Public Health Commons^™

Mode Of Delivery And Child And Adolescent Psychological Well-Being: Evidence From Hong Kong’S “Children Of 1997” Birth Cohort, Cherry Y. Leung, Gabriel M. Leung, C. Mary Schooling

Publications and Research

Mode of delivery (vaginal or cesarean section) is thought to affect gut microbiota, which in turn may affect psychological well-being. As such, mode of delivery is potentially a modifiable factor for psychological well-being. Here we examined the association of mode of delivery with child and adolescent psychological well-being. We used multivariable linear regression in a populationrepresentative Hong Kong Chinese birth cohort, “Children of 1997,” to examine the adjusted associations of mode of delivery with behavioral problems assessed from parent-reported Rutter score at ~7 (n = 6294) and ~11 years (n = 5598), self-esteem assessed from self-reported Culture-Free Self- Esteem Inventory …

A Human-Centered Platform For Hiv Infection Reduction In New York: Development And Usage Analysis Of The Ending The Epidemic (Ete) Dashboard, Ashish Joshi, Chioma Amadi, Benjamin Katz, Sarah Kulkarni, Denis Nash

Publications and Research

Background: Dashboards have been increasingly used in clinic-based interventions, such as clinical performance improvement and monitoring risk of hospital readmissions, and are now gaining traction in population-based interventions, especially in disease assessment.

Objective: We describe the design, development, and usage analysis of a geovisualization dashboard, the Ending the Epidemic (ETE) Dashboard. The ETE dashboard is a tool developed to track New York’s progress towards achieving the goal of its ETE Initiative, to reduce new HIV infections from 3000 per year to 750 per year by the end of 2020.

Methods: The ETE dashboard was adapted from an existing human-centered geovisualization …

Assessing The Public Health Impact Of The Mhealth App Business, Nicholas Freudenberg

Publications and Research

Do mobile health applications (mHealth apps) promise solutions to such pressing public health problems as increasing access to care, reducing inequalities in health, lowering health care costs, and providing people with new tools to reduce risky behavior and manage chronic diseases? To answer this question, public health professionals and researchers need to examine how the more than 259 000 mHealth apps now available in the US market contribute to improved population health now and will in the future.

In this issue of AJPH, Grundy et al. (p. 1783) provide evidence that may temper the often uncritically enthusiastic response to …

First Trimester Medication Abortion Practice In The United States And Canada, Heidi E. Jones, Katharine O'Connell White, Wendy V. Norman, Edith Guilbert, E. Steve Lichtenberg, Maureen Paul

Publications and Research

We conducted a cross-sectional survey of abortion facilities from professional networks in the United States (US, n = 703) and Canada (n = 94) to estimate the prevalence of medication abortion practices in these settings and to look at regional differences. Administrators responded to questions on gestational limits, while up to five clinicians per facility reported on 2012 medication abortion practice. At the time of fielding, mifepristone was not approved in Canada. 383 (54.5%) US and 78 (83.0%) Canadian facilities participated. In the US, 95.3% offered first trimester medication abortion compared to 25.6% in Canada. While 100% of providers were …

Women’S Sexual Fantasies In Context: The Emotional Content Of Sexual Fantasies, Psychological And Interpersonal Distress, And Satisfaction In Romantic Relationships, Sarah Constantine

Dissertations, Theses, and Capstone Projects

Background: Psychoanalytic thinkers propose that aspects of an individual’s sexual fantasies are related to her psychological and interpersonal functioning. The present study aims to elucidate the significance of sexual fantasies with respect to women’s emotional and interpersonal lives. The study evaluated a model, which hypothesized that internal representations of self and others (e.g. attachment security, maturity of object relations) along with psychological and interpersonal factors would predict both the emotional content (guilt, fear, affection) of written sexual fantasy narratives, and overall romantic satisfaction in heterosexual women. Methods: Five hundred and thirty four women completed self-report questionnaires online. Subsequently, the sexual …

Association Of Body Shape Index (Absi) With Cardio-Metabolic Risk Factors: A Crosssectional Study Of 6081 Caucasian Adults, Simona Bertoli, Alessandro Leone, Nir Y. Krakauer, Giorgio Bedogni, Angelo Vanzulli, Valentino Ippocrates Redaelli, Ramona De Amicis, Laila Vignati, Jesse C. Krakauer, Alberto Battezzati

Publications and Research

A Body Shape Index (ABSI) was specifically developed as a transformation of waist circumference (WC), statistically independent of BMI to better evaluate the relative contribution of WC to central obesity and clinical outcomes. Previous studies have found ABSI is associated with total mortality and cardiovascular events. However, no study has specifically evaluated the joint contribution of ABSI and BMI to cardio-metabolic outcomes (high triglycerides, low HDL, high fasting glucose and high blood pressure). With this aim, we performed a retrospective study on 6081 Caucasian adults. Subjects underwent a medical interview, anthropometric measurements, blood sampling, measurement of blood pressure, and measurement …

An Investigation Of Public Injection Drug Use In New York City: A Mixed-Methods Study, Taeko M. Frost

Dissertations and Theses

Background: Drug use and injection-related harms are on the rise in the United States (US). As a result, new outbreaks of HIV and viral hepatitis C (HCV) attributed to injection drug use have been identified across the country. In addition to HIV and HCV, skin and soft tissue infection (SSTIs) that result from risky injection practices lead to preventable and costly emergency department (ED) visits. The concurrent opioid overdose epidemic has prompted a national conversation on how to effectively address drug-related harms and associated costs. International studies have identified that the place a person injects is related to adverse health …

Nonprofit Hospital Community Benefit Requirements: An Exploration Of National Health Policy Models, Justin P. Swearingen

Dissertations and Theses

Introduction: Nonprofit hospital organizations are public charities with complete tax immunity. Such exemptions are worth $24.6 billion and impact the health of hundreds of millions of people, yet what these charities must do to meet the current “community benefit standard” to maintain their tax-exempt status remains a policy debate. To help inform policymaking, an evaluation of four national requirement models was performed: Tax Value Requirement (at least the value of the tax exemptions must be spent on community benefit), Grassley Requirement (at least 5% of revenue must be spent on community benefit), Expense Requirement (at least 3% of expenses must …

Trends In Hpv Vaccine Initiation And Completion Among Girls In Texas: Behavioral Risk Factor Surveillance System Data, 2008–2010, Tatjana Gazibara, Haomiao Jia, Erica I. Lubetkin

Publications and Research

Objective: The objective of this study was to evaluate the trend of HPV vaccine initiation and completion among girls in Texas from 2008 to 2010.

Methods: Data were obtained from the Behavioral Risk Factors Surveillance System (BRFSS) over 3 years (2008–2010). The information regarding HPV vaccination was gathered from the parents of 9- to 17-year-old daughters (choosing only 1 per household) in randomly selected households in the sample area.

Results: The highest prevalence of vaccine initiation and completion were detected in 2010 (20.9% and 9.7%, respectively). Over the study period, HPV vaccine initiation statistically significantly increased (2008, 14.9%; 2009, 20.7%; …

Thyroid Function And Ischemic Heart Disease: A Mendelian Randomization Study, Jie V. Zhao, C. Mary Schooling

Publications and Research

To clarify the role of thyroid function in ischemic heart disease (IHD) we assessed IHD risk and risk factors according to genetically predicted thyroid stimulating hormone (TSH), free thyroxine (FT4) and thyroid peroxidase antibody (TPOAb) positivity. Separate-sample instrumental variable analysis with genetic instruments (Mendelian randomization) was used in an extensively genotyped case (n = 64,374)-control (n = 130,681) study, CARDIoGRAMplusC4D. Associations with lipids, diabetes and adiposity were assessed using the Global Lipids Genetics Consortium Results (n = 196,475), the DIAbetes Genetics Replication And Meta-analysis case (n = 34,380)-control (n = 114,981) study, and the Genetic Investigation of ANthropometric Traits (body …

Differences In Neighborhood Social Cohesion And Aerobic Physical Activity By Latino Subgroup, Rosenda Murillo, Sandra Echeverria, Elizabeth Vasquez

Publications and Research

Previous research has examined the role of neighborhood social cohesion in physical activity outcomes; however, less is known about this relationship across Latino subgroups. The purpose of our study was to examine the association between neighborhood social cohesion and aerobic leisure-time physical activity (LTPA) among Latino adults and to determine whether these associations differ by Latino subgroup. We used cross-sectional 2013–2014 National Health Interview Survey (NHIS) data on Latinos originating from 5 countries/regions (i.e., Latinos of Puerto Rican, Mexican/Mexican-American, Cuban/Cuban-American, Dominican and Central or South American origin) aged ≥18 years (n=11,126). Multivariable logistic regression models were used to estimate associations …

The Effect Of Paid Sick Leave On Physician Office-Based Visits, Korvin Vicente

Theses and Dissertations

This paper uses a balanced sample of workers from cross-sections of the National Health Interview Survey to estimate the causal effects of paid sick leave on the medical care seeking behavior of individuals, as measured by physician office-based visits.

Blogs As Channels For Disseminating Health Technology Innovations, Ashish Joshi, Rinzin Wangmo, Chioma Amadi

Publications and Research

Objectives: The objective of this study was to describe the features of health informatics blogs on the Internet.

Methods: A search was conducted in August, 2016 using the search engine, Google, and key words: ‘mobile health blog,’ ‘telehealth/telemedicine blog,’ ‘Electronic Health Record blog,’ ‘personalized health record blog,’ ‘population health decision support system blog,’ and ‘public/population health dashboard blog.’ The first 24 blogs resulting from each key word search were recorded, generating 144 blogs. A total of 109 unique blogs resulted after removing duplicates and non-functional sites.

Results: Blogs with ‘.com’ extensions were most prevalent (72%, n = 79). More than …

Maternal Choline Supplementation Alters Fetal Growth Patterns In A Mouse Model Of Placental Insufficiency, Julia H. King, Sze Ting (Cecilia) Kwan, Jian Yan, Kevin C. Klatt, Xinyin Jiang, Mark S. Roberson, Marie A. Caudill

Publications and Research

Impairments in placental development can adversely affect pregnancy outcomes. The bioactive nutrient choline may mitigate some of these impairments, as suggested by data in humans, animals, and human trophoblasts. Herein, we investigated the effects of maternal choline supplementation (MCS) on parameters of fetal growth in a Dlx3+/− (distal-less homeobox 3) mouse model of placental insufficiency. Dlx3+/− female mice were assigned to 1X (control), 2X, or 4X choline intake levels during gestation. Dams were sacrificed at embryonic days E10.5, 12.5, 15.5, and 18.5. At E10.5, placental weight, embryo weight, and placental efficiency were higher in 4X versus 1X choline. Higher concentrations …

Effects Of A Multidisciplinary Weight Loss Intervention In Overweight And Obese Children And Adolescents: 11 Years Of Experience, Chiara Mameli, Jesse C. Krakauer, Nir Y. Krakauer, Alessandra Bosetti, Chiara Matilde Ferrari, Laura Schneider, Barbara Borsani, Sara Arrigoni, Erica Pendezza, Gian Vincenzo Zuccotti

Publications and Research

Aims To evaluate the effects of an outpatient multidisciplinary weight loss intervention in reducing body mass index (BMI) in children and adolescents suffering overweight and obesity, changes in A Body Shape Index (ABSI, waist circumference normalized to height and weight) and Hip Index (HI, normalized hip circumference) during treatment and correlation between the ABSI and HI with change in BMI z score.

Methods We analyze anthropometric data from pediatric patients affected by overweight and obesity aged 2 to 18 years old who entered our multidisciplinary weight loss intervention, which included medical, psychological and nutritional sessions, from January 1st 2006 to …

Divergent Secular Trends In Blood Pressure And Body Mass Index In Children And Adolescents In Hong Kong, Man Ki Kwok, Gabriel M. Leung, Thomas H.W. Chung, Karen K.Y. Lee, C. Mary Schooling

Publications and Research

Secular trends in blood pressure (BP) and body mass index (BMI) during childhood and adolescence are sentinels for the future population cardiovascular disease burden. We examined trends in BP z-score (ages 9-18 years from 1999 to 2014) and BMI z-score (ages 6-18 years from 1996 to 2014) in Hong Kong, China. Overall, BP z-score fell, systolic BP from 0.08 to -0.01 in girls and from 0.31 to 0.25 in boys. However, the trends were not consistent, for both sexes, systolic BP z-score was stable from 1999, decreased slightly from 2002 to 2005 and increased slightly to 2014, diastolic BP z-score …

Public Health Research Priorities To Address Us Human Trafficking, Emily F. Rothman, Hanni Stoklosa, Susie B. Baldwin, Makini Chisolm-Straker, Rumi Kato Price, Holly G. Atkinson

Publications and Research

In this Perspective, HEAL Trafficking, the nation's leading public health anti-trafficking organization maps out a national research agenda to tackle the problem of human trafficking. Given the paucity of research on trafficking, HEAL Trafficking engaged its membership in a consensus development process throughout 2016 to develop its national research agenda. HEAL Trafficking proposes five priorities that public health researchers should focus on in the decade ahead to make meaningful progress on preventing and responding to human trafficking in the Unites States.

Exploring The Health Effects Of Precarious Employment By Sex/Gender Using Mixed Methods, Kathleen Flandrick

Dissertations and Theses

Employment in the United States has changed dramatically since the mid-1970s. Labor market forces like globalization and diversification of the American workforce have led to a heavily segmented labor market where new types of flexible employment such as temporary, contingent, and nonstandard work arrangements are increasingly common. These newer types of work are often on the lower end of the precarious employment continuum, categorizing jobs by their degree of: 1) temporariness, 2) disempowerment, 3) vulnerability, 4) compensation (wages), 5) rights, and 6) ability to exercise worker rights. The increase in precarious employment likely disproportionately affects women when compared to men, …

The New York City Childcare Influenza Vaccine Mandate: A Case Study, Amy E. Metroka

Dissertations and Theses

Background. In 2014, New York City (NYC) became the third jurisdiction in the United States (US) to enact a childcare influenza vaccine mandate, after the states of New Jersey and Connecticut. The mandate was enacted by the NYC Board of Health by amending the NYC Health Code. The mandate’s goal was to increase vaccination rates among 6-59-month-olds attending city-regulated public and private childcare programs, including prekindergarten, to protect children, families, and the community against influenza. Children younger than 5 years are at high risk for severe illness and complications from influenza. Children are also known to be a major source …

Self-Reported Racial/Ethnic Discrimination And Bronchodilator Response In African American Youth With Asthma, Sonia Carlson, Luisa N. Borrell, Celeste Eng, Myngoc Nguyen, Shannon Thyne, Michael A. Lenoir, Nadine Burke-Harris, Esteban G. Burchard, Neeta Thakur

Publications and Research

Importance Asthma is a multifactorial disease composed of endotypes with varying risk profiles and outcomes. African Americans experience a high burden of asthma and of psychosocial stress, including racial discrimination. It is unknown which endotypes of asthma are vulnerable to racial/ethnic discrimination.

Objective We examined the association between self-reported racial/ethnic discrimination and bronchodilator response (BDR) among African American youth with asthma ages 8 to 21 years (n = 576) and whether this association varies with tumor necrosis factor alpha (TNF-α) level.

Materials and methods Self-reported racial/ethnic discrimination was assessed by a modified Experiences of Discrimination questionnaire as none or any. …

A Systematic Review Of Occupational Music-Induced Hearing Loss, Lilach Gez Saperstein

Dissertations, Theses, and Capstone Projects

The prevalence of noise induced hearing loss (NIHL) is a public health concern with government regulations (i.e. OHSA, NIOSH) in place to protect employees in occupational settings. Sound pressure levels (SPL) of various industries have been measured and exposure dosages monitored as per the national regulations. Previous research has demonstrated that occupational exposure to loud noise has led to audiometric evidence of NIHL. Thus, it raises the question about the impact of occupational exposure to music on hearing. For the purposes of this capstone, literature pertaining to occupational music exposure levels, and the effects on both hearing threshold levels and …

Narrating School, Narrative Self: Identity, Agency And The Hidden Curriculum Of (Hetero)Normativity, Mikela Bjork

Dissertations, Theses, and Capstone Projects

This dissertation analyzes sober women’s narratives of their schooling experiences to reflect on how educators and policy makers can improve the schooling experiences for othered students.. Inspired by the self-reflective and agentic pedagogy found within the figured world of Alcoholics Anonymous, I focused on the narratives of women in Alcoholics Anonymous, ages 18-85, as they narrated their schooling stories from pre-Kindergarten up to the last grade they completed. What the data of this qualitative research project reveals is that, despite the detrimental culture of denial at home and school, the participants, through the radical act of self-reflexivity and personal narrative, …

Deconstructing Rape Culture Through An Exploration Of Consent, Desire, And Pleasure, Yael Rosenstock

Dissertations, Theses, and Capstone Projects

Desire and pleasure based education combats the notion of passive consent by prioritizing positive experiences for all members involved in sexual activities. A focus on desire requires that we learn and listen to our partner’s needs and respect their boundaries. It questions a patriarchal script of sex in which male pleasure, specifically when penetrating a partner, is the critical part of the sexual act. Sex motivated by mutual desire and pleasure forces us to step back and learn, not just about our partners but ourselves, so that we may communicate our wants and needs effectively.

To understand how to navigate …

Incorporating Place And Space: A Hierarchical Spatial Approach To Exploring Preventable Congestive Heart Failure Hospitalizations In New York City, Rachael Weiss Riley

Dissertations and Theses

Background: Faced with rising medical care costs, increasing prevalence, and widening health disparities, preventing congestive heart failure (CHF) hospitalizations is a central public health concern. Despite evidence of geographical clustering in preventable CHF admissions, there is a lack of research designed to examine spatial patterning of CHF and the local area neighborhood determinants that contribute to this variability. This study sought to assess and evaluate the importance of both space and place in analyzing preventable CHF hospitalizations and readmissions by applying appropriate statistical techniques, clarifying the assumption inherent in each method, and interpreting the findings within the context of existing …

The Role Of Socioeconomic Context In The Association Between Educational Attainment And Morbidity And Mortality, Jennifer Brite

Dissertations and Theses

Although the association between educational attainment and health is one of the most studied in the social science, little is known about the role of social and economic context. Fundamental Cause Theory suggests that the education-health gradient will be weakest in contexts where the better educated are unable to leverage their resources to achieve better health. This dissertation tests several different factors that may moderate the association between educational attainment and morbidity and mortality: 1. Demographic characteristics, including race, immigration status, and gender, 2. Status consistency (defined as education equivalent to that required for current occupation), 3. Unemployment rates at …

How Much Are Ecuadorians Willing To Pay To Reduce Maternal Mortality? Results From A Pilot Study On Contingent Valuation, Maria-Isabel Roldos, Phaedra Corso, Justin Engel

Publications and Research

Context:

There is an established association between the provision of health care services and maternal mortality. In Ecuador, little is known if the societal value is greater than the resources expended in preventive medicine.

Aims:

The purpose of this research is to investigate Ecuadorians’ willingness to pay to prevent maternal death and disabilities due to complications of care during childbirth in the context of universal coverage.

Methods and Materials:

The study elicited a “contingent” market on morbidity and mortality outcomes, specific to Ecuador’s epidemiologic profiles between a hypothetical market that included a 50% reduction in the risk of maternal mortality …

Transitional Healthcare Coordination In New York City Jails Among People With Chronic Health Conditions: Contributions To Reduced Reincarceration And Improved Health, Janet J. Wiersema

Dissertations and Theses

People in correctional settings often have poorer health than the general US population. For example, it is estimated that 27.9% of persons in jail have hypertension, 8.1% have diabetes, and 1.6% have HIV, compared to 25.6%, 6.5%, and 0.5%, respectively, in the general population. Jail and other correctional settings are also increasingly recognized as viable places to engage poor and underserved communities into the healthcare system by offering transitional care coordination services to connect people to healthcare and other services to meet priorities after incarceration. At the same time, recidivism is an issue—over 50% of persons in New York City …

A Multilevel Analysis To Understand The Role Of The Federal Vaccine Financing Program In Socioeconomic Disparities In Vaccination Coverage Among Children And Adolescents In New York City, Alexandra Ternier

Dissertations and Theses

A Multilevel Analysis to Understand the Role of the Federal Vaccine Financing Program in Socioeconomic Disparities in Vaccination Coverage among Children and Adolescents in New York City

Objectives: The purpose of this study was to examine the role of the federal vaccine financing program, the Vaccines For Children (VFC) program, in vaccine series completeness among children and adolescents in New York City. In addition, we aimed to investigate possible effect measure modification by selected neighborhood variables to explain socioeconomic disparities in vaccination coverage.

Methods: We used data from the New York City (NYC) Citywide Immunization Registry (CIR) and the American …

From Food To Food Justice: Pathways And Narratives Of Young Food Activists In New York City, Amy Kwan

Dissertations and Theses

With a rise in obesity and other non-communicable, diet-related health problems and the persistence of food insecurity among many vulnerable populations, the involvement of young people in the current, burgeoning food-justice movement has the potential to bring forth transformative changes to our food system and thus improve population health. While much is known about the outcomes of providing opportunities for young people to be actively and civically engaged in their communities, there is a lack of research on the pathways, narratives, and experiences that bring young people into food justice activism.

Through semi-structured, in-depth interviews with 25 young food activists …

Quantitative Analysis Of Opioids And Cannabinoids In Wastewater Samples, Alethea Jacox

Student Theses

Wastewater-based epidemiology is an innovative approach that uses the analysis of human excretion products in wastewater to obtain information about exposure to drugs in defined population groups. We developed and validated an analytical method for the detection and quantification of opioids (morphine, oxycodone, hydrocodone, oxymorphone and hydromorphone), and cannabinoids (9-tetrahydrocannabinol, 11-nor 9-carboxy- tetrahydrocannabinol (THCCOOH) and THCCOOH-glucuronide) in raw influent wastewater samples by ultra-high performance liquid chromatography-tandem mass spectrometry. Method validation included linearity (5–1 000 ng/L for opioids, 10–1 000 ng/L for cannabinoids), imprecision (<21.2%), accuracy (83%–131%), matrix effect (from –35.1% to –14.7%) and extraction efficiency (25%–84%), limit of detection (1–5 ng/L) and quantification (5–10 ng/L) and auto-sampler stability (no loss detected). River, sewage overflow and wastewater samples were collected in triplicate from different locations in New York City and stored at -20 C until analysis. River water samples were negative for all the compounds. Water from sewage overflow location tested positive for morphine (10.7 ng/L), oxycodone (4.2–23.5 ng/L), oxymorphone (4.8 ng/L) and hydromorphone (4.2 ng/L). Wastewater samples tested positive for morphine (133.0– 258.3 ng/L), oxycodone (31.1– 63.6 ng/L), oxymorphone (16.0–56.8 ng/L), hydromorphone (6.8–18.0 ng/L), hydrocodone (4.0– 12.8 ng/L) and THCCOOH (168.2– 772.0 ng/L). This method is sensitive and specific for opioids and marijuana determination in wastewater samples.