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Global Health And The Law, Lawrence O. Gostin, Devi Sridhar

Georgetown Law Faculty Publications and Other Works

The last two decades have brought revolutionary changes in global health, driven by popular concern over AIDS, novel influenzas, and maternal mortality. Given the rapid globalization that is a defining feature of today’s world, the need for a robust system of global health law has never been greater. Global health law has been defined as the legal norms, processes, and institutions designed primarily to attain the highest possible standard of physical and mental health for the world’s population. Global health law is not an organized legal system, with a unified treaty monitoring body, such as the World Trade Organization. There …

Coal Ash And Children's Sleep : A Community-Based Study., Clara G. Sears

Electronic Theses and Dissertations

Kentucky is the fifth largest producer of coal ash, a by-product of coal combustion. The small spherical coal ash particles contain heavy metals like arsenic, lead, mercury, and cadmium. Coal ash is currently classified as nonhazardous by the EPA, which allows it to be stored in open-air impoundments near low-income communities. The primary object of the study is to determine the prevalence of sleep disruptive behaviors in children exposed to coal ash, compared to a group of demographically similar non-exposed children. Parents or guardians from five neighborhoods surrounding a coal ash storage facility, and one non-exposed community, participated in a …

Determinants Of Head And Neck Cancer Survival In Nevada For 1995-2008, Xiao Q. Li

UNLV Theses, Dissertations, Professional Papers, and Capstones

Head and neck cancer (HNC), also known as oral cavity and pharyngeal cancer, comprises a group of cancers that arise in the head or neck region, such as the nasal cavity, sinuses, lips, mouth, salivary glands, and pharynx. Use of tobacco, alcohol, or a combination of the two, are major risk factors for head and neck cancer. Approximately 75% of oral cancers are attributable to smoking and/or alcohol consumption. More recently, the human papilloma virus (HPV) has also been associated with the development of head and neck cancer.

The objective of the present study is to investigate head and neck …

University Students And The Risk Of Hiv And Other Sexually Transmitted Infections In Uganda: The Crane Survey., George W. Rutherford, Andrew Anglemyer, Danstan Bagenda, Michael Muyonga, Christina P. Lindan, Joseph L. Barker, Lisa Johnston, Wolfgang Hladik

Journal Articles: Epidemiology

Adolescents and young adults are at high risk of human immunodeficiency virus (HIV) infection in sub-Saharan Africa. Previous reports have found that university students in Africa comprise a sexually active population, although the prevalence of HIV or sexually transmitted infections (STI) has not been measured. We conducted a cross-sectional survey of students from five large universities in Kampala, Uganda, using respondent-driven sampling. We asked students to complete behavioral questionnaires and provide biological samples to test for HIV, Chlamydia trachomatis, Neisseria gonorrhoeae, Treponema pallidum, Trichomonas vaginalis, and bacterial vaginosis. We enrolled 649 students and obtained interpretable data from 640. Around 50% …

Cognitive Decline And Polypharmacy In An Elderly Population., Ximena A. Oyarzun Gonzalez

Electronic Theses and Dissertations

Aging is associated with increased risk of chronic disease, comorbidities, and greater medication use. Polypharmacy, the concomitant use of 5 or more medications, has been associated with adverse health effects, and potentially cognitive decline. The proposed hypothesis is that polypharmacy increases the risk of cognitive decline in elderly people. Using longitudinal data from 572 participants from the New Mexico Aging Process Study cohort, the impact of polypharmacy on the Mini Mental State Examination (MMSE) scores and Mild Cognitive Impairment (MCI) was studied. The statistical analyses were performed using mixed linear regression multivariable models and generalized estimating equations, adjusting for important …

Latinas And The Traditional Genetic Counseling Model: A Qualitative Study, Stephanie Thompson

Dissertations and Theses (Open Access)

The traditional genetic counseling model reflects an individualized counseling session that includes the presentation of information about genes, chromosomes, personalized risk assessment, and genetic testing and screening options. Counselors are challenged to balance providing educational information with discussion of implications of this information in an allotted amount of time. The aim of this study was to explore the perceptions of pregnant Latinas on the benefits and limitations of the traditional prenatal genetic counseling model and to determine the specific preferences for receiving prenatal genetic counseling. Data were collected through focus groups and one-on-one, semi-structured interviews of twenty-five Spanish speaking Latinas …

Vitamin D Status Of College Students: Implications For Health Leaders, Eileen M. Cress

Electronic Theses and Dissertations

Vitamin D deficiency is considered to be a pandemic with implications for compromised bone health and other chronic diseases. Few studies have examined vitamin D status in college-aged individuals where prevention of future health consequences is still possible. Serum vitamin D 25(OH)D status and vitamin D intake were examined in 98 college students ages 18-29 years during winter. BMI was classified as < 25and 25 or greater. Race was categorized as Caucasian or other. Overall, 69.5% had suboptimal serum vitamin D levels, <30ng/mL. Only 8 students (8.2%) met the EAR (400 IU) per day for vitamin D intake. t tests were used to determine if there were significant differences in serum vitamin D level and dietary intake based on gender, race and BMI. Significant differences were found in serum vitamin D level when compared by gender and race. Females tended to have a higher serum vitamin D level than males. Those representing minorities had lower serum vitamin D levels than Caucasians; One hundred percent of the minority students had suboptimal serum vitamin D levels. Based on these findings, dietitians should increase efforts to target college-aged individuals in educational programming related to factors affecting vitamin D synthesis, vitamin D intake, and health consequences of suboptimal vitamin D status, particularly in winter. Consideration should be given to vitamin D fortification of foods that meet the preferences of today’s consumer.

Development Of A Molecular Method For Detecting The Causative Agent Of Swimmer's Itch (Trichobilharzia) In Freshwater Ecosystems, Heidi Mcmaster

UNLV Theses, Dissertations, Professional Papers, and Capstones

Cercarial dermatitis, commonly known as swimmer's itch, is caused by penetration of larvae of the schistosome,Trichobilharzia, into the dermis and epidermis layers of the skin. Symptoms are characterized by painful swelling and itching at the site of penetration. The normal hosts for the life cycle of the schistosome are aquatic birds and aquatic snails. The most frequently used method of detection forTrichobilharziais microscopy. With increases in the occurrence of cercarial dermatitis outbreaks in freshwater in the Southwestern United States, it is becoming increasingly important to develop and standardize a molecular method for rapid detection that can assist health professionals and …

Assessing The Impacts Of Unrestricted Pesticide Use In Small-Scale Agriculture On Water Quality And Associated Human Health And Ecological Implications In An Indigenous Village In Rural Panam[Aacute], Sarah Louise Watson

USF Tampa Graduate Theses and Dissertations

In 2014, the global pesticide industry's projected worth is $52 billion and by 2020, the developing world will make up one-third of the world's chemical production and consumption. Pesticides can have unintended negative consequences for human health and the environment, especially in the developing world where regulations are loose or nonexistent. One country with unrestricted use of pesticides is Panam[aacute], especially in Santa Rosa de Cucunatí. In this indigenous village, small-scale farmers and ranchers spray paraquat, glyphosate, picloram, and 2,4-D at higher elevations than the spring water source of a gravity-fed water system, the river, and the village. The objective …

Knowledge, Attitude And Practices Regarding Hiv/Aids Among Adult Fishermen In Coastal Areas Of Karachi., Mubashir Zafar, Nighat Nisar, Masood Kadir, Zafar Fatmi, Zeeshan Ahmed, Kashif Shafique

Community Health Sciences

BACKGROUND:

Migrant populations are at high risk of Human Immuno Deficiency Virus infection (HIV) and Acquired Immunodeficiency Syndrome (AIDS). Studies of HIV/AIDS knowledge, attitudes and practices among fishermen in developing countries have shown gaps in knowledge and fear of contagion with ambivalent attitudes towards HIV/AIDS and inconsistent universal precautions adherence. The aim of this study was to determine the knowledge, attitude and practices regarding HIV/AIDS among adult fishermen in a coastal area of Karachi, Pakistan.

METHODS:

Community based cross sectional study was conducted among fishermen in coastal area of Karachi from June to September 2012. A total of 297 adult …

Long-Term Mindfulness Meditation: Anxiety, Depression, Stress And Pain, Is There A Connection For Public Health?, Sara Spowart

USF Tampa Graduate Theses and Dissertations

Long-term mindfulness meditation for anxiety, depression, pain and stress has not been adequately investigated in academic literature. The majority of literature in relation to mindfulness meditation and these ailments concerns Kabat-Zinn's Mindfulness-Based Stress Reduction (MBSR) program. This is a short-term 6-8 week program that requires a licensed professional, is limited in availability, high cost, and combines other elements aside from mindfulness meditation, such as yoga, martial arts, group discussion, poetry and other teaching techniques meant to increase mindfulness concentration. Furthermore, efficacy studies, which have assessed the long-term impact of MBSR are inconclusive. Although these studies on long-term practice demonstrate a …

Physical And Mental Health Status Of Adults With Serious Mental Illness Participating In A Jail Diversion Intervention, Robin Telford

USF Tampa Graduate Theses and Dissertations

Adults with mental illnesses are at an increased risk to be diagnosed with one or more comorbid physical illnesses compared to the general population. Much of the disparities faced by adults with serious mental illnesses (SMI) can be attributed to medication side effects, increased risk for metabolic diseases, inability to communicate about severity and monitor physical health symptoms, poor health behaviors, high rates of smoking, and poor quality health care. The rate of physical illnesses for adults with mental illnesses are even higher among those who have been involved with the criminal justice system. In order to understand the relationship …

Drinking Water In The Developing World: Sources Of Fecal Contamination In Pitcher Pump Systems And Measurement Alternatives, Meghan Wahlstrom

USF Tampa Graduate Theses and Dissertations

It has been reported that globally we have achieved Millennium Development Goal (MDG) Target 7C, to halve the proportion of the population without access to safe drinking water; however, there is a major flaw with this statement. While Target 7C calls for access to `safe' drinking water, what is actually being measured and reported is access to an `improved' water source. The World Health Organization (WHO) maintains that they must use this proxy measure because the methods for water quality testing are too expensive and logistically complicated, but by doing so, they may be over reporting safe water coverage.

This …

The Relationship Among School Playground Design And Conditions And Physical Activity Levels In Children, Ipuna Estavillo Black

UNLV Theses, Dissertations, Professional Papers, and Capstones

Almost 20% of children aged 6 to 11 years are obese in the United States, tripling over the last ten years. The rise in childhood obesity challenges nurses in their efforts to improve community health and sustainability. A decrease in physical activity (PA) levels has been associated with an increase in obesity. Schools have been identified as a primary setting to provide children adequate amounts of daily PA, and nurses working in the area of child health promotion can work with schools to provide opportunities for children to increase PA levels. The playground is one environment where children can increase …

Determining The Presence Of Carbapenem Antibiotic Resistance In Clinical Isolates, Fidelis Uzoma Enyinnaya

UNLV Theses, Dissertations, Professional Papers, and Capstones

Carbapenems are β-lactam antibiotics reserved for the treatment of severe microbial infections, especially those targeting the Enterobacteriaceae. Introduced in the 1980s, carbapenems have been used successfully in hospitals, and in the 1990s resistance was discovered. Carbapenem resistance is conferred through the production of carbapenemases. In the U.S., the most common carbapenemase is Klebsiella pneumoniae carbapenemase (KPC). In 2012, the National Healthcare Safety Network reported a carbapenem resistance rate of 13.0% among Klebsiella pneumoniae infections, and indicated that the mortality rate associated with carbapenem resistant Enterobacteriaceae (CRE) infections ranged from 48.0-71.9%. According to the Food and Drug Administration (FDA), carbapenem resistance …

Health Care In The Motor City: Thriving Or Surviving?, Sally Coberly, William J. Scanlon

National Health Policy Forum

This site visit explored the forces shaping the delivery of health care in Detroit. Health care providers in Detroit face the twin challenges of controlling costs and serving a bifurcated metropolitan area that includes large numbers of uninsured, low-income, and vulnerable residents as well as more prosperous residents of a reviving inner core and the surrounding suburbs and counties. The program looked at the underlying economic, social, and physical conditions that make improving the health of the city's residents extremely challenging. Efforts to contain costs through payment innovations such as the Blue Cross Blue Shield of Michigan's Physician Group Incentive …

Tumor Microenvironment-Based Feed-Forward Regulation Of Nos2 In Breast Cancer Progression, Julie L. Heinecke, Lisa A. Ridnour, Robert Y.S. Cheng, Christopher H. Switzer, Michael M. Lizardo, Chand Khanna, Sharon A. Glynn, S. Perwez Hussain, Howard A. Young, Stefan Ambs, David A. Wink

United States Public Health Resources

Inflammation is widely recognized as an inducer of cancer progression. The inflammation-associated enzyme, inducible nitric oxide synthase (NOS2), has emerged as a candidate oncogene in estrogen receptor (ER)-negative breast cancer, and its increased expression is associated with disease aggressiveness and poor survival. Although these observations implicate NOS2 as an attractive therapeutic target, the mechanisms of both NOS2 induction in tumors and nitric oxide (NO)-driven cancer progression are not fully understood. To enhance ourmechanistic understanding of NOS2 induction in tumors and its role in tumor biology, we used stimulants of NOS2 expression in ER- and ER+ breast cancer cells and examined …

Drug Use And Social Support Outcomes In Probationers: A Longitudinal Social Network Analysis, Anne Rhodes

Theses and Dissertations

This study focuses on the social networks of probationers, who comprise the largest segment of the criminal justice population in the United States, but about whom there are few studies of network processes. It provides information on how elements of a probationer’s social network change over time and can affect drug use. This study employs longitudinal analysis of the social networks for 251 substance abusers on probation to examine how these networks are influenced by an intervention designed to increase pro-social behaviors and how network changes impact drug use. Baseline drug use of the probationers was examined according to the …

Adverse Health Effects Of Intestinal Parasitic Infections In Rural Peruvian Clinic Patients, Jonathan M. Stofer

Master of Public Health Program Student Publications

Intestinal Parasitic Infections (IPIs) pose a significant global health concern. IPIs annually contribute to 3.5 billion infections and 450 million illnesses worldwide. In hyperendemic countries, IPIs pose a significant economic and health burden, especially in rural areas. IPIs have many routes of transmission and cause a wide range of symptoms associated largely with poor health, impeded growth, and worsening of secondary infections. Such diseases are widespread in poor communities living in the Peruvian Amazon. This study aims to describe common chief complaints, diagnoses, treatments, as well as behaviors and practices associated with IPIs presenting in clinic patients. As part of …

Federal Disaster Declarations And Denials: Analyzing Spatial Equity In The Implementation Of The Stafford Act, Richard Salkowe

USF Tampa Graduate Theses and Dissertations

Federal disaster declarations are authorized by the president under the provisions of the Robert T. Stafford Disaster Relief and Emergency Assistance Act of 1988. Prior studies have found varying levels of political influence associated with the declaration process. Factors including electoral votes, reelection years, congressional committee appointments, geographic location, and party favoritism have been implicated in claims of inequity associated with the distribution of federal disaster assistance. Compounding these concerns is evidence of recurring problems associated with disparities in the long-term recovery from disasters based on social and economic factors. This dissertation is a response to the call for further …

The Effects Of Size On Ag Nanosphere Toxicity In Macrophage Cell Models And Lung Epithelial Cell Lines Is Dependent On Particle Dissolution, Raymond F. Hamilton, Sarah Buckingham, Andrij Holian

Public and Community Health Sciences Faculty Publications

Silver (Ag) nanomaterials are increasingly used in a variety of commercial applications. This study examined the effect of size (20 and 110 nm) and surface stabilization (citrate and PVP coatings) on toxicity, particle uptake and NLRP3 inflammasome activation in a variety of macrophage and epithelial cell lines. The results indicated that smaller Ag (20 nm), regardless of coating, were more toxic in both cell types and most active in the THP-1 macrophages. TEM imaging demonstrated that 20 nm Ag nanospheres dissolved more rapidly than 110 nm Ag nanospheres in acidic phagolysosomes consistent with Ag ion mediated toxicity. In addition, there …

Childhood Obesity And Familial Hypercholesterolemia: Genetic Diseases That Contribute To Cardiovascular Disease, Alyssa Caudle

Senior Honors Theses

Childhood obesity occurs as the result of an imbalance between caloric intake and energy expenditure. Genetic risk factors for obesity have become an area of research due to its permanency. Mutated genes such as Fat Mass and Obesity Associated (FTO), Leptin (LEP), Leptin Receptor (LEPR), Melanocortin 4 Receptor (MC4R), Adiponectin C1Q and Collagen Domain Containing (ADIPOQ), Proprotein Convertase Subtilisin/Kexin Type 1 (PCSK1), and Peroxisome Proliferator-Activated Receptor Gamma (PPARG) all contribute to the development of childhood obesity. In the presence of high cholesterol caused by obesity, the genetic condition known as familial hypercholesterolemia is exacerbated. Familial hypercholesterolemia is caused by a …

Frailty And Depression: A Latent Trait Analysis, Matthew Lohman

Theses and Dissertations

Background: Frailty, a state indicating vulnerability to poor health outcomes, is a common condition in later life. However, research and intervention progress is hindered by the current lack of a consensus frailty definition and poor understanding of relationships between frailty and depression. Objectives: The goal of this research is to understand the interrelationships between frailty and depression among older adults. Specifically, this project aims 1) to examine the construct overlap between depression and three definitions of frailty (biological syndrome, medical burdens, and functional domains), 2) to determine the degree to which this overlap varies by age, gender, race/ethnicity and other …

Perinatal Distress In Women In Low- And Middle-Income Countries: Allostatic Load As A Framework To Examine The Effect Of Perinatal Distress On Preterm Birth And Infant Health, Shahirose Sadrudin Premji

School of Nursing & Midwifery

In low- and middle-income countries (LMIC), determinants of women's and children's health are complex and differential vulnerability may exist to risk factors of perinatal distress and preterm birth. We examined the contribution of maternal perinatal distress on preterm birth and infant health in terms of infant survival and mother-infant interaction. A critical narrative and interpretive literature review was conducted. Peer-reviewed electronic databases (MEDLINE, Embase, Global Health, CINHAL), grey literature, and reference lists were searched, followed by a consultation exercise. The literature was predominantly from high-income countries. We identify determinants of perinatal distress and explicate changes in the hypothalamic-pituitary-adrenal axis, sympathetic, …

Barriers Latin American Immigrant Women Face In Accessing Reproductive Health Services In The United States, Isabel Odean

Annual Undergraduate Conference on Health and Society

Immigration and reproductive health care are two high profile topics in the politics of the United States. Both are constantly on the news, with ongoing debates about policies and reform. However, the link between the two topics gets very little media coverage. In this paper, I will address some of the overlap, looking at the question: what are the barriers for Latina immigrant women in accessing reproductive health care? Immigrant women in the United States face pronounced barriers in accessing reproductive health care, legally, socially, and culturally. These barriers stem from a history of political control of immigrant women’s reproduction, …

Defining Obesity: An Argument For The Social Environment Perspective, Meghan Mcinnis

Annual Undergraduate Conference on Health and Society

It is well documented that obesity is a growing problem in the U.S. and worldwide. By 2010, 35.9% of U.S. adults age 20 and older were obese (Overweight and Obesity, CDC). Obesity has been associated with many health problems, including hypertension, type 2 diabetes, osteoarthritis, stroke, and cardiac disease (Lucey, 2008, p.202). What has just been described is the traditional, medicalized narrative of obesity. In this narrative, obesity is viewed as an epidemic that demands an immediate and widespread response (Lucey, 2008, p.202). The blame is placed largely on individuals, while social factors, such as socioeconomic status and neighborhood environment, …

Cardiovascular Disease Risk Among The Mexican American Population In The Texas-Mexico Border Region, By Age And Length Of Residence In United States, Jennifer J. Salinas, Bassent Abdelbary, Anne R. Rentfro, Susan P. Fisher-Hoch, Joseph B. Mccormick

Physician Assistant Studies Faculty Publications

Introduction: Although the relationship between health behaviors and outcomes such as smoking and obesity with longer residence in the United States among Mexican American immigrants is established, the relationship between length of residency in the United States and risk for cardiovascular disease (CVD) is not fully understood. The objective of this study was to determine the relationship between immigrant status, length of residence in the United States, age, and CVD markers in a sample of Mexican American adults living in Brownsville, Texas.

Methods: We categorized participants in the Cameron County Hispanic Cohort study as immigrants in the United States for …

Demographic Makeup And Population Projections For Southern Nevada: Understanding The Emerging Healthcare Needs In Our Community, Jennifer Pharr, Courtney Coughenour, Shawn Gerstenberger

Nevada Journal of Public Health

Even with a leveling-off of population growth from 2008 to 2011, Southern Nevada had one of the fastest growing populations in the nation over the past decade. While population growth is projected to increase for the next ten years, the rate of growth will be slower than in the past decade. The Hispanic population, as a percentage of the total population, is projected to surpass the White population somewhere near the year 2030. The Southern Nevada population is aging, as the median age in the region increased between 2000 and 2010. The 65+ age group is projected to increase as …

Analysis Of The Morbidity And Mortality Of Severe Influenza Infection In Clark County, Nevada For The 2010-2011 Influenza Season, Kindra St. Jacques, Patricia Cruz, Brian Labus

Nevada Journal of Public Health

Throughout the duration of any influenza season, influenza strains have the ability to evolve through mutation causing alterations in virulence. These changes may result in severe illness or death among susceptible populations; therefore, it is important to closely monitor influenza-associated hospitalizations and deaths. The University of Nevada, Las Vegas in collaboration with the Southern Nevada Health District analyzed data from the hospitalized influenza morbidity and mortality surveillance project for Clark County for the 2010-2011 influenza season. Among the study population (N= 158): the influenza strain type was found to be significantly associated with deaths (n= 25), vaccination status was not …

Politics Of Health: The 2013 Integration Policy’S Effect On Immigrant Access To Care, Amy Chang

Independent Study Project (ISP) Collection

In September of 2013, King Mohammed VI announced a regularization campaign, implementing a new policy of integration with respect to undocumented immigrants in the country. Deviating from former official discourse, the new measure allowed in principle for—among provision of residence cards and lifted criminalization of undocumented immigrants—greater immigrant access to healthcare services. The purpose of the following research was to assess whether the effects of this new provision are being positively felt on the ground in ensuring inclusivity of health services.Individual interviews on personal experiences with the Moroccan healthcare system were held with members of various immigrant sub-populations: refugees, asylum …