Public Health Commons^™

Residential Radon Exposure And Lung Cancer: Variation In Risk Estimates Using Alternative Exposure Scenarios, R. William Field, Brian J. Smith, Daniel J. Steck, Charles F. Lynch

Physics Faculty Publications

The most direct way to derive risk estimates for residential radon progeny exposure is through epidemiologic studies that examine the association between residential radon exposure and lung cancer. However, the National Research Council concluded that the inconsistency among prior residential radon case-control studies was largely a consequence of errors in radon dosimetry. This paper examines the impact of applying various epidemiologic dosimetry models for radon exposure assessment using a common data set from the Iowa Radon Lung Cancer Study (IRLCS). The IRLCS uniquely combined enhanced dosimetric techniques, individual mobility assessment, and expert histologic review to examine the relationship between cumulative …

Manténgase Fresco Cuando Tenga Calor!, Kentucky Injury Prevention And Research Center

Kentucky Haz Alerts--Other

No abstract provided.

Projected Smoking-Related Deaths Among U.S. Youth: A 2000 Update, Ellen J. Hahn, Mary Kay Rayens, Frank J. Chaloupka, Chizimuzo T.C. Okoli, Jun Yang

Nursing Reports

This paper projects the long term consequences of the rise in youth smoking in the 1990s by updating the state estimates for projected smoking-related deaths among youth in the U.S. using information from the Behavioral Risk Factor Surveillance System (BRFSS) 2000 and the U.S. Census 2000. This analysis is similar to that from an earlier study published by the Centers for Disease Control and Prevention (CDC), Office on Smoking and Health (MMWR, 45[44], November 8, 1996). The 1996 analysis used young adult smoking prevalence data from 1994 and 1995; whereas, the analysis presented here represents smoking prevalence data from 2000. …

Clinical, Pathological And Molecular Factors Predicting Axillary Node Involvement In Primary Breast Cancer In Pakistani Women, T. Siddiqui, A. Salam, S. Khan, N. Kayani, Shahid Pervez

Department of Pathology and Laboratory Medicine

Background:

Axillary lymph node involvement in primary breast cancer is one of its most important prognostic features. Thus any factors that may predict axillary lymph node involvement in this setting could be potentially helpful in treatment planning and other interventions.

Objective:

The objective of this study was to evaluate clinical, pathological and immuno-histochemical markers in univariate and multivariate analysis, which may be helpful predictors of axillary lymph node involvement in breast cancer.

Method:

A retrospective analysis of 555 cases. Of these 58% had axillary nodal positivity and 42% were negative.

Conclusion:

Factors of no significance included patient’s age, height, weight, …

Applying Managed Fee-For-Service Delivery Models To Improve Care For Dually Eligible Beneficiaries, Stuart Bratesman, Paul Saucier

Disability & Aging

No abstract provided.

Public Health Emergency Preparedness: Fundamentals Of The "System", Eileen Salinsky

National Health Policy Forum

This paper examines the existing public health infrastructure, with an emphasis on the resources and activities necessary for public health emergency preparedness and response. It provides a brief historical overview of the evolution of public health and contrasts public health interventions with medicine and health care services. The paper summarizes the broad range of activities that constitute public health practice today and provides a more detailed review of functions and services that are critical to emergency response capabilities. It explores the legal foundation for public health authorities, discussing constitutional, federal, and state public health law. The paper also summarizes how …

Child And Family Health Initiatives In The Bay Area, Jennifer Ryan, Wakina Scott

National Health Policy Forum

This site visit to the San Francisco Bay Area provided an opportunity to study locally based health initiatives in Santa Clara, Alameda, and San Francisco Counties that were designed to reach beyond the existing structures of the Medi-Cal and Healthy Families programs. Site visitors had the opportunity to interact with health care providers, state officials, and consumer advocates, as well as leaders in health coverage innovation. They also met with many of the leaders of the three local initiatives; visited Asian Health Services (AHS), a local clinic that has been serving the Asian community for over 25 years; and toured …

Dietary Exposures And Oral Precancerous Lesions In Srikakulam District, Andhra Pradesh, India, James R. Hébert, Prakash C. Gupta, Ramesh B. Bhonsle, Hemali Mehta, Wei Zheng, Maureen Sanderson, Jane Teas

Faculty Publications

Objective: To test the effect of dietary nutrients on oral precancerous lesions in a reverse-smoking (i.e. smoking with the glowing end inside the mouth) population in South India. Design: Case–control. Cases with precancerous lesions were matched to an equal number of lesion-free controls matched on age (^5 years), sex and village. All subjects used tobacco in some form. Dietary data were obtained using an intervieweradministered food-frequency questionnaire, designed for use in this population. All interviews were conducted blinded to the disease status of the subject. Data were analysed using logistic regression. Setting: Nineteen rural villages in Srikakulam District, Andhra Pradesh. …

Key Health Issues Facing Latinas, Dharma E. Cortés, Helen Cajigas, Odilia Bermúdez

Gastón Institute Publications

Acknowledging the relationship that exists among health outcomes, socioeconomic factors, and access to health care is key to understanding the health status of Latinas in Massachusetts. For example, poverty disproportionately affects Latinos in Massachusetts, and they have the lowest rate of health insurance in the Commonwealth despite the fact that Massachusetts has one of the most inclusive and comprehensive public health insurance programs in the nation. This situation impacts access to regular health care for Latinos and affects their overall health status. This fact sheet provides information on the following health areas of particular concern to Latinas: maternal and child …

A Study To Examine The Attitudes And Perceptions Of Saudi Women In The United States And Canada Toward Exercise And Physical Activity, Tawfeeq E. Al-Bakry

Human Movement Studies & Special Education Theses & Dissertations

This study is an examination of the knowledge and perceptions of Saudi women in the United States and Canada in regard to exercise and physical activity. No studies on exercise, physical activity or sport for women in Saudi Arabia were found in the literature.

This study focused on ascertaining knowledge of Saudi women regarding physical and psychological benefits of exercise and physical activity. Furthermore, this study investigated the barriers that limit Saudi women from participating in exercise and physical activity. The population for this study included Saudi women who are associated with Saudi clubs and student organizations in the United …

Production Of A Monoclonal Antibody Against Benzo[Α]Pyrene Diol Epoxide Dna Adducts, Brian Peden Austin

Chemistry & Biochemistry Theses & Dissertations

Benzo[α]pyrene is a ubiquitous pollutant produced from the incomplete combustion of organic material such as fossil fuels. It is found in the workplace, urban air, drinking water, and the food supply. Recently, it has been proposed that benzo[α]pyrene may be the causative agent in the formation of lung adenocarcinomas among some Taiwanese women exposed to cooking oil fumes without adequate ventilation. In this study, calf thymus DNA was modified in vitro with benzo[α]pyrene-diol epoxide (BPDE) to a level consistent with that found in biological samples. This DNA of low modification was used as an immunogen in the production of a …

Pharmacy Benefits: New Concepts In Plan Design, Veronica V. Goff

National Health Policy Forum

This issue brief examines changes to prescription drug benefit coverage in large-employer plans and implications for a Medicare prescription drug benefit. The brief discusses reasons behind employer benefit plan redesign and recent coverage trends, as well as potential paths to modernize benefits.

Transitions Along The Continuum Of Care: Elderly And Disabled Persons In New York, Lisa Sprague, Nora Super

National Health Policy Forum

This site visit examined transitions along the continuum of care for elderly and disabled persons in New York. The state offers its residents an extensive array of services, including nursing homes, home health care, personal care, and community-based services. New York spends more than any other state on its Medicaid program, which is reflected in a comprehensive benefit package, full-cost reimbursement of hospitals, high nursing home rates, and extensive coverage of personal care services. Site visitors were briefed on the history and development of long-term care in the state as well as the various care settings available. Panels discussed transitions …

Welfare Reform Reauthorization In 2002:What Are The Issues For Tribal Communities And Indian Families?, Kathleen A. Maloy

Health Policy and Management Issue Briefs

American Indian tribes have new options under the 1996 Welfare Reform legislation that created Temporary Assistance for Needy Families (TANF), a block grant enacted to replace the Aid to Families with Dependent Children (AFDC). TANF, which expires in September of this year, provides cash assistance to poor families with children, including poor American Indian Families, and gives tribes the option to design and administer their own family assistance programs following approval of the plan by the Department of Health and Human Services. As Congress considers TANF reauthorization, three new publications prepared for the Kaiser Family Foundation provide insight into the …

How Should Governments Address High Levels Of Natural Radiation And Radon--Lessons From The Chernobyl Nuclear Accident And Ramsar, Iran, S. M. Javad Mortazavi, M. Ghiassi-Nejad, Azam Niroomand-Rad, P. Andrew Karam, John R. Cameron

RISK: Health, Safety & Environment (1990-2002)

The authors discuss the high levels of natural background radiation in Ramsar, Iran, and offer data indicating that this has had little effect on the health of Ramsar's inhabitants. The authors then examine the implications their research could have for public health policy.

Bse: Risk, Uncertainty, And Policy Change, Enda Cummins, Pat Grace, Kevin Mcdonnell, Shane Ward

RISK: Health, Safety & Environment (1990-2002)

The authors discuss how, in our "risk society," a range of potential risks and uncertainties are associated with new technologies and new diseases, such as BSE. These risks bring with them worries about human health, while the ability to assess and manage new health scares is an essential skill for government and related industries.

The Precautionary Principle And Radiation Protection, Kenneth L. Mossman, Gary E. Marchant

RISK: Health, Safety & Environment (1990-2002)

The authors examine the application of the precautionary principle through a case study of ionizing radiation control and suggest a reevaluation of current radiation safety standards and practices.

Nutrition And Disability, Kathleen Humphries, Meg Traci, Tom Seekins Ph.D., Joyce Brusin, University Of Montana Rural Institute

Health and Wellness

A disability often can be complicated by additional medical, psychological, or environmental problems. Under an emerging framework of health promotion for persons with disabilities, these additional health problems are referred to as secondary conditions (Brandt & Pope, 1997; Marge, 1988; Pope & Tarlov, 1991). Until recently, it was common to conceptualize these ailments as symptomatic of the primary disability; however, it is now presumed that because these conditions can be prevented or managed, they are secondary conditions distinct from the primary disability. Although information on secondary conditions experienced by people with developmental disabilities is limited, the literature does contain descriptions …

A Description Of Female, Adult Recreational Drug Users: A Sub-Analysis Of The Drugnet Survey, Leslie Bickett

Masters Theses & Specialist Projects

Drug abuse can be a serious, chronic, and relapsing health problem for both men and women. Among women, however, drug use and abuse present an array of different challenges to health and well-being. In addition, the health of women has been given less attention than the health of men. Little research has been conducted to identify and describe the invisible or hidden population of drug users, not abusers, who are not in treatment or incarcerated on drugrelated charges. The purpose of this study is to provide a descriptive and behavioral profile of adult, female, recreational drug users (i.e., not abusers). …

Tribal Wisdom For Today’S World, H Sudarshan

IIMB Management Review

No abstract provided.

Measuring Health Status And Quality Of Life In Disease Management Programs, Dea Belazi

College of Population Health Faculty Papers

Current medical practice is largely disease and problem focused, concentrating on the diagnosis and treatment of anatomic or physiologic problems. This approach assumes that physiologic parameters accurately reflect the patient's status of health. It also assumes that, when a patient's disease is ameliorated, his or her quality of life will improve. Many health services researchers find these parameters to be imperfect determinates for good outcomes of patients' perceived health status. However, there are many valid and reliable methods to measure patients' health status and quality of life. Recently available survey tools that measure quality of life are based on modern …

Epidermal Growth Factor Receptor (Egfr) As A Prognostic Marker: An Immunohistochemical Study On 315 Consecutive Breast Carcinoma Patients, S. A. Aziz, Shahid Pervez, N. Kayani, M. H. Rahbar, S. Khan

Department of Pathology and Laboratory Medicine

Objective: To assess the independent and interdependent prognostic value of epidermal growth factor receptor (EGFR) in carcinoma of breast in female population. The Type I family of growth factor receptors includes epidermal growth factor receptor (EGFR also known as EGFRI).

Methods: The expression of EGFR protein was analysed immunohistochemically on 315 tumour specimens of infiltrating ductal carcinoma of breast. These patients also had axillary lymph nodes sampling.

Results: Overexpression and/or amplification of EGFR was observed in 70 (22.00%) tumours. Eleven (16%) were grade I, 43 (61%) grade II and 16 (23%) grade Ill tumours. Axillary lymph node metastasis had significant …

Comparing Bottled Water And Tap Water: Experiments In Risk Communication, Branden B. Johnson

RISK: Health, Safety & Environment (1990-2002)

The author discusses results of experiments in risk communication comparing bottled water and tap water.

Welfare Reform In Maryland: Flexibility In Action, Jennifer Ryan, Judith D. Moore

National Health Policy Forum

This site visit took federal participants on a tour around Maryland, providing a three-way comparison of suburban, urban, and rural service delivery in a diverse state. The site visit focused on the Family Investment Program, a statewide effort to reduce the state's welfare caseload through temporary cash assistance (TCA) and other needed supports to help customers become self-sufficient. In particular, site visitors examined rural perspectives on reform, substance abuse assessment and treatment innovations, and fatherhood and family support initiatives. The group heard from state officials, researchers, advocates, and a variety of direct service providers about the successes and challenges of …

Promoting Marriage As Welfare Policy: Looking At A Public Role In Private Lives, Jane Koppelman

National Health Policy Forum

This issue brief discusses the interest in and politics surrounding government's using welfare reform legislation to carve out a stronger role in promoting marriage. It examines trends in family formation, their impact on society, and the effect of single parenting, divorce, and stepparenting on child well-being. The paper also looks at the treatment of marriage in current government programs, new state activities to promote marriage, proposals for a stronger government role, and marriage experts' expectations for the success of marriage education programs.

Correlates Of Vigorous Physical Activity For Children In Grades 1 Through 12: Comparing Parent-Reported And Objectively Measured Physical Activity, James F. Sallis, Wendell C. Taylor, Marsha Dowda, Patty S. Freedson, Russell R. Pate

Faculty Publications

Correlates of physical activity were examined in young people in grades 1 through 12, and analyses were conducted separately for eight age/grade and sex subgroups. Twenty-one explanatory variables were assessed by parental report. Physical activity was assessed in 781 young people via parent report, and 200 wore an accelerometer for seven days. Between 11% and 36% of parent-reported child vigorous physical activity was explained. The most consistent correlates were peer support and use of afternoon time for active rather than sedentary recreation. Peer support was the only significant correlate of objectively monitored activity in multiple subgroups.

From Diagnosis To Payment: The Dynamics Of Coding Systems For Hospital, Physician, And Other Health Services, Karen Matherlee

National Health Policy Forum

This background paper reviews the two principal coding systems used to describe health services in the United States: ICD-9-CM and HCPCS, a combination of CPT-4 and national and local codes. It probes the relationships of these coding systems to payment policy, administrative simplification under HIPAA, and other concerns. The paper also addresses four coding issues: governance of CPT; adoption of ICD-10-CM; the appropriateness, accuracy, and responsiveness to change of the codes themselves; and the degree of documentation needed to monitor health services and determine payment.

Who Will Be There To Care? The Growing Gap Between Caregiver Supply And Demand, Nora Super

National Health Policy Forum

This paper examines the increasing demand for long-term care services and the concurrent decrease in the supply of paid and unpaid caregivers. It considers workforce trends for paraprofessionals, such as certified nursing assistants, home health aides, and personal care attendants, as well as several public and private efforts to address staff shortages and quality-of-care. The paper explores the sociodemographic factors that have affected the demand for and supply of informal care provided by family and friends. It also reviewes policy proposals designed to provide support for family caregivers and/or to give choices to consumers.

Diagnostic And Therapeutic Procedures Among Australian Hospital Patients Identified As Indigenous, Joan Cunningham

Aboriginal Policy Research Consortium International (APRCi)

Objectives: To determine whether hospital patients identified as Indigenous are less likely than other inpatients to have a principal procedure recorded, and the extent to which any disparity in procedure use can be explained by differences in patient, episode and hospital characteristics. Design: Retrospective analysis of routinely collected administrative data from the National Hospital Morbidity Database (NHMD). Setting: Australian public and private hospitals. Patients: All patients included in the NHMD whose episode type was recorded as acute and whose separation occurred between 1 July 1997 and 30 June 1998. Patients admitted for routine dialysis treatment were excluded. Main outcome measure: …

Managed Care: As Good As It Gets? (Los Angeles), Lisa Sprague

National Health Policy Forum

This site visit was a return trip to southern California to examine the state of managed care. Between the Forum's last visit (in late 1998) and this one, the marketplace underwent considerable change, including significant movement away from global capitation, the collapse of physician practice management firms, and the development of new insurance products. Site visitors were briefed on managed care trends in the state, and panel discussions focused on issues related to physician group solvency, employer and consumer expectations, managed care regulation, and plan and provider strategies for surviving and prospering in the difficult southern California market. Site visitors …