Public Health Commons^™

Guidelines For Managing Dysautonomia Dysfunction, Angela Coleman Webb

Walden Dissertations and Doctoral Studies

Dysautonomia dysfunction (DD) is a disorder of the autonomic nervous system. Over 70 million people suffer from some type of DD, and the average length of time from symptoms to diagnosis is 6 years. Most facilities and providers choose not to treat DD due to the number of symptoms and the difficulty of being able to diagnose correctly. The purpose of this project study was to create guidelines for the diagnosis, treatment, and management of DD. The research question addressed the effectiveness of these guidelines to help nurses and providers caring for patients with DD provide better care. Watson’s theory …

Stress On Correctional Officers In High Demand And Low Control Work Environments, Amy Whiting

Walden Dissertations and Doctoral Studies

Many major health concerns can be caused due to stress that stems from the demands put upon a person from their job. Correctional officers can experience high demands from their job as well as little control due to on-the-job experiences, such as being assaulted by an inmate, witnessing an assault by an inmate on another correctional officer, or having a complaint filed against them by an inmate. The purpose of this study was to determine if there is a relationship between these experiences and stress-related symptoms, such as gastrointestinal issues, headaches, neck or back pain, difficulty concentrating, and more while …

Assessment Of Multidrug Resistance Among Tuberculosis Patients In Lesotho, Jerry Yakubu Yahaya

Walden Dissertations and Doctoral Studies

The emergence of multidrug-resistant tuberculosis (MDR-TB) jeopardizes the tremendous efforts in the fight against tuberculosis in Lesotho. To understand the occurrence of MDR-TB, it is important to identify the associated risk factors and how to address them. There is a literature gap on the sociodemographic risk factors associated with MDR-TB in Lesotho. This study assessed whether there is any significant association between age, employment, income, sex, education, place of residence and MDR-TB. The association between HIV and MDR-TB was also evaluated. Guided by the health belief model and social cognitive theory, a retrospective case-control study design and a proportionate stratified …

Social Capital And Food Insecurity In Two Counties In Wisconsin, Yvonne Denise Greer

Walden Dissertations and Doctoral Studies

Hunger and food insecurity are public health issues with 38 million people in the US struggling with food hardship. This study examined if there was a relationship between four types of social capital (SC) (bonding, bridging, community structural-formal, and community structural-informal), income, and food insecurity risk (FIR), in two counties in Wisconsin. A quantitative descriptive correlational study design involving multiple linear regression analysis and the integral model framework was conducted with cross-sectional secondary data from the 2014-2016 Survey of the Health of Wisconsin. Participants were from Milwaukee (n = 335) and Dane County (n = 235). Results revealed that in …

Predictors Of Homelessness Among Female Veterans And Civilians, Victoria Caridad Justiniano Quinones

Walden Dissertations and Doctoral Studies

Homelessness among female veterans is a problem that is likely to increase as growing numbers of women in the U.S. military reestablish themselves into their communities as veterans. There has been increasing concern about the greater risk for homelessness found among female veterans when compared to their nonveteran counterparts, so further investigation of homeless incidence by gender is also warranted. This quantitative, exploratory study was grounded in the social ecological theory, the Balshem and colleagues conceptual model of risk factors for veteran homelessness, and the Susser, Moore, and Link conceptual model which investigated causal pathways that are possible risk factors …

Examining Health Care Utilization Among Adult Heart Disease Patients With Self-Reported Depressive Symptoms, Courtney R. Lockett

Walden Dissertations and Doctoral Studies

Health care costs are most commonly concentrated among small groups of high-cost patients, or high utilizers. Many of these patients receive unnecessary and ineffective care and often critical health care needs can go unmet, even when substantial care from multiple sources is received. Thus, there is a need to look into high utilizing patients for not only quality improvement but also effective resource allocation. The operational problem for health care administrators is managing resources and improving quality of care by targeting specific medical conditions that may be high utilizers of medical resources. The purpose of this study was to identify …

The Factors Urban African American Men Perceive As Preventing Early Prostate Cancer Screening, Joel Mongo

Walden Dissertations and Doctoral Studies

Prostatic carcinoma, or prostate cancer, is the leading cause of death among adult males in the United States. The highest rate of prostate cancer is found in males of African American ethnicity, as males within this cohort are 50% more likely to develop prostate cancer than other ethnicities. African Americans men are 1.6 times more likely to develop prostate cancer and 2.4 times more likely to die from it than Caucasians. The purpose of this qualitative study was to examine the perceptions of urban African American men about factors that prevent them from seeking and receiving prostate cancer screening, and …

Alzheimer's Disease: Risk And Protective Factors To Improve Detection And Prevention, Darryl Clay Nevels

Walden Dissertations and Doctoral Studies

Alzheimer’s disease (AD) is a growing epidemic and is the sixth-leading cause of death in the United States. Individuals with AD often have comorbidities due to the aging process. There is a lack of research on comorbidities as associated risk factors for AD. The leading hypothesis indicates that cardiovascular health issues, environmental exposure, social isolation, and amyloid-beta plaques influence cognitive health and are associated with AD. This study, guided by Finch and Kulminski’s AD exposome, is a caveat to explore a patient’s physical history of cardiovascular health, modifiable behavior, social isolation, and an AD diagnosis. Participants provided health information collected …

Factors Affecting Fetal Death Among Women With Cesarean Section(S) In The United States, Iheanyi Emmanuel Nwosuh

Walden Dissertations and Doctoral Studies

AbstractThe United States has a higher rate of fetal death compared to other industrialized nations. Although many studies on the factors that contribute to fetal death have been conducted among women in general, little of this phenomenon is known among women who have had a previous Cesarean section (C-section). The purpose of this study was to explore the factors of fetal death among women with a previous C-section(s) and offer suggestions for interventions. The social determinants of health theory was used with other social constructs to provide a theoretical and conceptual framework for the study. As part of the cross-sectional …

Health Department Prevention/Education Plans And Perceived Risks Of Zika Infection, Lacey Jacques

Walden Dissertations and Doctoral Studies

AbstractZika virus is an infectious disease caused by the bite of an infected mosquito that has been linked to increased rates of microcephaly and other devastating birth defects. The existing body of knowledge has focused on the individual-level factors that influence a person’s decisions about prevention activities and risk perceptions related to Zika virus. The purpose of this study was to determine the relationship between state-level plans for prevention and education and individual-level risk perceptions. Rosenstock’s health belief model lays a foundation for why individuals make the health decisions they do and helps explain how these can be influenced for …

The Relationship Between Types Of Workplace Trauma Exposure, Burnout, And Ptsd In Mental Health Workers, Armando Dominguez

Walden Dissertations and Doctoral Studies

Work-related traumatic exposure has been studied but has not been concisely defined in the widest range of research studying trauma exposure. Specifically, it is not known from previous research whether direct, indirect, and vicarious trauma exposure predict burnout and PTSD in acute care mental health care workers. The emotional processing theory was used as theoretical foundation informing this study as the habituation of response to stress and trauma has been shown to occur incidentally and cumulatively; the theory supports the concept of dichotomous and continuous type of trauma exposure over time. The purpose of this study was to use a …

Oral Health Behaviors, Attitudes, And Dental Diseases In Native American/Alaskan Native School-Age Children, Tawanda Martin

Walden Dissertations and Doctoral Studies

Dental disease is a highly preventable pediatric disease, and 70% of Native American/Alaskan Native (NA/AN) preschool children have a history of dental caries, which is 3.5 times higher than in the general population. This study aimed to conduct a meta-analysis examining the impact of oral health behaviors and attitudes of NA/AN parents and guardians on dental disease in NA/AN school-age children. The impact of frequency of flossing and brushing, consumption of sugary foods, dental visits, dental attendance reason, sealants, fluoride treatment, and oral health education by NA/AN parents and guardians on children’s caries and periodontal diseases status was explored. Additionally, …

Comprehensive Sex Education, Religious Affiliated Organizations, And Std Knowledge Among Young Adults, Leslie Marie Shaffer

Walden Dissertations and Doctoral Studies

AbstractEvery year there are approximately 20 million new cases of sexually transmitted diseases (STDs) in the United States, and half of these are among young adults. Stark County, Ohio recently experienced an increase in chlamydia, gonorrhea, and syphilis cases among 18- to 24-year-old individuals. Public health practitioners have since called for research regarding factors that affect STD knowledge and perceptions in this population. This cross-sectional study was guided by the social-ecological model and assessed the association between attendance at a religious-affiliated institution, access to comprehensive sex education, and STD knowledge. One hundred thirty-eight (n=138) participants, aged 18 to 24 years, …

Experiences Of Critical Care Nurse Managers In Addressing Nurses' Work-Related Stress, Mariana Tsucuneli

Walden Dissertations and Doctoral Studies

AbstractNurses who work in the critical care unit are more likely to experience work-related stress, fatigue, understaffing, undesirable performance outcomes, and compromised workplace safety than general care nurses. Nurse managers in these units possess insights into nurses' stress-inducing challenges, in addition to managerial and administrative perspectives. Yet there is a lack of available knowledge about the experiences of critical care nurse managers in addressing nurses' work-related stress. The purpose of this study was to explore critical care nurse managers’ experiences of potential strategies to effectively address work-related stress among nurses. The job-demand resource model was the theoretical framework for the …

Comparative Effectiveness Study Of Acute Ischemic Stroke Care Between Stroke Belt And Non-Stroke Belt Hospitals Using The Get With The Guidelines-Stroke Program, Michael Earl Brown Jr

Walden Dissertations and Doctoral Studies

Stroke is a leading cause of mortality in the United States, particularly in a cluster of states termed the stroke belt. This study examined the efficacy of the Get With The Guidelines (GWTG)-Stroke program in stroke belt hospitals (SBHs) compared to non-stroke belt hospitals (NSBHs) regarding disparities related to mortality and acute ischemic stroke (AIS) treatment (i.e., recombinant tissue-type plasminogen activator [r-tPA] rates, Door-to-Needle [DTN], Door-to-Imaging [DTI]). Use of the GWTG-Stroke program was assessed to determine if SBHs and NSBHs were quantitatively equivalent in terms of specific core stroke measures. This quantitative employed an equivalence study design with over 2.9 …

Providers’ Perspectives On Barriers Associated With Repeat Teen Pregnancies In Rural Southeastern United States, Vanessa Iheoma Iheanachor

Walden Dissertations and Doctoral Studies

Teen (or adolescent) pregnancy remains a significant public health problem in the United States. Rapid repeat pregnancy, defined as any pregnancy that occurs within 24 months of a previous birth, has been linked to adverse maternal and neonatal outcomes. The purpose of this quantitative, cross-sectional study was to understand the perceptions of health care providers (HCPs) regarding barriers that influence repeat pregnancies among adolescents in rural southeastern United States. The theoretical framework that guided this study was Urie Bronfenbrenner’s social ecological model. A survey instrument was developed and disseminated to HCPs using Qualtrics, an online survey platform. Data (n=32) were …

Spirituality-Based Programs For African American Women, Sophelia Predom Kelly

Walden Dissertations and Doctoral Studies

Because spirituality or personal value conflicts might arise between social workers and their clients, the purpose of the study was to understand personal and spirituality value conflicts. The theoretical framework for this study was adult transformative learning theory. The research questions examined how the participants described personal and spirituality value conflicts. Data were collected from interviews with two groups from Houston, Texas; Group 1 represented homeless or previously homeless African American women who self-identified as spiritual but nonreligious, and Group 2 represented White licensed master social workers. Researcher responses to the same interview questions were also recorded. Thematic data analysis …

Hospital Readmission Reduction Penalties And Chronic Obstructive Pulmonary Disease Readmissions, Anthony Aduro

Walden Dissertations and Doctoral Studies

AbstractChronic obstructive pulmonary disease (COPD) is a serious disease that affects the respiratory system, creating poor patient outcomes. Additionally, persons with COPD have higher hospital readmission rates than other patient populations. Not only is hospital readmission indicative of poor patient outcomes, but hospital readmissions are costly to healthcare organizations as well. High readmission rates are associated with wasted resources and money, and negatively impact organizational performance. The Centers for Medicaid and Medicare Services (CMS) implemented the Hospital Readmissions Reduction Program (HRRP) to reduce the rate of avoidable hospital readmissions for diseases including COPD. However, how HRRP penalties have impacted readmission …

Readiness Of Adolescent And Young Sickle Cell Patients To Transition From Pediatric To Adult Care, Tanisha D. Belton

Walden Dissertations and Doctoral Studies

Patients with sickle cell disease (SCD) face many challenges as they enter adulthood; therefore, preparing for the transition to adult care is crucial. Assessing the knowledge and skills adolescents and young adults (AYAs) possess before transitioning to adult care can aid in the success of their transition. However, a gap exists regarding factors attributed to guiding patients’ sense of readiness. The purpose of this quantitative study, driven by the theory of self-care management of SCD, was to examine the self-perceived readiness of SCD patients as they prepare to transition to adult care. Cross-sectional survey data were collected from 68 sickle …

The Impact Of Electronic Cigarettes Use On Traditional Cigarette Uses Among U.S. Adolescents, Ismail Mensah Dwumfour-Poku

Walden Dissertations and Doctoral Studies

The increased usage of e-cigarettes among adolescents in the United States (U.S.) is a major public health concern. According to the Centers for Disease Control and Prevention (CDC), nicotine, an active ingredient in e-cigarettes, is the most addictive drug in use today. The purpose of the current study was to explore the relationship between smoking of e- cigarettes and the risk of smoking traditional cigarettes among middle and high school students in Grades 6 through 12 in the U.S., and to determine if demographic factors contribute to this predisposition. This, quantitative cross-sectional study used the social ecological model as the …

Relationship Between Early Years’ Activities Of Daily Living And Alzheimer’S Disease Onset, Linyi Fan

Walden Dissertations and Doctoral Studies

A few promising studies have indicated that activities of daily life (ADL) may be a useful way of predicting Alzheimer’s Disease (AD). However, the existing cross-sectional studies fail to show how ADLs in early years predict AD, and how social factors influence health either in addition to or in interaction with individual risk factors. Using a social epidemiology framework, this study examined the relationship between early years’ ADL and the development of AD in later years. This quantitative study included 4,526 participants derived from the Health and Retirement Study (HRS) dataset. The dependent variable was whether the participant has been …

Fielding Vaccines-Challenges And Opportunities In Outbreaks, Complex Emergencies, And Mass Gatherings, Laura J. Fischer, Robert C. Rains, Sherry M. Brett-Major, Mikiko Senga, Debra Holden, David Brett-Major

Journal Articles: Epidemiology

With the recent COVID-19 pandemic, the importance of vaccine development, distribution, and uptake has come to the forefront of the public eye. Effectively fielding vaccines during an emergency-whether that emergency is a result of an infectious disease or not-requires an understanding of usual vaccine-related processes; the impact of outbreak, complex emergencies, mass gatherings, and other events on patients, communities, and health systems; and ways in which diverse resources can be applied to successfully achieve needed vaccine uptake. In this review, both the emergency setting and briefly vaccine product design are discussed in these contexts in order to provide a concise …

Differential Methylation Patterns In Lean And Obese Non-Alcoholic Steatohepatitis-Associated Hepatocellular Carcinoma, Emma Hymel, Kurt W. Fisher, Evi A. Farazi

Journal Articles: Epidemiology

BACKGROUND: Nonalcoholic fatty liver disease affects about 24% of the world's population and may progress to nonalcoholic steatohepatitis (NASH), cirrhosis, and hepatocellular carcinoma (HCC). While more common in those that are obese, NASH-HCC can develop in lean individuals. The mechanisms by which HCC develops and the role of epigenetic changes in the context of obesity and normal weight are not well understood.

METHODS: In this study, we used previously generated mouse models of lean and obese HCC using a choline deficient/high trans-fat/fructose/cholesterol diet and a choline supplemented/high trans-fat/fructose/cholesterol diet, respectively, to evaluate methylation differences in HCC progression in lean versus …

Bilateral Retractile Testis: A Possible Risk Factor For Male Infertility, Syed Intesar Burni, Shazia R. Khan, Fareena Khalil Ahmed, Sameera Ali Rizvi, Tazeen Saeed Ali

School of Nursing & Midwifery

Healthy youth is an asset and strength for economic and social growth of any society. Developmental changes during puberty of youngsters need proper guidance to avoid future physical, physiological and psychological ailments. Bilateral Retractile Testis (BRT) is a health problem if remains unnoticed till adolescence can lead to tribulations. BRT may affect testicular parenchyma and spermatogenesis. Cremasteric muscles (muscles attached with testes) pull the testes up into groin so it randomly moves up and down and do not reside in its natural pouch always. It has been a controversial issue in male infertility as retraction may affect infertility.
Objective: To …

Black Vs. White: What Is Bipolar Disorder?, Delmy Mendoza, Kendall Childs, Maedot Aklilu, Tynise Phillips

DC Health and Academic Prep Program (DC HAPP)

This intervention will show that underdiagnosing and misdiagnosing mental health disorders can be prevented by creating more high school medical pipeline programs and encouraging POC students interested in healthcare to participate in diversifying the healthcare system. Pipeline programs have shown to be beneficial in increasing the numbers and quality of underrepresented ethnic minority applicants from disadvantaged backgrounds, and achievement motivation. For example, the pipeline program The Teen Medical Academy created in 2008 combated unrepresentative health disparity in adolescents by successfully improving interest in medical and allied health careers, confidence in their ability to accomplish a health profession, learning surgical and …

Sequencing Sars-Cov-2 Genomes From Saliva, Tara Alpert, Chantal B. F. Vogels, Mallery I. Breban, Mary E. Petrone, Anne L. Wyllie, Nathan D. Grubaugh, Joseph R. Fauver

Journal Articles: Epidemiology

Genomic sequencing is crucial to understanding the epidemiology and evolution of Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Often, genomic studies rely on remnant diagnostic material, typically nasopharyngeal (NP) swabs, as input into whole-genome SARS-CoV-2 next-generation sequencing pipelines. Saliva has proven to be a safe and stable specimen for the detection of SARS-CoV-2 RNA via traditional diagnostic assays; however, saliva is not commonly used for SARS-CoV-2 sequencing. Using the ARTIC Network amplicon-generation approach with sequencing on the Oxford Nanopore MinION, we demonstrate that sequencing SARS-CoV-2 from saliva produces genomes comparable to those from NP swabs, and that RNA extraction is …

Increasing Hpv Vaccination In Elliott And Lawrence Counties, Keeghan Francis

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

Appalachian counties within Kentucky have higher rates of HPV-related cancers, including cervical cancer. HPV vaccines are effective at reducing the risk of cervical cancer, but vaccination coverage in Appalachia remains low. The proposed program relies on recommended strategies to improve vaccine uptake by increasing access and demand for HPV vaccines. This will be done through school vaccine clinics and parent education on HPV, cervical cancer, and HPV vaccines.

Key Factors Associated With Late-Stage Diagnosis Of Endometrial Cancer In Kentucky, Lexee Long

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

Objectives: Cancer of the endometrium is the most common female reproductive cancer in the United States, but is understudied in relation to stage at diagnosis, which is a potential predictor of survival. The primary objective of this study is to analyze potential associations of independent variables such as age at diagnosis, race, marital status, smoking status, Appalachian status, and insurance type with late-stage diagnosis of endometrial cancer.

Methods: This population-based study used Kentucky Cancer Registry data to study endometrial cancer cases diagnosed between January 1^st,2015 and December 31^st, 2019. Chi-square statistics were used to examine bivariate …

Patterns Of Continuous Glucose Monitoring Utilization Among Adults With Type 1 Diabetes, 2016-2018, Katherine Elizabeth Lee

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

BACKGROUND: Continuous glucose monitoring (CGM) improves diabetes control by reducing HbA1c and decreasing rates of hypoglycemia. Despite clinical benefits and clear guidelines from the American Diabetes Association, <20% of patients with type 1 diabetes mellitus (T1DM) use CGM. Studies report disparities in CGM among youth with T1DM by race/ethnicity, socioeconomic status, and region, but, insight into patterns of CGM utilization in adults with T1D is limited. METHODS: This project retrospectively analyzed CGM utilization among individuals with T1DM age 18-64 using the Truven MarketScan® Commercial Claims and Encounters (CCAE) database from 1/1/2016-12/31/2018. CGM utilization was determined using National Drug Code (NDC), Current Procedural Terminology (CPT), or Healthcare Common Procedure Coding system II (HCPCS II) claim identifiers. Individuals with >365 days of continuous medical and pharmacy insurance eligibility were followed from their first Type 1 diabetes-related diagnosis code until the end of the study period or >120 day gap in coverage. Using descriptive statistical analysis, CGM utilization was examined in the overall population and was stratified by patient demographics (age, sex, region), and clinical characteristics (insulin pump, diabetes complications). As a secondary analysis, CGM utilization was further stratified by both calendar year …

Academic Pathology's "Spiderless Network": The Power Of A Professional Society, Its Listserv, And Its Journal During A Public Health Emergency, Mark L Tykocinski

COVID-19 Papers, Posters, and Presentations

No abstract provided.