Environmental Public Health Commons^™

Subjects With Discordant Airways Obstruction: Lost Between Spirometric Definitions Of Copd, Bernd Lamprecht, Lea Schirnhofer, Bernhard Kaiser, Sonia A. Buist, David Mannino, Michael Studnicka

Preventive Medicine and Environmental Health Faculty Publications

Background. Since the FEV1/FVC ratio declines with age, using the fixed ratio of 0.70 leads to overdiagnosis of COPD in older populations and underdiagnosis among young adults. Objective. To evaluate whether discordant obstructive cases (FEV1/FVC < 0.70 but ≥LLN) are a healthy population or have clinical features that would place them at increased risk. Methods. We used post-bronchodilator spirometry data from the population-based Austrian Burden of Obstructive Lung Disease (BOLD) study. Those with post-bronchodilator FEV1/FVC ratio

Public Health Systems And Services Research: Bridging The Practice-Research Gap., F. Douglas Scutchfield, Cynthia D. Lamberth

Preventive Medicine and Environmental Health Faculty Publications

Public health practitioners understand the principles of evidence-based practice

and the science that should drive their efforts to improve the community’s

health through the implementation of science-driven public health programs.

However, the translation of research to practice still has numerous barriers.

This commentary provides suggestions to strengthen the link between research

and practice.

Recent Trends In Exposure To Secondhand Smoke In The United States Population, Chieh-I Chen, Tanya Burton, Christine L. Baker, Vera Mastey, David Mannino

Preventive Medicine and Environmental Health Faculty Publications

BACKGROUND: Previous research using the National Health and Nutrition Examination Surveys (NHANES) data documented a significant downward trend in secondhand smoke (SHS) exposure between 1988 and 2002. The objective of this study was to assess whether the downward trend in exposure continued from 2001 through 2006.

METHODS: We analyzed data from the 2001-2006 NHANES to estimate exposure of nonsmokers to SHS. Geometric means of serum cotinine levels for all nonsmokers were computed.

RESULTS: Overall serum cotinine levels (95% Confidence Intervals) in 2001-2002, 2003-2004, and 2005-2006 were 0.06 ng/mL (0.05-0.07), 0.07 ng/mL (0.06-0.09), and 0.05 ng/mL (0.05-0.06), respectively. Subgroup analysis by …

Bridging The Care Continuum: Patient Information Needs For Specialist Referrals., Carol L. Ireson, Svetla Slavova, Carol L. Steltenkamp, F. Douglas Scutchfield

Preventive Medicine and Environmental Health Faculty Publications

BACKGROUND: Information transfer is critical in the primary care to specialist referral process and has been examined extensively in the US and other countries, yet there has been little attention to the patient's perspective of the information transfer process. This cross-sectional study examined the quality of the information received by patients with a chronic condition from the referring and specialist physician in the specialist referral process and the relationship of the quality of information received to trust in the physicians.

METHODS: Structured telephone interviews were conducted with a random sample of 250 patients who had experienced a referral to a …

Public Health Systems And Services Research: Dataset Development, Dissemination, And Use, F. Douglas Scutchfield, Nikki Lawhorn, Rick Ingram, Debra Joy Pérez, Rick Brewer, Michelyn Bhandari

Preventive Medicine and Environmental Health Faculty Publications

Public health systems and services research (PHSSR) is defined as "a field of study that examines the organization, financing, and delivery of public health services within communities and the impact of those services." PHSSR is a relatively young field and suffers from a paucity of research resources. In this article, we describe the development and utility of a data resource, housed on the Health Services and Sciences Research Resources website maintained by the National Library of Medicine, which provides easy access to instruments, indices, and datasets that are relevant to PHSSR researchers. We also investigate efforts to promote the use …

Gender Specific Differences In The Pros And Cons Of Smoking Among Current Smokers In Eastern Kentucky: Implications For Future Smoking Cessation Interventions, Dana A. Hazen, David M. Mannino, Richard Clayton

Preventive Medicine and Environmental Health Faculty Publications

This study investigated gender differences in the perceived “pros” and “cons” of smoking using the constructs of decisional balance (DB) and stage of change from the Transtheoretical Model. The population distribution for stage of change among a population-based, cross-sectional survey of 155 current smokers over 40 years was: precontemplation (22.6%), contemplation (41.9%), preparation (35.5%). Results of stepwise regression models indicated significant gender differences in DB were in the preparation stage of change; scores on the DB measure increased 3.94 points (95% CI: 1.94, 5.93) for male smokers. Interventions targeting the “pros” and “cons” of smoking may need to be gender …

The Kentucky Plan Revisited: Lessons Learned From An Innovative Doctoral Education Program., Joel M. Lee, F. Douglas Scutchfield, Raymond Hill

Preventive Medicine and Environmental Health Faculty Publications

In the first doctoral education special issue of the Journal of Health Administration Education, the authors presented the University of Kentucky College of Public Health's plans for an innovative new Doctor of Public Health (Dr. P.H.) degree. The degree as designed, prepares graduates for professional practice, and included extensive supervised field experience as part of the academic training linking theory with practice. Based upon the interest that the Kentucky Dr.P.H. degree program received, the authors will share the experience of the degree's initial years of operation through a "lessons learned" paper. As the program evolved there have been many lessons …

Content And Criterion Validity Evaluation Of National Public Health Performance Standards Measurement Instruments., Joyce Beaulieu, F. Douglas Scutchfield, Ann V. Kelly

Preventive Medicine and Environmental Health Faculty Publications

OBJECTIVE: The Centers for Disease Control and Prevention's National Public Health Performance Standards Program (NPHPSP) has developed instruments to measure the performance of local and state public health departments on the 10 "Essential Services of Public Health," which have been tested in several states. This article is a report of the evaluation of the content and criterion validity of the local public health performance assessment instrument, and the content validity of the state public health performance assessment instrument.

METHODS: Health department performance is measured using a set of indicators developed for the 10 Essential Services of Public Health and a …

Assessment Of Validity Of The National Public Health Performance Standards: The Local Public Health Performance Assessment Instrument., Joyce Beaulieu, F. Douglas Scutchfield

Preventive Medicine and Environmental Health Faculty Publications

The National Public Health Performance Standards Program (NPHPSP) has developed performance standards measurement instruments, based on the 10 "Essential Services of Public Health" that are being tested in several states. This article is a report on the face and content validity of the instrument designed for local public health systems. Judgments about the face validity of the standards were obtained in a survey of local public health systems that had used the instrument in a test state. The validity of each standard was addressed along the following dimensions: the importance of the standard as a measure of the Essential Service; …

The Kentucky Plan: An Innovative Approach To Professional Doctoral Education In Public Health., Joel M. Lee, F. Douglas Scutchfield

Preventive Medicine and Environmental Health Faculty Publications

The Doctor of Public Health (Dr.P.H.) degree is designed to prepare graduates for the highest levels of leadership in public health related careers in both public and private settings. The Kentucky School of Public Health has developed an innovative generalist professional degree program offering an extensive battery of courses based on the body of professional public health knowledge. The degree includes extensive supervised field experience as part of the academic training, linking theory with practice. Issues related to professional degrees, curriculum, accreditation and certification, admission, evaluation, plans for institutional cooperation, and demand are addressed.

Chronic Arsenic Exposure And Risk Of Infant Mortality In Two Areas Of Chile, Claudia Hopenhayn-Rich, Steven R. Browning, Irva Hertz-Picciotto, Catterina Ferreccio, Cecilia Peralta, Herman Gibb

Preventive Medicine and Environmental Health Faculty Publications

Chronic arsenic exposure has been associated with a range of neurologic, vascular, dermatologic, and carcinogenic effects. However, limited research has been directed at the association of arsenic exposure and human reproductive health outcomes. The principal aim of this study was to investigate the trends in infant mortality between two geographic locations in Chile: Antofagasta, which has a well-documented history of arsenic exposure from naturally contaminated water, and Valparaíso, a comparable low-exposure city. The arsenic concentration in Antofagasta's public drinking water supply rose substantially in 1958 with the introduction of a new water source, and remained elevated until 1970. We used …

The Hidden Work Of The Farm Homemaker, Deborah B. Reed, Susan C. Westneat, Steven R. Browning, Lana Skarke

Preventive Medicine and Environmental Health Faculty Publications

Despite women’s involvement in agricultural production, the work role of women residing in farm households has not been thoroughly examined. Data collected in 1994-1995 as part of the NIOSH-sponsored Farm Family Health and Hazard Surveillance Project were used to address task issues and health status of farm women in Kentucky. In 1996, the farm woman component of the Kentucky study was replicated in five counties in west Texas, allowing an examination of farm women in two large agricultural states. The Kentucky study employed a two-stage cluster design;the Texas study was based on a systematic quota sample of farms. Both studies …

Farm Tractor Safety In Kentucky, 1995, Steven R. Browning, Susan C. Westneat, Helena Truszczynska, Deborah Reed, Robert Mcknight

Preventive Medicine and Environmental Health Faculty Publications

Objective: Tractor rollovers are a major cause of farm injuries and fatalities. The authors used data from a statewide surveillance study to estimate the prevalence of safety features such as rollover protective structures, seat belts, and power take-off shields on farm tractors in Kentucky.

Methods: Using data from the Farm Family Health and Hazard Surveillance Project, the authors report on the prevalence of farm tractor safety features by size of farm, by region of the state, by number of tractors per farm, and by tractor age and estimate the prevalence of tractors equipped with rollover protection by region and for …

Triazine Herbicide Exposure And Breast Cancer Incidence: An Ecologic Study Of Kentucky Counties, Michele A. Kettles, Steven R. Browning, Timothy Scott Prince, Sanford W. Horstman

Preventive Medicine and Environmental Health Faculty Publications

The incidence of breast cancer in the United States has steadily increased for the past three decades. Exposure to excess estrogen, in both natural and synthetic forms, has been implicated as a risk factor for the development of this disease. Considerable interest has been focused on organochlorines, such as the triazine herbicides, and their possible role in the initiation or promotion of human breast cancer. To explore this relationship, an ecologic study of Kentucky counties was designed. Exposure to triazines was estimated by use of water contamination data, corn crop production, and pesticide use data. A summary index of triazine …

Use Of Rollover Protective Structures -- Iowa, Kentucky, New York, And Ohio, 1992-1997, Craig Zwerling, Leon Burmeister, S. Reynolds, Robert H. Mcknight, Steven R. Browning, Deborah Reed, John Wilkins Iii, T. Bean, L. Mitchell, Eric Hallman, John J. May, A. Stark

Preventive Medicine and Environmental Health Faculty Publications

Agriculture has one of the highest occupational fatality rates of all industries in the United States (1). Tractors and other types of agricultural equipment account for a large proportion of these fatalities, and farm-tractor rollovers account for approximately 130 work-related deaths each year in the United States (2). Although rollover protective structures (ROPS) are effective in protecting tractor operators from fatal injuries during rollovers (3-5), most tractors in the United States are not equipped with ROPS (4-7). Beginning in 1985, tractor manufacturers in the United Sates agreed to sell only tractors with ROPS; however, many older tractors without ROPS remain …