Digital Commons Network^™

Social Exclusion And Mental Health Of Youths Affected By Parental Hiv/Aids In China: Based On A Serial Mediating Model, Jiaojiao Wan, Lili Ji, Zheqian Wang, Junfeng Zhao, Xiaoming Li

Faculty Publications

The mental health of youth living with patients with HIV needs focused attention. The primary source of psychological distress they experience may stem from social exclusion. Therefore, the current study was designed to explore the relationship between social exclusion and mental health among youths affected by parental HIV/AIDS in rural China.

Methods

297 youths affected by parental HIV/AIDS were recruited to completed questionnaires of social exclusion, perceived stress, future orientation and mental health. The bootstrap method was used to examine the mediation effects.

Results

It showed that: (1) the social exclusion (M = 32.48, SD = 15.25) significantly and …

Impact Of An Adapted Diabetes Prevention Program In A Spanish Primary Care Setting: Protocol For A Type Ii Hybrid Effectiveness-Implementation Cluster-Randomized Trial (Aladim), Miquel Bennasar-Veny, Manuela Abbate, Miquel Colom-Rosselló, Laura Capitán-Moyano, Ivonne C Hernández-Bermúdez, Ignacio Ricci-Cabello, Aina M Yañez, Maria E Fernandez

Faculty, Staff and Student Publications

Background: Type 2 diabetes (T2D) is a global health concern affecting 10.5% of the adult population and is projected to rise significantly in the coming decades. Lifestyle modification programs, such as the Diabetes Prevention Program (DPP), can effectively reduce T2D risk among individuals with prediabetes. However, their implementation in real-world healthcare settings remains poor, particularly in Spain, where T2D prevalence is the highest in Europe. The ALADIM study aims to evaluate the effectiveness and implementation of an adapted DPP in Spanish Primary Care Centers (PCCs). The primary effectiveness outcome is weight, the co-primary implementation outcome is implementation fidelity. We will …

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 …

The Gender Effects Of Covid: Evidence From Equity Analysts, Frank Weikai Li, Baolian Wang

Research Collection Lee Kong Chian School Of Business

We use COVID-19 and sell-side analysts as an experiment to study the effects of gender on labor productivity. We find that the forecast accuracy of female analysts declined more than that of male analysts, especially when schools were closed and among analysts who were more likely to have young children, were inexperienced, were busier, or lived in southern states of the US. Relative to male analysts, females also reduced their forecast timeliness and resorted to more heuristic forecasts but did not reduce coverage or updating frequency. Relative to pre pandemic, female analysts’ careers were more negatively affected than male analysts’. …

Quality Of Life And Patient Experience In Black Women With Alopecia, Annyella Douglas, Jayson Suriano, Neda Nikbakht

Department of Dermatology and Cutaneous Biology Faculty Papers

No abstract provided.

Occupational Stress: Lifestyle And Health In Blue- And White-Collar Workers In The United States, Carice T. Craffey

Dissertations and Theses

ABSTRACT

Occupational Stress: Lifestyle and Health in Blue- and White-Collar Workers in the United States

by

Carice Craffey

Advisor: Catherine M. Schooling, Ph.D.

Background: Heart disease and diabetes are leading causes of death in the United States and globally, particularly heart disease in men. Employment conditions can contribute to illness and death. Occupational or job stress (OS) is a potential contributor to heart disease and diabetes, but its conceptualization and role for men and women remain unclear. To address this gap, I conceptualized OS, then examined the role of OS in heart disease and diabetes.

Methods: I used a literature …

Understanding Garden Resource Use By Low-Income Families With Children, Mai Thao, Rita S. Stephenson, Katherine R. Arlinghaus, Abby L. Gold

Journal of Human Sciences and Extension

Home gardens are an important supplemental source of food for many families and provide multiple health benefits. However, the practice of gardening may be more challenging for low-income families with limited access to gardening resources. The University of Minnesota Extension offers gardening resources, but it is unclear how these resources are used by low-income families with children. Aim 1 of the project was to understand access to and use of Extension and other vegetable gardening resources by low-income families with children. Aim 2 of the project was to develop a set of recommendations for improving access to existing resources and …

What, When, And How Food And Beverage Are Advertised On Ghanian Television, Morgan Boncyk, Krystal K. Rampalli, Marian N. Winters, Muskaan K. Makkar, Silver Nanema, Gideon S. Amevinya, Amos Laar, Edward A. Frongillo Ph.D., Christine E. Blake

Faculty Publications

Food marketing has increased volume, precision, and reach to influence viewers’ food attitudes, beliefs, and eating behaviors. What and how much people eat has implications for health. While many countries regulate food advertising to protect consumers and encourage healthy eating, Ghana has none. Understanding the content and framing of food and beverage advertisements can inform the development of effective policies and practices that encourage healthier diets. This content analysis examines the foods and beverages advertised, their timing, and marketing techniques on Ghanaian television. From February to May 2020, 486 hours of advertisements were recorded. Advertisements with ≥1 actors were coded …

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

Institute for Human Development, East Africa

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

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

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

How Do Health Insurer Practices Affect Health Equity For Gay And Bisexual Men And Transmasculine Individuals? A Qualitative And Health Policy Assessment, Alexa D'Angelo

Dissertations and Theses

In the U.S. there continue to be stark disparities in health that affect LGBTQ+ communities. These disparities include those related to mental health, sexually transmitted infections, along with chronic illnesses and some cancers. Higher health needs across diagnostic categories mean that LGBTQ+ individuals require access to the healthcare system both to prevent conditions disproportionately affecting the community, and to treat conditions as they arise. In the U.S., access to healthcare often requires either reliable insurance coverage or another payer to cover costs associated with care. Thus, health insurance status and coverage of care, along with coverage regulations and health policies …

Sunlight Exposure And The Risk Of Mortality And Breast Cancer Incidence, Noor Nadhim

Loma Linda University Electronic Theses, Dissertations & Projects

Background: Prolonged sun exposure increases the risk of skin cancer. However, multiple sunlight-related health benefits have been identified. The overall impact of sun exposure on mortality is not clear. Sunlight could be associated with breast cancer risk via stimulating vitamin D photosynthesis; however, evidence has been mixed. Objectives: To investigate the association of time spent outdoors in daylight (in warmer and cooler months, and the total [annual]) and UV irradiance using the residential locations of participants with the risks of mortality (all-cause and cause-specific: cancer, cardiovascular [CVD], and non-cancer non-CVD) and primary invasive breast cancer.

Methods: This research …

Tobacco, Alcohol, And Poverty In Lao Pdr Based On National Survey Analysis, Robert M. Semakula

Loma Linda University Electronic Theses, Dissertations & Projects

Tobacco and alcohol use are among the most prevalent and harmful addictive behaviors globally, including in the Lao People’s Democratic Republic (Lao PDR). In Southeast Asia and the Western Pacific, substance use patterns are shaped by cultural, social, economic, policyrelated, and environmental factors. This study aimed to: (1) explore associations between different patterns of alcohol and tobacco use among men and women in Lao PDR, and (2) investigate the effect of poverty on the relationship between alcohol and tobacco use. We conducted a secondary analysis of the 2013 Lao National Adult Tobacco Survey (N = 9,706), a nationally representative sample …

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 …

A Comprehensive Literature Review Of Gender Differences In Perception And Response To Stress, Zoe M. Shankland

University Honors Theses

It is well established that psychological stress, whether acute, chronic, or recurring, creates an imbalance in the body’s ability to regulate itself, leading to the potential for long-term disease. This paper looks at the possibility that women (anyone who identifies as a woman) experience more general mental stress than men (anyone who identifies as a man) due to women experiencing unique stressors under a patriarchal society. Men and women live different lives in modern society due to differing societal expectations and biological processes for women (menstruation, pregnancy, menopause). These extra feelings of stress may be tied to traditional gender roles …

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

University Honors Theses

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

Transforming The Future Of Health: Building Learning Health Systems Across The Globe, Sandra Yankah, Robert Saunders, Mark L. Tykocinski, Claudia Salzberg, Jonathan Gonzalez-Smith, Rachel Bonesteel, Cameron Joyce, Charles Kahn, Mark Mcclellan, Eyal Zimlichman

Department of Pathology, Anatomy, and Cell Biology Faculty Papers

Health care has faced disruptions over the past 5 years, including a global pandemic, supply chain interruptions, workforce shifts, and the introduction of new artificial intelligence (AI) tools. Health care organizations continue to leverage the learning health system (LHS) concept to adapt to these challenges through iterative feedback loops. The Future of Health (FOH), an international community of over 50 senior health leaders that focuses on shared challenges across international health systems, collaborated with the Duke-Margolis Institute for Health Policy in a consensus-building process with FOH members to identify opportunities for action in an LHS. Key areas for action identified …

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.

Digesting The Details: How Cooking Shapes The Microbiome And Influences Obesity, Tracy Lieu

University Honors Theses

Obesity is a growing global health concern linked to chronic diseases and changes in the gut microbiome. While diet is known to affect gut microbes, less attention has been given to how food processing methods, such as heating, fermentation, and cold processing, change food in ways that influence the gut microbiome and health. This thesis reviews research on how different cooking and preparation techniques affect the availability of nutrients for microbial fermentation and the resulting effects on microbial diversity and metabolism. The findings show that fermentation and cold processing are the most supportive of gut health. These methods help preserve …

Structure Vs Agency: The Intersectionality Of Race, Mental Health, And Homelessness, Jayley Martin

University Honors Theses

This project investigates the intersectionality between race, mental health, and homelessness, emphasizing the dynamic interplay between structural factors and individual characteristics. Through an integrative literature review, the research addresses the question of how race, mental health, and homelessness are interconnected. The findings suggest a distinct relationship between untreated mental illness and an increased risk of homelessness, particularly among marginalized racial groups. In addition, some mental illnesses, such as anxiety and depression, have a higher incidence among those who face conflict due to racial discrimination. Structural components such as systemic racism in social services and healthcare practices significantly impact access to …

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 …

A Bundle To Prevent Postinduction Hypotension In High-Risk Noncardiac Surgery Patients: The Zero-Hypotension Single-Arm Interventional Proof-Of-Concept Study, Kristen K Thomsen, Alina Kröker, Linda Krause, Karim Kouz, Christian Zöllner, Daniel I Sessler, Bernd Saugel, Moritz Flick

Faculty, Staff and Student Publications

Background: Postinduction hypotension is common and associated with organ injury but might be largely preventable by careful anaesthetic management. We thus aimed to quantify the severity and duration of postinduction hypotension in high-risk noncardiac surgery patients treated with a hypotension prevention bundle.

Methods: In this prospective single-arm interventional proof-of-concept study, 107 high-risk noncardiac surgery patients were treated with a hypotension prevention bundle. The bundle included continuous intra-arterial blood pressure monitoring, a hypotension alarm set at a mean arterial pressure (MAP) of 75 mm Hg, careful administration of anaesthetic drugs, and continuous administration of norepinephrine when MAP decreased below 75 mm …

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 …

Longitudinal Trends In Pediatric Survival By Congenital Heart Defect In Texas, 1999 To 2017, Sara B Stephens, Shaine A Morris, Renata H Benjamin, Mark A Canfield, Charles J Shumate, Ruosha Li, Cecilia Cazaban-Ganduglia, A J Agopian

Faculty, Staff and Student Publications

Background: Despite previously improved survival among children with congenital heart defects (CHDs), U.S. population-level evaluations of survival within recent years are scarce.

Objectives: The purpose of this study was to describe the survival landscape among children with CHDs in a large population-based birth defects registry overall and by CHD lesion.

Methods: This population-based cohort study evaluated 1999 to 2017 live births with ≥1 major CHD in the statewide Texas Birth Defects Registry. Variables included CHD lesion, demographics, gestational age at birth (term/preterm), low birthweight (< 2,500 g at birth), among others. Kaplan-Meier analyses were used to describe survival to 7 days, 28 days, 1 year, 5 years, and 10 years of life. Kaplan-Meier survival estimates were generated for 1-year survival for CHDs overall by lesion, using log-rank tests assessing differences by exposure.

Results: Of 61,656 children with CHDs, survival was 98.1% and 90.7% at 7 days and …

Protecting The Future Of Medical Innovation: Balancing Fiscal Responsibility With The Need For National Institutes Of Health And Federal Health Funding, Irina Petrache, Raed A. Dweik, Michelle Ng Gong, Jesse Roman, M. Patricia Rivera, Karen J. Collishaw

Division of Pulmonary, Allergy, and Critical Care Medicine Faculty Papers

No abstract provided.

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 …

The Association Of Vision And Hearing Impairment On Cognitive Function And Loneliness: Evidence From The Mexican Health And Aging Study, Kimberly Hreha, Rafael Samper-Ternent, Heather E Whitson, L P Downer, Jessica S West, Brian Downer

Faculty, Staff and Student Publications

Objectives: We investigated whether self-reported vision and hearing were associated with cognitive function and loneliness among Mexican adults aged 50 and older.

Methods: Mexican Health and Aging Study data. Vision/hearing status was self-reported (excellent-very good, good, fair-poor). Cognition was measured using nine tasks. Loneliness was measured using the UCLA Loneliness Scale. Analyses controlled for demographic and health characteristics.

Results: Among 12,353 participants (mean age = 67, 58% female), poor vision, but not hearing, was associated with lower global cognition (β = -0.03, p < .05). Poor vision (OR = 1.57, 95% CI = 1.30-1.91) and hearing (OR = 1.35, 95% CI = 1.14-1.61) were associated with higher odds of being lonely after adjusting for demographics and comorbidities, but not when adjusting for limitations in daily activities and depressive symptoms.

Discussion: Poor vision is a potentially modifiable risk factor for lower cognition and loneliness among Mexican adults. …

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, …

Implementation Of An Opt-Out And Rapid Point-Of-Care Syphilis Testing Program For Pregnant Patients Presenting To The Emergency Department, Irene Stafford, Carrie Bakunas, Joe Haydamous, Ana Mosqueda, Jeffrey D Klausner, Leandro Mena, Sean C Blackwell

Faculty, Staff and Student Publications

Background: Adult and congenital syphilis rates are rising in the United States. The aim of this pre- and post-implementation study was to determine whether implementation of an opt-out laboratory-based and rapid syphilis point-of-care testing program in the emergency department (ED) improves the detection and treatment of syphilis during pregnancy in a high-prevalence region.

Methods: This pre- and post-implementation study was conducted at the University of Texas Health Science Center, Houston, TX. During the pre-implementation phase (November 1, 2023-February 29, 2024), pregnant patients presenting to the ED underwent laboratory-based syphilis testing using the reverse algorithm only when clinically indicated. In the …

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 …

Dietary Interventions To Support And Improve Sleep Disturbances And Insomnia Disorder In Menopause: From Bench To Bedside, Rosie H Musgrave, Sara Nowakowski, Tamlyn J Watermeyer, Emily J Arentson-Lantz, Greg J Elder

Faculty, Staff and Students Publications

Sleep is essential for maintaining physical and psychological health, and also cognitive health (referred to as 'brain health'). However, the transition to menopause has a direct impact upon sleep. Sleep disturbances are reported by approximately 40%-60% of menopausal women, and insomnia disorder is also prevalent. Diet-based interventions could potentially be used to improve subjective sleep quality in this population, and although there are several promising interventions which have been used in other groups that could be trialled, the evidence base is currently lacking. One particularly promising area for future research is that these interventions might be used alongside, or instead …