Public Health Commons^™

Multiple Proteinopathies And Their Role In Cognitive Impairment And Neurodegenerative Diseases, Shama D. Karanth

Theses and Dissertations--Epidemiology and Biostatistics

Most age-related neurodegenerative disorders are associated with the aggregation of misfolded and aberrant proteins. Alzheimer’s disease (AD) is one of the most common neurodegenerative disorders and is highly prevalent in older adults. Neuropathologically, AD is characterized by the accumulation of amyloid-β (Aβ) plaques and neurofibrillary tangles (NFTs). Other misfolded proteins, including α-synuclein and transactive response DNA-binding protein 43 (TDP-43), are also commonly observed in aged brains. Aberrant α-synuclein has been associated with Parkinson's disease, Dementia with Lewy bodies, and multiple system atrophy, whereas TDP-43 has been associated with multiple neurological diseases, the most common of which was designated as limbic-predominant, …

Enhancing Drug Overdose Mortality Surveillance Through Natural Language Processing And Machine Learning, Patrick J. Ward

Theses and Dissertations--Epidemiology and Biostatistics

Epidemiological surveillance is key to monitoring and assessing the health of populations. Drug overdose surveillance has become an increasingly important part of public health practice as overdose morbidity and mortality has increased due in large part to the opioid crisis. Monitoring drug overdose mortality relies on death certificate data, which has several limitations including timeliness and the coding structure used to identify specific substances that caused death. These limitations stem from the need to analyze the free-text cause-of-death sections of the death certificate that are completed by the medical certifier during death investigation. Other fields, including clinical sciences, have utilized …

Environmental Respiratory Exposures And Pulmonary Function Among Residents Of Rural Appalachia, Kentucky, John C. Flunker

Theses and Dissertations--Epidemiology and Biostatistics

Introduction

Resource extraction exposures are hypothesized to promote adverse respiratory health outcomes among residents of rural Appalachia, yet no studies to date have simultaneously quantified small-scale geographic variation in residential exposure, individual level health factors, and respiratory health outcomes.

Methods

The Mountain Air Project (MAP) is a community engaged cross-sectional study based in Harlan and Letcher counties of Southeastern Kentucky. MAP utilized a novel small-scale method to define residential exposure boundaries: hydrologic unit code (HUC), which represents distinct drainages (AKA “hollows”) where residents cluster. We assigned the HUC level density of active and abandoned surface and underground mining, oil/gas wells, …

Psychological Distress And Relationship Satisfaction Among Survivors Of Sexual Violence, Alyssa Campbell

Theses and Dissertations--Family Sciences

The World Health Organization (WHO; 2002) has indicated that sexual violence is a serious public health concern, and both the WHO and the United Nations (UN) have declared that violence against women, in particular, is a profound violation of human rights (UN General Assembly, 1993; WHO, 2017). Although the systemic and negative impact of trauma on family and intimate relationships have been well documented, the empirical literature regarding the effects of adult sexual trauma on relationship satisfaction is less robust. These studies are designed to address this gap and will do so with analyses centered on an understudied population: the …

Covid-19 Student Mental Health Check, Dianna Blankenship, Irma S. Jones

Criminal Justice Faculty Publications

The COVID-19 pandemic has produced many changes in the lives of our students and families. In this article, the responses of students in criminal justice classes at a Hispanic serving institution in south Texas were collected and synthesized. The 252 responses were divided into seven frequently observed and repeated themes: jobs and job related, school and courses, graduation, routine, family, positivity, and groceries/shopping. Findings for this time period matched what much of what the national and international news and reports have all reported. It indicates that, as teaching professionals, we must be mindful to provide the added support to assist …

Maintaining Population Health In Low‐ And Middle‐Income Countries During The Covid‐19 Pandemic: Why We Should Be Investing In Community Health Workers, Benjamin Palafox, Alicia Renedo, Gideon Lasco, Lia M. Palileo-Villanueva, Dina Balabanova, Martin Mckee

Development Studies Faculty Publications

Community health workers in low- and middle-income country primary health care systems are well suited to perform essential functions on the frontlines of Covid-19 pandemic responses. However, clear and coordinated guidance, updated infection control training, and reliable access to personal protective equipment must be ensured in order to deploy them safely and effectively. With these additional responsibilities, community health workers must also be supported to ensure that hard-fought gains in population health, including progress on non-communicable diseases, are sustained throughout the pandemic.

Medical Knowledge As A Recalcitrant Epistemological System: An Application Of Standpoint Epistemology In The Analysis Of Marginalization Within U.S Healthcare, Abby Deshazo

CMC Senior Theses

Research on healthcare disparities outside the field of epistemology tend to miss the true origins of oppressions imposed on marginalized individuals by the U.S healthcare system. This happens because of the false belief that these oppressions are reducible to social or political oppressions. By employing the perspective of a standpoint epistemologist, we can better identify the origins of these oppressions and subsequently consider more appropriate solutions. The standpoint epistemologist’s perspective (1) provides an intuitive case for the role individuals’ schemas play in the evaluation of what healthcare professionals know; (2) situates medical knowledge within epistemology, leading us to …

Postpartum Depression Rates In Latine Birthing Parents During The Covid-19 Pandemic: A Closer Look At Cultural Protective Factors And Acculturation, Perla Barajas

CMC Senior Theses

In the Latine community, the prioritization of social or familial support (familism) serves as a cultural protective factor that has typically guarded against unfavorable health outcomes. However, during the COVID-19 pandemic, social interactions and familial support were substantially limited. A vulnerable population during this pandemic was Latine birthing parents because previous studies have shown that perception of social support directly impacts postpartum depression (PPD) in this group. This study will use data from the Pregnancy Risk Assessment Monitoring System to compare PPD rates for Latine birthing parents from before the COVID-19 pandemic to the PPD rates during the pandemic. Moreover, …

Combined Influence Of Transfer Distance, Pace, Handled Mass And Box Height On Spine Loading And Posture, Xavier Robert-Lachaine, Philippe Corbeil, Antoine Muller, Jasmin Vallée-Marcotte, Hakim Mecheri, Denys Denis, André Plamondon

Études primaires

Work-related low back disorders are commonly associated with handling tasks. The objective of this study was to determine the combined influence of distance, pace, handled mass and height, on back loading and posture during free box transfer. Kinematics and kinetics of 17 handlers were recorded during a box transfer task between two pallets. Four-way repeated measures ANOVA were conducted on four lift-deposit height conditions (from lift and deposit of 0.16 or 1.16 m), three distances between pallets (1.5, 1.0 and 0.5 m), two handled masses (10 and 20 kg) and two paces (free and faster). The interaction between distance and …

Structural Remodeling Of The Lumbar Multifidus, Thoracolumbar Fascia And Lateral Abdominal Wall Perimuscular Connective Tissues: Medium-Term Test-Retest Reliability Of Ultrasound Measures, Christian Larivière, Dany H. Gagnon, Richard Preuss

Études primaires

Abstract

Introduction

Growing interest is being paid to the lumbar multifidus (LM) intramuscular fatty infiltrations and fibrosis that are secondary to low back pain as well to the remodeling of perimuscular connective tissues (fasciae) such as the thoracolumbar fascia and fascia sheets separating the abdominalwall muscles. Magnetic resonanceimaging and computed tomography have traditionally been used but rehabilitative ultrasound imaging (RUSI) is much more affordable and practical, which can accelerate research and clinical applications on this topic. The aim of this study was to test the medium-term (8 weeks) test-retest reliability of the corresponding RUSI measures.

Methods

Thirty-four participants …

Peoples’ Experiences With Birth Doulas, Emily A. Gunderson

All Graduate Theses, Dissertations, and Other Capstone Projects

Birth doulas, as a non-medical resource for people going through the birthing process, have seen overall positive reception by providing a service otherwise missing from the recently medicalized birth environment (Gruber et al. 2013, Steel et al. 2015); this coincides with a time when fathers are being asked to play a more active role in their child’s birth (Coltrane 1996, Odent 2009). However, while we know a little about how mothers experience the services of a birth doula and how fathers experience birth generally, we have yet to find out how birthing people, both partnered and un-partnered, make sense of …

Determinants Of Private Well Water Testing In Maine, Jenny Carwile, Shravanthi M. Seshasayee, Kritika Anand, Abby F. Fleisch

Costas T. Lambrew Research Retreat 2021

Objectives: Describe sociodemographic characteristics associated with ever testing well water using data from the 2014-2017 Maine Behavioral Risk Factor Surveillance System (BRFSS) (n= 12,152).

Equine West Nile Virus In Kentucky: Characteristics Of Historical Testing And Analysis Of Causal Factors, Kaelyn Short

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

As the arbovirus with the highest incidence in both humans and horses in the United States, West Nile Virus (WNV) presents a significant risk to the equine population of Kentucky. Widespread infection has the potential to cause a significant economic impact to the state and long-term health complications for the horses. To better understand the burden of equine WNV, historical diagnostic testing archives the University of Kentucky Veterinary Diagnostic Lab were analyzed along with environmental and census data collected from additional sources. A total of 2146 test results were analyzed utilizing descriptive statistics, chi-square tests of independence, and binary logistic …

Secular Trends In Low Birth Weight And Preterm Birth Disparity Between Infants Born To Teenage And Adult Mothers: An Exploratory Analysis, Elizabeth Edwards

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

Introduction. Increased risk of preterm birth and low birthweight for infants born to teenage mothers (15-19), when compared to infants born to adult mothers (20-29), is well documented in the United States. Trends in preterm birth and low birthweight are also well documented over time. Examination of the difference in incidence of preterm birth or low birthweight between infants born to teenage mothers and to adult mothers over time is not present in the literature. This study aimed to fill this gap in the literature and determine how preterm birth and low birthweight differences have changed over time.

Methods. Natality …

Colorectal Cancer Differences In Staging And Survival: Appalachian And Non-Appalchian Kentuckians, Ripley Lucas

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

Colorectal cancer is the third most commonly diagnosed cancer in the United States. Historically, the Appalachian region of Kentucky has experienced disparities in colorectal cancer screening and survival as compared to both the non-Appalachian region of the state and the United States. The aim of this paper is to investigate the differences in cancer staging and survival after diagnosis in Appalachian and non-Appalachian Kentuckians. The present time period of study is a retrospective, population-based cohort with data taken from the Kentucky Cancer Registry. Binomial logistic regression and Cox proportional hazards models were used to estimate unadjusted and adjusted odds ratios …

Applying Mixed-Effects Modeling To Behavioral Economic Demand: An Introduction, Brent A. Kaplan, Christopher T. Franck, Kevin Mckee, Shawn P. Gilroy, Mikhail N. Koffarnus

Family and Community Medicine Faculty Publications

Behavioral economic demand methodology is increasingly being used in various fields such as substance use and consumer behavior analysis. Traditional analytical techniques to fitting demand data have proven useful yet some of these approaches require preprocessing of data, ignore dependence in the data, and present statistical limitations. We term these approaches “fit to group” and “two stage” with the former interested in group or population level estimates and the latter interested in individual subject estimates. As an extension to these regression techniques, mixed-effect (or multilevel) modeling can serve as an improvement over these traditional methods. Notable benefits include providing simultaneous …

A Comparison Of Health Habits Between Nursing And Non Nursing Majors, Reilly K. Gilmour

Honors Theses and Capstones

No abstract provided.

Heat Stress In Urban Environments: A Case Study Of Heat Vulnerability In New Haven, Ct, Logan M. Howard

Library Map Prize

A place-based understanding of heat and its behavior is necessary for appropriately preparing our cities and protecting the most vulnerable populations from this urgent climate and public health threat. This paper aims to identify the areas in New Haven, CT that have the highest autumnal temperature exposure and sensitivity to provide evidence for developing mitigation and adaptation measures. Original temperature data was collected using a bike-mounted Smart T sensor and then compared with data on land cover and water proximity. These heat exposure estimates were analyzed with 2019 Census data on age, income, race, and ethnicity, for 19 census tracts …

Comparing Melatonin Use To Bright Light Therapy In Mitigating Cardiovascular Effects Due To Shift Work Disorder In Shift Working Adults, Alexandra Hirt

Capstone Showcase

Introduction: Circadian Misalignment is a term used to describe a mismatch in one’s physiologically determined sleep patters and their actual sleep wake behaviors. Shift workers often end up in a vicious cycle of being in a state of chronic circadian misalignment, which then can lead to health problems, extreme fatigue, and insomnia, known as Shift Work Disorder (SWD).This has been studied in night shift workers who, when compared to daytime workers, have an increased risk of developing metabolic syndrome, type 2 diabetes, and coronary heart disease.These results are not dependent on any behavioral risk factors, such as smoking and poor …

Opioid Use Disorder: The Timeline For Medication Assisted Therapy, Alexander Cristofori

Capstone Showcase

Opioid Use Disorder is patterns of opioid use leading to withdrawal, giving up important life events in order to use opioids, and excessive time spent using opioids, to name a few diagnostic criteria. The clinical progression of the disorder involves periods of acute exacerbation and remission that are cyclic in nature. Treatment is most effective when it includes both pharmacological and psychosocial modalities, referred to as medication assisted therapy (MAT). Three drugs used commonly in MAT-based treatment for OUD from oldest to newest include Methadone, Buprenorphine-naloxone, and Naltrexone. Treatment program models that prioritize total abstinence from the addictive substance attached …

Safety And Efficacy Of Bioidentical Hormone Therapy In Menopause: A Literature Review, Kathryn Akre

All Graduate Theses, Dissertations, and Other Capstone Projects

Vasomotor symptoms (VMS) experienced during menopause can negatively impact a woman’s quality of life, productivity, sleep, and mood. Systemic hormone therapy (HT) is the most effective treatment for moderate to severe VMS, however safety concerns raised by the 2002 Women’s Health Initiative (WHI) trial have led to a decrease in overall HT use and a growing demand for custom-compounded bioidentical HT. Misconceptions regarding the superior safety and efficacy of custom-compounded hormones and lack of clinician expertise in menopause management contribute to ongoing uncertainty and low uptake of United States (U.S.) Food and Drug Administration (FDA) approved bioidentical HT products. This …

Reducing Disease Exacerbation In Women With Confirmed Copd: A Systematic Literature Review, Jill Essay

All Graduate Theses, Dissertations, and Other Capstone Projects

Abstract

A systematic literature review was conducted to establish whether gender specific treatment exists for patients with Chronic Obstructive Pulmonary Disease (COPD), specifically, women with (COPD). The PICO question developed for this review is as follows: In women with confirmed diagnoses of COPD, does gender-specific treatment, compared to standard treatment, impact the frequency of exacerbations? Could the number of COPD exacerbations in women be reduced by incorporating interventions designed with (female) gender in mind? Four databases were included in the search: CINAHL, Pubmed, Medline, and Nursing and Allied Health. Articles included addressed gender differences in relation to the disease process, …

Analysis Of Circadian Rhythm Irregularities On The Health Of Shift Workers, Sahil Rajan

Williams Honors College, Honors Research Projects

Circadian rhythms involve the natural 24 wake-sleep cycle that governs proper maintenance of biological sleep schedules. Circadian rhythm disruption has been associated with health issues such as diabetes, obesity, and mental health disorders such as bipolar and sleep disorders. In this study, a survey method was utilized in order to analyze specific population demographics to determine whether working day or night shifts predisposed individuals to health issues due to disruptions in their circadian rhythms. This study was also carried out to observe popular coping strategies among night shift workers. Of all the variables tested comparing the difference between day and …

Symptoms Of Depression And Anxiety Are Associated With Substances Used In Electronic Nicotine Delivery Systems (Ends): A Longitudinal Analysis From The Texas Adolescent Tobacco And Marketing Surveillance System (Tatams), Jacob Smith, Stephanie Clendennen, Anna V. Wilkinson, Melissa B. Harrell

MEDI 9331 Scholarly Activities Clinical Years

Introduction

Electronic nicotine delivery systems (ENDS) use with nicotine or THC among adolescents and young adults is increasing. The goal of our research was to examine relationships between symptoms of anxiety or depression and ENDS use, whether with nicotine or THC, among young people in four major metropolitan areas of Texas.

Methods

The sample was 57.6% female and 37.6% Hispanic. Data were derived from Wave 9 (Spring, 2019) and Wave 10 (Fall, 2019) of the Texas Adolescent Tobacco and Marketing Surveillance system. Logistic regression analyses examined associations between symptoms of depression, anxiety, or comorbid depression and anxiety in the Spring, …

The Impact Of The Hospital Value-Based Purchasing Program On Healthy Days, Health Inequity, And Hospital Community Benefit Spending, Samhita Kadiyala

Scripps Senior Theses

The Hospital Value-Based Purchasing Program (HVBP) is a Centers for Medicare and Medicaid Services (CMS) program implemented in 2012 to reward acute-care hospitals with incentive payments for the quality of care provided to Medicare patients in inpatient settings. Under this policy, payment adjustments are made based on a variety of factors including clinical quality, patient experience, and cost reductions. This paper uses state-level variation in the implementation of HVBP to ascertain whether the policy led to improvements in Healthy Days (a CDC-designed composite measure of individuals’ self-reported number of physically and mentally “healthy” days per month), health disparities, and community …

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

Poverty, Gender, and Youth

[In Arabic] 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.

This document contains the Building Assets Toolkit’s Asset Cards (110), set of Age Cards (age 6 to 20), and Program Planning Worksheet (sample provided). The Age Cards are to be printed out and placed according to the instructions. The …

The Attitudes And Perceived Barriers Regarding The Practice Of Evidence-Based Management Among Healthcare Managers In Saudi Arabia, Njoud Alsubaie, Bussma Bugis

Internet Journal of Allied Health Sciences and Practice

Purpose: The study purpose was to explore attitudes and identify perceived barriers regarding the practice of evidence-based management (EBMgt) by healthcare managers. Method: A cross-sectional descriptive study was conducted using a simple random sample. The study population included middle- and lower-level healthcare managers at a specialized hospital in Saudi Arabia. A total of 165 healthcare managers were invited to complete a hard copy-survey. Results: The surveys were completed by 120 respondents, yielding a response rate of 72%. The study results showed that most of the participants had a favourable attitude towards the practice of EBMgt. However, a lack of …

Statistical Methods For Evaluating Confounding In Nutritional Epidemiology: Examining The Association Of Dietary Measures And Incident Type 2 Diabetes, Stephanie E. Tison

All ETDs from UAB

Nutrition is a key factor in the development of noncommunicable diseases (NCDs) such as cardiovascular disease, diabetes, obesity, and cancer, which are continuing to increase globally. Research on dietary patterns is crucial for informing what aspects of diet are most critical for preventing and possibly reversing chronic disease. Dietary patterns focus on the types of food that are consumed which reflects the complexity and cultural aspects of diet rather than focusing on a single food or nutrient. Observational cohort studies are able to observe typical dietary intake and thus better reflect the real association between diet and chronic disease. In …

Pain Among Older Adults With Cancer-Results From The Cancer And Aging Resilience Evaluation (Care) Registry, Mustafa Al Obaidi

All ETDs from UAB

Purpose: The impact of pain on functional status and mental health among older adults with cancer is a relevant, yet understudied issue. Our aim of this study sought to identify prevalence of pain at diagnosis in older adults with cancer and evaluate the association with functional status limitations, cognition, and mental health issues. Methods: This study included patients diagnosed with cancer at age ≥60 enrolled in the CARE Registry at University of Alabama at Birmingham. Patients completed a patient-reported geriatric assessment at the time of their initial visit with a medical oncologist. Pain measured in numeric rating scale from 0-10. …

Statistical Methodology For Mendelian Randomiztion Analysis, Phillip Hunter Allman

All ETDs from UAB

Instrumental variable (IV) methods are causal analysis techniques used on observational data to address confounding, provided that certain assumptions are met. In the usual observational setting, some exposure of interest �� is associated with some outcome of interest ��, but confounders �� could distort the measure of the association between �� and ��. A valid IV is a proxy of sorts for �� which behaves in a very specific way, in that the IV operates analogously to the treatment group assignment seen in randomized trials. Finding a valid IV is no trivial task, but if one exists and we identify …