Digital Commons Network^™

Exploring Methods To Increase Hiv Testing In Kentucky, Chukwudi Yagazie Mbagwu

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

This project was conducted to develop a policy proposal that would increase HIV testing after evaluating current Kentucky Law and Regulations, current health insurance laws, studies on acceptability of different HIV test, barriers to testing from both providers and patients/individuals, and factors associated with positive likelihood of HIV testing. Based on these findings a proposal was developed that would require changing Kentucky regulations on providers communicating test results to patients, change in what form HIV testing would be covered under certain insurances, develop incentives for patients to be tested and report their results to their provider (and hence increasing surveillance …

Improving Access To Clean Water In Rural Ecuador: The Connection Between Willingness To Pay And Population Health, Micalea Leaska

Capstone Collection

Climate change is affecting social and environmental determinants of health through access to safe drinking water, safely managed sanitation systems, and access to health care services and the ability for individuals to break free from unsuitable circumstances. Ecological disturbances such as those caused by climate change can cause a shift in host vectors or a change in habitat that results in a greater likelihood of the pathogen coming in contact with humans. Water, sanitation, and hygiene (WASH) services and their accessibility to populations can directly impact a community’s vulnerability to diseases and limiting factors to increase economic growth. If rural …

Health Risk Tolerance As A Key Determinant Of (Un)Willingness To Behavior Change: Conceptualization And Scale Development, Hyoyeun Jun, Yan Jin

International Crisis and Risk Communication Conference

After the study of testing determinants of risk tolerance affecting information sharing, this study was conducted as a second step to actually develop the scale for risk tolerance. Firstly, this study followed qualitative steps, such as in-depth interview and focus group, to capture how public describes the situation when they are tolerating the risk, when they knew what the recommended behavior is to relieve the risk. Secondly, this study collected 1000 U.S. public sample for the survey questionnaire that are the items generated from the qualitative steps.

Strategies To Increase Human Immunodeficiency Virus Testing In Rural Areas Of The United States: A Systematic Review, Avery Petrucci, Kristen Custer, Eric C. Nemec

Physician Assistant Studies Student Publications

Purpose: HIV incidence continues to increase, with a large portion of new diagnoses found in rural areas of the United States. The worsening statistics in rural areas may be attributed to stigma alone and contribute to the lack of testing available for patients. The objective of this systematic review is to identify accessible and feasible strategies to increase HIV testing within the rural communities in the United States. Methods: A systematic literature search of CINAHL Complete, MEDLINE with Full Text, and PsycINFO with restrictions of the English language and rural communities outside of the United States through August 2, 2018. …

Predictors Of Incomplete Evaluation Among Pediatric Household Contacts Of Pulmonary Tuberculosis Patients In Kampala, Uganda: A Secondary Analysis, Giyoung Lee

Public Health Theses

Background: Contact investigation is an active approach to identifying new TB cases by screening contacts of known patients for symptoms and risk factors. This is particularly important for child contacts of TB patients because young children are at higher risk of progressing to severe disease compared to adults. Moreover, children are unable or unlikely to travel to clinics for evaluation independently, so their access to TB evaluation may depend on the adults in their household.

Objective: To evaluate the association between individual- and household-level characteristics and completion of TB evaluation for children under 15 years.

Setting: Seven public tuberculosis (TB) …

Evaluating Clostridioides Difficile Infection (Cdi) Risk Factors By Comparing The Use Of Piperacillin/Tazobactam, Cefepime, And Ceftazidime, Shardul Rathod

Public Health Theses

Introduction: Over the past several years, Clostridioides difficile infection (CDI) incidence has been rising. The primary risk factor for CDI is antibiotic use. Many studies indicate that penicillin drugs are among the low-risk antibiotic classes associated with CDI whereas cephalosporin drugs are among the high-risk antibiotic classes. However, there is variation in studies evaluating the healthcare-associated CDI (HA-CDI) risk associated with antibiotics within a class and limited data comparing the use of penicillin versus cephalosporin drugs.

Methods: An observational cohort study was performed using patient data from BH and YNHH. Minitab (Version 18) was used to perform survival analysis and …

Single-Cell Transcriptomics In The Protozoan Parasite Trypanosoma Brucei During Acquisition Of Infectivity, Trisha Kaye Ramsdell

Public Health Theses

Single cell RNA-sequencing (scRNA-seq) is a recent innovation that allows sequencing of transcriptomes from a vast number of single cells, thus providing an unbiased view of cell-to-cell variability in gene expression within a population of cells. The Tschudi laboratory has previously established an in vitro differentiation system based on the inducible expression of the RNA-binding protein 6 (RBP6) in cultured non-infective procyclics, which recapitulates Trypanosoma brucei developmental stages that have been previously described in tsetse fly vector. Thus, I aimed to utilize scRNA-seq in this system to describe the potential heterogeneity in transcript abundance of known and suspected T. brucei …

Retrospective Policy Analysis Of Kentucky House Bill 1, Sarah E. B. Covey

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

Background: In 2011, the Centers for Disease Control (CDC) coined the phrase, “opioid epidemic” in response to the staggering increase in opioid use and opioid- related deaths. Kentucky House Bill 1 (HB1) passed in 2012, attempted to stifle the impact of the opioid epidemic on the citizens of the Commonwealth by imposing supply-side restrictions on the prescription and dispensing of opioid pills. Objective: The primary objective of this analysis is to evaluate the effectiveness of HB1 on the reduction of opioid-related deaths, opioid prescription rates, and intravenous opioid drug use rates. Methods: This analysis employed Eugene Bardach’s framework for policy …

A Cross Sectional Study Of Drinking Water Quality And Health Effects In The El Bua Tsáchila Community, Santo Domingo De Los Tsáchilas, Ecuador, Dannette Cook

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

Background: Access to clean water and sanitation is known to decrease childhood mortality, improve health outcomes, and decrease risk of water-borne diseases. However, access to clean water is often restricted in impoverished or indigenous communities. This cross-sectional study evaluated the primary source of drinking water for forty homes, the Est. Cheche river, a local spring, and a local school in the TsáChila indigenous community of El Bua, Santo Domingo, Ecuador. This analysis focused on the presence of coliforms and E. coli in the water source (well or city/piped), the physical parameters of the water and the type of sanitation …

Evaluation By Geospatial And Spatiotemporal Distribution Of Tularemia Cases In Arkansas, Toni Kathleen Beavers

Walden Dissertations and Doctoral Studies

Tularemia is a vector-borne disease of global concern with diverse regional foci. Arkansas is an endemic state with differences in case distribution and land suitability supporting host and vector sustainment. The aim of this study was to conduct a geospatial and spatiotemporal assessment of factors associated with case distribution and timeliness and completeness of public reporting. Guided with direction from spatial epidemiology and nidality, referring to the association of ecology, climate, and proximity of disease, analysis included secondary data collected from the Arkansas Department of Health between 1995 and 2018. Using Poisson-based software, 2 clusters were found: a high-risk cluster …

New Epidemic Needs New Epidemiologic Thinking, Shirley Joann Smart, Aurela N. Nikaj, Carlene Robinson, Kadiatou Diallo, Sylvia Ofori, Neil Mistry, Jian Zhang

Eagles Talking About the Public’s Health

No abstract provided.

Beta-Lactam Plus Macrolide Vs Fluoroquinolone For Empiric Therapy Of Hospitalized Patients With Cap: Results From The University Of Louisville Pneumonia Study, Vidyulata Salunkhe, Stephen P. Furmanek, Forest W. Arnold

The University of Louisville Journal of Respiratory Infections

Background

Current guidelines recommend a β-lactam plus a macrolide or fluoroquinolone monotherapy as initial empiric antibiotic therapy for treatment of patients hospitalized with community-acquired pneumonia (CAP). Multiple studies have shown different results comparing the two regimens for the treatment of CAP. Our objective, in a city-wide prospective study, was to compare outcomes among hospitalized patients with CAP who received empiric treatment either with a β-lactam plus a macrolide or fluoroquinolone monotherapy.

Methods

This was a propensity score matched case-control study of the University of Louisville Pneumonia Study. It was a prospective population-based cohort study of all hospitalized adults with CAP. …

Playing To Live: Outcome Evaluation Of A Community-Based Psychosocial Expressive Arts Program For Children During The Liberian Ebola Epidemic, Caroline A. Decosimo, J. Hanson, Megan Quinn, P. Badu, E. G. Smith

ETSU Faculty Works

Background. This paper reviews the efficacy of a community psychosocial arts program focused on building mental health capacity within post-Ebola Liberia. The aim of this paper was to evaluate the outcome effects of two groups using pre- and post-treatment data. We hypothesized that there would be a difference in symptoms pre- and post-treatment, and the longer program would yield more significant results.

Methods. There was a total of 870 child participants. Of 40 sites, 24 were selected for a 5-month treatment (TG1) while the remaining 16 sites received 3 months of treatment (TG2). Paired t tests and a mixed-model analysis …

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 …

Assessing Medical Expenditure Disparities Among U.S. Adults With Hiv Or Cardiovascular Diseases, Lorraine Nnacheta

Walden Dissertations and Doctoral Studies

Older adults with infectious and chronic diseases, such as cardiovascular disease and human immunodeficiency virus (HIV), are at high risk for associated chronic comorbidities, which are associated with increased medical expenditures to cover treatment costs. The purpose of this study was to investigate (a) whether adults 65 or older with either HIV or cardiovascular disease were predisposed to increased medical expenditures versus adults 64 and younger, and (b) the impact of race and type of health service used on total direct medical expenditures incurred among adults with HIV or cardiovascular disease. A quantitative, deductive, retrospective cross-sectional design was used, and …

Assessment Of In-Service Training And Continuing Education (Ist/Ce) For Frontline Health Workers In Bauchi And Cross River States, Nigeria, Ekechi Okereke, Iliyasu Zubairu, Udoh Nsekpong, Godwin Unumeri, Ibrahim Suleiman, Aisha Jibril

Reproductive Health

Training contributes tremendously to the development and sustenance of health workers’ competencies for quality healthcare services. Although Nigeria has a higher stock of human resources for health compared to other African countries, the World Health Organization argues that its distribution is highly skewed toward urban areas. Building and maintaining staff capacities requires continuing professional development through in-service training (IST) and continuing education (CE). This study assesses current IST and CE for health workers in Bauchi and Cross River states to provide evidence to inform policy and planning and improve implementation of capacity-building for health workers in Nigeria.

Risk Mitigation For Travelers: Managing Endemic And Emerging Threats, Shannon M. Wood, David Brett-Major

Journal Articles: Epidemiology

International travel continues to increase in numbers and complexity. Despite the availability of pretravel health advice, travelers remain at risk for exposure to common organisms as well as emerging pathogens. With low rates of travel clinic utilization, it is important for the general practitioner to remain aware of the importance of travel health, risk factors unique to individual patients, and evolving threats. This review highlights important considerations when evaluating ill travelers, incorporating emerging infectious threats.

Water And Life. A Cross-Sectional Study On Determinants Of Beverage Consumption And Water Access In One Tribal Community, Christina White

All Master's Theses

Increasingly, poor diet has been shown to be one of the most crucial factors associated with cause of death, even more critical than smoking. Research in the past two decades has consistently linked increased consumption of sugar-sweetened beverages (SSB) to the obesity epidemic contributing to a public health crisis all over the United States. Native Americans, among other minority groups, suffer obesity disproportionately from the rest of the US population, yet they continually fail to be included in research on the subject. Traditional research methods, sparse care coverage on reservations, consolidation of unique tribes into one classification, and failure to …

The Effect Of Six-Month Aerobic Exercise And Health Education Program Intervention On Body Composition To Reduce Visceral Fat And Waist Circumference Among Army Male Officers At Support Office Armed Forces Development Command: Quasi-Experimental Study, Patchamol Masakul

Chulalongkorn University Theses and Dissertations (Chula ETD)

Overweight and obesity are global pandemics consistent to the annual checkup of the army in support units from 2016 to 2018 found that the problem of continuously increasing BMI over the standard values. The six-month aerobic exercise and health education program intervention on body composition to reduce Visceral Fat and Waist Circumference among army male officer might have positive effects to help resolve this problem. To evaluate the effects of six-month aerobic exercise and health education program intervention on body composition to reduce Visceral Fat and Waist Circumference among army male officers at Support Office Armed Forces Development Command. Total …

Cardiovascular Risk Factors Associated With Venous Thromboembolism, John Gregson, Stephen Kaptoge, Thomas Bolton, Lisa Pennells, Peter Willeit, Carlos J. Crespo, Multiple Additional Authors

OHSU-PSU School of Public Health Faculty Publications and Presentations

Importance It is uncertain to what extent established cardiovascular risk factors are associated with venous thromboembolism (VTE).

Objective To estimate the associations of major cardiovascular risk factors with VTE, ie, deep vein thrombosis and pulmonary embolism.

Design, Setting, and Participants This study included individual participant data mostly from essentially population-based cohort studies from the Emerging Risk Factors Collaboration (ERFC; 731 728 participants; 75 cohorts; years of baseline surveys, February 1960 to June 2008; latest date of follow-up, December 2015) and the UK Biobank (421 537 participants; years of baseline surveys, March 2006 to September 2010; latest date of follow-up, February …

Body Weight Self-Perceptions And Experiences Of Nigerian Women Immigrants, Fatimah Binta Ali

Walden Dissertations and Doctoral Studies

Low-income immigrants in the United States experience declining health with increasing length of stay in the country. Their declining health over time has been associated with increased smoking, obesity prevalence, and higher risk for developing diabetes and heart disease. How immigrants perceive their body weight and size, influenced by social interaction, culture, gender, and acculturation is also significant to healthy weight maintenance. Not knowing one's healthy weight could result in body weight misperception and resistance to attaining a healthy weight. The aim of this qualitative study, based on the social constructivist framework, was to understand Nigerian women immigrants' (NWI's) body …

Barriers To Utilization Of Malaria Preventive Measures In Rural Nigeria Among Pregnant Women, Olabosipo O. Oreyomi

Walden Dissertations and Doctoral Studies

Malaria is a mosquito transmitted tropical disease that accounts for more cases and deaths in Nigeria than in any other country worldwide. Globally malaria accounts for 300,000 deaths among young children and pregnant women annually. The promotion of the use of insecticide treated nets (ITNs) to reduce pregnant women's contact with mosquitoes has been the focus of malaria prevention efforts in Nigeria. However, the use of ITNs during pregnancy has been inexplicably low in Nigeria. A quantitative cross-sectional study was conducted to examine barriers to the utilization of ITNs among pregnant women in rural Nigeria. The social ecological model was …

Papanicolaou Test Status Among Inner-City Adolescent Girls In Accra, Ghana, Collins Kwesi Asamoa-Afriyie

Walden Dissertations and Doctoral Studies

Cervical cancer is an emerging public health problem in developing countries. Globally, it is the 3rd most common malignancy in women after breast and colorectal cancers and 4th most frequent cancer in women, with an estimated 570,000 new cases and 311,000 deaths in 2018. Cervical cancer screening in the developed countries is credited with the reductions in cervical cancer morbidity and mortality during the last 50 years. However, nearly 90% of cervical cancer deaths occur in less developed countries. Ghana has a cervical cancer rate of 26.4%. Further, it is the highest cancer incidence faced among women 25 to 44 …

Child Malnutrition In A Developing Country: A Persistent Challenge In Haiti, Jeanne M. Constant-Edma

Walden Dissertations and Doctoral Studies

Malnutrition is characterized by the insufficient intake of certain nutrients and the inability of the body to absorb or use these nutrients. This health problem continues to be a persistent challenge among children under 5 years of age in developing countries, including Haiti, despite food aid provided. The purpose of this study was to determine the association between dietary habits in children under 5 years of age in Haiti and their malnutrition status. Community organization theory was used to determine the association between determinants of health such as dietary habits, parents' knowledge and experience, cultural eating habits, socioeconomic status, and …

Evaluating The Consistency Of A Breathing Flow Recording Device Across Different Elastomeric Half-Mask Respirators, Samuel Jennings Munnis

Graduate Theses, Dissertations, and Problem Reports (ETD)

The National Institute of Occupational Safety and Health (NIOSH) is the organization in charge of approving respiratory devices in the United States, as permitted by 42 CFR Part 84. Standards that NIOSH uses to certify powered air-purifying respirators (PAPRs) are based on respiratory data collected before the 21^st century. With new technologies, it is possible to gain a more accurate understanding of breathing flow of healthcare workers (HCWs). A new portable breathing flow recording device developed by The S.E.A. Group was intended for use with a Sundström SR100 mask with a P100 filter. This study tests the device with …

Performance Study Of An Unconventional Breathresponse Papr Against A N95 Ffr And Conventional Paprs, Huihui Yang

Graduate Theses, Dissertations, and Problem Reports (ETD)

Healthcare workers (HCWs) are the first responders when infectious pathogens occur. Powered air-purifying respirators (PAPRs) are one of the most widely used personal protective equipment for healthcare workers. Currently, few studies have been performed with HCWs in the actual healthcare work environments to assess discomforts, acceptance and protective efficiency towards wearing and use of PAPRs. The main purpose of this dissertation was to introduce and assess a brand new unconventional PAPR (Koken breath-response PAPR). The protection performance and user preferance of this unconventional PAPR were studided and compared to that of a N95 FFR and traditional PAPRs.

Firstly, a laboratory …

Barriers To Using New Needles Encountered By Rural Appalachian People Who Inject Drugs: Implications For Needle Exchange, Stephen M. Davis, Alfgeir L. Kristjansson, Danielle Davidov, Keith Zullig, Adam Baus, Melanie Fisher

Faculty & Staff Scholarship

Background

Using a new needle for every injection can reduce the spread of infectious disease among people who inject drugs (PWID). No previous study has examined new needle use barriers among PWIDs residing in the rural Appalachian part of the United States, an area currently in the midst of a heroin epidemic.

Objective

Therefore, our primary aim was to explore self-reported barriers to using a new needle by PWID attending a needle exchange program (NEP).

Methods

We conducted a cross-sectional survey of PWID attending two NEPs in rural West Virginia located in the heart of Central Appalachia. A convenience sample …

Women's Occupational Health And Safety In The Informal Economy: Maternal Market Traders In Accra, Ghana, Joyceline Amoako

Dissertations and Theses @ UNI

Improving maternal health and women’s health is necessary, especially in countries with high maternal and child mortality rates. Most research on maternal health focuses on women’s reproductive health and, as a result, very little is known about the impact of occupation on maternal health (World Health Organization, 2006). It is also interesting to know that “Occupational Health Research” has been heavily criticized for the general absence of a gender standpoint, usually resulting in the exclusion of women and their concerns at the workplace (World Health Organization, 2006). In Ghana, an open-air market is an integral place of work for women. …

Analysis Of User Preference With N95 And Powered Air-Purifying Respirators In A Healthcare Work Environment, Brittany Renee Carver

Graduate Theses, Dissertations, and Problem Reports (ETD)

For those working in the healthcare field, personal protective equipment is vital. Healthcare workers are often first responders when it comes to dealing with patients who are infected or when a disease outbreak occurs. The Occupational Safety and Health Administration (OSHA) requires all healthcare operations to provide employee protection against blood borne pathogens. With the increase of life-threatening disease outbreaks, such as SARS in 2003 and Ebola in 2014, it is of the upmost importance to make sure respirators are best suited for users and acceptable for long term use. It has been shown through previous studies that due to …

Sawubona From Swaziland! A Global Health View Of The Hiv/Aids Epidemic In Swaziland, Abby Hardin

Posters

Describes a global health learning experience with Baylor International Pediatric AIDS Initiative in Swaziland.