Digital Commons Network^™

Association Between Age-Related Macular Degeneration And Sleep-Disordered Breathing, Jeffrey A. Nau

Walden Dissertations and Doctoral Studies

Age-related macular degeneration (AMD) is a chronic, irreversible disease that robs individuals of vision, quality of life, and independence. It is the leading cause of blindness in industrialized countries. Sleep-disordered breathing (SDB) is a condition characterized by repeated episodes of apnea and/or hypopnea, insomnia, short sleep duration, and/or sleep disturbances (snoring, gasping, etc.). Because SDB has been shown to cause chronic hypoxia resulting in oxidative stress on the retina, it has been proposed that SDB may be associated with AMD. Based on the life course theory of chronic disease, this quantitative, cross-sectional study used data from the 2005-2008 National Health …

Hassles Of African Americans With Type 2 Diabetes, Sharon H. Murff

Walden Dissertations and Doctoral Studies

There has been a steady increase in the incidence of diabetes in the United States. The purpose of this study was to determine whether there was a difference in the daily hassles of African American adults with a self-reported diagnosis of type 2 diabetes compared to those of African American adults without a self-reported diagnosis of type 2 diabetes. The theoretical underpinning for this quantitative, descriptive study was the cognitive appraisal theory (CAT), but the concept of stress and the effects stress has on the body was the broad framework that connected all the variables. The CAT was used to …

Predictors Of Uti Antibiotic Resistance For Female Medicaid Recipients In U.S. Ambulatory Care Settings, Wendy Denise Wiesehuegel

Walden Dissertations and Doctoral Studies

Urinary tract infections are diagnosed in female populations primarily in ambulatory care settings in the United States. Yet, published evidence documents that many of the antibiotics prescribed in these settings are unnecessary, erroneous, or, inappropriately prescribed. Improper management of uncomplicated urinary tract infections in nonpregnant women has resulted in higher morbidity rates due to antibiotic resistance. The purpose of this retrospective observational cohort study was to explore a current national database for associations between nonpregnant American female patients who were exposed to poverty and at risk for urinary tract infection antibiotic resistance in an ambulatory care setting. Krieger's ecosocial theory …

Impact Of Social Support Networks On Level Of Stress And Self-Esteem Among Canadian Immigrants, Jackie Williamson

Walden Dissertations and Doctoral Studies

Immigration may be an effective survival strategy for individuals from countries involved in war or political unrest.However, the immigration process may exacerbate a number of physical and psychological health symptoms. There are limited data on the health status of new Canadian immigrants, and some social support networks are not formally connected to settlement programs.The purpose of this cross-sectional quantitative study was to assess the level of stress and self-esteem of 400 recent and older immigrants in Canada, and to investigate the impact of social support networks on the mental well-being of recent immigrants.Cultural care and general adaptation theory provided the …

Barriers To Preventive Healthcare For Immigrants In Michigan, Sondos Ghazi Al-Hachim

Walden Dissertations and Doctoral Studies

The Affordable Care Act expanded insurance coverage to the general population; however, expanding insurance coverage to immigrants might not be sufficient to improve utilization of annual physical preventive exams. This study evaluated adult Michigan immigrants' individual demographics, perceptions, and behaviors, as well as the collective cultural and system characteristics that might act as barriers to the utilization of annual physical preventive exams. Ken Wilber's integral operating system model for medicine conceptual framework was used to create a comprehensive map of factors and bring more clarity and understanding to the barriers to annual physical preventive exam. The quantitative survey was the …

Factors Impacting Hiv Post Exposure Prophylaxis Among Health Care Workers, Ulunma Njemanze

Walden Dissertations and Doctoral Studies

Health care workers are at risk of contracting HIV as a result of occupational exposure while treating infected patients. HIV postexposure prophylaxis (PEP) is an effective antiretroviral treatment course used in preventing potential HIV infection following an accidental occupational exposure to HIV. The objective of this cross sectional study was to identify the factors that impact the practice of HIV PEP among health care workers at the National Hospital, Abuja, Nigeria. A cross-sectional survey using self-administered, structured questionnaires was conducted on 182 health care workers at the National Hospital comprising of medical doctors, nurses, and laboratory scientists. A chi-square test …

U.S. Young Adults Stds, Risk Perception, Risk Behaviors, And Health Information Seeking, Amanda Robison-Chadwell

Walden Dissertations and Doctoral Studies

Sexually transmitted diseases (STD) are preventable conditions for which treatment failure (specifically in gonorrhea) is becoming problematic. U.S. young adults (20-29 years) have high rates of STD incidence and prevention of these diseases, but reaching them to provide primary prevention educations is challenging due to low perceived susceptibility to infection and lack of knowledge about how young adults seek health information. The purpose of this quantitative survey study was to assess the association between perceived susceptibility to STDs, sexual risk behavior, and the acquisition of health information as it pertains to sexual health topics in young adults. The Health Belief …

The Experiences Of African American Women Participating In Church-Based Weight Loss Programs, Mangle L. Shanks

Walden Dissertations and Doctoral Studies

While obesity is a nationwide phenomenon, African Americans - especially women - continue to be more severely affected than any other ethnic group. According to the Centers for Disease Control and Prevention, over 20% of African American women are obese compared to 15.6% of Caucasian women. The church is an important community center for many African Americans, and is often a site for health promotion programs, though little is known of the effectiveness of these programs. The purpose of this qualitative study was to study the experiences and attitudes of African American women who have gone through a church-based weight-loss …

A Nested Environmental Approach To Typhoid Epidemiology In Central Division, Fiji, Aaron Jenkins

Theses: Doctorates and Masters

Many current disease threats involve interactions within and between nested subsystems of biological organisation. Typhoid fever is a serious disease threat in the South Pacific region, with Fiji reporting the highest annual number of cases, yet risk factors in this setting have been poorly studied. While localised behaviours have dominated perspectives on typhoid transmission, interactions between distal ecological conditions, conditions of the residential environment and localised behaviour deserve greater attention for their potential to influence transmission. This thesis demonstrates a nested approach to typhoid epidemiology using a fivefold methodology to explore how regional, river basin, residential, socio-cultural and behavioural subsystems …

Multigenic Dna Vaccine Induces Protective Cross-Reactive T Cell Responses Against Heterologous Influenza Virus In Nonhuman Primates, Merika T. Koday, Jolie A. Leonard, Paul Munson, Adriana Forero, Michael Koday, Debra L. Bratt, Karen Duus

College of Osteopathic Medicine (TUN) Publications and Research

Recent avian and swine-origin influenza virus outbreaks illustrate the ongoing threat of influenza pandemics. We investigated immunogenicity and protective efficacy of a multi-antigen (MA) universal influenza DNA vaccine consisting of HA, M2, and NP antigens in cynomolgus macaques. Following challenge with a heterologous pandemic H1N1 strain, vaccinated animals exhibited significantly lower viral loads and more rapid viral clearance when compared to unvaccinated controls. The MA DNA vaccine induced robust serum and mucosal antibody responses but these high antibody titers were not broadly neutralizing. In contrast, the vaccine induced broadly-reactive NP specific T cell responses that cross-reacted with the challenge virus …

Characterization Of Hiv Diversity, Phylodynamics And Drug Resistance In Washington, Dc., Marcos Pérez-Losada, Amanda D Castel, Brittany Lewis, Michael Kharfen, Charles P Cartwright, Bruce Huang, Taylor Maxwell, Alan E Greenberg, Keith A Crandall

Epidemiology Faculty Publications

No abstract provided.

Phase I Dose-Escalation Trial Of Intravaginal Curcumin In Women For Cervical Dysplasia, Leda Gattoc, Paula M. Frew, Shontell N. Thomas, Kirk A. Easley, Laura Ward, H-H Sherry Chow, Chiemi A. Ura, Lisa Flowers

Environmental & Global Health Faculty Research

Background: This is a Phase I trial demonstrating safety and tolerability of intravaginal curcumin for future use in women with cervical neoplasia. Objective: The objective of this study was to assess the safety, tolerability, and pharmacokinetics of intravaginal curcumin in healthy women. Study design: We conducted a 3+3 dose-escalation Phase I trial in a group of women aged 18–45 years. Thirteen subjects were given one of four doses of curcumin powder (500 mg, 1,000 mg, 1,500 mg, and 2,000 mg) packed in gelatin capsules, which was administered intravaginally daily for 14 days. The primary end point for this study was …

Geographical Incidence Of Antimicrobial Resistant Gonorrhea, Christofer A. Rodriguez

Master's Projects and Capstones

Evolving throughout the last century, Gonorrhea has become a superbug, becoming difficult to treat. As the second most commonly reported notifiable disease, gonorrhea rates have been increasing, despite efforts in prevention and treatment. Populations at risk are mainly MSM and FSW. In 2015, men’s gonorrhea rates in the United States were higher compared to women, at 140.9 and 107.2 per 100,000 population, respectively. Illinois has consecutively had higher rates of infection compared to the US, at 133.5 per 100,000 population compared to the US rate of 123.9 per 100,000 population. The surveillance of gonococcal isolate resistance to current antimicrobials began …

Barriers To Pediatric Triage Guideline Compliance: A Survey Of Nebraska Emergency Departments, Jonathon J. Gruba

Theses & Dissertations

Nebraska emergency departments may be underprepared for a mass casualty event involving a large number of children, as indicated by the results from the 2013 Emergency Medical Services for Children’s (EMSC) Pediatric Readiness Project (PRP) report. This was primarily evident by the lack of existence of a pediatric triage policy among Nebraska emergency departments. Utilizing a survey, this study attempted to identify the emergency departments in Nebraska that followed the EMSC guideline of having a pediatric triage policy, as well as to identify possible barriers to guideline adherence among those that did not have the policy.

It was found that …

Qualitative Health Research Involving Indigenous Peoples: Culturally Appropriate Data Collection Methods, Amy L. Wright, Olive Wahoush, Marilyn Ballantyne, Chelsea Gabel, Susan M. Jack

The Qualitative Report

Historically, health research involving Indigenous peoples has been fraught with problems, including researchers not addressing Indigenous research priorities and then subsequently often failing to utilize culturally appropriate methods. Given this historical precedence, some Indigenous populations may be reluctant to participate in research projects. In response to these concerns, the Government of Canada has developed the Tri-Council Policy Statement (TCPS2): Research Involving the First Nations, Inuit and Métis Peoples of Canada, which stipulates the requirements for research collaborations with Indigenous communities. Utilizing this policy as an ethical standard for research practices, this paper describes, critiques and synthesizes the literature on culturally …

Cause For Question: Risk And Postmodern Panic In The Vaccine Safety Debate, Marygrace Trifilio

Theses and Dissertations

This thesis analyzes the thoughts and feelings of non-vaccinating parents in America and argues that contemporary vaccine refusal results from overwhelming information saturation in the Internet age. Non-vaccinating parents express distrust of competing scientific research and call for a return to a more natural, toxin-free lifestyle.

Epidemiology Of White Spot Syndrome Virus In The Daggerblade Grass Shrimp (Palaemonetes Pugio) And The Gulf Sand Fiddler Crab (Uca Panacea), Muhammad

Dissertations

Ever since the first outbreaks of White spot syndrome virus (WSSV), which causes White Spot Disease (WSD), in Asia in the early 1990s, the pathogen has been a major constraint to the profitability of the shrimp aquaculture industry across the globe. WSSV has a broad host range and is routinely detected in wild decapod crustaceans. In the present study, two common species in the tidal salt marsh along the northern coast of the Gulf of Mexico, the daggerblade grass shrimp (Palaemonetes pugio) and the Gulf sand fiddler crab (Uca panacea), were investigated for their role as …

Pertussis-Associated Pneumonia In Infants And Children From Low- And Middle-Income Countries Participating In The Perch Study., Breanna Barger-Kamate, Maria Deloria Knoll, E Wangeci Kagucia, Christine Prosperi, Henry C Baggett, Daniel E. Park, +31 Additional Authors

Epidemiology Faculty Publications

BACKGROUND:  Few data exist describing pertussis epidemiology among infants and children in low- and middle-income countries to guide preventive strategies.

METHODS:  Children 1-59 months of age hospitalized with World Health Organization-defined severe or very severe pneumonia in 7 African and Asian countries and similarly aged community controls were enrolled in the Pneumonia Etiology Research for Child Health study. They underwent a standardized clinical evaluation and provided nasopharyngeal and oropharyngeal swabs and induced sputum (cases only) for Bordetella pertussis polymerase chain reaction. Risk factors and pertussis-associated clinical findings were identified.

RESULTS:  Bordetella pertussis was detected in 53 of 4200 (1.3%) cases …

Analysis Of Hiv Diversity In Hiv-Infected Black Men Who Have Sex With Men (Hptn 061), Iris Chen, Gordon Chau, Jing Wang, William Clarke, Mark A. Marzinke, Manya Magnus, +14 Additional Authors

Epidemiology Faculty Publications

Background

HIV populations often diversify in response to selective pressures, such as the immune response and antiretroviral drug use. We analyzed HIV diversity in Black men who have sex with men who were enrolled in the HIV Prevention Trials Network 061 study.

Methods

A high resolution melting (HRM) diversity assay was used to measure diversity in six regions of the HIV genome: two in gag, one in pol, and three in env. HIV diversity was analyzed for 146 men who were HIV infected at study enrollment, including three with acute infection and 13 with recent infection (identified …

Cost Of Care For Hospitalized Patients With Pulmonary Mycobacterial Diseases In The United States., Mary Beth Wells Allen

Electronic Theses and Dissertations

Background: Pulmonary mycobacterial diseases describe both tuberculosis (TB) and nontuberculous mycobacteria (NTM). Few data are available measuring the cost burden of mycobacterial diseases on the national level. The purpose of this study was to evaluate the cost burden and measure emerging trends in hospitalization of pulmonary TB and NTM in the US from 2001 through 2012. Methods: This study was a retrospective community based cost analysis of hospitalized patients with a principal diagnosis of pulmonary mycobacterial diseases from 2001 through 2012. Data for pulmonary TB and NTM were retrieved from the Healthcare Cost and Utilization Project (HCUP), US Department of …

Interventions To Increase Vaccination Rates In Homeless Adults Aged 50 Years And Older In A Shelter-Based Clinic, Rubeena Smith

Doctor of Nursing Practice

Pronounced disparities in adult immunizations exist across the country. In homeless adults over 50 years of age with chronic diseases, coverage rates for influenza and pneumococcal vaccinations falls at 30% as compared to the 60% coverage rate found in the general public. Hepatitis B immunization rates are also significantly lower in the elderly homeless population. Increased prevalence of chronic diseases in the elderly homeless shelter residents’ increase their risk for severe complications following influenza, hepatitis B and meningococcal infections. To prevent disease epidemics and further disability in the homeless population, the need for appropriate and timely vaccinations is critical. Attitudes …

The Relationship Between Pediatric Asthma And Obesity In Nevada, Jennifer Anne Lucas

UNLV Theses, Dissertations, Professional Papers, and Capstones

Asthma and obesity are two of the most common comorbid health problems in the U.S. Currently nearly 8% of Nevada youth are affected by asthma and more than 30% are overweight or obese. Obesity is a risk factor for asthma, yet asthma-related factors such as decreased physical activity and use of oral corticosteroids for asthma control can lead to obesity. This study examined the relationship between asthma and obesity in two pediatric populations in Nevada. It was hypothesized that children with asthma and elevated BMI would have more severe asthma symptoms, decreased lung function, poorer quality-of-life measures, and different atopic …

Real Talk: Developing A Computer-Delivered Sexual Health Program For Black Men Who Have Sex With Men, Charles H. Klein, Carmela Lomonaco

Anthropology Faculty Publications and Presentations

HIV disproportionately affects Black men who have sex with men (MSM), yet there are few evidence-based programs that respond to the diverse realities of Black MSM communities. This article examines the development of Real Talk, a new harm reduction-based, sexual health intervention for Black MSM. We first analyze the key themes from our formative research: (1) stigma, discrimination, and intersectionalities in the lives of Black MSM, (2) the importance of safe spaces and community provided by health promotion programs, and (3) moving beyond condoms in sexual health messaging. We then describe our agile design product development process and present an …

Indoor Tobacco Legislation Is Associated With Fewer Emergency Department Visits For Asthma Exacerbation In Children., Christina E. Ciaccio, Tami Gurley-Calvez, Theresa I. Shireman

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: During the past 3 decades, numerous cities and states have adopted laws that ban smoking in public indoor spaces. The rationale for these policies has been to protect nonsmokers from the adverse health effects of secondhand smoke.

OBJECTIVE: To determine whether the implementation of indoor smoking legislation is associated with a decrease in emergency department visits for asthma in children.

METHODS: This retrospective analysis used a natural experiment to estimate the impact of clean indoor air legislation on the rate of emergency department admissions for asthma exacerbation in children. Data were obtained from the Pediatric Health Information System. A …

Update From The Advisory Committee On Immunization Practices., Jennifer E. Schuster, Sean O'Leary, David W. Kimberlin

Manuscripts, Articles, Book Chapters and Other Papers

The Advisory Committee on Immunization Practices (ACIP) consists of medical and public health experts who develop recommendations on vaccine use in the United States. The ACIP meets 3 times per year, and members and Centers for Disease Control (CDC) staff present findings and discuss vaccine research, vaccine effectiveness (VE) and safety, clinical trial results, and labeling/package insert information. Outbreaks of vaccine-preventable diseases and vaccine shortages are also discussed. Nonvoting representatives from the American Academy of Pediatrics and the Pediatric Infectious Diseases Society are present. The ACIP met on June 22-23, 2016 to discuss proposed recommendations for influenza vaccination, for human …

Quality Of Care Assessment At A Resident-Based Primary Care Hiv Clinic, Amanda Lacue, Marshall Miller, Md

CwiC Posters

A quality improvement study based in a primary care resident-based HIV clinic, the Kendig Clinic, was conducted within Jefferson Family Medicine Associates. The study objectives were to

• Determine the percentage of the clinic patients meeting each quality measure

• Compare these calculated clinic measures to known national averages

• Use the data to determine areas to target for future quality improvement initiatives.

Indeks Massa Tubuh Dan Waktu Terjadinya Konversi Sputum Pada Pasien Tuberkulosis Paru Bta Positif Di Rsup Persahabatan Tahun 2012, Tika Dwi Tama

Jurnal Epidemiologi Kesehatan Indonesia

Lebih dari 50% pasien tuberkulosis memiliki indeks massa tubuh (IMT) yang rendah. Rendahnya IMT dapat memperburuk respon pengobatan dan memperbesar risiko gagal pengobatan. Studi kohort retrospektif ini dilakukan untuk mengetahui hubungan IMT dengan konversi sputum pada pasien tuberkulosis paru BTA positif. Studi dilakukan pada Desember 2013- Januari 2014 di poli paru RSUP Persahabatan dengan jumlah sampel sebanyak 120 pasien (60 pasien dengan IMT < 18,5 kg/m2 dan 60 pasien dengan IMT >18,5 kg/m2 ). Sampel diambil secara konsekutif. Probabilitas kumulatif gagal konversi pada pasien tuberkulosis paru BTA positif adalah 17% dan 9,2% pasien mengalami gagal konversi. Pasien tuberkulosis paru BTA positif dengan IMT < 18,5 kg/m2 (24,4%) memiliki probabilitas kumulatif gagal konversi yang lebih besar dibanding pasien dengan IMT > 18,5 kg/m2 (9,3%). Pada pasien …

Hepatitis C Screening In The Homeless Population Of Philadelphia, Adam Zimilover

CwiC Posters

Hepatitis C is a viral infectious disease that is a major cause of liver disease around the world. By the 1970s, it was recognized that many hepatitis cases were not due to the known hepatitis A or hepatitis B viruses. It was not until 1989 when the virus, then known as non--‐A, non--‐B hepatitis, was identified as a new distinct virus, hepatitis C. The virus has seven major genotypes, with genotype 1 causing about 75% of cases in the United States. By 1990, a screening test for the virus was developed, and within a year, the first treatment for the …

Faktor-Faktor Yang Berhubungan Dengan Perilaku Perawatan Diri Eks-Penderita Kusta Di Unit Pelaksana Teknis Rehabilitasi Sosial Eks-Penderita Kusta Nganget, Tuban, Jawa Timur, Erni Astutik, Nuning Maria Kiptiyah

Jurnal Epidemiologi Kesehatan Indonesia

Kusta adalah penyakit kronis, disebabkan oleh Mycobacterium leprae dan menyebabkan cacat jika tidak dilakukan perawatan diri. Kabupaten Tuban merupakan daerah di Jawa Timur dengan kasus kusta dan cacat tingkat 2 yang tinggi. Tujuan penelitian ini adalah untuk mengetahui gambaran dan faktor-faktor yang berhubungan dengan perilaku perawatan diri eks penderita kusta yang tinggal di Unit Pelaksana Teknis Rehabilitasi Sosial Eks-Penderita Kusta Nganget, Tuban. Penelitian ini menggunakan desain cross-sectional. Populasinya adalah seluruh eks-penderita kusta di Unit Pelaksana Teknis Rehabilitasi Sosial Eks-Penderita Kusta Nganget dan semuanya diikutkan dalam penelitian sebagai sampel. Pengambilan data dilakukan pada 14-17 Desember, 2011. Hasil menunjukkan bahwa umur rata-rata …

The Impact Of Digital Technology On Health Of Populations Affected By Humanitarian Crises: Recent Innovations And Current Gaps, Sandra Mesmar, Reem Talhouk, Chaza Akik, Patrick Olivier, Imad H. Elhajj, Shady Elbassuoni, Sarah Armoush, Joumana Kalot, Madeline Balaam, Aline Germani, Hala Ghattas Ph.D.

Faculty Publications

Digital technology is increasingly used in humanitarian action and promises to improve the health and social well-being of populations affected by both acute and protracted crises. We set out to (1) review the current landscape of digital technologies used by humanitarian actors and affected populations, (2) examine their impact on health and well-being of affected populations, and (3) consider the opportunities for and challenges faced by users of these technologies. Through a systematic search of academic databases and reports,weidentified 50digital technologies used by humanitarian actors, and/or populations affected by crises. We organized them according to the stage of the humanitarian …