Public Health Commons^™

Contextualizing The Health Belief Model And The Social Epidemiology Theories In The Study Of Aids In Malawi, Kumbirai Madondo

All Theses

The association between HIV/AIDS knowledge, risk perception and risky sexual behavior remains a valuable area of study among scholars seeking to understand the AIDS epidemic in Africa. Past research has focused only on either the Health Belief Model or social epidemiology ideas to understand AIDS but never combined the two. The current study is unique and adds to the body of knowledge by making use of both the Health Belief Model and social epidemiology ideas to understand these relationships more clearly and, more importantly, to explore the role that keeping AIDS a secret has in the contexts of risk perception, …

Assessing Mississippians’ Preparedness For Disasters Using The Citizen Corps National Survey 2009, Carl Huston Mangum Ii

Dissertations

Disaster preparedness, a shared responsibility of all citizens and disaster agencies, is the most critical component in minimizing risk and damage from disaster. Mississippi has been affected by some of the most devastating disasters in American history, both in terms of physical destruction and human life. The purpose of this study was to assess Mississippians’ disaster preparedness by replicating The 2009 Citizen Corps National Survey (CCNS). The 65 question 2009 CCNS was slightly modified to survey 678 randomly selected Mississippians about the Citizen Corps Personal Disaster Preparedness Model: Demographics, Volunteering, Drills/Exercises, Community Plan, Household Plan, Disaster Supplies, Prevention, Self-efficacy, Reliance, …

Body Image In Middle-Aged Mormon Women: A Comparative Case Study, Janette Olsen

Faculty Publications

Body image is a multifaceted construct developed from perceived experiences and personal and cultural attitudes towards the body. Women are more vulnerable than men to internal and external influences regarding negative body image. A qualitative comparative case study design was utilized to explore how 10 lifelong, middle-aged LDS women, either married (n=5) with children or single, never married (n=5), experienced body image through their perceptions of religiosity and spirituality. The participants lived along the Wasatch Front in Utah and were recruited through known LDS gatekeepers. Each participant completed three in-person interviews and three audio or paper journals, which were transcribed …

Examining The Interrater Reliability Of The Comprehensive Inventory Of Mental Health And Recovery And Rehabilitation Services (Cimhrrs), Robert W. Johnson

Department of Psychology: Dissertations, Theses, and Student Research

This dissertation is one step in the continuing development, evaluation, and validation of the Comprehensive Inventory of Mental Health and Recovery and Rehabilitation Services (CIMHRRS). The CIMHRRS is an instrument to guide comprehensive assessment of programs that provide integrated services to people with serious mental illness (SMI).

The project described in this dissertation evaluated three key aspects of its performance in real world application: practical feasibility, internal consistency and reliability, and ability to distinguish between different programs. Investigators utilized a combination of principles and methods, associated with psychometric scale development, field methods, and program evaluation. Using a structured site review …

Medicare Physician Fees: The Data Behind The Numbers, Laura A. Dummit

National Health Policy Forum

Medicare’s physician fee schedule distributes nearly $60 billion annually and is a critical determinant of individual physicians’ incomes, beneficiaries' access to health care services, and Medicare spending, as well as the basis for physician fees used by many private payers. The Centers for Medicare & Medicaid Services (CMS) relies on data derived from expert judgment and other sources to update the fee schedule. Although CMS’s methods and data for maintaining the fee schedule have improved over the years, concerns remain about medical specialty society involvement and the lack of an effective ”counterweight” to vested interests in establishing and updating the …

The Development And Use Of A Geographic Information System For Evaluating The Association Between Pesticide Exposure And Prostate Cancer, Kristen Wells

Theses and Dissertations

Abstract 1 – A Geographic Information System for Evaluating Residential Pesticide Exposure and Prostate Cancer Incidence Agricultural pesticide exposure is hypothesized to be a risk factor for prostate cancer, and such exposures are of particular concern for men living in farming communities where large-scale pesticide applications occur. Prostate cancer incidence data were obtained from the State Health Registry of Iowa for the years 1996 through 2006, and county and census tract level age-adjusted incidence rates were calculated. Historical crop-specific land use records and pesticide sales data for the state of Iowa during 1990 were integrated into a geographic information system …

Tapping The Potential Of The Health Care Workforce: Scope-Of-Practice And Payment Policies For Advanced Practice Nurses And Physician Assistants, Robert Cunningham

National Health Policy Forum

Expanding coverage and increasing delivery of team-based care are likely to entail a growing role in the
health system for advanced practice nurses (APNs), physician assistants (PAs), and other nonphysician clinicians. These professions have already grown rapidly and have increased access to primary and specialty care, especially in rural and other underserved areas. This background paper provides an overview of the role of APNs and PAs. It reviews the primary features of the training and credentialing of these health professions, including the impact of public policies and market forces on their growth and deployment. It describes variations in state scope-of-practice …

Assessing Community Health Center (Chc) Assets And Capabilities For Recruiting And Retaining Physicians: The Chc Community Apgar Questionnaire, David Schmitz, Ed Baker, Ayaka Nukui, Benjamin Tverdy

Public and Population Health Faculty Publications and Presentations

Community factors play a key role in the recruitment and retention of physicians. While prior workforce studies often investigated characteristics of the candidate-physician, the initial Critical Access Hospital Community Apgar Questionnaire (CAH CAQ) study identified community factors at critical access hospitals which help determine the success of achieving and maintaining an adequate local physician workforce. The goals of the current study are to identify opportunities for improvement in physician retention and recruitment in Idaho’s Community Health Center (CHC) systems and to develop a better understanding of the community factors in this dynamic process.

Interpretations Of Interpretations: Combining Community-Based Participatory Research And Interpretive Inquiry To Improve Health, Jessica Gregg, Lourdes Centurion, Julio Maldonado, Raquel Aguillon, Rosemary Carmela Celaya-Alston, Stephanie Farquhar

Community Health Faculty Publications and Presentations

Background: Latina immigrants from Mexico suffer significantly increased morbidity and mortality from cervical cancer when compared with non-Hispanic White women, largely owing to lack of screening and appropriate treatment. Objectives: To demonstrate that by combining the tools of community-based participatory research (CBPR) with the tools of interpretive inquiry, it is possible to address explicit community concerns surrounding a particular problem such as cervical cancer while also examining what other, perhaps less immediately visible, matters consume the time and attention of community members. Methods: We first briefly discuss and compare CBPR as an approach to research and interpretive inquiry as a …

Download Full Pdf Issue Of Jefferson School Of Population Health Master Of Public Health E-News Public Health Link, Vol. 6, Iss. 2, Summer 2010

Public Health Link

This issue includes a MPH spotlight on JoAnne Fischer, Executive Director of the Maternity Care Coalition (MCC). Other articles include: 13th Annual Health Education Advocacy Summit Student Perspectives, Health Reform Provides Major Benefits to Public Health summary, Food Inspection Opportunity, congratulations to Spring Capstone presenters, and information on 2 symposia: Symposium on Community Based Participatory Research on Chronic Disease Prevention and Symposium on National Public Health Week - One Community at a Time.

Co-Varying Patterns Of Physical Activity And Sedentary Behaviors And Their Long-Term Maintenance Among Adolescents, Jihong Liu, Jinseok Kim, Natalie Colabianchi, Andrew Ortaglia, Russell R. Pate

Faculty Publications

Background: We examined the covarying patterns of physical activity and sedentary behaviors among adolescents and their long-term maintenance. Methods: Data came from the National Longitudinal Study of Adolescent Health (1995-2002). We used latent class analysis to identify distinct covarying patterns in adolescence. Logistic regression models were used to predict odds of meeting moderate-to-vigorous physical activity (MVPA) recommendations (≥5 bouts/week) and exceeding screen time guidelines (>2 hours/day) 6 years later based on their adolescent class profile. Results: Five classes for each gender were identified and labeled as low physical activity (PA)/low sedentary behaviors (SED), moderate (Mod) PA/high (HI) SED, Mod …

Plasma Prekallikrein Levels Are Positively Associated With Circulating Lipid Levels And The Metabolic Syndrome In Children., James A. Mackenzie, Kristen A. Roosa, Brooks B. Gump, Amy K. Dumas, Kestutis G. Bendinskas

Falk College Research Center

Plasma prekallikrein (PK) has been shown to be associated with cardiovascular disease (CVD) and its risk factors, but these associations have not been investigated in children. The present study examined PK activity in relation to well-established cardiovascular risk factors in a cohort of children aged 9–11 years (N = 97). We found a significant and positive association between PK and fasting levels of total cholesterol (p < 0.01), non-high-density lipoprotein cholesterol (p < 0.01), and triglycerides (p < 0.001). In addition, there was a significant association between PK activity and the metabolic syndrome, a clustering of risk factors considered to have an impact on atherosclerosis and CVD mortality. Finally, we found that children with a family history of CVD had significantly elevated PK activity. These novel findings warrant further investigations into the relationship between circulating PK levels and CVD risk factors because PK may be involved in the progression of the disease state. Il est bien connu que la pre´kallicre´ine (PK) est associe´e a` la maladie cardiovasculaire (CVD) et a` ses facteurs de risque, mais ces associations n’ont pas e´te´ ve´rifie´es chez les enfants. Cette e´tude se propose de ve´rifier l’association entre l’activite´ de la PK et les facteurs de risque de CVD aupre`s d’une cohorte d’enfants aˆge´s de 9 a` 11 ans (N = 97). On observe une corre´lation positive significative entre la PK et les variables suivantes : la concentration totale de choleste´rol a` jeun (p < 0,01), les concentrations des lipoprote´ines non a` haute densite´ (p < 0,01) et la concentration des triglyce´rides (p < 0,001). De plus, on observe une corre´lation significative entre l’activite´ de la PK et le syndrome me´tabolique constitue par un ensemble de facteurs ayant un effet sur l’athe´roscle´rose et la mortalite´ due a` la CVD. En dernier lieu, les enfants avec des ante´ce´dents familiaux de CVD pre´sentent une plus importante activite´ de la PK, et ce, de fac¸on significative. Ces premie`res observations sugge`rent d’autres e´tudes sur la relation entre la concentration sanguine de PK et les facteurs de risque de CVD, car la PK pourrait eˆtre implique´e dans la progression de la maladi

A Current Examination Of Dietary Intakes Of Fiber, Calcium, Iron, And Zinc And Their Relationship To Blood Lead Levels In U.S. Children Aged 1–5 Years, Stephanie A. Melchert

Department of Nutrition and Health Sciences: Dissertations, Theses, and Student Research

A CURRENT EXAMINATION OF DIETARY INTAKES OF FIBER, CALCIUM, IRON, AND ZINC AND THEIR RELATIONSHIP TO BLOOD LEAD LEVELS IN U.S. CHILDREN AGED 1-5 YEARS Stephanie Ann Melchert, M.S. University of Nebraska, 2010 Adviser: Kaye Stanek Krogstrand The effect of lead on the health and well-being of those exposed has been well documented and many efforts have been made to reduce exposure of lead to the United States population. Despite these efforts, many studies have documented cognitive impairments and behavioral problems in children with even low levels of lead in their blood. Previous studies have suggested that a proper diet …

Prescriptions For Excellence In Health Care Issue 9 Summer 2010 Download Full Pdf

Prescriptions for Excellence in Health Care Newsletter Supplement

No abstract provided.

A Parasitological Paradox: Why Is Ascarid Infection So Rare In The Prehistoric Americas?, Daniela Leles, Karl Reinhard, Martín Horacio Fugassa, Luis Fernando Ferreira, Alena M. Iñiguez, Adauto Araujo

Karl Reinhard Publications

Ascaris lumbricoides (giant roundworm) and Trichuris trichiura (whipworm) are the most common intestinal parasites found in humans worldwide today and they almost always co-occur. However, we find two distinct patterns in archae­ological material. In historical North American and Old World contexts, the association of A. lumbricoides and T. trich­iura is similar to the modern epidemiological picture. In contrast, the co-occurrence of A. lumbricoides and T. trichiura eggs in prehistoric South America is rare. For prehistoric contexts, T. trichiura is the most common parasite found in ar­chaeological material. Recently molecular biology techniques pointed to a subdiagnosis of roundworm infection in pre- …

Hiv And Hepatocellular And Esophageal Carcinomas Related To Consumption Of Mycotoxin-Prone Foods In Sub-Saharan Africa, Jonathan H. Williams, Jessica A. Grubbs, Jerry W. Davis, Jia-Sheng Wang, Pauline E. Jolly, Nii-Ayi Ankrah, William O. Ellis, Evans Afriyie-Gyawu, Natalie M. Johnson, Abraham G. Robinson, Timothy D. Phillips

Environmental Health Sciences: Faculty Publications

Background: Promotion of the HIV epidemic by aflatoxin is postulated but not yet established. Sub-Saharan populations commonly consume food contaminated by mycotoxins, particularly aflatoxins (predominantly found in peanut, maize, rice, and cassava) and fumonisins, which occur primarily in maize. Aflatoxin promotes hepatocellular cancer, and fumonisin may promote esophageal cancer.

Objectives: This analysis was undertaken to test the hypotheses that consumption of mycotoxin-prone staple foods is 1) related to the incidence of HIV infection in Africa and 2) related to “signature” cancer rates confirming exposure to aflatoxins and fumonisins.

Design: World Health Organization data for causes of death and the Food …

Clinical And Economic Impact Of Infusion Reactions In Patients With Colorectal Cancer Treated With Cetuximab., K A Foley, P F Wang, B L Barber, S R Long, J E Bagalman, V Wagner, X Song, Z Zhao

College of Population Health Faculty Papers

BACKGROUND: Systemic agents in cancer treatment were often associated with possible infusion reactions (IRs). This study estimated the incidence of IRs requiring medical intervention and assessed the clinical and economic impacts of IRs in patients with colorectal cancer (CRC) treated with cetuximab.

PATIENTS AND METHODS: Details on patients with CRC receiving cetuximab in 2004-2006 were extracted from a large USA administrative claims database. IRs were identified based on the occurrence of outpatient treatment, emergency room (ER) visit, and/or hospitalization for hypersensitivity and allergic reactions. Multivariate regressions were used to examine potential risk factors and quantify the economic impact of IRs. …

Women's Compliance In Outpatient Substance Abuse Treatment: The Role Of Children And Mental Health, Cathy Gertrude Cooke

Psychology Theses & Dissertations

The purpose of this study was to examine the role of children and mental illness in women's compliance in a treatment program for substance abuse. Information was retrieved from medical records of female clients ( N=221) who took part in a community-based day treatment program for substance abuse in a large city in southeastern Virginia during a 32-month period. It was anticipated that, as compared to women who resided with minor children, women who did not reside with minor children would have greater treatment success defined as: (1) more days in the treatment program; (2) higher percentage of negative …

Aids Epidemic In The Russian Federation And Policy Reform, Veronika Kiselev

Independent Study Project (ISP) Collection

The AIDS epidemic in the Russian Federation has been a constant struggle for the government and the population since the early 90’s. The epidemic is the most rapidly growing epidemic of HIV/AIDS seen in history and has caused much international attention. The epidemic coinciding with the fall of the Soviet Union and the transition of the Russian government from socialist to democratic state has had a huge impact on the policy and government actions to fight the epidemic. The financial struggles that hit a large portion of the population as a result of the fall of the Soviet Union caused …

Situational Analysis Of Household Energy And Biomass Use And Associated Health Burden Of Indoor Air Pollution And Mitigation Efforts In Pakistan, Zafar Fatmi, Asma Rahman, Ambreen Kazi, Muhammad Masood Kadir, Nalini Sathiakumar

Community Health Sciences

Biomass fuel burning leads to high levels of suspended particulate matter and hazardous chemicals in the indoor environment in countries where it is in common use, contributing significantly to indoor air pollution (IAP). A situational analysis of household energy and biomass use and associated health effects of IAP was conducted by reviewing published and un-published literature about the situation in Pakistan. In addition to attempt to quantify the burden of ill health due to IAP, this paper also appraises the mitigation measures undertaken to avert the problem in Pakistan. Unfortunately, IAP is still not a recognized environmental hazard in Pakistan …

The Decontamination Of Methamphetamine Labs - A Search For Best Practices, Robert Perry

Master of Public Health Program Student Publications

The use of methamphetamine as a drug of abuse in the United States has skyrocketed in recent years, with much of the drug being manufactured in primitive makeshift laboratories clandestinely located in residential dwellings. The contamination of these environments with methamphetamine, its precursors, and its by-products can be severe. Often, after being contaminated, these dwellings are re-occupied by people unaware of the former use as a methamphetamine production site, and unaware of the contaminant load they now find themselves living in. This paper discusses the extent of contamination of the lab area and how this contaminant loading may affect the …

Strengthening Primary Care To Bend The Cost Curve: The Expansion Of Community Health Centers Through Health Reform, Leighton C. Ku, Patrick Richard, Avi Dor, Ellen Tan, Peter Shin, Sara J. Rosenbaum

Geiger Gibson/RCHN Community Health Foundation Research Collaborative

The recent enactment of health reform sets into motion important changes that will expand health insurance coverage, increase funding for community health centers and alter the way that health centers are paid. These reforms will have a major impact on two major challenges of health reform: bolstering the capacity of the nation's primary care system and reducing the long term growth in health care costs.

Our analyses examine the impact of the new health reform law on the number of patients who will receive primary care services at community health centers and the effect of the service expansions on overall …

Improving Statistical Analysis Of Prospective Clinical Trials In Stem Cell Transplantation. An Inventory Of New Approaches In Survival Analysis, Aurelien Latouche

COBRA Preprint Series

The CLINT project is an European Union funded project, run as a specific support action, under the sixth framework programme. It is a 2 year project aimed at supporting the European Group for Blood and Marrow Transplantation (EBMT) to develop its infrastructure for the conduct of trans-European clinical trials in accordance with the EU Clinical Trials Directive, and to facilitate International prospective clinical trials in stem cell transplantation. The initial task is to create an inventory of the existing biostatistical literature on new approaches to survival analyses that are not currently widely utilised. The estimation of survival endpoints is introduced, …

Who Is Exposed To Smoke At Home? A Population-Based Cross-Sectional Survey In Central Vietnam, Motoi Suzuki, Vu Dinh Thiem, Lay-Myint Yoshida, Dang Duc Anh, Paul E. Kilgore, Koya Ariyoshi

Department of Pharmacy Practice

No abstract provided.

Gender, Germs, And Dirt: A Case Study Of Properly Politicised Science, Sharyn Clough

XIV IAPh Symposium 2010

This presentation is part of the Feminist Perspectives in the Sciences: Epidemiology track.

The relatively recent increase in cases of allergies and asthma, especially in industrialised nations of the north and west, has been explained by the “hygiene hypothesis”—viz., that increased cleanliness and sanitation have unintended negative consequences for immune health—an hypothesis that has received robust epidemiological support (e.g., Platts-Mills 2002). Over the last few years, support for the hypothesis has increased with the discovery that populations regularly exposed to certain parasitic worms (helminths) have very low incidence of chronic inflammatory diseases such as Crohn’s (Elliot, Summers, and Weinstock 2007). …

Dukungan Suami Dalam Pemberian Asi Eksklusif Di Wilayah Kerja Puskesmas Air Tawar Kota Padang, Sumatera Barat, Mery Ramadani, Ella Nurlaella Hadi

Kesmas

Manfaat pemberian ASI yang sangat besar ternyata belum mampu meningkatkan angka cakupan ASI eksklusif. Hal tersebut terlihat pada tingkat pemberian ASI eksklusif di tanah air yang masih rendah berada pada kisaran 39%-40%. Tujuan penelitian ini mengetahui dukungan suami dalam pemberian ASI eksklusif di Wilayah Kerja Puskesmas Air Tawar, Kota Padang Tahun 2009. Rancangan penelitian potong lintang digunakan pada bulan Maret-April 2009 dengan responden ibu bayi usia 7-12 bulan. Hasil penelitian mendapatkan 55,4% ibu memberikan ASI eksklusif dan 57% ibu mendapat dukungan suami dalam pemberian ASI eksklusif. Ada hubungan antara dukungan suami dengan pemberian ASI eksklusif, ibu yang suaminya mendukung pemberian …

Persepsi Risiko Berkendara Dan Perilaku Penggunaan Sabuk Keselamatan Di Kampus Universitas Indonesia, Depok, Ing Kurnia Salihat, L. Meily Kurniawidjaja

Kesmas

Kematian dan cedera akibat kecelakaan lalu lintas telah menjadi masalah kesehatan masyarakat di seluruh dunia termasuk Indonesia. Di lingkungan Universitas Indonesia, setiap tahun terjadi peningkatan kejadian kecelakaan. Penelitian ini bertujuan melihat hubungan antara persepsi risiko keselamatan berkendara dengan perilaku penggunaan sabuk keselamatan pada mahasiswa Universitas Indonesia. Penelitian ini menggunakan pendekatan semi kuantitatif dan desain penelitian potong lintang. Partisipan adalah 98 mahasiswa Universitas Indonesia di Kampus Depok, berusia 18-25 tahun yang mengendarai kendaraan sendiri. Faktor internal yang membentuk persepsi risiko keselamatan berkendara secara bermakna adalah pengalaman (nilai p = 0,000) dan kepercayaan (nilai p = 0,008), sedangkan faktor eksternal yang signifikan …

Kebijakan Pengelolaan Kualitas Udara Terkait Transportasi Di Provinsi Dki Jakarta, Andi Alfian Zainuddin

Kesmas

Pemerintah Daerah Khusus Ibukota Jakarta yang mengeluarkan beberapa kebijakan penanggulangan pencemaran udara menghadapi banyak kendala implementasi. Tujuan penelitian ini mengetahui implementasi kebijakan pengelolaan kualitas udara perkotaan terkait transportasi di provinsi tersebut dengan pendekatan model sistem. Faktor yang diamati meliputi instrumen kebijakan, sumber daya dan manajemen. Penelitian ini menggunakan metode penelitian kualitatif yang menggunakan sumber data primer dengan metode wawancara mendalam dan sumber data sekunder telaah dokumen. Data primer digali dari berbagai informan yang berkompeten meliputi Dewan Perwakilan Rakyat Daerah, Biro Hukum, Badan Pengelola Dampak Lingkungan Daerah, Dinas Perhubungan, Dinas Kesehatan dan Samsat. Penelitian ini menemukan bahwa instrumen kebijakan telah ada, …

Keeping Health Insurance After A Job Loss: Cobra Continuation Coverage And Subsidies, Kathryn Linehan

National Health Policy Forum

Many Americans under 65 have health insurance through an employer. Beginning in 1985, a federal law known as COBRA required that eligible workers and their dependents have the option to continue employer-based group health coverage when employment is terminated. Because premiums for COBRA coverage can be very expensive, the 111th Congress included provisions in the American Recovery and Reinvestment Act of 2009 (and subsequent legislation) to temporarily subsidize premiums for those who have lost their jobs since September 2008. This issue brief outlines the eligibility rules for COBRA as well as the current COBRA subsidies. It also discusses the possible …

Recent Trends In Exposure To Secondhand Smoke In The United States Population, Chieh-I Chen, Tanya Burton, Christine L. Baker, Vera Mastey, David Mannino

Preventive Medicine and Environmental Health Faculty Publications

BACKGROUND: Previous research using the National Health and Nutrition Examination Surveys (NHANES) data documented a significant downward trend in secondhand smoke (SHS) exposure between 1988 and 2002. The objective of this study was to assess whether the downward trend in exposure continued from 2001 through 2006.

METHODS: We analyzed data from the 2001-2006 NHANES to estimate exposure of nonsmokers to SHS. Geometric means of serum cotinine levels for all nonsmokers were computed.

RESULTS: Overall serum cotinine levels (95% Confidence Intervals) in 2001-2002, 2003-2004, and 2005-2006 were 0.06 ng/mL (0.05-0.07), 0.07 ng/mL (0.06-0.09), and 0.05 ng/mL (0.05-0.06), respectively. Subgroup analysis by …