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Understanding Factors Influencing Adverse Sex Ratios At Birth And Exploring What Works To Achieve Balance: The Situation In Selected Districts Of Nepal, Mahesh Puri, Anand Tamang

Poverty, Gender, and Youth

The goal of this study is to identify programs and sociocultural factors underlying disparities in sex ratios at birth in some parts of Nepal, by comparing the situation in districts with high and normal sex ratios at birth and among under-5 children. Findings are expected to inform the design of programs intended to raise the value of girls in general and counter the practice of gender-biased sex selection in particular. The study was conducted in two adjoining hill districts of the western development region of Nepal, namely Kaski (where sex ratios are adverse) and Tanhaun (where sex ratios are normal). …

An Innovative Financing Model For The Progesterone Contraceptive Vaginal Ring Through Voucher Programs, Ishita Chattopadhyay, John Townsend, Saumya Ramarao

Reproductive Health

This technical report introduces the theoretical framework for the demand generation and supply chain mechanisms for an effective reproductive health voucher system. The key roles and functions of an effective voucher system are described. A methodology for implementation of a voucher system for the Population Council’s Progesterone Contraceptive Vaginal Ring (PCVR), also referred to as the PCVR Voucher Based Care (VBC) program, has been designed to introduce the PCVR in the context of choice, equity in price, and range of outlets, ensuring quality of care and consistent availability of services. The model provides a framework and guidelines on how the …

Utilizing Social Marketing And Social Franchising Models To Expand Access To The Progesterone Contraceptive Vaginal Ring, Ishita Chattopadhyay, John Townsend, Saumya Ramarao

Reproductive Health

The Population Council’s Progesterone Contraceptive Vaginal Ring (PCVR) is an effective, user-initiated contraceptive option that helps meet the need for postpartum family planning (PPFP). It is exclusively designed for postpartum breastfeeding women who want to space or delay pregnancies the first year following childbirth. This technical report describes a social marketing and social franchising model that will be adopted for the introduction and scale-up of the PCVR. A methodology for implementation of this model, also referred to as the PCVR–Social Marketing and Social Franchising (PCVR-SM/SF) Model, has been designed to introduce the PCVR in the context of choice among other …

Offering Progesterone Contraceptive Vaginal Rings For Postpartum Women Through Integrated Family Planning And Immunization Services, Ishita Chattopadhyay, John Townsend, Saumya Ramarao

Reproductive Health

This technical report describes a model for providing the Population Council’s Progesterone Contraceptive Vaginal Ring (PCVR) through integrated FP/Immunization (FP/I) services, the core components of the model, the types of inputs required, and the steps for introduction and scale-up. It describes how the PCVR can be offered to breastfeeding women in the first year following childbirth. A methodology for implementation of the PCVR-Family Planning/Immunization model (also referred to as PCVR-FP/I) has been designed to introduce the PCVR in the context of accessibility, choice, equity, and, quality. A proposed structure to introduce and integrate the PCVR has been outlined and described …

Validation Study Of Lqas-2 In Uttar Pradesh Behavior Change Management Project, Arupendra Mozumdar, Jaleel Ahmad, M.E. Khan

Reproductive Health

India’s Uttar Pradesh Behavior Change Management project studied the potential of community mobilization through Self Help Groups (SHGs) to improve healthy behaviors that may have a direct bearing on maternal, newborn, and child health outcomes. Multiple rounds of Lot Quality Assurance Sampling (LQAS) surveys were undertaken to monitor project activities and take corrective measures to improve project indicators. The surveys also evaluated the diffusion of health messages in the project area. The LQAS-2 validation study aimed to examine the accuracy of LQAS-2 data and understand the process of administering the LQAS. The study, which documented the process of survey administration, …

Being Ready To Treat Ebola Virus Disease Patients, David Brett-Major, Shevin T. Jacob, Frederique A. Jacquerioz, George F. Risi, William A. Fischer, Yasuyuki Kato, Catherine F. Houlihan, Ian Crozier, Henry Kyobe Bosa, James V. Lawler, Takuya Adachi, Sara K. Hurley, Louise E. Berry, John C. Carlson, Thomas C. Button, Susan L. Mclellan, Barbara J. Shea, Gary G. Kuniyoshi, Mauricio Ferri, Srinivas G. Murthy, Nicola Petrosillo, Francois Lamontagne, David T. Porembka, John S. Schieffelin, Lewis Rubinson, Tim O'Dempsey, Suzanne M. Donovan, Daniel G. Bausch, Robert A. Fowler, Thomas E. Fletcher

Journal Articles: Epidemiology

As the outbreak of Ebola virus disease (EVD) in West Africa continues, clinical preparedness is needed in countries at risk for EVD (e.g., United States) and more fully equipped and supported clinical teams in those countries with epidemic spread of EVD in Africa. Clinical staff must approach the patient with a very deliberate focus on providing effective care while assuring personal safety. To do this, both individual health care providers and health systems must improve EVD care. Although formal guidance toward these goals exists from the World Health Organization, Medecin Sans Frontières, the Centers for Disease Control and Prevention, and …

Prevalence Of Schistosoma Haematobium Infection Among School-Age Children In Afar Area, Northeastern Ethiopia, Abraham Degarege, Zeleke Mekonnen, Bruno Levecke, Mengistu Legesse, Yohannes Negash, Jozef Vercruysse, Berhanu Erko

Journal Articles: Epidemiology

In this study, the prevalence and intensity of Schistosoma haematobium infection was determined among school-age children living in the Middle and Lower Awash Valley, Afar Regional State of Ethiopia. Between February and May 2014, urine samples were collected from 885 school-age children (5-16 years of age) from the Middle (n = 632; 4 villages) and Lower (n = 253; 3 villages) Awash Valley. All samples were processed using urine filtration to detect and quantify S. haematobium eggs. In addition, a subset of the urine samples was tested for hematuria using a urine dipstick (n = 556). The overall prevalence was …

You Are What You Tweet: Connecting The Geographic Variation In America's Obesity Rate To Twitter Content, Ross J. Gore, Saikou Diallo, Jose Padilla

VMASC Publications

We conduct a detailed investigation of the relationship among the obesity rate of urban areas and expressions of happiness, diet and physical activity on social media. We do so by analyzing a massive, geo-tagged data set comprising over 200 million words generated over the course of 2012 and 2013 on the social network service Twitter. Among many results, we show that areas with lower obesity rates: (1) have happier tweets and frequently discuss (2) food, particularly fruits and vegetables, and (3) physical activities of any intensity. Additionally, we provide evidence that each of these results offer different and unique insight …

Documenting Perceived Effectiveness Of Community-Based Health Promotion Coalitions: A Grounded Theory Approach, Alyssa Brooke Mayer

USF Tampa Graduate Theses and Dissertations

Introduction: Community coalitions with public health-related missions are formal, semi-permanent, action-oriented partnerships comprised of community members, representatives of government agencies, policymakers, and academic partners. Despite their potential to promote sustainable change, coalitions have had mixed success in effecting long-term improvements in community health. There is a need to assist them in developing strategies for improving and sustaining their functionality. The purpose of this study was to improve understanding of the elements of coalition success and sustainability that are vital to health-related community-based participatory research.

Methods: Although the literature describes coalition functions for effecting sustainable programs and policies, most research reports …

Program Active Ii: Design And Methods For A Multi-Center Community-Based Depression Treatment For Rural And Urban Adults With Type 2 Diabetes, Mary De Groot, Jay H. Shubrook, Frank Schwartz, W. Guyton Hornsby Jr., Yegan Pillay, Chandan Saha

Faculty Publications & Research of the TUC College of Osteopathic Medicine

Objective: Depression affects one in four adults with type 2 diabetes (T2DM) and is associated with worsened diabetes complications, increased health care costs and early mortality. Rural and low-income urban areas, including the Appalachian region, represent an epicenter of the T2DM epidemic. Program ACTIVE II is a comparative effectiveness treatment trial designed to test whether a combination of cognitive behavioral therapy (CBT) and community-based exercise (EXER) will offer greater improvements in diabetes and depression outcomes compared to individual treatment approaches and usual care (UC). The secondary aims are to assess changes in cardiovascular risk factors across groups and to …

Quintessential Intractability: Attractors And Barriers In The Palestinian-Israeli Conflict, Samuel (Muli) Peleg

Cardozo Journal of Conflict Resolution

Intractable conflicts are those that linger despite the parties' understanding that they would be better off resolving their disagreements in negotiation. The obvious ensuing question is why these conflicts persist when rational considerations indicate they should cease. A valuable way to examine this ostensible paradox is through the lens of Dynamical Systems Theory ("DST") and specifically by applying the concept of conflict attractors, which are "patterns of thinking, feeling and acting ... pulling ... toward a negative, destructive state that becomes self-organizing and selfperpetuating." The DST frame is particularly useful to observe intractable conflicts since it focuses on nonlinear, multi-dimensional …

Demographic Profile Of The “Farmworker Population” In The United States, Carlos Siordia, Athena Ramos

Reports: Health Promotion, Social & Behavioral Health

The health and economic well-being of farmworkers has been investigated by social scientists for many decades [1,2,3]. General research on occupational safety and farmworker justice has also been developed more recently [4]. Because Hispanics/Latinos are commonly associated with farmworker occupations, especially migrant farm work, research has paid special attention to their population [5]. For example, researchers have investigated the health of Latina farmworkers [6], injury in youth from Latino farmworker families [7], and learning ability amongst Latino farmworkers [8]. However, Latinos only make up about half of the “farmworker population” is the United States (US). The specific aim of this …

Taxonomy And Molecular Epidemiology Of Echinococcus Granulosus Sensu Lato, Thomas Romig, Dennis Ebi, Marion Wassermann

Harold W. Manter Laboratory of Parasitology: Library Materials

Echinococcus granulosus, formerly regarded as a single species with a high genotypic and phenotypic diversity, is now recognized as an assemblage of cryptic species, which differ considerably in morphology, development, host specificity (including infectivity/pathogenicity for humans) and other aspects. This diversity is reflected in the mitochondrial and nuclear genomes and has led to the construction of phylogenetic trees and hypotheses on the origin and geographic dispersal of various taxa. Based on phenotypic characters and gene sequences, E. granulosus (sensu lato) has by now been subdivided into E. granulosus sensu stricto (including the formerly identified genotypic variants G1-3), …

Is Conflict A Factor In A Population's Quality Of Life? A Comparative Study Of University Students In The Palestinian Territories And Jordan, Yara Asi

Electronic Theses and Dissertations

As nearly one third of the world's population lives in an area that is in some way touched by war, researchers have long been interested in the varied impacts of conflict on civilians. Many indicators, measuring both physical and mental constructs, have been assessed in war-torn populations from around the world, one of which is health-related quality of life (HRQoL). The occupied Palestinian Territories (oPt) are one region in which copious research on health indicators has been undertaken in an effort to understand how long-term conflict manifests itself in noncombatant populations. However, existing studies focus primarily on indicators within the …

Global Estimates Of The Prevalence And Incidence Of Four Curable Sexually Transmitted Infections In 2012 Based On Systematic Review And Global Reporting, Lori Newman, Jane Rowley, Stephen Vander Hoorn, Nalinka Saman Wijesooriya, Magnus Unemo, Nicola Low, Gretchen Stevens, Sami Gottlieb, James Kiarie, Marleen Temmerman

Obstetrics and Gynaecology, East Africa

Background: Quantifying sexually transmitted infection (STI) prevalence and incidence is important for planning interventions and advocating for resources. The World Health Organization (WHO) periodically estimates global and regional prevalence and incidence of four curable STIs: chlamydia, gonorrhoea, trichomoniasis and syphilis.

Methods and Findings: WHO’s 2012 estimates were based upon literature reviews of prevalence data from 2005 through 2012 among general populations for genitourinary infection with chlamydia, gonorrhoea, and trichomoniasis, and nationally reported data on syphilis seroprevalence among antenatal care attendees. Data were standardized for laboratory test type, geography, age, and high risk subpopulations, and combined using a Bayesian meta-analytic approach. …

Creating Knowledge, Volume 8, 2015

Creating Knowledge

Dear reader,

I am delighted to introduce this eighth volume of Creating Knowledge: The LAS Journal of Undergraduate Scholarship. This volume features 19 essays and 14 art works, representing advanced coursework produced in twenty different departments and programs during the 2014-2015 academic year. Several of the essays have been honored with department awards and several draw on research supported by undergraduate research grants. Many were originally written in senior capstone seminars, research-intensive seminars, and independent studies, and many were presented in some form at one of the numerous conferences and showcases sponsored by departments and programs throughout the year. All …

Exploring Body Image And The Association Between Body Image Dissatisfaction And Waist Circumference Among Overweight And Obese Rural African American Women Participating In A Weight Loss Program, Erica Rayshelle Johnson

All ETDs from UAB

African American (AA) women are disproportionately burdened by obesity, an epidemic with implications that reach beyond physiological consequences. Given that perceptions of body image may impact health-promoting behaviors and weight management efforts, we sought to evaluate the presence and magnitude of body image dissatisfaction (BID) and explore its relationship with waist circumference (WC), independent of weight among overweight and obese treatment-seeking rural AA women. Participants referred to images from the Pulvers Figure Rating Scale that included nine body silhouettes to answer: “How I think I look now” (i.e., current body image) and “How I would like to look” (i.e., desired …

Spatial Analysis Of Hypertension Prevalence Using A Large Us Cohort, Matthew Loop

All ETDs from UAB

Stroke mortality rates are highest in the Southeast US, and the cause for this "Stroke Belt" is not well understood. We investigate the spatial distribution of hypertension, an important risk factor for stroke. This investigation explores statistical issues in performing spatial analysis in a large cohort (over 30,000 participants), relating to type 1 error rate control and geocoding error. Recommendations for handling these statistical issues are made. In an applied analysis, we find that hypertension prevalence varies across the continental US, and is highest in northeast Louisiana, southeast Arkansas, west Mississippi, and east Michigan. These areas are not concordant with …

The Effect Of Joining A Health System On Financial Performance, Kenneth Joseph Cochran

All ETDs from UAB

The rate of hospitals merging has increased significantly over the last few years. The number of hospital mergers between 2003 and 2009 averaged 55 per year, while mergers for 2010 and 2011 were 72 and 90, respectfully. This research moved beyond anecdotal reports and by using publicly reported data to not only evaluate the financial success of mergers, but also to look at other factors such as size, ownership, geography, environment (urban vs. rural), and market competitiveness to assess impacts on financial outcomes of mergers. This study examined the effect of joining a hospital system based on financial performance. Further, …

Should I Stay Or Should I Go? Exploring The Job Preferences Of Allied Health Professionals Working With People With Disability In Rural Australia, G Gallego, A Dew, M Lincoln, A Bundy, R Chedid, K Bulkeley, J Brentnall, C Veitch

Medical Papers and Journal Articles

Introduction: The uneven distribution of allied health professionals (AHPs) in rural and remote Australia and other countries is well documented. In Australia, like elsewhere, service delivery to rural and remote communities is complicated because relatively small numbers of clients are dispersed over large geographic areas. This uneven distribution of AHPs impacts significantly on the provision of services particularly in areas of special need such as mental health, aged care and disability services.

Objective: This study aimed to determine the relative importance that AHPs (physiotherapists, occupational therapists, speech pathologists and psychologists – “therapists”) living in a rural area of Australia and …

The Impact Of Accented English On Speech Comprehension, Benigno Valles

Open Access Theses & Dissertations

ABSTRACT

In the context of shifting demographics in the United States and with an increasing multicultural workforce, the verbal exchange of information is vital especially between health care providers and patients. Although English is the official language in the United States, many individuals from different national origins speak English with some degree of accent. Before we can address health care provider/patient communication, it is necessary to investigate the potential impact of accented English on speech comprehension and its implications on basic communicative interactions. The verbal exchange of information between health care providers and patients is important in diagnostics, treatment, patient …

A Model For A Haitian Comprehensive Community Mental Health Center: An Accounting, Corey Gifford

Antioch University Dissertations & Theses

Haiti is the poorest country in the Western hemisphere. Mental health resources are minimal and in need of further development. The goal of this dissertation project was to develop a model for a comprehensive outpatient Community Mental Health Center (CMHC) in Port-au-Prince, Haiti. It was both critical and essential that the development of a CMHC be considered within the sociopolitical and economic context of Haiti. As such, this project first examined relevant information regarding Haitian geography, poverty, government, and culture. Within this context, the impact of the 2010 earthquake was considered. This context was then used to consider relevant literature, …

Evaluation Of Postthaw Sperm Parameters And Fertility Of Cholistani Service Bulls, Umer Farooq, Syed Aamer Mahmood, Ijaz Ahmad, Nazir Ahmad, Musadiq Idris, Muhammad Tariq Abbas

Turkish Journal of Veterinary & Animal Sciences

The present study was conducted with the objective of evaluating Cholistani service bulls on the basis of their postthaw sperm parameters and fertilizing potential through artificial insemination under the prevailing local climate. Semen from each experimental bull (n = 6) was collected at weekly intervals over a 12-month period, frozen, thawed, and evaluated for postthaw sperm parameters. Fertility rate of postthaw samples was determined by inseminating 1200 Cholistani cows in 2 trials: Trial 1 had 600 cows with 100 inseminations per bull to assess the effect of individual bulls and Trial 2 had 600 inseminations with 150 insemination doses frozen …

Soil Arsenic And Lead Concentrations And Preterm Birth: Investigating Racial Disparities, Sources, Neighborhood Effects, And Spatial Patterns, Pamela Harley Thornton Davis

Theses and Dissertations

Preterm birth, generally defined as birth at <37 weeks of gestation, is an important public health issue that has multiple risk factors related to characteristics of both the mother and her environment. The purpose of this dissertation was to examine potential sources of spatially interpolated (kriged) environmental concentrations of arsenic (As) and lead (Pb) in residential soils and preterm birth in a Medicaid population of mothers giving birth in South Carolina (SC) from 1996-2001. The first objective was to investigate if a racial disparity existed for estimated soil As and Pb concentrations, after adjusting for proximal and distal sources of these metals (including distance and direction to industrial facilities) in a subset of SC Medicaid mothers living in areas of SC where soil samples were collected and analyzed for these metals. The second objective was to test the hypothesis that estimated soil As and Pb concentrations were associated with increased odds of early (<34 weeks) and late (34-36 weeks) preterm births in the same subset of SC Medicaid mothers, after adjusting for individual and neighborhood level risk factors, and examine if measure of neighborhood deprivation and racial residential segregation modified these associations. The third objective was to examine if early and all preterm births, aggregated at the county level, varied spatially and/or temporally in SC for all Medicaid mothers giving birth from 1996-2001 in Bayesian models.

For the first objective, black mothers had significantly higher estimated As and Pb soil concentrations than white mothers in the study population (adjusted betas were 0.12 and 0.22 for As and Pb, respectively; all p<0.006), and proximal sources of metals (e.g., percent of Census block group are covered by roads) were more strongly associated with estimated soil As and Pb concentrations than composite As and Pb releases from industrial facilities categorized by distance from and direction to Census block groups in which maternal residences were located.

For the second objective, estimated soil concentration of neither As nor Pb were associated with increased odds of early or late preterm birth after adjusting for maternal and neighborhood level risk factors. Only individual level covariates were associated with these birth outcomes, and associations were stronger for early as compared to late preterm births. Neighborhood deprivation and racial …

Impact Of Geography On The Control Of Type 2 Diabetes Mellitus: A Review Of Geocoded Clinical Data From General Practice, Moyez Jiwa, Ori Gudes, Richard Varhol, Narelle Mullan

Medical Papers and Journal Articles

Objective: To review the clinical data for people with diabetes mellitus with reference to their location and clinical care in a general practice in Australia.

Materials and methods: Patient data were extracted from a general practice in Western Australia. Iterative data-cleansing steps were taken. Data were grouped into Statistical Area level 1 (SA1), designated as the smallest geographical area associated with the Census of Population and Housing. The data were analysed to identify if SA1s with people aged 70 years and older, and with relatively high glycosylated haemoglobin (HbA1c) were significantly clustered, and whether this was associated with their medical …

Factors Affecting Retention Of Allied Health Professionals Working With People With Disability In Rural New South Wales, Australia: Discrete Choice Experiment Questionnaire Development, G Gallego, A Dew, K Bulkeley, C Veitch, M Lincoln, A Bundy, J Brentnall

Medical Papers and Journal Articles

Objective: This paper describes the development of a discrete choice experiment (DCE) questionnaire to identify the factors (attributes) that allied health professionals (AHPs) working with people with disability identify as important to encouraging them to remain practising in rural areas.

Methods: Focus groups and semi-structured interviews were conducted with 97 purposively selected service providers working with people with disability in rural New South Wales, Australia. Focus groups and interviews were digitally recorded, transcribed, and analysed using a modified grounded theory approach involving thematic analysis and constant comparison.

Results: Six attributes that may influence AHPs working with people with disability in …

Relational Coordination: An Exploration Of Nursing Units, An Emergency Department And In-Patient Transfers, Mary Coffey

Theses and Dissertations

Emergency department (ED) crowding is a patient safety concern that has been increasing for more than a decade. Increased visits have resulted in ED crowding, longer wait times, ambulance diversions, and boarding of admitted patients (Hing & Bhuiya, 2012). Numerous factors affect ED crowding. Once various extraneous issues are resolved and a bed is available for a patient, it becomes the responsibility of nurses across unit boundaries to coordinate the patient transfer. This study applies Relational Coordination Theory (RCT) as a framework to provide nurses insight into the relational aspects of their work in the transfer of ED patients to …

Slavery, Agriculture, And Malaria In The Arabian Peninsula, Benjamin Reilly

Ohio University Press Open Access Books

In Slavery, Agriculture, and Malaria in the Arabian Peninsula, Benjamin Reilly illuminates a previously unstudied phenomenon: the large-scale employment of people of African ancestry as slaves in agricultural oases within the Arabian Peninsula. The key to understanding this unusual system, Reilly argues, is the prevalence of malaria within Arabian Peninsula oases and drainage basins, which rendered agricultural lands in Arabia extremely unhealthy for people without genetic or acquired resistance to malarial fevers. In this way, Arabian slave agriculture had unexpected similarities to slavery as practiced in the Caribbean and Brazil.

This book synthesizes for the first time a body of …

Situating Contraceptive Practices And Public Health Strategy In The Bronx: Perspectives From Female Youth, Healthcare Workers, And Reproductive Health Leaders, Hannah Louise Helmy

USF Tampa Graduate Theses and Dissertations

In the United States, concerns about adolescent childbearing and its perceived corollaries – negative health outcomes for mother and child, the disintegration of the nuclear family, and “over-dependence” on public resources – began to circulate widely in policy spheres and popular media in the 1970’s, resulting in a proliferation of policies, programs, and services designed to address its prevention. Although national birth rates among adolescents are currently at their lowest since peaking in the early 1990’s, this decline masks persistent and significant disparities between groups of young people by race, ethnicity, geography, and poverty level. The concomitant existence of social …

Toward Transforming Health Systems: A Practice Study Of Organizing And Practical Inquiry In Academic Medicine, Thomas A. Ellison

Antioch University Dissertations & Theses

Transformation of health care systems will be grounded in new professional relations and collective, cross-disciplinary actions to impact care delivery. Organizing such relations and actions involves practical inquiry rather than applying professional knowledge. This dissertation presents an exploratory, performative study of the initial organizing of the Health Systems Innovation and Research (HSIR) Program in Health Sciences at the University of Utah. The HSIR program was conceived principally to catalyze cross-disciplinary innovation and health services research and enhance care delivery changes by documenting care improvements and publishing research. This study includes a composite narrative of the organizing and practical inquiry work …