Digital Commons Network^™

Bridging Evidence, Policy, And Practice To Strengthen Health Systems For Improved Maternal And Newborn Health In Pakistan, Atsumi Hirose, Sarah Hall, Zahid Memon, Julia Hussein

Centre of Excellence in Women and Child Health

Policy and decision making should be based on evidence, but translating evidence into policy and practice is often sporadic and slow. It is recognised that the relationship between research and policy uptake is complex and that dissemination of research findings is necessary, but insufficient, for policy uptake. Political, social, and economic context, use of (credible) data and dialogues between and across networks of researchers and policymakers play important roles in evidence uptake. Advocacy is the process of mobilising political and public opinions to achieve specific aims and its role is crucial in mobilising key actors to push for policy uptake. …

Paleoparasitology – Human Parasites In Ancient Material, Adauto Araújo, Karl Reinhard, Luiz Fernando Ferreira

Karl Reinhard Publications

Parasite finds in ancient material launched a new field of science: paleoparasitology. Ever since the pioneering studies, parasites were identified in archaeological and paleontological remains, some preserved for millions of years by fossilization. However, the paleoparasitological record consists mainly of parasites found specifically in human archaeological material, preserved in ancient occupation sites, from prehistory until closer to 2015. The results include some helminth intestinal parasites still commonly found in 2015, such as Ascaris lumbricoides, Trichuris trichiura and hookworms, besides others such as Amoebidae and Giardia intestinalis, as well as viruses, bacteria, fungi and arthropods. These parasites as a …

Investigation Of Low Back And Shoulder Demand During Cardiopulmonary Resuscitation: The Effect Of Different Compression-Ventilation Ratios, Richard Scott Dainty

Theses and Dissertations (Comprehensive)

Background: The current American Heart Association (AHA) standard cardiopulmonary resuscitation (CPR) is performed with a compression-ventilation ratio of 30:2 (standard CPR), meaning 30 compressions are applied to the chest followed by the administration of two breaths to the victim. Some evidence has shown that performing continuous chest compressions rather than standard CPR with breaks in chest compressions for administering breaths, may increase survival rates after cardiac arrest. Cont-CPR has been shown to be very fatiguing in nature, with a significant drop in chest compression force within the first two minutes of CPR. The purpose of this study was to examine …

Project Spraoi: A Strategy To Improve Nutrition And Increase Physical Activity In Primary School Children, Lisa Delaney

Masters

Introduction: Paediatric obesity has become a global epidemic with many countries developing strategies to help tackle its prevalence. School based physical activity (PA) and nutrition interventions have proven to play a promising role in tackling childhood obesity.

Background: Project Spraoi is an Irish primary school based intervention. The intervention was delivered to an intervention school to help enhance PA and nutritional behaviour amongst pupils. The intervention school was assigned an ‘Energizer’; a trained PA and nutrition change agent who worked with the school to achieve the objectives. For evaluation purposes a control school was recruited.

Methodology: Pupils from the intervention …

Uric Acid Level Is Associated With Postprandial Lipemic Response To A High Saturated Fat Meal, Roy Gail Cutler

Walden Dissertations and Doctoral Studies

Hyperlipidemia caused by a diet high in saturated fat can lead to visceral fat weight gain, obesity, and metabolic syndrome. Being over-weight from visceral fat has been linked to increased risk of developing most age-related diseases and disability, along with a lower income potential and quality of life. However, researchers are just beginning to understand the biological mechanisms that regulate the conversion of excess calories into visceral fat storage rather than glycogen or muscle. Epidemiological studies have repeatedly shown a comorbid association between age-related diseases involving hyperlipemia and circulating levels of uric acid, but not a direct association. This study …

The Predictors Of Obesity In Young Adults, Dominic Richard Tarinelli

Walden Dissertations and Doctoral Studies

Obesity is becoming an increasing health concern for young adults. There have been numerous studies on the potential predictors of obesity. However, few studies have researched the predictors of obesity in young adults. Guided by the health belief model, this quantitative cross sectional study investigated the potential predictors of obesity in young adults. The 2011 Behavioral Risk Factor Surveillance System was used to gather data on the potential predictors of obesity, including physical activity, health care coverage, excessive alcohol consumption, and demographic characteristics on 1,511 young adults, aged 18-34 years, who were living in New York State. Data were analyzed …

The Healthy, Hunger-Free Kids Act And High School Obesity, Derek Grills

Walden Dissertations and Doctoral Studies

United States high school student obesity rates have doubled in the past 30 years to 13%, threatening the health of millions of adolescents. To mitigate the epidemic, Congress passed the Healthy, Hunger-Free Kids Act (HHFKA) in 2010, which mandated significant changes to school nutrition and physical education. From a public policy perspective, the HHFKA changed school nutrition and exercise policy to affect obesity rates by changing intake and energy expenditure at school, though no study using national-level data examined this relationship. As such, the purpose of the study was to examine whether HHFKA policy compliance had a statistically significant effect …

Physician Assistants' Preventive Medicine Practices And Related Habits, Attitudes, And Beliefs, Judia Yael Malachi

Walden Dissertations and Doctoral Studies

Physician assistants play a pivotal role in expanding access to care, yet research on their preventive medicine practices is limited. Guided by Lewis's conceptual model for predicting counseling practices, this cross-sectional study examined the relationship between physician assistants' preventive medicine practices, personal health habits, prevention and counseling attitudes, and perceived barriers to the delivery of clinical preventive services. A 104-item self-administered survey was used to collect data from 314 physician assistants attending the American Academy of Physician Assistants' 42nd Annual Conference. Data were analyzed using descriptive statistics, Pearson's correlation, and stepwise multiple regression. Results indicated that physician assistants engaged in …

Electronic Benefit Transfer: Food Choices, Food Insecurity, And Type 2 Diabetes, Diana Louise Malkin-Washeim

Walden Dissertations and Doctoral Studies

The purpose of this research was to examine food security for people with prediabetes participating in the Supplemental Nutrition Assistance Program (SNAP), focusing on their food choice decisions and coping strategies over a 30-day benefit cycle that potentially increases the risk of Type 2 diabetes. A cross-sectional, quantitative design based on food choice process model constructs was used. SNAP participants (n = 36) with prediabetes, aged 21-70 years, were recruited as outpatients from Bronx Lebanon Hospital and completed self-reported questionnaires on demographics and health, food security, and food frequency. Descriptive statistics, Pearson chi square tests, and regression analysis were performed …

Understanding Health Literacy Skills Of Patients With Cardiovascular Disease And Diabetes, Patrick J. Dunn

Walden Dissertations and Doctoral Studies

Health literacy is the ability to understand and act on health information and is linked to health outcomes. It is unclear how health literacy skills are developed in patients with complex conditions, such as cardiovascular disease and diabetes. The purpose of this grounded theory study was to gain perspectives of both patients and healthcare professionals on how health literacy skills were developed in patients with cardiovascular disease or diabetes. The research questions addressed how knowledge and skills were acquired, the role of digital tools, instructional strategies used by healthcare professionals, and how the instructional strategies of the healthcare professionals matched …

A Staff Development Program: Diabetes And Tb Education And Screening, Relyndo Manalo Salcedo

Walden Dissertations and Doctoral Studies

There is a growing body of evidence on the positive association between diabetes and tuberculosis (TB), especially in populations with low socioeconomic status. According to the CDC and the WHO, diabetes is increasingly seen as a global epidemic, one that poses a threat to global TB control. The goal of this DNP project was to develop a program to educate clinical staff on the importance of early identification of diabetic and TB patients. The logic model was chosen as the framework for this project because it allows the planner to rationally observe each stage of a project's development. The program …

Racial Differences In The Impact Of A Worksite Wellness Program On Cardiovascular Biomarkers, Ceabert Joseph Griffith

Walden Dissertations and Doctoral Studies

Cardiovascular disease (CVD) is responsible for approximately 600,000 deaths in the United States each year, with African Americans (AAs) disproportionately affected. Individual-level approaches to reducing CVD remain ineffective, mobilizing a movement that advocates for population-based solutions. Workplace wellness programs (WWPs) have gained considerable traction as a viable strategy for ameliorating CVD burden among workers in general. However, no studies have looked at the efficacy of WWPs in ameliorating CVD specifically among AA employees--a knowledge gap that this investigation aimed to close. Based on the health belief model and the social cognitive theory, this retrospective cohort study used de-identified secondary data …

Educational Intervention: Effects On Heart Disease Risk Factor Knowledge Among African Americans, Linda M. Smith

Walden Dissertations and Doctoral Studies

Abstract

Fatal coronary heart disease among African Americans is associated with a

disproportionate burden of cardiovascular disease (CVD) risk factors. Research has indicated that CVD risk factor knowledge and the prevalence of ideal CVH both persist at suboptimal levels. However, few researchers have investigated the relationship between culturally-tailored community-based heart health sessions, short-term knowledge acquisition of CVD risk factors, and the awareness of the American Heart Association's (AHA's) CVH construct. The purpose of this cross-sectional, secondary analysis study was to examine the interplay between these variables in an urban African American sample. Guided by social cognitive theory, the study analyzed …

Social Ecological Influences Of Wic Programming Behavior Change Of Former Wic Participants, Joyce L. Terrell

Walden Dissertations and Doctoral Studies

The Special Supplemental Women, Infants, and Children (WIC) Program is one of many United States Department of Agriculture's (USDA) food subsidy programs that serves 8.6 million participants, deemed nutritionally at risk. WIC is designed to influence nutritional and health behaviors to a population least capable of functioning. The purpose of this study was to identify if participation in WIC's nutrition education activities and restricted use of food subsidy benefits had a post-factorial effect on their nutritional behaviors. This study provides data on Bronfenbrenner's social ecological influences and how it impacts on long-term behavioral change. A quantitative causal-comparative design utilizing a …

Effect Of Placard Grading On Food Safety In Retail Food Facilities, Christopher Ogbonna Ogbu

Walden Dissertations and Doctoral Studies

Most people have had an episode of foodborne illness at one time or another; however, the majority of those stricken with foodborne illness fails to associate ill health with something consumed within the past 72 hours. The World Health Organization (WHO) estimates that foodborne diseases affect 30% of the population in developed countries, and that in developing countries, about 2 million people die yearly due to foodborne illness. Previous researchers have indicated that food handlers with poor personal hygiene are potential sources of infection. Although public health agencies in many countries already regularly inspect food facilities to control potential foodborne …

Health Education To Decrease Obesity In Adolescents With Asthma, Mitzie Eumarie Thomas

Walden Dissertations and Doctoral Studies

Obesity increases asthma severity and is costing the health care industry a significant amount of money. Decreasing adolescents' obesity will decrease the risk for chronic health problems, which can have a significant impact in adulthood. Implementing a school-based health education program can decrease the prevalence of obesity amongst adolescents. This program will be implemented by school nurses in the after-school program at Public School 59 (P.S) in New York City. The purpose of this project is to develop adolescents' school-based obesity prevention policies and documentation which will focus on increasing their nutrition education, increasing physical activities, and providing skills to …

Relationships Between A Prenatal Nutrition Education Intervention And Maternal Nutrition In Ethiopia, Divya Lakshmi Selvakumar

Walden Dissertations and Doctoral Studies

In Ethiopia, 17% of pregnant women ages 18-49 are malnourished and have low awareness of prenatal nutrition, which may relate to increasingly high rates of maternal and infant mortality. The purpose of this mixed methods research study was to determine the effects of a community-based prenatal nutrition education intervention program on maternal nutrition knowledge and attitudes in the Alaje district of Ethiopia. The theoretical framework was Sen's capability theory of poverty, in which opportunities can lead to well-being and promote economic development. Research questions focused on the relationships among 8 independent variables-age, income source, degree of program implementation, marital status, …

Assessment Of Organizational Readiness: Parent Advisory Councils In A Children's Hospital Within A Hospital, Suzanne R. Springate

DNP Projects

Background: A children’s hospital within a hospital (CHWH) in the Midwest region of the United States established a strategic goal to become the preferred provider for children in the region. Outcomes in patient and family experience had fallen short of established organizational expectations. Recognizing that parent advisors are an essential component of patient and family centered care, the strategic plan called for integrating parents into formal, advisory roles.

Purpose: The purpose of this practice improvement project was to perform an assessment of organizational readiness to incorporate parents into formal advisory roles at this CHWH.

Methods: A cross-sectional survey design was …

Development, Implementation, And Evaluation Of Refugee Health Literacy Program (R-Help), Cecilia A. Boateng

DNP Projects

Problem Statement: United States refugees often encounter significant barriers when adapting to their new host country; such as cultural and language barriers, and difficulty in navigating through the American healthcare system. For example, navigating through the American Pharmacy system to buy or refill medications is a great challenge for most refugees. To make matters worse, most refugees have difficulty understanding medications instructions which puts them at risk for making medication errors.

Purpose: The purpose of this study was to develop, implement, and evaluate the feasibility of delivering an evidence based health literacy medication educational program for all newly-arrived refugees attending …

The Effect Of Breakfast Protein Source On Postprandial Hunger And Glucose Response In Normal Weight And Overweight Young Women, Christina Crowder, Brianna I. Neumann, Jamie I. Baum

Discovery, The Student Journal of Dale Bumpers College of Agricultural, Food and Life Sciences

Breakfast consumption has been linked to health benefits such as improved weight regulation and glucose control. Studies have shown higher protein breakfasts lead to a greater reduction in hunger compared to breakfasts higher in carbohydrates. However, few studies have examined the impact of higher protein breakfasts from differing protein sources. The objective of this study was to determine if protein quality (animal (AP) versus plant (PP) protein) influences postprandial appetite, food cravings, food intake and glucose response in participants consuming a high protein breakfast (~30% energy from protein). We hypothesized that AP would be more satiating than PP. Normal weight …

Count Models With Multiple Inflations, Arvind Tripathi

All ETDs from UAB

The goal of this research is to develop new statistical models for the analysis of count data even if data exhibit over dispersion or under dispersion and has multiple inflated counts. Although many statistical models are available for the analysis of count data, there is no available statistical model that can address the presence of more than expected multiple counts together with over/under dispersion. In our first paper, we develop a multiple-inflation negative binomial (MINB) model and use the expectation maximization (EM) algorithm along with a numerical optimization to obtain maximum likelihood estimates. We applied the one step smoothly clipped …

Individual, Family, And Social Factors Associated With Adolescent Obesity: A Policy Relevant Focus, Janice Marguerite Utley

All ETDs from UAB

INDIVIDUAL, FAMILY, AND SOCIAL FACTORS ASSOCIATED WITH ADOLESCENT OBESITY: A POLICY RELEVANT FOCUS JANICE M. UTLEY PUBLIC HEALTH ABSTRACT This dissertation is comprised of three papers that examined individual, family, and social factors associated with adolescent overweight and obesity with the aim of generating data that could inform the design of policy interventions to prevent or reverse rising prevalence. The first investigation was a type of literature review called a scoping study that examined the extent, range, and type of research activity on adolescent obesity that used a multilevel or hierarchical design to look at two or more contextual areas …

An Examination Of Farm-To-Consumer Retail Outlet Usage Among Participants Of The Special Supplemental Nutrition Program For Women, Infants, And Children (Wic) In Birmingham, Al, Chelsea Renee Singleton

All ETDs from UAB

Disparities in the neighborhood retail food environment have been hypothesized to be associated with poor diet quality and adverse health outcomes such as obesity. Studies have found that lower income communities often have reduced access to affordable healthy foods. In 2009, the Centers for Disease Control and Prevention proposed direct farm-to-consumer (FTC) retail outlets (i.e. farmers markets, farm/roadside stands, community gardens and community supported agriculture programs) as a potential strategy to alleviate retail food environment disparities in communities with limited resources. Information on the behavioral and health implications of FTC outlet usage by lower income individuals is limited. This research …

Presence And Mobilization Of Staphylococcus Aureus Pathogenicity Islands (Sapis) Among Bovine Mastitis Isolates, Laura Kate Parker

All ETDs from UAB

Bovine mastitis is inflammation of the mammary gland that occurs in cattle, as a result of invading bacteria. Staphylococcus aureus, a causative agent of bovine mastitis, produces toxins such as the toxic shock syndrome toxin (TSST-1) and the staphylococcal enterotoxins (SEs). The genes for these toxins are coded on S. aureus pathogenicity islands (SaPIs), which are mobile genetic elements associated with virulence factors. SaPIs can be mobilized by bacteriophages, resulting in the production of transducing particles that can spread virulence factors throughout a bacterial population. This research assessed the role and prevalence of SaPIs among bovine mastitis samples. In this …

Cost Effectiveness Of Hypertension Treatment: New Model, Methods, And Focus On African Americans, Gabriel Saidimu Tajeu

All ETDs from UAB

This dissertation focuses on the potential benefits of hypertension (HTN) treatment for the general population and African Americans (AAs) specifically. We undertake three research projects that are interconnected. First, using a systematic review methodology we assess the current state of the cost-effectiveness of HTN treatment literature in order to identify potential gaps in the cost-effectiveness literature, methodological shortcomings, and provide policy makers and researchers with a summary of the current findings as well as methods used in the literature. Second, building off our findings in paper 1, we construct a cost-effectiveness model. We assess the cost-effectiveness of HTN treatment not …

Impact Of A Community-Based Perinatal And Newborn Preventive Care Package On Perinatal And Neonatal Mortality In A Remote Mountainous District In Northern Pakistan, Zahid Memon, Gul N Khan, Sajid Bashir Soofi, Imam Y Baig, Zulfiqar Ahmed Bhutta

Centre of Excellence in Women and Child Health

Background: There is limited evidence from community-based interventions to guide the development of effective maternal, perinatal and newborn care practices and services in developing countries. We evaluated the impact of a low-cost package of community-based interventions implemented through government sector lady health workers (LHWs) and community health workers (CHWs) of a NGO namely Aga Khan Health Services on perinatal and neonatal outcomes in a sub-population of the remote mountainous district of Gilgit, Northern Pakistan.
Methods: The package was evaluated using quasi experimental design included promotion of antenatal care, adequate nutrition, skilled delivery and healthy newborn care practices. Control areas …

The Normative Authority Of The World Health Organization, Lawrence O. Gostin, Devi Sridhar, Daniel Hougendobler

Georgetown Law Faculty Publications and Other Works

The World Health Organization (WHO) was born after the devastation of World War II, as a normative agency endowed with unprecedented constitutional powers. But even as it has achieved stunning successes, such as the eradication of smallpox, it has failed to live up to the exalted expectations of the postwar health and human rights movement e exemplified most recently by its inadequate response to the Ebola epidemic. Our aim is to offer innovative ideas for restoring the Organization to its leadership position by exercising its normative authority, even as it faces a crowded and often chaotic global health architecture. Before …

Impact Of Goodwill Organizations And Community Collaboration On Aids-Orphans' Needs In Nyanza Province, Kenya, Anthonia Nwagbo

Walden Dissertations and Doctoral Studies

A number of researchers have explored the toll of AIDS on the children who have become orphans as a result of the disease; others have investigated the roles of aid-giving agencies on the alleviation of the orphans' situation. However, despite researchers' pointing to the germaneness of community and goodwill agency liaison, no study had examined the impact of such collaboration on the resources available to the orphans. To this end, the heads-of-household of 532 AIDS orphans under 18 years old in Kenya's Nyanza province were surveyed to investigate the impact of community-referral on the state of AIDS orphans with regard …

Perspectives On Hiv/Aids: American-Based Nigerian Women Who Experienced Polygamy In Rural Nigeria, Christianah Oluseyi Olorunfemi

Walden Dissertations and Doctoral Studies

Traditionally, in Nigeria women play a subservient role in relation to men. While a man can practice polygamy by marrying many wives, women cannot marry more than one husband at a time. Although researchers have documented the effects of polygamy on the spread of HIV/AIDS, little is known about the experiences of polygamy by Nigerian women who stopped practicing polygamy by immigrating to the United States without their husbands. It is important to know the experiences of these women as they pertain specifically to the spread of HIV/AIDS so as to develop a preventive intervention for HIV/AIDS among Nigerian women …

Obesity And Workplace Injury In Hazardous Occupations Among The Hispanic/Latino Population, Barbara Klyde

Walden Dissertations and Doctoral Studies

Over the past 20 years, adult obesity has increased in the United States, especially among the Hispanic/Latino population. In 2010, the Occupational Safety and Health Administration Environmental and Safety News, reported that younger workers, ages 18 to19 years of age, worked in the most high-risk occupations such as agriculture, construction, fishing, and manufacturing. The reported fatality rates for these occupations were 5.6 times greater for Hispanic workers compared to other race/ethnicity groups reported by the Bureau of Labor Statistics in 2013. This study determined whether obesity contributed to workplace injury or mortality in hazardous occupations, using federal, state, and independent …