Digital Commons Network^™

Can Environmental Law Solve The "Forever Chemical" Problem?, Mark P. Nevitt, Robert V. Percival

Faculty Articles

Although federal environmental law purports to provide the public with comprehensive protection against chemical risks, the U.S. chemical industry is characterized by self­ regulation. This self-regulation is exemplified by the dangers posed by per- and polyfluoroalkyl substances (''PFAS'')­ broad classes of persistent toxic substances that have now entered nearly every American's bloodstream and hundreds of public drinking water systems. Despite data linking exposure to these "forever chemicals" to cancer, infertility, and a host of other public health harms, environmental law has failed to safeguard the American people from PFAS' toxic legacy. How did this occur? And what should be done …

Coping, Affirmation, Resilience, And Empowerment (Care) Program And Its Impact On Depression And Quality Of Life Among Youth Living With Depression In Banjarmasin City, Indonesia : A Mixed-Method Study, Lafi Munira

Chulalongkorn University Theses and Dissertations (Chula ETD)

Background: The national prevalence of depression among young adults in Indonesia was 29.3% for moderate and 8.0% for severe depression. There are few intervention studies on coping skills training and group cognitive therapy through internet-based intervention for youth living with depression in Indonesia. Objectives: 1) To explore participants’ perception, experience, and cope with depression before and after CARE Program; 2) To investigate effects CARE Program on depression and quality of life among youth living with depression in Banjarmasin City, Indonesia. Method: This study used a convergent parallel mixed method. A qualitative and quasi experimental with two groups pre-post tests among …

Factors Associated With The Utilization Of Preventive Dental Treatments Among Elderly Patients In Faculty Of Dentistry, Chulalongkorn University: A Secondary Data Analysis, Weerachon Panthueng

Chulalongkorn University Theses and Dissertations (Chula ETD)

Objective: This study aimed to explore the potential factors associated with utilization of preventive dentistry among elderly patients attending a university dental hospital in Thailand. Materials and methods: The research design of this study was a cross-sectional study. This study used secondary data from a cross-sectional study from undergraduate project, conducted completely during July 2021- January 2022 for independent data and dependent variable from dental hospital resource system. The participants were 363 elderly patients who were both males and females in Faculty of Dentistry Chulalongkorn University. Descriptive statistics, chi-square test, and binary logistic regression were performed to analyze the data. …

Factors Associated With The Dental Attendance Among Elderly Patients In Faculty Of Dentistry, Chulalongkorn University: A Secondary Data Analysis, Narongrit Nampikul

Chulalongkorn University Theses and Dissertations (Chula ETD)

Objective: To identify the predisposing factors, enabling factors, and need factors related to dental attendance of elderly patients at dental hospitals, Faculty of Dentistry, Chulalongkorn University using the conceptual framework of the Anderson model. Materials and methods: this study was a secondary analysis study. The participants were 402 elderly patients who were both males and females. Data was collected from telephone questionnaires and dental records of dental hospitals. Faculty of Dentistry Chulalongkorn University. Data were analyzed using chi-square statistics and binary logistic regression analysis. Results: age was the only predisposing factor that was statistically significantly associated with dental attendance among …

Dental Health Expenditure And Associated Factors Among Elderly Patients In Faculty Of Dentistry, Chulalaongkorn University, Rawitsara Suwannimit

Chulalongkorn University Theses and Dissertations (Chula ETD)

The affordability has been one of the barriers to access dental care for elderly. However, In Thailand and among the elderly, there were very few studies about dental health expenditure and the factors related to it. This study aimed to investigate and identify the factors that are related to dental health expenditure for patients who are over 60 years old and receive treatment at the Faculty of Dentistry, Chulalongkorn University. This study used secondary data from an initial survey and the Medical Record System for oral treatments, among the patients who were over 60 years and received treatments at the …

The Utilization Of Physical Literacy To Understand Physical Activity In Individuals With A History Of Anterior Cruciate Ligament Reconstruction, Rachel Renee Kleis

Theses and Dissertations--Rehabilitation Sciences

Injury to the anterior cruciate ligament (ACL) is common in physically active populations. Anterior cruciate ligament reconstruction (ACLR) is commonly performed after injury in order to restore joint stability and knee function and return patients to desired levels of physical activity. However, not everyone will return to their pre-injury levels of sport after surgery and recent evidence reveals that individuals with a history of ACLR are less likely to meet the recommended physical activity guidelines. Specifically, previous literature has reported that individuals with a history of ACLR take fewer daily steps and participate in less moderate-to-vigorous physical activity compared to …

Implementation Of Physical Activity In Kentucky Public Schools: From Theory To Policy, Nancy Kearns

Theses and Dissertations--Rehabilitation Sciences

Physical activity in schools improves academic performance and fitness measures in children. However, state policy supporting implementation of physical activity remains poor. Identifying specific barriers to implementing physical activity minutes in Kentucky public schools is pivotal in preserving the cognitive and physical health of our children. This is of particular interest as physical activity minutes remain low despite the positive effects of exercise on cognition. The purpose of this dissertation is to provide policymakers and school administrators a method of identifying current policies, attitudes and infrastructure that inhibit the implementation of physical activity minutes in public schools. Thus, the findings, …

Childhood Obesity Interventions In The Republic Of Trinidad And Tobago: A Qualitative Study Exploring Government Policies And Their Implementation By Health Practitioners, Phyllis Woolford

Dissertations

Because of the rising prevalence of childhood obesity and overweight in the Republic of Trinidad and Tobago, and the observation that efforts to address the problem were showing disappointing results, this study seeks to explore the experiences and views of policymakers, health practitioners, and parents of overweight and obese children, in order to inform leaders and policy makers regarding the current interventions.

Method

A qualitative research case study methodology is the research design used, which, with my research questions, I considered would best uncover knowledge and provide perspectives that would provide an increased understanding of the issues arising from the …

Stemming The Shadow Pandemic: Integrating Sociolegal Services In Contact Tracing And Beyond, Medha D. Makhlouf

Faculty Scholarly Works

The COVID-19 pandemic has shed light on the challenges of complying with public health guidance to isolate or quarantine without access to adequate income, housing, food, and other resources. When people cannot safely isolate or quarantine during an outbreak of infectious disease, a critical public health strategy fails. This article proposes integrating sociolegal needs screening and services into contact tracing as a way to mitigate public health harms and pandemic-related health inequities.

Project Spraoi: The Implementation And Outcomes Of A Process Evaluation Of A School-Based Health Promotion Intervention, Yvonne Larrissa O’Byrne

Theses

Large multi-site school-based interventions are challenging to implement and difficult to evaluate due to the complex adaptive nature of schools as a research setting. This study focused on implementing a comprehensive process evaluation of a multicomponent primary school-based health promotion called Project Spraoi (PS), alongside intervention delivery, to aid the translation of outcomes and understand the moderating role of contextual factors on intervention delivery. PS is led by a physical activity (PA) specialist known as an Energizer and aims to improve children’s PA levels and reduce sedentary time by delivering 20 minutes extra daily moderate to vigorous PA (MVPA) during …

Healing Sanctuary, Kammy Downs

Master's Theses or Doctor of Nursing Practice

The natural world has hidden wisdom and resources that are disregarded as we misuse our responsibility to care for them. The benefits of being in tune with nature have been traded for a culture that manipulates nature on the altar of expediency, waste, and unquenchable desire. Healing Sanctuary presents a duality. My work speaks about the relationship between the seen and unseen, represented by ten larger-than-life drawings of medicinal herbal plants that have had a profound physical healing effect on me. At the same time, plants, roots, and seeds create visceral metaphors for mental health. Our accomplishments, outlook on life, …

Disparities In Uptake Of The Primary Sars-Cov-2 Vaccine Series In A Southern Indiana Vaccine Clinic, Cassidy Padgett

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

Objective: COVID-19 is a potentially severe respiratory disease caused by infection from the SARS-CoV-2 virus. COVID-19 was first discovered in 2019 and vaccines against the virus began development in early 2020. COVID-19 vaccines are effective at preventing severe illness, hospitalizations, and death from SARS-CoV-2 infection. Clark Memorial Health is a 236-bed community health system located in southern Indiana. As one of the first four hospitals in the state of Indiana to receive the Pfizer-BioNTech’s COVID-19 vaccine in December of 2020, this health system led the area in vaccine administration. Prior to the emergency use authorization (EUA) of the COVID-19 vaccines, …

Implementation Of Farmers Markets In Bell County, Kentucky, Rachael Schmetzer

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

This proposal addresses the link between food insecurity and obesity through the implementation of farmers markets in Bell County, Kentucky as a way to increase access and consumption of fruits and vegetables in this rural, low-income community.

Increasing Physical Activity Rates Among High School Girls In Jefferson County, Kentucky, Haley Copeland

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

Obesity rates across the U.S. are increasing, especially among adolescent females. Physical activity rates have been associated with obesity and many related health outcomes. Regular physical activity can help adolescents improve their cardiorespiratory fitness, build strong bones, control their weight, and reduce depression ¹. It can also help reduce the risk of developing health conditions like heart disease, cancer, high blood pressure, osteoporosis, type II diabetes, and obesity ¹. Thus, physical activity among youth provides a risk factor to target, with the intention of eventually decreasing obesity rates.

Recommended physical education class CDC guidelines are not being met …

Frequency And Type Of Diabetes Screening Tests In A Sample Of Women With Polycystic Ovarian Syndrome: A Descriptive Study, Jacklyn Vollmer

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

Introduction: Polycystic ovarian syndrome (PCOS) is a hormonal disorder that affects 6-12% of United States women of reproductive age. Women with PCOS are at an increased risk of developing type 2 diabetes and fall into high-risk groups for screening guidelines put out by the American College of Obstetricians and Gynecologists (ACOG). Guidelines further suggest that an oral glucose tolerance test (OGTT) be used for diabetes screening in women with PCOS as opposed to an A1C or fasting plasma glucose test. The purpose of this study is to examine rates and type of diabetes screening used among a sample of women …

An Analysis Of The Association Between Cognitive Decline And Geographic Residence Among Women Over 65 In The Southeastern United States, Christine Invergo

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

Abstract

Introduction: The United States is an increasingly aging nation, and aging increases the risk of cognitive decline. Information on the relationship between cognitive decline and geographic residence in the U.S. is limited. Available evidence suggests that rural residents tend to suffer persistent disadvantages in cognitive functioning when compared to sociodemographically similar urban peers. This analysis focused on women over 65 years of age living in the southeastern U.S. The primary objective of this analysis was to determine if there was a significant association between geographic residence and cognitive decline. A secondary objective was to explore variables of interest that …

An Analysis Of The Association Between Cognitive Decline And Geographic Residence Among Women Over 65 In The Southeastern United States, Christine Invergo

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

Abstract

Introduction: The United States is an increasingly aging nation, and aging increases the risk of cognitive decline. Information on the relationship between cognitive decline and geographic residence in the U.S. is limited. Available evidence suggests that rural residents tend to suffer persistent disadvantages in cognitive functioning when compared to sociodemographically similar urban peers. This analysis focused on women over 65 years of age living in the southeastern U.S. The primary objective of this analysis was to determine if there was a significant association between geographic residence and cognitive decline. A secondary objective was to explore variables of interest that …

Policy Approaches To Address Childhood Obesity, Omoadoni Roseline Obielodan

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

Background: Childhood obesity continues to be a serious international public health concern. Unfortunately, there are limited treatment options for obesity. One notable intervention option is the University of Kentucky (UK) Pediatric high BMI clinic intervention for childhood obesity. The Clinic provides intervention for childhood obesity through healthy lifestyle habits. This intervention has been reported to be effective.

Even though there is evidence that public health policies that promote healthy behaviors would substantially reduce and prevent the alarming prevalence of childhood obesity, the state of Kentucky does not have well-established practical policies that promote healthy behaviors in children. Studies have shown …

Racial And Ethnic Disparities In Diabetes-Related Healthcare Service Use In The United States, 2016–2020, Gaole Song

CGU Theses & Dissertations

Diabetes is a serious public health issue in the United States. As one of the leading causes of death, the prevalence of diabetes has increased steadily and leads to an enormous medical and societal burden each year. Compared to non-Hispanic White adults, racial/ethnic minority adults have a higher risk to develop diabetes and its complications. Proper healthcare service use is important for reducing the prevalence of diabetes and the risk of complications. However, minority populations receive a lower quality healthcare service and have greater barriers to diabetes self-management. To get a better understanding of racial disparities in diabetes-related healthcare service …

The Online Ordering Behaviors Among Participants In The Oklahoma Women, Infants, And Children Program: A Cross-Sectional Analysis, Qi Zhang, Kayoung Park, Junzhou Zhang, Chuanyi Tang

Community & Environmental Health Faculty Publications

The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) is a nutrition assistance program in the United States (U.S.). Participants in the program redeem their prescribed food benefits in WIC-authorized grocery stores. Online ordering is an innovative method being pilot-tested in some stores to facilitate WIC participants' food benefit redemption, which has become especially important in the COVID-19 pandemic. The present research aimed to examine the online ordering (OO) behaviors among 726 WIC households who adopted WIC OO in a grocery chain, XYZ (anonymous) store, in Oklahoma (OK). These households represented approximately 5% of WIC households who redeemed …

Essential Factors For A Healthy Microbiome: A Scoping Review, Patricia Grace-Farfaglia, Heather Frazier, Maura D. Iversen

Health Science Faculty Publications

Recent discoveries of the purpose and potential of microbial interactions with humans have broad implications for our understanding of metabolism, immunity, the host–microbe genetic interactions. Bioavailability and bioaccessibility of phytonutrients in foods not only enrich microbial diversity in the lower human gastrointestinal tract (GIT) but also direct the functioning of the metagenome of the microbiota. Thus, healthy choices must include foods that contain nutrients that satisfy both the needs of humans and their microbes. Physical activity interventions at a moderate level of intensity have shown positive effects on metabolism and the microbiome, while intense training (>70% VO₂max) …

A Scoping Review Comparing Sustainable Diet Indices, Natalie Henning

Public Health Theses

Interest in environmentally sustainable diets (i.e., diets beneficial for both human and planetary health) has increased as the role of food systems in climate change and population health has become better understood. Sustainable diet indices have been proposed as a holistic approach to assessing diets around the world with regards to human and planetary outcomes. The aim of this scoping review was to summarize and compare sustainable diet indices and their applicability to various populations.A literature search of three databases (Scopus, PubMed, and the Climate Change and Human Health Literature Search Portal) was conducted to identify articles that developed, validated, …

The Joint Effects Of Pre-Pregnancy Bmi, Race/Ethnicity On Infants’ Birth Weights, Mei Wang

Public Health Theses

AbstractObjective: We characterized the joint impacts of maternal race/ethnicity and pre-pregnancy BMI on adverse birth weight outcomes including low birth weight (LBW), and macrosomia. Methods: Retrospective cohort study of linked birth data for the years 2016-2020. Maternal race/ethnicity and maternal BMI were the key exposures; we analyzed their joint impact on outcomes using Poisson regression models. Results: When using race-specific reference groups, the difference in risk between NHB and NHW decreased as pre-pregnancy BMI increased and additionally, the difference in risk of macrosomia between the two groups increased with increasing BMI. NHB women generally had higher risk of low birth …

Factors Associated With Unsafe Children's Stool Disposal: An Analysis From 2015-2016 Myanmar Demographic And Health Survey, Naw Lah Say Wah

Chulalongkorn University Theses and Dissertations (Chula ETD)

Introduction: Safe sanitation is essential for preventing the transmission of diarrhoeal diseases and other infections. Sanitation projects and programs targeted at household sanitation have paid little focus to the disposal of children's stools. Due to the common misconception of children’s stool as less infectious, parents improperly manage children's stools for disposal. Unsafe disposal of children's stools has become an unhindered part of public health problems primarily in low and middle-income countries. Objective: To identify the association between children's stool disposal methods and factors associated with unsafe children’s stool disposal methods in Myanmar Method: This study is the cross-sectional secondary data …

The Phenomenon Of Integration Of Religious Practices As An Auxiliary Tool In Contemporary Medicine: Ukrainian Hospital Chapels In Modern Times, Mariia Ovchar, Yalovyk Anton, Igor Koreshchuk

Occasional Papers on Religion in Eastern Europe

The relevance of the research topic is ensured by the wide integration of such religious practices as an aid in contemporary medicine. The article describes the activities of more than 15 currently operating famous hospital chapels. The histories behind the foundation of each of them are analyzed, and the facts of public participation and the leadership of hospitals in the establishment of chapels at medical institutions are given. Special attention is paid to the characteristics of the psychological support component as an auxiliary factor along with the main course of treatment. For clarity of the descriptive part, the study presents …

Association Between Childhood Obesity, Family Meals, And Dietary Quality Among Us Children Aged 6 To 17 Years Residing In Snap-Eligible Households, Noemi Rodriguez

Dissertations and Theses

Background:

Between 20 and 21% of US children 6-19 have obesity. Children residing in households eligible for the Supplemental Nutrition Assistance Program (SNAP) are exposed to vulnerable socioeconomic conditions, often living in low-resourced households and communities. These children are at a high risk for obesity, and thus to obesity-related comorbidities as well as adulthood obesity. The US Department of Agriculture (USDA) recommends family meals as well as diets meeting the American Dietary Guidelines as an obesity prevention strategy. These are connected; the dominantly theorized pathway by which family meals protect against childhood obesity is through the diet quality of the …

Qualitative Analysis Of Cancer Care Experiences Among Rural Cancer Survivors And Caregivers, Kendra L. Ratnapradipa, Jordan Ranta, Krishtee Napit, Lady Beverly Luma, Tamara Robinson, Danae Dinkel, Laura Schabloske, Shinobu Watanabe-Galloway

Journal Articles: Epidemiology

PURPOSE: Rural (vs urban) patients experience poorer cancer outcomes and are less likely to be engaged in cancer prevention, such as screening. As part of a community needs assessment, we explored rural cancer survivors' and caregivers' experiences, perceptions, and attitudes toward cancer care services.

METHODS: We conducted 3 focus groups (N = 20) in Spring 2021 in rural Nebraska.

FINDINGS: Three patterns of cancer diagnosis were regular care/screening without noticeable symptoms, treatment for symptoms not initially identified as cancer related, and symptom self-identification. Most participants, regardless of how diagnosis was made, had positive experiences with timely referral for testing (imaging …

Interactions Of International Pilots' Stress, Fatigue, Symptoms Of Depression, Anxiety, Common Mental Disorders And Wellbeing, Marion Venus, Martin Grosse Holtforth

International Journal of Aviation, Aeronautics, and Aerospace

Objective

This study Investigates more dimensions than previous studies simultaneously: pilots’ duty rosters, stress, sleep difficulties, fatigue levels, wellbeing, symptoms of depression, anxiety, and common mental disorders (CMD), and how they are interrelated.

Background

Several scientific studies have confirmed that fatigue can pose a significant risk to flight safety. Other studies reported positive depression screening results for more pilots, compared with the general population.

Method

A cross-sectional online survey was completed by 406 international pilots, who reported their duty rosters of the last two months. Pilots also self-assessed their stress-levels, sleep problems, fatigue, wellbeing, and mental health.

Results

Although pilots …

Human Health Risk Assessment Of Heavy Metals In Roadside Dust Near Hydropower Dams Construction Areas In Wangduephodrang District Of Bhutan, Kinley Dorjee

Chulalongkorn University Theses and Dissertations (Chula ETD)

The concern over the heavy metal laden dust and its impact on human health has gained global importance over the decade. Exposure to roadside dust is associated with various acute and chronic health issues. Bhutan too is battling environmental health issues due to increasing anthropogenic and developmental activities such as hydropower dam construction. This study analyses the heavy metals concentrations in roadside dust near hydropower dam construction areas and assesses the noncancer and cancer risk of exposure to heavy metals laden dust through inhalation. This study was a cross sectional study. The roadside dust samples near hydropower dam construction in …

Who's Included? A Systematic Review Of Socio-Demographics And Participant Recruitment Within The Investigation Of Periodontal Disease And Its Treatment Effect On Hemoglobin A1c, Jaclyn L. Johnson

All Master's Theses

Diabetes mellitus and periodontal disease are major global public health concerns. Within the United States (U.S.) over 34 million adults have diagnosed diabetes (Centers for Disease Control and Prevention [CDC], 2020a), and 64 million U.S. adults have periodontitis (American Academy of Periodontology [AAP], 2021a). Research has shown that persons with diabetes have a coinfection with periodontal disease at a rate between 2.6 and 2.9 times higher than persons without diabetes (Wang et al., 2014). Diabetes and periodontal disease collectively and disproportionately affect persons of low socioeconomic status (SES), age, and particular racial/ethnic identities (AAP, n.d.b; CDC, 2021; Connolly et al., …