Public Health Commons^™

Social Networks, Identity, Health, And Quality Of Life Among Older Gay And Lesbian Individuals In Rural Environments, Marc Aaron Guest

Theses and Dissertations--Gerontology

The goal of this dissertation was to explore aging lesbian and gay individuals living in rural communities, in terms of their social networks and the relationships between these networks, identity, health, and quality of life. Guiding the study were three overarching questions. Using a multi-method design, the research was grounded within a socio-ecological context and focused on how structural systems create pathways for health and are affected by social position (intersectionality). Participants (n=25) were recruited from Kentucky (n=20), West Virginia (n=3), and Tennessee (n=2). Thirteen participants self-identified as gay and twelve as lesbian. Findings highlight the complexity of the aging …

“Throwing Drops Of Water At A Wildfire”: Patient And Provider Strategies For Navigating Housing Instability And Type 2 Diabetes, Marlene Edelstein

Public Health Theses

Type 2 diabetes and housing access are growing independent and intersecting crises in the United States, and unstable housing is associated with poor health outcomes for people with type 2 diabetes. A growing body of evidence points to the challenges of adhering to diabetes management without access to stable housing, and that provider behavior is impacted when their patients face housing instability. In this qualitative study, we investigate the ways that primary care providers and people with type 2 diabetes strategically navigate the challenges posed by homelessness and unstable housing. Semi-structured interviews from two qualitative studies were analyzed. The first …

A Review On Antibiotic Stewardship In Pediatric Primary Care, Paulina Kaminski

Public Health Theses

Background. Misuse of antibiotics for upper respiratory tract infections (URTIs) in pediatric primary care settings persists despite growing concern over antibiotic resistance. Interventions aimed at improving prescription use, coined Antibiotic Stewardship Programs (ASPs) often target clinicians for improved clinical decision-making. More recently, ASPs have begun educating patients to antibiotic needs, and for pediatric cases, parents who might pressure clinicians into prescribing unneeded antibiotics. While many reviews have targeted adult patients or emergency settings, few evaluate practices for pediatric populations. For this reason, we performed a review of the literature to summarize common strategies used to reduce antibiotic overprescribing for pediatric …

Old & Sexy: Investigating And Reducing Stigmatization Of Sexually-Active Older Persons, Samantha Nicole Levy

Public Health Theses

Media often portrays older persons as asexual or perversely sexual. This stigmatization may harm older persons’ sexual, mental, and physical health and well-being. As such, our study aimed to investigate the stigmatization of sexuality in later life and see if it can be reversed. Our four hypotheses included: (1) sexually-active older persons would be more stigmatized than sexually-inactive older persons; (2) negative age beliefs would predict stigmatization of sexually-active older adults; (3) participants would think more negatively about sexually-active older men compared to sexually-active older women; and (4) a brief writing intervention would help improve participants’ views towards sexually-active old …

The People Living With Hiv Stigma Index 2.0: Preliminary Results From The Dominican Republic, Project Soar

HIV and AIDS

Stigma and discrimination among people living with HIV (PLHIV) contributes to poor quality health care, coercion and violence, job loss, and exclusion from social gatherings. Addressing stigma affecting PLHIV is a global priority, given its impact on the HIV epidemic. In 2008, the Global Network of People Living with HIV, the International Community of Women Living with HIV, the International Planned Parenthood Federation, and UNAIDS launched the People Living with HIV Stigma Index (Stigma Index) to provide evidence on stigma and discrimination that can be used to advocate for the rights of PLHIV. As of November 2017, more than 100,000 …

Experiences Of Formal Caregivers Providing Dementia Care To American Indians, Damon Grew Peter Syphers, C.J. Schumaker, Ronald P. Hudak

Journal of Sustainable Social Impact

Alzheimer’s disease (AD) is a significant public health concern for all elders in the United States. It is a particular concern for the American Indian (AI) population, which is one of the fastest aging populations in the United States and the smallest, most underrecognized, and most culturally diverse group in the country. A formal caregiver understanding of AD in the AI population is scarce. This phenomenological study was designed to discern what is known about AD in the AI population by exploring the cultural beliefs and experiences of formal caregivers who provide care for AI dementia patients. Specifically, this study …

An Analysis And Critique Of Mental Health Treatment In American State Prisons And Proposal For Improved Care, Shelby Hayne

Scripps Senior Theses

Mental health treatment in state prisons is revealed to be highly variable, under-funded, and systematically inadequate. Existing literature exposes this injustice but fails to provide a comprehensive proposal for reform. This paper attempts to fill that gap, outlining a cost-effective, evidence-based treatment proposal, directly addressing the deficits in care revealed through analysis of our current system. In addition, this paper provides historical overviews of the prison system and mental health treatment, utilizing theoretical perspectives to contextualize this proposal in the present state of affairs. Lastly, the evidence is provided to emphasize the potential economic and social benefits of improving mental …

Global Health Elective: Santo Domingo, Dominican Republic, Joan Strong

Posters

Describes the experiences of a pediatric anesthesiology fellow's time working Medical Aid for Children of Latin America (MACLA) in Santo Domingo, Dominican Republic.

Snake Bite, Meghna Arora, Rajendra Prasad

Digital Journal of Clinical Medicine

No abstract provided.

Open Science Precision Medicine In Canada: Points To Consider, Palmira Granados Moreno, Sarah E. Ali-Khan, Benjamin Capps, Timothy Caulfield, Damien Chalaud, Aled Edwards, E. Richard Gold, Vasiliki Rahimzadeh, Adrian Thorogood, Daniel Auld, Gabrielle Bertier, Felix Breden, Roxanne Caron, Priscilla M.D.G. César, Robert Cook-Deegan, Megan Doerr, Ros Duncan, Amalia M. Issa, Jerome Reichman, Jacques Simard, Derek So, Sandeep Vanamala, Yann Joly

Faculty Scholarship

Open science can significantly influence the development and translational process of precision medicine in Canada. Precision medicine presents a unique opportunity to improve disease prevention and healthcare, as well as to reduce health-related expenditures. However, the development of precision medicine also brings about economic challenges, such as costly development, high failure rates, and reduced market size in comparison with the traditional blockbuster drug development model. Open science, characterized by principles of open data sharing, fast dissemination of knowledge, cumulative research, and cooperation, presents a unique opportunity to address these economic challenges while also promoting the public good.

The Centre of …

Use Of Complementary And Alternative Medicine Among People With Cardiovascular Diseases In Southeast Georgia, Chimuanya Okoli, Stacy Carswell, Sewuese Akuse, Kelly L. Sullivan

Biostatistics, Epidemiology & Environmental Health Sciences: Faculty Publications

Background: Heart disease is a leading cause of death in the United States. Proper treatment of patients with cardiovascular disease is essential and can be challenged by non-disclosed use of complementary or alternative treatments. The objective of this study was to assess which demographics were associated with complementary and alternative medicine (CAM) use and if education affects the use of CAM.

Methods: A cross-sectional survey was conducted among a stratified random sample of residents of Southeastern Georgia. Sampling was stratified by urban/rural residence in order to reach sufficient rural residents. Participants that indicated they had been diagnosed with hypertension or …

Quasi-Likelihood Ratio Tests For Homoscedasticity Of Variance In Linear Regression, Lili Yu, Varadan Sevilimedu, Robert Vogel, Hani Samawi

Biostatistics, Epidemiology & Environmental Health Sciences: Faculty Publications

Two quasi-likelihood ratio tests are proposed for the homoscedasticity assumption in the linear regression models. They require few assumptions than the existing tests. The properties of the tests are investigated through simulation studies. An example is provided to illustrate the usefulness of the new proposed tests.

An Oasis In The Hospital Desert – General Aviation Meets Medicine, Ariel Braverman

International Journal of Aviation, Aeronautics, and Aerospace

Use of General Aviation and to support medical services is not novel. However, this paper is an attempt to establish a concept of a framework of using aviation, especially relatively low-operational cost fixed-wing aircraft as a convenient high-speed transport to bring medical staff to the rural and remote areas. Operating flight network will also be more efficient from the financial point of view - better than attracting medical personnel with high salaries. Existing regional and local airport system can be a feasible basis for airport-based medical network. This article is just an initial one and additional work needs to evaluate …

Women's Postpartum Experiences, Courtney Watkins

Online Theses and Dissertations

Current literature explores childbirth options and evidence-based approaches for care of an infant such as kangaroo care and breastfeeding, but there is little to no research on women’s birthing experiences and its impact on daily routines. This paper will reveal themes related to postpartum experiences and the impact on occupations for women who have given birth in the last six months. This qualitative study, using a convenience sample, explores a woman’s birthing experience and the influence it has on her postpartum occupations. The Centers for Disease Control and Prevention (2017) listed almost four million births that occurred during 2016 in …

Consort Checklist, Myopia Outcome Study Of Atropine In Children (Mosaic): Design And Methodology, Saoirse Mccrann, Daniel Ian Flitcroft, John Butler, James Loughman

Articles

Purpose

The Myopia Outcome Study of Atropine in Children (MOSAIC) aims to explore the efficacy, safety, acceptability and mechanisms of action of 0.01% atropine for myopia control in a European population.

Methods

MOSAIC is an investigator-led, double-masked, placebo-controlled, randomised clinical trial (RCT) investigating the efficacy, safety and mechanisms of action of 0.01% atropine in myopia progression management. During Phase 1 of the trial, 250 children aged 6-16 years with progressive myopia apply eye drops once nightly in both eyes from randomisation to month 24. No treatment is given during Phase 2 from month 24 to 36 (washout period) for those …

The Medicalisation Of Female Genital Mutilation/Cutting In Kenya: Perspectives Of Families And Health Care Providers, Population Council

Reproductive Health

This evidence brief summarizes key findings from a study that sought to understand the shifts in FGM/C including medicalization among several communities Kenya. The study finds that medicalization is increasing because: 1) it is perceived to be safer because the procedure is reportedly performed under sterile conditions by trained health professionals; 2) it is believed to shorten the recovery period; and 3) it is a response to the law prohibiting the practice because it allows FGM/C to be performed in secret. These findings indicate that medicalization is an adaptation to awareness of the health complications associated with FGM/C and the …

Assessment Of Perceived Levels Of Stress And Coping Mechanisms Among University Students, Nancy Adomako-Saahene

All Graduate Theses, Dissertations, and Other Capstone Projects

Majority of researchers have documented stress among college students. This study contributes to the existing literature on stress by assessing the relationship between perceived stress levels and the coping strategies utilized by university students. The study was conducted using a descriptive, inferential, cross-sectional, and correlational research design. The population for this study was students at a large, Midwestern university. A convenience sampling technique was used to select the students for the study. Perceived Stress Scale (PSS) was used to assess the participant’s perceived level of stress, whereas COPE Inventory was used to examine strategies participants use in coping with stress. …

Examining Patients’ Satisfaction In Jordanian Emergency Departments Through Business Process Improvement Implementation, Mohammed Shaker Ibrahim

Master's Theses and Doctoral Dissertations

There have been recent advancements in healthcare services provision to enhance patients’ satisfaction. Previous research has concluded that Jordanian ratings of service quality and quality of care provided in public hospitals are lower compared to other nations in the region and abroad. These studies, however, failed to utilize any standardized customer satisfaction tools. At the same little empirical research has attempted to investigate the link of business process improvement in Jordanian hospitals to the enhancement of patients’ satisfaction. This research bridges the gap in the literature by first testing and validating SERVQUAL, a customer satisfaction tool, in Jordanian hospital environments …

The Global Compact On Refugees: How The Sauti/Voice Project Fits, Josephine Ngebeh, Chi-Chi Undie, Joanina Karugaba

Reproductive Health

How can stakeholders support refugees in the present-day unprecedented global refugee crisis? At least one way is by entering into a clearly defined compact to do so. Developed in 2018, the Global Compact on Refugees is a nonbinding agreement among United Nations Member States and other relevant stakeholders, including international organizations. A symbol of political will, the Compact demonstrates the commitment of the international community to enhanced cooperation and solidarity with both refugees and their host communities. The Global Compact on Refugees provides the international community with guidance for supporting present-day refugee communities, characterized by large populations and protracted refugee …

Sauti/Voice Project: First Unhcr-Population Council Regional Workshop, Josephine Ngebeh, Chi-Chi Undie, Joanina Karugaba, George Odwe, Nachela Chelwa, Harriet Birungi, Michael Mbizvo

Reproductive Health

In 2014, the UNHCR East and Horn of Africa and Great Lakes (EHAGL) Africa Bureau in Nairobi, and the Population Council/Nairobi established technical cooperation for Improving Evidence-based Programming for Sexual and Gender-based Violence (SGBV) in Refugee Operations in the East and Horn of Africa. The Africa Bureau works closely with the Council to initiate appropriate interventions for the prevention of, and response to, SGBV in refugee operations. The Council’s technical team is represented by the Council-led Africa Regional SGBV Network. Technical cooperation between the Africa Bureau and the Council has resulted in a new initiative: VOICE—Violence Prevention and Response Through …

Lead Exposure And Metabolic Syndrome In U.S. Population, Nhanes 2013-2014, Khadra Gukadowr

Master of Public Health Program Student Publications

Background: Lead is a known endocrine disruptor and can impair regulation of blood glucose, blood pressure, abdominal adiposity, blood lipid levels which are risk factors for metabolic syndrome (MetS).

Objective: To study the association of lead exposure and MetS in United States (U.S.) adults.

Methods: Data from 523 male and 528 female participants aged 20 years and older from the 2013 to 2014 National Health and Nutrition Examination Survey (NHANES) were analyzed. Based on blood lead distribution in males and females, participants were categorized into low and high blood lead groups in both genders. Adjusted logistic regression analysis was used …

Who Is Testing? Demographic And Sexual Risk Factors Associated With Hiv Testing Among African American College Students, Elizabeth Gonder-Strutz

Master of Public Health Program Student Publications

Despite significant progress made in reducing HIV diagnoses, many populations are still disproportionately affected. Although African American college students tend to engage in safer sex practices than their peers, they are still at an elevated risk for contracting HIV. Therefore, it is important that HIV prevention programs understand the unique needs and risk factors among African American college students. HIV testing is an essential component of HIV prevention. This study examined the relationship between HIV testing and demographic and behavioral factors among African American college students from two universities. The study found that older students (upperclassmen) are significantly more likely …

Next-Generation Sequencing Of Hiv-1 Single Genome Amplicons, Gustavo H. Kijak, Eric Sanders-Buell, Phuc Pham, Elizabeth A. Harbolick, Celina Oropeza, Anne Marie O'Sullivan, Meera Bose, Charmagne G. Beckett, Mark Milazzo, Merlin L. Robb, Sheila A. Peel, Paul T. Scott, Nelson L. Michael, Adam W. Armstrong, Jerome H. Kim, David Brett-Major, Sodsai Tovanabutra

Journal Articles: Epidemiology

The analysis of HIV-1 sequences has helped understand the viral molecular epidemiology, monitor the development of antiretroviral drug resistance, and design candidate vaccines. The introduction of single genome amplification (SGA) has been a major advancement in the field, allowing for the characterization of multiple sequences per patient while preserving linkage among polymorphisms in the same viral genome copy. Sequencing of SGA amplicons is performed by capillary Sanger sequencing, which presents low throughput, requires a high amount of template, and is highly sensitive to template/primer mismatching. In order to meet the increasing demand for HIV-1 SGA amplicon sequencing, we have developed …

Using "Outbreak Science" To Strengthen The Use Of Models During Epidemics., Caitlin Rivers, Jean-Paul Chretien, Steven Riley, Julie A. Pavlin, Alexandra Woodward, David Brett-Major, Irina Maljkovic Berry, Lindsay Morton, Richard G. Jarman, Matthew Biggerstaff, Michael A. Johansson, Nicholas G. Reich, Diane Meyer, Michael R. Snyder, Simon Pollett

Journal Articles: Epidemiology

Infectious disease modeling has played a prominent role in recent outbreaks, yet integrating these analyses into public health decision-making has been challenging. We recommend establishing ‘outbreak science’ as an inter-disciplinary field to improve applied epidemic modeling.

New Filovirus Disease Classification And Nomenclature, Jens H. Kuhn, Takuya Adachi, Neill K.J. Adhikari, Jose R. Arribas, Ibrahima Elhadj Bah, Daniel G. Bausch, Nahid Bhadelia, Matthias Borchert, Arne Broch Brantsæter, David Brett-Major, Timothy H. Burgess, Daniel S. Chertow, Christopher G. Chute, Theodore J. Cieslak, Robert Colebunders, Ian Crozier, Richard T. Davey, Hilde De Clerck, Rafael Delgado, Laura Evans, Mosoka Fallah, William A. Fischer, Tom E. Fletcher, Robert A. Fowler, Thomas Grünewald, Andy Hall, Angela L. Hewlett, Andy I.M. Hoepelman, Catherine F. Houlihan, Giuseppe Ippolito, Shevin T. Jacob, Michael Jacobs, Robert Jakob, Frederique A. Jacquerioz, Laurent Kaiser, Andre C. Kalil, Rashidatu F. Kamara, Jimmy Kapetshi, Hans-Dieter Klenk, Gary Kobinger, Mark G. Kortepeter, Colleen S. Kraft, Thomas Kratz, Henry S. Kyobe Bosa, Marta Lado, François Lamontagne, H. Cliff Lane, Leslie Lobel, Julius Lutwama, G. Marshall Lyon, Moses B.F. Massaquoi, Thomas A. Massaquoi, Aneesh K. Mehta, Vital Mondonge Makuma, Srinivas Murthy, Tonny Seikikongo Musoke, Jean-Jacques Muyembe-Tamfum, Phiona Nakyeyune, Carolina Nanclares, Miriam Nanyunja, Justus Nsio-Mbeta, Tim O'Dempsey, Janusz T. Pawęska, Clarence J. Peters, Peter Piot, Christophe Rapp, Bertrand Renaud, Bruce Ribner, Pardis C. Sabeti, John S. Schieffelin, Werner Slenczka, Moses J. Soka, Armand Sprecher, James Strong, Robert Swanepoel, Timothy M. Uyeki, Michel Van Herp, Pauline Vetter, David A. Wohl, Timo Wolf, Anja Wolz, Alie H. Wurie, Zabulon Yoti

Journal Articles: Epidemiology

The recent large outbreak of Ebola virus disease (EVD) in Western Africa resulted in greatly increased accumulation of human genotypic, phenotypic and clinical data, and improved our understanding of the spectrum of clinical manifestations. As a result, the WHO disease classification of EVD underwent major revision.

De Novo Assembly Of The Brugia Malayi Genome Using Long Reads From A Single Minion Flowcell, Joseph R. Fauver, John Martin, Gary J. Weil, Makedonka Mitreva, Peter U. Fischer

Journal Articles: Epidemiology

Filarial nematode infections cause a substantial global disease burden. Genomic studies of filarial worms can improve our understanding of their biology and epidemiology. However, genomic information from field isolates is limited and available reference genomes are often discontinuous. Single molecule sequencing technologies can reduce the cost of genome sequencing and long reads produced from these devices can improve the contiguity and completeness of genome assemblies. In addition, these new technologies can make generation and analysis of large numbers of field isolates feasible. In this study, we assessed the performance of the Oxford Nanopore Technologies MinION for sequencing and assembling the …

Evaluation Of A Patient Navigation Program For Vulnerable Families, Hillary Chisholm

Public Health Theses

Abstract

Objectives: Low-income and minority children experience worse health outcomes for reasons that are complex and multifactorial. The aims of this study were to examine the experiences of caregivers and providers who participated in a patient navigation program designed to address these disparities, and to understand how the program was impactful to participants.

Methods: As part of a larger pilot-stage intervention, we conducted a qualitative study using a modified Realist Evaluation approach. Between April and October 2018, we conducted semi-structured interviews of a group of caregivers who were enrolled in the intervention, and the providers who cared for these children. …

Global Health Experience In Botswana, Sarah Bieser

Posters

Describes experience providing care at the Botswana-Baylor Children's Center of Excellence in Gabarone, Botswana and the Princess Marina Hospital.

Global Health Elective, Philippine Children's Medical Center, Keith J. Martin

Posters

Describes a global health learning experience working in the Philippine Children's Medical Center in Quezon City, Metro Manila, Philippines.

Global Health Elective In San Pedro La Laguna, Guatemala, Page Pomo

Posters

Future outpatient general pediatrician serving bilingual populations describes working in rural Guatemala and opportunities to practice Spanish language skills.