Public Health Commons^™

Associations Among Hospital Capacity, Utilization, And Mortality Of Us Medicare Beneficiaries, Controlling For Sociodemographic Factors., E. S. Fisher, J. E. Wennberg, T. A. Stukel, J. S. Skinner, S. M. Sharp

Dartmouth Scholarship

To explore whether geographic variations in Medicare hospital utilization rates are due to differences in local hospital capacity, after controlling for socioeconomic status and disease burden, and to determine whether greater hospital capacity is associated with lower Medicare mortality rates.

Site Visit To Arizona — Managed Medicaid: Arizona's Ahcccs Experience, Nora Super, Lisa Sprague, Judith D. Moore

National Health Policy Forum

This site visit featured a review of a unique Medicaid managed care system, the Arizona Health Care Cost Containment System (AHCCCS), which has operated as a research and demonstration waiver since its inception in 1982. Site visitors heard from speakers who provided historical and background information, a discussion of competitive bidding, contracting and performance management, and insights into the delivery of behavioral health under the mandatory AHCCCS program. The group also heard discussions about services to the uninsured and Arizona's safety net providers. Other topics covered during the visit included the state's KidsCare program under the State Child Health Insurance …

Reshaping Ahcs' Role In Biomedical Research, Karen Matherlee

National Health Policy Forum

This issue brief explores the reconfiguration of academic health centers (AHCs) in response to health marketplace and other pressures. It reviews four roles AHCs play in medical innovation: (a) development of new drugs, devices, diagnostic techniques, and therapeutic procedures; (b) adoption of new technologies, instruments, and drugs; (c) evaluation of new technologies; and (d) assessment of the need for new modalities and monitoring of their initial uses. The paper examines ways in which these roles are enhanced or threatened by evolving economic forces in the public and private sectors.

How Tuberculosis Threatens Supporters And Opponents Of Racial Profiling, Ibpp Editor

International Bulletin of Political Psychology

This article explores peculiarities of logic and reason among supporters and opponents of racial profiling as a tool of developing and implementing public policy.

Frequency Of Use And Perceived Credibility Of Information Sources And Variations By Socioeconomic Factors Among Savannah River Stakeholders, Bryan L. Williams, Alex Vallei, Sylvia Brown, Michael Greenberg

RISK: Health, Safety & Environment (1990-2002)

The authors examine the factors effecting credibility of risk communication in the communities surrounding the Savannah River Nuclear Weapons Site.

Effect Of Preventive Home Visits By A Nurse On The Outcomes Of Frail Elderly People In The Community: A Randomized Controlled Trial, Dawn M. Dalby, John W. Sellors, Fred D. Fraser, Catherine Fraser, Cornelia Van Ineveld, Michelle Howard

Kinesiology and Physical Education Faculty Publications

Background: Timely recognition and prevention of health problems among elderly people have been shown to improve their health. In this randomized controlled trial the authors examined the impact of preventive home visits by a nurse compared with usual care on the outcomes of frail elderly people living in the community. Methods: A screening questionnaire identified eligible participants (those aged 70 years or more at risk of sudden deterioration in health). Those randomly assigned to the visiting nurse group were assessed and followed up in their homes for 14 months. The primary outcome measure was the combined rate of deaths and …

Attributional Style And Disability Outcome, Craig Ravesloot Ph.D., Quincy-Robyn Young, Tom Seekins Ph.D., Ann Szalda-Petree Ph.D., University Of Montana Rural Institute

Health and Wellness

Disability is both a very personal and social issue. In 1999, The World Health Organization (WHO) published their latest revisions to the ICIDH-2. This document includes the latest conceptual developments in understanding the structure and process of disabling conditions. The document highlights that disability outcome occurs within a dynamic system characterized by the impairment itself, environmental and personal factors (World Health Organization, 1999).

Erisa Health Plan Liability: Issues And Options For Reform, Karl Polzer

National Health Policy Forum

This background paper was written as congressional conferees faced the task of resolving differences between patient protection bills by the U.S. House of Representatives and U.S. Senate in late 1999. In order to discuss the principal issues facing policymakers and options for reform, it begins by describing problems raised by the federal law governing private-sector employee health plans (the Employee Retirement Income Security Act of 1974) from a consumer perspective. It then discusses approaches proposed by the Clinton administration and the House and Senate to give consumers greater ability to challenge health plan coverage decisions, focusing in particular on issues …

Sulfa Or Sulfone Prophylaxis And Geographic Region Predict Mutations In The Pneumocystis Carinii Dihydropteroate Synthase Gene, Laurence Huang, Charles B. Beard, Jennifer Creasman, Deborah A. Levy, Jeffrey S. Duchin, Sherline Lee, Norman Pieniazek, Jane L. Carter, Carlos Del Rio, David Rimland, Thomas R. Navin

Journal Articles: Epidemiology

To determine factors associated with mutations in the Pneumocystis carinii dihydropteroate synthase (DHPS) gene, a prospective study of human immunodeficiency virus (HIV)-infected patients with confirmed P. carinii pneumonia was conducted in Atlanta, Seattle, and San Francisco. Clinical information was obtained from patient interview and chart abstraction. DHPS genotype was determined from DNA sequencing. Overall, 76 (68.5%) of 111 patients had a mutant DHPS genotype, including 22 (81.5%) of 27 patients from San Francisco. In multivariate analysis, sulfa or sulfone prophylaxis and study site were independent predictors of a mutant genotype. Fourteen (53.8%) of 26 patients who were newly diagnosed with …

Ambulatory Care Physician Barriers Contributing To The Low Advance Directive Education Rate, Cindy Lynn Grant

Theses Digitization Project

No abstract provided.

The Effects Of An Educational Intervention On Calcium Intake And Bone Mineral Content In Young Women With Low Calcium Intake., B. Peterson, R. Klesges, E. Kaufman, Theodore Cooper, C. Vukadonovich

Selected Works Temporary Series

No abstract provided.

Current First Aid And Cpr Credentials Of Selected Head High School Athletic Coaches In West Virginia, Amy Robinson

Theses, Dissertations and Capstones

Coaches are typically the immediate caregivers to high school athletes. To date the state of West Virginia has no mandatory laws that coaches be first-aid and CPR certified before they are hired as a coach. The general purpose of this study is to assess current status of first-aid and CPR certifications held by high school head athletic coaches in the state of West Virginia. A packet will be sent to the 160 high schools in West Virginia. The principal will randomly choose five head coaches, at least two females and two males, to fill out the survey which are to …

Healthy Families Maine: Final Evaluation Report, Erin E. Oldham Phd, Tammy Richards, Anne B. Keith Rn, Drph, C-Pnp, Julie Atkins Ma

Children, Youth, & Families

The first year's evaluation featured a process study documenting the implementation of the program at six pilot sites. The second year evaluation report followed the evolution of the Healthy Families Maine program, through both a process study and the introduction of an exploratory outcomes study.iv While the second year report focused on all of the children being served by the six Healthy Families programs, the present report is a more in-depth, longitudinal study of a group of 89 children and families served by their local Healthy Families program.

Response To Critique Of The Claim Of Cannibalism At Cowboy Wash, Patricia M. Lambert, Banks L. Leonard, Brian R. Billman, Richard A. Marlar, Margaret E. Newman, Karl J. Reinhard

Karl Reinhard Publications

The original authors of Billman et af. (2000) are joined by three other analysts from the Cowboy Wash research team to respond to the critique of this article by Dongoske et af. (2000). Dongoske and his coauthors state that Billman et af. (2000) failed to test alternative hypotheses or to consider alternative explanations for the findings at 5MTJOOJO and similar sites. The original authors point out that alternative hypotheses were examined and rejected, leaving a violent episode of cannibalism as the most plausible explanation for the remains found at 5MTJOOJO. Dongoske et af. also question many aspects of the osteological, …

Realities And Treatment Of Rape, Alison S. Brennan

Graduate Research Papers

One in three women have experienced a sexual assault. The impact of sexual assault can affect numerous aspects of a woman's life including: sexual health, cognitions, behaviors, emotions, interpersonal relationships, and self-perceptions. The healing journey for a rape victim is often initiated with the aid of a counselor. For this reason alone, it is crucial for counselors to have a basic knowledge of the symptoms as well as the various treatments for rape victims.

The Effects Of An Educational Intervention On Calcium Intake And Bone Mineral Content In Young Women With Low Calcium Intake., B. Peterson, R. Klesges, E. Kaufman, Theodore Cooper, C. Vukadonovich

Departmental Papers (Psych)

No abstract provided.

‘Gene Shaving’ As A Method For Identifying Distinct Sets Of Genes With Similar Expression Patterns, Trevor Hastie, Robert Tibshirani, Michael B. Eisen, Ash Alizadeh, Ronald Levy, Louis Staudt, Wing C. Chan, David Botstein, Patrick Brown

United States Public Health Resources

Background: Large gene expression studies, such as those conducted using DNA arrays, often provide millions of different pieces of data. To address the problem of analyzing such data, we describe a statistical method, which we have called ‘gene shaving’. The method identifies subsets of genes with coherent expression patterns and large variation across conditions. Gene shaving differs from hierarchical clustering and other widely used methods for analyzing gene expression studies in that genes may belong to more than one cluster, and the clustering may be supervised by an outcome measure. The technique can be ‘unsupervised’, that is, the genes and …

Interleukin-1 Polymorphisms Associated With Increased Risk Of Gastric Cancer, Emad M. El-Omar, Mary Carrington, Wong-Ho Chow, Kenneth E. L. Mccoll, Jay H. Bream, Howard A. Young, Jesus Herrera, Jolanta Lissowska, Chiu-Chin Yuan, Nathaniel Rothman, George Lanyon, Maureen Martin, Joseph F. Fraumeni Jr., Charles S. Rabkin

United States Public Health Resources

Helicobacter pylori infection is associated with a variety of clinical outcomes including gastric cancer and duodenal ulcer disease¹. The reasons for this variation are not clear, but the gastric physiological response is influenced by the severity and anatomical distribution of gastritis induced by H. pylori. Thus, individuals with gastritis predominantly localized to the antrum retain normal (or even high) acid secretion², whereas individuals with extensive corpus gastritis develop hypochlorhydria and gastric atrophy³, which are presumptive precursors of gastric cancer4. Here we report that interleukin-1 gene cluster polymorphisms suspected of enhancing production of interleukin-1-beta …

U.S. Obstetric Procedures, 1998, Sally C. Curtin, T. J. Mathews

United States Public Health Resources

According to the latest birth data from the National Center for Health Statistics, the use of electronic fetal monitoring, ultrasound, stimulation of labor, and induction of labor continued to rise in 1998 to unprecedented levels (1). At the same time, the total cesarean rate, which had fallen each year from 1989 to 1996, rose for the second consecutive year while the primary cesarean rate (rate per 100 births to women with no previous cesarean) rose for the first time during the 1989–1998 period. After increasing by 50 percent between 1989 and 1996, the rate of vaginal birth after previous cesarean …

The Annual Report To The Nation On The Status Of Cancer, 1973– 1997, With A Special Section On Colorectal Cancer, Lynn A. G. Ries, Phyllis A. Wingo, Daniel S. Miller, Holly L. Howe, Hannah K. Weir, Harry M. Rosenberg, Sally W. Vernon, Kathleen Cronin, Brenda K. Edwards

United States Public Health Resources

BACKGROUND. This annual report to the nation addresses progress in cancer prevention and control in the U.S. with a special section on colorectal cancer. This report is the joint effort of the American Cancer Society, the National Cancer Institute (NCI), the North American Association of Central Cancer Registries (NAACCR), and the Centers for Disease Control and Prevention (CDC), including the National Center for Health Statistics (NCHS).

METHODS. Age-adjusted rates were based on cancer incidence data from the NCI and NAACCR and underlying cause of death as compiled by NCHS. Joinpoint analysis was based on NCI Surveillance, Epidemiology, and …

Hyperphosphorylation Of The Asialoglycoprotein Receptor In Isolated Rat Hepatocytes Following Ethanol Administration, Benita L. Mcvicker, Dean J. Tuma, Carol A. Casey

United States Public Health Resources

Ethanol administration leads to altered function and impaired receptor-mediated endocytosis of the hepatocyte asialoglycoprotein receptor (ASGP-R). The purpose of the present study was to examine the effects of ethanol on the phosphorylation of the ASGP-R to determine whether this post-translational modification could contribute mechanistically to the observed ethanol-induced alterations. The methodological approach of this work involved the measurement of the phosphorylation state of the receptor obtained from isolated rat hepatocytes, using a combination of experimental designs from the biosynthetic incorporation of phosphate to the determination of steady-state phosphotyrosine levels. We report here that both short-term (1- to 2-week) and chronic …

Genetic Characterization Of H3n2 Influenza Viruses Isolated From Pigs In North America, 1977–1999: Evidence For Wholly Human And Reassortant Virus Genotypes, Alexander I. Karasin, Melissa M. Schutten, Lynn A. Cooper, Catherine B. Smith, Kanta Subbarao, Gary A. Anderson, Suzanne Carman, Christopher W. Olsen

United States Public Health Resources

Since 1998, H3N2 viruses have caused epizootics of respiratory disease in pigs throughout the major swine production regions of the U.S. These outbreaks are remarkable because swine influenza in North America had previously been caused almost exclusively by H1N1 viruses. We sequenced the full-length protein coding regions of all eight RNA segments from four H3N2 viruses that we isolated from pigs in the Midwestern U.S. between March 1998 and March 1999, as well as from H3N2 viruses recovered from a piglet in Canada in January 1997 and from a pig in Colorado in 1977. Phylogenetic analyses demonstrated that the 1977 …

Lessons Learned In Applying The U.S. Epa Proposed Cancer Guidelines To Specific Compounds, Melvin Andersen, M. Elizabeth Meek, Gary Boorman, David Brusick, Samuel Cohen, Yvonne Dragan, Clay Frederick, Jay Goodman, Gordon Hard, Ellen O'Flaherty, Denise Robinson

United States Public Health Resources

An expert panel was convened to evaluate the U.S. Environmental Protection Agency’s “Proposed Guidelines for Carcinogen Risk Assessment” through their application to data sets for chloroform (CHCl₃) and dichloroacetic acid (DCA). The panel also commented on perceived strengths and limitations encountered in applying the guidelines to these specific compounds. This latter aspect of the panel’s activities is the focus of this perspective. The panel was very enthusiastic about the evolution of these proposed guidelines, which represent a major step forward from earlier EPA guidance on cancer-risk assessment. These new guidelines provide the latitude to consider diverse scientific data …

Municipalities' Suits Against Gun Manufacturers - Legal Folly, Lawrence S. Greenwald, Cynthia A. Shay

Journal of Health Care Law and Policy

No abstract provided.

A Sense Of Duty: Retiring The "Special Relationship" Rule And Holding Gun Manufacturers Liable For Negligently Distributing Guns, Rachana Bhowmik, Jonathan E. Lowy, Allen Rostron, Rachel Hoover

Journal of Health Care Law and Policy

No abstract provided.

Point Blank: Product Liability Law Takes Aim At Guns, Deborah Robinson

Journal of Health Care Law and Policy

No abstract provided.

Male Circumcision And Hiv Prevention: Directions For Future Research, Johannes Van Dam, Marie Christine Anastasi

HIV and AIDS

A growing body of scientific publications suggests that male circumcision is associated with reduced risk of HIV infection in sub-Saharan Africa. Thus, male circumcision is being considered as a potential intervention in the prevention of sexually transmitted HIV infection, even though this procedure has profound cultural implications and carries the risk of complications, and its benefits are realized only many years later. This report presents the findings of a meeting of international researchers, organized by the Horizons Project to explore the programmatic and research implications of the association between male circumcision and HIV prevention. Most studies on male circumcision and …

The Female Condom: Dynamics Of Use In Urban Zimbabwe, Deanna Kerrigan, Steve Mobley, Naomi Rutenberg, Andrew A. Fisher, Ellen Weiss

HIV and AIDS

In July 1997, Population Services International (PSI), at the request of the Zimbabwe National AIDS Coordination Programme, launched a social marketing program for the female condom in Zimbabwe. To avoid stigma associated with condoms and STI prevention, the female condom was marketed as a family planning product or “contraceptive sheath” under the brand name “Care.” It was initially sold through pharmacies and clinics at a heavily subsidized retail price of US $0.24 for two; distribution has since expanded to other urban outlets, including supermarkets and convenience stores. Approximately one year after the start of the social marketing program, the Horizons …

Peer Education And Hiv/Aids: Past Experience, Future Directions, Deanna Kerrigan, Ellen Weiss

HIV and AIDS

Peer education typically involves training and supporting members of a given group to effect change among members of the same group. Peer education is often used to effect changes in knowledge, attitudes, beliefs, and behaviors at the individual level. However, peer education may also create change at the group or societal level by modifying norms and stimulating collective action that contributes to changes in policies and programs. Worldwide, peer education is one of the most widely used strategies to address the HIV/AIDS pandemic. This report presents findings from a project designed to identify components and principles that influence HIV/AIDS peer …

Genetic Variation In Pneumocystis Carinii Isolates From Different Geographic Regions: Implications For Transmission, Charles B. Beard, Jane L. Carter, Scott P. Keely, Laurence Huang, Norman J. Pieniazek, Iaci N. S. Moura, Jacquelin M. Roberts, Allen W. Hightower, Michelle S. Bens, Amanda R. Freeman, Sherline Lee, James R. Stringer, Jeffrey S. Duchin, Carlos Del Rio, David Rimland, Robert P. Baughman, Deborah A. Levy, Vance J. Dietz, Paul Simon, Thomas R. Navin

Journal Articles: Epidemiology

To study transmission patterns of Pneumocystis carinii pneumonia (PCP) in persons with AIDS, we evaluated P. carinii isolates from patients in five U.S. cities for variation at two independent genetic loci, the mitochondrial large subunit rRNA and dihydropteroate synthase. Fourteen unique multilocus genotypes were observed in 191 isolates that were examined at both loci. Mixed infections, accounting for 17.8% of cases, were associated with primary PCP. Genotype frequency distribution patterns varied by patients' place of diagnosis but not by place of birth. Genetic variation at the two loci suggests three probable characteristics of transmission: that most cases of PCP do …