Public Health Commons^™

"When You Tell Them, Your Secret Is Out There": Experiences Of Sexuality And Intimacy Among Hiv Positive Black Women, Mackenzie Rae Tewell

USF Tampa Graduate Theses and Dissertations

HIV/AIDS infections disproportionately impact African Americans within the United States. In 2010, black Americans made up 12 percent of the United States population, yet accounted for 44 percent of new HIV/AIDS infections (Kaiser Family Foundation 2013). The majority of black women (85 percent) are infected with the virus through heterosexual contact, meaning it is critical examine their sexual lives in order to gain insight into this infection within this population (CDC 2011b). Through semi-structured interviews at a Tampa, Florida AIDS service organization, this study presents the experiences of sexuality and intimacy among HIV positive black women. Results demonstrate that HIV …

Eco-Epidemiology Of Eastern Equine Encephalitis Virus, Patrick Vander Kelen

USF Tampa Graduate Theses and Dissertations

ABSTRACT

Eastern Equine Encephalitis virus (EEEV) is an alphavirus with high pathogenicity in both humans and horses. Florida continues to have the highest occurrence of human cases in the USA, with four fatalities recorded in 2010. Unlike other states, Florida supports year-round EEEV transmission. This research uses Geographic Information Science (GIS) to examine spatial patterns of documented sentinel seroconversions and horse cases in order to understand the relationships between habitat and transmission intensity of EEEV in Florida. Sentinel sites were categorized as enzootic, periodically enzootic, and negative based on the amount of chicken seroconversions to EEEV. Sentinel sites were analyzed …

A Critical Ethnography Of Globalization In Lesotho, Africa: Syndemic Water Insecurity And The Micro-Politics Of Participation, Cassandra Lin Workman

USF Tampa Graduate Theses and Dissertations

In spite of decades-long development programs, Lesotho faces an ongoing problem of water insecurity with far- reaching individual and social impacts. The purpose of this research was to understand how women in Lesotho are impacted by the synergistic epidemics, or syndemics, of water insecurity and HIV/AIDS and how they respond to these forces. Little has been done to address how water insecurity, defined in terms of both sufficient amount and quality of water, catalyzes the syndemic impact on the people of Lesotho. Access to safe and reliable sources of water is crucial for all individuals, particularly those who have been …

Exploring Potential Risk Factors Of Fetal Origins Of Diabetes: Maternal Stressors During Pregnancy And Birth Outcomes Among Women In A Hospital In The Municipality Of Caguas, Puerto Rico, Juan Pablo Arroyo

USF Tampa Graduate Theses and Dissertations

Puerto Rico has the highest prevalence of type 2 diabetes, low birth-weight, and the second highest prevalence of preterm-birth in all the U.S. and its non-incorporated territories. These conditions are related. Birth-weight at both ends of the spectrum and preterm-birth are associated with an increased risk for developing type 2 diabetes and immune-inflammatory dysregulations. Maternal psychosocial stressors during pregnancy have also been recognized as potential risk factors for type 2 diabetes, and have been consistently associated with preterm-birth and low birth-weight across populations. Current evidence points toward epigenetic fetal metabolic-programming as the mechanism that underlies the increased risk for the …

The Effect Of Drug Resistance On Plasmodium Falciparum Transmission And Gametocyte Development, Samantha Olivia Aylor

USF Tampa Graduate Theses and Dissertations

In order to reduce malaria prevalence worldwide, a better understanding of parasite transmission and the effect of drug resistance is needed. The effect of drug resistance on malaria transmission has been examined for some drugs, but not for mitochondrial inhibitors such as atovaquone and the current basis of malaria therapy, artemisinin. Therefore, the goal of this study was to produce gametocytes, the life cycle stage that transmits from mosquito to human, in several different drug resistant patient isolates as well as to determine the effect of drug resistance on gametocyte development and transmission. Previous studies have shown that the mutation …

Quality Of Life In Female Breast Cancer Survivor In Panama, Mayela Castro

USF Tampa Graduate Theses and Dissertations

Abstract

Introduction: Breast cancer is the most common female cancer worldwide and it is also the principal cause of death from cancer among women globally. Breast cancer has the highest prevalence among Panamanian women and its incidence is also growing every year. Women living with and beyond breast cancer have special needs that have to be considered by society and the health care systems. After diagnosis, the quality of life (QOL) of women is highly affected, due to the emergence of physical, psychological and social effects which lead to changes in attitudes and expectations towards life.

Purpose: To evaluate the …

Uncontrolled Hypertension And Associated Factors In Hypertensive Patients At The Primary Healthcare Center Luis H. Moreno, Panama: A Feasibility Study, Roderick Ramon Chen Camano

USF Tampa Graduate Theses and Dissertations

Background: According to the World Health Organization (WHO), hypertension is a major risk factor for cardiovascular disease (CVD), renal impairment, peripheral vascular disease, and blindness. In Panama, a recent study estimated the prevalence of hypertension at 38.5% in the two main provinces of the country, with a rate of uncontrolled hypertension of 47.2%.

Objectives: The aims of this study were to assess the feasibility of the study design and to describe the characteristics of the hypertensive population and the physician's adherence to Panamanian antihypertensive protocols and their relationship with uncontrolled hypertension.

Methods: This is a cross-sectional study of adult hypertensive …

Patients' Perspectives In Following Hypertensive Guidelines On Sodium Intake And Lifestyle Modifications In Panama, Lissette Raquel Chang

USF Tampa Graduate Theses and Dissertations

The purpose of this study was to explore patients' perception and knowledge regarding hypertension and hypertensive guidelines on sodium intake and lifestyle modifications in a work environment in the Republic of Panama. Hypertension is important not only because of its high prevalence but also because it is a major modifiable risk factor for cardiovascular diseases. In Panama the prevalence of hypertension is about 38.7% and uncontrolled hypertension is almost 50%.This number may translate into complications for the general population. For instance 52.8% of the population has had an ischemic disease and death by ischemic disease climbed from third place to …

School Mental Health: Views Of Services Integration And Attitudes Toward Evidence-Based, Donna L. Burton

USF Tampa Graduate Theses and Dissertations

ABSTRACT

Purpose of the study. Through secondary data analysis of results from the School Mental Health Services Integration Survey (SMHSIS), this study describes indicators of school mental health integration preparedness, including role identification, willingness to engage in tasks associated with mental health services integration and implementation facilitators. The study also investigated the utility of a modified version of the Evidence-Based Practice Attitude Scale (EBPAS) for use with school staff.

Study rationale. With as many as 20% of children meeting criteria for mental disorders that cause impairment, the gaps in mental health services delivery to this special needs population are evident …

Universal Tumor Screening For Lynch Syndrome: Identification Of System-Level Implementation Factors Influencing Patient Reach, Deborah Le Cragun

USF Tampa Graduate Theses and Dissertations

Lynch syndrome (LS) is the most prevalent cause of hereditary colorectal cancer (CRC) and confers high risks for several other types of cancer. Universal tumor screening (UTS) of all newly diagnosed patients with CRC can improve LS identification and decrease associated morbidity and mortality among patients and family members. However, for UTS to be effective, patients who screen positive must pursue genetic counseling and confirmatory germline testing (i.e., high patient reach). The purposes of this study were to characterize UTS programs, identify barriers and facilitators to implementation, document whether there have been negative outcomes, and determine institutional and implementation conditions …

Referral Tracking Pilot And Referral Outcome Rates For The School Health Program In Panama, Jesica Eileen Candanedo

USF Tampa Graduate Theses and Dissertations

Background: The School Health Program (SHP) in the Republic of Panama includes preventive healthcare services delivery and referral issuing at elementary schools nationwide. Despite these early prevention efforts, a majority of referrals are apparently not achieving their desired outcome. This idea is supported by the SHP data showing preventable diseases on the rise. Thus, learning the outcome rates of particular referral outcomes may provide a basis for appropriately targeted action.

Methods: Three focus groups were conducted with health workers, medical records staff, and teachers, respectively. Following systems thinking and framework analysis, a pilot plan for referral tracking and referral outcome …

Cost Of Treatment Of Asthma Attacks In A Tertiary Level Healthcare Hospital In Panama, Nydia Flores Chiari

USF Tampa Graduate Theses and Dissertations

Asthma is a chronic respiratory disease characterized by inflammation of the airway and the presence of recurrent attacks (exacerbations) of breathlessness, wheezing, cough, chest tightness, or some combination of these symptoms. In the US, about 53% of people with asthma had an asthma attack in 2008, and 57% of these, were children. One in ten children (10%) had asthma in 2009, and boys were more likely than girls to have asthma. Internationally, the prevalence of asthma varies widely in different countries, but the disparity is narrowing due to rising prevalence in low and middle income countries. Unfortunately, we do not …

The Water Culture Beliefs Of Embera Communities And Maternal And Child Health In The Republic Of Panama, Ilenia Anneth Forero

USF Tampa Graduate Theses and Dissertations

Water has cultural and spiritual values to indigenous people. These beliefs expose them to unsafe water sources and make them vulnerable to waterborne diseases. This background is not taken into account when countries write their water legislations, therefor imposing a management of water not readily accepted by them. The Embera group is one of the indigenous groups from the Republic of Panama, who have strong water beliefs. They live along the shore of rivers in houses built on high stilts away from urban areas. The purpose of this cross-sectional community based study is to describe through a survey the relation …

The Relationship Between Socioeconomic Status And Body Mass Index On Vitamin D Levels In African American Women With And Without Diabetes Living In Areas With Abundant Sunshine, Shani Vann Davis

USF Tampa Graduate Theses and Dissertations

OBJECTIVE: To examine the relationships between socioeconomic status (SES), body mass index (BMI), and vitamin D levels in African American (AA) women living in areas with abundant sunshine; and to explore if diabetes moderates these relationships.

SIGNIFICANCE: More AA's live in poverty, and experience obesity, diabetes, and chronic disease compared to other groups. Eighty percent of AA women are overweight or obese, and rates of type 2 diabetes is highest in this group. Minority race, obesity, and diabetes increase risks for low vitamin D, and are associated with p

DESIGN AND METHOD: A cross-sectional descriptive research design was used to …

African Americans And Hospice: A Culture-Centered Exploration Of Disparities In End-Of-Life Care, Patrick Dillon

USF Tampa Graduate Theses and Dissertations

As the United States' population ages and grows more diverse, scholars and practitioners have grown increasingly concerned about persistent disparities in the cost and quality of end-of-life health care, particularly with regard to African Americans. Although a variety of factors may influence these disparities, most scholars agree that the underutilization of hospice care by this population is an important contributor. Drawing from the culture-centered approach to health communication and narrative theory, the present study explores African American patients and caregivers' experiences with hospice care and takes an initial step toward addressing disparities in end-of-life care. I begin this study, first, …

Mother- To - Child Transmission Of Hiv And Congenital Syphilis: A Snapshot Of An Epidemic In The Republic Of Panama, Lorna Elizabeth Jenkins

USF Tampa Graduate Theses and Dissertations

ABSTRACT

Background: Worldwide HIV is going through a feminization and rejuvenation as more women are living with HIV/AIDS, increasing the risk of vertical transmission. Despite the efforts in Latin America and the Caribbean (LAC) by 2010, Panama was the third most affected country in the region with HIV/AIDS, with females aged 15-24 twice as affected as men.

Methods: This descriptive epidemiological study of HIV vertical transmission in Panama reviewed clinical charts to identify health care personnel's practices during pregnancies in 2008. This study also examines the impact of interventions comparing the HIV outcome of the children at the end of …

Evaluation Of Pulmonary Risks Associated With Selected Occupations, Stephen Casey Harbison

USF Tampa Graduate Theses and Dissertations

Occupational health surveillance programs are designed to evaluate and reduce injury, illness, and deaths related to workplace hazards. In the state of Florida, there are numerous industries where workers are potentially exposed to airborne hazards from gases, vapors and dusts. Airborne occupational exposures to irritants, vesicants, and fibrogens have the potential to cause pulmonary function impairment if exposures are not properly controlled for high-level acute exposure as well as chronic exposure. For occupations that demand workers be exposed to substances known to be associated with pulmonary function impairment, respirators may be a principal method for exposure

control. OSHA requires pulmonary …

The Relationship Between High School Coaches' Beliefs About Sports Injury And Prevention Practice Readiness, Siwon Jang

USF Tampa Graduate Theses and Dissertations

Although sports and other forms of physical activities are associated with numerous health benefits, adolescent sports injury has emerged as an important public health problem. As the most immediate caregivers for athletes, coaches are expected to play an important role in preventing and reducing injuries, -considering that sports medical staff, such as athletic trainers are not always available to care for athletes. However, research on coaches' beliefs and practices related to injury prevention has been limited to coaching competency issues, in which injury prevention is considered only one component. Therefore, the purpose of the study was to describe the coaches' …

Parent Distress In Life With A Child With Type 1 Diabetes, Lauren Nicole Johnson

USF Tampa Graduate Theses and Dissertations

Objective:

The purpose of this study was to highlight parent distress in diabetes, identify factors associated with distress and to show how public health and clinical professionals can assist parents in coping with their child's diabetes and living positively as a family unit.

Methods:

Parents of youth with diabetes (N = 41 qualitative, N = 332 quantitative) were engaged in focus groups, interviews, and survey research to understand their needs and stressors in life with a child with diabetes. Themes were examined in the qualitative data, and correlations and a regression model were run and analyzed from the quantitative data …

The Experiences Of Mothers Of Children With Autism In Jamaica: An Exploratory Study Of Their Journey, Angela R. Mann

USF Tampa Graduate Theses and Dissertations

Autism Spectrum Disorders (ASDs), also referred to as Pervasive Developmental Disorders (PDDs), are characterized by deficits in verbal and nonverbal communication, social interaction, and repetitive or restricted interests and behaviors. To date, much of the literature on ASDs has been conducted from a western perspective, although interest in ASDs from a global perspective has dramatically increased in recent years. Over the last decade, there have been numerous conceptual papers attempting to explain how autism might be experienced in other parts of the world. However, in actuality, little research has been conducted in this area, and further exploration of the experiences …

Quantifying The Ergonomic Impact On Healthcare Workers Using A Needle-Free Injector Device, Humberto Jose Olivero Lara

USF Tampa Graduate Theses and Dissertations

Background: Jet injectors are advantageous over needle injectors by eliminating sharps hazards. The Government Accountability Office estimates 29% preventable sharp injuries with an estimated direct cost of more than $500 million out of the CDC's reported incidence of 385,000 needle stick injuries per year among US hospital healthcare workers. Yet the forces required to set and trigger devices using spring mechanisms for medication delivery have not been explored. This laboratory experiment measured forces exerted by healthcare workers (HCWs) using a particular jet injector approved by FDA in 2011.

Objectives: In order to quantify the ergonomic impact on HCWs using a …

Evaluation Of Occupational Risk Factors For Nurses And Cnas: Analysis Of Florida Workers' Compensation Claims Database, Sheila Mohammed

USF Tampa Graduate Theses and Dissertations

Musculoskeletal injuries lead to most claims even though needlestick injuries receive the most attention. In 2010, health expenditures in the United States neared $2.6 trillion. CNAs, orderlies, and attendants had the highest rates of musculoskeletal disorders of all occupations with an incidence of 249 per 10,000 compared to 34 per 10,000 for all workers. The financial burden of back injuries in the healthcare industry is estimated to add up to $20 billion annually. Data was extracted for cause of injury, nature of injury and body part injured. Extracted data was analyzed both descriptively and by logistic and linear regression using …

Statistical Analysis And Modeling Of Brain Tumor Data: Histology And Regional Effects, Keshav Prasad Pokhrel

USF Tampa Graduate Theses and Dissertations

Comprehensive statistical models for non-normally distributed cancerous tumor sizes are

of prime importance in epidemiological studies, whereas a long term forecasting models

can facilitate in reducing complications and uncertainties of medical progress. The statistical

forecasting models are critical for a better understanding of the disease and supply

appropriate treatments. In addition such a model can be used for the allocations of budgets,

planning, control and evaluations of ongoing efforts of prevention and early detection of

the diseases.

In the present study, we investigate the effects of age, demography, and race on primary

brain tumor sizes using quantile regression methods to …

Daily Recovery From Work: The Role Of Guilt, Eunae Cho

USF Tampa Graduate Theses and Dissertations

Acknowledging the critical role that occupational factors play in employee health, researchers have tried to understand ways to reduce the harmful effects of work on employee health. As the process by which individuals recharge resources that have been depleted, recovery has been recognized as important due to its potential to mitigate the negative effects of work on employee well-being. Although the recovery literature has continued to grow, many questions remain unanswered. The purpose of the present study was to expand our knowledge of recovery by examining situational (job characteristics) and individual (trait guilt) predictors of recovery and investigating psychological attributes …

The Elimination Of Blindness: An Ethnographic Exploration Of The Fight Against Trachoma In Niger, Kelley Cosby Sams

USF Tampa Graduate Theses and Dissertations

The goal of this study is to explore specialized and popular cultural models of trachoma, and the interaction between the trachoma elimination program and its target audience in one trachoma hyper-endemic intervention community. Eighty four million people worldwide, mainly children, are infected with active bacterial trachoma. For some, this will lead to painful and progressive corneal opacity and eventual blindness. The disease is most commonly spread by person-to-person contact or by flies, and affects very specific populations living in resource-poor areas such as rural Niger, which has one of the highest prevalence rates worldwide.

The World Health Organization formed an …

Community And Household Management Strategies For Water Supply And Treatment In Rural And Peri-Urban Areas In The Developing World, Ryan William Schweitzer

USF Tampa Graduate Theses and Dissertations

Eighty percent of the 780 million people worldwide that access water from an unimproved source live in rural areas. In rural areas, water systems are often managed by community based organizations and many of these systems do not provide service at the designed levels. The Sustainability Analysis Tool developed in Chapter 2 can inform decision making, characterize specific needs of rural communities in the management of their water systems, and identify weaknesses in training regimes or support mechanisms. The framework was tested on 61 statistically representative geographically stratified sample communities with rural water systems in the Dominican Republic. The results …

Knowledge, Attitudes And Traditions Regarding Water Consumption And Sanitary Practices Of The Ngäbe-Buglé Indigenous Women In The Chiriquí Province In Panama, Natalia Vega

USF Tampa Graduate Theses and Dissertations

Background: In 2007, approximately 66.2% of the population of the Comarcas (indigenous reservations) in Panama had access to potable water. However, over 50% of this population lacked access to sanitation. As a result, the leading causes of death in the Comarca Ngäbe-Buglé are due to severe diarrhea and gastroenteritis of infectious origin. The present project assessed the need for an in-depth understanding of the Ngäbe-Buglé women and their communities regarding their knowledge, attitudes, beliefs and behaviors about water and sanitation. Methodology: In this cross-sectional exploratory study, a convenience sample of 52 women were interviewed, utilizing a questionnaire guided by the …

Predictors Of The Incidence And Charges For Lumbar Spinal Fusion Surgery In Florida Hospitals During 2010, Anna Ialynychev

USF Tampa Graduate Theses and Dissertations

Over the past several decades rates of spine surgeries in the U.S. have increased dramatically. Spinal fusion surgery rates, in particular, have grown exponentially despite being one of the most costly, invasive, and controversial methods for treating patients suffering from back conditions. Furthermore, lumbar fusion surgeries continue to be performed at increasing rates despite a lack of scientific evidence and consensus that they are cost-effective and produce better clinical outcomes than less radical treatment of lower back pain. As a result, large amounts of healthcare dollars continue to be invested in these costly procedures which are potentially dangerous and have …

A Monte Carlo Approach To Change Point Detection In A Liver Transplant, Alexia Melissa Makris

USF Tampa Graduate Theses and Dissertations

Patient survival post liver transplant (LT) is important to both the patient and the center's accreditation, but over the years physicians have noticed that distant patients struggle with post LT care. I hypothesized that patient's distance from the transplant center had a detrimental effect on post LT survival. I suspected Hepatitis C (HCV) and Hepatocellular Carcinoma (HCC) patients would deteriorate due to their recurrent disease and there is a need for close monitoring post LT. From the current literature it was not clear if patients' distance from a transplant center affects outcomes post LT. Firozvi et al. (Firozvi AA, 2008) …

Factors Related To The Professional Management Of Early Breastfeeding Problems: Perspectives Of Lactation Consultants, Erica Hesch Anstey

USF Tampa Graduate Theses and Dissertations

Addressing the sub-optimal breastfeeding initiation and duration rates has become a national priority. Inadequate support for addressing early breastfeeding challenges is compounded by a lack of collaboration between providers such as lactation professionals, nurses, pediatricians, and the family. The purpose of this exploratory study was to understand International Board Certified Lactation Consultants' (IBCLCs) perceived barriers to managing early breastfeeding problems. This qualitative study was guided by the symbolic interactionist framework through a grounded theory methodological approach. In-depth interviews were conducted with 30 IBCLCs from across Florida. IBCLCs were from a range of practice settings, including hospitals, WIC clinics, private practice, …