Digital Commons Network^™

Association Of Prior Periodontal Disease With Cancer – Exploring Epidemiologic Evidence Of Periodontal Exudate-Exposed Site Cancer Risk Versus Remote Gastrointestinal Sites, Asma Alzahrani

Theses and Dissertations

Background: Periodontal disease, a chronic bacterial infection of the gums, if untreated, causes chronic inflammation over years and eventual tooth loss. The associations between periodontal disease (measured by missing teeth) and certain sites of cancer have been established, in epidemiological studies, and attributed to systemic inflammatory impacts causing carcinogenic change over decades. Because periodontal exudates are toxic, containing locally bioactive bacteria and toxins, this study hypothesized and studied the potential higher cancer risk of anatomic sites exposed to oral exudates (exudate-exposed site cancers (EEC); head and neck, oral, pharynx, larynx, esophagus, stomach). The study studied the risk of exudate exposed …

Covid-19 And The College Student Experience, Benjamin Cochran

Senior Theses

In March of 2020, COVID-19 consumed the globe, affecting individuals’ physical and mental health. Physical health disparities among states of different political affiliations became clearer as the pandemic continued unrelentingly, but mental health disparities were not. This thesis attempted to note any mental health disparities among college students in states of both political affiliations across the country through an online survey. The 23-question survey was completed by 97 undergraduates at six universities - three in liberal states and three in conservative states. Respondents at universities in the liberal states rated their university and the state in which it is located …

Selective Iga Deficiency In Spontaneously Hypertensive Rats With Gut Dysbiosis, Piu Saha, Blair Mell, Rachel M Golonka, Venugopal R Bovilla, Ahmed A Abokor, Xue Mei, Beng San Yeoh, Peter A Doris, Andrew T Gewirtz, Bina Joe, Matam Vijay-Kumar

Faculty, Staff and Student Publications

BACKGROUND: The spontaneously hypertensive rat (SHR) is extensively used to study hypertension. Gut microbiota dysbiosis is a notable feature in SHR for reasons unknown. Immunoglobulin A (IgA) is a major host factor required for gut microbiota homeostasis. We hypothesized that inadequate IgA contributes to gut microbiota dysbiosis in SHR.

METHODS: IgA was measured in feces, cecum, serum, liver, gut-associated lymphoid tissue, and milk from SHR and Wistar Kyoto rats. IgA regulatory factors like IgM, IgG, and

RESULTS: Compared with Wistar Kyoto rats, SHR displayed remarkably near-deficient IgA levels accompanied by compensatory increases in serum IgM and IgG and gut-liver

CONCLUSIONS: …

In Search Of A Value Proposition For Covid-19 Testing In The Work Environment: A Social Marketing Analysis, Claudia Parvanta, Alberto J. Caban-Martinez, Naciely Cabral, Cynthia K. Ball, Kevin G. Moore, Adrienne Eastlake, Jeffrey L. Levin, Dalia E. Nessim, Matthew S. Thiese, Paul A. Schulte

School of Medicine Faculty Publications and Presentations

Background: This study examined employer experience with SARS-CoV-2 (COVID-19) asymptomatic testing through a social marketing lens. Social marketing uses commercial marketing principles to achieve socially beneficial ends including improved health and safety behavior. Method: Twenty employers across 11 occupational sectors were interviewed about implementation of COVID-19 testing from January through April 2021. Recorded transcripts were coded and analyzed using marketing's "Four P's": "product," "price," "place," "promotion." Results: COVID-19 tests (product) were uncomfortable, were easily confused, and didn't solve problems articulated by employers. Testing was not widely available or didn't line up with shifts or locations (place). The perceived price, which …

Impact Of Adjuvant Radiation Therapy After Definitive Surgery In Senior Adults >80 Years Old With Advanced Head And Neck Squamous Cell Carcinoma On Overall Survival., Joann M Butkus, Meghan Crippen, Voichita Bar-Ad, Adam Luginbuhl

Department of Otolaryngology - Head and Neck Surgery Faculty Papers

Background: Adjuvant radiotherapy (RT) following surgical resection confers a survival benefit for adult patients with locally advanced head and neck squamous cell carcinoma (HNSCC). We aim to investigate if adjuvant RT provides a similar survival advantage to patients ages 80+ through a national curated database.

Methods: This retrospective cohort study queried the National Cancer Database (NCDB) for all cases of HNSCC between 2004-2016. Patients treated with surgical resection alone were compared to those treated with surgery plus adjuvant RT. Overall survival (OS) was compared within adult (age <80 >years) and senior adult (age ≥80 years) cohorts using Kaplan-Meier analysis. Hazard ratios …

Assessing Primary Care Rns Impact On Quality Patient Care, Elizabeth Carreira

Nursing Research and EBP Day 2022

The purpose of this work was to examine how a large multi-site primary care based organization established an organizational structure that supported the determination, definition, measurement, and reporting of nursing sensitive indicators (NSIs) specific to ambulatory care nursing. NSIs capture the value of care provided by nurses and are a critical component of ANCC Magnet designation. The organization considered that successful pursuit of Magnet designation in an all ambulatory organization would involve establishing a framework to report NSIs that included defining nursing units and NSIs meaningful to the organization.

A multidisciplinary team led by nursing was established to examine and …

Service Of People With Psychiatric Problems (Odmk) At The Pasar Baru Health Center And Pabuaran Tumpeng Health Center In Tangerang City In 2022: A Comparative Study, Mentari Kirana Firdaus, Masyitoh Basabih

Journal of Indonesian Health Policy and Administration

Mental health is one of the global health issues with cases that continue to increase every year. In 2019, psychiatric problems were the second leading cause of disability worldwide with a total of 970 million cases. This research is a comparative study that aims to determine the difference between ODMK services at Pasar Baru Health Center and Pabuaran Tumpeng Health Center. This research uses a qualitative approach with a case study method, data collection is done through in-depth interviews and document review. The variables analyzed include input, process, and output. The results of the study found that in the input …

Recent Emergence Of Bovine Coronavirus Variants With Mutations In The Hemagglutinin-Esterase Receptor Binding Domain In U.S. Cattle, Aspen M. Workman, Tara G. Mcdaneld, Gregory P. Harhay, Subha Das, John Dustin Loy, Benjamin M. Hause

School of Veterinary and Biomedical Sciences: Faculty Publications

Bovine coronavirus (BCoV) has spilled over to many species, including humans, where the host range variant coronavirus OC43 is endemic. The balance of the opposing activities of the surface spike (S) and hemagglutinin-esterase (HE) glycoproteins controls BCoV avidity, which is critical for interspecies transmission and host adaptation. Here, 78 genomes were sequenced directly from clinical samples collected between 2013 and 2022 from cattle in 12 states, primarily in the Midwestern U.S. Relatively little genetic diversity was observed, with genomes having >98% nucleotide identity. Eleven isolates collected between 2020 and 2022 from four states (Nebraska, Colorado, California, and Wisconsin) contained a …

Recent Emergence Of Bovine Coronavirus Variants With Mutations In The Hemagglutinin-Esterase Receptor Binding Domain In U.S. Cattle, Aspen M. Workman, Tara G. Mcdaneld, Gregory P. Harhay, Subha Das, John Dustin Loy, Benjamin M. Hause

School of Veterinary and Biomedical Sciences: Faculty Publications

Bovine coronavirus (BCoV) has spilled over to many species, including humans, where the host range variant coronavirus OC43 is endemic. The balance of the opposing activities of the surface spike (S) and hemagglutinin-esterase (HE) glycoproteins controls BCoV avidity, which is critical for interspecies transmission and host adaptation. Here, 78 genomes were sequenced directly from clinical samples collected between 2013 and 2022 from cattle in 12 states, primarily in the Midwestern U.S. Relatively little genetic diversity was observed, with genomes having >98% nucleotide identity. Eleven isolates collected between 2020 and 2022 from four states (Nebraska, Colorado, California, and Wisconsin) contained a …

An Assessment Model Of The Healthcare Entrepreneurship Ecosystem To Foster Solutions For Underserved Communities, Abdalilah Saleh Owaishiz

Dissertations and Theses

There are significant disparities in access to healthcare treatment and this study investigates the healthcare entrepreneurship ecosystem and the challenges and considerations associated within. There is a lack of research on how to evaluate and assess the healthcare entrepreneurship ecosystem especially when applying multi-criteria decision-making (MCDM) methods. The Hierarchical Decision Model (HDM) has been utilized to identify several perspectives and factors grouped under them by the expert’s quantification. This research concentrates on underserved communities because that is where the biggest needs and impact can be made to support achieving health equity and universal health coverage. The findings of this research …

Efficacy Of A Smartphone-Based Care Support Programme In Improving Post-Traumatic Stress In Families With Childhood Cancer: Protocol Of A Randomised Controlled Trial, Jun Ma, Han-Zhu Qian, Yueyang Peng, Yali Xiang, Minghua Yang, Jessica Hahne, Can Gu

2020-Current year OA Pubs

INTRODUCTION: Diagnosis and treatment represent distressing experiences for the families of children with cancer. Psychosocial challenges are faced by these families in China because of limited health services and resources for psychosocial oncology care. Effective interventions tailored to the knowledge level and cultural values of this population are needed. The goal of this study is to evaluate a smartphone-based care support (SBCS) programme for the families of children with cancer in China.

METHODS AND ANALYSIS: A parallel randomised controlled trial will be conducted to examine the efficacy of an evidence-based and culturally tailored SBCS programme for the families of children …

Wastewater-Informed Public Health Intervention Playbook

Sustain Magazine

As the SARS-CoV-2 pandemic quickly spread from country to country and continent to continent in 2020, governments and scientists needed a way to track COVID-19 through populations in order to position public health interventions in the most impactful locations. Having a decision-based risk framework may help to guide policy creation that could minimize or prevent possible outbreaks and surges of infection within communities. The University of Louisville in partnership with Louisville’s Department of Public Health and Wellness tested this strategy in 2021 and 2022. This Wastewater-Informed Public Health Intervention Playbook describes the decisions and actions of that academic and public …

Availability Of Hospital-Based Cancer Services Before And After Rural Hospital Closure, 2008-2017, Whitney Zahnd Ph.D., Peiyin Hung Ph.D., Sylvia Kewei Shi, Anja Zgodic, Melinda A. Merrell Ph.D., Elizabeth L. Crouch, Janice C. Probst, Jan Eberth Ph.D.

Faculty Publications

Introduction

Rural populations have less access to cancer care services and experience higher cancer mortality rates than their urban counterparts, which may be exacerbated by hospital closures. Our objective was to examine the impact of hospital closures on access to cancer-relevant hospital services across hospital service areas (HSAs).

Methods

We used American Hospital Association survey data from 2008 to 2017 to examine the change in access to cancer-related screening and treatment services across rural HSAs that sustained hospitals over time, experienced any closures, or had all hospitals close. We performed a longitudinal analysis to assess the association between hospital closure …

American Indians And Covid-19: Morbidity And Mortality Disparities Among Indigenous Populations In The Rural South, Leslie Musshafen, Thomas E. Dobbs, Aaron Robinson, Thomas Wyatt, Michael Puskarich, Richard Summers, Seth Lirette, Caroline Compretta

Journal of Public Health in the Deep South

Background The COVID-19 pandemic has highlighted health inequities among indigenous populations, with those in rural settings facing compounded barriers.Purpose To investigate morbidity and mortality experiences among hospitalized, COVID-19+ American Indian adults from rural and urban settings.Methods The described cross-sectional study used retrospective discharge data from the University of Mississippi Medical Center and Hennepin County Medical Center. Adults (≥ age 18) admitted from January 1, 2020 to August 8, 2021with a COVID-19 diagnosis and known race were included.Results A total of 3,659 inpatients met inclusion criteria. Among adults hospitalized with COVID-19 at the University of Mississippi Medical Center, American Indians (n=73) …

Neighborhood Characteristics And Dementia Symptomology Among Community-Dwelling Older Adults With Alzheimer’S Disease, Dana M. Alhasan, Matthew C. Lohman Ph.D., Jana A. Hirsch, Margaret Chandlee Miller Ms, Ph.D., Bo Cai Ph.D., Chandra L. Jackson

Faculty Publications

Background: Neuropsychiatric symptoms (NPSs) lead to myriad poor health outcomes among individuals with Alzheimer’s disease (AD). Prior studies have observed associations between the various aspects of the home environment and NPSs, but macro-level environmental stressors (e.g., neighborhood income) may also disrupt the neuronal microenvironment and exacerbate NPSs. Yet, to our knowledge, no studies have investigated the relationship between the neighborhood environment and NPSs.

Methods: Using 2010 data among older adults with AD collected from a sample of the South Carolina Alzheimer’s Disease Registry, we estimated cross-sectional associations between neighborhood characteristics and NPSs in the overall population and by race/ethnicity. Neighborhood …

Barriers To Sars-Cov-2 Testing Among U.S. Employers In The Covid-19 Pandemic: A Qualitative Analysis Conducted January Through April 2021, Alberto J. Caban-Martinez, Claudia Parvanta, Naciely Cabral, Cynthia K. Ball, Adrienne Eastlake, Jeffrey L. Levin, Kevin Moore, Dalia Nessim, Ernie Stracener, Matthew S. Thiese, Paul A. Schulte

School of Medicine Faculty Publications and Presentations

During the first year of the COVID-19 pandemic, U.S. companies were seeking ways to support their employees to return to the workplace. Nonetheless, the development of strategies to support the access, use, and interpretation of SARS-CoV-2 testing was challenging. In the present study, we explore, from the perspective of owners and company leadership, the barriers to SARSCoV-2 testing among U.S. companies. Key informant interviews with company representatives were conducted during January--April 2021 about SARS-CoV-2 testing. A pre-interview survey assessed respondent socio-demographic and organizational characteristics. Interview sessions were transcribed, coded, and analyzed using MaxQDA. A total of twenty interviews were completed …

Association Between Socioeconomic Status And Mental Health Among China’S Migrant Workers: A Moderated Mediation Model, Yubo Shao, Huang Ying, Xiaoming Li Ph.D., Lian Tong

Faculty Publications

Mental health problems are prevalent among China’s internal migrant workers. However, research on the relationship between socioeconomic status (SES) and mental health is insufficient. Therefore, this study, utilizing the China’s National Dynamic Monitoring Survey data from a sample of 15,997 migrant workers aged 15–59 years to explore differences in the relationship between migrants’ objective and subjective SES and mental health status in 2015. Both the mediating effect of perceived interpersonal discrimination and the moderating effect of age were examined through structural equation modeling. The results indicated that subjective SES has a stronger direct relationship with mental health than objective SES. …

Athlete Experiences Of Communication Strategies In Applied Sports Nutrition And Future Considerations For Mobile App Supportive Solutions, David Mark Dunne, Carmen Lefevre-Lewis, Brian Cunniffe, Samuel George Impey, David Tod, Graeme Leonard Close, James P. Morton, Rebecca Murphy

Research outputs 2022 to 2026

Aim:

This study aimed to explore athletes' experiences and opinions of communication strategies in applied sports nutrition, as well as capture suggestions for future mobile app supportive solutions.

Methods:

A qualitative approach was used for this research. Data was generated from semi-structured focus groups (n = 9) with a purposive sample of 41 (male = 24, female = 17) full time professional athletes (mean age 24 ± 4.59) from five sports (football, rugby union, athletics, cycling, and boxing). Data was analyzed using reflexive thematic analysis.

Results:

The analysis identified four higher order themes and five sub themes. Athletes appear dissatisfied …

Associations Of 24-Hour Movement Behaviors, Parental Academic Support, And Academic Achievement In Alaskan Adolescents, You Fu, Ryan D. Burns, Nora Constantino, Xavier Lopez, Samantha Dyer

International Journal of Physical Activity and Health

The purpose of this study was to examine the associations between meeting recommendations for 24-hour movement behaviors, parental academic support, and student academic achievement in a sample of Alaskan adolescents. Data were obtained from the 2019 Alaska Youth Risk Behavior Survey (YRBS; N = 1,897; mean age = 15.8 ± 1.3 years old). The associations between meeting recommendations for the 24-hour movement behaviors of physical activity, screen use, and sleep with high academic achievement (mostly A’s and B’s) were examined using weighted multivariable logistic regressions. Subpopulation analyses determined if associations differed by levels of parental academic support. Approximately 18.8% of …

Air Quality And Cancer Prevalence Trends Across The Sub-Saharan African Regions During 2005–2020, Omolola Okunromade, Jingjing Yin, Clara Ray, Atin Adhikari

Health Policy & Community Health: Faculty Publications

Poor air quality and environmental pollution remain some of the main etiological factors leading to cancers and cancer-related deaths worldwide. As a result of human activities, deleterious airborne chemicals can be dispersed not only in the environment but also released in occupational environments and industrial areas. Air pollutants and cancer links are now established through various oxidative stress-related mechanisms and related DNA damages. Generally, ambient and indoor air pollutants have been understudied in sub-Saharan Africa (SSA) compared to other regions in the world. Our study not only highlights the deleterious effects of air pollutants in these developing countries, but it …

Volume 5, Issue 1 (2022) Migration, Community, And Environment During A Pandemic

International Journal on Responsibility

No abstract provided.

Geographic Proximity To Primary Care Providers As A Risk-Assessment Criterion For Quality Performance Measures, Nathaniel Bell, Ana Lopez-De Fede Ph.D., Bo Cai Ph.D., John Brooks Ph.D.

Publications

Importance Previous studies have found a mixed association between Patient-Centered Medical Home (PCMH) designation and improvements in primary care quality indicators, including avoidable pediatric emergency department (ED) encounters. Whether these associations persist after accounting for the geographic locations of providers relative to where patients reside is unknown. Objective To examine the association between geographic proximity to primary care providers versus hospitals and risk of avoidable and potentially avoidable ED visits among children with pre-existing diagnosis of attention-deficit/hyperactivity disorder or asthma. Methods Retrospective cohort study of a panel of pediatric Medicaid claims data from the South Carolina from 2016–2018 for 2,959 …

Concentrated Incarceration And The Public-Housing-To-Prison Pipeline In New York City Neighborhoods, Jay Holder, Ivan Calaff, Brett Maricque, Van C Tran

2020-Current year OA Pubs

Using public housing developments as a strategic site, our research documents a distinct pathway linking disadvantaged context to incarceration-the public-housing-to-prison pipeline. Focusing on New York City Housing Authority (NYCHA) housing developments as a case study, we find that incarceration rates in NYCHA tracts are 4.6 times higher than those in non-NYCHA tracts. More strikingly, 94% of NYCHA tracts report rates above the median value for non-NYCHA tracts. Moreover, 17% of New York State's incarcerated population originated from just 372 NYCHA tracts. Compared with non-NYCHA tracts, NYCHA tracts had higher shares of Black residents and were significantly more disadvantaged. This NYCHA …

Frequency Of Bystander Exposure To Antibiotics For Enteropathogenic Bacteria Among Young Children In Low-Resource Settings, Elizabeth T. Rogawski Mcquade, Stephanie A. Brennhofer, Sarah E. Elwood, Timothy L. Mcmurry, Joseph A. Lewnard, Estomih R. Mduma, Sanjaya Shrestha, Najeeha Talat Iqbal, Pascal O. Bessong, Gagandeep Kang

Department of Paediatrics and Child Health

Children in low-resource settings carry enteric pathogens asymptomatically and are frequently treated with antibiotics, resulting in opportunities for pathogens to be exposed to antibiotics when not the target of treatment (i.e., bystander exposure). We quantified the frequency of bystander antibiotic exposures for enteric pathogens and estimated associations with resistance among children in eight low-resource settings. We analyzed 15,697 antibiotic courses from 1,715 children aged 0 to 2 y from the MAL-ED birth cohort. We calculated the incidence of bystander exposures and attributed exposures to respiratory and diarrheal illnesses. We associated bystander exposure with phenotypic susceptibility of E. coli isolates in …

Bone Health Management In The Continuum Of Prostate Cancer Disease, Ettickan Boopathi, Ruth Birbe, Sunday A. Shoyele, Robert B. Den, Thangavel Chellappagounder

Department of Medicine Faculty Papers

Prostate cancer (PCa) is the second-leading cause of cancer-related deaths in men. PCa cells require androgen receptor (AR) signaling for their growth and survival. Androgen deprivation therapy (ADT) is the preferred treatment for patients with locally advanced and metastatic PCa disease. Despite their initial response to androgen blockade, most patients eventually will develop metastatic castration-resistant prostate cancer (mCRPC). Bone metastases are common in men with mCRPC, occurring in 30% of patients within 2 years of castration resistance and in >90% of patients over the course of the disease. Patients with mCRPC-induced bone metastasis develop lesions throughout their skeleton; the 5-year …

Persistent Disparities In Colorectal Cancer Screening: A Tell-Tale Sign For Implementing New Guidelines In Younger Adults, Po-Hong Liu, Nina N Sanford, Peter S Liang, Amit G Singal, Caitlin C Murphy

Faculty, Staff and Student Publications

BACKGROUND: In May 2021, the U.S. Preventive Services Task Force began recommending initiating colorectal cancer screening at age 45 (vs. 50) years.

METHODS: We estimated prevalence of colorectal cancer screening (by colonoscopy, sigmoidoscopy, CT colonography, or stool-based tests) in adults ages 50 to 75 years using data from the National Health Interview Survey in 2000, 2003, 2005, 2008, 2010, 2013, 2015, and 2018. For each survey year, we estimated prevalence by age, race/ethnicity, educational attainment, family income, and health insurance. We also compared increases in prevalence of screening from 2000 to 2018 in 5-year age groups (50-54, 55-59, 60-64, 65-69, …

Chd1 Promotes Sensitivity To Aurora Kinase Inhibitors By Suppressing Interaction Of Aurka With Its Coactivator Tpx2, Haoyan Li, Yin Wang, Kevin Lin, Varadha Balaji Venkadakrishnan, Martin Bakht, Wei Shi, Chenling Meng, Jie Zhang, Kaitlyn Tremble, Xin Liang, Jian H Song, Xu Feng, Vivien Van, Pingna Deng, Jared K Burks, Ana Aparicio, Khandan Keyomarsi, Junjie Chen, Yue Lu, Himisha Beltran, Di Zhao

Faculty, Staff and Student Publications

UNLABELLED: Clinical studies have shown that subsets of patients with cancer achieve a significant benefit from Aurora kinase inhibitors, suggesting an urgent need to identify biomarkers for predicting drug response. Chromodomain helicase DNA binding protein 1 (CHD1) is involved in chromatin remodeling, DNA repair, and transcriptional plasticity. Prior studies have demonstrated that CHD1 has distinct expression patterns in cancers with different molecular features, but its impact on drug responsiveness remains understudied. Here, we show that CHD1 promotes the susceptibility of prostate cancer cells to inhibitors targeting Aurora kinases, while depletion of CHD1 impairs their efficacy in vitro and in vivo. …

Exit Rates Of Accountable Care Organizations That Serve High Proportions Of Beneficiaries Of Racial And Ethnic Minority Groups, Sunny C Lin, Karen E Joynt Maddox, Andrew M Ryan, Nicholas Moloci, Addison Shay, John Malcolm Hollingsworth

2020-Current year OA Pubs

Importance: The Medicare Shared Savings Program provides financial incentives for accountable care organizations (ACOs) to reduce costs of care. The structure of the shared savings program may not adequately adjust for challenges associated with caring for patients with high medical complexity and social needs, a population disproportionately made up of racial and ethnic minority groups. If so, ACOs serving racial and ethnic minority groups may be more likely to exit the program, raising concerns about the equitable distribution of potential benefits from health care delivery reform efforts.

Objective: To evaluate whether ACOs with a high proportion of beneficaries of racial …

Prevalence And Risk Factors Associated With Depression In Pregnant Adolescents In Nairobi, Kenya, Albert Tele, Joseph Kathono, Shillah Mwaniga, Vincent Nyongesa, Obadia Yator, Onesmus Gachuno, Dalton Wamalwa, Beatrice Amugune, Zul Merali, Manasi Kumar

Brain and Mind Institute

Background: Adolescent parenthood can be associated with a range of adverse outcomes for young mothers such as depression, substance abuse, and posttraumatic stress disorder. Identification of depression and understanding risk factors among pregnant adolescents is important for development of appropriate interventions and programs focused on adolescent mental health. This paper reports on the findings of the prevalence of depression and its associated risk factors among pregnant adolescents in Nairobi, Kenya.

Methods: We recruited 153 pregnant adolescent (14-18 years) who were accessing maternal health services in one of two Nairobi County primary health care facilities in the cross-sectional survey …

Understanding Distruptive Change In Health Care: Perspectives From The Front Lines Of Covid, Wendy Vaughon

Dissertations and Theses

COVID-19 dramatically stressed an already overburdened healthcare system. Physicians, susceptible to burnout, bore the brunt of this threat as frontline providers. Limited data are available describing how the pandemic may have affected physician perceptions and beliefs, including experiences of burnout and plans to exit the field. Reddit, a social media website, allows physicians the ability to interact with their peers pseudonymously on a purpose-driven, publicly viewable subreddit (r/medicine). By providing a space for “physicians and other medical professionals” to interact, it is possible to observe unfiltered discourse.

This dissertation explores physician-peer discourse on Reddit prior to and during the COVID-19 …