Medicine and Health Sciences Commons^™

A Proposal For Enhancing And Measuring Infant-Directed Maternal Utterances And Incidental Teaching Within The Safecare® Parent-Infant Interaction Module, Megan O. Smith

Public Health Theses

Child maltreatment is a serious and pervasive public health problem in the United States. In 2008, there were 772,000 children who were substantiated victims of maltreatment and 1,740 children died as a result of maltreatment. Approximately 33 percent of maltreatment victims were under the age of four. Among numerous other negative sequelae, children who have been maltreated have an elevated incidence of language delay and poor cognitive functioning, both strong predictors of literacy skills and later academic achievement. Further, maternal language input is critical to a child’s cognitive development and language acquisition. Maltreating mothers provide their children with far less …

Evaluation Of Health Workforce Competence In Maternal And Neonatal Issues In Public Health Sector Of Pakistan: An Assessment Of Their Training Needs, Shabina Ariff, Sajid B. Soofi, Kamran Sadiq, Asher B. Feroze, Shuaib Khan, Sadiqua N. Jafarey, Nabeela Ali, Zulfiqar A. Bhutta

Department of Paediatrics and Child Health

Background: More than 450 newborns die every hour worldwide, before they reach the age of four weeks (neonatal period) and over 500,000 women die from complications related to childbirth. The major direct causes of neonatal death are infections (36%), Prematurity (28%) and Asphyxia (23%). Pakistan has one of the highest perinatal and neonatal mortality rates in the region and contributes significantly to global neonatal mortality. The high mortality rates are partially attributable to scarcity of trained skilled birth attendants and paucity of resources. Empowerment of health care providers with adequate knowledge and skills can serve as instrument of change. Methods: …

Building Capacity For Public And Population Health Research In Africa: The Consortium For Advanced Research Training In Africa (Carta) Model, Alex C. Ezeh, Chimaraoke O. Izugbara, Caroline W. Kabiru, Sharon Fonn, Kathleen Kahn, Lenore Manderson, Akinyinka Omigbodun, Margaret Thorogood, Ashiwel S. Undieh

Publications and Research

Background: Globally, sub-Saharan Africa bears the greatest burden of disease. Strengthened research capacity to understand the social determinants of health among different African populations is key to addressing the drivers of poor health and developing interventions to improve health outcomes and health systems in the region. Yet, the continent clearly lacks centers of research excellence that can generate a strong evidence base to address the region’s socio-economic and health problems. Objective and program overview: We describe the recently launched Consortium for Advanced Research Training in Africa (CARTA), which brings together a network of nine academic and four research institutions from …

Put Your Money Where Your Butt Is: A Commitment Contract For Smoking Cessation, Xavier Giné, Dean Karlan, Jonathan Zinman

Dartmouth Scholarship

We designed and tested a voluntary commitment product to help smokers quit smoking. The product (CARES) offered smokers a savings account in which they deposit funds for six months, after which they take a urine test for nicotine and cotinine. If they pass, their money is returned; otherwise, their money is forfeited to charity. Of smokers offered CARES, 11 percent took up, and smokers randomly offered CARES were 3 percentage points more likely to pass the 6-month test than the control group. More importantly, this effect persisted in surprise tests at 12 months, indicating that CARES produced lasting smoking cessation. …

Injury In Nevada, Michelle Chino, Jonathon Lavalley, Darlene R. Haff, Deborah A. Harris, Andrea R. Rivers

Public Health Faculty Publications

Injury is a major threat to health and safety. In a typical day in the US, 400 people will die as the result of an injury, 7,500 will be hospitalized due to an injury, and more than 150,000 will suffer an injury severe enough to restrict activities and seek medical attention. Many of these deaths, hospitalizations, and disabling events will be the result of motor vehicle crashes. Others will result from vio­lence, falls, drowning, and poisoning – all of which are considered injuries.

The costs of injury are high. In the United States, the cost of injuries is estimated to …

A Comparison Of Methods To Assess Practitioner Fidelity In A Parent-Training Program, Ashwini Tiwari

Public Health Theses

As evidence-based programs are implemented in real world settings, there is a strong need to effectively and efficiently monitor fidelity, or adherence to a program, in order to maintain the expected effects demonstrated in research settings. The purpose of this study was to compare two methods of assessing fidelity to an evidence-based, parent-training model (SafeCare®) as implemented by community service providers. Specifically, analyses compared fidelity assessed via video versus audio recordings. SafeCare modules often require mobility and high interaction, thus, video recordings may provide a more accurate view of home visitor and family interactions for scoring fidelity. However, videos are …

The State Of Primary-Care Research, David Mant, Chris Del Mar, Paul Glasziou, Andre Knottnerus, Paul Wallace, Chris Van Weel

Paul Glasziou

In March, 2003, the editor of The Lancet attended an international conference in Kingston, Ontario, Canada, on primary-care research, subsequently running a rather dyspeptic editorial entitled "Is primary-care research a lost cause?" (1) This article highlighted the unacceptable weakness of primary-care research worldwide. A particular concern of the conference was the shortage of primary care research in less economically developed countries to inform the clinical and public health management of malnutrition, malaria, AIDS, water-borne infection, and other illnesses of poverty (2). However, problems exist even in economically developed countries. In Australia, for example, a crude measure of research productivity with …

Cardiovascular Risk Assessment - From Individual Risk Prediction To Estimation Of Global Risk And Change In Risk In The Population, John A. Batsis, Francisco Lopez-Jimenez

Dartmouth Scholarship

Cardiovascular disease is the most common cause of death and risk prediction formulae such as the Framingham Risk Score have been developed to easily identify patients at high risk that may require therapeutic interventions. Using cardiovascular risk formulae at a population level to estimate and compare average cardiovascular risk among groups has been recently proposed as a way to facilitate surveillance of net cardiovascular risk and target public health interventions. Risk prediction formulas may help to compare interventions that cause effects of different magnitudes and directions in several cardiovascular risk factors, because these formulas assess the net change in risk …

Latin America And The Caribbean: Assessment Of The Advances In Public Health For The Achievement Of The Millennium Development Goals, Amal K. Mitra, Gisela Rodriguez-Fernandez

Faculty Publications

To improve health and economy of the world population, the United Nations has set up eight international goals, known as Millennium Development Goals (MDGs), that 192 United Nations member states and at least 23 international organizations have agreed to achieve by the year 2015. The goals include: (1) eradicating extreme poverty and hunger; (2) achieving universal primary education; (3) promoting gender equality; (4) reducing child mortality; (5) improving maternal health; (6) combating HIV/AIDS, malaria and other diseases; (7) ensuring environmental sustainability; and (8) developing a global partnership for development. Having been in the midway from the 2015 deadline, the UN …

A Policy Analysis Of The Nursing Shortage In Selected Sub-Saharan African Countries, Julia Twining

Master's Theses, Dissertations, Graduate Research and Major Papers Overview

This paper will begin with a comprehensive literature review of the nursing shortage in the sub-Saharan African region. The global nursing crisis is explored with a focus on the economics of nursing, challenges presented by the nursing shortage, interventions to increase nursing capacity, and partnerships that have been implemented to achieve this goal. The nursing shortage in selected sub-Saharan African countries is analyzed from a policy perspective using Fawcett and Russell’s Conceptual Model of Nursing and Health Policy (2005). Then, McLaughlin and McLaughlin's Policy Analysis Process (2008) is used to identify, analyze, evaluate, and make recommendations to create health policy. …

Oral Cancer In Nevada: A Public Health Perspective, Karl Kingsley

UNLV Theses, Dissertations, Professional Papers, and Capstones

Cancer is the second leading cause of death in the United States, and oral cancer remains the eighth leading cause of cancer death among US males. Although previous epidemiologic studies have found that overall rates of cancer, including oral cancer, have declined in the US in recent decades – these declines are neither uniform nor consistent within this population. Anecdotal evidence has suggested that rates of oral cancer in Nevada are relatively high, although no evidence was available to support these assertions.

Oral Cancer Epidemiology: Based upon this information, a detailed and thorough epidemiologic examination of oral cancer rates in …

Unmasking The Moving Threat: Reckless Driving, Borderline Personality Disorder, And The Impact On Motor Vehicle Accidents, Charlene Lam

Master of Public Health Program Student Publications

Background: Motor vehicle accidents (MVAs), a leading cause of mortality in the United States have an enormous impact on public health. Researchers contend that approximately 90% of all MVAs are, to some extent, a result of driver characteristics and behavior (Lewin, 1982). One of the least researched driver characteristics is psychiatric comorbidity, especially borderline personality disorder (BPD), a disorder that is characterized by impulsivity and emotional volatility.

Objective: The purpose of this study is to examine the relationship between BPD and driving citations.

Method: Using two measures for BPD, we surveyed a consecutive sample of patients who were being seen …

Analysis Of Primary Risk Factors For Oral Cancer From Us States With Increasing Rates, Anthony Bunnell, Nathan Pettit, Nicole Reddout, Kanika Sharma, Susan O'Malley, Michelle Chino, Karl Kingsley

Public Health Faculty Publications

Objectives

To examine the primary risk factor for oral cancer in the US, smoking and tobacco use, among the specific US states that experienced short-term increases in oral cancer incidence and mortality.

Methods

Population-based data on oral cancer morbidity and mortality in the US were obtained from the National Cancer Institute's (NCI) Surveillance, Epidemiology, and End Results (SEER) database for analysis of recent trends. Data were also obtained from the Centers for Disease Control and Prevention (CDC) Behavioral Risk Factor Surveillance System (BRFSS) to measure current and former trends of tobacco usage. To comprehensive measures of previous state tobacco use …

Cultural Competency: A Growing Need To Better Serve Our Diverse Populations, Rob Simmons Drph, Mph, Ches, Cph, Nancy L. Chernett Mph, Elain Yuen Phd, Susan Toth-Cohen Phd, Otr/L

Population Health Matters (Formerly Health Policy Newsletter)

No abstract provided.

Recreational Physical Activity And Premenstrual Syndrome In College-Aged Women, Aimee R. Kroll

Masters Theses 1911 - February 2014

It is estimated that up to 85% of premenopausal women experience at least one premenstrual symptom and 15-20% meet clinical criteria for premenstrual syndrome (PMS). PMS has a high morbidity level and reduces the quality of life for many women of reproductive age, with pharmaceutical treatments having limited efficacy and substantial side effects. Physical activity has been recommended as a method of reducing menstrual symptom severity. However, little evidence exists to support a clear relationship between physical activity and PMS. Using a cross-sectional design, we evaluated the relationship between physical activity and PMS and menstrual symptoms among 186 women aged …

Hospital Evacuations: Historical Precedence And Modern Preparedness, Nicholas Squillace

Master of Public Health Program Student Publications

Objectives: The purpose of this research was to identify common problems encountered during hospital evacuations and how those problems are or should be addressed when creating a hospital evacuation plan.

Methods: Articles relating to hospital evacuations were retrieved from PubMed and CINAHL in addition to government websites and the Joint Commission on Accreditation of Healthcare Organizations. The articles collected were limited to within the last 20 years, from 1990 to 2010. Hospital plans were collected from search engines including Google and Yahoo. Moreover, a plan was obtained from a Dayton area hospital.

Results: Numerous instances of hospital evacuations that were …

The Relationship Between Body Image And Body Mass Index In Attendees At A Health Fair, Millie S. Olds

Master of Public Health Program Student Publications

The purpose of this study was to examine the relationship between body image and body mass index (BMI) in attendees at a health fair. BMI and body image was also compared between races, ages and genders. It was hypothesized that there would be discrepancies between perceived body image and weight status, as measured by BMI. Sixty-two participants at a health fair in Cincinnati completed a survey about perceived body image and had their height and weight measured and BMI calculated later. Results suggested a positive relationship between BMI and body image. Participants with a higher BMI identified themselves with a …

Socioeconomic And Environmental Causes For Respiratory Infection Death In Alaska Native Villages, Sarah Mcbeth

Master of Public Health Program Student Publications

Objectives. This ecological study evaluates the association between community characteristics and death rates from pneumonia/influenza, tuberculosis, and infectious diseases in 196 Alaska Native villages.

Methods. Ecological variables studied included percentage of Natives in the population, age distribution, latitude, average household size, socioeconomic status, percentage of homes with complete plumbing and/or kitchens, type of heating fuel used, community alcohol restrictions, level of healthcare access, and residence in specific regions of Alaska. These data come from the 2000 U.S. Census, the Alaska Alcohol Beverage Control Board, and the Alaska Native Tribal Health Consortium. A stepwise analysis of variance using the Proc GLM …

Diabetes Obesity-Wellness Opportunity Program (Dowop) Evaluation, Francis Banahene

Master of Public Health Program Student Publications

The aim of the study was to evaluate Diabetes Obesity - Wellness Opportunities Program (DOWOP) for overweight and obese adolescents aged eight to 14 years.

The study was conducted over 14 weeks at Victor J. Cassano, Sr. Health Center in Dayton, Ohio. Thirteen weekly nutrition, exercise and cognitive presentations were held. Cooking class was held on week thirteen. Participants completed food and activity diaries. The program sessions focused on healthy eating, increasing physical activity, decreasing sedentary behavior and supporting participants maintain healthy lifestyle.

Nurses recorded BMI and waist circumference at baseline, week 7 and week 14. Program administrators were interviewed …

Demographic Factors That Predict Cervical Cancer Screenings In Ohio Women With Disabilities, Shari Mae Martin

Master of Public Health Program Student Publications

Background: Cervical cancer screening (CCS) rates are lower for women with disabilities than for the general population. The purpose of this project was to describe cervical cancer screening rates in women with disabilities, living in Ohio, and explore the relationship of select demographic factors to cervical cancer screening participation.

Methods: A chart audit of 350 randomly selected women with disabilities, ages 20-80, enrolled in a statewide home care waiver program was completed.

Results: Less than half of the women (45.4%) had obtained a CCS within the last 3 years, compared to a rate of 82% for the general population of …

The Public Health Impacts Of Concentrated Animal Feeding Operations On Local Communities, Michael Greger, Gowri Koneswaran

Environment Collection

Large-scale farm animal production facilities, also known as concentrated animal feeding operations (CAFOs), release a significant amount of contaminants into the air and water. Adverse health effects related to exposure to these contaminants among CAFO workers have been welldocumented; however, less is known about their impact on the health of residents in nearby communities. Epidemiological research in this area suggests that neighboring residents are at increased risk of developing neurobehavioral symptoms and respiratory illnesses, including asthma. Additional research is needed to better understand community-scale exposures and health outcomes related to the management practices and emissions of CAFOs.

Department Of Family Medicine And Public Health Sciences 2009 Annual Report, Wayne State University School Of Medicine, Department Of Family Medicine And Public Health Sciences

Annual Reports

2009 annual report includes: External Funding in 2009; Peer-Reviewed Publications in 2009; Full-time Affiliate and Voluntary Faculty; Honors, Awards, and Appointments in 2009.

“They Don't Want Anything To Do With You”: Patient Views Of Primary Care Management Of Chronic Pain., Gonzalo Bacigalupe

Gonzalo Bacigalupe, EdD, MPH

No abstract provided.

Pollution And Public Health In A Shrinking World: Concentrated Animal Feeding Operations As A Paradigm For Emergent Needs In Environmental And Public Health Policy, Leland Stillman

Self-Designed Majors Honors Papers

Environmental factors play a major part in human health. Environmental pollutants are often as poisonous to humans as the environment. Presently, much time and energy is dedicated to keeping pollution apart from human society, with varying success. But as global population densities rise, current levels of pollution will become inviable due to public health concerns. An emergent example of this is in the concentration of livestock operations. Recent changes in the structure of U.S. hog farming have resulted in an industry-wide shift from small or medium production farms to high capacity, “concentrated animal feeding operations” (CAFO). These operations have become …

Keeping Prevention In The Crosshairs: A Better Hiv Exposure Law For Maryland, Sara Klemm

Journal of Health Care Law and Policy

No abstract provided.

Barriers To Accessing Primary Dental Care For The Uninsured/ Underinsured Population In The City Of Cincinnati, Kiana R. Trabue

Master of Public Health Program Student Publications

Despite federal, state and local efforts to provide access to dental services to vulnerable populations such as the uninsured and underinsured, many people still do not receive adequate dental care. This study seeks to identify barriers to primary dental care in the City of Cincinnati. The Cincinnati Health Department (CHD) operates five safety net health centers which provide dental care for the citizens of the Cincinnati service area. Surveys conducted in these centers found that cost was the main reason individuals do not see the dentist regularly. Even in those with dental insurance cost was a major barrier, although most …

Safe Choices: An Examination Of Contraceptive Choices Of The Patient Population Of Planned Parenthood Of Central Ohio, Chloe Williams

Master of Public Health Program Student Publications

Objective: This study sought to evaluate the variation between racial groups and contraceptive methods chosen by women served by Planned Parenthood of Central Ohio (PPCO) in 2009 in order to better understand the issue of unintended pregnancy.

Methods: This two part study used administrative records provided by PPCO that included raw data for all women who were scheduled for an appointment to receive, or be consulted on contraception from January 1, 2009 through December 31, 2009 which included three PPCO clinic locations in Franklin County, Ohio. A chi-square analysis was performed with java-based mathematical software from the Math Beans Project …

Southern Lagoon And Village Of Gales Point, Belize, Ca: Water Uses, Water Quality, And Potential Health Impacts, Rasmi Nair, Ritchie Taylor

Impact Belize

An International Health Service Learning Program, Impact Belize 2010, was conducted by Western Kentucky University. Faculty and students worked closely with Gales Point villagers to gain an insight into the use of Southern Lagoon. The objective of the study was to assess fecal coliform levels in Southern lagoon, its primary and secondary contact use by villagers and its potential impact on health. Study methodology involved collection of water samples, both near shore and offshore, in the lagoon and incubating them using ColiQuant EZ method approved by EPA. A questionnaire was administered to villagers attending the WKU clinic to collect data …

Maternal Characteristics And Infant Birth Weight In Dayton, Ohio, Matthew Pellerite

Master of Public Health Program Student Publications

Objective: To better understand and identify modifiable maternal risk factors that are driving the increased incidence of low birth weight (LBW) in Montgomery County.

Background Information: LBW has lifelong effects on growth and development. These medical and social implications are coupled with an enormous economic burden. In the US, over 5.8 billion dollars are spent annually to care for LBW babies. Despite the recognition of these medical and economic challenges and the implementation of public campaigns to decrease rates, LBW trends have continued to increase. Between 1995 and 2005 the LBW rates in the US incrementally increased from 7.3% to …

Unmet Medical Need Of Underserved Population In A Safety-Net Organization, Leslie Clem

Master of Public Health Program Student Publications

Background: Safety net providers serve a large proportion of America’s uninsured and low income population. The purpose of this study is to determine if differences in unmet medical needs exist between the provisional and clinic populations, age groups, and sex and race categories. This research study provides information about the population that receives services from Good Neighbor House, a non-profit social service organization in Dayton, Ohio.

Methods: GNH created a survey to assess the unmet medical need of their clients. The instrument contains questions about routine medical care, unmet medical care in the last 12 months, medical bills, and demographic …