Public Health Commons^™

Social Factors Affecting Treatment Of Cervical Cancer: Ethical Issues And Policy Implications, Shannon N. Westin, Dan Bustillos, Jacalyn B. Gano, Margaret M. Fields, Ann L. Coker, Charlotte C. Sun, Lois M. Ramondetta

CRVAW Faculty Journal Articles

Health care in the United States has become a privilege rather than a right. Patients who have the greatest need are the ones most likely to be denied this privilege. Despite recent advances in disease detection and treatment, many patients do not receive even the bare minimum of care. The high complexity of the health care system in the setting of patients with low levels of health literacy significantly affects the ability to seek and receive treatment in a timely fashion. In addition, lack of insurance, transportation, and social support further complicate access to care. To truly provide a standard …

Finding Order In Complexity: A Typology Of Local Public Health Delivery Systems, Glen P. Mays, F. Douglas Scutchfield, Michelyn Bhandari, Sharla A. Smith

Health Management and Policy Reports

Public health decision-makers and researchers currently lack an evidence-based framework for describing, classifying, and comparing public health delivery systems based on their organizational components, operational characteristics, and division of responsibility. Related typologies developed in the health services sector have proven extremely valuable for policy and administrative decision-making as well as for ongoing research. Performance assessment, quality improvement, and accreditation activities are now blossoming in public health—adding urgency to the need for classification and comparison frameworks. This brief describes a newly-developed empirical typology for local public health systems and highlights its policy and managerial applications.

Promoting Physical Activity In Middle School Girls: Trial Of Activity For Adolescent Girls, Larry S. Webber, Diane J. Catellier, Leslie A. Lytle, David M. Murray, Charlotte A. Pratt, Deborah Rohm Young, John P. Elder, Timothy G. Lohman, June Stevens, Jared B. Jobe, Russell R. Pate

Faculty Publications

Background - Physical activity is important for weight control and good health; however, activity levels decline in the adolescent years, particularly in girls.

Design - Group randomized controlled trial.

Setting/participants - Middle school girls with English-speaking skills and no conditions to prevent participation in physical activity in 36 schools in six geographically diverse areas of the United States. Random, cross-sectional samples were drawn within schools: 6th graders in 2003 (n=1721) and 8th graders in 2005 (n=3504) and 2006 (n=3502).

Intervention - A 2-year study-directed intervention (fall 2003 to spring 2005) targeted schools, community agencies, …

Film Retakes In Digital And Conventional Radiography, Waseem Akhtar Mirza, Mubashir Aslam, Arif Ali, Kashif Mirza, Nadeem Ahmad

Department of Radiology

Objective: To determine the film-retake rates and causes in digital radiography comparison to conventional X-rays method.
Study design: Comparative study.
Place and duration of study: Radiology Department, Aga Khan University Hospital, Karachi, from January 2004 to December 2006.
Patients and methods: X-rays of different body parts, conducted during the year 2004, with conventional radiography (n=170300), and in 2006 with digital radiography (n=174550), were included in this study. Measurements were done for number of X-rays re-take due to different quality control reasons for both the conventional and digital radiography. Quality control reasons included underexposure, overexposure, positioning errors, patient movements, portable X-rays, …

Accumulating Disadvantage Over The Life Course: Evidence From A Longitudinal Study Investigating The Relationship Between Educational Advantage In Youth And Health In Middle Age, Katrina M. Walsemann, Arline T. Geronimus, Gilbert C. Gee

Faculty Publications

Recent studies suggest the importance of examining cumulative risk or advantage as potential predictors of health over the life course. Researchers investigating the cumulative health effects of education, however, have mainly conceptualized education in years or degrees, often disregarding educational quality and access to educational opportunities that may place individuals on divergent academic trajectories. We investigate whether educational advantages in youth are associated with an individual's health trajectory. We develop a novel index of educational advantage and employ random-intercept modeling using data from the National Longitudinal Survey of Youth. We find a widening health disparity in adulthood between respondents with …

Download Full Pdf Issue Of Thomas Jefferson University Mph Public Health Link Newsletter, Vol. 4, Iss. 1, March 2008

Public Health Link

This issue includes a faculty spotlight on Dr. Crawford, an article by Dr. Plumb "Addressing the Public Health Crisis in Philadelphia" and program announcements.

Birth Weight, Infant Growth, And Childhood Body Mass Index: Hong Kong’S Children Of 1997 Birth Cohort, L. L. Hui, Mary Schooling, Shirley Sze Lee Leung, Kwok Hang Mak, Lai Ming Ho, Tai Hing Lam, Gabriel M. Leung

Publications and Research

Objective
To investigate the association between birth weight, infant growth rate, and childhood adiposity as a proxy for adult metabolic or cardiovascular risk in a Chinese population with a history of recent and rapid economic development.

Design
Prospective study in a population-representative birth cohort.

Setting
Hong Kong Chinese population.

Participants
Six thousand seventy-five term births (77.5% successful follow-up).

Main Exposures
Birth weight and growth rate (change in the weight z score) at ages 0 to 3 and 3 to 12 months.

Main Outcome Measure: Body mass index (BMI) (calculated as the weight in kilograms divided by the height in …

Simulation-Based Training For Patient Safety: 10 Principles That Matter, Eduardo Salas, Katherine A. Wilson, Elizabeth Lazzara, Heidi B. King, Jeffery S. Augenstein

Publications

Simulation-based training can improve patient care when factors influencing its design, delivery, evaluation, and transfer are taken into consideration. In this paper, we provide a number of principles and practical tips that organizations in health care can use to begin implementing effective simulation-based training as a way to enhance patient safety. We commend the health care community for their efforts thus far. We hope that the information provided in this paper will encourage thinking beyond the "bells and whistles" of the simulation and bring to light full potential of simulation-based training in health care and patient safety.

Using Built Environment Characteristics To Predict Walking For Exercise, Gina S. Lovasi, Anne V. Moudon, Amber L. Pearson, Philip M. Hurvitz, Eric B. Larson, David S. Siscovick, Ethan M. Berke

Dartmouth Scholarship

Environments conducive to walking may help people avoid sedentary lifestyles and associated diseases. Recent studies developed walkability models combining several built environment characteristics to optimally predict walking. Developing and testing such models with the same data could lead to overestimating one's ability to predict walking in an independent sample of the population. More accurate estimates of model fit can be obtained by splitting a single study population into training and validation sets (holdout approach) or through developing and evaluating models in different populations. We used these two approaches to test whether built environment characteristics near the home predict walking for …

Rx For Pennsylvania: Healing The Healthcare System

Population Health Matters (Formerly Health Policy Newsletter)

No abstract provided.

Retail Medicine, Eric J. Moskowitz Md/Mba Candidate, 2009, David B. Nash Md, Mba

Population Health Matters (Formerly Health Policy Newsletter)

No abstract provided.

Chronic Care At The Crossroads

Population Health Matters (Formerly Health Policy Newsletter)

No abstract provided.

Cancer Rehabilitation: An Expanding Need, Deborah Franklin Phd,Md

Population Health Matters (Formerly Health Policy Newsletter)

No abstract provided.

A Global Phr, David B. Nash, Md, Mba

Population Health Matters (Formerly Health Policy Newsletter)

No abstract provided.

Marginal Structural Models For Partial Exposure Regimes, Stijn Vansteelandt, Karl Mertens, Carl Suetens, Els Goetghebeur

Harvard University Biostatistics Working Paper Series

Intensive care unit (ICU) patients are ell known to be highly susceptible for nosocomial (i.e. hospital-acquired) infections due to their poor health and many invasive therapeutic treatments. The effects of acquiring such infections in ICU on mortality are however ill understood. Our goal is to quantify these effects using data from the National Surveillance Study of Nosocomial Infections in Intensive Care

Units (Belgium). This is a challenging problem because of the presence of time-dependent confounders (such as exposure to mechanical ventilation)which lie on the causal path from infection to mortality. Standard statistical analyses may be severely misleading in such settings …

How Does Investment In Community Health Centers Affect The Economy?, Peter Shin, Brad Finnegan, Sara J. Rosenbaum

Geiger Gibson/RCHN Community Health Foundation Research Collaborative

The economic slowdown that began in 2007 has prompted policymakers to focus on investments that can produce rapid economic gains in communities. Building on a previous analysis, this Research Brief estimates that a $250 million appropriations increase in the community health centers program would yield health care for an additional 1.8 million patients and a nationwide four-to-one return on investment:

• nearly $1 billion in direct community economic benefits, and
• over $1.1 billion in indirect benefits in jobs and other community investments.

On a state-by-state basis, each $1 million in federal appropriations would assure care for an additional 8,400 patients and …

Faktor Prediksi Persepsi Ibu Tentang Diare Pada Balita, Joko Supono

Kesmas

Diare pada balita masih menjadi masalah kesehatan masyarakat yang penting di Indonesia. Persepsi keseriusan penyakit diare yang rendah merupakan kendala upaya menurunkan angka kesakitan diare. Penelitian yang menggunakan desain cross sectional ini bertujuan menguji hubungan antara faktor pengetahuan, pengalaman kontak, dan kepercayaan, dengan persepsi ibu terhadap diare pada balita. Populasi pada penelitian ini adalah ibu balita yang bermukim di Kecamatan Bekasi Utara, Jawa barat. Dari hasil penelitian terbukti bahw pengetahuan, pengalaman kontak, dan kepercayaan berhubungan secara bermakna dengan persepsi ibu terhadap diare pada balita. Ibu balita yang berpengetahuan rendah berisiko 2,5 kali untuk berpersepsi diare sebagai penyakit biasa daripada ibu …

Hubungan Aktivitas Fisik Berat Dengan Back Pain Pada Penduduk Usia Kerja Di Jawa Dan Bali, Achmad Zaki

Kesmas

Penelitian ini bertujuan mengetahui hubungan lama aktivitas fisik berat dengan Gejala Back pain pada penduduk usia kerja 18 – 55 tahun di wilayah Pulau Jawa dan Bali. Penelitian ini menggunakan data sekunder Survei Kesehatan Nasional Tahun 2001. Penelitian ini menggunakan desain potong-lintang dengan metode analisis regresi logistik ganda. Hasil penelitian mendapatkan ada hubungan antara aktivitas fisik berat dengan gejala back pain, setelah dikontrol oleh variabel-variabel confounding seperti lama aktivitas fisik duduk atau sedikit berjalan (terkait pekerjaan ataupun tidak), jenis kelamin, dan pendidikan. Responden dengan lama aktivitas fisik berat (bekerja 1-5 jam) memiliki risiko 2,03 kali untuk mengalami gejala back pain …

Dampak Penggunaan Briket Batubara Dibandingkan Dengan Bahan Bakar Lain Terhadap Keluhan Pernafasan Kronik Pekerja Di Ukm, Johan Mardansyah

Kesmas

Pemerintah Indonesia berencana meningkatkan penggunaan batubara sebagai bahan bakar alternatif. Untuk itu, diperlukan studi mengenai dampak kesehatan akibat pengguna briket batubara. Tujuan penelitian untuk mengetahui hubungan antara pajanan di udara tempat kerja dengan keluhan pernafasan kronik pekerja pengguna kompor briket batubara di UKM. Penelitian dengan disain Kohort Retrospektifl ini dilakukan terhadap data primer hasil wawancara dan pemeriksaan fisik pekerja serta hasil pengukuran pajanan di udara tempat kerja. Pajanan yang diukur meliputi debu total, NO2, SO2, Benzen, Cd dan Mn. Sampel terdiri dari 61 responden pada kelompok yang terpajan briket batubata dan 61 responden pada kelompok pembanding yang terpajan bahan bakar …

Male Semi-Truck Driver Killed In Rollover Crash On County Road, Kentucky Injury Prevention And Research Center

Fatality Case Reports--Motor Vehicle

Early in the morning during the winter of 2005, a 31-year-old male semi-truck driver died when the semi-tractor trailer he was driving left the roadway and rolled over into a ditch. He had just picked up a load of raw lumber from a lumber yard and pulled out of the gate onto a county road and driven about a mile when the incident occurred. His destination was a lumber mill approximately 150 miles away. He was driving on a straight stretch of the road when the right tires left the pavement and dropped onto the sloped grassy area next to …

Healing Kentucky, Nancy Disher Baird

Library Faculty Publications

No abstract provided.

Coal Truck Driver Fatally Injured In Collision With Another Coal Tractor-Trailer, Kentucky Injury Prevention And Research Center

Fatality Case Reports--Motor Vehicle

During the winter of 2008, a 39 –year-old tractor-trailer driver died after striking the right rear of a coal tractor-trailer with his vehicle, then veering into an embankment, rolling over and catching fire. The driver of a coal tractor-trailer (Truck 1) and the decedent driver of a second coal tractor-trailer (Truck 2) had descended a hill in the lane next to one another on a four-lane undivided highway. Truck 1 stopped at a traffic light at an intersection at the bottom of a hill while Truck 2 approached the intersection from behind in the left lane. The light turned green …

Soda: Seniors For Organ Donation Awareness “Increasing The Enrollment Of Senior Citizens (Age 65 Years And Older) In The Ohio Donor Registry”, Laurie L. Phillips

Master of Public Health Program Student Publications

Research Hypothesis: A targeted informational awareness program about organ and tissue donation to senior citizens (age >65 years) in Montgomery County, Ohio will produce an increase in the number of registered organ donors in the Ohio Donor Registry, hence, allowing more available organs for transplant for aging patients (50 years of age or older) in need across the region. Subsequently, another research objective is to identify and address underlying factors causing senior citizens to be the lowest number of registered donors in Montgomery County, Ohio, in fact, across the state. This information will assist in future public education efforts of …

The Mind-Body Connection: The Association Between Adolescent Locus Of Control And Indicators Of Physical Health, C. Jayne Brahler, James Cropper

Physical Therapy Faculty Publications

Locus of control (LOC) describes an individual’s generalized beliefs or expectancies that their reinforcements are under internal versus external control (1). An individual exhibits either an internal or external LOC. This study examines the link between LOC and selected health risk factors in adolescents. A convenience sample of 167 high school physical education students completed a 13-item LOC questionnaire based on Rotter’s 1966 instrument.

Various anthropometric measurements, blood pressure, body mass index (BMI), and body fat were recorded on all subjects. A subsample of 61 female students received blood chemistry analysis that included a lipid profile, hemoglobin A1c (HbA1c), Apo …

Air Toxics Under The Big Sky: A Real-World Investigation To Engage High School Science Students, Earle Adams, Garon C. Smith, Tony Ward, Diana Vanek, Nancy Marra, David Jones, Melissa Henthorn, Jim Striebel

Public and Community Health Sciences Faculty Publications

This paper describes a problem-based chemistry education model in which students perform scientific research on a local environmentally relevant problem. The project is a collaboration among The University of Montana and local high schools centered around Missoula, Montana. "Air Toxics under the Big Sky" involves high school students in collecting air samples inside and outside their homes within and near Missoula. As part of this program, teachers, students, and university researchers investigate the relationship between air pollutants and their harmful respiratory effects. Students experience scientific research, use scientific equipment, gain an insight into the relationship between the environment and public …

Changing Corporate Practices To Reduce Cancer Disparities, Nicholas Freudenberg, Sandro Galea, Marianne Fahs

Publications and Research

While reducing racial/ethnic and socioeconomic disparities in cancer mortality has been identified as a national goal, current policies are unlikely to achieve it. In order to advance the development of policies for the primary prevention of cancer and cancer disparities, we propose that the practices of the tobacco, alcohol, and food industries be considered as modifiable social determinants of health. We review evidence that the practices of these industries in product design, marketing, retail distribution, and pricing contribute to cancer risk behavior, incidence, and disparities, then examine public health strategies designed to reduce health-damaging practices of these industries and encourage …

Water System Preparedness For Pandemic Influenza, Phil Van Atta

Master of Public Health Program Student Publications

This project involved an investigation of water utility preparedness and best practices for pandemic influenza. A pandemic could cause serious disruptions to the operations of critical infrastructure, including drinking water systems. These disruptions could be caused by staffing shortages, power disruptions, and shortages of chemicals and other supplies. Ensuring continuity of operations for drinking water systems is crucial to protect public health and safety, and to the economy of all communities. Literature searches, interviews, and a survey of Ohio water systems indicated that water systems in Ohio and across the United States are preparing for pandemic influenza. Pandemic influenza preparation …

Childhood Obesity Predicts Adult Metabolic Syndrome: The Fels Longitudinal Study, Shumei S. Sun, Ruohong Liang, Terry T-K Huang, Stephen R. Daniels, Silva Arslanian, Kiang Liu, Gilman D. Grave, Roger M. Siervogel

Publications and Research

Objectives—To determine the age of significant divergence in body mass index (BMI) and waist circumference in adults with and without the metabolic syndrome, and to provide age- and sexspecific childhood values that predict adult metabolic syndrome.

Study design—Part 1 of this study is a retrospective cohort study of 92 men and 59 women (mean age, 51 years) who had metabolic syndrome and 154 randomly selected adults matched for age and sex who did not have the syndrome. Part 2 is a study of predictive accuracy in a validation sample of 743 participants.

Results—The first appearance of differences …

Infant Feeding Decisions Among Pregnant Black Wic Participants And The Role Of Peer Support, Astrid D. Mickens

Loma Linda University Electronic Theses, Dissertations & Projects

The purpose of this study was to identify the important factors that impact infant feeding decisions among Black women, and to determine whether peer support influences the relationship among theoretical constructs of the social learning theory. A convenience sample of 110 Black pregnant women, ages 18-45, attending Women, Infant and Children (WIC) clinics throughout Riverside and San Bernardino Counties were recruited to participate in the study through the Nutrition Services Department. Eligible participants included pregnant Black WIC clients in any stage of pregnancy.

The survey questions contained information about perceived support, cognitive knowledge, abilities and beliefs regarding breastfeeding. The goal …

Model Selection And Health Effect Estimation In Environmental Epidemiology, Francesca Dominici, Chi Wang, Ciprian Crainiceanu, Giovanni Parmigiani

Johns Hopkins University, Dept. of Biostatistics Working Papers

In air pollution epidemiology, improvements in statistical analysis tools can translate into significant scientific advances, because of the unfavorable signal-to-noise ratios, and large correlations between exposures and confounders. Therefore, the use of a novel model selection approach in identifying time windows of exposure to pollutants that lead to adverse health effects is important and welcome. However, previous literature has raised concerns about approaches that select a model based on a given data set, and then estimate health effects in the same data assuming that the chosen model is correct. Problems can be particularly severe when: 1) the sample size is …