Public Health Commons^™

Quality Of Life Of Families With Children Who Have Severe Developmental Disabilities: A Comparison Based On Child Residence, Joni Taylor Mcfelea, Sharon Raver

Communication Disorders & Special Education Faculty Publications

This study measured the quality of life of two groups of families with children who had severe developmental disabilities-families whose child lived at home and families whose child lived in a residential facility. Participants were 54 primary caregivers of children who had severe intellectual disabilities and who lacked the ability to both ambulate without assistance and communicate conversationally. Participants completed the "Family Quality of Life Scale" (Hoffman, Marquis, Poston, Summers, & Turnbull, 2006). Analyses revealed that both groups rated their family quality of life (FQOL) as exemplary. FQOL was higher in the family home group than in the residential facility …

Victimization From Bullying Among School-Attending Adolescents In Grades 7 To 10 In Zambia, Seter Siziya, Emmanuel Rudatsikira, Adamson S. Muula

Community & Environmental Health Faculty Publications

Background:

Among school- attending adolescents, victimization from bullying is associated with anxiety, depression and poor academic performance. There are limited reports on victimization from bullying in Zambia; we therefore conducted this study to determine the prevalence and correlates for victimization from bullying among adolescents in grades 7 to 10 in the country in order to add information on the body of knowledge on victimization from bullying.

Methods:

The 2004 Zambia Global School-based Health Survey (GSHS) data among adolescents in grades 7 to 10 were obtained from the World Health Organization. We estimated the prevalence of victimization from bullying. We also …

A System Dynamics Model For Simulating Ambulatory Health Care Demands, Rafael Diaz, Joshua G. Behr, Mandar Tulpule

VMASC Publications

Introduction: This article demonstrates the utility of the system dynamics approach to model and simulate US demand for ambulatory health care service both for the general population and for specific cohort subpopulations over the 5-year period, from 2003 to 2008. A system dynamics approach that is shown to meaningfully project demand for services has implications for health resource planning and for generating knowledge that is critical to assessing interventions.

Methods: The study uses a cohort-component method in combination with structural modeling to simulate ambulatory health care utilization. Data are drawn from the National Ambulatory Medical Care Survey and the National …

Analyzing The Effects Of Policy Options To Mitigate The Effect Of Sea Level Rise On The Public Health And Medically Fragile Population: A System Dynamics Approach, Rafael Diaz, Joshua Behr, Anna Jeng, Hua Liu, Franceso Longo

VMASC Publications

A critical question related to climate change concerns to how rising sea level will affect underserved populations and medically fragile population in coastal zones and floodplains. As sea levels rise, coastal waters will regain near-tidal areas and co-mingle with human-made pollutants, resulting from decades of industrial and commercial activity. This poses potential threat and risks to public health and the environment. It is critical that decision makers will initiate a process of parsing resources to the mitigation and management of these issues. The purpose of this research is to model the inherent dynamics of this process and understand how near-term …

Prevalence And Correlates For School Truancy Among Pupils In Grades 7-10: Results From The 2004 Zambia Global School-Based Health Survey, Adamson S. Muula, Emmanuel Rudatsikira, Olusegun Babaniyi, Peter Songolo, Seter Siziya

Community & Environmental Health Faculty Publications

Background

There are limited data on the prevalence and associated factors of truancy in southern Africa. Yet truancy should attract the attention of public health professionals, educators and policy makers as it may be associated with adolescent problem behaviours. The objectives of the study were to estimate the prevalence and determine correlates of school truancy among pupils in Zambia.

Findings

We used data collected in 2004 in the Zambia Global School-based Health Survey. Logistic regression analysis was conducted to identify factors associated with truancy. A total of 2257 pupils participated in the survey of whom 53.9% were male. Overall 58.8% …

Effect Of A Physician Uncertainty Reduction Intervention On Blood Pressure In Uncontrolled Hypertensives-A Cluster Randomized Trial, David J. Hyman, Valory N. Pavik, Anthony J. Greisinger, Wenyaw Chan, Jose Bayona, Carol Mansyur, Victor Simjms, James Pool

Community & Environmental Health Faculty Publications

BACKGROUND: Clinical inertia, provider failure to appropriately intensify treatment, is a major contributor to uncontrolled blood pressure (BP). Some clinical inertia may result from physician uncertainty over the patient’s usual BP, adherence, or value of continuing efforts to control BP through lifestyle changes.

OBJECTIVE: To test the hypothesis that providing physicians with uncertainty reduction tools, including 24-h ambulatory BP monitoring, electronic bottle cap monitoring, and lifestyle assessment and counseling, will lead to improved BP control.

DESIGN: Cluster randomized trial with five intervention clinics (IC) and five usual care clinics (UCC).

SETTING: Six public and 4 private primary care clinics.

PARTICIPANTS: …

Delineating Interpersonal Communication Networks: A Study Of The Diffusion Of An Intervention Among Female Entertainment Workers In Shanghai, China, Yiyun Chen, Carl Latkin, David D. Celentano, Xiushi Yang, Xiaoming Li, Guomei Xia

Sociology & Criminal Justice Faculty Publications

Diffusion of innovation (DOI) is widely cited in the HIV behavior change literature; however there is a dearth of research on the application of DOI in interventions for sex workers. Following a randomized-controlled trial of HIV risk reduction among female entertainment workers (FEWs) in Shanghai, China, we used qualitative approaches to delineate potential interpersonal communication networks and contributing factors that promote diffusion of information in entertainment venues. Results showed that top-down communication networks from the venue owners to the FEWs were efficient for diffusion of information. Mammies/madams, who act as intermediaries between FEWs and clients form an essential part of …

Are Low Wages Risk Factors For Hypertension?, J. Paul Leigh, Juan Du

Economics Faculty Publications

Objective: Socio-economic status (SES) is strongly correlated with hypertension. But SES has several components, including income and correlations in cross-sectional data need not imply SES is a risk factor. This study investigates whether wages-the largest category within income-are risk factors. Methods: We analysed longitudinal, nationally representative US data from four waves (1999, 2001, 2003 and 2005) of the Panel Study of Income Dynamics. The overall sample was restricted to employed persons age 25-65 years, n = 17 295. Separate subsamples were constructed of persons within two age groups (25-44 and 45-65 years) and genders. Hypertension incidence was self-reported based on …

An Examination Of Factors Affecting Non-Urgent Use Of Emergency Department Services By Patients With "Universal" Healthcare, Gregory Smith Feltenberger

Health Services Research Dissertations

The purpose of this research is to examine the factors affecting non-urgent utilization of emergency department (ED) services by individuals with "universal" healthcare using the Behavioral Model of Health Services Use. Since Air Force Medical Service beneficiaries have free and unlimited use of the full-range of healthcare services, they are ideally suited for this study. The findings of this research may also apply to other populations with free or low-cost access to healthcare (i.e., universal or single-payer healthcare). Using secondary data extracted from the Air Force Medical Service's electronic health record system at several military hospitals, this study will present …

Intimate Partner Physical Violence Against Women In Saudi Arabian Primary Healthcare Clinics, Halah M. Eldoseri

Health Services Research Dissertations

Intimate partner violence against women (IPPVAW) is a serious public health concern. The Ecological Model provides a model to study several factors associated with IPPVAW. In Saudi Arabia, studies addressing IPPVAW are limited and do not cover the various aspects of the problem. The purpose of this study was to investigate the various factors associated with IPPVAW at the personal, interpersonal, community and societal levels. Methods: 200 ever-married women attending six PHC in Jeddah, Saudi Arabia were recruited via convenient sampling method. Women were interviewed on factors related to IPPVAW using an adapted version of WHO survey for violence against …

Use Of Optimal Control Models To Predict Treatment Time For Managing Tick-Borne Disease, Holly D. Gaff, Elsa Schaefer, Suzanne Lenhart

Biological Sciences Faculty Publications

Tick-borne diseases have been on the rise recently, and correspondingly, there is an increased interest in implementing control measures to decrease the risk. Optimal control provides an ideal tool to identify the best method for reducing risk while accounting for the associated costs. Using a previously published model, a variety of frameworks are assessed to identify the key factors influencing mitigation strategies. The level and duration of tick-reducing efforts are key metrics for understanding the successful reduction in tick-borne disease incidence. The results show that the punctuated nature of the tick's life history plays a critical role in reducing risk …

Using Modeling And Simulation To Improve Oral Health Services Delivery In Hampton Roads, Virginia, Mohammad J. Alzahrani

Health Services Research Dissertations

The purpose of this study is to examine the system performance in delivering oral health services in a public health district based on the Conceptual Framework to Measure Performance of the Public Health System (PHS). Using modeling and simulation, a predictive model based on the conceptual framework dimensions: mission, structural capacity, processes, and outcomes was developed to predict the performance of public health district in delivering oral health services.

This is a retrospective longitudinal study. The main objective of this study is to use a modeling and simulation approach to predict the performance of public health district dental clinic in …

Prenatal Smoking And Drinking Implications For Subsequent Child Maltreatment, Nicholas Alexander Adams

Sociology & Criminal Justice Theses & Dissertations

Prenatal smoking and drinking are very serious problems that have continued to plague society. They have multiple negative effects on the child both physically and cognitively. This study explored the relationship between prenatal abuse, i.e., prenatal smoking and prenatal drinking, and subsequent child physical abuse and official reports of child maltreatment. It was hypothesized that mothers who smoked or drank prenatally would be more likely to physically abuse their child postnatally and have official reports of child maltreatment. The sample included women participating in Wave III of the National Longitudinal Survey of Adolescent Health. N = 620 women who answered …

Early Diagnosis Of Pulmonary Embolism: Review And Cost-Effectiveness Analysis, Efstathios Polychronopoulos

Health Services Research Dissertations

Pulmonary embolism (PE) is a serious, life-threatening thrombotic disease, which results in considerable health and economic consequences each year for the United States. These consequences include a toll of 83,000 deaths and an economic impact between 1,5 and 5 billion. Approaches to strategy selection by physicians and other health-care specialists are based mainly upon cost, technology availability, and cultural tolerance regarding radiation exposure. The purpose of this study was to determine the most cost-effective diagnostic strategy with patients suspected of PE among several strategies currently used by examining their detection failure rates. This objective was met by (a) assessing parameter …

Uptake Of Nanoparticles Of Cerium Oxide And Yttrium Oxide By Acanthamoeba Castellanii (Protozoa) And Daphnia Magna (Crustacea), James R. Palmieri, Geneva Gehring, Catherine Minichino, Shaadi F. Elswaifi

Virginia Journal of Science

Currently, nanoparticles are synthesized and used at an unprecedented rate for industrial, medical, and research applications. The use of cerium oxide nanoparticles (CeONP) and yttrium oxide nanoparticles (YtONP) results in their spread as contaminants into the environment. Once in the environment, CeONP and YtONP can be taken up by organisms in the food chain where they may pose a public health risk. In this study we determine whether Acanthamoeba castellanii and Daphnia magna uptake CeONP or YtONP from their environment and thereby play a role in the transmission of the nanoparticles. Using electron microscopy, orgranisms exposed to the nanoparticles were …

Adoption Of Electronic Health Records By Admitting Physicians: A Heuristic Model, John Sharon Hudson

Health Services Research Dissertations

Background: Although hospital electronic health records (EHRs) are generally perceived to improve care, physician resistance may hinder EHR adoption.

Purpose: This study uses constructs from diffusion of innovations and resource dependence theories to predict adoption and rate of adoption of an EHR by admitting physicians from three of ten hospitals in a highly integrated health system in Virginia. Functions evaluated: computerized physician order entry (CPOE), electronic history and physical (EH&P) and electronic discharge summary (EDS). The study tested hypotheses that adoption would be associated with: working at larger, academic hospitals; financial alignment; larger physician groups; office EHR; youth; males; medical …

Decomposing The Intergenerational Disparity In Income And Obesity, Qi Zhang, Buhong Zheng, Ning Zhang, Youfa Wang

Community & Environmental Health Faculty Publications

Intergenerational disparity in income and health violates the norm of equal opportunity and deserves the attention of researchers and policy makers. To understand changes in intergenerational disparity, we created the intergenerational mobility index (IMI), which can simultaneously measure changes in income rankings and in health outcomes across two generations. We selected obesity as one health outcome to illustrate the application of IMI due to its severe health and financial consequences for society and the significant changes in the distribution of obesity across income groups. Although obesity has increased in all income groups in the last four decades, higher income groups …

Maximizing Treatment Fidelity In Public Health Clinical Trials, James Alan Neff

Community & Environmental Health Faculty Publications

(First paragraph) In relatively few pages (1), Professor Borelli provides a cogent overview of one of the vexing issues in assessing whether public health interventions “work.” The comprehensiveness of the presentation, covering issues ranging from treatment development through outcome evaluation, makes the article a valuable resource for practitioners and students in a variety of disciplines. Of particular value is the detailed template listing fidelity assessment strategies at the Treatment Design, Provider Training, Treatment Delivery, Treatment Receipt, and Treatment Enactment Stages.

Quality Of Life Perceptions Of Caregivers Of Individuals With Intellectual Disabilities In The United States And The Czech Republic, Milan Valenta, Jan Michalík, Sharon Raver-Lampman, Anne Michalek

Human Movement Studies & Special Education Faculty Publications

Caregivers of individuals with disabilities in the United States have been reported to experience additional hardships than families with typical children as they attempt to balance family and work (Parish, Rose, Grinstein-Weiss, Richman, & Andrews, 2008). In this study, 31 caregivers of individuals with intellectual disabilities from the United States and 225 from the Czech Republic completed a qualitative quality of life survey. Similarities in the two groups were found in reported gains and losses from caregiving responsibilities. Differences in perceived spirituality, personal sense of peace and serenity, life optimism, ability to rejoice in life, personal life perspective, health, financial …

Review Of The Multi-Level Factors Contributing To Fruit And Vegetable Consumption In The U.S., Qi Zhang, Liuliu Fu

Community & Environmental Health Faculty Publications

The consumption of fruits and vegetables (F&V) has a significant protective effect in reducing various cardiometabolic diseases. In recent years, the U.S. government has made a lot of effort to promote F&V consumption through different projects and programs, including the MyPyramid food guidance system supported by the USDA’s Center for Nutrition Policy and Promotion, and the Fruits & Veggies More Matters program (previously called the 5-A-Day for Better Health program), supported by the Centers for Disease Control and Prevention (CDC) and other public and private agencies. However, modest success has been achieved in promoting healthy diets among the American public. …

Self-Reported Poor Oral Hygiene Among In-School Adolescents In Zambia, Seter Siziya, Adamson S. Muula, Emmanuel Rudatsikira

Community & Environmental Health Faculty Publications

Background

Dental health is a neglected aspect of adolescent health globally but more so in low-income countries. Secondary analysis using the 2004 Zambia Global School-Based Health Survey (GSHS) was conducted in which we estimated frequencies of relevant socio-demographic variables and explored associations between selected explanatory variables and self-reported poor oral hygiene (not cleaning or brushing teeth) within the last 30 days of the completion of questionnaire.

Findings

Most of the 2257 respondents were males (53.9%) and went hungry (82.5%). More than 4 in 10 respondents drank alcohol (42.2%) while 37.2% smoked cannabis. Overall 10.0% of the respondents reported to have …

United Airways Disease Among Florists, Muge Akpinar-Elci, Omur C. Elci, Aygul Odabasi

Community & Environmental Health Faculty Publications

Previously we observed an excess risk for occupational asthma among florists with rhinitis. To further evaluate the link between upper and lower airways, we investigated united airways disease in the same occupational group. Occupational history, symptoms and atopy were investigated among 128 florists. Age-, smoking-, and gender-adjusted risks were calculated using logistic regression models comparing symptomatic and asymptomatic individuals. The prevalence of work-related rhinitis symptoms was 13.3%, conjunctivitis symptoms and asthma-like symptoms were 14.1%. We observed an excess risk of work-related asthma symptoms among florists with work-related conjunctivitis (OR: 8.5, 95% CI: 2.4-29.9) and rhinitis (OR: 13.1, 95% CI: 3.0- …

Efficacy Of The Pentavalent Rotavirus Vaccine, Rotateq (Rv5), Between Doses Of A 3-Dose Series And With Less Than 3 Doses (Incomplete Regimen), Penelope D. Dennehy, Timo Vesikari, David O. Matson, Robbin F. Itzler, Michael J. Dallas, Michelle G. Goveia, Mark J. Dinubile, Penny M. Heaton, Max Ciarlet

Community & Environmental Health Faculty Publications

Post-hoc analyses of the Rotavirus Efficacy and Safety Trial (RES T) were conducted to determine whether the pentavalent rotavirus vaccine (RV5) confers early protection against rotavirus gastroenteritis (RVGE) before completion of the 3-dose regimen. To evaluate the efficacy of RV5 between doses in reducing the rates of RVGE-related hospitalizations and emergency department (ED) visits in infants who ultimately received all 3 doses of RV5/placebo, events occurring from 2 weeks after the first and second doses to receipt of the subsequent dose (Analysis A) and events occurring from 2 weeks after the first and second doses to 2 weeks after the …

Alcohol Consumption In Lusaka Urban District, Zambia: A Population Based Survey, 2007, Selestine H. Nzala, Olusegun Babaniyi, Peter Songolo, Adamson S. Muula, Emmanuel Rudatsikira, Seter Siziya

Community & Environmental Health Faculty Publications

Alcohol use is an important preventable risk factor for several non-communicable diseases (NCDs) and injuries that is related to lifestyle choices. The objective of the study was to determine the prevalence of alcohol consumption and its correlates. A cross sectional study utilizing a WHO stepwise approach to surveillance of NCDs was conducted in Lusaka district, Zambia. Current alcohol consumption was defined as having consumed alcohol in the previous 30 days to the survey. Complex samples logistic regression was used to determine independent predictors. A total of 1928 individuals participated in the survey. A third of the participants were males and …

Demographic, Cultural, And Environmental Factors Associated With Frequency And Severity Of Malnutrition Among Zambian Children Less Than Five Years Of Age, Selestine H. Nzalal, Seter Siyizal, Olusegun Babaniyi, Peter Songolo, Adamson S. Muula, Emmanuel Radatsikira

Community & Environmental Health Faculty Publications

Under-nutrition prevents growth and development in children and is the leading factor to illness and death among children less than five years of age in developing countries. The objective of the study was to determine associations of demographic, cultural and environmental factors with frequency and severity of malnutrition among children less than five years of age in Zambia. We used data from the Zambia multiple indicator cluster survey (MICS) from years of 1999 to 2000. Altogether 6,142 children participated in the survey. The prevalence rates for being "underweight", "stunted" and "wasted" were 17.6, 37.5 and 4.1%, respectively. Compared to children …

Prevalence Of Hypertension And Its Correlates In Lusaka Urban District Of Zambia: A Population Based Survey, Fastone M. Goma, Selestine H. Nzala, Olusegun Babaniyi, Peter Songolo, Cosmos Zyaambo, Emmanuel Rudatsikira, Seter Siziya, Adamson S. Muula

Community & Environmental Health Faculty Publications

Background

Hypertension is a leading cause for ill-health, premature mortality and disability. The objective of the study was to determine the prevalence and associated factors for hypertension in Lusaka, Zambia.

Methods

A cross sectional study was conducted. Odds ratios and their 95% confidence intervals were calculated to assess relationships between hypertension and explanatory variables.

Results

A total of 1928 individuals participated in the survey, of which 33.0% were males. About a third of the respondents had attained secondary level education (35.8%), and 20.6% of males and 48.6% of females were overweight or obese. The prevalence for hypertension was 34.8% (38.0% …

Prevalence And Socio-Demographic Correlates For Serious Injury Among Adolescents Participating In The Djibouti 2007 Global School-Based Health Survey, Adamson S. Muula, Seter Siziya, Emmanuel Rudatsikira

Community & Environmental Health Faculty Publications

Background

Mental health and injury are neglected public health issues especially in low-income nations. The objective of the study was to determine the prevalence and socio-demographic correlates for serious injury in the last 12 months.

Findings

The study used data of the 2007 Djibouti Global School-based Health Survey. Logistic regression analysis was used to establish associations. Of the 1, 777 respondents, 61.1% (63.2% males and 57.8% females) reported having sustained serious injury (SSI). Compared to participants who were not bullied, those who reported being bullied 3-9 days per month were more likely to have sustained serious injury in the last …

Mathematical Model To Assess The Relative Effectiveness Of Rift Valley Fever Countermeasures, Holly Gaff, Colleen Burgess, Jacqueline Jackson, Tianchan Niu, Yiannis Papelis, David Hartley

Biological Sciences Faculty Publications

Mathematical modeling of infectious diseases is increasingly used to explicate the mechanics of disease propagation, impact of controls, and sensitivity of countermeasures. The authors demonstrate use of a Rift Valley Fever (RVF) model to study efficacy of countermeasures to disease transmission parameters. RVF is a viral infectious disease that propagates through infected mosquitoes and primarily affects animals but also humans. Vaccines exist to protect against the disease but there is lack of data comparing efficacy of vaccination with alternative countermeasures such as managing mosquito population or destroying infected livestock. This paper presents a compartmentalized multispecies deterministic ordinary differential equation model …

The Relationship Of Financial Performance, Quality Indicators, And The Role Of Nurse Executives In Virginia Nursing Homes, Jeany V. Murphy

Health Services Research Dissertations

Problem statement. The dynamic nature of the healthcare industry has triggered changes in nurse executive functions. The job has expanded into entrepreneurial roles to be able to provide the most cost effective services while maintaining good quality outcomes for the residents. The new responsibility requires a different set of knowledge and competencies that is usually achieved through advanced education. It is not known whether nurse executives in long term care in Virginia possess the skills to influence both the financial and quality outcomes of the facility.

Methods. This descriptive research study examined the relationship of the nurse executives' technical, human, …

Estimating The Reproductive Numbers For The 2008-2009 Cholera Outbreaks In Zimbabwe, Zindoga Mukandavire, Shu Liao, Jin Wang, Holly Gaff, David L. Smith, J. Glenn Morris Jr.

Biological Sciences Faculty Publications

Cholera remains an important global cause of morbidity and mortality, capable of causing periodic epidemic disease. Beginning in August 2008, a major cholera epidemic occurred in Zimbabwe, with 98,585 reported cases and 4,287 deaths. The dynamics of such outbreaks, particularly in nonestuarine regions, are not well understood. We explored the utility of mathematical models in understanding transmission dynamics of cholera and in assessing the magnitude of interventions necessary to control epidemic disease. Weekly data on reported cholera cases were obtained from the Zimbabwe Ministry of Health and Child Welfare (MoHCW) for the period from November 13, 2008 to July 31, …