Public Health Commons^™

Pressure Thresholds And Stiffness On The Plantar Surface Of The Human Foot, Thilina W. Weerasinghe, Ravindra S. Goonetilleke, Uwe Reischl

Public and Population Health Faculty Publications and Presentations

The objective was to develop a methodology to assess Pressure Discomfort Thresholds (PDT), Pressure Pain Thresholds (PPT), and tissue stiffness on the plantar surface of the foot. Ten male and ten female participants volunteered for the study. Foot landmarks were used to create a standardized grid-type template of 95 points. For each test point, PPT and PDT values were obtained, and stiffness was calculated for each of the twenty participants. Cluster analyses were performed to determine the regions of similarity for the three dependent variables, PPT, PDT and stiffness. Moran’s-I-index was used to determine the spatial auto correlations. The use …

Statin Use And Risk Of Developing Diabetes: Results From The Diabetes Prevention Program, Diabetes Prevention Program(Dpp) Research Group, Marinella G. Temprosa

GW Biostatistics Center

Objective Several clinical trials of cardiovascular disease prevention with statins have reported increased risk of type 2 diabetes (T2DM) with statin therapy. However, participants in these studies were at relatively low risk for diabetes. Further, diabetes was often based on self-report and was not the primary outcome. It is unknown whether statins similarly modify diabetes risk in higher risk populations.

Research design and methods During the Diabetes Prevention Program Outcomes Study (n=3234), the long-term follow-up to a randomized clinical trial of interventions to prevent T2DM, incident diabetes was assessed by annual 75 g oral glucose tolerance testing and semiannual fasting …

Anti-Müllerian Hormone And Its Relationships With Subclinical Cardiovascular Disease And Renal Disease In A Longitudinal Cohort Study Of Women With Type 1 Diabetes, Catherine Kim, Yuanyuan Pan, Barbara Braffett, Valerie Arends, Michael Steffes, Hunter Wessells, Aruna V. Sarma

GW Biostatistics Center

Background

Reproductive age may be a risk factor for vascular disease. Anti-Müllerian hormone (AMH) is produced by viable ovarian follicles and reflects reproductive age. We examined whether AMH concentrations were associated with markers of subclinical cardiovascular disease (CVD) and kidney disease among women with type 1 diabetes.

Methods

We performed a cross-sectional analysis of the Epidemiology of Diabetes Interventions and Complications Study. Participants included women with type 1 diabetes and ≥1 AMH measurement (n = 390). In multivariable regression models which adjusted for repeated measures, we examined the associations between AMH with CVD risk factors, estimated glomerular filtration rate, …

Biomarkers Of Tubulointerstitial Damage And Function In Type 1 Diabetes, Ian De Boer, Xiaoyu Gao, Ionut Bebu, Andrew Hoofnagle, John Lachin, Diabetes Control And Complications Trial/Epidemiology Of Diabetes Interventions And Complications (Dcct/Edic) Research Group.

Epidemiology Faculty Publications

Objective To evaluate biomarkers of renal tubulointerstitial damage and function in type 1 diabetes with and without diabetic kidney disease.

Research design and methods Cross-sectional case-control study of Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications Study participants. Cases (N=43) had incident persistent estimated glomerular filtration rate (eGFR) <60 mL/min/1.73 m2 with urinary albumin excretion >300 mg/24 hour. Controls (N=43) had persistent eGFR >90 mL/min/1.73 m2 and urinary albumin excretion <30 mg/24 hour. Urinary and plasma biomarkers reflecting tubular injury, inflammation, fibrosis, secretion, and synthetic function were measured from stored specimens collected at the first study visit with reduced eGFR (for case participants) or the corresponding study year (for control participants).

Results Mean (SD) age was 51 (9) and 50 (8) years for case and control participants, and mean (SD) duration of diabetes was 30 (6) and 30 (5) years, respectively. Mean (SD) eGFR was 39 …

Interrelationship Between Climatic, Ecologic, Social, And Cultural Determinants Affecting Dengue Emergence And Transmission In Puerto Rico And Their Implications For Zika Response., Angela Matysiak, Amira Roess

Global Health Faculty Publications

Objective

The global resurgence of dengue has been attributed to rapid population growth, urban expansion, increased air travel, globalization, and climate change. Dengue is now endemic in Puerto Rico. Puerto Rico is at risk for Zika, another emerging arbovirus. The interrelationship between climatic, ecological, social, and cultural factors that affect dengue and other arboviruses' transmission is understudied.

Design

The objective of this systematic review is to examine the interrelationship between climatic, ecological, social, and cultural factors on dengue transmission in Puerto Rico and to draw lessons for Zika response.

Results

A comprehensive search of peer-reviewed journal articles was performed, producing …

Translating Mental Health Diagnostic And Symptom Terminology To Train Health Workers And Engage Patients In Cross-Cultural, Non-English Speaking Populations, Bibhav Acharya, Madhur Basnet, Pragya Rimal, David Citrin, Soniya Hirachan, Brandon Kohrt, +Several Additional Authors

Psychiatry and Behavioral Sciences Faculty Publications

Although there are guidelines for transcultural adaptation and validation of psychometric tools, similar resources do not exist for translation of diagnostic and symptom terminology used by health professionals to communicate with one another, their patients, and the public. The issue of translation is particularly salient when working with underserved, non-English speaking populations in high-income countries and low- and middle-income countries. As clinicians, researchers, and educators working in cross-cultural settings, we present four recommendations to avoid common pitfalls in these settings. We demonstrate the need for: (1) harmonization of terminology among clinicians, educators of health professionals, and health policymakers; (2) distinction …

From Sea To Shining Sea, And The Great Plains To Patagonia: A Review On Current Knowledge Of Diabetes Mellitus In Hispanics/Latinos In The U.S. And Latin America, Larissa Aviles-Santa, Uriyoán Colon-Ramos, Nangel Lindberg, Joseimer Mattei, Francisco Pasquel, Cynthia Perez

Global Health Faculty Publications

The last two decades have witnessed many advances in the prevention, treatment, and control of diabetes mellitus and its complications. Increased screening has led to a greater recognition of Type 2 diabetes mellitus (Type 2 DM) and prediabetes; however, Hispanics/Latinos, the largest minority group in the U.S., have not fully benefited from these advances. The Hispanic/Latino population is highly diverse in ancestries, birth places, cultures, languages, and socioeconomic backgrounds, and it populates most of the Western Hemisphere. In the U.S., the prevalence of diabetes mellitus varies among Hispanic/Latino heritage groups, being higher among Mexicans, Puerto Ricans, and Dominicans, and lower …

Anaesthesia Error In United States: Reasons For Mismanagement, Abby Wolfe, Anh Nguyen, Ashleigh Galles, Madison Wolfe, Ben Lundberg

Posters and Presentations: College of Public Health

A poster from the UNMC Undergraduate Public Health Workshop

Association Between Age-Related Macular Degeneration And Sleep-Disordered Breathing, Jeffrey A. Nau

Walden Dissertations and Doctoral Studies

Age-related macular degeneration (AMD) is a chronic, irreversible disease that robs individuals of vision, quality of life, and independence. It is the leading cause of blindness in industrialized countries. Sleep-disordered breathing (SDB) is a condition characterized by repeated episodes of apnea and/or hypopnea, insomnia, short sleep duration, and/or sleep disturbances (snoring, gasping, etc.). Because SDB has been shown to cause chronic hypoxia resulting in oxidative stress on the retina, it has been proposed that SDB may be associated with AMD. Based on the life course theory of chronic disease, this quantitative, cross-sectional study used data from the 2005-2008 National Health …

Benefit Of Ultrasound Curriculum Development For Family Medicine Residents, Nithin Natwa, Uzair Munshey, Duncan Vos, Robert Baker

Research Day

Introduction/Purpose: Musculoskeletal problems comprise some of the most common reasons for ambulatory care encounters in the United States, accounting for 8.3% of the 1.2 billion visits per year according to the CDC. Musculoskeletal Ultrasound use has become more common in primary care for diagnosis and therapeutics. In Family Medicine Residency (FMR) Programs there is a deficiency of a structured, competency-based musculoskeletal ultrasound (MSK US) training despite its growing popularity. Currently, there is no formalized requirement for Ultrasound education as in other residency programs in spite of its benefit. Methods: We received a positive response on our needs analysis survey for …

Global Health Experience In Swaziland, Anik Patel

Posters

Describes a global health learning experience at the Baylor Center of Excellence in Swaziland, where diagnosis and treatment of HIV/AIDS and TB, along with maternal health, women's health, and adolescent care are provided.

Why Is Education Important In Ems?, Adriana Goad

A with Honors Projects

In EMS, education is vital. As prehospital healthcare providers, we must constantly be educating ourselves on the advances and changes that are made within our protocols and by research. Frequent renewal deadlines for the licenses we hold are put in place so that we remain competent in our skills and are up to date to the most current of standards. There is another factor to our professional need for education, and that is community education. By educating those around us, we can be a means of prevention. While EMS is our career and passion, we want nothing more than to …

Expanding Dental Practices Into Long-Term Care, American Dental Association

Action for Dental Health

No abstract provided.

Understanding Zoonotic Enteric Disease In Minnesota: A Spatio Temporal Analysis And Causal Theory Approach, Suchismita Swain

All Graduate Theses, Dissertations, and Other Capstone Projects

With 75 percent of diseases in humans having origin in animals or animal products, zoonotic diseases have an enormous impact on the global disease burden. A significant portion of this can be attributed to bacterial zoonotic enteric pathogens. This study was designed to locate clusters of bacterial zoonotic enteric outbreaks in the State of Minnesota and study the seasonality of these outbreaks. In addition to identifying hot spots for zoonotic enteric outbreaks in Minnesota, the study also aimed to design a causal model to improve understanding of risk factors. This thesis considered only the bacterial zoonotic pathogens with significant disease …

Swaziland: A Journey Into Culture And Health Care, Claire Hickey

Posters

Describes a global health learning experience with Baylor International Pediatrics AIDS Initiative in Swaziland in 2017.

Sanibonani! A Global Health View Of The Hiv/Aids Epidemic In Swaziland, Angie Schmidt

Posters

Describes a global health learning experience with the Baylor International Pediatric AIDS Initiative in Swaziland.

Unconditional Government Cash Transfer In Support Of Orphaned And Vulnerable Adolescents In Western Kenya: Is There An Association With Psychological Wellbeing?, Sylvia Shangani, Don Operario, Becky Genberg, Kipruto Kirwa, Miriam Midoun, Lukoye Atwoli, David Ayuku, Omar Galárraga, Paula Braitstein

Community & Environmental Health Faculty Publications

Background

Orphaned and vulnerable adolescents (OVA) in sub-Saharan Africa are at greater risk for adverse psychological outcomes compared with their non-OVA counterparts. Social interventions that provide cash transfers (CTs) have been shown to improve health outcomes among young people, but little is known about their impact on the psychological wellbeing of OVA.

Objective

Among OVA in western Kenya, we assessed the association between living in a household that received monthly unconditional government CTs and psychological wellbeing.

Methods

We examined the likelihood of depression, anxiety, post-traumatic stress symptoms (PTSS) and positive future outlook among 655 OVA aged between 10 and 18 …

Self-Reported Adherence To Physical Activity For Cancer Survivors: An Update From The 2015 Nhis Database, Andrew Jackson Shearer

Theses and Dissertations--Kinesiology and Health Promotion

Cancer is the second leading cause of death in America. It’s been suggested that regular physical activity (PA) can improve health outcomes in cancer survivors. An estimate from BRFSS data (2009) suggested that 47% of all cancer survivors met recommended guidelines and that this estimate was not different from the population at large (48%). Several factors were examined from these BRFSS data to determine whether subgroups of survivors existed who might benefit from interventions aimed at improving their PA status. The purpose of this investigation was to obtain more recent estimates of adherence to established PA guidelines for cancer survivors. …

Gastrointestinal Bleeding Events And Statin Use: A Large Propensity Score-Matched Retrospective Cohort Study, Ashley I. Martinez

Theses and Dissertations--Pharmacy

Literature is conflicting regarding the association between statin use and gastrointestinal (GI) bleeding. This study sought to determine whether there is an association between statin use and GI bleeding by comparing incidence of gastrointestinal events between statin users and an active comparator group.

Data was obtained from a large administrative claims database composed of subjects enrolled in a selection of insurance plans throughout the United States from 2009-2014. New statin users (exposed) and thyroid medication users (active comparator, unexposed) were followed from the baseline period (one year prior to medication initiation) until first event, discontinuation, or disenrollment. Subjects were matched …

Promotion Of Early Pediatric Hearing Detection Through Patient Navigation, Matthew L. Bush

Theses and Dissertations--Clinical and Translational Science

Congenital hearing loss is the most common neonatal sensory disorder and it is crucial to diagnose hearing loss as soon as possible after birth in order to facilitate rapid treatment. Universal standards of infant hearing healthcare dictate that infant hearing screening should be completed by one month of age and abnormal screening tests should be followed with definitive audiological testing by three months of age. Obtaining diagnostic testing can be complicated by limited access to care in rural areas, breakdowns in communication, lack of parental support, and poor coordination of care. There is no established method to address appointment non-adherence …

A Month At The Lake Clinic - Cambodia, Mara Horwitz

Posters

Describes a global health learning experience in Cambodia on floating clinics that serve residents of remote villages of the Tonie Sap Lake and Stung Sen River.

Exploring Pediatrics In The Philippines, Taylor Hansen

Posters

Describes her learning experience in the Philippines with the Jose Fabella Memorial Milk Bank, Fabella's Kangaroo Mother Care Unit, and Talisay Health Center in 2017.

Tender Loving Care At The Lake Clinic, Cambodia, Shubra Srinivas

Posters

Describes a global health learning experience at The Lake Clinic in Cambodia caring for children and adults in a low resource setting in 2017.

L’Expérience De Femmes Ayant Subi Une Grossesse Non Désirée Au Sénégal : Une Étude Qualitative, Fatou Mbow, Nafissatou Diop

Reproductive Health

Au Sénégal, l’avortement n’est autorisé que lorsque la vie de la mère est menacée. Depuis 2013, le Comité de plaidoyer pour l’accès à l’avortement médicalisé au Sénégal (plus connu sous le nom de « Taskforce ») mène des activités de plaidoyer pour une révision de la loi. L’avortement est maintenant plus ouvertement discuté, mais la voix des femmes victimes de grossesse non désirée n’est pas entendue. Cette étude documente l’expérience de ces femmes pour fournir des évidences pour le plaidoyer. L’autorisation de l'avortement médicalisée contribuera à respecter les droits humains et de santé des femmes, ainsi qu’à réduire les conséquences …

Senegal: Explorer Le Processus De La Collaboration Multisectorielle Mise En Place Pour L’Étude Qualitative, Fatou Mbow, Nafissatou Diop, Awa Diop Dabo, Awa Tounkara Cissé, Seynabou Ba Diakhaté

Reproductive Health

En 2015, STEP UP a mené une étude qualitative sur l’expérience de femmes ayant subi une grossesse non désirée suite à un viol ou inceste dans la région de Dakar, Sénégal, en partenariat avec le Comité de plaidoyer pour l’accès à l’avortement médicalisé, plus connu sous le nom de «Taskforce». L’objectif général de l’étude était de développer une meilleure compréhension de la vie de ces femmes et d’apporter leur voix au débat sur la légalisation de l’avortement médicalisé. Cette étude de cas examine les caractéristiques de la collaboration, comment elle a été efficace, les leçons apprises, et les recommandations formulées …

Bangladesh: Using Strong Evidence And Strategic Collaboration To Increase Access To Menstrual Regulation With Medication, Nancy Termini Lachance, Sharif M.I. Hossain

Reproductive Health

Through close cooperation with the Ministry of Health and Family Welfare of Bangladesh, and other partners, STEP UP generated strong evidence and cultivated ongoing collaboration that contributed to policy changes and program expansions to increase access to menstrual regulation with medication (MRM). Study results demonstrate that MRM is acceptable and effective in Bangladesh, and has thus been legalized and folded into the national FP program and scaled up nationwide. However, ongoing observation and studies are still needed to understand whether the efficacy and acceptability of MRM remains the case when services are delivered at scale on a national level. Furthermore, …

Introduction And Approval Of Menstrual Regulation With Medication In Bangladesh: A Stakeholder Analysis, Fauzia Akhter Huda, Sadia Afrin, Bidhan Krishna Sarker, Hassan Rushekh Mahmood, Anadil Alam

Reproductive Health

Despite the significant progress that the government of Bangladesh has made toward introducing menstrual regulation with medication (MRM) into the national health program, there has been no systematic documentation on the introduction of MRM in Bangladesh, and on the approval process of local manufacturing of the mifepristone-misoprostol combination for menstrual regulation. This Research Report presents findings from the stakeholder analysis which was initiated to document the entire process of introducing MRM in the country. Findings from key informant interviews indicated some crucial factors that facilitated the process; these are presented here according to a four-part policy analysis framework: context, content, …

Harmonizing National Abortion And Pregnancy Prevention Laws And Policies For Sexual Violence Survivors With The Maputo Protocol, Jill Thompson, Chi-Chi Undie, Avni Amin, Ronald Johnson, Rajat Khosla, Ian Askew, Leopold Ouedraogo, Triphonie Nkurunziza, Sarah Rich, Elizabeth Westley, Melissa Garcia

Reproductive Health

In April 2016, the Population Council, the World Health Organization (WHO), and the International Consortium for Emergency Contraception (ICEC) convened a three-day regional technical meeting aimed at helping participating countries meet their obligations under the Maputo Protocol to protect and promote the reproductive health rights of women and girls, with a special emphasis on survivors of sexual and intimate partner violence. Participants included representatives from six countries in sub-Saharan Africa—Botswana, Ethiopia, Kenya, Malawi, Rwanda, and Zambia—as well as international and regional experts on reproductive health, law, and human rights. Presentations and discussions focused primarily on the prevention and management of …

Comparison Of Allergens Collected From Furnace Filters And Vacuum Floor Dust., Ryan Allenbrand, Charles S. Barnes, Mubeen Mohammed, Luke Gard, Freddy Pacheco, Kevin Kennedy, Anita Didonna, Jay M. Portnoy, Chitra Dinakar

Manuscripts, Articles, Book Chapters and Other Papers

No abstract provided.

Should School Boards Discontinue Support For High School Football?, Lewis H. Margolis, Greg Canty, Mark Halstead, John Lantos

Manuscripts, Articles, Book Chapters and Other Papers

A pediatrician is asked by her local school board to help them decide whether to discontinue their high school football program. She reviews the available evidence on the risks of football and finds it hopelessly contradictory. Some scholars claim that football is clearly more dangerous than other sports. Others suggest that the risks of football are comparable to other sports, such as lacrosse, ice hockey, or soccer. She finds very little data on the long-term sequelae of concussions. She sees claims that good coaching and a school culture that prioritizes the health of athletes over winning can reduce morbidity from …