Public Health Commons^™

Male Escorts’ And Male Clients’ Sexual Behavior During Their Last Commercial Sexual Encounter: Comparing And Contrasting Findings From Two Online Studies, Christian Grov, Carlos E. Rodríguez-Díaz, Gerardo G. Jovet-Toledo

Publications and Research

Much of what is known about commercial sexual encounters between men is based on data gathered from escorts. With few exceptions, studies have not compared male clients’ reports of behavior during commercial sexual encounters with male escorts’. The present study draws from two datasets, a 2012 survey of clients (n = 495) and a 2013 survey of escorts (n = 387)—both used virtually identical measures of sexual behavior during the most recent commercial sexual encounter. For clients and escorts, the majority eschewed having sex without a condom, and kissing and oral sex were among the most common behaviors reported. Using …

Effects Of Dehydration On Changes In Arterial Stiffness With Passive Heating, Az Satterfield

Health, Human Performance and Recreation Undergraduate Honors Theses

Context: There is an inverse relationship between baseline arterial stiffness and the change in arterial stiffness with passive heating. However, it is unknown whether this relationship is affected by dehydration. Objective: To investigate the effect of acute dehydration on arterial stiffness during passive heat stress. Design: Two randomized counter-balanced trials. Setting: Laboratory. Patients or Other Participants: Eleven healthy males (age=24.5 ± 2.8 years, body mass=76.6 ± 9.1 kg, body fat=16.8 ± 6.4%). Interventions: In one trial subjects were dehydrated (DE) and in another euhydration (EU) was maintained during passive heating to a 1.5°C increase in body temperature. Subjects were euhydrated …

Bridging The Location Gap: Physician Perspectives Of Physician-Pharmacist Collaboration In Patient Care (Bridge Phase Ii), Keri D. Hager, Donald Uden, Daniel M. Tomaszewski

Pharmacy Faculty Articles and Research

Background: To optimize patient outcomes, the patient-centred medical home model emphasizes comprehensive team-based care. Pharmacists are qualified to enhance appropriate medication use and help improve patient outcomes through provision of medication therapy management (MTM) services. To optimally provide MTM, pharmacists must effectively collaborate with physicians. This study explored factors that influence pharmacist-physician collaboration.

Methods and Findings: A convenience sample of five physicians participated in semi-structured interviews and the resulting data were analyzed using qualitative methods. Transcripts of the interviews were independently coded for themes by two researchers. Five themes emerged: trustworthiness, role specification, relationship initiation, effects on practice, …

Policy Considerations For Community Health Workers In An Era Of Health Reform, Sara Kahn-Troster

Muskie School Capstones and Dissertations

In order to better understand how CHWs are being integrated in state health reform initiatives, including facilitating care coordination, enhancing access to community-based services, and addressing social determinants of health, the author, working in collaboration with the National Academy for State Health Policy (NASHP), developed a nation-wide scan of CHW policy activity, published online as State Community Health Worker Models in February, 2015. The CHW chart gives a comprehensive look at how states are utilizing CHWs as part of quality improvement, health care reform, and expanded models of public health.

Evaluation Of Patient To Provider Oriented Telemedicine In Hospitals And Physician Practices, Macklin G. Gaynor

Muskie School Capstones and Dissertations

This project explores barriers to telemedicine adoption and meaningful integration with contemporary healthcare delivery systems.

Conception To Implementation: Quality Improvement In Behavioral Health Home Organizations, Elizabeth A. Miller

Muskie School Capstones and Dissertations

This capstone project developed quality improvement tools to be used by community mental health agencies participating in the Maine Behavioral Health Homes Initiative. Providing technical assistance, analysis of feedback, and developing recommendations were the foundation of this project with a central tenet to enhance the existing Quality Improvement Project Template created by MaineCare, Maine’s Medicaid Office. These recommendations suggest the Quality Improvement Project Template may be improved by providing an additional fillable quality improvement process outline, providing a list of example projects and focus areas for quality improvement projects, and providing tools to assist in implementation of quality improvement projects. …

An Inventory Of Community Wellness Programs In Biddeford, Maine, A Silver

Muskie School Capstones and Dissertations

This report highlights wellness initiatives from the perspective of two population segments: those with chronic condition, or those who may be at risk for chronic conditions, and high-risk populations, which this project defines as those living below the federal poverty level who engage in behaviors that potentially lead to avoidable health problems. The rationale was that these groups require extensive resources and that it would be easier to identify gaps in community wellness support for these populations.

Telephone Usage At Mercy Hospital's Primary Care Practices, Julia C. Nason

Muskie School Capstones and Dissertations

This capstone focuses on Mercy’s primary care practices, reviews how their phone process currently works, reasons for patients calling, and then researching best practices for the telephones.

Issues Of Sovereignty In Wabanaki Communities And Impacts On Health Outcomes, Ralph E. Cammack

Muskie School Capstones and Dissertations

The purpose of this capstone is to explore how Wabanaki communities of Maine experience sovereignty as it relates to the dominant culture of Maine and how this interaction has led to current health outcomes and disparities. I do this by examining how the communities view sovereignty and understanding how internalized anger impacts these communities.

Evidence Informed Checklist Increase Patient Experience Of Quietness During A Hospital Stay, Monica Alborg

Muskie School Capstones and Dissertations

This checklist is made to be used by staff at hospitals, especially nurse managers and quality improvement specialists. A staff member can pick and choose what items on the checklist are feasible to implement within their organization. Ongoing quality improvement strategies are suggested in the checklist to remain abreast of ways to mitigate noise in hospitals.

Accidental Phosphine Gas Poisoning With Fatal Myocardial Dysfunction In Two Families, Saleem Akhtar, Arshalooz Rehman, Surraya Bano, Anwarul Haque

Department of Emergency Medicine

ABSTRACT Aluminum phosphide is commonly used as a rodenticide and insecticide and is one of the most fatal poisons. The active ingredient is Phosphine gas which inhibits cytochrome oxidase and cellular oxygen utilization. The clinical symptoms are due to multiorgan involvement including cardiac toxicity which is the most common cause of mortality. Severity of clinical manifestations depends upon the amount of the gas to which a person is exposed. There is no specific antidote available. High index of suspicion and early aggressive treatment is the key to success. We report 2 cases of aluminum phosphide toxicity in 2 families due …

Sexual Relationships Outside Primary Partnerships And Abstinence Are Associated With Lower Adherence And Adherence Gaps: Data From The Partners Prep Ancillary Adherence Study, Alexander Kintu, Susan E. Hankinson, Raji Balasubramanian, Karen Ertel, Elioda Tumwesigye, David Bangsberg, Jessica E. Haberer

OHSU-PSU School of Public Health Faculty Publications and Presentations

Objective—To assess the role of sexual relationships on levels and patterns of adherence to medication for pre-exposure prophylaxis (PrEP) against HIV.

Methods—We enrolled 1,147 HIV-negative individuals in long-term serodiscordant relationships at three sites in Uganda from the Partners PrEP Study- a randomized placebo-controlled trial of daily oral tenofovir and emtricitabine/tenofovir. We used generalized estimation equations to assess the effects of sexual relationships on low adherence (

Results—Fifty-three percent were male, 51% were 18-34 years and 24% were polygamous. Participants who reported sex in the past month with someone other than their primary partner and with

Conclusions—Risk of low overall adherence …

Super Learner Analysis Of Electronic Adherence Data Improves Viral Prediction And May Provide Strategies For Selective Hiv Rna Monitoring, Maya L. Petersen, Erin Ledell, Joshua Schwab, Varada Sarovar, Robert Gross, Nancy Reynolds, Jessica E. Haberer, Kathy Goggin, Carol E. Golin, Julia Arnsten, Marc Rosen, Robert H. Remien, David Etoori, Ira B. Wilson, Jane M. Simoni, Judith A. Erlen, Mark J. Van Der Laan, Honghu Liu, David Bangsberg

OHSU-PSU School of Public Health Faculty Publications and Presentations

Objective—Regular HIV RNA testing for all HIV positive patients on antiretroviral therapy (ART) is expensive and has low yield since most tests are undetectable. Selective testing of those at higher risk of failure may improve efficiency. We investigated whether a novel analysis of adherence data could correctly classify virological failure and potentially inform a selective testing strategy.

Design—Multisite prospective cohort consortium.

Methods—We evaluated longitudinal data on 1478 adult patients treated with ART and monitored using the Medication Event Monitoring System (MEMS) in 16 United States cohorts contributing to the MACH14 consortium. Since the relationship between adherence and virological failure is …

Management Of Pediatric Headaches In The Emergency Department At Connecticut Children’S Medical Center, Chevaughn Wellington

Honors Scholar Theses

Headaches are a common complaint for children presenting to the Emergency Department (ED) at Connecticut Children’s Medical Center (CCMC). Currently, there is little published regarding a standard treatment plan for pediatric headaches. The purpose of this study is to determine which medications are most commonly utilized and which are most effective in managing pediatric headaches. Differences in management of acute and chronic headaches in the ED at CCMC were examined. A retrospective chart review was conducted of all children who presented to the ED from January 1 to March 31, 2013 with a chief complaint or discharge diagnosis of “headache” …

Connecticut's Elderly Population: An In-Depth Analysis Of Current And Future Trends In Elder Care, With A Focus On Dementia And Cognitive Decline, Emily J. Snodgrass

Honors Scholar Theses

The aging population in Connecticut currently represents ~15% of the state’s population but is anticipated to rapidly increase over the next 20 years. My thesis is an examination of the types of interventions and programs currently available for elderly persons with memory impairment and cognitive decline, as well as the challenges associated with caring for a larger elderly population. Data collected from interviews with CT healthcare and research professionals representative of the diverse specialties of aging together with an analysis of current research literature are used to demonstrate the importance of continued research and expansion of appropriate and accessible services …

Genetics Of Obesity In Starr County, Texas Mexican Americans, Heather M. Highland

Dissertations and Theses (Open Access)

Currently, over two-thirds of Americans are classified as over-weight or obese. Obesity increases risk for many other diseases including type 2 diabetes, heart disease, stroke, and cancer, making obesity the largest public health problem in America and most other Westernized nations. Hispanics have a higher rate of both obesity and type 2 diabetes, making them a particularly interesting population in which to study obesity. For the last 33 years, the Starr County Health Studies has collected an array of phenotypes and biological samples from residents of Starr County, along Texas-Mexico border. This study includes 825 subjects who were not known …

Impact Of Numeracy On Parental Self-Efficacy And Treatment Outcome Of Children On Complex Diets., Diana Cardina Pantalos

Electronic Theses and Dissertations

Health numeracy, a counterpart to health literacy, can be a mediator of health disparities. This study analyzed the impact of both cognitive and affective numeracy on the pathway linking health behavior to health outcomes, and the role of self-efficacy in this relationship, based on the Health Belief Model. The context was parental management of children's complex diets that require numerical calculations. Parents of children ages 12 months to 12 years with type 1 diabetes (T1D) or phenylketonuria (PKU) were recruited at clinics or community events in east-central states. Ninety-eight participants completed a standardized test of math skills, an instrument to …

The Association Of Medical Student Debt On Choice Of Primary Care Specialty And Rural Practice Location., Craig Ziegler

Electronic Theses and Dissertations

A shortage of primary care physicians (PCP) is present nationally and within Kentucky. The shortage is expected to worsen, unless a dramatic increase occurs in the generation of additional primary care clinicians. Geographical maldistributions of PCP also exist. Whereas 20% of the US population resides in rural areas, only 10% of physicians practice in these areas. This study explores factors that influence medical students’ decisions to select primary care residency training programs, and to practice in rural areas. Specifically, the levels of debt among 1391 graduates from University of Louisville School of Medicine (ULSOM) during 2001-2010 were examined in association …

The Relationship Between Financial Empowerment And Health Related Quality Of Life In Family Scholar House Participants., Chelsey Erbaugh Franz

Electronic Theses and Dissertations

The Family Scholar House program was a unique intervention designed to stop the cycle of poverty by providing college education and support to single parents. The different aspects of the Family Scholar House program addressed each of the five social determinants of health (economic stability, education, social and community context, health care, and neighborhood and built environment). Results of the studies showed that participant’s mental health and general health rating, as measured by a health-related quality of life survey, improved during the time in the Family Scholar House program. Upon graduation from the program, the mental health and the health …

Implementation Of Break Time For Employee Nursing Mothers At The University Of Louisville : A Case Study., Robin Elise Weiss, 1971-

Electronic Theses and Dissertations

This dissertation is a mixed methods look at the barriers to successful implementation of the Break Time for Nursing Mothers provisions of the Affordable Care Act (ACA) at an upper southern-midwestern university. As public health and medical officials push the desire for an increase in breastfeeding initiation and duration, many mothers must overcome barriers within the employment arena. Previous work has failed to look at how the university setting presents unique challenges with a diverse workforce, varied jobs, and differing space availability. In other settings, barriers have been identified; the goal of this dissertation was to identify what the specific …

The Influence Of Child Physical Activity Programs On Parent Physical Activity In A Rural Community., Katie F. Leslie

Electronic Theses and Dissertations

Introduction: In 2008, a coalition of community leaders and parents sought to increase access to physical activity opportunities for residents of Meade County, a rural Kentucky community. To date, the Meade Activity Center has implemented a variety of year-round programs conducted at borrowed spaces from local schools that have targeted children, utilizing the strategy to first engage children as a way to extend behavior change to other members of the community. This study assessed the influence of child participation in physical activity programs on parent physical activity, and determined potential methods of intervention to increase adult physical activity in a …

Body Of Knowledge: Field Use Of Direct-Reading Instruments For Detection Of Gases And Vapors, Cheryl L. Marcham, Et Al.

Publications

AIHA and its members and volunteers worked collaboratively to develop the technical framework, known as the Body of Knowledge (BoK), that outlines the knowledge and skills a competent person should possess and be able to demonstrate when operating direct-reading instruments (DRIs) for detection of gases and vapors.

Texas Physicians' Awareness And Utilization Of Genetic Services, Callie L. Jenevein

Dissertations and Theses (Open Access)

The number of disorders for which genetic testing is available has increased nearly 500% in the past 15 years. Access to the majority of genetic tests and services hinges on physicians’ ability to identify patients at risk for genetic disease and provide appropriate testing and counseling or refer to genetic specialists. Recent research demonstrates the need for referrals to genetic specialists by showing that many physicians lack skills required to perform appropriate genetic services, such as making proper risk assessments, providing genetic counseling, ordering genetic testing and interpreting results. However, little research exists on physicians’ awareness and utilization of genetic …

Puerto Rican Mother-Child Communication About Sexuality And Sexual Health: Results From An Ethnographic Community Survey In Springfield, Ma, María Idalí Torres, Phillip Granberry, Sarah Rustan

Gastón Institute Publications

This bilingual report presents data from an ethnographic survey on the experiences of Spanish-speaking Puerto Rican mothers communicating with children ages 10 to 19 regarding sexuality and sexual health. Results of this survey will be used as baseline data to evaluate a media campaign promoting Puerto Rican mother-child communication. This Spanish media campaign was implemented from March to May, 2015 using public service announcements in television, radio, and newspapers and on public transportation.

In this report, we use three main concepts with specific definitions: mother, sexuality, and sexual health protection, defined as follows. Mother is defined as the female adult …

Use Of The Robson Classification To Assess Caesarean Section Trends In 21 Countries: A Secondary Analysis Of Two Who Multicountry Surveys, Joshua P. Vogel, Ana Pilar Betrán, Nadia Vindevoghel, João Paulo Souza, Maria Regina Torloni, Jun Zhang, Özge Tunçalp, Rintaro Mori, Naho Morisaki, Eduardo Ortiz-Panozo, Bernardo Hernandez, Ricardo Pérez-Cuevas, Zahida Qureshi, A Metin Gülmezoglu, Marleen Temmerman

Obstetrics and Gynaecology, East Africa

Background: Rates of caesarean section surgery are rising worldwide, but the determinants of this increase, especially in low-income and middle-income countries, are controversial. In this study, we aimed to analyse the contribution of specific obstetric populations to changes in caesarean section rates, by using the Robson classification in two WHO multicountry surveys of deliveries in health-care facilities. The Robson system classifies all deliveries into one of ten groups on the basis of five parameters: obstetric history, onset of labour, fetal lie, number of neonates, and gestational age.

Methods: We studied deliveries in 287 facilities in 21 countries that …

The Influence Of Race And Gender On Hiv Risk Behaviors In High School Students In The Southern States Of The United States, Malendie T. Gaines

Electronic Theses and Dissertations

The incidence of the Human Immunodeficiency Virus (HIV) is highest in the southern states of the United States (US), with adolescents in this region being one of the most affected populations in the country. A limited amount of information is available on adolescent HIV risk behaviors in the southern states, specifically focusing on race and gender. The purpose of this study was to use the Centers for Disease Control and Prevention’s National Youth Risk Behaviors Survey (YRBS) for high school students in the southern states for 2011 and 2013 to examine the influence of race and gender on 1) early …

A Hierarchical Graph For Nucleotide Binding Domain 2, Samuel Kakraba

Electronic Theses and Dissertations

One of the most prevalent inherited diseases is cystic fibrosis. This disease is caused by a mutation in a membrane protein, the cystic fibrosis transmembrane conductance regulator (CFTR). CFTR is known to function as a chloride channel that regulates the viscosity of mucus that lines the ducts of a number of organs. Generally, most of the prevalent mutations of CFTR are located in one of two nucleotide binding domains, namely, the nucleotide binding domain 1 (NBD1). However, some mutations in nucleotide binding domain 2 (NBD2) can equally cause cystic fibrosis. In this work, a hierarchical graph is built for NBD2. …

Weaving Quality Improvement And Patient Safety Skills Into All Levels Of Medical Training: An Annotated Bibliography., Eugene Mochan, Phd, Do, David B. Nash, Md, Mba

College of Population Health Faculty Papers

With the launching of the Liaison Committee on Medical Education’s new accreditation Standard ED-19-A in July 2013, a new era in quality improvement/patient safety (QI/PS) has begun. Core curriculum of medical schools must now include multidisciplinary teamwork; that is, inclusion of practitioners and/or students from other health professions. This Standard ED-19-A is harmonious with the earlier Accreditation Council for Graduate Medical Education’s (ACGME) Competency IV.A.5.c., which calls for QI to be integrated into residents’ training curricula. Residents need to be able to determine their strengths and deficiencies. ACGME requires residents to systematically analyze practice using QI methods; to incorporate formative …

Statement And Action Agenda From The Girls In Emergencies Collaborative, Omar Robles, Judith Bruce, Holly G. Atkinson, Dale Buscher, Karen Scriven, Kristin Kim Bart, Shelby French, Judithe Registre, Audrey Anderson

Publications and Research

Many adolescent girls—the poorest girls in the poorest communities—already live in an “emergency.” Humanitarian crises only amplify the call on their coping and caring capacities, while exacerbating their vulnerabilities. The frequency and intensity of emergencies, including natural disasters, conflicts, and infectious disease outbreaks such as Ebola, appear to be growing. These emergencies threaten entire communities and whole countries, often with global implications. Many become virtually permanent.

The Impacts Of A Smoking Ban On Gaming Volume And Customers' Satisfaction In The Casino Industry In South Korea, Sojeong Lee

UNLV Theses, Dissertations, Professional Papers, and Capstones

A growing number of countries have legislated smoke-free policies in enclosed public areas and have extended the policies to hospitality facilities. However, some states and countries exempt gaming areas from the smoking law fully or partially. Anti-smoking policy is controversial for a number of reasons, such as smokers’ strong opposition, government ordinance, public health, and economic anxiety. Casino management may worry that a smoking ban policy will result in a significant decline of casino revenue because the break for smoking may interfere with continuing play.

This thesis examined a smoking ban impacts on gaming volume and customers’ satisfaction in the …