Medicine and Health Sciences Commons^™

Relationship Between The Experience Of Perceived And Physician Diagnosed Arthritis And The Presence Of Dsm-Iv Criteria-Based Major Depression (Mdd) Among Older, Ryan Neil Schmidt

Theses and Dissertations

BACKGROUND: The purpose of this study was to explore both positive screened MDD and the perception of being depressed (P) and the likelihood of either increasing if the patient suffered from arthritis (P/E), either perceived or evaluated by a physician. The study explored the univariate, bivariate, and multivariate relationships between MDD and depression (P) to better describe influencing characteristics and their prevalence, as related to MDD and depression (P).

METHODS: The study examined a cross section of patients 65 years and older (n=8,205) within the National Epidemiologic Survey on Alcohol Abuse and Alcoholism (NESARC) [2001-02] sponsored by the National Institute …

Hybrid Pet/Mri Nanoparticle Development And Multi-Modal Imaging, David Hoffman

Theses and Dissertations

The development of hybrid PET/MRI imaging systems needs to be paralleled with the development of a hybrid intrinsic PET/MRI probes. The aim of this work was to develop and validate a novel radio-superparamagnetic nanoparticle (r-SPNP) for hybrid PET/MRI imaging. This was achieved with the synthesis of superparamagnetic iron oxide nanoparticles (SPIONs) that intrinsically incorporated 59Fe and manganese iron oxide nanoparticles (MIONs) that intrinsically incorporated 52Mn. Both [59Fe]-SPIONs and [52Mn]-MIONs were produced through thermal decomposition synthesis. The physiochemical characteristics of the r-SPNPs were assessed with TEM, DLS, and zeta-potential measurements, as well as in imaging phantom studies. The [59Fe]-SPIONs were evaluated …

Transcending Microbial Source Tracking Techniques Across Geographic Borders: An Examination Of Human And Animal Microbiomes And The Integration Of Molecular Approaches In Pathogen Surveillance In Brazil And The United States, Amber Mae Koskey

Theses and Dissertations

Waterborne illnesses, attributed to the ingestion or contact with contaminated water, present a significant global health concern. Surface water sources can be impacted by wide array of pollution inputs, but fecal pollution generates the most significant and acute threat to human health. Therefore, the detection of fecal bacteria in surface water sources remains an important public health objective. Current surface water monitoring employs the use of fecal indicator bacteria (FIB) including E. coli and enterococci as proxies for pathogenic organisms carried in fecal pollution. These traditional indicators, detected by culture-based microbiological methods, do not discriminate fecal sources from another. New …

Trends In Work-Related Injury Rates And The Associated Incurred Costs In Long-Term Care Centers, Darcie Lange Olson

Theses and Dissertations

Background. Nursing assistants, working in long-term care facilities, have consistently been among the top occupational groups experiencing work-related musculoskeletal injuries. These injuries have been attributed the physical demands of lifting and moving the individuals in their care. Great strides in research have identified successful risk reduction strategies such as the implementation safe patient handling and mobility programs. The benefits of these programs have been advocated over the last two decades, but the rate of injuries among nursing assistants continues to be more than double the national average for all other industries. The purpose of this study was to investigate the …

The Influence Of Position Type And Generational Grouping On Job Satisfaction Of Milwaukee County's Public Health Workforce, Jeanette L. Kowalik

Theses and Dissertations

Nationally, the public health workforce (PHW) consists of 155,000 staff (NACCHO, 2010). It is projected that half of the PHW will soon retire. Health departments must find ways to retain its diverse workforce.

Job Satisfaction is a critical variable that impacts a sustained PHW. Job Satisfaction assessments can promote sustainability of the workforce because the data assembled from the assessments can inform research, policy, and practice. Public health workers that report high Job Satisfaction are less likely to quit as well as delay retirement (RWJF, 2013).

The purpose of this study is to examine the influence of position type and …

Effects On Volunteer Peer Leaders Participating In A Health Promotion Program For U.S. Veterans, Leslie A. Patterson

Theses and Dissertations

Health-focused peer-led interventions demonstrate success in reducing risk-related behaviors among participants with chronic illnesses, yet few researchers have explored the effects of such interventions on the health of volunteer peer leaders who participate in the interventions. Using data from the project entitled, An RCT of a Peer Support Intervention to Improve Hypertension, this study explored volunteer peer leaders' self-care behaviors that contribute to blood pressure control in two hypertension interventions for U.S. veterans. Inspection of the study's findings demonstrated that volunteer peer leaders improved their health habits and hypertension knowledge significantly more than the peer groups they served. Findings revealed …

Feasibility And Preliminary Outcomes From A Pilot Study Of The Smile Curriculum For Mother-Infant Co-Occupational Engagement And Maternal Self-Efficacy, Emily Whitlock

Theses and Dissertations

OBJECTIVE: To report on the feasibility and preliminary outcomes from a pilot study of the SMILE curriculum, a new educational program designed to enhance the mother-infant relationship by focusing on improvement of co-occupational engagement within daily routines.

METHOD: Six mothers, each with an infant diagnosed with special medical needs who received services in a local birth-to-three program, participated in an exploratory design study. Each mother was assigned to a SMILE curriculum intervention group or a waiting-list control group. Mothers were evaluated pre- and post-intervention using the Perceived Maternal Parenting Self-Efficacy (PMP-SE) Scale for measurement of maternal self-efficacy and the Center …

Personal Characteristics And Learning Preference In End-Of-Life Decision Making Of Chronically Ill Community Dwelling Elders, Leigh Ann Bonney

Theses and Dissertations

Leigh Ann Bonney, RN, MSN; Susan Kossman, RN, PhD; MyoungJin Kim, PhD; Wendy Woith, PhD, Caroline Mallory, PhD

Illinois State University, Mennonite College of Nursing

Personal Characteristics and Learning Preference in End-of-Life Decision Making of

Chronically Ill Community Dwelling Elders

Purpose and Background: Clear decision-making (DM) about end-of-life [EOL] contributes to a good death This requires knowledge of life-sustaining treatment with lack of knowledge contributing to feelings of decisional conflict Decision aids can increase knowledge, but elders' preferred learning methods are unknown. Identifying characteristics associated with preferred learning method and decisional conflict can help nurses tailor information to assist in …

Positron Emission Tomography For Pre-Clinical Sub-Volume Dose Escalation, Christopher Bass

Theses and Dissertations

Purpose: This dissertation focuses on establishment of pre-clinical methods facilitating the use of PET imaging for selective sub-volume dose escalation. Specifically the problems addressed are 1.) The difficulties associated with comparing multiple PET images, 2.) The need for further validation of novel PET tracers before their implementation in dose escalation schema and 3.) The lack of concrete pre-clinical data supporting the use of PET images for guidance of selective sub-volume dose escalations. Methods and materials: In order to compare multiple PET images the confounding effects of mispositioning and anatomical change between imaging sessions needed to be alleviated. To mitigate the …

Parents' Treatment Of Their Children's Pain At Home: Pharmacological And Non-Pharmacological Approaches, Ayala Y. Gorodzinsky

Theses and Dissertations

During childhood, individuals often experience pain on a daily or nearly daily basis (American Academy of Pediatrics and American Pain Society, 2001). Pain can be treated using pharmacological or non-pharmacological techniques. This study will focus on the techniques provided by parents, since parents most often treat children's painful experiences at home (Finley, McGrath, Forward, McNeill & Fitzgerald, 1996). The processes involved in parental decision-making regarding which techniques to use include a combination demographic, availability and perceived need factors (Andersen, 1995). Seven hundred and fifty-six parents of children 6 to 17 years completed a survey regarding use and effectiveness of pharmacological …

Impact Of The Arthritis Foundation's Walk With Ease Program On Self-Efficacy, Quality Of Life And Pain Reduction In A Group Format, Kelly Nicole Reese

Theses and Dissertations

Objective: To evaluate the effectiveness of the Arthritis Foundation's Walk With Ease Program for individuals with self- or medically-diagnosed arthritis within a group format. The study also investigates the individuals' perceptions on self-efficacy, quality of life and pain reduction pre- and post- intervention.

Background: The prevalence of arthritis is increasing and this places a major burden on individuals, health systems and social care systems globally. Osteoarthritis, the most common arthritis condition, is a major cause of impaired mobility and disability for aging populations. Osteoarthritis affects millions of people around the world. Self-management programs like the Walk With Ease Program have …

Examining Mediators To Physical Activity As A Link To Interventional Efforts Aimed At Increasing Activity Levels And Improving Physical Functioning In Older Adults, Christopher Dondzila

Theses and Dissertations

The number of older adults living in the United States is growing at an increasingly rapid rate, and is host to a high prevalence of chronic diseases and physical impairments. Physical activity and exercise have been shown to be beneficial in impacting such conditions, yet the majority of older adults remain inactive. The purpose of this dissertation was to employ a sequence of studies to investigate mediators to physical activity, leading to an intervention to increase activity and promote health.

The purpose of Project VOICE was to examine whether awareness and utilization of community resources to promote physical activity and …

Essays In Health Economics And Public Health Policy, Rahi Abouk

Theses and Dissertations

This dissertation consists of three essays. In the first essay I study the effect of texting bans on fatal accidents on roadways. Since 2007, many states passed laws prohibiting text messaging while driving. Using vehicular fatality data from across the United States and standard difference-in-differences techniques, bans appear moderately successful at reducing single vehicle, single occupant accidents if they are universally applied and enforced as a primary offense. Bans enforced as secondary offences, however, have at best no effect on accidents. Any reduction in accidents following texting bans is short-lived, however, with accidents returning to near former levels within a …

Relationship Between Hpv Vaccination And Sexual Activity, Sexual Health Care Utilization, And Perceived Risk, Danielle Lee Jirovec

Theses and Dissertations

The relationship between sexual activity, sexual health care utilization, and perceived risk for HPV-related outcomes was examined in sample of college women, to explore recent concerns that HPV vaccination may be related to an increase in risky sexual behaviors. Vaccinated and not vaccinated women completed an anonymous, online survey including age of vaccination, age at each sexual partner, condom use, use and intentions to use sexual health care services, and perceptions of risk. Vaccinated women also reported perceptions of change because of vaccination. Women were matched on age, race, and poverty status. Number of partners since vaccination was calculated among …

Utilization Of Focus Groups To Design Curricula To Teach 3d/4d Technology, Dustin Reinholtz

Theses and Dissertations

Diagnostic medical sonography is a tool utilized daily in the medical field. Currently there is a trend of moving from 2D technologies to newer, advanced 3D/4D technologies. The issue involved with adding 3D/4D technology to the echocardiography exam is how to best teach the sonographers how to become comfortable with using the newer technology. The aim of this study was to use focus groups and grounded theory as tools for curriculum development to teach cardiac sonographers 3D/4D technology to calculate left ventricular volume. The setting for this study was an academic medical center in which eight cardiac sonographers were recruited …

Principled Variance Reduction Techniques For Real Time Patient-Specific Monte Carlo Applications Within Brachytherapy And Cone-Beam Computed Tomography, Andrew Sampson

Theses and Dissertations

This dissertation describes the application of two principled variance reduction strategies to increase the efficiency for two applications within medical physics. The first, called correlated Monte Carlo (CMC) applies to patient-specific, permanent-seed brachytherapy (PSB) dose calculations. The second, called adjoint-biased forward Monte Carlo (ABFMC), is used to compute cone-beam computed tomography (CBCT) scatter projections. CMC was applied for two PSB cases: a clinical post-implant prostate, and a breast with a simulated lumpectomy cavity. CMC computes the dose difference between the highly correlated dose computing homogeneous and heterogeneous geometries. The particle transport in the heterogeneous geometry assumed a purely homogeneous environment, …

Time Dependent Cone-Beam Ct Reconstruction Via A Motion Model Optimized With Forward Iterative Projection Matching, David Staub

Theses and Dissertations

The purpose of this work is to present the development and validation of a novel method for reconstructing time-dependent, or 4D, cone-beam CT (4DCBCT) images. 4DCBCT can have a variety of applications in the radiotherapy of moving targets, such as lung tumors, including treatment planning, dose verification, and real time treatment adaptation. However, in its current incarnation it suffers from poor reconstruction quality and limited temporal resolution that may restrict its efficacy. Our algorithm remedies these issues by deforming a previously acquired high quality reference fan-beam CT (FBCT) to match the projection data in the 4DCBCT data-set, essentially creating a …

Pain Management And Menopausal Health Outcomes In Multiple Sclerosis, Rachel Jawahar

Theses and Dissertations

Background: Previous studies have addressed multiple sclerosis (MS) symptom management and improved health-related quality of life (HrQOL). Yet lowered estrogen levels in post-menopasual women with MS may further worsen physical function and symptomology and not all types of pain management have been examined. Objectives: For post-menopausal women with MS, we evaluated the extent to which smoking is associated with worsened health outcomes and HrQOL, and the extent to which menopausal hormone treatment (MHT) improves health outcomes and HrQOL. For all adult men and women with clinically diagnosed MS, we systematically reviewed pharmacological and non-pharmacological strategies for the reduction of pain. …

Automatic Block-Matching Registration To Improve Lung Tumor Localization During Image-Guided Radiotherapy, Scott Robertson

Theses and Dissertations

To improve relatively poor outcomes for locally-advanced lung cancer patients, many current efforts are dedicated to minimizing uncertainties in radiotherapy. This enables the isotoxic delivery of escalated tumor doses, leading to better local tumor control. The current dissertation specifically addresses inter-fractional uncertainties resulting from patient setup variability. An automatic block-matching registration (BMR) algorithm is implemented and evaluated for the purpose of directly localizing advanced-stage lung tumors during image-guided radiation therapy. In this algorithm, small image sub-volumes, termed “blocks”, are automatically identified on the tumor surface in an initial planning computed tomography (CT) image. Each block is independently and automatically registered …

A Study Of Coverage Optimized Planning Incorporating Models Of Geometric Uncertainties For Prostate Cancer, Huijun Xu

Theses and Dissertations

A fundamental challenge in the treatment planning process of multi-fractional external-beam radiation therapy (EBRT) is the tradeoff between tumor control and normal tissue sparing in the presence of geometric uncertainties (GUs). To accommodate GUs, the conventional way is to use an empirical planning treatment volume (PTV) margin on the treatment target. However, it is difficult to determine a near-optimal PTV margin to ensure specified target coverage with as much normal tissue protection as achievable. Coverage optimized planning (COP) avoids this problem by optimizing dose in possible virtual treatment courses with GU models directly incorporated. A near-optimal dosimetric margin generated by …

Optimization Of Radiation Therapy In Time-Dependent Anatomy, W. Tyler Watkins

Theses and Dissertations

The objective of this dissertation is to develop treatment planning techniques that have the potential to improve radiation therapy of time-dependent (4D) anatomy. Specifically, this study examines dose estimation, dose evaluation, and decision making in the context of optimizing lung cancer radiation therapy. Two methods of dose estimation are compared in patients with locally advanced and early stage lung cancer: dose computed on a single image (3D-dose) and deformably registered, accumulated dose (or 4D-dose). The results indicate that differences between 3D- and 4D- dose are not significant in organs at risk (OARs), however, 4D-dose to a moving lung cancer target …

Correlates And Predictors Of Risky Sexual Partnering, Jennifer Nield

Theses and Dissertations

Introduction: Sexually Transmitted Diseases, including HIV/AIDS, continue to be a major burden in the United States. Sexual partnering behaviors contribute to the spread of STDs. Sexual concurrency has been shown to exponentially increase STD prevalence in populations. Serial monogamy with short periods between sexual partners also introduces risk. Methods: We identified sexually active men and women from the 2006-2010 National Survey of Family Growth (NSFG) and used sub sets for each particular study. Sexual partnering was defined as being concurrent, serially monogamous or monogamous in the previous year. Polytomous logistic regression models were developed to evaluate the associations between age …

Health Risk Assessments Of Waste Combustion Emissions Using Surrogate Analyte Models, Michael A . Schmidt

Theses and Dissertations

Exposure assessments of open burn pits are often complicated by a lack of sampling equipment and resources. This research investigated the hypothesis of carbon dioxide (CO₂) as a viable surrogate for particulate matter with diameter ≤ 2.5 μm (PM2.5). Large-scale solid waste combustion tests resulted in linear trends between mean PM2.5 and CO₂ (R2 = 0.964 - 0.989). This pilot study demonstrates the feasibility of using CO₂ as a surrogate of PM2.5 concentration as CO₂ sensors potentially provide a cost-effective solution for monitoring in lieu of expensive PM instruments. It also indicates the potential reduction …

Patient Understanding Of Coordinated Medical Treatment Success Within The Minnesota Medical Home Model: An Exploratory Qualitative Inquiry, Jeremy F. Stockinger

Theses and Dissertations

The US health care system is often described as a complex, fragmented system where patients experience less access, coordinated, and comprehensive care that is ultimately more costly (Rosenberg, 2009). The problem addressed in this study was to understand coordinated medical treatment in the medical home model from the patient perspective. This study provides the opportunity to increase the understanding of the factors affecting coordinated medical treatment success.

An Assessment Of Injury Presentation To Determine Elder Abuse Prevalence In South Carolina, Brittani L. Harmon

Theses and Dissertations

As the number of individuals age 60 years of age and older continues to rise in the United States, the care and safety of this population will be a growing issue. There are many contributing factors and reasons why elder abuse occurs. Elder abuse is an emerging issue; however there is limited research and understanding in the area. There are barriers to the detection and prevention of the issue. Emergency department staff is essential to the identification and detection of possible abuse, and it is important that these providers understand the risk factors and physical manifestations of abuse and neglect …

Promoting Early Childhood Development Through Community Health Worker Interventions: Implementation And Measurement Issues In Rural Pakistan, Zaeem Haq

Theses and Dissertations

Appropriate nutrition and psychosocial stimulation during the first three years of life can have long-lasting effects on a child's health and development. However, not all children in the world receive adequate nutrition and psychosocial stimulation during this period. There has been enormous interest in developing the evidence on the most effective ways of implementing and assessing early childhood development (ECD) promotion interventions in resource poor settings. Despite the interest, the integration of ECD interventions into pre-existing public health programs, and assessment of these interventions in extended family, rural household environment have not been addressed.

The dissertation research presented here was …

Fishing And Fish Consumption Patterns In The Gullah/Geechee Sea Island Population, Jamelle Heyward Ellis

Theses and Dissertations

The Gullah/Geechee (G/G) people are descendants of West African slaves who remained in seclusion on the Sea Islands of South Carolina, North Carolina, Georgia, and Florida until the end of the Civil War in 1865. In addition to retaining their unique cultural language, they also remain largely a fishing subsistence population. Decades of urban development have reduced the G/G population's access to traditional fishing locations and have increased exposures to environmental contaminants in some bodies of water that are frequently fished by the G/G. Approximately 98.4% of SC rivers and streams and 77.6% of lakes have been assessed for aquatic …

Evaluation Of Mass Media Campaigns To Change Smokers' Knowledge, Attitudes, And Behaviors In China And Taiwan, Li-Ling Huang

Theses and Dissertations

Research in high income countries (HICs) suggest that anti-smoking television advertisements are most effective if they contain emotionally evocative graphic messages or personal testimonials that depict serious consequences from smoking. The ability to effectively translate these messaging strategies to low- and middle-income (LMICs) countries outside of Western cultures remains understudied. It is critical to determine which smoking cessation messages work best in LMICs because they increasingly bear the global burden of tobacco-related disease. To date there is limited evidence on the efficacy of tobacco control mass media campaigns and the relative effectiveness of different tobacco control messaging strategies in China …

Bmi At Diagnosis And Its Association With Markers Of Hiv Disease Progression And Cardiovascular Disease Risk., Kelly Deshon Johnson

Theses and Dissertations

Highly active antiretroviral treatment (HAART) has transformed the state of human immunodeficiency virus (HIV) from acute to chronic. As a result, the long-term effect of HAART has caused weight gain among HIV-infected individuals, leading to an increased prevalence of overweight and obesity. Increased Body Mass Index (BMI) has been associated with adverse health outcomes in non-HIV and HIV populations, yet among HIV-infected individuals, a higher BMI at diagnosis offers a slower progression from HIV to AIDS. Pre-HAART, studies reported that obese HIV-infected individuals have higher increases in CD4 count over time. However post-HAART, some report that overweight HIV-infected individuals with …

Postnatal Depression In Mexico: Healthcare Provider Conceptualizations And Policies In The Public Health Sector, Jean Marie Sims Place

Theses and Dissertations

Background: The World Health Organization (WHO) and the United Nations Population Fund (UNFPA) highlight education and training for healthcare providers and the development of a policy framework as core strategies to address maternal mental health in low- and middle-income countries. This research critically examines these strategies with respect to postnatal depression in Mexico. The research 1) addresses how healthcare providers in Mexico conceptualize postnatal depression, and 2) assesses the policies that exist in Mexico regarding postnatal depression, which will inform the next steps for policy development. The research informs appropriate healthcare provider education and training, as well as the next …