Public Health Commons^™

Public Health And Personal Choice: The Ethics Of Vaccine Mandates And Parental Refusal In The United States, Rebecca Horan

Undergraduate Honors Theses

No abstract provided.

Autonomy, Intimate Partner Violence, And Maternal Health-Seeking Behavior: Findings From Mixed-Methods Analysis In Bangladesh, Pooja Sripad, Sharif M.I. Hossain, Charity Ndwiga, Charlotte E. Warren

Reproductive Health

Gendered norms and discriminatory practices often limit women’s decision-making power, which over time can lead to social norms that systematically subordinate women. Aspects of empowerment were explored in a global evaluation of Demographic and Health Survey data that measured how gendered social norms influenced maternal health-seeking behaviors. Analysis specifically explored associations of women’s autonomy and acceptability of intimate partner violence against women (IPVAW) on antenatal care (ANC) use and facility delivery in 63 low- and middle-income countries. Service utilization is positively associated with increased autonomy and negatively associated with increased acceptability of IPVAW, but variability exists across countries and regions. …

Implementing Components Of The Primary Health Care Pre-Eclampsia/Eclampsia Model In Bangladesh: A Cost Analysis, Sharif M.I. Hossain, Pooja Sripad, Sara Chace Dwyer

Reproductive Health

Between 2016 and 2018, the Population Council, in collaboration with the Directorate General of Family Planning and Obstetrical and Gynecological Society of Bangladesh, implemented an intervention to confront pre-eclampsia/eclampsia (PE/E). This was part of the Ending Eclampsia project, a five-year USAID investment that implemented aspects of the Primary Health Care (PHC) PE/E Model in Bangladesh, Nigeria, and Pakistan. The intervention in Bangladesh comprised two components of the PHC for PE/E Model: 1) Task sharing to detect and manage PE/E (MgSO4 and referral) with PHC providers (Family Welfare Visitors, Sub-Assistant Community Medical Officers, and Nurse-Midwives), and 2) Introducing antihypertensive drug provision …

Construction And Validation Of A Non-Medical Use Of Prescription Opioids Outcome Expectancies Scale Among College Students In China, Cheuk Chi Tam

Theses and Dissertations

Background:Non-medical use of prescription opioids (NMUPO) has become a clear threat to public health. Young adults (aged 18 to 25) have a high risk of NMUPO. My prior work on Chinese undergraduates indicates a high prevalence of lifetime NMUPO (49.2%). Health behavior theories propose that outcome expectancies are robust psychosocial determinants of substance use. Literature has identified the influence of outcome expectancies on alcohol and drug use. However, the role of outcome expectancies in NMUPO in China is unknown, and a scarcity of a valid measures for NMUPO outcome expectancies may be a barrier. Our previous research also found …

Response To "From A Polemic Paradox To A Proper Perspective Of Job Burnout And Job Satisfaction, Eric Laurent, Irvin Sam Schonfeld, Renzo Bianchi

Publications and Research

Juárez García and colleagues considered that “part of the conceptual and empirical problem of burnout is that many researchers force it into a biomedical disease model despite its being a psychosocial one.” Problematically, these authors’ scholastic argument a priori excludes biological or bodily factors from psychological conceptualizations. Scientists usually face considerable difficulties when trying to describe complex processes. If the understanding of biological processes sheds light on the complex processes that bear on burnout, then there is no reason to exclude research on those processes.

Does Widowhood Affect Cognitive Function Among Chinese Older Adults?, Zhenmei Zhang, Lydia W. Li, Hongwei Xu, Jinyu Liu

Publications and Research

There is growing evidence from Western countries that widowhood may affect cognitive health in later life. However, little is known about whether widowhood isassociated with cognitive health in Eastern Asian countries such as China and what factors may explain the association between widowhood and cognitive health. Weadd to this line of research by investigating the effect of widowhood on 2-year change in cognitive function among Chinese adults ages 55 and older from 2011 to2013, using data from the China Health and Retirement Longitudinal Study. Cognitive function was measured by episodic memory and mental intactness (i.e.,attention and time orientation). Our results …

A Program Of Research On Burnout-Depression Overlap, Irvin Sam Schonfeld

Publications and Research

The article describes a program of research aimed at unraveling the nature of the relationship of job-related burnout to depression. The research tends to show that burnout symptoms are depressive symptoms and what is termed a state of burnout often reflects an episode of depression.

Mold, Allergic Diseases And Asthma: Assessing The Validity And Usefulness Of Indoor Air Sampling As A Tool In Providing Health Protective Advice To Occupants, William M. Sothern

Dissertations and Theses

Background: Asthma is a major health problem throughout the world, disproportionately affecting occupants of low-income housing, and exposure to damp and moldy living conditions is recognized as a significant risk factor for asthma and other respiratory diseases. However, there are no authoritative health guidance values (HGV's) for airborne mold, and current scientific thought holds that the establishment of such guidelines is not practicable. Nonetheless, environmental practitioners take air samples for mold as a routine component of their indoor environmental investigations and use the laboratory results as a tool together with other findings to guide recommendations for health protective actions. The …

Evaluating Ways To Reduce Errors In Medication Reconciliations Performed By Nurses In A Rural Hospital Setting, Kalen T. Freeman

MPA/MPP/MPFM Capstone Projects

Medication reconciliation, also known as “med recs”, are an important part of a patient’s care during their hospitalization. A med rec is when hospital personnel generate a list of the medications the patient takes at home. Med recs are vital in the hospital admission process because home medications need to be restarted at appropriate times to fully care for the patient. Also, mistakes in a home medication list can lead to serious consequences in the patient’s health. This study focuses on med recs being performed at Marcum and Wallace Hospital in Irvine, Kentucky. More specifically, the study explores the different …

Impact Of Area-Under-The-Curve Monitoring For Vancomycin On Incidence Of Acute Kidney Injury In Orthopedic Patients, Kelli R. Keats

MPA/MPP/MPFM Capstone Projects

Vancomycin is an antibiotic used regularly in hospitals across the world. The most concerning adverse effect of vancomycin is its documented effect on kidney function. This study examines the impact of two dosing strategies of vancomycin on patients’ kidney function at the University of Kentucky Albert B. Chandler Medical Center. It specifically focuses on patients on the orthopedic service because these patients traditionally receive higher doses of vancomycin for longer periods of time due to the severity of their infections, which puts them at an increased risk of vancomycin-induced nephrotoxicity compared to other patients.

This study will serve as a …

Fraud Detection Protocol For Web-Based Research Among Men Who Have Sex With Men: Development And Descriptive Evaluation, April M. Ballard, Trey Cardwell, April M. Young

Epidemiology and Environmental Health Faculty Publications

Background: Internet is becoming an increasingly common tool for survey research, particularly among “hidden” or vulnerable populations, such as men who have sex with men (MSM). Web-based research has many advantages for participants and researchers, but fraud can present a significant threat to data integrity.

Objective: The purpose of this analysis was to evaluate fraud detection strategies in a Web-based survey of young MSM and describe new protocols to improve fraud detection in Web-based survey research.

Methods: This study involved a cross-sectional Web-based survey that examined individual- and network-level risk factors for HIV transmission and substance use among young MSM …

A Lifestyle Intervention To Decrease Risk Of Developing Type 2 Diabetes Mellitus In A Rural Population, Amanda Culp-Roche

Theses and Dissertations--Nursing

Individuals with type 2 diabetes mellitus (T2DM) are at risk for developing life-threatening comorbidities such as cardiovascular disease (CVD). As a consequence, T2DM is associated with increased morbidity and mortality and decreased quality of life, thus highlighting the importance of prevention of T2DM. Further, the prevalence of T2DM is substantially greater in rural populations compared to urban populations, making rural individuals particularly appropriate targets for T2DM prevention.

T2DM is a largely preventable disease that is associated with modifiable risk factors such as poor diet, sedentary lifestyle, and obesity. Lifestyle interventions to improve these modifiable risk factors have been used to …

The Impact Of A Fruit And Vegetable Farmers' Market Voucher Prescription Program On A Low-Income Rural Population, Kevin Anthony Richie

Theses and Dissertations--Nutrition and Food Systems

Objective: Measures the impact of the Farmers’ Market Voucher program on weight, body mass index, waist circumference, during the 2016 summer on a rural, low-income population residing in Appalachian Kentucky.

Background: Rural communities often have limited access to fresh fruits and vegetables (FV) which contributes to low levels of consumption. FV are calorie poor, nutrient dense and are inversely associated with inflammation markers, obesity, hypertension, and high blood glucose levels. Appalachian rural communities have a higher prevalence of obesity, diabetes, strokes, and death by heart attack when compared to the U.S. Farmers’ markets

Methods: Pre-experimental intervention design examining FV consumption …

Promotion Of Fruit And Vegetable Intake Through Recipe Card Distribution And Sampling At Farmers’ Markets Throughout Kentucky, Umaima Sidra Afsheen Syeda

Theses and Dissertations--Nutrition and Food Systems

The Center for Disease Control and Prevention (CDC) reports indicate that 8% and 6.3% of Kentuckians consume enough fruits and vegetables, respectively. The Plate It Up! Kentucky Proud (PIUKP) project is a recipe-development project that aims to boost produce consumption by incorporating local fruits and vegetables. The purpose of this study was to implement promotional strategies using PIUKP recipes at farmers’ markets and determine their effects on consumers’ intent of purchasing and preparing the produce. The study was conducted at nine farmers’ markets across Kentucky (n=300) in collaboration with Cooperative Extension agents/assistants.

The consumers’ impression of the sample was positively …

Violent Death Rates In The Us Compared To Those Of The Other High-Income Countries, 2015, Erin Grinshteyn, David Hemenway

Nursing and Health Professions Faculty Research and Publications

Violence is a serious public health issue in the U.S. This research compares the US and other high-income countries in terms of violent death. we used data from the World Health Organization for populous, high-income countries. Data from CDC's WISQARS and WONDER systems were used to assess mortality data among US white and non-white populations and in low-, medium-, and high-gun states in 2015. Death rates per 100,000 population were calculated overall, by age, and by sex. Poisson and negative binomial regression were used to test for significance. The homicide rate in the US was 7.5 times higher than the …

The Equality Toolkit: Practical Skills For Lgbtq And Dsd-Affected Patient Care, Laura Weingartner, Emily Noonan, Amy Holthouser, Jennifer Potter, Stacie Steinbock, Suzanne Kingery, Susan Sawning

Undergraduate Medical Education

The eQuality Toolkit is a training manual that helps healthcare providers build a foundation of inclusive clinical skills to competently care for lesbian, gay, bisexual, transgender, and queer-identified (LGBTQ) patients and individuals born with differences of sex development (DSD). Although this toolkit was designed for medical students, any healthcare provider who wants to learn inclusive clinical skills can benefit from this accessible, brief primer through its actionable steps to improve clinical care.

Befasta Education To Change Attitudes To Call 911 When Stroke Symptoms Occur, Holly J. Swanson

Theses and Graduate Projects

In the 1990s, the medication Alteplase was starting to be used to treat ischemic stroke. It

is necessary to administer this medication within 4.5 hours from the time the person is last known to be without symptoms of stroke. To raise public awareness of stroke symptoms and the need to present to a hospital quickly to receive this medical treatment, the acronym FAST representing facial drooping, arm weakness, speech difficulties, and time, was developed in 1998. FAST has successfully been used in many public awareness efforts. Research studies have demonstrated the effectiveness of FAST in helping people remember the symptoms …

Factors Associated With Hospital Readmissions Among United States Dialysis Facilities, Amber B. Paulus

Theses and Dissertations

Hospital readmissions are a major burden for patients with end stage renal disease (ESRD). On average, one in three hospital discharges among patients with ESRD are followed by a readmission within 30 days. Currently, dialysis facilities are held accountable for readmissions via the ESRD Quality Incentive Program standardized readmission ratio (SRR) clinical measure. However, little is known about facility-level factors associated with readmission. Additionally, unlike other standardized measures of quality in the dialysis setting, incident patients within their first 90-days of dialysis are included in the performance calculation. This study analyzed CMS Dialysis Facility Report data from 2013 to 2016 …

Illumination Of The Golgi Apparatus Of Pathogenic And Nonpathogenic Naegleria Species, Tyler M. Poe

Theses and Dissertations

In this study, Naegleria fowleri, a pathogenic amoeba and the causative agent of Primary Amebic Meningoencephalitis (PAM), was utilized to determine the presence or absence of classically conserved Golgi molecules featured in the expression of a Golgi apparatus. Previous studies concluded no Golgi expression via light microscopy and transmission electron microscopy, but a recent report on Naegleria gruberi indicated the presence of dispersed Golgi tubules. Non-pathogenic species of the Naegleria genus such as Naegleria gruberi 30540 and Naegleria lovaniensis 30569 were utilized in Western immunoblot analysis compared to reduced whole-cell lysate proteins of two strains of N. fowleri and …

Occupational Health And Safety Implementation Issues In Egypt / مشكلات تطبيق الصحة والسلامة المهنية في مصر, Nihal Hatem Said, Nourhan Fahmy, Ossama Hanafy

Papers, Posters, and Presentations

This policy paper addresses the current OHS implementation issues in Egypt and situates them within a global context that comprises agreed upon international safety regulations, conventions and management systems as well as international certification such as the ISO. Through a review of the implementation process of OHS in Egypt, complex legal, institutional and technical issues arise, illuminating the deficiencies present in the current OHS policy framework. This paper delves into the shortcomings present in the documentation and inspection processes that represent a cornerstone of the overall implementation of OHS standards whether by the government or the private sector.