Public Health Commons^™

Improving Public Health Readiness For Sea Level Rise: A New Initiative In Coastal Virginia, Steven M. Becker

Community & Environmental Health Faculty Publications

Sea level has been rising around the world, and in recent decades, the rate has been accelerating. Because rising seas have the potential to directly or indirectly affect the health of vast numbers of coastal communities and inhabitants, public health agencies and professionals—in conjunction with other fields—have a pivotal role to play in helping to protect populations, reduce and prevent health impacts, and foster resilience. This article discusses a novel effort that has been undertaken in Coastal Virginia to help prepare the next generation of public health professionals to grapple with sea level rise issues. The effort grew out of …

Wic Participation And Breastfeeding After The 2009 Wic Revision: A Propensity Score Approach, Kelin Li, Ming Wen, Megan Reynolds, Qi Zhang

Community & Environmental Health Faculty Publications

In this study, we examined the association between participation in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) and breastfeeding outcomes before and after the 2009 revisions. Four-thousand-three-hundred-and-eight WIC-eligible children younger than 60 months were included from the 2005-2014 National Health and Nutrition Examination Survey (NHANES). We compared two birth cohorts with regard to their associations between WIC participation and being ever-breastfed and breastfed at 6 months. We estimated the average effect of the treatment for the treated to assess the causal effect of WIC participation on breastfeeding based on propensity score matching. The results showed that …

A Single Campus Study Of The Green Dot Bystander Intervention Program, Brittany F. Hollis

Psychology Theses & Dissertations

Sexual assault is a serious public health issue that is especially problematic on college campuses. To combat sexual violence on college campuses prevention programs have been instituted by many universities. One such prevention program, the Green Dot program, works to teach students what constitutes sexual violence and how to prevent it by increasing bystander intervention. The current study examined the effectiveness of Green Dot at a large southeastern university. The Theory of Planned Behavior (TPB) was used as the theoretical framework. TPB examines how efficacy, attitudes, and norms influence behavior. Students were recruited to participate in the Green Dot program …

Factors Associated With Prolonged Length Of Stay For Elective Hepatobiliary And Neurosurgery Patients: A Retrospective Medical Record Review, Siu Yin Lee, Soo-Hoon Lee, Jenny H.H. Tan, Howard S.L. Foo, Phillip H. Phan, Alfred W.C. Kow, Sein Lwin, Penelope M.Y. Seah, Siti Zubaidah Mordiffi

Management Faculty Publications

Background: Patients with prolonged length of hospital stay (LOS) not only increase their risks of nosocomial infections but also deny other patients access to inpatient care. Hepatobiliary (HPB) malignancies have some of highest incidences in East and Southeast Asia and the management of patients undergoing HPB surgeries have yet to be standardized. With improved neurosurgery techniques for intracranial aneurysms and tumors, neurosurgeries (NS) can be expected to increase. Elective surgeries account for far more operations than emergencies surgeries. Thus, with potentially increased numbers of elective HPB and NS, this study seeks to explore perioperative factors associated with prolonged LOS for …

Range Expansion Of Tick Disease Vectors In North America: Implications For Spread Of Tick-Borne Disease, Daniel E. Sonenshine

Biological Sciences Faculty Publications

Ticks are the major vectors of most disease-causing agents to humans, companion animals and wildlife. Moreover, ticks transmit a greater variety of pathogenic agents than any other blood-feeding arthropod. Ticks have been expanding their geographic ranges in recent decades largely due to climate change. Furthermore, tick populations in many areas of their past and even newly established localities have increased in abundance. These dynamic changes present new and increasing severe public health threats to humans, livestock and companion animals in areas where they were previously unknown or were considered to be of minor importance. Here in this review, the geographic …

Association Between Acculturation And Body Weight Status Among Migrant Children In Guangzhou, China: A Cross-Sectional Study, Xiaoling Huang, Wen Chen, Yanwei Lin, Qi Zhang, Li Ling

Community & Environmental Health Faculty Publications

Objective To assess the association between acculturation and body weight status among internal migrant children in China. Design, setting and participants A cross-sectional study was conducted among 1154 pairs of migrant children aged 11–17 years and their primary caregivers in Guangzhou, China, from April to May 2016. Measures Migrant children’s body weight status was measured by body mass index. Acculturation was measured by a questionnaire, developed and validated by the research team. The questionnaire had three dimensions with five factors, namely language, social interaction, custom, dressing and diet. Social anxiety was measured by Social Anxiety Scale for Children. Food intake …

Making A Global Impact One Vaccine At A Time, Janice E. Hawkins, Deborah C. Gray

Ellmer School of Nursing Faculty Publications

(First paragraph) Did you know that, worldwide, almost one third of deaths among children under age 5 can be prevented by vaccines? It's stunning to think that one child dies every 20 seconds from an immunization-preventable disease. That equates to 12 lives that could be saved in the time it takes to read this brief article!

Needlestick Injury Prevention Training Among Health Care Workers In The Caribbean, Muge Akpinar-Elci, Satesh Bisaisee, Praveen Durgampudi, Roger Radix, Julietta Rodriquez-Guzman, Myngoc Thuy Nguyen, Omur Cinar Elci

Center for Global Health Publications

The rate of human immunodeficiency virus (HIV), hepatitis B virus (HBV), and hepatitis C virus (HCV) infections among health care workers that is caused by sharps injuries is higher in the Caribbean and Latin America than in other regions of the world. To respond to and reduce occupational exposures to bloodborne pathogens while also strengthening capacities in the Caribbean, needlestick injury prevention training programs for health care workers were implemented, beginning in 2011. The programs included lectures, workshops, policy reviews, evaluations of safety devices, and workplace assessment. During the training, baseline data from health care workers on their personal history …

A Systematic Review On The Validity Of Teledentistry, Jafar H. Alabdullah, Susan J. Daniel

Dental Hygiene Faculty Publications

Objectives: The aim of this systematic review was to evaluate the validity of using teledentistry in oral care examination and diagnosis.

Methods: In June 2016, a systematic search of the literature was conducted without time restrictions in three electronic databases (Ebscohost, Pubmed, and Scopus). Two reviewers screened the retrieved articles first by title and then by abstract to determine relevant articles for full text review. Studies included were as follows: (1) related to teledentistry, (2) available in full text and English, (3) compared teledentistry application to a gold standard, and (4) provided clear statistical tests for validity. The methodological …

Structure Of The Picornavirus Replication Platform: A Potential Drug Target For Inhibiting Virus Replication, Meghan Suzanne Warden

Chemistry & Biochemistry Theses & Dissertations

Picornaviruses are small, positive-stranded RNA viruses, divided into twelve different genera. Members of the Picornaviridae family cause a wide range of human and animal diseases including the common cold, poliomyelitis, foot and mouth disease, and dilated cardiomyopathy. The picornavirus genome is replicated via a highly conserved mechanism involving a presumed cloverleaf structure located at the 5’ noncoding region of the virus genome. The 5’ cloverleaf consists of three stem loops (B, C, and D) and one stem (A), which interact with a variety of virus and host cell proteins during replication. In this dissertation, human rhinovirus serotype 14 (HRV-14) SLB …

Temporal Trends In Human Vulnerability To Excessive Heat, Scott C. Sheridan, Michael J. Allen

Political Science & Geography Faculty Publications

Over recent decades, studies have examined various morbidity and mortality outcomes associated with heat exposure. This review explores the collective knowledge of the temporal trends of heat on human health, with regard to the hypothesis that humans are less vulnerable to heat events presently than in the past. Using Web of Science and Scopus, the authors identified all peer-reviewed articles that contained keywords on human impact (e.g. mortality, morbidity) and meteorological component (e.g. heat, heatwave). After sorting, a total of 71 articles, both case studies and epidemiological studies, contained explicit assessments of temporal trends in human vulnerability, and thus were …

Cultural Stressors, Identity Development, And Substance Use Attitudes Among Hispanic Immigrant Adolescents, Timothy J. Grigsby, Myriam Forster, Alan Meca, Byron L. Zamboanga, Seth J. Schwartz, Jennifer B. Unger

Psychology Faculty Publications

The goal of this investigation was to determine whether various cultural stressors (bicultural stress, perceived discrimination, and perceived negative context of reception [PNCR]) predict positive and negative substance use attitudes, directly and indirectly through personal identity, in a sample of immigrant Hispanic adolescents. Data on cultural stressors, substance use attitudes, and covariates were collected from 302 Hispanic immigrant adolescents (152 from Miami [61% Cuban] and 150 from Los Angeles [70% Mexican]) at 3 time points. PNCR was associated with identity confusion (𝛽=.175, p=.033). Identity confusion significantly predicted higher positive attitudes toward alcohol and other drug (AOD; 𝛽 =.216, p<.001) and cigarette use (𝛽=.191, p=.015) and mediated the relationship between PNCR with unfavorable AOD attitudes (𝛽 =-.019, 95% confidence interval [CI] [-0.052,-0.001]) and favorable AOD attitudes (𝛽=0.038, 95% CI [0.003, 0.086]). Perceptions of a negative context of reception may hinder successful personal identity formation and impact health outcomes for immigrant youth.

Workplace Bullying: A Survey Of Virginia Dental Hygienists, Gayle B. Mccombs, S. Lynn Tolle, Tara L. Newcomb, Ann M. Bruhn, Amber W. Hunt, Lanah K. Stafford

Dental Hygiene Faculty Publications

Purpose: Workplace bullying in health care has been identified as a problem that negatively affects career satisfaction, career longevity and patient outcomes. The purpose of this pilot study was to determine the prevalence of workplace bullying in a convenience sample of dental hygienists in the state of Virginia.

Methods: Two hundred and forty Virginia dental hygienists attending a continuing education seminar were invited to participate. Using the Negative Acts Questionnaire-Revised (NAQ-R), respondents were asked to indicate how often they had experienced 22 negative acts or behaviors according to rate of occurrence (never, now and then or monthly, weekly or …

Predictors Of Medical Students’ Attitudes Towards Abortion And Their Changes Overtime, Rebecca Elizabeth Morales

Sociology & Criminal Justice Theses & Dissertations

As new legislation is regularly being introduced to minimize Roe v. Wade’s protection of women’s right to choose in a medical setting, it is imperative to study what predictors may have an impact on abortion attitudes within the demographic of medical students, as well as how these predictors impact one’s willingness to provide the service in the future. The current study then, uses data collected in 2000 and 2015 from a medical school located in Virginia, and in collaboration with a research university in the state to examine what factors are associated with a willingness to provide an abortion, as …

Reducing The Rate Of Cesarean Delivery On Maternal Request Through Institutional And Policy Interventions In Wenzhou, China, Yushan Yu, Xiangyang Zhang, Caixia Sun, Huijie Zhou, Qi Zhang, Chun Chen

Community & Environmental Health Faculty Publications

The objective of this study was to evaluate the effect of institutional and policy interventions on reducing the rate of cesarean delivery on maternal request (CDMR) in Wenzhou, China. Institutional interventions included health education, painless delivery introduction, and doula care. Additionally, a series of health policies were developed by the Chinese central and local governments to control cesarean section rates, mostly through controlling CDMR rates. We conducted a pre-/post-intervention study using 131,312 deliveries between 2006 and 2014 in three tertiary-level public hospitals in Wenzhou, China. Chi-square tests and predictive models were used to examine changes in the CDMR rate before …

Demystifying Research: Accessing & Understanding Evidence For Clinical Practice, Kimberly A. Murphy, Meredith Poore Harold, Mary Huston

Communication Disorders & Special Education Faculty Publications

The demands on clinicians for evidence-based practice (EBP) are great. However, many speech-language pathologists have received little to no training in how to ‘do’ EBP. In this presentation, we aim to describe and provide practical suggestions for two of the steps in EBP—accessing, then reading and interpreting research to inform clinical decision-making. Our goal is to give clinicians the tools and confidence they need to grow into expert clinicians.

Learner Outcome 1: Describe the components of evidence-based practice (EBP)

Learner Outcome 2: Identify ways to access research

Learner Outcome 3: Identify steps in reading and evaluating the …

The Relationship Between Obesity And Periodontal Disease, Jean Conover

Dental Hygiene Master's Papers and Projects

Obesity has been targeted as the sixth most significant risk factor worldwide that is known to contribute to both oral and other associated systemic diseases.² According to the Centers for Disease Control and Prevention (CDC), the prevalence of obesity among adults in the U.S. is 40% and 18.5% in youth with prevalence higher among middle aged adults (42.8%) than younger adults (35.7%).³ As of 2016, nearly two billion people worldwide were either overweight or obese.¹ Research indicates accumulated excessive fat from being overweight or obese contributes to serious health impairments.⁴ World-wide obesity is associated with increased …

A Social-Ecological Framework Of Theory, Assessment, And Prevention Of Suicide, Robert J. Cramer, Nester D, Kapusta

Community & Environmental Health Faculty Publications

The juxtaposition of increasing suicide rates with continued calls for suicide prevention efforts begs for new approaches. Grounded in the Centers for Disease Control and Prevention (CDC) framework for tackling health issues, this personal views work integrates relevant suicide risk/protective factor, assessment, and intervention/prevention literatures. Based on these components of suicide risk, we articulate a Social-Ecological Suicide Prevention Model (SESPM) which provides an integration of general and population-specific risk and protective factors. We also use this multi-level perspective to provide a structured approach to understanding current theories and intervention/prevention efforts concerning suicide. Following similar multi-level prevention efforts in interpersonal violence …

Healthcare Outcomes And Resource Utilization Associated With Neonatal Hypoglycemia: Analysis Of Data From The Hcup Kid’S Inpatient Database, Brook T. Alemu

Health Services Research Dissertations

Neonatal hypoglycemia is the most common metabolic abnormality in infants and is associated with neurological damage and death. The risk of developing hypoglycemia among infants born from diabetic mothers is even higher. Although much work has been performed addressing issues for treatment and care, research related to neonatal hypoglycemia has been focused on the clinical or individual level risk factors. Contextual risk factors such as hospital characteristics, neighborhood economic status, and regional variations were not considered in earlier studies. Additionally, although healthcare resources utilization of hypoglycemia has been adequately addressed in the adult population, this topic has not been studied …

Effects Of A Unilateral Strength And Plyometric Training Program For Division I Soccer Players, Eric Potter

Human Movement Studies & Special Education Theses & Dissertations

The current thesis examined the effects of a unilateral strength and plyometric program on power (bilateral and unilateral vertical jumps), speed (20 meter sprint), and agility (Agility T- Test) in collegiate soccer players compared to a traditional bilateral-based training program. Due to the fact that a majority of the research on performance variables in athletes is done using bilateral lifting and plyometric programs, yet most movements in field sports such as sprinting and changing direction are unilateral-based, this specific topic could have value for enhanced performance for athletic populations. The participants included 34 male and female Division-I soccer players who …

A Web-Based Interprofessional Education Program For School Nurses And Athletic Trainers: A Pilot Study, Lauren Ashley Welsch

Health Services Research Dissertations

Background: Interprofessional education (IPE) programs have been shown effective in improving interprofessional collaborative practice (ICP) through increased communication and teamwork amongst healthcare professionals with the ultimate goal of improving patient safety and outcomes. However, their use and subsequent outcomes have not been reported amongst athletic trainers (ATs) and school nurses (SNs) in secondary school healthcare. The purpose of this study is to develop, implement and evaluate an IPE program designed to meet the needs of this unique healthcare setting. In addition, qualitative analysis will further describe the communication between ATs and SNs. Methods: A mixed method exploratory design was employed. …

Effects Of A Collaborative Care For Depression Intervention On Health Service Utilization And Depression Severity, Girlyn Arganza Cachaper

Health Services Research Dissertations

Depression is the leading cause of disability worldwide, disproportionately affecting the Medicaid population. Collaborative care programs for depression are transforming primary care to increase access and coordinate physical and behavioral health services. Understanding the relationships between components of collaborative care programs, characteristics of participants, and their effect on outcomes can maximize program effectiveness. A pilot collaborative care for depression program within a Medicaid managed care organization was evaluated using administrative claims and case management data. Participants (n=444) included adults with prior Medicaid coverage and a comparison group identified using one-to-one propensity score-matching. Multivariate logistic regression models estimated the odds of …

Advances In Developing Therapies To Combat Zika Virus: Current Knowledge And Future Perspectives, Ashok Munjal, Rekha Khandia, Kuldeep Dharma, Swati Sachan, Kumaragurubaran Karthik, Ruchi Tiwari, Yashpal S. Malik, Deepak Kumar, Raj K. Singh, Hafiz M. N. Iqbal, Sunil K. Joshi

Bioelectrics Publications

Zika virus (ZIKV) remained largely quiescent for nearly six decades after its first appearance in 1947. ZIKV reappeared after 2007, resulting in a declaration of an international “public health emergency” in 2016 by the World Health Organization (WHO). Until this time, ZIKV was considered to induce only mild illness, but it has now been established as the cause of severe clinical manifestations, including fetal anomalies, neurological problems, and autoimmune disorders. Infection during pregnancy can cause congenital brain abnormalities, including microcephaly and neurological degeneration, and in other cases, Guillain-Barré syndrome, making infections with ZIKV a substantial public health concern. Genomic and …

The Effect Of Magnification Loupes On Dental Hygienists' Posture While Exploring, Emily Ludwig, Gayle B. Mccombs, Susan L. Tolle, Daniel M. Russell

Dental Hygiene Faculty Publications

Purpose: The purpose of this study was to determine the effects of dental magnification loupes on posture during instrumentation.

Methods: A convenience sample of 27 right-handed dental hygienists, with no prior history of injuries or disabilities of the head, neck, or trunk region, enrolled in the study. Baseline posture calibration was taken and tri-axial accelerometers were placed on four locations of the head and trunk (occipital region of head; cervical vertebrae C5; thoracic vertebrae T5; lumbar vertebrae L1) to measure acceleration and the orientation of the body to gravity. Participants were randomly assigned to wear self-supplied magnification loupes during either …

Unmet Needs And Service Utilization By Informal Caregivers, Ryan Marie Diduk-Smith

Health Services Research Dissertations

The number of Americans expected to live into their 80’s and 90’s is growing at an increased rate in the United States, and the numbers of those aging adults with multiple chronic conditions also continues to grow. It is estimated that by 2050, there will be 89 million adults over the age of 65 years living in the United States. For a variety of reasons, including policy, personal, and financial reasons, many aging adults are choosing to “age in place” or to remain in the community. With the increase in the numbers of aging adults in the community, the ability …

Alcohol And Substance Use Knowledge, Attitudes, Subjective Norms, Self-Efficacy, Perceived Behavioral Control, And Behavioral Intentions Among Omani College Students, Muna S. Bait Ajzoon

Health Services Research Dissertations

Alcohol and/or substance use among college students is a serious public health issue. In Oman, studies addressing college student’s alcohol and/or substance use are limited. The purpose of this study was to identify knowledge, attitudes, subjective norms, self-efficacy, and perceived behavioral control associated with alcohol and/or substance usage patterns among Omani college students (OCSs); identify behavioral intentions for alcohol and/or substance use among OCSs; and facilitate the development of culturally relevant evidenced-based interventions for Omani young people by communicating study findings to policymakers and healthcare program leaders.

A cross-sectional design used an online survey completed by college students from Oman …

Protective Factors Against Peer And Social Media Sex Messages: The Moderating Role Of Parental Influences On African American Emerging Adult Students' Sexual Behaviors, Jacqueline Eunice Haywood

Psychology Theses & Dissertations

The most recent research on risky sexual behaviors is primarily based on adolescent, predominately White, or multiple race (e.g., African American and White) samples. There is a paucity of literature focused exclusively on African Americans, particularly African American emerging adults between the ages of 18 and 25. Given the increased risk for sexually transmitted infections (STIs) for college aged African Americans, it is important to understand factors that may decrease engaging in risky sexual behaviors that are specific to this group. The current study examined the roles of parental warmth and communication about sex as protective factors. Participants (n = …

Sexual Orientation Differences In Treatment Expectation, Alliance, And Outcome Among Patients At Risk For Suicide In A Public Psychiatric Hospital, Martin Plöderl, Sabine Kunrath, Robert J. Cramer, Jen Wang, Larissa Hauer, Clemens Fartacek

Community & Environmental Health Faculty Publications

BACKGROUND: Sexual minority (SM) individuals (gay, lesbian, bisexual, or otherwise nonheterosexual) are at increased risk for mental disorders and suicide and adequate mental healthcare may be life-saving. However, SM patients experience barriers in mental healthcare that have been attributed to the lack of SM-specific competencies and heterosexist attitudes and behaviors on the part of mental health professionals. Such barriers could have a negative impact on common treatment factors such as treatment expectancy or therapeutic alliance, culminating in poorer treatment outcomes for SM versus heterosexual patients. Actual empirical data from general psychiatric settings is lacking, however. Thus, comparing the treatment outcome …

Ebola Virus - Epidemiology, Diagnosis, And Control: Threat To Humans, Lessons Learnt, And Preparedness Plans - An Update On Its 40 Year's Journey, Raj Kumar Singh, Kuldeep Dhama, Yashpal Singh Malik, Muthannan Andavar Ramakrishnan, Kumaragurubaran Karthik, Rekha Khandia, Ruchi Tiwari, Ashok Munjal, Mani Saminathan, Perumal Arumugam, Sunil Kumar Joshi

Bioelectrics Publications

Ebola virus (EBOV) is an extremely contagious pathogen and causes lethal hemorrhagic fever disease in man and animals. The recently occurred Ebola virus disease (EVD) outbreaks in the West African countries have categorized it as an international health concern. For the virus maintenance and transmission, the non-human primates and reservoir hosts like fruit bats have played a vital role. For curbing the disease timely, we need effective therapeutics/prophylactics, however, in the absence of any approved vaccine, timely diagnosis and monitoring of EBOV remains of utmost importance. The technologically advanced vaccines like a viral-vectored vaccine, DNA vaccine and virus-like particles are …

Sleep Disorders And Kidney Transplant Outcomes: Findings From An 18-Year (1997-2015) Historical Cohort Study, Margaret M. Lubas

Health Services Research Dissertations

A historic cohort study of kidney transplant recipients with a failed graft was conducted to examine the associations between sleep disorders and kidney transplant outcomes. Adult kidney transplant recipients who were transplanted and failed or died with a functioning graft during the designated study time period (January 1, 1997 to September 1, 2015, inclusive) were included (n=299). The primary independent variables, any sleep disorder and any sleep-disordered breathing disorders, were defined through a diagnosis in a subject’s medical record. Transplant outcomes included: death with a functioning graft, graft survival time, and patient survival time after graft failure.

Chi-square statistics were …