Public Health Commons^™

Factors Associated With Institutionalization For Treatment Of Active Tuberculosis: A Synopsis From In-Depth Patient Interviews, Robert J. Mcdermott, Carol A. Bryant, Jeannine Coreil, Aimee R. Eden, Lori K. Buhi

Florida Public Health Review

To increase the effectiveness of therapeutic regimens for tuberculosis (TB) and to reduce the societal risks for both infected and uninfected individuals, it is beneficial to be able to predict factors associated with non-adherence to treatment. The purpose of this study was to acquire detailed case histories of TB patients admitted to a hospital setting and to gain a better understanding of how patients explain the life events leading up to their admission for treatment. Twenty-one patients with active TB were interviewed concerning their knowledge of TB, diagnosis and treatment history, recent history prior to hospitalization, reactions to and life …

Stigma And Therapy Completion For Latent Tuberculosis Among Haitian-Origin Patients, Jeannine Coreil, Michael Lauzardo, Heather Clayton

Florida Public Health Review

A prospective cohort study of LTBI treatment conducted within the Haitian population of South Florida investigated the predictive association between illness-related stigma among patients near the beginning of treatment and completion of preventive therapy. Factors associated with perceived stigma were also investigated. Ninety patients from Broward and Palm Beach counties were administered a questionnaire that included items related to illness history, perceptions and understanding of latent tuberculosis, and a 25-item stigma scale adapted from previously developed measures of tuberculosis-related stigma. Therapy completion was determined through a follow-up chart review. Data analyses compared patients who completed therapy with those who defaulted …

Diagnosing Decisions: An Examination Of Medical Career Choices And Their Effects On The Health Care System, Nicole Craker '10

Honor Scholar Theses

With the passage of the new health care bill in March of this year, President Obama was able to promise health care coverage to millions of Americans (Health Reform, 2010). While this was a major step towards increasing the health of our nation, promise of coverage does not automatically equate with the promise of better health. Rather, the expanded coverage may more significantly correlate with expanded physician wait lists. As newly insured Americans attempt to make appointments, they may have a difficult time finding a physician who has the time to take them due to a shortage of available doctors. …

Information And Incentives: Improving The Health Of New York City's Low-Income Population, Kathryn Linehan, Lisa Sprague

National Health Policy Forum

The National Health Policy Forum sponsored a site visit to New York City (NYC) in April 2010 to explore health care delivery for Medicaid beneficiaries and the uninsured in New York City’s hospital-dominated market. New York offers real-time examples of government policy and provider initiatives in health information technology (IT) and quality improvement being played out on a large, complex, and dynamic stage with multiple stakeholders. Site visit participants heard from providers and others who discussed efforts to improve the quality of care for low-income New Yorkers through a variety of methods, such as the adoption and use of electronic …

Strategies To Recruit And Retain College Smokers In Cessation Trials, M. Meghan Davidson, Nikole J. Cronk, Kari J. Harris, Solomon W. Harrar, Delwyn Catley, Glenn E. Good

Public and Community Health Sciences Faculty Publications

Techniques to recruit and retain college fraternity and sorority members who reported past 30-day smoking into a cessation trial are described. Recruitment efforts included relationship-building, raffles, and screening survey administration during existing meetings. Surveys were administered to 76% (n = 3,276) of members in 30 chapters, 79% of eligible members agreed to participate, and 76% of those completed assessments and were enrolled in the trial (n = 452). The retention rate was 73%. Retention efforts included cash incentives, flexible scheduling, multiple reminders, chapter incentives, and use of chapter members as study personnel. Retention was not related to demographic, …

Wku Scholar, Pamela Napier, Editor-In-Chief

WKU Scholar

No abstract provided.

A Colorectal Cancer Screening Project In An Old Order Mennonite Community: Capstone Project Technical Report, Maria Eve Main

Nursing Faculty Publications

The purpose of this project was to determine if colorectal cancer (CRC) screening education and community access to fecal occult blood tests (FOBT) is associated with an increase in the uptake of FOBT in an old order Mennonite community. Utilizing a modified cultural model, an educational offering on CRC screening and access to FOBT in the community was delivered to a self-selected sample of age-eligible participants. Thirty-three age eligible residents completed the CRC screening questionnaires and received education on CRC screening. Twenty-nine of the age-eligible participants were found to be at average risk and twenty-three elected to receive FOBT testing …

An Intervention To Reduce Environmental Tobacco Smoke Exposure Improves Pregnancy Outcomes, Ayman El-Mohandes, Michele Kiely, Susan M. Blake, Marie G. Gantz, M. Nabil El-Khorazaty

Publications and Research

Objective—We tested the efficacy of a cognitive-behavioral intervention in reducing environmental tobacco smoke exposure (ETSE) and improving pregnancy outcomes among African-American women.

Methods—We recruited 1,044 women to a randomized controlled trial during 2001-2004 in Washington, DC. Data on 691 women with self-reported ETSE were analyzed. A subset of 520 ETSE women and salivary cotinine levels (SCLs)/ml was also analyzed. Individually tailored counseling sessions adapted from evidence-based interventions for ETSE and other risks, were delivered to the intervention group. The usual care group received routine prenatal care as determined by their provider. Logistic regression models were used to predict …

Hiv Risk Factors Among Moroccan And Turkish Same-Sex Attracted Youth In Amsterdam, Daniel Woznica

Independent Study Project (ISP) Collection

This report is the outcome of a month-long exploratory study on the main HIV risk factors among Moroccan and Turkish same-sex attracted (SSA) youth in Amsterdam. Data was obtained by way of interviews conducted with five experts, categorized as: academics, sexual and ethnic minority activists, and HIV professionals. Five main risk factors were determined: cultural differences; language barriers; stigma and taboo around sexuality and HIV within Islamic communities; socioeconomic marginalization; and lack of a positive term for same-sex sexual behavior and identity among the target group. Recommendations for future research include interviews with Moroccan and Turkish SSA youth themselves. Implications …

Annual Report, Western Kentucky University College Of Health & Human Services, Dr. John Bonaguro, Dean, Wku College Of Health & Human Services

College of Health & Human Services Publications

No abstract provided.

An Approaching Epidemic: Exploring Diabetes Awareness & Care In Mombasa, Kenya, Benjamin Marhan Dropkin

Independent Study Project (ISP) Collection

The prevalence of Type II Diabetes Mellitus (T2DM) has become an increasing problem in virtually every city in the world due to lifestyle changes in recent decades that have greatly reduced healthy eating habits as well as exercise. Research has shown that T2DM is largely preventable through healthy lifestyle choices. It is crucial for every country’s population to be aware of the risk factors and complications of diabetes so that they can take active steps to avoid the monumental physical and financial burden of the disease. This study attempted to gauge diabetes awareness among patients living with diabetes and to …

Factors That Contribute To The Low Uptake Of Skilled Care During Delivery In Malindi, Kenya, Alexandra Carter

Independent Study Project (ISP) Collection

In Kenya, maternal mortality ratios remain high and the number of births attended by skilled health attendants hovers at just 44%. Using both qualitative and quantitative data, a study was conducted to determine the uptake of antenatal care and skilled attendance in Malindi District and to explore factors that contribute to the low use of maternal health services during delivery. It was found that after the first antenatal visit attendance to health facilities begins to decline ending in low rates of births attended by skilled care and that socio-cultural and economic factors play a larger role than access alone in …

Salud Reproductiva De Mujeres En Edad Fertil De La Zona De Intag: Deteccion Oportuna Del Cancer Cervico Uterino (Doc) Papanicolaou, Astia Roper-Batker

Independent Study Project (ISP) Collection

El cáncer delcuello uterino es el segundo más frecuente tipo de cáncer entre las mujeres a nivel mundial (15). La falta de planificación resulta en una alta incidencia de partos y abortos. Estos factores, junto con otros, significan una predisposición al cáncer del cuello uterino (18). El tratamiento más efectivo en la lucha contra este cáncer, es la prevención a través de la detección temprana por el examen de papanicolaou (16, 15,17). En la zona de Intag, localizada en Ecuador, 289 mujeres se realizaron papanicolaou y fueron encuestadas sobre su salud reproductiva. El estudio presente tiene por objetivo determinar si …

Trapped In The Street: Defining The Health Care Use Of The Homeless Adult In Salvador, Bahia, Nicole Lunardi

Independent Study Project (ISP) Collection

Problem Statement

Homelessness is a universal problem. This population represents some of society’s most marginalized members who, paradoxically, need society’s help the most. In this study, data was collected in order to discern in which circumstances and how homeless people utilize medical care in order to better understand the concepts of self efficacy and self agency among this population.

Question and Hypothesis

In what circumstances and by what means does the adult homeless population seek medical attention?

Since the homeless population is marginalized by society, I believe that this population lacks the self efficacy and agency that is required to …

Youth Health Coordinating Council Ward 8 Secret Health Clinic Shopper Report, The Center For Health And Health Care In Schools

Center for Health and Health Care in Schools

No abstract provided.

Download Full Pdf Issue Of Jefferson School Of Population Health Master Of Public Health E-News Public Health Link, Vol. 6, Iss. 1, Spring 2010.

Public Health Link

This issue includes a faculty spotlight on Theresa Pluth Yeo, PhD, MPH, MSN, AOCNP, a recap on the two conferences held in Philadelphia in November: the Society for Public Health Education (SOPHE) and the American Public Health Association, highlights from the APHA Annual Meeting: Student Perspective, an article on the Philadelphia Urban Food and Fitness Alliance (PUFFA), and Jefferson School of Population Health Welcomes the US, Dept. of Health and Human Services and Healthy People 2020.

75 Hours, 18 Babies, Dozens Of Women, And Me: Exploring Gynecological And Obstetrical Care In Bamako, Minnie Yordon

Independent Study Project (ISP) Collection

Mali has the third highest total fertility rate in the world, with each woman having an average of 6.62 children in the year 2009. Gynecological and obstetrical care, therefore, plays a large role in the lives of these women; 70% of women attend at least one prenatal consultation over the course of their pregnancy, and a skilled attendant is present at approximately 50% of all births. In this paper, I seek a better understanding of gynecological and obstetrical care in Bamako, the capital, from the perspective of an Ob/Gyn, which often centers on pregnancy and childbirth. Based on real experiences …

Comparing Modelled Predictions Of Neonatal Mortality Impacts Using List With Observed Results Of Community-Based Intervention Trials In South Asia, Ingrid K. Friberg, Zulfiqar Ahmed Bhutta, Gary L. Darmstadt, Abhay Bang, Simon Cousens, Abdullah H. Baqui, Vishwajeet Kumar, Neff Walker, Joy E. Lawn

Woman and Child Health

Background:There is an increasing body of evidence from trials suggesting that major reductions in neonatal mortality are possible through community-based interventions. Since these trials involve packages of varying content, determining how much of the observed mortality reduction is due to specific interventions is problematic. The Lives Saved Tool (LiST) is designed to facilitate programmatic prioritization by modelling mortality reductions related to increasing coverage of specific interventions which may be combined into packages.
Methods: To assess the validity of LiST outputs, we compared predictions generated by LiST with observed neonatal mortality reductions in trials of packages which met inclusion criteria …

Tuberculosis Screening And Treatment Of Latent Tuberculosis Infection Among International College Students, Bhavna Bhardwaj, Eknath Naik, Beata Casanas, Michael D. Breglia, Michael Lauzardo

Florida Public Health Review

Tuberculosis (TB) remains in the crosshairs of many public health policies worldwide that are taking aim at eradicating this potentially curable and preventable illness. Although tuberculosis (TB) incidence has been declining in the United States for over a decade, it still remains a serious public health concern. Currently, there is no public health policy that requires the screening of non-immigrant international university students visiting the United States. Given the rising numbers of visiting international students, this population has come under scrutiny as potential vectors of transmission of TB into the United States. Foreign-born persons from countries with consistently elevated TB …

Policies That Restrict Sweetened Beverage Availability May Reduce Consumption In Elementary-School Children, Sonya J. Jones, Wendy Gonzalez, Edward A. Frongillo Jr.

Faculty Publications

Objective:We investigated whether having a policy regarding the availability of sweetened beverages in school was associated with children's purchase of total weekly and daily consumption of sweetened beverages.

Design: Data were obtained in the Early Childhood Longitudinal Study-Kindergarten cohort. Multilevel logistic regression was used to determine the magnitude and significance of relationships between the availability of different beverages and purchase of sweetened beverages at school and overall consumption of beverages.

Results: The purchase of sweetened beverages by children in school was strongly associated with the administrative policy of sweetened beverage availability. Compared with children in schools without an administrative …

A Pda Intervention To Sustain Smoking Cessation In Clients With Socioeconomic Vulnerability, Lynne Buchanan, Deepak Khazanchi

Information Systems and Quantitative Analysis Faculty Publications

This article describes a pilot study to explore use of a personal digital assistant (PDA) to sustain smoking cessation after discharge in clients with socioeconomic vulnerability. The major aim is to describe technology acceptance (perceived ease of use, usefulness, and attitude), portability, technical difficulty, satisfaction, and use time. The sample includes 31 medical surgical clients with average age of 47.35 (±13.3), average household income of $13,629 (±8,204), average number in the household of 2.67 (±2.22), and average education of 11th grade. The results demonstrate mean use time of 9.28 (±3.23) hr, or about 1 hr over 8 weeks. Technology acceptance …

Prescriptions For Excellence In Health Care Spring 2010 Dowload Full Pdf

Prescriptions for Excellence in Health Care Newsletter Supplement

No abstract provided.

Anticipated Effects Of The U.S. Mexico City Policy On The Attainability Of The Millennium Development Goals And Future Development Efforts In Sub-Saharan Africa, Katherine Clare Alexander

Anthós

In the low-income countries of sub-Saharan Africa, the performance of pyramidal reproductive health and family planning services with public outreach initiatives has not met the expectations or the needs of the communities they serve. Insufficient case management, limited management capacity and referral and communication failures are challenges faced on the delivery level, while on the policy level these health clinics face insufficient coordination among organizations and weak links between programs (Schneider, 2006). The Mexico City Policy, first introduced by President Reagan in 1984, only exacerbated these challenges for organizations that offer comprehensive contraception and family planning programs by denying any …

Trends And Correlates Of Breast Cancer Screening Among Florida Women: Analysis Of 2001 And 2008 Brfss Data, Alicestine Ashford, Gebre-Egziabher Kiros, Ivette A. López

Florida Public Health Review

This study examined trends and correlates of breast cancer screening among women aged ≥40 years old by race/ethnicity using the 2001 and 2008 Florida Behavioral Risk Factor Surveillance System (BRFSS). Breast cancer screening was measured using both mammography and clinical breast examination (CBE). The total sample size was 10,386, with 4,938 women in the 2001 BRFSS and 5,448 in 2008. Significant disparities in breast cancer screening by race/ethnicity were found both in 2001 and 2008, with Hispanics having the lowest screening participation, compared to non-Hispanic whites and non-Hispanic Blacks. In 2008, non-Hispanic Black women had the highest percentage of timely …

The Many Faces Of Health: Dialogue And Research At The University Of New Hampshire, Emily D. Robbins

Inquiry Journal 2010

No abstract provided.

Birth Order Modifies The Effect Of Il13 Gene Polymorphisms On Serum Ige At Age 10 And Skin Prick Test At Ages 4, 10 And 18: A Prospective Birth Cohort Study, Ikechukwu U. Ogbuanu, Wilfried J. Karmaus, Hongmei Zhang, Tara Sabo-Attwood, Susan L. Ewart, Graham Roberts, Syed Hasan Arshad

Faculty Publications

Background: Susceptibility to atopy originates from effects of the environment on genes. Birth order has been identified as a risk factor for atopy and evidence for some candidate genes has been accumulated; however no study has yet assessed a birth order-gene interaction.

Objective: To investigate the interaction of IL13 polymorphisms with birth order on allergic sensitization at ages 4, 10 and 18 years.

Methods: Mother-infant dyads were recruited antenatally and followed prospectively to age 18 years. Questionnaire data (at birth, age 4, 10, 18); skin prick test (SPT) at ages 4, 10, 18; total serum IgE and specific inhalant screen …

Associations Between Polycyclic Aromatic Hydrocarbon-Related Exposures And P53 Mutations In Breast Tumors, Irina Mordukhovich, Pavel Rossner Jr., Mary Beth Terry, Regina M. Santella, Yu-Jing Zhang, Hanina Hibshoosh, Lorenzo Memeo, Mahesh Mansukhani, Chang-Min Long, Gail Garbowski, Meenakshi Agrawal, Mia M. Gaudet, Susan E. Steck, Sharon K. Sagiv, Sybil M. Eng, Susan L. Teitelbaum, Alfred I. Neugut, Kathleen Conway-Dorsey, Marilie D. Gammon

Faculty Publications

BACKGROUND: Previous studies have suggested that polycyclic aromatic hydrocarbons (PAHs) may be associated with breast cancer. However, the carcinogenicity of PAHs on the human breast remains unclear. Certain carcinogens may be associated with specific mutation patterns in the p53 tumor suppressor gene, thereby contributing information about disease etiology.

OBJECTIVES: We hypothesized that associations of PAH-related exposures with breast cancer would differ according to tumor p53 mutation status, effect, type, and number.

METHODS: We examined this possibility in a population-based case–control study using polytomous logistic regression. As previously reported, 151 p53 mutations among 859 tumors were identified using Surveyor nuclease and …

Patient Centered Care Approach To Adherence With Cardiovascular Medications: Self-Determination Theory Integration, David S. Li

Health Services Research Dissertations

Problem statement. Behavioral intervention is used to improve adherence with medication in patients with cardiovascular diseases (CVD), but the effect was not sustainable. Patient-centered care (PCC) as a consumer movement has gained acceptance, but it lacks a theoretical framework. Self-determination theory (SDT) may provide an alternative to improve patients' adherence to chronic cardiovascular medication, as well as a theoretical framework for PCC. Both approaches to CVD management have not been evaluated.

Methods. The study was a quasi-experimental pretest posttest comparison design with consecutive sampling of a hospitalized cardiac patient population. Sixty patients each for the usual care (UC) …

An Analysis Of Continuous Chest Compression Cpr For Ems Providers During Out Of Hospital Cardiac Arrest, Megan L. Gleason

Honors Projects

A significant amount of research has been done in an attempt to improve the outcomes of patients found in cardiac arrest outside the hospital. The American Heart Association has long advocated Advanced Cardiac Life Support (ACLS), a procedure that encompasses cycles of chest compressions with advanced airway maintenance and defibrillation. Recent evidence has suggested that these current guidelines are ineffective due to prolonged “hands off” time. New research suggests utilizing a technique known as continuous chest compression CPR that delays advanced airway management and instead focuses on defibrillation and continuous chest compressions. Across the country, research has demonstrated that when …

A Gis Analysis Of The Environmental Variables Related To Rift Valley Fever Outbreaks, Jacqueline Florette Jackson

Health Services Research Dissertations

Rift Valley fever is a mosquito-borne disease that causes widespread febrile illness and mortality in domestic animals as well as humans (Gaff, 2007). Rift Valley fever virus was first isolated in 1931 (Daubney, 1931), and since then, outbreaks have occurred in sub-Saharan Africa, southern Africa, Egypt, Saudi Arabia, Yemen and Madagascar, proving it to be a virus able to invade ecologically diverse regions (Gaff, 2007). The potential introduction of Rift Valley fever into the United States suggests the potential for human infection and major economic disruption. It is important to understand the role environmental variables have played in historical outbreaks …