Public Health Commons^™

Odds Of Autism At 5 To 10 Years Of Age For Children Who Did Not Pass Their Aabr Newborn Hearing Screen, But Were Diagnosed With Normal Hearing, Shihfen Tu, Craig A. Mason, Deborah L. Rooks-Ellis, Patricia Lech

Journal of Early Hearing Detection and Intervention

Background: Research has found atypical Auditory Brainstem Response (ABR) activity in some children with Autism Spectrum Disorder (ASD). The current study examined whether an association may also be found between ASD and pass/refer results obtained via Automated Auditory Brainstem Response (AABR) screening. As stewards of large-scale AABR data, an AABR – ASD association may be of interest to EHDI programs.

Methods: State EHDI data for 29,350 children born in Maine between 2003 and 2005 were linked with education records, including special education status, for the 2010/2011 and 2013/2014 school years.

Results: Children who did not pass their …

Costing Of Actions To Safeguard Vulnerable Mexican Households With Young Children From The Consequences Of Covid-19 Social Distancing Measures, Mireya Vilar-Compte, Víctor Pérez, Graciela Teruel, Aranzazu Alonso, Rafael Pérez-Escamilla

Department of Public Health Scholarship and Creative Works

COVID-19 has imposed unprecedented challenges to society. As the pandemic evolves, the social distancing measures that have been globally enforced, while essential, are having undesirable socioeconomic side effects particularly among vulnerable populations. In Mexico, families who depend upon informal employment face increased threats to their wellbeing, and households who in addition have young children may face long-term consequences. The Mexican government has not yet taken actions, but a coalition of non-governmental organizations is advocating in partnership with academic institutions for social protection actions such as a cash transfer and basic services subsidies for families with young children, subsisting from the …

Student Wellbeing And Open Studio Process In The School Curriculum, Maria Kim

Expressive Therapies Dissertations

This study aimed to explore whether Open Studio Process (OSP) increased wellbeing of middle and high school students when facilitated by teachers as a part of the regular art curriculum. It was hypothesized that OSP might increase the sense of wellbeing among middle and high school students as well as facilitating teachers. The research was conducted as a mixed methods study in South Korea where students need preventative interventions for their wellbeing. The researcher trained eight teachers to facilitate OSP and five of them implemented it with their classes for seven sessions. Quantitative data (K-YSR; pre- and posttest) were collected …

Exploring The Experience Of Psychological Distress For Young Adults With Cancer: Implications For A New Diagnosis Of Medical Traumatic Stress, Audrey Ryan

Counseling and Psychology Dissertations

The purpose of this qualitative study was to investigate how a serious medical diagnosis, such as cancer, can act as an acute or prolonged trauma. This was explored through the lived experiences of psychological distress of young cancer survivors. Participants were 12 men and women who had been diagnosed with cancer within the past seven years when they were between the ages of 18 and 39. From these interviews several themes emerged that describe the phenomenon of what I have termed medical traumatic stress.

Trauma from a medical event does not currently meet criteria for PTSD in the DSM-5 …

Socioeconomic Status And Symptoms Of Anxiety And Depression In Pregnant Women, Meagan Mandabach

Honors Theses

Pregnancy is a period of great change in a woman’s body as her baby develops. During this period, women commonly experience symptoms of anxiety (Dennis et al., 2017) and depression (Shidhaye & Giri, 2014). Literature has suggested that socioeconomic status (SES) can contribute to the severity at which pregnant women experience anxiety and depression (Arora & Aeri, 2019; Field et al., 2008; Shagufta & Shams, 2019), and women of low socioeconomic status may be more likely to experience symptoms of anxiety and depression during pregnancy (Field et al., 2008). The present study aimed to assess the relationships between household income …

Polysubstance Exposure And Its Relationship To Pharmacological Treatment Characteristics, Parker Miller

Undergraduate Honors Theses

Neonatal Abstinence Syndrome (NAS) remains an ever-growing public health issue and a continued avenue for future research. The research question for this retrospective study was whether polysubstance exposure is related to the dose of medication the infant received or to the number of opioid-medications required to treat the infants’ withdrawal symptoms? The hypothesis for the retrospective study was there will be a significant relationship between polysubstance exposure and the dose of medication the infant received as well as the number of opioid-medications required to treat the infants’ withdrawal symptoms. A bivariate correlational indicated that there was not a significant association …

Safe Patient Handling – A Case For National Legislation, David O. Oba

Dissertations and Theses (Open Access)

Introduction: This study examined the effectiveness of Safe Patient Handling (SPH) legislations in difference states across the country. In January 2006, the state of Texas legislated the Safe Patient Handling and Movement Practices Act which required all hospitals and nursing homes to implement safe patient handling and movement program. To date, 10 other states have enacted law or regulations to control work-related musculoskeletal disorders (MSDs) among healthcare workers (HW). Despite the effectiveness of these policies in the individual states, MSDs remain prevalent among HW nationwide. Hence, the call for national legislation. Methods: Using the state-level incidence rate data from the …

Physician Hospital Arrangement Influence On Nonprofit Hospital Quality,Financial Performance And Community Benefit Expenditures, Andrea Cervin

Dissertations and Theses (Open Access)

Federal policy has encouraged hospitals to provide certain quality outcomes and cost containment. Hospitals have responded by forming physician hospital organizations in attempts to achieve quality outcomes and capture reimbursements. At the same time, federal policy has awarded hospitals with nonprofit status with the requirement to provide community benefits in exchange for the tax exemption they receive. With the formation of physician hospital organizations, there remains the question of whether hospitals are achieving desired quality metrics and whether hospitals are financially viable. There is also public and media interest recently regarding whether nonprofit hospitals fulfill their obligations for community benefit …

T​He​ E​Ffect​ ​Of​ U​Nconventional​ G​As​ ​And​ O​Il​ D​Rilling​ E​Missions​ ​On​ A​Sthma​ ​And​ R​Espiratory D​Iseases​ ​In​ ​The​ B​Arnett​ S​Hale​ ​Of​ T​Exas, Stella A. Okoroafor

Dissertations and Theses (Open Access)

Unconventional gas and oil drilling (UGOD) has increased substantially in the United States for more than a decade. The resultant environmental unsafe air pollution effects of UGOD both locally and regionally have been well documented in the literature. Despite the dramatic increase in unconventional well drilling and the toxicant exposure, the health consequences of UGOD remain largely uncertain. This study assesses the relationship between active wells and healthcare use for respiratory diseases by zip code from 2004 to 2008 in the Barnett shale area of Texas. The first modern shale gas well was drilled in the Barnett shale area of …

A Geospatial Examination Of The Association Between Geographic Food Access And Food Insecurity In Central Texas: The Role Of Race/Ethnicity And Urbanicity, Kathryn Janda

Dissertations and Theses (Open Access)

Food insecurity is a public health issue that affects one in ten Americans, one in seven Central Texans, and is associated with malnutrition, chronic disease, and obesity. Geographic food access is the most intervened upon aspect of food insecurity and is often measured objectively through mapping software, such as ArcGIS. Yet when geographic food access is only measured in terms of distance to food retail, analyses do not full capture the nuances of community context. Thus, other sources of data, like survey data, and demographic indicators, such as race/ethnicity and urbanicity, should be incorporated into the research exploring the association …

Determining The Drivers Of Quality Of Life In Hiv Patints Treated With Antiretroviral Therapy In Subsaharan Africa, Oubote Sangbana

Dissertations and Theses (Open Access)

During the last decade, HIV in sub-Saharan Africa has shifted from a fatal disease to a chronic condition thanks to the expansion of antiretroviral therapy (ART). As a result, the focus of care has transitioned from survival to quality of life (QoL), and the latter has become a significant outcome measure during patient follow up. Yet, the determinants of QoL among HIV patients in western and central Africa are not well known. The objective of this dissertation was to determine the main factors associated with QoL among ART-treated HIV adult patients in western and central Africa to ensure healthcare providers …

Utility Of Plasma Biomarkers In The Validation Of Reported Loc & Pta For Gcs 13-15 Patients: A Track-Tbi Pilot Study, Jeffrey Brennan

Dissertations and Theses (Open Access)

Depending on a brain injury patient to accurately report their duration of unconsciousness and amnesia is clearly flawed. We constructed biomarker-based models to validate these self-reported measurements using a GCS 13-15 subset of participants from TRACK-TBI, a multi-institutional study on traumatic brain injury. Potential covariates were assessed for significant interactions with biomarker level. We report that the predictions of LOC and PTA failed. GFAP exhibited the most consistent serum level increase between categories of both LOC and PTA. Given a number of issues with the study sample, we recommend continued investigation on the prediction of LOC and PTA using a …

Mode Of Delivery And Infant Cognitive Development, Madison Olson, Laura M. Glynn

Student Scholar Symposium Abstracts and Posters

The rate of nonindicated cesarean births is increasing each year within the United States. Although cesarean delivery can function as a life- saving intervention, emerging evidence suggests that it may also be associated with deleterious developmental consequences for the child. Here we test the hypothesis that mode of delivery is associated with cognitive development during infancy. 229 pregnant women were recruited and their infants’ cognitive development was assessed at 6, 12 and 24 months with the Bayley Scales of Infant Development. Medical charts were reviewed by obstetric nurses to determine prenatal medical risk and birth outcomes, including mode of delivery. …

Self Perception Of Dental Esthetics And Its Impact Among Adults Self Esteem In Sonoma And Marin County, Carolina Camacho

Global Public Health | Senior Theses

Background

One out of four American adults refrain from smiling attributable to the condition of their dentofacial area. The aim of this study was to analyze the relationship between self-perception of dental esthetics and individual self-esteem among Sonoma and Marin County adults. Analytical concepts and processes were utilized to determine and describe the statistical significance of this plausible association.

Methods

In order to assess the interconnection of this relationship from an analytical approach, an observational study design method was utilized consisting of both a quantitative and qualitative analysis. A total of 163 participants consensually responded to an online questionnaire containing …

The Impact Of Location On Healthcare Access For Individuals With Disabilities, Addison Kimber

Honors Scholar Theses

This paper analyzes healthcare access for individuals with disabilities living in rural areas. In current political discussion, we typically think of insurance coverage as the metric to analyze healthcare access. However, as demonstrated by studies of healthcare in the United Kingdom, people with disabilities continue to face barriers to health care even with universal healthcare systems. In particular, individuals in rural areas have less healthcare access than urban residents. This is due to factors including socioeconomic status, insurance coverage, access to competent care, and transportation. This study aims to understand if disability status exacerbates the issue of access in rural …

Assessing Conduct Disturbance And Fly Ash Exposure In Children., Jillian G. Winn

College of Arts & Sciences Senior Theses

Minimal research has been conducted on fly ash (a byproduct of coal combustion) and health outcomes among exposed communities, and even less has looked at its effect on children’s behavior. This study specifically looks at fly ash exposure and conduct disturbance, using logistic regression to characterize their relationship. Conduct disturbance was gauged by t-scores of 55 or higher on the dimensions of aggression and delinquency of the Child Behavior Checklist. Fly ash exposure was determined by air and surface sampling of the children’s homes. While the odds ratios suggested fly ash exposure increases the likelihood of conduct disturbance, the results …

Sample Size Calculations For Longitudinal Mediation Analysis With Continuous-Time Markov Chain Variables, Abigail Christine Sedory

Dissertations and Theses (Open Access)

Mediation is a type of analysis used to determine the causal mechanism linking a predictor and an outcome through a mediator variable. Various research has examined the inclusion of different variable types for the predictor, mediator, and outcome. However, no studies include the presence of a continuous-time Markov chain (CTMC) as any of the components in a mediating model. If researchers wanted to design a study with a CTMC in the mediating process, one of the first steps would be to determine the minimum number of subjects or observations needed to detect a significant mediating effect. Therefore, in this study, …

Nudging Quality Improvement In Cancer Care: Influence Of A Clinical Decision Support System To Nudge Adherance To Evidence Based Guidelines In Adult Cancers, Debra Patt

Dissertations and Theses (Open Access)

Cancer care is changing rapidly. Understanding of the increasing subtypes of cancer and exponentially increasing therapeutic interventions are unprecedented due to the rapid pace of scientific discovery and clinical innovation. This immense change within the field, lends itself to quality control initiatives, especially among general oncology providers who see a wide array of cancer types as general oncologists will see many different tumor types, and most of which have several potential treatment choices that have grown over time. Evidence-based pathways are an effective way to nudge quality control by presenting choice architecture at the point of care to facilitate guideline …

Understanding Participation In A Workplace Physical Activity Intervention Using Self-Determination Theory: The Booster Break Study, Kathleen Ochipa

Dissertations and Theses (Open Access)

Abstract: Sedentary behavior can lead to premature mortality, cardiovascular disease, Type 2 diabetes, and cancer incidence. Office workers are at risk for high amounts of sedentary behavior. Even brief bouts of physical activity that interrupt sedentary behavior can improve office workers’ physical and mental health. The workplace is an optimal setting for increasing physical activity and reducing sedentary behavior among office workers. However, limited literature exists related to the characteristics of participants that adhere to workplace physical activity interventions. This study aimed to identify characteristics of participants who enrolled in the Booster Break program, a 15 minute once-daily intervention during …

Economic Evaluation Of Implementing Hpv Vaccine Promotion Interventions For Cervical Cancer In The United States, Chi-Fang Wu

Dissertations and Theses (Open Access)

The HPV vaccine has been proven as a safe and effective method for preventing cervical cancer. However, the HPV vaccine coverage rate in the U.S. is suboptimal. Various interventions have been implemented to improve HPV vaccine coverage. However, evidence of the cost-effectiveness of HPV vaccine promotion interventions is lacking. We conducted an economic evaluation to assess HPV vaccine promotion interventions of cervical cancer in the U.S. Firstly, a systematic review was conducted to review evidence on interventions aimed at increasing HPV vaccine coverage and to summarize the cost and effectiveness of these interventions. We included 56 HPV vaccine promotion studies …

Comparison Of Interactive Electronic Versus Standard Document Method For Obtaining Patient Informed Consent, Jermaine Mcmillan

Dissertations and Theses (Open Access)

The primary objective of this study was to determine whether participants who received an interactive electronic consent (EC) had a better understanding of a medical procedure (apheresis) compared to those who received the standard document (SD) consent. The study was conducted with apheresis donors whose responses were used to determine if the EC facilitated better comprehension and retention of consent information by the study participants than by SD consenting methods. By comprehension, the goal was to have participants who can understand, summarize, or make judgments based on the content presented in the informed consent. By retention, the goal was to …

A Partial Likelihood Approach To Longitudinal Categorical Data Using A Continuous Time Semi-Markov Chain Model, Kusha A. Mohammadi

Dissertations and Theses (Open Access)

Longitudinal studies have been critical in understanding the characteristics of chronic diseases or interventions. Since many processes have natural multi-categorical responses over time, multi-state stochastic models have been used to estimate the transition rates between stages. Some multi-state models applied in practice assume the Markov property. The Markov property constrains the sojourn distribution to be exponentially distributed. While useful theoretical properties arise by the Markov assumption, we will consider a more flexible framework by allowing arbitrarily distributed waiting times. This describes a semi-Markov process which has already been applied to various fields in Public Health. Similar to Markov model developments, …

Pediatric Wound Care: What Can We Learn From A Systematic Review Of The Literature? Using A Systematic Review And A Clinical Consensus Group To Assess The Quality And Content Of Systematic Reviews Focusing On Pediatric Wound Care. Then Providing And Analytical Outline For Creation Of Pediatric Wound Care Guidelines For Evidence Based Clinical Practice, Ryan Krasnosky

Dissertations and Theses (Open Access)

Background: Wound care practices for neonatal and pediatric patients including the category of products, specific products within each category, and length of application of the products have created lack of standardized evidence-based guidelines for treatments in clinical practices. This dissertation addresses this concern by encompassing three crucial steps in developing evidence-based clinical guidelines for wound care specialists. Using a three-paper method, an expert consensus group was formed, a systematic review of reviews completed and a process for creating clinical decision trees created. Methods: Criteria for selection of the consensus group members included: 1) Research graduate active in Pediatric Wound Care …

Statistical Methods For Functional Annotation-Based Rare Variant Association Analysis, Yiding Ma

Dissertations and Theses (Open Access)

Despite ongoing large-scale population-based whole-genome sequencing (WGS) projects such as the TOPMed program, WGS-based association analysis of complex traits remains a tremendous challenge. External biological knowledge, such as functional annotations based on the ENCODE, Epigenomics Roadmap and GTEx projects, may be helpful in distinguishing causal rare variants from neutral ones; however, each functional annotation can only provide certain aspects of the biological functions. Our knowledge for selecting informative annotations a priori is limited and incorporating non-informative annotations will introduce noise and lose power. In the first part of this dissertation, we propose FunSPU, a versatile and adaptive test that incorporates …

An Assessment Of Outpatient Clinic Room Ventilation Systems And Possible Relationship To Disease Transmission, Kristin G. King

Dissertations and Theses (Open Access)

The delivery of healthcare in the United States is shifting from a largely inpatient model to an outpatient services model, but the physical infrastructure for outpatient clinics or medical offices may not be as robust as inpatient hospitals regarding whole room ventilation requirements. Guidelines for the design of healthcare facilities and national standards for ventilation establish generally acceptable ventilation rates for outpatient clinics, but it is unclear if these standards are actually being integrated into these settings. Published peer reviewed literature indicates that inadequate ventilation rates can be a risk factor in airborne transmission of infectious diseases in outpatient clinics, …

The Influence Of Brand Equity On Prescriber Behaviour In A Multisource Drug Market, Wanjiku Kariuki

Dissertations and Theses (Open Access)

When a patent expires, innovator (brand-name) drugs lose their monopoly status and new generic competitors are free to enter the market. Theoretically, free market entry and exit should lead to a drop in the price of the innovator drug as per the tenets of perfect competition. Yet instead of prices decreasing, innovator drug prices are often minimally impacted by generic competition and the innovator continues to maintain both market power and market share – a phenomenon labelled the generic competitor paradox (Scherer, 1993) That the expected supply and demand dynamic is less pronounced in multisource drug markets, suggests that non-price …

Development Of A Culinary Nutrition-Based Training For Dietitians And A Clinic-Based Nutrition Intervention To Improve Health Outcomes Among Low-Income Minority Patients, John Wesley Mcwhorter

Dissertations and Theses (Open Access)

Substantial evidence demonstrates the relations between a healthy dietary pattern rich in fruits, vegetables, and whole grains and a lower risk of chronic diseases including type 2 diabetes. Despite well supported studies, programs, and public health campaigns presenting the health benefits of consuming a healthy dietary pattern, most Americans fall far short of the recommendations. Further, the compounding effects of food insecurity and the consumption of energy-dense and nutrient-deficient foods disproportionately affect low income minority populations. Culinary medicine (CM) and food prescription programs are gaining popularity as tools for (1) decreasing food insecurity; (2) increasing personal agency; (3) promoting healthy …

The Intersection Of Diet, Health And The Environment: Plant Based Diets And Public Health, Christine E. Jovanovic

Dissertations and Theses (Open Access)

Both globally and within the United States, chronic disease has become a major driver of mortality and morbidity. In the United States in 2017, the top ten causes of mortality accounted for 74% of all deaths [2]; of these causes, half are closely linked to diet (heart disease, cancer, stroke, Alzheimer’s and diabetes). [3] In 2013, Ioannidis estimated that 26% of deaths and 14% of disability adjusted life years (DALYs) in the United States may be attributable to dietary risk factors, controlling for obesity. [4] At the same time, diet also has an important impact on the environment. Direct emissions …

Shared Decision Making In The Care Of Post-Acute Psychiatric Individuals With Serious Mental Illness, Natalie J. Maples

Dissertations and Theses (Open Access)

Severe mental illness in adults refers to a group of mental health conditions including schizophrenia and schizoaffective, bipolar and major depressive disorders. These conditions are often characterized by recurring symptoms, multiple hospitalizations, and significant disability. The public health concern with these conditions is amplified because many individuals with severe mental illness fail to engage in outpatient treatment. Methods to support greater rates of participation in outpatient treatment are needed. Encouraging participation in medical decision making is viewed as one method to optimize patient empowerment, increase engagement in care and decrease the negative outcomes that often characterize this population. Shared Decision …

Exploring Community-Based Weight Loss Initiatives, Retention, And Motivation, Miriam Martinez

Dissertations and Theses (Open Access)

Obesity puts individuals at risk of developing diabetes, cardiovascular disease, and cancer. Traditionally obesity was primarily perceived as a personal disorder requiring treatment at the individual level. Strategies to prevent obesity have shifted to an ecological approach. Organizations such as the World Health Organization recommend population based community approaches that connect people, families, schools, and municipalities. Community programs to facilitate weight loss are an effective strategy to reach large populations. The overall goal of this study is to assess community programs, factors associated with retention, and motivation for completing a community weight-loss initiative. A systematic review was conducted to characterize …