Public Health Commons^™

Table Of Contents

Michigan Journal of Public Health

No abstract provided.

Quality Improvement In Small Office Settings: An Examination Of Successful Practices., Daniel Wolfson, Elizabeth Bernabeo, Brian Leas, Shoshanna Sofaer, Gregory Pawlson, Donna Pillittere

College of Population Health Faculty Papers

BACKGROUND: Physicians in small to moderate primary care practices in the United States (U.S.) (<25>physicians) face unique challenges in implementing quality improvement (QI) initiatives, including limited resources, small staffs, and inadequate information technology systems 23,36. This qualitative study sought to identify and understand the characteristics and organizational cultures of physicians working in smaller practices who are actively engaged in measurement and quality improvement initiatives.

METHODS: We undertook a qualitative study, based on semi-structured, open-ended interviews conducted with practices (N = 39) that used performance data to drive quality improvement activities.

RESULTS: Physicians indicated that benefits to performing measurement and …

Concepts Of Contraception For Adolescents With Obesity: Pathways Of Judicial Moderation, Donald E. Greydanus, Hatim A. Omar, Artemis Tsitsika

Pediatrics Faculty Publications

All sexually active youth, whether obese or normal weight, should be offered counseling regarding contraception and appropriate contraceptive methods. However, obese youth who are sexually active may be less likely than their normal weight peers to use contraceptives correctly. Methods of contraception for obese adolescents are reviewed in this discussion. Combined oral contraceptives (COCs) and the contraceptive patch have higher failure rates in obese versus normal weight females, though failure rates are lower than noted with barrier contraceptives. The risk for venous thrombosis is higher in obese youth on COCs. Progestin-only pills and the levonorgestrel intrauterine system appear to be …

Obesity And Hyperandrogenism, Amit M. Deokar, Shawn J. Smith, Amanda J. Goodwin, Hatim A. Omar

Pediatrics Faculty Publications

This chapter has a two-fold objective. One, it addresses the association of hyperandrogenism and obesity and the complex metabolic derangements that are part of the problem. Clinical management of these co-morbidities is challenging and complex. Second, this article will aid health care providers with the key features to an early diagnosis and intervention to decrease the morbidities in the short as well as long term. Method: Systematic review of articles and information on the topic of interest that were published in the last 15 years. Conclusion: Obesity and hyperandrogenism are integral parts of Metabolic Syndrome/Polycystic Ovarian Syndrome (PCOS)/Hyperandrogenism, Insulin resistance, …

Obesity And Lack Of Physical Activity, Hatim A. Omar, Efrat Merrick-Kenig, Joav Merrick

Pediatrics Faculty Publications

Lack of physical activity and overweight status continues to be a significant health problem in the United States. To assess the actual prevalence of these problems, we reviewed data from the School-based Health Promotion Centers in one middle school, and one high school in central Kentucky. A total of 232 6th graders and 607 9th graders were included. A total of 92% of 6th graders and 45% of 9th graders reported complete lack of regular exercise. 37% of 9th graders and 59% of 6th graders had inappropriate nutrition, 47% of 9th graders and 33% of 6th graders had Body Mass …

The Implementation Of The Kentucky Transitions: A Money Follows The Person Demonstration Grant Program, Amie Goodin

MPA/MPP/MPFM Capstone Projects

Kentucky Transitions is a Kentucky Medicaid program that is funded primarily by a grant from the Centers for Medicare and Medicaid Services. The purpose of this program is to transition individuals residing in long-term care facilities back into the community, where they will continue to receive health, social, and other benefits but do so in an approved residential setting. Individuals living in the community may experience higher quality of life and the increased ability to choose how and when they receive services, while Medicaid reaps the projected financial benefit of providing less-expensive community alternatives for care.

Though Kentucky Transitions operates …

Medication Therapy Management: Is It Worth Medicare’S Time?, Jennifer White

MPA/MPP/MPFM Capstone Projects

Problem:

Medication Therapy Management (MTM) is a service that a pharmacist can provide to any of their patients, but mostly to those who are either high risk patients for adverse events or those who are new to chronic medication therapy. As Medicare Part D has begun to cover MTM services, more and more pharmacists and other clinicians are becoming providers of MTM.

The intent of MTM is to decrease adverse events and healthcare costs to both the patient and the third party payer. In realizing the benefits of MTM, it is important to assess these outcomes to see if clinical, …

Policy Issues Affecting Maine’S Hospitals, John A. Gale Ms, Jennifer D. Lenardson Mhs

Rural Hospitals (Flex Program)

Legislators and other policymakers will be continually challenged to balance the needs of hospitals for appropriate reimbursement and oversight with supporting their provision of important services to local communities.

Minnesota Health Care Programs: Renville County Human Servics Outreach Project, Bethany Leindecker

All Graduate Theses, Dissertations, and Other Capstone Projects

Purpose:

To develop an outreach program for use by Renville County Human Services staff to educate potential service recipients and other community residents about Minnesota health care programs.

To assist outreach staff in gaining skills and knowledge necessary to effectively conduct the outreach.

Best Practices For Vulnerable Adult Investigation Policies And Procedures At Blue Earth County, Anna Stindt

All Graduate Theses, Dissertations, and Other Capstone Projects

The purpose of this project is to update the policies and procedures for conducting vulnerable adult investigations in Blue Earth County to reflect changes in the statute and to incorporate current best practices for conducting investigations.

When To Spray: A Time-Scale Calculus Approach To Controlling The Impact Of West Nile Virus, Diana Thomas, Marion Weedermann, Lora Billings, Joan Hoffacker, Robert Washington-Allen

Department of Mathematics Faculty Scholarship and Creative Works

West Nile Virus (WNV) made its initial appearance in the New York City (NYC) metropolitan area in 1999 and was implicated in cases of human encephalitis and the extensive mortality in crows (Corvus sp.) and other avian species. Mosquitoes were found to be the primary vectors and NYC’s current policy on control strategies involved an eradication program that depends on the synchronicity of the summer mosquito population’s increases with the occurrence of cases in humans. The purpose of this paper is to investigate whether this is the most effective control strategy because past mathematical models assumed discrete behavior that …

Lead Poisoning: An Alarming Public Health Problem In Bangladesh, Amal K. Mitra, Akhlaque Haque, Manirul Islam, S.A. M.K. Bashar

Faculty Publications

To assess the risk of lead poisoning among preschool and school-aged children in Bangladesh, 345 children were screened for blood lead levels (BLLs) from one rural and two urban areas in Bangladesh from September 2007 through January 2008. An urban industrial area at Tongi was identified as a disaster area, where 99% (104/105) of those tested had BLLs >= 10 mu g/dL. Industrial emissions and use of leaded gasoline by two-stroke engine vehicles were identified as possible sources of lead in that area. A rural nonindustrial area at Chirirbandar, Dinajpur was identified as another high-risk area, where 14% of the …

The Association Of Dust Events With Asthma Exacerbation In The U.S.-Mexico Border Children: A Pilot Study, Monika Gaytan

Open Access Theses & Dissertations

Background. Asthma is one of the most prevalent chronic pediatric illnesses in the U.S. and a major cause of childhood disability, hospitalization, and missed schooldays. Air pollution is one of a number of known environmental triggers known to exacerbate pediatric asthma. Emerging evidence also suggests that exposure to dust aerosols associated with dust storm events may trigger asthmatic symptoms. The Paso del Norte (PDN) region is the single most dust-prone major metropolitan area in the U.S., averaging 14.5 major dust events/yr. The annual peak in dust event activity occurs during March to May where there is a 42% chance of …

Prenatal Physical Activity Patterns And Determinants In An Urban Ecuadorian Population, Erika Gonzalez Beltran

Open Access Theses & Dissertations

Background & Significance. Evidence has accumulated over the past two decades suggesting that healthy pregnant women who engage in regular moderate physical activity (PA) may reduce their risk for certain adverse pregnancy and postnatal health outcomes. The U.S. Department of Health and Human Services (DHHS)/Centers for Disease Control and Prevention (CDC) recently issued the 2008 Physical Activity Guidelines for Americans which recommends at least 150 minutes/week of moderate-intensity aerobic PA for pregnant women. The American College of Obstetricians and Gynecologists (ACOG, 2002) recommends 30 min of moderate-intensity PA, specified as derived from recreational or leisure activities on most or all …

The Relation Of Alcohol Expectancies To Alcohol Consumption And Alcohol-Related Problems Among College Students, Michelle Nicholle Greco

Open Access Theses & Dissertations

The purpose of the present study was to examine the relationships among positive and negative alcohol expectancies and alcohol consumption and alcohol-related problems in a sample of Hispanic, predominantly Mexican-American, college students. It was hypothesized that positive expectancies would be positively related to alcohol consumption and alcohol-related problems and that negative expectancies would be negatively related to alcohol consumption and alcohol related problems. Little is known and understood about the role of positive and negative expectancies in Hispanic college students and even less is known about how expectancies relate to alcohol related problems in this population.

This study was a …

Walk To Jerusalem: Facilitating Physical Activity In A Faith Community, Lisa Schmidt

Master's Theses and Doctoral Dissertations

Obesity and physical inactivity are on the rise in our society today. Combined with poor eating habits, many Americans are overweight or obese. Churches have become important settings for providing health education programs, especially for African-American populations. There have been mixed results from faith-based physical activity studies, and few have been conducted with Caucasian populations. The present study used the Walk to Jerusalem program as a motivational tool within a Caucasian faith-based setting. The objectives were to increase physical activity, decrease blood pressure and weight, if needed, and improve attitude toward physical activity. The primary objective of the project was …

Complete Identification Of Permissible Sampling Rates For First-Order Sampling Of Multi-Band Bandpass Signals, Yan Wu, Daniel F. Linder

Biostatistics: Faculty Publications

The first-order sampling of multi-band bandpass signals with arbitrary band positions is considered in this paper. Gaps between the spectral sub-bands are utilized to achieve lower sampling rates than the Nyquist. The lowest possible sampling rate along with other permissible sampling rates is identified via a unique partition of the frequency axis. With the complete identification of all the permissible sampling rates, a necessary and sufficient sampling theorem for multi-band bandpass signals is presented in terms of a series of csinc-interpolators.

Promoting Breast Cancer Screening Among Chinese American Women Through Young Children's Theatrical Performance, Angela Sun

Walden Dissertations and Doctoral Studies

Research has revealed that underutilization of breast cancer screening by ethnic minorities often is related to language difficulties and cultural values and beliefs about cancer. The problem addressed in this secondary data analysis was the late diagnosis of breast cancer in the Chinese immigrant community. The purpose of the quasi-experimental study was to test the efficacy of a theatrical preschool performance, guided by the diffusion of innovation theory, in educating Chinese American women about breast cancer detection. The research questions sought to determine whether the performance increased the participants' knowledge of breast cancer screening guidelines and whether country of origin, …

Intrapersonal And Community-Related Influences Of Rural Adolescent Pregnancy: A Mixed-Method Approach, Kimberly Becknel Brodie

Walden Dissertations and Doctoral Studies

The majority of data on adolescent pregnancy pertains to urban communities, therefore, the individual and social influences associated with adolescent pregnancy in rural communities have not been extensively explored. The pregnancy rate among adolescent women aged 15 to 19 in rural Vance County, North Carolina, is 113.7 per 1,000, nearly twice the state average. This sequential mixed-method study used the social ecological model to evaluate the intrapersonal and community-related factors associated with adolescent pregnancy in this rural area. A quantitative survey assessed intrapersonal factors, namely sexual health knowledge, sex-related attitudes, and self-esteem in pregnant or parenting and nonpregnant or nonparenting …

War Of The Worlds: Our Worlds Are Colliding And Infectious Disease Is Winning - Emerging Diseases And The One Health Initiative, Richard French

The University Dialogue

No abstract provided.

Project L.E.A.N.: An After-School Health And Exercise Project For Elementary School Children In El Paso, Texas, Hendrik De Heer

Open Access Theses & Dissertations

INTRODUCTION: After-school activities provide valuable opportunities for health promotion activities that do not interfere with the regular school day, especially in minority populations with higher rates of obesity and type 2 diabetes. The current study is an evaluation of an after-school health education and physical activity program conducted in nine elementary schools in 2008 in El Paso, Texas. METHODS: The intervention consisted of a 10-12 week (twice a week) after school program consisting of a pilot (with two experimental schools) and main intervention (six schools each including a control and experimental group). The main outcome variables were Body Mass Index, …

Evaluation Of A Community-Based Cervical Cancer Education Program On Perceptions And Knowledge Of Screening Among Low-Income Hispanic Women, Claudia S. Lozano

Open Access Theses & Dissertations

Cervical cancer affects Hispanic women disproportionately in comparison to their non-Hispanic white counterparts. In 2004, the incidence rate was 12.2 per 100,000 persons among Hispanic women compared to 7.5 per 100,000 among non-Hispanic white women (U.S. Cancer Statistics Working Group, 2007). Although this form of cancer is easily diagnosed through recommended screening tests, Hispanic women are often less likely to get screened (U.S. Department of Health and Human Services, 2000). Research based on the Health Belief Model (HBM) examining attitudes and beliefs about cervical cancer and screening among Hispanic women has demonstrated that non-compliance with Pap smear screening was attributed …

The Role Of Resilience And Purpose In Life In Habituation To Heat And Cold Pain, Bruce W. Smith, Erin M. Tooley

Arts & Sciences Faculty Publications

This study examined the role of resilience in habituation to heat and cold pain in healthy women (n = 47). Heat and cold pain thresholds were each assessed across 5 equally spaced trials. Re- silience, purpose in life, optimism, social support, and neuroticism were assessed using self-report measures. The hypothesis was that the resilience and the associated resilience factors would be pos- itively related to habituation to heat and cold pain while controlling for neuroticism. Multilevel mod- eling was used to test the hypothesis. When considering each characteristic separately, resilience and purpose in life predicted greater habituation to heat pain …

Understanding Middle School Students' Perspectives Regarding Physical Activity And Fitness, Susan Yesalonia

Walden Dissertations and Doctoral Studies

Research confirms inactivity increases in adolescence and that unfit youth are at risk of acquiring cardiovascular diseases, diabetes, obesity, or other significant physical disorders later in life. Thus, the purpose of this phenomenological study was to describe the experience of chronically inactive children who were exposed to an exercise intervention program. The specific focus of the research was to better understand the essential educational needs of the participants and the effective elements of the program, Moving for Fun (MFF), a 7-week after-school fitness intervention program designed to modify chronic inactivity. Open-ended interviews and 3 observations were conducted with 8 middle …

A Comparison Of Lifestyle Intervention Sessions And Clinical Screening As Motivators In The South Dakota Wisewoman Program, Jacy Clarke

Walden Dissertations and Doctoral Studies

WISEWOMAN (WW) is a comprehensive program for medically underserved women in South Dakota (SD), aged 30 to 64, which aims to reduce morbidity and mortality from chronic diseases. Screening services include blood total cholesterol, blood pressure and blood glucose, and body mass index (BMI). Lifestyle intervention (LSI) sessions are also offered to address physical activity and nutrition. The purpose of this retrospective longitudinal study was to quantitatively examine whether the combination of LSI's and clinical screenings or clinical screenings alone lead to improvements in blood pressure, blood glucose, total cholesterol, and/or BMI at rescreening 10 to14 months from initial screening. …

Sample Size Calculation For Finding Unseen Species, Hongmei Zhang, Hal Stern

Faculty Publications

Estimation of the number of species extant in a geographic region has been discussed in the statistical literature for more than sixty years. The focus of this work is on the use of pilot data to design future studies in this context. A Dirichlet-multinomial probability model for species frequency data is used to obtain a posterior distribution on the number of species and to learn about the distribution of species frequencies. A geometric distribution is proposed as the prior distribution for the number of species. Simulations demonstrate that this prior distribution can handle a wide range of species frequency distributions …

Wikipedia, Me, And Ohp, Irvin Sam Schonfeld

Publications and Research

No abstract provided.

Étude Exploratoire Des Parcours D’Emploi En Lien Avec L’Apparition Des Premières Lésions Chez Les Jeunes De 16 À 24 Ans, Jean-François Godin, Benoît Laplante, Élise Ledoux, Mircea Vultur, Zacharie Tsala Dimbuene

Rapports de recherche scientifique

Depuis une vingtaine d’années, plusieurs études ont mis en évidence le fait que les jeunes de moins de 25 ans se blessent suffisamment fréquemment au travail pour que cette situation devienne une préoccupation de santé publique tant au Canada, aux États-Unis qu’en Europe. Au Québec, ce constat préoccupe de plus en plus les partenaires du réseau de la SST.

À ce jour, la problématique des jeunes et de la santé et sécurité du travail a surtout été documentée à partir d’enquêtes transversales. Ces analyses ont permis d’identifier, entre autres, les secteurs d’activité et les types d’emploi où se produisent le …

An Evaluation Of Lead Hazards In Pre-1978 Residental Housing Within Clark County, Nevada, Usa, Erika Raquel Torres

UNLV Theses, Dissertations, Professional Papers, and Capstones

Lead poisoning remains a public health concern due to leads persistence in the environment from anthropogenic uses. Initial efforts to address the impacts of lead on vulnerable communities have included secondary prevention measures which typically occur after a child has been poisoned. However, in recent years there has been a pragmatic shift toward primary prevention efforts.

This study evaluates lead hazards identified through primary prevention activities in residential housing within Clark County, Nevada, USA. It is the first study to systematically address and evaluate pre-1978 housing in Southern Nevada. Risk assessments were conducted in 81 dwellings built prior to 1979 …

Recent High School Graduates Knowledge About Physical Activity Guidelines And Disease Related To Sedentary Lifestyle, Soojin Yoo

UNLV Theses, Dissertations, Professional Papers, and Capstones

This study examined recent high school graduates' knowledge about physical activity (PA) guidelines and disease related to sedentary lifestyle. Using a cross-sectional descriptive design, focus was on assessing knowledge performance and relating it to gender, ethnicity, PA behavior, and conceptualizations about high school health education (HE) and physical education (PE). Study participants were 394 recent high school graduates between the ages of 18-20 years of age. Participants completed a questionnaire designed to measure knowledge about PA guidelines and disease associated with sedentary lifestyle. In addition, the questionnaire also comprised items designed to capture demographical information and provide some information about …