Public Health Commons^™

Applied Methodologies Demonstrated Through Three Independent Studies For Assessing The Effects Of Socioeconomic, Environmental Chemical Exposure, And Therapeutic Factors On Oncological Diseases And Covid-19, Bayarmagnai Maggie Munkhjargal

Legacy Theses & Dissertations (2009 - 2024)

When trying to understand risk factors for a disease, even before we know the causal agents, it is necessary to create a surveillance data set that answers the questions of who, when, and where, and includes any potential covariates which may either promote or prevent the disease. There are a wide variety of surveillance data. For example, hospital discharge data, such as the New York Statewide Planning and Research Cooperative System (SPARCS) data, encompass all hospitalized cases in the state, while clinical datasets cover a specially constructed population in pursuit of research of a certain disease type. Analysis of surveillance …

Legacy And Emerging Per- And Polyfluoroalkyl Substances : Analysis, Environmental Distribution, And Bioconcentration, Richard Anthony Brase

Legacy Theses & Dissertations (2009 - 2024)

Per- and polyfluoroalkyl substances (PFAS) constitute a broad class of anthropogenic chemicals that have been used in numerous industrial and consumer-product applications since the late 1940s. The environmental persistence of these compounds in combination with their widespread commercial use have led PFAS to be recognized as contaminants of concern on the global scale. Despite regulatory efforts calling for the decreased use of certain perfluorocarboxylic and -sulfonic acids referred to as “legacy” PFAS, these compounds continue to be detected in both environmental and biological matrices. Moreover, manufacturers have begun to replace the legacy PFAS with emerging alternatives for which the regulations …

Evaluating The Incidence Of Melanoma And Lung Cancer Of Current And Former Active-Duty U.S. Military Who Were Deployed In Support Of Operation Enduring Freedom And Operation Iraqi Freedom, Brian Kovacic

Theses and Dissertations--Epidemiology and Biostatistics

The incidence of melanoma and lung cancer has been gradually increasing in the United States over the past three decades with the reputed causes due to etiological and environmental exposures, and tobacco usage. There has been concern that melanoma and lung cancer incidence among military personnel may be associated with deployment to environments with intense sun exposure and increased smoking rates due to post-traumatic stress disorder. The aim of this study was to examine associations between deployment in support of Operation Enduring Freedom (OEF) or Operation Iraqi Freedom (OIF), from 2001 through 2015, with subsequent melanoma and lung cancer incidence. …

Sexual Behaviors Associated With Online Partner-Seeking Among Men Who Have Sex With Men From Small/Midsized Towns Or Rural Areas In Kentucky, Vira Pravosud

Theses and Dissertations--Epidemiology and Biostatistics

The HIV epidemic remains one of the most significant public health issues in the United States, particularly among men who have sex with men (MSM). New avenues for partner-seeking have emerged over the past three decades, including through the Internet, social media, and geosocial networking applications. Consisting of three cross-sectional studies, this dissertation research aimed to determine associations between the use of various online tools for partner-seeking (hereafter collectively referred to as “apps”) and HIV-related sexual behaviors among 252 young adult MSM residing in small/midsized towns or rural areas in Central Kentucky, a group that has been under-represented in the …

Building Assets Toolkit: Developing Positive Benchmarks For Adolescent Girls—Instruction Guide [Arabic], Judith Bruce, Sarah Engebretsen, Kimberly Glazer

Poverty, Gender, and Youth

English Summary:
The Building Assets Toolkit is an approach for developing programs for specific segments of girls that will prepare them to better face the challenges of growing up. It will help program managers understand the needs of the girls in their community, engage stakeholders at different levels and with different viewpoints, and build concrete and meaningful programming for adolescent girls. The toolkit contains all the materials needed to help make a preliminary assessment of the assets a girl should acquire and the age by which she should acquire them. This document contains the Building Assets Toolkit’s List of …

Targeted Teacher Education To Improve Primary Preservice Teachers’ Knowledge And Understanding Of Uv And Effective Sun Protection Measures For Children, Joseph J. Scott, Robyn S. Johnston, Natasha Bear, Sonia Gregory, Sally Blane, Mark Strickland, Jill Darby, Elin S. Gray

Australian Journal of Teacher Education

Teachers are responsible for children at school during peak ultraviolet (UV) times of the day. It is paramount that teachers have knowledge and understanding of UV to effectively protect themselves and their students. The aim of this pilot study was to investigate the effect of a short intervention on preservice teachers’ sun protective behaviours, knowledge and perceived skill to teach sun safety. Participants (n =161; median age=20 years) attended a 45-minute preservice teacher sun safety intervention and completed pre- and post-test surveys. Post-intervention, most participants indicated they felt: i) more informed about the dangers of UV and risks of developing …

The Lived Experiences Of Avoiding Recidivism Among African American Male (First-Time) Former Offenders, Jeff Hines

Walden Dissertations and Doctoral Studies

AbstractThe United States has a high recidivism rate within its criminal population, especially among men of African American descent. However, within this population, some first-time former offenders have used successful approaches to avoid re-incarceration. The objective of this study was to investigate how these first-time former offenders desist from crime and avoid recidivism. This was a phenomenological study, utilizing the Desistance Theory as a framework, to explore how these men survived the consequences of post-incarceration and remained crime-free. In-depth, semi-structured, open-ended interviews were conducted with six African American male first-time former offenders (age 25 and older) who were not on …

Protocol For Safe, Affordable, And Reproducible 1 Isolation And Quantitation 2 Of Sars-Cov-2 Rna From Wastewater, Monica Trujillo, Kristen Cheung, Anna Gao, Irene Hoxie, Sherin Kannoly, Nanami Kubota, Kaung Myat San, Davida S. Smyth, John J. Dennehy

Publications and Research

The following protocol describes our workflow for processing wastewater with the goal of detecting the genetic signal of SARS-CoV-2. The steps include pasteurization, virus concentration, RNA extraction, and quantification by RT-qPCR. We include auxiliary steps that provide new users with tools and strategies that will help troubleshoot key steps in the process. This protocol is one of the safest, cheapest, and most reproducible approaches for the detection of SARS-CoV-2 RNA in wastewater. Furthermore, the RNA obtained using this protocol, minus the pasteurization step, can be sequenced both using a targeted approach sequencing specific regions or the whole genome. The protocol …

Beyond The Adhd Diagnosis: Does The Insurance Rate, Mental Health Status In Parents, And Food Availability In The United States Impact Or Predict The Prevalence Of Diagnosis Of Adhd In Children?, Kaitie Kudlac

Scholarship in Medicine - All Papers

More than 6 million children in the US have been diagnosed with ADHD in 2016 and many studies such as those performed through the National Survey of Children’s Health have seen those numbers climbing through 2017.¹ Prevalence of ADHD itself has increased by 42% over the past 8 years.² This study analyzed, through the use of public data available through County Health Ranking and data through the Data Resource Center for Child and Adolescent Health if the insurance status, mental health standing of parents, and food availability in the United States could impact or predict the diagnostic prevalence …

Access To Care, Food Quality Index, And Employment As Predictors Of Poor Mental Health Days In Ohio, Louisiana, California, And New York, Eugene Matthew P. Almazan

Scholarship in Medicine - All Papers

Objective: Analyze how the availability of mental health providers has changed in Ohio from 2016 to 2020 with relation to changes in mental health outcomes reported. Compare to other regions of the United States (Louisiana, California, New York) in terms of access to healthcare, unemployment status, and food quality index. Lastly, to identify which socioeconomic and health factors are most predictive of poor mental health days.

Methods: Participant data from Ohio (OH), Louisiana (LA), California (CA), and New York (NY) was acquired from countyhealthrankings.org annual survey results that were published from 2016 through 2020. SPSS was utilized for statistical analysis …

Diabetes Link To Social Determinants Of Health, Tyler Schimmoeller

Scholarship in Medicine - All Papers

Objective: The purpose of this paper is to investigate diabetes and how premature death rate; income inequality and social associations relate to diabetes prevalence in the state of Washington in 2020. Methods: I investigated the rate of diabetes change in Washington from 201 to 2020 using a paired t-test. The correlation of diabetes rates and the premature age-adjusted mortality was calculated by county in Washington in 2020 using a Pearson/Spearman correlation. I compared the rate of diabetes in Washington to South Carolina, Ohio, and Louisiana by county in 2020 using an ANOVA with posthoc. Lastly, I used a stepwise linear …

Exploring Preventable Hospital Stays In Maryland, Janet Lubov

Scholarship in Medicine - All Papers

Objective: The objective of this study is to analyze data to determine the factors that influence preventable hospital stays in all Maryland counties. Explicitly, I am examining how preventable hospital stays changes over the past eight years, comparing preventable hospital stays in Maryland and Virginia, correlating preventable hospital stays with Flu vaccinations, and lastly, examining how the rate of uninsured and income inequality can predict the variance in preventable hospital stays by county.

Methods: The data I will be using is sourced from the 2020 County Health Rankings and Roadmaps report. The most recent data available in this published 2020 …

A Multi-Dimensional View On Mental Distress Of Alaskan Adults, Katelyn Hagstrom

Scholarship in Medicine - All Papers

Mental health impacts every facet of day-to-day life, and therefore it is important to determine what factors influence mental wellbeing in order to best target those areas to improve individuals’ mood and health. This paper analyzes how mental distress rates in Alaskan counties are affected by environmental and societal issues such as latitude, insufficient sleep, access to healthy food, presence of severe housing issues and rates of physical inactivity. By specifically studying mental distress in Alaskan residents, the extremes of day length and population size bring a new dimension to previous research done on mental distress. The variables were derived …

Sociodemographic Differences In Breastfeeding Rates For Children Born Between 2010-2015, Megha Patel

Scholarship in Medicine - All Papers

Breastfeeding is a natural component of life and has proven to provide benefits to both the mother and the child. The mother’s mental health as well as physical health including losing pregnancy weight are influenced by breastfeeding. The child receives immune system strengthening leaving them less susceptible to certain diseases in the short term and later in life. There are a variety of factors that have the potential to influence breastfeeding rates. In this study, seven of these factors were examined including sex of the baby, race of the baby, maternal education, poverty income ratio, marital status of the mother, …

Health Insurance Coverage, Sociodemographic Factors, And Treatment Completion For Opioid Abusers In Indiana, Ibrahim Samna

Walden Dissertations and Doctoral Studies

Many accidental deaths have recently occurred in Indiana due to opioid overdose. The current study sought to assess the association between sociodemographic factors, health insurance, and successful treatment completion for opioids abusers in Indiana based on the existing literature gap. In this study, the dependent variables considered were treatment completion status and opioid abuse. The independent variables included health insurance coverage and sociodemographic factors of education, marital status, employment status, race, gender, and age. I measured both dependent and independent variables as categorical. A cross-sectional and quantitative research approach was used by analyzing data from the 2017-Treatment Episode Data Set …

Isocitrate Dehydrogenase-1 Mutation As A Prognostic Factor In Recurrent Glioblastoma, Haroon R. Hashmi

Walden Dissertations and Doctoral Studies

Glioblastoma (GBM) is an aggressive form of brain cancer that has a high recurrence rate and very poor prognosis. The prognostic value of various molecular markers (e.g., IDH 1 mutation, MGMT promoter methylation, etc.) and clinical factors (e.g., age, KPS, surgery and chemotherapy) has been studied in GBM after initial diagnosis but not as extensively in the recurrent GBM. Utilizing a retrospective cohort design, based on quantitative data collected through medical chart reviews, and the conceptual framework of outcomes research in oncology, this study evaluated the prognostic value of IDH-1 mutation in recurrent GBM in the context of key predictor …

The Impact Of Midwifery On Infant And Maternal Outcomes Among Black Mothers, Joann Honoré

Walden Dissertations and Doctoral Studies

According to recent studies, disparities are prevalent in maternal and fetal outcomes between Black and White mothers in the United States. Researchers have established that using a midwife versus other healthcare practitioners can elicit positive maternal and fetal outcomes for Black mothers. However, no within-race research has been conducted exploring midwifery as an insulating factor against these disparities. The purpose of this quantitative retrospective cohort study was to explore the impact of midwifery on infant and maternal outcomes compared to outcomes associated with other prenatal care models/caregivers among Black mothers in California using secondary data. The ecological model was used …

More Than A Myth: The Benefits Of Incorporating Holistic Healing Methods From Native American And Mexican Cultures To Approach Opioid Use Disorder (Oud) Treatment, Juliana Favela

CMC Senior Theses

Opioid Use Disorder (OUD) is a substance use disorder that characterizes a dependence on and an addiction to opioids. Opioids attack the prefrontal cortex, the dopaminergic reward system, and the hypothalamic-pituitary-adrenal (HPA) axis which is responsible for the body’s stress response. Opioids constantly shift one’s “set point” to the point where normal actions that cause joy and excitement no longer cause those feelings, resulting in craving and dependence. The opioid epidemic is currently ravaging the United States and has disproportionately affected Native American populations specifically in the rural areas (Tipps, et.al, 2018). The current methods for addressing OUD include medicine …

Respecting Autonomy And Enabling Diversity: The Effect Of Eligibility And Enrollment On Research Data Demographics, Kayte Spector-Bagdady, Shengpu Tang, Sarah Jabbour, Nicholson Price, Ana Bracic, Melissa S. Creary, Sachin Kheterpal, Chad M. Brummett, Jenna Wiens

Articles

Many promising advances in precision health and other Big Data research rely on large data sets to analyze correlations among genetic variants, behavior, environment, and outcomes to improve population health. But these data sets are generally populated with demographically homogeneous cohorts. We conducted a retrospective cohort study of patients at a major academic medical center during 2012–19 to explore how recruitment and enrollment approaches affected the demographic diversity of participants in its research biospecimen and data bank. We found that compared with the overall clinical population, patients who consented to enroll in the research data bank were significantly less diverse …

Primary Care Physician-Nurse Practitioner Collaboration And Physicians Career Satisfaction, Tania Alidina

Electronic Theses and Dissertations, 2020-2023

Dissatisfaction amongst US physicians has been steadily increasing over the past few decades as health care reform changes the practice of medicine (Hoff, Young, Xiang, & Raver, 2015; Rosenstein, & Mudge-Riley, 2010). In 2008, physician dissatisfaction rates had increased to 19% (Mazaurenko & Menachemi, 2012). By 2012, 42% of physicians voiced dissatisfaction, with family medicine reporting most likely to be dissatisfied (Sorrell & Jennings, 2014). One factor that could affect physician career dissatisfaction/satisfaction that has not been studied is collaborative relationships with other healthcare providers, such as nurse practitioners. This study used secondary quantitative data from the National Survey of …

Prevalence And Perceptions Of Herbal Medicine Use In Eastern Jamaica, Jacqueline Jepsen

Scholarship in Medicine - All Papers

Objective: The purpose of this research was to determine the prevalence of herbal medicine use in rural St. Mary Parish, Jamaica. It also aimed to identify which herbs are commonly used and gauge the population’s general attitude toward herbal remedies vs conventional medicine. Methods: A cross-sectional population survey was developed and distributed at eight different clinics throughout St. Mary Parish, Jamaica with a sample size of 68.

Results: It was determined that herbal medicine use is common amongst the Eastern Jamaican population, with 63% of subjects reporting its use. A wide variety of herbal remedies are utilized, with aloe vera, …

Ct Scan Effective Radiation Dose Reduction In Pediatric Trauma Patients, Benjamin Clouse, Elizabeth Ey, Sara J. Paton, Frank Pianki, Jeffrey C. Pence, Lisa Schwing, Melody Campbell

Scholarship in Medicine - All Papers

This project attempts to address the problem of excessive radiation exposure via CT imaging for pediatric patients presenting at adult regional trauma centers.

To answer this question, we utilized the pediatric trauma registry to conduct a retrospective chart review of consisting of all patients under 14 years of age that received trauma related CT imaging and that were transferred from an adult trauma center to Dayton Children’s Hospital in the time period of January 2019 to December 2019.Cases of unnecessary imaging will be determined by subject matter expert review, based on ACS and Image Gently guidelines. Cases of overexposure to …

Teeka Tehreek: Increasing Epi Vaccinations In Khyber Pakhtunkhwa, Pakistan, Narjis Fatima Hussain

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

Abstract

Globally, Pakistan ranks third among countries with the most unvaccinated and under-vaccinated children. Within the country, there are huge regional disparities, and the Khyber Pakhtunkhwa region (KPK FATA) has one of the lowest vaccination rates in the country. Low vaccination rates contribute to the high burden of childhood infectious diseases in Pakistan that cause 70% of childhood deaths. Addressing the issue requires an understanding of the barriers towards vaccinations; 30% of refusals are due to religious reasons and other misconceptions that are compounded by low literacy rates. Since religion has a critical authority in shaping the population’s beliefs, attitudes, …

Nurse Home Visitation Program In Hamilton County, Oh To Increase Maternal And Child Health Outcomes, Hannah Widner

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

Hamilton County Ohio currently has poor outcomes related to maternal and infant health, specifically among African Americans. Compared to the Healthy People 2020 goals, Hamilton County has higher rates of infant mortality, preterm birth, neonatal infant mortality, and conception within 18 months of previous pregnancies. These rates are disproportionate among African Americans. For instance, African American babies born in Ohio have higher infant mortality rate (14.3 per 1,000) prematurity as a cause of death (4 per 1,000) and neonatal mortality rate (9.2 per 1,000). These are compared to White babies in Ohio with infant mortality rate (5.1 per 1,000), prematurity …

Implementing The Mothers And Babies Program To Reduce Preterm And Low Birth Weight Deliveries, Tan Frison

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

Georgia ranks fourth (4th) in the nation for the highest low birth weight rate at 10%, and sixth (6th) in the nation for preterm birth rate at 11.7%, among the states. Based on statistical data Bulloch county has maintained an average low birth weight statistic of 10% for over a decade. In 2019, there were 107 preterm and 79 low weight births in Bulloch county, Georgia. These numbers confirm there is a need for more preventive resources for mothers and children within this community. To address this burden, the Bulloch County health department has decided to implement the Mothers and …

Farmer Suicide: Rates, Trends, And Associations To Commodity Production Among States Reporting Violent Deaths, 2003-2017, Paul Norrod

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

Occupational studies show that farmers are at higher risk for suicide with rates at least two-fold those of the U.S. population.2-4 Therefore, the purpose of this study was to (1) determine age- and sex-specific farmer suicide rates, (2) evaluate rate trends, and (3) assess the relationship between commodity production and farmer suicide using the National Violent Death Reporting System (NVDRS) and quinquennial Census of Agriculture. We identified 1,652 farmer suicide cases from the NVDRS. Age-specific rates showed the highest rates among male farmers over 64 at 14.03 per 100,000. Annual rates for the 15-year study period peaked during 2013 at …

Recovery Housing In The United States And The Importance Of Data Collection, Maanasa Manchikanti

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

Substance use disorder (SUD) has been a prevalent issue in both the clinical and public health sectors for some time. Substance use disorder can be defined as a disease that affects an individual’s brain and behavior, causing them to develop an inability to control the use of legal or illegal drugs and substances (Mayo Clinic, 2021). Substances include but are not limited to alcohol, marijuana, opioids, and other controlled substances (Mayo Clinic, 2021). Substance misuse is a large topic of focus in public health because it not only deteriorates the quality of health in individuals and society, but also comes …

Rates Of Diabetes Screening In Kentucky Before And After Implementation Of The Affordable Care Act (Aca), Cory Reinert

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

Diabetes mellitus, commonly referred to as “diabetes”, is currently at epidemic proportions in the United States as its prevalence has drastically increased over the past several decades. The percentage of Americans with diagnosed diabetes has risen from 0.93 percent of the population in 1958 to 10.5 percent in 2018 (ADA, 2021). Diabetes also impacts record numbers of Kentucky residents.

Regular screening for those considered at-risk can encourage patients to implement lifestyle modifications, pharmacological therapy, or other interventions earlier in the course of disease. This can help prevent or delay onset of T2D and can reduce diabetes-related complications in those who …

Implementing The Textme Cardiovascular Mobile Health Intervention In Detroit, Michingan, Melissa Horton

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

Cardiovascular disease is currently the leading cause of death in the United States. One of the cities with the highest rates of cardiovascular disease is Detroit, Michigan. Those diagnosed with cardiovascular disease are encouraged to make lifestyle modifications to improve their health. However, if cardiovascular disease is not managed, it can lead to serious health outcomes such as stroke, heart disease, and death. The TEXTMe program is designed to send randomized text messages to participants to encourage lifestyle changes around diet, exercise, and smoking cessation. Participants in the program will be recruited from three health clinics located in the city …

Fiscal Waivers And State "Innovation" In Health Care, Matthew B. Lawrence

Faculty Articles

This Article describes how the Department of Health and Human Services (HHS) has used fiscal waiver authorities—delegated power to alter federal payments to states under Medicaid and the Affordable Care Act (ACA)—to influence state health policy choices. It highlights how the agency uses its fiscal waiver authorities to shape which reforms states choose to pursue, in some cases inspiring genuine state innovation and in others encouraging states to adopt reforms favored by HHS or discouraging states from adopting disfavored reforms. Moreover, while HHS has sometimes influenced state policy making in ways that further the substantive goals of the ACA and …