African American Women and Healthcare 

I want to explain how healthcare is perceived in the African American community especially amongst women and if their concerns and apprehension are justified. The paper must include a title page, introduction section, abstract section, literature review section, methods section, results section, discussion section, and a signature page. I will attach some samples that were given to me.

Modeling of PM2.5 and Health Effects in Seven California Counties

COH 692: Master of Public Health Capstone Project

National University

Dr. Gina M. Piane

August 27, 2011

1

Table of Contents

Abstract

Acknowledgement

Introduction

Literature Review

PM2.5 Studies in the East Coast and other 50 States

PM2.5 Studies in California

Methodology

Sampling Sites:

Table 1. Description of air pollution monitoring stations.

Sampling Method and Laboratory Chemical Analysis

Table 2. Samples collected by season for each county.

Quality Assurance/Quality Control (QA/QC):

PM2.5 Modeling:

Table 3. Pooled estimates of percent changes in daily mortality categories

Results

Characterization of PM2.5, Yearly-Seasonal Trends and Potential Contributing Sources

Fresno

Sacramento

Sacramento-site-1:Del Paso Manor

Sacramento-site-2-T Street

1

Table of Contents

San Diego County

El Cajon

Escondido

Los Angeles

Riverside

Kern County (Bakersfield)

Santa Clara County (San Jose)

Figure 1. Daily PM2.5 Mass Concentration .

Figure 2. Seasonal Averaged PM2.5 Mass Concentration

Figure 3. Chemical Composition of Daily PM2.5 Concentrations Health Effects

Figure 4a. The Number of Population in the three Major Mortality Categories

Figure 4b. The Percent Increase of the three Major Mortality Categories

Figure 4c. The Percent Increase of other factors under Mortality

Table 4a. The Percent Increase of all Mortality Categories in Bakersfield

Table 4b. The Percent Increase of all Mortality Categories in El Cajon

Table 4c. The Percent Increase of all Mortality Categories in Escondido

Table 4d. The Percent Increase of all Mortality Categories in Fresno

Table 4e. The Percent Increase of all Mortality Categories in Los Angeles

Table 4f. The Percent Increase of all Mortality Categories in Riverside

Table of Contents

Table 4g. The Percent Increase of all Mortality Categories in Sacramento Del Paso

Manor(Kern County).

Table 4h. The Percent Increase of all Mortality Categories in Sacramento T Street(Kern

County).

Table 4i. The Percent Increase of all Mortality Categories in San Jose (Santa Clara County).

Discussion

Limitations

Conclusion

References

Abstract

Mortality due to respiratory disease, cardiovascular disease, and diabetes has been shown

to have an association with an elevated fine particle concentration on a daily basis. This study

describes t

Running Head: SMOKING AND DEPRESSION

CAUSAL RELATIONS BETWEEN SMOKING & DEPRESSION: A META ANALYSIS

Student’s Name: Mehwish Shabbir

Institution: National University

Instructor’s Name: Dr. Gina Piane

Date of Submission:

SMOKING AND DEPRESSION 2

Abstract

This paper seeks to reconcile the recent empirical and theoretical evidence on the

existence of a causal link between smoking and depressive symptoms. In order to attain this, it

sets off with comprehensive information on both depression and smoking, and the implications

of both on the public health. This is followed by a meta-analytical review of the most recent

publications on the topic, selected through searches of the leading medical and public health

databases. The choice of the studies was limited by the date of publication, the nature of the

research design and the subjects. It includes of 16 different publications, analyzed against each

other’s design, subjects, time, place and the ultimate results. These are presented individually

and in a comprehensive table, which is followed by a discussion of the findings in support and

against the existence of a causal link between smoking and the development of depressive

symptoms. While there is compelling evidence that smoking causes depression, this analysis

throws upexamins the possibility of the existence of multiple causal factors as well as common

risk factors that causes both smoking and depression. These are included in the findings

reviewed in the analysis, but are not mainstream.

SMOKING AND DEPRESSION 3

Introduction

The possibility of the existence of a causal relationship between smoking and depressive

symptoms, which may lead to the development of clinical depression presents mmay assive be a

significant public health problems risk factorfor the United States and the rest of the world.

Depression is among the four leading causes of disability in the world today, and has seen

increasing prevalence rates across the world (Kahler, Spillane, Busch, & Leventhal, 2011). It is

estimated that upwards of 121 million people across the world live with one or more forms of

depression, with more than 25% of the people lacking access to mental health care services.

Tobacco smoking on the other hand, accounts for upwards of 90% of all deaths resulting from

chronic lung diseases result from smoking (World Health Organization, 2008). If there is indeed

a causal link between smoking and depression, then the world is faced with a twin public health

threats, needing urgent attention. The comorbidity between depression and smoking arises from

when depr

Methods

Journal article collection for this systematic review consisted of comprehensive and cited

reference searchers, and was conducted January 5th through January 26th, 2017 utilizing two

primary online databases provided by National University Library Services (NULS): National

University Smart Search (NUSS) and EBSCO Host. After selection of a journal article for

review, the researcher was redirected to secondary databases for retrieval of the article.

Secondary databases included Academic One File, Academic Search Premier, Elsevier, Oxford

Journals, ProQuest Central, PubMed Central, and Science Direct, all of which were provided via

NULS. Google Scholar’s database was utilized for journal retrieval by title if it was located in

the primary database but not provided for reading in one of the aforementioned secondary

databases provided by NULS. Inter-library request for journal articles by title located in the

above mentioned primary databases, but not available for reading in the above secondary

databases or Google Scholar were requested through and provided by NULS in a timely matter.

A comprehensive search was conducted with NUSS and EBSCO Host, using the Boolean

term, ‘AND’. It included all possible combinations of the following key terms and keywords:

‘PTSD pharmacological prevention’, ‘case studies’, ‘trials’, ‘somatic’, ‘primary’, ‘secondary’, ‘pre-

trauma’, ‘pre-symptomatic’, ‘preclinical’, ‘clinical’, ‘observational’, ‘retrospective’, ‘rodent’, ‘mouse’,

and ‘rat’. The publication date range was from 2004 to 2016.

Cited references found and used within journal articles presented in this systematic

review were located via the aforementioned primary databases and then obtained for further

review either through the above secondary databases, Google Scholar, or Inter-library request.

Inter-library requests were fulfilled by NULS in a timely manner. Cited references will be

presented in the Results section of this systematic review. The publication date range was from

2004 to 2016.

Inclusion Criteria

Inclusion Criteria for all searches consists of articles that pertained to hypothesized

somatic pharmacologic PTSD preventions and included themes pertinent to this review: somatic,

primary prevention, secondary prevention, pre-trauma prevention, pre-symptomatic prevention,

preclinical case studies, clinical case studies, observational case studies, retrospective case

studies, rodent trials, mouse trials, and rat trials. The date range was 2004-2016 to obtain articles

that were up-to-date and to narrow search results.

Exclusion Criteria

Exclusion Criteria for articles that did not fit the

TH
E

AB
ST

RA
CT

TITLE

10 to 12 words

General Study Design

Key Results of the Study

WRITE THE ABSTRACT LAST

Limit to 120-180 words

Structured or Unstructured (with or without headings)

Include

Purpose of the Study (1 sentence)

Methods used (2 sentences)

Key results (include level of significance)

Conclusion based on the results

Key interpretations and implication of results

  • Slide 1
  • Title
  • Write the Abstract last

Table of Contents

Abbreviations ……………………………………………………………………………………………… 4

Introduction ………………………………………………………………………………….…….……… 5
Background of the Problem ………………………….…………………………….………… 7

Purpose Statement ………………………….…………………………….………… …………………. 9
Definition of Terms ………………………….…………………………….…………………… 9

Review of the Literature ………………………….…………………………….……………………. 10
Complication and Challenges ………………………….…………………………….…….. 10
Attitudes and Beliefs ………………………….…………………………….………………… 12
Efficacy …………………………….………………………….……………………….……….. 16
Hesitancy ………………………….…………………..………….…………………….……….. 16
Hesitation Risks ………………………….…………………….……….……………………… 19

Methods ………………………….…………………………………………………………….………… 20
Inclusion Criteria …….…………………………………………………………….………….. 21
Exclusion Criteria …….…………………………………………………………….…………. 21

Results ………………………….…………………………………………………………….…..………. 22
Table 1: Number of Articles Based On Theme ………………………………….…………… 22
Table 2: Article Summaries .………………………………………………….….……………………. 23

Discussion ………………………….…………………………………………….…………….………… 27
Limitations ………………………….…………………………….…………………….……… 30
Assumptions ………………………….…………………………….…………………..……… 30
Ways to Address the Problem ….…………………….……….………………..……………31

References ………………………….………………………………………………………….………… 33

TITLE OF PAPER IN ALL CAPS

Name of Student

Capstone Project

In partial fulfillment of the degree Master of Public Health

National University

Date

I accept this capstone project on behalf of the Community Health Department, School of Health
and Human Services, National University.

__________________________________________ ___________

Faculty/Professor of Capstone Date
First name Last name

__________________________________________ ___________

MPH Program Director Date
Steve Bowman PhD

Introduction

Post Traumatic Stress Disorder (PTSD) diagnosis is often the outcome of exposure to an

overwhelming stressful event or series of events, such as military combat, rape, or abuse and is a

normal response by normal people to an abnormal situation (Schiraldi, 2009). It is estimated that

more than 80% of adults in the United States experience traumatic events that would qualify for

acute stress disorder (ASD) or PTSD diagnosis and 7 or 8 out of every 100 people will have

PTSD at some point in their lives (Breslau, 2012; National Center for PTSD, 2016). The annual

cost to society of anxiety disorders is estimated to exceed well over $42.3 billion due to

psychiatric and non-psychiatric medical treatment costs, indirect workplace costs, mortality

costs, and prescription drug costs (PTSD United, 2013). It is without question one of the largest

public health concerns to date.

Tertiary treatment options such as cognitive behavioral therapy (CBT), eye movement

desensitization and reprocessing (EMDR), virtual-reality exposure therapy (VRET), group

therapy (GT), and many other palliative treatment options accompanied with selective serotonin

reuptake inhibitors (SSRIs) have been the subject of numerous studies discussed in hundreds of

scholarly comprehensive reviews (National Center for PTSD, 2016; Howlett & Stein, 2015).

Common risk factors among PTSD sufferers that have been associated with tertiary treatment

options include: Living through dangerous events and traumas, getting hurt, seeing another

person hurt, seeing a dead body, childhood trauma, having little or no social support after a

traumatic event, and having a history of mental illness or substance abuse (National Institutes of

Mental Health [NIH], 2016). Identifying these at risk populations accompanied with primary

and secondary preventative measures should hypothetically drastically decrease occurrence of

PTSD. Somatic pharmacologic interventions may be the most viable pre-treatment and pre-

symptomatic options for these at risk populations.

PTSD and ASD according to the Diagnostic and Statistical Manual of Mental Disorders

(DSM-5) are classified as a trauma and stressor related disorder (American Psychiatric

Association, 2013). The most widely used structured clinical interviews for diagnosing PTSD is

the clinician-administered PTSD scale or (CAPS) (American Psychiatric Association, 2013;

Frijiling, et. al., 2014). Researchers and Clinicians agree that trauma is a precursor to a PTSD

diagnosis, knowing this pharmacologic research to develop interventions has significantly

increased; however, regardless of progress, clinical evidence for

Discussion

Journal articles selected for this systematic review have proven that the efficacy for

hypothesized somatic pharmacological PTSD prevention should be considered for further

research. Each of the hypothesized somatic pharmacological PTSD preventions discussed in this

review: Ketamine, Oxytocin, Cannabinoids, Opioids, Omega 3, Modafinil, and Albuterol, from

their respective study design proved to be efficacious. However, each of the hypothesized

preventative PTSD pharmaceuticals presented in this review indicated the need for further

research whether it be refined pre-clinical, clinical studies, or larger RCTs.

The systematic review outlined that more preclinical and clinical research needs to be

done before ketamine and other NMDA receptors can be used in large scale RCTs for PTSD

treatment or prevention; they are as follows: collecting more data on long-term ketamine use

before it can be recommended for routine use, studying its intraoperative effects versus sub-

anesthetic doses administered to conscious patients, and identifying its precise mechanism of

action (Ito et al., 2015; Rasmussen, 2016; Westfall & Nemeroff, 2016; Zhang e. al., 2014).

Advances in pre-clinical and clinical technology may be the answer to filling in the data gaps

indicated above. Recently deployed technological advances aim to identify biomarkers of

response to rapid-acting NMDA antagonists such as ketamine and to identify the neurobiological

changes that are involved in this response. Technologies such as structural and functional

neuroimaging, genetics, polysomnography (a type of sleep study) and electrophysiology studies

in patients taking part in clinical trials at this time who are being treated with ketamine could

identify its precise mechanism of action while at the same time identifying the ideal patient

population (Brain & Behavior Research Foundation, 2017). In addition to ketamine, other

medications that regulate the glutamate system are also being studied.

According to the systematic review, oxytocin may affect amygdala reactivity differently

within male and female populations (Frijiling et al., 2015). The review also specified that future

studies should aim to address oxytocin’s effect on patient samples, especially sex (Eckstein et al.,

2015; Frijiling et al. 2015). A recent double-blind, randomized, placebo-controlled cross-over

fMRI study utilizing male and female police officers investigated whether IN-OT enhanced

neural sensitivity to social reward in PTSD patients (Nawijn et al., 2016). The study concluded

that by increasing neural sensitivity to social reward, a single intranasal oxytocin administratio

Review of the Literature

A literature review search was conducted in order to retrieve articles relevant to the topic

of vaccination and the various beliefs, benefits, and consequences of such. The articles retrieved

focused on various areas including both individual and family beliefs of vaccination

encompassing the proponents and opponents of vaccination. Numerous risk factors and benefits

associated with vaccination, contributing factors to hesitancy, and conflicting attitudes were

examined in an attempt to combat the controversial issue at various levels. Another important

component to cover is the controversy or political debate of mandatory governmental regulations

were reviewed. In addition to hesitancy, it was also important to review the risks that adhere to

hesitancy risks.

Complications and Challenges

There are many symptoms or side effects that can result from vaccination. The National

Vaccine Information Center (NVIC) (2016b) identifies the most common side effects, which

comprise of swelling or redness, inconsolable crying, joint pain or muscle weakness, excessive

bruising, body rash, high fever, fatigue, diarrhea, and twitching of the body. Similar to any

medical intervention, risks associated with vaccines can result in either the product not working,

or the product causing harm. According to the NVIC (2016b), the following are considered to be

the most common complications connected to vaccination: brain inflammation, anaphylaxis,

Chronic Nervous System Dysfunction (CNSD), febrile seizures, acute and chronic arthritis,

brachial neuritis, thrombocytopenia; smallpox, polio, measles and varicella zoster vaccine strain

infection, deltoid bursitis, syncope, shock, inconsolable crying, and death. Due to the lack of

methodological sound studies, the Institute of Medicine IOM is unable to confirm or deny the

connection between the present childhood vaccination schedule and chronic brain and immune

disorders such as asthma, autism, allergies, seizures, Tourette’s syndrome, and other learning

disorders (NVIC, 2016b).

A recent challenge occurring in 2015 was the measles outbreak that occurred in the U.S.

with over 120 people in 17 various states (Poland. & Poland, 2015). The primary cause of this

outbreak was identified as the increased rates of vaccination hesitation or refusal (Poland &

Poland, 2015). According to Pullen (2016), more than half (56.8%) of recent measles cases in

the U.S. can be attributed to vaccine refusal. In addition, 24% – 45% of recent pertussis outbreaks

occurred in unvaccinated individuals or vaccinated individuals living in a location with a high

prevalenc