Public Health Commons^™

The Effect Of The Implementation Of A Quarterly Triad Tool In The Pain Clinic Setting On The Assessment And Mitigation Of Risks In Patients On Chronic Opioid Therapy, Caroline Asava

Evidence-Based Practice Project Reports

The concurrent use of opioids and benzodiazepines (BZDs poses a formidable challenge for clinicians who manage chronic pain. While the escalating use of opioid analgesics for the treatment of chronic pain and the concomitant rise in opioid-related abuse and misuse are widely recognized trends, the contribution of combination use of BZDs, alcohol, and/or other sedative agents to opioid-related morbidity and mortality is underappreciated, even when these agents are used appropriately. Patients with chronic pain who use opioid analgesics along with BZDs have a defined increase in rates of adverse events, overdose, and death, warranting close monitoring. To improve patient outcomes, …

Alcohol Sale Status And Homicide Victimization In Kentucky, 2005-2012: Is There A Spatial Association?, Hanan Abdulghafoor Khaleel, Sabrina Brown, Steven T. Fleming, W. Jay Christian

Epidemiology and Environmental Health Faculty Publications

To date, the association between the alcohol sale status of decedents’ residence and alcohol-related homicide victimization have not been studied as far as we know. The current study aims to: i) determine whether homicide victims who were residents of wet counties had higher odds of testing positive for alcohol than their counterparts in moist or dry counties after adjusting for confounders; ii) determine whether homicides and alcohol-related homicides tend to cluster spatially; iii) determine whether the aforementioned associations exist only in highly-populated counties. A multilevel logistic regression analysis was used to analyze the data on homicide victims in the Kentucky …

Incorporating Oral Health Care In Pediatric Primary Care Practice, Salamatu Yusif

Evidence-Based Practice Project Reports

The most common chronic disease in childhood is dental caries and is more prevalent than asthma and hay fever (HHS, 2000). Data show that in the United States from 2011-2014, 24% of children aged 2-5 years had experienced dental caries in their primary teeth, with 11% having untreated caries (Dye et al., 2017). Primary care clinicians have an important role to play in promoting children’s oral health as much as dentists because they have more contact with children. The purpose of this evidence-based practice project was to integrate an evidence-based oral health program for children in a pediatric primary care …

The Stories Behind The Struggle: A Closer Look At First Experiences With Opioid Misuse, Khary Rigg, Shannon M. Monnat, Kate Mclean, Ashton Verdery, Glenn Sterner

Population Health Research Brief Series

Opioid use disorders and overdoses from prescription opioids, heroin, and fentanyl have become a national public health crisis. Improving our knowledge about how people first come to misuse opioids can help to inform prevention and treatment interventions. This research brief dives into the stories behind opioid use initiation and provides intervention strategies.

Rural Hospital Nursing Skill Mix And Work Environment Associated With Frequency Of Adverse Events., Jessica G. Smith, Colin M. Plover, Moira C. Mcchesney, Eileen T. Lake

College of Population Health Faculty Papers

Introduction: Though rural hospitals serve about one fifth of the United States (U.S.), few studies have investigated relationships among nursing resources and rural hospital adverse events.

Objectives: The purpose was to determine relationships among nursing skill mix (proportion of Registered Nurses (RNs) to all nursing staff), the work environment and adverse events (medication errors, patient falls with injury, pressure ulcers, and urinary tract infections) in rural hospitals.

Methods: Using a cross-sectional design, nurse survey data from a large study examining nurse organizational factors, patient safety, and quality from four U.S. states were linked to the 2006 American Hospital Association data. …

Localization Of Five Target Proteins In Tachyzoites Of Toxoplasma Gondii, Abigail M. Kaiser

USF Tampa Graduate Theses and Dissertations

Five target genes were selected in Toxoplasma gondii tachyzoites for localization studies. These five genes, detected through proteomics studies, included TgME49_227450, TgME49_223080, TgME49_262390, TgME49_230940, and TgME49_269620. Localization of these five target proteins is a first step to confirm their interaction with TgCrk2 and understand their function and role in TgCrk2 regulation of the tachyzoite cell cycle. Gene models for the targets were analyzed using ToxoDB and ApE analysis tools. Endogenous tagging constructs were created for each target. Transgenic parasites were created. Finally, localization analysis of the target proteins in tachyzoites was completed using immunofluorescent microscopy following. One protein was found …

Optimization Of Surgical Prophylaxis In Penicillin-Allergic Labeled Patients, Katie A. Vandervelde

Research Days

No abstract provided.

Childhood Obesity: Getting Back To The Basics, Fanny Powell

DNP Qualifying Manuscripts

Childhood obesity is an epidemic that affects the nation. The Centers for Disease Control and Prevention (CDC) (2015) states that over the past thirty years, the prevalence of childhood obesity has more than doubled in younger children and quadrupled in adolescents (CDC, 2015). Although obesity is a multifactorial health issue that is affected by genetics, metabolic factors, socioeconomic factors, and lifestyle choices (Stanford, 2018), a majority of pediatric obesity is as a result of consuming more energy than the body utilizes. There are both immediate and long-term consequences of obesity that negatively affect a child’s health which may carry over …

Health Care In The Caribbean: A Comparative Analysis Between Cuba And Puerto Rico, Matheus Moreira Sanches Peraci

Honors Projects

The paper at hand focuses on comparing the differences of the Cuban and Puerto Rican health care (HC) system and conditions. As this is a comparative research analysis, this was done by reviewing many different reliable sources and compiling the relevant information from Cuba and Puerto Rico. The factors that were taken into account are: (a) Political and Health Care Systems, (b) Natural and Artificial Disaster and (c) Country’s Demographics and Health Statistics.

Typical Diet Quality In New Zealand Compared To Other Westernized Countries With An Emphasis On Chronic Disease, Emily Kollar

Honors Projects

The diet quality was analyzed for people living in New Zealand and people living in other Westernized Countries (United States, Canada, Western Europe) based on the dietary guidelines. Diet quality was analyzed by looking at consumption of food groups such as fruits, vegetables, meat, and seafood as well as nutrients such as saturated/trans/unsaturated fat, sodium, and added sugars. These nutrients have been linked to certain health outcomes and chronic disease; therefore, the prevalence of chronic disease was researched to determine if there was a correlation between New Zealand's diet and their chronic disease rates in comparison to other Westernized countries.

A Cross-Sectional Questionnaire-Based Descriptive Study Exploring The Presence Of Behavioral Risk Factors For Infection With Zika Virus Among Students And Employees At An Institution Of Higher Education In South Florida., Dorothy Contiguglia-Akcan, Shasank Chennupati, Sebastian Cuitiva, Christian-Immanuel Oliveros, Carol Marie Fraley, Tiffany Race, Daniel Garrido

Florida Public Health Review

In 2016 and 2017, South Florida was involved in an outbreak of locally-transmitted Zika virus. This questionnaire- based descriptive pilot study demonstrated the presence of behaviors that may be associated with increased risk of Zika transmission in a sample of respondents selected from an institution of higher education in the region. The majority of the 101 respondents living in Miami-Dade County reported inconsistent or no use of mosquito bite prevention methods, over one third (38.6%) traveled to local areas of active transmission, and almost two thirds (64.7%) of those reporting that their sexual partners traveled to local zones of viral …

Sociodemographic Correlates Of Bariatric Surgery By Procedure Type Among A Statewide Ethnically Diverse Patient Population, Alisha Monnette, Tulay Koru-Sengul, Nadia L. Fleurantin, Sarah E. Messiah, Wayway M. Hlaing

Florida Public Health Review

Florida Agency for Health Care Administration (AHCA) 2013 inpatient data was used to conduct a retrospective review using International Classification of Diseases 9th edition (ICD-9) procedure codes to examine the sociodemographic correlates of three bariatric procedures [Laparoscopic Roux-en-Y Gastric Bypass (RYGB), Laparoscopic Adjustable Gastric Banding (LAGB), and Sleeve Gastrectomy (SG)]. Race-ethnic groups included non-Hispanic white (NHW), non- Hispanic black (NHB), Hispanic, and other. The sample (n=6,424, mean age 46 years) was predominantly NHW (57.4%), female (74.9%), commercial-insurance carriers (51.2%), and severely obese (98.8%). SG was the most common procedure (57.9%) followed by RYGB (39.3%), and LAGB (2.8%). Regardless of bariatric …

Analysis Of Tobacco Use Vital Sign Assessment, Latonya King

Electronic Theses and Dissertations

There is a massive problem of tobacco-related cancer outcomes in patients that are affected by race and ethnicity. Although this is a known disparity, there continues to be a gap in care for asking patients if they use tobacco and in advising and assisting them in making a quit attempt. Health information technology requirements and meaningful use regulations require the utilization of systematic electronic documentation. In order to improve and support tobacco use screening, systematic tobacco use assessment and documentation are essential. There is a widespread belief that adding screening for tobacco use to the vital sign assessment will lead …

The Efficacy Of An Educational Intervention To Improve Low Influenza Vaccination Rates Among Federal Health Care Workers, Cynthia Berfect-Shelby

Electronic Theses and Dissertations

Influenza is a preventable communicable illness that has a significant impact on people of all ages. In 2018 it was estimated that 80,000 people died of influenza-related illnesses. Infants and elderly people are among the most vulnerable populations. The Centers for Disease Control and Prevention and Healthy People 2020 recommend that health care facilities have a 90% vaccination rate. Despite the recommendations and a mandatory directive, many facilities within the Veterans Health Administration struggle to reach influenza vaccination rates above 60%. Pender’s health promotion model was used as the theoretical framework to explore the reasons why health care workers refuse …

Public Health Policy: An Ethical Analysis Of Quarantine, Dina Alqahtani

Electronic Theses and Dissertations

As a public health measure quarantine has both historical and contemporary significance both in the United States and abroad. On the surface it represents a low-cost, low-tech way in which the spread of disease can be mitigated as its core requirement is that those who may have been exposed to an infectious agent are kept away from those who have not been exposed to that agent for enough time to determine whether or not infection has been spread. This has been utilized for centuries with both limited questions and scattered, inconsistent, or impossible to achieve oversight and goals. In understanding …

A Multifaceted Approach To Antibiotic Stewardship In The Outpatient Clinical Setting For Bronchitis, Elizabeth A. Weaver

Evidence-Based Practice Project Reports

Antimicrobial resistance is a world-wide health crisis (Infectious Disease Society of America [IDSA], 2016; World Health Organization [WHO], 2017) expedited by the overuse/inappropriate use of antibiotics. In the outpatient setting it has been determined that approximately 60% of antibiotic therapies are prescribed (Centers for Disease Control and Prevention [CDC], 2016). Antibiotic stewardship is the coordinated effort to improve the use of antibiotic therapies, minimize misdiagnosis and delayed diagnosis and select appropriate antibiotic drug regimens (IDSA, 2016). The purpose of this evidence-based practice project was to evaluate the effects of an antibiotic stewardship program (presentation, survey collection, bimonthly e-mail reminders, patient …

Use Of Smartphone Application To Facilitate Weight Loss And Promote Accountability In Obese And Overweight Patients, Angela M. Turner

Evidence-Based Practice Project Reports

In 2015, the U.S. Department of Health and Human Services published a National Health and Nutrition Survey (NHANES) on obesity from 2011 through 2014. From the survey, it was determined that the prevalence of obesity in the U.S. was 36% in adults and 17% in young adults/children (Ogden et al., 2015). Lifestyle modifications including moderation of caloric intake and increased exercise have been shown to be effective for both prevention and treatment of obesity. The purpose of this evidence-based practice (EBP) project involved the design, administration, and evaluation of a technology-assisted weight loss intervention to address the health problem of …

Health Literacy Screening To Increase Antihypertensive Medication Adherence, Boyann Bonjean

Evidence-Based Practice Project Reports

Hypertension contributes to the risk of developing cardiovascular disease (CVD), stroke, heart attack, and chronic kidney disease (CKD) (Abegaz et al., 2016; Weir, 2014; Whelton et al., 2017). Evidence indicates that 30 to 50% of people who are prescribed antihypertensive medication therapy are nonadherent (Hedna et al., 2015). Non-adherence to antihypertensive medications is a major contributor to hypertension treatment failure (Al Ghurair et al., 2012; Hu, 2016; Whelton et al., 2017). Evidence has shown that low health literacy may impact antihypertensive therapy (Slade, 2017). The purpose of this EBP project was to provide an organizational change by implementing a health …

Precision Medicine And It's Ethical And Social Implications: Public Health And Gobal Persepctives, Evangel Sarwar

Electronic Theses and Dissertations

Ever since President Obama's launch of the Precision Medicine Initiative (PMI) in 2015, precision medicine (PM) has been anticipated as the new paradigm for healthcare with the capacity to “empower patients, researchers, and providers to work together toward the development of individualized care,” through research, technologies, and policies (President Obama, 2015). Precision Medicine (PM), in the form of genomics, offers unprecedented promise of providing new tools for improving health and reducing the burden of diseases, not just for the U.S. - but also globally. According to World Health Organization, genomics research and precision medicine will play a major part in …

Perceptions Of Parents And Religious Leaders Regarding Minimal Invasive Tissue Sampling To Identify The Cause Of Death In Stillbirths And Neonates: Results From A Qualitative Study, Anam Shahil Feroz, Mohsina Noor Ibrahim, Elizabeth M. Mcclure, Anum Shiraz Ali, Shiyam Sunder Tikmani, Sayyeda Reza, Zahid Abbasi, Jamal Raza, Haleema Yasmin, Khadija Bano, Afia Zafar, Sameen Siddiqi, Robert L. Goldenberg, Sarah Saleem

Community Health Sciences

Background: Recently, the minimal invasive tissue sampling (MITS) procedure has been developed to support determination of the cause of death as an alternate to conventional autopsy, especially in countries where complete diagnostic autopsy is not routine. To assess the feasibility of implementation of the MITS procedure for a study to determine cause of death in premature births and stillbirths in south Asia, we explored the views and perceptions of parents and religious leaders on the acceptability of MITS.
Methods: A qualitative study was conducted at the National Institute of Child Health (NICH) hospital of Karachi, Pakistan. Focus group discussions (FGDs) …

Vile Blood: Hereditary Degeneracy In Victorian England, Dalton Lee Brock

Theses and Dissertations from 2019

During the late 1800s, the people of England grew anxious about hereditary degeneracy. That anxiety was rooted in the medical literature of the Victorian period. Nature predetermined individuals to be either healthy or unhealthy. Unhealthy individuals were marked by degenerative mental or physical characteristics such as epilepsy. Medical professionals, including Henry Maudsley, emphasized reversion and its hereditary nature as a threat to individuals and society. All based their works and arguments on Charles Darwin’s idea of inheritance. Darwin, in turn, had adopted and modified Lamarckian inheritance to make up for the absence of an inheritance principle in his theory of …

Rising Rural Body-Mass Index Is The Main Driver Of The Global Obesity Epidemic In Adults, Honor Bixby, James Bentham, Bin Zhou, Mariachiara Di Cesare, Christopher J. Paciorek, James E. Bennett, Cristina Taddei, Gretchen A. Stevens, Andrea Rodriguez-Martinez, Rodrigo M. Carrillo-Larco, Young Ho Khang, Maroje Sorić, Edward W. Gregg, J. Jaime Miranda, Zulfiqar A. Bhutta

Journal Articles

Body-mass index (BMI) has increased steadily in most countries in parallel with a rise in the proportion of the population who live in cities1,2. This has led to a widely reported view that urbanization is one of the most important drivers of the global rise in obesity3–6. Here we use 2,009 population-based studies, with measurements of height and weight in more than 112 million adults, to report national, regional and global trends in mean BMI segregated by place of residence (a rural or urban area) from 1985 to 2017. We show that, contrary to the dominant paradigm, more than 55% …

Redesigning Systems To Improve Teamwork And Quality For Hospitalized Patients (Reset): Study Protocol Evaluating The Effect Of Mentored Implementation To Redesign Clinical Microsystems, Kevin J. O'Leary, Julie K. Johnson, Milisa Manojlovich, Jenna D. Goldstein, Jungwha Lee, Mark V. Williams

Center for Health Services Research Faculty Publications

Background: A number of challenges impede our ability to consistently provide high quality care to patients hospitalized with medical conditions. Teams are large, team membership continually evolves, and physicians are often spread across multiple units and floors. Moreover, patients and family members are generally poorly informed and lack opportunities to partner in decision making. Prior studies have tested interventions to redesign aspects of the care delivery system for hospitalized medical patients, but the majority have evaluated the effect of a single intervention. We believe these interventions represent complementary and mutually reinforcing components of a redesigned clinical microsystem. Our specific objective …

Rising Rural Body-Mass Index Is The Main Driver Of The Global Obesity Epidemic In Adults, Con Burns, Tara Coppinger, Janette Walton, Et Al

Publications

Body-mass index (BMI) has increased steadily in most countries in parallel with a rise in the proportion of the population who live in cities1,2. This has led to a widely reported view that urbanization is one of the most important drivers of the global rise in obesity3,4,5,6. Here we use 2,009 population-based studies, with measurements of height and weight in more than 112 million adults, to report national, regional and global trends in mean BMI segregated by place of residence (a rural or urban area) from 1985 to …

Temporal Trends In Cardiovascular Hospital Discharges Following A Mass Chlorine Exposure Event In Graniteville, South Carolina, Ashley V. Howell, John E. Vena, Bo Cai, Daniel T. Lackland, Lucy Ingram, Andrew B. Lawson, Erik R. Svendsen

Faculty Publications

Background: On January 6, 2005, a train derailed in Graniteville, South Carolina, releasing nearly 60,000 kg of toxic chlorine gas. The disaster left nine people dead and was responsible for hundreds of hospitalizations and outpatient visits in the subsequent weeks. While chlorine gas primarily affects the respiratory tract, a growing body of evidence suggests that acute exposure may also cause vascular injury and cardiac toxicity. Here, we describe the incidence of cardiovascular hospitalizations among residents of the zip codes most affected by the chlorine gas plume, and compare the incidence of cardiovascular discharges in the years leading up to the …

An Exploration Of Factors Of Lgbt Cultural Competency Among Prospective Healthcare Professionals, Heather Isbell

Electronic Theses and Dissertations

Literature suggests there is a relationship between cultural competency and health outcomes as well as a perceived fear of discrimination LGBT individuals face when attempting to receive healthcare services. The aim of this study is to assess the level of LGBT CC (cultural competency) among prospective professionals who are expected to provide health care services and to explore factors that affect those attributes. Multiple linear regressions were conducted to test the effect of the following factors of LGBT CC: postsecondary experience, relations with LGBT individuals, and religion using a sample of 57 different healthcare students in a faith-based university during …

Résistance Des Garde-Corps En Bois Fixés Sur Des Structures Neuves Et Comportement Sous Charges De Garde-Corps Métalliques Fixés Sur Des Structures Existantes, Bertrand Galy, André Lan

Rapports de recherche scientifique

Malgré les réglementations nationales et internationales qui exigent de protéger les travailleurs exposés à un risque de chute, les chutes de hauteur restent l’une des principales causes de décès pour les travailleurs de la construction. Elles sont la deuxième cause d’accidents en ce qui a trait aux coûts (397 millions de dollars par an sur la période 2010-2012) et représentent 16,1 % des décès au travail en 2017. Les garde-corps temporaires sont un moyen efficace de protection contre les chutes de hauteur, par ailleurs, s’agissant d’un moyen de protection passif, ils permettent de maintenir une productivité élevée. La conception des …

Social Determinants Of Health And Variability In Weight Trends Of Children Of Low Income Families Living In New Mexico, Molly Aileen Morrison

Individual, Family, and Community Education ETDs

When evaluating the prevalence of obesity rates throughout New Mexico (NM), it appears these rates have reached a plateau. A recent study conducted by the NM Department of Health (DOH) found that NM was among 19 other states that have had a first time decrease in child obesity rates among low income families. However, when examined deeper, when looking at geographical areas throughout NM, hidden geography of weight disparities become apparent. Although obesity rates may have decreased in some areas, they have increased in others. The purpose of this study is to effectively evaluate variability in weight trends between geographical …

“I Don’T Know If I Have The Courage”: Reproductive Choices In Times Of Zika, Ana Rosa Linde Arias, Elisa Tristan-Cheever, Grace Furtado, Eduardo Siqueira

Gastón Institute Publications

Neste estudo transnacional, pretendemos fornecer informações sobre as opiniões e atitudes das mulheres em relação aos seus direitos reprodutivos durante a epidemia do Zika. Mulheres de diferentes nacionalidades e etnias foram recrutadas em vários locais do Brasil, Porto Rico e Estados Unidos. Foram realizadas entrevistas semiestruturadas que sugerem que as decisões reprodutivas dos participantes estavam intimamente relacionadas às convicções pessoais e crenças culturais, e suas ações e pensamentos foram incorporados em suas normas socioculturais. A maioria das mulheres entrevistadas comunicou que é preciso coragem para tomar a decisão extrema, emocional e esmagadora de fazer um aborto. Os achados deste estudo …

Health Literacy Challenges And Opportunities: Bringing Children’S Mercy And Kansas City Together, Jennifer A. Lyon, Angie Knackstedt, Barbra Rudder, Mamta Reddy Md, Courtney R. Butler

Posters

BACKGROUND: A multidisciplinary group at Children's Mercy Kansas City applied for and received the NNLM MCR's Immersive Workshop Grant in December, 2017, and used the funding to organize and host a two-day immersive, interprofessional workshop in April, 2018, that 1) brought together health literacy-invested groups and individuals within the Kansas City community to learn about health literacy including cultural, language, numeracy and digital inclusion factors; and 2) provided specialized training to targeted CM participants to improve the provision of bedside health information to patients and caregivers. Objectives included: increasing community-wide collaboration, sharing resources, encouraging participants to become change agents, and …