Medicine and Health Commons^™

The Social Impact Of Diabetes, Denise Lujan

Natural Sciences Student Research Presentations

This poster describes the social impact of living with Type 1 and Type 2 diabetes.

Improving Function In Age-Related Macular Degeneration: Design And Methods Of A Randomized Clinical Trial., Barry W Rovner, Robin J Casten, Mark T Hegel, Robert W Massof, Benjamin E Leiby, William S Tasman

Department of Psychiatry and Human Behavior Faculty Papers

Age-Related Macular Degeneration (AMD) is the leading cause of severe vision loss in older adults and impairs the ability to read, drive, and live independently and increases the risk for depression, falls, and earlier mortality. Although new medical treatments have improved AMD's prognosis, vision-related disability remains a major public health problem. Improving Function in AMD (IF-AMD) is a two-group randomized, parallel design, controlled clinical trial that compares the efficacy of Problem-Solving Therapy (PST) with Supportive Therapy (ST) (an attention control treatment) to improve vision function in 240 patients with AMD. PST and ST therapists deliver 6 one-hour respective treatment sessions …

Universal Or Indicated Screening In Primary Care?, Matthew Wintersteen, Md

Department of Psychiatry and Human Behavior Faculty Papers

To the Editor: In the November 2010 issue, Schmitt and colleagues (1) reported that the duration of visits increased when depression screening was conducted in primary care. This report is timely given recent recommendations for both adult and pediatric screening for depression in primary care. Schmitt and colleagues examined data representative of more than 641 million primary care visits in2005–2007 and found that when depression screening was documented in patients’ records, physicians’ time with patients increased significantly.

High-Risk Human Papillomavirus (Hpv) Screening And Detection In Normal, Healthy Patient Saliva Samples: A Pilot Cluster Randomized Study, Deirdre O. Turner, Shelley J. Williams-Cocks, Ryan Bullen, Jeremy Catmull, Jesse Falk, Daniel Martin, Jerom Mauer, Annabel E. Barber, Robert C. Wang, Shawn Gerstenberger, Karl Kingsley

Environmental & Global Health Faculty Research

Background: The human papillomaviruses (HPV) are a large family of non-enveloped DNA viruses, mainly associated with cervical cancers. Recent epidemiologic evidence has suggested that HPV may be an independent risk factor for oropharyngeal cancers. Evidence now suggests HPV may modulate the malignancy process in some tobacco- and alcohol-induced oropharynx tumors, but might also be the primary oncogenic factor for inducing carcinogenesis among some non-smokers. More evidence, however, is needed regarding oral HPV prevalence among healthy adults to estimate risk. The goal of this study was to perform an HPV screening of normal healthy adults to assess oral HPV prevalence.

Methods: …

Attachment-Based Family Therapy For Adolescents With Suicidal Ideation: A Randomized Controlled Trial., Guy S. Diamond, Matthew B. Wintersteen, Gregory K. Brown, Gary M. Diamond, Robert Gallop, Karni Shelef, Suzanne Levy

Department of Psychiatry and Human Behavior Faculty Papers

OBJECTIVE: To evaluate whether Attachment-Based Family Therapy (ABFT) is more effective than Enhanced Usual Care (EUC) for reducing suicidal ideation and depressive symptoms in adolescents. METHOD: This was a randomized controlled trial of suicidal adolescents between the ages of 12 and 17, identified in primary care and emergency departments. Of 341 adolescents screened, 66 (70% African American) entered the study for 3 months of treatment. Assessment occurred at baseline, 6 weeks, 12 weeks, and 24 weeks. ABFT consisted of individual and family meetings, and EUC consisted of a facilitated referral to other providers. All participants received weekly monitoring and access …

Assessing Abortion-Related Experiences And Needs In Four Districts Of Maharashtra And Rajasthan, 2006, Shireen J. Jejeebhoy, A.J. Francis Zavier, Shveta Kalyanwala

Poverty, Gender, and Youth

Recognizing the urgent need to enable rural women to acquire accessible and high-quality abortion services in India, a consortium of organizations—including the Population Council—has come together with the goal of increasing access to legal, safe, and comprehensive abortion services, including postabortion family planning, in the public health system, especially among the rural poor. One of its key activities was to develop a comprehensive and evidence-based abortion care model suitable for rural women. The aim of this report is to shed light on community-level perspectives about abortion services and probe the experiences of women who had undergone abortion, to better understand …

Communalism Predicts Prenatal Affect, Stress, And Physiology Better Than Ethnicity And Socioeconomic Status, Cleopatra M. Abdou, Christine Dunkel Schetter, Belinda Campos, Clayton J. Hilmert, Tyan Parker Dominguez, Calvin J. Hobel, Laura M. Glynn, Curt A. Sandman

Psychology Faculty Articles and Research

The authors examined the relevance of communalism, operationalized as a cultural orientation emphasizing interdependence, to maternal prenatal emotional health and physiology and distinguished its effects from those of ethnicity and childhood and adult socioeconomic status (SES). African American and European American women (N = 297) were recruited early in pregnancy and followed through 32 weeks gestation using interviews and medical chart review. Overall, African American women and women of lower socioeconomic backgrounds had higher levels of negative affect, stress, and blood pressure, but these ethnic and socioeconomic disparities were not observed among women higher in communalism. Hierarchical multivariate regression analyses …

Children's Health Insurance Program: The Dynamics Of Federalism And Health Care Policy, Erik White

Political Science Theses and Capstones

On February 4^th, 2009, President Obama signed into law the reauthorization of the Children Health Insurance Program. The federal government will now spend 30 billion dollars towards the goal of ensuring that more children in the United States are insured. I investigate this particular health care policy and look at the different dynamics that affect the ultimate goal of universal health insurance for children. Because this program allows for state flexibility under broad federal guidelines, one is able to look at individual states, and their particular actions and characteristics, to determine the best approach to insuring the most …

Sexual And Reproductive Health Needs Of Adolescents Perinatally Infected With Hiv In Uganda, Harriet Birungi, John Frank Mugisha, Juliana K. Nyombi, Francis Obare, Humphres Evelia, Hannington Nyinkavu

Reproductive Health

In Uganda, HIV/AIDS treatment, care and support programs are still organized around either adult or pediatric care and fail to adequately address the needs of adolescents, specifically perinatally-infected adolescents. This study, implemented jointly by the Population Council's Frontiers in Reproductive Health (FRONTIERS) program and the AIDS Support Organization (TASO), aimed to better understand the reproductive health and sexuality of this population group, and to identify anxieties or fears they have around entering social stages of adulthood. This study confirms that wide programmatic gaps exist in addressing the sexual and reproductive health needs of young people perinatally infected with HIV who …

Off-Label Psychopharmacologic Prescribing For Children: History Supports Close Clinical Monitoring., Julie M Zito, Albert T Derivan, Christopher J Kratochvil, Daniel J Safer, Joerg M Fegert, Laurence L Greenhill

Department of Psychiatry and Human Behavior Faculty Papers

The review presents pediatric adverse drug events from a historical perspective and focuses on selected safety issues associated with off-label use of medications for the psychiatric treatment of youth. Clinical monitoring procedures for major psychotropic drug classes are reviewed. Prior studies suggest that systematic treatment monitoring is warranted so as to both minimize risk of unexpected adverse events and exposures to ineffective treatments. Clinical trials to establish the efficacy and safety of drugs currently being used off-label in the pediatric population are needed. In the meantime, clinicians should consider the existing evidence-base for these drugs and institute close clinical monitoring.

Care Patterns And Outcomes For Hospitalized Patients With Diabetes In Nevada, Jay J. Shen

Nevada Journal of Public Health

This study demonstrates substantial differences between Nevada and the national average in patterns of hospital based care in patients with type 2 diabetes. Diabetic patients in Nevada are more likely to be hospitalized through the emergency department, and more likely to be admitted for a condition related to diabetes. Moreover, in Nevada, Medicaid and uninsured patients with diabetes are more likely to experience adverse outcomes then their privately insured counterparts. These differences may be primarily reflective of variances in access to ambulatory care, care seeking behavior, and availability of health services and facilities. Policies promoting expansion of health care benefits …

The Status Of Childhood Lead Poisoning And Prevention In Nevada, Usa, Anne Rothweiler, Elena E. Cabb, Shawn Gerstenberger

Environmental & Global Health Faculty Research

One of the first steps in addressing the problem of childhood lead poisoning is to identify the possible sources of exposure in specific communities and target high-risk populations with appropriate interventions. Due to several factors, such as lack of funding and lack of blood lead reporting, little information exists regarding the occurrence of childhood lead poisoning and the prevalence of potential exposure sources in the state of Nevada. Following the recent establishment of a Nevada-based Lead Poisoning Program, we compiled the most current information available on Nevadans, and use this knowledge to suggest future research objectives and outreach activities for …

Episiotomy And Obstetric Trauma In Nevada: Evidence From Linked Hospital Discharge And Birth Data, Gulzar H. Shah, Joseph A. Greenway, Wei Yang

Nevada Journal of Public Health

Based on the perception that episiotomy prevents obstetric trauma, the procedure is liberally performed in U.S. Hospitals. Using linked Nevada Birth Registry and Nevada Impatient Hospital Discharges (2000 to 2005), we applied descriptive analyses and logistic regression to examine the status of Nevada episiotomy practice and its impact on birth trauma for mothers. Of 106,461 vaginal live births, 26,383 (24.8%) episiotomies were conducted. Obstetric trauma rate declined from 5.2% of vaginal deliveries in 2000 to 4.4% in 2005. After statistically controlling for the effect of other risk factors, zero parity, episiotomy, other instrument assisted deliveries, non-MDs as birth attendants, rural …

Hydroxyurea And Sickle Cell Anemia: Effect On Quality Of Life, Samir K. Ballas, Franca B. Barton, Myron A. Waclawiw, Paul Swerdlow, James R. Eckman, Charles H. Pegelow, Mabel Koshy, Bruce A. Barton, Duane R. Bonds

Wayne State University Associated BioMed Central Scholarship

Abstract

Background

The Multicenter Study of Hydroxyurea (HU) in Sickle Cell Anemia (MSH) previously showed that daily oral HU reduces painful sickle cell (SS) crises by 50% in patients with moderate to severe disease. The morbidity associated with this disease is known to have serious negative impact on the overall quality of life(QOL) of affected individuals.

Methods

The data in this report were collected from the 299 patients enrolled in the MSH. Health quality of llife (HQOL) measures were assessed in the MSH as a secondary endpoint to determine if the clinical benefit of HU could translate into a measurable …

Testing The Effectiveness Of Integrating Community-Based Approaches For Encouraging Abandonment Of Female Genital Cutting Into Care's Reproductive Health Programs In Ethiopia And Kenya, Jane Chege, Ian Askew, Susan Igras, Jacinta Muteshi-Strachan

Reproductive Health

CARE International, with technical support from the Frontiers in Reproductive Health Program completed a study in Ethiopia and Kenya designed to test the effectiveness of education activities using behavior change communication (BCC) approaches and advocacy activities by religious and other key leaders to abandon female genital cutting (FGC). In Ethiopia, the increased knowledge of harmful FGC effects and human rights issues translated to a positive attitude in support of FGC abandonment and an intention not to cut their daughters in the future. In Kenya, the analysis indicated mixed results in attitude and intended behavior change.

An Analysis Of The Changing Forces Behind Health Insurance Coverage Of Homebirth, Christina Anne Gasbarro

Dissertations and Theses

The expansion of managed care, which is premised on containing costs while maintaining market share, represents a radical transformation of the U.S. health care system. A central question for medical sociologists is to determine how the changes brought by managed care influence health insurance and health care options. In evaluating the impacts of managed care, obstetrics is a particularly important site of study. Part of this agenda involves gathering baseline data on a specific transformation in obstetrics practice new to the managed care scene: the emergence of health insurance coverage for the option of home birth. The research project detailed …

Cardiac Rehabilitation: Gender Differences In Factors Influencing Participation, Lani Lieberman, Marta Meana, Donna E. Stewart

Psychology Faculty Research

This study investigates gender differences in the barriers and incentives that are most influential in the coronary patient's decision to participate in cardiac rehabilitation (CRPs) and suggests strategies to counter these barriers. Patient surveys were administered to consecutive English-speaking attenders and referred nonattenders to a cardiac rehabilitation center at a university healthcare system in Toronto, Canada. A survey questionnaire, constructed from a literature review and advice from key informants, examined potential factors affecting decisions to engage in CRPs. One129 attenders at a CRP and 61 referred nonattenders completed the questionnaire. Physician recommendation was reported to be the most important factor …

Virginity And Celibacy As Health Issues, Mary Guinan

School of Public Health Faculty Research

Sexual behavior is both a health issue and a moral issue. Hence public education on sexuality has traditionally come from two main sources, those individuals or groups concerned with health and those concerned with morals. In his book No Magic Bullet (Oxford University Press, 1985), Allan Brandt describes the tensions that developed between these groups over the control of sexually transmitted diseases in the United States early in this century. Both groups wanted to control sexual behavior, but for different reasons. Public health personnel wanted to change sexual behavior in order to control infection and disease, while moralists believed that …

Pms Or Perifollicular Phase Euphoria?, Mary Guinan

School of Public Health Faculty Research

Why is it that so little is known about PMS? First of all, there is no agreement on what PMS is. If investigators are referring to different sets of symptoms, how can studies be comparable? In fact, they are not. Not only are the symptoms different, but the timing of symptoms is different, Some studies describe symptoms that occur 7 to 10 days before the onset of menses, while others include symptoms that begin 14 days before the onset of menses and continue for 7 days after onset. This definition suggests that women may have PMS-related symptoms during 21 days …

Ua68/10/1 Sociological Symposium No. 8 – Childbirth & Infancy Life Cycle Series, Wku Sociology

WKU Administration Documents

Table of Contents:

• Hernandez, Pedro F. Catholic Church & Birth Control in Latin America
• Kovit, Leonard. Labor is Hard Work: Notes on the Social Organization of Childbirth
• McNurlen, Lewis J. Childbirth: A Family Affair
• Miller, Rita Seiden & Ron Miller. Social Values Supporting Pregnancy: Dilemma for Population Control
• Newman, John F. & William L. Graves. Neo-Natal Mortality & Socio-Economic Status
• Newman, Lucille F. The Anthropology of Birth
• Rutzen, S. Robert. Urban Life & Breast Feeding: A Sociological Analysis
• Schulz, Barbara & Richard Schulz. Family Size Preferences & Sex Composition
• Steinhoff, Patricia G., Roy G. Smith & Milton Diamond. Characteristics & …