Medicine and Health Sciences Commons^™

Factors Associated With Large Vehicle Collision Fatalities From 2009-2015, An Assessment Of Factors Relevant To The 2014 Implementation Of The National Registry Of Certified Medical Examiners And Strategies For Driver Safety, Melinda L. Carol

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

OBJECTIVE: The Federal Motor Carrier Safety Administration (FMCSA) developed a National Registry of Certified Medical Examiners (NRCME) as a stride toward greater driver safety and public health. This retrospective, observational, cross-section study is intended to trend and analyze driver related factors that are pertinent to FMCSA certifying medical examination performed by NRCME providers in addition to driver behaviors and environmental factors from the years 2009 to 2015. The results of this study are intended to speculate the effectiveness of the NRCME and propose additional public health interventions aimed to reduce large vehicle fatalities.

METHODS: Data was extracted from …

Vaccine-Preventable Disease Surveillance In Kentucky, Katherine Jay

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Background: Vaccine-preventable disease (VPD) surveillance is important component to the success of vaccines. This report examines the levels of 13 of these VPDs in the state of Kentucky from 2005 to 2015.

Methods: All reported cases in the state of Kentucky for the years 2005 to 2015 of 13 vaccine-preventable diseases were obtained from the Disease Surveillance Module (DSM) and the National Electronic Disease Surveillance System (NEDSS). Where enough cases were reported, descriptive statistics were prepared. For acute hepatitis B and pertussis, more thorough analysis was performed.

Results: Rates of acute hepatitis B in Kentucky from 2005 …

Shaping Our Appalachian Region (Soar): Beginning To Now, Samantha Zarycki

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Introduction

Appalachian Kentucky has been and is currently facing difficult times including low employment rates, low education rates and less-than-favorable healthcare and health status for the people of the region (Estep, 2014). There have been multiple government and non-government agencies who have implemented interventions with the purpose of lifting up the region. Shaping Our Appalachian Region, or SOAR, is a bipartisan organization which began in 2013, and was established for the purpose of caring for the region.

Methods

A qualitative data analysis using confidential interviews with six people involved with SOAR was used for this project. Using the deductive approach …

Dusty Occupations And Pulmonary Obstruction In Kentucky: A Proportionate Mortality Analysis, Neil Bradford Horsley

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Background

Chronic obstructive pulmonary disease (COPD) is the third leading cause of death in the United States. Occupational exposure to vapors, gases, dusts, or fumes (VGDFs), in combination with smoking, significantly increases the risk of developing COPD. Amongst agricultural workers, exposure to pesticides has been found to cause significantly elevated rates of annual decline in lung function, ultimately leading to a clinical diagnosis of pulmonary obstruction if the period of exposure is sufficient.

Purpose

It is hypothesized that, when compared to the standard population, workers in “dusty” occupations (where VGDF workplace exposure is significant) die at significantly elevated rates from …

Hepatitis C Screening And Treatment Of Prisoners: Analysis Of Policy And Practice In Kentucky, Charity Faith Kranz

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

INTRODUCTION

The United States and the Commonwealth of Kentucky are currently overwhelmed by a triad of complex epidemics—incarceration, opioid overdose deaths secondary to substance use disorders, and hepatitis C. Research has suggested hepatitis C screening and treatment of prisoners may be a cost-effective strategy to address the hepatitis C epidemic. Since Kentucky has been particularly impacted by these interrelated health threats, further exploration of hepatitis C in Kentucky prison populations and their potential role in addressing these epidemics is warranted.

Primary Objective

The main goal of this research was to examine hepatitis C screening and treatment policy and practice within …

Validity Of The Public Health Accreditation Board’S Governance Measures, Badr Alnasser

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Background. The dynamics through which governance operates and impacts performance has been the focus of scholars in recent years. This is also true in public health systems, where there is a growing tendency to understand governance mechanisms and dimensions, as illustrated in the Public Health Accreditation Board’s (PHAB’s) Domain 12, which tends to measure governance engagement in health departments. The development of Domain 12 standards and measures has undergone systematic revisions by subject matters and experts. However, there is still a need for a scientific approach to assess the validity of such measures, or examine whether they measure what …

The Effects Of Tobacco Policy On Tobacco Treatment In Psychiatric Institutions, Terrence A. Sharper Ii

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Introduction: Tobacco use among those with mental illnesses is substantially higher than the general population. To avoid tobacco related comorbidities, tobacco policies are an important aspect for control of tobacco use, exposure, and to support tobacco treatment.

Aim: To conduct a systematic literature review of tobacco treatment policies in psychiatric institutions and examine the knowledge, availability of resources, and perceived barriers for treating tobacco use among managers.

Method: There were two main parts used to examine tobacco treatment policies in psychiatric facilities. First, a review of the literature summarized the effect of different tobacco-free policies on tobacco treatment delivery in …

An Assessment Of The Effectiveness Of Unannounced Safety Inspections Versus Announced Inspections In Academic Research Laboratories That Utilize Biological Hazards, Holley M. Trucks

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Inspections are integral to comprehensive biosafety programs at academic research institutions that use a wide variety of infectious agents. However, there is no standardization of biosafety inspection procedures from institution to institution. This study analyzed results of 2,098 documented inspections conducted from January 2012 through December of 2016 performed by biosafety staff at a large Research I land grant institution in order to evaluate the effectiveness of an unannounced versus the more traditional announced approach to inspection procedure. Results demonstrated that: a) more findings were noted during unannounced inspections, therefore more accurately informing biosafety staff of the true day to …

Use Of Clonidine In Sedation Dentistry, Asma Kumar

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Background:

Clonidine is an alpha-2 adrenergic agonist which has been used to treat hypertension for over 40 years. In October 2008, clonidine was approved by the FDA for use as a premedication agent prior to sedation. The overall goal of this study is to determine if clonidine can be used as a pre- operative sedative agent in moderate sedation dentistry and if so, what should be considered a safe level.

The following specific aims were established for this study:

1. To determine whether patients receiving clonidine required less intravenous medications.
2. To determine if clonidine can lower blood pressure and pulse to …

Hepatocellular Carcinoma Among Kentencky Residents From 1995 To 2011: Risk Factors For Late-Stage Diagnosis And Survivability, Zilahatou B. Tohon

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Introduction: Hepatocellular carcinoma incidence and mortality rates are the rise in the United States and in Kentucky as well. According to the National Cancer Institute, there will be an estimated 40,710 new cases of liver and intrahepatic bile duct cancer and 28,920 deaths in 2017, with than 20% of 5-years survivors ¹. The numbers of new cases expected by year 2030 is 37,574 ². The aim of this capstone is to assess the risk factors of late-stage diagnosis and survivability in Kentucky.

Methods: A combined dataset from the Kentucky Cancer Registry and the Behavioral Risk Factor Surveillance System …

Effect Of One Piece Versus Two Piece Mini Implants On Bone Height Of Implant Retained Mandibular Overdenture, Fardos N. Rizk, Jehan Fikry Prof., Amr Badr, Ahmed Damarisy Dr.

Dentistry

Introduction: Severely atrophied mandibles are a common problem within elderly completely edentulous patients. Given their small diameters, long height and self-tapping characteristics, miniimplant retained over-dentures are a valuable treatment option in such patients. Mini-implants are usually once-piece implants, however recently two-piece mini-implants were introduced with aim of addressing the angulation problems. The success of the latter has not been thoroughly studied. Crestal bone height measurements are normally used to evaluate implant success. Therefore this study was conducted to evaluate the effect of one piece versus two piece ERA mini implants on crestal bone height of implant retained mandibular over-denture. Materials …

Mucosa-Supported Stereolithographic Surgical Guide Versus Conventional Surgical Stent In Implant Supported Overdenture, Fardos N. Rizk, Marwa Sabet Prof., Shaimaa Azoz, Eman Gamal

Dentistry

Purpose: The aim of the study was to compare between the accuracy of mucosa-supported stereolithographic surgical guide versus conventional surgical stent in implant supported overdenture. Materials and methods: Twelve patients with completely edentulous patients were selected for this study and divided into three groups. Group (A): 8 implants were placed in the mandible using conventional surgical stents during implant insertion. Group (B): 8 implants were placed in the mandible using partially limiting mucosa-supported stereolithographic (SLA) surgical guide during implant insertion. Group (C): 8 implants were placed in the mandible using completely limiting mucosa-supported stereolithographic (SLA) surgical guide during implant insertion. …

Comparison Of Conception Rates In Beef Cattle Inseminated With Either Sexedultra™ Sex-Sorted Semen Or Conventional Semen In Fixed-Time Artificial Insemination (Ftai) Protocols, Benjamin R. Crites

Theses and Dissertations--Animal and Food Sciences

Estrous synchronization and artificial insemination (ESAI) are reproductive technologies that cattlemen can use to improve the reproductive performance of their herds. Controlling the gender ratio of the calf-crop can also improve the opportunity for increased revenue and profit. Producers are able to shift and/or control the gender ratio of their calf crop by incorporating sex-sorted semen into their AI programs. However, decreased conception rates to AI have been previously observed when sex-sorted semen was used in comparison to conventional semen of the same sires. The objective of the first study was to determine if conception rates will differ …

Substance Use Among Transgender Students In California Public Middle And High Schools, Kris Tunac De Pedro, Tamika D. Gilreath, Christopher Jackson, Monica Christina Esqueda

Educational Leadership & Workforce Development Faculty Publications

BACKGROUND: Transgender adolescents face tremendous social stress in families and schools, which often leads to behavioral health disparities. This study assessed whether rates of substance use were higher among transgender adolescents when compared to nontransgender adolescents.

METHODS: This study is a secondary data analysis of the 2013-2015 California Healthy Kids Survey (CHKS) that examines whether rates of substance use are higher among transgender youth when compared to nontransgender youth. Participants included 4778 transgender and 630,200 nontransgender students in middle and high schools in nearly all school districts in California. The study outcomes were lifetime, recent, and in-school use of …

Social Health Insurance Coverage And Financial Protection Among Rural-To-Urban Internal Migrants In China: Evidence From A Nationally Representative Cross-Sectional Study, Wen Chen, Qi Zhang, Andre M. N. Renzaho, Fangjing Zhou, Hui Zhang, Li Ling

Community & Environmental Health Faculty Publications

INTRODUCTION: Migrants are a vulnerable population and could experience various challenges and barriers to accessing health insurance. Health insurance coverage protects migrants from financial loss related to illness and death. We assessed social health insurance (SHI) coverage and its financial protection effect among rural-to-urban internal migrants (IMs) in China.

METHODS: Data from the '2014 National Internal Migrant Dynamic Monitoring Survey' were used. We categorised 170 904 rural-to-urban IMs according to their SHI status, namely uninsured by SHI, insured by the rural SHI scheme (new rural cooperative medical scheme (NCMS)) or the urban SHI schemes (urban employee-based basic medical insurance (UEBMI)/urban …

The Role Of Neighborhood Characteristics In Late Stage Melanoma Diagnosis Among Hispanic Men In California, Texas, And Florida, 1996-2012, Valerie M. Harvey, Clinton W. Enos, Jarvis T. Chen, Hadiza Galadima, Karl Eschbach

Community & Environmental Health Faculty Publications

Background. Hispanics diagnosed with cutaneous melanoma are more likely to present at advanced stages but the reasons for this are unknown. We identify census tracts at high risk for late stage melanoma diagnosis (LSMD) and examine the contextual predictors of LSMD in California, Texas, and Florida. Methods. We conducted a cross-sectional study using geocoded state cancer registry data. Using hierarchical multilevel logistic regression models we estimated ORs and 95% confidence intervals for the impact of socioeconomic, Hispanic ethnic concentration, index of dissimilarity, and health resource availability measures on LSMD. Results. We identified 12,493 cases. In California, late …

Unconditional Government Cash Transfer In Support Of Orphaned And Vulnerable Adolescents In Western Kenya: Is There An Association With Psychological Wellbeing?, Sylvia Shangani, Don Operario, Becky Genberg, Kipruto Kirwa, Miriam Midoun, Lukoye Atwoli, David Ayuku, Omar Galárraga, Paula Braitstein

Community & Environmental Health Faculty Publications

Background

Orphaned and vulnerable adolescents (OVA) in sub-Saharan Africa are at greater risk for adverse psychological outcomes compared with their non-OVA counterparts. Social interventions that provide cash transfers (CTs) have been shown to improve health outcomes among young people, but little is known about their impact on the psychological wellbeing of OVA.

Objective

Among OVA in western Kenya, we assessed the association between living in a household that received monthly unconditional government CTs and psychological wellbeing.

Methods

We examined the likelihood of depression, anxiety, post-traumatic stress symptoms (PTSS) and positive future outlook among 655 OVA aged between 10 and 18 …

Stand At Ease, Then Forward, March!, Janice E. Hawkins

Ellmer School of Nursing Faculty Publications

(First paragraph) I enlisted in the U.S. Army in 1985. After reporting for basic training, I learned to execute military formation maneuvering commands. Military formations help organize ceremonial parades, gain tactical advantage, and create discipline. It occurs to me that the same elements that contribute to effective functioning of a military unit- ceremony, tactical planning, and discipline- also contribute to achieving one's goals after completing graduate school.

Detecting Agitation Onset In Individuals With Dementia Using Smart Phone Sensors, Christianne Fowler, Ajay Gupta, Kurt Maly, Karen Karlowicz, Maheedhar Gunnam, Rohila Gudipati, Mahesh Kukunooru, Rahul Rachamalla

Ellmer School of Nursing Faculty Publications

Individuals living with dementia (ILWD) often experience problematic agitated behaviors, this occurs in up to 80% of ILWD. These behaviors lead to stress for caregivers and increased frequency of institutionalization. There are many proven methods to intervene during agitated behavior outburst and the earlier these methods are used the better the results. Technology has been used successfully to monitor many aspects of health monitoring for older adults. Technology is now being investigated to evaluate the effectiveness of predicting the onset of problem behaviors, especially escalating agitation in ILWD. Off the shelf technology, smart watches and android phones, are being tested …

Educational Model To Increase The Number And Diversity Of Rn To Bsn Graduates From A Resource-Limited Rural Community, Janice E. Hawkins, Lynn Wiles, Karen Karlowicz, Kimberly Adams Tufts

Ellmer School of Nursing Faculty Publications

Increasing the number of BSN-prepared nurses at the bedside is directly linked to improved health care outcomes. However, employers are challenged to find enough BSN graduates to meet workforce demands. This article presents an educational model that uses evidence-based practices to increase enrollment, retention, and graduation rates of RN students in a BSN program (RN-BSN) in a resource limited rural community. This exemplar may equip nurse educators with strategies to adopt in their own communities.

Impact Of Disease On The Survival Of Three Commercially Fished Species, John M. Hoenig, Maya L. Groner, Matthew W. Smith, Wolfgang K. Vogelbein, David M. Taylor, Donald F. Landers Jr., John T. Swenarton, David T. Gauthier

Biological Sciences Faculty Publications

Recent increases in emergent infectious diseases have raised concerns about the sustainability of some marine species. The complexity and expense of studying diseases in marine systems often dictate that conservation and management decisions are made without quantitative data on population-level impacts of disease. Mark-recapture is a powerful, underutilized, tool for calculating impacts of disease on population size and structure, even in the absence of etiological information. We applied logistic regression models to mark-recapture data to obtain estimates of disease-associated mortality rates in three commercially important marine species: snow crab (Chionoecetes opilio) in Newfoundland, Canada, that experience sporadic epizootics …

Changes In Postural Sway Behavior Across The Life Span, Maria M B N R Santos

Graduate Student Theses, Dissertations, & Professional Papers

The present study aimed to investigate human balance control by assessing postural sway on three groups representing three stages of life (6-12, 19-40 and 65-74 years old). There were 14 individuals in each group and they were tested during upright bipedal stance with either eyes open or closed. Focus was given to multiple sway indices representing multi-dimensional features of postural sway in quiet stance and included: the center of pressure area, amplitude, root mean square (RMS), velocity, jerkiness, and sample entropy. Results confirmed that children and seniors swayed more (p<.004), faster (p<.001) and their body sway was shakier (p<.001) than young adults. Seniors also presented faster (p<.006) and shakier (p<.001) sway than children and a more unpredictable pattern of body sway in time (p<.002) than children and young adults. In addition, children presented a more random anterior-posterior sway (p<.034) and a more regular medio-lateral sway (p<.043) than young adults, and a higher synchronization between anterior-posterior and medio-lateral body sway (p<.012) than young adults and seniors. We also observed that postural control of children and young adults becomes relatively more challenged in experimental situations when eyes were closed for most postural indices. In conclusion, this study suggests that multi-dimension posturography is sensitive to detect subtle age-related changes in the postural behavior and each stage of life may have their own signature patterns of postural behavior. Therefore, we expect that quantifications of this nature may be used to assess not only postural instability and fall risk but also to aid the testing of the efficacy of balance interventional protocols.

Caregiver Perspectives: A Phenomenological Study Of Group Education During An Intensive Comprehensive Aphasia Program, Maggie Colstad

Graduate Student Theses, Dissertations, & Professional Papers

The purpose of this study was to explore the benefits of a caregiver education, training, and wellness program to improve caregiver outcomes in the context of aphasia rehabilitation. Eight caregivers participated in one-hour group treatment sessions across four weeks as part of an intensive comprehensive aphasia program. Information about stroke and aphasia was provided in a didactic format, and facilitative communication strategies were discussed and practiced using Kolb’s (1984) experiential learning cycle model. This qualitative study adhered to Moustakas’ phenomenological approach. Participant post-treatment interviews were transcribed and coded for themes relating to their experiences throughout the treatment program. Caregivers described …

Examining The Relationship Between Different Pitching Mechanics And Throwing Injuries, Zachary M. Mccarthy

Graduate Student Theses, Dissertations, & Professional Papers

Throwing injuries in baseball are increasing amongst major league baseball pitchers. Injuries to the shoulder complex and elbow ligamentous structures are increasing. Variables including pitch count, pitch type, throwing style, and duration of the game have all been “linked” to potential injury. Noticing the realtionship between these variables and injuries can lead to an upward trend in the decrease of throwing injuries.

Poison In Pink, Sydney V. Cook

Graduate Student Theses, Dissertations, & Professional Papers

Humans slather, spray, mist, and cleanse their bodies with personal care products like lotion, hairspray, cologne, and shampoo every day. Our cupboards are stocked full of them, but few of us understand what is in those jars and bottles. We trust that if it’s on the shelf at the store, it’s safe. However, this is not always the case, and many personal care products contain chemicals that are harmful to human and environmental health.

My multi-disciplinary Environmental Studies thesis project combines evidenced-based research, interviews, nonfiction narrative, and science communication to create part of a book manuscript intended to educate general …

A Study Of Visible Tattoos In Entry -Level Dental Hygiene Education Programs, Kathryn R. Search, Susan L. Tolle, Gayle Mccombs, Aaron Arndt

Dental Hygiene Faculty Publications

Purpose: The purpose of this study was to survey entry-level dental hygiene program directors in the United States (US) to assess their perceptions of dental hygienists with visible tattoos as well as to determine current policies related to dress codes in US dental hygiene programs.

Methods: Data was collected with an online survey emailed to 340 dental hygiene program directors from March to April 2016, yielding a 43% (n = 141) response rate. Participants indicated their opinions of visible tattoos on the basis of professionalism and school policy requirements.

Results: Eighty percent of respondents reported their program …

Defining The Risk Of Zika And Chikungunya Virus Transmission In Human Population Centers Of The Eastern United States, Carrie A. Manore, Richard S. Ostfeld, Folashade B. Agusto, Holly Gaff, Shannon L. Ladeau

Biological Sciences Faculty Publications

The recent spread of mosquito-transmitted viruses and associated disease to the Americas motivates a new, data-driven evaluation of risk in temperate population centers. Temperate regions are generally expected to pose low risk for significant mosquito-borne disease; however, the spread of the Asian tiger mosquito (Aedes albopictus) across densely populated urban areas has established a new landscape of risk. We use a model informed by field data to assess the conditions likely to facilitate local transmission of chikungunya and Zika viruses from an infected traveler to Ae. albopictus and then to other humans in USA cities with variable human …

Autologous Blood And Platelet-Rich Plasma Injections In The Treatment Of Achilles Tendinopathy: A Critically Appraised Topic, Cori Sinnott, Hayley M. White, Jennifer W. Cuchna, Bonnie L. Van Lunen

Rehabilitation Sciences Faculty Publications

Clinical Scenario: Achilles tendinopathy is a painful condition commonly affecting the general and athletic population. It presents with localized pain, stiffness, and swelling in the midportion of the Achilles tendon. The physical stress placed on the tendon results in microtrauma, which leads to subsequent inflammation and degeneration. While it is not surprising that this condition affects the physically active, nearly one-third of Achilles tendinopathy cases occur in sedentary individuals. Etiology for this condition stems from a change in loading patterns and/or overuse of the tendon, resulting in microscopic tearing and degenerative changes. There are numerous causes contributing to the …

Comparison Of A Head Mounted Impact Measurement Device To The Hybrid Iii Anthropomorphic Testing Device In A Controlled Laboratory Setting, Eric Schussler, David Stark, John H. Bolte, Yun Seok Kang, James A. Onate

Rehabilitation Sciences Faculty Publications

Background: Reports estimate that 1.6 to 3.8 million cases of concussion occur in sports and recreation each year in the United States. Despite continued efforts to reduce the occurrence of concussion, the rate of diagnosis continues to increase. The mechanisms of concussion are thought to involve linear and rotational head accelerations and velocities. One method of quantifying the kinematics experienced during sport participation is to place measurement devices into the athlete’s helmet or directly on the athlete’s head.

Purpose: The purpose of this research to determine the accuracy of a head mounted device for measuring the head accelerations experienced by …

60 ปี จุฬาลงกรณ์เวชสาร: รากฐานจากอดีตสู่การพัฒนา ในปัจจุบันและความก้าวไกลในอนาคตอย่างยั่งยืน, สิทธิศักดิ์ หรรษาเวก

Chulalongkorn Medical Journal

ตลอด 60 ปีที่ผ่านมา จุฬาลงกรณ์เวชสารและวารสาร Asian Biomedicine สามารถเจริญรุดหน้าจากอดีตสู่ปัจจุบันได้อย่างสง่างามและน่าภาคภูมิใจ เพราะคุณูปการของบรรดาอาจารย์ทั้งหลาย ตลอดจนผู้บริหารที่มีวิสัยทัศน์และบุคลากรอื่นอีกมากที่ไม่ได้กล่าวถึง จากอดีตถึงปัจจุบัน ได้ช่วยกันพัฒนามาอย่างต่อเนื่อง การที่วารสารทั้ง 2 จะก้าวไกลไปสู่อนาคตอย่างยั่งยืนได้ ย่อมต้องอาศัยความร่วมมือร่วมใจ รวบรวมพละกำลังกาย กำลังใจและสติปัญญา รวมทั้งการเสียสละอุทิศเวลาของทุกคนในคณะแพทยศาสตร์ และโรงพยาบาลจุฬาลงกรณ์ตลอดจนนิสิตแพทย์ แพทย์ประจำบ้าน นิสิตระดับปริญญาโท/เอก อาจารย์ และเจ้าหน้าที่ทุกระดับ สามารถส่งบทความวิชาการเพื่อเข้ารับการพิจารณาตีพิมพ์ได้ตลอดเวลา อันจะทำให้กิจการของวารสารดำเนินไปได้ขอขอบคุณบุคลากรในหน่วยวารสารทุกคน ซึ่งช่วยกันทำงานอย่างเต็มความสามารถการได้รับการสนับสนุนบุคลากรและงบประมาณจากทางคณะ จะช่วยให้วารสารทั้ง 2 ได้ดำเนินก้าวหน้ามั่นคงถาวรไปในอนาคตอย่างยั่งยืน.