Digital Commons Network^™

The Acceptance And Use Of Digital Technologies For Self-Reporting Medication Safety Events After Care Transitions To Home In Patients With Cancer: Survey Study, Yun Jiang, Misun Hwang, Youmin Cho, Christopher R Friese, Sarah T Hawley, Milisa Manojlovich, John C Krauss, Yang Gong

Faculty, Staff and Student Publications

BACKGROUND: Actively engaging patients with cancer and their families in monitoring and reporting medication safety events during care transitions is indispensable for achieving optimal patient safety outcomes. However, existing patient self-reporting systems often cannot address patients' various experiences and concerns regarding medication safety over time. In addition, these systems are usually not designed for patients' just-in-time reporting. There is a significant knowledge gap in understanding the nature, scope, and causes of medication safety events after patients' transition back home because of a lack of patient engagement in self-monitoring and reporting of safety events. The challenges for patients with cancer in …

Observation On Efficacy And Underlying Mechanism Of Cheek Acupuncture On Ovulation Induction For Infertile Women With Pcos: Case Series, Yi Yang, Lihua Jin, Shasha Xu, Huijun Ye, Xi Luo, Ruilan Li, Yuebing Yue

Faculty, Staff and Student Publications

RATIONALE: Polycystic ovary syndrome (PCOS) is the most common reproductive endocrine disorder among women of childbearing age and is the primary cause of anovulatory infertility, accounting for 70% to 80% of cases. Ovulation induction is the main treatment approach for infertile patients with PCOS. Commonly utilized medications for this purpose are clomiphene citrate (CC) and letrozole (LE). Clomiphene citrate administration results in an ovulation rate ranging from 60% to 85%, while the pregnancy rate is limited to 35% to 40%, and a further reduction is observed in live birth rates. Letrozole demonstrates a slightly higher pregnancy rate and live birth …

Understanding Adherence To Prescribed Medical Regimen To Treat Hypertension Among African American Males, Yolanda Lucian George

Walden Dissertations and Doctoral Studies

Hypertension is referred to as the silent killer and has been for decades. African Americans have been affected disproportionately compared to Whites, leading to a significant medical and financial burden. The literature has demonstrated that even though African Americans have a similar or better awareness of hypertension, they are more likely to have poorer treatment outcomes and have their hypertension less controlled. In this study, the health belief model and the ecological social model were used as the guiding framework to understand this phenomenon. In this qualitative study, semistructured interviews were used to explore and understand the perception of adherence …

Liax Is A Surrogate Marker For Cell Envelope Stress And Daptomycin Non-Susceptibility In Enterococcus Faecium, Dierdre B Axell-House, Shelby R Simar, Diana Panesso, Sandra Rincon, William R Miller, Ayesha Khan, Orville A Pemberton, Lizbet Valdez, April H Nguyen, Kara S Hood, Kirsten Rydell, Andrea M Detranaltes, Mary N Jones, Rachel Atterstrom, Jinnethe Reyes, Pranoti V Sahasrabhojane, Geehan Suleyman, Marcus Zervos, Samuel A Shelburne, Kavindra V Singh, Yousif Shamoo, Blake M Hanson, Truc T Tran, Cesar A Arias

Faculty, Staff and Student Publications

Daptomycin (DAP) is often used as a first-line therapy to treat vancomycin-resistant

Nigerian Nurses' Perceptions Of Caring For Women With Female Genital Mutilation, Jane-Frances Echeozo

Walden Dissertations and Doctoral Studies

There are numerous health problems associated with female genital mutilation (FGM) practice. In Nigerian healthcare, professionals need to ensure culturally sensitive care for FGM cases. However, there was a literature gap involving culturally sensitive care for Nigerian women with FGM complications, evidenced by some northern Nigerian nurses who were not able to identify FGM categories or cultural given names associated with FGM types. Thus, this qualitative study involved ascertaining the worldview of Nigerian nurses and midwives in Owerri regarding providing culturally competent nursing care for FGM complications, guided by the process of cultural competence in the delivery of healthcare services …

Hypertension In Pregnancy Among Immigrant And Swedish Women: A Cohort Study Of All Pregnant Women In Sweden, Per Wändell, Casey Crump, Xinjun Li, Nouha Saleh Stattin, Axel C Carlsson, Jan Sundquist, Kristina Sundquist

Faculty, Staff and Student Publications

BACKGROUND: Little is known about risks of hypertensive disorders of pregnancy in both first- and second-generation immigrant women in Europe and other Western countries; such knowledge may help elucidate the influence of genetic versus social factors on such risks. We aimed to study both first- and second-generation immigrant women for the presence of all types of hypertension (preexisting hypertension, gestational hypertension, preeclampsia, and eclampsia) during pregnancy.

METHODS AND RESULTS: A cohort study was conducted using data derived from the Swedish National Birth Register, the National Patient Register, and the total Population Register. We used Cox regression analysis to compute hazard …

Sex Differences In Revascularization, Treatment Goals, And Outcomes Of Patients With Chronic Coronary Disease: Insights From The Ischemia Trial, Harmony R Reynolds, Derek D Cyr, C Noel Bairey Merz, Leslee J Shaw, Bernard R Chaitman, William E Boden, Karen P Alexander, Yves D Rosenberg, Sripal Bangalore, Gregg W Stone, Claes Held, John Spertus, Kaatje Goetschalckx, Olga Bockeria, Jonathan D Newman, Jeffrey S Berger, Ahmed Elghamaz, Renato D Lopes, James K Min, Daniel S Berman, Michael H Picard, Raymond Y Kwong, Robert A Harrington, Boban Thomas, Sean M O'Brien, David J Maron, Judith S Hochman, Ischemia Research Group

Faculty, Staff and Student Publications

BACKGROUND: Women with chronic coronary disease are generally older than men and have more comorbidities but less atherosclerosis. We explored sex differences in revascularization, guideline-directed medical therapy, and outcomes among patients with chronic coronary disease with ischemia on stress testing, with and without invasive management.

METHODS AND RESULTS: The ISCHEMIA (International Study of Comparative Health Effectiveness with Medical and Invasive Approaches) trial randomized patients with moderate or severe ischemia to invasive management with angiography, revascularization, and guideline-directed medical therapy, or initial conservative management with guideline-directed medical therapy alone. We evaluated the primary outcome (cardiovascular death, myocardial infarction, or hospitalization for …

High Clinical Exome Sequencing Diagnostic Rates And Novel Phenotypic Expansions For Nonisolated Microphthalmia, Anophthalmia, And Coloboma, Bhavana Kunisetty, Bailey A Martin-Giacalone, Xiaonan Zhao, Pamela N Luna, Brian P Brooks, Robert B Hufnagel, Chad A Shaw, Jill A Rosenfeld, A J Agopian, Philip J Lupo, Daryl A Scott

Faculty, Staff and Student Publications

PURPOSE: A molecular diagnosis is only made in a subset of individuals with nonisolated microphthalmia, anophthalmia, and coloboma (MAC). This may be due to underutilization of clinical (whole) exome sequencing (cES) and an incomplete understanding of the genes that cause MAC. The purpose of this study is to determine the efficacy of cES in cases of nonisolated MAC and to identify new MAC phenotypic expansions.

METHODS: We determined the efficacy of cES in 189 individuals with nonisolated MAC. We then used cES data, a validated machine learning algorithm, and previously published expression data, case reports, and animal models to determine …

Exploring Imageability Through Architecture To Study Neuroscience: Preliminary Results Of A Systemic Review, Cristian Maestre, Shana Garza, Silvia Mejia-Arango, Jesus D. Melgarejo, Gladys E. Maestre

Research Symposium

Background: Neuroscience and architecture are often combined to study the impact of environment, physical spaces, colors, shapes, and buildings on brain activity and health. This is an emerging field with distinct areas examining architecture in relation to neuroscience. Among the numerous elements of architecture, imageability seems to be of particular interest. Imageability refers to the quality of a physical space that evokes strong images in people’s mind, and influence cognitive functions including visual, memory, and spatial recall. It is hypothesized that environments, spaces, and buildings with poor imageability might negatively affect cognition, behavior, and brain health. Diverse studies have been …

Medical Home Implementation And Follow-Up Of Cancer-Related Abnormal Test Results In The Veterans Health Administration, Suja S Rajan, Shashank Sarvepalli, Li Wei, Ashley N D Meyer, Daniel R Murphy, Debra T Choi, Hardeep Singh

Faculty, Staff and Student Publications

IMPORTANCE: Lack of timely follow-up of cancer-related abnormal test results can lead to delayed or missed diagnoses, adverse cancer outcomes, and substantial cost burden for patients. Care delivery models, such as the Veterans Affairs' (VA) Patient-Aligned Care Team (PACT), which aim to improve patient-centered care coordination, could potentially also improve timely follow-up of abnormal test results. PACT was implemented nationally in the VA between 2010 and 2012.

OBJECTIVE: To evaluate the long-term association between PACT implementation and timely follow-up of abnormal test results related to the diagnosis of 5 different cancers.

DESIGN, SETTING, AND PARTICIPANTS: This multiyear retrospective cohort study …

Changes In Real-World Dispensing Of Adhd Stimulants In Youth From 2019 To 2021 In California, Anika Patel, Rishikesh Chavan, Cyril Rakovski, Richard C. Beuttler, Sun Yang

Mathematics, Physics, and Computer Science Faculty Articles and Research

Introduction: Attention-deficit/hyperactivity disorder (ADHD) is one of the most common pediatric neurobehavioral disorders in the U.S. Stimulants, classified as controlled substances, are commonly used for ADHD management. We conducted an analysis of real-world stimulants dispensing data to evaluate the pandemic’s impact on young patients (≤ 26 years) in California.

Methods: Annual prevalence of patients on stimulants per capita across various California counties from 2019 and 2021 were analyzed and further compared across different years, sexes, and age groups. New patients initiating simulants therapy were also examined. A case study was conducted to determine the impact of socioeconomic status on patient …

Clinical Pathway Using Arabic Written Medical Information To Improve Incontinence Healthcare Utilization, John F. Knapp, Codrut Radoiu, Emma Ross, Jack Vercnocke Md, Aron Liaw Md, Nivedita Dhar

Medical Student Research Symposium

Introduction and Objective: Metro Detroit holds ~13% of all Arabic speakers in the U.S.A. and 91% of those in Michigan. Evidence supports that patients who do not speak the local language have poor access to healthcare. This study describes our preliminary experience of managing Arabic only speaking women with bothersome stress urinary incontinence (SUI) from May 2022 to October 2023. These women routinely request same-sex interpreters, which is not always possible, leading to a lack of detailed translation. A potential solution is to use Arabic written medical information (AWMI). The purpose of the study was to retrospectively look at the …

Life Satisfaction Changes And Adaptation In The Covid-19 Pandemic: Evidence From Singapore, Terence C. Cheng, Seonghoon Kim, Kanghyock Koh

Research Collection School Of Economics

We provide novel evidence on how COVID-19 affected overall life satisfaction using a monthly longitudinal survey of middle-aged and older Singaporeans. We study how the subjective well-being of individuals evolves over the course of 18 months including the outbreak of the pandemic, the implementation of the lockdown and the spike of cases due to the delta variant in a country where COVID-19 is controlled in a sustained manner. Using an event-study design framework, we find large declines in overall life satisfaction in the lead-up to and following the lockdown. Fifteen months after the outbreak of the pandemic, and 13 months …

“No Matter How Hot It Is, You Just Have To Do The Work”: Examining Farmworkers’ Experiences With Heat And Climate Change In Idaho, Carly Hyland, Delmy Flores, Grace Augusto, Irene Ruiz, Marielena Vega, Rulon Wood

Public and Population Health Faculty Publications and Presentations

Introduction: Farmworkers are one of the populations most vulnerable to climate change. In addition to disproportionate exposure to climate-intensified hazards such as extreme heat and wildfire smoke, many farmworkers face situational and psychosocial stressors that also impact their health.

Methods: We conducted open-ended interviews with 16 farmworkers in Southcentral Idaho during June-August 2023 as part of a digital storytelling project in partnership with the Idaho Organization of Resource Councils (IORC). Interviews assessed participants’ experiences with climate change, perceived impacts on their health, and strategies and barriers to protecting themselves. Bilingual (English/Spanish) study staff translated and transcribed all video recordings verbatim, …

The Great Resignation: Narratives Of Mid-Career Teacher Burnout And Attrition, Nicole Burton

Dissertations and Doctoral Documents, University of Nebraska-Lincoln, 2023–

The COVID-19 pandemic has increased the issues of teacher attrition. According to the U.S. Bureau of Labor and Statistics, from January to November 2021, there was a 40% increase in the quit levels of teachers within the state and local education agencies (John, 2022). While prior research has examined early-career teachers leaving the profession, mid-career teachers have largely been left out of the conversation. This narrative inquiry investigates the reasons that mid-career teachers are leaving the profession. Semi-structured interviews were conducted with four mid-career teachers hailing from the Midwest region. Interviews focused on understanding how teachers have experienced stress and …

Voices From Grenada: An Impact Evaluation Of A Community-Academic Partnership., Sade Richardson

Doctor of Social Work Capstone Projects

The purpose of this study was to evaluate the impact of the community-academic partnership between the University of Michigan School of Public Health Office of Public Health Practice and the Grenadian community. Five key informant interviews were conducted to analyze the partnership from the perspectives of the community partners in Grenada to understand the strengths, challenges, and existing opportunities, specifically within the context of a global collaboration.

The findings highlighted the benefits of community-based collaboration, considerations for partnership design, and opportunities for education, practice, policy, research, and leadership. The organizations spoke highly of the partnership, underscoring their desire for expanded …

Waning Effectiveness Of Mrna Covid-19 Vaccines Against Inpatient And Emergency Department Encounters, Theodoros V. Giannouchos, Nicole L. Hair Ph.D., Bankole Olatosi Ph.D., Xiaoming Li Ph.D.

Faculty Publications

In the United States, most real-world estimates of COVID-19 vaccine effectiveness are based on data drawn from large health systems or sentinel populations. More data is needed to understand how the benefits of vaccination may vary across US populations with disparate risk profiles and policy contexts. We aimed to provide estimates of mRNA COVID-19 vaccine effectiveness against moderate and severe outcomes of COVID-19 based on state population-level data sources. Using statewide integrated administrative and clinical data and a test-negative case-control study design, we assessed mRNA COVID-19 vaccine effectiveness against SARS-CoV-2-related hospitalizations and emergency department visits among adults in South Carolina. …

Metabolomic Association And Risk Prediction With Heart Failure In Older Adults, Guning Liu, Ngoc Quynh H Nguyen, Kari E Wong, Sunil K Agarwal, Eric Boerwinkle, Patricia P Chang, Brian L Claggett, Laura R Loehr, Jianzhong Ma, Kunihiro Matsushita, Carlos J Rodriguez, Joseph S Rossi, Stuart D Russell, R Brandon Stacey, Amil M Shah, Bing Yu

Faculty, Staff and Student Publications

Background: Older adults have markedly increased risks of heart failure (HF), specifically HF with preserved ejection fraction (HFpEF). Identifying novel biomarkers can help in understanding HF pathogenesis and improve at-risk population identification. This study aimed to identify metabolites associated with incident HF, HFpEF, and HF with reduced ejection fraction and examine risk prediction in older adults.

Methods: Untargeted metabolomic profiling was performed in Black and White adults from the ARIC study (Atherosclerosis Risk in Communities) visit 5 (n=3719; mean age, 75 years). We applied Cox regressions to identify metabolites associated with incident HF and its subtypes. The metabolite risk score …

Efficacy Of A Primary Care Ehealth Obesity Treatment Pilot Intervention Developed For Vulnerable Pediatric Patients, Joshua S Yudkin, Marlyn A Allicock, Folefac D Atem, Carol A Galeener, Sarah E Messiah, Sarah E Barlow

Faculty, Staff and Student Publications

Background:

Challenges to treat excess weight in primary care settings include time constraints during encounters and barriers to multiple visits for patient families, especially those from vulnerable backgrounds. Dynamo Kids! (DK), a bilingual (English/Spanish) e-health intervention, was created to address these system-level challenges. This pilot study assessed the effect of DK use on parent-reported healthy habits and child BMI.

Methods:

In this 3-month, quasi-experimental cohort design, DK was offered to parents with children aged 6–12 years with BMI ≥85th percentile in three public primary care sites in Dallas, Texas. DK included three educational modules, one tracking tool, recipes, and links …

Practical Considerations For Navigating Withdrawal From The Federal Select Agent Program, Scott J Patlovich, Kristin G King, Robert J Emery, Zackary B Becker, Rebecca B Kairis

Faculty, Staff and Student Publications

INTRODUCTION: Clear guidance is provided by the Federal Select Agent Program (FSAP) to assist registered entities in nearly all facets of compliance with the Federal select agent regulations (7 CFR Part 331; 9 CFR Part 121; 42 CFR Part 73). If a registered entity chooses to discontinue its registration, detailed instructions for registration withdrawal are deeply embedded within a document entitled "eFSAP Form 1 Amendment Instructions," which is found on the FSAP website within the electronic Federal Select Agent Program (eFSAP) Resource Center.

METHODS: Using the information found within the eFSAP Form 1 Amendment Instructions, as well as extensive written …

Plasma Protein Signatures Of Adult Asthma, Gordon J Smilnak, Yura Lee, Abhijnan Chattopadhyay, Annah B Wyss, Julie D White, Sinjini Sikdar, Jianping Jin, Andrew J Grant, Alison A Motsinger-Reif, Jian-Liang Li, Mikyeong Lee, Bing Yu, Stephanie J London

Faculty, Staff and Student Publications

Background: Adult asthma is complex and incompletely understood. Plasma proteomics is an evolving technique that can both generate biomarkers and provide insights into disease mechanisms. We aimed to identify plasma proteomic signatures of adult asthma.

Methods: Protein abundance in plasma was measured in individuals from the Agricultural Lung Health Study (ALHS) (761 asthma, 1095 non-case) and the Atherosclerosis Risk in Communities study (470 asthma, 10,669 non-case) using the SOMAScan 5K array. Associations with asthma were estimated using covariate adjusted logistic regression and meta-analyzed using inverse-variance weighting. Additionally, in ALHS, we examined phenotypes based on both asthma and seroatopy (asthma with …

The Use Of Optical Coherence Tomography (Oct) And Oct Angiography In Borderline Personality Disorder Compared To Health Control Subjects, Bei Xu, Fangling Li, Zhejia Zhang, Qian Xiao

Faculty, Staff and Student Publications

BACKGROUND: Optical coherence tomography (OCT) or OCT angiography (OCTA) has been investigated in few research studies of psychiatric disorders. No research has been done using OCT or OCTA in patients with borderline personality disorder (BPD).

METHODS: OCTA measured foveal avascular zone (FAZ), macular vessel density (MVD), and peripapillary vessel density (PVD). OCT measured the peripapillary retinal fiber layer (RNFL) and central retinal thickness (CRT). The study utilized the Ottawa Self-Injury Inventory, Hamilton Anxiety Rating Scale (HAMA), and Global Assessment of Functioning (GAF) to assess the symptom characteristics of individuals with BPD.

RESULTS: Fifty-nine eyes of BPD patients and 58 eyes …

The Accuracy Of Anal Self- And Companion Exams Among Sexual Minority Men And Transgender Women: A Prospective Analysis, Alan G Nyitray, Timothy L Mcauliffe, Cameron Liebert, Michael D Swartz, Ashish A Deshmukh, Elizabeth Y Chiao, Lou Weaver, Ellen Almirol, Jared Kerman, John A Schneider, J Michael Wilkerson, Lu-Yu Hwang, Derek Smith, Aniruddha Hazra

Faculty, Staff and Student Publications

BACKGROUND: Squamous cell carcinoma of the anus (SCCA) annual incidence among sexual minority men with and without HIV is 85/100,000 and 19/100,000 persons, respectively, which is significantly higher than the overall incidence (2/100,000). Incidence may also be higher in transgender women. Since SCCA tumours average ≥30 mm at diagnosis, we assessed the accuracy of individuals to self-detect smaller anal abnormalities.

METHODS: Using convenience sampling, the study enrolled sexual minority men and transgender women, aged 25-81 years, in Chicago, Illinois and Houston, Texas, USA, during 2020-2022. Individuals were taught the anal self-examination and anal companion examination (ASE/ACE). Then, a clinician performed …

Self-Efficacy To Refuse Sex Mediates The Relationship Between Dating Violence Victimization And Sexual Risk Behavior, Briana Edison, Shristi Bhochhibhoya, Elizabeth R Baumler, Christine M Markham, Melissa F Peskin, Ross Shegog, Susan T Emery, Robert C Addy, Jeff R Temple, Dennis E Reidy

Faculty, Staff and Student Publications

Purpose: While cross-sectional studies have shown that teen dating violence (TDV) victimization is linked to sexual risk behavior (SRB), the pathway between these variables is not well-understood. To address this knowledge gap, we explore the mediating role of self-efficacy to refuse sex in the longitudinal relationship between physical TDV victimization and subsequent SRB among adolescents.

Methods: Self-report data from three prior longitudinal studies were harmonized to create a single aggregated sample of primarily racial and ethnic minority adolescents (N = 4,620; 51.4% Hispanic, 38.5% Black, and 58% female) from 44 schools in the southwest U.S. Participants' physical TDV victimization at …

Lifetime Traumatic Brain Injury And Risk Of Post-Concussive Symptoms In The Millennium Cohort Study, Kalyn C Jannace, Lisa Pompeii, David Gimeno Ruiz De Porras, William Brett Perkison, Jose-Miguel Yamal, Daniel W Trone, Rudolph P Rull

Faculty, Staff and Student Publications

Traumatic brain injury (TBI) is prevalent among active duty military service members, with studies reporting up to 23% experiencing at least one TBI, with 10-60% of service members reporting at least one subsequent repeat TBI. A TBI has been associated with an increased risk of cumulative effects and long-term neurobehavioral symptoms, impacting operational readiness in the short-term and overall health in the long term. The association between multiple TBI and post-concussive symptoms (PCS), however, defined as symptoms that follow a concussion or TBI, in the military has not been adequately examined. Previous studies in military populations are limited by methodological …

Genome-Wide Interaction Analysis With Dash Diet Score Identified Novel Loci For Systolic Blood Pressure, Mélanie Guirette, Jessie Lan, Nicola M Mckeown, Michael R Brown, Han Chen, Paul S De Vries, Hyunju Kim, Casey M Rebholz, Alanna C Morrison, Traci M Bartz, Amanda M Fretts, Xiuqing Guo, Rozenn N Lemaitre, Ching-Ti Liu, Raymond Noordam, Renée De Mutsert, Frits R Rosendaal, Carol A Wang, Lawrence J Beilin, Trevor A Mori, Wendy H Oddy, Craig E Pennell, Jin Fang Chai, Clare Whitton, Rob M Van Dam, Jianjun Liu, E Shyong Tai, Xueling Sim, Marian L Neuhouser, Charles Kooperberg, Lesley F Tinker, Nora Franceschini, Tianxiao Huan, Thomas W Winkler, Amy R Bentley, W James Gauderman, Luc Heerkens, Toshiko Tanaka, Jeroen Van Rooij, Patricia B Munroe, Helen R Warren, Trudy Voortman, Honglei Chen, D C Rao, Daniel Levy, Jiantao Ma, Charge Gene-Lifestyle Interactions Working Group

Faculty, Staff and Student Publications

Background: The Dietary Approaches to Stop Hypertension (DASH) diet score lowers blood pressure (BP). We examined interactions between genotype and the DASH diet score in relation to systolic BP.

Methods: We analyzed up to 9 420 585 single nucleotide polymorphisms in up to 127 282 individuals of 6 population groups (91% of European population) from the Cohorts for Heart and Aging Research in Genomic Epidemiology consortium (n=35 660) and UK Biobank (n=91 622) and performed European population-specific and cross-population meta-analyses.

Results: We identified 3 loci in European-specific analyses and an additional 4 loci in cross-population analyses at Pinteraction<5e-8. We observed a consistent interaction between rs117878928 at 15q25.1 (minor allele frequency, 0.03) and the DASH diet score (P …