Public Health Commons^™

Emergency Medical Service Worker Knowledge Of And Compliance With Occupational Exposures To Infectious Diseases, Debra Ann Wrentz-Hudson

Walden Dissertations and Doctoral Studies

Firefighter Emergency Medical Service (EMS) responder personnel are at a high risk for occupational exposures to bloodborne and airborne infectious pathogens due to their unpredictable work duties in the pre-hospital environment. Not much is known about the compliance with Universal Precautions (UP) among firefighter EMS responders' personnel with regards to occupational exposures to infectious diseases. The purpose of this cross-sectional research study was to determine the relationship between compliance with UP, knowledge of UP, attitudes towards UP, occupational practices, and occupational exposures to bloodborne and airborne pathogens to prevent transmission of infectious disease among firefighter EMS responder personnel in the …

A Phenomenological Inquiry Into The Low Rates Of Influenza Vaccination Among Older African Americans, Delia Roxanne Howson-Santana

Walden Dissertations and Doctoral Studies

Influenza vaccination is recommended for persons with high-risk health conditions such as chronic diseases to prevent flu-related complications and death. African Americans 65 years and older have consistently been reported to have the lowest influenza vaccination rates compared to all other racial groups, despite having higher rates of chronic diseases. A review of the literature indicated that there is a dearth of qualitative studies examining the grounds for these low rates. In this study, 15 African Americans 65 years and older were interviewed to explore the factors that contribute to low rates of flu vaccination among this racial group. Research …

Stories Of Contaminated Waste Dump Sites In Amskapi Pikuni Blackfeet Country, Kimberly L. Paul

Graduate Student Theses, Dissertations, & Professional Papers

Abstract:

Significant health disparities affect much of the American Indian/Alaska Native (AI/AN) and Native Hawaiian (NH) populations of America_.^3,6,10,11,14 Inequalities in health care and delivery of services for these populations are a contributing factor to disparate health conditions.² Lack of equity in areas such as social services¹⁸, education, environmental contaminants^5,7,8,17, historical trauma¹ and acute poverty[a1] [KP2] ^{16, 19} strongly influence health conditions⁴. People residing within the remaining tribal lands of the Northern Plains experience markedly higher incidence of disease than other ethnicities within this nation¹⁰, ultimately …

Exploring The Association Between Network, Cognitive, Structural Social Capital And The Risk Of Clinical Depression In Taiwan, Yun-Hsuan Wu

Theses and Dissertations

Depression is the one of most common mental health conditions in Taiwan. Although evidence suggests that social capital is associated with depression, few studies have comprehensively explored the influence of social capital on depression. Also evidence in Taiwan is limited in comparison to other Western countries. Data from the 1997 Taiwan Social Change Survey (n=2,598), which is the only dataset that contains the best available information to measure and compare all three dimensions of social capital (network, cognitive, and structural social capital), were used to examine the association between three dimensions of neighborhood- and individual-level social capital and depression among …

Statewide Scale-Up Of Group Prenatal Care In South Carolina, Kristin M. Van De Griend

Theses and Dissertations

Background: Poor birth outcomes and racial disparities in birth outcomes in South Carolina are widely recognized problems. To improve maternal and child health outcomes, especially among vulnerable groups, universal access to timely, appropriate, and effective care should remain a priority through increased availability and accessibility. An interagency collaborative in South Carolina expanded CenteringPregnancy (CP) from two to five medical practices throughout the state. CenteringPregnancy is associated with improved birth outcomes and reduced rates of racial disparities in preterm birth throughout the United States. Important questions in the literature remain about strategies and determinants of scaling up sexual and reproductive …

Food Security Status And Life Events Among Households With Children In The Midlands Of South Carolina, Erin Rebekah Drucker

Theses and Dissertations

Purpose: Food insecurity is a major public health problem in the United States (US) with 14.5% of US households having experienced some level of food insecurity in 2012. Among households with children, 20% experienced low food security in 2012, and in half of these households, both the children and adults were affected. Food insecurity among children can have lifelong negative health and mental effects. Life events are defined as self-­‐reported life changes, which create a strain on resources and an opportunity for food insecurity, Methods: The Midlands Family Study (MFS) was a cross-­‐ sectional study that surveyed households …

A Decision Support Simulation Model For Bed Management In Healthcare, Raja A. Baru

Masters Theses

"In order to provide access to care in a timely manner, it is necessary to effectively manage the allocation of limited resources such as beds. Bed management is key to the effective delivery of high-quality and low-cost healthcare. An efficient utilization of beds requires a detailed understanding of the hospital's operational behavior. It is necessary to understand the behavior of a hospital in order to make necessary adjustments to its resources, and policies, which can improve patient's access to care. The aim of this research was to develop a discrete event simulation to assist in planning and staff scheduling decisions. …

The Relationship Between Sexual Functioning And Sleep Quality In A Female Undergraduate Student Sample, Alexander Kuka

All Graduate Theses, Dissertations, and Other Capstone Projects

A relative lack of literature exists regarding the relationship between sexual functioning and sleep quality in women. The current study assessed these constructs in a sample of 260 undergraduate female students via online administration of relevant measures for sleep quality, sexual functioning, stress, and medical conditions and prescription medications. The relationship between sleep quality and sexual functioning was positive but not significant, even when controlling for relevant variables such as stress. As such, future research might seek to clarify this relationship and to identify variables that mediate or moderate this relationship.

Endgame For Polio Eradication? Options For Overcoming Social And Political Factors In The Progress To Eradicating Polio., Pavan Ganapathiraju, Christiaan B Morssink, James D. Plumb

College of Population Health Faculty Papers

In 1988, the Global Polio Eradication Initiative (GPEI) was launched with the goal of eradicating polio by the year 2000. After 25 years, several dynamics still challenge this large public health campaign with new cases of polio being reported annually. We examine the roots of this initiative to eradicate polio, its scope, the successes and setbacks during the last 25 years and reflect on the current state of affairs. We examine the social and political factors that are barriers to polio eradication. Options are discussed for solving the current impasse of polio eradication: using force, respecting individual freedoms and gaining …

Community Perception Of Electronic Cigarettes And Their Role As Smoking Cessation Aids, Alejandro Velez

Family Medicine Clerkship Student Projects

The popularity of electronic cigarettes is increasing, yet the research is lagging behind. In an effort to better understand, and therefore better advice our patients, a small number of current daily cigarette smokers were surveyed on their understanding of electronic cigarettes and their usage. Two smoking cessation counselors were also interviewed to better contextualize the role of electronic cigarettes as possible smoking cessation aids. Finally, a review of the available research was done to produce a poster, and possibly a handout, in hopes to educate all patients (regardless of their current smoking habits) regarding electronic cigarettes.

A Tale Of Two Diseases: Mental Illness And Hiv/Aids, Lawrence O. Gostin

Georgetown Law Faculty Publications and Other Works

There have been dramatic advances in the treatment of HIV/AIDS. Whereas HIV was once a dire diagnosis, today it is treatable, and individuals who receive early and consistent treatment can expect to live a normal lifespan. Why has the scientific community made the same strides with mental illness? When I was the Legal Director of the National Association of Mental Health in the United Kingdom in the 1980s, major mental illnesses were primarily treated with powerful antipsychotics, such as haloperidol, that carried the debilitating side effects of tardive dyskinesia—involuntary movements of the tongue, lips, face, trunk, and extremities. When I …

An O'Neill Institute Briefing Paper: Ebola, The World Health Organization, And Beyond: Toward A Framework For Global Health Security, Lawrence O. Gostin, Eric A. Friedman, Daniel Hougendobler

Georgetown Law Faculty Publications and Other Works

The West African Ebola epidemic has demonstrated that the world remains ill-prepared to respond to infectious disease outbreaks. A host of institutions are now reviewing what went wrong, and new institutions are being considered, including an African Centers for Disease Control and Prevention and World Bank-initiated Pandemic Emergency Facility. The World Health Organization itself failed in one of its core functions by allowing a preventable infectious disease to spiral out of control in the world’s poorest region. The 68th World Health Assembly (WHA), held in May 2015, provided an opportunity for the Organization to reflect on what went wrong and …

Indonesia Has It Backward: It's Not E-Cigarettes That's The Problem But Smoking, Lawrence O. Gostin

Georgetown Law Faculty Publications and Other Works

Indonesia has announced it will be banning e-cigarettes. But that would do nothing to reduce smoking, which should be the main target of those interested in reducing tobacco use deaths and harms. Rather than ban e-cigarettes, it makes more sense to regulate them effectively so that they can serve as a useful anti-smoking tool. The availability of e-cigarettes to smokers can also make much more aggressive anti-smoking strategies more practically and politically viable-–perhaps even paving the way for banning cigarettes, instead.

Minority Stress, Depression, Relationship Quality, And Alcohol Use: Associations With Overweight And Obesity Among Partnered Young Adult Lesbians, Tyler B. Mason, Robin J. Lewis

Psychology Faculty Publications

Purpose: Although lesbian women are more likely to be obese compared to heterosexual women, relatively little research has examined correlates of overweight and obesity among lesbians. The purpose of this study was to examine the association of minority stress and depression, relationship quality, and alcohol-use variables to overweight and obesity among lesbians in relationships.

Method: Self-identified lesbians (n = 737) in current relationships completed measures of demographics, minority stress, depressive symptoms, relationship variables, and alcohol use.

Results: Overweight and obesity were associated with more public identification as a lesbian, more depressive symptoms, increased heavy drinking, longer relationship length, and lower …

Environmental Exposures And Childhood Pulmonary Function, Pallavi Prakash Balte

Theses and Dissertations

Fetal origins of adult disease hypothesis states that adverse influences early in developmental period and particularly during intrauterine life can result in permanent changes in physiology which may lead to increased disease risk of chronic diseases in adulthood. Both fetal and adolescent period are critical time periods for development of lungs. Any adverse environmental exposures during these critical periods of lung growth is a form of programming which can have long term effects on pulmonary function. The purpose of this dissertation was to examine the association between different environmental exposures and pulmonary function in children and late adolescents. The first …

Ethnic Discrimination: Measurement And Associations With Smoking-Related Outcomes Among Arab Male Current And Former Smokers In Israel, Amira Osman

Theses and Dissertations

We evaluated the psychometric properties of two instruments used to assess ethnic discrimination among Arabs in Israel. The “Experiences of Discrimination” (EOD) scale was adapted to assess interpersonal ethnic discrimination (EOD-A) and a new measure was developed to assess perceptions of institutional group discrimination (IGD) against Arabs as an ethnic group. Then, we examined the association between each form of ethnic discrimination (interpersonal and institutional) and smoking outcomes among Arab men from Israel, and whether social support and coping efficacy moderate these associations. Data were analyzed from a cross-sectional study of Arab male current and former smokers, aged 18-64. A …

Patient And Provider Characteristics And Practice Patterns Of Primary Care Physicians Of Weight-Related Counseling, Kolby T. Redd

Theses and Dissertations

Background: The United States Preventive Services Task Force (USPSTF) recommends three types of health education counseling for use in primary care practices for adult, obese patients. While these recommendations are well known, a low percentage of physicians provide this counseling to their patients on a consistent basis. There are inconsistencies in past studies in regards to what aspects of the health encounter influence the likelihood of receiving health education counseling during a primary care visit. The objective of this study was to (1) investigate the patterns of these three types of counseling occurring within primary care practices and to …

Maternal Obesity, Gestational Weight Gain And Offspring’S Asthma, Kristen Polinski

Theses and Dissertations

Introduction: Obesity is common among women of childbearing age and intrauterine exposures may influence the development of early childhood asthma. A handful of studies have investigated pre-pregnancy obesity, but even fewer have thoroughly explored gestational weight gain as possible childhood asthma risk factors. Gaps remain in the literature and to our knowledge, none have longitudinally explored these relationships in a nationally representative sample of U.S. children.

Methods: We used data from the Early Childhood Longitudinal Study – Birth Cohort, in which children were followed through age four (n≈5,200). Asthma was based on parent report of a physician’s diagnosis. …

The Influence Of Self-Reported Degree Of Masculinity/Femininity On Condom Use Among Black Men Who Have Sex With Men In The Deep South, Elizabeth D. Peeler

Theses and Dissertations

In the United States, 50,000 Americans are diagnosed with HIV each year (CDCa, 2014). The HIV/AIDS epidemic has had a particularly devastating impact on the southern U.S., especially the Deep South – Alabama, Georgia, Louisiana, Mississippi, North Carolina, and South Carolina (Reif, Whetten, Wilson, McAllaster, Pence, Legrand, & Gong, 2014). The Deep South, while only composing of 36% of the national population, accounts for 50% of all people living with HIV/AIDS in the nation (Human Rights Watch, 2010). No other population has been hit harder than men who have sex with men (MSM; Prejean, Tang, & hall, 2013). Black MSM …

Analytic Thinking Predicts Vaccine Endorsement: Linking Cognitive Style And Affective Orientation Toward Childhood Vaccination, Daniel A. Anderson

University Honors Theses

Though popular opinion in the US is favorable toward vaccination, a growing hesitancy to vaccinate children threatens rates of uptake and coverage. In response, researchers now study psychological factors thought to influence vaccine-decisions, as having this information might be useful in addressing vaccine hesitancy in the clinic and beyond. The present thesis reviews evidence from this body of work, and shares results of a new study on the influence of analytic and intuitive thinking styles upon endorsement of childhood vaccines. In a national sample (N = 543), analytic thinking predicted endorsement alone and in the presence of covariates in …

From Dar Es Salaam To Dartmouth: A Case Study Of The Experiences Of Fogarty Aids International Training And Research Program Fellows At Dartmouth College, Lisa Anne Purvis

Graduate College Dissertations and Theses

From Dar es Salaam to Dartmouth: A Case Study of the Experiences of Fogarty AIDS International Training and Research Program Fellows at Dartmouth

Lisa Purvis, EdD Candidate, MPH, MBA

Background

The United States (US) is a major host nation to international college students and scholars who study a variety of disciplines (Farrugia & Bhandari, 2014). Beginning in the last decade, the demand for global health training has risen (Kanter, 2008; Kerry, Ndung'u, Walensky, Lees, Kayanjas, & Bangsberg, 2011).

Since 2000, Geisel School of Medicine at Dartmouth has been one of 26 US universities participating in a global health training program, …

Defining Food Agency: An Ethnographic Exploration Of Home And Student Cooks In The Northeast, Maria Carabello

Graduate College Dissertations and Theses

According to popular and academic sources, home cooking is in decline. Nutrition and public health scholars concern that a loss of cooking abilities may diminish individuals' control over their food choices, thus contributing to poor health outcomes. Yet, there are still many unanswered questions. What skills, strategies, and knowledge sets are required to cook a meal on any given occasion? What capacity separates those who cook with ease from those who struggle to incorporate cooking into their daily routines? I propose that this difference is determined by an individual's capacity to employ a range of cognitive and technical skills related …

Slow Foods For Health Increasing Knowledge Of Glycemic Index In Adolescents For Healthier Food Choices, Meredith Kayleigh Sooy

Family Medicine Clerkship Student Projects

Obesity has reached epidemic proportions through the United States affect all age groups, genders, and races. This is especially troubling in the pediatric population where 12.5 million children were found to be overweight in 2010. Many adolescents have inadequate knowledge of nutrition basics to make healthy choices. Based on interviews within the community of Colchester, VT a need for information about the glycemic index was seen. A handout geared towards adolescents was created with information about the glycemic index and using this information to make healthy food choices. This handout was made available to all providers of Colchester Family Practice …

Ems Use By The Young Adult Population In The Region Of Waterloo, Karen J. Totzke

Theses and Dissertations (Comprehensive)

Anecdotal evidence suggests that university students are accessing local Emergency Medical Services (EMS) more frequently, usually as a result of alcohol consumption. In doing so, they endanger their personal health and create challenges for EMS and local hospitals. This study examined EMS use by young adults (ages 16-24 years) to identify differences between university students and youth in the Region of Waterloo, and to determine predictors of transport to hospital. This cross-sectional study used retrospective data collected during a six-year period (2006-2011) from a large, mixed urban and rural municipal ambulance service located in southwestern Ontario. Data were extracted from …

Transient Trunk Flexion: The Potential To Alleviate Low Back Pain During Prolonged Standing, Danielle M. Stewart

Theses and Dissertations (Comprehensive)

The current study examined potential benefits of intermittent, short-term periods of full trunk flexion on the development of low back pain (LBP) over two hours of standing. Sixteen participants completed a 2-hour standing protocol, on two separate days. On one day, participants stood statically for 2 hours; on the other day participants bent forward to full spine flexion for 5 seconds every 15-minutes. During both protocols, participants reported LBP using a 100mm visual analogue scale every 15-minutes. During the flexion trials, erector spinae muscle activation was monitored. Ultimately, intermittent trunk flexion reduced LBP by 36% (10mm) at the end of …

Pediatric Lipid Screening Guidelines: Information For Patients And Families, Erin R. Pichiotino, Mph

Family Medicine Clerkship Student Projects

Universal Pediatric Lipid Screening Guidelines are currently based on expert opinion only. Bright Futures/American Academy of Pediatrics currently recommends screening all patients ages 9-11 and again at ages 17-21. The US Preventive Services Task Force (USPSTF), however, concludes the evidence is insufficient to recommend for or against routine screening. This discordance leaves ambiguity for implementation in Family Medicine practices in Vermont. A survey of providers at Milton Family Practice showed that only 14% of providers at Milton Family Practice regularly perform lipid screening on their pediatric patients.

Lyme Disease Awareness In Downeast Maine, Justin L. Genziano

Family Medicine Clerkship Student Projects

Lyme disease is caused by the bacteria Borrelia burgdorferi and is transmitted by the deer tick (Ixodes scapularis). Lyme disease is endemic in the state of Maine with 1,399 probable and confirmed cases reported in 2014. The rate in coastal Hancock County has doubled since 2012, and has the third highest rate of infection in the state.

Medical providers in Hancock County have observed an increase in anxiety and concern about Lyme disease in the community, and have found that much of this is driven by hearsay or unreliable information from the internet. The goal of this project …

Improving Healthy Habits In Berlin, Vt, Amy I. Triano

Family Medicine Clerkship Student Projects

A significant percentage of patient’s at Berlin Family Practice have diagnoses of Type II Diabetes, hypertension, high cholesterol, and/or obesity. Essential to treatment and management of these conditions are a healthy diet and exercise. There are many local and national resources available but no single place where patient’s can find links to national as well as local resources in the Central Vermont community. There is also insufficient time for physicians or nurses to counsel patients on relevant resources. This project involved creation of a website with community and national resources for healthy living that providers could refer patients to. A …

Barriers To Recovery For Bangor's Buprenorphine Patients, John R. Mclaren, Erin Keller

Family Medicine Clerkship Student Projects

There are several buprenorphine providers at EMMc's Center for Family Medicine serving the greater Bangor, ME region - an area of substantial opiate use. Among the patient population of outpatient buprenorphine users, both locally and nationally, there are high rates of relapse (~32%). In order to decrease relapse rates, it's first imperative to conduct a baseline review of the current buprenorphine population to identify specific types of patients who are at higher risk of relapse. By understanding the barriers to recovery, the office hopes to apply an intervention to the current program, targeting this local demographic more effectively.

Determining Barriers To Oral Health Care In Bennington County, Taylor Goller Ms-3

Family Medicine Clerkship Student Projects

Bennington County has some of the worst oral health outcomes in the state of Vermont. A survey was designed to assess current oral health problems, maintenance habits, and barriers to oral health services access. Results are preliminary.