Public Health Commons^™

Suicides Among Farmers In Three Southeastern States, 1990-1998, Steven R. Browning, Susan C. Westneat, Robert H. Mcknight

Epidemiology and Environmental Health Faculty Publications

Several studies have documented higher rates of suicide among farmers in comparison to other occupational groups, both in the U.S. and internationally. The purpose of this study is to describe the epidemiology of farmer suicides in three southeastern states (Kentucky, North Carolina, and South Carolina) during the nine-year period 1990-1998. Electronic death certificate data were obtained from the National Center for Health Statistics. Over the nine-year period, there were 590 deaths related to suicide (E-codes: 950-959) among farmers (occupation codes: 473, 474, 475, 477, and 479) in the states of Kentucky, North Carolina, and South Carolina. The results of this …

Evaluating The Healthy States Initiative Policy Forums, Jessica Harmon

MPA/MPP/MPFM Capstone Projects

Since 2005, The Council of State Governments (CSG) has participated in a cooperative agreement funded by the Centers for Disease Control and Prevention (CDC) called the Healthy States Initiative. The initiative promotes public health by providing information resources to state legislators through publications and public health forums. CSG is interested in information about the impact of the public health forums on state legislators. More specifically, they would like to know if the forums have encouraged the participants to produce public health legislation, to support funding for public health projects, and to work closely with colleagues and various groups to improve …

The Influence Of Veterinary Schools On The Veterinary Labor Market, Kyle Bosh

MPA/MPP/MPFM Capstone Projects

Problem Statement:

Does the presence of a veterinary school in a state influence the supply of veterinarians practicing in that state? Citizens and animals in states without a veterinary school are at a disadvantage if the presence of a veterinary school significantly improves public health and access to medical services in those states that have a veterinary school.

Research Strategy:

The unit of analysis in this study is 50 states and the District of Columbia. The study is designed as a cross-sectional analysis of 2006 pet, 2002 livestock, 2006 human, labor, and economic data. The study uses simultaneous equations to …

Understanding Barriers For Adherence To Follow-Up Care For Abnormal Pap Tests, Katherine S. Eggleston, Ann L. Coker, Irene Prabhu Das, Suzanne T. Cordray, Kathryn J. Luchok

CRVAW Faculty Journal Articles

Objective: Approximately 4000 women annually will die from preventable and treatable cervical cancer. Failure to adhere to follow-up recommendations after an abnormal Pap test can lead to development of cervical cancer. This paper summarizes the body of literature on adherence to follow-up after an abnormal Pap test in order to facilitate development of interventions

to decrease morbidity and mortality due to cervical cancer.

Methods: We conducted a comprehensive search of published literature addressing risk factors for adherence or interventions to improve adherence following an abnormal Pap test as the outcome. We included peer-reviewed original research conducted in the …

Chemotherapy And Survival For Patients With Multiple Myeloma: Findings From A Large Nationwide And Population-Based Cohort, Nidhi Rohatgi, Xianglin L. Du, Ann L. Coker, Lemuel L. Moye, Michael Wang, Shenying Fang

CRVAW Faculty Journal Articles

Objective: To assess the patterns of chemotherapy use for patients with multiple myeloma and to determine if chemotherapy is effective in prolonging survival outside the clinical trial settings.

Methods: We studied a nationwide and population-based retrospective cohort of 4902 patients ≥65 years of age with stage II or III multiple myeloma from 1992 to 1999, identified from the Surveillance, Epidemiology, and End-Results-Medicare data. Multivariate logistic regression was used to estimate the odds ratio of receiving chemotherapy and Cox proportional hazard model was used to estimate the hazard ratio of mortality associated with chemotherapy.

Results: Of 4902 patients with stage II …

Suppression Of Peroxisomal Enzyme Activities And Cytochrome P450 4a Isozyme Expression By Congeneric Polybrominated And Polychlorinated Biphenyls, Larry W. Robertson, Isabelle Berberian, Tim Borges, Li-Chuan Chen, Ching K. Chow, Howard P. Glauert, Johannes G. Filser, Helmut Thomas

Toxicology and Cancer Biology Faculty Publications

The purpose of this study was to determine the effects of PCBs and PBBs on peroxisome proliferator-activated receptor-alpha-(PPARalpha-) associated enzyme activities or protein levels. Male Sprague-Dawley rats were administered a single IP injection (150 mu mol/kg) of either 3,3',4,4'-tetrabromobiphenyl, 3,3',4,4'-tetrachlorobiphenyl, 3,3',5,5'-tetrabromobiphenyl, 2',3,3',4,5-pentachlorobiphenyl, 3,3',4,4',5-pentachlorobiphenyl, 2,2',3,3',5,5'-hexachlorobiphenyl, or 3,3',4,4',5,5'-hexabromobiphenyl in corn oil (10 ml/kg). One week later, the activities of catalase, peroxisomal fatty acyl-CoA oxidase, and peroxisomal beta-oxidation as well as cytochrome P450 4A (CYP4A) protein content were determined in subcellular liver fractions. None of the peroxisomal enzyme activities were significantly increased by any of the halogenated biphenyl congeners tested. Except for minor …

Emergency Roadside Technician Dies When Struck By A Single-Unit Truck On An Interstate Shoulder, Kentucky Injury Prevention And Research Center

Fatality Case Reports--Motor Vehicle

In the winter of 2005 a 52-year-old male emergency roadside technician (ERT), (providing traffic control support for police), died when he fell approximately 75 – 80 feet from a bridge after being struck by a single-unit truck. A policeman had responded to a call from a semi-truck driver on the interstate who had blown a tire while driving on an interstate. After the tire blew, the driver immediately pulled the semi onto the right shoulder and called police for assistance. This section of the shoulder was on a bridge on the blind side of a hill, and was too narrow …

Workers Struck By Trains While Driving, Kentucky Injury Prevention And Research Center

Kentucky Haz Alerts--Motor Vehicle

To prevent injuries while driving vehicles across railroad tracks:

• A hazard assessment should be performed before crossing railroad tracks.
• Safety belts should be used while driving.
• Commercial vehicles should not be stopped on railroad tracks.
• Braking mechanism checks should be performed before commercial vehicles enter roadways.
• Cell phones should not be utilized while driving.
• Employers should provide employees training on railway traffic safety.

The Kentucky Plan Revisited: Lessons Learned From An Innovative Doctoral Education Program., Joel M. Lee, F. Douglas Scutchfield, Raymond Hill

Preventive Medicine and Environmental Health Faculty Publications

In the first doctoral education special issue of the Journal of Health Administration Education, the authors presented the University of Kentucky College of Public Health's plans for an innovative new Doctor of Public Health (Dr. P.H.) degree. The degree as designed, prepares graduates for professional practice, and included extensive supervised field experience as part of the academic training linking theory with practice. Based upon the interest that the Kentucky Dr.P.H. degree program received, the authors will share the experience of the degree's initial years of operation through a "lessons learned" paper. As the program evolved there have been many lessons …

The Health Implications Of Violence Against Women: Untangling The Complexities Of Actual And Chronic Effects: Part Two, Carol E. Jordan

Office for Policy Studies on Violence Against Women Publications

No abstract provided.

Adherence To Recommendations For Follow-Up To Abnormal Pap Tests, Katherine S. Eggleston, Ann L. Coker, Kathryn J. Luchok, Tamra E. Meyer

CRVAW Faculty Journal Articles

OBJECTIVE: To evaluate whether timely adherence rates differ by race among women with abnormal Pap tests participating in a cost-free or reduced-cost program.

METHODS: Eligible subjects included women aged 47-64 years who received a referral for follow-up care after an abnormal Pap test from 1999 to 2002 in South Carolina (n=330). Adherence was measured as days to receipt of follow-up care after an abnormal Pap test. Cox proportional hazards modeling was used to estimate risk factors associated with time to adherence within 60 and 365 days by race.

RESULTS: African-American and non-Hispanic white women had similar adherence to follow-up. Among …

Differential Neuromuscular Training Effects On Acl Injury Risk Factors In"High-Risk" Versus "Low-Risk" Athletes, Gregory D. Myer, Kevin R. Ford, Jensen L. Brent, Timothy E. Hewett

Kinesiology and Health Promotion Faculty Publications

BACKGROUND: Neuromuscular training may reduce risk factors that contribute to ACL injury incidence in female athletes. Multi-component, ACL injury prevention training programs can be time and labor intensive, which may ultimately limit training program utilization or compliance. The purpose of this study was to determine the effect of neuromuscular training on those classified as "high-risk" compared to those classified as "low-risk." The hypothesis was that high-risk athletes would decrease knee abduction moments while low-risk and control athletes would not show measurable changes.

METHODS: Eighteen high school female athletes participated in neuromuscular training 3x/week over a 7-week period. Knee kinematics and …

Long Haul Trucker Dies After Striking An Embankment At The End Of An Interstate Highway Off-Ramp, Kentucky Injury Prevention And Research Center

Fatality Case Reports--Motor Vehicle

In the fall of year 2005, at 12:40 AM, a 47-year-old male semi-truck driver began his delivery route hauling a refrigerated trailer loaded with 23,000 pounds of produce. His first delivery was approximately 265 miles away. After two hours and twenty minutes, he exited the interstate 23 miles from the start of his route. At the end of the exit ramp he attempted to turn right onto a 4-lane highway. He missed the turn and drove straight across the highway through a guardrail; the truck became airborne, and crashed into an embankment exploding into flames. An unidentified motorist driving behind …

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 …

Fatal Aerial Lift Injuries, Kentucky Injury Prevention And Research Center

Kentucky Haz Alerts--Motor Vehicle

To prevent injuries while working in aerial lifts:

• A “pre-job safety plan” should be developed for each job site and reviewed prior to each day on the job site.
• Mechanical checks should be performed on all equipment at each job site prior to each use.
• There should be communication between the worker in the elevated lift and ground control crew.
• Ensure that appropriate fall protection equipment is available and correctly used when working from elevations.
• Employees should work within job qualifications and job limits.

Evaluating If The Built Environment Has A Substantial Effect On Obesity In Fayette County, Kentucky, Will Warren

MPA/MPP/MPFM Capstone Projects

Background:

Obesity is a major health issue in the United States and Fayette County. As Fayette County has become increasingly obese, it too has had an issue of sprawl within its urban service area and beyond. Relationships between obesity and aspects of the built environment are continuing to be studied.

Objective:

To evaluate the impact certain factors may have on the body mass index of Fayette County residents, in particular whether urban sprawl has an overriding impact on the weight of residents.

Methods:

The study area used was Fayette County, which was broken down into its fourteen zip code areas …

Preparing For The Future: An Evaluation Of Alternative Methods For Estimating The Needed Capacity Of Nursing Home Beds In Kentucky, Michelle D. Woods

MPA/MPP/MPFM Capstone Projects

Due to the aging of the generation known as “Baby Boomers”, the nation is expected to witness extraordinary growth in the total population ages 65 and over. Population projections provided by the United States Bureau of the Census suggest that this segment of the population will double in size to 72 million by the year 2030. In order to prepare for the anticipated increase elderly Americans, policy officials have been analyzing the potential effects on the nation’s long-term care system. Although Baby Boomers can expect to live longer than their predecessors, as they age, it is predicted that this generation …

Senate Bill (Sb) 172: Governance Of Nutrition In Kentucky Public Schools: Implementation Analysis Final Report, Bill Brumbach

MPA/MPP/MPFM Capstone Projects

This report is intended to evaluate the implementation of Senate Bill (SB) 172 in Kentucky's public schools. This law requires that all schools in Kentucky implement strict nutrition standards that apply to all foods sold during the school day. This report highlights the different methods used by selected schools in implementing the requirements in SB 172. In performing my analysis, I traveled to different schools in central and southeastern Kentucky to assess how these select schools were meeting the requirements of the law. Site visits allowed me to discuss implementation strategies with school administrators and aided in my understanding of …

Stress, Coping, Social Support, And Prostate Cancer Risk Among Older African American And Caucasian Men, Ann L. Coker, Maureen Sanderson, Gary L. Ellison, Mary Kay Fadden

CRVAW Faculty Journal Articles

Objectives: While psychosocial stress and high effort coping have been associated with reduced immune function, no epidemiologic study has addressed psychological stress and risk of prostate cancer. The purpose of this analysis was to investigate the association between stress, coping, social support, and risk of prostate cancer among older men (age 65–79 years). Design: Population-based case-control study in South Carolina.

Participants: Cases were 400 incident, histologically confirmed prostate cancer cases identified through the South Carolina Central Cancer Registry between 1999 and 2001 (70.6% response rate). Controls were 385 men identified through the 1999 Health Care Financing Administration Medicare beneficiary file …

Victims Struck Out By Logging, Kentucky Injury Prevention And Research Center

Kentucky Haz Alerts--Tractors/Logging

To prevent injuries while felling trees:

• Loggers should attend the Kentucky Master Logger program for training and education regarding Occupational Safety and Health Administration logging standards and safety procedures.
• A “pre-job safety plan” should be developed for each job site and the plan should be reviewed prior to each day on the site.
• Proper notching and directional felling techniques should be utilized when felling trees.
• Develop a felling plan for each tree prior to felling that includes escape route, dead or hanging branches, vines, and nearby trees.

Amputation Injuries Due To Forklifts, Kentucky Injury Prevention And Research Center

Kentucky Haz Alerts--Other

To prevent injuries from forklifts while working:

• Before you operate a forklift, make sure that you are trained and certified.
• Remember if you are on a sit-down type forklift, and it starts to over-turn, lean in the opposite direction, stay with the forklift; don’t jump.
• When operating a forklift on site, slow the truck and sound the horn at cross aisles, exits, and other employee traverse points.
• Before dismounting, set the parking brake, lower the forks or lifting carriage, and neutralize controls.

Workers Killed In Falls From Ladders, Kentucky Injury Prevention And Research Center

Kentucky Haz Alerts--Falls

To prevent falls from ladders while working:

• Make sure that an extension or straight ladder are erected according to the “4 to 1” rule of thumb.
• Safe work practices should be established by the employer for ascending and descending extension or straight ladders with materials and/ or equipment.
• All non-self-supporting ladders should be secured at the top and stabilized at the bottom.
• While working from ladders, workers should wear appropriate footwear.

Passenger Dies When Semi-Truck Trailer Hits Cow In Roadway, Kentucky Injury Prevention And Research Center

Fatality Case Reports--Motor Vehicle

On November 8, 2005, a 26-year-old male laborer who was a passenger in a semi-truck died when the driver swerved to avoid hitting a cow that was standing in the parkway lane. The two employees had been traveling westbound for approximately one hour when the driver noticed a cow in his lane. He swerved to avoid hitting the cow but hit it anyway. The tractor and two trailers jack-knifed, traveled through the median with the cab and trailers flipped onto their right sides, slid across the eastbound lanes, then the cab slammed through the guardrail. The cab came to rest …

Racial Disparity And Socioeconomic Status In Association With Survival In Older Men With Local/Regional Stage Prostate Cancer: Findings From A Large Community-Based Cohort, Xianglin L. Du, Shenying Fang, Ann L. Coker, Corinne Aragaki, Janice N. Cormier, Yan Xing, Beverly J. Gor, Wenyaw Chan

CRVAW Faculty Journal Articles

BACKGROUND

Few studies have examined the outcomes for Hispanic men with prostate carcinoma and incorporated socioeconomic factors in association with race/ethnicity in affecting survival, adjusting for factors on cancer stage, grade, comorbidity, and treatment.

METHODS

We studied a population-based cohort of 61,228 men diagnosed with local or regional stage prostate carcinoma at age 65 years or older between 1992 and 1999 in the 11 SEER (Surveillance, Epidemiology, and End Results) areas, identified from the SEER-Medicare linked data with up to 11 years of followup.

RESULTS

Low socioeconomic status was significantly associated with decreasing survival in all men with prostate carcinoma. …

Worker Crushed To Death By Falling Steel Coil, Kentucky Injury Prevention And Research Center

Fatality Case Reports--Other

On April 13, 2005, a 40-year-old male laborer was moving a 5-feet by 9-inch coil of slitted steel, weighing 6600 pounds, when it fell on him. The laborer was in the process of wrapping a chain through the middle of the coil and through a homemade device on the forks of a forklift when the coil tipped over. As the laborer tried to move away from the falling coil, it landed on his left side, breaking his left leg and causing internal injuries. Other workers in the area did not see, but heard the commotion of the falling coil. The …

Working Drivers Killed In Motor Vehicle Collisions Were Not Wearing Safety Belts, Kentucky Injury Prevention And Research Center

Kentucky Haz Alerts--Motor Vehicle

To prevent motor vehicle injuries while working:

• Employers should implement a comprehensive employee driver safety training program.
• Employees should wear seat belts at all times.
• Employees should be aware of distractions and pay attention at all times.

A Case-Control Study Of Farming And Prostate Cancer In African-American And Caucasian Men, Tamra E. Meyer, Ann L. Coker, Maureen Sanderson, Elaine Symanski

CRVAW Faculty Journal Articles

Objective: To determine the risk of prostate cancer associated with farming by duration, recency and specific activities among African-Americans and Caucasians.

Methods: This population-based case–control study had information on farming-related activities for 405 incident prostate cancer cases and 392 controls matched for age, race and region in South Carolina, USA, from 1999 to 2001. Cases with histologically confirmed, primary invasive prostate cancer who were aged between 65 and 79 years were ascertained through the South Carolina Central Cancer Registry. Appropriately matched controls were identified from the Health Care Financing Administration Medicare Beneficiary File. Data were collected using computer-assisted telephone interviewing, …

Cervical Cancer Survival By Socioeconomic Status, Race/Ethnicity, And Place Of Residence In Texas, 1995–2001, Katherine S. Eggleston, Ann L. Coker, Melanie Williams, Guillermo Tortolero-Luna, Jeanne B. Martin, Susan R. Tortolero

CRVAW Faculty Journal Articles

Objective: The current study explored whether socioeconomic status (SES), race/ethnicity, and rural residence may be linked to poorer cervical cancer survival by stage at diagnosis.

Methods: Data from 7,237 cervical cancer cases reported to the Texas Cancer Registry from 1995–2001 were used to address the association by stage at diagnosis and cause of death. Zip code-level census data were used to classify residence and to develop a composite variable for SES. Multilevel Cox proportional hazards modeling was used to estimate hazard ratios

(HR) and 95% confidence intervals (CI).

Results: Late stage at diagnosis was a strong predictor …

Mental Illness And Barriers To Health Care Access, Charlene Powell

MPA/MPP/MPFM Capstone Projects

Statement of Problem

Access to health care in the United States is major concern, despite the fact that the country spends more per capita on health care than any other country. Individuals with mental illness may face greater access problems than the general population.

Research Question

• Does mental illness predict greater difficulties with access to health care?

Methodology

The 2004 National Health Interview Survey (NHIS) was used to examine the barriers to health care among individuals reporting a mental illness diagnosis. Nine questions relating to health access problems were drawn from the survey and combined into an access index. Multivariate …

Dump Truck Driver Dies After Unintentional Release Of Asphalt, Kentucky Injury Prevention And Research Center

Fatality Case Reports--Motor Vehicle

On June 6, 2005 a 55-year-old male dump truck driver (Driver 1) died when he was buried waist deep in 400-degree Fahrenheit asphalt. Driver 1 stopped along the highway to help another dump truck driver (Driver 2), (both were independent truck drivers), who had experienced brake problems. As the two men were examining the pneumatic brake system at the rear of the disabled dump truck, the tailgate opened unexpectedly, spilling hot asphalt onto the decedent who was under the rear of the truck.

To prevent similar incidents, the following recommendations have been made:

Recommendation No. 1: Tailgate chains should always …