Medicine and Health Sciences Commons^™

Effects Of The U.S. Veterinary Feed Directive Final Rule On The Prevalence Of Violative Antibiotic Residues And Antibiotic-Resistant Bacteria In Animal Products, Md Shamim Sarkar

Doctoral Dissertations

Antibiotic-resistant is a public health concern. The dissertation objective was to assess the effect of the implementation of the Veterinary Feed Directive (VFD) rule changes on the prevalence of violative antibiotic residues and antibiotic-resistant bacteria in food-animal tissues, retail meats, and cecal samples from food animals compared to the pre-VFD rule change period in the U.S. To understand the effect of implemented VFD rule changes on violative antibiotic residues in food-animal tissues, inspector-generated sampling (IGS) data from the U.S. National Residue Surveillance Program (NRP) was analyzed. An important observation was that implementing VFD rule changes was associated with the decreased …

Spatial Epidemiology Of Prediabetes And Diabetes In Florida, Md Marufuzzaman Khan

Doctoral Dissertations

The burden of diabetes and diabetes-related Emergency Department (ED) visits has increased in Florida. However, Diabetes Self-management Education (DSME) Program participation remained considerably low. Little is known about disparities of DSME participation, diabetes complications, and ED use by diabetes patients in Florida and yet this information is important for guiding health programs aimed at reducing diabetes burden. Therefore, the objectives of this study were to investigate: (a) disparities of diabetes prevalence and DSME participation; (b) disparities of diabetes-related ED visit risks; and (c) prevalence and predictors of stroke among persons with prediabetes and diabetes.

Behavioral Risk Factor Surveillance System and …

Healthcare Service Utilization And Life Satisfaction In South Africa, Tamara Chavez-Lindell

Doctoral Dissertations

South Africa has achieved improvements in many health measures over the past 30 years, yet significant disparities in healthcare utilization and health outcomes persist. There is evidence that healthcare utilization has a strong influence on health outcomes and life satisfaction. Unfortunately, rural areas tend to have poorer accessibility and utilization of health services, leading to disparities in health outcomes. In rapidly urbanizing countries such as South Africa, identification of disparities and predictors of public healthcare utilization and life satisfaction may provide information that can be used to guide development of programs aimed at improving population health outcomes, quality-of-life, and overall …

Perinatal Health In North Dakota: Emerging Issues, Grace N. Njau

Doctoral Dissertations

Preterm birth, newborn screening refusal, and postpartum depression represent three emerging areas of concern that have not been previously investigated in North Dakota. Their potential impact creates significant social, behavioral, and economic burdens. Although various studies have investigated preterm birth and postpartum depression, to the best of my knowledge, newborn screening refusal in the United States has not been previously investigated. In alignment with the role of Title V of the Social Security Act (Maternal and Child Health) Programs to conduct ongoing statewide needs assessments, the objectives of this study was to investigate and identify predictors of preterm birth, newborn …

Agent-Based Dynamics Of A Spahr Opioid Model On Social Network Structures, Owen Queen, W. C. Strickland, Leigh B. Pearcy

Chancellor’s Honors Program Projects

No abstract provided.

An Epidemiologic Study Of Vaccination Exemptions And Pertussis Risk, Corinne B. Tandy

Doctoral Dissertations

The incidence of pertussis, a vaccine-preventable disease that can have severe complications in infants, has been increasing in the United States over the past three decades. Vaccine hesitancy and refusal have also increased and are associated with vaccination exemptions, which in turn are associated with outbreaks of vaccine-preventable diseases, including pertussis. Understanding attitudes towards vaccinations and identifying geographic disparities of vaccination exemptions and pertussis risks is useful for guiding control programs. Therefore, the objectives of this study were to: (i) investigate attitudes towards vaccinations; (ii) identify county-level geographic disparities and sociodemographic predictors of vaccination exemptions in Florida; (iii) investigate county-level …

One Spark Can Light A Fire: How To Become A Mental Health Advocate, Marquinta Harvey, Shannon Jackson

Black Issues Conference

One Spark Can Light a Fire: How to Become a Mental Health Advocate

There is increasing awareness surrounding mental health and conversations are beginning to make their way to the forefront of issues that demand significant attention. However, the path from awareness to advocacy remains poorly understood. Mental Illness is an important issue that affects 1 in 4 individuals and unlike most chronic illnesses the onset occurs early in the life spectrum, usually in adolescence and young adulthood.

The issue of mental health is not limited to individual genetic predisposition and/or behaviors but involves many layers related to individual, family-related, …

Prevalence Of Rats And Rodent Borne Pathogens Across Post-Katrina New Orleans, Bruno Marco Ghersi

Doctoral Dissertations

Disasters are happening at an increasingly higher rate and intensity a trend that is expected to continue as more humans migrate to coastal urban areas. Disasters, and as importantly, disaster recovery can affect how native and pest populations will recover. My aim was to improve understanding of disease risk by evaluating the socioecological conditions that have shaped commensal rat recovery and distribution, as well as the pathogens they carry, across New Orleans after Hurricane Katrina. I first estimated relative abundance and distribution of commensal rats from rodent trapping conducted between mid-2014 and early-2017 across 96 sites in 10 areas of …

Emerging Zoonotic Pathogens At The Human-Wildlife Interface In Protected Areas: Game In The Southeastern United States And Bushmeat In Northern Uganda, Breeanna M. Dell

Doctoral Dissertations

The emergence of zoonotic pathogens through contact with animal reservoirs is a well-documented phenomenon and growing concern for public health. Particularly in light of the ongoing Ebola epidemic in the Democratic Republic of the Congo and the coronavirus pandemic, the need to understand mechanisms of contact and disease transmission at the human-wildlife interface and to understand which infectious agents may reside within wildlife reservoirs crucial. In this project, we investigated the potential introduction of zoonotic cestode Echinococcus canadensis to public lands in Tennessee subsequent to elk translocation effort and aimed to identify whether a transmission cycle was established in this …

Applying Modern Immunology To The Plague Of Ancient Athens, Juhi C. Patel

Pursuit - The Journal of Undergraduate Research at The University of Tennessee

During the 5^th century BCE, ancient Athens and Sparta were involved in a major war during which an epidemic disease broke out in Athens, claiming the lives of a substantial part of the population. Although the ancient Greek historian Thucydides provides a first-hand account of the symptoms of the plague, modern historians have not been able to definitively identify the pathogen that caused the deadly epidemic. In 1994, a burial tomb of Athens was unearthed that unveiled the likely remains of plague victims. In 2005, scientists conducted molecular testing on the dental remains and used suicide PCR to compare …

Park Usage In Relationship To Available Features And Amenities In A Large Urban Park, Hannah Bradford Clauss

EURēCA: Exhibition of Undergraduate Research and Creative Achievement

Purpose: The purpose of this study was to examine the relationship between park features and park use in a large urban park. At 45.33 acres, West Hills Park has amenities such as athletic courts and fields, picnic areas, and a 1.9-mile paved trail. Methods: Park usage was assessed using the System for Observing Play and Recreation in Communities tool that measures use by gender, age, ethnicity, and moderate to vigorous physical activity (MVPA). Data was collected in 18 zones over four days with three observations per day (morning, midday, and evening). Park features, amenities, and condition, were assessed using the …

Applying Modern Immunology To The Plague Of Ancient Athens, Juhi C. Patel

Chancellor’s Honors Program Projects

No abstract provided.

Evaluation Of The Performance Of Tn Integrated Food Safety Center Of Excellence Online Training Courses, Amal S. Humidat

Masters Theses

Foodborne disease outbreaks are still a challenge in the United States even with the improvements that are continuously made to the food integrity system. The Center for Agriculture and Food Security and Preparedness (CAFSP), in conjunction with the Tennessee Integrated Food Safety Center of Excellence, has developed two web-based courses to support investigation of foodborne illnesses. These courses are entitled as “Foodborne Outbreak Investigation and Response Team Roles and Responsibilities, Part A and B” respectively. The overall goal of this study was to evaluate each course by assessing the participants' satisfaction, learning, and perception of knowledge gained and impact on …

Population Modeling For Resource Allocation And Antimicrobial Stewardship, Jason Bintz

Doctoral Dissertations

This dissertation contains two types of population models with applications in conservation biology and epidemiology. In particular, it considers models for resource allocation and antimicrobial stewardship.

In a population model with a parabolic differential equation and density dependent growth, we study the problem of allocating resources to maximize the net benefit in the conservation of a single species while the cost of the resource allocation is minimized. The net benefit is measured in terms of maximizing population abundance and the goal of maximizing abundance is divided between the goal of maximizing the overall abundance across space and time and the …

Physical Activity And Its Effect On Reducing Disease: A Literature Review Of The National Runner's Health Study, Graham William Edson

Chancellor’s Honors Program Projects

No abstract provided.

Development Of The Biostatistics And Clinical Epidemiology Skills Assessment For Medical Residents, Patrick Brian Barlow

Doctoral Dissertations

This study developed the Biostatics and Clinical Epidemiology Skills (BACES) assessment, and established its preliminary item characteristics and validity evidence. Unlike previous instruments, the BACES assessment was developed and tested using an item response theory (IRT) approach to measurement to create a new, adaptive biostatistics and clinical epidemiology knowledge assessment for graduate medical professionals. Thirty multiple-choice questions were written to focus on interpreting relevant examples of clinical epidemiology and statistical methods. A four person expert panel reviewed these items for content validity. After this review, the BACES assessment was administered to 147 medical residents across three academic medical centers. Results …

Associations Of Total Activity Counts And Physical Activity Intensity Levels With The Metabolic Syndrome: A Structural Equation Modeling Approach, Dana Lizbeth Wolff

Doctoral Dissertations

To clarify the protective benefits of physical activity (PA), epidemiologists and public health researchers continue to seek improved methods of assessing PA. In particular, accelerometers have gained acceptance with researchers as they provide reliable estimates of PA and can record both the amount and intensity of ambulatory movement. However, there is concern that accelerometer data reduction techniques may not provide quantitatively accurate measurements of time spent in various PA intensity categories. One way to circumvent these inaccuracies is to use the accelerometer-derived total activity counts (TAC), which is a more direct expression of what the monitor records.

In order to …

Physical Activity And Its Effect On Reducing Disease: A Literature Review Of The National Runner's Health Study, Graham William Edson

Kinesiology, Recreation, and Sport Studies Publications and Other Works

In 1996, Dr. Paul Williams began The National Runner’s Health Study. The study had over one hundred thousand respondents who were questioned about their physical activity habits (walking or running), diet, weight, height, and use or previous use of tobacco and alcohol. Some of the participants were involved in case studies of several years. Primarily, the study tested the effects of vigorous physical activity and its ability to reduce disease. For close to twenty years, Dr. Williams has continued an impressive amount of research on various topics in the health and exercise field. The study is one of the most …

Geographic And Temporal Epidemiology Of Campylobacteriosis, Jennifer Weisent

Doctoral Dissertations

Campylobacteriosis is a leading cause of gastroenteritis in the United States. The focus of this research was to (i) analyze and predict spatial and temporal patterns and associations for campylobacteriosis risk and (ii) compare the utility of advanced modeling methods. Laboratory-confirmed Campylobacter case data, obtained from the Foodborne Diseases Active Surveillance Network were used in all investigations.

We compared the accuracy of forecasting techniques for campylobacteriosis risk in Minnesota, Oregon and Georgia and found that time series regression, decomposition, and Box-Jenkins Autoregressive Integrated Moving Averages reliably predict monthly risk of infection for campylobacteriosis. Decomposition provided the fastest, most accurate, user-friendly …

Latin Hypercube Sampling And Partial Rank Correlation Coefficient Analysis Applied To An Optimal Control Problem, Boloye Gomero

Masters Theses

Latin Hypercube Sampling/Partial Rank Correlation Coefficient (LHS/PRCC) sensitivity analysis is an efficient tool often employed in uncertainty analysis to explore the entire parameter space of a model. Despite the usefulness of LHS/PRCC sensitivity analysis in studying the sensitivity of a model to the parameter values used in the model, no study has been done that fully integrates Latin Hypercube sampling with optimal control analysis.

In this thesis, we couple the optimal control numerical procedure to the LHS/PRCC procedure and perform a simultaneous examination of the effects of all the LHS parameter on the objective functional value. To test the effectiveness …

Geographic Disparities Associated With Stroke And Myocardial Infarction In East Tennessee, Ashley Pedigo Golden

Doctoral Dissertations

Stroke and myocardial infarction (MI) are serious conditions whose burdens vary by socio-demographic and geographic factors. Although several studies have investigated and identified disparities in burdens of these conditions at the county and state levels, little is known regarding their geographic epidemiology at the neighborhood level. Both conditions require emergency treatments and therefore timely geographic accessibility to appropriate care is critical. Investigation of disparities in geographic accessibility to stroke and MI care and the role of Emergency Medical Services (EMS) in reducing treatment delays are vital in improving health outcomes. Therefore, the objectives of this work were to: (i) classify …

Spatial Epidemiology And Temporal Trends Of Heart Attack And Stroke In Middle Tennessee, Doreen Busingye

Masters Theses

Despite declines in mortality risks of myocardial infarction (MI) and stroke in the US since the 1960’s, the burdens of these conditions remain high. These conditions require emergency and specialized care and therefore quick transportation of patients to appropriate hospitals is critical. Geographic disparities in MI and stroke burdens have been consistently reported in the US with the south-east having the highest risks. Most studies of geographic disparities have been performed at county or higher geographic units. Therefore, spatial patterns at neighborhood levels are unclear. Moreover, it’s important to investigate disparities at neighborhood levels to better understand neighborhood health needs. …

Assessing Risk In Focal Arboviral Infections: Are We Missing The Big Or Little Picture?, A D. Haddow, Agricola Odoi, C J. Jones

Faculty Publications and Other Works -- Biomedical and Diagnostic Sciences

BACKGROUND: Focal arboviral infections affecting a subset of the overall population present an often overlooked set of challenges in the assessment and reporting of risk and the detection of spatial patterns. Our objective was to assess the variation in risk when using different at-risk populations and geographic scales for the calculation of incidence risk and the detection of geographic hot-spots of infection. We explored these variations using a pediatric arbovirus, La Crosse virus (LACV), as our model. METHODS AND FINDINGS: Descriptive and cluster analyses were performed on probable and confirmed cases of LACV infections reported to the Tennessee Department of …

Risk Factors Of Gastrointestinal Nematode Parasite Infections In Small Ruminants Kept In Smallholder Mixed Farms In Kenya., Agricola Odoi, J M. Gathuma, C K. Gachuiri, A Omore

Faculty Publications and Other Works -- Biomedical and Diagnostic Sciences

BACKGROUND: Helminth infections in small ruminants are serious problems in the developing world, particularly where nutrition and sanitation are poor. This study investigated the burden and risk factors of gastrointestinal nematode parasite infections in sheep and goats kept in smallholder mixed farms in the Kenyan Central Highlands. Three hundred and seven small ruminants were sampled from 66 smallholder mixed farms in agro-ecological zones 1 (humid) and 3 (semi-humid) in the Kenyan Central highlands. The farms were visited once a month for eight months during which a health and production survey questionnaire was administered. Fecal samples were collected at each visit …

Inequalities In Neighbourhood Socioeconomic Characteristics: Potential Evidence-Base For Neighbourhood Health Planning., Agricola Odoi, R Wray, M Emo, S Birch, B Hutchison, J Eyles, T Abernathy

Faculty Publications and Other Works -- Biomedical and Diagnostic Sciences

BACKGROUND: Population health planning aims to improve the health of the entire population and to reduce health inequities among population groups. Socioeconomic factors are increasingly being recognized as major determinants of many aspects of health and causes of health inequities. Knowledge of socioeconomic characteristics of neighbourhoods is necessary to identify their unique health needs and enhance identification of socioeconomically disadvantaged populations. Careful integration of this knowledge into health planning activities is necessary to ensure that health planning and service provision are tailored to unique neighbourhood population health needs. In this study, we identify unique neighbourhood socioeconomic characteristics and classify the …

Investigation Of Clusters Of Giardiasis Using Gis And A Spatial Scan Statistic., Agricola Odoi, S W. Martin, P Michel, D Middleton, J Holt, J Wilson

Faculty Publications and Other Works -- Biomedical and Diagnostic Sciences

BACKGROUND: Giardia lamblia is the most frequently identified human intestinal parasite in Canada with prevalence estimates of 4-10%. However, infection rates vary by geographical area and localized 'pockets' of high or low infection rates are thought to exist. Water-borne transmission is one of the major routes of infection. Sources of contamination of drinking water include humans, domestic and wild animals. A previous study in southern Ontario, Canada, indicated a bivariate association between giardiasis rates and livestock density and/or manure use on agricultural land; however these variables were not significant when the variable 'rural' was added to the model. In that …

Geographical And Temporal Distribution Of Human Giardiasis In Ontario, Canada., Agricola Odoi, S W. Martin, P Michel, J Holt, D Middleton, J Wilson

Faculty Publications and Other Works -- Biomedical and Diagnostic Sciences

BACKGROUND: Giardia is the most frequently identified intestinal parasite in North America. Although information on geographical distribution of giardiasis is critical in identifying communities at high risk, little has been done in this area. Therefore, the objective of this study was to investigate the geographical and temporal distribution of human giardiasis in Ontario in order to identify possible high risk areas and seasons. Two spatial scales of analyses and two disease measures were used with a view to identifying the best of each in assessing geographical patterns of giardiasis in Ontario. Global Moran's I and Moran Local Indicators of Spatial …