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Unintended Pregnancies Among Married Women In Sindh Pakistan: Role Of Lady Health Workers, Sumera Aziz Ali, Unaib Rabbani

Community Health Sciences

Background: Unintended pregnancies, which pose substantial risks to both mothers and children, account for 24% of all pregnancies in Pakistan. Door to door visits and service provision by lady health workers (LHWs) may be related to the reduction of such pregnancies, particularly in rural areas. This study aimed to determine the association of knowledge about Lady Health Visitors (LHWs) and door to door visits by LHWs with unintended pregnancies among rural women.
Methods: We conducted a community-based, nested case-control study of 800 pregnant women, identified from the database of an active surveillance mechanism, which registers and follows all pregnant women …

Comparative Investigation Of Some Behavior Traits Of Honamlı,Hair, And Saanen Goats In A Mediterranean Maquis Area, Aykut Asim Akbaş, Özkan Elmaz, Mustafa Saatci

Turkish Journal of Veterinary & Animal Sciences

The study was conducted to investigate comparatively some behavior traits (grazing, resting, bipedal stance, agonistic behavior, rumination, and browsing) of Honamlı, Hair, and Saanen goat breeds in the morning and afternoon periods between April and September in maquis shrublands. A total of 30 two-year-old goats including 10 from each goat breed were used. While grazing behavior of Saanen goats was observed mostly in April and May as 75.45%-71.65% and 73.16%-78.25% for morning and afternoon in these months, respectively, these values were respectively 62.52%-64.23% and 59.94%-67.67% for Hair goats and 60.12%-62.94% and 46.42%-54.78% for Honamlı goats. It was observed that Hair …

Rural Haitian Women's Experiences With Poor Health Through Poverty, Geralda Felix

Walden Dissertations and Doctoral Studies

People living in rural Haiti lack access to basic health care services due to poverty. Rural poverty in Haiti particularly affects women's health because Haiti has had the highest maternal mortality and infant mortality rates in the Americas, in addition to some of the worst health statistics in the Western Hemisphere. The purpose of this phenomenological study was to cultivate a greater understanding of the poverty factors that affect access to health care services specifically among poor women living in rural Haiti. This study was based on the social ecological model for population health development, theorizing that a person's health …

Community Engagement And Integrated Health And Polio Immunisation Campaigns In Conflict-Affected Areas Of Pakistan: A Cluster Randomised Controlled Trial, Atif Habib, Sajid Soofi, Simon Cousens, Saeed Anwar, Najib Ulhaque, Imran Ahmed, Noshad Ali, Rehman Tahir, Zulfiqar A Bhutta

Department of Paediatrics and Child Health

Background: Pakistan faces huge challenges in eradicating polio due to widespread poliovirus transmission and security challenges. Innovative interventions are urgently needed to strengthen community buy-in, to increase the coverage of oral polio vaccine (OPV) and other routine immunisations, and to enhance immunity through the introduction of inactivated polio vaccine (IPV) in combination with OPV. We aimed to evaluate the acceptability and effect on immunisation coverage of an integrated strategy for community engagement and maternal and child health immunisation campaigns in insecure and conflict-affected polio-endemic districts of Pakistan.
Methods: We did a community-based three-arm cluster randomised trial in healthy children …

Pharmaceutical M&A Activity: Effects On Prices, Innovation, And Competition, Barak D. Richman, Will Mitchell, Elena Vidal, Kevin Schulman

Faculty Scholarship

The rise of blockbuster pharmaceutical acquisitions has prompted fears that unprecedented market concentration will weaken competition. Two of the most prominent concerns focus on the upstream and downstream ends of the pharmaceutical industry: (1) the concern that these mergers will concentrate the market for discovery and will therefore lead to fewer discoveries; and (2) the concern that merging large marketing, sales, and distribution forces will strengthen the hands of select pharmaceutical manufacturers and weaken downstream competition. Having considered potential dynamic effects in the industry and conducted a series of preliminary interviews with knowledgeable observers, though, this Article argues that neither …

Public Health Implications Of Oil Pollution In Koluama: Nigeria, Esther Bridget Sako

Walden Dissertations and Doctoral Studies

As the global demand for oil increases, human health implications related to its discovery and transport remain a serious concern. The Niger Delta has been the site of severe environmental degradation since the oil boom of the 1970s. While some researchers have examined the environmental effects of oil procurement, few have explored human health implications in this region. This phenomenological study investigated the human physical and mental health consequences of oil-related environmental degradation through the perceptions and lived experiences of villagers in Koluama, Nigeria. The conceptual framework for the study was based on research conducted by Morello-Frosch, Zuk, Jerrett, Shamasunder …

Maternal Health Literacy, Antenatal Care, And Pregnancy Outcomes In Lagos, Nigeria, Olubunmi Adanri

Walden Dissertations and Doctoral Studies

Maternal mortality, an example of poor maternal health outcomes, is widely accepted as an indicator of the overall health of a population. One of the Millennium Development Goals was reduction in maternal mortality by 3 quarters by 2015. These goals were not met in Nigeria and it is important to look at some of the reasons why. Education has been shown to have positive impact on pregnancy outcomes; however, the characteristics of pregnant women, their health literacy level, their usage of antenatal care services and how these impact pregnancy outcomes are yet to be analyzed in Lagos, Nigeria. Guided by …

Leadership Among Directors Of Social Services At Rehabilitative Healthcare Chains, John Paul Tuanqui Abenojarj

Walden Dissertations and Doctoral Studies

Rehabilitation and healthcare centers (RHCs) provide ongoing care to the elderly and chronically ill. To maximize the quality of this care, RHC staff must be properly trained to respond to patient care crises and communicate across departments. Although researchers have studied the leadership styles, strategies, and interactions of facility administrators and nursing directors, there is a substantial gap in the literature on the leadership styles and strategies employed by directors of social services (DSSs). The aim of this phenomenological study was to address this gap in the research by exploring how DSSs influenced leadership policies, prepared subordinates for crisis intervention …

Health System Predictors Of Access To Maternal Health Medicines In Low And Middle Income Countries, Chinonso Esther Nnorom

Walden Dissertations and Doctoral Studies

The strength of health systems predict access to medicines that prevent death from pregnancy related complications (essential maternal health medicines). But little is known about the relative impact of each health system building block on access. This quantitative cross-sectional study applied Ishikawa model to examine the relative effect of health systems governance, facilities, service delivery, financing and medicine procurement and distribution (independent variables), on availability, affordability and accessibility (dependent variables) of maternal health medicines in resource poor settings. Data analyzed was pulled from 37 WHO pharmaceutical country profiles and USAID MCHIP survey that assessed national programs for the prevention and …

Influence Of Dual Process Decision-Making Theory In Patients Diagnosed With Cancer, Bonnie D. Quinonez

Walden Dissertations and Doctoral Studies

Each year millions of people face the medical decision-making cycle that comes with a diagnosis of cancer. For patients and their families, this can be a rollercoaster of confusion and fear. Researchers have indicated that the complexity of the decision-making process is underrepresented in the current approach of informed decision-making. The purpose of this study was to add to scientifically-validated research expanding the identification of factors that influence decision-making for individuals diagnosed with cancer. Fuzzy trace theory (FTT) is the dual process memory theory used as the framework for this study. Qualitative data were collected using semistructured interviews with 10 …

Impact Of Plans, Finance, And Zoning Policies On What Developers Choose To Build, Michele Ann Williams

Walden Dissertations and Doctoral Studies

While there is considerable academic research on the intersection of comprehensive plans, finance policies, zoning policies and how these factors influence real estate developers' choice of what land to develop and what buildings to construct on that land, little is understood about whether these three variables promote or hinder real estate developers' choice of whether to build communities that promote healthy living. Using urban planning theory as the foundation, the purpose of this correlational study was to determine how real estate developers' decisions are made to support healthy New Urbanism development in the United States. Secondary data from the Urban …

The Molecular Epidemiology Of Tuberculosis In South Carolina, 2005-2011: Estimates Of Recent Transmission And Risk Factors For Genotype Clustering, Amy Kathleen Roach

Walden Dissertations and Doctoral Studies

Because tuberculosis (TB) is a public health threat that continues to elude elimination in the United States, there is a need to identify contributing factors that may have implications for targeted control measures. Molecular studies of genetic clustering are crucial for pinpointing these contributing factors. It is for this reason this study was conducted. This was a non-experimental, cross-sectional population-based molecular epidemiological study of TB in SC from 2005 to 2011. Its purpose was to estimate the proportion of TB that may be due to recently acquired infection and to determine the risk factors associated with the genetic clustering of …

Women And Coronary Artery Disease, Gwendolyn Yvonne Stancell-Smith

Walden Dissertations and Doctoral Studies

Heart disease, including coronary artery disease, affects approximately 42 million women in the United States. Many of those affected are not aware they have the condition. Contributing to the problem is the fact that women are more likely than men to be misdiagnosed and undertreated for heart disease. Morbidity and mortality are high in women affected by heart disease, making the problem important to address. The purpose of this project was to understand the coronary artery or heart disease risk and the treatment for the condition provided for 31 participants at a cardiology service in the Northeast U.S. The project …

Medical Floor Confusion Assessment Method: Implementation And Assessment Of Risk Factors, Michaelynn R. Paul

Walden Dissertations and Doctoral Studies

An estimated 50% of older hospitalized patients experience delirium. This has created significant complications costing an estimated $164 billion or more per year worldwide. The ability to identify patients developing delirium would allow the implementation of specific interventions to decrease or eliminate the adverse effects of delirium. The purpose of this quality improvement project was to provide high quality delirium education to determine if medical unit nursing staff could successful implement the Confusion Assessment Method (CAM) screening tool to identify patients experiencing delirium as the first phase of an overall plan. Implementation of the project followed Roger's diffusion of innovations …

Predictors Of Uti Antibiotic Resistance For Female Medicaid Recipients In U.S. Ambulatory Care Settings, Wendy Denise Wiesehuegel

Walden Dissertations and Doctoral Studies

Urinary tract infections are diagnosed in female populations primarily in ambulatory care settings in the United States. Yet, published evidence documents that many of the antibiotics prescribed in these settings are unnecessary, erroneous, or, inappropriately prescribed. Improper management of uncomplicated urinary tract infections in nonpregnant women has resulted in higher morbidity rates due to antibiotic resistance. The purpose of this retrospective observational cohort study was to explore a current national database for associations between nonpregnant American female patients who were exposed to poverty and at risk for urinary tract infection antibiotic resistance in an ambulatory care setting. Krieger's ecosocial theory …

Mandated Continuing Education And The Competency Of Illinois Physical Therapists, Denise Lynn Hunter Ethington

Walden Dissertations and Doctoral Studies

Continuing education (CE) mandate laws are passed by states because it is in the public interest. The intent behind the passage of Illinois's CE law for physical therapists is to protect public health and safety through ensuring the competency of providers. However, studies into the impact of mandated CE on competency have been mixed. The problem addressed by this study was whether Illinois's CE law was effective in improving the competency of physical therapists and its impact on patient care. The purpose of this study was to understand what role mandated CE played in developing the competency of physical therapists …

Breaking The Silence: Postpartum Depression Among Reproductive-Aged Women In Akwa Ibom State, Nigeria, Atim Henshaw

Walden Dissertations and Doctoral Studies

Postpartum depression (PPD) is internationally recognized as one of the most prevalent and severe but neglected maternal mental health complications of childbirth. Previous studies have indicated that there is a high burden of disease associated with PPD in both developed and developing countries. However, there remain gaps in the current literature regarding the recognition and management of PPD in remote parts of the developing world. Therefore, the purpose of this study was to understand the perceptions, attitudes, and beliefs of health professionals towards PPD and examine the factors that either facilitated or hindered its recognition and management in a remote …

Concussion Knowledge Of Missoula Youth Hockey Participants And Their Parents, Samantha Riordan

Graduate Student Theses, Dissertations, & Professional Papers

Abstract:

Background: The Dylan Steigers Protection of Youth Athletes Act (DSPYAA) was passed by Montana legislature in 2013 which calls for mandatory concussion education of coaches, parents, and athletes. This law only applies to school sponsored sports, excluding those involved in youth sports organizations (YSO), such as youth hockey.

Hypothesis: Participating youth athletes and parents will not be able to identify signs and symptoms of a concussion and will not be able to identify future consequences of a poorly managed concussion.

Study Design: Cross sectional survey. Level of Evidence: Level 4

Methods: A descriptive questionnaire, Concussion Knowledge in Youth Sports …

A New Diagnosis Of Multiple Sclerosis In A 29-Year-Old Former Collegiate Basketball Player With Initial Symptoms Of Recurrent Bell’S Palsy: A Case Report, Eric R. Reynolds, Andrew D. Ashbaugh, Christopher A. Mcgrew

UNM Orthopaedic Research Journal

Multiple sclerosis (MS) is a demyelinating disorder of the central nervous system, characterized by immunemediated destruction of myelinated axons, which leads to notable physical disability. Although presence among active athletes is extremely low, it can cause considerable lifestyle changes for those athletes affected as they transition into life after competitive athletics. We describe a 29-year-old former collegiate women’s basketball player in whom MS was diagnosed during a visit for recurrent evaluation of Bell palsy. Subsequent neurology consult and magnetic resonance imaging led to the confirmation of the diagnosis of MS, and the patient began treatment for relapsing-remitting MS. During visits …

Hierarchical Modeling Versus Regression Analysis For Evaluating Results Of Orthopaedic Studies That Use The National Inpatient Sample, Joshua W. Hustedt, Kade Mcquivey, John C. Hustedt

UNM Orthopaedic Research Journal

Background: Owing to its hierarchical sampling structure, the National Inpatient Sample (NIS) often involves clusters of study data. We aimed to (1) understand the statistical methods of currently published orthopaedic studies using NIS and (2) examine the role of hierarchical modeling versus traditional regression analysis in a retrospective cohort of patients from NIS.

Methods: We conducted a systematic review to examine statistical methods of orthopaedic studies (published between 2005 and 2014) using NIS. Ultimately, 132 studies were identified. We noted percentages of studies that used hierarchical modeling versus traditional regression analysis. Using NIS, we identified a retrospective cohort of patients …

Slc11a1 Polymorphisms And Host Susceptibility To Cutaneous Leishmaniasis In Pakistan., Mariam Sophie,, Abdul L Hameed Institute Of Biomedical And Genetic Engineering (Ibge), 24-Mauve Area, G- 9/1, Islamabad, Pakistan., Akhtar Muneer, Azam J. Samdani, Saima Saleem, Abid Azhar

Department of Medicine

Background:The vector-borne cutaneous leishmaniasis (CL) is endemic in several regions of Pakistan mainly affecting poor populations. Host genetic factors, particularly SLC11A1 (solute carrier transmembrane protein) within macrophages, play a crucial role in disease pathology and susceptibility. Association of SLC11A1 with cutaneous leishmaniasis, a neglected tropical disease, is not well established. Inconsistencies have been observed within different populations worldwide with respect to genetic susceptibility. This study was designed to investigate genetic variation(s) in SLC11A1 and to assess possible association with cutaneous leishmaniasis in Pakistan.

Results: Eight polymorphisms (rs2276631, rs3731864, rs2290708, rs2695342, rs201565523, rs17215556, rs17235409, rs17235416) were genotyped across SLC11A1 in …

Reducing The Rate Of Late Stage Breast Cancer Through Effective Health Communication: An Opinion Piece, Rachele Hendricks-Sturrup

Internet Journal of Allied Health Sciences and Practice

Purpose: Health and illness are traditionally characterized and treated differently across various ethnic groups, which encourages American health systems serving these diverse populations to explore culturally competent and safe ways to effectively reduce illness within such populations. Certain ethnic groups of women in the United States (US) bear greater risk of late stage breast cancer because of various circumstances, which include but are not limited to a lack of insurance or underinsurance and discomfort with and/or resentment toward the US healthcare system. The dominant culture and the social aspects of the modern American health system often and most favorably serve …

Characterization Of Hiv Diversity, Phylodynamics And Drug Resistance In Washington, Dc., Marcos Pérez-Losada, Amanda D Castel, Brittany Lewis, Michael Kharfen, Charles P Cartwright, Bruce Huang, Taylor Maxwell, Alan E Greenberg, Keith A Crandall

Epidemiology Faculty Publications

No abstract provided.

Connecting Culturally And Spiritually To Healthy Eating: A Community Assessment With Native Hawaiians, Mary Frances Oneha, Joan Dodgson, Mabel Ho`Oipo Decambra, Carol Titcomb, Rachelle Enos, Sandie Morimoto-Ching

Asian/Pacific Island Nursing Journal

Many of the chronic illnesses disproportionately experienced by Native Hawaiians are directly related to poor diets and long-standing obesity beginning in childhood. We report on the findings of in-depth key informant interviews (N = 14) that took place in two Native Hawaiian communities as part of a larger, community-based participatory research study that included a community assessment through individual interviews and focused group discussions, and a pilot intervention targeting pregnant women, their infants, and families. Four categories emerged from the qualitative analysis of interview transcripts that described an understanding of “healthy eating”: family roles and responsibilities, aspects of community …

The Effects Of Frequency Of Social Interaction, Social Cohesion, Age, And The Built Environment On Walking, Gretchen Allison Luhr

Dissertations and Theses

The purpose of this dissertation was to explore, through a social ecological framework, the multifaceted effects of the neighborhood environment by investigating how dimensions of both the built environment and the neighborhood social context may interact to influence walking. Aesthetics, land use mix, crime, and pedestrian infrastructure were considered with respect to built environment walkability, and the neighborhood social context was conceptualized using measures of both social cohesion and social interaction with neighbors. This research used data from an Environmental Protection Agency (EPA)-funded study of 748 adults (18 years of age and older) residing in the Lents neighborhood in Portland, …

Tobacco Use, Cessation, And Locus Of Control Among College Students, Bernard Ambe

Electronic Theses and Dissertations

ABSTRACT

The purpose of this study was to (a) determine the locus of control among American college students (b) determine if tobacco use or cessation correlate with any demographic variables to better understand the efficacy of tobacco interventions and help design an intervention most effective in the prominent LOC of college students.

The Global Adult Tobacco Survey (GATS) was modified for the purposes of this study and used to determine demographic factors and tobacco usage status. The modified GATS survey also included the LOC questionnaire which yielded the data. Seventy-four responses were recorded. The mean locus of control scores were …

Nursing Student Work-Study Internship: Partnering To Bridge The Education-To-Practice Gap, Jonalyn M. Wallace

Doctor of Nursing Practice (DNP) Projects

Abstract

Discussed for decades, the need for transitional experiences bridging educational and practice settings gained momentum in the mid-1970s with the release of Kramer’s groundbreaking book Reality Shock: Why Nurses Leave Nursing. Nursing student internship programs were developed in the 1970s as one effort to address this issue. The Northern California Region of Kaiser Permanente partners with five universities to conduct the Nursing Student Work-Study Internship Program (WSP). The program provides senior level nursing students with a paid internship in clinical practice settings, working under the supervision of RN preceptors. The aim of the program is to improve the …

Quality Of Death People With Terminal Illnesses Are Turning To An Age-Old Method To End It All: Self-Starvation, Kazi E. Awal, Alyssa Pagano

Capstones

Voluntarily stopping eating and drinking (VSED) is getting more attention in the medical community. Though physician assisted dying legislation passed in two more states in 2016--there are now 7 states where it is legal--the practice, where doctors prescribe a lethal dose of sedatives so that terminally ill patients can end their own lives, is inaccessible to many. But fasting to death is a way for patients suffering from terminal illnesses or other debilitating diseases to end their lives on their own terms that is legal everywhere. As extreme as it sounds, research shows the process can be made comfortable with …

Ada News - 12/12/2016, American Dental Association, Publishing Division

ADA News

Established in 1970 as the official newspaper of the American Dental Association, the ADA News serves practicing dentists and others allied to the dental profession in the U.S. and internationally. It is the No. 1 source of news and information about the many benefits and services the ADA delivers to members daily as well as timely information on scientific, social, political and economic developments affecting dentistry and health care.

Qualitative Health Research Involving Indigenous Peoples: Culturally Appropriate Data Collection Methods, Amy L. Wright, Olive Wahoush, Marilyn Ballantyne, Chelsea Gabel, Susan M. Jack

The Qualitative Report

Historically, health research involving Indigenous peoples has been fraught with problems, including researchers not addressing Indigenous research priorities and then subsequently often failing to utilize culturally appropriate methods. Given this historical precedence, some Indigenous populations may be reluctant to participate in research projects. In response to these concerns, the Government of Canada has developed the Tri-Council Policy Statement (TCPS2): Research Involving the First Nations, Inuit and Métis Peoples of Canada, which stipulates the requirements for research collaborations with Indigenous communities. Utilizing this policy as an ethical standard for research practices, this paper describes, critiques and synthesizes the literature on culturally …