Medicine and Health Sciences Commons^™

The Relationship Between Self-Reported Depressive Symptoms At 3 Timepoints And Infant Sleep Practices At 6-Month Follow-Up In A Population Of Mothers In Santo Domingo, Ecuador, Kassidy Lane

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Abstract

Background

Previous studies have linked maternal depression with poor infant sleep (e.g., waking up at night and infants having trouble settling to sleep). This study examined the relationship between maternal depressive symptoms at three time points and safe infant sleep at 6-month follow-up.

Methods

Data was collected from a randomized clinical trial including 100 women recruited from a health center in Santo Domingo, Ecuador during their third trimester of pregnancy. Log-binomial regression was used to estimate prevalence ratios (PR) and 95% confidence intervals (CI) of safe infant sleeping at 6 months among mothers who reported depressive symptoms at 3 …

An Examination Of Three Transitional Events In The Substance Misuse Trajectories Of Women With Criminal Legal System Involvement, Martha Tillson

Theses and Dissertations--Sociology

Research has consistently demonstrated that criminal legal system (CLS)-involved women are distinct from men in initiation and course of drug use, with important differences on biological, environmental, and sociocultural levels. Thus, the unique pathways and transitions into and out of drug use for women with CLS involvement are critical to consider from a research perspective, but also from a need to develop and support evidence-based, women-centered services in correctional contexts. This dissertation project uses a three-paper format to investigate three aims: (1) to understand CLS-involved women’s initiations to injection drug use and their experiences providing injection initiation assistance (IIA) to …

A Content Analysis Of Reddit Comments Discussing Fibroadenoma Appraisal And Decision Making, Hayley Marie Kay Stahl

Theses and Dissertations--Communication

Though fibroadenomas are clinically benign in most cases, clinical research suggests that these lesions can cause diagnosis-related physical health complications and psychological distress. However, this research is limited and should be investigated further. Thus, this study aimed to explore how patients appraise their fibroadenoma diagnosis uncertainty. Additionally, this study sought to determine if a correlation existed between appraisal and decision making as well as identify the factors that influence the most common treatment decision: removal. Data was retrieved from Reddit discussions for a content analysis. These discussions were then qualitatively analyzed using codebooks associated with this study’s research questions. Findings …

An Assessment Of Kentucky Birth Records, Focusing On Early-Onset Hypertensive Disorders Of Pregnancy, Environmental Metal Exposures, And Geocoding Precision, 2008-2017, Courtney J. Walker

Theses and Dissertations--Epidemiology and Biostatistics

Using live and stillbirth records from Kentucky (2008-2017), this dissertation assessed the county-level prevalence and geospatial patterns of early-onset hypertensive disorders of pregnancy (eHDP); examined the geocoding precision of addresses recorded on birth records, and evaluated the association between individual risk factors and environmental metal exposures on eHDP prevalence. After adjusting for maternal demographic factors and pre-existing health conditions, we observed that eHDP prevalence was 38% higher (aPR=1.38, 95%CI:1.16, 1.64) in counties with the highest prevalence of married women (> 53.8%) compared to lower prevalence areas (31.6%) had a 20% higher prevalence of eHDP(aPR=1.20, 95%CI:1.00, 1.44) compared to counties with …

Population Assessment To Determine The Eligibility For Birth Center Care At University Of Kentucky Midwife Clinic, Dolores Polito

DNP Projects

Background: The COVID-19 crisis prompted patients to inquire about their options to avoid going to the hospital for birth. Outside of the hospital, birth center care has been identified as an evidence-based model for healthy women during pregnancy and birth, but it is not available in Kentucky.

Purpose The purpose of this study was to determine if there are women eligible for birth center care who have been part of a nurse midwifery service and given birth in a large, academic, tertiary care setting.

Methods: A retrospective chart review was used for this study. It involved a collection of …

Implementing The Mothers And Babies Program To Reduce Preterm And Low Birth Weight Deliveries, Tan Frison

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Georgia ranks fourth (4th) in the nation for the highest low birth weight rate at 10%, and sixth (6th) in the nation for preterm birth rate at 11.7%, among the states. Based on statistical data Bulloch county has maintained an average low birth weight statistic of 10% for over a decade. In 2019, there were 107 preterm and 79 low weight births in Bulloch county, Georgia. These numbers confirm there is a need for more preventive resources for mothers and children within this community. To address this burden, the Bulloch County health department has decided to implement the Mothers and …

Psychological Distress And Relationship Satisfaction Among Survivors Of Sexual Violence, Alyssa Campbell

Theses and Dissertations--Family Sciences

The World Health Organization (WHO; 2002) has indicated that sexual violence is a serious public health concern, and both the WHO and the United Nations (UN) have declared that violence against women, in particular, is a profound violation of human rights (UN General Assembly, 1993; WHO, 2017). Although the systemic and negative impact of trauma on family and intimate relationships have been well documented, the empirical literature regarding the effects of adult sexual trauma on relationship satisfaction is less robust. These studies are designed to address this gap and will do so with analyses centered on an understudied population: the …

Impact Of Smoking And Hpv Status On Cervical Cancer Survival In Women Living In Kentucky, 2004-2005 And 2014-2015, Brittany M. Mckinley

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

BACKGROUND/ OBJECTIVE: Cervical cancer is the fourth most commonly occurring malignancy in women worldwide, with an estimated 530,000 new cases and 270,000 new deaths each year (Small et al, 2017). While the incidence of cervical cancer has decreased by approximately 1.9% per year between 2007 and 2011, the death rate has remained stable (Bernard et al, 2014). Studies have shown that nearly all cervical cancer cases are associated with the Human Papilloma Virus (HPV). Many studies support the association of smoking with increased risk of invasive cervical cancer in women with high-risk HPV (Castle et al, 2002; Fang et al, …

Nurse Home Visitation Program In Hamilton County, Oh To Increase Maternal And Child Health Outcomes, Hannah Widner

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Hamilton County Ohio currently has poor outcomes related to maternal and infant health, specifically among African Americans. Compared to the Healthy People 2020 goals, Hamilton County has higher rates of infant mortality, preterm birth, neonatal infant mortality, and conception within 18 months of previous pregnancies. These rates are disproportionate among African Americans. For instance, African American babies born in Ohio have higher infant mortality rate (14.3 per 1,000) prematurity as a cause of death (4 per 1,000) and neonatal mortality rate (9.2 per 1,000). These are compared to White babies in Ohio with infant mortality rate (5.1 per 1,000), prematurity …

Evaluating Providers’ Perceptions On Preconception Care For Women With Sud, Corinna Hughes

DNP Projects

Background: Substance use disorders (SUDs) has become an epidemic. Women of reproductive age with SUDs have particularly complex healthcare needs including an increased risk of having an unintended pregnancy and associated sequela of negative birth outcomes (NBO). Little is known about how medication assisted treatment (MAT) providers are adequately addressing their unique needs. Identifying provider barriers and tools to address the reproductive needs of women with SUDs can optimize their health outcomes and prevent NBOs.

Purpose: The purpose of this study was to evaluate MAT Nurse Practitioners’ (NPs) knowledge and perceptions of providing preconception care to women with …

Cardiac Effects Of Obesity During Pregnancy In C57bl/6j Mice, Kayla Lynn Dudick

Theses and Dissertations--Nutrition and Food Systems

Objective: Pregnancy requires profound cardiac and metabolic adaptation. Left ventricular (LV) mass is increased in response to pregnancy, but is not associated with cardiac damage. In contrast, obesity-mediated cardiac hypertrophy is pathological. Data from animal studies indicate dietary fatty acid composition may have a protective effect during states of extreme cardiac physiological adaptation. In contrast, aberrant cardiac metabolism is a hallmark of disease. Over a third of reproductive-age women in the United States are obese, but there is a paucity of data describing the effect of obesity on maternal cardiac adaptation to pregnancy. The objective of this study was to …

Utilization Of A Community Pharmacy-Based Service For The Treatment Of Uncomplicated Urinary Tract Infections In Scotland, Robert Borchardt

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Introduction: In November 2013, Scotland piloted a program in Grampian for the treatment of Urinary Tract Infections (UTIs) in community pharmacies, increasing health access for patients and reducing general practitioner workload. This program became known as ‘Pharmacy First’ and was later implemented nationwide in November 2017. This paper seeks to understand utilization of the Pharmacy First program across Scotland by patients and potential barriers to access.

Methods: Using data from the Prescribing Information System collected by the National Health Service of Scotland from July 2013 to April 2019, orders for uncomplicated UTIs were gathered by examining all nitrofurantoin and trimethoprim …

The Influence Of Patient-Provider Interaction, Self-Concept, And The Socio-Physical Environment On Pelvic Exam Seeking Behavior, Anxiety, And The Health Care Experience, Julie Lasslo

Theses and Dissertations--Education Sciences

Regular gynecological screenings are critical for women in promotion of health and preventing diseases like cervical cancer. Despite the importance of such examinations, many women fail to adhere to recommended screening protocols. As a result, women experience an increased disease risk. The current study examined the relationship between patient-provider communication quality, skill, and empathy on pelvic exam seeking behavior and exam-related anxiety and satisfaction. Additionally, negative self-concept, perceived poor genital self-image, and various elements of the socio-physical clinic environment were explored to better understand their impact on a women’s care seeking behavior.

A total of 350 women 19 through 80 …

A Population-Based Analysis Of Patient Age And Other Disparities In The Treatment Of Ovarian Cancer In Central Appalachia And Kentucky, Robert Ore

Theses and Dissertations--Clinical Research Design

Objectives: Adherence to National Comprehensive Cancer Network (NCCN) guidelines for ovarian cancer treatment improves patient outcomes. The aim of this study was to assess disparities associated with ovarian cancer treatment in the state of Kentucky and central Appalachia.

Methods: Data on patients diagnosed as having ovarian cancer from 2007 through 2011 were extracted from administrative claims-linked Kentucky Cancer Registry data. NCCN compliance was defined by stage, grade, surgical procedure, and chemotherapy. Selection criteria were reviewed carefully to ensure data quality and accuracy. Descriptive analysis, logistic regression, and Cox regression analyses were performed to examine factors associated with guidelines compliance and …

Prevalence Of Sports-Related Stress Urinary Incontinence In The Female Collegiate Athlete, Stacey Pagorek

Theses and Dissertations--Rehabilitation Sciences

Urinary incontinence is a health condition that is associated with involuntary leakage of urine. Stress urinary incontinence (SUI) describes involuntary leakage of urine on effort or exertion and can impact one’s ability to participate in activities and affect quality of life. Furthermore, clinical management of this health condition is challenging as individuals who experience urinary incontinence often do not report this concern to a health care provider.

Stress urinary incontinence is not typically a health concern associated with young, healthy athletes. However, researchers have begun to examine the presence of this health condition amongst both a younger population and in …

Uterine Corpus Malignancies In Appalachia Kentucky: Incidence, Survival And Related Health Disparities, Marian Symmes Johnson

Theses and Dissertations--Clinical Research Design

Uterine cancer is the nation’s most common gynecologic malignancy but is understudied in the geographically and socioeconomically diverse state of Kentucky (KY). This study assessed the frequency, distribution, and survival of uterine corpus malignancies in KY, and specifically the differences between Appalachia (AP) and non-Appalachia (NAP).

This study utilizes SEER and Kentucky Cancer Registries to study uterine corpus malignancy between January 1, 2000 and December 31, 2014. The analysis looks at incidence between diagnoses in AP and NAP. Evaluation criteria includes: tumor histology (Type I, Type II, sarcoma, and mixed uterine malignancy), age, race, smoking status, stage at diagnosis, insurance …

Reproducing Childbirth: Negotiated Maternal Health Practices In Rural Yucatan, Veronica Miranda

Theses and Dissertations--Anthropology

This ethnographically informed dissertation focuses on the ways rural Yucatec Maya women, midwives and state health care workers participate in the production of childbirth and maternal health care practices. It further addresses how state health programs influence the relationships and interactions between these groups. Although childbirth practices in Yucatan have always been characterized by contestation, negotiation and change, their intensity and speed have significantly increased over the last decade. Drastic changes in the maternal health of rural indigenous communities in Mexico and throughout the world are directly connected to intensified state interventions that favor biomedicine over traditional health systems. In …

Riding Through Life: A Lifespan Study Of The Attitudes, Behaviors, And Areas Of Educational Opportunity For Female Equestrians Toward Bra Use And Health Outcomes When Engaged In Equestrian Sports, Karin Pekarchik

Theses and Dissertations--Community & Leadership Development

Equestrian sport is a popular exercise choice for females of all ages, although the links between this exercise choice, health outcomes, and risk to health have not been thoroughly examined. These issues are of particular interest because the female equestrian has the opportunity to ride and/or compete for decades, from early to very late in life, covering almost the full sequence of the female lifespan. Equestrian sports provide physical activity through riding and caring for the horse, and promote positive mental outcomes through tangible practices, such as engaging in physical activity and hard work, goal-setting, acquisition of skills, and participation …

Comprehensive Sexuality Education In Kentucky, Luciana D. Hockersmith

Theses and Dissertations--Community & Leadership Development

Discussions of sex education of any kind can be controversial in a given setting. Traditional approaches to sex education prompt debate regarding effectiveness. Key indicators central to the effectiveness of sex education continue to be rates of teen pregnancy and transmission of sexually transmitted diseases (STDs). With discontentment surrounding the effectiveness of “traditional approaches,” a more wide-ranging method is worthy of being explored. The curriculum approach of Comprehensive Sexuality Education (CSE) includes six key concepts, and subsequent sub-concepts, intended to provide a broad and even all-inclusive range of topics for a similarly broad and even all-inclusive range of ages of …

Assessing Provider Adherence To An Emergency Contraception Guideline In Reproductive Age Women, Amber E. Davis

DNP Projects

Purpose: To determine current provider adherence to the 2010 ACOG Emergency Contraception (EC) guidelines, specifically by assessing provider EC counseling with patients at well-woman annual exam visits or during contraceptive counseling visits. A second aim of this study is to identify provider facilitators and barriers of EC discussion with patients.

Methods: Using a retrospective design, 90 medical records of patients presenting to a university clinic within the previous year were reviewed for the discussion of EC during annual exams or contraceptive counseling. Forty-five medical records were reviewed prior to implementation of the Ambulatory Electronic Health Record (AEHR) and forty-five medical …

Dating Violence On Small Rural College Campuses: Are Administrator And Student Perceptions Similar?, Jean Allen Oldham

Theses and Dissertations--Kinesiology and Health Promotion

In recent years dating violence has become more and more prevalent on college campuses. Reports of the range of dating violence vary widely, with studies reporting from 20% to 85% of college women experiencing dating violence. However, almost all research has been conducted among urban and/or large colleges and universities, with virtually no attention to what is happening on small and/or rural college and university campuses.

When a possible 20% of college women have experienced dating violence on college campuses, there becomes a crucial need for administration at a college to have an accurate assessment of the college’s liability, and …

Behind The Mirrors: Examining The Role Of African American Cosmetologists And Salons In Domestic Violence Advocacy And Education, Pangela H. Dawson

Theses and Dissertations--Educational Policy Studies and Evaluation

African American beauty salons across the country have historically served as settings for social interaction, political activism, and community organizing in the African American community. These settings often offer opportunities for intimacy between cosmetologists and their clients. Research findings suggest that the unique bonds between women in salons can be a viable option when providing health intervention and education to large numbers of women. Data indicates that salon campaigns and promotions which focused on health issues such as stroke and diabetes education, breast and cervical cancer awareness, healthy living, and smoking cessation, have been efficacious in changing unhealthy habits or …

Untangling Neoliberalism’S Gordian Knot: Cancer Prevention And Control Services For Rural Appalachian Populations, George F. Bills

Theses and Dissertations--Sociology

In eastern Kentucky, as in much of central Appalachia, current local storylines narrate the frictions and contradictions involved in the structural transition from a post-WWII Fordist industrial economy and a Keynesian welfare state to a Post-Fordist service economy and Neoliberal hollow state, starving for energy to sustain consumer indulgence (Jessop, 1993; Harvey, 2003; 2005). Neoliberalism is the ideological force redefining the “societal infrastructure of language” that legitimates this transition, in part by redefining the key terms of democracy and citizenship, as well as valorizing the market, the individual, and technocratic innovation (Chouliaraki & Fairclough, 1999; Harvey, 2005). This project develops …