Public Health Commons^™

In Memoriam: Herbert L. Needleman (1927-2017), Aldemaro Romero Jr.

Publications and Research

On July 18, 2017, Dr. Herbert L. Needleman, of Squirrel Hill, Pittsburgh, a pediatrician and a child psychiatrist who greatly contributed to improve environmental health worldwide by demonstrating in the late 1970s that children exposed to even small amounts of lead could suffer intellectual and behavioral disorders, passed away. He was living at Weinberg Village, an assisted living home in Glen Hazel, neighbor in Pittsburgh, Pa., where he had spent the last two years while suffering from Alzheimer's disease. Dr. Needleman's work prompted regulations that limited or banned the metal in a range of common products, like gasoline and paint, …

A New Benchmarking Methodology To Monitor Industry's Investment In Community-Based Obesity Prevention And Food Access Initiatives: Gaps And Opportunities, Olivia Barata Cavalcanti

Dissertations and Theses

Background:

Despite increased public health efforts and investment in obesity prevention, obesity continues to be a growing problem in the United States.¹ Excess weight increases the risk for a series of correlated diseases, such as type 2 diabetes, hyperinsulinemia, hypertension, dyslipidemia, joint abnormalities, polycystic ovarian syndrome, nonalcoholic fatty liver disease, sleep disturbances and a decreased life span.^2–9

Traditional interventions to improve nutrition or decrease obesity have not achieved the desired success so far because obesity is a complex problem, involving a vast number of factors, sectors and actors that influence individuals’ energy balance.^10,11 To achieve change in …

Mobile Alcohol Primary Prevention: Feasibility With Urban Communter College Students, Janice Chisholm

Dissertations and Theses

The first year and possibly as early as the first two to six weeks of college are marked with personal and social transitions that may help to define academic and other behavior for new college students, including alcohol use patterns.1 Evidence suggests that alcohol use by college students negatively affects learning, retention, and graduation,2,3 and is associated with alcohol related unintentional injury, deaths, sexual violence, suicide and other problems.4 Young adults entering college have been found to increase their usage during the transition from high school, particularly for students with certain social characteristics (male sex, history of conduct issues, peer …

Incidence, Risk Factors, And Prediction Of Gastrointestinal And Intracranial Bleeding In A Cohort Of Older Veterans Prescribed Oral Anticoagulants, Angela Laurio

Dissertations and Theses

ABSTRACT

Incidence, Risk Factors, and Prediction of Gastrointestinal and

Intracranial Bleeding in a Cohort of Older Veterans Prescribed Oral Anticoagulants

by

Angela L. Laurio

Advisor: Marianne (Mimi) C. Fahs, PhD, MPH

Objectives:

The objectives of this dissertation were to: (1) describe and compare the incidence and odds of gastrointestinal and intracranial bleeding in veterans age 50 to 89 who were prescribed warfarin, direct oral anticoagulants, or no oral anticoagulants; (2) identify risk factors for gastrointestinal and intracranial bleeding among older veterans prescribed oral anticoagulants, and to calculate the relative risk of bleeding over time through time-to-event analysis; and (3) develop …

The Impact Of Comorbidities, Depression, And Substance Use Problems On Quality Of Life Among Older Adults Living With Hiv, Brett M. Millar, Tyrel Starks, Sitaji Gurung, Jeffrey T. Parsons

Publications and Research

Older adults living with HIV (OALWH) comprise a growing population with a range of complex and interconnecting medical and psychosocial needs. Based on the biopsychosocial model with its emphasis on a holistic approach to various aspects of people’s lives, the current study explored associations between physical health, psychological health, substance use, and overall quality of life. Drawing on data from 114 substance-using OALWH (aged 50 or older), we employed linear regression to show associations between the number of current comorbid health conditions on quality of life, over and above depression, substance use problems, and demographic characteristics (age, race/ethnicity, gender, sexual …

Thrive With Me: Protocol For A Randomized Controlled Trial To Test A Peer Support Intervention To Improve Antiretroviral Therapy Adherence Among Men Who Have Sex With Men, Keith J. Horvath, K. Rivet Amico, Darin Erickson, Alexandra M. Ecklund, Aldona Martinka, James Dewitt, Jeffrey Mclaughlin, Jeffrey T. Parsons

Publications and Research

Background: The suboptimal rate of viral suppression among persons aged 13 years and older and residing in 37 states and the District of Columbia leaves considerable opportunities for onward transmission and contributes to poor health outcomes. Men who have sex with men (MSM) represent one of the most at-risk groups in the United States. There is a clear and continued need for innovative adherence support programs to optimize viral suppression. To address this gap, we designed and are implementing a randomized controlled trial (RCT) to test the efficacy of the Thrive with Me intervention for MSM living with HIV. Critical …

Rates Of Developmental And Behavioral Screening Of Young Children: Implications For Health Care Policy And Practice, Shirley Berger

Dissertations and Theses

Background: The skills and capacities developed during early childhood are the foundation for a child’s future academic functioning, economic productivity, and lifelong health and mental health. When young children have developmental delays or disabilities, early identification and intervention lead to better outcomes; however, only a minority are identified before school entry. Primary care is an important setting for identification of developmental and behavioral conditions as most young children attend well-child visits regularly and parents expect developmental guidance from pediatricians. Two key pediatric preventive services are recommended: developmental monitoring/surveillance at every well-child visit and developmental screening at 9 months, 18 months, …

Emerging Themes In Coping With Lifetime Stress And Implication For Stress Management Education, Asrat G. Amnie

Publications and Research

Background: Adults with adverse childhood experiences and exposure to adverse life events experience a diverse array of physical, mental, and social health problems across their lifespan. Adult exposure to emotional trauma, physical injury, or other adverse life events may result in the development of post-traumatic stress and post-traumatic stress disorder. Understanding individuals’ response to stress and their coping strategies is as important as the stimulus or the causes of the stress for effective stress management interventions.

Methods: This is a mixed quantitative and qualitative online survey study which explores the coping strategies to stress in adults with adverse childhood experiences …

Assessing The Ordinality Of Response Bias With Item Response Models: A Case Study Using The Phq-9, Venessa N. Singhroy

Dissertations, Theses, and Capstone Projects

Improper scale usage in psychological and clinical assessment is an important problem. If respondents do not use the scales in a consistent manner, the reliability of a composite is likely to be attenuated. This is particularly problematic when particular items are singled out for special treatment or when subscales are of interest, not just a total score. This study used both non-parametric and parametric item response theory (IRT) methods to gain further insight into the validity of the PHQ-9, a dual purpose instrument that assesses the severity of depressive symptoms using nine Likert-scale items and allows the investigator to establish …

Culture Care Needs Of Puerto Rican Women Receiving Hiv Care From Nurse Practitioners In New York City, Michele Crespo-Fierro

Dissertations, Theses, and Capstone Projects

The purpose of this mini-ethnonursing research study was to discover, describe, and interpret culture care values, beliefs, expressions, practices and needs of Puerto Rican women receiving HIV care from nurse practitioners (NPs) and other providers in New York City. The emic, or insider, perspective of Puerto Rican women living with HIV was the focus of this study and Leininger’s Culture Care Theory (CCT) provided the theoretical framework. Various enablers of the CCT, including Leininger’s Sunrise Enabler to Discover Culture Care, guided the design andimplementation of the study. Six key and twelve general informantswere interviewed and data from the interviews were …

Factors Associated With Household Contacts' Tuberculosis Testing And Evaluation, Elvy G. Barroso

Dissertations, Theses, and Capstone Projects

Contact investigation (CI) is one of the core elements of tuberculosis (TB) control. It is intended to achieve early identification of contacts who may have been exposed to a patient with infectious active TB and contacts who may benefit from treatment for latent tuberculosis infection (LTBI). LTBI is an infection in which the Mycobacterium tuberculosis organisms cause no signs and symptoms but the infection can be reactivated and develop into full-blown active TB disease. Failure to be identified as a contact is the primary reason for disease development in more than half of TB patients, thus a complete and timely …

Understanding The New Blood Pressure Guidelines, Susan H. Davide, Anty Lam

Publications and Research

Oral health professionals who are well versed in the new guidelines will be best prepared to handle the implications on patient care.

Involuntary Sterilization Among Hiv-Positive Garifuna Women From Honduras Seeking Asylum In The United States: Two Case Reports, Holly G. Atkinson, Deborah Ottenheimer

Publications and Research

Voluntary sterilization is one of the most widely used forms of contraception by women worldwide; however, involuntary sterilization is considered a violation of multiple human rights and grounds for asylum in the United States. Women have been disproportionately affected by this practice. We report two cases of involuntary sterilization in HIV-positive Garifuna women from Honduras who sought asylum in America and were medically evaluated at the request of their attorneys. Key lessons can be drawn from these cases with regard to the importance of medical evaluations in establishing persecution. These include the need for a detailed account of the events …

Healthcare Coverage In The United States And New York Metropolitan Area, 2009 - 2015, Andrew S. Alger

Center for Latin American, Caribbean, and Latino Studies

Introduction: This study examines trends regarding health insurance coverage in the United States along lines of sex, race/ethnicity, place of birth, and poverty status between 2009 and 2015.

Methods: This study uses the American Community Survey PUMS (Public User Microdata Series) for the years 2009, 2011, 2013, and 2015. These datasets were downloaded from the IPUMS USA website hosted by the University of Minnesota. The variables used in the study describe these populations in terms of sex, the four major race/ethnic groups (non-Hispanic white, non-Hispanic black, Latino, and Asian), being born either within the United States or abroad, and being …

Resistance Training-Induced Gains In Muscle Strength, Body Composition, And Functional Capacity Are Attenuated In Elderly Women With Sarcopenic Obesity, Alessandro De Oliveira Silva, Maurílio Tiradentes Dutra, Wilson Max Almeida Monteiro De Moraes, Silvana Schwerz Funghetto, Darlan Lopes De Farias, Paulo Henrique Fernandes Dos Santos, Denis Cesar Leite Vieira, Dahan Da Cunha Nascimento, Vânia Silva Macedo Orsano, Brad J. Schoenfeld, Jonato Prestes

Publications and Research

Objectives: The purpose of this study was to compare the effects of resistance training (RT) on body composition, muscle strength, and functional capacity in elderly women with and without sarcopenic obesity (SO).

Methods: A total of 49 women (aged $60 years) were divided in two groups: without SO (non-SO, n=41) and with SO (n=8). Both groups performed a periodized RT program consisting of two weekly sessions for 16 weeks. All measures were assessed at baseline and postintervention, including anthropometry and body composition (dual-energy X-ray absorptiometry), muscle strength (one repetition maximum) for chest press and 45° leg press, and functional capacity …

Data And Statistical Methods To Analyze The Human Microbiome, Levi Waldron

Publications and Research

The Waldron lab for computational biostatistics bridges the areas of cancer genomics and microbiome studies for public health, developing methods to exploit publicly available data resources and to integrate-omics studies.

An Empirical Study Of Chronic Diseases In The United States: A Visual Analytics Approach To Public Health, Wullianallur Raghupathi, Viju Raghupathi

Publications and Research

In this research we explore the current state of chronic diseases in the United States, using data from the Centers for Disease Control and Prevention and applying visualization and descriptive analytics techniques. Five main categories of variables are studied, namely chronic disease conditions, behavioral health, mental health, demographics, and overarching conditions. These are analyzed in the context of regions and states within the U.S. to discover possible correlations between variables in several categories. There are widespread variations in the prevalence of diverse chronic diseases, the number of hospitalizations for specific diseases, and the diagnosis and mortality rates for different states. …

Market Integration Predicts Human Gut Microbiome Attributes Across A Gradient Of Economic Development, Keaton Stagaman, Tara J. Cepon-Robins, Melissa A. Liebert, Theresa E. Gildner, Samuel S. Urlacher, Felicia C. Madimenos, Karen Guillemin, J. Josh Snodgrass, Lawrence S. Sugiyama, Brendan J. M. Bohannan

Publications and Research

Economic development is marked by dramatic increases in the incidence of microbiome-associated diseases, such as autoimmune diseases and metabolic syndromes, but the lifestyle changes that drive alterations in the human microbiome are not known. We measured market integration as a proxy for economically related lifestyle attributes, such as ownership of specific market goods that index degree of market integration and components of traditional and nontraditional (more modern) house structure and infrastructure, and profiled the fecal microbiomes of 213 participants from a contiguous, indigenous Ecuadorian population. Despite relatively modest differences in lifestyle across the population, greater economic development correlated with significantly …

Adherence To Antiretroviral Therapy In A Clinical Cohort Of Hiv-Infected Children In East Africa, Rachel C. Vreeman, Samuel O. Ayaya, Beverly S. Musick, Constantin T. Yiannoutsos, Craig R. Cohen, Denis Nash, Deo Wabwire, Kara Wools-Kaloustian, Sarah E. Wiehe

Publications and Research

Objective To describe antiretroviral therapy (ART) adherence and associated factors for a large HIVinfected pediatric cohort followed by sites of the East Africa International Epidemiologic Databases to Evaluate AIDS (IeDEA) consortium.

Methods This study utilized prospectively collected clinical data from HIV-infected children less than 13 years of age who initiated ART within 4 clinical care programs (with 26 clinical sites) in Kenya, Uganda, and Tanzania and were followed for up to 6 years. Programs used one of 3 adherence measures, including 7-day quantitative recall, 7-day categorical recall, and clinician pill assessments. We fit a hierarchical, three-level, logistic-regression model to examine …

Resveratrol And Pterostilbene Exhibit Anticancer Properties Involving The Downregulation Of Hpv Oncoprotein E6 In Cervical Cancer Cells, Kaushiki Chatterjee, Dina Alsharif, Christina Mazza, Palwasha Syar, Mohamed Al Sharif, Jimmie E. Fata

Publications and Research

Cervical cancer is one of the most common cancers in women living in developing countries. Due to a lack of affordable effective therapy, research into alternative anticancer compounds with low toxicity such as dietary polyphenols has continued. Our aim is to determine whether two structurally similar plant polyphenols, resveratrol and pterostilbene, exhibit anticancer and anti-HPV (Human papillomavirus) activity against cervical cancer cells. To determine anticancer activity, extensive in vitro analyses were performed. Anti-HPV activity, through measuring E6 protein levels, subsequent downstream p53 effects, and caspase-3 activation, were studied to understand a possible mechanism of action. Both polyphenols are effective agents …

Obesity, Type 2 Diabetes, And Dietary Acculturation Among Foreign-Born Blacks In New York City, Margrethe F. Horlyck-Romanovsky

Dissertations and Theses

Background: Black immigration to the US quadrupled between 1980 and 2000, and between 2000 and 2013 it further increased by 56%. The US Census estimates that by 2060, 16.5% of the US Black population will be foreign-born. Half of all foreign-born Blacks (FBBs) in the US, or more than 1.9 million people, are from the Caribbean, and of those, 682,000 were born in Jamaica alone. Besides the Caribbean, there are 1.36 million immigrants from sub-Saharan Africa. In New York City, non-Hispanic black Caribbean and West African immigrants constitute 19% and 4%, respectively, of the total foreign-born population. Research is limited …

Evaluating The Dietary And Nutritional Apps In The Google Play Store, Harleigh Schumer, Chioma Amadi, Ashish Joshi

Publications and Research

Objectives: The objective of this study was to evaluate the features of diet and nutrition apps available in the Google Play Store.

Methods: A search was conducted in August 2017 using the Google Play Store database to identify apps related to diet and nutrition. Terms entered into the app search engine included ‘diet apps’ and ‘nutrition apps’. The first 50 apps resulting from each search term was assessed. Duplicates were removed, and a comparative analysis was performed on the remaining diet and nutrition apps.

Results: A total of 86 diet and nutrition apps were identified. One hundred percent (n = …

The Impact Of The Boko Haram Insurgency In Northeast Nigeria On Childhood Wasting: A Double-Difference Study, Gillian Dunn

Publications and Research

Background: This research examines the relationship between violent conflict and childhood wasting in Northeast Nigeria, where residents have been subjected to fighting between the Nigerian government and Boko Haram - an extremist Islamist movement - since 2009.

Methods: Using two Demographic and Health Surveys from before and after the Boko Haram insurgency started, a double-difference (difference-in-difference) approach is used to assess the impact of the conflict on mean weight for- height z-scores and the likelihood of wasting.

Results: Results suggest that if children exposed to the conflict had not been exposed, their mean weight-for height z-score would be 0.49 standard …

Toxicdocs: A New Resource For Assessing The Impact Of Corporate Practices On Health, Nicholas Freudenberg

Publications and Research

In the past century, corporations have contributed to premature death and preventable illnesses globally. A growing body of evidence shows how the practices of corporations and their allies contribute to chronic diseases, injuries, and toxic exposures [1–3]. Public health researchers can chart how business practices such as marketing, product formulation and pricing, and corporate political activity such as lobbying, election campaign contributions, sponsored research, and public relations promote the behaviors, environments, and policies that shape patterns of health and disease [4–6].

Factors Associated With Perceived Accuracy Of The Undetectable = Untransmittable Slogan Among Men Who Have Sex With Men: Implications For Messaging Scale-Up And Implementation, H Jonathon Rendina, J T. Parsons

Publications and Research

Introduction: Recent research has shown high efficacy of HIV treatment for reducing the risk of HIV transmission to sexual partners. As the efficacy of treatment as prevention (TasP) has proliferated, a new messaging campaign, Undetectable = Untransmittable, has been gaining popularity. The purpose of this paper was to assess factors associated with the perceived accuracy of this TasP messaging strategy among a large and diverse sample of gay, bisexual, and other men who have sex with men (GBMSM) in order to inform subsequent efforts at large-scale and implementation of the HIV prevention message.

Methods: We conducted a nationwide survey of …

The Association Between A Body Shape Index And Cardiovascular Risk In Overweight And Obese Children And Adolescents, Chiara Mameli, Nir Y. Krakauer, Jesse C. Karakauer, Alessandra Bosetti, Chiara Matilde Ferrari, Norma Moiana, Laura Schneider, Barbara Borsani, Teresa Genoni, Gianvincenzo Zuccotti

Publications and Research

A Body Shape Index (ABSI) and normalized hip circumference (Hip Index, HI) have been recently shown to be strong risk factors for mortality and for cardiovascular disease in adults. We conducted an observational cross-sectional study to evaluate the relationship between ABSI, HI and cardiometabolic risk factors and obesity-related comorbidities in overweight and obese children and adolescents aged 2±18 years. We performed multivariate linear and logistic regression analyses with BMI, ABSI, and HI age and sex normalized z scores as predictors to examine the association with cardiometabolic risk markers (systolic and diastolic blood pressure, fasting glucose and insulin, total cholesterol and …

The Effectiveness Of Critical Time Intervention For Abused Women Leaving Women’S Shelters: A Randomized Controlled Trial, Danielle A. M. Lako, Marielle D. Beijersbergen, Irene E. Jonker, Renee De Vet, Daniel B. Herman, Albert M. Van Hemert, Judith R. L. M. Wolf

Publications and Research

Objectives: To examine the effectiveness of critical time intervention (CTI)—an evidence-based intervention—for abused women transitioning from women’s shelters to community living. Methods A randomized controlled trial was conducted in nine women’s shelters across the Netherlands. 136 women were assigned to CTI (n = 70) or care-as-usual (n = 66). Data were analyzed using intention-to-treat three-level mixed-effects models.

Results: Women in the CTI group had significant fewer symptoms of post-traumatic stress (secondary outcome) (adjusted mean difference - 7.27, 95% CI - 14.31 to - 0.22) and a significant fourfold reduction in unmet care needs (intermediate outcome) (95% CI 0.06–0.94) compared to …

Ten Years Of Food Policy Governance In New York City: Lessons For The Next Decade, Nicholas Freudenberg, Nevin Cohen, Janet Poppendieck, Craig Willingham

Publications and Research

No abstract provided.

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

Publications and Research

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

"Burned Out" At Work But Satisfied With One's Job: Anatomy Of A False Paradox, Eric Laurent, Irvin Sam Schonfeld, Renzo Bianchi

Publications and Research

In a recent study of 346 US neurosurgery residents Attenello et al reported that 67% of their participants suffered from burnout. The authors also found that 81% of surveyed residents were satisfied with their career. Attenello et al described their results as paradoxical. We criticize their methodology.