Public Health Commons^™

Virgin Islands: Heart Disease, Dylan Hayden

Global Public Health

The Virgin Islands are located in the Caribbean. The arc of Caribbean islands begins off the coast of Florida and extends all the way to South America. When the Revised Organic Act of 1954 was established, the United States Congress declared the U.S. Virgin Islands to be an unincorporated territory of the United States. The Virgin Islands government consist of three branches that are known as Judicial, Executive , and Legislative branch. There are some major challenges in Virgin Islands. Some of them are: several hurricanes in recent years, frequent and severe droughts and floods, and occasional earthquakes. With that …

South Africa: Hiv/Aids, Ninna Therese P. Mendoza

Global Public Health

South Africa is found in the southernmost part of the African continent. Over half of its 54.8 million people live in urban areas such as Johannesburg and Cape Town, which are the largest urban centers in the country. Some major challenges this country currently faces include the growing drug trade, border disputes, and racial tensions attributed to their history with the apartheid. When it comes to public health, one of their biggest challenges is the HIV/AIDS epidemic, which is currently the largest in the world. Although no cure exists yet, antiretroviral treatments (ARTs) have been highly successful for reducing transmission. …

Palau: Obesity, Tavia Weis

Global Public Health

Located in the heart of the Western Pacific Ocean is a large group of small islands that make up the country of Palau. Known for its growing tourism, beautiful landscapes, and cultural beliefs. Although the country is developing, the current health issue of obesity is a growing concern. With almost half of the population obese and the other half in jeopardy, the rising concerns of the obesity epidemic have taken global news and brought the attention of major countries to try and fix these rising issues. This public health brief will discuss the problems of obesity in Palau and the …

Hiv/Aids: Nigeria, Lauren Tropinski

Global Issues in Public Health

Nigeria has one of the largest prevalence rates of HIV infections in Africa. HIV is a communicable disease that is transmitted by bodily fluids through unprotected sex, using contaminated needles, or mother to child. The most affected populations include heterosexuals who have unprotected sex, followed by sex workers, and men who have sex with men. People will experience three stages of HIV before the last stage referred to as AIDS. Rapid diagnostic tests are used to diagnose the disease. There is no cure for HIV/AIDS. However, people with HIV are given antiretrovirals to keep HIV at a low level throughout …

Infant Mortality: Sub-Saharan Africa, Danielle Rae Steffen

Global Issues in Public Health

Like much of the third world, the countries found in Sub-Saharan Africa have a distressingly high infant mortality rate compared to those recorded in places such as the United States and Europe. While there are many factors that play a role in the increased number of infant deaths in this region, lack of access to adequate healthcare for infants and their families is one of the main overarching causes. Although infant mortality rates remain high, there has been significant improvement in infant survival over the last several years which is largely due to the implementation of the Millennium Development Goals …

Outdoor Air Quality, Taylor Curley

Global Issues in Public Health

Outdoor air quality is a significant issue for the entire world. It affects any and all people, but is more of an issue in low-income countries and among people that are more susceptible to respiratory issues such as young children, pregnant women, the elderly, and people who already suffer from respiratory problems like asthma. Poor air quality is caused by the burning of fossil fuels which releases particles and chemicals into the air like carbon dioxide, particulate matter, and nitrogen to name a few. It can cause multiple health issues such as respiratory problems to people who are exposed to …

Gun Violence: Chicago, Illinois, Kayla Dillon

Global Issues in Public Health

Gun violence has been, and continues to be, a significant problem in Chicago, Illinois. There have been several programs in place that have worked towards improving the level of gun violence. One of the most noticeable being Project Safe Neighborhood, which began in 2001. Part of what makes these programs, and programs similar to it, necessary is that it targets the populations most at-risk of gun violence. By targeting these specific regions of the city, these programs can provide the resources necessary to improve the condition of the city in the long-term, as well as prevent the condition from spreading …

Indoor Air Quality: The United States, Paola Solano

Global Issues in Public Health

Indoor air quality is one of today’s most prevalent public health concerns. It is quite shocking to learn that almost all populations in the world can be affected. We oftentimes expect to be home and be safe, but our indoor environment can also be harming to our health. In certain regions, there is more pollution indoors than outdoors due to the surrounding environment. There exist numerous factors that can cause poor air quality. Some of the most common causes include mold, carbon dioxide, moisture damage, and other indoor air contaminants. Although alarming, there are many practices that can better the …

Water Scarcity: Sudan, Catherine Priebe

Global Issues in Public Health

Water scarcity is an environmental global problem that will only become more pressing as time goes on. It is a public health issue that affects every continent, although certain areas of the world are facing more serious water scarcity than others such as Sudan. Populations that are more vulnerable to the effects of water scarcity are the poor, women, children, and those living in areas of political unrest. For example, South Sudan’s urban water systems have been damaged during recent warfare. Water scarcity is also an issue that disproportionately affects women who are forced from a young age to travel …

Rwanda: Hiv/Aids, Alissa Anderson

Global Public Health

Rwanda is a small country in Africa. Rwanda has had many conflicts within its borders with wars, genocide, and disease. One of Rwanda’s current threats is HIV/AIDS. This disease is spreading through its population, and making it easier for other diseases; such as hepatitis and tuberculosis, to spread as well. Rwanda is a country that is putting into effect many efforts to decrease its HIV/AIDS population by means of education, campaigns, and treatments regarding the disease. In this article, I use peer reviewed and reliable articles to show the past and current issues that Rwanda has to face with the …

Cuba: Coronary Heart Disease, Michaela Loizzi

Global Public Health

Cuba has a strong health care system with universal health care for their citizens over 40 years old. Despite the strong health care system Cuba lacks the resources necessary to treat coronary heart disease, the leading cause of death in the country. The country’s whole population is affected by coronary heart disease however the most affected is the lower class due unaffordable treatment. The primary causes of coronary heart disease includes their daily lifestyle such as, physical inactivity, diet, and excessive smoking. It is important to note that the major factors in Cuba leading to coronary heart disease are all …

Tackling Stunting And Anemia In Egypt, Abeer Alanwar, Hend Ahmed, Sabreen Mahmoud, Wessam Adly

Papers, Posters, and Presentations

Stunting and anemia rates in children between the age of 0-24 months (0-2 years) have been two of the most persistent public health problems facing the Egyptian society and government. Based on the researchers' analysis of the problem, current policies, and on the opportunities Egypt has, this policy paper targets the Egyptian Ministry of Health and Population and recommends reformulating a specific nutrition policy to tackle stunting and anemia as well providing awareness and education about the appropriate IYCF and to give high priority to strengthening the health provision of the required micronutrients in family care units (FCU), as well …

Describing Independent And Chain Pharmacies Within The Kentucky Medicaid Network, Kimber Woodrum

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

The shift in healthcare towards cost-savings mechanisms is hindering business operations of pharmacies in Kentucky, especially independent pharmacies. Independent pharmacists have reported that the operations of pharmacy benefit managers within Kentucky Medicaid networks have created financial hardships for their pharmacies and there is a threat of closure that could be associated with a potential access barrier to pharmacy services for Medicaid beneficiaries. During legislative meetings, much focus was on this issue and several bills are currently being drafted to correct this issue. It is important to define independent pharmacy and describe, geographically and in terms of utilization, chain and independent …

Overdose Prevention And Naloxone Distribution In Jefferson County, Brittany Coleman

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

The United States in battling an opioid epidemic, and rates of overdose fatality have soared to record highs. Kentucky is among the states with highest rates of opioid overdose fatality, and Jefferson County is responsible for about a quarter of all cases. Overdose Prevention and Naloxone Distribution (OPND) programs have been shown to decrease fatality rates by providing a medication that literally reverses opioid overdose. The programs provide other services such as education and connection to recovery facilities.

Currently, the Kentucky Harm Reduction Coalition provides naloxone kits to the residents of Jefferson County, but they do not have a regular …

Examining The Issue Of Compliance With Personal Protective Equipment Among Wastewater Workers Across The Southeast Region Of The United States, Tamara L. Wright

College of Graduate Studies: Theses & Dissertations

Wastewater workers are exposed to different occupational hazards such as chemicals, gases, viruses, and bacteria. Personal Protective Equipment (PPE) is a significant factor that can reduce or increase the probability of an accident from hazardous exposures to chemicals and microbial contaminants. The purpose of this study was to identify wastewater worker’s beliefs and practices on wearing PPE and protections offered by PPE through the integration of the Health Belief Model (HBM). Participants were workers in the wastewater industry, which included wastewater operators, laboratory analysts, maintenance workers, wastewater collection workers, equipment operators, managers, and supervisors (n=272). The instrument was a self-administered …

Improving Public Health Readiness For Sea Level Rise: A New Initiative In Coastal Virginia, Steven M. Becker

Community & Environmental Health Faculty Publications

Sea level has been rising around the world, and in recent decades, the rate has been accelerating. Because rising seas have the potential to directly or indirectly affect the health of vast numbers of coastal communities and inhabitants, public health agencies and professionals—in conjunction with other fields—have a pivotal role to play in helping to protect populations, reduce and prevent health impacts, and foster resilience. This article discusses a novel effort that has been undertaken in Coastal Virginia to help prepare the next generation of public health professionals to grapple with sea level rise issues. The effort grew out of …

Usefulness Of The Captia Syphilis Igg Eia Test Method And Reverse Algorithm For Detection Of Syphilis Infection In A Public Health Setting, Patricia Armour

Theses and Dissertations

Syphilis, a systemic sexually transmitted disease, is on the rise in the US, with infection rates the highest recorded since 1994 according to the CDC. Useful laboratory testing is an important diagnostic tool for determining individual syphilis infection and preventing community-wide disease spread.

The purpose of this study was to determine the usefulness of a specific automated treponemal test method, the Captia^TM Syphilis IgG EIA, and the syphilis reverse algorithm interpretation for detecting syphilis infection among patients seeking care in a public health clinic. The study employed a retrospective, nonexperimental descriptive correlational design with data collected between 2012-2013 from …

Practice Of And Barriers To Prevention By Secondary School Athletic Trainers, Caroline C. Guindon, Zachary K. Winkelmann, Lindsey E. Eberman, Kenneth E. Games

Internet Journal of Allied Health Sciences and Practice

Purpose: Prevention is a key aspect of care from athletic trainers. There is limited research on the practice strategies employed to prevent injury by secondary school athletic trainers (SSATs). The purpose of this study was to describe the prevention practice strategies and barriers faced by secondary school athletic trainers. Methods: Athletic trainers (n=3010) were recruited from secondary schools through e-mails provided by the national professional organization database. Secondary school athletic trainers were surveyed on their self-reported prevention practices and barriers using a web-based survey platform. Respondents were 28±3 years, predominantly female (n=260/359, 72.4%), with about 5 years (±2yrs) of …

Aps’Aalooke Led Diabetes Prevention Program, Lucy Hollingsworth Williamson

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

The primary objective of this proposed program is to decrease the burden of diabetes mellitus type II among the Crow Indian tribe members in Montana by preventing the progression of prediabetes to diabetes. Type II diabetes mellitus (DMII), is a debilitating disease that contributes to increased morbidity and mortality, in addition to billions of healthcare costs annually. In the United States, minority populations carry a higher burden of DMII, however American Indians have the highest prevalence of all. In fact, American Indians are 2.4 times more likely to be diagnosed with diabetes than white people.

In Montana, the Crow Indian …

Implementation Of An Evidenced-Based Opioid Treatment Program To Improve Maternal-Child Outcomes In Eastern Kentucky, Jordan Rice

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

The Kentucky River Area District Health Department proposes implementation of CHARM-Kentucky, a treatment program for pregnant women with opioid use disorder (OUD), in eastern Kentucky. Over 115 Americans die each day from an opioid overdose, resulting in approximately 42,000 deaths in 2016. In addition to an overall increase in opioid use in recent years, the use of opioids in pregnancy has also increased from 1.19 per 1,000 hospital births in 2000 to 5.63 in 2009. Opioid use during pregnancy results in poor neonatal outcomes including: low birth weight, preterm delivery, small head circumference, increased child maltreatment, and risk for long-term …

A Program Evaluation Of A Colon Cancer Screening Program Using At-Home Fecal Immunochemical Tests With Certified Patient Navigators, Candace E. H. Brunk

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

Colorectal cancer is the second leading cause of cancer-related death in this country, but 33% of these deaths could be prevented by screening. While colonoscopy is an effective screening tool, it is expensive, invasive, and prone to encounter considerable patient resistance. An alternative is to first screen those at-risk using at-home fecal immunochemical test (FIT) kits. This study determined factors associated with the return of these kits distributed by Kentucky CancerLink, a non-profit organization, and its affiliates to participants in a colon cancer prevention program.

Objectives: To identify factors associated with: completing a FIT kit, completing the kit with minimal …

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Faculty Articles

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

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

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

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

Reducing Depression And Suicide Ideation Among College Students, Andrew Ritzel

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

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

Implementing Counseling African Americans To Control Hypertension Intervention In Louisville Metro, Raven Robbins

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

Hypertension disproportionately affects Africans Americans more than their White counterparts. Counseling African Americans to Control Hypertension (CAATCH) is an intervention program that is targeted at African American adults to decrease uncontrolled hypertension. The CAATCH intervention has three components, which includes 1) computerized hypertension education, 2) at home blood pressure monitoring, and 3) behavioral counseling. The CAATCH intervention will be implemented in three sites in the northwest portion of Jefferson County in Louisville, KY. The overall goals of the CAATCH intervention are to decrease the number of participants who suffer from uncontrolled hypertension, increase knowledge of hypertension among participants, increase the …

The Financial Impact Of A Healthy Eating Intervention In A Government Worksite Cafeteria, Andrew M. Wheeler

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

Unhealthy eating habits are associated with a greater risk of obesity and many chronic diseases. Historically, public health nutrition interventions have focused on education of the individual to induce dietary behavior change. However, given that many factors influence food choices, more comprehensive interventions that address these multiple factors are needed. Worksite cafeterias provide a unique opportunity to intervene at multiple levels of influence on employees eating habits. In this paper we used cafeteria sales data to evaluate the changes in purchases and the financial impact of implementing a healthy eating intervention using an environmental change and various promotional efforts to …

Evaluation Of Anemia In Communities Served By Shoulder To Shoulder Global: A Cross-Sectional Study In Santo Domingo, Ecuador, Kevin Mercer

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

BACKGROUND: Shoulder to Shoulder Global (STSG) recognizes anemia as a cause of morbidity among patients in Santo Domingo, Ecuador. Little research has been done to assess targetable anemia risk factors to serve as a foundation for future pharmacotherapeutic interventions. This study sought to identify risk factors for anemia in this population.

METHODS: Data obtained from existing patient records from January 1, 2010 to August 31, 2016 included hemoglobin/hematocrit, age, sex, pregnancy status, and presenting community. Chi-square tests compared means to examine risk factors associated with anemia. Poisson regression and incidence rate ratios (IRR) were used to estimate risk factors associated …