Medicine and Health Sciences Commons^™

Health Barriers, Health Perceptions, And Cardiovascular Risk Factors Of Adolescent Black American Males, Desmarie Jackson Decuir

Theses and Dissertations (ETD)

Area of Investigation: Cardiovascular (CV) diseases are the leading cause of death among Black American adult males. Health behaviors that contribute to CV disease are probably learned during adolescence yet few researchers have studied the factors that influence health promotion behaviors in adolescent Black American males. This study described the health barriers, health perceptions (health self-efficacy and health status), and CV risk factors reported by and the influence of these variables on health promotion behaviors of a sample of Black American adolescent males without known CV disease.

Methods and Procedures: A descriptive correlation study design was used to …

The Role Of Gender Equality And Economic Development In Explaining Female Smoking Rates, Samina Shariff

Public Health Theses

Globally female smoking rates are considerably lower than male smoking rates. However, there is great concern regarding female smoking due to the potential for future increases and the associated harm to health. To gain a better understanding regarding female smoking, this study examines the role of gender equality and economic development in explaining the variability in female smoking rates and female-to-male smoking differentials by examining data from 193 World Health Organization member states. Data on the dependent variables, female smoking prevalence rates and female-to-male smoking prevalence ratio, were obtained from the Tobacco Atlas. Data on independent variables i.e., measures of …

The Impact Of The “Learn The Signs. Act Early.” Public Health Awareness Campaign On Early Intervention Behavior, Kinjal Prabodh Patel

Public Health Theses

Autism is the fastest-growing developmental disability in the United States. Proactive adult behaviors leading to early intervention are a child’s best hope to reach their full potential. The Centers for Disease Control and Prevention partnered with Porter Novelli to develop a public health campaign called “Learn the Signs. Act Early.” The goal of this campaign was to increase awareness about the early warning signs of autism to help invoke positive behaviors in parents so that children receive services at the youngest age possible. HealthStyles survey data were analyzed to assess the difference in level of autism awareness of those surveyed …

Investigating Potential Risk Factors For Nursing Home Admission Associated With Individuals Enrolled In Georgia’S Community Care Services Program, Matthew L. Johnson

Public Health Theses

This retrospective study examined records of 230 low-income elderly and disabled individuals enrolled in the Georgia Community Care Services Program (CCSP) which provides home health services in the client’s home rather than a nursing facility (NF). This study sought to determine if any common characteristics exist in program enrollees who enter a NF within one year of enrollment. Common factors found could be used to identify those who are at the highest risk for entering an NF. This knowledge could lead to reduced costs for the State of Georgia and better service for CCSP enrollees. Findings associated with NF entry …

Parental Views Of Otitis Media And Antibiotic Treatment, Courtney Leigh Ross

Doctoral Dissertations

Antibiotic resistance is a rapidly growing problem throughout the world. Antibiotic resistance can be due to a number of factors, including unnecessary antibiotic prescriptions, antibiotic misuse, and transmission of resistant bacteria.

Otitis media is the most often diagnosed childhood illness and accounts for the majority of the United States' annual antibiotic prescriptions. Both parents and physicians can contribute to unnecessary antibiotic treatment for otitis media. Understanding parental views of otitis media and antibiotic treatment may help reduce unnecessary antibiotic prescriptions and lead to the subsequent reduction in antibiotic resistance.

The purpose of this capstone project is to develop a questionnaire …

Soil-Transmitted Helminths In Schoolchildren In Grand Bois Haiti: A Prevalence Study, John M. De Pasquale

Public Health Theses

This study used secondary data collected in 2006 to assess the prevalence and severity of three common soil-transmitted helminths in schoolchildren in rural, mountainous, eastern Haiti, and using a case-control design looked at age and gender as independent risk factors, and at anemia and growth failure as potential outcomes of infection. The primary aim was to determine if prevalence and severity were high enough to meet World Health Organization (WHO) population-based deworming criteria. Results do support mass deworming, but overall, indicate no correlation between the other independent variables or outcome measures with presence of disease. A secondary data set from …

Repeatability Of Serial Carotid Intima Media Thickness Scanning On Individual Subjects, Judi Nightingale

Loma Linda University Electronic Theses, Dissertations & Projects

Background. Heart disease affects millions of Americans each year. In order to improve primary prevention, early risk identification is essential. B-mode ultrasound of the common carotid artery (CCA) intima-media thickness (IMT) assesses risk of a coronary event early in the process of plaque development. Because IMT changes are so small over time, in order to determine clinically significant versus clinically insignificant changes in IMT over a 12 month time period, a protocol is needed which can detect the least significant difference (LSD) of at least 0.030 mm.

Purpose. The purpose of this study was to develop and test a well-defined …

Down-Regulation Of Natural Killer Cell Activation In Response To Influenza Virus In Older Adults, Yu Jing

Theses and Dissertations in Biomedical Sciences

Immune senescence contributes to influenza-associated high mortality and morbidity and reduced vaccine efficacy in elderly people. Type I T cell (Thl)-mediated immunity plays a significant role in Immune responses to influenza infection and vaccination. Natural killer (NK) cells secrete significant amount of IFN-7 , a hallmark Thl cytokine, in response to influenza infection. How aging influences human NK cell IFN-7 production in response to influenza virus has not been well documented. In this study we employed human peripheral blood mononuclear cells (PBMC) and performed intracellular cytokine staining and flow cytometry primarily to investigate how aging influences NK cell activation with …

Food Facilities, Food Service Workers And The Flow Of Food: Food-Borne Illnesses In Taiwan's Preschools, Shu-Chen Lin

Graduate Student Dissertations, Theses, Capstones, and Portfolios

This study examined food-borne illnesses in Taiwan's preschools which are a major cause of personal distress and preventable death. They are of particular concern in preschools as very young children are highly susceptible to food-borne illnesses. Previous studies that comprehensively investigated the factors impacting food-borne illnesses in Taiwan were not found in the literature. The development of a universal food safety model is necessary as a means to measure relevant constructs. Application of the model should be able to prevent the occurrence of food-borne illnesses in organizations. This explanatory (correlational) study examined the relationships among food facilities, food service workers, …

The Association Between Lifestyle Factors And Inflammatory Markers, Kerry Ann Stonebrook

Loma Linda University Electronic Theses, Dissertations & Projects

Background: Cardiovascular disease (CVD) is the leading cause of death for both men and women in the United States. While smoking, high blood pressure, and elevated cholesterol levels are established risk factors for CVD, inflammation is being evaluated as a potential independent risk factor. A key cytokine regulator of the inflammatory response, interleukin-1 (IL-1), has emerged as playing a particularly important role at the genetic level in determining the degree to which the inflammation pathway is turned on. How an individual’s genetic make-up affects inflammation, CVD risk, and response to lifestyle intervention is an area of research that is in …

The Association Between Adult Self-Reported Asthma & Potential Exposures To Asthma Triggers In Virginia Workplaces: An Ecological Study, Jeanette R. Bowman

Theses and Dissertations

Introduction: Work-related asthma (WRA) is thought to be the most common occupational lung disease in the U.S., but there is no standard case definition of WRA. Most states, including Virginia, do not require WRA diagnoses to be reported to health departments. At present, there is too little epidemiological data on WRA in Virginia to direct public health planning efforts. Objectives: The first objective of this study was to estimate potential exposure to workplace asthma triggers in each of Virginia's 35 health districts. The second objective was to examine associations at the health district level between workplace asthma triggers, other asthma …

Access To Health Information And Health Care Decision-Making Of Women In A Rural Appalachian Community, Tracy L. Legrow

Theses, Dissertations and Capstones

Access to health care is a challenge in rural communities. Higher rates of chronic illness and poor use of preventive health practices combine to increase mortality rates among residents of rural areas. The health status of residents of West Virginia is among the poorest in the United States. The current study utilizes both quantitative and qualitative methodology, including the use of surveys, participant observation and ethnographic interviews, to explore the health status, beliefs and social support of women in a rural Appalachian community. Seven major themes were identified relevant to women’s experiences with health care: Definitions of Health, Barriers and …

Evaluation Of A Behavioral Health Integration Program In A Rural Primary Care Facility, Tina W. Billmeyer

Theses, Dissertations and Capstones

Behavioral or mental health has historically been seen as a separate entity from medical or primary health care. With the increased utility of psychotropic medication, more and more patients are presenting to their primary care provider with behavioral health issues prompting the healthcare field to look for methods to integrate medical and behavioral health services. The current study examined the effectiveness of a pilot program that attempted to integrate services at a rural primary care clinic. The study asked whether participation in the program resulted in improved scores on a questionnaire of perceived health status and whether participating medical providers …

Analgesic Use In U.S. Emergency Departments For Patients Reporting Moderate To Severe Pain: Diagnosis And Select Patient Characteristics Influencing Narcotic Analgesic Prescribing Practices, Hassan Zakaria

Theses and Dissertations

Objective: This study aims to examine the relationship between emergency department patient encounter characteristics and narcotic analgesic prescribing practices in order to determine what patient characteristics, if any, influence the decision to prescribe narcotics.Methods: Cross sectional data on patients presenting to U.S. emergency departments from the 2003 and 2004 National Hospital Ambulatory Medical Care Survey were analyzed. Patients reporting moderate to severe pain were included in the sample and analysis. Chi square tests of significance were used to assess the association between individual demographic and encounter characteristics to narcotic prescription or administration. Separate multiple logistic regressions were then performed on …

Disparities In The Use Of Emergency Contraceptives, Rebecca Dallman

Theses and Dissertations

Purpose: Unintended pregnancies are often a burden to pregnant women and to the health care system. The rates of unintended pregnancies have decreased since the wide use of contraceptives has increased; however, young women, women with low income, and racial/ethnic minorities are more likely to use contraceptives inconsistently, which increases the risk of an unintended pregnancy. This risk could be reduced with the proper use of emergency contraceptives (ECs).Methods and Analysis: A cross-sectional study was conducted using the data from the female respondents of the 2002 Cycle 6 NSFG. Logistic regression was used to determine rates of use of ECs …

The Utility Of Depression Screening Measures After Traumatic Brain Injury, Amy H. Riddick

Theses and Dissertations

Objectives: Identifying reliable, practical and easy to use tools to assess depression in patients with traumatic brain injury (TBI), is a necessary first step to addressing a high incidence problem. The intention of this study is to validate depression screening measures with a criterion-based structured interview among people with TBI. The final outcome will identify which measure is the best indicator of depression diagnosis in this population. Methods: 112 participants with TBI were administered the Beck Depression Inventory (BDI), Neurobehavioral Functioning Inventory (NFI), The Hamilton Rating Scale for Depression (Ham-D), and the Structured Clinical Interview for DSM-IV TR Axis I …

Impact Of Combat Stress On Mental Health Outcomes: Brfss Survey Data 2006, Emily Pedneau

Theses and Dissertations

Objectives: This study sought to determine the relationship between combat experience and mental health outcomes. The study sought to determine whether age was a significant factor in poor mental health outcomes. Methods: Multiple logistic regression (n = 195,048) and multiple linear regression (n = 264,154) were performed on the 2006 Behavioral Risk Factor Surveillance System (BRFSS) survey. Veteran status and a host of demographic and health status questions were analyzed in relation to diagnosis of anxiety or depressive disorder (multiple logistic regression) and to number of days poor mental health (multiple linear regression). Results: Diagnosis of anxiety or depression was …

Changes In Formal-Informal Caregiving In Elderly Stroke Survivors, Holly Anne Beard

Health Services Research Dissertations

The purpose of this study is to determine the extent to which the Andersen and Aday Model of Health Services Use to predict cross-sectional and longitudinal differences in the caregiving source among stroke survivors (n=477) over a six-year period. This study involves a secondary analysis of a longitudinal panel study focusing upon three waves of interview data from the HAS/AHEAD study spanning 1998 through 2002. Multinomial logistic regression was utilized to examine caregiving source cross-sectionally at each wave. Clustered multinomial logistic regression was used to examine relationships between predictor variables in the model and caregiving source across waves while holding …

Has Richmond, Virginia Become Safer In The Past Five Years (2002-2006)?: An Analysis Of Ambulance Data Regarding Penetrating Trauma Incidents, Ashleigh K. Mccabe

Theses and Dissertations

Introduction: The World Health Assembly declared violence as a worldwide public health problem. Homicides have been identified as a leading cause of death in the United States across all age groups. The national homicide rate for 2004 and 2005 are 5.5 and 5.6 per 100,000 population, respectively. The reported rates for Virginia are 5.2 (2004) and 5.6 (2005) per 100,000 population, showing a 16.9% increase. Richmond has been ranked as high as the sixth most dangerous among similar cities in the United States. This study examines penetrating trauma injuries identified through 9-1-1 calls as an indicator of the incidence of …

Student Perceptions Of The Effectiveness Of A Student Random Drug Testing Program In One New Jersey High School, Lisa Brady

Seton Hall University Dissertations and Theses (ETDs)

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The Latino Caregiver Experience Among Dementia And Non-Dementia Caregivers : Can Community Based Care Management Improve Caregiver Health?, Catherine Oliveros

Loma Linda University Electronic Theses, Dissertations & Projects

Purpose: This study provides an analysis of the Latino caregiving community in Southeast Texas and the role community based care management plays in influencing caregiver physical and emotional well-being. Design and Methods: A non-random sample of 63 Latino caregivers was interviewed by phone. Caregiver physical and emotional well-being was studied through burden, depression, perceived health status, and resourcefulness. Regression, correlation, and comparison analysis was performed with key variables. Results: Acculturation was positively correlated with care management use. In comparing dementia and non-dementia caregivers both groups had similar levels of depression and burden, however, the dementia group had significantly lower levels …

Trend Analysis Of Automobile Collision Amongst 15-19 Year Olds In Virginia, 2000-2004, Imo F. Ndem

Theses and Dissertations

Purpose. This research study on automobile collision in Virginia amongst fifteen to nineteen (15-19) year olds looked into the trend analysis over a five (5) year period of 2000 to 2004. Trend analysis is usually done for aggregates of all injuries—either intentional or unintentional injuries, or both. The primary objective of this research study was to examine the trend in hospitalization rates and mortality rates for males and females independently. It further looked into the trend, if any, in hospitalization rates, mortality rates, and case-fatality rates, for both males and females combined. The different Tables illustrate the extent and the …

Examination Of Birth Outcomes With Mode Of Delivery For Breech Presentation, Kelly Marie Arey

Theses and Dissertations

Introduction: Approximately 3% to 4% of all pregnancies at term will have a fetus with a breech presentation. Studies have shown that the US has almost completely abandoned vaginal delivery for breech presentation through the influence of the "Term Breech Trial" (TBT) which concluded that a policy of planned caesarian section would reduce perinatal mortality, late neonatal mortality, and serious neonatal morbidity by approximately two-thirds for term fetuses. However, the recommendations are still being challenged by others.Objectives: The purpose of the study was to describe who in Virginia is having a vaginal delivery for a breech presentation and to determine …

Outcomes Of Status Epilepticus In The Elderly, Alan R. Towne

Theses and Dissertations

Background: Status epilepticus (SE) is a serious medical condition associated with significant morbidity and mortality. Few studies have addressed this condition in the elderly. The present study examines predictors of SE mortality in this growing population.Methods: SE patients visiting the Virginia Commonwealth University Medical Center from July 1, 1989, to June 30,2006 were included in the study. Data on demographic characteristics, SE type, etiology, time to treatment and mortality were collected. Logistic regression analysis was conducted to examine the determinants of mortality due to SE. Data was stratified by age to examine the characteristics of SE among the elderly population.Results: …

Breast And Cervical Cancer Screening In Virginia: The Impact Of Insurance Coverage And The Every Woman's Life Screening Program, Kamila Somayaji

Theses and Dissertations

Background: Screening for breast and cervical cancers is important because early detection increases cancer survival. Since 1991, the U.S. government has helped finance a national early detection program for breast and cervical cancer among uninsured low-income women, known in Virginia (VA) as Every Woman's Life (EWL).Objectives: This study aims to determine whether there are differences in the prevalence of breast and cervical cancer screening based on insurance coverage, assess the prevalence of screening by health district, and evaluate the ability of EWL to effectively reach its target population.Methods: Cross-sectional data from the 2005 Behavioral Risk Factor Surveillance System survey were …

Determinants Of Obesity: Racial Differences, Nikkia L. Goforth

Theses and Dissertations

BACKGROUND: Obesity is a major public health problem. Studies have shown that there are racial and ethnic differences in the prevalence of obesity. However, there is limited research that examines the effects of sedentary and poor lifestyle behaviors and obesity among different racial and ethnic groups. Furthermore, most studies focus on the problem of obesity among children. This study was conducted to examine racial differences in determinants of obesity in adults in the United States. METHODS: Data from the 2005 Behavioral Risk Factor Surveillance System was used for this analysis. Demographics, lifestyle behaviors, and existence of chronic diseases were assessed. …

The Influence Of Indoor Air Quality (Iaq) On Student Test Performance, Denise M. Hreha

Seton Hall University Dissertations and Theses (ETDs)

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Association Between The Exposure To Aflatoxin And Micronutrient Status Of Hiv Infected Adults In Ghana, Francis Ayodele Obuseh

All ETDs from UAB

Aflatoxins, found naturally in some foods are toxic metabolites of some Aspergillus species.They constitute the most potent hepatocarcinogens known and are also mutagenic and hepatotoxic. The preponderance of evidence indicates that aflatoxin is the major cause of hepatocellular cancer. In studies conducted in Africa, food-borne aflatoxin exposure is common (Oyelami et al. 1996; Egal et al. 2005). There is a critical need for additional information on health outcomes associated with exposure to aflatoxin in humans, especially in developing countries with a higher degree of malnutrition and likelihood of HIV infections. We sought to test the hypothesis that aflatoxin B1 and …

Examination Of Novel Statistical Designs For Phase Ii And Phase Iii Clinical Trials, Ayanbola Olajumoke Ayanlowo

All ETDs from UAB

Clinical trials to determine the usefulness of a new treatment are usually conducted in four (4) phases. Each phase is designed to answer a distinct research question about the usefulness of the new treatment. Phase I trials determine the safe dose range of the new treatment identify the possible side effects and other treatment associated toxicity issues, in a small group of healthy people. In phase II trials, the efficacy and safety of the new treatment is investigated in a larger group of individuals usually from the diseased population of interest. Phase III trials, conducted in large groups of people, …

Impact Of Immunosuppression On The Incidence And Clearance Of Human Papillomavirus In Hiv-Infected Women In Alabama, Madhav P. Bhatta

All ETDs from UAB

Persistent infection with certain “high-risk” types of human papillomavirus (HPV) infection is central to the development of cervical cancer. Human immunodeficiency virus (HIV)-infected women are at a higher risk of HPV infection, high grade cervical intraepithelial lesions, and cervical cancer. This study examined type-specific distribution of prevalent and incident HPV infections, clearance rates, and associated factors using novel molecular assays for HPV detection and genotyping in a cohort of 280 HIVinfected women in Alabama. First, we described the cohort’s sociodemographic characteristics and behavioral risk profile for HIV and other sexually transmitted infections, and assessed the factors associated with HIV-1 viral …