Public Health Commons^™

Development Of Dose Conversion Coefficients For Radionuclides Produced In Spallation Neutron Sources: Quarterly Progress Report 9/1/04 – 12/31/04, Phillip W. Patton, Mark Rudin

Transmutation Sciences Physics (TRP)

The research consortium comprised of representatives from several universities and national laboratories has successfully generated internal and external dose conversion coefficients for twenty radionuclides produced in spallation neutron sources. In addition, the group has identified twenty radionuclide that are missing electron capture files and eighteen additional radionuclides missing substantial physical data.

Public Health Abstracts 2004

Florida Public Health Review

No abstract provided.

Public Health, Primary Care, And Privatization

Florida Public Health Review

No abstract provided.

Estimating Percentile-Specific Causal Effects: A Case Study Of Micronutrient Supplementation, Birth Weight, And Infant Mortality, Francesca Dominici, Scott L. Zeger, Giovanni Parmigiani, Joanne Katz, Parul Christian

Johns Hopkins University, Dept. of Biostatistics Working Papers

In developing countries, higher infant mortality is partially caused by poor maternal and fetal nutrition. Clinical trials of micronutrient supplementation are aimed at reducing the risk of infant mortality by increasing birth weight. Because infant mortality is greatest among the low birth weight infants (LBW) (• 2500 grams), an effective intervention may need to increase the birth weight among the smallest babies. Although it has been demonstrated that supplementation increases the birth weight in a trial conducted in Nepal, there is inconclusive evidence that the supplementation improves their survival. It has been hypothesized that a potential benefit of the treatment …

A Hybrid Newton-Type Method For The Linear Regression In Case-Cohort Studies, Menggang Yu, Bin Nan

The University of Michigan Department of Biostatistics Working Paper Series

Case-cohort designs are increasingly commonly used in large epidemiological cohort studies. Nan, Yu, and Kalbeisch (2004) provided the asymptotic results for censored linear regression models in case-cohort studies. In this article, we consider computational aspects of their proposed rank based estimating methods. We show that the rank based discontinuous estimating functions for case-cohort studies are monotone, a property established for cohort data in the literature, when generalized Gehan type of weights are used. Though the estimating problem can be formulated to a linear programming problem as that for cohort data, due to its easily uncontrollable large scale even for a …

Public Health Nursing Acceptance Of The 5 A’S Protocol For Prenatal Smoking Cessation, Jihong Liu

Faculty Publications

Oregon’s efforts in tobacco cessation have historically focused on the general population and have depended on quit line services as the primary intervention. The Oregon Smoke Free Mothers and Babies Program (SFMB) was developed in 2002 to focus on public health nurses and prenatal care providers who work with high risk pregnant women. It seeks to increase smoking cessation among low income and other high risk pregnant women by disseminating the U.S. Public Health Service best practices, the 5 A’s (Ask, Advise, Assess, Assist, Arrange) tobacco brief intervention protocol, to public health nurses and prenatal care providers. Interventions included teaching …

Ranking Usrds Provider-Specific Smrs From 1998-2001, Rongheng Lin, Thomas A. Louis, Susan M. Paddock, Greg Ridgeway

Johns Hopkins University, Dept. of Biostatistics Working Papers

Provider profiling (ranking, "league tables") is prevalent in health services research. Similarly, comparing educational institutions and identifying differentially expressed genes depend on ranking. Effective ranking procedures must be structured by a hierarchical (Bayesian) model and guided by a ranking-specific loss function, however even optimal methods can perform poorly and estimates must be accompanied by uncertainty assessments. We use the 1998-2001 Standardized Mortality Ratio (SMR) data from United States Renal Data System (USRDS) as a platform to identify issues and approaches. Our analyses extend Liu et al. (2004) by combining evidence over multiple years via an AR(1) model; by considering estimates …

Referent Selection Strategies In Case-Crossover Analyses Of Air Pollution Exposure Data: Implications For Bias, Holly Janes, Lianne Sheppard, Thomas Lumley

UW Biostatistics Working Paper Series

The case-crossover design has been widely used to study the association between short term air pollution exposure and the risk of an acute adverse health event. The design uses cases only, and, for each individual, compares exposure just prior to the event with exposure at other control, or “referent” times. By making within-subject comparisons, time invariant confounders are controlled by design. Even more important in the air pollution setting is that, by matching referents to the index time, time varying confounders can also be controlled by design. Yet, the referent selection strategy is important for reasons other than control of …

Quality Improvement In Maryland: Partnerships And Progress, Judith D. Moore, Lisa Sprague

National Health Policy Forum

This one-and-a-half-day site visit to Easton, Maryland, explored the activities of the Delmarva Foundation, the Quality Improvement Organization (QIO) for Maryland and the District of Columbia. The program reviewed Delmarva’s responsibilities under their Medicare contract and the initiatives they have undertaken with hospitals and other providers to improve health care outcomes and to define, collect, and report quality data. Local hospital officials added their perspective on quality programs and working with Delmarva. Topics of particular interest were health information technology, patient safety, and quality reporting both to government agencies and to consumers.

Semi-Parametric Single-Index Two-Part Regression Models, Xiao-Hua Zhou, Hua Liang

UW Biostatistics Working Paper Series

In this paper, we proposed a semi-parametric single-index two-part regression model to weaken assumptions in parametric regression methods that were frequently used in the analysis of skewed data with additional zero values. The estimation procedure for the parameters of interest in the model was easily implemented. The proposed estimators were shown to be consistent and asymptotically normal. Through a simulation study, we showed that the proposed estimators have reasonable finite-sample performance. We illustrated the application of the proposed method in one real study on the analysis of health care costs.

A Bjs Statistical Profile, 1992-2002: American Indians And Crime, Steven W. Perry

United States Public Health Resources

This report represents a compilation and new analysis of data on the incidents, prevalence, and consequences of violent crime among American Indians. The report uses data from a wide variety of sources, including statistical series maintained by the Bureau of Justice Statistics (BJS), the Federal Bureau of Investigation (FBI), the Bureau of Prisons (BOP), and the U.S. Census Bureau.
The findings reveal a disturbing picture of the victimization of American Indians and Alaska Natives. The rate of violent crime estimated from self reported victimizations for American Indians is well above that of other U.S. racial or ethnic groups and is …

West Nile Virus Blood Transfusion-Related Infection Despite Nucleic Acid Testing, Alexandre Macedo De Oliveira, Brady D. Beecham, Susan P. Montgomery, Robert S. Lanciotti, Jeffrey M. Linnen, Cristina Giachetti, Larry A. Pietrelli, Susan L. Stramer, Thomas J. Safranek

United States Public Health Resources

BACKGROUND: A case of West Nile virus (WNV) encephalitis associated with transfusion of blood that did not react when tested for WNV by minipool (MP) nucleic acid testing (NAT) is described. A Nebraska man developed clinical encephalitis 13 days after surgery and transfusion of 26 blood components. Antibody testing confirmed WNV infection. An investigation was initiated to determine the source of this infection.
STUDY DESIGN AND METHODS: The patient’s family members were interviewed to identify risk factors for WNV infection. Residual samples were retested for WNV RNA using transcription-mediated amplification (TMA) assay and two polymerase chain reaction (PCR) assays. Blood …

Comparison Of Two Approaches To Structured Physical Activity Surveys Of Adolescents, Robert G. Mcmurray, Kimberly B. Ring, Margarita S. Treuth, Gregory J. Welk, Russell R. Pate, Kathryn H. Schmitz, Julie L. Pickrel, Vivian Gonzalez, Maria João C. A. Almeida, Deborah Rohm Young, James F. Sallis

Faculty Publications

Purpose - To compare the test-retest reliability, convergent validity, and overall feasibility/usability of activity-based (AB) and time-based (TB) approaches for obtaining self-reported moderate-to-vigorous physical activity (MVPA) from adolescents.

Methods - Adolescents (206 females and 114 males) completed two 3-d physical activity recalls using the AB and TB surveys, which contained identical lists of physical activities. The participants wore an MTI Actigraph^® accelerometer for the same period.

Results - The TB instrument took about 3 min longer to complete (P=0.022). Overall 2-d test-retest correlations for MVPA were similar for the two surveys (r=0.676 and 0.667), but the girls …

Perceptions And Practices Of Indiana School Superintendents In Response To The Problem Of Sick Building Syndrome, Janet Elaine Hiller

All-Inclusive List of Electronic Theses and Dissertations

The purpose of this study was to compare the perceptions and practices of Indiana public school superintendents who represent two groups, those who had experienced building exposure to mold and those who had not experienced building exposure to mold. Seventy-five Indiana public school superintendents responded to the opinionnaire with a return rate of 81.5%. Results indicate that: (1) Indiana public school superintendents who had not experienced building exposure to mold had higher mean values than those who had experienced building exposure to mold relative to closing only classrooms affected by mold and to relocating staff and students exposed to mold; …

Metal Fabrication Shop Owner Dies When Crushed By Falling Steel Plate, Kentucky Injury Prevention And Research Center

Fatality Case Reports--Other

On December 15, 2003, a metal fabrication shop owner died when a 4,000 pound steel base plate fell on him. While inside the shop building, the work crew of least three men, including the owner, fabricated a 10’x 20’ steel base plate to be used at a water treatment plant. The base plate was to house or serve as a bas anchor a large water pump. After welding connectors and channel iron beams to one side of the plate, the crew pushed the plate through a bay door with a forktruck to an outside area in back of the shop. …

Evaluation Of The Biological Sampling Kit (Biskit) For Large-Area Surface Sampling, Mark P. Buttner, Patrica Cruz, Linda Stetzenbach, Amy Klima-Comba

Environmental & Global Health Faculty Research

Current surface sampling methods for microbial contaminants are designed to sample small areas and utilize culture analysis. The total number of microbes recovered is low because a small area is sampled, making detection of a potential pathogen more difficult. Furthermore, sampling of small areas requires a greater number of samples to be collected, which delays the reporting of results, taxes laboratory resources and staffing, and increases analysis costs. A new biological surface sampling method, the Biological Sampling Kit (BiSKit), designed to sample large areas and to be compatible with testing with a variety of technologies, including PCR and immunoassay, was …

Live Smoke Free Or Die: The Battle For Smoke Free Restaurants In New Hampshire, Jody Hodgdon

The University of New Hampshire Law Review

[Excerpt] "The need for a strict statutory scheme prohibiting or effectively segregating tobacco smoke in restaurants and public buildings in New Hampshire is compelling. One evening, during the summer of 2003, I took my wife and daughter to a restaurant in New Hampshire for dinner. When the time came to be seated, the waiter asked if we preferred to be seated in the smoking or non-smoking section. At our request, he led us to the non- smoking section. Over the course of dinner, I considered the irony of why the restaurant even had a non-smoking section. Smoke was coming over …

Diagnosing Crohn's Disease: An Economic Analysis Comparing Wireless Capsule Endoscopy With Traditional Diagnostic Procedures, Neil I. Goldfarb, Laura T. Pizzi, Joseph P. Fuhr Jr., Christopher Salvador, Vanja Sikirica, Asher Kornbluth, Blair Lewis

College of Population Health Faculty Papers

The purpose of this study was to review economic considerations related to establishing a diagnosis of Crohn's disease, and to compare the costs of a diagnostic algorithm incorporating wireless capsule endoscopy (WCE) with the current algorithm for diagnosing Crohn's disease suspected in the small bowel. Published literature, clinical trial data on WCE in comparison to other diagnostic tools, and input from clinical experts were used as data sources for (1) identifying contributors to the costs of diagnosing Crohn's disease; (2) exploring where WCE should be placed within the diagnostic algorithm for Crohn's; and (3) constructing decision tree models with sensitivity …

Mainecare Behavioral Health Care Expenditures State Fiscal Years 1996 – 2002, Susan Payne Phd, Stuart Bratesman Mpp, David Lambert Phd

Disability & Aging

No abstract provided.

38 Year-Old Construction Laborer Dies When Trench Walls Collapse, Kentucky Injury Prevention And Research Center

Fatality Case Reports--Other

On November 3, 2003, a 38-year-old male construction laborer died when the unprotected 8-foot high walls of the trench he was working in collapsed. The decedent was working for a subcontractor who was contracted by a construction company to remove old gas, storm and sanitary sewer lines and install similar new lines. The old abandoned 6-inch diameter gas line was a high pressure, 300 – 320 psi gas line in 10-inch steel casing and was 600 feet long. There were five employees at the job site employed by the subcontractor; a foreman who was a certified competent person, a lab …

Laborer Dies When Caught In Arms Of A Skidsteer Loader, Kentucky Injury Prevention And Research Center

Fatality Case Reports--Other

On September 19, 2003, a 23-year-old male laborer (decedent) died when he became caught in the activated arms of a skidsteer loader. A work crew consisting of a contractor and 3 laborers had spent the day installing fence on a dairy farm. Earlier in the day, the contractor had borrowed a skidsteer from the farm owner. The work crew used the skidsteer to set fence posts in the ground. At the end of the work day (approximately 4:00 PM), the contractor instructed the decedent to return the skidsteer to the barn area. From the work site, the decedent drove the …

Promotion Of Jump Rope In An Elementary School

Florida Public Health Review

No abstract provided.

The Effects Of Copayments On The Use Of Medical Services And Prescription Drugs In Utah's Medicaid Program, Leighton Ku, Elaine Deschamps, Judi Hilman

Health Policy and Management Faculty Publications

In recent years, a number of states have increased cost-sharing for low-income Medicaid beneficiaries as one approach to Medicaid cost-containment. While copayments have been most commonly applied to prescription drugs, they also have been assessed for other services, such as physician visits, hospital admission, or outpatient clinic use.

Prior research has found that when low-income patients are required to pay more for health care services or for prescription drugs, they use fewer services or medications.[2] In some cases, their health could deteriorate, with the result that they may subsequently require more expensive emergency room or inpatient hospital care. While …

Prevention Conference Vii - Obesity, A Worldwide Epidemic Related To Heart Disease And Stroke: Executive Summary, Robert H. Eckel, David A. York, Stephan Rössner, Van Hubbard, Ian Caterson, Sachiko T. St. Jeor, Laura L. Hayman, Rebecca M. Mullis, Steven N. Blair

Faculty Publications

No abstract provided.

Clinical Implications Of Obesity With Specific Focus On Cardiovascular Disease: A Statement For Professionals From The American Heart Association Council On Nutrition, Physical Activity, And Metabolism, Samuel Klein, Lora E. Burke, George A. Bray, Steven N. Blair, David B. Allison, Xavier Pi-Sunyer, Yuling Hong, Robert H. Eckel

Faculty Publications

Obesity adversely affects cardiac function, increases the risk factors for coronary heart disease, and is an independent risk factor for cardiovascular disease. The risk of developing coronary heart disease is directly related to the concomitant burden of obesity-related risk factors. Modest weight loss can improve diastolic function and affect the entire cluster of coronary heart disease risk factors simultaneously. This statement from the American Heart Association Council on Nutrition, Physical Activity, and Metabolism reviews the relationship between obesity and the cardiovascular system, evaluates the effect of weight loss on coronary heart disease risk factors and coronary heart disease, and provides …

Comparative Cost Analysis Of Crrt In Icu/Ccu Patients Undergoing Cardiovascular Surgery Vs. Other Procedures At A Texas Hospital, Tejaswi Belavadi, Alberto Coustasse, Douglas Mains, Antonio A. Rene

Management Faculty Research

The purpose of this study was to conduct a comparative analysis of hospital costs incurred by patients undergoing Cardiovascular Surgery (CVS) and patients undergoing other medical procedures who received Continuous Renal Replacement Therapy (CRRT) in a teaching hospital. A total of 117 patients were identified through review of medical charts for the period of January 1999 to August 2002. Twenty one percent of them were identified having CVS. Eighty-eight percent of the CVS patients admitted to the ICU for CRRT died compared to 67% for non-CVS patients (p=0.047). Average actual costs of hospitalization were $47,225 for CVS patients and $51,724 …

Ethics, Physician Incentives And Managed Care, Alberto Coustasse, Douglas Mains, Kristine Lykens

Management Faculty Research

The authors review the principle features of the managed care system in an effort to understand the ethical assumptions inherent in managed care. The interrelationships among physician incentives, responsibilities of patients and the physician-patient relationship are examined in light of the ethical concerns identified in the managed care system. The managed care system creates ethical tensions for those who influence the allocation of scare resources.

Managed care’s administrative controls have increasingly changed the doctor-patient relationship to the business person-consumer relationship. Managed care goals of quality and access demand that physicians be both patient advocate and organizational advocate, even though these …

Reexamining Mandatory Hiv Partner Notification In Florida

Florida Public Health Review

No abstract provided.

Aging In Place At Harbor Point: Outreach Follow-Up Of Older Adults Living In Independent Mixed-Income Apartments, Judith M. Conahan, Nina M. Silverstein, Kelly Fitzgerald

Gerontology Institute Publications

Most older people, despite functional impairments, plan to stay in their homes and/or communities as long as possible. According to an AARP survey, 82% of adults 65+ reported that they believe that they are “very likely” or “somewhat likely” to stay in their current homes or apartments for the rest of their lives. With increasing age, housing and community characteristics and services gain importance in meeting the challenges of “aging in place.” Staying in their homes maximizes elder’s independence, sustains their social connections, and reaffirms their identity and value.

A Study Of Pediatric Heart Transplant Patients In Relationship To Post Transplant Coronary Artery Disease, Mark Randall

Loma Linda University Electronic Theses, Dissertations & Projects

Post transplant coronary artery disease influences short and long-term survival of pediatric heart transplant recipients. Associated cardiovascular disease risk factors among non-heart transplant adult and pediatric heart populations for development of coronary artery disease have been documented. Little is known about these typical cardiovascular disease risk factors as well as other possible risk factors in the development of post transplant coronary artery disease. Objective: The purpose of this research was to examine children/adolescents (n=194), 5-18 years old, at least one-year post heart transplant. This study also investigated if there were physiological and psychological/behavioral differences between recipients with (n = 28) …