Public Health Commons^™

Policies Addressing Barriers To Low-Income Women And Children’S Health Care Utilization In The United States And Kenya: The Role Of Physician Payments And Cash Transfer Programs, Muloongo Simuzingili

Theses and Dissertations

This dissertation examined two policies to improve low-income women and children’s healthcare utilization: physician payments and cash transfer programs. Higher physician payments increase the supply of healthcare services while cash transfers increase individuals’ demand for healthcare services. Cash transfer programs can improve health outcomes, yet the extent to which they are a cost-effective strategy is largely understudied. Therefore, this dissertation examines three overarching research questions:

1. Are Medicaid physician fees associated with access to substance abuse disorder (SUD) treatment among low-income women of reproductive age?
2. Do economic preferences moderate cash transfer program effects on children’s health care utilization? Evidence from a …

The Risks For Eating Disorders/Disordered Eating In Refugee & Immigrant Experiences And The Imperative Of Culturally Alert Screening, Chantal A. Bushelle

Graduate School of Professional Psychology: Doctoral Papers and Masters Projects

Eating Disorders (ED)/Disordered Eating (DE) largely remain outside of global mental health agendas. There are limited data on the epidemiology EDs/DE in refugee and immigrant populations, and there is a paucity of research on refugee and immigrant experiences of EDs/DE. Study of acculturation issues in refugee and immigrant populations have historically missed investigating what role and impact experiences of stress and trauma (e.g., historical, chronic) along with cultural change and transition may have on their food attitudes and eating behaviors. While there has been some study of eating habits within refugee and immigrant populations, the focus is typically on food …

A Cross Sectional Study On Resilience And Coping Strategies Among Medical Officers During The Covid-19 Pandemic And It's Association With Depression And Anxiety, Rahul Yong Wern Kean

Student Works (2020-2029)

Introduction: The mental well-being of medical officers during the Covid-19 pandemic is becoming an increasing concern. The on-going pandemic has drastically increased work demands for doctors and this resulted in high levels of stress, depression and burnout among medical officers. Objectives: This study aims to determine the patterns of resilience and coping strategies of front-line medical officers during the Covid-19 pandemic, as well as their association with depression and anxiety. Study design: This is a single center, cross sectional study on Covid-19 front-line medical officers posted in medical wards in Hospital Tuanku Ja’afar, Seremban. The instruments used were a sociodemographic …

Advocates And Researchers Working Together To Improve School Health Education, Joseph Donnelly, Michael Young, Katherine J. Roberts

Department of Public Health Scholarship and Creative Works

Purpose: This article discusses the need for continued evaluation of health education interventions/curricula and provides tools and resources to facilitate the selection of appropriate, evidencebased interventions/curricula for school health education programs. Methods: We review the literature related to the evaluation of school health education programs, provide a review of the basics for understanding evaluation design and results, and identify resources for selecting effective curricula. Conclusions: There is a need for additional rigorously designed evaluations of school health education programs. School health educators and other advocates for school health education must have a basic understanding of evaluation design and how to …

A Method For Cultivation, Fractionation, And Metal Determination To Evaluate Metal Removal By The Combination Of Nps And Bacteria, Xiufeng Cao, Liang Xu, Alan W. Decho, Jamie Lead

Faculty Publications

Metals being released into the environment are posing an increasing risk to both environments and public health. Developing improved approaches to remove these metals from the environment is urgent. A current publication discovered that metal bioremediation was significantly improved by nanoparticles (NPs), and the remediation duration was shortened. However, there is no relevant method for the preparation and evaluation of this novel idea. Hence, we developed this method for bacteria -EPS (Extracellular Polymeric Substances) cultivation, bacteria sub-cellular fractionation, and metal determinations in cultivating solution, EPS and different fractions of bacteria to evaluate metal removal by the combination of NPs and …

Molecular Identification Of Parasites In An Intestinal Coprolite From A Mummified Religious Dignitary Of The Piraino Mother Church Crypt, Sicily, Amanda Rollins, Krystiana Krupa, Georgia Millward, Dario Piombino-Mascali, Karl Reinhard, Frederika Kaestle

Karl Reinhard Publications

Intestinal contents were sampled from a spontaneously enhanced mummy from the Sepulcher of the Priests of the Piraino Mother Church in the Province of Messina, Sicily. This adult male mummy, Piraino 1, is an unidentified religious dignitary dating from the late-18th to mid-19th centuries. Immunological and molecular diagnostics were used to test for common and clinically significant parasites. A morphological diagnosis of Trichuris trichiura (whipworm) was confirmed genetically. A previously undetected Enterobius vermicularis (pinworm) infection was also identified genetically. These data indicate that the Piraino 1 individual was simultaneously infected with multiple intestinal parasite species indicative of poor hygiene. This …

Interesting Case Of Headache With “Can’T Mix Food & Can’T Swallow”, Dr. Shreeraksha K.S, Dr. Shasthara P

Digital Journal of Clinical Medicine

No abstract provided.

Attention Deficit Hyperactivity Disorder, Dr. Anu Janardhan, Dr. Kishor M

Digital Journal of Clinical Medicine

No abstract provided.

Case Of Severe Depression With Psychotic Symptoms In Childhood, Vijaykumar Hiremath, Dr. Anusha Pogula, Dr. Kishor M

Digital Journal of Clinical Medicine

No abstract provided.

How Did We Learn About Sex? —— Sex Education And Sexual Health In Chinese Youth, Yujuan Liu

Theses and Dissertations (Comprehensive)

Attitudes toward sexuality among Chinese youth have become more liberal in recent generations, but sex education remains controversial and limited. Due to the lack of awareness of sexual risks, many Chinese youth engage in unprotected sexual activities resulting in unintended pregnancy, abortions, and STIs. Therefore, understanding successful pathways and unique challenges are crucial to develop adequate sex education for youth’s sexual health in China. The current study used semi-structured in-depth interviews and investigated 28 Chinese youths’ experiences of sex education and sexual health. The results mapped out youth’s sex education experiences by age and sources and demonstrated the impacts of …

Responding To The Call: Building A Training Program To Diversify The Academy In Alzheimer’S Disease Research, Lucy Annang Ingram Phd, Marvella E. Ford, Christiana L. Johnson, Brianna Ashford-Carroll, Quentin Mccollum, Daniela B. Friedman, Sue E. Levkoff

Faculty Publications

Alzheimer's disease and related dementias (ADRD) are at the forefront of the United States (US) public health agenda due to their tremendous human and financial burden. Further, disproportionately high ADRD rates among racial/ethnic minorities require incorporating the unique perspectives of racially and ethnically diverse scientists, which will necessitate diversifying the scientific workforce that investigates disparities in aging. The purpose of this paper is to describe the training and mentorship initiatives of the National Institute on Aging (NIA)-funded Carolina Center on Alzheimer's Disease and Minority Research, emphasizing lessons learned from our engagement with underrepresented minority and minoritized (URM) Scientists. We highlight …

Improving Human Papillomavirus Vaccination Rates Among Kentucky Adolescents, Cori Arena

DNP Projects

Background: The Human Papillomavirus (HPV) is a significant factor associated with the development of HPV-associated cancers in the United States. The administration of the HPV vaccination is a critical prevention strategy in reducing HPV-related cancers in the United States. The state of Kentucky has lower than average HPV vaccination rates compared to the national average. There is a significant amount of evidence exploring barriers and facilitators of the HPV vaccination administration. There are several multi-level barriers associated with low uptake of the HPV vaccination in adolescents. Multiple sources of evidence have indicated that parents who receive a provider recommendation are …

Population Assessment To Determine The Eligibility For Birth Center Care At University Of Kentucky Midwife Clinic, Dolores Polito

DNP Projects

Background: The COVID-19 crisis prompted patients to inquire about their options to avoid going to the hospital for birth. Outside of the hospital, birth center care has been identified as an evidence-based model for healthy women during pregnancy and birth, but it is not available in Kentucky.

Purpose The purpose of this study was to determine if there are women eligible for birth center care who have been part of a nurse midwifery service and given birth in a large, academic, tertiary care setting.

Methods: A retrospective chart review was used for this study. It involved a collection of …

Nutritional Approach For Increasing Public Health During Pandemic Of Covid-19: A Comprehensive Review Of Antiviral Nutrients And Nutraceuticals, Vahideh Ebrahimzadeh-Attari, Ghodratollah Panahi, James R. Hébert Scd, Alireza Ostadrahimi, Maryam Saghafi-Asl, Neda Lotfi-Yaghin, Behzad Baradaran

Faculty Publications

Background: The novel coronavirus (COVID-19) is considered as the most life-threatening pandemic disease during the last decade. The individual nutritional status, though usually ignored in the management of COVID-19, plays a critical role in the immune function and pathogenesis of infection. Accordingly, the present review article aimed to report the effects of nutrients and nutraceuticals on respiratory viral infections including COVID-19, with a focus on their mechanisms of action.

Methods: Studies were identified via systematic searches of the databases including PubMed/ MEDLINE, ScienceDirect, Scopus, and Google Scholar from 2000 until April 2020, using keywords. All relevant clinical and experimental studies …

The Need To Incorporate Communities In Compartmental Models, Michael J. Kane, Owais Gilani

Faculty Journal Articles

Tian et al. provide a framework for assessing population- level interventions of disease outbreaks through the construction of counterfactuals in a large-scale, natural experiment assessing the efficacy of mild, but early interventions compared to delayed interventions. The technique is applied to the recent SARS-CoV-2 outbreak with the population of Shenzhen, China acting as the mild-but-early treatment group and a combination of several US counties resembling Shenzhen but enacting a delayed intervention acting as the control. To help further the development of this framework and identify an avenue for further enhancement, we focus on the use and potential limitations of compartmental …

Seafaring And Impact On Seafaring Families In The Philippines: A Qualitative Study, Queenie Abad

Public Health Theses

Objective/Purpose: The Philippines is the largest occupational source of seafarers for the international shipping industry. Inherent to this occupation are the recurrent and long duration deployments overseas away from the seafarers’ families and communities which may negatively impact family wellness. In this qualitative study, we explored challenges that Filipino seafaring families face and identified protective factors for family and community well-being.Methods: Participants were selected by purposeful and snowball sampling. Participants were seafarers and their families. We conducted semi-structured interviews which were audio-recorded, transcribed, and loaded on Dedoose to facilitate line-by-line coding. Data was analyzed with a grounded theory approach using …

Prevalence And Health Burden Of Cardiovascular Disease In Older U.S. Veterans: Results From The 2019-2020 National Health And Resilience In Veterans Study, Cailin Arechiga

Public Health Theses

Importance. Cardiovascular disease (CVD) is one of the leading causes of death in the U.S. and is associated with a range of demographic, military, trauma, and clinical characteristics and physical and mental health conditions. Older military veterans may have an increased risk for CVD, given their advanced age and military experiences. However, the prevalence and health burden of CVD in population-based samples has not been well characterized. Objective. To characterize the current prevalence of CVD, and its association with sociodemographic, military, trauma, and clinical variables in a large, contemporary, and nationally representative sample of older U.S. veterans. Design. Cross-sectional study …

Health Care Utilization And Costs For Dementia Patients In China, Fang Ba

Public Health Theses

The number of people in the world living with Alzheimer’s Disease and related dementias (ADRD) continues to rise rapidly, which places a substantial burden on people with dementia (PWD), their families, and the society. Such a burden has been rising faster in low-income and middle-income countries (LMIC) where around two-thirds of PWD live. While prior research documents dementia prevalence in China and indicates its large geographic disparities, no study to date has documented the national pattern of health care utilization, quality and costs in China. The absence of knowledge would largely impede the effective allocation of resources for combating dementia …

United States Long-Term Trends In Adult Bmi From 1959 To 2018 By Income, Education, And Race/Ethnicity, Julia Banas

Public Health Theses

Obesity prevalence has increased dramatically since the 1950s. While cross-sectional comparisons across racial, ethnic, and socioeconomic groups are abundant, there is less work on long-term trends. We assessed trends in average adult body mass index (BMI) in the United States by income, education, and racial/ethnic groups from 1959 to 2018 using the National Health and Nutrition Examination Survey, which assesses repeated cross-sectional, representative samples of the United States population. Height, weight, income, education, and race variables were extracted from raw data files; income data was converted to constant dollars prior to analysis. BMI was calculated from height and weight measurements. …

Healthcare Provider Perspectives On The Influence Of Cultural Beliefs On Infant And Young Child Feeding Practices Within Ghanaian Refugee Camps: A Qualitative Analysis, Morgan Nadene Veronica Buchanan

Public Health Theses

Adherence to breastfeeding and complementary feeding recommendations is a proven strategy for promoting the well-being of infants and young children and ensuring their proper development. Cultural beliefs inform caregivers’ likelihood to follow these guidelines as they influence caregivers’ thoughts about maternal behavior during the prenatal and lactation periods, child feeding behaviors, and health. Refugee camps or settlements are a unique space to study the coexistence of cultural beliefs held by residents and staff. Understanding the pathways by which cultural beliefs modulate caregiver infant and young child feeding (IYCF) behavior (and therefore impact child health) within these settings is of paramount …

Effects Of Substance Use Disorder Section 1115 Waivers On Medicaid Population Utilization Of Buprenorphine And Naltrexone, Evangeline Cai

Public Health Theses

Background: In 2015, the Centers for Medicare and Medicaid Services (CMS) issued guidelines for a Medicaid Section 1115 behavioral health waiver with the intention of improving access to treatment for individuals with substance use disorder (SUD). One provision of the waiver allowed states to lift federal guidelines that originally prohibited states from using Medicaid funds to reimburse adults aged 21-64 years old for SUD services that occurred at “institutions for mental disease” (IMDs) with more than 16 beds. As of February 2021, 31 states have an approved the waiver.

Objective: To determine whether the Section 1115 SUD waivers, originally issued …

Caesarean Delivery Among Women Of Color Is Associated With Risk Of Early Childhood Developmental Delays In Brazil, Haley Case

Public Health Theses

Background. Poverty, racism, and other sources of oppression threaten children’s nurturing environments and associated early childhood development (ECD). Women of Color and their children are disproportionately exposed to risk factors for poor ECD in Brazil. There is a growing body of evidence supporting the claim that unnecessary cesarean section (CS) is associated with poor maternal health outcomes and ECD delays. There is an existing gap in the literature on risk factors, including obstetric factors, of poor ECD among children of Women of Color in Brazil.

Objective. The objective of this thesis was to investigate factors, including obstetric characteristics of CS …

Developing A Framework For Civilian-Military Public Health Operations Involving Non-State Armed Groups, Andrew James Chambers

Public Health Theses

Introduction: The interface of military forces, civilian actors and non-state armed groups (NSAGs) during a public health emergency within an active conflict is a situation fraught with legal and ethical challenges not adequately addressed in established doctrine or international guidance documents. Ongoing public health crises in Yemen and Afghanistan represent the real-world consequences of threats to population health and security if these critical gaps are not addressed. Methods: A list of five diverse medical scenarios was developed as an initial attempt to produce a practical, historically-informed framework for use in future civilian-military (CIV-MIL) training events and guidance. Ten virtual interviews …

Extreme Heat Vulnerability And Spatial Accessibility To Cooling Centers In Connecticut, Nicholas Elton

Public Health Theses

Extreme heat is becoming an increasingly prevalent and prominent environmental health issue under climate change. The goal of this study is to evaluate heat vulnerability at the census tract level in the state of Connecticut and assess the spatial accessibility to cooling centers – an extreme heat intervention. A variety of environmental and sociodemographic variables related to heat and health were identified based on previous literature and used in a varimax-rotated principal component analysis to reduce dimensionality and identify key components that constitute a heat vulnerability score. In addition, cooling center locations were identified based on news media and a …

Sexual Orientation Disclosure And Depression Among Thailand Men Who Have Sex With Men: Associations With Intimate Partner Violence And Social Support, Eduardo Encina

Public Health Theses

Objectives: The analytical goal of this project is to better understand the association of sexual orientation disclosure among different social networks of Thailand men who have sex with men (MSM) and depression. Along with this, we aim to extensively explore the intersectional influence of social support and intimate partner violence (IPV) experiences with each other, with disclosure, and ultimately depression outcomes.

Methods: The secondary dataset for this project was comprised of results from a cross-sectional study. This study utilized a web-based epidemiological and behavioral survey, distributed among young MSM ages 15-24. Self-reported data was provided through collaboration with Mahidol University …

Quantification Of Anesthetic And Analgesic Compounds In E-Liquids And Their Aerosols, Deyri Sugey Garcia

Public Health Theses

The unprecedented rise of vaping has resulted in gaps of scientific understanding of the health hazards this new phenomenon has created, as well as delayed regulations surrounding vape products, including coolants. Coolants are additives that create anesthetic, physical sense-reducing, and/or analgesic, properties that numbs the airways and add a minty flavor to vape products. However, it is unclear how much coolant is added to vape products electronic liquid (e-liquid), and how much of this content carries over into the aerosolized vaped form. To determine compositional analysis and carryover of common synthetic coolants, eugenol in 35 clove e-liquids and menthol, methone, …

‘I’M Never Saying A Damn Word Again’: Approaches To Community Support And Help Seeking Among Black Youth Experiencing Suicidal Thoughts, Alexis Renee Hopkins

Public Health Theses

Background. Suicidal behavior among Black youth is rising in the United States , yet little is known about how Black Youth engage and navigate suicidality. While we know that suicide ideation and death by suicide is decreasing overall among youth in the U.S., incidences of death by suicide are still rising among Black youth. There is very little understanding of what community support is accessible to Black youth who are experiencing suicidality. The present study examines how Black young adults who experienced suicidality in their youth turned to their social support systems and communities for support. Method. Seventeen semi-structured in-depth …

The Impact Of Economic Intimate Partner Violence On Women’S Sexual And Reproductive Health In Asia & The Pacific, Marina Katague

Public Health Theses

Intimate partner violence is a human rights violation and serious threat to global public health. Economic intimate partner violence is a unique form of abuse whose effects on health need clarification. Data from the 2011-2012 UN Multi-country Study on Men and Violence, comprised of cross-sectional samples in China, Papua New Guinea, and Sri Lanka were collected on ever-partnered women aged 18-49 years. The sample averaged some (1.14) economic violence exposure across summed behaviors (range 0-12; standard deviation=2.04). Multivariable regressions were run to assess the relationship between severity of IPV abuse types and 14 sexual and reproductive health outcomes. Adjusted analyses …

Factors Associated With Early Childhood Development Outcomes For Children Of Adolescent And Young Adult Mothers In Brazil, Lily Benson Kofke

Public Health Theses

Objectives: A descriptive analysis to explore the risks for early childhood development (ECD) delays among children of adolescent and young adult mothers in Brazil. Methods: A secondary analysis of cross-sectional data of a representative sample of children under age 2 and their mothers from community health centers in Brasília, Brazil. The Denver Developmental Screening Test II was used to assess overall and domain-specific ECD (personal-social, fine motor, gross motor, and language). Mothers were subset into two groups based on age. Bivariate analyses and multivariable logistic regressions were used to examine the associations between maternal age and risk of ECD delay, …

Gene-Gene Interactions Contributing To Asthma Susceptibility, An Exploration Using Uk Biobank Dataset, Yuyuan Lin

Public Health Theses

Background: Previous studies have attempted to identify gene-gene interactions for asthma. However, most of these studies suffered from lack of replication or insufficient statistical power. In this study, we aimed to explore the gene-gene interactions affecting asthma susceptibility and tried to replicate the results. Both the discovery and replication datasets were nested in UK Biobank data.

Methods: Nested case-control design was used. In the discovery analysis (N= 306,859, cases = 35,483, controls = 271,376), Univariate genome-wide association analysis was performed to prioritize loci for the interaction analysis. Pairwise search for epistasis was conducted among 5,389 SNPs. Replication of the top …