Public Health Commons^™

The Effect Of Health Insurance On Institutional Delivery In Indonesia, Mazda Novi Mukhlisa, Pujiyanto Pujiyanto

Kesmas

Pemanfaatan pelayanan persalinan di fasilitas kesehatan berdampak pada menurunnya angka kematian ibu (AKI). Di Indonesia, persalinan di fasilitas kesehatan mengalami peningkatan setiap tahunnya, tetapi masih terdapat sekitar 30% ibu yang bersalin di rumah. Sayangnya, peningkatan pemanfaatan pelayanan persalinan di fasilitas kesehatan tersebut tidak diimbangi dengan penurunan AKI, sehingga Indonesia tidak berhasil mencapai target MDGs. Untuk mencapai Universal Health Coverage, Indonesia mengimplementasikan program Jaminan Kesehatan Nasional (JKN) yang mengintegrasikan empat jaminan kesehatan, yaitu Askes/ASABRI, Jamsostek, Jamkesmas, dan Jamkesda. Jaminan kesehatan dapat mengatasi kendala biaya pada persalinan di fasilitas kesehatan. Dengan menggunakan data Riset Kesehatan Dasar 2013 dan data Potensi Desa 2011 …

Risk Of Adolescent Pregnancy Toward Maternal And Infant Health, Analisis Of Idhs 2012, Anni Fithriyatul Mas'udah, Besral Besral, Bimandra Adiputra Djaafara

Kesmas

Dampak kehamilan pada remaja erat kaitannya dengan risiko kesehatan ibu dan bayi. Penelitian ini bertujuan untuk mengembangkan komposit indeks kesehatan ibu, indeks kesehatan bayi dan untuk menelaah pengaruh kehamilan remaja terhadap kesehatan ibu dan bayi. Penelitian ini menggunakan data Survei Demografi Kesehatan Indonesia tahun 2012, dengan sampel 2.167 responden yang memenuhi syarat inklusi (wanita usia subur yang pernah melahirkan anak pertama sejak Januari 2007 sampai survei dilaksanakan). Analisis menggunakan Polychoric Principal Component Analysis untuk menentukan komposit indeks kesehatan ibu dan bayi, serta regresi logistik untuk mengetahui besar hubungan kehamilan remaja terhadap kesehatan ibu dan bayi. Kesehatan ibu dapat ditentukan melalui …

Exclusive Breastfeeding Intention Among Pregnant Women, Tria Astika Endah Permatasari, Ratu Ayu Dewi Sartika, Endang Laksminingsih Achadi, Urip Purwono, Anies Irawati, Dwiana Ocviyanti, Evi Martha

Kesmas

Intensi pemberian ASI eksklusif adalah intensi ibu untuk memberikan hanya ASI pada bayinya sejak dilahirkan hingga berusia enam bulan. Intensi pada periode prenatal merupakan penentu langsung pemberian ASI eksklusif. Penelitian ini bertujuan mengetahui faktor paling dominan berhubungan dengan intensi pemberian ASI eksklusif pada ibu hamil di sebuah rumah sakit ibu dan anak di Kota Tangerang Selatan. Penelitian dengan desain studi potong lintang dilakukan secara primer. Sampel berjumlah 143 ibu hamil trimester ketiga dipilih secara purposive sampling. Intensi pemberian ASI eksklusif diukur menggunakan kuesioner the Infant Feeding Intentions scale. Sedangkan sikap, norma subjektif dan persepsi kontrol perilaku dinilai menggunakan modifikasi kuesioner …

Technical Considerations In The Use Of The E-Value, Tyler J. Vanderweele, Peng Ding, Maya Mathur

Harvard University Biostatistics Working Paper Series

The E-value is defined as the minimum strength of association on the risk ratio scale that an unmeasured confounder would have to have with both the exposure and the outcome, conditional on the measured covariates, to explain away the observed exposure-outcome association. We have elsewhere proposed that the reporting of E-values for estimates and for the limit of the confidence interval closest to the null become routine whenever causal effects are of interest. A number of questions have arisen about the use of E-value including questions concerning the interpretation of the relevant confounding association parameters, the nature of the transformation …

Strategies To Adjust For Response Bias In Clinical Trials: A Simulation Study, Victoria R. Swaidan

USF Tampa Graduate Theses and Dissertations

Background: Response bias can distort treatment effect estimates and inferences in clinical trials. Although prevention, quantification, and adjustments have been developed, current methods are not applicable when subject-level reliability is used as the measure of response bias. Thus, the objective of the current study is to develop, test, and recommend a series of bias correction strategies for use in these cases. Methods: Monte Carlo simulation and logistic regression modeling were used to develop the strategies, examining the collective impact of sample size (N), effect size (ES), reliability distribution, and response style on estimating the treatment effect size in a series …

The Association Of Long-Term Exposure To Particulate Matter Air Pollution With Brain Mri Findings: The Aric Study., Melinda C Power, Archana P Lamichhane, Duanping Liao, Xiaohui Xu, Clifford R Jack, Rebecca F Gottesman, Thomas Mosley, James D Stewart, Jeff D Yanosky, Eric A Whitsel

Epidemiology Faculty Publications

BACKGROUND: Increasing evidence links higher particulate matter (PM) air pollution exposure to late-life cognitive impairment. However, few studies have considered associations between direct estimates of long-term past exposures and brain MRI findings indicative of neurodegeneration or cerebrovascular disease.

OBJECTIVE: Our objective was to quantify the association between brain MRI findings and PM exposures approximately 5 to 20 y prior to MRI in the Atherosclerosis Risk in Communities (ARIC) study.

METHODS: ARIC is based in four U.S. sites: Washington County, Maryland; Minneapolis suburbs, Minnesota; Forsyth County, North Carolina; and Jackson, Mississippi. A subset of ARIC participants underwent 3T brain MRI in …

Dietary Inflammatory Index And Cardiovascular Risk And Mortality—A Meta-Analysis, Nitin Shivappa, Justyna Godos, James R. Hébert, Michael Wirth, Gabriele Piuri, Attilio Speciani, Giuseppe Grosso

Faculty Publications

Diet and chronic inflammation have been suggested to be risk factors in the development of cardiovascular disease (CVD) and related mortality. The possible link between the inflammatory potential of diet measured through the Dietary Inflammatory Index (DII^®) and CVD has been investigated in several populations across the world. The aim of this study was to conduct a meta-analysis on studies exploring this association. Data from 14 studies were eligible, of which two were case-control, eleven were cohort, and one was cross-sectional. Results from the random-effects meta-analysis showed a positive association between increasing DII, indicating a pro-inflammatory diet, and …

Lower Dietary Inflammatory Index Scores Are Associated With Lower Glycemic Index Scores Among College Students, Yeonsoo Kim, Jie Chen, Michael Wirth, Nitin Shivappa, James R. Hébert

Faculty Publications

The association between the Dietary Inflammatory Index (DII^®), the glycemic index (GI), and the glycemic load (GL) is not known, although it is known that carbohydrates are pro-inflammatory. We aimed to measure the association between the DII and both GI and GL among college students. In this cross-sectional study, 110 college students completed a 3-day food diary, which was used to calculate the DII, the GI, the GL, and the healthy eating index (HEI)-2010. Least square means and 95% confidence intervals of the GI, the GL, and the HEI-2010 were presented per DII tertile using generalized linear mixed …

Chikungunya: India, Allison Harvey

Global Issues in Public Health

A communicable disease is an infectious disease, transmissible by direct contact with an affected individual or the individual’s discharges, or by indirect means. The more direct contact people have, the more disease spreads explaining why larger populations have more outbreaks of communicable diseases. India, in particular, has one of the biggest population sizes and makes them susceptible to those diseases. Many can be fatal. However, other diseases, such as chikungunya, are also dangerous viruses that put specific populations at risk for health problems if infected. With chikungunya symptoms such as fever or rashes may develop. Some symptoms such as joint …

Cholera: Uganda, Emilie Verran

Global Issues in Public Health

The bacterium Vibrio cholerae, when ingested, infects the intestines and causes a communicable diarrhea disease called cholera. Outbreaks of cholera occur in areas with poor sanitation and sewage treatments where fecal material of an infected person contaminates the water. These areas include Southeast Asia, Haiti, and sub-Saharan Africa, including Uganda. From 2011-2016, an analysis of Ugandan cholera data showed ‘hot spots’ of cholera cases in fishing communities with incidence rates as high as 120-998 cases per 100,000 people. An analysis of these same districts from 2011-2015 showed an average Case-Fatality Ratio of 2.4%, with the worst district as high …

Low Vaccination Rates: Africa, Karen Ruiz

Global Issues in Public Health

Vaccination is a treatment that produces immunity, protecting individuals and general populations from infectious and often deadly diseases. Low vaccination rates have for a long time been a pervasive issue in the continent of Africa. There are many extenuating circumstances that become contributory causes for low rates of populations being vaccinated. These circumstances can be in relation to the health professionals and facilities that distributes vaccinations, lack of resources in health facilities, false determiners for children’s eligibility, etc. Other contributory causes concern the general environments in which people live. These contributory causes can present barriers for accessing health services and …

Outdoor Air Quality, Taylor Curley

Global Issues in Public Health

Outdoor air quality is a significant issue for the entire world. It affects any and all people, but is more of an issue in low-income countries and among people that are more susceptible to respiratory issues such as young children, pregnant women, the elderly, and people who already suffer from respiratory problems like asthma. Poor air quality is caused by the burning of fossil fuels which releases particles and chemicals into the air like carbon dioxide, particulate matter, and nitrogen to name a few. It can cause multiple health issues such as respiratory problems to people who are exposed to …

Climate Change: Antarctica, Marika Vi

Global Issues in Public Health

Climate change is a public health issue that affects the entire globe. These effects include the rising in sea levels, shrinking of mountain glaciers, accelerating ice melt, and shifts in flower and plant blooming. The cause of climate change is due to what is known as the “greenhouse effect.” This is where certain gases block heat from getting out of the atmosphere. The cause of this effect is due to many factors like the overuse of fossil fuels and overpopulation. The impact of climate change on the Antarctic, to be specific, is that it has been seen to affect the …

Dengue, Edward Ramos

Global Issues in Public Health

The dengue virus puts one third of the world’s population at risk. Humans carry the virus and mosquitoes pick it up and are able to spread to more people. As long as there are mosquitoes near you there is the possibility that you could become infected with the dengue virus. However, people living in tropical areas that are poverty stricken are much more likely to bit by these mosquitoes and developed dengue fever. Things like mosquito netting and proper plumbing help lower the amount of these mosquitoes from biting people. There are very few treatments for when a person gets …

Malaria: Sub-Saharan Africa, Caroline Morris

Global Issues in Public Health

Sub-Saharan Africa is the large area situated south of the Saharan desert. It is considered one of the poorest regions in the world; the territory faces many challenges in respect to public health. One of the most important issues that sub-Saharan Africa faces is malaria. It is spread through the female Anopheles mosquito. Environmental factors of sub-Saharan Africa heavily influence the rates of incidence in the region due to high populations of mosquitoes. Social determinants of health affect risk in the sub-Saharan populations. Little access to healthcare, built environment, and education all impact incidence of malaria in the region. Children …

Indoor Air Quality: The United States, Paola Solano

Global Issues in Public Health

Indoor air quality is one of today’s most prevalent public health concerns. It is quite shocking to learn that almost all populations in the world can be affected. We oftentimes expect to be home and be safe, but our indoor environment can also be harming to our health. In certain regions, there is more pollution indoors than outdoors due to the surrounding environment. There exist numerous factors that can cause poor air quality. Some of the most common causes include mold, carbon dioxide, moisture damage, and other indoor air contaminants. Although alarming, there are many practices that can better the …

Water Scarcity: Sudan, Catherine Priebe

Global Issues in Public Health

Water scarcity is an environmental global problem that will only become more pressing as time goes on. It is a public health issue that affects every continent, although certain areas of the world are facing more serious water scarcity than others such as Sudan. Populations that are more vulnerable to the effects of water scarcity are the poor, women, children, and those living in areas of political unrest. For example, South Sudan’s urban water systems have been damaged during recent warfare. Water scarcity is also an issue that disproportionately affects women who are forced from a young age to travel …

Waking Up Every Day In A Body That Is Not Yours: A Qualitative Research Inquiry Into The Intersection Between Eating Disorders And Pregnancy, Elizabeth A. Claydon, Danielle M. Davidov, Keith J. Zullig, Christa L. Lilly, Lesley Cattrell, Stephanie C. Zerwas

Faculty & Staff Scholarship

Background: Women with eating disorders are more likely to negatively react to finding out they are pregnant, although this difference in attitudes between women with eating disorders and controls disappears at 18-weeks’ gestation. Those with anorexia also are twice as likely to have an unplanned pregnancy and those with bulimia have a 30-fold increased chance compared with healthy controls. Therefore, due to these considerations, pregnancy and the transition to motherhood can be an extremely challenging time for these women both psychologically and physically. The purpose of this qualitative descriptive study was to understand the intersection between eating disorders and pregnancy …

Rubella Immunity And Serum Perfluoroalkyl Substances: Sex And Analytic Strategy, Courtney S. Pilkerton, Gerald R. Hobbs, Christa Lilly, Sarah S. Knox

Faculty & Staff Scholarship

Background

Perfluoroalkyl substances (PFASs) have been associated with decreased immunity to child- hood tetanus and diphtheria immunizations. If these vaccinations are vulnerable to influence from PFASs, questions arise about associations with other common inoculations.

Objective

To examine whether serum PFASs were associated with reduced immunity to rubella immu- nization, and whether interactions with sex or ethnicity warranted analytic stratification. Usually, toxicology analyses are calculated controlling for race and sex. However, sex differ- ences in immune function have been reported and a reduction of immunity to rubella in women could pose risks such miscarriage.

Methods

We analyzed a nationally representative sample …

Food Choice Priorities Change Over Time And Predict Dietary Intake At The End Of The First Year Of College Among Students In The U.S., Melissa J. Vilaro, Sarah E. Colby, Kristin Riggsbee, Wenjun Zhou, Carol Byrd-Bredbenner, Melissa D. Olfert, Tracey E. Barnett, Tanya Horacek, Morgan Sowers, Anne E. Matthews

Faculty & Staff Scholarship

This study assessed food choice priorities (FCP) and associations with consumption of fruits and vegetables (FV), fiber, added sugars from non-beverage sources, and sugar-sweetened beverages (SSB) among college students. Freshmen from eight U.S. universities (N = 1149) completed the Food Choice Priorities Survey, designed for college students to provide a way to determine the factors of greatest importance regarding food choices, and the NCI Dietary Screener Questionnaire. Changes in FCP and dietary intake from fall 2015 to spring 2016 were assessed. Multiple regression models examined associations between FCP and log-transformed dietary intake, controlling for sex, age, race, and BMI. Participant …

Adverse Event Detection By Integrating Twitter Data And Vaers, Junxiang Wang, Liang Zhao, Yanfang Ye, Yuji Zhang

Faculty & Staff Scholarship

Background: Vaccinehasbeenoneofthemostsuccessfulpublichealthinterventionstodate.However,vaccines are pharmaceutical products that carry risks so that many adverse events (AEs) are reported after receiving vaccines. Traditional adverse event reporting systems suffer from several crucial challenges including poor timeliness. This motivates increasing social media-based detection systems, which demonstrate successful capability to capture timely and prevalent disease information. Despite these advantages, social media-based AE detection suffers from serious challenges such as labor-intensive labeling and class imbalance of the training data.

Results: Totacklebothchallengesfromtraditionalreportingsystemsandsocialmedia,weexploittheircomplementary strength and develop a combinatorial classification approach by integrating Twitter data and the Vaccine Adverse Event Reporting System (VAERS) information aiming to identify potential AEs after …

Method Overtness, Forensic Autopsy, And The Evidentiary Suicide Note: A Multilevel National Violent Death Reporting System Analysis, Ian R. H. Rockett, Eric D. Caine, Steven Stack, Hilary S. Connery, Kurt B. Nolte, Christa L. Lilly, Ted R. Miller, Lewis S. Nelson, Sandra L. Putnam, Paul S. Nestadt, Haomiao Jia

Faculty & Staff Scholarship

Objective

Higher prevalence of suicide notes could signify more conservatism in accounting and greater proneness to undercounting of suicide by method. We tested two hypotheses: (1) an evidentiary suicide note is more likely to accompany suicides by drug-intoxication and by other poisoning, as less violent and less forensically overt methods, than suicides by firearm and hanging/suffocation; and (2) performance of a forensic autopsy attenuates any observed association between overtness of method and the reported presence of a note.

Methods

This multilevel (individual/county), multivariable analysis employed a generalized linear mixed model (GLMM). Representing the 17 states participating in the United States …

The Complementary Health Approaches For Pain Survey (Chaps): Validity Testing And Characteristics Of A Rural Population With Pain, Termeh Feinberg, Dina L. Jones, Christa Lilly, Amna Umer, Kim Innes

Faculty & Staff Scholarship

Objectives

Little is known about patterns and correlates of Complementary Health Approaches (CHAs) in chronic pain populations, particularly in rural, underserved communities. This article details the development and implementation of a new survey instrument designed to address this gap, the Complementary Health Approaches for Pain Survey (CHAPS).

Design

Following pilot-testing using pre-specified criteria to assess quality and comprehension in our target population, and after feedback regarding face-validity from content experts and stakeholders, the final cross-sectional self-report survey required 10–12 minutes to com- plete. It contained 69 demographic, lifestyle and health-related factors, and utilized a Trans- theoretical Model (TTM) underpinning to …

Brief Report: Exercise And Blood Pressure In Older Adults—An Updated Look, George A. Kelley, Kristi S. Kelley

Faculty & Staff Scholarship

Background/Objectives. Raised blood pressure is a major problem in older adults. Using a random-effects model, a recent meta- analysis reported statistically significant reductions in both resting systolic blood pressure (SBP) and diastolic blood pressure (DBP) as a result of aerobic, resistance, and combined aerobic and resistance exercise in adults ≥65 years. To provide more objective information regarding this nonpharmacologic approach, this study applied more robust methods to this data. Design. Meta-analysis of 41 randomized controlled trials representing 96 groups (52 exercise; 44 control). Setting. Any location where a randomized controlled trial could be conducted. Participants. Adults ≥65 years. Intervention. Trials …

Brief Report: Exercise And Anxiety In Adults With Arthritis And Other Rheumatic Diseases: Support For Evidential Value, George A. Kelley, Kristi S. Kelley, Leigh F. Callahan

Faculty & Staff Scholarship

Objective. Given the high prevalence of anxiety in adults with arthritis and other rheumatic diseases (AORD) and the subsequent need for interventions to reduce anxiety, this brief report sought to determine if evidential value exists to support the role of exercise for reducing anxiety in adults with AORD. Methods. Utilizing data from a prior meta-analysis, a recently developed approach, P- curve, was used to determine evidential value by assessing for publication bias and p-hacking. Binomial tests as well as the more robust Stouffer’s test were used to examine for evidential value. To examine the influence of selected studies on p-curve …

Effects Of Mantra Meditation Versus Music Listening On Knee Pain, Function, And Related Outcomes In Older Adults With Knee Osteoarthritis: An Exploratory Randomized Clinical Trial (Rct), Kim Innes, Terry Kit Selfe, Sahiti Kandati, Sijin Wen, Zenzi Huysmans

Faculty & Staff Scholarship

Objective. Disease-modifying treatments for OA remain elusive, and commonly used medications can have serious side effects. Although meditation and music listening (ML) have been shown to improve outcomes in certain chronic pain populations, research in OA is sparse. In this pilot RCT, we explore the effects of two mind-body practices, mantra meditation (MM) and ML, on knee pain, function, and related outcomes in adults with knee OA. Methods. Twenty-two older ambulatory adults diagnosed with knee OA were randomized to a MM (N=11) or ML program (N=11) and asked to practice 15-20 minutes, twice daily for 8 weeks. Core outcomes included …

Perfluoroalkyl Substances And Kidney Function In Chronic Kidney Disease, Anemia, And Diabetes, Baqiyyah N. Conway, Ashley N. Badders, Tina Costacou, John M. Arthur, Kim E. Innes

Faculty & Staff Scholarship

Background: Anemia often complicates chronic kidney disease (CKD), leading to insufficient tissue oxygenation and hypoxic injury, the factor thought to underlie progression from CKD to renal failure. Perfluorocarbons are potent oxygen transporters used in organ preservation and synthetic blood development. Data are scarce on their relationship with kidney function, especially in diabetes where anemia and hypoxia are more prevalent. We investigated the relationship of perfluoroalkyl acids (PFAS) with kidney function and variation by diabetes and anemia status.

Methods: Data on 53,650 adults (5,210 with diabetes) were obtained from the C8 Health Project. CKD was defined as an estimated glomerular filtration …

Discerning Suicide In Drug Intoxication Deaths: Paucity And Primacy Of Suicide Notes And Psychiatric History, Ian Rh Rockett, Eric D. Caine, Hilary S. Connery, Gail D'Onofrio, David J. Gunnell, Ted R. Miller, Kurt B. Nolte, Mark S. Kaplan, Nestor D. Kapusta, Christa L. Lilly, Lewis S. Nelson, Sandra L. Putnam, Steven Stack, Peeter Varnik, Lynne R. Webster, Haomiao Jia

Faculty & Staff Scholarship

Objective

A paucity of corroborative psychological and psychiatric evidence may be inhibiting detec- tion of drug intoxication suicides in the United States. We evaluated the relative importance of suicide notes and psychiatric history in the classification of suicide by drug intoxication versus firearm (gunshot wound) plus hanging/suffocation—the other two major, but overtly violent methods.

Methods

This observational multilevel (individual/county), multivariable study employed a general- ized linear mixed model (GLMM) to analyze pooled suicides and undetermined intent deaths, as possible suicides, among the population aged 15 years and older in the 17 states participating in the National Violent Death Reporting System …

Novel Caries Loci In Children And Adults Implicated By Genome-Wide Analysis Of Families, Manika Govil, Nandita Mukhopadhyay, Daniel E. Weeks, Eleanor Feingold, John R. Shaffer, Steven M. Levy, Alexandre R. Vieira, Rebecca L. Slayton, Daniel W. Mcneil, Robert J. Weyant, Richard J. Crout, Mary L. Marazita

Faculty & Staff Scholarship

Background: Dental caries is a common chronic disease among children and adults alike, posing a substantial health burden. Caries is affected by multiple genetic and environmental factors, and prior studies have found that a substantial proportion of caries susceptibility is genetically inherited.

Methods: To identify such genetic factors, we conducted a genome-wide linkage scan in 464 extended families with 2616 individuals from Iowa, Pennsylvania and West Virginia for three dental caries phenotypes: (1) PRIM: dichotomized as zero versus one or more affected primary teeth, (2) QTOT1: age-adjusted quantitative caries measure for both primary and permanent dentitions including pre-cavitated lesions, and …

Regulation Of Radioactive Fracking Waste, Elizabeth Ann Glass Geltman, Nichole Leclair

Publications and Research

Natural gas extracted form shale reached record production totals in 2015 in the United States and the US Energy Information Administration (EIA) forecasts natural gas production will continue to increase. Wastes from shale gas extraction can contain the radioactive isotopes radium-226 (Ra-226) and radium-228 (Ra-228), which decay further into radon (Rn). Exposure to radon, a form of naturally occurring radioactive materials (NORM), is the leading cause of lung cancer in the United States, after smoking. This article explores how states handle the disposal of technologically enhanced naturally occurring radioactive materials (TENORM) and/or NORM waste from oil and gas operations to …