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Articles 1 - 30 of 35
Full-Text Articles in Medicine and Health Sciences
Access To Care And The Use Of Healthcare Services By Women In Rural Cameroon: A Participatory Action Research Study, Grace Tadzong-Awasum
Access To Care And The Use Of Healthcare Services By Women In Rural Cameroon: A Participatory Action Research Study, Grace Tadzong-Awasum
Electronic Theses and Dissertations
Women in rural Cameroon do not access health care as timeously and as often as they should. They fail to get screened for common diseases, with the consequence that such diseases are often diagnosed at a very advanced stage. This accounts for the high morbidity and mortality rates as well as low life expectancy recorded among women. The purpose of this study was to explore and understand the health access experiences of women in rural Cameroon. Methodology: Participatory action research was used guided by a Focused ethnography in phase one. Twenty-five women aged 21-77 years were recruited through local the …
The Ecology Of Fecal Indicators, Dennis A. Gilfillan
The Ecology Of Fecal Indicators, Dennis A. Gilfillan
Electronic Theses and Dissertations
Animal and human wastes introduce pathogens into rivers and streams, creating human health and economic burdens. While direct monitoring for pathogens is possible, it is impractical due to the sporadic distribution of pathogens, cost to identify, and health risks to laboratory workers. To overcome these issues, fecal indicator organisms are used to estimate the presence of pathogens. Although fecal indicators generally protect public health, they fall short in their utility because of difficulties in public health risk characterization, inconsistent correlations with pathogens, weak source identification, and their potential to persist in environments with no point sources of fecal pollution. This …
The Role Of Non-Neuronal Acetylcholine In Urogenital Chlamydial Infection, Jessica R. Lockhart
The Role Of Non-Neuronal Acetylcholine In Urogenital Chlamydial Infection, Jessica R. Lockhart
Electronic Theses and Dissertations
Chlamydia trachomatiscauses a bacterial sexually transmitted infection, Chlamydia, that is often chronic and casues reproductive complications in women. We hypothesized that Chlamydia infection increases local acetylcholine (ACh) production, which regulates the host’s inflammatory response to the infection. Female mice infected with C. muridarumwere sacrificed at days 3, 9, 15, and 21 post-infection, genital tract tissues harvested, and immunohistochemistry performed to enumerate ACh-producing cells. Infection increased the number of ACh-producing cells in cervical tissue at days 3,15, and 21 post-infection (pi), uterine tissue at day 3 and 9 pi, and ovarian tissue day 3, 15, and 21 pi. These …
Adolescent Sexual And Reproductive Health In The Gambia., Sandhya Lohani
Adolescent Sexual And Reproductive Health In The Gambia., Sandhya Lohani
Electronic Theses and Dissertations
Adolescence is a crucial period in human development. Knowledge and awareness about when to have children, when to have sex, and use of contraceptives impacts the chances of teenage pregnancy and risk of sexually transmitted diseases. The objective of this study is to determine the prevalence and associated risk factors related to age of sexual debut, teenage pregnancy, and use of contraceptives in the Gambia. This study also compares the data with 2014 survey research conducted in the Gambia. The total study population were 50 adolescents aged 13-21 years from Bafuluto and surrounding communities in the Gambia. Among 50 respondents, …
Evaluation Of The Predictive Ability Of A Screening Instrument Used To Diagnose Co-Occurrence Of Anxiety In Children With High-Functioning Autism., Austin Zachary
Electronic Theses and Dissertations
Anxiety has shown to have a high co-occurrence in children with Autism Spectrum Disorder (ASD), but has been difficult to co-diagnose. This study analyzed the ability of the Screen for Child Anxiety-Related Emotional Disorders (SCARED) to predict positive ASD screenings of the Social Responsiveness Scale (SRS). Parents and children ages 8 to 18 years (N = 100) were screened for anxiety using the SCARED and autism using the SRS. Moderate correlation was found between parent-reported SCARED and positive screening of the SRS (r = .579), with weak correlation found in the child-reported SCARED (r = .105). LASSO regression was conducted …
Lead And Crime: An Ecological Study Between Lead Contaminated Topsoil And Violent Crime., Brian Guinn
Lead And Crime: An Ecological Study Between Lead Contaminated Topsoil And Violent Crime., Brian Guinn
Electronic Theses and Dissertations
Lead is a known neurotoxicant. Human exposure to lead comes primarily through environmental exposures, including remnant lead paint, lead contaminated topsoil and lead contaminated water. Prenatal and early life lead exposure has been associated with numerous neurocognitive and neuropsychiatric disorders. This dissertation presents findings from an ecological study which evaluated the geospatial association between topsoil lead content and the incidence of FBI designated violent crime in Jefferson County, Kentucky. A total of 412 topsoil samples were collected along roadways (n=300) and from Louisville Metro Parks (n=112). Jefferson County crime data was obtained from the Louisville Metro Police Department – Crime …
Association Between Cigarette Smoking And Ovarian Reserve Among Women Seeking Fertility Treatment With Effect Modification By Race And Nat2 Genotype., Islamiat A. Oladipupo
Association Between Cigarette Smoking And Ovarian Reserve Among Women Seeking Fertility Treatment With Effect Modification By Race And Nat2 Genotype., Islamiat A. Oladipupo
Electronic Theses and Dissertations
Cigarette smoking in women has been associated with adverse reproductive outcomes such as reduced ovarian reserve, poorer in vitro fertilization (IVF) outcomes and increased adverse pregnancy outcomes. This study examined the association of smoking with ovarian reserve in a cross-sectional study of women seeking fertility treatment, and potential effect modification by race and NAT2 acetylator phenotype. Data from 265 women from the Louisville Tobacco Smoke, Genetic Susceptibility, and Infertility (LOUSSI) Study were analyzed. A total of 265 women were recruited through a single infertility clinic between September 2016 and June 2018. Information on current smoking status was assessed using a …
Is Macrolide And Beta-Lactam Combination Therapy Associated With Early Clinical Stability Or 30 Day Mortality In Hospitalized Patients With Pneumonia? An Assessment Of Confounding By Indication., Evangeline Pierce
Electronic Theses and Dissertations
Pneumonia and influenza are one of the leading causes of infectious disease-related deaths worldwide. Current guidelines for the treatment of hospitalized patients with community acquired pneumonia (CAP) include empiric antimicrobial therapy with a macrolide and a beta-lactam. There is little consensus among studies as to which antimicrobial regimen is best. The confusing results seen may very well be due to lack of assessment of confounding by indication (CBI). This analysis was a secondary analysis from Hospitalized Adults with Pneumococcal Pneumonia: Incidence Study (HAPPI). The study participants were those in HAPPI who had received either macrolide and beta-lactam combination therapy or …
Self-Regulation Abilities Of Low-Income Mothers In Community Based, Expanded Food And Nutrition Education Program, Alyssa Abreu
Self-Regulation Abilities Of Low-Income Mothers In Community Based, Expanded Food And Nutrition Education Program, Alyssa Abreu
Electronic Theses and Dissertations
Diet is strongly associated with many risk factors for chronic disease. Educational programs such as the Expanded Food and Nutrition Education Program (EFNEP) are designed to improve dietary behaviors among low-income populations. Although EFNEP has seen improvements, they are not yet up to recommendations. Previous studies have been successful in eliciting behavior change when improving self-regulation in conjunction with dietary education. Thus, the purpose of this study was to examine self-regulation in EFNEP participants and its relationship to participants change in dietary behavior. All participants were currently enrolled in an EFNEP program and were asked to complete an additional self-regulation …
Post-Diagnosis Quality Of Life And Mortality In Non-Hispanic White And Hispanic Women Diagnosed With Invasive Breast Cancer., Delvon T. Mattingly
Post-Diagnosis Quality Of Life And Mortality In Non-Hispanic White And Hispanic Women Diagnosed With Invasive Breast Cancer., Delvon T. Mattingly
Electronic Theses and Dissertations
The prevalence of breast cancer is increasing, and the health-related quality of life (HRQOL) of breast cancer survivors may help to further understand survivorship. This study evaluated HRQOL as a potential prognostic factor for mortality among Non-Hispanic White (NHW) and Hispanic women diagnosed with invasive breast cancer. Data were used from the Health, Eating, Activity, and Lifestyle (HEAL) Study. Data for 351 participants were analyzed for associations between HRQOL scores (subscale, component) and mortality. Cox proportional hazards regression was conducted to assess the relationship between HRQOL and mortality outcomes (all-cause, breast cancer-specific, non-cancer). Median follow-up time from HRQOL assessment (approximately …
Social Determinants Of Health And A Grounded Mixed-Methods Approach To Explain Declining Life Expectancy In Eastern Kentucky : 1980 – 2014., William Renda
Electronic Theses and Dissertations
Trends in life expectancy for the United States from 1980-2014 suggest general improvement overall. However, eastern Kentucky stands out with a cluster of counties experiencing declining life expectancy. Given that life expectancy is an excepted indicator of overall population health, this anomaly in eastern Kentucky warrants investigation. This thesis uses a grounded mixed methods approach to explore this trend across the greater Appalachian region. Content and discourse analysis of interviews with public health and medical professionals in the study area revealed key themes perceived as being related to declining life expectancy, which informed variable selection for regression analysis. Regression models …
Generalized Spatiotemporal Modeling And Causal Inference For Assessing Treatment Effects For Multiple Groups For Ordinal Outcome., Soutik Ghosal
Generalized Spatiotemporal Modeling And Causal Inference For Assessing Treatment Effects For Multiple Groups For Ordinal Outcome., Soutik Ghosal
Electronic Theses and Dissertations
This dissertation consists of three projects and can be categorized in two broad research areas: generalized spatiotemporal modeling and causal inference based on observational data. In the first project, I introduce a Bayesian hierarchical mixed effect hurdle model with a nested random effect structure to model the count for primary care providers and understand their spatial and temporal variation. This study further enables us to identify the health professional shortage areas and the possible impacting factors. In the second project, I have unified popular parametric and nonparametric propensity score-based methods to assess the treatment effect of multiple groups for ordinal …
Coal Ash Exposure And Behavioral Impairments Among Children In Louisville, Kentucky., Chisom Nmesoma Odoh
Coal Ash Exposure And Behavioral Impairments Among Children In Louisville, Kentucky., Chisom Nmesoma Odoh
Electronic Theses and Dissertations
Introduction: Coal ash, generated from the combustion of coal is principally made up of fly ash, which consists of small particles and metals that can affect the development of children. Coal ash is predominately stored in landfills and surface impoundments, of which many are in proximity to residential areas. According to the Environmental Protection Agency, 25% of residents in proximity to electric power plants are children. Few studies have reported a positive association between coal ash and its by-products and neurobehavioral disorders. The purpose of this study was to explore the relationship between coal ash and its components and …
Hiv-Related Knowledge, Attitudes, And Behaviors In Two Low Resource Settings, Candice Lynn Collins
Hiv-Related Knowledge, Attitudes, And Behaviors In Two Low Resource Settings, Candice Lynn Collins
Electronic Theses and Dissertations
Two Human Immunodeficiency Virus (HIV) outbreaks occurred almost simultaneously in the United States (US) (2014-2015) and in Cambodia (2015). Information is lacking on HIV-related knowledge, stigmatizing attitudes, and high-risk behaviors (KAB) among the general population, which may affect the transmission of HIV and lead to outbreaks. The current study aimed to: 1) assess KAB among the general population in a high-risk county in the US, 2) analyze KAB among the general population of Cambodia, and 3) compare KAB across samples from a high-risk county in Northeast Tennessee and a province in Cambodia. Tennessee data were collected in 2017 and Cambodian …
Context, Delivery, And Providers’ Perspectives Of Family Life Education In Tn, Usa, Ruby Yadav
Context, Delivery, And Providers’ Perspectives Of Family Life Education In Tn, Usa, Ruby Yadav
Electronic Theses and Dissertations
In 2015, TN had the 9th highest teen birth rate in the United States. School-based sex education programs have shown promise in curbing teen pregnancy rates. In TN public schools, sex education could be taught by teachers of subjects like biology, health education, or invited guests from ministries, or national or local nonprofit agencies. The content, rigor, and approach of sex education taught by these diverse groups of providers remains unknown. This pilot study tested a survey questionnaire and methodology, while providing information on the providers’ sex education practices and perspectives.
We adapted validated measures from past sex education …
Exploration Of Rape Myths Among Former Military Professionals, Gabrielle Caldara
Exploration Of Rape Myths Among Former Military Professionals, Gabrielle Caldara
Electronic Theses and Dissertations
Sexual violence is sometimes considered a taboo topic for discussion, but it gained widespread attention in the media in late 2017 due to the social movements addressing the sexual assault of women. However, sexual violence perpetrated against men lacks publicity in America, and highlights a similar situation in the Armed Forces. A discussion of sexually violent acts committed against men is sometimes impeded by cultural norms. This discrepancy associated with civilian and military communities inspired this exploratory study.
A convenience sample of 520 former American military professionals completed an anonymous online survey to describe their attitudes and beliefs regarding rape …
Evaluating Socially Determined Health In Rural Appalachia: Use Of The Social Quality Theory, Paula Masters
Evaluating Socially Determined Health In Rural Appalachia: Use Of The Social Quality Theory, Paula Masters
Electronic Theses and Dissertations
People living in rural America face unique social circumstances that can prevent them from reaching optimal health status. This fact holds especially true in the rural Appalachian region of the United States where income, education, living circumstances, and lack of resources create an environment that has some of the highest rates of morbidity and mortality in the country. While the rest of the country has seen improvement in many health behaviors and health outcomes, rural Appalachian communities remain unchanged and further behind other regions. In many cases, programming and policy have failed to create a culture of health in Appalachia. …
An Exploration Of Barriers To Health Care Access Among Uninsured Patients: Using The Moderating Effect Of Patients’ Enablement, Enedelia L. Jessup
An Exploration Of Barriers To Health Care Access Among Uninsured Patients: Using The Moderating Effect Of Patients’ Enablement, Enedelia L. Jessup
Electronic Theses and Dissertations
ABSTRACT On March 23, 2010, Congress passed the Patient Protection and Affordable Care Act (ACA) to increase value of care, improve clinical outcomes, decrease health care costs, and increase affordability in health care access. The purpose of the study attempts to examine the moderating effects of patient enablement impacting barriers, low socio economic status, and unmet basic needs, toward health care access in uninsured populations post ACA. Only certain aspects of patient enablement in self-management of an individual’s health care goals have been conducted with uninsured populations with barriers toward health care access. The research design was a quantitative, exploratory, …
The Effects Of Polychlorinated Biphenyls Exposure On Non-Alcoholic Fatty Liver Disease : Role Of Aryl Hydrocarbon Receptor., Hongxue Shi
Electronic Theses and Dissertations
Polychlorinated biphenyls (PCBs) are detectable in serum of 100% of adults in US, and has been associated with fatty liver disease in epidemiological studies. PCBs are classified as either dioxin-like (DL) or non-dioxin-like (NDL) PCB based on their ability to activate the aryl hydrocarbon receptor (AhR). We used exposures that reflect human bioaccumulation patterns, which resembles Aroclor 1260 with a low level of the DL-PCB, PCB 126. Our aim was to determine if this exposure will activate the human and mouse AhR and examine if receptor activation influences these steatotic responses due to PCB exposures. DL-PCBs exposure-induced AhR activation in …
Work And Family Conflict: A Comparative Analysis Among Staff Nurses, Nurse Managers, And Nurse Executives, Amanda Raffenaud
Work And Family Conflict: A Comparative Analysis Among Staff Nurses, Nurse Managers, And Nurse Executives, Amanda Raffenaud
Electronic Theses and Dissertations
The nursing workforce increasingly faces issues that affect clinical and managerial practice. One such issue is work-family conflict (WFC) and family-work conflict (FWC). Nurses face role strain as they confront the pressures from often competing work-and-family roles. This study assessed WFC/FWC among varying nurse roles: staff nurses, managerial nurses, and nurse executives. A random sample of 5,000 nurses, generated from registered nurses practicing in the state of Florida, was surveyed for this research study. Nurses were surveyed on demographics, perceptions regarding the work environment, and perceptions of WFC/FWC. Descriptively, nurses experienced more work-family conflict than family-work conflict. Regression analyses and …
Risk In Privacy Breach Determination: The Application Of Prospect Theory To Healthcare Privacy Officers, Amanda Walden
Risk In Privacy Breach Determination: The Application Of Prospect Theory To Healthcare Privacy Officers, Amanda Walden
Electronic Theses and Dissertations
A significant concern in healthcare is that of patient privacy and how organizations protect against unauthorized access to protected health information. The federal government has responded by instituting policies and guidelines on requirements for protection. However, the policy language leaves areas open to interpretation by those following the guidelines. Reporting to the Office for Civil Rights and/or the patient can open an organization to risk of financial and possible criminal penalties. There is a risk of harm to their reputation which could impact patient visits and market share. Therefore, Privacy Officers might view risk in different ways and therefore handle …
Interaction Between Income, Health Insurance, And Self-Rated Health: A Path Analysis., Atalie Ashley West
Interaction Between Income, Health Insurance, And Self-Rated Health: A Path Analysis., Atalie Ashley West
Electronic Theses and Dissertations
The political focus of equitable health outcomes in the United States have long centered on access to medical care. However, there is compelling evidence that access to medical care is only the bare minimum necessary to achieve health, and the true influence of health insurance on health is still unclear. Widely accepted models of health estimate that less than 20% of health outcomes can be attributed to clinical care, while greater than 50% is related to social and economic determinants of health, with income being the most consistent predictor. As a result, this study investigated whether earned income is related …
Weight Management Related Factors And Healthy Behaviors In Adults, Sumadhuri Pamarthi
Weight Management Related Factors And Healthy Behaviors In Adults, Sumadhuri Pamarthi
Electronic Theses and Dissertations
Obesity is an ongoing global pandemic that affects more than one in three adults in the United States. Being overweight or obese also increases the risk of chronic health conditions. Weight management does not only center on immediate weight loss but also on the proper maintenance of an appropriate body weight over the years. Methods of weight management include eating a healthy diet and meeting physical activity guidelines. Such weight management practices are important to ensure that the people suffering from obesity can decrease risks of morbidity or even mortality. Nevertheless, unhealthy weight management strategies might lead to unintended health …
Characteristics Associated With Local Health Departments’ Completion Of Community Health Assessment, Community Health Improvement Plan, And Strategic Planning, Abraham Deng Ater
Characteristics Associated With Local Health Departments’ Completion Of Community Health Assessment, Community Health Improvement Plan, And Strategic Planning, Abraham Deng Ater
Electronic Theses and Dissertations
Local health departments engage in community health assessment, community health improvement plan, strategic planning to systematically monitor health, identify risk factors, and to set strategic priorities to improve population health outcomes. Successful completion of these three processes within the last five years is also paramount as they are required for accreditation by the Public Health Accreditation Board. The main purpose of this study was to analyze characteristics of local health departments that are associated with completion of community health assessment, community health improvement plan, strategic planning, and accreditation processes. This cross-sectional study drew data from the 2016 NACCHO profile of …
Facilitators And Barriers To Implementing Farm To School Programs In Rural Georgia: Perspectives Of School Nutrition Directors, Linda Baffo
Electronic Theses and Dissertations
Introduction: Childhood obesity is a growing public health problem. In the US, over 13.7 million children are obese. Specifically in Georgia, childhood obesity among children between ages 10 – 17 is the 8th highest in the nation. Rural Georgia has disproportionately higher rates of overweight and obesity than urban areas of Georgia. Schools are an ideal venue through which to address childhood obesity because many US children consume up to half of their daily calories at school. The aim of this research was to determine the facilitators and barriers to implementing farm to school activities from the perspective of …
Experimentally Investigating The Joint Effects Of Physical Activity And Sedentary Behavior On Depression: A Randomized Controlled Trial, Jeremiah Blough
Experimentally Investigating The Joint Effects Of Physical Activity And Sedentary Behavior On Depression: A Randomized Controlled Trial, Jeremiah Blough
Electronic Theses and Dissertations
Objective: To experimentally examine whether increasing sedentary behavior, among a young adult active population, for one week is still associated with increased depression symptomology even when allowing for a moderate engagement in physical activity (PA). Methods: Participants were confirmed as active via self-report and accelerometry during baseline and randomly assigned to one of three experimental groups. The Sedentary Intervention Group (n=19) reduced steps to less than 5000/day and were not alloto exercise for one-week; the Reduced MVPA (moderate-to-vigorous PA) Group (n=18) reduced steps to less than 5000/day but exercised for 50% of their previously reported vigorous PA for one-week; and …
The Role Of Programs And Policies In Shaping The Observed School Nutrition Environment And Rural Childhood Obesity, Shadai Martin
The Role Of Programs And Policies In Shaping The Observed School Nutrition Environment And Rural Childhood Obesity, Shadai Martin
Electronic Theses and Dissertations
Childhood obesity is an ongoing public health concern that impacts many children in the United States. Research has shown that the prevalence of childhood obesity is higher in rural populations compared to non-rural populations. This may be attributable to differences in the school nutrition environment, particularly school meals and school wellness policy implementation. In order to design effective intervention targeted at weight management and obesity reduction, information regarding the school nutrition environment must be known. Therefore, the purpose of this research was to examine the school nutrition environment, particularly school lunch participation and weight outcomes between metro, non-metro and rural …
Acute And Chronic Vascular Responses To Blood Flow Restriction In The Upper Body, J. Grant Mouser
Acute And Chronic Vascular Responses To Blood Flow Restriction In The Upper Body, J. Grant Mouser
Electronic Theses and Dissertations
Blood flow restriction (BFR) with low load exercise increases muscular size and strength. Little is known of vascular adaptations to this training modality, and nothing was known at very low loads. These studies examined cardiovascular responses to high load (70% of one-repetition maximum (1RM)) and very low load (15%1RM) exercise, alone or at two levels of BFR. Study 1: Participants performed unilateral biceps curls using either 15%1RM with no BFR (15/00), 40% of arterial occlusion pressure (AOP) (15/40), or 80%AOP (15/80), or 70%1RM (70/00). Systolic and diastolic blood pressure (SBP, DBP) and blood flow (BF) were measured in the arms …
Examining The Issue Of Compliance With Personal Protective Equipment Among Wastewater Workers Across The Southeast Region Of The United States, Tamara L. Wright
Examining The Issue Of Compliance With Personal Protective Equipment Among Wastewater Workers Across The Southeast Region Of The United States, Tamara L. Wright
Electronic Theses and Dissertations
Wastewater workers are exposed to different occupational hazards such as chemicals, gases, viruses, and bacteria. Personal Protective Equipment (PPE) is a significant factor that can reduce or increase the probability of an accident from hazardous exposures to chemicals and microbial contaminants. The purpose of this study was to identify wastewater worker’s beliefs and practices on wearing PPE and protections offered by PPE through the integration of the Health Belief Model (HBM). Participants were workers in the wastewater industry, which included wastewater operators, laboratory analysts, maintenance workers, wastewater collection workers, equipment operators, managers, and supervisors (n=272). The instrument was a self-administered …
Association Between Local Health Departments’ Engagement In Phab Accreditation And Budget Cuts Prevention, Ghadeer M. Albashir
Association Between Local Health Departments’ Engagement In Phab Accreditation And Budget Cuts Prevention, Ghadeer M. Albashir
Electronic Theses and Dissertations
Objectives: The primary purpose of this study is to examine whether engagement in Public Health Accreditation Board (PHAB) accreditation process and its requirements are associated with budget cuts prevention for local health departments (LHDs). Methods: For this study, we performed multinomial logistic regression using the 2016 National Profile of Local Health Departments Survey conducted by the National Association of County and City Health Officials. Results: While budget did not change for a majority of LHDs in comparison with previous year (48.6%), there were 28.7% that reported budget increase, and almost a quarter of LHDs had reduced budget (23%). The multinomial …