Digital Commons Network^™

Urban School Neighbourhoods Dominated By Unhealthy Food Retailers And Advertisements In Greater Tunis: A Geospatial Study In The Midst Of The Nutrition Transition, Christelle Akl, Nehmat El-Helou, Gloria Safadi, Aline Semaan, Aya El Sammak, Tarek Trabelsi, Sonia Sassi, Chaza Akik, Jalila El Ati, Pierre Traissac, Hala Ghattas Ph.D.

Faculty Publications

Objective:

Food environments are a major determinant of children’s nutritional status. Scarce evidence on food environments exists in low- and middle-income countries (LMIC). This study aims to fill this gap by documenting the obesogenicity of food environments around schools in Greater Tunis, Tunisia – an LMIC of the Middle East and North Africa region with an ongoing nutrition transition and increasing rates of childhood obesity.

Design:

In this cross-sectional study, we assessed built food environments around fifty primary schools. Ground-truthing was performed to collect geographic coordinates and pictures of food retailers and food advertisement sets within an 800-m road network …

Patient Priorities-Aligned Care For Older Adults With Multiple Conditions: A Nonrandomized Controlled Trial, Toyomi Goto, Lilian Dindo, Fan Li

Faculty, Staff and Student Publications

IMPORTANCE: Older adults with multiple conditions receive health care that may be burdensome, of uncertain benefit, and not focused on what matters to them. Identifying and aligning care with patients' health priorities may improve outcomes.

OBJECTIVE: to assess the association of receiving patient priorities care (PPC) vs usual care (UC) with relevant clinical outcomes.

DESIGN, SETTING, AND PARTICIPANTS: In this nonrandomized controlled trial with propensity adjustment, enrollment occurred between August 21, 2020, and May 14, 2021, with follow-up continuing through February 26, 2022. Patients who were aged 65 years or older and with 3 or more chronic conditions were enrolled …

Microbial Co-Occurrences On Catheters From Long-Term Catheterized Patients, Erin Lowry, Aleksandra Klim, Karen W Dodson, Ana L Flores-Mireles, Jennifer N Walker, Daniel Garrett Wong, Alana Desai, Michael G Caparon, Scott J Hultgren

Faculty, Staff and Student Publications

Catheter-associated urinary tract infections (CAUTIs), a common cause of healthcare-associated infections, are caused by a diverse array of pathogens that are increasingly becoming antibiotic resistant. We analyze the microbial occurrences in catheter and urine samples from 55 human long-term catheterized patients collected over one year. Although most of these patients were prescribed antibiotics over several collection periods, their catheter samples remain colonized by one or more bacterial species. Examination of a total of 366 catheter and urine samples identify 13 positive and 13 negative genus co-occurrences over 12 collection periods, representing associations that occur more or less frequently than expected …

Clonal Hematopoiesis And Incident Heart Failure With Preserved Ejection Fraction, Mary B Roberts, April P Carson, Amil M Shah, Christie M Ballantyne, Alexander G Bick, Pradeep Natarajan, Joann E Manson, Eric A Whitsel, Charles B Eaton, Alexander P Reiner

Faculty, Staff and Student Publications

IMPORTANCE: Clonal hematopoiesis of indeterminate potential (CHIP), the age-related clonal expansion of hematopoietic stem cells with leukemogenic acquired genetic variants, is associated with incident heart failure (HF).

OBJECTIVE: To evaluate the associations of CHIP and key gene-specific CHIP subtypes with incident HF with preserved ejection fraction (HFpEF) and reduced ejection fraction (HFrEF).

DESIGN, SETTING, AND PARTICIPANTS: This population-based cohort study included participants from 2 racially diverse prospective cohort studies with uniform HF subtype adjudication: the Jackson Heart Study (JHS) and Women's Health Initiative (WHI). JHS participants were enrolled during 2000 to 2004 and followed up through 2016. WHI participants were …

Inpatient Costs Of Treating Patients With Covid-19, Ankita Podichetty, Raymond S Greenberg

Faculty, Staff and Student Publications

IMPORTANCE: With more than 6.2 million hospitalizations due to COVID-19 in the US, recognition of the average hospital costs to provide inpatient care during the pandemic is necessary to understanding the national medical resource use and improving public health readiness and related policies.

OBJECTIVE: To examine the mean cost to provide inpatient care to treat COVID-19 and how it varied through the pandemic waves and by important sociodemographic patient characteristics.

DESIGN, SETTING, AND PARTICIPANTS: This cross-sectional study used inpatient-level data from March 1, 2020, to March 31, 2022, extracted from a repository of clinical, administrative, and financial information covering 97% …

"Once I Take That One Bite": The Consideration Of Harm Reduction As A Strategy To Support Dietary Change For Patients With Diabetes, Alexzandra Gentsch, Megan Reed, Amy Cunningham, Anna Marie Chang, Stephanie Kahn, Danielle Kovalsky, Amanda Doty, Geoffrey Mills, Judd Hollander, Kristin Rising

College of Population Health Faculty Papers

BACKGROUND: Despite well-established guidelines to treat diabetes, many people with diabetes struggle to manage their disease. For many, this struggle is related to challenges achieving nutrition-related lifestyle changes. We examined how people with diabetes describe barriers to maintaining a healthy diet and considered the benefits of using a harm reduction approach to assist patients to achieve nutrition-related goals.

METHODS: This is a secondary analysis of 89 interviews conducted with adults who had type 1 or type 2 diabetes. Interviews were analyzed using a content analysis approach. Themes regarding food or diet were initially captured in a "food" node. Data in …

Integrated Multi-Omics Analyses Identify Anti-Viral Host Factors And Pathways Controlling Sars-Cov-2 Infection, Jiakai Hou, Yanjun Wei, Jing Zou, Roshni Jaffery, Long Sun, Ningbo Zheng, Nicholas A Egan, Ritu Bohat, Si Chen, Caishang Zheng, Xiaobo Mao, S Stephen Yi, Ken Chen, Daniel J Mcgrail, Nidhi Sahni, Pei-Yong Shi, Yiwen Chen, Xuping Xie, Weiyi Peng

Faculty, Staff and Student Publications

Host anti-viral factors are essential for controlling SARS-CoV-2 infection but remain largely unknown due to the biases of previous large-scale studies toward pro-viral host factors. To fill in this knowledge gap, we perform a genome-wide CRISPR dropout screen and integrate analyses of the multi-omics data of the CRISPR screen, genome-wide association studies, single-cell RNA-Seq, and host-virus proteins or protein/RNA interactome. This study uncovers many host factors that are currently underappreciated, including the components of V-ATPases, ESCRT, and N-glycosylation pathways that modulate viral entry and/or replication. The cohesin complex is also identified as an anti-viral pathway, suggesting an important role of …

Cell State Of Origin Impacts Development Of Distinct Endometriosis-Related Ovarian Carcinoma Histotypes, Ian Beddows, Huihui Fan, Karolin Heinze, Benjamin K Johnson, Anna Leonova, Svetlana Djirackor, Celeste Leigh Pearce, David G Huntsman, Michael S Anglesio, Hui Shen

Faculty, Staff and Student Publications

Clear cell ovarian carcinoma (CCOC) and endometrioid ovarian carcinoma (ENOC) are ovarian carcinoma histotypes, which are both thought to arise from ectopic endometrial (or endometrial-like) cells through an endometriosis intermediate. How the same cell type of origin gives rise to two morphologically and biologically different histotypes has been perplexing, particularly given that recurrent genetic mutations are common to both and present in nonmalignant precursors. We used RNA transcription analysis to show that the expression profiles of CCOC and ENOC resemble those of normal endometrium at secretory and proliferative phases of the menstrual cycle, respectively. DNA methylation at the promoter of …

The Association Between Early Exposure To Antibiotics And Childhood Asthma Incidence, Victoria Fischer

Soaring: A Journal of Undergraduate Research

This review examines the association between early exposure to antibiotics and the incidence of asthma in childhood, highlighting significant public health concerns related to antibiotic overuse. The misuse of antibiotics not only contributes to antibiotic resistance but may also impact long-term health outcomes, particularly respiratory diseases like asthma. Emerging evidence suggests that early antibiotic exposure may disrupt gut microbiota, altering immune responses and increasing the risk of asthma development. A systematic review of twenty-seven studies identified a significant correlation between antibiotic use in infancy and subsequent asthma diagnoses. However, there remains a need for further research to delineate the extent …

Methodological Assessment Of A Review Of Knowledge, Attitude And Practice About Human Papilloma Virus Vaccination In India, Abraham Degarege, Purnima Madhivanan

Journal Articles: Epidemiology

A well-conducted review provides quality evidence to inform policy and practice. It is important that the review is as rigorous and as fully reported as possible if the evidence from the review is incorporated into clinical practice. We are writing in response to an article titled, ‘Evidence of Knowledge, Attitude, and Practice Regarding Human Papilloma Virus Vaccination at the Community Level in India: A Systematic Review and Meta-Analysis’ by Pal et al published in Asian Pacific Journal of Cancer Prevention in March 2024. There are some major methodological flaws in the paper that might have biased the conclusions drawn from …

Addressing The Big Picture As A Community-Engaged Linguist: Community-Engaged Scholarship And Applied Learning For Systemic Change, Rachel E. Showstack

International Journal of the Linguistic Association of the Southwest

Through a narrative about the formation and advancement of Wichita State University’s community-based health equity initiative Alce su Voz (‘Speak Out’), this article presents a reflection on the author’s role as a community-engaged scholar and the multiple levels of work in which linguists can engage to support linguistic social justice. The paper begins with a discussion of the role of the applied linguist in social change and a discussion of community-engaged scholarship, including community-based learning and community-based research. Then, using Alce su Voz’s approach to improving health equity for speakers of Spanish and Indigenous languages as an example, the author …

Pediatric Vaccination Adherence: Enhancing Compliance Among First-Generation Asian American Parents, Katelyn Leong

Nursing | Senior Theses

Background: Vaccine adherence in the pediatric population refers to receiving vaccines as per the recommended schedule, which significantly reduces vaccine-preventable diseases and enhances community immunity. Vaccine hesitancy, driven by concerns such as safety, misinformation, or cultural beliefs can affect adherence. National coverage of state-mandated vaccines among kindergarteners declined from 95% to around 93% between 2019 and 2022, varying across different vaccines. Objective: This research proposal’s focus is to determine if an educational intervention targeting first-generation Asian Americans, who have adopted their immigrant parents' misinformation about vaccines, will effectively increase vaccination rates among their children. The study aims to assess the …

The Effects Of Adverse Childhood Experiences And Racism On The Risk For Poor Birth Outcomes In Women Of Color, Audrey Hermosura

Nursing | Senior Theses

Background: Adverse childhood experiences, or ACEs, are traumatic challenges experienced before the age of 18. These adversities have lifelong effects on physiologic and mental health. A relationship has been made between the number of ACEs and occurrences of poor birth outcomes. The toxic stress that accumulates from ACEs compounded by racism increases the risk for poor birth outcomes in women of color. Understanding the importance of screening for these events can mitigate the negative effects on women’s health during and after gestation. Purpose: This current paper, in addition to a literature review, proposes a research design to validate the feasibility …

Satisfaction And Absenteeism To Lectures:Cross-Sectionnel Study Of Dental Students, Manal El Hijazi, Soundouss Soulami, Ihsane Benyahya

Health Sciences

Introduction: Lectures are still the main pedagogical tool in universities. The aim of this study was to evaluate student satisfaction with lectures and to analyze the factors behind student absenteeism.

Methods: A descriptive cross-sectional study was carried out among dental student by a voluntary, anonymous self-administered questionnaire with open and closed question. Statistical analysis was performed by SPSS version 25 and the Chi2 test was used to compare percentages, with a significance level of p

Reimagining Equitable Care: Simulation-Based Education And The Dismantling Of Implicit Bias And Stigma Of Vulnerable Populations In Hospitals, Vanessa Smith

Nursing | Senior Theses

Background: Simulation-based education consists of using high-fidelity mannequins and equipment to provide a safe space for healthcare professionals to practice crucial skills within healthcare. Used within hospitals and schools, simulation most commonly surrounds practicing hands-on skills such as central line insertion, IV insertion, Ultrasound-guided procedures, code blue response, etc. However, a large portion of healthcare that is overlooked is tackling issues within patient-provider relationships. Simulation can help dismantle the negative behaviors and feelings providers push onto patients through the use of standardized patients and role-playing. By using these methods, simulation can reduce providers’ personal implicit biases and the stigma associated …

Environmental Metrics In Action: Exploring U.S. Superfund Sites Affiliated With The Fashion Industry, Nidia K. Trejo

Textile Society of America: Symposium Proceedings

Little is known of Superfund sites, long-term clean up sites, affiliated with the apparel and footwear supply chain in the United States. The United States Environmental Protection Agency (US EPA) manages the clean up of contaminated sites that pose a significant risk to human health and the environment under the Superfund program. A site can become contaminated if hazardous waste from industrial operations are mismanaged or dumped into the environment, in an uncontrolled manner. In this study, a proposed Superfund site (Mohawk Tannery in Nashua, New Hampshire), an active Superfund site (Ciba-Geigy Corp. in Toms River, New Jersery), and a …

Understanding Social Dynamics In Toxic Conversations And Public Health Intervention Acceptance On Social Media, Ana Aleksandric

Computer Science and Engineering Dissertations - Archive

Social media is now central to daily life, offering users a space to share content and opinions. However, these platforms also facilitate the spread of hate speech and misinformation, which can negatively impact public health. This dissertation develops methodologies to analyze social media data for insights that could inform health interventions. The research first examines user responses to toxic content, focusing on behavioral and emotional reactions, as well as group dynamics and bystander effects in toxic interactions. Another key focus is public opinion toward health interventions, particularly COVID-19 vaccination, using geolocated posts and analyzing factors such as race, ethnicity, and …

Knowledge And Perception Of Hand Hygiene And Associated Factors Among Final Year Medical And Nursing Students In Dar Es Salaam Tanzania, Anthony Baltazary Ngowi

Master of Obstetrics and Gynecology

Hand hygiene, when practiced correctly and consistently is a simple and effective

method to prevent healthcare associated infections. These infections are acquired during a patients’ hospital stay and pose a major worldwide public health problem. The knowledge and practices related to hand hygiene among health workers need to be instilled early on during their training to develop a culture of correct and consistent practice. Existing literature has explored hand hygiene among health workers but very few studies have looked at it amongst medical and nursing students, who are the healthcare workers of tomorrow. This study aimed to assess hand hygiene …

Challenges In Post Graduate General Surgery Training In Tanzania: A Trainee’S Perspective, Shabbir Adamjee

Master of Surgery

v>

General Surgery residency training is a complex vigorous program which includes long working hours and complex surgical cases, in order to develop and attain the knowledge and the skills the trainee needs by the end of the program. Worldwide, general surgery programs have high attrition rates and residents have identified challenges which may be work related, related to social wellbeing and/or the residency program structure. Tanzania has public and private institutions providing general surgery residency training and although most have a quality assessment program the data is not readily available. Each institution has its personalized curriculum with its unique …

Managing Stress: A Study Of Stress Response Mechanisms In Mycobacteria, Augusto C. Hunt Serracin

Biology Dissertations - Archive

Mycobacteria encompass many pathogenic species known to cause severe disease in humans. A well-known example is Mycobacterium tuberculosis (Mtb), the causative agent of the lung disease tuberculosis, which kills millions of humans worldwide yearly. Pathogenic mycobacteria like Mtb are challenging to treat because of their innate ability to adapt to environmental stress. Their unique cell physiology and conserved stress responses allow them to combat biological insults, regulate growth, and regulate genes involved in stress; all these responses increase tolerance to antibiotics. The current therapies to treat mycobacterial infections are lengthy and, at times, unsuccessful, partly due to antibiotic tolerance. A …

Resilience Of Mental Health Services Amidst Ebola Disease Outbreaks In Africa, Frankline Sevidzem Wirsiy, Nancy B. Tahmo, Lambed Tatah, David Brett-Major

Journal Articles: Epidemiology

INTRODUCTION: Health systems including mental health (MH) systems are resilient if they protect human life and produce better health outcomes for all during disease outbreaks or epidemics like Ebola disease and their aftermaths. We explored the resilience of MH services amidst Ebola disease outbreaks in Africa; specifically, to (i) describe the pre-, during-, and post-Ebola disease outbreak MH systems in African countries that have experienced Ebola disease outbreaks, (ii) determine the prevalence of three high burden MH disorders and how those prevalences interact with Ebola disease outbreaks, and, (iii) describe the resilience of MH systems in the context of these …

Climate Change And Its Hidden Victims: A Review Of The Link Between Climate Change Impacts And Sexual And Gender-Based Violence In East Africa, Ezinwa Osuoha

Public Health Theses

Introduction: Climate change is having profound and disproportionate impacts on East Africa. Rising temperatures, unpredictable rainfall patterns, and prolonged droughts have become prevalent, leading to profound humanitarian challenges. The effects of climate change in East Africa span beyond those related to agriculture, food insecurity, and economic well-being. Sexual and gender-based violence (SGBV) is only proliferated in the climate change context. In the event of natural disasters, sexual and gender-based violence increases in tandem with the increase in vulnerability and instability in affected communities. Due to its myriad health consequences, SGBV requires the attention of public health professionals, policymakers, and those …

Exploring The Willingness Toward Hiv Immediate Test And Treat Among Msm In Nairobi And Its Environs: A Cross-Sectional Study., Kingori Ndungu, Peter Gichanga, Marleen Temmerman

Centre of Excellence in Women and Child Health

Background: In the test and treat initiative, high-risk populations are screened for human immunodeficiency virus (HIV) infection and start early treatment if diagnosed positive. This study explores factors associated with willingness to initiate testing and immediate treatment among men who have sex with men (MSM) in Nairobi and its environs. The study was informed by a conceptual framework combining the AIDS Risk Reduction Model (ARRM) and the Modified Social Ecological Model.

Methods: This cross-sectional exploratory study targeted MSM (aged 18–60 years) reporting active engagement in anal or oral sex with men in Nairobi and its surrounding areas. Purposive sampling was …

Umbrella Review As A Data Collection Tool: Towards Observation, Analysis, And Empirical Transformation Of Qualitative Drivers Describing Healthcare Workforce Shortage Factors Into Quantitative Data To Support Medical Education Interventions In A Global Challenge., Fabio Galli, Marco Grech

Digital Journal of Clinical Medicine

A healthcare workforce shortage of 18 million is expected by 2030, against a global demand of 80 million, and it is difficult to analyse and monitor the real drivers driving this personnel shortage on a global level. The transformation of qualitative data into quantitative data can be a strategy in this global challenge, that can implement the medical education intervention strategies.

Impact Of Blue Wavelength Light From Mobile Devices On Sleep And Quality Of Life In Belmont University Undergraduates, Amanda A. Parente, Christian Williams, Frecia Gonzalez

SPARK Symposium Presentations

Introduction: Previous studies have documented an association of excessive blue wavelength light exposure with negative health consequences including reduced sleep time, lower sleep quality, and emotional symptoms. The increased use and ubiquity of mobile blue wavelength light-emitting devices raises the possibility of prevalent negative effects on sleep and quality of life, particularly among college-aged individuals where use of these devices is especially frequent.

Methods: In 2024, cross-sectional, internet survey-based study designed to examine the relationship between self-reported exposure to mobile devices and measures of sleepiness and quality of life. Eligible participants were undergraduate students at Belmont University, aged 18+ years …

Outpatient Fall Prevention In Ambulatory Adults 65 Years Old And Over, Dorothy L. Osborne-White

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Background: In the United States (U.S.), falls are the leading cause of injury among adults 65 and over, resulting in 36 million falls yearly (Moreland et al., 2020). According to the Centers for Disease Control and Prevention (CDC, 2023), one in four older adults experiences a fall each year. Falls are the world's second most prominent cause of accidental deaths (World Health Organization [WHO], 2021). Falls are the leading cause of both fatal and non-fatal injuries among older adults (Moreland et al., 2020).

Methods: A quality improvement project that included a fall bundle was implemented in a primary clinic. A …

Cognitive Functioning In Well-Controlled Asthma, Erin Walsh

West Chester University Doctoral Projects

Asthma is a common lung disease that impacts lung functioning through inflammatory based mechanisms. Past research suggests that decreased blood oxygenation due to asthma attacks may impair cognitive capabilities (Irani et al., 2017). Moreover, the observed differences in cognition between those with and without asthma may be associated with disease severity or asthma control respectively in asthma populations. The current study explored differences in cognitive functioning between college students with and without self-reported asthma. Sociodemographic data, self-reported asthma severity, and measures of asthma control were collected. The current study did not find significant differences in measures of cognitive efficiency between …

Effects Of Virtual Reality As A Patient Education Tool: A Meta-Analysis, Yun Li, Mirim Kim, Armanto Sutedjo

Journal of Educational Technology Development and Exchange (JETDE)

This meta-analysis aims to systematically review and synthesize existing literature on the effects of Virtual Reality (VR) on patient education outcomes. A comprehensive search was conducted across major academic databases. Data were extracted from 11 studies, encompassing a total sample size of 878 participants. Results from the meta-analysis revealed a significant positive effect of VR interventions on improving patient satisfaction (d = 0.39, CI [0.03,0.76], p

Examination Of Urinary Pesticide Concentrations, Protective Behaviors, And Risk Perceptions Among Latino And Latina Farmworkers In Southwestern Idaho, Carly Hyland, Alejandra Hernandez, Éric Gaudreau, Jessica Larose, Jean-François Bienvenu, Lisa Meierotto, Rebecca L. Som Castellano, Cynthia L. Curl

Public and Population Health Faculty Publications and Presentations

Introduction: Studies have documented high levels of pesticide exposure among men farmworkers; however, few have examined exposures or the experiences of women farmworkers. Data gaps also exist regarding farmworkers’ perceived risk and control related to pesticides, information that is critical to develop protective interventions.

Objective: We aimed to compare urinary pesticide biomarker concentrations between Latino and Latina farmworkers and examine associations with occupational characteristics, risk perceptions, perceived control, and protective behaviors.

Methods: We enrolled a convenience sample of 62 farmworkers (30 men and 32 women) during the pesticide spray season from April–July 2022 in southwestern Idaho. Participants were asked to …

Veterans Direct Admission Reassessment Tool Validation For The Reduction Of Rapid Response Code Blue, And Code Stroke Team Activations In Newly Arrived Direct Admission Veterans, Joshua Monroe Wells

DNP Projects

Abstract

Purpose: Rapid clinical assessment of newly arriving direct admission veteran patients to the Department of Veterans Affairs Health Care System (VAHCS) Lexington is of the utmost importance to determine current patient condition, alteration from previously known condition at time of provider acceptance or time of report, and appropriate level of care for these veterans. The facility has seen an increase in the number of unexpected patient declines by direct admission patients presenting to medical surgical units at the VA Health Care System Lexington KY. This recurrent decline resulted in the facility performing a Root Cause Analysis (RCA), which identified …