Digital Commons Network^™

Symptom Presentation Frequency And Severity Associated With Adult Lyme Disease By Ross Scale Review, Vicki A. Stanavitch

Walden Dissertations and Doctoral Studies

Although Lyme disease is the most frequently reported vector-borne illness in the United States, recent evidence from the CDC suggests that Lyme disease incidence in the United States may be much higher than reported. Lyme disease symptoms can be mistaken for a wide variety of diseases, which can complicate the diagnosis. To date, no diagnostic criteria analysis has been conducted examining the association between sociodemographic variables (sex and age) and seasonality of infection with the severity and symptomology found in Lyme disease cases. Using the CDC's outbreak investigation model, a primary case/control study was conducted using the ROSS Scale to …

Socioeconomic Status Mobility And Lifetime Exposure To Discrimination On Cardiovascular Disease Events, Nkenge H. Jones-Jack

Walden Dissertations and Doctoral Studies

Blacks in the United States have the highest rates of hypertension in the world, and their cardiovascular disease mortality rates are higher than for any other population group as a result of traditional risk factors such as obesity and stronger family history. However, additional underlying factors, such as social determinants of health (e.g., socioeconomic status [SES]) and macrosocial factors (e.g., racism), also correlate with adverse health outcomes. This study investigated whether the interaction between SES mobility over the lifecourse and lifetime racial discrimination influenced the extent to which hypertension contributed to the cardiovascular disease health disparities observed among Blacks in …

Impact Of Pneumococcal Conjugate Vaccine Thirteen Valent On The Reduction Of Invasive Pneumococcal Disease, Aissata Coulibaly

Walden Dissertations and Doctoral Studies

Many children under the age of 5 die each year of invasive pneumococcal disease. Childhood vaccination against this disease reduces morbidity and mortality. Despite the introduction of a pneumococcal conjugate vaccine (PCV13) in a central African country in 2011, all provinces have not yet been vaccinated. The purpose of this quantitative quasi-experimental study was to determine whether there was an association between the introduction of PCV13 and new cases of pneumococcal disease in 2 provinces in central Africa. The sample size for the study was 380. The theoretical framework for this study was the epidemic model supported by the concept …

Comparing African- And U.S.-Born Blacks At Stage Of Diagnosis And Treatment For Nonsmall Cell Lung Cancer, Relindis K. Fofung

Walden Dissertations and Doctoral Studies

Lung cancer is a disease with a high mortality rate for the U.S. Black population. There had been considerable research done on different population demographics, necessary to achieve the Healthy People 2020 overarching goals to eliminate health disparities, gain health equity and maintain quality health. Yet, the African-born Black (AFBB) population has been understudied for nonsmall cell lung cancer (NSCLC). This study sought to determine whether within race differences in stage at diagnosis and treatment of NSCLC exists between AFBB and American-born Blacks (AMBB) populations in the United States. The study data is secondary data collected as part of the …

Comparison Of Neovascular Age-Related Macular Degeneration Populations In The United States, Susan Lynette Coultas

Walden Dissertations and Doctoral Studies

Age-related macular degeneration (AMD) is one of the leading causes of blindness in the United States in people who are 50 and older. The safety and efficacy of aflibercept for the treatment of late stage neovascular AMD (NAMD) has been demonstrated by clinical trials among several populations; however, it is unclear whether all NAMD patients respond in the same manner as was studied in the clinical trials. The purpose of this study was to examine if populations of patients treated with aflibercept for the treatment of NAMD were significantly different from one another in terms of health characteristics, treatment regimens, …

Post Foley Removal Guideline Process And Outcome Evaluation, Sarah E. Gabbard

DNP Projects

When patients are admitted to a hospital patient safety should be a priority in all aspects of the care they receive. Preventing patients from acquiring hospital infections (HAIs) is one example of patient safety. All hospital employees have the responsibility to ensure that standard workflow and processes are in place to ensure this safety. The purposes of this Practice Inquiry Project (PIP) were to examine and develop interventions to decrease the risk of catheter associated urinary tract infections (CAUTIs), incorporate an effective process and standard workflow to implement evidence practice practices (EBP), and to evaluate the effectiveness of implementing the …

Impact Of The Advanced Practice Registered Nurse On The Stroke Patient Population, Jessica Moldenhauer

DNP Projects

PURPOSE: The purpose of this study is evaluate the APRN care model utilized for stroke patients by examining the pre and post impact on outcomes of the stroke clinical practice guidelines (CPGs), patterns of service use, stroke patient outcomes, and patient satisfaction.

METHODS: This study was a single-center, pre-post implementation retrospective study of the impact for the stroke APRN care model on the stroke patient population at Norton Brownsboro Hospital. The sample consisted of 145 patients for the pre-implementation period, March 2012 to August 2012, and 202 patients for the post-implementation period, March 2014 to August 2014.

RESULTS: No differences …

Evaluating Hepatitis C Screening In Primary Care, Nicole A. Brink

DNP Projects

Purpose: The purpose of this study was to evaluate primary care provider screening for hepatitis C virus (HCV) in three high risk populations. The specific aims were to determine the percentage of patients born between 1945-1965 who had a one-time screening for HCV, to determine what proportion of patients with a history of human immunodeficiency virus (HIV) or intravenous drug use (IVDU) have been screened for HCV, and to examine providers’ thoughts on their HCV screening practices.

Methods: A retrospective chart review of patient electronic medical records (EMR’s) from 2015 was conducted in an urban primary care site. SPSS was …

Community Level Assessment For Breastfeeding In The Gateway District, Vanessa Flannery

DNP Projects

Purpose: To assess community level support for breastfeeding in the Gateway District of eastern Kentucky.

Methods: A descriptive study was conducted to identify institutional support of breastfeeding women. Data collected during interviews included community level support based on the framework of the Ten Step program from the Baby-Friendly Hospital Initiative (BFHI) (WHO & UNICEF, 2009) and the Mother-Friendly Worksite Initiative (Texas Department of State Health Services, 2012). Respondents answered questions to determine breastfeeding support from the healthcare, education and business communities.

Results: Of the ten organizations whose representatives were interviewed, 100% perceived health benefits for mothers and infants from breastfeeding. …

An Evaluation Of The Screening And Management Of Patients With Type 2 Diabetes, Laura A. Cahoe

DNP Projects

Purpose: This purpose of this project was to evaluate preventive screening practices and adherence to guidelines for patients with type 2 diabetes (T2DM) as recommended by the American Diabetes Association (ADA) and United States Preventive Services Task Force (USPSTF) in the primary care setting. The specific aims were to: 1) determine the percentage of patients who received recommended screenings from the ADA, 2) determine the percentage of patients who received recommended screenings from the USPSTF, and 3) determine if the proportion of patients to receive the recommended screenings met established benchmarks set by Healthy People 2020 (HP2020).

Methods: A retrospective …

The Owl Sensor: A Smart Nanostructure For Single Nucleotide Variation Analysis, Rebekah Karadeema

Electronic Theses and Dissertations

Analysis of single nucleotide variations (SNVs) in DNA and RNA sequences is extensively used in healthcare for detection of genetic mutations and analysis of drug resistant pathogens. Here we developed a nucleic acid sensor able to differentiate between a fully matched analyte and one with a SNV in a wide temperature range of 5°C-32°C. The sensor, dubbed here the 'Owl Sensor' due to the complex's resemblance to owl eyes, utilizes recent developments in DNA nanotechnology and synthetic biology to self-assemble a fluorescent DNA nanostructure called a Double Crossover, or DX Tile, capable of differentiating SNVs in a large temperature range, …

Rrh Library Newsletter, January 2016, Libraries At Rochester Regional Health

Rochester Regional Health authored publications and proceedings

Newsletter sections include: Phantom Menace Surfaces; Wednesdays at Werner begins January 27th

To Accommodate Or Not To Accommodate: (When) Should The State Regulate Religion To Protect The Rights Of Children And Third Parties?, Hillel Y. Levin, Allan J. Jacobs, Kavita Arora

Scholarly Works

When should we accommodate religious practices? When should we demand that religious groups instead conform to social and legal norms? Who should make these decisions, and how? These questions lie at the very heart of our contemporary debates in the field of Law and Religion.

Particularly thorny issues arise where religious practices may impose health-related harm to children within a religious group or to third parties. Unfortunately, legislators, scholars, courts, ethicists, and medical practitioners have not offered a consistent way to analyze such cases and the law is inconsistent. This Article suggests that the lack of consistency is a troubling …

Assessing It Projects Success With Extended Fuzzy Cognitive Maps & Neutrosophic Cognitive Maps In Comparison To Fuzzy Cognitive Maps, Kanika Bhutani, Megha Kumar, Gaurav Garg, Swati Aggarwal

Neutrosophic Sets and Systems

No abstract provided.

Broadly Neutralizing Human Antibodies Inhibit Dengue Virus Infection In Aedes Mosquitoes, Colette Jolynn Matysiak

Public Health Theses

Introduction

Dengue virus is the leading cause of morbidity and mortality among mosquito-borne viruses globally. There are four Dengue serotypes; immunity to one serotype provides protective immunity to that serotype but increases the risk of severe disease upon infection with a second serotype. Dengue virus, like all Flaviviruses, utilizes class II fusion proteins to gain entry into the host cytoplasm. The fusion loop, which is responsible for viral-host fusion, lies within the envelope (E) glycoprotein and has nearly 100% amino acid identity among all Flaviviruses. Two anti-Dengue virus human monoclonal antibodies (hMAbs), 1.6D and D11C, were isolated from Dengue infected …

Spatial And Temporal Dynamics Of Glossina Pallidipes In Nguruman National Park (Kenya)., Michael Frederic Mengual

Public Health Theses

Abstract:

Background: Glossina pallidipes is a significant vector of trypanosomiasis for humans and livestock across Sub-Saharan Africa. Nguruman national park in Kenya is regarded as a potential location for targeted vector control activity. We screened flies from three locations in Nguruman in 2003, 2009, and 2015 using 13 microsatellite loci to assess population structures of G. pallidipes.

Methods: We acquired Tsetse samples from three sites across Nguruman in Kenya at three time points. We then performed genetic analyses on 267 flies using 13 microsatellite loci and evaluated genetic structure of Tsetses across a geographic distance of about 22 km and …

Sociodemographic Differences In Human Papillomavirus Vaccine Impact: A Systematic Review, Alexandra Nichole Montano

Public Health Theses

IMPORTANCE: The majority of literature related to disparities in human papillomavirus (HPV) vaccination has been focused on sociodemographic differences in vaccine uptake. Now nearly ten years after the introduction of the vaccine, and with a better understanding of disparities in uptake, a small but growing body of evidence is beginning to examine the impacts of the vaccination campaign. Monitoring disparities in the impact of the vaccine is crucial in order to better understand the full implications of the vaccine and to properly guide future programs and recommendations.

OBJECTIVE: To systematically review the literature on the impact of the human papillomavirus …

Knowledge And Attitudes Towards Non-Communicable Diseases (Ncd) Amongst Village Health Teams (Vht) In Iganga And Mayuge Districts, Uganda., Temitope Ojo

Public Health Theses

Background: Community health workers (CHW) have successfully contributed to prevention, management and care for NCD interventions in several low and middle income countries (LMIC). In Uganda, the CHW, known as Village Health Teams (VHT) are the initial point of care in their communities. Though their present roles only attend to infectious diseases, maternal and child health issues, their skills could potentially be utilized in national efforts to promote NCD prevention in communities.

Aim: To assess baseline knowledge of and attitudes toward NCD and NCD care among VHT in Uganda as a step towards identifying a potential role for VHT in …

Respiratory Syncytial Virus In Connecticut: Predictors Of Seasonal Epidemic Timing, Douglas Brian Noveroske

Public Health Theses

Introduction: Respiratory syncytial virus (RSV) is a primary cause of hospitalizations in children worldwide. Prophylaxis (Palivizumab) can be given to infants who are at high-risk of a severe RSV infection, but the timing of seasonal RSV epidemics need to be known in order to administer prophylaxis at the appropriate time.

Methods: This study used data from the Connecticut State Inpatient Database to identify RSV hospitalizations based on ICD-9 diagnosis codes. A harmonic regression analysis was used to evaluate RSV epidemic timing at the county level; subsequently, a hierarchical model was fit to assess RSV epidemic timing at the ZIP code …

A Systematic Review Of Sexual Violence And Hiv In The Post-Disaster Context: Latin America And The Caribbean, Jane O'Bryan

Public Health Theses

ABSTRACT

INTRODUCTION: In the last decade, over 800 disasters struck Latin America and the Caribbean, cumulatively affecting an estimated 64 million people. Three quarters of the region’s population lives in disaster risk areas. There is widespread consensus that sexual violence increases in the aftermath of disasters, however historically its prevention has not been prioritized, and in general it remains a vastly understudied phenomenon at the intersection of health and human rights. The linkage between sexual violence and Human Immunodeficiency Virus (HIV) in the post-disaster context is similarly unrepresented in the literature.

OBJECTIVES: This systematic review aims to assess the extent …

Patterns Of Drug Use And Correlates Of Active Amphetamine-Type Substance Use Among Sex Workers In Kuala Lumpur, Malaysia, Courtney Jo Pedersen

Public Health Theses

Objective: To describe the female and transgender sex worker population in Kuala Lumpur, Malaysia, understand their patterns of substance use, and examine the correlates of active amphetamine-type substance (ATS) use.

Methods: We administered a cross-sectional survey and performed biological testing on 492 sex workers to assess lifetime and active substance use history and frequency, criminal justice involvement, alcohol and substance abuse disorders, sexual risk behaviors, experience of childhood and adulthood physical and sexual abuse, depression, and prevalence of HIV, syphilis, chlamydia, and gonorrhea. We performed descriptive statistics to describe demographics and lifetime and active drug use patterns and employed bivariate …

Likelihood Of Achieving Who Leprosy Goals: An Expert Survey, Alex Rittel

Public Health Theses

Much progress has been made in the global fight against leprosy, as evidenced by dramatic declines in prevalence rates in recent years. However, leprosy has proven elusive. New case detection rates have remained fairly stable, particularly in countries with remaining pockets of high endemicity such as India, Brazil, and Indonesia. In 2012, the World Health Organization spearheaded the London Declaration, which in part aimed for the goal of interruption of transmission of global leprosy by 2020. Aggregating the opinions of experts can supplement existing data to help determine the feasibility of reaching the WHO goals. To obtain the opinions of …

Macrophage Migration Inhibitory Factor Polymorphisms And Tuberculosis Disease Susceptibility In Kwazulu-Natal, South Africa, Max Mu Wang

Public Health Theses

Background: TB is a leading cause of mortality, infecting over one-third of the world’s population. Difficulties combating the disease are compounded by the fact that a majority of TB infections remain in an asymptomatic latent state. Macrophage migration inhibitory factor (MIF) is an innate cytokine that is encoded in a functionally polymorphic genetic locus with characterized allelic variants that correlate to TB progression. Understanding the genetic factors that regulate host immune responses to TB will help to identify individuals who are at higher risk of severe infection.

Methods: A case-control study of HIV+ active pulmonary TB cases and HIV+ controls …

Neurocognitive Impairment Impacts Hiv Medication Adherence, Damian Weikum

Public Health Theses

Objective: To examine neurocognitive impairment (NCI) and its association with antiretroviral therapy (ART) medication adherence among HIV-infected men who have sex with men (MSM) and transgender women (TGW) in Lima, Peru.

Methods: A cross-sectional survey assessed 313 HIV-infected Peruvian MSM and TGW prescribed ART using a computer-assisted survey instrument to examine NCI and its association with optimal ART adherence, defined as taking ≥90% of prescribed medications. The survey included demographic characteristics and standardized measures for drug and alcohol use disorders, depression, and other factors associated with non-adherence.

Results: An exploratory factor analysis was conducted to optimize an NCI self-report scale …

Whole-Genome Sequencing And Phylogenetic Analysis Of Novel Paramyxoviruses Discovered In Bats From Brazil, Heather Louise Wells

Public Health Theses

Wildlife disease surveillance has been increasing in recent years in an effort to identify and characterize novel emerging zoonoses. In particular, bats have been targets of active surveillance because of their recent associations with diseases of global public health importance, such as Ebola virus, SARS-like coronaviruses, and Nipah and Hendra virus. The high species richness, large population sizes, and frequent inter- and intra-species interactions of bats make them ideal reservoirs of infectious diseases. For this molecular epidemiological study, novel paramyxoviruses discovered through surveillance of bats in Brazil were fully sequenced to allow for a range of genetic analyses, including the …

Outbreaks Reveal Deficiencies In Biotech R&D For Emerging Diseases, Rebecca Byler

Public Health Theses

The absence of commercial diagnostics, therapeutics, and vaccines hindered control efforts during the recent Zika and Ebola epidemics. This study evaluates the connectivity and productivity of both viruses’ R&D networks before, during, and after the epidemics to ascertain the ability of current R&D practices to support the development of crucial biotechnologies. Both network maps exhibited low baseline connectivity with emergent collaborative R&D practices during the identified outbreak period that correlated with increased research productivity. It is argued that formally establishing permanent collaborative, open R&D practices prior to epidemics can enhance scientific knowledge and innovation capabilities to more effectively advance commercial …

Care-Seeking Patterns Among Rural Communities In The Republic Of Congo, Haotian Cai

Public Health Theses

In 2014, a mobile pharmacy project was launched to provide accessible and affordable medicines to Yaka hunter-gatherer communities in the Likouala and Sangha regions of the Republic of Congo. This mixed methods study describes the use of available health services by the minority Yaka and the majority Bantu served by the mobile pharmacy and to compare the health-care seeking behavior among these different communities. Overall, 178 households were surveyed about their utilization of available health services and the order in which they seek health services in the event of illness. To provide context to these responses, 18 key informants were …

Predictors Of Nutritional Status Among Young Samoan Children, Courtney C. Choy

Public Health Theses

The nutrition transition is associated with the rising burden of non-communicable diseases in low-and middle-income countries and in Samoa, young children are particularly vulnerable to malnutrition in various forms. In this present study, we documented the current prevalence and co-existence of child nutritional status outcomes within this population and by census region. We then examined the role of selected child, maternal, and household characteristics as potential predictors of child nutritional status. A cross-sectional, community-based design was used to collect data from singleton pairs of a non-pregnant mother and child between 24 to 59 months olds in the Samoan island of …

A Qualitative Analysis Of Multi-Level Barriers To Hiv Testing Among Women In Lebanon, Kirsty Amy Clark

Public Health Theses

The Middle East and North Africa (MENA) is a region of concern in regards to the global HIV epidemic. In 2015, a call to action was released through the American University of Beirut urging an expansion of research and policy regarding women and HIV in the MENA region. Through individual, semi-structured interviews with sexual healthcare providers and NGO staff, we sought to understand barriers to HIV testing among women in Lebanon. Using purposive and snowball sampling strategies, key informants were recruited from neighborhoods in greater Beirut (N=21; 12 physicians, 9 NGO staff). Data were analyzed utilizing a Grounded Theory inductive …

Azithromycin Pharmacodynamics Against Non-Typeable H. Influenzae, James Fisher

Public Health Theses

Introduction

Chronic Obstructive Pulmonary Disease (COPD) is the third leading cause of death in the United States. Significant clinical disease in COPD patients has been tied to non-typeable Haemophilus influenzae (NTHI) infection. However, reasons why some NTHI strains persist despite antimicrobial therapy remain unknown.

Objective

The primary objective was to characterize the pharmacodynamics of azithromycin against a persistent pair of NTHI isolates.

Methods

A persistent pair of NTHI isolates (5P28H1 and 5P54H1) cultured from the sputum of an adult with COPD and determined to be the same strain by multilocus sequence typing was carried for 819 days. The Minimum Inhibitory …