Public Health Commons^™

Estimating Effects By Combining Instrumental Variables With Case-Control Designs: The Role Of Principal Stratification, Russell T. Shinohara, Constantine E. Frangakis, Elizabeth Platz, Konstantinos Tsilidis

Johns Hopkins University, Dept. of Biostatistics Working Papers

The instrumental variable framework is commonly used in the estimation of causal effects from cohort samples. In the case of more efficient designs such as the case-control study, however, the combination of the instrumental variable and complex sampling designs requires new methodological consideration. As the prevalence of Mendelian randomization studies is increasing and the cost of genotyping and expression data can be high, the analysis of data gathered from more cost-effective sampling designs is of prime interest. We show that the standard instrumental variable analysis is not applicable to the case-control design and can lead to erroneous estimation and inference. …

Family Education For Psychosis, Amresh Srivastava

Data and Test Instruments

No abstract provided.

Using Primary Care To Bend The Curve: Estimating The Impact Of A Health Center Expansion On Health Care Costs, Leighton C. Ku, Patrick Richard, Avi Dor, Ellen Tan, Peter Shin, Sara J. Rosenbaum

Geiger Gibson/RCHN Community Health Foundation Research Collaborative

This research brief, the third in a series examining the link between national health reform proposals and community health centers, estimates the cost savings that would be realized by making important investments in non-profit health centers as an element of national health reform. Key findings include:

Increasing health center capacity by another 20 million patients by 2019 (to 39 million patients) under health reform can be expected to generate an additional $35.6 billion savings in 2019 and $212 billion in additional savings over the 2010-2019 ten-year time period.

Were the Medicaid prospective payment rate system to be applied to exchange …

Characteristics Of A Healthy Environment, Saima Khalid

Institute for Educational Development, Karachi

No abstract provided.

Workers Electrocuted While Working In Elevated Buckets, Kentucky Injury Prevention And Research Center

Kentucky Haz Alerts--Motor Vehicle

To prevent worker electrocutions while working near over-head power lines:

• Employers should implement and enforce a formal written electrical safety training program that includes work around overhead lines.
• An observer should be designated by the employer to perform an electrical hazard
• evaluation prior to commencing new work activities.
• A hazard assessment of the job site and route of travel, including aerial and ground hazards and obstacles, within the job site should be performed by a competent person before work commences.

Chinese Coal Mines--The Industrial Death Trap, Amber Mehmood

Department of Emergency Medicine

No abstract provided.

Quality Of Life Estimation With Structural Equation Modeling In School Aged Children With Asthma, Sheniz Moonie, Xuan Huang, David A. Sterling

Environmental & Global Health Faculty Research

Significant increases in childhood asthma prevalence and mortality has prompted federal and regulatory agencies to work towards a national framework to address childhood asthma. Quality of life is an important component of chronic disease, and the evaluation of healthcare outcomes. There is little discussion in the literature regarding the implications of QoL as a theoretical construct. This study determined the effect of asthma on the QoL of our study population and caregiver’s missed workdays on the child’s QoL scores. A negative relationship was found between the child’s QoL and the caregiver’s missed workdays due to their child’s asthma. The use …

Counting On Care Work: Human Infrastructure In Massachusetts, Randy Albelda, Mignon Duffy, Nancy Folbre

Center for Social Policy Publications

In Massachusetts, as in every other place in the world, all children need to be cared for and educated, everybody has physical and mental health needs that require attention, and some individuals need assistance with the daily tasks of life because of illness, age, or disability. The labor of meeting these needs – which we call care work – is a complex activity that has profound implications for personal, social and economic well-being. Care work is not just a cornerstone of our economy – it is a rock-bottom foundation. Care work provides the basis for our human infrastructure, and we …

Synthesis, Characterisation And Anti-Candida Activity Of Inorganic And Organic Derivatives Of 1,10-Phenanthroline, Ruth Cogan

Masters

This thesis reports results in three areas: (i) the synthesis, characterisation and biological activity of simple metal salts incorporating 1,10-phenanthroline (phen) and 1,10 phenanthroline- 5,6-dione (phendione) ligands, (ii) the synthesis, characterisation and biological activity of three different organic derivatives of phendione, and (iii) the synthesis or attempted synthesis, characterisation and biological activity of phendione-amino acid conjugates.

Impact Of Ambient Air Pollution On Survival Of Renal Transplant Recipients, Rhonda Kristine Hwang

Loma Linda University Electronic Theses, Dissertations & Projects

There is increasing evidence that ambient air pollution is associated with coronary heart disease morbidity and mortality. This research has focused on the general public and less so on possible sensitive subgroups even though these may have even greater susceptibility to adverse effects of ambient air pollution. With highly prevalent traditional as well as nontraditional risk factors, renal transplant recipients may potentially be a sensitive subgroup. The purpose of this study was to evaluate the possible effect of between long-term exposure to air pollution on the risk of CHD mortality among renal transplant recipients. This cohort study includes 32,239 adult, …

Development And Formative Implementation Of A Nutrition Assessment And Peer Education Program Based On Dietary Analysis At A California State University, Janay Jelso

Master's Theses

A healthy diet has been established as a key component contributing to an individual’s quality of life. Statistics show that the diet of Americans needs improvement (Guenther et al., 2007) indicating possible lack knowledge of what healthy eating behaviors are. There is an abundance of nutrition misinformation available to the consumer (American Dietetic Association, 2002a). Dietary interventions that provide credible education based on readiness to change behaviors and goal setting have been successful in increasing awareness of what healthy eating behaviors are and changing existing behaviors over time (Ammerman et al., 2002; Evans & Sawyer-Morse, 2002; Gambera et al., 1995; …

Senate Bill 42: Implementation And Impact On Physical Activity In Middle Schools, Cristina S. Barroso, Steven H. Kelder, Andrew E. Springer, Carolyn L. Smith, Nalini Ranjit, Christopher Ledingham, Deanna M. Hoelscher

Health & Human Performance Faculty Publications

Purpose

In 2005, the Texas State Legislature passed Senate Bill 42 (SB42), which required public middle school students (grades 6–8) to participate in 30 minutes of daily structured physical activity. The purpose of this study was to assess awareness of and adherence to SB42 in Texas middle schools, and to assess the impact of SB42 on the frequency and quality of structured physical activity.

Methods

Key informant (school principals, physical education [PE] instructors, nurses, or designated personnel) telephone interviews on the implementation of SB42 were conducted from a statewide representative sample of public middle schools (n = 112). Direct observation, …

Study Of The Four Factor Theory Of Women’S Sexual Function, Julie M. Merrell

Loma Linda University Electronic Theses, Dissertations & Projects

Tiefer, Hall, and Tavris (2002) described factors comprising four categories of female sexual function. They suggested that unique factors need to be examined to understand sexual function in women. Socio-cultural, political, or economic factors, partner and relationship factors, psychological factors, and medical factors were described as aspects of women’s lives that can be the source of sexual dysfunction. In a previous study, Merrell (2007) utilized Tiefer et al’s (2002) four factor model of sexual functioning to examine female sexual functioning looking specifically at body shame, relationship satisfaction, positive and negative affect, sexual self-schema, and overall health. Based on the results …

Patient/Physician Communication In Type 2 Diabetes-Related Health Behavior Change, Barbara Marie Thomas

Loma Linda University Electronic Theses, Dissertations & Projects

Adult type 2 diabetes is an increasing problem in the United States and affected over 16 million Americans in 2004. Most patients are treated in primary care settings and managed medically, but controlling insulin resistance through activity and diet is considered the greatest challenge for the next 30 years (Katen, et al., 2007). Understanding how physicians and patients communicate about health behaviors is necessary for developing the most effective strategies for facilitating health behavior change in this population. In the current study, adults with type 2 diabetes (n= 87) from the Loma Linda University Diabetes Treatment Center (LLUDTC), …

Coverage And Payment For Prescription Drugs Under Medicare Part B: A Complex Patchwork, Amanda Cassidy

National Health Policy Forum

As part of the diverse discussions around health care reform, many have looked to refining Medicare payment systems as a way to give health care practitioners and providers greater incentives to deliver care more efficiently, and thus slow health care spending growth. Understanding how Medicare currently pays for Part B services, including drugs covered under Part B, is essential to understanding the potential impact of these types of reforms. Most items and services covered under Part B, including most Part B drugs, are paid individually, which means practitioners and providers generally receive more payments for providing more services. Some reform …

Stimulus Bill Implementation: Expanding Meaningful Use Of Health It, Rob Cunningham

National Health Policy Forum

The American Recovery and Reinvestment Act authorizes an estimated $38 billion in incentives and supports for health information technology (IT) from 2009 to 2019. After years of sluggish health IT adoption, this crisis-driven investment of public funds creates a unique opportunity for rapid diffusion of a technology that is widely expected to improve care, save money, and facilitate transformation of the troubled U.S. health system. Achieving maximal effect from the stimulus funds is nevertheless a difficult challenge. The Recovery Act strengthens the federal government’s leadership role in promoting health IT. But successful adoption and utilization across the health system will …

Penilaian Kualitas Pelayanan Puskesmas Dengan Model Donabedian: Studi Kasus Puskesmas Di Kota Depok, Dian Ayubi

Kesmas

Perkembangan struktur sosio-demografi penduduk dan infrastruktur Kota Depok yang pesat berpengaruh terhadap masalah kesehatan yang semakin kompleks. Pada era desentralisasi, Dinas Kesehatan Pemerintah Kota Depok dituntut memberikan pelayanan kesehatan masyarakat yang berkualitas antara lain melalui pelayanan kesehatan tingkat primer di puskesmas. Penelitian ini bertujuan menganalisis mutu pelayanan puskesmas dan hubungan struktur dan proses terhadap hasil pelayanan puskesmas, kepuasan pelanggan. Survey di rumah responden dilakukan pada bulan Maret 2004, dalam wilayah kerja enam puskesmas kecamatan di Kota Depok. Populasi adalah semua penduduk yang bermukim di wilayah kerja Puskesmas Kecamatan se-Kota Depok. Sampel adalah 300 rumah tangga yang tersebar di setiap kelurahan …

Masyarakat Depok Memilih Fogging Yang Tidak Dimengerti, Tri Krianto

Kesmas

Sampai kini, demam berdarah dengue masih menjadi masalah kesehatan yang utama di Kota Depok. Hal tersebut terlihat pada jumlah kasus yang terus meningkat dan semua kelurahan sudah berkembang menjadi daerah endemis demam berdarah dengue yang dapat dicegah dengan mengendalikan vektor. Upaya pembersihan sarang nyamuk PSN 3M Plus adalah teknologi yang disarankan untuk mengendalikan kejadian demam berdarah dengue, tetapi belum mendapat dukungan pelaksanaan dari masyarakat. Studi ini bertujuan untuk menggali informasi tentang pengetahuan, sikap dan praktek masyarakat dalam pengendalian vektor demam berdarah dengue di Kota Depok. Hasil studi menunjukkan bahwa pengetahuan dan partisipasi masyarakat dalam pengendalian vektor DBD masih rendah, dan …

Pengaruh Kemiskinan Keluarga Pada Kejadian Pneumonia Balita Di Indonesia, Rizanda Machmud

Kesmas

Pneumonia merupakan penyakit infeksi saluran pernapasan akut yang menjadi kausa utama kematian balita. Di Indonesia, pada akhir tahun 2000, angka kematian balita akibat pneumonia diperkirakan 4,9/1000 balita. Faktor sosio-ekonomi berkontribusi besar terhadap penyakit saluran pernapasan. Tujuan penelitian ini adalah mengetahui faktor sosio-ekonomi yang paling berpengaruh terhadap pneumonia pada balita. Penelitian dengan dengan disain krosseksional ini menggunakan sumber data sekunder Benefit Evaluation Study (BES) II oleh Pusat Penelitian Kesehatan Universitas Indonesia bekerja sama dengan Proyek Intensifikasi Pemberantasan Penyakit Menular, Departemen Kesehatan. Sampel diambil berdasarkan multilevel statistical frameworkdari 7.170 ba-lita pada 10.900 rumah tangga di 27 kabupaten di tujuh provinsi. Metode analisis …

Makanan Etnik Minahasa Dan Kejadian Penyakit Jantung Koroner, Grace Debbie Kandou

Kesmas

Penyakit jantung koroner yang menjadi kausa utama kematian di seluruh dunia merupakan masalah kesehatan masyarakat yang penting di seluruh dunia, termasuk Indonesia dan Sulawesi Utara. Kebiasaan makan yang dipengaruhi oleh faktor budaya, adat istiadat, agama dan kepercayaan berperan penting dalam proses kejadian penyakit. Penelitian ini bertujuan mengetahui pengaruh kebiasaan makan etnik Minahasa terhadap kejadian penyakit jantung koroner. Penelitian di RSU Prof. Dr. R.D. Kandou ini menggunakan disain studi kasus kontrol dengan ukuran sampel 128 kasus dan 128 kontrol. Data frekuensi makan dikumpulkan dengan Food Frequency Quationnaire (FFQ). Makanan etnik Minahasa ditentukan berdasarkan 41 jenis makanan yang dikompositkan. Asam lemak jenuh …

The Development And Evaluation Of Low-Load Resistance Exercise With Blood Flow Restriction As A Countermeasure To Muscular Unloading, Summer B. Cook

Dissertations - ALL

Future space exploration must overcome both scientific and non-scientific obstacles. In accordance with the mission statement of the National Aeronautics Space Administration (NASA) (described in Chapter I), there were four major aims of these experiments. The first was to develop an exercise countermeasure to prevent muscle atrophy and weakness during simulated microgravity. The second and third aims were to determine the physiological adaptations in the knee extensor muscles and plantar flexor muscles following prolonged unloading in human subjects and to assess the effectiveness of the exercise countermeasure at preventing disuse atrophy. The final aim was to assess the relationship between …

Urogenital Abnormalities In Men Exposed To Diethylstilbestrol In Utero: A Cohort Study, Julie R. Palmer, Arthur L. Herbst, Kenneth L. Noller, Deborah A. Boggs, Rebecca Troisi, Linda Titus-Ernstoff, Elizabeth E. Hatch, Lauren A. Wise, William C. Strohsnitter, Robert N. Hoover

Dartmouth Scholarship

Background: Diethylstilbestrol (DES), a synthetic estrogen widely prescribed to pregnant women during the 1940s70s, has been shown to cause reproductive problems in the daughters. Studies of prenatally-exposed males have yielded conflicting results.

Methods: In data from a collaborative follow-up of three U.S. cohorts of DES-exposed sons, we examined the relation of prenatal DES exposure to occurrence of male urogenital abnormalities. Exposure status was determined through review of prenatal records. Mailed questionnaires (1994, 1997, 2001) asked about specified abnormalities of the urogenital tract. Risk ratios (RR) were estimated by Cox regression with constant time at risk and control for year of …

Modulations Of Cell Cycle Checkpoints During Hcv Associated Disease, Anwar Ali Siddiqui, Saira Sarfraz, Wasim Jafri, Saeed Hamid, Syed Ali

Department of Biological & Biomedical Sciences

Background

Impaired proliferation of hepatocytes has been reported in chronic Hepatitis C virus infection. Considering the fundamental role played by cell cycle proteins in controlling cell proliferation, altered regulation of these proteins could significantly contribute to HCV disease progression and subsequent hepatocellular carcinoma (HCC). This study aimed to identify the alterations in cell cycle genes expression with respect to early and advanced disease of chronic HCV infection.

Methods

Using freshly frozen liver biopsies, mRNA levels of 84 cell cycle genes in pooled RNA samples from patients with early or advanced fibrosis of chronic HCV infection were studied. To associate mRNA …

Health Center Data Warehouses: Opportunities And Challenges For Quality Improvement, A. Seiji Hayashi, Emily Jones, David M. Stevens, Peter Shin, Brad Finnegan, Sara J. Rosenbaum

Geiger Gibson/RCHN Community Health Foundation Research Collaborative

This Policy Research Brief reports on a pilot effort to leverage the growing presence of health center data warehouses to advance health care quality improvement through data sharing and exchange. This project builds on a partnership between the Michigan Primary Care Association and The George Washington University's Geiger Gibson/RCHN Community Health Foundation Research Collaborative that centers on developing approaches to using existing health center data for quality improvement.

Survival Of Shigella Flexneri In Swimming Pool Water, Monique Gomez, Helen J. Wing

Undergraduate Research Opportunities Program (UROP)

Shigellosis is a disease caused by the pathogenic bacterium Shigella flexneri. The bacterium causes bloody diarrheadiarrhea, fever and abdominal pain. Infections can be and may cause fatal. . The disease may also cause bloody diarrhea and intense intestinal crampings. In the United States, there have been many outbreaks of shigellosis have been traced back to associated with inadequately disinfectedchlorinated public swimming pools and wading pools. These outbreaks of sShigellosis are most commonly seen among small children who play in these pools. . My goal is to determine how well Shigella survives in freshly chlorinated pool water and in pool water …

Birth Weight As A Risk Factor For Breast Cancer: A Meta-Analysis Of 18 Epidemiologic Studies, Xiaohui Xu, Amy B. Dailey, Mary Peoples-Sheps, Evelyn O. Talbott, Ning Li, Jeffrey Roth

Health Sciences Faculty Publications

Background: Birth weight has been identified as a birth-related factor associated with the risk of breast cancer. However, the evidence is inconsistent.

Methods: To investigate the association between birth weight and breast cancer, we conducted a meta-analysis of published studies between 1996 and 2008. Eighteen studies encompassing 16,424 breast cancer cases were included in the meta-analysis. Data were combined using a fixed-effect or random-effect model depending on the heterogeneity across studies.

Results: Women with their own birth weight >4000 g or 8.5 lb had a higher risk for developing breast cancer than those with birth weight(OR¼1.20, 95% CI 1.08, 1.34). …

Sedentary Behavior And Obesity In A Large Cohort Of Children, Jonathan A. Mitchell, Calum Mattocks, Andy R. Ness, Sam D. Leary, Russell R. Pate, Marsha Dowda, Steven N. Blair, Chris Riddoch

Faculty Publications

The purpose of this study was to examine the association between sedentary behavior and obesity among 12-year-old children, while adjusting for moderate-to-vigorous physical activity (MVPA) and other potential confounding variables.

Cross-sectional analyses were carried out with data from 5434 children who participated in the Avon Longitudinal Study of Parents and Children (ALSPAC). Fat mass was derived using dual x-ray emission absorptiometry (DXA), and height and weight measurements were used to calculate body mass index (BMI; kg/m²). The children wore an accelerometer for seven days. The cut points for sedentary behavior and MVPA were ≤199 cpm and ≥3600 cpm, …

Solar Water Disinfection In Household Settings:Hype Or Hope?, Zulfiqar Ahmed Bhutta

Woman and Child Health

No abstract provided.

Is Chaalia/Pan Masala Harmful For Health? Practices And Knowledge Of Children Of Schools In Mahmoodabad And Chanesar Goth, Karachi, Sameena Shah, Riaz Qureshi, Iqbal Azam Syed

Department of Family Medicine

OBJECTIVE: To determine the practices and knowledge of harmful effects regarding use of Chaalia and Pan Masala in three schools of Mahmoodabad and Chanesar Goth, Jamshed Town, Karachi, Pakistan.

METHODS: To achieve the objective a cross-sectional design was used in three government schools of Mahmoodabad and Chanesar Goth, Jamshed Town, Karachi. Students of either gender drawn from these schools fulfilling the inclusion and exclusion criteria were interviewed using a pre-coded structured questionnaire. Along with demographic data, questions regarding frequency of Chaalia and Pan Masala use, practices of this habit in friends and family and place of procurement of these substances, …

Pandemic Flu Planning In Africa: Thoughts From A Nigerian Case Study, Cheryl Loeb, Lynn Mcgrath, Sudhir Devalia

Defense and Technology Papers

This paper discusses the Avian Influenza/Pandemic Influenza Policy Planning workshop held in Nigeria in June 2007, the objective of which was assisting selected Nigerian officials in evaluating their nation’s pandemic response plan.