Medicine and Health Sciences Commons^™

Maine Ems Community Paramedicine Pilot Program Evaluation, Karen B. Pearson Mlis, Ma, George Shaler Mph

Emergency Medical Services (EMS)

In November 2014, the Muskie School of Public Service at the University of Southern Maine was awarded a contract to evaluate the implementation of the statewide CP Pilot Program in Maine. This report presents process level results from the evaluation. The report includes findings from interviews with the twelve community paramedicine pilot sites in Maine and with the state of Maine EMS office.

The layout of the report follows the key themes and categories from our interviews:

• Staffing
• Training
• Stakeholders and Partners
• CP Services
• CP Event
• Data Collection
• Funding
• Challenges
• Successes
• Sustainability

The report concludes with lessons learned which may …

Health Literacy Improves Health Care Quality, Rebecca Cook

Applied Research Projects

A lack of knowledge about health literacy is a cause for quality healthcare concern as the world advances in health information technology. Many patients struggle to understand and navigate their health and well-being as a result of lack of understanding of the treatment plan due to low literacy skills. Several federal policy initiatives promote health literacy as the responsibility of the healthcare organization. Improving health outcomes through health literacy should be a commitment of healthcare organization through providing clear communication, simplified forms, assistance, and even follow-up calls. Three major initiatives will combat health literacy to include the Affordable Care Act; …

Phosphorus Ingestion Improves Oral Glucose Tolerance Of Healthy Male Subjects: A Crossover Experiment, May Khattab, Christelle Abi-Rashed, Hala Ghattas Ph.D., Sani Hlais, Omar Obeid

Faculty Publications

Background:

Fasting serum phosphorus (P) was reported to be inversely related to serum glucose and insulin, while the impact of P ingestion is not well documented. The effect of P intake with or before glucose ingestion on postprandial glucose and insulin statuses was investigated.

Method:

Two cross over experiments using healthy male subjects were conducted. Experiment 1: Overnight fasted subjects (n∈=∈7) randomly received: 500 mg of P tablets, glucose (75 g) solution with placebo or 500 mg of P tablets. Experiment 2: Overnight fasted subjects (n∈=∈8) underwent similar procedures to those of experiment 1, except that placebo or 500 mg …

“Everyone Is Doing It”: When Did Teenage Peer Sexual Harassment Become “Normal”?, Kathleen Phillips, Misty Rhoads, Lauri Deruiter-Willems, Shelia Simons, Richard Cavanaugh, Katrina Werner

Faculty Research and Creative Activity

A disturbing trend involves the ambivalence of students towards actions and behaviors of sexual harassment that they consider “normal”. This poster explores perceptions among teens concerning acceptance of peer-peer sexually implicit actions and behaviors.

Using Height-For-Age Differences (Had) Instead Of Height-For-Age Z-Scores (Haz) For The Meaningful Measurement Of Population-Level Catch-Up In Linear Growth In Children Less Than 5 Years Of Age, Jef L. Leroy, Marie Ruel, Jean-Pierre Habicht, Edward A. Frongillo Jr.

Faculty Publications

Background: Evidence from studies conducted in nutritionally deprived children in low- and middle-income countries (LIMC) in past decades showed little or no population-level catch-up in linear growth (mostly defined as reductions in the absolute height deficit) after 2 years of age. Recent studies, however, have reported population-level catch-up growth in children, defined as positive changes in mean height-for-age z-scores (HAZ). The aim of this paper was to assess whether population-level catch-up in linear growth is found when height-for-age difference (HAD: child’s height compared to standard, expressed in centimeters) is used instead of HAZ. Our premise is that HAZ is inappropriate …

Positive Psychiatry, Amresh Srivastava

Data and Test Instruments

Revolutionary advances in understanding mental disorders and in providing novel treatments have enhanced the expectations of patients and relatives. There is a growing demand on newer research in providing interventions that allow patients to live a normal life. Of late, concept of the illness itself has undergone significant change. It is now proposed that expected outcome from treatment of mental disorder is to achieve a state of ‚ ‘wellness.’ Positive psychiatry is a newer branch of psychological medicine that seeks to promote understanding of wellness and examines its application in intervention and prevention of mental disorders. The concept of positive …

Prevalence Of Depression Among Active Tb And Tb/Hiv Patients In Kisumu County, Esther Lee

Independent Study Project (ISP) Collection

According to the World Health Organization (WHO), one in four people have been affected by a mental health disorder at one point in their lives.^[1] Kenya’s mental disorders account for 5.9% of the total global burden.[2] Mental disorders like depression is often comorbid with TB and HIV and disproportionately affects those with lower socio-economic income. Kisumu, a city in Nyanza province, has the highest HIV and TB prevalence in Kenya. This study aimed to determine the prevalence of depression among TB non-coinfected and TB/HIV co-infected patients at Jaramogi Oginga Odinga Teaching and Referral Hospital (JOOTRH) and the Clinical …

Hurdles To Health: An Exploration Of The Social Determinants That Affect Attitudes Toward Hpv Vaccination In Salvador, Bahia, Brazil, Megan Rogers

Independent Study Project (ISP) Collection

In 2014, the Brazilian government began supplying free, preventative human papillomavirus (HPV) vaccines for girls between the ages of 9 and 13. This public health campaign has the potential to greatly reduce the high HPV infection rate in Brazil, but without targeted education and information to supplement this medical intervention the program is predicted to have a smaller impact. This study aims to assess how well information about the HPV vaccine is currently reaching young Brazilian girls and their families. Data was gathered by interviewing professionals who work in STD education, women’s issues, and healthcare advocacy, as well as one …

Exercising Agency In Medical Decision-Making Processes Conventional And Traditional Medicine -A Case Study Of 67ha, Antananarivo-, Sakura Oyama

Independent Study Project (ISP) Collection

The formal integration of traditional and conventional medicine has been touted as a prime method to improve access to quality healthcare in Madagascar. This study draws on interviews with both traditional and conventional medical professionals as well as 100 residents of 67ha, Antananarivo to critically analyze the advantages of each sector in order to understand how integration can be used to strengthen the medical-decision making capacities of marginalized populations. Currently the ability for millions of Malagasy to exercise their freedom of choice in seeking their treatment method of choice is seriously compromised not only by cost and accessibility but by …

Treatment Accessibility For Co-Infected Idus In China: A Likelihood For Hiv, An Improbability For Hepatitis C, Jessica Collins

Independent Study Project (ISP) Collection

In a country which provides free medicine and care for patients living with HIV/AIDS, China has not included a crucial piece of the problem in its health care scheme. In Yunnan Province alone, 77.7 % of intravenous drug users are co-infected with HIV and hepatitis C. While these patients can obtain treatment for HIV with ease, they cannot do so to treat their hepatitis C infection, a viral disease that leads to liver failure. Recent trends indicate that more co-infected patients are dying of HCV rather than HIV due to treatment inaccessibility. This study investigates theseverity of HCV in China, …

European Policies On Cardiovascular Disease Prevention And Health Promotion: A Comparative Study, Alison Council

Independent Study Project (ISP) Collection

As the number one cause of death, cardiovascular disease represents a threat to both the economic and social well being of European countries. As a result of a variety of coordinated efforts between the European Union (EU), national governments, nonprofits, private industry, and local communities, cardiovascular disease (CVD) has been decreasing in most countries in recent years. Measures such as bans on trans fats in Denmark, social mobilization and prevention policy in Finland, and nutrition labeling in the United Kingdom have had major impacts on heart disease. For instance, Finland’s prevention programs have resulted in a 63% reduction in deaths …

Dissemination Of An Electronic Manual To Build Capacity For Implementing Farmers’ Markets With Community Health Centers, M Aaron Guest, Darcy Freedman, Kassandra A. Alia, Heather M. Brandt, Daniela B. Friedman

Faculty Publications

Community-university partnerships can lend themselves to the development of tools that encourage and promote future community health development. The electronic manual, "Building Farmacies," describes an approach for developing capacity and sustaining a community health center-based farmers' market that emerged through a community-university partnership. Manual development was guided by the Knowledge to Action Framework and experiences developing a multivendor, produce-only farmers' market at a community health center in rural South Carolina. The manual was created to illustrate an innovative solution for community health development. The manual was disseminated electronically through 25 listservs and interested individuals voluntarily completed a Web-based survey to …

Goddesses Versus Gynecologists: An Analysis Of The History Of Women’S Healthcare, Marion A. Mckenzie

Student Publications

Starting from the downfall of Goddess cultures in Europe, women's health care has been negatively impacted for generations. The rise of the white, male Indo-European "dominator model" along with the witch craze, caused the end of widespread wise women traditions and pharmacopeia methods. After women's traditional voice was silenced, medical colleges were established to pronounce new, "professional" knowledge. Only those who attended these universities were allowed to legally practice medicine; however, during this time, medical research and treatments for women primarily included mutilation and painful, nonsensical regimens. The horrifying state of women's healthcare has since improved, but was originally a …

#Aulivewholly, Patricia Spangler

Faculty Publications

Andrews University officially launched its new University Health & Wellness initiative on Wednesday, September 23. The initiative will integrate five deeply connected pillars: physical, spiritual, mental, relational and professional wellness, but mainly focus on physical health and wellness to address the gaps that have been identified.

Social And Behavioral Implications Of National Collegiate Athletic Association Sickle Cell Trait Screening: The Athletes' Perspective, Raymona H. Lawrence, Alison Scott, Carlton Haywood Jr., Kayin Robinson, Mondi Mason

Community Health: Faculty Publications

Background: In August 2010, the National Collegiate Athletic Association (NCAA) implemented a policy mandating sickle cell trait (SCT) testing for all Division I collegiate athletes. Subsequently, all Division II-III athletes were also compelled to undergo SCT testing. This decision has met with controversy among healthcare providers, researchers, and sickle cell advocates. However, there is little information concerning the athletes’ perspective of this policy. The purpose of this paper is to report the findings of a qualitative study that explored college athletes’ perceptions of sickle cell trait SCT, NCAA policies on SCT testing, and potential implications of SCT screening.

Methods: …

El Impacto De Los Lazos Familiares En La Salud Física, Emocional Y Espiritual En Cuidados Paliativos: Un Estudio De La Clínica Familia, Max Meyerhoff

Independent Study Project (ISP) Collection

Research Question: How do Chilean family ties impact the physical, emotional and spiritual health of patients in a palliative care facility?

Objective: Understand the role that the tight-knit Chilean family structure plays during the palliative care process and how these family ties affect the physical, emotional and spiritual well being of the patient.

Background: Chile has recently gone through an epidemiological transition. Due to improved access to primary care fewer people are dying from infectious diseases. However, because they are now living longer, more Chileans are now dying from slow-acting noncommunicable diseases. Due to these slower acting …

Child Nutrition And Fitness In Switzerland And The United Kingdom: Analyzing Preventative Solutions For The Developing Obesity And Diabetes Crises, Nicolas Selemon

Independent Study Project (ISP) Collection

The current study takes a novel approach to analyzing how child nutrition and fitness can be used as preventative measures to solve the ongoing crises of obesity and diabetes. A comparison case-study between two stereotypically different European nations, Switzerland and the United Kingdom, was utilized to address how nutrition and fitness education, policy, culture and programs affect the health of the country. Each nation was analyzed comprehensively, accounting for dietary and exercise practices from infant stages to adolescence. Personal interviews with experts in the fields of breastfeeding, nutrition and fitness provided the main sources of information. Primary research was supplemented …

Factors Associated With Colorectal Cancer Screening Among Younger African American Men: A Systematic Review, Charles R. Rogers, Patricia Goodson, Margaret Foster

Journal of Health Disparities Research and Practice

Of cancers affecting both men and women, colorectal cancer (CRC) is the second leading cancer killer among African Americans in the U.S. Compared to White men, African American men have incidence and mortality rates 25% and 50% higher from CRC. Despite the benefits of early detection and the availability of effective screening, most adults over age 50 have not undergone testing, and disparities in colorectal cancer screening (CRCS) persist. Owing to CRC’s high incidence and younger age at presentation among African American men, CRCS is warranted at age 45 rather than 50. However, the factors influencing young adult (i.e., age < 50) African American men’s intention to screen and/or their CRCS behaviors has not been systematically assessed. To assess whether the factors influencing young adult African American men’s screening intentions and behaviors are changeable through structured health education interventions, we conducted a systematic review, with the two-fold purpose of: (1) synthesizing studies examining African American men's knowledge, beliefs, and behaviors regarding CRCS; and (2) assessing these studies’ methodological quality. Utilizing Garrard’s Matrix Method, a total of 28 manuscripts met our inclusion/exclusion criteria: 20 studies followed a non-experimental research design, 4 comprised a quasi-experimental design, and 4, an experimental design. Studies were published between 2002 and 2012; the majority, between 2007 and 2011. The factors most frequently assessed were behaviors (79%), beliefs (68%), and knowledge (61%) of CRC and CRCS. Six factors associated with CRC and CRCS emerged: previous CRCS, CRC test preference, perceived benefits, perceived barriers, CRC/CRCS knowledge, and physician support/recommendation. Studies were assigned a methodological quality score (MQS – ranging from 0 to 21). The mean MQS of 10.9 indicated these studies were, overall, of medium quality and suffered from specific flaws. Alongside a call for more rigorous research, this review provides important suggestions for practice and culturally relevant interventions.

Assessment Of The Perceived Role And Function Of A Community Advisory Board In A Nih Center Of Excellence: Lessons Learned, Margaret L. Walsh, Desiree Rivers, Maria Pinzon, Nina Entrekin, Emily M. Hite, Julie A. Baldwin

Journal of Health Disparities Research and Practice

Background: The Community Advisory Board (CAB) was a vital component of the Center for Equal Health. The center addressed health disparities through community-based research and educational outreach initiatives. Objectives: To evaluate the perceived relationship of the CAB and Center, explore members’ perceptions of the CAB’s role, and elicit feedback on how to enhance the relationship between the Center and the CAB. Methods: Ten in-depth, semi-structured interviews were conducted. All interviews were transcribed verbatim and analyzed with a focus on predetermined codes. Results: Main themes focused on perception of CAB roles and need for utilization of board members; overall center challenges; …

The Complexities Of Childhood Obesity: A Qualitative Study Among Mexican American Mothers, Erica T. Sosa, E. Lisako Mckyer, Buzz Pruitt, Patricia Goodson, Linda Castillo

Journal of Health Disparities Research and Practice

Introduction: Mothers play an important role in preventing childhood obesity; however, might differ in how they define healthy weight and the associated consequences. Due to the lack of research investigating how Mexican American mothers perceive childhood obesity, the purpose of this paper is to qualitatively assess Mexican-American mothers’ perceptions regarding childhood obesity, its causes and consequences.

Methods: Three focus groups, two in Spanish and one in English, were conducted with 23 mothers in Bryan, TX. Thematic analysis was performed by three researchers independently using sentences as the unit of meaning.

Findings: Mexican American mothers believed that a …

The Controversy Of Vaccinations, Nicholas G. Aboreden

The Kabod

Recently vaccination has become a controversial topic. There is a growing number of people who believe that vaccines carry great health risks to patients and therefore refuse to be vaccinated or to vaccinate their children. This ill-informed view of immunizations is beginning to cause serious problems in the United States as growing numbers of disease cases are being seen. A closer look into the science of vaccines and the benefits they have brought, clearly show that not only do vaccines carry very little risk to patients, but they are responsible for the eradication and reduction of multiple debilitating diseases.

Think Inside The Blocks: Health Literacy Outreach To Disadvantaged People In Their Own Environment, Nancy Patterson

Georgia International Conference on Information Literacy

This bilingual (Spanish/English) poster highlights six creative health literacy outreach projects that have proven to be successful in increasing participation in health-related events in their communities and in boosting health literacy in the process.

For example, in Georgetown, South Carolina, a beauty salon owner, concerned about her clients’ frequent frustration with trying to decipher medical information, partners with her local public library and is grant funded to provide a Wellness Workstation in her salon. Years later, her clients research health information between services using the workstation, evening health literacy classes are regularly conducted for community members and continued funding has …

Parenting Around Child Snacking: Development Of A Theoretically-Guided, Empirically Informed Conceptual Model, Kirsten K. Davison, Christine E. Blake Ph.D., Rd, Rachel E. Blaine, Nicholas A. Younginer, Alexandria Orloski, Heather A. Hamtil, Claudia Ganter, Yasmeen P. Bruton, Amber E. Vaughn, Jennifer O. Fisher

Faculty Publications

Background: Snacking contributes to excessive energy intakes in children. Yet factors shaping child snacking are virtually unstudied. This study examines food parenting practices specific to child snacking among low-income caregivers. Methods: Semi-structured interviews were conducted in English or Spanish with 60 low-income caregivers of preschool-aged children (18 non-Hispanic white, 22 African American/Black, 20 Hispanic; 92% mothers). A structured interview guide was used to solicit caregivers' definitions of snacking and strategies they use to decide what, when and how much snack their child eats. Interviews were audio-recorded, transcribed verbatim and analyzed using an iterative theory-based and grounded approach. A conceptual model …

A Socio-Ecological Model Of Affordable Care Act Acceptance, Pratiksha Vaghela

USF Tampa Graduate Theses and Dissertations

Background: Since 1965, there have not been any major revisions of the healthcare laws in the United States, until the recent implementation of the Affordable Care Act (ACA). However, ACA is not well understood and is often controversial. The purpose of this study is to: (1) evaluate the relationship between the employers’ and the employees’ perceptions regarding the ACA mandates for small businesses, (2) evaluate the relationship between the self-reported and the tested knowledge of individuals regarding the ACA mandates for small businesses, and (3) determine if socio-demographic factors influence individual’s perception of the law. Based on the gathered information, …

Early Childhood Development And The Social Determinants Of Health Inequities: A Review Of The Evidence, Tim Moore, Myfanwy Mcdonal, Harriet Mchugh-Dillon

Mickey Leland Center Information Portal

This report focuses on early childhood development and the social determinants of health inequities. It is one of eight reviews of evidence commissioned by VicHealth to support the use of a planning tool for health promotion policy and practice in Victoria, known as Fair Foundations.

Exploring Cyber Harassment Among Women Who Use Social Media, Sloane Burke Winkelman, Jody Oomen-Early, Ashley D. Walker, Lawrence Chu, Alice Yick-Flanagan

Community Health: Faculty Publications

The number of Internet users around the word is at an all-time high. The majority of North Americans are internet users and over two-thirds participate in some kind of social network (i.e. Facebook, Twitter, etc.). Social networks and mobile technology enable individuals to connect instantaneously or asynchronously, across geographic boundaries publicly or anonymously. Few studies exploring cyber harassment have been conducted, primarily because these technologies are relatively recent. The purpose of this descriptive study was to examine U.S. women's experiences with and attitudes toward cyber harassment by way of an anonymous electronic survey. A total of 293 adult women (mean …

Sociodemographic Factors To Dengue Hemmorrhagic Fever Case In Indonesia, Desy Nuryunarsih

Kesmas

Demam berdarah dengue (DBD) adalah penyebab utama rawat inap dan kematian pada anak-anak. Indonesia adalah salah satu negara yang oleh WHO dikategorikan hyperendemicity dengan empat serotipe virus tersebar di daerah perkotaan. Faktor sosiodemografi dianggap sebagai faktor pendukung terjadinya DBD di Indonesia. Studi ini menggunakan data sekunder yang diunduh dari Basis Data Kesehatan Provinsi tahun 2010 Kementerian Kesehatan Republik Indonesia untuk menentukan korelasi antara ketiga faktor sosiodemografi dengan insiden DBD. Penelitian ini menggunakan metode kuantitatif deskripsi korelasi. Hasil penelitian menunjukkan bahwa dua faktor sosiodemografi terpilih memiliki korelasi linier dengan insiden DBD. Analisa regresi multivariat menunjukkan kecilnya korelasi antara insiden DBD dengan …

Penerapan Sistem Remunerasi Dan Kinerja Pelayanan, Tri Wisesa Soetisna, Dumilah Ayuningtyas, Misnaniarti Misnaniarti

Kesmas

Remuneration can influence worker`s motivation, and improve their performance. Likewise in hospital as capital-intensive, human resources-intensive as well as knowledge and technology-intensive health care institution. This study aimed to analyze employee’s perception of remuneration system implementation and adult cardiac surgery services unit’s performance at hospital. This study used a mixed method approach (quantitative and qualitative). Quantitative study design was cross-sectional using questionnaire for self-assesment. Meanwhile, qualitative study design was descriptive conducted through focus group discussion and document review on data in forms of schedule book, registration book, nursing notes and medical records. Data collection was conducted in 2013 at one …

Analisis Sif Kerja, Masa Kerja, Dan Budaya K3 Dengan Fungsi Paru Pekerja Tambang Batu Bara, Qomariyatus Sholihah, Aprizal Satria Hanafi, Wanti Wanti, Ahmad Alim Bachri, Sutarto Hadi

Kesmas

Penambangan batu bara merupakan salah satu sumber pencemaran udara berupa partikel debu batu bara yang dapat mengganggu kesehatan pernapasan bila terhirup manusia. Risiko kerja yang sering terjadi dapat berasal dari faktor pekerjaan atau perilaku pekerja sendiri, di antaranya sif kerja dan masa kerja. Tujuan penelitian adalah untuk mengetahui hubungan sif kerja, masa kerja, dan budaya keselamatan dan kesehatan kerja (K3) dengan fungsi paru pekerja tambang batu bara. Penelitian ini merupakan desain kasus kontrol dengan jumlah masing-masing sampel untuk kasus dan kontrol sebesar 178 responden. Penelitian dilakukan pada bulan Oktober November 2014 di PT. X Kalimantan Selatan. Hasil penelitian berdasarkan uji …

Tradisi Dan Lingkungan Sosial Memengaruhi Dukungan Menyusui Pada Bayi Berat Badan Lahir Rendah Di Kota Malang, Muladefi Choiriyah, Elsi Dwi Hapsari, Wiwin Lismidiati

Kesmas

Berat badan lahir rendah (BBLR) merupakan salah satu penyebab utama kematian bayi di dunia. World Health Organization tahun 2003 telah merekomendasikan menyusui sebagai salah satu penanganan BBLR. Namun, ibu yang memiliki bayi BBLR mengalami kesulitan di awal persalinan. Selain itu, menyusui di Indonesia juga dipengaruhi oleh sosial dan budaya yang dipercayai sehingga memengaruhi keputusan ibu untuk memilih tetap menyusui atau tidak sama sekali di periode awal postpartum. Tujuan penelitian ini untuk mengeksplorasi makna pengalaman ibu untuk tetap menyusui bayi dengan BBLR. Penelitian kualitatif ini dengan pendekatan fenomenologi. Tujuh orang partisipan adalah ibu yang pernah menyusui bayi BBLR. Pengumpulan data dilakukan …