Digital Commons Network^™

Fall 2021

Scientia

A Decade of Progress and Success; Speech Language Pathology Program; COVID-19 Long-Hauler Study; Peer Mentors Initiative; Faculty Update; Expert Engagement: Three CSH initiatives further education and scholarship while supporting communities in need; Strategic Command: Business consultant and med tech expert Stephen Sichak helps others face pandemic challenges; Taking Care: A School of Nursing research team plumbs the pandemic experiences of nurses nationwide

55-Word Stories: Insight Into Healthcare, Nancy E. Krusen

Translational Science in Occupation

Narrative medicine and health humanities focus on arts, ethics, and clinical practice. Many health education programs incorporate creative activities to facilitate learner self-awareness and insight. We include them to address programmatic themes of professional growth and translational science.

Clinician Perspectives On Fistula Mental Health, Victoria K. Leonard

Doctoral Dissertations

Background – Obstetric fistula is a childbirth injury caused by prolonged labor that leads to stillbirth and incontinence, spurring social exclusion and isolation. These layers of trauma put women with fistula at great risk for psychological suffering, which has profound negative socioeconomic impacts on them, their families, and communities. This study captured treatment as usual at Comprehensive Community Based Rehabilitation in Tanzania (CCBRT), the country’s largest provider of fistula care.

Method – Improving holistic fistula treatment requires engaging the clinicians who care for women with fistula. This study aimed to investigate the training, beliefs, and treatment approaches of nurses and …

Prevalence And Risk Factors Of Obesity Among Undergraduate Student Population In Ghana: An Evaluation Study Of Body Composition Indices, Christian Obirikorang, Evans A. Adu, Enoch O. Anto, Anthony A. A. Awuah, Angela N. B. Fynn, George Osei-Somuah, Patience N. Ansong, Alexander O. Boakye, Ivy Ofori-Boadu, Yaa Obirikorang, Austin G. Adobasom-Anane, Eric N. Y. Nyarko, Lois Balmer

Research outputs 2022 to 2026

Background: Obesity is a classified risk factor for several of the world’s leading causes of death. In this study, we combined information contained in body mass index (BMI), total percentage body fat (TPBF) and relative fat mass (RFM) to estimate obesity prevalence and examine the risk factors associated with obesity. Methods: The study recruited 1027 undergraduate students aged between 16 and 25 years using a cross-sectional study design and two-stage stratified random sampling between January and April 2019 from the Kwame Nkrumah University of Science and Technology, Kumasi, Ghana. Demographic, lifestyle, and family history of chronic disease data, were collected …

Co-Design Of A Personalised Digital Intervention To Improve Vegetable Intake In Adults Living In Australian Rural Communities, Katherine M. Livingstone, Jonathan C. Rawstorn, Laura Alston, Stephanie R. Partridge, Amber Bastian, Kate Dullaghan, Sarah A. Mcnaughton, Gilly A. Hendrie, Lauren C. Blekkenhorst, Ralph Maddison, Yuxin Zhang, Scott Barnett, John C. Mathers, Stephanie L. Godrich

Research outputs 2022 to 2026

Background: Diets low in vegetables are a main contributor to the health burden experienced by Australians living in rural communities. Given the ubiquity of smartphones and access to the Internet, digital interventions may offer an accessible delivery model for a dietary intervention in rural communities. However, no digital interventions to address low vegetable intake have been co-designed with adults living in rural areas. This paper describes the co-design of a digital intervention to improve vegetable intake with rural community members and research partners. Methods: Active participants in the co-design process were adults ≥ 18 years living in three rural Australian …

Association Between Inflammatory Bowel Disease And Cancer Risk: Evidence Triangulation From Genetic Correlation, Mendelian Randomization, And Colocalization Analyses Across East Asian And European Populations, Di Liu, Meiling Cao, Haotian Wang, Weijie Cao, Chenguang Zheng, Yun Li, Youxin Wang

Research outputs 2022 to 2026

Background: Inflammatory bowel disease (IBD), which includes Crohn’s disease (CD) and ulcerative colitis (UC), has been associated with several cancer risks in observational studies, but the observed associations have been inconsistent and may face the bias of confounding and reverse causality. The potential causal relationships between IBD and the risk of cancers remain largely unclear. Methods: We performed genome-wide linkage disequilibrium score regression (LDSC), standard two-sample Mendelian randomization (MR), and colocalization analyses using summary genome-wide association study (GWAS) data across East Asian and European populations to evaluate the causal relationships between IBD and cancers. Sensitivity analyses for the MR approach …

Effect Of Insufficient Sleep On Activity Limitation: Results From The Brfss 2022 Survey, Jonathan Meyer

Capstone Experience

Objective: To determine whether insufficient sleep (less than 7 hours per night) is associated with activity limitation (14 days or more of poor mental or physical health interfering with everyday activities) in Behavioral Risk Factor Surveillance System (BRFSS) survey data from 2022. Methods: BRFSS is a nationally representative cross-sectional survey of non-incarcerated US adults. The exposure of interest was insufficient sleep, and the outcome of interest was activity limitation. Other demographic variables used in a final weighted adjusted analysis include age >65 years, race/ethnicity, gender, marital status, income, and total physical inactivity. Results: The weighted prevalence of insufficient sleep for …

Restoring, Protecting, And Expanding Abortion Access In The United States: Seeking Consensus Through The Delphi Method, Sarah Pickering

Dissertations and Theses

Background: The Dobbs v. Jackson Women’s Health Organization Supreme Court decision exacerbated inequitable access to abortion in the US. Agreement is needed on which strategies should be prioritized to restore, protect, and expand abortion access.

Methods: We convened a multidisciplinary, geographically diverse Delphi panel of clinical, research, policy, legal, and advocacy experts to reach consensus (i.e., agreement >67%) on recommended actions. Using feedback from three rounds of surveys, and input from a select expert advisory group (N=10), we iteratively refined the statements and recommendations.

Results: The panel (N=85) developed 25 consensus statements and 32 recommendations for action by advocates, funders, …

Environmental Magnesium Ion Affects Global Gene Expression, Motility, Biofilm Formation And Virulence Of Vibrio Parahaemolyticus, Xue Li, Xiaobai Zhang, Miaomiao Zhang, Xi Luo, Tingting Zhang, Xianjin Liu, Renfei Lu, Yiquan Zhang

Journal Articles

No abstract provided.

Contemporary Analysis Of Reexcision And Conversion To Mastectomy Rates And Associated Healthcare Costs For Women Undergoing Breast-Conserving Surgery, Youngran Kim, Cecilia Ganduglia-Cazaban, Nina Tamirisa, Anthony Lucci, Trudy Millard Krause

Journal Articles

PURPOSE: This study was designed to provide a comprehensive and up-to-date understanding of population-level reoperation rates and incremental healthcare costs associated with reoperation for patients who underwent breast-conserving surgery (BCS).

METHODS: This is a retrospective cohort study using Merative™ MarketScan

RESULTS: The commercial cohort included 17,129 women with a median age of 55 (interquartile range [IQR] 49-59) years, and the Medicare cohort included 6977 women with a median age of 73 (IQR 69-78) years. Overall reoperation rates were 21.1% (95% confidence interval [CI] 20.5-21.8%) for the commercial cohort and 14.9% (95% CI 14.1-15.7%) for the Medicare cohort. In both cohorts, …

Efficacy And Safety Of Tepotinib In Asian Patients With Advanced Nsclc With Met Exon 14 Skipping Enrolled In Vision, Terufumi Kato, James Chih-Hsin Yang, Myung-Ju Ahn, Hiroshi Sakai, Masahiro Morise, Yuh-Min Chen, Ji-Youn Han, Jin-Ji Yang, Jun Zhao, Te-Chun Hsia, Karin Berghoff, Rolf Bruns, Helene Vioix, Simone Lang, Andreas Johne, Xiuning Le, Paul K Paik

Journal Articles

BACKGROUND: Tepotinib, a MET inhibitor approved for the treatment of MET exon 14 (METex14) skipping NSCLC, demonstrated durable clinical activity in VISION (Cohort A + C; N = 313): objective response rate (ORR) 51.4% (95% CI: 45.8, 57.1); median duration of response (mDOR) 18.0 months (95% CI: 12.4, 46.4). We report outcomes in Asian patients from VISION (Cohort A + C) (cut-off: November 20, 2022).

METHODS: Patients with advanced METex14 skipping NSCLC, detected by liquid or tissue biopsy, received tepotinib 500 mg (450 mg active moiety) once daily.

PRIMARY ENDPOINT: objective response (RECIST 1.1) by independent review. Secondary endpoints included: …

Application Of Methods To Population-Based Surveys To Reduce Bias In Estimates Of Sars-Cov-2 Infection Burden In The Population, Saba Qasmieh

Dissertations and Theses

BACKGROUND: Population-based surveys designed to randomly sample the population can be a critical and complementary tool to traditional surveillance approaches. Probability-based surveys enable the measurement of SARS-CoV-2 testing and outcomes that avoid issues around self-selection into testing, making them an effective approach to address ascertainment bias in passive surveillance. For surveys to be a useful and reliable surveillance tool for understanding the burden and distribution of SARS-CoV-2 infection, they need to capture prevalence estimates that are both valid and reliable to be optimally informative for public health measures. The dissertation was undertaken to address three main gaps that have implications …

Strengthening U.S. Jail Systems’ Response To Infectious Diseases: An Evaluation Of The Covid-19 Pandemic, Erinn Bacchus

Dissertations and Theses

Jails across the United States were struck with increased infections and deaths during the COVID-19 pandemic. Studies have shown the structural make up of jails, lack of preparedness plans, and overcrowding contributed to health risks and poor health outcomes both inside jails and local communities. Yet little research has been dedicated to strengthening jail responses to infectious disease outbreaks spanning prevention measures, data collection, and reentry planning. Gaps include information on the (1) myriad infectious disease mitigation strategies used in jails and adherence to CDC prevention guidelines, (2) development of a standardized epidemiologic surveillance system, and (3) experiences working at …

Nature Of The Evidence Base And Approaches To Guide Nutrition Interventions For Individuals: A Position Paper From The Academy Of Nutrition Sciences, Mary Hickson, Constantina Papoutsakis, Angela M Madden, Mary Anne Smith, Kevin Whelan

Journal Articles

This Position Paper from the Academy of Nutrition Sciences is the third in a series which describe the nature of the scientific evidence and frameworks that underpin nutrition recommendations for health. This paper focuses on evidence which guides the application of dietary recommendations for individuals. In some situations, modified nutrient intake becomes essential to prevent deficiency, optimise development and health, or manage symptoms and disease progression. Disease and its treatment can also affect taste, appetite and ability to access and prepare foods, with associated financial impacts. Therefore, the practice of nutrition and dietetics must integrate and apply the sciences of …

Differences In Immigrant And U.S. Native Born Patients’ Experiences In The American Healthcare System: A Correlational Study, Betaneya W. Daniel

Virginia Journal of Public Health

Objective: To examine any perceived barriers that might exist in the United States healthcare system and gather data on how different patients experience the system.

Methods: The study utilized a correlational analysis with usage of a Likert scale survey administered to U.S.- born natives, immigrants, and healthcare providers. The survey assessed respondents of their access to healthcare services, barriers to healthcare services, healthcare provider trust/relationships, and health institutions’ relations. Another survey assessed healthcare providers’ belief in the efficacy of their services and health institutions’.

Results: No statistically significant differences were found between U.S. natives and immigrants, but notable distinctions were …

Health Equity: Communicating Impaired Water Status, Emily Potter

Virginia Journal of Public Health

Introduction: Land use changes in the Rivanna River and James River Watersheds have increased the number of impaired recreational waters, and there is a disparity in the equitable communication of these impairments to different populations. Ineffective communication contributes to inequities in access to safe, accessible, and affordable water for vulnerable populations, placing public health at risk.

Methods: This study uses secondary data from the Environmental Protection Agency’s Watershed Index Online (WSIO) Indicator Data Tables, Virginia Department of Environmental Quality (DEQ), Rivanna River Association, and James River Association. Correlations, linear regression, and percent change were used to identify statistically significant trends …

Addressing Farm Safety: Farm Safety Dinner Theaters In The Shenandoah Valley, Tammy Kiser, Michelle Seekford, Jeremy Daubert

Virginia Journal of Public Health

Statistics demonstrate that farm safety and wellness issues affect all ages in the agricultural community. However, an increased proportion of youth and older farm workers comprise the highest rates of farm-related morbidity and mortality. Engaging farmers in increasing safe practices in the agricultural community is an important, ongoing challenge.

Methodology

Farm Safety Dinner Theaters, an initiative created through community-based participatory research (CBPR) at the University of Kentucky, provide a relaxed environment where farmers and their families can identify safety and wellness issues, watch as the actors process these issues, and enjoy a meal. Seeing the situations played out in theater …

Mentorship Matters: Promising Results From Vpha’S Pilot Mentorship Program, Ashley Tharpe, Stacey B. Plichta, Anna R. Robertson, Kim Baskette

Virginia Journal of Public Health

Purpose

The Virginia Public Health Association (VPHA) Pilot Mentorship Program seeks to support public health students, early career professionals, and career switchers throughout the Commonwealth of Virginia in their growth as public health professionals. The program provides opportunities for participants to gain job-seeking and professional communication skills through live webinars, to connect with each other through online networking events, to manage stress through wellness webinars, and to interact with experienced public health professionals.

Methods

VPHA formed a volunteer committee to develop and implement the program in Fall 2022. Initially, the program was envisioned as a traditional one-to-one mentoring program; however, …

Describing Trends In Virginia's Dentist And Dental Hygienist Workforce: Challenges And Opportunities, Shillpa Naavaal, Yetty Shobo, Barbara Hodgdon

Virginia Journal of Public Health

Purpose: Regular assessment of the dental workforce is essential to improve the population's oral health. This analysis aimed to understand the trends in the distribution of dentists and dental hygienists (DHs) in Virginia.

Methods: Annual survey data (2013-2022) of dentists and DHs from the Virginia Department of Health Professions Healthcare Workforce Data Center was used to examine the trends in provider distribution by age, gender, race/ethnicity, and geography across Virginia.

Results: In 2022, there were 5,720 dentists and 5,290 DH licensees in Virginia. In the dentist workforce, there was a high representation of those aged ≥60 years (23%), males (58%), …

Exploring The Lived Experiences Of Rural Texas School Counselors Working With Students’ Mental Health After The Covid-19 Pandemic, Lanessa K. Allman

Doctoral Dissertations and Projects

The purpose of this qualitative descriptive phenomenological study was to describe the lived experiences of rural Texas counselors when working with students’ mental health in the aftermath of the COVID-19 pandemic. The study aims to answer questions of what school counselors describe as the mental health environment for students in rural Texas schools prior, during, and after the COVID-19 pandemic and the changes in the mental health environment of rural students. Most existing research has been focused on how COVID-19 changed school counselors’ roles and responsibilities and how the pandemic affected students’ mental health. The current study concentrated on the …

Assessing Health Needs In A Dominican Republic Community During An Interprofessional Service-Learning Trip, Gabriela Andonie, Hanna Rotundo, Ashanti Jones, Logan Dugas, Shylon Francis

Journal of Interprofessional Practice and Collaboration

Purpose: International medical missions may increase access to medicines and care, but international teams must understand local needs to implement appropriate services. In 2023, a multidisciplinary team from our institution partnered with a nonprofit organization in the barrio of Cienfuegos, Dominican Republic with the goal of strengthening local health services. The primary objective of this study was to identify health-related needs in Cienfuegos from the perspective of community members and local health care workers.

Methods: A qualitative study was conducted as part of a service-learning initiative. After obtaining informed consent, the investigators conducted individual semi-structured interviews facilitated by multi-lingual interpreters. …

The Covid-19 Vaccine Challenge Innovation Sprint: The Utility Of Active Learning In Fostering Interdisciplinary Collaboration In The Hypothetical Development Of A Covid-19 Vaccination Campaign, Jennifer Shaffer Foster, Gabriel N. Attallah, Ritika Bhajiawala, Steven J. Gabriel, Ray Huang, Parveen Attai, Maisha Rahman, Maia Weiss, Sadia M. Rifah, Oluwademilade Daniel Aguda, Dean S. Seneca, Lina Mu

The SUNY Journal of the Scholarship of Engagement: JoSE

In this paper, we discuss the design, goals, and outcome of the COVID-19 Vaccine Challenge Innovation Sprint, which provided an extracurricular, active learning opportunity for undergraduate and graduate students in Fall 2020. The design of the competition drew elements from both innovation sprints, commonly employed in technology and entrepreneurship, and global health case competitions which are largely used in academic settings. Interdisciplinary, multi-level teams of students were tasked with advancing an equitable (and at the time, hypothetical) COVID-19 immunization program with the goal of reaching as many people as possible in the region surrounding the university. We provide student participants’ …

Using College Students As Peer Leaders In A Tobacco Prevention Program And The Effect On Student Participant Smoking Beliefs And Social Influence Leadership, Elizabeth A. Kleitz, Namuna Sunar, Greenlee Rigby

Undergraduate Research Journal for the Human Sciences

This study evaluates the effectiveness of using college students as peer leaders in an after-school tobacco prevention program for upper elementary students. Thirty-three students and three counselors participated in a six-week intervention, focusing on social influence and active-learning strategies. The program aimed to improve students' smoking outcome expectancies and their ability to influence peers against tobacco use. Despite following best practices, the study found no significant changes in students' smoking beliefs or observed leadership abilities. These results suggest that while initial anti-tobacco beliefs remained strong, the short duration and structured setting may have limited opportunities for significant behavioral changes. This …

Mainehealth Cancer Care Network Ticket Intake Process, Lauren Couture, Brett Cropp, Gavin Carr, Ashok Kunche, Heather Boulier, Evelyn Taylor

Operational Transformation

The MaineHealth Cancer Care Network informatics team is manually submitting most reporting tickets for oncology customers. The current intake ticket process includes various communication channels to the business intelligence developers [BID] when a reporting need is identified resulting in workflow deficiencies and redundancies. As of FY23, MaineHealth has moved to a new ticket reporting system called ServiceHub which includes new customer self-service tools that have not yet been utilized.

Creating Capacity To Accommodate Additional Cardiac Catheterization Procedures, Kristin Anthony

Operational Transformation

Patient access to diagnostic outpatient (OP) cardiac catheterization is limited by a perceived lack of capacity. Outpatient cardiac cath pts flow through the ACU for pre/post procedure care. Current schedule limits pts that may be scheduled through the ACU to two OP procedures/day. Cardiologists request the ability to schedule beyond the two procedures/day allowed. Significant variation in pre/postoperative care orders exist amongst cardiologists resulting in variability in length of stay. Cardiac procedures are booked either as 60/90/120 minutes – Epic case averaging technology is not active in the cath lab. As a result, the case minutes in the cath lab …

The Use And Effectiveness Of Diet And Physical Activity As Interventions For Polycystic Ovary Syndrome. A Review., Caroline C. Jones, Jinkyung Park

The Corinthian

Polycystic Ovary Syndrome (PCOS) is a hormonal disorder that is common among women who are of reproductive age, most commonly in ages between 15 and 44 years of age (Moran et al., 2010). While the exact cause of PCOS is unknown, it is widely believed by many experts that genetic factors including excess levels of insulin and excess androgen are attributing factors (Moran et al., 2010) . Women with PCOS experience several different signs and symptoms including; infrequent or prolonged menstrual periods leading to infertility and the development of cysts (Iatrakis et al., 2006). Some other common symptoms of PCOS …

Artistic Expression Of Medical Experiences Of Mothers Of Color: Perspectives Using Art Therapy, Lauren Barrett

Expressive Therapies Dissertations

The purpose of this study was to qualitatively examine perspectives of mothers of color living in the US and their experiences in the healthcare system through art therapy. The study aimed to further identify personal narrative experiences of mothers of color navigating the healthcare system, promote individual voices, and acknowledge disparities impacting those within marginalized communities. The participants in this study included a total of eight identified mothers of color (non-White) living in the US. Participants took part in four weeks of consecutive art therapy sessions either in 60-minute group or individual virtual meetings. One art therapy directive was provided …

Lyme Disease In The Northeast: The Unintended Consequence Of Suburban Development, Hayden Neubert

Student Theses 2015-Present

This paper addresses the role of suburban development in the suburbs of the Northeastern United States in increasing human Lyme disease infection. Over the past 50 years, Lyme disease has become the most common vector-borne disease in the United States. In 2021, the two states with the most Lyme disease cases were New York and New Jersey, with a collective 6,524 cases, with Connecticut still representing 541 total cases. It is not a coincidence that case numbers are concentrated in suburban areas with high forest fragmentation. Chapter 1 of this essay analyzes how human land development disrupts bioregulatory ecosystem actors …

What Is The Effect Of Telehealth And The Internet Of Medical Things (Iomt) On Outcomes When Used In At-Risk Pregnancies: A Scoping Review Of The Components Of Remote Maternal Monitoring For Hypertensive Disorders That Can Successfully Be Done Via Digital Technology?, Leighton Pitter

MUSC Theses and Dissertations

IoMT (Internet of Medical Things) is an emerging technology that facilitates individualized remote e-health services to improve patient's quality of life and satisfaction while decreasing healthcare expenditures. The objective of this scoping review is to explore the usage of IoMT and remote patient monitoring (RPM) in at-risk pregnancies for hypertensive disorders to mitigate pregnancy-related complications. IoMT and other devices in an intelligent health system can meaningfully ameliorate maternal care management in the United States (U.S.). Wearables and nearables, subcategories of IoMT, can be utilized to facilitate patient-centered care and promote excellence in health maintenance/management through a holistic continuum of care …

Medical-Legal Partnerships: Clinician And Lawyer Collaboration To Address The Social Determinants Of Health, Anne Mcdermott, Theresa C. Brabson, Daniel Taylor, Kelly Courts, Noah Buboltz, Hans Kersten

St. Chris Research Day

No abstract provided.