Public Health Commons^™

Clinical And Demographic Factors Associated With Peg-Asparaginase-Related Toxicities In Patients With Acute Lymphoblastic Leukemia, Priyadarshani Dharia

Dissertations and Theses (Open Access)

Introduction: Polyethylene glycol (PEG)-asparaginase is one of the first-line drugs in pediatric ALL treatment. Although a complete and prolonged treatment with PEGasparaginase has been instrumental in improving the survival of ALL patients, it is associated with four common toxicities: hypersensitivity, hyperbilirubinemia, pancreatitis, and venous thromboembolism (VTE). PEG-asparaginase-related toxicities may require modifications and delays in treatment, which often leads to poor treatment outcomes. Previous studies of PEG-asparaginase-related toxicities have mainly focused on individual toxicities. Further, these studies were conducted in study populations which were predominantly self-reported non-Hispanic whites. Therefore, there is a gap in the knowledge regarding the cumulative burden of …

Quantifying The Financial & Clinical Impact Of Annual Vs. Biennial Mammography Screening, Danmeng Huang

Dissertations and Theses (Open Access)

Current guidelines for screening mammography recommend different start ages and intervals for women with average cancer risk. Longer intervals between mammograms allow more time for a tumor to grow, to become symptomatic and clinically detectable, and more likely to be at advanced stage. Existing literature on the associations between mammography screening frequency and risk of more advanced breast cancer have mixed results. Studies have showed that advanced breast cancer costs more to treat, but real-world cost estimates following different mammography screening frequencies are unavailable. To fill the gaps, this dissertation aimed to quantify the clinical and financial impact following annual …

Characterizing Risk & Burden Of Lower Cranial Neuropathy (Lcnp) As Late Effect Among Oropharyngeal Cancer Survivors, Puja Aggarwal

Dissertations and Theses (Open Access)

Background: Lower cranial neuropathy (LCNP) is a rare but potentially disabling late effect of radiotherapy (RT) and other head and neck cancer therapies. Survivors who develop late LCNP may experience profound functional impairment with deficits in swallowing, speech, and voice. The aims of this research were: 1) to quantify the cumulative incidence of late LCNP and identify clinical predictors of late LCNP; 2) to investigate the impact of late LCNP on severity of cancer treatment-related symptoms, general functional impairment (GFI), and single item scores of the most severe symptoms; and 3) to quantify the association of late LCNP with swallowing-related …

Moving Beyond The Single Gene: Integrative Gene Set Analysis For Rna-Seq, Andrew Richard Aschenbrenner

Dissertations and Theses (Open Access)

RNA-seq is the next-generation sequencing technology for gene expression and while many tools have been developed to assess differential expression, most focus on gene-level statistics. Gene-level statistics implicitly ignore any dependence among genes. In order to directly incorporate correlation into testing for differential expression, genes are sorted into networks using Ingenuity Pathway Analysis (IPA) and the gene expression of each network is modeled using Generalized Estimating Equations (GEE). Since the gene network data often exhibits correlation structures containing positive and negative values, a new intermediate correlation structure is developed. This structure provides a compromise between an exchangeable (one parameter for …

Physical Activity Among Preschool-Aged Children: Considerations For Waking Activity Patterns And Health, Erin Dooley

Dissertations and Theses (Open Access)

With nearly one-quarter (23%) of U.S. preschool children (ages 3-5 years) having overweight or obesity, supporting healthy growth and development is paramount. Hispanic children have the highest prevalence within this age group (15.6%) and a large projected population growth. Energy expenditure through physical activity is one way to combat excess development of obesity and poor health outcomes. Yet there is limited evidence about the correlates associated with physical activity and health within this population. The three studies of this dissertation examined sociodemographic-, cultural-, and context-related factors related to waking activity patterns and the subsequent impact on health indicators. The overall …

Quantifying The Financial & Clinical Impact Of Annual Vs. Biennial Mammography Screening, Danmeng Huang

Dissertations and Theses (Open Access)

Current guidelines for screening mammography recommend different start ages and intervals for women with average cancer risk. Longer intervals between mammograms allow more time for a tumor to grow, to become symptomatic and clinically detectable, and more likely to be at advanced stage. Existing literature on the associations between mammography screening frequency and risk of more advanced breast cancer have mixed results. Studies have showed that advanced breast cancer costs more to treat, but real-world cost estimates following different mammography screening frequencies are unavailable. To fill the gaps, this dissertation aimed to quantify the clinical and financial impact following annual …

Epidemiological Evaluation Of The National Sickle Cell Screening Program In The Republic Of Uganda, Arielle G. Hernandez

Dissertations and Theses (Open Access)

Sickle cell anemia contributes substantially to childhood morbidity and mortality in sub-Saharan Africa, where there are scarce health resources and inadequate awareness among healthcare providers and the community. Without early diagnosis and initiation of preventive treatments, most infants will die of acute complications before their fifth birthday. Information on the mortality associated with sickle cell anemia is excluded from global statistical summaries due to the lack of accurate data, making sickle cell anemia an invisible killer of children on the African continent. Information from long-term large-scale sickle cell screening efforts is not yet available in Africa; therefore, a mixed-methods study …

The Associations Between Fat And Clinical Outcomes Among Lung Cancer Patients: Dietary Intake And Genetic Determinants, Fang Yu Lin

Dissertations and Theses (Open Access)

Higher dietary fat intake and alterations in fatty acid metabolism may affect cancer development and progression. This dissertation conducted a series of studies examining whether dietary fat intake and genetic variants in fatty acid metabolism genes have an impact on clinical outcomes among non-Hispanic whites newly diagnosed with non-small cell lung cancer (NSCLC). First, a cohort of 2,262 NSCLC patients was prospectively examined for intakes of total, saturated, monounsaturated, and polyunsaturated fat in relation to overall survival and recurrence. Dietary fat intake at diagnosis was assessed with a previously validated food frequency questionnaire and categorized by Dietary Reference Intakes. Multivariable …

External Environmental Dimensions And Financial Performance Of Major Teaching Hospitals In The U.S, Karima Lalani

Dissertations and Theses (Open Access)

Background: Teaching hospitals have a unique mission to not only deliver graduate medical education, but to also provide both inpatient and ambulatory care, and to conduct clinical and medical research; therefore, they are under constant financial pressure, and it is important to find out what types of external environmental components affect their financial performance. No recent studies have been comprehensively conducted for all major teaching hospitals in the U.S. to examine if there is an association between the external environmental dimensions based upon Resource Dependence Theory (Munificence, Uncertainty, Complexity) and the short-term financial performance, measured by days cash on hand …

Access To Antibiotics Without Prescription For Travelers And Colombian Citizens At Community Pharmacies In Bogota, Colombia, Marie Kasbaum

Dissertations and Theses (Open Access)

The misuse of antibiotics has been shown to exacerbate the global antibiotic resistance crisis, which could have major consequences on public health worldwide (Auta et al., 2018). In Bogotá, Colombia, the non-prescription sale of antibiotics still occurs in pharmacies despite national regulations requiring a prescription from a physician or health agency before dispensing antibiotics to a patient (Vacca et al., 2011). The purpose of this study was to investigate the non-prescription sale of antibiotics in community pharmacies to foreign travelers and Colombian citizens in Bogotá, Colombia. Trained Simulated Clients (SCs) gathered experimental data in pharmacies distributed throughout 20 geographic districts …

Examining Differences In Physical Activity By Socio-Demographics, Employment, And Social Support Among U.S. Adolescents, Ashleigh Marie Johnson

Dissertations and Theses (Open Access)

The overall decline in physical activity levels during adolescence supports the examination of intrapersonal-, interpersonal-, and behavior-level factors that may influence physical activity behavior among this population. The three papers within this dissertation aimed to examine associations of socio-demographics and socio-environmental factors with physical activity among U.S. adolescents. Papers 1 and 3 used data from the Family Life, Activity, Sun, Health, and Eating (FLASHE) Study. Paper 1 examined differences in adolescent physical activity by gender and race/ethnicity, and examined modification by grade and socioeconomic status (SES). Paper 3 examined the association of parent- and adolescent-reported parental social support with adolescent …

Nonlinear Functional Models On Causal Inference, Rong Jiao

Dissertations and Theses (Open Access)

Statistical analysis has experienced significant progress on association study, but it remains elusive to understand the etiology and mechanism of complex phenotypes. As a major analytical platform, association analysis may hamper the theoretic development of biomedical science and its application. Thus, many researchers suggest making the transition from association to causation. The mainstream of research in genetics and epigenetics data analysis focuses on statistical association or exploring statistical dependence between variables. Despite significant progress in dissecting the genetic architecture of complex diseases by genome-wide association studies (GWAS), the signals identified by association analysis can only explain a small proportion of …

Understanding The Relatlonships Between Survivorship Care Plans And Survivor Level Outcomes Among Breast And Colorectal Cancer Survivors, Jessica Danielle Austin

Dissertations and Theses (Open Access)

PURPOSE: Cancer survivors have complex journeys following the completion of active treatment. The Institute of Medicine and other high-profile organizations have recommended and mandated the use of a survivorship care plan (SCP) despite mixed evidence supporting the impact of SCPs on key survivor-level outcomes. The purpose of this dissertation was to understand the complex relationship linking the delivery of SCPs and to relevant survivorlevel outcomes. STUDY GROUP: This dissertation focuses on breast and colorectal cancer survivors because they comprise nearly 30% of the entire cancer survivor population in the US and are the two most prevalent cancers in men and …

Blueprint For Shared Safety Strategic Plan, Reann Ramos

Capstone Projects and Master's Theses

The Blueprint for Shared Safety strategic plan will be adopted by Santa Cruz County Community Corrections Partnership as a framework of principles and practices that community leaders can use to lead shared safety strategies. By shifting the focus from the traditional criminal justice system to investments that can truly make our communities safer, the Blueprint aims to re-envision public safety together. The Community Corrections Partnership Community Education and Engagement Workgroup (CCP CEEW) has conducted data analysis to identify the key assets and gaps in Santa Cruz County. After identifying the key assets and gaps there were recommendation review sessions that …

Examining Racial & Ethnic Disparities In The Reach Of The Medicare Shared Savings Program, Lindsey Arneson

Capstone Experience: Master of Public Health

It is important to understand the quality of health care for racial and ethnic minorities covered under the largest U.S. government-run insurance program, Medicare, because the demographics of the U.S. are becoming older and more diverse. A new value-based program under Medicare is the Shared Savings Program (MSSP), which creates incentives to improve care quality and health outcomes for Medicare beneficiaries with a specific focus on increasing the provision of preventive care services. This capstone project aims to understand the representation of racial/ethnic minority Medicare beneficiaries, namely African Americans/Blacks and Hispanics/Latinxs, that receive care from providers or facilities (i.e., Accountable …

Preface For Special Section On Archaeoparasitology: A Global Perspective On Ancient Parasites And Current Research Projects, Jong Yil Chai, Min Sea, Karl Reinhard, Dong Hoon Shin

Karl Reinhard Publications

Archaeoparasitological research has rapidly developed in recent years, entering a new stage of improved understanding of our ancestors’ parasitic infections across the world. This progress is based on a variety of recently developed research techniques. During a period of rapid innovation since 2016, there has been no much opportunity for parasitologists to gather and share in-depth views about this novel research field. This was remedied by the 14th International Congress of Parasitology (ICOPA) held in Korea (Aug. 19-24, 2018; EXCO, Daegu). For archaeoparasitologists, ICOPA provided a unique opportunity to gather and exchange research and ideas. The participation was unprecedented in …

Confusing A Pollen Grain With A Parasite Egg: An Appraisal Of “Paleoparasitological Evidence Of Pinworm (Enterobius Vermicularis) Infection In A Female Adolescent Residing In Ancient Tehran”, Morgana Camacho, Karl Reinhard

Karl Reinhard Publications

There is often the risk of confusing pollen grains with helminth eggs from archaeological sites. Thousands to millions of pollen grains can be recovered from archaeological burial sediments that represent past ritual, medication and environment. Some pollen grain types can be similar to parasite eggs. Such a confusion is represented by the diagnosis of enterobiasis in ancient Iran. The authors of this study confused a joint-pine (Ephedra spp.) pollen grain with a pinworm egg. This paper describes the specific Ephedra pollen morphology that can be confused with pinworm eggs.

Pinworm Infection At Salmon Ruins And Aztec Ruins: Relation To Pueblo Iii Regional Violence, Karl Reinhard, Morgana Camacho

Karl Reinhard Publications

The study of coprolites has been a theme of archaeology in the American Southwest. A feature of archaeoparasitology on the Colorado Plateau is the ubiquity of pinworm infection. As a crowd parasite, this ubiquity signals varying concentrations of populations. Our recent analysis of coprolite deposits from 2 sites revealed the highest prevalence of infection ever recorded for the region. For Salmon Ruins, the deposits date from AD 1140 to 1280. For Aztec Ruins, the samples can be dated by artifact association between AD 1182-1253. Both sites can be placed in the Ancestral Pueblo III occupation (AD 1100-1300), which included a …

Effect Of Self-Regulated Learning For Improving Dietary Management And Quality Of Life In Patients With Type-2 Diabetes Mellitus At Dr. Ramelan Naval Hospital, Surabaya, Indonesia, Yayuk Estuningsih, Thinni Nurul Rochmah, Merryana Andriani, Trias Mahmudiono

Kesmas

Self-regulated learning is a process of learning how to manage and regulate oneself to obtain skills and knowledge without depending on others. It is expected that diabetes patients can manage their diabetes by themselves. This study aimed to analyze the effect of self-regulated learning-based educational intervention on quality of life for patients with type-2 diabetes mellitus (DM) at Dr. Ramelan Naval Hospital, Surabaya. This was a quasi-experimental study in the form of pretest and posttest with a control group design. A total of 20 patients with DM were randomly divided into intervention and control groups to undergo a 4-week intervention. …

Maternal Knowledge, Attitude, And Practices About Traditional Food Feeding With Stunting And Wasting Of Toddlers In Farmer Families, Betty Yosephin Simanjuntak, Miratul Haya, Desri Suryani, Ali Khomsan, Che An Ahmad

Kesmas

Traditional foods are foods consumed by a certain ethnic group in a specific region. The habit of consuming traditional foods is usually inherited by the family members, including toddlers, of a respective generation. The study aimed to determine relationship of maternal knowledge, attitude, and practices in traditional food feeding with stunting and wasting of toddlers in the farmer families of the Central Bengkulu District. This study employed a cross-sectional design with a sample of mothers with children aged 12–59 months. The sample included a total of 115 farmer families. Data on nutritional knowledge, attitude, practices about traditional food, sex of …

Overweight And Obesity Status With Dental Caries Among Children Aged 7–12 Years Old In Badung District, Bali 2018, Hariani Rafitha, Putri Bungsu Machmud, Ratna Djuwita, Dwi Gayatri, Fakhrana Ariani Ayub

Kesmas

Dental caries is an infectious disease that Dental is characterized by the dental damage resulting from microorganism products in carbohydrate fermentation. Dental caries and obesity in children are multifactorial diseases associated with eating habits and certain lifestyle factors. This study aimed to assess the association between overweightness, obesity, and dental caries among children aged 7–12 years in Badung district, Bali province in 2018. The total sample of 426 children and their mothers were recruited from all first to fifth elementary grade students in three schools selected by simple random sampling. The logistic regression analysis has demonstrated a significant association between …

Personal Exposure Of Traffic Policeman To Particulate Matter In Jakarta: Distribution Of Size, Chemical Composition, And Work Time, Doni Hikmat Ramdhan, Eka Fitriani Ahmad, Fitri Kurniasari, Zuly Prima Rizky, Hardy Atmajaya, Muhayatun Santoso

Kesmas

Particulate matter (PM) is an air pollutant that has an impact on public health, especially in an urban area. The objective of this study was to analyze the personal concentration of PM2.5 and its composition among police working in the roadside area in Jakarta. PM measurement has done to the policeman that controlled traffic on four near highway locations in Jakarta. Sioutas impactor, Leland Legacy personal pump, and quartz fiber filter were chosen to measure the fine particles. Each PM was measured for 8-hour period. PM concentration was analyzed by the gravimetric method while tracing element and black carbon in …

Users’ Perception Of The Hospital Information System In A Maternity Hospital In Lampung, Indonesia, Al Asyary, Arief Kurniawan Nur Prasetyo, Tris Eryando, Solvay Gerke

Kesmas

Hospital information systems (HIS) have been applied on a massive scale; however, user evaluation of their effectiveness, efficiency, and service quality improvements remain rare. This study aimed to describe the utility of information systems from the users’ point of view by using the Technology Acceptance Model (TAM) in a maternity hospital in Lampung, Indonesia. The study provided an overview of the features of the information system and the workflow of the user through this information system. Screenshots were taken by using Camtasia Studio 2.0 Trial Version application software for one day (two shifts) in the outpatient service. The HIS generally …

Knowledge, Attitude, Practices, And Health Beliefs Of Pregnant Women About Urinary Tract Infection And Its Associated Risk Factors: A Local Filipino Community Experience, Annalyn Navarro, Raphael Enrique Tiongco, Reynaldo Bundalian Jr.

Kesmas

Urinary tract infection (UTI) during pregnancy is assumed to be associated with increased maternal and fetal morbidity and mortality; hence, a proper assessment of knowledge and practices is crucial to formulate preventive strategies to ensure the health of both the mother and the baby. The study determined the knowledge, attitude, practices (KAP), and the beliefs of pregnant women about UTI based on the Health Belief Model. A survey questionnaire was used to gather data from pregnant women with and without UTI. The association of the pregnant women’s sociodemographic characteristics with their KAP and health beliefs was determined using Pearson’s chi-square …

Midwife’S Role In The Mother-To-Child Transmission Prevention Program In Primary Health Care In Yogyakarta, Niken Meilani, Nanik Setiyawati, Sammy Onyapidi Barasa

Kesmas

Curing and eradicating Human Immunodeficiency Virus (HIV)/Acquired Immunodeficiency Syndrome (AIDS) are to the core principles of the United Nations’ Sustainable Development Goals (SDGs). The incidence of HIV in the world remains high. Although midwives play a pivotal role in PMTCT implementation, the factors associated with midwives’ role in its implementation are not well understood. The aim of this study was to determine factors associated with midwives’ role in implementation of PMTCT. This study used a cross-sectional design. The subjects were 80 midwives at 14 primary health care in Yogyakarta City, Indonesia. The study was conducted from April to August 2017. …

Sexual Dysfunction Among Women With Diabetes In A Primary Health Care At Semarang, Central Java Province, Indonesia, Lintang Dian Saraswati, Ari Udiyono, Dian Sutrisni, Muh Fauzi

Kesmas

Sexual dysfunction is associated with pain during sexual intercourse. Diabetes mellitus (DM) has been reported to be one of the causal factors for sexual dysfunction in women. This cross-sectional study was conducted to describe the status of sexual dysfunction in women with DM in the Tlogosari Kulon Primary Health Care, Semarang, Indonesia, in March 2017. A total of 103 women with DM attending the health center participated in this study. Data were collected using a questionnaire-guided interview and through measurements (blood pressure and random blood glucose test). Results showed that 74.8% of women with DM had sexual dysfunction. The proportion …

Improving Access To Mental Health Care With Nurse Practitioners, Jessica Whelan

Dissertations

Problem: Over 40% of those with mental illness are untreated since the supply of psychiatrists does not meet the demand. The psychiatric mental health nurse practitioner (PMHNP) may be an adjunct in providing those services. The purpose of this quality assurance study was to evaluate outcomes of care between a PMHNP and a psychiatrist (medical doctor [MD]).

Methods: An observational, descriptive design with a retrospective medical record review of adult patients over a six-month period in a suburban, Midwestern, privately owned psychiatric practice.

Results: A total of 787 individual patients encountered at least one visit (N=787) although 3,679 …

What Happened To This Child? Identifying Factors That Influence The Identification And Categorization Of Child Maltreatment In The United States, Erika Tullberg

Dissertations and Theses

Background: Research has shown that adverse childhood experiences are strongly linked with health outcomes over the life course, and that child maltreatment – generally defined as physical abuse, sexual abuse, emotional maltreatment and neglect – can have an immediate, negative impact on child health and development and a longer-term impact on adolescent and adult health, including the leading causes of morbidity and mortality in the U.S. With such significant consequences, the accurate identification of child maltreatment is critical.

Child welfare caseworkers are charged with protecting the safety and fostering the well-being of children who have been identified as maltreated or …

Climate Change And Human Rights: Shaping The Narrative For Reflexive Responses From Civilization’S Leadership To Counter And Abate Climate Change And Enhance The Role Of Human Rights In The Rule Of Law, Michael Donlan

New England Journal of Public Policy

This article offers a bold new legal process for enhancing and upgrading the rule of law to enable civilization to cope with and counter the mounting damage and injustice caused by climate change. Climate change, once an unimaginable threat, is now a brutal, ubiquitous game changer that is leading inexorably to the demise of all humanity. Only by enhancing the rule of law and melding international law with domestic law can civilization fashion a coherent, global action plan for survival.

For almost three centuries greenhouse gases have been emitted around the world by the burning of fossil fuel, and—most alarming—these …

Healthy Older Adults’ Motivation And Knowledge Related To Food And Meals, Kai Victor Hansen

The Qualitative Report

The population over 60 years old is growing rapidly in Norway and in many other countries, and researchers often focus on elderly people and various diseases. This article examines the healthy elderly who are active in their daily lives to understand their motivation and knowledge about food and meals. The method used was CurroCus® group interviews, or fast focus groups. Nine CurroCus® groups were conducted, lasting for 37 to 56 minutes (average = 45 minutes). Altogether, 76 persons participated, ranging in age from 60 to 87 years; participants were predominantly female (>80%). The article discusses two areas: motivation and …