<p> The high incidence of medical and surgical errors in U.S. hospitals and clinics affects patients&rsquo; safety. Not enough is known about the relationship between physician characteristics and medical error rates. The purpose of this quantitative correlational study was to examine the relationship between selected physician characteristics and surgical errors in U.S. hospitals. The ecological model was used to understand personal and systemic factors that might be related to the incidence of surgical errors. Archived data from the National Practitioner Data Bank database of physician surgical errors were analyzed using bivariate and multivariate logistic regression analyses. Independent variables included physicians&rsquo; home state, state of license, field of license, age group, and graduation year group. The dependent variable was surgical medical errors. Physicians&rsquo; field of license and state of license were significantly associated with surgical error. Findings contribute to the knowledge base regarding the relationship between physician characteristics and surgical medical errors, and findings may be used to improve patient safety and medical care.</p>

Thesis (Ph.D.)--Michigan State University. Dept. of Epidemiology, 2008. / Title from PDF t.p. (viewed on Apr. 2, 2009) Includes bibliographical references (p.145-152). Also issued in print.

Thesis (M.A.)--Georgia State University, 2005. / Title from title screen. Jeremy Crampton, committee chair; Michael Eriksen, Dona Stewart, committee members. Electronic text (94 p. : ill., maps (some col.)) : digital, PDF file. Description based on contents viewed July 10, 2007. Includes bibliographical references (p. 88-94).

<p> People living with HIV/AIDS (PLWH) experience stigma that creates barriers have the net effect of limiting access to care and decreased quality of life. This study seeks to identify, quantify, and measure mechanisms that produce the negative outcomes of provider-based stigma in regards to PLWH. The study employs the Health Care Provider HIV/AIDS Stigma Scale (HPASS), a new instrument based on a tripartite model of measuring prejudice, stereotyping and discrimination as developed by Wagner et al. in 2014. The study shows stereotyping is prevalent in the sample as a whole while prejudice was statistically significant in both correlations and comparisons made among groups. The study concludes that stigma is both frank and occult in its operation within the healthcare delivery model and recommends concrete and targeted interventions suitable for the setting where the study takes place.</p>

<p> Hepatitis E virus (HEV) has over the last three decades emerged as a cause of outbreaks in displaced populations. Effective deployment of an HEV intervention toolkit that includes HEV vaccines requires epidemiological characterization of HEV trends in vulnerable populations. The study purpose is to describe the epidemiology of HEV and identify factors for severe HEV disease in displaced populations of South Sudan. The agent-host-environment model was used. A nested retrospective cohort study was used with a sample of 14,404 cases for the descriptive case-series and 4,810 cases for the retrospective cohort. Data analyses included cumulative incidence and mortality rates, SatScan^&reg; space-time analysis, correlation and simple linear regression, odds ratio, and logistic regression. Sustained HEV transmission occurred from 2012 to 2017 with rising transmission in the rainy season but no significant correlation between precipitation and HEV cases. The median outbreak duration was 1 year 11 months. The outbreaks were attributed to HEV genotype 1 subtype 1e with the risk of HEV disease and death (as cases and deaths per 10,000) being higher in males (591 versus (vs) 23), adults (18&ndash;59 years) (367 vs 14), and elderly (60+ years) (353 vs 22). The factors associated with severe HEV disease include (a) altered mental status (adjusted Odds Ratio [a<i> OR</i>] = 640.24, 95% CI: 209.35&ndash; 1958.02), (b) death (a<i>OR</i> 28.06, 95% CI: 14.77&ndash;53.29), (c) pregnancy (a<i> OR</i> 16.90, 95% CI: 9.54&ndash;29.94), (d) illness onset in rainy season (a<i>OR</i> 0.33, 95% CI: 0.23&ndash;0.46). The implications for positive social change entail using present findings to guide clinical screening of HEV cases and to inform the effective deployment of the HEV intervention toolkit, including HEV vaccines that reduce the impact of HEV in displaced populations.</p><p>

<p> In the United States, many hospitalized patients with indwelling urinary catheters acquire catheter-associated urinary tract infections (CAUTI) during their hospital stay. CAUTI negatively affects peoples&rsquo; health and quality of life and causes a financial burden to individuals and the nation. The purpose of this quantitative cross-sectional study was to explore the relationship between gender, age, and hospital types and CAUTI incidence in New York and North Carolina over a 3-year period. The theoretical framework of choice was the Donabedian model. Simple logistic regression and hierarchical multivariable logistic regression analysis were performed on archival data that was requested from Healthcare Cost and Utilization Project (HCUP) agency. According to the findings, males (<i>n</i> = 61,040) were at a higher risk of developing CAUTI compared to female (<i>n</i> = 66,792) (<i>p</i> &lt; .001) in New York and North Carolina between 2012 and 2014. The odds of getting CAUTI were much higher among age &ge; 45 compared to the &lt; 17 years. These findings fit in with previous literature identifying age and gender as having a significant relationship with CAUTI occurrence. The outcomes in this study may guide the formulation of policies that are age-appropriate, gender-specific, and facility-tailored to reduce the incidence of CAUTI.</p><p>

<p> The Human Papillomavirus (HPV) is a common sexually transmitted infection (STI) and etiological agent of cervical cancer. It has been suggested that religiosity may promote a generalized disassociation between all STIs/STDs, including HPV, and personal relevance thus contributing to lower levels of HPV awareness and knowledge among certain groups. This study sought to identify the role of religiosity as a predictor of HPV awareness and knowledge among women in a Christian university. Religiosity was defined and measured using the Duke University Religion Index (DUREL). The schemata and social identity theories provided the theoretical framework for this study. A total of 173 women completed the modified survey instrument to assess level of HPV awareness and knowledge, attitudes toward premarital sex, and level of religiosity. Multiple linear regression analysis was used to test the hypotheses. Religiosity, as defined by the intrinsic religiosity subscale of the DUREL significantly contributed to HPV awareness (<i>p</i> = .002) and HPV knowledge (<i>p</i> = .036). The positive social change implications of this study include a better understanding of the role of religiosity in HPV awareness and knowledge; consideration of religiosity in dissemination of health information by informing public health policies and programs to ensure adequate and culturally relevant education and awareness about HPV transmission, HPV-related cancers, and HPV vaccination.</p><p>

Taenia solium is a zoonotic helminth which is thought to be one of the leading causes of acquired epilepsy in the developing world. T. solium cysticercosis infections in pigs and humans and human taeniasis were diagnosed using antigen-capture ELISAs. The parasite was found to be endemic in the study site, with cysticercosis being detected by HP10 Ag-ELISA in 6.6% of human samples (95% C.I. 5.6-7.8%) and 17.2% (95% C.I. 10.2-26.4%) of porcine samples. Human taeniasis was detected by Copro-Ag ELISA in 19.9% (95% C.I. 18.2-21.8%) of faecal samples. The study site was found to be co-endemic with a large selection of other neglected tropical diseases, including soil transmitted helminthiasis, schistosomiasis, strongyloidiasis and amoebiasis. Potential control measures for this parasite have been modeled and the exclusion of infective pork from the food chain through the use of a pre-slaughter test for pig farmers, traders and slaughtermen was found to have the potential to avoid 72.6% (95% C.I. 62.1-80.9%) of infective meals consumed in the area at an incremental cost-effectiveness ratio (ICER) of $0.25 (0.2-0.35). Such a diagnostic tool is currently under development and its performance was evaluated as part of this thesis. The novel, user-friendly lateral flow assay, utilising the HP10 monoclonal antibody, was evaluated using a Bayesian framework and was estimated to perform with a Sensitivity of 82.7% (95% B.C.I. 72.5-91.9%) and Specificity of 87% (95% B.C.I. 80.2-93.4), results which demonstrate the potential utility of this test in epidemiological studies and in control strategies. Free-ranging pig production has been previously demonstrated to be a key risk factor for porcine cysticercosis and is commonly practised in this study region. A study carried out as part of this thesis found that these pigs have a home range of 15,085m2 which is almost 10 times the average area of a homested. This work indicates that pigs can be exposed to infective eggs from any human T. solium carriers within that homerange area, greatly assisting transmission of this parasite. Western Kenya is a severely deprived region where pig production is becoming hugely popular and is seen as a major tool for economic development, yet the data presented in this thesis indicates an area with endemic status for the harmful parasite T. solium, for which effective control strategies are desperately required.

The ability to control one’s own personally identifiable information is a worthwhile human right that is becoming increasingly vulnerable. However just as significant, if not more so, is the right to health. With increasing globalisation and threats of natural disasters and acts of terrorism, this right is also becoming increasingly vulnerable. Public health practice – which is charged with the protection, promotion and mitigation of the health of society and its individuals – has been at odds with the right to privacy. This is particularly significant when location privacy is under consideration. Spatial information is an important aspect of public health, yet the increasing availability of spatial imagery and location-sensitive applications and technologies has brought location-privacy to the forefront, threatening to negatively impact the practice of public health by inhibiting or severely limiting data-sharing. This study begins by reviewing the current relevant legislation as it pertains to public health and investigates the public health community’s perceptions on location privacy barriers to the practice. Bureaucracy and legislation are identified by survey participants as the two greatest privacy-related barriers to public health. In response to this clash, a number of solutions and workarounds are proposed in the literature to compensate for location privacy. However, as their weaknesses are outlined, a novel approach - the multidimensional point transform - that works synergistically on multiple dimensions, including location, to anonymise data is developed and demonstrated. Finally, a framework for guiding decisions on data-sharing and identifying requirements is proposed and a sample implementation is demonstrated through a fictitious scenario. For each aspect of the study, a tool prototype and/or design for implementation is proposed and explained, and the need for further development of these is highlighted. In summary, this study provides a multi-disciplinary and multidimensional solution to the clash between privacy and data-sharing in public health practice.

Thesis (Ph. D.)--Ohio State University, 2006. / Title from first page of PDF file. Includes bibliographical references (p. 223-241).