Medicine and Health Sciences Commons^™

Self-Reported Racism, Transphobia, Their Intersection And Impact On Past-Year Hiv Related Sexual Risk Behaviour, Roxanne M. Longman Marcellin

Electronic Thesis and Dissertation Repository

Background: Studies examining HIV prevalence and risk behaviors within trans subgroups have identified them as high risk. Yet few studies have addressed how discrimination impacts this prevalence. Minority stress theory suggests that there is a relationship between minority stress and HIV-related risk behaviour. We hypothesize that multiple minority statuses may result in discriminatory experiences, specifically self-reported transphobia and racism in synchrony with other attributes, that interact to alter past-year HIV-related risk behaviour.

Methods: Data came from the Trans PULSE project, a mixed-methods, community-based research study that used respondent-driven sampling to access 433 trans Ontarians, between May 2009 and …

Evaluation Of The Survival Effect For Various Treatment Modalities Among Stage Ii And Iii Rectal Cancer Patients In California, 1994-2009, Myung Mi Cho

Loma Linda University Electronic Theses, Dissertations & Projects

Background: European trials evaluating the effect of preoperative (PreOP) versus postoperative chemoradiotherapy (PostOP CRT) found no survival benefit. However, the effect of a change from PostOP to PreOP CRT has not been evaluated in a population-based setting. We sought to evaluate multimodal treatment changes and overall survival for perioperative (PeriOP) CRT versus surgery alone and for PreOP versus PostOP CRT from 1994 through 2009 among patients receiving radical surgery for stage II and III rectal cancer (RC).

Patients and Methods: We conducted a nonconcurrent cohort study evaluating demographic predictors of multimodal therapy for stage II and III RC using …

Antenatal Care Determines Immunization And Care For Fever And Diarrhea In Ghanaian Children, Natalie K. Mcglynn

Electronic Thesis and Dissertation Repository

Enhancing maternal and child health comprise key Millennium Development Goals (MDGs), driving an analysis of whether efforts to improve maternal health through quality antenatal care (ANC) is associated with the recommended health-related care of children in Sub-Saharan Africa, where under-five mortality is the highest.

This study examines ANC as a potential determinant of immunization and appropriate care for fever and diarrhea in Ghanaian children. Data were pooled from the 1998, 2003, and 2008 Ghana Demographic Health Surveys, and Andersen’s Behavioural Model provided the conceptual framework.

Multivariate logistic regression indicated that quality ANC increases the odds of immunization and appropriate care …

Screening For Adult Adhd In Ontario: A Cross-Sectional Study Examining Sex Differences, Mental Health Correlates And Substance Use, Deanne Daigle

Electronic Thesis and Dissertation Repository

The vast majority of studies on attention-deficit/hyperactivity disorder (ADHD) are based on samples with inherent age, sex, and referral biases. Therefore, the current study used population-based data to 1) estimate the prevalence of adult ADHD (as well as previous diagnosis and medication use using an ADHD screener) and co-occurring psychiatric distress and substance use in Ontario 2) examine the sex differences in ADHD screening status and co-occurring psychiatric distress and substance use and 3) model ADHD screening status as a risk factor for psychiatric distress using the 2011 cycle of the Centre for Addiction and Mental Health Monitor. A positive …

Investigating Personality Vulnerability To Suicide Ideation In Community-Residing Older Adults, James Andrew Mcclure

Electronic Thesis and Dissertation Repository

This study assessed associations between suicide ideation and personality characteristics in a sample of community-residing adults 65 years of age and older. Measures of personality, suicide ideation, and depression were administered at two time points 6-12 months apart. Multiple linear regression analyses were employed to investigate cross-sectional and longitudinal associations between personality characteristics and suicide ideation. A total of 106 older adults (mean age=74.2 years, SD=5.8, including 78 women) completed both phases of the study. The majority of participants included in this study were relatively emotionally and psychologically healthy. Within this sample of older adults, more severe suicide ideations was …

Using Box-Jenkins Modeling Techniques To Forecast Future Disease Burden And Identify Disease Aberrations In Public Health Surveillance Report, Larry C. Garrett

Dissertations

The analysis of public health surveillance data to identify departures from historical patterns of disease is required to facilitate the timely identification of potential outbreaks. Using the Box-Jenkins forecasting model, this study examines the potential to predict future disease burden based upon the historical record within local public health jurisdictions. Box-Jenkins forecasting was developed as a direct result of forecast problems in the business, economic, and control-engineering applications, yet it has not been systematically examined for use with public heath surveillance data.

Box-Jenkins forecast models are constructed by stratifying 84,029 disease reports from the State of Utah by year (n …

Complexity And Uncertainty In Human And Ecological Risk Assessment, Matthew Jordan Dellinger

Theses and Dissertations

Multiple interacting stressors in the environment present increasingly complex risks to human health. Too often, however, the data required for traditional risk assessment are either lacking or unavailable at the necessary spatial or temporal scale. In addition, assessment practices and management policies need to move away from single factor approaches in order to accommodate the reality of complex chemical mixtures and environmental stressors. Recent literature suggests that a paradigm shift is under way. This points to a need for the development of new techniques both for rapid data collection and flexible risk assessment strategies that can adapt to make use …

Timeliness Of Electronic And Traditional Laboratory Reporting In Southern Nevada, 1999-2012, Jennifer Anne Lucas

UNLV Theses, Dissertations, Professional Papers, and Capstones

This study compares the timeliness of Electronic Laboratory Reporting (ELR) with traditional reporting. ELR has been implemented in parts of the United States, and is perceived to be faster than traditional reporting. Faster reporting leads to faster public health response to prevent outbreaks, and to reduce the burden of infectious disease in communities. Nevada State law requires that diseases be reported within certain time frames. Timeliness of laboratory reporting at the Southern Nevada Health District (SNHD) from 1999-2012 was assessed by analyzing cases of four common diseases in this retrospective secondary analysis of extant data.

The difference in timeliness regarding …

The Effectiveness Of Health Education Materials In Influencing Hiv Testing Behavior: The Unlv-Siphi Study, Rebecca Tsegay

UNLV Theses, Dissertations, Professional Papers, and Capstones

The UNLV-SIPHI (Sexual Health Internet-Based Public Health Intervention) Study focused on HIV prevention by improving HIV testing behavior through the development and dissemination of health education materials. The goal of the UNLV-SIPHI Study was to develop effective, custom-made HIV health education materials that promote the knowledge, intention and practice of HIV testing among UNLV students. The UNLV-SIPHI Study was conducted during Spring 2012 semester in selected UNLV undergraduate classes. An online quasi-randomized-control trial (RCT) was used to measure the difference in HIV testing behavior contributing factors among students exposed to the health education materials. Several nonparametric tests were used to …

Social Support As A Determinant Of Health Related Quality Of Life In Breast Cancer Survivors In California, Faiza Rab

Electronic Thesis and Dissertation Repository

Objective:

To evaluate the relationship between perceived social support and HRQOL (physical and emotional) in low SES breast cancer survivors.

Methods:

A cross-sectional study design was used to measure perceived social support at 18 months and HRQOL at 3 years after breast cancer diagnosis using MOS SS and MOS SF-36, respectively. Multiple regression analyses were used to evaluate the relationship.

Results:

Menopause at the time of diagnosis, adjunct chemotherapy, adjunct radiation therapy, co-morbidities, treatment side effects and depression were negatively associated with PCS scores (p < 0.01). Treatment side effects, anxiety and depression were negatively associated with MCS scores (p < 0.01).

Conclusions:

Perceived social support was not associated with HRQOL in low SES breast cancer survivors …

Weight Status Underestimation Among Canadian Adolescents: An Important And Frequently Overlooked Aspect Of The Childhood Obesity Epidemic, Mary Ellen Kuenzig

Electronic Thesis and Dissertation Repository

Objectives: Overweight adolescents frequently fail to recognize that they are overweight. This project examines the magnitude of weight status underestimation among overweight adolescents and identifies predictors of this underestimation.

Methods: Data from the Canadian Community Health Survey (2001-2010) were used. Overweight adolescents (N=11,452) reporting they were underweight or about right were classified as underestimating their weight. The time trend in underestimation and effects of individual-level characteristics on underestimation were examined using logistic regression. Multilevel analysis examined the effect of weight status of community-based reference groups.

Results: For every 5 overweight male adolescents, 3 underestimated their weight; 2 of 5 overweight …

Latin Hypercube Sampling And Partial Rank Correlation Coefficient Analysis Applied To An Optimal Control Problem, Boloye Gomero

Masters Theses

Latin Hypercube Sampling/Partial Rank Correlation Coefficient (LHS/PRCC) sensitivity analysis is an efficient tool often employed in uncertainty analysis to explore the entire parameter space of a model. Despite the usefulness of LHS/PRCC sensitivity analysis in studying the sensitivity of a model to the parameter values used in the model, no study has been done that fully integrates Latin Hypercube sampling with optimal control analysis.

In this thesis, we couple the optimal control numerical procedure to the LHS/PRCC procedure and perform a simultaneous examination of the effects of all the LHS parameter on the objective functional value. To test the effectiveness …

Genetic Predictors Of Clinical Outcomes In Non-Small Cell Lung Cancer Patients, Xia Pu

Dissertations & Theses (Open Access)

Lung cancer is the leading cause of cancer-related mortality in the US. Emerging evidence has shown that host genetic factors can interact with environmental exposures to influence patient susceptibility to the diseases as well as clinical outcomes, such as survival and recurrence. We aimed to identify genetic prognostic markers for non-small cell lung cancer (NSCLC), a major (85%) subtype of lung cancer, and also in other subgroups. With the fast evolution of genotyping technology, genetic association studies have went through candidate gene approach, to pathway-based approach, to the genome wide association study (GWAS). Even in the era of GWAS, pathway-based …

Evaluating The Montreal Cognitive Assessment (Moca) And The Mini Mental State Exam (Mmse) For Cognitive Impairment Post Stroke: A Validation Study Against The Cognistat, Lauren Friedman

Electronic Thesis and Dissertation Repository

Objective. To identify the better of two commonly used screening tools for detecting probable cognitive impairment in stroke patients in a large regional rehabilitation hospital (ParkwoodHospital,London,Ontario). This was a validation study of the Mini-Mental State Exam (MMSE) and the Montreal Cognitive Assessment (MoCA), using the Cognistat, as the criterion or ‘gold standard’. It was hypothesized that the MoCA is a superior screening instrument to the MMSE for the detection of cognitive impairment in stroke patients.

Methods. The MMSE and the MoCA were administered by occupational therapists and the Cognistat was administered by the student investigator. A second Cognistat was administered …

Multilevel Analysis Of Physical Activity Among Us Adults Across Us Census Regions: The Role Of Environmental Contexts, Sariyamon Tiraphat

Health Services Research Dissertations

This study uses nationally representative data to explain the variation in physical activity among U.S. adults across four geographic regions of Northeast, Midwest, South, and West. The purpose of the study is to investigate whether environmental conditions inclusive of natural amenity, built environment, urbanization, crime, and social economic neighborhood are associated with physical activity and whether these associations are modified by geographic region. The study also investigates whether the influences of environmental contexts vary by subgroup and whether they are modified by geographic region. Determining regional factors that influence physical activity is essential to planning appropriate physical activity interventions.

The …

The Symptom Of Fatigue In Primary Care: A Comparative Study Of Health Care Utilization Patterns Using Electronic Medical Records, Kathryn A. Nicholson

Electronic Thesis and Dissertation Repository

The experience of fatigue has been a common problem among community populations for decades. The symptom of fatigue is also a frequent health complaint in primary care practices. Fatigue patients have been shown to be significantly high users of health care resources, particularly when compared to non-fatigued patient populations. To date, an understanding of the presence and the impact of the symptom of fatigue within the context of the Canadian health care system has been understudied.

The objective of this research was to determine the number of patients who were suffering from the symptom of fatigue within a primary care …

Association Between The Fast-Food Environment And Obesity In Canada: A Cross-Sectional Analysis, Simon Hollands

Electronic Thesis and Dissertation Repository

Frequent fast-food consumption is associated with weight gain therefore it is hypothesized that relative availability of fast-food is a risk factor for obesity. This thesis examined the association between the neighbourhood-level density of fast-food outlets and adult body mass index (BMI) in Canada. Population-based data on BMI and socio-economic variables from the 2008 Canadian Community Health Survey [CCHS] and selected neighbourhood-level socio-economic data from 2006 Canadian Census were merged with a commercial database containing geographic locations of all restaurants in Canada. The association between BMI and fast-food density (per 10,000 people in CCHS respondent’s FSA) was analyzed using ordinary least …

Predictors Of Contralateral Breast Cancer In Brca Negative Women, Ann E. Simmons

Dissertations & Theses (Open Access)

Breast cancer is the most common cancer diagnosis and second leading cause of death in women. Risk factors associated with breast cancer include: increased age, alcohol consumption, cigarette smoking, white race, physical inactivity, benign breast conditions, reproductive and hormonal factors, dietary factors, and family history. Hereditary breast and ovarian cancer syndrome (HBOC) is caused by mutations in the BRCA1 and BRCA2 genes. Women carrying a mutation in these genes are at an increased risk to develop a second breast cancer. Contralateral breast cancer is the most common second primary cancer in patients treated for a first breast cancer. Other risk …

Modeling The Effects Of Substance Dependence On General Self-Reported Health Using Nominal Regression, Taylor Moseley

UNLV Theses, Dissertations, Professional Papers, and Capstones

The goal of this research project was to produce a model of the effects of drug dependence on general self-rated health. Due to power issues, two additional models, one for cocaine and one for heroin, were required. The models used data from the 2005-2009 National Survey on Drug Use and Health. The result of this effort was a ranking of the effects of drug dependence on general health for individuals and for the study population. The model controlled for infectious, chronic and mental illness as well as sociodemographic variables. Significantly increased odds ratios were found for alcohol, marijuana, analgesics, and …

Variables Associated With Critical Illness Among Clark County Residence Hospitalized With H1n1 Influenza A Virus During The 2009 Influenza Season., Jonathan P. Hyatt

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background:In 2009, a novel H1N1 Influenza A virus was detected in the population. Because it can potentially affect a different population than the influenza strains circulating for the past 35 years, it is critical for physicians, practitioners and public health organizations to understand who is susceptible to this disease, and which sub-populations are most likely to suffer critical illness. The objective of this study was to examine the factors unique to 2009 H1N1 infection, with the goal of finding the variables associated with ICU admission (Critical Illness) in the Clark County 2009 H1N1 patient.

Methods:Factors that were assessed in this …

Exploring The Social Determinants Of Sexually Transmitted Disease And High-Risk Sexual Behaviors, River Pugsley

Theses and Dissertations

Abstract 1: A multi-level assessment of disproportionate population sex ratios and high-risk sexual behaviors among STD clinic patients Low male-to-female sex ratios in a population may influence high-risk sexual behaviors, such as multiple sex partners and inconsistent condom use, which facilitate the transmission of STDs. This study used multi-level modeling to assess whether population sex ratios were associated with these two individual-level behaviors. All analyses were stratified by gender. Interview data were collected from patients (N = 9,203, 48% male) attending participating STD clinics. Interviews included information on socio-demographics and sexual behavior, including number of sex partners in the previous …

The Relationship Between Diet Quality And Obesity In Canadian Adults: Evidence From The 2004 Canadian Community Health Survey, Kalaivaani Sundararajan

Electronic Thesis and Dissertation Repository

Background: The relationship between diet quality and obesity is unknown in Canadian adults.

Objectives: The objective of this study is to examine the association of diet quality with obesity in Canadian adults.

Methods: Data were taken from the 2004 Canadian Community Health Survey. Three indices were constructed using diet recall data: Diet Quality Index (DQI), Healthy Eating Index (HEI) and Glycemic Index (GI). Obesity was measured with body-mass index. Various confounders were also controlled. Latent-class and ordered probit modeling were used to investigate the association between diet quality and obesity.

Results: Latent-class analysis suggested that the …

Long Term Weight Variability In Adults Of Adventist Health Study 1 And 2, Namgyal Lhawang Kyulo

Loma Linda University Electronic Theses, Dissertations & Projects

Background: The effect of overweight and obesity on the risk of fatal disease tends to attenuate with age. One plausible explanation is that a proportion of elderly people in the ideal weight category (19 to 25 kg/m ) experienced disease-related weight loss - an effect that will attenuate health risk related to overweight and obesity. One potential approach to controlling for this bias would be to examine fluctuations in weight during the adult lifespan by considering multiple measures of weight or recall of body weight during adulthood. Some of these measures are available in the Adventist Health Study cohorts and …

Constrained Optimal Control For A Multi-Group Discrete Time Influenza Model, Paula Andrea Gonzalez Parra

Open Access Theses & Dissertations

During the last decades, mathematical epidemiological models have been used to understand the dynamics of infectious diseases and guide public health policy. In particular, several continuous models have been considered to study single in uenza outbreaks and the impact of dierent control policies. In this dissertation, a discrete time model is introduced in order to study optimal control strategies for in uenza transmission; since epidemiological data is collected on discrete units of time, a discrete formulation is more ecient. From a mathematical point of view, continuous time model are easier to analyze, however, the numerical solution of discrete-time models is …

Evaluating Retention In Medical Care And Its Impact On The Health Outcomes Of Individuals Living With Human Inmmunodeficiency Virus, Timothy N. Crawford

Theses and Dissertations--Epidemiology and Biostatistics

In the last few years, engagement in medical care among individuals living with HIV has become a major priority among HIV medical providers and public health researchers. Engagement in medical care is an important concept as it involves the process of linking newly diagnosed individuals into medical care and retaining those individuals in care throughout the course of their infection. Although there have been major advances in the management of HIV, like the advent of Highly Active Antiretroviral Therapy, morbidity and mortality due to HIV cannot be fully reduced if the individual does not optimally retain in care. Retention in …

Intimate Partner Physical Violence Against Women In Saudi Arabian Primary Healthcare Clinics, Halah M. Eldoseri

Health Services Research Dissertations

Intimate partner violence against women (IPPVAW) is a serious public health concern. The Ecological Model provides a model to study several factors associated with IPPVAW. In Saudi Arabia, studies addressing IPPVAW are limited and do not cover the various aspects of the problem. The purpose of this study was to investigate the various factors associated with IPPVAW at the personal, interpersonal, community and societal levels. Methods: 200 ever-married women attending six PHC in Jeddah, Saudi Arabia were recruited via convenient sampling method. Women were interviewed on factors related to IPPVAW using an adapted version of WHO survey for violence against …

Detection And Epidemiological Patterns Of Drug Resistance Mutations In Nys Plasmodium Falciparum Clinical Malaria Specimens, Jennifer L. Conaway

Legacy Theses & Dissertations (2009 - 2024)

Plasmodium falciparum is a human-infective parasite that causes the most severe form of malaria. Resistance to a wide spectrum of antimalarials has been documented in this species, and single strains may be resistant to several drugs. A new technology, pyrosequencing, has been shown to be useful for the rapid detection of SNPs involved in drug resistance. It can be used in a clinical setting and readily detects new mutants, which frequently appear in this species due to strong selection for antimalarial resistance. In this study, a pyrosequencing protocol was developed to identify mutations in the Plasmodium falciparum genes Pfcrt, Pfdhps, …

The Association Of Summer Temperatures With Hospital Admissions For Renal Diseases In New York State : A Case-Crossover Study, Barbara A. Fletcher

Legacy Theses & Dissertations (2009 - 2024)

This study assessed the association between high temperatures and increased odds of hospitalization for renal diseases which, to date, has been examined in only a small number of studies. A case-crossover design was used to study 147,885 hospital admissions with renal diagnoses during July and August, 1991-2004 in New York State. Regional temperature, humidity and barometric pressure data from automated monitors were used as exposure indicators. Using time-stratified referent selection and conditional logistic regression analysis, an overall 9% increase in odds of hospitalization for acute renal failure per 5°F (2.78°C) was found for mean temperature at a one day lag …

The Relationship Between Hiv/Aids Knowledge And Condom Use Among Reproductive Age Women In Georgia, Lia Gvinjilia

Legacy Theses & Dissertations (2009 - 2024)

Objective: To assess changes in HIV/AIDS knowledge over a decade with substantial educational efforts and reported condom use.

Ecological Literacy, Nutrition Knowledge, And Dietary Practices Among Students At University At Albany, Elaine Hills

Legacy Theses & Dissertations (2009 - 2024)

University students (N=1,924) at a large public university were surveyed to measure their nutrition knowledge, dietary practices, and ecological literacy. A quantitative measure of ecological literacy was developed for this purpose, reflecting familiarity with nature, awareness of one's personal impact on local and global ecologies, and personal lifestyle choices that demonstrate civic responsibility for the natural environment. The association between nutrition knowledge and dietary practices was compared to the association between ecological literacy and dietary practices. The results showed that: (1) many students were not familiar with public health eating recommendations and did not eat recommended amounts of foods, particularly …