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The Development Of A Survey Instrument To Assess Racial And Cultural Inclusiveness: A Case Study Of Staff, Jolene Rios

All Master's Theses

Background:

The hierarchy of the medical system and its lack of racial and cultural inclusiveness has created systematically inequitable healthcare with direct outcomes to health disparities. Inequitable non-inclusive healthcare perpetuated and negatively impacted health disparities among minorities and has been a major preventable public health problem. Research studies have established a correlation between racism and various adverse health outcomes, including higher mortality, lower rates of cancer screening, elevated blood pressure, higher C-reactive protein levels, substance use, and mental health conditions (Shavers et al, 2012). Measuring exposure to racism has been essential to establishing racism’s influence on equitable, inclusive healthcare and …

Opioid Use Disorder: The Timeline For Medication Assisted Therapy, Alexander Cristofori

Capstone Showcase

Opioid Use Disorder is patterns of opioid use leading to withdrawal, giving up important life events in order to use opioids, and excessive time spent using opioids, to name a few diagnostic criteria. The clinical progression of the disorder involves periods of acute exacerbation and remission that are cyclic in nature. Treatment is most effective when it includes both pharmacological and psychosocial modalities, referred to as medication assisted therapy (MAT). Three drugs used commonly in MAT-based treatment for OUD from oldest to newest include Methadone, Buprenorphine-naloxone, and Naltrexone. Treatment program models that prioritize total abstinence from the addictive substance attached …

Policies Addressing Barriers To Low-Income Women And Children’S Health Care Utilization In The United States And Kenya: The Role Of Physician Payments And Cash Transfer Programs, Muloongo Simuzingili

Theses and Dissertations

This dissertation examined two policies to improve low-income women and children’s healthcare utilization: physician payments and cash transfer programs. Higher physician payments increase the supply of healthcare services while cash transfers increase individuals’ demand for healthcare services. Cash transfer programs can improve health outcomes, yet the extent to which they are a cost-effective strategy is largely understudied. Therefore, this dissertation examines three overarching research questions:

1. Are Medicaid physician fees associated with access to substance abuse disorder (SUD) treatment among low-income women of reproductive age?
2. Do economic preferences moderate cash transfer program effects on children’s health care utilization? Evidence from a …

Molecular Identification Of Parasites In An Intestinal Coprolite From A Mummified Religious Dignitary Of The Piraino Mother Church Crypt, Sicily, Amanda Rollins, Krystiana Krupa, Georgia Millward, Dario Piombino-Mascali, Karl Reinhard, Frederika Kaestle

Karl Reinhard Publications

Intestinal contents were sampled from a spontaneously enhanced mummy from the Sepulcher of the Priests of the Piraino Mother Church in the Province of Messina, Sicily. This adult male mummy, Piraino 1, is an unidentified religious dignitary dating from the late-18th to mid-19th centuries. Immunological and molecular diagnostics were used to test for common and clinically significant parasites. A morphological diagnosis of Trichuris trichiura (whipworm) was confirmed genetically. A previously undetected Enterobius vermicularis (pinworm) infection was also identified genetically. These data indicate that the Piraino 1 individual was simultaneously infected with multiple intestinal parasite species indicative of poor hygiene. This …

“It Didn’T Matter What The Bill Said...”: Influences On Abortion Policy Legislative Decision-Making In Georgia, Erica Barton, Subasri Narasimhan, Dabney P. Evans

Journal of the Georgia Public Health Association

Background: In March 2019 the Georgia legislature passed HB 481 described as a “heartbeat bill”, prohibiting abortion at around six weeks gestation. Given the prevalence of anti-abortion legislation and the public health implications of abortion restrictions, we sought to understand how Georgia legislators made decisions on this early abortion ban legislation.

Methods: We conducted in-depth interviews with nine legislators from the Georgia House of Representatives who participated in the 2019 legislative session. In-depth interviews were conducted in-person and over the phone. Interview recordings were transcribed verbatim and inductive codes identified. Codes focused primarily on views of: abortion in general; specific …

The Role Of Insurance Coverage In Outpatient Substance Use Disorder Treatment Referral, Utilization, And Outcomes, Huyen Pham

Theses and Dissertations

Opioid-related overdoses increased dramatically in recent years. Medicaid plays a predominant role in paying for opioid use disorder (OUD) treatment. However, there is a critical gap in understanding the role of Medicaid coverage in referrals to treatment, treatment utilization, and treatment retention. The three studies used observational and quasi-experimental (i.e., natural experiment) designs leveraging state and year variation in Medicaid expansion to characterize the role of Medicaid coverage in OUD treatment. We found that individuals with OUD with Medicaid insurance were more likely to use outpatient treatment, whereas those who were uninsured were more likely to use self-help groups only. …

Perceptions Of Local Board Of Health Effectiveness In Georgia, Amber Erickson

College of Graduate Studies: Theses & Dissertations

Objective: The purpose of this study is to examine the perceptions of the local board of health chairpersons in Georgia on their engagement in six governance functions and examining the challenges faced and facilitators perceived by local boards of health in performing the governance functions properly. Methods: For this descriptive mixed method study design, a survey was administered to all local board of health chairpersons and key informant interviews were conducted with a small selection of board of health chairpersons. Descriptive statistics were produced for recoded survey data variables and themes from qualitative data collected through the surveys and interviews …

An Exploration Of Depression In African American Adults With Sickle Cell Disease: Symptoms, Coping Strategies And The Potential Benefits Of Religiosity, Delores P. Quasie-Woode

College of Graduate Studies: Theses & Dissertations

Depressive symptoms in adults with Sickle Cell Disease (SCD) often go unrecognized and untreated. SCD is one of the most common inherited hemoglobin disorders in the United States, affecting 1 in 365 African Americans. Individuals with SCD and co-morbid Depression lead to high hospitalization rates and healthcare utilization. The objective of this study is to explore depressive symptoms and preferred coping strategies among African American Adults with SCD. Furthermore, the aim is to explore the acceptability of religiosity among those who self-identify as religious.

Interviews were conducted with 30 African American adults, recruited during their hematology appointment at the Center …

Addressing Hidden Barriers To Follow Up Healthcare: A Community Referral Pilot Project, Amber Williams

Doctor of Nursing Practice Projects

Objective: The project was aimed to reduce the number of participants lost to primary care follow-up following a mobile health unit screening event.

Design: A pilot study program screening tool implementation was utilized to address the hidden barriers of the Social Determinants of Health (SDoH) during a Winter 2021 event.

Sample: A group of 12 participants were screened during a mobile health unit event. Eight of the participants opted to be a part of the pilot study.

Measurements: A comparison ratio of Primary Care follow up was compared from the Winter of 2020 with Winter of 2021, where the screening …

Doctors Can’T Be Doctors All Of The Time: A Qualitative Study Of How General Practitioners And Medical Students Negotiate Public-Professional And Private-Personal Realms Using Social Media, Megan Marshall, Vikram Niranjan, Eimear Spain, Joe Macdonagh, Jane O'Doherty, Raymond O'Connor, Andrew O'Regan

Articles

The objective of this study is to explore the experiences and perspectives of general practitioners’ and medical students’ use of, and behaviour on, social media and to understand how they negotiate threats to professional and personal life on social media.

Decomposing Differences In Coronavirus Disease 2019-Related Case-Fatality Rates Across Seventeen Nations, Ashley Wendell Kranjac, Dinko Kranjac

Sociology Faculty Articles and Research

As of 1 November 2020, estimated case-fatality rates associated with coronavirus disease 2019 are not uniformly patterned across the world and differ substantially in magnitude. Given the global spatial heterogeneity in case-fatality rates, we applied the Blinder-Oaxaca regression decomposition technique to identify how putative sociodemographic, structural, and environmental sources influence variation in case-fatality rates. We show that compositional and associational differences in country-level risk factors explain a substantial proportion of the coronavirus disease 2019-related case-fatality rate gap across nations. Asian countries fair better vis-à-vis case-fatality rate differences mainly due to variation in returns to sociodemographic, structural, and environmental sources among …

Who Are The Older Adults Who Drown In Western Australia? A Cluster Analysis Using Coronial Drowning Data., Meg Abercromby, Dr Justine E. Leavy, Lauren Nimmo, Dr Gemma Crawford

International Journal of Aquatic Research and Education

Drowning amongst older people is a growing concern. Exploring demographic and other factors associated with unintentional drowning incidents amongst older adults may assist to identify key target groups and refine prevention strategies. This study sought to examine the heterogeneity of older individuals who have drowned and identify population subgroups in Western Australia (WA). A cluster analysis was used to segment the population by examining coronial data 2001-2018 (n = 93). Analysis identified four groups; 1) ‘men who boat & fish in company’ 2) ‘affluent men with poor health’ 3) ‘non-drinkers who boat and fish’, and 4) ‘older men, who slipped …

Inaction On Lead Despite The Relevant Knowledge: Predictors, Covariates, And Outreach Implications, Alessandra Rossi, Bernabas Wolde, Pankaj Lal, Melissa Harclerode

Department of Biology Faculty Scholarship and Creative Works

Testing residential soil and paint for lead provides actionable information. By showing where and how much lead exists on the residence, it allows one to quantify risk and determine the best ways to reduce exposure along with the corresponding health and financial costs. For these reasons, several federal and state programs offer outreach to audiences on the benefits of testing residential soil and paint for lead. Not all individuals who know about lead’s adverse health effects, however, test their residence for lead, potentially limiting the actionable information that could have helped to reduce their exposure. Such individuals represent a challenge …

Health Insurance And The Undocumented Immigrant, Anja Diercks

Honors Theses

The purpose of this thesis is to perform a comparative analysis on how seven different countries (USA, South Africa, Germany, England, Canada, France and Singapore) organize their healthcare system to cope with the issue of undocumented immigrants and whether or not these systems in place were “fair.” The thesis will also explore the possible ways the United States could change to be more inclusive and fairer in the world of healthcare and health insurance for the undocumented immigrant. A study on what fairness means both in ethical and economical terms is done to suggest a new basis of a fair …

Less Worthy Lives? We Must Prioritize People With Intellectual And Developmental Disabilities In Covid-19 Vaccine Allocation, Scott D. Landes, Margaret A. Turk, Katherine E. Mcdonald, Maya Sabatello

Population Health Research Brief Series

Individuals with developmental and intellectual disability should prioritized during COVID-19 vaccination allocation.

Covid-19 Viral Testing Disparities In Los Angeles City, Laura Cyphers

Student Scholar Symposium Abstracts and Posters

Hispanic and Black communities have been disproportionately impacted by COVID-19-related morbidity and mortality (California Department of Public Health, 2020). Inequitable access to viral testing resources may have exacerbated these COVID-19-related racial and ethnic health disparities. For example, reports from the Los Angeles Department of Public Health revealed glaring viral testing disparities in April 2020 (early pandemic), with predominantly White communities in Los Angeles County receiving 65% more tests than Hispanic and Black communities. In response, California statewide testing was expanded for communities of color (Vann et al., 2020). To investigate access to viral testing in Los Angeles City, the current …

The Youthful Pandemic, Brook Sahlemariam

Nursing | Senior Theses

This paper attempts to examine the neurological, physical, and societal effects of e-cigarette use among youth and young-adults in North America. Furthermore, the paper investigates the parallels between e-cigarette users, tobacco users, and dual users in regard to behavioral patterns, reasons for use, and age of initiation.

Homelessness Prevention Contacts Datasheet, Juan Whitehead

Capstone Projects and Master's Theses

The Coalition of Homeless Providers, located in Seaside, California provides services for over 2,400 homeless people in Monterey County. This organization collaborates with other agencies to provide support for those who are in need of emergency, transitional, or permanent housing. Because of lack of affordable housing in the area, and the lack of available resources, many men and women, as well as families find themselves without a place to stay. Homelessness Prevention Contacts Datasheet establishes a list of rental property management companies and landlords who may be interested in some of the programs provided by the Coalition. These programs provide …

Move For A Healthy Mind: A Program Of Peer-Led Physical Activity For Adolescents With Depression And Anxiety, Emily Edwards

Master's Projects and Capstones

The following discusses adolescent depression and anxiety and the utilization of physical activity as an intervention or coping mechanism. Adolescents have been experiencing increased rates of anxiety or depression diagnoses over the past roughly two decades. Adolescence is, physiologically, a formative period in the developmental stage from childhood to adulthood. Current barriers to achieving optimal mental health among the adolescent population include the stigmatization of mental health issues, lack of education, socioeconomic status and healthcare access. Further, physical activity has been studied and identified to be an effective treatment for individuals experiencing depression and anxiety. In an effort to treat …

Understanding The Significance Of Virtual Support During Global Pandemic In Young Adults Diagnosed With Hepatitis C, Veronika Arkhipova

Master's Projects and Capstones

Hepatitis C is a viral infection that attacks the liver and leads to inflammation. In recent years, the prevalence of hepatitis C infections among 20 and 30 years of age has increased by 300 percent, and between 30 and 39 years by 400 percent. Due to the global coronavirus pandemic, people diagnosed with Hepatitis C have lost access to mental health services and resources, including in-person meetings with support groups. Since most states enforced stay-at-home order, many community centers, non-profit organizations that work with Hepatitis C patients and the affected population provide limited to no access to support group meetings …

Covid-19 Needs Assessment And Support For Primary Care Practices In Western North Carolina, Sheri Denslow, Jill Fromewick, Kacey Scott, Jesse Bossingham, Brian Cass, Bryan Hodge, Erica L. Richman, Tammy Garrity, Kathleen Mottus, Jacqueline R. Halladay

HCA Healthcare Journal of Medicine

Background: It is critical to ensure that Primary Care Providers (PCPs) have adequate personal protective equipment (PPE), supplies, training, staffing, and contingency planning during pandemics, particularly in rural areas. In March 2020, during the onset of the COVID-19 pandemic, the Mountain Area Health Education Center (MAHEC), in collaboration with the Cecil G. Sheps Center for Health Services Research at UNC Chapel Hill, rapidly created and conducted a needs assessment of PCPs in western North Carolina (WNC).

Methods: A group of twenty volunteers conducted a telephone survey of PCPs in a 16 county region of WNC. Practices were asked about their …

Seroprevalence Of Novel Coronavirus Sars-Cov-2 At A Community Hospital Emergency Department And Outpatient Laboratory In Northern Orange County, California, Jason Yamaki, Harry Peled, Sajen Mathews, David Park, Mina Firoozi, Kim Smith, Lee Nguyen

Pharmacy Faculty Articles and Research

Introduction

The severe acute respiratory syndrome related coronavirus 2 (SARS-CoV-2) has infected more than 20 million people worldwide, and the spread is most prevalent in the USA, where California had accounted over 240,000 cases in the initial 5 months of the pandemic. To estimate the number of infected persons in our community, we conducted a cross-sectional study to estimate seroprevalence of SARS-CoV-2 infection.

Methods

This cross-sectional study evaluated the presence of immunoglobulin G, antibody for SARS-CoV-2 during the time period of July 15, 2020, to July 27, 2020. Testing was done on serum samples from patients who had visited affiliated …

Open For Business: Offering Physical Library Spaces In The Covid Era, Katie Sparks, Hannah Rogers

Southern Chapter/Medical Library Association Annual Conference

Objective: Our goal was to safely reopen physical library spaces at the Woodruff Health Sciences Center Library for use by various Emory University user groups including students, faculty, and staff during the COVID pandemic of 2020. Because our university brought a subset of students back to campus, we felt it was important to offer safe, socially distanced seating and workstations in the library.

Methods: In collaboration with Emory University’s environmental and safety health officers, we made determinations of the number of seats that could safely be offered. Seating was removed or cordoned off or otherwise signposted. We implemented a reservations …

Why Can't Homeless Addicts Get Help Too, Rachael D. Causland

English Department: Research for Change - Wicked Problems in Our World

Homeless people today struggle more with addiction than people who have stability in their life. Whether it’s due to financial issues, or not having a support system, homeless people struggle to get the help they need for both their addiction and their homelessness. A high number of homeless people report to have started an addiction since being homeless, and they do so to stay alive, in turn people are continuing to stay homeless and many of these people are dying of overdoses or just staying stuck in the situation they are forced to deal with alone. There are some states …

Using Participatory Mapping To Diagnose Upstream Determinants Of Health And Prescribe Downstream Policy-Based Interventions, Jason A. Douglas, Andrew M. Subica, Laresha Franks, Gilbert Johnson, Carlos Leon, Sandra Villanueva, Cheryl T. Grills

Health Sciences and Kinesiology Faculty Articles

Participatory mapping is a powerful methodology for working with community residents to examine social and environmental determinants of public health disparities. However, this empowering methodology has only been applied sparingly in public health research and practice, with limited examples in the literature. To address this literature gap, we 1) review participatory mapping approaches that may be applied to exploring place-based factors that affect community health, and 2) present a mixed-methods participatory geographic information systems (PGIS) examination of neighborhood assets (eg, streetlights) and challenges (eg, spaces of crime and violence) related to access to public parks in South Los Angeles, California. …

Hypercholesterolemia Differences Based On Body Fat Percentage In Diabetic Patients At Pasar Minggu Primary Health Care 2018, Asti Shafira, Ratu Ayu Dewi Sartika, Diah Mulyawati Utari

Indonesian Journal of Public Health Nutrition (IJPHN)

Hypercholesterolemia is the leading predictor of various cardiovascular disease (CVD) which is the leading cause of death in the world. This study aims to determine whether there are any differences the incidence of hypercholesterolemia based on factors related to it in people with diabetes mellitus at Pasar Minggu Primary Health Care in 2018. This study used a cross-sectional method with a sample size of 126 respondents using consecutive sampling. Research variables studied were incidence of hypercholesterolemia, sex, duration of diabetes mellitus, family history of diabetes mellitus, smoking habit, physical activity, stress level, body fat percentage and fat intake. The results …

Body Weight Prediction Model Using Mid Upper Arm Circumferences And Knee Height In Adult, Katherina Katherina, Trini Sudiarti

Indonesian Journal of Public Health Nutrition (IJPHN)

Bodyweight is one of the most common anthropometric components to determin e a prescription for diet and drugs. However, this way proved to be a challenge for individuals who are unconscious and or have disabilities. The present study aims to derive a simple equation to estimate the bodyweight of adults in Jakarta by using a cross-sectional study on data taken with simple random sample method. Measurements of body weight (BW), the mid-upper arm circumference (MUAC), and the knee height (KH) were done in 164 adults in South Jakarta in May 2017. The resulting equation, which is derived by multi linear …

Associations Of Dietary Diversity And Other Factors With Prevalence Of Stunting Among Children Aged 6-35 Months, Kelvin Halim, Ratu Ayu Dewi Sartika, Trini Sudiarti, Primasti Nuryandari Putri, Nurul Dina Rahmawati

Indonesian Journal of Public Health Nutrition (IJPHN)

Prevalence of stunting among under five children in Indonesia is still considered as a public health problem. Dietary diversity, one of the important assessments in infant and child feeding practice, is one of important determinants of stunting. This study is aimed to examine associations between dietary diversity with other factors with prevalence of stunting in Babakan Madang District, Bogor Regency in 2019. A cross-sectional design study was performed in this study during April-June in 2019. A total of 149 children’s height aged 6- 35 months was measured and defined based on WHO growth standards. Dietary diversity scores were collected from …

The Differences Of Haemoglobin Changes Between Two Methods Of Ifa Supplementations Among Anemic Female Adolescent Students Of Miftahul Huda Al Azhar Langgensari Islamic Boarding School, West Java, Syabilila Indraswari, Endang L. Achadi

Indonesian Journal of Public Health Nutrition (IJPHN)

Female adolescent students in boarding schools are vulnerable in having anemia due to packed schedule and limited animal source food. The aim of this research was to compare the differences of haemoglobin level after weekly Iron Folate Acid (IFA) tablet supplementation and weekly plus daily IFA tablet supplementation during menstruation for 8 week of intervention among anemic students. This study used quasi experimental non equivalent control group design. A total of 40 anemic respondents was selected in this study, 20 of them received a weekly IFA tablet supplementation (treatment 1 group), and the 20 other respondents received weekly plus daily …

Factors Associated With Minimum Dietary Diversity Among Breastfed Children Aged 6-23 Months In Indonesia (Analysis Of Indonesia Dhs 2017), Aniza Rizky Aprilya Sirait, Endang L. Achadi

Indonesian Journal of Public Health Nutrition (IJPHN)

Poor complementary feeding practices can lead to malnutrition in infants and young children. Minimum dietary diversity (MDD) is one of the determinants of children’s nutritional status and has been found to predict stunting. This study examined factors associated with MDD achievement among breastfed children aged 6-23 months based on Indonesia’s Demographic and Health Survey 2017. This study used chi-square and multiple logistic regression to analyze the data. Among 2,976 children only around 53% children met MDD recommendation. Multivariate analysis found that the diversity of diet is better among older children than younger children. Children aged 18-23 months have possibility of …