Digital Commons Network^™

Improving Obesity And Related Chronic Disease Outcomes: Developing Nurse Practitioner Competence In Motivational Interviewing, Jodi Wilson

Doctor of Nursing Practice Final Manuscripts

Background: Despite America’s persistent focus on health, over 40% of the US population is obese. A significant obstacle to mitigating disease in those with obesity is inspiring lasting behavioral change. Motivational Interviewing (MI) is highly effective yet under-utilized for catalyzing personal change inertia. Recent meta-analyses demonstrated statistically significant improvement in BMI, A1C, and blood pressure. Objectives: This evidenced-based project (EBP) aimed to develop nurse practitioner (NP) skills in deploying fidelity-based MI, resulting in increased adherence to lifestyle interventions. Implementation: This EBP project implemented MI into routine primary care through a self-paced healthcare provider MI certification and a 45-minute skill …

Review Of Treatment Of Hepatitis C Among Persons Who Are Housing Insecure And Use Substances, Kate Kelley

Faculty Scholarship

With the advent of direct-acting antiviral agents (DAA), reduction of hepatitis C infection (HCV) has become a public health priority. The World Health Organization’s goal of global elimination of HCV by 2030 has brought to light the challenges in treating certain populations. This review examines the burden of HCV infection on unhoused individuals and people who use substances in the United States in the last five years, and presents best practices in patient care and treatment.

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’ …

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

Operations 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

Operations 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 …

Impact Of The Department Of Defense Maternity Leave Policy Change On Retention And Postpartum Depression And The Air Force Postpartum Physical Fitness Policy Change On Physical Readiness Outcomes, Minette S. R. Herrick

Dissertations and Doctoral Documents, University of Nebraska-Lincoln, 2023–

Understanding the implications of health policy is paramount to support continued execution and further wide-spread distribution. The Department of Defense has made many recent family friendly policy changes in effort to improve the health and morale of the force. Two such policies were analyzed in this study. The first was the change in maternity leave, in 2016, from allotting women six weeks time off to twelve weeks time off in the postpartum period. The second was executed by the Air Force to permit postpartum women a longer duration for their required physical fitness assessment (an increase from six months to …

Global Age-Sex-Specific Mortality, Life Expectancy, And Population Estimates In 204 Countries And Territories And 811 Subnational Locations, 1950–2021, And The Impact Of The Covid-19 Pandemic: A Comprehensive Demographic Analysis For The Global Burden Of Disease Study 2021, Austin E. Schumacher, Hmwe Hmwe Kyu, Catherine M. Antony, Aleksandr Y. Aravkin, Gulrez Shah Azhar, Catherine Bisignano, Katrin Burkart, Kelly M. Cercy, Eunice Chung, Kaleb Coberly, Haley Comfort, Ewerton Cousin, Garland T. Culbreth, Matthew Cunningham, Nicole Davis Weaver, Louisa Degenhardt, Lee Deitesfeld, M. Ashworth Dirac, Kara Estep, Valery L. Feigin, Abraham D. Flaxman, Luisa S. Flor, Lisa M. Force, John E. Fuller, Veincent Christian Pepito

Ateneo School of Medicine and Public Health Publications

Background

Estimates of demographic metrics are crucial to assess levels and trends of population health outcomes. The profound impact of the COVID-19 pandemic on populations worldwide has underscored the need for timely estimates to understand this unprecedented event within the context of long-term population health trends. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 provides new demographic estimates for 204 countries and territories and 811 additional subnational locations from 1950 to 2021, with a particular emphasis on changes in mortality and life expectancy that occurred during the 2020–21 COVID-19 pandemic period.

Methods

22 223 data sources …

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 …

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 …

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 …

Development Of An Endometriosis Toolkit To Support Clinicians In Providing Quality Care For Women, Rachel Hasbun

Doctor of Nursing Practice (DNP) Projects

Abstract

Background: Endometriosis is the abnormal growth of endometrium-like tissue outside the uterine cavity, affecting approximately 11% of women in the United States during their reproductive years. Diagnostic challenges stem from its varied clinical presentations, reliance on laparoscopy for definitive diagnosis, and limited awareness among practitioners and patients, potentially leading to diagnostic delays of up to 13 years.

Problem: The complexities of diagnosing endometriosis in primary care and specialty settings, combined with limited provider awareness and a lack of comprehensive resources, hinder timely and accurate identification. This leads to suboptimal treatment and care for women affected by the condition.

Methods: …

Teaching Medical Procedural Skills For Performance, Kersi Taraporewalla, Paul Barach, André Van Zundert

College of Population Health Faculty Papers

Procedures are a core element of medical professional practice. Today's training approach was formulated in the mid-twentieth century based on a computer analogue of the brain. Despite minor modifications, the system has remained relatively unchanged for the past 70 years. It delivers competence. However, competence is not reliable performance. The inability to adapt to the variety of patients and variations in the performance environments, such as the operating room, results in patient morbidity and mortality. There is a need for changes in the development and training of medical procedural skills based on current theories of skill acquisition, movement theory, and …

Addressing Mental Health In Young Adults: A Modern Approach Compared To Previous Generations, Breeha A. Shah

DePaul Journal of Health Care Law

The escalating prevalence of mental health issues among today's young adults underscores the vital importance of addressing mental health in the pursuit of public health objectives. In response to this, The House Education and Labor Committee issued a report on the Mental Health Services for Students Act of 2020 (the Act), to amend the Public Health Service Act relating to school children. This revision seeks to bolster the support for students and young people by ensuring their access to comprehensive mental health programs within the school environment. The Act recognizes that safeguarding mental health is an immediate concern for public …

Optical Coherence Tomography-Guided Brillouin Microscopy Highlights Regional Tissue Stiffness Differences During Anterior Neural Tube Closure In The Mthfd1l Murine Mutant, Yogeshwari S Ambekar, Carlo Donato Caiaffa, Bogdan J Wlodarczyk, Manmohan Singh, Alexander W Schill, John W Steele, Jitao Zhang, Salavat R Aglyamov, Giuliano Scarcelli, Richard H Finnell, Kirill V Larin

Faculty, Staff and Students Publications

Neurulation is a highly synchronized biomechanical process leading to the formation of the brain and spinal cord, and its failure leads to neural tube defects (NTDs). Although we are rapidly learning the genetic mechanisms underlying NTDs, the biomechanical aspects are largely unknown. To understand the correlation between NTDs and tissue stiffness during neural tube closure (NTC), we imaged an NTD murine model using optical coherence tomography (OCT), Brillouin microscopy and confocal fluorescence microscopy. Here, we associate structural information from OCT with local stiffness from the Brillouin signal of embryos undergoing neurulation. The stiffness of neuroepithelial tissues in Mthfd1l null embryos …

Automate Isolation Infection-Prevention Precautions (Aid-Ip): Improving The Efficiency Of Hospital Isolation With Viral Respiratory Infections, Timothy Burchard, Michael Platt, La'sonya Buford

Research Days

The AID-IP project is a QI study working to improve the process of isolation and de-isolation regarding respiratory viruses at Children's Mercy Hospital. Specifically, we aim to improve adherence to proper isolation precautions, minimize cognitive workload regarding the maintenance of isolation for staff, and improve family satisfaction with isolation practice.

Improving Healthcare Workers’ Biohazardous Spill Safe Handling Skills, Zeina Mhanna, Ahmad Tassi

BAU Journal - Health and Wellbeing

All healthcare workers (HCWs) are exposed to biohazardous material. Biohazardous material may come in the form of spills, posing a risk of infection to (HCWs) who are not trained on how to safely handle them. While international guidelines recommend training HCWs on how to safely handle biohazardous spills in order to improve their skills, there are no studies that tackled this recommendation. The aim of this study is to improve HCWs’ biohazardous spill safe handling skills through training, and to evaluate the association between the HCWs’ improvement level and demographical characteristics. The study was conducted in a Southern Lebanese hospital …

Knowledge And Attitude Of Lebanese Adults Towards Asthma In Beirut, Lebanon, Farah Hatem Haidar, Doaa Issa, Maha Aboul Ela, Karim Raafat

BAU Journal - Health and Wellbeing

Asthma, a serious global health problem, has been an area of interest due to its increasing prevalence, expanding treatment costs, and rising burden on patients and the community. Since asthma cannot be cured, clinical episodes can be prevented and controlled by adequate management and sufficient knowledge of the disease. Appropriate treatment may relieve asthma symptoms and improve quality of life. However, poor knowledge of asthma disease and medication use, misdiagnoses, misuse of inhalers and inadequate self-management of disease symptoms may have a greater impact on the disease process. Therefore, assessment of the population’s knowledge and attitude toward asthma is essential. …

Pour Une Diffusion Éthique Des Connaissances De La Médecine Traditionnelle: L’Intersection De La Culture Yoruba Et Des Besoins Médicaux, Isabel Sala

CISLA Senior Integrative Projects

No abstract provided.

High All-Cause Mortality And Increasing Proportion Of Older Adults With Tuberculosis In Texas, 2008–2020, Belinda A Medrano, Miryoung Lee, Gretchen Gemeinhardt, Lana Yamba, Blanca I Restrepo

Faculty, Staff and Student Publications

Pulmonary tuberculosis (PTB) elimination efforts must consider the global growth of the ageing population. Here we used TB surveillance data from Texas, United States (2008-2020; total n = 10656) to identify unique characteristics and outcomes in older adults (OA, ≥65 years) with PTB, compared to young adults (YA, 18-39 years) or middle-aged adults (40-64 years). We found that the proportion of OA with PTB increased from 15% in 2008 to 24% in 2020 (trend p < 0.05). Diabetes was highly prevalent in OA (32%) but not associated with adverse outcomes. Death was 13-fold higher in OA compared to YA and was 7% at the time of diagnosis which suggests diagnostic delays. However, once TB was suspected, we found no differences in culture, smear, or nucleic acid detection of mycobacteria (although less lung cavitations) in OA. During treatment, OA had less drug-resistant TB, few adverse reactions and adhered with TB treatment. We recommend training healthcare workers to 'think TB' in OA, for prompt treatment initiation to diminish deaths. Furthermore, OA should be added as a priority group to the latent TB treatment guidelines by the World Health Organization, to prevent TB disease in this highly vulnerable group.

Impact Of An Electronic Human Papillomavirus Vaccination Catch-Up Module For Women With Criminal-Legal System Involvement, Shawana Moore

Electronic Theses and Dissertations

Introduction: Cervical cancer can often be prevented with targeted strategies such as Pap smear screenings and the human papillomavirus (HPV) vaccination, now also recommended for those aged 27-45 who have not received the vaccine previously. However, women involved in the criminal-legal system often miss out on primary and secondary prevention measures and are at increased risk for the development of cervical cancer caused by HPV. Purpose: The purpose of this study was to examine the feasibility and acceptability of an electronic HPV catch-up module for women in the criminal-legal system aged 27-45. The study, guided by the Health Belief Model, …

An Analysis Of Professional Education For Future Physicians To Address Implicit Racial Bias In Black Maternal Health, Jasmine Butler

Honors Theses

The history of medicine in the United States is littered with incidences of racism and exploitation of Black Americans. The extensive history of medical racism has continued to be perpetuated in healthcare today. Within the field of maternal health, the dark history of medicine shows its face with the treatment of black mothers. Black maternal health is a current public health crisis currently being exacerbated through discrimination in the form of implicit bias. Implicit bias is a current issue in our healthcare system that needs to be addressed through adequate training of both medical students and physicians. This qualitative research …

A Bioinformatic Analysis Of T-Cell Epitope Diversity In Sars-Cov-2 Variants: Association With Covid-19 Clinical Severity In The United States Population, Grace J. Kim, Jacob H. Elnaggar, Mallory Varnado, Amy K. Feehan, Darlene Tauzier, Rebecca Rose, Susanna L. Lamers, Maya Sevalia, Najah Nicholas, Elizabeth Gravois, Daniel Fort, Judy S. Crabtree, Lucio Miele

School of Graduate Studies Faculty Publications

Long-term immunity against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) requires the identification of T-cell epitopes affecting host immunogenicity. In this computational study, we explored the CD8+ epitope diversity estimated in 27 of the most common HLA-A and HLA-B alleles, representing most of the United States population. Analysis of 16 SARS-CoV-2 variants [B.1, Alpha (B.1.1.7), five Delta (AY.100, AY.25, AY.3, AY.3.1, AY.44), and nine Omicron (BA.1, BA.1.1, BA.2, BA.4, BA.5, BQ.1, BQ.1.1, XBB.1, XBB.1.5)] in analyzed MHC class I alleles revealed that SARS-CoV-2 CD8+ epitope conservation was estimated at 87.6%–96.5% in spike (S), 92.5%–99.6% in membrane (M), and 94.6%–99% in …

Physical Activity In Underserved Preadolescents: Characterization Of Accumulation And Patterns, Alma I. Behar, Matthew T. Mahar, Gregory Norman, John P. Elder, Michael Pratt, Patricia Dionicio, Noe C. Crespo

International Journal of Physical Activity and Health

Objectives: The increasing rates of physical inactivity and sedentary behaviors among youth are a significant public health concern. The greatest disparities in physical activity (PA) are experienced by underserved (racial/ethnic minority, low-income) youth. This study aimed to characterize accelerometer-measured PA behaviors in a sample of low-income, predominantly Latino, preadolescents. Methods: Participants wore wrist worn GENEActiv accelerometers for 7 days. PA levels were classified as sedentary (< 50 mg), light (50-150 mg), moderate (> 150-500 mg), vigorous (> 500 mg), and MVPA (≥ 150 mg). Time spent in PA levels and sedentary time (ST), prevalence of meeting MVPA guidelines, and PA volume were estimated from accelerometer data. Three-way …

Assessing The Effectiveness Of Treatment Programs Among Veterans With Opioid Use Disorder In New York State, Olatoye Oluwaseyi Itaniyi

Walden Dissertations and Doctoral Studies

New York State (NYS) is home to millions of veterans and has the fifth-largest veteran population in the country. Veterans represent a vulnerable population and are at higher risk for mental and physical health struggles. The focus of this quantitative study was to assess if there is any significant difference between pre- and post-OUD 24-hour detoxification treatment services, residential/rehabilitation treatment services, ambulatory outpatient treatment services, frequency of opioid use at discharge, and mental disorder among veterans with opioid use disorder in NYS when controlling for age, gender, race, and marital status. The study utilized the harm reduction framework and the …

Perception Of African Immigrants Living In The United States Towards Latent Tuberculosis Infection Treatment Hesitancy, Akinwale O. Obatayo

Walden Dissertations and Doctoral Studies

About 80% of active tuberculosis (TB) cases are caused by untreated latent tuberculosis infection (LTBI), with most being foreign-born United States residents. Despite the availability of preventive therapies, African immigrants living in the United States are hesitant to accept LTBI treatment. Although researchers have explored LTBI treatment hesitancy among foreign-born United States citizens, no study has explored the perspectives of African immigrants living in the United States. This generic qualitative study explored the perception of African immigrants living in the United States on LTBI treatment hesitancy. Participants’ inclusion criteria include those 18 years and older with a positive TB test, …

Health Care Utilization And Behavior Changes After Workplace Genetic Testing At A Large Us Health Care System, Elizabeth Charnysh, Subhamoy Pal, Jonathan Reader, Wendy R. Uhlmann, Sarah Mccain, Kunal Sanghavi, Drew Blasco, Rachael Brandt, William Gregory Feero, Rebecca Ferber, Veda N. Giri, Katherine Hendy, Anya E. R. Prince, Charles Lee, J. Scott Roberts

College of Life Sciences Faculty Papers

PURPOSE: This study explored employee health behavior changes and health care utilization after workplace genetic testing (wGT). Wellness-program-associated wGT seeks to improve employee health, but the related health implications are unknown.

METHODS: Employees of a large US health care system offering wGT (cancer, heart disease, and pharmacogenomics [PGx]) were sent electronic surveys. Self-reported data from those who received test results were analyzed. Descriptive statistics characterized responses, whereas logistic regression analyses explored correlates of responses to wGT.

RESULTS: 53.9% (n = 418/776) of respondents (88.3% female, mean age = 44 years) reported receiving wGT results. 12.0% (n = 48/399) received results …

Impact Of Covid-19 On Opioid Misuse, Mental Health, And Substance Abuse Treatment Of Adults, David Stephen Reed

Walden Dissertations and Doctoral Studies

The purpose of this quantitative cross-year comparison of two cross-sectional studies was to examine whether there is an impact of the COVID-19 pandemic on opioid misusers seeking mental health and substance abuse treatment, taking into consideration the social, ecological, and economic factors of age, gender, poverty status, and county of residence metropolitan status. The theoretical foundations of this study are the social-ecological framework in terms of the geographic and economic impacts, and the structural and social determinants of health framework to examine the influences of economic and community on individual behaviors, to answer the research questions while controlling for the …

Determinants Of Mosaic Chromosomal Alteration Fitness, Yash Pershad, Taralynn Mack, Hannah Poisner, Yasminka A Jakubek, Adrienne M Stilp, Braxton D Mitchell, Joshua P Lewis, Eric Boerwinkle, Ruth J F Loos, Nathalie Chami, Zhe Wang, Kathleen Barnes, Nathan Pankratz, Myriam Fornage, Susan Redline, Bruce M Psaty, Joshua C Bis, Ali Shojaie, Edwin K Silverman, Michael H Cho, Jeong H Yun, Dawn Demeo, Daniel Levy, Andrew D Johnson, Rasika A Mathias, Margaret A Taub, Donna Arnett, Kari E North, Laura M Raffield, April P Carson, Margaret F Doyle, Stephen S Rich, Jerome I Rotter, Xiuqing Guo, Nancy J Cox, Dan M Roden, Nora Franceschini, Pinkal Desai, Alex P Reiner, Paul L Auer, Paul A Scheet, Siddhartha Jaiswal, Joshua S Weinstock, Alexander G Bick

Faculty, Staff and Student Publications

Clonal hematopoiesis (CH) is characterized by the acquisition of a somatic mutation in a hematopoietic stem cell that results in a clonal expansion. These driver mutations can be single nucleotide variants in cancer driver genes or larger structural rearrangements called mosaic chromosomal alterations (mCAs). The factors that influence the variations in mCA fitness and ultimately result in different clonal expansion rates are not well understood. We used the Passenger-Approximated Clonal Expansion Rate (PACER) method to estimate clonal expansion rate as PACER scores for 6,381 individuals in the NHLBI toPMed cohort with gain, loss, and copy-neutral loss of heterozygosity mCAs. Our …

The Relationship Between Ultrarunning Status, Subjective Well-Being, And Life Satisfaction, Raquel Ramirez Hernandez

Walden Dissertations and Doctoral Studies

The COVID-19 pandemic resulted in a rise in mental health challenges across the United States. Consequently, two important well-being measures for Healthy People 2030—subjective well-being and life satisfaction—were negatively impacted. A plethora of evidence exists about the benefits of running for physical and mental health. Yet, there is no available evidence that shows the benefits of ultrarunning, subjective well-being, and life satisfaction. This quantitative cross-sectional study examined the relationship between ultrarunning status, subjective well-being, and life satisfaction among adult runners in the United States. The advanced triangle of epidemiology served as the conceptual framework. A convenience sample included 369 adult …

Progress Toward A Vaccine For Extraintestinal Pathogenic Coli (Expec) Ii: Efficacy Of A Toxin-Autotransporter Dual Antigen Approach, Yikun Xing, Justin R Clark, James D Chang, Jacob J Zulk, Dylan M Chirman, Felipe-Andres Piedra, Ellen E Vaughan, Haroldo J Hernandez Santos, Kathryn A Patras, Anthony W Maresso

Faculty, Staff and Students Publications

Extraintestinal pathogenic Escherichia coli (ExPEC) is a leading cause of worldwide morbidity and mortality, the top cause of antimicrobial-resistant (AMR) infections, and the most frequent cause of life-threatening sepsis and urinary tract infections (UTI) in adults. The development of an effective and universal vaccine is complicated by this pathogen’s pan-genome, its ability to mix and match virulence factors and AMR genes via horizontal gene transfer, an inability to decipher commensal from pathogens, and its intimate association and co-evolution with mammals. Using a pan virulome analysis of >20,000 sequenced E. coli strains, we identified the secreted cytolysin α-hemolysin (HlyA) as a …