Public Health Commons^™

Decision Aid Models For Resource Sharing Strategies During Global Influenza Pandemics, Alfredo Santana Reynoso

USF Tampa Graduate Theses and Dissertations

Pandemic influenza outbreaks have historically entailed significant societal and economic disruptions. Today, our quality of life is threatened by our inadequate preparedness for the imminent pandemic. The key challenges we are facing stem from a significant uncertainty in virus epidemiology, limited response resources, inadequate international collaboration, and the lack of appropriate science-based decision support tools. The existing literature falls short of comprehensive models for global pandemic spread and mitigation which incorporate the heterogeneity of the world regions and realistic travel networks. In addition, there exist virtually no studies which quantify the impact of resource sharing strategies among multiple countries. This …

Food Deserts' And 'Food Swamps' In Hillsborough County, Florida: Unequal Access To Supermarkets And Fast-Food Restaurants, Dana Beth Stein

USF Tampa Graduate Theses and Dissertations

Research has shown that the suburbanization of supermarkets has created `food deserts', defined as areas where socially disadvantaged individuals lack access to nutritious food outlets. Additionally, the growing presence of fast-food restaurants has created `food swamps', or areas where socially disadvantaged individuals encounter an overabundance of unhealthy food outlets. While previous studies have analyzed either `food deserts' or `food swamps' using conventional statistical techniques, a more comprehensive approach that includes samples of both healthy and unhealthy entities and considers the variety of available food options is necessary to improve our understanding of the local food environment and related disparities.

This …

Growing Up With Hiv: Disease Management Among Perinatally Infected Adolescents, Barbara J. Szelag

USF Tampa Graduate Theses and Dissertations

Children born with HIV in the 1980s and 1990s are surviving into adolescence and adulthood, due to the availability of highly active antiretroviral therapy (HAART). Growing up with a chronic and stigmatized disease presents considerable challenges as young people explore their sexuality, develop relationships, and take steps to become independent and productive adults. Adherence to HAART is an essential and life-long practice for the maintenance of health and longevity. For adolescents born with HIV, a daily medication schedule is one aspect of disease management that also includes medical visits, HIV status acceptance, bouts of illness, and disclosure of HIV status …

Indicators Of Early Adult And Current Personality In Parkinson's Disease, Kelly Sullivan

USF Tampa Graduate Theses and Dissertations

Introduction: Previous epidemiologic studies suggest that the personality of Parkinson's disease (PD) patients differs from that of controls, and laboratory evidence supports a potential common pathophysiology of personality traits and PD. One nested case-control study found that PD cases were significantly more anxious than controls before the clinical onset of the disease, and additional data suggest that certain occupations may be risk factors for the disease. Additionally, the latent period that precedes the onset of motor symptoms of PD is unknown.

Objectives: The objectives of this study were to evaluate the association of PD with objective indicators of current and …

A Comparison Of Latina Women In Centeringpregnancy And Individual Prenatal Care, Tara E. Trudnak

USF Tampa Graduate Theses and Dissertations

CenteringPregnancy is a model of group prenatal care that replaces routine, individual prenatal care. The program brings women together into small groups to receive their care and prenatal education, and is based on three components: risk assessment, education, and support. The model is client-centered, designed to empower pregnant women and support persons, and involves the woman in small group discussions of 8-10 other women of similar gestational age. The group discussions provide support, help women educate each other, and invoke self-monitoring. Currently, there have been few publications that closely examined maternal weight and obesity and associated outcomes in women involved …

Detection Of Polybrominated Diphenyl Ethers In Ambient Air At A Wastewater Treatment Facility In Tampa, Florida, Brenda L. White

USF Tampa Graduate Theses and Dissertations

The goal of this study was to quantify the ambient air concentrations of polybrominated diphenyl ethers (PBDEs) from three locations within the Howard Curren Wastewater Treatment Facility located in Tampa, Florida. PBDEs have been linked to endocrine disruption, cancer, developmental concerns in children, as well as other toxic effects; however their precise roles concerning these deleterious effects remains to be determined. The present study was motivated by these potential health concerns posed by inhalational exposure to PBDEs. Ambient air was monitored with a Tisch Environmental PUF high volume sampler for 48 hours with collection on three types of media-quarts filter, …

Sharps Injuries In Medical Training: Higher Risk For Residents Than For Medical Students, Rachel Williams

USF Tampa Graduate Theses and Dissertations

Because of their relative inexperience in performing procedures and handling sharps devices, medical students and resident physicians are considered to be at high risk for sharps injuries. A higher rate of sharps injuries for medical trainees implies a higher risk for occupationally-acquired infection with bloodborne pathogens and may have financial and legal implications for training institutions. This study examines the prevalence of sharps injuries among US medical students and resident physicians. A systematic review of the literature yielded 10 studies that gave data on sharps injuries for US medical students or residents, and those data were combined with data from …

A Mixed Method Study On The Peripartum Experience And Postpartum Effects Of Emergency Hysterectomy Due To Postpartum Hemorrhage, Cara De La Cruz

USF Tampa Graduate Theses and Dissertations

Background: Little is known about the experience and psychological outcomes for women who experience emergency peripartum hysterectomy (EPH). The objective of this study was to explore women's experiences of EPH and to determine if women who experience EPH were more likely to experience mental health sequelae.

Methods: This mixed method design involved a quantitative and a qualitative phase. The quantitative phase used a retrospective cohort design. Women were sampled through on-line communities, including an EPH support group, and a larger website for mothers. Women completed on-line surveys covering sociodemographic, obstetric/gynecological/ and psychiatric information, including screens for depression and Post-Traumatic Stress …

Assessing The Relationship Of Monocytes With Primary And Secondary Dengue Infection Among Hospitalized Dengue Patients In Malaysia, 2010: A Cross-Sectional Study, Benjamin Glenn Klekamp

USF Tampa Graduate Theses and Dissertations

Dengue, a group of four similar viruses transmitted through the bite of a mosquito, is estimated to infect upwards of 100 million annually in over 100 nations throughout the global equatorial belt. Distribution of global dengue is highly skewed as Southeast Asian and Western Pacific regions endure 75% of the global dengue burden. Similar to other regional countries, Malaysia has been rapidly urbanizing, which has supported a hyperendemic dengue state.

The biological pathway by which dengue infection causes a wide range of clinical manifestations, spanning asymptomatic to life-threatening severe complications, is not comprehensively understood. Historically, severe dengue complications have primarily …

Navigating The Child Welfare System: An Exploratory Study Of Families' Experiences, Lianne Fuino Estefan

USF Tampa Graduate Theses and Dissertations

Growing up in a family environment that includes child maltreatment can result in an array of negative consequences for children, including health, behavioral, developmental, and social difficulties, and these consequences can persist over the lifetime. Families who have come to the attention of child welfare services for child maltreatment are at particularly high risk for experiencing multiple concurrent problems, including intimate partner violence, substance abuse, and mental health issues, as well as other family challenges. It is essential to intervene effectively with this population. However, there are few qualitative studies of parent experiences in the child welfare system through which …

A Pilot Study Of Small-Scale Variations In Outdoor Benzene Concentrations, Samantha Catherine Fridh

USF Tampa Graduate Theses and Dissertations

Benzene is an important toxic chemical in urban air and known human carcinogen released substantially by mobile sources. It's important to understand the spatial variation of benzene concentrations in order to understand exposures of susceptible sub-populations such as children and minority groups. Current monitoring networks use large and expensive air samplers that require electricity and restrict the location and number of samplers, not allowing for fine spatial resolution data.

The goals of this study are to develop and evaluate protocols for passive sampling and analysis of ambient benzene concentrations, and conduct a pilot study investigating small-scale variations over an area …

Apparent Total Evaporative Resistance Values From Human Trials Over A Range Of Heat Stress Levels, Brian Grace

USF Tampa Graduate Theses and Dissertations

Clothing can influence heat stress depending on the design and its ability to act as a barrier. The progressive heat stress protocol permitted the collection of data to empirically estimate the apparent total evaporative resistance (R_e,T,a). Five different clothing ensembles were evaluated, which included work clothes, cotton coveralls, and three limited-use protective clothing ensembles including a pthesis-barrier ensemble, (Tyvek^® 1424), water-barrier, vapor-permeable ensemble (NexGen^® LS 417), and a vapor-barrier ensemble (Tychem QC^®). The study design called for three metabolic level's: low, moderate, and high (L, M, & H) and three heat stages: compensable, transitional, …

The Impact Of Managed Care On The Utilization And Distribution Of Inpatient Surgical Procedures With Demonstrated Volume And Outcome Endogeneity, Linda Stephens Gipson

USF Tampa Graduate Theses and Dissertations

Purpose

This study is designed to determine whether managed care has had an influence on the number and distribution of procedures with demonstrated volume and outcome endogeneity in Florida healthcare markets; in addition, methods are developed to determine which measures of managed care activity best predict the impact of managed care in health care markets.

Rationale

A retrospective population based cohort design is used capitalizing on the variability among Florida markets between 1995 and 1999, a period which captured the full business life cycle of managed care plans statistical areas and competing hospitals (market share) over time. Multiple regression models …

Case-Control Study Of Sunlight Exposure And Cutaneous Human Papillomavirus Seroreactivity In Basal Cell And Squamous Cell Carcinomas Of The Skin, Michelle R. Iannacone

USF Tampa Graduate Theses and Dissertations

Non-melanoma skin cancer (NMSC), comprised of basal cell carcinoma (BCC) and squamous cell carcinoma (SCC), is the most common cancer in Caucasians. Ultraviolet radiation (UVR) exposure is the most important environmental risk factor for both BCC and SCC development. However, the precise relationship between UVR and the risk of NMSC is complex, and the relationship may differ by skin cancer type. It has been hypothesized that intermittent patterns and childhood sunlight exposure are important for BCC while continuous (chronic) and lifelong (i.e. childhood and adulthood) sunlight exposure is important for SCC. Epidemiologic studies have demonstrated that cutaneous human papillomavirus (HPV) …

An Evaluation Of The Early Steps Referral Process In Hillsborough County To Detect Delays In Access To Early Intervention Services, Jessica Fry Johnson

USF Tampa Graduate Theses and Dissertations

Early intervention services are important in obtaining better outcomes for infants with a developmental delay or a condition that may result in a delay. In Florida, a primary resource for providing these services is the Early Steps Program. This study analyzed the Early Steps referral process to identify barriers to prompt access. The guiding hypothesis was if differences exist in key outcomes of the referral process, then these differences may reveal where improvements can be made. Improving access to early intervention should produce better outcomes and reduce the costs of services required later by addressing developmental concerns earlier.

The dataset …

Gender Differences In Lung Cancer Treatment And Survival, Margaret Anne Kowski

USF Tampa Graduate Theses and Dissertations

The objectives of this research were to test treatment and survival differences between women and men with lung cancer as there is minimal investigation in the literature. Three research questions were developed with statistical testing for gender differences based on similar cancer type, stage, treatment assignment and survival. Data for 44,863 primary lung cancer cases were collected from eight U.S. state-based cancer registries to investigate the research questions. The lung cancer incidence data included the morphological cell-types of adenocarcinoma (AC); squamous cell carcinoma (SCC); large cell carcinoma (LCC) and small cell carcinoma (SCC). Stage, grade, treatment type, as well as, …

Performance Assessment Of Predicted Heat Strain In High Heat Stress, Ronald Eugene Long

USF Tampa Graduate Theses and Dissertations

Heat stress is a common physical agent associated with many occupations. The most commonly used method of assessing heat stress exposure is an empirical method using the Wet Bulb Globe Temperature Index but his method is limited in its ability to parse out individual contributors to the heat stress. The International Organization for Standardization (ISO) published a rational model called Predicted Heat Strain (PHS) in 2004, and rational methods have the advantage of separating out the individual pathways for heat exchange. The objective of this research was a performance assessment of the current PHS model. This experimental design consisted of …

Numeracy, Cancer Risk Perceptions, And Self-Protective Behaviors Among U.S. Adults, Teri Malo

USF Tampa Graduate Theses and Dissertations

Individuals have become more involved in health-related decisions, in part due to an unprecedented access to information that can be used to enhance both physical and mental health. Much of this health-related information is presented in a numerical format; unfortunately, research suggests many Americans may not possess the literacy skills necessary to comprehend numerical health-related information. More research needs to be conducted to examine numeracy and its role in cancer risk perceptions, and how those risk perceptions relate to cancer self-protective behaviors. The purpose of the current study was to: (a) examine socio-demographic variables associated with numeracy, (b) determine which …

Validation Of The Usf Safe Exposure Time Equation For Heat Stress, Arden Bruce Andersen

USF Tampa Graduate Theses and Dissertations

Heat stress conditions are prevalent in the working environment around the world. Often they are not readily engineered out. Administrative controls and, in extreme/toxic environments, personal protective gear are the means available to protect workers. For every combination of metabolic work rate, clothing ensemble and environmental WBGT, there is a time of exposure threshold, beyond which the worker can no longer compensate for the heat stress, and signs and symptoms of heat strain appear. Increasingly, worker environments require specialty clothing either for worker protection or to maintain a clean/sanitary environment. Prior to the publication of the USF safe exposure time …

Contextualizing Hiv/Aids Prevention And Treatment Programs In Zanzibar, Tanzania, Naheed Ahmed

USF Tampa Graduate Theses and Dissertations

International aid organizations and wealthy nations have contributed billions to combat the spread and treatment of HIV/AIDS in sub-Saharan Africa; however, these programs have been critiqued for not addressing the socioeconomic and cultural context of the epidemic, instead relying upon generalized approaches. The prevalence rate in Zanzibar, Tanzania is low in the general population, but high among vulnerable segments of Zanzibari society, resulting in interventions focusing on particular groups (e.g. sex workers, drug users, and men who have sex with men). Through interviews with government agencies, non-profit organizations, medical professionals, vulnerable populations, and HIV/AIDS patients, this paper examines how local …

The Natural History Of Human Papillomavirus Related Condyloma In A Multinational Cohort Of Men, Gabriella Anic

USF Tampa Graduate Theses and Dissertations

Human papillomavirus (HPV) is the most common sexually transmitted infection in the United States, but few studies have examined the progression from HPV infection to disease in men. Genital condyloma are the most common clinical manifestation of HPV infection. Though not associated with mortality, condyloma are a source of emotional distress, and treatment is often painful with a high recurrence rate. The aims of this study were to examine the distribution of HPV types present on the surface of condyloma, estimate the incidence of condyloma overall and after type-specific HPV infections, assess the sociodemographic and sexual behavior factors independently associated …

Drug Courts Work, But How? Preliminary Development Of A Measure To Assess Drug Court Structure And Processes, Blake Barrett

USF Tampa Graduate Theses and Dissertations

The high prevalence of substance use disorders is well-documented among criminal offenders. Drug courts are specialty judicial programs designed to: 1) improve public safety outcomes; 2) reduce criminal recidivism and substance abuse among offenders with substance use disorders; and 3) better utilize scarce criminal justice and treatment resources. Drug courts operate through partnerships between the criminal justice, behavioral health and public health systems. Offenders participate in an intensive regimen of substance abuse treatment and case management while under close judicial supervision. Drug courts' effectiveness in reducing criminal recidivism and drug use has been documented through numerous primary studies as well …

An Examination Of The Impact Of Preconception Health On Adverse Pregnancy Outcomes Through The Theoretical Lens Of Reciprocal Determinism, Mary Elizabeth Buie

USF Tampa Graduate Theses and Dissertations

Statement of Purpose

The purpose of this study is to examine the impact of preconception health on adverse pregnancy outcomes through the theoretical lens of reciprocal determinism. Thus, this study aims to develop a preconception health conceptual framework that accounts for the interactive relationships among behavior, the environment, and the person.

Rationale for the Study

Women may not recognize a pregnancy until the first or second missed menstrual cycle, a full four to eight weeks or more after conception. Once a woman realizes the possibility of a pregnancy, it takes further time to confirm the pregnancy with a home pregnancy …

Disparities In Survival And Mortality Among Infants With Congenital Aortic, Pulmonary, And Tricuspid Valve Defects By Maternal Race/Ethnicity And Infant Sex, Colleen Conklin

USF Tampa Graduate Theses and Dissertations

Background: The etiology of congenital heart valve defects is not well understood; little is known about the risk factors that contribute to the survival and mortality outcomes of children with these defects.

Methods: Using data from the Texas Birth Defects Registry (TBDR) we conducted a retrospective cohort study of 2070 singleton infants with congenital aortic, pulmonary, or tricuspid valve atresia or stenosis born in Texas between January 1, 1996 and December 31, 2007 to Hispanic, Non-Hispanic (NH) black, and NH white women. TBDR data were death-to-birth matched by the Texas Vital Statistics Unit for deaths between January 1, 1996 and …

Adolescence Is An Ocean: A Biocultural Investigation Of Youth Food Consumption In Tanzania, Elizabeth J. Danforth

USF Tampa Graduate Theses and Dissertations

This study investigates adolescents' relationships with food and other community and household members' perceptions of youth and their food consumption to understand the multifactorial dynamic processes which create nutritional outcomes among urban and rural youth in central Tanzania. Youth are an important and demographically large population in developing countries. The identities created during this distinct stage of cultural production can be reflected in youths' food consumption and relationships with food. Nutrition likely affects how youth transition through a variety of states, including their growth and development stages, primary to secondary to higher education, child to parent, or unemployed to employed. …

Apparent Total Evaporative Resistance Values From Human Trials Over A Range Of Metabolic And Heat Stress Levels, Matthew David Dooris

USF Tampa Graduate Theses and Dissertations

Failure to maintain thermal equilibrium can cause uncontrollable increases in body core temperature beyond critical upper limits. In selecting clothing, consideration must be given to the heat transfer properties of clothing that may restrict the cooling capacity of the human body under heat stress conditions, most importantly, apparent total evaporative resistance (R_e,T,_a). This study calculated and compared R_e,T,_a for five clothing ensembles under varying heat stress conditions, including three relative humidity (RH) levels and three stages of heat stress to determine if R_e,T,_a values varied or remained the same with …

Apparent Total Evaporative Resistance For Clothing Ensembles At High Heat Stress Levels, Patrick Rodriguez

USF Tampa Graduate Theses and Dissertations

Donning protective clothing for mitigation of hazard from chemical agents poses a problem in the form of heat stress. When choosing protective clothing, many factors must be taken into account including insulative properties and evaporative resistance. This study calculated and compared R_e,T,a for three clothing ensembles at levels of heat stress past the level of compensation for heat gain to determine if R_e,T,a values varied or remained the same with changes in heat stress level. A three-way mixed model analysis of variance demonstrated significant differences for estimated R_e,T,a values among ensembles, heat stress levels and interactions among …

Impact Of A Wellness Clinic Visit On Cardiovascular Risk Biomarkers In Employees Of A Va Medical Center, Margaret Asomaning

USF Tampa Graduate Theses and Dissertations

Background: Worksite screening programs are increasingly being provided by employers as a means to reduce cardiovascular risk in employees. A screening program that consists of fasting serum analysis of glucose plus a lipid panel is offered yearly to employees at the VA medical center in Tampa. A retrospective study was conducted to determine if a wellness clinic exposure resulted in significant changes in employees' markers of cardiovascular risk.

Methods: Computerized records were used to follow serial outcomes for glucose, triglycerides, HDL cholesterol, and LDL cholesterol in employees whose screening results showed abnormal levels of one or more of …

Literacy And Hazard Communication Comprehension Of Employees Presenting To An Occupational Health Clinic, Christine Bouchard

USF Tampa Graduate Theses and Dissertations

More than 100 million American workers, 7 million workplaces, and 945,000 hazardous chemical products are covered under the Hazard Communication Standard (HCS), regulated by the Occupational Safety and Health Administration. There were a total of 1,183,500 recordable non-fatal illnesses and injuries in private industry workplaces in 2006 resulting in days away from work. Of these, 19,480 were due to chemicals and chemical products. In addition, there were a total of 5,703 work-related fatalities in 2006. In 191 of these, chemicals and chemical products were listed as the primary source of injury and as the secondary source of injury in 104 …

Evaluation Of Common Inherited Variants In Mitochondrial-Related And Microrna-Related Genes As Novel Risk Factors For Ovarian Cancer, Jennifer Permuth Wey

USF Tampa Graduate Theses and Dissertations

Epithelial ovarian cancer (EOC) is a leading cause of morbidity and mortality among women in the United States, and the etiology is incompletely understood. Common, low penetrant genetic variants such as single nucleotide polymorphisms (SNPs) likely contribute to a significant proportion of EOC. We examined whether SNPs in two understudied yet biologically important types of genes, mitochondrial-related and miRNA-related genes, may contribute to EOC susceptibility using data from a large, homogeneous study population of 1,815 EOC cases and 1,900 controls (frequency-matched on age-group and race/ethnicity) genotyped through stage 1 of an ongoing genome-wide association study. Inter-individual variation in genes involved …