Public Health Commons^™

The Health Care Access And Cost Consequences Of Reducing Health Center Funding, Peter Shin, Sara J. Rosenbaum

Geiger Gibson/RCHN Community Health Foundation Research Collaborative

For over four decades, community health centers have served a critical role in providing affordable access to quality care to some of the nation's most vulnerable populations. Health centers have historically enjoyed broad bipartisan support, based on the evidence documenting their high quality care, crucial role in both urban and rural communities, and ability to "bend the cost curve."

On February 20, 2011, the U.S. House of Representatives voted to reduce discretionary health center funding by $1.3 billion in FY 2011 alone. Although the spending bill was rejected by the U.S. Senate on March 10, 2011, final spending measures for …

Combating Biological Terrorism From Imported Food, Jeffrey S. Nelson

Theses and Dissertations

There is a threat that a terrorist or terrorist organization will use access to the US food supply to kill or sicken Americans by contaminating imported food products from Mexico. The food that Americans eat is coming more and more often from foreign countries such as Mexico. Foodborne diseases infect nearly fifty million people in the US each year, resulting in over three thousand deaths. There are many terrorist organizations that would like to deliberately contaminate American food. Drug cartels and terrorist organizations currently operate in Mexico, one of the leading food importers into the US. The purpose of this …

Evaluation Of Xmx/2l-Mil Virtual Impactor Performance And Capture And Retention Of Aerosol Particles In Two Different Collection Media, Jon E. Black

Theses and Dissertations

The United States Air Force uses the XMX/2L-MIL (XMX) high volume air sampler to collect samples for biological analysis. The XMX uses a virtual impactor to concentrate particles 1.0 to 10 μm in size into a secondary flow prior to sample collection using a liquid impinger in a collection tube. There are no known published studies regarding virtual impactor inter-instrument variability, effect of reducing the secondary flow on particle concentration, or capture and retention efficiency (CRE) of particles in the collection media performance characteristics when using the XMX. These performance characteristics were evaluated by lofting test aerosols of Arizona Road …

Retrospective Geospatial Modeling Of Pm10 Exposures From Open Burning At Joint Base Balad, Iraq, John P. Rinker

Theses and Dissertations

Predicting, determining, and linking theater-related source-specific exposures to health effects has proven difficult. The purpose of this research is to delineate retrospective exposure zones using spatially interpolated particulate air sampling point data from Joint Base Balad, create burn pit exposure isopleths from dispersion model outputs, and merge into a combined exposure model in GIS. Interpolated monitoring results and dispersion modeled results were combined to compare modeled exposures across base. Burn pit contribution to total PM10 was also modeled. The combined dispersion and interpolation map showed elevated concentrations within a 1 kilometer buffer of the burn pit. Buildings within this area …

Characterization Of Graphite Composite Material Particulates From Usaf Aircraft Maintenance Operations, Richard E. Yon

Theses and Dissertations

Due to the benefits of their material properties, advanced composite materials (ACM) are increasingly being used as structural components on aircraft, especially within the United States Air Force. As a result, the potential exists for occupational exposures to structural maintenance employees while repairing and fabricating aircraft components. Two field studies were conducted for this thesis in order to characterize ACM aerosol size distribution, determine the feasibility of utilizing direct reading instruments (DRIs) in the field, and ensure workers are protected with adequate controls. In order to characterize exposure, traditional integrated air sampling and DRIs were positioned together near an ACM …

Development Of Optimized Guidelines For Therapeutic Strategies For Organophosphate Poisoning, Craig A. Holder

Theses and Dissertations

Organophosphates such as nerve agents have been used on several occasions in the past to inflict harm upon military and civilian populations in various parts of the world. The threat of these chemicals use against the military and civilians continues today, and the suggested treatment guidelines available may be ineffective or possibly cause harm. The guidelines investigated during the research presented here all included the use of two antidotes, atropine and oxime. The efficacy of oximes has been questioned and it has been suggested that they may cause harm to the patient. Both atropine and oxime are issued to military …

The Epidemiology Of Human Rabies Postexposure Prophylaxis In Virginia, 2002 And 2003, Marilyn Goss Haskell

Theses and Dissertations

Objective: To describe a sample that received human rabies postexposure prophylaxis (PEP) in Virginia as a result of animal exposures in 2002 and 2003 and to determine the extent to which PEP decisions were appropriate.Methods: PEP surveillance data were requested from 35 Virginia health districts within 5 regions. Retrospective chart review was used to gather demographic, exposure and source animal data from patient records and animal exposure reports. Descriptive statistics are presented. True exposures and appropriateness of PEP were defined using the 2004 Virginia Rabies Control Guidelines and the Recommendations of the 1999 Advisory Committee on Immunization Practices. The 2003 …

Substance Abuse In Georgia, The Burruss Institute Of Public Service And Research

Georgia Journal of Public Policy

In order to create a snapshot of substance use and abuse in Georgia, the Burruss Institute of Public Service and Research requested access to data from the National Survey on Drug Use and Health conducted on behalf of the Substance Abuse and Mental Health Services Administration (SAMHSA), a unit of the Department of Health and Human Services (HHS).  SAMHSA would not provide access to the raw data; instead, the Institute was given a series of tables with estimates of the average annual number of users of various substances among Georgians ages 12 and older between the years 2002 and 2008. …

Second-Hand Smoke In A University Campus: Attitudes And Perceptions Of Faculty, Staff And Students, Cecilia M. Watkins, Sandeep Mishra, Herpreet Kaur Thind, Srinivasa B. Gokarakonda, Grace Lartey, Monia Chahal

Public Health Faculty Publications

Purpose: To examine the attitudes and perceptions of faculty, staff and students concerning tobacco policies at a university campus in a tobacco producing state. Methods: A questionnaire was administered to faculty, staff and students to assess knowledge, attitudes and beliefs related to smoking and exposure to second-hand smoke on campus. A 3-wave e-mailing was used to send the questionnaire. Results: A total of 2,914 individuals responded to the questionnaire. Majority (60%) of the participants believed a smoke free policy would be a positive move and could possibly improve the quality of life for the campus community, while not negatively affecting …

Lady Health Workers Programme In Pakistan: Challenges, Achievements And The Way Forward, Assad Hafeez, Bile Khalif Mohamud, Mobasher Riaz Shiekh, Syed Ayyaz Imran Shah, Rashid Jooma

Section of Neurosurgery

Objectives: To review the Lady Health Workers programme and critically explore various aspects of the process to extract tangible implications for other similar situations.
Methods: A descriptive study was carried out over a period of one year (2007-08). A detailed desk review of project documents, interaction with relevant stakeholders, performance validation and extensive feedback from the community were collected. The data so obtained was analyzed and evaluated against predetermined benchmarks.
Results: Each LHW serves a population of 1,000 people in the community and extends her services in the catchment population through monthly home visits. The scope of work includes over …

Racial/Ethnic Disparities In Survival Among Men Diagnosed With Prostate Cancer In Texas, Arica L. White, Ann L. Coker, Xianglin L. Du, Katherine S. Eggleston, Melanie Williams

CRVAW Faculty Journal Articles

BACKGROUND:

To the authors' knowledge, few studies to date have examined racial differences in prostate cancer survival while controlling for socioeconomic status (SES). No such studies have examined this association in Texas, a large state with significant ethnic and racial diversity. The objective of this analysis was to determine whether racial disparities in survival for men diagnosed with prostate cancer in Texas from 1995 through 2002 remained after adjusting for SES, rural residence, and stage of disease.

METHODS:

A cohort of 87,449 men who were diagnosed with prostate cancer was identified from the Texas Cancer Registry. The SES measure was …

Semi Drivers Killed After Vehicle Rollovers, Kentucky Injury Prevention And Research Center

Kentucky Haz Alerts--Motor Vehicle

To prevent semi truck rollovers, employers should:

• Implement and enforce a seat belt safety program
• Establish and strengthen a company policy to reduce fatigue on the job

Employees should:

• Always wear a seat belt while in the vehicle
• Use correct lights during a fog
• Use proper precautions to reduce sloshing
• Reduce inadequate evasive actions

Do Physical Activity Facilities Near Schools Affect Physical Activity In High School Girls?, Jennifer L. Trilk, Dianne S. Ward, Marsha Dowda, Karin A. Pfeiffer, Dwayne E. Porter, James Hibbert, Russell R. Pate

Faculty Publications

Objective - To investigate associations between the number of physical activity facilities within walking distance of school and physical activity behavior in 12^th grade girls during after-school hours.

Methods - Girls (N=1394) from 22 schools completed a self-report to determine physical activity after 3:00 pm. The number of physical activity facilities within a 0.75-mile buffer of the school was counted with a Geographic Information System. Associations between the number of facilities and girls' physical activity were examined using linear mixed-model analysis of variance.

Results - Overall, girls who attended schools with ≥ 5 facilities within the buffer reported more …

Behavioral Contexts, Food-Choice Coping Strategies, And Dietary Quality Of A Multiethnic Sample Of Employed Parents, Christine E. Blake, Elaine Wethington, Tracy J. Farrell, Carole A. Bisogni, Carol M. Devine

Faculty Publications

Employed parents' work and family conditions provide behavioral contexts for their food choices. Relationships between employed parents' food-choice coping strategies, behavioral contexts, and dietary quality were evaluated. Data on work and family conditions, sociodemographic characteristics, eating behavior, and dietary intake from two 24-hour dietary recalls were collected in a random sample cross-sectional pilot telephone survey in the fall of 2006. Black, white, and Latino employed mothers (n=25) and fathers (n=25) were recruited from a low/moderate income urban area in upstate New York. Hierarchical cluster analysis (Ward's method) identified three clusters of parents differing in use of food-choice coping strategies (ie, …

Understanding The Context Of Balanced Scorecard Implementation: A Hospital-Based Case Study In Pakistan., F Rabbani, Sabrina Nh Lalji, Farhat Abbas, Sm Wasim Jafri, Junaid A. Razzak, Naheed Nabi, Firdous Jahan, Agha Ajmal, Max Petzold, Mats Brommels, Goran Tomson

Section of Urology

Background: As a response to a changing operating environment, healthcare administrators are implementing modern management tools in their organizations. The balanced scorecard (BSC) is considered a viable tool in high-income countries to improve hospital performance. The BSC has not been applied to hospital settings in low-income countries nor has the context for implementation been examined. This study explored contextual perspectives in relation to BSC implementation in a Pakistani hospital. Methods: Four clinical units of this hospital were involved in the BSC implementation based on their willingness to participate. Implementation included sensitization of units towards the BSC, developing specialty specific BSCs …

The Impact Of Bisphenol A And Triclosan On Immune Parameters In The U.S. Population, Nhanes 2003–2006, Erin M. Rees Clayton, Megan Todd, Jennifer B. Dowd, Allison E. Aiello

Publications and Research

Background: Exposure to environmental toxicants is associated with numerous disease outcomes, many of which involve underlying immune and inflammatory dysfunction.

Objectives: To address the gap between environmental exposures and immune dysfunction, we investigated the association of two endocrine-disrupting compounds (EDCs) with markers of immune function.

Methods: Using data from the 2003–2006 National Health and Nutrition Examination Survey, we compared urinary bisphenol A (BPA) and triclosan levels with serum cytomegalovirus (CMV) antibody levels and diagnosis of allergies or hay fever in U.S. adults and children ≥ 6 years of age. We used multivariate ordinary least squares linear regression models to examine …

Maternal Health Behaviours During Pregnancy In An Irish Obstetric Population And Their Assocations With Socio-Demographic And Infant Characteristics, Roslyn Tarrant, Katherine Younger, Margaret Sheridan-Pereira, John Kearney

Articles

Objectives: To examine the prevalence and combined occurrence of peri-conceptional folic acid (FA) supplement use, smoking and alcohol consumption during pregnancy in a sample of women in Dublin, and determine the factors associated with these health behaviours.

Subjects/Methods: A prospective observational study (2004-2006) involving the recruitment of 491 pregnant women from antenatal clinics in a Dublin maternity hospital, with postpartum follow-up of 450 eligible mothers. Data on FA use, maternal smoking and alcohol consumption patterns during pregnancy were collected from the antenatal patient-administered questionnaire, which was completed by participants, and returned to the investigator on the day of recruitment. …

The Effects Of Consumption Of California Dried Mission Figs On Serum Lipid Concentrations In Hyperlipidemic Adults, Joycelyn M. Peterson

Loma Linda University Electronic Theses, Dissertations & Projects

Background: The National Cholesterol Education Program and American Heart Association have recommended the use of functional or cholesterol-reducing foods, some categories of which include viscous or soluble fibers, soy protein, plant sterols, and nuts, as aids to reduce serum cholesterol concentrations. Figs are a rich source of viscous fiber and antioxidants. Fig consumption has not been studied in regard to effects in reducing serum lipid concentrations. In previous pilot data, increasing fig consumption for six weeks among volunteers was found to be feasible.

Objective: To evaluate the effect of the consumption of California dried mission figs on serum lipid …

Organs Watch: Possibilities And Perils For Public Anthropology, Roberto Abadie

Department of Sociology: Faculty Publications

Recent technological advances in biomedicine have introduced new therapeutic possibilities but have also contributed to the emergence of a global market for human bodies and body parts. For example, artificial modes of human reproduction created a market for eggs, semen, and surrogate wombs. In addition, organ transfer generated a demand for kidneys and half livers. The whole body has become a valuable commodity as professional research subjects venture into the economy of Phase I Clinical Trials, testing drug safety for pharmaceutical companies. In the process, the trade has become a deeply unequal one in which poor, vulnerable, and easily exploited …

Providing Better Care At Lower Cost: Building Maine's Health Data Infrastructure To Support Financing And Delivery System Reform, Andrew F. Coburn Phd

Health System Reform

Maine needs a robust and functional health data infrastructure to support efforts by health care providers and purchasers to improve quality, address Maine’s health care cost problems, and improve the health of individuals and populations through payment and delivery system reform. Although Maine has been a leader in building and using health data systems such as the hospital discharge data set and the all-payer claims database, new performance-based financing and delivery system arrangements are highlighting shortcomings in these systems and the need for a renewed vision of Maine’s future health data infrastructure.

The Health Data Workgroup was created by The …

Circadian Rhythm Of Cortisol And Neighborhood Characteristics In A Population-Based Sample: The Multi-Ethnic Study Of Atherosclerosis, D. Phuong Do, Ana V. Diez Roux, Anjum Hajat, Amy Auchincloss, Sharon Merkin, Nalini Ranjit, Steven Shea, Teresa Seeman

Faculty Publications

Although stress is often hypothesized to contribute to the effects of neighborhoods on health, very few studies have investigated associations of neighborhood characteristics with stress biomarkers. This study helps address the gap in the literature by examining whether neighborhood characteristics are associated with cortisol profiles. Analyses were based on data from the Multi-Ethnic Study of Atherosclerosis Stress study which collected multiple measures of salivary cortisol over three days on a population based sample of approximately 800 adults. Multilevel models with splines were used to examine associations of cortisol with neighborhood poverty, violence, disorder, and social cohesion. Neighborhood violence was significantly …

Validation Of The Actical Activity Monitor In Middle-Aged And Older Adults, Steven P. Hooker, Anna Feeney, Brent E. Hutto, Karin A. Pfeiffer, Kerry Mciver, Daniel P. Heil, John E. Vena, Michael J. Lamonte, Steven N. Blair

Faculty Publications

Purpose: This study was designed to validate the Actical activity monitor in middle-aged and older adults of varying body composition to develop accelerometer thresholds to distinguish between light and moderate intensity physical activity (PA).

Methods: Nonobese 45 to 64 yr (N = 29), obese 45 to 64 yr (N = 21), and ≥65 yr (N = 23; varying body composition) participants completed laboratory-based sitting, household, and locomotive activities while wearing an Actical monitor and a portable metabolic measurement system. Non-linear regression analysis was used to identify activity count (AC) cut-points to differentiate between light intensity (<3 METs) and moderate intensity (≥3 METs) PA.

Results: Using group-specific algorithms, …

A Geographic Information Assessment Of Exposure To A Toxic Waste Site And Development Of Systemic Lupus Erythematosus (Sle): Findings From The Buffalo Lupus Project, Edith M. Williams, Robert Watkins, Judith Anderson, Laurene Tumiel-Berhalter

Faculty Publications

The Buffalo Lupus Project was a community-based participatory research partnership formed to address the relationship between an identified hazardous waste site and high rates of lupus and other autoimmune diseases in the surrounding community. Most cases identified began experiencing symptoms and were diagnosed in the periods when the site was inactive. Trends suggest that the impact of the site was more likely due to chronic exposure to waste rather than it being an acute trigger.

Lifeskills Training Wellness Program: An Application For Young Adults In Supermarkets, Christopher Williams, Jessica Samuolis, Kenneth W. Griffin, Gilbert J. Botvin

Psychology Faculty Publications

To address the need for workplace substance use prevention programming, National Health Promotion Associates (NHPA) developed the LifeSkills Training Wellness Program (LST-WP) with funding from the Substance Abuse and Mental Health Services Administration’s (SAMHSA’s) Young Adults in the Workplace (YIW) grant program. LST-WP adapts and extends the highly effective, school-based LifeSkills Training (LST) model program (Botvin, 1998; Botvin et al., 1995) and provides comprehensive skills training for adolescent and young adult employees in communication, problem-solving, conflict resolution, drug resistance, and related life skills. Overall, the program is designed to be highly flexible to meet employee and manager needs across different …

Prevalence Of Herpes Simplex Virus 1 And 2 In A Sexually Transmitted Disease Clinic In Miami, Maya Morrison-Bryant, Maria Alcaide, Khaled Deeb, Jose G. Castro

Florida Public Health Review

The Prevalence of HSV-1 and HSV-2 among STD clinics in Miami is not known. The objective of this study was to evaluate infection rates of HSV 1 and 2, and to describe the socio-demographic characteristics, sexual orientation and co-infection with HIV and other STIs, in individuals attending a Sexually Transmitted Diseases (STD) clinic in Miami. A cross-sectional study of 663 patients tested for HSV type-specific serology or herpes culture during the year 2007 was performed. An overall infection rate of HSV-1 was 42.1% and 36.7% for HSV-2. Statistically higher infection rates for HSV-1and 2 were seen among Hispanics (56.7%, 54.4%) …

Consumption Of Single Cigarettes And Quitting Behavior: A Longitudinal Analysis Of Mexican Smokers, James F. Thrasher, Victor Villalobos, Joaquin Barnoya, Raul Sansores, Richard J. O'Connor

Faculty Publications

Background: Previous cross-sectional research has suggested single cigarettes could either promote or inhibit consumption. The present study aimed to assess the effects of single cigarette availability and consumption on downstream quit behavior.

Methods: We analyzed population-based, longitudinal data from adult smokers who participated in the 2008 and 2010 administrations of the International Tobacco Control Policy Evaluation Survey in Mexico.

Results: At baseline, 30% of smokers saw single cigarettes for sale on a daily basis, 17% bought singles at their last purchase, and 7% bought singles daily. Smokers who most frequently purchased singles, both in general and specifically to control their …

Pendapat Pembaca Awam Terhadap Buku “Air Susu Ibu: Dari Ayah Untuk Ibu Dan Bayi”, Judhiastuty Februhartanty, Andi Mariyasari Septiari, Suci Destriatania

Kesmas

Kendati ayah diketahui berperan sebagai pendukung praktik pemberian air susu ibu (ASI), akses ayah terhadap informasi mengenai praktik pemberian ASI yang benar sangat minim. Buku dapat menjadi salah satu saluran informasi yang potensial. Studi pendahuluan ini bertujuan untuk menggali pendapat para pembaca sukarelawan laki-laki dan perempuan mengenai isi dan manfaat sebuah buku tentang ASI dan peran ayah. Studi ini menggunakan pendekatan kualitatif deskriptif. Sukarelawan dipilih sebagai informan secara purposif berdasarkan tingkat pendidikan, jenis kelamin, status perkawinan, paritas, dan tingkat kegemaran membaca buku. Analisis isi (content analysis) dilakukan terhadap hasil wawancara dengan menggunakan matriks perbandingan (comparative matrix). Sebagai temuan studi ini, …

Repellency Test Of Wet Tissue Containing Deet (N,N-Diethyl- 3-Metatoluamide) And Citronella Oil (Cymbopogon Citratus) Againts Aedes Aegypti Mosquitoes, Tri Baskoro T. Satoto, Budi Mulyaningsih, M.M. Sintorini, A.F. Sugiarto, B. A Kesuma

Kesmas

Demam berdarah merupakan salah satu masalah utama kesehatan di Indonesia. Karena penyakit ini disebarkan oleh nyamuk Aedes aegypti, berbagai cara telah dilakukan untuk memutus rantai pejamu, agen, dan lingkungan, termasuk mencegah kontak manusia dengan vektor dengan menggunakan bermacam-macam pengusir serangga. Uji ini membandingkan waktu proteksi N,N-diethyl-3-metatoluamide (DEET) dengan waktu proteksi minyak sitronella yang terkandungkan dalam tisu basah terhadap Aedes aegypti. Untuk uji ini, dibuat larutan 12,5% DEET dalam etanol dan larutan 20% minyak sitronella. Sejumlah tisu kering dicelupkan ke dalam masing-masing larutan ini, ditiriskan dalam udara terbuka, kemudian dibungkus dengan lembaran aluminium dan disimpan selama satu hari dan satu minggu. …

Pemanfaatan Fasilitas Pelayanan Kesehatan Pemerintah Dan Swasta Di Kabupaten Sleman, Anita Sulistyorini, Purwanta Purwanta

Kesmas

Di Sleman, masyarakat yang memanfaatkan fasilitas pelayanan kesehatan swasta (52%) lebih tinggi daripada yang memanfaatkan fasilitas kesehatan pemerintah (37,6%). Fenomena ini diduga berhubungan dengan kebijakan kesehatan. Penelitian ini bertujuan mengetahui pola pemanfaatan fasilitas pelayanan kesehatan pemerintah dan swasta oleh keluarga di Kabupaten Sleman serta berbagai faktor yang mempengaruhinya. Penelitian dengan rancangan studi cross sectional ini dilakukan di 13 kecamatan terpilih di Kabupaten Sleman. Teknik pengambilan sampel yang digunakan adalah cluster sampling dua tahap menghasilkan jumlah sampel penelitian 240 responden dari 30 cluster. Instrumen pengumpulan data yang digunakan adalah kuesioner yang sebelumnya telah disiapkan. Metoda uji chi-square digunakan untuk melihat hubungan …

Kebutaan Pada Pasien Glaukoma Primer Di Rumah Sakit Umum Dr. Cipto Mangunkusumo Jakarta, Fetty Ismandari, Helda Helda

Kesmas

Glaukoma adalah penyebab kebutaan permanen nomor dua di Indonesia yang sering tidak disadari oleh penderita. Proporsi pasien baru glaukoma yang datang ke RSUPN Dr Cipto Mangunkusumo (RSCM) dalam kondisi buta cukup tinggi. Tujuan penelitian ini mengetahui berbagai faktor yang berhubungan dengan kebutaan tersebut. Penelitian ini dilakukan terhadap 420 pasien glaukoma primer yang berkunjung di poliklinik penyakit mata RSCM pada Januari 2007-Oktober 2009 dan memenuhi kriteria inklusi dan eksklusi. Metode analisis yang digunakan adalah analisis Cox’s Proportional Hazard Model untuk mendapatkan nilai prevalence ratio (PR). Penelitian ini didapatkan hubungan bermakna antara kebutaan akibat glaukoma primer tekanan intraokular (PR = 1,01; 95% …