Public Health Commons^™

Frequency And Characteristics Of Breast Lymphomas Presenting To A Tertiary Care Hospital, Pakistan, Nausheen Yaqoob, Shahid Pervez, Naila Kayani, Rashida Ahmed, Zubair Ahmed, Sheema Hasan

Department of Pathology and Laboratory Medicine

Objective: To assess the relative frequency of (primary and secondary) mammary lymphomas presenting to a tertiary care hospital, Pakistan and its categorization according to WHO classification of lymphoid neoplasms.

Methods: All NHLs (nodal and extra nodal) diagnosed in the section of histopathology during 1992-2004 were retrieved and reviewed. All patients (n=30) diagnosed with lymphomatous involvement of the breast were selected. Distinction between primary and secondary breast lymphomas was not made owing to lack of availability of clinical information.

Results: A total of 5637 breast malignancies were diagnosed in our department during the study period of 10 years and the total …

What Is Available Vs. What Is Accessible: An Evaluation Of Resources For Kwazulu Natal Diabetics Based On The Data Of Kwazulu Natal Experts And Cato Manor Diabetics, Mollie Gurian

Independent Study Project (ISP) Collection

The objective of this study was to learn about the resources available to a diabetic and the actual ability of diabetics to access these resources. I found that two ideal paradigms of care were consistently mentioned by experts in KwaZulu Natal and at the World Diabetes Congress (WDC), the international conference on diabetes that I attended in Cape Town. The first is self-management of the disease and a patient centered approach to care. The second is a collaborative team approach to treating diabetics which involves a number of experts besides a physician. These two concepts are connected in that a …

The Complex Realities Of Indigenous Health Care Delivery, Megan Waterman

Independent Study Project (ISP) Collection

The indigenous population of Australia faces a life expectancy that is eighteen years lower than the general population. This study addresses this incredible disparity by exploring the historical, cultural and social forces that impact on health status, focussing especially on health care service utilisation. Qualitative methods of interviewing and participant observation have been used to examine the two sectors of Aboriginal health service delivery in urban Victoria: Aboriginal community controlled health organisations (ACCHOs) and mainstream organisations. Accounting for the complex forces and realities in health service delivery, this is a discussion of the important components of the current realities for …

A Needs Assessment Of Hypertension In Georgia, Faye Lopez, Marylen Rimando, Harshali Khapekar

Journal of the Georgia Public Health Association

Hypertension is a leading cause of stroke, coronary artery disease, heart attack, and heart and kidney failure in the United States. In Georgia, the percentage of those with hypertension and related diseases remain above the national average. The aim of this paper is to offer a basic review of hypertension including physical complications of the disease and to provide statistics regarding the scope of hypertension in the state of Georgia. Additionally, the paper provides insights on current hypertension programs such as the National High Blood Pressure Education Program (NHBPEP) and Dietary Approaches to Stop Hypertension (DASH). In conclusion, a statewide …

Care Quality For Adult Medicaid Beneficiaries With Type 2 Diabetes Varies By Primary Care Provider Subspecialty, Robert M. Mayberry, Rita Finley, Ernest Alema-Mensah, Trobiand A. Davis

Journal of the Georgia Public Health Association

The Georgia Medicaid primary care case management (PCCM) program, phased in over the 1994-1997 period, has now given way to a capitated managed care model of regional care management organizations (CMOs). Using Georgia Medicaid eligibility and provider claim data for 1996-1998, this study investigated diabetes care quality and whether it varied by primary care provider subspecialty in a longitudinal follow-up of newly diagnosed adults with type 2 diabetes during the early phase of the PCCM program. Results indicated that the quality of diabetes care was suboptimal and varied significantly by PCP subspecialty, with patients seen by generalists least likely to …

Pregnancy And Delivery Costs In Georgia Medicaid: Pccm Versus Fee-For-Service Enrollees, Chery Raskind-Hood, Kathleen E. Adams, Ernest Alema-Mensah, Robert M. Mayberry

Journal of the Georgia Public Health Association

This study examines the enrollment, resource utilization, and prenatal care cost patterns among pregnant black and white women in Georgia’s PCCM program, Georgia Better Health Care (GBHC), compared with those acquiring pregnancy and delivery services through Georgia’s Fee for Service (FFS) sector. Birth certificate data from 1998 were linked with Medicaid enrollment and claims data from 1997 and 1998 to construct a retrospective pregnancy history for each Medicaid woman giving birth in Georgia hospitals in 1998. Total payments for pregnancy and delivery services and on the total number of prenatal care visits were derived for each woman in the sample. …

Treatment Evolution In High-Risk Congenital Diaphragmatic Hernia: Ten Years' Experience With Diaphragmatic Agenesis, Kevin P Lally, Pamela A Lally, Krisa P Van Meurs, Desmond J Bohn, Carl F Davis, Bradley Rodgers, Jatinder Bhatia, Golde Dudell

Faculty, Staff and Student Publications

OBJECTIVE: The objective of this study was to evaluate the impact of newer therapies on the highest risk patients with congenital diaphragmatic hernia (CDH), those with agenesis of the diaphragm.

SUMMARY BACKGROUND DATA: CDH remains a significant cause of neonatal mortality. Many novel therapeutic interventions have been used in these infants. Those children with large defects or agenesis of the diaphragm have the highest mortality and morbidity.

METHODS: Twenty centers from 5 countries collected data prospectively on all liveborn infants with CDH over a 10-year period. The treatment and outcomes in these patients were examined. Patients were followed until death …

Biologic Interaction And Their Identification, Tyler J. Vanderweele, James Robins

COBRA Preprint Series

The definitions of a biologic interaction and causal interdependence are reconsidered in light of a sufficient-component cause framework. Various conditions and statistical tests are derived for the presence of biologic interactions. The conditions derived are sufficient but not necessary for the presence of a biologic interaction. Through a series of examples it is made evident that in the context of monotonic effects, but not in general, the conditions which are derived are closely related but not identical to effect modification on the risk difference scale.

A Theory Of Sufficient Cause Interactions, Tyler J. Vanderweele, James M. Robins

COBRA Preprint Series

Sufficient-component causes are discussed within the potential outcome framework so as to formalize notions of sufficient causes, synergism and sufficient cause interactions. Doing so allows for the derivation of counterfactual conditions and statistical tests for detecting the presence of sufficient cause interactions. Under the assumption of monotonic effects, more powerful statistical tests for sufficient cause interactions can be derived. The statistical tests derived for sufficient cause interactions are compared with and contrasted to interaction terms in standard statistical models.

Exploiting Gene-Environment Independence For Analysis Of Case-Control Studies: An Empirical Bayes Approach To Trade Off Between Bias And Efficiency , Bhramar Mukherjee

The University of Michigan Department of Biostatistics Working Paper Series

Standard prospective logistic regression analysis of case-control data often leads to very imprecise estimates of gene-environment interactions due to small numbers of cases or controls in cells of crossing genotype and exposure. In contrast, modern ``retrospective'' methods, including the celebrated ``case-only'' approach, can estimate the interaction parameters much more precisely, but they can be seriously biased when the underlying assumption of gene-environment independence is violated. In this article, we propose a novel approach to analyze case-control data that can relax the gene-environment independence assumption using an empirical Bayes (EB) framework. In the special case, involving a binary gene and a …

Girls' Perception Of Physical Environmental Factors And Transportation: Reliability And Association With Physical Activity And Active Transport To School, Kelly R. Evenson, Amanda Birnbaum, Ariane L. Bedimo-Rung, James Sallis, Carolyn C. Voorhees, Kimberly Ring, John P. Elder

Department of Public Health Scholarship and Creative Works

Background

Preliminary evidence suggests that the physical environment and transportation are associated with youth physical activity levels. Only a few studies have examined the association of physical environmental factors on walking and bicycling to school. Therefore, the purpose of this study was (1) to examine the test-retest reliability of a survey designed for youth to assess perceptions of physical environmental factors (e.g. safety, aesthetics, facilities near the home) and transportation, and (2) to describe the associations of these perceptions with both physical activity and active transport to school.

Methods

Test and retest surveys, administered a median of 12 days later, …

Spatial Cluster Detection For Censored Outcome Data, Andrea J. Cook, Diane Gold, Yi Li

Harvard University Biostatistics Working Paper Series

No abstract provided.

Extending Marginal Structural Models Through Local, Penalized, And Additive Learning, Daniel Rubin, Mark J. Van Der Laan

U.C. Berkeley Division of Biostatistics Working Paper Series

Marginal structural models (MSMs) allow one to form causal inferences from data, by specifying a relationship between a treatment and the marginal distribution of a corresponding counterfactual outcome. Following their introduction in Robins (1997), MSMs have typically been fit after assuming a semiparametric model, and then estimating a finite dimensional parameter. van der Laan and Dudoit (2003) proposed to instead view MSM fitting not as a task of semiparametric parameter estimation, but of nonparametric function approximation. They introduced a class of causal effect estimators based on mapping loss functions suitable for the unavailable counterfactual data to those suitable for the …

Assessing The Adequacy Of Variance Function In Heteroscedastic Regression Models, Lan Wang, Xiao-Hua Andrew Zhou

UW Biostatistics Working Paper Series

Heteroscedastic data arise in many applications. In a heteroscedastic regression model, the variance is often taken as a parametric function of the covariate or the regression mean. This paper presents a kernel-smoothing based nonparametric test for checking the adequacy of such a postulated variance structure. The test does not need to specify a parametric distribution for the random errors. It has an asymptotical normal distribution under the null hypothesis and is powerful against a large class of alternatives. Numerical simulations and an illustrative example are provided.

Download Full Pdf Issue Of Thomas Jefferson University Mph Public Health Link Newsletter, Vol. 2, Iss. 6, September 2006

Public Health Link

Vol. 2, Iss. 6 of the MPH Public Health Link highlights faculty member Vic Spain, the formal announcement of national accreditation for Jefferson Master of Science Program in Public Health and new course offerings for the Spring.

Amputation Injuries Due To Forklifts, Kentucky Injury Prevention And Research Center

Kentucky Haz Alerts--Other

To prevent injuries from forklifts while working:

• Before you operate a forklift, make sure that you are trained and certified.
• Remember if you are on a sit-down type forklift, and it starts to over-turn, lean in the opposite direction, stay with the forklift; don’t jump.
• When operating a forklift on site, slow the truck and sound the horn at cross aisles, exits, and other employee traverse points.
• Before dismounting, set the parking brake, lower the forks or lifting carriage, and neutralize controls.

Promoting Physical Activity In Children And Youth: A Leadership Role For Schools: A Scientific Statement From The American Heart Association Council On Nutrition, Physical Activity, And Metabolism (Physical Activity Committee) In Collaboration With The Councils On Cardiovascular Disease In The Young And Cardiovascular Nursing, Russell R. Pate, Michael G. Davis, Thomas N. Robinson, Elaine J. Stone, Thomas L. Mckenzie, Judith C. Young

Faculty Publications

No abstract provided.

Making Health Care Accountable: Why Performance-Based Funding Of Health Services In Developing Countries Is Getting More Attention. A Review, Nkenchor N. Igue

Economic and Financial Review

This article examines the impact of performance based health funding in developing countries. It findings reveals that developing countries spent more on performance based health services which was identified as key factor to actualizing the target goal of the United Nation (UN) program called Millennium Development Goals.

Geographic Data On Health Inequities: Understanding Policy Implications, Gregory Pappas

Community Health Sciences

No abstract provided.

Reduction In Urinary Arsenic With Bottled-Water Intervention, Arun B. Josyula, Hannah Mcclellen, Tracy A. Hysong, Margaret Kurzius-Spencer, Gerald S. Poplin, Stefan Stürup, Jefferey L. Burgess

Dartmouth Scholarship

The study was conducted to measure the effectiveness of providing bottled water in reducing arsenic exposure. Urine, tap-water and toenail samples were collected from non-smoking adults residing in Ajo (n=40) and Tucson (n=33), Arizona, USA. The Ajo subjects were provided bottled water for 12 months prior to re-sampling. The mean total arsenic (microg/L) in tap-water was 20.3+/-3.7 in Ajo and 4.0+/-2.3 in Tucson. Baseline urinary total inorganic arsenic (microg/L) was significantly higher among the Ajo subjects (n=40, 29.1+/-20.4) than among the Tucson subjects (n=32, 11.0+/-12.0, p<0.001), as was creatinine-adjusted urinary total inorganic arsenic (microg/g) (35.5+/-25.2 vs 13.2+/-9.3, p<0.001). Baseline concentrations of arsenic (microg/g) in toenails were also higher among the Ajo subjects (0.51+/-0.72) than among the Tucson subjects (0.17+/-0.21) (p<0.001). After the intervention, the mean urinary total inorganic arsenic in Ajo (n=36) dropped by 21%, from 29.4+/-21.1 to 23.2+/-23.2 (p=0.026). The creatinine-adjusted urinary total inorganic arsenic and toenail arsenic levels did not differ significantly with the intervention. Provision of arsenic-free bottled water resulted in a modest reduction in urinary total inorganic arsenic.

Intestinal Enzymes During Malnutrition & Infection In Rabbits, Sufia Islam, Amal K. Mitra, Ashish K. Chowdhury, Nur Haque Alam

Faculty Publications

Background & objectives: Malnutrition plays an important role in the intestinal absorption of nutrients. However, reports are not consistent whether intestinal enzymes are decreased in the presence of malnutrition. It is also not clear whether simultaneous presence of malnutrition and infection adds to the problem of malabsorption of nutrients. The aim of the present study was to determine intestinal functions in terms of concentrations of disaccharidase enzymes during diarrhoea and protein energy malnutrition. Methods: Concentrations of three disaccharidase enzymes, namely maltase, sucrase and lactase were measured in nine energy-restricted and five control rabbits during diarrhoea induced by rabbit diarrhoeagenic Escherichia …

An Ergonomic Job Analysis Of A Work Process Within A Glovebox, Tamara Mcnair

Theses

Gloveboxes have been used in various industries to protect the user and environment from hazardous materials and/or isolate the materials from environmental contamination. As the use of gloveboxes continues to grow in an effort to reduce contamination and the dependency of personal protective equipment as well as increase the level of safety through containment, technical design specifications have been studied and investigated to great lengths. Unfortunately, ergonomic design criteria for this enclosed and restricting workstation have not been extensively investigated or documented.

This research evaluated ergonomic risk factors associated with the use of a glovebox in a pharmaceutical production facility. …

Effect Of Glove Port Height On Upper Body Stress For Performing Laboratory Work, Jason Mark Williams

Theses

Glove boxes are used in many industries to constrain environmental contamination and protect the worker from harmful or hazardous exposures. This research specifically evaluates the effect of height of the glove box arm ports on the efficiency of task performance and physiological costs of work for the glove box users.

Seven male and two female participants performed liquid mixing and vial filling tasks within a portable glove box. The tasks were designed to simulate common glove box tasks performed in pharmaceutical and laboratory settings. Each participant repeated the designed tasks while the glove port height was set at two different …

Structural Inference In Transition Measurement Error Models For Longitudinal Data, Wenqin Pan, Xihong Lin, Donglin Zeng

Harvard University Biostatistics Working Paper Series

No abstract provided.

Estimation In Semiparametric Transition Measurement Error Models For Longitudinal Data, Wenqin Pan, Donglin Zeng, Xihong Lin

Harvard University Biostatistics Working Paper Series

No abstract provided.

Nonparametric Regression Using Local Kernel Estimating Equations For Correlated Failure Time Data, Zhangsheng Yu, Xihong Lin

Harvard University Biostatistics Working Paper Series

No abstract provided.

Causal Inference In Hybrid Intervention Trials Involving Treatment Choice, Qi Long, Rod Little, Xihong Lin

Harvard University Biostatistics Working Paper Series

No abstract provided.

A Comparison Of Methods For Estimating The Causal Effect Of A Treatment In Randomized Clinical Trials Subject To Noncompliance, Rod Little, Qi Long, Xihong Lin

Harvard University Biostatistics Working Paper Series

No abstract provided.

Kelangsungan Hidup Bayi Di Perkotaan Dan Pedesaan Indonesia, Demsa Simbolon

Kesmas

Kelangsungan hidup bayi di Indonesia yang masih rendah terlihat pada angka kematian bayi (AKB) yang menempati posisi tertinggi di Asean, kondisi intermediate rock dan sangat bervariasi. Penelitian yang menggunakan sumber data sekunder SDKI 2002-2003 ini bertujuan mengetahui gambaran kelangsungan hidup bayi di wilayah perkotaan dan pedesaan di Indonesia serta berbagai faktor yang berpengaruh. Besar sampel yang digunakan adalah 11.588 terdiri dari 4.769 bayi di perko- taan dan 6.819 bayi di pedesaan. Metoda analisis yang digunakan meliputi metode life table dan regresi cox. Hasil penelitian memperlihatkan probabilitas kelangsungan hidup bayi di perkotaan (98,59%) lebih tinggi daripada bayi di pedesaan (97,54%) dan …

Infestasi Kecacingan Pada Anak Sd Di Kecamatan Sei Bingai Langkat, Sumut, 2005, Limin Ginting

Kesmas

Indonesia masih menghadapi masalah kesehatan yang berhubungan dengan kondisi lingkungan yang jelek, seperti infestasi cacing usus yang ditularkan melalui tanah (Soil Transmitted Helminths). Infestasi cacing pada anak akan mengganggu pertumbuhan, menurunkan kemampuan fisik, produktifitas belajar dan intelektualitas. Hasil Pemeriksaan yang dilakukan di beberapa SD di Kecamatan Stabat dan Kecamatan Hinai menemukan prevalensi kecacingan berada pada kisaran 30-60%. Penelitian ini bertujuan untuk menilai prevalensi infestasi kecacingan pada anak SD di Kecamatan Sei Bingai, Kabupaten Langkat serta mengetahui faktor-faktor yang mempengaruhinya. Penelitian dengan disain studi kasus kontrol ini dilakukan di 4 SD Kecamatan Sei Bingai, Kabupaten Langkat, Propinsi Sumatera Utara. Populasi adalah …