Public Health Commons^™

Nature, Scope And Use Of Economic Evaluation Of Healthcare Programmes: With Special Reference To Pakistan., Muhammad Ashar Malik, Saleem Perwaiz Iqbal, Farina Abrejo

Community Health Sciences

Economic evaluation (EE)/cost effectiveness analysis(CEA) of healthcare programmes is an emerging area, yet the resource base to apprehend EE/CEA is very limited in Pakistan. This paper attempts to fill this gap by providing a basic text in the field of EE with special reference to Pakistan. We used four dimensional criteria (available, relevant, complete and accurate) for reviewing the EE contents in the locally available textbooks and reading material on public health. We find CEA as core competency and skill of medical doctors in undergraduate medical curricula yet we could not find EE contents in the recommended textbooks. We find …

Did Contracting Effect The Use Of Primary Health Care Units In Pakistan?, Ashar Muhammad Malik, Ellen Van De Poel, Eddy Van Doorslaer

Community Health Sciences

For many years, Pakistan has had a wide network of Basic Health Units spread across the country, but their utilization by the population in rural and peri-urban areas has remained low. As of 2004, in an attempt to improve the utilization and performance of these public primary healthcare facilities, the government has gradually started contracting-in intergovernmental organizations to manage these BHUs. Using five nationally representative household surveys conducted between 2001 and 2012, and exploiting the gradual roll-out of this reform to apply a difference-in-difference approach, we evaluate its impact on BHU utilization. We find that contracting of the BHU management …

Meaning Of Pregnancy Terms Among African-American Women, Stephanie Solomon, Sandra G. Suther, Ivette Lopez, Alicestine Ashford, Linda C. Amankwaa, Gareth Dutton

The Qualitative Report

The concept of pregnancy intendedness is complex and may not bear the same meaning to all women. Moreover, researcher definition and women’s meaning were thought to be different. Some researchers have indicated that it is unclear how well women understand and relate to questions used by the National Survey of Family Growth (NSFG) and how the classifications relate to women’s lives. The purpose of this study was to explore the meaning of terms such as planned and/or intended pregnancy among African-American women of childbearing age using a qualitative exploratory descriptive method. Although African-American women want children, they are three times …

Evaluation Of A Fluorescence Method For Quantifying Bioaerosol Concentrations On Air Quality Filter Samples, Rachel Kolberg

UNLV Theses, Dissertations, Professional Papers, and Capstones

Airborne particulate matter (PM) in outdoor environments contains many components that cause adverse human health effects. The size of the particulates determine in what manner the particles would bypass the body’s defense mechanisms to enter the respiratory system and is directly related to their health impacts. Currently the United States Environmental Protection Agency is enforcing the National Ambient Air Quality Standards (NAAQS) to regulate the annual and 24-hour average concentrations of PM2.5 and PM10 in the air. PM2.5 are fine particles with aerodynamic diameter <2.5μm, small enough to reach the deepest parts of the bronchi and lungs. PM10 include PM2.5 and larger particles with aerodynamic diameter of 2.5-10μm. Both PM2.5 and PM10 contain multiple components from multiple sources. Bioaerosols are an important component of PM, but there is limited knowledge about how bioaerosols contribute to PM2.5 and PM10 concentrations. There is also a lack of research about the incidence and prevalence of disease caused by bioaerosols and about the limits of exposure to bioaerosol particulates. The main barrier to assess bioaerosol concentrations and health-related effects is the absence of quick and inexpensive methodology for quantifying bioaerosols. This study explored the feasibility of using fluorescence microscopy to quickly quantify bioaerosols in PM2.5 and PM10 collected on polycarbonate filters. Bioaerosols were stained with a DNA marker directly on a filter, followed by fixation, microscopic imaging, and automatic counting. The method was first validated using reference samples prepared by depositing different known concentrations of E. coli onto blank polycarbonate filters. The results indicated a linear response over two orders of magnitude (R2 = 0.9) and an accuracy within ±25%. E. coli were also deposited onto selected ambient PM10 and PM2.5 filter samples to determine if pre-loaded particles would interfere with bioaerosol imaging and counting. It was found that despite an increase in uncertainty (variability), the calibration slope remained within ±10% of unity for both PM2.5 and PM10 samples. Bioaerosol concentrations in ambient samples, as quantified by this method, were on average 14% higher for PM10 than for PM2.5 acquired concurrently in a desert environment of Las Vegas, Nevada. The application of this method to other types of compliance filters, such as Teflon filters and tapes of a Beta Attenuation Monitor (BAM) were also explored in this study. By means of a high-yield approach this method is expected to facilitate bioaerosol research, support exposure and health assessments, and help refine NAAQS for PM2.5 and PM10.

Distracted Driving In Clark County, Nevada: Analysis Of An Intervention On College Students, Heidi Ann Manlove

UNLV Theses, Dissertations, Professional Papers, and Capstones

Distracted driving is a growing public health concern. Highlighted in the media, local and government agencies and in peer-review literature are increased associations of motor vehicle crash related injuries and fatalities with distracted driving, especially involving youth drivers. The goal of this thesis was to analyze the effects of a distracted driving intervention on college students at University of Nevada, Las Vegas. Quantitative statistical analysis was performed to compare self-reported pre and post-intervention questionnaire responses of the experimental and control groups. Between-group analysis was performed using independent t-tests and ANOVA. Within-group differences were analyzed with Repeated Measures ANOVA (RM-ANOVA) and …

A Rural And Urban Study Of The Food Environment In Select Nevada Geographies, Joseph Nickelson

UNLV Theses, Dissertations, Professional Papers, and Capstones

National and county level examination of urban and rural food environments has taken place, but primary validation of venue existence and in-venue data are lacking. The literature show disparities in access to healthy foods through low density of large grocers/supermarkets, low variety and quality of produce and higher prices for a healthy diet in rural versus urban geographies. Rural areas are of unique concern due to poor health indicators such as higher obesity rates, higher diabetes rates, lower incomes and lower educations than urban residents. The goal of this study was to explore differences in the community and consumer level …

Association Of Genetic Factors With Chronic Kidney Disease In Us Young Adults, Sabra Stanford

UNLV Theses, Dissertations, Professional Papers, and Capstones

Albumin, a protein that when found in urine, is an early indicator of Chronic Kidney Disease (CKD). Genetic contributions have been shown to illustrate the gene-environment interactions that may lead to CKD in an individual; however, few studies have highlighted the interaction between responses of gene variations associated with the risk of increased albumin in young adults. This study’s purpose is to evaluate the hypothesis that candidate genes are related to microalbuminuria in young adults of the third wave of the National Longitudinal Study of Adolescent Health (Add Health Wave III). This longitudinal study includes an assessment of various candidate …

Assessing Organizational Health Literacy At An Academic Health Center: A Quantitative Research Study, Latrina Y. Prince

Graduate Theses and Dissertations

Inadequate health literacy is a national health problem that affects about 90 million Americans. Health literacy is the degree to which a person is able to make good health decisions based on his/her ability to read, understand, and use health information and services. Organizational Health Literacy (OHL) is the degree to which an organization considers and promotes the health literacy of patients by providing easy to read, understand, and use health information and services. Since it is difficult to determine which patients have inadequate health literacy, a recommended intervention for addressing health literacy is to use OHL practices at all …

Are Vending Machine Selections Healthier? Trends In Dietary Quality Of Vending Machine Food And Beverage Selections Among Nhanes Participants Age 6-19 Years Between 2003-2012, Aurora Maria Buffington

UNLV Theses, Dissertations, Professional Papers, and Capstones

Dietary intake is related to 4 major causes of death and may be influenced by the food environment, which includes the $64.3 billion revenue-producing vending machine industry. Most machines contain low nutrient energy dense foods and beverages associated with poor dietary choices, while healthier vending initiatives are seen as a strategy to increase access to healthy foods. Elementary and secondary schools have increasingly adopted healthier vending standards in response to federal child nutrition regulation and student wellness policy implementation, however an association between vending and diet has not been made using a large sample of nationally representative data. The purpose …

Does Educational Level Influence Postmenopausal Breast Cancer Mortality Among Asians In U.S.?, Sfurti Maheshwari

UNLV Theses, Dissertations, Professional Papers, and Capstones

Studies on mortality from postmenopausal breast cancer (PMBC) by education level have not shown consistent results among US women. For US Asians, often seen as a “model” minority in terms of affluence and education this relationship has never been studied despite PMBC being the most common cancer in the country.

We analyzed 2008-2012 California Vital Statistics data and population data from the American Community Survey 2012 to compute age and education adjusted mortality ratios using negative binomial regression model for White (as a reference category) and Asian women. In total 3,277,106 (80%) White women and 852,376 (20%) Asian women died …

Substance Use, Treatment, And Demographic Characteristics Of Pregnant Women Entering Treatment For Opioid Use Disorder Differ By United States Census Region., Dennis J Hand, Vanessa L Short, Diane J Abatemarco

Department of Obstetrics and Gynecology Faculty Papers

Opioid use disorder (OUD) among pregnant women increased substantially between 1992 and 2012 across the United States, with the greatest increases occurring in the southern states. We analyzed the 2013 Treatment Episodes Database-Admissions to determine how substances used, characteristics of treatment, and demographics of pregnant women entering treatment for opioid use disorder vary between geographical regions. Analyses were restricted to cases where women reported being pregnant at the time of admission and reported opioids as the primary substance problem leading to the treatment admission. Characteristics were compared between U.S. census regions using Chi-square tests and logistic regression with the South …

Poster: Communication Strategies For The School Nurse Mentor: A Pilot Training Program, Amy Hotler Dnp, Rn, Lsn, Aphn-Bc

Doctor of Nursing Practice Scholarly Projects

Mentorship has widespread support among many disciplines for the impact on improved job satisfaction, decreased job turnover and decreased costs to organizations. Ongoing support through mentorship is critical to nurses transitioning to a new role and nurse mentors must be prepared for the role with relevant education tailored to their needs . Though literature describing training programs for mentors is limited, some studies have reported an increase in confidence among mentors after training. In addition, improved mentoring skills (that includes communication) is in literature.

In one large urban school district in Ohio, a school nurse, mentorship program was developed and …

Chuukese Migrant Women In Guam: Perceptions Of Barriers To Health Care, Margaret Hattori-Uchima

Asian/Pacific Island Nursing Journal

This descriptive qualitative study examined perceived barriers to health care among Chuukese migrant women in Guam and explored which factors influenced health-seeking behaviors. Study participants recommended interventions which may reduce those perceived barriers. Since the Compact of Free Association with the United States was enacted in 1985, there has been a dramatic rise in the numbers of Chuukese migrating to Guam. This migration is anticipated to continue with more migrants needing health care, education, and social services. Little is known about their perceptions of barriers to health care services or the cultural, social, economic, and other factors that influence their …

Epidemiology News, Georgia Southern University

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

• Georgia Southern Student wins Third Place at GPHA Conference

College Of Public Health News, Georgia Southern University

College of Public Health: News & Publications

• Georgia Southern Student wins third Place at GPHA Conference
• Distinguished Faculty

Community Health News, Georgia Southern University

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

• Distinguished Faculty

How Safe Is Healthcare? Perceptions Within The Healthcare Community And The General Public., Rodhan A. Khthir, Shahed Elhamdani, Ibrahim Hatab, Felyn Espina, Gerry Asuncion, Sutoidem Akpanudo

Marshall Journal of Medicine

Objectives: Complexity of health care is progressively increasing and with that the number of medical errors and adverse events are increasing to an alarming level. The purpose of this study is to assess the perception of healthcare safety within the healthcare community and the general public and examine the association between the perception regarding healthcare safety and the prior exposure to medical errors.

Methods: The study is a cross-sectional online survey. The online survey included basic demographics and a series of questions related to the knowledge and perception about healthcare safety and personal healthcare experience.

Results: 504 respondent …

Promoting Reproductive Health Using Telemedicine: A Prospective Study Among Rural Appalachian High School Teens, Raj Singh, Mohit Harsh, Keegan Mullins, Brian Dunlap, Jennie L. Yoost

Marshall Journal of Medicine

Introduction:

Telemedicine allows rural underserved populations access to medical resources that may not be available in their communities. Following promising results with a telemedicine project aimed at educating female students in McDowell County, West Virginia on reproductive health (RH) in 2015, we conducted a follow-up study including both male and female high school students during the 2016 school year.

Materials and Methods:

Telemedicine sessions on RH were incorporated into existing afterschool programs at two rural high schools. Students’ knowledge on RH was assessed via pre-test, immediate post-test, and 6-month post-test evaluations. RH was taught by medical students and faculty at …

The Malaria Testing And Treatment Landscape In Benin., Kathryn A. O'Connell, Vamsi Vasireddy, Megan Littrell, Andria Rusk, Actwatch Group, Cyprien Zinsou, Adjibabi Bello Cherifath

Collected Faculty Scholarship

BACKGROUND: Since 2004, artemisinin-based combination therapy (ACT) has been the first-line treatment for uncomplicated malaria in Benin. In 2016, a medicine outlet survey was implemented to investigate the availability, price, and market share of anti-malarial treatment and malaria diagnostics. Results provide a timely and important benchmark to measure future interventions aimed at increasing access to quality malaria case management services.

METHODS: Between July 5th to August 6th 2016, a cross sectional, nationally-representative malaria outlet survey was conducted in Benin. A census of all public and private outlets with potential to distribute malaria testing and/or treatment was implemented among 30 clusters …

Activity Of Distinct Growth Factor Receptor Network Components In Breast Tumors Uncovers Two Biologically Relevant Subtypes, Moom Roosan, Shelley M. Macneil, David F. Jenkins, Gajendra Shrestha, Sydney R. Wyatt, Jasmine A. Mcquerry, Stephen R. Piccolo, Laura M. Heiser, Joe W. Gray, W. Evan Johnson, Andrea H. Bild

Pharmacy Faculty Articles and Research

Background
The growth factor receptor network (GFRN) plays a significant role in driving key oncogenic processes. However, assessment of global GFRN activity is challenging due to complex crosstalk among GFRN components, or pathways, and the inability to study complex signaling networks in patient tumors. Here, pathway-specific genomic signatures were used to interrogate GFRN activity in breast tumors and the consequent phenotypic impact of GRFN activity patterns.

Methods
Novel pathway signatures were generated in human primary mammary epithelial cells by overexpressing key genes from GFRN pathways (HER2, IGF1R, AKT1, EGFR, KRAS (G12V), RAF1, BAD). The pathway analysis toolkit Adaptive Signature Selection …

Can Global Health Governance Contend With Transnational Corporate Activities? A Case Study On The Chinese Tobacco Industry, Xing Gao

Geography Honors Projects

In the past two decades, China’s state-owned tobacco enterprise (CNTC) has expanded its operation and influence abroad under the “going global” strategy. These globalization activities directly and indirectly impact the Framework Convention on Tobacco Control (FCTC), the first international treaty signed under the WHO auspices. In this project, I explore how certain CNTC expansionary strategies undermine FCTC articles, as well as the ways in which FCTC articles have failed to curb the tobacco industry’s transnational growth. Using international political economy as an overarching framework for the analysis of global health governance, I argue that the FCTC fails to halt the …

Anti-Malarial Landscape In Myanmar: Results From A Nationally Representative Survey Among Community Health Workers And The Private Sector Outlets In 2015/2016., Kathryn A. O'Connell, Vamsi Vasireddy, Megan Littrell, Andria Rusk, Actwatch Group, Si Thu Thein, Hnin Su Su Khin, Aung Thi

Collected Faculty Scholarship

BACKGROUND: In 2015/2016, an ACTwatch outlet survey was implemented to assess the anti-malarial and malaria testing landscape in Myanmar across four domains (Eastern, Central, Coastal, Western regions). Indicators provide an important benchmark to guide Myanmar's new National Strategic Plan to eliminate malaria by 2030.

METHODS: This was a cross-sectional survey, which employed stratified cluster-random sampling across four regions in Myanmar. A census of community health workers (CHWs) and private outlets with potential to distribute malaria testing and/or treatment was conducted. An audit was completed for all anti-malarials, malaria rapid diagnostic tests.

RESULTS: A total of 28,664 outlets were approached and …

Insights Into The Availability And Distribution Of Oral Artemisinin Monotherapy In Myanmar: Evidence From A Nationally Representative Outlet Survey., Kathryn A. O'Connell, Vamsi Vasireddy, Megan Littrell, Andria Rusk, Actwatch Group, Si Thu Thein, Hnin Su Su Khin, Aung Thi

Collected Faculty Scholarship

BACKGROUND: The containment of artemisinin resistance in Myanmar, historically an important probable origin and route of anti-malarial resistance to the India sub-continent and beyond, is crucial to global malaria control and elimination. This paper describes what is currently known about the sale and distribution of oral artemisinin monotherapy (AMT) across Myanmar, where this medicine is commonly found.

METHODS: A nationally representative 2015 outlet survey was conducted in the private sector, and among community health workers across four geographical domains. A national sample of outlets was screened for availability of malaria testing and treatment, and an audit was completed for all …

What Happened To Anti-Malarial Markets After The Affordable Medicines Facility-Malaria Pilot? Trends In Act Availability, Price And Market Share From Five African Countries Under Continuation Of The Private Sector Co-Payment Mechanism., Kathryn A. O'Connell, Vamsi Vasireddy, Megan Littrell, Andria Rusk, Actwatch Group, Sarah Tougher, Kara Hanson, Catherine Goodman

Collected Faculty Scholarship

BACKGROUND: The private sector supplies anti-malarial treatment for large proportions of patients in sub-Saharan Africa. Following the large-scale piloting of the Affordable Medicines Facility-malaria (AMFm) from 2010 to 2011, a private sector co-payment mechanism (CPM) provided continuation of private sector subsidies for quality-assured artemisinin combination therapies (QAACT). This article analyses for the first time the extent to which improvements in private sector QAACT supply and distribution observed during the AMFm were maintained or intensified during continuation of the CPM through 2015 in Kenya, Madagascar, Nigeria, Tanzania and Uganda using repeat cross-sectional outlet survey data.

RESULTS: QAACT market share in all …

Evidence On Anti-Malarial And Diagnostic Markets In Cambodia To Guide Malaria Elimination Strategies And Policies, Kathryn A. O'Connell, Vamsi Vasireddy, Megan Littrell, Andria Rusk, Actwatch Group, Sochea Phok, Dysoley Lek

Collected Faculty Scholarship

BACKGROUND: Understanding Cambodia's anti-malarial and diagnostic landscape in 2015 is critical for informing and monitoring strategies and policies as Cambodia moves forward with national efforts to eliminate malaria. The aim of this paper is to present timely and key findings on the public and private sector anti-malarial and diagnostic landscape in Cambodia. This evidence can serve as a baseline benchmark for guiding implementation of national strategies as well as other regional initiatives to address malaria elimination activities.

METHODS: From August 17th to October 1st, 2015, a cross sectional, nationally-representative malaria outlet survey was conducted in Cambodia. A census of all …

More Than 95 Percent Of U.S. Children Had Health Insurance In 2015, Michael J. Staley

Carsey Publications

In this brief, author Michael Staley examines rates of children’s health insurance across the United States, by region and by place type, breaking down rates by private and public coverage. He reports that over 95 percent of all U.S. children under age 18 were covered by some form of health insurance in 2015—the highest share since the American Community Survey began measuring insurance rates in 2008. Rates of coverage increased between 2014 and 2015 in all four U.S. regions, and the greatest growth occurred in the South and West. Growth in public insurance—Medicaid and the Children’s Health Insurance Program— remained …

Governing Multisectoral Action For Health In Low- And Middle-Income Countries, Kumanan Rasanathan, Sara Bennett, Vincent Atkins, Robert Beschel, Gabriel Carrasquilla, Jodi Charles, Rajib Dasgupta, Kirk Emerson, Douglas Glandon, Churnrurtai Kanchanachitra, Shehla Zaidi

Community Health Sciences

No abstract provided.

Health Care Transitions For Adolescents And Young Adults With Special Health Care Needs: Where Are We Now?, Nicole Mubanga, Dennis J. Baumgardner, Jessica J. F. Kram

Journal of Patient-Centered Research and Reviews

Eventually, all adolescents must “graduate” from pediatric-oriented to adult-oriented health care. This transition, most often occurring during young adulthood, is especially important for adolescents with special health care needs and involves not only primary care physicians, but also both pediatric and adult subspecialists. Several studies support the benefit of transitional programs for adolescents and young adults with special health care needs. Additionally, the American Academy of Pediatrics named transitional care as one of its top priorities. However, transitional programs have yet to become an established norm among hospitals and providers, specifically outside of children’s hospitals. This topic synopsis aims to …

An Experience Of Practitioners Navigating The Role Of Patient/Caregiver, Susan M. Shaw, Rain Lamdin

Patient Experience Journal

This journey involved one of us having (repeat) intraspinal surgery in a country far from home but of a similar culture and with the same first language. The carer travelled across the world to be present during the hospital stay. We kept a journal during our admission, and following discharge realised there were significant differences between how we had documented our experience and the record presented in the clinical notes. The particular examples we present illustrate the relationships, rules and issues that we navigated. We share our experience in the form of moments from our journal, some of them alongside …

Reconnecting The Mind And Body: A Pilot Study Of Developing Compassion For Persistent Pain, Sarah L. Parry Dr, Zoey Malpus Dr

Patient Experience Journal

As an alternative to the more typical cognitive behavioural approach to pain management, a novel pain management group based on the principles of compassionate mind training was developed for a particular sub-group of patients. Participants were patients of a community pain clinic, who were invited to participate in this alternative approach to pain management. The eight-week Compassion in Pain Groups included psychoeducation around persistent pain, the underlying principles of compassionate mind training, practical exercises such as diaphragmatic breathing, followed by a series of compassionate imagery exercises and group discussions. Both quantitative and qualitative analyses were undertaken to gain further insights …