Public Health Commons^™

Safety And Efficacy Of Bendamustine In The Conditioning Regimen For Autologous Stem Cell Transplantation In Patients With Relapsed/Refractory Lymphoma, Munira Moosajee, Samad Jehangir, Sobia Sawani, Tariq Muhammed, N. Ali, Usman Shaikh, Salman Adil

Section of Haematology/Oncology

Background: Bendamustine is an attractive option for the management of both de novo and relapsed lymphomas. It is being increasingly used in the conditioning regimen for autologous stem cell transplantation (SCT) and can be an alternative to the traditionally-used carmustine. In this study, we aimed to determine the safety and efficacy of bendamustine in the conditioning regimen for autologous SCT in refractory/relapsed lymphomas.
Methods: We designed a descriptive study to evaluate bendamustine in combination with etoposide, cytarabine, and melphalan (BeEAM) in the conditioning regimen for autologous SCT.
Results: Fourteen patients (median age, 28 yr) with Hodgkin's lymphoma (HL) (N=8), non-Hodgkin's …

We Are Constantly Expected To Disregard Ourselves And Our Personal Needs: Addressing The Daily Stressors Of Private Emergency Medical Services, Erich Jimenez Bonilla

Electronic Theses, Projects, and Dissertations

ABSTRACT

Background Private Emergency Medical Services serve a vital role in the community, as such they are subject to job related stress. Currently, there is a limited amount of research related to the stressors related to the job.

Objective The purpose of this study was to define the type of daily stressors faced by Private EMS personnel and investigate how they impact their Sense of Coherence.

Study Design A mixed methods approach was used in this study to obtain the necessary data. Semi-structured one-on-one interviews were conducted with current employees of an EMS agency that provides 911 service in their …

The Effects Of A Low-Glycemic Index Diabetes Management Program On Weight, Body Mass Index, Triglycerides, Cholesterol And Hemoglobin A1c Values, Morgan Williston

Master's Theses

The purpose of this study was to evaluate effects of a low-glycemic index diet on weight, body mass index (BMI), triglycerides, cholesterol levels, and hemoglobin A1c

(HbA1c) following participation in a 12-hour outpatient diabetes self- management education (DSME) program. This DSME program is unique as it

focuses on a low-glycemic index diet rather than the traditional carbohydrate consistent diet to control blood glucose levels. Health outcomes obtained post participation were compared to baseline data. Participants were 283 individuals with type 2 diabetes including 94 (33%) men and 189 (67%) women, with a mean baseline HbA1c of 8.7 ±2.2%. Statistically significant …

The Lived Experience Of Discharged And Readmitted African Americans With Chronic Obstructive Pulmonary Disease To A Safety-Net Hospital, Kiiyonna Jones

Dissertations

Background:Chronic Obstructive Pulmonary Disease (COPD) is a debilitating respiratory disease that negatively affects the quality of life of those affected and has been a major contributor to the continuous rise in healthcare cost in the Unites States (Guarascio, Ray, Finch, & Self, 2013; National Heart Lung and Blood Institute, 2009; Shavelle, Paculdo, Kush, Mannino, & Straus, 2009; Scott, Smith, Sullivan, & Mahajan, 2001). In 2014, Centers for Medicare & Medicaid Services (CMS) identified COPD as an applicable condition to the Hospital Readmissions Reduction Program, which penalizes healthcare organizations having readmissions higher than the national average. COPD is the second …

Do Not Miss Your Shot: Improving Follow-Up In Patients Receiving Long-Acting Injectable Medications, Mary O'Hara

Doctor of Nursing Practice Final Manuscripts

Background: Serious mental illness including schizophrenia and bipolar disorder affects 1 in 24 adults in California. These chronic disorders are difficult to treat and often sabotaged by medication nonadherence. Long-acting injectable (LAI) medications are one strategy to combat medication nonadherence. Effectively providing treatment with LAI medications can be challenging at the clinic level.

Objectives: Reduce the number of days without medication by reducing the number of days between injection due date and injection administration for patients receiving LAI medications.

Design: Establish appointments for all injection visits. Standardize visit protocol for injection encounters to optimize provider time. Arrange immediate follow-up and …

Building Financial Management Capacity For Community Ownership Of Development Initiatives In Rural Zambia, Viviane Sakanga, Parker S. Chastain, Kathleen L. Mcglasson, Jeanette L. Kaiser, Misheck Bwalya, Melvin Mwansa, Kaluba Mataka, David Kalaba, Nancy Scott, Taryn Vian

Nursing and Health Professions Faculty Research and Publications

Background: Building financial management capacity is increasingly important in low- and middle-income countries to help communities take ownership of development activities. Yet, many community members lack financial knowledge and skills.

Methods: As part of a larger health intervention, we designed and conducted financial management training for 83 members from 10 community groups in rural Zambia. Change scores between pre- and post-tests on financial knowledge were calculated and multivariate linear regression models run. Qualitative feedback was elicited.

Results: The training significantly improved knowledge of financial concepts. Participants with some or more than some secondary education had greater improvements …

Analysis Of A Universal Depression Screening Workflow At An Integrated Healthcare Center, Arthur Roehr

Doctor of Nursing Practice Final Manuscripts

Purpose: Evaluation of an evidence-based protocol that measures the effectiveness of universal depression screening at an integrated healthcare center. At risk patients are those who complete a patient health questionnaire (phq-9) and score ≥ 10 when presenting for a primary care visit. A score of ≥ 10 prompts further evaluation by the primary care provider (PCP) prior to behavioral health care management (BHCM) referral.

Background: In 2016, 16.2 million adults aged 18 or older in the U.S. experienced a major depressive episode (MDE). 65.3% of those received some form of treatment from a healthcare professional (therapy and/or medication). Early identification …

Prescription Opioid Use Patterns, Use Disorder Diagnoses, And Addiction Treatment Receipt After The 2014 Medicaid Expansion In Oregon, Rachel Springer, Miguel Marino, Steffani R. Bailey, Heather Angier, Jean O'Malley, Megan Hoopes, Stephan Lindner, Jennifer E. Devoe, Nathalie Huguet

OHSU-PSU School of Public Health Faculty Publications and Presentations

Background/Aims: Evidence suggests Medicaid beneficiaries in the USA are prescribed opioids more frequently than are people who are privately‐insured, but little is known about opioid prescribing patterns among Medicaid enrollees who gained coverage via the Affordable Care Act Medicaid expansions. This study compared the prevalence of receipt of opioid prescriptions and opioid‐use‐disorder (OUD), along with time from OUD diagnosis to medication‐assisted treatment (MAT) receipt between Oregon residents who had been continuously insured by Medicaid, were newly insured after Medicaid expansion in 2014, or returned to Medicaid coverage after expansion.

Design: Cross‐sectional study using inverse‐propensity weights to adjust for …

Promoting Resilience In Economically Disadvantaged Adolescents Through School-Based Expressive Arts Groups, Bailey Knox

Expressive Therapies Capstone Theses

Since 2013, the majority of students served by the public school system in the United States have been considered “low-income” by the federal government. The stressors associated with low socioeconomic status significantly increase risk for social, emotional and behavioral challenges at all age levels, but can be particularly damaging to adolescents coping with heightened stress levels related to the intense multi-dimensional changes that define this developmental period. As the correlation between economic disadvantage and negative socio-emotional and academic outcomes is increasingly evidenced, schools have begun to recognize their responsibility for providing preventative mental health care to high-risk students. Over the …

A Literature Review Of Nature-Based Expressive Arts Therapy For Bereaved Children, Wendy Dalton

Expressive Therapies Capstone Theses

There is a need for increased visibility of child bereavement to expand research in and accessibility of developmentally appropriate supports, which views the child holistically and within their biopsychosocial context. Worden’s (1996) formative work with child bereavement resulting in the "tasks" of child bereavement was the first and most recent study of its scale and kind. This marked an affirming of grief as normative response to death and occurring throughout the developmental lifespan. This work also highlights the need for additional inquiry to expand and deepen understanding of child bereavement. A growing body of research suggests that ecotherapy and expressive …

“Do I Need Exercise?” A Qualitative Study On Factors Affecting Leisure-Time Physical Activity In India, Shalini Garg, V Raman Kutty

The Qualitative Report

Physical activity can reduce the risk of premature mortality from various chronic diseases. Previous research in Kerala, India indicates several barriers which can impact physical activity levels. Perceptions about the importance of health-promoting physical activity were examined among adults in Kerala and various facilitators, motivators and barriers to physical activity were identified using focus group discussions and interviews with key informants. At present, the attitude of people and health professionals is that physical activity has to be taken up when diagnosed with a disease (obesity, diabetes) and advised by a health professional. Men were more likely to start exercising after …

Using Mobile Phones To Improve Young People's Sexual And Reproductive Health In Low- And Middle-Income Countries: A Systematic Review Protocol To Identify Barriers, Facilitators And Reported Interventions, Anam Shahil Feroz, Farina Abrejo, Sumera Aziz Ali, Rozina Nuruddin, Sarah Saleem

Community Health Sciences

Background: Due to a growing reliance on mobile phone technology and decreasing mobile phone costs, the use of mobile phones is on the rise, especially among the youth population. Young people are responsive and enthusiastic to use novel approaches such as mHealth to access sexual and reproductive health information and services. Globally, reproductive health programs have used mHealth to provide sexual and reproductive health education and services to young people, through diverse communication channels. However, few attempts have been made to systematically review the mHealth programs for young people sexual and reproductive health (SRH) in low- and middle-income countries (LMICs). …

Adolescent Sexual Reproductive Health Course: A Mixed Media Intervention And Quality Improvement Project In A School-Based Setting, Stephanie Calabrese

Doctor of Nursing Practice (DNP) Projects

Section I: Abstract

Problem: California’s adolescents carry a significant burden of newly acquired sexually transmitted infections (STIs) and gaps in adolescent sexual and reproductive health (SRH) knowledge have led to poor adolescent health outcomes. (CDE, 2019). Context: The California Healthy Youth Act (AB 329) was enacted on January 1, 2016, calling all school districts to ensure that all pupils receive comprehensive sexual health education, and HIV prevention education (CDE, 2019). In a proactive motion, parents from a northern California middle school approached a university to provide a Doctor of Nursing Practice (DNP) student to instruct its sixth grade’s …

Enhancing Nutrition Education For School Aged Children; A Preventive Health Measure And Quality Improvement Project, Fanny M. Powell

Doctor of Nursing Practice (DNP) Projects

Objective: The purpose of the DNP project was to improve nutritional knowledge of the adolescents at Kings Canyon Unified School District while also improving their perceived ability to choose healthy food. This project was enveloped in a larger community outreach mission utilizing a free school-based clinic for the purposes of providing sports physicals to students and health screening and physicals to the community. Additionally, nurse practitioner students engaged in a cultural immersion experience through clinical rotations in Central Valley.

Methods: Adolescent students who registered for the clinic watched a nine-minute nutrition video, created by the DNP student, while waiting …

The Effects Of A Mobile Fitness Application On Weight Management And Physical Acticity Amongst University Students, Erica Deenihan

Evidence-Based Practice Project Reports

The prevalence of obesity, and obesity related diseases throughout America, specifically in regard to the college student population has steadily climbed over the course of the last forty years, due largely in part to the increase in sedentary lifestyle behaviors, amongst other factors (Swanson, 2016). Physical activity has been widely recognized as a valid means of combatting obesity and weight gain while promoting health related quality of life (Swanson, 2016). Therefore, implementing strategies aimed at increasing physical fitness in attempt to control weight management is imperative to promoting improved health outcomes. The purpose of this evidence-based project was to examine …

The Effect Of Home Blood Pressure Monitoring And Self-Titration On Achieving Blood Pressure Targets, Katina A. Varner

Evidence-Based Practice Project Reports

One-third of U.S. adults over the age of 20 are hypertensive, with an estimated cost of $47.5 billion in direct medical expenses and increased individual CVD risk (CDC, 2018). Routine office visits afford primary care providers a means of managing hypertension; however, time constraints limit the ability to accurately assess and track BP in most patients (Jung, 2015). The purpose of this project was to determine if implementation of HBPM and an algorithm for selftitration of antihypertensive medications increased the number of participants at guideline recommended BP goal over a 90-day period. The Health Promotion Model provided the theoretical framework …

Childhood Obesity: Getting Back To The Basics, Fanny Powell

DNP Qualifying Manuscripts

Childhood obesity is an epidemic that affects the nation. The Centers for Disease Control and Prevention (CDC) (2015) states that over the past thirty years, the prevalence of childhood obesity has more than doubled in younger children and quadrupled in adolescents (CDC, 2015). Although obesity is a multifactorial health issue that is affected by genetics, metabolic factors, socioeconomic factors, and lifestyle choices (Stanford, 2018), a majority of pediatric obesity is as a result of consuming more energy than the body utilizes. There are both immediate and long-term consequences of obesity that negatively affect a child’s health which may carry over …

Health Care In The Caribbean: A Comparative Analysis Between Cuba And Puerto Rico, Matheus Moreira Sanches Peraci

Honors Projects

The paper at hand focuses on comparing the differences of the Cuban and Puerto Rican health care (HC) system and conditions. As this is a comparative research analysis, this was done by reviewing many different reliable sources and compiling the relevant information from Cuba and Puerto Rico. The factors that were taken into account are: (a) Political and Health Care Systems, (b) Natural and Artificial Disaster and (c) Country’s Demographics and Health Statistics.

Typical Diet Quality In New Zealand Compared To Other Westernized Countries With An Emphasis On Chronic Disease, Emily Kollar

Honors Projects

The diet quality was analyzed for people living in New Zealand and people living in other Westernized Countries (United States, Canada, Western Europe) based on the dietary guidelines. Diet quality was analyzed by looking at consumption of food groups such as fruits, vegetables, meat, and seafood as well as nutrients such as saturated/trans/unsaturated fat, sodium, and added sugars. These nutrients have been linked to certain health outcomes and chronic disease; therefore, the prevalence of chronic disease was researched to determine if there was a correlation between New Zealand's diet and their chronic disease rates in comparison to other Westernized countries.

Analysis Of Tobacco Use Vital Sign Assessment, Latonya King

Electronic Theses and Dissertations

There is a massive problem of tobacco-related cancer outcomes in patients that are affected by race and ethnicity. Although this is a known disparity, there continues to be a gap in care for asking patients if they use tobacco and in advising and assisting them in making a quit attempt. Health information technology requirements and meaningful use regulations require the utilization of systematic electronic documentation. In order to improve and support tobacco use screening, systematic tobacco use assessment and documentation are essential. There is a widespread belief that adding screening for tobacco use to the vital sign assessment will lead …

Public Health Policy: An Ethical Analysis Of Quarantine, Dina Alqahtani

Electronic Theses and Dissertations

As a public health measure quarantine has both historical and contemporary significance both in the United States and abroad. On the surface it represents a low-cost, low-tech way in which the spread of disease can be mitigated as its core requirement is that those who may have been exposed to an infectious agent are kept away from those who have not been exposed to that agent for enough time to determine whether or not infection has been spread. This has been utilized for centuries with both limited questions and scattered, inconsistent, or impossible to achieve oversight and goals. In understanding …

Perceptions Of Parents And Religious Leaders Regarding Minimal Invasive Tissue Sampling To Identify The Cause Of Death In Stillbirths And Neonates: Results From A Qualitative Study, Anam Shahil Feroz, Mohsina Noor Ibrahim, Elizabeth M. Mcclure, Anum Shiraz Ali, Shiyam Sunder Tikmani, Sayyeda Reza, Zahid Abbasi, Jamal Raza, Haleema Yasmin, Khadija Bano, Afia Zafar, Sameen Siddiqi, Robert L. Goldenberg, Sarah Saleem

Community Health Sciences

Background: Recently, the minimal invasive tissue sampling (MITS) procedure has been developed to support determination of the cause of death as an alternate to conventional autopsy, especially in countries where complete diagnostic autopsy is not routine. To assess the feasibility of implementation of the MITS procedure for a study to determine cause of death in premature births and stillbirths in south Asia, we explored the views and perceptions of parents and religious leaders on the acceptability of MITS.
Methods: A qualitative study was conducted at the National Institute of Child Health (NICH) hospital of Karachi, Pakistan. Focus group discussions (FGDs) …

Potentially Reduced Exposure Products, Occupational Variations In Smoking, And Hardcore Smokers: Examining Important Elements In The Tobacco Use Spectrum, Raees A. Shaikh

Theses & Dissertations

The purpose of this research was to examine three important aspects of the smoking phenomenon that are, and will remain, important for the future of tobacco control research and policy. First and currently one of the most debated and researched topics in the tobacco research field relates to the group of products regarded by some as the potentially reduced exposure products (PREPs). We studied determinants of use of these products. Second aspect was to examine the socioeconomic subgroup of smokers based on their occupations who might potentially benefit from the use of PREPs and the third stage involved studying the …

Increasing Food Security: Developing And Testing A Nutrition Education Curriculum For A Mobile Food Pantry, Alexandra Lepecha, Kathleen M. Kraft

Senior Honors Projects, 2010-2019

Background: The Neighborhood Produce Market (NPM) is a food distribution model similar to a mobile food pantry. NPM stakeholders observed a lack of community engagement and familiarity with produce offered.

Project Description: The objective was to develop a nutrition education curriculum for NPM volunteers to better engage families and community members by providing food samples, recipes, and nutrition education. A stakeholder steering committee guided the needs assessment, curriculum development, volunteer training, and pilot test. The curriculum consisted of food safety, cultural considerations, and nutritional information for nine produce items and food tasting procedures and recipes. Seven student volunteers were trained …

An Examination Of Factors Associated With Body Appreciation, Sociocultural Attitudes Of Appearance, And Ratings Of Diverse Performing Artists, Stephanie Rathjen

Senior Honors Projects, 2010-2019

Introduction: Multiple studies have found that performing artists have low body image which may be associated with the media’s portrayal of performers. Low body image can cause negative health effects including depression and eating disorders. This study explores body attitudes among performing and non-performing arts students and the possible media influences on those attitudes.

Methods: Undergraduate students (n=522) were asked to participate in an anonymous online survey regarding their perceptions of their individual body perception. During the survey, they were randomized to watch a video depicting either slim mostly Caucasian performers (video A) or performers of different ethnicities …

Community-Based Healthcare | Interlace Of Biophilic Design In Outpatient Facilities, Joshua Robinson

Bachelor of Architecture Theses - 5th Year

This thesis questions how architects can redesign typical healthcare typology in response to the medical and sociological needs of the community while integrating the measures of wellness and biophilic design. By redefining architectural programs within a wellness clinic, this can allow the facility to prioritize the communities needs through non-medical determinants. The research will look at both the social and medical needs of a community, along with the Seven Standards of Wellness as defined by the Well Building Standard and The Fourteen Patterns of Biophilic Design as defined by the Terrapin Bright Green, to develop a connection between the facility …

Referral Patterns, Procedures, And Outcomes Of A Large Community- Based Urology Group: A Retrospective Chart Review, Hassan A. Al Saleh, Gregory C. Mcmahon, Michael Douglas, Michael Console, Mihir Thaker, Gordon A. Brown

Rowan-Virtua Research Day

In 2012 The United States Preventive Services Task Force (USPSTF) recommended against prostate cancer (Pca) screening. The purpose of our study is to assess the effects of the USPSTF grade D recommendation for PSA based screening on new PCa diagnoses within a large-community based private practice setting. We completed a retrospective chart review of men with an elevated PSA seen in our clinic between May 2009–May 2015 who had undergone a prostate biopsy and were diagnosed with PCa. We observed that following the 2012 USPSTF recommendations, there was a significant increase in patients with clinically significant prostate cancer GG ≥ …

The Modifiability Of Risk Factors Associated With Adolescent Suicide And Its Preventions, Nastaeen Tajin

Honors College Theses

Adolescent suicide has been of major concern in the past few decades, with the rates steadily increasing every year. Suicide can be defined as the act of intentionally taking one’s life. Adolescent refers to children between the age of 13 and 19, although the term will be used interchangeably with ‘teen’ throughout this paper. The purpose of this study had been to identify the risk factors of suicide associated with children of this age range, and propose preventative measures based on the modifiability of these risk factors. In order to achieve this, the two search catalogs utilized were the Wayne …

The Relationship Of Creatinine, Sodium, Hematocrit And Hemoglobin A1c To 30-Day Hospital Readmission Among Older Adults With Type 2 Diabetes, Shmilah Choudhary, Meet Shah, Sanath Shetty, Terri Ginsberg, Matthew H. Mclaughlin

Rowan-Virtua Research Day

Introduction:Reducing thirty-day hospital readmissions is a top healthcare priority. However, there is little research describing the risk factors of readmission among patients with diabetes, especially for older adults. Understanding what the risk factors are for 30-day hospital readmission for older adults with type 2 diabetes would help identify patients at risk of rehospitalization.

Objective:The aim of this study was to identify factors associated with 30-day unplanned hospital readmissions among older adults with T2DM. Factors to be investigated are: patient demographics and three admission laboratory values.

Methods:Participants were older adult s>65 years old with T2DM, admitted to a community hospital …

The Relationship Of Cardiovascular Disease To 30-Day Hospital Readmission Among Older Adults With Type 2 Diabetes Mellitus, Meet Shah, Shmilah Choudhary, Sanath Shetty, Terrie Ginsberg, Matthew H. Mclaughlin

Rowan-Virtua Research Day

Reducing thirty-day hospital readmissions is a top healthcare priority. However, there is little research describing the risk factors of readmission among patients with diabetes, especially for older adults. Understanding what the risk factors are for 30-day hospital readmission for older adults with type 2 diabetes (T2DM) would help identify patients at risk of rehospitalization. The aim of this study was to identify factors associated with 30-day unplanned hospital readmissions among older adults with T2DM.Factors to be investigated are: patient demographics and whether the patient was hospitalized for cardiovascular disease. Participants were older adults>65 years old with T2DM, admitted to …