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Articles 271 - 300 of 379
Full-Text Articles in Public Health
Cost Of Care For Hospitalized Patients With Pulmonary Mycobacterial Diseases In The United States., Mary Beth Wells Allen
Cost Of Care For Hospitalized Patients With Pulmonary Mycobacterial Diseases In The United States., Mary Beth Wells Allen
Electronic Theses and Dissertations
Background: Pulmonary mycobacterial diseases describe both tuberculosis (TB) and nontuberculous mycobacteria (NTM). Few data are available measuring the cost burden of mycobacterial diseases on the national level. The purpose of this study was to evaluate the cost burden and measure emerging trends in hospitalization of pulmonary TB and NTM in the US from 2001 through 2012. Methods: This study was a retrospective community based cost analysis of hospitalized patients with a principal diagnosis of pulmonary mycobacterial diseases from 2001 through 2012. Data for pulmonary TB and NTM were retrieved from the Healthcare Cost and Utilization Project (HCUP), US Department of …
Awareness, Perception, And Self-Reported Purchasing Behaviors Of College Students Regarding Front-Of-Package Nutrition Labeling Systems And Symbols, Audrey L. Kessler
Awareness, Perception, And Self-Reported Purchasing Behaviors Of College Students Regarding Front-Of-Package Nutrition Labeling Systems And Symbols, Audrey L. Kessler
Electronic Theses and Dissertations
Traditional students enroll in post-secondary institutions during emerging adulthood. College enrollment is increasing and adult weight gain occurs most rapidly during the college-age years, with poor food decisions as a potential contributing factor. The present study examined the awareness, perception, and self-reported purchasing behaviors of college students regarding four front-of-package (FOP) nutrition labeling systems and symbols. Students were sent a 24-question web-based survey, with 908 completed surveys that met the research criteria. There were 888 (98.3%) respondents who recognized at least one of the four presented FOP nutrition labels. There were no significant differences between the groups that recognized one …
Factors Influencing Healthy Eating And Physical Activity Behaviors Of Adolescents In Appalachia, Natalie Walker
Factors Influencing Healthy Eating And Physical Activity Behaviors Of Adolescents In Appalachia, Natalie Walker
Electronic Theses and Dissertations
This study examined the TPB constructs of attitude, perceived behavioral control, and subjective norms and their ability to predict healthy eating and physical activity behaviors among adolescents living in Southern Appalachia. The study also considered the relative utility of subjective norms and social support in predicting these behaviors. Data for this research were derived from a larger study, Team Up for Healthy Living, conducted September 2011 through November 2014 with high school students in the Appalachian region (Study ID: R01MD006200 from the National Institute on Minority Health and Health Disparities). Participants (n=963) completed a three-part paper survey collecting data about …
Memory And Fine Motor Skill Test Performance Among Children Living Near Coal Ash Storage Sites., Lindsay Koloff Tompkins
Memory And Fine Motor Skill Test Performance Among Children Living Near Coal Ash Storage Sites., Lindsay Koloff Tompkins
Electronic Theses and Dissertations
Coal ash, a byproduct of coal combustion,is reduced in 47 U.S. states andfrequently contains heavy metals, some of which are known neurotoxins. An estimated 1.5 million children live near sites where coal ash is produced andstored, yet there have been no studies assessing coal ash exposure and children’s neuro behavioral health. This study is part of a larger cross-sectional study, Coal Ash and Neuro behavioral Symptoms in Children Aged 6- 14 Years Old, and aimed to determine the relationship between children’s memory and fine motor skill test performance and the proximity of the home to coal ash storage sites, the …
Type 2 Diabetes Mellitus (T2dm) Onset And "Remission"., Srikanth Tangelloju
Type 2 Diabetes Mellitus (T2dm) Onset And "Remission"., Srikanth Tangelloju
Electronic Theses and Dissertations
Background: Type 2 diabetes mellitus (T2DM) is a progressive disease condition. As the disease progresses the function of beta (β) cells (cells which regulate insulin) decline, thereby increasing the circulating blood glucose levels. If left unmanaged the disease progresses from onset to development of T2DM related complications and eventually death. When managed, in certain individuals, T2DM onset can be prevented and/or slowed down and in certain T2DM individuals, remission is observed. There are some known modifiable risk factors such as diet and physical activities that are associated with the speed and direction of progression, but much is still unknown. In …
The Impact Of The Patient Protection And Affordable Care Act’S Risk Adjustment Program On Adverse Selection : First Year Case Study., Steven K. Zimmerman
The Impact Of The Patient Protection And Affordable Care Act’S Risk Adjustment Program On Adverse Selection : First Year Case Study., Steven K. Zimmerman
Electronic Theses and Dissertations
In 2014 the Patient Protection and Affordable Care Act (ACA) implemented a risk adjustment program to stabilize premiums and neutralize premiums in the individual health insurance marketplace. This dissertation will examine the impact of the ACA risk adjustment program on adverse selection for one insurer during 2014. This study utilized enrollment and claims data for one insurer and employs graphical analysis to test for adverse selection. Previous studies have been unable to utilize actual insurer data to test for adverse selection in under the ACA risk adjustment program. Until the implementation of the ACA, insurers relied on underwriting methods to …
Air Pollution, Pulmonary Oxidative Stress, And The Endothelin System In The Development Of Cardiovascular Injury., Jordan B. Finch
Air Pollution, Pulmonary Oxidative Stress, And The Endothelin System In The Development Of Cardiovascular Injury., Jordan B. Finch
Electronic Theses and Dissertations
The goal of this project was to examine the role of endothelin-1 (ET-1) as a mediator in the pathway between air pollution exposure and the development of vascular injury. A human cohort and male mice (C57BL/6 and ecSOD-Tg) were used to evaluate changes in the ET-1 system in response to exposures of fine particulate matter (PM2.5). Human ET-1 levels were significantly associated with environmental factors and markers of vascular change, but were decreased with increased PM2.5. No association was seen between ET-1 and endothelial progenitor cells (EPCs) except for EPC-4, possibly indicating a regulatory relationship with this specific population. In …
Using The Theory Of Planned Behavior To Predict Executives’ Intentions To Hire Psychologists In Federally Qualified Health Centers, Robert M. Tolliver
Using The Theory Of Planned Behavior To Predict Executives’ Intentions To Hire Psychologists In Federally Qualified Health Centers, Robert M. Tolliver
Electronic Theses and Dissertations
Health psychologists with training in integrated care are ideal candidates to work in Federally Qualified Health Centers (FQHCs). However, despite the large documented need for more behavioral health providers in FQHCs, psychologists are underrepresented in this setting compared to other behavioral health professions. The purpose of this study was to: 1) examine the specific beliefs that are most relevant to executives’ intentions to hire psychologists, 2) determine how executives’ perceived control over hiring psychologists varies by several demographic variables, and 3) examine how well the Theory of Planned Behavior (TPB) predicts executives’ intentions to hire psychologists. Method: Executives (N …
Psychological And Sociocultural Influences Of Current And Historical Intimate Partner Violence In Pregnancy, Cindy D. Phillips
Psychological And Sociocultural Influences Of Current And Historical Intimate Partner Violence In Pregnancy, Cindy D. Phillips
Electronic Theses and Dissertations
The Centers for Disease Control and Prevention (CDC) estimates that 1.5 million women are victims of intimate partner violence (IPV) each year, and 324,000 of these women are pregnant (2013). Research on the predictability of certain factors and their relationship to current and historical IPV is limited. In order to better understand IPV as it related to a sample of 1,016 Appalachian pregnant women selected for the Tennessee Interventions for Pregnant Smokers (TIPS), it was important to evaluate various influences that may predict the prevalence of IPV in this population when compared to the State of Tennessee and the U.S. …
Biosand Water Filter Evaluation: Meta-Evaluation And Pilot Study Of Field Use Indicators, Bethesda O'Connell
Biosand Water Filter Evaluation: Meta-Evaluation And Pilot Study Of Field Use Indicators, Bethesda O'Connell
Electronic Theses and Dissertations
Diarrheal diseases are a global public health burden, killing 1.8 million people annually. Diarrhea disproportionately affects children and those in poverty. Most diarrheal cases can be prevented through safe drinking water, basic hygiene and/or sanitation measures, with drinking water interventions having the most impact on reducing diarrheal disease. A meta-evaluation was completed of studies evaluating a specific household water treatment method, the biosand water filter. Results from the meta-evaluation illustrate that biosand water filters improve drinking water quality and reduce diarrheal disease. However, there is no generally agreed upon field method for determining biosand water filter effectiveness that is useable …
Women And Healthcare In Appalachia: Impeding Circumstance And The Role Of Technology, Ashley Cano
Women And Healthcare In Appalachia: Impeding Circumstance And The Role Of Technology, Ashley Cano
Electronic Theses and Dissertations
For decades, healthcare access and quality in central and southern Appalachia have trailed the rest of the country. Entrenched poverty and low educational attainment compound healthcare problems. This study examines the healthcare obstacles women encounter in southern and central Appalachia and analyzes how technology use, such as Internet searching and social media affect women’s healthcare decisions. Data were analyzed from four focus groups conducted with women from the region. Results indicate that seeing a physician or not did not influence women’s propensity to search the Internet for health-related information or to seek support through social media sites. Additionally, women reported …
Leveling The Playing Field Through Partnerships And Collaboration : Neighborhood Revitalizations And The Influence Of Social Determinants Of Health And Institutional Logics., J. M. Bohn
Electronic Theses and Dissertations
A qualitative study guided by grounded theory was on a Midwest US city (population > 50,000 people), three of its inner city neighborhoods, and community coalition and partnership efforts in neighborhood revitalizations. A two-phase semi-structured interview methodology assessed interviewees’ experiences in initiatives focused on improving social determinants of health in the neighborhoods. Phase I interviews (n= 11) identified the spectrum of partnerships and initiatives while Phase II interviews (n=28) captured detailed experiences of interviewees. Inter-institutional systems and institutional logics theory were applied in the post-data collection analysis. Interviewees were from public and private sectors including: built environment, economic development, residential/commercial property …
Environmental Vegetation : A Possible Association With Cardiovascular Disease Risk., Ray Anthony Yeager Ii
Environmental Vegetation : A Possible Association With Cardiovascular Disease Risk., Ray Anthony Yeager Ii
Electronic Theses and Dissertations
The built environment affects numerous aspects of human health and wellbeing, including risk of cardiovascular disease (CVD), the leading cause of morbidity and mortality in both the U.S. and worldwide. The amount and quality of environmental vegetation, is an important aspect of the built environment that affects known CVD risk factors, including psychosocial stress, health behaviors, and exposure to air pollutants. Nevertheless, little evidence on the role of potential mechanisms and geographic scale in these relationships exists. Of previous studies that describe associations between vegetation and CVD outcomes, limited investigation has been performed to assess these observed relationships in differing …
The Influence Of Nutrition Education And Self-Efficacy On Fruit And Vegetable Consumption For Low-Income Women In Rural West Kentucky., Lewatis Darnell Mcneal
The Influence Of Nutrition Education And Self-Efficacy On Fruit And Vegetable Consumption For Low-Income Women In Rural West Kentucky., Lewatis Darnell Mcneal
Electronic Theses and Dissertations
Objective: To examine how participation in nutrition education programs, self-efficacy to consume fruit and vegetables and predictor of behavior to eat health foods (POB) influences the consumption of fruit and vegetables for low-income women in west Kentucky eligible or participating in federal supplemental nutrition assistance programs. Methods: A comparative study was conducted between low-income women participating in Special Supplemental Nutrition Assistant Program for Women and Children (WIC) and those eligible for SNAP but were not participating. The study examined consumption in six categories of fruit and vegetables, self-efficacy to consume fruit and vegetables, predictor of behavior to eat healthy foods …
The Impact Of Medicaid Expansion On Utilization Of Mental Health Services In West Louisville, Kentucky., Susan Theresa Buchino
The Impact Of Medicaid Expansion On Utilization Of Mental Health Services In West Louisville, Kentucky., Susan Theresa Buchino
Electronic Theses and Dissertations
Mental health is an essential component of overall health status, and mental illnesses are a leading cause of disability. In addition to expanding insurance coverage, the Affordable Care Act (ACA) reinforced parity for mental health services in insurance plans. This mixed-methods study assessed mental health service utilization by an urban and predominately African-American population following the successful implementation of the ACA and Medicaid expansion in Louisville, KY. Claims data from one Medicaid Managed Care Organization were analyzed to assess mental health care utilization patterns pre- and post- Medicaid expansion and determine differences in utilization rates between the Medicaid expansion population …
Assessing Adult Tobacco Smoking Cessation In Low-And-Middle Income Countries: Analysis Of The Global Adult Tobacco Survey Data, 2009 – 2012, Daniel Owusu
Electronic Theses and Dissertations
Smoking cessation can reduce health risk and prevent millions of tobacco-related deaths. However, cessation rates are low in low-and-middle income countries (LMICs), with only a small proportion of smokers intending to quit. Given the paucity of literature to support tobacco cessation programs in LMICs, this study aimed to: 1) identify factors associated with intention to quit smoking, 2) assess the relationship between health care provider quit advice/tobacco screening and utilization of cessation assistance, and 3) examine the relationship between home smoking rule and smoking intensity across three stages of smoking cessation (precontemplation, contemplation and preparation) in LMICs. Data were obtained …
The Stigma Effect: The Role Of Internalized Racism And Internalized Homophobia In Risky Sexual Behavior Among Black Gay Men, Darren Lovell Whitfield
The Stigma Effect: The Role Of Internalized Racism And Internalized Homophobia In Risky Sexual Behavior Among Black Gay Men, Darren Lovell Whitfield
Electronic Theses and Dissertations
Black gay, bisexual, queer, and same-gender-loving (GBQSGL) men account for less than 1% of US population, yet account for 36% of all new HIV infections. While, Black GBQSGL men experience higher rates of HIV infection compared to other gay, bisexual, and men who have sex with men (MSM) from other racial groups, they are no more likely to report engaging in condomless anal sex (CAS). These findings suggest that one possible explanation is that the context of sexual behavior for Black GBQSGL men may be riskier because of the prevalence of HIV in the community. Furthermore, research suggests that racism …
Identity Theory And Women’S Choice Of Medical Specialty, Kelli A. Rolfsmeyer
Identity Theory And Women’S Choice Of Medical Specialty, Kelli A. Rolfsmeyer
Electronic Theses and Dissertations
The purpose of this study was to answer the research question: Does a self theory of social action account for female physicians’ perceptions of past choice of specialty? Perceptions of self changed as she prepared herself to become a physician. During her medical training, a medical student gains a better sense of who she is as a person who will become a doctor. The ability to act back on one’s self, called selfreflexivity, is the mechanism involved in the transitions of a physician’s biographical self. The data for this study was collected through interviews centered on questions chosen from the …
Icook 4-H: 0 To 24-Month Accelerometer-Derived Physical Activity And Sedentary Time In Youth, Emily Hofer
Icook 4-H: 0 To 24-Month Accelerometer-Derived Physical Activity And Sedentary Time In Youth, Emily Hofer
Electronic Theses and Dissertations
To assess accelerometer-derived physical activity and sedentary time from 0 to 24- months in youth in the iCook 4-H program. The iCook 4-H Program was a 5-state, randomized, control-treatment, family-based childhood obesity prevention intervention promoting cooking, eating and playing together. Youth, 9-10 years old, and their main adult meal preparer, participated in the 12-week program followed by monthly newsletters and bi-yearly booster sessions until 24-months. Physical activity and sedentary time were determined for youth who wore an Actigraph GT3X+ accelerometer for 7 days at 0, 4, 12, and 24-months and met defined accelerometer compliance standards. Mean daily minutes of sedentary …
Utility Of The Information-Motivation-Behavioral Skills Model In Measuring And Predicting Protection Behaviors Among Skin Cancer Patients, Vinayak Kumar Nahar
Utility Of The Information-Motivation-Behavioral Skills Model In Measuring And Predicting Protection Behaviors Among Skin Cancer Patients, Vinayak Kumar Nahar
Electronic Theses and Dissertations
Adoption of effective protection behaviors (SPB) is of paramount importance, particularly among individuals previously diagnosed with non-melanoma skin cancer (NMSC), since they have a considerably higher risk of new NMSC and malignant melanoma; the most lethal form of skin cancer (Nahar et al., 2015). The objective of the current study was to examine the utility of the information-motivation-behavioral skills (IMB) model in measuring and predicting SPB among people who have had NMSC. For this descriptive cross-sectional study, a convenience sample of NMSC patients was recruited at the University of Mississippi Medical Center between July 2015 and April 2016. Inclusion criteria …
The Influence Of Perceived Organizational Support, Perceived Coworker Support & Debriefing On Work-Related Compassion Satisfaction, Burnout, And Secondary Traumatic Stress In Florida Public Safety Personnel, Anastasia Miller
Electronic Theses and Dissertations
The purpose of this study was to examine the relationships between perceived organizational support, perceived coworker support, and debriefing on the one hand, and compassion satisfaction, burnout, and secondary traumatic stress on the other hand in Florida law enforcement, fire, emergency medical services, and dispatch public safety workers. In order to explore the relationships between these constructs, the research questions examined the relationships of the work environment of Florida public safety by administering surveys gauging perceived organizational support, perceived coworker support, psychological resilience, and debriefing activities that the personnel participate in. The Professional Quality of Life: Compassion Satisfaction and Compassion …
Bone Mineral Density, Preventative Behaviors And Risk Factors In African American And Caucasian Mother-Daughter Pairs, Mary Haskins Haskins
Bone Mineral Density, Preventative Behaviors And Risk Factors In African American And Caucasian Mother-Daughter Pairs, Mary Haskins Haskins
Electronic Theses and Dissertations
It is expected that by 2030, elderly minorities will comprise 20.2 million of the total 72.8 million population of Americans over 65 years (pollard, 2013). For African American women over the age of 50, 5% have osteoporosis and an estimated 35% have low bone mass (nof, n.d.). It is estimated that while over 40% of African American women over 80 years meet criteria for treatment, yet less than 12% are actually treated (Cauley, 2011). Striking disparities exist between African American and Caucasian women's likelihood for dual-energy x-ray absorptiometry (dxa) referral, the measurement tool that is used to diagnosis osteoporosis. (Hamrick, …
Biological And Psychosocial Risk Factors Of Stroke In African Americans Enrolled In The Jackson Heart Study (Jhs), Sasikiran Nunna
Biological And Psychosocial Risk Factors Of Stroke In African Americans Enrolled In The Jackson Heart Study (Jhs), Sasikiran Nunna
Electronic Theses and Dissertations
Objectives: the objective of this study is to estimate the impact of biological, psychosocial and other risk factors on stroke in African Americans enrolled in the JHS and determine the population attributable risk of risk factors. Methods: this study used a nested case control design. Cases were patients with stroke during the follow up period. Corresponding controls were selected from subjects who are alive at that time period and who are at risk of stroke by matching on the person-years spent in the cohort. Odds ratios (OR) and population attributable risks (PAR) were calculated to understand the association of risk …
Political, Economic, And Health Determinants Of Tuberculosis Incidence, Ashley Rutherford
Political, Economic, And Health Determinants Of Tuberculosis Incidence, Ashley Rutherford
Electronic Theses and Dissertations
The epidemiologic transition has shifted major causes of mortality from infectious disease to chronic disease; however, infectious diseases are again re-emerging as a major global concern (Diamond, 1997; Karlen, 1995; McNeil, 1976). This research aimed to identify potential areas of infectious disease influence that are not health-related in order to help governments and policymakers establish new policies, correct current policies, or further address these issues in order to effectively prevent and combat infectious disease. This study employed a retrospective, cross-sectional, non-experimental design via structural equation modeling (SEM) and examined tuberculosis incidence rates at the country-level. Secondary data from open-source, international …
The Effect Of The Patient Protection And Affordable Care Act On The Medicare Part D Coverage Gap As Reflected In Diabetes Medication Adherence., Jennifer A. Forristal
The Effect Of The Patient Protection And Affordable Care Act On The Medicare Part D Coverage Gap As Reflected In Diabetes Medication Adherence., Jennifer A. Forristal
Electronic Theses and Dissertations
This dissertation involves an evaluation of the effect of the Patient Protection and Affordable Care Act (ACA) on diabetic medication adherence for mail order utilizers over 6 years as the Medicare Part D coverage gap begins to close. The study had 3 objectives: 1) to evaluate diabetes medication adherence of health plan members before they reach the coverage gap and then while they are in the coverage gap, 2) to compare diabetes medication adherence between two similar groups with differing benefit structures, one group with a gap in coverage as opposed to a group with no benefit changes within the …
Evaluation Of Liver Transplant Prioritization Methods For Hepatocellular Carcinoma Patients Using Multistate Models., Sarah Katharine Alver
Evaluation Of Liver Transplant Prioritization Methods For Hepatocellular Carcinoma Patients Using Multistate Models., Sarah Katharine Alver
Electronic Theses and Dissertations
The Model for End Stage Liver Disease (MELD), used for prioritizing liver transplantation, predicts mortality from liver disease. Patients with hepatocellular carcinoma (HCC) risk disease progression not reflected in their MELD score. Exception scores prioritize HCC patients higher than their MELD scores, but advantage them over non-HCC patients. To address this, a delay of six months for using exception scores has been implemented, and alternative HCC-specific scores have been developed. Using multistate models, this study projects waitlist dropout and transplant probabilities under the delay and under two alternative scores. The delay improves equity between HCC and non-HCC patients for the …
Rural Opioid And Other Drug Use Disorder Diagnosis: Assessing Measurement Invariance And Latent Classification Of Dsm-Iv Abuse And Dependence Criteria, Billy Brooks
Electronic Theses and Dissertations
The rates of non-medical prescription drug use in the United States (U.S.) have increased dramatically in the last two decades, leading to a more than 300% increase in deaths from overdose, surpassing motor vehicle accidents as the leading cause of injury deaths. In rural areas, deaths from unintentional overdose have increased by more than 250% since 1999 while urban deaths have increased at a fraction of this rate. The objective of this research was to test the hypothesis that cultural, economic, and environmental factors prevalent in rural America affect the rate of substance use disorder (SUD) in that population, and …
Network Participation In Public Health : The Development Of Instruments And Adapted Theory To Predict Stakeholder Participation In A Public Health Network., David Johnson
Electronic Theses and Dissertations
Background: Participation in public health networks is important to achieve the goals of public health. This dissertation addresses a common problem in public health management—of how to measure support and predict participation by individuals and organizations in network level collaboratives—through testing an adapted theory producing a newly developed instrument. Purpose: Community health collaboratives have grown in popularity and in funding opportunities in the past couple decades, but they notoriously fail to achieve measureable results. By adapting theory and relevant instruments to a specific public health network context, factors that enable and inhibit participation are identified. Method: A prospective, theory-driven, sequential …
Impact Of Numeracy On Parental Self-Efficacy And Treatment Outcome Of Children On Complex Diets., Diana Cardina Pantalos
Impact Of Numeracy On Parental Self-Efficacy And Treatment Outcome Of Children On Complex Diets., Diana Cardina Pantalos
Electronic Theses and Dissertations
Health numeracy, a counterpart to health literacy, can be a mediator of health disparities. This study analyzed the impact of both cognitive and affective numeracy on the pathway linking health behavior to health outcomes, and the role of self-efficacy in this relationship, based on the Health Belief Model. The context was parental management of children's complex diets that require numerical calculations. Parents of children ages 12 months to 12 years with type 1 diabetes (T1D) or phenylketonuria (PKU) were recruited at clinics or community events in east-central states. Ninety-eight participants completed a standardized test of math skills, an instrument to …
The Association Of Medical Student Debt On Choice Of Primary Care Specialty And Rural Practice Location., Craig Ziegler
The Association Of Medical Student Debt On Choice Of Primary Care Specialty And Rural Practice Location., Craig Ziegler
Electronic Theses and Dissertations
A shortage of primary care physicians (PCP) is present nationally and within Kentucky. The shortage is expected to worsen, unless a dramatic increase occurs in the generation of additional primary care clinicians. Geographical maldistributions of PCP also exist. Whereas 20% of the US population resides in rural areas, only 10% of physicians practice in these areas. This study explores factors that influence medical students’ decisions to select primary care residency training programs, and to practice in rural areas. Specifically, the levels of debt among 1391 graduates from University of Louisville School of Medicine (ULSOM) during 2001-2010 were examined in association …