Public Health Commons^™

Activating Nursing To Address Unmet Needs In The 21st Century, Patricia Pittman

Health Policy and Management Faculty Publications

No abstract provided.

Interrupted Progress: Water And Sanitation In Haiti, Emily Bauer

Thinking Matters Symposium Archive

Haiti has faced damaging environmental and social impacts, which have interrupted progress towards clean drinking water and adequate sanitation facilities for its over 10 million people. Natural disasters, disease outbreak, political corruption and economic instability have contributed to poor health and social outcomes for the small, island nation. This study used the most recent data from the World Health Organization and United Nations Children’s Fund Joint Monitoring Programme (WHO/UNICEF JMP) to assess national trends in water source and sanitation facility improvements from 1990-2015. WHO/UNICEF JMP defines water improvements as piped or non-piped protected water, and sanitation improvements as networked, flushed …

What Gun Safety And Access Policies Did Participants Think Would Be Effective In Preventing Accidental Gun Deaths?, Bridget O’Keefe, Stephen White

Thinking Matters Symposium Archive

Firearm-related incidents are often highly publicized tragedies that fuel unproductive political debates on gun policies at the local, state, and national levels. Current best practices in safe gun storage suggest that caregivers can protect their children from injury or death from an accidental gun discharge by keeping guns unloaded, locked up, and stored separately from their ammunition (Crifasi, Doucette, McGinty, Webster, & Barry, 2018). Child access prevention mechanisms including trigger locks, lock boxes, gun safes, and safe storage legislation are encouraged by the American Academy of Pediatrics (Dowd & Sege, 2012). This study gathers quantitative responses from 1,021 participants using …

Opioid Use Treatment Via Telemedicine: Treatment Options For Rural Maine, Benjamin Knapp

Thinking Matters Symposium Archive

The ongoing opioid crisis has overwhelmed the traditional opioid use disorder (OUD) treatment resources across America. The treatment resources in rural communities have been especially hard hit as geographic and financial barriers limit service capacity. Telemedicine, or medicine delivered via remote means, has been proposed as a potential solution to the lack of conventional opioid treatment resources in rural Maine. Current legalities in the US prohibit telemedicine being used to prescribe opioid agonist drugs, and insurance reimbursement for telemedicine remains a major barrier. This qualitative content analysis looks at the existing research on telemedicine's treatment efficacy for use with OUD …

Child Poverty, Physical & Mental Health In Maine, Katelyn Malloy

Thinking Matters Symposium Archive

Children who live below the national poverty line account for nearly one fifth of Maine’s overall population. Child poverty is a determinant of health that can lead to negative health outcomes that affect childhood development, educational achievement, as well as physical and mental health. The purpose of this study was to identify five Maine counties with the highest rates of child poverty according to the national average. Comparison of poverty rates between counties were analyzed along with two leading health indicators – mental and physical distress. This study used 2016 county-level childhood poverty estimates, assessed by the American Community Survey …

Lending A Hand: Healthcare Cost And Treatment Impact Of Peer Recovery Services, A Review Of The Literature, Nicholas J. Bush

Senior Honors Projects

Background: In the United States, the need for mental health and substance misuse treatment has been on the rise leading to an increase in healthcare costs and a reduction in barriers to care. Recently, there has been a growing interest in implementing peer support services (PSS) to increase access to care, improve treatment outcomes, and reduce healthcare related costs, such as emergency room visits, psychiatric hospitalization, and crisis stabilization.

Aims: This Honors project reports on a systematic review of the literature on treatment outcomes associated with PSS in mental health and/or substance misuse populations. It reviews the evidence that PSS …

A Collaborative Perspectives Approach For Understanding Effective Care Coordination In Autism Spectrum Disorder, Rachel Severs

Dissertations

Autism spectrum disorder (ASD) is a neurodevelopmental disorder that causes significant impairment in social and communication areas. The severity of the disorder can often result in a substantial degree and amount of service access and expenditures relating to a child’s needs. This study examined the experiences of how family caregivers and service providers of children with ASD view service delivery using a basic qualitative research design. For the study, 10 participants (five family caregivers and five service providers) were enrolled and interviewed. Interview data were collected and coded to produce a qualitative analysis of the experiences of these individuals who …

Opioid Overdose And Unemployment In The Uk, Hayden Grace

Mahurin Honors College Capstone Experience/Thesis Projects

Opioid overdose in the United Kingdom has risen drastically over the last few years along with the rise in the use of zero-hours contracts. Zero-hours contracts are contracts for employment that guarantee no work but can anchor a person to a job that doesn’t pay above minimum wage when they do not receive work. Since opioid use is often associated with poorer economic conditions in the United States, this paper attempts to measure any correlation between poverty and opioid use in the UK. Using zero-hours contracts as a proxy for underemployment we use several regression models to determine the predictability …

The Impact Of The Aca Cost-Sharing Elimination Provision On The Utilization Of Breast, Cervical, And Colorectal Cancer Screening Services Among Insured Individuals In The United States, Sara Salah Atallah

Dissertations and Theses (Open Access)

Preventive cancer screenings are essential to early detect cancer and subsequently save lives. However, out-of-pocket expenditures for cancer screening services deter individuals from obtaining them. In an effort to improve the utilization of cancer screening, the Affordable Care Act (ACA) implemented a cost-sharing elimination provision that removes all forms of cost sharing including copayments, co-insurance and deductibles from certain preventive care services that are recommended by widely known scientific figures such as the United States Preventive Services Task Force (USPSTF). This study evaluated the impact of the ACA cost-sharing elimination provision for preventive care services from 2008 through 2016 using …

La Adherencia A Las Recomendaciones De Sueño Seguro Por Parte De Las Enfermeras En Unidades De Cuidado Intensiva Neonatal (Ucin) De Hospitales Públicos Y Privados En El Gran Buenos Aires / The Adherence To Safe Sleep Recommendations By Nurses In Neonatal Intensive Care Units (Nicus) Of Public And Private Hospitals In Grand Buenos Aires, Joelle M. Schauer

Independent Study Project (ISP) Collection

El Síndrome de Muerte Súbita de Lactante (SMSL) es “la muerte de un niño menor de 1 año que ocurre, aparentemente, durante el sueño y no puede ser explicada luego de una investigación exhaustiva, que incluye una autopsia completa, la investigación de las circunstancias de la muerte y la revisión de la historia clínica" (Jenik et al., 2015, p. 2). La Academia Americana de Pediatría (AAP) tiene recomendaciones sobre las prácticas del sueño seguro que pueden disminuir el riesgo de SMSL y otras Muertes Súbitas Inesperadas Infantiles (MSII).

El objetivo de esta investigación es analizar la adherencia a estas recomendaciones …

El Rol De Los Agentes Sanitarios Para Mejorar El Acceso A La Salud Sexual Y Reproductiva Para Mujeres En San Carlos, Mendoza. / The Role Of Agentes Sanitarios In Improving Access To Sexual And Reproductive Health For Women In San Carlos, Mendoza., Laura Hult

Independent Study Project (ISP) Collection

Introducción: Es evidente que Argentina tiene un enfoque que atiende a la salud sexual y reproductiva, dado que tiene cobertura universal y la ley de Programa Nacional de Salud Sexual y Procreación Responsable que establece un estándar de cuidado para toda la población. Sin embargo, cobertura universal no implica acceso universal, el cual que está determinado por el transporte, el idioma y la cantidad de recursos de la región. En lugares como San Carlos, Mendoza, donde no hay transporte regular y hay pocos recursos, existe inequidad en la salud, lo que puede aumentar las tasas de embarazos no intencionales y …

Internamente Solo: Escuchando Y Resistiendo La Soledad De Adultos Mayores En La Araucanía, Chile / Internally Alone: Hearing And Resisting The Loneliness Of Seniors In La Araucanía, Chile, Grace Ellrodt

Independent Study Project (ISP) Collection

Research Question: Which current patterns drive or diminish loneliness among seniors of the Region of the Araucanía in the city of Temuco and surrounding rural communes?

Objectives: Understand and interpret the roots and the antidotes of the loneliness phenomenon experienced by seniors in Temuco and surrounding communes in the present moment.

Identify and analyze the drivers of pathological elder loneliness in structural, intermediary, and proximal factors.

Highlight the perspectives and narratives of seniors, community leaders, and health resources with respect to strategies to reduce the crisis.

Background: Currently, the population of seniors has risen and will continue to rise in …

Hábitos Sobre El Autocuidado En Salud Bucodental En La Ciudad Autónoma De Buenos Aires (Caba): Estudio De Caso En Los Alumnos De Una Escuela Primaria Pública En Caballito / Habits About Self-Care In Oral Health In The Autonomous City Of Buenos Aires (Caba): Case Study Of Students In A Public Elementary School In Caballito, Franklin Zhang

Independent Study Project (ISP) Collection

Información contextual: Las enfermedades bucodentales son unas de las enfermedades no transmisibles (ENT) y una de las cargas más grandes del mundo. Según la Organización Mundial de la Salud, entre el 60% y 90% de los escolares de todo el mundo tienen caries dentales, siendo una enfermedad extremadamente prevalente en el nivel primario. Además de visitas al odontólogo para chequeos de rutina, es importante prevenir esta la caries dental con una integración entre salud y educación y desarrollar hábitos saludables. El objetivo del siguiente trabajo es explorar los conocimientos sobre el autocuidado de la salud bucodental en los alumnos de …

Health On The Move: Health-Seeking Behavior Of Changpa Nomads In Ladakh, India, Maya Lubeck-Schricker

Independent Study Project (ISP) Collection

The goal of this study is to understand the health-seeking behavior of Changpa nomads in the Changthang region of Ladakh, India including what health issues these communities face, what they do when they fall sick, any preventative health behavior they implement, as well as the health infrastructure available to them. Very little literature exists on the health seeking-behavior of people in South Asia in general, much less among nondominant lifestyles such as that of nomadic or semi-nomadic people. As such, this research hopes to move towards closing that knowledge gap by conducting and analyzing 26 in depth semi-structured interviews and …

Where Do We Go From Here?: Two Key Informants' Perspectives On How To Address Conscientious Objection In Top Provision In South Africa, Talia Parker

Independent Study Project (ISP) Collection

This perspectives research endeavor examines the barriers to TOP access that arise from conscientious objection through the conflicting network of rights and legislation in South Africa. While previous research has evidenced the demonstrable barriers to accessing TOP care in South Africa, this project aims to push the existing literature and the field as a whole one step further to interrogate how to move forward within the realities of conscientious objection.

To do so, I conducted interviews with key informants in the field of reproductive healthcare provision, research, and activism in Cape Town on their perspectives about the practice of conscientious …

Z4, A Slow Puncture: An Autoethnographic Exploration Of Language, Embodiment, And Meaning-Making, Charlotte Rose Samuels

Independent Study Project (ISP) Collection

In my ISP, I explored language as it relates to the ways in which people living in Cato Manor make sense of HIV/AIDS in their community. With 7.1-7.2 million people living with HIV (PLWHIV) in South Africa, individuals across the country are either infected or affected by illness. KwaZulu-Natal (KZN), the province with the highest rate of HIV, is also the province that was surveyed with the disproportionately highest internal stigma rates for PLWHIV. High prevalence of HIV, particularly in KZN, calls for a constant contextualization of life in the presence of illness.

Throughout the world, metaphor and symbolism is …

Characterizing Systems Of Reporting And Mitigating Anthrax Outbreaks Near Mto Wa Mbu, Monduli District, Tanzania, Megan Levy

Independent Study Project (ISP) Collection

Northern Tanzania has experienced several anthrax outbreaks in the recent past. In Monduli district, an outbreak in 2016 prompted an organization of district officials to create an updated outbreak response action plan. The pastoralist community is often affected by these outbreaks due to their frequent direct contact with cattle and herds’ proximity to wild species potentially affected by the disease. This characterization of the existing systems of reporting and mitigating anthrax outbreaks was accomplished through structured interviews with ward and village officers, local veterinarians, and members of the pastoralist community in Monduli district near Mto wa Mbu. The purpose of …

Cancer Management In Kenya - Awareness And The Struggles Patients Face To Access Treatment, Care & Support, Ashley Nmoh

Independent Study Project (ISP) Collection

The amount of cancer cases in Africa, and Kenya specifically, are rising at an alarming rate. This study was conducted to determine the challenges that patients with cancer in Kenya face to access treatment, care and support. Thirty-nine cancer patients were interviewed and thirty cancer patients filled out a questionnaire about their experiences of having cancer in Kenya. In addition, twenty key informants were interviewed including doctors, caregivers, cancer NGO executives, a researcher, a psychologist, a National Health Insurance Fund official and a director from the Ministry of Health. A breast cancer awareness survey was also administered to fifty-nine women …

Nationalizing Services For The Trans-National: How Sub-Saharan Migrants Navigate Healthcare Access In Tunisia, Batoul Hasan

Independent Study Project (ISP) Collection

The right to human health and the resources that empower this state is an entitlement recognized under international law. With the circumstances surrounding their journeys, migrants face increased risks and vulnerabilities that necessitate social protections. Nations of reception, due to exclusionary policies or lack of capacity, may fail to guarantee these protections. This study investigates how this phenomenon unfolds in Tunisia, a middle-income nation undergoing a host of political and economic changes, but one that’s nonetheless become an alluring destination for migrants, specifically those from sub-Saharan African nations. The analysis proceeds from an assessment of the public health situation in …

Spatial Analysis Of Exposure To Soil Heavy Metals, Oral Bioaccessibility And Risk Assessment In Houston, Texas, Tsai Shu Chu

Dissertations and Theses (Open Access)

Chronic exposure to heavy metals could lead to adverse health effects such as cancer, neurological development diseases and immunological diseases. The ingestion pathway has been considered the major exposure route for heavy metal contaminated soils. Heavy metals may be proportionally bioaccessible for the human body to absorb. There are no risk assessment studies done in Houston to evaluate health risks from exposure to heavy metals and no spatial analysis done yet. The aims of this dissertation are (1) to characterize 13 heavy metals: magnesium (Mg), vanadium (V), chromium (Cr), manganese (Mn), iron (Fe), cobalt (Co), nickel (Ni), copper (Cu), zinc …

Stochastic Search Variable Selection Applied To A Bayesian Hierarchical Generalized Linear Model For Dyads, Adriana Lopez Ordonez

Dissertations and Theses (Open Access)

In behavioral science research, many outcomes of interest can be influenced by interpersonal relationships (Gyarmathy & Neaigus, 2007). To assess such outcomes, data can be collected using dyads. Each dyad has two elements, an actor, who responds to a stimulus and a partner, who can potentially influence the actor (Kenny, Kashy, & Cook, 2006). One popular model for analyzing dyadic data is the Actor Partner Interdependence model (APIM). In this study, we proposed a variable selection method applied to a probit Bayesian Hierarchical Generalized Linear Model (Bayesian HGLM) to fit the APIM to dyadic data. The proposed method used stochastic …

Kolmogorov-Smirnov Type Tests Under Spatial Correlations, Wenjun Zheng

Dissertations and Theses (Open Access)

Kolmogorov-Smirnov test is a non-parametric hypothesis test that measures the probability of deviations, that the interested univariate random variable is drawn from a pre-specified distribution (one-sample KS) or has the same distribution as a second random variable (twosample KS). The test is based on the measure of the supremum (greatest) distance between an empirical distribution function (EDF) and a pre-specified cumulative distribution function (CDF) or the largest distance between two EDFs. KS test has been widely adopted in statistical analysis due to its virtue of more general assumptions compared to parametric test like t-test. In addition, the p-value derived from …

Substance Use Prevention: Communication And Strategies To Reduce Alcohol, Marijuana, And E-Cigarette Use Among College Students, Emily Bauer

Muskie School Capstones and Dissertations

Substance use among college students impacts universities, communities and student outcomes across the United States. Based on the Monitoring the Future study (MTF), college students have a higher prevalence of past 30-day alcohol use at 63% than their non-college peers (59%) (2016). Nearly one-third of college students (32%) have had five or more drinks in a row in the past two weeks (2016). Monthly marijuana use for college students has remained steady at 22% (2016). Electronic cigarette (e-cigarette) use is 6.9%, which is gaining in popularity but still lower than traditional cigarettes (8.9%) (2016). There are many prevention communication strategies …

Redefining Burnout: Exploring Common Conceptualizations And The Neurophysiology Of Chronic Stress To Establish An Integrated Allostatic Model, Danny A. Guzzi

Dissertations

Burnout is a widely researched stress-related phenomenon associated with numerous adverse outcomes for employees and organizations. Unfortunately, burnout is not well understood and research to this point has been flawed due to a lack of consensus on the definition, dimensionality, and context of the construct. Prevalent conceptualizations of burnout have been criticized for being arbitrarily developed without solid theoretical foundation and for failing to clearly distinguish burnout from depression or other work-related conditions such as compassion fatigue, secondary traumatization, and vicarious traumatization. The current project first examines relevant literature to identify commonalities among prevalent burnout conceptualizations. Then relevant stress research …

Quality Over Quantity: A Comparative Analysis Of The Quality Measures And Performance Between Switzerland And The United States, Lexi Farina

Independent Study Project (ISP) Collection

Even in the best health systems, poor quality of care continues to cause harm to patients and prevent them from receiving the best treatment possible. Thus, it is important to record and report quality of care measures because they can help inform policy changes and improve performance. In this paper, a comparative analysis between the United States and Switzerland is conducted to understand the process for defining and assessing quality indicators in each country as well as compare their quality of care performance results. The methods for this study include a literature review of relevant background information relating to quality …

Understanding Sexual Pleasure And Health: A Study Of Urban Middle-Class Women’S Narratives In New Delhi, India, Solana Chertow

Independent Study Project (ISP) Collection

The following study seeks to explore how urban-middle class women in Delhi understand, value, and access sexual pleasure. Simultaneously, it looks to understand the relationship between ideas of agency, power, and pleasure. This project was prompted by the lack of colloquial conversation happening on these subjects both globally, and in the communities familiar to the researcher. Although sex and pleasure, in both theory and practice, are extremely prominent in the lives of people around the world, discussion remains stigmatized. With these constraints in mind, this study investigates how a certain population of women became knowledgeable, and are still learning about …

My Body, Their Choice: Childbearing Attitudes And Practices In Jamkhed, Maharashtra, Sienna Sewell

Independent Study Project (ISP) Collection

Understanding the beliefs and practices of women and their families during pregnancy and childbirth is fundamental to the creation of successful public health interventions that target maternal and infant mortality. This study explores the childbearing practices of women in rural Jamkhed, as well as the social and economic factors that influence family planning, reproductive health-seeking, and delivery. Interviews and quantitative surveys were conducted with women in villages that have partnered with the Comprehensive Rural Health Project (CRHP) to examine how and why women access prenatal care during pregnancy. The influence of CRHP’s “Jamkhed Model” on healthcare access is considered in …

Exploring Mobility Help-Seeking Behavior Among People With Physical Disabilities: A Case Study Of Jaipur Foot, Alex Podell

Independent Study Project (ISP) Collection

It is estimated that as many as 90 million people living in India experience some sort of disability (The World Bank, 2007). As India’s population keeps growing and aging, not only will the medical aspects, but also the societal impacts of disability need to be brought to the forefront of discussion, developmental strategy, and policy implementation. This study sought to analyze factors influencing the process of seeking help from formal and informal sources for people with physical disabilities. Data was collected from 10 people with physical disabilities receiving a variety of mobility aids from the NGO, Bhagwan Mahaveer Viklang Sahayata …

Pasantía En Red Oss: Más Que Una Clínica, Saad Ehsan

Independent Study Project (ISP) Collection

RED OSS es una organización en Conchalí, Santiago que provee pruebas rápidas de VIH y actualiza otras pruebas para ETS en una manera gratuita desde 1991. Durante mi pasantía, investigué como una organización disminuye las desigualdades de salud. También aprendí sobre el financiamiento de RED OSS, las pruebas rápidas y el nicho de RED OSS en un país con un sistema pública. Utilicé observaciones y entrevistas para estudiar la clínica. Tuve oportunidades para asistir los talleres para prevenir homofobia y ver las consejerías con un voluntario. También actualicé el sitio web para reflejar los servicios que RED OSS ofrece. En …

Social Support And Discrimination: The Experiences Of Recovering Heroin Addicts In Kunming, China, Phoebe Li

Independent Study Project (ISP) Collection

Opioids have had a long, complex position in Chinese society, dating all the way back to the Ming dynasty. In 1949, 5% of the overall Chinese population and 25% of the population in Yunnan smoked opium regularly, which led to societal collapse and economic downturn. Since then, the Chinese government has used many different methods to attempt to control drug use and trafficking, including registering all users, executing traffickers, and using Compulsory Rehabilitation Centers. Starting in 2008, the government switched to a harm reduction approach and began to invest in methadone clinics, community support groups, and needle exchange programs. Because …