Community Health and Preventive Medicine Commons^™

Cardiovascular Disease And Post Traumatic Stress Disorder In Adults Exposed To The Terrorist Attacks On The World Trade Center, Katie C. Imhof

Master of Public Health Program Student Publications

Following events of terrorism communities and individuals are subject to the cumbersome responsibilities associated with rescue and recovery efforts. In addition to the loss of life and direct injuries sustained during the incident, long term health outcomes among the exposed population are often seen. Both physical and mental health can be affected as a result of the exposure, and some outcomes do not immediately present themselves. The population exposed to the September 11, 2001 terrorist attacks on the World Trade Center in New York City is no different, and the World Trade Center Health Registries database has been established by …

Individual And Combined Effects Of Dehydration, Hyperthermia, And Fatigue On Movement Patterns And Cognition, Rachel M. Karslo

Master's Theses

Individual and Combined Effects of Dehydration, Hyperthermia, and Fatigue on Movement Patterns and Cognition

Rachel M. Karslo, University of Connecticut

Purpose: The purpose of the study was to examine the individual and combined of effects of dehydration, hyperthermia, and fatigue on movement patterns and cognition.  Secondly, we wanted to see if the effects of dehydration, hyperthermia, and fatigue lead to a combined increase in injury risk.

Methods: 12 males completed a within-subject repeated measures design to study the effects of hyperthermia, dehydration and fatigue on movement and cognition.  Subjects completed 4 randomized test sessions in different conditions: hydrated normothermic, dehydrated …

Bitewing Radiographic Evaluation Of Interproximal Carious Lesions On Permanent First Molars In 6 And 12 Year-Olds In The Public Health System Of Chile, Rodrigo Alejandro Haristoy Dr.

Master's Theses

No abstract provided.

Reducing Maternal And Perinatal Mortality Through Labor And Delivery Practices At A Kwazulu-Natal, South Africa District Hospital, Kristen E. Culmo

Renée Crown University Honors Thesis Projects - All

Maternal and perinatal mortality have become main focuses in global health, including in the country of South Africa. Many maternal and perinatal deaths can be prevented just before, during, and directly after the labour and delivery process. This study examines such prevention practices being employed at a district hospital serving a rural population in north-eastern KwaZulu-Natal, South Africa. The study looks at the methods used by the hospital to reduce maternal and perinatal mortality in the labour ward during the intrapartum and immediate postpartum periods, from the start of contractions through three hours post delivery.

Lead Concentrations In Extracted Primary Teeth Among Clark County Pediatric Patients, Jennifer A. Berger

UNLV Theses, Dissertations, Professional Papers, and Capstones

Childhood lead poisoning is a completely preventable condition, yet only a small portion of children in Nevada are screened for elevated blood lead levels. In 2009 only 6.11 percent of children in Nevada were screened for lead indicating that Nevada would benefit from an alternative method of screening for childhood lead exposure. Deciduous teeth are not currently recognized by the Centers for Disease Control and Prevention as diagnostic samples for the measurement for lead exposure. However, this unique and innovative detection method utilizes opportunistic samples that will contribute to the childhood lead poisoning prevention efforts in Nevada.

The objectives of …

High-Risk Human Papillomavirus (Hpv): An Emerging Health Issue For Women And Minorities, Dierdre O. Turner

UNLV Theses, Dissertations, Professional Papers, and Capstones

The human papillomavirus (HPV) is the cause of nearly all cases of cervical cancers worldwide. HPV viral DNA is found in more than 99% of cervical cancers. In addition to cervical cancer, HPV is also associated with some breast and oral cancers. White women have been showing a decline in breast cancer rates while black women are continuously showing higher rates of mortality from both breast and cervical cancer. Minority women are also more likely to receive a late diagnosis and are showing increased incidence of oral cancer, which makes study of HPV in women and minorities significant.

To date, …

The Effect Of Low-Cost Incentives On Active Transportation To School Rates Among Elementary School Students, Sheila G.J. Clark

UNLV Theses, Dissertations, Professional Papers, and Capstones

This study assessed the effectiveness of a school-based active transportation to school (ATS) encouragement program for elementary school students. ATS shows promise for increasing physical activity and preventing excessive weight gain in children. ATS rates were assessed through frequency counts at the control school (N=697) and intervention school (N=693). The intervention encouraged ATS through the distribution of low-cost incentives on one weekday each week. It also required helmet use for participation and included a Walking School Bus component. Findings from this study suggest that the intervention effectively increased ATS on both intervention and non-intervention days.

Exploring Geographic Proximity To Fast-Food Restaurants And Convenience Stores With Dental Caries In Patients At The University Of Nevada Las Vegas School Of Dental Medicine, Charles K. Hill

UNLV Theses, Dissertations, Professional Papers, and Capstones

Dental caries is present worldwide and has afflicted over 90% of all adults in the United States. Biological determinants of the disease are well understood but social determinants and how they interact with biological factors are not. Programs designed to reduce incidence and prevalence of caries often target certain individuals and involve behavioral change. Some programs are more successful when environmental and societal issues are also addressed (Watt, 2002). Biological and behavioral processes leading to caries should include the modification of social factors to enhance results of prevention programs designed to reduce caries in populations. Preventing disease comes not only …

Medicare's Accountable Care Organization Regulations: How Will Medicare Beneficiaries Who Reside In Medically Underserved Communities Fare?, Sara J. Rosenbaum, Peter Shin

Geiger Gibson/RCHN Community Health Foundation Research Collaborative

On March 31, 2011, the Centers for Medicare and Medicaid Services (CMS) released proposed regulations implementing the Medicare Shared Savings Program (MSSP). The thrust of the MSSP is to promote savings to Medicare as well as the greater clinical integration of health care through incentive payments to accountable care organizations (ACOs) that meet Medicare standards for structure, performance, and health care outcomes. The effort to spur greater clinical integration through the MSSP was part of a broader set of reforms contained in the Affordable Care Act (ACA) whose aim was to improve health care quality and efficiency. Among these reforms …

Dual Testing Algorithm Of Bed-Ceia And Axsym Avidity Index Assays Performs Best In Identifying Recent Hiv Infection In A Sample Of Rwandan Sex Workers, Sarah L. Braunstein, Denis Nash, Andrea A. Kim, Ken Ford, Lambert Mwambarangwe, Chantal M. Ingabire, Joseph Vyankandondera, Janneke H. H. M. Van De Wijgert

Publications and Research

Background

To assess the performance of BED-CEIA (BED) and AxSYM Avidity Index (Ax-AI) assays in estimating HIV incidence among female sex workers (FSW) in Kigali, Rwanda.

Methodology and Findings

Eight hundred FSW of unknown HIV status were HIV tested; HIV-positive women had BED and Ax-AI testing at baseline and ≥12 months later to estimate assay false-recent rates (FRR). STARHS-based HIV incidence was estimated using the McWalter/Welte formula, and adjusted with locally derived FRR and CD4 results. HIV incidence and local assay window periods were estimated from a prospective cohort of FSW. At baseline, 190 HIV-positive women were BED and Ax-AI …

Dhhs' And Epa's Proposal To Lower Fluoride Levels In Drinking Water, Shannon Wirz

College of Health Sciences Poster Presentations

On January 7th, 2011 the U.S. DHHS recommended setting the level of fluoride in drinking water to the lowest end of the current optimal range (0.7 to 1.2 ppm). EPA is initiating a review of the maximum amount of fluoride allowed in drinking water based on scientific assessments of health effects from too much fluoride. MCL (Maximum Contaminant Level) is the legal threshold limit on the amount of a substance allowed in public water systems. EPA sets the MCL to address adverse health effects. Current MCL for fluoride is 4 mg/L. The EPA is unsure if they will revise the …

Youth Dating Culture In Urban Vietnam: Attitudes, Behaviors, And Influences, Alexa Difiore

Independent Study Project (ISP) Collection

This paper attempts to research urban youth’s attitudes and behaviors concerning everything having to do with dating (the process, PDA, typical dating spots and behavior) and opinions towards “hot issues” in contemporary, Vietnam such as pre-marital sex and co-habitation. My research question focuses on what the term “dating” means among youth in urban Vietnam, and the various influences that affect youth’s dating and sexual lives. Through an extensive literature review, I learned that there is an overall lack of information and discussion about sex in Vietnam. There is also a general idea that from parents, the government, and school that …

Let's Move! From Dc To Pc: Policy And Programming In Providence Charter Schools Around Student's Awareness Towards Living Healthy, Carmine Perrotti

Public & Community Service Studies Student Scholarship

A thesis developed out of an intership for the Office of the First Lady's "Let's Move Initiative". Following said internship, the author conducted original research on the local level - namely, Providence charter schools - to design, implement, and assess a series of educational “interventions”. These interventions were created to provide information to students and their parents about the benefits of healthy eating and exercise. Over 500 elementary-level students were surveyed for the research. See document abstract for more information.

Influence Of Sexual Education On Sexual Behavior And Contraceptive Use Among 15 To 19 Year-Olds At Colégio Azevêdo Fernandes In Salvador, Brazil, Julia Still

Independent Study Project (ISP) Collection

Although sexual health education provided by the government through schools has shown positive results, such as those distributed by the Brazilian Ministry of Health, it is not the only source, nor the most implemented source, in which adolescents are exposed to and gain knowledge on the subjects of sexual behavior and sexual health. Just as Article 24 of the Convention on the Rights of the Child details, parents, schools and communities play important roles in the process of sexual education and are required to provide guidance and direction to youth (Pan American Health Organization, 2010). In addition to sexual health …

A Case Study Of Health Interventions And The Caste System: Addressing The Social Determinants Of Health Through Development At Crhp Jamkhed, Laura Kroart

Independent Study Project (ISP) Collection

In the Southeast Asian country of India, the ancient but in some cases still rigidly intact caste system plays a role in determining health status and outcomes for much of its population of over 1.2 billion people.[1] The Comprehensive Rural Health Project, located in Jamkhed in the state of Maharashtra, India, approaches health interventions from a development standpoint, addressing biomedical needs, structural and environmental concerns, and the social and economic determinants of health that impact the lives of over a million villagers in the surrounding area.[2] This independent study project was designed to analyze how the Comprehensive Rural …

The Hospitalist: Better Value In Inpatient Care?, Lisa Sprague

National Health Policy Forum

From perhaps a few hundred practitioners in 1996 to an estimated 30,000 today, the discipline called hospital medicine has shown remarkably rapid growth. It represents a fundamental separation of the inpatient and outpatient components of internal and family medicine. The split has implications for the quality and efficiency of care delivery, the outlook for the physician workforce, and the development of new models such as accountable care organizations (ACOs).

Medicare's Bundling Pilot: Including Post-Acute Care Services, Laura A. Dummit

National Health Policy Forum

Fee-for-service Medicare, in which a separate payment is made for each service, rewards health care providers for delivering more services, but not necessarily coordinating those services over time or across settings. To help address these concerns, the Patient Protection and Affordable Care Act of 2010 requires Medicare to experiment with making a bundled payment for a hospitalization plus post-acute care, that is, the recuperative or rehabilitative care following a hospital discharge. This bundled payment approach is intended to promote more efficient care across the acute/post-acute episode because the entity that receives the payment has financial incentives to keep episode costs …

The Role Of Community Health Centers In Addressing The Needs Of Uninsured Low-Income Workers: Implications Of Proposed Federal Funding Reductions, Peter Shin, Sara J. Rosenbaum

Geiger Gibson/RCHN Community Health Foundation Research Collaborative

The severe economic downturn over the past few years has demonstrated the heightened importance of strengthening the health care safety net, particularly for working Americans who may have lost their health insurance coverage or do not have access to employer-sponsored benefits. Both historically and most recently during the current recession, health centers have played a critical role in providing services to the working poor, assuring that they continue to receive timely preventive care that obviates the need for, and minimizes use of, more costly services. We estimate that 1 in 4 low income, uninsured working adults depend on health centers …

The Health Care Access And Cost Consequences Of Reducing Health Center Funding, Peter Shin, Sara J. Rosenbaum

Geiger Gibson/RCHN Community Health Foundation Research Collaborative

For over four decades, community health centers have served a critical role in providing affordable access to quality care to some of the nation's most vulnerable populations. Health centers have historically enjoyed broad bipartisan support, based on the evidence documenting their high quality care, crucial role in both urban and rural communities, and ability to "bend the cost curve."

On February 20, 2011, the U.S. House of Representatives voted to reduce discretionary health center funding by $1.3 billion in FY 2011 alone. Although the spending bill was rejected by the U.S. Senate on March 10, 2011, final spending measures for …

Substance Abuse In Georgia, The Burruss Institute Of Public Service And Research

Georgia Journal of Public Policy

In order to create a snapshot of substance use and abuse in Georgia, the Burruss Institute of Public Service and Research requested access to data from the National Survey on Drug Use and Health conducted on behalf of the Substance Abuse and Mental Health Services Administration (SAMHSA), a unit of the Department of Health and Human Services (HHS).  SAMHSA would not provide access to the raw data; instead, the Institute was given a series of tables with estimates of the average annual number of users of various substances among Georgians ages 12 and older between the years 2002 and 2008. …