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Affecting Absenteeism Through School-Based Health Services Delivery: A Configurational Comparative Methods Study Of Oregon's Public Secondary Schools, Kelly Elizabeth Coates

Dissertations and Theses

A student's ability to attend school regularly can be profoundly affected by poor health-related behaviors, illnesses, and chronic diseases that are left unaddressed and unattended. The delivery of health services in the school environment is uniquely positioned to interrupt the effects these health barriers to learning (HBLs) can have on subsequent diminished educational and health outcomes. The literature widely acknowledges the intersectionality between health and education, but no comprehensive overview exists of how different structures and processes within a school work (or do not work) together to lead to higher or lower student absenteeism. This research sought to fill that …

Predicting The Environmental Suitability For Onchocerciasis In Africa As An Aid To Elimination Planning, Elizabeth A. Cromwell, Joshua C P. Osborne, Thomas R. Unnasch, Maria-Gloria Basáñez, Katherine M. Gass, Kira A. Barbre, Elex Hill, Kimberly B. Johnson, Katie M. Donkers, Zulfiqar Ahmed Bhutta

Centre of Excellence in Women and Child Health

Recent evidence suggests that, in some foci, elimination of onchocerciasis from Africa may be feasible with mass drug administration (MDA) of ivermectin. To achieve continental elimination of transmission, mapping surveys will need to be conducted across all implementation units (IUs) for which endemicity status is currently unknown. Using boosted regression tree models with optimised hyperparameter selection, we estimated environmental suitability for onchocerciasis at the 5 × 5-km resolution across Africa. In order to classify IUs that include locations that are environmentally suitable, we used receiver operating characteristic (ROC) analysis to identify an optimal threshold for suitability concordant with locations where …

Association Of X-Ray Absorptiometry Body Composition Measurements With Basic Anthropometrics And Mortality Hazard, Nir Y. Krakauer, Jesse C. Krakauer

Publications and Research

Dual-energy X-ray absorptiometry (DEXA) is a non-invasive imaging modality that can estimate whole-body and regional composition in terms of fat, lean, and bone mass. We examined the ability of DEXA body composition measures (whole-body, trunk, and limb fat mass and fat-free mass) to predict mortality in conjunction with basic body measures (anthropometrics), expressed using body mass index (BMI) and a body shape index (ABSI). We used data from the 1999–2006 United States National Health and Nutrition Examination Survey (NHANES), with mortality follow-up to 2015. We found that all DEXA-measured masses were highly correlated with each other and with ABSI and …

Why Is Safe Food Handling Important? [English/Arabic], Celina Wille

All Current Publications

This handout, available here in both English and Arabic, provides information to prevent illness through safe food handling practices.

Why Is Safe Food Handling Important? [English/Somali], Celina Wille

All Current Publications

This handout, available here in both English and Somali, provides information to prevent illness through safe food handling practices.

Why Is Safe Food Handling Important? [English/Spanish], Celina Wille

All Current Publications

This handout, available here in both English and Spanish, provides information to prevent illness through safe food handling practices.

Why Is Safe Food Handling Important? [English/Karen], Celina Wille

All Current Publications

This handout, available here in both English and Karen, provides information to prevent illness through safe food handling practices.

Why Is Safe Food Handling Important? [English/Tigrinya], Celina Wille

All Current Publications

This handout, available here in both English and Tigrinya, provides information to prevent illness through safe food handling practices.

Increasing Obesity Odds Among Foreignborn New Yorkers Are Not Explained By Eating Out, Age At Arrival, Or Duration Of Residence: Results From Nyc Hanes 2004 And 2013/2014, Margrethe F. Horlyck-Romanovsky, Sean J. Haley

Publications and Research

Background: Among the foreign-born in the United States (US) dietary acculturation and eating out may increase obesity risk. Using the 2004 (N = 1952) and 2013/14 (N = 1481) New York City (NYC) Health and Nutrition Examination Surveys, we compared for the foreign-born and US-born by survey year: 1) odds of obesity; 2) association between eating out and obesity and 3) effect of age at arrival and duration of residence among the foreign-born. Weighted logistic regression estimated odds of obesity.

Results: Compared to the US-born, the foreign-born had lower odds of obesity in 2004, (aOR = 0.51 (95%CI 0.37– 0.70), …

Prevalence Trend And Disparities In Rheumatoid Arthritis Among Us Adults, 2005–2018, Yingke Xu, Qing Wu

School of Public Health Faculty Research

Rheumatoid arthritis (RA) trends among US adults and disparities in RA patients in recent years have not been well described. We aimed to examine the trend of RA prevalence and disparities among US adults. Data from the National Health and Nutrition Examination Survey (NHANES) of the years 2005–2018 were analyzed to examine the self-reported RA prevalence trend. Age-adjusted RA prevalence stratified by race/ethnicity and socioeconomic status (SES), as well as associated linear trends, were calculated for both genders. The multivariable adjustment was used to evaluate the association between race, SES, and RA. During 2005–2018, there was no significant linear trend …

Geospatial Analysis Of Rurality And Food Banks In Appalachian Ohio, Cooper T. Johnson, Rebecca Fischbein, Kristin Baughman

Journal of Appalachian Health

Introduction: Food insecurity is a problem for individuals across Ohio, including those living in Appalachia. Adequate access to resources that help combat food insecurity is important for these populations.

Purpose: To examine how rurality relates to food insecurity and need for food resources, as well as availability of those resources including food pantries and soup kitchens, in 15 northern Ohio Appalachian counties.

Methods: A cross-sectional study with a geographical analysis was conducted using data from the American Community Survey census data, County Health Rankings data, and regional foodbank websites.

Results: Rural counties had a higher ratio of potential clients per …

Addressing Diabetes Distress In Self-Management Programs: Results Of A Randomized Feasibility Study, Ranjita Misra, Samantha Shawley-Brzoska, Raihan Khan, Brenna O. Kirk, Sijin Wen, Usha Sambamoorthi

Journal of Appalachian Health

Background: West Virginia ranks 1st nationally in the prevalence of hypertension (HTN; 43.8%) and diabetes (16.2%). Patients with type 2 diabetes mellitus (T2DM) are distressed over physical and psychological burden of disease self-management.

Methods: This study investigated the effectiveness of an intervention to reduce diabetes distress and outcomes [glycemic control, blood pressure (BP)] among T2DM adults with comorbid HTN. Participants were randomized to a 12-week diabetes and hypertension self-management program versus a 3-month wait-listed control group. Trained health coaches and experts implemented the lifestyle program in a faith-based setting using an adapted evidence-based curriculum. Twenty adults with T2DM and HTN …

Diabetes Knowledge, Behaviors, And Perceptions Of Risk In Rural West Virginia Counties, Ranjita Misra, Sara Farjo, Renee Mcginnis, Megan Adelman Elavsky, Summer Kuhn, Catherine Morton-Mcswain

Journal of Appalachian Health

Introduction: A little less than half of American adults have diabetes or pre-diabetes. In 2016, West Virginia (WV) had the highest percentage (15.2%) of adults with diagnosed diabetes in the U.S.

Purpose: In partnership with the Health Sciences and Technology Academy (HSTA), a cross-sectional study was preformed to assess knowledge, behaviors, and perceptions of diabetes risk.

Methods: Data was collected by trained HSTA students and teachers who lived in rural counties in WV. Information was assessed using validated surveys, and HbA1c was obtained by utilizing professional point-of-care (Bayer) kits.

Results: Mean age and Body Mass Index (BMI) was 36.11±17.86 years …

Disease, Development, And Disorder: Examining The Effect Of Health On Subnational Development And Conflict In Sub-Saharan Africa, Dlorah C. Jenkins

Doctor of International Conflict Management Dissertations

Progress towards achieving the Sustainable Development Goals (SDGs) has been uneven across and within countries - particularly in Africa, least developed countries, and low-income countries. The COVID-19 pandemic has threatened to reverse much of the progress made towards achieving the SDGs, especially SDG 3, which aims to “ensure healthy lives and promote well-being for all at all ages”.

The tendency for disease, underdevelopment, and conflict to occur concomitantly suggests potential causal mechanisms linking them. This study attempts to address two pieces of the puzzle: the causal effect of disease on underdevelopment and the impact of development on conflict risk. Focusing …

Physical Activity Barriers And Assets In Rural Appalachian Kentucky: A Mixed-Methods Study, Natalie Jones, Deirdre Dlugonski, Rachel Gillespie, Emily M. Dewitt, Joann Lianekhammy, Stacey A. Slone, Kathryn M. Cardarelli

Sports Medicine Research Institute Faculty Publications

Obesity is an increasing public health concern in the U.S. and a contributor to chronic illness, with trends revealing a rise in adult obesity and chronic disease rates among the most vulnerable and disadvantaged populations, including those in rural communities. A mixed-methods approach was used to examine perspectives on perceived physical activity barriers, resources, and level of community support. Researchers utilized the socioecological model to examine the multiple domains that support physical activity in rural Appalachia. The present study focuses on baseline data, including a cohort survey to assess physical activity, health status, and barriers to physical activity, and five …

Prevalencia Mensual De Trastorno De Ansiedad Generalizada Durante La Pandemia Por Covid-19 En México, Pablo Gaitán-Rossi, Víctor Pérez-Hernández, Mireya Vilar-Compte, Graciela Teruel-Belismelis

Department of Public Health Scholarship and Creative Works

Objective. Estimate the prevalence of generalized anxiety disorder (GAD) from April to June 2020. Materials and methods. Repeated cross-sections design based in the Encovid-19, a series of monthly mobile surveys with represen- tative samples of Mexico (N= 833-1 674).The questionnaire includes the GAD-2 scale, and, in July, the GAD-7 scale was added; we examined its internal validity with confirmatory factor analysis and its concurrent validity with sociodemo- graphic variables. Using GAD-7 as criterion, we analyzed the predictive validity of the GAD-2.We estimated the monthly prevalence with the GAD-2. Results. The GAD-7 and the GAD-2 are reliable and valid.The GAD-2 has …

Risk Of Infection And Transmission Of Sars-Cov-2 Among Children And Adolescents In Households, Communities And Educational Settings: A Systematic Review And Meta-Analysis, Omar Irfan, Jiang Li, Kun Tang, Zhicheng Wang, Zulfiqar Ahmed Bhutta

Woman and Child Health

Background: There is uncertainty with respect to SARS-CoV-2 transmission in children (0-19 years) with controversy on effectiveness of school-closures in controlling the pandemic. It is of equal importance to evaluate the risk of transmission in children who are often asymptomatic or mildly symptomatic carriers that may incidentally transmit SARS-CoV-2 in different settings. We conducted this review to assess transmission and risks for SARS-CoV-2 in children (by age-groups or grades) in community and educational-settings compared to adults.
Methods: Data for the review were retrieved from PubMed, EMBASE, Cochrane Library, WHO COVID-19 Database, China National Knowledge Infrastructure (CNKI) Database, WanFang Database, Latin …

Gut Integrity And Duodenal Enteropathogen Burden In Undernourished Children With Environmental Enteric Dysfunction, Zehra Jamil, Najeeha Talat Iqbal, Romana Idress, Zubair Ahmad, Kamran Sadiq, Junaid Iqbal, Sana Syed, Aneeta Hotwani, Furqan Kabir, Kumail Ahmed, Sheraz Ahmed, Fayyaz Umrani, Fatima Aziz, Adil Kalam, Syed Asad Ali

Department of Biological & Biomedical Sciences

Environmental enteric dysfunction (EED) is a subclinical condition of intestinal inflammation, barrier dysfunction and malabsorption associated with growth faltering in children living in poverty. This study explores association of altered duodenal permeability (lactulose, rhamnose and their ratio) with higher burden of enteropathogen in the duodenal aspirate, altered histopathological findings and higher morbidity (diarrhea) that is collectively associated with linear growth faltering in children living in EED endemic setting. In a longitudinal birth cohort, 51 controls (WHZ > 0, HAZ > -1.0) and 63 cases (WHZ< -2.0, refractory to nutritional intervention) were recruited. Anthropometry and morbidity were recorded on monthly bases up to 24 months of age. Dual sugar assay of urine collected after oral administration of lactulose and rhamnose was assessed in 96 children from both the groups. Duodenal histopathology (n = 63) and enteropathogen analysis of aspirate via Taqman array card (n = 60) was assessed in only cases. Giardia was the most frequent pathogen and was associated with raised L:R ratio (p = 0.068). Gastric microscopy was more sensitive than duodenal aspirate in H. pylori detection. Microscopically confirmed H. pylori negatively correlated with HAZ at 24 months (r = -0.313, p = 0.013). Regarding histopathological parameters, goblet cell reduction significantly correlated with decline in dual sugar excretion (p< 0.05). Between cases and controls, there were no significant differences in the median (25th, 75th percentile) of urinary concentrations (μg/ml) of lactulose [27.0 (11.50, 59.50) for cases vs. 38.0 (12.0, 61.0) for controls], rhamnose [66.0 (28.0, 178.0) vs. 86.5 (29.5, 190.5)] and L:R ratio [0.47 (0.24, 0.90) vs. 0.51 (0.31, 0.71)] respectively. In multivariable regression model, 31% of variability in HAZ at 24 months of age among cases and controls was explained by final model including dual sugars. In conclusion, enteropathogen burden is associated with altered histopathological features and intestinal permeability. In cases and controls living in settings of endemic enteropathy, intestinal permeability test may predict linear growth. However, for adoption as a screening tool for EED, further validation is required due to its complex intestinal pathophysiology.

Blood's Concentration Of Lead And Arsenic Associated With Anemia In Peruvian Children, Ana Maria Linares, Jason M. Unrine, Amanda Thaxton Wigging, Juan C. Tantalean, Vlad C. Radulescu

Nursing Faculty Publications

This exploratory, descriptive cohort study (N = 60) determined lead (Pb) and arsenic (As) blood concentrations in Peruvian children and their association with hematological parameters of iron-deficient anemia (IDA) and anthropometric measurement. The mean age of children was 10.8 months (SD = 4.7) and ranged from 3 to 24 months old. Anemia (Hb levels below 10.5 g/dL) was found in 20% of this cohort. Additionally, microcytosis (MCV < 70 fL) was present in 54%, and hypochromia (MCH < 23 pg) in 42% of the group of children. Chi-square analysis showed that 88% of the children with anemia also had microcytosis and hypochromia (p < 0.001). Pb and As were detected in 100% of the infants’ blood samples, and the concentrations were significantly higher in older infants than in younger ones. Pb and As were not associated with the sex, anthropomorphic parameters, or infant hemogram changes. Infants who received iron supplementation were 87% less likely to have low Hb compared with those who did not (OR = 0.13, 95% CI = 0.02–0.88, p = 0.04). Herbal tea intake was significantly associated with microcytosis and hypochromia. Our finding uncovered that hematological parameters for anemia are modified in Peruvian children with high levels of microcytosis …

Factors Influencing Rural Women’S Physical Activity Behaviors: A Social Ecological Perspective, Karen Lynn Webb

Nursing ETDs

ABSTRACT

Chronic disease and poor mental health are disproportionally impacting adults living in rural America. Regular physical activity has been shown to promote overall well-being and prevent many chronic diseases. Yet, research shows that many rural adults do not engage in enough physical activity to meet the recommended levels put forth by the federal government. The purpose of this descriptive qualitative study was to explore and describe the experiences of physical activity as perceived by rural women in their own words. Data were collected through semi-structured individual interviews of 20 women aged 25 to 34 living in McDowell County, West …

The Kids Cook Monday Program Can Help Reduce Child Obesity, Mary Kate Schutt

Population Health Research Brief Series

Childhood obesity is a growing U.S. population health problem. Regularly consuming fast food and other take-out meals is linked to higher rates of childhood obesity. While the COVID-19 pandemic exacerbated takeout, rates of takeout and delivery have been increasing since 2012. Engaging children in preparing family meals can protect against childhood obesity and other risky behaviors. The Healthy Monday program, Kids Cook Monday, can support families to regularly cook meals together.

The Joys Of Cooking When You’Re A Depressed And Anxious Student, Miles Bowman, Shahryar Chaudhry, Jinhe Huang, Michaela Kearney, Abigail Kuplicki, Tim Nold, Toni Lupro

Patient Education Projects

No abstract provided.

Healthy Beats Healthy Hearts: Using Accessible Health Work Outs, Yasmeen Alcodray, Sarah Alemara, Anthony Chifor, Rosetta Irons, Patrick Pawlaczyk, Noah Welker, Amer Tamr

Patient Education Projects

No abstract provided.

Congenital Heart Disease, Katie Furman, Suraj Jaipalli, Sanika Kulkarni, Enxhi Lalo, Elizabeth Lewis, Rohan Thomas, Shankar Ashwin

Patient Education Projects

No abstract provided.

Grocery Store Virtual Tour: Preventing Cardiovascular Disease Through Nutrition Education, Esther Bae, Sahar Elmenini, Myles Hardeman, Jacob Kalkman, Riley Reed, Jason Valencia, Amrit Misra

Patient Education Projects

No abstract provided.

Managing Diabetes As A 65+ Individual, Terry Buford-Pendergast, Marlee Hewitt, Alyssa Kalsbeek, Cedrick Mutebi, Tristayn Owen, Nikita Sathiaprakash, Abdel-Rhman Mohamed

Patient Education Projects

No abstract provided.

Health Maintenance Strategies For Diabetes In Young Adults, Xavier Akins, Haneen Ali, Cole Goodman, Erika Ouchi, Noor Suleiman, Bobby Teng, Abdel-Rhman Mohamed

Patient Education Projects

No abstract provided.

Chronic Kidney Disease Frozen And Fast Food Nutritional Fact Sheet, Andrew Abdallah, Andrea Batchev, Alexis Berry, Tilmira Smith, Samuel David Weitzen, Michael Yu, Rujuta Patil

Patient Education Projects

No abstract provided.

Analysis Of Anxiety And Depression In Detroit Adolescents Receiving Supplemental Nutrition Assistance Program (Snap) Benefits., Maya Baiyasi, Aya Dudar, Sebastian Duncan, Jerry Graham, Jared Hudson, Alexis Thuy Nguyen, Maria Awad

Patient Education Projects

No abstract provided.

Delicious Diabetes Dishes, Osama Alkhalili, Kiana Cabasa, Sikander Chohan, Carly Conway, David Huynh, Cassandra Keinath, Lavina Desai

Patient Education Projects

No abstract provided.