Digital Commons Network^™

Oral Glucose Insulin Secretion Test For Identifying Patients With Insulin Resistance, David Kershner

Walden Dissertations and Doctoral Studies

Insulin resistance is an increasing public health issue with the current literature, suggesting reduced sensitivity of insulin leads to adult onset diabetes and associated downstream pathologies that reduce life expectancy. The main objectives of this study were to evaluate the ability of the Oral Glucose Insulin Secretion Test (OGIST) to identify insulin resistance and examine differences in the insulin sensitivity based on gender, age, and ethnicity. This study was supported by the insulin resistance theory which focuses on the reduced ability of insulin to bind to the cellular insulin receptor, reducing the sensitivity of insulin. The OGIST lab results of …

Latent Tuberculosis Infection Treatment Completion And Predictors Of Noncompletion Among Visa Holders In The Rural Setting, Scott Hutton

Walden Dissertations and Doctoral Studies

Latent tuberculosis infection (LTBI), a product of exposure to Mycobacterium tuberculosis (Mtb), can lead to tuberculosis (TB) and further cause death if untreated. Fortunately, TB can be prevented with LTBI treatment. Targeting newly arrived visa holders for LTBI screening and treatment is an effective strategy for decreasing future TB burden. However, LTBI treatment completion rates are low, and researches had primarily focused on the nonrural U.S. setting. This study, using a retrospective cohort design under the epidemiological disease triangle framework evaluated (a) the treatment completion rates for 2 cohorts of visa holders (i.e., immigrants, N = 31 and refugees, N …

Implementation Of Food Safety Regulations In Food Service Establishments, Steve Randolph Mcallister

Walden Dissertations and Doctoral Studies

Food service businesses in the United States have experienced millions of dollars in losses caused by foodborne illness outbreaks, which can lead to bankruptcy and business closures. More than 68% of all foodborne illness outbreaks occur in food service establishments. The purpose of this descriptive case study was to explore the strategies leaders of food service establishments use to implement food safety regulations. Force field analysis was the conceptual framework for this study. The population for the study consisted of 3 leaders of food service establishments located in the southeastern region of the United States. Data were collected using semistructured …

Perceptions Of Chiropractors In Mississippi Regarding Obesity, Phelesia Nakita Foster

Walden Dissertations and Doctoral Studies

Obesity continues to be a growing problem across the United States. Chiropractors have made claims of providing health promotion services within their treatment protocol; however, there is a lack of empirical research regarding a need for the chiropractic profession to train chiropractors to address Healthy People 2020 public health initiatives. The purpose of this qualitative study was to examine the perceptions of Mississippi Delta Region chiropractors regarding their role in obesity management as nonmedical practitioners that implement public health objectives in their practice. The research questions aimed at addressing possible barriers and limitations that influenced chiropractors' perceptions regarding their role …

Factors Affecting Utilization Of Family Planning Services Among Married Women Of Reproductive Age Living In The Rural Area Of Kayin State, Myanmar, Sabai Tun

Chulalongkorn University Theses and Dissertations (Chula ETD)

The rewards of promoting family planning services not only restricted to improving maternal or child health but also significantly advanced the fitting occasion to gain higher educational status, better employment, empowerment and greater socioeconomic status especially for girls and women. The main purpose of this study was to assess the utilization proportion of family planning services for contraception and to determine the factors affecting the utilization of contraception among 388 married women of reproductive age living in the rural area of Hpa-an Township, Kayin state, Myanmar. The data was collected by face to face interview in this quantitative cross-sectional descriptive …

Online Social Media And Applications Use Engaing In Sexual Risk Behaviors Among Hiv Infected Men Who Have Sex With Men In Bangkok, Thailand, Sasithorn Bureechai

Chulalongkorn University Theses and Dissertations (Chula ETD)

The purpose of this study is to identify the pattern of social media use and risky sexual behavior of men who have sex with men in Bangkok, Thailand by using a mixed method.This is a cross-sectional study based upon quantitative and qualitative data collection. The target population is Bangkok MSM aged over 15 who visit a research institute for consultancy. The data collection took 6 months from June to November 2018, and the subjects participating in this study total at 201. All subjects respond to a set of close-end and open-end questions. The data is analyzed with SPSS V.22 with …

Indoor Air Quality In Schools, Clint Pinion Jr.

EKU Faculty and Staff Scholarship

An indoor air quality study was conducted on a ‘net-zero energy’ school using a TSI Velocicalc Model 9555-p with probe model 982, passive radon monitors, visual inspection protocol, and an indoor environmental quality survey of school faculty and staff. Average indoor temperature, relative humidity, and carbon dioxide levels in several areas within the school were not within IAQ guidelines. Three rooms on the school’s grounds had radon levels exceeding the action level. Recommended solutions included installing return and supply air ducts in hallways and relative humidity and temperature monitors in classrooms with high-pitched ceilings.

Sedentary Time And The Cumulative Risk Of Preserved And Reduced Ejection Fraction Heart Failure: From The Multi-Ethnic Study Of Atherosclerosis, Brandi Scot Rariden

UNF Graduate Theses and Dissertations

ABSTRACT

Purpose: The purpose of this study was to examine the relationship between self-reported sedentary time (ST) and the cumulative risk of preserved ejection fraction heart failure (HFpEF) and reduced ejection fraction heart failure (HFrEF) using a diverse cohort of U.S. adults 45-84 years of age.

Methods: Using data from the Multi-Ethnic Study of Atherosclerosis (MESA), we identified 6,814 subjects (52.9% female). All were free of baseline cardiovascular disease. Cox regression was used to calculate the hazard ratios (HR) associated with baseline ST and risk of overall heart failure (HF), HFpEF, and HFrEF. Weekly self-reported ST was dichotomized …

Heart Failure In A Contemporary Biracial Cohort, Matthew Mefford

All ETDs from UAB

Heart failure (HF) is the inability of the heart to meet the perfusion needs of the body. HF is a leading contributor to the burden of cardiovascular disease (CVD) and remains a public health concern. Hypertension is a major modifiable risk factor for the prevention and management of HF. Hypertension develops earlier, is less controlled, and has a stronger association with some CVD and renal outcomes among blacks versus whites. These disparities may extend to HF. In addition, adults with HF often have complex treatment regimens due to multimorbidity, making medication adherence an issue. The goal of this dissertation was …

Psychological Well-Being And Smoking Cessation, Christopher Thorne

All ETDs from UAB

Introduction: The substantial death toll from smoking combined with the low success rates of current treatment approaches warrants further investigation into mechanisms that promote cessation. While the role of negative affect has been studied extensively in relationship to smoking cessation, the role of psychological well-being (PWB; e.g., life satisfaction, optimism, positive affect, purpose in life, resilience) has received little attention. Treatment outcomes might improve with a better understanding of PWB’s role in smoking cessation. Methods: Relationships between smoking and PWB were examined in three studies. First, using panel data from the biennial, longitudinal Health and Retirement Study, I developed separate …

Social Factors, Public Policies, And Infant Mortality, Lauren Wallace

All ETDs from UAB

Despite consistent and substantial investments, the United States’ infant mortality rate (IMR) has not decreased significantly in the 21st century and disparities between racial and ethnic groups have increased. This study investigates the impact of social and health factors, and public policies on IMR at the state level. The research aims were to: 1) evaluate which state-level social factors and public policies were associated with state IMRs using principal component (PC) analysis; and 2) evaluate whether states cluster on their PC scores and IMRs using cluster analysis. The data used were six composite index scores based on social factor and …

Assessment Of A Peer Mentoring Program At Lawson State Community College, Teneasha Washington

All ETDs from UAB

ABSTRACT Colleges and universities have begun implementing mentoring programs to offset rising attrition rates; however, the literature on the benefits of these programs is limited particularly among community colleges with peer mentoring programs serving minority students. Further limiting our understanding of post-secondary peer mentoring programs is the lack of research on mentor’s as well as mentee’s perspectives on the mentoring experience. As mentors and mentees serve in a variety of capacities within the mentoring program, it is often difficult to identify outcomes that can be assessed within the mentoring program. Although the success of peer mentoring programs is directly affected …

Simulation Of Correlated Variables, Mixture Distributions, And Repeated Measures And Comparison Of Pharmacogenetic Prediction With Machine Learning Methods, Allison Cynthia Fialkowski

All ETDs from UAB

Pharmacogenetics aims to improve individualized medicine by combining genetic information with clinical data when assigning drug treatments. Different diseases are often associated with different factors, each with its own distributional characteristics. For rare or complex diseases, these characteristics may not be well understood and standard analysis methods may not be appropriate. In psychiatric disorders, for example, multiple drug treatments need to be compared across small sample sizes with heterogeneous patient populations, making implementation of standard methods difficult. Simulating data that mirrors clinical data is important because it allows investigators to determine which method is best suited for data from their …

Psychosocial Job Stress And Oxidative Stress In Emergency Department Nurses, Rupkatha Bardhan

All ETDs from UAB

Job stress often causes work-related physical injuries and chronic exposure to such environment may lead to poor health outcomes. Job stress in recent years has grown significantly within the workforce due to performance pressure, long work hours and poor pay structures. Nurses work in the forefront to save patients’ lives. High job demand in this noble profession often leads to progressive decline in physical and mental health. There are existing reports that nurses in the United States (US) suffer from “burnout” syndrome which may also negatively affect patient care. There are very few studies that measured work-related stress in nurses …

Immunophenotype In The Molecular Epidemiology Of Breast Cancer, Michael Behring

All ETDs from UAB

This research analyzes the underlying genomic features of breast tumors during immune response, with the overall goal of discovering markers of how tumor immunity and the known features of disease pathology relate. We aimed to 1) identify and validate somatic copy number variation and RNA expression associated with nodal metastasis; 2) construct an array-based measure of tumor infiltrating immune cells and determine its prominent clinical and transcriptional features; and 3) examine the relationship between somatic mutations within p53 and tumor immune cell infiltration status. In two sets of data, gene-level copy number variation (CNV) and RNA expression from the primary …

Interaction Between Income, Health Insurance, And Self-Rated Health: A Path Analysis., Atalie Ashley West

Electronic Theses and Dissertations

The political focus of equitable health outcomes in the United States have long centered on access to medical care. However, there is compelling evidence that access to medical care is only the bare minimum necessary to achieve health, and the true influence of health insurance on health is still unclear. Widely accepted models of health estimate that less than 20% of health outcomes can be attributed to clinical care, while greater than 50% is related to social and economic determinants of health, with income being the most consistent predictor. As a result, this study investigated whether earned income is related …

Racial/Ethnic Differences In The Treatment Of Elderly Non-Small Cell Lung Cancer Patients, Cheryl Mokrzecky

Walden Dissertations and Doctoral Studies

Racial and ethnic disparities related to lung cancer treatments and outcomes are not fully understood but may be due to individual or institutional factors. Following established national cancer treatment guidelines may improve patients' quality of life, outcome to treatment, and facilitate the eradication of lung cancer. There are limited data on the real-world treatment of racial/ethnic groups with non-small cell lung cancer (NSCLC) according to clinical practice guidelines, therefore this population-based cohort study examined the receipt of first line treatment for advanced or metastatic NSCLC according to the National Comprehensive Cancer Network (NCCN) practice guidelines. The Social Cognitive Theory served …

Factors Influencing Alzheimer's Disease Healthcare Utilization Patterns In Puerto Rico, Carlamarie Noboa

Walden Dissertations and Doctoral Studies

Alzheimer's disease (AD) is associated with substantial healthcare utilization costs, resulting in a public health priority. In this study, the relationship between the demographic characteristics of age, gender, and type of health insurance; the presence of comorbidities of older Puerto Rican residents diagnosed with AD; and their healthcare utilization patterns (i.e., medical office and emergency room visits and hospital admissions) was examined using Andersen's behavioral model. Data from the 2013 Puerto Rico Health Study was used in this retrospective cohort design study. All AD cases aged -?¥ 60 years were extracted using systematic random sampling. One-way ANOVA-WELCH, Mann-Whitney U test, …

The Impact Of Transmission Mode On Hiv/Aids Medication Adherence, Lindsey Wilde

Walden Dissertations and Doctoral Studies

Medication adherence amongst HIV/AIDS infected individuals can be challenging for many reasons. I examined whether there was an association between mode of HIV transmission, such as sexual intercourse, mother to child, or IV drug use, and medication adherence among HIV+ individuals 18 years and older living in New York City. The theoretical base for this study was the Social Ecological Systems Theory. Logistic regression analyses were conducted on field data obtained from the New York State Medicaid Agency from 2015. Results indicated that transmission mode, age, race, and poverty level all have statistically significant associations with the dependent variable of …

Association Between Genetic Ancestry And Body Mass Index Among A Cohort Of Hispanic American Children, Sahel Hazrati

Walden Dissertations and Doctoral Studies

Childhood obesity is disproportionately higher among children from Hispanic backgrounds. Ethnicity is a social and cultural construct and does not capture true ancestral heterogeneity. Hispanic Americans have a wide variety of genetic admixture proportions of European (EUR), Native American (AMR), and African (AFR) ancestry. The objective of this cross-sectional study was to assess the contribution of ancestral genetic composition to body mass index (BMI), and to evaluate the relationship of obesity risk factors to BMI among 154 2-year-old Hispanic American children. The theory of Evolutionary Developmental Biology was utilized to investigate the relationship between children's growth process and ancestral background. …

Racial And Cultural Etiology Of Body Satisfaction Among Obese, Young Adult Women, Deirdre Lynnett Moyer

Walden Dissertations and Doctoral Studies

Obesity, a public health issue in the United States, has been linked to numerous chronic diseases. A gap exists in the literature related to racial and cultural etiology of body satisfaction for obese women. The purpose of this qualitative phenomenological study was to describe the racial and cultural etiology of body satisfaction for obese Black women and White women residing in a rural area of the state of North Carolina. Social comparison theory provided the theoretical underpinning for this examination. The central research question was how do obese, young adult Black women and White women describe their perceptions about and …

Parental Influence On Hiv Vertical Transmission In Kenya, Hussein Abdi Nunow

Walden Dissertations and Doctoral Studies

Mother-to-infant vertical transmission of HIV usually occurs during pregnancy, labor, delivery or breastfeeding. It is the third leading cause of transmission of HIV after sexual intercourse and blood transfusions. In 2008, 12 million women aged 15 years and above were anticipated to be living with HIV in countries within Sub-Saharan Africa. In this study, the association between parental HIV knowledge, attitudes and risk reduction practices, and HIV vertical transmission in Kenya were explored. The health belief model was used to help understand and interpret the findings. For this quantitative study, data were collected via surveys from 212 participants in 3 …

A Limited Rational Choice Theory In Local Public Health Decision Making, Lona Bryan

Walden Dissertations and Doctoral Studies

The threat and occurrence of terrorist attacks have increased in the United States since September 2011, heightening concerns for weaponized anthrax, other biological pathogens, and epidemics and pandemics. Early decisions and funding levels in local public health agencies can be the first line of defense or first point of failure; yet little is understood about how decisions are made when there are budget cuts before a biological event happens. Using Lindblom's conceptualization of limited rational choice theory, the purpose of this single case study was to understand how a local public health official made decisions after budget cuts in a …

Determinants Of Low Birth Weight In A Population-Based Sample Of Zimbabwe, Paul Nesara

Walden Dissertations and Doctoral Studies

Low birth weight (LBW) is a major public health concern globally. Despite its negative social and economic impact on the family and community at large, it has remained relatively unexplored at population level in Zimbabwe. The purpose of the study was to establish determinants of LBW using data from the 2015 Zimbabwe Demographic and Health Survey. The socioecological model was the conceptual framework for the study. A secondary analysis was conducted on 4,227 mother-infant dyads. Independent variables were duration of pregnancy, number of births within the past 5-year period, exposure to mass media, type of fuel used for cooking in …

Awareness And Attitudes Of Young Nigerian Immigrants In The United States To Sickle Cell Screening And Premarital Genetic Testing, Timothy Atolagbe

Walden Dissertations and Doctoral Studies

The carrier frequency for sickle cell anemia among Nigerians, who account for a high percentage of African immigrants in the United States, is high, according to the World Health Organization. Even though sickle cell disease contributes $2.4 billion annually to U.S. health care expenditures, ascertaining the number of affected individuals in the U.S. is difficult because sickle cell is not a reportable genetic disease. However, according to the Census Bureau, the number of African immigrants continues to grow at a steady pace among the foreign-born immigrant population in the U.S. There is a lack of research on the contribution of …

Head Start Parent Perspectives On Child Exposure To Secondhand Smoke At Home, Christiana Abani Bekie

Walden Dissertations and Doctoral Studies

Children exposed to secondhand smoke (SHS) are at risk of developing ear infections, asthma, wheezing, bronchitis, as well as retarded lung growth. Indoor smoking is the main source of children's exposure to SHS. Despite a downward trend in smoking, children from low income families, especially African American and Hispanic children, continue to be exposed to SHS at a higher rate than their wealthier counterparts. This multiple case study explored the perceptions of 15 parents of 3- to 5-year-old children currently enrolled in Head Start regarding children's exposure to SHS. This study relied on the social ecological model, the theory of …

Improving Glycemic Control In Adult With Type 2 Diabetes, Basirat Romoke Triplett

Walden Dissertations and Doctoral Studies

Ninety percent of people with diabetes have Type 2 diabetes mellitus (T2DM). T2DM is a complex disease that affects every organ in the body, which makes effective management of the disease imperative. The American Association of Clinical Endocrinologist (AACE) and American College of Endocrinology (ACE) strongly recommended early treatment initiation among the target population to delay disease progression and complications. The purpose of this evidence-based project was to examine the impact of using the T2DM management algorithm for effective management of adults with T2DM over a 3-month period. The shared experience decision-making model and the chronic care model were used …

Infant Feeding Practices In China And Ireland - Ireland Chinese Mother, Qianling Zhou, Katherine Younger, John Kearney

Articles

Introduction: Migration to another country may induce changes in infant feeding practices especially where such practices differ considerably between the two countries. This study was undertaken to compare the infant feeding practices between Chinese mothers who gave birth in Ireland (CMI) with immigrant Chinese mothers who gave birth in China (CMC), and to examine the factors that influence these practices. Methods: A cross-sectional self-administrated survey was conducted among a convenience sample of 322 Chinese mothers living in Ireland. Data were obtained from mailed questionnaires. Infant feeding practices between CMC and CMI were compared by Chi-square or independent sample t-test. Binary …

Optimization Of Folic Acid Supplementation In The Prevention Of Neural Tube Defects, Shona Cawley, Daniel Mccartney, Jayne V. Woodside, Mary Rose Sweeney, Robert Mcdonnell, Anne M. Molloy, Michael J. Turner

Articles

Background We examined the relationship between timing and duration of folic acid (FA) supplementation in achieving red blood cell (RBC) folate levels in early pregnancy which are optimal (>906 nmol/l) for the prevention of neural tube defects (NTDs). Methods Clinical, FA supplementation and dietary folate details were computerized at the first antenatal visit. Maternal blood samples were analysed for RBC and serum folate. Results Of the 502 women, 98.2% (n = 493) reported taking FA. There was a positive correlation between duration of supplementation and both RBC folate (r = 0.43, P < 0.001) and serum folate (rho = 0.29, P < 0.001). The optimal RBC folate level was achieved in 80.4% (n = 46) of women who started FA 400 μg 4–8 weeks before their LMP compared with only 53.6% (n = 153) in women who started 4–8 weeks after their LMP (P < 0.001). Conclusions This study provides, for the first …

Public Health Implications Of Metal Ash Concentrations From Prescribed Burns: A Study Of Open Jarrah Forests, John Edwards

Theses: Doctorates and Masters

Ash is not a homogenous product. It is the solid residue of combustion and contains a complex mixture of chemical products. The fire that produces ash is non-discriminatory in that it will burn anything that is combustible. The ash residue resulting from fires varies and is dependent on its source, and burn characteristics such as the temperature of the fire. Ash comprises particles of carbon, soot and trace elements. Ash presents public health risk to people and communities, through direct and indirect ingestion, inhalation and absorption. The health effects of ash exposure are not limited to symptoms affecting the eyes, …