Public Health Commons^™

Expanding Delivery System Research In Public Health Settings: Lessons From Practice-Based Research Networks, Glen P. Mays, Rachel A. Hogg

Health and Clinical Sciences Faculty Publications

BACKGROUND: Delivery system research to identify how best to organize, finance, and implement health improvement strategies has focused heavily on clinical practice settings, with relatively little attention paid to public health settings-where research is made more difficult by wide heterogeneity in settings and limited sources of existing data and measures. This study examines the approaches used by public health practice-based research networks (PBRNs) to expand delivery system research and evidence-based practice in public health settings.

METHODS: Practice-based research networks employ quasi-experimental research designs, natural experiments, and mixed-method analytic techniques to evaluate how community partnerships, economic shocks, and policy changes impact …

Respiratory Symptoms And Illnesses Among Brick Kiln Workers: A Cross Sectional Study From Rural Districts Of Pakistan, Shiraz Shaikh, Asaad Ahmed Nafees, Vikash Khetpal, Abid Ali Jamali, Abdul Manan Arain, Akram Yousuf

Community Health Sciences

Background: Occupational risk factors are one of the major causes of respiratory illnesses and symptoms, and account for 13% of chronic obstructive pulmonary disease and 11% of asthma worldwide. Majority of brick kilns in Pakistan use wood and coal for baking the bricks which makes the brick kiln workers susceptible to high exposure of air pollution. This study was designed to describe frequency of chronic respiratory symptoms and illnesses and study the association between these symptoms and different types of work.
Methods: This was a questionnaire based cross sectional survey conducted among the brick kiln workers in Larkana and Dadu …

Sexual And Reproductive Health Care Access And Utilization By Mexican Immigrant Women In New York City – A Descriptive Study, Gabriela Betancourt

Center for Latin American, Caribbean, and Latino Studies

Introduction: This study examines reproductive health care access and utilization by Mexicans in New York City.

Methods: This report uses data collected by Planned Parenthood of New York City (PPNYC) as part of a larger sexual and reproductive health (SRH) needs assessment. We analyzed various demographic factors and barriers to describe SRH access and utilization of services among Mexican immigrant women residing in New York City (NYC). We purposely sampled 151 adult women seeking assistance from the Mexican Consulate of New York City and other community-based organizations (CBOs). Women choosing to participate were administered an anonymous survey. Data collected included …

The Design And Testing Of A Solar Autoclave With Broad Spectrum Sterilization Capabilities, Sarah S. Trabia

Honors College Theses

Energy is difficult to come by in developing countries and this interferes with the ability of doctors to provide good healthcare to their patients. Without decent sterilization, patients can become infected and diseases can spread throughout hospitals. This study involves designing a solar autoclave for developing countries that is as efficient as electrical autoclaves. The design is intended to not require any electrical input and to be affordable to those who cannot afford advanced medical equipment. Once the solar autoclave is designed, it will be tested to determine if it can sterilize equipment against a variety of different bacteria, including …

Cancer In Louisiana: 2005-2009, Volume 27, Louisiana Tumor Registry, Patricia A. Andrews, Mei-Chin Hsieh, Lisa Pareti, Brent Mumphrey, Xiangrong Li, Beth A. Schmidt, Diane Ferguson, Christina Lefante, Lauren Maniscalco, Xiao-Cheng Wu, Vivien W. Chen

Policy & Position Papers

Mission:

To collect and report complete, high-quality, and timely population-based cancer data in Louisiana to support cancer research, control, and prevention.

Vision:

To reduce suffering and death from cancer using information collected by the Louisiana Tumor Registry.

History:

Cancer registration in Louisiana began in 1947 at the Charity Hospital Tumor Registry in New Orleans. In 1974, as part of its Surveillance, Epidemiology and End Results (SEER) Program, the National Cancer Institute provided funds for a population-based cancer incidence and survival registry covering Jefferson, Orleans, and St. Bernard parishes. Five years later, the Louisiana Tumor Registry (LTR) was transferred to the …

Characterization Of Dusts In The Food Seasonings Sector, Brigitte Roberge, Simon Aubin, Yves Cloutier

Rapports de recherche scientifique

Les épices et les herbes aromatiques contiennent des substances organiques - nommées également substances actives - pouvant causer des irritations ou ayant un potentiel allergène pour la peau et pour le système respiratoire. De 1995 à 2007, la CSST a indemnisé 9 cas d’asthme survenus dans le secteur des autres industries de produits alimentaires qui comprennent notamment la production d’assaisonnements. Les auteurs ont caractérisé les poussières dans l’air d’établissements de fabrication de mélanges d’assaisonnement à base d’épices et d’herbes aromatiques en termes de poussières totales, de fractions inhalable et respirable ainsi que la granulométrie des poussières générées lors de diverses …

Characterization Of Dusts In Traditional Bakeries, Brigitte Roberge, Simon Aubin, Yves Cloutier

Rapports de recherche scientifique

Plusieurs études concluent que les boulangers exposés à la poussière de farine risquent d'être sensibilisés et de développer des symptômes respiratoires, voire de l'asthme professionnel (AP). D'autres rapportent une augmentation du risque de sensibilisation à la farine à des niveaux de 2 mg/m³ bien qu'il y ait prévalence de sensibilisation chez les boulangers exposés à 1 mg/m³ de poussière de farine. Selon des études récentes, les travailleurs de boulangeries industrielles ou artisanales pourraient être exposés jusqu'à 7,8 mg/m³ et ceux des meuneries jusqu'à 16 mg/m³. La majorité des études rapportent des niveaux exprimés en fraction …

High Prevalence Of Subclinical Atherosclerosis By Carotid Ultrasound Among Mexican Americans: Discordance With 10-Year Risk Assessment Using The Framingham Risk Score, Susan T. Laing, Beverly Smulevitz, Kristina Vatcheva, Anne R. Rentfro, David D. Mcpherson, Susan P. Fisher-Hoch, Joseph B. Mccormick

School of Mathematical & Statistical Sciences Faculty Publications

Background: Framingham risk scores (FRS) were validated in a mostly Caucasian population. Evaluation of subclinical atherosclerosis by carotid ultrasound may improve ascertainment of risk in nonwhite populations. This study aimed to evaluate carotid intima-media thickness (cIMT) and carotid plaquing among Mexican Americans, and to correlate these markers with coronary risk factors and the FRS.

Methods/results: Participants (n = 141) were drawn from the Cameron County Hispanic Cohort. Carotid artery ultrasound was performed and cIMT measured. Carotid plaque was defined as areas of thickening >50% of the thickness of the surrounding walls. Mean age was 53.1 ± 11.7 years (73.8% female). …

Health Care Insurance And Advance Directive Completion: A Population Based Study, Wei Yang, Sally P. Hardwick, Noel Tiano, Clare T. Pettis

Nevada Journal of Public Health

Background: The relationship between advance directive (AD) completion and health insurance status is rarely studied.

Method: AD completion information was collected through the 2008 Nevada Behavior Risk Factor Surveillance System (BRFSS), a statewide cross-sectional telephone survey. Nevada non-institutionalized population over 18 were randomly selected as a population sample. Respondents were divided to “health care plan group” (HCPG) and “no health care plan group” (NHCPG). Demographic and behavior risk factors were also collected. Weighted multiple logistic regressions were utilized to assess the relationships between ADs, healthcare coverage and other factors.

Results: Of 4,461 respondents completing the survey, HCPG were six times …

Blood Lead Levels In Nevada Children, Arthur F. Di Salvo, Terry R. Hall

Nevada Journal of Public Health

The purpose of this study was to assess the prevalence of plumbism in children one to six years of age in Nevada. During a four-year period from 1992 – 1996, 10,700 children were screened for evidence of blood lead intoxication. The capillary specimens were analyzed by atomic absorption spectrometry. All children with a lead level => 10 ug/L were retested using venous blood. Ninety three percent of the children had blood lead levels < 10 µg/dL

Carbohydrate Consumption And Fatigue: A Review, Jennifer R. Pharr

Nevada Journal of Public Health

Fatigue is a condition that negatively impacts quality of life and occurs in about twenty four percent of adults worldwide. Many factors may contribute to fatigue. One factor is the macronutrient composition of a person’s diet, particularly, the amount of simple carbohydrates. This paper is a review of the current literature and examines the relationship of carbohydrate consumption and fatigue to determine if a diet low in simple carbohydrates results in an improvement in fatigue ratings. Results of studies regarding carbohydrate consumption and fatigue vary, the preponderance demonstrate a positive relationship between simple carbohydrate consumption and fatigue. Additionally, diets low …

Barriers To The Effective Implementation Of Immunization Information Systems In A Private Provider Setting, Echezona E. Ezeanolue, Ineada Jack, William Downey, Benjamin Hart, Chad L. Cross

Nevada Journal of Public Health

One of the goals of Healthy People 2010 is to increase the proportion of children less than 6 years of age with two or more vaccinations recorded in a fully operational population-based immunization information system to 95%. In 2008, we piloted the Nevada web-based immunization information system (WEBIZ) in a large private pediatric clinic in north-west Las Vegas. Our objectives were: (1) to determine compliance with the recommendation that all vaccine providers report immunization activities to the WEBIZ without a state mandate and (2) to determine perceived barriers to compliance and suggestions on how to overcome expressed barriers. We documented …

Adverse Maternal Outcomes In Nevada: Does Asthma Matter?, Jay J. Shen, Hong Wei, Robin Mukalian

Nevada Journal of Public Health

Objective. Asthma is a common clinical complication of pregnancy and women with asthma are at greater risk of having complications. This study compared adverse maternal outcomes between women with asthma and women without asthma in Nevada.

Methods. A total of 64,664 hospital discharges of delivery were abstracted from the Nevada 2003-2004 hospital discharges and thirteen adverse maternal outcomes were examined. Logistic regression was applied to compare the maternal outcomes between women with and without asthma.

Results. Women with asthma were more likely to have pre-eclampsia (OR [CI] 1.73 [1.13, 2.65]), transient hypertension of pregnancy (OR [CI] 1.76 [1.11, 2.78]), pregnancy-induced …

The Economic Impact Of The Nevada Clean Indoor Air Act In Clark County, Nevada – Preliminary Findings, Robin Mukalian, Fang Lin, Christopher R. Cochran, Jay J. Shen, Nancy L. York

Nevada Journal of Public Health

Objective. The primary purpose of this exploratory study was to quantitatively evaluate the economic impact of the Nevada Clean Indoor Air Act (NCIAA) on businesses in Clark County.

Methods. The goal of this research was to assess economic indicators over a ten year period utilizing measurable data points, including restaurant and drinking establishment employment rates, taxable sales, openings and closings, as well as slot gaming revenues. This ten year time period consisted of a seven year span prior to the enactment of the NCIAA, and three years post enactment. Researchers conceived this study as a means to independently evaluate and …

The Long-Term Coercive Effect Of State Community Benefit Laws On Hospital Community Health Orientation, Charles B. Moseley, Jay J. Shen, Gregory O. Ginn

Nevada Journal of Public Health

This study is an examination of the long-term coercive effect of state community benefit laws (CB Laws) on the provision of community health activities in U.S. acute care hospitals. The sample included all the not-for-profit and investor owned acute care hospitals for which 1994 and 2006 AHA Annual Survey data were available. A panel design was used to longitudinally examine the effect that state CB Laws had on hospital community health orientation activities and the provision of health promotion services, after controlling for the influence of other organizational and environmental variables that might affect these activities and services. The authors …

Prevalence And Antimicrobial Susceptibility Of Methicillin-Resistant Staphylococcus Aureus In Pregnant Women And Their Newborns In Las Vegas, Nevada, Mark P. Buttner, Echezona E. Ezeanolue, Patricia Cruz, Joanne L. Henry, Ineada Jack, Chad L. Cross

Nevada Journal of Public Health

Colonization and infection by resistant strains of Staphylococcus aureus are being reported in epidemic proportions. The goal of this study was to determine the local prevalence of methicillin-resistant Staphylococcus aureus (MRSA) colonization in pregnant women in southern Nevada and how it correlates with colonization and infection of their neonates. Signed consent was obtained, and a brief questionnaire was administered by the medical staff to each pregnant woman to collect demographic data and pertinent medical, family and social history. Nasal and vaginal specimens were obtained from pregnant women at ≥35 weeks gestation, and nasal and umbilicus specimens were obtained from their …

Future Of Nursing: Advancing Health Through Interprofessional Collaboration, Margaret A. Hadinger Edd, Ms, Mary Ellen Miller Phd, Rn, Abby S. Letcher Md, Lucy Tuton Phd

Department of Education

No abstract provided.

Estimating Scale And Scope Effects In Public Health Delivery: Implications For Regionalization, Glen P. Mays, Rachel A. Hogg, Rick Ingram, Kristina Rabarison

Health Management and Policy Presentations

OBJECTIVES: The nation's public health delivery system comprises nearly 3000 local public health agencies that vary widely in capabilities. Economic pressures, workforce shortages, and new national accreditation standards are leading these agencies to explore mechanisms for pooling resources to enhance delivery and improve population health.

METHODS: A longitudinal cohort design is used to analyze changes in the availability and perceived effectiveness of services delivered by local public health providers. A stratified random sample of the nation's 3000 local public health agencies (n=497) were surveyed in 1998 and again in 2006 and 2011 (70% response) to measure the availability of 20 …

Effects Of The Master Settlement Agreement On Smoking Among Nevada Teens: A Decade After Implementation And Implications Of Reduced Funding, Christina A. Demopoulos, Christopher R. Cochran

Nevada Journal of Public Health

Background: Tobacco control programs that have adapted the Centers for Disease Control and Prevention (CDC) Best Practices for a Comprehensive Tobacco Control Program (CTCP) have been effective in reducing the rates of tobacco use. This paper investigates the effectiveness that Nevada’s tobacco control programs have had on teen tobacco use and rates to date and examines changes to programs given reduced Master Settlement Agreement (MSA) funding.

Methods: Aggregate data from the Nevada Department of Health and Human Services/Fund for a Healthy Nevada program was analyzed to determine if the tobacco control programs adapted the CDC’s Best Practices for a CTCP. …

Analysis Of Lead Levels In Deciduous Teeth From Children In Clark County, Nevada., Kristin Murphy, Jennifer Berger-Ritchie, Shawn L. Gerstenberger, Amol B. Amin, Jason K. Nitta, Frederick G. More, Jeanne A. Hibler, Karl Kingsley

Nevada Journal of Public Health

Background: Elevated blood lead levels (EBLL) are declining in the United States, although some population subgroups continue to exhibit significant health disparities. A childhood lead poisoning prevention program was recently started in Nevada, and many efforts have been made to support this program and increase the screening rates.

Methods: To expand the potential pool of children screened for EBLLs, a pilot study was performed to evaluate lead concentrations in extracted deciduous teeth using Graphic Furnace Atomic Absorption Spectrometry (GFAAS), Inductively Coupled Plasma Mass Spectrometry (ICP-MS), and X-Ray Fluorescence (XRF) analysis.

Results: Lead concentrations as determined by GFAAS and ICP-MS were …

Chronic Disease And Risk Factors Among Nevadans With Disabilities: A 2009 Brfss Study, Jennifer R. Pharr, Sheniz Moonie

Nevada Journal of Public Health

Previous research has found that people with disabilities are more likely to have chronic diseases (coronary artery disease, stroke, cancer, asthma, diabetes), secondary conditions (high blood pressure, high cholesterol) and risk factors for chronic disease (physical inactivity and obesity) (Havercamp, Scandlin, & Roth, 2004; Kinne, Patrick, & Doyle, 2004; Nosek, Hughes, Petersen et al., 2006; Reichard, Stolzle, & Fox, 2011). The purpose of this study was to conduct a secondary analysis using data from the 2009 Behavioral Risk Factor Surveillance System (BRFSS) to identify differences in chronic disease risk factors and chronic disease/ secondary conditions between adults with and without …

Nutrition Education In Clark County, Nevada, Matt Bittle, Mildred Mcclain, Jeanne A. Hibler, Marcia M. Ditmyer

Nevada Journal of Public Health

Over 51 million school hours are missed annually by school-aged children due to a dental problem or visit, with 117 hours missed per 100 children (NIDCR, 2002). Approximately half a million of California's 7.2 million school-age children missed at least one day of school in 2007 because of dental issues such as toothaches (Pourat, & Nicholson, 2009). Independent research regarding various educational and intervention programs have been conducted in elementary schools across the country that focus on nutrition and/or physical activity, some of which have found that the programs positively impacted students’ dietary behaviors (Edwards, Mauch, & Winkelman, 2011; Muth, …

Utilization Of Preventative Health Services By Nevadans With Disabilities, Jennifer R. Pharr, Sheniz Moonie

Nevada Journal of Public Health

Health disparities are differences in access to health care, quality of health care and health outcomes observed between population-specific groups of people (Health Resources and Services Administration, 2000). Previous research has found that people with disabilities experience unequal access to preventative health care services. The purpose of this study was to conduct a secondary data analysis using data from the 2008 Behavioral Risk Factor Surveillance System (BRFSS) to determine differences in utilization of preventative health services between adults with and without disabilities in Nevada. Nevadans with disabilities were significantly more likely to have access to health insurance and to have …

Primary Care Survival Skills In An Age Of Reform, Therese M. Zink, Peter Harper, Nancy Arnston, Jean Jansen

Family Medicine Faculty Publications

The Triple Aim - improved outcomes/quality of care, improved patient experience, and reduced cost - is driving health care reform in Minnesota and nationally. Minnesota is among those states moving quickly to new payment models that reward practices for meeting these three goals and is gradually reducing payments based only on increased volume of services. Primary care is growing into a new leadership role to meet these new demands while managing the reality that full funding for population based care is developing more slowly than the rhetoric. There are many encouraging signs, including an expanding interest in primary care medical …

Demam Berdarah Dengue Di Perdesaan, Erna Kusumawardani, Umar Fahmi Achmadi

Kesmas

Berbeda dengan beberapa negara, laporan kejadian kasus demam berdarah dengue (DBD) di perdesaan Indonesia belum banyak dilaporkan. Penelitian ini bertujuan untuk memberikan gambaran kejadian DBD di perdesaan di wilayah perbatasan Kabupaten Bogor dan Kabupaten Lebak, Jawa Barat. Penelitian ini menggunakan desain studi kasus seri dengan sampel seluruh penderita DBD yang tercatat di puskesmas pada periode bulan Januari 2011 sampai April 2012. Hasil penelitian menemukan 18 kasus DBD dan 4 kasus kematian (case fatality rate, CFR = 22%). Sebagian besar kasus berjenis kelamin laki-laki (58,3%), berusia > 15 tahun (58,3%), tidak bekerja/ibu rumah tangga (50%), melakukan mobilitas (66,7%), mempunyai pengetahuan yang baik …

Konseling Postpartum Dan Penerapan Metode Kontrasepsi Amenore Laktasi, Sri Mulyani, Tri Budi Wiryanto, Ropitasari Ropitasari

Kesmas

Keberhasilan metode amenore laktasi yang merupakan metode kontrasepsi efektif wanita menyusui tergantung pada pemberian air susu ibu (ASI) secara eksklusif. Konseling postpartum diperlukan untuk meningkatkan pengetahuan tentang metode kontrasepsi postpartum. Tujuan penelitian ini untuk menilai hubungan konseling postpartum dan penerapan metode kontrasepsi amenore laktasi setelah mengendalikan pengaruh variabel paritas, status pekerjaan, dukungan petugas kesehatan, dan dukungan keluarga. Penelitian observasional ini menggunakan rancangan cross sectional dengan pendekatan kuantitatif dan kualitatif. Subjek penelitian adalah ibu yang mempunyai bayi usia 7 – 12 bulan dan memberikan ASI eksklusif. Hubungan antara variabel penelitian dianalisis dengan regresi logistik multivariat dengan chi square, kekuatan hubungan dihitung …

Analisis Bahaya Titik Kendali Kritis Proses Pengolahan Bola-Bola Daging Di Instalasi Gizi Rumah Sakit, Inoy Trisnaini

Kesmas

Pada simpul lingkungan terdapat beberapa media yang dapat menjadi transmisi penularan penyakit, salah satunya melalui makanan. Bola-bola daging dengan bahan utama daging sapi merupakan salah satu makanan yang dibuat di Instalasi Gizi Rumah Sakit Umum Pusat (RSUP) dr. Mohammad Hoesin Palembang. Bahan pangan hewani merupakan sumber utama bakteri penyebab infeksi dan intoksikasi termasuk Salmonella sp. dan Escherichia coli . Bola-bola daging rentan mengalami kontaminasi oleh bahaya fisik, biologi, maupun kimia. Tujuan dari penelitian ini ialah analisis bahaya dan titik kendali kritis terhadap proses pengolahan bola-bola daging. Penelitian ini merupakan penelitian deskriptif kualitatif. Sumber informasi terdiri atas enam orang informan. Penelitian …

Studi Epidemiologi Deskriptif Talasemia, Dwi Sarwani Sri Rejeki, Nunung Nurhayati, Supriyanto Supriyanto, Elva Kartikasari

Kesmas

Talasemia adalah penyakit kelainan darah akibat kekurangan atau penurunan produksi hemoglobin. Jumlah penderita talasemia di Yayasan Talasemia Indonesia cabang Banyumas terus meningkat. Tujuan penelitian ini untuk mendeskripsikan karakteristik penderita talasemia di Yayasan Talasemia Indonesia cabang Banyumas tahun 2012. Penelitian kuantitatif dengan desain penelitian cross sectional ini dilakukan terhadap 64 sampel yang diambil dengan teknik proportionate stratified random sampling . Data dikumpulkan meliputi melalui wawancara terstruktur menggunakan kuesioner. Metode analisis yang digunakan adalah analisis deskriptif univariat. Hasil penelitian menunjukkan bahwa penderita talasemia rata-rata berusia 12,28 tahun, berjenis kelamin laki-laki (51,6%), sedang sekolah SD (40,6%), bukan angkatan kerja (92,2%), talasemia β-mayor (90,6%), …

Importance Performance Analysis Pelayanan Jaminan Sosial Kesehatan Di Puskesmas Swakelola Pembina, Asmaripa Ainy, Misnaniarti Misnaniarti, Nur Alam Fajar

Kesmas

Kunjungan pasien Jaminan Sosial Kesehatan (Jamsoskes) di puskesmas pembina selama tahun 2009 adalah 24.014 orang. Kunjungan per catur wulan memperlihatkan trend yang menurun. Jumlah pengunjung puskesmas pembina pada periode bulan Januari – April 2009 adalah 9.295 orang, pada Mei – Agustus 2009 adalah 8.162 orang, dan September – Desember 2009 adalah 6.557 orang. Hal ini dapat disebabkan oleh minat masyarakat yang rendah untuk menggunakan Jamsoskes. Oleh sebab itu, perlu dilakukan kajian kualitas pelayanan Jamsoskes menurut perspektif pasien. Penelitian dengan desain cross sectional ini menggunakan data primer yang dilakukan dengan metode wawancara terstruktur atau survei. Sampel terdiri dari 100 pasien Jamsoskes …

Health Policy & Management News, Georgia Southern University

Health Policy & Community Health: News & Publications (2011-2018)

• JPHCOPH Examines Cancer Screenings