Public Health Commons^™

Social Network Analysis Of Cellphone Surveillance Data For Ebola In Sierra Leone, Jia B. Kangbai

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

Aim: To explore and visualize the connectivity of suspected Ebola cases and surveillance callers who used cellphone technology in Moyamba District in Sierra Leone for Ebola surveillance, and to examine the demographic differences and characteristics of callers who make more calls as well as more likely to make at least one positive Ebola call.

Methods: Surveillance data for 393 suspected Ebola cases (192 males, 201 females) were collected from October 23, 2014 to June 28, 2015 using cellphone technology. UCINET and NetDraw were used to explore and visualize the social connectivity between callers and suspected Ebola cases. Poisson and logistic …

Self Center: Addressing Teen Pregnancy In Wolfe County, Ky, Lindsey Smith

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

Teen pregnancies and births are at an all-time low across the United States. Despite this decline in rates within the last decade, the teen pregnancy rate in Kentucky remains significantly higher than that of the overall United States. Additionally, teen pregnancy still has significant economic and health impacts on both teen parents and their children. In rural communities, such as Wolfe County, KY, teen birth rates are approximately one-third higher than the rest of the country. Self Center is an evidence-based teen pregnancy prevention program that involves school-linked reproductive health services and provides participants with education, counseling, and healthcare services. …

Hiv/Sti And Teen Pregnancy Prevention Within Mclennan County Texas, Kayla M. Storrs

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

In response to the Center for Disease Control and Prevention (CDC) funding announcement, the McLennan County Health Department proposes to implement Be Proud! Be Responsible!, an evidence-based HIV/STI and teen pregnancy prevention program into the pre-existing health curriculum of the sixth grade classes within the county. With the highest rates of chlamydia and gonorrhea within the state of Texas, and $7 million per year of teen pregnancy related costs spent in Waco, Texas alone, this intervention aims to increase HIV/STI knowledge, increase positive perceptions of safe sexual behaviors, increase parent-student communication about safe sexual behaviors, prolong first sexual initiation, and …

Prescription Opioid Policy And Illicit Drug Use, Douglas Keith Branham

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

Opioids have become a major public health concern in recent years with non-medical use of both prescription opioids and heroin on the rise. There have been increases in opioid related overdoses, accidental deaths, treatment admissions, and sales associated with the increased illicit use of opioids. The following capstone project uses the three paper model to explore some of the issues associated with this rising epidemic including prescription opioid policies enacted in recent years, the populations these policies impact, and potential effects they may have on drug use behavior, as well as additional factors that potentially influence opioid user behavior. Paper …

Correlates Of Influenza Vaccination Uptake Among Older Adults, Cheryl Hilliman

Walden Dissertations and Doctoral Studies

Seasonal influenza is associated with signiï¬?cant morbidity and mortality among older adults, aged 65 and older. Since vaccination is the single most effective preventive measure against seasonal influenza, clinicians and senior citizen center administrators need a better understanding of the perceptions of older adults concerning the reason for poor influenza vaccine uptake. The purpose of this study was to identify perceived factors that may be associated with poor influenza vaccination uptake among older adults. The health belief model (HBM) guided the study. The research questions examined perceptions predicting the odds of influenza vaccination uptake among older adults. This quantitative cross-sectional …

“Exchange Northern Ky”: An Evidence-Based Needle & Syringe Exchange Program Serving The Northern Kentucky Area Development District, Amanda Hunter

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

Intravenous drug users (IDUs) account for nearly 16% of new HIV infections in the United States and almost one half (48%) of newly reported acute hepatitis C virus (HCV) infections have been found to be IDU related.1 Within the Northern Kentucky Area Development District, hepatitis C infections have soared with an incidence of more than 1,000 newly reported cases during 2015 alone.⁴ Rigorous scientific evidence complied by the U.S. Department of Health & Human Services has indicated that one of the most unique and effective strategies for the curtailing HIV incidence among IDUs is by ensuring users’ access to …

Cellmapper: Rapid And Accurate Inference Of Gene Expression In Difficult-To-Isolate Cell Types, Bradlee D. Nelms, Levi Waldron, Luis A. Barrera, Andrew W. Weflen, Jeremy A. Goettel, Guoji Guo, Robert K. Montgomery, Marian R. Neutra, David T. Breault, Scott B. Snapper, Stuart H. Orkin, Martha L. Bulyk, Curtis Huttenhower, Wayne I. Lencer

Publications and Research

We present a sensitive approach to predict genes expressed selectively in specific cell types, by searching publicly available expression data for genes with a similar expression profile to known cell-specific markers. Our method, CellMapper, strongly outperforms previous computational algorithms to predict cell type-specific expression, especially for rare and difficult-to-isolate cell types. Furthermore, CellMapper makes accurate predictions for human brain cell types that have never been isolated, and can be rapidly applied to diverse cell types from many tissues. We demonstrate a clinically relevant application to prioritize candidate genes in disease susceptibility loci identified by GWAS.

The Physical Activity And Redesigned Community Spaces (Parcs) Study: Protocol Of A Natural Experiment To Investigate The Impact Of Citywide Park Redesign And Renovation, Terry T. K. Huang, Katarzyna E. Wyka, Emily Ferris, Jennifer Gardner, Kelly R. Evenson, Devanshi Tripathi, Gabriel Martinez Soto, Matthew S. Cato, Jon Moon, Julia Wagner, Joan M. Dorn, Diane J. Catellier, Lorna E. Thorpe

Publications and Research

Background: The built environment plays a critical role in promoting physical activity and health. The association between parks, as a key attribute of the built environment, and physical activity, however, remains inconclusive. This project leverages a natural experiment opportunity to assess the impact of the Community Parks Initiative (CPI), a citywide park redesign and renovation effort in New York City, on physical activity, park usage, psychosocial and mental health, and community wellbeing.

Methods: The project will use a longitudinal design with matched controls. Thirty intervention park neighborhoods are socio-demographically matched to 20 control park neighborhoods. The study will investigate whether …

Assessment Of Her2-Neu In Breast Cancer Lines Upon Differential Exposures To Xenoestrogens, Abha Aggarwal

Walden Dissertations and Doctoral Studies

Synthetic xenoestrogens have differential estrogenic properties. Research has shown that exposures to xenoestrogens could promote breast cancer by disrupting normal function of the human epidermal growth factor receptor 2 (Her2) gene. Although animal models demonstrated a connection between xenoestrogen exposure and Her2 activity, no study using human cells has systematically examined their carcinogenic potential influencing the Her2 gene expression. Furthermore, breast cancer cells are phenotypically disparate (ER+, Her2+), with some phenotypes (Her2+), leading to more aggressive disease. This study aimed to dosimetrically assess the carcinogenic potential of commonly used xenoestrogens influencing Her2 gene expression, and delineate cellular phenotypes at greater …

Assessment Of Obesity Management In A Primary Care Setting, Katie Diffenderfer

DNP Projects

Purpose: The purpose of this study was to evaluate the current practices related to obesity in the primary care setting in University of Kentucky’s Healthcare System. The specific aims were to: 1) Determine the proportion of obese patients who had an ICD-9/10 diagnosis code for obesity, 2) Determine the proportion of obese patients who received interventions related to their obesity, 3) Determine whether obesity diagnosis and interventions varied based on patient demographics, and 4) Compare actual obesity interventions to those outlined in the clinical practice guidelines.

Methods: A retrospective chart review of male and female patients between the ages of …

Human Trafficking: The Health Of Men Forced Into Labor Trafficking In The United States, Christina Omole

Walden Dissertations and Doctoral Studies

Human trafficking is a criminal act that occurs globally. It affects both women and men, but most studies have focused on female victims; few have explored trafficked men or their related health issues. Though there are many forms of trafficking, it is believed that most male victims are trafficked as forced labor. Using gender schema theory as a framework, this quantitative study examined archival data to identify the types of trafficking men are subjected to, their health ailments, and how these differ from the health ailments of trafficked women. Archival data from 124 individuals subjected to human trafficking in Florida …

An Exploration Of A State Mandated Health Education Program, Patricia Lyons

Walden Dissertations and Doctoral Studies

Shaken baby syndrome (SBS) is one of the most violent forms of physical child abuse. In 2007, the State of Ohio enacted a health education mandate known as Claire's law. Claire's law requires all birthing hospitals to provide SBS education to mothers prior to their discharge. This law is the result of public demand and advocacy initiatives; however, it was not clear how the mandate was developed or whether or not the mandate and subsequent educational programs have had an impact on efforts to prevent SBS. The purpose of this qualitative case study was to explore the state of Ohio's …

Findings From Landscape Analysis In Nigeria On Pre-Eclampsia/Eclampsia, Population Council

Reproductive Health

Maternal and newborn deaths due to pre-eclampsia and eclampsia (PE/E) are preventable, yet in Nigeria this is the most significant direct cause of maternal mortality. The Population Council conducted a landscape analysis on PE/E in 2015 in seven states in Nigeria. This brief details the findings on national policy awareness, service provider knowledge and skills, facility capacity and preparedness, quality of care and community knowledge and perceptions. The brief concludes with recommendations based on these findings.

Adolescent Sexual And Reproductive Health Situation: Insights From The 2014 Kenya Demographic And Health Survey, Francis Obare, George Odwe, Harriet Birungi

Reproductive Health

The 2015 Kenya National Adolescent Sexual and Reproductive Health Policy recognized the importance of addressing adolescent sexual and reproductive health (SRH) needs for achieving the country’s development goals. Although estimates from the 2014 Kenya Demographic and Health Survey (DHS) show the country registered improvements in key reproductive, maternal, and child health outcomes, adolescent outcomes likely remain poor given the challenges associated with adequately addressing their sexual and reproductive health needs. This report presents findings of further analysis of the 2014 Kenya DHS on key SRH outcomes among adolescent girls and boys 15 to 19 years old in Kenya. Understanding the …

Testing Multi-Theory Model (Mtm) In Predicting Initiation And Sustenance Of Physical Activity Behavior Among College Students, Vinayak K. Nahar, Manoj Sharma, Hannah Priest Catalano, Melinda J. Ickes, Paul Johnson, M. Allison Ford

Kinesiology and Health Promotion Faculty Publications

Background: Most college students do not adequately participate in enough physical activity (PA) to attain health benefits. A theory-based approach is critical in developing effective interventions to promote PA. The purpose of this study was to examine the utility of the newly proposed multi-theory model (MTM) of health behavior change in predicting initiation and sustenance of PA among college students.

Methods: Using a cross-sectional design, a valid and reliable survey was administered in October 2015 electronically to students enrolled at a large Southern US University. The internal consistency Cronbach alphas of the subscales were acceptable (0.65-0.92). Only those who did …

E-Cigarettes: Effective Cessation Tools Or Public Health Threat?, Luke Clancy, Kate Babineau

Articles

In a short time, electronic cigarettes have become a multi-billion dollar industry. Since their introduction to the market, prevalence of ever-use among smokers in the USA appears to have increased from 2% in 2010 to >30% in 2012, and the rate of increase appears to be similar in the United Kingdom, Ireland and other Western countries according to a special Eurobarometer survey in 2014.1 The e-cigarette market is estimated to be worth over $3 billion. However, there is no consensus on the role of e-cigarettes and their contribution to the provision of smoking cessation (SC) services, nor to global tobacco …

Blood, Donors And Dollars: Rethinking Financial Sustainability Of Safe Blood Services In Tanzania, Kahabi Isangula, Sharon Brownie, Abela Mahimbo, Solomon Kibona, Abdu Juma, Deus Mogela

School of Nursing & Midwifery, East Africa

Introduction: Collection, processing and distribution of safe blood in Tanzania occurs within a free-for-service context, that is, a collection from non-remunerated blood donors and distributing freely to the needy people through health facilities. The safe blood services in the country appear to be crippled with many challenges and cannot meet the demand for blood and its products. As such, a need for rethinking collection methods, financial models and possible mechanisms for donor remuneration is evident.

Methods: In this paper, we venture on multi-stakeholder meetings and ongoing discussions regarding the internal mechanisms of safe blood transfusion financing. The intent is to …

Associations Between Performance On An Abbreviated Cogstate Battery, Other Measures Of Cognitive Function, And Biomarkers In People At Risk For Alzheimer's Disease, Annie M. Racine, Lindsay R. Clark, Sara C. Berman, Rebecca L. Koscik, Kimberly D. Mueller, Derek Norton, Christopher R. Nicholas, Kaj Blennow, Henrik Zetterberg, Bruno M. Jedynak, Murat Bilgel, Cynthia M. Carlsson, Bradley T. Christian, Sanjay Asthana, Sterling C. Johnson

Mathematics and Statistics Faculty Publications and Presentations

It is not known whether computerized cognitive assessments, like the CogState battery, are sensitive to preclinical cognitive changes or pathology in people at risk for Alzheimer's disease(AD). In 469 late middle-aged participants from the Wisconsin Registry for Alzheimer's Prevention(mean age 63.8±7 years at testing; 67% female; 39% APOE4+), we examined relationships between a CogState abbreviated battery(CAB) of seven tests and demographic characteristics, traditional paper-based neuropsychological tests as well as a composite cognitive impairment index, cognitive impairment status(determined by consensus review), and biomarkers for amyloid and tau(CSF phosphorylated-tau/Aβ42 and global PET-PiB burden) and neural injury(CSF neurofilament light protein). CSF and PET-PiB …

Développer Les Compétences De Protection Des Filles: Ensemble D’Outils Pour La Conception D’Un Programme, Population Council

Poverty, Gender, and Youth

Les adolescentes sont devenues une population cible clé pour les initiatives d'autonomisation, de santé et de développement dans les pays en développement. Cette collection d’outils est destinée aux organisations qui se sont engagées à étendre leurs programmes pour atteindre les sous-catégories de filles et jeunes femmes exclues: les filles les plus pauvres dans les communautés les plus pauvres; les filles âgées de 10 à 14 ans non scolarisées et n’habitant pas avec leur père ou leur mère; ou d’autres sous-catégories de jeunes filles qui sont tout simplement susceptibles d’être laissées pour compte. Cet ensemble contient des outils et des exercices …

Boîte À Outils: Renforcement Des Compétences, Judith Bruce, Sarah Engebretsen, Kimberly Glazer

Poverty, Gender, and Youth

Grâce à un processus appelé «conception intentionnelle», les outils d’apprentissage du Population Council aident à centraliser les besoins des filles. Ces outils s'appuient sur des preuves de la nécessité de maintenir les filles en bonne santé, de les intégrer socialement et de les préparer économiquement. La boîte à outils Renforcement des Compétences du Population Council aide les praticiens, les décideurs et les défenseurs à élaborer un contenu adapté, significatif et positif pour aider des sous-populations spécifiques de filles. La boîte à outils guide les praticiens à travers une série d'étapes qui doivent être suivies pour définir des cibles de bon …

Abriendo Oportunidades Para Alcanzar Mi Plan De Vida: Programa De 5 Meses—8 A 13 Años, Cecilia Garcés

Poverty, Gender, and Youth

Esta es la guía curricular del programa Abriendo Oportunidades del Population Council de Guatemala. Esta guía es para niñas de 8 a 13 años. Este programa de cinco meses ayuda a las niñas a desarrollar pasos para lograr su plan de vida, en módulos sobre los temas siguientes: llevarse bien con otras niñas; conocerse y valorarse a sí mismo; autoestima; derechos humanos; aprendiendo a ser mujer; la fertilidad y el embarazo; reconociendo el peligro; y la importancia del ahorro.

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This is the curriculum guide for the Abriendo Oportunidades program of the Population Council of Guatemala. This guide is for …

Adolescent Girls Empowerment Program (Agep): Savings Account, Population Council

Poverty, Gender, and Youth

Through the Adolescent Girls Empowerment Program (AGEP), the Population Council and partners implemented a social, health, and economic asset-building program for over 10,000 vulnerable adolescent girls aged 10–19 years in Zambia. The AGEP intervention was comprised of three major components: 1) safe spaces groups in which girls met once a week over the course of two years for training on sexual and reproductive health, life skills, and financial education; 2) a health voucher that girls could use at contracted private and public facilities for a package of general wellness and sexual and reproductive health services; and 3) a savings account …

Adolescent Girls Empowerment Programme In Zambia: Qualitative Evaluation Report, Zoe Duby, Chipo Natasha Zulu, Karen Austrian

Poverty, Gender, and Youth

The Adolescent Girls Empowerment Program (AGEP) reaches over 10,000 vulnerable girls 10–19 years old in five urban and five rural sites spread across four provinces in Zambia. The program works to build adolescent girls’ social, health, and economic assets, providing them with key skills and opportunities to help them transition from adolescence to adulthood in a healthy way. This report presents these valuable insight into the views and experiences of girls who were involved in the AGEP program, as well as the perceptions of program mentors, the girls’ parents, and community leaders. In addition, these findings highlight the areas in …

Towards Effective Youth Participation [Arabic], Magued Osman, Hanan Girgis

Poverty, Gender, and Youth

[In Arabic] Egyptian youth amazed the world in 2011 during the 18 days of the January 25 revolution, and again in 2013 during the June 30 revolution, however this has not had a significant impact on their political and social participation. This brief aims to shed light on young people’s participation in the aftermath of these revolutions, which embodied their hopes for greater empowerment and participation. The brief uses data from the second round of the Survey of Young People in Egypt conducted by the Population Council in 2013/2014 in collaboration with the Central Agency for Public Mobilization and Statistics, …

Addressing Adolescent Girls' Vulnerability To Hiv/Aids: Lessons From The Meri Life Meri Choice Project, Sunil Mehra, Rajesh R. Singh, Vandana Nair, K.G. Santhya, A.J. Francis Zavier

Poverty, Gender, and Youth

This report details findings from an assessment of the Meri Life Meri Choice (MLMC) project in India, implemented by MAMTA—Health Institute for Mother and Child, with the support of the Elton John AIDS Foundation. The MLMC project sought to reduce the vulnerability of rural adolescent girls to HIV by enhancing their knowledge about sexual and reproductive matters and equipping them with skills that enable them to address vulnerability to HIV; increasing their utilization of sexual and reproductive health services from the public sector; and developing a supportive environment that enables adolescent girls to adopt protective actions to reduce vulnerability to …

Building Girls' Protective Assets: A Collection Of Tools For Program Design, Population Council

Poverty, Gender, and Youth

Adolescent girls have become a key target population for empowerment, health, and development initiatives in low- and middle-income countries. This collection of tools is intended for organizations that are committed to extending their programs to reach excluded subpopulations of girls and young women—whether they are the poorest girls in the poorest communities, the 10–14-year-old girls who are out of school and not living with either parent, or another subpopulation of young girls who are likely to miss out. The collection contains tools and exercises to help programmers translate evidence on “what works” into girl-centered programming. The resources in this collection …

'Her Future Is Marriage': Young People's Attitudes Towards Gender Roles And The Gender Gap In Egypt, Maia Sieverding, Rasha Hassan

Poverty, Gender, and Youth

This report examines youth gender-role attitudes in Egypt using quantitative data, from the nationally representative Survey of Young People in Egypt 2009 and 2014, which provides a broad overview of youth gender-role attitudes throughout the country and among different subpopulations of youth. Qualitative data complements this analysis by offering a more in-depth view of how young people think about men and women’s roles in society and why they hold these beliefs. The findings also highlight the extent to which conservative attitudes of gender relations may influence practices even in the face of legal change. Gender-role attitudes are a deeply held …

Methodology: Reaching The Most Vulnerable Adolescent Girls, Population Council

Poverty, Gender, and Youth

The objective of the Adolescent Girls Empowerment Programme (AGEP) is to provide vulnerable adolescent girls with needed social, health, and economic assets that they can draw upon to overcome their vulnerabilities and expand their opportunities. As a component of the AGEP evaluation, a household census was conducted in 2013 in the areas where the program was to be implemented. The census revealed that a significant percentage of adolescent girls aged 10–19 contend with multiple levels of socioeconomic vulnerability that include—but are not limited to—geographic remoteness, social isolation, living without parents, living in low-income households, and not attending school. The analysis …

Delaying Child Marriage Through Community-Based Skills-Development Programs For Girls: Results From A Randomized Controlled Study In Rural Bangladesh, Sajeda Amin, Johana Ahmed, Jyotirmoy Saha, Md. Irfan Hossain, Eashita Haque

Poverty, Gender, and Youth

In Bangladesh, where efforts to prevent child marriage have focused on the enforcement of laws and policies, little research exists on what approaches work best to delay marriage and why. To help fill this evidence gap, in 2012 the Population Council and partners embarked on a four-year study to understand whether skills-building approaches to empower girls can delay marriage in three districts in southern Bangladesh where child marriage rates are high. The BALIKA project reported here is the first rigorously evaluated study to provide evidence on approaches to delay child marriage in Bangladesh. BALIKA results show that programs that educate …

The International Health Regulations: The Governing Framework For Global Health Security, Lawrence O. Gostin, Rebecca Katz

Georgetown Law Faculty Publications and Other Works

• The International Health Regulations (IHR) are the governing framework for global health security yet require textual and operational reforms to remain effective, particularly as parallel initiatives are developed.
• The World Health Organization (WHO) is the agency charged with oversight of the IHR, and its leadership and efficient functioning are prerequisites for the effective implementation of the IHR.
• We reviewed the historical origins of the IHR and their performance over the past 10 years and analyzed all of the ongoing reform panel efforts to provide a series of politically feasible recommendations for fundamental reform.
• This article offers proposals for fundamental reform—with …