Public Health Commons^™

Community Characteristics And Financial And Operational Performance Of Rural Health Clinics In The United States: A Chartbook, John Gale Ms, Zachariah Croll Mph, Jamar Croom Ms, Louisa Munk Mph, Yvonne Jonk Phd

Rural Health Clinics

This chartbook provides an overview of Rural Health Clinic (RHC) characteristics and issues using data from CMS’s Provider of Services file, Medicare Cost Reports, and the Robert Wood Johnson Foundation’s’ County Health Ranking and will be useful to policymakers and others interested in the performance of RHCs nationally. It can also be useful to RHC administrators to benchmark staffing patterns, productivity, and efficiency. Finally, it provides a discussion of the challenges related to collection and reporting of RHC quality data.

For more information, please contact John Gale, [email protected]

Lgbtq+ Health Disparities: Healthcare Intervention, Kara Steinbrecher

The Eleanor Mann School of Nursing Undergraduate Honors Theses

The lesbian, gay, bisexual, transgender, and queer (LGBTQ+) community has carried the burden of countless health disparities throughout its history tied to discrimination, bias, prejudice, and stigma. LGBTQ+ individuals are disproportionately at higher risk for substance abuse, sexually transmitted diseases, cardiovascular disease, mental illness, suicide, and unequal access to healthcare, related to social stigma and bias that exists in healthcare itself. The purpose of this systematic literature review is to analyze existing health disparities among the LGBTQ+ population in the United States and the efficacy of various interventions of health care professionals to reduce them. Twenty-one articles from multiple online …

Dexmedetomidine Vs. Propofol In Postoperative Delirium Prevention, Jaclyn Burnett Rn, Srna, Montana Betts Rn, Srna, Christhian De Ochoa Rn, Srna, Maciej Chec Rn, Srna, Dwayne Accardo Dnp, Crna, Aprn

Doctor of Nursing Practice Projects

Purpose/Background Postoperative delirium (POD) is an acute neurological condition affecting large numbers of surgical patients in various practice settings. Patients suffering from this condition face postoperative complications, increased lengths of stay, and tremendous financial burden. Understanding the contributing factors for POD, and how adjustments in intraoperative agents can prevent or reduce the incidence, is a crucial aspect of anesthesia practice. This scoping review will examine associations between POD and the intraoperative use of propofol versus dexmedetomidine with general anesthesia.

Methods Studies in this review were limited to peer-reviewed literature, published in medical and nursing journals within the last five years. …

The Effects Of Hormonal Contraceptive Use On Perceptions Of Social Stress In Women, Ashton Jones

Biological Sciences Undergraduate Honors Theses

Hormonal contraceptives are widely used due to their efficiency in preventing pregnancy. Although women are often informed of the physical effects of hormonal contraceptives, there is little emphasis on mental effects, such as increased rates of depression and changes in social perception. The current study examined perceptions of social stress among women before beginning hormonal contraceptives, and two months after using hormonal contraceptives. I hypothesized that women would experience increased social stress after beginning hormonal contraceptives, compared to a control group of women who were also assessed twice. Results did not support this hypothesis; there was no difference in interpersonal …

Identification Of Individual And Regional Features Impacting Hiv/Aids Knowledge And Sentiment, Stetson Ledbetter

Health, Human Performance and Recreation Undergraduate Honors Theses

Despite constant media coverage and public interest in current epidemics, the prevalence and lack of awareness of HIV/AIDS is often overlooked on campuses and communities associated with colleges and universities. Several interrelated factors, such as LGBTQ+ status, being a college student, gender, coming from a rural area, ethnicity, and educational attainment are known to contribute to behaviors regarding sexual health, especially non-curable diseases such as HIV/AIDS. Consequently, it is imperative to explore trends in both the HIV/AIDS knowledge and sentiments towards individuals with HIV/AIDS in college environments. Current work utilizes a nonprobability sample recruited through media platforms, representing individuals that …

The Need For Specialized Substance Abuse Treatment For Gay Men In The United States, Sarah Nance

Health, Human Performance and Recreation Undergraduate Honors Theses

Substance misuse and abuse is a global public health issue that affects sexual minority populations at a higher rate than the heterosexual population. Many popular gay socialization strategies include gay bars and chemsex, or sexualized drug use, in which substance use is common in both. The Minority Stress Model provides an explanation as to how stigma embedded in a society and within a person can act as a stressor and manifest into a substance abuse disorder. This stigma acts for many as a barrier to seeking healthcare out of fear of discrimination, causing many to hide their identity when seeking …

Financial Hardship From Purchasing Prescription Drugs Among Older Adults In The United States Before, During, And After The Medicare Part D “Donut Hole”: Findings From 1998, 2001, 2015, And 2021, Anthony W. Olson, Jon C. Schommer, David A. Mott, Olajide Adekunle, Lawrence M. Brown

Pharmacy Faculty Articles and Research

BACKGROUND: Cost-related nonadherence compromises successful and effective management of chronic disease. The Medicare Modernization Act of 2003 (MMA) and Patient Protection and Affordable Care Act of 2010 (ACA) aimed to increase the affordability of outpatient prescription drugs for older adults (older than age 64 years). The Medicare Part D prescription drug insurance coverage gap (“donut hole”) created by the MMA was fully closed in 2020 by the ACA.

OBJECTIVES: To (1) describe prescription drug coverage and financial hardship from purchasing prescription drugs among older American adults for 2021, (2) compare these results with findings from data collected before the MMA …

Examining The Effects Of Oral Contraceptive Use On Thermoregulation, Whitley C. Atkins

Graduate Theses and Dissertations

Purpose: The purpose of this investigation was to evaluate the effects of combined (estradiol and progestin) monophasic oral contraceptive pill (OCP) use on thermoregulation. Further, we sought to evaluate OCP use on acute rehydration post-exercise in the heat using recommended rehydration guidelines. Methods: Twelve healthy, aerobically trained (VO2peak = 47.8 ± 4.7 mL/kg/min), long term female oral contraceptive users completed a familiarization trial and two experimental days separated by ≥ 7 days. The two experimental trials were identical except for the hormone dosing phase. One trial was completed during the third week of active pill dosing (ACT) and one during …

Unveiling The Opioid Crisis: The Impact Of Opioids On Body Systems And Alternative Treatment Options To Reduce The Nationwide Opioid Epidemic, Krishna S. Patel, Elizabeth A. Manheim Ph.D.

Kean Quest

No abstract provided.

Cyclic-Di-Gmp-Binding Proteins Regulate Acinetobacter Baumannii Motility, Gabriel Smith

Undergraduate Honors Theses

Acinetobacter baumannii is a prevalent nosocomial pathogen where, like many other infectious bacteria, A. baumannii is increasingly considered a multi-drug resistant pathogen. This research study was designed to find a way to affect the persistence of A. baumannii such that it can be applied to a hospital setting to prevent further nosocomial infections. One regulatory mechanism potentially used by A. baumannii to persist on hospital surfaces is through the use of the bacterial second messenger cyclic-di-GMP (c-di-GMP). This nucleotide signal is regulated in response to environmental conditions, and then activates c-di-GMP-binding proteins that induce phenotypic changes. One c-di-GMP-regulated phenotype is …

How To Smoothen Ai Implementation In Healthcare, Adrian Yeow, Pin Sym Foong

Asian Management Insights

Three domain-focused prescriptions.

Periodontal Disease And Covid-19, Zhaozhao Chen Dds, Ms, Phd, Laurie K. Mccauley Dds, Ms, Phd, Purnima S. Kumar Bds, Ms, Phd, Hom-Lay Wang Dds, Ms, Phd

The Journal of the Michigan Dental Association

As the gateway to the respiratory system, the oral cavity can play an essential role in SARS-CoV-2 invasion and transmission. Besides high expression of angiotensin‐converting enzyme 2 (ACE2), the oral cavity can harbor viral particles in saliva, gingival crevicular fluid, and the periodontal pocket. Microbial and inflammatory associations closely link periodontitis and COVID-19. In this review, we summarize the possible oral manifestations of COVID‐19, its association with periodontal diseases, the plausible underlying mechanisms of microbial and inflammatory crosstalk between COVID‐19 and periodontal diseases, and mitigation protocols during periodontal treatment.

Public Health Contagion Of White Supremacy: Examining The Pipeline Of Attitudes About Racism And Racial History Education Among High School Students., Trinidad Jackson

Electronic Theses and Dissertations

We are living in compounded states of upheaval. Violence and exemption from it across socioecological levels have shaped how humans survive, thrive, and die. While different violence typologies exist, the U.S., prioritizes interpersonal violence as its primary target of intervention, often through structural means that foster and reinforce interpersonal violence. The omission of structural and cultural agents and outcomes of violence allows perpetrators to infiltrate and reproduce savage, dehumanizing ideologies in perpetuity. Instead of sustaining societal pillars that oppress and destroy, we must fertilize public health research, practice, and sociopolitical activism with pillars that both inform and activate liberatory consciousness …

Tennessee Abortion Policy Summary - May 2022, Center For Applied Reasearch And Evaluation In Women's Health, East Tennessee State University

Center for Applied Research and Evaluation (CARE) in Women's Health Issue Briefs

With the U.S. Supreme Court anticipated to overturn the 1973 Roe v. Wade decision (and the modifications to that decision by Planned Parenthood of Southeastern Pennsylvania v. Casey from 1992), the protection, regulation, or prohibition of abortion would likely default to state laws and state constitutions. Therefore, to understand how this upcoming Supreme Court decision could impact access to abortion in Tennessee, it is useful to examine both key current state laws in effect related to abortion access, as well as the current state of access to abortion in Tennessee. This brief intends only to summarize current Tennessee state laws …

Expand Nemt Across Central And Western Nebraska, Bri Parr

Theses/Capstones/Creative Projects

The average age of adults in the US is increasing, especially in rural areas. Approximately 60 million individuals live in the rural US, including millions of Medicare beneficiaries. Older rural Americans are more likely to be in poverty, unhealthy, and medically underserved. They rely heavily on government health insurance programs, such as Medicare, to provide for their health care needs. Unfortunately, for many older adults living in rural areas, health care is both difficult to access or in some cases completely unavailable. This is due to several factors, including the lack of specialist care in rural areas (mental health specialists, …

Hiv And The African American Church: Millennial Faith Leader's Perspectives., Kelsey Leann Burton

Electronic Theses and Dissertations

African Americans are disproportionately impacted by HIV compared to other racial groups. Stigma surrounding HIV has created challenges for effective HIV prevention and stigma reduction programs. The African American church has been criticized for its slow and stigmatizing response to the HIV epidemic. Despite this, African American faith leaders play significant roles in guiding the perspective of the community. Numerous studies examine African American pastors’, faith leaders’, and ministers’ perspective about HIV and other HIV-related topics. However, there is no research that specifically examines young African American pastors’ perspectives of addressing HIV, stigma, and prevention. The purpose of this dissertation …

Understanding Public Emergency Preparedness Before And During The Coronavirus Outbreak: Implications For Effective Public Health And Risk Communication., Raphael Adjetey Fumey

Electronic Theses and Dissertations

The COVID-19 pandemic has resulted in a dramatic loss of human lives globally and presents an unprecedented challenge to public health, the world of work, and our food systems. The social and economic disruption caused by the COVID-19 pandemic is devastating, putting several millions of people at risk of falling into extreme poverty, with over 500 million people being undernourished. It is evident from the data on COVID-19 cases, deaths, and hospitalizations that the United States is the worse hit country, which can be attributed to the lack of preparedness at the individual, environmental, and government levels. This study applied …

Protest-Related Tear Gas Exposure And Menstrual Function, Emily Kathleen (Steinmetz) Reece

Electronic Theses and Dissertations

During the racial justice protests of 2020 and 2021, crowd control chemical irritants (referred to as “tear gas”) were deployed against protesters, after which there were anecdotal reports of altered menstrual cycles among exposed individuals. There is only one peer reviewed published study on tear gas exposure and menstrual health. This study examined whether tear gas exposure was associated with menstrual cycle outcomes among women attending the 2020-2021 protests. Data from 103 women who attended racial justice protests in 2020 and 2021 were collected through an online questionnaire. Data included protest attendance, acute symptoms of tear gas exposure, whether medical …

Person-Centered Decision-Making And Socio-Cultural Contexts Influencing Cesarean Deliveries: A National Analysis., Alice M. Story

Electronic Theses and Dissertations

The cesarean delivery rate has increased and accounts for a third of pregnancies in the U.S., especially among marginalized women. This study applied a newly developed conceptual model to identify potential areas of influence that could reduce rates of cesarean deliveries. The Giving Voice to Mothers - United States data was used for analyses to predict covariates associated with having a cesarean delivery vs. spontaneous vaginal delivery (n=1,876). Significant covariates were determined and included the following: having a prior cesarean delivery (OR: 14.11, 95% CI: 7.99 - 24.90); more than one child (OR: 0.21, 95% CI: 0.13 - 0.35); elevated …

Positive And Negative Deviant Counties: Identification Of Factors Associated With Health Outcomes, Olivia Egen

Electronic Theses and Dissertations

Rural counties in the United States vary drastically on metrics related to socioeconomic status and dominant economic industry as well as health behaviors and outcomes. This study sought to understand the underlying structural reasons why some rural counties have better or worse than expected health outcomes using a positive deviance (PD) approach. The study aimed to: 1) create an area deprivation index and divide counties into quartiles using the index; 2) identify positive, negative, and non-deviant counties using health outcome metrics; 3) analyze differences between deviance on a variety of local public health system metrics; and 4) analyze differences between …

Examining The State Of Substance Use Treatment Among Youth And Adults In The United States, Esther Adejoke Adeniran

Electronic Theses and Dissertations

In the United States (US), substance use, misuse, and substance use disorders are significant public health problems. Additionally, the difference between needing substance use treatment (SUT) and receiving treatment is becoming more pronounced. Therefore, the aims of this dissertation include, 1) to synthesize evidence of barriers and facilitators to integrating SUT into mainstream health care (MHC) after the Affordable Care Act was nationally implemented in 2014, 2) to examine the rate of treatment completion and dropout, along with its associated factors, among youth who received Medication-Assisted Opioid Therapy (MAT), 3) to determine the relationship between prior treatment episodes and length …

If A Tree Falls In The Forest: Presidential Press Conferences And Early Media Narratives About The Covid-19 Crisis, Masha Krupenkin, Kai Zhu, Dylan Walker, David Rothschild

Business Faculty Articles and Research

Throughout the COVID-19 crisis, as we confronted questions about social distancing, masking wearing, and vaccines, public safety experts warned that the consequences of a misinformed population would be particularly dire due to the serious nature of the threat and necessity of severe collective action to keep the population safe. Thus, the media and the political elites (e.g., President of the United States) who possess the power to set the information agenda around COVID-19 bear a huge responsibility for the general welfare. Through automated text analysis of complete transcripts of national cable, network, and local news, we explore their narratives surrounding …

The Influence Of Violence, Policing, And Substance Use Stigma On Sexual And Substance Use Risk Engagement In Substance Using Men Along The U.S.-Mexico Border, William Campillo Terrazas

Open Access Theses & Dissertations

Background: Cities along the U.S.-Mexico border are unique environments where structural level variables place residents at risk for increased substance use subsequently impacting HIV rates and acquisition. Growing evidence emphasizes the importance of understanding how structural drivers of infectious diseases impact community and social networks to develop interventions to reduce HIV transmission among hard-to-reach populations.

Aims and Objectives: The goal of this study was to investigate the influence of structural factors such as neighborhood disruption, harsh policing, and substance use stigma on engagement of HIV risk behaviors among social networks of people who use drugs and who reside in El …

Regulation Of C-C Chemokine Receptor 7 (Ccr7) Ligand-Mediated Internalization And Chemotaxis By G Protein-Coupled Receptor Kinase Family 4 (Grk-4, 5, 6) In Human Pediatric T-Cell Acute Lymphoblastic Leukemia (T-All), Eduardo Elias Chaib

Open Access Theses & Dissertations

Background and Significance: The Hispanic population is disproportionally affected by T-ALL (T-cell acute lymphoblastic leukemia) when compared to other races in the US. C-C Chemokine Receptor 7 (CCR7) in T-ALL is used during disease progression, and may lead to migration of cancerous cells into the Central Nervous System (CNS) of patients. Goals and Objectives: This project aims to find relevant rates and risk factors for T-ALL for the Hispanic population in the US/Mexico border region. The other aim is to assess the effect of the G protein-coupled Receptor Kinase 4 (GRK-4) family proteins on migration and receptor internalization through CCR7 …

The Use Of Person-First Language In Diabetes Care & Research. How Far Have We Come Since Ada & Adces Recommendations?: A Systematic Review, Denise Nicole Portillo

Open Access Theses & Dissertations

Background: Diabetes is a chronic medical condition that affects more than 34 million people across the United States (Centers for Disease Control and Prevention (CDC), 2020). Diabetes is characterized as the inability to create or regulate insulin adequately (Costabile et al., 2020). There are three main types of diabetes, type 1 diabetes mellitus (T1D), type 2 diabetes mellitus (T2D), and gestational diabetes (CDC, 2020). Of the more than 34 million people with diabetes, 5 to 10% have T1D, while the remaining 90-95% have T2D (CDC, 2020). In 2017, the Association of Diabetes Care & Education Specialists (ADCES) and the American …

Omicron Infection Milder In Nursing Home Residents, Robin L.P. Jump

Faculty Scholarship

No abstract provided.

Eat Well, Be Well: Basic Needs Initiative's Online Hub For Nutrition Education, Misha Moseley

Capstone Projects and Master's Theses

Basic Needs Initiative at California State University, Monterey Bay is a department that provides students with food, housing, and wellness resources. Over half of the university's students experience food insecurity, and over 85% use non-academic resources to learn about nutrition. This project adds a dietary health section to the department’s website to increase students’ access to nutrition education. It addresses the micro-level agency problem that too few students eat a healthy, balanced diet. Unhealthy eating is a risk factor for food insecurity, so the project indirectly addresses the macro-level health problem that too many college students in California experience food …

Notice: Youth, Poc & Lgbtq+ Big Tobacco Wants You, Tucosha Lopez

Capstone Projects and Master's Theses

Breathe California of the Bay Area, Golden Gate, and Central Coast is a 501(c)3 non-profit that works with local communities to fight lung disease. This capstone project was developed for the Tobacco Control Program and addressed how Big Tobacco disproportionately targets youth, people of color, and LGBTQ+. Less awareness of tobacco-related issues, targeted marketing schemes, and individual susceptibility to negative health behaviors result in addiction, decreased physical/mental health, and increased negative behaviors. The project was a 45-minute educational resource video to be published on the Breathe California YouTube channel. It consists of topics about the warning signs of nicotine addiction …

Hurricane Sheltering In A Time Of Covid, David Holcombe

Journal of the Louisiana Public Health Association

No abstract provided.

Louisiana Public Health Institute, Brittany Fowler

Journal of the Louisiana Public Health Association

No abstract provided.