Medical Specialties Commons^™

Prevalence Trend And Disparities In Rheumatoid Arthritis Among Us Adults, 2005–2018, Yingke Xu, Qing Wu

Public Health Faculty Publications

Rheumatoid arthritis (RA) trends among US adults and disparities in RA patients in recent years have not been well described. We aimed to examine the trend of RA prevalence and disparities among US adults. Data from the National Health and Nutrition Examination Survey (NHANES) of the years 2005–2018 were analyzed to examine the self-reported RA prevalence trend. Age-adjusted RA prevalence stratified by race/ethnicity and socioeconomic status (SES), as well as associated linear trends, were calculated for both genders. The multivariable adjustment was used to evaluate the association between race, SES, and RA. During 2005–2018, there was no significant linear trend …

Assessing Clinical Change In Individuals Exposed To Repetitive Head Impacts: The Repetitive Head Impact Composite Index, Charles Bernick, Guogen Shan, Lauren Bennett, Jay Alberts, Jeffrey Cummings

Public Health Faculty Publications

Background: There is a current lack of any composite measure for the effective tracking and monitoring of clinical change in individuals exposed to repetitive head impacts (RHI). The aim of this study is to create a composite instrument for the purposes of detecting change over time in cognitive and behavioral function in individuals exposed to RHI. Methods: The data to derive the composite instrument came from the Professional Fighters Brain Health Study (PFBHS), a longitudinal study of active and retired professional fighters [boxers and mixed martial arts (MMA) fighters] and healthy controls. Participants in the PFBHS underwent assessment on an …

Machine Learning Approaches For Fracture Risk Assessment: A Comparative Analysis Of Genomic And Phenotypic Data In 5130 Older Men, Qing Wu, Fatma Nasoz, Jongyun Jung, Bibek Bhattarai, Mira V. Han

Public Health Faculty Publications

The study aims were to develop fracture prediction models by using machine learning approaches and genomic data, as well as to identify the best modeling approach for fracture prediction. The genomic data of Osteoporotic Fractures in Men, cohort Study (n = 5130), were analyzed. After a comprehensive genotype imputation, genetic risk score (GRS) was calculated from 1103 associated Single Nucleotide Polymorphisms for each participant. Data were normalized and split into a training set (80%) and a validation set (20%) for analysis. Random forest, gradient boosting, neural network, and logistic regression were used to develop prediction models for major osteoporotic fractures …

Opioid Use Disorders And Hospital Palliative Care Among Patients With Gastrointestinal Cancers: Ten-Year Trend And Associated Factors In The U.S. From 2005 To 2014, Jinwook Hwang, Jay J. Shen, Sun Jung Kim, Sung-Youn Chun, Pearl C. Kim, Se Won Lee, David Byun, Ji Won Yoo

Public Health Faculty Publications

This study aimed to analyze the trends of opioid use disorders, cannabis use disorders, and palliative care among hospitalized patients with gastrointestinal cancer and to identify their associated factors. We analyzed the National Inpatient Sample data from 2005 to 2014 and included hospitalized patients with gastrointestinal cancers. The trends of hospital palliative care and opioid or cannabis use disorders were analyzed using the compound annual growth rates (CAGR) with Rao-Scott correction for χ2 tests. Multivariate logistic regression analyses were performed to identify the associated factors. From 2005 to 2014, among 4,364,416 hospitalizations of patients with gastrointestinal cancer, the average annual …

Birth History As A Predictor Of Adverse Birth Outcomes: Evidence From State Vital Statistics Data, Dejun Su, Kaeli Samson, Ashvita Garg, Corrine Hanson, Ann L. Anderson Berry, Ge Lin Kan, Ming Qu

Public Health Faculty Publications

One of the most important predictors of preterm births (PTBs) or low-birth-weight births (LBWBs) is whether a mother has had a history of these birth outcomes. This study examined how different characterizations of birth history (e.g., any previous incidence of PTBs or LBWBs, immediate previous birth that was preterm or of low birth weight, and number of previous PTBs or LBWBs) were associated with PTBs or LBWBs. Based on birth records (n = 98,776) reported to the vital statistics electronic registration system in Nebraska from 2005 to 2014, mothers with a history of PTBs or LBWBs were more likely to …

Household Catastrophic Medical Expenses In Eastern China: Determinants And Policy Implications, Xiaohong Li, Jay J. Shen, Jun Lu, Mei Sun, Chengyue Li, Fengshui Chang, Mo Hao

Public Health Faculty Publications

Background: Much of research on household catastrophic medical expenses in China has focused on less developed areas and little is known about this problem in more developed areas. This study aimed to analyse the incidence and determinants of catastrophic medical expenses in eastern China.

Methods: Data were obtained from a health care utilization and expense survey of 11,577 households conducted in eastern China in 2008. The incidence of household catastrophic medical expenses was calculated using the method introduced by the World Health Organization. A multi-level logistic regression model was used to identify the determinants.

Results: The incidence of household catastrophic …

Health Disparities Experienced By People With Disabilities In The United States: A Behavioral Risk Factor Surveillance System Study, Jennifer Renee Pharr, Timothy J. Bungum

Public Health Faculty Publications

The Americans with Disabilities Act became law in 1990; since then research has shown that people with disabilities continue to experience barriers to health care. The purpose of this study was to compare utilization of preventive services, chronic disease rates, and engagement in health risk behaviors of participants with differing severities of disabilities to those without disabilities. This study was a secondary analysis of 2010 data collected in the Behavioral Risk Factor Surveillance System national survey in the United States. Rao Chi square test and logistic regression were employed. Participants with disabilities had significantly higher adjusted odds ratios for all …

Special Report On Children Born To Hiv Positive Parents In Nevada, 1991-1999, Drew Mather, Mary Guinan, Richard Whitley, Wei Yang

Public Health Faculty Publications

Background:

This report encompasses an effort to look at the number of children born to HIV (Human Immunodeficiency Virus) and/or AIDS (Acquired Immunodeficiency Syndrome) infected parents during the years 1991 to 1999 in Nevada.

According to the Healthy People 2000 (HP 2000) Review for the years 1998- 1999, infants of untreated or undetected HIV positive women have been identified as a distinct population at risk for contracting the virus that causes AIDS.

The State of Nevada’s Bureau of Disease Control and Intervention Services in collaboration with the Bureau of Health Planning and Statistics has taken the initial step to “cross …

Preventing Perinatal Transmission Of Hiv Costs And Effectiveness Of A Recommended Intervention, Robin D. Gorsky, P G. Farnham, Walter L. Straus, Blake Caldwell, D R. Holtgrave, R. J. Simonds, M F. Rogers, Mary Guinan

Public Health Faculty Publications

In the United States, nearly all new human immunodeficiency virus (HIV) infections in children are acquired through perinatal (mother-to-infant) transmission. Each year, approximately 7000 infants are born to HIV-infected women in the United States.¹ Without intervention, an estimated 15-30% of these infants would become infected.² In 1994, results of the AIDS Clinical Trial Group (ACTG) Protocol 076 showed that treatment of infected pregnant women and their infants with zidovudine (ZDV) reduced the rate of perinatal HIV transmission from 25% to 8%.^3,4 Following these findings, the Public Health Service (PHS) issued recommendations for ZDV therapy to prevent perinatal …

Menopausal Hormone Replacement: Not Necessarily Routine, Mary Guinan

Public Health Faculty Publications

No abstract provided.

Finding Hiv-Infected Women - The Clinician's Role, Mary Guinan

Public Health Faculty Publications

An estimated 100,000 women are currently infected with the human immunodeficiency virus (HIV) in the United States, and a great majority of them are unaware of their condition. Approximately 20,000 HIV-infected women were identified through publicly funded HIV screening programs in 1989 and 1990, and an unknown number through private screening. Because most HIV-infected women are believed to be in the lower socioeconomic strata, it is unlikely that a significant number were identified in the private sector. Therefore, up to 80% of HIV-positive women may not know they are infected.

Female Condoms, An Urgent Need, Mary Guinan

Public Health Faculty Publications

As of February 1991, more than 16,000 cases of AIDS in women had been reported in the United States, but the ". tidal wave of cases in women is yet to come. World Health Organization (WHO) estimates of the number of women infected with the human immunodeficiency virus (HIV) range from 1.5 million in Africa to I 00,000 in the United States. Within the next ten years, the majority of these women will develop AIDS and die. Some will live a bit longer, but all are eventually doomed to die prematurely. Most will not live to see their 40th year.

Pms And Eosinophilia-Myalgia Syndrome, Mary Guinan

Public Health Faculty Publications

No abstract provided.

Amwa Endorses Uniform Mammography Screening, Mary Guinan

Public Health Faculty Publications

Breast cancer is gaining on us at an increasing rate each year. In 1990 in the United States alone we expect about 145,000 new cases and 45,000 breast cancer deaths in women. What are we doing about it? What is AMWA doing, and what are women physicians doing- for themselves and their patients? Can we do anything? The answer is yes, we can. We can reduce mortality considerably if the cancer is detected early. The five-year survival rate for women with breast cancer diagnosed in its early (localized) stages is 90%, but for women with cancer diagnosed after it has …

Three Cheers For Elective Hysterectomy, Mary Guinan

Public Health Faculty Publications

Hysterectomy is the second (after cesarean section) most commonly performed major surgical procedure in the United States today.1 About [650,000 American women will have hysterectomies in 1989. Thirty-seven percent of all US women will have had a hysterectomy by the time they reach age 60. The number of hysterectomies increased dramatically Born 1965 to 1975, but then leveled off and decreased to the present level of about 7 per 1000 women. The ~ghest rates occur in women aged 35 to 44 years, the age group the so called baby boomers are now entering in large numbers. Therefore, if the age-specific …

Virginity And Celibacy As Health Issues, Mary Guinan

Public Health Faculty Publications

Sexual behavior is both a health issue and a moral issue. Hence public education on sexuality has traditionally come from two main sources, those individuals or groups concerned with health and those concerned with morals. In his book No Magic Bullet (Oxford University Press, 1985), Allan Brandt describes the tensions that developed between these groups over the control of sexually transmitted diseases in the United States early in this century. Both groups wanted to control sexual behavior, but for different reasons. Public health personnel wanted to change sexual behavior in order to control infection and disease, while moralists believed that …

Pms Or Perifollicular Phase Euphoria?, Mary Guinan

Public Health Faculty Publications

Why is it that so little is known about PMS? First of all, there is no agreement on what PMS is. If investigators are referring to different sets of symptoms, how can studies be comparable? In fact, they are not. Not only are the symptoms different, but the timing of symptoms is different, Some studies describe symptoms that occur 7 to 10 days before the onset of menses, while others include symptoms that begin 14 days before the onset of menses and continue for 7 days after onset. This definition suggests that women may have PMS-related symptoms during 21 days …

Have You Had Your Mammogram, Doctor?, Mary Guinan

Public Health Faculty Publications

Breast cancer incidence continues to increase in the United States, with more than 130,000 new cases and 42,000 deaths expected this year. Today, one in every ten women in the United States will develop breast cancer at sometime during their lives. Breast cancer can be prevented by early prophylactic bilateral mastectomy, ie, removal of the breasts before any signs or symptoms develop. This practice was advocated by a male gynecologist colleague of mine. When I expressed horror at his suggestion that I have such a procedure at age 32, he challenged me to defend myself against advocating a practice that …

Vaginal Colonization With Staphylococcus Aureus In Healthy Women: A Review Of Four Studies, Mary Guinan, Bruce B. Dan, Richard J. Guidotti, Arthur L. Reingold, George P. Schmid, Elena J. Bettoli, Joseph G. Lossick, Kathryn N. Shands, Mark A. Kramer, Nancy T. Hargrett, Roger L. Anderson, Claire V. Broome

Public Health Faculty Publications

Four studies assessed the frequency of vaginal Staphylococcus aureus colonization in healthy women and associated risk factors. An association was found between S. aureus vaginal colonization and colonization at the labia minora and the anterior nares. Significant risk factors associated with an increased risk of vaginal S. aureus in at least one study were a history of genital herpes simplex infection, insertion of tampons without an applicator, and the use of Rely (Procter & Gamble) tampons. The use of systemic antibiotics within 2 weeks of the vaginal culture decreased the risk of recovery of S. aureus. The overall frequency …