Digital Commons Network^™

Suicidal Ideation Among American Indian And Alaska Natives In The United States, Lacie Lashawn Tillman

Walden Dissertations and Doctoral Studies

Suicidal ideation is a silent public health issue across the United States. Evidence suggests that suicidal ideation is a predictor of suicide attempt and completion. Suicide is a leading cause of death among American Indians and Alaska Natives (AIs/ANs) in the United States, especially among younger people. Alcohol and illicit drug use, coupled with poor social conditions, can lead to suicidal ideations—and sometimes suicide completion. Using social cognitive theory, this quantitative cross-sectional study compared variables within the 2017, 2018, and 2019 National Survey on Drug Use and Health to determine the effect that alcohol and/or illicit drug use has on …

Association Of Incident Cancer To Low-Value Care And Healthcare Cost Burden Among Elderly Medicare Beneficiaries, Chibuzo Iloabuchi

Graduate Theses, Dissertations, and Problem Reports (ETD)

In the United States (US), 25% of healthcare spending is considered wasteful because it is spent reimbursing low-value care. Low-value care is the utilization of healthcare services, medical tests, and procedures that have unclear or no clinical benefit to patients but still exposes them to risk. World-wide, low-value care imposes a significant economic burden on patients, payers, governments, and society. Cancer care among older adults > 65 years is one of the biggest drivers of healthcare expenditure in the US and accounts for nearly 40% of all spending, and low-value care among cancer patients is prevalent and contributes to the financial …

Functional Seizures Are Not Less Important Than Epilepsy, A A Asadi-Pooya, Francesco Brigo, Benjamin Tolchin, Kette D. Valente

Department of Neurology Faculty Papers

Functional seizures (FS) are frequently encountered in neurology clinics, often affect young adults, and have significant negative impacts on many aspects of a person's life. In the current narrative review, we searched the literature regarding some of the consequences of FS (i.e., psychiatric comorbidities, social consequences, costs that are associated with the condition, cognitive impairment in patients with FS, the quality of life of the people with FS, and the increased risk of mortality that is associated with FS). Evidence shows that FS have significant negative consequences, comparable in their magnitude to those affecting patients with epilepsy. The clinical and …

An Evaluation Of The Spread And Scale Of Patienttoc™ From Primary Care To Community Pharmacy Practice For The Collection Of Patient-Reported Outcomes: A Study Protocol, Margie Snyder, Betty Chewning, David Kreling, Susan M. Perkins, Lyndee M. Knox, Omolola A. Adeoye-Olatunde, Heather A. Jaynes, Jon C. Schommer, Matthew M. Murawski, Nisaratana Sangasubana, Lisa A. Hillman, Geoffrey M. Curran

Department of Pharmacy Practice Faculty Publications

Background

Medication non-adherence is a problem of critical importance, affecting approximately 50% of all persons taking at least one regularly scheduled prescription medication and costing the United States more than $100 billion annually. Traditional data sources for identifying and resolving medication non-adherence in community pharmacies include prescription fill histories. However, medication possession does not necessarily mean patients are taking their medications as prescribed. Patient-reported outcomes (PROs), measuring adherence challenges pertaining to both remembering and intention to take medication, offer a rich data source for pharmacists and prescribers to use to resolve medication non-adherence. PatientToc™ is a PROs collection software developed …

Impact Of Covid-19 On Ohio's National Parks Visitation, Ryan Grzeschik

Williams Honors College, Honors Research Projects

The COVID-19 pandemic has fundamentally changed the way in which society operates in order to get the novel disease under control. Businesses throughout the United States have had to close or reduce provided services, stay at home orders have secluded many people, and social distancing limits contact between others so many are turning to the parks system to cope with these changes. This study aims to find how the visitation of national parks in Ohio have been affected through the first six months of the pandemic. Visitation statistics were compared from March to August of 2020 to those same months …

A Comprehensive Review On Medical Diagnosis Using Machine Learning, Kaustubh Arun Bhavsar, Ahed Abugabah, Jimmy Singla, Ahmad Ali Alzubi, Ali Kashif Bashir, Nikita

All Works

The unavailability of sufficient information for proper diagnosis, incomplete or miscommunication between patient and the clinician, or among the healthcare professionals, delay or incorrect diagnosis, the fatigue of clinician, or even the high diagnostic complexity in limited time can lead to diagnostic errors. Diagnostic errors have adverse effects on the treatment of a patient. Unnecessary treatments increase the medical bills and deteriorate the health of a patient. Such diagnostic errors that harm the patient in various ways could be minimized using machine learning. Machine learning algorithms could be used to diagnose various diseases with high accuracy. The use of machine …

"Let Me Know When I'M Needed": Exploring The Gendered Nature Of Digital Technology Use For Health Information Seeking During The Transition To Parenting, Bradley Hiebert, Jodi Hall, Lorie Donelle Phd, Rn, Fcan, Danica Facca, Kim Jackson, Ewelina Stoyanovich

Publications

This paper presents results of a qualitative descriptive study conducted to understand parents' experiences with digital technologies during their transition to parenting (i.e. the period from pre-conception through postpartum). Individuals in southwest Ontario who had become a new parent within the previous 24 months were recruited to participate in a focus group or individual interview. Participants were asked to describe the type of technologies they/their partner used during their transition to parenthood, and how such technologies were used to support their own and their family's health. Focus group and interview transcripts were then subjected to thematic analysis using inductive coding. …

A Multilevel Mixed Methods Examination Of Treatment Nonadherence Among Rural Cancer Survivors, Bonny Morris

Theses and Dissertations

While mortality rates have been decreasing over the last 40 years, cancer remains a leading cause of death in the United States. Over 1.7 million people were diagnosed with cancer in 2019, and there were more than 600,000 cancer deaths. Of the 15 million cancer survivors in the US, nearly 3 million reside in rural areas and experience 3% higher cancer incidence and 10% higher cancer mortality compared to their nonrural counterparts. During 2006-2015, the annual age-adjusted mortality rates for all cancer sites combined decreased at a slower pace in rural areas versus nonrural areas (-1.0% vs -1.6% per year, …

The Association Of Demographic Characteristics And Social Vulnerability With Covid-19 Outcomes, Gloria D. Boone

College of Graduate Studies: Theses & Dissertations

The Association of Demographic Characteristics and Social Vulnerability With COVID-19 Outcomes

by

Gloria Boone

(Under the Direction of Gulzar Shah)

ABSTRACT

This research explored 102 Illinois counties' COVID-19 data to determine whether demographic characteristics and social vulnerability are associated with increased vulnerability to COVID-19 infections and deaths. COVID-19 is disproportionately impacting vulnerable groups and has been deadlier for African American and Hispanic people. The findings of this research will contribute to the knowledge base regarding social vulnerability and assist public health officials in targeting resources and designing interventions. This study used a retrospective cross-sectional design to assess demographic characteristics of …

United States Nursing Homes And Health Equity During The Covid-19 Pandemic, Carla Cooper

College of Graduate Studies: Theses & Dissertations

Objective: The COVID-19 pandemic disproportionately affected older populations, with nursing homes impacted early on by the disease. The contribution of race/ethnicity of nursing home residents and facility characteristics on COVID-19 were unknown. The Donabedian model framework was used to study the relationship between the racial/ethnic characteristics of nursing home residents and COVID-19 outcomes and to examine if this relationship was moderated by the racial/ethnic composition of the county of nursing home location.

Method: Cross-sectional research design merging data from five publicly available sources. Laboratory confirmed COVID-19 cases and deaths were compared by the racial composition of the county and nursing …

Geocoding Cryptosporidiosis Cases In Ireland (2008–2017)—Development Of A Reliable, Reproducible, Multiphase Geocoding Methodology, Lisa Domegan, Patricia Garvey, Paul Mckeown, Howard Johnson, Paul Hynds, Jean O'Dwyer, Coilín Óhaiseadha

Articles

Background: Geocoding (the process of converting a text address into spatial data) quality may affect geospatial epidemiological study findings. No national standards for best geocoding practice exist in Ireland. Irish postcodes (Eircodes) are not routinely recorded for infectious disease notifications and > 35% of dwellings have non-unique addresses. This may result in incomplete geocoding and introduce systematic errors into studies.

Aims: This study aimed to develop a reliable and reproducible methodology to geocode cryptosporidiosis notifications to fine-resolution spatial units (Census 2016 Small Areas), to enhance data validity and completeness, thus improving geospatial epidemiological studies.

Methods: A protocol was devised to utilise …

Extreme Heat Vulnerability And Spatial Accessibility To Cooling Centers In Connecticut, Nicholas Elton

Public Health Theses

Extreme heat is becoming an increasingly prevalent and prominent environmental health issue under climate change. The goal of this study is to evaluate heat vulnerability at the census tract level in the state of Connecticut and assess the spatial accessibility to cooling centers – an extreme heat intervention. A variety of environmental and sociodemographic variables related to heat and health were identified based on previous literature and used in a varimax-rotated principal component analysis to reduce dimensionality and identify key components that constitute a heat vulnerability score. In addition, cooling center locations were identified based on news media and a …

Development Of Novel Point-Of-Care-Testing For Oxalate Detection In Urine Based On Oxalate-Binding Ligands, Naruerat Joybumrung

Chulalongkorn University Theses and Dissertations (Chula ETD)

Kidney stone disease is the third most common urinary tract disease worldwide that is more prevalent in the tropics. In Thailand, the highest stone prevalence up to 17% is reported in the Northeast. The disease is highly recurrent with a recurrence rate of about 50% within 5-10 years. The most common type of kidney stones is calcium oxalate (CaOx), and an increased urinary oxalate excretion is an important risk factor. Most of kidney stone patients have a hyperoxaluria condition (urinary oxalate >40 mg/day or >0.46 mmol/day). Therefore, urinary oxalate measurement has been widely used for estimating the risk of CaOx …

A Comparative Study Of Gut Microbiota In The Healthy Elderly And The Elderly With Colorectal Cancer, Nutta Iadsee

Chulalongkorn University Theses and Dissertations (Chula ETD)

Colorectal cancer is one of the third most common cancer worldwide. Dysbiosis of the human gut microbiota has been linked to sporadic colorectal cancer (CRC). This study aimed to compare the gut microbiota profile of a total of 80 Thai volunteers, who were above 50 years old, among 25 CRC patients, 33 adenoma patients, and 22 healthy controls (HC). The 16S rRNA sequencing was utilized to characterize the gut microbiome in both mucosal tissue and stool samples. Moreover, absolute quantitative PCR (qPCR) assay was conducted to quantify six CRC-associated bacteria including Fusobacterium nucleatum (FN), Parvimonas micra (PM), colibactin positive strains …

Study Of G6pd Deficiency With Clinical And Hematological Correlation In Newborn Infants, Thanaporn Pimpakan

Chulalongkorn University Theses and Dissertations (Chula ETD)

G6PD deficiency is the most common enzymatic aberration, affecting more than a million people worldwide. If severe cases at birth are not diagnosed and treated promptly, they can develop into cerebral jaundice and hyperbilirubinemia. Hyperbilirubinemia is caused by an imbalance between increased bilirubin production and ineffective excretion of bilirubin. This can result in the neurotoxicity of bilirubin, kernicterus, and fatal mental retardation. Besides, It has been speculated that the presence of a high number of reticulocytes in newborns interferes with the diagnosis of G6PD deficiency since reticulocytes contain higher amounts of G6PD enzyme than mature erythrocytes. Therefore, the purposes of …

Cross-Cultural Adaptation And Psychometric Properties Of The Thai Version Of The Neurophysiology Of Pain Questionnaire, Pichet Pasangkayo

Chulalongkorn University Theses and Dissertations (Chula ETD)

Background: Pain neurophysiology knowledge is hypothesized to influence pain beliefs and physical performance in individuals with chronic low back pain (LBP). Valid and reliable measures of such knowledge is important to evaluate the pain treatment on this domain as well as to understand its role in both physical and psychological functions of individuals with chronic pain. This study aimed to culturally adapt the revised Neurophysiology of Pain Questionnaire into Thai (T-rNPQ), using the Functional Assessment of Chronic Illness Therapy (FACIT) methodology, and to evaluate its reliability and validity. Two hundred sixty-three individuals with chronic LBP completed the T-rNPQ and seven …

Effectiveness Of A Social Health Security Program In Improving Financial Risk Protection Against The Health Expenditures Of The Insured Populations In Four Districts Of Nepal: A Mixed Method Study, Gaj Bahadur Gurung

Chulalongkorn University Theses and Dissertations (Chula ETD)

Background: Most low and low-middle income (LMICs) countries adopting National Health Insurance (NHI) programs to achieve Universal Health Coverage are struggling to implement the program and thus have failed to achieve the expected outputs. The Nepal NHI program initiated in 2016 has experienced numerous implementation challenges, due to inadequate inputs and throughput, resulting in negative output such adverse selection, poor health service delivery, low enrollment of the poor household and low annual non-renewals of the NHI membership. However, there is a lack of research that focuses on these problems. So, this study has two objectives. Firstly, delved into the NHI …

Analysis Of Influenza A Genomes And Bacterial Microbiota In Upper Respiratory Tracts Of Influenza Patients, Somruthai Rattanaburi

Chulalongkorn University Theses and Dissertations (Chula ETD)

Seasonal influenza is a contagious respiratory illness caused by influenza viruses that infect the upper respiratory tract (URT) of humans and represent a major burden for public health. Furthermore, the URT is colonized by a diverse microbial community which is a key factor protective from pathogens and may directly or indirectly affect viral infection. Therefore, the first aim of this study focuses on influenza A genome characterization and mutation analysis based on NGS technology. The phylogenetic analysis based on the deduced amino acid sequences revealed that the recommended vaccine (A/H1N1) strain might be less effective, whereas the recommended vaccine (A/H3N2) …

Analysis Of Covid 19 Mortality And Case Fatality In A Low Income Region Of Brazil, Carlos Eduardo Siqueira, Luiz C De Abreu

Gastón Institute Publications

Introduction: Inserted in the vulnerable context of the Brazilian Amazon, the state of Tocantins has suffered damages with the dissemination of COVID-19 in its territory; however, little evidence is published from this state. Objective: This study aims to analyze the case-fatality, mortality, and incidence of COVID-19 in Tocantins. Methods: This is an ecological study, population-based, time- series analysis of COVID-19 cases and deaths in the state of Tocantins from March 2020 to August 2021. Results: During the examined period, 219,031 COVID-19 cases, and 3,594 deaths were registered due to disease. Two possible occurrence peaks were characterized in this time- series …

A Time-Series Ecological Study Protocol To Analyze Trends Of Incidence, Mortality, Lethality Of Covid-19 In Brazil, Luiz C De Abreu, Khalifa Elmusharaf, Carlos Eduardo Siqueira

Gastón Institute Publications

Introduction: since the first case of COVID-19 was confirmed in February 2020, Brazil has reported more than 20 million cases and more than 600,000 deaths on October 31, 2021. The behavior of the pandemic was also different in the various states, from the less developed to the more developed, such as the state of São Paulo. Objective: to describe step-by-step time series for analyzing trends in mortality, lethality and incidence of COVID-19 in Brazil. Methods: a protocol for an ecological study of time series, covering the 26 states and the federal district (Brasilia). Results: the descriptions have the potential to …

Statistical Methods For Evaluating Confounding In Nutritional Epidemiology: Examining The Association Of Dietary Measures And Incident Type 2 Diabetes, Stephanie E. Tison

All ETDs from UAB

Nutrition is a key factor in the development of noncommunicable diseases (NCDs) such as cardiovascular disease, diabetes, obesity, and cancer, which are continuing to increase globally. Research on dietary patterns is crucial for informing what aspects of diet are most critical for preventing and possibly reversing chronic disease. Dietary patterns focus on the types of food that are consumed which reflects the complexity and cultural aspects of diet rather than focusing on a single food or nutrient. Observational cohort studies are able to observe typical dietary intake and thus better reflect the real association between diet and chronic disease. In …

Living In An Oil-Polluted Region In Nigeria As A Risk Factor In Colorectal Cancer Development, Steve Nwachi Onya

Walden Dissertations and Doctoral Studies

Due to differences in exposure to various risk factors, colorectal cancer (CRC) rates differ in regions of Nigeria. Although the people living in the Southsouth, an oil-producing region, are concerned that they are most affected, there is insufficient research to address these concerns. The purpose of this quantitative ecological study was to investigate whether living in the oil-polluted region in Nigeria is associated with an excess CRC incidence rate. The potential spatial autocorrelation of CRC incidence among the contiguous regions was also examined. The study was grounded in the ecosocial theoretical framework. Data were extracted from the Nigeria National System …

Medical Brain Drain And Its Effect On The Nigerian Healthcare Sector, Oluwakemi Osigbesan

Walden Dissertations and Doctoral Studies

Nigeria suffers from a huge brain drain issue across different sectors, particularly in the healthcare sector. The WHO assessed that there is a current shortage of 2.8 million physicians in the world A heuristic phenomenological method was used in this study to explore the lived experiences of 12 Nigerian healthcare practitioners that migrated to the United States. The push-pull theory served as the theoretical framework that grounded this study. The central research questions for this study focused primarily on the reasons healthcare practitioners are leaving Nigeria and what the impact of those decisions have on the Nigerian healthcare sector. Qualitative …

Effects Of Trained Providers And Naloxone Distribution On Prescription Opioid Use Disorder, Samuel Sarpong

Walden Dissertations and Doctoral Studies

AbstractOpioid abuse and overdose are associated with substantial morbidity and mortality rates, as well as social and economic costs. The purpose of this study was to evaluate the independent and interactive effects of state-sponsored prescription drug monitoring program (PDMP) trained healthcare providers and community-based naloxone distribution program related factors in the states of Florida and Georgia for the prevention and reduction of prescription opioid use disorder, overdose, and deaths. The research theory adopted was the socio-ecological model with an emphasis on risk factors such as age. The study used secondary data from 2014 to 2018 from the Florida and Georgia …

Predictors Of Obesity Among Young Adults In The State Of Maryland, Kala Shahi

Walden Dissertations and Doctoral Studies

AbstractObesity has become a global wellness concern for young adults. In the past, there were very few studies conducted on predictors of obesity among young adults, even though there have been several studies on the potential predictors of obesity on the general population. The social ecological model was used to guide this quantitative cross-sectional study to identify the possible predictors of obesity among young adults. The Behavioral Risk Factor Surveillance System was used to analyze the potential predictors of obesity among young adults between the ages 18 – 34 years old in Montgomery County, Frederick County, and Princess Georges County, …

Unmet Needs Of Children With Special Health Care Needs When Transitioning To Adult Services, Kiara Monee Moseby

Walden Dissertations and Doctoral Studies

Health care transition planning could help decrease health care disparities among those who identify as an individual on the autism spectrum; however, less than a quarter of the adolescent population living with autism spectrum disorder receive transition planning. Decreasing health care disparities could lead to an increase in health care quality and longevity. The purpose of this study was to analyze if there was a relationship between (a) the number of physician visits, (b) if the physician treats only children, (c) if the physician talks about the child seeing physicians who treat adults, (d) if the physician worked with the …

The Relationship Between Hospitals’ Electronic Health Records Maturity And Excess Readmission Ratio, Cynthia Saint-Ulysse

Walden Dissertations and Doctoral Studies

Since the Health Information Technology for Economic and Clinical Health Act was enacted in 2009, a majority of U.S. hospitals have adopted electronic health records (EHR) to improve quality of care. However, variations exist in the technology's capability and maturity, making it difficult for researchers to analyze the full impact. The purpose of this quantitative study was to explore the relationship between hospitals' EHR maturity and the quality measure of excess readmissions, as well as the relationship between hospital characteristics, specifically, hospital location and the number of licensed beds in Medicare hospitals (N = 1,006). Both the chi-square statistical test …

Effects Of Cultural And Lived Experiences On Health Access Of Chamorro People On Saipan, Esther Lizama Muna

Walden Dissertations and Doctoral Studies

More than half of the population of the Commonwealth of the Northern Mariana Islands had not visited their primary care provider for a year in 2016. The Chamorro people are less willing to seek or access care than other ethnic groups. This qualitative study aimed to understand the Chamorro people's access and utilization of Saipan's health care services to improve their access and, ultimately, their health. The theoretical frameworks included Penchansky and Thomas's theory of access to explore the Chamorro people of Saipan's lived experiences with availability, accessibility, accommodation, affordability, and acceptability of health care services, as well as Spector's …

Connectivity: Insights From The U.S. Long Term Ecological Research Network, David M. Iwaniec, Michael Gooseff, Katharine N. Suding, David Samuel Johnson, Daniel C. Reed, Debra P. C. Peters, Byron Adams, John E. Barrett, Brandon T. Bestelmeyer, Max C. N. Castorani, Elizabeth M. Cook, Melissa J. Davidson, Peter M. Groffman, Niall P. Hanan, Laura F. Huenneke, Pieter T. J. Johnson, Diane M. Mcknight, Robert J. Miller, Gregory S. Okin, Daniel L. Preston, Andrew Rassweiler, Chris Ray, Osvaldo E. Sala, Robert L. Schooley, Timothy Seastedt, Marko J. Spasojevic, Enrique R. Vivoni

Advanced Science Research Center

Ecosystems across the United States are changing in complex and surprising ways. Ongoing demand for critical ecosystem services requires an understanding of the populations and communities in these ecosystems in the future. This paper represents a synthesis effort of the U.S. National Science Foundation-funded Long-Term Ecological Research (LTER) network addressing the core research area of “populations and communities.” The objective of this effort was to show the importance of long-term data collection and experiments for addressing the hardest questions in scientific ecology that have significant implications for environmental policy and management. Each LTER site developed at least one compelling case …

Ethical Health Care In An African Context: Linking Conventional Medicine And Traditional Healing Practices In Igboland, Nigeria., Michael Osondu Okoro

Dissertations

This dissertation argues that in Nigeria’s Igboland, a health care ethic reflective of the Roman Catholic Christian faith must build links between the rightful practices of both conventional Western medicine and traditional Igbo healers. It calls such a health care ethic an “integral health care ethic” in the Nigerian Igbo context.The inspiration for this dissertation comes from the growing respect given to indigenous people and their knowledge by the Roman Catholic Church since the Second Vatican Council and, more specifically, the attention Pope Francis has given to indigenous people in his writings and speeches. For example, in his remarks on …