Public Health Commons^™

Racial /Ethnic Disparities In Hypertension In United States Residents: A Cross-Sectional Study Of Potential Explanatory Covariates, Franklin I. Opara

Walden Dissertations and Doctoral Studies

Racial/ethnic disparities persist in hypertension (HTN) prevalence in the United States, and African Americans are disproportionately affected. The incidence is more than two-folds in African Americans compared to Caucasians, and mortality is highest among African Americans. Understanding the risk factors in HTN and how these factors vary across racial/ethnic groups is essential to reducing the mortality among African Americans. This study examined the prevalence of HTN among a sample non-institutionalized U.S. residents (N = 30,852), assessed racial/ethnic disparities and determined factors associated with racial/ethnic variance in HTN. A cross-sectional design was used to address these aims, utilizing the National Health …

Who Shares? Managerial Knowledge Transfer Practices In British Columbia's Ministry Of Health Services, Gwendolyn Elizabeth Lock

Walden Dissertations and Doctoral Studies

The British Columbia government's Ministry of Health Services will experience significant loss of operational knowledge from an aging managerial workforce, increased staff turnover, and difficulties in recruitment. The purpose of this study is to provide the ministry's Strategic Human Resources Planning branch staff with a map and description of knowledge transfer practices used by approximately 40 managers within the ministry's Health Sector Information Management/Information Technology division and its Vital Statistics Agency. The study is a mixed-methods case study of knowledge retention and transfer practices founded on a knowledge management and social network theoretical foundation. To understand the ministry's complex nature …

Metabolic Actions Of Insulin In Men And Women, Faidon Magkos, Xuewen Wang, Bettina Mittendorfer

Faculty Publications

Insulin is an important regulator of glucose, lipid and protein metabolism. It suppresses hepatic glucose and triglyceride production, inhibits adipose tissue lipolysis and whole-body and muscle proteolysis and stimulates glucose uptake in muscle. In this review we discuss what is currently known about the control of substrate metabolism by insulin in men and women. The data available so far indicate that women are more sensitive to insulin with regards to glucose metabolism (both in the liver and in muscle) whereas there are no differences between men and women in insulin action on lipolysis. Potential differences exist in the regulation of …

The Effect Of Direct Contact On Public Attitudes Towards People Living With Human Immunodeficiency Virus (Hiv) And Acquired Immune Deficiency Syndrome (Aids) In Zimbabweans, Mavis Mashingaidze

Walden Dissertations and Doctoral Studies

Stigma surrounding HIV and AIDS poses a significant threat to the curtailing of the epidemic by acting as a barrier to HIV testing and disclosure of serostatus. Previous research in the United States found personal knowledge of someone with HIV/AIDS to be a predictor of lower levels of HIV/AIDS-related stigma. However, no study to date has examined this relationship in Zimbabweans. Allport's contact hypothesis was hypothesis was the theoretical frame used to assess the effect of direct contact on public attitudes towards people living with the human immunodeficiency virus (HIV) and acquired immune deficiency syndrome (AIDS) in Zimbabweans with the …

Clinical Recognition Of Obstructive Sleep Apnea In A Population-Based Sample, Mark R. Zellmer

Walden Dissertations and Doctoral Studies

Obstructive sleep apnea (OSA), a disorder in which the airway intermittently collapses and obstructs during sleep, is associated with increased cardiovascular and cerebrovascular morbidity and mortality, increased risk of motor vehicle accidents, metabolic syndrome, hypertension, and depression. Treatment of OSA attenuates or reverses many of these associated risks. However, most cases of OSA are unrecognized and untreated. The two most recent studies using 1990s data found that only 6.5 - 15.4% of OSA cases, depending on severity, are clinically recognized in mixed gender populations. Based on a conceptual framework of improved physician awareness of OSA, and reduced diagnostic access bias …

Racial /Ethnic Differences In Susceptibility And Intention To Smoke On Smoking Behavior Among Adolescents, Kafilat Tolani Jimba

Walden Dissertations and Doctoral Studies

Every year, more than 400,000 Americans die prematurely because of tobacco use, and most users began smoking during their teen years. Adolescent tobacco use remains the nation's most preventable threat to life and health. A better understanding of the relationships between susceptibility to smoking and intention to smoke on smoking behavior by ethnicity, age, and gender is useful for program planners and health educators in designing ethnic, age, and gender specific strategies for tobacco control and prevention initiatives. The purpose of this study was to test the relationships between susceptibility to smoking and intention to smoke on smoking behavior among …

The Relationship Between Leadership Styles And Performance Success In Hospitals, Beverly J. D. Hernandez

Walden Dissertations and Doctoral Studies

Upheavals in the health care landscape threaten the sustainability of contemporary hospital organizations. Yet there is limited research regarding the characteristics of leaders within successful hospitals. The problem is the leadership styles needed to effectively run hospital organizations have not been identified and/or established. The purpose of this study was to develop a model of congruent leadership styles linked to the success of hospitals in one metropolitan city. The research questions sought to uncover (a) consistent leadership styles within successful hospitals, and (b) what, if any, relationship exists between leadership styles and measures of success. Examination of the literature uncovered …

Prolonged Injustice In Urban America, Jametta Magwood, Edith M. Williams, Saundra H. Glover

Faculty Publications

Environmental inequality is the suggestion that the working class, the poor, persons of color, and ultimately the economically disadvantaged are subjected to living conditions that may prove to be hazardous both personally, professionally, and also to the infrastructure of the urban communities that these people inhabit. These injustices affect not only housing but education, quality healthcare access, and access to employment. This article investigates the distinct relationship of environmental inequalities imposed in urban communities that are promoted by a prominent institution: the government. It has been suggested that the government is primarily controlled by individuals who are incapable of identifying …

Cesarean And Vbac Rates Among Immigrant Vs. Native-Born Women: A Retrospective Observational Study From Taiwan Cesarean Delivery And Vbac Among Immigrant Women In Taiwan, Jung-Chung Fu, Sudha Xirasagar, Jihong Liu, Janice C. Probst

Faculty Publications

Background:Cultural and ethnic roots impact women’s fertility and delivery preferences This study investigated whether the likelihood of cesarean delivery, primary cesarean, and vaginal delivery after cesarean (VBAC) varies by maternal national origin.

Mehods: We conducted a nation-wide, population-based, observational study using secondary data from Taiwan. De-identified data were obtained on all 392,246 singleton live births (≥500 g; ≥20 weeks) born to native-born Taiwanese, Vietnamese and mainland Chinese-born mothers between January 1 2006 and December 31 2007 from Taiwan’s nation-wide birth certificate data. Our analytic samples consisted of the following: for overall cesarean likelihood 392,246 births, primary cesarean 336,766 (excluding …

Specialty Care Use In Us Patients With Chronic Diseases, Jessica D. Bellinger, Rahnuma M. Hassan, Patrick A. Rivers, Qiang Cheng, Edith M. Williams, Saundra H. Glover

Faculty Publications

Despite efforts to eliminate health disparities, racial, ethnic, and geographic groups continue lag behind their counterparts in health outcomes in the United States. The purpose of this study is to determine variation in specialty care utilization by chronic disease status. Data were extracted from the Commonwealth Fund 2006 Health Care Quality Survey (n = 2475). A stratified minority sample design was employed to ensure a representative sample. Logistic regression was used in analyses to predict specialty care utilization in the sample. Poor perceived health, minority status, and lack of insurance was associated with reduced specialty care use and chronic disease …

The Neighborhood Cancer Center, Gregory R. Harper Md, Phd, Debbie Salas-Lopez Md, Mph, Keith J. Weinhold Mha, Elliot J. Sussman Md, Mba

Administration & Leadership

No abstract provided.

Inadequate Health Numeracy Affects Cancer Screening Practices In Vulnerable Populations, Sherrine Eid Mph, Dorothy Faulkner Phd

Administration & Leadership

No abstract provided.

Racial Disparities Between The Sex Steroid Milieu And The Metabolic Risk Profile, Arlette C. Perry, Xuewen Wang, Ronald B. Goldberg, Robert Ross, Loreto Jackson

Faculty Publications

Aims and Method. The present study examined the relationship between the metabolic risk profile (MRP) and total testosterone (TT) and free testosterone using the free androgen index (FAI) and sex hormone binding globulin (SHBG) in 36 Caucasian American (CA) and 30 African-American (AA) women volunteering for a weight loss study. Results. After controlling for age, significant relationships were found between TT and diastolic blood pressure (P = .004 and P = .015 in CA and AA women, resp.). Additionally, total cholesterol (P = .003), low density lipoprotein cholesterol (P = .004), apolipoprotein B (P = .006), …

Social Categories And Health Care Outcomes: African American Women And Hiv Survival In The Urban South, Alyson J. O'Daniel

University of Kentucky Doctoral Dissertations

This ethnographic research examines the daily life and institutional conditions under which low-income Black women in urban North Carolina perceived and attended to HIV health-related needs. I focus specifically on the interplay among women’s living conditions, programmatic service needs, and their strategies for navigating the local system of care to explore and refine the categorical label “low income.” I found that there were significant differences among study participants in terms of their monthly incomes and financial resources, housing quality and status, and personal experiences with incarceration and substance abuse. The economic differences among women translated into social differences within the …

Health Promotion And Health Education: Nursing Students’ Perspectives, Kathleen Ann Halcomb

University of Kentucky Doctoral Dissertations

The purpose of this study was to determine student nurses’ perceptions of (1) the role of the nurse in health promotion, and (2) how the concept of health promotion is presented in nursing curricula. Research questions for this study included the following: 1) Can nursing students explain the difference between health education and health promotion? 2) What have nursing students been exposed to within their curriculum regarding health promotion? 3) What health promoting behaviors are nursing faculty role modeling as perceived by nursing students? 4) What is the role of the nurse in implementing health promotion as perceived by nursing …

A Markov Transition Model To Dementia With Death As A Competing Event, Liou Xu

University of Kentucky Doctoral Dissertations

The research on multi-state Markov transition model is motivated by the nature of the longitudinal data from the Nun Study (Snowdon, 1997), and similar information on the BRAiNS cohort (Salazar, 2004). Our goal is to develop a flexible methodology for handling the categorical longitudinal responses and competing risks time-to-event that characterizes the features of the data for research on dementia. To do so, we treat the survival from death as a continuous variable rather than defining death as a competing absorbing state to dementia. We assume that within each subject the survival component and the Markov process are linked by …