Public Health Commons^™

The Use Of Animal-Assisted Therapeutic Interventions In The Hospital Setting During The Covid-19 Pandemic, Alicia Cesare

Graduate Theses/Dissertations

Handlers of therapy and/or facility dogs working within hospital settings have experienced various barriers and challenges within their practice during the COVID-19 pandemic. Animal-assisted interventions, specifically therapeutic working dogs, are a valued source of support to individuals, communities, hospital settings, and disaster sites during times of community distress. The purpose of this study was to identify barriers and solutions to the continued use of animal-assisted therapeutic interventions in support of patients and families within the hospital setting during the COVID-19 pandemic. This researcher’s position within the research is the knowledge and experience of being a facility dog handler within the …

Cross-Sectional Analysis Of The Relationship Between Violent Crime And Mental Health Disorders In A Sample Of Homeless Adults Recently Released From Jail, Addison Ransom

Dissertations and Theses (Open Access)

Adverse mental health conditions among incarcerated populations are high, and treatment for these conditions is particularly low. Additionally, there is a culture of stigma in the United States towards those with mental health conditions and violent criminal history, contributing to mass incarceration. The present cross-sectional study sought to assess the association between violent criminal history and mental health symptoms among recently incarcerated homeless adults in Dallas, Texas. This study included 230 participants, taking place at The Bridge Homeless Recovery Center, evaluating non-violent versus violent criminal history. Outcome measures of positive screens for post-traumatic stress disorder, generalized anxiety disorder, and depression …

Mapping Geographical Inequalities In Oral Rehydration Therapy Coverage In Low-Income And Middle-Income Countries, 2000–17, Kirsten E. Wiens, Robert C. Reiner Jr, Arianna Maever L. Amit, Veincent Christian F. Pepito, Local Burden Of Disease Diarrhoea Collaborators, 702 Co-Authors

Ateneo School of Medicine and Public Health Publications

Background

Oral rehydration solution (ORS) is a form of oral rehydration therapy (ORT) for diarrhoea that has the potential to drastically reduce child mortality; yet, according to UNICEF estimates, less than half of children younger than 5 years with diarrhoea in low-income and middle-income countries (LMICs) received ORS in 2016. A variety of recommended home fluids (RHF) exist as alternative forms of ORT; however, it is unclear whether RHF prevent child mortality. Previous studies have shown considerable variation between countries in ORS and RHF use, but subnational variation is unknown. This study aims to produce high-resolution geospatial estimates of relative …

Sex Differences In Problem Alcohol Use In High School As A Function Of Recent Sexual Violence Victimization Or Perpetration, Christal L. Badour, Samuel C. Bell, Emily R. Clear, Ann L. Coker

Psychology Faculty Publications

To investigate sex differences in associations between sexual violence victimization (SVV), sexual violence perpetration (SVP), and binge drinking and/or alcohol problems among high school students. While SVV has been linked to problem alcohol use among young women, little research has addressed the unique associations of SVV and SVP on alcohol use/problems within both sexes. A cross-sectional analysis of 16,992 high school students’ self-reports of past-year SVP and SVV was used where SVV/SVP was defined by three tactics (sexual coercion, drug/alcohol-facilitated or incapacitated sex, and physically forced sex). Alcohol measures included past-month binge drinking and past-year alcohol problems. Rates of SVV …

Atitiudes Tow Ards Computer Games For Learning And Pl.A Yer Archetypes: An Exploration Of Measures On Preintervention Player Characteristics For Serious Game-Based Interventions, Benjamin Lee

Dissertations and Theses (Open Access)

Serious game-based interventions offer promising health outcome results with the aid of pre-intervention player tailoring and the development of measurements that evaluate pre-intervention player characteristics and subgroups. Video gaming measures can potentially provide helpful tailoring information that discerns individual video gaming preferences which could influence their overall user experience. It is critical that measures that target adolescent video gaming be psychometrically validated. There is a gap in the literature with psychometrically validated measures evaluating adolescent attitudes towards computer games for learning and gaming archetypes. Therefore the aims of this dissertation were to 1) evaluate the psychometric properties (i.e., reliability and …

Costs Of Coronary Artery Bypass Grafting And Percutaneous Coronary Intervention In Texas, Saleh Hamed Alsarhan

Dissertations and Theses (Open Access)

Background: Coronary artery bypass grafting (CABG) surgery and percutaneous coronary intervention (PCI) procedures have been associated with substantial financial costs in Texas. The annual hospital charges in 2016 for CABG surgeries and PCI procedures in Texas were $3.6 billion and $4.1 billion, respectively. Recently, these two procedures have become a target for bundled payment initiatives. Due to the lack of information about the demographics and variations associated with CABG and PCI episode payments for commercially insured patients, more research needs to be conducted to understand the magnitude of payments and the drivers of variation in payments in Texas. Objective: This …

Semiparametric Methods To Improve Risk Assessment And Dynamic Prediction, Wen Li

Dissertations and Theses (Open Access)

Incorporating promising biomarkers to improve risk assessment and prediction is the central goal in many biomedical studies. Cost-effective designs and longitudinal designs are often utilized for measuring biomarker information, but they pose challenges to the data analyses. Statistical analyses for these kinds of data are routinely performed using parametric models. When the model assumptions are violated, parametric models may lead to substantial bias in parameter estimation, risk evaluation and prediction. In this dissertation, we will develop robust, exible statistical methods for risk assessment for matched case-control, nested case-control, and case-cohort designs, as well as a dynamic prediction tool for longitudinal …

A Qualitative Inquiry Exploring Help-Seeking Behaviors And Resilience Strategies Women With Disabilities Utilize When Experiencing Gender-Based Violence In Rural Communities, Kimberly Ann Aguillard

Dissertations and Theses (Open Access)

Women with disabilities (WWD) are at pronounced risk of experiencing multiple forms of severe and prolonged violence, and they face barriers to accessing help. A multitude of factors associated with disability and rurality may compound the experience of violence, including geographic and social isolation, forcing WWD in rural settings to navigate extremely dangerous situations with limited avenues for accessing help and securing safety. This research explored how women with disabilities experiencing violence while living in rural communities navigate programs and policies, make decisions about seeking and securing help, and build resilience despite experiencing violence. The current study methodology empowers this …

A Comparison Of Interdisciplinary Palliative Care Teams And Leadership Attitudes Of Nci-Designated And Non-Nci-Designated Cancer Centers In The United States From 2009-2018, Joseph Chen

Dissertations and Theses (Open Access)

Background: Interdisciplinary palliative care (PC) teams (IDTs) are essential to improving patient outcomes while cancer center executives have a key role in defining the future of PC. Objectives: To compare PC team compositions and executives’ attitudes towards PC between NCI (National Cancer Institute)-designated cancer centers (NCI-CCs) and non-NCI-designated cancer centers (non-NCI-CCs) in 2018 and to compare changes in team composition and executives’ attitudes and beliefs between 2009-2018. Methods: PC program leaders (PL) and cancer center executives at all 62 NCI-CCs and a random sample of 60 of 1252 non-NCI-CCs were surveyed from April-August 2018. The PL survey examined team composition …

Disparities In Patient Safety Events For Hospitalized Patients, Nnabuchi Anikpezie

Dissertations and Theses (Open Access)

Background: Twenty years post IOM’s landmark publication, “To Err is Human: Building a Safer Health System”, still no consensus on case definition for patient safety events (PSEs). Available data on incidence and magnitude of PSEs are more than 10 years old, while data on disparities are ambiguous. Objective: To examine the racial and socioeconomic disparities in reported patient safety events (PSEs) among hospitalized individuals. Design, Setting, and Participants: Cross-sectional study of patient safety events using the 2016 National Inpatient Sample (NIS) from the Healthcare Cost and Utilization Project (HCUP). A total of 6,753,100 discharges were identified as being at risk …

Determining The Racial And Ethnic Differences In Neonatal Intensive Care Unit Admission Rates, Youngran Kim

Dissertations and Theses (Open Access)

Background: Recent trends show that the utilization of neonatal intensive care unit (NICU) has extended beyond severely ill infants and increased substantially across all birth weights. However, little is known about what drives the growth of NICU admission rates and whether these trends differ by race/ethnicity. Methods: The study used 2008-2018 Natality Files with restricted use of state and county-level information. Crude and risk-adjusted NICU admission rates, overall and stratified by birth weight group, were compared between black and white infants and between Hispanic and white infants. Kitagawa decomposition and Oaxaca-Blinder decomposition analyses were conducted for the temporal increase in …

Causal Analysis Theory And Application To Alzheimer’S Disease (Ad) And Heart Failure (Hf), Shudi Li

Dissertations and Theses (Open Access)

Alzheimer's disease (AD) and heart failure (HF) are two complex diseases that are caused by the combination of genetic and epigenetic, environmental and other lifestyle factors. Understanding the relationships between genetic and epigenetic variants and other factors of such complex diseases could assist researchers discover disease mechanisms and develop targeted therapies. Much of the research in genetics/epigenetics studies regarding AD and heart diseases have been focused on association analysis. Many researchers have identified genetic/epigenetics variants and phenotypes that are significantly associated with disease pathology. While most of these studies utilize association analysis as the analytical platform, the signals identified by …

Heat Stress Related Symptoms And Pulmonary Function In Oil Spill Response And Cleanup Workers Following The Deepwater Horizon Disaster, Yiyou Li

Dissertations and Theses (Open Access)

The objective of this study was to estimate the relationship between heat stress and pulmonary function among OSRC workers following the Deepwater Horizon (DWH) disaster. Methods: Pulmonary function test results were analyzed from a cohort of oil spill response and cleanup workers 1-3 years following the DWH disaster (N=5,131). Proxies for heat stress was employed by using information on heat stress-related symptoms as well as a questionnaire on stopping work due to heat reported during a structured telephone enrollment questionnaire. Associations between heat stress proxies and lung function were estimated using multivariable linear models and binomial logistic regression models while …

Epidemiology Of No -Syndromic, Orofacial Clefts In A Registry­Based, Birth-Cohort In Texas: Differences By Cleft Type And Presence Of Additional Defects, Maria Luisa Navarro Sanchez

Dissertations and Theses (Open Access)

Although orofacial clefts, which include cleft palate alone (CP) and cleft lip with or without cleft palate (CL±P), are among the most common birth defects, their etiology is complex and is generally not well understood. While some clefts are caused by rare syndromes, the majority occur in the absence of a syndrome, either in association with co-occurring defects or as isolated defects. Among these non-syndromic cases, epidemiologic studies have identified demographic variables that are associated with CP and/or CL±P, such as geographic location and infant sex, as well as several maternal characteristics, though some of these associations have been weak …

Heat Stress Related Symptoms And Pulmonary Function In Oil Spill Response And Cleanup Workers Following The Deepwater Horizon Disaster, Yiyao Li

Dissertations and Theses (Open Access)

Objective: The objective of this study was to estimate the relationship between heat stress and pulmonary function among OSRC workers following the Deepwater Horizon (DWH) disaster. Methods: Pulmonary function test results were analyzed from a cohort of oil spill response and cleanup workers 1-3 years following the DWH disaster (N=5,131). Proxies for heat stress was employed by using information on heat stress-related symptoms as well as a questionnaire on stopping work due to heat reported during a structured telephone enrollment questionnaire. Associations between heat stress proxies and lung function were estimated using multivariable linear models and binomial logistic regression models …

Area-Level Landfill Density And Asthma Prevalence In Urban Texas Areas, Jessica Meighan Herrin

Dissertations and Theses (Open Access)

Environmental exposures, especially air pollutants, pose a threat for an increase in asthma prevalence. In particular, hydrogen sulfide (H2S) gas can cause severe health effects closely resembling asthmatic symptoms. Ambient concentrations of H2S gas correlates with the amount of solid waste found in landfills. The potential for adverse health risks associated with H2S emitted from landfills is of concern for those populations living in close proximity to landfills. Asthma is one of the adverse health effects that can occur due to H2S exposure. However, there is a lack of detailed studies characterizing possible associations between the density of landfills and …

Impact Of Substance Use In Social Networks On Antiretroviral Therapy Adherence For Hiv-Positive Younger Men Who Have Sex With Men, Natascha Del Vecchio

Dissertations and Theses (Open Access)

The community of young men who have sex with men (YMSM) has higher rates of substance use than the general population and the use of alcohol, cannabis, and illicit drugs has been shown to have a negative impact on the HIV care continuum. Our first aim was to understand the prevalence of substance use in the community through the use of self-reported, RDS-II, and RDS-SS estimates. We used multivariable logistic and negative binomial GEE with QIC selection to determine the factors important to having a prescription and staying adherent, respectively. Selected variables were included with a subset of substance use …

Effect Of The Expanded Prospective Payment System On Dialysis Initiation, The Usage Of Erythropoiesis-Stimulating Agents, And Medicare Expenditures, Lu Zhang

Dissertations and Theses (Open Access)

In January 2011, the U.S. Centers for Medicare & Medicaid Services (CMS) implemented the expanded prospective payment system (PPS) for financing the management of end-stage renal disease (ESRD). Expanded PPS may not only change healthcare providers’ decisions about patient care by removing the financial incentives associated with the previous composite rate payment methodology, but also change the Medicare expenditures associated with various treatment patterns by using a constant base rate for all dialysis modalities. This study aimed to examine the effect of the expanded PPS on providers’ decisions on timing of dialysis initiation and ESA utilizations in ESRD patients as …

Hospital Market Analysis Using A Cohort Of Privately Insured Patients With Total Hip And Knee Replacement Procedures, Elifnur Yay Donderici

Dissertations and Theses (Open Access)

Background: Several recent studies have analyzed the contribution of hospital inpatient prices and utilization to variation in medical spending. However, it is still unknown how the drivers of spending for specific procedures differ within privately insured patients. Next, the market concentration of hospitals has been a matter of concern for several decades. However, researchers usually calculate Herfindahl-Hirschman index (HHI) as a measure of market concentration or power, but there is a drawback of using this measure. Hospitals sell differentiated products, and the HHI measure does not take this differentiation into account in its formulation (Gaynor and Town, 2011). Objective: First …

The Multilevel Factors Facilitating Or Impeding Healthcare Access Among Refugees Residing In Bexar County Texas, Howaida Werfelli

Dissertations and Theses (Open Access)

The goal of this study was to increase understanding of healthcare access among refugees by investigating the multilevel factors that facilitate or impede healthcare access among refugees who have resettled in Bexar County, Texas. The multilevel factors facilitating or impeding access to healthcare for refugees resettled in Bexar County were identified as follows: health literacy, level of educational attainment, proficiency (reading, writing and, speaking) in English, proficiency (reading, writing and speaking) in native language, translation services, public transportation, income level, a shortage of healthcare providers, navigation of the healthcare system, the fragmentation of the healthcare system, insurance status, staff shortages …

Health Disparities Across Funcitonal Disability Groups, Katherine Sanches

Dissertations and Theses (Open Access)

Background: People with disabilities experience higher rates of chronic disease and poor health status compared to those without disability. People with disabilities do not participate in community health programs to the same degree as those without disability due to social, programmatic, and environmental barriers. The Community Health Inclusion Index (CHII) is a community health assessment tool which evaluates the degree to which community-level health promoting opportunities to promote nutrition and physical activity are inclusive and accessible to people with disabilities. The CHII assess barriers to inclusion across five domains: build environment, equipment, program/services, staff, and policies. Objective: The purpose of …

Barriers Inhibiting Detection And Management Of Postpartum Hemorrhage By Providers In Madagascar, Breakthrough Research, Usaid's Health Evaluation And Applied Research Development

Reproductive Health

Breakthrough RESEARCH partner ideas42 conducted research in June 2019 in peri-urban and rural areas of Vohipeno and Manakara districts of Madagascar's Vatovavy-Fitovinany region to identify health care providers' challenges for detecting and managing complications during childbirth including postpartum hemorrhage and identify optimal solutions. This brief summarizes the results of a behavioral diagnosis that reveals “Facility-based providers do not consistently follow best practices for the detection and management of complications during childbirth.” Low perception of risk of postpartum hemorrhage, limited review of compliance with best practices, consequences of current practices, and resource scarcity can negatively affect provider decision-making and clinical practice.

Obstacles Limitant La Détection Et La Prise En Charge De L’Hpp Par Les Prestataires De Soins De Santé À Madagascar, Breakthrough Research

Reproductive Health

Breakthrough RESEARCH partner ideas42 conducted research in June 2019 in peri-urban and rural areas of Vohipeno and Manakara districts of Madagascar's Vatovavy-Fitovinany region to identify health care providers' challenges for detecting and managing complications during childbirth including postpartum hemorrhage and identify optimal solutions. This brief summarizes the results of a behavioral diagnosis that reveals “Facility-based providers do not consistently follow best practices for the detection and management of complications during childbirth.” Low perception of risk of postpartum hemorrhage, limited review of compliance with best practices, consequences of current practices, and resource scarcity can negatively affect provider decision-making and clinical practice.

Severe Acute Respiratory Syndrome Coronavirus 2 Transmission Potential, Iran, 2020, Kamalich Muniz-Rodriguez, Isaac Fung, Shayesteh R. Ferdosi, Sylvia Ofori, Yiseul Lee, Amna Tariq, Gerardo Chowell

Biostatistics, Epidemiology & Environmental Health Sciences: Faculty Publications

To determine the transmission potential of severe acute respiratory syndrome coronavirus 2 in Iran in 2020, we estimated the reproduction number as 4.4 (95% CI 3.9–4.9) by using a generalized growth model and 3.5 (95% CI 1.3–8.1) by using epidemic doubling time. The reproduction number decreased to 1.55 after social distancing interventions were implemented.

Responding To Covid-19: How Massachusetts Senior Centers Are Adapting, Ceara Somerville, Caitlin Coyle, Jan Mutchler

Center for Social and Demographic Research on Aging Publications

The COVID-19 pandemic has swept the United States with force and speed. Massachusetts is one of the hardest hit states in nation, with over 120,000 cases and over 8,500 deaths to date. Local governments across the Commonwealth have had to work quickly to meet the needs of their constituents in a constantly changing environment. With older adults being at high risk of contracting COVID-19, having more severe symptoms, and at higher risk of dying from the disease, special efforts are warranted to ensure that they are supported in their efforts to maintain physical distance while meeting needs for food and …

Life Expectancy And Active Life Expectancy By Marital Status Among Older U.S. Adults Results From The U.S. Medicare Health Outcome Survey (Hos), Haomiao Jia, Erica I. Lubetkin

Publications and Research

Background: Previous investigations of the relationship between marital status and life expectancy and healthy life expectancy rely on the assumption that participants will remain in a given marital status until death. This study estimated total life expectancy (TLE) and active life expectancy (ALE) for respondents by their baseline marital status using a large longitudinal sample of the U.S. community-dwelling elderly population.

Methods: Data were from the Medicare Health Outcomes Survey Cohort 15 (2012 baseline, 2014 follow-up). We included respondents aged ≥65 years (n = 164,597). Multi-state models estimated TLE and ALE by marital status to allow participants' marital status to …

Social Vulnerability And Hurricane Evacuation Behavior In Hampton Roads, Va: Emergency Management Stakeholders’ Perceptions Of Low-To-Moderate Income Households In A Social Construction Paradigm, Mechelle Bonit Smith

School of Public Service Theses & Dissertations

The purpose of this research is to examine current emergency management (EM) evacuation policies and practices with respect to vulnerable populations’ hurricane evacuation behaviors. The response of vulnerable households and local and state governments’ implementation of emergency evacuation policies and practices provide possible linkages to continual problems faced by local governments in addressing its most vulnerable residents. Using social construction as a theoretical foundation provides context for the consideration of vulnerable populations in emergency management policy and hurricane evacuation.

This research is a qualitative case study of emergency management policies, practices, and perceived household evacuation behaviors in several cities of …

The Prevalence And Predictors Of Complementary And Alternative Medicine (Cam) Use Among Racially/Ethnically Diverse College Students, Hermella Misiker

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background: National data on complementary and alternative medicine (CAM) use, available through the National Health Interview Survey (NHIS), convey higher prevalence of CAM use among college students compared to the general U.S population. NHIS findings also highlight non-vitamin non- mineral (NVNM) products are the most widely used form of CAM in the U.S. The purpose of this study was to identify the socio-cognitive and demographic predictors of CAM and NVNM use among a racially/ethnically diverse college student body.

Methods: An online survey was used to collect data from 392 University of Nevada, Las Vegas (UNLV) undergraduate, graduate, and professional students. …

Reproductive Health In The Philippines: Poverty, Religiosity, And Navigating Reproductive Choices, Allison Goncena

International Studies (MA) Theses

This dissertation centers the Philippines as a case study in which quantitative and qualitative data from empirical studies, science journal articles, social science texts, and interviews are cross-examined to ascertain two main areas of interest. The first incentive is to identify and analyze the Catholic Church’s resources in perpetuating moral male-dominant rhetoric that have delayed efforts supporting reproductive health intended to aid low-income women concerning their sexual and reproductive health. The second incentive is to detect how low-income women’s thoughts and behaviors in making reproductive decisions are resonant or not of the Church’s moral rectitude over SRH through their demonstrations …

A Mixed-Methods Analysis Of Abortion Attitudes And Perceptions Among Women Living In Alabama And South Carolina, Anthony Peluso

Electronic Theses and Dissertations

Legal induced abortion is a safe option for terminating a pregnancy for women of reproductive age in the United States (U.S.), though access has varied since the Roe v. Wade and Doe v. Bolton cases in 1973. Information is lacking on women’s attitudes toward and perceptions of abortion as well as on related constructs such as pregnancy attitudes and contraceptive use. Exploring these constructs is important in that it can provide much needed context to women’s reproductive life planning. This research aimed to explore perceptions of abortion access and safety and examine the potential associations between attitudes toward abortion access …