Public Health Commons^™

Involvement Of Men In Responsible Parenthood In Croatia, India, And Mexico: Major Factors, Correlates, And National Policy, Salima Kasymova

Theses and Dissertations

For this research I explored the association between men's gender attitudes and their endorsement of paternity leave policies as a way to begin to understand the determinants of men’s support of paternity leave policies. In addition, in order to understand factors that influencing paternal involvement, I examined the association between men’s gender attitudes and their actual involvement in caregiving among a sub-sample of fathers. I also explored whether men's leave-taking when their child was born mediated the association between their gender attitudes and involvement in child care. Considering the importance of national policy documents for promotion men’s participation in childcare, …

Analysis Of Food Exposures In Foodborne Disease Outbreaks, Alecia T. Alianell

Theses and Dissertations

Foodborne illness remains a serious public health problem in the United States in general as well as South Carolina in particular. Obtaining good food ingestion histories as well as possible risky environmental exposures is one of the earliest, most important tasks to complete in any foodborne outbreak investigations. Because time is of the essence in investigations, we have evaluated a rarely used biostatistical method, Random Forests, to data obtained from DHEC. Random Forests has the potential to facilitate more rapid identification of foods or environmental exposures that may be associated with outbreaks. We also examined previous cases of salmonellosis using …

A Potential Tool For Clinicians; Evaluating A Computer-Led Dietary Assessment Method In Overweight And Obese Women During Weight Loss, Adrianne Widaman, Nancy Keim, Dustin Burnett, Beverly Miller, Megan Witbracht, Keith Widaman, Kevin Laugero

Faculty Publications

Many Americans are attempting to lose weight with the help of healthcare professionals. Clinicians can improve weight loss results by using technology. Accurate dietary assessment is crucial to effective weight loss. The aim of this study was to validate a computer-led dietary assessment method in overweight/obese women. Known dietary intake was compared to Automated Self-Administered 24-h recall (ASA24) reported intake in women (n = 45), 19–50 years, with body mass index of 27–39.9 kg/m2. Participants received nutrition education and reduced body weight by 4%–10%. Participants completed one unannounced dietary recall and their responses were compared to actual intake. Accuracy of …

Relationship Of Religiosity And Spirituality To Hazardous Drinking, Drug Use, And Depression Among Sexual Minority Women, Laurie Drabble, Cindy Veldhuis, Barth Riley, Sharon Rostosky, Tonda Hughes

Faculty Publications

Using data from Wave 3 of the Chicago Health and Life Experiences of Women (CHLEW) study (N = 699), we explored whether religiosity and spirituality were associated with risk of hazardous drinking, drug use, and depression among sexual minority women (SMW; i.e., lesbian, bisexual) and possible differences by race/ethnicity. Participants were more likely to endorse spirituality than religiosity, and endorsement of each was highest among African American SMW. We found no protective effect of religiosity or spirituality for hazardous drinking or drug use. An association initially found between identifying as very spiritual and past-year depression disappeared when controlling for help-seeking. …

Characteristics Of Hiv-Infected Children At Enrollment Into Care And At Antiretroviral Therapy Initiation In Central Africa, A Adedimeji, A Edmonds, Donald R. Hoover, Qiuhu Shi, J Sinayobye, M Nduwimana, P Lelo, D Nash, K Anastos, M Yotebieng

NYMC Faculty Publications

BACKGROUND: Despite the World Health Organization (WHO) regularly updating guidelines to recommend earlier initiation of antiretroviral therapy (ART) in children, timely enrollment into care and initiation of ART in sub-Saharan Africa in children lags behind that of adults. The impact of implementing increasingly less restrictive ART guidelines on ART initiation in Central Africa has not been described. MATERIALS AND METHODS: Data are from the Central Africa International Epidemiologic Databases to Evaluate AIDS (IeDEA) pediatric cohort of 3,426 children (0-15 years) entering HIV care at 15 sites in Burundi, DRC, and Rwanda. Measures include CD4 count, WHO clinical stage, age, and …

Early Life Factors And Health Outcomes In Children And Mothers, Olubunmi Olufunke Orekoya

Theses and Dissertations

This dissertation focused on early life exposures and their impact on children and mothers’ health. It consists of three distinct studies with an overarching goal of understanding how early life factors influence health outcomes among children and mothers. The broad aims are: 1) to examine the association between maternal gestational weight gain and offspring weight at 1 year, while assessing the mediating role of birth weight; 2) to determine the association between breastfeeding practices and development of allergic conditions (eczema/skin allergy, hay fever/respiratory allergy, and asthma); and 3) to examine the association between breastfeeding and postpartum weight retention at 12 …

Endocrine Disruption In Largemouth Bass (Micropterus Salmoides) From A Pcb-Contaminated Reservoir, Stephanie B. Laplaca

Theses and Dissertations

There are numerous cases of intersex condition in fish, specifically immature oocytes in testicular tissue, documented in recent literature. Typically, these cases identify a point source input of endocrine disrupting compounds impacting the fish, such as wastewater treatment effluent. Legacy contaminants such as polychlorinated biphenyls (PCBs) have been suggested as endocrine disruptors in fish species. The objective of this study was to assess endocrine disruption in wild largemouth bass (Micropterus salmoides) from exposure to PCBs at a Superfund site in South Carolina on Lake Hartwell (SV-107), where high levels of PCBs in sediment and fish tissue samples have been detected …

The Association Between Sexual Risk Behaviors Of Latinos And Hiv Knowledge In South Carolina, Danielle Nicole Sill

Theses and Dissertations

HIV/AIDS inordinately impacts Hispanics/Latinos, which are the fastest growing minority group in the United States. 16,222 South Carolinians are infected with HIV, with 70 new cases being diagnosed each month. Few studies have been conducted to determine if HIV knowledge is associated with sexual risk behaviors in South Carolina. Bilingual/bicultural interviewers conducted a survey of Latinos living in the Pee Dee and Midlands regions of South Carolina. The survey consisted of questions regarding demographic characteristics, HIV knowledge, and sexual risk behaviors. We enrolled 203 participants in which 193 were eligible for our study (97 females and 96 males). We hypothesized …

Association Of Freestanding Dialysis Facility Size, Quality Incentive Program Scores And Patient Survival, Fozia Ajmal

Theses and Dissertations

Background

In 2011, The Centers for Medicare and Medicaid Services (CMS) has introduced a bundled payment reform along with a Quality Incentive Program (QIP) to bring efficiency in End stage renal disease (ESRD) care. The QIP rates facilities using clinical and reporting criteria, but misses out on patient outcomes. It penalizes facilities not achieving a target score by 0-2% of payments. The small facilities are expected to be impacted more by a reduction in payments. We determined the association between ESRD facility size and QIP scores and the association between QIP scores and patient survival.

Methods

We used the Medicare …

Multilevel And Multisectoral Processes Of Implementing Nutritionsensitive Ideology And Programming In Ethiopia’S Development Landscape, Andrea Marie Warren

Theses and Dissertations

This research sought to understand the ways in which ideas and discourses in international development are adapted in a country context. Our particular focus was on how ideas at the international and national level become reality at the subnational and community levels. We primarily examined the sensitization of Ethiopia’s Productive Safety Net Program to nutrition across sectors and down levels of government as a way to understand how the global momentum around nutrition, particularly multisectoral or nutrition-sensitive initiatives, can be translated into action.

The first manuscript delves further into the operational realities of implementing multisectoral nutrition-sensitive programming among the neglected …

Internet Speed And The Effect On Health Information Technology Adoption, Matthew W. Yuen

Theses and Dissertations

Background. The Internet has become pervasive in everyday life; the Pew Research Center reported over 84% of Americans use the Internet either on their phone or a computer. However, due to the methods by which the Internet was created, an Internet digital divide was created. The Internet digital divide is the disparity in access and speed of Internet of certain populations. This study looked into the disparity between urban and rural populations and their Internet access in two forms: e-prescriptions adoptions and Internet health information seeking behavior (HISB) through their mobile devices.

Methods. This study used 4 datasets, …

Racism Across The American South: The Association Between Racism On Twitter, Rurality, & Black Mortality, Jarrod Bullard

Theses and Dissertations

Racism can be understood as a system of dominance and power designed to uphold the racially privileged of society. One can be exposed to racism through various mechanisms including the Internet and social media. Evidence indicates that exposure to racism is associated with poor mental and physical health outcomes as well as unhealthy behaviors. Current literature studying the effects of racism focus primarily on experienced or perceived racism. Furthermore, the geographic influence of racism on health at the county level and across levels of rurality is currently unknown. The purpose of this study was twofold; 1.) To explore the geographic …

Marginal Structural Cox Model For Survival Data With Treatment-Confounder Feedback, Yanan Zhang

Theses and Dissertations

In an observational longitudinal study, there can be time-varying exposure/treatment and time-varying confounders. When the confounders affect the exposure and prior exposure also has an impact on levels of confounders, there is treatment confounder feedback. To admit estimation of unbiased causal effects, these conditions need to be hold, exchangeability, positivity, consistency. The traditional method of conditioning on potential confounders does not meet these 3 conditions. Therefore, parameter estimates from traditional Cox model are biased casual effect estimates when the treatment confounder feedback exists. The marginal structural Cox model can be used to address this issue. By calculating and including inverse …

The Impact Of Autoimmune Disease On Breast Cancer Survival, Samantha Truman

Theses and Dissertations

Background Breast cancer is the second leading cause of cancer death for women in developed countries, while autoimmune disease effects approximately 10 million people in the United States, of which approximately 80% are female. Both diseases are associated with hormonal risk factors and are related to the divergent effects of the cellular and humoral immunity that is associated with the T-helper 1 and T-helper 2 immune response. To investigate the potential implications that autoimmune disease may have on breast cancer-specific mortality, we have conducted a population-based retrospective cohort study of women who were diagnosed with breast cancer between January 1, …

Trends In Gestational Weight Gain In South Carolina, 2004 - 2015, Marilyn Elizabeth Wende

Theses and Dissertations

Objective: Excessive and inadequate gestational weight gain (GWG) are associated with a myriad of adverse pregnancy outcomes. The objective of this study was to examine secular trends in GWG in South Carolina (SC) from 2004 to 2015. We hypothesized that there was a trend of higher GWG z scores (GWGZ) over this 11-year time period after adjusting for changes in population characteristics. We also hypothesize that a trend of higher mean GWGZ at higher percentiles is more apparent for African Americans, rural women, and women who are overweight or obese before pregnancy.

Data and Methods: Data came from SC …

Development Of An Estrogen-Related Dietary Pattern And Lifestyle Score To Examine Breast Cancer Risk In Postmenopausal Women, Mark Andrew Guinter

Theses and Dissertations

Introduction: Studies examining the association between individual dietary components and breast cancer have been inconclusive. The use of dietary patterns is a holistic approach which may yield stronger associations. We sought to develop a dietary pattern based on an estrogen metabolite (EM) profile hypothesized to increase breast cancer risk (high unconjugated estradiol and low ratio of 2- to 16-hydroxylated EMs (2/16 ratio)). This estrogen-related dietary pattern (ERDP) was examined for associations with postmenopausal breast cancer in two study populations and was incorporated into an estrogen-related lifestyle score (ERLS) with other modifiable risk factors for breast cancer.

Methods: EM …

Feasibility Of Antiretroviral Treatment Monitoring In The Era Of Decentralized Hiv Care: A Systematic Review, Minh D. Pham, Lorena Romero, Bruce Parnell, David A. Anderson, Suzanne M. Crowe, Stanley Luchters

Population Health, East Africa

Background: Regular monitoring of HIV patients who are receiving antiretroviral therapy (ART) is required to ensure patient benefits and the long-term effectiveness and sustainability of ART programs. Prompted by WHO recommendations for expansion and decentralization of HIV treatment and care in low and middle income countries, we conducted a systematic review to assess the feasibility of treatment monitoring in these settings.

Methods: A comprehensive search strategy was developed using a combination of MeSH and free text terms relevant to HIV treatment and care, health service delivery, health service accessibility, decentralization and other relevant terms. Five electronic databases and two conference …

Food Insecurity And Fruit And Vegetable Consumption Among Regional And Remote Western Australian Children: Determinants, Prevalence And Predictors, Stephanie Louise Godrich

Theses: Doctorates and Masters

Living in a community with adequate availability of nutritious food, and the capacity to access and utilise it, are key food security determinants (FSD). However, inequities relating to these determinants exist between regional and remote Western Australian (WA) communities, particularly regarding fruit and vegetables (F&V). This negatively impacts vulnerable populations, especially children. In order to understand determinants, prevalence and predictors of F&V and food security (FS), three concepts were explored in this PhD; (1) F&V consumption among regional and remote WA children (including determinants of F&V consumption, quantities, types, varieties of F&V consumed); (2) FS among regional and remote WA …

Effects Of Bidi Smoking On All-Cause Mortality And Cardiorespiratory Outcomes In Men From South Asia: An Observational Community-Based Substudy Of The Prospective Urban Rural Epidemiology Study (Pure), Mylinh Duong, Sumathy Rangarajan, Xiaohe Zhang, Kieran Killian, Prem Mony, Sumathi Swaminathan, Ankalmadagu Venkatsubbareddy Bharathi, Sanjeev Nair, Krishnapillai Vijayakumar, Indu Mohan, Romaina Iqbal, Khawar Kazmi

Community Health Sciences

Background: Bidis are minimally regulated, inexpensive, hand-rolled tobacco products smoked in south Asia. We examined the effects of bidi smoking on baseline respiratory impairment, and prospectively collected data for all-cause mortality and cardiorespiratory events in men from this region.
Methods: This substudy of the international, community-based Prospective Urban Rural Epidemiology (PURE) study was done in seven centres in India, Pakistan, and Bangladesh. Men aged 35–70 years completed spirometry testing and standardised questionnaires at baseline and were followed up yearly. We used multilevel regression to compare cross-sectional baseline cardiorespiratory symptoms, spirometry measurements, and follow-up events (all-cause mortality, cardiovascular events, respiratory events) …

Role Of Mhealth Applications For Improving Antenatal And Postnatal Care In Low And Middle Income Countries: A Systematic Review, Anam Shahil Feroz, Shagufta Perveen, Wafa Aftab

Community Health Sciences

Background: From 1990 to 2015, the number of maternal deaths globally has dropped by 43%. Despite this, progress in attaining MDG 5 is not remarkable in LMICs. Only 52% of pregnant women in LMICs obtain WHO recommended minimum of four antenatal consultations and the coverage of postnatal care is relatively poor. In recent years, the increased cellphone penetration has brought the potential for mHealth to improve preventive maternal healthcare services. The objective of this review is to assess the effectiveness of mHealth solutions on a range of maternal health outcomes by categorizing the interventions according to the types of mHealth …

Unintended Pregnancies Among Married Women In Sindh Pakistan: Role Of Lady Health Workers, Sumera Aziz Ali, Unaib Rabbani

Community Health Sciences

Background: Unintended pregnancies, which pose substantial risks to both mothers and children, account for 24% of all pregnancies in Pakistan. Door to door visits and service provision by lady health workers (LHWs) may be related to the reduction of such pregnancies, particularly in rural areas. This study aimed to determine the association of knowledge about Lady Health Visitors (LHWs) and door to door visits by LHWs with unintended pregnancies among rural women.
Methods: We conducted a community-based, nested case-control study of 800 pregnant women, identified from the database of an active surveillance mechanism, which registers and follows all pregnant women …

The Effect Of Breastfeeding On The Cognitive And Language Development Of Children Under 3 Years Of Age: Results Of Balochistan-Early Childhood Development Project, Meesha Iqbal Iqbal, Ghazala Rafique, Sumera Aziz Ali

Community Health Sciences

Background: Breastfeeding is known to be an important factor in the overall growth and development of children. Breastfeeding is thought to lead to enhance cognitive and language development of a child. However, this association has not yet been scientifically and statistically established. This study aimed to explore this association in children under 3 years of age.
Methods: This was a secondary data-analysis of the baseline data of “Balochistan – Early Childhood Development Project”. The final sample comprised of 604 children less than 3 years of age. The children were selected by three-stage stratified random sampling from three districts of Balochistan …

Can Right To Health Help Policy Makers To Address Maternal Mortality?: A Short Communication, Sumera Aziz Ali, Nadir Suhail, Savera Aziz Ali

Community Health Sciences

No abstract provided.

Lead Content Of Lip Balms: A Cross Sectional Convenience Sample With Exposure Assessment Estimating An Average Daily Intake For Young Children, Julie Grunklee

Dissertations and Theses @ UNI

Lead remains one of the largest environmental toxins affecting children today (Costa, et al., 2004). It is associated with lower IQ, learning difficulties, decreased economic potential and other negative health effects and social behaviors (Kordas et al., 2006). In the United States (U.S.), high amounts of lead remain in and immediately around housing built before 1978 (Tarragó, 2015) as well as a variety of other sources, including cosmetics such as lip balms, that are marketed to the most lead-vulnerable population: young children. Lip balm was found to be the source a lead poisoned child in Minnesota (Minnesota resident, 28 years …

Reproducing Childbirth: Negotiated Maternal Health Practices In Rural Yucatan, Veronica Miranda

Theses and Dissertations--Anthropology

This ethnographically informed dissertation focuses on the ways rural Yucatec Maya women, midwives and state health care workers participate in the production of childbirth and maternal health care practices. It further addresses how state health programs influence the relationships and interactions between these groups. Although childbirth practices in Yucatan have always been characterized by contestation, negotiation and change, their intensity and speed have significantly increased over the last decade. Drastic changes in the maternal health of rural indigenous communities in Mexico and throughout the world are directly connected to intensified state interventions that favor biomedicine over traditional health systems. In …

Associated Factors Of Hepatitis C Infection In Pregnantwomen At Outpatient Department Of Peoples Medical University And Hospital District Shaeed Benazir Abadsindh Province Pakistan, Akhlaque Hussain

Chulalongkorn University Theses and Dissertations (Chula ETD)

Purpose: The prevalence of hepatitis C is 3% of the world population with more the 3 million new cases are being reported, In Pakistan, the prevalence of hepatitis C virus Infection ranges from 8%-15% in the general population. In Pakistan about 13 million people are infected. Prevalence of hepatitis C in pregnancy has been studied across Pakistan and is reported with the range of 3.27%-8.9%. Methods: A descriptive cross sectional study was conducted between may to June 2018. in people's medical university at outpatient Department of gynaecology and obstetrics in district shaheed Benazir abad Sindh Pakistan. All pregnant Patient age …

Effectiveness Of An Educational Program To Promote The Safe Use Of Pesticide Among Vegetable Farmers In India : A Quasi Experimental Study, Ajit Pal Singh Raina

Chulalongkorn University Theses and Dissertations (Chula ETD)

Objectives: 1)To provide information on baseline use and Health impacts of pesticides. 2) To provide information on knowledge, attitude, and Practice for pesticide. 3) To design a self- explanatory and affordable educational tool for vegetable farmers which can be used to train farmers on safe use of pesticides and finally 4) To assess change in KAP score and reduction in pesticide exposure symptoms to farmers and their families. Methods: After developing a simple educational tool, its effectiveness was assessed by measuring change in mean scores of knowledge, attitude, practice (KAP) and in-home pesticide safety behavior in households of farmers. Pictorial …

Knowledge, Attitude And Cultural Factors Towards Utilization Of Insecticide Treated Nets (Itns) Among Rakhine Ethnic Group In Ann Township, Rakhine State, Myanmar, Aung Phyo Oo

Chulalongkorn University Theses and Dissertations (Chula ETD)

This study is to find associations between general characteristic, knowledge, attitudes and cultural factors on malaria prevention toward utilization of insecticidal nets (ITNs) among Rakhine ethnic groups, in Ann Township, Rakhine State, Myanmar. An analytic cross sectional study was conducted among 420 Rakhine ethnic groups aged more than 18 years old from 10 villages in Ann Township. Data were collected by using face-to-face interview. The study found only 3.6% of respondents had good knowledge level, 19.0% good attitude level and 38.8% good practice level towards utilization of ITNs. Female participants were 8.015 times had good practice level than male (p-value <0.001, AOR 8.015, 95% CI = 3.395-18.923). High school level participants likely to use ITNs for 14.518 times than lower education level (p-vale <0.001, AOR 14.518, 95% CI = 4.642-45.408). Married participants were 13.753 times done good practice (p-vale <0.001, AOR 13.753, 95% CI = 4.371-43.267) and widowed participants were 5.403 times done good practice than singles (p-vale 0.039, AOR 5.403, 95% CI = 1.085-26.909). Regarding the cultural factors, participants who always worked from dawn to night time were 2.203 times had good practice level than who never work at that time (p-vale 0.032, AOR 2.203, 95% CI = 1.070-4.536). Regarding knowledge level of the participants, moderate and good knowledge level were 5.125 times had good practice level than lower knowledge level participants (p-vale <0.001, AOR 5.125, 95% CI = 1.062-6.429). Health education and encouragement of people should be done to improve knowledge and utilization to use insecticide treated nets.

Health Status And Behavior Influences To Sleep Quality Among Community-Dwelling Elderly In Chanthaburi Province, Thailand, Chanisa Siripanich

Chulalongkorn University Theses and Dissertations (Chula ETD)

Purpose - The trend of sleep disorder is typically more common in aged changes due to health condition changes leading to poor sleep satisfies. Therefore the purpose of this study was to examine the rate and factors associated to sleep quality among Community-Dwelling Elderly in Chanthaburi Province, Thailand. Design/methodology/approach – A cross-sectional was conducted in 208 elderly by multi-stage sampling. All participants were interviewed by the questionnaire. sleep quality was assessed by Pittsburgh sleep quality index (PSQI). Sleep quality score ≥ 5 indicating poor sleep quality. Chi-square tests and Multivariate logistic regression models were performed to find significant associations. Findings …

Assessment Of Alcohol Consumption And Quality Of Life Amongchronic Liver Disease Patients In Mandalay, Myanmar, Chan Hein Tun

Chulalongkorn University Theses and Dissertations (Chula ETD)

Background: Alcohol drinking is one of the common addictive hazardous behaviours nowadays that would definitely cause consequent health system deteriorations, especially the hepatobiliary system - chronic liver diseases. This study was to find out the patterns of alcohol consumption, levels of alcohol screening, quality of life according to gender and age groups and associations between variables among the chronic liver disease patients in Mandalay, Myanmar. Methodology: A cross-sectional study, data collection was completed by face to face interviews and secondary data from medical records from total 280 chronic liver disease patients. The questionnaires consisted of structured parts, Alcohol Use Disorder …