Digital Commons Network^™

Reducing Stillbirths: Prevention And Management Of Medical Disorders And Infections During Pregnancy., Esme V Menezes, Mohammad Yawar Yakoob, Tanya Soomro, Rachel A Haws, Gary L Darmstadt, Zulfiqar Ahmed Bhutta

Woman and Child Health

Background:An estimated two-thirds of the world's 3.2 million stillbirths occur antenatally, prior to labour, and are often overlooked in policy and programs. Poorly recognised, untreated or inadequately treated maternal infections such as syphilis and malaria, and maternal conditions including hypertensive disorders, are known risk factors for stillbirth.

Methods:

We undertook a systematic review of the evidence for 16 antenatal interventions with the potential to prevent stillbirths. We searched a range of sources including PubMed and the Cochrane Library. For interventions with prior Cochrane reviews, we conducted additional meta-analyses including eligible newer randomised controlled trials following the Cochrane protocol. We …

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 …

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.

Factors Related To Objectively Measured Physical Activity In Preschool Children, Karin A. Pfeiffer, Marsha Dowda, Kerry L. Mciver, Russell R. Pate

Faculty Publications

This study examined correlates of objectively measured physical activity (PA) in a diverse sample of preschool children (age 3-5 years; n=331). Accelerometer min∙hr^-1 of moderate-to-vigorous physical activity (MVPA) and nonsedentary activity (NSA) were the outcome measures. Correlations among potential correlates and PA ranged from r=-0.12-0.26. Correlates in the final MVPA model were age, race, sex, BMI Z score, and parent perception of athletic competence, explaining 37% of the variance. The NSA model included the latter two variables, explaining 35% of the variance. Demographic factors were correlates of PA; parent perceptions of children's competence may be important regarding …

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 …

Correlates Of Soy Food Consumption In Adventist Health Study-2, Yen Ang

Loma Linda University Electronic Theses, Dissertations & Projects

Much has been discussed about the health benefits and risks of soy consumption but very little is known about who the consumers are. Most of what is known has been observed mainly in Asian populations who consume high levels of soy. Very little is known about soy food intake in the western population who typically has low consumption level. The Seventh-Day Adventist cohort in North America is the only population known in the West with soy food intake that is comparable to the Asian population living in the East.

Soy consumers in a population known for its healthier lifestyle and …

Effect Of Obesity On The Traditional And Emerging Cardiovascular Disease Risk Factors In African American Women, Queen Obiageli Henry-Okafor

Theses and Dissertations (ETD)

Background: Obesity is a growing health care concern with cardiovascular disease (CVD) implications. African American women (AAW) have the highest prevalence rate of obesity and highest CVD morbidity and mortality rate of all ethnic groups. The traditional CVD risk factors have not been sufficient to explain this disparity in disease prevalence and outcomes. Current knowledge is limited regarding the interaction between various levels of adiposity and both traditional and emerging CVD risk factors, particularly in AAW. This study sought to explore these interactions.

Methods: The study design was a cross-sectional, descriptive, correlational analysis of 48 AAW ages 18 to 45 …

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 …

Does Admission Hyperglycemia Predict Intracranial And Extracranial Vasculopathy?, Ather Mohammed Taqui, Ayeesha Kamran Kamal, Saqib Ali Gowani, Bhojo A Khealani, Shafquat Rozi

Community Health Sciences

Objective: To study the association between admission hyperglycaemia and the presence and pattern of intracranial and extracranial vascular disease.
Methods: This retrospective study was conducted at a major tertiary care hospital in Karachi, Pakistan. Patients who had presented with acute stroke and had undergone a carotid ultrasound doppler of the carotids and/or Magnetic Resonance Angiography (MRA) of the brain were included in the study. A multiple logistic regression analysis of variables was done for an abnormal finding on each investigation.
Results: Out of the total of 216 patients, the age of majority of the patients (83.3%) was >50 years …

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, …

History Of Pregnancy Termination As A Risk Factor For Preterm Birth, Virginia 2000-20007, Jennifer Macdonald

Theses and Dissertations

Abstract Objectives: The objective of this study was to determine if an association exists between prior induced and prior spontaneous pregnancy termination (PIPT and PSPT) and preterm birth (PTB) of first live births in Virginia. Methods: Data was collected by linking maternal data from Virginia’s live birth and fetal death registries. All first live, singleton births occurring in Virginia from 2000-2007 were analyzed. Logistic regression models that controlled for various demographic, medical and obstetric history factors were used to determine associations among prior pregnancy termination types. Results: Compared with women who had no history of previous pregnancy terminations, women who …

Delayed And Forgone Care For Children With Special Health Care Needs In Virginia: A Cross-Sectional Study Using 2005-2006 Ns-Cshcn, Nevena Skoro

Theses and Dissertations

Objectives The objectives of our study were to: 1) summarize illness characteristics and functional ability difficulties among Children With Special Health Care Needs (CSHCN) in Virginia, 2) examine the distribution of socio-demographic, health insurance, and health-related factors among Virginia’s CSHCN, 3) quantify the influence of these socio-demographic, health insurance, and health-related factors on delayed and forgone care of CSHNC in Virginia, and 4) analyze reasons for delayed and forgone care among Virginia’s CSHCN. Methods Data from the 2005-2006 National Survey of Children with Special Health Care Needs (NS-CSHCN) were used for this study. Three categories of predictor variables were studied: …

Does Admission Hyperglycemia Predict Intracranial And Extracranial Vasculopathy?, Ather Mohammed Taqui, Ayeesha Kamran Kamal, Saqib Ali Gowani, Bhojo A. Khealani, Shafquat Rozi

Department of Medicine

Objective: To study the association between admission hyperglycaemia and the presence and pattern of intracranial and extracranial vascular disease.
Methods: This retrospective study was conducted at a major tertiary care hospital in Karachi, Pakistan. Patients who had presented with acute stroke and had undergone a carotid ultrasound doppler of the carotids and/or Magnetic Resonance Angiography (MRA) of the brain were included in the study. A multiple logistic regression analysis of variables was done for an abnormal finding on each investigation.
Results: Out of the total of 216 patients, the age of majority of the patients (83.3%) was >50 years …

Predictors Of Hpv Knowledge And Awareness In Rural America, Melanee Dulfon

UNLV Theses, Dissertations, Professional Papers, and Capstones

Prior research has shown that overall awareness of HPV is low among women in America. Yet limited research exists as to the awareness of HPV among rural U.S. women. The goal of this study was to determine the factors that predict women's knowledge and awareness of HPV in rural America. Secondary data was utilized from the National Cancer Institute Health Information National Trends Survey (HINTS) of 2005. The sample consisted of 788 adult women over the age of 18 from rural areas of the U.S. Results indicated younger age, increased education, receipt of a Pap exam in over three years, …

The Pakistan Risk Of Myocardial Infarction Study: A Resource For The Study Of Genetic, Lifestyle And Other Determinants Of Myocardial Infarction In South Asia, Danish Saleheen, Moazzam Zaidi, Asif Rasheed, Usman Ahmad, Abdul Hakeem, Muhammed Murtaza, Waleed Kayani, Rashid Jooma, Nadir Khan, Nabi Shah, Asad Ali Shah, Maria Samuel, Farina Hanif, Madiha Yameen, Sobia Naz, Aisha Sultana, Aisha Nazir, Shehzad Raza, Muhammad Shazad, Sana Nasim, Muhammad Ahsan Javed, Syed Saadat Ali, Mehmood Jafree, Muhammad Imran Nisar, Altaf Hussain, Ayeesha Kamran Kamal, Philippe M. Frossard

Department of Biological & Biomedical Sciences

The burden of coronary heart disease (CHD) is increasing at a greater rate in South Asia than in any other region globally, but there is little direct evidence about its determinants. The Pakistan Risk of Myocardial Infarction Study (PROMIS) is an epidemiological resource to enable reliable study of genetic, lifestyle and other determinants of CHD in South Asia. By March 2009, PROMIS had recruited over 5,000 cases of first-ever confirmed acute myocardial infarction (MI) and over 5,000 matched controls aged 30-80 years. For each participant, information has been recorded on demographic factors, lifestyle, medical and family history, anthropometry, and a …

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 …

Meta-Analysis: Racial Disparities In Prostate Cancer Survival And Case-Control Study: Association Between Family History Of Cancers, Obesity And Prostate Cancer, Gayathri Sridhar

Theses and Dissertations

This is a compilation of 3 abstracts for the three manuscripts included in this dissertation. I. Meta-Analysis: Racial Disparities in Prostate Cancer Survival: Prostate cancer is the second leading cause of cancer-related mortality in men. Previous studies have drawn inconsistent conclusions on racial differences in prostate cancer survival. This meta-analysis was conducted to investigate the relationship between race and survival from prostate cancer. A systematic review of published articles from 1968 to 2007 assessing survival from prostate cancer among African American and White men was conducted. The search yielded 20 eligible published manuscripts. Analysis of unadjusted studies showed African American …

Schedule H: New Community Benefit Reporting Requirements For Hospitals, Eileen Salinsky

National Health Policy Forum

In recent years, some policymakers have questioned whether not-for-profit hospitals benefit the communities they serve at a level commensurate with the tax exemptions they receive as charitable organizations. This background paper reviews the new community benefit reporting requirements hospitals will face in 2009 under Schedule H of the Internal Revenue Service's revised Form 990 (the return used by organizations exempt from federal income tax). The paper provides a descriptive summary of the quantitative and qualitative information to be reported on Schedule H, such as charity care, bad debt, and the unreimbursed costs of Medicaid and Medicare.

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 …

Bacillus Anthracis In China And Its Relationship To Worldwide Lineages, Tatum S. Simonson, Richard T. Okinaka, Bingxiang Wang, W. Ryan Easterday, Lynn Huynh, Jana M. U'Ren, Meghan Dukerich, Shaylan R. Zanecki, Leo J. Kenefic, Jodi Beaudry, James M. Schupp, Talima Pearson, David M. Wagner, Alex Hoffmaster, Jacques Ravel, Paul Keim

United States Public Health Resources

Background: The global pattern of distribution of 1033 B. anthracis isolates has previously been defined by a set of 12 conserved canonical single nucleotide polymorphisms (canSNP). These studies reinforced the presence of three major lineages and 12 sub-lineages and sub-groups of this anthrax-causing pathogen. Isolates that form the A lineage (unlike the B and C lineages) have become widely dispersed throughout the world and form the basis for the geographical disposition of "modern" anthrax. An archival collection of 191 different B. anthracis isolates from China provides a glimpse into the possible role of Chinese trade and commerce in the spread …

Una Manera De Vida Diferente: Embarazos En Adolescentes Y Planificación Familiar En La Zona De Intag, Ecuador, Jennifer Dabrow

Independent Study Project (ISP) Collection

Lack of family planning and high rates of adolescent pregnancy plague the poorest regions of the world. Not only does this deficiency result in the deaths of infants and mothers as well as significantly depressing quality of life, but, as the human population expands, we risk destroying much of the environment and natural resources upon which we depend. In Intag, a rural network of communities in the cloud forest of Ecuador, adolescent pregnancy is the norm and women commonly have upwards of 7 children. Working in the Subcentro health clinic of Apuela, I interviewed 50 mothers regarding their age during …

Constructions Of Disease In Mayo Village, Rachel Eades

Independent Study Project (ISP) Collection

Understanding how individuals and institutions negotiate illness and construct ideas about disease is important to public health efforts across the globe. Countries in sub-Saharan Africa suffer from a variety of health problems that many regions of the world have long since eradicated. Economic hardship, combined with high rates of communicable diseases, food poverty, lack of sanitation, and poor water quality make countries in sub-Saharan Africa some of the poorest and sickest in the world. Tanzania is a prime example. The purpose of this study was to explore how people in one rural, Tanzanian village construct ideas about disease – its …

Inflammatory Biomarkers And Subclinical Atherosclerosis In African-American Women With Systemic Lupus Erythematosus (Sle), Edith M. Williams, Carlos J. Crespo, Joan Dorn

Community Health Faculty Publications and Presentations

Women with lupus are at increased risk for developing cardiovascular disease (CVD). Previous studies of atherosclerosis in SLE have not been representative of the minority groups most affected by lupus and its complications. Therefore, a study of 41 lupus cases and 83 controls was conducted to investigate the relationship between carotid atherosclerosis and inflammation in African-American women. Participation consisted of a questionnaire, physical examination, fasting blood draw, and ultrasound of the carotid arteries. There were observed differences between cases and controls with regard to carotid intima media thickness (IMT) and traditional cardiovascular risk factors, although few reached statistical significance. Tumor …

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 …

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 …

Adult And Child Semantic Neighbors Of The Kroll And Potter (1984) Nonobjects, Holly L. Storkel, Suzanne M. Adlof

Faculty Publications

Purpose - The purpose was to determine the number of semantic neighbors, namely semantic set size, for 88 nonobjects (J. F. Kroll & M. C. Potter, 1984) and determine how semantic set size related to other measures and age.

Method - Data were collected from 82 adults and 92 preschool children in a discrete association task. The nonobjects were presented via computer, and participants reported the first word that came to mind that was meaningfully related to the nonobject. Words reported by two or more participants were considered semantic neighbors. The strength of each neighbor was computed as the …

Soil Zinc Content, Groundwater Usage, And Prostate Cancer Incidence In South Carolina, Sara E. Wagner, James B. Burch, Jim Hussey, Tom Temples, Susan Bolick-Aldrich, Catishia Mosley-Broughton, Yuan Liu, James R. Hébert

Faculty Publications

Background

Prostate cancer (PrCA) incidence in South Carolina (SC) exceeds the national average, particularly among African Americans (AAs). Though data are limited, low environmental zinc exposures and down-regulation of prostatic zinc transporter proteins among AAs may explain, in part, the racial PrCA disparity.

Methods

Age-adjusted PrCA rates were calculated by census tract. Demographic data were obtained from the 1990 census. Hazardous waste site locations and soil zinc concentrations were obtained from existing federal and state databases. A geographic information system and Poisson regression were used to test the hypothesis that census tracts with reduced soil zinc concentrations, elevated groundwater use, …

Gst Polymorphism And Excretion Of Heterocyclic Aromatic Amine And Isothiocyanate Metabolites After Brassica Consumption, Susan E. Steck, James R. Hébert

Faculty Publications

Brassica vegetable intake has been associated with decreased risk and well-done meat intake has been associated with increased risk of cancers at multiple organ sites in epidemiologic studies. Experimental studies suggest a role of modulation of phase I and phase II metabolizing enzymes as one mechanism for these associations. Heterocyclic aromatic amines (HAAs) are carcinogens formed in meat that has been cooked to well-done and at high temperatures. Phase I metabolizing enzymes catalyze the activation of HAAs, and phase II metabolizing enzymes serve to detoxify the active carcinogens. The glutathione S-transferase (GSTs) are a family of phase II metabolizing enzymes …

Pah-Dna Adducts, Cigarette Smoking, Gst Polymorphisms, And Breast Cancer Risk, Kathleen M. Mccarty, Regina M. Santella, Susan E. Steck, Rebecca J. Cleveland, Jiyoung Ahn, Christine B. Ambrosone, Kari North, Sharon K. Sagiv, Sybil M. Eng, Susan L. Teitelbaum, Alfred I. Neugut, Marilie D. Gammon

Faculty Publications

BACKGROUND: Polycyclic aromatic hydrocarbon (PAHs) may increase breast cancer risk, and the association may be modified by inherited differences in deactivation of PAH intermediates by glutathione S-transferases (GSTs). Few breast cancer studies have investigated the joint effects of multiple GSTs and a PAH biomarker.

OBJECTIVE: We estimated the breast cancer risk associated with multiple polymorphisms in the GST gene (GSTA1, GSTM1, GSTP1, and GSTT1) and the interaction with PAH-DNA adducts and cigarette smoke.

METHODS: We conducted unconditional logistic regression using data from a population-based sample of women (cases/controls, respectively): GST polymorphisms were genotyped using …