Digital Commons Network^™

Do Physiological Variables Predict The Need For Transport To Hospital From Music Festivals? An Analysis Of Australian Festival Data, Ned Douglas, Jake Donovan, James Carew, Kayla Brouwer, Ebony Edwards, Mitchell Gibson, Jacqueline Leverett, Joseph Paul, Lachlan Holbery-Morgan, Jessica Pritchard, Elyssia Bourke, Erin Smith

Research outputs 2022 to 2026

Objective:

Using physiological markers to detect patients at risk of deterioration is common. Deaths at music festivals in Australia prompted scrutiny of tools to identify critically unwell patients for transport to hospital. This study evaluated initial physiological parameters to identify patients selected for transport to hospital from a music festival.

Methods:

A retrospective audit of 2045 presentations at music festivals in Victoria, Australia, was performed. Presentation heart rate, systolic blood pressure, respiratory rate, oxygen saturation, temperature, and Glasgow Coma Scale were assessed using area under the receiver operating characteristic curve (AUROC) analysis, with a prespecified threshold of 0.7.

Results:

The …

Maternal Educational Attainment In Pregnancy And Epigenome-Wide Dna Methylation Changes In The Offspring From Birth Until Adolescence, Priyanka Choudhary, Giulietta S. Monasso, Ville Karhunen, Justiina Ronkainen, Giulia Mancano, Caitlin G. Howe, Zhongzheng Niu, Xuehuo Zeng, Weihua Guan, John Dou, Jason I. Feinberg, Charles Mordaunt, Giancarlo Pesce, Nour Baïz, Rossella Alfano, Dries S. Martens, Congrong Wang, Elena Isaevska, Elina Keikkala, Sanna Mustaniemi, Chris H. L. Thio, Eliza Fraszczyk, Elmar W. Tobi, Anne P. Starling, Marta Cosin-Tomas, Jose Urquiza, Stefan Röder, Thanh T. Hoang, Christian Page, Dereje D. Jima, John S. House, Rachel L. Maguire, Raffael Ott, Xenia Pawlow, Lea Sirignano, Lea Zillich, Anni Malmberg, Sebastian Rauschert, Phillip Melton, Tong Gong, Robert Karlsson, Ruby Fore, Wei Perng, Zachary M. Laubach, Darina Czamara, Gemma Sharp, Carrie V. Breton, Enrique Schisterman, Edwina Yeung, Sunni L. Mumford, M. Daniele Fallin, Janine M. Lasalle, Rebecca J. Schmidt, Kelly M. Bakulski, Isabella Annesi-Maesano, Barbara Heude, Tim S. Nawrot, Michelle Plusquin, Akram Ghantous, Zdenko Herceg, Lorenza Nisticò, Marina Vafeiadi, Manolis Kogevinas, Marja Vääräsmäki, Eero Kajantie, Harold Snieder, Eva Corpeleijn, Regine P. M. Steegers-Theunissen, Ivana V. Yang, Dana Dabelea, Serena Fossati, Ana C. Zenclussen, Gunda Herberth, Maria Magnus, Siri E. Håberg, Stephanie J. London, Monica C. Munthe-Kaas, Susan K. Murphy, Cathrine Hoyo, Anette-G Ziegler, Sandra Hummel, Stephanie H. Witt, Fabian Streit, Josef Frank, Katri Räikkönen, Jari Lahti, Rae-Chi Huang, Catarina Almqvist, Marie-France Hivert, Vincent W. V. Jaddoe, Marjo-Riitta Järvelin, Marko Kantomaa, Janine F. Felix, Sylvain Sebert

Research outputs 2022 to 2026

Maternal educational attainment (MEA) shapes offspring health through multiple potential pathways. Differential DNA methylation may provide a mechanistic understanding of these long-term associations. We aimed to quantify the associations of MEA with offspring DNA methylation levels at birth, in childhood and in adolescence. Using 37 studies from high-income countries, we performed meta-analysis of epigenome-wide association studies (EWAS) to quantify the associations of completed years of MEA at the time of pregnancy with offspring DNA methylation levels at birth (n = 9 881), in childhood (n = 2 017), and adolescence (n = 2 740), adjusting for relevant covariates. MEA was …

An Interpretive Description Study Of The Views And Experience Of Obstetric Fistula Risk Factors Among Women Attending Evangel Vesico Vagina Fistula Centre In Nigeria, Lydia Babatunde-Bulndi

Theses: Doctorates and Masters

An obstetric fistula is a hole between the birth canal and the bladder or rectum, which is caused by prolonged, obstructed labour without intervention. Sufferers of obstetric fistula may experience chronic urinary and/or faecal incontinence. Although obstetric fistula is directly caused by prolonged obstructed labour, factors such as unskilled birth assistance can increase fistula risk indirectly. Harmful traditional practices, such as female genital mutilation, lack of formal education, illiteracy, poverty, limited social role for women, malnutrition, early marriage before the full development of the pelvis, and a lack of emergency obstetric services are some of the additional factors associated with …

Protecting Low-Income Consumers In The Era Of Digital Grocery Shopping: Implications For Wic Online Ordering, Qi Zhang, Priyanka Patel, Caitlin M. Lowery

Community & Environmental Health Faculty Publications

The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) is now expected to allow participants to redeem their food benefits online, i.e., via online ordering, rather than only in-store. However, it is unclear how this new benefit redemption model may impact participants’ welfare since vendors may have an asymmetric information advantage compared with WIC customers. The WIC online ordering environment may also change the landscape for WIC vendors, which will eventually affect WIC participants. To protect WIC consumers’ rights in the new online ordering model, policymakers need an appropriate legal and regulatory framework. This narrative review provides that …

Psychometric Properties Of The Persian Version Of Consideration Of Future Safety Consequence (Cfsc) Scale, Fazel Rajabi, Hamidreza Mokarami, Payam Farhadi, Sean Banaee, Mehdi Jahangiri

Community & Environmental Health Faculty Publications

Background: Personality traits, due to having a relative stability, are important factors for predicting employees’ safety behavior. Consideration of Future Safety Consequence (CFSC) is a personality trait that was recently introduced to predict the safety behaviors. The purpose of this study was to translate and assess the psychometric properties of the Persian version of the CFSC scale.

Methods: In the first stage of this cross-sectional study, the instrument was prepared by the forward-backward forward translation technique and evaluated by 487 employees of a gas refinery. The validity of the scale was evaluated through face, concurrent, validity, and construct validity. The …

Period Poverty And Life Strains: Efforts Made To Erase Stigma And To Expand Access To Menstrual Hygiene Products, Jennifer L. Brinkley, Nicole Niebuhr

Indiana Journal of Law and Social Equality

No abstract provided.

Does Environmental Testing Of C. Difficile Predict Whether A Patient Is Positive With C. Difficile?, David Caccese

Public Health Theses

Clostridioides difficile is a major public health threat and frequent cause of healthcare-associated infections. Hospitals have struggled to control C. difficile due in part to the challenge of identifying asymptomatic C. difficile carriers and because of C. difficile’s ability to survive on environmental surfaces for long periods. Asymptomatic carriers and environmental surfaces can contribute to C. difficile transmission. Screening of all patients for C. difficile upon hospital admission is not feasible and asymptomatic patients may not be accepting of surveillance testing. Thus, this study examines whether sampling the patient’s room environment once they have been admitted can indicate a patient …

Association Of Prenatal Exposure To Air Pollutants With Select Birth Defects Using The Case-Cohort Approach, Abigail Jeanne Stamm

Legacy Theses & Dissertations (2009 - 2024)

Background: Annually, 3-5% of infants are born with birth defects in the United States. In New York State (NYS), air pollution, specifically ozone (O3) and fine particulate matter (PM2.5), is detectable at levels that affect human health. Air pollution is associated with poor birth outcomes and contains components that are suspected to cause oxidative stress, which is one mechanism by which birth defects are formed.Methods: This study investigated the relationship between the development of select birth defects (oral clefts, craniosynostosis, and clubfoot) in singleton live births in NYS between 2002 and 2015 and weekly peak and average concentrations of O3 …

Gestational Epigenetic Aging : Prenatal Influences And Early Life Associations, Emilia Pawlowski

Legacy Theses & Dissertations (2009 - 2024)

Development Origins of Health (DOHaD) evidence suggests that prenatal exposures have an important impact on offspring health throughout the life course. Environmental and psychosocial exposures during fetal development are associated with a range of health outcomes for offspring, and effects are often sex specific. One of the mechanisms which may explain differences in health outcomes is epigenetic alterations, which are the molecular mechanisms that regulate gene expression and can be modified during fetal development. Many studies have shown that psychosocial stress and social adversity can modulate epigenetic mechanisms and affect health. While there are several methods for measuring epigenetic alterations, …

Toward A New Approach To Job-Related Distress: A Three-Sample Study Of The Occupational Depression Inventory, Renzo Bianchi, James Sowden, Jay Verkuilen, Irvin Sam Schonfeld

Publications and Research

The Occupational Depression Inventory (ODI) was recently developed to assess depressive symptoms that individuals specifically attribute to their work. One purpose of the ODI is to respond to limitations of current assessments of job-related distress, most notably, assessments relying on the burnout construct. In this study, we conducted a thorough examination of the psychometric and structural properties of the ODI using exploratory structural equation modelling bifactor analysis and Mokken scale analysis. The study involved three samples of employed individuals, recruited in France (N = 3454), Switzerland (N = 1971), and Australia (N = 1485). Results were consistent across the three …

Medically Accurate Evidence-Based Sex Education And Abstinence-Only Sex Education: Impact On Teen Pregnancies In The United States, Nicole Chiu

Nursing | Senior Theses

The U.S. has funded abstinence-only programs to combat pregnancy rates for a long time. With numerous factors contributing to teen pregnancies, there have been a lot of ways that people have decided to try to decrease the number of teen pregnancies. For example, schools have either decided that they intend to fully educate their teenage students using medically accurate evidence-based sex education or come from a more conservative approach and give abstinence-only education. The objective of this investigation is to identify whether evidence-based sex education or abstinence-only sex education is more effective at combating teen pregnancy and abortion rates. This …

5. A Chicana Pedagogy For Digital Pen Pals, Diana Noreen Rivera, Leigh Johnson

Literatures and Cultural Studies Faculty Publications

No abstract provided.

A Midwestern United States Latino Study Of Sexual Behaviors Among Latino Adolescents, Astrid Alejandra Cartagena Cabrera

Walden Dissertations and Doctoral Studies

Increasing rates of adolescent unwanted pregnancies can be detrimental to families and the health of the infant. Rates of teen pregnancy among Blacks, Whites, Asians, and other races has decreased; however, the Latino population has not seen similar declining numbers. The Hispanic population currently has the highest rate of teen pregnancy that continues to increase in comparison to any other racial–ethnic group. In this study involving data from the Youth Risk Behavioral Surveillance System, a sample of 17,303 was used. Chi-square analyses and descriptive frequencies were used to identify associations between teen pregnancy and sexual behaviors; and how existing programs …

A Midwestern United States Latino Study Of Sexual Behaviors Among Latino Adolescents, Astrid Alejandra Cartagena Cabrera

Walden Dissertations and Doctoral Studies

Increasing rates of adolescent unwanted pregnancies can be detrimental to families and the health of the infant. Rates of teen pregnancy among Blacks, Whites, Asians, and other races has decreased; however, the Latino population has not seen similar declining numbers. The Hispanic population currently has the highest rate of teen pregnancy that continues to increase in comparison to any other racial–ethnic group. In this study involving data from the Youth Risk Behavioral Surveillance System, a sample of 17,303 was used. Chi-square analyses and descriptive frequencies were used to identify associations between teen pregnancy and sexual behaviors; and how existing programs …

The Experiences Of Women In The Healthcare Profession With Alcohol Use During The Covid-19 Pandemic, Amber Olsen

Walden Dissertations and Doctoral Studies

Women have severe health risks associated with drinking alcohol long-term and excessively. The purpose of this qualitative study was to explore the lived experience of women in healthcare positions regarding alcohol use during the COVID-19 pandemic. The study was informed by the theory of planned behavior. Semistructured interviews were used to gather information from participants based on their firsthand experiences with alcohol usage. Understanding women’s attitudes toward alcohol use during the COVID-19 pandemic can improve intervention. Data were analyzed using an inductive, thematic procedure. Participants associated their own use of alcohol with socialization, and all participants reported that they regarded …

Experiences Of Older Adults With Hiv/Aids Enrolled In Case Management Programs In Northwest Indiana, Antoinette Cardenas

Walden Dissertations and Doctoral Studies

AbstractIn 2016, more than half of those infected with HIV/AIDS were age 50 years or older. Since the introduction of antiretroviral therapy, the survival rate of HIV patients has been on the rise with a predicted increase by 2030, but this has also contributed to early onset of comorbidities such as cardiovascular disease, osteoporosis, and kidney failure. The purpose of this generic qualitative study, driven by ecological systems theory, was to explore the experiences of older adults (age 50 and older) with HIV/AIDS who were enrolled in case management programs in Northwest Indiana. Data were collected from semi structured interviews …

Association Between Psychosocial, Obstetric, And Lifestyle Factors And Antenatal Depression, Tomnema Xiong

Walden Dissertations and Doctoral Studies

Antenatal depression, or depression during pregnancy, is a mental health concern in the United States that impacts mothers and their infants. This study examined the associations between psychosocial, obstetric, lifestyle factors, and antenatal depression. This study was guided by social cognitive theory, specifically the reciprocal determinism construct. Secondary data from the 2007–2018 National Health and Nutritional Examination Survey (NHANES) were used in this quantitative cross-sectional study. Every participant of the NHANES completed the Patient Health Questionnaire-9 depression screening form. The study sample consisted of 274 women who were pregnant at the time of participating in the NHANES, approximately 28.8% of …

Association Between Covid-19 Health Knowledge, Self-Efficacy And Preventive Behaviors Among Nursing Students, Josephine Miane Britanico

Walden Dissertations and Doctoral Studies

Abstract Nursing students possess valuable public health knowledge to prevent the spread of COVID-19 infection. They can provide health education to the public with reliable information and adequate resources. To better understand the role nursing students can take in prevention efforts, the purpose of this quantitative correlational study was to examine the association between COVID-19 health knowledge, self-efficacy, and preventive behavior among undergraduate nursing students. The health belief model was the theoretical framework that guided this study. The primary research questions assessed (a) if there was a statistically significant association between COVID-19 health knowledge and preventive behavior among nursing students, …

Increasing Organizational Value Of A Private Healthcare Education Academy, Diana Skaff

Walden Dissertations and Doctoral Studies

Amid the dynamic changes and innovations of the healthcare field, healthcare providers seek educational activities that enhance their growth and decrease their knowledge gap. Healthcare education organizations responsible for providing high-quality healthcare education, have opportunities to differentiate their programs to acquire, attract, activate, and retain healthcare providers. Grounded in the five forces of competition and the value chain theories, this mixed method formative program evaluation aimed to improve the business development program by developing a differentiation by quality strategy that will increase its competitive advantage. Participants included three decision-makers and nine leaders in a healthcare education organization in the Kingdom …

The Daily Patterns Of Emergency Medical Events, Mary Elizabeth Helander, Margaret K. Formica, Dessa K. Bergen-Cico

Social Science - All Scholarship

This study examines population level daily patterns of time-stamped emergency medical service (EMS) dispatches to establish their situational predictability. Using visualization, sinusoidal regression, and statistical tests to compare empirical cumulative distributions, we analyzed 311,848,450 emergency medical call records from the U.S. National Emergency Medical Services Information System (NEMSIS) for years 2010 through 2022. The analysis revealed a robust daily pattern in the hourly distribution of distress calls across 33 major categories of medical emergency dispatch types. Sinusoidal regression coefficients for all types were statistically significant, mostly at the p < 0.0001 level. The coefficient of determination ($R^2$) ranged from 0.84 and 0.99 for all models, with most falling in the 0.94 to 0.99 range. The common sinusoidal pattern, peaking in mid-afternoon, demonstrates that all major categories of medical emergency dispatch types appear to be influenced by an underlying daily rhythm that is aligned with daylight hours and common sleep/wake cycles. A comparison of results with previous landmark studies revealed new and contrasting EMS patterns for several long-established peak occurrence hours--specifically for chest pain, heart problems, stroke, convulsions and seizures, and sudden cardiac arrest/death. Upon closer examination, we also found that heart attacks, diagnosed by paramedics in the field via 12-lead cardiac monitoring, followed the identified common daily pattern of a mid-afternoon peak, departing from prior generally accepted morning tendencies. Extended analysis revealed that the normative pattern prevailed across the NEMSIS data when re-organized to consider monthly, seasonal, daylight-savings vs civil time, and pre-/post- COVID-19 periods. The predictable daily EMS patterns provide impetus for more research that links daily variation with causal risk and protective factors. Our methods are straightforward and presented with detail to provide accessible and replicable implementation for researchers and practitioners.

Real-Time Surveillance Of The Drug Epidemic: An Assessment And Comparative Visualization Of Substance Abuse In The Commonwealth Of Kentucky, Julia Van Hosen

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

The purpose of this study was to implement and examine a new surveillance system for Kentucky State Police’s forensics unit to track trends of illicit drugs and drug trafficking, and to see if the implementation of this new system was associated with a decrease in overall drug counts over a period of five months. An extensive review of the literature showed that the drug epidemic in the United States continues to worsen, with public health and law enforcement institutions leading the fight in attempting to end the epidemic, but little evidence showing these two joining forces to work together.

Results …

"Disparities In Suicide Mortality Among Healthcare Support Workers In The United States, 2003-2019", Sol Ngam

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

Objectives: To identify differences in demographic and contextual characteristics of suicide mortality among healthcare support workers (HCSWs) and to estimate annual suicide rates among HCSW in the United States from 2003-2019 using the National Violent Death Reporting System (NVDRS) and the United States Bureau of Labor Statistics (BLS).

Methods: Demographic variables of healthcare support worker suicide decedents were collected using the NVDRS. Odds ratios for circumstantial risk factors by sex were calculated. Crude rates for healthcare support worker suicide decedents were calculated and compared to the U.S. general population suicide crude rates.

Results: Male HCSW were more likely to have …

Public Health Law’S Digital Frontier: Addictive Design, Section 230, And The Freedom Of Speech, Matthew B. Lawrence

Faculty Articles

This Article argues that, even if courts are unpersuaded by the broadest arguments in favor of a public health approach to regulation of addictive design, they should nonetheless reject the platforms’ efforts to make addictive design a public-health-law-free zone. The public health and internet paradigms can be reconciled as a policy matter because addictive design threatens both public health and innovation online. The public health and internet paradigms can also be reconciled as a legal matter be-cause even strong theories of section 230 and the First Amendment, properly understood, leave states a safe harbor in which to regulate much addictive …

Changes In Severity Of Diabetes At Diagnosis Following The Onset Of The Sars-Cov-2 Pandemic, Annelise King

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

During the SARS-CoV-2 pandemic it was seen that diabetes was a risk factor for severe COVID-19. The objective of this study is to assess the severity of diabetes at diagnosis during the COVID-19 pandemic compared to pre-pandemic to see how the pandemic and SARS-CoV-2 infection impacted the severity of diabetes. This study used University of Kentucky electronic health records of 13,794 patients who developed diabetes. The majority of patients were female, white non-Hispanic, 65+, and living in an urban area. There were differences seen between the COVID-19 positive and negative cohorts in the DKA and HbA₁c variables, with …

The Prepare Mobile Program For Hiv Prevention In Washington D.C., Gabrielle Cochran

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

Incidence rates of HIV have decreased in the United States in the past decade, but the southern United States has higher rates of HIV than other regions, and cities in the south, like Washington D.C., have some of the highest rates of HIV incidence in the nation. Risky sexual behavior, needle sharing, and substance use increase the risk of transmitting or acquiring HIV, and these behaviors are more common among unhoused people (CDC, 2021; CPPH, 2022).

Expansion of community resources in cities with high levels of HIV have allowed for many people at high risk for HIV to comply with …

The Relationship Between Maternal Depressive Symptoms And Unsafe Infant Sleep Practices In A Low-Resource Community, Rebecca D. Day, Ketrell L. Mcwhorter, Hartley C. Feld, Steven R. Bronwing

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

Objectives: To determine the relationship between maternal depressive symptoms and unsafe infant sleep intention and practices during and after pregnancy.

Methods: This study recruited 100 women from a small clinic in a low-resource community of Santo Domingo, Ecuador from 2018 to 2020. Information on intention to practice safe sleep was collected during the third trimester of pregnancy and safe sleep practices were assessed at 1 month and 6 months postpartum via survey. Depressive symptoms were measured using the Patient Health Questionnaire 2 (PHQ-2). Using log-binomial regression, we estimated prevalence ratios (PR) and 95% confidence intervals (CI) cross-sectionally at …

Breastfeeding Promotion In The Workplace, Katie C. Nettesheim

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

Breastfeeding is one of the best things a mother can do for her baby. It has many protective qualities including a reduced risk of sudden infant death syndrome (SIDS), asthma, obesity, type 1 diabetes, respiratory infections, ear infections, and stomach bugs for the baby (CDC, 2022). There are also protective qualities for the mother as well, including a reduced risk of high blood pressure, breast and ovarian cancer, and type II diabetes. Breastfeeding exclusively, the infant only receives breastmilk and no other supplementation for 6 months, which maximizes the many benefits that breastfeeding has.

Rural areas of the United States …

Obesity During Adolescence And Feeding Practices During Infancy: Cross-Sectional Study, Reem Sharaf-Alddin, Radhia Almathkoori, Hara Kostakis, Ahmed N. Albatineh, Abdullah Al-Taiar, Muge Akpinar-Elci

Community & Environmental Health Faculty Publications

Background: Breastfeeding is proposed to play a role in reducing the risk of obesity throughout life. Kuwait has an extremely high prevalence of childhood obesity (45% of adolescents are overweight/obese) and extremely low breastfeeding indicators, particularly exclusive breastfeeding. In fact, little is known about the association between breastfeeding and obesity from Kuwait and the broader Middle East.

Aims: To estimate the prevalence of overweight/obesity in female adolescents in Kuwait and assess its association with breastfeeding during infancy.

Methods: This is a cross-sectional study that included 775 girls randomly selected from public and private high schools in Kuwait. The primary exposure …

Lessons Learned From Interdisciplinary Efforts To Combat Covid-19 Misinformation: Development Of Agile Integrative Methods From Behavioral Science, Data Science, And Implementation Science, Sahiti Myneni, Paula Cuccaro, Sarah Montgomery, Vivek Pakanati, Jinni Tang, Tavleen Singh, Olivia Dominguez, Trevor Cohen, Belinda Reininger, Lara S Savas, Maria E Fernandez

Faculty, Staff and Student Publications

BACKGROUND: Despite increasing awareness about and advances in addressing social media misinformation, the free flow of false COVID-19 information has continued, affecting individuals' preventive behaviors, including masking, testing, and vaccine uptake.

OBJECTIVE: In this paper, we describe our multidisciplinary efforts with a specific focus on methods to (1) gather community needs, (2) develop interventions, and (3) conduct large-scale agile and rapid community assessments to examine and combat COVID-19 misinformation.

METHODS: We used the Intervention Mapping framework to perform community needs assessment and develop theory-informed interventions. To supplement these rapid and responsive efforts through large-scale online social listening, we developed a …

Empowering Low-Income Women With Breast Cancer: Promoting Acupuncture At Community Health Fairs, Katrina Ramos

Nursing | Student Research Posters

No abstract provided.