Medicine and Health Sciences Commons^™

A Call To Action: Person-Centered Care Aligned With Reproductive Justice For Incarcerated Pregnant People With Substance Use Disorder, Essence Hairston, Aunchalee El Palmquist, Andrea K. Knittel, Kevin Mensah-Biney, Crystal M. Hayes, Amelia Mack, Hendrée E. Jones

School of Social Work Faculty Publications

Although research has proven that jails and prisons are ineffective in preventing or reducing substance use among pregnant people, the USA continues to rely heavily on the criminal legal system as its intervention. Pregnant people with an opioid use disorder are more likely to experience incarceration than pregnant people without an opioid use disorder. In some states, pregnant people are transported from jail to prison through the process of safekeeping in order to receive physical or mental health care that the jail does not provide, despite conviction status. When pregnant and postpartum safekeepers with an opioid use disorder experience incarceration, …

Effect Of Body Mass Index Percentile On Complicated Appendicitis, Postoperative Complications And Health Service Utilization Among Pediatric Patients In The United States, Nutan Hebballi

Dissertations and Theses (Open Access)

While overweight and obesity have been extensively studied for complicated appendicitis, postoperative complications, and health service utilization, the effects of being underweight are unknown. This dissertation assesses the associations between the body mass index (BMI) spectrum with complicated appendicitis, postoperative complications, and healthcare service utilization in pediatric patients.  A retrospective review of pediatric patients who underwent appendectomy surgery (01/01/2016-12/31/2020) was conducted using the National Surgical Quality Improvement Program database. Computed age and gender-specific BMI percentiles were categorized into underweight, normal weight, overweight and obese. The 30-day postoperative complications were grouped into minor, major, and any. Healthcare service utilizations were compared …

Neuroimaging Manifestatations In Covid-19 And Its Sequelae, Abhigna M, Vikram Patil

Digital Journal of Clinical Medicine

BACKGROUND: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) emerged as a novel pathogenic virus in late 2019, infecting millions of people with severe pulmonary infections. It spread worldwide in a short time and became a pandemic, after which the World Health Organization (WHO) declared it a public health emergency. Central nervous system involvement by COVID-19 is already an established entity in the literature. The aim of this study was to evaluate in detail the acute and delayed neurological manifestations of COVID -19.

RESULTS: COVID-19 infection can cause various neurologic manifestations and imaging findings. The most common neuroradiological abnormality is cerebrovascular …

Clinical And Demographic Attributes Of Patients With Diabetes Associated With The Utilization Of Telemedicine In An Urban Medically Underserved Population Area, Lisa Ariellah Ward, Gulzar H. Shah, Kristie C. Waterfield

Health Policy & Community Health: Faculty Publications

Marginalized populations often experience health disparities due to the significant obstacles to care associated with social, economic, and environmental inequities. When compared with advantaged social groups, these populations frequently experience increased risks, poorer health outcomes, and reduced quality of life (QoL). This research examines the clinical and demographic characteristics—age, gender, and race—related to patients with varying stages of type 2 diabetes mellitus (T2DM), comparing the utilization of telemedicine (TM) with traditional healthcare face-to-face (F2F) appointments in an urban medically underserved population area (UMUPA). A logistic regression model, was used to analyze retrospective electronic patient health records (EHRs) from 1 January …

Examining The Association Between Emotional Intelligence, Meaning In Life, Stress, And Burnout Among Preâ??Medical Students In The United States, Nayla Paulina Paulina Bejarano Chacon

Open Access Theses & Dissertations

Background and significance: The Association of American Medical Colleges (AAMC) has estimated that by 2034 there will be a physician shortage of around 124,000 physicians. With burnout being one of the main drivers, it is crucial to assess it. Burnout is characterized by high levels of emotional exhaustion and cynicism and low levels of academic efficacy.There has been substantial research on burnout among healthcare providers across different levels of training; however, few studies have examined burnout among undergraduate students who wish to pursue a graduate degree in healthcare. Given the shortage of healthcare providers in the United States, it is …

Variability In Anesthesia And Its Implications For Improving Patient Safety, Joshua Michael Biro

All Dissertations

Improving patient safety in anesthesia has proven to be an arduous and challenging task. Despite the many strategies and interventions to improve patient safety that have been employed, patient harm in anesthesia remains a problem. The struggle to reduce patient harm in anesthesia is both attributable to and representative of the complexity of the anesthesia system. In navigating this complex system, anesthesia providers have different approaches to how they accomplish their work, which results in variability in anesthesia practice. This variability provides an immense challenge to designing and implementing efforts to improve patient safety, as rigid interventions are often met …

Assessing The Role Of Distance To Level I Trauma Units On Atv Rollovers, Tractor Rollovers, And Machinery Entanglement Outcomes, Andrew K. Schissel

Capstone Experience: Master of Public Health

All-Terrain Vehicle (ATV) rollovers, tractor rollovers, and machinery entanglements cause traumatic injuries to agricultural workers. Response time of first responders combined with travel to trauma units can take a significant amount of time in rural areas, potentially leading to an increased risk of fatal outcomes for those involved in these incidents. The aim of this study is to determine if distance to a level I trauma unit is a factor in the outcomes of these incidents. ATV rollovers, tractor rollovers, and machinery entanglement injuries and fatalities, collected from a 7-state Midwestern region were entered into a GIS system along with …

Occupational Exposures Associated With Thyroid Cancer In The Thyroid Tumor And Cancer Collaborative Registry In The Integrated Cancer Center Repository For Cancer Research, James Buckley

Capstone Experience: Master of Public Health

Thyroid cancer is one of the fastest growing cancers in the United States, with the rate of new cases increasing from 5.2 per 100,000 in 1985 to 13.8 per 100,000 in 2019, with a peak of 14.5 per 100,000 in 2015. Increased thyroid cancer incidence is associated with certain occupations, including healthcare and agriculture. Most existing literature on occupational exposures and thyroid cancer evaluate their association in terms of occupation type and thyroid cancer, rather than specific occupational exposures and thyroid cancer. This study sought to utilize the wide range of occupational exposure data in the Integrated Cancer Center Repository …

Influence Of Sexual Orientation On Sexual Risk Behaviors Among High School Students – United States, 2023, Carley J. Cortez

Capstone Experience: Master of Public Health

The Lesbian, Gay, Bisexual, Transgender, Queer/Questioning, Intersex, Asexual, and other (LGBTQIA+) community participate in higher sexual health risk behaviors that lead to outcomes such as sexually transmitted infections and unwanted pregnancies than their heterosexual peers. Youth and adolescent LGBTQIA+ populations also experience this increased sexual health risk which will increase the risk for negative health outcomes as adults. The 2019 Youth Behavioral Risk Survey dataset was used to assess the association between sexual orientation on specific sexual health risk behaviors such as total number of sexual partners, history of sexually transmitted infections (STIs) and human immunodeficiency virus (HIV) testing, and …

Rural-Urban Differences In The Age-Adjusted Pediatric Cancer Mortality In The United States (2000-2020), Reitumetse A. Setai

Capstone Experience: Master of Public Health

In the United States (U.S.), 5-year survival for pediatric cancers improved from 58% in 1975 to 85% in 2017. However, pediatric cancer remains the second leading cause of death in children between 0 – 14 years. Despite the growing body of pediatric cancer research, there is limited knowledge of the urban and rural disparities of pediatric cancer mortality. This study examined: 1) the differences in the U.S. pediatric cancer mortality rates between rural and urban residents during 2016-2020 by demographic characteristics (age group, sex, race/ethnicity, and income) and cancer types and 2) the trend of pediatric cancer mortality in the …

The Impact Of Doulas On Breastfeeding In Black Women: A Literature Review, Delaney C. Holland

Capstone Experience: Master of Public Health

This literature review was conducted to explore the impacts doulas have on breastfeeding initiation and continuation in the Black population. Black women’s breastfeeding and continuation is exceptionally low compared to white women and other races and ethnicities. Six journal articles were used to examine the relationships that doulas have on breastfeeding initiation and continuation in black communities. There was an array of study designs found throughout the articles to help support the doula and breastfeeding relationship in Black women. The results of this literature review were preliminarily positive, but more evidence is required to firmly establish the positive impact of …

The Risk Factors Associated With Personal Protective Equipment Usage Rates In The Central States By Generalized Multilevel Models, Carter E. Vogel

Capstone Experience: Master of Public Health

Background: Agriculture producers in the United States face some of the highest rates of fatal and non-fatal injuries among all occupations. This includes a high risk of respiratory damage when working in dusty environments, chemical and health hazards when working with pesticides or other dangerous chemicals, and hearing damage when working in noisy environments. These risks can be reduced using personal protective equipment (PPE). While some workplaces are required by the Occupational Safety and Health Administration (OSHA) to provide necessary PPE and monitoring according to the risks of a job, many small farms are not required by OSHA to provide …

Housing Is Safety: An Evaluation Of A Transitional Housing (Th), Rapid-Rehousing (Rrh), And Joint Th/Rrh Program For Survivors Of Interpersonal Violence, Bridget L. Claborn

Capstone Experience: Master of Public Health

In this capstone project, I created a program evaluation plan and conducted preliminary analysis for the Mar􏰀 Parrish Center􏰁s (MPC) transitional housing (TH), rapid-rehousing (RRH), and joint TH/RRH programs for survivors of interpersonal violence and their families. The intent of the project is: (1) to better understand the impact of MPC housing programs; (2) to inform strategies for continuous improvement in client outcomes, access, and satisfaction; (3) to further evaluation capacity for the organization; and (4) to generate practice-based evidence to inform the field at large. As a practitioner in the field of interpersonal violence and former MPC staff member, …

The Relationship Between Congenital Heart Disease And Infant Mortality In Low- And Middle-Income Countries: A Comprehensive Literature Review, Helen Nneoma Odo

Capstone Experience: Master of Public Health

Congenital heart diseases (CHD) are conditions that are present at birth and can affect the structure of an infant’s heart and the way it works. Millions of children are born each year with congenital heart disease yet screening for CHD is not practiced in Low- and Middle-income countries (LMICs). Studies on access to healthcare for infants with congenital heart disease have not kept pace. This literature review centers on the role of congenital heart disease in infant mortality, its burden, incidence and prevalence in LMICs. The databases of PubMed, Google Scholar and Embase were searched and the selected articles for …

Effects Of Hospital Interventions On Maternal Mortality Rates Of African American Women: A Literature Review, Oluwatosin A. Soyege

Capstone Experience: Master of Public Health

Maternal mortality is a serious health concern and harms society’s economic, physical, and psychological well-being. It is tragic for the woman’s family and community when a woman passes away during pregnancy, at delivery, or shortly after delivery. Hospital interventions are needed to mitigate the social impact of maternal mortality. In the U.S., several initiatives have been enacted to reduce maternal mortality. Fighting racism would also help African American women’s rates of maternal mortality as they are subject to stigma in everyday contexts, during pregnancy and obtaining healthcare, and when obtaining resources and services during pregnancy. This paper reviews the literature …

Assessing Meatpacking Worker's Perceptions Of Supervisors' Concern For Safety And Supervisors' Support, Sara Reyes

Capstone Experience: Master of Public Health

Occupational safety is a major public health issue, given that failure to meet safety regulations can lead to incidents and death. Meat processing facilities have some of the highest rates of non-fatal and fatal injuries compared to other industries. A reported 5.9 incidents per 100 full-time occupied within meat processing industries. The majority of workers within meat processing plants are people of color and immigrants, leading to a disproportion in reports of incidents and safety concerns. Immigrant workers frequently occupy positions within the kill floor and fabrication departments. Supervisors are often at the forefront of safety, yet workers often report …

The Incidence And Modifiable Risk Factors For Necrotizing Enterocolitis Inpreterm Infants A Retrospective Cohort Study, Kelvin Gitau, Roseline Ochieng, Mary Limbe, Caroline Kathomi, James Orwa

Paediatrics and Child Health, East Africa

Objectives: To evaluate the incidence and modifiable risk factors for Necrotizing enterocolitis (NEC) in preterm infants born at ≤32 weeks of gestation weighing <1500 grams, at a private tertiary care hospital in Kenya.

Materials and methods: This retrospective cohort study was conducted at the Aga Khan University Hospital Neonatal Intensive Care Unit (NICU). Preterm infants born at ≤ 32 weeks’ gestation and weighing <1500 grams admitted to NICU between 2009 and 2019, were recruited into the study. The primary outcome was NEC Bell Stage IIa-IIIb based on Modified Bell’s criteria. Maternal and neonatal characteristics were evaluated. The association between variables of interest and NEC was determined using logistic regression analysis and the incidence of NEC for the study period was calculated.

Results: A total of 261 charts of infants born at ≤ 32 weeks’ gestation, weighing <1500 were reviewed, and 200 charts met the inclusion criteria. Fifteen preterm infants developed the primary outcome of interest: NEC Stage ≥2a within the first 30 days of admission. The overall incidence of NEC for the study period was 7.5%. Three risk factors were identified as significantly associated with NEC on multivariate logistic regression analysis: antenatal exposure to steroids (OR = 0.056 CI = 0.003-0.964 p = 0.047), cumulative duration of exposure to invasive mechanical ventilation (OR = 2.172 CI = 1.242-3.799 p = 0.007) and cumulative duration of exposure to umbilical vein catheter (OR = 1.344 CI = 1.08-1.672 p = 0.008).

Conclusions: The overall incidence for the study period of NEC Stage ≥ II a was 7.5%. Exposure to antenatal steroids, duration of mechanical ventilation, and duration of umbilical vein catheterization were …

Does Gender And Cultural Diversity Matter For Sustainability In Healthcare? Evidence From Global Organizations, Kylie De Klerk, Favil Singh

Research outputs 2022 to 2026

Global healthcare organizations are fundamental in addressing the healthcare needs of local and global communities. This highly regulated sector means it is under constant scrutiny for health, safety, and ethical compliance risks by federal regulatory bodies. Despite higher monitoring, an increasing number of healthcare companies receive fines for their irresponsible practices, manifesting significant questions about their corporate governance and sustainability practices. Against this backdrop, this study examines the relationship between boardroom diversity on the sustainability performance of companies operating in healthcare. Utilizing a global sample of publicly listed healthcare companies, using panel regression data and the system-GMM estimator accounting for …

Prevalence And Factors Associated With Sexual And Reproductive Health Literacy Among Youth Living With Hiv In Uganda: A Cross-Sectional Study, Benedicto Mugabi, Miisa Nanyingi, Richard Kabanda, Juliet Ndibazza, Peter Elyanu, John Baptist Asiimwe, Gorret Nazziwa, Gilbert Habaasa, Adeodata Kekitiinwa

School of Nursing & Midwifery, East Africa

Background

Adequate sexual and reproductive health literacy (SRHL) among young people has been linked to informed sexual behaviours. Studies on SRHL have largely been conducted among the general adolescent population. Little is known about youth aged 15-24 years living with human immunodeficiency virus (YLHIV). There is a possible lack of SRHL in this population, considering the high rate of teenage pregnancies and unprotected sex reported by YLHIV. This study aimed to assess the prevalence and associated personal and environmental factors for SRHL among YLHIV at a high-volume urban HIV Clinic in Uganda.

Methods

Through a cross-sectional survey, YLHIV receiving routine …

Investigation Of Orthohantavirus Genetics In Rodent Reservoirs And Clinical Samples, Samuel Melvin Goodfellow

Biomedical Sciences ETDs

Orthohantaviruses are negative-sense, single stranded RNA viruses with trisegmented genomes that can cause severe disease in humans and are carried by several host reservoirs throughout the world. In the United States, Sin Nombre orthohantavirus (SNV) is the primary cause of hantavirus cardiopulmonary syndrome (HCPS) with a fatality rate of ~36% and the highest cases occuring in the southwest region. The primary SNV host reservoir is thought to be the western deer mouse, Peromyscus maniculatus, however it has been shown that other rodents can carry different orthohantaviruses. We designed a pan-orthohantavirus detection tool to survey several small mammal populations throughout New …

Evaluating The Association Between Social Determinants Of Health And Substance Use Disorder In A New York State Mental Health Population, Marum Sadiq

Legacy Theses & Dissertations (2009 - 2024)

BackgroundOne in three adults in the United States had a mental illness or substance use disorder in 2021 and co-occurring disorders affect 7.6% of the adult population. Substance use disorders are more common in individuals with mental health problems, and serious mental illness is three times more prevalent in adults with substance use disorder (SUD). Social determinants of health such as socioeconomic status, criminal justice involvement, and unemployment may contribute to vulnerability for co-occurring mental health and substance use disorders. The purpose of this study was to examine the association between social determinants of health and substance use disorder in …

Investigation Of The Protein Components In A Periplasmic Mechanism Regulating Bacterial Morphology, Alexandra Pulliam

Electronic Theses and Dissertations

Salmonella is a leading bacterial cause of foodborne illness worldwide. During a previous study investigating the enzymes responsible for regulating cyclic-di-GMP concentrations, a mutant in the cyclic-di-GMP-specific phosphodiesterase STM3615 was identified that displayed a phenotype characterized by decreased survival on agar plates and a shorter bacterium length. I was able to determine that the periplasmic domain of STM3615 was responsible for this phenotype, not the enzymatic phosphodiesterase domain. Based upon a bioinformatic analysis of the protein, I then hypothesized that the periplasmic domain of STM3615 was interacting with a periplasmic protein to give rise to this phenotype. To identify this …

Overdose Prevention Behaviors And The Rural Risk Environment Among People Who Inject Drugs In Rural Appalachia, Jody Teel

Electronic Theses and Dissertations

Introduction: The entire United States has felt the effects of the overdose epidemic, but rural Appalachia has experienced disproportionate overdose deaths. This variation in overdose mortality can be attributed to the risk environment for overdose in rural Appalachia. Overdose prevention behaviors are individual level behaviors that people who inject drugs can implement that may have the potential to reduce their risk of overdose, however limited research exists regarding the utilization of those behaviors. It is important to consider how the risk environment can influence the utilization of overdose prevention behaviors among people who inject drugs. Therefore, the purpose of this …

Exploring Food-Based Cultural Practices To Address Food Insecurity In Rural Appalachia, Lauren Cassidy Batey, Emily M. Dewitt, Dawn Brewer, Kathryn M. Cardarelli, Heather Norman-Burgdolf

UK CARES Faculty Publications

Background. Health behaviors, like diet, are influenced by a person’s culture and the society where they reside, contributing to the presence of health disparities within a unique region. Such disparities are evident in Central Appalachia where a unique cultural identity exists. Culture-based initiatives focused on improving food security and other nutritional challenges have had success in other diverse groups, yet similar interventions considering geographically tied culture, like Appalachia, are limited. Aim. This study aims to identify specific aspects of Appalachian culture that address food insecurity to inform future initiatives that may improve adult dietary habits and food security status. Methods. …

Household Environments And Functional Decline Among Middle-Aged And Older Adults In China, Dandan Zhao

All Theses

This thesis investigates the associations between household social, economic, and physical environment conditions and the trajectory of self-reported functional limitations over time among middle-aged and older adults in China. Despite the increasing interest in the impact of household environments on functional decline, most existing studies are cross-sectional or concern changes in functioning observed in two waves of surveys, and they primarily focus on the influence of one condition. This thesis explores how the trajectory of functional decline is influenced jointly by multiple household factors, including living arrangement, annual living expenditure per capita, indoor air pollution resulting from solid fuels, and …

Healthcare Built Environment And The Covid-19 Pandemic, A Mixed-Method Study, Mohammad Saleh Nikooopayan Tak

All Theses

The outbreak of COVID-19 presented an unparalleled risk to public health, leading to urgent scientific efforts in understanding transmission mechanisms and mitigating risks, especially in healthcare settings. This mixed-methods study examines knowledge advancement regarding indoor air quality in healthcare facilities during the pandemic. A systematic literature review of 163 post-COVID studies identifies key research thrusts and 31 recommendations related to building ventilation, air filtration, surface disinfection, and monitoring. Comparison with over 200 pre-pandemic publications reveals both reliance on established infection control principles and unique contributions, such as detecting viral RNA in air and surface samples indicating potential airborne and fomite …

Services Provided To Aging Individuals With Intellectual Disabilities: Survey Of Speech Language Pathologists, Claire H. Gatewood

College of Education and Human Sciences: Dissertations, Theses, and Student Research

Purpose: The present study explored current speech-language pathology service provision for aging individuals with intellectual disabilities in the United States, including areas and domains of services, factors restricting service provision, and reported knowledge and confidence of individuals within the field of speech-language pathology in providing services, to identify possible gaps of service and needed improvement.

Methods: Participants (n = 272) from across the United States completed an online survey to gather descriptive information about current speech-language pathology service provision for aging individuals with intellectual disabilities. Participants were recruited through state speech-language hearing associations and universities with speech-language pathology clinics …

Adverse Childhood Experiences Among Adolescent Girls In Residential Treatment: Relationship With Trauma Symptoms, Substance Use, And Delinquency, Akemi E. Mii

Department of Psychology: Dissertations, Theses, and Student Research

Adverse childhood experiences (ACEs) refer to negative events during childhood or adolescence including abuse, maltreatment, and exposure to household dysfunction (Kalmakis & Chandler, 2014). ACEs are associated with negative outcomes including mental and behavioral health concerns and offending (Fox et al., 2015). The risk of negative outcomes associated with ACEs increases when an individual experiences polyvictimization (experiencing multiple types of adverse events; Felitti et al., 1998; Finkelhor et al., 2011). A majority of adolescents served by residential treatment programs (RTPs) have experienced polyvictimization (Briggs et al., 2013). Research examining juvenile offending and youth delinquency has focused on boys. Thus, research …

Diet By Genomic Interactions In Determining Metabolic Traits And Profiles On Glucose Metabolism Among Mexican Americans In Starr County, Texas, Shinhye Chung

Dissertations and Theses (Open Access)

Worsening glycemia, prediabetes and diabetes, is one of the essential diseases in public health, considering their high prevalence, the enormous impact on multiple organs, and the economic burden on the community. Various factors can affect the pathogenesis of worsening glycemia, and this study focused on macronutrient intake, genes, and their interactions with metabolome data. 616 self-reported Mexican American participants in Starr County were recruited with informed consent. 308 identified and 2,471 unidentified metabolites were used for the analysis, and all the metabolites were inverse normalized with less than half of the missing rate. Each of the five glycemic and lipid …

Economic And Policy Determinants Of National Abortion Rates: A Cross-National Study, Olufunke Akiyode

Dissertations and Theses (Open Access)

Abortion is as old as humanity and exists in all cultures. The number and rate of abortions differ among countries and regions of the world. Some determinants of abortion may include economic indicators and policy restrictiveness. This study analyzes the economic and policy determinants of abortion by evaluating the association of income and policy on abortion rates. It uses a panel data regression to examine the association between income, Gini Coefficient and abortion rates. Gini Coefficient measures income inequality, and GNI represents a country’s income. Publicly available longitudinal data obtained from the World Bank, United Nations, United Nations Population Development …