Public Health Commons^™

Using Steroids In Patients With Community-Acquired Pneumonia At The University Of Louisville Hospital: Who, What, And When, Rodrigo Cavallazzi, Julio A. Ramirez

The University of Louisville Journal of Respiratory Infections

No abstract provided.

Lung Cytokines And Systemic Inflammation In Patients With Copd., Alessandra Morello Gearhart, Rodrigo Cavallazzi, Paula Peyrani, Timothy L. Wiemken, Stephen P. Furmanek, Andrea Reyes-Vega, Umair Gauhar, Hiram Rivas-Perez, Jesse Roman, Julio A. Ramirez, Rafael Fernandez-Botran

Faculty and Staff Scholarship

Rationale: Chronic obstructive pulmonary disease (COPD) is characterized by lung and systemic inflammation. The role of cytokines in local and systemic inflammation in COPD is not well understood. This study aimed to compare plasma and bronchoalveolar lavage (BAL) fluid cytokine levels in COPD and non-COPD subjects with the intent of better understand their potential roles in driving local and systemic inflammation.

Methods: This cross-sectional study analyzed data from 65 subjects: 31 with COPD confirmed by spirometry and 34 non-COPD controls. All subjects underwent spirometry, plasma sample collection, and bronchoscopy/BAL. Levels of 21 inflammatory cytokines were measured in the plasma (systemic …

Knowledge, Attitudes, And Behaviours Of New Zealand Youth In Surf Beach Environments, Stacey M. Willcox-Pidgeon, Bridget Kool, Kevin Moran Ph.D.

International Journal of Aquatic Research and Education

New Zealand youth are over-represented in drowning statistics yet little is known about their understanding of water safety, especially in surf beach context. This study aimed to ascertain current youth surf safety knowledge, specifically rip current awareness, explore self-reported competencies and confidence when surf swimming, and examine youth behaviour when at the beach. A cross-sectional survey was conducted among senior high school students (n = 599) in Auckland, New Zealand. Over half (58%) reported they were unable to swim > 100 m in a pool. Males and students of European-New Zealand and Maori (New Zealand’s indigenous population) heritage were most …

How Useful Is Gsv As An Environmental Observation Tool? An Analysis Of The Evidence So Far., Katherine Nesse, Leah Airt

SPU Works

Researchers in many disciplines have turned to Google Street View to replace pedestrian- or carbased in-person observation of streetscapes. It is most prevalent within the research literature on the relationship between neighborhood environments and public health but has been used as diverse as disaster recovery, ecology and wildlife habitat, and urban design. Evaluations of the tool have found that the results of GSV-based observation are similar to the results from in-person observation although the similarity depends on the type of characteristic being observed. Larger, permanent and discrete features showed more consistency between the two methods and smaller, transient and judgmental …

Managing The Cost Of Diabetes, Laressa Bethishou

Pharmacy Faculty Articles and Research

"This is of concern to health care providers because inadequate management of diabetes results in short- and long-term complications. Patients with diabetes and no health insurance have fewer physician visits and are prescribed fewer medications for management of their diabetes. Patients with diabetes make up 11.9% of all emergency department visits in the United States.Hispanic and non-Hispanic blacks are at greater risk for developing diabetes and serious associated health complications, including chronic kidney disease. This may be attributed to a combination of genetics, diet, and exercise. However, access to health care resources may also play an important role."

Mobile-Based Sidewalk Inventory App For Smart Communities, Health, And Safety, Madhav Erraguntla, Dursun Delen, Rupesh K. Agrawal, Karthic Madanagopal, Richard Mayer

Suburban Sustainability

As the United States and other nations strive to cope with the obesity epidemic (NCHS, 2015), progressive communities are developing sidewalk infrastructure to promote physical activity and health. The Center for Disease Control (CDC) recommends that community-based interventions like neighborhood walk, bike programs etc. have shown to be effective in promoting physical activity and health. Smart cities are embracing the development of community trails and promoting their use to increase physical activity among youth and adults. System implementation, data collection, and analysis were performed from January 2015 through July 2015. To promote these objectives, communities and cities need accurate information …

Marketing Strategies To Encourage Rural Residents Of High-Obesity Counties To Buy Fruits And Vegetables In Grocery Stores, Emily Liu, Tammy Stephenson, Jessica Houlihan, Alison Gustafson

Dietetics and Human Nutrition Faculty Publications

Introduction

Obesity rates in Appalachia are among the highest in the United States, and knowledge of upstream approaches to decrease prevalence among this vulnerable population is limited. The primary aim of this study was to examine the association between healthy, diet-based, social marketing interventions in grocery stores and frequency of fruit and vegetable intake.

Methods

A social marketing campaign was conducted among 17 grocery stores (N = 240 participant surveys) over 4 months in 5 rural Kentucky counties. Interventions included providing food samples, recipe cards, and promotional discounts on fruits and vegetables and moving high-calorie foods to side aisles.

Results …

The Role Of Intermittent Preventive Treatment For Malaria In Saving Lives And Promoting Drug Resistance, Carrie Manore

Annual Symposium on Biomathematics and Ecology Education and Research

No abstract provided.

Assessing The National Cancer Institute's Smokefreemom Text-Messaging Program For Pregnant Smokers: Pilot Randomized Trial., Lorien C Abroms, Shawn Chiang, Laura Macherelli, Leah Leavitt, Margaret Montgomery

Prevention and Community Health Faculty Publications

BACKGROUND: Automated text messages on mobile phones have been found to be effective for smoking cessation in adult smokers.

OBJECTIVE: This study aims to test the acceptability and feasibility of SmokefreeMOM, a national smoking cessation text-messaging program for pregnant smokers.

METHODS: Participants were recruited from prenatal care and randomized to receive SmokefreeMOM (n=55), an automated smoking cessation text-messaging program, or a control text message quitline referral (n=44). Participants were surveyed by phone at baseline and at 1 month and 3 months after enrollment.

RESULTS: Results indicate that the SmokefreeMOM program was highly rated overall and rated more favorably than the …

Community Paramedicine Pilot Programs: Lessons From Maine, Karen B. Pearson Mlis, Ma, George Shaler Mph

Emergency Medical Services (EMS)

Community paramedicine programs are beginning to flourish across the nation, and the need to provide demonstration or pilot programs is essential to providing a consistent and high-level standard for this model of care. While the overarching goals are to align with the Triple Aim, piloting a community paramedicine program also allows each community to develop and implement a program tailored to the healthcare needs of their specific community. A successful program builds the evidence base that can then be used to create legislative change necessary to financially sustain this model of care across the healthcare delivery system. This article provides …

Women Of Leh Town, Ladakh: An Overview Of Perceptions Of Health, Health-Seeking Behaviors, And Access To Health Care, Sophia Marion

Independent Study Project (ISP) Collection

The following study seeks to investigate access to health care services and perceptions of health care among women residing in traditional farming communities around the Ladakh region, and to analyze perspectives on health, health-seeking behavior, and access to health care. This project was prompted by the fact that health care in this region is understudied. This study also focuses on marginalized communities including local women and immigrant women. Methods used for the collection of data were qualitative interviews conducted with 24 women, as well as an amchi worker, doctors, and informal and formal conversations with people from different nongovernmental Organizations …

When Knowledge Flows: A Case Study Of Village Health Workers’ Motivations In Jamkhed, Selaem Hadera

Independent Study Project (ISP) Collection

Across the field of global health, there have been many attempts to cater to the health needs of the most marginalized populations. Community health workers (CHWs) are individuals that live in the communities they serve and are typically low-­‐income women with little to no formal education. After a period of training by their program, they enter their communities equipped as a bridge between the community and the health system. Although CHWs do play a substantial role in health delivery and education, the structure of CHW programs varies widely, but a common characteristic of these programs is that the CHWs are …

Community Perception Of The Hiv Vaccine In Western Kenya: Acceptability, Potential Behavior Changes, And Views On Compulsory Vaccination, Deborah Keen

Independent Study Project (ISP) Collection

Human Immunodeficiency Virus (HIV) suppresses the immune system by attacking T cells, leading to the development of acquired immunodeficiency syndrome (AIDS). HIV affects over 30 million people around the world and 1.6 million people in Kenya. On August 18, 1987, the FDA sanctioned the first human testing of a candidate vaccine for HIV. Currently, multiple HIV vaccines—projected to be on the market in five to ten years—are being tested for efficacy and safety. The goal of this study was to explore opinions related to the HIV vaccine so that there is a guide for future policy development in Western Kenya. …

Increasing Empathy And Conflict Resolution Skills Through Nonviolent Communication (Nvc) Training In Latino Adults And Youth, Marcianna Nosek, Maite Durán

Nursing and Health Professions Faculty Research and Publications

Background: Children of Latino immigrants often are torn between their native homes and new communities. Having supportive interpersonal relationships increases resilience to delinquent and violent behaviors stemming from immigration challenges. Communication fostering empathy may improve conflict resolution and supportive relationships.

Objectives: Community-based participatory research (CBPR) was conducted to evaluate the impact of nonviolent communication (NVC) trainings in Latino adults and youth.

Methods: Four sessions in NVC were provided by bilingual Latino trainers for Latino adults and youth. Pre- and post-training focus groups evaluated effectiveness of training.

Results: Three themes emerged from adult post training focus groups—enter the others’ shoes, making …

Hiv Harm Reduction Methods: A Comparison Between Switzerland And The United States, Erin Major

Independent Study Project (ISP) Collection

This paper explores the connections between harm reduction methods and the prevalence of HIV/AIDS in Switzerland and the United States of America, focusing primarily on the harm reduction methods of needle exchange programs, safe drug consumption spaces, and sex education. While these two countries are largely similar in their culture and geopolitical approaches, there are some key differences in how HIV is approached in each. Switzerland’s somewhat unique approach with relaxed drug policies and more pragmatic, harm reduction based response to the AIDS epidemic sets a model framework for other countries to follow, with comparatively widespread use of needle exchange …

Effect Of Intimate Partner Violence Education On Nurses Readiness To Screen, Felisha Dixon-Brazier

Doctor of Nursing Practice (DNP) Translational and Clinical Research Projects

This quality improvement translational project was intended to increase the confidence of nurses screening for intimate partner violence, through education. The project utilized a focus group and the Physicians Readiness to Manage Intimate Partner Violence Survey to gather needs, knowledge gaps, and prior education to develop IPV education for a group of nurses at a public health department. Nurses were found to have a low level of IPV knowledge, with a mean score of 42.44 (SD= 15.13), on a 100-point scale. Six of the nurses also reported less than one hour of previous IPV training in the past. Nurses reported …

A Social-Ecological Framework Of Theory, Assessment, And Prevention Of Suicide, Robert J. Cramer, Nester D, Kapusta

Community & Environmental Health Faculty Publications

The juxtaposition of increasing suicide rates with continued calls for suicide prevention efforts begs for new approaches. Grounded in the Centers for Disease Control and Prevention (CDC) framework for tackling health issues, this personal views work integrates relevant suicide risk/protective factor, assessment, and intervention/prevention literatures. Based on these components of suicide risk, we articulate a Social-Ecological Suicide Prevention Model (SESPM) which provides an integration of general and population-specific risk and protective factors. We also use this multi-level perspective to provide a structured approach to understanding current theories and intervention/prevention efforts concerning suicide. Following similar multi-level prevention efforts in interpersonal violence …

Retrospective Cohort Study Of The Efficacy Of Azithromycin Vs. Doxycycline As Part Of Combination Therapy In Non-Intensive Care Unit Veterans Hospitalized With Community-Acquired Pneumonia, Justin Spivey, Heather Sirek, Robert Wood, Kalpit Devani, Billy Brooks, Jonathan Moorman

ETSU Faculty Works

The IDSA Community-Acquired Pneumonia (CAP) Guideline recommends ceftriaxone in combination with doxycycline as an alternative to combination therapy with ceftriaxone and azithromycin for non-intensive care unit (ICU) patients hospitalized with CAP. This is an attractive alternative regimen due to recent concerns of increased cardiovascular risk associated with azithromycin. The objective of this study was to compare the clinical outcomes of azithromycin and doxycycline each in combination with ceftriaxone for non-ICU Veterans hospitalized with CAP.

Older Adults’ Experience In Owning A Guide Dog, Jeffrey Kou, Yvonne Lam, Patricia Lyons, Susan Nguyen

Student Research Posters

Low vision is an age-related condition that affects many older adults, and may create challenges in everyday activities in older adults. Guide dogs have been shown to be an effective assistive device that can help older adults within their community. Despite vast research on dog companionship, there is limited research on the facilitators and barriers of owning a guide dog among older adults with low vision. The purpose of this qualitative phenomenological study is to explore the facilitators and barriers of owning a guide dog as experienced by older adults with low vision participating in Guide Dogs for the Blind …

Las Condiciones De Vida De Los Usuarios Adultos Mayores Del Hospital Makewe / The Living Conditions Of Elderly Users Of Makewe Hospital, Taylor Selembo

Independent Study Project (ISP) Collection

Life conditions are a fundamental aspect of the health of senior citizens, as these are the factors that determine their quality of life and capacity to satisfy their needs. Life conditions are dependent on the particular social, political, economic, and geographic context of the region. This study intends to answer the following question: How are the life conditions of senior citizens belonging to Hospital Makewe, located in the IX region of Chile? This quali-quantitative study utilized observation, surveys (n = 40) and interviews (n = 15) in order to accomplish the main objective. The main objective was to describe senior …

A Comparative Study Of The Barriers To Hiv Self-Management Among Myanmar Migrant And Han Chinese Women In Yunnan, China, Anna Gaden

Independent Study Project (ISP) Collection

HIV has transitioned from high-risk populations to the general population through sexual transmission – now the primary mode of transmission in China – and is currently the biggest public health crisis in China. Those who are not directly involved with commercial sex work (CSW) or intravenous drug use (IDU) are now vulnerable to contraction. Han Chinese women, especially young women, are generally more vulnerable to transmission than their male counterparts, both physically and socially, and the virus affects their lives more deeply. Myanmar migrant women are even more vulnerable, as their migrant status leaves them without support structures or protections …

Health-Related Quality Of Life Variations By Sociodemographic Factors And Chronic Conditions In Three Metropolitan Cities Of South Asia: The Carrs Study, Kavita Singh, Dimple Kondal, Roopa Shivashankar, Mohammed K. Ali, Rajendra Pradeepa, Vamadevan S. Ajay, Viswanathan Mohan, Muhammad Masood Kadir, Mark Daniel Sullivan, Nikhil Tandon, K M Venkat Narayan, Dorairaj Prabhakaran

Community Health Sciences

Objectives: Health-related quality of life (HRQOL) is a key indicator of health. However, HRQOL data from representative populations in South Asia are lacking. This study aims to describe HRQOL overall, by age, gender and socioeconomic status, and examine the associations between selected chronic conditions and HRQOL in adults from three urban cities in South Asia.
Methods: We used data from 16 287 adults aged ≥20 years from the baseline survey of the Centre for Cardiometabolic Risk Reduction in South Asia cohort (2010-2011). HRQOL was measured using the European Quality of Life Five Dimension-Visual Analogue Scale (EQ5D-VAS), which measures health status …

Opening A Student-Run Pro Bono Occupational Therapy Pediatric Clinic, Anne H. Zachry

Faculty Presentations

This presentation described the opening of a student-run pro bono pediatric therapy clinic that provides services to children/families who are economically disadvantaged. The benefits of participation for students and clients were reviewed, and fund-raising and the development of a mission statement were discussed.

Insights Into How Hias Are Characterized In The Press: Findings From A Media Analysis Of Widely Circulated United States Newspapers, Maxim Gakh Jd, Mph, Courtney Coughenour Phd, Jennifer Pharr Phd, Aaliyah Goodie, Samantha To

School of Public Health Faculty Research

Background: Health impact assessments (HIAs) are burgeoning tools in the policy process, where the media plays a critical role by focusing attention on issues, informing consumers, and influencing positions. Examining how media portrays HIAs is critical to understanding HIAs in the policy context. Methods: This study considered how widely circulated, U.S. newspapers represent HIAs. After searching newspaper databases, we used a qualitative document analysis method consisting of open and axial coding to examine specific phrases of HIA depictions. Results: In coding over 1,000 unique phrases from the 62 documents generated in our search, we found an uptick in HIA-related publications …

Towards A Global Policy Against Alcohol Marketing To Youth: Challenges And Recommendations For Research., Alisa Padon, Rajiv N Rimal

Prevention and Community Health Faculty Publications

No abstract provided.

Web Resources For Physician Wellness, Elizabeth C. Lawrence

Office of Physician and Student Wellness (OPSW)

A current listing of websites, TED talks, and podcasts related to physician wellness and resiliency.

Persistence Of Macrocytosis After Discontinuation Of Zidovudine In Hiv-Infected Patients, Inski Yu, Richard N. Greenberg, Timothy N. Crawford, Alice C. Thornton, Thein Myint

Family Medicine Faculty Publications

The duration of macrocytosis after stopping zidovudine (ZDV) is unknown. Among 104 HIV-infected patients treated with ZDV for more than 1 year, 84 patients had macrocytosis at ZDV discontinuation. The median mean corpuscular volume (MCV) was 114.6 fL (range 100-128 fL). Patients were divided into 2 groups: those who did (resolved macrocytosis, n = 36) and did not (persistent macrocytosis, n = 48) normalize MCV at 3 to 6 months after ZDV discontinuation. Alcohol use (P =.02), smoking (P =.03), and lower (but within normal range) folic acid levels (P =.05) were related to the persistence of macrocytosis. A persistence …

Preventing Horse-Related Injuries By Watching Out For Other Humans, William R. Gombeski Jr., Fernanda C. Camargo, Holly Wiemers, Connie Jehlik, Polly Haselton Barger, James Mead

Animal and Food Sciences Faculty Publications

The more one rides or handles horses, the more likely one is to have a horse-related injury. These injuries are caused by many factors, including those generated by other riders, handlers or spectators. An analysis of 266 cases of injured equestrians showed that 16% of those injuries were caused by other humans. A panel of horse riding safety experts felt 63% were preventable, and the injured individuals themselves felt 51% were preventable. The study findings suggest that increased awareness of the role others play in causing horse-related injuries and increased education about common people-caused injuries could reduce the number of …

Healthcare Contact And Treatment Uptake Following Hepatitis C Virus Screening And Counseling Among Rural Appalachian People Who Use Drugs, Dustin B. Stephens, April M. Young, Jennifer R. Havens

Behavioral Science Faculty Publications

Background—Hepatitis C virus (HCV) remains a major contributor to morbidity and mortality worldwide. Since 2009, Kentucky has led the United States in cases of acute HCV, driven largely by injection drug use in rural areas. Improved treatment regimens hold promise of mitigating the impact and transmission of HCV, but numerous barriers obstruct people who inject drugs (PWID) from receiving care, particularly in medically underserved settings.

Methods—503 rural people who use drugs were recruited using respondent-driven sampling and received HCV screening and post-test counseling. Presence of HCV antibodies was assessed using enzyme immunoassay of dried blood samples. Sociodemographic and …

Student Pharmacists Provide Tobacco Use Prevention Education To Elementary School Children: A Pilot Experience, Jared L. Ostroff, Marissa L. Wolff, Christina Andros, Eric C. Nemec

Physician Associate Studies Faculty Publications

Background and purpose: The purpose of this article is to describe a service learning experience involving tobacco prevention education and to measure the education's effect on the learners' knowledge of tobacco products.

Educational activity and setting: Student pharmacists planned and presented a 40-min tobacco prevention education program using the Tar Wars curriculum to fourth and fifth grade students at three suburban elementary schools in Western Massachusetts. Mean scores on a five-question assessment given to school age children before and after the presentation were compared. A total of 206 elementary school students in ten classrooms participated.

Findings: The average survey score …