Public Health Commons^™

Hospital Oversight In Medicare: Accreditation And Deeming Authority, Lisa Sprague

National Health Policy Forum

To be eligible to receive payment from Medicare, hospitals must be certified to meet certain conditions. Hospitals may gain such credentials by choosing to be reviewed by a state certification agency under contract to the Centers for Medicare & Medicaid Services or to be accredited by either the Joint Commission on Accreditation of Healthcare Organizations or the American Osteopathic Association. This issue brief looks at how accreditation of hospitals developed and how it continues to change. It considers the legal and practical reasons that a majority of hospitals choose accreditation and why some hospitals do not, along with broader consideration …

Evaluation Of Over-The-Counter Sales As A Syndromic Surveillance Method For Waterborne Disease In New Mexico, Camilla M. Bustamante

Health, Exercise, and Sports Sciences ETDs

This research evaluates the use of Over-the-Counter anti-diarrheal medications as a potential syndromic indicator and surveillance mechanism for waterborne disease in New Mexico. The purpose was to determine the usefulness of such data for either supplemental or stand alone use in a system for waterborne disease surveillance. The use of syndromic indicators for waterborne disease was elevated in 1993 after an outbreak of cryptosporidium was detected in Milwaukee Wisconsin by an alert pharmacist who noticed increased sales of over-the-counter medications over a period of time. In 2001, terrorist threats for anthrax exposure to U.S. populations further prompted funding and research …

Our Public Health History In Florida: Interview With Charles S. Mahan

Florida Public Health Review

No abstract provided.

Exposure Assessment Of Mercury In Fish From Kentucky Surface Waters, Najla Gubari

Masters Theses & Specialist Projects

Consumption of fish contaminated with mercury is the primary exposure pathway by which humans are exposed to mercury. Mercury is known to be a neurological toxin that can cause attention and language deficits, impaired memory, and impaired visual and motor function, especially in children under the age of six. In addition, mercury exposure can lead to other health problems in adults, such as damage to the kidney and increased risk of coronary heart disease. This study assesses the exposure to mercury through consumption of fish from Kentucky surface waters. The exposure assessment is based on data collected by the Kentucky …

Relationships Between Environmental Factors And Fungi On Occupants' Perceptions Of Indoor Air Quality, Monica Rodriguez

Masters Theses & Specialist Projects

In recent decades, concerns about potential health effects resulting from exposure to contaminants that cause indoor air pollution have dramatically increased. The purpose of this study was to assess the indoor air quality of three buildings at Western Kentucky University and to examine and characterize indoor levels of basic comfort parameters, carbon dioxide, and fungi as well as occupants' perceptions of poor indoor air quality and the role of fungi on reported health symptoms. The three buildings included in the study were: Tate Page Hall (TPH), Jones Jagger Hall (JJH) and Science and Technology Hall (STH). Fifty-three questionnaires were completed …

Reliability And Validity Of Skinfold Testers When Estimating Body Composition In Indiana High School Wrestlers: A Case Report, William Rowe Mathie Jr.

All-Inclusive List of Electronic Theses and Dissertations

Objective: To determine the reliability and validity of the measurements taken by skin fold testers on Indiana High School wrestlers. Design and Setting: A 2 x 3 x 3 repeated measures design was used for this study. Three independent variables were evaluated. The first independent variable was Body Composition technique (skin fold and hydrostatic weighing), the second is Tester (1 thru 3) and the third is Trial (1 thru 3). The one dependent variable was Body Fat Percentage. Subjects: Three Indiana certified skin fold measurers were recruited to be testers for this study. Twelve male high school wrestlers (age: 16.1±0.9, …

Environmental Factors In Autoimmunity: Assessment Of Immunotoxicity Of Phthalates In The Induction Of Lupus-Type Anti-Dna Antibodies, So-Yon Lim

All-Inclusive List of Electronic Theses and Dissertations

Objectives: Little is known of the role of specific environmental factors in promoting autoimmune disorders such as systemic lupus erythematosus (SLE). The broad objective of this study was to address how exposure to phthalates, common environmental factors m foods, and biomedical devices could affect the immune functions of resistant and autoimmune-prone mice. Methods: The environmental chemical model used in this study is phthalates, which are widely used in various forms and readily occur during day-to-day human contacts. Groups of nonautoimmune-prone (BALB/c, DBA/2 and C57BL/6) and susceptible (NZB, NZB/W Fl) mice were immunized with phthalates ( ortho, meta and para) conjugated …

Parents' Perception Of Their Children's Asthma, 2002-2008: A Community-Based Study, John M. Pascoe, William Spears, Shalini Forbis, Jessica L. Saunders

Population and Public Health Sciences Faculty Publications

Childhood asthma is a chronic health condition that is one of the leading causes of hospitalizations and missed school days for children. It also affects the lives of both asthmatic children and their families.

Scale Development For Perceived School Climate For Girls’ Physical Activity, Amanda Birnbaum, Kelly R. Evenson, Robert W. Motl, Rod K. Dishman, Carolyn C. Voorhees, James F. Sallis, John P. Elder, Marsha Dowda

Department of Public Health Scholarship and Creative Works

Objectives: To test an original scale assessing perceived school climate for girls' physical activity in middle school girls. Methods: Confirmatory factor analysis (CFA) and structural equation modeling (SEM). Results: CFA retained 5 of 14 original items. A model with 2 correlated factors, perceptions about teachers' and boys' behaviors, respectively, fit the data well in both sixth and eighth-graders. SEM detected a positive, significant direct association of the teacher factor, but not the boy factor, with girls' self-reported physical activity. Conclusions: School climate for girls' physical activity is a measurable construct, and preliminary evidence suggests a relationship with physical activity.

Exposure To Secondhand Smoke And Nicotine Dependence, Chizimuzo T.C. Okoli, Ellen J. Hahn, Steven R. Browning, Mary Kay Rayens

Nursing Presentations

Background

• Nicotine dependence (ND) : “the smoking behavior accompanied by a reluctance to quit (Khurana, Batra, Patkar, & Leone, 2003).

• The US Public Health Service Clinical Practice Guideline ‘Treating Tobacco Use and Dependence’: A chronic condition that often requires repeated interventions (Office of the Surgeon General, 2000).

• Secondhand Smoke (SHS) is a potential source of exposure to high levels of nicotine. (Dimich-Ward, Gee, Brauer, Leung,1997)

• No current studies addressing the contribution of SHS to Nicotine Dependence (ND) or smoking behaviors

Our Public Health History In Florida: Interview With Peter J. Levin

Florida Public Health Review

No abstract provided.

Influence Of Cardiorespiratory Fitness On The Association Between C-Reactive Protein And Metabolic Syndrome Prevalence In Racially Diverse Women, Michael J. Lamonte, Barbara E. Ainsworth, J. Larry Durstine

Faculty Publications

No abstract provided.

Health Insurance Coverage For Small Employers, Dawn Gencarelli

National Health Policy Forum

For workers of small employers, access to affordable health insurance coverage is a growing concern. This paper examines the problems these firms and their employees face in obtaining health insurance coverage they can afford. The degree to which these challenges become obstacles varies greatly, depending on, for instance, the size of the employer and the characteristics of its employees. Reviewed here are these challenges to access, as well as some of the efforts made through state and federal reforms to address them, including rules regarding guaranteed issue and guaranteed renewability. This paper also explores some of the more recent initiatives …

Landscaping Laborer Dies When Struck By Bouncing Log, Kentucky Injury Prevention And Research Center

Fatality Case Reports--Tractors/Logging

On March 5, 2004, a 57-year-old male laborer died when a 19 inch wide x 31 inch long log rolled down a mountain hitting him in his head and chest. The laborer had been employed for three days by a landscaping company contracted to clear the tree canopy over a gas line right-of-way. At approximately 2:20 pm, the company owner and five laborers were felling trees and bucking downed trees with chain saws and pole saws to remove the trees and limbs hanging over and growing in the gas line right-of-way. Two of the laborers were working topside at the …

Fundamentals Of Underwriting In The Nongroup Health Insurance Market: Access To Coverage And Options For Reform, Mark Merlis

National Health Policy Forum

Although the majority of Americans with health insurance obtain coverage through their employers, many individuals must negotiate the nongroup insurance market alone. Insurers use a process called medical underwriting to identify applicants with current or recent medical problems. Because these applicants are likely to cost the insurer more in claims than a healthier person, insurers may charge them higher premiums or restrict or deny coverage. This background paper reviews the practice of underwriting, state and federal regulation of insurers offering nongroup health coverage, and several proposed options for improving access to coverage for applicants who are in poor health.

Causal Inference In Longitudinal Studies With History-Restricted Marginal Structural Models, Romain Neugebauer, Mark J. Van Der Laan, Ira B. Tager

U.C. Berkeley Division of Biostatistics Working Paper Series

Causal Inference based on Marginal Structural Models (MSMs) is particularly attractive to subject-matter investigators because MSM parameters provide explicit representations of causal effects. We introduce History-Restricted Marginal Structural Models (HRMSMs) for longitudinal data for the purpose of defining causal parameters which may often be better suited for Public Health research. This new class of MSMs allows investigators to analyze the causal effect of a treatment on an outcome based on a fixed, shorter and user-specified history of exposure compared to MSMs. By default, the latter represents the treatment causal effect of interest based on a treatment history defined by the …

Health Savings Accounts: The Fundamentals, Beth Fuchs, Julie A. James

National Health Policy Forum

This paper explores the fundamentals of health savings accounts (HSAs). While not intended to be an exhaustive review of these accounts, it describes their intellectual and legislative origins and the mechanics of how they work, explores the early returns on how they are faring in the insurance market, and identifies major issues and controversies that they raise. The paper looks specifically at the basic rules for HSAs and the requirements for health insurance that qualifies as a high-deductible health plan (HDHP) for HSA purposes. Also considered are issues related to provider payments under HSAs and the administration of the benefit …

Documentation Des Risques Dans Les Centres De Transfert Des Matières Dangereuses, Brigitte Roberge, Marc Baril, Claude Bariteau

Rapports de recherche scientifique

No abstract provided.

History-Adjusted Marginal Structural Models: Time-Varying Effect Modification, Maya L. Petersen, Mark J. Van Der Laan

U.C. Berkeley Division of Biostatistics Working Paper Series

Marginal structural models (MSM) provide a powerful tool for estimating the causal effect of a treatment, particularly in the context of longitudinal data structures. These models, introduced by Robins, model the marginal distributions of treatment-specific counterfactual outcomes, possibly conditional on a subset of the baseline covariates. However, standard MSM cannot incorporate modification of treatment effects by time-varying covariates. In the context of clinical decision- making such time-varying effect modifiers are often of considerable interest, as they are used in practice to guide treatment decisions for an individual. In this article we introduce a generalization of marginal structural models, which we …

History-Adjusted Marginal Structural Models: Optimal Treatment Strategies, Maya L. Petersen, Mark J. Van Der Laan

U.C. Berkeley Division of Biostatistics Working Paper Series

Much of clinical medicine involves choosing a future treatment plan that is expected to optimize a patient's long-term outcome, and modifying this treatment plan over time in response to changes in patient characteristics. However, dynamic treatment regimens, or decision rules for altering treatment in response to time-varying covariates, are rarely estimated based on observational data. In a companion paper, we introduced a generalization of Marginal Structural Models, named History-Adjusted Marginal Structural Models, that estimate modification of causal effects by time-varying covariates. Here, we illustrate how History-Adjusted Marginal Structural Models can be used to identify a specific type of optimal dynamic …

Addressing The Marion County Health Department’S Need For A Comprehensive Resource Detailing Florida Medicare’S Medical Necessity Policies

Florida Public Health Review

No abstract provided.

Una Enfermedad De La Sociedad: Una Investigación De Las Causas, Los Tratamientos, Y La Prevención De La Desnutrición De Niños En El Centro De Nutrición Infantil, Albina R. De Patiño, Kimberly A. Mukerjee

Independent Study Project (ISP) Collection

Antes de empezar mi proyecto en el Centro de Nutrición Infantil, investigué los datos sobre la situación actual de desnutrición en Bolivia. Es importante incluir esta información para identificar los datos epidemiológicos de esta región de Cochabamba, y comparar con los datos obtenidos del país y de América Latina. Este es un resumen crítico de la información obtenida. La crisis de la pobreza en América Latina es un gran factor que afecta la salud de la población infantil. Cerca de un millón de niños latinoamericanos mueren al año víctimas de las condiciones inherentes a la pobreza, como la desnutrición, las …

Epidemiology Of Escherichia Coli O157:H7 Outbreaks, United States, 1982–2002, Josefa M. Rangel, Phyllis H. Sparling, Collen Crowe, Patricia M. Griffin, David L. Swerdlow

United States Public Health Resources

Escherichia coli O157:H7 causes 73,000 illnesses in the United States annually. We reviewed E. coliO157 outbreaks reported to Centers for Disease Control and Prevention (CDC) to better understand the epidemiology of E. coli O157. E. coli O157 outbreaks (>2 cases of E. coli O157 infection with a common epidemiologic exposure) reported to CDC from 1982 to 2002 were reviewed. In that period, 49 states reported 350 outbreaks, representing 8,598 cases, 1,493 (17%) hospitalizations, 354 (4%) hemolytic uremic syndrome cases, and 40 (0.5%) deaths. Transmission route for 183 (52%) was foodborne, 74 (21%) unknown, 50 (14%) person-to-person, 31 (9%) …

Correlates Of Physical Activity In Persons With Arthritis: Review And Recommendations, Sarah Wilcox, Cheryl Der Ananian, Patricia A. Sharpe, Jennifer Robbins, Theresa Brady

Faculty Publications

Background: Physical activity (PA) is important for arthritis self-management. A better understanding of the PA correlates in persons with arthritis will help inform interventions. Methods: Computer searches were conducted on PubMed, PsychInfo, Current Contents, and Cinahl databases. Reference lists of extracted articles were also searched. Thirty-six studies published between 1976 and February 2004 met inclusion criteria. Results: PA correlates are presented for sociodemographic, psychological, health-related, social, and environmental categories. Self-efficacy, perceived benefits and barriers, mental well-being, prior PA, and pain received the most consistent support as PA correlates, whereas sociodemographic, social, and environmental variables were the least studied. Too few …

Prevention Research Centers: Contributions To Updating The Public Health Workforce Through Training, Adele L. Franks, Ross C. Brownson, Carol Bryant, Kelli Mccormack Brown, Steven P. Hooker, Delores M. Pluto, Dennis M. Shepard, Russell R. Pate, Elizabeth A. Baker, Kathleen N. Gillespie, Terry L. Leet, Margret A. O'Neall, Eduardo J. Simoes

Faculty Publications

Because public health is a continually evolving field, it is essential to provide ample training opportunities for public health professionals. As a natural outgrowth of the Centers for Disease Control and Prevention's Prevention Research Centers Program, training courses of many types have been developed for public health practitioners working in the field. This article describes three of the Prevention Research Center training program offerings: Evidence-Based Public Health, Physical Activity and Public Health for Practitioners, and Social Marketing. These courses illustrate the commitment of the Prevention Research Centers Program to helping create a better trained public health workforce, thereby enhancing the …

A New Kind Of "Outrageous Misconduct": Effects To Undermine The Law's Ability To Deter And Punish Intentional And Outrageous Corporate Behavior, Candace Howard

Student Articles and Papers

The current tort "reform" movement, if successful, will completely undermine our most effective tool for deterring outrageous corporate misconduct: the threat of punitive damages. Such "reform" would have a particularly egregious impact on the environment and public health because, due to a lack of enforcement and the undetectable nature of many pollutants, environmental offenses are often more difficult to deter than other types of offenses. The essay argues that, although rarely imposed for environmental offenses, punitive damages are especially vital in that arena because, when imposed, they are richly deserved. It concludes that, rather than tort reform, what we need …

Comparisons Between Rail-Trail Users And Nonusers And Men And Women's Patterns Of Use In A Suburban Community, Philip J. Troped, Ruth P. Saunders, Russell R. Pate

Faculty Publications

Background: Physical activity research on trails is limited. We compared rail-trail users and nonusers on demographics, physical activity, and barriers/concerns about trail use; and described use among men and women. Methods: Four hundred thirteen adults completed a physical activity survey during fall 1998. Chi-square statistics and t-tests were used to compare trail users to nonusers, and men and women on trail use. Results: More trail users (79%) performed recreational physical activity ≥ 3 d/wk, compared to nonusers (47%). Walking was the most common activity for trail users and nonusers. Both groups shared concerns about safe access to the trail …

Correlates Of In-Home Smoking Behavior Of Parents With Newborns, James Kyung Jo

Loma Linda University Electronic Theses, Dissertations & Projects

Secondhand smoke has been shown to have adverse health effects on young children. It is associated with various health effects such as respiratory infections, Sudden Infant Death Syndrome (SIDS), and asthma. Because of the dangers secondhand smoke poses to young children, there is a need for educating parents about the dangers of secondhand smoke as well as determining factors associated with secondhand smoke exposure among children. Understanding these factors may be first step toward developing strategies to reduce ETS exposure.

The study examined correlates of in-home smoking behavior of parents with newborns by analyzing 657 respondents who filled out the …

The Legacy Of Irop: Giving Back The Gift Of Mentorship, Elizabeth Gagnon

Inquiry Journal 2005

No abstract provided.

The Great Pestilence: Yellow Fever In Portsmouth, Virginia, 1855, Burden Susan Lundgren

Health Services Research Dissertations

In 1855, the town of Portsmouth, Virginia was devastated by an epidemic of yellow fever. Most citizens fled. Of those who remained, most became infected and a thousand died. The municipal government collapsed. In their place, a small organization known as the Portsmouth Relief Association assumed responsibility for ensuring the survival of the town. This organization managed the care of the sick, the burial of the dead, and the care of orphans. It was the sole agent receiving and allocating the funds and resources that poured into the community. Scarce food, drugs and other supplies were available only through the …