Digital Commons Network^™

Salmonellosis In Kentucky Cattle - 2003-2014, Azia Elizabeth Ramirez

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

The group of bacteria known collectively as Salmonella has historically been a major cause of both health and economic hardships. In particular, Salmonella in bovine has been estimated to cause the economy to lose billions of dollars annually, both due to the increased morbidity and mortality rates of the cattle themselves and the indirect loss of potential profits, and also results in the spread of the bacteria to humans to ill effect. Salmonella thus can be quite taxing to agricultural communities, the animals upon which they rely, and the consumers that buy said communities’ commodities. Thus, the importance of an …

Outbreak Severity Index: The International Response To The Global Outbreaks, Mohamed A. Abofaye

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

Outbreaks are emergency situations that carry hazards of death, disability, loss of home and property, and variety of other calamities. With technological advancement, not only people and commodities are easy to transfer but also disease outbreaks. However, outbreaks are dealt with by different countries based on the differences in their healthcare systems and their ability to achieve effective control of the outbreak. SARS, MERS, and Ebola are example of such outbreaks that traveled around the globe and successful control was different according to the virulence of outbreak agent and to the effectiveness of local health system control measures. This capstone …

Injury Prevention In An Industrial Environment Via Strategic Job Placement, Michelle Cooper

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

Objectives. This study investigated the effects of an injury prevention program, specific to work related musculoskeletal disorders (WMSDs), which placed employees into jobs based on their physical abilities compared to the physical demands of their prospective jobs.

Methods. Employee injury data (N=3550) from a large auto manufacturer in the U.S. was analyzed to examine changes in injury rates for employees that were hired pre versus post-strategic placement. Bivariate and multivariate analyses were used to determine dependence between placement, injury within 120 days of hire and gender.

Results. Chi-square tests of independence revealed that injury rates and job placement may be …

Organizational Effectiveness Frameworks In Public Health Nonprofit Systems: A Case Study, Morgan Floyd

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

Problem: Nonprofits, especially in public health, have become more and more prevalent in recent years. With that increase in support, come greater awareness from stakeholders evaluate nonprofits as effective and impactful on the communities they serve. Frameworks of Organization Effectiveness allow investigators to predict how effective an organization might be in their work. The aims of this study were to identify key Organizational Effectiveness frameworks that could be used to evaluate Nonprofits and use them in practice. Therefore, individuals wishing to become involved with effective nonprofits will be empowered to make good investments of volunteer time and donations

Method: This …

Are Semen Quality Parameters Sufficient For Biomonitoring Spermatozoa Dna Integrity And Oxidatively Damaged Dna, Hueiwang Anna Jeng, Ruei-Nian Li, Wen-Yi Lin

Community & Environmental Health Faculty Publications

The present study aimed to investigate the relationship between semen quality parameters and DNA integrity, and determine whether semen quality parameters could serve as a reliable biomarker for monitoring sperm DNA damage. Conventional semen parameters from a total of 202 male human subjects were analyzed. DNA fragmentation and 8-oxo-7,8-dihydro-2′- deoxyguanosine (8-oxoGuo) were used to assess sperm DNA integrity. DNA fragmentation was analyzed by the terminal deoxynucleotidyl transferase dUTP nick end labeling (TUNEL) assay and sperm chromatin structure assay (SCSA), while 8-oxodGuo was quantified by the liquid chromatography/tandem mass spectrometry (LC-MS/MS) coupled with an on-line solid phase system. The levels of …

Association Between Stressful Life Events And Change Of Maternal Smoking During Pregnancy Using Prams 2011-2012, Shidie Tang

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

Objective: To examine the association between stressful life events during pregnancy and change of maternal smoking behaviors.

Methods: We used data from the CDC’s Pregnancy Risk Assessment Monitoring System (PRAMS) to conduct the research. Our data included 24 states from 2011-2012. We considered 13 stressful life events and grouped them into four categories: emotional, partner-related, financial and traumatic stressors. Change of Maternal Smoking during pregnancy was defined by smoking at the last trimester of pregnancy versus smoking at 3 months prior to smoking. Confounders included maternal age, race/ethnicity, education, marital status, Medicaid coverage upon delivery and income prior …

Developments In Nonparametric Regression Methods With Application To Raman Spectroscopy Analysis, Jing Guo

Theses and Dissertations--Epidemiology and Biostatistics

Raman spectroscopy has been successfully employed in the classification of breast pathologies involving basis spectra for chemical constituents of breast tissue and resulted in high sensitivity (94%) and specificity (96%) (Haka et al, 2005). Motivated by recent developments in nonparametric regression, in this work, we adapt stacking, boosting, and dynamic ensemble learning into a nonparametric regression framework with application to Raman spectroscopy analysis for breast cancer diagnosis. In Chapter 2, we apply compound estimation (Charnigo and Srinivasan, 2011) in Raman spectra analysis to classify normal, benign, and malignant breast tissue. We explore both the spectra profiles and their derivatives to …

Nonlinear Hierarchical Models For Longitudinal Experimental Infection Studies, Michael David Singleton

Theses and Dissertations--Epidemiology and Biostatistics

Experimental infection (EI) studies, involving the intentional inoculation of animal or human subjects with an infectious agent under controlled conditions, have a long history in infectious disease research. Longitudinal infection response data often arise in EI studies designed to demonstrate vaccine efficacy, explore disease etiology, pathogenesis and transmission, or understand the host immune response to infection. Viral loads, antibody titers, symptom scores and body temperature are a few of the outcome variables commonly studied. Longitudinal EI data are inherently nonlinear, often with single-peaked response trajectories with a common pre- and post-infection baseline. Such data are frequently analyzed with statistical methods …

The Non-Steroidal Anti-Inflammatory Drugs-Myocardial Infarction Association: An Investigation Of Kentucky Medicaid Prescription Claims, Leonard A. Gordon

Theses and Dissertations--Epidemiology and Biostatistics

Non-steroidal anti-inflammatory drugs (NSAIDs) are among the most widely used medications globally. There are generally two types: selective (COX-2) and traditional NSAIDs (COX-1). They are primarily used for the treatment of pain. They gained attention after a study about their basic mechanisms highlighted their toxicity.

Several studies have reported an association between NSAIDs and risk of myocardial infarction (MI). However, the direction of the relationship is not conclusive. Further studies are needed to ascertain the direction of this relationship and evaluate the present situation with available drugs. Due to the seriousness of cardiovascular diseases as one of the leading cause …

Effects Of Education On Victims Of Domestic Violence, Julette N. Anderson

Walden Dissertations and Doctoral Studies

The purpose of this project was to improve support for victims of domestic violence. To that end, this project developed an evidence-based program to provide information about domestic violence including safe and confidential ways to seek assistance, rights as cohabiting intimate partners, and the resources available to community members. Several approaches were used to develop, validate, and plan for implementation and evaluation of this program, which was developed for 3 sites in Broward and Miami-Dade counties where the project is situated. The program logic model and the social ecological model, including the individual, relationship, community, and societal levels, were used …

Assessment Of Vitamin D Levels And Depression Among Adults In The United States, Troy Jean-Luc Owens

Walden Dissertations and Doctoral Studies

Vitamin D is essential to optimizing health; vitamin D deficiency (VDD) can increase risk of hypertension, cardiovascular disease, and insulin resistance. VDD occurs when individuals do not receive sufficient oral intake or obtain adequate sun exposure. Previous researchers indicated there is a relationship between VDD and depression, while others have indicated there is no relationship. The purpose of this study was to examine the relationship between vitamin D levels and depression, and how this relationship might be moderated by an individual's demographic characteristics (gender, age, smoking status, or marital status). This study was a quantitative data analysis of archival data …

The Association Between Exhaled Nitric Oxide In Exhaled Breath Condensate And Chronic Obstructive Pulmonary Disease, Colin Mitchell

Walden Dissertations and Doctoral Studies

Chronic obstructive pulmonary disease (COPD), a progressive and nonreversible disease, is a leading cause of mortality and morbidity throughout the world. Detecting COPD early in the disease process will help in decreasing later stage COPD severity. Because airway inflammation is a hallmark of COPD, it has been proposed that measuring exhaled nitric oxide, a marker of inflammation, in exhaled breath condensate could prove to be an inexpensive and efficient method to detect COPD in outpatient settings. Using the hypothetico-deductive theory as a guideline, this study used secondary data from the National Health and Nutrition Examination Survey 2007 to 2010 to …

Relationship Between Modality And The Degree Of Knowledge Retention In Bioterrorism Training, Gaylon Rashun Crawford

Walden Dissertations and Doctoral Studies

A public health workforce must be trained to react quickly, especially in the case of terrorist attack. Political leaders and emergency management experts have often cited inadequate emergency training as a contributing factor in the public health system's failed preparations for a bioterrorist event. As a result of these failures, billions of dollars have been allocated towards correcting infrastructure deficiencies including training for public health nurses (PHNs), who are critical to a communitywide medical response. This quantitative study used Pearson's correlation and a multivariate regression analysis to evaluate the most effective modality of bioterrorism training (BTT) for PHNs working in …

Evaluating Retention Strategies For At-Risk Undergraduate Nursing Students, Joanna L. Ramsden-Meier

Walden Dissertations and Doctoral Studies

As there continues to be a nursing shortage and a lack of diversity in the nursing profession, it is important to retain at-risk students who have been admitted to nursing programs. The purpose of this program evaluation was to compare at-risk students who had not received retention services to at-risk students who had received retention services at a Midwestern college. A formative evaluation was conducted using information from three sources: the college, the students, and the community. Guided by a constructivist theory defined by Ponticell, this study examined the effectiveness of the retention program in terms of its impact on …

The Synergistic Impact Of Income And Rurality On Timely Mammograms In A National Sample Of Women In The United States, Asri Mumpuni

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

Introduction. Breast cancer is the cancer of highest incidence among women in the U.S., making it a significant public health problem. Currently, the U.S. Preventive Services recommends biennial screening mammography for women ages 50-74. This study examined the associations between socioeconomic status and rurality on breast cancer screening behavior. Methods. Data for this study come from the Centers for Disease Control and Prevention (CDC) Behavioral Risk Factor Surveillance System Survey (BRFSS). Breast cancer screening behavior was dichotomized into those who did not meet screening mammogram recommendations (2 years or more) and those who met screening mammogram recommendations (within the …

Association Between Psychological Trauma From Assault In Childhood And Metabolic Syndrome, W Sumner Davis

Walden Dissertations and Doctoral Studies

Metabolic syndrome and its component conditions of hypertension, obesity, and insulin resistance are on the increase in United States. Metabolic syndrome substantially increases the risk of cardiovascular disease and type 2 diabetes (T2D). To date, no published study has examined the relationship between psychological traumas from physical and/or sexual assault in childhood and metabolic syndrome or its components. This study, using the psychoneuroimmunology (PNI) model, investigated associations between psychological trauma (physical/sexual abuse) in childhood and metabolic syndrome in adulthood using data from the Midlife in the United States II (MIDUS-II) study. This research was undertaken to investigate whether a history …

Weight Management Of Women Of Childbearing Age, Marcia Hagen

Walden Dissertations and Doctoral Studies

Black River Memorial Hospital identified obesity as a priority health concern in its rural service area; this concern was in line with the county's needs assessment. It was identified that women of childbearing age affect the lifestyle and health choices of their families and that they are at higher risk for the additional health risks associated with obesity affecting pregnancy and birth. Despite the identification of these risk factors, the factors that affect healthy weight management have not been well understood. Using the life course theory, a qualitative inquiry in the form of a structured interview was developed with local …

Bayesian Nonparametric Cross-Study Validation Of Prediction Methods, Lorenzo Trippa, Levi Waldron, Curtis Huttenhower, Giovanni Parmigiani

Publications and Research

We consider comparisons of statistical learning algorithms using multiple data sets, via leave-one-in cross-study validation: each of the algorithms is trained on one data set; the resulting model is then validated on each remaining data set. This poses two statistical challenges that need to be addressed simultaneously. The first is the assessment of study heterogeneity, with the aim of identifying a subset of studies within which algorithm comparisons can be reliably carried out. The second is the comparison of algorithms using the ensemble of data sets. We address both problems by integrating clustering and model comparison. We formulate a Bayesian …

Patchy Progress On Obesity Prevention: Emerging Exemplars, Entrenched Barriers, And New Thinking, Christina A. Roberto, Boyd Swinburn, Corinna Hawkes, Terry T-K Huang, Sergio Costa, Marice Ashe, Lindsey Zwicker, John H. Cawley, Kelly D. Brownell

Publications and Research

Although there have been positive pockets of change, no country has yet turned around its obesity epidemic. Preventing an increase in obesity prevalence will require urgent actions from government as well as a broader spectrum of stakeholders than previously emphasized. In this paper, we review a number of regulatory and non-regulatory actions taken around the world to address obesity and discuss some of the reasons for the patchy progress. In addition, we preview the papers in this Lancet series, which each identify priority actions on key obesity issues and challenge some of the entrenched dichotomies that present obesity and its …

Peer Support Education For Uncontrolled Hypertension Among African Americans Adults, Melvina Juliana Semper

Walden Dissertations and Doctoral Studies

Hypertension is a major chronic health problem that can lead to heart attack, stroke, and kidney failure. African Americans disproportionately suffer from the morbidity and mortality of hypertension-related illnesses. The purpose of this comparative project was to determine the impact of peer support educational workshops as an avenue for lifestyle modification, using changes in blood pressure (BP) before and after participation. The target population consisted of 64 African Americans with hypertension in Brooklyn NY, aged 20 to 65 years old. BP measurements were taken within 1 month before and after participating in a weekly peer support educational workshop facilitated by …

Preventative Strategies To Improve Birth Outcomes Among African American Women In Rhode Island, Yvonne Michele Heredia

Walden Dissertations and Doctoral Studies

Despite increased access to prenatal care, birth outcomes continue to be a major source of disparity among women in the United States. The focus on lifestyle choices and negative behaviors prior to a pregnancy to reduce adverse birth outcomes has become a well-documented strategy. The purpose of this study was to determine if preparing for a pregnancy in advance improves birth outcomes for African American women of childbearing age between the ages of 12 and 45 years in the State of Rhode Island (RI). The theoretical foundation for this study was based on Prochaska's model of change, which is also …

Baseline Survey Instruments: Adolescent Girls Initiative–Kenya, Population Council

Poverty, Gender, and Youth

This document contains various AGI-K survey instruments, including: Household Characteristics Survey (English), Respondent’s Schooling History (English), Respondent’s Work in Last Year (English), Respondent’s Spending in Last Year (English), Respondent’s Savings in Last Year (Kiswahili), Respondent’s Savings in Last Year (English).

Building Assets Toolkit: Developing Positive Benchmarks For Adolescent Girls—Resource Manual, Judith Bruce, Sarah Engebretsen, Kimberly Glazer

Poverty, Gender, and Youth

This document contains the Building Assets Toolkit’s Resource Manual, which includes valuable information about building meaningful program content as well as detailed notes on each asset for use in the toolkit’s “Asset Building Exercise.” This exercise is designed to involve multiple stakeholders in determining what assets girls need in order to survive and thrive. The Building Assets Toolkit is an approach for developing programs for specific segments of girls that will prepare them to better face the challenges of growing up. It will help program managers understand the needs of the girls in their community, engage stakeholders at different levels …

Understanding Factors Influencing Adverse Sex Ratios At Birth And Exploring What Works To Achieve Balance: The Situation In Selected Districts Of Nepal, Mahesh Puri, Anand Tamang

Poverty, Gender, and Youth

The goal of this study is to identify programs and sociocultural factors underlying disparities in sex ratios at birth in some parts of Nepal, by comparing the situation in districts with high and normal sex ratios at birth and among under-5 children. Findings are expected to inform the design of programs intended to raise the value of girls in general and counter the practice of gender-biased sex selection in particular. The study was conducted in two adjoining hill districts of the western development region of Nepal, namely Kaski (where sex ratios are adverse) and Tanhaun (where sex ratios are normal). …

Anneau Vaginal À Progestérone: Évite Les Grossesses, Population Council

Reproductive Health

Cette fiche de renseignements fournit des informations sur l’utilisation de l’anneau contraceptif vaginal à la progestérone pour prévenir la grossesse. L'anneau vaginal à progestérone (AVP) offre une nouvelle manière de fournir un moyen de contraception. Il a été prouvé qu'il s'agit d'une méthode contraceptive sûre et efficace pour les femmes qui allaitent. Utilisé par ces femmes, l'AVP évite les grossesses en inhibant la croissance folliculaire et, par conséquent, empêchant l'ovulation; renforçant les effets inhibiteurs de l'allaitement maternel sur l'ovulation; étendant l'aménorrhée post-partum; et épaississant la glaire cervicale, et donc en empêchant les spermatozoïdes d'atteindre l'ovule. L'AVP donc étend la gamme …

Progesterone Vaginal Ring: Prevents Pregnancy, Population Council

Reproductive Health

This fact sheet provides information about how the progesterone vaginal contraceptive ring works to prevent pregnancy. The progesterone vaginal ring (PVR) offers a novel way of delivering safe and effective contraceptives for lactating women. When used by such women it prevents pregnancy by inhibiting follicular growth, hence preventing ovulation; reinforcing the inhibitory effect of breastfeeding on ovulation; extending postpartum amenorrhea; and thickening the cervical mucus, thus inhibiting sperm from meeting the egg. The PVR expands the range of contraceptives available to lactating women and has the potential to contribute to improving maternal and infant health.

Are Parents Talking To Adolescents About Sexuality? Evidence From Four Slums In Ghana, Selina F. Esantsi, Francis Onyango, Gloria Quansah Asare, Emmanuel Kuffour, Placide Tapsoba, Harriet Birungi, Ian Askew

Reproductive Health

This evidence brief summarizes the essential information from a part of a larger study that assessed the sexual and reproductive health (SRH) needs of adolescents in four slums in two regions of Ghana. The objective of this brief is to provide evidence to support and facilitate the improvement of parent–adolescent communication on sexuality. This study echoes several other studies by providing evidence that a majority of parents are not opposed to in-school sex education for their children and welcome the idea of empowering themselves (parents) to have productive discussions with their children. Nevertheless, there is a mismatch between the proportion …

What Are The Sexual And Reproductive Health Needs Of Adolescents In Ghana’S Slums?, Selina F. Esantsi, Gloria Quansah Asare, Placide Tapsoba

Reproductive Health

To address the need for quality evidence on the sexual and reproductive health (SRH) needs of adolescents in slums, the STEP UP project conducted a study in four slum settings in Ghana. This policy brief highlights key points, including the need for a well-designed, comprehensive sex education curriculum; interventions that address sexual coercion and violence as an integral component of current adolescent reproductive health programs; and the need to involve all stakeholders including parents/guardians and community leaders in addressing adolescent SRH needs. Evidence from the study can be used to improve ASRH programming so that it better meets the needs …

Understanding The Reproductive Health Needs Of Adolescents In Selected Slums In Ghana: A Public Health Assessment, Selina F. Esantsi, Francis Onyango, Gloria Quansah Asare, Emmanuel Kuffour, Placide Tapsoba, Harriet Birungi, Ian Askew

Reproductive Health

Over the past decade, adolescent sexual and reproductive health (ASRH) concerns have increasingly been on the development agenda of the government of Ghana. This concern has been driven by such factors as early age of sexual debut, early childbearing, and prevalence of HIV/AIDS among this subgroup of the population. The overall objective of the study was to generate evidence on the knowledge, perceptions, and practices regarding ASRH among slum communities in Ghana. The findings of the study indicate a need for intensifying efforts to inform and educate adolescents living in the slums about responsible and healthy attitudes toward sexuality, delaying …

Education Sector Response To Early And Unintended Pregnancy: A Review Of Country Experiences In Sub-Saharan Africa, Harriet Birungi, Chi-Chi Undie, Ian Mackenzie, Anne Katahoire, Francis Obare, Patricia Machawira

Reproductive Health

In Sub-Saharan Africa (SSA), early and unintended pregnancy leads to a colossal loss of educational opportunities for girls. Existing studies that show associations between early/unintended pregnancy and school dropout lead to critical questions about how the education sector is responding to the issue in SSA. Conducted from August 2014 to April 2015, this review was devoted to an examination of such responses across six countries: Botswana, Kenya, Malawi, Tanzania, Uganda, and Zambia. The review focused on several key issues, including: education-sector policies for pregnant students and adolescent mothers; integration of pregnancy prevention into sexuality education curricula; the school environment as …