Medicine and Health Sciences Commons^™

Opportunities For Mental Health Interventions In Rural Mississippi Communities During The Covid-19 Pandemic: A Quantitative Analysis, Brice Fortinberry

Theses and Dissertations

COVID-19 presented unique challenges for rural Mississippi communities including impacts on the mental health of rural individuals. This research study aimed to identify opportunities for mental health interventions to provide health promotion professionals with quantitative data on the accessibility and the likelihood of engagement with mental health-fostering behaviors. A secondary objective of this research was to categorize these behaviors within the constructs of the Social Ecological Model. Demographics for rural Mississippi communities were collected and displayed, and using multivariate analyses including Spearman’s correlation and a Mann-Whitney U test the correlation between mental health fostering behaviors and demographic factors was obtained. …

Dietary Inflammatory Index During Pregnancy And Changes Over Time: Associations With Post-Partum Sleep Duration And Quality And Depressive Symptoms., Nowrin Tamanna

Theses and Dissertations

STUDY OBJECTIVES: Sleep and mental health are two important factors for a new mother, as adequate sleep and a healthy mind help her prioritize self-care, seek support when needed, and create a nurturing environment for both her and her baby. Among various plausible theories exploring the etiology of sleep disturbances and depression, the concept of inflammation is gaining attention. This study examined the hypothesis that more pro-inflammatory diets during pregnancy are associated with a decrease in sleep quality and duration, abnormal sleep timing and higher Edinburg Postnatal depression score (EPDS) scores 6 months and 12 months post-partum.

METHODS: A secondary …

The Genetic Associations Of Circadian Rhythm And Sleep Disorder Traits With Risk Of Monoclonal Gammopathy Of Undetermined Significance And Multiple Myeloma, Brittany Crawford

Theses and Dissertations

Background: Circadian rhythm disruption and sleep have been widely studied for their roles in immunity and cancer development. Evidence for an association of circadian rhythm and sleep traits with multiple myeloma (MM) risk is inconclusive. No studies have investigated these traits in relation to monoclonal gammopathy of undetermined significance (MGUS). Given that MGUS precedes almost all MM cases, investigating sleep and circadian rhythm in relation to both MM and MGUS is necessary. The purpose of this dissertation was to explore the genetic influences of circadian rhythm and sleep traits on the risk of MGUS and MM. Methods: Data were leveraged …

A Cross-Sectional Analysis Of Infectious Causes Of Congenital Morbidity And Mortality In Central America: Torch, El Salvador, Mary Katherine Lynn

Theses and Dissertations

The primary goal of this dissertation was to understand the prevalence of the most regionally salient TORCH pathogens among a group of perinatal women from a highly vulnerable region of El Salvador at the time of parturition. TORCH pathogens, that cause TORCH congenital syndromes, are classically defined as Toxoplasma gondii, other infectious causes of concern (Zika virus, malaria, human immunodeficiency virus, etc), Rubella virus, Cytomegalovirus(CMV), and Herpes Simplex Viruses. These infections can be passed from mother to fetus through the placenta or other perinatal routes and cause severe maternal and neonatal morbidity and mortality. This dissertation sought to understand perinatal …

Food Insecurity In Youth And Young Adults With Diabetes: Prevalence And Association With Health Behaviors, Lauren Helene Martini

Theses and Dissertations

Given the life-long impact of diabetes(1-5), it is important to engage in behaviors that promote health and wellness to delay or prevent negative health outcomes(3, 6-10). Despite this, youth and young adults with diabetes generally do not adhere to nutritional(11-17) or physical activity(18, 19) recommendations. In households experiencing financial difficulties, especially those who are having difficulty providing sufficient food to all of its members, adhering to recommendations may be even more difficult.

The purpose of this dissertation is to better understand and contextualize food insecurity among youth and young adults (YYA) with youth-onset T1DM and T2DM. The first aim addresses …

Prospective Investigation Of Insomnia Symptoms And Sleep Duration As Risk Factors For Stroke Incidence And All-Cause Mortality In U.S Adult, Wendemi Sawadogo

Theses and Dissertations

Background and Objectives: Stroke is the second leading cause of death in the world. In the United States, on average, someone has a stroke every 40 seconds and someone dies as a result of stroke every 3.5 minutes. Identifying modifiable risk factors of stroke is therefore a public health priority. The purpose of this study was to investigate the extent to which insomnia symptoms and sleep duration contribute to stroke incidence, all-cause mortality, and explore potential causal pathways.

Methods: The Health and Retirement Study (HRS) and the REasons for Geographic And Racial Differences in Stroke (REGARDS) study were …

A Multi-Method Exploration Of Health Disparities And Covid-19 Incidence And Mortality In The United States, S M Asger Ali

Theses and Dissertations

The 21^st century experienced several health crises, especially in the form of infectious disease outbreaks such as the SARS outbreak in 2003, the H1N1 in 2009, and Ebola outbreaks in 2013. However, none has produced a worldwide socio-economic and health impact compared to the recent pandemic, known as COVID-19. As of October 4, 2022, more than 614 million cases with 6 million deaths have been reported worldwide. The United States is currently in the leading position with more than 98 million cases and 1 million deaths. The pandemic, however, did not impact the entire region similarly, and the infections …

Unearthing An Emerging Neglected Bacterial Disease: Evidence Of Spotted Fever Group Rickettsioses In El Salvador, Kyndall Christian Braumuller

Theses and Dissertations

The main objectives of this dissertation were to investigate the seroprevalence of Spotted Fever Group Rickettsioses (SFGR) antibodies in a specific vulnerable population at high risk for vector-borne disease in El Salvador, understand the relevant risk factors for SFGR past and acute infection in this same population through logistic regression modeling, and clarify the presence of SFGR bacteria in locally collected ticks.

SFGR are a group of bacterial diseases caused by species in the Rickettsia genus of the phylogenetic spotted fever group. These are tick-borne diseases (TBD) that have been described in almost every region of the world. SFGR are …

Rural-Urban Differences In Survival Among People With Early Onset Colorectal Cancer, Radhika Ranganathan

Theses and Dissertations

Colorectal cancer (CRC) is the third most common cancer and the second most among cancer deaths both in the US and globally. Early Onset Colorectal Cancer (EOCRC), occurring between the ages of 20 and 49, has continued to rise over the past decades. Several studies have reported a persistent increase in EOCRC incidence and mortality, especially in rural areas as compared to urban areas, despite decreases in rates for people over the age of 50 years. Increase in EOCRC may have played a role in lowering the age of screening recommendation to 45-49 age group. The objective of this study …

Association Between Postpartum Weight Retention And The Dietary Inflammatory Index, Nyrobi Tyson

Theses and Dissertations

Objective: The objective of this thesis is to examine the relationship between the Dietary Inflammatory Index (DII), measured during the postpartum period, and postpartum weight retention.

Setting and Participants: We used the Infant Feeding Practices Study (IFPS) II (n=5000), a longitudinal study of women from late pregnancy through their infant’s first year of life conducted between 2005 and 2007. Survey topics included feeding practices, infant health, food allergies, sleeping arrangements, mother’s employment, childcare, and mother’s dietary intake.

Main Outcomes: Postpartum weight retention (PPWR) was calculated in kilograms by subtracting self-reported body weight at 3, 6, 9, and 12 months postpartum …

Using Geospatial Analysis To Evaluate Relationships Between Cancer Incidence And Social Factors In Brooklyn, Ny, Sheena Philogene

Theses and Dissertations

This study explored the spatial distribution of cancer incidence in Brooklyn, NY. Using publicly available data, the relationships between cancer incidence and factors linked to cancer were investigated. Furthermore, the study explored the value of using large amounts of data with GIS techniques to quickly analyze geographic trends for cancer.

Detailing The Genetic And Environmental Influences Shared Between Conventional And Electronic Cigarette Use Across Measures Of Initiation And Past 12-Month Use, James Clifford

Theses and Dissertations

Introduction. Tobacco use is a public health crisis with nearly 500,000 Americans suffering premature mortality attributable to tobacco use in 2014. New development efforts have created new nicotine delivery systems whose health consequences are not yet fully understood such as electronic cigarettes (ECIG). It is possible there are shared genetic and environmental factors that influence an individual’s liability to initiate cigarette (CIG) or ECIG use, as both systems are designed to deliver nicotine.

Methods. Four study designs were used to resolve the genetic and environmental influences that underlie CIG and ECIG initiation. A twin study, scoping review, genome-wide association study …

Exploring Predictors In The Receipt Of Patient/Family-Centered Care, Arami Anwell

Theses and Dissertations

Study 1

OBJECTIVES: The research aim of this study was to identify predictors associated with the receipt of PFCC among U.S. children/families

METHODS: Caregivers of 38,803 non-institutionalized children, aged 0 to 17 years, were surveyed by the National Survey of Children’s Health (NSCH) 2018–20019. Patient/family-centered care (PFCC) was measured using five components of health care delivery that were answered on a 4-point Likert scale. Logistic regression models were analyzed for the overall receipt of PFCC and each component of PFCC, with survey weighting added to adjust for complex sampling design.

RESULTS: Many predictors were associated with the receipt of PFCC. …

Utilization Of Remote Sensing To Analyze Aedes Mosquito Egg Abundance With Combined Weather Variables In Two Southeastern Coastal Cities, Danielle M. Johnson

Theses and Dissertations

Several vector-borne diseases have recently resurfaced, and many have suddenly spread to new areas in the United States (U.S.) due to climate change and tropicalization. Two vectors of public health importance are Aedes aegyptiand Aedes albopictus. The Southeastern region of the U.S. appears to be a preferential ecological niche for both Aedes species. Aedes aegyptiand Aedes albopictus are highly susceptible to environmental conditions, such as humidity, precipitation, temperature. Remote sensing technology has proven to be useful for estimating vector populations. Miami-Dade County is an established hotspot for disease transmission. Charleston County is newly vulnerable due to similar …

Dysbiosis-Related Medications And The Association With Cognitive Decline, Cognitive Impairment, And Dementia, Nicholas Victor Resciniti

Theses and Dissertations

The main objectives of this dissertation were to quantitatively assess whether there is an association between medications (e.g., antibiotics, PPIs, antipsychotics) and cognitive performance over time, conduct a causal mediation analysis to evaluate the role of inflammation (C-reactive protein) in the association between medications and subsequent cognitive decline, and examine if dysbiosis-related medications (DRM) are associated with a greater risk of dementia for participants that were cognitively normal and had MCI at baseline.

The Health and Retirement Study (HRS) was used to conduct a secondary data analysis that used longitudinal data from 2004 to 2016. The HRS is an ongoing, …

Diabetes, Anti-Diabetic Medication Use, And The Risk Of Ovarian Cancer, Chantaezia Joseph

Theses and Dissertations

Background- Although ovarian cancer is a rare disease, it is the 5th leading cause of cancer-related deaths among women in the United States. Diabetes is a serious chronic disease that plagues over 436 million adults worldwide and was ranked 7th in causes of death in the US in 2017. Epidemiologic evidence suggests that diabetes may lead to an increased risk of ovarian cancer due to shared risk factors such as sedentary behaviors, smoking and poor diet or through biological mechanisms related to hyperglycemia and obesity, but the epidemiologic evidence yields mixed results. Certain anti-diabetic medications may increase the risk …

Household Food Security, Lifestyle Factors, And Glycemic Control Among Youth And Young Adults With Diabetes, Lauren A. Reid

Theses and Dissertations

The purpose of this study was to assess the associations between household food insecurity (HFI) and glycemic control, physical activity, and diet quality in youth and young adults (YYA) with type 1 diabetes (T1D) and type 2 diabetes (T2D). Among older adults, HFI has been shown to complicate diabetes management due to the essential role of diet in diabetes management and the financial stress associated with HFI. Although HFI is more prevalent among YYA with diabetes than the general population, there are only a handful of studies that have focused on this population and, studies that include YYA with T2D …

Intersection Of Maternal Disability Status, Prescription Opioid Use Before And During Pregnancy, And Adverse Birth Outcomes, Chelsea Lynes Richard

Theses and Dissertations

Nationally, individuals with disability, like those with chronic health conditions, have higher rates of opioid use and misuse and are prescribed higher dosages than those without disability. Because opioid agonists and antagonists can cross the placenta rapidly, there is biological plausibility that they may have an impact on birth outcomes. Therefore, monitoring prescription opioid use, particularly among pregnant women, is of great public health importance. While evidence for the impact of opioid use on preterm birth and low birthweight are conflicting; findings are consistent that opioid use during pregnancy is associated with a higher risk of small for gestational age, …

Association Of Nsaids And Acetaminophen Prescriptions During Pregnancy With Autism Spectrum Disorders In The Child, Mohiuddin Ahsanul Kabir Chowdhury

Theses and Dissertations

Neurodevelopmental disorders in children including Autism Spectrum Disorders (ASD) and Intellectual disability (ID) are the topics of growing concern and recently many studies looked for the risk factors of these disorders. Although antidepressants and antiepileptics consumption during pregnancy have been reported to be associated with ASD, the effect of NSAID or acetaminophen, two most common drugs used during pregnancy, have been under researched. We conducted a prospective cohort study linking data from Medicaid, Department of Education, and Department of Disabilities and Special Needs with birth certificate data from mothers and children between 2010-2017. Beside exposure variables, NSAID and acetaminophen, and …

The Inflammatory Potential Of Diet And Its Relationship With Metabolic, Mental, And Cardiovascular Health Among Childhood Cancer Survivors: The St. Jude Lifetime Cohort Study (Sjlife), Christian Ricardo Alvarado

Theses and Dissertations

Background: Diet is now known to play an important role in the process of inflammation and subsequent chronic health events, such as cancer, metabolic syndrome (MetS), anxiety, depression, and cardiovascular disease (CVD). The Dietary Inflammatory Index (DII®) and energy-adjusted DII (E-DIITM) are tools that can estimate the inflammatory potential of diet of individuals. Previous research has focused predominantly on diet-associated inflammation and adverse health effects in populations that were not composed of cancer survivors. As of the time of this dissertation, none have focused on childhood cancer survivors. Childhood cancer survivors are at an elevated risk of suffering from an …

The Current State Of Health Care Facility Preparedness, Health Care Utilization, And Covid-19 Knowledge Amidst The Covid-19 Pandemic In The Malaria-Endemic Setting Of Manicaland Province, Zimbabwe, Julia Grace Scott

Theses and Dissertations

The impact of the coronavirus disease 2019 (COVID-19) pandemic has been felt worldwide, especially in Sub-Saharan Africa (SSA). With fractured health systems, disrupted supply chains, limited resources, and continued fighting of endemic diseases such as malaria, SSA is at risk for greater impact. Manicaland Province has the highest incidence rate of malaria in Zimbabwe, and a higher malaria mortality rate than the national average. Manicaland also has the third highest number of COVID-19 cases and deaths in Zimbabwe. In this study, health care facilities and households throughout Makoni, Mutare, and Buhera districts in Manicaland Province were administered cross-sectional surveys. We …

A Multilevel And Spatial Analysis Of Oral And Pharyngeal Cancer In South Carolina, Deborah M. Hurley

Theses and Dissertations

Objective: Disparities in the distribution of oral and pharyngeal cancer exist worldwide. This is also true in the United States and in South Carolina. Differences exist in oral and pharyngeal cancer stage and survival by race and sex, with higher incidence rates for Whites but higher proportions of late-stage cancer and lower survival for Blacks. This study was conducted to evaluate whether any differences exist in the spatial distribution of oral and pharyngeal cancer stage at diagnosis and survival, and to evaluate the association of income inequality, material deprivation and other measures of social determinants of health (contextual risk factors) …

A Mixed Methods Approach To Examine Racial Disparities In Adherence To Surveillance Mammography Among Breast Cancer Survivors, Megan C. Edmonds

Theses and Dissertations

PURPOSE: Annual surveillance mammography is a critical part of routine cancer care for breast cancer (BC) survivors; reducing mortality by 39%. However, disparities exist with regard to adherence to surveillance mammograms among BC survivors; Black women are 44% less likely to adhere than their White counterparts. Despite the existence of this racial disparity for over a decade, little is known about factors that explain reasons for Black BC survivors’ non-adherence. This is because most studies have not evaluated the role of healthcare delivery or psychosocial factors. Guided by the Behavioral Model for Vulnerable Populations, the purpose of this mixed methods …

Modeling Substance Use And Mental Disorder Comorbidity Using Latent Variable And Network Approaches, Courtney T. Blondino

Theses and Dissertations

Introduction. Substance use disorder (SUD) is a common condition that affects millions of Americans. Addressing SUD has been complicated by comorbid mental disorders and co-occurring substance use. Consequently, detailing and addressing SUD and comorbid SUD represent an important goal to improve the health of Americans.

Objective. The research goal of this dissertation was to characterize the comorbidity between substance use, including tobacco use, and mental disorder symptoms measured as negative affect and externalizing symptoms in a population-based sample using latent variable and network approaches.

Methods. Waves 1 – 3 from the Population Assessment of Tobacco and Health Study were used. …

Health Outcomes And Utilization Associated With Renal Diseases In Patients With Cancer In The United States, Mitisha Dedhia

Theses and Dissertations

Background: Adverse events and impairments associated with cancer and its treatments causes worse outcomes. Increased incidence of renal diseases among cancer patients is of particular concern. Objective: To determine the risk factors for renal disease in cancer patients and compare healthcare costs, utilization and health-related quality of life (HRQoL) of cancer patients with a renal disease and cancer patients without renal diseases. Methods: Medical Expenditure Panel Survey files from 2009 – 2018 for cancer patients was used for this study. Multiple logistic regression, generalized linear model, Poisson regression and multiple linear regression for analyses after adjusting for demographic, socioeconomic and …

Estimating Covid-19 Survival Rate And Inferring Case Severity With Respect To Milwaukee County Policy Change Using Logistic Regression, Geoff M. Chappelle

Theses and Dissertations

Coronavirus disease 2019 (COVID-19) is a global issue, and it is affecting 170 countries in very different ways. In the United States, a lot of efforts have been made nationally and by individual states to curb the spread and severity of COVID-19. Policy changes and recommendations have been met with variable success across the country. There is a wealth of information on where COVID-19 infection and death are prevalent, and there are several articles discussing disparities in those outcomes among different populations. However, those findings are not necessarily tied to a policy change or, in the weeks that follow a …

Parent-Child Sexual Communication And Sexual Risk: A Meta-Analytic Review, Brittnie Star Peck

Theses and Dissertations

This meta-analysis examines the effect of parent-child sexual communication (PCSC) on sexual risk behaviors and outcomes during adolescence. Results confirm that PCSC increases risk prevention strategies and reduces sexually risky behaviors with corresponding reductions in unplanned pregnancy and sexually transmitted infections (STI). Moderating variables include extent of communication, the content of PCSC interactions, operationalization of risk, timing of the interaction, biological sex of the adolescent, the dyadic composition of the parent-child interaction (e.g., mother-daughter, father-son), and the racial or ethnic makeup of the sample. The frequency, depth, and breadth of PCSC interactions, and inclusion of descriptive/instructional and contraception/risk information are …

A Study Of Covid-19 Mortality Under Varying Patient Frailty, Alison N. Sifuentes

Theses and Dissertations

Modeled the spread and mortality of COVID-19 throughout the city of Chicago. By incorporating group frailty into a classic SEIR infectious disease model, we were able to differentiate the population of Chicago by their response to COVID-19. Three age groups with different COVID-19-induced death rates were examined, and the model sought to showcase the multiplicative deviation of each age group death rate from the average disease-induced death rate. This adjustment for different death rates among age groups accounted for heterogeneity within the population, and sought to introduce a more accurate manner for modeling the spread of infectious diseases.

Association Between Urinary Enterolignans As A Marker For Gut Microbiome Diversity And Depression In Nhanes, Marie Knoll

Theses and Dissertations

Depression is a chronic disease which inflicts functional and emotional impairment that has been a growing issue in the United States (US). Depression is the most prevalent mental disorder in the US and is the leading cause of disability in the world. By 2030, It is projected that major depressive disorder will be the second largest contributor to global burden of disease. Causes of depression are still largely unknown and treatments are often expensive, time consuming, and only available to certain populations. Treatment often requires a combination of medicines and therapy to be effective. In recent years, the gut microbiome …

Intracranial Atherosclerotic Stenosis And Its Association With Inflammation And Meditarrenean Diet, Tushar Trivedi

Theses and Dissertations

Intracranial Atherosclerotic Stenosis (ICAS) is associated with 8 to 10% of all strokes in the U.S. Although there is some evidence that in the Asian population inflammation plays a role in asymptomatic ICAS, it has not been shown in the U.S. population. Prior studies have shown associations between diet and regulation of inflammation. Mediterranean dietary pattern has been associated with lower levels of inflammation and cardiovascular disease (CVD). In light of the important role of inflammation in intermediate stroke risk factors including atherosclerotic disease, and potential role of diet in modulating inflammation, understanding individuals’ diets according to their inflammatory properties …