Public Health Commons^™

Socioeconomic Determinants And Maternal Mortality In Liberia, Monee Sherman

Walden Dissertations and Doctoral Studies

High rates of pregnancies and childbirth contribute to a heightened risk of maternal mortality among women between 15 and 49 in Liberia. Most women are uninformed about their maternal risk behaviors, symptom severity, and delayed care-seeking. The mortality rate for women between 25 and 34 during pregnancy and childbirth is unacceptably high. The highest increase in maternal mortality rates is seen among women between 40 and 44 who choose to delay motherhood. In Liberia, the deaths of 4.5 women a day are caused by complications during pregnancy and childbirth. We examined the influence of participant background characteristics, socioeconomic factors, and …

Pressing Issues For Oral Care Quality Improvement: Findings From The Eu Deliver Project, Paulo Melo, Leonor Frey-Furtado, Daniela Correia, Stefan Listl, Michael Lorenz, Nagihan Bostanci, Álvaro Azevedo, Maria Lurdes Pereira

Faculty, Staff and Student Publications

BACKGROUND: While oral health often takes a backseat to other health domains, it silently affects nearly half of the Worldwide population. The DELIVER project, funded by the EU's Horizon Europe program, seeks to develop a blueprint model for improving the quality of oral health care for everyone.

METHODS: Applying the Nominal Group Technique (NGT), 17 stakeholders from various backgrounds participated in identifying pressing issues for oral care quality improvement across practice, community, and policy levels.

RESULTS: The results revealed significant differences at the different levels, with accessibility emerging as a prominent issue, encompassing affordability, availability, and acceptability of oral healthcare …

Clathrin Light Chains Negatively Regulate Plant Immunity By Hijacking The Autophagy Pathway, Hu-Jiao Lan, Jie Ran, Wen-Xu Wang, Lei Zhang, Ni-Ni Wu, Ya-Ting Zhao, Min-Jun Huang, Min Ni, Fen Liu, Ninghui Cheng, Paul A Nakata, Jianwei Pan, Steven A Whitham, Barbara J Baker, Jian-Zhong Liu

Faculty, Staff and Students Publications

The crosstalk between clathrin-mediated endocytosis (CME) and the autophagy pathway has been reported in mammals; however, the interconnection of CME with autophagy has not been established in plants. Here, we report that the Arabidopsis CLATHRIN LIGHT CHAIN (CLC) subunit 2 and 3 double mutant, clc2-1 clc3-1, phenocopies Arabidopsis AUTOPHAGY-RELATED GENE (ATG) mutants in both autoimmunity and nutrient sensitivity. Accordingly, the autophagy pathway is significantly compromised in the clc2-1 clc3-1 mutant. Interestingly, multiple assays demonstrate that CLC2 directly interacts with ATG8h/ATG8i in a domain-specific manner. As expected, both GFP-ATG8h/GFP-ATG8i and CLC2-GFP are subjected to autophagic degradation, and degradation of GFP-ATG8h is …

How Is Diagnostic Uncertainty Communicated And Managed In Real World Primary Care Settings?, Jessica Russell, Laura Boswell, Athena Ip, Jenny Harris, Hardeep Singh, Ashley N D Meyer, Traber D Giardina, Afsana Bhuiya, Katriina L Whitaker, Georgia B Black

Faculty, Staff and Students Publications

Background: Managing diagnostic uncertainty is a major challenge in primary care due to factors such as the absence of definitive tests, variable symptom presentations and disease evolution. Maintaining patient trust during a period of investigative uncertainty, whilst minimising scope for diagnostic error is a challenge. Mismanagement can lead to diagnostic errors, treatment delays, and suboptimal patient outcomes.

Objective: Our aim was to explore how UK primary care physicians (GPs) address and communicate diagnostic uncertainty in practice.

Design: This qualitative study used video and audio-recordings. Verbatim transcripts were coded with a modified, validated tool to capture GPs' actions and communication in …

A Social Media Game To Increase Physical Activity Among Older Adult Women: Protocol Of A Randomized Controlled Trial To Evaluate Challenge, Michael C Robertson, Maria Chang Swartz, Karen M Basen-Engquist, Yisheng Li, Kristofer Jennings, Debbe Thompson, Tom Baranowski, Elena Volpi, Elizabeth J Lyons

Faculty, Staff and Student Publications

BACKGROUND: Older adult women often do not engage in sufficient physical activity (PA) and can encounter biological changes that exacerbate the negative effects of inadequate activity. Wearable activity monitors can facilitate PA initiation, but evidence of sustained behavior change is lacking. Supplementing wearable technologies with intervention content that evokes enjoyment, interest, meaning, and personal values associated with PA may support long term adherence. In this paper, we present the protocol of an NIA-funded study designed to evaluate the efficacy of CHALLENGE for increasing step count and motivation for PA in insufficiently active older women (Challenges for Healthy Aging: Leveraging Limits …

Molecular Detection Of Pathogenic Bacteria In American Dog Ticks (Dermacentor Variabilis) In Brown County, Nebraska, Nicole Messbarger, Darby Carlson, Keith Geluso, Julie Shaffer

Transactions of the Nebraska Academy of Sciences and Affiliated Societies

Ticks carry and transmit disease pathogens that cause many human illnesses. Many of these diseases in humans are accompanied by a wide variety of symptoms making tick-borne illnesses often difficult to diagnose. The rate of reported tick-borne illnesses in humans has increased during the past decades in the United States, alongside a rise in concern for public health and safety. In northern Nebraska, the American dog tick (Dermacentor variabilis) is the primary tick encountered by humans and domestic animals in the region. This species is a known vector for spotted fever group (SFG) rickettsioses and tularemia (Francisella …

The Status Of Abortion Care Training For Medical Providers Amidst The Current Abortion Access Crisis: A Literature Review, Leah Johnson

Theses and Graduate Projects

Background: While a common, safe, and essential aspect of reproductive healthcare, abortions have been subject to countless legal restrictions and bans in the United States, especially after the overturn of Roe v. Wade. This has also exacerbated the current shortage of abortion providers. Within this crisis of worsening abortion access, it is imperative to appropriately train future clinicians to provide abortion care. Purpose: This literature review will investigate the status of abortion training in medical schooling. It will explore physician-specific education in abortion and look specifically at the impact of recent legal threats on the availability of this training. Finally, …

Relationship Between Driving While Impaired And Riding With An Impaired Driver Among Adolescents In The United States, Michael S. Dunn

Public Health

Background: Alcohol, tobacco, and other drug use (ATOD) and sexual risk-taking are contributors to the health and welfare of adolescents and a significant percentage engage in these behaviors. These behaviors may contribute to other risk-taking such as driving while impaired (DWI) or riding with an impaired driver (RWI). The purpose of this study was to assess the relationship between DWI and RWI and ATOD use, sexual risk-taking, and physical fighting among adolescents. Methods: Date for this study were derived from the 2017, 2019, 2021 Youth Risk Behavior Survey (YRBS) (n = 45,132). Logistic regression models were used to estimate the …

A Systematic Review: Longevity And Quality Of Life In Blue Zones, Salmaan Mulla

Theses and Graduate Projects

Ikaria, Loma Linda, Sardinia, Okinawa, and Nikoya. These 5 cities around the world are famed for their increased longevity and quality of life and are termed “Blue Zones”. Blue zones are areas around the world noted for their population of centenarians, overall long life expectancy and high quality of life compared to the average population. Studying these communities offer insights into the commonalities they share to better understand the unique aspects of living a healthy, fulfilling and long life. A comprehensive literature review was conducted using Google Scholar, with the search terms “Ikaria, Greece longevity; Loma Linda, California longevity; Sardinia, …

The Role Of Aarp Mississippi In Healthy Aging, Kimberly Campbell, Melinda Bertucci

Journal of Public Health in the Deep South

No abstract provided.

Integrated Delivery Of Health Care And Continuity Of Care For Older Mississippians With Mental And Behavioral Health Concerns, Tockie V. Hemphill

Journal of Public Health in the Deep South

The mental health of older adults is of national concern. There is some uncertainty regarding access to care and whether mental and behavioral health care will be readily available in primary care settings. This paper explores the concepts of integrated delivery of care and continuity of care for older adults. The definitions of the two concepts vary in detail, but are similar in purpose. There is an array of strategies presented that outline a continuity of care that involves an integrated delivery system. Relationship development is the core of this system, as well as older adults’ ability and willingness to …

Aging Redefined: Moving Past The Deficit Model, Aaron Guest

Journal of Public Health in the Deep South

The remarkable increase in longevity is the pivotal triumph of public health over the last two centuries. Yet, even as we experience the benefits of increased longevity, we continue to face rampant ageism – or the prejudice and discrimination directed at individuals perceived as 'old.' Worst of all, we know that ageism is associated with increased medical costs, poorer health outcomes, and increased mortality. Efforts to combat ageism have been insufficient. The triumvirate of ageism, gerontological illiteracy, and gerontophobia have resulted in a deficit model of aging. Far from being a liability, the rapid increase in the aging population presents …

Caregiver To Caregiver: An Exploratory Case Study In Adult Family Caregiving Experiences, Tamara Brocks, Kaye Bender

Journal of Public Health in the Deep South

Adult family caregiving is a national public health issue which is more prominently recognized since the COVID pandemic. The National Strategy to Support Family Caregivers (2022) highlights more than three hundred federal government actions in support of family caregivers and more than 150 actions that can be addressed at other levels of government with their partnerships to build a caregiver support system. A partnership between the Mississippi State Department of Health (MSDH), the Mississippi Public Health Association (MPHA) and AARP MS is working to address many of the issues related to the heathy aging ecosystem in Mississippi. This case study …

Implementing Policy To Increase Health Literacy In Falls Prevention: A Teach-Back And Show-Back Intervention, Yalanda M. Barner, Lollie Vaughan-Robinson, Jazmin Adjei

Journal of Public Health in the Deep South

Background: Although falls are preventable, falls among older adults remain a public health concern. Research indicates that over one-third of persons over 65 fall. Approximately 3 million report to emergency rooms due to falls annually. Falls are attributed to health conditions such as cognitive impairment, poor eyesight, arthritis, and polypharmacy.

Purpose: This study adapted the Teach-Back/Show-Back method for older persons in adult daycare and faith-based settings to assess their understanding of falls prevention techniques. Therefore, the purpose of this study was to examine the risk factors, prevention strategies, and policy recommendations of falls prevention among older adults.

Methods: A survey …

Personality Profile Of Rural-Dwelling Older Adults With Hoarding Disorder, Mary E. Dozier, Caitlyn A. Nix, Hilary L. Deshong

Journal of Public Health in the Deep South

Hoarding in late life represents a major barrier to aging in place, particularly for rural-dwelling older adults. One risk factor for hoarding disorder in late life may be underlying personality factors. However, there has not yet been an investigation of late life hoarding and possible maladaptive personality factors from the continuous five-factor model perspective in a sample of individuals diagnosed with hoarding disorder. Thus, we evaluated the five-factor personality profiles of older adults enrolled in treatment studies for hoarding disorder in rural Mississippi. Raw scores on the International Personality Item Pool-NEO-60 were converted into categories of Low (<1SD from …

Chronic Obstructive Pulmonary Disease Hot Spots In Mississippi, Taylor Jansen, Elizabeth Dugan

Journal of Public Health in the Deep South

Abstract

Introduction. Chronic obstructive pulmonary disease (COPD) is the sixth leading cause of death in the US and approximately 10% of people 65 years and older have COPD. This study examines the association of geographic-level risk factors with chronic obstructive pulmonary disease (COPD) prevalence using spatial-based analyses with the goal of identifying risk factors associated with county-level COPD and to identify communities at risk.

Methods. The study sample consisted of all N=82 counties in Mississippi and all data is reported at the county level. All measures were drawn from the 2023 Mississippi Healthy Aging Data Report. A hot spot …

The Mississippi Healthy Aging Data Report: Tools To Advance Health Equity, Elizabeth Dugan, Taylor Jansen, Chae Man Lee, Nina M. Silverstein, Yan-Jhu Su

Journal of Public Health in the Deep South

Introduction. This article describes the Mississippi Healthy Aging Data Report, which includes 125 indicators reported at the county and state level.

Methods. Data sources include the American Community Survey from the U.S. Census, the Behavioral Risk Factor Surveillance Survey, the Centers for Medicaid and Medicare Services, and other sources. Small-area estimation techniques are used to calculate age- and gender-adjusted county rates. Data visualizations illustrate health disparities.

Results. Mississippi is home to 663,581 people age 60 or older – 22% of the state’s total population. Approximately 12.9% of Medicare beneficiaries in Mississippi have Alzheimer’s disease or a related …

Association Of Self-Report Measures With Salivary Biomarkers In Post-Menopausal Women, Laree M. Hiser, Karen Arrant, Jung Hye S. Lee, Lei Zhang

Journal of Public Health in the Deep South

Background: Symptoms of menopause include inadequate sleep, depression, and anxiety. Studies of healthy aging frequently use self-report tools that are unverified by objective measures.

Purpose: To investigate the correlation between self-report measures of sleep or affect and salivary biomarkers in a small (n=32) sample of post-menopausal women.

Methods: Salivary cortisol and a-amylase were quantified by laboratory tests. Self-report data included hours of sleep and Patient-Reported Outcomes Measurement Information System (PROMIS^®) tools for sleep disturbance, anxiety, and depression. Correlation analyses were conducted between self-reported measures and biomarker concentrations.

Results: No statistically significant correlations were found between cortisol …

Let’S Have A Family Conversation, Kimberly C. Tarver, Kina White

Journal of Public Health in the Deep South

No abstract provided.

Strategic Advocacy: Doula Care, Liminality, And Reproductive Justice, Julie Johnson Searcy, Ellen Block, Angela N. Castañeda

Sociology Faculty Publications

No abstract provided.

Cycle Syncing: Optimizing Women's Quality Of Life, Megan Francois

Theses and Graduate Projects

A woman’s hormones are in constant fluctuation throughout the menstrual cycle. This 28-day, on average, fluctuation can cause major shifts in mood, cognition, exercise tolerance, and nutrition needs. Because of this, there is potential to optimize quality of life if each phase is synced with diet, exercise, and complementary medicine utilizing holistic methods. Implications for further research include a need for additional longitudinal and prospective studies. Factors that need to be addressed include further analysis of the windows of vulnerability over the menstrual cycle according to female hormone fluctuations, effects of hormonal contraceptives, and effects of pathology on the cycle.

Unveiling Healthcare Disparities By Addressing Historical Traumas To Build Inclusive Spaces For Marginalized Communities: An Autoethnographic Study, Helena Humphreys

Theses and Graduate Projects

This paper delves into the pervasive disparities within the healthcare system, rooted in historical injustices that are perpetuated by systemic biases, particularly affecting Black, Indigenous, and People of Color (BIPOC) communities, as well as the LGBTQIA2S+ community. Through a comprehensive literature review and autoethnographic study, the paper examines the deep-seated issues faced by these marginalized groups, including access barriers, discrimination, mistrust of healthcare providers, and the enduring impact these have on health outcomes. Historical traumas such as the Tuskegee Syphilis Study and the use of HeLa cells underscore the enduring impact of past injustices on present-day healthcare experiences. Moreover, the …

Association Between Agrichemical Mixtures And Pediatric Health Outcomes: Evidence From A Nebraska Population-Based Surveillance, Jabeen Taiba

Theses & Dissertations

Human exposure to environmental contaminants is associated with various pediatric health outcomes. Agrichemicals are a significant environmental risk factor for childhood cancers and congenital anomalies, and reduced exposure could improve pediatric health outcomes. Previous studies in Nebraska have explored the association between single pollutants and pediatric cancers and birth defects. However, it is important to estimate the overall effect of the agrichemical mixture on these pediatric health outcomes. In addition to environmental risk factors, several social vulnerability factors also contribute to increased agrichemical exposure and show disparities in pediatric cancers and birth defects. The objectives of this dissertation are to …

Respiratory Syncytial Virus In The United States: A Research Proposal For A Prospective Cohort Study Of Rsv Vaccines, Kenneth D. Chiu

Master's Projects and Capstones

Objective

This paper proposes a phase IV study to estimate the effectiveness of Abryvso and Arexvy in older adults against severe RSV disease. Additionally, the study aims to assess factors involved with low vaccine uptake for these RSV vaccines.

Methods

For the background literature review of this proposal, I conducted a search of the PubMed and CINAHL Ultimate databases for articles on older adults and RSV. I filtered out results within the period of 2020 to 2024 that were publicly available and focused on RSV burden, vaccinations, or knowledge in the United States.

The proposed phased IV study is a …

Addressing The Increased Prevalence Of Gestational Diabetes Among Hispanic/Latino Pregnant Persons In The Central Valley Of California, Kathleen Janise Farrell Wardell

Master's Projects and Capstones

Gestational Diabetes (GDM) is a preventable noncommunicable disease that has been on the rise over the last 60 years. Pregnant persons with gestational diabetes are 10 times higher of acquiring Type 2 Diabetes after pregnancy (Ionannou et al., 2024). There is an urgent need to address this public health threat because of its increase in mortality. To address this complex chronic disease, this literature review explored multi-level interventions using the socioecological model to mitigate GDM in the Central Valley’s, Tulare County. Tulare County is disproportionately affected by chronic diseases like diabetes especially among the Hispanic and Latinx communities. Therefore, it …

Exploring The Impact Of Weekly Farmers’ Market In The City Of Carson, Ca In Promoting Equitable Access To Locally Grown Fruits And Vegetables, Daisy Lopez Valdez M.P.H.

Master's Projects and Capstones

Despite their many benefits to the community, farmers’ markets suffer from several important limitations. This paper will provide guidance on practices and interventions that can improve the effectiveness of the local Carson, California farmers’ market, known as the South Bay Pavilion Farmer’s Market, in increasing equitable access to and consumption of locally grown fruits and vegetables with the goal of reducing obesity and diabetes rates among residents.

The needs and assets assessment developed will evaluate the success of the City of Carson South Bay Pavilion Farmers’ Market and provide recommendations based on the findings. The proposed research will follow an …

The Mental Effect Of Obesity On Active-Duty Service Members In The United States: A Phenomenological Approach, Tegan M. Quigley

Doctoral Dissertations and Projects

This phenomenological research was intended to explore the impact that obesity has on the mental health of soldiers in the U.S. military. The U.S. military has stringent physical fitness standards that must be met by each soldier regardless of sex. These standards can be challenging to maintain. Obesity is an increasing issue in the United States, and soldiers are not immune. Research regarding the physical issues that occur from obesity has been performed, but this study aimed to explore the behavioral or mental health effects that obesity can have within the military community. This study explored the following questions: In …

The Impact Of Minimally Processed High Fat Meals On Postprandial Glucose, Lipids And Metabolic Index In Pre-Diabetics, Oluwafemi Ayoola

Masters Theses, 2020-current

There is an increasing global prevalence of prediabetes, commonly diagnosed through increased fasting glucose (GLU). Elevated levels of GLU and triglycerides (TRG) have also been linked with more severe diabetes-related complications. Even a single high-fat meal (HFM) may result in adverse metabolic outcomes, in healthy individuals and prediabetics, which are a better predictor of disease risk than measuring fasting levels. Therefore, reducing these metabolic outcomes after a typical HFM often consumed in the Western diet is of critical importance to reduce chronic disease risk. The aim is to determine whether incorporating polyphenols and dietary fiber into an HFM would reduce …

Addressing Rural Food Insecurity: A Flexible Approach Using Evidence-Based Practices, Alison Clayshulte

Master's Projects and Capstones

Food insecurity is a major public health problem in the United States that can lead to worse physical and mental health outcomes for millions of Americans. Rural communities struggle with food insecurity at a higher rate, leading to disproportionately higher levels of chronic conditions, obesity, and stress. Food insecurity is a symptom of many factors including underlying social, economic, and institutional obstacles that affect the quantity and quality of available food. Examples of evidence-based programs implemented to address these factors abound, however rural communities have unique challenges that must be considered to ensure programmatic success. This paper explores these challenges …

Telehealth For Healthy Aging: A Multi-Level, Multi-Methods Approach, Vaibhavi Mone

Theses & Dissertations

Telehealth, rapidly adopted during the pandemic, has shown its usefulness and limitations, yet was not designed with older adults in mind. This dissertation encompasses three interconnected studies exploring telehealth utilization for Medicare Annual Wellness Visits (AWVs) among older adults, provider perspectives on telehealth AWVs, and the impact of teleconferencing on primary care providers' knowledge and confidence in geriatric care. The objectives are to determine patient characteristics using telehealth AWV (study 1), understand provider perspectives on telehealth AWV (study 2), and evaluate the effectiveness of geriatrics education through telehealth (study 3). Study 1 investigates the changes in AWV utilization among 18,405 …