Medicine and Health Sciences Commons^™

Ready, Set, Action: Potential Breakthrough Therapy For Treatment-Resistant Depression, Alvin Garlejo

Master's Projects and Capstones

Major depressive disorder is a psychiatric illness that is associated with a variety of debilitating symptoms such as persistent sadness, lack of interest and motivation, lassitude, pessimistic thoughts, and in severe cases, suicidal ideation and behavior. Current psychological and pharmacological treatments have been demonstrated efficacious; however, an ever-growing number of individuals frequently report minimal to no improvement with these treatments; and in some cases, a worsening of symptoms. This inadequacy to treatment is commonly known as treatment-resistant depression. At Kadima Neuropsychiatry Institute, Dr. Feifel treats individuals with treatment-resistant depression with advanced treatments such as TMS and ketamine. During my fieldwork …

A Novel Model Of “Remedy And Elimination Of Tuberculosis”, Akanksha Mishra

Master's Theses

Tuberculosis (TB), is one of the top ten causes of death worldwide. TB is commonly linked to poverty and creates poverty as it is the single largest cause of death in the 15-49-year-old age group in South-East Asia (WHO, 2017). It is also linked to the HIV population, and its leading cause of death. TB is effected by socio-economic factors, cultural factors, and health policy. My goal of this dissertation is to identify systematic approaches that shall support the mission set by World Health Organization (WHO): to eliminate TB globally by the year 2050. Measures might include addressing social barriers …

Lessons Learned From Cuba: Using Healthcare Systems And Stillbirth Rate Example, Ravi Patel

Master's Projects and Capstones

Cuba and the U.S. have different health care systems but similar health outcomes. In 2015 U.S. and Cuba had the same stillbirth rate. Cuba is a prevention-based system that is free for all, while the U.S. is a treatment-based system that uses a fee for service system. Cuba has ratified international laws that hold it accountable for improving health outcomes especially for women and children. The U.S. can learn from Cuba when it comes to improving health outcomes. The U.S. can improve their health outcomes by including more preventative based interventions and ratifying international law that will hold the U.S. …

Relationships Between Complex Pediatric Health Conditions And The Built, Physical And Social Environments, Brittany Corley

Theses & Dissertations

The relationship between human health and the environment is complex and overall poorly understood. The environment has a lasting impact on health, and the processes appear to start at conception. Thus, this dissertation examines the potential relationship between pediatric health and the environment.

The first relationship examined was between the built environment and comorbid Attention Deficient Hyperactivity Disorder and Autism Spectrum Disorder. Many publications have reported the relationship between socioeconomic disadvantage, Attention Deficient Hyperactivity Disorder, and Autism Spectrum Disorder. However, the link between the built environment and Attention Deficient Hyperactivity Disorder and Autism Spectrum Disorder symptom severity is poorly understood. …

Public Health Perspectives On Sexual Health And Family Planning, Molly Mccarthy

Theses & Dissertations

Large bodies of evidence document the importance of sexual and reproductive health (SRH) in the lives of individuals and among populations. Of particular interest are sexually transmitted diseases (STDs), due to their potential for long-term health consequences, and unintended pregnancy because of its association with social and economic outcomes for women and families.

This dissertation addressed three distinct but related areas of reproductive health and family planning: counseling for condom use following an STD test, counseling for contraception following a pregnancy test in a clinical setting, and the effect of abortion on having and achieving long-term plans. These topics are …

Implementation Of A Fruit And Vegetable Voucher Program In San Francisco, Alexandra Kambur

Master's Projects and Capstones

Chronic disease has emerged as the predominant public health challenge of the 21st century. Chronic diseases like cardiovascular disease, cancer, type 2 diabetes and obesity have maintained their top positions as the leading causes of poor health, disability, death, and high health-care expenditures for over a decade. Health and hunger go hand-in-hand. Today over 15 million households in the United States struggle with food insecurity, meaning they do not have sufficient access to food that meets their dietary needs for an active and healthy life. The issue of food insecurity in cities like San Francisco, California is exacerbated by the …

Oh Baby! Evaluating The Impact Of Blossom's Natural Childbirth Prep Course On Women's Childbirth Experience, Florence Oxenham

Master's Projects and Capstones

The United States has some of the highest rates of maternal morbidity and mortality among developed countries. Comprehensive childbirth education is an important component of improving maternal health outcomes. This project was a pilot evaluation of a childbirth education course offered by Blossom Birth Services, a community-based non-profit organization providing resources for new and expectant families in the San Francisco Bay Area. A 41-item survey questionnaire was developed and administered to explore the impact of Blossom’s Natural Childbirth Prep course on women’s knowledge, feelings, and sense of self-efficacy regarding childbirth. Likert scales were used and thematic analysis of qualitative data …

No More Baby Steps: Preventing Unintended Pregnancies Of Los Angles Minorities And Adolescents, Rachel Bass

Master's Projects and Capstones

Previous studies have identified pregnancy intention to correlate with both maternal and fetal health. Though unintended pregnancy rates are dropping in America, they remain high among minority and young women. Contraceptive usage, a leading protective factor for unintended pregnancies, has been found to vary greatly by age and ethnicity. These two projects aimed to decrease unintended pregnancy rates through increasing patient knowledge of contraceptive options and correct usage. The first project focused on creating a comprehensive, oral contraceptive pill instructional handout for research participants of the birth control pill study. This handout was created through the analysis of compliance errors …

A Roadmap For The Journey Home - A Supplemental Tool Guiding Patients From Hospital To Home, Michelle Basco

Master's Projects and Capstones

Centers for Medicare and Medicaid (CMS) have recognized readmission rates as a public health problem. CMS incentivizes hospitals to reduce readmission rates and reduce payments for hospitals with high readmission rates (Berry et al., 2013). Patient education and discharge planning are associated with decreased readmission rates. I gained fieldwork experience at Children’s Health System of Texas in Dallas. Children’s Health, a pediatric non-profit, is the 8th largest pediatric health care provider in the U.S. Prior to discharge patient education occurs on topics related to their diagnosis, plus patients are provided discharge instructions including their diagnosis, medications, and simple instructions for …

Health Starts In The Home: An Assessment Of Efforts To Improve Occupant Health Through Healthy Building Materials In San Francisco’S Affordable Housing, Staci Hoell

Master's Projects and Capstones

Americans spend 90% of their lives indoors, and much of this time is spent at home, surrounded by building materials that typically have added chemicals like flame retardants, highly fluorinated compounds, and antimicrobials. Recent research has linked these chemicals to adverse health outcomes such as asthma, endocrine disruption, cancer, neurodevelopmental issues, and reproductive problems (Bayer et al., n.d.; Green Science Policy Institute). Furthermore, these chronic health conditions disproportionately affect low-income populations. Fortunately, substantial efforts in research, practice, and policy are working to reduce the use of these potentially harmful chemicals in building materials, particularly in San Francisco’s affordable housing sector. …

Acquisition Of Aquatic Motor Skills Through Children’S Motor Stories, Juan Antonio Moreno Murcia, Elisa Huescar Hernandez, Jose Antonio Richart Parra

International Journal of Aquatic Research and Education

An increasing interest in the renewal of traditional recreational content and the use of the aquatic environments as educational resources is supported by very few empirical, evidence-based studies that link the two. This quasi-experimental study analyzed the role of stories in influencing perceived motor competence and real motor skills in seventy-eight children ages between 4 and 5 years through the administration of two questionnaires on aquatic motor ability and aquatic motor competence. Differences were found in aquatic motor competence (p < .01) and aquatic motor ability (p < .05) for the experimental group, where higher means values were obtained after the intervention. We present this methodological proposal as a useful educational tool for early childhood stimulation with achievements that go beyond motor progress itself.

Evaluation Of Iowa’S Anti-Bullying Law, Marizen Ramirez, Patrick Ten Eyck, Corinne Peek-Asa, Joseph E Cavanaugh, Angela Onwuachi-Willig

Angela Onwuachi-Willig

Background Bullying is the most common form of youth aggression. Although 49 of all 50 states in the U.S. have an anti-bullying law in place to prevent bullying, little is known about the effectiveness of these laws. Our objective was to measure the effectiveness of Iowa’s anti-bullying law in preventing bullying and improving teacher response to bullying. Methods Sixth, 8th, and 11th grade children who completed the 2005, 2008 and 2010 Iowa Youth Survey were included in this study (n = 253,000). Students were coded according to exposure to the law: pre-law for 2005 survey data, one year post-law for …

Carbohydrates And Fungal Toxin Exposure Influence The Vaginal Microbiota, Metabolome, And Reproductive Health Of Women, Stephanie L. Collins

Electronic Thesis and Dissertation Repository

The reproductive health of women is influenced by microorganisms and their metabolites, namely those representing the vaginal microbiota and those producing toxins that are ingested. To manipulate the vaginal microbiota toward a health-associated, Lactobacillusdominant state, an approach adopting prebiotic lactulose was taken. Using batch culture, lactulose supported Lactobacillus maintenance and positively altered metabolites, while not disrupting indigenous L. crispatus epithelial adherence. The vagina also harbours abundant glycogen, but initial assumptions that lactobacilli utilize it were incorrect. I have now shown that glycogen selectively stimulates organisms associated with dysbiosis and L. iners in a self-limiting manner. Other compounds such as environmental …

Prevalence Of And Trends In Diabetes Among Veterans, United States, 2005–2014, Ying Liu, Sonica Sayam, Xiaonan Shao, Kesheng Wang, Shimin Zheng, Ying Li, Liang Wang

ETSU Faculty Works

Diabetes is a highly prevalent chronic disease among US adults, and its prevalence among US veterans is even higher. This study aimed to examine the prevalence of and trends in diabetes in US veterans by using data from the US National Health and Nutrition Examination Survey from 2005 through 2014. The overall prevalence of diabetes and undiagnosed diabetes was 20.5% and 3.4%, respectively, and increased from 15.5% in 2005–2006 to 20.5% in 2013–2014 (P = .04). Effective prevention and intervention approaches are needed to lower diabetes prevalence among US veterans and ultimately improve their health status.

The Italian Agreement Between The Government And The Regional Authorities: National Guidelines For Aai And Institutional Context, Martina Simonato, Marta De Santis, Laura Contalbrigo, Daniele Benedetti, Elisabetta Finocchi Mahne, Vincenzo Ugo Santucci, Silvio Borrello, Luca Farina

People and Animals: The International Journal of Research and Practice

Animal-assisted interventions (AAI) have developed considerably in the last half century, prompting various private and public realities dealing with AAI worldwide to work on and establish standards and best practice. However, AAI are still far from being regulated harmoniously. In this context, Italy offers a unique example at world level: here the spread of AAI has set in motion an ethical and legal reflection that led to the creation of the Italian National Reference Centre for AAI (NRC AAI) by ministerial decree in 2009 and the approval of National Guidelines for AAI in 2015. The Italian legislation on AAI is …

Quality And Access To Care For Cardiovascular Disease Prevalence In Women Veterans: Population Estimate Using Electronic Health Records, Meena Marie Kim-Dopp, Vanessa Gow-Lee, Linda Ferry, Sharon Jamie, Ralph Clark, Suma Singh

Loma Linda University Student Journal

Electronic Health Records are used to measure quality indicators for cardiovascular disease (CVD), but have not been tested for sensitivity and specificity. Computerized Patient Record System (CPRS) used by the Veterans Health Affairs (VHA), has active CVD clinical reminders from Healthcare Effectiveness Data & Information Set (HEDIS) that are compared nationally. San Bernardino County, CA has a 7.8% prevalence of self-reported CVD in both genders. For HEDIS measures, there is only a 4 point CVD composite score gender difference for VHA nationally, but at the Loma Linda VHA there is an 18 point gender difference (2016). Women Veterans (WV) are …

Obesity And Diabetes: Evaluating The Impact Of Promotores As A Prevention And Intervention Strategy In The Latino Community, Jessica Castaneda

Master's Projects and Capstones

This paper aims to examine obesity and diabetes among the Latino population as a health problem. As the largest minority racial group in the U.S, Latino rates of obesity and diabetes are greatly higher than whites. The prevalence of obesity in Latinos is 45% compared to that of whites at 34.5% (CDC, 2015). The disproportionate rates at which Latinos are affected by obesity and diabetes have prompted numerous programs to combat this health problem. Promotores or Latino community health workers have been able to provide the important piece of culturally and linguistically appropriate education for the population. Evidence shows Promotores …

Social Marketing For A Farmer's Market In An Underserved Community: A Needs Assessment, Meg Skizim, Melinda Sothern, Ondrej Blaha, Tung-Sung Tseng, Lauren Griffiths, Jonathan Joseph, Henry Nuss

School of Public Health Faculty Publications

The aim of the present paper is to assess local residents' awareness of utilizing Supplemental Nutrition Assistance Program (SNAP) benefits to purchase fresh produce at local farmers' markets, and to determine internet use and media preferences of study participants prior to implementation of a social marketing campaign. A needs assessment was conducted to collect baseline data in an underserved neighbourhood in New Orleans (La, USA). The study was carried out August 2014-May 2015. The assessment revealed that 73% of the respondents were unaware that the SNAP benefits could be used to purchase food in farmers' markets; 63% of low-income participants …

Development And Applications Of A Real-Time Magnetic Electron Energy Spectrometer For Use With Medical Linear Accelerators, Paul Ethan Maggi

LSU Doctoral Dissertations

Purpose – This work presents a design for a real-time electron energy spectrometer, and provides data analysis methods and characterization of the real-time system. This system is intended for use with medical linear accelerators (linacs). The goal is 1 Hz acquisition of the energy range 4-25 MeV, reconstructed in 0.1 MeV increments.

Methods – Our spectrometer uses a nominal 0.54 T permanent magnet block as the dispersive element and scintillating fibers coupled to a CCD camera as the position sensitive detector. A broad electron beam produced by a linac is collimated by a 6.35 mm dimeter aperture at the entrance …

Patient-Provider Relationship And Perceived Provider Weight Bias Among American Indians And Alaska Natives, Kelly L. Gonzales, Ginny Garcia, Michelle M. Jacob, C. Muller, Lonnie A. Nelson, Spero M. Manson

OHSU-PSU School of Public Health Faculty Publications and Presentations

Objective The objective of this study was to examine patient–provider relationships among American Indians and Alaska Native (AI/AN) patients by examining associations between patient activation, perceived provider weight bias and working alliance. Patient activation is generally defined as having the knowledge, skills and confidence to manage one's health.

Methods Among a sample of 87 AI/AN adults presenting for general medical care at an urban clinic in the north-west region of the USA, ordinary least squares regression analysis was completed to examine associations.

Results Better working alliance scores were associated with increased patient activation, while perceived provider weight bias was associated …

Community Development Projects In Moldova, Berkend Pura

Capstone Collection

This Independent Practitioner Inquiry Capstone (IPIC) aims to provide relevant information, from a Peace Corps (PC) Volunteer (PCV) standpoint, on a renovation project that was implemented in the village of Vorniceni, Republic of Moldova. At its core, this was a community development project that involved the active participation of the community of Vorniceni, providing local resources and knowledge towards the goal of building a healthier sanitation facility on the second floor of the local kindergarten.

The results of this effort indicate that the involvement of the client (people) is crucial to sucess in implementing projects, and it also shows that …

Vietnamese American Women’S Beliefs And Perceptions On Cervical Cancer, Cervical Cancer Screening, And Cancer Prevention Vaccines: A Community-Based Participatory Study, Connie Kim Yen Nguyen-Truong, Kim Quy Vo Nguyen, Thai Hien Nguyen, Tuong Vy Le, Anthony My Truong, Keara Rodela, Rachael Allan

Asian/Pacific Island Nursing Journal

Cervical cancer remains commonly diagnosed in Vietnamese American women. Despite efforts to increase cervical cancer screening among Vietnamese American women, participation rates are persistently lower than the national goal. The objective of this study is to explore beliefs of Vietnamese American women about cervical cancer, cervical cancer screening, and cancer prevention vaccines. A qualitative descriptive investigation captured group perceptions about meaning and beliefs of cervical cancer, screening, and cancer prevention vaccines, and participants’ stories using a community-based participatory research approach.

Forty Vietnamese American women were recruited from the Portland, Oregon metropolitan area into four focus groups. Using a process of …

Genetic Epidemiology Of Neural Tube Defects, Philip J Lupo, A J Agopian, Heidi Castillo, Jonathan Castillo, Gerald H Clayton, Nienke P Dosa, Betsy Hopson, David B Joseph, Brandon G Rocque, William O Walker, John S Wiener, Laura E Mitchell

Journal Articles

It has been estimated that 60-70% of neural tube defects (NTDs) have a genetic component, but few causative genes have been identified. The lack of information on genes associated with non-syndromic NTDs in humans is especially notable as the "genomic revolution" has led to new tools (e.g., genome-wide genotyping arrays, next-generation sequencing) that are helping to elucidate the full spectrum of genetic variation (from common to rare) contributing to complex traits, including structural birth defects. However, the application of modern genomic approaches to the study of NTDs has lagged behind that of some other common structural birth defects. This may …

Antibiotic Resistance In Escherichia Coli Iron Transport Mutants, Madeline Brandt

Honors Projects

Studies previously completed on Escherichia coli mutants suggested the possibility of iron uptake as an influence on the antibiotic resistance seen in different strains. The research focused on the TonB energy transduction system and its contributions to efflux-mediated antibiotic resistance. To test the hypothesis that iron uptake has an influence on antibiotic resistance in Escherichia coli, the sensitivity to a variety of antibiotics was evaluated in strains of E. coli lacking genes that relate to the uptake of iron or the efflux system that is necessary for the uptake of iron. To test the efflux systems TolC and TonB …

Beyond The End Line - Putting The Mental Health Of Female Athletes First, Katherine Scholten

Honors Projects

Currently one in five adults are affected by mental illness. Student-athletes are a population that is under diagnosed for mental illness. In the world of college athletics, mental pain is as regular as physical pain. Coaches often push their athletes to suffer in silence for the betterment of the team. The NCAA has recognized the importance of mental health in college athletics, yet there is still much work to be done among universities across the country. This document is to serve as a resource and a guide on the effects of mental health among female student athletes and the best …

Chronic Disease Risk Prediction Models And Their Impacts On Behavioural And Health Outcomes: A Systematic Review And Meta-Analysis, Patrick Kim

Electronic Thesis and Dissertation Repository

Risk prediction models are tools that predict an individual’s risk of developing a health outcome. They were developed to influence patient management by guiding preventive interventions, with the goal of reducing the incidence of new diseases. Studies examining their impacts are uncommon, and no consensus regarding their effects has been reached. This systematic review sought to determine the impact of risk prediction models for chronic diseases on physician behaviour, patient behaviour, and patient health outcomes. Twenty-two studies were found to be eligible for review. The results demonstrated that: 1) physician behaviour may be positively influenced, though a statistically significant result …

The Emerging Role Of Two-Pore Domain Potassium Channels In Breast Cancer, Keith A. Dookeran, Auer Paul

Public Health Faculty Articles

Potassium ion channels are transmembrane proteins that selectively facilitate ion flow down an electrochemical gradient between intracellular and extracellular environments. There is accumulating evidence which suggest that potassium channel protein activity is important in the pathophysiology of cancer, and associations of the two-pore domain family of potassium channels and breast cancer are currently emerging. The aim of this review is to summarize data on mechanisms of action related to oncogenic properties and examine the role of the two-pore domain family in breast cancer.

Changes In The Utilization Of Osteoporosis Drugs After The 2010 Fda Bisphosphonate Drug Safety Communication, Bander Balkhi, Enrique Seoane-Vazquez, Rosa Rodriguez-Monguio

Pharmacy Faculty Articles and Research

Introduction

In October 2010, the US Food and Drug Administration (FDA) issued a safety communication regarding the risks of atypical fractures of the femur, with bisphosphonates drugs. This study evaluated the impact of the bisphosphonates FDA safety communication on the utilization of osteoporosis medications in Medicaid programs.

Methods

Osteoporosis drugs utilization data from the July 2006 to June 2014 were extracted from the national Summary Files from the Medicaid State Drug Utilization Data maintained by the Centers for Medicare & Medicaid Services (CMS). We performed an interrupted time series analyses to evaluate trends in utilization of osteoporosis drugs before and …

Introduction Of Iodised Salt Benefits Infants’ Mental Development In A Community-Based Cluster-Randomised Effectiveness Trial In Ethiopia, Karim Bougma, Frances E. Aboud, Tizita M. Lemma, Edward A. Frongillo Jr., Grace S. Marquis

Faculty Publications

The effectiveness of salt iodisation in improving the mental development of young children has not been assessed. We implemented a community-based cluster-randomised effectiveness trial in sixty randomly selected districts in the Amhara region of Ethiopia. We randomly allocated each district to treatment and randomly selected one of its villages. In parallel to national salt iodisation efforts, iodised salt was brought early into the markets of the thirty intervention villages before it became widely available in the thirty control villages 4–6 months later. The primary outcome was children’s mental development scores on the Bayley Scales. This was an intention-to-treat analysis using …

Impacts Of Active School Design On Schooltime Sedentary Behavior And Physical Activity: A Pilot Natural Experiment, Jeri Brittin, Leah Frerichs, John R. Sirard, Nancy M. Wells, Beth M. Myers, Jeanette Garcia, Dina Sorensen, Matthew J. Trowbridge, Terry Huang

Interior Design Program: Faculty Scholarly and Creative Activity

Background Children spend a significant portion of their days in sedentary behavior (SB) and on average fail to engage in adequate physical activity (PA). The school built environment may influence SB and PA, but research is limited. This natural experiment evaluated whether an elementary school designed to promote movement impacted students' school-time SB and PA.

Methods Accelerometers measured SB and PA at pre and post time-points in an intervention group who moved to the new school (n = 21) and in a comparison group experiencing no school environmental change (n = 20). Difference-in-difference (DD) analysis examined SB and PA outcomes …