Digital Commons Network^™

Breastfeeding Duration And Reasons Given For Early Cessation Of Breastfeeding Among Wic Mothers, Amy Willa

Dissertations and Theses (Open Access)

The Breastfeeding Duration and Reasons for Early Cessation of Breastfeeding Among WIC Mothers study was conducted to describe the duration of and factors associated with early breastfeeding cessation among the Women, Infants, and Children (WIC) population. We collected data from a random sample of WIC medical records, sampling medical records belonging to mothers who initiated breastfeeding an infant but did not breastfeed to 52 weeks. Data were analyzed to answer the questions: How long do WIC mothers breastfeed? What reasons are given during counseling sessions at WIC for early cessation of breastfeeding? Do socio-economic, demographic, or medical factors influence the …

Learning Before And During The Covid-19 Outbreak: A Comparative Analysis Of Crisis Learning In South Korea And The Us, Seulki Lee, Jungwon Yeo, Chongmin Na

Research Collection School of Social Sciences

Learning is imperative in government responses to crises like the COVID-19 pandemic. This study examines the South Korean and United States governments’ responses to COVID-19 from a comparative perspective. The analysis focuses on crisis learning conducted before and during the COVID-19 outbreak, using the conceptual categories of intercrisis/intracrisis learning and single-/double-loop learning. The findings suggest that double-loop, intercrisis learning allows for more effective crisis management by (re)developing a common operating framework. The efficacy of learning is enhanced when double-loop learning is followed by single-loop learning that embeds new structures and operational procedures. The findings also suggest that intercrisis learning facilitates …

Gender Difference In Mortality Among Pulmonary Tuberculosis Hiv Co-Infected Adults Aged 15-49 Years In Kenya, Rose J. Kosgei, Steven Callens, Peter Gichangi, Marleen Temmerman, Anne-Beatrice Kihara, Gathara David, Eunice Nyaboe Omesa, Enos Masini, E. Jane Carter

Obstetrics and Gynaecology, East Africa

Setting: Kenya, 2012–2015

Objective: To explore whether there is a gender difference in all-cause mortality among smear positive pulmonary tuberculosis (PTB)/ HIV co-infected patients treated for tuberculosis (TB) between 2012 and 2015 in Kenya.

Design: Retrospective cohort of 9,026 smear-positive patients aged 15–49 years. All-cause mortality during TB treatment was the outcome of interest. Time to start of antiretroviral therapy (ART) initiation was considered as a proxy for CD4 cell count. Those who took long to start of ART were assumed to have high CD4 cell count.

Results: Of the 9,026 observations analysed, 4,567(51%) and 4,459(49%) were women and men, …

The Relationship Among Sociocultural Assimilation, Dietary Behavior, And Physical Activity In Adult Latinxs In The U.S., Erick Lopez

UNLV Theses, Dissertations, Professional Papers, and Capstones

This dissertation examines the relationship between sociocultural assimilation and health behaviors among adult Latinxs in the United States to address whether different assimilation models promote or hinder Latinx health. Existing research on assimilation and health behaviors among Latinxs relies heavily on the use of proxy measures of assimilation such as length of time in the U.S., nativity, age of arrival, and language preferences for surveys. These studies tend to show that greater assimilation to mainstream U.S. culture among Latinxs is associated with the adoption of poor health behaviors and the erosion of the immigrant health advantage. Research that uses sociocultural …

Disparities In Oral Health: Socioeconomic Status And Policies To Increase Access To Primary Dental Care, Mckenzie Nutter

Theses/Capstones/Creative Projects

Primary dental care is a patient-centered service consisting of routine dental checkups. The oral cavity is the first point of entrance to the body for many harmful pathogens. Therefore, primary dental care is essential to not only prevent and treat conditions in the mouth, but to also reduce the number of systemic diseases in the rest of the body. However, people with higher incomes or wealth have increased access to primary dental care. People with low socioeconomic status have decreased access to primary dental care, at least in part due to difficulties in paying for separate dental insurance. Disparities in …

Characterization Of Adiposity And Inflammation Genetic Pleiotropy Underlying Cardiovascular Risk Factors In Hispanics., Mohammad Yaser (Anwar)

Electronic Theses and Dissertations

The observed overlap between genetic variants associated with both adiposity and inflammatory markers suggests that changes in both adiposity and inflammation could be partially mediated by common pathways. The pervasive but sparsely characterized “pleiotropic” genetic variants associated with both adiposity and inflammation have been hypothesized to provide insight into the shared biology. This study explored and characterized the genetic pleiotropy underpinning adiposity and inflammation using genetic and phenotypic observations from the Cameron County Hispanic Cohort (CCHC). A total of 3,313 samples and >9 million single nucleotide polymorphisms (SNPs) were examined in this study. Mixed model genome-wide association studies (GWAS) were …

Reproducibility And Sensitivity Of Thirty-Six Methods To Quantify The Sars-Cov-2 Genetic Signal In Raw Wastewater: Findings From An Interlaboratory Methods Evaluation In The U.S., Brian M. Pecson, Emily Darby, Charles N. Haas, Yamrot M. Amha, Mitchel Bartolo, Richard Danielson, Yeggie Dearborn, George Di Giovanni, Christobel Ferguson, Stephanie Fevig, Erica Gaddis, Donald Gray, George Lukasik, Bonnie Mull, Liana Olivas, Adam Olivieri, Yan Qu, Sars-Cov-2 Interlaboratory Consortium, John J. Dennehy

Publications and Research

In response to COVID-19, the international water community rapidly developed methods to quantify the SARS-CoV-2 genetic signal in untreated wastewater. Wastewater surveillance using such methods has the potential to complement clinical testing in assessing community health. This interlaboratory assessment evaluated the reproducibility and sensitivity of 36 standard operating procedures (SOPs), divided into eight method groups based on sample concentration approach and whether solids were removed. Two raw wastewater samples were collected in August 2020, amended with a matrix spike (betacoronavirus OC43), and distributed to 32 laboratories across the U.S. Replicate samples analyzed in accordance with the project's quality assurance plan …

A Meta-Analysis Of Group Treatment Outcomes For Veterans With Substance Use Disorders, Robert “Tony” Dice

Counseling & Human Services Theses & Dissertations

Group therapy is commonly used in the treatment of substance use disorders (SUD). Many studies exist related to the efficacy of group interventions for veterans with SUDs. A meta-analysis and systematic review of the literature addressing the use of group therapy, specifically psychoeducational groups, cognitive behavioral therapy (CBT) groups and support groups, in the treatment of SUDs with veterans was conducted. The following questions guided the research: What are viable treatment outcomes for psychoeducational, CBT, and support groups of veterans with SUDs? and What are the measures that capture outcomes related to psychoeducational, CBT, and support groups of veterans with …

Postacute Covid-19: An Overview And Approach To Classification, Eva M Amenta, Amy Spallone, Maria C Rodriguez-Barradas, Hana M El Sahly, Robert L Atmar, Prathit A Kulkarni

Faculty, Staff and Students Publications

As the coronavirus disease 2019 (COVID-19) pandemic has progressed, a large volume of literature has developed delineating the clinical manifestations of acute infection. Recent reports have also started to describe persistent symptoms extending beyond the period of initial illness or hospitalization. Anecdotes of different signs and symptoms occurring after acute infection have also arisen in the lay press. Here we describe the current existing medical literature on the emerging concept of postacute COVID-19 and suggest an approach to classifying different manifestations of the syndrome. We also review long-term clinical manifestations observed in patients who recovered from infection due to other …

Spirituality As A Moderator Between Ptss And Cardiovascular Reactivity, Kriti Sharda

Honors Scholar Theses

Posttraumatic stress symptoms (PTSS) can be distressing and produce robust cardiovascular symptoms, such as increased heart rate and blood pressure, which have been implicated in higher risk of developing cardiovascular disease (CVD). Identifying factors that may reduce symptoms may suggest therapeutic strategies. One such potential factor is spirituality, given that spirituality is associated with both reducing PTSS and with preventing or improving CVD. We sampled 63 young college women who indicated being exposed to unwanted sexual contact. We asked them to write about their experience while we took heart rate (HR), systolic blood pressure (SBP) and diastolic blood pressure (DBP) …

Long-Term Neurocognitive And Educational Outcomes Of Neonatal Insults In Kilifi, Kenya, Dorcas N. Magai, Hans M. Koot, Paul Mwangi, Esther Chongwo, Charles R. Newton, Amina Abubakar

Institute for Human Development, East Africa

Background: There is little data on the long-term neurocognitive and educational outcomes among school-aged survivors of neonatal jaundice (NNJ) and hypoxic-ischemic encephalopathy (HIE) in Africa. This study investigates the long-term neurocognitive and educational outcomes and the correlates of these outcomes in school-aged survivors of NNJ or HIE in Kilifi, Kenya.

Methods: We conducted a cross-sectional study on neurocognitive and educational outcomes among school-aged survivors (6–12 years) of NNJ (n = 134) and HIE (n = 107) and compared them to a community comparison group (n = 134). We assessed nonverbal intelligence, planning, working memory, attention, syntax, pragmatics, wordfinding, …

Genetic And Clinical Determinants Of Racial/Ethnic Differences In Multiple Myeloma Susceptibility And Outcomes Focusing On Hispanics, Alem Belachew

Dissertations and Theses (Open Access)

Multiple Myeloma (MM) constitutes 10% of diagnosed hematologic malignancies in the US, with over 12,000 deaths recorded each year. Race/ethnicity is a well-known MM risk factor, where individuals of African descent have over 2- to 3-fold increased risk of incidence compared to those of European descent. Additionally, Hispanics are diagnosed approximately three years younger than white American counterparts, for unknown reasons. Differences in clinical phenotype are also present for MM patients by ancestry, including varying rates of common initiation mutations such as IgH translocations and TP53 mutation between patients of European and African descent. Studies have begun to interrogate the …

Effect Of Climate Change On Lyme Disease Cases In 4 New Jersey Counties, Meredith Olson

Capstone Experience: Master of Public Health

Since its discovery more than 40 years ago, there has been an increasing occurrence of Lyme disease. Lyme disease is a tick-borne illness found predominantly in the Northeastern region of the United States. Studies have shown that environmental factors play an important role on the life cycle of ticks. Due to the complexity of environmental changes as well as the life cycle of different tick species, the variety of factors that could influence the increase in Lyme disease can be different depending on tick species and region. This study compared different regions of New Jersey, a highly Lyme disease endemic …

Development Of A Web-Based Agriculture Health Risk Assessment Tool For Military Veteran Farmers And Ranchers, Alyssa Damke

Capstone Experience: Master of Public Health

In the U.S., significant health disparities exist among rural populations compared to their urban counterparts. These disparities can be compounded in agricultural workers due to the dangerous and unpredictable nature of their work. Agricultural producers who are also military Veterans may experience additional health pressures that are often overlooked in the healthcare setting. Over 2.5 million Veteran Health Administration (VHA) patients reside in rural areas and the healthcare infrastructure to care for these Veterans may not include an agricultural occupational approach. To address healthcare disparities in Veteran farmers and ranchers, this study, in collaboration with AgriSafe Network, will be used …

Perceptions Of Voice Health, Voice Health Care, And Voice Health Education In The Performance Community, Katelyn Nelson

Capstone Experience: Master of Public Health

There is a medical consensus that proper voice health precautions can protect the voice and decrease the occurrence and severity of voice disorders in vocal performers. Similarly, seeking medical treatment for voice disorders can speed recovery time and preserve the voice. Voice disorders are common in performance students and professionals because of demanding curricula and frequent voice use, but little is known about their voice care needs, preferred voice care resources, and clinical care. The purpose of this study was to add to the research on voice health by interviewing faculty members in the College of Communication, Fine Arts, and …

Gardasil Vaccine Trends Within Nevada, California, And The U.S.: A Comparative Study, Karen S. Gutierrez

UNLV Theses, Dissertations, Professional Papers, and Capstones

Despite decreasing incidence in cervical cancer in the U.S., there continues to be an increase in public health concern for cervical cancer worldwide. Recent studies report that individuals are disproportionately affected based on region, sex, and race. Additionally, the human papillomavirus (HPV) attributable cancers may be reduced between 70% and 90% through the universal use of HPV-vaccines. In order to expand current knowledge and implement intervention programs in Nevada, it is critical to examine the associations among the Gardasil vaccine, cervical cancer screening, and adverse events following immunization as well as to understand the different socio-demographic subgroups affected. To our …

Effects Of Climate Change On The Epidemiology Of Flood-Related Waterborne Disease: A Systematic Literature Review, Sarah M. Cadarette

Capstone Experience: Master of Public Health

Natural disasters, such as flooding related to extreme precipitation, can lead to many adverse health effects (i.e. waterborne disease). Several outbreaks of waterborne disease have been linked to extreme precipitation, and gastrointestinal infection has been shown to increase after floods. Climate change is likely to lead to a higher frequency of waterborne disease through increases in extreme precipitation and associated flooding affecting water and sanitation infrastructure. This review sought to answer 2 research questions: 1. Has the epidemiology of waterborne disease related to floods changed over time? 2. Can this difference be related to climate change? A literature search was …

Developing A Rabies Prevention Program Based On Rabies Exposure Data In Nebraska, Jill Oatman

Capstone Experience: Master of Public Health

Eighty-nine percent of Nebraska’s towns are considered rural, with populations of less than 3,000 people and with many towns having less than 1,000 residents. Rural areas consist of crop ground, livestock facilities and regions inhabited by wildlife. Nebraska has two large urban cities, Lincoln and Omaha. Animal and human health in these communities can be greatly impacted by infectious diseases that are transmitted between animals and humans, known as zoonotic diseases. One zoonotic disease of great concern is rabies. Zoonotic diseases not only impact the health of animals and humans, but the social well-being of communities and result in increased …

Exploring The Niche Of Rickettsia Montanensis (Rickettsiales: Rickettsiaceae) Infection Of The American Dog Tick (Acari: Ixodidae), Using Multiple Species Distribution Model Approaches, Catherine A. Lippi, Holly Gaff, Alexis L. White, Heidi K. St. John, Allen L. Richards, Sadie J. Ryan

Biological Sciences Faculty Publications

The American dog tick, Dermacentor variabilis (Say) (Acari: Ixodidae), is a vector for several human diseasecausing pathogens such as tularemia, Rocky Mountain spotted fever, and the understudied spotted fever group rickettsiae (SFGR) infection caused by Rickettsia montanensis. It is important for public health planning and intervention to understand the distribution of this tick and pathogen encounter risk. Risk is often described in terms of vector distribution, but greatest risk may be concentrated where more vectors are positive for a given pathogen. When assessing species distributions, the choice of modeling framework and spatial layers used to make predictions are important. …

Ultraviolet Exposure And Photokeratitis Complaints Among Informal Welding Workers In Depok, West Java, Indonesia, Maria K I J Yustheresani, Fajaria Nurcandra, Azizah Musliha Fitri, Annisa Ika Putri, Dyah Utari

Kesmas

One of the photokeratitis risk factors is acute reversible radiation of ultraviolet (UV) rays, which injure the cornea's epithelial tissue. Informal welding workers are susceptible populations to UV rays exposure. This study aimed to confirm the influence of UV radiation exposure on photokeratitis complaints in welding workers in Cimanggis, Depok, West Java. A cross-sectional study was conducted from February to June 2019 and used to select 100 welding workers purposively. A semi-structured questionnaire was used to determine photokeratitis complaints, age, education level, eye protection, safety knowledge, and work period; the UV radiation measured by A UV meter. Data were analyzed …

Hemoglobin Concentrations And Adverse Birth Outcomes In South Asian Pregnant Women: Findings From A Prospective Maternal And Neonatal Health Registry, Sumera Aziz Ali, Shiyam Sunder Tikmani, Sarah Saleem, Archana B. Patel, Patricia L. Hibberd, Shivaprasad S. Goudar, Sangappa Dhaded, Richard J. Derman, Janet L. Moore, Elizabeth M. Mcclure, Robert L. Goldenberg

Community Health Sciences

Background: While the relationship between hemoglobin (Hb) concentrations and pregnancy outcomes has been studied often, most reports have focused on a specific Hb cutoff used to define anemia. Fewer studies have evaluated pregnancy outcomes across the entire range of Hb values. Moreover, to date, most studies of the relationship of Hb concentrations to pregnancy outcomes have been done in high-income countries. Thus, we have sought to determine the relationship between the range of maternal Hb concentrations and adverse birth outcomes among South Asian pregnant women.
Methods: For this study, we used data collected from two South Asian countries (Pakistan - …

Smoking Behaviors In Patients Offered Lung Cancer Screening, Sara Elizabeth Golden

Dissertations and Theses

In the United States, smoking causes preventable diseases, including lung cancer, which is the leading cause of cancer deaths. Improving smoking cessation rates is important to decrease lung cancer deaths. Health care visits with a discussion about lung cancer screening (LCS) may help in increasing prevalence of smoking cessation. Importantly, insurers now require clinicians to have a shared decision-making discussion with patients that includes discussion of smoking abstinence before they can receive an LCS scan (i.e., a low-dose computed tomography scan). This discussion may represent a unique opportunity to encourage smoking cessation since it may prompt positive smoking behavior change. …

Association Between Appendicular Skeletal Muscle Index And Leukocyte Telomere Length In Adults: A Study From National Health And Nutrition Examination Survey (Nhanes) 1999-2002, Lingzhi Chen, Nitin Shivaooa, Xiuxun Dong, Jingjing Ming

Faculty Publications

Background A higher body mass index (BMI) is associated with shorter telomeres. The loss of muscle mass with aging is associated with adverse outcomes. The appendicular skeletal muscle index (ASMI) is currently used to quantify muscle mass. Objective We investigated the association of the ASMI with leukocyte telomere length in adult Americans. Methods This cross-sectional study used the National Health and Nutrition Examination Survey (NHANES) 1999–2002 dataset. Body composition was measured by dual-energy X-ray absorptiometry. Low muscle mass was defined using sex-specific thresholds of the appendicular skeletal muscle mass index (ASMI). The telomere-to-single-copy gene ratio (T/S ratio) was converted to …

Relationship Between Psychosocial-Cultural Factors And African American Women Obesity., Francoise Knox-Kazimierczuk

Journal of Health Disparities Research and Practice

Objective: To determine associations between African American female obesity and SEM variables.

Design: Data from the National Survey of American Life Self-Administered Questionnaire (NSAL-SAQ), a 2001–2003 nationally representative cross-sectional survey was used to extract data for African American women.

Participants: African American females at a BMI of 18.5 kg/m2 or greater were included in the final sample (n = 2,100) for analysis.

Main Outcome Measure(s): BMI

Analysis: Measures for socioecological model (SEM) were analyzed using a regression model in SPSS.

Results: Intrapersonal and community/institutional levels were found to be significantly associated with BMI. Two multiple regression analyses models were developed …

Employing Position Generators To Assess Social Capital And Health: A Scoping Review Of The Literature And Recommendations For Measurement In Future Population-Based Surveillance, Steven Meanley, Candice Biernesser, Teagen O'Malley, Todd Bear, Jeanette Trauth

Journal of Health Disparities Research and Practice

Beneficial social connections are critical to individual-level health because they can be used to avoid or minimize the risks and consequences associated with diseases. How to best measure beneficial social connections to inform social network-level health interventions remains poorly understood. A scoping review of health surveillance studies was conducted to highlight the utility of employing position generators to assess how access to beneficial social connections was associated with population health and disparities. Our review yielded 39 articles conducted across 14 predominantly high-income countries. Most studies (77%) with composite measures for beneficial social connections exhibited health-protective associations. Of the remaining articles, …

Epidemiology And Pathophysiology Of Common Skin Diseases In West Africa: An Immunodermatological Framework, Osazomon Imarenezor

All HCAS Student Capstones, Theses, and Dissertations

This capstone reviews the common skin diseases on a global scale. With these dermatoses being further funneled into Africa and then magnified into common West African dermatoses, the meta-analyses of literature available paints a clear picture of the epidemiological & pathological factors and their contribution to the skin disease. Each article analysed in this analysis was taken from a 20-year span of January 2000 to December 2019. The selection of articles was fine-tuned by identifying the distribution of skin disease, revealing the populations affected (age, gender, ethnicity, etc), the main causes, country of origin, the prognosis of disease, and the …

Review Of: From The Front Lines Of The Appalachian Addiction Crisis Healthcare Providers Discuss Opioids, Meth And Recovery, Carl G. Leukefeld

Journal of Appalachian Health

The Journal of Appalachian Health is dedicated to reviewing various types of media related to contemporary concepts that affect the health of Appalachia. As the opioid-related overdose deaths ravish Appalachia, now more than ever, we each must devote energy to understanding addiction and pathways to recovery. Dr. Carl Leukefeld reviews the book From the Front Lines of the Appalachian Addiction Crisis: Healthcare Providers Discuss Opioids, Meth and Recovery.

Rural Community Toolbox To Help Battle Opioid Epidemic, Liz Carey

Journal of Appalachian Health

An online data repository and toolbox created by the Office of National Drug Control Policy is designed to provide communities with knowledge and resources to fight the opioid epidemic according to their unique needs.

Impact Of Diabetes On The Gut And Salivary Iga Microbiomes, Eric L Brown, Heather T Essigmann, Kristi L Hoffman, Noah W Palm, Sarah M Gunter, Joel M Sederstrom, Joseph F Petrosino, Goo Jun, David Aguilar, William B Perkison, Craig L Hanis, Herbert L Dupont

Faculty, Staff and Student Publications

Mucosal surfaces like those present in the lung, gut, and mouth interface with distinct external environments. These mucosal gateways are not only portals of entry for potential pathogens but also homes to microbial communities that impact host health. Secretory immunoglobulin A (SIgA) is the single most abundant acquired immune component secreted onto mucosal surfaces and, via the process of immune exclusion, shapes the architecture of these microbiomes. Not all microorganisms at mucosal surfaces are targeted by SIgA; therefore, a better understanding of the SIgA-coated fraction may identify the microbial constituents that stimulate host immune responses in the context of health …

Trust: Assessing The Efficacy Of An Intervention To Increase Hiv Self‑Testing Among Young Black Men Who Have Sex With Men (Msm) And Transwomen, Victoria Frye, Vijay Nandi, Mark Q. Paige, Jermaine Mccrossin, Debbie Lucy, Marya Gwadz, Patrick S. Sullivan, Donald R. Hoover, Leo Wilton

Publications and Research

HIV testing among young Black MSM and transwomen (YBMSM/TW) is the gateway to biomedical HIV prevention or treatment. HIV self-testing (HST) is a method that may increase consistent HIV testing. TRUST, a brief, peer-based behavioral intervention, was designed to increase uptake of consistent (every three months) HST among YBMSM/TW in New York City. To test the efficacy of the intervention, we randomized 200 friend pairs into either the intervention condition (TRUST) or a time and attention control condition. A modified intent-to-treat analysis found that self-reported HST at 3-month follow-up was statistically significantly higher (uOR 2.29; 95% CI 1.15, 4.58) and …