Medicine and Health Sciences Commons^™

Understanding Public Health Professional Socialization And Professional Identity Formation Experiences, Jennifer M. Freiheit

Theses and Dissertations

Public health is in unstable times with funding decreasing, an exodus of retirees, and a paradigm shift with emergency preparedness and response critically changing the identity of the profession. Public health is at a grave trigger point where if something is not done, the entire field may be in jeopardy of caving in to consolidations, poor succession planning, and a field that cannot work toward the health of the public if they themselves are not operating well. It is commonly accepted that orientation practices exist in public health agencies, but the orientations that currently exist lack transfer to full socialization …

Association Of Childhood Blood Lead Levels With Firearm Violence Perpetration And Victimization, Lindsay Rae Emer

Theses and Dissertations

Over 10,000 Americans are killed in firearm homicides each year, and an additional 40,000 are injured in nonfatal shootings. There is a significant public health need to identify risk factors that can be modified to prevent firearm violence. Environmental lead exposure is a demonstrated neurotoxicant which causes behavior changes that are known to be criminogenic. More recent research has demonstrated that homicides and nonfatal shootings differ by the circumstances that lead to the shootings (i.e. gang, domestic violence, arguments) and aggregating them could lead to biased results. Although studies have found a relationship between childhood lead exposure and criminal behaviors, …

Social Engagement And Health: A Structural Equation Modelling Analysis Of Downstream Links To Health Outcomes Among White-Collar Professionals, Ahmad Iqmer Nashriq Bin Mohd Nazan

Theses and Dissertations

ABSTRACT

SOCIAL ENGAGEMENT AND HEALTH: A STRUCTURAL EQUATION MODELLING ANALYSIS OF DOWNSTREAM LINKS TO HEALTH OUTCOMES AMONG WHITE-COLLAR PROFESSIONALS

by

Ahmad Iqmer Nashriq bin Mohd Nazan

The University of Wisconsin – Milwaukee, 2017

Under the Supervision of Associate Professor Amy E. Harley

High level of social engagement has been associated with improved health outcomes. Its capacity to influence one’s health has led to the conception of Berkman’s social relationship model which hypothesizes that health is impacted by social relationship through a series of causal processes that begin at the macro-social level (upstream factors) to micro-psychobiological processes (downstream factors). Social engagement …

Unveiling Recovery: A Discourse Analysis Of Mental Illness Recovery Narratives, Elizabeth Albert

Theses and Dissertations

The discussion of mental illness recovery, both academically and socially, has been framed mainly as a morally necessary medical pursuit and has left shadowed the deeper social and cultural implications of recovery ideologies and practices. Previous research has embraced the growing demand for recovery-based practices in mental health organizations, especially those led by persons labeled mentally ill (or “peers”); however, they have yet to more deeply uncover and understand the subjective meanings of recovery. More specifically, how cultural and social interactions of daily life, while both experiencing and being labeled mentally ill, direct the course and meaning of an individual’s …

Communicating Consent: An Investigation Of Predictors Of College Student Sexual Consent Communication, Erin L. Link

Theses and Dissertations

Often, sexual consent is only discussed and explored in the context of sexual assault. While consent is often the deciding factor to determine if a crime occurred, consent is also a vital part of an equally enjoyable sexual encounter. The present study examines a variety of variables effects on consent attitudes, norms, and communication behaviors to attempt to identify predictors of college student consent communication. Findings and recommendations are discussed that highlight the necessity of viewing consent as a communicative act.

Utilization Of Lung Cancer Screening And Molecular Testing To Improve Lung Cancer Outcomes, Jennifer Lynne Ersek

Theses and Dissertations

Despite progress in detection and treatment, lung cancer remains the leading cause of cancer-related death in the United States. The United States Preventive Services Task Force (USPSTF) recommends adults at high risk for lung cancer undergo annual low-dose computed tomography (LDCT) screening, however, lung cancer screening (LCS) uptake remains low. Qualitative research on family physician (FP) perceptions and experiences with LCS has been limited since USPSTF publication and Centers for Medicare and Medicaid Services (CMS) decision memo. We conducted a qualitative study to assess FP knowledge and perceptions of LCS and gain insight into their current experiences with LDCT. A …

Characterization Of Jet Fuel Combustion Emissions During A C-130 Aeromedical Evacuation Engines Running Onload, Michelle L. Page

Theses and Dissertations

The purpose of this research was to characterize jet fuel combustion emissions (JFCE) in an occupational setting. Prior research demonstrated that aircraft emit hazardous species, especially at engine start-up and ground idle. Complaints of eye, nose, and throat irritation from occupational exposures near aircraft exist. In this study JFCE were tested during an aeromedical evacuation engines running patient onload (ERO) on a C-130 Hercules at the 179^th Airlift Wing, Mansfield-Lahm Air National Guard. Ultrafine particles, VOC, formaldehyde, carbon monoxide (CO), sulfuric acid, and metals were sampled simultaneously in approximate crew and patient breathing zones. Testing methods were portable condensation …

The Effect Of Paid Sick Leave On Physician Office-Based Visits, Korvin Vicente

Theses and Dissertations

This paper uses a balanced sample of workers from cross-sections of the National Health Interview Survey to estimate the causal effects of paid sick leave on the medical care seeking behavior of individuals, as measured by physician office-based visits.

Cultural Correlates Of Ptsd In Latinos Residing In The U.S., Gabriela A. Nagy

Theses and Dissertations

The present study examined the associations between cultural variables (i.e., acculturative stress, discrimination, social support, migration planning, and reasons for migrating) and exposure to trauma and PTSD in a sample of Latinos (N=2,554) residing in the United States, who participated in the National Latino and Asian America Study (NLAAS). Results showed that there were significant positive associations between trauma exposure and migrating because of political reasons, migrating in search of medical attention, migrating due to

marital or family problems, and forced migration, suggesting they may be risk factors for being exposed to trauma. There was a negative association between trauma …

The Impact Of Stand-Biased Desks On After-School Physical Activity Behaviors In Children, Nathan Tokarek

Theses and Dissertations

The purpose of this study was to assess changes in after-school time spent performing sedentary behavior (SB), light intensity physical activity (LPA), and moderate to vigorous-intensity physical activity (MVPA) among elementary school children in response to the introduction of stand-biased desks in the classroom. Thirty-one 6th grade participants randomly assigned by their teacher to a traditional (CON) or stand-biased (INT) desk provided complete accelerometer data. After-school PA and SB were measured on four consecutive weekdays at baseline and 10-weeks. Wilcoxon Rank Sum Tests were used to detect significant differences (p<0.10) in changes in the proportion of after-school wear time performing SB and PA between groups. Results suggested no significant differences in changes in after-school time performing SB (p=0.770), LPA (p=0.740), or MVPA (p=0.470). Significant differences in the change in moderate PA (INT: -1.4%; CON: -0.2%, p=0.093) were detected. Stand-biased desks were not detrimental to children’s after-school PA and SB.

Impact Of Sexual Violence Prevention Programming At Rowan University, Emily Kofman

Theses and Dissertations

The primary purpose of this study was to explore the impact of sexual violence prevention programming on the main Rowan University campus. This study focused primarily on the Take Back the Night event on April 4, 2017. The study evaluated the impact of the event on those who attended as well as looking at Social Norm Theory. A total population of 167 Rowan students were surveyed at the event with the instrument Take Back the Night Survey. Results of the data revealed that students positively benefitted from attending the event and were able to increase their knowledge of the subject. …

Which Activities Count? Gender And Socioeconomic Differences In The Conceptualization Of Physical Activity: The Role Of Leisure, Housework And Dependent Care, And Paid Work, Rachel N. Cusatis

Theses and Dissertations

Survey research on the overall health and physical activity of the United States has relied on self-reports from questions that ask about leisure-only activity. Leisure activity patterns are known to be plagued by social forces that inhibit access and opportunity for women, compared to men, and for lower-socioeconomic individuals, compared to higher-socioeconomic individuals, making the further unpacking of leisure and other time use patterns imperative. To address this, the objective of this dissertation is to assess the different pathways individuals take to engage in health-benefiting physical activity and investigate the reliability and validity of physical activity survey questions as they …

Exploring Factors Influencing Health Promoting Behaviors Among Latino Immigrants, Martin Joseph Mikell

Theses and Dissertations

Latinos immigrants may experience stress during acculturation to the U. S., which can influence their ability to engage in health-promoting behaviors, such as dietary intake and physical activity. Dietary intake and physical activity influence the prevention or development of pre-diabetes/Type 2 Diabetes (T2DM). The immigrant’s ability to perform health-promoting behaviors can also be influenced by their perceptions of self-efficacy to engage in health-promoting behaviors. Limited information is available in the literature on effective strategies for decreasing stress during the acculturation process of Latino immigrants, while also increasing self-efficacy on health-promoting behaviors. The purpose of this study was to explore the …

Complementary And Integrative Health Services In A Low-Resource Community: A Retrospective Examination, Barbara M. Wesson

Theses and Dissertations

ABSTRACT

COMPLEMENTARY AND INTEGRATIVE HEALTH SERVICES IN A LOW-RESOURCE COMMUNITY: A RETROSPECTIVE EXAMINATION

by

Barbara M. Wesson

The University of Wisconsin – Milwaukee, 2017

Under the Supervision of Professor Ron Cisler

Study Background and Significance: Complementary and Integrative Health (CIH) continues to be widely utilized despite a lack of consensus regarding its efficacy. Since 2001, CORE El Centro (CEC) has been providing acupuncture, massage, reiki, and mindful movement classes, charging sliding scale fees in a low-resource, primarily Latino community; underrepresented in the CIH literature.

Purpose: This study examined the association between CIH use (time and treatment), subjective well-being assessments, biometrics …

Layperson Perceptions And Attitudes Towards A National Electronic Health Record Introduction In Saudi Arabia, Jwaher Abdullah Almulhem

Theses and Dissertations

Introduction: Since patients and the general public may interact with a national electronic health record (EHR), including them during implementation of an EHR is important. Such acceptance has been documented as one of the critical areas in the development of a national EHR. However, only a few studies have considered public perceptions and attitudes regarding use of their health information in a universal EHR. This is the first study that concentrated on Saudi patients and citizens’ attitudes regarding a national EHR. . Objectives: The purpose of this quantitative study was to understand perceptions and attitudes regarding the introduction of a …

Multimorbidity And Mortality Risk: The Effect Of Depressive Symptom Trajectories Among Middle-Aged And Older Adults, Katherine Reynolds O’Shields

Theses and Dissertations

Introduction

Multimorbidity, commonly defined as having two or more chronic conditions, is a major burden in middle-aged and older adults, causing increased risks for hospitalizations, medical care costs, and even death. One condition with severe adverse effects in the older population is depression. Depression has been shown to increase ones social isolation while compounding self-management, eventually increasing ones chance for mortality. Multimorbidity coupled with depression has been shown to increase the risk for mortality; however, these results are typically based on a one-time depression evaluation. The main objective of this study is to examine if depressive symptom trajectories modifies the …

Optimal Configurations For Aerosol Monitoring With Multi-Rotor Small Unmanned Aerial Systems, Inna D. Chavez

Theses and Dissertations

Applicability of aerosol sampling on multi-rotor unmanned aerial systems (UAS) platform was investigated. Multi-rotor UAS have impacts of wind speed, turbulence, and orientation possibly contributing to sampling bias. The SKC IMPACT sampler, Tecora C.A.Th.I.A., and modified three-dimensionally printed Universal Inlet for Airborne-Particle Size-Selective Sampling were selected based on particle size-selectivity and operational independence to wind. Airflow visualizations concluded that below UAS fuselage was optimal sampler placement. Tests were conducted with Arizona Road Dust in a still-air chamber, and aerosolized sugar in a wind tunnel. Inlet mounting was evaluated in, upright, upside-down, and horizontal orientations. Horizontal orientations of all inlets resulted …

Establishing Sustainable Community Garden Interventions With Aid From Health Promotion Organizations, Rachel Joann Buenemann

Theses and Dissertations

Community garden interventions provide policy, system and environmental change at the community level to establish health behaviors, which act in contest to obesity risk factors. Limited research examines factors, which influence the sustainability of community garden interventions. Therefore, in this study, a sample of 10 Midwestern community gardens associated through funding from a health promotion organization in 2013, collected data through the interviewing and surveying of 10 garden administrators and surveying of 12 garden volunteers. The study identified garden benefits perceived by garden administrators and volunteers to include contributions to social justice, continued education, enhanced social cohesion, increased access to …

Health Aid In Africa: Placement, Service Utilization, And Benefit, Carrie Dolan

Theses and Dissertations

While the health sector has attracted significant foreign aid, evidence on the effectiveness of this support is mixed. This dissertation examines the allocation of health aid within the context of placement, service utilization, and benefit. The first paper examined the sub-national allocation of Chinese development aid projects across Africa. I determined how political preferencing of Chinese aid specifically, allocating aid to the birth region of the current political leader differs across sectors such as health, education, and transportation. I find some evidence that aid, more broadly defined, is subject to political preferencing in recipient countries, which could potentially limit its …

Exploring Spatial Patterning And The Impact Of Obesogenic Built Environments For Youth Obesity, S. Morgan Hughey

Theses and Dissertations

Youth obesity is a major public health concern due to an array of physical, social, and psychological health consequences. Residential location, often referred to as ‘place’, has continued to emerge as a key health determinant with studies showing that where a child lives impacts their health. Environments where it is easy for individuals to have low levels of physical activity – either by discouraging active behavior or promoting sedentary behavior – and easy for individuals to consume unhealthful foods – either by the limited availability of healthful foods or increased availability of unhealthy foods – have been coined ‘obesogenic’. Additional …

Internet Speed And The Effect On Health Information Technology Adoption, Matthew W. Yuen

Theses and Dissertations

Background. The Internet has become pervasive in everyday life; the Pew Research Center reported over 84% of Americans use the Internet either on their phone or a computer. However, due to the methods by which the Internet was created, an Internet digital divide was created. The Internet digital divide is the disparity in access and speed of Internet of certain populations. This study looked into the disparity between urban and rural populations and their Internet access in two forms: e-prescriptions adoptions and Internet health information seeking behavior (HISB) through their mobile devices.

Methods. This study used 4 datasets, …

Effectiveness Of Community-Based Eibi Treatment: A Longitudinal Analysis Of Adaptive Behavior And Language Outcomes, John Kuntz

Theses and Dissertations

Autism spectrum disorders (ASDs) are a group of lifelong, neurodevelopmental disorders characterized by deficits in social interaction, communication, relationship development and by the presence of repetitive or stereotypical behaviors including restricted interests. Continued advances in understanding treatment outcomes and broadening access to effective treatment is critical to improving the quality of life of children with autism and their families and minimizing the cost associated with care. The overall aim of this study is to assess the effectiveness of a community-based implementation of an Early Intensive Behavioral Intervention (EIBI) treatment program through a large-sample, longitudinal secondary analysis of administrative data. Additionally, …

Recovery From Design, Cassandra J. Ellison

Theses and Dissertations

Through research, inquiry, and an evaluation of Recovery By Design, a ‘design therapy’ program that serves people with mental illness, substance use disorders, and developmental disabilities, it is my assertion that the practice of design has therapeutic potential and can aid in the process of recovery. To the novice, the practices of conception, shaping form, and praxis have empowering benefit especially when guided by Conditional and Transformation Design methods together with an emphasis on materiality and vernacular form.

Person-Centered Treatment To Optimize Psychiatric Medication Adherence, Natalie Bareis

Theses and Dissertations

Objectives: Adherence to psychotropic medication is poor among individuals with bipolar disorder (BD). To understand treatment experiences and associated adherence among these individuals, we developed a novel construct of Clinical Net Benefit (CNB) using psychiatric symptoms, adverse effects and overall functioning assessments. We tested whether adherence differed across classes of CNB, whether individuals transitioned between classes over time, and whether these transitions were differentially associated with adherence.

Methods: Data come from individuals aged 18+ during five years of the Systematic Treatment Enhancement Program for Bipolar Disorder (STEP-BD). Latent class analysis identified groups of CNB. Latent transition analysis determined probabilities of …

Sustainable Adapted Treatments For Eating Disorders: The Role Of Cultural Adaptation In Prevention, Sarah J. Javier

Theses and Dissertations

Despite demonstrating eating disorder rates equivalent to White women, African American and Asian American women are less likely to seek treatment and are more likely to terminate treatment prematurely. One of the most successful programs for eating disorder prevention has only focused on surface-level cultural adaptations. Prevention literature maintains that deep-structure cultural adaptation (e.g., integrating cultural values and beliefs) can enhance outcomes for ethnic minorities. This dissertation examined the feasibility of Sustainable Adapted Treatments for Eating Disorders (SATED), a pilot intervention that included a culturally- targeted pre-treatment to an eating disorder dissonance-based intervention. A sample of 72 women (ages 18-30) …

An Algorithm To Improve Deformable Image Registration Accuracy In Challenging Cases Of Locally-Advanced Non-Small Cell Lung Cancer, Christopher L. Guy

Theses and Dissertations

A common co-pathology of large lung tumors located near the central airways is collapse of portions of lung due to blockage of airflow by the tumor. Not only does the lung volume decrease as collapse occurs, but fluid from capillaries also fills the space no longer occupied by air, greatly altering tissue appearance. During radiotherapy, typically administered to the patient over multiple weeks, the tumor can dramatically shrink in response to the treatment, restoring airflow to the lung sections which were collapsed when therapy began. While return of normal lung function is a positive development, the change in anatomy presents …

The Impact Of Autoimmune Disease On Breast Cancer Survival, Samantha Truman

Theses and Dissertations

Background Breast cancer is the second leading cause of cancer death for women in developed countries, while autoimmune disease effects approximately 10 million people in the United States, of which approximately 80% are female. Both diseases are associated with hormonal risk factors and are related to the divergent effects of the cellular and humoral immunity that is associated with the T-helper 1 and T-helper 2 immune response. To investigate the potential implications that autoimmune disease may have on breast cancer-specific mortality, we have conducted a population-based retrospective cohort study of women who were diagnosed with breast cancer between January 1, …

Assessing The Relationship Between Periodontal Disease And Subsequent Inflammatory Responses And Headache Disorders, Bryn E. Davis

Theses and Dissertations

Headaches are the sixth leading cause of disability worldwide, and the third leading cause of disability amongst those aged 50 and older. Several headache disorders, including migraines, have been associated with nitric oxide production. It is widely accepted that the pain associated with headache disorders is due to the ability of nitric oxide to function as a vasodilator. While nitric oxide is a known vasodilator and has been linked to headache disorder, it is also produced in response to bacterial infections. Periodontal disease is the result of long term bacterial infections occurring in the gum line and nitric oxide is …

The Role Of Afrocentric Features In Mental Healthcare Utilization And Counselor Preferences In Black College Students, Randl B. Dent

Theses and Dissertations

Though mental health issues are prevalent in Black young adults, they underutilize mental healthcare services. This research examined the role of feature-based discrimination in mental healthcare (under)utilization. Study 1, a secondary analysis of the National Longitudinal Study of Adolescent to Adult Health, provided no evidence supporting a link between skin tone and mental healthcare utilization, when controlling for depression diagnosis. However, when controlling for depression symptoms, there was a trend such that Black young adults with darker, as opposed to lighter, skin tone utilized healthcare less. Study 2, an experimental study with 33 Black college students, showed 73% of the …

Understanding Over-The-Counter Medication Use And Decision-Making Among Community-Dwelling Us Older Adults: A Mixed-Methods Approach, Yoshita Paliwal

Theses and Dissertations

Introduction

Older adults are regular consumers of over-the-counter (OTC) medications. OTC medications are generally considered safe, and convenient to use without requiring a prescription. However, the safety of an OTC medication and the final health outcome depends in part upon consumers’ perceptions, beliefs, and their decision-making about OTC medication use. The main objectives of this study were: 1) to examine the prevalence and characteristics of OTC medication use among community-dwelling US older adults (65 years and older), 2) to explore older adults’ knowledge, attitudes, beliefs and experiences about OTC medications, and 3) to elicit the OTC medication decision-making process in …