Medicine and Health Sciences Commons^™

Self-Reported Racism, Transphobia, Their Intersection And Impact On Past-Year Hiv Related Sexual Risk Behaviour, Roxanne M. Longman Marcellin

Electronic Thesis and Dissertation Repository

Background: Studies examining HIV prevalence and risk behaviors within trans subgroups have identified them as high risk. Yet few studies have addressed how discrimination impacts this prevalence. Minority stress theory suggests that there is a relationship between minority stress and HIV-related risk behaviour. We hypothesize that multiple minority statuses may result in discriminatory experiences, specifically self-reported transphobia and racism in synchrony with other attributes, that interact to alter past-year HIV-related risk behaviour.

Methods: Data came from the Trans PULSE project, a mixed-methods, community-based research study that used respondent-driven sampling to access 433 trans Ontarians, between May 2009 and …

Evaluation Of Heat Stress In Migrant Farmworkers, Stephen L. Mcqueen

Electronic Theses and Dissertations

The rate of heat-related fatalities in crop production workers is almost 20 times that of other industries. Heat stress was investigated in migrant tomato workers in July, 2012, using measurements of body temperature, heart rates, body weight loss, evaluation of the thermal environment, and survey data. Using occupational safety criteria, these workers were found to work in an environment that should require protective measures to prevent heat strain. Increases in body temperature, heart rate, and physiological strain correlated with heat exposure. One third of workers had body weight percentage losses that indicated dehydration. However, working in hot environments appears to …

A Practical Scale For Multi-Faceted Organizational Health Climate Assessment, Zandra M. Zweber

Master's Theses

The current study sought to develop a practical scale to measure workplace health climate in a way that has not previously been conceptualized – as a three-faceted approach from the employee perspective serving as an indicator of a healthy organization. The goal was to create a short, useable yet comprehensive scale that could translate into practical use by organizations and occupational health professionals planning workplace interventions. To accomplish this, the proposed multi-faceted organizational health climate scale (MOHCA) assesses three-facets which match up with three organizational levels: 1) organization 2) supervisor and 3) workgroup. Ten items were developed and tested on …

Evaluation Of The Survival Effect For Various Treatment Modalities Among Stage Ii And Iii Rectal Cancer Patients In California, 1994-2009, Myung Mi Cho

Loma Linda University Electronic Theses, Dissertations & Projects

Background: European trials evaluating the effect of preoperative (PreOP) versus postoperative chemoradiotherapy (PostOP CRT) found no survival benefit. However, the effect of a change from PostOP to PreOP CRT has not been evaluated in a population-based setting. We sought to evaluate multimodal treatment changes and overall survival for perioperative (PeriOP) CRT versus surgery alone and for PreOP versus PostOP CRT from 1994 through 2009 among patients receiving radical surgery for stage II and III rectal cancer (RC).

Patients and Methods: We conducted a nonconcurrent cohort study evaluating demographic predictors of multimodal therapy for stage II and III RC using …

Parents' Perceptions Of Activity Restrictions In Children With Epilepsy: First Two Years Post-Diagnosis, Nathan C. King

Electronic Thesis and Dissertation Repository

Children with epilepsy are less physically and socially active than their peers. The objective is to explore whether parents represent a barrier to children’s activity, by examining associations between child and family factors and parents’ perceptions of epilepsy-related activity restrictions. Data were from the Health Related Quality of Life in Children with Epilepsy Study, a longitudinal study of children 4-12 years old with new-onset epilepsy. Parents reported on activity restrictions and family factors and neurologists reported on epilepsy-related characteristics at baseline, 6, 12, and 24 months. Linear mixed models were used to model relationships among child and family factors and …

Screening For Adult Adhd In Ontario: A Cross-Sectional Study Examining Sex Differences, Mental Health Correlates And Substance Use, Deanne Daigle

Electronic Thesis and Dissertation Repository

The vast majority of studies on attention-deficit/hyperactivity disorder (ADHD) are based on samples with inherent age, sex, and referral biases. Therefore, the current study used population-based data to 1) estimate the prevalence of adult ADHD (as well as previous diagnosis and medication use using an ADHD screener) and co-occurring psychiatric distress and substance use in Ontario 2) examine the sex differences in ADHD screening status and co-occurring psychiatric distress and substance use and 3) model ADHD screening status as a risk factor for psychiatric distress using the 2011 cycle of the Centre for Addiction and Mental Health Monitor. A positive …

Antenatal Care Determines Immunization And Care For Fever And Diarrhea In Ghanaian Children, Natalie K. Mcglynn

Electronic Thesis and Dissertation Repository

Enhancing maternal and child health comprise key Millennium Development Goals (MDGs), driving an analysis of whether efforts to improve maternal health through quality antenatal care (ANC) is associated with the recommended health-related care of children in Sub-Saharan Africa, where under-five mortality is the highest.

This study examines ANC as a potential determinant of immunization and appropriate care for fever and diarrhea in Ghanaian children. Data were pooled from the 1998, 2003, and 2008 Ghana Demographic Health Surveys, and Andersen’s Behavioural Model provided the conceptual framework.

Multivariate logistic regression indicated that quality ANC increases the odds of immunization and appropriate care …

Investigating Personality Vulnerability To Suicide Ideation In Community-Residing Older Adults, James Andrew Mcclure

Electronic Thesis and Dissertation Repository

This study assessed associations between suicide ideation and personality characteristics in a sample of community-residing adults 65 years of age and older. Measures of personality, suicide ideation, and depression were administered at two time points 6-12 months apart. Multiple linear regression analyses were employed to investigate cross-sectional and longitudinal associations between personality characteristics and suicide ideation. A total of 106 older adults (mean age=74.2 years, SD=5.8, including 78 women) completed both phases of the study. The majority of participants included in this study were relatively emotionally and psychologically healthy. Within this sample of older adults, more severe suicide ideations was …

The Psychosocial Effects Of Beryllium Sensitization And Chronic Beryllium Disease, Jeffrey Robert Miller

Doctoral Dissertations

The purpose of this study was to develop and validate a theoretical model that explains the psychosocial effects of beryllium sensitization (BeS) and chronic beryllium disease (CBD). Sequential, mixed research methods were used. The study population was current and former workers from Department of Energy laboratories and manufacturing facilities who have either BeS or CBD. A theoretical model based on uncertainty in illness and psychosocial adjustment to illness theories was developed. It was hypothesized that uncertainty had a negative effect on health quality of life unless mediated by the ability to make psychosocial adjustments to illness. Qualitative study results supported …

A Systematic Framework For Radio Frequency Identification (Rfid) Hazard Mitigation In The Blood Transfusion Supply Chain From Donation To Distribution, Natalie Simone Rahming

Theses and Dissertations

The RFID Consortium is developing what will be the first FDA-approved use of radio frequency identification (RFID) technology to identify, track, manage, and monitor blood throughout the entire blood transfusion supply chain. The iTraceTM is an innovative technological system designed to optimize the procedures currently employed when tracing blood from the donor to the recipient. With all novel technologies it is essential to consider not only the advantages, but also the potential harms that may come about from using the system. The deployment of the iTraceTM consists of two phases: 1) Phase One - application of the iTraceTM from the …

Recycling And Reuse Of Radioactive Materials, Thomas Joseph O'Dou

UNLV Theses, Dissertations, Professional Papers, and Capstones

The Radiochemistry Program at the University of Nevada, Las Vegas (UNLV) has a Radiation Protection Program that was designed to provide students with the ability to safely work with radioactive materials in quantities that are not available in other academic environments. Requirements for continuous training and supervision make this unique program capable of turning out graduates that have an understanding of contamination and dose control techniques that complement their knowledge of the elements that they work with. The Program has also adopted a radionuclide recovery and reuse program that has provided materials from other universities, government agencies, and private companies …

"Choices" Florida's Version Of Obamacare, Jason Lamarr Wasden

UNLV Theses, Dissertations, Professional Papers, and Capstones

"CHOICES" Florida's version of ObamaCare was a unique case voted in by the public in Alachua County Florida. A mixed methods research design was utilized and provided context in which policy entrepreneurs operated, as well as an explanatory model of internal determinants. Social, economic and political factors were examined to determine the predictor variable in the adoption of the "CHOICES" health services program. The results revealed that voters 51 years of age and older had a greater probability of voting for the Alachua Referendum. "CHOICES" legality has not been under contention but its effectiveness has. This study found that "CHOICES" …

The Effect Of Text Messaging Alerts Upon Testicular Self-Examination (Tse) Adherence, Lisa Soler

HIM 1990-2015

Based on Kim Witte's proven Extended Parallel Process Model, a mobile communication system was developed in which men were sent reminders about their health. This study focused on reminding men about testicular self-examination (TSE), a proactive behavior used to detect testicular cancer, through the use of text messaging. A cohort of 75 men were recruited for this study and placed into one of four groups. All participants were provided with information concerning TSE and told to perform the exam monthly; two of the four groups were sent reminders via text message while the other two groups were told once about …

Factors Associated With Bed-Sharing Within Racial Groups In A Sample Of Mothers And Young Infants In Wisconsin, Trina C. Salm Ward

Theses and Dissertations

Since 2005, the American Academy of Pediatrics has recommended a separate but proximate sleep surface for infants (AAP, 2005). However, racial differences in the prevalence of bed-sharing and infant mortality (especially as a result of SIDS or unsafe sleep) continue. Limited research has examined predictors of bed-sharing by racial group, especially the AAP's 2005 policy statement against it. The purpose of this study was to explore maternal-infant bed-sharing and infant sleep position for African-Americans and Whites in a sample of 2,530 respondents (822 African-American and 1,708 Whites) to the Wisconsin Pregnancy Risk Assessment and Monitoring System (PRAMS), a stratified sample …

The Morbidity & Mortality Of Prevalent Heart Failure, Jennifer Kwon

Loma Linda University Electronic Theses, Dissertations & Projects

The first study population included 292 unselected consecutive patients from the LLUMC heart failure clinic who were enrolled in the study from January to July 2006 and were followed up through the end of December 2010. The treatment policy at the clinic was to uptitrate dosages of beta-adrenergic blockade (β-blockers), angiotensin-converting-enzyme inhibitors (ACEi) and angiotensin II receptor blockers (ARB) to the most tolerable levels in order to reach target dosages, as recommended by the Heart Failure Society of America (HFSA). Patients were classified into systolic heart failure (ejection fraction (EF) < 40%) or diastolic heart failure (EF≥40%). All dosages of β-blockers, ACEi and ARB were extracted through chart reviews and were used as the main predictors of the patients' survival. Results from analyses showed that reaching target dosages of β-blockers and ACEi/ARB may increase survival when compared to not reaching target among the systolic HF population (HR_{β_biockers}= 0.64, 95% CI 0.26-1.56 and HR_ACEi/ARB=0.50, …

Using Box-Jenkins Modeling Techniques To Forecast Future Disease Burden And Identify Disease Aberrations In Public Health Surveillance Report, Larry C. Garrett

Dissertations

The analysis of public health surveillance data to identify departures from historical patterns of disease is required to facilitate the timely identification of potential outbreaks. Using the Box-Jenkins forecasting model, this study examines the potential to predict future disease burden based upon the historical record within local public health jurisdictions. Box-Jenkins forecasting was developed as a direct result of forecast problems in the business, economic, and control-engineering applications, yet it has not been systematically examined for use with public heath surveillance data.

Box-Jenkins forecast models are constructed by stratifying 84,029 disease reports from the State of Utah by year (n …

Effects Of Obesity On Thermoregulation And Cardiovascular Function During Exercise In Females, Jon David Adams

Graduate Theses and Dissertations

Previous research has shown that obese individuals are at greater risk for heat illnesses because of impaired thermoregulation. However, laboratory studies investigating cardiovascular and thermoregulatory function in obese individuals are difficult to interpret because of low sample sizes and methodological concerns. The purpose of this study was to determine if there are differences in thermoregulatory and cardiovascular function between obese and non-obese females. Twenty-four females, 13 obese (43.3 ± 4 .3 % fat, 77.2 ± 13.7 kg) and 11 non-obese (27.8 ± 6.0 % fat, 55.7±6.7 kg), cycled for 60 min in a warm environment (~40°C, 30% humidity) at a …

Dreissena Rostiformis Bugensis: Desiccation Of Adult Quagga Mussels Found In Lake Mead As A Preventive Measure Against Overland Dispersal In The Western United States, Matthew Kappel

UNLV Theses, Dissertations, Professional Papers, and Capstones

The expansion of civilization across all borders of the world has proven to affect major components of ecosystems. Since the introduction and establishment of the aquatic invasive species (AIS),Dreissena rostiformis bugensis, commonly known as the quagga mussel, into the United States there has been an extensive amount of time and money spent on controlling and preventing their expansion across the United States. The quagga mussel is of major concern because of its ability to disrupt the ecological communities in previously non-infested bodies of water, which may cause a loss in biodiversity and effect environmental health. The quagga mussel has spread …

Complexity And Uncertainty In Human And Ecological Risk Assessment, Matthew Jordan Dellinger

Theses and Dissertations

Multiple interacting stressors in the environment present increasingly complex risks to human health. Too often, however, the data required for traditional risk assessment are either lacking or unavailable at the necessary spatial or temporal scale. In addition, assessment practices and management policies need to move away from single factor approaches in order to accommodate the reality of complex chemical mixtures and environmental stressors. Recent literature suggests that a paradigm shift is under way. This points to a need for the development of new techniques both for rapid data collection and flexible risk assessment strategies that can adapt to make use …

Predictors Of Healthcare Cost In A Wisconsin Acute Leukemia Population: Utilization Of A State-Level All Payer Claims Database, Patricia Ann Steinert

Theses and Dissertations

Understanding cost predictors of low incidence high cost cancers is increasingly important as the U.S. attempts to control health care costs. Acute myeloid and acute lymphoblastic leukemia are hematologic cancers requiring high cost care.

Using Anderson's model of health care utilization this study explores the influence of patient and community factors on health care costs. Insurance claims cost data obtained from the Wisconsin Health Information Organization provided a sample of 837 acute leukemia patients from April, 2009 and June, 2011. Total, ancillary, inpatient, outpatient, pharmacy and professional services costs were analyzed using a GLM gamma log link regression model to …

Timeliness Of Electronic And Traditional Laboratory Reporting In Southern Nevada, 1999-2012, Jennifer Anne Lucas

UNLV Theses, Dissertations, Professional Papers, and Capstones

This study compares the timeliness of Electronic Laboratory Reporting (ELR) with traditional reporting. ELR has been implemented in parts of the United States, and is perceived to be faster than traditional reporting. Faster reporting leads to faster public health response to prevent outbreaks, and to reduce the burden of infectious disease in communities. Nevada State law requires that diseases be reported within certain time frames. Timeliness of laboratory reporting at the Southern Nevada Health District (SNHD) from 1999-2012 was assessed by analyzing cases of four common diseases in this retrospective secondary analysis of extant data.

The difference in timeliness regarding …

The Effectiveness Of Health Education Materials In Influencing Hiv Testing Behavior: The Unlv-Siphi Study, Rebecca Tsegay

UNLV Theses, Dissertations, Professional Papers, and Capstones

The UNLV-SIPHI (Sexual Health Internet-Based Public Health Intervention) Study focused on HIV prevention by improving HIV testing behavior through the development and dissemination of health education materials. The goal of the UNLV-SIPHI Study was to develop effective, custom-made HIV health education materials that promote the knowledge, intention and practice of HIV testing among UNLV students. The UNLV-SIPHI Study was conducted during Spring 2012 semester in selected UNLV undergraduate classes. An online quasi-randomized-control trial (RCT) was used to measure the difference in HIV testing behavior contributing factors among students exposed to the health education materials. Several nonparametric tests were used to …

Family Physician Access Among Trans People In Ontario: A Cross-Sectional Analysis Of Social Determinants Of Health And Inequality Issues., Xuchen Zong

Electronic Thesis and Dissertation Repository

For trans Ontarians with access to publicly insured health care, this study aimed to determine predictors of not having a family physician, as well as to identify factors that influence a trans patient’s comfort discussing trans status or trans-related health needs with their physician. Previously collected demographic and family physician access related data (n=433) were used. Multiple logistic predictive model showed that age, marital status, education, employment, income-to-needs ratio, and social support independently predicted not having a family physician. Marital status, negative trans-specific experience with family physicians, and perception of family physician's knowledge about trans health needs were identified as …

Epid-Based Dose Verification For Adaptive Radiotherapy, Joseph Gardner

Theses and Dissertations

Dose verification is a critical component of adaptive radiotherapy, as it provides a measurement of treatment delivery success. Based on the measured outcome, the plan may be adapted to account for differences between the planned dose and the delivered dose. Although placement of an EPID behind the patient during treatment allows for exit dosimetry which may be used to reconstruct the delivered patient dose via backprojection of the fluence, there have not been any studies examining the basic assumption of backprojection-based dose verification: that deviations between the expected and delivered exit fluences are totally caused by errors in the delivered …

Evaluating The Impact Of Two Different Methods Of Diabetes Self-Management Education On Knowledge, Attitude, And Behaviours Of Patients With Type 2 Diabetes Mellitus, Laura B. Briden

Electronic Thesis and Dissertation Repository

This study compared the effectiveness of diabetes self-management education (DSME) methods by examining changes in knowledge, attitude, and behaviour (KAB) after receiving education. Participants from a convenience sample were randomized into two groups, one receiving education through conversation maps and the other through traditional group education. Participants’ knowledge and attitude changes were measured by using a repeated measures pre-test/post-test design and changes in Hb A1c were observed. Focus groups were conducted after education was received to obtain perceptions and self-reported behaviour changes. Significant knowledge and attitude score changes were observed in the conversation map group after education. When comparing the …

Social Marketing And Falls Prevention: Market Segmentation And Product Positioning, Eric C. Stemmler

Electronic Thesis and Dissertation Repository

The present study sets out to better understand how falls prevention can be marketed and positioned in order to increase participation rates in seniors. Market segmentation was used to create unique marketing mixes for individual groups of seniors. The senior market was segmented into frequent falling males and females, and non-falling males and females. Frequent fallers were defined by having experienced 2 or more falls in the past year, where non-fallers had experienced 1 or less falls. Twelve focus groups were conducted with thirty-five participants (N=35), 65 years or older. Differences were mainly found between number of falls …

The Design And Testing Of A Solar Autoclave With Broad Spectrum Sterilization Capabilities, Sarah S. Trabia

Honors College Theses

Energy is difficult to come by in developing countries and this interferes with the ability of doctors to provide good healthcare to their patients. Without decent sterilization, patients can become infected and diseases can spread throughout hospitals. This study involves designing a solar autoclave for developing countries that is as efficient as electrical autoclaves. The design is intended to not require any electrical input and to be affordable to those who cannot afford advanced medical equipment. Once the solar autoclave is designed, it will be tested to determine if it can sterilize equipment against a variety of different bacteria, including …

The Cost-Effectiveness Of Combination Treatment Consisting Of Either Cetuximab Or Panitumumab Plus Folfiri Versus Treatment With Bevacizumab Plus Folfiri As First-Line Treatment For Kras Wild-Type Metastatic Colorectal Cancer Patients In Ontario, Emmanuel M.G. Ewara

Electronic Thesis and Dissertation Repository

I conducted a cost-effectiveness analysis of combination cetuximbab or panitumumab plus FOLFIRI as first-line treatment for patients with metastatic colorectal cancer (MCRC) from the perspective of the Ontario healthcare payer. I developed a Markov decision analytical model to simulate the lifetime costs and benefits of each treatment option. The model was parameterized using data collected from administrative databases in the province of Ontario and from published clinical trials. In the base case scenario, treatment consisting of bevacizumab plus FOLFIRI was found to dominate other treatment options. The ICER values were found to be sensitive to the efficacy of first-line treatment, …

Obesity And Health Care Utilization Trends In Canada During The Period 1996-7 To 2009-10, Michael Lebenbaum

Electronic Thesis and Dissertation Repository

In Canada, there have been large improvements in the management of chronic diseases attributed to obesity such as diabetes, hypertension and high cholesterol since the 1990s. How this trend has impacted the health care utilization patterns of obese individuals relative to normal weight individuals is unknown in Canada. This study examined health care utilization across categories of body mass index in Canada during the time period 1996 to 2010 using the 1996-7 National Population Health Survey and the 2000-1 and 2009-10 Canadian Community Health Surveys. I found that there were significant declines in the intensity of utilization of general practitioner/family …

Do The Opportunities Offered During The School Day Provide The Recommended Physical Activity Levels For Children?: An Assessment Of The Upson County Pre-Kindergarten And Elementary School Physical Activity Occurrences, Cheryl Lynn Robinson Gaddis

Electronic Theses and Dissertations

Problem Statement: Almost 90% of students do not meet the national recommendations for physical activity in school. The purpose of this study was to determine the need for school policy changes to incorporate classroom-based physical activity programs in an effort to increase school physical activity levels for children in grades pre-kindergarten through five by assessing the levels of and the barriers/facilitators to physical activity engagement.

Methods: This was a sequential explanatory mixed methods study utilizing school board members, principals, and teachers in the Upson County School System as participants. The online survey was adapted from the School Health …