Digital Commons Network^™

A Tale Of Two Countries: Progress Towards Unaids 90‐90‐90 Targets In Botswana And Australia, Tafireyi Marukutira, Mark Stoove, Shahin Lockman, Lisa A. Mills, Tendani Gaolathe, Refeletswe Lebelonyane, Joseph N. Jarvis, Sherrie L. Kelly, David P. Wilson, Stanley Luchters

Population Health, East Africa

UNAIDS 90‐90‐90 targets and Fast‐Track commitments are presented as precursors to ending the AIDS epidemic by 2030, through effecting a 90% reduction in new HIV infections and AIDS‐related deaths from 2010 levels (HIV epidemic control). Botswana, a low to middle‐income country with the third‐highest HIV prevalence, and Australia, a low‐prevalence high‐income country with an epidemic concentrated among men who have sex with men (MSM), have made significant strides towards achieving the UNAIDS 90‐90‐90 targets. These two countries provide lessons for different epidemic settings. This paper discusses the lessons that can be drawn from Botswana and Australia with respect to their …

Angiostrongylus Cantonensis: Epidemiologic Review, Location-Specific Habitat Modelling, And Surveillance In Hillsborough County, Florida, U.S.A., Brad Christian Perich

USF Tampa Graduate Theses and Dissertations

Angiostrongylus cantonensis is a parasitic nematode endemic to tropical and subtropical regions and is the leading cause of human eosinophilic meningitis. The parasite is commonly known as rat lungworm because the primary host in its lifecycle is the rat. A clinical overview of rat lungworm infection is presented, followed by a literature review of rat lungworm epidemiology, risk factors, and surveillance projects. Data collected from previous snail surveys in Florida was considered alongside elevation, population per square kilometer, median household income by zip code territory, and normalized difference vegetation index specific to the geographic coordinates from which the snail samples …

Market Integration Predicts Human Gut Microbiome Attributes Across A Gradient Of Economic Development, Keaton Stagaman, Tara J. Cepon-Robins, Melissa A. Liebert, Theresa E. Gildner, Samuel S. Urlacher, Felicia C. Madimenos, Karen Guillemin, J. Josh Snodgrass, Lawrence S. Sugiyama, Brendan J. M. Bohannan

Publications and Research

Economic development is marked by dramatic increases in the incidence of microbiome-associated diseases, such as autoimmune diseases and metabolic syndromes, but the lifestyle changes that drive alterations in the human microbiome are not known. We measured market integration as a proxy for economically related lifestyle attributes, such as ownership of specific market goods that index degree of market integration and components of traditional and nontraditional (more modern) house structure and infrastructure, and profiled the fecal microbiomes of 213 participants from a contiguous, indigenous Ecuadorian population. Despite relatively modest differences in lifestyle across the population, greater economic development correlated with significantly …

Patient-Provider Race And Sex Concordance: New Insights Into Antibiotic Prescribing For Acute Bronchitis, Jake R. Morgan, Mari-Lynn Drainoni, Cindy Christiansen, Tamar F. Barlam

Journal of Health Disparities Research and Practice

Objective: To examine whether patient and provider concordance by sex or race predicts antibiotic prescribing for acute bronchitis.

Study setting: General Internal Medicine and Family Medicine adult clinics at a large safety-net hospital.

Study design: We used a logistic model of prescribing as a function of race and sex concordance.

Data extraction: Data were extracted from de-identified patient records for those with an acute bronchitis visit between 2008 and 2010.

Principal findings: 71% (95% CI 68%-73%) of visits resulted in an antibiotic prescription. Patients in race-concordant visits were 17% (95% CI 8%-25%) less likely to receive …

Examining The Impact Of Food Environment Changes On County-Level Obesity Prevalence In The Appalachian Region, Jaime Booth, Kai Wei, Allison Little

Journal of Health Disparities Research and Practice

The aim of the present study was to understand the impact of changes in the food environment on county-level obesity prevalence in the Appalachian Region. We examined the food environment in 412 counties across the Appalachian Region using data from the Behavioral Risk Factor Surveillance System, the American Community Survey, and the Food Environment Atlas. We found there was an overall decrease of per capita food stores from 2007 to 2011 in this region. There was also a significant relationship between the decrease of grocery stores per capita from 2007 to 2011 and the increase of county-level obesity in 2012. …

Wdph 2017 Summer Internship Report, Lauren Meininger

Mosakowski Institute for Public Enterprise

In the spring of 2014, the Worcester Division of Public Health, UMass Memorial Health Care, and Clark University’s Mosakowski Institute for Public Enterprise joined forces to begin developing a partnership that would combine academic resources, student input, and public health needs in the City of Worcester. Founders of this program were motivated to seek and implement innovative interventions for public health issues while simultaneously inspiring a new generation of public health professionals.

Each year, the Academic Health Collaborative of Worcester (AHCW) brings in student interns to work on the pressing public health issues of the moment. Interns work alongside epidemiologists, …

Pregnancy Outcomes Among Women With An Unintended Pregnancy: Findings From A Prospective Registry In Rural Pakistan, Sumera Aziz Ali, Shiyam Sunder Tikmani, Margo S. Harrison, Sarah Saleem, Robert L. Goldenberg, Elizabeth M. Mcclure, Omrana Pasha

Community Health Sciences

Background: Unintended pregnancies are an important public health issue in both developed and developing countries. An unintended pregnancy may affect maternal health seeking behavior during the antenatal and postpartum periods, which can adversely affect perinatal outcomes. Aim: The specific aim of our study was to measure antepartum, intrapartum, and postpartum pregnancy outcomes among women with unintended pregnancies in a rural Pakistani population.
Methods: Using a prospective maternal and newborn health registry in Thatta Pakistan, we evaluated temporal associations between unintended pregnancy and several dimensions of health seeking behavior including: antenatal care, preference for private versus government facility for antenatal care, …

Pharmacists' Role In Harm Reduction: A Survey Assessment Of Kentucky Community Pharmacists' Willingness To Participate In Syringe/Needle Exchange, Amie Goodin, Amanda Fallin-Bennett, Traci Green, Patricia R. Freeman

Nursing Faculty Publications

Background: Pharmacists' role in harm reduction is expanding in many states, yet there are limited data on pharmacists' willingness to participate in harm reduction activities. This study assessed community pharmacists' willingness to participate in one harm reduction initiative: syringe/needle exchange.

Methods: In 2015, all Kentucky pharmacists with active licenses were emailed a survey that examined attitudes towards participation in syringe/needle exchange. Response frequencies were calculated for community pharmacist respondents. Ordinal logistic regression estimated the impact of community pharmacist characteristics and attitudes on willingness to provide clean needles/syringes to people who inject drugs and to dispose of used syringes/needles, where both …

An Ambivalent Embrace: Service Needs And Gaps For Asian Immigrants In New Destinations, John J. Chin

Journal of Health Disparities Research and Practice

Asian immigrants to the U.S. are settling in "new destinations," but there has been little research on their health care and social service needs. Our analysis of Census data to identify cities with the fastest Asian immigrant population growth (1990-2000) yielded 33 smaller cities in 13 states. The cities ranged in population from 7,677 to 86,660; were spread across 13 states in the Northeast, South, and Midwest regions of the US; and varied widely demographically. Pilot surveys conducted in 2009 indicated that, although many residents had positive attitudes towards immigrants, many were also concerned about job competition and dilution of …

Teens As Teachers In The Garden: Cultivating A Sustainable Model For Teaching Healthy Living, Virginia Bolshakova, John Gieng, C. Sheena Sidhu, Mary Vollinger, Lorena Gimeno, Jessica Guild

Faculty Publications

School gardens are an ideal space to deliver a healthy living curriculum, such as nutrition and physical activity education, to elementary school youth. However, public schools often lack the resources and support to establish sustainable garden-based programming. We created the Healthy Living Ambassador program, a collaborative after-school garden program in low-income communities that brought together resources from schools, community programs, and University of California Cooperative Extension. This school garden program featured culturally competent teens as teachers to serve as near-peer educators and mentors to elementary school youth. The program development model incorporated lessons from sustainable community-based health program interventions and …

Chile: Air Pollution, Kara Eder

Global Public Health

Chile faces a constant issue of air pollution, reaping respiratory health problems for citizens in urban areas. While the many cases over the past century have increased officials to take action on the issue, the growing infrastructure and economy of the country makes it difficult to regulate harmful emissions. Wood-burning heaters within urban residential areas also contribute to the unhealthy smog. Ingestion of these forms of matter in the air causes respiratory symptoms such as bronchitis and cardiovascular disease. Bans on such heaters and taxes on vehicle emissions were placed in order to prevent the severity of pollutants in the …

Kenya: Hiv/Aids, Mckenzie Mcnally

Global Public Health

Kenya is a country in Africa that has been dealing with the detrimental effects of HIV and AIDs. HIV/AIDs are a virus and a syndrome that affects a person’s immune system. It is spread through the sharing of bodily fluids (ex. blood, semen, etc.). HIV/AIDs is a known problem in Kenya, and although the numbers are declining it still affects a large percentage of the population. The spread of HIV/AIDs can be stopped through getting tested, using condoms, and education of what the disease is and how to stop it. Part of the reason it spreads, despite the multiple charities …

The South Sudan: Tuberculosis, Blake Schwarz

Global Public Health

The South Sudan is a country that recently gained independence from the Sudan after a bloody twenty year civil war. They lost nearly two million lives during the war, and are now ravaged by Tuberculosis, or TB. After gaining their independence in 2011, the South Sudan has an average of 18,000 cases of TB at any time. This would consider TB in the South Sudan an endemic, as it always has a base level of TB cases that does not vary. There is medication for TB that is available to the citizens on the South Sudan, but the prescription is …

Tonga: Chronic Diseases, Muhammad Taimoor

Global Public Health

Tonga is an Archipelago in the south Pacific Ocean, south of Samoa. The public health brief project is on chronic diseases in Tonga. The total population of Tonga was 107,122 in 2010. The Free Wesleyan Church of Tonga is the established religion in Tonga. Tongan’s make up the majority of the population but there are other ethnicities such as Euromericans and Europeans too. The major challenges faced by Tonga are decaying infrastructure, low economy, and political corruption. The widespread of non-communicable diseases such as cancer is a major health issue in Tonga. 74% of all adults in Tonga are the …

Virgin Islands: Heart Disease, Dylan Hayden

Global Public Health

The Virgin Islands are located in the Caribbean. The arc of Caribbean islands begins off the coast of Florida and extends all the way to South America. When the Revised Organic Act of 1954 was established, the United States Congress declared the U.S. Virgin Islands to be an unincorporated territory of the United States. The Virgin Islands government consist of three branches that are known as Judicial, Executive , and Legislative branch. There are some major challenges in Virgin Islands. Some of them are: several hurricanes in recent years, frequent and severe droughts and floods, and occasional earthquakes. With that …

Palau: Obesity, Tavia Weis

Global Public Health

Located in the heart of the Western Pacific Ocean is a large group of small islands that make up the country of Palau. Known for its growing tourism, beautiful landscapes, and cultural beliefs. Although the country is developing, the current health issue of obesity is a growing concern. With almost half of the population obese and the other half in jeopardy, the rising concerns of the obesity epidemic have taken global news and brought the attention of major countries to try and fix these rising issues. This public health brief will discuss the problems of obesity in Palau and the …

Human Trafficking, Alyssa Noosbond

Global Issues in Public Health

Human trafficking is a major problem not just somewhere around the world but possibly in your own neighborhood. Human trafficking is a non-communicable disease that is caused by a person being in a vulnerable position whether they are in a foreign country, leaving a place of poverty, leaving for political reasons, or for an overall change to better their life. With human trafficking being a $150 billion industry, there are unfortunately 20.9 million victims with 26 percent being children, 55 percent of the people being trafficked are women and girls leaving 45 percent to be men and boys. Women and …

Perceived Benefits And Barriers Of A Community-Based Diabetes Prevention And Management Program, Samantha Shawley-Brzoska, Ranjita Misra

Faculty & Staff Scholarship

This study examined the perceptions of benefits of and barriers to participating in a community-based diabetes program to improve program effectiveness. The Diabetes Prevention and Management (DPM) program was a twenty-two session, 1-year program, modeled after the evidence-based National Diabetes Prevention Program and AADE7 Self-Care Behaviors framework. Community-based participatory research approach was used to culturally tailor the curriculum. Participants included overweight or obese adults with dysglycemia. A benefits and barriers survey was developed to gather information on participants’ perception of the program, as well as information on demographics and health literacy levels. Eighty-nine adults participated in the DPM program (73% …

Ten Years Of Food Policy Governance In New York City: Lessons For The Next Decade, Nicholas Freudenberg, Nevin Cohen, Janet Poppendieck, Craig Willingham

Publications and Research

No abstract provided.

Integrated Analysis Of The Value Of Wetland Services In Coastal Adaptation; Methodology And Case Study Of Hampton-Seabrook Estuary, New Hampshire, Paul Kirshen, Semra Aytur, David M. Burdick, Diane Foster, Tom Lippmann, Ellen Douglas, Sydney Nick, Chris Watson

Jackson Estuarine Laboratory

The present impacts from coastal storms and high tides grow significantly over time due to SLR even over the relatively short period to 2060. Hydrodynamic model simulations of storm surge with and without sea level rise scenarios show that although flooding and inundation increases with increasing subtidal forcing and higher sea level, dissipation of the tide and storm surge in the estuary channel somewhat limits the maximum inundation that might otherwise be expected in the back marsh areas. The estuary is dominated by high marsh, which lies high in the intertidal zone and by 2060 it will convert to mostly …

Social Medicine And International Expert Networks In Latin America, 1930–1945, Eric D. Carter

Faculty Publications

This paper examines the international networks that influenced ideas and policy in social medicine in the 1930s and 1940s in Latin America, focusing on institutional networks organised by the League of Nations Health Organization, the International Labour Organization, and the Pan-American Sanitary Bureau. After examining the architecture of these networks, this paper traces their influence on social and health policy in two policy domains: social security and nutrition. Closer scrutiny of a series of international conferences and local media accounts of them reveals that international networks were not just ‘conveyor belts’ for policy ideas from the industrialised countries of the …

Greece: Infection, Joshua Teets

Global Public Health

Greece is a country that has shaped the western world’s architecture, societies, and governments. They also seem to have some of the greatest internal issues of developed countries in the world with the recent refugee crisis stemming from the Middle East. Greece, a country which already experiences many financial issues, is left with a huge lack of resources and staff to accommodate even their own population. With the lack of health resources and nurses, many short-cuts have led to an unprecedented amount of infection related deaths from the country that created Western Civilization. This brief discusses the causes of these …

Overdose Prevention And Naloxone Distribution In Jefferson County, Brittany Coleman

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

The United States in battling an opioid epidemic, and rates of overdose fatality have soared to record highs. Kentucky is among the states with highest rates of opioid overdose fatality, and Jefferson County is responsible for about a quarter of all cases. Overdose Prevention and Naloxone Distribution (OPND) programs have been shown to decrease fatality rates by providing a medication that literally reverses opioid overdose. The programs provide other services such as education and connection to recovery facilities.

Currently, the Kentucky Harm Reduction Coalition provides naloxone kits to the residents of Jefferson County, but they do not have a regular …

Complementary Infant Feeding Practices In Afghanistan, Hasibullah Na Niayesh

Walden Dissertations and Doctoral Studies

Children are at greater risk of malnutrition in Afghanistan than they are in many other countries. Malnutrition impairs the mental and physical growth of more than 50% of children in Afghanistan. It also exacerbates the risks of mortality by 45% in infants and children in Afghanistan. The purpose of this study was to determine the association between mothers' knowledge, attitudes, and practices regarding complementary feeding and malnutrition in children in Afghanistan. The precaution adoption process model served as a theoretical framework in this quantitative cross-sectional research study. Data analyzed were collected from 306 mothers and children at 6 randomly selected …

Modeling Geographic Factors And Assessing Their Accuracy In Identifying Health Disparities In Fayette County, Ian Jones

Lewis Honors College Capstone Collection

The purpose of this capstone is to conduct a review of existing literature to determine the effects of a variety of geographic variables on health and wellness. The student will use their findings to create a visual aid to displaying these geographic factors and their distributions within Fayette County. Furthermore, the student will analyze the intersection of these variables to predict potential pockets of discrepancy within Fayette County. Based on this analysis, the student will propose possible interventions with a basis in current literature. This project will provide the student with the opportunity to conduct a study of existing literature, …

Temporal And Geospatial Trends Of Pediatric Cancer Incidence In Nebraska Over A 24-Year Period, Evi A. Farazi, Shinobu Watanabe-Galloway, L. Westman, B. Rettig, P. Hunt, R. Cammack, John W. Sparks, Don W. Coulter

Journal Articles: Epidemiology

BACKGROUND: Data from the Surveillance, Epidemiology, and End Results (SEER) revealed that the incidence of pediatric cancer in Nebraska exceeded the national average during 2009-2013. Further investigation could help understand these patterns.

METHODS: This retrospective cohort study investigated pediatric cancer (0-19 years old) age adjusted incidence rates (AAR) in Nebraska using the Nebraska Cancer Registry. SEER AARs were also calculated as a proxy for pediatric cancer incidence in the United States (1990-2013) and compared to the Nebraska data. Geographic Information System (GIS) mapping was also used to display the spatial distribution of cancer in Nebraska at the county level. Finally, …

Collaboration Across The Curriculum: Urban Planning & Public Health, Lula Geyre

Senior Honors Theses and Projects

The way our communities are designed impacts our health. and there is an increasing need for collaboration between urban planners and public health professionals. Yet, it is not clear to what extent universities are preparing public health and planning students to work together. Our research will shed light on this important topic by evaluating the course requirements for both of these disciplines in accredited institutions and look at how they are addressing interprofessional issues such as land development, transportation policies, air/water quality, and community growth issues. The current study explores the availability of interdisciplinary courses in accredited undergraduate and graduate …

Mental Health And Drivers Of Need In Emergent And Non-Emergent Emergency Department (Ed) Use: Do Living Location And Non-Emergent Care Sources Matter?, Moira C. Mcmanus, Robert J. Cramer, Maureen Boshier, Muge Akpinar-Elci, Bonnie Van Lunen

Community & Environmental Health Faculty Publications

Emergency department (ED) utilization has increased due to factors such as admissions for mental health conditions, including suicide and self-harm. We investigate direct and moderating influences on non-emergent ED utilization through the Behavioral Model of Health Services Use. Through logistic regression, we examined correlates of ED use via 2014 New York State Department of Health Statewide Planning and Research Cooperative System outpatient data. Consistent with the primary hypothesis, mental health admissions were associated with emergent use across models, with only a slight decrease in effect size in rural living locations. Concerning moderating effects, Spanish/Hispanic origin was associated with increased likelihood …

Root-Cause Analysis Of Persistently High Maternal Mortality In A Rural District Of Indonesia: Role Of Clinical Care Quality And Health Services Organizational Factors, Mohammad Afzal Mahmood, Ismi Mufidah, Steven Scroggs, Amna Rehana Siddiqui, Hafsa Raheel, Koentijo Wibdarminto, Bernardus Dirgantoro, Jorien Vercruyssen, Hayfaa A. Wahabi

Community Health Sciences

Background: Despite significant reduction in maternal mortality, there are still many regions in the world that suffer from high mortality. District Kutai Kartanegara, Indonesia, is one such region where consistently high maternal mortality was observed despite high rate of delivery by skilled birth attendants.
Method: Thirty maternal deaths were reviewed using verbal autopsy interviews, terminal event reporting, medical records' review, and Death Audit Committee reports, using a comprehensive root-cause analysis framework including Risk Identification, Signal Services, Emergency Obstetrics Care Evaluation, Quality, and 3 Delays.
Findings: The root causes were found in poor quality of care, which caused …

Predictors Of Pm 2.5 And Radon Concentrations In Residences Of Central Kentucky: A Cross Sectional Study, Kyle T. Hancock

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Aim: To measure levels of respirable particles (PM 2.5) and radon in homes in Central Kentucky and assess modifiable risk factors that could reduce the morbidity and mortality of cardiovascular and respiratory disease.

Methods: PM 2.5 and radon samples were taken in homes (n=21) in Central Kentucky. An in- home checklist was completed for each home that assessed a variety of potential environmental respiratory exposures.

Results: The geometric mean of PM 2.5 for all 21 homes was 8.4 μg/m³ which was well below the EPA air quality standard of 35 μg/m³. Smoking status, burning candles, and general …