Medicine and Health Sciences Commons^™

Gastrointestinal Health As A Stimulus For Native American Attraction To Medicinal Asteraceae And Further Implications For Human Evolution, Christopher David Stiegler

Graduate Theses and Dissertations

The Asteraceae, or the daisy family, is the largest family of flowering plants in the world, and its ethnobotanical, medical, and economic value is readily apparent cross-culturally. The aim of this thesis is to examine why constituent genera of the Aster family have remained such an integral part of human medicinal plant knowledge, and thereby to reveal any potential physiological, biological, or evolutionary mechanisms underlining human patterns of use regarding the Asteraceae. The present study focuses specifically on Native American plant knowledge made available by the expansive database in the works Daniel Moerman (Moerman 2003). Frequencies of plant use and …

The Effect Of Confirmation Bias In Criminal Investigative Decision Making, Wayne A. Wallace

Harold L. Hodgkinson Award for Outstanding Dissertation

Confirmation bias occurs when a person believes in or searches for evidence to support his or her favored theory while ignoring or excusing disconfirmatory evidence and is disinclined to change his or her belief once he or she arrives at a conclusion. The purpose of this quantitative study was to examine whether emotionally charged evidence and evidence presentation order could influence an investigator's belief in a suspect's guilt. The study included 166 sworn police officers (basic training recruits, patrol officers, and criminal investigators) who completed online surveys in response to criminal vignettes across different scenarios to record their measure of …

Building From The Hiv Response Toward Universal Health Coverage, Jonathon Jay, Kent Buse, Marielle Hart, Robert Marten, Scott Kellerman, Morolake Odetoyinbo, Jonathan D. Quick, Timothy Evans, Peter Piot, Mark Dybul, Agnes Binagwaho

Dartmouth Scholarship

Universal health coverage (UHC) has gained prominence as a global health priority. The UHC movement aims to increase access to quality, needed health services while reducing financial hardship from health spending, particularly in low- and middle- income countries.
As a policy agenda, UHC has been identified primarily with prepayment and risk-pool- ing programs. While financing policies provide important benefits, increasing access to health services will require broader reforms.
For lessons, the UHC movement should look to the global HIV response, which has confronted many of the same barriers to access in weak health systems. Considerable success on HIV has resulted …

Manufacturer Perspectives On Content Transparency And Material Health In The Us Building Products Industry, Alexandra A. Muller

Open Access Theses

Flawed U.S. federal regulation of chemicals has resulted in a materials market that undervalues human and environmental health in favor of the more traditional attributes of price, performance and aesthetics. In the building products industry, global, dynamic supply chains and proprietary information concerns further complicate the task of assessing the material health of products.

Voluntary material health programs in the green building industry are intended to incentivize the manufacture and selection of safer products by getting companies to gather and assess ingredient, hazard and risk information from their supply chain. Building product manufacturers considered early adopters of the main material …

South Asian Women's Sexual Relationship Power: Examining The Role Of Sexism, Cultural Values Conflict, Discrimination, And Social Support, Chandni D. Shah

Open Access Dissertations

The lack of literature examining sexual experiences of South Asian women in dating relationships has important implications for the healthy development of long lasting romantic relationships. It is important to understand South Asian women’s relationship experiences in the context of power and sexism (interpersonal power framework; Pulerwitz, Gortmaker, & DeJong, 2000) and the role of specific sociopolitical factors (e.g., discrimination). Understanding South Asian women’s experiences of power in a sociopolitical context will help professionals when working with them to develop healthier sexual relationships through therapy outreach, and community programming. I used a correlational, quantitative study to examine the associations between …

Risks And Health Consequences Of Forgoing, Delaying, Or Having Trouble Accessing Needed Health Care Among Medicare Beneficiaries, Angelitta M. Spells

Open Access Dissertations

Medicare provides health care coverage for approximately 93% of non-institutionalized older adults. Compared to uninsured adults, Medicare beneficiaries have greater access to needed healthcare including preventative care. However, disparities in accessing needed health care still exist among Medicare beneficiaries. Prior research has described barriers to accessing needed health care among older Medicare beneficiaries, such as transportation and health system characteristics, but little is known about prevalence, risks, or health consequences of older Medicare beneficiaries delaying, forgoing, or having trouble accessing needed health care. The three studies included in this dissertation followed a nationally representative sample of older Medicare beneficiaries to …

Evaluating The Prevalence And Effectiveness Of Breed-Specific Legislation, Felicia E. Trembath

Open Access Dissertations

Dog bites pose a persistent public health problem, which some jurisdictions pass breed-specific legislation (BSL) to address. However, very little non-anecdotal evidence regarding the efficacy of BSL has been presented. Currently, BSL research is hampered by the absence of standard terminology, an established prevalence, or a scientific consensus on its effectiveness. The purpose of this study is to propose standardized terminology for BSL, establish the prevalence of each type of BSL in the USA, and conduct a systematic review of the effectiveness of BSL.

After review of terminology currently in use, as well as review of the regulatory actions of …

Impact Of Peer Relationship And Exposure To Violence On Posttraumatic Stress For Children At Risk For Maltreatment, Aura Ankita Mishra

Open Access Theses

Post-traumatic Stress (PTS) symptomology includes ruminating thoughts and feelings around trauma, inability to feel and express emotions, and avoidance of things related to the traumatic event (American Psychiatric Association, 2000). Children and youth exposed to child maltreatment (abuse and neglect) are at higher risk of experiencing PTS. Extra-familial support, including peer support can reduce post-traumatic stress among youth (Pina et al., 2008). In the present study, Witnessing, Victimization, and Both Witnessing and Victimization due to Exposure to In-Home Violence and Peer Relationship Quality are evaluated as to their relative impact on PTS for children at risk for child maltreatment. Peer …

Breast Is Best: A Case Study Of Bottom-Up Implementation, Britni Ayers

Graduate Theses and Dissertations

The institutional narrative surrounding breastfeeding is that breast is best. Research on infant feeding practices in the United States are abundant, especially among WIC recipients. Although WIC is championed as being a breastfeeding promotional venue, WIC recipients demonstrate lower breastfeeding rates than non-WIC recipients of similar economic standing suggesting the need for further research into the policies and breastfeeding promotional tools being implemented within WIC. Concurrently, research demonstrates that breastfeeding duration rates among WIC recipients can be prolonged with women’s interaction with a Breastfeeding Peer Counselors (BFPC). However, there has been little exploration into the experiences of BFPC or the …

The Influence Of Strength-Training Exercises On The Functional Fitness In Older Adults, Susie Engle

Graduate Theses and Dissertations

The purpose of this study was to examine the influence of strength-training exercises on the functional fitness in older adults. The original convenience sample consisted of 658 participants who attended group strength-training classes offered through the Cooperative Extension Service. The Senior Fitness Test was used to assess baseline fitness levels at the beginning and end of the 12-week strength-training program. Data was collected from 2008 to 2015. Of the 658 participants, 110 were aged 60 to 94 and presented posttest scores occurring approximately 12 weeks after pretest dates. Of the 110 subjects, 99 were female and 11 were male. The …

Hispanic Bilingual Learners' Perceptions And Educational Experiences Of Spanish-Speaking In South Texas, Isela B. Stephens

Theses and Dissertations

The present study focuses on a subset of data obtained from a larger interdisciplinary project, Proyecto Posible, which investigates how sociocultural and instructional factors predict positive outcomes among Spanish- and English-speaking Hispanic bilingual learners. As one part of Proyecto Posible, interviewers asked learners to speak in their language of preference about their experiences in school and feelings developed during interactions with others, as bilinguals. This study examines the qualitative component on bilingual learners’ perceptions of their own language proficiency in English and Spanish, perceptions of language use across a broad range of contexts including school, home, and community, …

Stretching The Boundaries Of Medical Education: A Case Of Medical College Embracing Humanities And Social Sciences In Medical Education, Kulsoom Ghias, Kausar S. Khan, Rukhsana Ali, Shireen Azfar, Rashida Ahmed

Community Health Sciences

Objective:

Aga Khan University, a private medical college, had a vision of producing physicians who are not only scientifically competent, but also socially sensitive, the latter by exposure of medical students to a broad-based curriculum. The objective of this study was to identify the genesis of broad-based education and its integration into the undergraduate medical education program as the Humanities and Social Sciences (HASS) course.

Methods:

A qualitative methodology was used for this study. Sources of data included document review and in-depth key informant interviews. Nvivo software was utilized to extract themes.

Results:

The study revealed the process of operationalization …

Ethics In Community-Based Research With Vulnerable Children: Perspectives From Rwanda, Theresa Betancourt, Mary C. Smith Fawzi, Anne Stevenson, Fredrick Kanyanganzi, Catherine Kirk, Lauren Ng, Christina Mushashi, Justin I. Bizimana, William Beardslee, Guiseppe Raviola, Stephanie Smith, Yvonne Kayiteshonga, Agnes Binagwaho

Dartmouth Scholarship

A “risk of harm” protocol to identify youth in need of immediate emergency assistance in a study on mental health and HIV in Rwanda among 680 youth ages 10–17 is described. Cases are presented that describe the experience in using this protocol to ensure safety of participants, with ethical and logistical challenges considered. Among the population of the study, 3.2% were deemed "risk of harm.” The most prevalent presenting problem was non-fatal suicidal behavior (91% of risk of harm cases), with 36% having a history of a reported previous attempt. Challenges included: acute food insecurity/significant poverty; lack of support/adequate supervision …

The Effect Of The Expanded Food And Nutrition Education Program On Participants’ Diet Quality: Does Supermarket Access Matter?, Rachel Ann Spencer

Graduate Theses and Dissertations

This project assesses the effectiveness of the Expanded Food and Nutrition Education Program (EFNEP) within the context of supermarket access. EFNEP is a national community nutrition education program that strives to give participants the tools to live healthier lives. Analysis was performed on participants from 16 Arkansas counties that completed EFNEP during 2013 or 2014. The program outcome is measured in terms of the change in Healthy Eating Index (HEI) as calculated from 24-hour diet recalls at program entry and exit. Supermarket locations were obtained from the USDA Food Nutrition Service’s SNAP Retail Locator and represent the food environment near …

Evaluation Of Negative Energy And Mineral Balance In Periparturient Holstein-Friesian Cattle, Ameer Ahmed Abdelhameed

Open Access Dissertations

Most cows experience a state of negative energy and mineral balance during the periparturient period. This imbalance is a major problem in the dairy industry and it is more frequently seen in multiparous cattle due to their high milk production. A large amount of fat and protein is mobilized in order to address the energy deficit during the periparturient period. The ability to accurately monitor energetics and electrolytes status using accurate, rapid, and low cost point-of-care instruments will assist in optimizing animal health and productivity.

This dissertation contains three studies that evaluated point-of-care instruments for measuring blood and plasma glucose, …

Neural Activity Reveals Effects Of Aging On Inhibitory Processes During Word Retrieval, Ranjini Mohan

Open Access Dissertations

Word retrieval difficulties are one of the most frustrating problems in older adults. Poorer access to phonological (speech sound) representation of the target word has been postulated as the underlying deficit, supported by findings of improvement in word retrieval after phonological priming. But the great variability in naming performance among older adults may reflect cognitive scaffolding or compensatory neurophysiological processes related to maintenance or decline of naming abilities. In order better understand aging effects in the underlying neurophysiological changes associated with phonological retrieval, the present study examined electrophysiological correlates of phonological priming and word retrieval in adults across the lifespan. …

The Economic Burden Attributable To A Child’S Inpatient Admission For Diarrheal Disease In Rwanda, Fidele Ngabo, Mercy Mvundura, Lauren Gazley, Maurice Gatera, Celse Rugambwa, Eugene Kayonga, Yvette Tuyishme, Jeanne Niyibaho, Jason M. Mwenda, Philippe Donnen, Philippe Lepage, Agnes Binagwaho, Deborah Atherly

Dartmouth Scholarship

Backround:

Diarrhea is one of the leading causes of childhood morbidity and mortality. Hospitalization for diarrhea can pose a significant burden to health systems and households. The objective of this study was to estimate the economic burden attributable to hospitalization for diarrhea among children less than five years old in Rwanda. These data can be used by decision-makers to assess the impact of interventions that reduce diarrhea morbidity, including rotavirus vaccine introduction.

Methods:

This was a prospective costing study where medical records and hospital bills for children admitted with diarrhea at three hospitals were collected to estimate resource use and …

Identification Of Medicare Recipients At Highest Risk For Clostridium Difficile Infection In The Us By Population Attributable Risk Analysis, Erik R. Dubberke, Margaret A. Olsen, Dustin Stwalley, Ciarán P. Kelly, Dale N. Gerding, Yinong Young-Xu, Cedric Mahé

Dartmouth Scholarship

Background: Population attributable risk percent (PAR%) is an epidemiological tool that provides an estimate of the percent reduction in total disease burden if that disease could be entirely eliminated among a subpopulation. As such, PAR% is used to efficiently target prevention interventions. Due to significant limitations in current Clostridium difficile Infection (CDI) prevention practices and the development of new approaches to prevent CDI, such as vaccina- tion, we determined the PAR% for CDI in various subpopulations in the Medicare 5% random sample. Methods: This was a retrospective cohort study using the 2009 Medicare 5% random sample. Comorbidities, infections, and healthcare …

Designing Prenatal M-Health Interventions Through Transmigrants Reflection On Their Pregnancy Ecology, Hana Aljaberi

Open Access Dissertations

This dissertation presents the findings from three participatory focus group and co-design sessions with Caribbean transmigrant women in the United States. Informed by their focus group discussions regarding their pregnancy experiences in the United States, the participants produced design ideas that reflected on physical, emotional, informational and social gap themes. The purpose of this study was to understand the challenges affecting the women’s prenatal wellbeing practices, and to conceive a set of recommendations and opportunities for mHealth technology design to assist with prenatal preventative care and management. The study uses the theoretical concept of pregnancy ecology to identify gaps in …

Early Adverse Experiences And Health: The Transition To College, Kelly B. Filipkowski, Kristin E. Heron, Joshua M. Smyth

Psychology Faculty Publications

Objective: This study cross-sectionally and prospectively examined the impact of adversity experienced prior to college on the health and well-being of students adjusting to their first college semester. Methods: Two-hundred sixteen (216) first-year students completed measures of adverse life experiences, perceived stress, physical symptoms, and health-related behaviors during the first 2 weeks of college entry and again at the end of the first semester. Results: Reported adversity prior to college predicted greater perceived stress and physical symptoms at college entry and an increase in physical symptoms over the semester; perceived stress mediated the prospective changes. Early adversity …