Digital Commons Network^™

Potential Overfeeding Among Formula Fed Special Supplemental Nutrition Program For Women, Infants And Children Participants And Associated Factors, Christopher E. Anderson, Catherine E. Martinez, Alison K. Ventura, Shannon E. Whaley

Kinesiology and Public Health

Background: The Special Supplemental Nutrition Program for Women, Infants and Children (WIC) provides enough formula to meet the known nutritional needs of infants up to 6 months of age whose mothers report not breastfeeding, but many mothers report WIC providing insufficient formula, indicating potential overfeeding.

Objective: To estimate the prevalence of potential overfeeding among formula-feeding WIC participants and identify associated factors.

Methods: Potential overfeeding was identified among participants of the longitudinal Infant and Toddler Feeding Practices Study-2 (ITFPS-2) receiving the fully formula feeding WIC infant package at 1 month of age (n = 1235, weighted n = 197 079). Associations …

The Link Between Heart Disease In Low Socioeconomic Communities In America, Khristopher Chea

Nursing | Senior Theses

As a future medical professional in the healthcare field, we continue to see patients admitted for cardiovascular issues. Cardiovascular diseases (CVDs) remain the leading cause of mortality among adults living in the U.S. despite advances in treatment throughout the past century. A number of risk factors such as hypertension, obesity, smoking, and physical inactivity contribute to the significant rise of cardiovascular disease. Research data suggests that there is correlation between cardiovascular disease, low socioeconomic status, and diet. According to the American Phycological Association socioeconomic status is measured by income, educational status, and occupation, and has been shown to be closely …

The Drug Overdose Epidemic Seen Through Different Lenses, Barbara Blake Gonzalez, Richard Cebula, James V. Koch

Economics Faculty Publications

The age-adjusted death rate from drug overdoses in the United States per 100,000 individuals rose from 6.8 in 2010 to 17.1 in 2018. The most common explanation offered is the deaths of despair hypothesis. We identify additional factors that have contributed to the rise in drug overdose deaths in cities and counties. Methods: We utilize a period fixed effects model with a multi-variate panel data set for 94 independent cities and counties in Virginia for the period 2008 through 2017. Results: The drug overdose mortality rate is: (a) an increasing function (prob.

Improving Health Care Accessibility Among Geriatric Patients In Rural Communities, Capriana Calvachi

Honors Projects

The following literature review and analysis compiles information regarding ways to improve rural geriatric healthcare accessibility through the use of interprofessional care and outreach. I also wish to bring to light the various deficiencies often seen in this realm of care, and the reasons behind the inadequate rural physician retention rates. Using this background information, I compiled various collaborative approaches which seek to ease the strain faced by the healthcare system and its elderly patients.

Improving healthcare accessibility through the use of interprofessional care and outreach is an essential facet in geriatric medicine. By exploring the deficiencies of geriactric healthcare …

The Green House Nursing Home Model: The Gh Elements And Their Impact On Quality Of Care In Nursing Homes., Deborah Kaminka Niyongabo

Electronic Theses and Dissertations

Nursing homes (NHs) have been described as hospital-like facilities where residents are more likely to experience isolation or abuse. The Green House (GH) model is a type of culture change which focuses on deinstitutionalizing traditional NHs to provide better quality of care and quality of life to NH residents. The two main objectives of this study are: to describe the GH model and its elements and to identify which GH elements impact the quality of care. This study also seeks to identify organizational theories used in the GH analysis. The next objective is to analyze the impact of the GH …

Asthma-Copd Overlap Syndrome And Disease Progression In The Copdgene Cohort Study, Caitlyn Winter

Dissertations and Theses (Open Access)

Chronic Obstructive Pulmonary Disease (COPD) is a debilitating and degenerative lung disease characterized by progressive airway obstruction and alveolar destruction. When asthma and COPD co-occur and interact, with asthma having been diagnosed first, the resulting respiratory disease is called Asthma-COPD Overlap Syndrome (ACOS). Current research suggests that persons with ACOS may have more severe respiratory disease and lifestyle limitations than those with either disease alone. The purpose of the current study was to determine if and how disease progression differs in patients with ACOS versus COPD only, using data collected during the COPDGene cohort study. Demographic characteristics and disease outcome …

Breastfeeding Duration And Reasons Given For Early Cessation Of Breastfeeding Among Wic Mothers, Amy Willa

Dissertations and Theses (Open Access)

The Breastfeeding Duration and Reasons for Early Cessation of Breastfeeding Among WIC Mothers study was conducted to describe the duration of and factors associated with early breastfeeding cessation among the Women, Infants, and Children (WIC) population. We collected data from a random sample of WIC medical records, sampling medical records belonging to mothers who initiated breastfeeding an infant but did not breastfeed to 52 weeks. Data were analyzed to answer the questions: How long do WIC mothers breastfeed? What reasons are given during counseling sessions at WIC for early cessation of breastfeeding? Do socio-economic, demographic, or medical factors influence the …

Gender Difference In Mortality Among Pulmonary Tuberculosis Hiv Co-Infected Adults Aged 15-49 Years In Kenya, Rose J. Kosgei, Steven Callens, Peter Gichangi, Marleen Temmerman, Anne-Beatrice Kihara, Gathara David, Eunice Nyaboe Omesa, Enos Masini, E. Jane Carter

Obstetrics and Gynaecology, East Africa

Setting: Kenya, 2012–2015

Objective: To explore whether there is a gender difference in all-cause mortality among smear positive pulmonary tuberculosis (PTB)/ HIV co-infected patients treated for tuberculosis (TB) between 2012 and 2015 in Kenya.

Design: Retrospective cohort of 9,026 smear-positive patients aged 15–49 years. All-cause mortality during TB treatment was the outcome of interest. Time to start of antiretroviral therapy (ART) initiation was considered as a proxy for CD4 cell count. Those who took long to start of ART were assumed to have high CD4 cell count.

Results: Of the 9,026 observations analysed, 4,567(51%) and 4,459(49%) were women and men, …

Datashare Monterey County Website, Audra Ketchem

Capstone Projects and Master's Theses

The DatashareMontereyCounty website was created by combining Conduent technology and knowledgeable staff from the Monterey County Public Health Department. This project attempted to solve the disengagement between many people in Monterey County and health interventions/prevention initiatives set in place by the health department. Two contributing factors related to community disengagement were that residents were not always aware of works the health department was attempting to promote and the complexity of health data (statistics). The main focus of the project demonstrates how understanding health information may or may not impact decision making. When concepts are difficult to understand this can deter …

Disparities In Oral Health: Socioeconomic Status And Policies To Increase Access To Primary Dental Care, Mckenzie Nutter

Theses/Capstones/Creative Projects

Primary dental care is a patient-centered service consisting of routine dental checkups. The oral cavity is the first point of entrance to the body for many harmful pathogens. Therefore, primary dental care is essential to not only prevent and treat conditions in the mouth, but to also reduce the number of systemic diseases in the rest of the body. However, people with higher incomes or wealth have increased access to primary dental care. People with low socioeconomic status have decreased access to primary dental care, at least in part due to difficulties in paying for separate dental insurance. Disparities in …

Bystanders’ Perspectives On The Provision Of Informal, Hospital-Based Care To Bedridden Patients With Cancer In Sri Lanka, B. Sunil S. De Silva

Nursing ETDs

Due to the nursing shortage in Sri Lanka, patients need informal caregivers, known as bystanders, to help provide patient care. This study described bystanders’ perspectives on informal, hospital-based care to bedridden patients with cancer in Sri Lanka. In this qualitative descriptive study, 17 bystanders at Apeksa/Cancer Hospital, Sri Lanka, were recruited using snowballing sampling. Data were collected through telephone interviews and analyzed using content and thematic analyses. Findings showed that paid and unpaid bystanders cover all caregiving tasks with minimum interaction with nurses. Unpaid bystanders described the need for same-sex bystanders and additional help with patients’ mobilization and specialized care. …

External Stoma Diversion: A Palliative Measure For Peristomal Wound Healing In Resource-Limited Settings, Rachel W. Davis, Youmna A. Sherif, Catherine Anne Morrison

Faculty Publications

The provision of intestinal stoma care is challenging in austere settings due to limitations in surgical and wound care access as well as the high cost and sparsity of ostomy supplies. As a result, many surgical patients suffer from ostomy-related complications such as peristomal wounds and are unable to find relief for these complications from standard treatments and measures. This article describes the external stoma diversion, a cost-effective palliative surgical procedure that assists in the healing of peristomal wounds in resource-limited settings.

A Qualitative Analysis Of End-Of-Life Healthcare In Tennessee: Politics, Principles, And Perceptions, Erin Mauck

Electronic Theses and Dissertations

The unprecedented growth of the aging population in Tennessee is a significant demographic trend that highlights the necessity for healthcare policy that tackles end-of-life issues. This study examined the perceived quality of end-of-life healthcare in Tennessee, areas that are in need of improvement, policies that have the potential to influence improvements, and the role of politics in end-of-life healthcare policy. It also assessed the support for end-of-life healthcare policy that would advance quality of care and expand end-of-life choices for Tennesseans, while evaluating the policy-making process that legislators employ.

For this study, data were collected using semi-structured, in-depth interviews with …

Long-Term Neurocognitive And Educational Outcomes Of Neonatal Insults In Kilifi, Kenya, Dorcas N. Magai, Hans M. Koot, Paul Mwangi, Esther Chongwo, Charles R. Newton, Amina Abubakar

Institute for Human Development, East Africa

Background: There is little data on the long-term neurocognitive and educational outcomes among school-aged survivors of neonatal jaundice (NNJ) and hypoxic-ischemic encephalopathy (HIE) in Africa. This study investigates the long-term neurocognitive and educational outcomes and the correlates of these outcomes in school-aged survivors of NNJ or HIE in Kilifi, Kenya.

Methods: We conducted a cross-sectional study on neurocognitive and educational outcomes among school-aged survivors (6–12 years) of NNJ (n = 134) and HIE (n = 107) and compared them to a community comparison group (n = 134). We assessed nonverbal intelligence, planning, working memory, attention, syntax, pragmatics, wordfinding, …

Genetic And Clinical Determinants Of Racial/Ethnic Differences In Multiple Myeloma Susceptibility And Outcomes Focusing On Hispanics, Alem Belachew

Dissertations and Theses (Open Access)

Multiple Myeloma (MM) constitutes 10% of diagnosed hematologic malignancies in the US, with over 12,000 deaths recorded each year. Race/ethnicity is a well-known MM risk factor, where individuals of African descent have over 2- to 3-fold increased risk of incidence compared to those of European descent. Additionally, Hispanics are diagnosed approximately three years younger than white American counterparts, for unknown reasons. Differences in clinical phenotype are also present for MM patients by ancestry, including varying rates of common initiation mutations such as IgH translocations and TP53 mutation between patients of European and African descent. Studies have begun to interrogate the …

Implementation Fidelity Of Nutritional Counselling, Iron And Folic Acid Supplementation Guidelines And Associated Challenges In Rural Uasin Gishu County Kenya, Roselyter Riang’A, Anne Nangulu, Jacqueline Broerse

Population Health, East Africa

Background: Implementation fidelity which is defined as the degree to which programmes are implemented as intended is one of the factors that affect programme outcome, thus requiring careful examination. This study aims to acquire insight into the degree to which nutritional counselling and Iron and Folic Acid supplementation (IFAs) policy guidelines during pregnancy have been implemented as intended and the challenges to implementation fidelity.

Methods: Data were collected in rural Uasin Gishu County in the western part of Kenya through document analysis, questionnaires among intervention recipients (n = 188) and semi-structured interviews with programme implementers (n = 6). …

The Cortico-Limbo-Thalamo-Cortical Circuits: An Update To The Original Papez Circuit Of The Human Limbic System, Jochen Profit, Paul J Sharek, Xin Cui, Courtney C Nisbet, Eric J Thomas, Daniel S Tawfik, Henry C Lee, David Draper, J Bryan Sexton

Faculty, Staff and Student Publications

OBJECTIVES: Key validated clinical metrics are being used individually and in aggregate (Baby-MONITOR) to monitor the performance of neonatal intensive care units (NICUs). The degree to which perceptions of key components of safety culture, safety climate, and teamwork are related to aspects of NICU quality of care is poorly understood. The objective of this study was to test whether NICU performance on key clinical metrics correlates with caregiver perceptions of safety culture.

STUDY DESIGN: Cross-sectional study of 6253 very low-birth-weight infants in 44 NICUs. We measured clinical quality via the Baby-MONITOR and its nine risk-adjusted and standardized subcomponents (antenatal corticosteroids, …

The Relationship Among Sociocultural Assimilation, Dietary Behavior, And Physical Activity In Adult Latinxs In The U.S., Erick Lopez

UNLV Theses, Dissertations, Professional Papers, and Capstones

This dissertation examines the relationship between sociocultural assimilation and health behaviors among adult Latinxs in the United States to address whether different assimilation models promote or hinder Latinx health. Existing research on assimilation and health behaviors among Latinxs relies heavily on the use of proxy measures of assimilation such as length of time in the U.S., nativity, age of arrival, and language preferences for surveys. These studies tend to show that greater assimilation to mainstream U.S. culture among Latinxs is associated with the adoption of poor health behaviors and the erosion of the immigrant health advantage. Research that uses sociocultural …

How Does Stress And Coping Impact Undergraduate Students' Mental Health On A Racially Diverse Campus?, Kristina Ricker-Boles

UNLV Theses, Dissertations, Professional Papers, and Capstones

The study focuses on how subjective stress and mastery skills impact physical and mental wellbeing among UNLV undergraduate college students. Bovier, Chamot, and Perneger’s (2004) study was repeated within a racially diverse campus setting. The Transactional Model of Stress and Coping provided the foundation of this study with an emphasis on primary and secondary appraisal among racial and ethnic groups. The study utilized the Pearlin Coping Questionnaire, the Short Form-12 (SF-12), the Brief Encounter Psychosocial Instrument (BEPSI), and Duke-UNC Functional Social Support Questionnaire to assess subjective stress, mastery skills, and the moderator of social support while comparing the results among …

Frequency Of Hypocalcemic Fits In Children 2 Months To 2 Years Of Age, Presenting With The First Episode Of Afebrile Seizures At Hospital Settings In Urban Pakistan: A Cross-Sectional Study, Waseem Rahman, Heeramani Lohana, Sarwat Urooj, Sheraz Ahmed, Abdul Moeed, Khadija Nuzhat Humayun

Department of Paediatrics and Child Health

Introduction: Seizures are common in the pediatric age group, occurring approximately 10% of children. Hypocalcemia is one of the most common metabolic causes of afebrile seizures. The objective of the study was to determine the frequency of hypocalcemic fits in children presenting with the first episode of afebrile seizures from 2 months to 2 years of age.
Methods: The study was conducted at the Aga Khan hospital Karachi and its three secondary hospitals including the following sites of Kharadar, Hyderabad, and garden. It was a cross-sectional study. The duration of the study was of 6 months from 18th July 2017 …

Informing Strategy To Ensure Detection: Perceptions Of Coronavirus Testing In A Southeastern U.S. Urban Homeless Population, Colleen Bell, Theodore Bosi, Barbara L. Gracious

HCA Healthcare Journal of Medicine

Introduction: Attitudes of those in the homeless population toward testing, particularly during a pandemic, are critical to understand, so that they and their communities may be safely triaged and protected. Homeless persons are more likely to be exposed during viral epidemics, and have greater vulnerability for more severe viral illness, due to greater medical comorbidities. The literature reflects a dearth of published papers describing the perceptions, interest, and motivations of homeless people to seek or receive viral testing, despite their status as a high-risk population.

Methods: A quality improvement project consisting of a cross-sectional survey took place at 8 SARS-CoV-2 …

The Relationship Between Birth Intervals And Adverse Maternal And Neonatal Outcomes In Six Low And Lower-Middle Income Countries, Melissa Bauserman, Kayla Nowak, Tracy L. Nolen, Jackie Patterson, Adrien Lokangaka, Antoinette Tshefu, Archana B. Patel, Patricia L. Hibberd, Sarah Saleem, Saleem Jessani

Community Health Sciences

Background: Due to high fertility rates in some low and lower-middle income countries, the interval between pregnancies can be short, which may lead to adverse maternal and neonatal outcomes.
Methods: We analyzed data from women enrolled in the NICHD Global Network Maternal Newborn Health Registry (MNHR) from 2013 through 2018. We report maternal characteristics and outcomes in relationship to the inter-delivery interval (IDI, time from previous delivery [live or stillborn] to the delivery of the index birth), by category of 6-17 months (short), 18-36 months (reference), 37-60 months, and 61-180 months (long). We used non-parametric tests for maternal characteristics, and …

When Will The Covid-19 Pandemic In Indonesia End?, Dewi Susanna

Kesmas

On January 30, 2020, the World Health Organization(WHO) declared 2019-nCOV to be a Public Health Emergency of International Concern (PHEIC), due to the significant increase in confirmed new cases in various countries.1 In Indonesia, the first confirmed COVID-19 case was a female who had a closed contact with the 24th confirmed case in Malaysia and the second case was the mother of the first case.2 As time goes by, the number of new cases has increased significantly, reaching 160.165 confirmed cases with 6,944 deaths by August 27, 2020.3 The time when the COVID-19 pandemic in Indonesia will end is not …

Policy Implementation: Teachers’ Role As First Responders In Emergencies And Disasters, Shabir Hyder, Adnan Fazal Manzoor, Muhammad Amjad Iqbal

Kesmas

During the past decade, the schoolchildren faced many disasters and emergencies originating from natural and man-made sources. The safety of schoolchildren rests with school management and teachers. This study aimed to assess teachers' awareness with regard to disaster prevention and health, safety, security, and environment (HSSE) policies at primary schools in Pakistan. In addition, it explores the suitability of teachers to perform as emergency handlers in the absence of school nurses and resource officers (SROs). The study involved a qualitative study, based on open-ended interviews from a sample of 25 school teachers. Methodology triangulation was applied to reduce bias. Results …

Obesity Indicators And C-Reactive Protein In Indonesian Adults (More Than Equal To 40 Years Old): The Indonesian Family Life Survey 5, Yeni Mahwati, Dieta Nurrika

Kesmas

C-reactive protein (CRP) is the best clinical marker for systemic inflammation. Obesity is associated with increased CRP levels. Systemic inflammation is present before morbidity occurs. Research reveals that the identification of obesity indicators and CRP levels is limited among Indonesians. The present study investigated the associations between obesity indicators (body mass index [BMI], waist circumference [WC], waist-to-hip ratio [WHR], waist-to-height ratio [WHtR]) and CRP levels among Indonesian adults. This cross-sectional study based on Indonesian Family Life Survey-5 2014–2015 was conducted among 3,386 adults (≥ 40 years) living in 13 provinces in Indonesia during the study period. All data were collected …

Using The Reach, Effectiveness, Adoption, Implementation, Maintenance Framework In The Evaluation Of Community-Based Adolescent Care Pilot Program, Badra Al Aufa, Wahyu Sulistiadi, Mochamad Iqbal Nurmansyah, Agung T R Syiroj, Ibrahim Isa Koire

Kesmas

Posyandu Remaja (Posmaja) is a community-based adolescent care service in Indonesia that comprises a group of adolescents working as volunteers and healthcare workers under the guidance and responsibility of the Public Health Centre and City Health Office. The study aims to provide a formative evaluation program of Posmaja using the Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework. This research used a qualitative approach and took place in South Tangerang City, Indonesia. The data were collected from July until December 2018. Nineteen people participated in the study. The study used in-depth interviews and focus group discussions that adopted the RE-AIM …

Association Between Social Media Exposure To Food And Beverages With Nutrient Intake Of Female Adolescents, Cholida Adiba, Siti Fatimah Pradigdo, Martha Irene Kartasurya

Kesmas

Communication technology development has influenced adolescent food choices and intakes. This study aimed to investigate the association between social media exposure to food and beverage content and nutrient intake among female adolescents. The study was conducted in a cross-sectional design. The targeted population was 104 female students aged 14–18 years old at 'XY' High School in Semarang, Central Java, Indonesia. Eighty-one subjects were chosen by clustered random sampling. Data were collected by interviews using structured questionnaires and a 3x24-hour recall method. Data analyses were conducted by chi-square, Fisher exact tests, and logistic regression. The median and standard deviations of social-media, …

Ultraviolet Exposure And Photokeratitis Complaints Among Informal Welding Workers In Depok, West Java, Indonesia, Maria K I J Yustheresani, Fajaria Nurcandra, Azizah Musliha Fitri, Annisa Ika Putri, Dyah Utari

Kesmas

One of the photokeratitis risk factors is acute reversible radiation of ultraviolet (UV) rays, which injure the cornea's epithelial tissue. Informal welding workers are susceptible populations to UV rays exposure. This study aimed to confirm the influence of UV radiation exposure on photokeratitis complaints in welding workers in Cimanggis, Depok, West Java. A cross-sectional study was conducted from February to June 2019 and used to select 100 welding workers purposively. A semi-structured questionnaire was used to determine photokeratitis complaints, age, education level, eye protection, safety knowledge, and work period; the UV radiation measured by A UV meter. Data were analyzed …

Cultural And Religious Belief Approaches Of A Tuberculosis Program For Hard-To-Reach Populations In Mentawai And Solok West Sumatera, Indonesia, Rizanda Machmud, Irvan Medison, Finny Fitry Yani

Kesmas

Tuberculosis (TB) is a leading public health concern in Indonesia. It ranks second on the list of high-burden TB countries. In West Sumatra, 47% of TB cases are undetected, late diagnosed, and received incomplete treatment because of low-level awareness and knowledge and stigma, especially among the hardest to reach populations. The study aims to identify the best communication channel to reach those who live in vulnerable and remote areas. This study was a qualitative study applying in-depth interviews to the informal leaders, health officers, cultural artists, and religious leaders across districts in Mentawai and Solok Districts, which are remote and …

A Study On Knowledge, Attitudes, And Practices On Rabies In The Philippines, Reynaldo Jr Bundalian, Monalisa Lacson, Catherine Bacani, Dinah Rose Soriano, Agnes Garing, Artemio Jr Aquino, Archie Policarpio, Joey Kyle Mallari, Remedios San Jose, Maria Fe Bulao, Neil Tanquilut, Patricia Joy Magsino

Kesmas

In 2007, the Philippine government passed the Anti-Rabies Act to address rabies in the country. However, rabies is still a major public health concern in many provinces. This study aimed to evaluate the knowledge, attitude, and practices (KAP) of residents on rabies, the Anti Rabies Act, and responsible pet ownership (RPO) in Pampanga, Philippines. A cross-sectional survey was done from October 2017 to February 2018 in 92 randomly selected barangays in the province. Questionnaires were adapted from similar studies. Logistic regression was used to identify factors associated with KAP. Results showed that most people have good knowledge of the Anti-Rabies …