Public Health Commons^™

Examining The Relationships Between Religiosity, Spirituality, Internalized Homonegativity, And Sexual Risk Behaviors Among African-American Men Who Have Sex With Men: The Sexual Health In Faith Traditions (Shift) Study, Stacy Whichard Smallwood

Theses and Dissertations

Background: African-American men who have sex with men (AAMSM) are at disproportionate risk for HIV infection. Although the disparities in infection rates between AAMSM and MSM of other groups have been well-documented, little is known about the factors that contribute to the disparity, particularly psychosocial factors. One such factor, internalized homonegativity (IH), has been identified as a potential predictor of AAMSM engagement in risky sexual behaviors. However, little has been known about the ways in which IH manifests itself in the lives of AAMSM, or the role that sociocultural institutions, such as African-American faith communities, play in the development of …

A Preliminary Study Exploring Racial Differences In Triage, Hospitalization Status, And Discharge Medication In An Emergency Department In Graniteville, Sc, Clare Pollock

Theses and Dissertations

Purpose

This study seeks to identify any racial differences present in assigned triage scores, hospitalization status and discharge medications in a rural hospital likely experiencing a surge after a mass casualty incident involving chlorine gas as a result of a train derailment. Differences were examined between Non-Hispanic White and African American adults who were moderately ill and who presented to the emergency department of the closest hospital to the accident site within 24 hours of the incident.

Methods

Non-Hispanic White and African American adults who presented to the emergency department of the closest hospital to the accident site and who …

Understanding The Early Stages Of Development Of A Global Health Partnership, Wendy Raquel Gonzalez Navarrete

Theses and Dissertations

Maternal and child undernutrition contributes to more than one-third of child deaths. Global Health Partnerships (GHP) have emerged as a response to undernutrition and other pressing health problems. GHPs promote joint decision-making among donors, multilateral agencies, and country partners. Despite their positive impact on health problems, GHPs have generated unintended negative effects on country partners. This study aimed to understand the factors, strategies, and processes conducive to the establishment of an effective GHP in the context of a cooperative regional effort to reduce undernutrition and improve maternal and child health in eight countries in Latin America, Regional Health Initiative (RHI). …

Geographical Proximity To Health Facilities And Breast Cancer Morbidity And Mortality Among Women In South Carolina's Best Chance Network, Leepao Khang

Theses and Dissertations

Death rates for breast cancer have steadily decreased in women due to early detection, such as mammography, and improved treatments. Despite the benefit of mammography, many women are not up-to-date on screening and do not receive timely follow-up after abnormal mammogram finding. Breast cancer is a major contributor to morbidity and mortality among women in South Carolina. To reduce the disproportionate burden of breast cancer and cervical cancer among women in South Carolina, the South Carolina Best Chance Network (BCN) was established to provide service delivery and ensures timely and complete diagnostic follow-up and treatment initiation for underserved women.

The …

Association Between Breastfeeding And Infant Growth: A Probable Reverse Causality, Shraddha Vyas

Theses and Dissertations

Background: Much conflicting results exist in the association between breastfeeding and infant growth. One of these confusions is related to the temporal sequence between breastfeeding practice and infant growth.

Objective: This study aimed at examining the association and investigating a possible reverse causality between breastfeeding and infant growth.

Method: Infant Feeding Practices Survey II, a national longitudinal database with repeated measurements, following women prenatally and until one year postpartum (N=2914) was used. Mixed linear model assessed the impact of breastfeeding from the 2nd, 4th, 6th and 9th months on infant growth at the 3rd, 5th, 7th and 12th months, respectively. …

Understanding Online And Offline Sex Seeking Behavior Among Young Men Who Have Sex With Men: Implications For Hiv/Aids Interventions, Winston Eromosele Abara

Theses and Dissertations

Men who have sex with men (MSM), especially in the southeastern US are disproportionately impacted by the HIV/AIDS epidemic. Young MSM and African American MSM are particularly burdened accounting for a greater proportion of HIV/AIDS diagnoses. Factors such as risky sexual behavior, perception of sexual risk, ignorance about HIV sero-status, internalized homonegativity/homophobia (IH), stigma, and alcohol and illegal drug use have been advanced as reasons for this disproportionate burden. HIV/AIDS prevention efforts aimed at stemming the epidemic among MSM have focused on locations where MSM meet other men for sex such as parks, beaches, bathhouses, adult book stores, clubs, and …

Smokers' Neurological Responses To Imagery From Cigarette Package Warning Labels, Johann Fridrik Fridriksson

Theses and Dissertations

Tobacco use is the leading cause of preventable death in the United States. The Family Smoking Prevention and Tobacco Control Act was signed into law in 2009 and gave the U.S. Food and Drug Administration (FDA) the authority to implement pictorial health warning labels (HWLs) on cigarette packages. Multiple studies investigating self-reported affective, cognitive and behavioral impacts of HWLs suggest that the most effective warnings include imagery that depicts physical damage to the body due to smoking. However, self-report methods of assessment used in these studies may be biased. Far less is known about how HWLs directly modulate brain activity. …

Exploring African American And White 18-19 Year Old Males' Communication Experiences With Their Parents And Partners About Sex And Contraception, Charlotte Toole Galloway

Theses and Dissertations

Background: Increasing parent-child and partner communication about sex and contraception have been identified as protective factors that are amenable to change by teen pregnancy prevention programs.

Purpose and Methods: From June through July 2012, a total of six focus groups (N=30) were conducted with African American and White 18-19 year old males to retrospectively explore their communication experiences with parents and partners about sex and contraception, and their attitudes and beliefs about sex, pregnancy, and contraception.

Results: Most participants felt that parent-child sexual risk communication would be more effective when parents had a history of open communication and a good …

Investigating Developmental Patterns Of Symptom And Impairment Change Among Youth With Adhd, Subthreshold Adhdand Youth Without Adhd, Lorie Love Geryk

Theses and Dissertations

Introduction. Despite a substantial prevalence of subthreshold Attention-Deficit/Hyperactivity Disorder (ADHD) and research indicating that many youth with this disorder have impaired functioning and negative outcomes, few studies have considered patterns of symptom and functioning change for youth with probable ADHD, subthreshold ADHD and youth without ADHD transitioning from childhood to adolescence. Additionally, we are not aware of any studies examining predictors of impairment severity among youth with subthreshold ADHD, and few studies have examined predictors of treatment utilization and patterns of symptom and functioning change based on medication status for youth with subthreshold ADHD compared to youth with ADHD. Methods. …

A Qualitative Study Of An Urban Community Garden: Creating Healthier Neighborhood Environments, Lauren Workman

Theses and Dissertations

Neighborhoods influence population level health; the places where people live, work, and grow are an essential setting for health promotion interventions. In efforts to create healthier neighborhood environments, there is a movement to better understand neighborhood social characteristics. The neighborhood social environment potentially includes social relationships (including trust and cohesion), networks, norms, and the resources that may be generated from relationships. In addition, more work is needed to learn about how people may become engaged in neighborhood initiatives. Community gardens are a 1) potential strategy to promote health at community and individual levels 2) mechanism to involve community members in …

Bmi At Diagnosis And Its Association With Markers Of Hiv Disease Progression And Cardiovascular Disease Risk., Kelly Deshon Johnson

Theses and Dissertations

Highly active antiretroviral treatment (HAART) has transformed the state of human immunodeficiency virus (HIV) from acute to chronic. As a result, the long-term effect of HAART has caused weight gain among HIV-infected individuals, leading to an increased prevalence of overweight and obesity. Increased Body Mass Index (BMI) has been associated with adverse health outcomes in non-HIV and HIV populations, yet among HIV-infected individuals, a higher BMI at diagnosis offers a slower progression from HIV to AIDS. Pre-HAART, studies reported that obese HIV-infected individuals have higher increases in CD4 count over time. However post-HAART, some report that overweight HIV-infected individuals with …

The Relationship Between Electronic Health Record Implementation And Outcomes Of Care For Three Cardiovascular Procedures, Deshia Ann Leonhirth

Theses and Dissertations

Background. The U.S. healthcare movement to improve quality and patient outcomes has prompted investigations into tools that can assist in these aims. Electronic health records (EHRs) are one tool proposed by the Institute of Medicine (IOM). The objective of this original dissertation research was to examine the relationship between electronic health record functionalities and two outcomes of care as proxies for quality: risk-adjusted mortality for abdominal aortic aneurysm (AAA) repair, coronary artery bypass grafting (CABG), and percutaneous coronary intervention (PCI) and log estimated cost-per-discharge. Methods. This study used 2009-2010 hospital inpatient administrative discharge data from the Nationwide Inpatient Sample (NIS), …

Food Environment And Birth Outcomes In South Carolina, Xiaoguang Ma

Theses and Dissertations

An increasing number of studies examined the association between neighborhood characteristics and birth outcomes. However, the results can be difficult to compare because of the variety of indicators used to characterize the neighborhood. As an important neighborhood characteristic, the food environment is associated with residents' nutrition status, diet quality, and related health outcomes. In addition, the food environment has been found to influence women's diet quality during pregnancy, which is a key factor in predicting birth outcomes. However to date, studies on food environment and birth outcomes are extremely limited.

This study examined the association between food environment (evaluated by …

Differential Effects Of The Great Recession On Minority Populations, Samuel Towne

Theses and Dissertations

Times of severe economic flux may burdend individuals at differing levels. The Great Recession affected individuals differently by racial group. Vulnerable individuals who may already be burdened by economic strains and health disparities may benefit from state policies that work to improve the health and health care access of individuals. Medicaid Generosity for parents or childless adults is associated with differences in individuals' health status and reporting forgone medical care. Individuals in states that have higher levels of Medicaid eligibility defined as eligibility in relation to the percent of the Federal Poverty Level report lower levels of poor or fair …

An Assessment Of Injury Presentation To Determine Elder Abuse Prevalence In South Carolina, Brittani L. Harmon

Theses and Dissertations

As the number of individuals age 60 years of age and older continues to rise in the United States, the care and safety of this population will be a growing issue. There are many contributing factors and reasons why elder abuse occurs. Elder abuse is an emerging issue; however there is limited research and understanding in the area. There are barriers to the detection and prevention of the issue. Emergency department staff is essential to the identification and detection of possible abuse, and it is important that these providers understand the risk factors and physical manifestations of abuse and neglect …

Promoting Early Childhood Development Through Community Health Worker Interventions: Implementation And Measurement Issues In Rural Pakistan, Zaeem Haq

Theses and Dissertations

Appropriate nutrition and psychosocial stimulation during the first three years of life can have long-lasting effects on a child's health and development. However, not all children in the world receive adequate nutrition and psychosocial stimulation during this period. There has been enormous interest in developing the evidence on the most effective ways of implementing and assessing early childhood development (ECD) promotion interventions in resource poor settings. Despite the interest, the integration of ECD interventions into pre-existing public health programs, and assessment of these interventions in extended family, rural household environment have not been addressed.

The dissertation research presented here was …

Postnatal Depression In Mexico: Healthcare Provider Conceptualizations And Policies In The Public Health Sector, Jean Marie Sims Place

Theses and Dissertations

Background: The World Health Organization (WHO) and the United Nations Population Fund (UNFPA) highlight education and training for healthcare providers and the development of a policy framework as core strategies to address maternal mental health in low- and middle-income countries. This research critically examines these strategies with respect to postnatal depression in Mexico. The research 1) addresses how healthcare providers in Mexico conceptualize postnatal depression, and 2) assesses the policies that exist in Mexico regarding postnatal depression, which will inform the next steps for policy development. The research informs appropriate healthcare provider education and training, as well as the next …

Race, Ethnicity, And Differential Perceptions Of Sexual Victimization (Assault), Kaleea Regina Lewis

Theses and Dissertations

The purpose of this pilot study is to ascertain how a sample of female college students perceives a hypothetical victim of a fabricated sexual assault. Participant perceptions of the sexual assault were explored through three distinct parameters: (1) victim responsibility attributes, (2) levels of trauma suffered due to the experience, and (3) levels of social support. This study addressed the two following research questions: (1) how does the hypothetical sexual assault victim's race and ethnicity affect how the study parameters are assessed and (2) how do participants perceive a hypothetical sexual assault victim, when presented in different races and ethnicities, …

Epid-Based Dose Verification For Adaptive Radiotherapy, Joseph Gardner

Theses and Dissertations

Dose verification is a critical component of adaptive radiotherapy, as it provides a measurement of treatment delivery success. Based on the measured outcome, the plan may be adapted to account for differences between the planned dose and the delivered dose. Although placement of an EPID behind the patient during treatment allows for exit dosimetry which may be used to reconstruct the delivered patient dose via backprojection of the fluence, there have not been any studies examining the basic assumption of backprojection-based dose verification: that deviations between the expected and delivered exit fluences are totally caused by errors in the delivered …

Validation Of 3'-Deoxy-3'-[18f]-Fluorothymidine Positron Emission Tomography For Image-Guidance In Biologically Adaptive Radiotherapy, Marian Axente

Theses and Dissertations

Accelerated tumor cell repopulation during radiation therapy is one of the leading causes for low survival rates of head-and-neck cancer patients. The therapeutic effectiveness of radiotherapy could be improved by selectively targeting proliferating tumor subvolumes with higher doses of radiation. Positron emission tomography (PET) imaging with 3´-deoxy-3´-[18F]-fluorothymidine (FLT) has shown great potential as a non-invasive approach to characterizing the proliferation status of tumors. This thesis focuses on histopathological validation of FLT PET imaging specifically for image-guidance applications in biologically adaptive radiotherapy. The lack of experimental data supporting the use of FLT PET imaging for radiotherapy guidance is addressed by developing …

Exploring The Social Determinants Of Sexually Transmitted Disease And High-Risk Sexual Behaviors, River Pugsley

Theses and Dissertations

Abstract 1: A multi-level assessment of disproportionate population sex ratios and high-risk sexual behaviors among STD clinic patients Low male-to-female sex ratios in a population may influence high-risk sexual behaviors, such as multiple sex partners and inconsistent condom use, which facilitate the transmission of STDs. This study used multi-level modeling to assess whether population sex ratios were associated with these two individual-level behaviors. All analyses were stratified by gender. Interview data were collected from patients (N = 9,203, 48% male) attending participating STD clinics. Interviews included information on socio-demographics and sexual behavior, including number of sex partners in the previous …

Probabilistic Model For Laser Damage To The Human Retina, David A. Wooddell Jr.

Theses and Dissertations

Understanding how lasers interact with media during propagation is a premiere field of physics. The subject area known as laser bioeffects explores laser interactions with biological cells, tissues, organs, and bodies. This research includes laser applications used in medicine, establishes safe exposure limits for industry and academia, and generally studies the many effects of laser light on living creatures. The bioeffects community relies heavily on deterministic modeling and simulation tools to support experimental research into damage thresholds and laser effects. However, recent laser applications require a probabilistic approach to support risk management and analyses methodologies. Some probabilistic models exist, but …

Comparative Analysis Of Two Biological Warfare Air Samplers Using Live Surrogate Agents, James C. Enderby

Theses and Dissertations

The United States Air Force has several high-volume biological air samplers, including the XMX/2L-MIL and the Biocapture 650. Limited information is available on either in terms of its collection of viruses and bacteria. However, previous research on the XMX/2L-MIL has determined that modifications to the secondary flow rate and the use of a virus preserving collection media may provide improved virus collection rates. In this thesis, these modifications were investigated to determine their impact on the collection of viral and bacterial aerosols. Additionally, relative collection rates were compared against those for the Biocapture 650. MS2 bacteriophage was the viral surrogate …

Influence Of Ph On The Transport Of Silver Nanoparticles In Saturated Porous Media: Laboratory Experiments And Modeling, Jason R. Flory

Theses and Dissertations

Given the ubiquity of silver nanoparticles (AgNPs), the largest and fastest growing category of nanomaterials, and their potential for toxic effects to both humans and the environment, it is important to understand their environmental fate and transport. The purpose of this study is to gain information on the transport properties of unmodified AgNP suspensions in a glass bead-packed column under saturated flow conditions at different solution pH levels. Commercial AgNPs were characterized using high resolution transmission spectroscopy (HRTEM), dynamic light scattering (DLS) and ultraviolet (UV) visible spectroscopy. Transport data were collected at different pH levels (4, 6.5 and 9) at …

A Structural Equation Modeling Analysis Of The Effects Of School, Community And Individual Factors On Substance Use Among Girls In Rural Counties, Taniesa Moore

Theses and Dissertations

Substance use among adolescent girls in the United States is increasing. In some regions substance use by rural adolescent girls exceeds that of its urban and suburban counterparts. The purpose of this study is to investigate the adequacy of constructs within Catalano, Hawkins, and the Social Development Research Group's (1996) social development model (SDM) as an empirical-based model pertaining to early adolescent girls' pathways to substance use by examining school, community, and individual risk and protective factors. Risk factors are defined as those traits, variables, or vulnerabilities that, if present for a particular individual, increase the likelihood of those individual …

Smoking In The United States Air Force: Trends, Most Prevalent Diseases And Their Association With Cost, Michail Gkoutouloudis

Theses and Dissertations

This research focuses on the smoking rates among the Active Duty Air Force (ADAF) personnel and the association of smoking and cost of hospitalization because of diseases related to smoking. Three types of analyses were used in this research. The Contingency Analysis was based on the data taken from the Air Force Web HA questionnaire. The Pivot Table Analysis and the Regression Analysis were based on a second data set associated with the cost of hospitalization. The Contingency Analysis showed that smoking in the U.S. Air Force is more prevalent among the enlisted, males, and the younger age groups. The …

A Quantitative Method For Reproducible Ionization Chamber Alignment To A Water Surface For External Beam Radiation Therapy Depth Dose Measurements, James Ververs

Theses and Dissertations

Ionization chambers (ICs) are the most commonly used detectors for radiation therapy dose measurements. Typical IC measurements use cylindrical ICs in a water phantom and therefore require initial IC alignment to the water surface. This alignment has long been ignored and only recently has a qualitative governing recommendation been made. This thesis describes a reproducible methodology for quantitative ionization chamber water surface alignment. Depth-ionization measurements are taken with twenty-eight IC designs under varying conditions including, but not limited to, changes in scan direction, speed, and resolution, radiation beam type, field size, energy, and electron contamination. Measurements are acquired using standard …

Statistical Image Reconstruction For Quantitative Computed Tomography, Joshua Evans

Theses and Dissertations

Statistical iterative reconstruction (SIR) algorithms for x-ray computed tomography (CT) have the potential to reconstruct images with less noise and systematic error than the conventional filtered backprojection (FBP) algorithm. More accurate reconstruction algorithms are important for reducing imaging dose and for a wide range of quantitative CT applications. The work presented herein investigates some potential advantages of one such statistically motivated algorithm called Alternating Minimization (AM). A simulation study is used to compare the tradeoff between noise and resolution in images reconstructed with the AM and FBP algorithms. The AM algorithm is employed with an edge-preserving penalty function, which is …

Contextual Factors And Reproductive Control In U.S. Women, Brianna Magnusson

Theses and Dissertations

Introduction: Access to family planning services is a major public health issue. State policies and funding for family planning services may increase access to contraceptive services and help women avoid unintended pregnancies. Study Design: We identified sexually active, fertile women participants of the National Survey of Family Growth (2006-2008). Women were categorized as consistent or inconsistent users of contraceptives based on self-report. States were classified based on 2006 Medicaid family planning waiver status (income expansions, limited expansions, or no Medicaid family planning expansions), 2006 public funding for family planning in dollars per woman, and insurance coverage of contraceptive mandate status …

Radiation Therapy Treatment Plan Optimization Accounting For Random And Systematic Patient Setup Uncertainties, Joseph Moore

Theses and Dissertations

External-beam radiotherapy is one of the primary methods for treating cancer. Typically a radiotherapy treatment course consists of radiation delivered to the patient in multiple daily treatment fractions over 6-8 weeks. Each fraction requires the patient to be aligned with the image acquired before the treatment course used in treatment planning. Unfortunately, patient alignment is not perfect and results in residual errors in patient setup. The standard technique for dealing with errors in patient setup is to expand the volume of the target by some margin to ensure the target receives the planned dose in the presence of setup errors. …