Public Health Commons^™

Burden Of Lipohypertrophy Among Insulin Dependent Diabetes Mellitus Patients In China: An Analysis Of Outcomes And Impact Of Pen Needle Reimbursement Policy, Arthi Chandran

Dissertations and Theses

Background

Diabetes is a global epidemic and with an aging population accompanied by rapid urbanization China ranks highest in disease prevalence and associated burden. Independent of diabetes type, insulin is an eventual and costly requirement for disease management. The consequences of insulin administration however are poorly understood. Lipohypertrophy (LH) is one such consequence. It is hypothesized that method of insulin delivery and poor delivery technique are significant risk factors for this condition which is believed to alter insulin pharmacodynamics. Subsequently, insulin pen needles are a critical component of care however access to pen needles varies across China.

Objective

The objective …

Using The Theory Of Planned Behavior To Understand Student Compliance To Tobacco-Free Policies In California Universities, Harit Agroia

Loma Linda University Electronic Theses, Dissertations & Projects

Background: In California, the mortality rate associated with smoking ranks as the sixth highest among all states in the nation (CDPH, 2016). To reduce this rate, many universities in California have adopted tobacco-free policies in recent years (Mamudu, Veeranki, Kioko, Boghozian & Littleton, 2016). Due to the recent adoption of such policies, there is limited research available which aim to assess the effectiveness of these on tobacco use behavior on campus among university students.

Purpose: The purpose of this study was to understand student compliance to tobacco-free policies within select universities in California, specifically those that implemented their …

Metabolic Syndrome And The Risk Of Breast Cancer And Subtypes By Race, Menopause And Bmi, Daniel T. Dibaba, Dejana Braithwaite, Tomi Akinyemiju

Epidemiology and Environmental Health Faculty Publications

The objective of this study was to investigate the association of metabolic syndrome (MetS) with the risk of invasive breast cancer and molecular subtypes across race, menopause, and body mass index (BMI) groups. We examined the association of metabolic syndrome and its components with risk of invasive breast cancer among 94,555 female participants of the National Institute of Health-American Association of Retired Persons (NIH-AARP) Diet and Health Study, accounting for ductal carcinoma in situ as a competing risk. Cox proportional hazard regression with the Fine and Gray method was used to generate hazard ratios (HR) and 95% confidence intervals (CI) …

Hypermethylation Of Mir21 In Cd4+ T Cells From Patients With Relapsing-Remitting Multiple Sclerosis Associates With Lower Mirna-21 Levels And Concomitant Up-Regulation Of Its Target Genes, Sabrina Ruhrmann, Ewoud Ewing, Eliane Piket, Lara Kular, Julio Cesar Cetrulo Lorenzi, Sunjay Jude Fernandes, Hiromasa Morikawa, Shahin Aeinehband, Sergi Sayols-Baixeras, Stella Aslibekyan, Devin M. Absher, Donna K. Arnett, Jesper Tegner, David Gomez-Cabrero, Fredrik Piehl, Maja Jagodic

Epidemiology and Environmental Health Faculty Publications

Background: Multiple sclerosis (MS) is a chronic inflammatory disease of the central nervous system caused by genetic and environmental factors. DNA methylation, an epigenetic mechanism that controls genome activity, may provide a link between genetic and environmental risk factors.

Objective: We sought to identify DNA methylation changes in CD4+ T cells in patients with relapsing-remitting (RR-MS) and secondary-progressive (SP-MS) disease and healthy controls (HC).

Methods: We performed DNA methylation analysis in CD4+ T cells from RR-MS, SP-MS, and HC and associated identified changes with the nearby risk allele, smoking, age, and gene expression.

Results: We observed significant methylation differences in …

Race Analysis In An African American Majority Sample Of Individuals With Serious Mental Illness And Comorbid Diabetes Participating In A Self-Management Research Treatment Trail, Martha Sajatovic, Molly Howland, Douglas Gunzler, Kristin A. Cassidy, Richard Mccormick, Thomas Scheidemantel, Charles Thomas, Carol Blixen, Neal V. Dawson

Faculty Scholarship

Objectives: Targeted Training in Illness Management (TTIM) focuses on enhancing care engagement for people living with serious mental illness and diabetes. This secondary analysis from a 60-week, randomized controlled trial of TTIM versus treatment as usual evaluated racial subgroup outcomes. Method: Demographics, clinical characteristics, and diabetes status were evaluated for those self-identifying as non-Hispanic White, African American, and Hispanic. Longitudinal response to TTIM was evaluated using a multiple domain risk index. Due to their small sample size; those identifying as Hispanic were excluded from this analysis. Results: Non-Hispanic White participants had greater baseline socioeconomic advantages. Baseline risk scores, glycosylated hemoglobin …

Patient Safety And The Ageing Physician: A Qualitative Study Of Key Stakeholder Attitudes And Experiences, Andrew A. White, William M. Sage, Paulina H. Osinska, Monica J. Salgaonkar, Thomas H. Gallagher

Faculty Scholarship

Background Unprecedented numbers of physicians are practicing past age 65. Unlike other safety-conscious industries, such as aviation, medicine lacks robust systems to ensure late-career physician (LCP) competence while promoting career longevity.

Objective To describe the attitudes of key stakeholders about the oversight of LCPs and principles that might shape policy development.

Design Thematic content analysis of interviews and focus groups.

Participants 40 representatives of stakeholder groups including state medical board leaders, institutional chief medical officers, senior physicians (>65 years old), patient advocates (patients or family members in advocacy roles), nurses and junior physicians. Participants represented a balanced sample from …

Increasing Access To Pre-Exposure Prophylaxis (Prep) Among Transgender Women And Trans Feminine Non-Binary Individuals In New York City, Augustus Klein

Dissertations, Theses, and Capstone Projects

In the United States transgender women (i.e., individuals born male whose gender identity is on the feminine spectrum) are a highly vulnerable and marginalized population at high risk for HIV. Substance use, survival sex work, depression, unstable housing, and high levels of victimization and violence are commonly reported by transgender women and trans feminine individuals, indicating the potential for multiple concurrent HIV risks and underlying vulnerabilities. Structural forms of discrimination may contribute to these risk factors, possibly leading to poor outcomes such as unemployment or underemployment, homelessness, and lack of access to gender-affirming health care. Given this context, a biomedical …

Casualties Of Racism: Racial And Ethnic Discrimination And Suicidal Thoughts And Behaviors Among Racial And Ethnic Minority Emerging Adults, Lillian Anais Polanco

Dissertations, Theses, and Capstone Projects

The evidence demonstrating that experiences of racial/ethnic discrimination is detrimental to the mental health of racial/ethnic minority youth is unequivocal. What remains unclear, however, is whether racial/ethnic discrimination increases vulnerability for suicidal thoughts and behaviors in particular, and if so, what are the underlying mechanisms to explain this relation. Drawing upon the Race-based Traumatic Stress Theory (Carter, 2007), which suggests that some individuals may experience racial/ethnic discrimination as a traumatic stressor, and thus, eliciting a traumatic stress response, the present study examined posttraumatic stress reactions (i.e., posttraumatic stress, depression, dissociation, stress sensitivity) as mediators in the relation between racial/ethnic discrimination …

Linking Hostile/Helpless Maternal Representations In Pregnancy And Later Child Protection Involvement: A Pilot Study, Madeleine Terry

Dissertations, Theses, and Capstone Projects

The present pilot study examined whether there are reliable indices in the narratives of pregnant women that can be used to identify child abuse and neglect potential before the birth of the child. The Hostile/Helpless (HH) Classification system (Lyons-Ruth et al., 1995-2005), which detects mental states associated with trauma, disturbances in early attachment, and severe pathology, was adapted for use with the Pregnancy Interview (PI), a semi-structured clinical interview (Slade, 2003) that assesses a woman's emotional experience of pregnancy, and quality of her developing relationship with her baby. The study sample was drawn from a replication study of the Minding …

Stereotype Threat As An Explanation For Sexual Risk Taking Behavior In Gay Men: A Multi-Study Exploration Of Mechanisms, Inna Saboshchuk

Dissertations, Theses, and Capstone Projects

Stereotype threat is a hindrance in performance that occurs when an individual’s awareness of negative stereotypes associated with his/her group results in inadvertent conforming to that stereotype. Stereotype threat research has been conducted on myriad group and domain identifications but gay men are strikingly absent from the stereotype threat literature. One of the most prevalent stereotypes about gay men indicates they are sexually promiscuous and that this promiscuity is linked to HIV infection. In a series of three research projects, a theoretical model proposing stereotype threat as a mechanism for sexual risk taking behavior in gay men is tested. In …

Influenza Virus Infectivity Is Retained In Aerosols And Droplets Independent Of Relative Humidity, Karen A. Kormuth, Kaisen Lin, Aaron J. Prussin, Eric P. Vejerano, Andrea J. Tiwari, Steve S. Cox, Micheal M. Myerburg, Seema S. Lakdawala, Linsey C. Marr

Faculty Publications

Pandemic and seasonal influenza viruses can be transmitted through aerosols and droplets, in which viruses must remain stable and infectious across a wide range of environmental conditions. Using humidity-controlled chambers, we studied the impact of relative humidity on the stability of 2009 pandemic influenza A(H1N1) virus in suspended aerosols and stationary droplets. Contrary to the prevailing paradigm that humidity modulates the stability of respiratory viruses in aerosols, we found that viruses supplemented with material from the apical surface of differentiated primary human airway epithelial cells remained equally infectious for 1 hour at all relative humidities tested. This sustained infectivity was …

Development And Implementation Of A Mobile Device-Based Pediatric Electronic Decision Support Tool As Part Of A National Practice Standardization Project, Russell J. Mcculloh, Sarah Fouquet, Joshua Herigon, Eric A. Biondi, Brandan Kennedy, Ellen Kerns, Adrienne G. Deporre, Jessica L. Markham, Y Raymond Chan, Krista Nelson, Jason G. Newland

Manuscripts, Articles, Book Chapters and Other Papers

© The Author(s) 2018.

Objective: Implementing evidence-based practices requires a multi-faceted approach. Electronic clinical decision support (ECDS) tools may encourage evidence-based practice adoption. However, data regarding the role of mobile ECDS tools in pediatrics is scant. Our objective is to describe the development, distribution, and usage patterns of a smartphone-based ECDS tool within a national practice standardization project.

Materials and Methods: We developed a smartphone-based ECDS tool for use in the American Academy of Pediatrics, Value in Inpatient Pediatrics Network project entitled "Reducing Excessive Variation in the Infant Sepsis Evaluation (REVISE)." The mobile application (app), PedsGuide, was developed using evidence-based …

Unequal Hopes, Lives, And Lifespans In The Usa: Lessons From The New Science Of Well-Being, Carol Graham

Center for Policy Research

Given that we have had historic increases in inequality, as well as stagnant poverty levels for several decades, I will tell the story of poverty and inequality in the U.S. from the perspective of the metrics of happiness and well-being. My research—and the book that resulted—found that inequality is part of this story, but not the only part. The story was much more complicated than I anticipated. One of the most interesting parts of the story includes different levels of hope and resilience across races and places. Poverty and inequality play a big role, but there is much more to …

Cancer In Louisiana: 2011-2015, Volume 33, Louisiana Tumor Registry, Lauren Maniscalco, Jennifer French, Carla Rosales, Christina Lefante, Mei-Chin Hsieh, Lu Zhang, Yong Yi, Lisa Pareti, Brent Mumphrey, Mary Anne Lynch, Xiao-Cheng Wu

Policy & Position Papers

Mission:

To collect and report complete, high-quality, and timely population-based cancer data in Louisiana to support cancer research, control, and prevention.

Vision:

To reduce suffering and death from cancer using information collected by the Louisiana Tumor Registry.

History:

Cancer registration in Louisiana began in 1947 at the Charity Hospital Tumor Registry in New Orleans. In 1974, as part of its Surveillance, Epidemiology and End Results (SEER) Program, the National Cancer Institute provided funds for a population-based cancer incidence and survival registry covering Jefferson, Orleans, and St. Bernard parishes. Five years later, the Louisiana Tumor Registry (LTR) was transferred to the …

Evaluation Of A Competency-Based Health Policy Training Program, Jim P. Stimpson, Kathleen Brandert, Brandon Grimm, Fernando A. Wilson

Reports: Center for Health Policy

An academic and practice partnership was formed to create and implement a competency-based training program for local health departments in health policy. We evaluated if the training program improved the policy knowledge and competency of participants.

Participants exhibited significant increases for self-assessed policy competency, including substantial improvements in “Critique the feasibility and expected outcomes of potential policy options”, “Identify and assess the strengths and motivations of key stakeholders and potential resistors”, and “Recommend a specific policy change”.

The policy competency instrument developed in this report could be used to measure policy knowledge and competency in future training implementations.

Evaluation Of A Competency-Based Health Policy Training Program, Jim P. Stimpson, Kathleen Brandert, Brandon Grimm, Fernando A. Wilson

Reports: Center for Health Policy

No abstract provided.

Economic Implications Of Tobacco Use For The State Of Nebraska Government, Fernando A. Wilson, Nizar K. Wehbi, Ali S. Khan

Reports: Center for Health Policy

We examine smoking-related expenditures for the state Medicaid program and for lost productivity among state government employees. The predicted number of new diagnoses of smoking-related illnesses among government employees ranged from 109 cases of kidney disease to 856 cases of arthritis and related diseases. We estimate over 6,000 lost workdays due to sick leave among currently smoking vs. non-smoking employees. Smoking-related illness is estimated to increase state budgetary expenditures on Medicaid by approximately $114.9 million annually.

It's About Communities: The Commitment To Promoting A Culturally Competent Environmental Health Workforce, Clint Pinion Jr., Leslie D. Mitchell, Jason W. Marion

EKU Faculty and Staff Scholarship

Environmental health and public health are profoundly local. The Association of Environmental Health Academic Programs (AEHAP) firmly agrees and for this reason, it is important to have local environmental health experts who know the pulse of their communities. AEHAP believes in supporting the advanced scientific education of environmental health in these communities through people from these communities. Accordingly, AEHAP has sought to promote and support accredited environmental health programs among a diverse cross-section of the U.S. higher education landscape. AEHAP’s students are diverse in many ways, including socioeconomically, racially, ethnically, and culturally. The value of this approach enhances the overall …

Reducing Typhoid Burden Within A Generation, Zulfiqar Ahmed Bhutta, Anita K. M. Zaidi, Tikki Pangestu

Department of Paediatrics and Child Health

No abstract provided.

College Of Public Health News, Georgia Southern University

College of Public Health: News & Publications

• American Statistical Association (ASA) announces 2018 winner of Award for Outstanding Statistical Contributions for the Betterment of Society

Factors Influencing Immunisation Schedule Adherence And Completion At The Regional Level In The Philippines, Paolo Miguel Manalang Vicerra

Kesmas

Penyebab utama kematian bayi sebagian besar dapat dicegah dan terdapat alasan baik dari sisi suplai maupun permintaan layanan kesehatan hal itu dapat terus berlangsung. Penelitian ini bertujuan memastikan faktor-faktor yang memengaruhi perilaku layanan kesehatan preventif imunisasi bayi di Filipina yang tepat waktu karena tingkat kelengkapan, atau kepatuhan, telah stabil dalam beberapa dekade terakhir. Metode yang digunakan adalah pembuatan model statistik di tingkat subnasional. Sampel berisi bayi yang lahir sebelum Survei Demografi dan Kesehatan Nasional Filipina tahun 2013 untuk menentukan kepatuhan yang tepat terhadap jadwal imunisasi yang dimandatkan oleh pemerintah. Hal ini melibatkan penggabungan 17 wilayah administratif negara ke tiga wilayah …

Husband’S Support For Their Wives In Antenatal Care Visit, Awalia Hanifah, Hadi Pratomo, Giang Hoang

Kesmas

Di wilayah Puskesmas Cimanggis, Kota Depok, cakupan kunjungan antenatal pertama (K1) dan kunjungan ke-4 (K4) sebesar 99,4% (2013) dan 91% (2014). Dukungan suami ibu hamil merupakan salah satu faktor yang berperan penting dalam kunjungan antenatal pada ibu hamil. Penelitian ini bertujuan menilai faktor predisposisi, pemungkin dan penguat dari dukungan suami terhadap ANC istrinya dengan menggunakan pendekatan kualitatif dengan desain Rapid Assessment Procedure. Lima suami dan istrinya yang sedang hamil dipilih sebagai informan serta dua bidan puskesmas sebagai informan kunci. Analisis data menggunakan matriks data kualitatif dan teknik analisis tematik. Hasil penelitian menunjukkan bahwa faktor predisposisi, pemungkin dan penguat dari suami …

Influential Host Factors To The Incidence Of Hiv/Aids In Key Populations In Pati District, Dwi Murtono, Puguh Riyanto, Zahroh Shaluhiyah

Kesmas

Human Immunodeficiency Virus (HIV) dan Acquired Immune Deficiency Syndrome (AIDS) merupakan penyakit berbahaya di dunia yang salah satu metode penularannya adalah melalui hubungan seksual. Penelitian ini bertujuan menjelaskan faktor-faktor yang berpengaruh terhadap kejadian HIV/AIDS pada populasi kunci. Penelitian dilakukan dari bulan Maret sampai September 2016. Penelitian analitik observasional dengan rancangan kasus kontrol pada populasi kunci di Kabupaten Pati. Kasus sebanyak 53 pasien positif HIV/AIDS, sedangkan kontrol sebanyak 53 pasien negative HIV/AIDS.Pengambilan sampel menggunakan teknik consecutive sampling. Data diperoleh dari riwayat medis dan wawancara kuesioner. Penelitian ini menggunakan uji kai kuadrat pada analisis bivariat dan regresi logistik ganda pada analisis multivariat. …

Unsafe Behavior Of Workers In Rotary Lathe Section In One Of The Plywood Industries In East Kalimantan, Iwan Muhamad Ramdan, Dyyka Indah Wijayanti

Kesmas

Kecelakaan kerja dan penyakit akibat kerja masih menjadi masalah kesehatan dunia, dua faktor utama penyebabnya adalah perilaku dan kondisi lingkungan kerja yang tidak aman. Penelitian sebelumnya membuktikan penyebab utamanya adalah faktor perilaku yang tidak aman. Penelitian ini bertujuan menganalisis faktor-faktor yang berhubungan dengan perilaku tidak aman dalam bekerja pada tenaga kerja di PT IAW dan menganalisis faktor yang paling berpengaruh. Penelitian potong lintang dilakukan pada bulan Juli sampai Agustus 2016 terhadap 104 sampel penelitian. Variabel bebas terdiri dari persepsi, komunikasi, pengawasan, ketersediaan alat pelindung diri (APD), pelatihan dan suhu lingkungan kerja. Variabel terikat adalah perilaku tidak aman. Analisis data menggunakan …

Direct Experience With Cervical Cancer Patient, Husband Support, And Self-Perception As Determinant Factors Of Women’S Desire To Take Via Screening Test, Nur Anisah Rahmawati, Linda Dewanti

Kesmas

Kanker serviks menyebabkan 10.3% kematian pada perempuan di Indonesia. Inspeksi visual asam asetat (IVA) telah digunakan untuk program skrining sejak tahun 2014 tetapi hanya 2,45 % perempuan yang melakukan pemeriksaan pada tahun 2015. Di tempat penelitian, cakupan skrining metode IVA kurang dari 1%. Penelitian sebelumnya menyebutkan faktor psikososial sebagai satu faktor penting, tetapi sedikit penelitian yang menganalisis peran dukungan suami dan pengalaman langsung dengan penderita kanker serviks. Penelitian ini bertujuan mempelajari hubungan antara pengalaman langsung dengan penderita kanker serviks, dukungan suami, persepsi diri dan keinginan perempuan melakukan skrining IVA. Penelitian potong lintang dilakukan secara acak pada perempuan berusia 25-55 tahun …

Web-Based Application To Support Physical Fitness Information Of Elderly People, Yudhy Dharmawan, Suroto Suroto, Priguna Septia Putra

Kesmas

Penduduk lanjut usia (lansia) semakin banyak seiring meningkatnya usia harapan hidup. Banyak upaya yang harus dilakukan untuk mencegah kesakitan di lansia, salah satunya dari aspek preventif dengan menjaga kebugaran para lansia. Untuk memonitor status kebugaran lansia, maka diperlukan aplikasi pemantauan kebugaran jasmani berbasis teknologi web karena tidak ada sistem yang merekam data kebugaran para lansia. Aplikasi ini ditujukan untuk merekam data kebugaran jasmani para lansia untuk merekomendasikan gym yang sesuai berdasarkan kondisi kesehatan yang dapat diakses di mana saja. Aplikasi ini dibuat dengan bahasa pemrograman PHP dan MYSQL sebagai pengolahan basis data yang dilengkapi dengan grafik untuk memantau kebugaran jasmaninya. …

The Implementation Of Documentation By Midwives In Pekanbaru, Wan Anita

Kesmas

Dokumentasi kebidanan adalah suatu bukti pencatatan dan pelaporan yang dimiliki oleh bidan dalam melakukan catatan perawatan yang berguna untuk kepentingan pasien, bidan, dan tim kesehatan. Pendokumentasian dapat diterapkan dengan metode Subjektif, Objektif, Analisa dan Perencanaan (SOAP). Penelitian ini bertujuan mengetahui faktor-faktor yang berhubungan dengan pelaksanaan dokumentasi SOAP oleh bidan di Kota Pekanbaru tahun 2016. Penelitian bersifat kuantitatif analitik observasional dengan desain penelitian potong lintang analitik. Sampel penelitian adalah seluruh populasi bidan yang praktik mandiri atau di rumah bersalin di Kota Pekanbaru dengan jumlah sampel sebanyak 191 bidan yang diambil dengan prosedur systematic random sampling. Data dikumpulkan melalui wawancara langsung dengan …

Adolescent’S Knowledge And Skill To Refuse Drugs, Lucky Herawati, Johan Arief Budiman, Haryono Haryono

Kesmas

Berbagai upaya telah dilakukan untuk mencegah remaja dari penggunaan narkoba, kendatipun evaluasi pengetahuan dan keterampilan remaja menolak narkoba belum pernah dilakukan. Penelitian ini dilakukan pada 300 remaja, siswa kelas 7 atau setara usia 12-15 tahun di dua kota di Provinsi Daerah Istimewa Yogyakarta. Penelitian analitik bertujuan mengetahui gambaran pengetahuan, keterampilan remaja menolak narkoba, dan hubungan keduanya dengan karakteristik remaja. Variabel yang diteliti adalah pengetahuan remaja tentang narkoba, keterampilan menolak narkoba, dan karakteristik remaja, yang dikumpulkan dengan menggunakan kuesioner (self-reported questionnaire). Data dianalisis dengan uji korelasi Pearson dan Spearman rho, dengan tingkat signifikansi 95 persen. Hasil penelitian menunjukkan bahwa rata-rata nilai …

Evaluation Of Self-Report Adherence Measures And Their Associations With Detectable Viral Load Among People Living With Hiv (Plhiv) In China, Wendi Da, Xiaoming Li Ph.D., Shan Qiao Ph.D., Yuejiao Zhou, Zhiyong Shen

Faculty Publications

Objectives Self-report antiretroviral therapy (ART) adherence has been consistently associated with clinical outcomes. This study aims to compare the accuracy of self-report ART adherence measures with varying recall timeframes or item contents to predict virological response.

Methods Data from a cross-sectional study among 2146 participants on ART in Guangxi, China were used. Detectable viral load was defined as viral load > 50 copies/ml. Adherence was measured using the number of days on which all doses were taken in the past month (i.e., the “one-month days taken” measure), the number of days on which any dose was missed in the past month …

The Association Between Physical Inactivity And Obesity Is Modified By Five Domains Of Environmental Quality In U.S. Adults: A Cross-Sectional Study, Christine L. Gray, Lynne C. Messer, Kristen M. Rappazzo, Jyotsna S. Jagai, Shannon C. Grabich, Danelle T. Lobdell

OHSU-PSU School of Public Health Faculty Publications and Presentations

Physical inactivity is a primary contributor to the obesity epidemic, but may be promoted or hindered by environmental factors. To examine how cumulative environmental quality may modify the inactivity-obesity relationship, we conducted a cross-sectional study by linking county-level Behavioral Risk Factor Surveillance System data with the Environmental Quality Index (EQI), a composite measure of five environmental domains (air, water, land, built, sociodemographic) across all U.S. counties. We estimated the county-level association (N = 3,137 counties) between 2009 age-adjusted leisure-time physical inactivity (LTPIA) and 2010 age-adjusted obesity from BRFSS across EQI tertiles using multi-level linear regression, with a random intercept for …