Public Health Commons^™

The Skin Cancer Health Crisis And Recommended Intervention Methods, Blaire Brooks

Senior Theses

Despite the increasing research connecting UVR exposures to skin cancer, rates of skin cancer are rising. Skin cancer is now the most common form of cancer and there are significant health care costs associated with treating the cases (Balk et al., 2013). As a result, the United States needs greater initiatives to increase educational programs, physician counseling, and political action regarding ultraviolet exposure and incidence of skin cancer. Evaluation of the types of skin cancer, perceptions of tanning, and current regulations and recommendations are required in order to form the initiatives to combat the growth of skin cancer.

Hearing And Vision Screening In Pediatric Primary Care And The Sharing Of Results With Early Care And Education Programs, Susan J. Macary, Lisa Honigfeld, Margaret W. Berry, Dorothy B. Wakefield

Journal of Early Hearing Detection and Intervention

This study explores the extent to which pediatric primary care (PPC) providers share hearing and vision screening results with early care and education (ECE) programs and report being unable to assess hearing and vision among pre-kindergarten children. Reports of hearing and vision screening are assessed to explore whether national support for early hearing detection and intervention has similarly promoted vision screening in PPC. We evaluated the reporting of hearing and vision screening data from 4,119 Early Childhood Health Assessment records, which were obtained from licensed ECE programs in Connecticut. Records were stratified by age group into younger or older per …

Organ Donation: A Comparison Of Altruistic And Market-Based Systems, Cameron Caputi

The Downtown Review: An Interdisciplinary Journal Written and Peer-Reviewed by Mandel Honors College Students at Cleveland State University

One of the most heavily regulated aspects of the Health Care industry is the organ donation system (“Legislation and Policy”). Regulations in this area ensure the quality of the organs and morality of the process through which they were procured. This system, however, is failing in at least one sense; the number of patients requiring organ transplants is increasing, but the number of donors remains stagnant (Gordon, Patel, Sohn, Hippen, Sherman , 2014). Due to the lack of available transplant organs, a debate has been sparked on whether the United States government should allow for the purchasing of these organs.

Cost Benefit Analysis Of Idaho’S Fit And Fall Proof Program, Susie Bergeron, Michelle Arnett, Sarah Toevs, Tami Cirerol, Rihana Hartung, Linda Petersen, Trina Stolp, Zijada Sulejmanovic, Maria Tellez, Hailee Tilton, Nicole Tuffield, Kenzie Wilson

Public and Population Health Faculty Publications and Presentations

Falls are common among the elderly population. Almost 30% of Idahoans aged 65+ fall at least one time per year (Bergen, Stevens, & Burns, 2016). Falls are a significant source of morbidity, mortality, and healthcare expense. Fall-related injuries often result in expensive hospitalizations with progression into costly long-term care facilities (CDC, 2015). In Idaho, estimated fall-related medical costs are estimated at $253 million annually (CDC, 2016; Mirel & Carper, 2014).

Fit and Fall Proof^TM (FFP), is a fall prevention program serving approximately 2500 community dwelling seniors throughout the state of Idaho. It is an exercise program led by peer …

College Of Public Health News, Georgia Southern University

College of Public Health: News & Publications

• Peace named Statesboro Herald Humanitarian of the Year

Zika Virus-Like Particle (Vlp) Based Vaccine, Héléne Boigard, Alexandra Alimova, George R. Martin, Al Katz, Paul Gottlieb, Jose M. Galarza

Publications and Research

The newly emerged mosquito-borne Zika virus poses a major public challenge due to its ability to cause significant birth defects and neurological disorders. The impact of sexual transmission is unclear but raises further concerns about virus dissemination. No specific treatment or vaccine is currently available, thus the development of a safe and effective vaccine is paramount. Here we describe a novel strategy to assemble Zika virus-like particles (VLPs) by co-expressing the structural (CprME) and non-structural (NS2B/NS3) proteins, and demonstrate their effectiveness as vaccines. VLPs are produced in a suspension culture of mammalian cells and self-assembled into particles closely resembling Zika …

New Outpatient Experience Survey Design: A Quality Improvement Case Study, Nathan Paluso

Muskie School Capstones and Dissertations

The purpose of this capstone project is to evaluate the implementation process for a new survey methodology introduced by Maine Medical Partners (MMP), by following the Plan-Do-Study-Act (PDSA) quality improvement cycle framework. This new survey has been implemented to collect data on patients’ experiences in the MMP outpatient facilities, and is offered to the patients via iPad at check-out after their appointment. Through observation at MMP practices and MMP staff interviews, strengths and weaknesses of the implementation process have been identified. Evidence-based solutions pertaining to the identified weaknesses have been selected through a literature review and are incorporated in recommendations …

2nd Place Research Paper: Patient Activation Among Diverse Populations: A Systematic Review, Megan Kenney

Kevin and Tam Ross Undergraduate Research Prize

The purpose of this article was to review the current research regarding patient activation among diverse populations. Patient activation is defined as an individual’s knowledge, skill, and confidence in managing his or her own health and health care. A total of 62 articles were used in this review (54 primary research articles, six retrospective analyses, and two systematic reviews). Articles were obtained using the EBSCO search engine through the Leatherby Libraries at Chapman University. Preliminary and secondary searches were conducted using the keywords “patient activation.” Only articles published within the last ten years (2007 to 2017) were included to ensure …

Text Messaging Appointment Reminders To Increase Patient Appointment Adherence Within A Prevention And Wellness Program, Janel Willingham

Graduate Theses, Dissertations, and Capstones

Abstract

Healthcare organizations want to provide quality care, decrease costs, and promote preventative services for the communities they service. Mobile health units have become an extension of many healthcare organizations and provide different types of services, such as mammography. Providing mammography and wellness exams on a mobile unit presents several challenges; appointment adherence is one of them. Mobile units typically travel to underserved areas to serve people at risk for various health conditions such as breast cancer. Breast cancer is estimated to affect over 250,000 women in the United States during 2017; women have a 1:8 lifetime risk of being …

How Income And Food Prices Influence Global Dietary Intakes By Age And Sex: Evidence From 164 Countries, Andrew Muhammad, Anna D'Souza, Birgit Meade, Renata Micha, Dariush Mozaffarian

Publications and Research

Background While income and prices are key drivers of dietary choices, how their influence varies by food category, nation, and demographics is not well established. Based on intake data for 164 countries and 11 food categories, we examined how income and food prices relate to food intake globally, including by world region, age, and sex.

Methods We used 2010 intake data from the Global Dietary Database, the first database of consumption estimates for major food categories by country, age, and sex. We combined these data with national per capita GDP and food price data. We estimated intake responsiveness to income …

Meaningful Use Of Electronic Health Records For Population Health Management In U.S. Acute Care Hospitals, Niodita Gupta

Theses & Dissertations

Population health management (PHM) is used to identify the needs of a population and to align strategies to improve the health of the population through care coordination. The Health Information Technology for Economic and Clinical Health (HITECH) Act of 2009 emphasized the meaningful use (MU) of electronic health records (EHRs) to improve clinical and population health outcomes. The American Recovery and Reinvestment Act (ARRA) of 2009 approved the EHRs incentives program for eligible hospitals to demonstrate the MU of EHRs. Further, eligible hospitals which failed to demonstrate the MU of EHRs could face payment adjustments. Given a heightened focus on …

Sex And Sexuality Of Breast Cancer Survivors, Aja D. Kneip Pelster

Theses & Dissertations

With new diagnostic technologies and treatment modalities available, more people than ever are living as cancer survivors in the United States. A large group of this population consists of breast cancer survivors. The purpose of this research was to explore the intersection of breast cancer survivorship, at points beyond the termination of treatment, and sexuality, including expressions and performance of gender, relationships, and sexual behavior. The current study used semi-structured interviews, conducted with 21 Midwestern women at least 6-months post-treatment, to better understand the intersection of these two concepts. Following traditions of narrative and phenomenological qualitative research, the women’s own …

Epidemiologic And Clinical Profiles Of Uterine Cancer In The Gharbiah Province Of Egypt, Saad Alshahrani

Theses & Dissertations

Background: Uterine cancer is one of the top-ranking cancers of women with wide international variations in incidence rates. Egypt has a lower incidence of uterine cancer than other countries in the Middle East. In addition to the international incidence variation, there are also wide variations in incidence by rural and urban areas within countries. Therefore, this research project focused on the Gharbiah province, north of Cairo in the Nile Delta, with the aims of investigating demographic and clinical characteristics of uterine cancer, assessing rural/urban variation in incidence rates, and evaluating the possible role of hysterectomy in under-estimating the disease incidence …

Epigenetic Modifications Of Human Placenta Associated With Preterm Birth, Drissa Toure

Theses & Dissertations

Preterm birth is a complex multifactorial process. Despite the well-known role of the placenta in supporting the fetal development and maternal-fetal tolerance, the placental epigenetic modifications and preterm birth (PTB) remains poorly understood and under investigated. Various maternal and environment factors can influence epigenetic programming during fetal development to affect the functioning and structures of organs, including the placenta, which can lead to adverse pregnancy outcomes, including PTB. The understanding of the placental epigenetic alterations and maternal determinants associated with PTB are apparently indispensable for the development of actual diagnosis and methods of prevention and treatment of premature labor. The …

College Of Public Health News, Georgia Southern University

College of Public Health: News & Publications

• Georgia Southern Examines Physical Activity Levels and Counseling in Cancer Survivors

Epidemiology News, Georgia Southern University

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

• Georgia Southern Examines Physical Activity Levels and Counseling in Cancer Survivors

Encouraging Medicare Advantage Enrollees To Switch To Higher Quality Plans: Assessing The Effectiveness Of A ‘‘Nudge’’ Letter, Benjamin L. Howell, Partha Deb, Sai Ma, Rachel O. Reid, Jesse Levy, Gerald F. Riley, Patrick H. Conway, William H. Shrank

Publications and Research

There are considerable quality differences across private Medicare Advantage insurance plans, so it is important that beneficiaries make informed choices. During open enrollment for the 2013 coverage year, the Centers for Medicare & Medicaid Services sent letters to beneficiaries enrolled in low-quality Medicare Advantage plans (i.e., plans rated less than 3 stars for at least 3 consecutive years by Medicare) explaining the stars and encouraging them to reexamine their choices. To understand the effectiveness of these low-cost, behavioral ‘‘nudge’’ letters, we used a beneficiary-level national retrospective cohort and performed multivariate regression analysis of plan selection during the 2013 open enrollment …

Common Histories And Common Failures: How The Historical Events Of Ireland And The United States Have Led To Their Vastly Different, Equally Failing, Health Care Systems, Kimberly Narro

Senior Theses

The United States healthcare system is a constant source of debate and public interest, with the only common ground between political parties being that the current system is deeply flawed and needing improvement. Individuals often point to European single-payer systems as the answer, neglecting to mention the flaws also inherent in these systems. This thesis aims to suss out the successes and failings of the Irish and American healthcare systems through a thorough scholarly literature review, with an emphasis on the two countries’ origins and development, to lead to a discussion about why two countries with similar historical beginnings have …

Health Policy & Management News, Georgia Southern University

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

• Georgia Southern Examines Physical Activity Levels and Counseling in Cancer Survivors

Case Study: Healthy Texas Women Program In The Abilene-Taylor County Public Health District, Saul Francisco Delgado

Electronic Theses and Dissertations

The public healthcare system faces continuous transformations and challenges of constant adjustments to the increasing usage of fee for service revenue and the decrease of federal investment to women’s healthcare services and to the safety net healthcare providers (Meit, 2013; Weisman, 1997).

In 2016, the Texas 84^th Legislation Session determined to consolidate two existing women’s healthcare service programs into one a single program: the Healthy Texas Women (HTW) program. The new women’s program is a preventative care program that provides services of family planning and chronic illness care under a complete fee for service reimbursement system as its sourse …

College Student Health: How Cooking Can Promote Nutrition And A Healthy Diet, Sara Garzia

Senior Theses

This paper focuses on college student health and the manner in which nutrition and overall health can be improved by cooking. College students are at a high risk of poor health because of the college lifestyle. They are faced with a great deal of demands on their time from classes, extracurricular activities, work, and friends. Many students cite this lack of time as one of the main reasons they do not prepare their meals at home. Students also struggle with the perceived inadequacy of their cooking skills, and therefore find it much easier to purchase prepared food instead of making …

The Impact Of Freedson Bout Vs. Non-Freedson Bout Physical Activity On Metabolic Syndrome Risk In College Students, Valerie Olijar

Masters Theses, 2010-2019

Purpose The aim of this study is to examine moderate to vigorous physical activity in Freedson bouts compared to non-Freedson bouts and their association with Metabolic Syndrome risk factors in college students.

Methods 72 subjects aged 18-26 were recruited from James Madison University. Subjects height, weight, waist circumference, blood pressure, and body composition were assessed on visit 1. Blood pressure, fasted blood glucose, and lipid profile were assessed on visit 2. Subjects wore an Actigraph GT3X+ accelerometer, which measured physical activity and sleep for 7 days and nights. Univariate Pearson correlation analyses were performed to determine the relationship physical activity …

The Role Of Simulation In Mixed-Methods Research: A Framework & Application To Patient Safety, Jeanne-Marie Guise, Matthew Hansen, William E. Lambert, Kerth O'Brien

Psychology Faculty Publications and Presentations

Background: Research in patient safety is an important area of health services research and is a national priority. It is challenging to investigate rare occurrences, explore potential causes, and account for the complex, dynamic context of healthcare - yet all are required in patient safety research. Simulation technologies have become widely accepted as education and clinical tools, but have yet to become a standard tool for research.

Methods: We developed a framework for research that integrates accepted patient safety models with mixed- methods research approaches and describe the performance of the framework in a working example of a large …

Gender Disparities In Midlife Hypertension: A Review Of The Evidence On The Arab Region, Christelle Akl, Chaza Akik, Hala Ghattas Ph.D., Carla Makhlouf Obermeyer

Faculty Publications

Objective

While gender differences in hypertension and increased prevalence rates among women at midlife have been documented in multiple settings, the evidence on the Arab world has not been systematically examined. This review summarizes the evidence related to gender disparities in midlife hypertension in this region.

Methods

We searched MEDLINE and Social Sciences Citation Index (SSCI) databases for studies, published between January 2000 and August 2015, on hypertension in the 22 countries of the Arab region. We abstracted information on the prevalence of hypertension among women and men, in general populations during midlife.

Results

Nineteen studies provided data on the …

Emergency Room Overuse And Medicaid Population: Creating A Toolkit To Decrease Er Misuse By Family Resources Clients, Nicole Johanne Morrissey Ms.

Celebration of Learning

One of the biggest issues facing healthcare in the United States is excessive spending on ER visits. This issue costs the United States healthcare field about $38 billion a year to treat patients who might not necessarily need the immediate attention. The Medicaid population is one of the highest users of the ER and the most common reasons are behavioral issues and no other place to go. Family Resources, a non-profit organization in Davenport, IA, works to connect families with healthcare facilities in the area based on each family’s needs. Much of their clientele uses Medicaid and struggles with ER. …

Not So Affordable Healthcare, Ashlee Charles

Honors College Theses

Rising healthcare cost in the United States has created a need to understand how a lack of healthcare coverage is decreasing women’s quality of life and leading to negative health outcomes. Though the goal of the 2010 Affordable Care Act is to give more Americans access to affordable health insurance and to reduce the growth in health care spending, it still remains unaffordable for many Americans. The purpose of this study was to identify what ecological factors impede and/or promote the quality of life for medically uninsured women. Through a focus group, participants shared information on how living without health …

Long-Term Trajectories Of Subjectively-And Polysomnographically-Assessed Sleep Patterns As Predictors Of Neuroendocrine Dysfunction And Weight Gain In Adults., Eric Reither

Funded Research Records

No abstract provided.

Cancer-Specific Mortality, Cure Fraction, And Noncancer Causes Of Death Among Diffuse Large B-Cell Lymphoma Patients In The Immunochemotherapy Era., Nadia Howlader, Angela B Mariotto, Caroline Besson, Gita Suneja, Kim Robien, Naji Younes, Eric A Engels

Epidemiology Faculty Publications

BACKGROUND

Survival after the diagnosis of diffuse large B-cell lymphoma (DLBCL) has been increasing since 2002 because of improved therapies; however, long-term outcomes for these patients in the modern treatment era are still unknown.

METHODS

Using Surveillance, Epidemiology, and End Results data, this study first assessed factors associated with DLBCL-specific mortality during 2002-2012. An epidemiologic risk profile, based on clinical and demographic characteristics, was used to stratify DLBCL cases into low-, medium-, and high-risk groups. The proportions of DLBCL cases that might be considered cured in these 3 risk groups was estimated. Risks of death due to various noncancer causes …

Private Sector Opportunities And Threats To Achieving Malaria Elimination In The Greater Mekong Subregion: Results From Malaria Outlet Surveys In Cambodia, The Lao Pdr, Myanmar, And Thailand., Kathryn A. O'Connell, Vamsi Vasireddy, Megan Littrell, Andria Rusk, Actwatch Group, Sochea Phok, Saysana Phanalasy, Si Thu Thein, Asawin Likhitsup

Collected Faculty Scholarship

BACKGROUND: The aim of this paper is to review multi-country evidence of private sector adherence to national regulations, guidelines, and quality-assurance standards for malaria case management and to document current coverage of private sector engagement and support through ACTwatch outlet surveys implemented in 2015 and 2016.

RESULTS: Over 76,168 outlets were screened, and approximately 6500 interviews were conducted (Cambodia, N = 1303; the Lao People's Democratic Republic (PDR), N = 724; Myanmar, N = 4395; and Thailand, N = 74). There was diversity in the types of private sector outlets providing malaria treatment across countries, and the extent to which …

Behavioral Determinants Of Physical Activity Across The Life Course: A "Determinants Of Diet And Physical Activity" (Dedipac) Umbrella Systematic Literature Review, Giancarlo Condello, Anna Puggina, Katina Aleksovska, Christoph Buck, Con Burns, Greet Cardon, Angela Carlin, Chantal Simon, Donatella Ciarapica, Tara Coppinger, Cristina Cortis, Sara D'Haese, Marieke De Craemer, Andrea Di Blasio, Sylvia Hansen, Licia Iacoviello, Johann Issartel, Pascal Izzicupo, Lina Jaeschke, Martina Kanning, Aileen Kennedy, Fiona Chun Man Ling, Agnes Luzak, Giorgio Napolitano, Julie Anne Nazare, Camille Perchoux, Caterina Pesce, Tobias Pischon, Angela Polito, Alessandra Sannella, Holger Schulz, Rhoda Sohun

Publications

Background: Low levels of physical activity (PA) are a global concern and increasing PA engagement is becoming a priority in current public health policies. Despite the large number of studies and reviews available, the evidence regarding the behavioral determinants of PA is still inconclusive. Thus, the aim of this umbrella systematic literature review (SLR) was to summarize the evidence on the behavioral determinants of PA across the life course. Methods: A systematic online search was conducted on MEDLINE, ISI Web of Science, Scopus, and SPORTDiscus databases. The search was limited to studies published in English from January, 2004 to April, …