Public Health Commons^™

Saludableomaha: Improving Readiness To Address Obesity Through Healthy Lifestyle In A Midwestern Latino Community, 2011–2013, Leah Frerichs, Jeri Brittin, Regina Robbins, Sharalyn Steenson, Catherine Stewart, Christopher Fisher, Terry T-K Huang

Publications and Research

Background A community’s readiness for change is a precursor to the effective application of evidence-based practices for health promotion. Research is lacking regarding potential strategies to improve readiness to address obesity-related health issues in underserved communities.

Community Context This case study describes SaludABLEOmaha, an initiative to increase readiness of residents in a Midwestern Latino community to address obesity and adopt healthy lifestyles.

Methods SaludABLEOmaha emphasized 2 core approaches, youth activism and collaboration among public and private institutions, which we applied to planning and implementing tactics in support of 3 interconnected strategies: 1) social marketing and social media, 2) service learning …

Maternal Characteristics And Clinical Diagnoses Influence Obstetrical Outcomes In Indonesia, Asri Adisasmita, Carl V. Smith, Ayman A.E. El-Mohandes, Poppy Elvira Deviany, Judith J. Ryon, Michele Kiely, Quail Rogers-Bloch, Reginald F. Gipson

Publications and Research

This Indonesian study evaluates associations between near-miss status/death with maternal demographic, health care characteristics, and obstetrical complications, comparing results using retrospective and prospective data. The main outcome measures were obstetric conditions and socio-economic factors to predict near-miss/death. We abstracted all obstetric admissions (1,358 retrospective and 1,240 prospective) from two district hospitals in East Java, Indonesia between 4/1/2009 and 5/15/2010. Prospective data added socio-economic status, access to care and referral patterns. Reduced logistic models were constructed, and multivariate analyses used to assess association of risk variables to outcome. Using multivariate analysis, variables associated with risk of near-miss/death include postpartum hemorrhage (retrospective …

Target Zero: Why States Choose To Eradicate Infectious Diseases And How They Succeed, Gifty Abraham

Dissertations, Theses, and Capstone Projects

Realism has remained the dominant paradigm within international relations for most of the modern era, emphasizing the competitive nature of the international arena and the unlikeliness of states to within it to cooperate. The attempts and further still, successes, by states to eradicate infectious diseases--which remain among the most cooperative enterprises--present a number of challenges to realism's assumptions, particularly with respect to the unlikely world historical-times during which the eradication campaigns took place. As such, a two-part puzzle arises. First, why would states, which are natural competitors, cooperate to eradicate infectious diseases given structural and situational incentives not to do …

Risk Factors And Costs Influencing Hospitalizations Due To Heat-Related Illnesses: Patterns Of Hospitalization, Michael T. Schmeltz

Dissertations, Theses, and Capstone Projects

The objective of this dissertation was to identify individual and environmental risk factors, investigate outcomes and hospital resource use, including costs, and document the pattern of heat-related illness hospitalizations in the United States. The main data source for the study population was the 2001-2010 Nationwide Inpatient Sample (NIS). The study population for heat-related illnesses (HRIs) consists of patients in the NIS with at least one diagnosis of a heat-related illness (ICD-9 codes 992.0 - 992.9) from 2001 to 2010. Outcome analysis included a study population of patients who had primary or secondary diagnoses of diabetes, cardiovascular diseases, respiratory illnesses, nephritic …

An Examination Of The Effect Of Vision-Related Factors And Availability Of Health Care Resources On Depression, Functional Status, And Falls Among New York City Senior Center Attendees, Lauren Evans

Dissertations, Theses, and Capstone Projects

There is substantial variability across different geographic regions and demographic groups in health outcomes and health resource availability. This dissertation examines the relationship between self-reported ocular disease and depression, functional status, and falls in a diverse sample of senior center attendees in New York City. Further, these analyses explored whether the availability of health care resources at the area level affects the observed relationship between ocular disease and these other adverse outcomes.

This dissertation project addresses two main gaps in the current research, specifically, the need to better understand elders' experiences with these conditions in different geographic regions and demographic …

The Impact Of Dentures On The Nutritional Health Of The Elderly, Michelle Gellar, Daniel Alter

Publications and Research

No abstract provided.

What The Obesity Prevention Field Can Learn From The Gay Marriage Movement, Sergio Costa, Emily Ferris, Terry T-K Huang

Publications and Research

In the US, two-thirds of adults and one-third of children continue to be affected by overweight or obesity despite two decades and billions of dollars' spent in public health efforts. In the last decade, public health has stepped up its call for greater emphasis on environmental and policy interventions, including active designs in urban planning and restrictions on food marketing to children, to incentivize healthy behaviors and disincentivize less healthy ones. However, there has been little success in policy change to prevent obesity. Voters in Berkeley, CA recently passed a one-cent-per-ounce soda tax, but a similar measure was defeated by …

Challenging Race-Based Stereotypes About Gay And Bisexual Men’S Sexual Behavior And Perceived Penis Size And Size Satisfaction, Christian Grov, Lena D. Saleh, Jonathan M. Lassiter, Jeffrey T. Parsons

Publications and Research

Racial prejudice and stereotyping in gay and bisexual communities may be important contextual factors that contribute to racial disparities in HIV. In an effort to challenge race-based stereotypes regarding gay and bisexual men’s sexuality, we sought to determine the extent to which race and ethnicity were associated with (1) racial homophily (i.e., same-race partnerships), (2) sexual behavior (e.g., number of partners, condomless anal sex (CAS), sexual position (top/versatile/bottom)), and (3) perceived penis size and size satisfaction. Data were taken from a survey of 1,009 gay and bisexual men recruited using a street-intercept method at gay, lesbian, and bisexual community events …

Is It Time To Consider The "Burnout Syndrome" A Distinct Illness?, Renzo Bianchi, Irvin Sam Schonfeld, Eric Laurent

Publications and Research

The "burnout syndrome" has been defined as a combination of emotional exhaustion, depersonalization, and reduced personal accomplishment caused by chronic occupational stress. Although there has been increasing medical interest in burnout over the last decades, it is argued in this paper that the syndrome cannot be elevated to the status of diagnostic category, based on (1) an analysis of the genesis of the burnout construct, (2) a review of the latest literature on burnout-depression overlap, (3) a questioning of the three-dimensional structure of the burnout syndrome, and (4) a critical examination of the notion that burnout is singularized by its …

Is Burnout Separable From Depression In Cluster Analysis? A Longitudinal Study, Renzo Bianchi, Irvin Sam Schonfeld, Eric Laurent

Publications and Research

Purpose: Whether burnout and depression represent distinct pathologies is unclear. The aim of this study was to examine whether burnout and depressive symptoms manifest themselves separately from each other or are so closely intertwined as to reflect the same phenomenon.

Methods: A two-wave longitudinal study involving 627 French schoolteachers (73 % female) was conducted. Burnout was assessed with the Maslach Burnout Inventory and depression with the 9-item depression module of the Patient Health Questionnaire.

Results: Burnout and depressive symptoms clustered both at baseline and follow-up. Cluster membership at time 1 (T1) predicted cases of burnout and depression at time 2 …

Motivational Interviewing Targeting Risky Sex In Hiv-Positive Young Thai Men Who Have Sex With Men, Chokechai Rongkavilit, Bo Wang, Sylvie Naar-King, Torsak Bunupuradah, Jeffrey T. Parsons, Apirudee Panthong, Juline Koken, Pichai Saengcharnchai, Praphan Phanuphak

Publications and Research

Motivational interviewing (MI) has been shown to reduce sexual risks among HIV-positive men who have sex with men (HMSM) in the US. We conducted a randomized trial of Healthy Choices, a 4-session MI intervention, targeting sexual risks among 110 HIV-positive youth ages 16–25 years in Thailand. Risk assessments were conducted at baseline, 1 month, and 6 months post-intervention. This report presents the analysis of 74 HMSM in the study. There were 37 HMSM in the Intervention group and 37 in the control group. The proportions of participants having anal sex and having sex with either HIV-uninfected or unknown partners in …

Patterns Of Client Behavior With Their Most Recent Male Escort: An Application Of Latent Class Analysis, Christian Grov, Tyrel J. Starks, Margaret Wolff, Michael D. Smith, Juline Koken, Jeffrey T. Parsons

Publications and Research

Research examining interactions between male escorts and clients has relied heavily on data from escorts, men working on the street, and behavioral data aggregated over time. In the current study, 495 clients of male escorts answered questions about sexual behavior with their last hire. Latent class analysis identified four client sets based on these variables. The largest (n = 200, 40.4 %, labeled Typical Escort Encounter) included men endorsing behavior prior research found typical of paid encounters (e.g., oral sex and kissing). The second largest class (n = 157, 31.7 %, Typical Escort Encounter + Erotic Touching) included men reporting …

Obesity, Food Intake And Exercise: Relationship With Ghrelin, G. Tiryaki-Sonmez, Serife Vatansever, Burcin Olcucu, Brad J. Schoenfeld

Publications and Research

Obesity, a disorder of body composition, is defined by a relative or absolute excess of body fat. In general adult population, obesity has been associated with a diverse array of adverse health outcomes, including major causes of death such as cancer, diabetes, cardiovascular disease, as well as functional impairment from problems such as osteoarthritis and sleep apnea. Ghrelin is a newly discovered peptide hormone which plays an important role in obesity. It is a powerful, endogenous orexigenic peptide and has a crucial function in appetite regulation, as well as short – and long-term energy homeostasis. In the presence of increased …

Computer-Based Video To Increase Hiv Testing Among Emergency Department Patients Who Decline, Ian David Aronson, Lisa A. Marsch, Sonali Rajan, Juline Koken, Theodore C. Baina

Publications and Research

The Centers for Disease Control and Prevention recommend routine HIV screening in clinical settings, including emergency departments (EDs), because earlier diagnosis enables treatment before symptoms develop and delivery of interventions to reduce continued transmission. However, patients frequently decline testing. This study delivered a 16-min video-based intervention to 160 patients who declined HIV tests in a high volume, urban ED. One third of participants (n = 53) accepted an HIV test post-intervention. Interviews with a subset of participants (n = 40) show that before the video, many were unaware HIV testing could be conducted without drawing blood, or that results could …

A Neural Network Analysis Of Treatment Quality And Efficiency Of Hospitals, Viju Raghupathi, Wullianallur Raghupathi

Publications and Research

Objectives: Due to the escalating healthcare expenditure and the number of hospitalizations, it is becoming increasingly important for healthcare organizations to evaluate the cost and improve the quality and efficiency of treatment.

Method: We deploy neural networks to examine the strategic association between hospitalization experience and treatment results. The healthcare data for the years 2009-2012 are downloaded from the Statewide Planning and Research Cooperative System (SPARCS) of the New York State Department of Health (NYSDOH). We operationalize the hospitalization experience using the indicators facility ID, procedure description, type of admission, patient disposition upon discharge, APR severity of illness, source of …

Physical, Cognitive, Social And Mental Health In Near-Centenarians And Centenarians Living In New York City: Findings From The Fordham Centenarian Study, Daniela S. Jopp, Min-Kyung S. Park, Jonathan Lehrfeld, Michelle E. Paggi

Publications and Research

Background: Despite their strong increase, the population of the very old, including near-centenarians and centenarians, represent an unstudied and underserved population. Available studies mostly concentrate on predictors of exceptional longevity, but rarely extend their focus to other areas of functioning. Also, little is known about what contributes to experiencing a quality life in very old age. The present population-based study aims at providing a comprehensive picture of key domain of functioning, including physical, cognitive, social and mental function in very old individuals and to determine predictors of mental health indicators.

Methods: A total of 119 individuals aged 95 to 107 …

Burnout-Depression Overlap: A Review, Renzo Bianchi, Irvin Sam Schonfeld, Eric Laurent

Publications and Research

Whether burnout is a form of depression or a distinct phenomenon is an object of controversy. The aim of the present article was to provide an up-to-date review of the literature dedicated to the question of burnout–depression overlap. A systematic literature search was carried out in PubMed, PsycINFO, and IngentaConnect. A total of 92 studies were identified as informing the issue of burnout–depression overlap. The current state of the art suggests that the distinction between burnout and depression is conceptually fragile. It is notably unclear how the state of burnout (i.e., the end stage …

Predicting Antidepressant Treatment Without Controlling For Depression Is Ill-Advised, Renzo Bianchi, Irvin Sam Schonfeld, Eric Laurent

Publications and Research

All in all, the link observed by Madsen et al. (2015) between burnout and antidepressant intake may well conceal an expected relationship between depression and antidepressant intake. The impossibility of ruling out this reasonable alternative hypothesis renders the study inconclusive. We recommend that future research on (psychotherapeutic or pharmacologic) treatments for burnout incorporate measures of depression in order to facilitate research advance on burnout's characterization and burnout-depression overlap.

Burnout: Absence Of Binding Diagnostic Criteria Hampers Prevalence Estimates, Renzo Bianchi, Irvin Sam Schonfeld, Eric Laurent

Publications and Research

Comments on an article by Jef Adriaenssens et al. (see record 2015-00662-015). In a recent review paper, Adriaenssens et al. concluded that about 26% of emergency nurses (EN) suffer from burnout and described their results as alarming. While commentators applaud Adriaenssens et al. efforts to provide a clearer picture of ill-health in EN, they thought that these authors' conclusions were weakened by a fundamental fact, namely, the absence of consensual, clinically valid diagnostic criteria for burnout. Trying to determine the prevalence of a condition that has no binding diagnostic criteria is problematic. Indeed, depending on how researchers decide to …

Bayesian Nonparametric Cross-Study Validation Of Prediction Methods, Lorenzo Trippa, Levi Waldron, Curtis Huttenhower, Giovanni Parmigiani

Publications and Research

We consider comparisons of statistical learning algorithms using multiple data sets, via leave-one-in cross-study validation: each of the algorithms is trained on one data set; the resulting model is then validated on each remaining data set. This poses two statistical challenges that need to be addressed simultaneously. The first is the assessment of study heterogeneity, with the aim of identifying a subset of studies within which algorithm comparisons can be reliably carried out. The second is the comparison of algorithms using the ensemble of data sets. We address both problems by integrating clustering and model comparison. We formulate a Bayesian …

Patchy Progress On Obesity Prevention: Emerging Exemplars, Entrenched Barriers, And New Thinking, Christina A. Roberto, Boyd Swinburn, Corinna Hawkes, Terry T-K Huang, Sergio Costa, Marice Ashe, Lindsey Zwicker, John H. Cawley, Kelly D. Brownell

Publications and Research

Although there have been positive pockets of change, no country has yet turned around its obesity epidemic. Preventing an increase in obesity prevalence will require urgent actions from government as well as a broader spectrum of stakeholders than previously emphasized. In this paper, we review a number of regulatory and non-regulatory actions taken around the world to address obesity and discuss some of the reasons for the patchy progress. In addition, we preview the papers in this Lancet series, which each identify priority actions on key obesity issues and challenge some of the entrenched dichotomies that present obesity and its …

Exploring Social Networking Technologies As Tools For Hiv Prevention For Men Who Have Sex With Men, Jorge Ramallo, Thomas Kidder, Tashuna Albritton, Gary Blick, John Pachankis, Valen Grandeleski, Trace Kershaw

Publications and Research

Social networking technologies are influential among men who have sex with men (MSM) and may be an important strategy for HIV prevention. We conducted focus groups with HIV positive and negative participants. Almost all participants used social networking sites to meet new friends and sexual partners. The main obstacle to effective HIV prevention campaigns in social networking platforms was stigmatization based on homosexuality as well as HIV status. Persistent stigma associated with HIV status and disclosure was cited as a top reason for avoiding HIV-related conversations while meeting new partners using social technologies. Further, social networking sites have different social …

Promoting Colorectal Cancer Screening Among Haitian Americans, Steven S. Coughlin, Erica I. Lubetkin, Jennifer L. Hay, Renald Raphael, Selina A. Smith

Publications and Research

Background

Few studies have examined colorectal cancer screening among Haitian Americans, although striking disparities in colorectal cancer screening and mortality are well-documented among U.S. Blacks. Race, socioeconomic status, and place of birth are factors associated with colorectal cancer incidence and mortality patterns.

Methods

In this article, we summarize published studies on colorectal cancer screening among Haitian Americans, identified through bibliographic searches in PubMed and CINAHL through August 2015, and offer recommendations for further research.

Results

Only one qualitative study and three quantitative surveys have examined colorectal cancer screening among Haitian Americans. A qualitative study found important differences in perceptions of …

Turning Waste Into Resources In Haiti, Alexis Barnes

Capstones

Sanitation infrastructure in Haiti is an ongoing problem- one that only exacerbated a massive cholera epidemic brought to the country by Nepalese United Nations peacekeeping troops. SOIL is an NGO that works in alternative sanitation- using "urine-diverting dry toilets" to turn waste into a fertile resource. In my capstone, I explore the potential for alternative sanitation in Haiti, how it works and what internal and external political and economic factors lead to the current state of water and sanitation infrastructure in the country.

Mcdonald's Or Mesquite: Struggles On The Salt River Pima Reservation, Stefani Kim

Capstones

The Salt River Pima Indians, prior to colonization, had a strong tradition of harvesting and food sovereignity. As the tribe adapted to a more Westernized diet which consisted mainly of processed food rations, the rate of diabetes began to skyrocket on the reservation and, at one point, the tribe had one of the highest per capita diabetes rates in the world. This year, the tribe's cultural resources department will resurrect a 16-year-old community garden program originally funded by a USDA/Habitat for Humanity grant as a way to help combat health problems related to a poor diet such as diabetes and …

Urgent Cares Outpace Health Policy In The U.S., Ashley Rodriguez

Capstones

More and more medical practices across the country are rebranding themselves as urgent care centers to meet the growing demand for fast, affordable health care. In many states, they are regulated like physicians groups. However, there is a debate brewing among health care policy experts and government officials over whether these centers should have their own regulations. Such oversight could help patients expecting acute care avoid confusion to such a degree that they receive poor treatment from professionals who aren’t prepared to offer emergency services, or delayed treatment because they are bounced around from facility to facility.

Rationale, Design, And Method Of The Diabetes & Women’S Health Study – A Study Of Long-Term Health Implications Of Glucose Intolerance In Pregnancy And Their Determinants, Cuilin Zhang, Frank B. Hu, Sjurdur F. Olsen, Allan Vaag, Robert Gore-Langton, Jorge E. Chavarro, Wei Bao, Edwina Yeung, Katherine Bowers, Louise Groth Grunnet, Seth Sherman, Michele Kiely, Marin Strøm, Susanne Hansen, Aiyi Liu, James Mills, Ruzong Fan

Publications and Research

Women who develop gestational diabetes mellitus or impaired glucose tolerance during pregnancy are at substantially increased risk for type 2 diabetes and comorbidities after pregnancy. Little is known about the role of genetic factors and their interactions with environmental factors in determining the transition from gestational diabetes mellitus to overt type 2 diabetes mellitus. These critical data gaps served as the impetus for this Diabetes & Women’s Health study with the overall goal of investigating genetic factors and their interactions with risk factors amenable to clinical or public health interventions in relation to the transition of gestational diabetes mellitus to …

Explaining Racial/Ethnic Disparities In Use Of High-Volume Hospitals: Decision-Making Complexity And Local Hospital Environments, Karl Kronebusch, Bradford H. Gray, Mark Schlesinger

Publications and Research

Racial/ethnic minorities are less likely to use higher-quality hospitals than whites. We propose that a higher level of informationrelated complexity in their local hospital environments compounds the effects of discrimination and more limited access to services, contributing to racial/ethnic disparities in hospital use. While minorities live closer than whites to high-volume hospitals, minorities also face greater choice complexity and live in neighborhoods with lower levels of medical experience. Our empirical results reveal that it is generally the overall context associated with proximity, choice complexity, and local experience, rather than differential sensitivity to these factors, that provides a partial explanation of …

Effects Of Extreme Climate Events On Tea (Camellia Sinensis) Functional Quality Validate Indigenous Farmer Knowledge And Sensory Preferences In Tropical China, Selena Ahmed, John Richard Stepp, Colin M. Orians, Timothy S. Griffin, Corene Matyas, Albert Robbat, Sean Cash, Dayuan Xue, Chunlin Long, Uchenna Unachukwu, Sarabeth Buckley, Edward J. Kennelly

Publications and Research

Climate change is impacting agro-ecosystems, crops, and farmer livelihoods in communities worldwide. While it is well understood that more frequent and intense climate events in many areas are resulting in a decline in crop yields, the impact on crop quality is less acknowledged, yet it is critical for food systems that benefit both farmers and consumers through high-quality products. This study examines tea (Camellia sinensis; Theaceae), the world’s most widely consumed beverage after water, as a study system to measure effects of seasonal precipitation variability on crop functional quality and associated farmer knowledge, preferences, and livelihoods. Sampling was conducted in …

A Meta-Analysis Of The Prediction Of Violence Among Adults With Mental Disorders, Hing Po Lam

Dissertations, Theses, and Capstone Projects

The study of the risk for violence among persons with mental disorders has received substantial scientific attention over the past few decades; however, many uncertainties and controversies remain due to the wide disparities in the reported results. Using the state-of-the-art perspective of public health, a meta-analysis was conducted to clarify the ambiguities by synthesizing quantitative findings from 85 research reports (completed between January 1970 and May 2010) on violence risk assessment among mentally disordered adults. Results of this meta-analytic study revealed that the estimates of the prevalence of violence among the psychiatric population varied considerably from 1.1% to 78.4% with …