Public Health Commons^™

Molecular Typing Of Rickettsia Akari, Marina E. Eremeeva

Biostatistics, Epidemiology & Environmental Health Sciences: Faculty Publications

Rickettsia akari is an obligate intracellular bacterium that causes smallpox rickettsia. Rickettsia akari is an atypical member of the rickettsia spotted fever (SFG) group because it circulates in gamasid mites; however, only limited data are available regarding the degree of genetic diversity of R. akari isolates. We examined 13 isolates of R. akari isolated from humans, rodents, and ticks in the United States, the countries of the former USSR, and the former Yugoslavia for the period from 1946 to 2003 for diversity in the composition of tandem repeats (TR) and intergenic regions (IGR). Using the Tandem Repeat Finder software (http://tandem.bu.edu) …

Rickettsialpox – A Rare But Not Extinct Disease: A Review Of The Literature And New Directions, Marina Eremeeva, Kamalich Muniz-Rodriguez

Biostatistics, Epidemiology & Environmental Health Sciences: Faculty Publications

Smallpox rickettsia is an urban zoonosis caused by Rickettsia akari. To date, R. akari is the only characterized representative of the group of spotted fevers transmitted by the gamasid mite Liponyssoides sanguineus, which is common among peridomic rodents. This disease was first described in New York in 1946, and a few years later a similar outbreak occurred in the Ukrainian SSR. Numerous serological studies and diagnostics of sporadic cases of smallpox rickettsiosis suggest its widespread occurrence on the planet; however, the current geography and incidence of smallpox rickettsiosis is unknown. Smallpox rickettsiosis is characterized by the classic clinical triad of …

The Enhanced Danger Of Physicians’ Off-Label Prescribing, Doriane Lambelet Coleman, Philip M. Rosoff

Faculty Scholarship

The COVID-19 pandemic represents a major challenge to both technologically advanced and resource-poor countries. There are currently no effective treatments for severe disease other than supportive care and advanced life support measures, including the use of mechanical ventilators. With the urgency and necessity bred from desperation, there have been many calls to utilize unproven therapies, such as hydroxychloroquine, for which little evidence of efficacy exists. We have previously argued that such off-label use, while legal, is problematic (and even dangerous) and have suggested several regulatory remedies that could protect patients and advance their interests while preserving the reasonable authority of …

Dysphoric Milk Ejection Reflex: A Narrative Inquiry Of Women's Experiences And Perceptions, Brandi Winchester

Online Theses and Dissertations

Background

Dysphoric milk ejection reflex is an idiopathic condition experienced by some breastfeeding women that is characterized by an abrupt experience of negative emotions or sensation prior to milk let-down. Many women struggle to make sense of the condition, and report barriers to communicating with others about their experiences and accessing support from healthcare providers. Dysphoric milk ejection reflex is often reported by women to impact self-efficacy and contribute to secondary psychological effects.

Research aim

Exploration of the experience of Dysphoric Milk Ejection Reflex. Investigation of the impact of diagnosis on the sense of wellness and self-efficacy of affected mothers. …

Understanding The Occupational Therapy Perspective Of Working With The Homeless Population: Self-Care Interventions, Marisa Leigh Sparbanie

Online Theses and Dissertations

Successful interventions, focused on self-care, have been implemented by occupational therapists in homeless populations. Yet, no study has attempted to explore experiences of occupational therapists implementing self-care interventions. This qualitative, descriptive study sought to understand the experience of occupational therapy practitioners implementing self-care interventions for individuals experiencing homelessness. The interventions took place in various healthcare practice settings. Four participants, recruited through purposive sampling, engaged in semi-structured interviews pertaining to their experiences. The interviews were transcribed and coded using an emergent approach. Three major themes emerged from the data, including experiences in different settings, client-centered care, and institutional barriers and supports.

Intravenous Lidocaine As A Non-Opioid Adjunct Analgesic For Traumatic Rib Fractures., Jeff Choi, Kirellos Zamary, Nicolas B Barreto, Lakshika Tennakoon, Kristen M Davis, Amber W Trickey, David A Spain

Articles, Abstracts, and Reports

INTRODUCTION: Pain management is the pillar of caring for patients with traumatic rib fractures. Intravenous lidocaine (IVL) is a well-established non-opioid analgesic for post-operative pain, yet its efficacy has yet to be investigated in trauma patients. We hypothesized that IVL is associated with decreased inpatient opioid requirements among patients with rib fractures.

METHODS: We retrospectively evaluated adult patients presenting to our Level 1 trauma center with isolated chest wall injuries. After 1:1 propensity score matching patients who received vs did not receive IVL, we compared the two groups' average daily opioid use, opioid use in the last 24 hours of …

Persistent Reduction In The Age Adjusted Mortality Rate From Aortic Valve Surgery In The United State With Elimination Of Gender Gap In Recent Years., Mohammad Reza Movahed, Sara Etemad, Mehrnoosh Hashemzadeh, Mehrtash Hashemzadeh

Articles, Abstracts, and Reports

BACKGROUND: Advancement in the surgical techniques should translate into better outcome. The goal of this study was to evaluate mortality trends from aortic valve surgery in the United State using large inpatient database.

METHOD: The Nationwide Inpatient Sample (NIS) database was used to calculate the age-adjusted mortality rate from aortic valve surgery from 1988 to 2011 in the United State using ICD-9 coding for aortic valve surgery.

RESULTS: We found that age adjusted mortality rate from aortic valve surgery gradually decreased from 1988 until end of study in 2011 to the lowest level with elimination of gender gap that was …

Perceptions, Attitudes, Self-Efficacy, And Behaviors Of Mouthguard Use Among Collegiate Athletes, Heather Prosser

All Graduate Theses, Dissertations, and Other Capstone Projects

With the high risk of dental trauma in contact sports, it is important that all athletes have a strong foundation of how to prevent such injuries. Properly fitted mouthguards are the best available protective equipment to prevent orofacial trauma; however, previous research has found them underutilized, with the need for evidence-based interventions to promote mouthguard use among athletes. This study used a descriptive, cross-sectional, correlational research design, focusing on studying collegiate athletes at one large, Midwestern university, to determine their current attitudes, perceptions, self-efficacy, and behaviors of mouthguard use during participation in a contact sport. A convenience sampling technique was …

Human Papillomavirus (Hpv) Infection And Vaccine Knowledge And Attitudes Among University Students, Mckenzie Schmitz

All Graduate Theses, Dissertations, and Other Capstone Projects

HPV is the “most common sexually transmitted infection,” with approximately four out of five sexually active individuals getting infected at some point in their lives (Planned Parenthood, n.d.b, para.1). Cancers of the throat, mouth, cervix, anus, penis, and vagina have all been linked to HPV infections. In addition to being tested for HPV, the utilization of barrier methods and reduction of risky sexual risk behaviors, are the best ways to prevent and treat sexually transmitted infections. This study contributes to existing literature on university students’ knowledge and attitudes about HPV infections and the vaccination. This study was conducted using descriptive, …

Pestilence And Poverty: The Great Influenza Pandemic And Underdevelopment In The New South, 1918-1919, Andrew Kishuni

Honors Undergraduate Theses

This study examines the "Spanish" influenza pandemic of 1918-1919 in the U.S. South, using case-studies of Jacksonville, Savannah, New Orleans, and Nashville to sculpt a "Southern flu" more identical to the Global South and the developing world than the rest of the U.S. I examine poverty and political and economic paralysis in the years between the end of Reconstruction and 1918, and the poor results of political indifference on public health and disease control. I also analyze the social and institutional racism against persons of color that defined high infectious disease mortality in Southern cities.

I argue that Southerners faced …

The Impact Of Covid-19 On Hiv Treatment And Research: A Call To Action, Tiffany Chenneville, Kemesha Gabbidon, Patricia Hanson, Cashea Holyfield

USF St. Petersburg Campus Faculty Publications

The impact of the COVID-19 pandemic is far reaching, with devastating effects on individuals, communities, and societies across the world. People with chronic health conditions may be at greater risk of contracting or experiencing complications from COVID-19. In addition to illness or death for those who contract the virus, the physical distancing required to flatten the curve of new cases is having a negative impact on the economy, the effects of which intersect with mental health and other existing health concerns, thus affecting marginalized communities. Given that HIV also has a disproportionate impact on marginalized communities, COVID-19 is affecting people …

"It’S Just A Bad Period" And Other Ways Of Dismissing Women's Pain: An Ethnographic Look Into The Experience Of Endometriosis, Selina Hays

Honors Undergraduate Theses

This thesis uses online ethnographic methods to analyze the impact of patriarchal values on the illness experiences of women with endometriosis. Current literature suggests that negative impact on patients with endometriosis with regard to cultural discourse surrounding menstruation and chronic illness. Utilizing a combination of critical discourse analysis and constructivist grounded theory, the results of this research demonstrate that patients engage in a form of performance that is reactive to normalization and dismissal of pain by doctors and wider social support due in part to cultural stigmas of menstruation and chronic pain, as well as the inherent power imbalance in …

Prophylaxis Of Food Allergen Sensitivity, Dustin Gottfeld

Physician Assistant Studies | Student Authored Articles

Food allergies can have a severe and drastic effect on a person’s lifestyle, while prevention of allergic disease can help to ensure others do not have to live with this burden. There are a variety of differing hypotheses that offer explanations for the early development of food allergies, particularly peanut allergies. Two of the foremost hypotheses are the Hygiene Hypothesis and the Dual-Allergen Hypothesis. The Hygiene Hypothesis claims that the diversity of a child’s microbiota creates a beneficial balance of microorganisms which can help prevent the development of allergic disease. Alternatively, the Dual-Allergen Hypothesis states that early environmental exposure to …

Association Between Breastfeeding And Child Stunting In Mexico, Ana Paola Campos, Mireya Vilar-Compte, Summer Sherburne Hawkins

Department of Public Health Scholarship and Creative Works

Background: Globally, the prevalence of child stunting has been decreasing over the past decades. How-ever, in low-and middle-income countries such as Mexico, stunting is still the most prevalent form of undernutrition affecting a large number of children in the most vulnerable conditions. Breastfeeding has been identified as one of the key affordable and modifiable maternal health behaviors protecting against child stunting. Objective: To examine the association between breastfeeding (defined as never breastfed, any breast-feeding for <6 months, and any breastfeeding for ≥6 months) and other individual-, household-, and area-level factors with child stunting (defined as length/height-for-age-z-score for sex under –2 standard deviations of the World Health Organization child growth standards’ median) in Mexico. Methods: Secondary data analysis using the 2012 Mexican Health and Nutrition Survey, which allowed representativeness of rural and urban areas at national level and among 4 regions in Mexico. Our subset included data on 2,089 singleton Mexican children aged 6–35 months with information on previously identified risk and protective factors for stunting. We conducted fixed-and mixed-effects logistic regression models sequentially controlling for each level of factors. Findings: Overall, 12.3% of children were stunted and 71.1% were breastfed for ≥6 months. Any breast-feeding and being female were consistent protective factors against child stunting across all models. In contrast, child low birthweight, maternal short stature, higher number of children aged <5 years per household, and moderate to severe food insecurity were consistent risk factors for child stunting across all models. Conclusions: According to our findings, efforts to reduce child stunting in Mexico should include prenatal strategies aiming to prevent low birthweight offspring particularly among short-stature women, moderate to severe food insecure households, families with a higher number of children aged <5 years, and indigenous communities. Postnatal components should include multilevel strategies to support breastfeeding.

Federal Health Reform: Breast Cancer Outcomes, Nia Imani Bailey

West Chester University Doctoral Projects

Young women are diagnosed with breast cancer; and young women die from breast cancer. This qualitative dissertation seeks to prove the significance of lowering the mammography age from 40 years old to 30 years old. Current policy and programs correlate to the mandated age of 40 years old, unless the woman is at high risk; such as having a family cancer history. This dissertation also seeks to implement an addendum to insurance policies to cover for younger women to have mammography screening in the event they are younger than the recommended age. The purpose of this study was to examine …

Applying Design Thinking For Community-Provider Collaboration: Designing A Culture- And User-Friendly Refugee Wellness Center, Oluwatoni Okuboyejo, Ellen Solomon, Shandon Coffman, Brandon Joa, Bon Ku, Md, Mpp

Phase 1

Background: Designing South Philadelphia’s first permanent healthcare facility dedicated to immigrant and refugee health presents a unique opportunity to integrate cultural sensitivity with principles of community health. Philadelphia is a city saturated with many medical institutions and hospitals, yet there are large health disparities within miles of each other. Bringing together healthcare providers with a common goal of improving community health needs from a cultural standpoint can be tasking, even when all are on the same page. Design thinking is an underexplored perspective that has the potential to address these concerns in an efficient way that improves both provider and …

Applying Design Thinking For Community-Provider Collaboration: Designing A Culture- And User-Friendly Refugee Wellness Center, Brandon Joa, Ellen Solomon, Oluwatoni Okuboyejo, Shandon Coffman, Bon Ku, Md, Mpp

Phase 1

Purpose: This case study demonstrates the application of design thinking to the process of building a culturally sensitive health center for refugees and immigrants.

Background: Refugee communities present a growing underserved population. Designing South Philadelphia’s first permanent healthcare facility dedicated to immigrant and refugee health presents a unique opportunity to integrate cultural sensitivity with principles of community health. Design thinking is a promising yet underutilized strategy for addressing health and social justice concerns in an efficient way that improves both provider and patient satisfaction. A project was conducted to utilize design thinking to make suggestions to the design of Hansjörg …

Design Thinking For Community-Provider Collaboration: Designing A Culture- And User-Friendly Refugee Wellness Center, Shandon Coffman, Oluwatoni Okuboyejo, Ellen Solomon, Brandon Joa, Bon Ku, Md, Mpp

Phase 1

Background: South Philadelphia has a growing immigrant and refugee population, increasing the need for a healthcare facility dedicated to refugee health that integrates cultural sensitivity with principles of community health. Design thinking (human-centered design) is a promising strategy to address health and social justice concerns through the development of innovative products and services that prioritize population needs. This project utilized design thinking to inform suggestions to the design of Hansjörg Wyss Wellness Center that promote a culturally sensitive and welcoming environment in order to improve healthcare outcomes for the refugee population in Philadelphia.

Methods: Standard qualitative data gathering methods were …

Evaluation Of The Coordinated Approach To Child Health (Catch) Program In Third Through Fifth Graders In Northern Illinois, Paulina Karecka

Graduate Research Theses & Dissertations

Background: The Coordinated Approach to Child Health (CATCH) is a school-based education program designed to improve dietary habits and increase physical activity among children and adolescents based on the Social Cognitive Theory (SCT). The objective of this study was to evaluate the effectiveness of CATCH program, delivered by dietetic interns and Northern Illinois University (NIU) students, to 3rd-5th graders in Northern Illinois, in increasing their nutrition knowledge and healthy choices behavior. Methods: In total, 167 elementary school children in grades 3-5 in Northern Illinois participated in a non-experimental program evaluation study. We delivered 6 CATCH lessons throughout the academic year …

Implementing The Icelandic Model For Preventing Adolescent Substance Use, Alfgeir L. Kristjansson, Michael J. Mann, Jon Sigfusson, Ingibjorg E. Thorisdottir, John P. Allegrante, Inga Dora Sigfusdottir

Public and Population Health Faculty Publications and Presentations

This is the second in a two-part series of articles about the Icelandic Model for Primary Prevention of Substance Use (IPM) in this volume of Health Promotion Practice. IPM is a community collaborative approach that has demonstrated remarkable effectiveness in reducing substance use initiation among youth in Iceland over the past 20 years. While the first article focused attention on the background context, theoretical orientation, evaluation and evidence of effectiveness, and the five guiding principles of the model, this second article describes the 10 core steps to practical implementation. Steps 1 to 3 focus on building and maintaining community …

Time Spent Exercising And Obesity: An Application Of Lewbel’S Instrumental Variables Method, Charles J. Courtemanche, Joshua C. Pinkston, Jay Stewart

Institute for the Study of Free Enterprise Working Papers

This paper examines the role physical activity plays in determining body mass using data from the American Time Use Survey. Our work is the first to address the measurement error that arises when time use during a single day—rather than average daily time use over an extended period—is used as an explanatory variable. We show that failing to account for day-to-day variation in activities results in the effects of time use on a typical day being understated. Furthermore, we account for the possibility that physical activity and body mass are jointly determined by implementing Lewbel’s instrumental variables estimator that exploits …

Food Insecurity And Healthy Food Availability In The State Of Ohio, Yanley Sánchez

Scholarship in Medicine - All Papers

Objective: This research study aims to determine the impact of food insecurity and healthy food availability in the state of Ohio. It investigates how food insecurity in Ohio has changed between 2016 and 2020. It also investigates how food insecurity correlates with education level by looking at high school graduation rates. It also investigates how Ohio, a state with a high level of food insecurity, compares to California which has low levels of food insecurity. This study also compares how food insecurity differs in rural and urban counties throughout the state of Ohio.

Methods: ANOVA with posthoc will be conducted …

Understanding The Relationship Between Early Childhood Education And Long-Term Health And Quality Of Life Outcomes, Ryan Mcnulty

Scholarship in Medicine - All Papers

Education is widely understood to be beneficial with regard to social opportunity, health outcomes, and quality of life scoring. Society opinion and literature are in accordance with this understanding. Much of the current literature, however, focuses on how higher education provides many of these benefits, but little investigates how early childhood education correlates with such outcomes. The objective of this study is to investigate what relationships there are between early childhood education performance and long-term health and quality of life outcomes. This investigation will explore Ohio’s third grade reading and math scores on standardized exams as compared to a national …

Aerosol And Surface Contamination Of Sars-Cov-2 Observed In Quarantine And Isolation Care, Joshua L. Santarpia, Danielle N. Rivera, Vicki L. Herrera, M. Jane Morwitzer, Hannah M. Creager, George W. Santarpia, Kevin K. Crown, David Brett-Major, Elizabeth R. Schnaubelt, M. Jana Broadhurst, James V. Lawler, St. Patrick Reid, John Lowe

Journal Articles: Epidemiology

The novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) originated in Wuhan, China in late 2019, and its resulting coronavirus disease, COVID-19, was declared a pandemic by the World Health Organization on March 11, 2020. The rapid global spread of COVID-19 represents perhaps the most significant public health emergency in a century. As the pandemic progressed, a continued paucity of evidence on routes of SARS-CoV-2 transmission has resulted in shifting infection prevention and control guidelines between classically-defined airborne and droplet precautions. During the initial isolation of 13 individuals with COVID-19 at the University of Nebraska Medical Center, we collected air …

Real-Time Public Health Communication Of Local Sars-Cov-2 Genomic Epidemiology, Chaney C. Kalinich, Cole G. Jensen, Peter Neugebauer, Mary E. Petrone, Mario Peña-Hernández, Isabel M. Ott, Anne L. Wyllie, Tara Alpert, Chantal B. F. Vogels, Joseph R. Fauver, Nathan D. Grubaugh, Anderson F. Brito

Journal Articles: Epidemiology

Genomic epidemiology can provide a unique, real-time understanding of SARS-CoV-2 transmission patterns. Yet the potential for genomic analyses to guide local policy and community-based behavioral decisions is limited because they are often oriented towards specially trained scientists and conducted on a national or global scale. Here, we propose a new paradigm: Phylogenetic analyses performed on a local level (municipal, county, or state), with results communicated in a clear, timely, and actionable manner to strengthen public health responses. We believe that presenting results rapidly, and tailored to a non-expert audience, can serve as a template for effective public health response to …

Acute Encephalopathy With Elevated Csf Inflammatory Markers As The Initial Presentation Of Covid-19, Shelli Farhadian, Laura R. Glick, Chantal B. F. Vogels, Jared Thomas, Jennifer Chiarella, Arnau Casanovas-Massana, Jing Zhou, Camila Odio, Pavithra Vijayakumar, Bertie Geng, John Fournier, Santos Bermejo, Joseph R. Fauver, Tara Alpert, Anne L. Wyllie, Cynthia Turcotte, Matthew Steinle, Patrick Paczkowski, Charles Dela Cruz, Craig Wilen, Albert I. Ko, Sean Mackay, Nathan D. Grubaugh, Serena Spudich, Lydia Aoun Barakat

Journal Articles: Epidemiology

BACKGROUND: COVID-19 is caused by the severe acute respiratory syndrome virus SARS-CoV-2. It is widely recognized as a respiratory pathogen, but neurologic complications can be the presenting manifestation in a subset of infected patients.

CASE PRESENTATION: We describe a 78-year old immunocompromised woman who presented with altered mental status after witnessed seizure-like activity at home. She was found to have SARS-CoV-2 infection and associated neuroinflammation. In this case, we undertake the first detailed analysis of cerebrospinal fluid (CSF) cytokines during COVID-19 infection and find a unique pattern of inflammation in CSF, but no evidence of viral neuroinvasion.

CONCLUSION: Our findings …

Motor Vehicle Fatalities During Memorial Day Weekends, 1981-2016, Yuni Tang, Kendra Ratnapradipa, Henry Xiang, Motao Zhu

Journal Articles: Epidemiology

OBJECTIVE: Motor vehicle crashes are a leading cause of injury death in the United States, and Memorial Day weekend is one of six holiday periods with an increased number of motor vehicle fatalities in the United States. However, few motor vehicle fatality comparisons were made between Memorial Day weekend and non-holiday periods. Our aims were to determine which day(s) during the holiday had highest motor vehicle fatality risk compared to non-holiday travel and to identify potential risk factors.

RESULTS: Of 43,457 traffic fatalities studied, 15,292 (35%) occurred during the holiday, with Saturday being deadliest but Monday having highest odds of …

Increased Motor Vehicle Fatalities Tuesday Through Thursday During The Us Thanksgiving Holiday (1980-2018), Kendra Ratnapradipa, Motao Zhu

Journal Articles: Epidemiology

Traffic crashes remain a leading cause of death in the United States; holidays are known to have increased travel and traffic fatalities. Our purpose was to determine which days during Thanksgiving had the highest crash fatality risk compared to non-holiday periods. Using time series and binomial approximations, we analyzed Fatality Analysis Reporting System data (1980-2018) with a Monday-Sunday holiday and matching comparisons the weeks before and after. Fatalities included 31,263 during the holiday, 30,361 the previous week, and 29,399 the following week. Deadliest days during the holiday were Saturday (16.7% of fatalities) and Wednesday (16.0%), but odds of a traffic …

Screens, School District Employees, And Sleep: Is There A Relationship?, Mary Kay L. Bruihler

All Graduate Theses, Dissertations, and Other Capstone Projects

Statement of the Problem

Working in a school can be stressful and about half of educators in a national survey reported less than the recommended minimum of seven hours of sleep. Smartphones and other screened devices can cause sleep loss and are becoming more prevalent. Is there a relationship between the use of screened devices and sleep among the employees of a school district?

Procedures

Employees (n=36) of a small southern Minnesota school district were given an online survey regarding their sleep habits utilizing the Pittsburg Sleep Quality Index (PSQI), their screen time use, utilizing the Screen Time Questionnaire (STQ), …

The Difference In Barriers To Colorectal Cancer Screening Between Men And Women In The 45-55-Year Age Group, Maren Christina Davis

All Graduate Theses, Dissertations, and Other Capstone Projects

Statement of the Problem: Adults, 50 years or older, should have a screening colonoscopy every ten years and fecal immunochemical test (FIT) every year. However, close to 22 million adults between the ages of 50-75 in the U.S. have never been screened for colorectal cancer, which delays treatment and can be fatal if the cancer is not found in time.

Procedure: This study used a descriptive, cross-sectional, survey-based design and a convenience sample of men and women between 45 and 55 years old to assess colorectal screening practices, barriers to screening, and knowledge levels about colorectal cancer screening.

Findings: A …