Public Health Commons^™

Multicomponent Approach To Delirium Prevention In The Acute Care Setting: An Evidence-Based Quality Improvement Project., Kelley James

Doctor of Nursing Practice Papers

Background: Acutely ill, hospitalized individuals are at an increased likelihood of developing delirium. Between 30-35% of those patients admitted to the hospital will develop delirium, and as a result, these individuals will face an increased risk of mortality, adverse medical events, restraint usage, and incur a more extended hospitalization. The literature supports early screening utilizing the Confusion Assessment Method (CAM) tool and nurse-driven, multicomponent interventions to aid in preventing its development.

Environment: This project was implemented in a long-term, acute care facility specializing in patients requiring long-term mechanical ventilation, advanced wound care, pulmonary and respiratory care, and the rehabilitation of …

Community Based Rehabilitation Programs For Resettled Muslim Women Refugees, Lori Maria Walton Phd, Dpt, Mscpt, Mph(S), Renee Hakim, Phd, Pt, Ncs, Veena Raigangar, Phd(C), Mscpt, M.Ed., Jennifer Schwartz, Dpt, Ncs, Sjm Ummul Ambia, Mscpt, Najah Zaaeed, Drph, Lmsw, Bassima Schbley

Journal of Health Ethics

According to the 2021 report from the United Nations High Commissioner for Refugees, 82.4 million people were forcibly displaced because of violence, wars, or persecution and over 26.4 million are currently living with refugee status. Displacement and resettlement trauma are associated with chronic disease onset and poor cognitive, physical, and mental health outcomes for refugee populations. To mitigate some of the deleterious effects of resettlement trauma, we propose a community-based rehabilitation program (CBRP) framework that is culturally sensitive, trauma-informed and focused on the vulnerabilities of women. The purpose of this novel CBRP framework is to address health inequities among a …

2022-08-01 Michiganoverview_Covidbedppe, Michigan Department Of Health & Human Services

Michigan COVID-19 Hospital Data

Contains the tables Statewide Hospital Capacity Report for COVID-19, COVID-19 Metrics, Statewide Hospital Available PPE Tracking for COVID-19, as well as the tables PPE Days On Hand and Patient Census.

Ethical Implications Of Covid-19 Surveillance In Karnataka Using Nancy Kass Framework, Apurva Jain, Lakshya Arora

Journal of Health Ethics

Numerous public health hurdles, including pandemics such as COVID-19, have led to concerns about community health practices in relation, necessitating the application of an ethical perspective. International research ethics guidelines are only used in a restricted range of contexts of public health. As a result, a variety of frameworks have been established to assist ethical analysis of public health concerns. In this study, we have used the Nancy Kass framework for analyzing COVID-19 surveillance in Karnataka state of India, which is a six-step approach that can assist public health practitioners in evaluating the ethical consequences of interventions, policy initiatives, services, …

Quality Improvement: Piloting A Pediatric Obesity Prevention Screening Tool And Intervention In A Family Practice Setting., Erin Shaye Semeyn

Doctor of Nursing Practice Papers

Background: In the United States today, nearly one third of children fall into the category of overweight or obese. Because it is extremely difficult to treat childhood obesity once it occurs, prevention is the optimal approach to childhood overweight and obesity (Brown & Perrin, 2018; Cooper & Mandel, 2020). An ideal time to address obesity prevention health behaviors is during pediatric primary care visits. Since the COVID-19 pandemic began in the United States in 2019, visits to primary care offices, including visits to an urban university-based family practice clinic in Kentucky, dropped as some pediatric patients and their caregivers worried …

2022-08-01_Michiganoverview_Covidoutbreak, Michigan Department Of Health & Human Services

Michigan COVID-19 Outbreak Reports

The Outbreak Data page was obtained from Michigan's COVID-19 data page: https://www.michigan.gov/coronavirus/stats/outbreak-reporting.

This report is created by the Michigan Department of Health & Human Services from data self-reported by local health departments. Data is updated every week.

COVID-19 outbreaks are generally defined as two or more cases with a link by place and time indicating a shared exposure outside of a household. Local health departments report the number of new and ongoing outbreaks they are investigating by the setting of the outbreak. New outbreaks are those outbreaks that were first identified during the current reporting week. Ongoing outbreaks are …

Life In An Endemic Covid-19: Older Adults' Well-Being, Activity, And Perceptions, Rachel Ngu, Micah Tan, Jia Ying Low

ROSA Research Briefs

The current research brief provides a preliminary examination of whether older adults have been able to ‘return’ to the pre-pandemic way of life in an endemic COVID-19. To do this, we look at several key indicators, including (1) tracking older adults’ overall life satisfaction, activity levels, and trust in government over the past 3 years, (2) older adults’ confidence to resume activities, as well as subjective perceptions about their safety when leaving the home in an endemic COVID-19, and (3) older adults’ ability to adhere to the Home Recovery Program (HRP), where individuals with COVID-19 are able to recover from …

A Policy Project: Implementing Safe Firearm Storage Legislation In Kentucky., Maggie M. Wiser

Doctor of Nursing Practice Papers

Ensuring the safe storage of firearms in the home is a research-supported method of reducing the incidence of firearm injury and death, specifically unintentional injury and self-harm in the pediatric population. The American Academy of Pediatrics recommends keeping all firearms stored locked, unloaded, and separate from ammunition. While evidence shows that implementing laws regulating the storage of firearms can be effective to reduce morbidity and mortality, the state of Kentucky currently has no such regulations. For this DNP project, John Kingdon’s Multiple Streams Framework was used as a guideline for policy analysis with the intention of identifying opportunities to advocate …

Sex And Gender Differences In Symptoms Of Early Psychosis: A Systematic Review And Meta-Analysis, Brooke Carter, Jared Wootten, Suzanne Archie, Amanda L Terry, Kelly K. Anderson

Epidemiology and Biostatistics Publications

First-episode psychosis (FEP) can be quite variable in clinical presentation, and both sex and gender may account for some of this variability. Prior literature on sex or gender differences in symptoms of psychosis have been inconclusive, and a comprehensive summary of evidence on the early course of illness is lacking. The objective of this study was to conduct a systematic review and meta-analysis of the literature to summarize prior evidence on the sex and gender differences in the symptoms of early psychosis. We conducted an electronic database search (MEDLINE, Scopus, PsycINFO, and CINAHL) from 1990 to present to identify quantitative …

Environmental Communication: Changing The Attitude-Behavioral Gap In Science Communication Utilizing Strategic Messaging, Carrie Helgeson Nelms

Graduate Theses and Dissertations

National Polls in the United States consistently find the public’s beliefs and attitudes about climate change and other environmental issues significantly diverge from those held by the science community. A communication gap between the findings on the causes and effects of environmental issues and the public’s inability to interpret or refuse to accept these findings are possible causes of this divergence. This communication gap constitutes a threat to society because of inaction to environmental problems and points to needed changes in scientific messaging that better informs and motivates behavioral change. The present research employed a strategic message design to affect …

Narrative Synthesis Systematic Review Of Pakistani Women's Health Outcomes From Primary Care Interventions, Sara Rizvi Jafree, Qaisar Khalid Mahmood, Sohail Mujahid, Muhammad Asim, Jane Barlow

Community Health Sciences

Objective: Women living in Pakistan have complex health problems including infectious and non-communicable diseases, accident and injuries, and mental health problems. While a majority of these women rely on primary healthcare services for all of their healthcare needs, there has to date been no overview of the extent of their effectiveness. The objective of this review was to (1) synthesise the available evidence regarding the effectiveness of primary care based interventions aimed at improving women's mental and physical health and (2) identify the factors that promote effectiveness for women's health outcomes.
Methods: Five academic databases were searched, including PubMed, BMC …

The History Of Air Quality In Utah: A Narrative Review, Logan E. Mitchell, Christopher Zajchowski

Human Movement Studies & Special Education Faculty Publications

Utah has a rich history related to air pollution; however, it is not widely known or documented. This is despite air quality being a top issue of public concern for the state’s urban residents and acute episodes that feature some of the world’s worst short-term particulate matter exposure. As we discuss in this narrative review, the relationship between air pollution and the state’s residents has changed over time, as fuel sources shifted from wood to coal to petroleum and natural gas. Air pollution rose in prominence as a public issue in the 1880s as Utah’s urban areas grew. Since then, …

Evaluating Traditional And Novel Modalities Of Self-Monitoring In Females With Low-Literacy & Obesity: A Feasibility Study, Anita H. Kelleher

Master's Theses

This study aimed to determine the feasibility of three distinct self-monitoring modalities employed as part of a weight-loss intervention among Spanish- and Mixtec-speaking women with low-no literacy who were overweight or obese (body mass index, BMI> 25). Primary outcomes assessed include self-monitoring adherence, weight, body composition, and diet quality. Participants (n=18) were recruited from the Cal Poly Women and Infants Mobile Health Unit, and contacted if they had a BMI> 25 and did not attend school beyond elementary level (6th grade). Upon enrollment, participants were asked to attend a weekly meeting at which the lifestyle intervention was delivered by a …

A Scoping Review Of Preterm Births In Sub-Saharan Africa: Burden, Risk Factors And Outcomes, Adam Mabrouk, Amina Abubakar, Ezra Too, Esther Chongwo, Ifedayo M. Adetifa

Institute for Human Development, East Africa

Preterm births (PTB) are the leading cause of neonatal deaths, the majority of which occur in low- and middle-income countries, particularly those in Sub-Saharan Africa (SSA). Understanding the epidemiology of prematurity is an essential step towards tackling the challenge of PTB in the sub-continent. We performed a scoping review of the burden, predictors and outcomes of PTB in SSA. We searched PubMed, Embase, and three other databases for articles published from the database inception to 10 July 2021. Studies reporting the prevalence of PTB, the associated risk factors, and/or its outcomes were eligible for inclusion in this review. Our literature …

Mindfulness, Psychological Distress, And Somatic Symptoms Among Women Engaged In Sex Work In China, Cheuk Chi Tam, Yuejiao Zhao, Shan Qiao, Xiaoming Li, Zhiyong Shen

Faculty Publications

Women engaged in sex work (WSW) in China encounter numerous disadvantages (e.g., exposure to violence) and have substantial risk for psychological distress and somatic symptoms. Intervention literature has attended to mindfulness, which is a protective factor for psychological outcomes, and its influences can further improve physical health. However, mindfulness has not been well studied in WSW. We aimed to examine the association among mindfulness, psychological distress, and somatic symptoms among Chinese WSW. Data were collected from 410 WSW in Guangxi, China, using an anonymous, self-administered survey evaluating demographics, mindfulness, psychological distress (i.e., depression, loneliness, and perceived stress), and somatic symptoms …

Understanding Deaths Of Despair In Us Counties Through Bourdieu's Theory Of Capital, Seulki Kim

Legacy Theses & Dissertations (2009 - 2024)

The overarching goal of this dissertation is to examine a recent rise in rates of deaths from suicide, alcohol, and drugs, labeled together as “deaths of despair” in the United States using Bourdieu’s theory of capital. Although the deaths of despair phenomenon is a product of a complex process related to various material and non-material factors, there is no theoretical framework that is able to account for different domains of predictors. Thus, this dissertation aims to fill this gap by drawing on Bourdieu’s theory of capital and systematically investigating the relationships of mortality rates attributed to suicide, alcohol, and opioid …

Barriers To Care For Poststroke Visual Deficits In Alberta, Canada, Kiran Pohar Manhas, Karim F. Damji, Katelyn Brehon, Jennis Jiang, Peter Faris, Fiona Costello

Department of Ophthalmology & Visual Sciences

Poststroke visual impairment (VI) negatively affects rehabilitation potential and quality of life for stroke survivors. In this cross-sectional observational study, stroke survivors and providers were surveyed to quantify perspectives regarding care for poststroke VI in Alberta, Canada (n = 46 survivors; n = 87 providers). Few patients (35%) felt prepared to cope with VI at the time of discharge from acute stroke and inpatient rehabilitation settings. Less than 25% of stroke survivors, and <16% of providers, felt referral processes were adequate. 95.2% of providers and 82% of stroke survivors advocated for a provincial clinical pathway to improve care quality for poststroke VI.

Investigating Fruit And Vegetable Variety In A National Food Co-Op: A Brighter Bites Evaluation, Katherine G. Hearne

Dissertations and Theses (Open Access)

American children eat fewer fruits and vegetables (F&V) and less variety of F&V than recommended for health. Food cooperatives and other programs have become a popular way to increase F&V intake, but little is known about the variety of F&V distributed by these programs or its relationship with program attendance or child F&V intake. Brighter Bites is a national, school-based food co-op distributing rescued, donated, fresh F&V to families in low-income schools. We evaluated, for the first time, the variety of F&V Brighter Bites distributed to families in the 2018-2019 school year and the relationships between that variety and both …

Three Essays About Preventing Mental And Behavioral Disorders, Snehal Lopes

All Dissertations

Prevention efforts in the public health field operate at various levels, including primary prevention among those without a disease of interest, secondary prevention among persons at high risk or showing early signs of the disease, and tertiary prevention among persons with the disease. The three essays presented in this dissertation are centered around the theme of prevention, and taken together, have implications for prevention at the primary, secondary, and tertiary levels. Specifically, the essays focus on the prevention of depressive disorders and the prevention of behavioral and mental health correlates for depression in the context of various populations (general adult, …

Adolescent Health Services: Access And Outcomes, Mackenzie Stuenkel

All Dissertations

Adolescence is a unique developmental period during which most lifelong mental health illnesses develop. Interventions and programs targeting adolescent health care utilization and effectiveness often fail to include measures of implementation science including long term sustainability and contextual characteristics. The purpose of this dissertation was to evaluate two programs designed to increase health care utilization and engagement in adolescent populations. Guided by the Practical, Robust, Implementation and Sustainability Framework (PRISM), strengths and weaknesses across model delivery and context of School-based Health Centers (SBHC) were assessed through in-depth interviews with clinicians, managers, and school staff. SBHC outcomes and services were assessed …

Building Consensus For A Shared Definition Of Adverse Events: A Case Study In The Profession Of Dentistry, Amy Franklin, Elsbeth Kalenderian, Nutan Hebballi, Veronique Delattre, Jini Etoule, Joel White, Ram Vaderhobli, Denice Stewart, Karla Kent, Alfa Yansane, Muhammad Walji

Faculty, Staff and Student Publications

BACKGROUND: To achieve high-quality health care, adverse events (AEs) must be proactively recognized and mitigated. However, there is often ambiguity in applying guidelines and definitions. We describe the iterative calibration process needed to achieve a shared definition of AEs in dentistry. Our alignment process includes both independent and consensus building approaches.

OBJECTIVE: We explore the process of defining dental AEs and the steps necessary to achieve alignment across different care providers.

METHODS: Teams from 4 dental institutions across the United States iteratively reviewed patient records after identification of charts using an automated trigger tool. Calibration across teams was supported through …

Longitudinal Reduction In Diversity Of Maternal Gut Microbiota During Pregnancy Is Observed In Multiple Low-Resource Settings: Results From The Women First Trial, Minghua Tang, Nicholas E. Weaver, Daniel N. Frank, Diana Ir, Charles E. Robertson, Jennifer F. Kemp, Jamie Westcott, Kartik Shankar, Sumera Aziz Ali, Sarah Saleem

Community Health Sciences

Objective: To characterize the changes in gut microbiota during pregnancy and determine the effects of nutritional intervention on gut microbiota in women from sub-Saharan Africa (the Democratic Republic of the Congo, DRC), South Asia (India and Pakistan), and Central America (Guatemala).
Methods: Pregnant women in the Women First (WF) Preconception Maternal Nutrition Trial were included in this analysis. Participants were randomized to receive a lipid-based micronutrient supplement either ≥3 months before pregnancy (Arm 1); started the same intervention late in the first trimester (Arm 2); or received no nutrition supplements besides those self-administered or prescribed through local health services (Arm …

Narrative Inquiry Into Postsecondary Transition Outcomes For Young Adults With Intellectual & Developmental Disabilities, Eric R. Sarrett

Walden Dissertations and Doctoral Studies

Young adults with intellectual and developmental disabilities (IDD) continue to struggle with community engagement despite decades of research and policy initiatives addressing postsecondary transition. Evidence shows that persons with IDD are engaging in employment, postsecondary education, independent living, socialization, and other roles at significantly diminished rates, yet little data exists describing this participation in the voices of those affected. The purpose of this narrative inquiry was to describe community integration of persons with IDD in the decade following postsecondary transition in their own words. Critical disability theory was used as a lens to explore the successes and failures of public …

Estimating The Health Effects Of Adding Bicycle And Pedestrian Paths At The Census Tract Level: Multiple Model Comparison, Ross J. Gore, Christopher Lynch, Craig Jordan, Andrew Collins, R. Michael Robinson, Gabrielle Fuller, Pearson Ames, Prateek Keerthi, Yash Kandukuri

VMASC Publications

Background: Adding additional bicycle and pedestrian paths to an area can lead to improved health outcomes for residents over time. However, quantitatively determining which areas benefit more from bicycle and pedestrian paths, how many miles of bicycle and pedestrian paths are needed, and the health outcomes that may be most improved remain open questions.

Objective: Our work provides and evaluates a methodology that offers actionable insight for city-level planners, public health officials, and decision makers tasked with the question “To what extent will adding specified bicycle and pedestrian path mileage to a census tract improve residents’ health outcomes over time?” …

Overview Of Transition Care Clinics And Patient No-Shows, Manul Awasthi

Electronic Theses and Dissertations

Introduction

Transition care clinics (TCCs) have proven to be effective in meeting the time-sensitive needs of patients in the post-discharge period and ensuring smooth transitions of patients from hospital to home. These clinics have led to lower readmissions, lower emergency department visits, cost savings, and lower rates of other adverse events following discharge. However, TCCs, including the East Tennessee State University Family Medicine (ETSU-FM) TCC have been facing high rates of patient no-shows.

Aim

The aim of this dissertation is to identify the different components and outcomes of TCC based on the literature. We further aim to analyze the TCC …

Examining Social Determinants Of Health And Cervical Cancer Risk And Outcomes In Ecuadorian Women, Pooja Tewari

Open Access Theses & Dissertations

Background and Significance: The burden of cervical cancer in the Latin American region is high. The crude incidence rate and the crude mortality rate in Ecuador are significantly higher than that of South America and the World. Riobamba, Ecuador, where the Fundación Internacional Buen Samaritano Paul Martel (FIBUSPAM) hospital is located, has been found to be one of the cities most affected with cervical cancer in the country. Risk factors for cervical cancer that have been identified in Latin American women include chronological age, age of first sexual intercourse, number of sexual partners, number of pregnancies, use of oral contraceptives, …

Case Report: Axilla Fibroadenoma - An Atypical Presentation, Safna Naozer Virji, Lubna Mushtaque Vohra, Syeda Sakina Abidi, Romana Idress

Department of Surgery Docs

No abstract provided.

Burnout And Wellness Strategies During The Covid-19 Pandemic, Cecilia Salinas Domene

MEDI 9331 Scholarly Activities Clinical Years

During the COVID-19 pandemic, healthcare workers not only had to manage how to treat a new disease but also had to increase their workload to keep up with the patients infected with the new virus. These physicians had to deal with an increase in patients and an increase in patient deaths. In addition, being a frontline worker meant that these physicians had more exposure to the virus than the general population. If they did contract the virus themselves, they had to go into quarantine, many times away from their families (Walton et al., 2020). A national survey done of physicians …

Racial Differences In Tobacco Use And Risk Factors Among Young Adults: Roles Of Expectancies And Emotion Regulation, Laurel Brockenberry

Psychology Theses & Dissertations

African Americans experience higher mortality from lung cancer and other smoking-related diseases than Caucasian Americans (Kochanek et al., 2016) despite engaging in cigarette and e-cigarette use significantly less or at comparable rates to other racial groups (CDC, 2015; Schoeborn, 2013). During adolescence, smoking prevalence is lower among African Americans than Caucasian Americans, but there is a “cross-over effect” whereby smoking rates become similar later in adulthood (Belgrave et al, 2010). The mechanisms driving this effect are poorly understood. Thus, examining motivating factors for tobacco use, such as outcome expectancies and emotion regulation, may be especially illuminating for young adult African …

Development Of A Quality Improvement Dental Chart Review Training Program, Elsbeth Kalenderian, Nutan B Hebballi, Amy Franklin, Alfa Yansane, Ana M Ibarra Noriega, Joel White, Muhammad F Walji

Faculty, Staff and Student Publications

INTRODUCTION: Chart review is central to understanding adverse events (AEs) in medicine. In this article, we describe the process and results of educating chart reviewers assigned to evaluate dental AEs.

METHODS: We developed a Web-based training program, "Dental Patient Safety Training," which uses both independent and consensus-based curricula, for identifying AEs recorded in electronic health records in the dental setting. Training included (1) didactic education, (2) skills training using videos and guided walkthroughs, (3) quizzes with feedback, and (4) hands-on learning exercises. In addition, novice reviewers were coached weekly during consensus review discussions. TeamExpert was composed of 2 experienced reviewers, …