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Application Of Methods To Population-Based Surveys To Reduce Bias In Estimates Of Sars-Cov-2 Infection Burden In The Population, Saba Qasmieh Jun 2024

Application Of Methods To Population-Based Surveys To Reduce Bias In Estimates Of Sars-Cov-2 Infection Burden In The Population, Saba Qasmieh

Dissertations and Theses

BACKGROUND: Population-based surveys designed to randomly sample the population can be a critical and complementary tool to traditional surveillance approaches. Probability-based surveys enable the measurement of SARS-CoV-2 testing and outcomes that avoid issues around self-selection into testing, making them an effective approach to address ascertainment bias in passive surveillance. For surveys to be a useful and reliable surveillance tool for understanding the burden and distribution of SARS-CoV-2 infection, they need to capture prevalence estimates that are both valid and reliable to be optimally informative for public health measures. The dissertation was undertaken to address three main gaps that have implications …


Examining The Relationship Between Deafness And Mental Health Status: An Analysis Of The Behavioral Risk Factor Surveillance System (Brfss) 2022, Brianna Stroud-Williams May 2024

Examining The Relationship Between Deafness And Mental Health Status: An Analysis Of The Behavioral Risk Factor Surveillance System (Brfss) 2022, Brianna Stroud-Williams

Capstone Experience

Objective: The objective of the research is to examine the association between mental health status as measured by number of mentally healthy days in the past month and deafness and binge drinking.

Methods: The Behavioral Risk Factor Surveillance System (BRFSS) study was conducted via telephone survey in 50 states, including the District of Columbia and US territories. The sample size is 402,156 participants. Univariate, bivariate, and multivariate regressions, odds ratio, and 95% confidence interval were used to measure the data.

Results: Deaf respondents have 1.56 times the odds of having poor mental health than those who are not deaf. (95% …


Examining The Impact Of Racial And Ethnic Disparities In Colorectal Cancer Screening Compliance In The United States And The Potential Of Targeted Interventions., Jessica Ware May 2024

Examining The Impact Of Racial And Ethnic Disparities In Colorectal Cancer Screening Compliance In The United States And The Potential Of Targeted Interventions., Jessica Ware

Capstone Experience

Objectives:

Examine Colorectal cancer (CRC) screening compliance among racial and ethnic groups in the United States (US) based on the US Preventive Services Task Force (USPSTF) recommendations.

Identify targeted interventions to promote screening compliance, early diagnosis, and CRC survivorship.

Methods: This cross-sectional study utilized 165,878 selected participant responses from the 2022 Behavioral Risk Factor Surveillance System. We modeled and investigated CRC screening compliance based on the USPSTF recommendations as inclusion criteria between racial/ethnic groups in the US while adjusting for covariates using a weighted stepwise logistic regression.

Results: With covariates adjustment, Hispanics (POR 1.16 95%CI 1.04-1.29), Asian …


Hiv Testing Among High-Risk Individuals In The Us: 2022 Brfss, Alissa Lorchick May 2024

Hiv Testing Among High-Risk Individuals In The Us: 2022 Brfss, Alissa Lorchick

Capstone Experience

Objective

Human Immunodeficiency Virus (HIV) infection is a global epidemic, and public health efforts are moderately effective to date. This cross-sectional study aimed to determine association between high-risk behavior (intravenous drug use, risky sexual behaviors) and odds of testing for HIV utilizing 2022 Behavioral Risk Factor Surveillance System (N= 445,132).

Methods

Using SAS 3.82, the age-stratified logistic regression model for exposure (high-risk behavior) and outcome (HIV testing) included covariates gender, race, income, mental health and checkup frequency.

Results

High-risk individuals had greater odds of testing compared to low-risk individuals (crude POR 2.98 [2.81 – 3.17]), with greatest odds observed among …


Disparities In Seasonal Influenza Immunization Between Hispanic And Non-Hispanic White Populations Within The United States: Findings From The 2022 Behavioral Risk Factor Surveillance System, Susanna Stageberg May 2024

Disparities In Seasonal Influenza Immunization Between Hispanic And Non-Hispanic White Populations Within The United States: Findings From The 2022 Behavioral Risk Factor Surveillance System, Susanna Stageberg

Capstone Experience

Objective: To determine if inequities in influenza immunization exist between Hispanic and non-Hispanic White populations living in the United States.

Methods: Statistical analyses were executed to study the association between ethnicity and influenza immunization. Logistic regression was performed to determine probabilities related to vaccination. Data from the 2022 Behavioral Risk Factor Surveillance System (BRFSS) was utilized.

Results: Hispanic respondents had higher odds of not being vaccinated against the flu when compared to non-Hispanic White respondents (COR = 1.82, 95% CI [1.73, 1.91]). Ethnicity, household income, education, insurance status, age, sex, preferred language, and primary care provider status …


Examining Fragility Of Health Systems In Afghanistan: Development And Application Of A Theoretical Framework For Fragile Health Systems, Faiza Rab Apr 2024

Examining Fragility Of Health Systems In Afghanistan: Development And Application Of A Theoretical Framework For Fragile Health Systems, Faiza Rab

Electronic Thesis and Dissertation Repository

Globally, health systems face destabilization amidst conflicts and natural disasters, adversely affecting populations' well-being. Understanding domains of health system fragility remains a gap in literature, hampering effective mitigation. In protracted conflict, Afghanistan's health system offers a crucial case for studying health system fragility. This research aimed to bridge gaps in comprehending health system fragility, with research questions:

1. What is the conceptual understanding of the fragility of health systems and its relationship with resilience, and how can it be applied in Afghanistan?

2. Did the introduction of female health workers to support Maternal, Neonatal, and Child Health service delivery by …


Predictors Of Prep Uptake By Black Gay And Bisexual Men In Ohio, Ade Elisha Apr 2024

Predictors Of Prep Uptake By Black Gay And Bisexual Men In Ohio, Ade Elisha

Walden Dissertations and Doctoral Studies

No abstract provided.


Impact Of Preexisting Hypertension And Demographic Factors On Pandemic-Era Anxiety Using The Coronavirus Anxiety Scale, Chukwuemeka Ogbonnaya Okpom Apr 2024

Impact Of Preexisting Hypertension And Demographic Factors On Pandemic-Era Anxiety Using The Coronavirus Anxiety Scale, Chukwuemeka Ogbonnaya Okpom

Walden Dissertations and Doctoral Studies

No abstract provided.


Decoding Implant-Related Sickness: Unraveling The Complexities Of Breast Implant Illness, Madison M. Stewart Apr 2024

Decoding Implant-Related Sickness: Unraveling The Complexities Of Breast Implant Illness, Madison M. Stewart

Senior Theses

This thesis investigates the phenomenon of breast implant illness (BII), examining its potential correlation with individual factors such as obesity and poor lifestyle habits. BII, characterized by nonspecific symptoms, is often self-diagnosed by patients influenced by social media and internet sources, leading to requests for implant removal. Conducting a comprehensive meta-analysis, the study scrutinizes existing literature to evaluate the association between BII, obesity, and lifestyle choices. Employing inclusion criteria, peer-reviewed publications are analyzed through systematic review methodology to offer insights into the interplay between BII and adiposity, exploring inflammatory mechanisms and patient behaviors like exercise and smoking. The research aims …


Individual Risk Factors Associated With Cesarean Section Surgical Site Infections Among African American Women In California, Paula St Hill Mar 2024

Individual Risk Factors Associated With Cesarean Section Surgical Site Infections Among African American Women In California, Paula St Hill

Walden Dissertations and Doctoral Studies

No abstract provided.


Sociodemographic Determinants Of Potentially Avoidable Hospitalizations Due To Ambulatory Care Sensitive Conditions Among Hospitalized Patients In The United States, Munira Kashem Feb 2024

Sociodemographic Determinants Of Potentially Avoidable Hospitalizations Due To Ambulatory Care Sensitive Conditions Among Hospitalized Patients In The United States, Munira Kashem

Electronic Thesis and Dissertation Repository

Social determinants of health play a crucial role in explaining the variation of potentially avoidable hospitalizations (PAH) due to Ambulatory Care Sensitive Conditions (ACSCs). Utilizing data from the National Inpatient Sample from 2018 to 2020 in the United States, this study conducted retrospective cohort analyses to explore the relationships between sociodemographic factors, specifically income, race, geography, age, and sex and PAH. Our approach used multilevel logistic regression models to adjust for potential confounders and account for clustering of admissions within hospitals. Of the 17,629,891 hospital admissions examined in this study, 1,868,609 (10.6%) were attributable to ACSCs. Our results indicate that …


The Association Between Cognitive Dysfunctions And Cardiovascular Disease Of Minority And Lgbtq+ Communities In The United States, Nathan G. De Shields Feb 2024

The Association Between Cognitive Dysfunctions And Cardiovascular Disease Of Minority And Lgbtq+ Communities In The United States, Nathan G. De Shields

Walden Dissertations and Doctoral Studies

Dementia, the loss of cognitive acuity is an umbrella term of neuro-degenerative symptoms that impact an estimated 6.5 million Americans, and amid heart disease, cancers, and emerging viruses, such as COVID-19, has reportedly increased in prevalence. A cross-sectional study of secondary data from the National Health and Nutrition Examination Survey (NHANES) was conducted to analyze minority and non-heterosexual experiences of health risks found higher in prior studies of distress rates in LGBTQ+ adults. The socio-ecological framework was used to interpret the competing ecologies of social health determinants in natural and social settings. Literature reviews on cognitive dysfunction and other vascular …


Covid-19 Vaccine And Survival Of Diabetes Patient On Dialysis, Luis Guillermo De Jesús Iii Vega Feb 2024

Covid-19 Vaccine And Survival Of Diabetes Patient On Dialysis, Luis Guillermo De Jesús Iii Vega

Walden Dissertations and Doctoral Studies

No abstract provided.


Association Between Malaria Educational Message Exposure And Malaria Prevalence Among Children In Nigeria, Eberechukwu Jacob Ajiwe Feb 2024

Association Between Malaria Educational Message Exposure And Malaria Prevalence Among Children In Nigeria, Eberechukwu Jacob Ajiwe

Walden Dissertations and Doctoral Studies

No abstract provided.


An Investigation Of The Relationship Between Adverse Childhood Experiences And Women’S Mental Health, Dr. Mercedes Zubieta Richmond Jan 2024

An Investigation Of The Relationship Between Adverse Childhood Experiences And Women’S Mental Health, Dr. Mercedes Zubieta Richmond

Walden Dissertations and Doctoral Studies

No abstract provided.


Racial/Ethnic Differences In The Association Between Health Literacy And Quality Of Life Among Breast Cancer Survivors, Tenesia D. Carey Jan 2024

Racial/Ethnic Differences In The Association Between Health Literacy And Quality Of Life Among Breast Cancer Survivors, Tenesia D. Carey

Walden Dissertations and Doctoral Studies

No abstract provided.


Correlates For Nonmedical Prescription Opioid Use Among Young Adults, Uchenna Sam Chinweuba Jan 2024

Correlates For Nonmedical Prescription Opioid Use Among Young Adults, Uchenna Sam Chinweuba

Walden Dissertations and Doctoral Studies

No abstract provided.


Provider And Staff Education Surrounding Universal Hcv Screening And Linkage To Care In An Ambulatory Care Setting, Lauren Clifford Jan 2024

Provider And Staff Education Surrounding Universal Hcv Screening And Linkage To Care In An Ambulatory Care Setting, Lauren Clifford

DNP Projects

Abstract

Background: In the United States, it is estimated that there are more than 2 million cases of Hepatitis C (HCV), with over 66,000 new cases since 2020 However, an estimated 75% of those with HCV go undiagnosed and less than 35% receive treatment within a year of diagnosis. In 2018, UK Healthcare (UKHC) implemented a universal HCV screening method using a Best Practice Advisory (BPA) for anyone 18 and older who presented to the Emergency Department and had labs ordered. Patients who screened positive were then referred to outpatient clinics for HCV treatment. Approximately ten percent of positive patients …


The Performance Of Marginal Modeling Methods For Rare Events With Application To Opioid Overdose Mortality And Morbidity, Shawn Nigam Jan 2024

The Performance Of Marginal Modeling Methods For Rare Events With Application To Opioid Overdose Mortality And Morbidity, Shawn Nigam

Theses and Dissertations--Epidemiology and Biostatistics

Opioid misuse is a nationwide epidemic, with Kentucky having one of the highest opioid overdose-related fatality rates across all US states. These rates have increased significantly over the past decade, with particularly large increases during the COVID-19 pandemic. This dissertation aims to study the behavior of these increases and the methods for the marginal modeling of count outcomes related to opioid overdose.

Opioid overdose-related fatality rates in Kentucky increased significantly during the COVID-19 pandemic. In this chapter, we characterize the changes in opioid overdose fatality rates in Kentucky and identify associations between potential factors and fatality rates. County-level opioid overdose …


Associations Between Physical Activity Levels And Physical And Mental Health In Military Veterans., Troy Hubert Jan 2024

Associations Between Physical Activity Levels And Physical And Mental Health In Military Veterans., Troy Hubert

Theses and Dissertations--Psychology

Research suggests that higher rates of health conditions are associated with lower levels of physical activity, but this association is not well characterized in U.S. Military Veterans. The current study utilized a sample of U.S. military veterans (n = 3,989) from the 2019-2020 National Health and Resiliency in Veterans Study (NHRVS). Physical activity levels (insufficient, moderate, and active), physical and mental health were evaluated with a variety of self-report questionnaires. After controlling for covariates, veterans with any disability, asthma, chronic pain, diabetes, high cholesterol, and stroke were significantly less likely to report sufficient physical activity compared to insufficient physical …


"Shut Down And Closed Off": A Routine Activity Approach To Investigating The Relationship Between Covid-19 School Closures And Child Sexual Abuse Report Characteristics In Georgia, Spencer E. Riner Jan 2024

"Shut Down And Closed Off": A Routine Activity Approach To Investigating The Relationship Between Covid-19 School Closures And Child Sexual Abuse Report Characteristics In Georgia, Spencer E. Riner

Electronic Theses and Dissertations

The COVID-19 pandemic of 2020 created a public health crisis that led to an unprecedented number of school closures. A major concern raised by child advocates, law enforcement, and social service providers was the possible increase in undetected child abuse and maltreatment. Undergirding this concern was the belief that this mitigation effort might place child abuse victims and offenders within proximity for extended periods of time. While this was a significant concern, it has rarely been analyzed empirically. To address this gap in the literature, this thesis investigates how school closures impacted the characteristics of child sexual abuse (CSA) reports …


Dna Methylation-Based Epigenetic Biomarkers In Cell-Type Deconvolution And Tumor Tissue Of Origin Identification, Ze Zhang Dec 2023

Dna Methylation-Based Epigenetic Biomarkers In Cell-Type Deconvolution And Tumor Tissue Of Origin Identification, Ze Zhang

Dartmouth College Ph.D Dissertations

DNA methylation is an epigenetic modification that regulates gene expression and is essential to establishing and preserving cellular identity. Genome-wide DNA methylation arrays provide a standardized and cost-effective approach to measuring DNA methylation. When combined with a cell-type reference library, DNA methylation measures allow the assessment of underlying cell-type proportions in heterogeneous mixtures. This approach, known as DNA methylation deconvolution or methylation cytometry, offers a standardized and cost-effective method for evaluating cell-type proportions. While this approach has succeeded in discerning cell types in various human tissues like blood, brain, tumors, skin, breast, and buccal swabs, the existing methods have major …


Opportunities For Mental Health Interventions In Rural Mississippi Communities During The Covid-19 Pandemic: A Quantitative Analysis, Brice Fortinberry Dec 2023

Opportunities For Mental Health Interventions In Rural Mississippi Communities During The Covid-19 Pandemic: A Quantitative Analysis, Brice Fortinberry

Theses and Dissertations

COVID-19 presented unique challenges for rural Mississippi communities including impacts on the mental health of rural individuals. This research study aimed to identify opportunities for mental health interventions to provide health promotion professionals with quantitative data on the accessibility and the likelihood of engagement with mental health-fostering behaviors. A secondary objective of this research was to categorize these behaviors within the constructs of the Social Ecological Model. Demographics for rural Mississippi communities were collected and displayed, and using multivariate analyses including Spearman’s correlation and a Mann-Whitney U test the correlation between mental health fostering behaviors and demographic factors was obtained. …


Duchenne Muscular Dystrophy: Age, Disease Stage, And Patient-Reported Quality Of Life, Sheila Jagers Dec 2023

Duchenne Muscular Dystrophy: Age, Disease Stage, And Patient-Reported Quality Of Life, Sheila Jagers

Walden Dissertations and Doctoral Studies

No abstract provided.


Effects Of The U.S. Veterinary Feed Directive Final Rule On The Prevalence Of Violative Antibiotic Residues And Antibiotic-Resistant Bacteria In Animal Products, Md Shamim Sarkar Dec 2023

Effects Of The U.S. Veterinary Feed Directive Final Rule On The Prevalence Of Violative Antibiotic Residues And Antibiotic-Resistant Bacteria In Animal Products, Md Shamim Sarkar

Doctoral Dissertations

Antibiotic-resistant is a public health concern. The dissertation objective was to assess the effect of the implementation of the Veterinary Feed Directive (VFD) rule changes on the prevalence of violative antibiotic residues and antibiotic-resistant bacteria in food-animal tissues, retail meats, and cecal samples from food animals compared to the pre-VFD rule change period in the U.S. To understand the effect of implemented VFD rule changes on violative antibiotic residues in food-animal tissues, inspector-generated sampling (IGS) data from the U.S. National Residue Surveillance Program (NRP) was analyzed. An important observation was that implementing VFD rule changes was associated with the decreased …


A Cross-Sectional Analysis Of Adverse Childhood Experience Exposure On Cancer Diagnosis Utilizing The 2022 Behavioral Risk Factor Surveillance Survey Data, Emma Zipperer Dec 2023

A Cross-Sectional Analysis Of Adverse Childhood Experience Exposure On Cancer Diagnosis Utilizing The 2022 Behavioral Risk Factor Surveillance Survey Data, Emma Zipperer

Capstone Experience

Objective: To determine the association between Adverse Childhood Experiences (ACEs) and cancer diagnosis based on ACE exposure levels.

Methods: We utilized data collected in the 2022 Behavioral Risk Factor Surveillance System (BRFSS) survey. The study population (n=54,148) was restricted to states that reported on the optional model of experiencing ACEs and those who responded about cancer diagnosis. A univariate analysis, bivariate analysis and a multivariate logistic regression were performed. Odds of cancer diagnosis among those with differing ACE exposure levels were calculated.

Results: High ACE exposure had 20% higher odds of cancer diagnosis when compared to low ACE exposure. White, …


Genetic Risk Scores For Hypertension And Chronic Kidney Disease In African Americans., Aastha Kakar Dec 2023

Genetic Risk Scores For Hypertension And Chronic Kidney Disease In African Americans., Aastha Kakar

Electronic Theses and Dissertations

Hypertension (HT) and chronic kidney diseases (CKD) are complex conditions, disproportionally prevalent among African Americans (AA) and are influenced by multiple genetic as well as environmental factors. Genetic risk scores (GRS) enable the analysis of the combined effects of multiple single nucleotide polymorphisms (SNPs). This study investigates the association of blood pressure (BP) and CKD GRS with BP, hypertension (HT) and CKD; early-onset HT and CKD; and investigates interactions of the GRSs with environmental measures in AA. We observed a significant association between the BP-GRS with HT, SBP and DBP. The odds of HT for one standard deviation (s.d.) increase …


Associations Between Self-Reported Cognitive Decline And Chronic Diseases: A Cross-Sectional Analysis Of Behavioral Risk Factor Surveillance System (Brfss) 2022, Hailey Child Dec 2023

Associations Between Self-Reported Cognitive Decline And Chronic Diseases: A Cross-Sectional Analysis Of Behavioral Risk Factor Surveillance System (Brfss) 2022, Hailey Child

Capstone Experience

Objective: This study seeks to capture how self-reports measure cognitive decline. The association between chronic conditions and cognition with age consideration in individuals aged 45 and older is investigated.

Methods: Univariate analysis generates frequencies and weighted percentages of 2022 BRFSS data. Chi-square tests and polytomous regressions generate odds ratios for bivariate analyses. A weighted multiple logistic regression model stratified by age group analyzes self-reported cognitive decline.

Results: Respondents ages 45 to 54 with three or more chronic diseases have the highest odds (OR = 6.81; 95% CI = 4.42, 10.48) of cognitive decline. Respondents 75 and older …


Environmental Exposures And Aging., Daniel Chris Gomes Dec 2023

Environmental Exposures And Aging., Daniel Chris Gomes

Electronic Theses and Dissertations

In recent years, research into air pollution has shown that exposure to certain components in air pollution, primarily PM2.5 can accelerate biological aging and thereby lead to increased susceptibility to multiple diseases. We hypothesize that prolonged exposure to air pollutants can result in premature aging leading to extensive tissue dysfunction and susceptibility to diseases. To examine this, we exposed mice to PM2.5 for 9, 15, and 21 days, then measured the telomere lengths, cellular senescence, and histone methylation patterns of multiple cell types. We found consistently increased telomere attrition, cellular senescence and advanced age-consistent histone methylation patterns in groups exposed …


Exploration Of The Implementation Of An Integrated Electronic Laboratory Information Management System On Quality Diagnostics Service Indicators At A County Level Public Hospital In Western Kenya., Kelly Allen Nov 2023

Exploration Of The Implementation Of An Integrated Electronic Laboratory Information Management System On Quality Diagnostics Service Indicators At A County Level Public Hospital In Western Kenya., Kelly Allen

Capstone Collection

Underinvestment in pathology and laboratory capacity caused by low visibility in research and in prioritization by public health leaders results in limited effective healthcare coverage and an estimated 1.1 million premature deaths annually in Low-and-Middle-Income Countries. Kenya’s public health laboratories provide a median 41% of the Essential Diagnostic List to their patients and in Kisumu County, as much as 44.2% of the population has little to no access to essential diagnostics. The government of Kisumu implemented the county Health Laboratory Strategic Plan 2018-2022 to address this public health challenge. Little information exists on the effectiveness of these initiatives and the …