Public Health Commons^™

Educating Nurses To Help Promote Diabetes Self-Care Management In Primary Care, Delphine E. Ikpasaja

Walden Dissertations and Doctoral Studies

Diabetes is a chronic disease that has a genetic and lifestyle component, and it affects individuals in various parts of the world. A lack of understanding of the nature of the disease has contributed to the complications experienced by patients with diabetes 2 (DM2), such as an elevated glycosylated hemoglobin (A1C) and hyperglycemia. At the clinic where this project took place, patients received an initial teaching but did not get any further support or resources to manage their disease. A four sections of a 30 minutes each was the educational presentation used with staff at the clinic to help them …

Analyzing Regional Impact Of Caregiving On Obesity Prevalence Among U.S. Adults, Myra Callis Johnston

Walden Dissertations and Doctoral Studies

Obesity remains one of the leading causes of morbidity and mortality in the United States. Historically, sparse research efforts have focused on informal caregiving as a possible risk factor for developing chronic illnesses across the United States. Identifying additional subgroups at higher risk of becoming obese could provide insights into where public health practitioners, the health care community, and policy makers can direct limited resources through a more targeted approach. The theoretical foundation for the current project was the social cognitive theory. In this secondary correlational analysis using the 2018 Behavioral Risk Factor Surveillance System data set, the relationship between …

Lifestyle Risk Factors, Quality Of Life, And Intervention Preferences Of Barrett's Esophagus Patients: A Prospective Cohort Study, Xiaotao Zhang, Sharmila Anandasabapathy, Julian Abrams, Mohamed Othman, Hoda J Badr

Faculty, Staff and Students Publications

BACKGROUND AND AIMS: Lifestyle counseling to achieve a healthy weight, quit smoking, and reduce alcohol is a cornerstone in the management of Barrett's Esophagus (BE). However, little is known about whether patients make these recommended lifestyle changes or the impact of non-adherence on their quality of life (QOL). This study characterized the lifestyle risk factors, QOL, and intervention preferences of BE patients as a first step toward developing lifestyle change interventions for this population.

METHODS: Patients with a confirmed BE diagnosis (N = 106) completed surveys at a surveillance endoscopy visit (baseline) and at 3- and 6-month follow-ups. Patients reported …

Examining Clinicians' Perspectives Screening For Depression In Patients With Type 2 Diabetes Mellitus, Vickie Lavette Bland

Walden Dissertations and Doctoral Studies

The United States has a significant diabetes problem. This chronic disease affects the body physically and mentally. One of the emotional effects of diabetes is depression. Depression is often present in individuals with diabetes, chiefly in those with type 2 diabetes mellitus (T2DM). While depression is common in T2DM and can interfere with treatment adherence, clinician screening for depression in T2DM patients is low. The purpose of this study was to examine clinicians' attitudes, behaviors, and perceptions concerning screening patients with T2DM for depression. Through a qualitative case study approach centered on reasoned action theory, 3 physicians and 5 nurse …

Knowledge And Perceptions Of Antibiotic Resistance Stewardship Among Prehealth And Agriculture Students, Claudia Maria Da Silva Carvalho

Walden Dissertations and Doctoral Studies

The global threat of antibiotic resistant infection has resulted in health organizations to compile an antibiotic stewardship program, in which the education of current/future medical prescribers and farmers is central for the preservation of current and future antimicrobial treatments. The purpose of this study was to assess and compare the knowledge and perceived threat of antibiotic and antibiotic resistance, as well as the perceived benefit of antibiotic stewardship, among undergraduate students in biology and agriculture at a state university in Kansas. Framed by the health belief model, a cross-sectional study was conducted using a structured online survey of 136 undergraduate …

Exploring The Influences Of Culture On Hand-Hygiene Beliefs Of Foreign-Born Healthcare Workers, Sheila Blanche Davis

Walden Dissertations and Doctoral Studies

AbstractThe hand-hygiene practices of nonadherent health care workers (HCWs) are a major threat to patient safety and thus continue to be a concern for healthcare leaders and administrators worldwide. Healthcare-associated infections (HAIs), which are linked to HCWs' unclean hands, are prevalent throughout global healthcare settings. Global migration in the nursing profession and intercontinental travel among direct patient care providers make it challenging for healthcare leaders to sustain HCWs' adherence to hand-hygiene practices. The purpose of this grounded study was to explore the influence of the cultural beliefs about hand-hygiene practices of foreign-born HCWs. The theory of planned behavior was used …

Impact Of Social Barrier Removal On Primary Care Use By Managed Care Enrollees, Pamme Lyons-Taylor

Walden Dissertations and Doctoral Studies

Personal health represents a complex relationship among social, physical, and emotional factors that can be influenced by health-seeking behaviors. Prior research indicates that greater use of preventive services leads to longer life and lower healthcare costs. For some populations, evidence suggests that social barriers hinder access to preventive services. To better understand the relationship between social factors and the other personal-health factors, de-identified healthcare claims and social service encounter data for 4,480 low-income individuals enrolled in Medicare Advantage or Managed Medicaid at one national health insurance were examined using a retrospective, quasi-experimental design for services rendered between October 1, 2014 …

Racial Disparities In Hypertension Self-Awareness And Hospitalizations For Hypertension-Related Illnesses Among Adult Arkansans, Chimfumnanya Nwanze-Smith

Walden Dissertations and Doctoral Studies

Black individuals in the United States are twice as likely as White individuals to die of cardiovascular diseases. Between 2010 and 2016 in Arkansas (AR), hypertension (HTN) and HTN-related diseases had an age-adjusted death rate of 230.4 deaths per 100,000 population compared to 173.6 deaths per 100,000 population for Whites. The purpose of this quantitative, cross-sectional study was to explore the potential association between HTN self-awareness and emergency department (ED) visits and hospitalization rates for HTN and HTN-related illnesses between Black and White individuals in AR. The socioecological framework was used to explore sociodemographic (SDF) and socioeconomic (SES) factors as …

Current Effects Of U.S. Preventive Care Quality Narratives On Preventive Health Services, James Fisher

Walden Dissertations and Doctoral Studies

In the interest of improving patient outcomes, significant investments in operationalized quality of care within the Medicare space have promulgated a low-resolution narrative predicated on conflation of higher quality scores with improved population health. Concomitant financial incentivization of Medicare Advantage plans through aligned Star Measures places contracts as the fundamental unit of most care quality analyses, but no studies have considered how present incentivization schema have impacted physician use and associated quality scores over time for breast cancer screening (BCS), colorectal cancer screening (CCS), and annual flu vaccination (AFV) at a county level. Guided by the Evidence Based Model framework, …

Connectivity: Insights From The U.S. Long Term Ecological Research Network, David M. Iwaniec, Michael Gooseff, Katharine N. Suding, David Samuel Johnson, Daniel C. Reed, Debra P. C. Peters, Byron Adams, John E. Barrett, Brandon T. Bestelmeyer, Max C. N. Castorani, Elizabeth M. Cook, Melissa J. Davidson, Peter M. Groffman, Niall P. Hanan, Laura F. Huenneke, Pieter T. J. Johnson, Diane M. Mcknight, Robert J. Miller, Gregory S. Okin, Daniel L. Preston, Andrew Rassweiler, Chris Ray, Osvaldo E. Sala, Robert L. Schooley, Timothy Seastedt, Marko J. Spasojevic, Enrique R. Vivoni

Advanced Science Research Center

Ecosystems across the United States are changing in complex and surprising ways. Ongoing demand for critical ecosystem services requires an understanding of the populations and communities in these ecosystems in the future. This paper represents a synthesis effort of the U.S. National Science Foundation-funded Long-Term Ecological Research (LTER) network addressing the core research area of “populations and communities.” The objective of this effort was to show the importance of long-term data collection and experiments for addressing the hardest questions in scientific ecology that have significant implications for environmental policy and management. Each LTER site developed at least one compelling case …

Semantics Of The Black-Box: Can Knowledge Graphs Help Make Deep Learning Systems More Interpretable And Explainable?, Manas Gaur, Keyur Faldu, Amit Sheth

Publications

The recent series of innovations in deep learning (DL) have shown enormous potential to impact individuals and society, both positively and negatively. The DL models utilizing massive computing power and enormous datasets have significantly outperformed prior historical benchmarks on increasingly difficult, well-defined research tasks across technology domains such as computer vision, natural language processing, signal processing, and human-computer interactions. However, the Black-Box nature of DL models and their over-reliance on massive amounts of data condensed into labels and dense representations poses challenges for interpretability and explainability of the system. Furthermore, DLs have not yet been proven in their ability to …

Healthcare Leadership In The Context Of Cognitive Diseases Of Aging: A Community-Based Participatory Research Model, Dean Sherzai

Dissertations

The Problem

The world is facing a tsunami of chronic diseases of the brain such as dementia, Parkinson's, and stroke. But all populations are not affected equally. Though we are all at greater risk of developing these diseases, minority communities such as the Black and Hispanic populations are at much greater risk of succumbing to these conditions. To date we have spent billions of dollars on research and public health measures that have repeatedly failed, but over the last decade it has become evident that much of these diseases can simply be averted through effective public health and community-based measures …

A Model For Inhalation Of Infectious Aerosol Contaminants In An Aircraft Passenger Cabin, Bert A. Silich

International Journal of Aviation, Aeronautics, and Aerospace

Aerosol contamination of an aircraft cabin by infectious passengers is a concern of passengers, aircrew and the aviation industry. This may be especially important during a pandemic, such as COVID-19, where the full extent of aerosol transmission is not well understood. A statistical method to determine the number of infectious passengers on board along with a mathematical model estimating the contaminant concentration of aerosols in the cabin and the number of inhaled infectious particles by passengers is presented. An example is used to demonstrated how the results can be estimated during normal operations and emergency conditions with malfunctions of the …

Health Reform Reconstruction, Lindsay F. Wiley, Elizabeth Y. Mccuskey, Matthew B. Lawrence, Erin C. Fuse Brown

Faculty Articles

This Article connects the failed, inequitable U.S. coronavirus pandemic response to conceptual and structural constraints that have held back U.S health reform for decades and calls for reconstruction. For more than a half-century, a cramped “iron triangle” ethos has constrained health reform conceptually. Reforms aimed to balance individual interests in cost, quality, and access to health care, while marginalizing equity, solidarity, and public health. In the iron triangle era, reforms unquestioningly accommodated four legally and logistically entrenched fixtures — individualism, fiscal fragmentation, privatization, and federalism — that distort and diffuse any reach toward social justice. The profound racial disparities and …

Risk Factors And Knowledge Associated With High Unintended Pregnancy Rates And Low Family Planning Use Among Pregnant Women In Papua New Guinea, Elizabeth Peach, Christopher Morgan, Michelle J. L. Scoullar, Freya J. I. Fowkes, Elissa Kennedy, Pele Melepia, Primrose Homiehombo, Lucy Au, Stanley Luchters, Alexandra J. Umbers

Population Health, East Africa

Unintended pregnancy is a major driver of poor maternal and child health in resource-limited settings. Data on pregnancy intention and use of family planning (FP) is scarce in Papua New Guinea (PNG), but are needed to inform public health strategies to improve FP accessibility and uptake. Data from a facility-based cross-sectional sample of 699 pregnant women assessed prevalence and predictors of unintended pregnancy and modern FP use among pregnant women in East New Britain Province, PNG. More than half (55%) the women reported their pregnancy as unintended. Few (18%) reported ever having used a modern FP method, and knowledge of …

Effect Of Occupational Welding Fume Exposure On Hemostatic & Inflammatory Blood Parameters And Cardiovascular Risks On Welders And Non-Welders In Confined Space: A Longitudinal Study, Ning Li

Chulalongkorn University Theses and Dissertations (Chula ETD)

Occupational welding fumes contains varies of toxic metal particles and may affect cardiovascular system like the Particulate Matters (PM). The hypothetical mechanisms of welding fume toxicity center on oxidative stress and inflammatory, similar as the mechanisms that link PM2.5 and cardiovascular diseases (CVDs). The popular mechanisms on toxicity of welding fumes agreed that PM was associated with increased WBC and neutrophil counts, and increased WBC counts lead to higher Cardiovascular risks and Coronary heart disease risks.Urine Mn and Cr level in the welder group was significantly higher than the non-welder group (Mn: 0.96 VS 0.22 ug/g creatinine, p < 0.001; Cr: 0.63 VS 0.22 ug/g creatinine, p < 0.01). One third of the non-welders were in the high metal-exposed group. When all the participants were divided by occupation type, two times measurements revealed that Hct, WBC and Eosinophil indices of the welder groups were significantly higher (all p < 0.05). Linear regression models showed that, comparing to non-welders, welding could cause alterations to most hemostatic indices majorly by effecting an increase: Hct (β = 0.015, p = 0.007), WBC (β = 0.047, p = 0.033), Eosinophil ratio % (β = 0.345, p = 0.001). When all the participants were divided by metal level groups, there was bidirectional relationship between urine Mn level and WBC count in the linear regression models ((β = - 0.049, p = 0.045 and β = 0.059, p = 0.007, separately for starting and ending point). The study participants (both welders and non-welders) had an average systolic BP in the “high normal” range (Welders: 125.21 ± 11.23 mmHg for systolic BP Non-welders: mean = 126.33 ± 11.41 mmHg for systolic BP). Systolic blood pressure of the welder group increased significantly higher than the non-welder group after one year follow up (welder group VS non-welder: 4.13 ± 11.76 VS - 0.15 ± 6.60 mmHg, p = 0.037).

Family And Household Characteristics And Violent Disciplinary Practices Towards The Children In Myanmar: An Analysis Of 2015-2016 Myanmar Demographic And Health Survey, Nyan Linn

Chulalongkorn University Theses and Dissertations (Chula ETD)

Background: Violence against children is one of the challenging public health problems. Violent disciplines not only affect negative health impacts but also are against children's right. However, those violent methods are still widespread across the countries, especially within the family. For prevention and control, it is required to clearly understand the country-specific information of violent child disciplines. In Myanmar, there are very few studies focusing on this area. This study was aimed to investigate the prevalence and factors associated with violent disciplines against children in Myanmar.Methodology: This study was a secondary data analysis of nationally representative 2015-2016 Myanmar Demographic and …

The Stress And Burnout Among Lecturers In The Universities With Online Teaching In Vietnam During Covid-19 Pandemic: A Cross-Sectional Study, Anh Hoang Thi Ngoc

Chulalongkorn University Theses and Dissertations (Chula ETD)

During COVID-19 pandemic, the education system is one of many aspects in our life which is changed according to the effect of pandemic. Changing from traditional teaching method to new digital teaching method, may lead to adverse health effects directly to mental health of lecturers, including stress and burnout. This study aimed 1) to investigate the level of stress and burnout among lecturers in the universities in Vietnam during COVID-19 pandemic 2) to find the association among demographic, COVID-19 factors, difficulties in teaching online, and stress, burnout among tertiary education lecturers in Vietnam. This study was a cross-sectional study conducted …

Health Risk Assessment Related To Cadmium And Lead Exposure From Cigarette Smoking Among Indonesian Smokers In Surakarta, Indonesia: A Cross-Sectional Study, Panji Mukti

Chulalongkorn University Theses and Dissertations (Chula ETD)

Indonesia is one of the developing countries that have the highest number of smokers and ranks third under China and India. Heavy metal such as cadmium and lead poses major health hazards which are found in tobacco smoke. This study aimed 1) to assess the cancer risk and non-cancer risk related to lead and cadmium exposure from cigarette smoking among Indonesian smokers 2) to find the association between socio-demographic, exposure factors, and health risk among Indonesian smokers. This study was a cross-sectional study using an online questionnaire to get the personal information and smoking behavior among Indonesian male smokers who …

Effect Of Diamond Application On Dietary Intake And Bmi Among Over Nutrition Female College Student In Malang City, Indonesia: A Quasi-Experiment Study, Nurnaningsih Herya Ulfah

Chulalongkorn University Theses and Dissertations (Chula ETD)

Recently, using mobile applications for assisting weight loss programs is a common trend. However, the overnutrition rate is increasing every year. This research aims to develop and investigate the effect of Diet Monitoring (Diamond) application on dietary intake and BMI among overnutrition female college students in Malang City, Indonesia. Using 2 phases, this study used a cross-sectional study for phase I developing the app and a quasi-experiment for phase II investigating the effect of the application. 217 respondents were involved in phase I and 123 participants in phase II. The measurement tools were Tanita DC-360, and ZT-120 Health Scale, including …

Effectiveness Of Communication Program On Reduction Of Tb Stigma And Discrimination Among High-School Students In Bangkok: A Quasi-Experimental Study, Saowaluk Moonsarn

Chulalongkorn University Theses and Dissertations (Chula ETD)

Tuberculosis (TB) is a contagious disease through airborne transmission, and it is still a major cause of illness in Thailand. In addition, some patients with TB infection suffer from stigma and discrimination while living in their community. However, the stigma of TB patients is also reported to be high among high school students. The study aimed to explore the effectiveness of communication program on reduction of TB stigma and discrimination among high-school students in Bangkok. A quasi-experimental study was implemented in two high schools with 212 high-school students (Experimental group =108; Control group=104). Purposive and systematic sampling techniques were adopted …

Association Between Working Condition And Musculoskeletal Disorders (Msds) Among Female Garmentworkers In Khan Mean Chey, Phnom Penh City, Cambodia, Try Phally

Chulalongkorn University Theses and Dissertations (Chula ETD)

Musculoskeletal disorders (MSDs) are a serious public health issue in both industrialized and developing countries. This study aims to investigate the prevalence of musculoskeletal symptoms and the association between working conditions and MSDs among female garment workers in Khan Mean Chey, Phnom Penh city, Cambodia. A cross-sectional research design was conducted among 423 female garment workers. Data collection was convenient sampling through face-to-face interview using a structured questionnaire consisted of socio demographics, working conditions, and the Standardized Nordic Questionnaire for musculoskeletal symptoms assessment during the period between April and May 2022. Descriptive statistics was used to present the prevalence of …

Effectiveness Of A Social Health Security Program In Improving Financial Risk Protection Against The Health Expenditures Of The Insured Populations In Four Districts Of Nepal: A Mixed Method Study, Gaj Bahadur Gurung

Chulalongkorn University Theses and Dissertations (Chula ETD)

Background: Most low and low-middle income (LMICs) countries adopting National Health Insurance (NHI) programs to achieve Universal Health Coverage are struggling to implement the program and thus have failed to achieve the expected outputs. The Nepal NHI program initiated in 2016 has experienced numerous implementation challenges, due to inadequate inputs and throughput, resulting in negative output such adverse selection, poor health service delivery, low enrollment of the poor household and low annual non-renewals of the NHI membership. However, there is a lack of research that focuses on these problems. So, this study has two objectives. Firstly, delved into the NHI …

Geographical Distribution Improvement Of Physicians In Thailand And Japan : A Comparative Longitudinal Secondary Data Analysis, Hiromichi Takahashi

Chulalongkorn University Theses and Dissertations (Chula ETD)

Background: The equitable distribution of healthcare workforces to all citizens is necessary to achieve health for all, and has been discussed and addressed in all countries including Thailand and Japan. The objective of this study was to longitudinally examine the change in the geographical distribution of physicians and related policies between 2008 and 2018 through a comparison between Thailand and Japan. Methodology: This research was a longitudinal comparative descriptive study. All data is open secondary data that can be downloaded in the government website. The number of physicians, the physician-population ratio, the Gini coefficient and the Spearman’s correlation coefficient between …

Effectiveness Of Positive Deviance, A Behavior Change Approach, To Improve Knowledge, Attitude And Practices On Dengue Prevention And Control In Selected Slums In Islamabad, Pakistan : A Mixed-Method Study, Muhammad Shafique

Chulalongkorn University Theses and Dissertations (Chula ETD)

This is the first practical application of positive deviance on dengue in the two selected low-income slums of Islamabad which was conducted during June-October 2020. A total of 112 participants (56 for intervention and 56 for the control group) participated in the study. The intervention arm received the positive deviance intervention through the identified positive deviance role models during the regular PD sessions, role plays, illustration competitions, and songs for two months. Three surveys were conducted, before the intervention, after two months, and after four months to assess the changes in knowledge, attitude, and practices. At the baseline, no statistically …

Effect Of Line Application On Action And Coping Plans On Exercise Adherence And Functional Performance For Older Adults With Knee Pain In Suburban Area Of Bangkok Metropolis, Thailand : A Quasi Experimental Study, Pattaraporn Piwong

Chulalongkorn University Theses and Dissertations (Chula ETD)

The known advantage of exercise for older adults who had knee pain is limited by low adherence to an exercise program. LINE application on action and coping plans do improve exercise adherence, knee functional performance and reduce knee pain. This quasi-experimental study determined the effect of LINE application on action and coping plans on exercise adherence, self-efficacy for exercise (SEE) , specific self-efficacy (task, maintenance, recovery), functional performance including knee range of motion (ROM), time up and go (TUG), 30-second chair stand (30CST) , knee outcome for activities of daily living (KOS-ADLS) and knee pain scale among older adults with …

A Policy Simulation Impact Of Tobacco Excise Tax Increase On Cigarette Consumption, Mortality, Medical Treatment Cost, Life-Years Gained, And Government Revenue In Indonesia, Ridhwan Fauzi

Chulalongkorn University Theses and Dissertations (Chula ETD)

The study aimed to examine the impact of tobacco excise tax increase on cigarette consumption, mortality, medical treatment cost, life-years gained, and government revenue in Indonesia. The study consisted of two phases. First, the demand for cigarettes was analyzed using the two-part econometrics model. Data were retrieved from the National Socioeconomic Survey (SUSENAS) 2015, 2016, 2017, 2019, and 2020. The smoking participation was examined using logit specification, while the second part (smoking intensity) used the Generalized Linear Model (GLMs). Second, a compartmental model involving 65 million smokers was employed to assess the impact of different tobacco excise tax increased scenarios …

Association Between Physical Activity And Mental Health Among University Students In Bangladesh : A Cross Sectional Study, Sanjida Sultana

Chulalongkorn University Theses and Dissertations (Chula ETD)

Introduction: Mental health is considered one of the most significant topics of public health as it makes up an integral part of a person’s ability to lead a fulfilling life. University students are one of the most vulnerable groups to be affected by mental health disorders due to a change in their life and societal pressure. Lifestyle modifications like physical activity can be one way to combat these Mental Health problems. Although a lot of research has been carried out to analyze the health impact of Physical exercise, impact of it on Mental Health still lags, especially during the Covid-19 …

Effectiveness Of Blended Learning Program For Cyber Sexual Harassment Prevention Among Female High School Students In Bangkok, Thailand, Siriporn Santre

Chulalongkorn University Theses and Dissertations (Chula ETD)

Cyber sexual harassment is increasing to be one of public health problem among youths. This study aimed to evaluate the effectiveness of blended learning program on knowledge, attitudes, intention to cope with cyber sexual harassment, behavioral coping strategies, and cyber sexual harassment among female high school students in Bangkok, Thailand. A quasi-experimental study design was conducted between May 2021 to October 2021. Total 112 students (56 in intervention and 56 in control group) were selected. The intervention group participated in blended learning program for 12 weeks, while the control group did not receive any program. Blended learning program based on …

Assessment Of Knowledge, Attitude And Usage On Personal Protective Equipment Among Mechanical Maintenance Workers Of A Power Generation Unit In Thailand, Titiphorn Tankian

Chulalongkorn University Theses and Dissertations (Chula ETD)

A Power Generation Unit has duty of electric power supply to the people by producing and distributing electric power. The mechanical maintenance department is one part of their responsibility to achieve the target. However, 207 accident cases were reported during 2012 to 2019. The main causes were found to be unsafe act and unsafe condition including improper usage and lack of personal protective equipment (PPEs). Thus, knowledge, attitude regarding to PPEs, its usage, and factors related to PPEs usage of mechanical maintenance workers need to be assessed. This survey study collected data through self-response questionnaire from 379 mechanical maintenance workers …