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To Vaccinate, Or Not? Health Care Providers And The Hpv Controversy, Nicole Elizabeth Hanbury

Honors Scholar Theses

Gardasil® – the vaccine was first thought to be a medical breakthrough in the fight against cancer, but it quickly became plagued with controversy. Despite wide media coverage, little attention has been paid to today’s health care professionals who are ultimately responsible for prescribing the vaccine, and who may be the most knowledgeable about it. The present study seeks to expand on previous literature by investigating health care providers’ current beliefs and practices with the human papillomavirus (HPV) immunization. It is essential that more recent research be performed in order to encompass current views of the vaccine, post FDA-approval.

Data …

Patients Evaluated For Liver Transplant: Transplant List Denial And Subsequent Outcomes, Kara Elam

Theses and Dissertations

Background: The evaluation process for listing a patient on the liver transplant list is complicated and involves multiple consultations from various specialists, as well as extensive imaging and physiological studies. Although there are data on the outcomes of those listed, we know little about those that are denied listing. This research project will identify the reasons for liver transplant listing denial and predictors of death following denial for this challenging group of patients. Methods: Data from all patients (n=1,500) evaluated for a liver transplant from 1997 to 2007 by the Department of Gastroenterology, Hepatology, and Nutrition located at Virginia Commonwealth …

Determinants Of Hepatitis B Vaccination Among Adults In The United States: Nhanes 1999-2006, Conschetta Wright

Theses and Dissertations

Purpose: The primary objective of this study was to estimate the prevalence of vaccination and HBV infection status of adults and to evaluate the trend in self reported vaccination and seroprevalence for Hepatitis B for this population. Additionally, this study sought to assess the association between vaccination rates, seroprevalence (HBsAg, anti-HBc, and anti-HBs), demographic (age, gender, location of birth, race/ethnicity), and socioeconomic (annual household income, education level, insurance coverage and access to care, marital status) characteristics. Methods: Eight years, 1999-2006, of the National Health and Nutrition Examination Survey (NHANES) data were used. NHANES participants aged 20-59 years who contributed data …

Does Unemployment Decrease Cancer Mortality?, Benjamin Torres Galick

Economics Honors Projects

Recent research indicates that healthier lifestyles during recessions decrease the most common U.S. mortalities, but not cancer. However, they combine specific cancer mortalities with different progressions into one, possibly obscuring cancer’s link to unemployment. This paper estimates a fixed-effects regression model on unemployment and the nine most prevalent cancers between 1988 and 2002 using state-level panel data. Five cancers and total cancer are procyclical, and suggest that unemployment affects both incidence and gestation for some cancers. Consistent with the medical literature, this paper contradicts previous economic research and suggests that behavioral factors significantly impact cancer mortality.

Exploring The Sensitivity Of Horn's Parallel Analysis To The Distributional Form Of Random Data, Alexis Dinno

Community Health Faculty Publications and Presentations

Horn's parallel analysis (PA) is the method of consensus in the literature on empirical methods for deciding how many components/factors to retain. Different authors have proposed various implementations of PA. Horn's seminal 1965 article, a 1996 article by Thompson and Daniel, and a 2004 article by Hayton et al., all make assertions about the requisite distributional forms of the random data generated for use in PA. Readily available software is used to test whether the results of PA are sensitive to several distributional prescriptions in the literature regarding the rank, normality, mean, variance, and range of simulated data on a …

Metro-Urbam Mental Health In Developing Countries: From Origin To Outcome: An Indian Experience, Amresh Srivastava

Data and Test Instruments

Metro-Urban Mental health in developing countries: from origins to outcome: an Indian experience Amresh Shrivastava: MD,DPM,MRCPsych, Executive Director: Mental Health Resource Foundation, and Prerana Charitable Trust, Mumbai, India. Assistant professor, Department of Psychiatry, University of Western Ontario, London, Ontario, Canada Address of presenting author E Mail: [email protected] 467, Sunset Drive, Regional Mental Health care, St.Thomas, Ontario, Canada, N5H 3V9 Phone: 519-631-8510 x 49252, fax 519-631-2512. and 519-641-3833 The life of the mentally ill in large metropolitan areas is presumed to be more Challenging. The impact of urbanization on service utilization and outcome is not clearly known. The present paper discusses …

Weight Perception And The Use Of Unhealthy Weight Loss Tactics Among Adults In The United States: A Cross-Sectional Study Of Nhanes Data, 2000-2006., Laura King

Theses and Dissertations

Introduction: Weight dissatisfaction and misperception are widespread problems in the United States as are unhealthy weight loss practices. These negative body image issues can lead to eating disorders which have serious health and quality of life consequences. Objective: To evaluate the extent to which the prevalence of distorted body image and unhealthy dieting tactics exist in adults in the US and how these are related. Methods: Data from NHANES 2000-20006 on adults aged 20-59 was used. Weight perception was assessed with the physical exam measurements of weight status and the weight history questionnaire item asking if the person considered him …

Determinants Of Physical Activity Behavior And Self-Efficacy For Exercise Among African American Women, Bridget K. Robinson

Theses and Dissertations (ETD)

Background: Inadequate physical activity behavior persists among African American women despite the widely documented benefits of physical activity. Literature notes a positive correlation between self-efficacy for exercise and physical activity behavior. In addition to socioeconomic factors, culturally influenced factors mediate self-efficacy for task such as physical activity. Past studies indicate differing perceptions related to religiosity and body image among African American populations. Additionally, reports indicate Southern and Midwestern states have the highest prevalence of obesity. These states are located in a geographical area known as the Bible belt. Moreover, 73.5% of the African American population in the U. S. resides …

Relationship Between Parental Role-Modeling Of Physical Activity And Child's Physical Activity, Katherine Culver

Theses and Dissertations

Trends in childhood obesity have lead to a generation that has a shortened lifespan, where excessive weight may decrease life expectancy by as much as five years. Physical inactivity is a major risk factor for childhood obesity as well as cardiovascular disease, osteoporosis, and cancer. Addressing inactivity in children could help keep the obesity epidemic from continuing to grow as well as help address other health concerns. The specific aims of this study are 1) To examine the effect of parental role-modeling of exercise on children’s activity level by specifically looking at the role of the mother and the father, …

A Culturally-Relevant, Emergent Approach To Exploring The Needs, Strengths, And Priorities Of Tribal Communities In Virginia, Amy Prorock-Ernest

Theses and Dissertations

Little is known about the health of the indigenous peoples in Virginia. When compared to the total U.S. population, indigenous peoples nationwide disproportionately experience disparities in health status across multiple health indicators. Research shows that these disparities are largely due to the inequitable distribution of social and economic determinants present within indigenous communities. Because the indigenous peoples of Virginia are affected by inequitable social and economic conditions, there is reason to believe that health indicators may mirror that of the indigenous population at-large. Outlined in this paper is a framework for exploring the needs, strengths, and priorities of indigenous communities …

Suicide Associated With Military Service, Margo R. Genderson, Irvin Sam Schonfeld, Mark S. Kaplan, Michael J. Lyons

Publications and Research

Suicide rates among soldiers and veterans of Operations Iraqi Freedom and Enduring Freedom (OIF/OEF) have been steadily growing since 2004, with sharp increases observed more recently. Suicides in the Army are a growing concern on Capitol Hill and in the media. Last month, the Senate Armed Services Committee held hearings on the growing incidence of suicides across the armed forces (Federal city digest, 2009, March 18). The Associated Press (AP) underlined the increasing suicide rates among Army personnel (Army reports sharp rise in suicides in January, 2009, Feb. 5). According to the AP, there were 64 suicides in 2004, and …

The Effect Of Concurrent Cell Phone Use And Walking On Gait Characteristics, Jennifer Marie Aldridge

UNLV Theses, Dissertations, Professional Papers, and Capstones

This study examined the effects that cell phone use has on gait and situation awareness. Subjects (n=18; 24.67±3.60 yrs) completed three five-minute treadmill walking conditions (self-selected speed): (1) CONTROL (walking only), (2) TALK (walking and talking), and (3) TEXT (walking and texting). The number of detected lights presented in the visual field was recorded, as were kinematic data of the feet. Using a one-way repeated measure ANOVA it was determined light detection (F _(2,17) =39.777, p<0.001) and TC_min (F_(2,17) =8.574, p=0.001) were different between conditions. Specifically, light detection decreased during TEXT (2.6±2.2 lights) versus TALK (5.8±0.05 lights, p<0.001) or CONTROL (5.9±0.05 lights, p<0.001); TC_min decreased …

Advance Practice Nurses Readiness To Change Assessment Methods In Parents Of Obese Children, Carolyn Leach

UNLV Theses, Dissertations, Professional Papers, and Capstones

The worldwide epidemic of child and adolescent overweight and obesity continues to increase at disturbing rates. Unhealthy dietary practice is one of multiple causative behaviors leading to child and adolescent overweight and obesity. This behavior can contribute to short and long-term health consequences. Parents are modulators in the development of children's dietary behavior practices. It is recommended clinical practice that pediatric nurse practitioners (PNPs) assess readiness to change behavior in parents of overweight or obese children. The components of the Prochaska and DiClemente's Transtheoretical Model (TTM) in correlation with the counseling style of Rollnick, Miller and Butler's methods of Motivational …

Cooking With A Chef: A Culinary Nutrition Intervention For College Aged Students, Andrew Warmin

All Theses

The primary objective of this study is to provide evidence that a culinary nutrition intervention is appropriate for, and of value to college students. A secondary objective is to provide evidence that the nutrition component of a culinary nutrition course can be delivered online through an interactive presentation. The study initially involved a review of literature highlighting the nutrition habits of college students, the strengths and weakness of existing cooking and nutrition classes, and other factors relating to the college student's health. Based on this literature review it was determined that a culinary nutrition course is an appropriate way to …

Modifying National Public Health Performance Standards For Local Public Health Department Accreditation, Jeffrey G. Kuhr

College of Education and Human Sciences: Dissertations, Theses, and Student Research

Public health officials throughout the United States are currently preparing for a national accreditation initiative for local and state public health agencies. As a voluntary program, the accreditation process will measure the degree to which state, local, tribal, and territorial public health departments meet nationally recognized standards and measures. Proponents of the initiative feel that evaluating public health agencies on their capacities to achieve certain standards will lead to improved service quality, consistency of public health roles nationally, and a greater understanding of those roles among the general population. However, in planning for agency accreditation some potential barriers must be …

Whom Can You Trust? Exploring Leadership Addressing Hiv Risk Prevention In African American Women

Florida Public Health Review

Within the last decade African American women have experienced serious increases in HIV diagnoses. Almost 40% of all newly diagnosed HIV-positive women in the United States are black women. Furthermore, black women are 23 times more likely to be diagnosed with AIDS than white women. This paper explores some of the underlying socioeconomic factors for high incidence rates of HIV among African American women—including poverty, racism, and stigma—that contribute to this health disparity and discusses current leadership approaches to addressing this problem. One common leadership approach focuses on adapting CDC intervention programs at a local level, a process that presents …

Using Leadership To Improve Community-Based Obesity Interventions

Florida Public Health Review

Obesity is an enormous health problem facing America in the 21st century. Despite great efforts, health educators have made little progress in meeting the goals laid out in Healthy People 2010. A more contextual, community- based approach is necessary to change the physical and social environment in which people live, work and play. Studies show that residents of neighborhoods that lack pedestrian-friendly features and have high crime rates are less likely to be physically active, an important point for health educators to take into account when designing interventions. Whereas professional health educators have done little in this area, exemplary grassroots …

Leadership Approaches To Providing Quality Hiv Prevention Care For Older Adults

Florida Public Health Review

Americans continue to face risks associated with human immunodeficiency virus (HIV). One population that receives little attention concerning HIV is that of older adults. Approximately 20% of all HIV cases are among adults aged 50 and older. Older adults and younger populations are at risk for HIV; however, few programs are in place to reduce the incidence of HIV among this priority population. Many cases of HIV among older adults go unnoticed because health care professionals perceive older adults as asexual. Many physicians and other health professionals, including health educators, are uncomfortable in discussing sexual histories with older adults, so …

Coordinating Care For People With Multiple Chronic Conditions: The Guided Care Model And Other Innovative Approaches, Judith D. Moore, Carol O'Shaughnessy

National Health Policy Forum

The Forum sponsored two site visits to explore the Johns Hopkins University's research and demonstration program on Guided Care, in April and August 2009. Guided Care is a patient-centered medical home model that uses an interdisciplinary approach to coordinating health care for older people with multiple chronic conditions. Guided Care nurses located in primary care practices work with Medicare patients on a long-term basis, coordinate their care among various providers, provide transitional care, and assist patients with self-management skills. Site visit participants learned about the complexities of caring for frail Medicare patients, some of whom see multiple physicians and other …

The Effect Of Obesity On State Health Care Expenditures: An Empirical Analysis, Kristen Collins

Honors Projects in Economics

The purpose of this study is to examine the effects of obesity rates on per capita state health care expenditures. A two-stage least square regression model is used. In the first stage of the estimation, factors influencing obesity rates are determined. The determinants of obesity rates are outlined throughout the research process. In the second stage, the impact of obesity rates on per capita health expenditures across states is evaluated. The empirical results indicate that obesity rates do indeed have a direct effect on state health care expenditures. After reviewing the project’s results, various solutions are proposed as possible methods …

Revisiting The Regulation Debate: The Effect Of Food Marketing On Childhood Obesity, Nicole E. Hunter

The University of New Hampshire Law Review

[Excerpt] “Despite the widespread concern regarding childhood obesity, there is broad divergence of opinion regarding responsibility for the crisis. Whether the government, food industry, or parents are accountable has become the focus of much debate. Public health groups have attempted various strategies to confront childhood obesity, such as litigation, legislation, and government regulation. While many researchers and advocates agree that government should play an affirmative role with respect to childhood obesity, they are very much divided over what that role should be. For example, although none of these acts has become law, eighty-six bills have been proposed regarding obesity since …

Beliefs And Behaviors Regarding Substance Use And Hiv Risk Among Men Who Have Sex With Men (Msm) In A Mid-Sized U.S. Community, David A. Patterson Silver Wolf (Adelv Unegv Waya) Phd, Martin Hall Mssw, Seana Golder Phd

Brown School Faculty Publications

This paper explores the beliefs and behaviors surrounding substance use and HIV risk among a convenience sample of 98 MSM in a mid-size community located in the central U.S. Several interesting patterns were identified in the descriptive analyses. Multivariate analysis identified two variables, belief that recreational drug use made sexual experiences better and reports that most MSM friends drank alcohol or took recreational drugs that were significant predictors of engagement in substance using behavior. Models accounted for 24% of the variance in drinking behavior and 15% of the variance in drug using behavior. Suggestions for HIV/AIDS prevention and intervention and …

Interdisciplinary, Translational, And Community-Based Participatory Research: Finding A Common Language To Improve Cancer Research, James R. Hébert, Heather M. Brandt, Cheryl A. Armstead, Swann Arp Adams, Susan E. Steck

Faculty Publications

Preventing cancer, downstaging disease at diagnosis, and reducing mortality require that relevant research findings be translated across scientific disciplines and into clinical and public health practice. Interdisciplinary research focuses on using the languages of different scientific disciplines to share techniques and philosophical perspectives to enhance discovery and development of innovations; (i.e., from the “left end” of the research continuum). Community-based participatory research (CBPR), whose relevance often is relegated to the “right end” (i.e., delivery and dissemination) of the research continuum, represents an important means for understanding how many cancers are caused as well as for ensuring that basic science research …

The Dynamics Of Income And Neighborhood Context For Population Health: Do Long Term Measures Of Socioeconomic Status Explain More Of The Black/White Health Disparity Than Single-Point-In-Time Measures?, D. Phuong Do

Faculty Publications

Socioeconomic status, though a robust and strong predictor of health, has generally been unable to fully explain the health gap between blacks and whites in the Untied States. However, at both the individual and neighborhood levels, socioeconomic status is often treated as a static factor with only single-point-in-time measurements. These cross-sectional measures fail to account for possible heterogeneous histories within groups who may share similar characteristics at a given point in time. As such, ignoring the dynamic nature of socioeconomic status may lead to the underestimation of its importance in explaining health and racial health disparities.

In this study, I …

Health Educator Job Analysis Project: Timeline Report, Eva Doyle, Beverly S. Mahoney

Faculty Publications and Presentations

No abstract provided.

Elder Abuse: A Policy Analysis, Cortni Davis

Undergraduate Research Conference

Elder abuse is a growing social problem in the United States. It takes on many forms, and is prevalent throughout various cultures. Elder Abuse Reporting Laws have been enacted throughout various states to prevent and intervene in elder abuse cases. California’s Financial Abuse Reporting Act of 2005 is one among many laws in the United States which was formed to help ensure social justice for the elderly citizens of America.

Impact Of Pedometer Use And Self-Regulation Strategies On Junior High School Physical Education Students' Daily Step Counts, Jane Shimon, Linda M. Petlichkoff

Kinesiology Faculty Publications and Presentations

Background: The aim of this study was to determine the impact of pedometer use and self-regulation strategies on adolescents’ daily physical activity.

Methods: Junior high school students (n = 113) enrolled in seventh- and eighth-grade physical education classes (52 girls, 61 boys) volunteered to participate in a 5-week study to assess daily step counts. Ten physical education classes were randomly assigned to 1 of 3 groups: (a) self-regulation, (b) open, and (c) control.

Results: A repeated-measures, mixed-model analysis of variance revealed a significant 3 × 4 (Group by Time) interaction effect, F_6,290 = 2.64, P < .02. Followup analyses indicated participants in the self-regulation group took 2071 to 4141 more steps/d than the control. No other significant differences emerged among groups on step counts.

Conclusions: It appears that …

Ethnic Differences In Trajectories Of Depressive Symptoms: Disadvantage In Family Background, High School Experiences, And Adult Characteristics, Katrina M. Walsemann, Gilbert C. Gee, Arline T. Geronimus

Faculty Publications

Although research investigating ethnic differences in mental health has increased in recent years, we know relatively little about how mental health trajectories vary across ethnic groups. Do these differences occur at certain ages, but not others? We investigate variations in trajectories of depressive symptoms, and examine the extent to which disadvantages in family background, high school experiences, and adult characteristics explain these differences. Employing random-coefficient modeling using the National Longitudinal Survey of Youth, we find that blacks and Hispanics experience higher symptom levels in early adulthood in comparison to whites, but equivalent levels by middle-age. Ethnic differences remained in early …

Advancing The Fiscal Health Of Low-Income Families: A Public And Community Health Approach, Doreen Treacy

Center for Social Policy Publications

For decades, health researchers have documented the links between individual and household income/wealth and clinical health outcomes. The research and literature consistently point to both income inequality (i.e. individual household income/wealth as compared to other households in the same state) and individual household income as predictors of diminished health and morbidity. And yet the current framework for providing financial education, disseminating asset building information, and overall responding to the financial health of individuals and households takes no cues from public health and community health best practices. Further, the documented links between financial stress and compromised physical health are compelling enough …

Environmental Tobacco Smoke Avoidance Among Pregnant African-American Nonsmokers, Susan M. Blake, Kennan D. Murray, M. Nabil El-Khorazaty, Marie G. Gantz, Michele Kiely, Dana Best, Jill G. Joseph, Ayman El-Mohandes

Publications and Research

Background—Environmental tobacco smoke (ETS) exposure during pregnancy contributes to adverse infant health outcomes. Limited previous research has focused on identifying correlates of ETS avoidance. This study sought to identify proximal and more distal correlates of ETS avoidance early in pregnancy among African-American women. Methods—From a sample of low-income, black women (n=1044) recruited in six urban, prenatal care clinics (July 2001–October 2003), cotinine-confirmed nonsmokers with partners, household/ family members, or friends who smoked (n=450) were identified and divided into two groups: any past-7-day ETS exposure and cotinine-confirmed ETS avoidance. Bivariate and multivariate logistic regression analyses identified factors associated with ETS …