Medicine and Health Sciences Commons^™

An Examination Of Intimate Partner Violence And Cigarette Smoking Among African American Women In 12 States, Eboneka Coleman

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Abstract

Introduction. African American female intimate partner victims (IVP) are more likely to abuse substances, suffer from depression and anxiety, and experience mental health issues, including PTSD, all of which are risk factors for smoking. The purpose of this study is to determine among African American women who have ever experienced IPV the prevalence of smoking and whether it is influenced by education and income.

Methods. Data for this study comes from the 2005 Centers for Disease Control and Prevention (CDC) state-based Behavioral Risk Factor Surveillance System (BRFSS). This primary study population was African American females who answered IPV-related questions …

Public Health System Partnerships And The Scope Of Maternal And Child Services: A Longitudinal Study, Sharla Smith, Glen Mays, Tommy Mac Bird, Michael A. Preston

Frontiers in Public Health Services and Systems Research

Local health departments (LHDs) struggle to serve their communities in the face of ongoing fiscal constraints. Fiscal constraints have led to the elimination and reduction of maternal and child health services (MCH). LHDs have used various strategies to minimize the negative impact fiscal constraints of elimination or reduction of services provided to their communities. Many LHDs have used strategies such as developing partnerships. While these strategies are assumed to increase the delivery of services and improve outcomes, there is limited research on the type of partnerships needed to service delivery. Our interest was identifying the type of partnerships associated with …

Exploring The Process, Models, And Outcomes Of Hospital-Public Health Partnerships, Danielle M. Varda, Jessica H. Retrum, Carrie Chapman

Frontiers in Public Health Services and Systems Research

Health care reform has resulted in changes throughout the health system, including the Affordable Care Act (ACA) requirement that hospitals conduct community health needs assessments, taking into greater consideration the public health of their respective communities. This has led to growing strategies to develop partnerships between hospitals and public health (PH) as a way to meet these needs¹. Meantime, there is a need for data on Hospital-PH partnerships, due to the growing emphasis that these types of partnerships get implemented in practice. In this paper we analyze a secondary data set to explore how hospitals and public health …

A Case Study Of Cross-Jurisdiction Resource Sharing: The Merger Of Two Tuberculosis Clinics In East Tennessee., Anne Kershenbaum, Margaret A. Knight, Martha L. Buchanan, Janet Ridley, Paul C. Erwin

Frontiers in Public Health Services and Systems Research

Cross-jurisdiction resource sharing is considered a possible means to improve efficiency and effectiveness of public health service delivery. A merger of the Tuberculosis (TB) clinics of a rural and a metropolitan jurisdiction in East Tennessee provided an opportunity to study service provision changes in real time. A mixed methods approach was used, including quantitative data on latent TB treatment outcomes and qualitative data from staff interviews, as well as documentation of changes in staffing time in TB services. Results showed a mix of efficiency changes, indicating probable increased pressure on key service providers after the merger, in addition to expected …

Health Communication As A Public Health Training And Workforce Development Issue, Nancy L. Winterbauer, Ann P. Rafferty, Katherine A. Jones, Mary Tucker-Mclaughlin, Colleen Bridger

Frontiers in Public Health Services and Systems Research

Effective communication is one of the core competencies for public health professionals and is required for local health department (LHD) accreditation. Public health communication specialists play a critical role as conduits of health information, particularly with regard to managing relationships with media and the message that is ultimately represented by news outlets. However, capacity for engagement with traditional media in community health improvement at the local level has not been well-described. As part of a larger study examining the use and impact of the County Health Rankings in North Carolina, LHD media staffing and interaction with traditional media were examined …

What “Community Building” Activities Are Nonprofit Hospitals Reporting As Community Benefit?, Erik Bakken, David Kindig, Jo Ivey Boufford

Frontiers in Public Health Services and Systems Research

In 2008, the Internal Revenue Service (IRS) revised and standardized the reporting policy for community benefit expenses for nonprofit hospitals. These expenses are required for tax exemption. At that time, the IRS designated some categories of activities as non-eligible as a community benefit, but still mandated their reporting on hospitals’ Form 990, the annual tax filing for nonprofit organizations. One such category was community building, which encompasses a broad range of nonmedical determinants of health and an important potential source of population health revenue. This is the first study to analyze community-building dollars at any level, examining New York State’s …

Continuing To Confront Copd International Physician Survey: Physician Knowledge And Application Of Copd Management Guidelines In 12 Countries, Kourtney J. Davis, Sarah H. Landis, Yeon-Mok Oh, David M. Mannino, Meilan K. Han, Thys Van Der Molen, Zaurbek Aisanov, Ana M. Menezes, Masakazu Ichinose, Hana Muellerova

Preventive Medicine and Environmental Health Faculty Publications

AIM: Utilizing data from the Continuing to Confront COPD (chronic obstructive pulmonary disease) International Physician Survey, this study aimed to describe physicians' knowledge and application of the GOLD (Global initiative for chronic Obstructive Lung Disease) Global Strategy for the Diagnosis, Management and Prevention of COPD diagnosis and treatment recommendations and compare performance between primary care physicians (PCPs) and respiratory specialists.

MATERIALS AND METHODS: Physicians from 12 countries were sampled from in-country professional databases; 1,307 physicians (PCP to respiratory specialist ratio three to one) who regularly consult with COPD, emphysema, or chronic bronchitis patients were interviewed online, by telephone or face …

Left Ventricular Assist Device As Destination Therapy, Maya Guglin, Leslie W. Miller

The VAD Journal

Mechanical circulatory support is the most rapidly evolving strategy in heart failure management. The growing number of patients who need better results than medical therapy can offer, the limited pool of donors for cardiac transplantation, and several technological breakthroughs have all made the option of implanting a left ventricular assist device (LVAD) as destination therapy more important.

In this review, we outline the indications and decision making process of considering a patient for a destination therapy LVAD, as well as outcomes, complications, and issues related to management of patients on currently approved devices. The future direction of the field will …

The Bubbling Aorta, Hesham R. Omar, Maya Guglin

The VAD Journal

We are presenting the image of the bubbles in the descending aorta in a patient on VA ECMO.

A New Cecal Slurry Preparation Protocol With Improved Long-Term Reproducibility For Animal Models Of Sepsis, Marlene E. Starr, Allison M. Steele, Mizuki Saito, Bill J. Hacker, B. Mark Evers, Hiroshi Saito

Surgery Faculty Publications

Sepsis, a life-threatening systemic inflammatory response syndrome induced by infection, is widely studied using laboratory animal models. While cecal-ligation and puncture (CLP) is considered the gold standard model for sepsis research, it may not be preferable for experiments comparing animals of different size or under different dietary regimens. By comparing cecum size, shape, and cecal content characteristics in mice under different experimental conditions (aging, diabetes, pancreatitis), we show that cecum variability could be problematic for some CLP experiments. The cecal slurry (CS) injection model, in which the cecal contents of a laboratory animal are injected intraperitoneally to other animals, is …

The Promise Of Novel Molecular Markers In Bladder Cancer, Jahan Miremami, Natasha Kyprianou

Urology Faculty Publications

Bladder cancer is the fourth most common malignancy in the US and is associated with the highest cost per patient. A high likelihood of recurrence, mandating stringent surveillance protocols, has made the development of urinary markers a focus of intense pursuit with the hope of decreasing the burden this disease places on patients and the healthcare system. To date, routine use of markers is not recommended for screening or diagnosis. Interests include the development of a single urinary marker that can be used in place of or as an adjunct to current screening and surveillance techniques, as well identifying a …

Bovine Colostrum Supplementation Optimises Earnings, Performance And Recovery In Racing Thoroughbreds, C. K. Fenger, Thomas Tobin, P. J. Casey, Edward A. Roualdes, J. L. Langemeier, D. M. Haines

Maxwell H. Gluck Equine Research Center Faculty Publications

Bovine colostrum (BC) is the first milk produced by cows after calving and contains numerous beneficial substances for the immunity and development of the newborn calf. Because of the growth and immune factors in BC, it has become an attractive supplement for use by athletes to support immunity and health during athletic performance. In order to evaluate the effects of oral BC supplementation on equine athletes, this study evaluated the earnings, performance, recovery and incidence of upper respiratory infections (URTI) in racing horses. The study design was a randomized cross-over racing performance study. 21 horses in race training were randomly …

Cd151-Α3Β1 Integrin Complexes Suppress Ovarian Tumor Growth By Repressing Slug-Mediated Emt And Canonical Wnt Signaling, Lauren A. Baldwin, John T. Hoff, Jason Lefringhouse, Michael Zhang, Changhe Jia, Zeyi Liu, Sonia Erfani, Hongyan Jin, Mei Xu, Qing-Bai She, John R. Van Nagell Jr., Chi Wang, Li Chen, Rina Plattner, David M. Kaetzel, Jia Luo, Michael Lu, Dava West, Chunming Liu, Fred R. Ueland, Ronny Drapkin, Binhua P. Zhou, Xiuwei H. Yang

Pharmacology and Nutritional Sciences Faculty Publications

Human ovarian cancer is diagnosed in the late, metastatic stages but the underlying mechanisms remain poorly understood. We report a surprising functional link between CD151-α3β1 integrin complexes and the malignancy of serous-type ovarian cancer. Analyses of clinical specimens indicate that CD151 expression is significantly reduced or diminished in 90% of metastatic lesions, while it remains detectable in 58% of primary tumors. These observations suggest a putative tumor-suppressing role of CD151 in ovarian cancer. Indeed, our analyses show that knocking down CD151 or α3 integrin enhances tumor cell proliferation, growth and ascites production in nude mice. These changes are accompanied by …

Sugihara Causality Analysis Of Scalp Eeg For Detection Of Early Alzheimer's Disease, Joseph C. Mcbride, Xiaopeng Zhao, Nancy B. Munro, Greg A. Jicha, Frederick A. Schmitt, Richard J. Kryscio, Charles D. Smith, Yang Jiang

Sanders-Brown Center on Aging Faculty Publications

Recently, Sugihara proposed an innovative causality concept, which, in contrast to statistical predictability in Granger sense, characterizes underlying deterministic causation of the system. This work exploits Sugihara causality analysis to develop novel EEG biomarkers for discriminating normal aging from mild cognitive impairment (MCI) and early Alzheimer's disease (AD). The hypothesis of this work is that scalp EEG based causality measurements have different distributions for different cognitive groups and hence the causality measurements can be used to distinguish between NC, MCI, and AD participants. The current results are based on 30-channel resting EEG records from 48 age-matched participants (mean age 75.7 …

Gender, Smoking And Tobacco Reduction And Cessation: A Scoping Review, Joan L. Bottorff, Rebecca Haines-Saah, Mary T. Kelly, John L. Oliffe, Iris Torchalla, Nancy Poole, Lorraine Greaves, Carole A. Robinson, Mary H. H. Ensom, Chizimuzo T.C. Okoli, J. Craig Phillips

Nursing Faculty Publications

Considerations of how gender-related factors influence smoking first appeared over 20 years ago in the work of critical and feminist scholars. This scholarship highlighted the need to consider the social and cultural context of women's tobacco use and the relationships between smoking and gender inequity. Parallel research on men's smoking and masculinities has only recently emerged with some attention being given to gender influences on men's tobacco use. Since that time, a multidisciplinary literature addressing women and men's tobacco use has spanned the social, psychological and medical sciences. To incorporate these gender-related factors into tobacco reduction and cessation interventions, our …

Even Perfusion Pump-Integrated Blood Oxygenator, Dongfang Wang, Joseph B. Zwischenberger

Surgery Faculty Patents

A blood oxygenator includes an integral pneumatic pump disposed substantially within a housing thereof, an inlet blood flow redirector, and an outflow blood collector. An atrium provided at an inlet of the oxygenator promotes even delivery of blood to the oxygenator. In use, the oxygenator provides an even dispersion of blood therethrough, establishing even perfusion and reducing areas of stagnant blood flow.

The Economics Of Implementing Population Health Strategies: Progress In Public Health Services & Systems Research, Glen P. Mays

Health Management and Policy Presentations

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 …

Challenges And Considerations In Optimizing Ovarian Stimulation Protocols In Oncofertility Patients, Kathryn Coyne, Mackenzie Purdy, Kathleen O'Leary, Jerome L. Yaklic, Steven R. Lindheim, Leslie A. Appiah

Obstetrics and Gynecology Faculty Publications

The scope of cancer treatment in women of childbearing age has changed in the last decade. Fertility preservation is no longer an afterthought but central to multi-disciplinary cancer treatment planning and should be addressed due to the cytotoxic effects of cancer therapy. However, oncology patients present as a unique treatment challenge as the physician must balance the urgency of fertility preservation with the risks of delaying cancer therapy. Controlled ovarian stimulation (COS) is routinely applied in assisted reproductive technology but can be contraindicated in women with estrogen-receptor-positive tumors. This paper reviews some of the challenges to consider when using COS …

Condom-Associated Erection Problems: A Study Of High-Risk Young Black Males Residing In The Southern United States, Cynthia A. Graham, Richard A. Crosby, Stephanie Sanders, Robin Milhausen, William L. Yarber

Health, Behavior & Society Faculty Publications

Previous research indicates that young men may experience condom-associated erection loss and that these problems may lead to inconsistent or incomplete condom use. The primary aim of this study was to assess, using a retrospective recall period of 2 months, correlates of condom-associated erection problems among young Black men attending sexually transmitted infection (STI) clinics. Data were collected in clinics treating patients with STIs in three southern U.S. cities. Males 15 to 23 years of age who identified as Black/African American and reported recent (past 2 months) condom use were eligible. A total of 494 men participated. Nineteen percent reported …

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

Health Management and Policy Presentations

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).

First Proof Of Concept Of Sustainable Metabolite Production From High Solids Fermentation Of Lignocellulosic Biomass Using A Bacterial Co-Culture And Cycling Flush System, Wanying Yao, Sue E. Nokes

Biosystems and Agricultural Engineering Faculty Publications

To improve the lignocellulose conversion for ABE in high solids fermentation, this study explored the feasibility of cycling the process through the cellulolytic or/and solventogenic phases via intermittent flushing of the fermentation media. Five different flushing strategies (varying medium ingredients, inoculum supplement and cycling through phases) were investigated. Flushing regularly throughout the cellulolytic phase is necessary because re-incubation at 65 °C significantly improved glucose availability by at least 6-fold. The solvents accumulation was increased by 4-fold using corn stover (3-fold using miscanthus) over that produced by flushing only through the solventogenic phase. In addition, cycling process was simplified by re-incubating …

Andreas Vesalius (1514-1564)–An Unfinished Life, Charles T. Ambrose

Microbiology, Immunology, and Molecular Genetics Faculty Publications

The fame of Andreas Vesalius (1514-1564) rests on his anatomy text, De humani corporis fabrica, regarded as a seminal book in modern medicine. It was compiled while he taught anatomy at Padua, 1537-1543. Some of his findings challenged Galen’s writings of the 2c AD, and caused De fabrica to be rejected immediately by classically trained anatomists. At age 29, Vesalius abandoned his studies and over the next two decades served as physician to Emperor Charles V of the Holy Roman Empire (HRE) and later to King Philip II of Spain in Madrid. In 1564, he sought to resume teaching anatomy …

On The Symbolism Of The White Coat, David A. Nash

Oral Health Science Faculty Publications

The white coat ceremony has become an academic ritual in the health professions: a ceremony that signals a transformation of status from ordinary student to that of one studying to become a health professional. While donning the white coat is a sign of a changed role, the white coat is also a powerful symbol of transformation. White is a symbol of purity, and the white coat symbolizes the purity of purpose being affirmed in becoming a health professional. Dentistry is afforded the status of a learned profession as a result of the power dentists possess over patients seeking care; this …

The Effects Of Temperature And Seasons On Subcutaneous White Adipose Tissue In Humans: Evidence For Thermogenic Gene Induction, Philip A. Kern, Brian S. Finlin, Beibei Zhu, Neda Rasouli, Robert E. Mcgehee Jr., Philip M. Westgate, Esther E. Dupont-Versteegden

Clinical and Translational Science Faculty Publications

Context: Although brown adipose tissue (BAT) activity is increased by a cold environment, little is known of the response of human white adipose tissue (WAT) to the cold.

Design: We examined both abdominal and thigh subcutaneous (SC) WAT from 71 subjects who were biopsied in the summer or winter, and adipose expression was assessed after an acute cold stimulus applied to the thigh of physically active young subjects.

Results: In winter, UCP1 and PGC1 α mRNA were increased 4 to 10-fold (p<0.05) and 1.5 to 2-fold, respectively, along with beige adipose markers, and UCP1 protein was 3-fold higher in the winter. The seasonal increase in abdominal SC WAT UCP1 mRNA was considerably diminished in subjects with a BMI > 30 kg/m², suggesting that dysfunctional WAT in obesity inhibits adipose thermogenesis. After applying an acute …

Focusing On Drug Versus Disease Mechanisms And On Clinical Subgrouping To Advance Personalised Medicine In Psychiatry, Jose De Leon

Psychiatry Faculty Publications

Personalised medicine has finally been featured in psychiatric journals, but psychiatrists have mainly focused on the promise of using disease mechanisms to personalise treatment. Psychiatric disorders such as schizophrenia and depression are not diseases, in the medical sense, and are probably more like syndromes. Instead of spending much time and effort focusing on the mechanisms of diseases that may instead be syndromes, the author believes that psychiatrists should (1) learn more about personalising prescription via drug mechanisms, a pharmacological approach to personalised medicine; and (2) reconsider prior attempts by traditional clinical psychopharmacologists to use sophisticated clinical approaches that try to …

Impact Of A Rapid Response System In A Children's Hospital, Erich C. Maul Do, Mph

Erich C. Maul DO MPH

My capstone project demonstrating the impact for a rapid response system in a children's hospital within a larger general hospital.

Simplified Post Processing Of Cine Dense Cardiovascular Magnetic Resonance For Quantification Of Cardiac Mechanics, Jonathan D. Suever, Gregory J. Wehner, Christopher M. Haggerty, Linyuan Jing, Sean M. Hamlet, Cassi M. Binkley, Sage P. Kramer, Andrea C. Mattingly, David K. Powell, Kenneth C. Bilchick, Frederick H. Epstein, Brandon K. Fornwalt

Saha Cardiovascular Research Center Faculty Publications

BACKGROUND: Cardiovascular magnetic resonance using displacement encoding with stimulated echoes (DENSE) is capable of assessing advanced measures of cardiac mechanics such as strain and torsion. A potential hurdle to widespread clinical adoption of DENSE is the time required to manually segment the myocardium during post-processing of the images. To overcome this hurdle, we proposed a radical approach in which only three contours per image slice are required for post-processing (instead of the typical 30-40 contours per image slice). We hypothesized that peak left ventricular circumferential, longitudinal and radial strains and torsion could be accurately quantified using this simplified analysis.

METHODS …

Quantitative Neuropathological Assessment To Investigate Cerebral Multi-Morbidity, Johannes Attems, Janna H. Neltner, Peter T. Nelson

Pathology and Laboratory Medicine Faculty Publications

The aging brain is characterized by the simultaneous presence of multiple pathologies, and the prevalence of cerebral multi-morbidity increases with age. To understand the impact of each subtype of pathology and the combined effects of cerebral multi-morbidity on clinical signs and symptoms, large clinico-pathological correlative studies have been performed. However, such studies are often based on semi-quantitative assessment of neuropathological hallmark lesions. Here, we discuss some of the new methods for high-throughput quantitative neuropathological assessment. These methods combine increased quantitative rigor with the added technical capacity of computers and networked analyses. There are abundant new opportunities - with specific techniques …

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

Health Management and Policy Presentations

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.

In Vivo Identification Of Eugenol-Responsive And Muscone-Responsive Mouse Odorant Receptors, Timothy S. Mcclintock, Kaylin Adipietro, William B. Titlow, Patrick Breheny, Andreas Walz, Peter Mombaerts, Hiroaki Matsunami

Physiology Faculty Publications

Our understanding of mammalian olfactory coding has been impeded by the paucity of information about the odorant receptors (ORs) that respond to a given odorant ligand in awake, freely behaving animals. Identifying the ORs that respond in vivo to a given odorant ligand from among the ∼1100 ORs in mice is intrinsically challenging but critical for our understanding of olfactory coding at the periphery. Here, we report an in vivo assay that is based on a novel gene-targeted mouse strain, S100a5-tauGFP, in which a fluorescent reporter selectively marks olfactory sensory neurons that have been activated recently in vivo. Because each …