Public Health Commons^™

Estimating Medical Cost Offsets Attributable To Public Health Spending, Glen P. Mays

Health Management and Policy Presentations

BACKGROUND: Policy strategies for reforming the U.S. health care system to control costs and improve health outcomes include the possibility of expanded support for public health activities that are designed to prevent disease and promote health on a population-wide basis. These activities include efforts to monitor and report on community health status, investigate and control disease outbreaks, educate the public about health risks and prevention strategies, develop and enforce laws and regulations to protect health, and inspect and assure the safety and quality of water, food, air and other resources necessary for health. The Patient Protection and Affordable Care Act …

All-Cause Gastroenteritis And Rotavirus-Coded Hospitalizations Among Us Children, 2000–2009, Rishi Desai, Aaron T. Curns, Claudia A. Steiner, Jacqueline E. Tate, Manish M. Patel, Umesh D. Parashar

United States Public Health Resources

Background. Rotavirus vaccine was recommended for US infants in 2006. We estimated baseline prevaccine burden and monitored postvaccine trends in gastroenteritis-coded and rotavirus-coded hospitalizations among US children.

Methods. We analyzed data from the State Inpatient Databases (SID) for 29–44 US states over a 10-year period (2000–2009) to calculate gastroenteritis and rotavirus-coded hospitalization rates by age group, sex, and region, among children <5 years of age. By extrapolating observed pre- and postvaccine gastroenteritis hospitalization rates to the US population <5 years and based on the 2009 cost of a diarrhea hospitalization, we estimated national reductions in diarrhea hospitalizations and associated treatment costs.

Results. The prevaccine (2000–2006) annual average gastroenteritis-coded hospitalization rate among children <5 years of age was 74 per 10 000 (annual range, 71–82 per 10 000), and declined to 51 and 50 per 10 000 in 2008 and 2009, respectively (P < .001). The prevaccine (2000–2006) annual average rotavirus-coded hospitalization rate among children <5 years of age was 15 per 10 000 (annual range, 13–18 per 10 000), and declined to 5 and 6 per 10 000 in 2008 and 2009, respectively (P < .001). The decreases in rotavirus-coded hospitalization rates in 2008 and 2009 compared with rates in prevaccine years were observed among all age groups and US regions. Nationally, during 2008 and 2009 combined, we estimated a reduction of approximately 77 000 diarrhea hospitalizations and approximately $242 million in hospital costs.

Conclusions. Since implementation of the US rota-virus vaccination program, a marked reduction in diarrhea hospitalizations and related hospital charges has occurred among US children.

School Day Segmented Physical Activity Patterns Of High And Low Active Children, Stuart J. Fairclough, Aaron Beighle, Heather Erwin, Nicola D. Ridgers

Kinesiology and Health Promotion Faculty Publications

BACKGROUND: Variability exists in children's activity patterns due to the association with environmental, social, demographic, and inter-individual factors. This study described accelerometer assessed physical activity patterns of high and low active children during segmented school week days whilst controlling for potential correlates.

METHODS: Two hundred and twenty-three children (mean age: 10.7 ± 0.3 yrs, 55.6% girls, 18.9% overweight/obese) from 8 north-west England primary schools wore ActiGraph GT1M accelerometers for 7 consecutive days during autumn of 2009. ActiGraph counts were converted to minutes of moderate (MPA), vigorous (VPA) and moderate-to-vigorous (MVPA) physical activity. Children were classified as high active (HIGH) or …

Selective Impact Of Hiv Disease Progression On The Innate Immune System In The Human Female Reproductive Tract., Timothy Lahey, Mimi Ghosh, John V. Fahey, Zheng Sheng, Lucy R. Mukura, Yan Song, Susan Cu-Uvin, Kenneth H. Mayer, Peter F. Wright, John C. Kappes, Christina Ochsenbauer, Charles R. Wira

Epidemiology Faculty Publications

Background

We have previously demonstrated intrinsic anti-HIV activity in cervicovaginal lavage (CVL) from HIV-infected women with high CD4 counts and not on antiretroviral therapy. However, the impact of HIV disease progression on CVL innate immune responses has not been delineated.

Methods

CVL from 57 HIV-infected women not on antiretroviral therapy were collected by washing the cervicovaginal area with 10 ml of sterile normal saline. We characterized subject HIV disease progression by CD4 count strata: >500 cells/µl, 200–500 cells/µl, or <200 cells/µl of blood. To assess CVL anti-HIV activity, we incubated TZM-bl cells with HIV plus or minus CVL. Antimicrobials, cytokines, chemokines and anti-gp160 HIV IgG antibodies were measured by ELISA and Luminex.

Results

CVL exhibited broad anti-HIV activity against multiple laboratory-adapted and transmitted/founder (T/F) viruses, with anti-HIV activity ranging from 0 to 100% …

Epidemiology News, Georgia Southern University

Biostatistics, Epidemiology & Environmental Health Sciences: News & Publications (2011-2018)

• Disparities in Breast Cancer

Health Policy & Management News, Georgia Southern University

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

• Disparities in Breast Cancer

Lung Cancer Screening For The Poor And Underserved: Should Routine Screening Be Performed?, Vaibhav Verma, Vladimir K. Gotlieb, Joshua Fogel, Alan S. Multz, Geeti Sharma

Publications and Research

Background: Lung cancer is a leading cause of death in United States. A recent study using low dose CT scans for screening long term smokers for lung cancer has, for the first time, demonstrated reduction in mortality, although it is not a standard of care in the community yet.

Methods: We analyzed lung cancer data for stages 0 through 4 for 1,412 individuals from, a public hospital, Nassau University Medical Center (NUMC) with patients of lower income, two private hospitals, North Shore University Hospital (NSUH) and Long Island Jewish Hospital (LIJ), with patients of higher income, with average household income …

Motivational Interviewing For Encouraging Quit Attempts Among Unmotivated Smokers: Study Protocol Of A Randomized, Controlled, Efficacy Trial, Delwyn Catley, Kari J. Harris, Kathy Goggin, Kimber Richter, Karen Williams, Christi Patten, Ken Resnicow, Edward Ellerbeck, Andrea Bradley-Ewing, Domonique Malomo, Robin Liston

Public and Community Health Sciences Faculty Publications

Background

Although the current Clinical Practice Guideline recommend Motivational Interviewing for use with smokers not ready to quit, the strength of evidence for its use is rated as not optimal. The purpose of the present study is to address key methodological limitations of previous studies by ensuring fidelity in the delivery of the Motivational Interviewing intervention, using an attention-matched control condition, and focusing on unmotivated smokers whom meta-analyses have indicated may benefit most from Motivational Interviewing. It is hypothesized that MI will be more effective at inducing quit attempts and smoking cessation at 6-month follow-up than brief advice to quit …

"Sewing A Safety Net: Scarborough's Maritime Community, 1747-1765", Charles Foy

Faculty Research & Creative Activity

From 1747 to 1765 Scarborough created a safety net to keep its maritime dependents from becoming impoverished. A web of kinship connections that permitted sailors to move between land and sea as well as between maritime roles as they aged; the employment of maritime servants; the extensive hiring of elderly seamen; the use of the Seamen’s Sixpence after legislative reform in 1747 to develop locally operated seamen’s hospitals for the benefit of sailors and their families; and strong community support of the hospitals worked together to provide a social safety net that was, by eighteenth century standards, robust and effective.

Analysis Of Dietary Patterns Over Freshman Year Of College, Chelsea Lofland

Statistics

This analysis is an investigation of changes in Cal Poly students’ eating habits over freshman year. The motivation behind this was an interest in college students’ lifestyles; college is the first time most students live on their own and it can be an important maturation period. College is stressful, exciting, liberating, and terrifying all at the same time. This distinctive life experience, along with my desire to handle big and messy data, led me to this research question.

The response variable analyzed was food consumption and the explanatory variables were: sex, race, quarter, food group, stress, exercise, BMI, sleep quality …

Foodborne Illness Outbreak Response: A Snapshot Of Ohio, Calen Wherry

Master of Public Health Program Student Publications

Biosurveillance is one of the primary roles of local Public health offices. As the all-hazards (biological, chemical, and radiation emergencies) approach adds to the responsibilities already performed in foodborne illness outbreak response, it is crucial to assess the capabilities and robustness of the local public health Foodborne Illness (FBI) response. By surveying the most populated counties in Ohio with a checklist based on the 2009 Council for Improvement of Foodborne Outbreak Response (CIFOR) guidelines, it was possible to obtain a snapshot of the current outbreak response capabilities. Though only one county reported 100% compliance with the checklist, the overall average …

Concepts Of Health In Older Urban African American Women With Chronic Health Conditions: A Focus Group Study, Priscilla T. Ryder, Linda Ellis, Doshia Harris, Anita Ohmit, Kathleen M. Russell, Amber Scott

Scholarship and Professional Work – COPHS

The purpose of this report is to relate the findings of the study ‘Concepts of Health in Older Urban African American Women with Chronic Health Conditions.’ This investigation, undertaken at the request of the Indiana Minority Health Coalition, Inc. (IMHC) is collaboration between IMHC, Butler University College of Pharmacy and Health Sciences, and the community partner, the Black Nurses Association of Indianapolis, Inc. (BNA). The purpose of the study is to gain an understanding of the ways older African American women from medically underserved areas of Indianapolis characterize the various parts of the concept of health; how they understand and …

Cannabis Use In Cape York Indigenous Communities: High Prevalence, Mental Health Impacts And The Desire To Quit, India Bohanna, Alan R. Clough

Aboriginal Policy Research Consortium International (APRCi)

Anecdotal reports suggest that high rates of cannabis use and dependence are significant issues in Indigenous communities in north Queensland; however, there is little scientific evidence to support or refute this.The Cape York Cannabis Project seeks to investigate cannabis use rates, cannabis dependence and mental health impacts for the first time in three Cape York Indigenous communities.

Change-Point Analysis Of Paired Allele-Specific Copy Number Variation Data, Yinglei Lai

GW Biostatistics Center

The recent genome-wide allele-specific copy number variation data enable us to explore two types of genomic information including chromosomal genotype variations as well as DNA copy number variations. For a cancer study, it is common to collect data for paired normal and tumor samples. Then, two types of paired data can be obtained to study a disease subject. However, there is a lack of methods for a simultaneous analysis of these four sequences of data. In this study, we propose a statistical framework based on the change-point analysis approach. The validity and usefulness of our proposed statistical framework are demonstrated …

Perceptions Of The Food Shopping Environment Are Associated With Greater Consumption Of Fruits And Vegetables, Jonathan L. Blitstein, Jeremy Snider, W. Douglas Evans

Prevention and Community Health Faculty Publications

Objective

The present study examined whether characteristics such as quality, selection and convenience are associated with dietary intake of fruits and vegetables independent of perceived costs in an inner-city, low-income population.

Design

Secondary analysis of baseline data from a social marketing intervention designed to change household dietary practices among parents of 3- to 7-year-old children.

Setting

A community sample drawn from six low-income, primarily minority neighbourhoods in Chicago, IL, USA.

Subjects From the parent study, 526 respondents completed the baseline survey and were eligible for inclusion. Of this number, 495 provided complete data on sociodemographic characteristics, fruit and vegetable consumption, …

Characteristics Of Children With Type 1 Diabetes And Persistent Suboptimal Glycemic Control., Hyuntae Kim, Angelo Elmi, Celia L. Henderson, Fran R. Cogen, Paul B. Kaplowitz

Epidemiology Faculty Publications

Objective: This study aims to determine the relationship between the duration of persistent poor glycemic control in type 1 diabetes mellitus (T1DM) children and the likelihood of subsequent improvement.

Methods: A retrospective cohort study was conducted on T1DM patients aged 6-18 years, followed for at least six visits at Children’s National Medical Center (Washington, DC) with at least one hemoglobin A1c (HbA1c) ≥10% after the first year since the initial visit (n=151). Medical records of patients with subsequently improved glycemic control were reviewed (n=39).

Results: Patients aged 12-18 years, females, and Medicaid patients were twice as likely to be in …

Accelerometry Cut Points For Physical Activity In Underserved African Americans, Nevelyn N. Trumpeter, Hannah G. Lawman, Dawn K. Wilson, Russell R. Pate, M. Lee Van Horn, Alicia K. Tate

Faculty Publications

Background: Despite their increased use, no studies have examined the validity of Actical accelerometry cut points for moderate physical activity (PA) in underserved (low-income, high-crime), minority populations. The high rates of chronic disease and physical inactivity in these populations likely impact the measurement of PA. There is growing concern that traditionally defined cut points may be too high for older or inactive adults. The present study aimed to determine the self-selected pace associated with instructions to "walk for exercise" and the corresponding accelerometry estimates (e.g. Actical counts/minute) for underserved, African American adults.

Method: Fifty one participants (61% women) had a …

Treatment Outcomes Of A Tailored Smoking Cessation Programme For Individuals Accessing Addiction Treatment Services, Milan Khara, Chizimuzo T.C. Okoli

Nursing Presentations

Background: Individuals with substance use disorders (SUD) have disproportionately higher smoking prevalence and tobacco-related mortality than the general population. This high prevalence of smoking warrants a need for targeted tobacco treatment efforts.

Objectives: To examine smoking cessation outcomes and predictors of successful smoking cessation among individuals with SUD accessing a tobacco dependence clinic (TDC) within Addiction Services.

Methods: Based on clinical guidelines, participants of the TDC received behavioural therapy combined with tailored pharmacotherapy for tobacco treatment (at no cost). A retrospective chart review from 678 participants enrolled in the TDC between Sept 2007 and Dec 2011 was analyzed. 7-day point-prevalence …

Exploring The Barriers And Opportunities For Building Social Support Among Burundians And Americans: Dayton, Oh, Colleen Quinlan Saxen

Master of Public Health Program Student Publications

No abstract provided.

Commencement Program 2012, Loma Linda University

Commencement Programs

CONTENTS

1 | Message from the President

3 | 2012 Events of Commencement

5 | The Academic Procession

7 | Significance of Academic Regalia

9 The Good Samaritan

10 | University History Highlights

12 | Loma Linda University Song - "Healing Love"

13 | The Speakers

24 | The University Honorees

36 | The School Honorees

54 | The Program

• School of Medicine, 55
• School of Pharmacy, 72
• School of Dentistry, 79
• School of Science and Technology/School of Behavioral Health and School of Religion, 97
• School of Nursing, 109
• School of Allied Health Professions - Physical Therapy, 117
• School of …

Enhancing Male Hpv Vaccine Acceptance: The Role Of Altruism And Awareness Of Male Specific Health Benefits, Katherine Bonafide

Psychology - Theses

While considerable research exists on female HPV vaccine acceptance, research is needed to clarify factors that facilitate vaccine uptake among boys and men. The benefits of male HPV vaccination exist on an individual and community level. Male HPV vaccination provides personal health protection to recipients, and can provide female health protection by minimizing transmission of HPV to sexual partners. As such, male vaccine acceptance may be enhanced by emphasizing both altruistic motives (female health protection) and personal health benefits. A sample of college-age men (N = 200; M age = 19.3; 31% Non-White) completed computer-administered surveys and were presented with …

Global Health Justice: A Perspective From The Global South On A Framework Convention On Global Health, Lawrence O. Gostin, Ames Dhai

Georgetown Law Faculty Publications and Other Works

A global coalition of civil society and academics recently launched the Joint Action and Learning Initiative on National and Global Responsibilities for Health (JALI), which is developing a post-Millennium Development Goal (MDG) framework for global health. JALI’s mission is the achievement of a global health treaty based on the right to health—a Framework Convention on Global Health (FCGH). The FCGH proposes establishing fair terms of international co-operation, with agreed-upon mutually binding obligations to create enduring health system capacities, meet basic survival needs, and reduce unconscionable inequalities in global health. States that bear a disproportionate burden of disease have the least …

The Association Of Diet With Affect, Patricia Ann Ford

Loma Linda University Electronic Theses, Dissertations & Projects

Nutrients such as omega-3 fatty acids have been associated with mental health yet few studies have examined whether foods protective or deleterious for cardiovascular disease affect mood. The purpose of this study was to examine associations between consumption of foods typical of Mediterranean and Western diets and fatty acids with positive and negative affect.

Adventist church attendees residing in North America completed a validated food frequency questionnaire in 2002-6 as part of the Adventist Health Study-2. A subset of these participants ^=9,121) completed the Positive and Negative Affect Schedule (PANAS) in the Biopsychosocial Religion and Health Study conducted in 2006-7. …

The Effect Of Non-Exercise Activity Thermogenesis On Subjects With Metabolic Syndrome, Samer Hammoudeh

Loma Linda University Electronic Theses, Dissertations & Projects

Metabolic syndrome is a cluster of metabolic abnormalities that increases the risk of cardiovascular disease and type 2 diabetes. Several criteria establish the diagnosis of metabolic syndrome, including high waist circumference, low HDL cholesterol, high triglycerides and glucose and above normal blood pressure. The prevalence of metabolic syndrome is on the rise following the rise in obesity across the globe. Qatar, a country in the Arabian Peninsula shares the burden of obesity with recent studies showing prevalences of'---61% among women and —39% among men. These studies found that metabolic syndrome is more common among women. Physical activity helps reduce visceral …

Effects Of Photovoice On Youth Perceptions Of Healthy Food Access In The Built Environment, Sharlene A. Gozalians

Loma Linda University Electronic Theses, Dissertations & Projects

Background. Minority communities are at a higher risk for chronic diseases related to obesity because they lack access to stores that have affordable, fresh, nutritious foods that are necessary for a healthy diet. Photovoice can serve as a tool to engage youth in positive health behaviors and behavior change. Healthy food access has been analyzed based on nutrition, yet there is a lack of literature as to what factors enable and prevent access to healthy foods.

Methodology. The purpose of this study was to determine if a photovoice intervention would create a difference in perception of food access, empowerment …

Rickettsia Felis In Ctenocephalides Felis From Guatemala And Costa Rica, Adriana Troyo, Danilo Alvarez, Lizeth Taylor, Gabriela Abdalla, Olger Calderon-Arguedas, Maria L. Zambrano, Gregory A. Dasch, Kim A. Lindblade, Laya Hun, Marina Eremeeva, Alejandra Estevez

Environmental Health Sciences: Faculty Publications

Rickettsia felis is an emerging human pathogen associated primarily with the cat flea Ctenocephalides felis. In this study, we investigated the presence of Rickettsia felis in C. felis from Guatemala and Costa Rica. Ctenocephalides felis were collected directly from dogs and cats, and analyzed by polymerase chain reaction for Rickettsia-specific fragments of 17-kDa protein, OmpA, and citrate synthase genes. Rickettsia DNA was detected in 64% (55 of 86) and 58% (47 of 81) of flea pools in Guatemala and Costa Rica, respectively. Sequencing of gltA fragments identified R. felis genotype URRWXCal2 in samples from both countries, and genotype Rf2125 in …

Rethinking The “Pre” In Pre-Therapy Counseling: No Benefit Of Additional Visits Prior To Therapy On Adherence Or Viremia In Ugandans Initiating Arvs, Mark J. Siedner, Alexander J. Lankowski, Jessica E. Haberer, Annet Kembabazi, Nneka Emenyonu, Alexander C. Tsai, Conrad Muzoora, Elvin H. Geng, Jeffrey N. Martin, David Bangsberg

OHSU-PSU School of Public Health Faculty Publications and Presentations

Background: Many guidelines recommend adherence counseling prior to initiating antiretrovirals (ARVs), however the additional benefit of pre-therapy counseling visits on early adherence is not known. We sought to assess for a benefit of adherence counseling visits prior to ARV initiation versus adherence counseling during the early treatment period.

Methods: We performed a secondary analysis of data from a prospective cohort of HIV-infected patients in Mbarara, Uganda. Adults were enrolled upon initiation of ARVs. Our primary exposure of interest was ARV adherence counseling prior to initiating therapy (versus concurrent with initiation of therapy). Our outcomes of interest were: 1) average adherence …

High Acceptability For Cell Phone Text Messages To Improve Communication Of Laboratory Results With Hiv-Infected Patients In Rural Uganda: A Cross-Sectional Survey Study, Mark J. Siedner, Jessica E. Haberer, Mwebesa B. Bwana, Norma C. Ware, David Bangsberg

OHSU-PSU School of Public Health Faculty Publications and Presentations

Background: Patient-provider communication is a major challenge in resource-limited settings with large catchment areas. Though mobile phone usership increased 20-fold in Africa over the past decade, little is known about acceptability of, perceptions about disclosure and confidentiality, and preferences for cell phone communication of health information in the region.

Methods: We performed structured interviews of fifty patients at the Immune Suppression Syndrome clinic in Mbarara, Uganda to assess four domains of health-related communication: a) cell phone use practices and literacy, b) preferences for laboratory results communication, c) privacy and confidentiality, and d) acceptability of and preferences for text messaging to …

Mean Cd4 Cell Count Changes In Patients Failing A First-Line Antiretroviral Therapy In Resource-Limited Settings, Alexandra Calmy, Eric Balestre, Fabrice Bonnet, Andrew Boulle, Eduardo Sprinz, Robin Wood, Eric Delaporte, Eugène Messou, James Mcintyre, Kamal Marhoum El Filali, Mauro Schechter, N. Kumarasamy, David Bangsberg, Patrick Mcphail, Stefaan Van Der Borght, Carlos Zala, Matthias Egger, Rodolphe Thiébaut, François Dabis, Art-Linc Of Iedea Collaboration (Asia, South America, East, Southern And West Africa)

OHSU-PSU School of Public Health Faculty Publications and Presentations

Background: Changes in CD4 cell counts are poorly documented in individuals with low or moderate-level viremia while on antiretroviral treatment (ART) in resource-limited settings. We assessed the impact of on-going HIV-RNA replication on CD4 cell count slopes in patients treated with a first-line combination ART.

Method: Naïve patients on a first-line ART regimen with at least two measures of HIV-RNA available after ART initiation were included in the study. The relationships between mean CD4 cell count change and HIV-RNA at 6 and 12 months after ART initiation (M6 and M12) were assessed by linear mixed models adjusted for gender, age, …

Plagiarism Among Undergraduate Students In An Online Course, Patricia Pence

Faculty Publications - Mennonite College of Nursing

No abstract provided.