Public Health Commons^™

Antibiotic Usage In Relation To Resistant Bacterial Infections And Liver And Kidney Cancer Outcomes In South Carolina, Prea Thathiah

Theses and Dissertations

Antibiotics are one of the most beneficial discoveries in medicine and public health. However, the use, overuse, and misuse of these drugs have led to increases in antibiotic resistant bacterial infections (ARI). Furthermore, previous epidemiological studies have linked antibiotic use to breast cancer, but these studies have not included effects on metabolic organs, such as the liver and kidneys. This dissertation investigates the role of antibiotic use in infections and liver and kidney cancers in the state of South Carolina. Using ecological study methods and Poisson regression to determine relative risk ratios, it was found that antibiotic use is a …

Antipsychotic Prescriptions For Children Aged 5 Or Younger: Do We Need Policy Oversight Standards?, Ana Lopez-De Fede, Medha Vyavaharkar, Jessica D. Bellinger

Publications

The use of antipsychotics in very young children is of concern given the lack of empirical evidence in their efficacy and long-term impact on children’s health. This study examined the prescription of antipsychotics among children aged ≤5 years enrolled in a state Medicaid program. Secondary data analysis was conducted using the Medicaid administrative data of a southeastern state. Using SAS 9.3, descriptive statistics were performed to examine socio-demographic characteristics, psychiatric diagnoses, off-label use, receipt of medications from multiple psychotropic drug classes, and receipt of non-pharmacologic psychiatric services among children aged ≤5 years who received antipsychotic prescriptions in calendar year (CY) …

The Comparative Effectiveness Of Group Prenatal Care On Women's Psychosocial Health, Emily Heberlein

Theses and Dissertations

Background: High rates of adverse birth outcomes persist in the United States despite increased access to individual prenatal care (IPNC). Psychosocial factors influence birth outcomes and affect infant and child development and maternal functioning. Group prenatal care (GPNC) combines individual physical assessments and facilitated group education and support. Studies of GPNC show promising results, including lowered preterm birth rates, but the GPNC psychosocial mechanisms influencing birth outcomes are unclear.

Methods: Surveys at study enrollment (N=248), late pregnancy, and six weeks postpartum assessed psychosocial effects of each PNC model. Multiple regression models and planned moderator analyses tested whether GPNC participants had …

The Association Between The Social Context Of Mealtime, Children's Diet, Caregiver's Experiences With Discrimination And Household Food Insecurity, Michael Patrick Burke

Theses and Dissertations

The social context of mealtime---defined as the social interactions and practices during mealtime---plays an important role in children's diet. Household food insecurity disrupts or causes worry about the household food supply, and therefore may negate the positive effect of the social context of meals; however, little research has examined household food security and the social context of mealtime. The purpose of this study was to examine the association between various aspects of the social context of mealtime---dietary modeling, parenting style, eating together, mealtime screen time, and priority and atmosphere of mealtime---and dietary quality among children within food-insecure households. The results …

Elucidating Perceived And Actual Cancer Risk In Disadvantaged Neighborhoods Differentially Impacted By Environmental Hazards To Inform Future Public Health Interventions, Lashanta J. Rice

Theses and Dissertations

In the United States, racial and ethnic minorities, economically disadvantaged and medically underserved groups bear a disproportionate amount of the cancer burden. Myriad social and environmental factors attribute to these disparities including disparate exposures to environmental pollutants, which account for two percent of all cancer deaths nationally. There is empirical evidence demonstrating risk perceptions and cancer worry are shaped by race/ethnicity and social and environmental experiences. Cancer risk perceptions among Non-Whites, especially Blacks compared to Whites is lower for various reasons. Low perceived cancer risk may explain persistent cancer disparities, since protective health behaviors are higher among persons who perceive …

Food Insecurity And Physical Activity Among U.S. Populations, Quyen G. To

Theses and Dissertations

Objectives: Examine the association between food insecurity (FI) and physical activity (PA) in the U.S. population.

Methods: Accelerometry (PAM) and self-report PA (PAQ) data from NHANES 2003-2006 were used. Those aged less than six years or were older than 65 years, pregnant, with physical limitations, or with family income above 350% of the poverty line were excluded. FI was measured by the USDA Household Food Security Survey Module. Crude and adjusted odd ratios were calculated from logistic regression to identify the association between FI and adherence to the PA recommendation. Crude and adjusted coefficients were calculated from linear regression to …

Microbes As Proton Exchange Membranes In Microbial Fuel Cells, Andrew Timothy Stroud

Theses and Dissertations

Microbial fuel cells (MFCs) use proton exchange membranes (PEMs) to deliver protons to the cathode for electricity production. MFCs have been limited to low power generation because of complex ionic media characteristic of MFCs using the conventional Nafion-based PEM with high attraction for the competing ions. Benthic microbial fuel cells (BMFCs) use the marine sediment between the anode, embedded in marine sediment, and cathode, overlying in water, as a PEM. BMFCs have been shown to generate high power densities representing high proton permeability by the marine sediment layer between the anode and cathode. However, there is limited knowledge about this …

Comparison Of Confidence Intervals Of Intracluster Correlation Coefficient Estimates For Binary Variables, Ashok Varma Samantapudi

Theses and Dissertations

The present study evaluates the length of the confidence interval and the percentage of time the true parameter is captured by the confidence interval for four intracluster correlation estimators. These are the ANOVA estimator, the Pearson pairwise estimator with constant weights (PEQ), the kappa type estimator called FC, and an estimator using a Resampling method (RM) for binary data. We compared these different estimates by using a large simulation study. The data we simulated is correlated binary data, which assumes an exchangeable correlation structure. We also included different variations of the number of clusters, cluster size, cluster size variation, event …

Gestational Weight Gain And The Risk Of Obesity Among Preschool Children: Is This Mediated Through Birth Weight?, Nomathamsanqa Louise Mgutshini

Theses and Dissertations

Data from the 2001 Early Childhood Longitudinal Study Birth- Cohort were used to examine the association between maternal gestational weight gain (GWG) and the risk of obesity in the offspring, and the possible mediating role of birth weight. The Centers for Disease Control growth 2000 reference charts and child's height and weight measured at age 4 or 5 years old were used to determine child body mass index (BMI) Z-scores or obesity status (greater than or equal to the 95th percentile). Multiple linear or logistic regression models were used to adjust for maternal age, race, education, smoking status and prepregnancy …

Hepatitis B, C Virus And Hiv Co-Infection Among Reported Female Cases In South Carolina, 2004 - 2011: An Epidemiological Analysis Of Pregnancy Outcomes, Afiba Manza-Azele Agovi

Theses and Dissertations

HIV, hepatitis B and C virus (HBV, HCV) are three of the most common blood-borne infections and they continue to be a major public health problem in the United States (US) and globally. It is not well understood if maternal infection with either HBV or HCV has an adverse impact on pregnancy outcomes as findings from previous studies have provided some mixed results. The overall goal of this study was to assess the risk of preterm birth, low birth weight (LBW), small for gestational age (SGA) and admission into neonatal intensive care unit (NICU) for babies born to HBV- and …

A Community-Driven Approach To The Development Of A Digital Decision Aid To Facilitate Informed Decision Making For Prostate Cancer Screening Among African-American Men In Communities Of Faith, Otis Lashaun Owens

Theses and Dissertations

Background: African American (AA) men are significantly more likely to die of prostate cancer (PrCA) than other racial groups. Therefore, it is critical to identify effective strategies for providing information about the risks, benefits, and uncertainties of PrCA screening and the importance of informed decision making (IDM). To assess whether a computer-based IDM decision aid (DA) for PrCA screening would be appropriate for middle-age and older AA men, this formative evaluation study examined participants (1) PrCA risk and screening knowledge, 2) decision-making processes for PrCA screening, and 3) usage of, attitudes toward, and access to interactive communication technologies (ICTs). The …

Primary Care And Youth Mental Health In Ireland: Qualitative Study In Deprived Urban Areas, Dorothy Leahy, Elisabeth Schaffalitzky, Claire Armstrong, Gerard Bury, Paula Cussen-Murphy, Rachel Davis, Barbara Dooley, Blanaid Gavin, Rory Keane, Eamon Keenan, Linda Latham, David Meagher, Pat Mcgorry, Fiona Mcnicholas, Ray O'Connor, Ellen O'Dea, Veronica O'Keane, Tom P. O'Toole, Edel Reilly, Patrick Ryan, Lena Sanci, Bobby P. Smyth, Walter Cullen

Faculty Publications

BACKGROUND: Mental disorders account for six of the 20 leading causes of disability worldwide with a very high prevalence of psychiatric morbidity in youth aged 15-24 years. However, healthcare professionals are faced with many challenges in the identification and treatment of mental and substance use disorders in young people (e.g. young people's unwillingness to seek help from healthcare professionals, lack of training, limited resources etc.) The challenge of youth mental health for primary care is especially evident in urban deprived areas, where rates of and risk factors for mental health problems are especially common. There is an emerging consensus that …

Relationship Between The Experience Of Perceived And Physician Diagnosed Arthritis And The Presence Of Dsm-Iv Criteria-Based Major Depression (Mdd) Among Older, Ryan Neil Schmidt

Theses and Dissertations

BACKGROUND: The purpose of this study was to explore both positive screened MDD and the perception of being depressed (P) and the likelihood of either increasing if the patient suffered from arthritis (P/E), either perceived or evaluated by a physician. The study explored the univariate, bivariate, and multivariate relationships between MDD and depression (P) to better describe influencing characteristics and their prevalence, as related to MDD and depression (P).

METHODS: The study examined a cross section of patients 65 years and older (n=8,205) within the National Epidemiologic Survey on Alcohol Abuse and Alcoholism (NESARC) [2001-02] sponsored by the National Institute …

Patients’ Attitudes Towards Patient Involvement In Safety Interventions: Results Of Two Exploratory Studies, Rachel Davis, Nick Sevdalis, Anna Pinto, Ara Darzi, Charles A. Vincent

Faculty Publications

BACKGROUND: In recent years, patient-focused interventions have been introduced aimed at increasing patient involvement in safety-related behaviours. However, patients' attitudes towards these interventions and comfort in participating in the recommended behaviours remain largely unexplored. OBJECTIVE: To evaluate patients' attitudes towards a video and leaflet aimed at encouraging patient involvement in safety-related behaviours. DESIGN: Two exploratory studies employing a within-subjects mixed-methods design. SETTING: Six hospital wards on an inner-city London teaching hospital. PARTICIPANTS: Medical and surgical inpatients: 80 patients in study 1 (mean age 55; 69% men) and 80 patients in study 2 (mean age 52; 60% men). INTERVENTION: Patients watched …

Emergency Department Utilization Among Recently Released Prisoners: A Retrospective Cohort Study, Suyanpeng Zhang, Allie Silverman, Sze Chaun Suen, Christina Andrews, Brian Chen

Faculty Publications

Background: The population of ex-prisoners returning to their communities is large. Morbidity and mortality is increased during the period following release. Understanding utilization of emergency services by this population may inform interventions to reduce adverse outcomes. We examined Emergency Department utilization among a cohort of recently released prisoners.

Methods: We linked Rhode Island Department of Corrections records with electronic health record data from a large hospital system from 2007 to 2009 to analyze emergency department utilization for mental health disorders, substance use disorders and ambulatory care sensitive conditions by ex-prisoners in the year after release from prison in comparison to …

Trauma History And Depression Predict Incomplete Adherence To Antiretroviral Therapies In A Low Income Country, Kathryn Whetten, Kristen Shirey, Brian Wells Pence, Jia Yao, Nathan Thielman, Rachel Whetten, Julie Adams, Bernard Agala, Jan Ostermann, Karen O'Donnell, Amy Hobbie, Venance Maro, Dafrosa Itemba, Elizabeth Reddy, Chat Research Team

Faculty Publications

Background: As antiretroviral therapy (ART) for HIV becomes increasingly available in low and middle income countries (LMICs), understanding reasons for lack of adherence is critical to stemming the tide of infections and improving health. Understanding the effect of psychosocial experiences and mental health symptomatology on ART adherence can help maximize the benefit of expanded ART programs by indicating types of services, which could be offered in combination with HIV care. Methodology: The Coping with HIV/AIDS in Tanzania (CHAT) study is a longitudinal cohort study in the Kilimanjaro Region that included randomly selected HIV-infected (HIV+) participants from two local hospital-based HIV …

Parental Height And Child Growth From Birth To 2 Years In The Who Multicentre Growth Reference Study, Cutberto Garza, Elaine Borghi, Adelheid W. Onyango, Mercedes De Onis, Edward A. Frongillo Jr.

Faculty Publications

inear growth from birth to 2 years of children enrolled in the World Health Organization Multicentre Growth Reference Study was similar despite substantial parental height differences among the six study sites. Within-site variability in child length attributable to parental height was estimated by repeated measures analysis of variance using generalized linear models. This approach was also used to examine relationships among selected traits (e.g. breastfeeding duration and child morbidity) and linear growth between 6 and 24 months of age. Differences in intergenerational adult heights were evaluated within sites by comparing mid-parental heights (average of the mother's and father's heights) to …

What Attributes Of Patients Affect Their Involvement In Safety? A Key Opinion Leaders’ Perspective, Stephen Buetow, Rachel E. Davis, Kathleen Callaghan, Susan Dovey

Faculty Publications

OBJECTIVE: Little is known about which attributes the patients need when they wish to maximise their capability to partner safely in healthcare. We aimed to identify these attributes from the perspective of key opinion leaders. DESIGN: Delphi study involving indirect group interaction through a structured two-round survey. SETTING: International electronic survey. PARTICIPANTS: 11 (65%) of the 17 invited internationally recognised experts on patient safety completed the study. OUTCOME MEASURES: 50 patient attributes were rated by the Delphi panel for their ability to contribute maximally to safe health care. RESULTS: The panellists agreed that 13 attributes are important for patients who …

Adults With Greater Weight Satisfaction Report More Positive Health Behaviors And Have Better Health Status Regardless Of Bmi, Christine E. Blake Ph.D., Rd, James R. Hébert Scd, Duck Chul Lee, Swann A. Adams, Susan E. Steck Phd, Mph, Rd, Xuemei Sui M.D., M.P.H., Ph.D., Jennifer L. Kuk, Meghan Baruth, Steven N. Blair

Faculty Publications

Background. Prior studies suggest that weight satisfaction may preclude changes in behavior that lead to healthier weight among individuals who are overweight or obese. Objective. To gain a better understanding of complex relationships between weight satisfaction, weight-related health behaviors, and health outcomes. Design. Cross-sectional analysis of data from the Aerobics Center Longitudinal Study (ACLS). Participants. Large mixed-gender cohort of primarily white, middle-to-upper socioeconomic status (SES) adults with baseline examination between 1987 and 2002 (n = 19,003). Main Outcome Variables. Weight satisfaction, weight-related health behaviors, chronic health conditions, and clinical health indicators. Statistical Analyses Performed. Chi-square test, t-tests, and linear and …

Association Between Adverse Childhood Experiences And Diagnosis Of Cancer, Monique J. Brown, Leroy R. Thacker, Steven A. Cohen

Faculty Publications

Objective: Adverse childhood experiences (ACEs) are linked to multiple adverse health outcomes. This study examined the association between ACEs and cancer diagnosis.

Methods: Data from the 2010 Behavioral Risk Factor Surveillance System (BRFSS) survey were used. The BRFSS is the largest ongoing telephone health survey, conducted in all US states, the District of Columbia, Puerto Rico, Guam and the U.S. Virgin Islands, and provides data on a variety of health issues among the non-institutionalized adult population. Principal component analysis (PCA) was used to derive components for ACEs. Multivariable logistic regression models were used to provide adjusted odds ratios (OR) and …

Early Prenatal Food Supplementation Ameliorates Thenegative Association Of Maternal Stress With Birth Size In A Randomised Trial, Amy L. Frith, Ruchira T. Naved, Lars Ake Persson, Edward A. Frongillo Jr.

Faculty Publications

Low birthweight increases the risk of infant mortality, morbidity and poor development. Maternal nutrition and stress influence birth size, but their combined effect is not known.We hypothesised that an early-invitation time to start a prenatal food supplementation programme could reduce the negative influence of prenatal maternal stress on birth size, and that effect would differ by infant sex. A cohort of 1041 pregnant women, who had delivered an infant, June 2003–March 2004, was sampled from among 3267 in the randomised controlled trial, Maternal Infant Nutritional Interventions Matlab, conducted in Matlab, Bangladesh. At 8 weeks gestation, women were randomly assigned an …

Confronting Myths About Household Food Insecurity And Excess Weight, Edward A. Frongillo Jr.

Faculty Publications

No abstract provided.

Indicators Of Family Care For Development For Use In Multicountry Surveys, Patricia Kariger, Edward A. Frongillo Jr., Patrice Engle, Pia M. Rebello Britto, Sara M. Sywulka, Purnima Menon

Faculty Publications

Indicators of family care for development are essential for ascertaining whether families are providing their children with an environment that leads to positive developmental outcomes. This project aimed to develop indicators from a set of items, measuring family care practices and resources important for caregiving, for use in epidemiologic surveys in developing countries. A mixed method (quantitative and qualitative) design was used for item selection and evaluation. Qualitative and quantitative analyses were conducted to examine the validity of candidate items in several country samples. Qualitative methods included the use of global expert panels to identify and evaluate the performance of …

Illness-Related Diabetes Social Support And Glycemic Control Among Middle Aged And Older Adults, Favel Leah Mondesir

Theses and Dissertations

Objective

The objective of this study is to investigate the association between illness-related diabetes social support (IRDSS) and glycemic control (GC) among a racially diverse sample of middle aged and older adults. In gender-stratified models we examine whether the relationship between IRDSS and GC is modified by race/ethnicity. Additionally, we explore the association between eight individual types of IRDSS and GC.

Methods

We used the Health and Retirement Study (HRS) 2002 and the 2003 Diabetes Survey. The final analytic sample consisted of 914 study respondents. Gender-stratified multivariable logistic regression models were used to calculate odd ratios (ORs) and 95% confidence …

Fishing And Fish Consumption Patterns In The Gullah/Geechee Sea Island Population, Jamelle Heyward Ellis

Theses and Dissertations

The Gullah/Geechee (G/G) people are descendants of West African slaves who remained in seclusion on the Sea Islands of South Carolina, North Carolina, Georgia, and Florida until the end of the Civil War in 1865. In addition to retaining their unique cultural language, they also remain largely a fishing subsistence population. Decades of urban development have reduced the G/G population's access to traditional fishing locations and have increased exposures to environmental contaminants in some bodies of water that are frequently fished by the G/G. Approximately 98.4% of SC rivers and streams and 77.6% of lakes have been assessed for aquatic …

The Children And Parents In Focus Project: A Population-Based Cluster-Randomised Controlled Trial To Prevent Behavioural And Emotional Problems In Children, R. Salari, H. Fabian, Ron Prinz, S. Lucas, I. Feldman, Amanda Fairchild, A. Sarkadi

Faculty Publications

Background: There is large body of knowledge to support the importance of early interventions to improve child health and development. Nonetheless, it is important to identify cost-effective blends of preventive interventions with adequate coverage and feasible delivery modes. The aim of the Children and Parents in Focus trial is to compare two levels of parenting programme intensity and rate of exposure, with a control condition to address impact and cost-effectiveness of a universally offered evidence-based parenting programme in the Swedish context. Methods/Design: The trial has a cluster randomised controlled design comprising three arms: Universal arm (with access to participation in …

Assessment Of The Effectiveness Of An Innovative Screening Colonoscopy Protocol In Producing High Quality Performance And Outcomes By Trained Primary Care Physicians, Yi Jhen Li

Theses and Dissertations

Colorectal cancer (CRC) is the 3rd most prevalent cancer and 2nd leading cause of cancer death in the U.S. Colonoscopies have been recommended as the preferred screening method to prevent cancer by removing polyps before they transform into cancer. Although colonoscopy every 10 years is considered to be the preferred screening method, it is not perfect mainly owing to the variable quality of screening colonoscopy under community-based practice conditions. Although the effectiveness of colonoscopy in preventing CRC is documented, screening colonoscopy coverage in the US population remains low. This is partly due to low colonoscopy capacity due to a shortage …

Associations Between The Perceived And Built Food Environment, Timothy L. Barnes

Theses and Dissertations

Neighborhood food environments have been associated with dietary intake and obesity. Measures of the food environment have typically been characterized with geographic information systems (GIS)-based measures, however, the use of perception-based measures of the food environment have increased in frequency. Few studies have fully examined the relationship between perceptions and GIS-based measures of the food environment, especially considering the congruency between perceived and GIS-based presence of specific retail food outlets, nor the relationship between food outlets and perceived availability of healthy foods or fast food opportunities.

Telephone survey data from 705 residents in an eight-county region of South Carolina were …

Evaluation Of Mass Media Campaigns To Change Smokers' Knowledge, Attitudes, And Behaviors In China And Taiwan, Li-Ling Huang

Theses and Dissertations

Research in high income countries (HICs) suggest that anti-smoking television advertisements are most effective if they contain emotionally evocative graphic messages or personal testimonials that depict serious consequences from smoking. The ability to effectively translate these messaging strategies to low- and middle-income (LMICs) countries outside of Western cultures remains understudied. It is critical to determine which smoking cessation messages work best in LMICs because they increasingly bear the global burden of tobacco-related disease. To date there is limited evidence on the efficacy of tobacco control mass media campaigns and the relative effectiveness of different tobacco control messaging strategies in China …

Examining The Role Of Electronic Medical Record Generated Provider Reminders On Provider Offering Of Breast Cancer Screening Services, Charles Beverley, Jr.

Theses and Dissertations

Introduction:Breast cancer affects the lives of millions of women each year in the United States. Early detection by mammography screening can reduce the risk for advanced stages of breast cancer and improve the probability of long-term survival in women. Electronic medical records (EMRs) have been identified as a successful approach for increasing the offering of preventive care in breast cancer. This study examines the impact of EMR usage, and EMR generated provider reminders on physician ordering or providing of mammography screenings.

Methods:This study used survey data from the 2008-2010 National Ambulatory Medical Care Survey (NAMCS). Our sample included non-federal office-based …