Public Health Commons^™

Understanding The Silent Crisis: An Analysis Of Suicide Methods Among Kentucky Females, Charles Hamilton Rhea

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

Background: Suicide has been called the ‘silent crisis’. As rates have increased in recent years, it is now the 10th leading cause of death in the United States. Within the state of Kentucky, females die by suicide most often through the use of firearms, differing from the national trend where poisoning is most common. With a drastic increase in firearm suicides has been observed beginning in 2010. The aim of this study is to investigate why Kentucky females who have died by suicide are using firearms most often, as opposed to other methods, and compare those results to other states …

Association Between Reproductive Factors And Breast Cancer Subtypes: A Meta-Analysis, Xihua Mao

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

Introduction: Hormone-related reproductive factors have been reported to be associated with breast cancer subtypes. However, the direction and magnitude of these associations were inconsistent. Additionally, for breast cancer defined by estrogen receptor (ER) and progesterone receptor (PR): ER+PR+, ER+PR-, ER-PR+, and ER-PR- subtypes, no meta-analysis was available for ER+PR-and ER-PR+ subtypes. For ER+PR+ and ER-PR- subtypes, only a few reproductive risk factors have been examined in meta-analyses.

Methods: Primary studies published from 2011 to 2017 were retrieved from PubMed, Embase, and Scopus. Following PRISMA guidelines, a total of 98 eligible studies investigated the association between reproductive factors and breast cancer …

An Assessment Of Agreement In Detection Methods For Histophilus Somni In Bovine Lungs, Laura Michelle Arnold

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

Objectives: To examine the inter-laboratory agreement between multiplex realtime quantitative polymerase chain reaction (qPCR) assay results and aerobic culture results on bovine lung samples for detection of Histophilus somni (HS), and to assess associations of laboratory-derived factors on test agreement.

Methods: A survey of records from the University of Kentucky Veterinary Diagnostic Laboratory (UKVDL) was conducted to evaluate test results from grossly pneumonic bovine lung samples submitted during the period April 1, 2015 through August 31, 2018. Cohen’s kappa coefficient with 95% confidence interval (CI) was calculated to describe the extent of agreement. Animal, environmental and laboratory factors were examined …

“You’Re Not Alone In This”: Navigating Patients To Colorectal Cancer Screening In Appalachian Kentucky Communities, Audrey Bachman

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

In eastern Kentucky, some communities experience colorectal cancer (CRC) mortality rates as high as 25.9 deaths per 100,000 people as compared to the national rate of 14.8 deaths per 100,000 people (NCI, 2018; Kentucky Cancer Registry, 2018). Innovative screening mechanisms, coupled with patient navigation services, may be the key to increasing screening rates and preventing unnecessary deaths in the region. The current study focuses on the accounts of patient navigators (n = 9) to identify the essential ingredients for addressing barriers to CRC screening cited by Appalachian Kentucky patients. Using the core tenants of effective patient navigation programs (Freeman & …

The Impact Of Adjuvant Chemotherapy On Survival For Patients With Stage Ii Colon Cancer Portfolio, Li Ding

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

This capstone project describes the results of a consultative experience in biostatistics.

The Morality Of Compulsory Licensing As An Access To Medicines Tool, Margo A. Bagley

Faculty Articles

This Article contemplates the validity of theft rhetoric in relation to the right of countries to grant compulsory licenses from an unconventional perspective; that of biblical teachings on what it means to steal.

Part I describes the use of theft rhetoric in relation to IP infringement broadly and drug-patent compulsory licenses in particular.

Part II challenges the contention, suggested by theft rhetoric, that compulsory licenses are morally wrong as a form of stealing, by considering the meaning of theft in the context of its Judeo-Christian origins.

Part III considers the cogency of the accusation that the issuance of compulsory licenses …

Geographic And Multilevel Influences Of School Environments On The Development Of Obesity And Physical Activity Among School Children In A U.S.-Mexico Border Community, Teresa M. Anchondo

Open Access Theses & Dissertations

Childhood obesity, especially in Hispanic populations, is the most serious public health challenge of the 21st century (World Health Organization, 2014). Identifying risk factors at the individual, school and neighborhood level will help prevent the development of poor health outcomes such as diabetes and heart disease. The purpose of this study was to determine the associations between neighborhood deprivation, the retail food environment, obesity and physical fitness in children residing in El Paso, Texas. The study population included children in grades three through eight attending school in the El Paso Independent School District from 2009 to 2013. Approximately 42,000 student …

Process Evaluation Of The Batterer Intervention And Prevention Program Of The Center Against Sexual And Family Violence In El Paso, Texas, Kathleen Anne O'Connor

Open Access Theses & Dissertations

Background: Intimate partner violence (IPV) is a significant public health issue. One in five women and one in seven men will experience severe physical violence from an intimate partner in their lifetime in the US; and one in three women globally (Breiding, Basile, Smith, Black, & Mahendra, 2015; World Health Organization, 2017). Notwithstanding such stark statistics, there is a gap in research on batterers and on batterer intervention and prevention programs (BIPP). Purpose: Program processes related to follow-up of clients were evaluated at the Center Against Sexual and Family Violence Batterer Intervention and Prevention Program (CASFV BIPP) through a mixed-methods …

Ethics And Cost-Effectiveness Of Naloxone, Allison Groch

Augustana Center for the Study of Ethics Essay Contest

This essay discusses the ethical components involved with using, distributing, and making naloxone readily available for reversing opioid overdoses. The cost-effectiveness of naloxone is also discussed as a reason why naloxone should be widely used in order to help fight the opioid epidemic.

Children And Adolescents At Risk Of Drug Addiction, Doreen Nambafu, Mahmoud Sabry, Maha Tantawy

Papers, Posters, and Presentations

This paper was commissioned to examine the reasons beyond the increasing rate of drug abuse and addiction among children and adolescents in Egypt since 2004 and to recommend policy alternatives to tackle the problem.

لأطفال والمراهقون المعرضون لخطر إدمان المخدرات, Doreen Nambafu, Mahmoud Sabry, Maha Tantawy

Papers, Posters, and Presentations

This paper was commissioned to examine the reasons beyond the increasing rate of drug abuse and addiction among children and adolescents in Egypt since 2004 and to recommend policy alternatives to tackle the problem.

1.5/2nd Generation Vietnamese-Americans And Their Health Beliefs And Attitudes, Theresa Dang

Pitzer Senior Theses

Vietnamese immigration is distinct from other Asian/Pacific Islander groups in its context – the bulk of Vietnamese immigration was not of educational, economic, or career opportunity, but a diaspora. After the Fall of Saigon during the Vietnam War, Vietnamese immigrants faced extreme adversities and trauma as they fled to neighboring countries. Understanding the context and history of Vietnamese immigration plays a huge role in the acculturation process, management of health, and ability to navigate institutions among these families. As these immigrant families learn to survive in a new country, they also must face and heal from the emotional, psychological, and …

Targeting Internal Publics During The 2014 Ebola Outbreak: An Analysis Of Kaiser Permanente’S Crisis Communication Strategy, Ingrid S. Greene, Denise P. Ferguson

International Crisis and Risk Communication Conference

Issues management in today’s quickly changing world can be complex and unpredictable, and in the case of the spread of Ebola, carry lethal implications. Kaiser Permanente (KP) faced a potential internal crisis due to the involvement of medical staff during the spread of the disease in the United States. In addition, KP needed to ensure the safety of the patients the healthcare provider serves. This case study examines how the corporate communications team at KP in Southern California communicated the necessary messages during this crisis in the U.S. in the fall of 2014. The methodology of this case is a …

Work And Family Conflict: A Comparative Analysis Among Staff Nurses, Nurse Managers, And Nurse Executives, Amanda Raffenaud

Electronic Theses and Dissertations

The nursing workforce increasingly faces issues that affect clinical and managerial practice. One such issue is work-family conflict (WFC) and family-work conflict (FWC). Nurses face role strain as they confront the pressures from often competing work-and-family roles. This study assessed WFC/FWC among varying nurse roles: staff nurses, managerial nurses, and nurse executives. A random sample of 5,000 nurses, generated from registered nurses practicing in the state of Florida, was surveyed for this research study. Nurses were surveyed on demographics, perceptions regarding the work environment, and perceptions of WFC/FWC. Descriptively, nurses experienced more work-family conflict than family-work conflict. Regression analyses and …

Emergency Department Visits For Sexual Assault By Emerging Adults: Is Alcohol A Factor?, Allison Tadros, Melinda J. Sharon, Shelley M. Hoffman, Danielle M. Davidov

Faculty & Staff Scholarship

Introduction: Emerging adults (18-25 years of age) are at increased risk for sexual assault. There is little Emergency Department (ED) data on sexual assaults that involve alcohol among this population. The purpose of this study was to analyze ED visits for sexual assault and determine if alcohol consumption by the patient was noted.

Methods: This study was a retrospective chart review of patients aged 18-25 presenting to an ED in a college town over a four-year period. Extracted variables included age, gender, delay in seeking care, sexual assault nurse examiner (SANE) evaluation, and alcohol consumption by the patient. For analysis …

Whether, When, And How: Fertility Intentions And Age In The U.S., Andrea Melnikas

Dissertations and Theses

Thinking about, planning for, and having children is a deeply personal experience influenced by myriad factors at individual, intrapersonal, community and larger social levels. Examining fertility intentions is of interest to researchers from numerous social science disciplines in part because these intentions are potentially tied to larger demographic and economic shifts. In recent years in the U.S. the mean age at first birth has been increasing, with more women of older ages (age 35 and older) giving birth, due to both delays in childbearing that accompanied larger social trends such as increased educational and career opportunities and a decrease in …

Enriching Clinical Learning Environments Through Partnerships: Academic And Practice Partnerships To Strengthen Care For Older Adults In Residential And Assisted Living Settings, Juliana Cartwright, Diana L. White

Institute on Aging Publications

This report was prepared by Oregon Health & Science University (OHSU) School of Nursing and the Institute on Aging at Portland State University to describe an academic-community partnership using the Enriching Clinical Learning Environments through Partnerships (ECLEPs) model. This two-year project was conducted with 34 students in the RN-BSN program in eight assisted living (AL) communities and ElderPlace, a PACE program serving residents in assisted living and other residential settings. Quality improvement was the focus of the project. Features of the ECLEPs model include:

• An intentional partnership between academic and clinical organizations
• Relationship-based; shared decision making
• Long-term commitment between partners …

Reducing Depression And Suicide Ideation Among College Students, Andrew Ritzel

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

Suicide rates have been on the rise for the past 30 years; 42,773 Americans dying every year by suicide. Suicide is the tenth leading cause of death among all ages, but the second leading cause of death among Americans ages 15-24. College students traditionally fall within this age group, and are especially at risk for suicide due to stressful life conditions. The University of Kentucky, located centrally within Kentucky in the city of Lexington, is an ideal location for a suicide prevention intervention. Students demonstrated an increased rate of depression compared to the national population (15.13% of students surveyed reported …

Environmental Exposure To Atrazine And Birth Defects: An Ecological Study In Kentucky, 2005-2014, Maria Dimitrios Politis

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

Atrazine is one of the most widely used pesticides in the United States. Studies have shown that pesticides, in particular herbicides such as atrazine, may be associated with birth defects. The purpose of this study is to evaluate the association between potential environmental exposures to atrazine in water systems and prevalence rates of birth defects for the state of Kentucky. An ecological study using the Kentucky Birth Defects Registry Surveillance and the Kentucky Geological Survey databases from 2005 to 2014 was conducted. Poisson regression was used to estimate crude and adjusted rate ratios of the association between agricultural exposure metrics …

Chinese Herbal Medicine Therapy And The Risk Of Mortality For Chronic Hepatitis B Patients With Concurrent Liver Cirrhosis: A Nationwide Population-Based Cohort Study, Tzung-Yi Tsai, Tsung-Hsing Hung, Hanoch Livneh, I-Hsin Lin, Ming-Chi Lu, Chia-Chou Yeh

Counselor Education Faculty Publications and Presentations

Chronic hepatitis B (CHB) is increasingly recognized as a public health problem in Taiwan. After affected patients are diagnosed with contaminant liver cirrhosis (LC), adverse clinical outcomes, especially death, are common. This study aimed to investigate the effect of Chinese herbal medicine (CHM), an essential branch of Traditional Chinese medicine (TCM), on the mortality risk among CHB patients with contaminant LC. This longitudinal cohort study used the Taiwanese National Health Insurance Research Database to identify 1522 patients 20–70 years of age with newly diagnosed CHB with LC during 1998–2007. Among them, 508 (33.37%) had received CHM products after the onset …

Incredible Years (Iy) Parents & Babies Well-Baby Program: Expanding The Reach Through Cultural Adaptation, Ayanda Chakawa, Briana Woods-Jaeger

Posters

No abstract provided.

Medium To Long Term Impacts On Former Participants Of The Shoulder To Shoulder Global Brigades To Ecuador, Craig Borie

Theses and Dissertations--Community & Leadership Development

Medium to Long Term Impacts on Former Participants of the Shoulder to Shoulder Global Brigades to Ecuador. International service learning and voluntourism programs in global health evoke benefits for both community and the intervener. While it is clear that the Shoulder to Shoulder Global program at the University of Kentucky provides a service to an economically resource poor community in Santo Domingo, Ecuador, what is unclear is the impact these interprofessional experiences have on the participants that travel with the four times a year health brigades. This study proposes to answer the question of what are the educational, personal and …

Investigating The Role Of Prescription Drug Monitoring Programs In Reducing Rates Of Opioid-Related Poisonings, Nathan James Pauly

Theses and Dissertations--Pharmacy

The United States is in the midst of an opioid epidemic. In addition to other system level interventions, almost all states have responded to the crisis by implementing prescription drug monitoring programs (PDMPs). PDMPs are state-level interventions that track the dispensing of Controlled Substances. Data generated at the time of medication dispensing is uploaded to a central data server that may be used to assist in identifying drug diversion, medication misuse, or potentially aberrant prescribing practices.

Prior studies assessing the impact of PDMPs on trends in opioid-related morbidity have often failed to take into account the wide heterogeneity of program …

Using Prescription Drug Monitoring Data To Inform Population Level Analysis Of Opioid Analgesic Utilization, Huong T. T. Luu

Theses and Dissertations--Epidemiology and Biostatistics

Increased opioid analgesic (OA) prescribing has been associated with increased risk of prescription opioid diversion, misuse, and abuse. States established prescription drug monitoring programs (PDMPs) to collect and analyze electronic records for dispensed controlled substances to reduce prescription drug abuse and diversion. PDMP data can be used by prescribers for tracking patient’s history of controlled substance prescribing to inform clinical decisions.

The studies in this dissertation are focused on the less utilized potential of the PDMP data to enhance public health surveillance to monitor OA prescribing and co-prescribing and association with opioid overdose mortality and morbidity. Longitudinal analysis of OA …

Investigation Of Environmental Cadmium Sources In Eastern Kentucky, Elizabeth Maher

Theses and Dissertations--Mining Engineering

Utilizing data collected by the University of Kentucky Lung Cancer Research Initiative (LCRI), this study investigated potential mining-related sources for the elevated levels of cadmium in Harlan and Letcher counties. Statistical analyses for this study were conducted utilizing SAS. A number of linear regression models and logarithmic models were used to evaluate the significance of the data. The linear regression models consisted of both simple and multivariate types, with the simple models seeking to establish significance between the potential sources and urine cadmium levels and the multivariate models seeking both to identify any statistically significant linear relationships between source types …

Cyber Threats And Healthcare Organizations: A Public Health Preparedness Perspective, Lauren Elizabeth Branch

Graduate Theses, Dissertations, and Problem Reports (ETD)

Healthcare in the United States, heavily reliant on digital technology in service provision, has recently seen an increase risk of cyberattacks. Coordinated electronic medical records, imaging, pharmaceutical services, lab services and even treatment devices all rely on electronic connectivity and represent critical services that must be secured from cyber threats. Hospitals have become increasingly complex systems, and this often makes the organization more vulnerable to failure. Planning for these events is often hard for hospitals because their main charge is to provide life-saving care to patients as they need it. This is a relatively new threat to healthcare organizations, and …

Effects Of Motion Segment Simulation And Joint Positioning On Spinal Loads In Trunk Musculoskeletal Models, F. Ghezelbash, A. H. Eskandari, A. Shirazi-Adl, N. Arjmand, Z. El Ouaaid, A. Plamondon

Études primaires

Musculoskeletal models represent spinal motion segments by spherical joints/beams with linear/nonlinear properties placed at various locations. We investigated the fidelity of these simplified models (i.e., spherical joints with/without rotational springs and beams considering nonlinear/linear properties) in predicting kinematics of the ligamentous spine in comparison with a detailed finite element (FE) model while considering various anterior-posterior joint placements. Using the simplified models with different joint offsets in a subject-specific musculoskeletal model, we computed local spinal forces during forward flexion and compared results with intradiscal pressure measurements. In comparison to the detailed FE model, linearized beam and spherical joint models failed to …

Trunk Musculoskeletal Response In Maximum Voluntary Exertions: A Combined Measurement-Modeling Investigation, F. Ghezelbash, Z. El Ouaaid, A. Shirazi-Adl, A. Plamondon, N. Arjmand

Études primaires

Maximum voluntary exertion (MVE) tasks quantify trunk strength and maximal muscle electromyography (EMG) activities with both clinical and biomechanical implications. The aims here are to evaluate the performance of an existing trunk musculoskeletal model, estimate maximum muscle stresses and spinal forces, and explore likely differences between males and females in maximum voluntary exertions. We, therefore, measured trunk strength and EMG activities of 19 healthy right-handed subjects (9 females and 10 males) in flexion, extension, lateral and axial directions. MVEs for all subjects were then simulated in a subject-specific trunk musculoskeletal model, and estimated muscle activities were compared with EMGs. Analysis …

Trunk Postural Adjustments: Medium-Term Reliability And Correlation With Changes Of Clinical Outcomes Following An 8-Week Lumbar Stabilization Exercise Program, Jean-Alexandre Boucher, Richard Preuss, Sharon M. Henry, Marilee Nugent, Christian Larivière

Études primaires

Background

Low back pain (LBP) has been previously associated with delayed anticipatory postural adjustments (APAs) determined by trunk muscle activation. Lumbar stabilization exercise programs (LSEP) for patients with LBP may restore the trunk neuromuscular control of the lumbar spine, and normalize APAs. This exploratory study aimed at testing the reliability of EMG and kinematics-based postural adjustment measures over an 8-week interval, assessing their sensitivity to LBP status and treatment and examining their relationship with clinical outcomes.

Methods

Muscle activation of 10 trunk muscles, using surface electromyography (EMG), and lumbar angular kinematics were recorded during a rapid arm-raising/lowering task. Patients with …

La Planificación De Un Álbum Virtual De Parásitos Intestinales [The Planning Of A Virtual Album Of Intestinal Parasites], Nathalie Chacon, Darling Sánchez

Physician Assistant Studies Faculty Publications

La planificación de un álbum virtual de microfotografías de parásitos intestinales es novedosa y su desarrollo requerirá de las tecnologías de la información y comunicación. La Sección de Geohelmintiasis del Instituto de Medicina Tropical está especializada en la atención de pacientes con parasitosis intestinales a nivel nacional, donde se realizan exámenes de heces con técnicas coproparasitológicas, lo que permitirá la recopilación del material fotográfico. El presente trabajo tiene como objetivo planificar la elaboración de un álbum de fotos virtual de parásitos intestinales y publicarlo en la web con fines divulgativos y educativos. A las muestras de heces de pacientes referidos …