Public Health Commons^™

Hospital Mortality In The United States Following Acute Kidney Injury, Jeremiah. R. Brown, Michael E. Rezaee, Emily J. Marshall, Michael E. Matheny

Dartmouth Scholarship

Acute kidney injury (AKI) is a common reason for hospital admission and complication of many inpatient procedures. The temporal incidence of AKI and the association of AKI admissions with in-hospital mortality are a growing problem in the world today. In this review, we discuss the epidemiology of AKI and its association with in-hospital mortality in the United States. AKI has been growing at a rate of 14% per year since 2001. However, the in-hospital mortality associated with AKI has been on the decline starting with 21.9% in 2001 to 9.1 in 2011, even though the number of AKI-related in-hospital deaths …

Global Trends In Cancer Burden Based On Geographic Location, Socio-Economic Status And Demographic Shift, Sanjib Chowdhury

Theses & Dissertations

The global burden of cancer is rising at an alarming rate. It remains as one of the top causes of morbidity and mortality worldwide. It is predicted that within 2020, there will be 15 million new cases of cancer in the world, with cancer-related deaths increasing to 12 million. According to the World Health Organization (WHO), the global cancer burden is expected to surge 57% worldwide in the next 20 years. A significant rise in cancer burden will occur in the low-income and middle-income (developing) countries not only due to demographic shifts, but also by the transition of risk factors …

Modifiable Barriers To Optimal Outcomes In Gout Management, Brian W. Coburn

Theses & Dissertations

Improving patient outcomes in chronic disease is of critical importance to the future of health care. Gout, affecting 4% of the US population, is a highly treatable chronic disease from which patients experience unnecessarily suboptimal outcomes. In this dissertation, I demonstrate how interrelated patient and provider factors affect patient outcomes in gout. First, I describe how only 14% of gout patients know their serum urate (SU) goal for urate lowering therapy (ULT) despite otherwise being knowledgeable about gout and its treatment. I then demonstrate the importance of multiple patient and provider factors in achieving SU goal. Specifically, I demonstrate that …

Applying The Social Cognitive Theory To The Hookup Culture Embodied In The Undergraduate Students Of James Madison University, Jacqueline M. Crawford

Senior Honors Projects, 2010-2019

The hookup culture on college campuses is creating a social shift away from traditional dating. The social influence of this culture could potentially be explained through the use of the Social Cognitive Theory (SCT). The SCT examines the effects of peer influence, environmental influence, and personal beliefs on individual behavior. The current study applied the SCT to the hookup culture embodied in the undergraduate student body at James Madison University. Research found that many students may be influenced by their peers and environment to participate in this culture and students misperceive the hookup behavior of their peers. These results can …

Assessing Understanding Of Sexual Assault Resources And Response Among Health Sciences Students, Michelle M. Pappalardo

Senior Honors Projects, 2010-2019

Background: The widely published statistic of 1 in 5 represents the number of women on college campuses who have been sexually assaulted (White House Office of the Press Secretary, 2014). Many colleges and universities have been attempting to address the sensitive topic of sexual assault for quite some time; however, sexual violence still remains prevalent on campuses throughout the United States (Allen, Ridgeway, & Swan, 2015). Many of the roadblocks an institution faces in its efforts may stem from a lack of understanding of the true nature of student attitudes surrounding the topic of sexual assault. The specific needs of …

Effective Communication Of School Health Screening Information: A Pilot Study Evaluating The Effect Of Electronic Communication Of Bmi Screening Information In Elementary Schools, Kara Elizabeth Carter

Senior Honors Projects, 2010-2019

Obesity is a growing concern surrounding today’s youth. School-based health screenings are promoted as a public health strategy to identify obese children and those at high risk for becoming obese. Despite numerous programs, data is lacking in effective school to parent communication of health related information. The purpose of this research is to determine the effect of electronic communication of health screening outcomes, including parents’ understanding of screening information, utilization of informational resources, and decision to seek physician follow-up. Screenings for body mass index, acanthosis nigricans and blood pressure were conducted during school hours among children in kindergarten and third …

Cancer Perceptions And Health Behaviors In Tazewell County, Virginia, Sarah E. Waddle

Senior Honors Projects, 2010-2019

Tazewell County is a community the citizens feel is plagued by cancer. This concern was so great the county officials requested a study be done by a local university, Virginia Polytechnic Institute and State University (Virginia Tech), to explore potential external factors causing these perceived high rates of cancer within the community. The results of the Virginia Tech study found the rates of cancer were no higher in Tazewell County than elsewhere in the state of Virginia. The purpose of the current study was to explore the idea of perceptions and the effect they may have on the health behaviors …

Parents Of Children With Arthritis-Related Diseases: An Examination Of Knowledge Of And Participation In Select Support Programs And Services Offered By The Arthritis Foundation, Margo B. Deihl

Senior Honors Projects, 2010-2019

The purpose of this pilot study was to identify the knowledge of and participation in select Arthritis Foundation support programs and services among parents of children with arthritis-related diseases. Parents attending the 2014 Juvenile Arthritis National Conference in Keystone, Colorado completed an online survey that asked about their knowledge of and participation in these programs. The data collected for the study was quantitative and qualitative. Respondents were given the opportunity to add comments to some survey items, and these items were analyzed by grouping them according to common themes. Results indicated that the parents were more knowledgeable about the Juvenile …

Syrian Refugees And Digital Health In Lebanon: Opportunities For Improving Antenatal Health, Reem Talhouk, Sandra Mesmar, Anja Thieme, Madeline Balaam, Patrick Oliver, Chaza Akik, Hala Ghattas Ph.D.

Faculty Publications

There are currently over 1.1 million Syrian refugees in need of healthcare services from an already overstretched Lebanese healthcare system. Access to antenatal care (ANC) services presents a particular challenge. We conducted focus groups with 59 refugees in rural Lebanon to identify contextual and cultural factors that can inform the design of digital technologies to support refugee ANC. Previously identified high utilization of smartphones by the refugee population offers a particular opportunity for using digital technology to support access to ANC as well as health advocacy. Our findings revealed a number of considerations that should be taken into account in …

Syrian Refugees And Digital Health In Lebanon: Opportunities For Improving Antenatal Health, Reem Talhouk, Sandra Mesmar, Anja Thieme, Madeline Balaam, Patrick Olivier, Chaza Akik, Hala Ghattas Ph.D

Faculty Publications

There are currently over 1.1 million Syrian refugees in need of healthcare services from an already overstretched Lebanese healthcare system. Access to antenatal care (ANC) services presents a particular challenge. We conducted focus groups with 59 refugees in rural Lebanon to identify contextual and cultural factors that can inform the design of digital technologies to support refugee ANC. Previously identified high utilization of smartphones by the refugee population offers a particular opportunity for using digital technology to support access to ANC as well as health advocacy. Our findings revealed a number of considerations that should be taken into account in …

Using Homeland Security Exercise Evaluation Program To Execute A Mass Prophylaxis Exercise In A Rural Community., Brian K. Smith

Theses & Dissertations

This project explores the execution of point of distribution exercises in a rural community. Harrison County Iowa is a rural county with a population over 15,000 located approximately 45 minutes north of the Omaha metro area. The project explored the existing point of distribution plans and inventory for the Harrison County Home and Public Health Department. Prior to this project, many staff at Harrison County Home and Public Health Department had no experience with table top or full scale exercises. The mass prophylaxis point of distribution plan had not been updated, and staff had not received training on the point …

Establishment Of Comprehensive Training Center In Tajikistan, Umeda Sadykova

Theses & Dissertations

There is a notable increase in the number of natural and manmade disasters all over the world in the past two decades. Emergency preparedness is a field that is drawing increased attention in many countries. Tajikistan is a disaster prone country with unforgiving nature and weak preparedness infrastructure/system. Tajikistan’s weak emergency preparedness system can be attributed to two main reasons; lack of coordination between the government and international emergency organizations, and the paucity of well trained and organized network of emergency professionals. This study drafted a proposal to establish a comprehensive training center in Tajikistan. This training center will be …

Human Papillomavirus And Its Impact On Vulnerable Populations, Harpriya Kaur

Theses & Dissertations

Human papillomavirus (HPV) is the most common sexually transmitted infection. The infection is higher in certain racial/ethnic groups and those who are immunocompromised including pregnant women. Because immune system is suppressed during pregnancy, women are at higher risk of various types of infection including HPV, a known risk factor for pregnancy complications. However, its role in adverse pregnancy outcomes is unclear. Another high risk population is Northern Plain American Indian. In the Northern Plains region, American Indian women have significantly higher rate of HPV infection than white counterparts and are infected with different types of HPVs than the general population. …

Exploring Emergency Communication Experiences In Response To The 2010 Haiti Earthquake: Lessons Learned From International Donors And Local Government Agencies, Pierre Marie Barbara Roussel

Theses & Dissertations

Background:

In almost every disaster situation, the use of standardized communication procedures among humanitarian relief agencies has been identified as one of the efficient practices to minimize the mismanagement of resources and thus to maximize the response effort among actors to reduce the incidence impact on the public and to increase their resilience capabilities.

Agencies have access to several guidelines to follow during domestic disasters, but there have been very few manuals developed to guide relief organizations on best practices during international large and complex natural disasters such as the 2010 Haiti earthquake.

Haiti has experienced over its history several …

Factors And Outcomes Associated With Potentially Inappropriate Medication Use In Rural Community-Dwelling Older Adults, Marcia Y. Shade

Theses & Dissertations

Potentially inappropriate medications (PIMs) use in older adults is a significant public health concern. The use of PIMs to avoid may lead to negative outcomes such as adverse drug events. Prior conceptual analysis of PIMs use and observation of health-related factors in rural adults led to the design of this dissertation study. A sample was recruited from a population of rural community-dwelling older adults to examine the following specific aims: 1) Describe the use of PIMs to avoid, 2) Explore individual demographic characteristics (age, gender, income, education, and rural home location), health experience (comorbidity, number of medications and health providers), …

Essays On Immigration-Related Disparities In Health Behavior And Health Care Utilization, Yang Wang

Theses & Dissertations

The number of immigrants in the United States has recently been increasing significantly. Immigrants may experience some worse health outcomes than natives, due to substantial legal and socioeconomic barriers. Many immigration-related disparities in health behavior and health care utilization still remain unexplored. This dissertation comprises of 3 independent studies examining such disparities across immigration status, including (1) E-cigarette use and acculturation effects; (2) Cancer-related office-based medical provider visits among cancer patients; and (3) Potentially preventable emergency department visits.

Two nationally representative data sources included National Health Interview Survey and Medical Expenditure Panel Survey. We categorized the respondents into three immigration …

Are Electronic Cigarettes The Solution To Smoking Cessation?, Heather L. Walsh, Audrey L. Mcmurray

Physician Assistant Capstones, 2016 to 2019

Objectives: Little is known regarding the effectiveness of electronic cigarettes (e-cigarettes) as therapy to aid in smoking cessation. Many hypothesize that e-cigarettes are equally as effective or more effective than alternate smoking cessation therapies. The purpose of this review was to examine the evidence on effectiveness of e-cigarettes on smoking cessation and quitting behavior as compared to other smoking cessation therapies, or no therapy at all.

Methods: Searches were done in PubMed utilizing the terms “electronic cigarettes” and “smoking cessation” [MeSH terms]. In PubMed, the following filters limits were used: published in the last 5 years, human species, …

Routine Screening For Abdominal Aortic Aneurysm: Is It For Everyone?, Catherine E. Nowak

Physician Assistant Capstones, 2016 to 2019

Objective: Determine whether routine abdominal ultrasound screening in all men ages 65 and over, not just those who are symptomatic or at risk, would be beneficial in reducing the mortality rate from abdominal aortic aneurysms (AAA). Design: Systematic literature review. Methods: The clinical question investigated is whether routine ultrasound screening of AAA for men over age 65 reduces AAA-related mortality as compared to not routinely screening. Searches were done through PubMed using the keywords: screening, abdominal aortic aneurysm, reduce, and mortality. Citations used by the USPSTF AAA screening guidelines were also added to the literature search. In PubMed, further limitations …

Want To Lose Weight? Commercial Weight Loss Programs Vs. Primary Care, Jessica Jacobson, Katherine Chui

Physician Assistant Capstones, 2016 to 2019

Context Overweight and obesity rates are on a continuous incline in the United States leading to increased rates of diabetes, cardiovascular disease and death. Much of the healthcare costs are going into treating this disease; therefore, it is vital to find effective weight loss treatments in both the primary care and community settings to reduce the prevalence of overweight and obesity and subsequent healthcare costs.

Objective To assess whether primary care-based therapy or commercial weight loss programs help overweight and obese patients lose 5% of their weight from baseline.

Design, Setting and Participants A systematic review of four randomized control …

Patient Satisfaction As A Reflection Of Quality Health Care And Outcomes, Ian C. Brown, Taylor M. Piatkowski

Physician Assistant Capstones, 2016 to 2019

Background: In 2006 the Centers of Medicaid and Medicare Services mandated that acute care centers begin submitting HCAHPS survey data for financial reimbursement for Medicare patients. The national shift to a patient centered focus and the financial incentive to improve patient satisfaction scores has stimulated debate regarding the relationship between patient satisfaction and quality healthcare.

Clinical Question: Does improvement in patient satisfaction with their healthcare and its providers, as measured by the HCAHPS survey, improve healthcare quality and outcomes?

Design: Systematic literature review.

Methods: Searches were performed using PubMed and Scopus databases.The terms used for the PubMed search were “patient …

Perceptions And Experiences Of Human Papillomavirus (Hpv) Infection And Testing Among Low-Income Mexican Women, Leith León-Maldonado, Emily Wentzell, Brandon Brown, Betania Allen-Leigh, Leticia Torres-Ibarra, Jorge Salmerón, Deborah L. Billings, Jim Thrasher, Eduardo Lazcano-Ponce

Faculty Publications

Background

HPV infection causes cervical cancer, a major contributor to morbidity and mortality among low-income Mexican women. Human papillomavirus (HPV) DNA testing is now a primary screening strategy in Mexico’s early cervical cancer detection program (ECDP). Research on Mexican women’s perceptions of HPV and testing is necessary for establishing culturally appropriate protocols and educational materials. Here, we explore perceptions about HPV and HPV-related risk factors among low-income Mexican ECDP participants.

Methods

We conducted semi-structured interviews with 24 ECDP participants from two primary care health clinics in Michoacán state, Mexico. Interviews addressed women’s understandings of and experiences with HPV and HPV …

A Comparison Of Health Care Systems In The Western World, Katherine Regan Lawall

Senior Theses

This senior thesis evaluates the health care systems of the Netherlands, Belgium, Switzerland, and Denmark, before looking at how their approaches could be adapted to the U.S. system. I picked these specific countries due to their similarity in geographic location, demographic, religious affiliations, and population size but have different styles of health care systems (public, mixed, and private) that are set up in varying ways. Additionally, these populations have similar health issues to one another, such as aging-populations, and to the U.S. as well like the top causes of death. However, these four western European countries have longer life expediencies …

Implementation And Evaluation Of A Social Media Campaign To Promote Cervical Cancer Prevention And Control, Kelsie Nicole Dirksing

Senior Theses

Background: Cervical Cancer-Free South Carolina (CCFSC) is a member state of the Cervical Cancer-Free Coalition focused on eliminating cervical cancer through screening, follow-up care, HPV vaccination, and education. CCFSC utilizes social media to help spread awareness about cervical cancer prevention and control.

Purpose: The purpose of this thesis was to develop, implement, and evaluate a social media campaign for CCFSC during Cervical Health Awareness Month in January 2016.

Methods: Two social media plans – one for CCFSC use and another for CCFSC partner use – were developed for use during Cervical Health Awareness Month in January 2016. The CCFSC posts …

Learning From Geographic Variation And Change In Preparedness: The 2016 National Health Security Preparedness Index, Glen P. Mays

Health Management and Policy Presentations

The 2016 release of the National Health Security Preparedness Index tracks the nation's progress in preparing for disasters and other emergencies that create health risks for large groups of people. Recent improvements in the Index computational methodologies and measures allow results to be compared validly across states and over time. The Index aggregates more than 130 individual measures from nearly 60 data sources into valid composite measures for 6 domains and 19 subdomains that reflect core functional areas of emergency preparedness and response. Improvements in normalization, weighting, imputation, and confidence interval construction enhance the validity and reliability of Index estimates …

Epidemiology News, Georgia Southern University

Biostatistics, Epidemiology & Environmental Health Sciences: News & Publications (2011-2018)

• Georgia Southern Estimates the Effects of Smoking Bans on Neonatal Health

Examining The High Rate Of Infant Mortality Among Minorities In Norristown, Pa, Wendy Kaye

Graduate Theses & Dissertations

Background: According to the Centers for Disease Control (CDC) (2016), infant mortality is defined as “the death of a baby before his or her first birthday”. The statistics provided by the CDC (2016) state that 23,440 infants died in the US in 2013. Racial and ethnic minorities experience higher rates of infant mortality than White people. In Norristown, PA, between 2008 and 2012, the rate of infant death for African Americans was 25 percent, versus 15 percent for their Caucasian counterparts.

Purpose: The purpose of this paper is to examine the reasons for high infant mortality, with the goal of …

Food Deserts: The Issue And Possible Solutions, Lauren Branham

Senior Honors Theses

Areas in which residents lack access to low-priced, nutritious food are called food deserts. Typical characteristics of food deserts include residents with limited income, high concentrations of ethnic minorities, difficultly accessing grocery stores with a produce section, and high exposure to fast food restaurants and convenience stores. The reason limited access to healthy, minimally processed foods is an issue is because foods that are highly processed typically have higher levels of fat, sugar, and salt content which have been linked to obesity, coronary artery disease, and other chronic diseases. Many different types of interventions have been attempted to combat this …

Saudi Arabians’ Health Beliefs Pertaining To Middle East Respiratory Syndrome – Coronavirus (Mers-Cov): Knowledge, Attitudes, And Practices (Kap) Assessment, Zahrah Alnakli

Graduate Theses & Dissertations

Background: Middle East Respiratory Syndrome (MERS-CoV) causes respiratory illness and has been linked to high morbidity (N=583) and mortality (N=1359) since it was first found in Saudi Arabia in 2012. Camels have been identified as the likely source of the infection of MERS in Egypt, Qatar, and Saudi Arabia. Currently, there is no available treatment for MERS; however, prevention and education have been established as the best practices for prevention by the World Health Organization, United States (U.S.) Centers for Disease Control and Prevention, and The Ministry of Health in Saudi Arabia.

Purpose: This study explores awareness and health behaviors …

College Of Public Health News, Georgia Southern University

College of Public Health: News & Publications

• Georgia Southern Estimates the Effect of Smoking Bans on Neonatal Heatlh

Health Policy & Management News, Georgia Southern University

Health Policy & Community Health: News & Publications (2011-2018)

• Georgia Southern Estimates the Effects of Smoking Bans on Neonatal Health