Medicine and Health Sciences Commons^™

Preying On The Desperate, Karen M. Savage

Capstones

In this story, I investigate the marketing and sale of concentrated hydrogen peroxide to individuals who are desperate to cure serious health maladies. The story follows an online marketer who was warned by the FDA more than ten years ago to stop claiming hydrogen peroxide ingestion could cure cancer and other ailments. But in spite of the warning and subsequent FDA investigation, the individual continues to claim high strength hydrogen peroxide helps with brain tumors and leukemia and he can now be tied to several different websites marketing various “brands” of high strength hydrogen peroxide. Another marketer distributes hydrogen peroxide …

Adoption Of Medication Management Technologies By U.S. Acute Care Hospitals After The Hitech Act, Aastha Chandak

Theses & Dissertations

Medication errors and adverse drug events (ADEs) are a significant public health concern in the United States as they pose a threat to patient safety. The medication management process is a complicated process in U.S. acute care hospitals, consisting of a series of steps such as ordering, transcribing, dispensing and administration and each step is prone to medication errors.The use of technology is considered to be an important intervention in improving the medication management process and thereby reducing medication errors and ADEs and further improve patient safety. The Health Information Technology for Economic and Clinical Health (HITECH) Act, implemented in …

Barriers To Pediatric Triage Guideline Compliance: A Survey Of Nebraska Emergency Departments, Jonathon J. Gruba

Theses & Dissertations

Nebraska emergency departments may be underprepared for a mass casualty event involving a large number of children, as indicated by the results from the 2013 Emergency Medical Services for Children’s (EMSC) Pediatric Readiness Project (PRP) report. This was primarily evident by the lack of existence of a pediatric triage policy among Nebraska emergency departments. Utilizing a survey, this study attempted to identify the emergency departments in Nebraska that followed the EMSC guideline of having a pediatric triage policy, as well as to identify possible barriers to guideline adherence among those that did not have the policy.

It was found that …

The Application Of The Literature Review Appraisal Toolkit On Environmental Health Systematic Reviews, Kristen M. Davis

Master's Projects and Capstones

Environmental health systematic reviews have long been of poor quality when comparing them to clinical health systematic reviews. The main reason for the poor quality of environmental health systematic reviews is the lack of a specific protocol. The University of California-San Francisco’s Program for Reproductive Health and the Environment has, because of the discrepancy, created a protocol specific to conducting environmental health systematic reviews. The protocols efforts would be futile without a nonbiased way to evaluate systematic reviews and therefore the protocol used. The Literature Review Appraisal Toolkit is a valuable tool created to navigate and evaluate the credibility of …

Geographical Incidence Of Antimicrobial Resistant Gonorrhea, Christofer A. Rodriguez

Master's Projects and Capstones

Evolving throughout the last century, Gonorrhea has become a superbug, becoming difficult to treat. As the second most commonly reported notifiable disease, gonorrhea rates have been increasing, despite efforts in prevention and treatment. Populations at risk are mainly MSM and FSW. In 2015, men’s gonorrhea rates in the United States were higher compared to women, at 140.9 and 107.2 per 100,000 population, respectively. Illinois has consecutively had higher rates of infection compared to the US, at 133.5 per 100,000 population compared to the US rate of 123.9 per 100,000 population. The surveillance of gonococcal isolate resistance to current antimicrobials began …

Self-Disclosure Among Male Survivors Of Child Sexual Abuse: Service Providers’ Perspective, Marudan Sivagurunathan

Electronic Thesis and Dissertation Repository

Previous research regarding child sexual abuse (CSA) indicates significant gender differences in disclosure rates: specifically, males are less likely to disclose their child sexual abuse in comparison to females. CSA can have lasting impact on a child’s emotional, physical, and psychological wellbeing. Trauma studies show support and early intervention is necessary for CSA survivors to re-establish a sense of safety and to experience better quality of life. Service providers play a key role in providing care and support for male CSA survivors. However, little is known about service providers, who work with male CSA survivors, and their perceptions and attitudes …

University Students' Involvement In A Health Promoting Lifestyle: Influencing Factors Of The Health Promotion Model, Madison Estrada

Electronic Theses & Dissertations

Abstract: This is a correlational study utilizing Nola Pender’s Health Promotion Model (HPM) for examining the key influential factors regarding involvement in a health promoting lifestyle (HPL) among undergraduate students at Pittsburg State University. Ninety-six (96) undergraduate students enrolled in general psychology courses at Pittsburg State University completed the Health Promoting Lifestyle Profile-II (HPLP-II; Walker, Sechrist, & Pender, 1987), the Exercise Benefits/Barriers Scale (EBBS; Pender, Walker, & Sechrist, 1987), the Self-Efficacy for Exercise Scale (SEE Scale; Resnick & Jenkins, 2000), and the Physical Activity Stages of Change Questionnaire (Marcus, Selby, Niaura, & Rossi, 1992). Spearman Correlation coefficients (one-tailed tests), were …

Inside The Juvenile Justice System, Megan Phalon

Master's Projects and Capstones

The United States of America is known for freedom and integrity and being a nation that stands for justice and equality for all. Within the United States there are systems in place to better the people and communities in order to provide safety and order. However, just as any nation, there is a struggle with violent behavior and tendencies among adults and adolescents. Within the last three decades, the United States has created a correctional system that specifically targets adolescents, and that acknowledges the differences between adult and juvenile development and deviant behavior. Within this literature review, academic databases were …

The Impact Of Electronic Health Records On Healthcare Service Delivery, Patient Safety, And Quality, Kate Elizabeth Trout

Theses & Dissertations

The HITECH Act has provided over $30 billion of support through the Meaningful Use program to implement Electronic Health Records (EHRs) with aims to improve healthcare service delivery, efficiency, quality, and patient safety. New healthcare models, such as pay-for-performance and value-based purchasing, were envisioned to aligning quality with reimbursement mediated with the use of EHRs. It is unclear of how EHRs and Meaningful Use have impacted health service delivery, patient safety, and quality of care. Thus, making it difficult to determine if the specific set of objectives for Meaningful Use have had a positive impact on outcomes, which ultimately is …

Using Multi-Modal Education In A Public Health System To Increase Rates Of Cervical Cancer Screening, Christina Nardi

Doctor of Nursing Practice (DNP) Projects

While Papanicolaou (Pap) screening has been implemented since the 1950’s, and is linked to decreased rates of cervical cancer, national screening rates are still below the national target screening rate. In Contra Costa County (CCC), the current cervical cancer screening rate is 50.92% (Contra Costa Health Services [CCHS], 2016a). This is far below the national goal of 93% and the first benchmark of 54.33% needed in order to receive state funding under the California Department of Health Care Services (DHCS) Medi-Cal 2020 waiver. The Medi-Cal 2020 waiver has a 5-year Public Health Incentives and Redesign in Medi-Cal (PRIME) program requiring …

Behavioral Care For Children In Urban And Rural Integrated Primary Care, David I. Taylor

Theses & Dissertations

Mental, emotional, and behavioral issues in children are a significant concern for the children, their families, and society. Despite the existence of evidence-based treatments, the success of behavioral healthcare to meet the needs of these families will require high quality communication and relationships across a wide range of stakeholders. Integration of care represents a patient-centered strategy to unify these stakeholders into a single cohesive care team. The purpose of this dissertation is to define the behavioral healthcare team in integrated primary care for children in terms of the functional roles involved and to evaluate the quality of relationships and communications …

Vitamin D, Calcium And Blood Pressure In The U.S., Sarah Bean

Master's Projects and Capstones

Vitamin D and calcium have received increased attention for their potential roles in improving cardiovascular health. The active form of vitamin D, 1,25-hydroxyvitamin D (25[OH]D), may influence blood pressure by increasing gastrointestinal calcium absorption. The objectives of this study were to first examine the association between blood pressure and blood serum 25(OH)D levels, and then explore the interaction between 25(OH)D, calcium intake, and blood pressure. Cross-sectional analysis featured 24,844 U.S. adults aged 20-80 years from three cycles of the National Health and Examination Survey (NHANES 2001-2006). Linear regression models were used to determine the adjusted association of 25(OH)D categories with …

Pharmacovigilance In Post-Marketing: Risk Assessment And Reporting Standards, Tiffany Jee

Master's Projects and Capstones

While there has been new targeted drug therapies released into the market over the recent years, pulmonary arterial hypertension (PAH) remains to be a rapidly progressive disease with poor prognosis. Over time the arteries stiffen and tighten subsequently leaving the heart to pump harder to try and provide enough blood to the body. The extra stress of the increased pumping leads to weakening and enlargement of the heart. The endothelin targeted therapy, Letairis (ambrisentan), is an oral tablet proven to improve quality of life in patients suffering from PAH, WHO Group I – functional class II and III by helping …

The Effect Of Agricultural Exposures And Genetics On Respiratory Phenotypes, Lisa W. Boyd

Theses & Dissertations

Agricultural workers are at risk for respiratory diseases, such as chronic obstructive pulmonary disease (COPD) and chronic bronchitis, due to exposures and inflammatory agents found in their work environment. While previous studies have been conducted to examine agricultural effects of chronic respiratory diseases more closely, there are still several significant gaps in the existing literature.

This dissertation explores the relationship between agricultural exposures and respiratory diseases. Utilizing two populations, the Keokuk Country Rural Health Study and the AgLung Study, this research: 1) used principal factor analysis (PFA) to distill exposure data into essential variables characterizing long-term agricultural exposures in order …

Mental Health Workout: Lifting Stigma, Jeremy Bambery

Master's Projects and Capstones

Mental illness affects one out of every five Americans between the ages 13-18, and it is estimated that two-thirds of these individuals will not seek treatment due to the stigma associated with having a mental illness or mental health issue (National Alliance on Mental Illness). Access to information and the ability to talk openly without fear will aid in creating a stigma free future. The goal of this project is to supply high school students in the San Francisco Bay Area with information regarding the stigma associated with mental health and mental illness via videos that will be used as …

Chna: The Role Of The Hospital In Addressing Specific Community Health Needs, Yesmina L. Zavala

Master's Projects and Capstones

The Patient Protection and Affordable Care Act (ACA) added a requirement for nonprofit hospitals to keep their tax-exempt status under the Internal Revenue System Code 501(c) 3. This code requires all nonprofit hospitals to complete Community Health Needs Assessment (CHNA) reports every three years and must include input from community stakeholders and underserved individuals representing the low-income, minority and chronically ill population.

In addition to the CHNA, implementation strategies are required to be executed in the geographic areas served in order to meet the identified prioritized needs from the CHNA. Oftentimes, CHNAs are difficult to conceptualize and operationalize within the …

Doula Support As A Means To Improve Birth Outcomes For Minority Women, Christina Bao Ngoc Thich

Master's Projects and Capstones

Ethnic minorities such as African Americans, American Indians, Hispanics, Laotions, Hmongs, and Alaskan Natives have higher rates of cesarean delivery, pre-term birth, fetal demise, perinatal laceration, and congenital abnormalities than their white counterparts. Continuous labor support by way of doula care has been recommended for all pregnant women as a means to prevent adverse birth outcomes. Despite this, the population most in need of such support in unable to access doula services due to low socioeconomic status, availability of services, and cultural inaccessibility. This paper focuses on my capstone experience with UCSF and Roots of Labor Birth Collective as we …

A Preliminary Examination Of Elevated Blood Lead Levels In A Rural Georgia County, R. Christopher Rustin, Yu Sun, Chris Calhoun, Christy Kuriatnyk

Environmental Health Sciences Faculty Publications

Background: Rural areas are often viewed as lower risk for lead poisoning and toxic exposures seriously impacting development of the brain and central nervous system; this report examines the prevalence of elevated blood lead levels for children <6 years of age in rural Ben Hill County, GA.

Methods: Lead surveillance data from the Georgia Department of Public Health (DPH) were analyzed using SAS®v-9.3 to calculate the prevalence of elevated blood lead levels (≥5ug/dL) among those children in Ben Hill County who had been tested for lead; the results were compared to Georgia and national data.

Results: A preliminary analysis of 2010-2015 screening data for Ben Hill County indicates that 8.73% …

An Assessment Of Data Related To Inspections Of Risk Factors For Public Swimming Pools, Shanita Shack, Maurice Redmond, R. Christopher Rustin

Environmental Health Sciences Faculty Publications

Background: The Georgia Department of Public Health (DPH) is mandated to ensure that public swimming pools are safe for those who use them. This mandate is carried out by the DPH and local environmental health professionals through regulations and inspections. In 2015, legislation was introduced proposing to reduce the authority of the DPH to inspect certain pool types (apartments, subdivision, condominiums) and thus reduce regulatory protections in place for swimmers. To ensure that the DPH had current information on the risks associated with pools, the EH team, with assistance from a graduate student, analyzed inspection data to evaluate risk factors …

Cost Effectiveness Of Potential Art Adherence Monitoring Interventions In Sub-Saharan Africa, Andrew N. Phillips, Valentina Cambiano, Fumiyo Nakagawa, Loveleen Bansi-Matharu, Papa Salif Sow, Peter Ehrenkranz, Deborah Ford, Owen Mugurungi, Tsitsi Apollo, Joseph Murungu, David R. Bangsberg, Paul Revill

OHSU-PSU School of Public Health Faculty Publications and Presentations

Background -Interventions based around objective measurement of adherence to antiretroviral drugs for HIV have potential to improve adherence and to enable differentiation of care such that clinical visits are reduced in those with high adherence. It would be useful to understand the approximate upper limit of cost that could be considered for such interventions of a given effectiveness in order to be cost effective. Such information can guide whether to implement an intervention in the light of a trial showing a certain effectiveness and cost.

Methods - An individual-based model, calibrated to Zimbabwe, which incorporates effects of adherence and resistance …

Kinder Ready: Exploring The Role Of Technology In Promoting School Readiness Among Low-Income Parents In A Clinic-Based Setting, Brenda Lu

Master's Projects and Capstones

The Stanford Pediatric Advocacy Program advocates to improve the health status of children in Silicon Valley and the surrounding community. This summer, I worked on a project called Kinder Ready, with the goal of evaluating the feasibility of technology use in promoting school readiness in children ages zero to five. We used a variety of qualitative research methods, including focus groups, one-on-one interviews, and surveys to collect feedback from the community on what their children need to transition into schools. Our local participatory research approach has paved the way for many new partnerships with local organizations, while strengthening existing ones. …

Identifying Disparities In Colorectal Cancer Screening Rates In Milwaukee-Based Academic And Nonacademic Clinics, Jasmine Wiley, Jonathan J. Blaza, Will Lehmann, Deborah Simpson, Jeffrey A. Stearns, Shelby L. Pischke, Tracy L. Greiten

Aurora Family Medicine Residents

Background: The Institute for Healthcare Improvement’s Triple Aim focuses on improving the patient’s experience of care, improving population health and reducing the per capita cost of health care. Health care systems and providers continuously seek to improve quality of care through understanding what percentage of their patients are achieving quality-of-care standards for various indicators, including immunizations, tobacco cessation, asthma and cancer screening. As health care moves toward reimbursing for value-based care, deepening our understanding of patient population characteristics within each of these conditions is vital to continuous quality improvement.

Purpose: To determine if there are race/ethnicity/age/preferred language (REAL) disparities in …

Decade-Long Trends In The Timeliness Of Receipt Of A Primary Percutaneous Coronary Intervention, Han-Yang Chen, Joel M. Gore, Kate L. Lapane, Jorge L. Yarzebski, Sharina D. Person, Catarina I. Kiefe, Robert J. Goldberg

Catarina I. Kiefe

OBJECTIVES: The purpose of this study was to examine decade-long trends (2001-2011) in, and factors associated with, door-to-balloon time within 90 minutes of hospital presentation among patients hospitalized with ST-segment elevation myocardial infarction (STEMI) who received a primary percutaneous coronary intervention (PCI).

METHODS: Residents of central Massachusetts hospitalized with STEMI who received a primary PCI at two major PCI-capable medical centers in central Massachusetts on a biennial basis between 2001 and 2011 comprised the study population (n=629). Multivariable regression analyses were used to examine factors associated with failing to receive a primary PCI within 90 minutes after emergency department (ED) …

Decade-Long Trends In The Timeliness Of Receipt Of A Primary Percutaneous Coronary Intervention, Han-Yang Chen, Joel M. Gore, Kate L. Lapane, Jorge L. Yarzebski, Sharina D. Person, Catarina I. Kiefe, Robert J. Goldberg

Jorge L. Yarzebski

OBJECTIVES: The purpose of this study was to examine decade-long trends (2001-2011) in, and factors associated with, door-to-balloon time within 90 minutes of hospital presentation among patients hospitalized with ST-segment elevation myocardial infarction (STEMI) who received a primary percutaneous coronary intervention (PCI). METHODS: Residents of central Massachusetts hospitalized with STEMI who received a primary PCI at two major PCI-capable medical centers in central Massachusetts on a biennial basis between 2001 and 2011 comprised the study population (n=629). Multivariable regression analyses were used to examine factors associated with failing to receive a primary PCI within 90 minutes after emergency department (ED) …

A Delphi Process To Address Medication Appropriateness For Older Persons With Multiple Chronic Conditions, Terri R. Fried, Kristina Niehoff, Jennifer Tjia, Nancy Redeker, Mary K. Goldstein

Jennifer Tjia

BACKGROUND: Frameworks exist to evaluate the appropriateness of medication regimens for older patients with multiple medical conditions (MCCs). Less is known about how to translate the concepts of the frameworks into specific strategies to identify and remediate inappropriate regimens.

METHODS: Modified Delphi method involving iterative rounds of input from panel members. Panelists (n = 9) represented the disciplines of nursing, medicine and pharmacy. Included among the physicians were two geriatricians, one general internist, one family practitioner, one cardiologist and two nephrologists. They participated in 3 rounds of web-based anonymous surveys.

RESULTS: The panel reached consensus on a set of markers …

Smoking Prevalence And Media Impact On Smoking Behaviors Among Adult Lgbt Persons, Christina Tuell

Health and Kinesiology Theses

Objective: The purpose of this study is to explore the prevalence of Lesbian, Gay, Bisexual, and Transgender (LGBT) smoking prevalence and to identify possible associations between smoking behavior and depictions of smoking presented in visual media programming commonly viewed by these groups.

Background: Recent studies have shown there is a higher prevalence of smoking in LGBT communities (Tang et al., 2004). Approximately 17.8% of adults age 18 or older in the U.S. smoke cigarettes; while, 26.6% - 36.0% of LGBT persons smoke. The Big Tobacco industry has been known to intentionally target sub-groups of the general population, particularly minorities such …

Dna Methylation Signatures Of Chronic Low-Grade Inflammation Are Associated With Complex Diseases, Symen Ligthart, Carola Marzi, Stella Aslibekyan, Michael M. Mendelson, Karen N. Conneely, Toshiko Tanaka, Elena Colicino, Lindsay L. Waite, Roby Joehanes, Weihua Guan, Jennifer A. Brody, Cathy Elks, Riccardo Marioni, Min A. Jhun, Golareh Agha, Jan Bressler, Cavin K. Ward-Caviness, Brian H. Chen, Tianxiao Huan, Kelly Bakulski, Elias L. Salfati, Whi-Empc Investigators, Giovanni Fiorito, Charge Epigenetics Of Coronary Heart Disease, Simone Wahl, Katharina Schramm, Jin Sha, Dena G. Hernandez, Allan C. Just, Jennifer A. Smith, Donna K. Arnett

Epidemiology and Environmental Health Faculty Publications

Background: Chronic low-grade inflammation reflects a subclinical immune response implicated in the pathogenesis of complex diseases. Identifying genetic loci where DNA methylation is associated with chronic low-grade inflammation may reveal novel pathways or therapeutic targets for inflammation.

Results: We performed a meta-analysis of epigenome-wide association studies (EWAS) of serum C-reactive protein (CRP), which is a sensitive marker of low-grade inflammation, in a large European population (n = 8863) and trans-ethnic replication in African Americans (n = 4111). We found differential methylation at 218 CpG sites to be associated with CRP (P < 1.15 × 10^–7) in the discovery panel …

Qualitative Health Research Involving Indigenous Peoples: Culturally Appropriate Data Collection Methods, Amy L. Wright, Olive Wahoush, Marilyn Ballantyne, Chelsea Gabel, Susan M. Jack

The Qualitative Report

Historically, health research involving Indigenous peoples has been fraught with problems, including researchers not addressing Indigenous research priorities and then subsequently often failing to utilize culturally appropriate methods. Given this historical precedence, some Indigenous populations may be reluctant to participate in research projects. In response to these concerns, the Government of Canada has developed the Tri-Council Policy Statement (TCPS2): Research Involving the First Nations, Inuit and Métis Peoples of Canada, which stipulates the requirements for research collaborations with Indigenous communities. Utilizing this policy as an ethical standard for research practices, this paper describes, critiques and synthesizes the literature on culturally …

College Of Public Health News, Georgia Southern University

Jiann-Ping Hsu College of Public Health News (2011-2023)

• Georgia Southern Examines Physical Activity Levels Of Older Cancer Survivors

Epidemiology News, Georgia Southern University

Epidemiology News (2012-2018)

• Georgia Southern Examines Physical Activity Levels of Older Cancer Survivors