Digital Commons Network^™

Exploring Barriers: An Analysis Of Access To Effective Tuberculosis Care In Cape Town, Yvonne Okaka

Independent Study Project (ISP) Collection

My independent study project (ISP) examines factors that hinder access to tuberculosis (TB) healthcare and its effective implementation in Cape Town. In order to expand research on the topic, important barriers will be examined and explained. This project is relevant due to the high prevalence and mortality rates of tuberculosis in South Africa, as well as the fact that an overwhelming emphasis on HIV can lead to overlooking the serious nature of TB as a public healthcare issue. It is hoped that this study will provide more insight into improving access to TB care, and be a resource for those …

Behavioral Attitudes And Preferences In Cooking Practices With Traditional Open-Fire Stoves In Peru, Nepal, And Kenya: Implications For Improved Cookstove Interventions, Evelyn L. Rhodes, Robert Dreibelbis, Elizabeth M. Klasen, Neha Naithani, Joyce Baliddawa, Diana Menya, Subarna Khatry, Stephanie Levy, James M. Tielsch, J. Jaime Miranda, Caitlin Kennedy, William Checkley

Global Health Faculty Publications

Global efforts are underway to develop and promote improved cookstoves which may reduce the negative health and environmental effects of burning solid fuels on health and the environment. Behavioral studies have considered cookstove user practices, needs and preferences in the design and implementation of cookstove projects; however, these studies have not examined the implications of the traditional stove use and design across multiple resource-poor settings in the implementation and promotion of improved cookstove projects that utilize a single, standardized stove design. We conducted in-depth interviews and direct observations of meal preparation and traditional, open-fire stove use of 137 women aged …

Systematic Review Of Potential Health Risks Posed By Pharmaceutical, Occupational And Consumer Exposures To Metallic And Nanoscale Aluminum, Aluminum Oxides, Aluminum Hydroxide And Its Soluble Salts, Calvin C. Willhite, Nataliya A. Karyakina, Robert A. Yokel, Nagarajkumar Yenugadhati, Thomas M. Wisniewski, Ian M. F. Arnold, Franco Momoli, Daniel Krewski

Pharmaceutical Sciences Faculty Publications

Aluminum (Al) is a ubiquitous substance encountered both naturally (as the third most abundant element) and intentionally (used in water, foods, pharmaceuticals, and vaccines); it is also present in ambient and occupational airborne particulates. Existing data underscore the importance of Al physical and chemical forms in relation to its uptake, accumulation, and systemic bioavailability. The present review represents a systematic examination of the peer-reviewed literature on the adverse health effects of Al materials published since a previous critical evaluation compiled by Krewski et al. (2007).

Challenges encountered in carrying out the present review reflected the experimental use of different physical …

Understanding Treatment Refusal Among Adults Presenting For Hiv-Testing In Soweto, South Africa: A Qualitative Study, Ingrid T. Katz, Janan Dietrich, Gugu Tshabalala, Thandekile Essien, Kathryn Rough, Alexi A. Wright, David Bangsberg, Glenda E. Gray, Norma C. Ware

OHSU-PSU School of Public Health Faculty Publications and Presentations

HIV treatment initiatives have focused on increasing access to antiretroviral therapy (ART). There is growing evidence, however, that treatment availability alone is insufficient to stop the epidemic. In South Africa, only one third of individuals living with HIV are actually on treatment. Treatment refusal has been identified as a phenomenon among people who are asymptomatic, however, factors driving refusal remain poorly understood. We interviewed 50 purposively sampled participants who presented for voluntary counseling and testing in Soweto to elicit a broad range of detailed perspectives on ART refusal. We then integrated our core findings into an explanatory framework. Participants described …

Syrian Refugee Families’ Awareness Of The Health Risks Of Child Marriage And What Organizations Offer Or Plan In Order To Raise Awareness, Rachel Fowler

Independent Study Project (ISP) Collection

The hypothesis of the study assumes: If Syrian refugee families understood the health risks involved with child marriage and the severity of these risks, they would be less likely to choose to marry off their daughter under the age of 18. If these families had more health educational programs and had more access to these programs, these programs would influence their decision towards avoiding child marriage for their daughter(s).

According to UNICEF, one-third of registered marriages among Syrian refugees in Jordan between January and March 2014 involved girls under the age of 18. Child marriage puts girls at risk of …

Breaking Barriers: The Influence Of Socioeconomic Status On Obesity Among Women In Salvador, Bahia, Brazil, Christina Camoriano

Independent Study Project (ISP) Collection

Obesity in Brazil has grown rapidly within the past decade, however research is conflicting in terms of who carries the burden of this disease- the economic elite or the poor. Despite the lack of clarity towards the current distribution of obesity, many studies have come to the conclusion that in developing countries, obesity is growing more rapidly among those of lower socioeconomic status.¹¹ Therefore, the purpose of my research study is to examine how socioeconomic status influences the dietary and exercise habits of lower and lower-middle income women who are obese. This study is relevant because it seeks to …

Hispanic Mothers' Normative Beliefs And Intentions About The Discussion Of Sex-Related Topics With Their Adolescent Daughters, Dana M. Rodriguez

Dissertations (1934 -)

Hispanic adolescent females continue to have rates of pregnancy and STIs, which exceed those of white non-Hispanic peers. When mothers engage in the discussion of sex-related topics (DSRTs) with their adolescent daughters, it has been shown to delay or decrease sexual intercourse. However, it has been found that Hispanic parents talk less with their daughters about sex-related topics (SRTs) when compared to other ethnic groups. Understanding why Hispanic mothers may or may not intend to engage in DSRTs is important in order to design culturally appropriate programs aimed at increasing their DSRTs. A sequential mixed-methods predictive correlational design framed by …

Conceptualization Of Autism In The Latino Community And Its Relationship With Early Diagnosis, Katharine E. Zuckerman, Brianna Sinche, Martiza Cobian, Marlene Cervantes, Angie Mejia, Thomas Becker, Christina Nicolaidis

School of Social Work Faculty Publications and Presentations

Objective—Early identification of autism spectrum disorders (ASD) has been linked to improved long-term developmental outcomes. However, Latino children are diagnosed later than white non- Latino children. We aimed to qualitatively assess the understanding and conceptualization of ASD in the Latino community in order to understand potential community barriers to early diagnosis.

Method—We conducted 5 focus groups and 4 qualitative interviews with 30 parents of typicallydeveloping Latino children in Oregon. Participants were asked structured questions concerning video vignettes that follow a Latina mother from the time she begins to worry about her 3-year-old son's behaviors to the time he receives an …

A Meta-Analysis Of The Prediction Of Violence Among Adults With Mental Disorders, Hing Po Lam

Dissertations, Theses, and Capstone Projects

The study of the risk for violence among persons with mental disorders has received substantial scientific attention over the past few decades; however, many uncertainties and controversies remain due to the wide disparities in the reported results. Using the state-of-the-art perspective of public health, a meta-analysis was conducted to clarify the ambiguities by synthesizing quantitative findings from 85 research reports (completed between January 1970 and May 2010) on violence risk assessment among mentally disordered adults. Results of this meta-analytic study revealed that the estimates of the prevalence of violence among the psychiatric population varied considerably from 1.1% to 78.4% with …

Understanding Factors Determining Early Termination From A Government Assistance Program For Maternal And Child Health: The Special Supplemental Nutrition Program For Women, Infants And Children (Wic), Anthony Dominic Panzera

USF Tampa Graduate Theses and Dissertations

The purpose of this dissertation is to understand why individuals enrolled in the Special Supplemental Nutrition Program for Women, Infants and Children (WIC) fail to retrieve food vouchers, miss WIC appointments, and become inactive in program components. In Kentucky, mothers who fail to pick up food instruments for 60 days are automatically terminated from the program. The specific research questions that guided this study are: (1) Which segments of enrollees are at greatest and least risks of nonparticipation in the WIC program? (2) How do predisposing, enabling and need characteristics impact WIC nonparticipation among eligible mothers? (3) How do WIC …

Internet Use For Health Information Among American Indians: Facilitators And Inhibitors, Melissa K. Filippi, Christina M. Pacheco, Charlotte Mccloskey, Rebecca Jeanne Crosthwait, Justin Begaye, Jb Kinlacheeny, Won S. Choi, K Allen Greiner, Christine M. Daley

Journal of Health Disparities Research and Practice

Our research team explored Internet use among a heterogeneous American Indian (AI) population to determine Internet use in relation to health information seeking behaviors. Participants examined an AI culturally-tailored tobacco website as an example to explain what they wanted in an AI Internet health site. Using community-based participatory research, we conducted 10 focus groups with non-college AI men and women (N=96), stratified by age (18-29, 30-49, and 50 and over) to better understand their perceptions of Internet use and health information needs. We found that Internet use varied greatly among all strata. Participants referenced WebMD^© more than any other …

American Indian Men's Perceptions Of Breast Cancer Screening For American Indian Women, Melissa K. Filippi, Joseph Pacheco, Aimee S. James, Travis Brown, Florence Ndikum-Moffor, Won S. Choi, K Allen Greiner, Christine M. Daley

Journal of Health Disparities Research and Practice

Screening, especially screening mammography, is vital for decreasing breast cancer incidence and mortality. Screening rates in American Indian women are low compared to other racial/ethnic groups. In addition, American Indian women are diagnosed at more advanced stages and have lower 5-year survival rate than others. To better address the screening rates of American Indian women, focus groups (N=8) were conducted with American Indian men (N=42) to explore their perceptions of breast cancer screening for American Indian women. Our intent was to understand men’s support level toward screening. Using a community-based participatory approach, focus groups were audio-taped, transcribed verbatim, and analyzed …

Health Insurance Benefits Advisors: Understanding Responsibilities, Regulations, Restrictions And The Relevance To Implementing The Affordable Care Act, Alexandra M. Stewart, Marisa A. Cox, Leighton Ku

Health Policy and Management Issue Briefs

This brief describes the operational differences among six different types of benefits advisors including: 1) Commercial agents and brokers, 2) Medicaid enrollment brokers, 3) navigators, 4) non-navigator assistance personnel (or in-person assisters), 5) certified applications assisters, and 6) health center outreach and enrollment assistance workers. We will address: 1) the role of each benefits advisor 2) the health plans with which benefits advisors are authorized to work 3) training requirements, 4) compensation 5) conflict of interest requirements, and 6) the impact benefits advisors have on consumer enrollment decisions.

Prevalence And Determinants Of Unintended Childbirth In Ethiopia, Yibeltal Tebekaw, Bezuhan Aemro, Charles Teller

Global Health Faculty Publications

Background

Ethiopia’s population policy specifically aims to reduce TFR from 7.7 to 4.0 and to increase contraceptive use from 4.0% to 44.0% between 1990 and 2015. In 2011, the use of contraceptive methods increased seven-fold from 4.0% to 27%; and the TFR declined by 38% to 4.8. The use of modern contraceptives is, however, much higher in the capital Addis Ababa (56%) and other urban areas but very low in rural areas (23%) far below the national average (27%). In 2011, one in four Ethiopian women had an unmet need for contraception. The main aim of this study was to …

West Virginia Nursing Homes: Are They Up To The Standard?, Guillermo Madero Md, Shirley M. Neitch Md

Internal Medicine

Quality measurement and performance monitoring are under continuous assessment in Nursing Homes (NH). Through this research project we assess the quality of care provided in the NH in the state of West Virginia by publicly accessible quality measurements. The methodology for this research study was through the retrieval of data from the Nursing Home Compare website in which a total of 80 NH were located and analyzed. The results demonstrate that more than 50% of NH in West Virginia are at or above the national average when compared using the Five Star Rating System by CMS, in overall rating (59%), …

Ifn-Gamma Au-Rich Element Removal Promotes Chronic Ifn-Gamma Expression And Autoimmunity In Mice, Deborah L. Hodge, Cyril Berthet, Vincenzo Coppola, Wolfgang Kastenmüller, Matthew D. Buschman, Paul M. Schaughency, Hidekazu Shirota, Anthony J. Scarzello, Jeff J. Subleski, Miriam R. Anver, John R. Ortaldo, Fanching Lin, Della A. Reynolds, Michael E. Sanford, Philipp Kaldis, Lino Tessarollo, Dennis M. Klinman, Howard A. Young

United States Public Health Resources

We generated a mouse model with a 162 nt AU-rich element (ARE) region deletion in the 3' untranslated region (3'UTR) of the interferon-gamma (IFN-γ) gene that results in chronic circulating serum IFN-γ levels. Mice homozygous for the ARE deletion (ARE-Del) (-/-) present both serologic and cellular abnormalities typical of patients with systemic lupus erythematosus (SLE). ARE-Del(-/-) mice display increased numbers of pDCs in bone marrow and spleen. Addition of IFN-γ to Flt3-ligand (Flt3L) treated in vitro bone marrow cultures results in a 2-fold increase in pDCs with concurrent increases in IRF8 expression. Marginal zone B (MZB) cells and marginal zone …

Persistent Hiv-Related Stigma In Rural Uganda During A Period Of Increasing Hiv Incidence Despite Treatment Expansion, Brian T. Chan, Sheri D. Weiser, Yap Boum Ii, Mark J. Siedner, Rain Mocello, Jessica E. Haberer, Peter Hunt, Jeffrey N. Martin, Kenneth H. Mayer, David Bangsberg, Alexander C. Tsai

OHSU-PSU School of Public Health Faculty Publications and Presentations

Objective—Program implementers have argued that the increasing availability of anti-retroviral therapy (ART) will reduce the stigma of HIV. We analyzed data from Uganda to assess how HIV-related stigma has changed during a period of ART expansion.

Design—Serial cross-sectional surveys.

Methods—We analyzed data from the Uganda AIDS Rural Treatment Outcomes (UARTO) study during 2007-2012 to estimate trends in internalized stigma among people living with HIV (PLHIV) at the time of treatment initiation. We analyzed data from the Uganda Demographic and Health Surveys (DHS) from 2006 and 2011 to estimate trends in stigmatizing attitudes and anticipated stigma in the general population. We …

Pengaruh Pendekatan Child Healthcare Modeldan Transtheoretical Model Terhadap Asupan Makan Anak Overweight Dan Obesitas, Kadek Ayu Erika, Elly Nurachmah

Kesmas

Overweight dan obesitas pada anak merupakan suatu masalah yang kompleks disebabkan multifaktor, yaitu interaksi genetik dan lingkungan. Gaya hidup perkotaan dipicu oleh asupan makanan yang berlebih pada anak overweight dan obesitas. Strategi untuk menurunkan asupan makan berlebih pada anak adalah dengan pendekatan child healthcare model dan transtheoretical model sehingga dapat mengendalikan gaya hidup anak. Penelitian ini bertujuan membuktikan pengaruh pendekatan child healthcare dan transtheoretical model terhadap asupan karbohidrat anak overweight dan obesitas. Penelitian ini dilaksanakan di wilayah kecamatan Biringkanaya dan Tamalanrea, Makassar, pada bulan Agustus 2013 sampai Maret 2014. Desain yang digunakan adalah quasy experiment yaitu pretest and posttest with …

Tingkat Pengetahuan Dan Persepsi Terhadap Shisha Pada Mahasiswa, Dhimas Nirwana Yudha, Yayi Suryo Prabandari, Purwanta Purwanta

Kesmas

Isu yang berkembang terkait pengetahuan dan persepsi seorang calon tenaga kesehatan memengaruhi keberhasilan pelayanan kesehatan dalam menjawab tantangan di masyarakat nantinya. Shisha (rokok dari Timur Tengah) mulai marak di Yogyakarta. Tujuan penelitian ini untuk memperoleh gambaran tentang tingkat pengetahuan dan persepsi terhadap shisha pada mahasiswa reguler tahap akademik Fakultas Kedokteran Universitas Gadjah Mada. Penelitian ini merupakan penelitian deskriptif menggunakan rancangan potong lintang. Sampel penelitian adalah mahasiswa dari tiga program studi yang dilakukan pada bulan September - Oktober 2013. Jumlah responden sebanyak 72 mahasiswa ilmu keperawatan, 74 mahasiswa gizi dan kesehatan dan 258 mahasiswa pendidikan dokter. Pengumpulan data dilakukan dengan kuesioner. …

Evaluasi Pelaksanaan Konseling Menyusui, Ika Murtiyarini, Dewi Marhaeni Diah Herawati, Irvan Afriandi

Kesmas

Salah satu upaya pemerintah dalam meningkatkan pemberian ASI di Indonesia adalah dengan memberikan konseling menyusui di pelayanan kesehatan. Penelitian perlu dilakukan untuk mengevaluasi pelaksanaan konseling menyusui di Kota Jambi dengan mengeksplorasi komponen input, activity, output, dan outcome. Penelitian ini merupakan penelitian kualitatif menggunakan strategi studi kasus. Penelitian dilakukan di empat puskesmas Kota Jambi pada bulan Desember 2013 sampai dengan Februari 2014. Pengumpulan data dilakukan dengan studi dokumen, observasi pelaksanaan konseling menyusui dan sarana prasarana, wawancara mendalam, serta focus group discussion. Analisis data yang digunakan adalah analisis tematik. Hasil penelitian menunjukkan bahwa komponen input dan activity kurang optimal seperti kurangnya sumber …

Fieldwork Summary Report: Reducing Repeat Teenage Pregnancy Through Program Planning And Evaluation, Winnie Y. Chan

Master's Projects and Capstones

This fieldwork summary report provides a synthesis of both my overall fieldwork experience at TAPP, Felton Institute’s Teenage Pregnancy and Parenting Program, and my Master of Public Health knowledge and skill sets. Since researching the huge social and economic impact that teenage pregnancy and parenting has not only on the teens and their children, but also the society at large, I strived to highlight prevention aspects to reduce repeat unwanted teenage pregnancy. So, I chose to intern at TAPP, focused my fieldwork project mainly on program development and evaluation, along with other aspects of improving wellness.

I begin this report …

Trauma Informed Practices For Oakland Unite Service Providers, Maereg D. Haile

Master's Projects and Capstones

Oakland, California - a home to almost 400,000 residents - is the top five most violent cities of the nation. There are lots of factors that greatly contribute to violence including: Poverty, housing/homelessness, unemployment, food insecurity, educational attainment, substance abuse. These factors feed to greater healthy disparities and increased trauma in low-income communities – specifically in east and west Oakland. Measure Y, now called Oakland Unite, is the current violence prevention effort that is set for reauthorization in November 2014. In order for these efforts to continue, Oakland Unite has started looking at comprehensive violence prevention initiatives that includes mental …

Discovering Community Assets: Master Of Public Health Culminating Experience, Megan E. Sirna

Master's Projects and Capstones

The Sonoma County Department of Health Services, through Cradle to Career, promotes collective impact around educational attainment and workforce development, and has become a leader in developing a framework for community schools. The first step in developing a community schools model is to understand and inventory what is already going on in the community. This process, known more formally as asset mapping, is a participatory process focused on documenting the strengths and resources of a community. The collaborative nature of the process helps to promote community involvement and build community cohesion. In order to assist schools wanting to begin an …

Nutrition Education And Community Advocacy At Marin Health And Human Services, Anna C. Allison

Master's Projects and Capstones

It would be a mistake to assume that all Marin neighborhoods look the same. The life expectancy in Ross is over 88 years. Less than 10 miles away in Hamilton Novato, the life expectancy is 75 years. That is a 13 year difference in life expectancy, roughly equivalent to the difference between living in the United States and Guyana. Marin is a small county, but it holds a great deal of variation. An effective health intervention in one neighborhood will not work in another, more importantly, there may not be the same health issue from one neighborhood to the next. …

Closing The Gap: Achieving Equitable Healthcare Outcomes For Kaiser Permanente Members, Trang T. Phan

Master's Projects and Capstones

The University of San Francisco provides a comprehensive Master of Public Health curriculum to deliver a wide breadth of public health knowledge. The MPH program not only equipped me with the skills and knowledge necessary to be successful, it also allowed me to find my passion. The well-established coursework and knowledgeable professors have instilled within me a passion to achieve health equity for everyone, regardless of their social, economic, or environmental disadvantages. I incorporated this mission into my practicum experience and completed over 400 hours at Kaiser Permanente to focus on eliminating health disparities for the patients, families, and communities …

Three-Year Change In The Wellbeing Of Orphaned And Separated Children In Institutional And Family-Based Care Settings In Five Low- And Middle-Income Countries, Kathryn Whetten, Jan Ostermann, Brian W. Pence, Rachel A. Whetten, Lynne C. Messer, Sumedha Ariely, Karen O'Donnell, Augustine I. Wasonga, Vanroth Vann, Dafrosa Itemba, Misganaw Eticha, Ira Madan, Nathan M. Thielman, The Positive Outcomes For Orphans (Pofo) Research Team

Faculty Publications

Background With more than 2 million children living in group homes, or “institutions”, worldwide, the extent to which institution-based caregiving negatively affects development and wellbeing is a central question for international policymakers.

Methods A two-stage random sampling methodology identified community representative samples of 1,357 institution-dwelling orphaned and separated children (OSC) and 1,480 family-dwelling OSC aged 6–12 from 5 low and middle income countries. Data were collected from children and their primary caregivers. Survey-analytic techniques and linear mixed effects models describe child wellbeing collected at baseline and at 36 months, including physical and emotional health, growth, cognitive development and memory, and …

Childhood Obesity Fieldwork Summary Report: The Food Education Project, Maria De Rosario Vasquez

Master's Projects and Capstones

Childhood Obesity and diabetes is on the rise and the health risk for developing various diseases is a major public health issue. This paper examines the public health issue on childhood obesity and diabetes. This paper explains the importance and magnitude of this problem by providing statistics, research efforts, educational efforts and the importance of preventing childhood obesity and diabetes. The paper will summarize, explain observations and provide insight on fieldwork completed through a project called The Food Education Project. The project focuses on addressing the major public health problem through educating children and adolescents on health, nutrition, food and …

Three-Year Change In The Wellbeing Of Orphaned And Separated Children In Institutional And Family-Based Care Settings In Five Low- And Middle-Income Countries, Kathryn Whetten, Jan Ostermann, Brian W. Pence, Rachel A. Whetten, Lynne C. Messer, Sumedha Ariely, Karen O'Donnell, Augustine L. Wasonga, Vanroth Vann, Dafrosa Itemba, Misganaw Eticha, Ira Madan, Nathan M. Thielman, Positive Outcomes For Orphans (Pofo) Research Team

Community Health Faculty Publications and Presentations

Background: With more than 2 million children living in group homes, or "institutions", worldwide, the extent to which institution-based caregiving negatively affects development and wellbeing is a central question for international policymakers.

Methods: A two-stage random sampling methodology identified community representative samples of 1,357 institutional dwelling orphaned and separated children (OSC) and 1,480 family-dwelling OSC aged 6–12 from 5 low and middle income countries. Data were collected from children and their primary caregivers. Survey-analytic techniques and linear mixed effects models describe child wellbeing collected at baseline and at 36 months, including physical and emotional health, growth, cognitive development and memory, …

The Development, Implementation, And Testing Of An Interactive Sexual Health Web-Based Application Intervention To Reduce Sexual Risk Behaviors Among College Students, Dawnyéa Dominique Jackson

Theses and Dissertations

College life is often regarded as a time for exploration and growth. One major area of exploration and growth for college students is sex and sexuality. Growth and exploration involves not only learning how to master these life situations, but also experiencing some negative consequences. Negative consequences for college students engaging in sexual risk-taking behaviors often lead to a high prevalence of sexually transmitted infections (STIs), unintended pregnancies, emotional distress, and large healthcare costs. Given the high prevalence of risky sexual behavior among young adults and the highly negative consequences of risky sexual behavior for this population, it is critical …

A Study Of An Uncharacterized Penicillium Species Isolated From A Hypersaline Pond In San Salvador, Bahamas, Virginia Elizabeth Hopkins

Theses and Dissertations

A large number of facultative marine fungi are unexplored (Lai et al., 2007). They exist in the hypersaline environment with reduced growth and metabolism for an indeterminable period of time and are believed to have no ecological role. Here we report the discovery of one novel facultative Penicillium species that we named Penicillium virginium. We show that when transferred from its native ecosystem, a salt pond in San Salvador, Bahamas, to a laboratory fungal growth medium, Penicillium virginium demonstrates a higher growth rate in absence of salt than in presence of salt confirming that it is a facultative marine fungus. …