Public Health Commons^™

Medicare's Accountable Care Organization Regulations: How Will Medicare Beneficiaries Who Reside In Medically Underserved Communities Fare?, Sara J. Rosenbaum, Peter Shin

Geiger Gibson/RCHN Community Health Foundation Research Collaborative

On March 31, 2011, the Centers for Medicare and Medicaid Services (CMS) released proposed regulations implementing the Medicare Shared Savings Program (MSSP). The thrust of the MSSP is to promote savings to Medicare as well as the greater clinical integration of health care through incentive payments to accountable care organizations (ACOs) that meet Medicare standards for structure, performance, and health care outcomes. The effort to spur greater clinical integration through the MSSP was part of a broader set of reforms contained in the Affordable Care Act (ACA) whose aim was to improve health care quality and efficiency. Among these reforms …

Semi Truck Driver Falls Asleep While Driving, Crashes And Dies, Kentucky Injury Prevention And Research Center

Fatality Case Reports--Motor Vehicle

A 56 year-old male long-haul semi-truck driver fell asleep while driving. It was approximately 4:15 AM and the driver was hauling a load of canned tomatoes. He was approximately 225 miles away from his destination driving in the right hand lane, on a four lane interstate traveling south, when he fell asleep. Upon falling asleep, the unit travelled to the right, across the rumble strip and the emergency lane, behind a guardrail, down an embankment and crashed into a grove of trees. A man driving a car behind the semi truck saw dust rise from the crash, stopped, called emergency …

Exploring Student Perceptions To Explain The Relationship Between Physical Activity And Academic Achievement In Adolescents: A Mixed Methods Study, Megan J. Hylok

College of Education and Human Sciences: Dissertations, Theses, and Student Research

A nationwide survey conducted by the Center for Disease Control in 2007 reported 65% of high school students did not meet the recommendation that youth participate in at least 60 minutes of physical activity most days of the week (CDC, 2008). While research has focused its attention primarily on bodily health, growing evidence supports the benefits of physical activity on brain health (Ratey & Hagerman, 2008). Physical activity is important and many adolescents are not meeting the recommendation, therefore, it is important to explore the adolescent perceptions to understand which factors influence physical activity participation. The significance of this study …

Aids/Hiv Denialism: Patients’ Privacy Rights, Fadia Abdullah, Guadalupe Medrano

Festival of Communities: UG Symposium (Posters)

HIV is a sexually transmitted disease that develops into AIDS. There is no cure for it, only treatment. In this poster, we look at the pros and cons of disclosing this type of information. People who decide to disclose their HIV status may have various reasons for doing so, but most do it for emotional support and for prevention of spreading the disease. Those who decide to keep it private primarily do it to not face rejection, discrimination, degradation, and loss of respect. (Petronio Page 72) The problem with creating a public database is that many organizations are against the …

Aids Denialism, Erika Jenel Delos Santos, Roy Llana, Jocelyn Tan

Festival of Communities: UG Symposium (Posters)

AIDS denialism is a growing issue in many parts the world. Through scholarly journal articles, book resources and other research tactics, further understanding how HIV/AIDS denialism is unethical can be distinguished. Discovering that AIDS is most prominent in South Africa explains why denialism is as critical as it is. However, the unethical aspect of AIDS denialism is in effect particularly amongst families. When a South African inhabitant realizes they have AIDS, they feel outcasted by their families due to shame. They fear as though they will be disowned because they have flaws that are unacceptable. These family values are significant …

Vaccines Controversy, Jackelin Ruiz, Keith Wellman

Festival of Communities: UG Symposium (Posters)

Our research was conducted on a Vaccine controversy which raised the question on ethics, morality, safety and effectiveness of vaccination on children. The case study we focused on was about a study done by Dr. Andrew Wakefield and twelve other Colleagues, which was published in a well know journal The Lancet. The study has recently been retracted because an investigation found that he failed to mention that his research of the MMR vaccine was funded through solicitors seeking evidence to use against vaccine manufactures (Deer, Brian). To conclude our research we compared the current vaccination rates with the rates …

Effect Of Balanced Protein Energy Supplementation During Pregnancy On Birth Outcomes, Aamer Imdad, Zulfiqar Ahmed Bhutta

Woman and Child Health

Background:The nutritional status of the mother prior to and during pregnancy plays a vital role in fetal growth and development, and maternal undernourishment may lead to adverse perinatal outcomes including intrauterine growth restriction (IUGR). Several macronutrient interventions had been proposed for adequate protein and energy supplementation during pregnancy. The objective of this paper was to review the effect of balanced protein energy supplementation during pregnancy on birth outcomes. This paper is a part of a series of reviews undertaken for getting estimates of effectiveness of an intervention for input to Lives Saved Tool (LiST) model.

Methods:

A literature search …

Impact Of Interventions To Prevent And Manage Preeclampsia And Eclampsia On Stillbirths, Mehnaz Jabeen, Mohammad Yawar Yakoob, Aamer Imdad, Zulfiqar Ahmed Bhutta

Woman and Child Health

Background:Pre-eclampsia and Eclampsia are relatively common complications of pregnancy, leading to considerable maternal and fetal mortality and morbidity. We sought to review the effect of aspirin, calcium supplementation, antihypertensive agents and magnesium sulphate on risk stillbirths.

Methods:

A systematic literature search was conducted to identify studies evaluating the above interventions. We used a standardized abstraction and grading format and performed meta-analyses where data were available from more than one studies. The estimated effect on stillbirths was determined by applying the standard Child Health Epidemiology Reference Group (CHERG) rules for multiple outcomes. For interventions with insufficient evidence for overall effect, …

Elective Induction For Pregnancies At Or Beyond 41 Weeks Of Gestation And Its Impact On Stillbirths: A Systematic Review With Meta-Analysis, Arwa Abbas Hussain, Mohammad Yawar Yakoob, Aamer Imdad, Zulfiqar Ahmed Bhutta

Woman and Child Health

Background:An important determinant of pregnancy outcome is the timely onset of labor and birth. Prolonged gestation complicates 5% to 10% of all pregnancies and confers increased risk to both the fetus and mother. The Purpose of this review was to study the possible impact of induction of labour (IOL) for post-term pregnancies compared to expectant management on stillbirths.

Methods:

A systematic review of the published studies including randomized controlled trials, quasi-randomized trials and observational studies was conducted. Search engines used were PubMed, the Cochrane Library, the WHO regional databases and hand search of bibliographies. A standardized data abstraction sheet …

Effect Of Routine Iron Supplementation With Or Without Folic Acid On Anemia During Pregnancy, Mohammad Yawar Yakoob, Zulfiqar Ahmed Bhutta

Woman and Child Health

Introduction:Iron deficiency is the most prevalent nutrient deficiency in the world, particularly during pregnancy. According to the literature, anemia, particularly severe anemia, is associated with increased risk of maternal mortality. It also puts mothers at risk of multiple perinatal complications. Numerous studies in the past have evaluated the impact of supplementation with iron and iron-folate but data regarding the efficacy and quality of evidence of these interventions are lacking. This article aims to address the impact of iron with and without folate supplementation on maternal anemia and provides outcome specific quality according to the Child Health Epidemiology Reference Group …

Effect Of Multiple Micronutrient Supplementation During Pregnancy On Maternal And Birth Outcomes, Batool Azra Haider, Mohammad Yawar Yakoob, Zulfiqar Ahmed Bhutta

Woman and Child Health

Objectives/Background:Given the widespread prevalence of micronutrient deficiencies in developing countries, supplementation with multiple micronutrients rather than iron-folate alone, could be of potential benefit to the mother and the fetus. These benefits could relate to prevention of maternal complications and reduction in other adverse pregnancy outcomes such as small-for-gestational age (SGA) births, low birth weight, stillbirths, perinatal and neonatal mortality. This review evaluates the evidence of the impact of multiple micronutrient supplements during pregnancy, in comparison with standard iron-folate supplements, on specific maternal and pregnancy outcomes of relevance to the Lives Saved Tool (LiST). Data sources/review methods: A systematic review …

Effectiveness Of Interventions To Screen And Manage Infections During Pregnancy On Reducing Stillbirths: A Review, Sidra Ishaque, Mohammad Yawar Yakoob, Aamer Imdad, Robert L. Goldenberg, Thomas P. Eisele, Zulfiqar Ahmed Bhutta

Woman and Child Health

Background:Infection is a well acknowledged cause of stillbirths and may account for about half of all perinatal deaths today, especially in developing countries. This review presents the impact of interventions targeting various important infections during pregnancy on stillbirth or perinatal mortality.
Methods: We undertook a systematic review including all relevant literature on interventions dealing with infections during pregnancy for assessment of effects on stillbirths or perinatal mortality. The quality of the evidence was assessed using the adapted Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach by Child Health Epidemiology Reference Group (CHERG). For the outcome of interest, namely …

Effect Of Breastfeeding Promotion Interventions On Breastfeeding Rates, With Special Focus On Developing Countries, Aamer Imdad, Mohammad Yawar Yakoob, Zulfiqar Ahmed Bhutta

Woman and Child Health

Background:Given the recognized benefits of breastfeeding for the health of the mother and infants, the World Health Organization (WHO) recommends exclusive breastfeeding (EBF) for the first six months of life. However, the prevalence of EBF is low globally in many of the developing and developed countries around the world. There is much interest in the effectiveness of breastfeeding promotion interventions on breastfeeding rates in early infancy.

Methods:

A systematic literature was conducted to identify all studies that evaluated the impact of breastfeeding promotional strategies on any breastfeeding and EBF rates at 4-6 weeks and at 6 months. Data were …

Effect Of Screening And Management Of Diabetes During Pregnancy On Stillbirths, Madiha Syed, Hasan Javed, Mohammad Yawar Yakoob, Zulfiqar Ahmed Bhutta

Woman and Child Health

Background:Diabetes during pregnancy is associated with significant risk of complications to the mother, fetus and newborn. We reviewed the potential impact of early detection and control of diabetes mellitus during pregnancy on stillbirths for possible inclusion in the Lives Saved Tool (LiST).

Methods:

A systematic literature search up to July 2010 was done to identify all published randomized controlled trials and observational studies. A standardized data abstraction sheet was employed and data were abstracted by two independent authors. Meta-analyses were performed with different sub-group analyses. The analyses were graded according to the CHERG rules using the adapted GRADE criteria …

Neonatal Resuscitation And Immediate Newborn Assessment And Stimulation For The Prevention Of Neonatal Deaths: A Systematic Review, Meta-Analysis And Delphi Estimation Of Mortality Effect, Anne C. C. Lee, Simon Cousens, Stephen N. Wall, Susan Niermeyer, Gary L. Darmstadt, Waldemar A. Carlo, William J. Keenan, Zulfiqar Ahmed Bhutta, Christopher Gill, Joy E. Lawn

Woman and Child Health

Background: Of 136 million babies born annually, around 10 million require assistance to breathe. Each year 814,000 neonatal deaths result from intrapartum-related events in term babies (previously "birth asphyxia") and 1.03 million from complications of prematurity. No systematic assessment of mortality reduction from tactile stimulation or resuscitation has been published. Objective:To estimate the mortality effect of immediate newborn assessment and stimulation, and basic resuscitation on neonatal deaths due to term intrapartum-related events or preterm birth, for facility and home births.

Methods:

We conducted systematic reviews for studies reporting relevant mortality or morbidity outcomes. Evidence was assessed using GRADE criteria …

Role Of Calcium Supplementation During Pregnancy In Reducing Risk Of Developing Gestational Hypertensive Disorders: A Meta-Analysis Of Studies From Developing Countries, Aamer Imdad, Afshan Jabeen, Zulfiqar Ahmed Bhutta

Woman and Child Health

Background:Hypertension in pregnancy stand alone or with proteinuria is one of the leading causes of maternal mortality and morbidity in the world. Epidemiological and clinical studies have shown that an inverse relationship exists between calcium intake and development of hypertension in pregnancy though the effect varies based on baseline calcium intake and pre-existing risk factors. The Purpose of this review was to evaluate preventive effect of calcium supplementation during pregnancy on gestational hypertensive disorders and related maternal and neonatal mortality in developing countries.
Methods: A literature search was carried out on PubMed, Cochrane Library and WHO regional databases. Data …

Screening And Triage Of Intrauterine Growth Restriction (Iugr) In General Population And High Risk Pregnancies: A Systematic Review With A Focus On Reduction Of Iugr Related Stillbirths, Aamer Imdad, Mohammad Yawar Yakoob, Saad Siddiqui, Zulfiqar Ahmed Bhutta

Woman and Child Health

Background:There is a strong association between stillbirth and fetal growth restriction. Early detection and management of IUGR can lead to reduce related morbidity and mortality. In this paper we have reviewed effectiveness of fetal movement monitoring and Doppler velocimetry for the detection and surveillance of high risk pregnancies and the effect of this on prevention of stillbirths. We have also reviewed effect of maternal body mass index (BMI) screening, symphysial-fundal height measurement and targeted ultrasound in detection and triage of IUGR in the community.

Methods:

We systematically reviewed all published literature to identify studies related to our interventions. We …

The Effect Of Folic Acid, Protein Energy And Multiple Micronutrient Supplements In Pregnancy On Stillbirths, Aamer Imdad, Mohammad Yawar Yakoob, Zulfiqar Ahmed Bhutta

Woman and Child Health

Background:Pregnancy is a state of increased requirement of macro-and micronutrients, and malnourishment or inadequate dietary intake before and during pregnancy, can lead to adverse perinatal outcomes including stillbirths. Many nutritional interventions have been proposed during pregnancy according to the nutritional status of the mother and baseline risk factors for different gestational disorders. In this paper, we have reviewed three nutritional interventions including peri-conceptional folic acid supplementation, balanced protein energy supplementation and multiple micronutrients supplementation during pregnancy. This paper is a part of a series to estimate the effect of interventions on stillbirths for input to Live Saved Tool (LiST) …

The Effect Of Providing Skilled Birth Attendance And Emergency Obstetric Care In Preventing Stillbirths, Mohammad Yawar Yakoob, Mahrukh Ayesha Ali, Mohammad Usman Ali, Aamer Imdad, Joy E. Lawn, Nynke Van Den Broek, Zulfiqar Ahmed Bhutta

Woman and Child Health

Background:Of the global burden of 2.6 million stillbirths, around 1.2 million occur during labour i.e. are intrapartum deaths. In low-/middle-income countries, a significant proportion of women give birth at home, usually in the absence of a skilled birth attendant. This review discusses the impact of skilled birth attendance (SBA) and the provision of Emergency Obstetric Care (EOC) on stillbirths and perinatal mortality.

Methods:

A systematic literature search was performed on PubMed/MEDLINE, Cochrane Database and the WHO regional libraries. Data of all eligible studies were extracted into a standardized Excel sheet containing variables such as participants' characteristics, sample size, location, …

Making Sense Of Health Care Planning In Ireland; The Street Level Public Organization (Slpo)., Vivienne Byers

Conference Papers

One of the central mechanisms of the Strategic Management Initiative (SMI) (Government of Ireland 1996) is the devolution of accountability and responsibility from the centre to executive agencies. Service planning was introduced in the Irish health care sector as part of this strategic planning ethos. This paper reports on a study that examined both the intent and the consequences of implementing legislatively mandated planning in the Irish health services, in the context of significant organizational change. In an effort to draw broader lessons, a comparison is drawn with the Canadian experience of service planning.

The choice was made to study …

Dual Testing Algorithm Of Bed-Ceia And Axsym Avidity Index Assays Performs Best In Identifying Recent Hiv Infection In A Sample Of Rwandan Sex Workers, Sarah L. Braunstein, Denis Nash, Andrea A. Kim, Ken Ford, Lambert Mwambarangwe, Chantal M. Ingabire, Joseph Vyankandondera, Janneke H. H. M. Van De Wijgert

Publications and Research

Background

To assess the performance of BED-CEIA (BED) and AxSYM Avidity Index (Ax-AI) assays in estimating HIV incidence among female sex workers (FSW) in Kigali, Rwanda.

Methodology and Findings

Eight hundred FSW of unknown HIV status were HIV tested; HIV-positive women had BED and Ax-AI testing at baseline and ≥12 months later to estimate assay false-recent rates (FRR). STARHS-based HIV incidence was estimated using the McWalter/Welte formula, and adjusted with locally derived FRR and CD4 results. HIV incidence and local assay window periods were estimated from a prospective cohort of FSW. At baseline, 190 HIV-positive women were BED and Ax-AI …

Does Comorbidity Explain The Ethnic Inequalities In Cervical Cancer Survival In New Zealand? A Retrospective Cohort Study, Naomi Brewer, Barry Borman, Diana Sarfati, Mona Jeffreys, Steven T. Fleming, Soo Cheng, Neil Pearce

Epidemiology and Environmental Health Faculty Publications

BACKGROUND: There are large ethnic differences in cervical cancer survival in New Zealand that are only partly explained by stage at diagnosis. We investigated the association of comorbidity with cervical cancer survival, and whether comorbidity accounted for the previously observed ethnic differences in survival.

METHODS: The study involved 1,594 cervical cancer cases registered during 1994-2005. Comorbidity was measured using hospital events data and was classified using the Elixhauser instrument; effects on survival of individual comorbid conditions from the Elixhauser instrument were also assessed. Cox regression was used to estimate adjusted cervical cancer mortality hazard ratios (HRs).

RESULTS: Comorbidity during the …

Local Health Departments’ Governance: A Visual Display Using Lhd Shape Files, Gulzar H. Shah Dr., Carolyn J. Leep, Reba Novich

Health Policy & Management: Faculty Presentations (2008-2022)

Analyses conducted for public health systems and services research (PHSSR) frequently include a variable that represents the relationship between state and local health departments (i.e., a governance category) in their analyses, either as an explanatory variable or a control variable. A number of organizations and researchers has categorized states according to governance, but the categorizations have been inconsistent across studies. This lack of agreement regarding governance category has been problematic for PHSSR.

The Association of State and Territorial Health Officials (ASTHO) in conjunction with NORC at the University of Chicago and with input from the National Association of County and …

An Evaluation Of Presence And Source Of Fecal Contamination At Golden Gardens Park, Jamie Minick, Nicola K. Beck, J. Scott Meschke

College of Health Sciences Poster Presentations

Golden Gardens is an 87.8 acre Park in Seattle, WA that has come under recent scrutiny over concerns about water quality in the streams and at the beach. Located just north of Shillshole marina in Seattle it has a swimming beach which is 1439 m in length, as well as a forested region directly east of the beach on a relatively steep hill with several drainages flowing into the sound. The purpose of this study was to assess the levels of indicator bacteria in beach water and in the fresh water drainages and to determine if the bacterial contamination is …

Dhhs' And Epa's Proposal To Lower Fluoride Levels In Drinking Water, Shannon Wirz

College of Health Sciences Poster Presentations

On January 7th, 2011 the U.S. DHHS recommended setting the level of fluoride in drinking water to the lowest end of the current optimal range (0.7 to 1.2 ppm). EPA is initiating a review of the maximum amount of fluoride allowed in drinking water based on scientific assessments of health effects from too much fluoride. MCL (Maximum Contaminant Level) is the legal threshold limit on the amount of a substance allowed in public water systems. EPA sets the MCL to address adverse health effects. Current MCL for fluoride is 4 mg/L. The EPA is unsure if they will revise the …

Intégration D’Une Culture De Prévention Durable Des Tms. Étape 1 : Portrait Systémique D’Une Grande Entreprise Manufacturière, Marie St-Vincent, Daniel Imbeau, Maud Gonella, Marie-Ève Chiasson, Marie-Andrée Lorange, Geslie Lassy

Rapports de recherche scientifique

Cette étude s’insère dans une séquence de projets, dont le but est d’implanter une culture de prévention durable des troubles musculo-squelettiques (TMS) dans une grande entreprise manufacturière. Cette première étape consistait à dresser un portrait systémique de l’entreprise. Les auteurs ont noté une prévalence de TMS très élevée; 78 % des travailleurs ont déclaré avoir eu des douleurs assez souvent ou tout le temps à au moins une région du corps au cours des 12 derniers mois. Par ailleurs, près de 70 % des travailleurs se sont dits ouverts à la rotation des postes, une forme d’organisation que la direction …

Acceptance Of The Human Papillomavirus Vaccine Amount College Age Adults: Survey Research, Emily Pippo

Honors Capstones

Capstone submitted as a graduation requirement for BSU Honors Program.

Tyrie, Betsy (Fa 22), Manuscripts & Folklife Archives

Folklife Archives Finding Aids

Finding aid only for Folklife Archives Project 22.  "The Life of Dr. C. C. Howard," an oral history project conducted by Betsy Tyrie about Dr. Carl Clifford Howard, the outstanding Glasgow, Kentucky, physician who was instrumental in the fight against tuberculosis and in founding hospitals in Glasgow.  Project contains interviews with Dr. Howard's family, friends, and colleagues as well as archived autobiographical information about Howard.

Bayesian Effect Estimation Accounting For Adjustment Uncertainty, Chi Wang, Giovanni Parmigiani, Francesca Dominici

Harvard University Biostatistics Working Paper Series

No abstract provided.

Youth Dating Culture In Urban Vietnam: Attitudes, Behaviors, And Influences, Alexa Difiore

Independent Study Project (ISP) Collection

This paper attempts to research urban youth’s attitudes and behaviors concerning everything having to do with dating (the process, PDA, typical dating spots and behavior) and opinions towards “hot issues” in contemporary, Vietnam such as pre-marital sex and co-habitation. My research question focuses on what the term “dating” means among youth in urban Vietnam, and the various influences that affect youth’s dating and sexual lives. Through an extensive literature review, I learned that there is an overall lack of information and discussion about sex in Vietnam. There is also a general idea that from parents, the government, and school that …