Public Health Commons^™

Health And Socio-Economic Impacts Of Livelihoods Programs Among People Living With Hiv In Cambodia: A Case-Control Study, Sovannary Tuot, Kouland Thin, Mayumi Shimizu, Samedy Suong, Samithrea Sron, Pheak Chhoun, Siyan Yi

Background: In Cambodia, the circumstances surrounding people living with HIV (PLHIV) remain serious conditions. To ameliorate these situations, KHANA has implemented livelihoods programs since 2010, including village saving and loans (VSL), skill trainings, and cash grants with on-going technical support. This study aims to evaluate the impacts of the programs in improving socio-economic conditions, health, and psychological well-being of PLHIV in Cambodia. Methods: In August 2014, a case-control study was conducted in six selected provinces. The cases were defined as PLHIV who lived in the selected operational districts where KHANA has implemented the livelihoods programs, and have participated in …

Improving Prevention And Care For Hiv And Sexually Transmitted Infections Among Men Who Have Sex With Men In Cambodia: The Sustainable Action Against Hiv And Aids In Communities (Sahacom), Siyan Yi, Sovannary Tuot, Pheak Chhoun, Khuondyla Pal, Chanrith Ngin, Sok Chamreun Choub, Carinne M. Brody

Background: The prevalence of HIV and sexually transmitted infections (STIs) among key populations in Cambodia continues to rise. To address this issue, KHANA, the largest national HIV organization in the country developed and implemented the Sustainable Action against HIV and AIDS in Communities (SAHACOM) project. This study aims to determine the impacts of the SAHACOM on sexual behaviors and the uptake of HIV/STI services among men who have sex with men (MSM) in Cambodia.

Methods: We compared outcome indicators at midterm (n = 352) and endline (n = 394). Surveys were conducted in 2012 and 2014 in Battambang …

Men Who Have Sex With Men In Cambodia: Population Size, Hiv Risky Behaviors, And Hiv Prevalence, Siyan Yi, Srean Chhim, Pheak Chhoun, Sovannary Tuot, Cheaty Ly, Phalkun Mun, Chanrith Ngin

Background: Men who have sex with men (MSM) constitute a significant proportion of HIV key populations in Cambodia. We conducted this study to estimate the national population size, assess HIV-related risk behaviors, and determine HIV prevalence among MSM in Cambodia. Methods: This research was conducted in 2014 in 12 study sites in Cambodia. MSM size estimation was performed using capture-recapture method with data collected in two time points within an 18-day interval. To assess HIV risk behaviors, a total of 838 MSM were randomly selected for face-to-face interviews during the capture round. A separate survey using a time …

Determinants Of Inconsistent Condom Use Among Hiv Serodiscordant Couples In Cambodia, Sovannary Tuot, Khuondyla Pal, Kouland Thin, Chrysanta Patio, Kelly Allbritton, Christie Blondek, Siyan Yi

Background: Globally, heterosexual transmission within serodiscordant relationships is a significant source of new HIV infections. In 2012, there were an estimated 1,350 incident cases of HIV in Cambodia, of which 37% were between heterosexual couples and 30% among sex workers. In combination with antiretroviral therapy (ART), consistent condom use can significantly reduce HIV transmission risk among serodiscordant couples. This study explored determinants of inconsistent condom use among serodiscordant couples in Cambodia. Methods: A cross-sectional study was conducted in Battambang, Pursat and Takeo provinces in September 2013. A structured questionnaire was used to collect data on condom use and …

A Pilot Study For Plant The Seed: A Nutrition Education Program Using Local Food Environment To Put Theory Into Action, Yeon Bai, Shahla M. Wunderlich, Karen A. Lee

Department of Nutrition and Food Studies Scholarship and Creative Works

The purpose of this study is to implement Plant the Seed, a garden-based nutrition education program designed to reconnect children with locally grown food, food environments of the past and present, and the benefits of eating seasonal foods. The pilot study investigates the environmental context and theory variables known to influence healthy food choice behavior. Social Cognitive Theory (SCT) provided a framework for the program’s curriculum and evaluation. The target audience is middle school students. Plant the Seed is a two-part program. In Part 1 (classroom), students participate in practical, interactive activities based on specific educational objectives that target …

Análisis De Las Políticas Públicas De Prevención Del Cáncer De Cuello Uterino Vinculadas Al Control Del Virus Del Papiloma Humano (Vph) En Argentina / An Analysis Of Argentina’S Public Health Prevention Strategies Of Cervical Cancer Related To The Control Of The Human Papiloma Virus (Hpv), Caroline Seman

Independent Study Project (ISP) Collection

El objetivo general de este estudio es analizar las políticas públicas de prevención del cáncer de cuello uterino (CCU) basadas en la incorporación de nuevas tecnologías como el test de VPH (Virus del Papiloma Humano) y la vacuna contra el VPH en Argentina. Los objetivos específicos son 1) describir la implementación del test de VPH y la campaña de vacunación obligatoria contra el VPH como estrategias de prevención primaria del CCU a nivel nacional: 2) identificar los factores que las facilitan y las obstaculizan. El CCU es el segundo cáncer más diagnosticado en las mujeres de Argentina. Desde el año …

Patient Self-Management: Impact Of Racism-Related Vigilance In The Management Of Hypertension In African-Americans, Rackelle N. Wilkinson-Alston

Writing Across the Curriculum

It is important to understand the role that discrimination plays in health disparities. This paper will discuss racism-related vigilance, and its role in health outcomes in hypertensive African-Americans (AAs). This paper will also attempt to provide insight on how the absence of a culturally competent health care system may predispose AAs to developing stress-induced hypertension due to racism-related vigilance. This paper will explore how community partnership programs may be beneficial interventions for building resilience and promoting positive health behaviors among hypertensive AAs in the face of discrimination-related vigilance.

Is There A Link Between Zika Virus And Microcephaly In Neonates?, Yuliya Salanovich

The Science Journal of the Lander College of Arts and Sciences

With Zika virus spreading worldwide, a lot of attention is drawn to researching its pathogenesis and etiology. It has also been noticed by various research groups and such health agencies such as CDC and WHO that there might be a connection between ZIKV and microcephaly, due to the spiking number of cases of microcephaly reported in areas with affected patients. Temporal and geographical data from the affected ZIKV areas, including Brazil and French Polynesia, suggests a connection between microcephaly and the virus. Tests of amniotic fluids of pregnant women with reported Zika virus infection and microcephalic fetuses revealed the presence …

Social Return On Investment: A Cost-Benefit Analysis Of The Hiv Integrated Care And Prevention Programs In Cambodia, Sovannary Tuot, Liza Tong, Sopheab Heng, Minh-Anh Luong, Khuondyla Pal, Pheak Chhoun, Siyan Yi

Background: KHANA’s HIV Integrated Care and Prevention (ICP) project provided comprehensive care and support to HIV-affected communities through home and community-based care teams from 2007 to 2011. The aim of this study was to use Social Return on Investment (SROI) methodology to evaluate the social, health, and economic impacts of the ICP project, enabling the calculation of a ratio cost-to-benefit for the community in terms of HIV care, support, and treatment. Methods: The SROI methodology is a social cost-benefit analysis framework that measures and accounts for the values created by a program or series of initiatives. Values were mapped to …

Acceptability Study On Hiv Self-Testing Among Transgender Women, Men Who Have Sex With Men, And Female Entertainment Workers In Cambodia: A Qualitative Analysis, Khuondyla Pal, Chanrith Ngin, Sovannary Tuot, Pheak Chhoun, Cheaty Ly, Srean Chhim, Siyan Yi

Background: In Cambodia, HIV prevalence is high while HIV testing rates remain low among transgender women (TG women), men who have sex with men (MSM), and female entertainment workers (FEW). Introducing self-testing for HIV to these key populations (KPs) could potentially overcome the under-diagnosis of HIV and significantly increase testing rates and receipt of the results, and thus could decrease transmission. Therefore, this study aimed to determine the acceptability of HIV self-testing (HIVST) among these three categories of KPs.

Methods: This study was conducted through focus group discussions (FGDs) with TG women, MSM, and FEW in Phnom Penh …

Chronic Pancreatitis, Pain, And Anxiety In An Alcohol And High Fat Mouse Model, Tiffanie Clinkinbeard

Theses and Dissertations--Gerontology

Homeodynamic space (HDS) shrinks as vulnerability increases with aging and repeated damage to the cells. HDS is lost in alcoholic pancreatitis patients due to overconsumption of alcohol, smoking, and high fat diets. Etiologically relevant animal models for study of chronic pancreatitis (CP) are needed. In order to begin filling this gap a central purpose of this dissertation research was to examine relationships between the alcohol and high fat diet (AHF) and pancreatitis with attention to hypersensitivity and anxiety-like behaviors. The AHF diet induced pancreatitis described here etiologically mimics human risk factors of AHF consumption for advancement to alcoholic CP.

In …

Lifestyle Contributors To Cardiovascular Disease Risk, Adam J. Berrones

Theses and Dissertations--Kinesiology and Health Promotion

Aortic stiffness is an independent risk factor that has prognostic value regarding future cardiovascular disease (CVD) events such as myocardial infarction, strokes, and heart failure. Although death rates due to coronary heart disease have declined in recent years, the leading global killer remains CVD and prevalence is still high. Understanding lifestyle contributors associated with aortic stiffness would provide the public with insight into targeting key health-related behaviors.

The purpose of this observational study was to examine the association of physical activity, physical function, and dietary quality as independent factors contributing to aortic stiffness in apparently healthy middle aged men. Fifty-two …

Evaluation Of A Diabetes Self-Management Program For Hispanics In Lexington Kentucky: A Pilot Study, Miguel A. Gamboa Oropeza

Theses and Dissertations--Nutrition and Food Systems

Hispanics are more affected by diabetes than non-Hispanic whites and they tend to experience more severe complications. Research shows that although self-management is poor among ethnic minorities, it is even more so among Hispanics. The “Taking Ownership of Your Diabetes” (TOYD) program has been shown to be successful in helping individuals manage their diabetes. However, no work has been conducted with Hispanic audiences in Kentucky. TOYD program allows individuals to modify lifestyle risks and solve problems related to diabetes management. The program was translated from English to Spanish. Hispanics males and females between ages 19 to 75 years …

The International Health Regulations: The Governing Framework For Global Health Security, Lawrence O. Gostin, Rebecca Katz

Georgetown Law Faculty Publications and Other Works

• The International Health Regulations (IHR) are the governing framework for global health security yet require textual and operational reforms to remain effective, particularly as parallel initiatives are developed.
• The World Health Organization (WHO) is the agency charged with oversight of the IHR, and its leadership and efficient functioning are prerequisites for the effective implementation of the IHR.
• We reviewed the historical origins of the IHR and their performance over the past 10 years and analyzed all of the ongoing reform panel efforts to provide a series of politically feasible recommendations for fundamental reform.
• This article offers proposals for fundamental reform—with …

Reasons For Missing Antiretroviral Therapy: Results From A Multi-Country Study In Tanzania, Uganda, And Zambia, Olivier Koole, Julie A. Denison, Joris Menten, Sharon Tsui, Fred Wabwire-Mangen, Gideon Kwesigabo, Modest Mulenga, Andrew F. Auld, Simon G. Agolory, Ya Diul Mukadi, Eric Van Praag, Kwasi Torpey, Seymour Williams, Jonathan Kaplan, Aaron Zee, David Bangsberg, Robert Colebunders

OHSU-PSU School of Public Health Faculty Publications and Presentations

Objectives To identify the reasons patients miss taking their antiretroviral therapy (ART) and the proportion who miss their ART because of symptoms; and to explore the association between symptoms and incomplete adherence.

Methods Secondary analysis of data collected during a cross-sectional study that examined ART adherence among adults from 18 purposefully selected sites in Tanzania, Uganda, and Zambia. We interviewed 250 systematically selected patients per facility (≥18 years) on reasons for missing ART and symptoms they had experienced (using the HIV Symptom Index). We abstracted clinical data from the patients’ medical, pharmacy, and laboratory records. Incomplete adherence was defined as …

The Waist To Height Ratio Is A Better Anthropometric Index Of Abdominal Obesity And Its Association With The Prevalence Of Diabetes Among Asian Americans, Yu Xiao

All Master's Theses

There is limited information about diabetes prevalence among Asian Americans. Diabetes risk factors include abdominal obesity (AO), which can be assessed by measuring waist circumference (WC) or waist-to-height-ratio (WHtR). The purpose of this study was to compare the prevalence of diabetes among Asians with non-Asians in the United States and compare WC and WHtR as predictors of diabetes. Data from the National Health and Nutrition Examination Survey (NHANES) 2011-14 was analyzed using SAS 9.2. There were 8,615 adult non-pregnant non-Asians and 1,224 Asians included in this study. Despite a lower prevalence of obesity among Asians compared to non-Asians (12% vs …

Success Of Bubble Cpap In Treatment Of Respiratory Distress Syndrome In Preterm Infants, Tufail Soomro, Shiyam Sunder Tikmani

Community Health Sciences

Background: To observe the survival of preterm infants with respiratory distress syndrome treated with bubble CPAP in a tertiary care hospital.
Methods: This prospective observational study was conducted in the NICU of Civil hospital Sukkur from 1st July 2013 to 18th August 2015. All consecutively born preterm neonates with gestational age between 27 weeks to 36 weeks of gestation, admitted to the neonatal intensive care unit with respiratory distress are included in the study.These neonates were managed by Bubble continuous positive airway pressure (bCPAP) in combination with surfactant (bovine derivative) via intubation, Surfactant replacement, extubation (INSURE) protocol Success was considered …

Investigating Cholera Using An Sir Model With Age-Class Structure And Optimal Control, K. Renee Fister, Holly Gaff, Elsa Schaefer, Glenna Buford, Bryce C. Norris

Biological Sciences Faculty Publications

The use of systems of differential equations in mathematical modeling in conjunction with epidemiology continues to be an area of focused research. This paper briefly acquaints readers with epidemiology, cholera, and the need for effective control strategies; discusses cholera dynamics through a variation on the SIR epidemiological model in which two separate age classes exist in a population; finds the numeric value for R₀ to be approximately 1.54 using estimated parameters for Bangladesh; and employs an optimal control resulting in a suggestion that a protection control be implemented at the end of the monsoon season.

Prevalence Of Nasal Colonization By Methicillin-Resistant Staphylococcus Aureus In Persons Using A Homeless Shelter In Kansas City, Megan Ottomeyer, Charles D. Graham, Avery D. Legg, Elizabeth S. Cooper, Chad D. Law, Mariam Molani, Karine Matevossian, Jerry Marlin, Charlott Williams, Ramon Newman, Jason A. Wasserman, Larry W. Segars, Tracey A H Taylor

Manuscripts, Articles, Book Chapters and Other Papers

Nasal colonization of methicillin-resistant Staphylococcus aureus (MRSA) plays an important role in the epidemiology and pathogenesis of disease. Situations of close-quarter contact in groups are generally regarded as a risk factor for community-acquired MRSA strains due to transmission via fomites and person-to-person contact. With these criteria for risk, homeless individuals using shelter facilities, including showers and toilets, should be considered high risk for colonization and infection. The aim of this study was to determine the prevalence of nasal colonization of MRSA in a homeless population compared to established rates of colonization within the public and a control group of subjects …

Contraceptive Provision To Adolescent Females Prescribed Teratogenic Medications., Stephani L. Stancil, Melissa K. Miller, Holley Briggs, Daryl Lynch, Kathy Goggin, Gregory Kearns

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND AND OBJECTIVES: Rates of adult women receiving contraceptive provision when simultaneously prescribed a known teratogen are alarmingly low. The prevalence of this behavior among pediatric providers and their adolescent patients is unknown. The objective of this study was to describe pediatric provider behaviors for prescribing teratogens concurrently with counseling, referral, and/or prescribing of contraception (collectively called contraceptive provision) in the adolescent population.

METHODS: A retrospective review was conducted examining visits in 2008-2012 by adolescents aged 14 to 25 years in which a known teratogen (US Food and Drug Administration pregnancy risk category D or X) was prescribed. The electronic …

Assessment Of The Knowledge And Skills Of School Personnel To Respond To Diabetic Emergencies In Georgia Public Schools, Alesha Wright

College of Graduate Studies: Theses & Dissertations

Diabetes is a common chronic disease that affects children in the United States. As children with diabetes attend school, the ability to appropriately manage their diabetes is essential to preventing life-threatening health complications. The purpose of the study was to assess school personnel’s knowledge of diabetes and perceived self-competence in performing diabetes management skills in response to a diabetic emergency. For the present study, a diabetic emergency was operationalized to include hypoglycemia, hyperglycemia, or diabetic ketoacidosis. A cross-sectional survey design, utilizing a fifty-two item self-administered questionnaire that accentuated the causes and symptoms of diabetes, definition of hypoglycemia and hyperglycemia, and …

Two Related Occupational Cases Of Legionella Longbeachae Infection, Quebec, Canada, Marianne Picard-Masson, Élisabeth Lajoie, Judith Lord, Cindy Lalancette, Geneviève Marchand, Éric Levac, Marc-André Lemieux, Patricia Hudson, Louise Lajoie

Études primaires

Two patients with no exposure to gardening compost had related Legionella longbeachae infections in Quebec, Canada. Epidemiologic investigation and laboratory results from patient and soil samples identified the patients’ workplace, a metal recycling plant, as the likely source of infection, indicating a need to suspect occupational exposure for L. longbeachae infections.

The Healthy Heart Program At The University Of Montana: A Program Review, Laura B. Porisch

Graduate Student Theses, Dissertations, & Professional Papers

Porisch, Laura, M.S., Spring 2016 Health and Human Performance

Abstract—The Healthy Heart Program at the University of Montana: A Program Review

Chairperson: Steven Gaskill

Purpose: The purpose of this paper is to identify whether the Healthy Heart Program at the University of Montana is successful at facilitating lifestyle behavior changes. Methods: Six participants from Spring of 2015 were interviewed 3-4 months post and again 9-10 months post participation in the program. Interview questions focused on whether participants were working toward goals as well as their opinion of the program and what could be done to improve it. Additionally, 18 participants …

Slug Bug: Quality Improvement With Orchestrated Testing Leads To Nicu Clabsi Reduction., Anthony J. Piazza, Beverly Brozanski, Lloyd Provost, Theresa R. Grover, John Chuo, Joan R. Smith, Teresa Mingrone, Susan Moran, Lorna Morelli, Isabella Zaniletti, Eugenia K. Pallotto

Manuscripts, Articles, Book Chapters and Other Papers

OBJECTIVE: Reduce central line-associated bloodstream infection (CLABSI) rates 15% over 12 months in children's hospital NICUs. Use orchestrated testing as an approach to identify important CLABSI prevention practices.

METHODS: Literature review, expert opinion, and benchmarking were used to develop clinical practice recommendations for central line care. Four existing CLABSI prevention strategies (tubing change technique, hub care monitoring, central venous catheter access limitation, and central venous catheter removal monitoring) were identified for study. We compared the change in CLABSI rates from baseline throughout the study period in 17 participating centers. Using orchestrated testing, centers were then placed into 1 of 8 …

Exploring The Role Of Intersectionality On Cardiovascular Disease Risk In Sexual Minorities, Leia Harper

Theses and Dissertations

Background: Previous research has shown that sexual minority individuals (SM) are twice as likely to smoke, twice as likely to be overweight or obese, and less likely to be physically active than heterosexual persons; all of which place SMs at an increased risk for cardiovascular disease (CVD). While information on CVD risk by race/ethnicity and socioeconomic status is well documented, there is scant literature examining race, gender, and the potential CVD risk in SMs. The purpose of this study was to examine CVD risk in sexual minorities.

Method: The current study used data from the National Longitudinal Study of Adolescent …

Frequency Of Birth Defects And Its Relationship To Parents Having Interfamily Marriages At A Tertiary Care Hospital, Tufail Soomro, Shiyam Sunder Tikmani

Community Health Sciences

Background: Inter family cousin marriages carries a risk of increased birth defects. The exact contribution of interfamily to birth defects risk is controversial. The aims of this study were to determine the frequency of birth defects in in relation to interfamily or outside family marriages.
Methods: This cross sectional study was conducted in the Civil hospital Sukkur from 9th November 2013 to 13th December 2015. Mothers giving birth to babies married in interfamily or outside family with their consent obtained were included in the study. Mothers not giving consent for study and having any known major illnesses were excluded from …

Frequency Of Retinopathy Of Prematurity In A Tertiary Care Hospital, Shiyam Sunder Tikmani, Tufail Soomro, Prashant Tikmani

Community Health Sciences

Introduction: Retinopathy of prematurity (ROP) is one of a preventable cause of blindness in neonates. Screening of preterm infants for ROP in Pakistan is currently under-recognized. The aim of this study was to determine the frequency of retinopathy of prematurity (ROP) in premature and very low birth weight neonates (birth weight ≤ 1500 g and gestational age ≤ 32 weeks) in a tertiary care hospital, Karachi, Pakistan.
Methods: This was a cross-sectional study carried out in the neonatal intensive care unit (NICU) of Civil Hospital Sukkur from 1st June 2014 to 17th June 2015. Preterm neonates with birth weight ≤ …

Japanese Encephalitis: Assessing Disease Risk Due To Landscape Factors At Multiple Scales, Julia E. Metelka

Theses and Dissertations (Comprehensive)

Japanese Encephalitis is a mosquito-borne disease and is the leading cause of viral encephalitis in Asia. In many Asian countries, the geographical distribution of JE is dependent on a variety of human-environment interactions that can be conceptualized as a complex social-ecological system. The JE transmission cycle is influenced by a few primary human-landscape factors; the abundance and the spatial configuration of rice paddy fields (which provide habitat for the vector), the distribution of pig farms (which position the virus' amplifying host), and the location of a susceptible human population. Our models integrate population dynamics, landscape characteristics, and weather variables that …

Climate Change And Malaria Control: The Importance Of Mitigation And A Call To Action, Emmanuel O. Adewuyi, Kazeem Adefemi

Research outputs 2014 to 2021

Malaria has remained an important target for global disease control efforts for decades. The streams of funds and, consequently, availability of effective interventions for the disease have resulted in considerable reduction in its burden, globally. Despite the relative success of such global efforts, malaria remains a significant threat in over a hundred countries, worldwide, leading to about one million deaths and hundreds of millions of hospital visits, annually. Many researchers and health commentators have argued that global warming, a consequence of climate change, could be linked – directly or indirectly – to the persistence as well as the re-emergence of …

Space-Time Modelling Of Emerging Infectious Diseases: Assessing Leptospirosis Risk In Sri Lanka, Cameron C F Plouffe

Theses and Dissertations (Comprehensive)

In this research, models were developed to analyze leptospirosis incidence in Sri Lanka and its relation to rainfall. Before any leptospirosis risk models were developed, rainfall data were evaluated from an agro-ecological monitoring network for producing maps of total monthly rainfall in Sri Lanka. Four spatial interpolation techniques were compared: inverse distance weighting, thin-plate splines, ordinary kriging, and Bayesian kriging. Error metrics were used to validate interpolations against independent data. Satellite data were used to assess the spatial pattern of rainfall. Results indicated that Bayesian kriging and splines performed best in low and high rainfall, respectively. Rainfall maps generated from …