Digital Commons Network^™

Screening Tools For Maternal Mental Health In Africa: A Systematic Review, Joyce Jebet, Irene Mageto, Benard Mutwiri, Abednego Ongeso, Ruth Wagathu, Rose Maina, Denis Munene, Kawira Kithuci, Peter Gatiti

School of Nursing & Midwifery, East Africa

Background:

Maternal health during pregnancy and the postnatal period encompasses mental health, which is a key aspect in enhancing a positive outcome. Despite screening for other possible complications during pregnancy and the postnatal period, very little attention has been paid to screening for mental health. Screening is a key tool in early diagnosis and, eventually, timely diagnosis and management in cases where complications arise.

Aim:

This study aimed to assess the available maternal mental health screening tools and compare the outcome on their utilization during pregnancy and postnatal periods in the African continent.

Methodology:

This was a …

The Impact Of Economic Stability On Diagnostic Timing Of Autism Spectrum Disorder In Children, Leslie Box Simms

ETDs from 2020-2029

Diagnosis of neurodevelopmental delays in children, including autism spectrum disorder, is an often lengthy and burdensome process, potentially placing children with economic instability at risk for diagnostic delay. The first aim of this dissertation was to explore the impact of economic stability on diagnostic timing of autism spectrum disorder via a scoping review of the literature. Papers were summarized by study design, data sourcing, handling of variables, statistical methodology, and the effect of economic stability factors on diagnostic timing of autism. Income and healthcare insurance were the most frequently employed measures of economic stability, with transportation, housing, and food security …

Exploring Racial And Ethnic Diversity Trajectories And Diabetes Prevalence In The United States, Jiue-An Yang, Calvin P Tribby, Anna Dmowska, Qian Xiao, Marta M Jankowska

Faculty, Staff and Student Publications

This study investigates whether long-term changes in neighborhood racial and ethnic diversity are associated with adult diabetes prevalence across the contiguous United States. We calculated diversity indexes for US census tracts (n = 72,033) using decennial census data from 1990 to 2020. Five diversity trajectory clusters were identified using K-means clustering. Diabetes prevalence in 2019 was obtained from the CDC's PLACES dataset. Linear mixed models (LMMs) assessed global associations between diversity trajectories and diabetes prevalence, adjusting for age, sex, poverty, marital status, and public insurance. Geographically weighted regression (GWR) examined local variations in these associations. Compared to the reference group …

Bridging The Diagnostic Gap: Expanding Dementia Care Navigation For Timely Diagnosis, Lucille Carriere, Morgan Minyo, David Bass, Katherine L Possin, Rafael Samper-Ternent, Joel Salinas, Nicole Deaner

Faculty, Staff and Student Publications

Over half of dementia cases remain undiagnosed, with persistent disparities across racial, ethnic, and socioeconomic groups. Dementia care navigation (DCN) has demonstrated value in post-diagnosis settings. If implemented earlier, DCN could address diagnostic delays and care gaps. We define the diagnostic window as the period from initial symptom awareness through diagnosis and early care planning. Drawing on deliberations from the Alzheimer's Association Dementia Care Navigation Roundtable, we present a pre-diagnosis DCN framework organized across six domains and describe navigator roles across three phases: pre-evaluation, diagnostic assessment, and immediate post-diagnosis and transition. We address special considerations, including people without a care …

Barriers And Facilitators To The Implementation Of The Diabetes Prevention Program (Dpp) In Health Settings: Protocol For A Mixed Methods Systematic Review, Miquel Colom-Rosselló, Manuela Abbate, Laura Capitán-Moyano, Elena Pastor-Ramon, Maria E Fernández, Aina M Yañez, Miquel Bennasar-Veny

Faculty, Staff and Student Publications

This is the protocol of a Campbell Systematic Review. The objectives are as follows: to identify implementation determinants from the perspectives of both participants and implementers, and to assess their influence on specific implementation outcomes, thereby clarifying why certain aspects of the implementation process succeed or fail. If sufficient data is available, variations in perceived barriers or facilitators related to individuals and program characteristics will also be explored.

Evaluation Of A Novel Antegrade-To-Retrograde Femoral Sheath Conversion System: A Preclinical, Cadaveric Study, Ramakrishnan Ranganath, Kerry K Gilbert, Randy Hickle, Anuva Iyer, Ryan Um, Rex Johnson, Randall Torrence, Daniel I Sessler

Faculty, Staff and Student Publications

Background: Peripheral arterial disease often affects the lower extremities, is frequently bilateral, and typically involves multiple leg segments. Symptomatic disease is usually treated endovascularly. Antegrade access may be necessary in some cases and can be challenging compared with retrograde common femoral artery access. The ability to convert a conventional retrograde access to antegrade access would thus be valuable. We developed and tested a novel system, named as antegrade-to-retrograde converter. Our aim was to establish antegrade superficial femoral artery access from initial retrograde entry and reconvert to retrograde access.

Methods: We tested the antegrade-to-retrograde converter bilaterally in 15 fresh (unembalmed) human …

Dental Care Utilization Among Sexual And Gender Minority Individuals, Ishita Singh, Oladipo Afolayan, Sarah S Jackson, Irene Tamí-Maury

Faculty, Staff and Student Publications

Objectives: Sexual and gender minority (SGM) individuals can experience notable health disparities, including higher HIV prevalence, social isolation, substance abuse, lack of culturally competent providers, and poorer health outcomes compared to heterosexuals due to stigma and discrimination. This study aims to identify predictors of dental care utilization across sexual minorities using the 2023 TEXAS PRIDE Survey.

Methods: We analyzed data from 517 SGM individuals, assessing sociodemographic characteristics, health behaviors, and recent medical and dental visits. Multivariable logistic regression identified predictors of dental care utilization (i.e., a dental visit in the past year).

Results: Among sexual orientation groups, reported dental care …

Trust In Cancer Information Sources And Awareness Of Human Papillomavirus As A Cause Of Cervical Cancer Among Us Adults, Olajumoke Ope Oladoyin, Paula Cuccaro, Lara S Savas, Robert Yu, Joel Fokom Domgue, Sheryl Mccurdy, Sanjay Shete

Faculty, Staff and Student Publications

Importance: Religiosity, trust in physicians, and trust in government health agencies influence individual decision-making and behavior toward public health programs. However, trust in information about cancer from these sources and their association with public awareness of human papillomavirus (HPV) as a cause of cervical cancer remain understudied.

Objective: To assess the association of trust in cancer information sources with awareness that HPV causes cervical cancer among US adults.

Design, setting, and participants: This cross-sectional study used the nationally representative 2022 Health Information National Trends Survey (HINTS) data on noninstitutionalized US adults aged 18 years or older collected between March 7 …

Association Of Insulin Resistance And Fracture Risk In The Osteoporotic Fractures In Men (Mros) Cohort, Jeonghoon Ha, Li-Yung Lui, Kristine Ensrud, Qian Xiao, Andrew R Hoffman, Joy Y Wu

Faculty, Staff and Student Publications

Context: Insulin resistance (IR) is more prevalent in men than in women, but evidence directly linking IR to fracture risk in older men remains limited.

Objective: To evaluate the association between insulin resistance (IR), estimated using the Homeostatic Model Assessment of Insulin Resistance (HOMA-IR) and the triglyceride-glucose (TyG) index, and fracture risk in older men.

Methods: Data from 5994 men (≥65 years) in the MrOS cohort were analyzed. A total of 5416 participants were included in the HOMA-IR analysis and 5384 in the TyG index analysis. Fractures were self-reported and confirmed radiographically. Participants were grouped into quartiles based on IR …

Voucher Model For Family Planning: Empowering Poor Women And Expanding Access To Family Planning Services In Punjab, Population Council Pakistan

Sexual and Reproductive Health, Rights, and Choices

Pakistan continues to face significant inequalities in access to family planning (FP) services, with the poorest women bearing a disproportionate burden of unmet need. Financial constraints, transportation costs, limited mobility, restricted decision-making power, and inadequate access to quality services often prevent women from obtaining the family planning services they need.

To address these barriers, the Population Council, in partnership with the Benazir Income Support Programme (BISP) and the Punjab Population Innovation Fund (PPIF), designed and rigorously evaluated an innovative Family Planning Voucher Scheme.

The model linked social protection with reproductive health services, enabling poor women from Rahim Yar Khan (RYK) …

A Qualitative Exploration Of Unanticipated Effects Experienced By People With Chronic Obstructive Pulmonary Disease Who Participated In Interventions Designed To Reduce Sedentary Behaviour, Fiona Coll, Vinicius Cavalheri, Daniel F. Gucciardi, Kylie Hill

Research outputs 2022 to 2026

Introduction: This study explored the lived experiences of people with chronic obstructive pulmonary disease (COPD) who participated in interventions designed to reduce the accumulation of sedentary behaviour in prolonged uninterrupted bouts. Methods: Ten participants with stable COPD participated in a multi-component intervention that spanned over 9 months and was designed to address the intervention message ‘If you have been sitting or resting continuously for 30 min, stand up and move’. Interventions comprised participation in an 8-week programme of supervised exercise training coupled with behaviour change techniques. Throughout the intervention period the person delivering the intervention kept detailed notes of their …

Alara+: Summit On Radiation And Orthopedic Risks In Fluoroscopic Laboratories: Endorsed By Acc, Acvp, Ase, Hrs, Scai, Sir, Snis, Svin, And Svs, Arash Salavitabar, Amit N. Vora, Dorothea Altschul, J. Fritz Angle, Chelsea Ballinger, Andrew Bojanowski, Anna E. Bortnick, Kyle Bugg, Emily Carpenter, Robert E. Foster, Joanna Ghobrial, Matthew Glogoza, Atul Gupta, James B. Hermiller, A. Kyle Jones, Summer L. Kaplan, Steven J. Kraus, Omar Khalique, Andrea Klein, Nick Morse, Preethi Ramchand, David G. Rizik, Lucy M. Safi, Cheryl C. Schultz, Kamala P. Tamirisa, R. Jay Widmer, Kristi Wilson, Jonathan X. Fang, Arnold Seto, Robert F. Riley

Department of Neurosurgery Faculty Papers

Occupational radiation exposure has a clear association with long-term health effects and has a particular impact on women, trainees, and supporting staff. There is a reliance on limited, traditional radiation protection and nonergonomic equipment, which carries associated orthopedic injury rates with adverse impacts on both individual career trajectories and health systems, and with significant challenges to widespread implementation of enhanced radiation protection devices. During the 2025 Society for Cardiovascular Angiography & Interventions Scientific Sessions in Washington, DC, a multidisciplinary Think Tank summit was convened and included representatives from multiple stakeholders, including other professional societies, advocacy groups, and industry partners. The …

Social Determinants As A Predictor For Heart Disease Mortality: Oregon Regional Study, Jewel Jones

University Honors Theses

The study examined the association between selected social determinants of health and heart disease mortality across geographic regions in Oregon. Using a regional analysis design, county-level population and mortality data were grouped into nine geographic regions to evaluate patterns of cardiovascular disease burden across the state. Social determinant variables were obtained from publicly available U.S. Census Bureau datasets and included poverty, crowding among households, single-parent households, lack of broadband internet subscription, housing cost burden, high school diploma attainment, and unemployment.

Heart disease mortality counts per 100,000 population were derived from official birth and death certificate records. Statistical analyses were conducted …

Geographic And Systemic Disparities In Maternal Health: A Systems Analysis Of Prenatal Care Access Across Rural Oregon, Cecelia Petrik

University Honors Theses

Objectives: In Oregon, 51% of hospitals providing labor and delivery services are located in rural areas. Consolidation of these hospitals and provider shortages has created severe geographic and systemic disparities in maternal healthcare. This thesis explores how geographic isolation and inadequate prenatal care access contribute to widening disparities in severe maternal morbidity (SMM) and mortality across Oregon's rural and frontier counties.

Methods: This study utilizes data from the Oregon Health Authority (OHA) Center for Health Statistics (2024) and analyzes spatial correlations across all 36 Oregon counties. A bivariate choropleth map was constructed to examine the structural intersection between health infrastructure …

Moving Beyond Traditional Cost Containment For Glp-1 Coverage Within Oregon's Proposed Universal Health Plan, Manoj Rajesh

University Honors Theses

In 2022, Oregon voters passed Measure 111, constitutionally mandating access to affordable health care. As the Universal Health Plan Governance Board (UHPGB) designs the state's proposed single-payer system, it faces an unprecedented financial vulnerability: the clinical demand for GLP-1 receptor agonists. These high-cost, indefinite-use medications for obesity and metabolic syndrome threaten to overwhelm fixed public budgets. Historically, both the Oregon Health Plan's Medicaid framework and commercial private insurers have relied on static cost-containment models—categorical exclusions, step therapy, and aggressive utilization management—that achieve short-term fiscal solvency at the expense of comprehensive preventative care. This thesis argues that to fulfill the mandate …

Enhancing Emergency Department Preparedness For Amniotic Fluid Embolism Through Evidence-Based Simulation Training, Olivia M. Smoak

Doctor of Nursing Practice Final Manuscripts

Maternal mortality in the United States remains a significant and worsening public health concern, with increasing reliance on emergency departments (EDs) as access points for maternal care. Emergency clinicians are therefore more likely to encounter high-acuity obstetric emergencies, including maternal cardiac arrest and amniotic fluid embolism (AFE), yet often receive limited formal training in these conditions. Simulation-based education, interdisciplinary training, and cognitive aids have been identified as effective strategies to improve performance in high-risk, low-frequency events.

The purpose of the evidence-based practice project was to evaluate whether an interdisciplinary simulation with obstetric-led debrief and introduction of the AFE checklist improves …

Optimizing Vitamin A Intervention: Strengthening Supplementation With Targeted Biscuit Fortification, Mayfa Yemima Simanjuntak, Nadia Amanda, Yuli Berliana Simanjuntak, Carissa Wityadarda, Lesta Livolina Simamora

Journal of Indonesian Health Policy and Administration

Vitamin A deficiency (VAD) remains a persistent public health challenge in Indonesia, particularly among children under five and breastfeeding mothers. This study aimed to analyze the distribution of vitamin A interventions and assess the potential of biscuit fortification as a complementary strategy. This study employs a literature review using the Health Policy Triangle (HPT) framework, examining policy context, content, key actors, and implementation processes related to vitamin A interventions. The analysis was conducted using secondary data from government reports, international agencies, and peer-reviewed literature published between 2018 and 2025, with comparative evidence from Vietnam, Bangladesh, and Ghana. The findings show …

Clinician Perspectives On Fistula Mental Health, Victoria K. Leonard

Doctoral Dissertations

Background – Obstetric fistula is a childbirth injury caused by prolonged labor that leads to stillbirth and incontinence, spurring social exclusion and isolation. These layers of trauma put women with fistula at great risk for psychological suffering, which has profound negative socioeconomic impacts on them, their families, and communities. This study captured treatment as usual at Comprehensive Community Based Rehabilitation in Tanzania (CCBRT), the country’s largest provider of fistula care.

Method – Improving holistic fistula treatment requires engaging the clinicians who care for women with fistula. This study aimed to investigate the training, beliefs, and treatment approaches of nurses and …

Resilience And Social Support On Depression Risk For Chronic Obstructive Pulmonary Disease Patients In South Tangerang, Indonesia, Adhityawarman Menaldi, Sali Rahadi Asih, Farah Ainul Mardhiyyah

Kesmas

Chronic obstructive pulmonary disease (COPD) is a major public health concern with psychosocial impacts, such as reduced resilience and depression. This study examined the moderating role of perceived social support on the relationship between resilience and depression among individuals diagnosed with COPD in South Tangerang, Indonesia. A quantitative cross-sectional study was conducted between January and February 2024 using self-administered questionnaires. Participants were adult patients with clinically diagnosed COPD, recruited from all public health centers (PHC) in South Tangerang. A total of 125 participants met the inclusion criteria and were included in the analysis. Participants had a mean age of 41.46±15.69 …

Determinants Of Musculoskeletal Disorder In Formal And Informal Workers In Indonesia, Herlina J. El-Matury, Nabila Syahlan, Mohd Rafee B. Baharuddin

Kesmas

Musculoskeletal disorders (MSDs) are a leading cause of disability globally and are strongly influenced by occupational conditions. Evidence comparing MSD risk between formal and informal workers remains limited, particularly in developing countries. This study examined the association between individual and job-related factors with MSD symptoms among formal and informal workers in Indonesia. A cross-sectional study was conducted among 1,089 workers in North Sumatra Province, Indonesia, from August 2024 to December 2025. Participants were recruited using stratified convenience sampling from both the formal (office and health workers) and informal (drivers, traders, and farmers) sectors. MSD symptoms were assessed using the Nordic …

Characteristics Of People Who Inject Drugs Approached For Injection Assistance In Rural Kentucky, April Young, Ryli Hockensmith, Preston T Tolbert, Susan Westneat, Peter Vickerman, Jack Stone, Hilary L Surratt, Kayo Fujimoto, Hannah K Knudsen, Rachel Vickers-Smith, Katherine L Thompson, Laura Fanucchi, Julia Kollitz, Jennifer R Havens, Melvin D Livingston

Faculty, Staff and Student Publications

Objective: This study aims to understand the characteristics of people who inject drugs approached by others for injection assistance.

Method: Peer-referral and outreach were used to recruit rural adults who recently injected drugs in Appalachian Kentucky (n=435). Interviewer-administered questionnaires elicited data on participant characteristics and injection assistance. Descriptive statistics and generalized estimating equations clustered on peer-referral recruitment chain were used for analysis.

Results: Nearly one-third (30.1%) reported others had come to them for injection assistance. People approached for assistance were slightly younger (prevalence ratio [PR]: 0.91, 95% confidence interval [CI]: 0.85-0.99) but otherwise, demographically similar to their counterparts. Those approached …

Extending The Global Impact Of Dnp Education: Integrating Scholarly Dissemination And International Practice Projects, Cynthia Plonien, Pricilla Muisyo, Deborah Behan, Kristine Cope, Cathy Brown

Nursing Faculty Publications & Presentations

The Doctor of Nursing Practice (DNP) Program at the University of Texas at Arlington initiated a global outreach effort in 2024 through two complementary strategies: expansion of a digital repository to support dissemination of DNP scholarly work and implementation of pilot DNP projects in Kenya. Together, these initiatives represent an integrated model for global engagement that combines knowledge dissemination with application of practice-based scholarship. The repository has facilitated international access to DNP projects, demonstrating significant global reach across multiple countries. Concurrently, a pilot project in Kenya was established through a strategic in-country professional partnership, enabling culturally relevant and sustainable implementation …

Do Rural-Urban Disparities Translate Into Nursing Complexity At Hospital Admission? Evidence From A Single Tertiary-Care Pediatric Hospital In Italy, Manuele Cesare, Gianfranco Damiani, Gloria Anderson, Jessica Preziosi, Rosemary Frasso, Leonardo Villani, Nursing And Public Health Group, Vittorio Maio, Antonello Cocchieri

College of Population Health Faculty Papers

BACKGROUND/OBJECTIVES: Rural-urban disparities are well documented in pediatric healthcare, influencing access, service organization, and outcomes. However, whether these differences extend to the domain of nursing care remains unclear. This study examined the association between degree of urbanization and nursing complexity among children admitted to a single tertiary-care pediatric hospital, comparing clinical, organizational, and nursing characteristics across geographic groups.

METHODS: Routinely collected electronic nursing documentation and hospital administrative records were retrospectively examined in a tertiary-care pediatric hospital in Rome, Italy. Children aged 2 to < 18 years were consecutively included. Degree of urbanization was defined using the ISTAT-derived DEGURBA classification. The study outcome for nursing complexity corresponded to the number of nursing diagnoses documented at hospital admission. Descriptive analyses and a multivariable negative binomial regression model assessed the association between urbanization and nursing complexity, adjusting for age, sex, DRG weight, number of medical diagnoses, and chronic conditions.

RESULTS: Among 1652 pediatric hospitalizations, those from rural areas showed a higher clinical burden, with significantly higher …

Food Insecurity And At-Home Vegetable And Sugar-Sweetened Beverage Availability: Tx Sprouts Randomized Controlled Trial, Keally Haushalter, Shreela V Sharma, Marissa Burgermaster, Natalie S Poulos, Erin A Hudson, Jennifer M Daspin, Mariela Jimenez Rivero, Jaimie N Davis

Faculty, Staff and Student Publications

Food insecurity and the at-home availability of vegetables and sugar-sweetened beverages both influence dietary intake. However, most research on food insecurity and the at-home availability of vegetables and sugar-sweetened beverages is cross-sectional, which is problematic as both change frequently. Therefore, this study assessed how changes in food insecurity were associated with changes in the at-home availability of vegetables and sugar-sweetened beverages among those in the intervention and control groups of TX Sprouts. Parents who participated in TX Sprouts, a gardening, cooking, and nutrition cluster-randomized trial conducted with primarily Hispanic, low-income 3rd-5th-grade students, completed surveys at baseline and at the nine-month …

Projected U.S. Cardiovascular Disease Burden From Heat Exposure For Future Greenhouse Gas Scenarios, Gokul Parmeswaran, Sai Rahul Ponnana, Santosh Kumar Sirasapalli, Niketh Surya, Tong Zhang, Zhuo Chen, Jean-Eudes Dazard, Salil V. Deo, Sanjay Rajagopalan

Faculty Scholarship

Importance: Climate change may reverse decades of improvements in cardiovascular disease (CVD) mortality in the US; however, comprehensive regional projections of heat-related CVD burden in the US are unavailable. Objective: To use the county-level observed (2010-2016) heat-related CVD burden in the US to obtain the projected rates through 2050 according to the mean (shared socioeconomic pathway [SSP] 2-4.5) and high (SSP5-8.5) greenhouse gas (GHG) emission pathways. Design, Setting, and Participants: This cross-sectional ecological analysis used county-level summary data including all counties in the contiguous US from 2010 through 2016 as baseline data with projections to 2030 and 2050 under SSP …

Evaluating Stroke Recognition And Prehospital Quality Metrics In Emergency Dispatch: A Retrospective Cohort Study Comparing Mimics And Confirmed Strokes, Nedim Leto, Elisabeth Farbu, Paul Barach, Conrad Arnfinn Bjørshol, Martin Kurz, Soffien Ajmi, Annette Fromm, Christopher Kalhagen Bjerkvig, Thomas Lindner

College of Population Health Faculty Papers

OBJECTIVES: Accurate identification of acute stroke by the Emergency Medical Dispatch Centre (EMDC) is essential for timely treatment and efficient resource use. However, stroke mimics-conditions resembling stroke can often lead to overtriage, complicating emergency care. We aimed to quantify EMDC stroke overtriage and compare characteristics of stroke mimics with confirmed stroke cases.

DESIGN: Retrospective cohort study.

SETTING: Patients with suspected stroke identified by the EMDC in Western Norway between 1 January 2021 and 31 December 2022.

PARTICIPANTS: A total of 8,261 patients with EMDC suspected stroke were included. Stroke suspicion was determined using the Norwegian Medical Priority Dispatch System, which …

Expert Recommendations To Strengthen Chikungunya Outbreak Surveillance And Reporting For Traveler Health Protection, Daniel C. Payne, Karoun H. Bagamian, Jeffery Goad, Nathan D. Grubaugh, Michael A. Johansson, Moritz U. G. Kraemer, Eyal Leshem, Francesca F. Norman, Alfonso J. Rodríguez-Morales, Henrik Salje, Stephen Thomas, Scott C. Weaver, Lindsey A. Laytner, Rebecca Sturgis, Suzanne K. Scheele, Davidson H. Hamer

Pharmacy Faculty Articles and Research

Chikungunya, a debilitating mosquito-borne disease caused by chikungunya virus, has surged dramatically in the past two decades. Chikungunya outbreaks can intensify rapidly, with infections posing a significant endemic health burden in tropical/subtropical areas and for travelers. Health professionals require timely and accurate outbreak information to adequately protect travelers and assess chikungunya risk. However, detection is often insufficient in the areas most susceptible to outbreaks, leading to diagnostic and reporting delays. Consequently, travelers are often unaware of increased chikungunya infection risk at their destination. We assessed chikungunya surveillance and reporting resources, and we developed expert recommendations for traveler health protection. Because …

Molecular Classification And Association With Survival Outcomes In High-Intermediate And High-Risk Early-Stage Endometrial Cancers: Ancillary Analysis Of Gog-0249, Lindsay Kuroki, Danielle Enserro, Heather Lankes, Kyle Strickland, Rebecca Previs, Aine Clements, Matthew Powell, Ann Klopp, Elena Ratner, Paul Disilvestro, Casey Cosgrove, Guilherme Henrique Cantuaria, Nicola Spirtos, Michael Carney, Mitchell Edelson, Gottfried Konecny, Penny Anderson, Christopher Tarney, Britt Erickson, Meredith Newton, Krishnansu Tewari, Premal Thaker, David Warshal, Amy Armstrong, Xun Clare Zhou, Angeles Alvarez Secord

Abington Jefferson Health Papers

OBJECTIVE: Determine whether mismatch repair (MMR) and p53 expression predict recurrence-free survival (RFS) and overall survival (OS) in early-stage endometrial cancer (EC) patients treated with vaginal cuff brachytherapy plus chemotherapy (VCB/C) versus pelvic radiation therapy (RT).

METHODS: In the GOG-0249 trial, 601 patients with high-intermediate risk (HIR) early-stage EC were randomized to VCB/C (carboplatin/paclitaxel for 3 cycles) or pelvic RT. Molecular subgroups, deficient MMR (dMMR), p53 wildtype (p53wt), p53 abnormal (p53abn), were determined by immunohistochemistry. Five-year RFS and OS were analyzed using Kaplan-Meier curves and Cox proportional hazards models, adjusting for lymphadenectomy, planned VCB, and treatment group.

RESULTS: Among 315 …

Internalized Homophobia As An Influence On Participation In Hiv Prevention Among Young Men Who Have Sex With Men (Ymsm), Kasey I. Brazee

Honors Scholar Theses

Stigma is a known barrier to accessing preventative services for human immunodeficiency virus (HIV), however, the types of stigmas involved in this relationship remain not well defined. Homophobia, or negative attitudes directed towards homosexuality, is a particularly important type of stigma considering the disproportionate effect of HIV on men who have sex with men (MSM). Young MSM (YMSM) are especially impacted, making them a key population in the context of HIV prevention research.  Internalized homophobia, which refers to homophobia that one directs towards themselves, is under researched regarding its role in participating in HIV prevention. In this study, we aimed …

Evaluating The Association Between Chronic Health Conditions And Caregiver Burden For Male Dementia Caregivers, Dareion D. Hill-Smith

Walden Dissertations and Doctoral Studies

No abstract provided.