Public Health Commons^™

School-Centered Approaches To Improve Community Health: Lessons From School-Based Health Centers, Olga Acosta Price

Center for Health and Health Care in Schools

No abstract provided.

Cardiovascular Outcome Trials In Type 2 Diabetes And The Sulphonylurea Controversy: Rationale For The Active-Comparator Carolina Trial, Julio Rosenstock, Nikolaus Marx, Steven E. Kahn, Bernard Zinman, John J. Kastelein, John M. Lachin, Erich Bluhmki, Sanjay Patel, Odd-Erik Johansen, Hans-Jurgen Woerle

Epidemiology Faculty Publications

Sulphonylureas (SUs) are widely used glucose-lowering agents in type 2 diabetes mellitus (T2DM) with apparent declining efficacy over time. Concerns have been raised from observational retrospective studies on the cardiovascular (CV) safety of SUs but there are few long-term data on CV outcomes from randomized controlled trials (RCTs) involving the use of this class of agents. Most of the observational studies and registry data are conflicting and vary with study population and methodology used for analyses. To address the SU controversy, we reviewed the recently published literature (until end of the year 2011) to evaluate the impact of SUs on …

Smoking Behaviours And Cessation Services Among Male Physicians In China: Evidence From A Structural Equation Model, Cheng Huang, Chaoran Gao, Shaohua Yu, Yan Feng, Julia Song, Michael Erikson, Pam Redmon, Jeffrey Koplan

Global Health Faculty Publications

Objective To investigate smoking prevalence and cessation services provided by male physicians in hospitals in three Chinese cities.

Methods Data were collected from a survey of male physicians employed at 33 hospitals in Changsha, Qingdao and Wuxi City (n=720). Exploratory factor analysis was performed to identify latent variables, and confirmatory structural equation modelling analysis was performed to test the relationships between predictor variables and smoking in male physicians, and their provision of cessation services.

Results Of the sampled male physicians, 25.7% were current smokers, and 54.0% provided cessation services by counselling (18.8%), distributing self-help materials (17.1%), and providing traditional remedies …

National And Regional Estimates Of Term And Preterm Babies Born Small For Gestational Age In 138 Low-Income And Middle-Income Countries In 2010, Anne C.C. Lee, Joanne D. Katz, Hannah Blencowe, Simon Cousens, Naoko Kozuki, James M. Tielsch, +30 Additional Authors

Global Health Faculty Publications

Background

National estimates for the numbers of babies born small for gestational age and the comorbidity with preterm birth are unavailable. We aimed to estimate the prevalence of term and preterm babies born small for gestational age (term-SGA and preterm-SGA), and the relation to low birthweight (<2500 >g), in 138 countries of low and middle income in 2010.

Methods

Small for gestational age was defined as lower than the 10th centile for fetal growth from the 1991 US national reference population. Data from 22 birth cohort studies (14 low-income and middle-income countries) and from the WHO Global Survey on Maternal …

I'M A Patient, Not A Problem: An Exploration Into The Roles Assigned In The Doctor-Patient Relationship, Monica C. Stewart

Honors Theses and Capstones

No abstract provided.

Violence Among Young Adults Receiving Housing Assistance: Vouchers, Race, And Transitions Into Adulthood, Tamara Leech

Department of Public Health Scholarship and Creative Works

Scholarly literature has been very attentive to violence among adolescents whose families receive vouchers. Yet, it provides little information about violence among the more than 400,000 very young adults who head households that receive vouchers. This article explores this relationship, paying particular attention to life course considerations and racial context. Data on 18–22-year-olds, numbering 208, who received housing assistance and participated in the National Longitudinal Survey of Youth 1997 in 2002 indicate that normative theoretical models may not accurately capture the relationship between the transition to adulthood and violence within this group. Results also suggest that among those who experience …

Aboriginal And Non-Aboriginal Students Learn About Natural Health Products From Different Information Sources, Sarah O. Alkholy, Samiah N. Alqahtani, Audrey Cochrane, Maria Pontes Ferreira, Fidji Gendron

Nutrition and Food Science Faculty Research Publications

Natural health products (NHPs) include naturally derived botanical and nonbotanical products. Past research indicates a high prevalence of NHPs use amongst adults in the United States and Canada but does not clearly characterize NHPs use amongst students, ethnic variations of such use, or how users learn about NHPs. We hypothesize that there is a difference between Aboriginal and non-Aboriginal students in how they learn about NHPs. To investigate this question, we conducted a cross-sectional study at First Nations University of Canada and the University of Regina, Saskatchewan, Canada, during the fall of 2011. Aboriginal (n=214) and non-Aboriginal (n=749) students participated …

Needle Stick Injuries--Risk And Preventive Factors: A Study Among Health Care Workers In Tertiary Care Hospitals In Pakistan., Asad Ali Khan Afridi, Ameet Kumar, Raza Sayani

Community Health Sciences

BACKGROUND:

Health care workers (HCWs) are at substantial risk of acquiring blood borne infections such as HIV, Hepatitis-B and Hepatitis-C through needle stick injuries (NSIs). This study aimed to assess the proportion of NSIs and their associated factors among HCWs and also to identify the areas in which preventive efforts might be directed to protect against this occupational hazard.

METHODOLOGY:

A cross-sectional study was conducted in two tertiary care hospitals of Pakistan representing both private and public health sector. A total of 497 HCWs (doctors and nurses) were interviewed using a structured questionnaire. Data was collected from January to May …

Assessing The Effectiveness Of Nutrition And Physical Activity Self-Assessment For Child Care (Nap Sacc) For Changes In Physical Activity Behavior, Policy, And Environment In Nebraska Family Child Care Homes, Katie K. Bolte

College of Education and Human Sciences: Dissertations, Theses, and Student Research

Nebraska is the first state to utilize NAP SACC and to modify the evidence-based program for family child care homes (FCCHs). The purpose of this study was to conduct a secondary data analysis to assess the effectiveness of a modified version of the NAP SACC approach in achieving changes in physical activity behavior, policy, and environment in Nebraska FCCHs caring for children ages 2-5 years. Results from this study will be used to improve the NAP SACC physical activity components for FCCHs and will help to inform trainers and the Nebraska Department of Health and Human Services, Nutrition and Activity …

A Type 2 Diabetes Prevention Website For African Americans, Caucasians, And Mexican Americans: Formative Evaluation, Belinda M. Reininger, Laura Person Mecca, Kendra Stine, Kevan Schultz, Luke Ling, David Halpern

Health & Human Performance Faculty Publications

Background: The majority of Americans now access the Internet, thereby expanding prospects for Web-based health-related education and intervention. However, there remains a digital divide among those with lower income and education, and among Spanish-speaking populations in the United States. Additional concerns are the low eHealth literacy rate among these populations and their interest in Internet-delivered interventions with these components. Given these factors, combined with the prevalence of type 2 diabetes among low socioeconomic status and Spanish-speaking Americans, strides need to be taken to reach these populations with online tools for diabetes prevention and management that are at once accessible and …

Child Emotional Abuse And Its Relationship To Obesity, Kelly Anderson Driscoll

Sociology & Criminal Justice Theses & Dissertations

Over the past 30 years in the United States childhood obesity has more than tripled (Center for Disease Control and Prevention, 2010). In 2008, 18.5% of adolescents of the age 12-18 years old were obese in the United States (Center for Disease Control and Prevention, 2010). With the increase of obesity Americans have spent approximately 9% of their total medical costs on obesity-related illnesses (Finkelstein, Fiebelkorn, &Wang, 2003). Previous research documented the relationship between virtually every form of child abuse and subsequent obesity. Restricting focus to child emotional abuse, while studies have linked emotional abuse to the long-term consequence of …

Adults With Greater Weight Satisfaction Report More Positive Health Behaviors And Have Better Health Status Regardless Of Bmi, Christine E. Blake Ph.D., Rd, James R. Hébert Scd, Duck Chul Lee, Swann A. Adams, Susan E. Steck Phd, Mph, Rd, Xuemei Sui M.D., M.P.H., Ph.D., Jennifer L. Kuk, Meghan Baruth, Steven N. Blair

Faculty Publications

Background. Prior studies suggest that weight satisfaction may preclude changes in behavior that lead to healthier weight among individuals who are overweight or obese. Objective. To gain a better understanding of complex relationships between weight satisfaction, weight-related health behaviors, and health outcomes. Design. Cross-sectional analysis of data from the Aerobics Center Longitudinal Study (ACLS). Participants. Large mixed-gender cohort of primarily white, middle-to-upper socioeconomic status (SES) adults with baseline examination between 1987 and 2002 (n = 19,003). Main Outcome Variables. Weight satisfaction, weight-related health behaviors, chronic health conditions, and clinical health indicators. Statistical Analyses Performed. Chi-square test, t-tests, and linear and …

A Community-Based Wellness Program To Reduce Depression In African Americans: Results From A Pilot Intervention, Christina Nicolaidis, Corliss Mckeever, Sandra Meucci

School of Social Work Faculty Publications and Presentations

Background

African-Americans are less likely than non-Hispanic Whites to find antidepressants acceptable or seek care for depression.

Objective

To develop and pilot-test a culturally-tailored, community-based, psycho-educational wellness and exercise promotion program to reduce depressive symptoms in African-Americans.

Methods

Participants were African-Americans with moderate depressive symptoms, who were interested in exercise, but were not exercising regularly. They attended a 6-week psycho-educational group program during which they set personal activity goals and learned depression self-management skills. We conducted pre- and post-intervention surveys and post-intervention feedback sessions.

Results

21 African-Americans participated in the intervention. The program had excellent attendance and satisfaction. We found …

Analysis Of Community-Based Accumulation Of Home Medications (Caches) Found At Death Scenes In Davidson County, Tennessee, Carrie E. Plummer

Theses and Dissertations (ETD)

Introduction: Stockpiling of unused medications by community-dwelling individuals results in Community-based ACcumulation of Home mEdicationS (CACHES). CACHES place the individual, health care and justice system, and ecosystem at risk for adverse outcomes including: a) diversion of prescription medications by friends and family, b) pediatric poisonings, c) adverse drug events, d) increased criminal justice system costs related to prescription drug abuse, e) increased health care costs, and f) pollution of local water supplies via improper medication disposal. This study explores the relationship among individual risk factors (gender, race, age, comorbid conditions), geographical location, health care risk factors (number of prescribers and …

Hiv-1 Autologous Antibody Neutralization Associates With Mother To Child Transmission, Elly Baan, Anthony De Ronde, Martijn Stax, Rogier W. Sanders, Stanley Luchters, Joseph Vyankandondera, Joep M. Lange, Georgios Pollakis, William A. Paxton

Population Health, East Africa

The HIV-1 characteristics associated with mother to child transmission (MTCT) are still poorly understood and if known would indicate where intervention strategies should be targeted. In contrast to horizontally infected individuals, exposed infants possess inherited antibodies (Abs) from their mother with the potential to protect against infection. We investigated the HIV-1 gp160 envelope proteins from seven transmitting mothers (TM) whose children were infected either during gestation or soon after delivery and from four non-transmitting mothers (NTM) with similar viral loads and CD4 counts. Using pseudo-typed viruses we tested gp160 envelope glycoproteins for TZM-bl infectivity, CD4 and CCR5 interactions, DC-SIGN capture …

The Epidemiology Of Human Herpesvirus-8: Transmission Of Infection To Children In Zambian Households, Kay L. Crabtree

School of Biological Sciences: Dissertations, Theses, and Student Research

Human Herpes virus-8 (HHV-8) is the known etiologic agent for several malignant pathologies, including Kaposi’s sarcoma (KS), the most common tumor in children in sub-Saharan Africa. Saliva is implicated as the culprit of transmission; however there is a paucity of information regarding transmission to young children. In this study, we investigated the hypothesis that household behaviors exposing the susceptible child to saliva increase the risk of transmission of HHV-8 to that child.

To test our hypothesis a large prospective cohort study in Lusaka, Zambia, enrolling 464 young children and their households, was followed for 48 months. Socio-demographics, health histories, feeding …

The Identification And Classification Of Flow Disruptions In The Operating Room During Laparoscopic Cholecystectomy And Open Hernia Repair Procedures, Sacha N. Duff

Doctoral Dissertations and Master's Theses

The operating room is one of the most complex work environments in healthcare; it is estimated that at least 7% of adverse events due to medical error occur in the operating room. Flow disruptions are events that cause a "break" in the primary surgical task, or the loss of any team member's situational awareness. An empirical link between flow disruptions and surgical errors in the OR has been established; therefore, identifying and classifying the specific flow disruptions present during different types of procedures should facilitate the development of evidence-based interventions. The goal of this study was to identify and classify …

Human Milk Cortisol Is Associated With Infant Temperament, Katherine R. Grey, Elyssia Poggi Davis, Curt A. Sandman, Laura M. Glynn

Psychology Faculty Articles and Research

The implications of the biologically active elements in milk for the mammalian infant are largely unknown. Animal models demonstrate that transmission of glucocorticoids through milk influences behavior and modifies brain development in offspring. The aim of this study was to determine the relation between human milk cortisol levels and temperament of the breastfed infant. Fifty-two mother and infant pairs participated when the infants were three-months old. Milk cortisol levels were assessed and each mother completed the Infant Behavior Questionnaire (IBQ), a widely used parent-report measure of infant temperament. Analyses revealed a positive association between milk cortisol and the negative affectivity …

The Stigmatization Of Disabilities In Africa And The Developmental Effects, Kelsey Koszela

Independent Study Project (ISP) Collection

Stigmatization still exists in large scale and leads to exclusion and continued poverty and poor standard of life for persons with disabilities, especially for those living in Africa. The main cause of stigmatization in Africa is a lack of education about disabilities and the needs of persons with disabilities. The unknown creates fear in society and exclusion for persons with disabilities, prohibiting them from obtaining decent education, proper health care and having access to jobs and financial support. Since the Convention for the Rights of Disabled Persons (CRPD) in 2006 societal education has been supplemented by implementation of development programs …

Support For A Smoke-Free Bylaw In Parks And On Beaches, Chizimuzo T.C. Okoli, Ann Pederson, Wendy Rice

Nursing Faculty Publications

BACKGROUND: In September 2010, Vancouver, Canada enacted a smoke-free bylaw in parks and on beaches.

OBJECTIVE: To examine demographic and attitudinal factors associated with the public opinion on Vancouver's outdoor smoke-free bylaw.

METHODS: From 496 randomly selected Vancouver residents, information on demographics, smoking status, and opinions and support for or opposition to the smoke-free bylaw were obtained by telephone surveys.

RESULTS: Approximately 84.2% of the sample endorsed the legislation; a greater proportion of non-smokers supported the bylaw than smokers (88.6% vs. 52.0%). In multivariate analysis, demographic variables significantly associated with supporting the smoke-free bylaw were being female, having completed community …

Factory Laborer Dies When A Car Driven By Coworker Crashes Into Him In Parking Lot, Kentucky Injury Prevention And Research Center

Fatality Case Reports--Motor Vehicle

On a summer day, a 29-year-old male manufacturing laborer was outside under a small metal stairway in the loading dock area of the manufacturing plant during his lunch break. Another employee entered her car in the employee parking lot to leave on her lunch break. Her car unexpectedly malfunctioned when in reverse, sped backward, and crashed into the stairway under which the worker was taking a break. The collision pushed the metal stairway along the wall of the factory, crushing the worker between the building and the passenger side of the car. Emergency medical services arrived and transported the worker …

The Relevance Of Social Contexts And Social Action In Reducing Substance Use And Victimization Among Women Participating In An Hiv Prevention Intervention In Cape Town, South Africa, Elizabeth Reed, Andrea N. Emanuel, Bronwyn Myers, Kim Johnson, Wendee M. Wechsberg

Prevention and Community Health Faculty Publications

Objectives: To examine qualitatively how women's social context and community mobilization (eg, mobilizing women to take social action and engaging their community in social change) influence substance use abstinence and victimization among women participating in a human immunodeficiency virus (HIV) intervention in Cape Town, South Africa.
Methods: Thirty women who had participated in a randomized controlled trial of a group-delivered intervention to address substance use, gender-based violence, and associated risk for HIV (The Women's Health CoOp) were selected to participate in semi-structured interviews about their perceived impact of the intervention on their substance use and exposure to victimization. The Women's …

Smoking Mediates The Relationship Between Adverse Childhood Experiences And Chronic Obstructive Pulmonary Disease In The Brfss Data, Andrew Messersmith

Master of Public Health Capstone Presentations

Associations between adverse childhood experiences (ACEs) and adult health outcomes are well grounded in the empirical literature; such studies generally find both direct and indirect effects of ACE on health outcomes such as liver disease, cancer, and heart disease. In this study, the association between ACEs and chronic obstructive pulmonary disease (COPD) was examined, and smoking was assessed as a partial mediator in the ACE-COPD relationship. Data were collected from five states in which an eight category ACE module was included in the 2011 Behavioral Risk Factor Surveillance System (BRFSS). Logistic regression models were developed to test the mediational hypothesis-that …

The Effect Of The Sphere Standards On The Incidence Of Communicable And Infectious Diseases In A Complex Humanitarian Emergency, Masashi Rotte

Master of Public Health Capstone Presentations

The purpose of this study was to determine what effect achieving the Sphere Standards relating to water and sanitation had on the incidence of communicable diseases in a returnee camp in South Sudan during a complex humanitarian emergency. The water and sanitation infrastructure of the returnee camp was tracked over time until it met the Sphere Standards. The total camp population was also tracked over the same period of time and compared to daily counts of diseases diagnosed in a medical clinic at the camp. A daily incidence of disease was then calculated for each communicable disease that was tracked. …

Knowledge And Attitudes Assessment Of Out-Of-Hospital Emergency Physicians In Yerevan, Armenia, Aline Baghdassarian, Md

Master of Public Health Capstone Presentations

Out-of-hospital emergency care is in an early stage of development in Armenia. While efforts are underway by the Ministry of Health (MOH) and other organizations to reform the emergency medical services (EMS) system, little data exists on the status of pediatric emergency care (PEC). To evaluate the knowledge and attitudes of out-of-hospital emergency physicians (EPs) in pediatric rapid assessment and resuscitation, and to identify areas of improvement to the pediatric EMS system and PEC education in the capital, Yerevan, a cross-sectional, anonymous, self-administered Knowledge and Attitudes survey regarding pediatric rapid assessment and resuscitation was distributed to all out-of-hospital EPs in …

We Must All Work To Solve Childhood Obesity, Lisa Barkley

UCF Forum

Obesity is a global epidemic. It is particularly affecting our children and adolescents. This new phenomenon of having a chronic medical condition affecting such a large proportion of those under 18 years old is unprecedented.

Health System Contributions To Public Health Activities Amid Policy And Economic Change: Estimating Complementarities, Substitutions, And Network Effects, Glen P. Mays

Health Management and Policy Presentations

Research Objective: The Affordable Care Act created new incentives for hospitals, insurers, employers, public health agencies, and others to contribute to activities designed to promote health and prevent disease an injury, potentially changing the structure of public health delivery systems and expanding the delivery of strategies that improve population health. At the same time, the economic recession has constrained government and private sector spending on health and health care, necessitating changes in the scope and scale of public health delivery. This study uses data from the 1998-2012 National Longitudinal Survey of Public Health Systems to examine: (1) the extent and …

Day Care Monitor Dies After Crash Of 15-Passenger Van, Kentucky Injury Prevention And Research Center

Fatality Case Reports--Motor Vehicle

In the late afternoon of a spring day, a day care van operator and a monitor loaded 16 children into a 15-passenger van. Carrying a total of 18 passengers in the 15-passenger van, the operator and the monitor proceeded to transport the children to their homes. After dropping off two children at their residences, the van was traveling 46-50 mph in the left hand lane headed east in a 35 mph zone on a non-divided four-lane state road. As the van approached a side street on the right, the right rear tire blew out and the van veered sharply to …

Variables To Predict Risk Of Hospital Readmission, Julie I. Carroll

Muskie School Capstones and Dissertations

As the healthcare industry transitions toward accountable care and payment reform, creative approaches to healthcare is imperative. Poorly coordinated care and shorter hospital stays have resulted in higher rates of readmissions. This has large implications for hospitals and health systems.

Emergency Department Utilization Among South Philadelphia Residents And Frequent Users In The Jefferson Community Benefit Area, Melissa Mccarey

Master of Public Health Capstone Presentations

Over the past decade, the rate of emergency department (ED) visits increased at almost double the rate that would be expected due to normal population growth. The implications of this increase in ED usage include decreased quality of care, overcrowding, increased wait times, and increased healthcare costs. The purpose of this analysis is to examine health issues, concerns, and underling social determinants of frequent ED users and South Philadelphia Residents who use the Thomas Jefferson University or Methodist Hospital emergency departments. This project is a retrospective data analysis using descriptive statistics, measures of central tendency, and cross-tabulation analysis to analyze …