Public Health Commons^™

Complexity Of Breastfeeding Health Policy In Tanzania, Africa, Theresa Thompson

Master of Public Health Program Student Publications

Background: The purpose of this study was to investigate Tanzanian health policy regarding the protection and promotion of breastfeeding.

Country Profile: Tanzania is a United Republic composed of the mainland and also the islands of Zanzibar. Tanzania is located in east Africa with a population of approximately 46 million. About 1.6 million babies are born each year in Tanzania, however only approximately 140,000 are registered annually. Tanzania’s infant mortality rate is 68 infant deaths per 1000 live births. Tanzania makes up for approximately 0.5% of the world population but 2% of the global infant death.

Approaches: In this study, the …

Diabetes And The Uninsured In Montgomery County, Ohio: Effects Of A County-Funded Health Services Program On Hemoglobin A1c Values, Mark Feighery

Master of Public Health Program Student Publications

Montgomery County Care (MCC) was a county-funded, limited benefit health services program launched in 2010 as a bridge to expanded Medicaid and the health insurance marketplaces for the uninsured of Montgomery County, Ohio. A principal goal was to help manage chronic disease, particularly diabetes. Approximately 20% of the MCC members assigned to a community health center were diagnosed with diabetes. Paired sample t-tests of Hemoglobin A1c values were compared for diabetic members enrolled in the program for a minimum of one year. Among 188 members for whom initial and subsequent values were recorded, HA1c values declined (showed an improvement) from …

Association Of Demographic Characteristics With Gestational Diabetes Mellitus And Gestational Hypertension In Ohio During 2012, Jared D. Klein

Master of Public Health Program Student Publications

Background: Gestational Diabetes Mellitus (GDM) and Gestational Hypertension (GHTN) are serious conditions that can arise during pregnancy. Both of these disorders can cause detrimental health effects to both mother and newborn. Methods: Ohio vital statistics birth data was obtained from Public Health- Dayton and Montgomery County. The data set included 137,268 women who gave birth during 2012 in Ohio and had a known GDM and/or GHTN status. IBM Statistical Package for Social Sciences for Mac Version 20 (SPSS, IBM, 2011) was used to analyze the data. Descriptive statistics, odds ratios, chi-square analyses, and multivariate logistic forward stepwise regressions were calculated …

Obtaining Efficiencies In Food-Borne Illness Protection For Residential, Health Department-Licensed, And Non-Licensed Entities, Ted W. Talley

Master of Public Health Program Student Publications

Severe storms, natural disasters, and other emergencies resulting in extended periods of power loss can negatively impact public health as the likelihood of food-borne illnesses resulting from the consumption of food products held in refrigerators and freezers at improper temperatures is greatly increased. Additionally, food products used or served during emergency responses present additional challenges as many of the products may have other risk factors often associated with food-borne illness outbreaks. These include food from unsafe sources (food prepared in a facility not subject to regulation or inspection), improper cooking temperatures, preparation on contaminated food contact surfaces, and poor hygienic …

Nutrition Knowledge Of High School Senior Students In Northwest Arkansas, Grace Heymsfield, Cynthia Moore

Discovery, The Student Journal of Dale Bumpers College of Agricultural, Food and Life Sciences

Though there are many complex factors influencing diet, nutrition knowledge correlates with healthier food choices in older adolescents and can play a pivotal role in health. Nutrition curriculum was addressed in the state of Arkansas through Arkansas Act 1220 of 2003. Numerous changes have been seen in the school environment regarding nutrition, but there is no means of testing nutrition curriculum effectiveness in terms of nutrition knowledge of students. It is the purpose of this descriptive study to improve understanding of the nutrition knowledge of high school seniors. High school senior students (n = 25; males = 12, females = …

Presence Of Antibiotic Resistance Genes From Wastewater Treatment Plant Effluent In Northwest Arkansas, Ryan Macleod, Mary Savin

Discovery, The Student Journal of Dale Bumpers College of Agricultural, Food and Life Sciences

Antibiotic resistance genes (ARGs) among bacterial populations are causing increasing concern with medical and agricultural implications. While the effluent of wastewater treatment plants (WWTPs) is treated with a variety of antimicrobial methods, bacteria and the genetic material that is able to pass on antibiotic resistance to environmental populations are not completely destroyed. Ampicillin (amp), tetracycline (tet), and sulfonamide (sul) antibiotics have been detected in Northwest Arkansas (NWA) streams, and IncP plasmids—which are especially notorious for containing antibiotic resistance genes and have been detected after disinfection in NWA WWTPs—are known to carry ARGs for those antibiotics. The objective of this inquiry …

Alteration Of Host Cell Ubiquitination By The Intracellular Bacterial Pathogen Coxiella Burnetii, Lindsay Pritchett, Daniel E. Voth

Discovery, The Student Journal of Dale Bumpers College of Agricultural, Food and Life Sciences

The intracellular bacterial agent of Q fever, Coxiella burnetii, replicates within a phagolysosomelike parasitophorous vacuole (PV) in human macrophages and delivers effector proteins to the host cytosol via a Dot/Icm type IV secretion system (T4SS). The T4SS effectors are critical for PV formation and prevention of host cell death that allows sufficient time for bacterial replication. Recruitment of ubiquitin-related components to the C. burnetii PV is also predicted to be involved in PV formation and bacterial replication and is likely controlled by effector proteins. In this study, we assessed the role of the Dot/Icm T4SS in regulating ubiquitination by comparing …

Associations Of Maternal Socio-Demographic And Psychosocial Characteristics With Alcohol Use During Pregnancy, Nneoma Adaobi Ilogu

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Alcohol is reported to be one of the most used legal substances among women of reproductive age, and its use during pregnancy is one of the most preventable causes of birth defects and developmental disabilities.1 Due to its teratogenic nature, alcohol use during pregnancy has been associated with a condition referred to as Fetal Alcohol Spectrum Disorders (FASD).2 This comprises of a wide spectrum of disorders such as Fetal Alcohol Syndrome (FAS), alcohol-related birth defects, and alcohol-related neurodevelopmental disorders, which are estimated to affect 1% of all births in the United States and can be prevented through the modification of …

Are There Benefits Of Smoking Reduction During Pregnancy? Smoking Status Of Pregnant Women And The Effect On Pre-Term Delivery, Kelli Ann Mclane

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Premature delivery is defined as a baby born before thirty-­‐seven completed weeks of pregnancy. Premature delivery can result in a longer hospital stay after delivery compared to babies born at full-­‐term.1 Babies born before 37 gestational weeks also have a greater potential for health problems such as acute respiratory, gastrointestinal, immunologic, central nervous system, hearing, and vision problems, as well as longer-­‐term motor, cognitive, visual, hearing, behavioral, social-­‐emotional, health, and growth problems.2 Premature births can impact at the individual level and at a societal level. “The birth of a preterm infant can bring considerable emotional and economic costs to families …

Factors Affecting School Health Scores: Wellsat Scores, School Policy, And The School Environment, Alicia Baker

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

A recent trend in school health intervention has been through policy creation and development. Studies have shown that changes in school health policy can improve student health behaviors, particularly in physical activity and nutrition. This study looked at how potential factors could affect the scores of a school policy assessment tool called the Wellness School Assessment Tool (WellSAT). Using a combination of t-tests, chi-square tests, and logistic regression, schools’ strength and comprehensiveness nutrition scores from the WellSAT were analyzed when compared to Free and Reduced Lunch Rates, type of school, and whether schools had separate policies from their school district. …

Effects Of Locality And Risk Of Late Stage Breast Cancer Diagnosis In Kentucky Females, 2001-2011, Michael Jacob Sither

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Breast cancer survival is heavily dependent on stage at diagnosis. Recent evidence supports rural women are more likely than urban women to be diagnosed with advanced stage disease but historically these findings have been mixed when investigated at the state level. Cancer surveillance in the Appalachian region suggests Kentucky females are at significantly greater risk of premature breast cancer mortality due to consistently lower prevalence of screening mammography utilization. In the literature, disparities in breast cancer outcomes have been largely explained by population demographics, areabased measures of socioeconomic deprivation, shortages of referring providers as well as differences in spatial access …

Evaluating Oral Health Trends In Kentucky, 2006-2012, Briana Michelle Forsythe

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

According to the former US Surgeon General, C. Everett Koop, “You’re not healthy without good oral health.” Poor oral health, comprising of the presence of caries and/or periodontal disease, can lead to edentulism, which in turn can yield poor physical health, inability to communicate properly, poor mental health, and a lesser quality of life. In Kentucky, over one quarter of the adult population has lost six or more teeth due to decay or gum disease, a figure 10% higher than the national average. Objectives: The purpose of this study was to examine: a) Kentucky’s Statewide Oral Health Strategic Plan, implemented …

Factors Influencing Differential Oral Health Care Use Between Hispanics And Non-Hispanic Whites In The U.S., Nathalie Astudillo

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Oral health is often considered merely the absence of disease. However, oral health involves much more. Good oral health facilitates very basic functions like eating and speaking; a healthy smile is also associated with good self-esteem and productivity.1 Most oral health diseases are largely preventable. Despite this, a large portion of the population in the United States still suffer from untreated dental decay.2 Poor oral health has a direct effect on systemic health, quality of nutrition, digestion, phonetics, selfimage and self-esteem.5 Whether considered individually or combined, each of these factors has a direct impact on the quality of life of …

Sovereignty, Citizenship, And Public Health In The United States, Polly J. Price

Faculty Articles

Sovereign boundaries, state borders, and distinctions between citizens and non-citizens undermine public health in the United States in a number of ways. For historical reasons, we are prone to view immigration and public health as separate interests, but they are in fact convergent. Historically, federal authority over immigration alleviated costs otherwise borne by state and local governments. Today, however, states are primarily responsible for the prevention and control of communicable disease acquired outside U.S. borders. The federal and state governments confront a stark division of authority with respect to non-citizens: The federal government decides which non-citizens to admit into the …

Uncovering The Silent Victims Of The American Medical Liability System, Joanna Shepherd

Faculty Articles

A frequently overlooked problem with the current medical liability system is the vast number of medical errors that go uncompensated. Although studies indicate that 1% of hospital patients are victims of medical negligence, fewer than 2% of these injured patients file claims. In this Article, I explain that many victims of medical malpractice do not file claims because they are unable to find attorneys willing to take their cases.

I conducted the first national survey of attorneys to explore medical malpractice victims' access to the civil justice system. The results from the survey indicate that the economic reality of litigation …

Environmental Factors And Progressive Myopia: A Global Health Problem, Jeffrey Weissman

The Science Journal of the Lander College of Arts and Sciences

Myopia, or nearsightedness, is a refractive error whose prevalence has increased over the past three decades, leading to a growing concern and interest among both the public and scientific communities. For years, the only explanation and basis for myopia has been genetic factors. However, the genetic model does not explain the dramatic increase in prevalence. Current research suggests that the increase is also due to environmental factors, such as fewer hours of outdoor activities, early educational pressures requiring intense close work, as well as a lack of exposure to sunlight. One study compared the prevalence and risk factors for myopia …

Antibiotic Usage In Relation To Resistant Bacterial Infections And Liver And Kidney Cancer Outcomes In South Carolina, Prea Thathiah

Theses and Dissertations

Antibiotics are one of the most beneficial discoveries in medicine and public health. However, the use, overuse, and misuse of these drugs have led to increases in antibiotic resistant bacterial infections (ARI). Furthermore, previous epidemiological studies have linked antibiotic use to breast cancer, but these studies have not included effects on metabolic organs, such as the liver and kidneys. This dissertation investigates the role of antibiotic use in infections and liver and kidney cancers in the state of South Carolina. Using ecological study methods and Poisson regression to determine relative risk ratios, it was found that antibiotic use is a …

Coaching Relationships With Walk-On Athletes, Cortland Blake Dubose

Open Access Theses & Dissertations

The purpose of this study was to discover what communication practices coaches used on walk-on athletes and to determine whether the coach was successful or unsuccessful from the athletes' perspective. 15 present and former walk-on athletes who played for The University of Texas at El Paso football team served as the participants for the present study. In order to obtain data, the researcher interviewed the walk-on athletes using the phenomenological approach (Sparks, 1993) which utilizes open-ended questions to find out what kind of experience(s) the walk-on athletes shared in relationship to their coach. Results suggested that six major themes surfaced …

Identification Of Stroke Risk Factors In The Adult Population In The Texas And New Mexico Border Region: A Gis And Statistical Approach, Nancy Ulloa Rondeau

Open Access Theses & Dissertations

Stroke is one of the leading causes of death among adults. Annually, an approximated 800,000 adults will suffer a stroke, and one victim will die every four minutes. In El Paso County and Dona Ana County it is estimated that the age-adjusted prevalence is 2.9% and 3.4% respectively. Little is known about the percentage of adults at risk for stroke in this border region. In this secondary analysis of a cross-sectional study conducted by the Far West Texas and Southern New Mexico Regional Advisory Council on Trauma and Emergency Healthcare (Border RAC), over 900 participants in these counties and rural …

Sampled University Students' Perceived Risk Of Diabetes & Self-Reported Diabetes Risk Factors, Ajibike R. Shodunke

All Graduate Theses, Dissertations, and Other Capstone Projects

The purpose of this research was to measure university students' perceived risk of diabetes and self-reported diabetes risk factors. Informed consent forms and survey questionnaires were distributed to students in randomly sampled courses (n=357), with students aged 18 to 24. Out of the 357 surveys completed, 325 surveys were used for analysis of this study. Forty-eight percent of participants between ages 18 to 24 perceived themselves at minimal risk for developing type II diabetes. Sampled participants reported a mean of 2.25 (type II) diabetes risk factors out of 18 diabetes risk factors. Additionally, there were significant differences ( …

A Mother's Paradox: Choosing A Birthing Method In The 21st Century, Jenae Franklin

Pitzer Senior Theses

Investigating childbirth, one of the biggest moments of a woman’s life, this thesis examines the reasons behind women’s preferred birthing methods. This research explores the fundamental decisions women make during the birthing process: the amount of prenatal care mothers will receive, the type of health care provider they will use, picking the place of delivery, views on technological and medical interventions, and outlooks on natural childbirth. In addition to an extensive literature review, in-depth interviews with mothers, midwives, and obstetricians are used to examine the various controversies of childbirth. This thesis begins with a review of the transition from midwives …

Antipsychotic Prescriptions For Children Aged 5 Or Younger: Do We Need Policy Oversight Standards?, Ana Lopez-De Fede, Medha Vyavaharkar, Jessica D. Bellinger

Publications

The use of antipsychotics in very young children is of concern given the lack of empirical evidence in their efficacy and long-term impact on children’s health. This study examined the prescription of antipsychotics among children aged ≤5 years enrolled in a state Medicaid program. Secondary data analysis was conducted using the Medicaid administrative data of a southeastern state. Using SAS 9.3, descriptive statistics were performed to examine socio-demographic characteristics, psychiatric diagnoses, off-label use, receipt of medications from multiple psychotropic drug classes, and receipt of non-pharmacologic psychiatric services among children aged ≤5 years who received antipsychotic prescriptions in calendar year (CY) …

Homeless For One Winter Night: A Nursing Student's Perspective, Hannah Alewett

A with Honors Projects

For an A with Honors project for Parkland College, the student reflects on her overnight volunteer experience with CU@Home's One Winter Night, an event to raise funds for the cause of homelessness. As a nursing student, the author also reflects on homelessness from a health care perspective.

Measuring Capability For Healthy Diet And Physical Activity, Robert L. Ferrer, Inez Cruz, Sandra Burge, Bryan Bayles, Martha Castilla

Public Health (Archived)

PURPOSE Patterns of diet and physical activity, major drivers of morbidity and mortality, are contingent on people’s feasible opportunities to pursue healthy behaviors. Our objective for this mixed methods study was to develop measures of feasible opportunities for diet and activity.

METHODS The Capability Approach framework for evaluating people’s real freedoms to pursue their values guided the research. A community-based participatory model was applied to conduct focus groups of adults with obesity or diabetes mellitus from an economically disadvantaged Latino community. Focus group themes were developed into survey items that assess how individual circumstances and neighborhood contexts influence opportunities for …

Injuries Among Miners In Kentucky During 2010-2012 From Workers Compensation Data, Evelyn Thomas

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Introduction: Coal miners in Kentucky have higher rates of injury morbidity and mortality than national rates. In order to understand better what is happening in this area, we not only analyzed the injuries and deaths, but also identified common characteristics between these nonfatal and fatal injuries. The objectives of this study were to 1) Identify injuries among coal miners in Kentucky; 2) Determine if there are any other risk factors for injuries other than working in a mine; and 3) Determine the different health effects on coal mine workers. Methods: Data from Kentucky Workers’ Compensation First Reports of Injuries and …

Influence Of Marianismo On Colorectal Cancer Screening Behavior Among Hispanic Women In The United States, Robin Thompson

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Colorectal cancer (CRC) is the third most commonly diagnosed cancer and the second leading cause of cancer death in the United States (U.S).1 Although early detection and treatment can reduce CRC-related morbidity and mortality, almost twothirds of patients are diagnosed with advanced stage disease indicating non-adherence to recommended screening guidelines.1 Indeed, less than half of individuals over 50 years of age get screened at recommended intervals.2 More specifically, lower rates of CRC screening exist among these groups: those identifying as being of Hispanic origin, the uninsured, disabled individuals, and women.3 In a 2011 report from the National Center on Health …

An Exploration Of Empowerment, Sexual Violence, And Hiv Among Indian Women, Brigid Kyung-Hwa Cecil

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Empowerment plays a major role in sexual violence and HIV among women worldwide. Findings on empowerment in relation to domestic violence or HIV are scarce and are conflicting. The purpose of this study was to examine the relationship between empowerment and HIV status by means of sexual violence, and to compare this relationship between previously married women (N = 2,658) and currently married women (N = 37,539) living in India. The Baron and Kenny mediated regression model was used, involving simple logistic and multiple logistic regression, drawing from the National Family Health Survey 2005-2006 (NFHS-3). Sexual violence was not found …

Association Of Hiv Testing, Educational Attainment, And Age Among Black And Non-Black Men, Ashley N. Martell

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Human Immunodeficiency Virus (HIV) infection can lead to a chronic condition, Acquired Immunodeficiency Syndrome (AIDS), but can be well managed with a combination of medications, treatments, and remedies.1 The emergence of HIV in the United States in 1981 created an atmosphere unlike any other at that time. Overtime, the science community has worked diligently to combat this disease through research, practice, and intervention. Although many efforts have been put forth over the past thirty years, millions of Americans still remain infected with HIV.2 Among those who are infected with HIV/AIDS we see disproportionate rates among specific races and gender. Research …

Patterns Of Pneumoconiosis Mortality In Kentucky: Analysis Of Death Certificate Data, Jake Beggs

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

ABSTRACT

Background: Despite ongoing surveillance efforts, mortality rates associated with total pneumoconiosis, and particularly coal worker’s pneumoconiosis, have remained elevated. Methods: Kentucky death certificate data from 2003-2011 was statistically compared to other coal mining states and descriptively analyzed from 2011-2013 to determine the mortality burden and public health implications of pneumoconiosis and coal worker pneumoconiosis (CWP) on Kentucky residents from 2003-2013. Results: Kentucky’s total pneumoconiosis and coal workers’ pneumoconiosis mortality rates decreased from 2003-2009, then increased in following years, showing a significant quadratic trend from 2003-2013 (p<.05) compared to West Virginia, Pennsylvania, and the overall United States rates that had significant negative linear trends from 2003-2011(p<.05). Deaths from pneumoconiosis primarily occurred in white males from CWP in the Appalachian region. Individuals diagnosed with pneumoconiosis died from respiratory illness 50% of the time, heart-related problems (23%) and cancer (12%). Autopsies were only performed on 12% of decedents over the three year study period and the primary locations of death were in hospital (47%) and at home (36%). Conclusions: Increased coal mining industry worker environmental exposure protection should be enhanced in Kentucky. Additionally, healthcare efforts should focus on increasing patient education to ensure early detection and treatment for individuals suffering from pneumoconiosis as well as for comorbid conditions such as Chronic Obstructive Pulmonary Disease. To further target healthcare and treatment of pneumoconiosis patients, increased autopsies of individuals with pneumoconiosis should be performed to identify involvement of other conditions such as silicosis and optimize pneumoconiosis fatality surveillance.

A Risk Prediction Model For The Assessment And Triage Of Women With Hypertensive Disorders Of Pregnancy In Low-Resourced Settings: The Minipiers (Pre-Eclampsia Integrated Estimate Of Risk) Multi-Country Prospective Cohort Study, Beth A. Payne, Jennifer A. Hutcheon, J. Mark Ansermino, David R. Hall, Zulfiqar Ahmed Bhutta, Shereen Z. Bhutta, Christine Biryabarema, William A. Grobman, Henk Groen, Farizah Haniff, Jing Li, Laura A. Magee, Mario Merialdi, Annettee Nakimuli, Ziguang Qu, Rozina Sikandar Sultanali, Nelson Sass, Diane Sawchuck, D. Wilhelm Steyn, Mariana Widmer, Jian Zhou, Peter Von Dadelszen

Department of Obstetrics & Gynaecology

Background: Pre-eclampsia/eclampsia are leading causes of maternal mortality and morbidity, particularly in low- and middle- income countries (LMICs). We developed the miniPIERS risk prediction model to provide a simple, evidence-based tool to identify pregnant women in LMICs at increased risk of death or major hypertensive-related complications.

Methods and Findings: From 1 July 2008 to 31 March 2012, in five LMICs, data were collected prospectively on 2,081 women with any hypertensive disorder of pregnancy admitted to a participating centre. Candidate predictors collected within 24 hours of admission were entered into a step-wise backward elimination logistic regression model to predict a composite …