Public Health Commons^™

Biokinetics Of Nanomaterials: The Role Of Biopersistence, Peter Laux, Christian Riebeling, Andy M. Booth, Joseph D. Brain, Josephine Brunner, Cristina Cerrillo, Otto Creutzenberg, Irina Estrela-Lopis, Thomas Gebel, Gunnar Johanson, Harald Jungnickel, Heiko Kock, Jutta Tentschert, Ahmed Tlili, Andreas Schäffer, Adriënne J. A. M. Sips, Robert A. Yokel, Andreas Luch

Pharmaceutical Sciences Faculty Publications

Nanotechnology risk management strategies and environmental regulations continue to rely on hazard and exposure assessment protocols developed for bulk materials, including larger size particles, while commercial application of nanomaterials (NMs) increases. In order to support and corroborate risk assessment of NMs for workers, consumers, and the environment it is crucial to establish the impact of biopersistence of NMs at realistic doses. In the future, such data will allow a more refined categorization of NMs. Despite many experiments on NM characterization and numerous in vitro and in vivo studies, several questions remain unanswered including the influence of biopersistence on the toxicity …

Social Franchising And A Nationwide Mass Media Campaign Increased The Prevalence Of Adequate Complementary Feeding In Vietnam: A Cluster-Randomized Program Evaluation, Rahul Rawat, Phuong Hong Nguyen, Lan Mai Tran, Nemat Hajeebhoy, Huan Van Nguyen, Jean Baker, Edward A. Frongillo Jr., Marie T. Ruel, Purnima Menon

Faculty Publications

Rigorous evaluations of health system-based interventions in large-scale programs to improve complementary feeding (CF) practices are limited. Alive & Thrive applied principles of social franchising within the government health system in Vietnam to improve the quality of interpersonal counseling (IPC) for infant and young child feeding combined with a national mass media (MM) campaign and community mobilization (CM). We evaluated the impact of enhanced IPC + MM + CM (intensive) compared with standard IPC + less-intensive MM and CM (nonintensive) on CF practices and anthropometric indicators. A cluster-randomized, nonblinded evaluation design with cross-sectional surveys ( = ∼500 children aged 6-23.9 …

Family Planning Dynamics In Zimbabwe, Heidi Weidele

Senior Honors Projects

Almost 90 percent of all women in Zimbabwe lack health insurance. Most are undereducated or underemployed, and only have access to maternal and contraceptive care via public clinics. There is a large gap in family planning services in both rural and urban areas, which leads to a lack of necessary care in many communities. Bivariate and multivariate analyses on demographic data (Zimbabwe Demographic and Health Survey 2015) collected by the Zimbabwe National Statistics Agency and compiled by the United States Demographic and Health Surveys Program were performed to determine the relationships among public health services and female demographics (including education, …

A Comparison Of Influenza & Tdap Vaccination Rates By Characteristics Of Child-Bearing-Aged Women, Francis Connor, Dnp, Msn, Mph, Fnp-Bc

Doctor of Nursing Practice Projects

Background

The Advisory Committee on Immunization Practices recommend childbearing-aged women receive an annual influenza vaccine, one dose of Tdap instead of TD after 18 years of age, and one dose of Tdap during the 3^rd trimester of each pregnancy. Despite these recommendations, influenza and Tdap vaccination rates remain lower than current goals.

Objectives

The purpose was to assess influenza and Tdap vaccination rates among women of childbearing age by pregnancy status, age group, and race/ethnicity.

Methods

The retrospective secondary data analysis included a nationally representative sample of women aged 18 to 44 years from the 2014 Behavioral Risk Factors …

Female Madness In Greek Tradition And Medicine, Caitlin T. Connelly

Student Publications

This paper considers the similarities and differences in Greek thought concerning female madness among both traditional views of madness and medical views. It identifies three broad types of female madness – Dionysian madness, most often associated with maenads and maenadism; desire-induced madness, associated with Aphrodite or Eros; and the medical views of madness of the Hippocratic Corpus, Plato, and other writers. Divinely-inspired madness was considered an assault on the individual from the outside, while the physicians considered madness to be an affliction from within. However, while desire-induced madness and medical madness were seen as the results of women avoiding men, …

The Role Of The Dental College Of Georgia In Meeting The Oral Health Needs Of Georgians, Carol A. Lefebvre

Journal of the Georgia Public Health Association

N/A

The Association Between Dental Coverage And Self-Reported Health In Older Adults Jgpha, Frances M. Yang, Solon T. Kao, Jordan S. Lundeen

Journal of the Georgia Public Health Association

Background: For the older population of the United States, lack of dental insurance coverage is a substantial health problem. The purpose of the present study was to examine the longitudinal relationship between dental coverage and self-reported health among older adults.

Methods: The Health and Retirement Study (HRS), a nationally representative biennial cohort study of community-dwelling individuals, includes 19,595 adults (aged 50 and older) living in the United States. For the 2010, 2012, and 2014 waves, the independent variable of dental coverage and the outcome of self-reported health were examined.

Results: At each time point, dental coverage for older adults had …

Std Services Delivery Arrangements In Georgia County Health Departments, Karmen S. Williams, Gulzar H. Shah, Angela Peden, Bill Livingood

Journal of the Georgia Public Health Association

Background: Uniformity, standardization, and evidence-based public health practice are needed to improve the efficiency and quality of services in local health departments (LHDs). Among the highest priority and most common public health services delivered by LHDs are services related to sexually transmitted diseases (STDs) and sexually transmitted infections (STIs).

Objective: The purpose of this study was to examine potential variations in the delivery of sexually transmitted disease (STD) services among county health departments (CHD) in Georgia, to determine if potential variations were due to varied administrative practices, and to understand delivery arrangements so that future cost studies can be supported. …

Increasing Breastfeeding Duration And Exclusivity In A Sample Of Rural Women: A Pilot Study, Joanne Chopak-Foss, Felicia Yeboah

Journal of the Georgia Public Health Association

Background: Increasing breastfeeding exclusivity and duration is an objective of Maternal and Child Health (MICH-21.4 and 21.5) of the Healthy People 2020 initiative. Breastfeeding rates differ considerably between high-income and low-income women.

Methods: This was a pilot project conducted to assess the feasibility of an intervention to increase breastfeeding practices overall and to improve exclusive breastfeeding rates among a sample of rural women enrolled in the Special, Supplemental Nutrition Program for Women, Infants and Children (WIC) in a rural Georgia county. Participants were recruited from the local regional hospital (n=27). Support group meetings were offered over a four-week period and …

Social Networks As Predictors Of Colorectal Cancer Screening In African Americans, Ernest Alema-Mensah, Selina A. Smith, Mechelle Claridy, Victor Ede, Benjamin Ansa, Daniel S. Blumenthal

Journal of the Georgia Public Health Association

Background: Early detection can reduce colorectal cancer (CRC) mortality by 15%–33%, and screening is widely recommended for average-risk adults beginning at age 50 years. Colorectal cancer mortality rates are higher in African Americans than in whites, while screening rates are somewhat lower. Individual social networks can reduce emotional and/or logistical barriers to healthpromoting but distasteful procedures such as CRC screening. The aim of this study was to examine social network interactions, and their impact on CRC screening among African Americans. We hypothesized a positive association between social network index (SNI) scores and CRC screening.

Methods: In a community intervention trial …

A Review Of Strategies To Increase Access To Oral Health Services, Breyanna Davis, Sara Plaspohl

Journal of the Georgia Public Health Association

Background: Leading Health Indicators (LHIs), a subset of objectives for Healthy People 2020, were selected to communicate at-risk health issues and actions that can be taken to address them. Nationally, the number of children, adolescents, and adults who visited the dentist in the past year has decreased, suggesting that oral health continues to be a problem caused by barriers preventing access to oral health services. This review aimed to identify strategies to increase access to oral health services that will be useful in moving toward the LHI objectives.

Methods: Preliminary research was conducted on the LHI via the Healthy People …

Dental College Of Georgia Teams Up With Richmond County Health Department To Help, Nancy Lyn Wilson, Mark Peacock, Christopher Cutler, Jamie De Stefano

Journal of the Georgia Public Health Association

Background: The Central Savannah River Area remains, for many of the poor, a dental health care shortage area. Each year, from December to March, fourth-year dental students perform outreach with faculty to search the community for unmet dental needs, including dental caries and periodontal disease, the treatment of which is required for the Central Regional Dental Testing Service (CRDTS) Exam, the dental licensing examination.

Methods: Fourth year students at the Augusta University Dental College of Georgia recruit patients for free dental pre-screenings at health fairs, community centers, the Barnyard Flea Market, and the dental school. Persons with periodontitis are invited …

Use Of A Teledentistry Partnership Program To Reach A Rural Pediatric Population, Tara E. Schafer, Bruce Riggs

Journal of the Georgia Public Health Association

Background: Teledentistry is “the practice of using video-conferencing technologies to diagnose and provide advice about treatment over a distance.” Teledentistry has been defined as “the practice of using video-conferencing technologies to diagnose and provide advice about treatment over a distance.” This report describes the partnership of two rural Georgia public health districts. Augusta University Dental College of Georgia’s Department of Pediatric Dentistry partnered with a private practice dentist in Georgia with the goal of increasing access to care.

Methods: A partnership was created that allowed dentists in a remote location to triage dental patients seen in a school-based clinic.

Results: …

Community Engagement To Address Socio-Ecological Barriers To Physical Activity Among African American Breast Cancer Survivors, Selina A. Smith, Mary S. Whitehead, Joyce Q. Sheats, Brittney Chubb, Ernest Alema-Mensah, Benjamin E. Ansa

Journal of the Georgia Public Health Association

Background: With high rates of obesity, low levels of physical activity (PA), and lack of adherence to physical activity guidelines (PAGs) among African American (AA) breast cancer survivors (BCSs), culturally appropriate interventions that address barriers to participation in PA are needed.

Methods: To develop intervention content, members of an AA breast cancer support group participated in four 1-hour focus group discussions (related to the barriers to PA, strategies for overcoming them, and intervention content), which were audiotaped, transcribed, and analyzed.

Results: The support group collaborated with researchers to construct the Physical Activity Intervention Developed (PAID) to Prevent Breast Cancer, a …

Pre-Pregnancy Body Mass Index Is Associated With Dietary Inflammatory Index And C-Reactive Protein Concentrations During Pregnancy, Dayeon Shin, Junguk Hur, Eun-Hee Cho, Hae-Kyung Chung, Nitin Shivappa, Michael D. Wirth, James R. Hébert, Kyung Won Lee

Faculty Publications

There have been a limited number of studies examining the association between pre-pregnancy body mass index (BMI) and dietary inflammation during pregnancy. Our aim is to examine the association between pre-pregnancy BMI and the Dietary Inflammatory Index (DII)™ and C-reactive protein (CRP) concentrations during pregnancy. The study included 631 pregnant American women from the National Health and Nutrition Examination Survey (NHANES) cross-sectional examinations from 2003 to 2012. Pre-pregnancy BMI was calculated based on self-reported pre-pregnancy weight and measured height. The cut-offs of <18.5 (underweight), 18.5–24.9 (normal), 25.0–29.9 (overweight), and ≥30 kg/m2 (obese) were used to categorize the weight status of pregnant women prior to pregnancy. The DII, a literature-based dietary index to assess the inflammatory properties of diet, was estimated based on a one-day 24-h recall. Multivariable linear and logistic regressions were performed to estimate beta coefficients and the adjusted odds ratios (AORs) and 95% confidence intervals (95% CIs) on the association of pre-pregnancy BMI categories with the DII and CRP concentrations during pregnancy. After controlling for variables including: race/ethnicity, family poverty income ratio, education, marital status, month in pregnancy, and smoking status during pregnancy; women who were obese before pregnancy (n = 136) had increased odds for being in the highest tertile of the DII and CRP concentrations compared to women with normal weight (AORs 2.40, 95% CIs 1.01–5.71; AORs 24.84, 95% CIs 6.19–99.67, respectively). These findings suggest that women with pre-pregnancy obesity had greater odds of reporting higher DII and having elevated CRP. In conclusion, high pre-pregnancy BMI was associated with increased odds of pro-inflammatory diet and elevated CRP levels during pregnancy in the USA.

Comparison Of Foeto-Maternal Outcome In Pregnant Women With Hepatitis E - A Review Of 12 Years., Tahira Naru, Farheen Yousuf, Ayesha Malik, Sumaira Naz, Humera Ismail

Department of Obstetrics & Gynaecology

Objective: To compare adverse maternal and foetal outcome in pregnant women with hepatitis E immunoglobulin M reactive versus non-reactive.
Methods: This retrospective study was conducted at the Aga Khan University Hospital, Karachi, and comprised records of pregnant patients at any gestational age with clinical and biochemical evidence of hepatitis E from January 2002 and December 2014. . Maternal and perinatal outcome of the subjects were analysed. SPSS 20 was used for data analysis.
Results: Out of the 200 subjects, 168(84 %) were hepatitis E immunoglobulin M reactive and 32(16%) were non-reactive. The overall mean age was 26.7±4.5 years. Also, 12(7%) …

The Benefits Of Breastfeeding, Annagrace E. Anderson

Senior Honors Theses

Breast milk is the gold standard for infant nutrition. In the past, infant formula was promoted as equal or superior to breast milk. However, research has shown that breastfeeding is the superior form of infant nutrition except in rare circumstances. Breast milk provides for all of a newborn’s caloric needs and has the correct balance of nutrients to promote proper development. In addition, breast milk provides protection against illnesses, supports an infant’s immune system, and promotes life-long health for the newborn. Mothers also experience personal benefits by breastfeeding such as decreased cancer risks, bonding with their babies, and faster postpartum …

Physician Role In Physical Activity For African-American Males Undergoing Radical Prostatectomy For Prostate Cancer, Faustine Williams, Kellie R. Imm, Graham A. Colditz, Ashley J. Housten, Lin Yang, Keon L. Gilbert, Bettina F. Drake

ETSU Faculty Works

Purpose

Physical activity is recognized as a complementary therapy to improve physical and physiological functions among prostate cancer survivors. Little is known about communication between health providers and African-American prostate cancer patients, a high risk population, regarding the health benefits of regular physical activity on their prognosis and recovery. This study explores African-American prostate cancer survivors’ experiences with physical activity prescription from their physicians.

Methods

Three focus group interviews were conducted with 12 African-American prostate cancer survivors in May 2014 in St. Louis, MO. Participants’ ages ranged from 49 to 79 years, had completed radical prostatectomy, and their time out …

Buprenorphine Physician Supply: Relationship With State-Level Prescription Opioid Mortality, Hannah K. Knudsen, Jennifer R. Havens, Michelle R. Lofwall, Jamie L. Studts, Sharon L. Walsh

Behavioral Science Faculty Publications

Background: Buprenorphine is an effective treatment for opioid use disorder but the supply of buprenorphine physicians is currently inadequate to address the nation’s prescription opioid crisis. Perception of need due to rising opioid overdose rates is one possible reason for physicians to adopt buprenorphine. This study examined associations between rates of growth in buprenorphine physicians and prescription opioid overdose mortality rates in US states.

Methods: The total buprenorphine physician supply and number of physicians approved to treat 100 patients (per 100,000 population) were measured from June 2013 to January 2016. States were divided into two groups: those with rates of …

Impact Of Health Policy Changes On Emergency Medicine In Maryland Stratified By Socioeconomic Status, Laura Pimentel, David Anderson, Bruce Golden, Edward Wasil, Fermin Barreuto, Jon M. Hirshon

Publications and Research

Introduction: On January 1, 2014, the financing and delivery of healthcare in the state of Maryland (MD) profoundly changed. The insurance provisions of the Patient Protection and Affordable Care Act (ACA) began implementation and a major revision of MD’s Medicare waiver ushered in a Global Budget Revenue (GBR) structure for hospital reimbursement. Our objective was to analyze the impact of these policy changes on emergency department (ED) utilization, hospitalization practices, insurance profiles, and professional revenue. We stratified our analysis by the socioeconomic status (SES) of the ED patient population.

Methods: We collected monthly mean data including patient volume, hospitalization percentages, …

Hspm 7333 (Section A) Crn 18906, Julie Reagan Phd,Jd,Mph

College of Public Health: Faculty Syllabi (2014-2021)

This course pertains to the management and governance of healthcare organizations by Trustees or Boards of Directors.

Tobacco Product Use Among Lesbian, Gay, And Bisexual Adolescents., Hongying Dai

Manuscripts, Articles, Book Chapters and Other Papers

OBJECTIVES: Sexual minority youth face health disparities and a high risk of substance abuse. This study sought to fully characterize the disparity of tobacco use and risk factors in this high-risk subpopulation.

METHODS: Using data from the 2015 Youth Risk Behavior Survey, the current use of various tobacco products (cigarettes, smokeless tobacco, cigars, and e-cigarettes) was compared according to sex and distinct sexual identities (lesbian, gay, bisexual, and unsure). Heterosexual/straight adolescents served as the control group.

RESULTS: Of 14 703 respondents, 88.8% were heterosexual/straight, 2.0% were lesbian or gay, 6.0% were bisexual, and 3.2% were unsure about their sexual identity. …

Association Of Depressive Symptomology And Psychological Trauma With Diabetes Control Among Older American Indian Women: Does Social Support Matter?, R. Turner Goins, Carolyn Noonan, Kelly Gonzales, Blythe Winchester, Vickie L. Bradley

OHSU-PSU School of Public Health Faculty Publications and Presentations

Aims—Among older American Indian women with type 2 diabetes (T2DM), we examined the association between mental health and T2DM control and if social support modifies the association.

Methods—Survey data were linked to T2DM medical record information. Mental health measures were the Center for Epidemiologic Studies – Depression Scale and the National Anxiety Disorders Screening Day instrument. T2DM control was all HbA1c values taken post mental health measures.

Results—There was not a significant association between depressive symptomatology and higher HbA1c although increased depressive symptomatology was associated with higher HbA1c values among participants with low social support. There was a significant association …

Curated Exhibit Price Of War: Advances In Military Medicine, Laura J. Hall

Posters and Presentations

The Price of War: Advances in Military Medicine exhibit, curated by Laura J. Hall, MFA, explored the significant medical innovations arising from wartime, with a special focus on New Mexico's contributions. The exhibit highlighted the development of the atomic bomb at Los Alamos National Labs and the Trinity Site, the post-war work of the Atomic Bomb Casualty Commission, and the pioneering efforts of Dr. Randy Lovelace in space medicine. On display from April 1, 2017, to March 17, 2020, it documented key medical advancements, from field surgical installations in World War II to modern prosthetics and regenerative medicine, showing how …

Rural Opioid Prevention And Treatment Strategies: The Experience In Four States [Policy Brief], John A. Gale Ms, Anush Yousefian Hansen Ms,Ma, Martha Elbaum Williamson Mpa

Mental Health / Substance Use Disorders

Little is known about what states with large rural populations are doing to combat opioid use disorders (OUD) in rural communities. This qualitative study identified rural challenges to the provision of OUD prevention, treatment, and recovery services and explored promising strategies to tackle the opioid crisis in rural communities.

Rural Opioid Prevention And Treatment Strategies: The Experience In Four States [Working Paper], John A. Gale Ms, Anush Hansen Ms,Ma, Martha Elbaum Williamson Mpa

Mental Health / Substance Use Disorders

Although opioid use rates are comparable in rural and urban counties, rural opioid users tend to be younger, unmarried, have lower incomes, and are more likely to lack health insurance, all vulnerabilities that may negatively impact their ability to seek treatment and recover. Additionally, the rural health care system is characterized by numerous resource, workforce, access, and geographic challenges that complicate the delivery of specialized care for OUDs in rural communities. The nature and scope of the opioid crisis vary across rural communities and require multifaceted, community-based strategies to address the problem. Based on interviews with key stakeholders in Indiana, …

Improving Health Outcomes In Trafficking Survivors Through Core Skills Development In The Workplace: Experience From The Philippines, Melinda A. Gill

Dignity: A Journal of Analysis of Exploitation and Violence

Whilst an emerging body of research documents the adverse physical and mental health outcomes of victims of trafficking following rescue, there is little research or guidance regarding interventions which improve these outcomes. In this article, I describe my experience as physician involved in a computer-based social enterprise for survivors of trafficking and slavery in the Philippines, and outline my evolving understanding of the requirements for health behavior change and improved outcomes. I conclude that while meaningful vocational skills, economic security, and adequate health-related knowledge are foundational, it is necessary to develop core skills to achieve improved health outcomes and that …

Dental Students Develop Program Addressing Geriatric Oral Health At Local Nursing Home, Nancy Lyn Wilson, Katherine Ciarrocca

Journal of the Georgia Public Health Association

Background: The elderly, especially those who reside in institutions and have a minority or low-income background, often have unmet oral health needs. As life expectancy increases, so will the need for oral health providers skilled in addressing the unique challenges presented by geriatric patients.

Methods: Dentists for Della is a student organization at the Dental College of Georgia that aims to improve the oral health status of residents at the Georgia War Veterans Nursing Home (GWVNH) in Augusta, Georgia. The students conduct fundraising activities so that third and fourth year students can provide needed dental treatment at no cost to …

El Suma Qamaña: La Convivencia En Relación A La Salud Según La Gente Aymara De Arica, Codpa, Y Putre / El Suma Qamaña: Coexistence In Relation To Health According To The Aymara People Of Arica, Codpa, And Putre, Alison Ogawa

Independent Study Project (ISP) Collection

Suma qamaña, comúnmente conocido como buen vivir o convivir bien, es un concepto andino relacionado con la manera en que la gente entiende la vida y conceptualiza la salud. Es un modelo de armonía en que se busca un equilibrio con todas las cosas, incluida la comunidad, la naturaleza, la espiritualidad, la familia, el cuerpo, y la mente. Esta investigación busca responder a la pregunta ¿Cómo se entiende y vive la salud en el marco del concepto del buen vivir de la gente aymara de Arica, Codpa, y Putre? También, intenta explicar el concepto del buen vivir o suma qamaña, …

Shifting Mental Health From The Back Burner: An Investigation Of The Mental Health Treatment Gap, Eva Hanorah Stanton

Independent Study Project (ISP) Collection

The purpose of this research project is to investigate solutions to the so-called ‘mental health treatment gap’. The need for scholarship in this area is underscored by the recent tragedy in the Gauteng province, which has brought the neglect of the mental health sector into the public eye. Through semi-structured interviews with six key stakeholders in the fields of mental health and health policy this project seeks to better understand the causes of the mental health treatment gap and the impact National Health Insurance (NHI) rollout may have on access to quality mental healthcare. Sub-themes explored include: the integration of …