Digital Commons Network^™

Gun Violence And Maternal Mortality In The Mississippi Delta: A Dual Public Health Crisis, Nelson Atehortua, Mary Shaw-Ridley

Journal of Public Health in the Deep South

No abstract provided.

The Culture Cure: Behavioral Supervision And The Regulation Of Financial Institutions, David B. Lourie

Mercer Law Review

This Article advances a normative claim: U.S. financial regulators must move beyond primarily adversarial, enforcement-driven models and adopt behavioral supervisory tools—particularly elements of culture assessments—to proactively help guide ethical firm conduct and mitigate systemic risk. Importantly, the proposal here is incremental and resource-efficient. Many recommendations place the onus on firms to assess and demonstrate their culture, while regulators set expectations, review outputs, and selectively verify findings. The framework proceeds in progressive stages—beginning with voluntary, partnership-based initiatives, moving toward light-touch integration within existing examinations, and scaling only where persistent governance weaknesses or systemic risks warrant closer attention. This tiered approach reflects …

Recognizing Structural And Social Determinants Of Health In The Diagnosis And Care Of Dementia, Shana D Stites, Sharnita Midgett, Nisha Patel, Kimberly Halberstadter, Rosalie Schumann, Marissa L Streitz, Yidan Shi, John C Morris, Jason Flatt, Crystal M Glover, Dawn Mechanic-Hamilton

2020-Current year OA Pubs

Structural and social determinants of health are environmental conditions that affect individuals' health and functioning across the life course. These determinants are salient factors at the apex of individual psychology, community variables, and larger sociological factors, exerting prominent effects on individuals' wellbeing. The National Institute on Aging seeks to understand their influence on aging and Alzheimer's disease. We propose that the benefits of doing so may reach beyond knowledge of disease mechanisms - it may also improve clinical outcomes. We describe efforts introducing structural and social determinants of health data into the national network of Alzheimer's disease research centers. We …

Navigating (M)Otherhood: Perception, Practice, & Policy Of Adolescent Pregnancy In The North Coast Of Perú, Mahir Rahman

USF Tampa Graduate Theses and Dissertations

“It’s a vicious circle”, the obstetricians of Huanchaco repeated time and time again after discussing a recently pregnant 13-year-old girl who had just moved to the North Coast of Perú. Adolescent pregnancy is an extremely stigmatized topic in global maternal and child health discourse. Pregnant adolescents are subject to educational policy, clinical protocol, and community practice. While global scholarship emphasizes adolescent pregnancy prevention, limited scholarship focuses on the conditions in which adolescent pregnancy is perceived, discussed, and managed. More importantly, these perspectives are even less documented amongst the North Coast of Perú.

This thesis serves as an ethnographic exploration of …

From Waitlist To Activation: Exploring Patient Barriers And Team Interactions In Kidney Transplant Readiness, Judith I. Eguzoikpe

Harrisburg University Dissertations and Theses

Kidney transplant candidates frequently experience prolonged inactive waitlist status due to incomplete readiness requirements, yet limited understanding exists regarding how patient barriers and team interactions intersect to influence activation timelines. This transcendental-phenomenological study explored how patient barriers and team dynamics contribute to delays in kidney transplant readiness, guided by Team Theory. Semi-structured interviews were conducted with 16 participants (8 patients, 8 healthcare professionals) between December 2025 and February 2026. Data were analyzed using systematic phenomenological methods to identify patterns that address patient barriers, team interaction effects, and the teamwork improvements needed for earlier activation. Five interconnected themes emerged: Navigating a …

The Relationship Between Social Determinants And Primary Care Utilization Among Medicaid Recipients In A Managed Care Community Health Worker Program, Rachel Elaine Rosensteel

Walden Dissertations and Doctoral Studies

Community health worker (CHW) programs are an increasingly important strategy for addressing social determinants of health (SDOH) within Medicaid systems. However, evidence on how specific SDOH impact healthcare utilization remains limited. In this quantitative, correlational study, the relationship between SDOH factors like housing instability, food insecurity, and transportation barriers, and primary care utilization among adult Medicaid recipients aged 18–65 who participated in a Medicaid managed care organization’s CHW program in Clark County, Nevada, during 2023 were examined. Retrospective administrative data from 441 participants were analyzed using negative binomial regression to assess associations between SDOH factors and postintervention primary care visits …

Managing Acute Myocardial Infarction In Remote Oman: Real-World Data From Al Wusta Governorate, Thuraiya Malik Abdullah Al Harthi, Ibrahim Al Mahrouqi, Amin Elbanna, Karema Hamed, Mohammed Abushilla, Venkatesh Kumar, Maryam Al Nabhani, Hasina Al Harthi, Abdulmunim Al Farsi, Adil Al Mahrouqi

Sultan Qaboos University Medical Journal

Objectives: Acute ST-segment elevation myocardial infarction (STEMI) is a time-sensitive cardiac emergency requiring prompt reperfusion therapy. Management and outcomes in remote areas are underexplored. This study explored the STEMI reperfusion network in Al Wusta governorate in Oman and evaluated the effectiveness of pharmacological thrombolysis in general practitioner (GP)-led, resource-limited hospitals. Methods: This retrospective study reviewed administrative health registries and medical records of patients presenting with STEMI to hospitals in the Al Wusta governorate between June 2017 and December 2024. Response to thrombolysis was defined as 50% resolution of ST-segment on electrocardiogram. Outcomes post-thrombolysis were prespecified. Multivariate logistic regression was used …

Associations Between The Microbiome And Immune Responses To An Adenovirus-Based Hiv-1 Candidate Vaccine Are Distinct Between African And Us Cohorts, Yuhao Li, Daniel J Stieh, Lindsay Droit, Andrew Hyoungjin Kim, Rachel Rodgers, Kathie A Mihindukulasuriya, Leran Wang, Maria G Pau, Olive Yuan, Herbert W Virgin, Dan H Barouch, Megan T Baldridge, Scott A Handley

2020-Current year OA Pubs

Optimization of prophylactic vaccine regimens to elicit strong, long-lasting immunity is an urgent need highlighted by the COVID-19 pandemic. Stronger vaccine immunogenicity is frequently reported in individuals living in high-income countries compared to individuals living in low- and middle-income countries. While numerous host genetic and immune factors may influence vaccine responses, geographic restrictions to vaccine effectiveness may also be influenced by the intestinal microbiota, which modulates host immune systems. However, the potential role of the gut microbiota on responses to HIV-1 vaccines has not yet been explored. We analyzed the bacteriome by targeted 16S sequencing and the virome by virus-like …

Global Public Health Feasibility: Digital Dentistry In Geriatric Population, Merna Amr Saleh

Theses and Dissertations

Oral health is a critical yet often overlooked determinant of well-being among older adults in Egypt, where mobility limitations, geographic barriers, and low awareness of preventive practices exacerbate dental disparities. DentalPal, a teledentistry-based mobile application, was developed to provide older adults with remote dental consultations, oral hygiene advice, and triage guidance. The platform enables users to submit oral photographs or radiographs for assessment, seek second opinions, and initiate follow-up chats directly with the healthcare provider. This flexible design allows users to access dental consultations on demand while ensuring continuity of care The question that guided this study was how older …

Beyond "Place Matters": Making Spatial Analysis Accessible With Dashboard-Driven Geography, Stephen Borders

Public Health

This article presents an instructional module that uses Tableau to teach spatial thinking and policy geography through an analysis of Supplemental Nutrition Assistance Program (SNAP) participation. Tableau’s ability to integrate custom spatial files with demographic and health data makes it an accessible platform for introducing geographic inquiry without requiring specialized GIS expertise. The lesson guides instructors through building maps, bullet charts, and scatterplots that highlight gaps between eligibility and enrolment, while connecting food insecurity to health outcomes. By lowering technical barriers, Tableau provides a pedagogical bridge that helps educators foster spatial literacy in diverse classroom contexts.

This article was published …

Ensuring Successful H. Pylori Test Of Cure: A Quality Improvement Initiative Focused On Post-Treatment Testing, Prajjwol D. Bhatta, Smriti Bhetuwal, Asim Pandey, Ahmed Shehadah, John Shrestha, Venkat Arutla, Chengu Niu, Himal Kharel, Abdullah Ahmed

Advances in Clinical Medical Research and Healthcare Delivery

Background

Eradication of Helicobacter. Pylori (HP) infection is crucial for preventing serious sequelae, such as peptic ulcer disease and gastric malignancies. The ACG guideline recommends mandatory re-testing to ensure HP eradication. However, studies have shown that only less than 25% of patients undergo eradication testing.

Objectives:

The main objective of this study is to evaluate the effectiveness of a simple educational intervention on test of cure compliance rate. Our target population includes patients with confirmed HP infection who were treated with HP eradication therapy.

Design: Quality improvement pre-post intervention

Participants: Internal Medicine residents

Intervention: Educational training on the importance …

The Scope And Impact Of Walking The Talk For Dementia 2024, Sherril B. Gelmon, Kate Irving, Walter Dawson, Jonathan Adrián Zegarra-Valdivia, Lingani Mbakile-Mahlanza, Fernando Aguzzoli-Peres

Institute on Aging Publications

Walking the Talk for Dementia (WTD) is a global educational initiative integrating a walk along the Camino de Santiago with a symposium to combat dementia stigma, raise awareness, and foster inclusion.

The Global Cancer Crisis: A Review Of Growing Burden, Deepening Inequality And Initiatives For Prevention And Early Detection, Charles Yankah, Jonathan Nwiloh, Carlos Mestres, Abdelmalek Bouzid, Tom Mwambu, Andrew Duncan, Mohamed Debieche, Samuel Omokhodion, Uvie Onakpoya, Matthias Angres

General Surgery, East Africa

Cancer constitutes one of the most urgent global health crises, with over 20 million new cases diagnosed annually worldwide, claiming 10 million lives. This devastating burden disproportionately affects vulnerable populations: 75% of cancer deaths occur in low- and middle-income countries despite these regions having lower reported incidence rates. Lung cancer leads the global toll, representing 12% of all cases but 19% of deaths, followed by breast cancer (12% of cases) and colorectal cancer (9.6%). A stark geographical inequity defines the cancer landscape—while wealthy regions such as North America, Northern Europe and Australia report the highest incidence rates, Africa and Latin …

The Concept Of Environmental Injustice In Allergy And Asthma, Ekta Perera, Christopher Codispoti, Mahboobeh Mahdavinia

Faculty, Staff and Student Publications

Purpose of review: This review examines how environmental injustice contributes to disparities in allergic diseases, including asthma, allergic rhinitis, and atopic dermatitis. It focuses on the role of social, geographic, and economic inequities in shaping disease prevalence, severity, and access to care among underrepresented racial and ethnic communities.

Recent findings: Recent studies emphasize the persistent exposure of low-income and racially marginalized populations to environmental hazards such as air pollution, substandard housing, and climate-related changes, factors that are linked to increased prevalence and severity of allergic diseases. While environmental policies have led to overall improvements in air quality, disparities in exposure …

Effects Of Dual-Eligible Integrated Care Plans On Medicaid Enrollment And Retention: Evidence From The Implementation Of Medicare-Medicaid Plans, Eric T Roberts, Eliza Macneal, Kenton J Johnston, José F Figueroa

2020-Current year OA Pubs

Medicare and Medicaid are separate programs that together cover 13 million low-income older adults and people with disabilities, known as dual-eligible individuals. Concern about a lack of coordination across Medicare and Medicaid has prompted the development of Integrated Care Programs (ICPs). Although the primary goal of ICPs is to coordinate financing and care across Medicare and Medicaid, ICPs may also influence whether low-income individuals obtain or keep Medicaid. We evaluated whether the rollout of Medicare-Medicaid Plans (MMPs)-one of the largest ICPs-was associated with changes in Medicaid take-up and retention among Medicare beneficiaries residing in high-poverty zip codes. Using a stacked …

Factors Associated With Rare Pediatric Cancer Trial Enrollment: A Report From The Children's Oncology Group Rare Tumors Committee, Brian R Englum, Jin Piao, Lindsay Younis, Reto M Baertschiger, Kenneth S Chen, Emily Christison-Lagay, Hetal Dholaria, Robyn Gartrell, M John Hicks, Junne Kamihara, Sarah G Mitchell, Manuela Orjuela-Grimm, Farzana Pashankar, Samara L Potter, Jennifer H Aldrink, Jeremy Rosenblum, Michael R Sargen, Kris Ann P Schultz, Brittani K N Seynnaeve, Mary Wedekind, Theodore W Laetsch

Faculty, Staff and Students Publications

Background: Over 90% of US children with cancer are treated at Children's Oncology Group (COG) centers, which seek to maximize enrollment in therapeutic and biobanking studies. Rare cancers have demonstrated lower than expected COG enrollment. We evaluated trends in COG rare cancer enrollment compared to US incidence from Surveillance, Epidemiology, and End Results (SEER) registries, examining the impact of COG therapeutic trials and Project:EveryChild, a cancer biobank/registry.

Procedure: COG and SEER data from 2002 to 2020 were queried for US patients younger than 18 years old with adrenocortical carcinoma (ACC), nasopharyngeal carcinoma (NPC), retinoblastoma (RB), thyroid carcinoma, and melanoma. We …

Determinants Of Severe Financial Distress In U.S. Acute Care Hospitals: A National Longitudinal Study, James R Langabeer, Francine R Vega, Audrey Sarah Cohen, Tiffany Champagne-Langabeer, Andrea J Yatsco, Karima Lalani

Faculty, Staff and Student Publications

Background: Financial sustainability remains a central challenge for U.S. hospitals as rising operating costs, shifting federal reimbursement, and policy uncertainty intensify economic pressures. This study estimates the prevalence and recent changes in financial distress among U.S. short-term acute care hospitals.

Methods: We conducted a national longitudinal analysis of all U.S. short-term acute care hospitals from 2021 to 2023 using financial and operational data from Medicare cost reports linked with community-level data from the American Community Survey. Financial distress was measured using the Altman Z-score, with severe distress defined as Z ≤ 1.8. Logistic regression models were used to …

Surviving Staten Island: Black Women’S Narratives Of Resilience, Motherwork, And Embodied Trauma, Jazmin Rivera

Student Theses

This oral history dissertation centers the experiences of six Black women who had formative experiences navigating hostile school and community-based settings on Staten Island during the 1970s, 1980s, and early 1990s. Guided by a conceptual framework that draws on Black orality, Black feminist thought, and endarkened feminist epistemology, this study demonstrates how Black women were required to cross geographic and social boundaries to survive hostile conditions in Staten Island communities and schools. Findings from this study highlight Black women’s use of community cultural wealth to inform their survival strategies and resilience. At the same time, their experiences indicate the potential …

The Influence Of The Mental Health Parity And Addiction Equity Act On Residential Behavioral Healthcare Facility Availability In The United States: A State-Level Analysis, Amanda Mellowspring

ETDs from 2020-2029

The need for accessible, quality behavioral healthcare (BH) has increased dramatically over recent decades. The availability of BH services for patients has long been complicated by high cost, lack of insurance coverage, and location accessibility. BH organizations face ongoing challenges to meet the demand for services including costs of operation, worker shortages, and navigating the payer landscape. The history of BH in the U.S. provides the foundation to conceptualize federal regulations and attempts at parity. Literature regarding federal legislation, such as the Mental Health Parity Addiction and Equity Act (MHPAEA), the Affordable Care Act, and Medicaid expansion; BH facilities and …

Nutrition Assistance Programs And Pediatric Weight Outcomes: A Systematic Review, Dan Ferris, Genevieve Davison, Tyler Frank, Amanda Gilbert, Fanice Thomas, Sydney Rothman, Kim Lipsey, Sarah Moreland-Russell

2020-Current year OA Pubs

BACKGROUND/OBJECTIVES: Food insecurity and pediatric obesity have increased concurrently in the U.S., raising questions about the role of Federal Nutrition Assistance Programs (FNAPs) in shaping weight outcomes. This systematic review examined evidence on relationships between FNAP participation and pediatric weight outcomes.

METHODS: Six databases were searched for U.S.-based, peer-reviewed studies published through July 2024 that assessed FNAP participation and pediatric weight outcomes.

RESULTS: Seventy-five studies met the inclusion criteria, and no consistent pattern indicated that any single FNAP or program type (educational setting-based or direct financial support) reliably reduced or increased childhood overweight or obesity risk. Twenty studies found statistically …

Respiratory Health And Environmental Risks Among California Children: The Role Of Socioeconomic Status, Wen Chieh Chia

Walden Dissertations and Doctoral Studies

Abstract Air pollution has been cited as a factor in the development of respiratory illness in children. Socioeconomic differences can intensify the effects of air pollution exposure on low-income children compared to higher-income children. This correlational study examined the relationship between air pollution exposure and respiratory health outcomes among California children, as well as the moderating role of socioeconomic status. The study was guided by the environmental health disparities framework and used secondary data from the California Environmental Health Tracking Program, analyzing data from 49 California counties (n = 49). Independent variables were PM2.5 concentrations and the number of ozone …

Liberalizing Hospital Proximity Requirements For Children/Young Adults With Low-Burden B-All Receiving Tisagenlecleucel., Lauren E. Appell, Christina Baggott, Khanh Nguyen, Snehit Prabhu, Holly Pacenta, Samuel John, Vanessa A. Fabrizio, Christine L. Phillips, Jenna Rossoff, Julie-An Talano, Amy Moskop, Rachel Phelan, Susanne H C Baumeister, Michael R. Verneris, Erin Hall, Gary Douglas Myers, Nicole A. Karras, Stacy L. Cooper, Muna Qayed, Sunil S. Raikar, Lena Winestone, Michelle Hermiston, Prakash Satwani, Christa Krupski, Amy K Keating, Danielle N. Friedman, Kevin J. Curran, Alex Hoover, Margaret L. Macmillan, Christen L. Ebens, Archana Ramgopal, April L. Rahrig, Crystal L. Mackall, Theodore W. Laetsch, Kevin Mcnerney, Liora M. Schultz

Manuscripts, Articles, Book Chapters and Other Papers

No abstract provided.

Learning Experiences From An Interprofessional, University-Based, Student-Led Healthcare Clinic In The Uk., Katharine Wood, Helen Frank, Konstantinos Papadopoulos

Journal of Interprofessional Practice and Collaboration

Student-led clinics (SLCs) are increasingly being adopted in physiotherapy and occupational therapy degree programs. SLCs are an innovative practice-based learning model that offers unique learning opportunities while solving the challenges of sourcing appropriate placements. However, there is little recent evidence of their use in healthcare education in the UK. To address this literature gap, a synchronous online focus group with seven participants was conducted to explore the learning experiences of undergraduate occupational therapy and physiotherapy students who attended an inter-professional, non-elective, university-based SLC in the UK. A thematic analysis approach was used to identify three main themes: (1) Learning With, …

Cancer Literacy And Social Determinants Of Health: An Epidemiological Analysis Of Trust, Digital Engagement, And Healthcare Utilization In Cancer Information Seeking, Kimberly Leeann Hazel

Walden Dissertations and Doctoral Studies

The rise of online health information has increased access to cancer resources but also amplified misinformation, creating trust gaps that threaten prevention, treatment, and health equity. This study examined how trust in cancer information sources, online information-seeking, and healthcare perceptions relate among U.S. adults. Guided by the health information seeking behavior, the socioecological model, and the structural influence model of health communication, data from the 2022 Health Information National Trends Survey (N = 6,197) were analyzed with logistic regression, mediation, and moderation modeling, controlling for demographics. Trust in government agencies predicted greater cancer information seeking (odds ratio [OR] = 1.94, …

The Black Mother-Daughter Developmental Model: A Life Course Framework For Understanding Matrescence, Identity, And Attachment In Black Family Systems, Brianna A. Baker

Publications and Research

This study introduces the Black Mother-Daughter Developmental Model (BMDDM), a life course framework that theorizes the evolving relational, psychological, and cultural dynamics of Black mother-daughter relationships across generations. Using a constructivist grounded theory approach, in-depth qualitative interviews were conducted with 18 Black women aged 18 to 65 and analyzed to examine patterns of attachment, identity development, rupture, and relational repair over time. Findings yielded a five-stage developmental model: (1) Black Matrescence and Prenatal Conditions, (2) Initial Attachment, (3) Separation and Detachment, (4) Negotiation and Reattachment, and (5) Matrescence Redux and Grandmatrescence. Across stages, participants described how gendered racial socialization, maternal …

Career Plans Among Graduating Us Emergency Medicine Residents, Dave W. Lu, Bo Gu, D. Mark Courtney, Bryan G. Kane, Michelle D. Lall, Michael Gottlieb, Yvette Calderon, Christopher Bennett

Department of Emergency Medicine Faculty Papers

IMPORTANCE: The emergency medicine (EM) workforce is undergoing complex change, including a potential projected physician surplus, the volatile and evolving interests of medical students, and the continued high rates of burnout. Understanding the career intentions of graduating residents is critical to inform workforce planning.

OBJECTIVE: To examine the career plans, anticipated career durations, and key factors associated with the career decisions of graduating US EM residents.

DESIGN, SETTING, AND PARTICIPANTS: This cross-sectional survey study, which sampled graduating residents from all Accreditation Council for Graduate Medical Education-accredited categorical EM programs, was conducted after the 2023 American Board of Emergency Medicine In-Training …

Career Plans Among Graduating Us Emergency Medicine Residents, Dave W. Lu, Bo Gu, D. Mark Courtney, Bryan G. Kane, Michelle D. Lall, Michael Gottlieb, Yvette Calderon, Christopher Bennett

Department of Emergency Medicine Faculty Papers

IMPORTANCE: The emergency medicine (EM) workforce is undergoing complex change, including a potential projected physician surplus, the volatile and evolving interests of medical students, and the continued high rates of burnout. Understanding the career intentions of graduating residents is critical to inform workforce planning.

OBJECTIVE: To examine the career plans, anticipated career durations, and key factors associated with the career decisions of graduating US EM residents.

DESIGN, SETTING, AND PARTICIPANTS: This cross-sectional survey study, which sampled graduating residents from all Accreditation Council for Graduate Medical Education-accredited categorical EM programs, was conducted after the 2023 American Board of Emergency Medicine In-Training …

Comparison Of Vagal Maneuvers And Antiarrhythmics On Adult Patients Presenting With Supraventricular Tachycardias (Svt), James S. Ng

The PA Department Journal of Medical Science

INTRODUCTION: SVT is a well-known and potentially life-threatening arrhythmia, with vagal maneuvers and/or antiarrhythmic drugs often attempted for first-line conversion. The purpose of this clinical review is to analyze the relative effectiveness and success rates of these specific maneuvers and medications.

METHODS: The following PubMed database search was performed:“((vagal maneuver*) OR (valsalva)) AND (pharmacologic) ((medication) OR (medical therapy) OR (adenosine) OR (beta blocker*) OR (calcium channel blocker*) OR (anti-arrhythmic*) OR (anti arrhythmic*) OR (antiarrhythmic)) AND ((SVT) OR (supraventricular tachycardia))”. Filters were then applied and article titles/abstracts reviewed, resulting in a final selection of five articles for review.

RESULTS:. The most …

Guidelines For Community Engaged Health Research, Carrie Leach, Hayley Thompson, Alex Sass, Patricia Wren, Rodlescia Sneed, Rhonda Dailey, Elizabeth Towner, Maha Albdour, Carla Caringi, Alyssa W. Beavers, Theresa A. Hastert, Vanessa Rorai, Peter A. Lichtenberg, Angulique Outlaw, Ijeoma Nnodim Opara

Institute of Gerontology

Executive Summary:

Wayne State University’s Guidelines for Community Engaged Health Research provide a practical framework for designing, conducting, and evaluating ethical, equitable, and impactful health research that engages community experts in projects that advance health equity in Detroit.

Purpose 

Developed for WSU faculty, staff, and research teams, the guidelines support the meaningful involvement of community experts across all phases of research. They respond to common challenges in community-engaged work, including limited experience with engagement approaches, the need for reflexive and equitable practices, and the time and coordination required for authentic collaboration.

The document defines Community-Engaged Research (CEnR) as collaborative work …

West Nile Virus Transmission Suitability Modeling For Culex Pipiens Via Temperature And Humidity, Hunter Jones, David Brett-Major, Joseph R. Fauver, Yeongjin Gwon, Jesse E. Bell

Journal Articles: Epidemiology

West Nile Virus (WNV) is the leading cause of mosquito-borne disease in the United States, yet predicting its transmission remains a significant challenge for public health officials. Many studies use correlative statistical models to predict disease cases using temperature and humidity, but accessible mechanistic approaches that simulate mosquito behavior traits can capture more of the transmission process. This study adapts an existing R-language package, the Mosquito-borne Viral Suitability Estimator (MVSE), which was created to model Aedes aegypti mosquito transmission of dengue, and tunes it to Culex pipiens transmission of WNV. Equations for mortality, biting rate, and incubation period were updated, …