Public Health Commons^™

Burnout: Moving Beyond The Status Quo, Renzo Bianchi, Irvin Sam Schonfeld, Éric Laurent

Publications and Research

Burnout has been defined as a job-induced syndrome combining emotional exhaustion, depersonalization/cynicism, and a sense of reduced personal accomplishment. In this article, we expand on past analyses of burnout by reviewing key, yet overlooked, problems affecting the construct. We concomitantly examine the implications of these problems for the overall validity of burnout research. Our work shows that burnout research is undermined by 4 main problems. First, what constitutes a case of burnout is unclear. Second, the basic conceptualization and operationalization of burnout are ill aligned. Third, burnout is unlikely to be the specifically job-induced syndrome it has been posited to …

Increasing Low-Income Residents’ Access To Fresh Produce Through A Local Mobile Pantry, Laura E. Wasson, L. Lanier Nalley, Mechelle Bailey, Laura Hill

Discovery, The Student Journal of Dale Bumpers College of Agricultural, Food and Life Sciences

Seeds that Feed (STF) is a mobile food pantry located in Fayetteville, Arkansas. STF receives produce from local farmers to distribute to residents in low-income housing sites throughout Northwest Arkansas. According to Feeding America, food insecurity affected 14.3% Washington County, Arkansas’ population in 2016. The purpose of this study was to determine if STF’s model is an effective way to increase individuals’ access to fresh fruits and vegetables and increase their potential to meet the United States Department of Agriculture’s Food Patterns (USDA-FP) for to fruit and vegetable consumption. Twenty-three participants from three sites completed the study. A survey was …

Gwas Of Qrs Duration Identifies New Loci Specific To Hispanic/Latino Populations, Brenton R Swenson, Tin Louie, Henry J Lin, Raúl Méndez-Giráldez, Jennifer E Below, Cathy C Laurie, Kathleen F Kerr, Heather Highland, Timothy A Thornton, Kelli K Ryckman, Charles Kooperberg, Elsayed Z Soliman, Amanda A Seyerle, Xiuqing Guo, Kent D Taylor, Jie Yao, Susan R Heckbert, Dawood Darbar, Lauren E Petty, Barbara Mcknight, Susan Cheng, Natalie A Bello, Eric A Whitsel, Craig L Hanis, Mike A Nalls, Daniel S Evans, Jerome I Rotter, Tamar Sofer, Christy L Avery, Nona Sotoodehnia

Faculty, Staff and Student Publications

BACKGROUND: The electrocardiographically quantified QRS duration measures ventricular depolarization and conduction. QRS prolongation has been associated with poor heart failure prognosis and cardiovascular mortality, including sudden death. While previous genome-wide association studies (GWAS) have identified 32 QRS SNPs across 26 loci among European, African, and Asian-descent populations, the genetics of QRS among Hispanics/Latinos has not been previously explored.

METHODS: We performed a GWAS of QRS duration among Hispanic/Latino ancestry populations (n = 15,124) from four studies using 1000 Genomes imputed genotype data (adjusted for age, sex, global ancestry, clinical and study-specific covariates). Study-specific results were combined using fixed-effects, inverse variance-weighted …

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.

Patient-Centered Medical Homes And Hospital Value-Based Purchasing: Investigating Provider Responses To Incentives, Lauryn Walker

Theses and Dissertations

Provider incentives are a commonly used policy tool to mold provider behaviors.¹ However, while we frequently measure the change in patient outcomes, failure to consistently produce changes in outcomes does not mean that providers are not changing their behavior. This paper focuses on two programs with null or inconsistent quality outcomes to try to identify why such inconsistency occurs. The two programs, both ratified in the Affordable Care Act, are 1) patient-centered medical homes (PCMHs), and 2) the Medicare Hospital Value-Based Purchasing (HVBP) program.

Chapter 1: Using data from the Medical Expenditure Panel survey (MEPS), I match provider characteristic …

Women's Empowerment And Its Impact On Reproductive Health Outcomes: Evidence From Nepal, Samyukta Ghimire

Masters Theses

The percentage of women utilizing maternal health care services in Nepal is relatively less than women in other South Asian countries. Moreover, large socio-economic and regional disparities have been the root causes for lower utilization of health care leading to increasing maternal mortality. Using a national representative sample of 9,475 women (2011) and 9,875 women (2016) from Nepal, I examine the impact of women empowerment in relation to prenatal care, place of delivery and postnatal care (3Ps) outcomes. A composite Women’s Empowerment Index (WEI) based upon responses is also constructed to include three empowerment domains namely, attitude toward violence, social …

Program Review Of Naloxone Training Within The Wisconsin Department Of Corrections’ Community Corrections Division, Chelsea Calhoon

All Graduate Theses, Dissertations, and Other Capstone Projects

One of the fastest growing drug problems in the United States is the abuse of opioids (United States Department of Health & Human Services, 2018). With the rising overdose rates, the criminal justice system may offer a pivotal role in the decrease of overdose deaths through opioid overdose recognition and naloxone administration training (World Health Organization, 2014). Training evaluation based on the Effectiveness Theory find significant predictors of training effectiveness and retention to be correlated with the training program, age, and employment tenure (Cowman & McCarthy, 2016). This thesis’ research question is, “Do demographics correlate to training retention for opioid …

Multiplicative Advantages Of Hispanic Men Living In Hispanic Enclaves: Intersectionality In Colon Cancer Care, Keren M. Escobar, Mollie Sivaram, Kevin M. Gorey

The Journal of Sociology & Social Welfare

We examined Hispanic enclave paradoxical effects on cancer care among socioeconomically vulnerable people in pre-Obamacare California. We conducted a secondary analysis of a historical cohort of 511 Hispanic and 1,753 non-Hispanic white people with colon cancer. Hispanic enclaves were neighborhoods where 40% or more of the residents were Hispanic, mostly first-generation Mexican American immigrants. An interaction of ethnicity, gender and Hispanic enclave status was observed such that the protective effects of living in a Hispanic enclave were larger for Hispanic men, particularly married Hispanic men, than women. Risks were also exposed among other study groups: the poor, the inadequately insured, …

Housing Cost Burden And Maternal Stress Among Very Low Income Mothers, Kaycee L. Bills, Stacia Michelle West, Jami Hargrove

The Journal of Sociology & Social Welfare

As the affordable housing shortage proliferates, more American households struggle with high housing cost burdens. Grounded in Belsky’s (1984) parenting stress framework, we use a weighted low-income sample from the Fragile Families and Child Wellbeing Study of mothers who rent their homes (N=388) to investigate a relationship between housing cost burden, or paying a substantial portion of income toward housing, and higher rates of reported maternal stress. Findings of the linear regression indicate that younger mothers and those paying 30% or more of their income each month toward rent have higher reported maternal stress scores. These findings are discussed with …

Hiv Testing Among Nigerian Men Who Have Sex With Men After Criminalization Of Homosexuality, Gerald Onyeka Ileka

Walden Dissertations and Doctoral Studies

Men who have sex with men (MSM) are at high risk of HIV in Nigeria. However, African countries like Nigeria, Botswana, Mali, and Mozambique have laws that prohibit homosexuality, making it a punishable crime in these countries. For example, the Nigerian government signed the anti-gay law in 2014. Laws like these affect the health status and outcomes among Nigerian MSM. The purpose of this qualitative study was to examine the influence criminalization of homosexuality has on the willingness to test for HIV among MSM in Abuja, Nigeria. Guided by the socio-political theory (SP) as the theoretical framework, a qualitative approach …

Effect Of Access To Health Services On Neonatal Mortality In Uganda, Imelda Atai Madgalene Musana

Walden Dissertations and Doctoral Studies

Since 2006, Uganda has experienced a nonchanging neonatal mortality rate of 27 out of 1,000 live births, which is higher than the global average of 19 deaths for every 1,000 live births. The purpose of this retrospective cross-sectional study was to determine factors affecting access to health services and their impact on newborn deaths in Uganda. Mosley and Chen's model for child survival in developing nations provided the framework for the study. Secondary data from the 2016 demographic and health survey (UDHS) collected by the Uganda Bureau of Statistics (UBOs) was used. A total of 7,538 cases were used and …

Iron Deficiency Anemia, Population Health And Frailty In A Modern Portuguese Skeletal Sample, Samantha M. Hens, Kanya Godde, Kristin M. Macak

Sociology & Criminal Justice Faculty Publications

INTRODUCTION

Portugal underwent significant political, demographic and epidemiological transitions during the 20th century resulting in migration to urban areas with subsequent overcrowding and issues with water sanitation. This study investigates population health during these transitions and interprets results within a framework of recent history and present-day public health information. We investigate skeletal evidence for anemia (cribra orbitalia and porotic hyperostosis) as indicators of stress and frailty-i.e., whether the lesions contribute to susceptibility for disease or increased risk of death.

METHODS

The presence and severity of skeletal lesions were compared against known sex and cause of death data to investigate potential …

Experiences Of Formal Caregivers Providing Dementia Care To American Indians, Damon Grew Peter Syphers, C.J. Schumaker, Ronald P. Hudak

Journal of Sustainable Social Impact

Alzheimer’s disease (AD) is a significant public health concern for all elders in the United States. It is a particular concern for the American Indian (AI) population, which is one of the fastest aging populations in the United States and the smallest, most underrecognized, and most culturally diverse group in the country. A formal caregiver understanding of AD in the AI population is scarce. This phenomenological study was designed to discern what is known about AD in the AI population by exploring the cultural beliefs and experiences of formal caregivers who provide care for AI dementia patients. Specifically, this study …

Associations Between Perceptions Of U.S. Immigration Enforcement Policies, Physical Health, Psychological Distress, And Health Care Utilization In A Hispanic Border Community, Isabel Katharina Maria Latz

Open Access Theses & Dissertations

Since the beginning of the current U.S. federal administration, immigration policies have become more restrictive and immigration enforcement has been strengthened. This cross-sectional survey study examines associations between perceptions of and experiences with current immigration enforcement policies and self-rated physical health, psychological distress, and health care utilization among Hispanic adults with different residency statuses in the U.S. Paso del Norte region. This study further investigates moderating effects of collective efficacy and engaged coping strategies on associations between policy perceptions and psychological distress.

The study sample included 211 Hispanic adult residents of the U.S. Paso del Norte Region (i.e., El Paso, …

Journeys Through Rough Country: An Ethnographic Study Of Blind Adults Successfully Employed In American Corporations, Kirk Adams

Antioch University Dissertations & Theses

Blind and visually impaired people in the United States face a dire employment situation within professional careers and corporate employment. The purpose of this research study was to gain insights into the phenomenon of employment of blind people through analyzing the lived experience of successfully employed blind adults through ethnographic interviews. Previous research has shown that seven out of ten blind adults are not in the workforce, that a large percentage of those who are employed consider themselves underemployed, and that these numbers have not improved over time. Missing from previous research were insights into the conditions leading to successful …

Geospatial Analysis Of Care And Mortality In The 2014 Liberia Ebola Outbreak, Marion Carlton Kinkade

Walden Dissertations and Doctoral Studies

The Ebola outbreak in West Africa in 2014 to 2016 had more than 28,000 suspected, probable, and confirmed cases. It was the largest Ebola outbreak in history. Of the 28,000 cases in the three Ebola-affected countries, Liberia had 10,000 cases with almost 5,000 deaths. The Ebola Virus Disease (EVD) entered Liberia along the border of Guinea and moved to the capital city of Monrovia where the virus spread. Ebola Treatment Units (ETUs) were constructed throughout the response in locations where there were available facilities versus distance to care challenges. This study examined the association of distance from villages to ETUs …

A Program Of Research On Burnout-Depression Overlap, Irvin Sam Schonfeld

Publications and Research

The article describes a program of research aimed at unraveling the nature of the relationship of job-related burnout to depression. The research tends to show that burnout symptoms are depressive symptoms and what is termed a state of burnout often reflects an episode of depression.

Youth Study Recruitment Using Paid Advertising On Instagram, Snapchat, And Facebook: Cross-Sectional Survey Study, Kelsey Lynett Ford, Tashuna Albritton, Tara A. Dunn, Kacy Crawford, Jessica Neuwirth, Sheana Bull

Publications and Research

Background:The use of paid social media advertising for targeted study recruitment is an effective strategy in health research and evaluation, specifically to reach diverse youth participants. Although the literature adequately describes the utility of Facebook in recruitment, limited information exists for social media platforms that are more popular with youth, specifically Instagram and Snapchat.

Objective:This paper outlines a paid advertising approach using Instagram, Snapchat, and Facebook to evaluate a statewide youth marijuana prevention campaign. The objective of this study was to compare recruitment metrics across Instagram, Snapchat, and Facebook for two surveys documenting youth knowledge, attitudes, and behaviors related to …

Developing An Evidence-Based Hiv Testing Message For Young African American Women, Melanie P. Moore

Theses and Dissertations

African American women have the highest rates of HIV infection among women of all racial/ethnic groups in the United States, and over 50% of HIV infected young adults are unaware of their infection. HIV testing is a cost-effective mechanism for reducing HIV transmission. Despite this, limited research has been devoted to developing interventions specifically promoting HIV testing. This two-part study proposed to address this gap through developing a culturally tailored HIV testing message aimed at increasing HIV test intentions among young African American women. Study 1 was a quantitative study that examined predictors of HIV testing history and future HIV …

From Sunrise To Sunset: A Lifespan Approach To Understanding The Mental Health Of A Subset Of American Farmers, Janna L. Imel

Theses and Dissertations

Prior research has indicated higher risk of suicide for farmers and identified depression and anxiety as mental health concerns, though the majority of research was conducted in the 1980s-1990s. In today’s economic, social, and political climate, farmers are exposed to situations and stressors reminiscent of the 1980s Farm Crisis. An added risk is the aging workforce of farmers, as age-related conditions can make farming even riskier. This study investigated the mental health of a subset of American farmers by exploring farm-related stressors, coping mechanisms, and mental health outcomes. Dispositional mindfulness was explored as a specific coping mechanism. Participants (N …

Construction And Validation Of A Non-Medical Use Of Prescription Opioids Outcome Expectancies Scale Among College Students In China, Cheuk Chi Tam

Theses and Dissertations

Background:Non-medical use of prescription opioids (NMUPO) has become a clear threat to public health. Young adults (aged 18 to 25) have a high risk of NMUPO. My prior work on Chinese undergraduates indicates a high prevalence of lifetime NMUPO (49.2%). Health behavior theories propose that outcome expectancies are robust psychosocial determinants of substance use. Literature has identified the influence of outcome expectancies on alcohol and drug use. However, the role of outcome expectancies in NMUPO in China is unknown, and a scarcity of a valid measures for NMUPO outcome expectancies may be a barrier. Our previous research also found …

Motivational Interviewing In A Team-Based Wellness Clinic: Perceptions And Fidelity, Jodi M. Winship

Theses and Dissertations

INTRODUCTION: Motivational Interviewing (MI) is an evidenced based counseling style to elicit health behavior change. Team-based student clinics are an ideal climate for students to learn and practice team-based care, yet little is understood as to how client-centered communication styles such as MI are implemented in a team setting.

PURPOSE: The purpose of this dissertation was to conduct an exploratory study using mixed methods to better understand how an MI training translates to team-based communication with clients, the factors impacting team-based implementation of MI, and how team-based MI impacts clients’ perceived autonomy at a student-led, interprofessional, team-based wellness clinic for …

An Evaluation Of Differences In Motivations To Receive Cervical Cancer Screening And Follow-Up Care Between Black And White Women, Ashlee Sawyer

Theses and Dissertations

Background: Cervical cancer among Black women is a major individual and public health concern. Despite advancements in medical technology and policy, disparities in cervical cancer diagnosis and mortality still exist between White and Black women, with Black women having higher rates of diagnosis (10.0 vs 7.1 per 100,000) and mortality (4.1 vs 2.0 per 100,000). Previous studies have focused heavily on barriers to obtaining cervical cancer screening among Black women and efforts to improve screening rates. Despite speculation by researchers that gaps in receipt of quality follow-up care may contribute to disparities, its role in disparate mortality rates between Black …

Predictors And Health Outcomes Of Treatment-Resistant Depression Among Adults With Chronic Non-Cancer Pain Conditions And Major Depressive Disorder, Drishti Shah

Graduate Theses, Dissertations, and Problem Reports (ETD)

Understanding major depressive disorder (MDD) as a comorbidity in patients with chronic non-cancer pain conditions (CNPC) is of importance because of the high prevalence and well documented bi-directional relationship between MDD and pain. Furthermore, presence of CNPC among adults with MDD often reduces benefits of antidepressant therapy, thereby increasing the possibility of treatment resistance. Treatment-resistant depression (TRD) commonly defined as insufficient response to multiple antidepressant trials, often worsens depression and pain symptoms and can amplify the clinical and economic burden among adults with CNPC and MDD. Additionally, long-term opioid therapy (LTOT) may be prescribed at a higher rate to adults …

Servant Leadership Characteristics And Empathic Care: Developing A Culture Of Empathy In The Healthcare Setting, Mark Anthony Martin

Antioch University Dissertations & Theses

The purpose of this study was to assess the degree to which servant leadership characteristics are exhibited in medical group practices, and the degree to which servant leadership characteristics correlated with measures of empathic care. This study featured an explanatory mixed methods research design embedded in appreciative inquiry. A total of 189 mid-level practitioners consisting of nurse practitioners, physician assistants, and practice mangers responded to a 32-item scale survey that featured a six-point Likert scale to measure servant leadership items and a 10-point continuous scale to assess measures of empathic care. The servant leadership items were based on the seven …

Patient Empowerment Via Mobile Personal Health Records And Mobile Health Applications: A Review Of The Current Use, Abdulaziz S. Alhomod, Saeed Alzahrani

Engineering and Technology Management Faculty Publications and Presentations

Consumer empowerment has gained a significant attention in the medical field recently, and despite the ambiguity of its definitions, elements and measurement tools, it is apparent that mobile and other communication technology can play a major role in keeping patients informed, involved and empowered. This paper aims to explore methods by which mobile applications contribute to consumer empowerment and allowed enhanced patient control over their health.

Is It Who Am I Or Who Do You Think I Am? Identity Development Of Adolescents With Substance Use Disorders, Danielle N. Treiber

Antioch University Dissertations & Theses

The purpose of this study was to unearth how adolescents with substance use disorders achieve the task of identity formation and the construction of self-concept in the midst of the drug culture and society that exists. It sought to uncover the social constructs designed to ignore and/or remove human complexities and allow an intersectional approach to be brought to a study on this population. Historically, there has been a failure to investigate the underlying social attitudes and behaviors that impact the very delicate and vulnerable process of finding self. Psychosocial and relational adjustment are strongly influenced by the extent to …