Public Health Commons^™

The Human Ecology Of A Disease: Dissemination Of Resources And Information On Hiv And Aids In Can Tho City And An Giang Province, Lucas Thornblade

Independent Study Project (ISP) Collection

HIV has spread worldwide. This virus, resulting in as-of-yet incurable destruction of the human immune system, has caused the death of millions in the last two decades through opportunistic infections manifest as AIDS. Though development of prevention and treatment measures have greatly improved in recent years, because of lack of resources, incidence of infection continues to increase annually in nearly all parts of the world including southeast Asia. This paper looks at how the disease has affected people’s lives in Can Tho City and An Giang Province in Vietnam’s southern Mekong Delta. This paper offers an epidemiological and biological argument …

Working With The Tabu: Hiv/Aids Education Strategies In Fiji, Amanda Butts

Independent Study Project (ISP) Collection

The focus of this paper is the cultural tabu, or taboo, in Fiji that prevents the open discussion of sex and therefore complicates education efforts towards HIV/AIDS awareness and prevention. Specific factors perpetuate the tabu including using it as an excuse to simply ignore a complex issue such as HIV/AIDS and using it to keep sex off social agendas in a predominantly Christian nation. Where organizations have taken strides to work with or break the tabu, the author examines and analyzes various education strategies employed by a variety of sectors including schools, health care facilities, faith-based organizations, the HIV positive …

Medicaid In 2006: A Trip Down The Yellow Brick Road?, Jennifer Ryan

National Health Policy Forum

This issue brief explores the continuing evolution of the Medicaid program on several fronts. It discusses the benefits and cost-sharing flexibility that is included in the Deficit Reduction Act of 2005 (DRA) and examines the implications of these provisions for states, beneficiaries, and providers. The paper also explores recent trends in section 1115 waiver development and considers the use of waivers as a vehicle for restructuring Medicaid financing systems and for testing completely new approaches to health care delivery. The role of section 1115 waivers in the context of the DRA and as a mechanism for continued state innovation is …

Reliability, Effect Size, And Responsiveness And Intraclass Correlation Of Health Status Measures Used In Randomized And Cluster-Randomized Trials, Paula Diehr, Lu Chen, Donald L. Patrick, Ziding Feng, Yutaka Yasui

UW Biostatistics Working Paper Series

Background: New health status instruments are described by psychometric properties, such as Reliability, Effect Size, and Responsiveness. For cluster-randomized trials, another important statistic is the Intraclass Correlation for the instrument within clusters. Studies using better instruments can be performed with smaller sample sizes, but better instruments may be more expensive in terms of dollars, lost opportunities, or poorer data quality due to the response burden of longer instruments. Investigators often need to estimate the psychometric properties of a new instrument, or of an established instrument in a new setting. Optimal sample sizes for estimating these properties have not been studied …

Sensitivity Of The Hazard Ratio To Non-Ignorable Treatment Assignment In An Observational Study, Nandita Mitra, Daniel F. Heitjan

UPenn Biostatistics Working Papers

In non-randomized studies, estimation of treatment effects generally requires adjustment for imbalances in observed covariates. One such method, based on the propensity score, is useful in many applications but may be biased when the assumption of strongly ignorable treatment assignment is violated. Because it is not possible to evaluate this assumption from the data, it is advisable to assess the sensitivity of conclusions to violations of strong ignorability. Lin et al [1] have implemented this idea by investigating how an unmeasured covariate may affect the conclusions of an observational study. We extend their method to assess sensitivity of the treatment …

Association Between Tobacco Use And Body Mass Index In Urban Indian Population: Implications For Public Health In India, Mangesh S. Pednekar, Prakash C. Gupta, Heema C. Shukla, James R. Hébert

Faculty Publications

Background: Body mass index [BMI, weight (kg)/height (m2)], a measure of relative weight, is a good overall indicator of nutritional status and predictor of overall health. As in many developing countries, the high prevalence of very low BMIs in India represents an important public health risk. Tobacco, smoked in the form of cigarettes or bidis (handmade by rolling a dried rectangular piece of temburni leaf with 0.15–0.25 g of tobacco) or chewed, is another important determinant of health. Tobacco use also may exert a strong influence on BMI.

Methods: The relationship between very low BMI (< 18.5 kg/m2) and tobacco use was examined using data from a representative cross-sectional survey of 99,598 adults (40,071 men and 59,527 women) carried out in the city of Mumbai (formerly known as Bombay) in western India. Participants were men and women aged ≥ 35 years who were residents of the main city of Mumbai.

Results: …

Development Of An Evaluation Methodology For Hazardous Waste Training Programs, Ryan A. Crowley

Theses and Dissertations

The Purpose of this research was to develop a methodology to measure hazardous waste training programs. The Air Force Material Command (AFMC) hazardous waste training program was used to conduct this research. To measure the effectiveness of AFMC's hazardous waste training program, the research attempted to answer four research questions. These questions addressed correlations between hazardous waste training programs and Environmental Compliance Assessment and Management Program (ECAMP) findings, the understanding personnel have of hazardous waste principles and concepts, the effectiveness of hazardous waste training courses, and how personnel feel about the hazardous waste training they are receiving. In addition, the …

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. …

Injury Profiles Of Indigenous And Non-Indigenous People In New South Wales, Kathleen F. Clapham, Mark R. Stevenson, Sing Kai Lo

Aboriginal Policy Research Consortium International (APRCi)

Objectives: To compare the injury profiles of the Indigenous population in New South Wales with that of the non-Indigenous population.

Design and setting: Descriptive analysis of NSW Health data obtained from the Health Outcomes Information and Statistical Toolkit (HOIST) database. Hospitalisation data were collected for the period 1 July 1999 to 30 June 2003. Mortality data were collected for the period 1 January 1999 to 31 December 2002.

Main outcome measures: Hospitalisation and death rates due to injury by age, sex, injury mechanism and Indigenous status. Rate ratios for comparison between Indigenous and non-Indigenous populations. Results: Rates of death from …

Rebalancing Long-Term Care: The Role Of The Medicaid Hcbs Waiver Program, Cynthia Shirk

National Health Policy Forum

This paper reviews the history and background of the Medicaid home and community-based services (HCBS) waiver program. It describes the eligibility, benefits, and financing structure, as well as the trends in program expenditures over time. The paper considers the contribution of the HCBS waiver program toward improving access to community-based care for Medicaid beneficiaries who are elderly and disabled and discusses the barriers that remain. This paper also summarizes the provisions included in the recently enacted Deficit Reduction Act of 2005 that may further expand Medicaid HCBS and considers how it may continue the process of redefining the concept of …

Geographic Factors Contributing To A High Seroprevalence Of West Nile Virus-Specific Antibodies In Humans Following An Epidemic, Beth K. Schweitzer, Wayne L. Kramer, Anthony R. Sambol, Jane L. Meza, Steven H. Hinrichs, Peter C. Iwen

United States Public Health Resources

Sera of 624 blood donors were evaluated to determine seroprevalence of West Nile virus (WNV) antibodies following the 2003 WNV epidemic in Nebraska. Geographic factors contributing to differences in WNV seropositivity were evaluated. The overall prevalence of WNV in Nebraska was higher than reported previously in other U.S. locations (9.5% WNV immunoglobulin G seroprevalence rate), with the highest prevalence identified in the western part of the state (19.7%), followed by the central (13.8%) and the eastern (4.2%) parts. Regions of the state with the highest WNV-positive mosquito rates correlated with the highest human WNV seroprevalence rates. The results showed that …

Download Full Pdf Issue Vol. 2, Iss. 2, Thomas Jefferson University-Public Health Link, March 2006

Public Health Link

Volume 2, Issue 2, March 2006 includes: accreditation update, poster sessions, Population Health Forum, Sigma XI Research Day and Annual APHA meeting.

Analysis Of Patient Information: An Empirical Modeling Approach, Tony A. Murphy

Theses and Dissertations

With rising costs and increasing complexities, many hospitals seek to better understand the intricate details of their operations. Increasingly, these organizations have a strong desire to accurately predict the resources required to effectively treat their patient load. This research investigates patient length-of-stay in a hospital neurological unit using an empirical modeling approach. Factors significantly affecting patient length of stay were identified and used to construct a regression model. The predictive model provides hospital decision makers with a compact tool to input what-if scenarios and predict future patient treatment lengths, thus, allowing the hospital to properly allocate resources.

Pnes: Neuropsychological Impairments & Psychological Symptomatology, Adriana Macias

Loma Linda University Electronic Theses, Dissertations & Projects

The present study utilized a standardized neuropsychological evaluation and self report measures to compare 52 female patients, 18 years of age and older with a video-electroencephalogram (V-EEG) confirmed diagnosis of psychogenic non-epileptic seizures (PNES) (n₁=29) to a group of left temporal lobe epilepsy (L-TLE) demographically matched patients (n₂=23). In an attempt to overcome methodological confounds of previously reported studies, participants were chosen based on stringent exclusion criteria, which barred mixed etiologies. The purpose of this study was to investigate possible differences in neuropsychological functioning, mood, and personality characteristics between individuals with PNES and those with L-TLE. …

Pakistan - Country Profile Of Cancer And Cancer Control 1995-2004, Yasmin Bhurgri, Asif Bhurgri, Sania Nishter, Ashfaq Ahmed, Ahmed Usman, Shahid Pervez, Naila Kayani, Rashida Ahmed, Sheema H. Hassan, Ahmed Riaz, Hadi Bhurgri, Imtiaz Bashir

Department of Pathology and Laboratory Medicine

No abstract provided.

Fitness, Knowledge, Progress: Assessing Physician Qualification, Lisa Sprague

National Health Policy Forum

The informed and empowered consumer is an ideal invoked by many would-be health care reformers. An actual consumer wishing to don the mantle of power may be hindered by the scarcity of information available, particularly with respect to choosing among physicians. How is one to know who is best qualified? This issue brief looks at the basics of physician qualification and the processes by which physicians are licensed, credentialed, and board-certified. It examines how the evolution of these processes (for example, the move from lifetime certification to ongoing maintenance of certification) affects clinicians and their patients. The rise of quality …

Identification Of Critical Determinants On Ace2 For Sars-Cov Entry And Development Of A Potent Entry Inhibitor, Dong P. Han, Adam Penn-Nicholson, Michael W. Cho

Faculty Scholarship

Severe acute respiratory syndrome (SARS) is caused by a novel coronavirus, SARS-CoV. Virus entry into cells is mediated through interactions between spike (S) glycoprotein and angiotensin-converting enzyme 2 (ACE2). Alanine scanning mutagenesis analysis was performed to identify determinants on ACE2 critical for SARS-CoV infection. Results indicated that charged amino acids between residues 22 and 57 were important, K26 and D30, in particular. Peptides representing various regions of ACE2 critical for virus infection were chemically synthesized and evaluated for antiviral activity. Two peptides (a.a. 22–44 and 22–57) exhibited a modest antiviral activity with IC(50) of about 50 μM and 6 μM, …

Different Public Health Interventions Have Varying Effects, Paula Diehr, Anne B. Newman, Liming Cai, Ann Derleth

UW Biostatistics Working Paper Series

Objective: To compare performance of one-time health interventions to those that change the probability of transitioning from one health state to another. Study Design and Setting: We used multi-state life table methods to estimate the impact of eight types of interventions on several outcomes. Results: In a cohort beginning at age 65, curing all the sick persons at baseline would increase life expectancy by 0.23 years and increase years of healthy life by .54 years. An equal amount of improvement could be obtained with a 12% decrease in the probability of getting sick, a 16% increase in the probability of …

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 …

Health Benefits In Retirement: Set For Extinction?, Mark Merlis

National Health Policy Forum

Nearly 18 million people rely on employer-provided retiree health benefits to fill gaps in Medicare’s coverage or to provide basic insurance until they reach Medicare age. Rising costs have led many employers to limit benefits, require participants to pay a larger share of the costs, or stop offering coverage at all for workers who have not yet retired. This background paper describes recent developments in retiree health benefits, possible future trends, and policy options for slowing the erosion of coverage or providing alternative ways for retirees to meet their expected medical expenses.

La Bibliothèque Publique, Un Lieu De Travail : L'Ergonomie Appliquée À Un Projet D'Aménagement De Comptoir De Service, Patrick Vincent, Micheline Marier, Élise Ledoux, Marie Bellemare, Louis Trudel, Sylvie Montreuil

Rapports de recherche scientifique

No abstract provided.

Download Full Pdf Issue Volume 2, Issue 1 - Msph Newsletter 2006

Public Health Link

This is the first issue of 2006 and it highlights upcoming events and an accreditation update.

Rural Health Research In Progress In The Rural Health Research Centers Program, Maine Rural Health Research Center, Muskie School Of Public Service

Faculty, Staff, and Alumni Books

This book describes the research and policy analysis projects underway in the Rural Health Research Centers Program of the Federal Office of Rural Health Policy (ORHP), Health Resources and Services Administration, U.S. Department of Health and Human Services. The objective of this program is to produce research and policy analyses that will be useful in the development of national and state policies to assure access to quality physical and behavioral health services for rural Americans.

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.

Tag Snp Selection For Finnish Individuals Based On The Ceph Utah Hapmap Database, Cristen J. Willer, Laura J. Scott, Lori L. Bonnycastle

University Faculty Publications and Creative Works

The pattern and nature of linkage disequilibrium in the human genome is being studied and catalogued as part of the International HapMap Project [2003: Nature 426:789-796]. A key goal of the HapMap Project is to enable identification of tag single nucleotide polymorphisms (SNPs) that capture a substantial portion of common human genetic variability while requiring only a small fraction of SNPs to be genotyped [International HapMap Consortium, 2005: Nature 437:1299-1320]. In the current study, we examined the effectiveness of using the CEU HapMap database to select tag SNPs for a Finnish sample. We selected SNPs in a 17.9-Mb region of …

Do Industrial Back Support Belts Reduce Stress In Asymmetric Lifting?, Ryan Jamor Brown

Theses

The objective of this research is to determine the effects of wearing a back support belt during repetitive asymmetric lifting in terms of heart rate, blood pressure, static lift capacity, body discomfort rating and subjective rating concerning the effectiveness of a back support belt. The type of belt used in this study was of knit nylon and elastic construction designed for industrial use.

Eight female participants lifted a crate from the table to knuckle height at a rate of three lifts per minute for a period of 20 minutes; one set with wearing back support belt and one without back …

The Vaccine Industry: Does It Need A Shot In The Arm?, Eileen Salinsky, Cole Werble

National Health Policy Forum

This paper broadly examines the scientific, regulatory, and economic factors that contribute to constrained vaccine production capacity, periodic vaccine shortages, and perceptions of inadequate investment in new vaccine product development. It describes the vaccine development and production processes and summarizes how regulatory requirements influence these activities. Market dynamics related to vaccine supply and demand are also explored, including an examination of the industry’s cost structure, potential market size, and purchaser price sensitivity. A broad range of policy interventions designed to address shortcomings of the vaccine market are considered.

Gpnn: Power Studies And Applications Of A Neural Network Method For Detecting Gene-Gene Interactions In Studies Of Human Disease, Alison A. Motsinger, Stephen L. Lee, George Mellick, Marylyn D. Ritchie

Dartmouth Scholarship

The identification and characterization of genes that influence the risk of common, complex multifactorial disease primarily through interactions with other genes and environmental factors remains a statistical and computational challenge in genetic epidemiology. We have previously introduced a genetic programming optimized neural network (GPNN) as a method for optimizing the architecture of a neural network to improve the identification of gene combinations associated with disease risk. The goal of this study was to evaluate the power of GPNN for identifying high-order gene-gene interactions. We were also interested in applying GPNN to a real data analysis in Parkinson's disease.

Survey Findings: Children Served By Mainecare, 2005, Catherine Ormond, Deborah Thayer

Disability & Aging

No abstract provided.

Energy Efficiency, R. Steven Konkel

Environmental Health Science Faculty and Staff Research

Using energy efficiently can reduce the cost of heating, ventilating, and air-conditioning, which account for a significant part of the overall cost of housing. Energy costs recur month-to-month and are hard to reduce after a home has been designed and built. The development of an energy-efficient home or building must be thought through using a systems approach