Community Health Commons^™

Multilevel Analysis Of Individual, Neighborhood, And Health Care Facility Characteristics Associated With Achievement And Maintenance Of Hiv Viral Suppression Among Persons Newly Diagnosed With Hiv In New York City, Ellen W. Wiewel

Dissertations, Theses, and Capstone Projects

Objective

To investigate the effect of individual, health care facility, and neighborhood characteristics on achievement and maintenance of HIV viral suppression, among New York City residents aged 13 years and older diagnosed with HIV between 2006 and 2012.

Methods

I used individual-level data from the New York City HIV surveillance registry and Case Surveillance-Based Sampling, facility-level data from the surveillance registry, and neighborhood-level data from the U.S. Census and American Community Survey. The outcomes of interest were first viral suppression after diagnosis (Aims 1 and 3; ≤400 copies/mL) and virologic failure after first suppression among persons who achieved suppression (Aim …

A Culture That Fosters Concussions: Does Increased Education Lead To More Accurate Reporting Of Concussions?, Michael Heptig

PCOM Psychology Dissertations

With over 1.7 million incidents reported annually, concussion has become the most common class of traumatic brain injury (TBI) in the United States (Bazarian, Zhu, Blyth, Borrino, & Zhong, 2012). As staggering a statistic as this may be, many believe it fails to represent the true number of concussions because the non-reporting of symptoms has been commonplace among athletes (Khurana & Kaye, 2012; Williamson & Goodman, 2006). The aim of this study was to determine those factors that influence the reporting of concussion symptoms. Specific variables that were examined include the amount of concussion education provided (determined by requisite amount …

Low Self-Esteem Leads To Depression Among Elderly: Case Study Of Nursing Home, Savera Aziz Ali, Nadir Suhail, Sumera Aziz Ali

School of Nursing & Midwifery

Background: Self-esteem is defined as “how we value our self”; it affects our trust and relationships in every part of life. Person with low self-esteem may feel powerless and incompetent about himself/herself. Moreover, low self-esteem operates as a risk factor for depression, which is most common disorder among elderly people both in developed and developing countries, causing multiple behavioral changes as well as may increase the chances of depression and suicide among the elderly people. Objective: The objective of this case study was to understand the problems faced by elderly people in the nursing home and to relate the self-esteem …

Development And Evaluation Of A Peer-To-Peer Intervention To Increase Self-Management Among Adult In-Center Hemodialysis Patients, Jennifer J. St Clair Russell

Theses and Dissertations

Background: Peer-to-peer (P2P) support programs have the potential to assist ESRD patients in managing their disease and improve outcomes. Yet, there is little research examining P2P programs’ impact on psychosocial outcomes and disease management behaviors.

Methods: A 4-month P2P mentoring intervention was designed and piloted in a facility serving 249 in-center hemodialysis patients in Lynchburg, Virginia. Preceded by a social marketing effort, which included a program naming contest and participant recruitment, the intervention included: (1) mentor training, (2) pairing of mentees and mentors, (3) kick-off social mixers, (4) ongoing meetings between mentees and mentors, (5) mentor training booster, and (6) …

Healthcare Access In Women’S Prisons: An Intersectional Perspective, Megan R. Bray

Undergraduate Research Posters

This project will be identifying the key factors that contribute to the significant lack of health care in prisons in the U.S., specifically in women’s correctional facilities. I will be lending my focus to disparities in mental health, HIV/AIDs care, reproductive health, trans health, and physical health issues among women who are either currently incarcerated or those who have completed their sentences and are at higher risk for re-entry after attempting re-integration. There is a lack of care, access, and proper treatment for women inmates in U.S. prisons and reform is needed. I foresee the best possible way to accomplish …

Hiv/Aids Care And Prevention Infrastructure In The U.S. Deep South, Susan S. Reif, Kristen Sullivan, Elena Wilson, Miriam Berger, Carolyn Mcallaster

Faculty Scholarship

No abstract provided.

794 Evaluating Disability In Adult Burn Injury Patients Treated At A Tertiary-Care Burn Unit In Karachi, Pakistan: A Longitudinal Study Using Who Disability Assessment Schedule Ii, Nukhba Zia, Asim Durrani, Safia Awan, Madiha Hashmi, Mazhar Nizam, Asad Latif

Department of Anaesthesia

Background: Disability after burn injury is not assessed in the context of Pakistan. This study assesses disability among adult burn injury patients presenting to a burn unit in Karachi, Pakistan.
Methods: This longitudinal study was conducted at a burn centre is Karachi, Pakistan. Adult patients(>18 years) who were discharge after 24-hour admission were enrolled from August 2014–March 2015. Baseline assessment before discharge and follow-up at 2,6 and 12 weeks after discharge via telephone was done using 12-item WHODAS 2.0 (5 -point likert-scale; 1 = none; 2 = mild; 3 = moderate; 4 = severe; and 5 = extreme) related …

Promoting Completion Of Advance Directives In A Hispanic Religious Congregation: An Evidence-Based Practice Project, Luis Daniel San Miguel, Mary Jo Clark

Doctor of Nursing Practice Final Manuscripts

Background: Hispanics utilize more aggressive medical treatment at the end of life and are less likely to receive end-of-life care consistent with their wishes than nonHispanic Whites. Hispanics are less likely than nonHispanic Whites to have an advance directive (AD). Increasing AD completion among Hispanics can promote end-of-life care consistent with their wishes, diminish healthcare disparities, and eliminate unnecessary healthcare spending. Objectives: To promote completion of advance directives by increasing knowledge, positive attitudes, and comfort with advance care planning (ACP) among Hispanics through culturally sensitive interventions. Intervention: The project was conducted in Spanish and implemented among a …

Cost Of Primary Health Care In Pakistan, Muhammad Ashar Malik, Wahid Gul, Saleem Per Waiz Iqbal, Farina Abrejo

Community Health Sciences

Background: Detailed cost analysis is an important tool for review of health policy and reforms. We provide an estimate of cost of service and its detailed breakup on out-door patient visits (OPV) to basic health units (BHU) in Pakistan.

Method: Six BHUs were randomly selected from each of the five districts in Khyber Pukhtonkhawa (KPK) and two agencies in Federally Administered Tribal Areas (FATA) of Pakistan for this study. Actual expenditure data and utilization data in the year 2005 –06 of 42 BHUs was collected from selected district health offices in KPK and FATA. Costs were estimated for outpatient visits …

The Role Of Occupational Therapy In Primary Care, Priti Patel

Occupational Therapy Doctorate Capstone Projects

The Capstone Project is focused on communicating, influencing and educating other health care professionals regarding the role of occupational therapy in the future model of primary care delivery initiated by the adoption of the Affordable Care Act and the Triple Aim Initiative. Currently, primary care, the largest health care platform in United States, is not inclusive of occupational therapy services. Occupational therapists have the scope, knowledge and understanding to be part of the redesigned team model of primary care. Educating those currently working in primary care about adding occupational therapy services can have a significant impact on the profession of …

Improving Depression Care For Older Home Health Patients, Sarah R. Schirmer

DNP Projects

Rates of depression in older home healthcare (HH) patients are highly prevalent. Although depression in this population is associated with increased rates of re-hospitalization, falls, and suicides, it is frequently under diagnosed and under treated. This Capstone Report examined this problem through three interrelated manuscripts. The first manuscript explored the problem through a review of the literature. This review determined that while there are many barriers to adequate depression care, programs that train clinicians to screen for depression and connect patients to depression care encourage adequate evaluation and treatment and can result in clinically significant changes in depression scores. This …

Utilization Of Anc And Pnc Services In Nepal : A Multivariate Analysis Based On Nepal Demographic Health Survey 2001 And 2006, Gehendra Mahara, Collins Asweto, Kai Cao, Ali M. Alzain, Andrea Sebastian, Jill Barr, Xiuhua Guo, Wei Wang

Research outputs 2014 to 2021

Background: Maternal Mortality is a public health problem in Nepal, which was highest in 1990 among the South Asian countries. Associated factors of maternal mortality are various; among them maternal health sevices such as antenatal (ANC) and postnatal care (PNC) services are the main. Methods: A multivariate secondary data analysis out based on Nepal Demographic Health Surveys 2001 and 2006. Logistic regression models was performed to compare the utilization of the ANC and PNC services, with background characteristics of women aged between 15 to 49 years old. Results: A total of 8913 reproductive aged groups (15-49) women were taken f …

La Cesárea Y El Parto Natural: Las Opiniones De Profesionales De La Salud En La Provincia De Buenos Aires / Cesarean Section And Natural Birth: The Opinions Of Health Provinces In The Province Of Buenos Aires, Jacqueline Chipkin

Independent Study Project (ISP) Collection

Introduction: The ways in which women of society give birth have the power to influence maternal-infant health and shape the economy of the healthcare system. Today, the rates of cesarean sections are increasing throughout the world. In Argentina, on average, more than 35% of pregnant women received cesarean sections in 2008, with large differences observed in the rates between the public and private health sectors. The World Health Organization (WHO) has established that healthcare systems should only employ a cesarean section if labor cannot progress safely. According to this standard, the organization estimates that cesarean sections should only be utilized …

Education And Training For Suicide Prevention In India, Amresh Srivastava

Data and Test Instruments

No abstract provided.

The Capus Project-Innovative Solutions For Hiv/Aids Linkage To Care, Melanie Gwynn, Jamila Ealey, Kate Racoff Musgrove

9th Annual Rural HIV Research & Training Conference (2014-2019) (Archived)

“The CAPUS Project-Innovative Solutions for HIV/AIDS Linkage to Care”

Objectives: 1) Expand knowledge of the current linkage to care landscape within Georgia; 2) Identify essential components of the Resource Hub to enhance linkage to care efforts throughout Georgia; and 3)Promote effective use of the Resource Hub to facilitate HIV/AIDS linkage to care within highly impacted communities

Tackling The Existing Burden Of Infectious Diseases In The Developing World: Existing Gaps And The Way Forward, Zulfiqar Ahmed Bhutta, Rehana A. Salam, Jai K. Das, Zohra S. Lassi

Department of Paediatrics and Child Health

This series evaluates the effectiveness of community-based interventions (CBIs) to prevent and control infectious diseases of poverty (IDoP). Evidence from our reviews suggests that CBIs and school-based delivery platforms are effective in averting risk behaviors and reducing the disease burden. Co-implementation of interventions through existing community-based programs including immunization campaigns, antenatal care and maternal and child health programs have the potential to scale-up interventions for IDoP. Future research should focus on the process of developing and implementing efficient community-based programs through a comprehensive approach, and to gauge the effectiveness of various existing delivery models in order to improve morbidity and …

Emerging Challenges And Health System Capacity: The Case Of Non- Communicable Diseases In Pakistan; A Review, Mubashir Zafar, Muhammad Ashar Malik

Community Health Sciences

Background: Pakistan is facing double burden of disease and the contribution of mortality by non-communicable diseases has over numbered the communicable diseases. The focus of health system of Pakistan is inclined more towards communicable disease and maternal & child health. Therefore, there is a need to review health policy, health sector budgeting and health setup in order to meet the needs of healthcare in context of non-communicable disease.

Objective: To review the health system capacity to manage the emerging challenge of non-communicable diseases in Pakistan.

Methodology: A thorough literature search on PubMed and Google Scholar was done. Reports from W.H.O, …

Nutrition Political Economy, Pakistan. Province Report:Sindh, Shehla Zaidi, Zulfiqar Ahmed Bhutta, Rozina Mistry, Gul Nawaz, Noorya Hayat, Shandana Khan Mohmand, Andres Mejia Acosta

Community Health Sciences

No abstract provided.

Suicidal Ideation In Callers To A Crisis Hotline In Mumbai,, Amresh Srivastava, Megan Johnston, Larry Stitt, Meghana Thanksr, Sunita Iyer, Nilesh Shah, David Lester

Data and Test Instruments

Suicidal ideation in callers to a crisis hotline in Mumbai, India Amresh K. Shrivastava1,2, Megan Johnston3, Larry Stitt4, Meghana Thakar5, Sunita Iyer6, Nilesh Shah7 and David Lester8* 1Silver Mind Hospital and Mental Health Foundation of India, (PRERANA Charitable Trust) Mumbai. 2Department of Psychiatry, University of Western Ontario, London, Canada. 3Department of Psychology, University of Toronto, 100 St. George St., Toronto, Ontario, Canada, M5S 2M2. 4Biostatistical Support Unit, Department of Epidemiology and Biostatistics, The University of Western Ontario, London, Ontario, Canada. 5Silver mind Hospital, Mumbai, Currently, Child and Adolescent Mental Health Practitioner, Lambeth CAMHS Early Intervention Team, South London and Maudsley …

Les Enfants Dans Les Coins: Une Comparaison D’Autisme En France Et Aux Etats Unis, Danya J. M. Rubin

Scripps Senior Theses

The year 2012 was a year of great controversy surrounding autism in France. Thus it is an ideal time for an investigation of the treatment of and attitudes about autism in France, specifically in comparison with the United States. This investigation encompass several specific categories, and the Freudian psychoanalytic method against the behavior modification method, the French education system and the identification of autism, "Maternal Madness" - the connection between sexism and autism, the philosophy of humanity and the history of medical experimentation and psychiatry in France. This paper questions how is it that all these categories influence the opinions …

Impact Of Water And Sanitation And Health Education Interventions On Health And Hygiene Behaviors: A Study From A Northern Pakistani Village, Aysha Zahidie, Fauziah Rabbani

Community Health Sciences

Introduction: Water and sanitation interventions were delivered in the northern areas of Pakistan as a joint venture of the Aga Khan University and the Aga Khan Health Systems Oshikhandass Diarrhea and Dysentery Project (1989-96) followed by the Aga Khan Water, Sanitation, Health and Hygiene Studies Program (WSHHSP). Through these interventions water treatment plants, new pit latrines along with a component of health education were introduced. Objectives: To explore perceptions, knowledge and practices of inhabitants of Oshikhandass village in Gilgit related to water quality, latrine use and hand washing following the intervention. Methods: Through a cross-sectional study during June-July 2012, six …

The Patient Process And Affordable Care Act Of 2010: Implementation Challenges In The Context Of Federalism, Robert F. Rich, Eric Cheung, Robert Lurvey

Journal of Health Care Law and Policy

No abstract provided.

Correlates Of Consistent Condom Use Among Female Entertainment Workers In Shanghai, China: A Repeated Measures Analysis, Xiushi Yang, Guomei Xia

Sociology & Criminal Justice Faculty Publications

Female entertainment workers (FEWs) in China are at increased risk of HIV and other sexually transmitted infections, but correlates of their risky sexual behaviour remain poorly understood. Using data from a series of four surveys, this paper employs repeated measures analysis to identify individual and social correlates of consistent condom use among FEWs in Shanghai. Results reveal that both individual cognitive and social influence factors are statistically significant in their bivariate relationships to consistent condom use with a stable or non-stable partner; only prevention motivation and perceived self-efficacy in condom use remain significant in the multiple regressions. When individual and …

Situation Analysis Of Child Labour In Karachi, Pakistan: A Qualitative Study, Asaad Ahmed Nafees, Kausar S. Khan, Zafar Fatmi, Mubashir Aslam

Community Health Sciences

In Karachi, large employment opportunities, burgeoning population and the availability of cheap labour might be the contributing factors for the increasing prevalence of child labour. A literature review was conducted in 2007 that included published and unpublished literature since 2000. Various organizations working in the field were also covered, while the perception of the child labourers was covered through three focus group discussions. Common health issues among the child labourers in Karachi included respiratory illnesses, fever and generalised pains, as well as drug and sexual abuse. Organisations working for child labour could be broadly categorised into those working for legal …

Evaluating The Effectiveness Of The Blood Pressure Plus Program At Thomas Jefferson University, Adam C. Winters

Department of Family & Community Medicine Faculty Papers

Thomas Jefferson University Hospital’s Blood Pressure Plus program enhances the role of the community in chronic disease prevention and management. There is much evidence that controlling disease and cost is greatly improved through the involvement of community leaders and resources. By offering free blood pressure screenings, the BP+ program was able to document the current status of many underserved individuals in the city of Philadelphia, provide the necessary education and referrals. Perhaps more importantly, the program allowed us to foster relationships with individuals who could further the efforts of chronic care management within their communities. More and more we’re seeing …

Primary Care Behavioral Health Consultation Reduces Depression Levels Among Mood-Disordered Patients, Bill Mcfeature, Thomas W. Pierce

Journal of Health Disparities Research and Practice

The purpose of this study was to examine the effects of behavioral health consultative services on levels of depressive symptoms in patients diagnosed with a mood disorder. Two-hundred fifty-one patients with a form of mood disorder completed the PHQ-9 screening tool for depression both before and after a treatment period lasting an average of three months, during which patients received behavioral health consultation services. Results showed that 49.8% of patients participating in this integrated behavioral health care program experienced improvements of at least 50% in PHQ-9 scores from pre- to post-test. Improvements in PHQ-9 scores of at least a five …

Community-Based Partnerships For Improving Chronic Disease Management, James Plumb, Laura Carson Weinsten, Rickie Brawer, Kevin Scott

Department of Family & Community Medicine Faculty Papers

With the growing burden of chronic disease, the medical and public health communities are re-examining their roles and opportunities for more effective prevention and clinical interventions. The potential to significantly improve chronic disease prevention and have an impact on morbidity and mortality from chronic conditions is enhanced by adopting strategies that incorporate a social ecology perspective, realigning the patient-physician relationship, integrating population health perspectives into the Chronic Care Model, and effectively engaging communities using established principles of community engagement.

Copyright © 2012 Elsevier Inc. All rights reserved.

Malnutrition In Young Pakistani Children, Shela Akbar Ali Hirani

School of Nursing & Midwifery

Background: Pakistan is a developing country with the second highest infant and child mortality rate in South Asia. In this region, malnutrition underlies much of the high infant and under five child morbidity and mortality rates. Although struggle to tackle the issue of malnutrition among young Pakistani children has been going on since many decades, till yet a realistic solution for this growing problem has not been found.

Objective: This paper aims at reviewing literature to analyse the biological, maternal, socio-cultural, environmental, and politico-economical determinants of malnutrition among young children in Pakistan so that need based interventions can …

Health Disparities Experienced By People With Disabilities In The United States: A Behavioral Risk Factor Surveillance System Study, Jennifer Renee Pharr, Timothy J. Bungum

School of Public Health Faculty Research

The Americans with Disabilities Act became law in 1990; since then research has shown that people with disabilities continue to experience barriers to health care. The purpose of this study was to compare utilization of preventive services, chronic disease rates, and engagement in health risk behaviors of participants with differing severities of disabilities to those without disabilities. This study was a secondary analysis of 2010 data collected in the Behavioral Risk Factor Surveillance System national survey in the United States. Rao Chi square test and logistic regression were employed. Participants with disabilities had significantly higher adjusted odds ratios for all …

The Influence Of Federally Qualified Health Centers On Selected Ambulatory Care Sensitive Conditions In Georgia, Mary W. King Mathis

College of Graduate Studies: Theses & Dissertations

Author's Abstract: Ambulatory care sensitive conditions (ACSCs) resulting in hospitalizations make up a substantial proportion of health care costs, but should not because these conditions are manageable in quality primary care settings that promote prevention in an effort to avoid exacerbations that can lead to hospitalization. The use of emergency departments (EDs) as a safety net for ACSCs has increased the burden on hospitals because patients who do not regularly utilize primary care often resort to the use of EDs for treatment of ACSCs. Federally qualified health centers (FQHCs) are designed to provide consistent, high-quality primary care to all people, …