Public Health Commons^™

Climate And Health: Impact Of Climate Education On Nursing Student Knowledge, Confidence, And Intent To Act, Beth Tremblay, Janice Hawkins

Ellmer School of Nursing Faculty Publications

Background: Because climate change negatively impacts human health, nurses need skills to mitigate climate change and nurse educators need effective educational strategies to teach climate change content in undergraduate nursing programs. To address this need, we embedded an energy efficiency treasure hunt and Climate for Health Ambassador Training into our prelicensure nursing curricula.

Purpose: To evaluate the impact of these educational activities on self-reported knowledge, confidence, and intent to engage in climate action.

Methods: A quasi-experimental one-group posttest design examined the effectiveness of 2 educational interventions on increasing knowledge, confidence, and intent to engage in climate action. A convenience sample …

Connecting Antibiotic Resistance To The Environment (Care): Introducing A Novel Framework Integrating Chemical Cross-Resistance And Place-Based Engagement To The Blue Marsh Watershed In Reading, Pennsylvania, Jill Felker

Antioch University Dissertations & Theses

Antibiotic resistance is a serious health threat around the world. Millions of individuals are infected with antibiotic-resistant bacteria yearly, and thousands die from previously curable illnesses. Although antibiotic resistance occurs naturally, misuse of antibiotics accelerates the loss of their effectiveness. Public health campaigns focusing on antibiotic awareness have not effectively communicated and educated the public on this health crisis. New efforts to combat antibiotic resistance are urgently needed. This dissertation focuses on the ecological and public health components of antibiotic resistance research that must be addressed to decelerate antibiotic resistance. A new interdisciplinary theoretical framework was developed to Connect Antibiotic …

Development Of A Scoring Tool For Australian Rural Food Retail Environments, Tracy L. Schumacher, Carissa A. Alderton, Leanne J. Brown, Susan Heaney, Laura Alston, Katherine Kent, Stephanie L. Godrich

Research outputs 2022 to 2026

Current tools scoring the healthiness of food retail outlets do not reflect outlets found in rural locations. This study aimed to adapt pre-existing Australian scoring tools to represent non-metropolitan areas. Rural nutrition experts were identified, and a modified Delphi technique was used to adapt two pre-existing, food-scoring tools in five iterative stages. Stages included identifying all relevant outlets, providing a description and score for each, ensuring consistency between outlet scores and pre-existing, metro-centric tools, and providing instructions for correct use. Six rural nutrition experts were identified and engaged in the modified Delphi technique. The final tool consisted of 12 categories …

On Kernel-Based Estimator Of Odds Ratio Using Different Stratified Sampling Schemes, Abbas Eftekharian, Hani Samawi, Haresh Rochani

Biostatistics, Epidemiology & Environmental Health Sciences: Faculty Publications

The kernel-based estimator of Cochran Mantel-Haenszel odds ratio based on stratified simple and ranked set sampling is proposed. The expectation and variance of the estimator are analytically obtained. Using a simulation study, the estimator based on stratified ranked set sampling is more efficient than its counterpart based on stratified simple random sampling. Finally, the estimator's performance is investigated by using base deficit data.

Medical Racism: Comparing Prenatal Care Across Races In The United States, Rubina Cheema

Student Research

Prenatal care describes any care a woman receives during her pregnancy. It is intended to keep both the mother and the child healthy and also to reduce the risk of complications during and after birth. This care is especially important for women with high-risk factors so that doctors and nurses are able to monitor their health and the health of their baby during the duration of their pregnancy. For prenatal care to be most effective, it is imperative to begin prenatal care within the first trimester of a woman's pregnancy. However, in the United States, medical racism creates a major …

Editorial: Sustainability Of Physical Activity Interventions And Public Health, Erica Y. Lau, Maureen C. Ashe, Sharon E. Taverno, Russell R. Pate Ph.D.

Faculty Publications

No abstract provided.

Association Of Chlorhexidine Use And Scaling And Root Planing With Birth Outcomes In Pregnant Individuals With Periodontitis: A Systematic Review And Meta-Analysis, Maxwell Akonde, Rajat Das Gupta, Maxwell Akonde, Mark Reynolds, Stephanie Smith-Warner, Jihong Liu Sc.D., Fouzia Tarannum, James Beck, Donald Mattison

Faculty Publications

Importance Chlorhexidine mouthwash enhances treatment effects of conventional periodontal treatment, but data on chlorhexidine as a source of heterogeneity in meta-analyses assessing the treatment of maternal periodontitis in association with birth outcomes are lacking.

Objective To assess possible heterogeneity by chlorhexidine use in randomized clinical trials (RCTs) evaluating the effect of periodontal treatment (ie, scaling and root planing [SRP]) vs no treatment on birth outcomes.

Data Sources Cochrane Oral Health’s Trials Register, Cochrane Pregnancy and Childbirth’s Trials Register, Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE Ovid, Embase Ovid, LILACS BIREME Virtual Health Library (Latin American and Caribbean Health Science …

Association Of Chlorhexidine Use And Scaling And Root Planing With Birth Outcomes In Pregnant Individuals With Periodontitis: A Systematic Review And Meta-Analysis, Anwar T. Nerchant, Rajat Das Gupta, Maxwell Akonde, Mark Reynolds, Stephanie Smith-Warner, Jihong Liu, Fouzia Tarannum, James Beck, Donald Mattison

Faculty Publications

Importance Chlorhexidine mouthwash enhances treatment effects of conventional periodontal treatment, but data on chlorhexidine as a source of heterogeneity in meta-analyses assessing the treatment of maternal periodontitis in association with birth outcomes are lacking.

Objective To assess possible heterogeneity by chlorhexidine use in randomized clinical trials (RCTs) evaluating the effect of periodontal treatment (ie, scaling and root planing [SRP]) vs no treatment on birth outcomes.

Data Sources Cochrane Oral Health’s Trials Register, Cochrane Pregnancy and Childbirth’s Trials Register, Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE Ovid, Embase Ovid, LILACS BIREME Virtual Health Library (Latin American and Caribbean Health Science …

Crisisready's Novel Framework For Transdisciplinary Translation: Case-Studies In Wildfire And Hurricane Response, Andrew Schroeder, Caleb Dresser, Akash Yadav, Jennifer Chan, Shenyue Jia, Caroline Buckee, Satchit Balsari

Institute for ECHO Articles and Research

Extreme weather events including wildfires and hurricanes are becoming increasingly hazardous due to climate change, and often result in transient or permanent population displacements. Disaster-related disruptions in infrastructure, workforce, wages, and social networks can combine with population displacements to result in interruptions in health care access and prolonged impacts on morbidity and mortality. The data needed to make health systems and emergency management approaches more resilient to these hazards, and more responsive to the needs of affected populations, are sequestered in silos across private corporations and public agencies. In two case studies, we describe how our research team at CrisisReady …

Predictors Of Covid-19 Vaccination Rate In Usa: A Machine Learning Approach, Syed M. I. Osman, Ahmed Sabit

WCBT Faculty Publications

In this study, we examine state-level features and policies that are most important in achieving a threshold level vaccination rate to curve the effects of the COVID-19 pandemic. We employ CHAID, a decision tree algorithm, on three different model specifications to answer this question based on a dataset that includes all the states in the United States. Workplace travel emerges as the most important predictor; however, the governors’ political affiliation (PA) replaces it in a more conservative feature set that includes economic features and the growth rate of COVID-19 cases. We also employ several alternative algorithms as a robustness check. …

A Bayesian Susceptible-Infectious-Hospitalized-Ventilated-Recovered Model To Predict Demand For Covid-19 Inpatient Care In A Large Healthcare System, Stella Coker Watson Self Ph.D., Ms, Rongjie Huang, Shrujan Amin, Joseph Ewing, Carolina Rudisill, Alexander C. Mclain Ph.D.

Faculty Publications

The COVID-19 pandemic has strained healthcare systems in many parts of the United States. During the early months of the pandemic, there was substantial uncertainty about whether the large number of COVID-19 patients requiring hospitalization would exceed healthcare system capacity. This uncertainty created an urgent need to accurately predict the number of COVID-19 patients that would require inpatient and ventilator care at the local level. As the pandemic progressed, many healthcare systems relied on such predictions to prepare for COVID-19 surges and to make decisions regarding staffing, the discontinuation of elective procedures, and the amount of personal protective equipment (PPE) …

A Bayesian Susceptible-Infectious-Hospitalized-Ventilated-Recovered Model To Predict Demand For Covid-19 Inpatient Care In A Large Healthcare System, Stella Coker Watson Self Ph.D., Ms, Rongjie Huang, Shrujan Amin, Joseph Ewing, Caroline Rudisill, Alexander C. Mclain

Faculty Publications

The COVID-19 pandemic has strained healthcare systems in many parts of the United States. During the early months of the pandemic, there was substantial uncertainty about whether the large number of COVID-19 patients requiring hospitalization would exceed healthcare system capacity. This uncertainty created an urgent need to accurately predict the number of COVID-19 patients that would require inpatient and ventilator care at the local level. As the pandemic progressed, many healthcare systems relied on such predictions to prepare for COVID-19 surges and to make decisions regarding staffing, the discontinuation of elective procedures, and the amount of personal protective equipment (PPE) …

Survival Of Epithelial Ovarian Cancer In Black Women: A Society To Cell Approach In The African American Cancer Epidemiology Study (Aaces), Joellen M. Schildkraut, Courtney Johnson, Lauren F. Dempsey, Bo Qin, Paul Terry, Maxwell Akonde, Edward S. Peters, Hannah Mandle, Michele L. Cote, Lauren Peres, Patricia Moorman, Ann G. Schwartz, Micheal Epstein, Jeffrey Marks, Melissa Bondy, Andrew B. Lawson, Anthony Alberg, Elisa V. Bandera

Faculty Publications

Purpose

The causes for the survival disparity among Black women with epithelial ovarian cancer (EOC) are likely multi-factorial. Here we describe the African American Cancer Epidemiology Study (AACES), the largest cohort of Black women with EOC.

Methods

AACES phase 2 (enrolled 2020 onward) is a multi-site, population-based study focused on overall survival (OS) of EOC. Rapid case ascertainment is used in ongoing patient recruitment in eight U.S. states, both northern and southern. Data collection is composed of a survey, biospecimens, and medical record abstraction. Results characterizing the survival experience of the phase 1 study population (enrolled 2010–2015) are presented.

Results …

Experiences Of Parents With Opioid Use Disorder During Their Attempts To Seek Treatment: A Qualitative Analysis, Christine Bakos-Block, Angela J Nash, A Sarah Cohen, Tiffany Champagne-Langabeer

Faculty, Staff and Student Publications

In the U.S., 12.3% of children live with at least one parent who has a substance use disorder. Prior research has shown that men are more likely to seek treatment than women and that the barriers are different; however, there is limited research focusing specifically on opioid use disorder (OUD). We sought to understand the barriers and motivators for parents with OUD. We conducted a qualitative study by interviewing parents with OUD who were part of an outpatient treatment program. Interviews followed a semi-structured format with questions on access to and motivation for treatment. The interviews were recorded and transcribed …

Effects Of A Behavioral Intervention On Physical Activity, Diet, And Health-Related Quality Of Life In Pregnant Women With Elevated Weight: Results Of The Hipp Randomized Controlled Trial, Sarah Wilcox Phd, Jihong Liu, Gabrielle Turner-Mcgrievy Ph.D., Rd, Alycia K. Boutte, Ellen Wingard Msph, Rd, Ld

Faculty Publications

Background

Physical activity (PA), diet, and health-related quality of life (HRQOL) are related to maternal and infant health, but interventions to improve these outcomes are needed in diverse pregnant women with elevated weight.

Methods

Health In Pregnancy and Postpartum (HIPP) was a randomized controlled trial. Women who were pregnant (N=219, 44% African American, 56% white) with overweight or obesity but otherwise healthy were randomized to a behavioral intervention grounded in Social Cognitive Theory (n=112) or to standard care (n=107). The intervention group received an in-depth counseling session, a private Facebook group, and 10 content-based …

Metabolic Alterations And Cardiovascular Risk After Hepatitis C Cure In Subjects With Or At Risk For Hiv, Christophe Maxime Fokoua Dongmo

Legacy Theses & Dissertations (2009 - 2024)

Background. Hepatitis C virus (HCV) infection engenders substantial metabolic changes. These changes are altered when the virus is cleared after successful treatment. We measured these metabolic alterations that occur after HCV cure; further, we assessed whether these alterations differed in subgroups defined by patients’ characteristics.

Evaluating The Health Impacts Of Fruit And Vegetable Intake At The Individual Level And Food Pantry Level Among Food Pantry Users, Jiacheng Chen

Legacy Theses & Dissertations (2009 - 2024)

Background: Chronic diseases impose heavy burdens on individuals and the healthcare system in the US. Many factors were found to be associated with chronic diseases, including demographics, family history, social environmental factors, and individual behavioral factors such as diet and physical activity. Among those factors, fruit and vegetable intake can have substantial health impacts via a variety of causal pathways. Fruit and vegetable (F&V) consumption is generally lower among individuals living in households experiencing food insecurity and rely on food assistance programs. Decreased F&V intake among food pantry users may negatively impact health. However, conducting quantitative analysis on this population …

Measuring The Economic Impact Of Recurrent Flooding On Workforce Productivity And Property, Joshua G. Behr, Wie Yusuf, George Mcleod, Sarah Stafford, Derek Loftis, Afi Anuar, Rafael Diaz

Presentations, Lectures, Posters, Reports

From the Executive Summary:

This research draws upon expertise across multiple disciplines and fields. Leveraged are natural systems data and social-behavioral data. The high-level objective is to advance our understanding of how very recent recurrent flooding has impacted residents within the City of Portsmouth, and then forecast these impacts under projections of sea level rise. While this research draws upon data for the City of Portsmouth, the findings may be generalized to the broader Hampton Roads region.

Estimating The Distribution Of Ratio Of Paired Event Times In Phase Ii Oncology Trials, Li Chen, Mark Burkard, Jianrong Wu, Jill M. Kolesar, Chi Wang

Markey Cancer Center Faculty Publications

With the rapid development of new anti-cancer agents which are cytostatic, new endpoints are needed to better measure treatment efficacy in phase II trials. For this purpose, Von Hoff (1998) proposed the growth modulation index (GMI), that is, the ratio between times to progression or progression-free survival times in two successive treatment lines. An essential task in studies using GMI as an endpoint is to estimate the distribution of GMI. Traditional methods for survival data have been used for estimating the GMI distribution because censoring is common for GMI data. However, we point out that the independent censoring assumption required …

Bayesian Methods For Graphical Models With Neighborhood Selection., Sagnik Bhadury

Electronic Theses and Dissertations

Graphical models determine associations between variables through the notion of conditional independence. Gaussian graphical models are a widely used class of such models, where the relationships are formalized by non-null entries of the precision matrix. However, in high-dimensional cases, covariance estimates are typically unstable. Moreover, it is natural to expect only a few significant associations to be present in many realistic applications. This necessitates the injection of sparsity techniques into the estimation method. Classical frequentist methods, like GLASSO, use penalization techniques for this purpose. Fully Bayesian methods, on the contrary, are slow because they require iteratively sampling over a quadratic …

Infrastructure Development For Personalized Risk Prediction To Reduce Cardiovascular Disease In Childhood Cancer Survivors, Suman Shrestha

Dissertations and Theses (Open Access)

Although childhood cancer survivors have lengthy life expectancies, they run the risk of experiencing long-term health issues as a result of their treatment. The most frequent non-cancerous cause of morbidity and mortality for these survivors is cardiac disease. Radiation therapy (RT) has been linked in numerous cohort studies to a higher chance of developing a late cardiac disease in these survivors, and this risk rises with higher mean heart doses and increased RT exposure to larger cardiac volumes. Since, the heart is a heterogeneous organ made up of several distinct substructures, RT dose received by the entire heart does not …

Use Of Healthcare Utilization Records For Analyzing Trends In Clinical Toxoplasmosis: A Comparison Of Nevada And The United States, Elijah Kreutzer

UNLV Theses, Dissertations, Professional Papers, and Capstones

Toxoplasmosis, a zoonotic disease caused by the parasitic protist Toxoplasma gondii, is a ubiquitous, global public health concern with a wide variety of clinical manifestations. Surveillance for the disease is lacking even in developed countries, and what surveillance is present most often focuses on pregnant women. This research investigated trends in clinical toxoplasmosis in Nevada and nationally to address the lack of knowledge concerning how Nevada discharges compare to national discharges in cases of toxoplasmosis. Specifically, this research sought to determine what characterizes toxoplasmosis in Nevada across inpatient, outpatient, and emergency department settings, as well as how these cases differ …

A Bootstrap Method For A Multiple-Imputation Variance Estimator In Survey Sampling, Lili Yu, Yichuan Zhao

Biostatistics, Epidemiology & Environmental Health Sciences: Faculty Publications

Rubin’s variance estimator of the multiple imputation estimator for a domain mean is not asymptotically unbiased. Kim et al. derived the closed-form bias for Rubin’s variance estimator. In addition, they proposed an asymptotically unbiased variance estimator for the multiple imputation estimator when the imputed values can be written as a linear function of the observed values. However, this needs the assumption that the covariance of the imputed values in the same imputed dataset is twice that in the different imputed datasets. In this study, we proposed a bootstrap variance estimator that does not need this assumption. Both theoretical argument and …

Pandemic Fatigue Impedes Mitigation Of Covid-19 In Hong Kong, Zhanwei Du, Lin Wang, Songwei Shan, Dickson Lam, Tim K. Tsang, Jingyi Xiao, Huizhi Gao, Bingyi Yang, Sheikh Taslim Ali, Sen Pei, Isaac Chun-Hai Fung, Eric H. Y. Lau, Qiuyan Liao, Peng Wu, Lauren Ancel Meyers, Gabriel M. Leung, Benjamin Cowling

Biostatistics, Epidemiology & Environmental Health Sciences: Faculty Publications

Hong Kong has implemented stringent public health and social measures (PHSMs) to curb each of the four COVID-19 epidemic waves since January 2020. The third wave between July and September 2020 was brought under control within 2 m, while the fourth wave starting from the end of October 2020 has taken longer to bring under control and lasted at least 5 mo. Here, we report the pandemic fatigue as one of the potential reasons for the reduced impact of PHSMs on transmission in the fourth wave. We contacted either 500 or 1,000 local residents through weekly random-digit dialing of landlines …

Association Between The Health Belief Model, Exercise, And Nutrition Behaviors During The Covid-19 Pandemic, Keagan Kiely, Bill Mase, Andrew R. Hansen, Jessica S. Schwind

Biostatistics, Epidemiology & Environmental Health Sciences: Faculty Publications

Introduction: The COVID-19 pandemic has affected our nation’s health further than the infection it causes. Physical activity levels and dietary intake have suffered while individuals grapple with the changes in behavior to reduce viral transmission. With unique nuances regarding the access to physical activity and nutrition during the pandemic, the constructs of Health Belief Model (HBM) may present themselves differently in nutrition and exercise behaviors compared to precautions implemented to reduce viral transmission studied in previous research. The purpose of this study was to investigate the extent of exercise and nutritional behavior change during the COVID-19 pandemic and explain the …

Laboratory Evaluation And Field Feasibility Of Micro-Encapsulated Insecticide Effect On Rhodnius Prolixus And Triatoma Dimidiata Mortality In Rural Households In Boyaca, Colombia, Lidia Gual-Gonzalez, Manuel Medina, Cesar Valverde-Castro, Virgilio Beltran, Rodrigo Caro, Omar Triana-Chavez, Melissa Nolan Ph.D., Mph, Omar Cantillo-Barraza

Faculty Publications

Chagas disease is a neglected vector-borne zoonosis caused by the parasite Trypanosoma cruzi that is primarily transmitted by insects of the subfamily Triatominae. Although control efforts targeting domestic infestations of Rhodnius prolixus have been largely successful, with several regions in Boyacá department certified free of T. cruzi transmission by intradomicile R. prolixus, novel native species are emerging, increasing the risk of disease. Triatoma dimidiata is the second most important species in Colombia, and conventional control methods seem to be less effective. In this study we evaluated the efficacy and usefulness of micro-encapsulated insecticide paints in laboratory conditions and its …

A Review Of Risk Concepts And Models For Predicting The Risk Of Primary Stroke, Elizabeth Hunter, John D. Kelleher

Articles

Predicting an individual's risk of primary stroke is an important tool that can help to lower the burden of stroke for both the individual and society. There are a number of risk models and risk scores in existence but no review or classification designed to help the reader better understand how models differ and the reasoning behind these differences. In this paper we review the existing literature on primary stroke risk prediction models. From our literature review we identify key similarities and differences in the existing models. We find that models can differ in a number of ways, including the …

I-Climate: A “Clinical Climate Informatics” Action Framework To Reduce Environmental Pollution From Healthcare, Dean F Sittig, Jodi D Sherman, Matthew J Eckelman, Andrew Draper, Hardeep Singh

Faculty, Staff and Student Publications

Addressing environmental pollution and climate change is one of the biggest sociotechnical challenges of our time. While information technology has led to improvements in healthcare, it has also contributed to increased energy usage, destructive natural resource extraction, piles of e-waste, and increased greenhouse gases. We introduce a framework "Information technology-enabled Clinical cLimate InforMAtics acTions for the Environment" (i-CLIMATE) to illustrate how clinical informatics can help reduce healthcare's environmental pollution and climate-related impacts using 5 actionable components: (1) create a circular economy for health IT, (2) reduce energy consumption through smarter use of health IT, (3) support more environmentally friendly decision-making …

Sars-Cov-2 Spike Conformation Determines Plasma Neutralizing Activity Elicited By A Wide Panel Of Human Vaccines, John E. Bowen, Young-Jun Park, Cameron Stewart, Jack T. Brown, William K. Sharkey, Alexandra C. Walls, Anshu Joshi, Kumail Ahmed, Asefa Shariq, Najeeha Talat Iqbal

Department of Paediatrics and Child Health

Numerous safe and effective coronavirus disease 2019 vaccines have been developed worldwide that use various delivery technologies and engineering strategies. We show here that vaccines containing prefusion-stabilizing S mutations elicit antibody responses in humans with enhanced recognition of S and the S1 subunit relative to postfusion S as compared with vaccines lacking these mutations or natural infection. Prefusion S and S1 antibody binding titers positively and equivalently correlated with neutralizing activity, and depletion of S1-directed antibodies completely abrogated plasma neutralizing activity. We show that neutralizing activity is almost entirely directed to the S1 subunit and that variant cross-neutralization is mediated …

The Dietary Inflammatory Index Is Associated With Subclinical Mastitis In Lactating European Women, Myriam C. Afeiche, Alison Iroz, Frank Thielecke, Antoino C. De Castro, Gregory Lefebvre, Colleen F. Draper, Cecilia Martiínez-Costa, Maria Jose Costeira, Mireille Vanpee, Claude Billeaud, Jean-Charles Picaud, Daryl Lim Kah Hian, Guimei Liu, Nitin Shivappa Mbbs, Mph, Ph.D., James Hébert Scd, Tinu M. Samuel

Faculty Publications

Subclinical mastitis (SCM) is an inflammatory state of the lactating mammary gland, which is asymptomatic and may have negative consequences for child growth. The objectives of this study were to: (1) test the association between the dietary inflammatory index (DII®) and SCM and (2) assess the differences in nutrient intakes between women without SCM and those with SCM. One hundred and seventy-seven women with available data on human milk (HM) sodium potassium ratio (Na:K) and dietary intake data were included for analysis. Multivariable logistic regression was used to examine the association between nutrient intake and the DII score in relation …