Epidemiology Commons^™

Detecting, Preventing, And Treating Sexually Transmitted Diseases Among Adolescent Arrestees: An Unmet Public Health Need, Christopher Salvatore, Steven Belenko, Richard Dembo, Matthew Rollie, Kristina Childs

Christopher Salvatore

Studies of detained and incarcerated adolescent offenders in the United States indicate that these juveniles have an elevated risk of sexually transmitted diseases (STDs). However, many more arrestees enter the “front end” of the juvenile justice system that is detained or incarcerated, and research into the STD risk profiles and service needs of this larger group is lacking. An expansion of STD testing (including of asymptomatic youths), prevention, and treatment is needed, as is improved knowledge about gender- and race-specific services. A pilot program in Florida has shown that juvenile justice and public health systems can collaborate to implement STD …

Understanding Maternity Care Coordination For Women Veterans Using An Integrated Care Model Approach, Kristin M. Mattocks, Aimee Kroll-Desrosiers, Rebecca L. Kinney, Sara Singer

Kristin M. Mattocks

BACKGROUND: An increasing number of women veterans are using VA maternity benefits for their pregnancies. However, because the VA does not offer obstetrical care, women must seek maternity care from non-VA providers. The growing number of women using non-VA care has increased the importance of understanding how this care is integrated with ongoing VA medical and mental health services and how perceptions of care integration impact healthcare utilization. Therefore, we sought to understand these relationships among a sample of postpartum veterans utilizing VA maternity benefits.

METHODS: We fielded a modified version of the Patient Perceptions of Integrated Care survey among …

The Use Of Vital Statistics Data For Research Of Consequence: Birth Outcomes And Population Health In A Rural Region, Claudia Kozinetz, Shimin Zheng, Eunice Mogusu

Shimin Zheng

Objective: The Affordable Care Act (ACA) has influenced increasing interests in population health and population health outcomes. The purpose of this study was to exemplify the importance of using existing vital statistics data for understanding and monitoring health outcomes and consequentially health disparities at the population level. Data from birth records for two geographic regions from 2009-2014 were compared; low birth weight (LBW) and preterm delivery (PD) were used as surrogates for population health outcomes. Methods: A population-based, multi-year, cross-sectional study design using a pooled dataset of birth records from Tennessee (TN) was the framework for the analyses. A sub-population …

Ideas For A Healthy Baby--Reducing Disparities In Use Of Publicly Reported Quality Data: Study Protocol For A Randomized Controlled Trial, Sarah L. Goff, Penelope S. Pekow, Katharine O. White, Tara Lagu, Kathleen M. Mazor, Peter K. Lindenauer

Sarah L. Goff MD

BACKGROUND: Publicly reported performance on quality measures is intended to enable patients to make more informed choices. Despite the growing availability of these reports, patients' use remains limited and disparities exist. Low health literacy and numeracy are two barriers that may contribute to these disparities. Patient navigators have helped patients overcome barriers such as these in other areas, such as cancer care and may prove useful for overcoming barriers to using publicly reported quality data. METHODS/DESIGN: The goals of this study are: to determine the efficacy of a patient navigator intervention to assist low-income pregnant women in the use of …

Ideas For A Healthy Baby--Reducing Disparities In Use Of Publicly Reported Quality Data: Study Protocol For A Randomized Controlled Trial, Sarah L. Goff, Penelope S. Pekow, Katharine O. White, Tara Lagu, Kathleen M. Mazor, Peter K. Lindenauer

Peter Lindenauer MD

BACKGROUND: Publicly reported performance on quality measures is intended to enable patients to make more informed choices. Despite the growing availability of these reports, patients' use remains limited and disparities exist. Low health literacy and numeracy are two barriers that may contribute to these disparities. Patient navigators have helped patients overcome barriers such as these in other areas, such as cancer care and may prove useful for overcoming barriers to using publicly reported quality data. METHODS/DESIGN: The goals of this study are: to determine the efficacy of a patient navigator intervention to assist low-income pregnant women in the use of …

Relative Roles Of Medical Interventions And Infrastructure In An Urban Community’S Infant Mortality Rate: 100 Years Of Infant Mortality In The City Of Worcester, Maya Y. Mauch, B. Dale Magee

B. Dale Magee

Background: The infant mortality rate (IMR), defined as the number of deaths in children under 1 year of age per 1000 live births, is regarded as a sensitive measure of population health (Blaxter). This reflects the overlap between those societal factors that impact infant mortality and those that affect the health of the larger community, such as SES, nutrition, living conditions, education, employment and access to health care. In 2003, Reidpath et al showed a strong linear relation between IMR and the disability adjusted life expectancy (DALE), a more comprehensive measure of population health. They concluded that either the IMR …

Why Are There Delays In Seeking Treatment For Childhood Diarrhoea In India?, Nisha Malhotra

Nisha Malhotra

Abstract Aim To examine the barriers and facilitating factors for seeking treatment for childhood diarrhoea and to determine the main causes for delay in seeking treatment.

Methods Data from Indian Demographic and Health survey 2005–06 (NFHS-III) was used. Mothers were asked if their children (<5-years) had suffered from diarrhoea during the two weeks preceding the survey. Data were collected on the time of seeking treatment after start of the illness, and days waited to seek treatment after the diarrhoea started. Multivariate logistic regression analysis was performed to find the determinants of seeking treatment at the health facility and the factors responsible for the “delay” in seeking advice/treatment.

Results Out of a sample of 41,287 children, 3890 (9.4%) reportedly had diarrhoea. Sixty percent of children with diarrhoea were taken to a health facility. Mother's education till higher secondary and above (OR 1.65; 95% CI, 1.08 – 2.54), richest (OR 1.76; 95% CI, 1.24 – 2.48) wealth index, mother's lack of knowledge of oral …

Mortalidade Materna No Paraná: O Que Mostra A Produção Científica Nos Últimos 10 Anos? / Maternal Mortality In Paraná: Showing The Scientific Production In The Last 10 Years?, Everton Fernando Alves, Thais Abigail Vidoto

Everton Fernando Alves

A mortalidade materna atrai inúmeras discussões e preocupações no Paraná visto que reflete a qualidade da assistência prestada nos serviços de saúde, bem como a operacionalização das políticas públicas voltadas à saúde da mulher. O objetivo deste trabalho foi conhecer o perfil epidemiológico da mortalidade materna no Estado do Paraná, por meio de revisão de estudos sobre o tema. Trata-se de uma revisão sistemática da literatura, realizada através da busca eletrônica de artigos científicos publicados entre 2000 e 2010, nas bases de dados LILACS e SciELO. Identificaram-se inicialmente 30 artigos. Após aplicação dos critérios de inclusão e exclusão restaram 09 …

Acculturation And Gestational Weight Gain In A Predominantly Puerto Rican Population, Alison Tovar, Lisa Chasan-Taber, Odilia I. Bermudez, Raymond R. Hyatt, Aviva Must

Lisa Chasan-Taber

Background Identifying risk factors that affect excess weight gain during pregnancy is critical, especially among women who are at a higher risk for obesity. The goal of this study was to determine if acculturation, a possible risk factor, was associated with gestational weight gain in a predominantly Puerto Rican population. Methods We utilized data from Proyecto Buena Salud, a prospective cohort study of Hispanic women in Western Massachusetts, United States. Height, weight and gestational age were abstracted from medical records among participants with full-term pregnancies (n=952). Gestational weight gain was calculated as the difference between delivery and prepregnancy weight. Acculturation …

Acculturation And Gestational Weight Gain In A Predominantly Puerto Rican Population, Alison Tovar, Lisa Chasan-Taber, Odilia I. Bermudez, Raymond R. Hyatt, Aviva Must

Alison Tovar

Background Identifying risk factors that affect excess weight gain during pregnancy is critical, especially among women who are at a higher risk for obesity. The goal of this study was to determine if acculturation, a possible risk factor, was associated with gestational weight gain in a predominantly Puerto Rican population. Methods We utilized data from Proyecto Buena Salud, a prospective cohort study of Hispanic women in Western Massachusetts, United States. Height, weight and gestational age were abstracted from medical records among participants with full-term pregnancies (n=952). Gestational weight gain was calculated as the difference between delivery and prepregnancy weight. Acculturation …

Postpartum Screening For Diabetes Among Women With A History Of Gestational Diabetes Mellitus, Lisa Chasan-Taber, A Tovar, E Eggleston, E Oken

Lisa Chasan-Taber

Introduction To make recommendations for future clinical, public health, and research practices for women with abnormal glucose tolerance during pregnancy, we reviewed the latest evidence regarding rates of postpartum diabetes screening and types of screening tests. Methods We searched PubMed for journal articles published from January 2008 through December 2010 that reported on postpartum screening and studies designed to prevent progression to type 2 diabetes among women with gestational diabetes mellitus (GDM). Two authors independently reviewed titles and abstracts from 265 articles. Results From 34% to 73% of women with GDM completed postpartum glucose screening. Predictors of higher screening rates …

Feasibility And Efficacy Of A Physical Activity Intervention Among Pregnant Women: The Behaviors Affecting Baby And You (B.A.B.Y.) Study, Lisa Chasan-Taber, Marushka Silveira, Bess H. Marcus, Barry Braun, Edward Stanek, Glenn Markenson

Lisa Chasan-Taber

Background: Physical activity during pregnancy is associated with reduced risk of adverse maternal and fetal outcomes. However, the majority of pregnant women are inactive and interventions designed to increase exercise during pregnancy are sparse. We evaluated the feasibility and preliminary efficacy of an exercise intervention among a diverse sample of pregnant women. Methods: The B.A.B.Y. (Behaviors Affecting Baby and You) Study is conducted at a large tertiary care facility in Western Massachusetts. We randomized 110 prenatal care patients (60% Hispanic) to an individually tailored 12-week exercise intervention arm (n = 58) or to a health and wellness control arm (n …

Smoking During Pregnancy And Risk Of Abnormal Glucose Tolerance: A Prospective Hohort Study, Lisa Chasan-Taber, Amy E. Haskins, Elizabeth R. Bertone-Johnson, Penelope Pekow, Elena Carbone, Renée T. Fortner

Lisa Chasan-Taber

Background Disturbances in glucose metabolism during pregnancy are associated with negative sequalae for both mother and infant. The association between smoking and abnormal glucose tolerance (AGT) remains controversial. Therefore, the aim of this study was to examine the relationship between smoking prior to and during pregnancy and risk of AGT. Methods We utilized data from a prospective cohort of 1,006 Hispanic (predominantly Puerto Rican) prenatal care patients in Western Massachusetts. Women reported pre- and early pregnancy smoking at recruitment (mean = 15 weeks) and mid pregnancy smoking at a second interview (mean = 28 weeks). AGT was defined as > 135 …

Smoking During Pregnancy And Risk Of Abnormal Glucose Tolerance: A Prospective Cohort Study, Amy E. Haskins, Elizabeth R. Bertone-Johnson, Penelope Pekow, Elana Carbone, Renée T. Fortner, Lisa Chasan-Taber

Lisa Chasan-Taber

Background Disturbances in glucose metabolism during pregnancy are associated with negative sequalae for both mother and infant. The association between smoking and abnormal glucose tolerance (AGT) remains controversial. Therefore, the aim of this study was to examine the relationship between smoking prior to and during pregnancy and risk of AGT. Methods We utilized data from a prospective cohort of 1,006 Hispanic (predominantly Puerto Rican) prenatal care patients in Western Massachusetts. Women reported pre- and early pregnancy smoking at recruitment (mean = 15 weeks) and mid pregnancy smoking at a second interview (mean = 28 weeks). AGT was defined as > 135 …

Strategies For Recruiting Hispanic Women Into A Prospective Cohort Study Of Modifiable Risk Factors For Gestational Diabetes Mellitus, Lisa Chasan-Taber, Renee T. Fortner, Valerie Hastings, Glenn Markenson

Lisa Chasan-Taber

Background The purpose of this article was to describe effective strategies for recruitment of Hispanic women into a prospective cohort study of modifiable risk factors for gestational diabetes mellitus (GDM). Although Hispanic women have two to four times the risk of developing GDM compared with non-Hispanic white women, few GDM prevention studies have included Hispanic women. Methods The study was conducted in the ambulatory obstetrical practices of Baystate Medical Center located in a socioeconomically and ethnically diverse city in Massachusetts. The study employed a range of strategies to recruit Hispanic women based on a review of the literature as well …

Strategies For Recruiting Hispanic Women Into A Prospective Cohort Study Of Modifiable Risk Factors For Gestational Diabetes Mellitus, Lisa Chasan-Taber, Renée T. Fortner, Valerie Hastings, Glenn Markenson

Lisa Chasan-Taber

Background The purpose of this article was to describe effective strategies for recruitment of Hispanic women into a prospective cohort study of modifiable risk factors for gestational diabetes mellitus (GDM). Although Hispanic women have two to four times the risk of developing GDM compared with non-Hispanic white women, few GDM prevention studies have included Hispanic women. Methods The study was conducted in the ambulatory obstetrical practices of Baystate Medical Center located in a socioeconomically and ethnically diverse city in Massachusetts. The study employed a range of strategies to recruit Hispanic women based on a review of the literature as well …

Anomalia Anorretal: Relato De Caso Clínico / Anorectal Malformations: A Case Report, Everton Fernando Alves, Jucélia Lins Dos Santos Oliveira, Maria Do Rosário Martins

Everton Fernando Alves

A Anomalia Anorretal é uma importante causa de obstrução gastrintestinal, com alta taxa de morbi-mortalidade em recém-natos. Há diversos mecanismos patológicos possíveis para explicar esta malformação e duas explicações clássicas de sua gênese são um defeito de recanalização do tubo intestinalou uma interrupção no suprimento sanguíneo durante a vida intra-uterina, entretanto a causa ainda é desconhecida. Desta forma, o presenteestudo tem por objetivo descrever um caso clínico de uma criança internada em um Hospital do Município de Maringá-PR, portadora de uma anomalia anorretal (Ânus imper-furado). Para este estudo, foram coletados dados do prontuário da criança, exame físico e uma entrevista …

Perfil Das Gestantes Adolescentes Na Assistência Ao Pré-Natal Na Clínica Materno Infantil Em Sarandi-Pr / Profile Of Pregnant Teens In Prenatal Care On Maternal And Child Clinic In Sarandi-Pr, Everton Fernando Alves, Adriana De Sant'ana Gasquez, Sandra Marisa Pelloso

Everton Fernando Alves

Este artigo tem como objetivo conhecer o perfil das gestantes adolescentes em consulta de enfermagem, ao primeiro atendimento da assistência ao Pré-natal na Clínica Materno Infantil em Sarandi – PR. Realizou-se um estudo descritivo no período de 23/09/2003 a 21/06/20004, avaliando o perfil das gestantes adolescentes através da investigação e análise de fichas perinatais dos prontuários de gestantes. Observamos a prevalência de evasão escolar entre as adolescentes que encontravam-se grávidas, além de iniciam o pré-natal mais cedo em relação as multíparas. Entretanto há uma preocupação em relação a idade gestacional de início do pré-natal pois podem haver fatores de risco …