Digital Commons Network^™

Women And Healthcare In Appalachia: Impeding Circumstance And The Role Of Technology, Ashley Cano

Electronic Theses and Dissertations

For decades, healthcare access and quality in central and southern Appalachia have trailed the rest of the country. Entrenched poverty and low educational attainment compound healthcare problems. This study examines the healthcare obstacles women encounter in southern and central Appalachia and analyzes how technology use, such as Internet searching and social media affect women’s healthcare decisions. Data were analyzed from four focus groups conducted with women from the region. Results indicate that seeing a physician or not did not influence women’s propensity to search the Internet for health-related information or to seek support through social media sites. Additionally, women reported …

Stop Stunting: Situation And Way Forward To Improve Maternal, Child And Adolescent Nutrition In Afghanistan, Ariel Higgins Steele, Piyali Mustaphi, Sherin Varkey, Humayoun Ludin, Najibullah Safi, Zulfiqar Ahmed Bhutta

Department of Paediatrics and Child Health

No abstract provided.

Beyond The Millennium Development Goals: An Evaluation Of The War On Hiv / Aids In Kenya, Robert G. Nyaga

Theses and Dissertations

HIV/AIDS remains a threat to Kenya and other developing nations. This thesis aimed at assessing the HIV/AIDS situation in Kenya by examining the knowledge of Kenyans towards infection and spread HIV/AIDS, attitudes towards people living with HIV/AIDS, involvement of community opinion leaders in the HIV/AIDS campaigns, sharing of HIV/AIDS information, and government efforts to control HIV/AIDS. A sample of Kenyans (N= 103) was surveyed and asked to respond to several scales assessing each of the above items. Quantitative and qualitative methods reveal the knowledge and attitudes portrayed by Kenyans and show that, although much has been achieved, there is need …

Geographic Distribution Of Maternal Group B Streptococcus Colonization And Infant Death During Birth Hospitalization: Eastern Wisconsin, Jessica J. F. Kram, Dennis J. Baumgardner, Kiley B. Vander Wyst, Melissa A. Lemke

Journal of Patient-Centered Research and Reviews

Purpose

Maternal group B Streptococcus (GBS) can be transmitted from a colonized mother to newborn during vaginal delivery and may or may not contribute to infant death. This study aimed to explore the geographic distribution and risk factors of maternal GBS colonization and infant death during birth hospitalization.

Methods

We retrospectively studied mothers with live birth(s) in a large eastern Wisconsin hospital system from 2007 through 2013. Associations between maternal and neonatal variables, GBS colonization and infant death were examined using chi-squared, Mann-Whitney U and t-tests. Multivariable logistic regression models also were developed.

Results

Study population (N = 99,305) had …

The Efficacy Of The Influenza Vaccine And The Implications On Vaccination Policy, Alexandra Dipietro

Honors Senior Capstone Projects

The purpose of this paper is to examine the efficacy of the influenza vaccine and its implication on vaccination policy as maintaining or increasing vaccination efficacy is important to public health intervention against this virus. To achieve this purpose a literature review will be conducted based on peer-reviewed research to examine current vaccination policy, efficacy of the influenza vaccine, approaches to improve efficacy, and the gap between vaccination policy and scientific evidence.

Why Children, Adults And The Elderly Are Living On The Streets In Moroccan Cities And What Morocco Is Doing About It., Nora Charidah

Independent Study Project (ISP) Collection

The aim of this independent study project is to explore the determinants of homelessness in the cities of Morocco, more specifically in Rabat,Casablanca and Salé, and how Non-Governmental Organizations (NGO’s) are working to eradicate this epidemic. Poverty, Dysfunctional Families, Mental Illness and Addiction can all be causes as well as results of homelessness; all of these factors have the potential of seriously affecting individuals throughout the entirety of their life. Children, Adults and the Elderly are all affected by poverty throughout Morocco yet street children and the rural impoverished are the populations of the homeless where most research predominately focuses. …

Factors Contributing To The "Dominican Paradox" Of Maternal Mortality, Cherissa Garcia

Master of Public Health Program Student Publications

Despite having one of the highest rates of institutionalized birth in the region, Dominican maternal mortality rates are higher than the regional average. This phenomenon is referred to as the “Dominican Paradox.” The purpose of this paper is to identify factors beyond the established healthcare system that may contribute to the “Dominican Paradox.” Literature about the “Dominican Paradox” often attempts to explain the paradox in terms of the current healthcare system alone. Over reliance on the healthcare system has likely contributed to the “Dominican Paradox.” Most of prevalent causes of maternal mortality in the Dominican Republic are strongly linked to …

Human Papillomavirus-Associated Cancers In Georgia, 2008-2012, Irene Solomon, Chrissy Mcnamara, A. Rana Bayakly

Journal of the Georgia Public Health Association

Background: High-risk human papillomaviruses (HPV) cause most anal, vaginal, vulvar, penile, and oropharyngeal cancers, and virtually all cervical cancers. In 2014, in Georgia (GA), fewer than half of adolescent females and males aged 13-17 years received the three doses of the HPV vaccine. Increasing vaccination coverage among this age group, education of adolescents in regard to HPV risks, and cervical cancer screening of adults can prevent HPV-associated cancers.

Methods: The incidence of HPV-associated cancers for 2008-2012 in GA was obtained from GA Comprehensive Cancer Registry data. Case definitions for HPV-associated cancers were based on standard definitions of the Centers for …

Healthcare Access For Syrian Refugees Lacking Legal Documentation In Jordan, Caroline Flynn

Independent Study Project (ISP) Collection

The purpose of this study is to analyze the access and utilization of health care services by Syrian refugees lacking documentation. This study focuses on the current procedures utilized by healthcare providers for addressing lack of legal documentation in their Syrian refugee patients, as well as broader policies and strategies for addressing the status and protection of these undocumented individuals. This study grapples with the relationship between legal documentation and access to services. The increased costs and barriers to healthcare that come with stateless and refugee status may influence health outcomes and socioeconomic opportunities that impact these individuals for the …

A Quantile Regression Approach To Measuring The Educational Effect On Body Mass Index, Dakshina G. De Silva, Bradley T. Ewing, Catherine P. Slade, Mark A. Thompson

Journal of the Georgia Public Health Association

Background: By use of a publically available database, the effects of education and geography on obesity as measured by body mass index (BMI) were evaluated with a quantile regression approach. The focus of the analysis was on the practical interpretation of the regression results to inform health policy decision makers about the importance of educational attainment for the growing public health issue of obesity in the US, particularly in the Southeast.

Methods: With data from the 2007 Behavioral Risk Factor Surveillance System (BRFSS), quantile regressions were employed to estimate the educational effect on BMI while controlling for relevant lifestyle, socioeconomic, …

The Two Georgias: Disparities In Rural Health And Healthcare, Gary D. Nelson

Journal of the Georgia Public Health Association

The Two Georgias: Disparities in Rural Health and Healthcare

Improving Rural Access To Care: Recommendations For Georgia’S Health Care Safety Net, Karen Minyard, Chris Parker, John Butts

Journal of the Georgia Public Health Association

Background: In Georgia, the safety net provides health care services to vulnerable populations scattered across 74 urban and 85 rural counties. In rural communities, the safety net is challenged with longstanding gaps in service provision and persistent difficulty in making services accessible. The rural safety net in Georgia is vulnerable.

Methods: An environmental scan was conducted of the Georgia rural safety net to assess who it serves, its providers, and how care is accessed in light of the Affordable Care Act (ACA). The scan included analysis of population-based census and health databases and a literature review to inform recommendations.

Results: …

Implementation And Evaluation Of The Carrera Program For Delaying Teen Sex In Georgia, Tressa Tucker, Mary Langley

Journal of the Georgia Public Health Association

Background: In three geographic areas in Georgia, rural, micropolitan, and urban, Morehouse School of Medicine (MSM) implemented the evidence-based Children’s Aid Society Carrera Program at community organizations with Boys and Girls Clubs (BGCs) as the comparison group. This study attempted to replicate the findings of reduced teen pregnancy and birth found for the New York Carrera Program.

Methods: For this longitudinal study with a quasi-experimental design, the sample included 400 youth who were in 6th or 7th grade. A total of 220 were enrolled in the intervention group and 180 in the comparison group. The study was performed in the …

The United Nations Sustainable Development Goals: Achieving The Vision Of Global Health With Justice, Eric A. Friedman, Lawrence O. Gostin

Georgetown Law Faculty Publications and Other Works

We are resolved to free the human race from the tyranny of poverty and want and to heal and secure our planet” (UN General Assembly, 2015, September 25, preamble). So pronounces the 2030 Agenda, the United Nations declaration on the Sustainable Development Goals (SDGs), adopted on September 25, 2015, succeeding the Millennium Development Goals (MDGs). If achieved, the SDGs will secure an improved level of health, development, and global justice. However, if the international community fails to live up to its commitments, an untold number of people will likely perish prematurely, people’s opportunities to thrive will be cut off, social …

The Good Food Jobs Nexus: A Strategy For Promoting Health, Employment, And Economic Development, Nicholas Freudenberg, Michele Silver, Lesley Hirsch, Nevin Cohen

Publications and Research

In the aftermath of the Great Recession, cities have looked to the rapidly growing food sector as a promising source of new employment, and yet most of the sector’s growth has come from low-wage, dead-end food jobs. A strategy to simultaneously increase food employment, improve conditions for food workers, and enhance access to healthy and affordable food to improve public health requires pursuing a “good food jobs” approach that supports policies and programs that advance all three goals. To inform such a strategy, this article analyzes policies and programs to create good food jobs in New York City and discusses …

Quantifying The Association Between Active Tuberculosis Incidence And Migrant Farm Worker Populations Among Florida Counties, 2009-2013: An Ecological Study, Ryan Nicolas Ortega

USF Tampa Graduate Theses and Dissertations

Nearly 20 studies conducted in the last 40 years indicate that tuberculosis (TB) represents a major health concern among migrant farm worker (MFW) populations, but their role in the transmission of TB within the broader community is poorly understood. To this end an ecological study was undertaken which examined 67 Florida counties between years 2009 through 2013. Its aims were as follows: (1) to describe the demographic, geographic, and temporal distribution of the incidence of active TB, (2) to examine the effect of agriculturally relevant seasonal periods on the incidence of active TB, and (3) to quantify the strength and …

Concerns Of Water Scarcity And Water Quality Among Two Andean Communities In Peru, Kelsey Anne Anderson

USF Tampa Graduate Theses and Dissertations

This thesis sought to explore the perceptions and experiences of Andean women regarding water quality, water scarcity, and health among two communities in Carhuaz province of Ancash, Peru. Household surveys (n=25), semi-structured interviews (n=10), unstructured interviews (n=2), and participant observation were conducted with local women to investigate their concerns and perceptions of water and health. An additional two unstructured interviews were conducted with a local water authority and doctor in order gain another perspective on the issues of water security and health.

The pressure of a changing climate and of a problematic water governance system in Andean Peru create an …

The Double Disparity Facing Rural Local Health Departments, Jenine K. Harris, Kate E. Beatty, J. P. Leider, Alana Knudson, Britta L. Anderson, Michael Meit

ETSU Faculty Works

Residents of rural jurisdictions face significant health challenges, including some of the highest rates of risky health behaviors and worst health outcomes of any group in the country. Rural communities are served by smaller local health departments (LHDs) that are more understaffed and underfunded than their suburban and urban peers. As a result of history and current need, rural LHDs are more likely than their urban peers to be providers of direct health services, leading to relatively lower levels of population-focused activities. This review examines the double disparity faced by rural LHDs and their constituents: pervasively poorer health behaviors and …

Health Policy & Management News, Georgia Southern University

Health Policy & Community Health: News & Publications (2011-2018)

• Georgia Southern hosts the 2016 Healthcare Symposium, “Truths and Myths behind Childhood Vaccinations”
• Georgia Southern Conducts a State-Level Analysis of MCH Partnerships

Unintended Pregnancies In Brazil - A Challenge For The Recommendation To Delay Pregnancy Due To Zika, Cynthia Schuck-Paim, Daniel Lopez, Lone Simonsen, Wladimir Alonso

Global Health Faculty Publications

Because of the potential link between the ongoing Zika virus outbreak and a surge in the number of cases of congenital microcephaly, officials in Latin America have recommended that women postpone pregnancy until this association is firmly established or the outbreak subsides. However, in all these countries a large proportion of babies are still born out of unplanned pregnancies. Teenage girls are particularly at high risk, as they often lack access to preventive contraception methods, or the knowledge to use them appropriately. To gauge the magnitude of the barriers preventing the implementation of such a recommendation in Brazil, the country …

Is The Closest Facility The One Actually Used? An Assessment Of Travel Time Estimation Based On Mammography Facilities, Jennifer Alford-Teaster, Jane M. Lange, Rebecca A. Hubbard, Christoph I. Lee, Jennifer S. Haas, Xun Shi, Heather A. Carlos, Louise Henderson, Deirdre Hill, Anna N. A. Tosteson, Tracy Onega

Dartmouth Scholarship

Characterizing geographic access depends on a broad range of methods available to researchers and the healthcare context to which the method is applied. Globally, travel time is one frequently used measure of geographic access with known limitations associated with data availability. Specifically, due to lack of available utilization data, many travel time studies assume that patients use the closest facility. To examine this assumption, an example using mammography screening data, which is considered a geographically abundant health care service in the United States, is explored. This work makes an important methodological contribution to measuring access--which is a critical component of …

Wic Participation As A Risk Factor For Loss To Follow-Up In The Wisconsin Ehdi System, Elizabeth L. Seeliger, Rebecca A. Martin, Andrea N. Gromoske, Anne B. Harris

Journal of Early Hearing Detection and Intervention

In 2011, Wisconsin’s Early Hearing Detection and Intervention (EHDI) program, Wisconsin Sound Beginnings (WSB), developed multiple strategies to reduce loss to follow-up (LTFU) for babies who did not pass their newborn hearing screening: Medical Outreach, Family Outreach, Regional Outreach and WIC Alert. WSB evaluated the outcomes of babies identified as at-risk for LTFU to determine whether WIC participation was an indicator of their risk for LTFU. Additionally, WSB evaluated whether babies who were identified as at-risk for LTFU and receiving WIC services in two WIC projects serving areas and populations with known health disparities, were at even greater risk for …

Re-Framing Informal Family Caregiving, Magdalena T. Ornstein-Sloan

Dissertations, Theses, and Capstone Projects

Informal family caregivers are the backbone of the long-term care system, providing an estimated 80% of the long-term care in the United States. Caregivers provide care to people with disabilities, the ill and older adults, often with little to no outside assistance from the formal long-term care system. Although caregivers receive attention in the academic literature, mainstream media and within public policy and services development, caregiver services continue to remain underutilized. The focus on service provision has various goals, including the desire to lessen the burden caregivers experience by providing services so they can provide care at home longer than …

Genomic Diversity Of Epec Associated With Clinical Presentations Of Differing Severity, Tracy H. Hazen, Michael S. Donnenberg, Sandra Panchalingam, Martin Antonio, Anowar Hossain, Inacio Mandomando, John Benjamin Ochieng, Shahida Qureshi, Farheen Quadri, Anita K. M. Zaidi

Department of Paediatrics and Child Health

Enteropathogenic Escherichia coli (EPEC) are diarrhoeagenic E. coli, and are a significant cause of gastrointestinal illness among young children in developing countries. Typical EPEC are identified by the presence of the bundle-forming pilus encoded by a virulence plasmid, which has been linked to an increased severity of illness, while atypical EPEC lack this feature. Comparative genomics of 70 total EPEC from lethal (LI), non-lethal symptomatic (NSI) or asymptomatic (AI) cases of diarrhoeal illness in children enrolled in the Global Enteric Multicenter Study was used to investigate the genomic differences in EPEC isolates obtained from individuals with various clinical outcomes. A …

Older Adults With Elevated Bmi Are At Greater Risk Of Accelerated Knee Osteoarthritis: Data From The Osteoarthritis Initiative, Kyle D. Wallace

Master of Public Health Program Student Publications

Background: Around 35% of adults with osteoarthritis (OA) have knee osteoarthritis (KOA), which generally progresses over several years; however, some individuals experience accelerated KOA (AKOA), a rapid progression to end-stage disease within 48-months. Purpose: To assess baseline differences among those who develop the different types of KOA, and to determine if baseline characteristics and measures can be used to predict an individual’s KOA status (Common KOA or AKOA) 48 months later.

Methods: Cross-sectional analysis of data from the Osteoarthritis Initiative (OAI) was completed. At baseline, 4,769 participants were enrolled. Data from individuals (n = 1,561) free of radiographic KOA (Kellgren-Lawrence …

Social Media In The Sexual Lives Of African American And Latino Youth: Challenges And Opportunities In The Digital Neighborhood, Robin Stevens, Jamie Dunaev, Ellen Malven, Amy Bleakley, Shawnika J. Hull

Prevention and Community Health Faculty Publications

There has been significant interest in the role of social media in the lives of adolescents, particularly as it relates to sexual risk. Researchers have focused on understanding usage behaviors, quantifying effects of social media exposure and activity, and using social media to intervene. Much of this work has focused on college students and non-minority youth. In this paper, we examine the growing body of literature around social media use among US minority youth and its intersection with sexual risk behavior. We introduce the concept of the “digital neighborhood” and examine the intersection of social media and sexual health in …

Chapter 5: Health Resources, Carol L. Watwood

DLPS Faculty Publications

No abstract provided.

Promoting Healthy Eating And Physical Activity: A Qualitative Examination Of Community-Based Obesity Interventions In Rural Kentucky, Brooke F. Butterworth

Theses and Dissertations--Nutrition and Food Systems

Rural Americans are medically underserved groups and are at greater risk of becoming obese than urban Americans. The purpose of this qualitative study was to determine the perceived causes of obesity in six counties of rural Kentucky and to determine how to customize strategies to reduce obesity in these areas. University of Kentucky Cooperative Extension Service Agents formed coalitions in each of the six counties to assess their communities’ needs and assets to inform plans for implementing evidence-based obesity interventions. Between February and August of 2015, the coalitions were convened for a total of 11 meetings. Each of the coalition …

Immigrants And Refugees As Vulnerable Populations: Considerations For School Based Health Centers, Gaïa D. C. Oliver

Master of Public Health Program Student Publications

School based health centers (SBHC) have been shown to benefit domestic populations both in terms of bettering health and bettering academics while being effective over the long term. There is, however, lacking evidence on how they impact immigrant and refugee communities, which are some of the most vulnerable United States communities in terms of health risks. Through discussion of literature, this paper defines and reviews the criteria for vulnerable populations and explains how this term applies to immigrant and refugee populations. School based health centers and their documented health and academic benefits for domestic high risk populations are discussed and …

Project Soar's Voluntary Medical Male Circumcision Portfolio, Project Soar

HIV and AIDS

Project SOAR has developed an extensive voluntary medical male circumcision (VMMC) portfolio to support multiple countries with data to make informed policy and programmatic decisions about VMMC that address their specific needs and environments. A critical component of this portfolio is research utilization. At the country level, Project SOAR seeks to generate data to support planning, implementing, and monitoring VMMC programs and increase access to and use of this data through user-friendly interfaces and dissemination strategies. Simultaneously, SOAR aims to advance VMMC as a vital prevention strategy by filling important data gaps in the global discourse around VMMC. This brief …