Public Health Commons^™

Global Health Security Agenda Legal Landscape Assessment, Natasha M. Nussbaum

Master's Projects and Capstones

The Global Health Security Agenda (GHSA) was created on February 13, 2014, to improve country's ability to detect, prevent and respond to emerging health threats. Eleven action packages were created. The detection action package included antimicrobial resistance, zoonotic diseases, national biosafety/biosecurity and immunization. The prevention action package included establishing a national laboratory system, strengthening real-time biosurveillance, advancing timely and accurate disease reporting and establishing a trained global health security workforce.The response action package focused on establishing emergency operation centers, linking public health and law enforcement and enhancing medical countermeasures/personnel deployment.

The following paper summarizes the components performed for the GHSA …

Impact Of Executive Order 13211 On Environmental Regulation: An Empirical Study, Elizabeth Ann Glass Geltman

Publications and Research

A great deal has been written about the Energy Policy Act of 2005 exempting oil and gas operations using hydraulic fracturing from the purview of certain federal environmental laws. Far less attention has been paid to George W. Bush’s Executive Order 13211 (EO 13211), entitled “Actions Concerning Regulations that Significantly Affect Energy Supply, Distribution or Use.” The executive order requires federal agencies to evaluate the impact of federal regulations on “supply, distribution and use of energy.” This study examined the impact of EO 13211 on United States environmental and conservation regulations proposed and promulgated by federal agencies. The study found …

Knowledge, Attitudes, And Intentions Toward Fertility Awareness And Oocyte Cryopreservation Among Obstetrics And Gynecology Resident Physicians, L. Yu, Brennan Peterson, M. C. Inhorn, Julia K. Boehm, P. Patrizio

Marriage and Family Therapy Faculty Articles and Research

STUDY QUESTION What knowledge, attitudes and intentions do US obstetrics and gynecology (OB/GYN) residents have toward discussing age-related fertility decline and oocyte cryopreservation with their patients?

SUMMARY ANSWER Most OB/GYN residents believe that age-related fertility decline, but not oocyte cryopreservation, should be discussed during well-woman annual exams; furthermore, nearly half of residents overestimated the age at which female fertility markedly declines.

WHAT IS KNOWN ALREADY Oocyte cryopreservation can be utilized to preserve fertility potential. Currently, no studies of US OB/GYN residents exist that question their knowledge, attitudes, and intentions toward discussing age-related fertility decline and oocyte cryopreservation with patients.

STUDY …

Inter-Organizational Network Effects On The Implementation Of Public Health Services, Glen P. Mays

Health Management and Policy Presentations

Background: The Affordable Care Act created new incentives for hospitals, insurers, public health agencies, and others to contribute to disease prevention and health promotion activities, potentially changing inter-organizational relationships and expanding implementation of strategies that improve population health. This study uses data from the 1998-2014 National Longitudinal Survey of Public Health Systems to examine: (1) the extent and nature of change in inter-organizational contributions to public health activities; (2) whether network changes attenuate or exacerbate disparities in public health implementation across communities; and (3) how network changes affect preventable mortality and resource use.

Methods: We follow a longitudinal cohort of …

Geographic Variation In The Implementation Of Public Health Services: Organizational, Economic, And Network Determinants, Glen P. Mays

Glen Mays

An expanding body of research-tested public health interventions exist to prevent disease and injury and promote health on a population-wide basis, such as those profiled in the CDC’s Guide to Community Prevention Services, but adoption and implementation of these strategies vary widely across states and communities. Public health services are delivered through diffuse constellations of governmental agencies and their private-sector and community-based counterparts using implementation mechanisms that are poorly understood. The studies in this panel examine how organizational, economic, and inter-organizational network characteristics influence the implementation of public health services across states and communities.

Inter-Organizational Network Effects On Public Health Service Implementation, Outcomes, And Disparities Across U.S. Communities, Glen P. Mays

Glen Mays

Background: The Affordable Care Act created new incentives for hospitals, insurers, public health agencies, and others to contribute to disease prevention and health promotion activities, potentially changing inter-organizational relationships and expanding implementation of strategies that improve population health. This study uses data from the 1998-2014 National Longitudinal Survey of Public Health Systems to examine: (1) the extent and nature of change in inter-organizational contributions to public health activities; (2) whether network changes attenuate or exacerbate disparities in public health implementation across communities; and (3) how network changes affect preventable mortality and resource use.Methods: We follow a longitudinal cohort of 360 …

Healthy Living For A Healthy Haiti, Elizabeth Grace Binney

Senior Theses

This project is twofold. The art and the book work synergistically to represent Haiti and health literacy. The pieces selected for this discussion are placed in chronological order of their creation, not the thematic order as they are organized in the book. This allows for discussion of the works as individual pieces of art, artistic development, the creation of a unified theme. They are the representation of a beautiful nation and people, as well as an expression of my inner self.

Puerto Rico’S Community Health Centers In A Time Of Crisis, Peter Shin, Jessica Sharac, Marie Nina Luis, Sara J. Rosenbaum

Geiger Gibson/RCHN Community Health Foundation Research Collaborative

In 2014, Puerto Rico’s twenty federally funded community health centers, operating in 71 sites located throughout the Commonwealth, served 330,736 patients, approximately one in ten Commonwealth residents. Compared to other Puerto Rico residents, health center patients are less likely to be insured. Despite considerable growth in Medicaid as a result of the supplemental funding provided under the Affordable Care Act, in 2014, 12.2% of health center patients remained uninsured.

Compared to health centers outside Puerto Rico, Puerto Rico’s health centers show a greater proportion of Medicaid patients served (69% compared to 46% outside Puerto Rico), a greater dependence on physician …

The Sustainable Development Goals: One-Health In The World’S Development Agenda, Lawrence O. Gostin, Eric A. Friedman

Georgetown Law Faculty Publications and Other Works

The Sustainable Development Goals (SDGs), adopted by the UN General Assembly in September 2015, embody a One-Health strategy—healthy people living on a habitable planet. Extending beyond the social development emphasis of the Millennium Development Goals (MDGs), which accelerated progress globally, though unequally, the SDGs also encompass a range of environmental and economic goals, with a health goal that is far more comprehensive than the infectious diseases and maternal/child health focus of the MDGs.

To be achieved, the SDGs require resources and political commitment that is yet to be demonstrated. With a cost that could reach $5 trillion for the SDGs …

Low-Intensity Physical Activity And Cardiometabolic Risk Factors Among Older Adults With Multiple Chronic Conditions, Yueyao Li

Theses and Dissertations

Introduction Cardiovascular disease (CVD) is the leading cause of death among older adults in the Unites States and is driven largely by cardiometabolic risk factors including elevated blood pressure and blood glucose. Studies have found the protective effect of moderate intensity physical activity (MIPA) and vigorous intensity physical activity (VIPA) on cardiometabolic risk factor; however, the association between light physical activity (LIPA) and cardiometabolic risk factor among older adults is not clear. Objectives 1). Examine the association between LIPA and cardiometabolic risk factors. 2). Examine whether the association between LIPA and cardiometabolic risk factor is moderated by multiple chronic conditions. …

Physical Activity And Breast Cancer In South Carolina, Chisom Onyeuku

Theses and Dissertations

This study examined the relationship between breast cancer incidence and recreational physical activity. It was one of the first studies in the southeastern US to examine incident breast cancer and physical activity in an ethnically diverse cohort of women. In terms of physical activity, both lifetime and recent physical activity were analyzed. All physical activity data were from validated self-reported surveys. The study examined BMI, menopausal status and race as key confounders and effect modifiers. The study found evidence that for Black women, there was a positive relationship between the amount of lifetime physical activity and the odds of incident …

Genetic And Epigenetic Variations In Asthma And Wheeze Illnesses, Todd M. Everson

Theses and Dissertations

Asthma, a chronic respiratory condition, is common worldwide with no cure and limited effective prevention strategies. It is well recognized that asthma has a multifaceted etiology, though many of the underlying mechanisms involved in asthma development, persistence and remission are still convoluted. Epigenetic mechanisms, such as DNA methylation, regulate gene-expression but are not related to changes in the actual DNA sequence. Recently, differential patterns of DNA methylation within many genes have been associated with asthma, particularly within genes involved in the differentiation of pro-inflammatory T-helper 2 (Th2) cells. DNA methylation patterns within less known biologic pathways undoubtedly are involved in …

Post-Fall Decision Making Among Older Women Living In Continuing Care Retirement Communities: A Mixed Methods Study, Caroline D. Bergeron

Theses and Dissertations

Introduction: One in every three adults over the age of 65 experiences a fall every year, with women experiencing more falls than men. Falls can affect how older women perceive themselves and their independence. The purpose of this study was to examine older women's health decision making after experiencing a fall. Methods: I conducted semi-structured interviews with 17 older women living independently in continuing care retirement communities (CCRCs) who had experienced a fall within the previous six months and 11 individuals the women identified as being involved in their post-fall decision making. I also conducted an exploratory survey on post-fall …

Refinement And Pilot Testing Social Networks For Encouraging Healthy Behaviors: The Social Pounds Off Digitally (Social Pod) Study, Sarah B. Hales

Theses and Dissertations

Currently about 71% of adults in the US are considered overweight or obese. Overweight and obesity are associated with higher risk of developing many chronic diseases; however, health risks associated with overweight and obesity can be reduced by as little as a 3% to 5% reduction in weight. Mobile health (mHealth) has shown promise as a way to deliver weight loss interventions, yet maintaining participant engagement over time has been a challenge. The purpose of this study was to develop, refine, and pilot test the Social Pounds Off Digitally (POD) Android app for personalized health monitoring and interaction; revise the …

Individual- And Neighborhood-Level Determinants Of Emergency Department Utilization Among Patients With Diabetes In South Carolina, Charity B. Breneman

Theses and Dissertations

AIM: The primary aim of this study was to evaluate the geographic variation in emergency department (ED) use in South Carolina using geographical information systems (GIS) and to examine the effects of both individual- and neighborhood-level characteristics on frequent ED use among patients with diabetes. METHODS: ED discharge data for 2013 was geocoded based on patients’ residential ZIP code using GIS. Frequent ED use among patients with diabetes was defined as three or more ED visits between January 1, 2013 and December 31, 2013. The boundaries for each neighborhood were defined by the U.S. Census Bureau ZIP Code Tabulation Areas …

Framing Risk, Responsibility, And Resolution: A Mixed-Methods Study Exploring Traditional And Social Media Coverage Of The 2014 Elk River Chemical Spill, Tracey Thomas

Theses and Dissertations

Background: The 2014 Elk River Chemical Spill raised policy questions concerning chemical safety and revealed an immediate need for improved emergency communication. This two-phase study explored how media presented causes of and longterm solutions to the spill through an examination of media frames. The study also explored how health risks were communicated through traditional and social media. The specific aims of Phase I were to examine media coverage in the days following the spill and compare coverage across media channels. The specific aims of Phase II were to understand how public health stakeholders perceived coverage of the spill and how …

Dietary Patterns And Prostate Cancer Aggressiveness In African-American And European-American Men, Lara Ryan Schneider

Theses and Dissertations

Several foods and nutrients have been linked to prostate cancer risk, but the effect of overall diet on prostate cancer outcomes is not well understood. Previous research has primarily examined a posteriori dietary patterns in relation to prostate cancer; studies that have used a priori dietary patterns and their relationship with prostate cancer have been inconclusive. Furthermore, racial differences in prostate cancer incidence and aggressiveness are not well understood. Data from the case-only North Carolina-Louisiana Prostate Cancer Project (PCaP) was used to examine the association between overall dietary pattern, as measured by the Mediterranean Diet (MED) score and the Dietary …

Support For Comprehensive Sexuality Education And Adolescent Access To Condoms And Contraceptions In South Carolina, Sarah H. Kershner

Theses and Dissertations

A statewide random-digit dialed telephone survey was administered to residents of a historically conservative southern state to 1) assess the level of support for comprehensive sexuality education (CSE) in public schools, 2) assess the support for availability to condoms and contraception as an effective strategy for reducing unintended pregnancies and sexually transmitted (STIs) among adolescents and 3) assess the perceived view of reproductive health as a moral or public health issue. Survey data were obtained from 841 South Carolina residents May through June 2013. Findings from the study revealed that the majority (90%) of South Carolina residents support CSE in …

Community-Level Factors Associated With Health-Related Quality Of Life Among Older Adults, Yu-Hsiu Lin

Theses and Dissertations

Objective: Health-related quality of life (HRQOL) and well-being is a new topic area for Healthy People 2020 in the U.S. In a broad-based literature review, more research explored individual level factors of HRQOL, and few focused on older adults. Multilevel analysis was seldom adopted to investigate the relationship between area-level socioeconomic or social environment factors and HRQOL. In lieu of the traditional Chapter 4 (Results) and Chapter 5 (Conclusion), two manuscripts representing the two specific research aims are included. The main aim of first manuscript was to explore the association between area deprivation, area health resources and older adults’ HRQOL. …

Relationship Between Job Satisfaction Among Frontline Staff And Patient Satisfaction: Evidence From Community Health Centers In South Carolina, Ashley Lynn Barnes

Theses and Dissertations

The role of frontline staff (FLS) is vital to the success of health delivery organizations as they are often the main point of patient contact and the primary source of feedback regarding the patient experience and satisfaction. Anecdotal evidence suggests that FLS have among the highest turnover rates in health delivery organizations, resulting in high recruitment and training costs as well as disruptions in day-to-day operations. However, few studies have examined the role of FLS and the factors affecting job satisfaction among FLS. Researchers have also not examined the impact of FLS satisfaction on patient satisfaction. To address these research …

Dental Insurance As A Mitigating Factor In Reducing The Risk Of Mortality Among Working-Age Adults With Dental Caries And Periodontitis, Naveed Sadiq

Theses and Dissertations

Background Poor oral health had been associated with increased risk of having systemic diseases and thus mortality. The purpose of this research was to find if dental coverage with health insurance could mitigate the risk of death due to untreated dental caries and periodontitis among working age U.S. adults. Methods Data were drawn from NHANES III (1988-1994) and linked to mortality updated till Dec. 31st, 2011. It was restricted to those in the age range of 20-64 years adults. Furthermore, it was restricted to those who had complete data collection on all measures. Unweighted propensity scores were calculated to control …

A Qualitative Study Of The Massage Therapy Foundation's Best Practices Symposium: Clarifying Definitions And Creating A Framework For Practice, Ann Blair Kennedy

Theses and Dissertations

Large numbers of individuals seek massage therapy for wellness/disease prevention purposes and research supports consumer reported benefits including physical and psychological improvements. However, challenges within the profession may be hindering the advancement of the field. To better understand the process and outcomes and ultimately develop best practices for massage therapy as well as better inform education, policy and research, it is necessary to investigate how massage and/or massage therapy are defined and operationalized in practice. This study entailed qualitative analysis of cross-sectional data using a grounded theory approach to examine the data gathered from a two-day symposium held in 2010 …

Abortion/Reproductive Rights, Sandra Klein

Sandra S. Klein

The issue of a woman's right to choose whether or not to continue with a pregnancy has proven to be complicated for many reasons, not the least of which is the implications for a person's right to do with her body as she sees fit. The bibliography that follows provides the researcher with an in depth look at this issue, with an emphasis on the privacy aspects.

Physical Activity And Public Health: Training Courses For Researchers And Practitioners, David Brown, Russell Pate, Michale Pratt, Fran Wheeler, David Buchner, Barbara Ainsworth, Caroline Macera

David C. Brown

No abstract provided.

Biomedical Research Leaders: Report On Needs, Opportunities, Difficulties, Education And Training, And Evaluation, Samuel Wilson, Deborah Brown, Jay Moskowitz, Dan Hurley, David Brown, David Brown, Byron Bailey, Michael Mcclain, Marilyn Misenhimer, Judith Buckalew, Thomas Burks

David C. Brown

The National Association of Physicians for the Environment (NAPE) has assumed a leadership role in protecting environmental health in recent years. The Committee of Biomedical Research Leaders was convened at the recent NAPE Leadership Conference: Biomedical Research and the Environment held on 1–2 November 1999, at the National Institutes of Health, Bethesda, Maryland. This report summarizes the discussion of the committee and its recommendations. The charge to the committee was to raise and address issues that will promote and sustain environmental health, safety, and energy efficiency within the biomedical community. Leaders from every important research sector (industry laboratories, academic health …

Correspondence Between Self-Report And Interview-Based Assessments Of Antisocial Personality Disorder, Laura Guy, Norman Poythress, Kevin Douglas, Jennifer Skeem, John Edens

Norman Poythress

Antisocial personality disorder (ASPD) is associated with suicide, violence, and risk-taking behavior and can slow response to first-line treatment for Axis I disorders. ASPD may be assessed infrequently because few efficient diagnostic tools are available. This study evaluated 2 promising self-report measures for assessing ASPD--the ASPD scale of the Personality Diagnostic Questionnaire-4 (PDQ-4; S. E. Hyler, 1994) and the Personality Assessment Inventory (PAI; L. Morey, 1991, 2007)--as well as the ASPD module of the Structured Clinical Interview for DSM-IV Axis II (SCID-II; M. B. First, R. L. Spitzer, M. Gibbon, J. B. W. Williams, and L. S. Benjamin, 1997). The …

Acute Effects Of Whole-Body Vibration On Lower Extremity Muscle Performance In Persons With Multiple Sclerosis, Kurt Jackson, Harold Merriman, Paul Vanderburgh, C. Brahler

C. Jayne Brahler

Background and Purpose: Whole-body vibration (WBV) is a relatively new form of exercise training that may influence muscle performance. This study investigated the acute effects of high (26 Hz) and low (2 Hz) frequency WBV on isometric muscle torque of the quadriceps and hamstrings in persons with multiple sclerosis (MS).

Participants and Method: Fifteen individuals (mean age = 54.6 years, SD = 9.6) with MS and Expanded Disability Status Scale (EDSS) scores ranging from 0-6.5 (mean = 4.2, SD = 2.3) participated in this randomized cross-over study. Following baseline measures of isometric quadricep and hamstring torque, subjects were exposed to …

Gender Differences In Motivation To Resolve Eating And Body Image Concerns In College Students, Harold Merriman, C. Brahler, Laura Dinan, Lauren Finzer

C. Jayne Brahler

The objective of this study was to identify similarities and differences between college women and men with respect to their eating and body image concerns, weight fluctuation and level of motivation to resolve these concerns. 101 University of Dayton students participated in this study. Students completed an eating and body concern survey online.

Body image concerns were significantly greater for females compared to males (p=0.007) and significantly greater as motivation level to resolve the concerns increased (p=0.019). Eating concerns followed the same trends but did not reach statistical significance. Weight fluctuation in both genders increased significantly as motivation level increased …

The Mind-Body Connection: The Association Between Adolescent Locus Of Control And Indicators Of Physical Health, C. Brahler, James Cropper

C. Jayne Brahler

Locus of control (LOC) describes an individual’s generalized beliefs or expectancies that their reinforcements are under internal versus external control (1). An individual exhibits either an internal or external LOC. This study examines the link between LOC and selected health risk factors in adolescents. A convenience sample of 167 high school physical education students completed a 13-item LOC questionnaire based on Rotter’s 1966 instrument. Various anthropometric measurements, blood pressure, body mass index (BMI), and body fat were recorded on all subjects. A subsample of 61 female students received blood chemistry analysis that included a lipid profile, hemoglobin A1c (HbA1c), Apo …

Health Education: An Unmet Needs For Refuges, Zahra Goliaei

Master's Projects and Capstones

Abstract:

The International Rescue Committee (IRC) is one of the organizations that serves refugees and asylums arriving into the United States. Each year between 4 to 500 individuals will resettle in Oakland through the IRC. However, after relocation, these individuals need information about life in the new country , community resources , and social services especially health care system in the country. Life pressures during the resettlement process, along with the language barrier and poverty usually lead to a less healthy diets and lifestyles. During the time, these factors will put refugees at the risk of obesity and later, chronic …