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Chapel Hill, NC, United States

Rogers B.,University of North Caroline
AAOHN journal : official journal of the American Association of Occupational Health Nurses | Year: 2010

The Center of Disease Control and Prevention reports that professionals in clinic setting may not be adequately storing and handling vaccine, leading to insufficient immunity of vaccinated individuals. This article provides information about proper cold chain storage and handling of vaccine and offers resources to begin, or reinforce, proper procedures in the occupational health unit to secure an effective immunization program.

Perron B.E.,University of Michigan | Mowbray O.,University of Michigan | Bier S.,University of Michigan | Vaughn M.G.,Saint Louis University | And 2 more authors.
Journal of Psychoactive Drugs | Year: 2011

Inhalant use is a serious global problem with consequences equal to or surpassing those of other drugs. Regrettably, few prior studies have examined inhalant users' patterns of service and treatment utilization. The purpose of this study is to identify factors associated with service use and barriers to treatment among a nationally representative sample of inhalant users. Data from the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) reveal that among inhalant users problem severity and substance use disorder comorbidity were associated with substance abuse treatment barriers and service usage. These findings can help improve the service delivery system to provide effective treatments and reduce the risk of emergency department usage, which is among the most expensive and least effective ways to deal with substance abuse. © Taylor & Francis Group, LLC.

Wu C.-H.,University of North Caroline | Erickson S.R.,University of Michigan
Journal of Asthma | Year: 2012

Objective. The purpose of this study was to evaluate the association between asthma status and the occurrence and length of work absences among the US working adults. Methods. A cross-sectional study was conducted using the 2008 Medical Expenditure Panel Survey (MEPS). Employed respondents between ages 18 and 55 years were included. The association between asthma status (whether respondents have asthma or not) and occurrence of absences and the length of time per absence was evaluated using a two-part model. A multivariate logistic regression as the first part of the model was to estimate the probability of being absent from work at least once during the observation period as a function of asthma status. A multivariate negative binomial regression as the second part of the model was used to assess whether the length of each absence from work was associated with asthma status among respondents who reported at least one absence from work. Sociodemographic, socioeconomic, employment-related, health status, and comorbidity variables were included in each model as covariates. Results. Of 12,161 respondents, 8.2 reported having asthma, which accounted for 10.4 million working adults in the United States in 2008. Employed adults with asthma were more likely to report having at least one absence from work compared to those without asthma in bivariate analyses (26.2 vs. 16.2, p < .01). After adjusting for the number of comorbid chronic conditions and other covariates, there was no significant difference between having asthma and absenteeism among respondents (odds ratio (OR) 1.31, 95 confidence interval (CI) 0.991.72, rate ratio (RR) 1.25, 95 CI 0.911.72). Conclusions. Overall burden of illness as measured by comorbidity indices and perceived health status, but not asthma alone, contributes to absenteeism as well as the number of days off during each occurrence among employed people. It is important for health services researchers to consider overall burden of illness when examining the association between a general outcome such as absence from work and specific conditions such as asthma. © 2012 Informa Healthcare USA, Inc.

Ozdemir S.,University of North Caroline | Mohamed A.F.,Research Triangle Institute | Johnson F.R.,Research Triangle Institute | Hauber A.B.,Research Triangle Institute
Health Economics | Year: 2010

Responses of inattentive or inconsistent subjects in stated-choice (SC) surveys can lead to imprecise or biased estimates. Several SC studies have investigated inconsistency and most of these studies dropped subjects who were inconsistent. However, none of these studies reported who is more likely to fail consistency tests. We investigated the effect of the personal characteristics and task complexity on preference inconsistency in eight different SC surveys. We found that white, higher-income and better-educated female subjects were less likely to fail consistency tests. Understanding the characteristics of subjects who are inattentive to the choice task may help in designing and pre-testing instruments that work effectively for a wider range of subjects. Copyright © 2009 John Wiley & Sons, Ltd.

Chino J.P.,Duke University | Jones E.,University of North Caroline | Berchuck A.,Duke University | Secord A.A.,Duke University | Havrilesky L.J.,Duke University
International Journal of Radiation Oncology Biology Physics | Year: 2012

Background: The appropriate uses of lymph node dissection (LND) and adjuvant radiation therapy (RT) for Stage I endometrial cancer are controversial. We explored the impact of specific RT modalities (whole pelvic RT [WPRT], vaginal brachytherapy [VB]) and LND status on survival. Materials and Methods: The Surveillance Epidemiology and End Results dataset was queried for all surgically treated International Federation of Gynecology and Obstetrics (FIGO) Stage I endometrial cancers; subjects were stratified into low, intermediate and high risk cohorts using modifications of Gynecologic Oncology Group (GOG) protocol 99 and PORTEC (Postoperative Radiation Therapy in Endometrial Cancer) trial criteria. Five-year overall survival was estimated, and comparisons were performed via the log-rank test. Results: A total of 56,360 patients were identified: 70.4% low, 26.2% intermediate, and 3.4% high risk. A total of 41.6% underwent LND and 17.6% adjuvant RT. In low-risk disease, LND was associated with higher survival (93.7 LND vs. 92.7% no LND, p < 0.001), whereas RT was not (91.6% RT vs. 92.9% no RT, p = 0.23). In intermediate-risk disease, LND (82.1% LND vs. 76.5% no LND, p < 0.001) and RT (80.6% RT vs. 74.9% no RT, p < 0.001) were associated with higher survival without differences between RT modalities. In high-risk disease, LND (68.8% LND vs. 54.1% no LND, p < 0.001) and RT (66.9% RT vs. 57.2% no RT, p < 0.001) were associated with increased survival; if LND was not performed, VB alone was inferior to WPRT (p = 0.01). Conclusion: Both WPRT and VB alone are associated with increased survival in the intermediate-risk group. In the high-risk group, in the absence of LND, only WPRT is associated with increased survival. LND was also associated with increased survival. © 2012 Elsevier Inc.

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