Medicine and Health Sciences Commons^™

Effectively Filling Gaps In Care: A Comparative Study Of Models Of Government Partnerships With Community Health Organizations In Kwazulu-Natal, South Africa, Madeline Ross

Independent Study Project (ISP) Collection

This study conducted Amatkiulu, Impendle, and Durban, KwaZulu-Natal, South Africa, utilizes three case studies to form a comparative analysisof the effectiveness of different models of public-private partnerships. Two expert interviews, three informal interviews, and many hours of observation inform this analysis of community health worker organizations employed through government clinics, tuberculosis tracer teams hired by government clinics, and independent non-governmental organizations heavily subsidized by the government. Subjective analysis found that the partnership between the Department of Health and a primary healthcare NGO, providing a wide range of comprehensive services, operated with the best efficiency and quality of care.

Reproductive Health Education In The Kibera Slum: Developing A Slum-Specific Curriculum, Susanna Schneider Banks

Independent Study Project (ISP) Collection

The principal objective of this Independent Study Project is to make recommendations for a slum-specific reproductive health curriculum to be used in primary schools that serve the Kibera Slum in Nairobi, Kenya. In order to obtain data and form a credible basis for the recommendations, interviews were conducted with teachers, focus groups were facilitated with students, and questionnaires were distributed to parents. Additionally, observations were made about the current state of reproductive health education at each school. Data was collected at Kibera School for Girls, a private school in Kibera, and Olympic Primary School, a public school at the edge …

Economic Empowerment And Hiv Prevention Among Young Women And Girls In Kenya: Lessons From The Study Of Economic Empowerment Programs, Samantha Van Putten

Independent Study Project (ISP) Collection

One of the major issues facing Kenya is HIV/AIDS. With recognition by the global community that providing women with economic opportunities can help both those who are HIV positive, as well as in prevention for those who are not infected, programs combining microfinance and HIV education have started to emerge. While women in these programs 3 3 have shown preliminary signs of success, young girls did not respond as well in part due to lack of interest in the particular programs themselves. As such, this study examines two economic empowerment programs for girls and young mothers at the non-governmental organization …

“El Tema No Existe”: La Salud Sexual Lésbica En Valparaíso, Chile, Isabel Osgood-Roach

Independent Study Project (ISP) Collection

This independent study project investigates the status of lesbian health care in Valparaíso, Chile. Over the course of three weeks, I conducted interviews with six women who engage in non-heterosexual intimate relationships. These individuals identify on a spectrum of sexual orientation that includes lesbian, bisexual and hetero-dissident. I also participated in a political demonstration organized by Acción Gay supporting a proposed Anti-Discrimination law. Finally, I attended a meeting of the recently formed lesbian health group Colectivo Ropa Tendida to gain insight into an organization working towards visibilizing lesbian realities. To contextualize my investigation, I worked with theories regarding essentialist and …

La Medicina Tradicional Y La Medicina Moderna En Cusco, Katelyn Scott

Independent Study Project (ISP) Collection

Cuando estaba tratando a escoger un tema para esta investigación encontré esta cita, “In the assessment of the World Health Organization (WHO), the majority of the population of most developing countries regularly use and rely on traditional medicine for their everyday healthcare needs[1]” (Bodeker 23). En hecho, WHO dice que casi 80% de la población de un país desarrollado todavía usa la medicina tradicional (Mendoza, 439). Estas citas me interesé y por eso decidí a investigar las perspectivas que las personas en Cusco tienen sobre la medicina tradicional y la medicina moderna. Quiera aprender si la medicina tradicional …

Individual And Small-Group Market Health Insurance Rate Review And Disclosure: State And Federal Roles After Ppaca, Kathryn Linehan

National Health Policy Forum

Oversight of private insurance, including health insurance, is primarily a state responsibility. Each state establishes its own laws and regulations regarding insurer activities, including premium increases for the insurance products within its purview. The authority that state regulators have to review and deny requests for premium changes varies from state to state, as do the amount of resources available to state insurance departments for reviewing premium changes. In some markets where insurers have proposed or implemented steep increases, such changes have received considerable attention from the press, state regulators, and policymakers. The Patient Protection and Affordable Care Act (PPACA) requires …

Targeting Diseases Beyond Our Borders, Richard Wamai

Richard G. Wamai

No abstract provided.

Identifying Important Breast Cancer Control Strategies In Asia, Latin America And The Middle East/North Africa, John Fp. Bridges, Benjamin O. Anderson, Antonio C. Buzaid, Abdul R. Jazieh, Louis W. Niessen, Barri M. Blauvelt, David R. Buchanan

David R Buchanan

Background: Breast cancer is the most frequent cause of cancer death in women worldwide, but global disparities in breast cancer control persist, due to a lack of a comprehensive breast cancer control strategy in many countries. Objectives: To identify and compare the need for breast cancer control strategies in Asia, Latin America and the Middle East/North Africa and to develop a common framework to guide the development of national breast cancer control strategies. Methods: Data were derived from open-ended, semi-structured interviews conducted in 2007 with 221 clinicians, policy makers, and patient advocates; stratified across Asia (n = 97), Latin America …

Community Health Centers And The Economy: Assessing Centers' Role In Immediate Job Creation Efforts, Sara J. Rosenbaum, Peter Shin

Geiger Gibson/RCHN Community Health Foundation Research Collaborative

Federal investment in community health centers not only creates health care access but, based on previous studies, generates an estimated 8:1 return for medically underserved communities while creating thousands of jobs. Since our earlier 2008 economic impact study, Congress has made two major program investments: $2 billion under the American Reinvestment and Recovery Act (ARRA) of 2009; and $11 billion under the Affordable Care Act (ACA). This analysis measures the economic and jobs-creation benefits of this cumulative investment in health centers, as well as the impact of legislation enacted in April, 2011, which reduced the first year of new …

Aligning Graduate Medical Education With Public Policy, Rob Cunningham

National Health Policy Forum

In late May–early June 2011, the Forum sponsored a site visit to Denver, Colorado, to observe innovative efforts to improve the health of Coloradans and reduce the cost of health care. The three-day agenda was designed to convey the breadth and interconnectedness of the efforts underway in Denver and to highlight both successes and challenges. The exploration concentrated on how three themes of national interest are unfolding in Denver: building and sustaining a robust and effective safety net in an evolving health care market; improving the health of people and their communities to prevent and reduce the need for health …

A Reappraisal Of Stroke Mortality Trends In Brazil (1979 To 2009), Paulo A. Lotufo

Paulo A Lotufo

Background: Brazil has the highest cerebrovascular death rate in the Western Hemisphere. We investigated temporal trends according to gender and stroke subtypes. Methods: We analysed mortality rates between 1979 and 2009 for different stroke subtypes. Data were stratified by sex and age (35–74 y). The annual percent change (APC) and significant changes in the trends were identified with joinpoint Poisson regression. The average annual percent change (AAPC) for 2005-09 was presented because that period had the best quality of information. Results: After excluding deaths due to stroke sequels, for men, the APCs (95% confidence intervals) were: 1979-84: 0.7 (-0.8 to …

Management Of Professional Boundaries In Rural Primary Care, Kathleen D. Brooks, Rebekah Pratt, Diann S. Eley, Therese M. Zink

Family Medicine Faculty Publications

No abstract provided.

Thermal Properties Of Reflective Helmet Exposed To Infrared Radiation, Uwe Reischl, Ravindra S. Goonetilleke

Public Health and Population Science Faculty Publications and Presentations

The thermodynamic properties of a model infrared heat reflective helmet were evaluated using an advanced thermal manikin technology. The aluminized model helmet was tested for infrared (IR) radiation attenuation properties. Total manikin heat gain and changes in surface temperature were documented for controlled IR radiation exposure levels. The results illustrate the benefits offered by an aluminized reflective surface in attenuating IR radiation and the advantages of using a spacer harness system to minimize radiant heat transfer from the helmet to the head.

Civic Attitude And Activity Of Loma Linda University Dental Graduates, Gregory W. Olson

Loma Linda University Electronic Theses, Dissertations & Projects

Introduction: Dentistry is regarded as a profession and granted certain privileges, such as self-regulation. Associated with this status are stated and implied responsibilities which are widely debated. In recent years, dental professionalism seems to be on the decline. Evidence cited includes access-to-care issues and decreased public trust in dentists. In response, academia and professional organizations have developed curricula and statements intended to bolster professionalism. Meanwhile little is known about practicing dentists’ attitudes or participation in health-related civic matters. Objectives: This study seeks to examine the importance Loma Linda University (LLU) dental graduates place on public roles, their reported participation in …

High Prevalence Of Vitamin D Insufficiency And Its Association With Obesity And Metabolic Syndrome Among Malay Adults In Kuala Lumpur, Malaysia, Awang Bulgiba Awang Mahmud

Awang Bulgiba Awang Mahmud

Background: Vitamin D status, as indicated by 25-hydroxyvitamin D is inversely associated with adiposity, glucose homeostasis, lipid profiles, and blood pressure along with its classic role in calcium homeostasis and bone metabolism. It is also shown to be inversely associated with metabolic syndrome and cardiovascular diseases in western populations. However, evidence from the Asian population is limited. Therefore, we aim to study the prevalence of vitamin D insufficiency (< 50 nmol/L) and the association of 25-hydroxyvitamin D with metabolic risk factors among an existing Malay cohort in Kuala Lumpur. Methods: This is an analytical cross sectional study. A total of 380 subjects were sampled and their vitamins D status (25-hydroxyvitamin D), fasting blood glucose, full lipid profile were assessed using venous blood. Systolic and diastolic blood pressure, weight, height and waist circumference were measured following standard protocols. Socio-demographic data such as sex, age, smoking status etc were also collected. Data was analysed using t-test, chi-square test, General Linear Model and multiple logistic regression. Results: Females made up 58% of the sample. The mean age of respondents was 48.5 (SD 5.2) years. Females had significantly lower mean Vitamin D levels (36.2; 95% CI: 34.5, 38.0 nmol/L) compared to males (56.2; 95% CI: 53.2, 59.2 nmol/L). Approximately 41% and 87% of males and females respectively had insufficient (< 50 nmol/L) levels of 25-hydroxyvitamin D (p < 0.001). The prevalence of Metabolic Syndrome for the whole sample was 38.4 (95% CI: 33.5, 43.3)%. In the multivariate model (adjusted for age, sex, abdominal obesity, HDL-cholesterol, diastolic blood pressure), insufficient Vitamin D status was significantly associated with 1-year age increments (OR: 0.93; 95% CI: 0.88, 0.98), being female (OR: 8.68; 95% CI: 5.08, 14.83) and abdominal obesity (OR: 2.57; 95% CI: 1.51, 4.39). Respondents with insufficient vitamin D were found to have higher odds of having Metabolic Syndrome (OR: 1.73; 95% CI: 1.02, 2.92) after adjusting for age and sex. Conclusions: Our results highlight the high prevalence of vitamin D insufficiency among Malay adults in Kuala Lumpur. Vitamin D insufficiency is independently associated with younger age, female sex and greater abdominal obesity. Vitamin D insufficiency is also associated with Metabolic Syndrome.

Supporting School Wellness Policices Through Game On! Implementation In 13 High-Need Connecticut Schools, Sarah M. Bourque

Master's Theses

No abstract provided.

The Community Action Framework In Practice: An Illustration Based On The Ready By 21 Coalition Of Austin/Travis County, Raphael Travis Jr., Tamara Leech

Department of Public Health Scholarship and Creative Works

The field of positive youth development has expanded focus from articulating and measuring desired manifestations of positive well-being to assembling the environmental conditions known to promote these desired outcomes. Evidence of the effectiveness of community-level efforts promoting positive youth development is still emerging, in particular theory-driven examples of community-driven youth development. This study examined the Community Action Framework, one theory-based community youth development model, through the experiences of the Ready by 21 Austin/Travis County coalition (RB21). The coalition connects youth-serving organizations and also regional coalitions, while promoting the positive development of area youth. Participant observation, interviewing, and archival strategies were …

Assessment Of Organic And Inorganic Phosphorus In Soils Derived From Cretaceous Sediments And Basement Complex Soils Of Guinea Savannah Of Kogi State, North Central Nigeria, Sunday I. Amhakhian, H H. Isitekhale, Charles I. Oyewole

Confluence Journal Environmental Studies (CJES), Kogi State University, Nigeria

A pot experiment was carried out using 20 surface soils (0-15cm depth) in 2008 to assess soil organic phosphorus and some fraction of inorganic phosphorus in other to know their availability in the soils of the studied area and also work have not been done in this areas in respect to organic and in-organic phosphorus. The experiment was conducted using 20 soils 10 from each geological formation (Cretaceous sediments and Basement complex soils), respectively. The mean organic phosphorus of 63.51 mgkg 1 soil was obtained for Cretaceous sediment soils and 158.54 mgkg 1 soil for the basement complex soils respectively. …

Development Of Functional Indices Of Facility Occurrence Towards The Distribution Of Social Services In Lagos Island Nigeria., Augustus O. Atubi

Confluence Journal Environmental Studies (CJES), Kogi State University, Nigeria

Proper coordination of transport and public facilities provision is vital to any balanced regional development strategy. The central aim of this study, therefore, is to find out what the relationship is between access to the transport network and the provision of functional indices of facility occurrence towards the distribution of social services in Lagos Island, Nigeria. In particular it seeks to find out areas that have below or above average level of facility occurrences relative to the level of accessibility. However, a pair wise correlation matrix of the eleven (11) variables employed in the index construction was carried out. The …

Bending The Health Care Cost Curve In North Carolina: The Experience Of Community Health Centers, Patrick Richard, Peter Shin, Kristina Vasilkovska, Sara J. Rosenbaum

Geiger Gibson/RCHN Community Health Foundation Research Collaborative

North Carolina is known for innovative practices in primary care delivery and education, and accordingly one might expect to see greater efficiencies overall in care delivery, and less direct, measurable impact by community health centers on cost and outcome. Of interest is whether community health centers (CHCs) are cost effective providers in states with a sophisticated primary care infrastructure and focus on the needs of medically underserved communities. Building on the large body of health services research literature that has documented the quality and cost-effectiveness of federally-funded primary health centers nationwide, as well as estimates of national savings that are …

The Health Status, Concerns, And Reform In Uruguay With An Emphasis On Health Promotion Programs Geared Towards The Care And Development Of The Country's Children And Adolescents, Melissa Raquel Ramírez

Honors Scholar Theses

This study was conducted in Montevideo, Uruguay, where I examined the actions that the country and society as a whole, its various communities, the Uruguayan government, and the people take in order to prevent disease and promote a healthy society. An ethnographic experiential and evidence-based approach, including personal experience, interviews, and official government documents, was used to fully describe the way the system operates. Due to Uruguay's demographic characteristics, particular attention was paid to children and adolescents. For this thesis, Uruguay is described in terms of its history, physical and mental health issues, society's shared health concerns, and its vulnerable …

Racial And Sexual Identity-Related Maltreatment Among Minority Ymsm: Prevalence, Perceptions, And The Association With Emotional Distress, Sheldon Fields

Sheldon D. Fields

Bullying is a form of violence characterized as an aggressive behavior that is unprovoked and intended to cause harm. Prior studies have found that lesbian, gay, bisexual, and transgender (LGBT) youth experience high levels of bullying related to their sexuality and this harassment can lead to engagement in risk behaviors, depression, and suicide. Ethnic/racial minority young men who have sex with men (YMSM) may experience dual levels of stigma and maltreatment due to both their sexuality and their race. The aim of the current study was to assess the prevalence and perceptions of racial and sexual identity-based abuse among a …

Age Of Msm Sexual Debut And Risk Factors: Results From A Multisite Study Of Racial/Ethnic Minority Ymsm Living With Hiv, Sheldon Fields

Sheldon D. Fields

The average reported age of sexual debut for youth in the United States is 14.4 years, with approximately 7% reporting their sexual debut prior to age 13. While the research literature on sexual debut for youth addresses gender and ethnic differences (with males and African-American youth experiencing earlier sexual debut), there is limited data regarding factors associated with sexual debut for young men who have sex with men (YMSM). Early sexual debut poses potential health risks, such as contracting HIV with an increased risk of unprotected intercourse. Given current high HIV infection rates for racial/ethnic minority YMSM, learning more about …

Sexual Behaviors Of Racial/Ethnic Minority Young Men Who Have Sex With Men., Sheldon Fields

Sheldon D. Fields

We assessed changes in sexual behaviors from baseline to 12-month follow-up among a multisite cohort of HIV-positive racial/ethnic minority young men who have sex with men enrolled in an outreach, linkage, and retention study. In the 3 months prior to their baseline interview, more than three-quarters of participants (78.5%) reported sex with at least one man (mean: 2.3 partners). Among sexually active participants, 44.2% had one partner; 50.5% had 2-9 partners; and 5.3% had 10 or more partners. Over three-quarters (77.5%) reported engaging in sex with at least one steady partner, 43.5% with at least one casual partner, and 29.5% …

Roles And Challenges Of Outreach Workers In Hiv Clinical And Support Programs Serving Young Racial/Ethnic Minority Men Who Have Sex With Men., Sheldon Fields

Sheldon D. Fields

The federal government has established rapid identification, linkage, and engagement in medical care of HIV-positive individuals as a high priority. Outreach workers and other linkage coordinators are identified as key personnel in implementing this policy. Young racial/ethnic minority men who have sex with men (MSM) have relatively high and growing rates of HIV infection and would benefit from the services of outreach workers. In this article, we describe the characteristics of outreach workers employed by eight demonstration sites participating in the federal Special Projects of National Significance (SPNS) Young MSM of Color Initiative, the linkage and retention models used by …

Comparing Cognitive Functioning And Adverse Metabolic Effects Of Consumers Taking Type 1 Or Type 2 Antipsychotic Medications With Un-Medicated Consumers, Muhammad Puri

Master of Public Health Program Student Publications

Obesity and metabolic side effects such as diabetes mellitus are major concerns in public health. Mentally ill people are a high risk subgroup for obesity and metabolic syndrome because of behavior, non treatment, and medication side effects. In this research, I conducted a retrospective chart review to compare the weight and body mass index of consumers who were prescribed antipsychotic Type 1 or Type 2 medications. The sample was drawn from consumers attending the Consumer Advocacy Model (CAM) program which is an outpatient substance abuse and mental health treatment program in the Wright State University Boonshoft School of Medicine Department …

Idaho Rural Family Physician Workforce Study: The Community Apgar Questionnaire, D. F. Schmitz, E. Baker, A. Nukui, T. Epperly

Public Health and Population Science Faculty Publications and Presentations

Context: Community factors of varied importance help determine the success of achieving and maintaining a physician workforce. The purpose of this study was to develop an evaluation instrument (Community Apgar Questioinnaire) useful to rural Idaho communities’ in their assessment of the assets and capabilities related to physician recruitment and retention.

Methods: A quantitative scoring interview instrument was developed based on a literature review, site visits and discussions with rural physicians and hospital administrators. A total of 11 rural Idaho communities differing in geography and other known variables were selected, some identified historically to have more success in recruitment and retention …

The Importance Of Self-Efficacy And Basic Psychological Needs In Children’S Physical Activity: Measurement, Prediction And Intervention, Casey E. Gray

Electronic Thesis and Dissertation Repository

The importance of physical activity in the overall health promotion and primary prevention of cardiovascular disease risk factors and metabolic diseases in children is well established. Nonetheless, interventions to increase physical activity among this population have been largely unsuccessful. The main objective of the research in this dissertation was to explore the suitability of self-efficacy and basic psychological needs for physical activity prediction and intervention in children. Item generation and psychometric evaluation of psychological questionnaires occurred in study 1 (Chapter 2). Using a prospective design, study 2 (Chapter 3) established task efficacy, barriers efficacy, competence, and autonomy as significant predictors …

Urban Climate And Challenges Of Tropical Cities, B E. Omogbai

Confluence Journal Environmental Studies (CJES), Kogi State University, Nigeria

This study examines the nature of urban climate, features and the challenges on the developing tropical cities in the 21st century. It argues that the use of principles of urban climate would help in providing comfortable living conditions and problem immune working environments for the inhabitants of tropical cities. The findings reveal that owing to poor environmental planning, inadequate geotechnical landscape surveys prior to the development of urban infrastructures, and non-adherence to the principles of urban climate, challenges of landscape degradation, excessive flooding of the built infrastructures, heat-island effects, and collapse of buildings have emerged. Suggested measures to avert these …

Toxic Chemicals Transported By Rail And Public Health Safety Using Gis In Montgomery County, Ohio, Jason Lipiec

Master of Public Health Program Student Publications

Hazardous chemicals transported by rail pass directly through urban cities and pose a safety and health threat to the community. Some of these chemicals can be in large quantities, extremely toxic, devastating to the environment and have the potential to cause mass casualties and death. Thousands of people could be in harm’s way. While there is always the possibility for accidental chemical release, they also have the potential to be used in acts of sabotage and terrorism. Evaluation of the rail line in Montgomery County, Ohio using standards in the 2008 Emergency Response Guidebook using geographic information systems (GIS) at …