Public Health Commons^™

Effect Of The Expanded Prospective Payment System On Dialysis Initiation, The Usage Of Erythropoiesis-Stimulating Agents, And Medicare Expenditures, Lu Zhang

Dissertations and Theses (Open Access)

In January 2011, the U.S. Centers for Medicare & Medicaid Services (CMS) implemented the expanded prospective payment system (PPS) for financing the management of end-stage renal disease (ESRD). Expanded PPS may not only change healthcare providers’ decisions about patient care by removing the financial incentives associated with the previous composite rate payment methodology, but also change the Medicare expenditures associated with various treatment patterns by using a constant base rate for all dialysis modalities. This study aimed to examine the effect of the expanded PPS on providers’ decisions on timing of dialysis initiation and ESA utilizations in ESRD patients as …

Hospital Market Analysis Using A Cohort Of Privately Insured Patients With Total Hip And Knee Replacement Procedures, Elifnur Yay Donderici

Dissertations and Theses (Open Access)

Background: Several recent studies have analyzed the contribution of hospital inpatient prices and utilization to variation in medical spending. However, it is still unknown how the drivers of spending for specific procedures differ within privately insured patients. Next, the market concentration of hospitals has been a matter of concern for several decades. However, researchers usually calculate Herfindahl-Hirschman index (HHI) as a measure of market concentration or power, but there is a drawback of using this measure. Hospitals sell differentiated products, and the HHI measure does not take this differentiation into account in its formulation (Gaynor and Town, 2011). Objective: First …

The Multilevel Factors Facilitating Or Impeding Healthcare Access Among Refugees Residing In Bexar County Texas, Howaida Werfelli

Dissertations and Theses (Open Access)

The goal of this study was to increase understanding of healthcare access among refugees by investigating the multilevel factors that facilitate or impede healthcare access among refugees who have resettled in Bexar County, Texas. The multilevel factors facilitating or impeding access to healthcare for refugees resettled in Bexar County were identified as follows: health literacy, level of educational attainment, proficiency (reading, writing and, speaking) in English, proficiency (reading, writing and speaking) in native language, translation services, public transportation, income level, a shortage of healthcare providers, navigation of the healthcare system, the fragmentation of the healthcare system, insurance status, staff shortages …

Health Disparities Across Funcitonal Disability Groups, Katherine Sanches

Dissertations and Theses (Open Access)

Background: People with disabilities experience higher rates of chronic disease and poor health status compared to those without disability. People with disabilities do not participate in community health programs to the same degree as those without disability due to social, programmatic, and environmental barriers. The Community Health Inclusion Index (CHII) is a community health assessment tool which evaluates the degree to which community-level health promoting opportunities to promote nutrition and physical activity are inclusive and accessible to people with disabilities. The CHII assess barriers to inclusion across five domains: build environment, equipment, program/services, staff, and policies. Objective: The purpose of …

Life Expectancy And Active Life Expectancy By Marital Status Among Older U.S. Adults Results From The U.S. Medicare Health Outcome Survey (Hos), Haomiao Jia, Erica I. Lubetkin

Publications and Research

Background: Previous investigations of the relationship between marital status and life expectancy and healthy life expectancy rely on the assumption that participants will remain in a given marital status until death. This study estimated total life expectancy (TLE) and active life expectancy (ALE) for respondents by their baseline marital status using a large longitudinal sample of the U.S. community-dwelling elderly population.

Methods: Data were from the Medicare Health Outcomes Survey Cohort 15 (2012 baseline, 2014 follow-up). We included respondents aged ≥65 years (n = 164,597). Multi-state models estimated TLE and ALE by marital status to allow participants' marital status to …

Barriers Inhibiting Detection And Management Of Postpartum Hemorrhage By Providers In Madagascar, Breakthrough Research, Usaid's Health Evaluation And Applied Research Development

Reproductive Health

Breakthrough RESEARCH partner ideas42 conducted research in June 2019 in peri-urban and rural areas of Vohipeno and Manakara districts of Madagascar's Vatovavy-Fitovinany region to identify health care providers' challenges for detecting and managing complications during childbirth including postpartum hemorrhage and identify optimal solutions. This brief summarizes the results of a behavioral diagnosis that reveals “Facility-based providers do not consistently follow best practices for the detection and management of complications during childbirth.” Low perception of risk of postpartum hemorrhage, limited review of compliance with best practices, consequences of current practices, and resource scarcity can negatively affect provider decision-making and clinical practice.

Obstacles Limitant La Détection Et La Prise En Charge De L’Hpp Par Les Prestataires De Soins De Santé À Madagascar, Breakthrough Research

Reproductive Health

Breakthrough RESEARCH partner ideas42 conducted research in June 2019 in peri-urban and rural areas of Vohipeno and Manakara districts of Madagascar's Vatovavy-Fitovinany region to identify health care providers' challenges for detecting and managing complications during childbirth including postpartum hemorrhage and identify optimal solutions. This brief summarizes the results of a behavioral diagnosis that reveals “Facility-based providers do not consistently follow best practices for the detection and management of complications during childbirth.” Low perception of risk of postpartum hemorrhage, limited review of compliance with best practices, consequences of current practices, and resource scarcity can negatively affect provider decision-making and clinical practice.

Hello, I’M Fat: Finding Myself In A Hulu Original, Mac Clark

Student Works

My first relationship happened when I was 18. We matched on Tinder and spent the following month doing everything people in relationships do, just without the label. This casual mindset was not my choice, and neither was the constant feeling of disappointment. I yearned to be respected; I knew it wasn’t right for him to sleep through our dates nor return my texts for days at a time. I wanted a real relationship, one where I wouldn’t have to beg for clarity, but as a fat, young woman, I believed this lesser form of relationship was my only option, so …

Severe Acute Respiratory Syndrome Coronavirus 2 Transmission Potential, Iran, 2020, Kamalich Muniz-Rodriguez, Isaac Fung, Shayesteh R. Ferdosi, Sylvia Ofori, Yiseul Lee, Amna Tariq, Gerardo Chowell

Biostatistics, Epidemiology & Environmental Health Sciences: Faculty Publications

To determine the transmission potential of severe acute respiratory syndrome coronavirus 2 in Iran in 2020, we estimated the reproduction number as 4.4 (95% CI 3.9–4.9) by using a generalized growth model and 3.5 (95% CI 1.3–8.1) by using epidemic doubling time. The reproduction number decreased to 1.55 after social distancing interventions were implemented.

Using Natural Language Processing And Sentiment Analysis To Augment Traditional User-Centered Design: Development And Usability Study, Curtis L. Petersen, Ryan Halter, David Kotz, Lorie Loeb, Summer B. Cook, Dawna M. Pidgeon, Brock Christensen, John A. Batsis

Dartmouth Scholarship

Background: Sarcopenia, defined as the age-associated loss of muscle mass and strength, can be effectively mitigated through resistance-based physical activity. With compliance at approximately 40% for home-based exercise prescriptions, implementing a remote sensing system would help patients and clinicians to better understand treatment progress and increase compliance. The inclusion of end users in the development of mobile apps for remote-sensing systems can ensure that they are both user friendly and facilitate compliance. With advancements in natural language processing (NLP), there is potential for these methods to be used with data collected through the user-centered design process.

Objective: This study aims …

Responding To Covid-19: How Massachusetts Senior Centers Are Adapting, Ceara Somerville, Caitlin Coyle, Jan Mutchler

Center for Social and Demographic Research on Aging Publications

The COVID-19 pandemic has swept the United States with force and speed. Massachusetts is one of the hardest hit states in nation, with over 120,000 cases and over 8,500 deaths to date. Local governments across the Commonwealth have had to work quickly to meet the needs of their constituents in a constantly changing environment. With older adults being at high risk of contracting COVID-19, having more severe symptoms, and at higher risk of dying from the disease, special efforts are warranted to ensure that they are supported in their efforts to maintain physical distance while meeting needs for food and …

The Prevalence And Predictors Of Complementary And Alternative Medicine (Cam) Use Among Racially/Ethnically Diverse College Students, Hermella Misiker

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background: National data on complementary and alternative medicine (CAM) use, available through the National Health Interview Survey (NHIS), convey higher prevalence of CAM use among college students compared to the general U.S population. NHIS findings also highlight non-vitamin non- mineral (NVNM) products are the most widely used form of CAM in the U.S. The purpose of this study was to identify the socio-cognitive and demographic predictors of CAM and NVNM use among a racially/ethnically diverse college student body.

Methods: An online survey was used to collect data from 392 University of Nevada, Las Vegas (UNLV) undergraduate, graduate, and professional students. …

Communication In Healthcare Settings: Access And Barriers To Care Experienced By Deaf Patients, Elizabeth Schniedewind

Boise State University Theses and Dissertations

Deaf persons who use American Sign Language (ASL) as their primary form of communication are members of a cultural and linguistic minority that experiences significant health disparities yet are not recognized as a health disparity population by the National Institutes of Health. Studies have reported ineffective communication in healthcare interactions and reduced access to care experienced by Deaf patients. Requests for sign language interpreters in healthcare encounters are frequently denied, despite federal mandates to provide effective communication. Comprised of three articles, this dissertation investigates the diminished access to communication in healthcare settings experienced by Deaf patients and qualitative research methods …

Evaluation Of The Humoral Immune Response As A Potential Indicator Of Disease Severity For Patients Hospitalized With Covid-19, Spencer Sterling

Capstone Experience: Master of Public Health

Members of the family Coronaviridae, including the severe acute respiratory syndrome coronaviruses (SARS-CoV-1 and SARS-CoV-2), Middle East respiratory syndrome coronavirus (MERS-CoV) and seasonal human coronaviruses (HCoV-HKU1and HCoV-OC43), are highly communicable respiratory viruses; SARS-CoV-1, SARS-CoV-2, and MERS can cause severe disease, while seasonal human coronaviruses present with mild to moderate illness. Coronavirus envelope spike (S) glycoproteins are involved in receptor binding and cell fusion, and are the primary target for a neutralizing humoral response. The S protein is comprised of the S₁ and S₂ subunits; the S₁ subunit contains the receptor-binding domain (RBD), while the S_{2 …}

The Long-Term Persistence And Tissue Tropism Of Brazilian Zika Virus In Monodelphis Domestica, Marisol Morales

Theses and Dissertations

Zika virus (ZIKV) rose as a major public health concern due to the congenital abnormalities of infants born to infected mothers during the 2015 Latin American outbreak. While animal models such as transgenic mice and nonhuman primates are used to study ZIKV pathogenesis, they display various limitations. Additionally, the persistence and tissue distribution of long-term ZIKV infection remains unknown. We describe the laboratory opossum, Monodelphis domestica, as a potential new model for ZIKV pathogenesis research to address these issues. We utilized immunohistochemistry, RT-PCR, and ELISA to show that: infant animals inoculated intracerebrally were susceptible to infection, ZIKV infection persisted …

A Mixed-Methods Analysis Of Abortion Attitudes And Perceptions Among Women Living In Alabama And South Carolina, Anthony Peluso

Electronic Theses and Dissertations

Legal induced abortion is a safe option for terminating a pregnancy for women of reproductive age in the United States (U.S.), though access has varied since the Roe v. Wade and Doe v. Bolton cases in 1973. Information is lacking on women’s attitudes toward and perceptions of abortion as well as on related constructs such as pregnancy attitudes and contraceptive use. Exploring these constructs is important in that it can provide much needed context to women’s reproductive life planning. This research aimed to explore perceptions of abortion access and safety and examine the potential associations between attitudes toward abortion access …

Social Vulnerability And Hurricane Evacuation Behavior In Hampton Roads, Va: Emergency Management Stakeholders’ Perceptions Of Low-To-Moderate Income Households In A Social Construction Paradigm, Mechelle Bonit Smith

School of Public Service Theses & Dissertations

The purpose of this research is to examine current emergency management (EM) evacuation policies and practices with respect to vulnerable populations’ hurricane evacuation behaviors. The response of vulnerable households and local and state governments’ implementation of emergency evacuation policies and practices provide possible linkages to continual problems faced by local governments in addressing its most vulnerable residents. Using social construction as a theoretical foundation provides context for the consideration of vulnerable populations in emergency management policy and hurricane evacuation.

This research is a qualitative case study of emergency management policies, practices, and perceived household evacuation behaviors in several cities of …

Investigation Of Factors Affecting The Hiv Continuum Of Care In Tennessee, Elaine Loudermilk

Electronic Theses and Dissertations

Introduction: Factors contributing to the HIV continuum of care (HCC) for adults in Tennessee (TN) have not been studied in depth with known predictors for HIV risk, specifically adverse childhood experiences (ACEs), among low annual income or sexual minority groups [lesbian, gay, bisexual, or transgender (LGBT)].

Methods: A mixed methods study design was used to assess factors related to the HCC. Quantitative analysis used the TN Behavioral Risk Factor Surveillance System data to examine at risk and ever tested for HIV, to (1) investigate ACEs among adults with low-income (<$25,000 annually) in 2016-2017 and (2) among LGBT in 2018. Descriptive statistics and multiple logistic regression (MLR) analysis stratified by TN grand division were performed. Qualitative analysis included 11 interviews with persons living with HIV (PLWH) receiving care at a local clinic to evaluate surveillance questions related to ACEs and the HCC to develop a culturally appropriate survey.

Results: Quantitative results found that among LGBT (N=262) and low-income …

Exploring The Relationships Between Mothers' Use Of Food To Soothe, Feeding Type And Mode, Maternal Feeding Style, Infant Behavior, And Infant Weight-Related Outcomes During Early Infancy, Megan K. Hupp

Master's Theses

Rapid infant weight gain (RWG) in the first six months postpartum is a strong predictor for obesity during childhood and adolescence. Although biological factors can influence infant weight gain trajectories, the modifiable factor of parent feeding practices can also have an influence. The use of food to soothe (FTS), or the act of feeding a child when he/she is upset for reasons other than hunger, has been associated with unhealthy eating behaviors and less-favorable weight outcomes in children and older infants. However, limited studies have explored the use of FTS during early infancy before the introduction of solids foods. The …

Telehealth Among Behavioral Health Providers In Louisiana During Covid-19 And A Mandatory Stay At Home Order, Evidence To Practice, Cep Briefs, Stephen Phillippi, Sonita Singh, Brian Bumbarger, Kaylin Beiter, Lindsay Simpson, Ashley Fenton

Policy & Position Papers

No abstract provided.

Learning From The Past: Distributed Cognition And Crisis Management Capabilities For Tackling Covid-19, Seulki Lee, Jungwon Yeo, Chongmin Na

Research Collection School of Social Sciences

The outbreak of coronavirus disease 2019 (COVID-19) has presented an unprecedented public health crisis across the globe. Governments have developed different approaches to tackle the complex and intractable challenge, showing variations in their effectiveness and results. South Korea has achieved exceptional performance thus far: It has flattened the curve of new infections and brought the outbreak under control without imposing forceful measures such as lockdowns and travel ban. This commentary addresses the South Korean government’s response to COVID-19 and highlights distributed cognition and crisis management capabilities as critical factors. The authors discuss how the South Korean government has cultivated distributed …

How Do Intercrisis Learning Outcomes Affect Intracrisis Learning? “Learning In The Making” In The Case Of South Korea’S Covid-19 Response, Chongmin Na, Seulki Lee, Jungwon Yeo

Research Collection School of Social Sciences

This study explores the processes of intercrisis and intracrisis learning and the link between them, drawing on South Korea’s responses to the COVID-19 pandemic as an example. The crisis management literature suggests that intracrisis learning is less likely to occur than intercrisis learning due to inherent barriers that hinder learning and adaptation in the heat of crisis. Based on the conceptual framework of problem-oriented governance and crisis learning, we unpack how prominent outcomes of intercrisis learning facilitate intracrisis learning during the acute phase of an emerging crisis. We postulate that learning after 2015 MERS crisis developed the core capabilities for …

The Relationship Between Physical Activity And Emotional Intelligence In Adolescents, Marie C. Gabour

Graduate Doctoral Dissertations

PURPOSE: We assessed the association of Physical Activity (PA) measures on overall Emotional Intelligence (EI) and domains of EI: Intrapersonal, Interpersonal, Adaptability, General Mood, and Stress Management in adolescents.

METHODS: Cross-sectional and two-year follow up analyses were conducted relating EI to PA measures using the National Longitudinal Survey of Children and Youth in adolescents between 10- 13 years. EI score was measured by using a validated the youth version of the Emotional Quotient Inventory; PA was self-reported. Regression analysis adjusted for age, gender, household annual income, and health status and was summarized using regression coefficients. A test of linear trend …

Family Planning And Afghan Refugee Women And Men Living In Melbourne, Australia: New Opportunities And Transcultural Tensions, Alana Russo, Belinda Lewis, Razia Ali, Atiq Abed, Grant Russel, Stanley Luchters

Population Health, East Africa

This research aimed to explore the family planning perspectives and experiences of Afghan women and men living in Melbourne. A total of 57 Afghan women and men participated in six focus groups and 20 semi-structured interviews. The majority of participants indicated a preference for two or three children and were open to using modern contraception. However, many women described experiencing negative side effects when using hormone-based contraception and expressed difficulty negotiating condom use with their husbands as an alternative. Some women described how these difficulties resulted in inconsistent contraceptive practices and, at times, unintended pregnancy. Participants recognised that health professionals …

Foster Positivity Amid Covid-19 Challenges, David Chan

Research Collection School of Social Sciences

Many behaviours have encouraged positivity during the pandemic. More can be done to create communities that nurture positive attitudes and experiences

Role Of Oxidative Stress And Altered Thyroid Hormones In Unexplained Infertility, Rehana Rehman, Hiba Ismail Rajpar, Mussarat Ashraf, Najeeha Talat Iqbal, Salima Lalani, Faiza Alam

Department of Biological & Biomedical Sciences

Objective: To explore the link between altered thyroid profile and oxidative stress marker in females with unexplained infertility.
Methods: The cross-sectional case-control study was carried out at the Islamabad Clinic Serving Infertile Couples, Islamabad, Pakistan, from June 2016 to August 2017, and comprised women aged 18-40 years regardless of ethnic background who were divided into two groups; those with unexplained infertility were the cases, while fertile women acted as the controls. Serum was analysed for triiodothyronine, thyroxine and thyroid stimulating hormone as well as for oxidative stress markers including manganese superoxide dismutase, glutathione reductase and adrenaline using enzymelinked immunosorbent assay. …

Atitiudes Tow Ards Computer Games For Learning And Pl.A Yer Archetypes: An Exploration Of Measures On Preintervention Player Characteristics For Serious Game-Based Interventions, Benjamin Lee

Dissertations and Theses (Open Access)

Serious game-based interventions offer promising health outcome results with the aid of pre-intervention player tailoring and the development of measurements that evaluate pre-intervention player characteristics and subgroups. Video gaming measures can potentially provide helpful tailoring information that discerns individual video gaming preferences which could influence their overall user experience. It is critical that measures that target adolescent video gaming be psychometrically validated. There is a gap in the literature with psychometrically validated measures evaluating adolescent attitudes towards computer games for learning and gaming archetypes. Therefore the aims of this dissertation were to 1) evaluate the psychometric properties (i.e., reliability and …

Epidemiology Of No -Syndromic, Orofacial Clefts In A Registry­Based, Birth-Cohort In Texas: Differences By Cleft Type And Presence Of Additional Defects, Maria Luisa Navarro Sanchez

Dissertations and Theses (Open Access)

Although orofacial clefts, which include cleft palate alone (CP) and cleft lip with or without cleft palate (CL±P), are among the most common birth defects, their etiology is complex and is generally not well understood. While some clefts are caused by rare syndromes, the majority occur in the absence of a syndrome, either in association with co-occurring defects or as isolated defects. Among these non-syndromic cases, epidemiologic studies have identified demographic variables that are associated with CP and/or CL±P, such as geographic location and infant sex, as well as several maternal characteristics, though some of these associations have been weak …

Physical Activity, Eating Behaviours And Body Satisfaction Among Private Preschoolers In Putrajaya, Poh Then Woh

Student Works (2020-2029)

Numerous studies had focused on examining the physical activity level, eating behaviours and body satisfaction worldwide. Additionally, some researchers have explored the gender differences of primary school students and adolescents as well as the correlation between these three variables. However, there are fewer studies that involve preschoolers and young children. Hence, the purpose of this study is to seek better understanding of the physical activity level, eating behaviour and body satisfaction among pre-schoolers in Malaysia. The Federal Territory of Putrajaya was being selected as the study’s location as it marked the highest percentage of children; and highest overweight and obesity …

Evaluation Of Enrichment And Identification Media For Isolation Of Common Bovine Salmonella Serotypes, Katie Irene Swanson

All Graduate Theses and Dissertations, Spring 1920 to Summer 2023

Salmonellosis is an important cause of diarrhea in humans and animals, which can lead to death in severe cases. Rapid and efficient detection of Salmonella spp. is essential to limit the spread of disease. Many enrichment procedures have been described for the isolation of Salmonella, and often include variations on Rappaport-Vassiliadis medium, which is recommended by the Food and Drug Administration (FDA). The current procedures vary in incubation temperature, incubation time, and type of media used for identification of Salmonella. This project compared four procedures for enrichment and identification of common bovine Salmonella serotypes. We determined the best …