Public Health Commons^™

Associations Between The Quality Of The Residential Built Environment And Pregnancy Outcomes Among Women In North Carolina, Marie Lynn Miranda, Lynne C. Messer, Gretchen L. Kroeger

Community Health Faculty Publications and Presentations

Background: The built environment, a key component of environmental health, may be an important contributor to health disparities, particularly for reproductive health outcomes.Objective: In this study we investigated the relationship between seven indices of residential built environment quality and adverse reproductive outcomes for the City of Durham, North Carolina (USA).

Methods: We surveyed approximately 17,000 residential tax parcels in central Durham, assessing > 50 individual variables on each. These data, collected using direct observation, were combined with tax assessor, public safety, and U.S. Census data to construct seven indices representing impor­tant domains of the residential built environment: housing damage, property disorder, …

Does Access To A Family Physician Matter For Adolescents?, Bridget L. Ryan, Moira Stewart, M. Karen Campbell, John J. Koval, Amardeep Thind

CRDCN Research Highlight/RCCDR en évidence

No abstract provided.

Post-Acute Care Payment Reform Demonstration: Final Report Volume 4 Of 4, Barbara Gage, Melvin Ingber, Laura Smith, Anne Deutsch, Tracy Kline, Jill Dever, Judith Abbate, Richard Miller, Brieanne Lyda-Mcdonald, Cynthia Kelleher, Danielle Garfinkel, Joshua Manning, Christopher M. Murtaugh, Margaret Stineman, Trudy Mallinson

Clinical Research and Leadership Faculty Publications

This is the Final Report for the Post-Acute Care Payment Reform Demonstration (PAC-PRD), authorized by section 5008 of the Deficit Reduction Act of 2005, Public Law 109-171. The report has 12 sections, which are divided into four volumes: Volume 1: Executive Summary. Volume 2: Sections 1-4 (Section 1: Introduction; Section 2: Underlying Issues of the PAC-PRD Initiating Legislation; Section 3: Developing Standardized Measurement Approaches: The Continuity Assessment Record and Evaluation (CARE); Section 4: Demonstration Methods and Data Collection) Volume 3: Sections 5-6 (Section 5: Framework for Analysis; Section 6: Factors Associated with Hospital Discharge Destination) Volume 4: Sections 7-12; References …

Post-Acute Care Payment Reform Demonstration: Final Report Volume 3 Of 4, Barbara Gage, Melissa Morley, Laura Smith, Melvin Ingber, Anne Deutsch, Tracy Kline, Jill Dever, Richard Miller, Brieanne Lyda-Mcdonald, Cynthia Mckeller, Danielle Garfinkel, Joshua Manning, Christopher M. Murtaugh, Margaret Stineman, Trudy Mallinson

Clinical Research and Leadership Faculty Publications

This is the Final Report for the Post-Acute Care Payment Reform Demonstration (PAC-PRD), authorized by section 5008 of the Deficit Reduction Act of 2005, Public Law 109-171. The report has 12 sections, which are divided into four volumes: Volume 1: Executive Summary. Volume 2: Sections 1-4 (Section 1: Introduction; Section 2: Underlying Issues of the PAC-PRD Initiating Legislation; Section 3: Developing Standardized Measurement Approaches: The Continuity Assessment Record and Evaluation (CARE); Section 4: Demonstration Methods and Data Collection) Volume 3: Sections 5-6 (Section 5: Framework for Analysis; Section 6: Factors Associated with Hospital Discharge Destination) Volume 4: Sections 7-12; References …

Post-Acute Care Payment Reform Demonstration: Final Report Volume 1 Of 4, Barbara Gage, Melissa Morley, Laura Smith, Melvin Ingber, Anne Deutsch, Tracy Kline, Jill Dever, Judith Abbate, Richard Miller, Brieanne Lyda-Mcdonald, Cynthia Kelleher, Danielle Garfinkel, Joshua Manning, Christopher M. Murtaugh, Margaret Stineman, Trudy Mallinson

Clinical Research and Leadership Faculty Publications

This is the Final Report for the Post-Acute Care Payment Reform Demonstration (PAC-PRD), authorized by section 5008 of the Deficit Reduction Act of 2005, Public Law 109-171. The report has 12 sections, which are divided into four volumes: Volume 1: Executive Summary. Volume 2: Sections 1-4 (Section 1: Introduction; Section 2: Underlying Issues of the PAC-PRD Initiating Legislation; Section 3: Developing Standardized Measurement Approaches: The Continuity Assessment Record and Evaluation (CARE); Section 4: Demonstration Methods and Data Collection) Volume 3: Sections 5-6 (Section 5: Framework for Analysis; Section 6: Factors Associated with Hospital Discharge Destination) Volume 4: Sections 7-12; References …

Benchmarking Us Department Of Veterans Affairs Dermatologic Services: Results From A National Survey, L. Kendall Krause, Leilani Townsend, Michael L. Orser, Jennifer Mulhausen, Jodi Duke, Weston T. Waxweiler, Robert P. Dellavalle

United States Public Health Resources

Background: How well Department of Veterans Affairs (VA) dermatology services provide clinical care, medical education, and innovative research is a largely unexplored topic in the literature.

Objective: We sought to benchmark VA dermatology services by surveying VA dermatologists about their environment, resources, and the pros and cons of working in the VA.

Methods: Printed surveys were mailed to VA dermatologists and responses were compiled and analyzed.

Results: Of 105 dermatology services surveyed, 48% returned surveys completed by board-certified dermatologists (n = 50); 20 surveys completed by nondermatologists were excluded from the analysis. Most services trained …

Does Secondary Inflammatory Breast Cancer Represent Post-Surgical Metastatic Disease?, Salman Hashmi, Ladan Zolfaghari, Paul H. Levine

Epidemiology Faculty Publications

The phenomenon of accelerated tumor growth following surgery has been observed repeatedly and merits further study. Inflammatory breast carcinoma (IBC) is widely recognized as an extremely aggressive malignancy characterized by micrometastasis at the time of diagnosis, with one interesting subgroup defined as secondary IBC where pathologically identifiable IBC appears after surgical treatment of a primary non-inflammatory breast cancer. One possible mechanism can be related to the stimulation of dormant micrometastasis through local angiogenesis occurring as part of posttraumatic healing. In this report, we review cases of secondary IBC and others where localized trauma was followed by the appearance of IBC …

Treating Methicillin-Resistant Staphylococcus Aureus With The Drug Vancomycin In A Home Infusion Therapy Setting, Joshua L. Webb, Alberto Coustasse, Dennis Emmett

Management Faculty Research

The basic purpose of this paper is to examine the effects the home infusion therapy has on the cost, duration of, and effectiveness of treatment between those individuals under 60 and those 60 and over. The results show that those 60 and over had a slightly higher cost/day. The older age group had slightly smaller treatment duration, then the younger group. The number of adverse effects was small. The results suggest that home infusion therapy appears to be a viable alternative to hospitalization.

Protecting Pakistan's Health During The Global Economic Crisis, Rashid Jooma, A Khan, A A. Khan

Section of Neurosurgery

The world is facing an unprecedented global economic crisis, with many countries needing to reconsider their level of health care spending. This paper explores the many consequences of the global economic turndown on Pakistan's health, including reduced government and donor spending and increased poverty with the consequent diversion of funds away from health. Nevertheless, these challenges may provide opportunities not only to mitigate the adverse effects of the economic crisis but also to institute some much-needed reforms that may not receive political support during more affluent times. Our suggestions focus on setting priorities based on the national disease burden, prioritizing …

Physical Activity Levels Of Adolescent Girls During Dance Classes, Jennifer R. O'Neill, Russell R. Pate, Michael W. Beets

Faculty Publications

Background: The aims of this study were to describe the physical activity levels of girls during dance classes and to identify factors associated with moderate-to-vigorous physical activity (MVPA) in those classes. Methods: Participants were 137 girls (11 to 18 years-old) enrolled in ballet, jazz, or tap dance classes from 11 dance studios. Participants wore an accelerometer during the selected dance class on 2 separate days. Factors hypothesized to be associated with MVPA were dance style, instructional level, instructor's experience, percent of class time spent in choreography, and participants' age, race/ethnicity, BMI-for-age percentile, and years of dance training. Data were analyzed …

Equity, Evidence & Ethics: Assessing The Implications Of Outdoor Smoke-Free Policies For Vulnerable Populations, Natasha Jategaonkar, Ann Pederson, Chizimuzo T.C. Okoli, Wendy Rice, Phoebe M. Long, Joan L. Bottorff, Natalie Hemsing, Lorraine Greaves

Nursing Presentations

Smoke-free policies in outdoor settings are becoming increasingly common. Economic and social conditions tend to influence tobacco use patterns as well as exposure to secondhand smoke. Thus, active and passive smoking are both health equity and social justice concerns.

Smoking on the Margins is a multi-component,mixed-methods project that applies an ethical framework to outdoor smoke-free policies in order to identify both concerns and opportunities to promote health and health equity.

Justification for smoke-free policies

Smoke-free spaces are primarily justified on the basis of three goals:

1) Reducing exposure to secondhand smoke;

2) Encouraging people to quit smoking; and

3) Preventing …

Outcomes Of A Tailored Smoking Cessation Program For Individuals With A Substance Use And/Or Psychiatric Disorder, Chizimuzo T.C. Okoli, Milan Khara

Nursing Presentations

BACKGROUND: Tobacco use remains a significant cause of morbidity and mortality globally. Although there has been a steady decline in the overall smoking prevalence in North America during the last decade some subsets of the population continue to smoke at high rates, particularly individuals with a history of substance use disorders (SUD) and/or psychiatric disorders (PD). Studies suggest that individuals with SUD’s and PD’s often have disproportionately higher smoking-related mortality. Studies further suggest that in clinical samples an estimated 75% of individuals with PD and up to 90% of individuals with PD concurrently smoke. This high prevalence of smoking among …

The Economic, Institutional, And Political Determinants Of Public Health Delivery System Structures, Richard C. Ingram, F. Douglas Scutchfield, Glen P. Mays, Michelyn W. Bhandari

Preventive Medicine and Environmental Health Faculty Publications

OBJECTIVES: A typology of local public health systems was recently introduced, and a large degree of structural transformation over time was discovered in the systems analyzed. We present a qualitative exploration of the factors that determine variation and change in the seven structural configurations that comprise the local public health delivery system typology.

METHODS: We applied a 10-item semistructured telephone interview protocol to representatives from the local health agency in two randomly selected systems from each configuration--one that had maintained configuration over time and one that had changed configuration over time. We assessed the interviews for patterns of variation between …

Examining Cancer-Related Pain And Study Enrollment Challenges In The Home Care Setting, Linda G. Alley Phd, Rn, Hannah D. Paxton Rn, Mph, Michelle D. Flores Bsn, Rn, Carol A. Foltz Phd, Jen Wike Mph, Mba, Vickie Cunningham Bsn, Rn, Jeffrey Etchason Md

Department of Community Health and Health Studies

No abstract provided.

The Significance Of Race For Neighborhood Social Cohesion: Perceived Difficulty Of Collective Action In Majority Black Neighborhoods, Tamara Leech, Tara Hobson-Prater

Department of Public Health Scholarship and Creative Works

This article explores William Julius Wilson's contentions about community cultural traits by examining racial differences in middle class neighborhoods' levels of social cohesion. Specifically, we explore the perceived difficulty of these actions-as opposed to general pessimism about their outcomes-as a potential explanation for low levels of instrumental collective action in Black middle class neighborhoods. Our results indicate that, regardless of other neighborhood factors, majority Black neighborhoods have low levels of social cohesion. We also find that this racial disparity is statistically explained by shared perceptions about the amount of effort required to engage in group action in different neighborhoods. These …

Health Status Of Children Entering Kindergarten: Results Of The 2011-2012 (Year Four) Nevada Kindergarten Health Survey, Nevada Institute For Children's Research And Policy Reports, Amanda Haboush, Tara Phebus, Brian Neau, Taylor Oliver, Enrique Lopez

Nevada Institute for Children's Research and Policy Reports

Academic achievement for children is vital to their success in life. Those that do well in school have greater opportunities for post-secondary education, and later have better prospects for employment. One of the major factors that can affect a child’s academic achievement is his or her health status. Academic outcomes and health conditions are consistently linked in the literature (Taras & Potts-Datema, 2005). Children with poor health status, and especially those with common chronic health conditions, have increased numbers of school absences and more academic deficiencies (Taras & Potts-Datema, 2005). In a study concerning excused versus unexcused absences, children with …

Factors Affecting Parents Misperception Of Overweight Or Obesity In Their Children, Carol Barnes Reid

Loma Linda University Electronic Theses, Dissertations & Projects

Background: Treating overweight children may be more difficult when parents themselves do not correctly recognize their child’s weight status (Camell, Edwards, Croker, Boniface, & Wardle, 2005 Boniface, & Wardle, 2005). While it is a commonly held belief in some cultures that overweight children are healthy, incorrectly assessing overweight in very young children results in unfavorable weight development throughout childhood (Kroje, Struthman, & Gunther, 2006). This is due to the increased likelihood that parents may not take the condition of obesity in their child as being serious, or they may fail to seek or accept professional help in correcting the problem …

Barriers And Perceptions Regarding Different Contraceptives And Family Planning Practices Amongst Men And Women Of Reproductive Age In Rural Pakistan: A Qualitative Study, Syed Khurram Azmat, Ghulam Mustafa, Waqas Hameed, Muhammad Ali, Aftab Ahmed, Mohsina Bilgrami

Community Health Sciences

Background: Pakistan ranks as one of the most poorest and most populous in the world with poor reproductive health indicators. This study helps in understanding barriers and perceptions regarding Family Planning (FP), modern contraception, quality of care and free of charge FP services amongst men and women in rural Pakistan.
Methods: Employing purposive sampling and Focus Group Discussion (FGD) technique, this qualitative study was conducted with men and women of reproductive age in Pakistan. A total of eight FGDs were conducted in Sindh and Punjab provinces. Being descriptive in nature, the study provided a thematic analysis of the relevant health …

Risk Factors For Depression Among Married Women Belonging To Higher And Lower Socioeconomic Status In Karachi, Pakistan, Saima Zainab, Zafar Fatmi, Ambreen Kazi

Community Health Sciences

OBJECTIVES: To determine the risk factors for depression among married women belonging to low and high socioeconomic status in Karachi.METHODS: The study design was cross-sectional. The data was collected from 128 adult married women during July to September 2005. The women were selected from different socioeconomic classes from five hospitals/institutes in Karachi. The Centre for Epidemiology Studies-Depression (CES-D) scale was used to screen the subjects for depression and a structured questionnaire was used to identify the factors for depression.RESULT: According to the CES-D scale, 65% of the study population was found to be depressed. Among the women from high socioeconomic …

Care Of The Dying Patient: A Neglected Issue In Pakistani Context, Waris Qidwai

Department of Family Medicine

No abstract provided.

Perceived Health In Lung Cancer Patients: The Role Of Positive And Negative Affect, Jameson K. Hirsch, Andrea R. Floyd, Paul R. Duberstein

ETSU Faculty Works

Purpose: To examine the association of affective experience and health-related quality of life in lung cancer patients, we hypothesized that negative affect would be positively, and positive affect would be negatively, associated with perceived health.

Methods: A sample of 133 English-speaking lung cancer patients (33% female; mean age = 63.68 years old, SD = 9.37) completed a battery of self-report surveys.

Results: Results of our secondary analysis indicate that trait negative affect was significantly associated with poor physical and social functioning, greater role limitations due to emotional problems, greater bodily pain, and poor general health. Positive affect was significantly associated …

Potential For False Positive Hiv Test Results With The Serial Rapid Hiv Testing Algorithm, Steven Baveewo, Moses R. Kamya, Harriet Mayanja-Kizza, Robin Fatch, David Bangsberg, Thomas J. Coates, Judith A. Hahn, Rhoda K. Wanyenze

OHSU-PSU School of Public Health Faculty Publications and Presentations

Background: Rapid HIV tests provide same-day results and are widely used in HIV testing programs in areas with limited personnel and laboratory infrastructure. The Uganda Ministry of Health currently recommends the serial rapid testing algorithm with Determine, STAT-PAK, and Uni-Gold for diagnosis of HIV infection. Using this algorithm, individuals who test positive on Determine, negative to STAT-PAK and positive to Uni-Gold are reported as HIV positive. We conducted further testing on this subgroup of samples using qualitative DNA PCR to assess the potential for false positive tests in this situation.

Results: Of the 3388 individuals who were tested, 984 were …

Sexual Behavior Of Hiv-Positive Adults Not Accessing Hiv Treatment In Mombasa, Kenya: Defining Their Prevention Needs, Avina Sarna, Stanley Luchters, Melissa Pickett, Matthew Chersich, Jerry Okal, Scott Geibel, Nzioki Kingola, Marleen Temmerman

Population Health, East Africa

Background: HIV spread continues at high rates from infected persons to their sexual partners. In 2009, an estimated 2.6 million new infections occurred globally. People living with HIV (PLHIV) receiving treatment are in contact with health workers and therefore exposed to prevention messages. By contrast, PLHIV not receiving ART often fall outside the ambit of prevention programs. There is little information on their sexual risk behaviors. This study in Mombasa Kenya therefore explored sexual behaviors of PLHIV not receiving any HIV treatment.

Results: Using modified targeted snowball sampling, 698 PLHIV were recruited through community health workers and HIV-positive …

School Racial Composition And Race/Ethnic Differences In Early Adulthood Health, Bridget J. Goosby, Katrina M. Walsemann

Faculty Publications

We investigate whether school racial composition is associated with racial and ethnic differences in early adult health. We then examine whether perceived discrimination, social connectedness, and parent support attenuates this relationship. Using U.S. data from Wave I and IV of the National Longitudinal Survey of Adolescent Health, we found that black adolescents attending predominantly white schools reported poorer adult health while Asians reported better health. Further research is warranted to understand whether there are qualitative differences in the treatment of racial and ethnic minorities within certain school contexts and how that differential treatment is related to adult health outcomes.

Heart Rate Variability And Exercise In Aging Women, Conrad P. Earnest, Steven N. Blair, Timothy S. Church

Faculty Publications

Background: Our group has shown a positive dose-response in maximal cardiorespiratory exercise capacity (VO_2max) and heart rate variability (HRV) to 6 months of exercise training but no improvement in VO_2max for women ≥60 years. Here, we examine the HRV response to exercise training in postmenopausal women younger and older than 60 years.

Methods: We examined 365 sedentary, overweight, hypertensive, postmenopausal women randomly assigned to sedentary control or exercise groups exercising at 50% (4 kcal/kg/week, [KKW]), 100% (8 KKW) and 150% (12 KKW) of the National Institute of Health (NIH) Consensus Development Panel physical activity guidelines. Primary outcomes …

Air Pollution And Acute Respiratory Response In A Panel Of Asthmatic Children Along The U.S.–Mexico Border, Stefanie E. Sarnat, Amit U. Raysoni, Wen-Whai Li, Fernando Holguin, Brent A. Johnson, Silvia Flores Luevano, Jose Humberto Garcia, Jeremy A. Sarnat

School of Earth, Environmental, & Marine Sciences Faculty Publications

Background: Concerns regarding the health impact of urban air pollution on asthmatic children are pronounced along the U.S.–Mexico border because of rapid population growth near busy border highways and roads.

Objectives: We conducted the first binational study of the impacts of air pollution on asthmatic children in Ciudad Juarez, Mexico, and El Paso, Texas, USA, and compared different exposure metrics to assess acute respiratory response.

Methods: We recruited 58 asthmatic children from two schools in Ciudad Juarez and two schools in El Paso. A marker of airway inflammation [exhaled nitric oxide (eNO)], respiratory symptom surveys, and pollutant measurements (indoor and …

Gifts Of The Heart… And Other Tissues: Legalizing The Sale Of Human Organs And Tissues, J. Randall Boyer

BYU Law Review

No abstract provided.

The Affordable Care Act Of 2010: A Brief Summary, Jim P. Stimpson

Reports: Center for Health Policy

In March 2010, the Patient Protection and Affordable Care Act (ACA, P.L. 111-148) as amended by the Health Care and Education Reconciliation Act of 2010 (HCERA, P.L. 111-152) (referred to hereafter as the ACA) was signed into law as the most comprehensive piece of legislation since the passage of Medicare and Medicaid legislation in 1965 aimed at creating sweeping health care reform. This brief provides a summary of the titles contained in the law, the implementation of the provisions, and the estimated financial impact.

Policy Analysis Of Impaired Driving Laws In Nebraska, Jim P. Stimpson, Kelly Shaw-Sutherland

Reports: Center for Health Policy

In Nebraska, motor vehicle crashes are the leading cause of injury death, and the second leading cause of injury-related hospitalization. More than a fourth of all motor vehicle deaths in Nebraska involved at least one alcohol-impaired driver. This brief provides a description of Nebraska alcohol-related statutes and regulations as of January 2011, and impaired driving policy recommendations based on the Nebraska Strategic Highway Safety Plan and recommendations of the Centers for Disease Control and Prevention.

Analysis Of National Health Policies Directed At Immigrants In The United States, Jim P. Stimpson

Reports: Center for Health Policy

This brief describes national policy efforts from 1986 to 2010 affecting access to health care for immigrants. An understanding of the policy actions that have affected immigrants’ access to health care will provide context for future policy discussions.