Digital Commons Network^™

Assessing The Impact Of Atrazine And Paraquat On Parkinson’S Disease Prevalence In Rural Nebraska Counties, Alex Egbuchiem

Capstone Experience: Master of Public Health

This study examines the association between exposure to the herbicides atrazine and paraquat and the prevalence of Parkinson’s Disease (PD) in various counties of Nebraska. PD is a neurodegenerative disorder that impacts rural agricultural regions in Nebraska, where pesticide application is prevalent. Through a thorough analysis of data sourced from the Nebraska PD Registry, environmental monitoring databases, and pesticide usage, this research aims to establish a correlation between the concentrations of atrazine and paraquat in both groundwater and surface water and the incidence of PD within this region. The study will employ statistical techniques to evaluate this association while accounting …

Enhancing Safety In Healthcare Construction: A Comprehensive Training Program On Managing Construction Dust, Melissa Nalath

Capstone Experience: Master of Public Health

In healthcare settings, construction activity poses significant risks due to the formation and release of construction dust containing allergens, pathogens, and toxic substances. This culminating project will develop a comprehensive training course for contractors to mitigate these risks while ensuring the safety of patients, employees, and construction workers. The training programs will raise awareness of the health risks associated with construction dust and educate contractors on proper dust handling techniques and ensure compliance with relevant regulations. Key elements such as containment, ventilation, and proper personal protective equipment (PPE) use will be emphasized. The program will also underscore the potential for …

A Landscape Analysis Of Rapid Evidence Curation During The 2022 Sudan Virus Disease Outbreak In Uganda, Jemimah J. Wachap

Capstone Experience: Master of Public Health

Uganda's 2022 Sudan Virus Disease (SVD) outbreak emphasized the need for rapid and effective evidence curation in public health emergencies. This analysis examines evidence curation practices during the SVD response, identifying challenges and assessing the timeliness and effectiveness of strategies in low-resource settings. While global responses to previous outbreaks, like COVID-19, have advanced evidence synthesis, the SVD outbreak revealed infrastructure and data integration gaps. The study aims to map the evidence curation landscape, focusing on models and tools, such as data-sharing platforms, mobile Polymerase Chain Reaction (PCR) labs, and Integrated Management Systems (IMS). It will also address gaps in surveillance, …

Testing A Benign Multi-Modal Bilingual Intervention To Increase Self-Efficacy, Intentions, And Willingness To Administer A Covid-19 Antigen Rapid Test In A Predominately Hispanic Sample, Uchenna Gbugu

Open Access Theses & Dissertations

Introduction. Testing is one of the most effective methods for reducing the spread of COVID-19. COVID-19 antigen tests can detect proteins from the COVID-19 virus called antigens and produce results within minutes, making them suitable for at-home use. Several factors have been identified as barriers to self-administering a COVID-19 antigen test, including the language of the testing instructions, the cost of testing, and access to tests. Interventions to reduce barriers to self-administering COVID-19 rapid tests are warranted to reduce the spread of COVID-19. The purpose of the present study is to test the impact of a benign multi-modal bilingual intervention …

Racial And Ethnic Differences In Knowledge Of Gender-Affirming Care Among Community And Student Participants In The Bloom Transgender Health Education Program In The Paso Del Norte Region, 2022-2024, Tandra Ghosh

Open Access Theses & Dissertations

SUMMARY OF BACKGROUND AND SIGNIFICANCE: There is a noticeable lack of training and knowledge regarding gender-affirming care (GAC) among providers and within the general community. OBJECTIVE: Assess racial and ethnic disparities in knowledge of GAC among participants in BLOOM, a quasi-experimental transgender health education program in the Paso Del Norte region. HYPOTHESES: Among community and student participants at pre-survey, assess racial and ethnic differences in sociodemographic characteristics, preparedness, attitudes, and basic knowledge regarding LGBT clients/patients and GAC. METHODS: Secondary data among community (pre: 53; post: 14) and student (pre: 29; post: 17) BLOOM participants in 2022-2024 were used. Descriptive statistics …

Insights Into Cancer Awareness And Health Practices In Rural Kenya: A Cross-Sectional Study Of Esophageal, Breast, Prostate, Cervical, And Colorectal Cancers, Rosebella Iseme-Ondiek, Joseph Abuodha, Anthony Ngugi, Mansoor Saleh, Innocent Abayo

Population Health, East Africa

PURPOSE; In sub-Saharan Africa (SSA), there has been an epidemiologic transition from infectious diseases to noncommunicable diseases, including a projected doubling in incidence of cancer. Understanding the underlying factors driving this surge is crucial for designing effective strategies to mitigate the cancer burden. This study focuses on assessing knowledge, attitudes, screening practices, and health behaviors related to five most prevalent cancers in SSA: prostate, breast, cervical, esophageal, and colorectal—among a predominantly rural coastal population in Kenya.

MATERIALS AND METHODS ;We used a cross-sectional study design targeting 1,500 adult respondents randomly selected from an existing community health and demographic surveillance system. …

Refractive Error And Axial Length (Real) Study: Feasibility Of A Population Study In The United States, Sarah E. Singh Dr, Lisa A. Ostrin, Kristen Kerber Dr, Concepcion Cayle, Celia Gong Dr, Lal Barsha Dr, Ian Flitcroft, Síofra Harrington, James Loughman, Kathryn Saunders Prof, Fuensanta Vera-Diaz Dr

Articles

Myopia is the most common eye disease and a leading cause of blindness. A contemporary, large, and ethnically and geographically diverse study of ocular biometry and refractive error in children in the United States is needed to help better describe differences between myopic and nonmyopic eyes.

This is an initial cross-sectional report from the Refractive Error and Axial Length Growth Curve Study that includes ocular component data as a function of age, gender, and geographic location. This feasibility report will inform a planned larger longitudinal ocular growth study in children in the United States.

Cross-sectional data on children, ages 3 …

Understanding The Care Experiences And Support Needs Of Uk Adults Treated In Hospital For Meningitis, Harriet Hay, Amy Tallett Dr, Bec Aeddi, Beverley Corbett, Claire Donovan, Jane Blewitt, Juan Abad Madroñero

Patient Experience Journal

Background: Meningitis often results in ongoing and multifaceted after-effects, which can impact many aspects of people's lives, yet relatively little support and follow-up is offered. This study explored post-treatment care experiences of UK adults aged 16 and over following a recent stay in hospital for meningitis. Methods: A survey was designed to ask about hospital discharge, recovery, information provision and aftercare support. The research involved 5 semi-structured, in-depth interviews and a 15-participant online asynchronous focus group. The themes arising from this qualitative stage informed the development of a quantitative 32-item questionnaire which was hosted and promoted online between September 2022 …

A Qualitative Study: Patients' Expectation Of Private Hospitals, Sarah Jada, Jessy Jacob, Ahmad Nasrallah

Patient Experience Journal

Objectives: This study was conducted to explore patients' expectations and perceptions of private healthcare facilities, understand the key factors influencing their choice of such facilities, also identify elements that enhance patient satisfaction and loyalty, enabling the development of actionable recommendations to improve patient-centered care in private healthcare settings. Method: A qualitative study using thematic analysis was conducted with 29 patients from various nationalities and backgrounds who received services in private hospitals in Kuwait, including Dar Al Shifa Hospital. Insights were gathered through semi-structured interviews. Results: The study delved into the significant correlation between patients' experience of their healthcare encounters and …

Escuchame: A Story Of Patient Resilience, Daniel Murillo Armenta, John Paul Braun

Patient Experience Journal

This article is a narrative following a patient's experience through the American Healthcare system. This article is written by a second-year medical student. During this time the individual repeatedly engaged in different specialties of medicine such as neurology, neurosurgery, oncology, emergency medicine, gynecology, and primary care. This narrative demonstrates how certain issues such as healthcare access, patient demographics, defective communication, and general mistrust of the healthcare system negatively impact patient outcomes. As an uninsured immigrant, the patient was in a disadvantaged position when her health problems first began. Due to her lack of insurance, she did not have an established …

Re-Recruitment: An Essential Aspect Of Human Experience, Thom Mayer, David Fessell, Amy Young

Patient Experience Journal

Healthcare staffing is a major issue facing leaders at all levels and is affected by turnover rates in ``The Great Resignation,'' as well as the issue of burnout, moral injury, and turnover. In seeking to deal with defining and making human experience as reality, these factors affect every level, from patient experience to workforce experience to community experience, all of which are related to not just adequate staffing and preventing turnover but doing so with our highest performing ``A Team'' members. Using the tool of re-recruitment of these high-level professionals and team members can be critical to retaining talent, while …

Intermittent Fasting And Cardiometabolic Health In Adults With Obesity: A Scoping Review, Tri Siswati, Lathifa Zahra Putri Nugroho, Natasya Nurul Gina, Almira Sitasari, Agus Wijanarka

Indonesian Journal of Public Health Nutrition (IJPHN)

Obesity is a significant global health challenge, with adverse impacts on cardiometabolic health such as hypertension, dyslipidemia, and insulin resistance. One promising intervention in obesity management is intermittent fasting (PI). However, scientific evidence on the impact of IF on cardiometabolic health is still limited. This study used a scoping review design to evaluate the association between IF and cardiometabolic health in obese adults. Reference sources are available in English at least abstract between 2015–2023 as well as from PubMed and Google Scholar web sources. The search keywords on PubMed are "Adult AND intermittent fasting AND cardiometabolic" and on Google Scholar …

Knowledge, Attitudes, And Practices Of Adults For Periodic Health Assessment In Al Ahsa, Saudi Arabia, Fatimah Yousef Alhafedh, Rawan Ahmed Almusaileem, Zahraa Hassan Aljaafar, Rayhanah Saleh Alaayesh, Edric Estrella

Makara Journal of Health Research

Background: Regular medical consultation, such as annually or semi-annually for check-ups, especially to diagnose chronic conditions, is essential for health maintenance, particularly in adults. The aim of this study is to analyze the knowledge, attitudes, and practices of adults aged 30 years or older for obtaining periodic professional health assessment in the city of Al Ahsa in Saudi Arabia.

Methods: A cross-sectional study was conducted in a total sample of 472 adults. Multistage sampling was employed, and data were collected using a Google Forms survey and analyzed using JASP and OpenEpi. Descriptive and logistic regression analysis was used …

Knowledge, Attitudes, And Motivation Regarding Exclusive Breastfeeding Between Medical And Nonmedical Students: A Cross-Sectional Study, Melviana Lubis, Meisyah Putri Rozi

Makara Journal of Health Research

Background: Exclusive breastfeeding provides substantial health benefits; however, disparities in knowledge and support persist. This study aimed to compare knowledge levels, attitudes, and motivation levels regarding exclusive breastfeeding between female medical and nonmedical students.

Methods: A cross-sectional survey was conducted at Universitas Muhammadiyah Sumatera Utara and involved 314 students from the 2023 cohort. A validated questionnaire was used to assess knowledge levels (16 items), attitude (IIFAS, 16 items), and motivation (15 items). Data were analyzed using the chi-square test, odds ratio (OR), and Spearman’s correlation.

Results: Medical students demonstrated significantly higher levels of knowledge (OR = 3.50; …

#Genderaffirminghormonetherapy And Health Information On Tiktok: Thematic Content Analysis, Julia Beatini, Nora Yanyi Sun, Julianna K. Coleman, Maetal E. Haas-Kogan, Andrea Pelletier, Deborah Bartz, Alex Sogomon Keuroghlian

Student Papers, Posters & Projects

BACKGROUND: Transgender and gender diverse people often turn to online platforms for information and support regarding gender-affirming hormone therapy (GAHT); however, analysis of this social media content remains scarce.

OBJECTIVE: We characterized GAHT-related videos on TikTok to highlight the implications relevant to GAHT prescribers.

METHODS: We used a web scraper to identify TikTok videos posted under the hashtags #genderaffirminghormonetherapy and #genderaffirminghormones as of November 2023. We identified recurrent themes via qualitative content analysis and assessed health education videos with the Patient Education Materials Assessment Tool for Audiovisual Materials (PEMAT-A/V) scale and a modified Currency, Relevance, Authority, Accuracy, and Purpose (CRAAP) …

Overcoming Barriers To Human Papillomavirus Vaccination In Guangdong Province, China, Shuaijing Zhang, Shiqi Li, Jingtai Ma, Guiyuan Ji, Zhifeng Li, Siyi Chen, Fenglin Zhang, Xingfen Yang, Jianpeng Xiao, Rong Cao, Chenggang Wu, Wei Wu

Faculty, Staff and Student Publications

Human papillomavirus (HPV) infection remains a critical public health challenge in China, particularly in Guangdong Province, where HPV-52, 16, and 58 genotypes predominate, and male infection rates exceed 40%. Despite the successful implementation of a government-funded school-based program that has achieved 88% HPV vaccine coverage among adolescent girls, several persistent barriers, including genotype mismatch (the free HPV vaccine covers < 50% of high-risk local strains), regional disparities (80% vs. 60% for first-dose coverage), and exclusion of males, thwart progress toward herd immunity. Financial sustainability risks pose an even more significant threat to the expansion of HPV vaccination programs, especially in Guangdong province where annual expenditures exceed CNY 200 million. This review delves into Guangdong's pioneering efforts and proposes practical solutions: accelerating domestic multivalent HPV vaccine development, adopting gender-neutral vaccination policies, and leveraging mobile clinics for remote populations. These strategies not only provide a roadmap for China but also serve as valuable insight for other LMICs striving to overcome HPV-related inequalities.

The Effect Of Using Pelvic Floor Exercises Administered Through A Smartphone Application In Postpartum Women With Pelvic Floor Dysfunction, Elizabeth A. Russell

Evidence-Based Practice Project Reports

Pelvic floor dysfunction (PFD) affects 50% of postpartum women and can lead to pelvic pain, stress urinary incontinence, fecal incontinence, pelvic organ prolapse, or sexual dysfunction (Grimes, 2023). The purpose of this evidence-based practice project was to determine if the implementation of pelvic floor exercise (PFE) as guided by a smartphone application, to improve adherence and technique of exercises, will improve PFD symptoms and quality of life (QOL). At an OBGYN clinic in northern Indiana, all women who presented for their 6-week postpartum appointment were screened for PFD with the Pelvic Floor Distress Inventory (PFDI-20) and QOL with the Pelvic …

What Are The Minimum Dimensions In A Marketing Plan Required For Starting Or Improving Marketing In A Small, New Home Health Agency?, Patrick Baker

MUSC Theses and Dissertations

Objective: To fulfill an unmet need for practical, parsimonious assistance for examples of a practical marketing plan for new, small home health care agencies. The home health (HH) care industry needs customized marketing plans tailored to the unique requirements of small, emerging HH agencies. These plans are essential for navigating the competitive market driven by an aging population and technological advancements. However, the industry's emphasis on this specific aspect is significantly lacking.

Methodology: We reviewed the published literature, numerous books and websites and selected sources that provided practical, small-scale approaches to marketing for health care organizations. We identified specific marketing …

Correction: A Mapping Review And Critique Of The Literature On Translation, Dissemination, And Implementation Capacity Building Initiatives For Different Audiences, Ana A Baumann, Danielle R Adams, Laura-Mae Baldwin, Rachel G Tabak, Sara Malone, Maura M Kepper, Anita D Misra-Hebert, Kathleen R Stevens, Maria E Fernandez, Sunil Kripalani

Faculty, Staff and Student Publications

This corrects the article "A mapping review and critique of the literature on translation, dissemination, and implementation capacity building initiatives for different audiences", 34.

A Pioneering Artificial Intelligence Tool To Predict Treatment Outcomes In Ovarian Cancer Via Diagnostic Laparoscopy, Xiaotian Ma, Yu-Chun Hsu, Amma Asare, Kai Zhang, Deanna Glassman, Katelyn F Handley, Katherine Foster, Khwahish Sharma, Shannon Westin, Amir Jazaeri, Nicole D Fleming, Pratip K Bhattacharya, Xiaoqian Jiang, Anil K Sood, Shayan Shams

Faculty, Staff and Student Publications

Ovarian cancer is associated with high rates of patient mortality and morbidity. Laparoscopic assessment of tumor localization can be used for treatment planning in newly diagnosed high-grade serous ovarian carcinoma (HGSOC). While spread to multiple intra-abdominal areas is correlated with worse outcomes, whether other morphological tumor differences are also associated with patient outcomes is unknown. Given the large volume of visual information in laparoscopic videos, we investigated whether deep-learning models can capture implicit features and predict treatment outcomes. We developed a novel deep-learning framework using pre-treatment laparoscopic images to assess clinical outcomes following upfront standard treatment, defined as short progression-free …

Risk Factors Of Self-Reported Prediabetes Status In New York State, Kari Ann Hunter Thompson

Walden Dissertations and Doctoral Studies

Prediabetes affects over 4 million people in New York State and increases the risk of Type 2 diabetes. Prior research identified risk factors such as poor diet, inactivity, obesity, hypertension, and smoking; but no studies examined these collectively or assessed their interactions. This quantitative, cross-sectional study analyzed a sample of 289 non-institutionalized adults aged 18 or older with landline or cellular phone, from the Behavioral Risk Factor Surveillance System. The study examined relationships between prediabetes and 16 factors in five categories: demographic (age, race, sex, education), socioeconomic (income, employment), behavioral (fruit intake, vegetable intake, physical activity, smoking), physiological (hypertension, BMI), …

Lack Of Patient-Centered Care Relative To Evidence-Based Practice In Clinical Diagnosis And Treatment Of Endometriosis In The U.S.: A Review, Piper E. Scoskie

Honors Theses

This scoping review examines the impact of combining Patient-Centered Care (PCC) and Evidence-Based Care (EBC) on clinical outcomes and patient satisfaction in the diagnosis and treatment of endometriosis in the United States. In particular, the review aims to (1) examine the body of research from the United States to learn more about the connection between PCC and EBC and their collective impact on patient satisfaction and clinical outcomes in the treatment of endometriosis; (2) identify the gaps in existing research and practice, specifically regarding PCC procedures, varying patient populations, and longitudinal investigations; and (3) provide recommendation for future research and …

Sbirt Workflow, Dory Hart Emery, Tory Gamage, Sara Watts, Carol Mcclure, Anne Barker, Liz Berry, Liz Anderson

Operations Transformation

SBIRT stands for Screening – Identify patients with unhealthy substance use. Brief Intervention – A collaborative conversation that raises a person’s awareness of substance use and its consequences and encourages behavioral changes. Referral to Treatment – Actively link patients to resources when needed. It is a substance use screening tool that we ask patients 18 yrs. old and older to fill out once a year when having their CPE or AWV. SBRIT has been recognized as an integral part of primary care. It is an approach that delivers prevention, detection, and early intervention for individuals at risk of substance use …

Adjuvant Radiotherapy In Pt3-4n0m0 Major Salivary Gland Cancer Without Other Adverse Features, Aman M. Patel, Afash Haleem, Praneet C. Kaki, Jake J. Lee, Russell Maxwell, Jason A. Brant, Robert M. Brody, Ryan M. Carey

SKMC Student Presentations and Publications

OBJECTIVE: To investigate adjuvant radiotherapy (aRT) utilization and associated differences in overall survival (OS) in pT3-4N0M0 major salivary gland cancer (MSGC) without evidence of other adverse pathologic features.

METHODS: The 2006 to 2018 National Cancer Database was queried for patients with MSGC classified as pT3-4N0M0. Patients with evidence of lymphovascular invasion or positive surgical margins were excluded. Multivariable binary logistic and Cox regression models adjusting for patient demographics, pathologic features including histology, and treatment were implemented.

RESULTS: Of 897 patients satisfying inclusion criteria, 368 (41.0 %) underwent aRT. Compared with those not undergoing aRT, patients undergoing aRT were younger (median …

Progesterone Signaling In Oviductal Epithelial Cells Modulates The Immune Response To Support Preimplantation Embryonic Development, Emily A Mcglade, Jiude Mao, Kalli K Stephens, Ryan M Marquardt, Feyza Nur Arguc, Peter F Lais, San-Pin Wu, Sarayut Winuthayanon, Haval Shirwan, Esma S Yolcu, Mark I Hunter, James K Pru, John P Lydon, Francesco J Demayo, Wipawee Winuthayanon

Faculty, Staff and Students Publications

More than 60% of pregnancy losses occur during the first trimester, highlighting the need to understand the role of the oviduct in early pregnancy. In this study, we conditionally ablated the classical progesterone receptor (Pgr) in oviductal epithelial cells, called the Pgrd/d mouse model. We found that 40% of embryos collected from Pgrd/d females were nonviable or developmentally delayed, indicating that epithelial PGR expression is crucial for embryonic development. Single-cell RNA sequencing revealed up-regulation of proinflammatory genes, including interleukin-22 (IL-22), in the epithelial cells of Pgrd/d females. Pharmacological inhibition of inflammation using nonsteroidal anti-inflammatory drugs …

Correction: Toward Personalized Digital Experiences To Promote Diabetes Self-Management: Mixed Methods Social Computing Approach, Tavleen Singh, Kirk Roberts, Kayo Fujimoto, Jing Wang, Constance Johnson, Sahiti Myneni

Faculty, Staff and Student Publications

No abstract provided.

Impact Of Hiv/Aids Stigma On University Students' Education: A Phenomenological Investigation, Ralph Ayuk Etchu

Doctoral Dissertations and Projects

The purpose of this transcendental, phenomenological study was to examine the experiences of 10-12 university students living with HIV/AIDS in the cities of Ndekville, Tontoh, and Kenyang of Southwest Ekong. Goffman’s social stigma theory guided this study and helped operationalize the research questions. The central research question was: What is the impact of HIV/AIDS stigma on the educational journey of university students in Ndekville, Tontoh, and Kenyang of Southwest Ekong? Sub-questions explored categorizing and characterizing participants' experiences and challenges of stigma and discrimination as per sex, gender, socioeconomic status, and cultural background. The researcher collected data through participant interviews, focus …

Psychological Treatment Behind The Walls:Insights From The Inside, Rogelio Serrano

Psychology Division Scholarship

Repeated eras of mass incarceration, criminalization of marginalized communities, and substance use policies have created a revolving door of justice involved populations. The ever-increasing prison population has repeatedly become the largest contingency of mental health clientele for an overburdened mental health system. Those who work with formerly incarcerated individuals in the community often don’t know the unique set of challenges faced by practitioners within the system. Increased understanding and coordination of care can offer opportunities for sustained recovery and reduced levels of recidivism. In this presentation participants will learn about the unique insights on mental health treatment that can be …

Challenging Race-Based Health Care Discrimination: A New Private Right Of Action, Aaron Pinkett

Northwestern University Law Review

The Hippocratic Oath calls on doctors to “do no harm.” Yet we know from extensive public health research that clinicians repeatedly cause harm to Black patients by dismissing their medical concerns, misdiagnosing them, and undertreating their pain. These practices of differential treatment for Black patients have led to steadily increasing racial disparities in health care outcomes throughout the United States. Title VI of the Civil Rights Act of 1964 prohibits this type of disparate impact, but modern Supreme Court jurisprudence forecloses opportunities for affected parties to seek legal relief—despite the clearly established legislative intent of Title VI. However, another legal …

Indeterminate Benefit Of Long-Term Beta-Blocker Use After Acute Myocardial Infarction For Some Patients, Logan S. Thayer, Khush Hussain, Nicholas Apostolakis, Gretchen Swift, Arifbillah Sarowar, Mohammad Al-Hadidi, Scott Yaekle

Clinical Research in Practice: The Journal of Team Hippocrates

A clinical decision report using:

Yndigegn T, Lindahl B, Mars K, et. al., Beta-blockers after myocardial infarction and preserved ejection fraction. N Engl J Med. April 7 2024;390:1372-1381. https://doi.org/10.1056/NEJMoa2401479

for a patient showing 55% left ventricular ejection fraction after myocardial infarction.