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Kenya Adolescent Sexual And Reproductive Health Policy, Ministry Of Health Kenya

Reproductive Health

This document is a review and revision of the National Adolescent Sexual and Reproductive Health Policy of Kenya, which involved in-depth consultations with a wide range of stakeholders through literature review, interviews, consultative meetings, and reviews of the various drafts. Many changes took place at the national and international levels that needed to be taken into account as the policy was reviewed, including the Constitution of Kenya (2010) with its attendant devolved governance structure as well as demographics, and social, economic, and technological environment. The government has made concerted efforts as part of Vision 2030 to respond to adolescents and …

Building Assets Toolkit: Developing Positive Benchmarks For Adolescent Girls—Asset Cards, Judith Bruce, Sarah Engebretsen, Kimberly Glazer

Poverty, Gender, and Youth

This document contains the Building Assets Toolkit’s Asset Cards (110), set of Age Cards (age 6 to 20), and Program Planning Worksheet (sample provided). The Age Cards are to be printed out and placed according to the instructions. The Asset Cards are to be printed out and cut in half. Blank Asset Cards are provided to create customized assets. The Building Assets Toolkit is an approach for developing programs for specific segments of girls that will prepare them to better face the challenges of growing up. It will help program managers understand the needs of the girls in their community, …

Women And Hiv: Risk Of Hiv Infection And How To Prevent [Arabic], Population Council

Poverty, Gender, and Youth

No abstract provided.

Gender-Biased Sex Selection In India: A Review Of The Situation And Interventions To Counter The Practice, Shireen J. Jejeebhoy, Sharmistha Basu, Rajib Acharya, A.J. Francis Zavier

Poverty, Gender, and Youth

This report on gender-biased sex selection in India is divided into six chapters, including an introduction in Chapter 1. Chapter 2 describes the laws and policies adopted by India to address gender-biased sex selection, as well as those intended to support and empower women and girls. Chapter 3 analyzes the trends and geographic variation in the sex ratio at birth and in the child sex ratio. Chapter 4 briefly describes the socioeconomic differences and factors underlying distorted sex ratios and gender-biased sex selection in India, and the social consequences of these practices. Experiences in implementing the PCPNDT Act, initiatives intended …

Curatorial Implications Of Ophyra Capensis (Order Diptera, Family Muscidae) Puparia Recovered From The Body Of The Blessed Antonio Patrizi, Monticiano, Italy (Middle Ages), Johnica J. Morrow, Diesel A. Baldwin, Leon G. Higley, Dario Piombino-Mascali, Karl J. Reinhard

Karl Reinhard Publications

The discovery of dipteran remains on mummified individuals can lead to either cause for curatorial concern or to a better understanding of the individual’s post-mortem environment. The present study analyzed insect remains associated with the body of a unique medieval mummy of religious significance, that of the Blessed Antonio Patrizi da Monticiano. A total of 79 puparia were examined and all were identified as Ophyra capensis (Diptera: Muscidae). Additionally, a desiccated moth (Lepidoptera: Tineidae) was encountered. Puparia of O. capensis would be associated with normal decomposition shortly after the death of the mummified individual, and not an infestation beginning during …

Scientific And Regulatory Policy Committee (Srpc) Review*: Interpretation And Use Of Cell Proliferation Data In Cancer Risk Assessment, Charles E. Wood, Renee R. Hukkanen, Radhakrisha Sura, David Jacobson-Kram, Thomas Nolte, Marielle Odin, Samuel M. Cohen

United States Food and Drug Administration: Publications

Increased cell proliferation is a central key event in the mode of action for many non-genotoxic carcinogens, and quantitative cell proliferation data play an important role in the cancer risk assessment of many pharmaceutical and environmental compounds. Currently, there is limited unified information on assay standards, reference values, targeted applications, study design issues, and quality control considerations for proliferation data. Here, we review issues in measuring cell proliferation indices, considerations for targeted studies, and applications within current risk assessment frameworks. As the regulatory environment moves toward more prospective evaluations based on quantitative pathway-based models, standardiza- tion of proliferation assays will …

Quantitation Of Ortho-Cresyl Phosphate Adducts To Butyrylcholinesterase In Human Serum By Immunomagnetic-Uhplc-Ms/Ms, Darryl Johnson, Melissa D. Carter, Brian S. Crow, Samantha L. Isenberg, Leigh Ann Graham, H. Akin Erol, Caroline M. Watson, Brooke G. Pantazides, Marcel J. Van Der Schans, Jan P. Langenberg, Daan Noort, Thomas A. Blake, Jerry D. Thomas, Rudolph C. Johnson

United States Public Health Resources

Tri-ortho-cresyl phosphate (ToCP) is an anti-wear, flame retardant additive used in industrial lubricants, hydraulic fluids and gasoline. The neurotoxic effects of ToCP arise fromthe liver-activated metabolite 2-(o-cresyl)-4H-1,3,2-benzodioxaphosphoran-2-one (cresyl saligenin phosphate or CBDP),which inhibits esterase enzymes including butyrylcholinesterase (BChE). Following BChE adduction, CBDP undergoes hydrolysis to form the aged adduct ortho-cresyl phosphoserine (oCP-BChE), thus providing a biomarker of CBDP exposure. Previous studies have identified ToCP in aircraft cabin and cockpit air, but assessing human exposure has been hampered by the lack of a laboratory assay to confirm exposure. This work presents the development of an immunomagnetic- UHPLC-MS/MS method for the quantitation …

Knowledge, Attitudes, Beliefs, And Behaviors Of Diabetes Among Afro-Caribbeans Near Brooklyn, Sophia I. Allen

Walden Dissertations and Doctoral Studies

Literature has found that some minority groups with diabetes have a negative perception of medical professionals when a health problem occurs. This trend is particularly problematic with the diabetes epidemic in the United States. African Americans are more than 2 times as likely to die from diabetes than are Whites, and diabetes prevalence has increased exponentially in New York City where a majority of Afro-Caribbeans live. To address this problem, a cross-sectional design was used to recruit Afro-Caribbeans diagnosed with type 2 diabetes across 7 churches to examine whether shared knowledge, attitudes, beliefs, and behaviors about diabetes screening and its …

The Impact Of Disability: A Comparative Approach To Medical Resource Allocation In Public Health Emergencies, Katie Hanschke, Leslie E. Wolf, Wendy F. Hensel

Faculty Publications By Year

It is a matter of time before the next widespread pandemic or natural disaster hits the United States (U.S.). The international response to the 2009 H1N1 influenza stands as a cautionary tale about how prepared the world is for such an emergency. Although the pandemic fortunately proved to be less severe than initially anticipated, it nevertheless resulted in shortages of medical equipment, overburdened hospitals, and preventable patient deaths, particularly among young people.

A pandemic will inevitably lead to difficult decisions about the allocation of medical resources, such as who will have priority access to ventilators and critical care beds when …

Toward Coherent Federal Oversight Of Medicine, Patricia J. Zettler

Faculty Publications By Year

The conventional wisdom in U.S. health law and policy holds that states regulate medical practice – the activities of physicians and other health care professionals – while the federal government regulates medical products. But relying on states as the principal regulators of medical practice has, at times, driven law and policy in directions that are problematic from a public health perspective, as demonstrated by a deadly 2012 outbreak of fungal meningitis that was linked to a state-regulated practice known as drug compounding. This Article argues that the federalism concerns underlying the conventional wisdom are misplaced. It demonstrates that, contrary to …

The Influence Of Self-Reported Degree Of Masculinity/Femininity On Condom Use Among Black Men Who Have Sex With Men In The Deep South, Elizabeth D. Peeler

Theses and Dissertations

In the United States, 50,000 Americans are diagnosed with HIV each year (CDCa, 2014). The HIV/AIDS epidemic has had a particularly devastating impact on the southern U.S., especially the Deep South – Alabama, Georgia, Louisiana, Mississippi, North Carolina, and South Carolina (Reif, Whetten, Wilson, McAllaster, Pence, Legrand, & Gong, 2014). The Deep South, while only composing of 36% of the national population, accounts for 50% of all people living with HIV/AIDS in the nation (Human Rights Watch, 2010). No other population has been hit harder than men who have sex with men (MSM; Prejean, Tang, & hall, 2013). Black MSM …

Food Security Status And Life Events Among Households With Children In The Midlands Of South Carolina, Erin Rebekah Drucker

Theses and Dissertations

Purpose: Food insecurity is a major public health problem in the United States (US) with 14.5% of US households having experienced some level of food insecurity in 2012. Among households with children, 20% experienced low food security in 2012, and in half of these households, both the children and adults were affected. Food insecurity among children can have lifelong negative health and mental effects. Life events are defined as self-­‐reported life changes, which create a strain on resources and an opportunity for food insecurity, Methods: The Midlands Family Study (MFS) was a cross-­‐ sectional study that surveyed households …

Maternal Obesity, Gestational Weight Gain And Offspring’S Asthma, Kristen Polinski

Theses and Dissertations

Introduction: Obesity is common among women of childbearing age and intrauterine exposures may influence the development of early childhood asthma. A handful of studies have investigated pre-pregnancy obesity, but even fewer have thoroughly explored gestational weight gain as possible childhood asthma risk factors. Gaps remain in the literature and to our knowledge, none have longitudinally explored these relationships in a nationally representative sample of U.S. children.

Methods: We used data from the Early Childhood Longitudinal Study – Birth Cohort, in which children were followed through age four (n≈5,200). Asthma was based on parent report of a physician’s diagnosis. …

Interpregnancy Weight Change And Adverse Maternal Outcomes, Chelsea Lynes

Theses and Dissertations

Obesity during pregnancy is associated with a high risk of adverse maternal outcomes. Little is known about how weight change between consecutive pregnancies impacts subsequent pregnancy complications and newborn outcomes. This study aimed to explore the association between interpregnancy BMI change and adverse maternal outcomes, specifically, gestational diabetes mellitus (GDM), gestational hypertension, pre-eclampsia, non-repeat cesarean delivery (C-section), and vaginal birth after cesarean delivery (VBAC). The study sample was derived from the Eunice Kennedy Shriver National Institute of Child Health and Human Development Consecutive Pregnancy Study, which collected data from 20 hospitals in Utah utilizing electronic medical records and International Classification …

Ethnic Discrimination: Measurement And Associations With Smoking-Related Outcomes Among Arab Male Current And Former Smokers In Israel, Amira Osman

Theses and Dissertations

We evaluated the psychometric properties of two instruments used to assess ethnic discrimination among Arabs in Israel. The “Experiences of Discrimination” (EOD) scale was adapted to assess interpersonal ethnic discrimination (EOD-A) and a new measure was developed to assess perceptions of institutional group discrimination (IGD) against Arabs as an ethnic group. Then, we examined the association between each form of ethnic discrimination (interpersonal and institutional) and smoking outcomes among Arab men from Israel, and whether social support and coping efficacy moderate these associations. Data were analyzed from a cross-sectional study of Arab male current and former smokers, aged 18-64. A …

Geographic Accessibility To Health Services And Neonatal Mortality Among Very Low Birthweight Infants In South Carolina, Portavia Featherstone

Theses and Dissertations

Introduction: Infant mortality is commonly denoted as a marker of population health with more than half of all infant deaths occurring during the neonatal period (0-27 days) of infancy. Mortality for infants born very low birthweight (<1500 grams) is markedly higher than the babies born with normal birthweight (2500-4000 grams). The purpose of this research project was to assess geographic access to perinatal health services and the risk of neonatal death among infants born with very low birth weight. Data and methods: The linked birth and death records of a retrospective cohort of very low birthweight (<1500 grams) infants born in South Carolina between the years 2010 and 2012 were used (n=3191). We assessed the impact of travel time from maternal residence to delivery hospital and travel time from maternal residence to the nearest prenatal care provider (obstetricians/gynecologists, community health center, or rural health clinic). Logistic regression modeling was performed with adjustments for maternal characteristics (race, age, chronic/gestational hypertension, chronic/gestational diabetes mellitus, smoking, prenatal care), newborn characteristics (gestational age, birthweight, gender, NICU admission at birth), and the birth in a level III hospital. Results: There were a total of 563 neonatal deaths in this population and the neonatal mortality rate was 17.64 neonatal deaths per 100 live births. We did not find significant associations of travel time from maternal residence to delivery hospital and to a closest prenatal care provider with neonatal death after adjusting for confounders. However, we found that a one-week increase in gestational age (OR: 0.61 [95% CI: 0.57-0.65]) and non-Hispanic Black mothers (versus non-Hispanic White mothers) (OR: 0.65 [95% CI: 0.45-0.94]), were associated with the lower odds of neonatal death, while non-NICU admission at birth (OR: 5.99 [95% CI: 4.05-8.84]) was associated with an increased odds of neonatal death. Conclusion: Although we did not find that travel time was associated with neonatal mortality among very low birthweight infants, our study identified a few significant correlates for neonatal deaths in this birthweight group. Future studies should investigate the role of geographic access to care on mortality during other periods of infancy and among other birthweight groups.

Cluster Analysis With Batch Effect, Yifan Tang

Theses and Dissertations

Clustering, as a fundamental process in data science, is frequently used in preliminary data analysis. Batch effects are a powerful source of variation that can come from many sources in data collection, and influence data. We propose a method to simultaneously remove batch effects and perform cluster analysis. We see a batch effect as a fixed value added on to each batch, and do not make assumptions about the distribution of batch effects. We represent the data using a Gaussian mixture model, and use the EM algorithm to estimate the cluster means, the cluster covariance matrices, and the batch effects, …

Examination Of Racial/Ethnic Disparities In Ovarian Cancer Stage Of Diagnosis, Surgery Treatment And Survival: Multilevel Analysis Of 2001-2012 Seer Data, Chen Chen

College of Graduate Studies: Theses & Dissertations

Context. Racial/ethnic disparities in cancer outcomes are major public health concerns. Ovarian cancer is the tenth most common cancer and the fifth leading cause of cancer-related deaths among women. Identifying individual- and contextual-level factors contributing to racial/ethnic disparities in ovarian cancer stage of diagnosis, surgery treatment and survival is necessary for reducing and eliminating these disparities.

Objective. The study aims to examine racial/ethnic disparities in ovarian cancer diagnosis, surgery treatment and survival outcomes; to explore individual- and contextual-level factors contributing to these disparities, and to examine the trend of ovarian cancer racial/ethnic disparities from 2001 to 2012.

Methods. The …

Age-Related Factors Influencing The Occurrence Of Undernutrition In Northeastern Ethiopia, Abraham Degarege, Elifaged Hailemeskel, Berhanu Erko

Journal Articles: Epidemiology

BACKGROUND: Undernutrition is a major public health problem on the globe particularly in the developing regions. The objective of the current study was to assess the prevalence of undernutrition in different age groups and examine the relationship of the disease to parasitic and socioeconomic factors among communities in Harbu Town, northeastern Ethiopia.

METHODS: Stool samples of the study participants were examined for intestinal helminth infections using the Kato-Katz method. Blood specimens were diagnosed for Plasmodium infection using CareStartTM Malaria Pf/Pv Combo test. The blood type was determined from blood samples using antisera A and antisera B. In addition, the height …

Incomplete Adherence Among Treatment-Experienced Adults On Antiretroviral Therapy In Tanzania, Uganda And Zambia, Julie A. Denison, Olivier Koole, Sharon Tsui, Joris Menten, Kwasi Torpey, Eric Van Praag, Ya Diul Mukadi, Robert Colebunders, Andrew F. Auld, Simon G. Agolory, Jonathan Kaplan, Modest Mulenga, Gideon Kwesigabo, Fred Wabwire-Mangen, David Bangsberg

OHSU-PSU School of Public Health Faculty Publications and Presentations

Objectives—To characterize antiretroviral therapy (ART) adherence across different programmes and examine the relationship between individual and programme characteristics and incomplete adherence among ART clients in sub-Saharan Africa.

Design—A cross-sectional study.

Methods—Systematically selected ART clients (≥18 years; on ART ≥6 months) attending 18 facilities in three countries (250 clients/facility) were interviewed. Client self-reports (3-day, 30-day, Case Index ≥48 consecutive hours of missed ART), healthcare provider estimates and the pharmacy medication possession ratio (MPR) were used to estimate ART adherence. Participants from two facilities per country underwent HIV RNA testing. Optimal adherence measures were selected on the basis of degree of association …

Development Of Population Protective Procedures For A Radiological Event, Daniel A. Baker

Master of Public Health Program Student Publications

Objective: The purpose of this investigation was to evaluate the execution of emergency preparedness procedures of the west central Ohio region during a radiological event. Preparedness plans were generated by the Dayton Metropolitan Medical Response System and Public Health – Dayton and Montgomery County, which would later be disseminated to eight counties in west central Ohio.

Methods: Two live scenarios, a region-wide functional exercise and a Medical Reserve Corps training exercise, were used to test different procedures and protocols for a radiological event relevant to various first response agencies (public health, law enforcement, emergency medical systems, hospitals, etc.). Exercise evaluation …

Healthcare Industry Injuries By Patient Contact Status In Kentucky, 2012-2014, Kristen Ranzenberger

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Objectives

The healthcare industry continues to have a high number of reported injuries. The purpose of this study was to 1) characterize healthcare industry injuries by patient contact status; 2) identify the occupations associated with healthcare injuries by patient contact status; and 3) determine healthcare injury rates by occupation, to gain a better understanding of healthcare industry compensated injuries , and better target healthcare industry safety practices and programs.

Methods

Workers’ Compensation first reports of injuries (FROI) from the healthcare industry in Kentucky were categorized into injuries involving in direct patient contact vs. injuries without direct patient contact using narrative …

Rural Healthcare Worker's Willingness To Report To Work During Catastrophic Events, Aaron M. Macdonald

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

In the events leading up to, during, and following a catastrophic event, healthcare workers play a critical role in the outcome of these events. Therefore it is of the utmost importance that healthcare workers are able and willing to report to work. Prior to September, 2001 there had been three willingness to report studies published in the literature. Post September, 2001 and up until 2011 there was a renewed interest in the topic which led to the publishing of twenty plus papers on the topic. The current literature has examined willingness to report thoroughly and definitively; however, there is a …

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 …

Gender Difference When Processing Death By Suicide: Attitudes Amongst Third Level Students Aged 18-25 Attending Cork Institute Of Technology And College Support Professionals, Sandra Conroy

Masters

Rationale behind research: Survivors of suicide/ suicide bereaved face unique challenges in their grief, resulting in a greater risk of conditions such as complicated grief, PTSD and suicidal ideation developing (Young, Iglewicz, Glorioso, Lanouette, Seay, llapakurti & Zisook, 2012). In dealing with or 'processing' the loss of a loved one by suicide, Wertheimer details that, "suicidal thoughts are not uncommon during the early months of bereavement" (1991: 178). The incidence of young men dying by suicide is notably higher than that of women in this country; a stubborn gender difference persists in Ireland with males representing on average 80% of …

Breast Cancer Screening For African American Women, Jennifer Ross

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

INTRO Breast cancer is the most common type of malignancy among women in the United States (U.S.) and the second leading killer. Despite the availability of effective breast screening tools, a disparity has formed. Specifically, white women over the age of 40 experienced a higher incidence rate of breast cancer, while African American women experience higher related mortality rate. The purpose of this study was to examine SES and ethnicity/race factors that may influence breast cancer screening rates, and specifically explore how those factors may differ between African American and white women.

METHODS Women between the ages of 50-74 who …

Impact Of Kentucky Vaccination Exemption Laws On Pertussis Incidence, Katherine Blain

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Purpose: According to CDC statistics, prior to pertussis vaccine development in the 1940’s, about 200,000 children contracted pertussis annually. Today, although this number has decreased drastically, pertussis cases began trending upward again in the 1980’s. There are several proposed contributory factors, including vaccination exemption. In Kentucky, there are both medical and religious exemptions to mandatory school vaccines. The purpose of this study was to examine possible correlations between reported school vaccination exemptions and pertussis incidence in Kentucky counties between the years 2004-2012.

Methods: This study retrospectively analyzed data from 120 Kentucky counties between 2004-2012. The Commonwealth of Kentucky School Annual …

Demographic Disparities In Children With Behavioral Or Conduct Disorders, Caitlin Dunworth

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

This study examines the demographic disparities in children with externalizing behavior disorders, such as oppositional defiant disorder and conduct disorder, utilizing secondary data from the 2011/2012 National Survey of Children’s Health (NSCH). Current literature suggests that children with externalizing behavior disorders are more likely to be male, live in a low-­‐income family, receive lower grades in school, and to develop later conditions such as depression. Chi square tests and logistic regression were used to examine the associations of presence of a current behavioral or conduct problems with age group, race/ethnicity, sex, household income level, and insurance type. Additionally, associations were …

Fatal Injuries Among Young Workers In Kentucky, 2005-2014, Allison Christian

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Background: Young workers have been more vulnerable to fatal and nonfatal work injuries. To gain a comprehensive understanding of the injuries that led to fatalities in younger workers, the goal of this study was to compare characteristics of young worker fatal injuries in those aged 16-24 to all workers aged 25 and older in Kentucky using a descriptive analysis.

Methods: A retrospective analysis of fatalities among workers under the age of 25 compared to workers aged 25 and older was performed over a ten-year period from 2005-2014 using Kentucky Fatality Assessment and Control Evaluation (FACE) program data.

Results …

Pulmonary Function Among Latino Thoroughbred Workers - A Pilot Study, John C. Flunker

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Background/Objectives

Evidence suggests working in horse barns is associated with adverse respiratory effects among Latino thoroughbred workers, yet no studies to date have measured pulmonary function. We examined the prevalence of self-reported respiratory symptoms, abnormal pulmonary function, and associated occupational factors among Latino thoroughbred farmworkers.

Methods

Participants were recruited via a community-based, purposive sampling strategy and participated in an interview-administered survey and spirometer test. Surveys and spirometry tests were administered to 80 participants by two trained health promoters (Promotoras) in July-September 2014. Pulmonary function (abnormal/normal) was classified by a pulmonologist. Demographic and occupational factors were assessed for associations with respiratory …