Public Health Commons^™

Cause For Question: Risk And Postmodern Panic In The Vaccine Safety Debate, Marygrace Trifilio

Theses and Dissertations

This thesis analyzes the thoughts and feelings of non-vaccinating parents in America and argues that contemporary vaccine refusal results from overwhelming information saturation in the Internet age. Non-vaccinating parents express distrust of competing scientific research and call for a return to a more natural, toxin-free lifestyle.

The Influences Of Family Supportive Supervisor Behaviors On The Relationships Among Work-Family Conflict, Stress, And Turnover Intention In Saudi Arabian Registered Nurses, Sitah S. Alshutwi

Theses and Dissertations

Many countries around the world are struggling to maintain adequate number of nurses. Inadequate nurse staffing could compromise the quality of patient care. Among many factors that contribute to RN turnover, the influence of work–family conflict (WFC) has gained little attention. In Saudi Arabia, the turnover rate among Saudi nurses reached 50 % of the total employed nurses. Work-family conflict was found to be a reason that influence Saudi nurses to leave their workplace. In addition, WFC was found to be significantly association with increased turnover intention (TI) among employees. Furthermore, WFC has been linked to a number of negative …

Patient-Delivered Partner Therapy: Elicitation Research Using A Mixed-Method Study Design To Support The Development Of A Behavioral Intervention For Sexually Transmitted Infection Clinic Patients, Steven Alan John

Theses and Dissertations

The transmission of sexually transmitted infections (i.e., STIs) remains a preventable public health problem within the United States. Repeatedly acquired STIs are highly prevalent despite efficacious treatment options, and mechanisms to increase partner notification are paramount to decreasing reinfections. One mechanism to accelerate the time to partner treatment, increase partner treatment, reduce repeat infections, and reduce community prevalence of STIs is the use of patient-delivered partner therapy (PDPT). PDPT is the practice of providing patients diagnosed with a bacterial STI medication to give directly to their partner for treatment without requiring the partner to participate in diagnostic testing, screening, or …

Point Of Use Biosand Filters Of The Rural Dominican Republic, Kurtis Quamme

Theses and Dissertations

The point of use biosand filter (BSF) is used globally as a drinking water treatment solution. In this research, point of use BSFs were inoculated with active biosand from the Linnwood Drinking Water Treatment plant slow sand filter beds (Milwaukee, Wisconsin) and with sands collected from point of use filters operating in the Dominican Republic. These filters were maintained with varying source waters (surface water, groundwater, or tap water to simulate chlorination encountered in the field). The microbial community of filters with varied influents and biosand inoculum were analyzed quantitatively by sequencing and qPCR. Filter efficacy and microbial community were …

Exploring Proximal And Distal Psychosocial Stressors Influencing The Health Outcomes Of Urban American Indians In The Midwest, Alina Aloma

Theses and Dissertations

Researchers have theorized that colonization and forced assimilation of American Indians/Alaska Natives (AI/AN) in the U.S. are associated with the current health outcomes of AI/AN groups. The literature has begun to link a number of negative health outcomes such as chronic illnesses, substance abuse, grief, depression, and anxiety with distal stressors associated with historical loss, as well as with proximal stressors that are continued reminders of historical trauma such as present day discrimination. The present study utilized a quantitative methodology along with a community informed framework through collaboration with multiple urban AI/AN-serving agencies in a metropolitan area of the Midwest …

Survey Of Assessing Pain In Clinical Practice And Applicability Of A New Assessment, Michelle Rose Konz

Theses and Dissertations

ABSTRACT

SURVEY OF ASSESSING PAIN IN CLINICAL PRACTICE AND APPLICABILITY OF A

NEW ASSESSMENT

by

Michelle Konz

The University of Wisconsin-Milwaukee, 2016

Under the Supervision of Professor Joyce Engel, PhD

Aims The purpose of this study is to identify pain assessments that are being used to measure an individual’s pain experience and to discover how occupational therapists are currently assessing pain in youths who have complex communication needs with a developmental disability (DD). Methods Phase 1: A literature review was conducted through the use of electronic databases to research 17 different methods of pain assessment to create descriptive charts to …

Examining Infant Health Outcomes Impacted By South Carolina's Regionalized System Of Perinatal Care, Michael Grady Smith

Theses and Dissertations

Perinatal regionalization systems have been shown to reduce the risk of neonatal mortality when very low birth weight infants are delivered in Level III hospitals with neonatal intensive care units, sub-specialist staffing, and adequate experience caring for high-risk pregnancies and neonates. However, studies to date examining the association between delivery in Level III hospitals and neonatal mortality have not accounted for censoring due to fetal deaths. Furthermore, studies of perinatal regionalization to date have not adequately assessed the association between delivery hospital level of care and the infant’s hospital length of stay. This dissertation examined 8,594 very low birth weight …

Frequency Of Colonoscopy Surveillance In Average-Risk Adults Relative To Guideline Recommendations, Meng-Han Tsai

Theses and Dissertations

Colorectal cancer (CRC) is the third leading cancer in the United States with an estimated 132,700 new cases and 49,700 deaths in 2015. Well-performed screening colonoscopies prevent cancer by allowing visualization of the entire colon and removal of precancerous polyps (adenomas). Persons with high-risk polyps at screening are therefore advised to undergo periodic surveillance colonoscopy. Screening and surveillance colonoscopy guidelines were updated by the U.S. Multi-society Task Force (USMSTF) in 2006, which emphasized risk stratification by polyp features at screening colonoscopy.

This is a retrospective cohort study of patients with screening colonoscopy at an endoscopy center in South Carolina between …

Bayesian Semiparametric Quantile Regression For Clustered Data, Xin Tong

Theses and Dissertations

Traditional frequentist quantile regression makes few assumptions on the form of the error distribution and thus is able to accommodate non-normal errors. However, inference on the quantile regression models could be challenging for the unknown error distribution, though asymptotic or resampling methods were developed. Bayesian literature on quantile regression with random effects is relatively limited. The quantile regression approach proposed in this dissertation is founded on Bayesian probabilistic modeling for the underlying unknown distributions. By adopting the error density with a nonparametric scale mixture models, we developed Bayesian semiparametric models to make an inference on any quantile of interest and …

Sleep Disruption And Cancer Incidence In A Southeastern Veteran Population, Alexandria F. Delage

Theses and Dissertations

Sleep disruption influences biological processes that can facilitate carcinogenesis. However, studies examining the relationship between sleep disruption and cancer risk have been inconclusive. This retrospective cohort study used de-identified data from the Veterans Administration (VA) electronic medical record to test the hypothesis that sleep disorder diagnoses among Veterans seeking care in the Southeast United States Service Network are associated with increased risk for cancer of the prostate, breast, colorectum, or total cancer (1999-2010, N=663,869). Sleep disorders were defined as patients with an in- or out-patient diagnosis as specified by the International Classification of Sleep Disorders. Cancer cases were defined as …

Effectiveness Of Community-Based Eibi Treatment: A Longitudinal Analysis Of Adaptive Behavior And Language Outcomes, John Kuntz

Theses and Dissertations

Autism spectrum disorders (ASDs) are a group of lifelong, neurodevelopmental disorders characterized by deficits in social interaction, communication, relationship development and by the presence of repetitive or stereotypical behaviors including restricted interests. Continued advances in understanding treatment outcomes and broadening access to effective treatment is critical to improving the quality of life of children with autism and their families and minimizing the cost associated with care. The overall aim of this study is to assess the effectiveness of a community-based implementation of an Early Intensive Behavioral Intervention (EIBI) treatment program through a large-sample, longitudinal secondary analysis of administrative data. Additionally, …

Smoking-Related Stigma: A Public Health Tool Or A Damaging Force ?, Paula A. Lozano

Theses and Dissertations

Cigarette smoking is the leading cause of preventable death in the world. In an effort to address the tobacco epidemic, the World Health Organization’s Framework Convention on Tobacco Control (FCTC) has formulated a number of policies that are thought to reduce cigarette consumption by making smoking socially unacceptable. It is possible that tobacco control policies that aim to make smoking socially unacceptable may also result in the stigmatization of smokers. Social factors such as social norms and socioeconomic status may also influence the development of smoking-related stigma. While some researchers suggest that smoking-related stigma may be an important public health …

Molecular Cues Of Pattern-Recognition-Receptor Pathways In Redox-Toxicity-Driven Environmental Nafld, Suvarthi Das

Theses and Dissertations

With the pandemic proportions of obesity and a correlative increase in fatty liver disease, there was a dire need to explore the missing link between the changed environment and progression of NAFLD in obesity. My research implies that environmental toxin bromodichloromethane induces early liver lesions in obesity, and is mediated by the synchronous insult of oxidative stress and increased levels of the adipokine leptin. In a two-pronged approach to investigate the molecular cues, I looked at the role of Purinergic receptor X7 and Toll 4 receptor. Both rodent models and cell-based systems were used. Also, in order to validate my …

Low-Intensity Physical Activity And Cardiometabolic Risk Factors Among Older Adults With Multiple Chronic Conditions, Yueyao Li

Theses and Dissertations

Introduction:

Cardiovascular disease (CVD) is the leading cause of death among older adults in the Unites States and is driven largely by cardiometabolic risk factors including elevated blood pressure and blood glucose. Studies have found the protective effect of moderate intensity physical activity (MIPA) and vigorous intensity physical activity (VIPA) on cardiometabolic risk factor; however, the association between light physical activity (LIPA) and cardiometabolic risk factor among older adults is not clear.

Objectives:

1. Examine the association between LIPA and cardiometabolic risk factors.
2. Examine whether the association between LIPA and cardiometabolic risk factor is moderated by multiple chronic conditions. …

Job Satisfaction And Intent To Quit Outcomes Among Home Health Aides In Home Health Care Industry Of The United States: A Multilevel Study, Seokwon Yoon

Theses and Dissertations

Backgrounds: Home health aides’ job satisfaction and intent to quit have been attributed to organizational and community level factors. The objective is to determine the effects of individual-, organizational-, and community-level factors on job satisfaction or intent to quit among home health aides.

Methods: This research used data from two subsets of the 2007 National Home and Hospice Care Survey and the 2007 National Home Health Aides Survey, sampling six eligible workers across the agencies in the Unites States. As another data source, the present study uses Area Health Resource File. The author used hierarchical linear modeling technique for handling …

Examining Crowdsourced Social Media Platforms And Their Association With College Students' Alcohol Consumption, Perceived Risk, And Behaviors, Danielle Gentile

Theses and Dissertations

Introduction: High-risk alcohol use by U.S. college students remains a significant threat to individual health and community well-being. Newly-emerging social media platforms and apps which relay information about alcohol-related law enforcement serve as an intriguing addition to college alcohol-use environments. The purpose of this study was to examine the information delivered to users by the local social media platform @Drinking Ticket (DT), determine which types of information were then relayed to others, and clarify how this information influences alcohol use, perceived risk, and alcohol-related risk behaviors among college students. Methods: One year of DT tweets (n=854 tweets) were qualitatively coded …

Conversations About Sexuality On A Public University Campus: Exploring Perspectives From Campus Ministry Leaders And Students, Charis Rebecca Davidson

Theses and Dissertations

Since the 1800s, religious organizations have been a presence on public universities. However, there is limited research on the influence these organizations may have on student health communication and behaviors. Prior research on campus ministries has focused primarily on the culture of individual organizations. In this study, researchers explored the goals and experiences of USC leaders related to communication around sexuality with their students, as well as student perceptions of these messages, and how students incorporate religious messages about sexuality into their lives. The present study had four aims:

1. Assess whether students participating in campus ministries at USC differ …

Variation In Restaurant Sanitary Scores In New York City, Kyle Gregory

Theses and Dissertations

The purpose of this study was to determine whether restaurants that are homogenous in nature would exhibit substantially different hygiene scores based on the underlying consumer learning behaviors present in the neighborhoods in which the restaurants are located.

Essays On Two Implications Of The Affordable Care Act (Aca), Esmaeil Salem

Theses and Dissertations

ESSAYS ON TWO IMPLICATIONS

OF THE AFFORDABLE CARE ACT (ACA)

by

Esmaeil Salem

The University of Wisconsin-Milwaukee, 2016

Under the Supervision of Professor Scott J. Adams

The main objective of my dissertation is to investigate some of the causal effects of the Affordable Care Act (ACA) on U.S. healthcare system. After an overview about some of the new provisions enacted by the ACA and their components and timelines, effects of the ACA on immunization coverage for children under age of three and its impact on retention of the insureds receiving newly established rebates would be assessed.

Chapter 2 evaluates changes …

Rn Perceptions Of Coworker Incivility And Collective Efficacy As Influential To Hospital Structures And Outcomes, Jessica Grace Smith

Theses and Dissertations

Background: An aging population and retiring workforce might affect United States health delivery care and could threaten the quality of care in hospitals. Nurses, as the largest profession in healthcare, can buffer these effects if supported in a safe nurse work environment. The purpose of this dissertation was to understand how peer-to-peer registered nurse workplace incivility as a mediator, and collective efficacy as a moderator, influence relationships among hospital structures (i.e. nurse manager leadership and staffing) and hospital outcomes (i.e. missed nursing care and patient safety cultures).

Methods: Donabedian’s (1980) structure-process-outcomes conceptual framework was the theoretical basis for this study. …

Three Essays On Public Policy And Health, Darin F. Ullman

Theses and Dissertations

This dissertation consists of three chapters. My first chapter examines the effect of mandatory first time offender ignition interlock laws. Specifically, I use difference in difference techniques to estimate the effect of the laws on alcohol related fatal accidents. I also discuss and link behavioral models of deterrence and incapacitation to the results, so that finding can easily be interpreted. Results of the study provide pivotal policy relevant information that are essential to maximizing public health and reducing dangerous alcohol related crashes. In particular, results show that states which adopt legislation that requires mandatory participation of first time offenders in …

Beyond The Millennium Development Goals: An Evaluation Of The War On Hiv / Aids In Kenya, Robert G. Nyaga

Theses and Dissertations

HIV/AIDS remains a threat to Kenya and other developing nations. This thesis aimed at assessing the HIV/AIDS situation in Kenya by examining the knowledge of Kenyans towards infection and spread HIV/AIDS, attitudes towards people living with HIV/AIDS, involvement of community opinion leaders in the HIV/AIDS campaigns, sharing of HIV/AIDS information, and government efforts to control HIV/AIDS. A sample of Kenyans (N= 103) was surveyed and asked to respond to several scales assessing each of the above items. Quantitative and qualitative methods reveal the knowledge and attitudes portrayed by Kenyans and show that, although much has been achieved, there is need …

Using Artificial Neural Networks To Predict Disease Associations For Chemicals Present In Burn Pit Emissions, Amanda R. Taylor

Theses and Dissertations

In June of 2015, 27,378 of the 28,000 returning Operation Iraqi Freedom/Operation Enduring Freedom (OIF/OEF) veterans report being exposed to burn pits. According to Barth et al. (2014), 9,660 returning OIF/OEF veterans were diagnosed with respiratory diseases, to include asthma, bronchitis, and sinusitis, thus strengthening the need to develop decision support tools that can be used to understand the relationships between chemical exposure and disease. In this study an Artificial Neural Network (ANN) was used to predict the chemical-disease associations for burn pit constituents. Ten burn pit constituents were tested using varying hidden layers, similar chemical structure relationships, and three …

Neck Injury Criteria Development For Use In System Level Ejection Testing; Characterization Of Atd To Human Response Correlation Under -Gx Accelerative Input, Craig M. Zinck

Theses and Dissertations

The use of Helmet Mounted Displays is ubiquitous in the field of aviation, adding operational capability, increasing head-supported weight and potential neck injury risk. Developing neck injury criteria to evaluate and quantify neck injury is important to ensure ejection systems are produced within acceptable standards. An ATD to human transfer function is developed that quantifies the difference between ATD and human neck response from -Gx accelerative tests, and demonstrates how this function can be applied to ATD test data to make previously developed human risk functions directly applicable to interpreting ATD data with a human based neck injury criterion. A …

Enhancing Parent-Child Communication And Promoting Physical Activity And Healthy Eating Through Mobile Technology: A Randomized Trial, Danielle E. Schoffman

Theses and Dissertations

Background

Although rates of pediatric and adult obesity remain high in the U.S., finding scalable and engaging ways to disseminate obesity prevention and treatment for families has been challenging. The purpose of the Motivating Families with Interactive Technology (mFIT) study was to test the feasibility, acceptability, and effectiveness of two remotely-delivered family-based health promotion programs for improvements physical activity (PA), healthy eating, and parent-child communication and relationship quality.

Methods

Parent-child (child age 9-12 years) dyads enrolled in a 12-week mobile intervention to increase physical activity and healthy eating, which included weekly email newsletters and the use of pedometers. Dyads were …

Provision Of Hospital-Based Palliative Care And The Impact On Organizational And Patient Outcomes, Marisa L. Roczen

Theses and Dissertations

Hospital-based palliative care services aim to streamline medical care for patients with chronic and potentially life-limiting illnesses by focusing on individual patient needs, efficient use of hospital resources, and providing guidance for patients, patients’ families and clinical providers toward making optimal decisions concerning a patient’s care. This study examined the nature of palliative care provision in U.S. hospitals and its impact on selected organizational and patient outcomes, including hospital costs, length of stay, in-hospital mortality, and transfer to hospice. Hospital costs and length of stay are viewed as important economic indicators. Specifically, lower hospital costs may increase a hospital’s profit …

Relationships Of Chronotype, Social Jetlag, Sleep, Physical Activity And Diet With Mood, Perceived Stress, Obesity, Blood Pressure And Prostate Cancer, Daria M. Mcmahon

Theses and Dissertations

Background: Chronotype, social jetlag, poor sleep, proinflammatory diet, and low physical activity have been associated with increased risk of chronic diseases: obesity, diabetes, cardiovascular disease, depression and cancer. Yet the relationships between these factors have not been extensively investigated in prospective studies.

Methods: Two studies were conducted. The first study followed 390 healthy men and women ages 21-35 for two years. Social jetlag [SJL] and sleep measures (total sleep time [TST], sleep onset latency [SOL], wake after sleep onset [WASO]), sleep efficiency [SE]), were derived from physical activity personal (armband) monitoring. The participants wore the armband for 4-10 …

Sustainability Of Food And Nutrition Security Policies During Presidential Transitions: Integrating Socio-Political And Nutritional Sciences, Jessica Liana Escobar-Alegría

Theses and Dissertations

Presidential transitions are uncertain periods in which relationships among power, accountability, and electoral support of a democratic process do not hold. Transitions challenge collaboration towards implementing policies contributing to food and nutrition security (FNSP). Sustaining these policies during transitions is critical for reaching long-term goals. Knowledge gaps remain on how to perform strategic multisectoral work during transitions to maximize FNSP sustainability.

This study aimed to examine what determines FNSP sustainability during presidential transitions and responded to the questions: How do policy actors define sustainability? What are the mechanisms determining policy sustainability? What are the implications of terminal logic behavior (TLB) …

The Association Between Physical Activity And Serum Immunoglobulin G (Igg) Antibodies Against Periodontal Bacteria, A. Paige Anderson

Theses and Dissertations

The purpose of this study is to add more research and evidence to the mechanisms surrounding periodontal disease, periodontal microorganisms, and physical activity. The main objective of this study is to evaluate and explore the association between physical activity and serum IgG antibodies, which are grouped into four distinct clusters, formed from species specific 19 periodontal antibody titers. This cross sectional study divided physical activity into three categories: adequately physically active, inadequately physically active, and inactive based on MET scores. Certain models were adjusted for confounders including age, sex, race/ethnicity, income-to-poverty ratio, years of formal education, smoking, alcohol intake, BMI, …

The Influence Of Fine Particulate Matter On Inflammatory Bowel Disease In South Carolina: An Ecological Analysis, Joshua Eric Sellner

Theses and Dissertations

Background. The Inflammatory Bowel Diseases, including both Ulcerative Colitis and Crohn’s Disease, are lifelong disorders of the Gastrointestinal tract. In recent years, both conditions have become much more prevalent and recognized as major public health issues. Environmental factors have become the focus of recent research around the cause of these diseases. Although shown to have detrimental effects on diseases similar to that of the Inflammatory Bowel Diseases, fine particulate matter’s role in these diseases has not been adequately investigated.

Aim. The purpose of this study was to test the relation of fine particulate matter with hospitalizations attributable to …