Public Health Commons^™

Effect Of Medicaid/Schip And Wic On Oral Health Of Low-Income Children, Dahlia Naqib

Theses and Dissertations

Oral caries is the most prevalent chronic disease among US children, and disproportionately impacts those of low socioeconomic status. Studies have shown that the Special Supplemental Nutrition Program for Women Infants and Children (WIC) improves access to dental care among Medicaid children. This study investigated the impact of WIC, Medicaid, and the State Children's Health Insurance Program (SCHIP) on the prevalence of dental caries among low-income children. The 1999-2000 and 2001-2002 NHANES data were utilized for this analysis. Children 2-4 years old who participated in WIC, Medicaid, or SCHIP, or who were uninsured, and for whom both interview and complete …

Analysis Of The Impact Of A Social Norms Campaign On The Alcohol Use Of Undergraduate Students At A Public, Urban University, Amanda B. Wattenmaker

Theses and Dissertations

Purpose: To conduct a secondary analysis of survey data collected at a large, urban university assessing for change in students' alcohol use perceptions and behaviors between 2002 and 2004. After the baseline data collection in 2002, the campus launched an intensive media intervention to normalize low-risk drinking. Simultaneously, the campus shifted from being a primarily commuter to primarily residential. Methods: This cross-sectional analysis used data collected from students in randomly selected undergraduate classes in February 2002 (n= 662) and 2004 (n=1334). The survey instrument used was the National College Health Assessment. Variables were categorized as demographic, alcohol perception, and alcohol …

Long-Term Consequences Of West Nile Virus In Virginia., Diana Cruz Ocampo

Theses and Dissertations

Objective: The purpose of this investigation was to describe the long-term effects and functional outcomes of patients in Virginia who were reported to the Virginia Department of Health with West Nile virus (WNV) non-neuroinvasive and neuroinvasive disease. The study identified the duration of symptoms after initial illness, the number of persons who fully recovered versus the number who continue to be symptomatic and how patients' quality of life differed after illness.Methods: The study population was drawn from 60 human cases that met the surveillance case definition for non-neuroinvasive and neuroinvasive WNV illness in Virginia between 2002-2004. Information was collected during …

Age At Sexual Assault And Posttraumatic Stress Disorder In Females Residents Of Virginia, Ahmed Gasmelseed Babiker

Theses and Dissertations

Background Post Traumatic Stress Disorder (PTSD) is a psychiatric debilitating condition that can occur in individuals who experience extremely stressful or traumatic life events. Sexual assault is considered as one of the most traumatic stressor in life. Although few studies investigated the association between history of sexual assault and PTSD, no studies have examined the impact of age at sexual assault on PTSD.Method A cross-sectional telephone survey was conducted among adult female residents of Virginia from November 2002 to February 2003. A total of 1,769 women aged 18 and older were interviewed using a random digit dialing method. Detailed screening …

The Prevalence Of Comorbid Chronic Disease In Virginia's Adult Patient Population During The Years 2001 And 2004, Joseph D. Schwartz

Theses and Dissertations

Objective: Chronic disease comorbidities, on the rise in the U.S. and Virginia, represent a new challenge to the way medicine is practiced and prescribed. This descriptive study uses Virginia hospital discharge data to describe the prevalence and trends of chronic disease comorbidities present in the state's over-45 population during the years 2001 and 2004.Methods: Data collected by Virginia Health Information was utilized. Adults over the age of 45 years and who selected for race and location were included in this analysis, with an aggregate sample size of 813,336 (N=458,593 [2001]; N=364,743 [2004]). Pearson chi-square analyses determined significant sample population differences …

Trends In Canine Lyme Disease On The Eastern Shore Of Virginia, 2000-2005, Ellen Garrett Hillyer

Theses and Dissertations

Introduction: Lyme disease is caused by the tick-borne spirochete Borrelia burgdorferi. Research has shown that dogs can be used as sentinels for human infection of Lyme disease. The purpose of this 5-year, retrospective study was to determine if there was any evidence that the incidence of canine Lyme disease has increased between 2000 and 2005 in Accomack and Northampton counties. An increased incidence in Lyme disease in dogs may indicate an increased present or future risk of Lyme disease in humans.Methods: Cases of canine Lyme disease were identified via practice invoicing systems and dogs that received doxycycline were entered into …

The Association Between Eating Habits And Hypertension Among African American Women Compared To Other Women, Anike N. Clark

Theses and Dissertations

Background: Hypertension is a major public health concern for African American women. Many studies have shown a greater prevalence of hypertension, as well as physical inactivity, excess weight, and diabetes, in African Americans. Objective: To determine if differences in eating patterns, as measured by Healthy Eating Index (HEI) scores, between African American women and other women in the United States are associated with hypertension. Methods: Data were extracted from the Third National Health and Nutrition Examination Survey (NHANESIII). The sample included 31,189,534 women aged 45 years or greater after survey weights were applied. The majority was White (86.1 %); minority …

The Incidence And Prevalance Of Cervical Cancer In Vietnamese Women (1993-1995): A Analysis Of Seer Reported Cases, Thuy Do

Theses and Dissertations

Background: Cervical cancer is the third most common reproductive cancer in the U.S. To date, one report concluded that U.S. Vietnamese women had the highest incidence rate (43.0/100,000). The current study examines whether U.S. Vietnamese women are more likely to have cervical cancer in comparison to Whites, Blacks, Hispanics, American Indians, and other Asian subgroups. Methods: SEER data of cervical cancers diagnosed from 1993-1995 (n = 37,790) was utilized. Using SPSS, chi-square statistics assessed whether Vietnamese women were older and more likely to be married or diagnosed at a later stage. Logistic regression assessed the amount of risk race/ethnicity contributes …

Assessing The Relationship Between Socioeconomic Variables And Risk Of Overweight Among Children 6 Years Of Age, Marilyn Cochon Batan

Theses and Dissertations

Background: The percentage of overweight children has tripled in the last thirty years. Inconsistent findings are published regarding the relationship between socioeconomic variables and being overweight in childhood.Objective: To determine whether socioeconomic variables are associated with risk of being overweight among six year olds. Methods: Six year olds with BMI data were selected from the National Survey of Children's Health (n=4,362). Variables were coded and a low socioeconomic index was created. Using population weights, descriptive statistics were generated and regression was utilized to assess the relationship between socioeconomic variables and being 'at risk' for overweight. Socioeconomic variables were also compared …

Predictors Of Induced Abortion Among Female Youth Center Users In Port-Au-Prince, Haiti, Rachel Barker

Theses and Dissertations

Objective: Induced abortions occur in every country in the world. However sixty percent of the world's women live in countries where abortion is illegal. 19 million pregnancies end in unsafe and/or illegal abortions. Annually, 68,000 women die from unsafe abortions. Legal or not, unsafe abortion is one of the great neglected problems of health care in developing countries like Haiti and is a serious concern to women during their reproductive lives. Methods: The data for this study was collected from youth centers (ages 15-24) and used to estimate percentage distributions of abortion ratios by selected characteristics of women, particularly age …

The Relationship Between Breastfeeding And The Development Of Asthma In Early Childhood, River Anne Pugsley

Theses and Dissertations

Purpose: Asthma can have significant adverse effects on the health and quality of life of children, and the prevalence of this condition continues to rise. Breastfeeding may protect against asthma, but some uncertainty remains. The purpose of this study was to further examine the relationship between breastfeeding and the risk of developing asthma in early childhood. Methods: Data were collected from the State and Local Area Integrated Telephone Survey: National Survey of Children's Health, 2003. The study population consisted of 33,315 children ages 0 to 5 years. Prevalence rates of asthma and breastfeeding ,were calculated, as were crude and Mantel-Haenszel …

Body Image And Attitudes Toward Obesity In College Students, Sarah Rebecca Goodwin

Theses and Dissertations

The current study was conducted in order to examine the impact of ethnicity on gender differences in body type preferences and perceptions and add to the literature examining racial differences in body type preferences and perceptions. The current study was an expansion of one by Gipson et al conducted at a historically Black university in 2004, in which responses and BMI measurements of 191 college students were examined for associations between BMI and gender, and body image and attitudes toward obesity. For the current study the sample of 176 college students enrolled at Virginia Commonwealth University, an ethnically diverse institution, …

Determinants Of Prenatal Care And Supplement Use: The Case Of Honduras, Catherine E. Henze

Theses and Dissertations

Context: Literature suggests that prenatal care and prenatal supplement use improves pregnancy outcomes. However, we do not know the factors associated with prenatal care and supplement use in Honduras.Objective: To identify characteristics of Honduran women who are the least and most likely to use prenatal care and supplements.Methods: Data from a 2001 Honduras cross-sectional survey of women was used to assess their use of prenatal care and supplements. All data was weighted, resulting in a sample size of n = 5647 women who had a live birth since January 1996. Bivariate and multivariate analyses were used to examine factors associated …

Rabies In Virginia, 1989-2003: With Particular Attention To Animals, Geographic Distribution, And Virus Variant, William Andrew Holzgrefe

Theses and Dissertations

Objectives: The description of the raccoon rabies epizootic in Virginia over fifteen years (1989-2003). Methods: Using simple statistical methods and a geographic information system (GIS)-based approach, and fifteen years worth of animal surveillance data, the progress of this epizootic has been charted in terms of the geographic spread of the disease, the major animal species affected by the disease and its spread, and the exposure and risk to humans and livestock animals presented by the expansion of the geographic range. Results: The resulting descriptive study illustrates the eastward expansion of the epizootic, the mushrooming of the disease in the northern …

Evaluation Of The Hayes E. Willis Health Center In South Richmond -- Has It Served Its Targeted Population?, Shannon Nicole Shaw

Theses and Dissertations

Objective: The Hayes E. Willis Health Center (HWHC) was opened in a neighborhood of South Richmond in October 1993 to remove the barriers that prevented South Richmond residents from accessing primary healthcare services. The major objective of this study was to determine the effectiveness of the HWHC in providing primary care to the South Richmond Community deemed to be in need. An additional objective was to describe the changes in characteristics of clinic users and illnesses seen over time.Methods: Patient data was compared from the HWHC�s first full year of operation in which patient data was collected (1995) to the …

Antioxidants As Risk Factors For Gingival Bleeding, Hee-Jeong Bahng

Theses and Dissertations

Background: Studies of gingival bleeding and the effects of antioxidants on extracellular matrix and immunologic and inflammatory responses provide a rationale for hypothesizing that antioxidants reduce the risk for gingival bleeding.Methods: This study evaluated the role of antioxidants as contributing risk factors for gingival bleeding utilizing the Third National Health and Nutrition Examination Survey (NAHNES III). A sample of 18,825 adults (20 to ≥ 90 years of age), with dental measurement and assessment of serum levels of antioxidants were included in the study. Gingival bleeding was defined as those who had more than 30 percent of gingival bleeding in 28 …

Is Number Of Pregnancies A Risk Factor For Heart Attack In Women?, Pavan Kumar Irukulla

Theses and Dissertations

Background: Studies regarding number of pregnancies and coronary heart disease have shown inconsistent results. In the present study, we assessed the association between number of pregnancies and heart attack (HA) in women.Methods: Using data from NHANES III a cross sectional data analysis of 10634 women aged 17 and above was conducted. We considered socio-demographic factors and other potential risk factors including physical activity, smoking, alcohol, diabetes, hypertension, hypercholesterolemia, BMI, age, and family history of heart attack. We conducted Bivariate analysis to determine prevalence and crude odds ratios. Multivariate logistic regression analysis was used to adjust for confounding variables using SPSS. …

Targeting The Male In Teen Pregnancy Prevention, Terri Burgan

Theses and Dissertations

Study Objectives: To examine demographic characteristics and contraceptive habits of young men.Methods: A descriptive study was conducted utilizing data analyzed from three waves of the National Survey of the Adolescent Male (NSAM) administered in 1988, 1991, and 1995. The first wave consisted of 1,880, never-married, noninstitutionalized 15-19 year old men living in the United States. The second wave consisted of 1,676 re-interviewed respondents who were 17-22 years old. The third wave consisted of 1,377 re-interviewed respondents who were 22-27 years old. Descriptive statistics were used to compare personal and demographic characteristics across each year group. Odds ratios, and their corresponding …

Association Between The Frequency Of Physical Education Classes And The Prevalence Of Overweight/Obesity In Adolescents, Collin N. Rice

Theses and Dissertations

Background/Objective: Overweight and obesity has been steadily on the rise in the United States for all groups. The prevalence of obesity for adolescents has tripled since 1980. The purpose of this study is to determine an association between the frequency of physical education classes and the prevalence of overweight/obesity in adolescents in the United States.Methods: This was a cross-sectional study that used the 2001 Youth Risk Behavior Survey (YRBS) of the Center for Disease Control. The outcome variable for the study was Body Mass Index (BMI). A BMI of 25 or greater was considered overweight or obese. The main independent …

Obesity And Health Status Among Urban Vs. Suburban Elderly In Philadelphia And Surrounding Counties, Ockidde Dufayne Harris

Theses and Dissertations

Obesity is a dangerous health condition affecting approximately 30% of all Americans and can be attributed to 300,000 deaths a year. Obesity has been found to disproportionately affect Blacks, Latinos, and those with lower SES. Although obesity is a problem for all age groups, its prevalence is highest among those 60-74 years of age. Studies have shown that there is an association between obesity and chronic conditions such as cardiovascular disease, arthritis, cancers, and type-2 diabetes. According to the Centers for Disease Control, chronic health conditions affect 80% of all elderly persons, many times limiting function and decreasing quality of …

Toothbrushing, Flossing, And Preventive Dental Visits By Richmond-Area Residents In Relation To Demographic And Socioeconomic Factors, Kim T. Isringhausen

Theses and Dissertations

Purpose. This study was conducted to identify factors that influence preventive dental behaviors and, from the results, target groups for intervention.Methods. Data were collected using the 1997 Behavioral Risk Factor Surveillance System (BRFSS) resulting in a probability sample of 399 dentate adults living in Richmond City, Henrico, Chesterfield and Hanover Counties in Virginia. All analyses were performed using the statistical software program STATA. Initial hypothesis testing was performed using univariate logistic regression models. Multivariate logistic regression models were used to test the significance of independent variables while controlling for other possible predictors of behavior.Results. Females were more likely than males …

Effect Of Repeated Dosing Of Delta 9-Tetrahydrocannabinol, The Major Psychoactive Ingredient Of Marijuana, On Memory In Mice, Floride Niyuhire

Theses and Dissertations

Purpose: Marijuana is the most widely used illicit drug in the United States. However, marijuana and cannabinoid derivatives have potential therapeutic uses. Studies in cannabis users have yielded contradictory results with regard to long-term effects on cognitive functions. There is no prospective study assessing this issue, and such studies may raise ethical issues in humans, whereas mice have been shown to exhibit similar cannabinoid-mediated behaviors as humans. The purpose of this study was to assess the consequences of chronic administration of Δ9-THC, the major psychoactive component of marijuana, in a mouse memory model. Methods: In Experiment 1, the dose-response relationship …

The Determinants Of Post-Discharge Healthcare Utilization And Outcomes For Veterans With Posttraumatic Stress Disorder: A Social Ecological Perspective, Shyuemeng Luu

Theses and Dissertations

Posttraumatic stress disorder (PTSD) has a persistent nature: PTSD troubles patients

even decades after the occurrence of traumatic events. The “health behavioral model” is

adopted to examine the effects of external environmental, predisposing, enabling, and

need for care factors on the use of VA post-discharge ambulatory care and readmissions.

Data were obtained from the Patient Treatment File (PTF) and the Outpatient Care File

(OPT), the Area Resource File (ARF), American Hospital Association data sets (AHA), and the Uniform Crime Report (UCR).

The use of VA post-discharge ambulatory care is analyzed by using structural equation modeling (SEM). The readmission to VAMCs …

Oral Performances As Ritual: Animating The Invisible In Mormon Women's Miscarriage Stories, Kristin Leifson Ballif

Theses and Dissertations

This thesis is comprised of ten Mormon women's miscarriage stories and it is their stories that are used as the text for my analysis. The purpose of the study is to provide a space for these women to share their experiences and to reveal their cultural values and beliefs. Because the women are all Mormon, there are some distinctive cultural and religious values that are shared within their stories and it is these aspects that are analyzed and discussed within the text.

Women need to be able to share their miscarriage stories so as to alleviate feelings of isolation and …

The Structural Response And Performance Of General Hospitals In A Managed Care Environment, Denise M. Mccollum

Theses and Dissertations

The study purpose is to link hospital structure, represented by each hospital’s professional contingent, service mix, and inpatient capacity; and its environment, characterized by the penetration of managed care enrollees. The secondary purpose is to test the relationship between hospital structural change and subsequent hospital performance.

The study employs a non-experimental panel design, with a sample of 1882 community hospitals (service type: general medical and surgical). Environmental variables are measured for the base year 1989. Hospital structural variables are measured for 1989 and 1994, with change variables computed. Performance variables are measured for 1989 and 1995, with change computed for …

Determinants Of The New Entry Of Hmos Into A Medicare Risk Contract: A Resource Dependence-Diversification Model, Chih-Wen Pai

Theses and Dissertations

The purpose of this study is to examine the determinants of the new entry of an HMO into a Medicare risk contract using a resource dependence—diversification model. This study is conducted through a non-experimental, panel design With one year time lag. An HMO’s market is defined as the service area. The primary sample for this study is composed of 440 HMOS that do not have a Medicare risk contract as of January 1994.

Data for the variables are extracted from the 1994 and 1995 InterStudy and Group Health Association of America (GHAA) directories, the 1996 Area Resource File, the 1994 …

Organizational Slack, Efficiency, And Quality Of Care In Acute Care Hospitals, Kyung Ii Youn

Theses and Dissertations

The relationship between technical efficiency and quality of care in hospitals is studied in the context of resource availability in hospital organizations. The resource availability of hospitals is conceptualized by organizational slack.

An integrated model is developed encompassing the source of organizational slack, its impact on technical efficiency and on quality of care, and its impact on the relationship between efficiency and quality. Organizational threat as an environmental factor affecting the level of slack is measured by the level of competition and regulation. Organizational slack is measured using financial and operational indicators of the hospitals. Technical efficiency is estimated by …

A Retrospective Quantitative Assessment Of Trichloroethylene Exposure Of Workers At Aircraft Maintenance Facilities At Hill Air Force Base Through The Use Of Modeling, Anthony O. Copeland

Theses and Dissertations

Monte Carlo simulation and source-receptor modeling are used to estimate the TCE exposures encountered by select workers at aircraft maintenance facilities at Hill Air Force Base between 1955 and 1979. An epidemiological study of this group, a retrospective cohort study of 14,457 workers who were employed at the base for a minimum of one year between 1952 and 1956, was headed by Dr. R. Spirtas of the National Cancer Institute to evaluate mortality associated with occupational exposure. One of the major conclusions of the study was that TCE 'probably does not pose a strong carcinogenic risk for man.' In the …

A Comparative Pharmacokinetic Study Of The Role Of Gender And Developmental Differences In Occupational And Environmental Exposure To Benzene, Elizabeth A. Brown

Theses and Dissertations

The purpose of this study is two-fold. First, it shows that physiological differences between men and women result in gender-specific exposures with respect to benzene. Second, it assesses the potential for a lactating woman's occupational and personal benzene exposure to impact a nursing infant's exposure, highlighting the possibility of subjecting an infant to the effects of industrial chemicals via breast feeding. This study employs physiologically based pharmacokinetic (PBPK) modeling to investigate the influence of physiological parameters and to evaluate the ability of inhaled benzene to transfer from mother to infant through breastmilk. The models are run through scenarios that simulate …

A Risk Assessment Of The Health Liabilities From Exposure To Toxic Metals Found In The Composted Material Of Air Force Municipal Solid Waste, Timothy L. Merrymon

Theses and Dissertations

This thesis assesses the risk of the health liabilities from exposure to toxic metals found in the composted material of Air Force municipal solid waste (MSW). The goal is to determine the probability that the composted MSW could be a health hazard if it were used as a soil amendment. The research limited the assessment of the exposure risk to heavy metals found in raw MSW and its resulting compost. The thesis uses reviews of present literature to examine the food and soil ingestion exposure pathways. These pathways are assessed using the heavy metal concentrations found in MSW compost and …