Public Health Commons^™

Adverse Childhood Experiences And Their Connection To Autoimmune Disease In Adulthood, Emma J. Molden

Honors Theses

Everyday in the United States, a child experiences a traumatic event. Autoimmune disease is one of the top two leading causes of death in the United States. Can these two horrifying events be connected? Autoimmune diseases currently affect millions of Americans and are considered an epidemic because of their prevalence within the adult population. Even with a high number of cases, this possible connection has been largely ignored and under researched for the history of modern medicine. However, two studies have begun to make the connection between adverse childhood experiences and how that affects the onset of autoimmune diseases in …

Agreement Success Plan, Miranda Holtz

Capstone Projects and Master's Theses

Monterey County Health Department’s Administration Bureau works with contracts and agreements for the Public Health Bureau, which detail what services programs will complete so that they can receive funding or maintain a partnership with the County. The problem was that a large portion of the management analyst’s time was dedicated towards technical support for agreements. The Agreement Success Pan is aimed to increase efficiency by aiding program staff with agreements through a Prezi, which is similar to a self-paced webinar. The project had three phases; interviews of program supervisors or managers, gathering supporting documents, and final launch. Afterward, a questionnaire …

Improving Healthy Relationship Skills In College Students, Madison Newton

Capstone Projects and Master's Theses

Many college students, because of their inexperience, may lack skills to develop healthy relationship behaviors and may not recognize signs of unhealthy or violent relationships. Using Albert Bandura's social learning theory with college students and increasing their knowledge of healthy relationship skills and skills to help friends in danger. This study shared that this method of instruction was successful and the college students were able to complete the learning outcomes of identify examples of healthy and unhealthy relationship behaviors and ways to help a friend in a violent relationship.

Should I Reduce My Red Meat Consumption?, Joshua Kojiro Bibbee

Capstone Projects and Master's Theses

Maintaining and improving the health of 5,000+ county employees is no easy task, but the Monterey County Health Department Employee Wellness (MCHDEW) program’s job is to do just that. There are many parts that fall under the category of health, and one area to research on is red meat consumption. A diet high in red meat can cause some of the health conditions of metabolic syndrome, which is a cluster of health conditions that increase a person’s risk of heart disease. This is relevant because metabolic syndrome is found in one-third of county employees, and this contributes to increased healthcare …

Not Just Survive, But Thrive: Capitalising On The Silver Linings Of The Pandemic, Gerard George, Foo Hau Koh

Asian Management Insights

You may not realise it, but the boardroom Zoom call you took in your pyjama pants this morning was part of the new industrial revolution.

Educating Children During Covid-19 And Beyond, Alvin Lee

Asian Management Insights

Since the World Health Organization declared Covid-19 a pandemic in March 2020, school closures across the Asia-Pacific region have affected some 325 million children.

Technology And Sustainability: The New Business Playing Field, Havovi Joshi

Asian Management Insights

Two topics that have consistently cropped up in conversations among business leaders during the pandemic are technology, in the context of the pervasiveness and quickening pace of digital transformation, and sustainability, especially how we should be doing business without harming the environment and society. The collective belief is that both topics will continue to rise on the world’s agenda, reshaping entire industries while creating new ones. They have changed the way of doing business. So what does the new playbook look like?

Does Social Support Moderate The Association Between Income And Food Security Status Among Seniors Living In Southern Nevada?, Adugna Teka Siweya

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background: Income is the strongest predictor of food insecurity among seniors, and social support also an essential factor to help mitigate the effects of food insecurity. However, little is known about the potential role that social support may play as a moderator of the association between income and food insecurity. Thus, we aim to examine social support as a moderator for the relationship between income and food insecurity among seniors. Methods: Logistic regression models were used to analyze data collected in 2019 from seniors residing in Southern Nevada. Predictors of food insecurity, sociodemographic factors, social support variables, and income and …

Food Insecurity And Risky Sexual Behaviors Among College Students, Bertille Octavie Mavegam Tango Assoumou M

UNLV Theses, Dissertations, Professional Papers, and Capstones

Food insecurity and sexually transmitted infections (STIs) are growing public health problems in the United States. Young people in general, and particularly college students, exhibit high prevalence of food insecurity, STIs, and risky sexual behaviors (RSB). Food insecurity and STIs among college students can have short- and long-term impacts on their academic success and their lives. Several studies have reported an association between food insecurity and some risky sexual behaviors among specific populations including HIV-infected people and homeless people. However, little is known about the relationship between food insecurity and RSB among college students. Given the high prevalence of food …

Movement Integration In Classrooms: Factors Associated With The Adoption And Implementation Of Physical Activity In Us Elementary Schools, R. Blake Densley

Boise State University Theses and Dissertations

The intentional integration of movement in elementary school classrooms—including both brief instructional breaks for physical activity, or the integration of physical activity with lessons—can benefit children’s physical health and education outcomes. Teachers are key implementation agents, but despite movement integration (MI) being considered an educational best practice, many classroom teachers do not regularly use it. The aim of this study was to obtain updated nationally-representative prevalence estimates in US public elementary schools, regarding four key outcomes pertaining to teachers’ implementation of physical activity: 1) school adoption of physically active lessons (PALs); 2) school adoption of physical activity breaks (PABs); 3) …

Influenza Surveillance: Comparative Analysis Of Influenza Cases Data In Nebraska, Anna Carpenter

Capstone Experience: Master of Public Health

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Alteration Of Perceptions Of Safety Before And After Fit Testing Among College Of Dentistry Students, Tanner H. Clark

Capstone Experience: Master of Public Health

The COVID-19 pandemic has changed how hospitals and healthcare academic programs operate. This change has restricted services provided as well as educational opportunities for those training to be in healthcare. Further, personal protective equipment (PPE) has been required to help protect workers potentially having contact with patients who may have COVID-19. Dentistry workers are at particularly high risk due to repeated and continuous aerosol generating procedures. Healthcare students have traditionally been restricted to areas with minimal risk during clinical experiences; however, with the exposure occurring ubiquitously, avoiding the risk is nearly impossible. There is no uniform inclusion of students in …

Mental Health Of Individuals Within Incarceration: A Systematic Literature Review, Steven I. Valladares

Capstone Experience: Master of Public Health

Mental Health Illness is on the rise in the United States. About 90% of incarcerated individuals have at least one mental health condition. The current federal and state incarceration systems do not seem to be well-equipped to transition an incarcerated individual to the civilian life. This is so because the incarceration system focuses too much on the punishment rather than rehabilitation. This framework could be deemed unsafe and dangerous to the civilian world once a prisoner gets released, due to incarcerated individuals not receiving adequate mental health treatment. This literature review highlights the flaws of the current incarceration system mental …

Predicting Suboptimal Care In Insured Nebraskans With Known And Suspected Chronic Conditions., Avery Wallace

Capstone Experience: Master of Public Health

Health insurance companies have a goal of improving population health for their members (people who the company insures). As a health insurance company, [Company] has ample data on the health of its members that can be utilized to improve the health, and by extension lives of the people they insure. Although [Company] does not deliver care, they communicate with their members and physicians to identify ways to improve the health of the member. Of specific interest are members with known chronic conditions who are receiving suboptimal care, as well as members who have undiagnosed chronic conditions. Two chronic conditions were …

The Migration Of Carbapenem-Resistant Acinetobacter Baumannii From The Battlefields Of Iraq And Afghanistan To The Healthcare Facilities Of The Veterans Health Administration, Jeffery Rogers

Capstone Experience: Master of Public Health

Multidrug-resistant organisms (MDRO) pose a great threat to health across the globe. That threat is also felt in the Veterans Health Administration (VHA). Wounded warriors returning home from the battlefields of Iraq and Afghanistan may have brought with them MDROs, such as the bacterium Acinetobacter baumannii, as they have transitioned from military service into the VHA facilities. This study investigates the interconnectedness of military service in the Department of Defense (DoD) and a lifetime of care at VHA through a longitudinal tracking of a linked cohort of combat veterans with battlefield injuries and subsequent MDR infections of A. baumannii. …

The Spatial-Temporal Model Of Covid-19 Tests, Cases, And Deaths In The State Of Nebraska, Makayla Schissel

Capstone Experience: Master of Public Health

The goal of this project was to illustrate the spread of COVID-19 tests, cases, and deaths within the state of Nebraska and identify non-random clusters using a spatial-temporal model. This project is pertinent and innovative, as few spatial-temporal models in the United States revolving around COVID-19 offer information at the county, let alone, the state level. De-identified data was extracted from the State of Nebraska’s Department of Health and Human Services COVID-19 dashboard, transformed and prepared for analysis using SAS coding language. Clusters were identified though SaTScan software using a space-time permutation model. The model identified 5 different clusters related …

Health Belief Model Implications For Cervical Cancer Screening Among Refugee Women In Omaha, Nebraska, Na-Omi Hassane Dan Karami

Capstone Experience: Master of Public Health

Literature gap

According to the World Health Organization (2020), cervical cancer is among the top four most common cancers in women. However, refugee women are the least screened for cervical cancer. There is limited research examining the uptake of cervical cancer screenings among refugee women using the health belief model. Little is known about barriers and facilitators associated with the uptake of cervical cancer screening among refugee women in Nebraska.

Objectives:

The purpose of the study is to assess the health behavior of refugee women in Omaha towards cervical cancer screening via the health belief model and to determine the …

Evaluating Urban Parks Accessibility And Equity: A Case Study Of Hartford, Ct And New Haven, Ct, Natalie Roach, Mara Tu

Honors Scholar Theses

Public parks provide cities with environmental benefits, positive health effects, recreational opportunities, community building, educational spaces, and public amenities. However, certain populations have been systematically denied their fair share of these benefits because of unjust practices in the creation and maintenance of urban parks. With a lens of environmental justice, the goal of this research was to assess park quality and accessibility of two Connecticut cities, Hartford and New Haven, by gathering publicly available information as well as using GIS tools.

The Trust for Public Land (TPL) has an existing ParkScore rating system that evaluates the quality of a city’s …

Inoculation Of Juvenile Monodelphis Domestica With Zika Virus Using Various Routes Of Infection, Juan Garcia Jr.

Theses and Dissertations

Monodelphis domestica is a small marsupial from South America that has been previously been used in human metabolism research. However, their suitability as models for Zika virus (ZIKV) research, is currently unknown. Preliminary studies have shown M. domestica susceptible to ZIKV through the intracerebral route. We utilized immunohistochemistry, and analyzation of serological responses to show that juvenile Monodelphis domestica can be infected with ZIKV by using various routes of infection that include subcutaneous, intraperitoneal, and intramuscular. ELISAs performed on sera confirmed that juveniles injected with ZIKV by all three routes generated anti-ZIKV antibodies. Additionally, ZIKV nonstructural protein 1 was detected …

Rurality As A Moderator Of Perception Of Need For Medical Care And Patient Satisfaction, Kyndal Grammer

Electronic Theses and Dissertations

Many individuals experience barriers to accessing medical care, especially in rural areas. Some barriers are attitudinal and represent perceptions of quality care. Patient satisfaction and perceived need for medical care are two such attitudinal barriers related to health care utilization, yet the relationship between these variables has not been explored. Using data from an online survey, the current study examined the association between these variables, and further, whether rurality status moderated this association. Results indicated a significant correlation between patient satisfaction and perception of need. Although the overall moderation model was significant, perception of need was not significantly associated with …

Sarcopenia Screening By Registered Dietitian Nutritionists (Rdns) In The United States (U.S.), Madison Marcom

Electronic Theses and Dissertations

Sarcopenia is a disease of muscle wasting primarily seen in older adults. Although this term was first coined over three decades ago, there is a lack of consensus on a definition, screening criteria, and treatment protocol for sarcopenia. The primary purpose of this study is to determine whether registered dietitian nutritionists (RDNs) in the United States (U.S.) screen for sarcopenia. Study participants were recruited through a randomized email list and included RDNs throughout the U.S. Respondents completed a survey questioning knowledge of sarcopenia, screening tools and company protocols in place, and the need and desire for sarcopenia education. Data revealed …

Prevalence And Mortality Of Epilepsies With Convulsive And Non-Convulsive Seizures In Kilifi, Kenya, Symon M. Kariuki, Anthony Ngugi, Martha Z. Kombe, Michael Kazungu, Eddie Chengo, Rachael Odhiambo, Amek Nyaguara, Brian G. Neville, Charles Rjc Newton

Population Health, East Africa

Objectives: The prevalence of all epilepsies (both convulsive and non-convulsive seizures) in Low- and Middle- Income Countries (LMIC), particularly sub-Saharan Africa is unknown. Under estimation of non-convulsive ep- ilepsies in data from these countries may lead to inadequate and sub-optimal allocation of resources to control and prevent epilepsy. We determined the prevalence of all types of epilepsies and compared the mortality be- tween convulsive seizures and non-convulsive seizures in a resource limited rural area in Kenya.

Methods: Trained clinicians identified cases of epilepsy in a randomly selected sample of 4,441 residents in the Kilifi Health and Demographic Surveillance System site …

Treatment Access For Dual Diagnosis Substance Use And Mental Health Disorders, Pedro Banuelos

Electronic Theses, Projects, and Dissertations

In 2018, of 1.3 million Latinx adults in the United States facing concurrent issues with substance use disorders (SUD) and mental health disorders (MHD) 93% remained untreated for either diagnosis. This is concerning since Substance Abuse and Mental Health Services Administration (SAMHSA) data reveals that this population is at greater risk for suicidal thoughts, plans, and attempts. They also face structural barriers such as employment, housing, legal involvement, and insurability that further impede access to treatment.

This study’s purpose was to examine barriers to accessing treatment for Latinx populations confronting co-occurring SUDs and MHDs. This study used a qualitative design …

Association Between Dietary Inflammatory Index, Dietary Patterns, Plant-Based Dietary Index And The Risk Of Obesity, Yoko B. Wang, Nitin Shivappa, James R. Hébert Scd, Amanda J. Page, Yohannes Adama Melaku

Faculty Publications

Evidence on the association between various dietary constructs and obesity risk is limited. This study aims to investigate the longitudinal relationship between different diet indices and dietary patterns with the risk of obesity. Non-obese participants (n = 787) in the North West Adelaide Health Study were followed from 2010 to 2015. The dietary inflammatory index (DII®), plant-based dietary index (PDI) and factor-derived dietary pattern scores were computed based on food frequency questionnaire data. We found the incidence of obesity was 7.62% at the 5-year follow up. In the adjusted model, results from multivariable log-binomial logistic regression showed that a prudent …

Diet Quality And Risk Of Lung Cancer In The Multiethnic Cohort Study, Song-Yi Park, Carol J. Boushey, Yurii B. Shvetsov, Michael David Wirth Msph,Ph.D., Nitin Shivappa Ph.D., James R. Hébert Sc.D., Christopher A. Haiman, Lynee R. Wilkens, Loic Le Marchand

Faculty Publications

Diet quality, assessed by the Healthy Eating Index-2015 (HEI-2015), the Alternative Healthy Eating Index-2010 (AHEI-2010), the alternate Mediterranean Diet (aMED) score, the Dietary Approaches to Stop Hypertension (DASH) score, and the Dietary Inflammatory Index (DII®), was examined in relation to risk of lung cancer in the Multiethnic Cohort Study. The analysis included 179,318 African Americans, Native Hawaiians, Japanese Americans, Latinos, and Whites aged 45–75 years, with 5350 incident lung cancer cases during an average follow-up of 17.5 ± 5.4 years. In multivariable Cox models comprehensively adjusted for cigarette smoking, the hazard ratios (95% confidence intervals) for the highest vs. lowest …

Association Between Appendicular Skeletal Muscle Index And Leukocyte Telomere Length In Adults: A Study From National Health And Nutrition Examination Survey (Nhanes) 1999-2002, Lingzhi Chen, Nitin Shivappa Mbbs, Mph, Ph.D., Xiuxun Dong, Jinjing Ming

Faculty Publications

Background

A higher body mass index (BMI) is associated with shorter telomeres. The loss of muscle mass with aging is associated with adverse outcomes. The appendicular skeletal muscle index (ASMI) is currently used to quantify muscle mass.

Objective

We investigated the association of the ASMI with leukocyte telomere length in adult Americans.

Methods

This cross-sectional study used the National Health and Nutrition Examination Survey (NHANES) 1999–2002 dataset. Body composition was measured by dual-energy X-ray absorptiometry. Low muscle mass was defined using sex-specific thresholds of the appendicular skeletal muscle mass index (ASMI). The telomere-to-single-copy gene ratio (T/S ratio) was converted to …

Polycystic Ovarian Syndrome And Insulin Resistance: An Evaluation Of Treatment Modalities And Complication Prevention, Sarah Mann

Senior Honors Theses

Polycystic ovarian syndrome (PCOS) is a reproductive and endocrine disorder in women of childbearing age. This disorder includes multiple clinical manifestations, namely insulin resistance (IR) and infertility related to hormonal imbalances and anovulation. Despite being a common condition, its etiology and treatment modalities remain poorly defined. Without proper understanding and management of the condition, women may suffer numerous complications besides infertility such as diabetes mellitus type II (DMII), endometrial cancer, and cardiovascular disease. Therefore, further research is critical. This integrative review will create a comprehensive understanding of PCOS' pathophysiology, potential complications, treatment methods, and nursing considerations to promote the health …

Equitable Distribution Of Covid-19 Vaccines: Can Data Visualization And Optimization Help?, Zhennan Wang

Honors College Theses

Coronavirus disease (Covid-19) is known as an infectious disease that has a bigger impact on urban areas with high-density populations. In New York City, however, there are huge differences in the impacts of Covid-19 at the neighborhood level. In addition, there is a negative correlation between the Covid Case Rate and the Vaccination Rate, and areas that are affected the most have poor socio-economic conditions. To better address the equitable distribution of Covid-19 vaccines, I collected social and economic data from Community Health Profiles as well as Covid-19 data from NYC Health. Using this data I created visualizations in Tableau …

Evaluating Insurance Approval Rates Of Exome Sequencing And Its Effect On Minority Patients' Access To Genetic Care, Katlyn Frane

Dissertations and Theses (Open Access)

Exome sequencing (ES) is often a standard step in the genetic testing process for patients with rare or complex disease. Despite clinical implementation of ES, insurance companies (payers) continue to deny this test. We investigated if the payer barrier is influenced by payer type, and if other demographic or clinical information correlated to ES approval and obtainment. To do this, a retrospective chart and clinical database review was completed on patients seen at a tertiary care center and community-based clinic. Patient demographics, clinical indications, and testing recommendations and outcomes were used to assess ES approval and obtainment. We found that …

Risk And Clinical Risk Factors Associated With Late Lower Cranial Neuropathy In Long-Term Oropharyngeal Squamous Cell Carcinoma Survivors, Puja Aggarwal, Ryan P Goepfert, Adam S Garden, Naveen Garg, Jhankruti S Zaveri, Xianglin L Du, Michael D Swartz, Stephen Y Lai, C David Fuller, Renata Ferrarotto, Erich M Sturgis, Linda B Piller, Katherine A Hutcheson

Faculty, Staff and Student Publications

IMPORTANCE: Lower cranial neuropathy (LCNP) is a rare, but permanent, late effect of radiotherapy and other cancer therapies. Lower cranial neuropathy is associated with excess cancer-related symptoms and worse swallowing-related quality of life. Few studies have investigated risk and clinical factors associated with late LCNP among patients with long-term survival of oropharyngeal squamous cell carcinoma (OPSCC survivors).

OBJECTIVE: to estimate the cumulative incidence of and identify clinical factors associated with late LCNP among long-term OPSCC survivors.

DESIGN, SETTING, AND PARTICIPANTS: This single-institution cohort study included disease-free adult OPSCC survivors who completed curative treatment from January 1, 2000, to December 31, …