Public Health Commons^™

Barriers And Facilitating Factors To The Integration Of The First Uk-Trained Physician Associates Onto Secondary Care Services In The British National Health Service, Tamara S. Ritsema

Theses & Dissertations

Introduction: The Physician Associate (PA) profession was brought from the United States (where it is called the "Physician Assistant" profession) to the United Kingdom (UK) approximately 15 years ago. Universities have begun to train PAs and these graduates are now starting work in the British National Health Service (NHS) in both primary and secondary care. The number of PAs graduating from PA programs and beginning to work in secondary care will increase substantially over the next few years. No research has been conducted on barriers and facilitators to the integration of a UK-trained PA onto a secondary service.

Methods: A …

The Correlation Between Undergraduate Students Who Attend The University Recreation Center And Students Exhibiting Symptoms Of An Eating Disorder, Olivia Daniels

Senior Honors Projects, 2010-2019

Background: The prevalence of eating disorders on college campuses indicates an important issue in contemporary society. As students experience a heightened level of freedom, they have the option to explore multiple forms of weight- management, including compulsive exercise.

Methodology: An online survey was distributed to female undergraduate students(n=206) at James Madison University.

Results: A significant relationship was found between eating disorder symptomology and where participants decided to spend their time at the University Recreation Center (UREC), as well as what type of physical activity they chose to perform. A significant inverse relationship between increasing muscle mass and burning calories was …

Increasing Food Security: Developing And Testing A Nutrition Education Curriculum For A Mobile Food Pantry, Alexandra Lepecha, Kathleen M. Kraft

Senior Honors Projects, 2010-2019

Background: The Neighborhood Produce Market (NPM) is a food distribution model similar to a mobile food pantry. NPM stakeholders observed a lack of community engagement and familiarity with produce offered.

Project Description: The objective was to develop a nutrition education curriculum for NPM volunteers to better engage families and community members by providing food samples, recipes, and nutrition education. A stakeholder steering committee guided the needs assessment, curriculum development, volunteer training, and pilot test. The curriculum consisted of food safety, cultural considerations, and nutritional information for nine produce items and food tasting procedures and recipes. Seven student volunteers were trained …

An Examination Of Factors Associated With Body Appreciation, Sociocultural Attitudes Of Appearance, And Ratings Of Diverse Performing Artists, Stephanie Rathjen

Senior Honors Projects, 2010-2019

Introduction: Multiple studies have found that performing artists have low body image which may be associated with the media’s portrayal of performers. Low body image can cause negative health effects including depression and eating disorders. This study explores body attitudes among performing and non-performing arts students and the possible media influences on those attitudes.

Methods: Undergraduate students (n=522) were asked to participate in an anonymous online survey regarding their perceptions of their individual body perception. During the survey, they were randomized to watch a video depicting either slim mostly Caucasian performers (video A) or performers of different ethnicities …

Understanding Awareness And Completion Of Advanced Care Directives: An Exploratory Study, Katherine Anna Chiu, Katherine Grace Topf

Senior Honors Projects, 2010-2019

Background: Advance Care Directives (ACDs) are forms that are beneficial for expressing end-of-life wishes during Advance Care Planning (ACP); however, few studies have focused on awareness and completion among college-aged populations. Completion of ACDs are more common among populations forced to think about potential of death, such as the elderly and chronically ill.

Methodology: This research is comprised of two parts in order to explore the availability of resources on four-year public institutions’ official websites (institutional level), and college-aged students’ beliefs and values. The institutional level took inventory of information available on the official websites of four-year public institutions (n=1,642). …

Impact Of Healthcare Delivery And Policies On Children's Outcomes After The Affordable Care Act Of 2010, Shreya Roy

Theses & Dissertations

The Patient Protection and Affordable Care Act (ACA) of 2010 introduced programs to promote integrated pediatric healthcare delivery and to expand public health insurance (Medicaid) eligibility for adults from low-income families in the United States. This dissertation examined whether progress was made towards integration of healthcare delivery for children with developmental disabilities after the implementation of ACA, and also whether expansion of Medicaid for adults impacted the preventive care utilization and school absenteeism of children from low-income families. A cross-sectional study design was used to examine whether integration of pediatric healthcare delivery was accomplished and a quasi-experimental difference-in-differences approach was …

God, I Hope This Part Of My Life Is Over: A Focused Ethnography Of A Correctional Youth Facility’S Therapeutic Climate, Eric Meyer

Theses & Dissertations

Although all prisons have the same goal of isolating offenders from society, the precise strategies used vary from one jurisdiction to the next. Some prisons use means of punishment to gain inmate compliance. Other prisons concentrate their limited resources on rehabilitation. Contained within the following pages are details of a focused ethnography that was completed in a state correctional youth facility that housed males between the ages of 15 and 21 years, all of whom were convicted of violent crimes. This study had the objective of exploring the climate of therapy in this correctional youth facility where rehabilitative programs were …

Potentially Reduced Exposure Products, Occupational Variations In Smoking, And Hardcore Smokers: Examining Important Elements In The Tobacco Use Spectrum, Raees A. Shaikh

Theses & Dissertations

The purpose of this research was to examine three important aspects of the smoking phenomenon that are, and will remain, important for the future of tobacco control research and policy. First and currently one of the most debated and researched topics in the tobacco research field relates to the group of products regarded by some as the potentially reduced exposure products (PREPs). We studied determinants of use of these products. Second aspect was to examine the socioeconomic subgroup of smokers based on their occupations who might potentially benefit from the use of PREPs and the third stage involved studying the …

Common Areas For Improvement From After Action Reports (Aars) Generated After Exercises Or Actual Disasters, As Reported By A National Sample Of U.S. Hospitals, Abdoulaye Abdoulaziz

Theses & Dissertations

Many hospitals conduct exercises every year, and they conclude the process with an After-Action Report and Improvement Plan. Therefore, there are thousands of AAR/IP’s across the country with limited opportunity to compare them or to learn from them collectively. Our project has gathered Improvement Plans (IP’s) and conducted a qualitative analysis which determined whether the “lessons learned” can be categorized into common themes.

Examining The Effects Of Approaches On Reducing Hospital Utilization: The Patient-Centered Medical Home, Continuity Of Care, And The Inpatient Palliative Consultation At The End-Of-Life, Xiaoting Sun

Theses & Dissertations

Background: It has become a national priority to reduce the high health care expenditure in the United States while improving the quality of care. Hospital care is taking up one-third of the healthcare spending, and services offered in hospitals are costly compared to others. Only one-twentieth of the patients with high-needs account for about half of the health care spending. They consuming a high level of hospital services if their conditions are not well-managed in the outpatient settings. Therefore, it is important to examine the effectiveness of the approaches that have the potentials to reduce costly care utilization through improvements …

Community-Based Healthcare | Interlace Of Biophilic Design In Outpatient Facilities, Joshua Robinson

Bachelor of Architecture Theses - 5th Year

This thesis questions how architects can redesign typical healthcare typology in response to the medical and sociological needs of the community while integrating the measures of wellness and biophilic design. By redefining architectural programs within a wellness clinic, this can allow the facility to prioritize the communities needs through non-medical determinants. The research will look at both the social and medical needs of a community, along with the Seven Standards of Wellness as defined by the Well Building Standard and The Fourteen Patterns of Biophilic Design as defined by the Terrapin Bright Green, to develop a connection between the facility …

Comparison Of Methods Used To Estimate The Global Burden Of Disease Related To Undernutrition And Suboptimal Breastfeeding, Alexander C. Mclain, Edward A. Frongillo Jr., Sonja Y. Hess, Ellen G. Piwoz

Faculty Publications

The Global Burden of Disease study (GBD) is an ambitious effort to estimate the disease burden attributable to various risk factors. The results from the GBD are used around the world to monitor the UN established Sustainable Development Goals, set health policies and research strategies, among others. The GBD along with other studies, such as those from the Maternal Child Epidemiology Estimation Group and the Lancet Breastfeeding Series Group, produce estimates of the nutrition-related global burden of disease that exhibit considerable differences. These differences are difficult to reconcile due to the estimation methods, which in recent years have substantially increased …

Differences In Current Hookah And Cigarette Smoking Status Attitudes And Beliefs At A Florida University: A Discriminant Analysis, Gail Castañeda, Tracey E. Barnett, Sergio Romero, Mi Jung Lee, Jann Macinnes

Florida Public Health Review

Rising college hookah use, in the absence of cigarettes, suggests attitudinal differences among both forms of tobacco consumption. This study examines which smoking attitudes/beliefs are most distinguishing across current non-smokers, cigarette smokers, hookah smokers, and dual (cigarette and hookah-only) smokers at a Florida university. Self- administered questionnaire data from 373 university students were categorized into four groups based on self-reported 30-day smoking status. Discriminant analysis was used to examine maximal differences between groups across perceived peer acceptability of cigarette smoking, peer acceptability of hookah smoking, hookah smoking harmfulness, and attitude toward peer hookah smoking. Descriptive analyses indicated an overall awareness …

Changes In Hiv Related Risk Behaviors: A Comparative Analysis Of Florida’S 2013 And 2016 Behavioral Risk Factor Surveillance System Survey., Daniel Diyaolu

Florida Public Health Review

Background: Identifying changes in HIV related risk factors is essential to reducing HIV rates in Florida. This study examines if changes occurred in HIV risk factors between 2013 and 2016. Methods: The study utilized secondary data from the Behavioral Risk Factor Surveillance System from 2013 and 2016. A logistic regression analysis was conducted to examine the changes between the years regarding health care coverage and routine HIV testing. Additionally, a separate analysis was performed for the 2016 dataset analyzing if HIV risk behaviors varied by gender, race, age, insurance coverage and HIV testing.

Results: The findings of this study suggest …

A Lifestyle Modification Program For Adult Patients With Coronary Artery Disease, Amanda M. Yarbrough

Evidence-Based Practice Project Reports

As a leading cause of death worldwide, coronary artery disease affects people of all races and ethnicities. The foundation for the prevention of secondary fatal cardiac events, such as stroke or myocardial infarction, is lifestyle modification to effectively lower cholesterol levels. Lifestyle change impacts diet, physical activity, smoking habits, vital sign measures, and stress management. The purpose of this evidence-based practice project was to reduce implement a lifestyle intervention to lower LDL-C levels and promote healthier lifestyles. This practice change was developed utilizing Stetler’s Research Utilization model to promote evidence-based practice changes in the clinical setting. Nola Pender’s Health Promotion …

Framework For Algorithmically Optimizing Longitudinal Health Outcomes: Examples In Cancer Radiotherapy And Occupational Radiation Protection, Lydia Joyce Wilson

LSU Doctoral Dissertations

Background: Advancements in the treatment of non-infectious disease have enabled survival rates to steadily increase in recent decades (e.g., diabetes, heart disease, and cancer). Epidemiological studies have revealed that the treatments for these diseases can have life-threatening and/or life–altering effects. Thus, realizing the full beneficial potential of advanced treatments necessitates new tools to algorithmically consider all major components of the health outcome, including benefit and detriment. The goal of this dissertation was to develop a framework for improving projected health outcomes following planned radiation exposures in consideration of all beneficial and detrimental, early and late, and fatal and non-fatal …

Impact Of The Affordable Care Act On The Cooper Women’S Care Center, Amanda Malik, Natali Franzblau

Cooper Rowan Medical Journal

Background: The Affordable Care Act (ACA) increased access to women’s health care by expanding Medicaid eligibility and requiring that insurance plans cover many gynecologic preventive services at no cost to patients. Before implementation of the ACA, pregnant women with low incomes qualified for Medicaid but childless adults of the same income did not, and though prenatal obstetrical visits were covered by plans at no or low cost to patients, most gynecologic services required out of pocket payments.

Objective: This study aimed to identify changes in the types of visits (gynecologic or obstetric) and patient demographics (including age, race, …

An Evaluation Of The Impact Of Leading Pedestrian Interval Signals In Nyc, Jeremy J. Sze

Theses and Dissertations

I evaluated the impact of the phased introduction of Leading Pedestrian Interval Signals (LPIs) on collision and injury outcomes at 12,987 signalized traffic intersections in New York City over the course of 25 quarters from 2012 to 2018. An intersection is treated when a LPIs is installed to give pedestrians lead time to cross the street before vehicles are allowed to move. Outcomes from NYPD’s Motor Vehicle Collisions data were matched to signalized intersections. I hypothesize that LPIs would reduce collisions and reduce injuries for pedestrians at intersections. A difference in difference fixed effects panel regression was used to identify …

Prevalence And Risk Factors Of Postpartum Depression Within One Year After Birth In Urban Slums Of Dhaka, Bangladesh, Rashidul Azad, Rukhshan Fahmi, Sadichhya Shrestha, Hemraj Joshi, Mehedi Hasan, Abdullah Nurus Salam Khan, Mohiuddin Ahsanul Kabir Chowdhury, Shams El Arifeen, Sk Masum Billah

Faculty Publications

Postpartum depression (PPD) is a serious pubic health concern and known to have the adverse effects on mother’s perinatal wellbeing; and child’s physical and cognitive development. There were limited literatures on PPD in Bangladesh, especially in urban slum context. The aim of this study was to assess the burden and risk factors of PPD among the urban slum women. A cross-sectional study was conducted between November-December 2017 in three urban slums on 376 women within first 12 months of postpartum. A validated Bangla version of Edinburgh Postnatal Depression Scale was used to measure the depression status. Respondent’s socio-economic characteristics and …

Referral Patterns, Procedures, And Outcomes Of A Large Community- Based Urology Group: A Retrospective Chart Review, Hassan A. Al Saleh, Gregory C. Mcmahon, Michael Douglas, Michael Console, Mihir Thaker, Gordon A. Brown

Rowan-Virtua Research Day

In 2012 The United States Preventive Services Task Force (USPSTF) recommended against prostate cancer (Pca) screening. The purpose of our study is to assess the effects of the USPSTF grade D recommendation for PSA based screening on new PCa diagnoses within a large-community based private practice setting. We completed a retrospective chart review of men with an elevated PSA seen in our clinic between May 2009–May 2015 who had undergone a prostate biopsy and were diagnosed with PCa. We observed that following the 2012 USPSTF recommendations, there was a significant increase in patients with clinically significant prostate cancer GG ≥ …

Addressing Lapses In Medical Education In Relation To Lgbtqia+ Healthcare Disparities, Daniel Pinto, Aubrey Olson

Rowan-Virtua Research Day

As the LGBT community gains more visibility and acceptance, the individuals identifying as LGBTQIA+ have been increasing. Unfortunately for this community, healthcare disparities for LGBT individuals continue. In fact in a national online survey done with LGBTQIA+ physicians, 65% had heard discriminatory comments made towards LGBTQIA+ patients, and 34% witnessed discriminatory care given to LGBTQIA+ patients. (Bonvinci) Rose Chapman, a senior lecturer at Curtin University Nursing School, contributed this discomfort that medical professionals seem to have with LGBTQIA+ families with socioeconomic background such as religious beliefs or familiarity with the topic. (Chapman) Nevertheless, another study published by the Medical Journal …

The Interface Between Invasive Species And The Increased Incidence Of Tick-Borne Diseases, And The Implications For Federal Land Managers, Ed Clark, Janis Mcfarland, Blaine Parker, Slade Franklin

National Invasive Species Council

Includes information on the dynamics of tick-borne disease, factors affecting the occurrence and density of ticks, matrices of ties between habitat, human activities, invasive plants, and ticks, federal resources and programs related to ticks and vector-borne disease in the United States, with references and an annotated bibliography of literature on ticks, vector-borne diseases, and invasive species.

The Modifiability Of Risk Factors Associated With Adolescent Suicide And Its Preventions, Nastaeen Tajin

Honors College Theses

Adolescent suicide has been of major concern in the past few decades, with the rates steadily increasing every year. Suicide can be defined as the act of intentionally taking one’s life. Adolescent refers to children between the age of 13 and 19, although the term will be used interchangeably with ‘teen’ throughout this paper. The purpose of this study had been to identify the risk factors of suicide associated with children of this age range, and propose preventative measures based on the modifiability of these risk factors. In order to achieve this, the two search catalogs utilized were the Wayne …

The Relationship Of Creatinine, Sodium, Hematocrit And Hemoglobin A1c To 30-Day Hospital Readmission Among Older Adults With Type 2 Diabetes, Shmilah Choudhary, Meet Shah, Sanath Shetty, Terri Ginsberg, Matthew H. Mclaughlin

Rowan-Virtua Research Day

Introduction:Reducing thirty-day hospital readmissions is a top healthcare priority. However, there is little research describing the risk factors of readmission among patients with diabetes, especially for older adults. Understanding what the risk factors are for 30-day hospital readmission for older adults with type 2 diabetes would help identify patients at risk of rehospitalization.

Objective:The aim of this study was to identify factors associated with 30-day unplanned hospital readmissions among older adults with T2DM. Factors to be investigated are: patient demographics and three admission laboratory values.

Methods:Participants were older adult s>65 years old with T2DM, admitted to a community hospital …

Correlation Of Chronic Conditions And Pain Scale With Varying Levels Of Obesity In The Geriatric Population, Shabbir Hossain, Adarsh Gupta

Rowan-Virtua Research Day

The overall objective of this study was to establish whether obesity’s contribution to pain is stronger than vice versa – the medical debilities in elderly patients that contribute to obesity. In the process, this study will allow us to achieve whether different age samples with similar BMIs demonstrate the same level of medical complexities in geriatric patients. In summary, the purpose of this research study was to correlate a relationship between obesity and aging. We hypothesized that obesity will contribute to greater pain in the aging population, and that patients – regardless of their age groups in the aging population …

The Relationship Of Cardiovascular Disease To 30-Day Hospital Readmission Among Older Adults With Type 2 Diabetes Mellitus, Meet Shah, Shmilah Choudhary, Sanath Shetty, Terrie Ginsberg, Matthew H. Mclaughlin

Rowan-Virtua Research Day

Reducing thirty-day hospital readmissions is a top healthcare priority. However, there is little research describing the risk factors of readmission among patients with diabetes, especially for older adults. Understanding what the risk factors are for 30-day hospital readmission for older adults with type 2 diabetes (T2DM) would help identify patients at risk of rehospitalization. The aim of this study was to identify factors associated with 30-day unplanned hospital readmissions among older adults with T2DM.Factors to be investigated are: patient demographics and whether the patient was hospitalized for cardiovascular disease. Participants were older adults>65 years old with T2DM, admitted to …

Assessment Of The Perceived Access To Health Care By Migrant And Seasonal Farm Workers In Southern New Jersey, Karen Custodio, Xitlalichomiha O'Dell, Lori Talbot

Rowan-Virtua Research Day

Migrant and seasonal farm workers (MSFW) are one of the most economically disadvantaged populations in the United States. MSFW confront numerous health challenges as a result of occupational hazards, poor living conditions, and inadequate nutrition, in addition to common health concerns like diabetes and hypertension. The objective of this study was to identify major barriers to health care for individuals working in the agriculture industry in southern New Jersey. Though there are numerous factors which impact health for migrant farmers, we hypothesized that language, financial burden, and fear from immigration status will be the most significant. Research was conducted using …

Effects Of Social Media On Patient Perceptions And Compliance, Annmarie Butare, Adarsh Gupta

Rowan-Virtua Research Day

It is the physician’s responsibility to ensure that their patients are collecting credible and accurate information. Considering the significant proportion of patients using social media to assist with medical decision making, physicians should incorporate this into their patient education in order to ensure patient understanding of the information gathered both outside and inside the medical office, thereby improving compliance and outcomes.

The goals of this study were to examine the influence of social media on patient perceptions of healthcare and use this infomration to improve physician understanding of patient health information-seeking behaviors to improve patient compliance. The three-part survey included …

An Industrial Hygiene Assessment Of Lead In Potable Water Outlets At Rowan University, Tyra Thomas, Rosemary Roberto, Thomas Boyle

Rowan-Virtua Research Day

The Office of Environmental Health and Safety (EHS) discovered lead in the water of a number of buildings on the Glassboro campus. This finding triggered the need for a comprehensive study to determine if lead was in the drinking water on the main campus.

Rowan University then partnered with an independent consultant to create a Lead Sampling Plan, collect water samples and to find a certified laboratory to provide water sample analysis.

A comprehensive plumbing survey of the campus also took place to determine how water is supplied to campus and how it is distributed to and throughout each building. …

Postoperative Cholecystitis From Nathanson Liver Retractor During Robotic-Assisted Laparoscopic Partial Nephrectomy, Lauren D. Gleich, Mihir G. Thaker, Gordon A. Brown

Rowan-Virtua Research Day

Proper visualization of the surgical field during any procedure is one of the most imperative elements of surgery. The tools used to obtain this goal come with their own set of risks. This report describes a patient who developed postoperative acalculous cholecystitis (PAC) after use of a Nathan liver retractor. PAC is a rare complication of urologic surgery and is often more severe than acalculous cholecystitis (AC), leading to significant morbidity.