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Articles 181 - 210 of 379
Full-Text Articles in Public Health
Characterization Of The Impact Of Prenatal Cigarette Smoke Exposure On Age- And Sex-Specific Sirt1-Mediated Hepatic Molecular Phenotype In C57bl/6 Mice., Kendall S. Stocke
Characterization Of The Impact Of Prenatal Cigarette Smoke Exposure On Age- And Sex-Specific Sirt1-Mediated Hepatic Molecular Phenotype In C57bl/6 Mice., Kendall S. Stocke
Electronic Theses and Dissertations
In the U.S., 7.2% of women still report having smoked at some point during pregnancy despite known risks to fetal health. Prenatal cigarette smoke exposure (CSE) in children puts them at risk for low birth weight, premature birth, and other adverse impacts on developmental and postnatal health. Children subjected to prenatal CSE have a higher risk of adulthood metabolic disease predicted by the Barker Hypothesis. The hepatic molecular phenotype associated with this risk is unknown. This dissertation characterizes the prenatal CSE-induced hepatic molecular phenotype during three key life stages. We used a murine model of prenatal CSE utilizing a Teague …
Probability Of Conception After Fertility Counseling And The Association Of Sexually Transmitted Infections With Pregnancy In The Loussi Study., Lindsey Adelle Wood
Probability Of Conception After Fertility Counseling And The Association Of Sexually Transmitted Infections With Pregnancy In The Loussi Study., Lindsey Adelle Wood
Electronic Theses and Dissertations
This study interrogated predictors of pregnancy and the effect of a history of sexually transmitted infection (STI) on probability of conception among a cohort of women seeking fertility counseling (N=170), using multivariable logistic regression and Cox proportional hazards models. There were 76 (44.7%) total pregnancies. 32 (39.0%) were achieved spontaneously by women who never received ART (N=82). Among women who did receive ART (N=88), 35 (39.7%) were achieved by ART and 9 (10.2%) achieved spontaneously. Among the full cohort (N=170), obesity was a significant negative predictor of pregnancy while history of human papilloma virus was a significant negative predictor of …
Determining The Effect Of An Educational Intervention On Medical Support Personnel's Knowledge To Administer A Standardized Developmental Screening Tool., Leslie Chiaventone Lopez
Determining The Effect Of An Educational Intervention On Medical Support Personnel's Knowledge To Administer A Standardized Developmental Screening Tool., Leslie Chiaventone Lopez
Electronic Theses and Dissertations
Early treatment of developmental delays leads to improved outcomes for children (Yeung et al., 2014). In order to benefit from early intervention, children with developmental delays must be identified and referred at a young age. Although the use of validated developmental screening tools is supported by American Academy of Pediatrics (AAP) guidelines, these instruments are used variably by general physicians in pediatric practice (King et al., 2010). Because of the expanding work roles of medical support personnel, it is worthwhile to determine if this group can administer and score a developmental screening tool after completing an educational intervention to assist …
Assessing Heat-Related Mortality And Morbidity Risks In Rural Populations And Sub-Populations, Emmanuel A. Odame
Assessing Heat-Related Mortality And Morbidity Risks In Rural Populations And Sub-Populations, Emmanuel A. Odame
Electronic Theses and Dissertations
Heat stress is an environmental and occupational hazard exacerbated by climate change. Rural populations and sub-populations continue to experience disproportionate risks of heat-related impacts due to their low adaptive capacities in terms of infrastructure, information and other resources which are critical in dealing with heat. The study goals were to determine heat-related mortality risks in rural populations globally, explore the contribution of the outdoor work environment and other factors in association with occupational heat-related illnesses (HRI), and assess the risk of heat stress among crop workers using the Wet Bulb Globe Temperature (WBGT). Published peer-reviewed scientific literature on heat-related mortality …
Heat Waves And Heat-Related Mortality In East Tennessee, Taiwo Adesoba
Heat Waves And Heat-Related Mortality In East Tennessee, Taiwo Adesoba
Electronic Theses and Dissertations
Heat waves represent a public health challenge that requires multiple responses and warnings to protect vulnerable populations. Although studies have reported an increasing trend of heat wave occurrence in many areas of the world, no clear trend exists in East Tennessee. Using data from Parameter-elevated Relationships on Independent Slope Models (PRISM), CDC WONDER and the United States Census Bureau, the relationship between mortality rates and year was estimated during heat wave events between 1999 and 2010. Five heat wave definitions were tested. Overall, 2007 and 2010 stand out as the years with the highest number of heat wave days in …
Exploring The Role Of Social Capital In The Implementation Of Fruit And Vegetable Incentive Programs: A Case Study Of The Appalachian Farmacy Program, Kiriinya Mwirigi
Exploring The Role Of Social Capital In The Implementation Of Fruit And Vegetable Incentive Programs: A Case Study Of The Appalachian Farmacy Program, Kiriinya Mwirigi
Electronic Theses and Dissertations
The study was conducted to explore the role of social capital in the implementation of Fruit and Vegetable Incentive Programs (FVIP) through a case study of the Appalachian Farmacy (AF) program and to fill a gap in literature on social capital utility in the implementation and evaluation of FVIPs. The study was guided by a conceptual model adopted from Berkman et al. (2000) to identify the mechanisms through which social networks can impact health. A qualitative content analysis was conducted retrospectively on secondary data from the evaluation of AF program to identify social capital attributes. In addition, the study conducted …
Analysis Of Tobacco Use Vital Sign Assessment, Latonya King
Analysis Of Tobacco Use Vital Sign Assessment, Latonya King
Electronic Theses and Dissertations
There is a massive problem of tobacco-related cancer outcomes in patients that are affected by race and ethnicity. Although this is a known disparity, there continues to be a gap in care for asking patients if they use tobacco and in advising and assisting them in making a quit attempt. Health information technology requirements and meaningful use regulations require the utilization of systematic electronic documentation. In order to improve and support tobacco use screening, systematic tobacco use assessment and documentation are essential. There is a widespread belief that adding screening for tobacco use to the vital sign assessment will lead …
The Efficacy Of An Educational Intervention To Improve Low Influenza Vaccination Rates Among Federal Health Care Workers, Cynthia Berfect-Shelby
The Efficacy Of An Educational Intervention To Improve Low Influenza Vaccination Rates Among Federal Health Care Workers, Cynthia Berfect-Shelby
Electronic Theses and Dissertations
Influenza is a preventable communicable illness that has a significant impact on people of all ages. In 2018 it was estimated that 80,000 people died of influenza-related illnesses. Infants and elderly people are among the most vulnerable populations. The Centers for Disease Control and Prevention and Healthy People 2020 recommend that health care facilities have a 90% vaccination rate. Despite the recommendations and a mandatory directive, many facilities within the Veterans Health Administration struggle to reach influenza vaccination rates above 60%. Pender’s health promotion model was used as the theoretical framework to explore the reasons why health care workers refuse …
Public Health Policy: An Ethical Analysis Of Quarantine, Dina Alqahtani
Public Health Policy: An Ethical Analysis Of Quarantine, Dina Alqahtani
Electronic Theses and Dissertations
As a public health measure quarantine has both historical and contemporary significance both in the United States and abroad. On the surface it represents a low-cost, low-tech way in which the spread of disease can be mitigated as its core requirement is that those who may have been exposed to an infectious agent are kept away from those who have not been exposed to that agent for enough time to determine whether or not infection has been spread. This has been utilized for centuries with both limited questions and scattered, inconsistent, or impossible to achieve oversight and goals. In understanding …
Precision Medicine And It's Ethical And Social Implications: Public Health And Gobal Persepctives, Evangel Sarwar
Precision Medicine And It's Ethical And Social Implications: Public Health And Gobal Persepctives, Evangel Sarwar
Electronic Theses and Dissertations
Ever since President Obama's launch of the Precision Medicine Initiative (PMI) in 2015, precision medicine (PM) has been anticipated as the new paradigm for healthcare with the capacity to “empower patients, researchers, and providers to work together toward the development of individualized care,” through research, technologies, and policies (President Obama, 2015). Precision Medicine (PM), in the form of genomics, offers unprecedented promise of providing new tools for improving health and reducing the burden of diseases, not just for the U.S. - but also globally. According to World Health Organization, genomics research and precision medicine will play a major part in …
An Exploration Of Factors Of Lgbt Cultural Competency Among Prospective Healthcare Professionals, Heather Isbell
An Exploration Of Factors Of Lgbt Cultural Competency Among Prospective Healthcare Professionals, Heather Isbell
Electronic Theses and Dissertations
Literature suggests there is a relationship between cultural competency and health outcomes as well as a perceived fear of discrimination LGBT individuals face when attempting to receive healthcare services. The aim of this study is to assess the level of LGBT CC (cultural competency) among prospective professionals who are expected to provide health care services and to explore factors that affect those attributes. Multiple linear regressions were conducted to test the effect of the following factors of LGBT CC: postsecondary experience, relations with LGBT individuals, and religion using a sample of 57 different healthcare students in a faith-based university during …
Factors Influencing Unmet Medical Need Among U.S. Adults: Disparities In Access To Health Services, Ahmad Khanijahani
Factors Influencing Unmet Medical Need Among U.S. Adults: Disparities In Access To Health Services, Ahmad Khanijahani
Electronic Theses and Dissertations
Inequities in access to health services has negative consequences on individual well-being, and imposes financial and emotional burden on patients, families, health care systems, and the public. Inequities engendered from differences in socioeconomic status, health insurance coverage, race, and other characteristics can engender disparities. This study aimed to identify the potential predictors of unmet medical need among the civilian noninstitutionalized U.S. adults. Inability to receive needed medical care or receiving medical care after a delay, due to the associated costs, constructed unmet medical need. This study used a four-year (2014-2017) National Health Interview Survey (NHIS) data (sample size: 296,301 adults) …
Uncovering The Stories Behind The Numbers : A Case Study Of Maternal Death Surveillance And Response In Goma, Democratic Republic Of Congo., Baraka Muvuka
Electronic Theses and Dissertations
Globally, 303 000 women die each year from preventable causes related to pregnancy, with the Democratic Republic of Congo (DRC) having the tenth highest maternal mortality rate. Maternal Death Surveillance and Response (MDSR) is a surveillance-action cycle that aims to eliminate preventable maternal mortality by linking actionable data on maternal deaths with multi-level actions. While countries are increasingly adopting MDSR, there are research gaps on its implementation, outcomes, and best practices in developing countries including the DRC. This study assessed MDSR implementation in Goma Health Zone (HZ), DRC, specifically its structure, process, quality, outcomes, and influencing factors. A qualitative case …
Evaluation Of The Health And Exposure Histories Of A Community Surrounded By Industry And Industrial Waste : A Mixed Methods Approach., Lindsay Koloff Tompkins
Evaluation Of The Health And Exposure Histories Of A Community Surrounded By Industry And Industrial Waste : A Mixed Methods Approach., Lindsay Koloff Tompkins
Electronic Theses and Dissertations
Environmental pollution is not distributed equally across members of society. Low-income individuals are more likely to live near waste sites and other sources of pollution, and, therefore, face greater exposure to environmental health hazards. One such community in Louisville, Kentucky, the Riverside Gardens neighborhood, consists of approximately 300 homes that are surrounded on three sides by industry and industrial waste, including a remediated Environmental Protection Agency Superfund site, a former coal-burning power plant and coal ash storage site, and multiple chemical, rubber, and plastic manufacturing companies. Residents have reported elevated rates of cancer and other chronic diseases and have requested …
Polydrug Use Among People Who Use Opioids, National Survey On Drug Use And Health 2002 To 2017., Diana Kuo Stojda
Polydrug Use Among People Who Use Opioids, National Survey On Drug Use And Health 2002 To 2017., Diana Kuo Stojda
Electronic Theses and Dissertations
Introduction: Mortality due to overdose has been increasing since 2010 in the U.S., with an increase in the reported use of heroin and co-use of heroin and prescription opioids. Trends and correlates of polydrug use need to be analyzed to propose policies to reduce overdose risk. The overall objective of this study is to characterize high-risk polydrug groups among people who use opioids (PWUO) to understand the patterns of co-used substances and overdose risk factors. Methods: Publicly available data from the 2002-2017 National Survey on Drug Use and Health were analyzed to obtain weighted prevalence rates and trends …
The Shape Study : The Survey Of Health And The Perceived Environment Study., Colette Patrice Davis
The Shape Study : The Survey Of Health And The Perceived Environment Study., Colette Patrice Davis
Electronic Theses and Dissertations
Introduction: Few studies have considered how an individual’s perception of their built environment may be a risk factor for being overweight or obese. Adolescents may be particularly vulnerable in the context of “impoverished environments”, which they may perceive to be difficult, dangerous, resource deficient, and unaesthetic. This study aids in clarifying how the built environment influences the risk of obesity among adolescents residing in a neighborhood in Louisville, KY. Objective: The overall objective was to conduct a cross-sectional epidemiologic pilot study among adolescents aged 12-17 years residing in West Louisville, Kentucky to evaluate the association between perceptions of …
An Evaluation Of The Supply And Demand Of Radiation Oncology Medical Physicists In The United States., Christine Marie Swanson
An Evaluation Of The Supply And Demand Of Radiation Oncology Medical Physicists In The United States., Christine Marie Swanson
Electronic Theses and Dissertations
Background: This dissertation is a mixed methods evaluation of the radiation oncology medical physics workforce in the United States. Radiation oncology medical physicists serve a vital role in the safe treatment of patients with radiation therapy. While cancer incidence continues to rise, the pathways to board certification in radiation oncology medical physics continue to narrow causing a potential shortage of radiation oncology physicists in the United States. While there is no lack of data about the medical physics community it has scarcely been used to evaluate the current state of the workforce. In order to ensure patient safety, appropriate physics …
Innovation And Equity In Public Health Research : Testing Arts-Based Methods For Trauma-Informed, Culturally-Responsive Inquiry., Tasha Golden
Electronic Theses and Dissertations
As the field of Public Health has shifted from a biomedical paradigm to a social ecological approach, focusing on health equity and social determinants of health, it has increasingly acknowledged the roles of culture and trauma in health outcomes. The field has responded by modifying some research practices, but continues to prioritize conventional methodologies—with few options designed to foreground trauma- and cultural-responsiveness. Unfortunately, to the extent that conventional approaches require health to be defined, communicated, or valued according to dominant norms, they risk perpetuating inequities. Health equity therefore requires the development of research methodologies that increase inclusivity and access, elicit …
Adverse Childhood Experiences, Homeless Chronicity, And Age At Onset Of Homelessness, Joseph T. Tucciarone Jr.
Adverse Childhood Experiences, Homeless Chronicity, And Age At Onset Of Homelessness, Joseph T. Tucciarone Jr.
Electronic Theses and Dissertations
Childhood adversity is associated with numerous negative outcomes across multiple domains, including mental and physical health, interrelationships, and social functioning. Notably, research suggests that childhood adversity has a dose-response relationship with these outcomes; that is, greater numbers of adverse experiences in childhood are associated with worse outcomes. These outcomes overlap with many risk factors of homelessness. This study sought to address two questions: 1) Does a dose-response relationship exist between childhood adversity and chronic homelessness? 2) Does childhood adversity negatively predict the age at which homelessness first occurs? Adults experiencing homeless who are accessing homeless services in the Tri-Cities area …
The Prevalence And Context Of Adult Female Overweight And Obesity In Sub-Saharan Africa, Ifeoma Ozodiegwu
The Prevalence And Context Of Adult Female Overweight And Obesity In Sub-Saharan Africa, Ifeoma Ozodiegwu
Electronic Theses and Dissertations
Adult women bear a disproportionate burden of overweight and obesity in Sub-Saharan Africa (SSA). Precise information to understand disease distribution and assess determinants is lacking. Therefore, this dissertation aimed to: (i) analyze the prevalence of adult female overweight and obesity combined in lower-level administrative units; (ii) analyze the effect modification of educational attainment and age on the association between household wealth and adult female overweight and obesity; (iii) synthesize qualitative research evidence to describe contextual factors contributing to female overweight and obesity at different life stages. Bayesian and logistic regression models were constructed with Demographic and Health Survey (DHS) data …
Social Determinants Of Health Theory: Policy Entry Points For Healthcare Providers, Kiah R. Vandergrift
Social Determinants Of Health Theory: Policy Entry Points For Healthcare Providers, Kiah R. Vandergrift
Electronic Theses and Dissertations
This thesis examines a shifting paradigm in the U.S. healthcare system that will re-define the role that the healthcare provider plays in the production of health. It does this by first acknowledging two differing economic theories on the production of health: Human Capital Theory and Social Determinants of Health theory, and how both schools of thought have contributed to the paradigm that healthcare providers only play a role in the end stages of health production - to heal those who are already ill. However, policy, payment, and delivery system reforms have begun to force healthcare providers to re-think how they …
Level Of Satisfaction Among Food Pantry Clients, Staff/Volunteers, And Directors And Its Association With Client Choice In Food Pantry Layouts, Myranda Dunmire
Level Of Satisfaction Among Food Pantry Clients, Staff/Volunteers, And Directors And Its Association With Client Choice In Food Pantry Layouts, Myranda Dunmire
Electronic Theses and Dissertations
Objectives: Food insecurity is an issue in rural communities, particularly among food pantry clients. Food pantries may not provide clients with the opportunity to choose their own foods (client choice), and instead may just give a set amount and type of foods. Client choice is important in regards to client health status as well as perceptions of autonomy and quality of life. Although client choice can be promoted in food pantries, it may be difficult to grasp the process of food pantry transitioning and how well changes such as these may be perceived by clients or food pantry personnel. We …
Physical Activity Environments In Rural Communities: Exploring The Relationship Between Community Perceptions And The Environment, Elizabeth M. Bye
Physical Activity Environments In Rural Communities: Exploring The Relationship Between Community Perceptions And The Environment, Elizabeth M. Bye
Electronic Theses and Dissertations
Purpose: To assess the physical activity environment, community perceptions of the physical activity environment, and the relationship between these variables in rural and/or underserved communities with high obesity prevalence.
Methods: The Rural Active Living Assessment (RALA) was used to assess the programs and policies (PPA), town-wide amenities (TWA), and street segments (SSA) of the physical activity environment and the Rural Active Living Perceived Environmental Support Scale (RALPESS) was used to assess community perception of the physical activity environment within eleven rural and/or underserved communities. Each section of the RALA and RALPESS are further broken down into additional subsections in order …
Wellness Policy Awareness Among School Leaders And The Impact On Written Policy Scores, Mariah Reil
Wellness Policy Awareness Among School Leaders And The Impact On Written Policy Scores, Mariah Reil
Electronic Theses and Dissertations
Background: All schools participating in the National School Lunch Program must possess a written School Wellness Policy (SWP) as mandated by the Healthy, Hunger- Free Kids Act of 2010.1 School officials and leaders play a major role in SWP implementation. It is essential to written SWP implementation that school level officials and leaders in the district are aware of the SWP. However, the association between school leader awareness of SWP and policy quality has not yet been studied.
Purpose: The purpose of the present study was to determine if school leader awareness of a SWP impacts the written SWP quality. …
Predictors Of Hospital Quality And Efficiency, Hoda Fotovvat
Predictors Of Hospital Quality And Efficiency, Hoda Fotovvat
Electronic Theses and Dissertations
American hospitals have made serious efforts to implement and expand their health information technology capabilities and to integrate different specialized care or high-tech services in order to maximize the efficiency and quality of care. In providing a variety of HIT-related services, these hospitals expanded their national reputation in line with integrated care goals. As a result, hospitals are encouraged to establish effective communication channels to facilitate patient-physician sharing of the patient care experience, to enhance effective pain management, and to transform patient-centered care modalities to solidify the adequacy of patient care processes. By analyzing national data sets publicly available, this …
Electronic Nicotine Delivery Systems (Ends): Reasons For Use And Associated Factors In Self-Selected Nicotine Concentrations, David D. Allen Iii
Electronic Nicotine Delivery Systems (Ends): Reasons For Use And Associated Factors In Self-Selected Nicotine Concentrations, David D. Allen Iii
Electronic Theses and Dissertations
This study aimed to examine e-cigarette user reasons for use, changes in their nicotine concentrations, and factors associated with changes in their chosen nicotine concentrations.
E-Cigarettes And Conventional Cigarettes: Perceived Risks And Benefits Among College Students, Evi Addoh
E-Cigarettes And Conventional Cigarettes: Perceived Risks And Benefits Among College Students, Evi Addoh
Electronic Theses and Dissertations
ABSTRACT Background: Accompanying the decline in cigarette smoking rates has been a rise in prevalence of electronic cigarette (e-cigarette) use. The ongoing investigations on the health impact of e-cigarettes have been accompanied by mixed messages and a lack of consensus which may lead college students to rely on their own perceptions of risk and benefits in deciding whether to use e-cigarettes. Conclusion: Considering the significant association of perceived risks and benefits with e-cigarette and cigarette use this study yields some findings that show the importance of appropriately addressing perceptions. It is paramount to keep the public updated on pertinent research …
Access To Care And The Use Of Healthcare Services By Women In Rural Cameroon: A Participatory Action Research Study, Grace Tadzong-Awasum
Access To Care And The Use Of Healthcare Services By Women In Rural Cameroon: A Participatory Action Research Study, Grace Tadzong-Awasum
Electronic Theses and Dissertations
Women in rural Cameroon do not access health care as timeously and as often as they should. They fail to get screened for common diseases, with the consequence that such diseases are often diagnosed at a very advanced stage. This accounts for the high morbidity and mortality rates as well as low life expectancy recorded among women. The purpose of this study was to explore and understand the health access experiences of women in rural Cameroon. Methodology: Participatory action research was used guided by a Focused ethnography in phase one. Twenty-five women aged 21-77 years were recruited through local the …
Evaluation Of The Predictive Ability Of A Screening Instrument Used To Diagnose Co-Occurrence Of Anxiety In Children With High-Functioning Autism., Austin Zachary
Electronic Theses and Dissertations
Anxiety has shown to have a high co-occurrence in children with Autism Spectrum Disorder (ASD), but has been difficult to co-diagnose. This study analyzed the ability of the Screen for Child Anxiety-Related Emotional Disorders (SCARED) to predict positive ASD screenings of the Social Responsiveness Scale (SRS). Parents and children ages 8 to 18 years (N = 100) were screened for anxiety using the SCARED and autism using the SRS. Moderate correlation was found between parent-reported SCARED and positive screening of the SRS (r = .579), with weak correlation found in the child-reported SCARED (r = .105). LASSO regression was conducted …
Adolescent Sexual And Reproductive Health In The Gambia., Sandhya Lohani
Adolescent Sexual And Reproductive Health In The Gambia., Sandhya Lohani
Electronic Theses and Dissertations
Adolescence is a crucial period in human development. Knowledge and awareness about when to have children, when to have sex, and use of contraceptives impacts the chances of teenage pregnancy and risk of sexually transmitted diseases. The objective of this study is to determine the prevalence and associated risk factors related to age of sexual debut, teenage pregnancy, and use of contraceptives in the Gambia. This study also compares the data with 2014 survey research conducted in the Gambia. The total study population were 50 adolescents aged 13-21 years from Bafuluto and surrounding communities in the Gambia. Among 50 respondents, …