perceived health status, drug use, and HIV care patterns. A multi-nominal model was utilized to calculate the adjusted odds ratio (AOR) of three levels of care: currently receiving care (having seen an HIV provider in the past 4 months), having dropped out of care (having seen an HIV provider at least once but not in the past 4 months), and never having …

What Floats Your Boaters? – A Commentary, Mary Martinasek

Florida Public Health Review

Florida has over one million registered boaters not including the plethora of canoes and other paddle craft for which registration is not required. Whereas wearing a seatbelt in a car is regulated by law and has become a routine practice for the majority of Floridians, wearing a personal floatation device (PFD) while boating is neither mandatory nor routine. Florida has ranked first annually among states in boating fatalities since 2003, and accounted for 10.9% of the total number of U.S. boating deaths in 2006. This commentary argues for making PFD use mandatory in an environment where the social norm is …

Applying Leadership To Facilitate Physician-Patient Communication And Promote Health In The Lesbian Community

Florida Public Health Review

Lesbian women experience health inequalities primarily related to their experiences of discrimination, homophobia, and the assumption of heterosexism. This milieu of experiences can lead to an avoidance of routine health care, screening, and non-disclosure of sexual orientation to physicians. Lesbians may participate in some health risk behaviors more than heterosexual women leading to an increase in risks for certain cancers, cardiovascular disease and HIV. Lesbians who discuss their sexual orientation and behavior with their physician report feeling more comfortable, experience better communication, and are more likely to seek routine medical care. Although the medical community has been making a shift …

Whom Can You Trust? Exploring Leadership Addressing Hiv Risk Prevention In African American Women

Florida Public Health Review

Within the last decade African American women have experienced serious increases in HIV diagnoses. Almost 40% of all newly diagnosed HIV-positive women in the United States are black women. Furthermore, black women are 23 times more likely to be diagnosed with AIDS than white women. This paper explores some of the underlying socioeconomic factors for high incidence rates of HIV among African American women—including poverty, racism, and stigma—that contribute to this health disparity and discusses current leadership approaches to addressing this problem. One common leadership approach focuses on adapting CDC intervention programs at a local level, a process that presents …

Using Leadership To Improve Community-Based Obesity Interventions

Florida Public Health Review

Obesity is an enormous health problem facing America in the 21st century. Despite great efforts, health educators have made little progress in meeting the goals laid out in Healthy People 2010. A more contextual, community- based approach is necessary to change the physical and social environment in which people live, work and play. Studies show that residents of neighborhoods that lack pedestrian-friendly features and have high crime rates are less likely to be physically active, an important point for health educators to take into account when designing interventions. Whereas professional health educators have done little in this area, exemplary grassroots …

Improving Folic Acid Consumption In Women At Risk For Neural Tube Defects In Florida, Jessica C. Bishop-Royse, Elizabeth Jensen, Melanie Simmons

Florida Public Health Review

Two providers who participated in the Florida VitaGrant program, a site providing early childhood services to primarily Mexican Hispanic families (Site A) and a site providing home visiting services to pregnant women and families with infants (Site B), are presented as alternative models for improving folic acid levels in reproductive aged women in Florida. Site A distributed multivitamins and education in the context of health education provided to women in a group setting, once a month. Site B provided the services primarily through home visits of varying frequency. Folic acid knowledge and consumption were measured at program initiation and at …

Hiv Testing Policies In Florida, Jennifer Syvertsen, Hilda Leon, Jeffrey Beal, Marlene Lalota, Sherry Riley, Michael D. Knox

Florida Public Health Review

To combat the HIV/AIDS epidemic, strong policies that promote HIV testing are a primary mechanism for helping public health officials to understand the populations at risk, informing prevention initiatives, and linking infected individuals to the timely care they need. This paper describes HIV testing policies with the goal of improving early diagnosis and treatment of Floridians.

Leadership Approaches To Providing Quality Hiv Prevention Care For Older Adults

Florida Public Health Review

Americans continue to face risks associated with human immunodeficiency virus (HIV). One population that receives little attention concerning HIV is that of older adults. Approximately 20% of all HIV cases are among adults aged 50 and older. Older adults and younger populations are at risk for HIV; however, few programs are in place to reduce the incidence of HIV among this priority population. Many cases of HIV among older adults go unnoticed because health care professionals perceive older adults as asexual. Many physicians and other health professionals, including health educators, are uncomfortable in discussing sexual histories with older adults, so …

The Evaluation Of Pain Experienced By Children Undergoing Simple Extraction Using 2% Lidocaine Versus Oraqix Topical Anesthetic Gel, John Haffner

Theses and Dissertations

Purpose: The purpose of this study is to examine the pain response experienced by children undergoing simple tooth extractions using 2% Lidocaine injection versus Oraqix topical anesthetic gel. Methods: This study is being conducted at VCU pediatric dentistry clinic. The sample size will consist of 15 children ages 7-12 undergoing a simple extraction procedure. Each participant is randomly assigned to one of two groups, the lidocaine injection group or the Oraqix topical group. The pain level will be measured at four key events during the procedure. The first event will evaluate the pain at baseline. The second event will measure …

Functional Health Literacy And The Use Of Dental Services In Young Children, Melissa Fries

Theses and Dissertations

Purpose: The purpose of this study is to examine parental Functional Health Literacy and their child’s subsequent utilization of dental services. Methods: This was a prospective cohort study of children (n=1175) enrolled in the Child Health Investment Partnership of Virginia (CHIP). Descriptive statistics and separate multivariate logistic regressions were used to determine the relationship between functional health literacy measures; 1) Health Care Literacy (HCL), 2) Personal Health Literacy (PHL), and 3) LSP 22 scale, with utilization as measured as number of dental visit/s. Results: Descriptive analysis of the cohort reveals: 45% black, 40% white, 10% Hispanic, 5% other, 41% of …

Sustaining A Fall Prevention Initiative- It Can Be Done!, Liz Gutwein-Guenther, Rn Bsn- Tjuh, Patricia Horner, Rn Msn-Tjuh

Jefferson Hospital Nurses Week

Prompted by an increase in falls in December of 2006, a group of nurses convened to address new approaches in fall prevention. This group quickly identified the need for a multidisciplinary approach. During the first year, the interdisciplinary committee effected policy changes in many departments and provided multi-hospital wide education. The committee also supported the development of a nursing Fall Prevention Resource Group that meets monthly and is composed of nurses and aides from each unit. The members are the “Champions for Fall Prevention”. The monthly meetings of both groups keep the fall prevention initiative alive.

The Case Of The Silent Crippler, Amanda Orme, Karlen E. (Beth) Luthy

Faculty Publications

Thirteen-year-old “Stephanie” has been complaining of bilateral leg pain and increasing lower extremity weakness. Stephanie's teacher recently approached her parents to inform them of concerns that Stephanie is walking differently and seems off balance at school.

Meta-Analysis: Racial Disparities In Prostate Cancer Survival And Case-Control Study: Association Between Family History Of Cancers, Obesity And Prostate Cancer, Gayathri Sridhar

Theses and Dissertations

This is a compilation of 3 abstracts for the three manuscripts included in this dissertation. I. Meta-Analysis: Racial Disparities in Prostate Cancer Survival: Prostate cancer is the second leading cause of cancer-related mortality in men. Previous studies have drawn inconsistent conclusions on racial differences in prostate cancer survival. This meta-analysis was conducted to investigate the relationship between race and survival from prostate cancer. A systematic review of published articles from 1968 to 2007 assessing survival from prostate cancer among African American and White men was conducted. The search yielded 20 eligible published manuscripts. Analysis of unadjusted studies showed African American …

Faulkner The Humanist: How His Nobel Prize Acceptance Speech Changed How We Interpret "Barn Burning", Jessie L. Magee

Student Research Conference Select Presentations

No abstract provided.

Protecting Walden Pond: A Step Towards Defending Ordinary Nature In The United States, Jessie L. Magee

Student Research Conference Select Presentations

No abstract provided.

A Huntington's Warrior Lays Down His Shield, Kenneth P. Serbin

At Risk for Huntington's Disease

No abstract provided.

Making The Connection: Creating Leaders In Research, Education, And Practice Through Doctoral Study In Occupational Science & Occupational Therapy, Carlin Lorena Daley, Courtney E. Daniels, Camille Marie Dieterle, Lisa D. Hickey, Karen Mccarthy, Elizabeth Pyatak, Tina C. Yang

Collected Faculty Scholarship

Current students and recent graduates of USC's OTD and PhD programs share innovative projects that address the Centennial Vision priority areas of practice. They share practical and creative strategies for bridging the gaps between research, education, and practice, and developing and implementing changes in a variety of practice settings.

Kebijakan Peningkatan Pemberian Asi Eksklusif, Helda Helda

Kesmas

Angka Kematian Bayi di Indonesia adalah 35/1000 kelahiran hidup berada di posisi keenam di negara Asean. Salah satu upaya yang efisien untuk menurunkan angka kematian tersebut adalah pemberian ASI eksklusif yang memperlihatkan tren yang menurun, pada tahun 1997, (40,2%), 2002 (39,5%) dan 2007 (32%). Artikel ini bertujuan mengkaji kebijakan pemerintah memenuhi hak anak terhadap ASI. Metode yang digunakan melakukan telaah berbagai studi tentang kebijakan dan perundangan ASI di dunia dan di Indonesia,pada periode 2000-2007. Angka ASI eksklusif di dunia sangat bervariasi dan tidak berbanding lurus dengan kemajuan suatu negara. Jepang dan Inggris adalah contoh negara maju dengan angka ASI eksklusif …

Frekuensi Dan Determinan Kontrasepsi Pria Di Indonesia, Ahmad Ahmad

Kesmas

Pertumbuhan penduduk Indonesia terlihat tinggi (1,25%) dengan pertambahan sekitar 7,3 juta penduduk setiap tahun. Sejak tahun 1980, program keluarga berencana berkontribusi terhadap penurunan angka fertilitas dari 5,61 menjadi 2,6 pada tahun 2002. Kontribusi pria menggunakan kontrasepsi berhubungan dengan banyak faktor antara lain meliputi pengetahuan, sikap, praktek, keterbatasan informasi aksesibilitas fasilitas pelayanan kontrasepsi pria, keterbatasan jenis kontrasepsi, dan persepsi masyarakat yang kurang menguntungkan. Penelitian ini bertujuan untuk mengetahui berbagai faktor yang berhubungan dengan penggunaan kontrasepsi pria di Indonesia. Penelitian ini menggunakan sumber data sekunder Survei Demografi Kesehatan Indonesia (SDKI) tahun 2002-2003. Disain penelitian yang digunakan adalah Cross Sectiona l dengan metode …

Kelangsungan Penggunaan Kontrasepsi Di Indonesia, Sariana Sistri

Kesmas

Indonesia merupakan negara dengan jumlah penduduk terbesar keempat di dunia setelah Republik Rakyat Cina, India dan Amerika Serikat. Pada periode 2000-2002, penduduk Indonesia meningkat 1,25% atau 7,3 juta setiap tahun, sehingga pada tahun 2002 jumlah penduduk Indonesia menjadi sekitar 215 juta jiwa. Berdasarkan data SDKI, Total Fertility Rate (TFR) tahun 1997 (2,8) dan 2003 (2,6), dalam kurun waktu dua dasawarsa. Contraceptive Prevalence Rate (CPR), di Indonesia, pada 1977 (26) meningkatan dua kali lipat pada tahun 1997 (57) Penelitian ini bertujuan untuk mengetahui kelangsungan pemakaian kontrasepsi sejak pertama kali pemakaian pada periode 1997-2002, berikut berbagai faktor yang berhubungan. Desain penelitian yang …

Kinerja Sanitarian Puskesmas, Ardinal Ardinal

Kesmas

Program penyehatan air bersih dilaksanakan untuk pemenuhan akses masyarakat terhadap air bersih yang mencakup aspek jumlah dan kualitas. Untuk itu, perlu kerja keras pemegang program penyehatan air, khususnya sanitarian puskesmas yang merupakan ujung tombak pelaksanaan program di puskesmas. Tujuan penelitian ini mendapatkan gambaran kinerja petugas sanitasi Puskesmas dan faktor-faktor yang berperan di Kabupaten Solok Tahun 2007. Penelitian ini menggunakan pendekatan kualitatif melalui wawancara mendalam, Diskusi Kelompok Terarah dan observasi, dengan informan sanitarian puskesmas dilanjutkan triangulasi sumber dengan Kepala Puskesmas dan Kepala Bidang PL & PKM Dinas Kesehatan Kabupaten Solok. Kinerja sanitarian puskesmas dalam pelaksanaan program penyehatan air bersih yang rendah …

Partisipasi Masyarakat Menanggulangi Lingkungan Demam Berdarah Dengue Di Kecamatan Rappocini Kota Makasar, Sri Syatriani, Esse Puji, Andi Susilowati

Kesmas

Demam Berdarah Dengue (DBD) menjadi wabah nasional pada tahun 2006, termasuk Makassar dan beberapa kabupaten di Sulawesi Selatan. Jumlah kasus DBD di kecamatan Rappocini tahun 2006 adalah 160 kasus tanpa kematian. Penelitian bertujuan untuk mengetahui berbagai bentuk partisipasi masyarakat untuk menciptakan lingkungan sehat dalam upaya penanggulangan DBD. Penelitian dilaksanakan di kecamatan Rappocini yang merupakan daerah endemis DBD. Jenis penelitian adalah penelitian observasional dengan pendekatan deskriptif. Sampel adalah kepala keluarga yang ada di Kelurahan Bonto Makkio dan Kelurahan Gunung Sari sebesar 300 KK. Analisis data yang digunakan adalah analisis deskriptif dari setiap variabel. Hasil penelitian menunjukkan bahwa partisipasi masyarakat terhadap upaya …

Pemanfaatan Posyandu Lansia Di Kota Pariaman, Yullie Mulyadi

Kesmas

Pemanfaatan Posyandu Lansia di Wilayah Kerja Puskesmas Naras Kota Pariaman 2007 masih sangat rendah yaitu 13,23% dari standar pelayanan minimal (SPM) Kota Pariaman 40%. Penelitian ini untuk mendapatkan informasi yang mendalam tentang pemanfaatan posyandu lansia serta faktor yang mendorong dan menghambat dalam pemanfaatan posyandu lansia di Kota Pariaman pada 2008. Menggunakan data primer dengan metode wawancara mendalam dan diskusi kelompok terarah. Informan berjumlah 53 orang, terdiri dari 24 orang informan yang memanfaatkan posyandu lansia, 24 orang informan yang tidak memanfaatkan posyandu lansia dan 5 orang informan kunci. Data dianalisis dengan teknik analisis isi dengan validasi hasil penelitian dilakukan triagulasi sumber …

Pengaruh Perilaku Keluarga Terhadap Penggunaan Jamban, Erlinawati Pane

Kesmas

Secara nasional , hanya 39% rumah tangga yang menggunakan jamban yang sehat, di daerah perkotaan (60%) lebih tinggi daripada di perdesaan (23%). Penggunaan jamban merupakan salah satu masalah kesehatan yang penting di daerah perdesaan seperti Desa Sukamurni di Kabupaten Bekasi. Hanya 19,8% rumah tangga yang mempunyai jamban sendiri di Desa Sukamurni. Tujuan penelitian ini adalah mengetahui determinan perilaku keluarga terhadap penggunaan jamban di Desa Sukamurni. Penelitian ini menggunakan desain cross-sectional. Sampel adalah ibu rumah tangga yang mempunyai anak balita sebanyak 196 responden yang dilaksanakan pada bulan April hingga Mei 2008. Pengumpulan data dilakukan dengan wawancara langsung menggunakan kuesioner. Hasil penelitian …

Hiv/Aids Di Indonesia : Fenomena Gunung Es Dan Peranan Pelayanan Kesehatan Primer, Hardisman Hardisman

Kesmas

Masalah HIV/AIDS di Indonesia diyakini bagaikan fenomena gunung es karena laporan resmi jumlah kasus tidak mencerminkan masalah yang sebenarnya. Prediksi besar masalah HIV/AIDS tersebut didasarkan atas jumlah penyalahgunaan narkotika suntik dan prostitusi yang tinggi. Keduanya merupakan faktor utama yang berperan sangat besar dalam penyebaran dan penularan HIV. Berbagai faktor risiko tersebut tidak hanya berkaitan dengan pelayanan keseha-tan tetapi juga dengan masalah sosial ekonomi. Permasalahan tersebut perlu diatasi dengan pendekatan pelayanan kesehatan primer komprehensif yang langsung menyentuh akar permasalahan mencakup masalah sosial ekonomi dan lingkungan kultural. Strategi tersebut dilakukan melalui berbagai langkah yang bersifat menyeluruh, meliputi preventif, promotif, kuratif dan rehabilitatif …

What Makes Women Tired? A Community Sample, Donna E. Stewart, Susan Abbey, Marta Meana, Katherine M. Boydell

Psychology Faculty Research

We aimed to determine the major health concerns or problems of women and their personal attributions for the causes of their primary health concerns. We used a survey of women from the Toronto area attending a women's health symposium. Completed questionnaires were returned by 153 (85%) of 180 women attendees. Persistent fatigue was the primary and most commonly cited health concern. Fatigue was ranked first by 42 (27.5%) women and among the top 10 concerns by 123 (80.4%) women. Women attributed their fatigue to a combination of home and outside work (63.4%), poor sleep (38.2%), lack of time for self …

Prediction Of Sublingual Bioavailability Of Buprenorphine In Newborns With Neonatal Abstinence Syndrome—A Case Study On Physiological And Developmental Changes Using Nonmem And Simcyp, Di Wu, Walter K. Kraft, Michelle E. Ehrlick, Jeffrey S. Barnett

Department of Pharmacology and Experimental Therapeutics Faculty Papers

Poster presented at 2009 American College of Clinical Pharmacology conference in Orlando. April 24-28.

Background: About 55 to 94% of infants born to opioid dependent mothershave neonatal abstinence syndrome (NAS). Buprenorphine (BUP) is usedclinically as an analgesic and a detoxification agent and a maintenancetreatment for opioid dependence. No data, however, has been reported about the use of sublingual administration of BUP below the age of 4 year, especially for term infants with NAS.

Objectives: Characterize pharmacokinetics (PK) of BUP in newborn patients;Evaluate the developmental changes in newborns in order to assist dosingoptimization in ongoing clinical studies.

Methods: In silico prediction …

Understanding Nurse Created Cognitive Artifacts: Personally-Created-Cognitive-Artifacts As External Representations Of Distributed Cognition, Sharon Mclane

Dissertations and Theses (Open Access)

Manuscript 1: “Conceptual Analysis: Externalizing Nursing Knowledge”

We use concept analysis to establish that the report tool nurses prepare, carry, reference, amend, and use as a temporary data repository are examples of cognitive artifacts. This tool, integrally woven throughout the work and practice of nurses, is important to cognition and clinical decision-making. Establishing the tool as a cognitive artifact will support new dimensions of study. Such studies can characterize how this report tool supports cognition, internal representation of knowledge and skills, and external representation of knowledge of the nurse.

Manuscript 2: “Research Methods: Exploring Cognitive Work”

The purpose of this …

The Economic Impact Of Antimicrobial Resistance In Patients With Nosocomial Staphylococcus Aureus Bacteremia, Suzanne Phillips

Theses and Dissertations

Background: The proportion of nosocomial Staphylococcus infections caused by methicillin-resistant Staphylococcus aureus (MRSA) has increased from 22% in 1995 to 63% in 2004. Blood stream infections, more commonly referred to as bacteremias, represented the majority (75.5%) of hospital-onset MRSA cases. The economic impact of Staphylococcus aureus bacteremia merits investigation. Methods: This was a retrospective cohort analysis within Cerner HealthFacts data warehouse. Eligible patients were those who had Staphylococcus aureus bacteremia and were discharged between January 1, 2000, and December 31, 2006. Inclusion criteria include age > 18 years old and onset of infection > 48 hours post admission. The crude association was …

Obesity, Adiposity, And Satiety In Mouse Models Of Smith-Magenis Syndrome And Dup(17)(P11.2) Syndrome, Brooke Burns

Theses and Dissertations

Smith-Magenis syndrome (SMS) is a complex disorder caused by haploinsufficiency of RAI1 and characterized by sleep disturbances, behavioral abnormalities, mental retardation, and obesity in teens and adults. Rai1+/- mice are obese after 20 weeks. Dup(17)(p11.2) syndrome is a complex disorder associated with overexpression of RAI1. A transgenic mouse model of dup(17)(p11.2) syndrome overexpresses Rai1 and results in a mouse that is growth delayed. In order to characterize the obese phenotypes of mouse models of SMS and the role of RAI1 in obesity, daily food intake and serum levels of insulin, glucose, PPY, and leptin were measured; adiposity was studied by …