Digital Commons Network^™

Evaluating The Efficacy Of A Childhood Lead Poisoning Risk Model As An Accurate Predictor Of Lead Exposure, Christopher R. Rustin

College of Graduate Studies: Theses & Dissertations

Lead poisoning is a significant public health problem with paint from old housing exposing thousands of children and leading to negative health and social outcomes. Identifying the highest risk children exposed to lead is important to public health agencies. The purpose of this study was to evaluate and assess the efficacy of a new geographically-based lead risk model that when combined with a child's physical address, predicts the extent of a child's risk of lead poisoning on a numeric risk scale. This model is unique because it calculates risk at the address level from parcel attributes of age and type …

Concussion Knowledge And Attitudes In English Football (Soccer), Joshua Williams

College of Graduate Studies: Theses & Dissertations

While concussions are prevalent in soccer, outside the US there has been limited investigation into soccer players' knowledge and attitudes regarding concussions. The purpose of the study was to access English soccer player' concussion knowledge and attitudes. This study used a cross sectional mixed methodology design. Participants included 26 respondents (Age: 23.4 ± 4.5 years, playing experience 16.4 ± 4.4 years) playing for a Championship team in England (Response rate: 89.6%). Fifty percent of respondents had a diagnosed concussion history. Participants were administered the valid and reliable ROCKAS-ST survey divided into 5 sections and includes 3 constructs: concussion knowledge (CKI), …

Tackling The Global Ncd Crisis: Innovations In Law And Governance, Bryan P. Thomas, Lawrence O. Gostin

Georgetown Law Faculty Publications and Other Works

35 million people die annually of non-communicable diseases (NCDs), 80% of them in low- and middle-income countries—representing a marked epidemiological transition from infectious to chronic diseases and from richer to poorer countries. The total number of NCDs is projected to rise by 17% over the coming decade, absent significant interventions. The NCD epidemic poses unique governance challenges: the causes are multifactorial, the affected populations diffuse, and effective responses require sustained multi-sectorial cooperation. The authors propose a range of regulatory options available at the domestic level, including stricter food labeling laws, regulation of food advertisements, tax incentives for healthy lifestyle choices, …

Rediscovering The Core Of Public Health, Steven Teutsch, Jonathan E. Fielding

Frontiers in Public Health Services and Systems Research

The success of public health has been its ability to understand contemporary health problems, to communicate the needs successfully, to identify solutions, and to implement them through programs and policies. In the past 50 years, those successes can be attributed largely to control of infectious disease, improved maternal and child health, delivery of other personal health care services, and changes in behaviors, particularly smoking. Yet health is primarily a product of our social, cultural, and physical environments. To continue to improve the nation’s health and reduce disparities, public health needs to return to its historical roots and engage with other …

Peranan Moderasi Soft Skills Dalam Meningkatkan Mutu Pelayanan Rumah Sakit, Viviyanti Azwar

Kesmas

Penurunan mutu pelayanan Rumah Sakit Umum Pusat Dr. M. Djamil merupakan penentu bagi kinerja rumah sakit sebagai perusahaan jasa. Penurunan mutu pelayanan diindikasikan dengan penurunan rata-rata pelayanan periode tahun 2008-2010 pada instalasi radiologi mencapai 11,29%, laboratorium 5,19%, farmasi 18,5%, instalasi rehabilitasi medik 3,74%, gizi 9,12%, pemulasan jenazah 11,86%, operasi 5,29%, dan hemodialisa 3,62%. Penelitian ini bertujuan untuk menganalisis peranan soft skills memoderasi sumber daya organisasi, keterikatan kerja, kinerja karyawan dalam meningkatkan mutu pelayanan rumah sakit. Pengukuran seluruh konstruksi dan indikator penelitian menggunakan kuesioner yang disebarkan kepada 530 karyawan rumah sakit sebagai tenaga medis maupun nonmedis yang dijadikan responden. Metode analisis …

Persepsi, Peluang Aksi, Dan Infomasi Serta Perilaku Pencegahan Malaria, Elviera Gamelia, Siwi Pramatama Mars Wijayanti

Kesmas

Di dunia, malaria masih menjadi masalah kesehatan masyarakat terutama di negara-negara tropis termasuk Indonesia. Di Jawa Tengah, kasus malaria terus memperlihatkan kecenderungan yang meningkat, salah satu daerah endemis malaria di Banyumas adalah Puskesmas II Sumpiuh. Berdasarkan survei pendahuluan masih banyak ditemukan perilaku berisiko yang dapat mengakibatkan terjadi malaria. Penelitian ini bertujuan mengetahui persepsi masyarakat, kemungkinan aksi, dan informasi tentang malaria yang berpengaruh terhadap perilaku pencegahan malaria di Puskesmas Sumpiuh II Banyumas. Penelitian observasional dengan pendekatan cross sectional ini dilakukan pada populasi kepala keluarga di Puskesmas II Sumpiuh. Jumlah sampel sebanyak 95 kepala keluarga ditarik menggunakan metode simple random sampling. Pengumpulan …

Penentu Kecepatan Pengeluaran Air Susu Ibu Setelah Sectio Caesarea, Desmawati Desmawati

Kesmas

Pengeluaran air susu ibu (ASI) secara dini adalah syarat penting dalam mendukung pemberian ASI eksklusif. Pengeluaran ASI pada ibu post sectio caesarea sedikit lebih lambat dibanding dengan ibu post partum normal. Tujuan penelitian untuk mengetahui pengaruh posisi menyusui, nyeri setelah sectio caesarea, mobilisasi, rooming in, dan rolling massage terhadap kecepatan pengeluaran ASI pada ibu post sectio caesarea. Populasi penelitian dengan metode cross sectional ini adalah ibu-ibu post sectio caesarea yang berjumlah 90 orang. Hasil penelitian menunjukkan ada hubungan posisi menyusui, nyeri setelah sectio caesarea, mobilisasi aktif, rooming in kontinu, dan intervensi rolling massage dengan kecepatan waktu pengeluaran ASI pada ibu …

Sweet Freedom: Smokers’ Rights & The Rebranding Of Philip Morris, Amy Dipierro

Annual Undergraduate Conference on Health and Society

This paper discusses how Philip Morris invoked strong American values to defend its own corporate speech as well as “smoker’s rights.” In particular, it examines Philip Morris Company’s Bill of Rights advertising campaign of the early 1990s, especially focusing on an advertisement featuring Everett Alvarez, a prisoner of war during Vietnam. This strategy reveals how Philip Morris was able to manipulate the public conversation about smoking from one about health and disease to one about human rights and freedoms.

Overweight And Obesity In Kaoma And Kasama Rural Districts Of Zambia: Prevalence And Correlates In 2008-2009 Population Based Surveys, Chola Besa, David Mulenga, Olesegun Babaniyi, Peter Songolo, Adamson S. Muula, Emmanuel Rudatsikira, Seter Siziya

Faculty Publications

Background: Overweight and obesity (overweight/obesity) is associated with hypertension. Low- and middleincome countries are experiencing an obesity epidemic. There is growing evidence that the epidemic is on the increase in urban settings of developing countries. However, there is scanty information on the magnitude of this epidemic and its correlates in rural settings. The objective of the current study was to establish levels of overweight/obesity and its correlates in rural areas of Zambia. Designing interventions based on the correlates for overweight/obesity to reduce its prevalence may in turn lead to a reduction in the prevalence of hypertension.

Methods: Cross sectional studies …

Health Risk Assessments Of Waste Combustion Emissions Using Surrogate Analyte Models, Michael A . Schmidt

Theses and Dissertations

Exposure assessments of open burn pits are often complicated by a lack of sampling equipment and resources. This research investigated the hypothesis of carbon dioxide (CO₂) as a viable surrogate for particulate matter with diameter ≤ 2.5 μm (PM2.5). Large-scale solid waste combustion tests resulted in linear trends between mean PM2.5 and CO₂ (R2 = 0.964 - 0.989). This pilot study demonstrates the feasibility of using CO₂ as a surrogate of PM2.5 concentration as CO₂ sensors potentially provide a cost-effective solution for monitoring in lieu of expensive PM instruments. It also indicates the potential reduction …

International And Domestic Student Health-Information Seeking And Satisfaction, Stacy Theodora Austin

Dissertations and Theses

This study examines two groups -international and domestic students at Portland State University (PSU) - in terms of their motivations to seek university-health services, and their satisfaction with university-health services. The Theory of Motivated Information Management (W. A. Afifi & Weiner, 2004) served as the foundation for this study to examine the preferences of students in terms of the ways they seek information about their health concerns. Differences in international and domestic students' anxiety, efficacy, and satisfaction with physicians were supported. International students reported more anxiety than domestic students. Domestic students reported being more efficacious than international students when talking …

United States Acculturation And Cancer Patients’ End-Of-Life Care, Alexi A. Wright, Heather Stieglitz, Yankel M. Kupersztoch, M. Elizabeth Paulk, Yookyung Kim, Ingrid T. Katz, Francisco Munoz, Rachel B. Jimenez, Jan Mutchler, Lorna Rivera, Anthony L. Back, Holly G. Prigerson

Women’s and Gender Studies Faculty Publication Series

Background: Culture shapes how people understand illness and death, but few studies examine whether acculturation influences patients’ end-of-life treatment preferences and medical care.

Methods and Findings: In this multi-site, prospective, longitudinal cohort study of terminally-ill cancer patients and their caregivers (n = 171 dyads), trained interviewers administered the United States Acculturation Scale (USAS). The USAS is a 19- item scale developed to assess the degree of ‘‘Americanization’’ in first generation or non-US born caregivers of terminally-ill cancer patients. We evaluated the internal consistency, concurrent, criterion, and content validity of the USAS. We also examined whether caregivers’ USAS scores predicted patients’ …

The Last Page: Following Schweitzer's Path, Rima Lathrop Carlson

Colby Magazine

Rima Lathrop Carlson '96 arrived at Albert Schweitzer's clinic in Gabon, West Africa, and discovered a link to past and future.

Palliative Care And The Health Care Crisis In The United States: A Candid Conversation With Dr. Diane Meier, Diane E. Meier

Center for Policy Research

This paper is a synthesis of the 2012 Lourie Lecture, framed as a series of questions and responses, and supported by images used in the lecture. I’m going to focus on the growth of this new field called palliative care and will make the connection that the crisis afflicting healthcare in the United States cannot be addressed without widespread scaling and implementation of palliative care across the system. My subject is not end-of-life care, but rather care during serious illness. A serious illness is something a person can live with for many years, such as emphysema, or end-stage renal disease …

Priority Interventions To Reduce Hiv Transmission In Sex Work Settings In Sub-Saharan Africa And Delivery Of These Services, Matthew F. Chersich, Stanley Luchters, Innocent Ntaganira, Antonio Gerbase, Ying-Ru Lo, Fiona Scorgie, Richard Steen

Population Health, East Africa

Introduction: Virtually no African country provides HIV prevention services in sex work settings with an adequate scale and intensity. Uncertainty remains about the optimal set of interventions and mode of delivery.

Methods: We systematically reviewed studies reporting interventions for reducing HIV transmission among female sex workers in sub-Saharan Africa between January 2000 and July 2011. Medline (PubMed) and non-indexed journals were searched for studies with quantitative study outcomes.

Results: We located 26 studies, including seven randomized trials. Evidence supports implementation of the following interventions to reduce unprotected sex among female sex workers: peer-mediated condom promotion, risk-reduction counselling and skills-building for …

Effectiveness Of A Community-Based Positive Prevention Intervention For People Living With Hiv Who Are Not Receiving Antiretroviral Treatment: A Prospective Cohort Study, Avina Sarna, Stanley Luchters, Eustasius Musenge, Jerry Okal, Matthew Chersich, Waimar Tun, Sabine Mall, Nzioki Kingola, Sam Kalibala

Population Health, East Africa

Background: We report effectiveness of an HIV-prevention intervention delivered by community health workers (CHWs) in Mombasa, Kenya, to PLHIV who have not initiated or who have discontinued ART-an often difficult-to-reach population because they fall outside the ambit of health care and prevention services.

Methods: A 2-arm cohort study assessed a structured risk-reduction intervention involving at least 4 one-to-one counseling sessions and personalized support. The control group received standard prevention services. CHWs recruited treatment-naïve people living with HIV (PLHIV) or those who had previously taken antiretroviral drugs. Data were analyzed using a Propensity Score Matched (PSM)-sample to control for baseline differences …

Impact Of Water And Sanitation And Health Education Interventions On Health And Hygiene Behaviors: A Study From A Northern Pakistani Village, Aysha Zahidie, Fauziah Rabbani

Community Health Sciences

Introduction: Water and sanitation interventions were delivered in the northern areas of Pakistan as a joint venture of the Aga Khan University and the Aga Khan Health Systems Oshikhandass Diarrhea and Dysentery Project (1989-96) followed by the Aga Khan Water, Sanitation, Health and Hygiene Studies Program (WSHHSP). Through these interventions water treatment plants, new pit latrines along with a component of health education were introduced. Objectives: To explore perceptions, knowledge and practices of inhabitants of Oshikhandass village in Gilgit related to water quality, latrine use and hand washing following the intervention. Methods: Through a cross-sectional study during June-July 2012, six …

Medical Tourism And International Healthcare Options, David Conley, Andrew Sikula Sr., William Willis, Alberto Coustasse

Management Faculty Research

Medical tourism has evolved from traveling to the United States (U.S.) and a select few other countries, such as India and Thailand, to a global trend in affordable alternative healthcare. Medical tourism in the U.S. and in other countries has evolved because of cost and lengthy waiting periods. Some insurance companies are marketing kidney transplants and joint replacements through medical choice programs in order to save overall expense. As an economical approach to controlling rising health care costs in the U.S., medical tourism is becoming a valid alternative.

Kondisi Sanitasi Lingkungan Perumahan Dan Kontaminasi Escherichia Coli Pada Penyajian Makanan Pendamping Air Susu Ibu Lokal, Aria Kusuma, Haryoto Kusnoputranto, I Made Djaja, Rizal Syarief

Kesmas

Bayi sangat rentan terhadap penyakit yang disebabkan oleh Makanan Pendamping Air Susu Ibu lokal (MP-ASI lokal). Sampai saat ini belum diketahui keamanan penyajiannya dari kontaminasi mikrobiologi. Penelitian ini bertujuan mengetahui kontaminasi Escherichia coli (E. coli) pada penyajian MP-ASI lokal dan mengamati hubungan antara kondisi sanitasi rumah, seperti Sarana Air Bersih (SAB), tempat mencuci peralatan makan bayi, kondisi Saluran Pembuangan Air Limbah (S PAL), kondisi tempat sampah dan keberadaan hewan berkeliaran di dalam rumah terhadap kontaminasi E. coli pada penyajian. Desain penelitian ini adalah potong lintang yang mengamati penyajian MP-ASI lokal bagi bayi usia 6-12 bulan pada 138 rumah. Lokasi penelitian …

Determinan Perilaku Pemberian Air Susu Ibu Eksklusif Pada Ibu Pekerja, Giri Inayah Abdullah, Dian Ayubi

Kesmas

Pemerintah Indonesia menargetkan cakupan pemberian air susu ibu (ASI) eksklusif sekitar 80%, tetapi hasil Riset Kesehatan Dasar tahun 2010 menunjukkan cakupan ASI eksklusif baru mencapai 15,3%. Dari tahun ke tahun, prevalensi pemberian ASI eksklusif cenderung menurun dengan berbagai alasan, antara lain ibu pekerja. Penelitian ini bertujuan untuk mengetahui proporsi pemberian ASI eksklusif pada ibu pekerja. Rancangan penelitian yang dipakai adalah potong lintang pada data primer yang terdiri dari 120 responden. Penelitian dilakukan pada bulan Mei 2012 menggunakan kuesioner yang diisi sendiri oleh responden. Analisis data yang dilakukan adalah analisis univariat, analisis bivariat menggunakan kai kuadrat, dan analisis multivariat menggunakan regresi …

Tingkat Keamanan Konsumsi Residu Karbamat Dalam Buah Dan Sayur Menurut Analisis Pascakolom Kromatografi Cair Kinerja Tinggi, Bambang Wispriyono, Arry Yanuar, Laila Fitria

Kesmas

Karbamat merupakan salah satu jenis pestisida yang banyak digunakan untuk membasmi hama buah dan sayur. Untuk menentukan bahwa residu karbamat dalam sayuran masih aman dikonsumsi manusia, telah dilakukan analisis beberapa residu karbamat seperti metomil, karbaril, karbofuran, dan propoksur. Sampel-sampel tomat, apel, selada air, kubis, dan sawi hijau dikumpulkan dari tiga supermarket dan satu pasar tradisional di Depok, Jawa Barat. Analisis dilakukan serempak untuk ke empat residu karbamat menggunakan kromatografi cair kinerja tinggi denganpereaksi o-ftalaldehida dan 2-merkaptoetanol dalam reaktor pascakolom dengan detektor fluoresensi. Dari sampel-sampel buah dan sayur yang dianalisis, hanya sawi hijau asal pasar tradisional yang positif mengandung propoksur dengan …

Determinan Penyakit Stroke, Woro Riyadina, Ekowati Rahajeng

Kesmas

Penyakit stroke merupakan penyebab kematian dan kecacatan kronik yang paling tinggi pada kelompok umur di atas usia 45 tahun terbanyak di Indonesia. Tujuan penelitian ini untuk mengidentifikasi determinan utama yang berhubungan dengan penyakit stroke pada masyarakat di kelurahan Kebon Kalapa Bogor. Analisis lanjut terhadap 1.912 responden subset baseline data penelitian “Studi Kohort Faktor Risiko Penyakit Tidak Menular” Data dikumpulkan dengan metode wawancara pada penduduk tetap di kelurahan Kebon Kalapa, Kecamatan Bogor Tengah, Bogor tahun 2012. Diagnosis stroke berdasarkan anamnesis dan pemeriksaan dokter spesialis syaraf. Variabel independen meliputi karakteristik sosiodemografi, status kesehatan dan perilaku berisiko. Data dianalisis dengan uji regresi logistik …

Effects Of Temperature, Relative Humidity, And Den-2 Virus Transovarial Infection On Viability Of Aedes Aegypti, Tri Baskoro T. Satoto, Sitti Umniyati, Adi Suardipa, Margareta Sintorini

Kesmas

Perubahan lingkungan memengaruhi hidup dan transmisi virus dengue dalam tubuh nyamuk. Tujuan penelitian ini adalah mengetahui pengaruh suhu, kelembaban udara(RH), terhadap transmisi virus DEN-2 pada nyamuk Aedes aegypti. Studi eksperimental dengan desain pre dan post tes control group dilakukan di laboratorium pusat kedokteran tropis, Fakultas Kedokteran, Universitas Gadjah Mada, Yogyakarta. Penelitian ini dilakukan pada kelompok Ae. aegypti betina umur 7 hari (F0). Virus DEN-2 diinfeksikan secara transovarial cara membran oral sampai generasi F2. Kelompok lain sebagai kontrol di inkubator temperatur dan suhu tertentu, waktu tertentu, jumlah telur yang dihasilkan, yang menetas dan mengandung virus dicatat. Hasil penelitian menemukan indeks transmisi …

Impact Of The Tohoku Earthquake And Tsunami On Pneumonia Hospitalisations And Mortality Among Adults In Northern Miyagi, Japan: A Multicentre Observational Study, Hisayoshi Daito, Motoi Suzuki, Jun Shiihara, Paul E. Kilgore, Hitoshi Ohtomo, Konosuke Morimoto, Masayuki Ishida, Taro Kamigaki, Hitoshi Oshitani, Masahiro Hashizume, Wataru Endo, Koichi Hagiwara, Koya Ariyoshi, Shoji Okinaga

Department of Pharmacy Practice

Background On 11 March 2011, the Tohoku earthquake and tsunami struck off the coast of northeastern Japan. Within 3 weeks, an increased number of pneumonia admissions and deaths occurred in local hospitals.

Methods A multicentre survey was conducted at three hospitals in Kesennuma City (population 74000), northern Miyagi Prefecture. All adults aged ≥18 years hospitalised between March 2010 and June 2011 with community-acquired pneumonia were identified using hospital databases and medical records. Segmented regression analyses were used to quantify changes in the incidence of pneumonia.

Results A total of 550 pneumonia hospitalisations were identified, including 325 during the pre-disaster period …

Hpv Vaccination Among Young Adult Women: A Perspective From Appalachian Kentucky, Laurel A. Mills, Katharine J. Head, Robin C. Vanderpool

Health, Behavior & Society Faculty Publications

INTRODUCTION: Few studies have assessed barriers to human papillomavirus (HPV) vaccination uptake and adherence, particularly among women of Appalachian Kentucky, a population with higher rates of cervical cancer, lower rates of HPV vaccination, and lower socioeconomic status compared with the rest of the nation. The objective of this study was to address women's reasons for declining the HPV vaccine and, among women who initiated the vaccine series, barriers to completion of the 3-dose regimen.

METHODS: We recruited 17 women aged 18 to 26 from a Federally Qualified Health Center who participated in in-depth, semistructured telephone interviews. All interviews were audio-recorded …

Growing Green Communities Through Urban Gardening In Haddington, Allison Rague, Zach Goldstein

CwiC-PH

Allison, Krista, and Zach worked on a farm and surrounding community gardens with high school students from Philadelphia Youth Network (PYN). The 25 PYN youths were divided into groups and focused on different projects related to urban gardening. The groups included social media, marketing, garden/landscape design, environmental education, and construction/ farm maintenance. Each youth was given the opportunity to explore his or her own interests within the realm of farming.

Environmental And Occupational Interventions For Primary Prevention Of Cancer: A Cross-Sectorial Policy Framework, Carolina Espina, Miquel Porta, Joachim Schüz, Ildefonso Hernández Aguado, Robert V. Percival, Carlos Dora, Terry Slevin, Julietta Rodriguez Guzman, Tim Meredith, Philip J. Landrigan, Maria Neira

Faculty Scholarship

Nearly 13 million new cancer cases and 7.6 million cancer deaths occur worldwide each year; 63% of cancer deaths occur in low and middle-income countries. A substantial portion of all cancers are attributable to carcinogenic exposures in the environment and the workplace.

The objective of this study was to develop an evidence-based global vision and strategy for the primary prevention of environmental and occupational cancer.

The study concluded that opportunities exist to revitalize comprehensive global cancer control policies by incorporating primary interventions against environmental and occupational carcinogens.

Assuring Access To Data For Chemical Evaluations, Lynn R. Goldman, Ellen K. Silbergeld

Environmental and Occupational Health Faculty Publications

Background: A database for studies used for U.S. Environmental Protection Agency (EPA) pesticide and chemical reviews would be an excellent resource for increasing transparency and improving systematic assessments of pesticides and chemicals. There is increased demand for disclosure of raw data from studies used by the U.S. EPA in these reviews.

Objectives: Because the Information Quality Act (IQA) of 2001 provides an avenue for request of raw data, we reviewed all IQA requests to the U.S. EPA in 2002–2012 and the U.S. EPA’s responses. We identified other mechanisms to access such data: public access databases, the Freedom of Information Act …

Drivers Killed Due To Tire Failures, Kentucky Injury Prevention And Research Center

Kentucky Haz Alerts--Motor Vehicle

To Prevent Tire Failures,

Employers should:

• Ensure that routine maintenance is performed on work vehicles
• Implement and enforce an employer seat belt safety program

Employees should:

• Be properly trained in safe work vehicle operation
• Perform routine pre-trip and post-trip inspections, including inspection of the tires
• Ensure that tires do not run below 80% of the recommended pressure

Industry’S Colonization Of Psychiatry: Ethical And Practical Implications Of Financial Conflicts Of Interest In The Dsm-5, Lisa Cosgrove, Emily E. Wheeler

Counseling, School Psychology & Sport Faculty Publication Series

The revision of the Diagnostic and Statistical Manual of Mental Disorders (DSM), scheduled for publication in May 2013 by the American Psychiatric Association (APA), has created a firestorm of controversy because of questions about undue industry influence. Specifically, concerns have been raised about financial conflicts of interest between DSM-5 panel members and the pharmaceutical industry. The authors argue that current approaches to the management of these relationships, particularly transparency of them, are insufficient solutions to the problem of industry’s capture of organized psychiatry. The conceptual framework of institutional corruption is used to understand psychiatry’s dependence on the pharmaceutical industry and …