Public Health Commons^™

Resources To Access Health Care For Low Socioeconomic Status Youth Athletes, Stephanie Walsh

College of Graduate Studies: Theses & Dissertations

Background: Approximately 60 million youth participate in organized sports, with 13.5 million receiving care for sports related injuries each year. Most youth sports organizations do not have readily accessible health care resources; relying on parents and guardians to manage injuries. However, a majority of parents and guardians are untrained in appropriate management of injuries, therefore there is a need for understanding the availability of health care resources within the community. Resources necessary to access health care include health services, health insurance, transportation, and communication. Barriers to these resources may affect lower socioeconomic status family’s accessibility to care. Purpose: Investigate the …

Attitudes Toward The Hpv Vaccine Among University Students: Identifying Barriers To Vaccine Uptake, Kristina L. Harbaugh

College of Graduate Studies: Theses & Dissertations

Background: In the United States, the Centers for Disease Control and Prevention (CDC) estimates that 32,000 cancers occur annually that can be directly attributable to the acquisition of the Human Papilloma Virus (HPV). Gender specificity data posits that 21,000 of the annual cancer cases are female and the remaining 11,000 cases occur among males. However, because the implementation and trajectory of HPV vaccination and prevention programs have been historically aimed toward women, vaccination rates for men remain significantly lower. The purpose of this study was to assess gender differences in knowledge attitude, subjective norms and perceived behavioral control about HPV …

Assessing The Percieved Barriers To Early Detection, Treatment, And Management Of Cervical Cancer Among Ghanaian Women, Angela D. Blackwell

College of Graduate Studies: Theses & Dissertations

Introduction: The purpose of this study was to assess the perceived barriers and strategies for improvement of timely detection, treatment, and management of cervical cancer among Ghanaian women in a tertiary hospital setting. Methods: Sixty semi-structured interviews, comprised of thirty-five cervical cancer patients and twenty-five healthcare professionals who provide cervical cancer care, were conducted. Two focus groups were conducted, including four healthcare professionals and another with two healthcare professionals—the data were analyzed using NVivo 12. A theoretical thematic analysis was utilized to identify common themes and sub-themes that arose from the participant interviews. The social-ecological model framework was employed to …

The Effect Of Patient And Hospital-Level Factors On 30-Day Readmission After Initial Hospitalization Due To Stroke, Emmanuel Akowuah

College of Graduate Studies: Theses & Dissertations

Background: Hospital readmissions account for a large part of healthcare costs, especially among stroke patients. Readmission is common among disabled stroke survivors because they often suffer some neurological deficits, functional impairment, and other preexisting cardiovascular conditions. Although previous studies have explored the relationship between hospital readmissions after initial hospitalization due to stroke and a set of predictors using various analytical models, it often remains uncertain which predictors are most influential or essential. This study aimed to assess the effect of patient and hospital-levels factors on 30-day readmission after initial hospitalization due to stroke using the Anderson model of healthcare …

Naloxone Availability In Georgia Retail Pharmacies 44 Months After Implementation Of A Statewide Standing Order, Enjoli Willis

College of Graduate Studies: Theses & Dissertations

Opioid overdose deaths have quadrupled since 1999. Georgia is one of 35 states with a significant increase in drug overdose deaths from 2013 – 2017, with deaths increasing by 70% during 2010-2018. Many states, including Georgia, have implemented naloxone standing orders to remove barriers to access to naloxone, an opioid overdose reversal drug that reverses opioid overdose symptoms. However, it is still not readily available in places where it is most needed. This research investigates naloxone availability in Georgia 44 months after the implementation of a statewide standing order. This research also seeks to determine if pharmacy and community-level factors …

Eye Screening In U.S. Adults With Diabetes: Examination Of Trends, Racial And Ethnic Differences, And Contribution Of Medicaid Expansion, Meps 2010-2017, Karon Lewis

College of Graduate Studies: Theses & Dissertations

Diabetic retinopathy (DR) is a prevalent cause of vision impairment and blindness among adults in the United States. Early diagnosis of DR through dilated eye examinations can reduce the risk of vision impairment or loss. Differences in eye examination rates by race and ethnicity have been suggested by prior studies emphasizing importance of increasing insurance coverage and access to care among minority populations. The Affordable Care Act aimed to expand health insurance coverage and improve access to care. This study examined trends overall and by race and ethnicity in eye examination rates and the contribution of Medicaid expansion on changes …

Assessing Hotel Employee Knowledge On Risk Factors And Risk Management Procedures For Microbial Contamination Of Hotel Water Distribution Systems, Brandon Leftwich

College of Graduate Studies: Theses & Dissertations

Background: Compromised hotel water supply lines by neglect or by physical and structural damage can lead to exposure of harmful pathogens to guests and staff. To reduce the risk of having contaminated water in a hotel plumbing system, some facilities may incorporate a water safety plan (WSP). WSPs are not mandatory for hotels in many US states, including the state of Georgia. As such, many hotel personnel are uninformed of WSPs and the precautions to take if their hotel water system is compromised. The purpose of this study was to identify hotel personnel’s knowledge and practices of WSPs through a …

Menthol In Electronic Cigarettes: A Contributor To Respiratory Disease?, Vijayalekshmi Nair, Malcolm Tran, Rachel Z. Behar, Song Zhai, Xinping Cui, Rattapol Phandthong, Yuhuan Wang, Songqin Pan, Wentai Luo, James F. Pankow, David C. Volz, Prue Talbot

Civil and Environmental Engineering Faculty Publications and Presentations

Menthol is widely used in tobacco products. This study compared the effects of menthol on human bronchial epithelium using submerged cultures, a VITROCELL® cloud chamber that provides air liquid interface (ALI) exposure without solvents or heating, and a Cultex ALI system that delivers aerosol equivalent to that inhaled during vaping. In submerged culture, menthol significantly increased calcium influx and mitochondrial reactive oxygen species (ROS) via the TRPM8 receptor, responses that were inhibited by a TRPM8 antagonist. VITROCELL® cloud chamber exposure of BEAS-2B monolayers increased mitochondrial protein oxidation, expression of the antioxidant enzyme SOD2, activation of NF-κB, and secretion of inflammatory …

Telemedicine Use And Associated Factors Related With Hba1c Level Among Type 2 Diabetes Outpatients During Covid-19 Outbreaks In Jakarta, Indonesia : A Cross-Sectional Study, Novi Sulistia Wati

Chulalongkorn University Theses and Dissertations (Chula ETD)

Introduction: The Large-Scale Social Restriction (PSBB) has been implemented in Indonesia since April 2020 as a response to the COVID-19 outbreaks. This prolonged restriction could impact routine diabetes care and glucose control among diabetes patients. Telemedicine is expected to be a solution to the disrupted diabetes care amid the pandemic. This study aimed to determine the telemedicine use and associated factors to glycemic control among type 2 diabetes mellitus (T2DM) outpatients during the pandemic. Methodology: This cross-sectional study was conducted online during March 2021. A structured questionnaire was administered to 264 subjects who were 25–54 years old, diagnosed with T2DM, …

Assessing The Efficiency Of Sub-National Units In Making Progress Towards Universal Health Coverage: Evidence From Pakistan, Faraz Khalid, Maria Petro Brunal, Abdul Sattar, Samia Laokri, Matthew Jowett, Wajeeha Raza, David R. Hotchkiss

Community Health Sciences

The World Health Report 2010 encourages countries to reduce wastage and increase efficiency to achieve Universal Health Coverage (UHC). This research examines the efficiency of divisions (sub-provincial geographic units) in Pakistan in moving towards UHC using Data Envelop Analysis. We have used data from the Pakistan National Accounts 2011-12 and the Pakistan Social Living and Measurement Survey 2012-13 to measure per capita pooled public health spending in the divisions as inputs, and a set of UHC indicators (health service coverage and financial protection) as outputs. Sensitivity analysis for factors outside the health sector influencing health outcomes was conducted to refine …

Connecting Communities To Primary Care: A Qualitative Study On The Roles, Motivations And Lived Experiences Of Community Health Workers In The Philippines, Eunice Mallari, Gideon Lasco, Don Jervis Sayman, Arianna Maever L. Amit, Dina Balabanova, Martin Mckee, Jhaki Mendoza, Lia M. Palileo-Villanueva, Alicia Renedo, Maureen L. Seguin, Benjamin Palafox

Development Studies Faculty Publications

Background

Community health workers (CHWs) are an important cadre of the primary health care (PHC) workforce in many low- and middle-income countries (LMICs). The Philippines was an early adopter of the CHW model for the delivery of PHC, launching the Barangay (village) Health Worker (BHW) programme in the early 1980s, yet little is known about the factors that motivate and sustain BHWs’ largely voluntary involvement. This study aims to address this gap by examining the lived experiences and roles of BHWs in urban and rural sites in the Philippines.

Methods

This cross-sectional qualitative study draws on 23 semi-structured interviews held …

Predictors Of Acne Vulgaris Among Adolescents In Kuwait, Mona Aikhabbaz, Abdullah Al-Taiar, Marwa Saeed, Reem Al-Sabah, Ahmed N. Albatineh

Community & Environmental Health Faculty Publications

Objectives: The prevalence of acne vulgaris (AV) among adolescents in Kuwait has remained mostly unknown. This study aimed to estimate the prevalence of AV and its predictors among adolescents in Kuwait.

Subjects and Methods: A cross-sectional study was conducted on 714 participants who were randomly selected from public schools using multistage cluster random sampling. The presence or absence of AV, as well as severity of AV, were assessed using the Global Acne Grading Scale. Data on risk factors and potential confounders were collected from the parents through a self-administered questionnaire, and from the adolescents by face-to-face interview. Weight and height …

Hear Me Roar, Abigail R. Seethoff

Graduate Student Theses, Dissertations, & Professional Papers

Hear Me Roar, a compilation of personal essays interspersed with short forms, grapples with the nuances of compliance versus autonomy in the context of the male gaze, beauty standards, and pop culture. The collection also explores what it means to treasure something—another person, an object—and how to express and deepen that affection.

Linking Health Behavior Theory And Interventions To Increase Human Papillomavirus Vaccine Uptake, Gretchen Elizabeth Neal

Graduate Student Theses, Dissertations, & Professional Papers

Human papillomavirus (HPV) is the most common sexually transmitted disease in adults in the United States (US). Persistent HPV infection can cause several cancers, including cervical, oropharyngeal, and anal cancer. To prevent these cancers, the U.S. Advisory Committee on Immunization Practices recommends that all adolescents start the HPV vaccine series at ages 11-12 years. Despite the safety and efficacy of available HPV vaccines, vaccine uptake rates remain lower than public health goals. In the US, only 51.1% of eligible adolescents have completed the vaccine series, a rate lower than the Healthy People 2020 goal of 80% coverage for series completion. …

Addressing The Covid-19 Nutrition Crisis In Vulnerable Communities: Applying A Primary Care Perspective, Madeline Mae A. Ong, Ronnah Marie Ong, Gladys Kaye Reyes, Lourdes S. Tanchanco

Ateneo School of Medicine and Public Health Publications

The coronavirus disease (COVID-19) pandemic and subsequent public health interventions have disrupted food systems all over the world. In the Philippines, where stringent lockdown rules have been implemented, households living in poverty have had to rely largely on food aid in the form of food packs distributed by local governments and private donors. An evaluation of the commonly distributed food items reveals a diet that addresses acute hunger but does not contain sufficient nutrients to promote and maintain health. Such a diet puts low-income households at a greater risk of acute and chronic disease. The negative health impact of commonly …

Physician Empathy In Public And Private Internal Medicine Residency Training Programs In Pasig City, Rafael Carlos C. Aniceto, Dave Ryan A. Dela Cruz, Mary Stephanie M. Dofitas, Kenneth Brian M. Fernando, Melody Hope L. Lee Yu, Joseph Anthony Lachica

Ateneo School of Medicine and Public Health Publications

Research Question:
What are the levels of patient-perceived and self-assessed physician empathy among internal medicine (IM) residents in two tertiary hospitals in Pasig City? Is there a significant difference in patient-perceived and self-assessed physician empathy levels between public and private tertiary hospitals?

Background:
Empathy is important because it has been speculated to have a positive effect on patient outcomes; it is a skill that can be learned and developed.

Objectives:
This study obtained quantitative measurements of patient-perceived and self-assessed physician empathy. Empathy levels between public and private tertiary hospitals were compared.

General Study Design:
This study utilized a quantitative cross-sectional …

Factors Affecting Vaccine Hesitancy Among Families With Children 2 Years Old And Younger In Two Urban Communities In Manila, Philippines, Julius Migriño Jr, Billy Gayados, Karen Rachel Joyc Birol, Lorelie De Jesus, Christopher Willis Lopez, Winona Colleen Mercado, Jan-Mark Caezar Tolosa, Joeylyn Torreda, Glaze Tulagan

Ateneo School of Medicine and Public Health Publications

Objective: The study aimed to determine the factors that influence vaccine hesitancy among parents and caregivers of children 2 years old and younger in selected urban communities in Manila, Philippines.

Methodology: The study used a cross-sectional study design with a modified questionnaire adapted from the SAGE Working Group on Vaccine Hesitancy. Self-administered surveys were conducted in two highly urbanized barangays (smallest administrative divisions) in Manila, Philippines.

Results: The survey was completed by 110 respondents, comprised mostly of 20–39-year-old mothers. Most respondents (95.5%) believed that vaccines are protective however vaccine hesitancy rates among the respondents reached 36.4%.
Respondents who believed in …

Anaphylaxis Diagnosis And Management In The Emergency Department Of A Tertiary Hospital In The Philippines, Michelle Joy De Vera, Iris Conela Tagaro

Ateneo School of Medicine and Public Health Publications

Background:
In the Emergency Department (ED), diagnosis and management of anaphylaxis are challenging with at least 50% of anaphylaxis episodes misdiagnosed when the diagnostic criteria of current guidelines are not used.

Objective:
Objective of our study was to assess anaphylaxis diagnosis and management in patients presenting to the ED.

Methods:
Retrospective chart review conducted on patients presenting to The Medical City Hospital ED, the Philippines from 2013–2015 was done. Cases were identified based on International Statistical Classification of Diseases, 10th revision coding for either anaphylaxis or other allergic related diagnosis. Cases fitting the definition of anaphylaxis as identified by the …

Politiques Pronatalistes Au Vietnam : Le Fardeau De La Colonisation Française, Tessa D. Schrupp

Honors Theses

French Colonialism shaped Vietnam in profound and enduring ways. In particular, policies of the colonial government influenced the landscape of maternity and altered cultural perceptions of what it means to be a mother. Pronatalism, the promotion of female fecundity, was a central tenet of the “mission civilisatrice” promulgated by French medical professionals and government officials alike. This project seeks to examine the myriad reasons for the idealization of motherhood, the diverse responses of Vietnamese people to intervention, and the way colonial policies continue to affect modern day reproduction.

Association Between Homophobia And Perceived Discrimination In Health Care Services Among Lesbians In Chengdu, China, Linghong Liao

Chulalongkorn University Theses and Dissertations (Chula ETD)

The lesbians and its unique subculture have always been excluded by the heterosexual society. In Chinese society, they are an invisible and neglected minority group. Internalized homophobia is common where they tend to reject themselves and afraid that the people will discriminate them because they are lesbians. This situation might occur in health care service which could lead into lower healthcare utilization by the lesbians. This study aimed to assess whether the internalized homophobia has an association with the perceived discrimination while receiving health care service among lesbians in China. A cross-sectional online survey was conducted in Chengdu, China from …

Assessing Embalmer Exposure To Bioaerosols And The Associated Health Risk, Geneviève Marchand, Loïc Wingert, Stéphane Hallé, Maximilien Debia

Rapports de recherche scientifique

Plusieurs manipulations réalisées sur les corps des défunts par les thanatopracteurs produisent des bioaérosols qui peuvent contenir des agents pathogènes infectieux. La ventilation générale est souvent le seul moyen utilisé dans les laboratoires de thanatopraxie pour maîtriser les bioaérosols. Toutefois, il n’y a pas de recommandations précises pour sa mise en application. De plus, peu d'études abordent les expositions professionnelles aux bioaérosols dans le domaine de la thanatopraxie tant quantitativement (niveau d’exposition) que qualitativement (identification et classification selon les groupes de risque). L’objectif de cette étude était d’évaluer l’exposition des thanatopracteurs aux bioaérosols afin d’apprécier les risques potentiels sur leur …

Effet De L’Expertise Et Du Sexe Sur Les Contraintes À L’Épaule En Manutention, Etienne Goubault, Romain Martinez, Najoua Assila, Jennifer Dowling-Medley, Élodie Monga-Dubreuil, Sophie-Anne Scherrer, André Plamondon, Mickaël Begon

Rapports de recherche scientifique

L’atteinte de troubles musculosquelettiques (TMS) parmi les travailleurs et travailleuses au Québec était récemment estimée à 732 000 cas (Stock et al., 2014). Ces TMS sont associés aux activités professionnelles impliquant des efforts physiques prolongés, intenses et/ou répétitifs, telles que des tâches d’assemblage, de manutention, d’aide à la personne ou encore de maintien de posture prolongée sur un poste de travail. Les membres supérieurs, qui représentaient 30,1 % des cas de TMS déclarés et acceptés au Québec de 1998 à 2007 (Michel et al., 2010), sont les plus touchés après le dos. Plus particulièrement, l’épaule figure comme l’articulation …

Solvants Verts : Fondements, Santé, Sécurité, Environnement Et Substitution, Denis Bégin, Caroline Couture, Michel Gérin, Maximilien Debia

Rapports de recherche scientifique

L’utilisation de solvants dans de nombreuses applications (dégraissage, nettoyage, décapage, imprimerie, peintures, adhésifs, fabrication de produits pharmaceutiques) constitue une préoccupation majeure. En effet, un grand nombre d’entre eux sont associés à des effets nocifs, tant sur la santé et la sécurité des travailleurs (brûlure, cancer, dermatite, encéphalopathie, fœtotoxicité, polynévrite) que sur l’environnement et la santé de la population générale (précurseurs de smog, pollution des eaux, couche d’ozone). Par ailleurs, de plus en plus d’entreprises veulent prendre le virage vert, c.-à-d. faire en sorte que leurs activités et leurs produits s’inscrivent dans la démarche du développement durable. C’est dans ce contexte …

Webexpo : Vers Une Meilleure Interprétation Des Mesures D'Exposition Professionnelle Aux Substances Chimiques Sur Les Lieux De Travail, Jérôme Lavoué, Lawrence Joseph, Tracy L. Kirkham, France Labrèche, Gautier Mater, Frédéric Clerc

Rapports de recherche scientifique

Une grande partie de l'activité des hygiénistes du travail consiste à mesurer les niveaux d'exposition professionnelle des travailleurs. La plupart des rapports d'évaluation de l'exposition font état d'une importante variabilité spatiale et temporelle quant à l'intensité de l'exposition, laquelle fluctue souvent du simple au décuple en dépit de conditions apparemment similaires. Il en résulte depuis toujours un défi de taille en ce qui concerne l'interprétation des niveaux mesurés par rapport aux valeurs limites d’exposition professionnelle (VLEP). Il existe désormais un cadre consensuel – issu d'une élaboration progressive au cours des deux dernières décennies – concernant l'analyse des niveaux d’exposition par …

Webexpo: Towards A Better Interpretation Of Measurements Of Occupational Exposure To Chemicals In The Workplace, Jérôme Lavoué, Lawrence Joseph, Tracy L. Kirkham, France Labrèche, Gautier Mater, Frédéric Clerc

Rapports de recherche scientifique

Une grande partie de l'activité des hygiénistes du travail consiste à mesurer les niveaux d'exposition professionnelle des travailleurs. La plupart des rapports d'évaluation de l'exposition font état d'une importante variabilité spatiale et temporelle quant à l'intensité de l'exposition, laquelle fluctue souvent du simple au décuple en dépit de conditions apparemment similaires. Il en résulte depuis toujours un défi de taille en ce qui concerne l'interprétation des niveaux mesurés par rapport aux valeurs limites d’exposition professionnelle (VLEP). Il existe désormais un cadre consensuel – issu d'une élaboration progressive au cours des deux dernières décennies – concernant l'analyse des niveaux d’exposition par …

The Correlation Between Maternal Postpartum Depression And Child Psychopathology, T'Keyah I. Vaughan

Theses and Dissertations

Background: Postpartum depression (PPD) is a phenomenon that affects nearly 10-15% of pregnancies in the US. It is characterized by depressed mood or anhedonia and lasting for more than 2 weeks. PPD changes how moms interact with family members and child-rearing behavior. Depression is a phenomenon that is also known to affect the psychopathology of children. However, the specifics of how postpartum depression impacts children remains controversial. Many studies do not control for major depressive disorder which makes it difficult to disentangle the impact depression has within the first year of life. Furthermore, other PPD risk factors may be confounding …

The Intersection Of Social Stress, Mental Well-Being, And Sexual Health Among Black Women In Emerging Adulthood, Brandi Galloway

Theses and Dissertations

With an estimated 37,000 new HIV infections each year, HIV continues to be a major public health concern. HIV affects some populations more than others. Young Black women, in particular, are disproportionately affected by HIV. While being a woman does not typically increase a person’s HIV risk, being Black and being a woman does.

Data indicate that individual-level factors do not fully address the differences in HIV and STIs between Black emerging adult women and their White counterparts. Thus, it is critical to better understand contextual factors such as social stress and mental-wellbeing which might better account for these disparities. …

Changing Landscapes: Perspectives Of Young African American Women Of Population-Wide Testing For Hereditary Breast Cancer Mutations, Alesha Henderson

Theses and Dissertations

Young African American women continue to die from breast cancer at higher rates than White women. In an effort to promote breast cancer prevention, population-wide testing (PWT) for all women in the U.S. starting at age 30 is a potential future initiative that is garnering a lot of attention. However, African American women currently utilize genetic testing for hereditary breast cancer at lower rates than White women. Therefore, if young African American women are not prioritized in a future roll out of PWT, then existing breast cancer and genetic testing disparities will likely continue to widen. The purpose of this …

Swipe Right For Condoms And Testing: Differences In High-Risk Sexual Behavior And Sexual Health Beliefs Among Dating App Users Compared To Non-App Users, Shelby A. Smout

Theses and Dissertations

Millions of Americans are currently using smartphone dating applications (apps) to socialize and meet with others. In some cases, app-based conversations lead to sexual interactions. Previous research examining the relationship between the use of dating apps and sexual behaviors has found that individuals who use dating apps and meet with partners from the app are more likely to engage in high-risk sexual behaviors such as having multiple partners and inconsistent condom use. Individuals between the ages of 18 and 24 are the group most likely to be using dating apps compared to other age groups and are a high-risk group …

Quality Of Medical Care For Adults With Intellectual/Developmental Disabilities, Priya Chandan

Theses and Dissertations

QUALITY OF MEDICAL CARE FOR ADULTS WITH INTELLECTUAL/DEVELOPMENTAL DISABILITIES

By Priya Chandan, M.D., M.P.H.

A dissertation submitted in partial fulfillment of the requirements for the degree of Doctor of

Philosophy at Virginia Commonwealth University.

Virginia Commonwealth University, 2020.

Director: Director: Gloria J. Bazzoli, Ph.D.

Bon Secours Professor, Department of Health Administration

People with intellectual/developmental disabilities (IDD) are difficult to identify in administrative data, limiting the ability to study the quality of health care provided to this population. This study utilized clinical diagnoses to define a sample of hospitalized patients with IDD in the largest publicly available all-payer inpatient care database—the …