This project will demonstrate that international aid organizations' relief efforts after the cholera epidemic in Haiti are misguided, and the publications the organizations release are somewhat deceptive to the public. The Haitian ministry of health underreported cholera incidence, international organizations use the January earthquake as a scapegoat, and Haitian contempt for UN involvement is disregarded. By looking at various narratives from Haitians present during the epidemic, one can contrast the perceptions of the epidemic from the local perspective and the outsider perspective. A content analysis will identify the popular themes of the juxtaposing view points and illustrate how priorities are misaligned. Dedoose 4.5.91 is the computer software tool used to analyze qualitative data.

The Patient Protection and Affordable Care Act of 2010 was created as an overhaul of the US Healthcare system with a goal of getting all American citizens and legal residents healthcare that was both affordable and of good quality. Now almost a year removed from it going into effect, this study looks to determine how the ACA has worked in getting individuals who were previously uninsured and required charitable-based healthcare into health insurance programs within a small population in Arizona. This study evaluates the type of insurance program, the quality and ease of access of the care, and the general affordability of the healthcare. This study found that 75% of individuals surveyed had gained health insurance in the last year, with 95% expecting to be insured for 2015. The large majority rated the quality of their care and the accessibility of it as good, with corresponding increased use of primary care providers as a health resource. The affordability of the care was still a major issue for those who were found to be uninsured and for those who were insured. Despite affordability issues, self-reported measures of general health and access to care were reported by the majority of respondents to have improved over the last 12 months.

A meta-analysis was conducted to compare the total amount of ionic liquid (IL) literature (n = 39,036) to the body of publications dealing with IL toxicity (n = 213), with the goal of establishing the state of knowledge and existing information gaps. Publications on IL toxicity were collected from the SciFinder database and sorted by cation and model organism studied. Studies focusing on pharmacokinetics and drug development were excluded, as were structure-activity relationship methods of data collection. Total publishing activity was used as a measure to gauge research and industrial usage of ILs as well as the knowledge base of toxicology. Five of the most commonly studied IL cations were identified and used to establish a relationship between toxicity data and potential of commercial use: imidazolium, ammonium, phosphonium, pyridinium, and pyrrolidinium. Toxicology publications for all IL cations represented 1.2% ± 0.62% of the total publishing activity; compared with other industrial chemicals, these numbers indicate that there is still a paucity of studies on the adverse effects of this class of chemicals. In vitro models and marine bacteria were the most frequently studied biological systems, contributing 18% and 15%, respectively, to the total body of IL toxicity studies. Whole animal studies (n = 87) comprised 41% of IL toxicity studies, with a subset of in vivo mammalian models consisting of 8%. Human toxicology data were found to be limited to in vitro analyses, indicating substantial knowledge gaps. Risks from long-term and chronic low-level exposure to ILs have not been established yet for any model organisms, reemphasizing the need for filling crucial knowledge gaps concerning human health effects and the environmental safety of ILs. Adding to the existing knowledge of the molecular toxicity characteristics of ILs can help inform the design of greener, less toxic and more benign IL technologies.

Background: While research has quantified the mortality burden of the 1957 H2N2 influenza pandemic in the United States, little is known about how the virus spread locally in Arizona, an area where the dry climate was promoted as reducing respiratory illness transmission yet tuberculosis prevalence was high.
Methods: Using archival death certificates from 1954 to 1961, this study quantified the age-specific seasonal patterns, excess-mortality rates, and transmissibility patterns of the 1957 pandemic in Maricopa County, Arizona. By applying cyclical Serfling linear regression models to weekly mortality rates, the excess-mortality rates due to respiratory and all-causes were estimated for each age group during the pandemic period. The reproduction number was quantified from weekly data using a simple growth rate method and generation intervals of 3 and 4 days. Local newspaper articles from The Arizona Republic were analyzed from 1957-1958.
Results: Excess-mortality rates varied between waves, age groups, and causes of death, but overall remained low. From October 1959-June 1960, the most severe wave of the pandemic, the absolute excess-mortality rate based on respiratory deaths per 10,000 population was 17.85 in the elderly (≥65 years). All other age groups had extremely low excess-mortality and the typical U-shaped age-pattern was absent. However, relative risk was greatest (3.61) among children and young adolescents (5-14 years) from October 1957-March 1958, based on incidence rates of respiratory deaths. Transmissibility was greatest during the same 1957-1958 period, when the mean reproduction number was 1.08-1.11, assuming 3 or 4 day generation intervals and exponential or fixed distributions.
Conclusions: Maricopa County largely avoided pandemic influenza from 1957-1961. Understanding this historical pandemic and the absence of high excess-mortality rates and transmissibility in Maricopa County may help public health officials prepare for and mitigate future outbreaks of influenza.

The transition from high school to college is, for many, a drastic change in lifestyle, social networks, and dietary choices. The prevalence of obesity in college students has been steadily increasing. Freshmen weight gains have been associated with a decrease in fruits and vegetables and an increase in unhealthy items such as desserts, alcohol, and late night snacking after dinner. A survey of college students was constructed to gauge students' perceptions of nutrition how these perceptions influenced dietary practices and behaviors. Survey results indicated that awareness of nutrition and health does not translate to dietary practices, aligning with results from previous studies. Several sex differences were noted in regards to dietary choices and perceptions, knowledge seeking behavior, and sources of information. While there were some similarities, it is clear from the results obtained that men and women have different approaches and thoughts with regard to nutrition. The results showed that college students who actively seek our nutritional information are more likely to do so in the form of social media or Internet sources. This study could be useful for those planning on conducting college-based nutritional programs in that the results indicate patterns and trends that should be taken into consideration in order for a successful nutrition intervention

Background: While prior studies have quantified the mortality burden of the 1957 H2N2 influenza pandemic at broad geographic regions in the United States, little is known about the pandemic impact at a local level. Here we focus on analyzing the transmissibility and mortality burden of this pandemic in Arizona, a setting where the dry climate was promoted as reducing respiratory illness transmission yet tuberculosis prevalence was high.

Methods: Using archival death certificates from 1954 to 1961, we quantified the age-specific seasonal patterns, excess-mortality rates, and transmissibility patterns of the 1957 H2N2 pandemic in Maricopa County, Arizona. By applying cyclical Serfling linear regression models to weekly mortality rates, the excess-mortality rates due to respiratory and all-causes were estimated for each age group during the pandemic period. The reproduction number was quantified from weekly data using a simple growth rate method and assumed generation intervals of 3 and 4 days. Local newspaper articles published during 1957–1958 were also examined.

Results: Excess-mortality rates varied between waves, age groups, and causes of death, but overall remained low. From October 1959-June 1960, the most severe wave of the pandemic, the absolute excess-mortality rate based on respiratory deaths per 10,000 population was 16.59 in the elderly (≥65 years). All other age groups exhibit very low excess-mortality and the typical U-shaped age-pattern was absent. However, the standardized mortality ratio was greatest (4.06) among children and young adolescents (5–14 years) from October 1957-March 1958, based on mortality rates of respiratory deaths. Transmissibility was greatest during the same 1957–1958 period, when the mean reproduction number was estimated at 1.08–1.11, assuming 3- or 4-day generation intervals with exponential or fixed distributions.

Conclusions: Maricopa County exhibited very low mortality impact associated with the 1957 influenza pandemic. Understanding the relatively low excess-mortality rates and transmissibility in Maricopa County during this historic pandemic may help public health officials prepare for and mitigate future outbreaks of influenza.

Background: This study examines how pro-vaccine flu messages, guided by the Extended Parallel Process Model (EPPM), affect parents’ intentions to vaccinate their children.

Methods: Parents of children six months to five years old (N = 975) were randomly exposed to one of four high-threat/high-efficacy messages (narrative, statistical, combined, control) and completed a follow-up survey. Differences between message conditions were assessed with one-way ANOVAs, and binary logistic regressions were used to show how constructs predicted intentions.

Results: There were no significant differences in the ANOVA results at p = .05 for EPPM variables or risk EPPM variables. There was a significant difference between message conditions for perceived manipulation (p = 0.026), authority, (p = 0.024), character (p = 0.037), attention (p < .000), and emotion (p < .000). The EPPM model and perceptions of message model (positively), and the risk EPPM model and fear control model (negatively), predicted intentions to vaccinate. Significant predictor variables in each model at p < .05 were severity (aOR = 1.83), response efficacy (aOR = 4.33), risk susceptibility (aOR = 0.53), risk fear (aOR = 0.74), issue derogation (aOR = 0.63), perceived manipulation (aOR = 0.64), character (aOR = 2.00), and personal relevance (aOR = 1.88). In a multivariate model of the significant predictors, only response efficacy significantly predicted intentions to vaccinate (aOR = 3.43). Compared to the control, none of the experimental messages significantly predicted intentions to vaccinate. The narrative and combined conditions significantly predicted intentions to search online (aOR = 2.37), and the combined condition significantly predicted intentions to talk to family/friends (aOR = 2.66).

Conclusions: The EPPM may not be effective in context of a two-way threat. Additional constructs that may be useful in the EPPM model are perceptions of the message and fear control variables. One-shot flu vaccine messages will be unlikely to directly influence vaccination rates; however they may increase information-seeking behavior. The impact of seeking more information on vaccination uptake requires further research. Flu vaccine messages should be presented in combined form. Future studies should focus on strategies to increase perceptions of the effectiveness of the flu vaccine.

Public risk communication (i.e. public emergency warning) is an integral component of public emergency management. Its effectiveness is largely based on the extent to which it elicits appropriate public response to minimize losses from an emergency. While extensive studies have been conducted to investigate individual responsive process to emergency risk information, the literature in emergency management has been largely silent on whether and how emergency impacts can be mitigated through the effective use of information transmission channels for public risk communication. This dissertation attempts to answer this question, in a specific research context of 2009 H1N1 influenza outbreak in Arizona. Methodologically, a prototype agent-based model is developed to examine the research question. Along with the specific disease spread dynamics, the model incorporates individual decision-making and response to emergency risk information. This simulation framework synthesizes knowledge from complexity theory, public emergency management, epidemiology, social network and social influence theory, and both quantitative and qualitative data found in previous studies. It allows testing how emergency risk information needs to be issued to the public to bring desirable social outcomes such as mitigated pandemic impacts. Simulation results generate several insightful propositions. First, in the research context, emergency managers can reduce the pandemic impacts by increasing the percent of state population who use national TV to receive pandemic information to 50%. Further increasing this percent after it reaches 50% brings only marginal effect in impact mitigation. Second, particular attention is needed when emergency managers attempt to increase the percent of state population who believe the importance of information from local TV or national TV, and the frequency in which national TV is used to send pandemic information. Those measures may reduce the pandemic impact in one dimension, while increase the impact in another. Third, no changes need to be made on the percent of state population who use local TV or radio to receive pandemic information, and the frequency in which either channel is used for public risk communication. This dissertation sheds light on the understanding of underlying dynamics of human decision-making during an emergency. It also contributes to the discussion of developing a better understanding of information exchange and communication dynamics during a public emergency and of improving the effectiveness of public emergency management practices in a dynamic environment.