Digital Commons Network^™

Food Policy: Urban Farming As A Supplemental Food Source, Bessie Didomenica

Walden Dissertations and Doctoral Studies

The distance between farms and cities and the limited access that some residents have to fresh foods can be detrimental to a city's capacity to feed people over time. This study addressed the under-studied topic of urban farming as a secondary food source, specifically by exploring the opportunities and limitations of urban farming in a large Northeastern city. Brundtland's food policy was the pivotal theory supporting food production to end global starvation, and was the link between environmental conservation and human survival. The research question for this study examined the potential food policy opportunities and limitations that assist urban farms …

Prehospital Staffing And Road Traffic Accidents: Physician Versus Trained Nonphysician Responders, Timothy A. Grant

Walden Dissertations and Doctoral Studies

Road traffic deaths, which affect people in their productive years, are projected to be the third leading cause of death by the year 2030. While most studies have focused on road infrastructure and vehicle safety, this study examined something new: the impact of prehospital response to road traffic accidents on the rate of death. Some countries send physicians to the scene of an accident; some send paramedics or registered nurses. The question this research sought to answer was whether the use of physician responders resulted in a lower rate of death compared to the use of nonphysician responders. The literature …

Glioblastoma Multiforme: Geographic Variations In Tumor Size, Treatment Options, And Survival Rate, Susan Rebecca Nohelty

Walden Dissertations and Doctoral Studies

Glioblastoma multiforme (GBM) is a destructive brain cancer that results in death 12 to 15 months after diagnosis. The purpose of this retrospective study was to determine if variations in tumor size at diagnosis, treatment options, and survival rate occur in GBM patients living in urban and rural areas of the United States. Using the behavior model of health services as the theoretical framework, this study used secondary data sets of GBM cases reported from 1988 to 2011 from the Surveillance, Epidemiology, and End Results program. Tumor size was measured in millimeters; treatment was evaluated by ascertaining the number of …

Caribbean Heat Threatens Health, Well-Being, And The Future Of Humanity, Cheryl C. Macpherson, Muge Akpinar-Elci

Community & Environmental Health Faculty Publications

Climate change has substantial impacts on public health and safety, disease risks and the provision of health care, with the poor being particularly disadvantaged. Management of the associated health risks and changing health service requirements requires adequate responses at local levels. Health-care providers are central to these responses. While climate change raises ethical questions about its causes, impacts and social justice, medicine and bioethics typically focus on individual patients and research participants rather than these broader issues. We broaden this focus by examining awareness among health-care providers in the Caribbean region, where geographic and socioeconomic features pose particular vulnerabilities to …

Basic Epidemiology, Center For Leadership In Public Health Practice

Preparedness and Emergency Response Learning Center

Basic Epidemiology, a training course from the USF Center for Leadership in Public Health Practice, develops the awareness and knowledge of public health workers who may be deployed on Field Epidemiology strike teams. It is designed to help them assist local, regional, state, and national epidemiology staff in disease investigations during surge capacity. Basic Epidemiology is a required prerequisite for the IFIRST and IFIRST-2 programs.

Physician Density And Location Of Physician Training : The Impact On Avoidable Hospitalizations, Robert Martiniano

Legacy Theses & Dissertations (2009 - 2024)

Avoidable hospitalizations are those hospitalizations that could have been avoided had there been appropriate levels of primary care, and higher levels of avoidable hospitalizations have been linked to higher rates of poverty and of race/ethnicity and to individuals who are on Medicaid or who are uninsured. The association with physician density has, however, been inconsistent, with research linking both better and worse physician density to higher rates of avoidable hospitalizations. Very little research, however, has been conducted on other physician characteristics and the rate of avoidable hospitalizations.

The Effects Of Landscape On Malaria Vectors Of The Neotropics, William David Lainhart

Legacy Theses & Dissertations (2009 - 2024)

Worldwide malaria control efforts have had varying degrees of success, leaving many countries either eliminating malaria or controlling malaria. In order to maintain forward momentum toward malaria elimination, malaria-eliminating and –controlling countries require different information regarding risk factors, spatial distributions of cases and vectors, vector biology metrics, and vector population genetics. The goal of this dissertation work was to provide information that addresses the knowledge gaps preventing the creation of effective vector and malaria control programs in one malaria-eliminating country (Panama) and two malaria-controlling countries (Peru and Brazil). Case data from Panama were analyzed to assess differences in risk factors …

An Evaluation Of Eligibility, Accessibility, And Social-Emotional Outcomes For Young Children In The New York State Early Intervention Program, Kirsten M. Siegenthaler

Legacy Theses & Dissertations (2009 - 2024)

A wealth of interdisciplinary research on early childhood development by the neurobiological, behavioral, and social sciences has occurred in the past 100 years. The findings from this research have led to an understanding and appreciation of the importance of early life experiences, the centrality of relationships in early childhood to support positive development, the complexity of social skills that are learned in early childhood and their long-term effect on adult success and well-being, and the ability to impact the trajectory of children’s development with effective early intervention. The New York State Early Intervention Program (NYSEIP) is one of the largest …

A Retrospective Evaluation Of The Locally Grown Produce Initiative Of New York State's Hunger Prevention And Nutrition Assistance Program, Marie Allsopp

Legacy Theses & Dissertations (2009 - 2024)

The Hunger Prevention and Nutrition Assistance Program (HPNAP) is administered by the Bureau of Nutrition Risk Reduction in the New York State Department of Health (NYSDOH). This program provides state funds to food banks, the United Way of New York City and other organizations within the emergency food network. Those organizations use HPNAP dollars to fund food and other resources for food pantries, soup kitchens and emergency shelters. In 2012, HPNAP received a one-time $2 million funding allocation for a Locally Grown Produce Initiative. This one-time stimulus to increase the proportion of state-grown fresh produce in emergency food relief services …

Gender-Biased Sex Selection In India: A Review Of The Situation And Interventions To Counter The Practice, Shireen J. Jejeebhoy, Sharmistha Basu, Rajib Acharya, A.J. Francis Zavier

Poverty, Gender, and Youth

This report on gender-biased sex selection in India is divided into six chapters, including an introduction in Chapter 1. Chapter 2 describes the laws and policies adopted by India to address gender-biased sex selection, as well as those intended to support and empower women and girls. Chapter 3 analyzes the trends and geographic variation in the sex ratio at birth and in the child sex ratio. Chapter 4 briefly describes the socioeconomic differences and factors underlying distorted sex ratios and gender-biased sex selection in India, and the social consequences of these practices. Experiences in implementing the PCPNDT Act, initiatives intended …

The Impact Of Disability: A Comparative Approach To Medical Resource Allocation In Public Health Emergencies, Katie Hanschke, Leslie E. Wolf, Wendy F. Hensel

Faculty Publications By Year

It is a matter of time before the next widespread pandemic or natural disaster hits the United States (U.S.). The international response to the 2009 H1N1 influenza stands as a cautionary tale about how prepared the world is for such an emergency. Although the pandemic fortunately proved to be less severe than initially anticipated, it nevertheless resulted in shortages of medical equipment, overburdened hospitals, and preventable patient deaths, particularly among young people.

A pandemic will inevitably lead to difficult decisions about the allocation of medical resources, such as who will have priority access to ventilators and critical care beds when …

Geographic Accessibility To Health Services And Neonatal Mortality Among Very Low Birthweight Infants In South Carolina, Portavia Featherstone

Theses and Dissertations

Introduction: Infant mortality is commonly denoted as a marker of population health with more than half of all infant deaths occurring during the neonatal period (0-27 days) of infancy. Mortality for infants born very low birthweight (<1500 grams) is markedly higher than the babies born with normal birthweight (2500-4000 grams). The purpose of this research project was to assess geographic access to perinatal health services and the risk of neonatal death among infants born with very low birth weight. Data and methods: The linked birth and death records of a retrospective cohort of very low birthweight (<1500 grams) infants born in South Carolina between the years 2010 and 2012 were used (n=3191). We assessed the impact of travel time from maternal residence to delivery hospital and travel time from maternal residence to the nearest prenatal care provider (obstetricians/gynecologists, community health center, or rural health clinic). Logistic regression modeling was performed with adjustments for maternal characteristics (race, age, chronic/gestational hypertension, chronic/gestational diabetes mellitus, smoking, prenatal care), newborn characteristics (gestational age, birthweight, gender, NICU admission at birth), and the birth in a level III hospital. Results: There were a total of 563 neonatal deaths in this population and the neonatal mortality rate was 17.64 neonatal deaths per 100 live births. We did not find significant associations of travel time from maternal residence to delivery hospital and to a closest prenatal care provider with neonatal death after adjusting for confounders. However, we found that a one-week increase in gestational age (OR: 0.61 [95% CI: 0.57-0.65]) and non-Hispanic Black mothers (versus non-Hispanic White mothers) (OR: 0.65 [95% CI: 0.45-0.94]), were associated with the lower odds of neonatal death, while non-NICU admission at birth (OR: 5.99 [95% CI: 4.05-8.84]) was associated with an increased odds of neonatal death. Conclusion: Although we did not find that travel time was associated with neonatal mortality among very low birthweight infants, our study identified a few significant correlates for neonatal deaths in this birthweight group. Future studies should investigate the role of geographic access to care on mortality during other periods of infancy and among other birthweight groups.

Relactation In Emergencies, Ashley N. Franz

Master of Public Health Program Student Publications

Disaster situations in the United States are unique entities that require solutions which are well thought out, appropriate for the population and planned well in advance. Infant and young child feeding in emergencies is no exception. While in peacetime infants may be safely nourished with both breastmilk and infant formula, disaster situations often add a level of complexity to feeding with infant formula, including lack of access to potable water and ability to effectively sterilize feeding items. Such complexities, along with the important and undeniable fact that breastmilk is the ideal form of food for all babies (and especially in …

Immigrant Women: Risk And Protective Factors Associated With Depression And Anxiety Disorders, Fartun Yussuf

Master of Public Health Program Student Publications

Purpose: The purpose of this review was to provide an international perspective on the effects of immigration on the mental health of women. Many of the current reviews focus on one ethnic group and the many factors influencing their mental health. This review examined many ethnic groups but attempted to focus on immigration-related factors that may act as risk or protective factors for depression and anxiety in first- and second-generation immigrant women.

Method: A search of electronic databases for peer-reviewed articles resulted in 30 studies, of which 19 were reviewed for this analysis. The search was limited to studies published …

Correlates Of Depression And Poor Respiratory Health: A Cohort Study In A Rural County, Stephanie Courtney

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

Objective

High rates of depression are widespread globally and are among the leading causes of disability. To better understand the effects of depression on health outcomes, more research is necessary. This study examines the associations between depression and adverse respiratory outcomes among a cohort of Iowa residents living in a rural county. This study also investigates differences in the reporting of chronic and incident respiratory outcomes.

Methods

Data were obtained from the Keokuk County Rural Health Study (1994-2004) for individuals 18 years of age or older (N=1012). The primary outcome, poor respiratory health (PRH), was based on self-reported diagnoses for …

Policy Analysis Of Kentucky Senate Bill 192, Sierra Nicole Dantzler

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

Needle sharing has become an important factor in the prevalence of HIV and viral hepatitis rates as injection drug use of illicit substances, such as heroin and prescription opioids, has increased across the United States. Kentucky, much like the rest of the nation, has also been devastated by the recent surge of injection drug use. In 2010, drug overdose rates ranked Kentucky as the third highest state in the nation. Hepatitis B (HBV) and Hepatitis C (HCV) rates within Kentucky have been consistently higher than the national rate since 2007 and 2003, respectively. Hospital discharge costs related to HCV infections …

A Public Duty: Medicine And Commerce In Nineteenth-Century American Literature And Culture, Heather E. Chacon

Theses and Dissertations--English

Using recent criticism on speculation and disability in addition to archival materials, “A Public Duty: Medicine and Commerce in Nineteenth-Century American Literature and Culture” demonstrates that reform-minded nineteenth-century authors drew upon the representational power of public health to express excitement and anxiety about the United States’ emerging economic and political prominence. Breaking with a critical tradition holding that the professionalization of medicine and authorship served primarily to support and define an ascending middle class, I argue that the authors such as Robert Montgomery Bird, Fanny Fern, George Washington Cable, and Pauline Hopkins fuse the rhetoric of economic policy and public …

The Synergistic Impact Of Income And Rurality On Timely Mammograms In A National Sample Of Women In The United States, Asri Mumpuni

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

Introduction. Breast cancer is the cancer of highest incidence among women in the U.S., making it a significant public health problem. Currently, the U.S. Preventive Services recommends biennial screening mammography for women ages 50-74. This study examined the associations between socioeconomic status and rurality on breast cancer screening behavior. Methods. Data for this study come from the Centers for Disease Control and Prevention (CDC) Behavioral Risk Factor Surveillance System Survey (BRFSS). Breast cancer screening behavior was dichotomized into those who did not meet screening mammogram recommendations (2 years or more) and those who met screening mammogram recommendations (within the …

A Global Map Of Hemispheric Influenza Vaccine Recommendations Based On Local Patterns Of Viral Circulation, Wladimir J. Alonso, Christine Yu, Cecile Viboud, Stephanie A. Richard, Cynthia Schuck-Paim, Lone Simonsen, Wyller A. Mello, Mark A. Miller

Global Health Faculty Publications

Both the Northern and the Southern Hemisphere annual WHO influenza vaccine recommendations are designed to ensure vaccine delivery before the winter-time peak of viral circulation in each hemisphere. However, influenza seasonal patterns are highly diverse in tropical countries and may be out of phase with the WHO recommendations for their respective hemisphere. We modelled the peak timing of influenza activity for 125 countries using laboratory-based surveillance data from the WHO’s FLUNET database and compared it with the influenza hemispheric recommendations in place. Influenza vaccine recommendations for respectively 25% and 39% of the Northern and Southern Hemisphere countries were out of …

Building Assets Toolkit: Developing Positive Benchmarks For Adolescent Girls—Instruction Guide, Judith Bruce, Sarah Engebretsen, Kimberly Glazer

Poverty, Gender, and Youth

The Building Assets Toolkit is an approach for developing programs for specific segments of girls that will prepare them to better face the challenges of growing up. It will help program managers understand the needs of the girls in their community, engage stakeholders at different levels and with different viewpoints, and build concrete and meaningful programming for adolescent girls. The toolkit contains all the materials needed to help make a preliminary assessment of the assets a girl should acquire and the age by which she should acquire them. This document contains the Building Assets Toolkit’s List of Contents and Instruction …

Building Assets Toolkit: Developing Positive Benchmarks For Adolescent Girls—Resource Manual, Judith Bruce, Sarah Engebretsen, Kimberly Glazer

Poverty, Gender, and Youth

This document contains the Building Assets Toolkit’s Resource Manual, which includes valuable information about building meaningful program content as well as detailed notes on each asset for use in the toolkit’s “Asset Building Exercise.” This exercise is designed to involve multiple stakeholders in determining what assets girls need in order to survive and thrive. The Building Assets Toolkit is an approach for developing programs for specific segments of girls that will prepare them to better face the challenges of growing up. It will help program managers understand the needs of the girls in their community, engage stakeholders at different levels …

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 …

Exploring Social Networking Technologies As Tools For Hiv Prevention For Men Who Have Sex With Men, Jorge Ramallo, Thomas Kidder, Tashuna Albritton, Gary Blick, John Pachankis, Valen Grandeleski, Trace Kershaw

Publications and Research

Social networking technologies are influential among men who have sex with men (MSM) and may be an important strategy for HIV prevention. We conducted focus groups with HIV positive and negative participants. Almost all participants used social networking sites to meet new friends and sexual partners. The main obstacle to effective HIV prevention campaigns in social networking platforms was stigmatization based on homosexuality as well as HIV status. Persistent stigma associated with HIV status and disclosure was cited as a top reason for avoiding HIV-related conversations while meeting new partners using social technologies. Further, social networking sites have different social …