Public Health Commons^™

Stop Stunting: Situation And Way Forward To Improve Maternal, Child And Adolescent Nutrition In Afghanistan, Ariel Higgins Steele, Piyali Mustaphi, Sherin Varkey, Humayoun Ludin, Najibullah Safi, Zulfiqar Ahmed Bhutta

Department of Paediatrics and Child Health

No abstract provided.

The National Diabetes Prevention Program An Intervention For Diabetes Risk Reduction, Kavita Batra

UNLV Theses, Dissertations, Professional Papers, and Capstones

Diabetes mellitus is among the most frequently occurring chronic conditions, affecting 28 million adults in the Nation. The Nevada diabetes prevalence rate is approaching the National average, with 1 out of 4 diabetic patients experiencing serious clinical complications. Diabetes is typically preceded by a preventable condition classified as prediabetes, in which the blood sugar level exceeds the normal level, yet not enough to be classified as Type 2 diabetes. Prediabetes increases the risk of developing diabetes within 10 years, if not effectively managed. In an attempt to help reduce this risk, the CDC recently introduced an evidence-based intervention, the National …

Differences In Perceived Importance Of Preventative Services And Healthcare Provider Trust Among Hispanics, Jonathan James Gore

UNLV Theses, Dissertations, Professional Papers, and Capstones

The Hispanic population varies greatly in their risk factors, health outcomes and access to care by country of origin, level of education and language dominance (Vega & Amaro, 1994) (Fiscella, Franks, Doescher, & Saver, 2002b). The differences within the Hispanic population also extend to their knowledge and attitudes toward health choices and maintenance, where they receive their health information, and what they access to meet their health care needs. Subpopulations within the Hispanic community as defined by language dominance and nativity must be understood as separate and distinct so that the health needs of each can be adequately addressed. The …

Cancer Among Asian American Population In The United States: Incidence And Survival Disparities, Hongbin Jin

UNLV Theses, Dissertations, Professional Papers, and Capstones

Part I

Cancer incidence disparities exist among specific Asian American populations. However, the existing reports exclude data from large metropoles like Chicago, Houston, and New York. Moreover, incidence rates by subgroup have been underestimated due to the exclusion of Asians with unknown subgroup. Cancer incidence data for 2009 to 2011 for eight states accounting for 68% of the Asian American population were analyzed. Race for cases with unknown subgroup was imputed using stratified proportion models by sex, age, cancer site, and geographic regions. Age-standardized incidence rates were calculated for 17 cancer sites for the six largest Asian subgroups. Our analysis …

Effectiveness Of Commercially-Available Cosmetic Cleaners On Cosmetics And Cosmetic Brushes, Vanessa Ortiz

UNLV Theses, Dissertations, Professional Papers, and Capstones

The complex nature of skin contributes to the microbial population present on its surface. While normal skin flora is either beneficial or has no effect on the body, there are instances where pathogenic microorganisms are present and can cause infections. Damaged skin is more susceptible to infections from these microbes. Behavioral characteristics, such as the use of cosmetics, can affect the microbial population present on the skin. Staphylococcus aureus is the organism most commonly isolated from cosmetics, and it can be responsible for conjunctivitis, impetigo, boils, and folliculitis.

There are many ways microbial contamination of cosmetics can occur, such as …

Impacts To Phytoplankton After The Establishment Of Quagga Mussels In Lake Mead, Nevada, Warren Bruce Turkett

UNLV Theses, Dissertations, Professional Papers, and Capstones

Quagga mussels (Dreissena rostriformis bugensis) are an invasive species that were discovered in Lake Mead in January of 2007, and rapidly spread throughout the lake. Quagga mussels are about the size of a fingernail, but are known to clog pipes, damage infrastructure and alter ecosystems. In large numbers, mussels can have a dramatic impact on an ecosystem by reducing the phytoplankton and potentially increasing toxin producing cyanobacteria. This research analyzed data collected from three separate basins in Lake Mead to determine if water quality characteristics that are commonly impacted by invasive mussels have changed. Transparency, chlorophyll-a, phytoplankton and zooplankton samples …

Microbial Contamination Of Ice At Food Establishments In Las Vegas, Nevada, Jerry Wills

UNLV Theses, Dissertations, Professional Papers, and Capstones

When food establishments make ice for consumption, it is important to use water free of pathogens and to employ hygienic practices. Freezing can reduce the number of culturable microorganisms present in water but does not eliminate them completely. Coliform bacteria are used as an indicator of water quality and are used to test for fecal contamination. The U.S. Environmental Protection Agency (EPA) establishes standards for drinking water, and has set a goal for zero total coliforms. Another commonly used tool to measure water quality is the heterotrophic plate count (HPC). The EPA limit for HPC is 500 colony forming units …

Short-Term Outcome Evaluation Of Healthy Habits, Healthy U: A School-Based Cancer Prevention Program, Alicia Anderson

Boise State University Theses and Dissertations

Healthy Habits, Healthy U (HHHU) is a school-based cancer prevention program. This program is a collaborative effort among Boise State University, St. Luke’s Mountain States Tumor Institute, and the Boise School District. HHHU started in April 2013 as a community outreach initiative designed to teach and reinforce positive health habits in students. HHHU lessons target eighth-grade students and offer a unique approach highlighting the relationships among nutrition, physical activity, sugar-sweetened beverages, and cancer risks, through a variety of educational materials.

The purpose of this study was to assess program efficacy by evaluating short-term outcomes. The study evaluated the effectiveness of …

Juvenile Justice—Translational Research On Interventions For Adolescents In The Legal System (Jj-Trials): A Cluster Randomized Trial Targeting System-Wide Improvement In Substance Use Services, Danica K. Knight, Steven Belenko, Tisha Wiley, Angela A. Robertson, Nancy Arrigona, Michael Dennis, John P. Bartkowski, Larkin S. Mcreynolds, Jennifer E. Becan, Hannah K. Knudsen, Gail A. Wasserman, Eve Rose, Ralph Diclemente, Carl G. Leukefeld, Jj-Trials Cooperative

Behavioral Science Faculty Publications

Background: The purpose of this paper is to describe the Juvenile Justice—Translational Research on Interventions for Adolescents in the Legal System (JJ-TRIALS) study, a cooperative implementation science initiative involving the National Institute on Drug Abuse, six research centers, a coordinating center, and Juvenile Justice Partners representing seven US states. While the pooling of resources across centers enables a robust implementation study design involving 36 juvenile justice agencies and their behavioral health partner agencies, co-producing a study protocol that has potential to advance implementation science, meets the needs of all constituencies (funding agency, researchers, partners, study sites), and can be implemented …

Descriptive Epidemiology Of Somatising Tendency: Findings From The Cupid Study., Sergio Vargas-Prada, David Coggon, Georgia Ntani, Georgia Ntani, Karen Walker-Bone, Keith T. Palmer, Vanda E. Felli, Raul Harari, Lope H. Barrero, Sarah A. Felknor, David Gimeno, Anna Cattrell, Matteo Bonzini, Eleni Solidaki, Eda Merisalu, Rima R. Habib, Farideh Sadeghian, Muhammad Masood Kadir, Sudath S. P. Warnakulasuriya, Ko Matsudaira, Busisiwe Nyantumbu, Malcolm R. Sim, Helen Harcombe, Ken Cox, Leila M. M. Sarquis, Maria H. Marziale, Florencia Harari, Rocio Freire, Natalia Harari, Magda V. Monroy, Leonardo A. Quintana, Marianela Rojas, E. Clare Harris, Consol Serra, J. Miguel Martinez, George Delclos, Fernando G. Benavides, Michele Carugno, Marco M. Ferrario, Angela C. Pesatori, Leda Chatzi, Panos Bitsios, Manolis Kogevinas, Kristel Oha, Tiina Freimann, Ali Sadeghian, Roshini J. Peiris-John, Nalini Sathiakumar, A. Rajitha Wickremasinghe, Noriko Yoshimura, Helen L. Kelsall, Victor C. W. Hoe, Donna M. Urquhart, Sarah Derrett, David Mcbride, Peter Herbison, Andrew Gray, Eduardo J. Salazar Vega

Community Health Sciences

Somatising tendency, defined as a predisposition to worry about common somatic symptoms, is importantly associated with various aspects of health and health-related behaviour, including musculoskeletal pain and associated disability. To explore its epidemiological characteristics, and how it can be specified most efficiently, we analysed data from an international longitudinal study. A baseline questionnaire, which included questions from the Brief Symptom Inventory about seven common symptoms, was completed by 12,072 participants aged 20-59 from 46 occupational groups in 18 countries (response rate 70%). The seven symptoms were all mutually associated (odds ratios for pairwise associations 3.4 to 9.3), and each contributed …

The Story Of Emily, Lori L. Jennings Ms, Barb O'Neil, Kim Bossy, Denise Dodman, Jill Campbell

Patient Experience Journal

This case study describes Bluewater Health’s quest to weave the philosophy and practice of patient and family-centered care from the boardroom to the bedside by introducing Emily. Emily’s image is a composite of photographs of staff, physicians, volunteers, patients and families exemplifying that each has a role in Emily’s care. Emily represents every patient and family of the past, present, and future. Emily’s journey started with the launch of Bluewater Health‘s 2013-2015 strategic plan and moved throughout the organization as patient councils were established and the organization embedded three foundational patient and family-centered RNAO Best Practice Guidelines into daily practice …

Applying Experience-Based Co-Design With Vulnerable Populations: Lessons From A Systematic Review Of Methods To Involve Patients, Families And Service Providers In Child And Youth Mental Health Service Improvement, Alison Mulvale, Ashleigh Miatello, Christina Hackett, Gillian Mulvale

Patient Experience Journal

The objective was to identify methods used to involve patients, family and service providers in child and youth mental health service improvement research. We analyzed the alignment of methods used with Experience-Based Co-Design (EBCD) methodology, and how power imbalances among participants were addressed. A systematic review of the English-language peer review literature since 2004 was carried out. The EMBASE, Scholar’s Portal, PubMed, Web of Science databases and the Ontario College of Art and Design University libraries were searched electronically for variations of ‘child’, ‘mental health’, ‘experience-based co-design’, ‘participatory research’ and ‘health care services’. Textual data was systematically extracted and analyzed. …

Impact Of Logo Wear On Provider Perception Of Patient, Bill R. Gombeski Jr

Patient Experience Journal

Patient’s appearance affects provider perception of patients and subsequent provider behavior. Based on anecdotal information, it was hypothesized that wearing a health organization’s brand would result in a more positive perception of a patient by providers and subsequently a better patient experience. A study of 121 individuals with patient contact was conducted. Using photos of patients with and without a health care brand on their shirts, study subjects rated the attractiveness and willingness to engage with photos of patients. Patients with a Mayo brand and UK HealthCare brand showed some significant positive attractiveness over the same patient without the brand. …

Patient Evaluations Of The Interpersonal Care Experience (Ice) In U.S. Hospitals: A Factor Analysis Of The Hcahps Survey, Geoffrey A. Silvera, Jonathan R. Clark

Patient Experience Journal

The Hospital Consumer Assessment of Healthcare Providers and Systems survey (HCAHPS) is widely used to evaluate patients’ perceptions of their inpatient healthcare experiences. The HCAHPS is organized into 10 measures: six composite measures, two individual measures, and two global measures.¹ In prior research on the link between patients’ care experiences and hospital’s quality and cost outcomes, scholars have grouped these measures in a variety of ways. The evident lack of consistency in these groupings along with the persistent lack of empirical justification for these groupings suggests a need to empirically examine the relational structure of HCAHPS measures. …

Developing Approaches To The Collection And Use Of Evidence Of Patient Experience Below The Level Of National Surveys, Elizabeth J. Gibbons, Chris Graham, Jenny King, Kelsey Flott, Crispin Jenkinson Professor, Raymond Fitzpatrick Professor

Patient Experience Journal

National approaches to collecting patient feedback provide trust level information which although can provide a benchmark for trusts often doesn’t provide information about specific services or patients experiences of pathways of care. This more granular level of data could be more informative for local service development and improvement. This research explored the feasibility and usefulness of such approaches. A conceptual model and standard questionnaire of patient experience was developed that might work across a range of services and pathways of care. Seven trusts were recruited as collaborating sites in which the model and survey instrument was tested. These were from …

Impact Of Hospital Diagnosis-Specific Quality Measures On Patients’ Experience Of Hospital Care: Evidence From 14 States, 2009-2011, Emily M. Johnston, Kenton J. Johnston, Jaeyong Bae, Jason M. Hockenberry, Arnold Milstein, Edmund Becker

Patient Experience Journal

In order to assess consistency across quality measures for Untied States hospitals, this paper uses patient responses to the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey for three years (2009-2011) from 1,333 acute-care hospitals in fourteen states to analyze patterns in hospital-reported patient experience-of-care scores by diagnosis-specific process and outcome measures for acute myocardial infarction, heart failure, and pneumonia. We also evaluate how scores have changed over the three-year period. We find significant differences in patient experience-of-care scores for 195 out of 230 relationships between HCAHPS patient experience-of-care scores and 23 diagnosis-specific process and outcomes measures. We …

Please Tick The Appropriate Box: Perspectives On Patient Reported Experience, Mette Sandager, Morten Freil, Janne Lehmann Knudsen

Patient Experience Journal

Patient experience surveys are increasingly used as a method for evaluating important aspects of quality of care and the results are used politically to support general decision-making. However, there have been limited attempts to summarize the newest and most essential knowledge on how to measure and interpret patient experience data. This paper aims to summarize knowledge on the association between delivered care and patient reported experience and the factors influencing this association, and to outline a conceptual model illustrating the association. The method employed is integrative literature review. Quantitative and qualitative studies as well as theoretical and discussion papers that …

Patient Perceptions Of An Aidet And Hourly Rounding Program In A Community Hospital: Results Of A Qualitative Study, Tosha Allen, Tyne Rieck, Stacie Salsbury

Patient Experience Journal

Quantitative evidence links patient satisfaction scores to the use of communication strategies such as AIDET (Acknowledge, Introduce, Duration, Explanation, and Thank you) and Hourly Rounding. However, little is known about patient perceptions of these tools in regards to their hospital experience. Qualitative interviews were conducted with a convenience sample of 14 adult medical/surgical inpatients in one mid-sized, community hospital, following hospital discharge. The interview data was transcribed and opened coded, utilizing constant comparison to identify common themes. Themes emerged in four topical areas: (a) patient experience of hospitalization, (b) AIDET, (c) Hourly Rounding, and (d) unexpected findings. Patients placed significant …

Evaluating Recall Of Key Safety Messages, And Attitudes And Perceptions Of A Patient Safety Initiative At A Pediatric Hospital, Deepika Sriram, Carol Cooke, Régis Vaillancourt, Gilda Villarreal, Annie Pouliot, Nanette Labelle, Tracy Wrong

Patient Experience Journal

Involving inpatients in their safety and well-being is becoming increasingly common. Interventions have been developed to encourage patients to be active in their own safety, but published evaluations are scarce. The Patient Safety Ambassador (PSA) program was developed to increase patient and parent/guardian engagement and knowledge in patient safety. This study aimed to determine recall ability of key safety messages and explore attitudes and perceptions towards the PSA program, hence obtaining feedback for program improvements. Participants were pediatric inpatients and parents of inpatients. Face-to-face semi-structured interviews were conducted. Cued and non-cued recall ability was determined using questions with and without …

Does She Think She’S Supported? Maternal Perceptions Of Their Experiences In The Neonatal Intensive Care Unit, Emily A. Lilo, Richard J. Shaw, Julia Corcoran, Amy Storfer-Isser, Sarah M. Horwitz

Patient Experience Journal

Parents’ involvement in the care of their infants in the neonatal intensive care unit (NICU) is critically important, leading many NICUs to implement policies and practices of family-centered care (FCC). Analyzing narrative interviews, we examined whether mothers of premature infants who participated in an intervention to help reduce anxiety, stress, and depression felt that their NICU experience reflected four key nursing behaviors previously identified as being necessary to achieving FCC. Fifty-six narratives derived from semi-structured interviews with the mothers were analyzed qualitatively and quantitatively to examine whether the women experienced emotional support, parent empowerment, welcoming environment, and parent education, as …

Female And Male Patients’ Perceptions Of Primary Care Doctors’ Communication Skills In Hong Kong, Vivienne Leung Dr., Kimmy Cheng Dr.

Patient Experience Journal

This study examined how female and male patients perceive primary doctors’ communication skills in the Chinese context. To do so, this study specifically investigates female and male patients’ general perceptions toward primary care doctors’ communication skills in medical consultations. Specifically, this study focused on (a) female and male patients’ satisfaction level toward primary care doctors’ communication skills in medical consultations (b) female and male patients’ perception of the types of verbal and nonverbal communication skills applied by primary care doctors in medical consultations (c) as well as which gender of doctors with whom patients prefer to communicate during primary care …

A Call To Excellence In Patient Experience, Geoffrey A. Silvera

Patient Experience Journal

In this address, the incoming associate editor describes his early experience with the Patient Experience Journal (PXJ) and issues a call to action to the PXJ community. In the call to action, the PXJ community is asked to build upon our collective history of scholastic and practical excellence. The combination of practical relevance and methodological rigor in our contributions will help to ensure a future in which patient experience is paramount in health service delivery conversations. In addition, gaps in the patient experience literature and emergent opportunities for theoretical and practical contributions are recommended.

Patient Experience: Driving Outcomes At The Heart Of Healthcare, Jason A. Wolf Phd

Patient Experience Journal

There is no longer a question that patient experience matters in healthcare today. It matters for those that are cared for and served and matters to all those working each and every day to provide the best in care at all touch points across the healthcare continuum. With this recognition, there too needs to be a change in mindset about patient experience itself. When addressing the topic of patient experience, the conversation is about something much broader than the “experience of care”, as identified in the triple aim. The idea of experience reflects our biggest opportunity in healthcare, where experience …

Grant Writing In Higher Education, Amos Bean

Muskie School Capstones and Dissertations

The primary aim of this capstone was to elicit feedback from public health and grant writing practitioners and funders in order to gather data that can be used to supplement teachings and readings for a course in the Muskie School of Public Service Masters in Public Health (MPH) graduate program. Two overarching questions served as the basis for this endeavor. The primary question for public health and grant writing practitioners was, “What are the most important lessons you have learned that you think graduate students who are writing their first proposals should know?” The primary question for funders was, “What …

Beyond The Millennium Development Goals: An Evaluation Of The War On Hiv / Aids In Kenya, Robert G. Nyaga

Theses and Dissertations

HIV/AIDS remains a threat to Kenya and other developing nations. This thesis aimed at assessing the HIV/AIDS situation in Kenya by examining the knowledge of Kenyans towards infection and spread HIV/AIDS, attitudes towards people living with HIV/AIDS, involvement of community opinion leaders in the HIV/AIDS campaigns, sharing of HIV/AIDS information, and government efforts to control HIV/AIDS. A sample of Kenyans (N= 103) was surveyed and asked to respond to several scales assessing each of the above items. Quantitative and qualitative methods reveal the knowledge and attitudes portrayed by Kenyans and show that, although much has been achieved, there is need …

Health Behaviors And Their Correlates Among Participants In The Continuing To Confront Copd International Patient Survey, Hana Müllerová, Sarah H. Landis, Zaurbek Aisanov, Kourtney J. Davis, Masakazu Ichinose, David M. Mannino, Joe Maskell, Ana M. Menezes, Thys Van Der Molen, Yeon-Mok Oh, Maggie Tabberer, Meilan K. Han

Preventive Medicine and Environmental Health Faculty Publications

Background and aims: We used data from the Continuing to Confront COPD International Patient Survey to test the hypothesis that patients with COPD who report less engagement with their disease management are also more likely to report greater impact of the disease.

Methods: This was a population-based, cross-sectional survey of 4,343 subjects aged ≥ 40 years from 12 countries, fulfilling a case definition of COPD based on self-reported physician diagnosis or symptomatology. The impact of COPD was measured with COPD Assessment Test, modified Medical Research Council Dyspnea Scale, and hospital admissions and emergency department visits for COPD in the prior …

A Review On The Respiratory System Toxicity Of Carbon Nanoparticles, Maricica Pacurari, Kristine L. Lowe, Paul B. Tchounwou, Ramzi Kafoury

School of Integrative Biological & Chemical Sciences (Formerly Dept. of Biology)

The respiratory system represents the main gateway for nanoparticles’ entry into the human body. Although there is a myriad of engineered nanoparticles, carbon nanoparticles/nanotubes (CNPs/CNTs) have received much attention mainly due to their light weight, very high surface area, durability, and their diverse applications. Since their discovery and manufacture over two decades ago, much has been learned about nanoparticles’ interactions with diverse biological system models. In particular, the respiratory system has been of great interest because various natural and man-made fibrous particles are known to be responsible for chronic and debilitating lung diseases. In this review, we present up-to-date the …

Sharing Local Public Health Services Across Jurisdictions: Comparing Practice In 2012 And 2014, Kusuma Madamala, Susan Zahner, Roger Brown

Frontiers in Public Health Services and Systems Research

Objective: Describe cross-jurisdiction service sharing (CJS) by local and tribal health departments (LHD) in Wisconsin in 2014 compared to 2012.

Design: An online survey of 91 LHD directors in Wisconsin was conducted. Results were compared to the results of a 2012 survey. Characteristics of CJS arrangements and differences in results by population size, geographic region, and governance type were described. Standardized proportion differences (h) were estimated using the arcsin transformation. Confidence intervals were estimated using unconditional exact confidence intervals for the difference of proportions.⁸ A forest plot of the estimates and confidence intervals was generated to visualize change in …

Trends In Clinical Billing By Local Health Departments, J. Mac Mccullough

Frontiers in Public Health Services and Systems Research

Background: Billing for clinical services is perceived to be increasingly important for local health departments (LHDs). Yet very little evidence exists regarding the frequency and relative financial importance of clinical billing revenues.

Purpose: The purpose of this study is to report on trends in the frequency and financial scope of clinical billing by LHDs from 2008 to 2013.

Methods: The study used data from the 2008, 2010, and 2013 National Association of City and County Health Officials Profile report surveys. Per capita revenues from clinical billing and percent of total LHD revenues from clinical billing were calculated. …

Tuberculosis And Local Health Department Expenditures On Tuberculosis Services, Michelle P. Yip, Betty Bekemeier

Frontiers in Public Health Services and Systems Research

Background: Although tuberculosis (TB) morbidity and mortality have decreased in recent decades, challenges exist regarding disproportionate distributions of TB among specific populations and geographic areas. Inconsistent local health department (LHD) funding for TB programs poses difficulties for LHDs to sustain resources and personnel that predisposes communities to risks of future outbreaks of TB and drug-resistant TB diseases.

Purpose: This study examined relationships between annual TB incidence rates and LHD expenditures on TB-related services to elucidate potential impacts of TB incidence on LHD TB spending.

Methods: This dataset included county-level TB incidence data with comparable, annual (2000–2010) TB-related service expenditures for …