South Henderson, NC, United States
South Henderson, NC, United States

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Zhang X.,Centers for Disease Control and Prevention | Decker F.H.,National Center for Health Statistics | Luo H.,Mount Olive College | Geiss L.S.,Centers for Disease Control and Prevention | And 4 more authors.
Journal of the American Geriatrics Society | Year: 2010

OBJECTIVES: To estimate trends in the prevalence and comorbidities of diabetes mellitus (DM) in U.S. nursing homes from 1995 to 2004. DESIGN: SAS callable SUDAAN was used to adjust for the complex sample design and assess changes in prevalence of DM and comorbidities during the study period in the National Nursing Home Surveys. Trends were assessed using weighted least squares linear regression. Multiple logistic regressions were used to calculate predictive margins. SETTING: A continuing series of two-stage, cross-sectional probability national sampling surveys. PARTICIPANTS: Residents aged 55 and older: 1995 (n=7,722), 1997 (n=7,717), 1999 (n=7,809), and 2004 (n=12,786). MEASUREMENTS: DM and its comorbidities identified using a standard set of diagnosis codes. RESULTS: The estimated crude prevalence of DM increased from 16.9% in 1995 to 26.4% in 2004 in male nursing home residents and from 16.1% to 22.2% in female residents (all P<.05). Male and female residents aged 85 and older and those with high functional impairment showed a significant increasing trend in DM (all P<.05). In people with DM, multivariate-adjusted prevalence of cardiovascular disease increased from 59.6% to 75.4% for men and from 68.1% to 78.7% for women (all P<.05). Prevalence of most other comorbidities did not increase significantly. CONCLUSION: The burden of DM in residents of U.S. nursing homes has increased since 1995. This could be due to increasing DM prevalence in the general population or to changes in the population that nursing homes serve. Nursing home care practices may need to change to meet residents' changing needs. © 2010, Copyright the Authors. Journal compilation © 2010, The American Geriatrics Society.

Luo H.,Mount Olive College | Fang X.,Centers for Disease Control and Prevention | Liao Y.,Centers for Disease Control and Prevention | Elliott A.,Centers for Disease Control and Prevention | Zhang X.,Centers for Disease Control and Prevention
Gerontologist | Year: 2010

Purpose:We compared the rates of specialized care for residents with Alzheimer's disease or dementia in special care units (SCUs) and other nursing home (NH) units and examined the associations of SCU residence with process of care and resident outcomes.Design and Methods:Data came from the 2004 National Nursing Home Survey. The indicators of process of care included physical restraints, continence management, feeding tubes, and influenza and pneumococcal vaccinations. Resident outcomes included pressure ulcers, hospitalization, emergency room visits, weight loss, and falls. Analyses were conducted by using Stata SE version 10.Results:Multivariate logistic regression analyses show that SCU residents were more likely to have received specialized dementia care and specialized behavioral problem management. They were less likely to have bed rails (adjusted odds ratio [AOR] = 0.39, AOR = 0.35, ps <. 01), use catheters (AOR = 0.33, AOR = 0.33, ps <. 01), and yet more likely to have toilet plans/bladder training for incontinence control (AOR = 1.90, AOR = 1.62, ps <. 01) than those in regular units and those in NHs without an SCU. Moreover, SCU residents were less likely to have pressure ulcers, hospitalization than those in regular units, and less likely to have experienced weight loss than those in NHs without an SCU. However, they were more likely to have falls (AOR = 1.32, AOR = 1.36, ps <. 05) than those in regular units and those in NHs without an SCU. Implications:Our study shows that SCU residents had, in general, better process of care than those in regular units and in NHs without an SCU. Further studies are needed to assess specific outcome changes among SCU residents and to evaluate the cost-effectiveness of having such units. © 2009 The Author. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved.

Luo H.,Mount Olive College | Luo H.,Oak Ridge Institute for Science and Education | Sotnikov S.,Oak Ridge Institute for Science and Education | Shah G.,Georgia Southern University | And 2 more authors.
Journal of Public Health Management and Practice | Year: 2013

Objectives: To describe and compare the capacity of local health departments (LHDs) to perform 10 essential public health services (EPHS) for obesity control in 2005 and 2008, and explore factors associated with provision of these services. Methods: The data for this study were drawn from the 2005 and 2008 National Profile of Local Health Department surveys, conducted by the National Association of County and City Health Officials. Data were analyzed in SAS version 9.1 (SAS Institute Inc, Cary, North Carolina). Results: The proportion of LHDs that reported that they do not provide any of the EPHS for obesity control decreased from 27.9% in 2005 to 17.0% in 2008. In both 2005 and 2008, the 2 most frequently provided EPHS for obesity control by LHDs were informing, educating, and empowering the people (EPHS 3) and linking people to needed personal health services (EPHS 7). The 2 least frequently provided services were enforcing laws and regulations (EPHS 6) and conducting research (EPHS 10). On average, LHDs provided 3.05 EPHS in 2005 and 3.69 EPHS in 2008. Multiple logistic regression results show that LHDs with larger jurisdiction population, with a local governance, and those that have completed a community health improvement plan were more likely to provide more of the EPHS for obesity (P < .05). Conclusions: The provision of the 10 EPHS for obesity control by LHDs remains low. Local health departments need more assistance and resources to expand performance of EPHS for obesity control. Future studies are needed to evaluate and promote LHD capacity to deliver evidence-based strategies for obesity control in local communities. Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins.

Zhang X.,Centers for Disease Control and Prevention | Luo H.,Mount Olive College | Gregg E.W.,Centers for Disease Control and Prevention | Mukhtar Q.,Centers for Disease Control and Prevention | And 3 more authors.
American Journal of Public Health | Year: 2010

Objectives. We assessed whether local health departments (LHDs) were conducting obesity prevention programs and diabetes screening programs, and we examined associations between LHD characteristics and whether they conducted these programs. Methods. We used the 2005 National Profile of Local Health Departments to conduct a cross-sectional analysis of 2300 LHDs nationwide. We used multivariate logistic regressions to calculate odds ratios (ORs) and 95% confidence intervals (Cls). Results. Approximately 56% of LHDs had obesity prevention programs, 51% had diabetes screening programs, and 34% had both. After controlling for other factors, we found that employing health educators was significantly associated with LHDs conducting obesity prevention programs (OR = 2.08; 95% Cl = 1.54, 2.81) and diabetes screening programs (OR = 1.63; 95% Cl = 1.23, 2.17). We also found that conducting chronic disease surveillance was significantly associated with LHDs conducting obesity prevention programs (OR = 1.66; 95% Cl = 1.26, 2.20) and diabetes screening programs (OR = 2.44; 95% Cl = 1.90, 3.15). LHDs with a higher burden of diabetes prevalence were more likely to conduct diabetes screening programs (OR = 1.20; 95% Cl = 1.11, 1.31) but not obesity prevention programs. Conclusions. The presence of obesity prevention and diabetes screening programs was significantly associated with LHD structural capacity and general performance. However, the effectiveness and cost-effectiveness of both types of programs remain unknown.

Tewari J.,Cornell University | Dixit V.,Cornell University | Malik K.,Mount Olive College
Sensors and Actuators, B: Chemical | Year: 2010

A novel on-line solvent drying technique has been described that is capable of simultaneously measuring the solvent end point in vapor phase and maintaining high accuracy with precision. The technique used non-contact infrared sensor for monitoring the solvent vapors during the pharmaceutical solvent drying process. The data presented demonstrated that on-line combined with non-contact sensor method had high degree of precision and accuracy for monitoring the end point of the solvent drying. The analysis of the three stages of drying process suggested that end point process can be precisely determined by the combination of principal component analysis-canonical variate analysis (PCA-CVA) and partial least square-canonical variate analysis (PLS-CVA). The PCA-CVA and PLS-CVA combos provided robust and accurate results with more than 97% classification accuracy between three stages. The Chemometric models also predicted the drying stages of the unknown samples. Agglomerative hierarchical clustering was also applied on the drying data to conform the Chemometric drying results that were very similar. Our findings strongly suggest that the on-line non-contact infrared sensor is a powerful tool. This sensor is capable of analyzing samples in less than 1 min and can determine known and unknown molecules with high accuracy. In addition it has the potential for improving the sensitivity of solvents end points measurement during the pharmaceutical processing. © 2009 Elsevier B.V. All rights reserved.

Wilson A.B.,Mount Olive College | Kerr B.J.,Central Michigan University | Bastian N.D.,Georgia Institute of Technology | Fulton L.V.,Texas State University
Journal of Healthcare Management | Year: 2012

From 1980 to 1999, rural designated hospitals closed at a disproportionally high rate. In response to this emergent threat to healthcare access in rural settings, the Balanced Budget Act of 1997 made provisions for the creation of a new rural hospital- the critical access hospital (CAH). The conversion to CAH and the associated cost-based reimbursement scheme significantly slowed the closure rate of rural hospitals. This work investigates which methods can ensure the long-term viability of small hospitals. This article uses a two-step design to focus on a hypothesized relationship between technical efficiency of CAHs and a recently developed set of financial monitors for these entities. The goal is to identify the financial performance measures associated with efficiency. The first step uses data envelopment analysis (DEA) to differentiate efficient from inefficient facilities within a data set of 183 CAHs. Determining DEA efficiency is an a priori categorization of hospitals in the data set as efficient or inefficient. In the second step, DEA efficiency is the categorical dependent variable (efficient = 0, inefficient = 1) in the subsequent binary logistic regression (LR) model. A set of six financial monitors selected from the array of 20 measures were the LR independent variables. We use a binary LR to test the null hypothesis that recently developed CAH financial indicators had no predictive value for categorizing a CAH as efficient or inefficient, (i.e., there is no relationship between DEA efficiency and fiscal performance).

Luo H.,Mount Olive College | Lin M.,University of Pittsburgh | Castle N.,University of Pittsburgh
American Journal of Alzheimer's Disease and other Dementias | Year: 2011

Aims: To estimate the use of different types of physical restraints and assess their associations to falls and injuries among residents with and without Alzheimer's disease (AD) or dementia in US nursing homes. Methods: Data were from the 2004 National Nursing Home Survey. AD or dementia was identified using International Classification of Diseases, Ninth Revision (ICD-9) codes. Analyses were conducted with the Surveyfreq and Surveylogistic procedures in SAS v.9.1. Results: Residents with either AD or dementia were more likely to be physically restrained (9.99% vs 3.91%, P <.001) and less likely to have bed rails (35.06% vs 38.43%, P <.001) than those residents without the disease. The use of trunk restraints was associated with higher risk for falls (adjusted odds ratio [AOR] = 1.66, P <.001) and fractures (AOR = 2.77, P <.01) among residents with the disease. The use of full bed rails was associated with lower risk for falls among residents with and without the disease (AOR = 0.67 and AOR = 0.72, Ps <.05, respectively). Conclusions: The use of a trunk restraint is associated with a higher risk for falls and fractures among residents with either AD or dementia. © 2011 The Author(s).

Cwik P.F.,Mount Olive College
Economic Affairs | Year: 2011

Three waves of mercantilism have arisen in the past few centuries. The first wave was countered by the classical economists. The second wave (neo-mercantilism) hit during the inter-war period. Today's third wave uses monetary policy. We explore the mercantilist waves and argue in favour of a free trade policy. We conclude that an international system of free banking best protects the economy from currency manipulation as a form of protectionism. © 2011 The Author. Economic Affairs © 2011 Institute of Economic Affairs.

Herath Bandara S.J.,Mount Olive College
Global journal of health science | Year: 2013

Obesity is a major health problem in the United States, and the burden associated is high. Hypertension seems to be the most common obesity-related health problem. Studies show that hypertension is approximately twice as prevalent among the obese as in the non-obese population. This study has two main objectives. First, to examine the association between obesity and hypertension within the context of economic growth in Appalachia, and second to estimate the cost of hypertension linked to obesity in Appalachia. The study uses simultaneous equations and Logit analysis for estimations. Data are from Behavior Risk Factor Surveillance Systems (BRFSS) surveys of 2001 and 2009. Results for simultaneous analysis show that hypertension decreases with decreasing obesity, increasing employment growth, and increasing income. Logit analysis highlights the importance of controlling obesity, income growth, employment growth, education, and exercises in mitigating hypertension in Appalachia. Ageing indicates a high potential of getting hypertension. Total economic cost of hypertension linked to obesity is $9.35 billion, significantly a high cost to Appalachia. Overall, results reveal the impacts of obesity on hypertension and some possible ways of mitigation. Thus, results suggest a comprehensive set of policies to Appalachia which sufficiently improve employment opportunities, educational facilities, and healthcare facilities with adequately addressed to obesity and hypertension.

Painter M.S.,Virginia Polytechnic Institute and State University | Dommer D.H.,Mount Olive College | Altizer W.W.,Virginia Polytechnic Institute and State University | Muheim R.,Lund University | Phillips J.B.,Virginia Polytechnic Institute and State University
Journal of Experimental Biology | Year: 2013

We provide evidence for spontaneous quadramodal magnetic orientation in a larval insect. Second instar Berlin, Canton-S and Oregon-R × Canton-S strains of Drosophila melanogaster exhibited quadramodal orientation with clusters of bearings along the four anti-cardinal compass directions (i.e. 45, 135, 225 and 315deg). In double-blind experiments, Canton-S Drosophila larvae also exhibited quadramodal orientation in the presence of an earth-strength magnetic field, while this response was abolished when the horizontal component of the magnetic field was cancelled, indicating that the quadramodal behavior is dependent on magnetic cues, and that the spontaneous alignment response may reflect properties of the underlying magnetoreception mechanism. In addition, a re-analysis of data from studies of learned magnetic compass orientation by adult Drosophila melanogaster and C57BL/6 mice revealed patterns of response similar to those exhibited by larval flies, suggesting that a common magnetoreception mechanism may underlie these behaviors. Therefore, characterizing the mechanism(s) of magnetoreception in flies may hold the key to understanding the magnetic sense in a wide array of terrestrial organisms. © 2013. Published by The Company of Biologists Ltd.

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