Public Health Commons^™

Using A New Evidence-Based Health Workforce Innovation Research Framework To Compare Innovations In Community Health Center And Other Ambulatory Care Settings, Leah E. Masselink, Patricia Pittman, Claire Houterman

Health Workforce Research Center Publications

In the United States, changing demographics, rising costs, and the impact of new regulations and payment models arising from the Affordable Care Act have placed unprecedented pressures on healthcare providers to increase access to care, improve quality and to control costs. To meet these challenges, some providers are forming accountable care organizations (ACOs) while others are pursuing medical homes or other novel payment and care delivery models designed to help meet these challenges. Within established organizations such as federally funded community health centers (CHCs), healthcare leaders are exercising significant latitude in developing innovative solutions for meeting their patients’ needs more …

In Search Of Safety, Negotiating Everyday Forms Of Risk: Sex Work, Criminalization, And Hiv/Aids In The Slums Of Kampala, Serena Cruz

FIU Electronic Theses and Dissertations

This dissertation offers an in-depth descriptive account of how women manage daily risks associated with sex work, criminalization, and HIV/AIDS. Primary data collection took place within two slums in Kampala, Uganda over the course of fourteen months. The emphasis was on ethnographic methodologies involving participant observation and informal and unstructured interviewing. Insights then informed document analysis of international and national policies concerning HIV prevention and treatment strategies in the context of Uganda. The dissertation finds social networks and social capital provide the basis for community formation in the sex trade. It holds that these interpersonal processes are necessary components for …

Reproductive Rights In Latin America: A Case Study Of Guatemala And Nicaragua, Katherine W. Bogen

Scholarly Undergraduate Research Journal at Clark (SURJ)

A lack of access to contraceptives and legal abortion for women throughout the nations of Nicaragua and Guatemala creates critical health care problems. Moreover, rural and underprivileged women in Guatemala and Nicaragua are facing greater limitations to birth control access, demonstrating a classist aspect in the global struggle for female reproductive rights. Although some efforts have been made over the past half-century to initiate a dialogue on the failure of medical care in these nations to adequately address issues of maternal mortality and reproductive rights, the women's reproductive health movements of Nicaragua and Guatemala have struggled to reach an effective …

La Relación Entre El Desamparo Y La Salud: El Caso Del Campamento Japón En Santiago, Chile, Chaveli Concepción

Independent Study Project (ISP) Collection

En esta investigación se busca exponer más a fondo como la desigualdad social afecta la salud de aquellos que han sido menos favorecidos. En esta ocasión se analizó el caso de los habitantes del Campamento Japón, en la comuna de Maipú, de Santiago, Chile, con el objetivo de entender el fenómeno de la desigualdad social y cómo esta afecta la salud de las personas que la sufren. La metodología de este estudio cualitativo se constituyó de investigación bibliográfica previa, y posteriormente visitas y trabajos voluntarios al Campamento Japón para hacer observaciones y entrevistas a los activistas del campamento, a los …

Factors Associated With Belief In Conspiracies About Hiv/Aids Among Hiv-Positive African-American Patients, Andrew A. Zekeri, Youssouf Diabate

Professional Agricultural Workers Journal

Abstract

The purpose of this study is to examine factors associated with belief in conspiracies about HIV/AIDS among HIV-Positive African American patients. Survey data were collected from 256 African American patients living with HIV/AIDS attending two HIV clinics in Montgomery and Dothan, Alabama. The study used multiple regression analysis to examine how sociodemographic factors contribute to belief in conspiracies about HIV/AIDS. Education and age were significantly related to belief in conspiracies about HIV/AIDS among men and women. Beliefs in conspiracies about HIV/AIDS may be a barrier to HIV prevention among African Americans. Public health officials should work toward obtaining the …

"A Doula Can Only Do So Much": Birth Doulas And Stratification In United States Maternity Care, Kaylee S. Wolfe

Honors Projects

No abstract provided.

Perceptions Of Potable Water In Rajasthan’S Jodhpur And Barmer Districts, Melissa Spross

Independent Study Project (ISP) Collection

This paper looks at differences and similarities in various populations’ perceptions of safe drinking water (SDW) within Rajasthan (RJ), India, developing suggestions for future initiatives addressing the movement for safe drinking water for all. For this study, surveys were used; the survey was conducted in RJ, India, both in urban Jodhpur and in surrounding rural villages. To analyze the data, all the responses were entered into Excel format to discover patterns, themes and trends within four subtopics: access, storage, quality and cultural significance. The responses indicate that while a distinct water culture spans the geographic area, each different population retains …

The Impact Of Vaccine Hesitancy On The Polio Vaccine In South Asia, Leah Everist

Independent Study Project (ISP) Collection

A disease that paralyzes hundreds of children each year, polio is incurable but also entirely preventable through vaccination. Though part of the reason some children are not reached for immunization is that they are in areas too volatile for healthcare workers to access, vaccine hesitancy is increasingly being recognized as an important player. The objective of this study is to ascertain the degree to which vaccine hesitancy affects polio vaccine campaigns in Afghanistan and Pakistan, the countries in South Asia where polio continues to be endemic, to assess the drivers behind hesitancy in this region, and to present recommendations for …

Analysis Of Traditional Medicine In Zanzibar, Tanzania, Jessica Baylor

Independent Study Project (ISP) Collection

Traditional medicine is used as a major source of health care in developing countries. A small island off the coast of Tanzania, Zanzibar has traditional medicine embedded in its culture. Informal interviews of community members and healers in four different villages as well as interviews with the Department of Forestry and the Traditional and Alternative Medicine Unit were conducted over a four week study. This study found that community members of four villages in Zanzibar supported the idea of a regulation of traditional medicine by the government. It also found that the majority of traditional medicine users have noticed a …

Fighting The Obesity Epidemic: Challenges And Ethics, Grace Brown

Independent Study Project (ISP) Collection

In recent decades, a double burden of disease has emerged that requires public health workers to fight both hunger and obesity. The obesity epidemic is unlike other epidemics in that it is largely man-made and dependent on social factors and industry influences, making it difficult to fight. The high global prevalence of obesity is partially a result of globalization, which has encouraged development and the liberalizing of economies all around the world, which in turn has increased the marketing and consumption of obesogenic products. Policy solutions have been proposed and implemented in some countries, but an international solution has yet …

Confronting Cultural Challenges For Migrant Healthcare In Switzerland, Rebecca Weiss

Independent Study Project (ISP) Collection

Switzerland is home to many migrants, and migration exacerbates health risks. In addition to physical health problems, migrants are more likely than Swiss nationals to face mental health challenges and cultural barriers, which complicate their experiences seeking healthcare. Similarly, clinicians encounter numerous challenges related to the special circumstances of migrant patients. As a response to the specific health needs of migrants, hospital networks and migrant support organizations promote the migrant health situation. However, these services are not ubiquitous in Switzerland, partly due to the partial freedoms of each canton to create its own health policy. This paper explores the barriers …

Accessing Healthcare: The Experience Of Individuals With Asd In Maine Report Summary, Alan Kurtz, Nancy Cronin

Health and Well-Being

A summary of report findings from the published research report, Accessing Healthcare: The Experience of Individuals with Autism Spectrum Disorders in Maine (2014).

Law, Ethics, And Public Health In The Vaccination Debates: Politics Of The Measles Outbreak, Lawrence O. Gostin

Georgetown Law Faculty Publications and Other Works

The measles outbreak of early 2015 is symptomatic of a larger societal problem–the growing number of parents who decide against vaccinating their children. This failure is causing the resurgence of childhood diseases once eliminated from the United States.

This article explores the legal and ethical landscape of vaccine exemptions. While all states require childhood vaccinations, they differ significantly in the types of religious and/or philosophical exemptions permitted, the rigor of the application process, and available review mechanisms. States with relaxed exemption policies disproportionately experience more outbreaks of vaccine-preventable disease.

Vaccine exemptions are an illustration of the “tragedy of the commons,” …

Do Clinical Decision-Support Reminders For Medical Providers Improve Isoniazid Prescription Rates Among Hiv-Positive Adults?, Eric P. Green, Caricia Catalani, Aggrey Keny, Lameck Diero, Charity Ndwiga, Dennis Israelski, Paul Biondich

HIV and AIDS

People living with HIV (PLHIV) are at increased risk of developing active tuberculosis (TB) and dying from TB. Isoniazid preventive therapy (IPT) can prevent this, but only a small fraction of HIV-positive individuals are on IPT. Previous research suggests that clinical decision support systems (CDSS)—electronic systems that use existing patient data and established algorithms to generate alerts, reminders, or recommendations intended to aid clinical decision-making—have the potential to improve provider adherence to diagnostic and treatment guidelines. Researchers conducted a cluster randomized controlled trial of a new CDSS intervention for TB screening, prevention, and treatment in a high HIV and TB …

Understanding Factors Influencing Adverse Sex Ratios At Birth In Bangladesh, Md. Noorunnabi Talukder, Ubaidur Rob, Md. Irfan Hossain, Forhana Rahman Noor

Poverty, Gender, and Youth

Nationally, the sex ratio at birth has persisted at its natural level of 105 male per 100 female newborns for the past half century in Bangladesh. However, at the regional level, Bangladesh is characterized by an east-west divide in sex ratios at birth. While the western region shows normal sex ratios at birth, the eastern region displays distorted sex ratios. To understand the factors that contribute to regional variations, a household survey was conducted among married women aged 18–49 years who had at least two living children. Views of health-care providers on gender-biased sex selection and of program implementers on …

Adhd Versus Ptsd In Preschool-Aged Children: Implications For Misdiagnosis, Klaudette D. Stewart

PCOM Psychology Dissertations

Attention Deficit Hyperactivity Disorder (ADHD) has been one of the most diagnosed disorders in children since it was included in the Diagnostic and Statistical Manual of Mental Disorders−III (DSM−III) in 1980. The number of children who have been diagnosed since that time has grown significantly, raising concerns about the overwhelming number of young children being diagnosed and prescribed medication. According to the literature, young children are diagnosed at a higher rate by pediatric primary care physicians (PCPs) than clinical child psychologists (CCPs) because they are taken to a PCP’s office by a parent, rather than referred from a school environment, …

Um Só Currículo: Directrizes Para Uma Educação Integrada Em Sexualidade, Género, Hiv E Direitos Humanos, International Sexuality And Hiv Curriculum Working Group, Nicole Haberland, Deborah Rogow

Poverty, Gender, and Youth

Education on sexuality and HIV can help adolescents develop the capacity for healthy, respectful relationships and protect themselves from unwanted and unsafe sex, unintended pregnancy, and sexually transmitted infections. A 2015 Population Council study found that sexuality and HIV education programs that address gender and power in intimate relationships are five times more likely to be effective than programs that do not. However, most curricula still do not address these issues. “It’s All One Curriculum” provides a rationale, content, and sample activities for placing gender and rights at the center of sexuality and HIV curricula—both as stand-alone modules and integrated …

Addressing Gender-Biased Sex Selection In Haryana, India: Promising Approaches, Shireen J. Jejeebhoy, Rajib Acharya, Sharmistha Basu, A.J. Francis Zavier

Poverty, Gender, and Youth

Persistently adverse sex ratios remain a challenge in India despite the enforcement of the PCPNDT (Pre-Conception and Pre-Natal Diagnostic Techniques) Act in 1994. Nevertheless, over the decade 2001–2011, positive shifts from very adverse to less adverse levels have occurred in a few states. Two districts in Haryana state—Kurukshetra and Sonipat—whose sex ratios displayed some and no improvement, respectively, are compared in an attempt to find promising programme directions to counter gender-biased sex selection. Comparisons are drawn from the attitudes and experiences of surveyed women and interviews with service providers and programme implementers, about sex-selection technology. Also addressed are differences in …

Falls Among Community-Dwelling Older Adults: Determining The Relationship Between Social Networks And The Risk For Falls, Smita Sikhrakar

All Graduate Theses, Dissertations, and Other Capstone Projects

Falls among community-dwelling older adults is a big public health problem, which have an effect on older adults' health, independence, and quality of life. The purpose of this study was to determine the relationship between social networks and the risk for falls among community-dwelling older adults. This was a descriptive correlational study, which utilized a cross-sectional survey for the data collection. The dependent and independent variable of this study were the risk for falls among the community-dwelling older adults, and the strength and type of social networks respectively. In this study, 218 community-dwelling older adults were recruited, who were living …

Jessie Huey Laurence Papers - Accession 5, Jessie Huey Laurence

Manuscript Collection

The Jessie Huey Laurence Papers primarily consist of correspondence, but also included are speeches, program notes, minutes, financial records, photographs, clippings, and scrapbooks relating to her role in the South Carolina Federation of Women’s Clubs (1928-1937); her promotion of a compulsory school attendance bill for South Carolina (1934-1936); the formation of the South Carolina Council for the Common Good (1935); Works Progress Administration (WPA) and Public Works Administration (PWA) projects in South Carolina; and her interest in the Catawba Indians of York County, as chairman of Indian Affairs Committee for the Catawba Chapter of the Daughters of the American Revolution. …

Physician Role In Enhancing Patient Communication, Tamanna Sahni

Undergraduate Research Posters

Communication in the in-patient environment is crucial, and the relationship between a patient and physician enhances patient health and wellness. Patients should feel confident with their abilities to feel comfortable conversing with physicians, which would thus treat symptoms more effectively. This communication has decreased over time, hence patients are often are unable to obtain medical information from their healthcare providers. What is the relationship between psychological factors, such as self-esteem, and quality of patient-physician communication? And can physicians ensure increased patient comfort in the medical environment?

Various factors can affect the patients’ comfort with their physicians, and when addressed, these …

Trends In Hiv Prevalence, Sexual And Health Seeking Behaviors, And Hiv-Related Discrimination Among Nigerian Youth, Population Council

HIV and AIDS

Nigeria, home to over 170 million people, has a disproportionately heavy youth population of 32 percent whose well-being is intricately tied to the country’s prospects for sustainable development. Nigeria has an HIV prevalence of 3.4 percent, the second highest number of infections in the world. In 2013, it was estimated that 160,000 adolescents in Nigeria were living with HIV. Although Nigeria has developed a national HIV strategic plan that forms a basis for the HIV response, national AIDS and related policies contain few youth-centered provisions. Overall, the national strategic plan targets youth as part of the general population. To fill …

A Secondary Analysis Of Retention Across The Pmtct Cascade In Selected Countries: Rwanda, Malawi, Kenya, And Swaziland, Godfrey Woelk, Aida Y. Berhan, Kwashie Kudiabor, Martha Mukaminega, John On'gech, Epiphanie Nyirabahizi, Caspian Chouraya, David Kimosop, Dieudonne Ndatimana, Mafayo Phiri, Heather Hoffman

HIV and AIDS

There is global consensus that transmission of HIV from mother to child can be eliminated. The Global Task Team, co-chaired by UNAIDS and the US Office of the Global AIDS Coordinator, has developed a global framework with the goal of eliminating new HIV infections among children (transmission rate of less than 5 percent) by 2015. Reaching the goal depends on optimal execution of each step in a complex cascade of activities, including testing and counseling for HIV, early attendance for antenatal care to optimize antiretroviral prophylaxis for prevention of mother-to-child transmission (PMTCT), adherence to the drugs, CD4 count testing, and, …

Barriers To Health Care Among Laotian Americans In Middle Tennessee, Xaiyavong Saenphansiri

DNP Scholarly Projects

Background. Laotian Americans have unique heath beliefs and practices. The cultural differences between Laotian American patients and American health care providers can create challenges in achieving not only evidence-based, but also culturally sensitive care. Although the current literature addresses barriers to health care for Asian Americans, there are few studies related to the Laotian-American minority.

Aim. Describing the particular barriers to preventive and curative care in the Laotian-American population in Middle Tennessee would inform strategies for successful prevention and early treatment programs for this population. The purpose of the study is to describe the health beliefs and barriers to …

An O'Neill Institute Briefing Paper: Ebola, The World Health Organization, And Beyond: Toward A Framework For Global Health Security, Lawrence O. Gostin, Eric A. Friedman, Daniel Hougendobler

Georgetown Law Faculty Publications and Other Works

The West African Ebola epidemic has demonstrated that the world remains ill-prepared to respond to infectious disease outbreaks. A host of institutions are now reviewing what went wrong, and new institutions are being considered, including an African Centers for Disease Control and Prevention and World Bank-initiated Pandemic Emergency Facility. The World Health Organization itself failed in one of its core functions by allowing a preventable infectious disease to spiral out of control in the world’s poorest region. The 68th World Health Assembly (WHA), held in May 2015, provided an opportunity for the Organization to reflect on what went wrong and …

Creating Healthy Community In The Postindustrial City, Brian A. Hoey

Brian A. Hoey, Ph.D.

Capitalizing On Distinctiveness: Creating Wv For A New Economy, Brian A. Hoey

Brian A. Hoey, Ph.D.

This article explores use of images and ideas of place to promote particular social and economic agendas within the regional context of Appalachia. Despite prevailing imageries of backwardness and isolation that adhere to the region, as well as recent history of often-bleak economic conditions, communities such as Huntington, West Virginia, are ideal places to observe inventive forms of community-building, place-making, and place-marketing that borrow from emerging cultural and economic models and stand in sharp contrast to a once dominant paradigm that encouraged capital investment by relying simply on tax breaks and the provision of cheap land and labor to attract …