Medicine and Health Sciences Commons^™

The Potential For Dickeya Dianthicola To Be Vectored By Two Common Insect Pests Of Potatoes, Jonas K. Insinga

Electronic Theses and Dissertations

Dickeya dianthicola (Samson) causing blackleg and soft rot was first detected in potatoes grown in Maine in 2014. Previous work has suggested that insects, particularly aphids, may be able to vector bacteria in this genus between plants, but no conclusive work has been done to confirm this theory. In order to determine whether insect-mediated transmission is likely to occur in potato fields, two model potato pests common in Maine were used: the Colorado potato beetle (Leptinotarsa decimlineata Say) and the green peach aphids (Myzus persicae Sulzer). Olfactometry and recruitment experiments evaluated if either insect discriminates between infected and …

“Pissing In The Wind”: Racially Discriminatory Economic Policies’ Impact On Today’S Banking Status, Use Of Alternative Financial Services And Health Outcomes., Gaberiel Jones Jr

Electronic Theses and Dissertations

Centuries of discriminatory policies and practices in the United States have created racially segregated, resource-poor urban communities. Differential benefits of banking and housing legislation were among the consequences of these policies as they contributed to drastic racial inequities in wealth. Today, racial differences in banking status and financial practices persist. However, a void exists in the literature exploring what alternative financial services (AFS) are used in lieu of banks by Black Americans, why those services are used, the thoughts and beliefs of Black Americans about the use of those services, the impact of bank locations on financial behavior patterns, and …

Characterization Of The Impact Of Prenatal Cigarette Smoke Exposure On Age- And Sex-Specific Sirt1-Mediated Hepatic Molecular Phenotype In C57bl/6 Mice., Kendall S. Stocke

Electronic Theses and Dissertations

In the U.S., 7.2% of women still report having smoked at some point during pregnancy despite known risks to fetal health. Prenatal cigarette smoke exposure (CSE) in children puts them at risk for low birth weight, premature birth, and other adverse impacts on developmental and postnatal health. Children subjected to prenatal CSE have a higher risk of adulthood metabolic disease predicted by the Barker Hypothesis. The hepatic molecular phenotype associated with this risk is unknown. This dissertation characterizes the prenatal CSE-induced hepatic molecular phenotype during three key life stages. We used a murine model of prenatal CSE utilizing a Teague …

Local Anesthesia Before Intravenous Cannula Insertion: Recommendations For Registered Nurses In Practice, Vera Campbell-Jones

Electronic Theses and Dissertations

Abstract

Administering local anesthetics, such as intradermal, should become standard practice for RNs in pretreatments for pain control prior to intravenous insertion. Peripheral venous cannulation has provoked the most fear and anxiety in adult patients about everyday practice in hospitals. Adult patients often state that this procedure causes considerable discomfort. Local anesthesia for cannulation is usually not offered to adult patients who are on general medical units. Evidence has indicated inconsistency in the use of pain management strategies during these procedures. The researcher’s goal in this project was to educate RNs about the intradermal pretreatment procedure, provide education on the …

Heat Waves And Heat-Related Mortality In East Tennessee, Taiwo Adesoba

Electronic Theses and Dissertations

Heat waves represent a public health challenge that requires multiple responses and warnings to protect vulnerable populations. Although studies have reported an increasing trend of heat wave occurrence in many areas of the world, no clear trend exists in East Tennessee. Using data from Parameter-elevated Relationships on Independent Slope Models (PRISM), CDC WONDER and the United States Census Bureau, the relationship between mortality rates and year was estimated during heat wave events between 1999 and 2010. Five heat wave definitions were tested. Overall, 2007 and 2010 stand out as the years with the highest number of heat wave days in …

Assessing Heat-Related Mortality And Morbidity Risks In Rural Populations And Sub-Populations, Emmanuel A. Odame

Electronic Theses and Dissertations

Heat stress is an environmental and occupational hazard exacerbated by climate change. Rural populations and sub-populations continue to experience disproportionate risks of heat-related impacts due to their low adaptive capacities in terms of infrastructure, information and other resources which are critical in dealing with heat. The study goals were to determine heat-related mortality risks in rural populations globally, explore the contribution of the outdoor work environment and other factors in association with occupational heat-related illnesses (HRI), and assess the risk of heat stress among crop workers using the Wet Bulb Globe Temperature (WBGT). Published peer-reviewed scientific literature on heat-related mortality …

Exploring The Role Of Social Capital In The Implementation Of Fruit And Vegetable Incentive Programs: A Case Study Of The Appalachian Farmacy Program, Kiriinya Mwirigi

Electronic Theses and Dissertations

The study was conducted to explore the role of social capital in the implementation of Fruit and Vegetable Incentive Programs (FVIP) through a case study of the Appalachian Farmacy (AF) program and to fill a gap in literature on social capital utility in the implementation and evaluation of FVIPs. The study was guided by a conceptual model adopted from Berkman et al. (2000) to identify the mechanisms through which social networks can impact health. A qualitative content analysis was conducted retrospectively on secondary data from the evaluation of AF program to identify social capital attributes. In addition, the study conducted …

Probability Of Conception After Fertility Counseling And The Association Of Sexually Transmitted Infections With Pregnancy In The Loussi Study., Lindsey Adelle Wood

Electronic Theses and Dissertations

This study interrogated predictors of pregnancy and the effect of a history of sexually transmitted infection (STI) on probability of conception among a cohort of women seeking fertility counseling (N=170), using multivariable logistic regression and Cox proportional hazards models. There were 76 (44.7%) total pregnancies. 32 (39.0%) were achieved spontaneously by women who never received ART (N=82). Among women who did receive ART (N=88), 35 (39.7%) were achieved by ART and 9 (10.2%) achieved spontaneously. Among the full cohort (N=170), obesity was a significant negative predictor of pregnancy while history of human papilloma virus was a significant negative predictor of …

Determining The Effect Of An Educational Intervention On Medical Support Personnel's Knowledge To Administer A Standardized Developmental Screening Tool., Leslie Chiaventone Lopez

Electronic Theses and Dissertations

Early treatment of developmental delays leads to improved outcomes for children (Yeung et al., 2014). In order to benefit from early intervention, children with developmental delays must be identified and referred at a young age. Although the use of validated developmental screening tools is supported by American Academy of Pediatrics (AAP) guidelines, these instruments are used variably by general physicians in pediatric practice (King et al., 2010). Because of the expanding work roles of medical support personnel, it is worthwhile to determine if this group can administer and score a developmental screening tool after completing an educational intervention to assist …

Blacklegged Tick (Ixodes Scapularis) Distribution In Maine, Usa, As Related To Climate Change, White-Tailed Deer, And The Landscape, Susan P. Elias

Electronic Theses and Dissertations

Lyme disease is caused by the bacterial spirochete Borrelia burgdorferi, which is transmitted through the bite of an infected blacklegged (deer) tick (Ixodes scapularis). Geographic invasion of I. scapularis in North America has been attributed to causes including 20th century reforestation and suburbanization, burgeoning populations of the white-tailed deer (Odocoileus virginianus) which is the primary reproductive host of I. scapularis, tick-associated non-native plant invasions, and climate change. Maine, USA, is a high Lyme disease incidence state, with a history of increasing I. scapularis abundance and northward range expansion. This thesis addresses the question: “To …

Analysis Of Tobacco Use Vital Sign Assessment, Latonya King

Electronic Theses and Dissertations

There is a massive problem of tobacco-related cancer outcomes in patients that are affected by race and ethnicity. Although this is a known disparity, there continues to be a gap in care for asking patients if they use tobacco and in advising and assisting them in making a quit attempt. Health information technology requirements and meaningful use regulations require the utilization of systematic electronic documentation. In order to improve and support tobacco use screening, systematic tobacco use assessment and documentation are essential. There is a widespread belief that adding screening for tobacco use to the vital sign assessment will lead …

The Efficacy Of An Educational Intervention To Improve Low Influenza Vaccination Rates Among Federal Health Care Workers, Cynthia Berfect-Shelby

Electronic Theses and Dissertations

Influenza is a preventable communicable illness that has a significant impact on people of all ages. In 2018 it was estimated that 80,000 people died of influenza-related illnesses. Infants and elderly people are among the most vulnerable populations. The Centers for Disease Control and Prevention and Healthy People 2020 recommend that health care facilities have a 90% vaccination rate. Despite the recommendations and a mandatory directive, many facilities within the Veterans Health Administration struggle to reach influenza vaccination rates above 60%. Pender’s health promotion model was used as the theoretical framework to explore the reasons why health care workers refuse …

Public Health Policy: An Ethical Analysis Of Quarantine, Dina Alqahtani

Electronic Theses and Dissertations

As a public health measure quarantine has both historical and contemporary significance both in the United States and abroad. On the surface it represents a low-cost, low-tech way in which the spread of disease can be mitigated as its core requirement is that those who may have been exposed to an infectious agent are kept away from those who have not been exposed to that agent for enough time to determine whether or not infection has been spread. This has been utilized for centuries with both limited questions and scattered, inconsistent, or impossible to achieve oversight and goals. In understanding …

Precision Medicine And It's Ethical And Social Implications: Public Health And Gobal Persepctives, Evangel Sarwar

Electronic Theses and Dissertations

Ever since President Obama's launch of the Precision Medicine Initiative (PMI) in 2015, precision medicine (PM) has been anticipated as the new paradigm for healthcare with the capacity to “empower patients, researchers, and providers to work together toward the development of individualized care,” through research, technologies, and policies (President Obama, 2015). Precision Medicine (PM), in the form of genomics, offers unprecedented promise of providing new tools for improving health and reducing the burden of diseases, not just for the U.S. - but also globally. According to World Health Organization, genomics research and precision medicine will play a major part in …

An Exploration Of Factors Of Lgbt Cultural Competency Among Prospective Healthcare Professionals, Heather Isbell

Electronic Theses and Dissertations

Literature suggests there is a relationship between cultural competency and health outcomes as well as a perceived fear of discrimination LGBT individuals face when attempting to receive healthcare services. The aim of this study is to assess the level of LGBT CC (cultural competency) among prospective professionals who are expected to provide health care services and to explore factors that affect those attributes. Multiple linear regressions were conducted to test the effect of the following factors of LGBT CC: postsecondary experience, relations with LGBT individuals, and religion using a sample of 57 different healthcare students in a faith-based university during …

Factors Influencing Unmet Medical Need Among U.S. Adults: Disparities In Access To Health Services, Ahmad Khanijahani

Electronic Theses and Dissertations

Inequities in access to health services has negative consequences on individual well-being, and imposes financial and emotional burden on patients, families, health care systems, and the public. Inequities engendered from differences in socioeconomic status, health insurance coverage, race, and other characteristics can engender disparities. This study aimed to identify the potential predictors of unmet medical need among the civilian noninstitutionalized U.S. adults. Inability to receive needed medical care or receiving medical care after a delay, due to the associated costs, constructed unmet medical need. This study used a four-year (2014-2017) National Health Interview Survey (NHIS) data (sample size: 296,301 adults) …

Adverse Childhood Experiences, Homeless Chronicity, And Age At Onset Of Homelessness, Joseph T. Tucciarone Jr.

Electronic Theses and Dissertations

Childhood adversity is associated with numerous negative outcomes across multiple domains, including mental and physical health, interrelationships, and social functioning. Notably, research suggests that childhood adversity has a dose-response relationship with these outcomes; that is, greater numbers of adverse experiences in childhood are associated with worse outcomes. These outcomes overlap with many risk factors of homelessness. This study sought to address two questions: 1) Does a dose-response relationship exist between childhood adversity and chronic homelessness? 2) Does childhood adversity negatively predict the age at which homelessness first occurs? Adults experiencing homeless who are accessing homeless services in the Tri-Cities area …

Uncovering The Stories Behind The Numbers : A Case Study Of Maternal Death Surveillance And Response In Goma, Democratic Republic Of Congo., Baraka Muvuka

Electronic Theses and Dissertations

Globally, 303 000 women die each year from preventable causes related to pregnancy, with the Democratic Republic of Congo (DRC) having the tenth highest maternal mortality rate. Maternal Death Surveillance and Response (MDSR) is a surveillance-action cycle that aims to eliminate preventable maternal mortality by linking actionable data on maternal deaths with multi-level actions. While countries are increasingly adopting MDSR, there are research gaps on its implementation, outcomes, and best practices in developing countries including the DRC. This study assessed MDSR implementation in Goma Health Zone (HZ), DRC, specifically its structure, process, quality, outcomes, and influencing factors. A qualitative case …

Polydrug Use Among People Who Use Opioids, National Survey On Drug Use And Health 2002 To 2017., Diana Kuo Stojda

Electronic Theses and Dissertations

Introduction: Mortality due to overdose has been increasing since 2010 in the U.S., with an increase in the reported use of heroin and co-use of heroin and prescription opioids. Trends and correlates of polydrug use need to be analyzed to propose policies to reduce overdose risk. The overall objective of this study is to characterize high-risk polydrug groups among people who use opioids (PWUO) to understand the patterns of co-used substances and overdose risk factors. Methods: Publicly available data from the 2002-2017 National Survey on Drug Use and Health were analyzed to obtain weighted prevalence rates and trends …

Evaluation Of The Health And Exposure Histories Of A Community Surrounded By Industry And Industrial Waste : A Mixed Methods Approach., Lindsay Koloff Tompkins

Electronic Theses and Dissertations

Environmental pollution is not distributed equally across members of society. Low-income individuals are more likely to live near waste sites and other sources of pollution, and, therefore, face greater exposure to environmental health hazards. One such community in Louisville, Kentucky, the Riverside Gardens neighborhood, consists of approximately 300 homes that are surrounded on three sides by industry and industrial waste, including a remediated Environmental Protection Agency Superfund site, a former coal-burning power plant and coal ash storage site, and multiple chemical, rubber, and plastic manufacturing companies. Residents have reported elevated rates of cancer and other chronic diseases and have requested …

The Shape Study : The Survey Of Health And The Perceived Environment Study., Colette Patrice Davis

Electronic Theses and Dissertations

Introduction: Few studies have considered how an individual’s perception of their built environment may be a risk factor for being overweight or obese. Adolescents may be particularly vulnerable in the context of “impoverished environments”, which they may perceive to be difficult, dangerous, resource deficient, and unaesthetic. This study aids in clarifying how the built environment influences the risk of obesity among adolescents residing in a neighborhood in Louisville, KY. Objective: The overall objective was to conduct a cross-sectional epidemiologic pilot study among adolescents aged 12-17 years residing in West Louisville, Kentucky to evaluate the association between perceptions of …

An Evaluation Of The Supply And Demand Of Radiation Oncology Medical Physicists In The United States., Christine Marie Swanson

Electronic Theses and Dissertations

Background: This dissertation is a mixed methods evaluation of the radiation oncology medical physics workforce in the United States. Radiation oncology medical physicists serve a vital role in the safe treatment of patients with radiation therapy. While cancer incidence continues to rise, the pathways to board certification in radiation oncology medical physics continue to narrow causing a potential shortage of radiation oncology physicists in the United States. While there is no lack of data about the medical physics community it has scarcely been used to evaluate the current state of the workforce. In order to ensure patient safety, appropriate physics …

Innovation And Equity In Public Health Research : Testing Arts-Based Methods For Trauma-Informed, Culturally-Responsive Inquiry., Tasha Golden

Electronic Theses and Dissertations

As the field of Public Health has shifted from a biomedical paradigm to a social ecological approach, focusing on health equity and social determinants of health, it has increasingly acknowledged the roles of culture and trauma in health outcomes. The field has responded by modifying some research practices, but continues to prioritize conventional methodologies—with few options designed to foreground trauma- and cultural-responsiveness. Unfortunately, to the extent that conventional approaches require health to be defined, communicated, or valued according to dominant norms, they risk perpetuating inequities. Health equity therefore requires the development of research methodologies that increase inclusivity and access, elicit …

The Prevalence And Context Of Adult Female Overweight And Obesity In Sub-Saharan Africa, Ifeoma Ozodiegwu

Electronic Theses and Dissertations

Adult women bear a disproportionate burden of overweight and obesity in Sub-Saharan Africa (SSA). Precise information to understand disease distribution and assess determinants is lacking. Therefore, this dissertation aimed to: (i) analyze the prevalence of adult female overweight and obesity combined in lower-level administrative units; (ii) analyze the effect modification of educational attainment and age on the association between household wealth and adult female overweight and obesity; (iii) synthesize qualitative research evidence to describe contextual factors contributing to female overweight and obesity at different life stages. Bayesian and logistic regression models were constructed with Demographic and Health Survey (DHS) data …

Predictors Of Hospital Quality And Efficiency, Hoda Fotovvat

Electronic Theses and Dissertations

American hospitals have made serious efforts to implement and expand their health information technology capabilities and to integrate different specialized care or high-tech services in order to maximize the efficiency and quality of care. In providing a variety of HIT-related services, these hospitals expanded their national reputation in line with integrated care goals. As a result, hospitals are encouraged to establish effective communication channels to facilitate patient-physician sharing of the patient care experience, to enhance effective pain management, and to transform patient-centered care modalities to solidify the adequacy of patient care processes. By analyzing national data sets publicly available, this …

Physical Activity Environments In Rural Communities: Exploring The Relationship Between Community Perceptions And The Environment, Elizabeth M. Bye

Electronic Theses and Dissertations

Purpose: To assess the physical activity environment, community perceptions of the physical activity environment, and the relationship between these variables in rural and/or underserved communities with high obesity prevalence.
Methods: The Rural Active Living Assessment (RALA) was used to assess the programs and policies (PPA), town-wide amenities (TWA), and street segments (SSA) of the physical activity environment and the Rural Active Living Perceived Environmental Support Scale (RALPESS) was used to assess community perception of the physical activity environment within eleven rural and/or underserved communities. Each section of the RALA and RALPESS are further broken down into additional subsections in order …

Social Determinants Of Health Theory: Policy Entry Points For Healthcare Providers, Kiah R. Vandergrift

Electronic Theses and Dissertations

This thesis examines a shifting paradigm in the U.S. healthcare system that will re-define the role that the healthcare provider plays in the production of health. It does this by first acknowledging two differing economic theories on the production of health: Human Capital Theory and Social Determinants of Health theory, and how both schools of thought have contributed to the paradigm that healthcare providers only play a role in the end stages of health production - to heal those who are already ill. However, policy, payment, and delivery system reforms have begun to force healthcare providers to re-think how they …

Electronic Nicotine Delivery Systems (Ends): Reasons For Use And Associated Factors In Self-Selected Nicotine Concentrations, David D. Allen Iii

Electronic Theses and Dissertations

This study aimed to examine e-cigarette user reasons for use, changes in their nicotine concentrations, and factors associated with changes in their chosen nicotine concentrations.

Let Me Upgrade You: Common Measures In Public Health Accreditation Action Plans, Gurleen K. Roberts

Electronic Theses and Dissertations

Objectives: The purpose of this study is to understand the success rates for health departments pursuing and achieving accreditation in version 1.0 and 1.5 of the Public Health Accreditation Board (PHAB) standards and measures. During the accreditation process, health departments that present performance gaps are asked to complete an Action Plan to specify how they plan to improve to meet the desired conformity. This study will highlight specific measures that are often included in Action Plans so that health departments pursuing accreditation can be better prepared to address these common pitfalls.

Methods: This study is a non-experimental, secondary …

Public Health Workforce Perceived Impact Of Emerging Issues In Public Health, Kristie C. Waterfield

Electronic Theses and Dissertations

Background: In an era where public health has been viewed as a global, multi-disciplinary field, the public health workforce has remained united to unfailingly holding fast to the mission of protecting, promoting, and improving the health of the public. However, the practice of public health is consistently evolving, and the workforce is continually facing a mirage of challenges. In order to overcome these challenges, practitioners need to be up-to-date on the necessary knowledge and skills to effectively deliver the core public health services.

Purpose: The purpose of this research was to explore the perceived impact of emerging trends in public …