Medicine and Health Sciences Commons^™

Predictive Modeling Of Influenza In New England Using A Recurrent Deep Neural Network, Alfred Amendolara

Theses

Predicting seasonal variation in influenza epidemics is an ongoing challenge. To better predict seasonal influenza and provide early warning of pandemics, a novel approach to Influenza-Like-Illness (ILI) prediction was developed. This approach combined a deep neural network with ILI, climate, and population data. A predictive model was created using a deep neural network based on TensorFlow 2.0 Beta. The model used Long-Short Term Memory (LSTM) nodes. Data was collected from the Center for Disease Control, the National Center for Environmental Information (NCEI) and the United States Census Bureau. These parameters were temperature, precipitation, wind speed, population size, vaccination rate and …

Burden And Risk Of Non-Aids Defining Cancers In Hiv-Infected Persons Receiving Antiretroviral Therapy, Brittney L. Dickey

Theses & Dissertations

The burden of cancers not previously associated with an HIV infection, called non-AIDS defining cancers (NADCs), have increased in the years since highly active anti-retroviral therapy has been introduced. The studies in this dissertation attempted to quantify this burden via incidence and mortality compared to the general population. Further, an assessment of risk factors and creation of a predictive risk model, a nomogram, were utilized to better understand how factors associated with demographics, lifestyle, and immune response affected risk for an NADC diagnosis once therapy was initiated and HIV better controlled. Standardized incidence and mortality ratios showed that burden of …

The Potential For Dickeya Dianthicola To Be Vectored By Two Common Insect Pests Of Potatoes, Jonas K. Insinga

Electronic Theses and Dissertations

Dickeya dianthicola (Samson) causing blackleg and soft rot was first detected in potatoes grown in Maine in 2014. Previous work has suggested that insects, particularly aphids, may be able to vector bacteria in this genus between plants, but no conclusive work has been done to confirm this theory. In order to determine whether insect-mediated transmission is likely to occur in potato fields, two model potato pests common in Maine were used: the Colorado potato beetle (Leptinotarsa decimlineata Say) and the green peach aphids (Myzus persicae Sulzer). Olfactometry and recruitment experiments evaluated if either insect discriminates between infected and …

: Examining How Factors Associated With Patients, Physicians, Hospitals, And Surrounding Communities Affect Primary And Repeat Cesarean Delivery Through A Social-Ecological Lens, Christina Ventura-Dipersia

Dissertations and Theses

Background: Childbirth is one of the most common reasons for hospitalization in the U.S., and Cesarean delivery (i.e., surgical childbirth) is costlier and has a higher likelihood of birth-related complications, maternal rehospitalization, and postpartum medical care utilization than vaginal delivery. The rate of Cesarean delivery in the United States (U.S.) has increased in recent years by over 60%, from 20.7% of all births in 1996 to 32.9% of all births in 2011. As Although this increasing trend of Cesarean delivery incidence has also been seen in other countries, the rate of Cesarean delivery has been rising more steadily within …

Insured And In Debt, Virginia Jeffries

Capstones

Many Americans with employer-sponsored health insurance are still going into debt to pay medical bills.

http://virginia-jeffries.com/cap/

More Than A Century After Problem Emerged, Manhole Explosions Still Injuring Dozens In New York City, Gaspard Le Dem, Gabriel Sandoval

Capstones

Since the early days of electrification, New York City has been rattled by manhole explosions –– underground blasts that injure residents, damage buildings, force evacuations, cause power outages and traffic disruptions.

Consolidated Edison, the city's largest electric provider, has for decades blamed manhole issues on bad weather and road salt that erodes underground wires. But some experts and former utility workers say lack of maintenance is at the root of the problem.

Meanwhile, city and state officials have failed to rein in the problem through weak laws and loose oversight. As a result, unsuspecting drivers and pedestrians continue to be …

Community Exposure To Particulate Matter And Its Impact For Students And Residents Near A Construction Asphalt Plant: A Case Study, Aman Gebremariam Gebreselassie

UNLV Theses, Dissertations, Professional Papers, and Capstones

Particulate matter (PM) consists of various small particles in the atmosphere that has been associated with environmental health risk factors for many deadly diseases. PM2.5 is particulate matter 2.5 micrometers or less in diameter, PM10 is particulate matter 10 micrometers or less in diameter and are both respirable particles that can penetrate the lungs and increase risk of cardiovascular problems and respiratory illness, among other health issues. Exposure to particulate pollution in the environment tends to cause lost income from work absence, students’ absences from school, hospital admissions as well as emergency and doctor room visits.

Although asphalt plants are …

An Evaluation Of Factors Associated With The Perceptions Of Diabetes In A Filipino American Sample Residing In Clark County, Nevada, Lawrence Nartatez Sagadraca

UNLV Theses, Dissertations, Professional Papers, and Capstones

This study assessed beliefs about the contribution of the Filipino diet and genetics to diabetes burden and its ability to control it without medical interventions. The data from a need’s assessment survey of 200 Filipino Americans residing in Clark County, Nevada, were analyzed by using the logistic regression model. A significant proportion of the participants believed that diabetes is a problem in the Filipino community (79%) and is related to the Filipino diet (75%) and genetics (69.0%), and that it can be controlled without medical intervention (52.4%). In univariate analyses, age (Odds ratio [OR]: 1.03, 95% confidence interval [CI]: 1.01 …

Carbon Management And Volatile Fatty Acid Production In Primary Clarifiers At A Wastewater Treatment Plant, Brittany Nicole Radke

UNLV Theses, Dissertations, Professional Papers, and Capstones

An increasing number of treatment plants are required to remove nutrients from domestic wastewater to lessen the impact of nutrient loading to water bodies. Enhanced Biological Phosphorus Removal (EBPR) is one of the processes commonly used to remove phosphorus from domestic wastewater. The presence of an adequate quantity of volatile fatty acids (VFA) in the wastewater influent to EBPR is important for process efficiency and stability. The objective of this research was to investigate the production of VFAs through fermentation of sludge in primary clarifiers as it related to improving nutrient removal, primarily targeting phosphorus.

The research tested, in full-scale, …

Compounding Effects Of Reducing Nurse Burnout And How It Can Produce An Increase In Patient Safety And Satisfaction, Alexander Mua

Master's Projects and Capstones

The reduction of nurse burnout has shown to have an increase in patient satisfaction and quality of care. It also has shown a decrease in patient-related or sentinel events. Accordingly, with the reduction of nurse burnout, there has also been a reduction of compassion fatigue. This project has illuminated the benefits of acuity-based caseload at the micro-level, including the cost-effective nature of overtime pay, including HCHAPS benefit score. The method of obtaining, planning, and implementing was based on the Plan, Do, Study, Act (PDSA), which required collaboration amongst multiple disciplines, groups, departments, and executives. The process and goals concluded to …

A Retrospective Survey Of Exercise Habits In Low-Income Female Senior Citizens, Kelly L. Bumgarner

UNLV Theses, Dissertations, Professional Papers, and Capstones

American adults spend at least 50% of their time sedentary with the most inactive demographic being low-income women over 60. This is detrimental because routine physical activity benefits for senior women include balancing hormones, maintaining bone mineral density, and decreasing the risk of breast cancer. Statements like “good exercise habits begin during youth; children should play sports to establish healthy habits they’ll continue throughout their lives” are common, but not clearly supported by literature. Objective: The purpose of this retrospective, cross-sectional study was to identify whether physical activity/exercise habits during youth and young adulthood predict old age physical activity/exercise habits …

Evaluating Parents Sociodemographic Factors And Childhood Vaccine Decisions, Mehret Girmay

UNLV Theses, Dissertations, Professional Papers, and Capstones

Vaccination is considered one of the most successful public health achievements of the 20th century. However, with increasing vaccine skepticism emerging over the past decades, there is a threat to the ongoing sustainment of vaccine coverage within all US communities. This study evaluated and compared parents’ sociodemographic factors associated with childhood vaccine decisions. This study is a secondary analysis of 893 parents/guardians, age 18-55 years with child(ren) < 7 years living in the U.S.

Predictive analysis was conducted using multinomial logistic regression modeling was used to examine vaccine decisions (accept, hesitant, and refuse) in relation to parents’ sociodemographic factors. Overall, (66.6%) of parents accepted recommended vaccines, while …

Disparities In Administrative Pediatric Asthma Prevalence In Clark County, Aaliyah Goodie

UNLV Theses, Dissertations, Professional Papers, and Capstones

Objective: Asthma is one of the most common chronic diseases affecting young children nationally and globally. Asthma affects more than 25 million people in the nation, of which 6

million are children. Lifetime asthma prevalence for children in Nevada is 11.5% (CDC, 2016). This is likely an underestimate due to a large undocumented Hispanic population. In Clark County School District (CCSD) during the 2016-2017 school year, 20,235 students (8%) listed asthma in school records as a health concern. Asthma burden varies by sociodemographic group with highest rates documented among Black/African American, Hispanic/Latino, and pediatric populations. The Centers for Disease Control …

Dirty Water: The Newburgh Water Crisis, Shantal Riley

Capstones

Dirty

Dirty Water: the Newburgh water crisis

Summary

This project covers the ongoing water crisis in the City of Newburgh, New York. It tells the story of the contamination of the city’s drinking water by chemicals known as PFAS – short for perfluoroalkyl and polyfluoroalkyl substances.

Valued for their resistance to water and oil, the chemicals are found in carpets, furniture, clothes, non-stick cookware, food packaging and a range of industrial products. They’re nicknamed “forever chemicals” because they don’t break down in the environment. They’re also found in fire foam, which was used at Stewart Air National Guard Base. Located …

Dnp Project: Development Of A Nurse-Led Pop-Up Clinic Model In San Diego, Jennifer King

Doctor of Nursing Practice (DNP) Projects

Baccalaureate nursing programs across California (CA) are required by the state board of nursing to provide theory of public health and applied clinical learning to meet the requirements of the state’s public health nurse (PHN) certification. Students in Bachelor of Science in Nursing (BSN) programs are expected to enter the workforce prepared to address population health needs that synthesize community-based assessment and understand epidemiologic approaches to strategize interventions in diverse populations at the local, state and national levels. To adequately prepare nurses for true population health practice, clinical experiences need to be in appropriate settings where they can apply theory …

Larc Method Appropriateness In Substance Use Treatment: A Quality Improvement Project For Integrated Care, Malia Johnson Dnp, Fnp, Alexa Curtis Phd, Fnp-Bc, Neda Afshar Dnp, Fnp-C, Msn, Cgrn

Doctor of Nursing Practice (DNP) Projects

Problem: Individuals with substance use disorder (SUD) have disproportionately higher rates of unintended pregnancy when compared to the general population, estimated to be 85% (Heil et al., 2011). Not only are poor maternal and fetal outcomes associated with unplanned pregnancies, but pregnancies in women with SUD are further complicated by additional risks and adverse outcomes (Black & Day, 2016).

Context: Addiction treatment centers and programs are primed with opportunity to offer family planning services, when contact with medical providers is increased for substance use treatment. In response to the opioid crisis and unprecedented rates of unintended pregnancy, this project …

Assessment Of Structural Competency In Baccalaureate Nursing Students: A Descriptive Study, Elle J. Del Gallo

Senior Honors Projects, 2010-2019

Cultural competence has been investigated extensively in nursing education to better prepare nurses to care for individuals of diverse backgrounds. While developing cultural competence is important to address individual care needs, it may not address the social and structural factors that influence health. Structural competency describes the ability to assess not only cultural factors that affect health disparities, but also structural inequalities and stigmas that can alter a patient’s presenting symptoms and risk for certain diseases.

How Does Access To Healthcare Affect Life Expectancy?, Yara Mahmoud

Senior Honors Projects, 2010-2019

Access to health care is a pressing issue in the United States, whether it be the cost of care or not having enough of it. To emphasize the importance of this topic, this paper assesses the impact of access to health services on life expectancy. A comparison is made between the universal health systems in France and Spain and the mixed system in the United States. Even though the United States spends the most on health care in the world, its statistics fall below those of other developed countries. After addressing other risk factors, it was found that individuals under …

Acceptability Of A Vaginal Ring To Prevent Hiv And Pregnancy: Integrating Multiple Qualitative Methods, Dana Watnick

Dissertations and Theses

Heterosexual vaginal sex can simultaneously put women at risk for unintended pregnancy and sexually transmitted infections, such as HIV, disproportionately impacting poor women around the world. Both unintended pregnancy and HIV are persistent public health concerns associated with negative outcomes for mothers, families and communities. The current mix of prevention tools available to women to protect against unintended pregnancy and HIV is limited. Multipurpose Prevention Technologies (MPTs) are innovative products that simultaneously offer protection against pregnancy and HIV. However, MPTs will only be effective in reducing unintended pregnancy and incident HIV if women are willing to use them. With an …

Offering Medical Providers Capacity And Competence In Caring For Transgender And Non-Binary Patients: Evaluation Of A Pilot Digital Training Program, Lexis Manzara

Master's Projects and Capstones

Purpose: Stigma and discrimination in health care settings contribute to health disparities for transgender and non-binary (TGNB) people. Evidence suggests that a lack of training on the care for transgender and non-binary TGNB patients in medical school curricula has contributed to providers feeling unprepared to provide quality care for this population. Health care providers have the opportunity to play a key role in the reduction of health disparities for TGNB patients.

Methods: Twenty-five health care providers completed the eight-module digital training program. Pre- and post-tests assessed provider knowledge, self-efficacy, preparedness, and behavior. Paired samples t-tests were conducted to compare pre-and …

Redefining Trauma: Utilizing Restorative Justice To Repair Care Systems, Emebet Aklilu

Master's Projects and Capstones

This project examined the ways in which restorative justice programming can improve trauma informed care among the African American population in Oakland, CA. With 23% of African American men and women living at or below the poverty line in the United States, this project assesses gaps in current trauma informed care practices as evident in the literature. Following a rigorous document review the author coded and organized key programming components following six factors detailed by Rowher, Schoones, and Young (2014). Further examination of these program components was conducted using Bloom’s taxonomy levels to assess program outcomes associated with specific modules …

Art-Based Health Education For Homeless And Marginally Housed Women In San Francisco, Trineca R-N Godfrey

Master's Projects and Capstones

San Francisco currently has the highest rate of unsheltered homeless persons in the United States. Between limited resources and stigma many women included in this most vulnerable population are left with little to no support. Cis women as well as trans and non- binary people are at high risk for negative mental health outcomes due to violence (physical and psychological), stigma, lack of social support, societal marginalization, and the lack of healthcare. Lyon-Martin Health Services and the Women’s Community Clinic, in San Francisco’s Mission Neighborhood, caters to this community through its Outreach Department. Following a staff and outreach client needs …

Changing Minds: Measuring The Impact Of A Student-Led Club To Reduce Mental Health Stigma Among Teenagers, Jennifer Anolin

Master's Projects and Capstones

Introduction: Stigma is a major barrier for teenagers to access mental health services. Additional barriers include low health literacy, and demographic factors, such as gender, socioeconomic status, and race/ethnicity. Studies show that successful solutions to decreasing stigma involve interventions inside of schools. The purpose of this project was to measure impact of the Bring Change 2 Mind (BC2M) program and recommend program improvement needs.

Methods: Four survey instruments were used to evaluate BC2M’s student-led club program and to determine the club’s impact on reducing stigma at each participating high school. Each survey consisted of both qualitative and quantitative questions fielded …

A Nurse Practitioner-Led Group Advance Care Planning Program In An Independent And Assisted Living Community, Alexander Bustos

DNP Qualifying Manuscripts

It has been well documented that the majority of people want to spend their last days in the comfort of their own homes, free of pain, and off any dependent machine. , However, the majority of people have not documented these wishes or talked with their family or provider about end of life care (Hamel, Wu, & Brodie, 2017). The Patient Self Determination Act (PSDA), which took effect on December 1, 1991, was enacted to raise awareness and promote discussions between patients and providers about end of life (EOL) healthcare decisions. The primary care nurse practitioner is in a prime …

Air Pollution & Asthma Prevalence: Hotspot Analysis On Environmental Injustice In Buffalo, New York, Zuveria Shaguphta

Graduate Dissertations and Theses

This research aims to focus on the historical impacts of segregation in these communities (with Census Bureau data) and whether we see that these are the areas with continued segregation and a disproportionate number of TRI facilities. The third part of this research will be to investigate the presence of asthma in these neighborhoods as documented by the New York State Health Department. Asthma is a chronic disease in which the airways are inflamed due to some kind of external factor causing this reaction. Literature shows that there is a relationship between outdoor air pollution from combustion of fossil fuels …

Is Sabr Cost-Effective In Oligometastatic Cancer? An Economic Analysis Of Sabr-Comet Randomized Trial, Yujie Chen

Electronic Thesis and Dissertation Repository

The phase II randomized study SABR-COMET demonstrated that in cancer patients with 1-5 oligometastatic lesions, stereotactic ablative radiotherapy (SABR) was associated with an improvement in both progression-free survival and overall survival compared to standard of care (SoC). SABR, however, is associated with higher costs and treatment-related toxicity. The objective of this study was to assess the cost-effectiveness of SABR versus SoC in patients with oligometastatic disease.

A time-dependent Markov model with five health states was constructed from the Canadian health care system perspective. Utility values and transition probabilities were derived from the SABR-COMET trial. Costs were obtained from the published …

Biological And Psychological Implications Of Mindfulness Meditation For College Students, Kelsey Madison Dietrich

Honors Projects

The purpose of this capstone project was threefold: investigate the psychological implications of mindfulness meditation for college students enrolled in a semester-long course introducing these practices, investigate the biological implications of mindfulness meditation for these students, and create the Peer Education “Mindfulness” presentation for the Wellness Connection to introduce mindfulness meditation methods to a greater quantity of college students. The following paper describes the two components of this capstone project that examine the implications of mindfulness meditation opportunities available for college students specifically at Bowling Green State University in Bowling Green, Ohio.

A Shift In Global Thought And Practice: Assessing The Impacts Of The Human Security Paradigm On Global Public Health, Elizabeth Livingston Leone

Honors College Theses

With the increasing emphasis on health through human security since the 1990s by the United Nations, scholars have debated how human security has influenced public health. I examine how the idea of human security has become a paradigm and if this paradigm has adopted in public health programs. I argue that the rise of human security has led to an emphasis on the role of global actors, preventative care and health education when states adopt the paradigm. This adoption should in turn improve public health in Ghana and the Ivory Coast.

Engaging Hmong Americans Long-Term Use Of Healthcare Technology Using Culturally Revised Social Cognitive Theory Model, Peggy Xiong

Theses and Dissertations

Purpose: Information technology benefits the world, and it’s required for health care system, such as electronic medical records (EMR). User acceptance model is to systematically study how users come to accept and use a technology. For example, the cultural values of a society restrict use of technology in which an individual can be less incline to accept it. There is a significant amount of Hmong population in great Milwaukee area. Spirits are a central part of Hmong religious beliefs where the spirit is tied to health. Chronic disease is believed to be caused by bad actions done by the individual’s …

Affordable Care Act And Preventive Care Usage: A Mixed Method Analysis Of Cardiovascular Care, Brit Peek

Theses & Dissertations

It is a commonly held belief that access to health insurance affects the level of utilization of preventive care services, and thus plays a crucial role in the effective management of avoidable chronic illnesses, decreasing levels of premature mortality, and enabling individuals to live wholesome long lives. Based on this belief, among other goals, the Affordable Care Act (ACA) was designed to increase access to health insurance and related medical services for the population of the United States. This dissertation attempts to identify whether this belief is valid or not by testing whether the usage of preventive care changed between …