Public Health Commons^™

Utilization Of Classroom Physical Activity Breaks, Danae M. Dinkel, Jung-Min Lee, Caitlin Golden, Connie Schaffer

Research Presentations

Historically within schools, physical education and recess periods have been utilized as the primary times for children to obtain some portion of physical activity (PA) recommendations during the school day. Due to academic pressure, opportunities for physical education and recess periods have been reduced. Fewer than 5% of schools require daily physical education and fewer than 12% require daily recess. Additional PA opportunities are needed throughout school day.

PURPOSE: The overall purpose of this study was to examine teachers’ utilization of classroom PA breaks.

METHODS: 332 Elementary school teachers from five school districts in a Midwest city were …

An Exploratory Study Of Infant Physical Activity In Relation To Obesity, Danae M. Dinkel, Jung-Min Lee, Kailey Snyder, Anastasia Kyvelidou

Research Presentations

Historically, society has thought that infants (0 to 1 year of age) are “active enough” and not in need of efforts to promote physical activity (PA). However, approximately 10% of infants in the U.S. are obese and research has shown low PA is one of the risk factors for obesity in toddlers. Little research has been done to systematically compare PA levels between normal weight infants and obese/overweight infants in the first year of life. PURPOSE: The purpose of this study was to determine the level of PA in normal weight and overweight infants. METHODS: Twenty-one normal weight …

The Effects Of Financial Literacy On Patient Engagement, Melanie Meyer

Walden Dissertations and Doctoral Studies

Health care reform has caused consumers to learn more about what it means to have health insurance and its costs. Patient engagement, a critical component of health care reform, reflects provider and consumer attention to shared decision making between patient and physician. The problem addressed in this study is that although researchers have studied patient engagement, there has been insufficient exploration of the relationship between financial literacy and patient engagement, which could negatively impact health outcomes not only for patients or consumers but for society as a whole. The purpose of this quantitative research was to determine if a relationship …

Cardiovascular Disease Risk Factors In Structural Firefighters, Nicholas W. Trubee

Theses and Dissertations--Kinesiology and Health Promotion

This dissertation is composed of two manuscripts assessing cardiovascular disease (CVD) risk in structural firefighters. Study 1 compared traditional CVD risk factors and health-related behaviors between professional and volunteer firefighters. Online questionnaires were sent to approximately 4000 firefighters in the state of Kentucky. The results indicated that 90% of volunteer and 58% of professional firefighters were classified as moderate-to-high CVD risk. Volunteer firefighters were significantly (p < 0.001) older and more likely (p = 0.026) to be current cigarette smokers. The mean body mass index among all firefighters in the sample was 30.8 kg·m^-2. Nearly 60% of volunteer firefighters were obese. Obese firefighters were more likely (p < 0.05) to have been diagnosed as diabetic or pre-diabetes compared to overweight and normal weight firefighters. These results indicate that volunteer firefighters may be at a greater CVD risk compared to professional firefighters.

Study 2 investigated the association of cardiorespiratory fitness (CRF) and body fat with arterial stiffness in professional firefighters. Forty-six …

A Public Duty: Medicine And Commerce In Nineteenth-Century American Literature And Culture, Heather E. Chacon

Theses and Dissertations--English

Using recent criticism on speculation and disability in addition to archival materials, “A Public Duty: Medicine and Commerce in Nineteenth-Century American Literature and Culture” demonstrates that reform-minded nineteenth-century authors drew upon the representational power of public health to express excitement and anxiety about the United States’ emerging economic and political prominence. Breaking with a critical tradition holding that the professionalization of medicine and authorship served primarily to support and define an ascending middle class, I argue that the authors such as Robert Montgomery Bird, Fanny Fern, George Washington Cable, and Pauline Hopkins fuse the rhetoric of economic policy and public …

Medication Misadventures: The Case Of Benzodiazepines, Sarah E. Wixson

Theses and Dissertations--Pharmacy

For patients afflicted with symptoms of anxiety and insomnia, benzodiazepines are generally a safe and effective short-term pharmacological treatment option. Although considered safer than other sedative-hypnotic medications, substantial concern exists regarding the addictive nature and abuse potential of benzodiazepines along with potentially inappropriate prescribing and utilization in clinically vulnerable populations. These medication misadventures can have a significant impact on public health. Examples of medication misadventures as they pertain to benzodiazepines include the prescribing and use in clinically vulnerable populations for whom they are contraindicated or their efficacy has not been evaluated, the development of tolerance or addiction, abuse of the …

Evidence-Based Hospitals, David R. Bardach

Theses and Dissertations--Epidemiology and Biostatistics

In 2011 the University of Kentucky opened the first two inpatient floors of its new hospital. With an estimated cost of over $872 million, the new facility represents a major investment in the future of healthcare in Kentucky. This facility is outfitted with many features that were not present in the old hospital, with the expectation that they would improve the quality and efficiency of patient care. After one year of occupancy, hospital administration questioned the effectiveness of some features. Through focus groups of key stakeholders, surveys of frontline staff, and direct observational data, this dissertation evaluates the effectiveness of …

Developments In Nonparametric Regression Methods With Application To Raman Spectroscopy Analysis, Jing Guo

Theses and Dissertations--Epidemiology and Biostatistics

Raman spectroscopy has been successfully employed in the classification of breast pathologies involving basis spectra for chemical constituents of breast tissue and resulted in high sensitivity (94%) and specificity (96%) (Haka et al, 2005). Motivated by recent developments in nonparametric regression, in this work, we adapt stacking, boosting, and dynamic ensemble learning into a nonparametric regression framework with application to Raman spectroscopy analysis for breast cancer diagnosis. In Chapter 2, we apply compound estimation (Charnigo and Srinivasan, 2011) in Raman spectra analysis to classify normal, benign, and malignant breast tissue. We explore both the spectra profiles and their derivatives to …

Nonlinear Hierarchical Models For Longitudinal Experimental Infection Studies, Michael David Singleton

Theses and Dissertations--Epidemiology and Biostatistics

Experimental infection (EI) studies, involving the intentional inoculation of animal or human subjects with an infectious agent under controlled conditions, have a long history in infectious disease research. Longitudinal infection response data often arise in EI studies designed to demonstrate vaccine efficacy, explore disease etiology, pathogenesis and transmission, or understand the host immune response to infection. Viral loads, antibody titers, symptom scores and body temperature are a few of the outcome variables commonly studied. Longitudinal EI data are inherently nonlinear, often with single-peaked response trajectories with a common pre- and post-infection baseline. Such data are frequently analyzed with statistical methods …

The Non-Steroidal Anti-Inflammatory Drugs-Myocardial Infarction Association: An Investigation Of Kentucky Medicaid Prescription Claims, Leonard A. Gordon

Theses and Dissertations--Epidemiology and Biostatistics

Non-steroidal anti-inflammatory drugs (NSAIDs) are among the most widely used medications globally. There are generally two types: selective (COX-2) and traditional NSAIDs (COX-1). They are primarily used for the treatment of pain. They gained attention after a study about their basic mechanisms highlighted their toxicity.

Several studies have reported an association between NSAIDs and risk of myocardial infarction (MI). However, the direction of the relationship is not conclusive. Further studies are needed to ascertain the direction of this relationship and evaluate the present situation with available drugs. Due to the seriousness of cardiovascular diseases as one of the leading cause …

Demographic Profile Of The “Farmworker Population” In The United States, Carlos Siordia, Athena Ramos

Reports: Health Promotion, Social & Behavioral Health

The health and economic well-being of farmworkers has been investigated by social scientists for many decades [1,2,3]. General research on occupational safety and farmworker justice has also been developed more recently [4]. Because Hispanics/Latinos are commonly associated with farmworker occupations, especially migrant farm work, research has paid special attention to their population [5]. For example, researchers have investigated the health of Latina farmworkers [6], injury in youth from Latino farmworker families [7], and learning ability amongst Latino farmworkers [8]. However, Latinos only make up about half of the “farmworker population” is the United States (US). The specific aim of this …

Determination Of Triglycidyl Isocyanurate From Air Samples By Ultra-Performance Liquid Chromatography Coupled With Coordination Ion Spray Mass Spectrometry, Sébastien Gagné, Marielle Carrier, Simon Aubin

Études primaires

Rationale

Ultra-performance liquid chromatography (UPLC) coupled with coordination ion spray tandem mass spectrometry was used for the analysis of air samples containing triglycidyl isocyanurate. The method is not affected by any chromatographic interference and the filter extract is compatible with the UPLC system, as opposed to approaches using high-performance liquid chromatography coupled with ultraviolet detection and gas chromatography coupled with mass spectrometry.

Methods

Accu-cap^™ filters that had sampled triglycidyl isocyanurate were extracted using a mixture of acetonitrile/acetone (95/5) diluted with 3 volumes of water and were then analyzed. The mass spectrometry method uses sodium as the alkali adduct complexing …

Particle Loading Time And Humidity Effects On The Efficiency Of An N95 Filtering Facepiece Respirator Model Under Constant And Inhalation Cyclic Flows, Alireza Mahdavi, Fariborz Haghighat, Ali Bahloul, Clothilde Brochot, Claude Ostiguy

Études primaires

It is necessary to investigate the efficiencies of filtering facepiece respirators (FFRs) exposed to ultrafine particles (UFPs) for long periods of time, since the particle loading time may potentially affect the efficiency of FFRs. This article aims to investigate the filtration efficiency for a model of electrostatic N95 FFRs with constant and ‘inhalation-only’ cyclic flows, in terms of particle loading time effect, using different humidity conditions. Filters were exposed to generated polydisperse NaCl particles. Experiments were performed mimicking an ‘inhalation-only’ scenario with a cyclic flow of 85 l min ^–1 as the minute volume [or 170 l min ^–1 as …

Health Literacy Proficiency, Sources Of Health Information, And Perceived Barriers To Health Literacy Among Selected Members Of The Hmong Community In Minnesota, Amanda Vang

All Graduate Theses, Dissertations, and Other Capstone Projects

The purpose of this study was to determine health literacy proficiency, sources of health information, and perceived barriers to health literacy among selected members of the Hmong community in Minnesota. Data for this cross-sectional study were collected using the Short Assessment on Health Literacy-English (SAHL-E) screening tool and a questionnaire. The SAHL-E screening tool and a questionnaire were distributed to 40 Hmong residents in the St. Paul/Minneapolis in Minnesota. When combining the numbers of health literacy scores, a mean of 15.5 was reported. The overall findings of this research assessed that the Hmong community in Minnesota has adequate health literacy …

Effects Of Education On Victims Of Domestic Violence, Julette N. Anderson

Walden Dissertations and Doctoral Studies

The purpose of this project was to improve support for victims of domestic violence. To that end, this project developed an evidence-based program to provide information about domestic violence including safe and confidential ways to seek assistance, rights as cohabiting intimate partners, and the resources available to community members. Several approaches were used to develop, validate, and plan for implementation and evaluation of this program, which was developed for 3 sites in Broward and Miami-Dade counties where the project is situated. The program logic model and the social ecological model, including the individual, relationship, community, and societal levels, were used …

Assessment Of Vitamin D Levels And Depression Among Adults In The United States, Troy Jean-Luc Owens

Walden Dissertations and Doctoral Studies

Vitamin D is essential to optimizing health; vitamin D deficiency (VDD) can increase risk of hypertension, cardiovascular disease, and insulin resistance. VDD occurs when individuals do not receive sufficient oral intake or obtain adequate sun exposure. Previous researchers indicated there is a relationship between VDD and depression, while others have indicated there is no relationship. The purpose of this study was to examine the relationship between vitamin D levels and depression, and how this relationship might be moderated by an individual's demographic characteristics (gender, age, smoking status, or marital status). This study was a quantitative data analysis of archival data …

The Association Between Exhaled Nitric Oxide In Exhaled Breath Condensate And Chronic Obstructive Pulmonary Disease, Colin Mitchell

Walden Dissertations and Doctoral Studies

Chronic obstructive pulmonary disease (COPD), a progressive and nonreversible disease, is a leading cause of mortality and morbidity throughout the world. Detecting COPD early in the disease process will help in decreasing later stage COPD severity. Because airway inflammation is a hallmark of COPD, it has been proposed that measuring exhaled nitric oxide, a marker of inflammation, in exhaled breath condensate could prove to be an inexpensive and efficient method to detect COPD in outpatient settings. Using the hypothetico-deductive theory as a guideline, this study used secondary data from the National Health and Nutrition Examination Survey 2007 to 2010 to …

Relationship Between Modality And The Degree Of Knowledge Retention In Bioterrorism Training, Gaylon Rashun Crawford

Walden Dissertations and Doctoral Studies

A public health workforce must be trained to react quickly, especially in the case of terrorist attack. Political leaders and emergency management experts have often cited inadequate emergency training as a contributing factor in the public health system's failed preparations for a bioterrorist event. As a result of these failures, billions of dollars have been allocated towards correcting infrastructure deficiencies including training for public health nurses (PHNs), who are critical to a communitywide medical response. This quantitative study used Pearson's correlation and a multivariate regression analysis to evaluate the most effective modality of bioterrorism training (BTT) for PHNs working in …

Knowledge Of Overdiagnosis And The Decision To Participate In Breast Cancer Screening, Kimberly T. Nembhard

Walden Dissertations and Doctoral Studies

In 2014, breast cancer was the second leading cause of death among Canadian women, with women over age 50 years making up 82% of the identified cases. To address this issue, the Ontario Breast Screening Program developed a media campaign that promoted the benefits of mammogram screening, but not the associated risks (i.e., false-positive, false-negative, radiation exposure, and overdiagnosis). This study was designed to determine whether there was a statistically significant relationship between knowledge of overdiagnosis and participation in mammogram screening. This cross-sectional, correlational study used schema theory supported by the effective health communication model. Forty-one women were invited to …

Knowledge Of Diabetes Mellitus And Health-Preventive Behaviors Among African American Adults, Wanka Ndifor

Walden Dissertations and Doctoral Studies

The purpose of this study was to gain insight into the risk within the African American population of developing diabetes, its complications, and the benefits associated with timely management and treatment of diabetes. The study also looked at how such knowledge may be related to preventive health behaviors. The Risk Perception Survey-Developing Diabetes and the Behavioral Risk Factor Surveillance System questionnaires were employed in this study. The theoretical basis of this study was the health belief model. This was a cross sectional, quantitative study with 126 participants. Descriptive analysis was employed to calculate the mean scores and frequencies across each …

Evaluating Retention Strategies For At-Risk Undergraduate Nursing Students, Joanna L. Ramsden-Meier

Walden Dissertations and Doctoral Studies

As there continues to be a nursing shortage and a lack of diversity in the nursing profession, it is important to retain at-risk students who have been admitted to nursing programs. The purpose of this program evaluation was to compare at-risk students who had not received retention services to at-risk students who had received retention services at a Midwestern college. A formative evaluation was conducted using information from three sources: the college, the students, and the community. Guided by a constructivist theory defined by Ponticell, this study examined the effectiveness of the retention program in terms of its impact on …

The Synergistic Impact Of Income And Rurality On Timely Mammograms In A National Sample Of Women In The United States, Asri Mumpuni

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Introduction. Breast cancer is the cancer of highest incidence among women in the U.S., making it a significant public health problem. Currently, the U.S. Preventive Services recommends biennial screening mammography for women ages 50-74. This study examined the associations between socioeconomic status and rurality on breast cancer screening behavior. Methods. Data for this study come from the Centers for Disease Control and Prevention (CDC) Behavioral Risk Factor Surveillance System Survey (BRFSS). Breast cancer screening behavior was dichotomized into those who did not meet screening mammogram recommendations (2 years or more) and those who met screening mammogram recommendations (within the …

Palliative Care: Evaluating And Designing Process Improvements For An Inpatient Consultative Program, Shawn M. Crouch

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

The purpose of this capstone project paper and study was to evaluate an inpatient palliative care consultation service and then make recommendations for improving the program. This paper includes a literature review related to palliative care models and best practices in structuring a successful inpatient palliative care service. The project included an analysis of how the program at one university based hospital measured success of the program and SWOT analysis based on interviews with members of the program’s team and leadership. Data sources used for the analysis included palliative care consultation utilization data from the identified hospital; other metrics used …

Alcohol Sale Status And Violent Deaths In Kentucky, Usa: 2005-2012, Hanan Abdulghafoor Khaleel

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Alcohol is one of the major public health problems worldwide because of its association with many health and psychological problems. This study adds to the extant literature by examining the association between being a resident in a wet county and having an alcohol related violent death, an alcohol related suicide, or an alcohol related homicide victimization.

The first aim of this study is to determine whether residents of wet counties have a higher odds of alcohol related violent deaths than residents of dry/moist counties after adjusting for other confounding factors. The second aim is to determine whether residents of wet …

Relationships Between The Coordinated School Health Program And Childhood Obesity In Tennessee, Tekeela Shonta Green

Walden Dissertations and Doctoral Studies

Childhood obesity rates have increased nationwide, but rates of childhood obesity are higher in Tennessee (TN). The Coordinated School Health (CSH) Program is a multicomponent approach designed to improve academics and health in children in Tennessee; however, researchers have not evaluated the 8 components of the plan and the impact it has on weight in children. The purpose of the study was to determine if a relationship existed between the Coordinated School Health Program and obesity in children. The conceptual framework for this study was Bandura's social cognitive theory. One hundred forty CSH coordinators in TN were surveyed and the …

Association Between Psychological Trauma From Assault In Childhood And Metabolic Syndrome, W Sumner Davis

Walden Dissertations and Doctoral Studies

Metabolic syndrome and its component conditions of hypertension, obesity, and insulin resistance are on the increase in United States. Metabolic syndrome substantially increases the risk of cardiovascular disease and type 2 diabetes (T2D). To date, no published study has examined the relationship between psychological traumas from physical and/or sexual assault in childhood and metabolic syndrome or its components. This study, using the psychoneuroimmunology (PNI) model, investigated associations between psychological trauma (physical/sexual abuse) in childhood and metabolic syndrome in adulthood using data from the Midlife in the United States II (MIDUS-II) study. This research was undertaken to investigate whether a history …

Weight Management Of Women Of Childbearing Age, Marcia Hagen

Walden Dissertations and Doctoral Studies

Black River Memorial Hospital identified obesity as a priority health concern in its rural service area; this concern was in line with the county's needs assessment. It was identified that women of childbearing age affect the lifestyle and health choices of their families and that they are at higher risk for the additional health risks associated with obesity affecting pregnancy and birth. Despite the identification of these risk factors, the factors that affect healthy weight management have not been well understood. Using the life course theory, a qualitative inquiry in the form of a structured interview was developed with local …

Bayesian Nonparametric Cross-Study Validation Of Prediction Methods, Lorenzo Trippa, Levi Waldron, Curtis Huttenhower, Giovanni Parmigiani

Publications and Research

We consider comparisons of statistical learning algorithms using multiple data sets, via leave-one-in cross-study validation: each of the algorithms is trained on one data set; the resulting model is then validated on each remaining data set. This poses two statistical challenges that need to be addressed simultaneously. The first is the assessment of study heterogeneity, with the aim of identifying a subset of studies within which algorithm comparisons can be reliably carried out. The second is the comparison of algorithms using the ensemble of data sets. We address both problems by integrating clustering and model comparison. We formulate a Bayesian …

Patchy Progress On Obesity Prevention: Emerging Exemplars, Entrenched Barriers, And New Thinking, Christina A. Roberto, Boyd Swinburn, Corinna Hawkes, Terry T-K Huang, Sergio Costa, Marice Ashe, Lindsey Zwicker, John H. Cawley, Kelly D. Brownell

Publications and Research

Although there have been positive pockets of change, no country has yet turned around its obesity epidemic. Preventing an increase in obesity prevalence will require urgent actions from government as well as a broader spectrum of stakeholders than previously emphasized. In this paper, we review a number of regulatory and non-regulatory actions taken around the world to address obesity and discuss some of the reasons for the patchy progress. In addition, we preview the papers in this Lancet series, which each identify priority actions on key obesity issues and challenge some of the entrenched dichotomies that present obesity and its …

African American Eighth Grade Students' Attitudes Toward Hiv/Aids In The District Of Columbia, Enock Kolawole Adewuyi

Walden Dissertations and Doctoral Studies

The group most affected by HIV/AIDS, according to the Centers for Disease Control and Prevention (CDC), is African Americans. The purpose of this study was to explore the knowledge of HIV/AIDS held by African American children as a first step towards developing prevention strategies for these youths. In order to bridge the knowledge-behavior gap, this study sought to investigate the attitude towards HIV/AIDS of African American 8th grade students. The study involved secondary data from the 2012 District of Columbia (DC) Middle School Youth Risk Behavior Survey, obtained from the District of Columbia Office of Superintendent of Education (OSSE). Guided …