Public Health Commons^™

Endogenous Policy Design In Healthcare : A Case Study Of Emergency Department Crowding, Katrina Alexandra Hull

Legacy Theses & Dissertations (2009 - 2024)

The United States’ health care system has faced growing per capita use, and subsequent crowding, of the emergency department since the 1990’s, evidenced by longer wait times and the institution of ambulance diversions. Emergency departments are but one element of a complex system, with difficulties which persist despite policy efforts.

Sexual Behaviours Of Adolescents In Creek Town, Cross River State, Nigeria, Kabiru K. Salami, Rowland E. Edet

Department of Sociology: Faculty Publications

Risky sexual behaviors of adolescents in Creek Town have not been fully profiled. This study investigated the sexual behaviors of adolescents and their various dimensions in Creek Town, in Cross River State, Nigeria. This cross-sectional survey design adopted multi-stage sampling procedure to administer a 112-items questionnaire to 422 adolescents, to elicit information on their sexual behaviors and practices. Four focus group discussion sessions were also conducted with in-school and out-of-school adolescents. The mean age of adolescents was 17 years. Majority (65.4%) of the adolescents were sexually active. The mean age at sexual debut was 15 years for both male and …

Preventing Obesity And Type 2 Diabetes In Immigrant Populations, Maxwell K. Chikuta

Walden Dissertations and Doctoral Studies

Obesity-related diseases have been increasing in African immigrants throughout the United States. Although research has been done to identify risk factors associated with many ethnic groups in the United States, only a few studies exist that explore obesity and type 2 diabetes diseases among Central African immigrants. The conceptual framework for this qualitative case study was social constructivism and the health belief model. The primary research question addressed the potential underlying causes for an increase in obesity and type 2 diabetes among Central African Immigrants. The secondary research questions explored how culture, illiteracy, and religion contribute to the problem of …

Deputizing Family: Loved Ones As A Regulatory Tool In The “Drug War” And Beyond, Matthew B. Lawrence

Faculty Articles

Many laws use family members as a regulatory tool to influence the decisions or behavior of their loved ones, i.e., they deputize family. Involuntary treatment laws for substance use disorder are a clear example; such laws empower family members to use information shared by their loved ones to petition to force their loved ones into treatment without consent. Whether such deputization is helpful or harmful for a patient’s health is a crucial and dubious question discussed in existing literature, but use of family members as a regulatory tool implicates important considerations beyond direct medical impacts that have not been as …

Occupational Health And Safety Implementation Issues In Egypt / مشكلات تطبيق الصحة والسلامة المهنية في مصر, Nihal Hatem Said, Nourhan Fahmy, Ossama Hanafy

Papers, Posters, and Presentations

This policy paper addresses the current OHS implementation issues in Egypt and situates them within a global context that comprises agreed upon international safety regulations, conventions and management systems as well as international certification such as the ISO. Through a review of the implementation process of OHS in Egypt, complex legal, institutional and technical issues arise, illuminating the deficiencies present in the current OHS policy framework. This paper delves into the shortcomings present in the documentation and inspection processes that represent a cornerstone of the overall implementation of OHS standards whether by the government or the private sector.

Vulnerable Older Populations Without Special Health Care In Egypt: A Need For Assessment & Reform / كبار السن الذين يفتقرون إلى الرعاية الصحية المتخصصة في مصر: متطلبات التقييم والإصلاح, Mahmoud Nassar, Sally Islam, Shaimaa Sabbah, Sondos Said Mubarak

Papers, Posters, and Presentations

The older population in Egypt needs a special healthcare system to fulfill its needs and expectations. Nowadays, the older people live longer than before due to the improvement of healthcare services. That leads to an increase in the number of older people and creates a pressure on resources especially with the limited resources in Egypt. Urbanization and the change in the Egyptian demographics is exacerbating the problem. Egypt now is becoming a nation of dignified older citizens that need additional care and special attention. A number of policies and reforms have already been discussed but never thoroughly analyzed. Some policies …

Logistical Resource Capability During A Mass Casualty Event In Washington State, Todd Devin Brauckmiller

Walden Dissertations and Doctoral Studies

The need for increasing efficiencies for medical resource delivery during a mass casualty incident/event is a paramount logistical planning factor that could mean life or death to the citizens affected by a disaster. As such, Washington State has prioritized emergency management and preparedness. Using the just-in-time system by way of Baghbanian' s complex adaptive decision-making theory as the foundation, gave purpose to this qualitative study. This was accomplished by analysis of emergency management professional responses, and to what degree, improvements can be made to the medical resource delivery system during a mass casualty incident/event. Data were collected through semi structured …

Survey Of U.S. Undergraduate Self-Reported Opioid Diversion And Heroin Use, Motives, Sources, And Collective Efficacy As Mediating Factors, Mark Francis Plaushin

Walden Dissertations and Doctoral Studies

Epic morbidity and mortality, and intractability make prescription opioid diversion a wicked problem. Meanwhile, college undergraduates are vulnerable to opioid misuse and its consequences. The purpose of this quantitative study was to assess U.S. undergraduate students' opioid misuse and the relationship between mediating factors. The study's theoretical framework rested on Wakeland's et al. opioid system model and Shaw and McKay's social disorganization theory. This study bridged the gap, measuring collective efficacy and testing its relationship to undergraduate decisions to regulate misuse. Thus, research questions focused on gauging the problem's scope and assessing relationships between factors that drive or potentially regulate …

Community Health Worker's Perceptions Of Integration Into The Behavioral Health Care System, Juliette Swanston Jenkins

Walden Dissertations and Doctoral Studies

Mental illness in the United States is a major public health problem. According to the Substance Abuse and Mental Health Services Administration, in 2017, 18.9% of adults in the United States had a mental illness. The purpose of this study was to gain insight into the perceptions held by community health workers (CHWs) regarding their integration into the behavioral health care system in Maryland. Using a social constructivism paradigm and phenomenological approach, a purposive sample of 11 CHWs who supported patients with behavioral health conditions in 17 counties in the state were interviewed. Howlett, McConnell, and Perl'€™s five stream confluence …

Immune Thrombocytopenia, Minal Agarwal, Rajendra Prasad

Digital Journal of Clinical Medicine

No abstract provided.

Collaboration With The University Of Calabar For Human Resources For Health Management Training For Bauchi And Cross River States, Ekechi Okereke, Godwin Unumeri, Ibrahim Suleiman, Aisha Jibril

Reproductive Health

A pool of knowledgeable staff is required within middle and senior management for long-term human resources for health (HRH) planning and effective management at all levels of the health system—federal, state, and local. This brief reports on the training by the Population Council, in partnership with the World Health Organization in Nigeria, of 105 key personnel on HRH planning, management, policy dialogue, advocacy, and resourcing for the HRH project “Enhancing the Ability of Frontline Health Workers to Improve Health in Nigeria.” Critical HRH-related capacities were built among key Nigerian health system personnel and managers, most significantly in the states of …

Health Financing And Family Planning In The Context Of Universal Health Care: Connecting The Discourse, Gabrielle Appleford, Saumya Ramarao

Reproductive Health

Financing is a major challenge and concern for the future of family planning (FP) programs. As countries commit to increasing access to and quality of FP services and to universal health care (UHC), it is crucial that UHC schemes include FP and other reproductive health services. While the importance of financing is recognized in relation to quality, the “how” of financing FP within the context of UHC is not well understood. This brief targets the “bridge” constituency that is coalescing between the health financing and FP communities of practice around a shared interest in making access to health services universal. …

Health Financing And Family Planning In The Context Of Universal Health Care: Connecting The Discourse In Kenya, Gabrielle Appleford, Saumya Ramarao

Reproductive Health

Financing is a major challenge and concern for the future of family planning (FP) programs. As countries commit to increasing access to and quality of FP services and to universal health care (UHC), it is crucial that UHC schemes include FP and other reproductive health services. This brief aims to: 1) document trends in UHC and health financing, drawing out implications for policymakers and programmers; and 2) identify opportunities for the FP community of practice to advocate for the inclusion of quality FP services within UHC and health financing discussions. With this brief, we aim to highlight experiences in Kenya, …

Evaluation Of A Palliative Care Initiative On The African Continent: Responsibly Improving Access To Pain Treatment, J. Spencer Hirschi

MPA/MPP/MPFM Capstone Projects

The African continent today faces a crisis of inadequate palliative care, in spite of the growing level of suffering of its citizens who are faced with debilitating diseases and injuries. Much of this problem stems from deeply ingrained attitudes towards opioids: while the American continent grapples with the effects of opioid overprescribing, physicians trained in Africa are taught that opioids are inappropriate for virtually all scenarios, and therefore they come to fear and avoid their use or simply remain untrained on them altogether. Patients fail to advocate for themselves out of submission to the doctor’s authority, governments remain apathetic to …

Evaluating The Impact Of Fine Particulate Matter Pollution Standards On Mortality Rates In The Southeastern United States, Lauren Wice

MPA/MPP/MPFM Capstone Projects

The Environmental Protection Agency (EPA) continuously monitors six criteria pollutants that are known to have impacts on public health and welfare. One of these pollutants, fine particulate matter, or PM_2.5 (which includes particles that are smaller than 2.5 micrometers in diameter), is easily inhalable and can enter the lining of the lungs and the bloodstream, posing a great risk to human health. Standards for allowable concentrations of PM_2.5 were amended in 1997, 2006, and again in 2012, becoming increasingly stringent each time. According to the EPA, health organizations, and other research studies, these particles can specifically contribute to …

Socioeconomic Correlates Of Overweight And Obesity Among Ever-Married Urban Women In Bangladesh, Tania Sultana Tanwi, Sayan Chakrabarty, Syed Hasanuzzaman, Sue Saltmarsh, Stephen Winn

Research outputs 2014 to 2021

Background

The escalating prevalence of overweight and obesity globally is reflected amongst urban women in many low-to-middle income countries. Evidence also shows that overweight and obesity is an increasing trend in Bangladesh. The present study assessed the prevalence and socioeconomic determinants of overweight and obesity among urban women in Bangladesh.

Methods

Data were extracted from Bangladesh Demographic and Health Survey (BDHS) 2014. A two-stage stratified sampling technique has been used for data collection in this cross-sectional survey. A sample of 1701 ever-married non-pregnant urban women aged 15–49 years was selected for statistical analysis. Descriptive analysis, multiple binomial logistic regression analysis …

Let Me Upgrade You: Common Measures In Public Health Accreditation Action Plans, Gurleen K. Roberts

College of Graduate Studies: Theses & Dissertations

Objectives: The purpose of this study is to understand the success rates for health departments pursuing and achieving accreditation in version 1.0 and 1.5 of the Public Health Accreditation Board (PHAB) standards and measures. During the accreditation process, health departments that present performance gaps are asked to complete an Action Plan to specify how they plan to improve to meet the desired conformity. This study will highlight specific measures that are often included in Action Plans so that health departments pursuing accreditation can be better prepared to address these common pitfalls.

Methods: This study is a non-experimental, secondary …

Prevention Of Violence Against Children: A Systems Readiness Assessment In Côte D’Ivoire, Marie-Kaye Soletchi Seya-Sery

College of Graduate Studies: Theses & Dissertations

Violence against children (VAC) is a global problem with significant consequences. Recognizing the need to better understand the problem of VAC in Côte d’Ivoire (CI), the government of CI recently completed a survey on violence against children. The recent data will support an evidence-based national action plan for the prevention of VAC. Research shows that initiatives tackling specific problems will only be as successful as the community’s readiness to take action. This study applied the community readiness model to assess the readiness of the multisectoral task force (MSTF) to implement the national action plan in CI. Eight MSTF participants’ interview …

Culture And The Development Of Traditional Medicine In Africa, Rowland Edet, Oyedolapo Isaac Bello, Julianah Babajide

Department of Sociology: Faculty Publications

Traditional medicine has been the dominant healthcare system in Africa before westernization, civilization and colonialism. For people living in the rural areas, traditional medicine is easily available, accessible and affordable. The purpose of this paper is to examine how the cultural way of the life of Africans has contributed to the emergence and development of traditional therapeutic systems in the continent. By explaining the way Africans perceive illness and disease, this paper argues that various forms of healing were predicated on the sociocultural environment of the people. The paper therefore opts for concerted efforts in the development of traditional medicine …

Put Your Money Where Your Mouth Is: Reforming Organized Dentistry To Address Persistent Oral Health Disparities In The U.S., Aparna Chintapalli

Pomona Senior Theses

The importance of oral health has been largely neglected from the conventional standards of healthcare in terms of public understanding & prioritization, the industrial infrastructure, and the scope of prevention & early-intervention services. Its adjunctive locus to the field of medicine has lead to the bifurcation of the oral cavity from the rest of the human body. As a result of this divide, there have been multiple factors that have allowed socially stratified oral health outcomes to manifest. This thesis examines the determinants of oral health disparities through a multidisciplinary lens (i.e. biology, public policy, infrastructure), and offers evidence of …

Evaluating Ways To Reduce Errors In Medication Reconciliations Performed By Nurses In A Rural Hospital Setting, Kalen T. Freeman

MPA/MPP/MPFM Capstone Projects

Medication reconciliation, also known as “med recs”, are an important part of a patient’s care during their hospitalization. A med rec is when hospital personnel generate a list of the medications the patient takes at home. Med recs are vital in the hospital admission process because home medications need to be restarted at appropriate times to fully care for the patient. Also, mistakes in a home medication list can lead to serious consequences in the patient’s health. This study focuses on med recs being performed at Marcum and Wallace Hospital in Irvine, Kentucky. More specifically, the study explores the different …

Everybody’S Working (But The Weakened): An Assessment Of Medicaid Work Requirements And Their Administrative Burdens, Samuel Misleh

MPA/MPP/MPFM Capstone Projects

Although Medicaid work requirements are currently halted in both Arkansas and Kentucky, this analysis utilizes the data available to make an assessment and estimate of what Kentucky’s Medicaid enrollment will look like if work requirements similar to those Arkansas had are ever implemented. The relative severity of the administrative burden of such requirements provide a tool for comparison, and a difference-in-differences analysis of the change in Medicaid enrollment between Arkansas and West Virginia, a state that has not implemented and currently has no plans to implement Medicaid work requirements, provide the bases for this estimate. After coding the work requirements …

Maintaining Confidentiality Among Hiv Infected Couples: Physicians' Patterns Of Decision In Nigeria, Francess Uju Ayaebene

Walden Dissertations and Doctoral Studies

Policies mandating HIV status disclosure to decrease incidence create ethical challenges for physicians on whether to breach or maintain infected patients' confidentiality. In Sub-Saharan Africa where HIV incidence is high, there is a need for clear guidelines/policies on making confidentiality decisions. The purpose of this quantitative quasi experiment was to determine whether the gender, gender orientation, and sexual relationship of an infected patient and physicians' demographics predicted physicians' decisions to breach confidentiality. In Plateau State, Nigeria, 222 physicians were given vignette questionnaires containing 6 different descriptions of gender, gender orientation, and sexual relationships of a hypothetical patient. Each physician decided …

Making The Business Case For An Addiction Medicine Consult Service: A Qualitative Analysis, Kelsey C. Priest, Dennis Mccarty

OHSU-PSU School of Public Health Faculty Publications and Presentations

Background

As the drug poisoning crisis worsens in North America and opioid use disorder (OUD)-related hospital admissions increase, policymakers and hospital administrators are beginning to recognize the important role of hospitals in the OUD care continuum. This study explores and describes how U.S. addiction medicine physicians created and presented business propositions to hospital administrators to support the development of addiction medicine consult (AMC) services.

Methods

Fifteen qualitative interviews were completed with board-certified or board-eligible addiction medicine physicians from 14 U.S. hospitals. The interviews occurred as part of a broader mixed methods study exploring hospital service delivery for patients admitted with …

Understanding Access To Menstrual Hygiene Products In The Akron Area, Corinne Plas

Williams Honors College, Honors Research Projects

Abstract

The purpose of this project is to contribute to the understanding of the nature of access to menstrual hygiene products in the Akron area. Questions being researched are “Do Akron area residents need better access to menstrual hygiene products?”, “What is the nature of current access to products in the Akron area?”, “What influences a lack of access to products, if anything?”, and “What kinds of products are preferred and actually used?” The project consists of a 30-question survey, which was taken online by 51 participants. Completed analyses were cross tabulation analyses using Qualtrics and IBM SPSS programs and …

Hiv With Opportunistic Neuroinfection, Rahul Vyas, Rajendra Prasad

Digital Journal of Clinical Medicine

No abstract provided.

Sheehan Syndrome, Riya Jain, Shashidhara Kc, Savitha Savitha

Digital Journal of Clinical Medicine

No abstract provided.

Ectopia Lentis, Pratheek Prabhu

Digital Journal of Clinical Medicine

No abstract provided.

Cerebro-Vascular Accident, Mehak Gera, Rajendra Prasad, Suresh Babu, Manthappa M

Digital Journal of Clinical Medicine

No abstract provided.

Pulmonary Thromboembolism In A Case Of Alopecia Areata, Rakshith M

Digital Journal of Clinical Medicine

No abstract provided.