Public Health Commons^™

Development Of A Quantitative Food Frequency Questionnaire For Use Among Rural South Africans In Kwazulu Natal, T. Sheehy, F. Kolahdooz, T. L. Mtshali, Tashmin Khamis, S. Sharma

Faculty of Health Sciences, East Africa

Background: South Africa is experiencing a dietary and lifestyle transition as well as increased rates of noncommunicable chronic diseases. Limited information is available on the diets of rural populations. The present study aimed to characterise the diets of men and women from rural KwaZulu-Natal (KZN) and develop a quantitative food-frequency questionnaire (QFFQ) specific for this population.

Methods: A cross-sectional study was carried out by collecting single 24-h dietary recalls from 81 adults and developing a QFFQ in Empangeni, KZN, South Africa.

Results: The diet of this population was limited in variety, high in plant-based foods (especially cereals and beans), and …

Trauma History And Depression Predict Incomplete Adherence To Antiretroviral Therapies In A Low Income Country, Kathryn Whetten, Kristen Shirey, Brian Wells Pence, Jia Yao, Nathan Thielman, Rachel Whetten, Julie Adams, Bernard Agala, Jan Ostermann, Karen O'Donnell, Amy Hobbie, Venance Maro, Dafrosa Itemba, Elizabeth Reddy, Chat Research Team

Faculty Publications

Background: As antiretroviral therapy (ART) for HIV becomes increasingly available in low and middle income countries (LMICs), understanding reasons for lack of adherence is critical to stemming the tide of infections and improving health. Understanding the effect of psychosocial experiences and mental health symptomatology on ART adherence can help maximize the benefit of expanded ART programs by indicating types of services, which could be offered in combination with HIV care. Methodology: The Coping with HIV/AIDS in Tanzania (CHAT) study is a longitudinal cohort study in the Kilimanjaro Region that included randomly selected HIV-infected (HIV+) participants from two local hospital-based HIV …

Addressing The Health Of Hispanic Migrant Farmworkers In Rural East Tennessee Through Interprofessional Education, Experiential Learning, And A University/Community Partnership, Sharon Loury, Mchael Bradfield, Joseph Florence, Kenneth Silver, Karin Hoffman, Alexis Andino

International Journal of Health Sciences Education

The concept of interprofessional practice and education is not new but has recently gained attention as the result of a paradigm shift in the future of healthcare and how it is delivered and financed. Universities are now addressing ways to incorporate interprofessional education and learning experiences into the curriculum to ensure graduating healthcare professionals are competent to collaborate as a team and deliver quality effective healthcare.

A regional research university in East Tennessee with health programs across five Health Science colleges (Clinical and Rehabilitative Health Sciences, Medicine, Nursing, Pharmacy, and Public Health), Psychology, and Social Work has offered an interprofessional …

Asthma And Risk Of Non-Respiratory Tract Infection: A Population-Based Case-Control Study, Duk Won Bang, Hyeon J Yang, Eell Ryoo, Majdi N. Al-Hasan, Brian Lahr, Larry M. Baddour, Barbara P. Yawn, Young J. Juhn

Internal Medicine Faculty Publications

OBJECTIVES: Asthmatics have increased risks of airway-related infections. Little is known about whether this is true for non-airway-related serious infections such as Escherichia coli bloodstream infection (BSI). We assessed whether asthma is associated with a risk of developing community-acquired E coli BSI.

DESIGN: The study was designed as a population-based retrospective case-control study.

SETTING: This population-based study was conducted in Olmsted County, Minnesota.

PARTICIPANTS: The study included 259 all eligible community-acquired E coli BSI cases in Olmsted County, MN between 1998 and 2007 and 259 birthday-matched, gender-matched and residency-matched controls.

PRIMARY AND SECONDARY OUTCOME MEASURES: Only community-acquired E coli BSI …

Illusion Or Ununderstood Reality: Spiritual Or Psychic Healing And Protection In Southern Madagascar, Henri Lucien Sandifer

Independent Study Project (ISP) Collection

Far from the hospital room and its doctor, the medicine and philosophies of Lakazy and its Ombiasa pertain to a domain largely untouched by western logic and science. Their practices appear to be effective and unique enough to have survived the advent of compelling new theological and scientific belief systems and the vastly different perspectives on community health and stability which these systems have brought to Madagascar. The prime examples of these new arrivals are Christianity and modern medicine, respectively. Within and without their sacred space, the mission of the true Ombiasa is to support their community and for this …

The Mosakowski Institute For Public Enterprise Five Year Report, Mosakowski Institute

Mosakowski Institute for Public Enterprise

This report contains the highlights of the first five years of Clark University’s Mosakowski Institute for Public Enterprise. It includes a description of the Institute’s founding, its commitment to use-inspired research, transformational educational experiences, and community connectedness, the Institute’s leadership and finances, and a listing of projects undertaken and faculty partners.

Knowledge, Training And Experience Of Emergency Responders In The Context Of Functional Needs In General Shelters, Athena K. Fannin

Master of Public Health Program Student Publications

Objective: Gathering and analyzing information on experience, training, and professional affiliation of disaster responders who will deal with functional needs clients in general shelters. Methods: The web-based survey administered in June, 2012 to 165 local Medical Reserve Corps (MRC) volunteers and 72 public health workers was part of a larger study designed to assess functional needs flow processes in general shelters. Descriptive statistics and simple logistic regression were used to analyze data.

Results: The response rate was 16.5%. The percent of survey respondents that had any disaster, medical, or functional needs training were approximately 80%, 70%, and 40% respectively. The …

The Pertinence Of Maternal Education On Child Immunization In Rural Uttarakhand: More Than Just Increased Rates, Sarah Banerji

Independent Study Project (ISP) Collection

Child immunization rates in India continue to remain low, despite the 1985 implementation of a Universal Immunization Program that provides free basic immunizations to all children. There are numerous logistical factors that contribute to the low rates of immunization, but rates are made further worse by a lack of parental awareness and education about immunization, especially in village communities. This study examines the maternal understanding of immunization in rural Uttarakhand, both in villages in which an NGO has been working to improve maternal immunization education and in villages with no NGO involvement. It finds a positive correlation between increased immunization …

The Perception Of Maternal Anemia And The Effect Of Nutritional Education: A Qualitative Analysis Among Village Mothers In Rural Kumaon, Uk, Kelsey Bash

Independent Study Project (ISP) Collection

Malnutrition is often associated with starving children in developing countries. However, while calorie and protein deficiencies—macronutrient deficiencies—are a cause for concern, micronutrient deficiencies can be equally detrimental and are even more pervasive. The most prevalent micronutrient deficiency is anemia, and the story of anemia in India is particularly grim. India has the largest number of anemic people in the world and severe anemia is the cause of death for an average of 22,000 Indians each year (The Micronutrient Initiative 2006). Anemia rates are exacerbated for women and even more so for pregnant women. According to the most recent National Family …

Care In Columbia: What We Can Glean From South American Medicine, Neil Flannery Haidorfer, Robert Simmons, Drph, Mph, Mches, Cph

CwiC-PH

The information presented is the product of a two month international rotation at Medellin General Hospital and the non-profit pediatric clinic, Santa Ana through an academic affiliation with La Universidad CES in Medellin, Antioquia. The goal of the rotation was to obtain an understanding of healthcare in Columbia and identify potential practices that could be utilized in the U.S.

Hiv/Aids In Yunnan Province: A Study Of Stigma And Support, Sofia Haile

Independent Study Project (ISP) Collection

I conducted a qualitative study on the ability of peer-HIV-support groups in Kunming, China to lessen the effects stigma. There is a lack of quantitative studies of stigma in Yunnan, and no studies that address the ability of Kunming peer-groups to lessen the effects of stigma. Over the course of one month, I collected data via questionnaire, individual interviews, group interviews, and scholarly research. My study had sixteen participants (five female sex workers, seven former intravenous drug users, and four men who have sex with men).

My scholarly research revealed that peer-groups are an effective way to: disseminate knowledge to …

La Situación De Las Cataratas En La Ciudad De Buenos Aires: Un Estudio De Caso En El Hospital Ramos Mejía / The Situation Of Cataracts In The City Of Buenos Aires: A Case Study In Ramos Mejía Hospital, Katie Elizabeth Kessler

Independent Study Project (ISP) Collection

Background: When a person has cataracts his or her lens becomes clouded by proteins, causing diminished vision. Though cataracts cause poor vision or in more serious cases blindness, what is special about cataracts is that they are treatable. Surgery replaces the clouded lens with a new artificial lens called an intraocular lens. In Argentina in 2006 only 10% of cataract surgeries were realized in the public sector, and the Ministry of Health of the Nation decided to develop a program called Program Eye Health and the Prevention of Blindness to fight these and other inequities in the realm of visual …

Schistosomiasis (Bilharzia) In Madagascar: A Case Study Of A Neglected Tropical Disease, Sarah Grace Sawyer

Independent Study Project (ISP) Collection

Over 50% of Madagascar’s population is infected with intestinal or urinary schistosomiasis (Rollinson et al., 2012). The disease slowly debilitates infected persons, who are frequently children, resulting in lower productivity and reduced learning in school-age children. The disease involves a vicious cycle perpetuated by a number of environmental, psychological, and social factors. A multifaceted approach, involving mass treatment, biological control, environmental control, education, and disease surveillance, can lead to schistosomiasis control and elimination in Madagascar. This would yield many socio-economic benefits such as increased productivity, increased school attendance rates, and generally better welfare. Schistosomiasis is the most burdensome and deadly …

Ndank-Ndank: How Governmental Health Organizations Can Take Their First Step To Help Other’S Take Their First Step: A Case Study Of A Prosthetics And Orthotics Rehabilitation Center In Dakar, Senegal, Sarah Jacobi

Independent Study Project (ISP) Collection

The number of people with disability in the world is very large, however; what having a disability means for each person is even more alarming. In a developing country, it is extremely difficult for people with disabilities to receive the health care they need. The organizations that offer health care to people with disabilities are faced with a number of challenges; but they continue to do the best they can. This study was done at a prosthetics and orthotics rehabilitation center in Dakar, Senegal. It is a case study that examines the difficulties the workers face, the motivations the workers …

Massachusetts Health Care Reform: Is It Working?, Joshua Mcadoo, Julian Irving, Stacie Deslich, Alberto Coustasse

Management Faculty Research

Before 2006, Massachusetts had more than 500 000 residents who lacked health insurance. Governor Mitt Romney enacted landmark legislation requiring all residents to obtain health insurance. Also, the legislation established a health insurance exchange for the purpose of broadening the choices of insurance plans made available to individuals in the state. The purpose of this research was to assess the Massachusetts health care reform in terms of access, cost, and sustainability. The methodology used was a literature review from 2006 to 2013; a total of 43 references were used. Health reform resulted in additional overall state spending of $2.42 billion …

Public Perceptions On Family Planning And Birth Spacing In The Cultural And Religious Context Of Senegal: A Case Study In Dakar, Senegal, Heidi Kahle

Independent Study Project (ISP) Collection

Much prior research has examined the prevalence rates of family planning and contraceptive use in Senegal, as well as the importance of family planning for reducing maternal and infant mortality, improving the well being of families, and improving the national economy. Few studies, though, have captured the perspectives of Senegalese persons and their attitudes and beliefs toward family planning, rumors and stigmas that surround it, and how different actors can work together to dispel rumors and encourage the use of family planning. I conducted my research in Dakar, Senegal, where I interviewed a variety of persons – two gynecologists, a …

A Silent Killer Of India’S Women: Investigating The Barriers To Adequate Tuberculosis Treatment And Diagnosis For Women In Bhopal, Madhya Pradesh, Evonne Mcarthur

Independent Study Project (ISP) Collection

Nearly 20 years ago, the World Health Organization declared tuberculosis as a global public health emergency, yet today TB still remains a major global health challenge. It is estimated that during 2012 8.6 million were infected with TB and 1.3 million died from the disease (WHO, 2013). Globally, more than one third of the population is infected with TB and, after HIV/AIDS, TB is the greatest killer world-wide due to a single infectious agent. 95 percent of the global TB burden lies within low and middle-income countries and among the 22 countries determined to be high epidemiological burden countries, India …

Nurturing The Whole Body: The Benefits Of Supplementing Tuberculosis Chemotherapy With Traditional Chinese Medical Practices, Rachel Levine

Independent Study Project (ISP) Collection

Although modern medicine has found a cure for Tuberculosis (TB), it remains a worldwide health threat. Due to poor adherence to TB chemotherapya multi-drug resistant strain of the TB bacteria (MDR-TB) has been created.It has been found that poor adherence is caused by many factors, two of which include the high cost of treatment and the many uncomfortable side effects. Through a month of research based in Kunming, China including interviews, observations and surveys,this project hoped to compare Western biomedicine and Traditional Chinese Medicine (TCM) to determine the potential benefits TCM holds for TB patients. TCM improves a TB patient’s …

Weza Motrin Pichikeche Meu: El Entendimiento Cultural De La Obesidad Infantil En El Pueblo Mapuche, Katherine Shaffer

Independent Study Project (ISP) Collection

Research Question: How do the Mapuche people interpret childhood obesity, and how do they use this interpretation to treat and prevent this disease?

Objective: To describe the Mapuche concept of childhood obesity used by families and community leaders in Makewe, Chile, and how this concept is used to treat and prevent this disease.

Background: Childhood obesity is a growing problem throughout much of the world, including Chile, with grave effects on physical and mental health. There are a plethora of causes of this disease, from individuals with an imbalance in calorie expenditure, to national and international policies in economy and …

Turning The Tide On An Epidemic: A Native Kentuckian Changes The Deadly Trajectory Of Hiv Infection, Dannette Smith Cook

Ex-Patt Magazine

Interview: Dr. Mina Hosseinipour did not know her research would positively change the trajectory of the worldwide HIV epidemic when she graduated with a bachelor’s degree from the University of Kentucky in the early 1990’s.

Suicide And Suicide Attempts In Kentucky, 2001‐2012, Joshua W. Lambert, Svetla Slavova

Kentucky Injury Prevention and Research Center Special Report

The data sources, methods, and definitions used in this report are based on the State Injury Indicators report: Instructions for Preparing 2011 Data, Atlanta, Georgia, March 2013, a publication of the National Center for Injury Prevention and Control, Centers for Disease Control and Prevention.

“Breastfeeding Perceptions And Practices” A Comparative Study Of Two Opposing Socio-Economic Level Quarters Within Yaoundé, Cameroon, Alexandria J. Ross

Independent Study Project (ISP) Collection

This research project aims to identify and analyze the conditions that influence breastfeeding perceptions and practices within two opposing socioeconomic level quarters of Yaoundé, Cameroon: Bastos and Madagascar. According to the World Health Organization recommendations for optimal infant and young child nutrition, mothers are advised to exclusively breastfeed for the first six months of life after birth before introducing complimentary feeding. Cameroon since 2005 has adhered to the International Code of Marketing of Breastmilk Substitutes. It is classified as a Category 1 as a country which discourages commercial pressures to feed alternative forms of nutrition known as breastmilk substitutes.

This …

Socio-Cultural Barriers To Family Planning Access, Aasha Jackson

Independent Study Project (ISP) Collection

This paper attempts to discern barriers to family planning access and use in the Manguier quarter of Yaoundé, Cameroon based on research collected during a three week period. Questionnaires and interviews were used to measure women’s use of and opinions towards family planning consultations and methods. The spread of rumors regarding negative side effects, mistaken beliefs about family planning, husband’s disapproval, and the availability of contraceptives elsewhere were found to be the major deterrents to the use of family planning by women in this study. This research shows the need for campaigns to educate women and men alike on the …

La Feminización De La Especialidad De Pediatría En La Ciudad De Buenos Aires, Argentina / The Feminization Of The Specialty Of Pediatrics In The City Of Buenos Aires, Argentina, Jessica Wilder

Independent Study Project (ISP) Collection

Background: In the context of feminization of pediatrics that is occurring rapidly worldwide, this investigation seeks to determine the underlying causes of the phenomenon in Argentina. It focuses on the field of pediatrics because pediatrics is one of the most feminized medical specialties. Through this narrowed focus, the investigation intends to suggest causes for the feminization occurring in all of medicine. It studies the pediatricians of the Autonomous City of Buenos Aires in order to illuminate the social, logistical, and personal motivations that attracted them to pediatrics. It is very important to discover these motivations and causes because they reflect …

Gender Disparities In Access To Hiv Testing And Antiretroviral Treatment Services, Wyatt Lombard Smith

Independent Study Project (ISP) Collection

Throughout a six-week practicum period at TASO Mulago in Kampala, Uganda and St. Francis Naggalama Hospital in Naggalama, Uganda, the researcher aimed to find methods to increase male engagement in all facets of comprehensive HIV/AIDS care. Women and children generally receive most global attention on the issue of HIV/AIDS in Uganda but men are beginning to demand more attention. Antiretroviral treatment has been critical in allowing countless people to live functionally with HIV but many research projects have hypothesized that delayed access to HIV/AIDS treatment and prevention methods has resulted in men exhibiting higher mortality rates upon initiation of this …

The Vancouver General Hospital Smoking Cessation Clinic: Outcomes From A Specialist Cessation Service Within Cardiology, Milan Khara, Chizimuzo T.C. Okoli

Nursing Presentations

PURPOSE: The purpose of our study is to examine pilot treatment outcomes of an outpatient Smoking Cessation Clinic (SCC) provided within Cardiology Services.

RELEVANCE/CONTEXT: Populations with cardiac conditions often continue to smoke at high rates (up to 62%), even after experiencing life-threatening cardiac events. Smoking cessation can greatly reduce the risk of further occurrence of a cardiac event and associated mortality. However few Cardiology services in Canada offer smoking cessation services and few Cardiologists refer smoking patients to such services. The Vancouver General Hospital’s SCC is housed within Cardiology Services and offers a longitudinal approach to smoking cessation. This …

The Association Between Insurance Status And Cervical Cancer Screening In Community Health Centers: Exploring The Potential Of Electronic Health Records For Population-Level Surveillance, 2008-2010, Stuart Cowburn, Matthew J. Carlson, Jodi A. Lapidus, Jennifer E. Devoe

Sociology Faculty Publications and Presentations

Introduction: Cervical cancer incidence and mortality rates in the United States have decreased 67% over the past 3 decades, a reduction mainly attributed to widespread use of the Papanicolaou (Pap) test for cervical cancer screening. In the general population, receipt of cervical cancer screening is positively associated with having health insurance. Less is known about the role insurance plays among women seeking care in community health centers, where screening services are available regardless of insurance status. The objective of our study was to assess the association between cervical cancer screening and insurance status in Oregon and California community health centers …

Prevention Of Type 2 Diabetes In Urban American Indian/Alaskan Native Communities: The Life In Balance Pilot Study, Daniel C. Benyshek, Michelle Chino, Carolee Dodge-Francis, Toricellas O. Begay, Hongbin Jin, Celeste Giordano

Environmental & Global Health Faculty Research

Objective: The Life in BALANCE (LIB) study is a pilot translational study modeling the Diabetes Prevention Program (DPP) intensive lifestyle coaching intervention among an underserved, high-risk population: American Indians/Alaska Natives (AI/ANs) living in a large urban setting (Las Vegas, Nevada). Research Design and Methods: A total of 22 overweight/obese AI/ANs (age, 39.6 ± 10.4 years; BMI, 34.1 ± 6.3 kg/m2) at increased risk for developing type 2 diabetes (HbA1c > 5.4 (36 mmol/mol) < 6.4 percent (46 mmol/mol) participated in the program between April and December, 2011. Study participants completed a 16 week intensive lifestyle coaching intervention. In addition to obtaining qualitative data regarding opportunities and challenges of applying the lifestyle intervention for AI/AN participants in an urban setting, clinical data, including BMI, waist circumference, blood pres- sure, fasting blood glucose, and blood lipids (HDL, LDL and Triglycerides), were collected. Results: Only 12 of the 22 participants remained in the LIB program at the final post-program follow-up. Participants demonstrated significant decreased waist circumference and elevated HDL cholesterol. Triglycerides manifested the highest percentage change without statistical significance. No significant change was ob- served in blood pressure or fasting blood glucose. Conclusions: LIB participants’ improvements in BMI, waist circumference, HDL cholesterol and triglycerides suggests type 2 diabetes prevention programs aimed at urban AI/ANs show significant potential for reducing the risk of developing type 2 diabetes among this underserved and high risk community. Qualitative data suggest the main challenge for type 2 diabetes prevention specific to this population is a need for improved community outreach strategies.

Intimate Partner Violence During Pregnancy: Victim Or Perpetrator? Does It Make A Difference?, Yuliya Shneyderman, Michele Kiely

Publications and Research

Objectives: To differentiate between forms of intimate partner violence (IPV)(victim only, perpetrator only, or participating in reciprocal violence) and examine risk profiles and pregnancy outcomes.

Design: Prospective

Setting: Washington, DC, July 2001 to October 2003

Sample: 1044 high-risk African-American pregnant women who participated in a randomized controlled trial to address IPV, depression, smoking, and environmental tobacco smoke exposure.

Methods: Multivariable linear and logistic regression

Main outcome measures: Low and very low birth weight, preterm and very preterm birth

Results: 5% of women were victims only, 12% were perpetrators only, 27% participated in reciprocal violence, and 55% reported no IPV. …

Sequential Screening For Psychosocial And Behavioural Risk During Pregnancy In A Population Of Urban African Americans, Michele Kiely, Marie G. Gantz, M. Nabil El-Khorazaty, Ayman El-Mohandes

Publications and Research

Objective: Screening for psychosocial and behavioral risks, such as depression, intimate partner violence and smoking, during pregnancy is considered state-of-the-art in prenatal care (PNC). This prospective longitudinal analysis examines the added benefit of repeated screening over a one-time screen in identifying such risks during pregnancy.

Design: Data were collected as part of a randomized controlled trial to address intimate partner violence (IPV), depression, smoking and environmental tobacco smoke exposure (ETSE) in African-Americans women.

Setting: PNC sites in the District of Columbia serving mainly minority women

Population: 1044 African-American pregnant women in the District of Columbia

Methods: Mothers were classified by …