Digital Commons Network^™

Epidemiology, Risk Factors, And Effectiveness Of Treatment Of Crimean Congo Hemorrhagic Fever In Turkey, 2007-2012, Eda Akyar

Public Health Theses

Objective: Crimean Congo Hemorrhagic Fever (CCHF) is caused by a Nairovirus of the Bunyaviridae family. It was first reported in Turkey in 2002. Infections commonly result from bites from ticks of Hyalomma marginatum marginatum or Rhipicephalus bursa species. Nosocomial infections also occur. CCHF infection occurs in over 30 countries in Europe, Asia and Africa. No vaccine exists and the effectiveness of ribavirin treatment remains controversial. This study's objective was to identify significant epidemiological, environmental, and clinical risk factors associated with disease and death caused by CCHF in Turkey. This study also evaluated the effectiveness of ribavirin as treatment for patients …

Hpv Vaccine Effectiveness In New Haven County, Connecticut Women Age 18-39, 2008-2012, Jennifer Lynn Berry

Public Health Theses

Background: HPV vaccines have demonstrated high efficacy in clinical trials against cervical lesions and infections by HPV vaccine types 16 and 18. Together these two types are responsible for approximately 70% of cervical cancer. Data on HPV vaccine effectiveness in general populations is limited.

Methods: Surveillance data monitoring high-grade cervical lesions in Connecticut was used. Medical records were reviewed and patients were interviewed to ascertain HPV vaccine history. Patients' biopsy specimens were typed to determine the presence of vaccine or non-vaccine type HPV. Odds ratios were determined using logistic regression, adjusting for age at diagnosis, grade of cervical lesion, race/ethnicity, …

Obesity Not A Risk Factor For Adverse Seasonal Influenza Outcomes Among Hospitalized Adults: Evidence From A Us Multisite Study, Elise Braun

Public Health Theses

Background Data on the association between obesity and seasonal influenza complications is unclear.

Objectives We explored the association between body mass index (BMI) and the adverse outcomes of artificial ventilation, intensive care unit (ICU) admission, and X-Ray confirmed pneumonia among patients hospitalized with laboratory-confirmed influenza during the 2012-2013 influenza season.

Methods We used a large, multi-site database with laboratory-confirmed influenza hospitalization surveillance data to examine the association between obesity and influenza complications. We controlled for various demographic characteristics, comorbidities, lifestyle factors, and patient care factors.

Results We explored the association between obesity and three influenza-related complications: artificial ventilation, ICU admission, …

Risk Factors For Q Fever Seroconversion In A Cohort Of Veterinary Students: A Comparative Analysis, Jessica Bonthius

Public Health Theses

Introduction: Coxiella burnetii (C. burnetii) is an extremely infectious, environmentally persistent intracellular bacterium and the causative agent of the zoonosis Q fever. An unprecedented epidemic in the Netherlands between 2007 and 2010 revealed its public health importance. Recent investigations have focused on C. burnetii seroprevalence among livestock workers. The burden of disease in veterinary students, a group with arguably similar exposures, has been insufficiently characterized.

Methods: Students beginning veterinary study at Utrecht University's Veterinary Medical School in 2006 were invited to participate. Questionnaires and serum samples for the detection of IgM and IgG antibodies against C. burnetii were collected at …

Risk Of Hypoglycemia Among T1dm Individuals Who Exercise Regularly, Jennifer Audrey Campbell

Public Health Theses

ABSTRACT

Objective: Exercise training and sport activity are important for good health among those with type 1 diabetes mellitus (T1DM); however, fear of hypoglycemia is a clear barrier to participation. We examined both the main demographic and exercise training risk profiles for exercise-associated and nocturnal hypoglycemia, including indicators of unawareness. Mode of insulin delivery, whether multiple daily injections (MDI) via pen or continuous subcutaneous insulin infusion (CSII) via pump, was an important consideration.

Research Design: Our study was based on data from an internet-based survey in the Netherlands that attracted T1DM participants who engage in routine exercise or sport activity. …

Lifetime Prevalence Of Male-Male Ipv Perpetration In A Community Health Clinic-Based Sample: Implications For Self-Reported Sti And Condom Use, Benjamin Richard Clopper

Public Health Theses

Men who engage in sexual behaviors with other men are at high risk for developing a sexually transmitted infection (STI). They also have reduced access to health care services and poorer health outcomes after developing an STI than their white or higher-income counterparts. Intimate partner violence (IPV) is an established risk factor for STI contraction and non-condom use in male-female dyads. Such research on IPV in male-male couples is lacking. The objectives of this study are to document the lifetime prevalence of male-male IPV among an urban, minority community health center-based sample, examine associations between male-male perpetrated IPV and self-reported …

Muddied Waters: Exploring Iowa's Water Policy And Practices, Jorgen D. Rose

Honors Program Theses

Clean, usable fresh water is a precious and valuable resource, but it is one that we often mistreat and misuse. Surface water in particular is extremely vulnerable to human actions and influences; nowhere is this more apparent than in agricultural states like Iowa, where nonpoint-source pollution (runoff) has a dramatic effect on our rivers, lakes, and streams. However, despite this continuing decline in the quality of Iowa’s water, there exists very little public policy aimed at dealing with the problems of nutrient contamination and other forms of nonpoint-source pollution. Furthermore, what policy does exist is either ineffective or insufficient. The …

Positional Plagiocephaly Among Tribal Societies And Contemporary Western Societies: A Comparison Of Treatments, Results, And Effects, Jacinda Rose Ruggles

Honors Program Theses

This study explores the two causes of positional plagiocephaly, or abnormal head shape in infants as well as effects and treatments. To do so, two groups were chosen for comparison: contemporary western societies and tribal Native American societies. In the first group, the medical condition known as positional plagiocephaly is considered before, during and after the Safe to Sleep campaign of the 1990’s. In the second group infant head flattening is discussed as a result of cradling practices and carrying techniques. The importance of this study is to contribute new insight into positional plagiocephaly and its treatments. The study combines …

Choosing Number And Scheduling Priority Of Warm-Hand Offs: A Des Model, Evelyn Cumberbatch

Public Health Theses

Background: The integration of behavioral health care into primary care is being promoted as a means to treat more people with behavioral health problems where they are most likely to be seen. Clinics with traditional behavioral health services may open slots among scheduled appointments to see these "warm-hand off" (WHO) patients identified by primary care providers (PCPs). The effects of giving priority for behavioral health appointments to either scheduled or WHO patients and of the number of appointments left open for WHO patients are investigated in this project.

Methods: A discrete event simulation model was built of a moderately integrated …

Qualitative Exploration Of Behaviors Related To Positive Child Growth In An Urban Slum Of Mumbai, Mary Rose D'Alimonte

Public Health Theses

Positive deviance research seeks out well-nourished children living in disadvantaged contexts with the intention of identifying local growth-promoting behaviors that contribute to their relatively healthy status. The aim of this study was to explore positive child health behaviors in the Dharavi slum of Mumbai. Children with a height-for-age z-score (HAZ)>0 (n=10) or a HAZ<-2.0 (n=12) were purposefully selected from the Society for Nutrition Education and Health Action's (SNEHA) Child Health and Nutrition program, a child growth monitoring program. Qualitative methods were employed by means of semi-structured interviews with mothers. Eligibility was restricted to households with limited resources and more than one child. A 24-hour dietary recall and anthropometric measurements were taken for the index child. An observation checklist assessed household hygiene. Coding was based on the Grounded Theory of qualitative research. Emergent themes among positive deviant families included: optimal infant and young child feeding practices; maternal information seeking behaviors; adequately managing household hygiene and food allocation; acknowledging the importance of maternal health; and social support. Common among all participants was the consumption of high-energy/non-nutritional snacks, the value of education, and an inability to save money. Findings will be disseminated to SNEHA for program improvement.

Trauma-Informed Services And Trauma Awareness Among Staff On The College Campus, Tricia Wisniewski

Honors Program Theses

For college students to work through the effects of trauma and be able to live a more normalized life, the availability of effective trauma-informed services on campus environments is crucial. Therefore, I chose to investigate the availability of trauma-informed services to all students on the college campus. The purpose of this study is to examine the relatively unexplored area of trauma informed services in the context of college campus through survey methods at the University of Northern Iowa (UNI). In particular, this study focuses on trauma-informed services and employees’ trauma awareness in four service units on the UNI campus: the …

Area-Based Poverty And Community Associated Clostridium Difficile Infection In New Haven County, 2011-2013, Ranjit Dhaliwal

Public Health Theses

BACKGROUND: The relationship between socioeconomic status and CA-CDI incidence has not been examined. I hypothesize that there will be higher incidence rates of CA-CDI in areas of higher socioeconomic status, where individuals are more likely to have health insurance, better access to care and are more educated.

METHODS: Community onset (CO) cases from Emerging Infections program surveillance were defined as those with a CDI positive specimen sample less than four days after admission to a health care facility. Community associated CO cases were defined as those that did not have a healthcare exposure in the prior three months. Unadjusted CA-CDI …

Medication Noncompliance In Patients Over The Age Of 65: Risk Factors, Problems, And Potential Solutions, Rachel N. Cook

Honors Program Theses

Medication noncompliance is linked with a complex medication regimen, poor drug knowledge, physical limitations, psychosocial characteristics, and poor communication. As important as this problem is to patients’ health especially those over the age of 65, there really is no solution to this problem or even steps to a solution. After interviewing eight care providers, I have come up with a few steps to begin solving this problem. These steps include a medication dispenser, communication between care providers, and education provided to patients by all care providers. In the end, there is no solution that will solve every case of medication …

Sustainability Of Sustainability: Exploring Alternatives In Alternative Energy, Corey C. Cooling

Honors Program Theses

In light of a gap in the literature of what makes or breaks student biodiesel conversion programs, this thesis will give a review and analysis of select existing biodiesel conversion programs and suggest a model reflecting the characteristics of successful student programs.

The study’s research questions are:

1. What are the common themes or factors successful programs exhibit?

2. What institutional factors create a productive environment for biodiesel programs?

3. Can the tactics of successful programs be generalized?

Firstly, I define successful programs as programs that are financially feasible, develop student skills, lower the environmental impact of universities and foster …

Minority Stress And Daily Affect Among Gay And Bisexual Men, Adam Ismail Eldahan

Public Health Theses

Objectives: The primary objective of this study was to examine the possible time-variant relationship between daily minority stress and same-day affect among gay and bisexual men. Additionally, this study sought to determine whether a lagged association exists between daily minority stress and next-day affect. Lastly, this study examined trajectories of minority stress and affect during the course of the study period. Methods: 371 gay and bisexual men in New York City completed a 30-day daily diary, recording daily experiences of minority stress and daily measures of positive affect (PA), negative affect (NA), and anxious arousal (AA) (n = 8,415 diary …

Association Between Parenting Processes And Child Behavior Outcomes: The Moderating And Mediating Role Of Child Characteristics, Taylor Elizabeth Ann Goetzinger

Honors Program Theses

Past research demonstrates the importance parents have in determining the outcomes in their children’s lives. Of these outcomes, child academic achievement is extremely important. In investigating past research on parenting practices and styles, factors such as parental monitoring and involvement as well as styles of authoritative, authoritarian and permissive parenting were examined to determine an association with academic achievement in middle school children. Learning disabilities, mental disorders, child personality characteristics and child academic characteristics were other measures explored as buffers in the parenting to academic achievement relationship. Mediating effects were also examined. The current study sampled 179 middle school students …

The Influence Of Perceived Control On Breast Cancer Screening In Hispanic/Latino Women, Lianne Epstein

Public Health Theses

Background: Breast cancer is the leading cause of cancer mortality for Hispanic/Latino (H/L) women in the United States. Although incidence rates are lower among H/L women than among white women and other minorities, H/L women are more likely to be diagnosed with late-stage breast cancer and to have lower 5-year relative survival compared with non-Hispanic white women. H/L women are less likely than white and African American women to receive screening mammography according to recommended guidelines. This study examines the relationship between perceived control over three health outcome domains: 1.) remaining healthy, 2.) being diagnosed with cancer, and 3.) the …

Household Food Insecurity And Iron Deficiency Anemia In Mexican Women Of Reproductive Age, Nils Clement Fischer

Public Health Theses

Objective: To investigate the association of household food insecurity (HFI) with iron deficiency anemia (IDA) in a nationally representative cross-sectional sample from Mexico of women of reproductive age (12-49 years old).

Material and Methods: We tested the association between HFI and IDA among 16,944 women of reproductive age using multiple logistic regression. HFI was measured using the Latin America and the Caribbean Food Security Scale (ELCSA). IDA was measured with capillary hemoglobin using HemoCue photometer and defined using the WHO standards.

Results: Multivariate analyses showed that adjusted odds for IDA were 33% and 36% higher among living in moderately and …

Dengue Epidemiology In An Urban Slum Community In Salvador, Brazil, Kristine Gauthier

Public Health Theses

Brazil has experienced a major increase in the incidence of dengue fever and severe dengue since the mid-1990s. Due to incomplete vector-control and transmission prevention efforts, all four serotypes of the dengue virus now circulate in Brazil. Communities such as Pau da Lima, an urban slum in the city of Salvador, Brazil, face a high burden of disease. Beginning in 2009 enhanced surveillance for dengue fever and other acute febrile illnesses has been conducted at the São Marcos Emergency Center (CESM), the only public urgent care health center in Pau da Lima. This sentinel surveillance site serves as a model …

The Association Of Masculinity Themes In Social Network Images And Sexual Risk Behavior, Elizabeth Nicole Genter

Public Health Theses

In spite of the high prevalence of active users on social networking sites (SNSs), research examining the ways in which online social network interactions are associated with health have been limited (Morgan, et al., 2010). The primary aim of this study was to understand the context in which emerging adult men post masculine themed images and videos on their SNS's and its relationship to sexual risk behavior (e.g. number of sexual partners, concurrency, and condom use) and offline communication about sex with friends (e.g. talking about sex, HIV/STDs, and relationships), by examining the relationship between 902 images and videos posted …

Post-Diagnosis Changes In Dietary Patterns And Body Weight Among Breast Cancer Survivors, Elizabeth George

Public Health Theses

Background

Weight gain is common after a breast cancer diagnosis and is known to be a risk factor for breast cancer recurrence and mortality independent of weight and BMI at diagnosis. Determining the factors associated with post-diagnosis weight gain will provide insight into improving weight management and ultimately improving breast cancer outcomes.

Purpose

This study examined dietary patterns of breast cancer survivors and whether weight gain after a diagnosis of breast cancer was associated with post-diagnosis dietary changes among breast cancer survivors.

Methods

The study sample consisted of 100 breast cancer survivors diagnosed an average of 3.3 ± 2.1 years …

Analysis Of The Gut-Specific Microbiome Of Field-Captured Tsetse Flies, And Its Potential Relevance To Host Trypanosome Vector Competence, Bridget Catherine Hamilton Griffith

Public Health Theses

The tsetse fly (Glossinasp.) gut is colonized by maternally transmitted and environmentally acquired bacteria. Maternally transmitted symbionts are well characterized, but little is known about the origin and function of environmentally acquired bacteria inhabiting the tsetse midgut. To address this shortcoming, culture dependent and independent methods were used to characterize and quantify bacterial communities that reside within the midgut of tsetse flies collected at five geographically isolated locations in Kenya and Uganda. Bacteria were isolated from 83.33% of flies using culture dependent methods. In total, 38 strains were isolated. To increase the depth of this analysis, Illumina-based deep-sequencing of the …

Comparison Of Capillary And Venous Parasitemia Measurements In Clinical Studies Of Malaria In Ugandan Children, Adults, And Pregnant Women (Cpcv), Musleehat Hamadu

Public Health Theses

Malaria is mesoendemic in Uganda; with an entomological inoculation rate (EIR) estimated at 562 infective bites per person year (PPY), Tororo, a rural district located in Eastern Uganda, is one of the highest transmission sites. This study leveraged participants enrolled in two NIH funded trails at the Tororo District Hospital in Tororo, Uganda in order to determine whether there is a difference in parasitemia levels and the strain dynamics of Plasmodium falciparum between simultaneously collected venous and capillary blood samples over the course of 42 days of follow-up. Parasitemia levels were examined on-site via microscopy of thick and thin blood …

Emotional Intelligence & Conflict Resolution In Middle School Aged Children: The Early Effects Of An Emotional Literacy Intervention (Ruler), Monique Haynes

Public Health Theses

Emotional literacy interventions have been successful in increasing classroom organization and emotional climate. However, little has been reported on the effects of these interventions on conflict resolution and their implications for youth violence and aggression. The aim of this thesis is to determine the early effects of an emotional literacy intervention (RULER) on conflict resolution skills in middle school aged children by examining the link between RULER and conflict resolution, including emotion regulation as a mediator. This was done using a multi-method, multi-level approach. Data from 57 sixth-grade classrooms (N=754) were analyzed and included conflict resolution scores and emotion regulation …

Assessing Solvent Exposure In Connecticut Auto Body Shops, Amy Linnea Wan He

Public Health Theses

Objective The objectives of this paper are to characterize solvent exposure on an individual basis by auto body shop tasks, establish if solvent concentrations fall below current regulatory standards, and to determine predictive factors for solvent exposure levels. Predictive factors being analyzed are: indoor temperature, outdoor temperature, indoor relative humidity, outdoor relative humidity, booth type, ventilation (bay door use and general exhaust use), paint type, and specific task.

Methods Data for this paper was obtained from The SPRAY (Survey of Painters and Repairers of Autobodies by Yale) study. All statistical analysis was performed in SAS. A log transformation was first …

An Assessment Of Hookworm Infection And Albendazole Treatment Failure Among Children Ages 7-12 In Kintampo North Municipality, Ghana, Erin Leah Jaske

Public Health Theses

Background

Hookworm is a soil-transmitted nematode (STN) infection associated with rural poverty that infects 576-740 million people worldwide, 200 million of which reside in Sub-Saharan Africa. In 2001, the WHO passed a resolution that recommended annual deworming for school-aged children where the prevalence of STNs is higher than 20%. Since this time, albendazole has been widely used across sub-Saharan Africa to treat hookworm infection. Given the widespread use of albendazole as a treatment for hookworms and other STNs in humans, it becomes pertinent to ensure that resistance is monitored at the local level, and detected as it emerges. Previous research …

Measuring Performance Of Physicians In The Diagnosis Of Endometriosis Using An Expectation-Maximization Algorithm, Susan Jin

Public Health Theses

The quality of clinical studies rests on the reliability of the disease diagnosis, and it is important to assess various factors associated with the ability of a physician to provide an accurate diagnosis. Endometriosis is a gynecological disorder in women, which has typically been difficult to diagnose and assess accurately. We focus on the analysis of data collected in the Physician Reliability Study of the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), on the agreement between physicians in obstetrics and gynecology in the diagnosis of endometriosis. The objective of our …

Household Food Insecurity And Sleep Patterns Among Mexican Adults: Results From Ensanut-2012, Monica Jordan

Public Health Theses

Objective: To examine the independent association of household food insecurity (HFI) with sleep duration and quality in a nationally representative cross-sectional survey of adults in Mexico.

Methods: We analyzed data from ENSANUT-2012. We assessed the association between HFI and self-reported sleep duration and quality among 11,356 adults using weighted multinomial and binomial logistic regression. The Latin American and Caribbean Food Security Scale (ELCSA) was used to categorize food security level as secure (25.5%), mild HFI (43.7%), moderate HFI (19.0%), or severe HFI (11.8%).

Results: Overall, 20.8% of individuals reported getting less than the recommended 7-8 hours of sleep/night, 20.4% reported …

Cost Effectiveness Of Non-Laboratory Cvd Screening In Uzbekistan, Shefali Kumar

Public Health Theses

Background-- Cardiovascular disease (CVD) risk scores that require laboratory testing (e.g., cholesterol testing) are often used to identify high- and low-risk individuals for primary CVD prevention interventions, such as statin treatment. However, laboratory testing can be expensive and difficult to conduct in resource-limited settings. The aim of this study was to compare CVD risk characterization and evaluate the cost-effectiveness of non-laboratory based and laboratory-based CVD risk scores for adults in Tashkent City, Uzbekistan.

Methods--CVD risk for 853 adults (376 men, 477 women) from Tashkent City, Uzbekistan was assessed using laboratory-based and non-laboratory-based scores calculated from 2002 Uzbekistan Health Examination Survey …

Adverse Childhood Experiences (Aces) And Their Influence On Social Connectedness, Tammie Kwong

Public Health Theses

Emerging evidence suggests that Adverse Childhood Experiences (ACEs) are prevalent within the population and are linked to various negative long-term health and social consequences. The effect childhood maltreatment has on an individual's ability to maintain social connectedness may be a potential pathway as to how early adversity increases the likelihood of future negative health consequences. Using the 2011/12 National Survey of Children's Health, this thesis will explore the influence ACEs has on three areas of social connectedness: bonding, bridging, and linking. Results from the multivariate logistic regression model show that there was a significant association between ACEs and bonding as …