Digital Commons Network^™

First-In-Human Phase 1 Study Of Khk2455 Monotherapy And In Combination With Mogamulizumab In Patients With Advanced Solid Tumors, Timothy A Yap, Olivier Rixe, Capucine Baldini, Ursa Brown-Glaberman, Sergey Efuni, David S Hong, Christophe Massard, Jameel Muzaffar, Andreea Varga, Emrullah Yilmaz, Yuta Ikawa, Lisa H Shiue, Yi Liu, Matthew W Hruska, Henry Zhao, Akihiro Tokunaga, Solmaz Sahebjam

Faculty, Staff and Student Publications

Background: Indoleamine 2,3-dioxygenase 1 (IDO1) is a heme-containing enzyme that degrades tryptophan (Trp) to kynurenine (Kyn), which suppresses effector T cells and reduces antitumor activity. KHK2455 is a long-acting selective IDO1 inhibitor that blocks the heme component of the IDO holoenzyme. Mogamulizumab is a humanized immunoglobulin G1 monoclonal antibody targeting CCR4. KHK2455 + mogamulizumab demonstrated enhanced antitumor activity in preclinical studies, which led to a first-in-human, two-part, multicenter, open-label, phase 1, dose-escalation, cohort-expansion trial (ClinicalTrials.gov identifier NCT02867007) evaluating the safety/tolerability, pharmacokinetics, and IDO1 activity of KHK2455 alone and in combination with mogamulizumab in patients with treatment-refractory advanced solid tumors. …

Adapt-Marketplace - A Web-Application For Xml-Based Template Sharing In Radiation Oncology, Dennis N Stanley, Joseph Harms, Gaurav N Rathi, Joel A Pogue, Ritish Nedunoori, John B Fiveash, Richard A Popple, Carlos E Cardenas

2020-Current year OA Pubs

PURPOSE: The adaption of radiotherapy (RT) plans in response to anatomical and physiological changes during treatment marks a significant shift toward personalized cancer care. However, the complexity of Online Adaptive Radiotherapy (OART) procedures often leads to variability in treatment quality across institutions. The development of planning templates, particularly through the Ethos treatment planning system (TPS) and Intelligent Optimization Engine (IOE) (Varian Medical Systems, Palo Alto, CA), plays a crucial role in standardizing and streamlining OART. To address the challenges of sharing and optimizing treatment templates across diverse clinical environments, we developed the ADaptive rAdiotherapy Planning Template (ADAPT-) Marketplace to facilitate …

Where Should The Cancer Control Interventions Target: A Geospatial Hotspot Analysis For Major Cancer Mortality 2018 To 2022 In The United States, Chongliang Luo, Saira Khan, Liyan Jin, Aimee S James, Graham A Colditz, Bettina F Drake

2020-Current year OA Pubs

BACKGROUND: Identifying changes in geographic disparities of cancer mortality reveals locations where cancer prevention and control efforts should be focused/targeted. We use recent cancer surveillance data to demonstrate the geographic disparity of major cancer mortality rates in the United States and its shift compared with previous data.

METHODS: This cross-sectional study used the 2018 to 2022 county-level mortality rates of colorectal, lung, breast, and prostate cancers from the Centers for Disease Control mortality data. Counties with suppressed death counts were imputed by spatial regression models. Getis-Ord Gi* statistics were used to evaluate the spatial clustering of county mortality. Identified hotspot …

Incident Depression After Breast Cancer Among Older Asian, Native Hawaiian, And Pacific Islander Women, Alzina Koric, Chun-Pin Esther Chang, Yuan-Chin Amy Lee, Mei Wei, Catherine Lee, Jing Wang, Mia Hashibe

2020-Current year OA Pubs

BACKGROUND: Longitudinal studies examining mental health outcomes among older (≥66 years) Asian, Native Hawaiian, and Pacific Islander (ANHPI) women diagnosed with breast cancer are limited. We evaluated incident depression after breast cancer among specific groups of older ANHPI compared with older non-Hispanic White (NHW) women. Predictors of depression and the risk of death following early onset of depression after breast cancer were also evaluated.

METHODS: A cohort of 26 776 older ANHPI women in the United States diagnosed with breast cancer between 2000 and 2017 was identified from the SEER-Medicare linked claims. There were 6694 older ANHPI and 20 082 …

Gut Virome Profile In New Onset Treatment Naïve Saudi Children With Ulcerative Colitis, Mohammad El Mouzan, Tor C Savidge, Ahmed Al Sarkhy, Shyam Badu, Badr Alsaleem, Mohammad Al Mofarreh, Abdullah Almasood, Asaad Assiri

Faculty, Staff and Students Publications

Background: Gut microbiome imbalance is well established in ulcerative colitis (UC) in Western populations. Significantly less is known about the gut virome and whether geography impacts the UC-associated microbiome. The aim of this study was to characterize gut bacteriophage changes, as well as to identify phage-bacterial associations that can serve as potential biomarkers of UC.

Methods: Twenty children with UC and 20 healthy controls were enrolled in the study. Inclusion criteria included newly diagnosed treatment-naïve children with UC with no antibiotic exposure for at least six months prior to sample collection. Deoxyribonucleic acid (DNA) was extracted from stool and rectal …

Unfolding The Mystery Of Autoimmunity: The Environmental Determinants Of Diabetes In The Young (Teddy) Study, Marian Rewers, Daniel Agardh, Suzanne Bennett Johnson, Ezio Bonifacio, Helena Elding Larsson, Patricia Gesualdo, William Hagopian, Michael J Haller, Heikki Hyöty, Randi Johnson, Richard Mcindoe, Eoin Mckinney, Jessica Melin, Åke Lernmark, Richard E Lloyd, Kristian F Lynch, Jill M Norris, Stephen S Rich, Roswith Roth, Desmond Schatz, Jorma Toppari, Eric Triplett, Kendra Vehik, Suvi M Virtanen, Anette-G Ziegler, Beena Akolkar, Jeffrey P Krischer, Teddy Study Group

Faculty, Staff and Students Publications

In 2025, the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) at the National Institutes of Health celebrates 75 years of leadership in diabetes research. The NIDDK serves people of the U.S. affected by or at risk for many chronic diseases, including diabetes and other endocrine, metabolic, and digestive disorders, by funding innovative research to develop better treatment and prevention and a cure for these conditions. Autoimmunity that leads to type 1 diabetes or celiac disease or thyroid autoimmunity affects 1 in 20 children and adolescents in the U.S. While treatments are available, prevention of these common autoimmune …

Living Heritage, Resilience And Ethically Informed Infrastructures In Malawi, Martha B. Lerski, Frank Puluputu Mwale

Publications and Research

Rooted in a rural community’s needs, this paper explores how historically, and ethically informed infrastructures can support community engagement towards identification, documentation, and dissemination of local, traditional, and indigenous knowledge relating to climate change. The paper examines climate adaptation and sustainability issues through the lenses of community organizing and Library & Information Science best practices. It draws on a growing body of literature identifying a role for expanded epistemological and subject discipline perspectives. While the impacts of climate on material culture are increasingly recognized, intangible, and biocultural heritage have not received as much attention. Living heritage traditions and knowledge systems …

Do Minorities Attend Culturally Competent Hospitals? The Case Of Minority-Serving And Safety-Net Hospitals, Rumel Mahmood

Journal of Social, Behavioral, and Health Sciences

Minorities disproportionately attend minority-serving hospitals (MSHs) and safety-net hospitals (SNHs). This study examines whether MSHs or SNHs are more culturally competent than their counterparts. No research to date has examined the cultural competency of MSHs and SNHs with hospitals outside of these categories. The literature on the determinants of hospital-level cultural competence is sparse, with limited measures used nationally and a robust measure used in a single U.S. state. I calculated a 100-point score of hospital cultural competence from a nationally representative survey of hospitals (N = 849 respondents). Using multilevel regression models, I found that MSHs are culturally …

Profiling Of Physical Activity Usage In Selected Urban Green Spaces In Marikina City, Trizsa Jasmin C. Ty, Alberto L. Dimarucut, Camille B. Castro, Danielle Naomi L. Uy

CSID Journal of Infrastructure Development

Urban Green Spaces (UGS) play an important role in providing opportunities for physical activity in urbanized cities. This observational cross-sectional study aims to profile two selected UGS, namely Marikina River Park and Marikina Heights Park Complex, in Marikina City, in the context of their use for physical activity and recreation. Interviews with two government officials were conducted to collect data on the historical background of the selected parks. Systematic observation, using the System for Observation of Play and Recreation in Communities tool, was conducted to observe park visitors and their physical activity for four days in each park. Each park’s …

Quality Improvement Project Educating Family Of Patients Dealing With Substance Use Disorder, Emmanuella Edekobi

Doctor of Nursing Practice Projects

Substance Use Disorder (SUD) creates significant hardships for individuals and their families. Although families play a vital role in recovery, they may not know how to provide effective support. To address this, a Doctor of Nursing Practice (DNP) quality improvement project introduced a structured educational program for non-professional caregivers at an outpatient psychiatric clinic. The goal was to enhance caregivers' confidence and readiness to support their loved ones during recovery (Filiz & Polat, 2022). Participants completed the General Self-Efficacy Scale (GSE) before and after the intervention. Statistical analysis showed a significant improvement in confidence (t(9) = -26.00, p < .001, Cohen's d = 8.22), supported by the Wilcoxon Signed-Rank Test (z = -2.88, p = .004) (Rezaie et al., 2022). The project was grounded in Bandura’s Social Cognitive Theory, using observational learning, reinforcement, and real-life examples. Caregivers gained practical strategies, emotional support, and a clearer understanding of their role (Mardani et al., 2023). Initial uncertainty gave way to increased comfort through group support. These findings suggest that even low-cost, brief interventions can strengthen caregiver self-efficacy. Incorporating family education into addiction treatment may improve outcomes in outpatient mental health settings (Kellar & Kelvin, 2020).

Epidemiology Of Acute Infectious Diarrhea-Associated Viruses In Children In Hangzhou, China, 2023, Ya-Jun Guo, Lin Li, Qin-Rui Lai, Wei Li

Journal of Pediatric Infectious Diseases

Objective: To investigate the epidemiological characteristics of children infected with diarrheal virus in Hangzhou, China, 2023.

Methods: From January 2023 to December 2023, 20,939 stool samples from children with acute infectious diarrhea were collected for detection of rotavirus A and human adenovirus, using Latex agglutination detection kits; 7584 stool samples were collected for detection of norovirus, using real‐time PCR reagent.

Results: 639 (3.0%, 639/20,939) tested positive for rotavirus A, and 1,201 (5.7%, 1,201/20,939) positive samples were detected by Colloidal gold method. The positive rates of norovirus were 42.2% (3,203/7,585). Among all age groups, the rotavirus A positive detection rate was …

Assessing The Impact Of Digital Transformation On Regulatory Processes And Systems Compared To Traditional Paper-Based Processes At The Egyptian Drug Authority, Rania Aa Soliman

Theses and Dissertations

In the past several decades, the rate of scientific and technological advancements in drug development and digital fields have been extraordinary. Internet of Things and block chain technologies are currently viable in the mature cloud computing industry, these transformative examples contrast starkly with the current pharmaceutical regulatory submission, review, and approval process of the EDA. However, with the emergence of initiatives that aim to improve and expedite regulatory decision-making, there is a promising future ahead. These initiatives, if successful, will not only transform the current transactional structure but also leverage scientific and technological advances to deliver patient-centric therapies. This radical …

Urban-Rural Divide In Inequality’S Impact On Substance Abuse, Jonathan E. Flores

Undergraduate Theses, Capstones, and Recitals

This thesis focuses on investigating the relationship between income inequality, measured through the Gini coefficient, and drug addiction, proxied through substance-related mortality. Specifically, this thesis focuses on how these dynamics vary across rural and urban counties in the United States, using population size as a proxy. County-level data from 2016 to 2020 were collected through both the CDC and the Census Bureau and subsequently analyzed using Stata, with crude death rates from drug and alcohol causes serving as a function of the Gini coefficient, labor force participation, racial composition, and other socioeconomic indicators. Through a quadratic version of the model, …

Adolescent Preventive Care Outcomes Before And After Covid-19 Onset: What Is The Role Of Telehealth?, Sarah Hayden Knipper

Dissertations and Theses

Adolescents are a developmentally distinctive population with unique primary health care needs; they comprise about 10% of Oregon's population and more than half are covered by the Oregon Health Plan (OHP). This dissertation investigated significant declines in preventive care utilization (well visits and HPV immunizations) among adolescents enrolled in OHP during the COVID-19 pandemic and the relationship between the decline in utilization and the rise in telehealth availability. The study focused specifically on the role of race/ethnicity, geography, and access to health systems in mitigating or exacerbating decreases in preventive care. A mixed methods approach was employed to understand not …

One Health Integration To Control And Prevent Zoonoses: Application Of Organizational Theory Literature, Lisset M. Dumet Poma, Sherril Gelmon, Julia M. Goodman, Seth E. O’Neal

Hatfield Graduate Journal of Public Affairs

Zoonoses are infectious diseases transmitted between animals and people that disproportionately affect low- and middle-income countries (LMICs). The One Health (OH) approach aims to integrate systems, incentivizing collaboration among animal, human, and environmental systems to address zoonoses and improve health. Innovative solutions for effectively and sustainably achieving systems integration are needed. Organizational theories can facilitate the study of the context of OH implementation, applying comprehensive approaches that recognize the interconnections among organisms, the environment, and social systems, including the diverse entities needing integration (e.g., policy, community, public organizations). This narrative review examines organization and systems literature to provide recommendations for …

Food Environments And Mental Health: Analyzing The Impact Of Fast-Food Availability On U.S. Adults (2011-2016), Nicole Tenner

NYMC Student Theses and Dissertations

This study investigates the relationship between the availability of fast food in US territories and mental health outcomes. Utilizing a cross-sectional design, the study examines data from the 2011 and 2016 Behavioral Risk Factor Surveillance System (BRFSS) from the CDC, along with data from the U.S. Department of Agriculture’s Food Environment Atlas. The analysis included a nationally representative sample of 351,823 participants across all 50 US states. Multiple regression models examined the association between fast food availability and two primary mental health outcomes: the number of self-reported poor mental health days and the likelihood of being diagnosed with a depressive …

Bereavement Needs Of Parent-Child Dyads Following Sibling Death, Shannon V. D'Alton

MUSC Theses and Dissertations

In the United States, nearly 62,000 children and adolescents experience the death of a sibling each year and sibling bereavement is one of the most distressing life events during childhood; however, it has received less attention in research compared to other forms of childhood loss. Bereaved siblings and parents are at increased risk for negative physical and psychological outcomes, yet little is known about their support and resource needs during the early years following the death. A limitation in understanding sibling bereavement is the methodological and ethical challenges of researching this vulnerable population. Consequently, the bereavement needs of surviving siblings …

Impact Of Sociodemographic Determinants On Enrollment Into Contemporary Lymphoma Clinical Trials: A Systematic Review, Jun Yang Jiang, Ang Li, Alexis Romero, Christopher R Flowers, Chijioke Nze

Faculty, Staff and Students Publications

While the incidence and survival associated with lymphoma have improved in recent years, outcome disparities related to sociodemographic factors such as age, sex, race, ethnicity, socioeconomic status (SES), and other social determinants of health (SDOH) remain prevalent in the modern era. Clinical trials are crucial for further improving outcomes, yet not all sociodemographic groups are equally represented in contemporary lymphoma trials. We conducted a systematic review of the literature evaluating the impact of SDOH on enrollment into clinical trials in the United States and identified 21 relevant studies. We confirmed that Black and Hispanic individuals are underrepresented in lymphoma clinical …

Functional Resilience Of Healthcare In The Critical Juncture Of The Covid-19 Pandemic, Avner Kronisch, Christian Bongiorno, Kerane Smith, John Baker

Working Papers Series

This paper offers a comparative analysis of eight national healthcare systems—spanning democracies, autocracies, and various institutional models—to evaluate resilience during the COVID-19 pandemic. Drawing on Shvetsova et al.’s framework of informational and authority redundancies, and Parker & Klein’s “choke point” theory of healthcare rationing, we examine how institutional structure shaped pandemic response, system adaptability, and continuity of non-COVID services. Using indicators like life expectancy, under-five mortality, hospital capacity, cancer survival, and excess mortality, we explore how systems absorbed shock and maintained essential care. We find that decentralized and polycentric governance structures, when paired with coordination and resource adequacy, enhanced resilience—exemplified …

An Escape Room To Cultivate Interprofessional Skills: A Mixed Methods Study, Rita Lenhardt, Blair Carsone, Dianna Lunsford, Melissa Goodman, Andrew Caswell

Teaching and Learning in Communication Sciences & Disorders

Interprofessional education is essential to developing future healthcare practitioners who can effectively collaborate with other professionals in practice settings. The current study examined the effectiveness of an escape room as an educational tool for interprofessional practice for occupational therapy, physical therapy, and speech-language pathology graduate students. This study employed a mixed-methods design. Eighteen healthcare graduate students agreed to participate in the educational escape room. The Students’ Perceptions of Interprofessional Clinical Education Revised instrument was used as a pre-and post-test to determine whether there were differences in the student perceptions before and after the educational escape room. In addition to the …

Arts-Based Sustainability: From New York To Malawi, Martha B. Lerski

Publications and Research

Recognizing that libraries serve multiple constituencies and subject areas, this chapter documents and advocates for development of transdisciplinary arts-based research (ABR) and culture-related projects linked to environmental challenges. Libraries contribute collections and spaces, as well as the research of library and information scientists. Libraries are currently among invisible contributors to sustainability planning and services. The chapter will link this invisibility to the value of what visual arts refer to as negative space elements in subjects ranging from traditional ecological knowledge to environmental science. Library collections, projects, and research contribute to education for sustainable development (ESD) as required to achieve the …

Withdrawal Management In Maine: Capacity Challenges And Opportunities For Improvement, Mary Lindsey Smith Phd, Katie Rosingana Ba, Tyler Egeland Ba, Sarah Mclaughlin Mph

Substance Use Research & Evaluation

This summary report presents findings from healthcare provider interviews conducted in 2024 to assess the current landscape of withdrawal management (WM) services in Maine. Sixteen providers, across eight counties and representing a range of substance use disorder (SUD) service types, were interviewed to evaluate capacity, challenges, and opportunities for improvement across the continuum of care. Thematic analysis identified widespread gaps in withdrawal management capacity, especially in ASAM Levels 1.7 to 4.0, with critical shortages in ambulatory and low-intensity residential services. Key barriers included geographic inequities, insufficient infrastructure, long waitlists, inadequate reimbursement, and workforce shortages exacerbated by stigma and provider discomfort. …

Feedback On Withdrawal Management Services In Maine From Persons With Lived Experience, Mary Lindsey Smith Phd, Katie Rosingana Ba

Substance Use Research & Evaluation

This summary report presents findings from interviews with twelve persons with lived experience of substance use disorder (PWLE). The interviews asked persons in recovery about their experiences accessing withdrawal management and broader substance use treatment services across Maine. Participants identified key barriers to treatment including high costs, limited bed availability, long wait times, geographic inaccessibility, and lack of centralized information. Gaps in service infrastructure, particularly for opioid withdrawal management, long-term treatment, and transition supports post-detox, were widely reported. Participants emphasized the critical need for more localized and individualized services, particularly for parents, rural residents, and low-income individuals. Recommendations include expanding …

The Epidemiology And Burden Of Injury In Countries Of The Association Of Southeast Asian Nations (Asean), 1990–2021: Findings From The Global Burden Of Disease Study 2021, Stephanie C C Van Der Lube, Lin Siew Chong, Simon I. Hay, Catherine Bisignano, Spencer I. James, Xiaochen Dai, Lay Hoon Goh, Swetha Acharya, Qorinah Estiningtyas Sakilah Adnani, Naveed Ahmed, Budi Aji, Joseph Uy Almazan, Carl Abelardo T. Antonio, Sumadi Lukman Anwar, Muhammad Shahzad Aslam, Atif Amin Baig, Amiel Nazer C. Bermudez, Ahmad Naoras Naoras Bitar, Muthia Cenderadewi, Hana Chen, Nicholas Ws Chew, Bryan Chong, Mayank Dalakoti, Hisham Atan Edinur, Crystal Amiel M. Estrada, Emerito Jose Aquino Faraon, Nelsensius Klau Fauk, Ni Kadek Yuni Fridayani, Fernando Barroga Garcia, Arief Hargono, Eka Mishbahatul Marah Has, Paul Michael Rafa Hernandez, Nahlah Elkudssiah Ismail, Vikash Jaiswal, Roland Dominic G. Jamora, Jost B. Jonas, Kehinde Kazeem Kanmodi, Inn Kynn Khaing, Yun Jin Kim, Chong-Han Kua, Maria Dyah Kurniasari, Dian Kusuma, Hilton Lam, Shaun Wen Huey Lee, Zheng Feei Ma, Roy Rillera Marzo, Kamarul Imran Musa, Firzan Nainu, Dina Nur Anggraini Ningrum, Sok King Ong, Veincent Christian Pepito, Thantrira Porntaveetus, Dimas Ria Angga Pribadi, Sheena Ramazanu, Bedanta Roy, Yoseph Leonardo Samodra, Siddharthan Selvaraj, Shazlin Shaharudin, Robert Sinto, Solikhah Solikhah, Chandrashekhar T. Sreeramareddy, Vetriselvan Subramaniyan, Thitiporn Sukaew, Ingan Ukur Tarigan, Jansje Henny Vera Ticoalu, Narayanaswamy Venketasubramanian, Taweewat Wiangkham, Anggi Lukman Wicaksana, Siyan Yi, Mustafa Z. Younis, Christopher J L Murray, Kanyin Liane Ong, Yee Wei Lim, Marie Ng

Ateneo School of Medicine and Public Health Publications

Background Injuries are among the top causes of mortality and disability in southeast Asia. Although injury prevention is a key health priority in the Post-2015 Health Development Agenda of the Association of Southeast Asian Nations (ASEAN), the focus was placed solely on road injuries. The absence of a broader recognition of injury burden and trends hinders future intervention efforts. This study aims to provide a comprehensive analysis of the burden and epidemiological trends of all injuries across ASEAN countries.

Methods In this analysis of the Global Burden of Disease, Injuries, and Risk Factors Study (GBD) 2021, we estimated incidence, cause-specific …

Familiarity Moderates Education Level Of Stigma For Professional Efficacy Of Treating Mental Illness, Jason J. Burrow-Sanchez, Shawnda Schroeder, Thomasine Heitkamp, Brian Urlacher, Sharon Cook, Paula Bennett, Carolina Corrales

Indigenous Health Faculty Publications

Background: About one in five adults in the United States experience any mental illness (AMI) whereas 14.2 million experience serious mental illness (SMI). The perception of stigma among these individuals can be associated with care seeking behavior and treatment adherence.

Purpose: Two factors that mitigate stigma are familiarity with someone experiencing AMI/SMI and general level of education. Heretofore, these factors have not been tested together to determine if familiarity moderates the relation between level of education and stigma of professional efficacy for treating mental illness.

Methods: In fall 2020, an online survey in the state of Utah measured 1,300 adults’ …

Exploring Early Childhood Development Programming In Kenya’S Arid And Semi-Arid Lands, Phyllis Magoma, Amina Abubakar, Martha Kaniala, Barack Aoko, Moses Wesala, Joyce Marangu, Susan Nyamanya, Margaret Kabue, Anil Khamis, Esther Chongwo

Institute for Human Development, East Africa

Background: Promoting high-quality early childhood development (ECD) is vital for individuals’ physical and social well-being and yields significant societal returns. However, children in marginalised regions like Kenya’s arid and semi-arid lands (ASALs) face significant barriers to accessing quality ECD services.

Aim: This study aimed to document existing ECD services in Kenya’s ASAL areas, including their availability, types and key characteristics; identify gaps in their provision and propose solutions to enhance access and quality. Setting: This qualitative study was conducted in 10 ASAL counties in Kenya.

Methods: Using purposive and snowball sampling techniques, 103 key informants, including pre-primary …

"Sex Out Of Boredom": Key Stakeholders' Perspectives On Teen Pregnancy Prevention In Emerging Immigrant Latino Rural Communities., Romina Barral, J Dennis Fortenberry, Astrid Guerrero Avitia, Mariana Ramirez, Abbey R. Masonbrink, Claire D. Brindis

Manuscripts, Articles, Book Chapters and Other Papers

INTRODUCTION: Teen pregnancy (TP) rates are 1.5 times higher among Latina youth than the United States national average and one-third times higher in rural counties. The Socio-Ecological framework recognizes the myriad of issues that impact TP, including four bidirectional levels of influence on teenagers' behaviors: macro, community, institutional, and interpersonal levels. We aim to fill critical knowledge gaps regarding the influence of key community stakeholders living in rural, Latino-majority communities shaping Latino/a, immigrant adolescents' TP-related environments.

METHODS: A purposive sample of 48 key stakeholders was drawn from three rural counties (Finney, Ford, and Seward) in southwestern Kansas from 2016 to …

Ecological Grief Among Farmers And Pastoralists In Ethiopia And Kenya, Syed Shabab Wahid, Christine Musyimi, Benjamin Oestericher, Linda Khakali, Lauren Carruth, Emily Mendenhall, Edna Bosire

Brain and Mind Institute

Climate change is a major cause of mental distress worldwide. In many ways, climate change has become a chronic disaster, while in other ways each acute event can accumulate and present challenges within and between communities. A growing body of evidence indicates that a changing climate can precipitate a cluster of negative affective states scholars call “ecological grief.” Ecological grief reflects psychological responses to climate changes and destruction of nature, species, culturally significant or sacred spaces. Until now, ecological grief has been conceptualized as a psychological response connected primarily to the destruction of the natural environment, and has not fully …

Access To Healthcare For Rural Transgender Adults In The United States, Devon Smith

University Honors Theses

Urban and rural healthcare differ significantly in the amount of facilities, providers and kinds of specialty care that are offered in each environment. The United States is split into urban and rural counties in any given region, and based on those population sizes, are the allocation of healthcare resources for residents. In rural areas in the U.S., transgender adults lack access to gender-affirming care and encounter a lack of gender-affirming care providers due to workforce shortages, discrimination, and a lack of cultural competency. To determine if these residents lacked access to care compared with their urban counterparts, I performed a …

Geographic Inequalities, And Social-Demographic Determinants Of Reproductive, Maternal And Child Health At Sub-National Levels In Kenya, Janette Karimi, Anitah Cherono, Victor Alegana, Martin Mutua, Hellen Kiarie, Rose Muthee, Marleen Temmerman, Peter Gichangi

Centre of Excellence in Women and Child Health

Background; Global initiatives have emphasized tracking indicators to monitor progress, particularly in countries with the highest maternal and child mortality. Routine data can be used to monitor indicators for improved target setting at national and subnational levels. Our objective was to assess the geographic inequalities in estimates of reproductive, maternal and child health indicators from routine data at the subnational level in Kenya.

Methods; Monthly data from 47 counties clustered in 8 regions, from January 2018 to December 2021 were assembled from the District Health Information Software version 2 (DHIS2) in Kenya. This included women of reproductive age receiving family …