Medicine and Health Sciences Commons^™

Do Hospitalists Or Physicians With Greater Inpatient Hiv Experience Improve Hiv Care In The Era Of Highly Active Antiretroviral Therapy? Results From A Multicenter Trial Of Academic Hospitalists, John A. Schneider, Qi Zhang, Andrew Auerbach, David Gonzales, Peter Kaboli, Jeffrey Schnipper, Tosha B. Wetterneck, David L. Pitrak, David O. Meltzer

Community & Environmental Health Faculty Publications

Background. Little is known about the effect of provider type and experience on outcomes, resource use, and processes of care of hospitalized patients with human immunodeficiency virus (HIV) infection. Hospitalists are caring for this population with increasing frequency.

Methods. Data from a natural experiment in which patients were assigned to physicians on the basis of call cycle was used to study the effects of provider type—that is, hospitalist versus non hospitalist—and HIV-specific inpatient experience on resource use, outcomes, and selected measures of processes of care at 6 academic institutions. Administrative data, inpatient interviews, 30-day follow-up interviews, and the National Death …

Lung Cancer Incidence Among American Indians And Alaska Natives In The United States, 1999–2004, Anne Bliss, Nathaniel Cobb, Teshia Solomon, Kym Cravatt, Melissa A. Jim, Latisha Marshall, Janis Campbell

United States Public Health Resources

BACKGROUND. Lung cancer incidence rates among American Indians and Alaska Natives (AI/ANs) in the United States have not been described well, primarily because of race misclassification and, until the 1990s, incomplete coverage of their population by cancer registries. Smoking, the predominant cause of lung cancer, is particularly prevalent among this population.

METHODS. Data from the National Program of Cancer Registries and the Surveillance, Epidemiology, and End Results Program were combined to estimate age adjusted incidence rates of lung cancer during 1999 through 2004. Cases were linked to Indian Health Service (IHS) registration databases to identify AI/ANs whose race …

Methods For Improving Cancer Surveillance Data In American Indian And Alaska Native Populations, David K. Espey, Charles Wiggins, Melissa A. Jim, Barry A. Miller, Christopher J. Johnson, Tom M. Becker

United States Public Health Resources

BACKGROUND. The misclassification of race decreases the accuracy of cancer incidence data for American Indians and Alaska Natives (AI/ANs) in some central cancer registries. This article describes the data sources and methods that were used to address this misclassification and to produce the cancer statistics used by most of the articles in this supplement.

METHODS. Records from United States cancer registries were linked with Indian Health Service (IHS) records to identify AI/AN cases that were misclassified as non-AI/AN. Data were available from 47 registries that linked their data with IHS, met quality criteria, and agreed to participate. Analyses …

Primary Liver Cancer Incidence Among American Indians And Alaska Natives, Us, 1999–2004, Melissa Jim, David G. Perdue, Lisa C. Richardson, David K. Espey, John T. Redd, Howard J. Martin, Sandy L. Kwong, Janet J. Kelly, Jeffrey A. Henderson, Faruque Ahmed

United States Public Health Resources

BACKGROUND. American Indians and Alaska Natives (AI/AN) experience higher morbidity and mortality from primary liver cancer than other United States (US) populations, but racial misclassification in medical records results in underestimates of disease burden.

METHODS. To reduce misclassification, National Program of Cancer Registries and Surveillance, Epidemiology, and End Results data were linked with Indian Health Service (IHS) enrollment records to compare primary liver cancer incidence and stage at diagnosis between AI/AN and non-Hispanic whites (NHW) living within the regionalized IHS Contract Health Service Delivery Area counties. Incidence rates are expressed per 100,000 persons and age-adjusted by 19 age …

Cancer Among American Indians And Alaska Natives In The United States, 1999–2004, Charles Wiggins, David K. Espey, Phyllis A. Wingo, Judith S. Kaur, Robin Taylor Wilson, Judith Swan, Barry A. Miller, Melissa Jim, Janet J. Kelly, Anne P. Lanier

United States Public Health Resources

BACKGROUND. Cancer incidence rates vary among American Indian and Alaska Native (AI/AN) populations and often differ from rates among non-Hispanic whites (NHWs). However, the misclassification of race for AI/AN cancer cases in central cancer registries may have led to underestimates of the AI/AN cancer burden in previous reports.

METHODS. Cases diagnosed during 1999 through 2004 were identified from population- based cancer registries in the United States. Age-adjusted rates were calculated for the 25 most common sites for AI/ANs and NHWs. To minimize the misclassification of race, cancer registry records were linked with patient registration files from the Indian …

The Uses Of Rickets: Race, Technology, And The Politics Of Preventive Medicine In The Early Twentieth Century, M. Allison Arwady

Yale Medicine Thesis Digital Library

Rickets, the bone disease classically caused by Vitamin D deficiency, was one of the most common diseases of children 100 years ago. It has been recognized as a disease of urban living and linked to issues of race and culture for generations. This paper uses unpublished patient records from 1904 to 1909 and archival and published materials from multiple community-based trials, including the New Haven Rickets Study (1923-1926), to explore how the definition, diagnosis, and treatment of rickets shifted in the first decades of the twentieth century in the United States. Before 1910, as evidenced by patient records, neither the …

Functional Analysis Of Human Beta Defensin-1: Novel Insight Into Its Role In Prostate Cancer, Rebecca S. Bullard

MUSC Theses and Dissertations

Prostate cancer is the second leading cause of cancer-related deaths in men in the United States. The molecular pathogenesis of this disease includes genetic alterations, infection, and exposure to inflammatory or dietary oxidants. Recently, research has focused on the role of host defense peptides in tumor immunity. Defensins, a highly conserved multigene family of proteins that possess antimicrobial and antiviral properties, play an essential role in innate and adaptive immunity. These peptides are categorized into alpha- and beta-defensins based upon the spacing and connection between the six conserved cysteine residues of the mature peptide. Human Beta Defensin-1 (hBD-1), an important …

Continuous Source Of Care Among Young Underserved Children: Associated Characteristics And Use Of Recommended Parenting Practices., Esther K Chung, Leny Mathew, Kelly F Mccollum, Irma T Elo, Jennifer F Culhane

Department of Pediatrics Faculty Papers

OBJECTIVES: The aim of this study was to 1) assess sociodemographic and health characteristics associated with having a continuous source of care (CSOC) among young children and 2) determine the relationship between having a CSOC and use of parenting practices.

METHODS: We conducted a prospective, community-based survey of women receiving prenatal care at Philadelphia community health centers. We conducted surveys at the first prenatal visit and at a mean age +/- standard deviation of 3 +/-1, 11 +/- 1, and 24 +/- 2 months postpartum, obtaining information on sociodemographic and health characteristics, child's health care provider, and 6 parenting practices. …

Analyse Comparative Des Programmes Et Des Procédures De Cadenassage Appliqués Aux Machines Industrielles, Yuvin Chinniah, Mathieu Champoux, Damien Burlet-Vienney, Renaud Daigle

Rapports de recherche scientifique

Click here for the English version of this report

Le cadenassage réduit les risques que posent les travaux de maintenance, de réparation et de déblocage des machines industrielles. Or, la CSST indiquait récemment que 5 225 accidents, dont six mortels, surviennent encore annuellement pendant l’exécution de tels travaux sur des machines mal ou non cadenassées. La norme canadienne CSA Z460-05 définit le cadenassage comme l’installation, conformément à une procédure précise, d’un cadenas ou d’une étiquette sur un dispositif d’isolement des sources d’énergie d’une machine pour indiquer que celui-ci ne doit pas être actionné avant le retrait du cadenas ou de …

Aoa Symposium. Orthopaedists Partnering With Other Physicians To Provide Musculoskeletal Care., Alan Hilibrand, Kurt P Spindler, Scott D Boden

Rothman Institute Papers

No abstract provided.

Turf Wars In Radiology: What Must Academic Radiology Do?, Vijay M. Rao, David C. Levin

Department of Radiology Faculty Papers

In a previous article in this series, we called upon private practice radiology groups to better support radiology research financially, but also pointed out that academic radiology must make some changes as well. In this article, we discuss those changes in detail. They include revising the structure of the radiology residency, changing the timing of the American Board of Radiology oral examinations, requiring that all residents receive research training, and emphasizing the value of clinical and translational research. The Society of Chairmen of Academic Radiology Departments (SCARD) needs to assume a leadership role in implementing these changes.

Funding Crisis In Title Vii Diversity Programs, Paula N O'Neill, Alvin H Strelnick

Faculty, Staff and Student Publications

No abstract provided.

Insights From The 2007 Disease Management Colloquium., David B Nash, Tine Hansen-Turton, Tracey Moorhead, Harry Leider, Donald F Wilson

College of Population Health Faculty Papers

No abstract provided.

Barriers To Recovery And Recommendations For Change: The Pennsylvania Consensus Conference On Psychiatry's Role., Joseph A. Rogers, Michael J. Vergare, Richard C. Baron, Mark S. Salzer

Department of Psychiatry and Human Behavior Faculty Papers

OBJECTIVE: Recovery has emerged over the past decade as a dominant theme in public mental health care.

METHODS: The 2006 Pennsylvania Consensus Conference brought together 24 community psychiatrists to explore the barriers they experienced in promoting recovery and their recommendations for change.

RESULTS: Twelve barriers were identified and classified into one of three categories: psychiatry knowledge, roles, and training; the need to transform public mental health systems and services; and environmental barriers to opportunity. Participants made 22 recommendations to address these barriers through changes in policies, programs, and psychiatric knowledge and practice.

CONCLUSIONS: The recommendations identify areas for change that …

Quality Of Care Measures For Migraine: A Comprehensive Review, Joshua J. Gagne, Brian Leas, Jennifer H. Lofland, Neil Goldfarb, Frederick Freitag, Stephen Silberstein

College of Population Health Faculty Papers

Migraine headache is a highly prevalent, chronic, episodic disorder that is associated with high direct and indirect costs. Migraine headache impacts not only patients, but also their employers due to substantial decreases in workplace productivity. Despite the prevalence and clinical and economic burdens of migraine, no national efforts to develop and implement standardized measures of quality of care have been made. The objective of this study was to collect and report on existing quality of care measures for migraine that could be suitable for quality measurement at the health-plan level. Published literature, the Agency for Healthcare Research and Quality's National …

Dermatology 75 Years Ago., Lawrence Parish, Joseph A Witkowski

Department of Dermatology and Cutaneous Biology Faculty Papers

It seems that the practicing dermatologist in 2007 is being attacked on all fronts. The Food and Drug Administration has mandated a cumbersome program for monitoring isotrentinoin usage, its analogue barely comes under scrutiny. iPledge is just a plain nightmare. The acumen of the board certified dermatologist is being challenged by Maintenance of Certification proposals because other specialties are doing it; yet, the neighborhood pharmacist is unhampered in dispensing all sorts of advice about treatment. The insurance clerk thrives on denying medication, prescribed by the physician, using flawed reasoning or else suggesting that a ten days’ supply of medicine should …

Bridging The Critical Chasm Between Service And Research: The Cancer Information Service’S Collaboratory, Linda Squiers, Nigel Bush, Robin C. Vanderpool, Ludmila Cofta-Woerpel, Cecilia Fabrizio

Health, Behavior & Society Faculty Publications

As a collaboratory for cancer communication and education research, the National Cancer Institute's (NCIs) Cancer Information Service (CIS) is in an ideal position to bridge the critical chasm that exists between service and research. This article describes the CIS' current research program as well as the CIS Research Agenda launched in 2005. The CIS' progress in developing and supporting recently funded studies that address this agenda is detailed. The unique resources and opportunities available to researchers, public health practitioners, health care providers, and community-based organizations interested in developing collaborative cancer communication and cancer education studies with the CIS are identified …

Chronic Disease Prevention In Adolescence, Hatim A. Omar, Joav Merrick

Pediatrics Faculty Publications

No abstract provided.

Adrb2 Arg16gly Polymorphism, Lung Function, And Mortality: Results From The Atherosclerosis Risk In Communities Study, Jill M. Ferdinands, David M. Mannino, Marta L. Gwinn, Molly S. Bray

Internal Medicine Faculty Publications

BACKGROUND: Growing evidence suggests that the Arg16Arg genotype of the beta-2 adrenergic receptor gene may be associated with adverse effects of beta-agonist therapy. We sought to examine the association of beta-agonist use and the Arg16Gly polymorphism with lung function and mortality among participants in the Atherosclerosis Risk in Communities study.

METHODOLOGY AND PRINCIPAL FINDINGS: We genotyped study participants and analyzed the association of the Arg16Gly polymorphism and beta-agonist use with lung function at baseline and clinical examination three years later and with all-cause mortality during 10 years of follow-up. Lung function was characterized by percent-predicted forced expiratory volume in 1 …

Sociodemographic Characteristics And Diabetes Predict Invalid Self-Reported Non-Smoking In A Population-Based Study Of U.S. Adults, Monica A. Fisher, George W. Taylor, Brent J. Shelton, Sara M. Debanne

Markey Cancer Center Faculty Publications

BACKGROUND: Nearly all studies reporting smoking status collect self-reported data. The objective of this study was to assess sociodemographic characteristics and selected, common smoking-related diseases as predictors of invalid reporting of non-smoking. Valid self-reported smoking may be related to the degree to which smoking is a behavior that is not tolerated by the smoker's social group.

METHODS: True smoking was defined as having serum cotinine of 15+ng/ml. 1483 "true" smokers 45+ years of age with self-reported smoking and serum cotinine data from the Mobile Examination Center were identified in the third National Health and Nutrition Examination Survey. Invalid non-smoking was …

Use Of Complementary And Alternative Medicine For Weight Control In The United States, Patricia A. Sharpe, Heidi M. Blanck, Joel E. Williams, Barbara E. Ainsworth, Joan M. Conway

Faculty Publications

Objectives: The purpose was to assess the prevalence and correlates of complementary and alternative medicine use for weight control.

Design: A list-assisted random-digit-dialed telephone survey of adults was conducted in the fall of 2002 (n = 11,211). The focus of the study was complementary and alternative medicine (CAM) use, other than dietary supplements, in the previous 12 months.

Settings/location: The sample of respondents was drawn from the total noninstitutionalized U.S. adult population residing in telephone-equipped locations.

Subjects: The sampling procedures were designed to obtain adequate representation of Hispanic and non-Hispanic black respondents. Data from the total sample of 11,211 …

Fidelity In Sensory Integration Intervention Research., L Diane Parham, Ellen S. Cohn, Susan Spitzer, Jane A. Koomar, Lucy Jane Miller, Janice P Burke, Barbara Brett-Green, Zoe Mailloux, Teresa A. May-Benson, Susanne Smith Roley, Roseann C. Schaaf, Sarah A. Schoen, Clare A. Summers

Department of Occupational Therapy Faculty Papers

OBJECTIVE: We sought to assess validity of sensory integration outcomes research in relation to fidelity (faithfulness of intervention to underlying therapeutic principles).

METHOD: We identified core sensory integration intervention elements through expert review and nominal group process. Elements were classified into structural (e.g., equipment used, therapist training) and therapeutic process categories. We analyzed 34 sensory integration intervention studies for consistency of intervention descriptions with these elements.

RESULTS: Most studies described structural elements related to therapeutic equipment and interveners' profession. Of the 10 process elements, only 1 (presentation of sensory opportunities) was addressed in all studies. Most studies described fewer than …

Goal Attainment Scaling As A Measure Of Meaningful Outcomes For Children With Sensory Integration Disorders., Zoe Mailloux, Teresa A. May-Benson, Clare A. Summers, Lucy Jane Miller, Barbara Brett-Green, Janice P. Burke, Ellen S. Cohn, Jane A. Koomar, L Diane Parham, Susanne Smith Roley, Roseann C. Schaaf, Sarah A. Schoen

Department of Occupational Therapy Faculty Papers

Goal attainment scaling (GAS) is a methodology that shows promise for application to intervention effectiveness research and program evaluation in occupational therapy (Dreiling & Bundy, 2003; King et al., 1999; Lannin, 2003; Mitchell & Cusick, 1998). This article identifies the recent and current applications of GAS to occupational therapy for children with sensory integration dysfunction, as well as the process, usefulness, and problems of application of the GAS methodology to this population. The advantages and disadvantages of using GAS in single-site and multisite research with this population is explored, as well as the potential solutions and future programs that will …

Public Health Performance, F. Douglas Scutchfield Md

Preventive Medicine and Environmental Health Presentations

No abstract provided.

Approval Of New Drugs By The U. S. Food And Drug Administration: Problems With The Process And Access To Unapproved Drugs, Christine M. Hoeft-Loyer

Master's Theses and Doctoral Dissertations

Today, the vast majority of drugs available for patient use have gone through a rigorous system of human clinical trials supervised by the Food and Drug Administration (FDA), to ensure the drugs are safe and efficacious. There are now citizen advocacy groups that seek use of drugs not yet approved by the FDA, to be administered to terminally ill patients who have exhausted all other available means of therapy. The FDA has programs for terminal patients, under the supervision of their physicians, to use unapproved drugs; however, the advocacy groups seek access to drugs in much earlier phases than is …

The Health Insurance Debate In Canada: Lessons For The United States?, Mary Anne Bobinski

Faculty Articles

This Essay begins with an intentionally ambiguous title. Are comparisons to Canada relevant and useful for policy-makers in the United States and, if so, what lessons can we learn? Part II of this Essay highlights some of the risks and benefits of cross-border comparisons between the United States and Canada. In Part III, I analyze some of the key data points often cited in comparing the two health care systems. Part IV explores the current Canadian debate about private health insurance. Finally, in Part V, I focus on the lessons from Canada for the health insurance debate in the United …

The Influence Of Indoor Air Quality (Iaq) On Student Test Performance, Denise M. Hreha

Seton Hall University Dissertations and Theses (ETDs)

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

College of Population Health Faculty Papers

Report on the US Summit

Guidelines And Standards For Performance Of A Pediatric Echocardiogram: A Report From The Task Force Of The Pediatric Council Of The American Society Of Echocardiography., Wyman W. Lai, Tal Geva, Girish S. Shirali, Peter C. Frommelt, Richard A. Humes, Michael M. Brook, Ricardo H. Pignatelli, Jack Rychik, Pediatric Council Of The American Society Of Echocardiography

Manuscripts, Articles, Book Chapters and Other Papers

No abstract provided.

Liver Transplant Recipient With Calcineurin-Inhibitor Induced Pain Syndrome: A Case Report, Nethra S. Ankam, Md, Stanley R. Jacobs, Md

Department of Rehabilitation Medicine Faculty Papers

Setting: University Hospital

Patient: 65-year-old female status-post liver transplant secondary to cirrhosis.

Case Description: Prior to the rehabilitation consult on post-operative day 42, she had an episode of acute rejection requiring rapid escalation of cyclosporine dosage, later changed to high dose tacrolimus for immunosuppression, resulting in high blood levels of both calcineurin inhibitors. She then complained of paroxysms of 10/10 pain over her entire body not relieved by opioids despite escalation in medication by the acute pain service. She was not participating in a rehabilitation program because of pain. Examination revealed an anxious woman for whom any tactile stimulation …