Public Health Commons^™

Hiv With Opportunistic Neuroinfection, Rahul Vyas, Rajendra Prasad

Digital Journal of Clinical Medicine

No abstract provided.

The Prevotella Copri Complex Comprises Four Distinct Clades Underrepresented In Westernized Populations, Adrian Tett, Kun D. Huang, Francesco Asnicar, Hannah Fehlner-Peach, Edoardo Pasolli, Nicolai Karcher, Federica Armanini, Paolo Manghi, Kevin Bonham, Moreno Zolfo, Francesca De Filippis, Cara Magnabosco, Richard Bonneau, John Lusingu, John Amuasi, Karl Reinhard, Thomas Rattei, Fredrik Boulund, Lars Engstrand, Albert Zink, Maria Carmen Collado, Dan R. Littman, Daniel Eibach, Danilo Ercolini, Omar Rota-Stabelli, Curtis Huttenhower, Frank Maixner, Nicola Segata

Karl Reinhard Publications

Prevotella copri is a common human gut microbe that has been both positively and negatively associated with host health. In a cross-continent metaanalysis exploiting >6,500 metagenomes, we obtained >1,000 genomes and explored the genetic and population structure of P. copri. P. copri encompasses four distinct clades (>10% inter-clade genetic divergence) that we propose constitute the P. copri complex, and all clades were confirmed by isolate sequencing. These clades are nearly ubiquitous and co-present in non-Westernized populations. Genomic analysis showed substantial functional diversity in the complex with notable differences in carbohydrate metabolism, suggesting that multi-generational dietary modifications may be …

Imaging Coprolite Taphonomy And Preservation, Karl Reinhard, Morgana Camacho, Breyden Geyer, Samantha Hayek, Chase Horn, Kaitlin Otterson, Julia Russ

Karl Reinhard Publications

The impact of coprolite taphonomy on parasite remains and aDNA recovery has been recognized. In general, coprolites from sites protected by geologic features such as caves and rock shelters exhibit the best preservation. In contrast, coprolites from open sites can be badly affected by taphonomic processes as shown by analyses of parasite eggs. For eggs, the impact of mites and free living nematodes has been quantified. Mites are associated with poor pinworm egg preservation. In other studies, percolation of water through sediments has a negative impact on egg recovery. We note that dietary remains can also decompose at open sites. …

The Self-Perceived Cultural Competency Of Hiv Interventionists, Tonya Herring

Walden Dissertations and Doctoral Studies

Despite significant research and inroads with the human immunodeficiency virus (HIV), disparities in HIV infection continue to widen for African American (AA) men who have sex with men (MSM). In recent times, cultural competence has been receiving increased attention as a possible factor to enhance the quality of health messaging and lessening HIV disparities. However, there is a dearth of research specifically dedicated to AA MSM and culturally competent HIV health messages. To address this gap, this qualitative research was designed to investigate the self-perceived cultural competency among HIV counselors. The theoretical framework for the project was the PEN-3 cultural …

Digital Information Technology Use And Patient Preferences For Internet-Based Health Education Modalities: Cross-Sectional Survey Study Of Middle-Aged And Older Adults With Chronic Health Conditions, Nancy P. Gordon, Elizabeth L. Crouch

Faculty Publications

Background: Health information, patient education, and self-management (health information and advice, HIA) tools are increasingly being made available to adults with chronic health conditions through internet-based health and mobile health (mHealth) digital information technologies. However, there is limited information about patient preferences for using specific types of health information and advice resources and how preferences and usage differ by age group and education.

Objective:The objective of this study was to examine how use of digital information technologies and preferred methods for obtaining health information and advice varies by age group and education among middle-aged and older adults with chronic …

Prevalence And Factors Influencing Use Of Internet And Electronic Health Resources By Middle-Aged And Older Adults In A Us Health Plan Population: Cross-Sectional Survey Study, Elizabeth L. Crouch, Nancy P. Gordon

Faculty Publications

Background: Health care organizations are increasingly using electronic health (eHealth) platforms to provide and exchange health information and advice (HIA). There is limited information about how factors beyond internet access affect use of eHealth resources by middle-aged and older adults.

Objective: We aimed to estimate prevalence of use of the internet, health plan patient portal, and Web-based HIA among middle-aged and older adults; investigate whether similar sociodemographic-related disparities in eHealth resource use are found among middle-aged and older adults; and examine how sociodemographic and internet access factors drive disparities in eHealth resource use among adults who use the internet.

Methods: …

Concentration-Dependent Effects Of A Dietary Ketone Ester On Components Of Energy Balance In Mice, Sarah E. Deemer, Rachel A. Davis, Barbara A. Gower, Andrew P. Koutnik, Angela M. Poff, Stephanie L. Dickinson, David B. Allison, Dominic P. D'Agostino, Eric P. Plaisance

Faculty Publications

Exogenous ketones may provide therapeutic benefit in treatment of obesity. Administration of the ketone ester (KE) R,S-1,3-butanediol acetoacetate diester (BD-AcAc) decreases body weight in mice, but effects on energy balance have not been extensively characterized. The purpose of this investigation was to explore concentration-dependent effects of BD-AcAc on energy intake and expenditure in mice. Forty-two male C57BL/6J mice were randomly assigned to one of seven isocaloric diets ( = 6 per group): (1) Control (CON, 0% KE by kcals); (2) KE5 (5% KE); (3) KE10 (10% KE); (4) KE15 (15% KE); (5) KE20 (20% KE); (6) KE25 (25% KE); and …

The Effect Of Narrative Medicine Combined With Medication Assisted Treatment On Decreasing The Desire To Use Intravenous Substances In Hospitalized Patients With Infective Endocarditis, Paula Works

DNP Projects

Substance abuse is a significant problem that spans the nation. Of particular concern is the growing population of patients at UK HealthCare who have endocarditis as a complication from IV substance abuse.

PURPOSE: The aims of this study were

1. To assess the effect of narrative medicine combined with MAT, compared to MAT alone, on desire to use in hospitalized patients with a history of IV substance use
2. To examine the changes in quality of life before and after the introduction of narrative medicine in hospitalized patients with a history of IV substance abuse using The Quality of Life Scale (QOLS). …

The Effect Of A Child's Guardian's Health Literacy On Asthma Knowledge In Pediatric Patients, Sylvan Ryder

DNP Projects

PURPOSE: The purpose of this project is to determine if there is a correlation between a guardian’s health literacy and their knowledge of their child’s asthma management.

METHODS: This is a cross-sectional study conducted in the University of Kentucky Pediatric Pulmonology Clinic in Lexington, Kentucky. The analysis focused on how a parent’s health literacy level effected their asthma knowledge. The Rapid Estimation of Adult Literacy in Medicine-Short Form was used to measure health literacy. An asthma knowledge questionnaire with a Likert-scale design was used to measure asthma knowledge. The sample included eight parents of children with an asthma diagnosis collected …

The Effect Of A School Nurse Intervention Program On Student Absenteeism In Jefferson County Public Schools: A Pilot Study, Eva Stone

DNP Projects

Background: School attendance has a significant impact on student achievement. In early grades, students who miss 10% or more of school are considered chronically absent and at risk to be behind in reading. High school students with similar attendance patterns are less likely to enroll and stay in college after graduation. Evidence shows that the presence of school nurses can result in improved school attendance.
Purpose: The purpose of this pilot project was to implement a targeted school nurse intervention at an elementary, middle and high school in Jefferson County. The intervention included assessment by a registered nurse for children …

Emergency Room Services Used By Pediatric Patients Who Have An Established Primary Care, Rebecca J. Cooksey

DNP Projects

Background: The use of emergency room services for primary care issues is an ongoing problem. The incidence is higher in the Medicaid population and is associated with emergency room overcrowding and excessive medical costs.

Purpose: The purpose of this study was to explore the extent of and the details surrounding non-acute emergency room visits in a pediatric population within an urban primary care clinic.

Methods: This was a two-part descriptive study with both quantitative and qualitative components. A retrospective chart review of this facility’s ER data constituted the quantitative descriptive part of the study. The qualitative arm of the study …

Provider Adherence To National Heart, Lung, And Blood Institute’S Guidelines On Screening, Diagnosis, And Treatment Of Hypercholesterolemia In The Pediatric Population Aged 9-11 Years, Alanna Cox

DNP Projects

Purpose: High cholesterol levels have been directly linked to atherosclerosis, which is a leading cause of cardiovascular disease (CVD). Risk factors that accelerate the development of atherosclerosis, such as high cholesterol can begin in childhood. The purpose of this project was to evaluate provider adherence to the National Heart, Lung, and Blood Institute’s (NHLBI) Guidelines for Cardiovascular Health and Risk Reduction in Children and Adolescents, specifically the guidelines on universal lipid screening in children aged 9-11 years. The objectives were: 1) determine the rate of lipid screening in children 9-11 years old; 2) determine the number of children who …

Tobacco Screening Among Adults In Primary Care: Evaluation Of The Use Of The 5a’S Framework For Treating Tobacco Dependence, Alexis Owens

DNP Projects

Abstract

Background: Tobacco use in the United States is the chief cause of preventable disease and death. Preventing and identifying tobacco use through screening and education is essential to assist users to quit and to decrease overall tobacco associated health risks.

Purpose: The purpose of this study was to assess the integration of the 5A’s tobacco engagement framework into the workflow at one Primary Care Center. Study objectives included determining baseline tobacco screening data prior to 5A’s education, providing providers and support staff education on the 5A’s process, reviewing and interpreting pre/post data of the 5A’s process, and identification of …

What Is The Prevalence Of Adhd In Children Who Were Diagnosed With Neonatal Abstinence Syndrome? A Retrospective Chart Review., Scott Graham

DNP Projects

Background: Neonatal abstinence syndrome (NAS) is the set of signs and symptoms present in a newborn whose mother was addicted to drugs while pregnant. NAS can occur due to sudden withdrawal from several drugs, including opioids, benzodiazepines, methamphetamines, and caffeine. It can cause many different issues in the newborn, including diarrhea, tremors, fever, and seizures. While these specific signs and symptoms are self-limited, research is showing that these children grow in to childhood and adolescence with increased risk of Attention-Deficit/Hyperactivity Disorder (ADHD), autism, motor dysregulation, and other cognitive and behavioral sequelae.

Purpose: The purpose of this project was to establish …

Increasing Smoking History Documentation And Lung Cancer Screening Orders In A Primary Care Clinic, Tabitha M. Caudill

DNP Projects

BACKGROUND: In 2018, there were approximately 234,030 new lung cancer diagnoses and 154,500 lung cancer deaths in the United States. Kentucky leads the nation in new lung cancer cases each year. The USPSTF estimates that 10% to 12% of lung cancers detected by routine screening would not have been detected until the cancer advanced; therefore, the USPSTF recommends yearly lung cancer screenings using low dose CT (LDCT) scans of the chest for patients 55 to 80 years old who have a 30 pack-year smoking history and are currently smoking or have quit within the last 15 years.

PURPOSE: …

Community Perceptions On Access To And Communication Gaps Regarding Dementia-Specific Health Resources And Services, Randi G. Bastian

College of Graduate Studies: Theses & Dissertations

The people of Appalachia have less access to healthcare resources subsequently leading to deficits in healthcare, health education, and health research. There is a need to address the communication of healthcare resources among populations with low economic status such as the Appalachian communities in Northeast Tennessee. Alzheimer’s disease and related dementias (ADRD) uniquely challenges the healthcare industry while further dividing communities already experiencing hardship in healthcare resources. The Baby Boomer generation is advancing into the age range frequently affected by ADRD, 65 and over. In preparation, healthcare continuum must acknowledge and set out to address dementia-specific care challenges. “Keep …

Food Insecurity Among College Students At A Historically Black College & University: Prevalence, Social Support & Coping Skills, And Academic Outcomes, Rebecca L. Larson

College of Graduate Studies: Theses & Dissertations

Introduction: College students experience food insecurity (FI) at higher rates than the U.S. adult population. Food insecurity among college students is frequently associated with several sociodemographic factors; limited social support and coping skills; poor mental and physical health; and poor academic outcomes. The purpose of this study was to determine the prevalence of FI among students at Fort Valley State University (FVSU), a Historically Black College & University, factors associated with FI, the impact of FI on academic outcomes, and the influence of social support and coping skills on the relationship between FI and academic outcomes.

Methods: A stratified random …

Public Health Workforce Perceived Impact Of Emerging Issues In Public Health, Kristie C. Waterfield

College of Graduate Studies: Theses & Dissertations

Background: In an era where public health has been viewed as a global, multi-disciplinary field, the public health workforce has remained united to unfailingly holding fast to the mission of protecting, promoting, and improving the health of the public. However, the practice of public health is consistently evolving, and the workforce is continually facing a mirage of challenges. In order to overcome these challenges, practitioners need to be up-to-date on the necessary knowledge and skills to effectively deliver the core public health services.

Purpose: The purpose of this research was to explore the perceived impact of emerging trends in public …

Burnout: Moving Beyond The Status Quo, Renzo Bianchi, Irvin Sam Schonfeld, Éric Laurent

Publications and Research

Burnout has been defined as a job-induced syndrome combining emotional exhaustion, depersonalization/cynicism, and a sense of reduced personal accomplishment. In this article, we expand on past analyses of burnout by reviewing key, yet overlooked, problems affecting the construct. We concomitantly examine the implications of these problems for the overall validity of burnout research. Our work shows that burnout research is undermined by 4 main problems. First, what constitutes a case of burnout is unclear. Second, the basic conceptualization and operationalization of burnout are ill aligned. Third, burnout is unlikely to be the specifically job-induced syndrome it has been posited to …

Relationship Of Sociodemographic Factors With Serum Levels Of Vitamin D In A Healthy Population Of Pakistan, Khalida Iqbal, Najmul Islam, Naseema Mehboobali, Ali Asghar, Saleem Perwaiz Iqbal, Mohammad Perwaiz Iqbal

Department of Biological & Biomedical Sciences

High prevalence of vitamin D deficiency has been reported from Pakistan. Association of sociodemographic factors with vitamin D status has received little attention in this region. Therefore, we embarked on investigating the relationship of sociodemographic factors with vitamin D levels in a healthy Pakistani population. Venous blood from 226 healthy participants (age range 19-69 years) was collected and analyzed for serum concentrations of 25(OH) vitamin D [25(OH)D] and other related biomarkers. Demographic characteristics of the study participants were collected. Vitamin D deficiency (25(OH)D levels less than 20 ng/ml) was found to be 75% in this cohort. Gender, sunlight exposure and …

Identifying Interactions Between Chikungunya Virus And Aedes Aegypti Salivary Gland Proteins, Alfred Jiang

Public Health Theses

Chikungunya virus (CHIKV), an emerging threat to global health, has been responsible for extensive arboviral epidemics in Southeast Asia and the Americas in recent years. In order to develop effective therapeutics and preventative measures, we must first gain a deeper understanding of both the host and vector factors that define the pathogen’s life cycle and transmissibility. Currently, the entry receptor and potential co-factors that facilitate CHIKV infection in the arthropod vector are unknown, highlighting a critical knowledge gap in our understanding of the viral life cycle. Furthermore, while secreted mosquito salivary proteins have been shown to modulate host infection through …

Putting The T In Mlp: The Role Of Trust In Medical Legal Partnerships, Jenny Ajl

Public Health Theses

The United States spends more on healthcare than any other country, while health outcomes lag behind many nations. This is often attributed to the disproportionately low spending on social services, and social determinants of health (SDOH) need to be addressed in order to improve the nation’s health. SDOH are increasingly understood to be key factors in predicting health outcomes. Medical legal partnerships (MLPs) are one intervention that seek to address SDOH. The MLP model comprises three core components: providing legal care for patients, improving systems of healthcare, and creating policy change outside the healthcare system. In this qualitative study, we …

Nicotine Dependence And Alternative E-Cigarette Use Behaviors: Dripping And Vape Tricks, Harmanpreet Bhatti

Public Health Theses

Background: E-cigarette use among youth is concerning due to the risk of exposure to hazardous chemicals and future combustible cigarette use. Alternative e-cigarette use behaviors, or dripping (i.e., applying drops of e-liquids directly onto heated coils) and vape tricks (i.e., blowing shapes or large clouds of visible exhaled aerosol), may also increase this risk. However, little is known about the risk of nicotine dependence among adolescents who engage in these behaviors. Therefore, the aim of this study was to determine the association between these alternative e-cigarette use behaviors and nicotine dependence among adolescents.

Research Design: Cross-sectional data were collected from …

So You Think You Can Exercise: The Gap Between Exercise Confidence And Physical Activity Among Samoan Adults, Diksha Brahmbhatt

Public Health Theses

Samoa is experiencing one of the highest prevalence of overweight and obesity in the world, placing its population at increased risk of developing several noncommunicable diseases including type 2 diabetes and cardiovascular disease. The role of physical activity in reducing the burden of these diseases and overweight is well-established. Exercise self-efficacy or confidence is a predictor, if not determinant, of recreational physical activity. The purpose of this study, therefore, is to assess the relationship between exercise confidence and levels of recreational physical activity among Samoan adults. We confirm that exercise confidence is correlated with time spent exercising. However, despite considerable …

Safety Of Opat In Older Versus Younger Adults, Kaylen Elizabeth Brzozowski

Public Health Theses

Introduction Outpatient parenteral antimicrobial therapy (OPAT) is considered practical, safe, and cost-effective, but roughly 20% of all adult patients on OPAT experience an adverse event (AE). Frequency of AEs and healthcare utilization, defined as emergency department visits and infectious disease office visits, phone calls, and emails, may be greatest in the first two weeks of OPAT. Given that older adults (age ≥ 65) have greater cognitive decline, ADL limitations, and comorbidities than younger adults, we sought to evaluate the frequency and timing of AEs in older adults on OPAT. We examine patients on OPAT at Yale New Haven Hospital (YNHH) …

Postpartum Weight Trajectories In A Cohort Of 127 Samoan Women: Does Breastfeeding Protect Against Postpartum Weight Retention?, Grace Castillo

Public Health Theses

Rising global obesity rates impact every aspect of health, including maternal-fetal health. Samoa has a disproportionate burden of obesity, with more than half of Samoan women entering pregnancy obese. Given Samoan women’s high parity (4), postpartum weight retention (PPWR) may be a significant source of weight gain over women’s lifetimes. Little is currently known about PPWR among Samoan women, so this analysis sought to document PPWR trajectories, assess factors – like breastfeeding -- associated with PPWR. Data of 127 mother-infant dyads from the 2017 Foafoaga O le Ola cohort were used in analysis. Researchers collected demographic and lifestyle data, as …

Attachment Security And Psychological Health In Adult Child Caregivers And Their Parents With Alzheimer’S Disease And Related Dementias, Wei Aiko Chang

Public Health Theses

Objective: Attachment theory is a helpful framework for examining one of the most fundamental needs in parent-child dyads across the lifespan and how attachment security might protect both dyad members’ psychological health, especially in times of crisis. In this study of adult child caregivers and their parents with early stage Alzheimer’s disease and related dementias (ADRD), we examined the associations between both dyad members’ attachment security, the adult child’s depressive symptoms, and quality of life of the parent with ADRD.

Method: Thirty-four individuals (parents) with ADRD and their 34 adult-child caregivers each completed the 12-item Experiences in Close Relationship Scale …

Persistence Of Ebola Virus In Survivors & Risks Of Sexual Transmission: A Systematic Review, Allison Cheung

Public Health Theses

Background: Longitudinal cohort studies of Ebola virus disease (EVD) survivors from the 2014-2016 West African outbreak have found evidence of Ebola virus (EBOV) and EBOV RNA persistence in the bodily fluids of survivors, particularly in semen. This new evidence has raised the possibility of sexual transmission of EBOV by EVD survivors. The current interim guidance issued by the World Health Organization (WHO) recommends safer sex practices for at least 12 months after acute disease onset (ADO). However, based on new evidence, these recommendations may require revision.

Objective: The main aim of this article is to present and evaluate evidence on …

Estimating Mortality After Natural Disasters In Low- And Middle-Income Countries: A Systematic Review, Joseph Clingerman

Public Health Theses

Background

The outcomes of natural disasters produce many complex uncertainties and statistics, many of which have no metrics to assess how accurate they are. In particular, mortality estimates in low- and middle-income countries encompass many variables in their inherently challenging physical, political, and logistical landscapes. Given that there has been no known systematic review of assessing mortality estimation methodologies, the author aimed to provide a systematic review of known methodologies and provide a framework to assess mortality estimation methodologies.

Methods

The author performed a systematic search of electronic databases from the past two decades up to January 2019. In addition, …

Exposure To Atmospheric Metals Using Moss Bio-Indicators And Neonatal Health Outcomes In Portland, Oregon, Saskia Comess

Public Health Theses

Background: Exposures to certain metals are associated with adverse birth outcomes, including inhibited fetal growth and congenital defects. Previous studies focused on metals such as lead and arsenic, and primarily assessed exposure using biological monitoring, which does not provide insights into sources. Examining exposure to metals via atmospheric pathways is challenging due to a lack of high-resolution air-pollution data. We applied a unique map of atmospheric metal pollution, derived from bio-indicator moss samples, as a screening tool to study neonatal health risks of atmospheric metal pollution in Portland, Oregon, a city of 640,000 people with several metal-emitting industrial sources.

Methods: …