Digital Commons Network^™

Comparison Of Risk Assessment Tools' Prediction Of Outcomes For Penetrating Trauma, Jeffrey Santos, Catherine M Kuza, Xi Luo, Tiffany Moon, Thomas Shoultz, Anne Feeler, Roman Dudaryk, Jose Navas, Georgia Vasileiou, Kazuhide Matsushima, Matthew Forestiere, Tiffany Lian, Areg Grigorian, Joni Ricks-Oddie, Jeffry Nahmias

Faculty, Staff and Student Publications

Introduction: The Trauma and Injury Severity Score (TRISS) uses anatomic and/or physiologic variables to predict mortality; however, Injury Severity Score is less reliable for penetrating trauma. National Surgical Quality Improvement Program Surgical Risk Calculator (NSQIP-SRC) and American Society of Anesthesiologists Physical Status (ASA-PS) include functional status and comorbidities. This study evaluates the accuracy of these tools in predicting mortality, length of stay (LOS), and complications for operative penetrating trauma.

Methods: Adult penetrating trauma patients (≥18 y) who underwent surgery within 24 h of admission were included in this subgroup analysis of a prospective observational study at four trauma centers. The …

Public Health Messaging About Dengue On Facebook In Singapore During The Covid-19 Pandemic: Content Analysis, Shirley S. Ho, Mengxue Ou, Nova Mengxia Huang, Agnes S.F. Chuah, Vanessa S. Ho, Sonny Rosenthal

Research Collection College of Integrative Studies

Background:Dengue, a mosquito-borne disease, has been a health challenge in Singapore for decades. In 2020, during the COVID-19 pandemic, Singapore encountered a serious dengue outbreak and deployed various communication strategies to raise public awareness and mitigate dengue transmission.Objective:Drawing on the Crisis and Emergency Risk Communication (CERC) framework, this study examines how dengue-related messages communicated on Facebook (Meta) during the COVID-19 pandemic fall into the CERC themes. This study also seeks to understand how these themes differ between dengue outbreak (eg, 2020) and nonoutbreak years (eg, 2021). In addition, we explore how message themes on dengue changed across different CERC phases …

Identification Of Frailty Clusters Using Cross-Sectional Frailty And Frailty Trajectory: Cohort Of Heart Failure Veterans, Javad Razjouyan, Saeed Tofighi, Ariela R Orkaby, Biykem Bozkurt, Amir Sharafkhaneh, Molly J Horstman, Parag Goyal, Christopher I Amos, Orna Intrator, Aanand D Naik

Faculty, Staff and Student Publications

BACKGROUND: Frailty is a syndrome associated with increased vulnerability and diminished physiological reserves. Three-quarters (78%) of heart failure (HF) patients are frail. Traditional frailty indices (FIs) assess cross-sectional deficits, while frailty trajectories (FTs) measure changes over time.

OBJECTIVES: This study aims to examine the interaction between FI and FT to enhance risk stratification in hospitalized adults with HF.

METHODS: This retrospective cohort study utilized data from the Veterans Health Administration, including 143,687 veterans aged >50 admitted for HF from 2005 to 2019. FT measurements were derived from FI calculations for each of the 3 years before index hospitalization. Unsupervised clustering …

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 …

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 …

Cdc’S Core Elements To Promote Diagnostic Excellence, Daniel J Morgan, Hardeep Singh, Arjun Srinivasan, Andrea Bradford, L Clifford Mcdonald, Preeta K Kutty

Faculty, Staff and Students Publications

Nearly a decade after the National Academy of Medicine released the "Improving Diagnosis in Health Care" report, diagnostic errors remain common, often leading to physical, psychological, emotional, and financial harm. Despite a robust body of research on potential solutions and next steps, the translation of these efforts to patient care has been limited. Improvement initiatives are still narrowly focused on selective themes such as diagnostic stewardship, preventing overdiagnosis, and enhancing clinical reasoning without comprehensively addressing vulnerable systems and processes surrounding diagnosis. To close this implementation gap, the US Centers for Disease Control and Prevention (CDC) released the Core Elements of …

Repeat Ascaris Challenge Reduces Worm Intensity Through Gastric Cellular Reprograming, Yifan Wu, Charlie Suarez-Reyes, Nina L Tang, Alexander R Kneubehl, Jill E Weatherhead

Faculty, Staff and Students Publications

Ascariasis (roundworm) is the most prevalent parasitic nematode infection worldwide, impacting approximately 500 million people predominantly in low- and middle-income countries (LMICs). While people of all ages are infected with Ascaris, infection intensity (defined by worm burden) paradoxically peaks in pre-school and school-aged children but then declines with age. The cause of age-dependent Ascaris worm intensity is not well understood but may be dependent on cellular changes in mucosal barrier sites. We have previously found that the gastric mucosa is a critical barrier site for Ascaris infection as ingested Ascaris larvae use acidic mammalian chitinase (AMCase) secreted by gastric chief …

The Small Gtpase Rap1 In Pomc Neurons Regulates Leptin Actions And Glucose Metabolism, Kentaro Kaneko, Weisheng Lu, Yong Xu, Alexei Morozov, Makoto Fukuda

Faculty, Staff and Students Publications

The hypothalamic leptin-proopiomelanocortin (POMC) pathway is critical for regulating metabolism. POMC neurons in the arcuate nucleus respond to leptin and play a pivotal role in mediating energy and glucose balance. However, during diet-induced obesity (DIO), these neurons often develop resistance to exogenous leptin. Recently, the small GTPase Rap1 has been implicated as an inhibitor of neuronal leptin signaling; however, its specific role within POMC neurons remains unexplored. We generated tamoxifen-inducible, POMC neuron-specific Rap1 knockout mice to selectively delete both Rap1a and Rap1b isoforms in POMC neurons. By analyzing these mice through metabolic phenotyping, immunohistochemistry, and biochemical assays, we show that …

The Contribution Of De Novo Coding Mutations To Meningomyelocele, Yoo-Jin Jiny Ha, Ashna Nisal, Isaac Tang, Chanjae Lee, Ishani Jhamb, Cassidy Wallace, Robyn Howarth, Sarah Schroeder, Keng Ioi Vong, Naomi Meave, Fiza Jiwani, Chelsea Barrows, Sangmoon Lee, Nan Jiang, Arzoo Patel, Krisha Bagga, Niyati Banka, Liana Friedman, Francisco A Blanco, Seyoung Yu, Soeun Rhee, Hui Su Jeong, Isaac Plutzer, Michael B Major, Béatrice Benoit, Christian Poüs, Caleb Heffner, Zoha Kibar, Gyang Markus Bot, Hope Northrup, Kit Sing Au, Madison Strain, Allison E Ashley-Koch, Richard H Finnell, Joan T Le, Hal S Meltzer, Camila Araujo, Helio R Machado, Roger E Stevenson, Anna Yurrita, Sara Mumtaz, Awais Ahmed, Mulazim Hussain Khara, Osvaldo M Mutchinick, José Ramón Medina-Bereciartu, Friedhelm Hildebrandt, Gia Melikishvili, Ahmed I Marwan, Valeria Capra, Mahmoud M Noureldeen, Aida M S Salem, Mahmoud Y Issa, Maha S Zaki, Libin Xu, Ji Eun Lee, Donghyuk Shin, Anna Alkelai, Alan R Shuldiner, Stephen F Kingsmore, Stephen A Murray, Heon Yung Gee, W Todd Miller, Kimberley F Tolias, John B Wallingford, Spina Bifida Sequencing Consortium, Sangwoo Kim, Joseph G Gleeson

Faculty, Staff and Students Publications

Meningomyelocele (also known as spina bifida) is considered to be a genetically complex disease resulting from a failure of the neural tube to close. Individuals with meningomyelocele display neuromotor disability and frequent hydrocephalus, requiring ventricular shunting. A few genes have been proposed to contribute to disease susceptibility, but beyond that it remains unexplained1. We postulated that de novo mutations under purifying selection contribute to the risk of developing meningomyelocele2. Here we recruited a cohort of 851 meningomyelocele trios who required shunting at birth and 732 control trios, and found that de novo likely gene disruption or …

Interventions To Improve Timely Cancer Diagnosis: An Integrative Review, Mark L Graber, Bradford D Winters, Roni Matin, Rosann T Cholankeril, Daniel R Murphy, Hardeep Singh, Andrea Bradford

Faculty, Staff and Students Publications

Cancer will affect more than one in three U.S. residents in their lifetime, and although the diagnosis will be made efficiently in most of these cases, roughly one in five patients will experience a delayed or missed diagnosis. In this integrative review, we focus on missed opportunities in the diagnosis of breast, lung, and colorectal cancer in the ambulatory care environment. From a review of 493 publications, we summarize the current evidence regarding the contributing factors to missed or delayed cancer diagnosis in ambulatory care, as well as evidence to support possible strategies for intervention. Cancer diagnoses are made after …

Antibiotic Prophylaxis With Urodynamic Studies In Spinal Cord Injury: Assessing Practice Patterns And Outcomes To Guide Future Practice In A Single Center, Du Pham, Bradley Chi, Felicia Skelton, Donna Huang

Faculty, Staff and Students Publications

Context/objective: Despite urinary tract infections (UTIs) being a common problem in patients with spinal cord injuries (SCIs), and a well-known complication of invasive urologic procedures, little consensus exists regarding the standard of care for peri-procedural antibiotic use for SCI patients undergoing urodynamics studies (UDS). Our research seeks to evaluate local antibiotic prophylaxis pattern in SCI patients undergoing UDS, assess incidence of post-procedural UTI, describe local antibiotic resistance trends, and provide antibiotic stewardship considerations to guide future practice.

Design/setting/participants: Retrospective cohort study of SCI patients undergoing UDS from January 2010 to January 2020 at a Veterans Affairs SCI Center. Data on …

Using A Transformer Language Model To Curate A Pulmonary Embolism Dataset From The Medical Information Mart For Intensive Care Iv: Mimic-Iv-Ext-Pe, Barbara D Lam, Shengling Ma, Iuliia Kovalenko, Peiqi Wang, Omid Jafari, Ang Li, Steven Horng

Faculty, Staff and Students Publications

Background: Pulmonary embolism (PE) is a leading cause of preventable in-hospital mortality. Advances in diagnosis, risk stratification, and prevention can improve outcomes. Large, publicly available datasets are needed to move research forward, but are lacking in the field of hemostasis and thrombosis.

Objectives: In this study, we experiment using a machine learning language model to automatically add PE labels to a large dataset.

Methods: We extracted all computed tomography pulmonary angiography radiology reports (N = 19,942) from the Medical Information Mart for Intensive Care IV, a database of adult patients who presented to the emergency room or were admitted …

Testing For Bleeding Disorders In Child Abuse: Aap Recommendation Adherence And Testing Results, Lyndsey Hultman, Angela Doswell, Henry T Puls, Shannon L Carpenter, Angela Bachim, Caitlin R Mcnamara, Farah W Brink, Lori D Frasier, Nancy S Harper, Natalie Laub, Kristine A Campbell, Daniel M Lindberg, Joanne N Wood, James Anderst

Faculty, Staff and Students Publications

Objectives: Using a multicenter child abuse pediatrics research network (CAPNET), the study objectives were to characterize the adherence to American Academy of Pediatrics (AAP) recommendations for bleeding disorder testing and the frequency of bleeding disorder identification.

Methods: We performed a descriptive study of bleeding disorder evaluations among children younger than 10 years of age who presented with bruising and/or intracranial hemorrhage (ICH) concerning for abuse from February 2021-May 2022 utilizing CAPNET. Cases were classified as bruising without ICH or ICH with or without bruising. Based on AAP guidance, testing was not recommended in cases with concomitant suspicious injuries, inflicted injury …

Voices From The Journey: Exploring Rehabilitation Experience Of Individuals With Disabilities In A South African Province, Senzelwe M. Mazibuko, Thayananthee Nadasan Dr, Pragashnie Govender

Patient Experience Journal

Background: Globally, 16% of the population is affected by disabilities, with increasing prevalence due to non-communicable diseases and longer lifespans. This group often faces shorter lifespans, poorer health, and greater challenges than non-disabled peers. Rehabilitation services are essential for improving independence, health, and quality of life by facilitating participation in education, work, and social roles. However, in South Africa, particularly in rural areas, providing these services is difficult. Methods: This qualitative study explored the experiences of people with disabilities in KwaZulu-Natal regarding their interactions with rehabilitation services. Six participants were recruited from a private facility using purposive sampling to …

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 …

Effectiveness Of Incident Reporting Tools In Ensuring Patient Safety: A Systematic-Narrative Hybrid Review, Valentina Cerrone, Vincenzo Andretta, Angela Prendin, Bernadette Ilardi, Carloluigi Bonetti, Mario Capunzo, Marco Cascella

Patient Experience Journal

Background: Ensuring Patient Safety in healthcare is essential and requires efficient methods to reduce risks and improve the quality of care. Although incident reporting tools are commonly used to identify possible and actual care failures, their efficacy differs among various environments. The aim is to evaluate the effectiveness of incident reporting tools in enhancing patient safety. Methods: This review employed a combined methodology that integrates systematic and narrative approaches to gain a thorough understanding of incident reporting practices. In accordance with PRISMA guidelines, databases including PubMed, Embase, and Cochrane Library were systematically searched for studies published from January 2013 to …

Patient Perspectives On Health Care Utilization At Two Free Clinics – A Qualitative Study, Patrick Fagan, Danny Guillen Perez, Roberta D. Baer, John Petrilli

Patient Experience Journal

Millions of uninsured Americans access health care through free clinics, but their experience with the medical system is understudied. This study sought to understand patterns in free clinic patients' experience with healthcare utilization through qualitative and descriptive analyses. Data were collected through face-to-face, open-ended interviews at two free clinics in an urban Florida community. The clinics included one student-run free clinic and one community-based free clinic. Survey questions were developed based on prior literature and validated through expert consensus and pilot interviews. The interviewers conducted 74 interviews between May 7 and June 10, 2022. Responses were coded by the authors, …

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 …

Health Literacy, Health Perception, And Influencing Factors Among Immigrants, Canan Birimoglu Okuyan, Ebru Deveci, Fatma Karasu

Makara Journal of Health Research

Background: Individuals living in rural areas face several healthcare disadvantages, including limited access to medical facilities and specialists during emergencies. This study examines healthy lifestyle behaviors, health perceptions, and influencing factors among immigrants in a rural region of southern Türkiye.

Methods: This cross-sectional study involved immigrants registered at a family health center. Data were collected using a sociodemographic questionnaire, the Perception of Health Scale, and the Health Literacy Scale.

Results: Statistically significant differences in THLS-32 scores were found based on participants’ occupation, marital status, and education level (p < 0.05). A moderately positive correlation was observed between health literacy and health perception scores (p < 0.05).

Conclusions: Research on the relationship between …

Cross-Cultural Adaptation And Expert Opinion Of Revised Trauma Quality Of Life Questionnaire (Rt-Qol): Malay Language Version, Sharifa Ezat Wan Puteh, Shamsinar Ibrahim, Malina Zulkifli, Azimatun Noor Aizuddin, Hanizah Mohd Yusoff

Makara Journal of Health Research

Background: This study examines the cross-cultural adaptation and expert validation of the Revised Trauma Quality of Life (RT-QOL) questionnaire, translating it from English to Malay.

Methods: The study employed Beaton’s adaptation guidelines and Takasaki’s framework for expert opinions, involving 51 road traffic injury patients recruited from the Emergency and Trauma Department (ED) of a public hospital in Kedah, Malaysia, from March to June 2022. Participants were contacted via telephone 30 days after their hospital visit regarding their involvement in the study. Three independent experts, comprising academicians in healthcare and emergency department clinicians, reviewed and reconciled the RT-QOL Malay …

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 …

Maternal Dietary, Nutritional Status, And Its Association With Low-Birth Weight: A Scoping Review, Tri Siswati, Devi Septia Ningrum, Adinda Safitri, Almira Sitasari

Indonesian Journal of Public Health Nutrition (IJPHN)

Maternal diet and nutritional status during pregnancy influence birth outcomes. This review article aims to synthesize key studies examining the relationship between maternal dietary intake, nutritional status, and the occurrence of low birth weight (LBW). This study applies a scoping review from PubMed and Google Scholar (2018–2023). Observational and experimental studies were included. Articles met the criteria if they involved pregnant women aged 17+, human studies, full-text availability, and were in English or Indonesian. Fourteen studies met the inclusion criteria and were analyzed. The findings revealed that maternal intake of essential macronutrients, including energy and protein, along with key micronutrients …

#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) …

Comparison Of Outcomes Among Neurovascular Patients Managed In Dedicated Neurological Intensive Care Units Vs. General Intensive Care Units, Joanna Roy, Basel Musmar, Nassos Tziviskos, Saarang Patel, Roberto Deleon, Ashley Thommana, Shady Mina, Stavropoula Tjoumakaris, Michael Gooch, Robert Rosenwasswer, Pascal Jabbour

Department of Neurosurgery Faculty Papers

Background/Objectives: Patients with neurovascular conditions often require multidisciplinary management to optimize recovery. Our systematic review identifies literature comparing outcomes among neurovascular patients managed at dedicated neurological intensive care units (ICUs) compared to general ICUs. Methods: PubMed was searched to identify articles that reported outcomes among patients managed at dedicated neurological ICUs versus general ICUs. Articles that reported outcomes among patients with neurovascular conditions were included. Articles that reported outcomes among patients managed at stroke units were excluded. The Newcastle Ottawa Scale (NOS) was used to assess for risk of bias across individual studies. Results: After a title and abstract screen …

Empowering Underserved Mandarin-Speaking Communities Through Medical Student-Led Culinary Education, Amy Lin, Qihua Sun, Nathan Huang, Virginia Uhley, Misa Mi

Posters

No abstract provided.

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 …

The Impact Of The Utilization Of Shared Decision-Making Tools In Contraceptive Counseling On Patient Satisfaction In Adolescents: A Scoping Review, Akaninyene Ruffin Msn,Fnp-C, Judith Tunney Bsn, Rn, Mary Katherine Fouquier Phd, Aprn, Cnm, Facnm, Margaret Harvey Phd, Aprn, Acnp-Bc

Doctor of Nursing Practice Projects

Purpose/Background

Robust adolescent contraceptive counseling requires deep understanding of the specific context in which adolescents are receiving reproductive health care. As teen pregnancy rates rise, particularly in places across the Deep South, providers must find ways to engage their adolescent patients about their sexual and reproductive health. Professional organizations like the American College of Obstetricians and Gyencologists and the American Academy of Pediatrics both offirm the need for robust contraceptive counseling for adolescents. The purpose of this is to ascertain the impact of utilizing shared-decision making aids during contraceptive counseling on patient satisfaction in adolescent populations.

Methods

A systematic literature …

Heavy Metals In Spices From Lancaster, Pa: Arsenic, Cadmium, And Lead Exposure Risks And The Need For Regulation, Andrew Huff, Hoi Lam, Anuj Ghimirey, Jay Goldring, Michelle Pimentel, Harriet Okatch

College of Population Health Faculty Papers

Heavy metal exposure is associated with adverse health effects in children including impaired cognitive functioning. Studies have identified spices as a potential source of heavy metals. However, in Lancaster, PA no such studies have been conducted. Hence the aim of this study was to quantify arsenic (As), cadmium (Cd) and lead (Pb) in spices from Lancaster, PA. Spices were either purchased from stores in Lancaster or obtained as donations from families in Lancaster. As, Cd, and Pb were quantified using inductively coupled plasma-mass spectrometry. The Wilcoxon rank sum test was used to compare the median heavy metal concentrations in store-purchased …