Digital Commons Network^™

A Systematic Review To Study The Global Patterns And Policies Of Hiv Harm Reduction Programs And Their Impact Among People Who Inject Drugs, Noura Shaltout, Rania Soliman, Lamia Refaey, Rim Ghazal, Mirna Atteya, Nahla Elmedany

Papers, Posters, and Presentations

Aim: This study aims to provide an updated estimate of HIV prevalence among people who inject drugs (PWID) globally, as well as investigate different policies and methods for applying harm reduction. This article focuses on the two major and the most frequently used harm reduction techniques, Syringe-Service Programs (SSPs) and Opioid Agonist Therapy (OAT). Methods: A comprehensive systematic review was undertaken across multiple international databases during the period of (August-December 2021). For studies conducted before 2005, we used data from a previous published systematic review. Thirty-six studies were included, including studies that had performed HIV testing and had a confirmed …

Relationship Between Patient Race And Provider Communication, Kristin M. Marino

Honors Undergraduate Theses

Health disparities by race in the United States have been persistent over decades and one possible reason for that could be that physicians are communicating differently with different races. The purpose of this study was to systematically review literature regarding the relationship of patient race/ethnicity with physician-patient communication. The overall project of which this is a part is a mixed methods review, but my part of the study involved only studies using observational data such as audio and video recordings of physician-patient encounters. This study investigated research that compares physician communication with patients across a wide range of ethnic groups, …

Using Wastewater-Based Epidemiology To Study Chlamydia Occurrence On A College Campus, Jessie E. Chin Quee

Honors Undergraduate Theses

Chlamydia is a sexually transmitted disease caused by Chlamydia trachomatis, commonly affecting sexually active college-aged adults. Presently, opportunistic testing, self-testing, and information campaigns are methods to screen vulnerable populations and raise awareness about chlamydia. Chlamydia remains underdiagnosed and undertested due to a lack of participation by individuals who may have been exposed to it. Wastewater-based epidemiology is a rising biomonitoring tool that detects the presence of disease- and drug-specific biomarkers in a community's wastewater. In this study, wastewater-based epidemiology was used to detect the presence of C. trachomatis on the University of Central Florida campus. Wastewater samples were collected …

Barriers And Care-Seeking Behavior Towards Breast And Cervical Cancer Screening Among Migrant Women In Casablanca, Morocco, Ala Mansour

Public Health Theses

Introduction: Over the past few decades, Morocco – a transit country for entry into Europe – has gradually evolved as a place of resettlement for migrants of sub-Saharan and West African origins. To combat inequities in healthcare utilization, the Moroccan government introduced a series of reforms designed to promote breast and cervical cancer screening and regularization of migrants. To date, few studies have explored the extent to which migrant residents in the country uptake these services or their awareness of cancer signs, symptoms, and risk factors relative to their native counterparts. The purpose of this study is to therefore delineate …

“I Was Reaching Out For Help And They Did Not Help Me”: Mental Healthcare In The Carceral State, Anna Grace Preston

Public Health Theses

Background: Despite the limitations the carceral environment may impose on mental wellness, mental healthcare is increasingly becoming a carceral endeavor. Over the course of the last several decades, prisons and jails have become the de facto mental healthcare provider for thousands of incarcerated individuals. Furthermore, practices like mandated mental healthcare for supervised individuals further broaden the population experiencing mental healthcare within the criminal legal system at large. This study examines the perspectives of nine individuals who experienced mental healthcare within the carceral state, whether in prison or on parole or probation, with a special focus on how attributes of the …

Saint Louis, Missouri Maternal Mortality Prevention Program: Rose Program, Abbi Peck

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

In the United States, maternal mortality has become a growing public health concern after recent studies revealed significant disparities in maternal health outcomes when compared to other high-income countries (The Commonwealth Fund, 2020). The World Health Organization (WHO) defines maternal mortality as the death of a pregnant woman or the death of a woman within 42 days of delivery, miscarriage, termination, or ectopic pregnancy (Centers for Disease Control and Prevention, 2022a). From 2017-2019, the maternal mortality in Saint Louis, Missouri, the state’s largest and most populated metropolitan area, was determined to be 36.4 maternal deaths per 100,000 live births. This …

Implementation Of A School-Based Adolescent Pregnancy Prevention Program In Harlan County, Kentucky, Jaycea Frederick

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Kentucky has the 6^th highest rate of adolescent pregnancy in the United States and Harlan County ranks among the highest rates in the state. Adolescent pregnancy is a public health problem and costs taxpayers in the United States around $9.4 billion each year. Overall, there have been declines in adolescent pregnancy but the national average soars above those in other Western industrialized nations such as the United Kingdom. Implementing a comprehensive sexual health education program in a public school setting is an efficient strategy to reach numerous adolescents and influence sexual health knowledge and help to delay the initiation …

Striving For Appropriate Antibiotic Use: A Biomarker Initiative, And Outcomes Associated With Azithromycin Exposure, Amanda Gusovsky

Theses and Dissertations--Pharmacy

The introduction of antibiotics into clinical practice is considered the greatest medical breakthrough of the 20^thcentury. However, the use of antibiotics can contribute to the development of resistance. In the United States (U.S.), approximately 2.8 million people are infected with antibiotic-resistant bacteria each year, and more than 35,000 people die as a result. Moreover, some antibiotics are known to cause cardiac side effects including QT prolongation, hypotension, and ventricular arrythmias. The U.S. Centers for Disease Control and Prevention (CDC) defines appropriate antibiotic use as the effort to use “the right antibiotic, at the right dose, for the right …

Clustering Hospital Performance Using Group-Based Multi-Trajectory Modeling With Singular Bayesian Information Criterion, Gaixin Du

Theses and Dissertations--Epidemiology and Biostatistics

Hospital performance is complex and patient-experience oriented. Currently, the Centers for Medicare and Medicaid Services (CMS) evaluate hospitals yearly with a single score of one to five ("Star Rating") using composite measures from five domains. However, a single composite score cannot fully describe it, and alternative measures should be considered. Healthcare quality improvement needs long-term data to validate effectiveness. Group-based multi-trajectory modeling (GBMTM) estimates probabilities of latent group membership based on longitudinal profiles from multiple outcomes. We use GBMTM to identify groups of hospitals with similar performance in SAS PROC TRAJ.

We downloaded Medicare-eligible hospitals (N=5,111) that provided patient care …

Evaluating The Impact Of Mental Health Needs And Services Disruption: Covid-19 & Wisconsin Children’S Welfare Services, Gavin Rienne

Theses and Dissertations--Epidemiology and Biostatistics

Children’s traumatic experiences have lifelong impacts on their mental health and quality of life, therefore mental health services are a critical part of necessary community resources. The increased frequency and severity of natural disasters such as hurricanes, tornadoes, and pandemics reinforces the need to examine and understand the importance of mental health and child services in response to disaster events. This research assesses the relationship between disasters and subsequent health service utilization amongst children and adolescents. We investigated current research on the relationship between children’s mental health and community mental health resource efficacy and accessibility after a major disaster by …

Coronary Heart Disease And Ischemic Stroke Polygenic Risk Scores And Atherosclerotic Cardiovascular Disease In A Diverse, Population-Based Cohort Study, Allison Bebo, Jamie A Jarmul, Mark J Pletcher, Natalie R Hasbani, David Couper, Vijay Nambi, Christie M Ballantyne, Myriam Fornage, Alanna C Morrison, Christy L Avery, Paul S De Vries

Faculty, Staff and Student Publications

The predictive ability of coronary heart disease (CHD) and ischemic stroke (IS) polygenic risk scores (PRS) have been evaluated individually, but whether they predict the combined outcome of atherosclerotic cardiovascular disease (ASCVD) remains insufficiently researched. It is also unclear whether associations of the CHD and IS PRS with ASCVD are independent of subclinical atherosclerosis measures. 7,286 White and 2,016 Black participants from the population-based Atherosclerosis Risk in Communities study who were free of cardiovascular disease and type 2 diabetes at baseline were included. We computed previously validated CHD and IS PRS consisting of 1,745,179 and 3,225,583 genetic variants, respectively. Cox …

European Epidemiological Patterns Of Cannabis- And Substance-Related Congenital Neurological Anomalies: Geospatiotemporal And Causal Inferential Study, Albert Stuart Reece, Gary Kenneth Hulse

Research outputs 2022 to 2026

Introduction: Of the many congenital anomalies (CAs) recently linked with community cannabis exposure, arguably the most concerning are neurological CAs (NCAs). We therefore conducted a detailed study of this in fourteen European nations.

Methods. Congenital anomaly data were from Eurocat. Drug exposure data were from European Monitoring Centre for Drugs and Drug Addiction. Income from World bank.

Results: The Netherlands, Spain, France and Bulgaria reported increasing rates of many NCAs. The NCA rate (NCAR) was: severe microcephaly 2.14 x 1013 higher in nations with increasing daily cannabis use when compared to those without (p = 0.0204, minimum E-value (mEV) = …

Hand Hygiene Knowledge And Demonstrated Technique Among Malawian Kindergarten Children: A Quasi-Experimental Study, Balwani Chingatichifwe Mbakaya, Maggie Zgambo, Fatch Welcome Kalembo

Research outputs 2022 to 2026

Aim: To evaluate hand hygiene knowledge and demonstrated technique before and after implementation of the hand hygiene programme and its sustainability among Malawian kindergarten students. Design: Quasi-experimental design, utilizing a repeated measure at three points, namely, before intervention (T0), soon after intervention (T1) and follow-up (T2). Methods: The hand hygiene programme consisted of integrating hand hygiene protocol into the school health curriculum, setting up proper handwashing facilities, training school teachers, health talks and developing reminders on hand hygiene. Fifty-three kindergarten children aged 3–6 years were enrolled in the programme. Data were collected at 3 months' intervals (T0, T1, and T2). …

Rethinking Adolescent School Nutrition Education Through A Food Systems Lens, Margaret Miller, Donna Barwood, Amanda Devine, Julie Boston, Sandra Smith, Martin Masek

Research outputs 2022 to 2026

BACKGROUND: Obesity-driven nutrition education in schools does not appear to result in healthier adolescent food choices. This study explored food systems as an alternative pedagogical approach to engage students in nutrition education. METHODS: After playing a food systems computer game, 250 13- to 16-year-old students in 5 Western Australian secondary schools, participated in group discussions to distinguish learning and interests in food systems. Discussion records were thematically coded using constant comparative analysis. RESULTS: Students reported crop growth, food production and food waste, healthier food choices, and food systems as knowledge outcomes of game play. They requested additional content on food …

A Current Affair: Worker Perceptions Of Noise Exposure And Occupational Hearing Loss In Australian Coal Mines, Adelle Liebenberg, Jacques Oosthuizen, Sue Reed

Research outputs 2022 to 2026

Background: The objective of the online survey was to determine worker attitudes towards, perceptions on hearing loss, and management of workplace noise; and to identify barriers within current strategies that prevent effective management of hearing health in Australian mines. Design: This cross-sectional study utilized a modified survey design, initially designed for use by Safe Work Australia for a broader study published in 2010. Study Sample: The survey questionnaire was made available online to volunteer participants, recruited with the assistance of State and National Health and Safety, and mining organizations. Volunteer participants were required to be proficient in English, be employed …

Development Of A Scoring Tool For Australian Rural Food Retail Environments, Tracy L. Schumacher, Carissa A. Alderton, Leanne J. Brown, Susan Heaney, Laura Alston, Katherine Kent, Stephanie L. Godrich

Research outputs 2022 to 2026

Current tools scoring the healthiness of food retail outlets do not reflect outlets found in rural locations. This study aimed to adapt pre-existing Australian scoring tools to represent non-metropolitan areas. Rural nutrition experts were identified, and a modified Delphi technique was used to adapt two pre-existing, food-scoring tools in five iterative stages. Stages included identifying all relevant outlets, providing a description and score for each, ensuring consistency between outlet scores and pre-existing, metro-centric tools, and providing instructions for correct use. Six rural nutrition experts were identified and engaged in the modified Delphi technique. The final tool consisted of 12 categories …

Working Conditions, Type 2 Diabetes Mellitus, And Health Behaviors In Latino And Other Minoritized Groups Living In The United States, Tailisha M. Gonzalez

Dissertations and Theses

Background: Type 2 Diabetes Mellitus (T2DM or ‘diabetes’) poses a significant public health challenge to the healthcare system, economy, and well-being of communities in the United States (U.S.). There are also substantial racial/ethnic and social disparities in diabetes incidence and control that have persisted for decades. For Latinos and other minoritized groups in the U.S., diabetes disparities may be linked to working conditions. Globally, work is considered a major determinant of health and yet studies in the U.S. tend to focus on legacy hazards, such as chemical, biological, and environmental factors. In recent years, occupational health scholars have argued …

Campus Sexual Violence In The Time Of Covid-L9, Hannah Holt

Master’s Theses

Campus sexual assault (CSA) was likely on the rise in the United States (Koss et al., 2022) even prior to the COVID-19 pandemic, during which there was a global increase in violence against women. The present study is a needed addition to the limited rigorous scientific studies on the impact of the COVID-19 pandemic on campus sexual assault (CSA). A mixed-methods, ecological, and critical feminist approach was used to investigate CSA during the mitigation period. The present study specifically utilized the Sexual Experiences Survey (Koss et al., 2007) to assess changes in frequency of victimization within two representative samples of …

A Biblioguidance Approach To Fostering Students’ Self-Efficacy To Advocate For Health, Jennifer R. Banas, Sara Gershon

Health Sciences and Physical Education Faculty Publications

Teaching the components of health advocacy is straightforward, but fostering young people’s self-efficacy to be health advocates for themselves, others, and their community is more complex. This complexity sometimes renders advocating for health, the basis of National Health Education Standard (NHES) #8, challenging to teach. We utilized a pedagogical approach called biblioguidance to teach this skill to 10th-grade students. The premise of biblioguidance, also called bibliotherapy, is that information, guidance, and even solace can be found through reading and vicariously living story events. To implement this approach, we consulted the literature and created a six-step framework to guide the design, …

The Struggles Black Women Face In Federally Qualified Community Health Centers In South Carolina: A Phenomenological Exploration Of Women In Leadership Positions, Sharon Black

Dissertations

This qualitative interpretive phenomenological study examined the professional lived experiences of Black women who hold leadership positions within Federally Qualified Community Health Centers (FQHCs) in South Carolina. The researcher examined their experiences through the lens of Belenky’s (1986) Ways of Knowing framework, focusing on self-expression, voice, and how the participants processed their leadership experiences. In addition, the study draws on Crenshaw’s Intersectionality and Black Feminist Post-structuralist theories. The study explores the difficulties, successes, and strategies these women use, focusing on stereotypes, challenges in leadership roles, diversity of experiences, and the importance of voice themes.

The study provides practical suggestions for …

Gender Differences In Administration Of Tpa In Treatment Of Ischemic Stroke, Christina Annerino

CURE Proceedings

As medicine and pharmacology advance through the years, new life-saving treatments are studied or discovered every day, and a medical emergency is no longer a death sentence. Even with conditions as serious as ischemic stroke, there is hope for survival and rehabilitation with the ‘clot-busting’ drug, tissue plasminogen activator, colloquially known as ‘tPA’. tPA is a thrombolytic agent, a substance that acts on fibrin in clots to dissolve them so they can no longer cause ischemia in blood vessels that results in a stroke. (Vega, 2022). tPA is an extremely effective treatment for ischemic stroke, demonstrated in 2013 by a …

Nasal Host Response-Based Screening For Undiagnosed Respiratory Viruses: A Pathogen Surveillance And Detection Study, Nagarjuna R. Cheemarla, Amelia Hanron, Joseph R. Fauver, Jason Bishai, Timothy A. Watkins, Anderson F. Brito, Dejian Zhao, Tara Alpert, Chantal B. F. Vogels, Albert I. Ko, Wade L. Schulz, Marie L. Landry, Nathan D. Grubaugh, David Van Dijk, Ellen F. Foxman

Journal Articles: Epidemiology

BACKGROUND: Symptomatic patients who test negative for common viruses are an important possible source of unrecognised or emerging pathogens, but metagenomic sequencing of all samples is inefficient because of the low likelihood of finding a pathogen in any given sample. We aimed to determine whether nasopharyngeal CXCL10 screening could be used as a strategy to enrich for samples containing undiagnosed viruses.

METHODS: In this pathogen surveillance and detection study, we measured CXCL10 concentrations from nasopharyngeal swabs from patients in the Yale New Haven health-care system, which had been tested at the Yale New Haven Hospital Clinical Virology Laboratory (New Haven, …

The Psychology Of Science Denialism And Lessons For Public Health Authorities, Brenna Moreno, Molly J. Walker Wilson

All Faculty Scholarship

As it wreaked tragedy on the world, the outbreak of COVID-19 helped expose a pandemic of a different kind, one steeped in distrust and contrarianism. This movement, termed science denialism, has been lurking and undermining public health efforts for decades. Specifically, it is “the employment of rhetorical arguments to give the appearance of legitimate debate where there is none, an approach that has the ultimate goal of rejecting a proposition on which a scientific consensus exists.” Unlike skepticism, which is “doubt as to the truth of something” and works to progress both science and society, denialism is characterized by individuals’ …

Determining The Food Choice Motivations Of Irish Teens And Their Association With Dietary Intakes, Using The Food Choice Questionnaire, Aisling Daly, Elizabeth O'Sullivan, Janette Walton, Laura Kehoe, Breige A. Mcnulty, Albert Flynn, John M. Kearney

Articles

During adolescence, teens start making their own food choices. While health and nutrition are important, practical and social concerns are also influential. This study aims to determine factors that motivate the food choices of Irish teens (using Food Choice Questionnaire), using data from the National Teens' Food Survey II (N = 428, 50% male, 13-18 years), and to identify how these motivations relate to dietary intakes (4-day semi-weighed food diaries). Data analysis used PCA to determine the food choice motivation subscales, and correlation and comparative statistical tests (t-test, ANOVA). Eight motivating factors were identified for Irish teens: Sensory Appeal, Price …

Workplace Accident Analysis In The Algerian Oil And Gas Industry, Hamza Zerrouki

Articles

A total of 42,032 workplace accidents were reported in 2021 by the Algerian National Social Insurance Fund for Salaried Workers in Algeria, of which 38,225 were accidents within the workplace and 3807 were related to traffic accidents or other reasons. Most of these accidents were recorded in the building and construction field, followed by the oil and gas company exploration and drilling, which comes at the forefront of the Sonatrach company. This study aims to analyze accidents in the workplace using quantitative and qualitative methods to determine the corresponding causes. Our study was carried out in collaboration with Sonatrach in …

Evaluation Of Irish Consumers’ Knowledge Of Salmonellosis And Foodhandling Practices, Ann Conway, Olugbenga Ehuwa, Meabh Manning, Aine Maye, Fintan Moran, Amit K. Jaiswal, Swarna Jaiswal

Articles

Salmonella is one of numerous food-borne pathogens that could possibly pose a major threat to global food safety. Salmonella is primarily associated with foods such as poultry, eggs, vegetables, and some dairy products. However, infected food handlers and faecal contaminated environments are also significant sources and reservoirs of this pathogen. This study comprehensively evaluated the Irish consumers’ food safety knowledge by exploring their knowledge level, practices and attitudes regarding raw meat handling, cross-contamination while handling different types of food products, and knowledge of Salmonella risk and associated food-handling practices. The online SurveyMonkey tool was used to distribute a quantitative survey …

The Promis Women Education Program: Promoting Cervical Cancer Prevention Methods Among Muslim Women In Virginia, Asmaa M. Namoos

Theses and Dissertations

Abstract

Purpose: US Muslim women have suboptimal participation in cervical cancer screening and prevention services. This is due in part to a lack of access to culturally relevant education programs. To address this issue three aims were identified: Aim 1. Adapt existing evidence- based educational materials for a religious and culturally appropriate intervention; Aim 2. Test the preliminary efficacy of the intervention and Aim 3. Assess the feasibility and acceptability of the intervention and materials.

Methods: The ORBIT model for developing behavioral interventions guided intervention design, refinement (Phase I), and preliminary testing (Phase II). Focus groups and interviews were conducted …

Impact Of The Washington State Covid-19 Lockdown On 5-10-Year-Ol School-Aged Children Residing In Kitties County, Peyton Rondeau

All Master's Theses

Background: The Washington State COVID-19 lockdown and subsequent school closures brought increased dependency on parents to provide nutritious meals and opportunities for physical activity for their children.

Purpose: The aim of this study was to describe the impacts of the Washington State COVID-19 lockdown on the dietary, physical activity, and screen time habits of children ages 5-10-years-old residing in Kittitas County.

Methods: A researcher-developed Qualtrics survey was created and validated via the Index of Item Objective Congruence. The survey was administered to parents via Facebook, using local Kittitas County Facebook groups.

Results: Most parents identified that the Washington lockdown negatively …

Choose Well: Summary Of Mid-Point Evaluation Findings, Center For Applied Reasearch And Evaluation In Women's Health, East Tennessee State University

Center for Applied Research and Evaluation (CARE) in Women's Health Reports

This report summarizes key findings related to the evaluation of the Choose Well Initiative at the mid-point. Results are not complete but provide a brief summary of key findings and evidence to date.

Policies For Expanding Hepatitis C Testing And Treatment In United States Prisons And Jails, Tessa Bialek, Dr. Matthew J. Akiyama M.D.

University of Michigan Journal of Law Reform

Hepatitis C virus (HCV) is highly prevalent in United States prisons and jails. In prisons and jails, rates of infection are ten to twenty times greater than national levels. And, more than thirty percent of all people living with HCV in the United States will spend time in prisons and jails in any given year. Rates are especially high among people who inject drugs (PWID), a population whose members are also likely to move between carceral settings and the community. Thus, addressing HCV among incarcerated populations would have a significant effect on the virus’s transmission both in and out of …