Digital Commons Network^™

The Impact And Cost Of Child Marriage Prevention In Three African Settings, Annabel Erulkar, Girmay Medhin, Eva Weissman

Poverty, Gender, and Youth

Girls in sub-Saharan Africa are disproportionately affected by child marriage; by 2050, half of the girls married during childhood will reside in Africa. The negative consequences of the practice are numerous and powerful, spanning health, welfare, development, and demographic domains. Yet, there is limited evidence on what works to delay child marriage in different cultural contexts and even less information on programmatic cost. This study develops and tests the most effective and minimum basic package approaches to delay marriage among older and younger adolescent girls, and estimates the cost and cost-effectiveness of implementing the different approaches, in Burkina Faso, Ethiopia, …

Practicing Therapeutic Recreation In A World Of Differences, Morgan Herrington

Honors College Theses

Therapeutic recreation (TR) services are available to any individual who wishes to increase quality of life and improve functioning. The profession is based on many conceptual foundations, including quality of life; perceived freedom; intrinsic motivation, self-efficacy, and self-determination; health, wellness, and disability; and recreation and leisure. However, these Western-ideological perspectives may hinder the introduction and practice of TR in countries with other worldviews. This study was designed to explore different worldviews and to evaluate the conceptual foundations of TR with respect to these differences. Findings attempt to identify ways to adapt and shape TR foundations so that it may be …

Comparative Analysis Of Selected Cagpai Genes And Different Vaca Genotypes In Iranian And Turkish H. Pylori-Positive Patients Suffering From Gastric Adenocarcinoma And Active Chronic Gastritis, Ali Bahadori, Mohammad Hossein Somi, Fi̇gen Doran, Amir Taher Eftekharsadat, Suna Kizilyildirim, Mahsa Esmaeillou, Maryam Yassi, Başak Bedi̇r, Fati̇h Köksal

Turkish Journal of Medical Sciences

Background/aim: Helicobacter pylori is a pathogen that colonizes a majority of the world's population. Genetic diversity within the virulence genes of bacteria such as cagPAI and vacA may have a modified effect on the pathogenic potential of the bacteria. This study aimed to investigate which genes can be suggested as potentially related virulence factors for H. pylori-associated active chronic gastritis and stomach adenocarcinoma in the northwest of Iran and south of Turkey. Materials and methods: Formalin-fixed, paraffin-embedded stomach biopsy tissue samples were obtained from Iranian and Turkish patients from selected geographical regions. The prevalence of selected cagPAI genes and vacA …

Multilevel And Multisectoral Processes Of Implementing Nutritionsensitive Ideology And Programming In Ethiopia’S Development Landscape, Andrea Marie Warren

Theses and Dissertations

This research sought to understand the ways in which ideas and discourses in international development are adapted in a country context. Our particular focus was on how ideas at the international and national level become reality at the subnational and community levels. We primarily examined the sensitization of Ethiopia’s Productive Safety Net Program to nutrition across sectors and down levels of government as a way to understand how the global momentum around nutrition, particularly multisectoral or nutrition-sensitive initiatives, can be translated into action.

The first manuscript delves further into the operational realities of implementing multisectoral nutrition-sensitive programming among the neglected …

Predictors Of Pneumococcal Carriage And The Effect Of The 13-Valent Pneumococcal Conjugate Vaccination In The Western Australian Aboriginal Population, Deirdre A. Collins, Anke Hoskins, Thomas Snelling, Kalpani Senasinghe, Jacinta Bowman, Natalie A. Stemberger, Amanda J. Leach, Deborah Lehmann

Research outputs 2014 to 2021

Background

The 7-valent pneumococcal conjugate vaccine (PCV7) was introduced to prevent invasive pneumococcal disease (IPD) in Western Australian (WA) Aboriginal people in 2001. PCV13 replaced PCV7 in July 2011, covering six additional pneumococcal serotypes; however, IPD rates remained high in Aboriginal people in WA. Upper respiratory tract pneumococcal carriage can precede IPD, and PCVs alter serotype distribution.

Methods

To assess the impact of PCV13 introduction, identify emerging serotypes, and assess risk factors for carriage, nasopharyngeal swabs and information on demographic characteristics, health, medication and living conditions from Aboriginal children and adults across WA from August 2008 to November 2014 were …

Telemedicine: An Augmentation Strategy To Mitigate The Primary Care Shortage, Kevin Jeffrey Mckinnon

Walden Dissertations and Doctoral Studies

According to the Association of American Medical Colleges, the primary care workforce shortage in 2025 will exceed 46,000 primary care physicians. Healthcare business leaders in Gwinnett County, Georgia have not evaluated the advantages and disadvantages of telemedicine (TM) to mitigate the workforce shortage. The purpose of this qualitative descriptive study was to determine factors primary care physician administrators consider when deciding to implement TM as a potential solution for the growing physician shortage. A purposive sample of 20 primary care physician administrators located in Gwinnett County, Georgia was drawn. The theory of disruptive technology was the conceptual framework. Data collected …

Predictors Of Obesity, Acculturation, And Perceived Stress In Meskhetian Turk (Ahiska) Immigrants In The United States, Zekeriya Temircan

Walden Dissertations and Doctoral Studies

Obesity is a risk factor for chronic diseases among the ethnic minorities for adult immigrants in the United States. There have been many research studies conducted to examine the relationship between the predictors and obesity in minority groups in the United States, that relationship was unknown in Meskhetian Turk (Ahiska) immigrant populations. Guided by social ecological model and acculturation theory, this study examined the predictors of obesity in the Meskhetian Turk (Ahiska) immigrant population in the western United States. Data were collected from 109 participants using CDC's Behavioral Risk Factor Surveillance System, Stephenson Multigroup Acculturation Scale, and Perceived Stress Scale. …

Snack Food Reinforcement During Work And Non-Work Hours Among U.S. Office Workers, Sherise Larks

Walden Dissertations and Doctoral Studies

The current epidemic of overweight and obesity has been partly credited to a growing trend for snacking and sedentary work behaviors. The purpose of this quantitative, cross-sectional survey was to investigate whether the difference between snack food reinforcement during work and non-work hours and work food motives predicted BMI among U. S. office workers. This study was based on the theoretical framework of the individual differences theory, in the context of the behavioral choice theory and reinforcement theory. The independent variables were food reinforcement and food motives; the dependent variable was BMI. Descriptive, correlational, and exploratory analyses were used. The …

Factors Affecting Inadequate Growth During Early Childhood In Guyana, South America, Valescia Xenobia John

Walden Dissertations and Doctoral Studies

Children under 5 years of age in Guyana are at an increased risk for inadequate growth. According to the United Nations Development Programme, 1 out of 3 children of preschool age are undernourished globally. This is a major public health concern as undernourishment in children under 5 years can lead to lifelong health complications. The study assessed the relationship between inadequate growth and urban classification in children under 5 years in Guyana, South America, after controlling for the following variables: mother's level of education, mother's age at birth of the child, household size, wealth, and marital status. The study framework …

The South Carolina Telestroke Program: Does County-Level Telestroke Access Increase The Odds That Patients Will Receive T-Pa?, Steven M. Dilembo

MUSC Theses and Dissertations

Stroke is a disease that is responsible for disabling more of its victims that any other disease in the United States. There are four types of stroke. However, ischemic stroke is responsible for 87% of all strokes. T-PA is a pharmaceutical that has proven an effective treatment for ischemic stroke patients since 1996. T-PA works by dissolving the thrombosis that has become lodged in a brain vessel. This pharmaceutical has its limitations; mainly it must be administered within 4.5 hours of symptom onset. Nationally, the medical field experiences low utilization rates, between 3-5%. The many variables that affect this low …

Cadmium Exposure And Residence-To-Road Proximity In Eastern Kentucky, Ellen Flora

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

Background and Objectives

Cadmium is a carcinogenic and toxic metal. The general population can be exposed to cadmium from multiple sources. The purpose of this study is to evaluate the association of urinary cadmium and residence distance-to-road by performing landscape analyses in eastern Kentucky, a region where smoking prevalence is high, coal production has been a primary industry, and the landscape is predominantly undeveloped. Composite dust samples were also collected and analyzed for Cadmium (Cd), Manganese (Mn), and Zinc (Zn). The primary objective of this study is to ascertain if there is an association between participants with elevated accumulated cadmium …

The Effects Of Improved Water And Sanitation Access On Under Five Child Diarrhea In Peru, April Ballard

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

Significance: Diseases related to poor or lack of access to clean water, sanitation, and hygiene negatively impact health, education, and development worldwide and cause millions of deaths in children each year. Health outcomes associated with lack of access to clean water and sanitation are under-evaluated.

Aim: To assess the effect of improved water and sanitation infrastructure development on child morbidity in Peru by investigating diarrhea in children under five years of age.

Methods: The child, family, and household data from the Peruvian Demographic and Health Surveys (DHS) were used to evaluate the association between access to water …

Do Numbers Matter? Comparing Single Homicide Followed By Suicide And Multiple Homicide Followed By Suicide Using The National Violent Death Reporting System, 2003-2012, Courtney Blondino

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

Introduction

Homicide-followed-by-suicide or homicide-suicides were examined to understand the dynamics of acting outwardly and inwardly violent in a single incident. The purpose of this study was to identify if specific circumstances had an association with the number of victims per homicidesuicide incident. This study addresses an important public health issue by encouraging an accurate viewpoint of homicide-suicide in order to properly program prevention efforts.

Methods

Using the restricted access data (RAD) from 17 National Violent Death Reporting System (NVDRS) states, we characterized 1904 homicide-suicide incidents through qualitative and quantitative analysis based on victim and suspect demographic information, method of injury, …

The Role Of Neighborhood Characteristics In Late Stage Melanoma Diagnosis Among Hispanic Men In California, Texas, And Florida, 1996-2012, Valerie M. Harvey, Clinton W. Enos, Jarvis T. Chen, Hadiza Galadima, Karl Eschbach

Community & Environmental Health Faculty Publications

Background. Hispanics diagnosed with cutaneous melanoma are more likely to present at advanced stages but the reasons for this are unknown. We identify census tracts at high risk for late stage melanoma diagnosis (LSMD) and examine the contextual predictors of LSMD in California, Texas, and Florida. Methods. We conducted a cross-sectional study using geocoded state cancer registry data. Using hierarchical multilevel logistic regression models we estimated ORs and 95% confidence intervals for the impact of socioeconomic, Hispanic ethnic concentration, index of dissimilarity, and health resource availability measures on LSMD. Results. We identified 12,493 cases. In California, late …

University Of Nebraska At Omaha 2017-2018 Course Catalog, University Of Nebraska At Omaha

Graduate Catalogs

The University of Nebraska Omaha (UNO) is a premier metropolitan university that combines the resources of a doctoral research institution with a thriving community in the heart of Omaha.

With a global reach and vision, UNO is large enough to provide opportunities students seek, yet personal enough to include the mentorship they need to achieve academic excellence, creativity, and engaged learningat competitive tuition rates.

UNO is committed to and engaged with the city surrounding it, allowing students unique hands-on opportunities, internships, service learning,applied research, and other collaborative activities that enhance time in the classroom.

This is the ”O” we want …

Social Determinants Of Health And Disparities In Outcomes Related To Cardiovascular Health In Vulnerable Populations, Jennifer L. Miller

Theses and Dissertations--Nursing

The purpose of this dissertation was to explore the mechanism of association between social determinants of health (SDH), particularly limited health literacy, and disparate outcomes related to cardiovascular disease in vulnerable populations. Specific aims were to 1) compare quality of life (QOL), anxiety, and depressive symptoms between genders in implantable cardioverter defibrillator (ICD) recipients; 2) examine the association between multi-morbidity burden and QOL; 3) determine whether health literacy levels independently predict CVD risk in the male prison population; 4) examine the relationship between health literacy and decisiveness regarding end of life (EOL) choices, and 5) examine SDH as predictors of …

A Grounded Theory Study Of Maternal Engagement Of Low Income, Young Rural Mothers In Home-Based, Early Intervention Services, Elaine K. Fehringer

Theses and Dissertations--Rehabilitation Sciences

Home-based, early intervention programs as a preferred delivery model are widely endorsed, heavily funded and highly utilized as prevention and remediation initiatives for families with young children (Eckenrode, et al., 2010; Karoly, Killion, & Cannon, 2005). Of concern, is that while an estimated 40 billion dollars are spent annually between federally funded programs and private foundations, a significant number of families disengage from services before the end of a child’s eligibility period (Stevens, Ammerman, Putnam, Gannon, & van Ginkel, 2005). Several meta-analyses indicate only modest effectiveness of home-based services (Tandon, et al., 2008). It is estimated that well over 500,000 …

Diagnostic Prevalence Of Diabetes Among Older Adults In Rural Appalachia, Gabriella Hodges

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

Background

The rural, mountainous Appalachian region continuously has poorer health outcomes than the rest of the United States. This is true for many chronic diseases including diabetes: the 7th leading cause of death in the United States. This study assessed differences in the prevalence of diagnosed diabetes between older adults in rural, Appalachian counties and rural, non- Appalachian counties.

Methods

Data for the year 2013 was extracted from the Centers for Medicare and Medicaid Services (CMS) Public Use Files for Medicare beneficiaries (September 2015), which provides county level prevalence for diabetes as well as several other conditions among Medicare fee-for-service …

A Model Of Health For Family Caregivers Of Elders, Florence M. Weierbach, Yan Cao

ETSU Faculty Works

Family members who provide care to their loved ones experience changes in their own health. The caregiver health model (CGHM) is a new model that identifies health holistically and identifies four determinant(s) that contribute to the health status of the family caregiver. The purpose is to introduce the CGHM: Hypothesis 1: the determinants of health in the CGHM contribute to the health of the Caregiver, Hypothesis 2: the determinants of health contribute to changes in the caregivers’ health at 8 and 16 weeks, and Hypothesis 3: a change in health occurs from baseline to 8 and 16 weeks. Methods: A …

Exploring The Association Between Fgm/C And Early/Child Marriage: A Review Of The Evidence, Jamlick Karumbi, David Gathara, Jacinta Muteshi-Strachan

Reproductive Health

Female genital mutilation/cutting (FGM/C) has been frequently linked to marriageability and thought to be associated with child marriage, yet there is remarkably little rigorous research to clarify the relationship between these two practices to inform discussions and responses. Furthermore, trends are also shifting in the timing of FGM/C from adolescence to early childhood, and the implications this might have on the links between early/child marriage and FGM/C are not well understood. This review of current available evidence aims to assess the association between FGM/C and early/child marriage in contexts where both practices are carried out. The social and cultural norms …

Exploring The Association Between Fgm/C And Fistula: A Review Of The Evidence, Pooja Sripad, Charity Ndwiga, Kaji Tamanna Keya

Reproductive Health

Female genital mutilation/cutting (FGM/C) and fistula are both conditions that have a range of health, socioeconomic, and lifestyle causes and consequences for women globally. There have been sparse empirical and conceptual efforts to look at how these two conditions manifest and relate to one another. This rigorous review of the literature aims to fill this research gap by assessing the state of evidence on the association of FGM/C and fistula and conceptually mapping this association within broader social, political, and health-systems contexts. Based on the findings, the authors of this report have developed a conceptual mapping framework to situate the …

Modeling And Mapping Of Girls' Female Genital Mutilation/Cutting (Fgm/C) In The Context Of Economic, Social, And Regional Disparities: Kenya Demographic And Health Surveys 1998-2014, Ngianga-Bakwin Kandala, Damaris Kinyoki, Ahmed Sarki, David Gathara, Paul Komba, Bettina Shell-Duncan

Reproductive Health

The aim of this research study is analysis of successive household data for estimating and revealing trends, similarities, and differences in geographic patterns for the burden of female genital mutilation/cutting (FGM/C) and related risk factors among girls ages 14 and younger in Kenya. This Evidence to End FGM/C study, from a coalition led by the Population Council, is intended to contribute to a deeper understanding of the recent burden of FGM/C among the girls within this very young age group, and to enhance knowledge of the geographic distribution of this practice over time. The report will inform current elimination efforts …

Rapid Evidence Assessment: Quality Of Studies Assessing Interventions To Support Fgm/C Abandonment, Tammary Esho, Jamlick Karumbi, Carolyne Njue

Reproductive Health

The last decade has seen increased focus and investment in interventions to eliminate female genital mutilation/cutting (FGM/C), along with the need to accelerate its abandonment. The UK Department for International Development (DFID) commissioned the Evidence to End FGM/C: Research to Help Girls and Women Thrive project to: 1) assess the quality of studies that have evaluated different interventions for the prevention of FGM/C, and 2) describe the FGM/C interventions that were evaluated by high-quality studies. The quality of evidence on the effectiveness and impact of FGM/C interventions is generally moderate to low. In addition, few baseline surveys are conducted prior …

Resilience And Community Response To Climate-Related Events: Case Studies From Four Countries, Aviva Klein Meyers, Karen Hardee

Reproductive Health

It is important for governments, aid organizations, and researchers to understand how developing communities respond to climate change and how their efforts can be improved within a framework of resilience thinking. This review explores the definition of resilience and, more specifically, community resilience and its components, then presents four case studies of community response to extreme weather events to illustrate community resilience in action. The review is intended to provide context for and inform more detailed exploration of community resilience in integrated programming (specifically, programming designed to improve health, environment, and population outcomes). It is also intended to capture references …

Wise And Well: A Pilot Study On The Effects Of Providing A Wellness Group Protocol To Enhance Occupational Fit Among Rural Community Dwelling Elderly Women, Brianna Berendt, Carly Hills

Occupational Therapy Capstones

Problem: There is a need for rural services for community-dwelling women due to a lack of resources, transportation, and social opportunities (Bacsu et a!., 2016; Averill, 201 2). Likewise, Shimada et a!. (2014) emphasized the impact and causes of social isolation on elderly individuals and how important it is for elderly individuals to establish a support system when facing challenges throughout later life. A third problem was described by Choi et a!. (2013) in that elderly individuals may experience a loss of independence and functional decline can result from being physically inactive. This indicates that there are increased health risks …

Opioid Maintenance Treatment: Methadone, Buprenorphine, And Naltrexone, Nicole Lemieux

Physician Assistant Scholarly Project Posters

Opioid dependence plagues the United States with millions of people suffering from the effects. Throughout recent years, there has been a surge in research in treatment options for patients suffering from opioid dependence. Three medications have stood out: methadone, buprenorphine, and naltrexone. The purpose of this study was to investigate the three and decipher which provides the best outcomes for patients. Research was conducted by reviewing literature via PubMed, PsychInfo and Cochrane. A review of the literature found that methadone has been used the longest and has been shown to be efficacious, but can be severely limiting for patients due …

Development Of Sunscreen Cream Containing Mangosteen Pericarp Extract Encapsulated In Solid Lipid Nanoparticles, Siti Nur Diniyanti

Chulalongkorn University Theses and Dissertations (Chula ETD)

The aim of this study was to develop cream containing mangosteen pericarp extract (MPE) encapsulated in solid lipid nanoparticles (SLNs) in order to achieve enhanced photoprotection and to be an alternative for synthetic sunscreens in the market. The MPE was prepared by maceration method and evaluated for SPF value by UV-Vis spectrophotometer. SLNs were prepared by ultrasonication method. Blank SLNs were formulated using stearic acid (SA) or palmitic acid (PA) as a solid lipid at a concentration of 3%. Tween® 80 or PVA was employed as a surfactant with concentrations ranging from 1 to 2%. The obtained blank-SLNs were investigated …

Assessment Of Knowledge, Attitude And Practice Regarding Malaria Prevention Towards Internal Migrant Population In Kawthoung Township, Kawthoung District, Tanintharyi Region, Myanmar: A Cross Sectional Study, Sa Aung Hein

Chulalongkorn University Theses and Dissertations (Chula ETD)

Since malaria is preventable disease, early diagnosis and effective treatment of malaria is necessary for optimal outcome. For people living in high transmission of malaria areas such as in Kawthoung Township, it is crucial for them to have good knowledge, attitude and practice toward malaria prevention. This study was aimed to assess and describe the socio-demographic factors, knowledge, attitude and practice towards malaria prevention in internal migrant people, Kawthoung Township, Kawthoung District, Myanmar. Research design was cross-sectional study which Three hundred and sixteen respondents who age range from 18 to 65 years old were interviewed face to face with structure …

Midwives’ And Patients’ Perspectives On Disrespect And Abuse During Labor And Delivery Care In Ethiopia: A Qualitative Study, Sahai Burrowes, Sarah Jane Holcombe, Dube Jara, Danielle Carter, Katheryn Smith

Background: It is increasingly recognized that disrespect and abuse of women during labor and delivery is a violation of a woman’s rights and a deterrent to the use of life-saving, facility-based labor and delivery services. In Ethiopia, rates of skilled birth attendance are still only 28% despite a recent dramatic national scale up in the numbers of trained providers and facilities. Concerns have been raised that women's perceptions of poor quality of care and fear of mistreatment might contribute to this low utilization. This study examines the experiences of disrespect and abuse in maternal care from the perspectives of …

Pronoun Marking In African American English-Speaking Children With And Without Specific Language Impairment, Gayatri Ramamoorthy Brown

LSU Master's Theses

The present study was designed to describe and quantify patterns of pronoun use by African American English (AAE)-speaking children with specific language impairment (SLI) relative to their AAE-speaking typically developing (TD) peers. Pronouns were of interest because: they are produced frequently in everyday speech, they are often targeted when a child’s language abilities are evaluated by a speech-language pathologist, and limited pronoun data exists for AAE-speaking children. The data were language samples that had been elicited from 96 children (35 SLI, 61 TD) enrolled in kindergarten. The samples were searched for 11 different pronoun forms, and these were coded as …