Medicine and Health Sciences Commons^™

Assessment And Comparison Of Behavior Risk Factor Surveillance Systems For The U.S., Canada, And Italy., Carolina Arana

Public Health Theses

Behavior risk factors include health risk factors that increase a person's chances of developing a disease, such as having a high blood pressure, high blood cholesterol, tobacco smoke, physical inactivity, obesity or overweight, diabetes, poor nutrition, lack of sex education and car safety. They can be classified as: Background risk factors, such as age, sex, level of education and genetic compositions; Behavioral risk factors, such as smoking, unhealthy diet and physical inactivity; and Intermediate risk factors, such a serum cholesterol levels, diabetes, hypertension and obesity/overweight. This study describes a comparison and assessment of Behavior Risk Factor Surveillance Systems for the …

Child Sexual And Physical Abuse As Precursors For Homelessness In Adolescence, Jacqueline Nicole Rion

Public Health Theses

Introduction: Homelessness is a living condition associated with a number of adverse health outcomes. Unaccompanied homeless youth are at risk for many of the same health outcomes as other homeless persons, but these youth are especially vulnerable because they are young and without the protection or support of an adult caregiver. Aim: The purpose of this capstone project is to present a basic overview of the topic as well as to highlight what more needs to be done to address this issue. Methods: This project involved a review of the literature related to homeless youth, child sexual or physical abuse, …

Using Iphones To Enhance And Reduce Face-To-Face Home Safety Sessions, Julie Jabaley

Public Health Theses

Innovative handheld technologies are changing the possibilities for delivering public health interventions. The present research describes a preliminary examination of the effects of iPhone™ both as an assessment tool for data collection and as an enhancement to an in-home child safety intervention. Three families with children under age seven were trained to use an iPhone to video targeted rooms in their homes following SafeCare® safety module intervention implementation during which rooms were secured for accessible safety and health hazards. The iPhone was used to communicate feedback, logistical information, and clarification of safety content. The effectiveness of iPhone and iPhone video …

A Spatial Analysis Of The Relationship Between Pedestrian Crash Events And Features Of The Built Environment In Downtown Atlanta, Emily Palmer Taquechel

Public Health Theses

Pedestrian injuries and fatalities due to motor vehicle crashes are a significant public health concern, and the urban campus of Georgia State University poses unique challenges to pedestrian safety issues. Previous studies of the built environment have link several features to increased pedestrian crash occurrences. Once identified, these features can be modified to create a healthier environment for pedestrians. This study examines the relationship between specific features of the built environment and pedestrian crash events. Environmental audits were conducted to collect information about the built environment around Georgia State campus, and pedestrian crash data was obtained from GDOT. Geographic Information …

A Survey Of Water Storage Practices And Beliefs In Households In Bonao, Dominican Republic In 2005, Shelley Holt

Public Health Theses

INTRODUCTION: More than 2.2 million people die each year from diarrheal disease. Most cases of diarrheal disease can be linked with a lack of access to clean water and sanitation. The proper usage of sanitation, hygiene and safe drinking water are all mechanisms by which to prevent or limit fecal contamination, and in turn, reduce the risk of diarrheal disease. As a result, it is imperative to examine and understand risk factors for fecal contamination of drinking water in the home. One way to assess fecal contamination is to use indicator bacteria such as E. coli. These bacteria can be …

Baseline Knowledge Assessment Of Cobb County Safe Kids Inspection Station Participants, Laurie Elizabeth Whorton

Public Health Theses

INTRODUCTION: The leading cause of injury and death among children in the United States is motor vehicle crashes. Even though laws have been amended and public awareness campaigns and education has increased, many children are still improperly restrained or not restrained at all. When correctly used, child restraints significantly reduce risk of injury or death in a motor vehicle crash. AIM: The purpose of the questions is to exhibit the baseline knowledge of participants before receiving car seat education from certified technicians. METHODS: Over an eight week period, Safe Kids Cobb County Car Seat Technicians distributed a 16-item survey, with …

Investigating The Association Of White Male Lung Cancer Mortality And State Of Residence, Thomas Jeffrey Doker

Public Health Theses

Lung cancer is the most common cause of cancer-related death. Most lung cancer is the result of a preventable cause, smoking. Nevertheless, U.S. tobacco production remains the fourth highest globally. This study examined the spatial aspects of U.S. White male lung cancer mortality and the associated risk factors of tobacco acreage, rural residence, smoking, poverty, lack of health insurance, and radon exposure. White male lung cancer mortality was significantly correlated with tobacco acreage (r = .455), rural residence (r = .389), and smoking (r = .475). Tobacco acreage (p = .005), rural residence (p = .011), and smoking (p = …

Does Educational Intervention Reduce The Number Of Food Violations., Karen Koechlin M. Koechlin

Public Health Theses

The objective of this study was to examine the educational intervention that restaurant employees received to see if it reduced the number of food violations in Orange County, California, U.S.. The class, which began in 2007, is known as the Food Employee Education and Sanitation Training (FEEST). This study revealed that the post-test results from FEEST demonstrated a significant improvement in food safety knowledge, and almost all of the participants showed a significant improvement in food safety knowledge. A comparison of inspection reports immediately before and after participation in FEEST showed that food establishments greatly reduced the number of major …

Tobacco Smoke Exposure And Levels Of Urinary Metals In The U.S. Youth And Adult Population: The National Health And Nutrition Examination Survey (Nhanes) 1999–2004, Patricia A. Richter, Ellen E. Bishop, Jiantong Wang, Monica H. Swahn

Public Health Faculty Publications

We assessed 12 urine metals in tobacco smoke-exposed and not exposed National Health and Nutrition Examination Survey participants. Our analysis included age, race/ethnicity, and poverty status. Gender and racial/ethnic differences in cadmium and lead and creatinine-adjusted and unadjusted data for group comparisons are presented. Smokers' had higher cadmium, lead, antimony, and barium levels than nonsmokers. Highest lead levels were in the youngest subjects. Lead levels among adults with high second-hand smoke exposure equaled smokers. Older smokers had cadmium levels signaling the potential for cadmium-related toxicity. Given the potential toxicity of metals, our findings complement existing research on exposure to chemicals …

A Spatial Analysis Of Demographic Factors Of West Nile Virus In Georgia, Sarah Bryant Boos

Public Health Theses

Background: West Nile Virus (WNV) is a serious mosquito-borne disease that can potentially lead to death. The purpose of this study is to spatially examine known risk factors for WNV within Georgia at the county level. The study produces maps that relate known WNV cases to high, medium, and low risk factor areas for additional analyses. Methodology: Cartographic visualization and statistical analysis software was used to examine the relationships between: the geographical distribution of age, race, gender, urbanicity, and population density of Georgians in relation to WNV cases by county. Chi-square analysis and odds rations were calculated to determine whether …

Evaluation Of Diabetes Education For Latinos Living In A Metropolitan Area, Anna Rockett Potter

Public Health Theses

Diabetes is a worldwide epidemic, especially as the prevalence of Type 2 diabetes has increased in recent years. Minorities are disproportionately affected by the disease and, at the same time, often have less access to resources including medication and education. The Emory Latino Diabetes Education Program (ELDEP) is a culturally component diabetes education program aimed at promoting increased knowledge about diabetes disease management within the Latino population of metropolitan Atlanta. The program considers cultural competence and acculturation theory in its learning structure. The purpose of this study was to evaluate ELDEP’s effectiveness in increasing knowledge of diabetes, healthy behaviors, and …

Factors Associated With The Illegal Sales Of Alcohol To Underage Persons In Georgia, Jonathan A. Powell

Public Health Theses

Despite the minimum legal drinking age of 21, many underage persons regularly purchase alcohol from licensed alcohol establishments. The purpose of this study was to determine the establishment, geographic, and community economic and demographic characteristics that are associated with illegal sales of alcohol to underage persons in Georgia. Multivariate logistic regression analysis was used to determine factors that were associated with illegal sales of alcohol to underage persons of Georgia. Statistical adjustments were made for ownership type (e.g., corporate owned), region (e.g., southeast Georgia, metro-Atlanta), rural vs. urban area, and many community economic and demographic variables (e.g., unemployment rate, minority …

State Medicaid Agencies Approaches To Quality Improvement: Implications For Policy, Practice And Health Outcomes, Dev Nair

Public Health Theses

Medicaid provides coverage to approximately 60 million individuals and is the largest single payer of healthcare for children. Given this scope of the program and the concentration of low-income and minority recipients, improvements to the quality of care delivered to Medicaid members represents a significant opportunity to reduce health care disparities and improve the overall delivery and quality of healthcare within the U.S. The current study sought to evaluate the various approaches that state Medicaid agencies are taking to assess and improve the quality of care to their managed care enrollees and the degree to which they have implemented recommendations …

Do Variations In State Mandatory Child Abuse And Neglect Report Laws Affect Report Rates Among Medical Personnel?, Amanda Ellen Faulkner

Public Health Theses

Each state and territory within the United States is required by the Child Abuse Prevention and Treatment Act [42 U.S.C. 5101 et seq.] to maintain a mandatory suspected child abuse and neglect reporting law, requiring certain professionals who regularly see children to report any suspicions of child maltreatment to child protective services. It is well documented that mandatory reporters fail to report each case of suspected child maltreatment they witness. This study sought to determine whether differences in three specific variables within the mandatory report laws had an effect on the frequency with which medical personnel report suspected child abuse …

Trends In Toxin Profiles Of Human Shiga Toxin-Producing Escherichia Coli (Stec) O157 Strains, United States, 1996-2008, Molly Maitland Leeper

Public Health Theses

Shiga toxin-producing E. coli (STEC) cause diarrhea, hemorrhagic colitis, and hemolytic uremic syndrome (HUS). All STEC produce one or both of two Shiga toxins, Stx1 and Stx2. STEC strains that produce Stx2 are more strongly associated with HUS than strains that produce Stx1 or both Stx1 and Stx2. Epidemiologic evidence indicates a recent increase in the rate of HUS among STEC outbreaks. The increasing rate of HUS could be explained by a shift in the toxin profiles of STEC strains. The purpose of this study was to examine trends in toxin profiles of human STEC O157 isolates from 1996 to …

Internally-Developed Teen Smoking Cessation Programs: Characterizing The Unique Features Of Programs Developed By Community-Based Organizations, Kymberle L. Sterling, Susan J. Curry, Sherry Emery, Amy K. Sporer, Robin J. Mermelstein, Michael Berbaum, Brian Flay

Public Health Faculty Publications

We have compared the unique features of teen tobacco cessation programs developed internally by community-based organizations (N=75) to prepackaged programs disseminated nationally (N=234) to expand our knowledge of treatment options for teen smokers. Internally-developed programs were more likely offered in response to the sponsoring organization’s initiative (OR=2.16, p

Race/Ethnicity: Is It An Outcome Predictor In Patients With Heart Failure?, Digant V. Bhatt

Public Health Theses

Objective: The aim of this study was to determine the role of race as a significant risk factor for prediction of outcomes in heart failure (HF). Methods: The data was collected on demographics, detailed history of HF, family history, vital signs, medication and laboratory profile for 585 patients from Heart failure Treatment Center of Emory University after year of 2000. Outcome of HF was defined as combination of death, placement of left ventricular assisted devise, heart transplant or emergency transplant. The independent relationship between race and outcomes of HF was evaluated by univariate and multivariate logistic regression analyses. The survival …

A Randomized Controlled Trial Of The Concrete Biosand Filter And Its Impact On Diarrheal Disease In Bonao, Dominican Republic., Christine E. Stauber, Gloria M. Ortiz, Dana P. Loomis, Mark Sobsey

Public Health Faculty Publications

A number of household water treatment and safe storage technologies, such as chlorine disinfection, solar disinfection, and ceramic filtration, have been documented for their ability to reduce diarrheal disease and improve microbial water quality. The biosand filter (BSF) is a promising household water treatment technology in use by > 500,000 people globally. The purpose of this research was to document the ability of BSFs to improve water quality and to reduce diarrheal disease in user compared with non-user households in a randomized controlled trial in Bonao, Dominican Republic, during 2005–2006. During the 6-month intervention period, 75 BSF households had significantly improved …

Randomized Controlled Trials Of The Plastic Housing Biosand Filter In Cambodia, Ghana And Honduras., Christine E. Stauber, Anna M. Fabiszewski De Aceituno, Erin L. Printy, Byron C. Kominek, Adam R. Walters, Kaida Liang, Mark Sobsey

Public Health Faculty Publications

No abstract provided.

Adaptive Vaccination Strategies To Mitigate Pandemic Influenza: Mexico As A Case Study, Gerardo Chowell, Cecile Viboud, Xiaohong Wang, Stefano M. Bertozzi, Mark A. Miller

Public Health Faculty Publications

Background

We explore vaccination strategies against pandemic influenza in Mexico using an age-structured transmission model calibrated against local epidemiological data from the Spring 2009 A(H1N1) pandemic.

Methods and Findings

In the context of limited vaccine supplies, we evaluate age-targeted allocation strategies that either prioritize youngest children and persons over 65 years of age, as for seasonal influenza, or adaptively prioritize age groups based on the age patterns of hospitalization and death monitored in real-time during the early stages of the pandemic. Overall the adaptive vaccination strategy outperformed the seasonal influenza vaccination allocation strategy for a wide range of disease and …

Epidemiological And Transmissibility Analysis Of Influenza A(H1n1)V In A Southern Hemisphere Setting: Peru, C V. Munayco, Victor Alberto Laguna-Torres, Juan Arrasco, Tadeusz Kochel, V Fiestas, J Garcia, I Torres, J Perez, Hiroshi Nishiura, Gerardo Chowell

Public Health Faculty Publications

We present a preliminary analysis of 1,771 confirmed cases of influenza A(H1N1)v reported in Peru by 17 July including the frequency of the clinical characteristics, the spatial and age distribution of the cases and the estimate of the transmission potential. Age-specific frequency of cases was highest among school age children and young adults, with the lowest frequency of cases among seniors, a pattern that is consistent with reports from other countries. Estimates of the reproduction number lie in the range of 1.2 to 1.7, which is broadly consistent with previous estimates for this pandemic in other regions. Validation of these …

Pandemic Influenza In A Southern Hemisphere Setting: The Experience In Peru From May To September, 2009, Jorge Gomez, Cesar Munayco, Juan Arrasco, L. Suarez, Victor Alberto Laguna-Torres, Patricia V. Aguilar, Gerardo Chowell, Tadeusz Kochel

Public Health Faculty Publications

This paper presents a description of Peru’s experience with pandemic H1N1 influenza 2009. It is based on data from four main surveillance systems: a) ongoing sentinel surveillance of influenza-like illness cases with virological surveillance of influenza and other respiratory viruses; b) sentinel surveillance of severe acute respiratory infections and associated deaths; c) surveillance of acute respiratory infections in children under the age of five years and pneumonia in all age groups; and d) case and cluster surveillance. On 9 May 2009, the first confirmed case of pandemic H1N1 influenza in Peru was diagnosed in a Peruvian citizen returning from New …

Severe Respiratory Disease Concurrent With The Circulation Of H1n1 Influenza, Gerardo Chowell, Stefano M. Bertozzi, M. Arantxa Colchero, Celia Alpuche-Aranda, Mauricio Hernandez

Public Health Faculty Publications

Background

In the spring of 2009, an outbreak of severe pneumonia was reported in conjunction with the concurrent isolation of a novel swine-origin influenza A (H1N1) virus (S-OIV), widely known as swine flu, in Mexico. Influenza A (H1N1) subtype viruses have rarely predominated since the 1957 pandemic. The analysis of epidemic pneumonia in the absence of routine diagnostic tests can provide information about risk factors for severe disease from this virus and prospects for its control.

Methods

From March 24 to April 29, 2009, a total of 2155 cases of severe pneumonia, involving 821 hospitalizations and 100 deaths, were reported …