http://hdl.handle.net/1957/19679 2013-06-20T03:27:01Z 2013-06-20T03:27:01Z Schure, Mark B. http://hdl.handle.net/1957/38984 2013-06-05T20:40:17Z 2013-05-02T00:00:00Z

Prevalence and association of depressive symptoms with physical disability and long-term care use among older American Indians Schure, Mark B. Health officials have recently been sounding the alarm that depression will soon surpass many of the major medical conditions in causing disability among adults. Recent demographic and health trends are generating public health concern about depression. First, the prevalence of chronic conditions has dramatically increased over the last several generations. Second, depression often accompanies chronic conditions and can exacerbate physical health outcomes. Third, the recent entry of the baby-boomers into the older age bracket is spawning an substantive expansion of the older adult population in this country, an age group that disproportionately experiences greater number of chronic conditions, physical disabilities, and associated long-term care needs. These health trends are even greater among older American Indians. However, despite greater prevalence of morbidity, depression, and physical disability among older American Indians, very little is known about the relative impact of morbidity and depression on physical disability. Therefore, the first manuscript examines 1) the prevalence and correlates of depressive symptoms and 2) the relationship of depressive symptoms with chronic conditions and physical disability among older American Indians, using the Native Elder Care Study data. The presence of depressive symptoms in older adults have been implicated in the need for and use of greater medical care, greater number of caregiving hours received, and increased medical expenditures above and beyond the severity of chronic conditions or physical disability. No published studies have examined the difference in amount of long-term informal and formal care receipt between older American Indians with different levels of depressive symptoms. Therefore, the second manuscript examines the difference in amount of informal and formal long-term care receipt between older American Indians with different levels of depressive symptoms. Examining the contribution of depressive symptoms to physical disability and long-term care use among older adults is important because it is a preventable and treatable condition afflicting a substantive proportion of this population. As the number of older adults increases, long-term care will be in greater demand. However, it is unclear whether our long-term care system will be able to meet the growing demand. Thus, this research contributes to our understanding of the factors leading to greater physical disability and long-term care use. Graduation date: 2013

2013-05-02T00:00:00Z Roldan, Josiah Javier http://hdl.handle.net/1957/35783 2012-12-14T22:41:20Z 2012-12-03T00:00:00Z

West Nile virus : forecasting models for a resurging vector-borne disease in Arizona, U.S.A. Roldan, Josiah Javier West Nile Virus (WNV), a vector-borne disease continues to be a serious threat to public health in the United States, particularly in the Southwest region. While all the states in the U.S. experienced a decreasing trend of WNV disease in 2010, the state of Arizona experienced a sharp increase from 20 in 2009 to 166 cases the following year. This dissertation endeavored to develop forecasting models to predict future cases of disease and identify counties with increased propensity for WNV. Furthermore, this study aimed to identify environmental and economic factors that contributed to the increase in WNV cases in Maricopa County, Arizona. A spatiotemporal stochastic regression model was developed using Bayesian principles and was successful in calculating the annual mean cases of disease from 2003 to 2011 for all counties. The model was also able to predict future cases of disease by fitting historical data. The model-based inference identified counties in the southern region of Arizona as having an elevated propensity for disease compared to counties in the northern region. A Seasonal Autoregressive Integrated Moving Average (SARIMA) model was developed and effectively forecasted monthly cases of human WNV in Maricopa County, Arizona. By fitting the SARIMA model to monthly historical disease data from 2005 to 2011, the temporal model presented a decreasing trend of monthly incidence of disease for 2012. The impact of home foreclosures, climate variability, and population growth on the resurgence of human WNV disease cases in Maricopa County during the 2010 epidemic was investigated. These factors were found to have contributed to the resurgence of the disease by creating the optimal environmental conditions that allowed the amplification of mosquito populations, thus increasing the risk of disease transmission to humans. As spatiotemporal disease data become readily available, forecasting models can be an important and viable risk assessment tool for public health practitioners. Forecasting models allow the mobilization and distribution of limited resources to areas with elevated propensity for disease, and the timely deployment of intervention programs to reduce the overall risk of disease. Graduation date: 2013

2012-12-03T00:00:00Z Bonnlander, Heinke P. http://hdl.handle.net/1957/35506 2012-12-05T20:10:02Z 1994-05-06T00:00:00Z

Two epidemiological studies in central Haiti Bonnlander, Heinke P. Two epidemiological studies, designed to expand our knowledge of morbidity and mortality indicators concerning malaria and Bacillus Calmette-Guerin vaccination in the Hospital Albert Schweitzer health district located in Central Haiti's Artibonite Valley, are presented. The hospital serves a rural population of 190,000 in its 610 square mile district. A large proportion of the rural population still relies on traditional healers in times of illness. Consequently, accurate morbidity and mortality data from individuals and communities in the district are scarce. The first study investigated an outbreak of axillary lymphadenitis and abscesses after Bacillus Calmette-Guerin vaccination among rural Haitian children treated at Hospital Albert Schweitzer from January 1986 through March 1991. Seventy-seven cases of vaccine-related complications were identified, all among children immunized before the age of 1 year. The proportions of children with complications were 0.017% for 1986 through 1989, 0.91% for 1990, and 2.2% for January through March 1991. The probable explanation for the increase is a change in the BCG strain or in the reactogenicity of the Pasteur strain. Graduation date: 1994

1994-05-06T00:00:00Z Byrd, Marcia J. http://hdl.handle.net/1957/35241 2012-11-26T18:50:13Z 1995-05-02T00:00:00Z

Drug and alcohol use by freshman at Siuslaw High School and their opinions regarding potentially effective drug and alcohol education programs Byrd, Marcia J. This study addressed the incidence of drug use by freshmen at Siuslaw High School in Florence, Oregon, and sought their opinions about effective drug and alcohol prevention programs. The purpose was to provide basic data which would ultimately assist in specific drug and alcohol programs for this population. In phase one, 83 students from four of seven freshmen Health Education randomly selected classes were given the Washington State Survey of Adolescent Health Behavior. This survey consisted of 81 questions about student demographics, students' drug use, and their opinions of drug prevention programs. During phase two, the students were asked open-ended questions about their suggestions for more effective drug prevention programs and curriculum. The survey revealed an average amount of drug use and that the students did not think the drug prevention program at Siuslaw was working. The survey also revealed that teenagers are influenced to drink and use drugs by the media, their friends, and by a lack of activities offered by the community. The study conclusions showed that Florence does have teenage drug use and the community should consider a variety of approaches. Data suggest that more youth support groups, more affordable counseling, and more recreational activities may help reduce drug use. The school needs to develop a more comprehensive drug prevention curriculum and implement it at the younger grade levels. The school combined with the community, should offer more drug-free alternatives and target those youths who are not using drugs and promote their positive behavior. Graduation date: 1995

1995-05-02T00:00:00Z