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Yelena Bird
  • Canada
Background: Cigarette smoking is the leading cause of preventable death worldwide. Tobacco use and secondhand-tobacco smoke (SHS) exposure are classified as a pediatric disease. In Mexico, the prevalence of smoking has decreased among... more
Background: Cigarette smoking is the leading cause of preventable death worldwide. Tobacco use and secondhand-tobacco smoke (SHS) exposure are classified as a pediatric disease. In Mexico, the prevalence of smoking has decreased among adults but paradoxically increased among adolescents, particularly among young females. This study was designed to determine the association between adolescents' smoking experiences (smoking behaviors and second hand smoke [SHS] exposure), family structure, parental smoking and socioeconomic status (SES) in Ciudad Juárez, Mexico. Methods: This is a cross-sectional, population-based study. Data was collected from sixth-grade students (N = 506) attending school in Ciudad Juárez, Mexico. Descriptive analyses were conducted. The relationship between key outcome variables (adolescents smoking and SHS exposure) and independent variables (family structure, parental smoking, and SES level) were examined. Adjusted odds ratios were calculated. Multiple logistic regression analysis was performed while controlling for possible confounders (i.e. gender and age).
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Purpose: The purpose of this study was to determine the prevalence of oncogenic and non-oncogenic associated HPV types and their correlation to clinical diagnostic criteria (Pap and Colposcopy examinations and staging) and risk factors... more
Purpose: The purpose of this study was to determine the prevalence of oncogenic and non-oncogenic associated HPV types and their correlation to clinical diagnostic criteria (Pap and Colposcopy examinations and staging) and risk factors for HPV infection and progression to cervical cancer among women in Ciudad Jurez, Mexico. Methods: A cross-sectional behavioral, clinical, and molecular biological study of 200 women, ages 18-58 years old, who self-referred for gynecological care to Hospital de la Familia, in Ciudad Jurez, Mexico was conducted during a specified 9-month time period. Seroreactivity to HPV was detected by use of the Luminex low-density suspension array and HPV genotyping was conducted by use of the linear array test. Results: Overall, the prevalence of HPV seropositivity was 44% while the HPV DNA positivity was 22%. In general, seroprevalence with high-risk HPV was 36.9% and multi-HPV exposure was 24.5%. The most commonly detected HPV types were HPV 58 (15.5%), HPV 35 (...
Background: Comprehensive non-smoking ordinances have been linked to decreases in the incidence of acute myocardial infarction (AMI). In 2002 the Delaware Clean Indoor Air Act was amended to restrict smoking in bars, restaurants, and... more
Background: Comprehensive non-smoking ordinances have been linked to decreases in the incidence of acute myocardial infarction (AMI). In 2002 the Delaware Clean Indoor Air Act was amended to restrict smoking in bars, restaurants, and casinos. Methods: In an analysis of Delaware Hospital Discharge Database we identified Delaware and non-Delaware residents discharged with AMI or asthma for the years 1999-2004. Data analysis compared the incidence of AMI or asthma before (1999-2002) and after (2003-2004) the amendment of Delaware's non-smoking ordinance for each group. Results: Pre-ordinance and post-ordinance quarterly rates of AMI for Delaware residents were 451 (se = 21) and 430 (se = 21) respectively, representing a 4.7% reduction and 169 fewer AMI over the two-year period after implementation of the comprehensive smoke-free ordinance (2003-2004). The risk ratio (RR) for post vs. pre-ordinance quarterly rate of AMI showed a statistically significant decrease of 0.95 (95% CI, 0....
Background: An estimated 250,000 to 3 million Americans are homeless at any given time, and a significant amount of homeless people regularly live on the streets because of lack of stable shelter. Throughout the past several years there... more
Background: An estimated 250,000 to 3 million Americans are homeless at any given time, and a significant amount of homeless people regularly live on the streets because of lack of stable shelter. Throughout the past several years there has been increasing recognition that the threat of STD and HIV/AIDS infection is disproportionately high among this vulnerable population. Methods: This study examines the reasons for the higher prevalence of STD and HIV/AIDS infection among homeless adults. By conducting a survey among 50 homeless adults in El Paso, TX and 50 homeless adults in Las Cruces, NM, the present study attempts to elucidate their sexual practices, attitudes and beliefs about STD and HIV/AIDS, and condom utilization. Results: The majority of the participants surveyed were between the ages 30-39 (33%). The preponderance were single (60.6%) currently involved in an intimate relationship (78.8%) and more than half (54%) have had more than 5 lifetime sexual partners. However, 68...
Background: Intimate partner violence (IPV) represents a significant, global public health problem that warrants attention from diverse disciplines. Pregnant women represent a vulnerable population, particularly when their intimate... more
Background: Intimate partner violence (IPV) represents a significant, global public health problem that warrants attention from diverse disciplines. Pregnant women represent a vulnerable population, particularly when their intimate partner is under the influence of alcohol or other drugs (AOD) during the abusive act. Purpose: The purpose of this study was to identify the nature and extent of IPV perpetrated against pregnant women by male intimate partner offenders under the influence of AOD. Methods: Data were collected over a two-month time period from all women who presented for prenatal care at a major hospital in Ciudad Jurez, Mexico. Results: Of 215 women who completed the survey, 28.8% (n = 62) self-reported being the victim of physical, sexual, or emotional abuse and 61.3% (n = 38) of those specified that their male intimate partner was under the influence of AOD at the time of the abusive act. Significant relationships were found between female physical abuse (e.g., punching...
Purpose: The study examined predictors of condom use among female sex workers (FSW) in Thailand. Methods: Cross sectional questionnaire survey was done on 150 Thai FSW. The Health Belief Model was used to assess the perceived... more
Purpose: The study examined predictors of condom use among female sex workers (FSW) in Thailand. Methods: Cross sectional questionnaire survey was done on 150 Thai FSW. The Health Belief Model was used to assess the perceived susceptibility of FSW to HIV/AIDS infection and benefits of condom use. Statistical analysis was performed on specific areas of interest including condom use, infection history and general concern and worries about sexually transmitted diseases. Results: Mean proportion of condom use among FSW was 51% suggesting nearly half (49%) of them do not practice safer sex. Correlation analysis indicated that worrying about HIV/AIDS (perceived susceptibility) and condom use prevents infection (perceived benefit) were the strongest predictors of condom use by FSW. Similarly, higher perceived risk of acquiring HIV/AIDS infection from westerner patrons was the next significant predictor for high condom use (76%) as compared to perceived risk by having sex with Thai patrons ...
Background: Hispanics women are less likely to undergo cancer screening procedures and more likely to be diagnosed at a later stage than their non-Hispanic counterparts. Objective: This study examines the knowledge, attitude and screening... more
Background: Hispanics women are less likely to undergo cancer screening procedures and more likely to be diagnosed at a later stage than their non-Hispanic counterparts. Objective: This study examines the knowledge, attitude and screening practices among Hispanic women with (FH+) and without (FH-) a family history of breast cancer. Methods: Cross sectional study was designed and a structured questionnaire was used to collect 141 study subjects' sociodemographic characteristics, knowledge, attitude and screening practices in three US-Mexico border counties. Results: Familial history of breast cancer was found in 32.6% (n=46) of the study subjects. FH+ women were more likely to have ever performed screening practices than FH- study subjects. Contrary to this, we found of those women having ever undergone screening procedures, a larger proportion of FH- participants were in compliance with the recommended mammography (88.9%), clinical breast examinations (CBEs) (91.5%), and breast ...
Background: There have been few studies about sexual practices and knowledge of STD/HIV among male, college football athletes. With limited amount of data, few studies suggest that many athletes have misconceptions about the risk of... more
Background: There have been few studies about sexual practices and knowledge of STD/HIV among male, college football athletes. With limited amount of data, few studies suggest that many athletes have misconceptions about the risk of contracting STD/HIV. Methods: The present study surveyed 50 male, college football athletes. All data collection was done by one investigator to ensure continuity. The questionnaires were anonymous and confidential, and examined four categories of interest: (1) Male, college football athlete's demographics, (2) Sexual history and beliefs, (3) Condom beliefs and utilization, and (4) Knowledge regarding condom use and STD/HIV transmission. Findings: More than half (60%) of male, college football athletes surveyed reported having more than five lifetime sexual partners. Only 34% reported always practicing safe sex, while 16% reported to have never practiced safe sex. Approximately 54% believed condom use is important only during vaginal sex, while only ...
It has been reported that nearly one in four adolescents actively smoke and three in four are exposed to SHS in Mexico. Therefore, public health initiatives that aim to prevent initiation and assist in the reduction of SHS exposure of... more
It has been reported that nearly one in four adolescents actively smoke and three in four are exposed to SHS in Mexico. Therefore, public health initiatives that aim to prevent initiation and assist in the reduction of SHS exposure of adolescents need to be employed as early as middle school
BACKGROUND: In spite of education on the consequences of unsafe sexual practices, only 45 % of college students practice safe sex through the use of condoms, which makes them vulnerable to high risk outcomes like HIV infection and... more
BACKGROUND: In spite of education on the consequences of unsafe sexual practices, only 45 % of college students practice safe sex through the use of condoms, which makes them vulnerable to high risk outcomes like HIV infection and unwanted pregnancies. PURPOSE: To compare attitudes, norms, self-efficacy, and barriers to condom use among students attending selected two-year colleges in New Mexico. METHODS: A stratified random sample of Basic English classes from three two-year institutions was selected for inclusion in the study. The instrument was an adaptation of an instrument developed by Yarber, Bauserman, Schereer, and Davis (1998). RESULTS: The sample population consisted of 234 students (63.2% women); of which 79% indicated they were sexually active. In regards to attitudes towards safe sex practices, 94.5 % (N = 221) believed that condoms should always be used, but only 79.1 % (N = 185) indicated that it was the norm. Female participants had more positive attitudes than males...
ABSTRACT Thesis (M.P.H.)--New Mexico State University, 2004. Includes vita. Includes bibliographical references (leaves 184-189).
Results-- The overall smoking prevalence was 31.5% (n=203); with 21.9% of the students being classified as irregular smokers (n=141) and 9.6% as regular smokers (n=62). Of the 203 students who were smokers, 51.2% (N=104) indicated they... more
Results-- The overall smoking prevalence was 31.5% (n=203); with 21.9% of the students being classified as irregular smokers (n=141) and 9.6% as regular smokers (n=62). Of the 203 students who were smokers, 51.2% (N=104) indicated they had initiated smoking at or before the age of 10 years. Smokers were more likely to be male (p<0.01), and of low socioeconomic status (SES) (p<0.01). Despite their relatively young age, regular smokers had significantly higher prevalence of hypertension (>120/80 mm Hg) (p<0.05), elevated Low Density Lipoprotein (LDL) (179± ...
: To illustrate important health disparities and issues at the international level, several different populations and regions are highlighted. In Juarez, Mexico, many women are uneducated about breast cancer and the importance of... more
: To illustrate important health disparities and issues at the international level, several different populations and regions are highlighted. In Juarez, Mexico, many women are uneducated about breast cancer and the importance of screening, leading to low awareness and late detection. Similarly, Romanian women show low rates of cervical cancer screening, and the factors contributing to the elevated mortality rate of cervical cancer in European countries will be discussed. Ethiopia, and specifically the Amhara region, has a ...
Purpose: This study was conducted to achieve a two prong objective:(a) to gather data and research the condom utilization among minor-aged (< 18 years old) FSW in Thailand brothels, and (b) to provide new and existing condom promotion... more
Purpose: This study was conducted to achieve a two prong objective:(a) to gather data and research the condom utilization among minor-aged (< 18 years old) FSW in Thailand brothels, and (b) to provide new and existing condom promotion programs with the pertinent information necessary to meaningfully improve their performance. Methods: The present study surveyed 130 minor-aged FSW from brothels in four geographic areas of Thailand, including: Bangkok, Chang Mai, Mae Hong Son, and small villages. The questionnaire ...
The human papillomavirus (HPV) is one of the most common sexually transmitted infections (STI) in the world and it is associated with cervical cancer. The development of a prophylactic HPV vaccine has proven effective in clinical trials... more
The human papillomavirus (HPV) is one of the most common sexually transmitted infections (STI) in the world and it is associated with cervical cancer. The development of a prophylactic HPV vaccine has proven effective in clinical trials and it is now available to the public. The HPV vaccine represents a viable prevention strategy against cervical cancer. However, parental preferences, perceptions, and willingness to use the HPV vaccine are crucial, and if not assessed accurately, may threaten the successful implementation of a ...
Background: The present study was conducted in a multi service-learning, student managed and operated, community-based clinic. Its aim was to measure the direct and indirect effects of how proximal factors (i.e., ‘management’, ‘support... more
Background: The present study was conducted in a multi service-learning, student managed and operated,
community-based clinic. Its aim was to measure the direct and indirect effects of how proximal factors (i.e.,
‘management’, ‘support received’, ‘duration of involvement’, and ‘average time spent per month’) and mediators
(i.e., ‘training received’, ‘motivation’, and ‘commitment’) influence distal outcomes (i.e., ‘performance’, ‘satisfaction’,
and ‘overall experience’) within a volunteer organization.

Methods: Participants were recruited through the use of an email list server. An online survey was used containing
multi-item measures from validated scales. Data were collected from 170 volunteers from July to August 2013. Data
analysis used a structural equation modeling (SEM) framework for the estimation of direct and indirect effects on
constructs and variables of interest. Only statistically significant relationships were reported at p < 0.05.

Results: In this study, there are several direct effects worthy of note. First, the proximal factor of ‘management’
plays an important role in influencing the mediators of ‘motivation’ (standardized beta = 0.55) and ‘training
received’ (0.65) by the student volunteers but has a relatively small impact on their ‘commitment’ (0.39) to the
organization. Second, the mediator of ‘motivation’ proved to have the strongest impact on the distal outcome of
volunteer ‘performance’ and ‘satisfaction’ levels (0.41 and 0.58 respectively), whereas ‘commitment’ (0.44) was the
key in determining their ‘overall experience’ with the organization. These results in turn, help contextualize the
indirect effects observed in our study. Namely, the proximal factor of ‘management’ played a distinctive role in
influencing the distal outcomes of volunteer ‘performance’ (0.32) and ‘overall experience’ (0.66), whereas the
organizational ‘support received’ by the volunteers was key to their ‘satisfaction’ (0.21).

Conclusions: The findings of the present study shed light into the direct and indirect effects of how proximal
factors and mediators, influence student volunteers distal outcomes within a community-based clinic. These results
provide useful information and serve as a valuable tool to higher education (curriculum experts, accreditation
specialists, students, faculty and administrators) and non-profit community organizations (clients, staff and managers)
in their efforts to improve student volunteer satisfaction and performance outcomes.

Keywords: Volunteerism, Evaluation, Satisfaction, Performance, Overall experience, College students, Community-based
clinic
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Introduction The role that socioeconomic status/income play in accounting for the increased prevalence of type 2 diabetes has not been sufficiently studied in Canada. The primary purpose of the present study was to determine the... more
Introduction
The role that socioeconomic status/income play in accounting for the increased prevalence of type 2 diabetes has not been sufficiently studied in Canada. The primary purpose of the present study was to determine the unadjusted and adjusted effect of income on type 2 diabetes. The secondary purpose was to determine the adjusted effect of income on diabetes associated conditions such as high blood pressure and being overweight or obese, and its main behavioral factor of physical inactivity.

Methods
This is a cross-sectional, population-based study. Data was analyzed from four cycles of the Canadian Community Health Survey (CCHS). It was conducted by Statistics Canada and covered the time period of 2000–2008 in the province of Saskatchewan, Canada. In this study, four separate and distinct multivariate models were built to determine the independent effect of income on type 2 diabetes and the associated conditions of high blood pressure, being overweight or obese, and physical inactivity.

Results
The total sample size was comprised of 27,090 residents from Saskatchewan. After statistically controlling for age, only six covariates were independently associated with type 2 diabetes prevalence including: having high blood pressure (OR = 3.26), visible minority cultural status (OR = 2.17), being overweight or obese (OR = 1.97), being of male gender (OR = 1.76), having a household income of $29,999 per year (OR = 1.63) and being physically inactive (OR = 1.15).

Conclusions
In this study, household income was strongly and independently associated with type 2 diabetes prevalence, its associated conditions of high blood pressure and being overweight or obese, and its main behavioral factor of physical inactivity. We suggest that income is an important but frequently overlooked factor for type 2 diabetes and worthy of further investigation, appropriate public debate and timely policy intervention.
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Results: When comparing the FEV1, FEV1/FVC and FEF25-75% values of the smoking group, they were found to be significantly lower than the values recorded in both the SHS exposed group as well as the nonsmokers not exposed to SHS group (P =... more
Results: When comparing the FEV1, FEV1/FVC and FEF25-75% values of the smoking group, they were found to be significantly lower than the values recorded in both the SHS exposed group as well as the nonsmokers not exposed to SHS group (P = 0.0040, 0.0100 and 0.0000, respectively). Additionally, the decrease in FEF25-75% was significantly correlated inversely with the number of cigarettes students smoked per day (P = 0.0261). A comparison of the group of students exposed to SHS revealed significantly lower values than the group who were ...
To assess the smoking behaviors, beliefs about the risks of smoking, and exposure to ETS among adolescents in Juárez, Mexico.
Breast cancer is the leading cause of cancer-related death among U.S. Hispanic women. Hispanics are less likely than non-Hispanic White women to be diagnosed at an early stage and survive breast cancer.
In Thailand, it is estimated that there are nearly 2 million female sex workers (FSWs), of whom 800,000 (40%) are under the age of 18 years. Studies examining condom use among adolescent FSWs in Thailand have been limited. Therefore, a... more
In Thailand, it is estimated that there are nearly 2 million female sex workers (FSWs), of whom 800,000 (40%) are under the age of 18 years. Studies examining condom use among adolescent FSWs in Thailand have been limited. Therefore, a survey was administered to a cross-sectional, nonrandomized sample of convenience among 130 adolescent, brothel-based FSWs in four geographic areas of Thailand. A condom utilization gap was evident in the present study, since on average adolescent FSWs used 3.8 condoms per day, while seeing 7.4 patrons per day. This is especially troubling since generalized condom utilization campaigns in the past have overlooked adolescent FSWs. Consequently, future public health efforts in Thailand need to recognize the existence and identify the unique healthcare needs of this vulnerable population, if they are to successfully decrease their sexually transmitted infection/HIV incidence rates.
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Rates of breast cancer (BC) have increased in Mexico, with the highest incidence and mortality rates observed in the northern Mexican states. This study aimed to describe the BC knowledge, attitudes and screening practices among Mexican... more
Rates of breast cancer (BC) have increased in Mexico, with the highest incidence and mortality rates observed in the northern Mexican states. This study aimed to describe the BC knowledge, attitudes and screening practices among Mexican women with and without a family history of BC residing along the Mexico-US border, and identify factors associated with screening behaviors. One hundred and twenty eight Mexican women aged 40 and older completed an interviewer-administered questionnaire on sociodemographic characteristics, knowledge, family history, and screening practices. There were no significant differences between Mexican women with and without a family history. Over 60% of women in both groups had never had a mammogram/breast ultrasound, and more than 50% had never obtained a clinical breast exam. Age, marital status, insurance, and breast cancer knowledge significantly influenced BC screening behaviors among Mexican women. Further research is needed to examine other key factors associated with screening utilization, in effort of improving BC rates.
Breast cancer is the leading cause of cancer-related death among U.S. Hispanic women. Hispanics are less likely than non-Hispanic White women to be diagnosed at an early stage and survive breast cancer.
Breast cancer is the leading cause of cancer-related death among U.S. Hispanic women. Hispanics are less likely than non-Hispanic White women to be diagnosed at an early stage and survive breast cancer.
This study sought to determine the actual levels of condom use by female sex workers (FSW) in Thailand brothels. Specifically, it examined the influence that the country of origin of the FSW patrons exerted on usage of a condom, and it... more
This study sought to determine the actual levels of condom use by female sex workers (FSW) in Thailand brothels. Specifically, it examined the influence that the country of origin of the FSW patrons exerted on usage of a condom, and it assessed the relevancy of constructs from the Health Belief Model in predicting FSW requesting condom usage by their clients. A survey was administered to a cross-sectional non-randomized convenience sample of 150 FSW in four geographic locations in Thailand, which included: Bangkok, Chang Mai, Mae Hong Son and Other (comprised mainly of brothels in small villages). Statistical interpretation of the data indicated that Thai FSW requested condom use in 63% of the cases, while the overall mean of condom use was only 51%. Condom use by patrons’ country of origin was as follows: westerners 76%, foreign Asians 52% and native Thai men 27%. These results fall considerably short of the Ministry of Health's goal of 100% condom use in Thai brothels. Furthermore, public health education initiatives need to effectively target the native Thai FSW patrons since they represent the clients least likely to use a condom (27%).
The purpose of this study was to identify the nature and extent of physical violence against pregnant women by male partners under the influence of alcohol and other drugs (AOD) using a sample of women who presented for prenatal care at a... more
The purpose of this study was to identify the nature
and extent of physical violence against pregnant women
by male partners under the influence of alcohol and other
drugs (AOD) using a sample of women who presented
for prenatal care at a major hospital in Ciudad Juárez,
Mexico. Of the 215 women who completed the survey,
17.7% (n = 38) self-reported being victims of physical
abuse, with 89.5% (n = 34) of them reporting their
male intimate partner being under the influence of AOD
at the time of the act (p < 0.01). The majority of these
women were poor, young housewives with less than a
high school education. Substance abuse treatment centers
in Juárez, Mexico may wish to incorporate physical
violence screening into their history-taking protocols and
offer suitable violence prevention services.
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