Public Health Commons^™

Who Will Pay For The Adverse Events Resulting From Smallpox Vaccination? Liability And Compensation Issues, Robin J. Strongin, Eileen Salinsky

National Health Policy Forum

This paper summarizes liability and compensation concerns surrounding the smallpox vaccination program announced by President Bush on December 13, 2002. The paper examines the nature of adverse health events that are likely to occur in connection with the smallpox vaccine, assesses the liability protections that have been established for organizations and individuals participating in the vaccination program, and discusses the compensation mechanisms being considered to address the damages incurred by volunteers who may suffer from adverse vaccine reactions. Specifically, the implications of the Federal Tort Claims Act, workers’ compensation programs, and the creation of a new no-fault compensation fund are …

Two Laborers Die From A Scaffolding Fall Inside A Water Tank, Kentucky Injury Prevention And Research Center

Fatality Case Reports--Falls

Two 20 year-old laborers died after falling approximately 25 feet from suspension scaffolding while preparing the inside of a municipal water tank for painting. Neither laborer was wearing fall personal protection equipment at the time of the fatal incident. The laborers were preparing the inside of a 200,000-gallon water tank for painting when one end of the scaffolding dropped after a support cable slipped. The job foreman arrived at the job site and entered the tank to check on the laborers. He found both laborers on the tank floor. Laborer 1 had respiratory vital signs but Laborer 2 did not. …

Hispanic Worker Dies Due To Trench Cave-In, Kentucky Injury Prevention And Research Center

Fatality Case Reports--Other

On December 3, 2002, a 30-year old Hispanic laborer died when an unsupported 8-foot wall of a trench collapsed on him. Three laborers were working in an unsupported trench when one side caved in, burying one laborer (decedent) and partially burying another Hispanic worker. The third laborer managed to escape the trench unharmed. Two of the laborers were Hispanic, the third was a brother to the owner of the company digging the trench. The coroner pronounced the 30-year old laborer dead at the scene due to asphyxiation.

To prevent similar incidents from occurring, Kentucky Fatality Assessment and Control Evaluation personnel …

Persistence Of Virus-Reactive Serum Immunoglobulin M Antibody In Confirmed West Nile Virus Encephalitis Cases, John T. Roehrig, Denis Nash, Beth Maldin, Anne Labowitz, Denise A. Martin, Robert S. Lanciotti, Grant L. Campbell

Publications and Research

Twenty-nine laboratory-confirmed West Nile virus (WNV) encephalitis patients were bled serially so that WNV-reactive immunoglobulin (Ig) M activity could be determined. Of those patients bled, 7 (60%) of 12 had anti-WNV IgM at approximately 500 days after onset. Clinicians should be cautious when interpreting serologic results from early season WNV IgM-positive patients.

A Cost-Effectiveness Analysis Of A Community-Based Health Promotion Intervention For Adults With Mobility Impairments: Living Well With A Disability, Craig Ravesloot Ph.D., Tom Seekins Ph.D., Catherine Ipsen M.A., Steve Seninger Ph.D., Colleen Murphy-Southwick Ph.D., Lisa Brennan M.L.S., Rita K. Fjeld M.A., Glen W. White Ph.D., Ann Branstetter Ph.D., Vivian Chapman M.A., Amanda Jay M.A., James A. Bovaird M.A., Janet Marquis Ph.D., University Of Montana Rural Institute

Health and Wellness

This document reports on research conducted by the University of Montana and the University of Kansas for the Office of Disability and Health at the Centers for Disease Control and Prevention. The research project, conducted between August 1,1997 and July 31, 2001, was conducted in four separate but related studies. The research was conducted in eight States. We contracted with nine centers for independent living (CIL) to conduct 34 Living Well with a Disability health promotion workshops and to collect outcome measures. These programs included 246 individuals. In the first study, we evaluated the effectiveness and cost outcomes of the …

Introduction Of A Waterless Alcohol-Based Hand Rub In A Long-Term Care Facility, Lona Mody, Mcneil A. Shelly, Rongjun Sun, Bradley Suzanne, Carol A. Kauffman

Sociology & Criminology Faculty Publications

OBJECTIVE:

To examine the impact of introduction of an alcohol-based hand rub on hand hygiene knowledge and compliance and hand colonization of healthcare workers (HCWs) in a long-term-care facility (LTCF).

METHODS:

Two floors of an LTCF participated. Ward A used the hand rub as an adjunct to soap and water; ward B was the control. HCWs' hands were cultured using the bag-broth technique for Staphylococcus aureus, gram-negative bacilli (GNB), Candida, and vancomycin-resistant enterococci (VRE). HCWs completed a questionnaire at baseline and after an educational intervention and introduction of rub.

RESULTS:

Hand hygiene practices, knowledge, and opinions did not change after …

A Comparative History Of Aids In Latin America: Brazil And Cuba, Shawn Smallman

International & Global Studies Faculty Publications and Presentations

According to a joint report of the World Health Organization and the Pan American Health Organization in September 2002 there were approximately 1.4 million HIV+ people in Latin America, and a further 420,000 HIV+ people in the Caribbean. The number of infections had increased by nearly 10% from the previous year in Latin America, and 16% in the Caribbean. While striking, these figures may obscure the diversity of the HIV epidemic in the region. Latin America has a varied pattern of infections, which means that the experience of Bolivia, Ecuador and Mexico is quite different from that of Honduras, Haiti …

The Jeffcare Preceptor Model For Asthma: A Primary Care Physician Tutorial Training Model, Jeffrey L. Lenow, Robert Bales, Stanton N. Smullens

College of Population Health Faculty Papers

The societal and economic impact of asthma is a well-documented phenomenon in this country. Despite improved knowledge and techniques of care, there have been signs of worsening morbidity/mortality and a seeming disconnect between physician and patients as regards communication of care strategies. In an attempt to fashion innovative educational strategies to enhance primary care physician (PCP) and caregiver efficiencies in improving patient outcomes (clinical and financial), the "Preceptor" model of one-to-one PCP/asthma specialist has been developed. Review of utilization and prescribing data demonstrates a clear pattern of statistically significant cost improvement in the aggregate care setting, as well as improved …

Breast Diseases: A Histopathological Analysis Of 3279 Cases At A Tertiary Care Center In Pakistan, M. S. Siddiqui, Naila Kayani, Shahid Pervez, S. A. Aziz, S. Muzaffar, Z. Setna, M. Israr, S. H. Hasan, M. S. Gill

Department of Pathology and Laboratory Medicine

Objective: To know the frequency of breast diseases in Pakistani females.

Methods: A retrospective analysis of 3279 breast specimens received over a period of 4 years (1 993-1996) at the department of pathology, the Aga Khan University Hospital.

Results: Out of a total of 3279 breast specimens, common breast lesions included infiltrating duct carcinoma 37%, followed by fibro adenoma 16.95%, fibrocystic change13.96%, mastitis 6.83% and duct ectasia 5.33%. Majority of the cases of infiltrating duct carcinoma were encountered in the 5th and 6th decades of life. Tumour size was 2 or >2 cms. in 93% of cases and 40% of …

Reasonable Modification Or Fundamental Alteration? Recent Developments In Ada Caselaw And Implications For Behavioral Health Policy, Sara J. Rosenbaum, Joel B. Teitelbaum, D. Richard Mauery, Alexandra M. Stewart

Center for Integrated Behavioral Health Policy

No abstract provided.

Utilization Of Algal And Bacterial Extracellular Polymeric Secretions (Eps) By The Deposit-Feeding Brittlestar Amphipholis Gracillima (Echinodermata), D. L. Hoskins, S. E. Stancyk, Alan W. Decho

Faculty Publications

Like many deposit-feeding organisms, the burrowing brittlestar Amphipholis gracillima feeds on particulate organic matter in surface sediments. Microbial exopolymeric secretions (EPS) are carbohydrate-enriched polymers produced by microalgae and bacteria that bind aggregates and form dense biofilms near the sediment-water interface. EPS are assimilable by some benthic infauna and may be utilized as a significant carbon source. EPS are absorbed by some deposit-feeders, including a holothurian, and may be supplemental sources of nutrition. The burrowing brittlestar A. gracillima is a deposit-feeder that was used in a mass balance approach to model the incorporation of radiolabeled EPS by bottom feeders. Brittlestars were …

Selecting Differentially Expressed Genes From Microarray Experiments, Margaret S. Pepe, Gary M. Longton, Garnet L. Anderson, Michel Schummer

UW Biostatistics Working Paper Series

High throughput technologies, such as gene expression arrays and protein mass spectrometry, allow one to simultaneously evaluate thousands of potential biomarkers that distinguish different tissue types. Of particular interest here is cancer versus normal organ tissues. We consider statistical methods to rank genes (or proteins) in regards to differential expression between tissues. Various statistical measures are considered and we argue that two measures related to the Receiver Operating Characteristic Curve are particularly suitable for this purpose. We also propose that sampling variability in the gene rankings be quantified and suggest using the “selection probability function”, the probability distribution of rankings …

Semiparametric Receiver Operating Characteristic Analysis To Evaluate Biomarkers For Disease, Tianxi Cai, Margaret S. Pepe

UW Biostatistics Working Paper Series

The receiver operating characteristic (ROC) curve is a popular method for characterizing the accuracy of diagnostic tests when test results are not binary. Various methodologies for estimating and comparing ROC curves have been developed. One approach, due to Pepe, uses a parametric regression model with the baseline function specified up to a finite-dimensional parameter. In this article we extend the regression models by allowing arbitrary nonparametric baseline functions. We also provide asymptotic distribution theory and procedures for making statistical inference. We illustrate our approach with dataset from a prostate cancer biomarker study. Simulation studies suggest that the extra flexibility inherent …

Semi-Parametric Regression For The Area Under The Receiver Operating Characteristic Curve, Lori E. Dodd, Margaret S. Pepe

UW Biostatistics Working Paper Series

Medical advances continue to provide new and potentially better means for detecting disease. Such is true in cancer, for example, where biomarkers are sought for early detection and where improvements in imaging methods may pick up the initial functional and molecular changes associated with cancer development. In other binary classification tasks, computational algorithms such as Neural Networks, Support Vector Machines and Evolutionary Algorithms have been applied to areas as diverse as credit scoring, object recognition, and peptide-binding prediction. Before a classifier becomes an accepted technology, it must undergo rigorous evaluation to determine its ability to discriminate between states. Characterization of …

Partial Auc Estimation And Regression, Lori E. Dodd, Margaret S. Pepe

UW Biostatistics Working Paper Series

Accurate disease diagnosis is critical for health care. New diagnostic and screening tests must be evaluated for their abilities to discriminate disease from non-diseased states. The partial area under the ROC curve (partial AUC) is a measure of diagnostic test accuracy. We present an interpretation of the partial AUC that gives rise to a new non-parametric estimator. This estimator is more robust than existing estimators, which make parametric assumptions. We show that the robustness is gained with only a moderate loss in efficiency. We describe a regression modelling framework for making inference about covariate effects on the partial AUC. Such …

Converging On Nursing Home Quality, Lisa Sprague

National Health Policy Forum

This paper looks at nursing home quality initiatives, built around public reporting of quality data, that have been inaugurated by the Centers for Medicare and Medicaid Services and the California HealthCare Foundation. How the projects were developed is explored, along with preliminary indicators of their impact on consumers and providers and likely next steps in their evolution.

Functional Health Literacy In An Urban Primary Care Clinic, Nancy Trygar Artinian, M. Patricia Lange, Thomas Templin, Lynda G Stallwood, Christopher E. Hermann

Nursing Faculty Research Publications

The purpose of this study was to determine the level of functional health literacy in a sample of patients treated in 1of our 5 primary care clinics. A total of 92 randomly selected adults (mean age = 59 years) completed the TOFHLA while waiting for a scheduled appointment. Twenty eight percent of the sample had less than adequate levels of functional health literacy. Income, car ownership and education were significant and independent predictors of literacy level in this sample. Low levels of functional health literacy limit a patient's ability to read, understand and act on health information. It is essential …

Severity Message From Hazard Alert Symbol On Caution Signs, Roger C. Jensen, Andrew M. Mccammack

Safety Health & Industrial Hygiene

Standards for the design of signal word panels specify different combinations of colors, signal words, and a hazard alert symbol. The warning sign standards of the American National Standards Institute specify a yellow signal word panel, with the word Caution and a hazard alert symbol, for signs marking people hazards. The same panel, without the symbol, is intended for property hazards. The purpose of this study was to determine if the presence or absence of the symbol effectively conveys the intended severity messages. A sample of 59 college students rated their impressions of a Caution sign with and without the …

Expanding Self-Direction In Services For The Aged And People With Disabilities, Ruth A. Burgess

Theses, Dissertations and Capstones

Medicaid-funded long-term care services are traditionally delivered in nursing homes. States may apply for waivers which allow them to provide home and community based services with Medicaid funds. Because these services are by definition an alternative to nursing home care, waiver services are generally based upon a medical model which emphasizes medical deficits and tends to restrict consumers’ movements to inside the home. Recent developments such as the Olmstead Decision and federal New Freedom Initiatives have caused states to recognize that consumers desire and have a legal right to be part of a community rather than institutionalized or homebound. These …

Profile: University Of Minnesota School Of Public Health Around The World In 10 Minutes

International Journal of Global Health

What does the phrase "global health" mean to you? Does it mean doing HIV/AIDS education in Mysore? Working to improve air quality in Manila? Or marrying eastern and western health practices for the Hmong in Minneapolis? If you answered "all of the above," you're right. Global health is all this and more. At the University of Minnesota School of Public Health, we ascribe to the philosophy whereby public health challenges are exchanged equally between developed and developing countries, and together we share the responsibility for finding solutions to these challenges.

Child Rearing Practices In Eastern Nigeria: Implications For Social Work In The United States, Chinyelu B. Okafor

International Journal of Global Health

This qualitative study describes the childrearing practices among the Igbos of Eastern Nigeria, and offers implications for social work and educational services for African immigrants raising families in the United States. First objective for the study was to ascertain how rural Igbos of Eastern Nigeria raise their children from birth to age eight years of age. Second objective was to determine parent's concept of reward and punishment, how gender role is communicated, and what constitutes parental expectations from successful parenting. Method: Focus group discussions with 400 men and women in 20 villages from five rural Local Government Areas (counties) of …

Increased Morbidity And Mortality In Single Parent Families: A Review, Katie Steneroden

International Journal of Global Health

American families have changed dramatically in composition in recent decades. Increasing proportions of children are being raised in single parent households, reflecting both rising divorce rates, the growing percentage of births to unmarried women and adoption by single parents. As fewer children grow up in traditional families, there is increasing concern about the impact of alternative family structures on children's health and well-being. Many believe that there is a vital connection between family structure and youth well-being, with the nuclear family constituting the optimal structure for fostering "normal" development. Some say the change in the typical nuclear family is one …

Cover - Front Matter - Table Of Contents

International Journal of Global Health

No abstract provided.

Assessing The Integrity Of Motivational Interviewing Interventions: Reliability Of The Motivational Interviewing Skills Code, Theresa Moyers, Tim Martin, Delwyn Catley, Kari Jo Harris, Jasjit S. Ahluwalia

Public and Community Health Sciences Faculty Publications

The motivational interviewing skills code (MISC) was used to review 86 audiotaped interactions between clinicians and patients participating in a smoking cessation intervention. Intraclass correlations (ICCs) were completed for two of the MISC elements: global evaluations and behavior counts. Results indicate 75% of the global ratings yielded ICCs in the good to excellent range, while only 44% of the behavior counts yielded this level of accuracy. Adherence scores were created to form overall ratings of clinician adherence to using motivational interviewing and 80% of these competence measures yielded ICCs in the good to excellent range. Specific recommendations regarding modifications for …

The Educational Interaction Between Physical Therapy And Occupational Therapy Students, Kimberly K. Cleary, Dana M. Howell

Occupational Science and Occupational Therapy Faculty and Staff Research

The objectives of this study were to identify the prevalence of shared learning in U.S. physical therapy (PT) and occupational therapy (OT) education programs; determine what terminology is used for these courses; and identify perceived barriers, benefits, and challenges of the educational interactions. A survey, designed to collect information about the educational interaction between PT and OT students, was mailed to all program directors (n = 206) at each of the academic institutions (N = 103) in the United States with accredited or developing entry-level programs in PT and OT. A census study was conducted, and the entire study population …

Environmental Planning, R. Steven Konkel

Environmental Health Science Faculty and Staff Research

Our understanding of the importance of healthy ecosystems and the impact of people on the natural and the built environment continues to grow. The need for stewardship to preserve, protect, and enhance the natural environment and promote healthy populations is increasingly seen as a universal responsibility of environmental health and safety (EHS) professionals.

Message Deleted? Resolving Physician-Patient E-Mail Through Contract Law, Michael Mccann

Law Faculty Scholarship

This article examines the impact of e-mail on the physician-patient relationship, and how contract law can resolve the uncertainties incumbent in this nascent form of communication. Significantly, courts have yet to indicate when the physician-patient relationship begins by e-mail, or to what extent e-mail affects the duties of the relationship. Instead of waiting for judicial guidance, physicians and patients can employ specialized contracts to clarify the role that e-mail plays in their relationship. As a result, more physicians and patients will regard e-mail correspondence as a valuable means of communication, and a tool for improving the quality of health care …

Progress And Opportunities In Lesbian, Gay, Bisexual And Transgender Health Communications, Laurie A. Drabble, J. Keatley, G. Marcelle

Faculty Publications

This article describes elements of effective health communication and highlights strategies that may best be adopted or adapted in relation to lesbian, gay, bisexual, and transgender (LGBT) populations. Studies have documented the utility of multidimensional approaches to health communication from the macro level of interventions targeting entire populations to the micro level of communication between health care provider and consumer. Although evidence of health disparities in LGBT communities underscores the importance of population-specific interventions, health promotion campaigns rarely target these populations and health communication activities seldom account for the diversity of LGBT communities. Advances in health communication suggest promising direction …

The Impact Of Asthma Self-Management Education Programs On The Health Outcomes: A Meta-Analysis (Systemic Review) Of Randomized Controlled Trials, Surender Gaddam

Theses Digitization Project

An attempt has been made in this study to critically appraise, systematically review and gather together the results obtained in individual trials and examine the strength of evidence supporting the component for Education for a Partnership in Asthma Care of the National Asthma Education and Prevention Program (NAEPP) to test whether health outcomes are influenced by education and self-management programs.

The Treatment Of Hypnotic Dependent Sleep Disorder: A Case Study, Theodore Cooper, K. Lichstein, N. Aguillard

Selected Works Temporary Series

No abstract provided.