Public Health Commons^™

Primary Care Physician Supply, Physician Compensation, And Medicare Fees: What Is The Connection?, Laura A. Dummit

National Health Policy Forum

Primary care, a cornerstone of several health reform efforts, is believed by many to be in a crisis because of inadequate supply to meet future demand. This belief has focused attention on the adequacy of primary care physician supply and ways to boost access to primary care. One suggested approach is to raise Medicare fees for primary care services. Whether higher Medicare fees would increase physician interest in primary care specialties by reducing compensation disparities between primary care and other specialties has not been established. Further, many questions remain about the assumptions underlying these policy concerns. Is there really a …

Toward Using National Cancer Surveillance Data For Preventing And Controlling Cervical And Other Human Papillomavirus-Associated Cancers In The Us, Mona Saraiya, Faruque Ahmed, Mary White, Herschel Lawson, Elizabeth R. Unger, Christie Eheman

United States Public Health Resources

This supplement, known as the ABHACUS (Assessing the Burden of HPV-Associated Cancers in the United States) supplement, contains 22 articles. Together, these articles provide a comprehensive snapshot of data related to the occurrence and control of multiple cancers that have been associated with the human papillomavirus (HPV). These analyses highlight the burden of HPV associated cancers in the US population as a whole and among vulnerable population subgroups. We anticipate that these findings will be an important resource for enhancing existing strategies for the prevention and control of HPV associated cancers.

HPV is estimated to be responsible for 5.2% of …

Surgical Management Of Blunt Pancreatic Trauma: A Modus Operandi Or Individualized Therapy?, Muhammad Rizwan Khan, Kiran Ejaz

Section of General Surgery

The overall rate of blunt pancreatic trauma observed in level one trauma centers is rather low compared to other injuries, with a reported prevalence of 0.4 per 100,000 hospital admissions. The situation may be further complicated by the presence of associated major visceral injuries in these patients. A number of previous reports indicate that blunt pancreatic trauma carries high morbidity and mortality rates, especially when diagnosis is delayed or inappropriate surgery is attempted. Many mandate prompt surgical explorations for organ-specific diagnosis on CT; however other literature and upcoming studies prove otherwise. Over the years, several technologic advances have increased the …

Childhood Lymphohematopoietic Cancer Incidence And Hazardous Air Pollutants In Southeast Texas, 1995–2004, Kristina W. Whitworth, Elaine Symanski, Ann L. Coker

CRVAW Faculty Journal Articles

BACKGROUND: Cancer is the second leading cause of death among U.S. children with few known risk factors. There is increasing interest in the role of air pollutants, including benzene and 1,3-butadiene, in the etiology of childhood cancers.

OBJECTIVE: Our goal was to assess whether census tracts with the highest benzene or 1,3-butadiene ambient air levels have increased childhood lymphohematopoietic cancer incidence.

METHODS: Our ecologic analysis included 977 cases of childhood lymphohematopoietic cancer diagnosed from 1995–2004. We obtained the U.S. Environmental Protection Agency’s 1999 modeled estimates of benzene and 1,3-butadiene for 886 census tracts surrounding Houston, Texas. We ran Poisson regression …

Breast Cancer Fatalism: The Role Of Women's Perceptions Of The Health Care System, Allyson G. Hall, Amal J. Khoury, Ellen D.S. Lopez, Nedra Lisovicz, Amanda Avis-Williams, Amal K. Mitra

Faculty Publications

Cancer fatalism, which can be understood as the belief that cancer is a death sentence, has been found to be a deterrent to preventive cancer screening participation. This study examines factors associated with breast cancer fatalism among women. We analyzed data from a 2003 survey of women 40 years of age. The survey collected information about respondents' knowledge and attitudes regarding breast health. Analyses compared the characteristics of women who reported and those who did not report a fatalistic attitude. Women with a fatalistic attitude were more likely to be African American, to have a family history of breast cancer, …

Exploratory Study Of Environmental Effects On Physical Activity And Overweight In Older Women: Research Update, Heather A. Whitcomb, Kosuke Tamura, Lauren Milius, Francine Laden, Steve Melly, Peter James, Robin Puett, Ellen Cromley, Eran Ben-Joseph, Philip J. Troped

GIS Day

Background: Physical inactivity and obesity are major public health issues. Recent studies have provided evidence that attributes of the built environment influence physical activity among adults and that factors such as greater urban sprawl are related to overweight and obesity. Few studies have developed objective individual-level measures of the built environment, a geographic scale that may be more relevant to certain types of physical activity, such as walking. In addition, further research is needed to assess the associations of both objective and perceived environmental factors with physical activity. In this 2-year exploratory study funded by the National Cancer Institute, we …

Neuroimaging And Recovery Of Language In Aphasia, Cynthia K. Thompson, Dirk B. Den Ouden

Faculty Publications

The use of functional neuroimaging techniques has advanced what is known about the neural mechanisms used to support language processing in aphasia resulting from brain damage. This paper highlights recent findings derived from neuroimaging studies focused on neuroplasticity of language networks, the role of the left and right hemispheres in this process, and studies examining how treatment affects the neurobiology of recovery. We point out variability across studies as well as factors related to this variability, and we emphasize challenges that remain for research.

Cardiorespiratory Fitness As A Predictor Of Fatal And Nonfatal Stroke In Asymptomatic Women And Men, Steven P. Hooker, Xuemei Sui, Natalie Colabianchi, John E. Vena, James N. Laditka, Michael J. Lamonte, Steven N. Blair

Faculty Publications

Background and Purpose - Prospective data on the association between cardiorespiratory fitness (CRF) and stroke are largely limited to studies in men or do not separately examine risks for fatal and nonfatal stroke. This study examined the association between CRF and fatal and nonfatal stroke in a large cohort of asymptomatic women and men.

Methods - A total of 46,405 men and 15,282 women without known myocardial infarction or stroke at baseline completed a maximal treadmill exercise test between 1970 and 2001. CRF was grouped as quartiles of the sex-specific distribution of maximal metabolic equivalents achieved. Mortality follow-up was through …

Roofing Foreman Dies From Telescopic Boom Lift Fall, Kentucky Injury Prevention And Research Center

Fatality Case Reports--Falls

On a winter day in 2008, a male roofer/ foreman died after falling from a telescopic boom lift. He and four other roofing crew members were installing a new roof at a residence undergoing restoration. They had arrived at the job site at approximately 7:45 AM.

At approximately 8:00 AM, the foreman and two roofers were installing flashing on the roof of an alcove on the south side of the house while two other roofers were in a pickup truck putting on coveralls. The crew on the roof needed red rosin underlayment (paper) which was in the pickup truck. Using …

Concept, Design And Implementation Of A Cardiovascular Gene-Centric 50 K Snp Array For Large-Scale Genomic Association Studies, Brendan J. Keating, Sam Tischfield, Sarah S. Murray, Tushar Bhangale, Thomas S. Price, Joseph T. Glessner, Luana Galver, Jeffrey C. Barrett, Struan F A Grant, Deborah N. Farlow, Hareesh R. Chandrupatla, Mark Hansen, Saad Ajmal, George J. Papanicolaou, Yiran Guo, Mingyao Li, Stephanie Derohannessian, Paul I W. De Bakker, Swneke D. Bailey, Alexandre Montpetit, Andrew C. Edmondson, Kent Taylor, Xiaowu Gai, Susanna S. Wang, Myriam Fornage, Tamim Shaikh, Leif Groop, Michael Boehnke, Alistair S. Hall, Andrew T. Hattersley, Edward Frackelton, Nick Patterson, Charleston K W Chiang, Cecelia E. Kim, Richard R. Fabsitz, Willem Ouwehand, Alkes L. Price, Patricia Munroe, Mark Caulfield, Thomas Drake, Eric Boerwinkle, David Reich, A Stephen Whitehead, Thomas P. Cappola, Nilesh J. Samani, A Jake Lusis, Eric Schadt, James G. Wilson, Wolfgang Koenig, Mark I. Mccarthy, Sekar Kathiresan, Stacey B. Gabriel, Hakon Hakonarson, Sonia S. Anand, Muredach Reilly, James C. Engert, Deborah A. Nickerson, Daniel J. Rader, Joel N. Hirschhorn, Garret A. Fitzgerald

Faculty, Staff and Student Publications

A wealth of genetic associations for cardiovascular and metabolic phenotypes in humans has been accumulating over the last decade, in particular a large number of loci derived from recent genome wide association studies (GWAS). True complex disease-associated loci often exert modest effects, so their delineation currently requires integration of diverse phenotypic data from large studies to ensure robust meta-analyses. We have designed a gene-centric 50 K single nucleotide polymorphism (SNP) array to assess potentially relevant loci across a range of cardiovascular, metabolic and inflammatory syndromes. The array utilizes a "cosmopolitan" tagging approach to capture the genetic diversity across approximately 2,000 …

Aggressive Vs Conservative Phototherapy For Infants With Extremely Low Birth Weight, Brenda H Morris, William Oh, Jon E Tyson, David K Stevenson, Dale L Phelps, T Michael O'Shea, Georgia E Mcdavid, Rebecca L Perritt, Krisa P Van Meurs, Betty R Vohr, Cathy Grisby, Qing Yao, Claudia Pedroza, Abhik Das, W Kenneth Poole, Waldemar A Carlo, Shahnaz Duara, Abbot R Laptook, Walid A Salhab, Seetha Shankaran, Brenda B Poindexter, Avroy A Fanaroff, Michele C Walsh, Maynard R Rasmussen, Barbara J Stoll, C Michael Cotten, Edward F Donovan, Richard A Ehrenkranz, Ronnie Guillet, Rosemary D Higgins

Faculty, Staff and Student Publications

BACKGROUND: It is unclear whether aggressive phototherapy to prevent neurotoxic effects of bilirubin benefits or harms infants with extremely low birth weight (1000 g or less).

METHODS: We randomly assigned 1974 infants with extremely low birth weight at 12 to 36 hours of age to undergo either aggressive or conservative phototherapy. The primary outcome was a composite of death or neurodevelopmental impairment determined for 91% of the infants by investigators who were unaware of the treatment assignments.

RESULTS: Aggressive phototherapy, as compared with conservative phototherapy, significantly reduced the mean peak serum bilirubin level (7.0 vs. 9.8 mg per deciliter [120 …

Calibrating Parametric Subject-Specific Risk Estimation, Tianxi Cai, Lu Tian, Hajime Uno, Scott D. Solomon, L. J. Wei

Harvard University Biostatistics Working Paper Series

No abstract provided.

Filariasis Limfatik Di Kelurahan Pabean Kota Pekalongan, Tri Ramadhani

Kesmas

Filariasis limfatik masih merupakan masalah kesehatan masyarakat di Indonesia, khususnya di Kota Pekalongan. Hal ini ditandai dengan semakin meningkatnya angka mikrofilaria dan perluasan daerah dengan kasus filariasis limfatik.Tujuan penelitian adalah untuk mengetahui situasi filariasis limfatik di Kelurahan Pabean Kota Pekalongan. Penelitian ini meliputi penduduk dan agent, dalam periode sekitar enam bulan (Juli-Desember 2007) dengan disain studi cross sectional. Pada penelitian ini dilakukan pemeriksaan klinis, survei darah jari dan identifikasi parasit penyebab filariasis limfatik. Hasil penelitian menunjukkan angka mikrofilaria (3,4) angka kesakitan akut filaria (0,4 %) yang tinggi, tetapi angka kesakitan kronis filaria rendah (0,00 %). Parasit penyebab filariasis di Kelurahan …

Kehamilan Pranikah Remaja Di Kabupaten Sumedang, Sri Dwi Omarsari, Ratna Djuwita

Kesmas

Kehamilan pranikah remaja adalah fenomena kehidupan remaja yang dapat mengganggu kesehatan reproduksi secara fisik, mental dan sosial serta komplikasi dan kematian ibu dan bayi. Secara psikososial, remaja dapat terkucil, merasa malu, depresi, putus sekolah, sulit bekerja, miskin dan menambah pertumbuhan penduduk. Tujuan penelitian ini adalah mengetahui gambaran epidemiologi dan faktor determinan dengan kehamilan pranikah remaja di Kabupaten Sumedang. Rancangan studi yang digunakan pada penelitian ini adalah rancangan studi cross sectional. Penelitian ini menemukan prevalensi kehamilan pranikah remaja di Kabupaten Sumedang tinggi (40,5%). Faktor yang berhubungan dengan kehamilan pranikah remaja meliputi usia ketika hamil, frekuensi pacaran, pola asuh orang tua, keutuhan …

Pemanfaatan Pos Pelayanan Terpadu Di Perumahan Pondok Cilegon Indah, Fenny Raharyanti, Ahmad Jubaedi, Feriyanto Feriyanto

Kesmas

Pos Pelayanan Terpadu (Posyandu) yang pada periode pemerintahan orde baru populer dan berkontribusi besar pada kesehatan ibu dan anak, kini meredup dan mengalami penurunan peran. Ketika kasus-kasus bayi kurang gizi bermunculan, banyak pihak yang menyadari bahwa posyandu merupakan faktor yang berkontribusi pada perbaikan gizi balita. Tujuan penelitian ini adalah mengetahui keberadaan posyandu, pengetahuan dan kesadaran ibu balita, membawa balita ke posyandu, keaktifan kader menghidupkan posyandu, dan kelayakan fasilitas pendukung Posyandu di komplek Perumahan Pondok Cilegon Indah dengan karakteristik sosial ekonomi penduduk yang beragam. Penelitian yang dilaksanakan pada bulan Desember 2006 mengamati populasi ibu balita dan kader bermukim di PCI dan …

Karakteristik Remaja Pengguna Narkoba Suntik Dan Perilaku Berisiko Hiv/Aids Di Kecamatan Ciledug Kota Tangerang, Fauzi Syarif, Zarfiel Tafal

Kesmas

Prevalensi penderita HIV/AIDS di Kota Tangerang yang merupakan daerah industri dari tahun ke tahun meningkat tajam. Kecenderungan peningkatan kemungkinan disebabkan oleh letak strategis Kota Tangerang yang berbatasan langsung dengan Jakarta serta dengan geografi dan demografi yang hampir sama dengan Jakarta. Bersamaan dengan itu kasus peredaran dan pemakaian narkotika di wilayah Tangerang dari tahun ke tahun meningkat tajam. Penelitian bertujuan untuk mengetahui hubungan antara karakteristik remaja pengguna narkoba suntik (penasun) dengan perilaku berisiko tertular HIV/AIDS di Kecamatan Ciledug Kota Tangerang Tahun 2007. Data yang dikumpulkan secara cross sectional dilakukan pada 206 sampel responden remaja berusia 15–24 tahun yang menggunakan narkoba suntik …

Perbedaan Persepsi Gambar Peringatan Bahaya Merokok Antara Masyarakat Jakarta Dan Cirebon, Nina Candra Dewi, Rita Damayanti

Kesmas

Kebiasaan merokok merupakan kausa kematian tinggi yang menjadi masalah kesehatan dunia. Data tahun 2004, jumlah perokok memperlihatkan tren meningkat dari 32% menjadi 35%. Jakarta menempati posisi tertinggi jumlah perokok. Penyakit ISPA non specific menempati level tertinggi dan terbanyak pada tahun 2006 dan diduga merupakan dampak kebiasaan merokok. Salah satu upaya pemerintah menurunkan kebiasaan merokok adalah peringatan tertulis pada label sigaret. Studi yang dilakukan pusat studi kesehatan Universitas Indonesia di Jakarta dan Cirebon pada tahun 2007 mengindikasikan bahwa 76,3% peringatan kesehatan terpilih dalam bentuk gambar dan tulisan merupakan peringatan kesehatan yang efektif. Perbedaan persepsi masyarakat pada gambar peringatan bahaya merokok berdasarkan …

Faktor Risiko Perilaku Pra-Diabetes Di Kota Padang Panjang, Fajrinayanti Fajrinayanti

Kesmas

Pra-diabetes adalah kondisi berisiko Diabates Melitus tipe 2 yang dipengaruhi oleh faktor keturunan dan perilaku dengan prevalensi yang lebih tinggi daripada Diabates Melitus. Tujuan penelitian ini adalah mengetahui hubungan faktor risiko perilaku konsumsi lemak, konsumsi serat, konsumsi karbohidrat, aktivitas fisik dan merokok dengan kejadian pra-diabetes setelah dikendalikan oleh faktor keturunan. Desain studi yang digunakan adalah kros seksional dengan pengumpulan data melalui survei. Responden sebanyak 174 orang dipilih secara acak sederhana dari tiap kelurahan yang menjadi kluster. Analisis data dilakukan secara univariat, regresi logistik sederhana dan regresi logistik ganda. Hasil penelitian menunjukkan rata-rata kadar Gula Darah Sewaktu kelompok umur 40-59 tahun …

Dampak Cadmium Dalam Ikan Terhadap Kesehatan Masyarakat, Agus Purnomo, Rachmadi Purwana

Kesmas

Kandungan Chemicals Oxygen Demand (COD) dan logam Cadmium pada air laut di Indonesia, dalam kisaran 123-398 ppm dan 0,024-0,044 ppm berada di luar batas yang diizinkan (COD = 40 ppm dan Cd = 0,01 ppm). Masyarakat Teluk Lampung setiap hari terpajan dengan ikan Kurisi (Nomipterus hexodon), ikan Kembung (Rastrelliger neglectus), dan ikan Tongkol (Auxis thazard) dengan kadar rata-rata kandungan cadmium 0,146; 0,144; dan 0,137 mg/kg. Penelitian ini bertujuan melakukan analisis risiko dampak pencemaran cadmium pada ikan terhadap kesehatan masyarakat Pulau Pasaran yang berada tepat di hadapan Kota Bandar Lampung di Teluk Lampung. Disain studi yang digunakan adalah disain cross sectional …

Tending To Richmond's Children: Community Strategies To Bridge Service Gaps, Judith D. Moore, Jessamyn Taylor

National Health Policy Forum

The National Health Policy Forum sponsored a site visit to Richmond, Virginia, in October 2008 to explore social and environmental determinants of children’s health, including the impacts that poverty and exposure to lead-based paint have on birth outcomes, child development, and school readiness; and the community's efforts to address them. Though not large in population terms, Richmond faces many of the social and economic problems often common in larger urban areas—concentrated poverty, migration of wealth and services to the surrounding counties, a high infant mortality rate, and troubled schools. The site visit explored community strategies to improve birth outcomes and …

Medicaid And Mental Health Services, Cynthia Shirk

National Health Policy Forum

Medicaid is the largest payer of mental health services in the United States, contributing more than any other private or public source of funding. This background paper highlights the variety of services and supports needed by individuals with mental illness and Medicaid’s increasing role in mental health coverage. It provides an overview of Medicaid coverage of mental health services and identifies some of the key challenges in providing that coverage.

The Std – Hiv Connection: Deficiencies In Knowledge And Practice Patterns Among Family Physicians And Gynecologists

Florida Public Health Review

Previous studies have shown suboptimal compliance with the Centers for Disease Control and Prevention recommendations for HIV testing in patients with sexually-transmitted disease (STDs). However, the literature is especially sparse with respect to family physicians and gynecologists in private practice. Further, there are no data regarding knowledge among these physicians of the causative relationship between STDs and HIV. All family physicians (238) and gynecologists (131) in private practice in Broward County, Florida were anonymously surveyed for their knowledge of the connection between STDs and HIV and to determine if they translated this into practice. Responses from 57 family physicians and …

Evaluating Subject-Level Incremental Values Of New Markers For Risk Classification Rule, Tianxi Cai, Lu Tian, Donald M. Lloyd-Jones, L. J. Wei

Harvard University Biostatistics Working Paper Series

No abstract provided.

Watkins, Dianne (Winkler), 1941-2024 (Fa 264), Manuscripts & Folklife Archives

Folklife Archives Finding Aids

Finding aid and full-text scan of paper (Click on “Additional Files” below) for Folklife Archives Project 264. Paper: "Lamaze Method of Prepared Childbirth" written by Dianne (Winkler) Watkins for a Western Kentucky University folk studies class. Also, four pamphlets related to childbirth and parenting.

Study Design And Biostatistics For The Bedside Healthcare Professional., Sherrine Eid Mph

Department of Community Health and Health Studies

No abstract provided.

College Students’ Knowledge About Meningococcal Disease And Preferences For Health Information

Florida Public Health Review

The purpose of this study was to measure college students’ knowledge about meningococcal disease, preferred sources of health information, and vaccine intentions. Participants included 519 students taking online undergraduate courses in public health. We developed and administered a brief, ten-question online survey, which was posted on BlackBoard®. Students demonstrated a high level of knowledge about risk factors for meningococcal disease, but reported a need for more information, preferably delivered through electronic media. About a third of students had received the meningococcal vaccine prior to the survey; students who lived on campus were more likely to be vaccinated. Further research is …

Creando Nuestra Salud (Creating Our Health) - Results And Findings From A Breast Cancer Education Program With Rural Hispanic Women

Florida Public Health Review

Rural Hispanic females practice breast-self exams (BSE) and other breast health screenings less than women from all other racial or ethnic groups. Questions remain as to why these women do not practice these important breast health behaviors. A qualitative design was used to assess the knowledge, attitudes, beliefs and barriers to breast health activities among 288 rural Hispanic women. Results revealed that along with external barriers such as transportation and money, internal barriers (shame of being seen naked, discomfort of touching their own breasts, and lack of knowledge) had a greater effect on their practice of breast health activities. The …

Acquisition De Modèles Pour L’Étude De L’Absorption Percutanée Des Substances Chimiques : Cellules De Diffusion À Flux Continu, Claude Viau, Suzanne Leroux, Ross Thuot, Sophie Lim

Rapports de recherche scientifique

Dans les milieux de travail où des substances chimiques sont utilisées, celles-ci peuvent se retrouver dans l’air. Les employés peuvent donc y être exposés par le fait de la respiration. C’est d’ailleurs pour ça que le règlement sur la santé et la sécurité du travail donne des valeurs limites d’exposition dans l’air pour près de 700 substances chimiques. Mais il est aussi possible d’être exposé par le contact des substances avec la peau. Quand on veut savoir à quel point un travailleur peut absorber des substances dans son organisme de cette manière, on doit savoir trois choses principales :

• la …

Assessing The Effects Of Medicaid Documentation Requirements On Health Centers And Their Patients: Results Of A "Second Wave" Survey, Lee Repasch, Brad Finnegan, Peter Shin, Sara J. Rosenbaum

Geiger Gibson/RCHN Community Health Foundation Research Collaborative

This report represents a "second wave" follow-up to a "first wave" study whose purpose was to measure the effects of the Deficit Reduction Act's citizenship documentation requirements on health centers and their patients. The earlier study, conducted six months after implementation, found that the law had a widespread impact, including delayed applications, interrupted enrollment, disruptions in care, and at least anecdotal evidence of a growth in the number of uninsured patients as a result of the denial or loss of Medicaid coverage. This "second wave" survey underscores the existence of serious, ongoing problems more than a year after implementation. Specifically, …

A Concentrated Look At Hiv/Aids: Transmission To Low Risk Women Through Intravenous Drug Users And Female Sex Workers In Da Nang City, Vietnam, Danielle A. Depeau

Independent Study Project (ISP) Collection

Female sex workers (FSW) and intravenous drug users (IDU) whom were living in Da Nang City, Vietnam, along with the women and children associated with these individuals, were interviewed to study the effects of Human Immunodeficiency Virus (HIV) and Acquired Immune Deficiency Syndrome (AIDS). In addition, an understanding how the epidemic was spreading from high-risk populations to the general population was explored. This was achieved by learning the history of sexual behaviors in regards to sexual partners and regularity of condom use, as well as drug injection practices, HIV/AIDS education, treatment, gender status and socio-demographic characteristics.

Informal interviews were conducted …