Digital Commons Network^™

El Uso Escondido De Anticonceptivos Modernos: Una Reflección Del Machismo De Los Hombres Y El Empoderamiento De Las Mujeres En El Alto Y La Paz, Kathleen Elizabeth Trocin

Independent Study Project (ISP) Collection

Contraception use has proven to be an extremely important public health issue in Bolivia since the later 20^th century given its relationship with the country’s high maternal and infant mortality rate in comparison to other nations in South America. In this research paper, I explore the hidden use of contraception in Bolivia. More specifically, I study women in the areas of El Alto and La Paz who hide their contraception use from their partners. This paper discusses machismo as the cause of the hidden use of contraception, the effects of hidden contraception use on the women, and the broader …

Influence Of Sexual Education On Sexual Behavior And Contraceptive Use Among 15 To 19 Year-Olds At Colégio Azevêdo Fernandes In Salvador, Brazil, Julia Still

Independent Study Project (ISP) Collection

Although sexual health education provided by the government through schools has shown positive results, such as those distributed by the Brazilian Ministry of Health, it is not the only source, nor the most implemented source, in which adolescents are exposed to and gain knowledge on the subjects of sexual behavior and sexual health. Just as Article 24 of the Convention on the Rights of the Child details, parents, schools and communities play important roles in the process of sexual education and are required to provide guidance and direction to youth (Pan American Health Organization, 2010). In addition to sexual health …

A Case Study Of Health Interventions And The Caste System: Addressing The Social Determinants Of Health Through Development At Crhp Jamkhed, Laura Kroart

Independent Study Project (ISP) Collection

In the Southeast Asian country of India, the ancient but in some cases still rigidly intact caste system plays a role in determining health status and outcomes for much of its population of over 1.2 billion people.[1] The Comprehensive Rural Health Project, located in Jamkhed in the state of Maharashtra, India, approaches health interventions from a development standpoint, addressing biomedical needs, structural and environmental concerns, and the social and economic determinants of health that impact the lives of over a million villagers in the surrounding area.[2] This independent study project was designed to analyze how the Comprehensive Rural …

Adoption Of Electronic Health Records By Admitting Physicians: A Heuristic Model, John Sharon Hudson

Health Services Research Dissertations

Background: Although hospital electronic health records (EHRs) are generally perceived to improve care, physician resistance may hinder EHR adoption.

Purpose: This study uses constructs from diffusion of innovations and resource dependence theories to predict adoption and rate of adoption of an EHR by admitting physicians from three of ten hospitals in a highly integrated health system in Virginia. Functions evaluated: computerized physician order entry (CPOE), electronic history and physical (EH&P) and electronic discharge summary (EDS). The study tested hypotheses that adoption would be associated with: working at larger, academic hospitals; financial alignment; larger physician groups; office EHR; youth; males; medical …

Role Of Breastfeeding And Current Lifestyle On Maternal Long-Term Weight Change, Denise R. Hinds

Loma Linda University Electronic Theses, Dissertations & Projects

Background: Evidence suggests that prolonged and exclusive breastfeeding is associated with health benefits to children and nursing mothers beyond the period of breastfeeding. Studies that support the role of breastfeeding in postpartum weight change primarily focused on short-term weight change (within 12 to 24 months postpartum) (Binns et al. 2003; Lederman 2004; Johnson et al. 2006), while few focused on the association between breastfeeding and long-term weight change (5 years or more postpartum) (Rooney, Schauberger et al. 2005).

Purpose: This study investigated the role of breastfeeding in long-term weight change, specifically 1) whether breastfeeding protects against weight gain, and 2) …

The Hospitalist: Better Value In Inpatient Care?, Lisa Sprague

National Health Policy Forum

From perhaps a few hundred practitioners in 1996 to an estimated 30,000 today, the discipline called hospital medicine has shown remarkably rapid growth. It represents a fundamental separation of the inpatient and outpatient components of internal and family medicine. The split has implications for the quality and efficiency of care delivery, the outlook for the physician workforce, and the development of new models such as accountable care organizations (ACOs).

Price, Access And Education At Philadelphia Farmers' Markets, Anna M. Quinn

Master of Public Health Capstone Presentations

Inadequate intake of fruits and vegetables is linked to chronic disease and obesity.   However, consumption rates of fruits and vegetables in the US and specifically in Philadelphia continue to fall short of recommendations for a healthy diet.  Access and price are two barriers in the food environment that prevent sufficient fruit and vegetable consumption. Farmers’ markets offer increased access to fruit and vegetables, yet continue to be perceived as being more costly than grocery stores. This study’s primary aim was to determine if the price of fruit and vegetables are more expensive at farmers’ markets than grocery stores in Philadelphia. …

Use Of Internet-Based Diabetes Self-Management Education: Emmi Solutions, Esther Pak

Master of Public Health Capstone Presentations

Diabetes is a serious public health problem in the United States and in Philadelphia. A 2007 CDC report stated that 7.8% in the US and 10.4% in Philadelphia had diabetes. While the key to managing one’s diabetes and lowering the risk of its adverse health outcomes is adherence to diabetes management guidelines, the prevalence of these behaviors among adult diabetics in the US remained relatively low. Attendance at a diabetes self-management class was particularly low (55.4%), which is of concern because of the importance of education in a patient’s adherence to diabetes-maintenance behaviors. Emmi Solutions recently developed three Internet-based diabetes …

Maternal Health Workforce Shortages In Southeast Pennsylvania, Jacqueline E. Kohl

Master of Public Health Capstone Presentations

Since 1997, 19 maternity wards have closed in Southeastern Pennsylvania, leaving only 23 to serve the women and families in the area.  Additionally, there have been reports of maternal health workforce shortages, causing many women difficulty in accessing the care they need.  This aims of this qualitative study were to define the problem of maternal health workforce shortages in the region and to identify potential solutions.  Ten key stakeholders were identified for participation.  A single researcher conducted interviews using a structured interview guide.  Results were analyzed for content and major themes by two researchers.    The eight sections include: 1. preconception …

Medicare's Bundling Pilot: Including Post-Acute Care Services, Laura A. Dummit

National Health Policy Forum

Fee-for-service Medicare, in which a separate payment is made for each service, rewards health care providers for delivering more services, but not necessarily coordinating those services over time or across settings. To help address these concerns, the Patient Protection and Affordable Care Act of 2010 requires Medicare to experiment with making a bundled payment for a hospitalization plus post-acute care, that is, the recuperative or rehabilitative care following a hospital discharge. This bundled payment approach is intended to promote more efficient care across the acute/post-acute episode because the entity that receives the payment has financial incentives to keep episode costs …

An Observation Of Immunological Effect, A Diet Enhanced With Spirulina And Treatment With Fractalkine In Models Of Parkinson's Disease, Mibel M. Pabón

USF Tampa Graduate Theses and Dissertations

In my dissertation research we used use human wild type α-synuclein gene expression using an adeno-associated viral vector (AAV9) that induced a slowly progressive loss of dopamine (DA) neurons in the Substantia nigra (SN) as one of our animal model of Parkinson’s disease (PD). It is our hypothesis that neuroinflammation predisposes the brain to susceptibility to neurodegenerative diseases. Thus we examined the progression of a PD lesion and examined the manipulations of the immune system to understand further the inflammatory role when we administered exogenous soluble fractalkine.

The specific etiology of neurodegeneration in PD is unknown, but the inflammatory mechanisms …

Engineered Nanomaterials: Exposures, Hazards, And Risk Prevention, Robert A. Yokel, Robert C. Macphail

Pharmaceutical Sciences Faculty Publications

Nanotechnology presents the possibility of revolutionizing many aspects of our lives. People in many settings (academic, small and large industrial, and the general public in industrialized nations) are either developing or using engineered nanomaterials (ENMs) or ENM-containing products. However, our understanding of the occupational, health and safety aspects of ENMs is still in its formative stage. A survey of the literature indicates the available information is incomplete, many of the early findings have not been independently verified, and some may have been over-interpreted. This review describes ENMs briefly, their application, the ENM workforce, the major routes of human exposure, some …

Threshold Regression Models Adapted To Case-Control Studies, And The Risk Of Lung Cancer Due To Occupational Exposure To Asbestos In France, Antoine Chambaz, Dominique Choudat, Catherine Huber, Jean-Claude Pairon, Mark J. Van Der Laan

U.C. Berkeley Division of Biostatistics Working Paper Series

Asbestos has been known for many years as a powerful carcinogen. Our purpose is quantify the relationship between an occupational exposure to asbestos and an increase of the risk of lung cancer. Furthermore, we wish to tackle the very delicate question of the evaluation, in subjects suffering from a lung cancer, of how much the amount of exposure to asbestos explains the occurrence of the cancer. For this purpose, we rely on a recent French case-control study. We build a large collection of threshold regression models, data-adaptively select a better model in it by multi-fold likelihood-based cross-validation, then fit the …

The Role Of Community Health Centers In Addressing The Needs Of Uninsured Low-Income Workers: Implications Of Proposed Federal Funding Reductions, Peter Shin, Sara J. Rosenbaum

Geiger Gibson/RCHN Community Health Foundation Research Collaborative

The severe economic downturn over the past few years has demonstrated the heightened importance of strengthening the health care safety net, particularly for working Americans who may have lost their health insurance coverage or do not have access to employer-sponsored benefits. Both historically and most recently during the current recession, health centers have played a critical role in providing services to the working poor, assuring that they continue to receive timely preventive care that obviates the need for, and minimizes use of, more costly services. We estimate that 1 in 4 low income, uninsured working adults depend on health centers …

An Exercise In Molecular Epidemiology: Human Rhinovirus Prevalence And Genitics, Catherine J. Albright, David J. Hall

Chemistry Department Faculty Publications

Human rhinovirus (HRV) is one of the most common human respiratory pathogens and is responsible for the majority of upper respiratory illnesses. Recently, a phylogeny was constructed from all known Ameri- can Type Culture Collection (ATCC) HRV sequences. From this study, three HRV classifications (HRVA, HRVB, and HRVC) were determined and techniques for classifying new isolates of HRV were reported. The genetic change of this virus in specific populations over time is of great interest to understand the evolution and epidemiology of viruses. To facilitate the collections of HRV sequences over a number of years, a virology experiment was designed …

Intimate Partner Violence In Urban Pakistan: Prevalence, Frequency, And Risk Factors, Tazeen S. Ali, Nargis Asad, Ingrid Mogren, Gunilla Krantz

School of Nursing & Midwifery

Background: Intimate partner violence (IPV) is an important public health issue with severe adverse consequences. Population-based data on IPV from Muslim societies are scarce, and Pakistan is no exception. This study was conducted among women residing in urban Karachi, to estimate the prevalence and frequency of different forms of IPV and their associations with sociodemographic factors.
Methods: This cross-sectional community-based study was conducted using a structured questionnaire developed by the World Health Organisation for research on violence. Community midwives conducted face-to-face interviews with 759 married women aged 25-60 years.
Results: Self-reported past-year and lifetime prevalence of physical violence was 56.3 …

Developing Countries, Vaccine Access And Influenza Outbreaks: Ethics And Global Health Governance When Facing A Pandemic, Shawn Smallman

International & Global Studies Faculty Publications and Presentations

The threat posed by influenza pandemics raises serious ethical issues, as well as questions of global health governance. In order to create pre-pandemic vaccines, global health authorities need access to virus from regional outbreaks. But because the countries where these outbreaks occur are unlikely to benefit from the vaccine, they are sometimes reluctant to share this seed stock, and may try to make proprietary arrangements with pharmaceutical companies, as briefly occurred in Indonesia. Although these arrangements may increase developing countries' access to vaccine, they hamper the global cooperation necessary to prepare for influenza outbreaks. Developing countries, in contrast, point to …

The Health Care Access And Cost Consequences Of Reducing Health Center Funding, Peter Shin, Sara J. Rosenbaum

Geiger Gibson/RCHN Community Health Foundation Research Collaborative

For over four decades, community health centers have served a critical role in providing affordable access to quality care to some of the nation's most vulnerable populations. Health centers have historically enjoyed broad bipartisan support, based on the evidence documenting their high quality care, crucial role in both urban and rural communities, and ability to "bend the cost curve."

On February 20, 2011, the U.S. House of Representatives voted to reduce discretionary health center funding by $1.3 billion in FY 2011 alone. Although the spending bill was rejected by the U.S. Senate on March 10, 2011, final spending measures for …

Combating Biological Terrorism From Imported Food, Jeffrey S. Nelson

Theses and Dissertations

There is a threat that a terrorist or terrorist organization will use access to the US food supply to kill or sicken Americans by contaminating imported food products from Mexico. The food that Americans eat is coming more and more often from foreign countries such as Mexico. Foodborne diseases infect nearly fifty million people in the US each year, resulting in over three thousand deaths. There are many terrorist organizations that would like to deliberately contaminate American food. Drug cartels and terrorist organizations currently operate in Mexico, one of the leading food importers into the US. The purpose of this …

Evaluation Of Xmx/2l-Mil Virtual Impactor Performance And Capture And Retention Of Aerosol Particles In Two Different Collection Media, Jon E. Black

Theses and Dissertations

The United States Air Force uses the XMX/2L-MIL (XMX) high volume air sampler to collect samples for biological analysis. The XMX uses a virtual impactor to concentrate particles 1.0 to 10 μm in size into a secondary flow prior to sample collection using a liquid impinger in a collection tube. There are no known published studies regarding virtual impactor inter-instrument variability, effect of reducing the secondary flow on particle concentration, or capture and retention efficiency (CRE) of particles in the collection media performance characteristics when using the XMX. These performance characteristics were evaluated by lofting test aerosols of Arizona Road …

Development Of Optimized Guidelines For Therapeutic Strategies For Organophosphate Poisoning, Craig A. Holder

Theses and Dissertations

Organophosphates such as nerve agents have been used on several occasions in the past to inflict harm upon military and civilian populations in various parts of the world. The threat of these chemicals use against the military and civilians continues today, and the suggested treatment guidelines available may be ineffective or possibly cause harm. The guidelines investigated during the research presented here all included the use of two antidotes, atropine and oxime. The efficacy of oximes has been questioned and it has been suggested that they may cause harm to the patient. Both atropine and oxime are issued to military …

Retrospective Geospatial Modeling Of Pm10 Exposures From Open Burning At Joint Base Balad, Iraq, John P. Rinker

Theses and Dissertations

Predicting, determining, and linking theater-related source-specific exposures to health effects has proven difficult. The purpose of this research is to delineate retrospective exposure zones using spatially interpolated particulate air sampling point data from Joint Base Balad, create burn pit exposure isopleths from dispersion model outputs, and merge into a combined exposure model in GIS. Interpolated monitoring results and dispersion modeled results were combined to compare modeled exposures across base. Burn pit contribution to total PM10 was also modeled. The combined dispersion and interpolation map showed elevated concentrations within a 1 kilometer buffer of the burn pit. Buildings within this area …

Characterization Of Graphite Composite Material Particulates From Usaf Aircraft Maintenance Operations, Richard E. Yon

Theses and Dissertations

Due to the benefits of their material properties, advanced composite materials (ACM) are increasingly being used as structural components on aircraft, especially within the United States Air Force. As a result, the potential exists for occupational exposures to structural maintenance employees while repairing and fabricating aircraft components. Two field studies were conducted for this thesis in order to characterize ACM aerosol size distribution, determine the feasibility of utilizing direct reading instruments (DRIs) in the field, and ensure workers are protected with adequate controls. In order to characterize exposure, traditional integrated air sampling and DRIs were positioned together near an ACM …

The Epidemiology Of Human Rabies Postexposure Prophylaxis In Virginia, 2002 And 2003, Marilyn Goss Haskell

Theses and Dissertations

Objective: To describe a sample that received human rabies postexposure prophylaxis (PEP) in Virginia as a result of animal exposures in 2002 and 2003 and to determine the extent to which PEP decisions were appropriate.Methods: PEP surveillance data were requested from 35 Virginia health districts within 5 regions. Retrospective chart review was used to gather demographic, exposure and source animal data from patient records and animal exposure reports. Descriptive statistics are presented. True exposures and appropriateness of PEP were defined using the 2004 Virginia Rabies Control Guidelines and the Recommendations of the 1999 Advisory Committee on Immunization Practices. The 2003 …

Substance Abuse In Georgia, The Burruss Institute Of Public Service And Research

Georgia Journal of Public Policy

In order to create a snapshot of substance use and abuse in Georgia, the Burruss Institute of Public Service and Research requested access to data from the National Survey on Drug Use and Health conducted on behalf of the Substance Abuse and Mental Health Services Administration (SAMHSA), a unit of the Department of Health and Human Services (HHS).  SAMHSA would not provide access to the raw data; instead, the Institute was given a series of tables with estimates of the average annual number of users of various substances among Georgians ages 12 and older between the years 2002 and 2008. …

Second-Hand Smoke In A University Campus: Attitudes And Perceptions Of Faculty, Staff And Students, Cecilia M. Watkins, Sandeep Mishra, Herpreet Kaur Thind, Srinivasa B. Gokarakonda, Grace Lartey, Monia Chahal

Public Health Faculty Publications

Purpose: To examine the attitudes and perceptions of faculty, staff and students concerning tobacco policies at a university campus in a tobacco producing state. Methods: A questionnaire was administered to faculty, staff and students to assess knowledge, attitudes and beliefs related to smoking and exposure to second-hand smoke on campus. A 3-wave e-mailing was used to send the questionnaire. Results: A total of 2,914 individuals responded to the questionnaire. Majority (60%) of the participants believed a smoke free policy would be a positive move and could possibly improve the quality of life for the campus community, while not negatively affecting …

Lady Health Workers Programme In Pakistan: Challenges, Achievements And The Way Forward, Assad Hafeez, Bile Khalif Mohamud, Mobasher Riaz Shiekh, Syed Ayyaz Imran Shah, Rashid Jooma

Section of Neurosurgery

Objectives: To review the Lady Health Workers programme and critically explore various aspects of the process to extract tangible implications for other similar situations.
Methods: A descriptive study was carried out over a period of one year (2007-08). A detailed desk review of project documents, interaction with relevant stakeholders, performance validation and extensive feedback from the community were collected. The data so obtained was analyzed and evaluated against predetermined benchmarks.
Results: Each LHW serves a population of 1,000 people in the community and extends her services in the catchment population through monthly home visits. The scope of work includes over …

Racial/Ethnic Disparities In Survival Among Men Diagnosed With Prostate Cancer In Texas, Arica L. White, Ann L. Coker, Xianglin L. Du, Katherine S. Eggleston, Melanie Williams

CRVAW Faculty Journal Articles

BACKGROUND:

To the authors' knowledge, few studies to date have examined racial differences in prostate cancer survival while controlling for socioeconomic status (SES). No such studies have examined this association in Texas, a large state with significant ethnic and racial diversity. The objective of this analysis was to determine whether racial disparities in survival for men diagnosed with prostate cancer in Texas from 1995 through 2002 remained after adjusting for SES, rural residence, and stage of disease.

METHODS:

A cohort of 87,449 men who were diagnosed with prostate cancer was identified from the Texas Cancer Registry. The SES measure was …

Semi Drivers Killed After Vehicle Rollovers, Kentucky Injury Prevention And Research Center

Kentucky Haz Alerts--Motor Vehicle

To prevent semi truck rollovers, employers should:

• Implement and enforce a seat belt safety program
• Establish and strengthen a company policy to reduce fatigue on the job

Employees should:

• Always wear a seat belt while in the vehicle
• Use correct lights during a fog
• Use proper precautions to reduce sloshing
• Reduce inadequate evasive actions

Behavioral Contexts, Food-Choice Coping Strategies, And Dietary Quality Of A Multiethnic Sample Of Employed Parents, Christine E. Blake, Elaine Wethington, Tracy J. Farrell, Carole A. Bisogni, Carol M. Devine

Faculty Publications

Employed parents' work and family conditions provide behavioral contexts for their food choices. Relationships between employed parents' food-choice coping strategies, behavioral contexts, and dietary quality were evaluated. Data on work and family conditions, sociodemographic characteristics, eating behavior, and dietary intake from two 24-hour dietary recalls were collected in a random sample cross-sectional pilot telephone survey in the fall of 2006. Black, white, and Latino employed mothers (n=25) and fathers (n=25) were recruited from a low/moderate income urban area in upstate New York. Hierarchical cluster analysis (Ward's method) identified three clusters of parents differing in use of food-choice coping strategies (ie, …