Medicine and Health Sciences Commons^™

2013 Survey Of Children Served By Mainecare, Jean A. Talbot Phd, Deborah Thayer Mba, Zachariah T. Croll Mph, Kimberley Fox Mpa

Medicaid

These survey results help identify areas for improvement for future initiatives both for the MaineCare program and for providers serving this population. Key Findings: MaineCare higher than the national average on most patient experience measures. Significant improvements in MaineCare provider/family communication and care coordination. MaineCare lower than national average on customer service, availability of treatment choices, and care coordination among providers. Patient experience generally similar for Medicaid and CHIP enrollees. Many MaineCare children have special health care needs. 35% of children enrolled in MaineCare have special health care needs, according to the 2013 survey. Experience of children with special health …

An Analysis Of Employment Policies And Their Effect On Work-Life Balance For Caregiving Parents Of Children With Special Needs, Sara Panella

Muskie School Capstones and Dissertations

This capstone addresses the work-­‐life conflict facing employed caregiver parents with special needs children by 1) identifying what employed parents of children with disabilities need from their employer in order to achieve a work-­‐life balance that improves economic security and emotional well-­‐being, and 2) evaluating how well policies address those needs. An investigation of work-­‐family conflict and stress among parents of special needs children is conducted by examining the current literature and conducting interviews with caregivers to explore their work-­‐life balance needs. Policy recommendations are provided, based on an analysis of public and workplace policies currently in use and policy …

Comparison Of How Ambient PmC And Pm2.5 Influence The Inflammatory Potential, Matthew Ferguson, Christopher T. Migliaccio, Tony Ward

Public and Community Health Sciences Faculty Publications

Airborne particulate matter (PM) is one of six criteria air pollutants currently regulated by the U.S. Environmental Protection Agency (EPA), with existing ambient standards for PM_2.5 and PM₁₀. Currently there are no health-based regulations for the size fraction between 2.5 and 10 μm, commonly known as the coarse fraction (PM_c). The present study investigates current gaps in knowledge for PM_c including exposure toxicity and PM ratios (PM_c:PM_2.5) in PM₁₀. Throughout the world, all three PM size fractions have been shown to be associated with adverse impacts. Recent studies …

The Influence Of Position Type And Generational Grouping On Job Satisfaction Of Milwaukee County's Public Health Workforce, Jeanette L. Kowalik

Theses and Dissertations

Nationally, the public health workforce (PHW) consists of 155,000 staff (NACCHO, 2010). It is projected that half of the PHW will soon retire. Health departments must find ways to retain its diverse workforce.

Job Satisfaction is a critical variable that impacts a sustained PHW. Job Satisfaction assessments can promote sustainability of the workforce because the data assembled from the assessments can inform research, policy, and practice. Public health workers that report high Job Satisfaction are less likely to quit as well as delay retirement (RWJF, 2013).

The purpose of this study is to examine the influence of position type and …

Determinants Of Child And Forced Marriage In Morocco: Stakeholder Perspectives On Health, Policies And Human Rights, Alexia Sabbe, Halima Oulami, Wahiba Zekraoui, Halima Hikmat, Marleen Temmerman, Els Leye

Obstetrics and Gynaecology, East Africa

Background: In Morocco, the social and legal framework surrounding sexual and reproductive health has transformed greatly in the past decade, especially with the introduction of the new Family Law or Moudawana. Yet, despite raising the minimum age of marriage for girls and stipulating equal rights in the family, child and forced marriage is widespread. The objective of this research study was to explore perspectives of a broad range of professionals on factors that contribute to the occurrence of child and forced marriage in Morocco.

Methods: A qualitative approach was used to generate both primary and secondary data for the analysis. …

The Long-Term Effects Of Childhood Malnutrition On Cognitive Development: The Case Of Famine In Ghana, Ampaabeng K. Samuel, Chih Ming Tan

Economics & Finance Faculty Publications

We examine the role of early childhood health in human capital accumulation. Using a unique data set from Ghana with comprehensive information on individual, family, community, school quality characteristics and a direct measure of intelligence together with test scores, we examine the long-term cognitive effects of the 1983 famine on survivors. We show that differences in intelligence test scores can be robustly explained by the differential impact of the famine in different parts of the country and the impacts are most severe for children under two years of age during the famine. We also account for model uncertainty by using …

Effects On Volunteer Peer Leaders Participating In A Health Promotion Program For U.S. Veterans, Leslie A. Patterson

Theses and Dissertations

Health-focused peer-led interventions demonstrate success in reducing risk-related behaviors among participants with chronic illnesses, yet few researchers have explored the effects of such interventions on the health of volunteer peer leaders who participate in the interventions. Using data from the project entitled, An RCT of a Peer Support Intervention to Improve Hypertension, this study explored volunteer peer leaders' self-care behaviors that contribute to blood pressure control in two hypertension interventions for U.S. veterans. Inspection of the study's findings demonstrated that volunteer peer leaders improved their health habits and hypertension knowledge significantly more than the peer groups they served. Findings revealed …

Development Of Novel Subunit Vaccine Against H5n1 Influenza, Lu Zhang

Graduate Theses and Dissertations

Influenza is a common infectious disease resulting from a frequently mutated RNA virus. Vaccination is currently the most effective method to prevent people from seasonal or pandemic influenza. The production of traditional egg-based influenza vaccine is time-consuming and provides limited effect against new strains. Therefore, it is necessary to develop a rapid method to produce influenza vaccines. We proposed a novel influenza vaccine based on the E.coli expression system. Hemagglutinin (HA) is the major target surface protein of influenza virus for vaccine development. In this study, we sub-cloned the HAs encoding gene into an E. coli expression vector; the signal …

Assessing The Indoor Tanning Behaviors And Risk Of Skin Cancer Among Illinois Wesleyan University Students, Ellen Cornelius '14

Outstanding Senior Seminar Papers

The purpose of this research is to assess the indoor tanning behaviors of students at Illinois Wesleyan University (IWU) in Bloomington, Illinois and formulate strategies to reduce students’ risk of skin cancer. Skin cancer is widespread, and is the second most common cancer among people aged 15-24 years. There is strong evidence to support that many skin cancer cases seen today could have been avoided if the individual had never used an indoor tanning device. Research suggests the use of indoor tanning devices is popular among college-aged females in the US, thus persuading this demographic to reduce their indoor tanning …

Telemental Health In Today's Rural Health System, David Lambert Phd, John A. Gale Ms, Anush Yousefian Hansen Ms, Ma, Zachariah T. Croll Ba, David Hartley Phd, Mha

Mental Health / Substance Use Disorders

Telemental health has long been promoted in rural areas to address chronic access barriers to mental health care. While support and enthusiasm for telemental health in rural areas remains quite high, we lack a clear picture of the reality of telemental health in rural areas, compared to its promise. This Research & Policy Brief reports on the first part of our study—the online survey of 53 telemental health programs—and describes the organizational setting, services provided, and the staff mix of these programs. We draw from our telephone interviews with 23 of these programs to help describe the organizational context of …

Public Health Research Implementation And Translation: Evidence From Practice-Based Research Networks, Glen P. Mays, Rachel A. Hogg, Doris M. Castellanos-Cruz, Anna G. Hoover, Lizeth C. Fowler

Health and Clinical Sciences Faculty Publications

BACKGROUND: Research on how best to deliver efficacious public health strategies in heterogeneous community and organizational contexts remains limited. Such studies require the active engagement of public health practice settings in the design, implementation, and translation of research. Practice-based research networks (PBRNs) provide mechanisms for research engagement, but until now they have not been tested in public health settings.

PURPOSE: This study uses data from participants in 14 public health PBRNs and a national comparison group of public health agencies to study processes influencing the engagement of public health settings in research implementation and translation activities.

METHODS: A cross-sectional network …

Diagnosis And Acute Management Of Patients With Concussion At Children's Hospitals., Jeffrey D. Colvin, Cary Thurm, Brian M. Pate, Jason G. Newland, Matt Hall, William P. Meehan Iii

Manuscripts, Articles, Book Chapters and Other Papers

Objectives: To describe the number of hospital admissions for concussion at paediatric hospitals in the USA. To describe the use of imaging and medications for acute concussion paediatric patients.

Design: Cross-sectional study.

Setting: Children's hospitals participating in the Pediatric Health Information System in the USA during a 10-year period.

Patients: All emergency department (ED) visits and inpatient admissions with the primary diagnosis of concussion, defined as International Classification of Diseases, Ninth Revision, Clinical Modification codes for: (1) concussion, (2) postconcussion syndrome or (3) skull fracture without mention of intracranial injury with concussion.

Main outcome measures: The proportion of concussion patients …

Full-Gestational Exposure To Nicotine And Ethanol Results In Long-Term Dysregulation In The Ventral Tegmental Area, Emily Elizabeth Roguski

Theses and Dissertations (ETD)

Nicotine is considered a gateway drug for other drugs of abuse. The majority of smokers that begin smoking in adolescence, continue into adulthood. Multiple factors have been linked with smoking initiation, including maternal smoking. Drug exposure during pregnancy has long been suspected to exert deleterious effects on the fetal brain. Concurrent use of smoking and drinking alcohol throughout pregnancy is an all too frequent occurrence in the human population especially in disadvantaged and younger women.

The present study investigated the potential contributing factors for the enhanced nicotine selfadministration as seen in offspring with gestational exposure to nicotine and ethanol (Nic+EtOH).* …

Feasibility And Preliminary Outcomes From A Pilot Study Of The Smile Curriculum For Mother-Infant Co-Occupational Engagement And Maternal Self-Efficacy, Emily Whitlock

Theses and Dissertations

OBJECTIVE: To report on the feasibility and preliminary outcomes from a pilot study of the SMILE curriculum, a new educational program designed to enhance the mother-infant relationship by focusing on improvement of co-occupational engagement within daily routines.

METHOD: Six mothers, each with an infant diagnosed with special medical needs who received services in a local birth-to-three program, participated in an exploratory design study. Each mother was assigned to a SMILE curriculum intervention group or a waiting-list control group. Mothers were evaluated pre- and post-intervention using the Perceived Maternal Parenting Self-Efficacy (PMP-SE) Scale for measurement of maternal self-efficacy and the Center …

Who Done It? Rurality Vs. Ses As Critical Factors In Evaluating The Prevalence Of Child Psychosocial Concerns In Primary Care, Robert M. Tolliver

Electronic Theses and Dissertations

The purpose of this study was to evaluate the prevalence of child psychosocial concerns in rural primary care, hypothesized to be greater than national averages due to lacking mental health services in rural areas. This study was an examination of the role of SES, various definitions of “rural,” and the interaction of SES and rurality, in predicting parent-reported child psychosocial concerns in Appalachian primary care clinics. Caregivers presenting with their child at one of 8 pediatric primary care sites (n=2,672) were recruited to complete a measure assessing demographics and the Pediatric Symptom Checklist (PSC). Results showed that while rural status …

Health Service Utilization And Stigma Among Hiv-Positive Men-Who-Have-Sex-With Men (Msm) In Rural Appalachia, Roger L. Blackwell Jr

Electronic Theses and Dissertations

ABSTRACT

Health Service Utilization and Stigma among

HIV-Positive Men-Who-Have-Sex-With-Men (MSM) in Rural Appalachia

by

Roger Lee Blackwell

The world has now entered the third decade of the AIDS epidemic. Men-who-have-sex-with-men continue to be disproportionately affected by HIV/AIDS. The United States still struggles in its response to this ongoing crisis in many areas: disease prevention, treatment, and HIV related stigma, prejudice and discrimination. Much of the information reported on MSM living with HIV has come from urban population centers, but only a few studies have focused on HIV positive MSM living in rural areas. Therefore, the overall aim of this dissertation …

Development And Evaluation Of Chitosan Particle Based Antigen Delivery Systems For Enhanced Antigen Specific Immune Response, Bhanuprasanth Koppolu

Graduate Theses and Dissertations

Particle-based vaccine delivery systems are under exploration to enhance antigen-specific immunity against safe but poorly immunogenic polypeptide antigens. Chitosan is a promising biomaterial for antigen encapsulation and delivery due to its ability to form nano- and microparticles in mild aqueous conditions thus preserving the antigenicity of loaded polypeptides. The objective of this work is to develop a chitosan particle based antigen delivery system for enhanced vaccine response. Chitosan particle sizes, which ranged from 300 nm to 3 ìm, were influenced by chitosan concentration, chitosan molecular weight and addition rate of precipitant salt. The composition of precipitant salt played a significant …

High Hiv Incidence Among Persons Who Inject Drugs In Pakistan: Greater Risk With Needle Sharing And Injecting Frequently Among The Homeless., Rab Nawaz Samo, Arshad Altaf, Ajmal Agha, Omrana Pasha, Shafquat Rozi, Ashraf Memon, Saleem Azam, Meridith Blevins, Sten Vermund, Sharaf Ali Shah

Community Health Sciences

BACKGROUND:

The incidence of HIV among persons who inject drugs (PWIDU) has fallen in many nations, likely due to successes of clean needle/syringe exchange and substance abuse treatment and service programs. However in Pakistan, prevalence rates for PWID have risen dramatically. In several cities, prevalence exceeded 20% by 2009 compared to a 2003 baseline of just 0.5%. However, no cohort study of PWID has ever been conducted.

METHODS:

We enrolled a cohort of 636 HIV seronegative PWID registered with three drop-in centers that focus on risk reduction and basic social services in Karachi. Recruitment began in 2009 (March to June) …

Building The Science Of Healthcare Public Reporting: Integrating Anecdotal Information To Enhance Sensemaking, Kapil Chalil Madathil

All Dissertations

Anecdotal information about a healthcare consumers' interaction with care providers and hospital facilities is becoming increasingly available to the public in the form of YouTube videos and as discussion posts on peer-support groups. This form of information can potentially jeopardize the utility of reports generated by Federal entities as it potentially diverts consumer attention from more reliable measures of quality. This dissertation investigates how a health consumer's choice of care is influenced by anecdotal information on the care process available on YouTube. This research then investigates the effect of information presentation methods such as narratives and active engagement with quality …

Validation Of The Simple Activity Measurement Instrument (Sam) Using Heart Rate And Pedometry; Simple Activity Measurement Instrument (Sam) For Measuring Mvpa In Physical Education, Joseph P. Anaya

Graduate Theses

In order to battle obesity in our schools, Physical Education standards are working to become more and more in accordance with the Physical Activity Guidelines set by the U.S. Department of Health and Human Services, and the American College of Sports Medicine. Physical Education teachers would benefit from a tool that measures the amount and type of activity that students are involved in while they are in Physical Education. Many of the instruments that teachers use to assess students’ physical activity are too expensive, too difficult and can be time consuming. The purpose of the current study was to test …

Patients’ Attitudes Towards Patient Involvement In Safety Interventions: Results Of Two Exploratory Studies, Rachel Davis, Nick Sevdalis, Anna Pinto, Ara Darzi, Charles A. Vincent

Faculty Publications

BACKGROUND: In recent years, patient-focused interventions have been introduced aimed at increasing patient involvement in safety-related behaviours. However, patients' attitudes towards these interventions and comfort in participating in the recommended behaviours remain largely unexplored. OBJECTIVE: To evaluate patients' attitudes towards a video and leaflet aimed at encouraging patient involvement in safety-related behaviours. DESIGN: Two exploratory studies employing a within-subjects mixed-methods design. SETTING: Six hospital wards on an inner-city London teaching hospital. PARTICIPANTS: Medical and surgical inpatients: 80 patients in study 1 (mean age 55; 69% men) and 80 patients in study 2 (mean age 52; 60% men). INTERVENTION: Patients watched …

Closing The Rural Mortality Gap? An Examination Of 10-Year Cardiovascular Mortality Trends In Washington And Aroostook Counties, Maine, Christy Daggett

Muskie School Capstones and Dissertations

This study examines a significant reduction in cardiovascular disease (CVD) mortality1 in two rural, white, low-income counties in Maine over 1999-2009: Washington County and Aroostook County. Two similar counties with similarly high rates of CVD mortality– Penobscot and Piscataquis - were selected as comparators. The study considers different factors known to correlate with CVD mortality, including behavioral risk factors, co-morbid conditions, insurance coverage, and social determinants of health.

Us Medical Specialty Global Health Training And The Global Burden Of Disease, Vanessa B. Kerry, Rochelle P. Walensky, Alexander C. Tsai, Regan W. Bergmark, Brian A. Bergmark, Chaturia Rouse, David R. Bangsberg

OHSU-PSU School of Public Health Faculty Publications and Presentations

Background: Rapid growth in global health activity among US medical specialty education programs has lead to heterogeneity in types of activities and global health training models. The breadth and scope of this activity is not well chronicled.

Methods: Using a standardized search protocol, we examined the characteristics of US medical residency global health programs by number of programs, clinical specialty, nature of activity (elective, research, extended curriculum based field training), and geographic location across seven different clinical medical residency education specialties. We tabulated programmatic activity by clinical discipline, region and country. We calculated the Spearman's rank correlation coefficient to estimate …

Introduction: A Global Approach To Reproductive Justice—Psychosocial And Legal Aspects And Implications, Joan C. Chrisler

William & Mary Journal of Race, Gender, and Social Justice

No abstract provided.

Bad Medicine: Abortion And The Battle Over Who Speaks For Women's Health, Andrea D. Friedman

William & Mary Journal of Race, Gender, and Social Justice

No abstract provided.

Adequate Assurance Or Medical Mediocrity: An Analysis Of The Limits On The Affordable Care Act's Application To Women's Health, Nicole M. Hartz

William & Mary Journal of Race, Gender, and Social Justice

No abstract provided.

Tick Toxic: The Failure To Clean Up Tsca Poisons Public Health And Threatens Chemical Innovation, Kristen Ekey

William & Mary Environmental Law and Policy Review

No abstract provided.

Factors Influencing The Decision And Ability To Seek Health Services Among Hiv/Aids Patients In Tanzania, Savitri Grover

Masters Theses & Specialist Projects

Understanding the barriers to treatment for individuals with HIV/AIDS in developing countries could have a major impact on their ability to seek healthcare services. The purpose of this study is to quantitatively analyze the effect of daily activities and structural factors, which act as barriers to seeking health services for individuals living with HIV/AIDS in Tanzania.

The study is based on the hypothesis that (1) Individuals living with HIV/AIDS who face both personal and structural barriers have poor health compared to those not facing the barriers. (2) Individuals living with HIV/AIDS demonstrate different decisions and abilities to seek health services …

Structure Matters: Examining Illness Behavior Using Parsons's Sick Role, Angela D. Byrd

Masters Theses & Specialist Projects

Although Talcott Parsons’s sick role theory, as described in 1951 in The Social System, has been severely criticized for its inapplicability to chronic illnesses, a portion of the theory is still a relevant and necessary factor in terms of understanding and treating chronic illness today. Using data from the 2012 National Health Interview Survey, this study looks at the individual effects of sex, age, race, cohabitation, education and region of residence on the likelihood of chronically ill patients considering themselves limited in their amount or kind of work as an indicator of sick role adaptation. Results show statistically significant relationships …

Quantifying Value In Public Health: Using Economic Methods To Analyze System Change, Theresa M. Green

Dissertations

In this time of economic downturn, it is becoming increasingly important for organizations, including those in public health, to “prove their worth,” to show the value in improvement strategies. Health agencies have learned to discuss impact in terms of health outcome and mortality/morbidity measures. However, it is critical that these impacts are also expressed in a way that shows cost-efficiency and economic benefit especially for promising, evidence-based public health interventions. Although several methods of economic evaluation including cost-effective analysis, cost-utility analysis, or cost-benefit analysis and return on investment (ROI) have been used in social sciences and health research, fewer examples …