The Impact Of Food Justice Advocates In Creating And Influencing Public Policy, Michael Joseph Chadukiewicz

Department of Conflict Resolution Studies Theses and Dissertations

This case study explored the impact that food justice advocates had on creating and implementing public policy to provide access to adequate, healthy, and culturally appropriate food for the residents of New Haven, Connecticut. The problem the case study explored is in 2020 food insecurity affected 22% of the residents of New Haven, more than twice the national average. This qualitative case study used grounded theory to analyze the experiences of 31 food justice advocates that were members of a coalition of researchers, food service providers, non-profit agencies, grassroot organizations, and residents tasked with improving the city’s emergency food system. …

Unpacking The Influence Of Islamic Religious Culture And Individual Religious Affiliation On Testing Hiv-Positive, Brittany Hayes, Amy Adamczyk

Publications and Research

The distribution of HIV cases varies cross-nationally. We separate the influences of Islam at the macro-and micro-levels to understand the role of religion in shaping the spread of HIV. Drawing on biomarker data from the Demographic and Health Surveys, we construct a multilevel database (Individual N= 568,476; Country N= 30). We examine a series of national-and individual-level predictors that may mediate the relationship between Islam and testing HIV-positive. Individual religious affiliation and proportion Muslim retained their risk-reducing effects even when accounting for a range of mediators and suppressors. Islam has a sui generis effect on testing HIV-positive.

Factors Associated With Mask Use In New York City Neighborhood Parks During The Covid-19 Pandemic: A Field Audit Study, Lisa Hitch, Marie A. Sillice, Hanish Kodali, Katarzyna E. Wyka, Javier Otero Peña, Terry Tk Huang

Publications and Research

Background: Mask use is a cost-effective measure to decrease COVID-19 transmission. Mask mandates intend to increase mask compliance but are often ambiguous when it comes to public outdoor spaces.

Methods: We used a field audit study to examine mask use in New York City neighborhood parks during COVID-19. 1453 park visitors were observed in 13 parks during July–August 2020 using a modified and validated park use audit tool (System for Observing Play and Recreation in Communities) that included items on general and proper mask use (i.e., mask covering both nose and mouth). Generalized estimating equation regression was used to determine …

Work-Based Concerns Of Australian Frontline Healthcare Workers During The First Wave Of The Covid-19 Pandemic, Michella Hill, Erin Smith, Brennen W. Mills

Research outputs 2014 to 2021

Objective: This research sought to gauge the extent to which doctors, nurses and paramedics in Australia were concerned about contracting SARS-CoV-2 during the country's first wave of the virus in April 2020.

Methods: Australian registered doctors, nurses and paramedics (n=580) completed an online questionnaire during April 16–30, 2020 (period immediately following the highest four-week period (first wave) of SARS-CoV-2 confirmed cases in Australia).

Results: During April 2020, two-thirds of participants felt it was likely they would contract SARS-CoV-2 at work. Half the participants suggested Personal Protective Equipment (PPE) supplies were inadequate for them to safely perform their job, with two-thirds …

Examining Psychological And Knowledge Barriers To Colorectal Cancer Screening In Rural Appalachian Kentucky, Caroline Jenkins, Matthew Rutledge, Lauren Hudson, Nathan L. Vanderford, Nancy Schoenberg

Markey Cancer Center Faculty Publications

While recent rates of colorectal cancer (CRC) screening have improved in Appalachian Kentucky due to public health efforts, they remain lower compared to both KY as a whole, and the USA. Suboptimal screening rates represent a missed opportunity to engage in early detection and prevention. The purpose of this study is to determine the impact that lack of knowledge has on psychological barriers (e.g., fear and embarrassment) to CRC screening as well as the potential effect of a psychosocial intervention to reduce these barriers. Participants were recruited through faith-based organizations and other community sites. After randomizing participants to either an …

Moyens De Réduction Des Risques Lors Des Phases De Nettoyage Et De Désinfection Des Machines Dans Le Domaine Agroalimentaire : Étude Exploratoire France-Québec, Laurent Giraud, Jean-Christophe Blaise, Nellie Perrin, Yuvin Chinniah, Pascal Poisson

Rapports de recherche scientifique

L’industrie de la transformation alimentaire est le plus important employeur industriel au Québec avec près de 56 000 emplois dans plus de 1 400 établissements en 2016. Cependant, au Québec, la Commission des normes, de l’équité, de la santé et de la sécurité du travail (CNESST) estime que le degré de risque de la plupart des secteurs agroalimentaires est critique. Cette industrie est également considérée à haut risque en Europe, notamment en France et en Grande-Bretagne, ainsi qu’aux États-Unis. Les statistiques dans ces pays montrent que les accidents surviennent majoritairement lors de tâches courantes et prévisibles comme le nettoyage et …

Getting Back To Global Health; Lake Atitlan, Guatemla, Kyra L. Mccarty

Posters

Describes pediatric resident's exposure to the Guatemala health service and medical education system.

Circling The Drain: The Extinction Crisis And The Future Of Humanity, Rodolfo Dirzo, Gerardo Ceballos, Paul R. Ehrlich

Harold W. Manter Laboratory of Parasitology: Library Materials

Humanity has triggered the sixth mass extinction episode since the beginning of the Phanerozoic. The complexity of this extinction crisis is centered on the intersection of two complex adaptive systems: human culture and ecosystem functioning, although the significance of this intersection is not properly appreciated. Human beings are part of biodiversity and elements in a global ecosystem. Civilization, and perhaps even the fate of our species, is utterly dependent on that ecosystem’s proper functioning, which society is increasingly degrading. The crisis seems rooted in three factors. First, relatively few people globally are aware of its existence. Second, most people who …

Malaria Resilience In South America: Epidemiology, Vector Biology, And Immunology Insights From The Amazonian International Center Of Excellence In Malaria Research Network In Peru And Brazil, Kathrine Torres, Marcelo U. Ferreira, Marcia C. Castro, Ananias A. Escalante, Jan E. Conn, Elizabeth Villasis, Maisa Da Silva Araujo, Gregorio Almeida, Priscila T. Rodrigues, Rodrigo M. Corder, Anderson R.J. Fernandes, Priscila R. Calil, Winni A. Ladeia, Stefano S. Garcia-Castillo, Joaquin Gomez, Lis Ribeiro Do Valle Antonelli, Ricardo T. Gazzinelli, Douglas T. Golenbock, Alejandro Llanos-Cuentas, Dionicia Gamboa, Joseph M. Vinetz

Harold W. Manter Laboratory of Parasitology: Library Materials

The 1990s saw the rapid reemergence of malaria in Amazonia, where it remains an important public health priority in South America. The Amazonian International Center of Excellence in Malaria Research (ICEMR) was designed to take a multidisciplinary approach toward identifying novel malaria control and elimination strategies. Based on geographically and epidemiologically distinct sites in the Northeastern Peruvian and Western Brazilian Amazon regions, synergistic projects integrate malaria epidemiology, vector biology, and immunology. The Amazonian ICEMR’s overarching goal is to understand how human behavior and other sociodemographic features of human reservoirs of transmission— predominantly asymptomatically parasitemic people—interact with the major Amazonian malaria …

Medicine Adherence As A Determinant Of Complication Development In Diabetes And Hypertension Patients On A Medical Aid Scheme In Zimbabwe, Tsitsi Moyo

Walden Dissertations and Doctoral Studies

Pharmacotherapy is a significant component of chronic disease management; its efficacy depends on long term, correct, and consistent use; however, medicine adherence rates remain low. The cost of medicines is considered a significant barrier to adherence, especially in low-income settings. This quantitative cross-sectional study was conducted using data from Cimas Medical Aid Society collected between 2015 and 2019. The purpose of the study was to determine the extent of the association between medicine adherence, complication development, and cost of care among diabetic and hypertensive patients while controlling for age and gender on a population that does not experience cost barriers …

Increasing Staff Compliance With Routine Hcv Screening And Improving Linkage To Care Among Patients Testing Hepatitis C Positive In The Emergency Department, Carson G. Swartz

DNP Projects

Background: Hepatitis C virus (HCV) is a blood-borne pathogen that can cause severe liver disease, cancer, and death and is a significant source of morbidity and mortality in the United States. Several academic medical centers including University of Kentucky Healthcare have implemented routine HCV screening for patients presenting to the emergency department (ED) and have discovered a large viral burden amongst patients who are often symptomatic.

Purpose: The purpose of this doctoral project is to increase staff compliance, confidence, and education regarding the HCV screening process in an urban, Level I emergency department, as well as to evaluate whether an …

Social Media Use And Mental Health: An Educational Intervention To Reduce Depression And Anxiety In Adolescents, Natalie Catlett

DNP Projects

Background: Most adolescents spend a great deal of their time using various social media platforms. However, excessive and maladaptive social media use is correlated with worsening symptoms of depression and anxiety among adolescents.

Objective: This project aimed to determine whether an educational intervention could help decrease overall time spent using social media and improve mood and mental health outcomes among adolescents with depression or anxiety disorders.

Methods: This was a quasi-experiment with a pretest and posttest design. An educational intervention about the relationship between social media use and symptoms of depression and anxiety among adolescents and strategies to minimize risk …

Addressing The Inpatient Penicillin Allergy: Implementing A Nurse-Driven Allergy Assessment Tool To Enhance Antimicrobial Stewardship., Shelby Ryan Bliss

DNP Projects

Background: In an acute care setting, more than half the inpatient population receives antibiotics. Approximately 10% of the general population reports an allergy to penicillin. It has been replicated in the literature with data that of those who report a penicillin allergy, up to 95% are incorrectly identified. When a patient is admitted to the hospital with a penicillin allergy on their electronic health record, they are at higher risk for adverse events such as a hospital acquired infection, the occurrence of an antibiotic resistant bacteria related to receiving broader therapy and increased healthcare utilization.

Purpose: The purpose of this …

The Effects Of Cultural Competency Training On Providers Knowledge, Skills And Attitudes Towards The Latino Population, Jennifer L. Peppiatt

DNP Projects

Background: Providers in the United States (U.S.) healthcare system need to understand the cultural values, beliefs, and traditions of the growing Latino population. As a result, academic institutions are incorporating cultural competency training in their curricula. However, a noticeable knowledge gap exists for those currently practicing in the healthcare arena, impacting patient and provider satisfaction and healthcare outcomes.

Purpose: The purpose of the study was to obtain a baseline assessment of the cultural competence of a select group of Advanced Practice Providers (APPs) caring for the Latino population at the University of Kentucky and provide a targeted educational intervention, followed …

Healthcare System Responses To Non-Communicable Diseases’ Needs Of Syrian Refugees: The Cases Of Jordan And Lebanon, Chaza Akik, Farah Asfahani, Tatiana Elghossain, Sandra Mesmar, Miriam Rabkin, Wafaa El Sadr, Fouad M. Fouad, Hala Ghattas Ph.D.

Faculty Publications

Introduction:

Since the start of the Syrian conflict in 2011, Jordan and Lebanon have hosted large refugee populations, with a high pre-conflict burden of non-communicable diseases (NCDs). We aimed to explore NCD service provision to Syrian refugees in these two host countries and to identify lessons learned that may inform the global response to the changing health needs of refugees.

Methods: Between January 2017 and June 2018, we conducted 36 in-depth interviews with stakeholders from Jordan and Lebanon, as well as global stakeholders, to understand the context, the achievements, gaps and priorities in the provision and uptake of NCD prevention, …

What Covid-19 Laid Bare: Adventures In Workers’ Compensation Causation, Michael C. Duff

All Faculty Scholarship

This essay performs a close analysis of workers’ compensation coverage of COVID-19 and arrives at the conclusion that it should not be “impossible” to prove in a legal sense that an employee’s COVID-19 was caused by work. Scientific proof is not the same as legal proof: workers’ compensation law has never required that claims must be supported by irrefutable scientific proof of workplace causation. Yet repeatedly one heard this suggestion during public discussion on workers’ compensation coverage of employees.

Still, there is good evidence that even when workers’ compensation undisputedly covers work-related disease employers seldom pay benefits (and states do …

Using Community-Based Screening To Quantify The Relationship Between Hiv And Hypertension In A Rural South African Community, Jessica Ainooson

Public Health Theses

Background: Over the past three decades, the prevalence of hypertension has increased in sub-Saharan Africa, paralleling the HIV/AIDS epidemic. The aim of this study is to assess the relationship between HIV status and elevated blood pressure in a rural South African community. Methods: A secondary analysis was conducted from a community-based screening program providing TB/HIV/blood pressure/glucose screening in the rural sub-district of Msinga, KwaZulu-Natal, South Africa from 2011 - 2017. Descriptive analyses were used to characterize the frequency of measured and self-reported hypertension, HIV status, and sociodemographic variables. Multivariable logistic regressions were used to estimate the relationship between HIV status …

Association Between Rheumatoid Arthritis Severity And Mental Health In A Prevalent Cohort Of American Adults, 2013-2022, Nicole-Anne Ballesteros

Public Health Theses

Objective/Purpose: The severity of rheumatoid arthritis and its association with depression and anxiety among a prevalent cohort of American adults has been neither well-researched nor backed by real-world data. This investigation seeks to test the hypothesis that there is an association between disease severity and the aforementioned psychological conditions, both of which are commonly observed in patients with rheumatoid arthritis.

Methods: Real-world data from OM1 Inc.’s rheumatoid arthritis registry (2013-2022) was used for this analysis. Disease severity (low, medium, and high), categorized using disease activity scores, was the main exposure, while depression and anxiety were the study’s two primary outcomes. …

Adverse Childhood Experiences & Breastfeeding - Pakistan, Paola Bojorquez-Ramirez

Public Health Theses

Rationale: Prior studies have found that a history of adverse childhood experiences (ACEs) is associated with breastfeeding, but the evidence is inconsistent. Despite low and middle income countries (LMICs) carrying a disproportionate amount of poor maternal and infant health outcomes, little research has assessed the relative impact of ACEs on breastfeeding initiation and exclusive breastfeeding in LMICs.Objective: The study investigates whether maternal ACEs are associated with breastfeeding initiation and exclusive breastfeeding at 3 and 6 months postpartum among a cohort of women from rural Pakistan. Methods: The cross-sectional analysis included 869 women 18-45 years of age from the Bachpan Cohort …

Circadian Factors And Cancer Survivorship: A Mini Review, Jiaqi Cui

Public Health Theses

Circadian clocks are molecular clocks that govern the temporal control of physiology to preserve homeostasis. The disruption of the circadian rhythm is important in carcinogenesis and aids the development of cancer hallmarks. On the other hand, carcinogenic activities disrupt circadian rhythms directly. In cancer treatment, pharmacological regulation of core clock genes is a novel approach. The use of circadian biology in cancer research opens up new avenues for improving cancer treatment effectiveness. This mini-review provides an overview of relationship between circadian factors including circadian gene expression, circadian genotype, circadian disruption and circadian gene methylation and the cancer survivorship. The review …

“She Trusts Us To Love Her, You Know?”: Using A Love Ethic Framework To Explore Faith Navigation And Acceptance Processes Among Mormon Mothers Of Lgbtq+ Individuals, Nandini Milind Deo

Public Health Theses

Parental acceptance is a key factor in bolstering the health and well-being of LGBTQ+ individuals across their lifespan (Needham & Austin, 2010; Ryan, 2010; Jin, 2020; Clark et al., 2021). One factor known to influence parental acceptance is family religiosity, which has typically been associated with conflict and/or rejection (Ryan, 2010; Johns & Hanna, 2012; Roe, 2017). The purpose of this study was to better understand faith navigation and acceptance processes among active Mormon mothers of LGBTQ+ individuals in an effort to inform public health engagement with highly religious parents of sexual and gender minority children. In-depth qualitative interviews were …

Support Or Interference: Relational Influences On Mother’S Exclusive Breastfeeding Practices In Ghana, Georgiana Esteves

Public Health Theses

Childhood malnutrition is a challenge that needs to be understood as a global health threat. Exclusive breastfeeding (EBF) is recognized as the best practice to improve a child’s growth and cognitive development in the first months of life. The World Health Organization recommends EBF until 6 months. Mothers need family support to adhere to EBF practices. This study aimed to understand the interpersonal level relational influences of fathers, grandmothers, and other family members on the mother-child dyad adherence to EBF practices, as well as document community and societal influences on EBF. This study took place in the Central Region of …

Proximity And Parental Interaction: Examining The Relationship Between Proximity Data And Mother-Infant Interaction Among Mothers With And Without Depression, Paige Farrenkopf

Public Health Theses

Background: There is a lack of data on response behaviors among young mothers in low- and middle-income countries. Emerging passive sensing technology has been increasingly allowing researchers to collect this type of day-to-day behavioral data.

Methods: We administered PHQ-9 depression surveys and the Observation of Maternal-Child Interaction (OMCI) measure to young mothers between the ages of 15-25 in the Chitwan region of Nepal, and conducted key informant interviews with all mothers selected for participation.

Results: Among 54 mother-infant dyads, we found that there was no statistically significant correlation between maternal responsiveness and proximity. When we stratified participant groups by depression …

The Role Of Childhood Trauma In Intergenerational Trauma (Igt), Audrey Huang

Public Health Theses

Emerging research has focused on the intersection of personal and parental trauma within intergenerational trauma (IGT) transmission, specifically offspring adverse childhood experiences due to trauma-related parenting behaviors. However, the role that offspring childhood trauma and its various subtypes may play in moderating or mediating IGT transmission, as well as the impact of caregiver sex, are still remains largely understudied. We examined how the transmission of PTSD between survivors of the 1994 genocide to their offspring might be either (a) mediated by overall and subtypes of offspring childhood trauma, or (b) moderated by overall and subtypes of offspring childhood trauma, and …

Comparing Dog And Owner Pfas Exposures Using Fresh Air Samplers, Emily Elizabeth Johnson

Public Health Theses

Per- and polyfluoroalkyl substances (PFAS) have gained attention given their prevalence and persistence in the environment and in our bodies. PFAS have been detected in water, food products, and consumer products. Furthermore, companion animals may be exposed to elevated PFAS levels due to sources from pet products as well as household items. A growing number of studies have been conducted to better understand the toxicological and public health impacts of legacy PFAS resulting from ingestion and dermal exposure pathways in both humans and domesticated animals. As alternative replacement PFAS emerge in the market, these compounds are shorter chain which allows …

Exploring Climate Policy And Health Perspectives In Samoa: A Mixed Methods Study, Erika-Ann Fumiko Kim

Public Health Theses

Background: Greenhouse gas emissions have driven human-induced climate change, bringing several impacts to small island nations in the Pacific. Samoa, a small island developing state located in the south Pacific Ocean, is at disproportionate risk from impacts of climate change such as rising surface temperatures, rising sea levels, increases in frequency and degree of heavy precipitation events, and increases in the frequency of droughts. Simultaneously, Samoan populations possess a high prevalence of non-communicable diseases such as diabetes, heart disease, and hypertension. For multiple decades, the Government of Samoa has framed climate change as a key issue that threatens the lives, …

How Medical Student Perceptions Of Faulty Interactions Influence Burnout, Meghan Elizabeth Lindsay

Public Health Theses

Objective: To assess the relationship between the perceptions of student-faculty interactions and self-reported burnout scores during professional medical education. Design: Cross-sectional study. Setting: 140 accredited US medical schools by the Association of American Medical Colleges in 2016 and 2017. Participants: 26,464 of 30,651 graduating medical students who completed the Association of American Medical Colleges’ Graduation Questionnaire in 2016 and 2017 and who had complete questionnaires for all aspects of our related measures. Main outcome measures: Exploratory factor analysis was used to identify latent constructs underlying 14 measured students’ perception of faculty interaction variables and develop factor based scales. The association …

A Prediction Model Of Rotavirus Vaccine Performance Based On Meta-Analysis And Variable Selection, Yueqi Li

Public Health Theses

Background: Rotavirus is the leading cause of diarrheal diseases worldwide and is responsible for substantial morbidity and mortality among children younger than 5 years of age. The introduction of national immunization programs against rotavirus has greatly reducedhospital admissions and deaths from rotavirus gastroenteritis, but vaccine efficacy and effectiveness vary substantially between high- and low-income settings. Given the disparity of vaccine performance across countries, we built a model to predict how well the vaccines would work in settings without vaccine introduction. Methods: Data on vaccine performance and relevant predictor variables were extracted from the literature and repositories. We performed a meta-analysis …

Evaluating The Cost-Effectiveness Of Varied Vaccination Strategies For Ebola Virus Disease In The Democratic Republic Of The Congo, Rachel Amanda Lobe-Costonis

Public Health Theses

Introduction: The 2018 outbreak of Ebola virus in the Democratic Republic of Congo was the first to occur in the context of an ongoing complex humanitarian emergency. Despite optimism for an effective response given the efficacious one-dose Merck vaccine (ERVEBO), the immense challenges to public health efforts caused by the ongoing armed conflict posed unprecedented complications to the recommended ring vaccination strategy. In the end, contract tracing efforts for ring vaccination reached only 82% of individuals at best estimate, and the outbreak lasted 89 weeks with a total cost of $734 million. In comparison, transmission dynamic modeling has shown the …

“I Still Have My Sorrows With Me.” A Qualitative Study Exploring How Nepali Adults Engage In Meaning-Making Following Suicide Experiences, Risika Mohanty

Public Health Theses

Background: Of all the global reported suicides, 78% of them occur in low and middle-income countries and 39% specifically occur in the Southeast Asia region. Nepal’s suicide rate was ranked 8th in the world by WHO estimates in 2014, with the third-highest suicide rate for females. While we know of certain suicide risk factors pertaining to Nepal, we have yet to understand how individuals make meaning of life following suicide experiences. Purpose: This study uses a narrative thematic analysis approach to understand how adults with lived experiences of suicide (ALES) navigate their internal and interpersonal lives following their suicide experience. …