Digital Commons Network^™

Physical Activity And Breast Cancer In South Carolina, Chisom Onyeuku

Theses and Dissertations

This study examined the relationship between breast cancer incidence and recreational physical activity. It was one of the first studies in the southeastern US to examine incident breast cancer and physical activity in an ethnically diverse cohort of women. In terms of physical activity, both lifetime and recent physical activity were analyzed. All physical activity data were from validated self-reported surveys. The study examined BMI, menopausal status and race as key confounders and effect modifiers. The study found evidence that for Black women, there was a positive relationship between the amount of lifetime physical activity and the odds of incident …

Genetic And Epigenetic Variations In Asthma And Wheeze Illnesses, Todd M. Everson

Theses and Dissertations

Asthma, a chronic respiratory condition, is common worldwide with no cure and limited effective prevention strategies. It is well recognized that asthma has a multifaceted etiology, though many of the underlying mechanisms involved in asthma development, persistence and remission are still convoluted. Epigenetic mechanisms, such as DNA methylation, regulate gene-expression but are not related to changes in the actual DNA sequence. Recently, differential patterns of DNA methylation within many genes have been associated with asthma, particularly within genes involved in the differentiation of pro-inflammatory T-helper 2 (Th2) cells. DNA methylation patterns within less known biologic pathways undoubtedly are involved in …

Post-Fall Decision Making Among Older Women Living In Continuing Care Retirement Communities: A Mixed Methods Study, Caroline D. Bergeron

Theses and Dissertations

Introduction: One in every three adults over the age of 65 experiences a fall every year, with women experiencing more falls than men. Falls can affect how older women perceive themselves and their independence. The purpose of this study was to examine older women's health decision making after experiencing a fall. Methods: I conducted semi-structured interviews with 17 older women living independently in continuing care retirement communities (CCRCs) who had experienced a fall within the previous six months and 11 individuals the women identified as being involved in their post-fall decision making. I also conducted an exploratory survey on post-fall …

A Qualitative Study Of The Massage Therapy Foundation's Best Practices Symposium: Clarifying Definitions And Creating A Framework For Practice, Ann Blair Kennedy

Theses and Dissertations

Large numbers of individuals seek massage therapy for wellness/disease prevention purposes and research supports consumer reported benefits including physical and psychological improvements. However, challenges within the profession may be hindering the advancement of the field. To better understand the process and outcomes and ultimately develop best practices for massage therapy as well as better inform education, policy and research, it is necessary to investigate how massage and/or massage therapy are defined and operationalized in practice. This study entailed qualitative analysis of cross-sectional data using a grounded theory approach to examine the data gathered from a two-day symposium held in 2010 …

Individual- And Neighborhood-Level Determinants Of Emergency Department Utilization Among Patients With Diabetes In South Carolina, Charity B. Breneman

Theses and Dissertations

AIM: The primary aim of this study was to evaluate the geographic variation in emergency department (ED) use in South Carolina using geographical information systems (GIS) and to examine the effects of both individual- and neighborhood-level characteristics on frequent ED use among patients with diabetes. METHODS: ED discharge data for 2013 was geocoded based on patients’ residential ZIP code using GIS. Frequent ED use among patients with diabetes was defined as three or more ED visits between January 1, 2013 and December 31, 2013. The boundaries for each neighborhood were defined by the U.S. Census Bureau ZIP Code Tabulation Areas …

Framing Risk, Responsibility, And Resolution: A Mixed-Methods Study Exploring Traditional And Social Media Coverage Of The 2014 Elk River Chemical Spill, Tracey Thomas

Theses and Dissertations

Background: The 2014 Elk River Chemical Spill raised policy questions concerning chemical safety and revealed an immediate need for improved emergency communication. This two-phase study explored how media presented causes of and longterm solutions to the spill through an examination of media frames. The study also explored how health risks were communicated through traditional and social media. The specific aims of Phase I were to examine media coverage in the days following the spill and compare coverage across media channels. The specific aims of Phase II were to understand how public health stakeholders perceived coverage of the spill and how …

Dietary Patterns And Prostate Cancer Aggressiveness In African-American And European-American Men, Lara Ryan Schneider

Theses and Dissertations

Several foods and nutrients have been linked to prostate cancer risk, but the effect of overall diet on prostate cancer outcomes is not well understood. Previous research has primarily examined a posteriori dietary patterns in relation to prostate cancer; studies that have used a priori dietary patterns and their relationship with prostate cancer have been inconclusive. Furthermore, racial differences in prostate cancer incidence and aggressiveness are not well understood. Data from the case-only North Carolina-Louisiana Prostate Cancer Project (PCaP) was used to examine the association between overall dietary pattern, as measured by the Mediterranean Diet (MED) score and the Dietary …

Support For Comprehensive Sexuality Education And Adolescent Access To Condoms And Contraceptions In South Carolina, Sarah H. Kershner

Theses and Dissertations

A statewide random-digit dialed telephone survey was administered to residents of a historically conservative southern state to 1) assess the level of support for comprehensive sexuality education (CSE) in public schools, 2) assess the support for availability to condoms and contraception as an effective strategy for reducing unintended pregnancies and sexually transmitted (STIs) among adolescents and 3) assess the perceived view of reproductive health as a moral or public health issue. Survey data were obtained from 841 South Carolina residents May through June 2013. Findings from the study revealed that the majority (90%) of South Carolina residents support CSE in …

Dental Insurance As A Mitigating Factor In Reducing The Risk Of Mortality Among Working-Age Adults With Dental Caries And Periodontitis, Naveed Sadiq

Theses and Dissertations

Background Poor oral health had been associated with increased risk of having systemic diseases and thus mortality. The purpose of this research was to find if dental coverage with health insurance could mitigate the risk of death due to untreated dental caries and periodontitis among working age U.S. adults. Methods Data were drawn from NHANES III (1988-1994) and linked to mortality updated till Dec. 31st, 2011. It was restricted to those in the age range of 20-64 years adults. Furthermore, it was restricted to those who had complete data collection on all measures. Unweighted propensity scores were calculated to control …

Community-Level Factors Associated With Health-Related Quality Of Life Among Older Adults, Yu-Hsiu Lin

Theses and Dissertations

Objective: Health-related quality of life (HRQOL) and well-being is a new topic area for Healthy People 2020 in the U.S. In a broad-based literature review, more research explored individual level factors of HRQOL, and few focused on older adults. Multilevel analysis was seldom adopted to investigate the relationship between area-level socioeconomic or social environment factors and HRQOL. In lieu of the traditional Chapter 4 (Results) and Chapter 5 (Conclusion), two manuscripts representing the two specific research aims are included. The main aim of first manuscript was to explore the association between area deprivation, area health resources and older adults’ HRQOL. …

Low-Intensity Physical Activity And Cardiometabolic Risk Factors Among Older Adults With Multiple Chronic Conditions, Yueyao Li

Theses and Dissertations

Introduction Cardiovascular disease (CVD) is the leading cause of death among older adults in the Unites States and is driven largely by cardiometabolic risk factors including elevated blood pressure and blood glucose. Studies have found the protective effect of moderate intensity physical activity (MIPA) and vigorous intensity physical activity (VIPA) on cardiometabolic risk factor; however, the association between light physical activity (LIPA) and cardiometabolic risk factor among older adults is not clear. Objectives 1). Examine the association between LIPA and cardiometabolic risk factors. 2). Examine whether the association between LIPA and cardiometabolic risk factor is moderated by multiple chronic conditions. …

Refinement And Pilot Testing Social Networks For Encouraging Healthy Behaviors: The Social Pounds Off Digitally (Social Pod) Study, Sarah B. Hales

Theses and Dissertations

Currently about 71% of adults in the US are considered overweight or obese. Overweight and obesity are associated with higher risk of developing many chronic diseases; however, health risks associated with overweight and obesity can be reduced by as little as a 3% to 5% reduction in weight. Mobile health (mHealth) has shown promise as a way to deliver weight loss interventions, yet maintaining participant engagement over time has been a challenge. The purpose of this study was to develop, refine, and pilot test the Social Pounds Off Digitally (POD) Android app for personalized health monitoring and interaction; revise the …

Relationship Between Job Satisfaction Among Frontline Staff And Patient Satisfaction: Evidence From Community Health Centers In South Carolina, Ashley Lynn Barnes

Theses and Dissertations

The role of frontline staff (FLS) is vital to the success of health delivery organizations as they are often the main point of patient contact and the primary source of feedback regarding the patient experience and satisfaction. Anecdotal evidence suggests that FLS have among the highest turnover rates in health delivery organizations, resulting in high recruitment and training costs as well as disruptions in day-to-day operations. However, few studies have examined the role of FLS and the factors affecting job satisfaction among FLS. Researchers have also not examined the impact of FLS satisfaction on patient satisfaction. To address these research …

From Data To Decision: An Implementation Model For The Use Of Evidence-Based Medicine, Data Analytics, And Education In Transfusion Medicine Practice, Nazanin Tabesh

Theses and Dissertations

Healthcare in the United States is underperforming despite record increases in spending. The causes are as myriad and complex as the suggested solutions. It is increasingly important to carefully assess the appropriateness and cost-effectiveness of treatments especially the most resource-consuming clinical interventions. Healthcare reimbursement models are evolving from fee-for-service to outcome-based payment. The Patient Protection and Affordable Care Act has added new incentives to address some of the cost, quality, and access issues related to healthcare, making the use of healthcare data and evidence-based decision-making essential strategies. However, despite the great promise of these strategies, the transition to data-driven, evidence-based …

Computational Analysis Of The Sir Mathematical Model For The Dengue Fever, Joseph Phillip Diaz

Theses and Dissertations

Dengue fever is a disease affecting people in more than 100 countries. Here we consider a host and vector model for the transmission of dengue fever. This SIR model consists of three compartments of susceptible, infective and removed for host (human) and two compartments of susceptible and infective for vector (dengue mosquitos). These five compartments yield five coupled nonlinear ordinary differential equations (ODEs). After non-dimensionalization, we have a system of three nonlinear ODEs. Reproductive number and two equilibrium points are calculated for various cases. Simulation is carried out for susceptible, infective and removed and the results are presented in graphical …

The Lived Experiences Of An Injured Athlete And Members Of A Performance Management Team During Injury Rehabilitation: An Interpretative Phenomenological Analysis, Courtney Wynne Hess

Theses and Dissertations

In response to an ever growing understanding of the biopsychosocial nature of health and well-being, multidisciplinary and interdisciplinary approaches to rehabilitation have grown in acceptance over the past decade. Studies that have explored the effect of these two approaches have found them to be effective in improving rehabilitation outcomes (McAlister et al., 2001; Tur et al., 2003). Although they have been shown to be objectively effective, the impact that these approaches have on the lived experiences of the team employing them, and the athlete or patient they serve, is not well understood. As such, the purpose of the current study …

Improving Mental Health Literacy: A Single-Subject Design Experiment Examining The Effects Of Text Messaging On Adolescent Mental Health Literacy, Emma Coffman

Theses and Dissertations

The purpose of the study is to determine the feasibility of delivering a text-based mental health literacy intervention for adolescent children who have family members with mental illness. The effectiveness of the text message intervention was measured using a single subject, multiple baseline study design. Each participant received three text messages per week for a total of 6 weeks, containing information regarding mental illness, managing crisis, resources, stigma, and assertiveness. The subjects were evaluated using qualitative and quantitative measures at multiple periods throughout the study. Assessments utilized include: Schizophrenia Vignette quiz developed by Jorm et. al. (1997), Perceived Stress Scale-14(PSS-14) …

Ancestral Dvelopmental Exposure To Methylmercury Induces Transgenerational Inheritance Of Visual And Neurobehavioral Deficits, Thomas Achankunju Kalluvila

Theses and Dissertations

Methylmercury (MeHg) is an environmental neurotoxicant of global concern. It is considered one of the top ten chemicals of public health concern by the World Health Organization. Prenatal exposure to MeHg has been associated with altered neurodevelopment, neurobehavioral and neurocognitive functions. The effects of low dose MeHg exposure are more subtle and can range from impaired motor function to sensory defects. Using quantitative neurobehavioral assays and zebrafish as a model organism, our laboratory has demonstrated that developmental MeHg exposure causes neurological dysfunction in adult zebrafish. Recently, a wide range of environmental insults (e.g., pesticides, fungicides, plasticizers and endocrine disruptors) has …

Health Of The Nation: The Impact Of Racial And Income Segregation On Food Insecurity In The United States, Mark Anthony Caldwell

Theses and Dissertations

One in six Americans experience food insecurity as a result of not being able to consistently obtain the food they need. Food insecurity ranges from not being able to afford balanced meals to the skipping meals as a way to stretch food budgets. Food insecurity impacts many people in the United States, but it disproportionately impacts people of color and those living in poverty. Racial and income segregation may act to concentrate food insecurity in a few geographic areas with high concentrations of minority and/or poor residents. This is an issue of major concern because studies have shown that racial …

Three Essays On Enhancing Clinical Trial Subject Recruitment Using Natural Language Processing And Text Mining, Euisung Jung

Theses and Dissertations

Patient recruitment and enrollment are critical factors for a successful clinical trial; however, recruitment tends to be the most common problem in most clinical trials. The success of a clinical trial depends on efficiently recruiting suitable patients to conduct the trial. Every clinical trial research has a protocol, which describes what will be done in the study and how it will be conducted. Also, the protocol ensures the safety of the trial subjects and the integrity of the data collected. The eligibility criteria section of clinical trial protocols is important because it specifies the necessary conditions that participants have to …

Diagnostics And Model Selection For Generalized Linear Models And Generalized Estimating Equations, Chelsea Boquet Deroche

Theses and Dissertations

The use of generalized linear models and generalized estimating equations in the public health and medical fields are important tools for research, specifically for modeling clinical trials, evaluating preventive measures, and secondary data analysis. It is important for these researchers to have the necessary tools to analyze and model their data correctly. This dissertation focuses on a penalized maximum likelihood estimation method for generalized linear models, measures of association such as the coefficient of determination and R² for generalized estimating equations, and a modified quasi-likelihood information criterion for generalized estimation equations.

Common problems that arise during estimation of generalized …

Smoking Cessation In Pregnancy And Gestational Weight Gain In South Carolinian Mothers, 2009-2011, Laquenta Latreese Weldon

Theses and Dissertations

Purpose: To determine if smoking cessation during pregnancy is associated with excessive gestational weight gain (GWG).

Methods: Data came from the 2009-2011 Pregnancy Risk Assessment Monitoring System (PRAMS), an ongoing population-based survey of live births in South Carolina (n=2,603). Participant smoking status was classified as nonsmoker (did not smoke before or during pregnancy), persistent smoker (smoked before and throughout pregnancy), or quitter (smoked before but quit during pregnancy). Multinomial logistic regression model was estimated to examine the association between smoking status and meeting the 2009 Institute of Medicine guidelines, while linear regression model was used for the continuous outcomes such …

Longitudinal Study Of The Effectiveness Of The South Carolina Medicaid Policy For The Application Of Fluoride Varnish For Children Age Three And Under, Christine N. Veschusio

Theses and Dissertations

In South Carolina, the burden of dental decay disproportionately affects disadvantaged children enrolled in Medicaid (Dye et al., 2012; Martin et al., 2012; Ayers et al., 2013). To address this oral health disparity, South Carolina’s Medicaid Program initiated payment to physicians for the delivery of fluoride varnish (FV), an evidence-based preventive dental service at the well-child visit, to children up to thirty-six months of age. Fluoride varnish has been found to reduce dental decay by thirty-seven percent when applied two to four times a year (Weyant et al., 2013; Marinho et al., 2013).

Two retrospective cohort studies were undertaken to …

Association Between Electronic Prescribing Among Ambulatory Care Providers And Adverse Drug Event Hospitalizations In Older Adults, Grishma Patel Bhavsar

Theses and Dissertations

Purpose.

This dissertation research sought to determine whether the proportion of physicians using electronic prescribing (e-prescribing) was associated with the hospitalization rate for adverse drug events (ADEs) among patients aged 65 and older in 2011. Additionally, we sought to determine whether increases in the proportion of e-prescribing physicians in a county were associated with decreases in the hospitalization rate for ADE among older adults.

Methods.

Two study designs were used, a cross-sectional study using 2011 data and a pre-post- study using 2008 and 2011 data. Data from the 2008 and 2011 State Inpatient Databases, the Office of the National …

Ecpat: Development And Testing Of Mobile Technology To Engage Youth In Active Living Policy, Systems, And Environmental Health Promotion Efforts, Gina M. Besenyi

Theses and Dissertations

Modifying the built environment is a promising way to promote youth physical activity and reduce obesity. Parks, in particular, are key intervention venues given their low cost and legislated ubiquity. Creating healthy communities, including better parks, will require the interest and participation of multiple constituencies, including youth. Creation of mobile technology environmental audit tools can provide a more interactive way for youth to engage with communities and facilitate participation in participatory action research (PAR) and health promotion efforts.

The purpose of the first study was to describe the development and validity and reliability testing of an electronic version of the …

By Word Of Mouth: A Qualitative Approach To Understanding The Integration Of Preventive Dental Health In Primary Care Settings, Joni D. Nelson

Theses and Dissertations

Childhood and adolescence are sensitive periods in the lifespan when oral and craniofacial appearances can help determine social interactions and lifetime outcomes. In this respect, oral health can be viewed as more than just brushing or flossing for healthy teeth; children’s oral health can influence their social development and behaviors, impact their academic growth, affect their guardian’s responsibility for healthcare cost and create a potential pathway for negative impacts on quality of life. Access to quality oral healthcare is vital for the prevention of unwanted diseases and to avoid the burden of oral health complications. Oral health disparities may not …

Spatial Analysis And Correlates Of Waterpipe Tobacco Smoking Among College Students In The United States, Frederick Richard Kates

Theses and Dissertations

Introduction: In the United States, young adults have the highest prevalence of waterpipe tobacco smoking (WTS) according to National Adult Tobacco Surveys (NATS) published by the Center for Disease Control (CDC). Experimentation of different tobacco products is highest among 18-24 year olds. Most recently, WTS has surged in popularity among this demographic group. The rapid diffusion of WTS among this population has been accelerated by marketing efforts on the Internet. There are misperceptions that WTS is less harmful than smoking cigarettes and there is a proliferation of WTS establishments due to tobacco retail exemptions. Presently, WTS establishments are almost completely …

Prostate Specific Antigen (Psa) Growth Curves: A Method To Improve Prostate Cancer Screening, Azza Shoaibi

Theses and Dissertations

Prostate cancer (PrCA) screening aimed at detecting aggressive disease represents a significant public health issue. Development of biomarkers to predict PrCA that is likely to kill if left untreated is a major challenge. This dissertation focused on analyzing existing repeated measures of prostatic specific antigen (PSA) to develop and validate a tool to improve both sensitivity and specificity of the PSA-based screening test to detect high-risk PrCA. We used the Prostate Lung Colorectal and Ovarian trial data (PLCO) for PSA growth model building. Using 6 years of annual PSA measurements we established the PSA growth curves for four groups of …

Using Omaha System Documentation To Understand Physical Activity Among Rural Women, Jeanette Melissa Olsen

Theses and Dissertations

Rural women are more inactive and have different barriers to physical activity than those who live in more urban settings, yet few studies have specifically examined physical activity and associated factors in this population. Clinical data documented with standardized terminology by nurses caring for rural women may provide an opportunity to generate evidence that informs and improves nursing care. However, the knowledge to be gained and utility of nurses' clinical documentation in regard to physical activity have not been explored. Accordingly, the purpose of this study was to increase understanding of physical activity and associated factors among rural women by …

Examining The Association Of Crime Laboratory Practices, Internal And External Determinants, And Dna Case Completion Time And Backlog, Eva Marie Lewis King

Theses and Dissertations

ABSTRACT

EXAMINING THE ASSOCIATION OF CRIME LABORATORY PRACTICES, INTERNAL AND EXTERNAL DETERMINANTS, AND DNA CASE COMPLETION TIME AND BACKLOG

by

Eva Marie Lewis King

The University of Wisconsin-Milwaukee, 2015

Under the Supervision of Dr. Ron Cisler

Crime laboratories across the country have reported caselog information that supports the fact that case submissions have resulted in very large DNA backlogs. The onset of these DNA backlogs developed a public safety and population health crisis. Literature suggests crime laboratories faced submission of DNA cases in a manner similar to the onset of an epidemic. Literature also suggests the use of novel approaches …