Public Health Commons^™

National Estimates Of Emergency Department Visits For Pediatric Severe Sepsis In The United States, Sara Singhal, Mathias W. Allen, John-Ryan Mcannally, Kenneth S. Smith, John P. Donnelly, Henry E. Wang

Emergency Medicine Faculty Publications

Objective. We sought to determine the characteristics of children presenting to United States (US) Emergency Departments (ED) with severe sepsis.

Study design. Cross-sectional analysis using data from the National Hospital Ambulatory Medical Care Survey (NHAMCS). Using triage vital signs and ED diagnoses (defined by the International Classification of Diseases, Ninth Revision codes), we identified children(triage fever or ICD-9 infection) and organ dysfunction (triage hypotension or ICD-9 organ dysfunction).

Results. Of 28.2 million pediatric patients presenting to US EDs each year, severe sepsis was present in 95,055 (0.34%; 95% CI: 0.29-0.39%). Fever and respiratory infection were the most common indicators of …

When Pictures Waste A Thousand Words: Analysis Of The 2009 H1n1 Pandemic On Television News, Westerly Luth, Cindy Jardine, Tania M. Bubela

Office of the Provost

Objectives: Effective communication by public health agencies during a pandemic promotes the adoption of recommended health behaviours. However, more information is not always the solution. Rather, attention must be paid to how information is communicated. Our study examines the television news, which combines video and audio content. We analyse (1) the content of television news about the H1N1 pandemic and vaccination campaign in Alberta, Canada; (2) the extent to which television news content conveyed key public health agency messages; (3) the extent of discrepancies in audio versus visual content.
Methods: We searched for "swine flu" and "H1N1" in local English …

The Olive Branch Program : A Proposal For Outreach To Survivors Of Trauma Highlighting The Restorative Potential Of Nature-Based Cultural Settings, Mariana I. Swick

Graduate Student Independent Studies

Addresses the long-term implications of sexual assault-related trauma on the lives of women survivors and demonstrates how nature-based cultural institutions can support the needs of this population throughout recovery. The study proposes the adoption of The Olive Branch Program (a hypothetical outreach program) by local nature-based cultural institutions in light of the long term needs of women survivors on various pathways towards recovery. In addition, the study proposes ways for cultural institutions to engage in interdisciplinary collaboration, address issues of accessibility, and offer socially relevant programming.

Effects Of A School-Based Education Intervention On Bmi And Physical Activity, Lauren M. Panner

Evidence-Based Practice Project Reports

In 2011, the CDC reported that there are 12.5 million obese children and adolescents living in the United States (U.S.). The financial burden of childhood obesity in the U.S. is estimated to be 14 billion dollars. The objective of this evidence-based practice (EBP) project was to answer the question: In school-aged children, how does school-based, structured, family-oriented physical activity education affect body mass index (BMI) compared to usual education over an eight week time period? The Stetler Model of EBP and the health belief model were used to guide this project in a rural, Northwest Indiana elementary school. For eight …

Understanding The Motivational Factors For College Students To Remain Non-Smokers, Chanler Hilley

Honors Theses

Cigarette smoking has long been recognized as a negative health behavior. Numerous studies have linked cigarette smoking to cancer, heart and circulatory problems, lung disease, and an array of other health issues, leading to lower quality of life and premature death. There is a wealth of knowledge relating to the negative outcomes of smoking behavior (USDHHS, 2010) and the factors leading to smoking behavior among adolescents (USDHHS, 2012). However, researchers have studied factors leading to nonsmoking behavior much less. The present study uses the Theory of Planned Behavior to understand the motivational factors that lead to a student's nonsmoking behavior, …

Truck Driver Dies When Tractor-Trailer Overturns After Leaving Road, Kentucky Injury Prevention And Research Center

Fatality Case Reports--Motor Vehicle

In the early morning hours of a spring day around 5:45 a.m., a 55-year-old male truck driver was driving south on an interstate transporting sheet metal. It is unknown how long he had been driving when he exited from the highway, traveled partially up the ramp, and struck the left side guard rail. The truck left the road, traveled down an embankment and overturned onto its roof. A passing motorist called emergency medical services. The driver was extricated by mechanical means and declared dead at the scene.

To prevent future occurrences of similar incidents, the following recommendations have been made: …

Analyzing The Health Care Cost Curve: A Case Study, Robert Lieberthal

College of Population Health Faculty Papers

This case study uses data from a self-insured employer plan to perform an analysis into the properties of the health care cost curve. The analysis shows that one statistical property of the health care cost curve is that costs rise continuously, not on an annual or monthly basis. Graphical analysis indicates that managed care techniques used to restrain costs can also smooth utilization, producing the continuously growing cost curve observed. The analysis further illustrates that there is no one ‘‘cost curve’’—analysis must be segmented by population. Finally, the power of predictive models to fit the cost curve varies by population. …

College Of Public Health News, Georgia Southern University

College of Public Health: News & Publications

• Quality Improvement

Estimating Effects On Rare Outcomes: Knowledge Is Power, Laura B. Balzer, Mark J. Van Der Laan

U.C. Berkeley Division of Biostatistics Working Paper Series

Many of the secondary outcomes in observational studies and randomized trials are rare. Methods for estimating causal effects and associations with rare outcomes, however, are limited, and this represents a missed opportunity for investigation. In this article, we construct a new targeted minimum loss-based estimator (TMLE) for the effect of an exposure or treatment on a rare outcome. We focus on the causal risk difference and statistical models incorporating bounds on the conditional risk of the outcome, given the exposure and covariates. By construction, the proposed estimator constrains the predicted outcomes to respect this model knowledge. Theoretically, this bounding provides …

Next Generation Public Health Delivery: Optimizing Health And Economic Impact, Glen P. Mays

Health Management and Policy Presentations

Improving population health in the context of significant policy and economic change will require governmental public health agencies to rethink their roles within the U.S. health and social services systems, giving much greater attention to "catalytic" functions intended to mobilize, direct, and coordinate the actions of others. A growing body of evidence and experience suggests that such changes are likely to be feasible, effective, and efficient.

Impact Of Storm Events On Water Quality Of A Karst Stream And Implications For Public Health Protection At A Historic Landmark, Ellen R. Barringer

Mahurin Honors College Capstone Experience/Thesis Projects

A water quality study was conducted on Lost River near Bowling Green, Kentucky. The emphasis of the study was to assess the influence of storm events on water quality and E. coli (cfu/100ml) levels. Lost River is a karst stream and flows underground for much of its course through Warren County and Bowling Green, Kentucky. The Lost River watershed is approximately 55 square miles and receives surface runoff from rural and urban land uses. Within the watershed exists the Lost River Cave and Valley, which receives secondary contact use throughout the year. A water quality assessment of multiple parameters was …

Members In Mind: Outreach & Education Strategies For Co-Op Insurance Plans. Final Report, Elizabeth Rogers

Muskie School Capstones and Dissertations

As envisioned by the federal policymakers who designed the Patient Protection and Affordable Care Act of 2011 (ACA), and the state-based health leaders who are founding them, Consumer Oriented and Operated Plans (CO-OPs) are intended to be a different kind of insurer: non-profit partners in health and healthcare. While many Americans (including Mainers) should welcome this new model, CO-OPs face challenges in establishing brand recognition and capturing the hearts and minds of consumers. The purpose of this research project was to support CO-OPs, particularly Maine’s CO-OP, Maine Community Health Options (MCHO), in assessing and developing communications strategies that enable individuals …

Do User Fees Increase Tuberculosis Notifications?, Chioma Y. Chukwumah

Economics Honors Projects

Public health sectors around the world strive to provide accessible and affordable care. Tight government budgets and growing populations lead countries to consider adding or raising charges to health care consumers. These user fees may affect the quality, equity and revenue of health care. This paper investigates the impact of user fees on notifications of tuberculosis. In the panel data composed of 176 countries from 1960 to 2012, I find no evidence that suggests user fees increase tuberculosis. In contrast, I find strong and robust evidence suggesting user fees are associated with fewer new cases of tuberculosis.

Factors Influencing Medical Adherence Of Clients In Aids Project Worcester, Marianne M. Sarkis, Abby Dnahue, Jacqueline Osei-Owusu, Shan Yi Koay, Maya Baum, Anna Shayo, Amanda Major

Local Knowledge: Worcester Area Community-Based Research

What are the factors and barriers that lead to levels of adherence for those receiving treatment for those in the HIV/AIDS community through AIDS Project Worcester?

Over the last few decades, the HIV/AIDS epidemic has undergone a visible shift. In particular, the demographics of HIV/AIDS infected persons have transitioned from mostly gay affluent, white males to women and men of various minority populations with lower resources and socioeconomic statuses. This trend has also been true for the Worcester community. Based in Worcester, Massachusetts, this research project seeks to identify patterns between the recent change in client demographics and the relation …

A Tale Of Two Health Sciences Libraries Working To Improve Health Literacy, Margot G. Malachowski Mls, Kate Saylor Msi

All Scholarly Works

Our presentation demonstrates two health sciences libraries performing outreach in public libraries to achieve these community goals: increased awareness of high-quality online resources for health information; improved confidence in finding and evaluating good health information; and increased knowledge of the resources and benefits to be gained from partnering with a health sciences library.

Game Change: What Have We Learned? Pt. 2, Robert E. Lang, Sonya D. Horsford, Marya L. Shegog, Ramona Denby-Brinson, Fatma Nasoz

Brookings Scholar Lecture Series

Share Knowledge. Change Lives. Transform our Community.

Our Mission: The Lincy Institute at UNLV conducts and supports research that focuses on improving Nevada's health, education, and social services.

Our Research Areas: Education, Health, Social Services, Information Technology

College Of Public Health News, Georgia Southern University

College of Public Health: News & Publications

• Delta Omega Inductions

Estimating The Impact Of Lost To Follow-Up On Breast Cancer Patients' Disease-Free Survival, Debbie Yan Qun Huang

Statistics

Background The 5-year survival rate for patients with breast cancer is much higher than patients with other types of cancer. Due to this longer survival period, breast cancer patients also tend to have increased rates of lost to follow-up, when compared to other cancers. When a patient becomes lost, the occurrence of distant metastasis cannot be reliably ascertained, unless the patient had a breast cancer-specific (BC) death. The impact of lost patients on recurrence rates and disease-free survival (DFS) was explored in breast cancer patients seen at the City of Hope from 1997 to 2012.

Methods Female breast cancer patients …

Homelessness: Relationships Between Program Completion At A Transformational Shelter And Mental Illness, Substance Abuse, And Trauma, Richard T. Mccutcheon

Theses & Dissertations

Each and every evening many people do not have a home to return to. Solving the epidemic problem of homelessness is an ongoing pursuit. Analyzing issues related to homelessness will help solve the problem of homelessness for some individuals and families. Data was gathered, prioritized and analyzed to determine correlations and relationships between completion of a transformational shelter’s program and mental illness, substance abuse, and trauma. Demographic variables were assessed as well. A person is more likely to complete the program if they have a substance abuse issue. Females are more likely than males to complete the program. Program completion …

Linking And Retaining Hiv Patients In Care: The Importance Of Provider Attitudes And Behaviors, Manya Magnus, Jane Herwehe, Michelli Murtaza-Rossini, Petera Reine, Damien Cuffie, Deann Gruber, Michael Kaiser

Epidemiology Faculty Publications

Retention in HIV treatment may reduce morbidity and mortality, as well as slow the epidemic. Myriad barriers to retention include stigma, homophobia, structural barriers, transportation, and insurance. The purpose of this study was to evaluate patient perceptions of provider attitudes among HIV-infected persons within a state-wide public hospital system in Louisiana. A convenience sample of patients attending HIV clinics throughout the state participated in an anonymous interview. Factors associated with negative perceptions of care were evaluated in conjunction with a validated stigma measure. Factors associated with having a delayed entry into or break in care were evaluated in conjunction with …

Chhs May/June 2013 E-Newsletter, Dr. John Bonaguro, Dean, Vashon S. Wells, Editor, Wku College Of Health & Human Services

College of Health & Human Services Publications

No abstract provided.

The Presence Of Coups D'État Within Revolutions: Effects On Population Health, Rose E. Facchini

Master's Theses

The present study is a comparative approach to revolutions and their effect on population health during the post-conflict period. Specifically, it attempts to determine whether revolutions that are accompanied by a coup d'état have a significant negative impact on post-revolution population health. Degree of revolutionary violence, governmental structures, and pre-revolution health systems is of particular interest as relevant variables. The study focuses on the Latin American countries of Nicaragua and Chile due to their similar region and timeframe. The revolutions and accompanying coup d'état in both of these countries do not demonstrate different patterns on public health in the post-conflict …

Resistance Training Behaviors In College-Aged Women 2013, Melanie Kornblatt

Master's Theses

The purpose of this study was to develop an understanding of women’s training behavior in the weight room. A secondary purpose was to determine what their beliefs and perceptions were in regards to lifting weights. Participants were college-aged females ranging in age from 17-29 years. Observations of weight lifting activities were conducted during peak hours of operation (Mondays, Wednesdays, and Fridays from 3- 6pm) in the fitness facility. A total of 60 hours of observations were conducted over a period of four weeks. In addition to observations, two focus groups were conducted. Participants were divided into two specific groups: I …

A Case Study On Pharmacy To Explore The Perceptions Of Pharmacy Leaders And Policy Makers On The Benefits, Risks, And Alternatives Of The Doctorate As The Entry Level Degree In Health Professions, Heidi Marie Crocker

Dissertations

The clinical doctorate is an emergent trend in many health profession disciplines. Collier (2008) projects continued momentum toward higher degrees for entry into practice and advancing the field in health professions. There has been minimal research on how the trend of doctoral education in health professions will affect health professions education, delivery of services, and interdisciplinary relationship among health care providers, or the wider society (Freburger, King, & Slifkin, 2008). This research focused on the transition to the clinical doctorate in one profession, Pharmacy, retrospectively examining the inception and enactment phase of the Pharm.D. The study provides important insight into …

Assessment Of Introduction Pathway For Novel Avian Influenza Virus Into North America By Wild Birds From Eurasia, Ryan S. Miller, Steven J. Sweeney, Judy E. Akkina, Emi K. Saito

Zoonotics and Wildlife Disease: Publications

A critical question surrounding emergence of novel strains of avian influenza viruses (AIV) is the ability for wild migratory birds to translocate a complete (unreassorted whole genome) AIV intercontinentally. Virus translocation via migratory birds is suspected in outbreaks of highly pathogenic strain A(H5N1) in Asia, Africa, and Europe. As a result, the potential intercontinental translocation of newly emerging AIV (e.g. A(H7N9) from Eurasia to North America via migratory movements of birds) remains a concern. An estimated 1.48 to 2.91 million aquatic birds, principally Anseriformes (ducks, geese, and swans) and Charadriiformes (gulls, terns, and shorebirds) move annually between Eurasia and North …

Knowledge, Attitudes, Behaviors, And Beliefs About Chronic Kidney Disease In Indiana’S Minority Communities: A Community-Based Survey, Priscilla T. Ryder, Kelsey Coy, Anita Ohmit, Chandana Saha

Scholarship and Professional Work – COPHS

The purpose of this report is to detail the findings of the study ‘Knowledge, Attitudes, Behaviors, And Beliefs about Chronic Kidney Disease in Indiana Minority Communities,’ undertaken as a collaboration between Indiana Minority Health Coalition, Inc. (IMHC) and the Butler University College of Pharmacy and Health Sciences (BUCOPHS). The purpose of the study was to understand knowledge of and beliefs about Chronic Kidney Disease (CKD) among racial/ethnic minorities in Indiana, to learn how these populations would like to receive information about CKD, to understand the factors associated with higher levels of CKD awareness, to estimate the proportion of people with …

Adults' Alcohol Consumption Behaviour And Support For Restrictions On Youth-Oriented Alcohol Advertisements, Sandina Begic, Elsa K. M. Howard, Theodore W. Mcdonald

Public and Population Health Faculty Publications and Presentations

Research suggests that underage drinking is a serious problem in the United States, and that many of the factors that influence minors to consume alcohol are environmental in their nature. One such factor is youth-oriented alcohol advertisements. Although many adults support restrictions on such advertisements, others do not or do so to a lesser degree. In this study, we explored one factor that may influence how strongly adults support restrictions on youth-oriented alcohol advertisements: The frequency with which adults themselves report consuming alcoholic beverages. A total of 767 adult Idahoans completed a survey asking about a variety of perceptions related …

Preventing Skin Cancer In Adolescent Girls Through Intervention With Their Mothers, Mary K. Baker

Electronic Theses and Dissertations

Indoor tanning (IT) before the age of 35 increases one’s risk for melanoma by 75%, and epidemiological data show a 6.1% annual increase in the incidence of melanomas in white women younger than age 44 in the US. Population-based studies reveal that 15% of adolescents and 8% to 14% of their primary caregivers have engaged in IT in the past year.

The compelling case for IT being a significant risk factor for melanoma, together with the high rates of IT in teen girls and their mothers, provided a strong rationale for conducting an antitanning intervention directed at mother-daughter dyads. This …

Biopiracy And Vaccines: Indonesia And The World Health Organization's New Pandemic Influenza Plan, Shawn Smallman

International & Global Studies Faculty Publications and Presentations

Viral samples of avian influenza are essential to preparing pre-pandemic vaccines. In 2007, the conflicting interests of the developed and developing nations led Indonesia to briefly stop sharing viral samples. The result was a struggle in which the two blocs argued for different paradigms for viral sample sharing. The first paradigm, articulated by the developed world, depicted the issue as one of health security, in which international law mandated the sharing of viral samples. The second paradigm, advanced by the developing world, depicted viral sample sharing as a form of biopiracy, which violated countries' sovereign control of their biological resources. …

The Effects Of Participation In Marching Band On Physical Activity And Physical Fitness In College Aged Men And Women, Joseph Vallee, Kristen Leander

Senior Honors Projects

Purpose: Regular physical activity is essential in preventing many chronic diseases and conditions including heart disease, obesity, type two diabetes and some forms of cancer. The majority of the population does not meet recommended guidelines for daily physical activity. Barriers to participation in regular physical activity include boredom and a lack of enjoyment for traditional exercises such as running. Novel forms of exercise that improve cardiorespiratory fitness and increase the number people meeting recommended guidelines has the potential to promote good health and prevent chronic disease. Therefore, the purpose of this study was to measure the effects of participating …