Concentrations Of Lead, Mercury, Arsenic, Cadmium, Manganese, And Aluminum In The Blood Of Pakistani Children With And Without Autism Spectrum Disorder And Their Associated Factors, Mohammad H. Rahbar, Shahnaz H. Ibrahim, Syed Iqbal Azam, Manouchehr Hessabi, Fatima Karim, Sori Kim, Jing Zhang, Nasreen Gulzar Ali, Katherine A. Loveland

Department of Paediatrics and Child Health

Background: Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder with early onset in utero or childhood. Environmental exposure to six metals (Pb, Hg, As, Cd, Mn, Al) is believed to be associated with ASD directly or interactively with genes. Objective: To assess the association of ASD among Pakistani children with the six metals and genotype frequencies of three GST genes (GSTP1, GSTM1, GSTT1).
Methods: We enrolled 30 ASD cases, age 2-12 years old, and 30 age- and sex-matched typically developing (TD) controls in Karachi, Pakistan. We assessed associations of ASD status with various factors using …

Use Of Telehealth In Home-Based End-Of-Life Care For Children In Rural Regions, Meaghann S. Weaver

Theses & Dissertations

A national shortage in pediatric-trained providers results in certain geographies, primarily rural, where children with special needs are not able to access home-based care at their end-of-life. Advances in technology have made the use of telemedicine a potential modality for palliative care subspecialty clinicians to provide clinical care and support for adult-trained hospice teams. This dissertation utilizes four approaches to consider telehealth as an unexplored opportunity in care delivery: (1) a systematic review of telehealth measures and instruments to select the Technology Acceptance Model as a validated metric of telehealth acceptance uniquely now applied to pediatric care; (b) a pilot …

Strategies For Addressing Vaccination Disparities And Rates In The U.S Among Racial/Ethnic Minority Adults, Harpreet Kaur

Master's Projects and Capstones

As new and emerging infectious diseases surface, public health officials are working harder to close the immunization gap. Every year, thousands of adults in the U.S suffer adverse health outcomes and die from vaccine-preventable diseases. The COVID-19 pandemic has reminded us of the power of vaccines as they have been able to eradicate diseases, save lives, and create healthier communities. A literature review was conducted to identify the gaps in research as it relates to vaccine disparities among racial/ethnic adult populations.

The literature indicates that ethnic/racial minorities are at disproportionate risk for vaccine-preventable diseases and data has shown increasingly high …

Protective Factors That Foster Resilience To Hiv/Aids: Insights And Lived Experiences Of Older Gay, Bisexual, And Other Men Who Have Sex With Men, Renato M. Liboro, Tammy C. Yates, Sherry Bell, Brandon Ranuschio, George Da Silva, Charles Fehr, Francisco Ibañez-Carrasco, Paul A. Shuper

Psychology Faculty Research

Since the beginning of the HIV/AIDS epidemic, gay, bisexual, and other men who have sex with men (gbMSM) have been disproportionately impacted by HIV/AIDS health disparities. Research showed that resilience to HIV/AIDS is associated with increased use of relevant health services, lower sexual health risks, and improved mental health outcomes among racially and ethnically diverse gbMSM. As the subpopulation that has historically been impacted by HIV/AIDS the longest, older gbMSM living with HIV/AIDS have inarguably exhibited resilience to HIV/AIDS the most. The qualitative study described in this paper sought to identify and examine protective factors that fostered resilience to HIV/AIDS …

Community-Dwelling Older Adult Fall Prevention Improvement Project, Evan Edminster Bsn, Rn, Cfrn, Tcrn, Cen, Nhdp-Bc

Master's Projects and Capstones

Abstract

Problem: Ground-level falls among community-dwelling adults 60 years and older are significant and contribute to adverse health outcomes such as fractures, functional decline, disability, and death. Additionally, falls among community-dwelling older adults are the number one mechanism of injury seen at a Northern California Level II trauma center. Falls often lead to post-fall fear, activity restriction, and physical deconditioning, further compounding fall risk.

Context: When trauma centers provide targeted outreach and screening for unmanaged health risks such as falls, they reduce unnecessary disability and premature death in the local population. Reducing total fall victim numbers and fall recidivism also …

Exploring Community Perceptions, Attitudes And Practices Regarding The Covid-19 Pandemic In Karachi, Pakistan, Anam Shahil Feroz, Naureen Akber Ali, Ridah Feroz, Noshaba Akber, Salima Nazim Meghani

Community Health Sciences

Background: The Government of Pakistan is facing difficulty to contain the surge of COVID-19 due to the country's social, political, economical and cultural context. Experiences from the previous epidemic suggest that community perceptions, social norms and cultural practices can impede COVID-19 containment. To understand social responses towards COVID-19, the study aims to explore the understanding of COVID-19 and the acceptance of control measures among community members.
Methods: We conducted an exploratory qualitative study using a purposive sampling approach, at two communities of Karachi, Pakistan. In-depth interviews were conducted with community members including, young, middle-aged and older adults of both genders. …

Guiding Change: A Multidisciplinary Framework For Interventions Addressing Systemic Racism In Healthcare, Lavette D. King

Master's Projects and Capstones

The relationship between systemic and institutional racism in the U.S., and health outcomes in people of the African Diaspora have been well documented (Bailey et al., 2017). Distrust in the healthcare system is the result of generational trauma compounded by an ongoing issue that has yet to be fully addressed (Scharff et al., 2015). For decades people of African descent have expressed concern about negative experiences with the U.S. healthcare system. Often the encounters leave them feeling, mistreated, unheard and or criminalized. These feelings result in trepidation over using the healthcare system which often further compounds health issues (Washington, 2008). …

Apple Cider Vinegar Weight Loss Drinks: Portrayal On Pinterest, Sydney Chamberlain, Jana Mitchell, Davis Major, Lena Elemam, Cassandra Cleland

PANDION: The Osprey Journal of Research and Ideas

Apple cider vinegar has shown great promise for weight loss in controlled lab settings, yet these claims are widely shared on social media and may not yield the same benefits. This study used directed content analysis to examine how apple cider vinegar weight loss drinks were portrayed on Pinterest, a social media website utilized to bookmark online content. Using the search terms “apple cider vinegar weight loss drinks,” researchers sampled every fifth pin to collect 200 relevant pins. A codebook was developed, pilot tested and used to code pins. Of the 200 pins, the majority of pins (66%) positively portrayed …

The Increasing Role Of Pragmatic Clinical Trials And Real-World Data In Healthcare Research, Julio A. Ramirez, Ruth Carrico

The University of Louisville Journal of Respiratory Infections

No abstract provided.

Proper Medication Adherence Is A Challenge For Older Snap Participants With Chronic Health Conditions, Colleen Heflin, Chinedum O. Ojinnaka, Irma Arteaga, Lauryn Quick

Population Health Research Brief Series

Diabetes and hypertension are among the leading causes of poor health and mortality in the United States. Properly taking prescribed medications to manage these conditions is critical for maintaining health and preventing complications. This is especially true for older adults, who are more likely to live with these chronic conditions. This brief summarizes findings from a study of an older adults in Missouri who participated in the Supplemental Nutrition Assistance Program (SNAP) between 2006 and 2014. On average, 1 in 4 individuals with hypertension and 1 in 3 with diabetes did not properly take prescribed medications to manage their health …

Improvement Cycles In Medical Education: From Quality Improvement To Patient Care And Clinical Research, Julio A. Ramirez

The University of Louisville Journal of Respiratory Infections

No abstract provided.

Perceptions And Experiences Of Healthcare Providers During Covid-19 Pandemic In Karachi, Pakistan: An Exploratory Qualitative Study, Anam Shahil Feroz, Nousheen Pradhan, Zarak Hussain Ahmed, Mashal Murad Shah, Nargis Asad, Sarah Saleem, Sameen Siddiqi

Community Health Sciences

Objective: To explore healthcare provider's perspectives and experiences of the barriers and facilitators to treat and manage COVID-19 cases.
Design and setting: We conducted an exploratory qualitative study using a purposive sampling approach, at a private tertiary care teaching hospital in Karachi, Pakistan. Study data were analysed manually using the conventional content analysis technique.
Participants: Key-informant interviews (KIIs) were conducted with senior management and hospital leadership and in-depth interviews (IDIs) were conducted with front-line healthcare providers.
Results: A total of 31 interviews (KIIs=19; IDIs=12) were conducted, between April and May 2020. Three overarching themes emerged. The first was 'challenges faced …

Examining Correlates Of Feeding Practices Among Parents Of Preschoolers, Deepa Srivastava, Lucy R. Zheng, Dipti Dev

Department of Child, Youth, and Family Studies: Faculty Publications

Background: Parent feeding practices play a critical role in children’s eating behaviors. Limited research has explored child-level correlates of parent feeding practices.

Aim: To identify correlates of feeding practices (responsive and controlling) among parents of preschoolers in the United States.

Methods: Participants included parents (n = 273) of preschoolers (3–5 years), recruited from early care and education settings (n = 24) located in a metropolitan city in the US. Analysis included descriptives, correlations, and multiple regression.

Results: For responsive feeding practices, positive associations included child’s weight with unintentional modeling (β = .17, 95% CI [0.12, 0.53]), child vegetable …

People With Disabilities Still At Risk In Congregate Care Settings, University Of Montana Rural Institute

Health and Wellness

This report provides an analysis of data to better understand where cases and deaths are rising in nursing homes as of August 8 2021. We hope this analysis can help support local community planning and networking among rural partners to improve outcomes.

• COVID-19 cases among residents and staff are on the rise in nursing homes with the steepest increases in urban areas and in the South and Midwest.
• Disabled people are disproportionately overrepresented in the resident populations of unsafe congregate settings, such as nursing homes.
• Vaccination rates across both residents and staff in nursing homes have stagnated.
• Policy priorities should …

Frequency Of Primiparous Mother Initiated Breastfeeding Earlier After Birth And Factors Associated With It In Sindh, Pakistan: A Secondary Analysis, Asma A. Bham, Sucheta Sharma, Akash Sardool, Umer F. Mujahid, Amrat Ayaz, Komal Valliani, Nawaal Maredia

Community Health Sciences

Background: Initiation of breastfeeding within one hour after delivery plays a vital role in a newborns life by not only increasing their survival rate but also reducing many life-threatening diseases in the newborn. The aim of the study was to determine frequency of early initiation of breastfeeding among primiparous mothers in a rural district of Thatta, Pakistan.
Methods: This study was conducted using survey data extracted from a cross-sectional study conducted in 2019 on prevalence of exclusive breastfeeding and factors associated with it among women in Thatta. The outcome was early initiation of breastfeeding. To determine factors associated with it, …

Application Of The Ultra-Poverty Graduation Model In Understanding Community Health Volunteers’ Preferences For Socio-Economic Empowerment Strategies To Enhance Retention: A Qualitative Study In Kilifi, Kenya, Njeri Nyanja, Nelson Nyamu, Lucy Nyaga, Sophie Chabeda, Adelaide Lusambili, Marleen Temmerman, Michaela Mantel, Anthony Ngugi

Family Medicine, East Africa

Background: A significant shortage of healthcare workforce exists globally. To achieve Universal Healthcare cover- age, governments need to enhance their community-based health programmes. Community health volunteers (CHVs) are essential personnel in achieving this objective. However, their ability to earn a livelihood is compromised by the voluntary nature of their work; hence, the high attrition rates from community-based health programmes. There is an urgent need to support CHVs become economically self-reliant. We report here on the application of the Ultra-Poverty Graduation (UPG) Model to map CHVs’ preferences for socio-economic empowerment strategies that could enhance their retention in a rural area …

Investir Dans Le Changement Social Et Comportemental Est Rentable Pour Améliorer Les Comportements Antipaludiques En Côte D’Ivoire, Breakthrough Research

Sexual and Reproductive Health, Rights, and Choices

Social and behavior change (SBC) interventions are considered an essential part of malaria prevention and treatment interventions, yet gaps in information on the cost and impact of SBC mean decisionmakers have underappreciated the value of SBC for contributing to improved health outcomes. To address this issue, Breakthrough RESEARCH has leveraged evidence from 112 studies on the impact of SBC interventions on malaria health behaviors and 70 studies on general SBC intervention costs to model the cost-effectiveness of SBC programming for malaria in the Business Case for Investing in Social and Behavior Change for Malaria.

"Going It Alone": Following The Male Cohort Of Survivors Of Sex Trafficking Of The Chab Dai Butterfly Longitudinal Research Project, Jarrett D. Davis, James Havey, Glenn M. Miles, Nhanh Channtha, Sreang Phally, Lim Vanntheary

Dignity: A Journal of Analysis of Exploitation and Violence

Over the past ten years, the Butterfly Longitudinal Research Project has followed 128 survivors of trafficking through their experiences in aftercare, reintegration, and beyond to better understand the recovery and reintegration of trafficking survivors within a Cambodian context. This paper focuses on the 19 males who were available to interview. Despite the project’s wealth of data and analysis, there are notable gaps regarding the male cohort. In response, this paper examines this cohort holistically, considering their statements and broader narratives, merging them with previous collective observations of the Butterfly Project. Throughout this paper, data indicates a pattern of violence among …

Investing In Social And Behavior Change Is Cost-Effective For Improving Malaria Behaviors In Côte D’Ivoire, Breakthrough Research

Sexual and Reproductive Health, Rights, and Choices

Social and behavior change (SBC) interventions are considered an essential part of malaria prevention and treatment interventions, yet gaps in information on the cost and impact of SBC mean decisionmakers have underappreciated the value of SBC for contributing to improved health outcomes. To address this issue, Breakthrough RESEARCH has leveraged evidence from 112 studies on the impact of SBC interventions on malaria health behaviors and 70 studies on general SBC intervention costs to model the cost-effectiveness of SBC programming for malaria in the Business Case for Investing in Social and Behavior Change for Malaria.

Using Population Health Management To Reduce Heart Diseases And Health Disparities Among African Americans: A Narrative Review, Adolfo Gonzalez

Electronic Theses, Projects, and Dissertations

The integration of Population Health Management (PHM) within the U.S. health care system may effectively decrease heart disease and health disparities among African American adults. Population Health Management strategies look at whether the health care system is meeting the needs of health care access, medical coverage, quality of care, and to reducing health disparities within specific population. Population Health Management strategies could be used to mitigate and reduce health disparities.

The purpose of this study is to discuss the potential impacts of Population Health Management within our health care system and how its influence can reduce heart diseases among African …

Exploring Opportunities For Prevention Of Child Sexual Abuse In A Diverse American Muslim Community., Rishtya Meena Kakar

Electronic Theses and Dissertations

Recognizing the significant mental, emotional, developmental and health consequences for victims of child sexual abuse (CSA) and sociopolitical consequences for families and communities in every cultural, ethnic, and religious group around the world, this study sought to determine key opportunities for prevention of CSA in a diverse American Muslim community using a public health socioecological lens, rooted in aspects of critical theory. While there is considerable research on situational and individual-level risk factors related to CSA cases, there is less research on the societal and community-level processes related to the primary prevention of CSA, especially among minoritized communities. Responding to …

Economic Insecurity, Poverty, And Parental Alcohol Misuse, Joey Tucciarone

Electronic Theses and Dissertations

Because parental alcohol misuse is associated with numerous negative outcomes for drinkers and other family members, it is important to examine factors predictive of alcohol misuse patterns among parents living with at least one child under the age of 18. Two possible factors include economic insecurity and poverty. This study sought to address whether measures of economic insecurity (i.e., housing and/or food insecurity in the past 12 months) and a dichotomous measure of poverty predict parental binge drinking and parental heavy alcohol consumption in a large population-based sample. It was hypothesized that economic insecurity and poverty, analyzed separately, would predict …

Evaluating A Community-Based Breastfeeding Support Organization In Nebraska, Katelyn Elaine Goodroe

Capstone Experience: Master of Public Health

Specific Aims: The aims of this evaluation plan are to investigate the role of the Nebraska nonprofit organization, MilkWorks, in promoting breastfeeding and family support programming and to identify future internal and external growth opportunities through an assessment of the organizational practices using stakeholder perspectives and marketing structure to better promote infant and parental health.

Significance: As a best practice, evaluation of MilkWorks is critical to providing proper services for promoting infant development and parental health in urban and rural Nebraska communities.

Background: MilkWorks was founded in Lincoln, Nebraska, by mothers with the intention of promoting breastfeeding by offering support …

California's Master Plan For Aging, Health Reimagined: A Case For Seniors To Age-In-Place, Remonia A. Bowie

Master's Projects and Capstones

Abstract

In 2021 Worldwide, communities face a singular yet common challenge; and this is the significant aging of their senior adult populations. Current evidence from the literature suggests that older adults prefer to stay in their homes as they age. However, the facilitators and challenges older people encounter in realizing their aging goals have been inadequately addressed by the current body of literature given the projected increase in the number of older people in the United States preferring to age from their homes. Aging adults are vulnerable to daily frustration, which could negatively impact their aging process. However, knowledge of …

Effectiveness Of Typhoid Conjugate Vaccine Against Culture-Confirmed Salmonella Enterica Serotype Typhi In An Extensively Drug-Resistant Outbreak Setting Of Hyderabad, Pakistan: A Cohort Study, Mohammad Tahir Yousafzai, Sultan Karim, Sonia Qureshi, Abdul Momin Kazi, Hina Memon, Amber Junejo, Zohra Khawaja, Najeeb Ur Rehman, Muhammad Sajid Ansari, Rafey Ali, Heera Mani Lohana, Farah Naz Qamar

Department of Paediatrics and Child Health

Background: Salmonella enterica serotype Typhi (S Typhi) is a major public health problem in low-income and middle-income countries. We aimed to investigate the effectiveness and impact of the typhoid conjugate vaccine Typbar-TCV against S Typhi among children in an outbreak setting of extensively drug-resistant (XDR) S Typhi in Pakistan.
Methods: This cohort study was done from Feb 21, 2018, to Dec 31, 2019. A census survey of all households located in the Qasimabad and Latifabad subdistricts of Hyderabad, Pakistan, was done at baseline, and 174 005 households were registered in the census. The Typbar-TCV immunisation campaign was initiated at temporary …

Opening Pandora’S Box From Readmissions To Transitional Care Patient-Centered Outcome Measures, Mathew J. Reeves, Michele C. Fritz, Ifeyinwa Osunkwo, Corita R. Grudzen, Lewis L. Hsu, Jing Li, Raymona H. Lawrence, Janet Prvu Bettger

Health Policy & Community Health: Faculty Publications

Background:

Measuring the effectiveness of transitional care interventions has historically relied on health care utilization as the primary outcome. Although the Care Transitions Measure was the first outcome measure specifically developed for transitional care, its applicability beyond the hospital-to-home transition is limited. There is a need for patient-centered outcome measures (PCOMs) to be developed for transitional care settings (ie, TC-PCOMs) to ensure that outcomes are both meaningful to patients and relevant to the particular care transition. The overall objective of this paper is to describe the opportunities and challenges of integrating TC-PCOMs into research and practice.

Methods and Results:

This …

Implementation Of Complex Interventions Lessons Learned From The Patient-Centered Outcomes Research Institute Transitional Care Portfolio, Sabina B. Gesell, Janet Prvu Bettger, Raymona H. Lawrence, Jing Li, Jeanne Hoffman, Barbara J. Lutz, Corita R. Grudzen, Anna M. Johnson, Jerry A. Krishnan, Lewis Hsu, Dorien Zwart, Mark V. Williams, Jeffrey L. Schnipper

Health Policy & Community Health: Faculty Publications

Background:

Despite the well-documented risks to patient safety associated with transitions from one care setting to another, health care organizations struggle to identify which interventions to implement. Multiple strategies are often needed, and studying the effectiveness of these complex interventions is challenging.

Objective:

The objective of this study was to present lessons learned in implementing and evaluating complex transitional care interventions in routine clinical care.

Research Design:

Nine transitional care study teams share important common lessons in designing complex interventions with stakeholder engagement, implementation, and evaluation under pragmatic conditions (ie, using only existing resources), and disseminating findings in outlets that …

Challenges Of Vietnam's Biggest Vaccination Campaign, Han Vu

International Programs

It's hard for Vietnam to meet its target of vaccinating 70% of the adult population by the end of 2021 for several reasons: a lack of vaccines, infrastructure, healthcare workers as well as a detailed, feasible plan.

Association Of X-Ray Absorptiometry Body Composition Measurements With Basic Anthropometrics And Mortality Hazard, Nir Y. Krakauer, Jesse C. Krakauer

Publications and Research

Dual-energy X-ray absorptiometry (DEXA) is a non-invasive imaging modality that can estimate whole-body and regional composition in terms of fat, lean, and bone mass. We examined the ability of DEXA body composition measures (whole-body, trunk, and limb fat mass and fat-free mass) to predict mortality in conjunction with basic body measures (anthropometrics), expressed using body mass index (BMI) and a body shape index (ABSI). We used data from the 1999–2006 United States National Health and Nutrition Examination Survey (NHANES), with mortality follow-up to 2015. We found that all DEXA-measured masses were highly correlated with each other and with ABSI and …

Why Is Safe Food Handling Important? [English/Arabic], Celina Wille

All Current Publications

This handout, available here in both English and Arabic, provides information to prevent illness through safe food handling practices.