Digital Commons Network^™

The Relationship Between Food Label Comprehension And Consumer Dietary Choices, Marline Denis

Walden Dissertations and Doctoral Studies

Poor dietary choices and limited understanding of nutritional information are ongoing public health concerns that contribute to the rise of chronic illnesses such as obesity, diabetes, and heart disease. This quantitative, cross-sectional, correlational study investigated the associations between health literacy and food label comprehension with consumer dietary choices and adherence to dietary guidelines among individuals aged 16 and older in the United States. Guided by the Nutrition Label Literacy (NLL) framework, this study explored whether components such as basic nutritional knowledge, numeracy skills, health motivation, and label usage predict healthier food choices. Age, education, and gender were included as covariates. …

Childhood Myopia Part Ii: Treatment Mechanisms, Emerging Options, And Considerations, Safal Khanal Dr, Erin S. Tomiyama Dr, Síofra Harrington Dr

Articles

Abstract

The rapidly increasing prevalence of myopia and its association with vision-threatening complications in later life has intensified efforts to identify treatments that can prevent the onset and slow the progression of myopia in children. These efforts have led to the development of several optical, environmental, and pharmacological myopia control treatments. Investigations of additional treatment options are ongoing and have shown great promise for clinical translation. Although significant progress has been made in identifying potential pathways and modes of action of these treatments, a complete mechanistic understanding is still lacking. This critical review article explores the potential mechanisms underlying the …

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 …

Public Health Simulation Infused Program (Pship) Toolkit, Desiree A. Díaz, Mindi Anderson, Francisco Guido-Sanz, Peggy Hill, Samantha Stephenson, Heather Peralta, Syretta Spears, Geraldine Luzincourt

Faculty Scholarship and Creative Works

Project Narrative

PURPOSE AND NEED

Purpose: Priorities set forth by the Health Resources & Services Administration (HRSA) are addressed in the proposed simulation program in an effort to meet curricular needs and foster care to the medically underserved in Florida, further exposing students to public healthcare needs. Interprofessional (nursing and social work) and intraprofessional (undergraduate nurse and Nurse Practitioner [NP]) instruction is essential in the simulation-based education (SBE) program, promoting important content on identifying risk factors and health assessment of the medically underserved community (MUC) (Education Priority 2, §831). Coordination of medical care is a vicarious learning opportunity for all …

Phage-Induced Protection Against Lethal Bacterial Reinfection, Yikun Xing, Haroldo J Hernandez Santos, Ling Qiu, Samantha R Ritter, Jacob J Zulk, Rachel Lahowetz, Kathryn A Patras, Austen L Terwilliger, Anthony W Maresso

Faculty, Staff and Students Publications

Bacteriophages, or phages, are viruses that target and infect bacteria. Due to a worldwide rise in antimicrobial resistance (AMR), phages have been proposed as a promising alternative to antibiotics for the treatment of resistant bacterial infections. Up to this point in history, phage use in preclinical animal studies, clinical trials, and emergency-use compassionate care cases has centered around the original observation from 1915 showing phage as lytic agent, and thus a treatment that kills bacteria. Here, we describe an activity associated with phage therapy that extends beyond lytic activity that results in long-term protection against reinfection. This activity is potent, …

How Far-Right Populism Harms Ethnic Minorities’ Health: The Case Of The United States, Dina Rosenberg

Working Papers Series

Public health is a political issue, and the health of ethnic minorities is a key component of it. We argue that far-right populism, whether grassroots or elitist, harms the health of immigrants and minorities. Anti-minority attitudes and policies—such as health chauvinism promoted by far-right populists—along with hate rhetoric and ensuing personal and institutional discrimination create a climate of hostility that negatively affects health outcomes in underprivileged communities. We hypothesize that immigrants and ethnic minorities living in such a climate are more likely to experience health problems and underutilize healthcare. To test this, we leverage the significant variation between U.S. states …

Longitudinal Outcomes Of The Covid-19 Pandemic On Youth Physical Fitness, Andjelka Pavlovic, David Leonard, Timothy J Walker, Derek W Craig, Jizyah Injil, Laura F Defina

Faculty, Staff and Student Publications

Importance: The COVID-19 pandemic led to a decline in physical activity levels among youths, which could have a negative impact on their fitness.

Objective: To examine longitudinal changes in cardiorespiratory fitness (CRF) and musculoskeletal fitness (MSF) among students at schools participating in a school-based physical activity program during fall 2019 through spring 2023.

Design, setting, and participants: This longitudinal cohort study included US schools reporting CRF and MSF data at least once during the pandemic (fall 2020 to fall 2021) and at least 1 additional time before or after. In a subset of schools for which learning modality data was …

Association Between Health Insurance, Antiretroviral Treatment, And Hiv Preexposure Prophylaxis In Men Aged 20–85 In Virginia, Lauren Elizabeth Maxwell

Walden Dissertations and Doctoral Studies

HIV prevention and treatment disparities persist among men in Virginia, particularly in racial and ethnic minority groups. This study examined how insurance type and demographic factors influence prescriptions for antiretroviral treatment (ART) and preexposure prophylaxis (PrEP). Addressing these disparities is critical to advancing public health equity and reducing HIV rates. The purpose was to assess whether age, race, ethnicity, region, and insurance type are associated with the type of oral HIV medication prescribed. Guided by the HIV prevention and care cascade frameworks, the study focused on access and adherence. Using a cross-sectional quantitative design, the study analyzed secondary data from …

Insights On Human Papillomavirus Among Medical Students And Professionals, Fathima Thansiha, Amogha Shree, Rashmi S

Digital Journal of Clinical Medicine

Background: As per World Health Organization, in 2022, 660000 women were diagnosed with cervical cancer worldwide and 350000 women died from the disease. Sexual behaviour is the major risk factor and exposure to Human Papillomavirus has been established as a causative agent in 70-80% of the cases for development of cervical cancer. Most infections with HPV resolve spontaneously and cause no symptoms, persistent infection can cause cervical cancer in women. Effective primary (HPV vaccination) and secondary prevention approaches (screening and treating precancerous lesions) will prevent most cervical cancer cases. Thus, study was conducted with the objective of assessing the knowledge …

Stress And Burnout: Is There A ‘Happily Ever After’?, Margaret S. Gingrich D.D.S.

The Journal of the Michigan Dental Association

Executive Summary Dental professionals experience significant stress and burnout due to high patient expectations, challenging patients, employee management issues, and insurance complexities. Dr. Margaret Gingrich outlines Christina Maslach's six stages of burnout, from the honeymoon phase to reduced personal accomplishment. Recovery requires intentional rest following the "rule of 42" - dedicating 42% of daily time to various forms of rest, including physical, emotional, sensory, mental, spiritual, social, and creative restoration. Key strategies involve setting boundaries, saying no, taking breaks, seeking social support, and, when necessary, terminating problematic patient relationships. The Michigan Dental Association and American Dental Association provide wellness resources, …

The Ethnobotany And Pharmacology Of Medicinal Plants For Caribbean Women’S Health, Ella Thomas Vardeman

Dissertations, Theses, and Capstone Projects

Approximately 55% of the world’s population lives in cities, and the United Nations estimates that this number will rise to 68% by 2050. Urban ethnobotany, the study of people’s traditional knowledge and use of plants in cities, is increasingly important as people adapt their cultural traditions to changing environments. In New York City (NYC), there have been several urban ethnobotany investigations in collaboration with Caribbean immigrant groups. However, there has yet to be an ethnobotanical survey that documents and botanically authenticates the medicinal plants used in the Haitian community. Previous collaborative research with women from the Caribbean in NYC has …

Analyzing “Sex Ed: The College Edition” - A Comprehensive Workshop Increasing Sexual Literacy On Cal Poly’S Campus, Merav Tzori

Kinesiology and Public Health

"Sex-Education: The College Edition", is a comprehensive and interactive workshop based on Cal Poly student data collected via survey. The workshop aimed to address sexual health knowledge and behavior gaps in the student population and provide sexual education about anatomy, barrier methods, contraception, STIs, and more. The following paper discusses the creation, execution, and efficacy of the workshop that was conducted with seven student groups.

Derivation And Internal-External Validation Of Clinical Prediction Model For Postoperative Clinically Important Hypotension In Patients Undergoing Noncardiac Surgery: An International Prospective Cohort Study, Stephen Su Yang, German Malaga, Maria Lazo-Porras, Patricia Busta-Flores, Aida Del Carmen Rotta-Rotta, Pavel S Roshanov, Daniel I Sessler, Amal Bessissow, Thomas Schricker, Vicky Tagalakis, Diane Heels-Ansdell, Shirley Pettit, P J Devereaux

Faculty, Staff and Student Publications

Background: Intraoperative and postoperative hypotension are associated with myocardial injury/infarction, stroke, acute kidney injury, and death. Because of its prolonged duration, postoperative hypotension contributes more to the risk of organ injury compared with intraoperative hypotension. A prediction model for clinically important postoperative hypotension after noncardiac surgery is needed to guide clinicians.

Methods: We performed a secondary analysis of the Vascular Events in Noncardiac Surgery Patients Cohort Evaluation (VISION) study. Patients aged ≥45 yr who had inpatient noncardiac surgery across 28 centres in 14 countries were included. In 14 of the centres selected at random (derivation cohort), we evaluated 49 variables …

Large-Scale Plasma Proteomic Profiling Unveils Diagnostic Biomarkers And Pathways For Alzheimer’S Disease, Gyujin Heo, Ying Xu, Erming Wang, Muhammad Ali, Hamilton Se-Hwee Oh, Patricia Moran-Losada, Federica Anastasi, Armand González Escalante, Raquel Puerta, Soomin Song, Jigyasha Timsina, Menghan Liu, Daniel Western, Katherine Gong, Yike Chen, Pat Kohlfeld, Allison Flynn, Alvin G Thomas, Joseph Lowery, John C Morris, David M Holtzman, Joel S Perlmutter, Suzanne E Schindler, Natalia Vilor-Tejedor, Marc Suárez-Calvet, Pablo García-González, Marta Marquié, Maria Victoria Fernández, Mercè Boada, Amanda Cano, Agustín Ruiz, Bin Zhang, David A Bennett, Tammie Benzinger, Tony Wyss-Coray, Laura Ibanez, Yun Ju Sung, Carlos Cruchaga

Faculty, Staff and Student Publications

Proteomic studies have been instrumental in identifying brain, cerebrospinal fluid and plasma proteins associated with Alzheimer's disease (AD). Here, we comprehensively examined 6,905 aptamers corresponding to 6,106 unique proteins in plasma in more than 3,300 well-characterized individuals to identify new proteins, pathways and predictive models for AD. We identified 416 proteins (294 new) associated with clinical AD status and validated the findings in two external datasets representing more than 7,000 samples. AD-related proteins reflected blood-brain barrier disruption and other processes implicated in AD, such as lipid dysregulation or immune responses. A machine learning model was used to identify a set …

Early Life Exposure To Fine Particulate Matter And Fine Motor Function, Attentional Function, And Working Memory Among Spanish School-Aged Children, Kristina W Whitworth, Aitana Lertxundi, Mingze Yuan, Alison Rector-Houze, Wei-Jen Chen, Mònica Guxens, Jordi Julvez, Michael Swartz, Elaine Symanski, Antonia Valentin, Carmen Iniguez, Llúcia L González-Safont, Jesús Ibarluzea

Faculty, Staff and Student Publications

Background: Evidence of the association between fine particulate matter (PM2.5) exposure and child neuropsychological function is equivocal. We examined early life PM2.5 exposure in relation to fine motor function, attention, and working memory in early childhood.

Methods: We used data from the Spanish INfancia y Medio Ambiente Project, 2003-2008. Exposure to PM2.5 (μg/m3) was assessed using spatiotemporal land-use random forest models and assigned based on residential address histories. Around age six, children completed the finger tapping test, attentional network test (ANT), and n-back task to evaluate fine motor speed, attention, and working memory, respectively. A total of 1,310 children had …

Understanding Utilization And Prevention Measures Associated With A Caries Risk Assessment In Oral Health Transformation, Melody Mcgee, Ryan Brandon, Muhammad Walji, Joel White, Kristen Moses, Eric P Tranby, Lisa J Heaton, Kristen Simmons

Faculty, Staff and Student Publications

Objectives: Dental decay is endemic in the United States, underscoring the need to measure the utilization of caries risk management tools to elucidate the effect of prevention interventions in reducing the dental decay rates of individuals. An academic institution partnered with a third-party institute to call attention to the utilization and prevention measures associated with caries risk assessment (CRA) used with children 0-18 years. This environmental scan examined claims across the United States to evaluate the proportion of dental examinations, CRAs, and caries prevention procedures within a calendar year.

Methods: A 12-month deidentified participant list categorized by age, race, sex, …

Europe–Africa Collaboration: Working Together To Strengthen Health Research, Implementation, And Equitable Systems, Lara Pandya, Irene Norstedt, Martin Seychell, Emer Cooke, Isabel De La Mata Barranco, Niklas Blomberg, Marleen Temmerman, Michael Makanga

Centre of Excellence in Women and Child Health

In September 2024, key representatives from European Union (EU) directorates and agencies convened to enhance collaboration with Africa in strengthening health research, innovation, and implementation. The meeting focused on bolstering joint efforts to improve health outcomes and support wellbeing across all ages in Africa. Despite progress in addressing infectious diseases, the continent faces a dual burden with the rise of non-communicable diseases and emerging threats such as antimicrobial resistance, climate change, falsified medicines, and pandemic risks. These challenges are exacerbated by fragile health systems, rapid population growth, urbanisation, and limited access to affordable medical interventions.

To address these issues, the …

Aapm Task Group No 249b-Essentials And Guidelines For Clinical Medical Physics Residency Training Programs, Jonathon A Nye, Joseph P Dugas, William D Erwin, David P Gierga, Darryl G Kaurin, Stephanie M Leon, Ho-Ling Anthony Liu, Zheng Feng Lu, Alphonso W Magri, Lynn N Rill, Leah K Schubert, Beth A Schueler, Irina Vergalasova, John Vetter, Brian D Wichman, Amy Shu-Jung Yu, Dandan Zheng

Faculty, Staff and Student Publications

The establishment of guidelines and curriculum standards for medical physics residency training is a critical component of setting expectations and competencies for the profession. Since the last publication of these standards, residency training has become integrated into the eligibility criteria for most medical physics certification bodies. The rapid growth of medical physics requires periodic review of the curriculum to remove outdated approaches, update established knowledge, and add emerging technologies. The goal of this document is to provide a reference standard for residency training program directors, training mentors, and residents to guide creation and/or optimization of their program's curriculum. The document …

Comparative Genotoxicological Analysis Of Occupational Pesticide Exposures: An Experimental Approach And Systematic Review, Moustafa Samy Sherif

Dissertations

This dissertation investigates the genotoxic and cytotoxic effects of pesticide exposure through three complementary research components: a systematic review of occupational pesticide exposure in Arab countries (AraSys), a systematic review on encapsulated versus conventional pesticide formulations (Encap-Sys), and experimental toxicological assessments of various pesticide formulations in human cell lines (Pyr-Ex). This experimental component includes cytotoxicity assays using propidium iodide and DNA damage assessments via alkaline comet assays in HL60 and HepG2 cell lines exposed to pyrethroid insecticides and glyphosate-based formulations.

The AraSys systematic review revealed a critical positive association between occupational pesticide exposure and DNA damage in agricultural workers in …

Airway Immune Signatures In Severe And Fatal Infection With Covid-19, Naresh Doni Jayavelu, Jing Jing Qi, Slim Fourati, Farrah Kheradmand, Charles R Langelier, Lauren I R Ehrlich, Joann Diray-Arce, Annmarie Hoch, Monica Kraft, Patrice M Becker, Matthew C Altman, Ruth R Montgomery

Faculty, Staff and Students Publications

No abstract provided.

Fine-Scale Population Structure Of Japanese Helicobacter Pylori Provides New Anthropological And Epidemiological Insights, Kohei Tomonari, Batsaikhan Saruuljavkhlan, Ricky Indra Alfaray, Kartika Afrida Fauzia, Osamu Matsunari, Daisuke Chinda, Tadashi Shimoyama, Phawinee Subsomwong, Nagisa Kinjo, Tetsu Kinjo, Yasuo Hanamure, Masato Shinzato, Rumiko Suzuki, Fukunori Kinjo, Shigeru Takigami, Toshio Fujioka, Takeshi Matsuhisa, Junko Akada, Takashi Matsumoto, Yoshio Yamaoka

Faculty, Staff and Students Publications

Helicobacter pylori is considered to contribute to gastric cancer and is also used as a marker to trace human migration due to its co-evolution with humans. To understand the recently proposed tripartite model suggesting three ancestral origins for the Japanese population and address the enigma of the high incidence of gastric cancer in Northeast Hondo (Hondo is mainland Japan), we conducted a fine-scale population structure analysis using a large Japanese H. pylori dataset, including 438 strains from 9 regions based on whole-genome sequences. As a result of fineSTRUCTURE analysis, it was found that H. pylori in Northeast Hondo is genetically …

Is Less More? Maximizing Outcomes By Tailoring Treatments To Patients: Oncofertility And Oncomenopause, Janice S Kwon, Marie Plante, Martha Hickey, Annabelle Huguenin, Sarah Hmaidan, Terri Lynn Woodard

Faculty, Staff and Students Publications

Notable advances have been made in improving survival outcomes in various cancers, but some have incurred undesirable costs and effects to patients with respect to fertility and menopause. Patients are living longer with cancer, and patient reported outcomes are influencing decision-making by individuals and their health care providers. It is essential to evaluate existing standards of care on an ongoing basis and prioritize quality of life and long-term survivorship, particularly for interventions in early-stage cancers and risk-reducing strategies that often yield long-term life expectancy.

Understanding Occupational Health And Safety Regulations And The Influence On Students' Behavior In Practical Workshops, M. Yusuf, I Ketut Gde Juli Suarbawa, Ni Wayan Merda Surya Dewi, Ni Wayan Sadiyani, I Made Sudana

Kesmas

Understanding occupational health and safety (OHS) is essential for engineering students, especially in high-risk environments such as mechanical workshops, where unsafe practices can lead to accidents and injuries. Although Regulation Number 5 of 2018 from the Indonesian Ministry of Manpower mandates OHS implementation in all workplaces, students’ knowledge and behavior still fall short of the expected safety standards. This study aimed to measure students’ understanding of OHS, their basic knowledge of OHS law, and their behavior during workshop practicum activities. A cross-sectional research design was used, involving 203 students in State Polytechnic in Badung District, Indonesia. Data were collected through …

Food Hygiene And Sanitation Of The University Canteens In South Sumatra Province, Indonesia, Anita Rahmiwati, Fatmalina Febry, Fenny Etrawati, Indah Purnama Sari, Yeni Yeni, Virgina Putri Sabila, Erike Septa Prautami, Maretalinia Maretalinia

Kesmas

Food safety is a critical public health issue, especially in institutional settings such as university canteens, where large populations are served daily. Inadequate hygiene and sanitation practices by food handlers can lead to foodborne illnesses, placing students and staff at risk. This study evaluated hygiene and sanitation conditions in the canteens of a leading public university in South Sumatra Province, Indonesia, known for its active food service facilities. This study examined food handlers’ knowledge, attitudes, and practices and assessed the microbiological safety of chicken curry by testing for Escherichia coli (E. coli) contamination and total plate count. Using a cross-sectional …

Development Of Audiovisual Media For Reproductive Health Education For Parents Of Adolescents, Tanjung Anitasari Indah Kusumaningrum, Nurul Latifatul Inayati, Setia Asyanti, Ayu Khoirotul Umaroh, Wardhatul Livia, Ramadani Nur Laili, Trijaya Trijaya, Ririn Cahya Dewanti, Yuli Kusumawati, Izzatul Arifah

Kesmas

Parents are the primary source of information for adolescents, but many parents lack an understanding of health materials. For knowledge to be increased, health media, one of which is audiovisual media, are desirable. This study aimed to develop audiovisual media on adolescents’ reproductive health. Media development utilized the analyze, design, develop, implement, and evaluate (ADDIE) model. The respondents in this study were parents of adolescents aged 10–14 years, comprising 10 parents in the small group evaluation, 20 in the field evaluation, and 10 in the implementation stage. The effectiveness of the media was tested through pretests and posttests. Using a …

Social Eating Role In Ultra-Processed Food Consumption Among Urban Young Adults: The 2018 Indonesian Food Barometer, Imas Arumsari, Nabilla Ayusyah Putri, Siti Nur Lulu Lathifah, Gita Aisyah Astrid Rosalba, Helda Khusun, Judhiastuty Februhartanty, Rahmatika Nur Aini

Kesmas

This study investigated the differences in ultra-processed food (UPF), fruit, vegetable, and total fat consumption in different aspects of social eating among urban young adults. This cross-sectional study used the 2018 Indonesian Food Barometer dataset with 180 participants aged 18–25 years living in urban areas from 6 provinces in Indonesia. The data on social eating (cooking habits, eating out, and eating alone), UPF, fruits, and vegetables were obtained from an extended 24-hour food recall interview. The Mann-Whitney U test (CI 95%) was employed for data analysis. This study found that groups with less frequent cooking habits tended to have more …

Availability And Distribution Of Stoma Bags For Colorectal Cancer Patients: A Case Study At National Referral And Private Hospitals, Ratna Aryani, Toar Jm Lalisang, Debie Dahlia, Evi Martha, Achir Yani S Hamid, Sukma Wicaturatmashudi, Helen Helen

Kesmas

Stoma bags are essential for colorectal cancer (CRC) patients with stomas. However, access and affordability in Indonesia remain challenging as the National Health Insurance (NHI) does not fully cover these devices. This study aimed to describe the availability and distribution of stoma bags for patients with CRC in national referral and private hospitals, focusing on outpatient access. A qualitative case study was conducted through observations and in-depth interviews with four enterostomal therapy nurses and six patients across three national referral hospitals and one private hospital in the Jakarta Metropolitan Area, Indonesia. Notably, the availability of stoma bags was limited in …

Is The Juice Worth The Squeeze: Anti-Xa Monitoring In Trauma Patients, Megan Dupont Bs, Jennifer M. Brewer Md, Alison A. Smith Md, Phd, Patrick Greiffenstein Md, Roslyn Alexander Do, Lillian Bellfi Pharmd

Quality Improvement & Patient Safety Forum

No abstract provided.

Caring For The Incarcerated Patient: Provider Perceptions Of Quality Of Care In The State Of Louisiana, Haley Beavers Khoury, Olivia K. Sugarman, Andrea Armstrong, Bruce Reilly, Ashley Wennerstrom

Journal of the Louisiana Public Health Association

Background: As of December 2023, there were roughly 28,000 people held in state custody in Louisiana. Prior research and litigation have documented challenges with healthcare service delivery within prisons, but less is known about the higher acuity care incarcerated people receive at state-contracted hospitals. Methods: Between November 2020 and January 2021, authors conducted semi-structured interviews with a convenience sample of Louisiana healthcare professionals about their experiences of providing incarcerated people care at hospitals. Interviews were audio-recorded and transcribed verbatim. Authors used applied thematic analysis techniques to synthesize qualitative data and identify themes. Results: Nine health professionals with diverse roles and …

Investigating Biomarkers Linking Tobacco Use With Cadiovascular Disease Occurrence, Kennedy Dorsey, Nubaira Rizvi, Donald Mercante, Micahel D. Celestin Jr., Tung-Sung Tseng, Qingzhao Yu

Journal of the Louisiana Public Health Association

Background: Smoking has been associated with negative cardiovascular health outcomes. We analyzed data from The Population Assessment of Tobacco and Health (PATH) Study to investigate whether certain biomarkers collected were related to both cardiovascular disease (CVD) occurrence and cigarette or ecigarette use. Methods: A total of 6,473 participants were grouped into cigarette users, e-cigarette users, and non-users. Among them, 6,020 (93%) developed CVD and 453 (7%) did not over PATH Study Waves 1 to 5. All participants were adults, had valid tobaccouse and biomarker data, and no pre-existing CVD prior to Wave 1. We conducted mediation analysis using nonlinear multiple …