2008
In Brief
Debunking an Urban Myth
Past research has shown that patients suffering heart attacks may be better off in an urban hospital than a rural one. But a recent, more analytic study conducted by University of Iowa researchers shows that this may not be the case.
Marcia Ward, Ph.D., professor of health management and policy, and colleagues aimed to eliminate biases against rural hospitals in previous research by using a more sensitive method of determining a hospital’s quality of care. For example, since elderly patients with more complicated health conditions may stay at a rural hospital to be closer to home and to their support systems, the rural hospital population may be less healthy than the urban one to begin with.
Taking these factors into consideration, as well as the physician’s role in directing patients from
rural to urban hospitals, the new study found that rural hospitals do not have higher death rates
among heart attack patients when compared to similar patients in urban hospitals.
Bringing Up Baby
New parents often hear that breast is best when it comes to feeding babies, and the media seem to agree—in theory. However, according to a study led by Leah Frerichs, a graduate of the Department of Community and Behavioral Health, when magazine articles encourage women to breastfeed, they tend to present mixed messages, focusing on the barriers to breastfeeding rather than its benefits.
For example, an article may suggest that breastfeeding is the best option for feeding a baby, but the content of the article focuses on the physical and social problems nursing women may face. Overall, the magazines examined in the study provided more information on breastfeeding than formula feeding, but images often portrayed bottle-fed babies. In addition, messages about breastfeeding placed much of the responsibility of infant feeding on the mother, while the role of social and partner support was diminished.
The study concluded that magazines need to present readers with information that will give them a more accurate and complete view of breastfeeding while balancing infant-feeding choices with individual and social concerns.
Just the Facts
The Center for Public Health Statistics, in partnership with the Iowa Department of Public Health, released the 2007 Iowa Health Fact Book, a broad-ranging report covering the health and health-related behaviors of Iowans.
“The book is a tremendous resource for Iowa’s health care providers, health policymakers, public health practitioners, and health educators and researchers,” said Jacob Oleson, Ph.D., assistant professor of biostatistics and editor of the 2007 edition. “Since the book is issued every other year, it’s a great way for health professionals to identify new, emerging concerns and to track progress in improving the health of Iowans.”
The book assembles current health-related statewide data on areas such as prenatal and infant
health, infectious diseases, cancer, chronic diseases, injury, and childhood blood lead poisoning. It also includes an update of several leading goals of Healthy Iowans 2010.
Oleson collaborated on the publication with Jane Pendergast, Ph.D., professor of biostatistics
and director of the Center for Public Health Statistics.
Rapid Response Saves Lives
Researchers in the Center for Emerging Infectious Diseases are using new molecular techniques to rapidly identify the various strains of adenovirus, a family of viruses responsible for a number of human diseases ranging from respiratory illness to gastroenteritis, conjunctivitis, cystitis, encephalitis, and sometimes death.
In a recent study, Gregory Gray, M.D., professor of epidemiology, and colleagues used molecular tools to update the epidemiology of human adenovirus infection in the United States. “Our best understanding of circulating adenovirus was from studies conducted in the 1970s, when molecular tools were not available,” said Gray, who is also director of the Center for Emerging Infectious Diseases. “Today’s molecular techniques have allowed us to greatly reduce the time it takes to go from detecting a virus to identifying the specific viral type.”
Gray and his colleagues are now able to identify adenovirus types in just two days as opposed to a week or longer. “Speed is crucial when combating some adenovirus infections,” Gray said. “Getting rapid test results has helped clinicians understand adenovirus outbreaks that occur in
communities, hospitals, and especially in long-term care facilities, where new strains have proven deadly. These tools are also helping us to better understand new strands of adenovirus and why they are associated with more severe disease.”
The researchers are currently using the molecular technique to assist clinicians in evaluating and treating certain patients with adenovirus infection and to help public health officials investigate adenovirus infection epidemics.
Now Hear This
Many Iowans are aware that farming, one of the most important industries in their home state, is dangerous. In fact, farmers are eight times more likely to suffer a fatal occupational injury than the average American worker and twice as likely to suffer a non-fatal occupational injury.
What many Iowans don’t realize, however, is the role hearing loss plays in many farming injuries. According to a study led by Nancy Sprince, M.D., professor emerita of occupational and environmental health, hearing loss can play a big part in a farmer’s risk of sustaining an on-the-job injury.
“Farmers who have difficulty hearing are 80 percent more likely to suffer an injury related to a fall on the farm than those who can hear normally, and farmers with severe enough hearing loss to need a hearing-aid are the most likely to be injured on the job,” said Sprince.
Because the loud conditions on farms created by tractors, combines, chain saws, and grain dryers can lead to noise-induced hearing loss, Sprince advocates for improved noise control on the farm, including more widespread use of hearing protection.
Not All Fun and Games
Today more than half of American children participate in organized sports. Sports provide young people with exercise, teach them cooperation, and are considered a right of passage by many in American culture.
But youth sports injuries pose a serious threat to the health and well-being of young people. More than four million sports injury episodes occur each year to school-aged children in the United States. Although most of these injuries are treated in emergency rooms, those that require
hospitalization represent the more serious cases and place a tremendous burden on the patient’s family, the health care system, and society as a whole.
To better understand the scope of youth sports injuries, Jingzhen Yang, Ph.D., assistant professor of community and behavioral health, and Corinne Peek-Asa, Ph.D., professor of occupational and environmental health, both with the Injury Prevention Research Center, conducted the first study of its kind to investigate the characteristics of children who are hospitalized for sports injuries and the hospitals where these injured children are treated.
Analyzing nationwide inpatient sample data, the researchers found an estimated 39,010 hospitalizations for sports-related injuries among 5- to 18-year-old children between
2000 and 2003. This translates into nearly 10,000 sports injury hospitalizations for this age group each year, resulting in annual charges of $113 million to $133 million. Given the cost and scope of the problem, the researchers recommend further investigation into the prevention of sports-related injuries.
Misinformation Could Have Dire Consequences
False ideas about HIV/AIDS are circulating widely via the Internet and could produce terrible public health consequences, according to Tara Smith, Ph.D., assistant professor of epidemiology.
Smith co-authored a policy paper outlining the strategies used by the human immunodeficiency virus (HIV) denial movement to spread misinformation about HIV/AIDS. Despite more than two decades of research showing that HIV is the cause of AIDS, denialist organizations reject this claim by denigrating the notion of scientific authority or arguing that the mainstream HIV community is intellectually compromised. Many denialist organizations utilize the Internet as a medium for spreading their ideas.
“We are concerned that since the lay public doesn’t have the scientific background to critique assertions made by HIV denialists, many people could put themselves at risk for HIV infection by abandoning safe sex practices, while those who are infected could end up seeking unproven, ineffective remedies,” Smith said.
In order to combat these harmful misconceptions, the researchers recommend that the scientific community collectively defend and promote the role of science in society and battle the growing problem of scientific illiteracy.
When Every Second Counts
Receiving timely and specialized care is critical for patients with traumatic brain injuries (TBI), since secondary damage can occur during the hours following an injury. According to a study conducted by researchers from the Injury Prevention Research Center, Iowans who suffer a TBI have a better chance of survival thanks to a statewide trauma system implemented in 2001.
In an effort to reduce brain injury deaths, improve patient outcomes, and reduce medical care costs, the Iowa trauma system includes training in advanced trauma life support, definition of triage protocol, and uniform data definition and collection. A total of nine hospitals statewide were required to have specialty coverage, including neurosurgery.
The researchers, including James Torner, Ph.D., professor and head of epidemiology, discovered that implementation of the trauma system was associated with a significant decreased risk of death overall and a nearly 50 percent reduction in the risk of death during the 72 hours following a TBI. According to the researchers, implementation of the system has led to more appropriate triage and transport for TBI patients, which has likely contributed to reduced in-hospital mortality.
A STAR is Born
Iowa ranks fourth among states in percentage of residents age 65 and older, and second in percentage of those age 85 and older. Yet researchers often have difficulty recruiting people from these higher age groups for their studies. To help solve this problem, the Center on Aging developed the program Seniors Together in Aging Research (STAR). A registry of research volunteers, STAR helps to connect individuals who are interested in participating in research studies with UI investigators who seek research volunteers. The registry is open to people age 50 and older who are healthy, as well as to those with medical conditions.
Researchers may draw from the pool of potential volunteers for various studies, such as surveys, clinical trials, and opinion gathering. Studies involving older people may address medical and health-related concerns, as well as social issues, and can lead to the development of new vaccines, new therapies to treat diseases such as cancer and diabetes, and improved ways to stop smoking.
Vaccinating Veterinarians
Outbreaks of avian influenza in Asia, Europe, and Africa over the past 10 years have caused increasing numbers of public health professionals to consider who would be at high risk for infection if an epidemic of the deadly virus struck closer to home. Researchers in the Center for Emerging Infectious Diseases (CEID) found that veterinarians who work with birds are at increased risk for infection.
CPH graduate Kendall Myers, Ph.D., and Gregory Gray, M.D., professor of epidemiology and director of the CEID, examined blood samples from a group of U.S. veterinarians to see if they had antibodies to various strains of avian influenza virus, which would indicate that they had been infected by a bird. Results showed that veterinarians who worked with birds had significantly higher levels of antibodies in their blood against the H5, H6, and H7 avian virus strains.
“We concluded that veterinarians and others who have frequent and close contact with birds may be among the first to be infected should a pandemic strain of avian influenza strike this country,” Myers said. “Since these workers have the potential to spread the illness to their families and communities, we recommend that they be considered for inclusion on priority access lists for pandemic influenza vaccines and antivirals.”
Magazines need to weigh in on obesity issues
More than 75 percent of African American women are considered overweight or obese, yet magazines targeted to African Americans may be falling short in their efforts to educate readers about weight loss, suggests a recent study co-authored by Shelly Campo, Ph.D., assistant professor of community and behavioral health.
Campo and Teresa Mastin, Ph.D., associate professor of advertising, public relations, and retailing at Michigan State University, analyzed 406 fitness and nutrition articles published between 1984 and 2004 in three major African American women’s magazines—Ebony, Essence, and Jet—and three popular mainstream women’s magazines—Good Housekeeping, Better Homes and Gardens, and Ladies’ Home Journal.
The researchers found that the magazines suggested many of the same weight-loss strategies, but African American women’s magazines were more likely to encourage fad diets and reliance on faith to lose weight, while mainstream women’s magazines focused more on evidence-based diet strategies.
Both types of magazines tended to place responsibility for weight loss on the individual, rather than examining environmental and economic factors that make weight loss difficult. “Both genres are highly guilty of over-reliance on individual strategies,” Campo says. “We blame individuals too much for circumstances that are not entirely within their control. We know people living in unsafe neighborhoods are much less likely to exercise. And fast food is cheap compared to fresh fruit and vegetables.”
The study also showed that the mainstream magazines increased fitness and nutrition coverage during the second decade as the severity of the obesity epidemic unfolded, but African American magazines did not. “The study clearly points to a need for public-health advocates and advocates of the African American community to push their media to increase coverage of overweight and obesity health issues,” Campo concludes.