Digital Commons Network^™

Globally Minded, Locally Serving: Refugee Health In Philadelphia, Sarah Jamieson, Angelica Montes, Gretchen Shanfeld, Mph, Rickie Brawer, Mph, Phd, Caryn Johnson, Ms, Otr/L, Faota, James D. Plumb, Md, Mph

CwiC-PH

Introduction

A refugee is someone who is forced to leave their country of origin due to war, violence, or persecution. The United States is the world’s top resettlement country. Out of the 50 states, Pennsylvania is 5^th in terms of the number of annually resettled refugees. Each year, Philadelphia resettles approximately 800 refugees. Bhutan, Burma, Iraq, Eritrea, Sudan, and Democratic Republic of Congo are the most frequent countries of origin in Philadelphia.

Risk Factors And Costs Influencing Hospitalizations Due To Heat-Related Illnesses: Patterns Of Hospitalization, Michael T. Schmeltz

Dissertations, Theses, and Capstone Projects

The objective of this dissertation was to identify individual and environmental risk factors, investigate outcomes and hospital resource use, including costs, and document the pattern of heat-related illness hospitalizations in the United States. The main data source for the study population was the 2001-2010 Nationwide Inpatient Sample (NIS). The study population for heat-related illnesses (HRIs) consists of patients in the NIS with at least one diagnosis of a heat-related illness (ICD-9 codes 992.0 - 992.9) from 2001 to 2010. Outcome analysis included a study population of patients who had primary or secondary diagnoses of diabetes, cardiovascular diseases, respiratory illnesses, nephritic …

An Examination Of The Effect Of Vision-Related Factors And Availability Of Health Care Resources On Depression, Functional Status, And Falls Among New York City Senior Center Attendees, Lauren Evans

Dissertations, Theses, and Capstone Projects

There is substantial variability across different geographic regions and demographic groups in health outcomes and health resource availability. This dissertation examines the relationship between self-reported ocular disease and depression, functional status, and falls in a diverse sample of senior center attendees in New York City. Further, these analyses explored whether the availability of health care resources at the area level affects the observed relationship between ocular disease and these other adverse outcomes.

This dissertation project addresses two main gaps in the current research, specifically, the need to better understand elders' experiences with these conditions in different geographic regions and demographic …

A Comparison Of Sexual Health And Sexual Pressure Among Young African American And Caucasian Women, Ann Gakumo

Journal of Health Disparities Research and Practice

Introduction. Condom self-efficacy, positive attitudes toward condom use, condom negotiation skills, HIV knowledge, and self-esteem have been associated with decreased HIV risk behavior among young women, but few studies have examined racial disparities that may exist in these social health indicators. Moreover, sexual pressure (inclusive of both coercive and non-coercive pressures to engage in unwanted or unprotected sex) has been understudied in women of different racial groups.

Study Purpose. The purpose of this study was to compare racial similarities and disparities in indicators of sexual health and sexual pressure in an urban sample of young African American and Caucasian women …

Project Thanks: A Socio-Ecological Framework For An Intervention Involving Hiv Positive African American Women With Comorbidities, Meena Mahadevan, Ndidiamaka Amutah, Lauren Juliette Ramos, Emily Rose Raines, Jerome King, Jodyann Mcintosh, Constance Leverett

Journal of Health Disparities Research and Practice

HIV-positive individuals are living longer today as a result of continuing advances in treatment but are also facing an increased risk for chronic diseases such as diabetes, and hypertension. These conditions result in a larger burden of hospitalization, outpatient, and emergency room visits. Impoverished African American women may represent an especially high-risk group due to disparities in health care, racial discrimination, and limited resources. This article describes an intervention that is based on the conceptual framework of the socio-ecological model. Project THANKS uses a community-based participatory, and empowerment building approach to target the unique personal, social, and environmental needs of …

Environmental Disparities Present A Challenge For Diabetes Prevention And Management Efforts In Dallas County, Theresa Mendoza, Sushma Sharma, Pamela Daughty, Crystee Cooper, Carol Young, Larry Tubb, Kristin Jenkins, Community Health Collaborative Of North Texas (Chc)

Journal of Health Disparities Research and Practice

The State of Texas is home to nearly 2 million men, women and children with diabetes, over half a million of which reside in the Dallas-Fort Worth (DFW) region. Recognizing the rising need to identify the disparities in implementing the diabetes prevention and management efforts and adopting the healthy life style in high diabetes prevalence areas in Dallas County, we explored the potential of Geographic Information System (GIS) methodology to analyze the data at zip code level from Dallas-Fort Worth Hospital Council (DFWHC) Research Foundation’s data registry. The objectives of this research were to identify the zip codes with the …

Race And Sex Differences In Correlates Of Systolic Blood Pressure In Community-Dwelling Older Adults, Cassandra Ford Phd, Patricia Sawyer, Patricia Parmelee, Olivio J. Clay, Martha Crowther, Richard M. Allman

Journal of Health Disparities Research and Practice

Objectives: To describe correlates of measured systolic blood pressure (SBP) among community-dwelling older African American and White Medicare beneficiaries.

Methods: Participants completed an in-home assessment and factors significantly correlated with SBP were tested using multivariable models.

Results: Among the 958 participants (mean age= 75.3 [SD = 6.8]; 49% African American; 49% female; 52% rural) African Americans were more often diagnosed with hypertension, more likely on anti-hypertensives, and on more anti-hypertensive medications. SBP was 2.7 mmHg higher in African Americans than Whites (p=.03). SBP was higher in women than men. Multivariable models revealed differences in the factors associated with SBP by …

Connecting Gender, Race, Class, And Immigration Status To Disease Management, Marie-Anne S. Rosemberg Phd, Mn, Rn, Jenny Hsin-Chun Tsai Phd, Arnp, Pmhcns-Bc

Journal of Health Disparities Research and Practice

Objective: Chronic diseases are the leading causes of death in the United States. Chronic disease management occurs within all aspects of an individual’s life, including the workplace. Though the social constructs of gender, race, class, and immigration status within the workplace have been considered, their connection to disease management among workers has been less explicitly explored. Using a sample of immigrant hotel housekeepers, we explored the connections between these four social constructs and hypertension management.

Methods: This qualitative research study was guided by critical ethnography methodology. Twenty-seven hotel room cleaners and four housemen were recruited (N = 31) and …

Assessments Of The Extent To Which Health‐Care Providers Involve Patients In Decision Making: A Systematic Review Of Studies Using The Option Instrument, Nicolas Couët, Sophie Desroches, Hubert Robitaille, Hugues Vaillancourt, Annie Leblanc, Stéphane Turcotte, Glyn Elwyn, France Légaré

Dartmouth Scholarship

Background: We have no clear overview of the extent to which health-care providers involve patients in the decision-making process during consultations. The Observing Patient Involvement in Decision Making instrument (OPTION) was designed to assess this. Objective: To systematically review studies that used the OPTION instrument to observe the extent to which health-care providers involve patients in decision making across a range of clinical contexts, including different health professions and lengths of consultation. We conducted online literature searches in multiple databases (2001-12) and gathered further data through networking.

Uncovering The Concealed Part Of Motherhood-Postpartum Depression In Mothers, Hunaina Hadi, Shamsa Hadi

School of Nursing & Midwifery

Introduction: Motherhood is the most pleasing experience of a woman's life. Birth of a child gives birth to new hopes and ambitions. But Post-partum Depression is a condition when this blessing turns into curse. It can affect the mother, the partner and the child and can even lead to infanticide as well as maternal death, often by suicide.

Method: A qualitative systematic review was conducted through electronic medium to explore the relevant literature. Various databases i.e. Pubmed, Google search engines, Science Direct, JPMA, the Cumulative Index to Nursing and Allied Health Literature CINHAL and SAGA were used. Manual search was …

Active Management Of The Third Stage Of Labor By Skilled Birth Attendants In A Rural Regional Hospital In Southern Ethiopia: A Qualitative Case Study, Marcella J. Gowan

Doctor of Education (EdD)

In Ethiopia, as in many developing countries, postpartum hemorrhage (PPH) is the leading cause of maternal mortality. PPH can be prevented through a three-step practice called active management of the third stage of labor (AMTSL), which can be learned by a skilled birth attendant (SBA). However, most SBAs have not adopted AMTSL into practice. The purpose of this case study was to investigate the use of AMTSL among SBAs in a rural regional hospital in southern Ethiopia. Six theoretical propositions and a conceptual framework were designed to guide the research and analysis. In-depth interviews were conducted with SBAs who worked …

Community Health Indicators In Southern Nevada, Courtney Coughenour, Jennifer Pharr, Shawn Gerstenberger

Nevada Journal of Public Health

Community design and access to services are essential components of healthy and sustainable communities. The purpose of this manuscript is to evaluate Southern Nevada with respect to community design and access, including both positive and negative traits, and to suggest realistic changes that could be made to improve these conditions. The region’s network of parks and open space recreation areas is one of its strongest assets. Clark County enjoys over 42 million acres of federal and state lands which offer a large variety of recreational opportunities. The region has an extensive trail system, with a total of 179 miles of …

Evaluating Obesity Prevention Efforts: What Have We Learned? Highlights From A Conversation Of Funders And Evaluators, Sumner M. Redstone Global Center For Prevention And Wellness

Sumner M. Redstone Global Center for Prevention and Wellness

Table of contents:

Executive Summary

Introduction

State of the Obesity Epidemic

The Community Context for Interventions and Evaluations

Investments to Date: Where Is the Strongest Agreement About What Works?

Early Care and Education Environments

Schools/Learning Environments

Parks, Trails, Open Spaces, and Recreation

Land Use and Transportation

The Next Tier: Mixed or Promising Results for Healthy Food Retail Interventions

Implementing Interventions: The Crucial Role of "How"

Other Topics

Summary and Next Steps

Appendix A: Citations and Resources for Key Elements/Components

The Impact Of Dentures On The Nutritional Health Of The Elderly, Michelle Gellar, Daniel Alter

Publications and Research

No abstract provided.

Women With Methylenetetrahydrofolate Reductase Gene Polymorphism And The Need For Proper Periconceptional Folate Supplementation, Maureen Sullivan, Tiffany Murray, Haregewein Assefa

Touro College of Pharmacy (New York) Publications and Research

Maternal folate supplementation is critical for fetal development. Women with MTHFR (methylenetetrahydrofolate reductase) gene polymorphisms may not be getting the proper folate form to support fetal development. The objectives of this review were to: (1) undertake a comprehensive review on the association of MTHFR polymorphisms with the risk for various congenital diseases and other adverse pregnancy outcomes, (2) assess the efficacy and safety of current folic acid and other supplementations in women with the MTHFR polymorphism, and (3) provide guidance on the appropriate supplementation for women of childbearing potential with the MTHFR gene polymorphism in order to decrease these adverse …

Experiences With Weight Loss Triggers In Women Prescribed To Lose Weight By Their Physician, Mark D. Faries, Elizabeth Espie, Erik Gnagy, Kyle P. Mcmorries

Faculty Publications

Background: With the global rise of individuals classified as overweight and obese, weight-related screenings have been promoted to combat their high prevalence and associated health problems. Hopefully, such screenings can act as a ‘trigger’ for health behavior change, however little is known about the experience of weight loss triggers.
Objectives: The aim of this study was to elaborate on the experiences and meanings of weight-control triggers in a sample of overweight women prescribed by their physician to lose weight.
Patients and Methods: We conducted exploratory qualitative interviews, grounded in phenomenological practices, to elaborate on the experience and meaning of weight …

The Relationship Of Female Physical Attractiveness To Body Fatness, Guanlin Wang, Kurosh Djafarian, Chima A. Egedigwe, Asmaa El Hamdouchi, Robert Ojiambo, Harris Ramuth, Sandra Johanna Wallner-Liebmann, Sonja Lackner, Adama Diouf, Justina Sauciuvenaite, Catherine Hambly, Lobke M. Vaanholt, Mark D. Faries, John R. Speakman

Faculty Publications

Aspects of the female body may be attractive because they signal evolutionary fitness. Greater body fatness might reflect greater potential to survive famines, but individuals carrying larger fat stores may have poor health and lower fertility in non-famine conditions. A mathematical statistical model using epidemiological data linking fatness to fitness traits, predicted a peaked relationship between fatness and attractiveness (maximum at body mass index (BMI) = 22.8 to 24.8 depending on ethnicity and assumptions). Participants from three Caucasian populations (Austria, Lithuania and the UK), three Asian populations (China, Iran and Mauritius) and four African populations (Kenya, Morocco, Nigeria and Senegal) …

Circulating Adipokines And Inflammatory Markers And Postmenopausal Breast Cancer Risk, M. J. Gunter, T. Wang, M. Cushman, X. Xue, S. Wassertheil-Smoller, H. D. Strickler, T. E. Rohan, J. E. Manson, A. Mctiernan, G. Y. Ho, +5 Additional Authors

Journal Articles

BACKGROUND: Adipokines and inflammation may provide a mechanistic link between obesity and postmenopausal breast cancer, yet epidemiologic data on their associations with breast cancer risk are limited. METHODS: In a case-cohort analysis nested within the Women's Health Initiative Observational Study, a prospective cohort of postmenopausal women, baseline plasma samples from 875 incident breast cancer case patients and 839 subcohort participants were tested for levels of seven adipokines, namely leptin, adiponectin, resistin, interleukin-6, tumor necrosis factor-alpha, hepatocyte growth factor, and plasminogen activator inhibitor-1, and for C-reactive protein (CRP), an inflammatory marker. Data were analyzed by multivariable Cox modeling that included established …

Heart Failure: An Exploration Of Recent Advances In Research And Treatment (A), A. Szema, A. Mclarty, H. Skopicki, M. Bloom, R. Jermyn

Journal Articles

No abstract provided.

Evaluation Of Social Media Utilization By Latino Adolescents: Implications For Mobile Health Interventions, Megan Landry, Amita Vyas, Monique Turner, Sara Nelson Glick, Susan Wood

Health Policy and Management Faculty Publications

Background: Trends in social media use, including sending/receiving short message service (SMS) and social networking, are constantly changing, yet little is known about adolescent’s utilization and behaviors. This longitudinal study examines social media utilization among Latino youths, and differences by sex and acculturation.

Objectives: The purpose of this study was to examine Latino adolescents’ social media utilization and behavior over a 16-month period, and to assess whether changes in use differed by sex and acculturation.

Methods: This study included 555 Latino youths aged 13-19 who completed baseline and 16-month follow-up surveys. Prevalence of social media utilization and frequency, by sex …

Improving Newborn Care Practices Through Home Visits: Lessons From Malawi, Nepal, Bangladesh, And Uganda., Deborah Sitrin, Tanya Guenther, Peter Waiswa, Sarah Namutamba, Gertrude Namazzi, Srijana Sharma, K. C. Ashish, Sayed Rubayet, Subrata Bhadra, Reuben Ligowe, Emmanuel Chimbalanga, Elizabeth Sewell, Kate Kerber, Allisyn Moran

Pediatrics Faculty Publications

Background: Nearly all newborn deaths occur in low- or middle-income countries. Many of these deaths could be prevented through promotion and provision of newborn care practices such as thermal care, early and exclusive breastfeeding, and hygienic cord care. Home visit programmes promoting these practices were piloted in Malawi, Nepal, Bangladesh, and Uganda.

Objective: This study assessed changes in selected newborn care practices over time in pilot programme areas in four countries and evaluated whether women who received home visits during pregnancy were more likely to report use of three key practices.

Design: Using data from cross-sectional surveys …

Seasonal Variations Of Complete Blood Count And Inflammatory Biomarkers In The Us Population - Analysis Of Nhanes Data, B. Liu, E. Taioli

Journal Articles

BACKGROUND: Recent studies reported seasonal differences in gene expression in white blood cells, adipose tissue, and inflammatory biomarkers of the immune system. There is no data on the seasonal variations of these biomarkers in the US general population of both children and adults. Then aim of this study is to explore the seasonal trends in complete blood count (CBC), and C-reactive protein (CRP) in a large non-institutionalized US population. METHODS: Seven cross-sectional data collected in the National Health and Nutrition Examination Survey (NHANES) during 1999-2012 were aggregated; participants reporting recent use of prescribed steroids, chemotherapy, immunomodulators and antibiotics were excluded. …

Body Composition Of Reserve Officers Training Corps (Rotc) Cadets: A Comparison Across Three Techniques Of Measurement, Namrata J. Dave

Master of Public Health Program Student Publications

Background: Physical fitness is imperative for the Army Reserves Officers’ Training Corps (ROTC) cadets to be commissioned for active duty. This project compared the standard anthropometric assessment of ROTC cadets using tape measurement to body composition measurements using Air Displacement Plethysmography (ADP) from the Bod Pod and the seven- site Pollock Skin Fold Thickness (SFM) measurement. These results were compared to the norms established by the Army Physical Fitness Test (APFT), recommending to improve ROTC body measurement method.

Method: Thirteen ROTC cadets were recruited from Central State and Cedarville Universities. Cadets were measured using the ADP (BODPOD) and SFM method. …

The Inclusion Of Women’S Health In Sustainable Medical Mission Trip Models: A Pa Student’S Perspective, Jillian G. Goles

VA Engage Journal

Like many disadvantaged countries around the world, Nicaragua is visited by numerous medical missions each year. The efficacy of these missions relies on the organization’s relationship with the communities they serve. Although the general goal of all medical missions is to ultimately help underserved populations, many missions inadvertently do harm. Two critical causes of such inadvertent harm are lack of sustainable practices and failure to form a long-term relationship with the communities. Shenandoah University’s Physician Assistant Program has worked tirelessly to form an ideal medical mission model and relationship with El Ayudante, a local non-government humanitarian organization, and the local …

Geographic Trends Of Tobacco-Related Cancers In Cyprus, Evi A. Farazi, Lina Lander, Pavlos Pavlou, Katherine Watkins, Lynne Le, Amr Soliman

Journal Articles: Epidemiology

BACKGROUND: Causal relationships have been previously established between smoking and various cancers. In Cyprus, 39 % of men and 14 % of women reported daily smoking in 2008. The objective of this study was to compare the incidence of tobacco-related cancers to all other cancers by district and rural-urban classification to understand the impact of tobacco in Cyprus.

METHODS: Data on lung, urinary bladder, oral, pharyngeal, head/neck, and laryngeal cancers were obtained from the Cyprus Cancer Registry (1998-2008). There were 3,635 patients with tobacco-related cancers and 18,780 with non-tobacco cancers. Univariate analysis comparing tobacco-related cancers and all other cancers were …

Breast Cancer Risk In Metabolically Healthy But Overweight Postmenopausal Women, M. J. Gunter, X. Xie, X. Xue, G. C. Kabat, T. E. Rohan, S. Wassertheil-Smoller, G. Y. Ho, J. Wylie-Rosett, J. Beasley, H. D. Strickler, +2 Additional Authors

Journal Articles

Adiposity is an established risk factor for postmenopausal breast cancer. Recent data suggest that high insulin levels in overweight women may play a major role in this relationship, due to insulin's mitogenic/antiapoptotic activity. However, whether overweight women who are metabolically healthy (i.e., normal insulin sensitivity) have elevated risk of breast cancer is unknown. We investigated whether overweight women with normal insulin sensitivity [i.e., homeostasis model assessment of insulin resistance (HOMA-IR) index, or fasting insulin level, within the lowest quartile (q1)] have increased breast cancer risk. Subjects were incident breast cancer cases (N = 497) and a subcohort (N = 2,830) …

Differential Expression Of Circulating Micrornas According To Severity Of Colorectal Neoplasia, G. Y. Ho, H. J. Jung, R. E. Schoen, T. Wang, J. Lin, Z. Williams, J. L. Weissfeld, J. Y. Park, O. Loudig, Y. Suh

Journal Articles

There is a need to develop a colorectal cancer (CRC) screening test that is noninvasive, cost effective, and sensitive enough to detect preneoplastic lesions. This case-control study examined the feasibility of using circulating extracellular microRNAs (miRNAs) to differentiate a spectrum of colorectal neoplasia of various severity and hence for early detection of colorectal neoplasia. Archived serum samples of 10 normal controls and 31 cases, including 10 with nonadvanced adenoma, 10 with advanced adenoma, and 11 with CRC, were profiled for circulating miRNAs using next-generation sequencing. Multiple linear regression, adjusting for age, gender, and smoking status, compared controls and the 3 …

Association Between Respiratory Syncytial Virus Activity And Pneumococcal Disease In Infants: A Time Series Analysis Of Us Hospitalization Data., Daniel M. Weinberger, Keith P. Klugman, Claudia A. Steiner, Lone Simonsen, Cécile Viboud

Epidemiology Faculty Publications

BACKGROUND:

The importance of bacterial infections following respiratory syncytial virus (RSV) remains unclear. We evaluated whether variations in RSV epidemic timing and magnitude are associated with variations in pneumococcal disease epidemics and whether changes in pneumococcal disease following the introduction of seven-valent pneumococcal conjugate vaccine (PCV7) were associated with changes in the rate of hospitalizations coded as RSV.

METHODS AND FINDINGS:

We used data from the State Inpatient Databases (Agency for Healthcare Research and Quality), including >700,000 RSV hospitalizations and >16,000 pneumococcal pneumonia hospitalizations in 36 states (1992/1993-2008/2009). Harmonic regression was used to estimate the timing of the average seasonal …

Ethical Perspectives Of Direct-To-Consumer Genetic Testing, Pawan Acharya, Rupesh Gautam

Journal of Health Ethics

Direct-to-consumer (DTC) genetic testing, which evolved from genomics is not free from controversies and ethical dilemmas. Conduction of genetic testing without direct communication between the users and certified medical professionals has aroused many ethical concerns. We discuss some ethical dilemmas surrounding DTC genetic testing in terms of quality assurance of the test, information communication process of the result, confidentiality of test result and the right to privacy, cost and price regulations, and user safety and harm mitigation. DTC genetic testing lies in the middle of a clash between liberal trade policies and state’s regulations as a case of extreme paternalism. …

Challenging Race-Based Stereotypes About Gay And Bisexual Men’S Sexual Behavior And Perceived Penis Size And Size Satisfaction, Christian Grov, Lena D. Saleh, Jonathan M. Lassiter, Jeffrey T. Parsons

Publications and Research

Racial prejudice and stereotyping in gay and bisexual communities may be important contextual factors that contribute to racial disparities in HIV. In an effort to challenge race-based stereotypes regarding gay and bisexual men’s sexuality, we sought to determine the extent to which race and ethnicity were associated with (1) racial homophily (i.e., same-race partnerships), (2) sexual behavior (e.g., number of partners, condomless anal sex (CAS), sexual position (top/versatile/bottom)), and (3) perceived penis size and size satisfaction. Data were taken from a survey of 1,009 gay and bisexual men recruited using a street-intercept method at gay, lesbian, and bisexual community events …