Public Health Commons^™

Physical Activity And Physical Activity Adherence In The Elderly Based On Smoking Status., Theodore Cooper, M. Resor, C. Stoever, P. Dubbert

Departmental Papers (Psych)

No abstract provided.

A Computational Model For Analysis Of Uncoupled No Synthase On Nitric Oxide And Superoxide Interaction In Microcirculation, William Richardson, Mahendra Kavdia

Discovery, The Student Journal of Dale Bumpers College of Agricultural, Food and Life Sciences

Nitric oxide (NO) produced by endothelial cells is a key component for blood-vessel dilation. Dilation is achieved through smooth muscle relaxation as a response to NO transport. Inhibition of this process occurs through the inactivation of NO by reactive oxygen species, especially superoxide (O2 -). NO and superoxide react quickly, forming peroxynitrite (ONOO-). Both superoxide and peroxynitrite apply oxidative stress on vascular tissue. Experimental studies investigating NO interactions are difficult since these reactions occur rapidly and over small distances. This study presents a computational model to describe the interactions of NO, superoxide, and peroxynitrite across an arteriole/venule pair. Based on …

Ethnic Differentials In Parental Health Seeking For Childhood Illness In Vietnam, Bussarawan Teerawichitchainan, James F. Phillips

Poverty, Gender, and Youth

The recent introduction of user fees for Vietnam’s primary healthcare services has generated concern that economic policies may adversely affect health-seeking behavior and health outcomes of the poor, particularly among impoverished families who are members of socially marginalized minority groups. This Population Council working paper examines this debate by analyzing parental recall of illness and care-seeking for sick children under age 5 recorded by the 2001–02 Vietnam National Health Survey. Ethnic differentials are evident in all geographic and income levels, although adverse effects of minority status are most pronounced among poor households in remote areas. Results suggest that social equity …

Tuko Pamoja: A Guide For Peer Educators, Program For Appropriate Technology In Health (Path)

Reproductive Health

This guide was developed by Program for Appropriate Technology in Health (PATH) and is part of the Kenya Adolescent Reproductive Health Project’s Tuko Pamoja (We Are Together) series. Based on KARHP’s Adolescent Reproductive Health and Life Skills Curriculum, the guide is designed to help facilitate dialogue between adults and young people on issues related to adolescent reproductive health. It can be used to help peer educators share information and lead discussions with their peers on physical and emotional changes during adolescence, staying healthy, planning for the future, making good decisions, and preventing pregnancy and HIV and AIDS. The information can …

Grandir En Harmonie: Document De Références, Population Council

Reproductive Health

Ce document de référence fournit des informations pour accompagner les animateurs du curriculum « Grandir en harmonie » en santé de la reproduction. Il s’adresse principalement aux pairs éducateurs et aux assistants d’adolescent(e)s pour les aider à préparer les adolescents(e) à aborder la sexualité en connaissance de cause, de manière responsable et dans le respect des valeurs de leur communauté. Son contenu peut également être adapté pour les jeunes de 20 à 24 ans. Le document couvre des sujets tels que : lʼadolescence; les valeurs; le genre; les mutilations génitales féminines; comprendre son corps; le tabagisme, l’alcoolisme et la toxicomanie; …

Grandir En Harmonie: Guide De L'Utilisateur, Population Council

Reproductive Health

Ce guide de l’utilisateur fournit des informations pour aider les animateurs du programme « Grandir en harmonie » à jouer efficacement leur rôle d’éducateur pair. Le guide décrit la mission, les tâches et la cible des activités à faire avec les adolescent(e)s/jeunes. Ces activités leur permettent de renforcer leurs capacités à prendre des décisions afin de mieux se réaliser maintenant et dans le futur. Le guide aide les animateurs avec l’organisation, la méthodologie et le matériel de soutien pour les sessions.

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This user’s guide provides information to help “Growing in Harmony” curriculum facilitators effectively carry out their role of …

Grandir En Harmonie: Curriculum D'Animation Des Pairs-Éducateurs Et Des Aides-Ados Ou Jeunes Écoutant, Population Council

Reproductive Health

« Grandir en harmonie » est un curriculum d’animation en santé de la reproduction a l’intention des pair éducateurs et des aides-adolescent(e)s, principalement, pour préparer les adolescent(e)s à aborder la sexualité en connaisance de cause, de manière responsable et dans le respect des valeurs de leur milieu. Son contenu peut aussi être utilisé par les jeunes de 20 à 24 ans, mais avec des méthodes appropriées (panel, thé-débat, etc.). D’autre types d’utilisateurs l’ont expérimenté et ont trouvé que c’était une ressource utile pour la conduite de leurs activités: aides-adolescent(e)s, enseignants, prestataires de santé et autres encadreurs de jeunes. Leurs remarques …

Grandir En Harmonie: Les Questions/Réponses Les Plus Fréquentes Posées Par Les Adolescent(E)S, Population Council

Reproductive Health

Ce guide compile les questions les plus fréquemment posées par les adolescent(e)s au cours du curriculum « Grandir en harmonie » en santé de la reproduction. Il s’adresse principalement aux pairs éducateurs et aux assistants d’adolescent(e)s pour les aider à répondre aux adolescent(e)s au sujet de la sexualité en connaissance de cause, de manière responsable et dans le respect des valeurs de leur communauté. Le document couvre des sujets tels que : l’adolescence, la puberté et les changements des corps; la culture et la sexualité; la santé sexuelle et la sexualité à moindre risque; la contraception et les grossesses indésirées; …

Guías De Referencia: Para Instituciones Y Establecimientos De Salud Que Buscan Acreditar La Calidad Y Enfoque De Género De Sus Servicios, Patricia Riveros Hamel, Erica Palenque, Ricardo Vernon, Ignacio Carreno

Reproductive Health

Esta guía busca presentar todos los elementos para que las organizaciones de salud reproductiva puedan implantar un sistema para mejorar la calidad de los servicios y su sensibilidad a asuntos de género a través de una estrategia de acreditación. La estrategia de acreditación comienza con una evaluación de las condiciones y servicios que ofrece la clínica, lo que permite identificar los estándares de calidad que no son cumplidos. Posteriormente, el personal de la clínica toma como insumo esta información y elabora un plan de trabajo para resolver los problemas identificados. Si la clínica demuestra cumplir cuando menos el 80 por …

Management Of Complications, Pregnancy, Childbirth And The Postpartum Period In The Presence Of Fgm/C, Kenya Ministry Of Health

Reproductive Health

This reference manual is intended for health-care providers in Kenya working among communities that have a high prevalence of female genital mutilation/cutting (FGM/C) and those who encounter women and/or girls who have undergone the practice. It was designed particularly for use by nonspecialist clinicians, including nurses/midwives, clinical officers, district medical officers, postgraduate medical officers, and medical students. It is also a resource for medical and other health-service providers at primary, secondary, and tertiary levels, particularly those working in areas with a high prevalence of FGM/C. Since the evidence base for effective clinical practice is constantly evolving, readers are encouraged to …

Bolivia: Marketing And Economic Analyses Help Ngos Develop Strategies For Sustainability, Frontiers In Reproductive Health

Reproductive Health

Many nongovernmental organizations (NGOs) face reduced funding for reproductive health services and are seeking ways to assess and enhance their ability to generate income to cover their service costs. In 2004, following a workshop on financial sustainability presented by the Population Council’s FRONTIERS Program, three Bolivian NGOs—Prosalud; the Center for Research, Education, and Services (CIES); and the Association of Rural Health Programs (APSAR)—developed operations research studies to improve their financial sustainability. The Prosalud and CIES studies included a cost-recovery study, a study measuring clients’ willingness to pay for services, and a market segmentation study to compare the NGOs’ services with …

Mainstreaming And Scaling Up The Kenya Adolescent Reproductive Health Project, Ian Askew, Humphres Evelia

Reproductive Health

From 1999–2003, FRONTIERS implemented a Global Agenda program of operations research (OR) projects to address the reproductive health (RH) needs of adolescents in four countries—Bangladesh, Kenya, Mexico, and Senegal. The project was implemented in two districts of Western Province in Kenya and was known as the Kenya Adolescent Reproductive Health Project (KARHP). The project supported a public sector, multisectoral intervention to enhance young people’s knowledge and behavior regarding HIV prevention and RH. Implemented jointly with PATH, this OR project demonstrated that such an intervention could be implemented by the public sector, that it was acceptable to communities, that its influence …

Mainstreaming Adolescent Reproductive Health In Senegal: Enhancing Utilization Of The Findings From The Youth Reproductive Health Project, Nafissatou J. Diop, Anta Fall Diagne

Reproductive Health

From 1999–2003, FRONTIERS implemented a Global Agenda program of operations research projects to address the reproductive health (RH) needs of adolescents in four countries—Bangladesh, Kenya, Mexico, and Senegal. The project was implemented in urban areas of Saint-Louis and Louga, in northwestern Senegal, and was known as Improving the Reproductive Health of Youth in Senegal. The project supported a public-sector, multisectoral intervention to enhance young people’s knowledge and behavior regarding HIV prevention and RH, and systematically tested its feasibility, acceptability, effectiveness, and cost. The intervention had a significant positive impact on young people’s awareness and understanding of RH issues. The pilot …

Assessment: Frontiers Small Grants Program, Koli Banik

Reproductive Health

This report reviews the Small Grants Program (SGP) implemented by FRONTIERS. It assesses the SGP’s areas of achievements and challenges, and explores the feasibility of using this approach to build capacity in operations research. The report provides ideas for implementing a successful SGP that can deliver high-quality, relevant, and timely information for program design. Although capacity building was not an objective in the FRONTIERS SGP, it did produce some increased capacity after two years. As was found with other small grants programs, the FRONTIERS experience suggests that considerable resources are required to produce good quality research and final products. Program …

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

Planning An Integrated Disease Surveillance And Response System: A Matrix Of Skills And Activities, Helen N. Perry, Sharon M. Mcdonnell, Wondimagegnehu Alemu, Peter Nsubuga

Dartmouth Scholarship

The threat of a global influenza pandemic and the adoption of the World Health Organization (WHO) International Health Regulations (2005) highlight the value of well-coordinated, functional disease surveillance systems. The resulting demand for timely information challenges public health leaders to design, develop and implement efficient, flexible and comprehensive systems that integrate staff, resources, and information systems to conduct infectious disease surveillance and response. To understand what resources an integrated disease surveillance and response system would require, we analyzed surveillance requirements for 19 priority infectious diseases targeted for an integrated disease surveillance and response strategy in the WHO African region.

Utilization Of Health And Medical Services: Factors Influencing Health Care Seeking Behaviour And Unmet Health Needs In Rural Areas Of Kenya, Trish Prosser

Theses: Doctorates and Masters

There are many factors that influence health and health care seeking. Although many of these factors are similar across populations, exactly how they interact and influence the actions of people is often unique to a population in the context of the environment they live in. The current study, a population-based cross sectional survey, identifies three specific geographically diverse populations in rural areas of Kenya, to gain information regarding overall influences on health care seeking, and also information specific to each geographical area to directly target the health needs of the individual population living there. Participants of the survey were interviewed …

A Report From The Forum Session "Complexity, Coordination And Compromise: States And The Medicare Drug Benefit" (August 4, 2006), Lee Partridge

National Health Policy Forum

This National Health Policy Forum meeting report reviews a technical session that took place on August 4, 2006. The invitation-only meeting was designed to discuss implementation issues related to the new Medicare drug benefit, with special consideration of state activities, problems, and concerns. This meeting followed similar ones sponsored by the Forum in 2004 and 2005 in which the state perspective was the primary focus of conversation. Participants, including current and former state Medicaid directors, other state officials and experts, federal officials, Medicare drug plan representatives, and beneficiary advocates, described their experiences during the implementation process and addressed continuing challenges. …

Personal Health Records: The People's Choice?, Lisa Sprague

National Health Policy Forum

Information technology (IT), especially in the form of an electronic health record (EHR), is touted by many as a key component of meaningful improvement in health care delivery and outcomes. A personal health record (PHR) may be an element of an EHR or a stand-alone record. Proponents of PHRs see them as tools that will improve consumers’ ability to manage their care and will also enlist consumers as advocates for widespread health IT adoption. This issue brief explores what a PHR is, the extent of demand for it, issues that need to be resolved before such records can be expected …

Value-Based Coverage Policy In The United States And The United Kingdom: Different Paths To A Common Goal, Wilhelmine Miller

National Health Policy Forum

This background paper traces the development within American health care of two interrelated trends and activities: an evidence-based approach to medical practice and the critical evaluation of new technologies with respect to their costs and effectiveness. Over the past 35 years each of these developments has increasingly shaped the coverage decisions of public and private health insurers, and their importance for coverage policy is certain to grow. The paper also contrasts the different approaches to such “evidence-” or “value-based” coverage policy in the mixed public and private U.S. health care enterprise with the approach taken in Great Britain’s single-payer National …

Medicare And Mental Health: The Fundamentals, Christopher Loftis, Eileen Salinsky

National Health Policy Forum

This background paper provides a review of mental health coverage in the Medicare program. It examines the prevalence of mental disorders among Medicare beneficiaries, treatment available through Medicare, and the cost of such treatment. A brief summary of relevant policy issues is provided, including Medicare’s outpatient mental health limitation and the potential effect of the prescription drug benefit on the provision of mental health services.

Epsdt: Medicaid's Critical But Controversial Benefits Program For Children, Christie Provost Peters

National Health Policy Forum

The Early and Periodic Screening, Diagnosis and Treatment (EPSDT) program under Medicaid provides the most comprehensive set of health benefits for children and adolescents in the public or private sector. A cornerstone of early childhood preventive and treatment services in the nation’s health care “safety net,” the EPSDT program serves nearly 30 million low-income children, including children with disabilities and special needs. Over the years, states have expressed frustration with the administrative burdens of EPSDT requirements. Rising Medicaid costs have put all Medicaid benefits, including the EPSDT program, in the budgetary crosshairs. This issue brief reviews the fundamental characteristics of …

Updating Medicare's Physician Fees: The Sustainable Growth Rate Methodology, Laura A. Dummit

National Health Policy Forum

Medicare’s method to annually update the fees it pays physicians has been under fire for some time—specifically, since the method determined that physician fees should be reduced rather than increased. The update method, called the sustainable growth rate (SGR), was implemented to control the growth in Medicare physician spending. Yet Congress, in response to physician concerns about beneficiary access to care, has acted to avert physician fee cuts since 2003. Although this signals dissatisfaction with the SGR methodology, there is yet to be a widely accepted physician fee update proposal that balances federal budgetary realities with the need to ensure …

The Nuts And Bolts Of Pdps, Mary Ellen Stahlman

National Health Policy Forum

This issue brief provides an overview of Medicare prescription drug plans (PDPs), with a focus on fundamentals such as enrollment, premiums, formularies, cost sharing, prices, payment, cost management, and appeals and grievance processes. It also highlights major changes to the PDP landscape between 2006 and 2007.

Updating The Wic Food Packages: It's About Time, Jessamyn Taylor

National Health Policy Forum

This issue brief reviews key revisions to the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) program proposed by the USDA, which are based substantially on recommendations by the Institute of Medicine. Should the changes become regulation, they will be the most significant revision of the WIC food packages in over 25 years. This brief describes the changes, the impetus for their consideration, and possible implementation issues from the perspectives of vendors, state and local WIC agencies, and participants.

Medicare Physician Payments And Spending, Laura A. Dummit

National Health Policy Forum

The Medicare program’s physician payment method is intended to control spending while ensuring beneficiary access to physician services, but there are signs that it may not be working. The physician’s role in the health care delivery system as the primary source of information and treatment options, together with growing demand for services and the imperfect state of knowledge about appropriate service use, challenge Medicare’s ability to achieve these two goals. This issue brief describes the history of physician spending and the contribution of escalating service use and intensity of services to the rise in Medicare outlays, setting the stage for …

The Complex Realities Of Indigenous Health Care Delivery, Megan Waterman

Independent Study Project (ISP) Collection

The indigenous population of Australia faces a life expectancy that is eighteen years lower than the general population. This study addresses this incredible disparity by exploring the historical, cultural and social forces that impact on health status, focussing especially on health care service utilisation. Qualitative methods of interviewing and participant observation have been used to examine the two sectors of Aboriginal health service delivery in urban Victoria: Aboriginal community controlled health organisations (ACCHOs) and mainstream organisations. Accounting for the complex forces and realities in health service delivery, this is a discussion of the important components of the current realities for …

Girls' Perception Of Physical Environmental Factors And Transportation: Reliability And Association With Physical Activity And Active Transport To School, Kelly R. Evenson, Amanda Birnbaum, Ariane L. Bedimo-Rung, James Sallis, Carolyn C. Voorhees, Kimberly Ring, John P. Elder

Department of Public Health Scholarship and Creative Works

Background

Preliminary evidence suggests that the physical environment and transportation are associated with youth physical activity levels. Only a few studies have examined the association of physical environmental factors on walking and bicycling to school. Therefore, the purpose of this study was (1) to examine the test-retest reliability of a survey designed for youth to assess perceptions of physical environmental factors (e.g. safety, aesthetics, facilities near the home) and transportation, and (2) to describe the associations of these perceptions with both physical activity and active transport to school.

Methods

Test and retest surveys, administered a median of 12 days later, …

Effects Of Food Marketing To Kids: I'M Lovin' It?, Eileen Salinsky

National Health Policy Forum

This issue brief reviews key findings and recommendations from the Institute of Medicine study on food marketing and its effects on childhood obesity. The brief describes the childhood obesity epidemic, discusses key trends associated with rising childhood obesity rates, and considers the relative role of marketing practices on diet and obesity within the broader context of complex contributory factors. The brief also summarizes the current legal framework for regulating marketing directed at children; discusses voluntary, self-regulatory mechanisms; and highlights proposals to re-orient marketing practices to combat childhood obesity.

A Closer Look At The Medicare Part D Low–Income Benchmark Premium: How Low Can It Go?, Mary Ellen Stahlman

National Health Policy Forum

This issue brief explains how the Medicare Part D low–income benchmark premium is calculated, what factors influence the level of the low-income benchmark premium in any given year, and the implications of the benchmark amount for Medicare drug plans and beneficiaries as it changes from year to year. The paper provides a simplified, two-year example of how the low-income benchmark premium is calculated in order to illustrate the key factors that influence it.