Digital Commons Network^™

Closing The Rural Mortality Gap? An Examination Of 10-Year Cardiovascular Mortality Trends In Washington And Aroostook Counties, Maine, Christy Daggett

Muskie School Capstones and Dissertations

This study examines a significant reduction in cardiovascular disease (CVD) mortality1 in two rural, white, low-income counties in Maine over 1999-2009: Washington County and Aroostook County. Two similar counties with similarly high rates of CVD mortality– Penobscot and Piscataquis - were selected as comparators. The study considers different factors known to correlate with CVD mortality, including behavioral risk factors, co-morbid conditions, insurance coverage, and social determinants of health.

An Analysis Of Employment Policies And Their Effect On Work-Life Balance For Caregiving Parents Of Children With Special Needs, Sara Panella

Muskie School Capstones and Dissertations

This capstone addresses the work-­‐life conflict facing employed caregiver parents with special needs children by 1) identifying what employed parents of children with disabilities need from their employer in order to achieve a work-­‐life balance that improves economic security and emotional well-­‐being, and 2) evaluating how well policies address those needs. An investigation of work-­‐family conflict and stress among parents of special needs children is conducted by examining the current literature and conducting interviews with caregivers to explore their work-­‐life balance needs. Policy recommendations are provided, based on an analysis of public and workplace policies currently in use and policy …

The Influence Of Family Dynamics On Contraceptive Use In Madagascar And The Ensuing Impact On Family Well-Being, Joel Zafitandra Hajason, Kayla Piña, Joel L. Raveloharimisy

Faculty Publications

While studies have shown a relationship between family dynamics and contraceptive use and between contraceptive use and family well-being, no empirical study has been conducted to test whether a relationship exists between family influence on contraceptive use and family wellbeing. The objective of this study is to explore whether there is such a relationship between family influence on contraceptive use and family well-being.

Determinants Of Child And Forced Marriage In Morocco: Stakeholder Perspectives On Health, Policies And Human Rights, Alexia Sabbe, Halima Oulami, Wahiba Zekraoui, Halima Hikmat, Marleen Temmerman, Els Leye

Obstetrics and Gynaecology, East Africa

Background: In Morocco, the social and legal framework surrounding sexual and reproductive health has transformed greatly in the past decade, especially with the introduction of the new Family Law or Moudawana. Yet, despite raising the minimum age of marriage for girls and stipulating equal rights in the family, child and forced marriage is widespread. The objective of this research study was to explore perspectives of a broad range of professionals on factors that contribute to the occurrence of child and forced marriage in Morocco.

Methods: A qualitative approach was used to generate both primary and secondary data for the analysis. …

Introduction: A Global Approach To Reproductive Justice—Psychosocial And Legal Aspects And Implications, Joan C. Chrisler

William & Mary Journal of Race, Gender, and Social Justice

No abstract provided.

Bad Medicine: Abortion And The Battle Over Who Speaks For Women's Health, Andrea D. Friedman

William & Mary Journal of Race, Gender, and Social Justice

No abstract provided.

Development Of A Control Banding Method For Selecting Respiratory Protection Against Bioaerosols, Jacques Lavoie, Eve Neesham-Grenon, Maximilien Debia, Yves Cloutier, Geneviève Marchand

Rapports de recherche scientifique

La sélection d’un appareil de protection respiratoire contre les bioaérosols peut s’avérer une tâche complexe compte tenu de l’absence de valeurs limites d’exposition et de données toxicologiques, ainsi que des limites des techniques d’échantillonnage actuelles et de la grande diversité des bioaérosols. Dans ces circonstances, une méthode qualitative d’évaluation et de gestion du risque fournit une alternative aux méthodes quantitatives utilisées en hygiène du travail. Ce rapport propose un modèle de gestion graduée du risque pour le choix de la protection respiratoire contre les bioaérosols infectieux et non infectieux applicable à l’ensemble des milieux de travail et s’adressant aux hygiénistes …

Tick Toxic: The Failure To Clean Up Tsca Poisons Public Health And Threatens Chemical Innovation, Kristen Ekey

William & Mary Environmental Law and Policy Review

No abstract provided.

Patients’ Attitudes Towards Patient Involvement In Safety Interventions: Results Of Two Exploratory Studies, Rachel Davis, Nick Sevdalis, Anna Pinto, Ara Darzi, Charles A. Vincent

Faculty Publications

BACKGROUND: In recent years, patient-focused interventions have been introduced aimed at increasing patient involvement in safety-related behaviours. However, patients' attitudes towards these interventions and comfort in participating in the recommended behaviours remain largely unexplored. OBJECTIVE: To evaluate patients' attitudes towards a video and leaflet aimed at encouraging patient involvement in safety-related behaviours. DESIGN: Two exploratory studies employing a within-subjects mixed-methods design. SETTING: Six hospital wards on an inner-city London teaching hospital. PARTICIPANTS: Medical and surgical inpatients: 80 patients in study 1 (mean age 55; 69% men) and 80 patients in study 2 (mean age 52; 60% men). INTERVENTION: Patients watched …

Health Service Utilization And Stigma Among Hiv-Positive Men-Who-Have-Sex-With Men (Msm) In Rural Appalachia, Roger L. Blackwell Jr

Electronic Theses and Dissertations

ABSTRACT

Health Service Utilization and Stigma among

HIV-Positive Men-Who-Have-Sex-With-Men (MSM) in Rural Appalachia

by

Roger Lee Blackwell

The world has now entered the third decade of the AIDS epidemic. Men-who-have-sex-with-men continue to be disproportionately affected by HIV/AIDS. The United States still struggles in its response to this ongoing crisis in many areas: disease prevention, treatment, and HIV related stigma, prejudice and discrimination. Much of the information reported on MSM living with HIV has come from urban population centers, but only a few studies have focused on HIV positive MSM living in rural areas. Therefore, the overall aim of this dissertation …

Who Done It? Rurality Vs. Ses As Critical Factors In Evaluating The Prevalence Of Child Psychosocial Concerns In Primary Care, Robert M. Tolliver

Electronic Theses and Dissertations

The purpose of this study was to evaluate the prevalence of child psychosocial concerns in rural primary care, hypothesized to be greater than national averages due to lacking mental health services in rural areas. This study was an examination of the role of SES, various definitions of “rural,” and the interaction of SES and rurality, in predicting parent-reported child psychosocial concerns in Appalachian primary care clinics. Caregivers presenting with their child at one of 8 pediatric primary care sites (n=2,672) were recruited to complete a measure assessing demographics and the Pediatric Symptom Checklist (PSC). Results showed that while rural status …

Factors Associated With Parental Decision Making And Childhood Vaccination, Zuwen Qiu-Shultz

UNLV Theses, Dissertations, Professional Papers, and Capstones

In order to better understand factors affecting immunization status, logistic regression was used to assess the association of various socio-demographic factors and whether parents would have their child immunized if not a state mandate. Factors included in the study were race, household income, number of children in the household, number of adults in the household, if the child had a primary provider, if the child had a health check-up in the last twelve months, and medical insurance status of the child. The combined Nevada Kindergarten Health Survey Result of 2009-2010 (Year Two) and 2010-2011 (Year Three) conducted by the Nevada …

Balancing The Presentation Of Information And Options In Patient Decision Aids: An Updated Review, Purva Abhyankar, Robert J. Volk, Jennifer Blumenthal-Barby, Paulina Bravo, Angela Buchholz, Elissa Ozanne, Dale C. Vidal, Nananda Col, Peep Stalmeier

Dartmouth Scholarship

Standards for patient decision aids require that information and options be presented in a balanced manner; this requirement is based on the argument that balanced presentation is essential to foster informed decision making. If information is presented in an incomplete/non-neutral manner, it can stimulate cognitive biases that can unduly affect individuals’ knowledge, perceptions of risks and benefits, and, ultimately, preferences. However, there is little clarity about what constitutes balance, and how it can be determined and enhanced. We conducted a literature review to examine the theoretical and empirical evidence related to balancing the presentation of information and options.

“Many Miles To Go …”: A Systematic Review Of The Implementation Of Patient Decision Support Interventions Into Routine Clinical Practice, Glyn Elwyn, Isabelle Scholl, Caroline Tietbohl, Mala Mann, Adrian G. K. Edwards, Catharine Clay

Dartmouth Scholarship

Two decades of research has established the positive effect of using patient-targeted decision support interventions: patients gain knowledge, greater understanding of probabilities and increased confidence in decisions. Yet, despite their efficacy, the effectiveness of these decision support interventions in routine practice has yet to be established; widespread adoption has not occurred. The aim of this review was to search for and analyze the findings of published peer-reviewed studies that investigated the success levels of strategies or methods where attempts were made to implement patient-targeted decision support interventions into routine clinical settings.

From (Un)Willingness To Involvement: Development Of A Successful Study Brand For Recruitment Of Diverse Msm To A Longitudinal Hiv Research, Paula M. Frew, Victoria A. Williams, Eve T. Shapiro, Travis Sanchez, Eli S. Rosenberg, Vincent L. Fenimore, Patrick S. Sullivan

Environmental & Global Health Faculty Research

Background. HIV continues to be a major concern among MSM, yet Black MSM have not been enrolled in HIV research studies in proportionate numbers to White MSM. We developed an HIV prevention research brand strategy for MSM. Methods. Questionnaires and focus groups were conducted with 54 participants. Descriptive statistics and chi-square analyses were performed and qualitative data were transcribed and content analyzed to identify common themes. Results. Formative research results indicated that younger Black MSM (18–29 years) were less likely to think about joining prevention studies compared to older (≥30 years) Black MSM (, ). Qualitative and quantitative results indicate …

Electronic Word Of Mouth On Twitter About Physical Activity In The United States: Exploratory Infodemiology Study, Ni Zhang, Shelly Campo, Kathleen F. Janz, Petya Eckler, Jingzhen Yang, Linda G. Snetselaar, Alessio Signorini

Faculty Research, Scholarly, and Creative Activity

Background:
Twitter is a widely used social medium. However, its application in promoting health behaviors is understudied.
Objective:
In order to provide insights into designing health marketing interventions to promote physical activity on Twitter, this exploratory infodemiology study applied both social cognitive theory and the path model of online word of mouth to examine the distribution of different electronic word of mouth (eWOM) characteristics among personal tweets about physical activity in the United States.
Methods:
This study used 113 keywords to retrieve 1 million public tweets about physical activity in the United States posted between January 1 and March 31, …

Household Wealth And Neurocognitive Development Disparities Among School-Aged Children In Nepal., Shivani A Patel, Laura E Murray-Kolb, Steven C Leclerq, Subarna K Khatry, James M. Tielsch, Joanne Katz, Parul Christian

Global Health Faculty Publications

BACKGROUND: Wealth disparities in child developmental outcomes are well documented in developed countries. We sought to (1) describe the extent of wealth-based neurocognitive development disparities and (2) examine potential mediating factors of disparities among a population-based cohort of children in rural Nepal.

METHODS: We investigated household wealth-based differences in intellectual, executive and motor function of n = 1692 children aged between 7 and 9 years in Nepal. Using linear mixed models, wealth-based differences were estimated before and after controlling for child and household demographic characteristics. We further examined wealth-based differences adjusted for three sets of mediators: child nutritional status, home …

Chhs November 2013 E-Newsletter, Vashon S. Wells, Editor, Dr. John Bonaguro, Dean, Wku College Of Health & Human Services

College of Health & Human Services Publications

No abstract provided.

Dental Hygienists' Knowledge Of Hiv, Attitudes Towards People With Hiv And Willingness To Conduct Rapid Hiv Testing, Anthony J. Santella, B Krishnamachari, Susan H. Davide, Marilyn Cortell, Winnie Furnari, B Watts, Sarah C. Hayden

Publications and Research

This study was aimed to determine the dental hygienists' knowledge of HIV, attitudes towards people living with HIV and willingness to conduct rapid HIV testing.

Construction Workers' Crystalline Silica Exposure: Statistical Analysis Of A Literature-Based Database, Jean-François Sauvé, Charles Beaudry, Denis Bégin, Chantal Dion, Michel Gérin, Jérôme Lavoué

Rapports de recherche scientifique

L’exposition prolongée par inhalation à des poussières de taille respirable contenant de la silice cristalline est reconnue pour causer des maladies respiratoires, dont le cancer du poumon et la silicose. De nombreuses études ont relevé la surexposition des travailleurs de la construction à la silice cristalline, puisque ce composé est présent dans de nombreux matériaux utilisés sur les chantiers. L’évaluation de l’exposition à la silice cristalline dans cette industrie constitue un défi en raison de la multitude de conditions de travail et de la nature temporaire des chantiers.

Dans le but d’améliorer les connaissances sur les conditions de travail pouvant …

Willow: Reaching Hiv-Positive African-American Women Through A Computer-Delivered Intervention, Charles H. Klein

Anthropology Faculty Publications and Presentations

This study evaluates the efficacy of Multimedia WiLLOW in enhancing HIV-protective sexual behaviors and psychosocial outcomes among HIV-positive African American women, including condom use for vaginal and anal sex, and psychosocial mediators associated with risk reduction practices. Using a community-based randomized controlled design, 168 participants completed a baseline and follow-up assessment as well as an exit satisfaction survey. Intervention participants reported significantly higher proportions of condom protected sex acts in the past 30 days (p=.002), with both HIV-negative (p=.040) and HIV-positive (p=.003) partners. They were also more likely to report 100% condom use (OR = .10; p=.030); a lower adjusted …

Personal Characteristics And Learning Preference In End-Of-Life Decision Making Of Chronically Ill Community Dwelling Elders, Leigh Ann Bonney

Theses and Dissertations

Leigh Ann Bonney, RN, MSN; Susan Kossman, RN, PhD; MyoungJin Kim, PhD; Wendy Woith, PhD, Caroline Mallory, PhD

Illinois State University, Mennonite College of Nursing

Personal Characteristics and Learning Preference in End-of-Life Decision Making of

Chronically Ill Community Dwelling Elders

Purpose and Background: Clear decision-making (DM) about end-of-life [EOL] contributes to a good death This requires knowledge of life-sustaining treatment with lack of knowledge contributing to feelings of decisional conflict Decision aids can increase knowledge, but elders' preferred learning methods are unknown. Identifying characteristics associated with preferred learning method and decisional conflict can help nurses tailor information to assist in …

Trauma History And Depression Predict Incomplete Adherence To Antiretroviral Therapies In A Low Income Country, Kathryn Whetten, Kristen Shirey, Brian Wells Pence, Jia Yao, Nathan Thielman, Rachel Whetten, Julie Adams, Bernard Agala, Jan Ostermann, Karen O'Donnell, Amy Hobbie, Venance Maro, Dafrosa Itemba, Elizabeth Reddy, Chat Research Team

Faculty Publications

Background: As antiretroviral therapy (ART) for HIV becomes increasingly available in low and middle income countries (LMICs), understanding reasons for lack of adherence is critical to stemming the tide of infections and improving health. Understanding the effect of psychosocial experiences and mental health symptomatology on ART adherence can help maximize the benefit of expanded ART programs by indicating types of services, which could be offered in combination with HIV care. Methodology: The Coping with HIV/AIDS in Tanzania (CHAT) study is a longitudinal cohort study in the Kilimanjaro Region that included randomly selected HIV-infected (HIV+) participants from two local hospital-based HIV …

Addressing The Health Of Hispanic Migrant Farmworkers In Rural East Tennessee Through Interprofessional Education, Experiential Learning, And A University/Community Partnership, Sharon Loury, Mchael Bradfield, Joseph Florence, Kenneth Silver, Karin Hoffman, Alexis Andino

International Journal of Health Sciences Education

The concept of interprofessional practice and education is not new but has recently gained attention as the result of a paradigm shift in the future of healthcare and how it is delivered and financed. Universities are now addressing ways to incorporate interprofessional education and learning experiences into the curriculum to ensure graduating healthcare professionals are competent to collaborate as a team and deliver quality effective healthcare.

A regional research university in East Tennessee with health programs across five Health Science colleges (Clinical and Rehabilitative Health Sciences, Medicine, Nursing, Pharmacy, and Public Health), Psychology, and Social Work has offered an interprofessional …

The Mosakowski Institute For Public Enterprise Five Year Report, Mosakowski Institute

Mosakowski Institute for Public Enterprise

This report contains the highlights of the first five years of Clark University’s Mosakowski Institute for Public Enterprise. It includes a description of the Institute’s founding, its commitment to use-inspired research, transformational educational experiences, and community connectedness, the Institute’s leadership and finances, and a listing of projects undertaken and faculty partners.

Knowledge, Training And Experience Of Emergency Responders In The Context Of Functional Needs In General Shelters, Athena K. Fannin

Master of Public Health Program Student Publications

Objective: Gathering and analyzing information on experience, training, and professional affiliation of disaster responders who will deal with functional needs clients in general shelters. Methods: The web-based survey administered in June, 2012 to 165 local Medical Reserve Corps (MRC) volunteers and 72 public health workers was part of a larger study designed to assess functional needs flow processes in general shelters. Descriptive statistics and simple logistic regression were used to analyze data.

Results: The response rate was 16.5%. The percent of survey respondents that had any disaster, medical, or functional needs training were approximately 80%, 70%, and 40% respectively. The …

Intimate Partner Violence During Pregnancy: Victim Or Perpetrator? Does It Make A Difference?, Yuliya Shneyderman, Michele Kiely

Publications and Research

Objectives: To differentiate between forms of intimate partner violence (IPV)(victim only, perpetrator only, or participating in reciprocal violence) and examine risk profiles and pregnancy outcomes.

Design: Prospective

Setting: Washington, DC, July 2001 to October 2003

Sample: 1044 high-risk African-American pregnant women who participated in a randomized controlled trial to address IPV, depression, smoking, and environmental tobacco smoke exposure.

Methods: Multivariable linear and logistic regression

Main outcome measures: Low and very low birth weight, preterm and very preterm birth

Results: 5% of women were victims only, 12% were perpetrators only, 27% participated in reciprocal violence, and 55% reported no IPV. …

Sequential Screening For Psychosocial And Behavioural Risk During Pregnancy In A Population Of Urban African Americans, Michele Kiely, Marie G. Gantz, M. Nabil El-Khorazaty, Ayman El-Mohandes

Publications and Research

Objective: Screening for psychosocial and behavioral risks, such as depression, intimate partner violence and smoking, during pregnancy is considered state-of-the-art in prenatal care (PNC). This prospective longitudinal analysis examines the added benefit of repeated screening over a one-time screen in identifying such risks during pregnancy.

Design: Data were collected as part of a randomized controlled trial to address intimate partner violence (IPV), depression, smoking and environmental tobacco smoke exposure (ETSE) in African-Americans women.

Setting: PNC sites in the District of Columbia serving mainly minority women

Population: 1044 African-American pregnant women in the District of Columbia

Methods: Mothers were classified by …

Schistosomiasis (Bilharzia) In Madagascar: A Case Study Of A Neglected Tropical Disease, Sarah Grace Sawyer

Independent Study Project (ISP) Collection

Over 50% of Madagascar’s population is infected with intestinal or urinary schistosomiasis (Rollinson et al., 2012). The disease slowly debilitates infected persons, who are frequently children, resulting in lower productivity and reduced learning in school-age children. The disease involves a vicious cycle perpetuated by a number of environmental, psychological, and social factors. A multifaceted approach, involving mass treatment, biological control, environmental control, education, and disease surveillance, can lead to schistosomiasis control and elimination in Madagascar. This would yield many socio-economic benefits such as increased productivity, increased school attendance rates, and generally better welfare. Schistosomiasis is the most burdensome and deadly …

Jordanian University Student’S Attitudes And Perceptions On Mental Health, Amira Khablein

Independent Study Project (ISP) Collection

The present study examines the attitudes and perceptions of students at a private, Jordanian University to examine, through surveys, interviews and a focus group whether the stigma commonly associated with mental health in the Middle East and North African region persists for students and the reasons behind this stigma. It was also investigated what kind of disorders came to mind when asked to name specifics to see if students focused on the illness of psychological disorders when weighing mental health. It was found that the stigma does not necessarily exist for students, though it is perpetuated throughout the community and …