Digital Commons Network^™

Education Of Infectious Diseases Fellows During The Covid-19 Pandemic Crisis: Challenges And Opportunities, Lisa M Chirch, Wendy S Armstrong, Gayle P Balba, Prathit A Kulkarni, Constance A Benson, Victoria Konold, Vera P Luther, Obinna N Nnedu, Sarah Perloff, Raymund R Razonable, Wendy Stead, George R Thompson, Michael T Melia

Faculty, Staff and Students Publications

One of the many challenges that has befallen the Infectious Diseases and Graduate Medical Education communities during the coronavirus disease 2019 (COVID-19) pandemic is the maintenance of continued effective education and training of the future leaders of our field. With the remarkable speed and innovation that has characterized the responses to this pandemic, educators everywhere have adapted existing robust and safe learning environments to meet the needs of our learners. This paper will review distinct aspects of education and training of the Infectious Diseases fellows we believe the COVID-19 pandemic has impacted most, including mentoring, didactics, and wellness. We anticipate …

Substance Use Disorder Program Facilities In Detroit: A Geographic Analysis, Oksana Doubrovski

Medical Student Research Symposium

Background: Over 630,000 Michiganders have a substance use disorder (SUD) and about 80% are not receiving care (1). The rate of unmet need for SUD care in the Detroit-Dearborn-Livonia area is 81% (1). Geographic placement of facilities may serve as a barrier in patient access to SUD program services. This geographic analysis investigates current Detroit SUD program facility locations and their community demographics.

Methods: ArcGIS Pro was used to visualize and analyze data by creating 2D maps and tables. Data on SUD programs, medically underserved areas, and zip codes were retrieved from government data portals. Census tract data …

Ua12/2/1 College Heights Herald, Vol. 96, No. 15, Wku Student Affairs

WKU Administration Documents

WKU campus newspaper reporting campus, athletic and Bowling Green, Kentucky news. This issue contains articles:

• Bertucci, Leo. An Alumnus’ Journey to Shape Education – Gary Houchens
• Latimer, Jacob. Student Government Association Prepares for Another Unusual Semester
• Differing State & WKU Quarantine Guidelines Are Confusing, But It Has to Be Done
• Pepke, Brenna. The Man Behind the Tie – Tyreon Clark, Boys to Men Leadership Group of Kentucky
• Gaylord, Kaden. Hilltoppers Series Against Old Dominion Postponed – Basketball
• Snyder, Sean. Kicking It Again, Lady Topper Soccer is Back
• Kieser, Nick. Views: Charles Bassey Continues to Bulk Resume for NBA

Early Stages Of Alzheimer's Disease: Evolving The Care Team For Optimal Patient Management., James E Galvin, Paul Aisen, Jessica B Langbaum, Eric Rodriguez, Marwan Sabbagh, Richard G. Stefanacci Do,Mgh,Mba,Agsf,Cmd, Robert A Stern, Elizabeth A Vassey, Arno De Wilde, Neva West, Ivana Rubino

College of Population Health Faculty Papers

Alzheimer's disease (AD) is a progressive, neurodegenerative disease that creates complex challenges and a significant burden for patients and caregivers. Although underlying pathological changes due to AD may be detected in research studies decades prior to symptom onset, many patients in the early stages of AD remain undiagnosed in clinical practice. Increasing evidence points to the importance of an early and accurate AD diagnosis to optimize outcomes for patients and their families, yet many barriers remain along the diagnostic journey. Through a series of international working group meetings, a diverse group of experts contributed their perspectives to create a blueprint …

Facilitators And Barriers To Patient-Centered Outcomes Research Partnership Sustainability In The United States, Tristen L. Hall, Charlene Barrientos-Ortiz, Griselda Peña-Jackson, Courtney Fultineer, Kevin Werner, Justine Sunshine

Journal of Patient-Centered Research and Reviews

Purpose: Engaging patients in research can enhance relevance and accelerate implementation of findings. Despite investment in patient-centered outcomes research (PCOR), short-term funding cannot maintain such efforts beyond the program timeframe. Sustained interaction between researchers, practitioners, patients, and other stakeholders is needed to sustain use of evidence-based practices and achieve maximum benefit. While previous literature describes components of public health program sustainability, such factors do not necessarily apply to the partnerships that implement those programs, and facilitators are likely to differ across disciplines. We sought to determine facilitators and barriers to PCOR partnership sustainability from participant experiences with sustainable and unsustainable …

Patient Recommendations For Providers To Avoid Stigmatizing Weight In Rural-Based Women With Low Income, Declan Watson, Katherine Hughes, Emma Robinson, Jacqueline Billette, Andrea E. Bombak

Journal of Patient-Centered Research and Reviews

Purpose: Weight stigma has become widespread within health care and disproportionately affects women, who are under greater appearance-based scrutiny than men. It is also well established that rural-based individuals with low incomes suffer greater health disparities compared with urban, higher-income counterparts, yet studies examining recommendations for nonstigmatizing health care among higher-weight women from low-income rural settings are lacking. This study examined the experiences and recommendations of higher-weight, low-income, rural women, with the aim of improving health care for similar populations.

Methods: In-depth, semi-structured interviews were conducted in a rural region of the Midwestern United States to explore participants’ recommendations for …

Houston Hurricane Harvey Health (Houston-3h) Study: Assessment Of Allergic Symptoms And Stress After Hurricane Harvey Flooding, Abiodun O Oluyomi, Kristen Panthagani, Jesus Sotelo, Xiangjun Gu, Georgina Armstrong, Dan Na Luo, Kristi L Hoffman, Diana Rohlman, Lane Tidwell, Winifred J Hamilton, Elaine Symanski, Kimberly Anderson, Joseph F Petrosino, Cheryl Lyn Walker, Melissa Bondy

Faculty, Staff and Students Publications

BACKGROUND: In August 2017, Hurricane Harvey caused unprecedented flooding across the greater Houston area. Given the potential for widespread flood-related exposures, including mold and sewage, and the emotional and mental toll caused by the flooding, we sought to evaluate the short- and long-term impact of flood-related exposures on the health of Houstonians. Our objectives were to assess the association of flood-related exposures with allergic symptoms and stress among Houston-area residents at two time points: within approximately 30 days (T1) and 12 months (T2) after Hurricane Harvey's landfall.

METHODS: The Houston Hurricane Harvey Health (Houston-3H) Study enrolled a total of 347 …

An Evaluation Of A Maternal Health And Extreme Heat Exposure Training, Adelle Dora Monteblanco, Jennifer K. Vanos, Sarah Leroy, Patricia M. Juarez, Gregg M. Garfin

Journal of Social, Behavioral, and Health Sciences

Growing empirical evidence documents the potential risk of extreme heat exposure to pregnant individuals. These risks include adverse birth outcomes, such as preterm birth and low birth weight. Climate change will exacerbate extreme heat exposures to a large portion of the global population, and pregnant individuals need to understand the risks and protective measures needed. Maternal health workers are a key mechanism for conveying this information to pregnant individuals. The authors assess a training of maternal health workers in El Paso, Texas, through two research instruments. First, eight maternal health workers completed an educational workshop and consented to participation; pre- …

Disparities In Cardiovascular Research Output And Disease Outcomes Among High-, Middle- And Low-Income Countries - An Analysis Of Global Cardiovascular Publications Over The Last Decade (2008-2017), Nada Qaisar Qureshi, Syed Hamza Mufarrih, Gerald S. Bloomfield, Wajeeha Tariq, Aysha Almas, Ali H. Mokdad, Muhammad Imran Nisar, Sameen Siddiqi, Zulfiqar Ahmed Bhutta, Zainab Samad

Department of Medicine

Background: Cardiovascular disease (CVD) is the leading cause of death and disability worldwide. Health research is crucial to managing disease burden. Previous work has highlighted marked discrepancies in research output and disease burden between high-income countries (HICs) and low- and lower-middle-income countries (LI-LMICs) and there is little data to understand whether this gap has bridged in recent years. We conducted a global, country level bibliometric analysis of CVD publications with respect to trends in disease burden and county development indicators.
Methods: A search filter with a precision and recall of 0.92 and 0.91 respectively was developed to extract cardiovascular publications …

Stay-At-Home Order And Spatial Disparities In Covid-19 Pandemic In New York City, Youqin Huang, Rui Li

Understanding and eliminating minority health disparities in a 21st-century pandemic: A White Paper Collection

Much of the world has adopted unprecedented lockdown policies as the key method to address the spread of COVID-19; yet their effect on pandemic outcomes remain largely unknown. This research determines how mobility restriction policies and public transit system shape intra-city health disparities in this pandemic, using New York City as a case study. With a spatial method and multiple sources of data, this research demonstrates the effectiveness of the stay-at-home order. On average, people spent about 20% more time at home in 2020 than in the same period in 2019. Census tracts with people spending more time at home …

Disposable Lives: Covid-19, Vaccines, And The Uprising, Matiangai Sirleaf

Faculty Scholarship

Two French doctors appeared on television and publicly discussed potentially utilizing African subjects in experimental trials for a tuberculosis vaccine as an antidote to the novel coronavirus (COVID-19). Tedros Adhanom Ghebreyesus, the Director-General of the World Health Organization (WHO), denounced these kinds of racist remarks as a “hangover from ‘colonial mentality’” and maintained that “Africa can’t and won’t be a testing ground for any vaccine.” The fallout on social media was similarly swift, with Samuel Eto’o, a Cameroonian football legend, referring to the doctors as “[d]es assasins” and several others questioning the motives behind testing a vaccine on the African …

Voices From The Field: A Qualitative Study Of The Challenges And Promising Practices Of Rural Public Health In Addressing Hiv And Hepatitis C, Martha Elbaum Williamson Mpa, Karen B. Pearson Mlis, Ms, Amanda R. Burgess Mppm, Jennifer D. Lenardson Mhs, Erika C. Ziller Phd

Population Health

Rural areas of the United States may be vulnerable to an HIV or hepatitis C (HCV) outbreak among persons who inject drugs. Researchers at the University of Southern Maine’s Rural Health Research Center examined the capacity of rural public health systems to prepare for, identify, control, and respond to an HIV or HCV outbreak. Through semi-structured interviews with 36 state and local public health professionals from six rural states, we sought to understand the challenges related to HIV, HCV, and serving rural persons who inject drugs and to identify strategies to address those challenges. Challenges limiting the public health capacity …

Multiplex Social Factors Affecting Hiv Prevalence In Colorado, Jesse Cannella

Scholarship in Medicine - All Papers

Objective: The objective of this paper was to investigate and analyze the relationships between the prevalence of HIV and geographic location, high-risk behaviors, and education status in Colorado in 2020. Methods: The author of this paper conducted Spearmen correlations on HIV prevalence with rural status, rates of flu vaccinations, and drug overdose deaths, as well as performed stepwise linear regressions on the variance of HIV prevalence accounted for by rates of teen births, sexually transmitted infections, high school graduation, and college education status. Results: Incidence of other STIS and teen births (F2,42 = 7.69, p = .001), as well as …

Understanding Challenges To Well-Being Among Latina Farmworkers In Rural Idaho Using In An Interdisciplinary, Mixed-Methods Approach, Cynthia L. Curl, Lisa Meierotto, Rebecca L. Som Castellano

Public and Population Health Faculty Publications and Presentations

The aim of this study was to identify social, cultural and workplace-related risk factors affecting well-being among Latina farmworkers in rural Idaho. We recruited 70 Latina farmworkers from southwestern Idaho in 2019. We employed an inter-disciplinary, mixed-methods approach—including surveys, focus groups, interviews, and pesticide biomonitoring—to characterize multiple domains that influence well-being, including food security and access, housing conditions, social supports, access to medical care, and workplace safety. Six major themes emerged as primary challenges to Latina farmworkers’ well-being. In the public sphere, study participants identified these challenges as long working hours, concerns regarding pesticide exposure, and lack of enforcement of …

Covid-19 Mortality In New York City Across Neighborhoods By Race, Ethnicity, And Nativity Status, Samantha Friedman, Tabassum Insaf, Jin-Wook Lee, Temilayo Adeyeye

Understanding and eliminating minority health disparities in a 21st-century pandemic: A White Paper Collection

New York City has lost more lives from COVID-19 than any other American city. Our paper examines variation in COVID-19 deaths across neighborhoods as it relates to the spatial variation in the racial, ethnic, and nativity-status composition of neighborhoods. This topic has received little scholarly attention and is imperative to explore, given the absence of racial and ethnic specific COVID-19 mortality rates by neighborhood. New York City is a racially and ethnically segregated city and a longstanding destination of immigrants, making some neighborhoods more susceptible to greater levels of COVID-19 mortality than others. Using ZCTA-level data on COVID-19 deaths and …

The Association Between Social Capital And Depression, Abdulrahman Abudawood

CGU Theses & Dissertations

Mental health is an integral component of a healthy and balanced life, and deterioration in mental health has a significant impact on the quality of life. Being an active member of the community can positively impact personal mental health and emotional wellbeing. The World Health Organization (WHO) considers Social Capital (SC) a significant determinant of individual mental health. Despite that, there are limited studies analyzing the association between SC and the prevalence or severity of depressive symptoms experienced by suburban residents of the United States. This study aimed to assess the relationships between the six dimensions of SC introduced by …

Exploring Barriers To Care: Provider Efforts To Improve Retention In Urban-Rural Clusters, Kenyata M. Fletcher

Walden Dissertations and Doctoral Studies

AbstractOver the years, the infection rates for HIV in the United States has changed partly due to lack of engagement and medication adherence which can lead to substantial declines in individual health. Factors that contribute to the individual’s adherence can include transportation cost, childcare, and lack of finances to name a few. These barriers can often be decreased with the help of supportive service providers and improvement in the patient-provider relationship. Currently, there is limited research that explores how to reduce patient barriers to care, specifically in rural areas. This qualitative study examines how Illinois health care providers help HIV-positive …

Risk Factors Associated With Childhood Vaccination Coverage In Afghanistan, Iqbal Mawani

Walden Dissertations and Doctoral Studies

Globally, vaccination is among the most successful and cost-effective public health practices in the prevention of infectious diseases. The purpose of this study was to examine the child, parental, and geographical risk factors that influence childhood vaccination coverage in Afghanistan. The health belief model and socio-ecological model was used in this study as the theoretical framework to examine the effects of these risk factors on vaccination coverage among children in Afghanistan. Univariate, bivariate, and multivariate tests were conducted within the secondary data analysis of the 2015 Afghanistan national Demographic and Health Survey dataset. Of the 32,420 children aged 0 to …

Maternal Proximity To Mountaintop Removal Mining And Birth Defects In Appalachian Kentucky, 1997-2003, Daniel B. Cooper

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Background: Extraction of coal through mountaintop removal mining (MTR) alters many dimensions of the landscape, and explosive blasts, exposed rock, and coal washing have the potential to pollute air and water with substances known to increase risk of developmental and birth anomalies. Previous research suggests that infants born to mothers living in MTR coal mining counties have higher prevalence of most types of birth defects.

Objectives: This study seeks to examine further the relationship between MTR activity and birth defects by employing individual level exposure estimation through precise satellite data of MTR activity in the Appalachian region and maternal residence …

Racial Disparities In Syringe Exchange Program Access In Kentucky, Ankur Bhargava

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Non-white Kentuckians use syringe exchange programs (SEPs) at lower rates than white Kentuckians. This analysis begins by documenting this disparity and then explores several potential causes. Access to SEPs is limited by law as only health departments may operate them. Areas of the state in which SEPs face political opposition are therefore underserved. A consequence of this legal limitation is distance to a SEP may be a barrier to access. Analysis of publicly available data indicates non-white drug users in Kentucky are located closer to syringe exchange programs in urban areas but farther away in rural areas. Proximity to a …

Effects Of Trained Providers And Naloxone Distribution On Prescription Opioid Use Disorder, Samuel Sarpong

Walden Dissertations and Doctoral Studies

AbstractOpioid abuse and overdose are associated with substantial morbidity and mortality rates, as well as social and economic costs. The purpose of this study was to evaluate the independent and interactive effects of state-sponsored prescription drug monitoring program (PDMP) trained healthcare providers and community-based naloxone distribution program related factors in the states of Florida and Georgia for the prevention and reduction of prescription opioid use disorder, overdose, and deaths. The research theory adopted was the socio-ecological model with an emphasis on risk factors such as age. The study used secondary data from 2014 to 2018 from the Florida and Georgia …

Understanding How Religious Practices Influence Self-Care In Black Churchgoers Diagnosed With Hypertension, Taquina C. Davis

Walden Dissertations and Doctoral Studies

Religion plays an essential role in managing health; however, there is limited research on religious practices among Black churchgoers diagnosed with hypertension. This research aims to understand how religious practices influence self-care in Black churchgoers diagnosed with hypertension. The sample consisted of 21 Black men and women, ages 29 to 70 years, with a clinical diagnosis of hypertension. Participants were recruited from two local, predominately Black churches in South Carolina and administered semistructured interviews to participants. A grounded theory design was used, and the data analysis consisted of constant comparison. Two core concepts were identified. One core concept identified was …

Drug-Resistant Neisseria Gonorrhoeae; Identification Of At-Risk Groups In Florida By Regional Variation, Scott August Herber

Walden Dissertations and Doctoral Studies

Neisseria gonorrhoeae has been on the rise in the State of Florida since 2013. Florida currently follows the Centers for Disease Control and Prevention guidelines for identifying those at-risk for gonorrhea and drug resistant gonorrhea infections. These groups are narrowly defined and do not consider the different population dynamics throughout the State. This study examined the question of who is at-risk for contracting drug resistant strains of gonorrhea in the eight different regions of Florida based on the prescribed use of last-line-of-antibiotic-defense. Florida’s Surveillance Tools and Reporting System provided 12 years of secondary data from 2007 to 2018. The data …

An Assessment Of Kentucky Birth Records, Focusing On Early-Onset Hypertensive Disorders Of Pregnancy, Environmental Metal Exposures, And Geocoding Precision, 2008-2017, Courtney J. Walker

Theses and Dissertations--Epidemiology and Biostatistics

Using live and stillbirth records from Kentucky (2008-2017), this dissertation assessed the county-level prevalence and geospatial patterns of early-onset hypertensive disorders of pregnancy (eHDP); examined the geocoding precision of addresses recorded on birth records, and evaluated the association between individual risk factors and environmental metal exposures on eHDP prevalence. After adjusting for maternal demographic factors and pre-existing health conditions, we observed that eHDP prevalence was 38% higher (aPR=1.38, 95%CI:1.16, 1.64) in counties with the highest prevalence of married women (> 53.8%) compared to lower prevalence areas (31.6%) had a 20% higher prevalence of eHDP(aPR=1.20, 95%CI:1.00, 1.44) compared to counties with …

Mapping Heat Vulnerability Index Based On Different Urbanization Levels In Nebraska, Usa, Babak Jalalzadeh Fard, Rezaul Mahmood, Michael Hayes, Clinton Rowe, Azar M. Abadi, Martha Shulski, Sharon J. Medcalf, Rachel Lookadoo, Jesse E. Bell

Journal Articles: Epidemiology

Heatwaves cause excess mortality and physiological impacts on humans throughout the world, and climate change will intensify and increase the frequency of heat events. Many adaptation and mitigation studies use spatial distribution of highly vulnerable local populations to inform heat reduction and response plans. However, most available heat vulnerability studies focus on urban areas with high heat intensification by Urban Heat Islands (UHIs). Rural areas encompass different environmental and socioeconomic issues that require alternate analyses of vulnerability. We categorized Nebraska census tracts into four urbanization levels, then conducted factor analyses on each group and captured different patterns of socioeconomic vulnerabilities …

Protecting Life And Lung: Protected Areas Affect Fine Particulate Matter And Respiratory Hospitalizations In The Brazilian Amazon Biome., Derek Michael Sheehan

Graduate Student Theses, Dissertations, & Professional Papers

I assessed the impacts of upwind protected area coverage on local respiratory health within the Brazilian Amazon. A hypothesized mechanism is the legal prohibition of human ignited fires within protected areas, reducing particulate matter pollution, impacting respiratory health downwind. The connection between fires and respiratory diseases in the Amazon is well established (Smith et al. 2014; Rangel and Vogl 2019; Rocha and Sant’anna 2020). What is not well understood is the potential that government policies aimed at preventing ecosystem loss may also promote health and wellbeing, combining the UN sustainable development goals 3 and 15. Protected areas currently dominate government …

Comunidad Y Contagio: La Narrativa Del Brote De Covid-19 En España, Samantha Lee

Honors Theses

La pandemia global de COVID-19 inició inesperadamente el enero del año 2020. Mientras que el nuevo coronavirus impactó a personas de todo el mundo, hay una narrativa particular del brote que se ha ocurrido en España. Las consecuencias corpóreas del virus han tenido mayores impactos en el tejido social, económico, político y cultural de España. Por resultado, hay una narrativa del brote que es específica a los valores, experiencias, suposiciones y creencias de personas en España. Esta historia de la pandémica se ha escrito a través de las redes sociales, así como los funcionarios de salud pública, profesionales medicales, autoridades …

Effects Of Resistance Training On Muscle Quality Index, Muscle Strength, Functional Capacity, And Serum Immunoglobulin Levels Between Obese And Non-Obese Older Women, Paulo Roberto Silva Junior, Dahan Da Cunha Nascimento, Ivo Vieira De Sousa Neto, Silvana Schwerz Funghetto, Ramires Alsamir Tibana, James W. Navalta, Fabiani Lage Rodrigues Beal, Jonato Prestes

Kinesiology and Nutrition Sciences Faculty Research

International Journal of Exercise Science 14(7): 707-726, 2021. Considering the negative impact of obesity on neuromuscular and immune systems, we sought to compare the effects of a 10-week resistance training (RT) program on muscle quality index (MQI), muscle strength, functional capacity, and immunoglobulins in older women with and without obesity. Thirty-nine older women participated in the present study (age: 69.02 ± 6.16, fat (%): 38.80% ± 6.28) and underwent a linear RT program performed on two non-consecutive days of the week. Body composition, functional tests, immunoglobulins, muscle quality of upper and lower limbs and absolute muscular strength of the upper …

Nurse Home Visitation Program In Hamilton County, Oh To Increase Maternal And Child Health Outcomes, Hannah Widner

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Hamilton County Ohio currently has poor outcomes related to maternal and infant health, specifically among African Americans. Compared to the Healthy People 2020 goals, Hamilton County has higher rates of infant mortality, preterm birth, neonatal infant mortality, and conception within 18 months of previous pregnancies. These rates are disproportionate among African Americans. For instance, African American babies born in Ohio have higher infant mortality rate (14.3 per 1,000) prematurity as a cause of death (4 per 1,000) and neonatal mortality rate (9.2 per 1,000). These are compared to White babies in Ohio with infant mortality rate (5.1 per 1,000), prematurity …

Farmer Suicide: Rates, Trends, And Associations To Commodity Production Among States Reporting Violent Deaths, 2003-2017, Paul Norrod

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Occupational studies show that farmers are at higher risk for suicide with rates at least two-fold those of the U.S. population.2-4 Therefore, the purpose of this study was to (1) determine age- and sex-specific farmer suicide rates, (2) evaluate rate trends, and (3) assess the relationship between commodity production and farmer suicide using the National Violent Death Reporting System (NVDRS) and quinquennial Census of Agriculture. We identified 1,652 farmer suicide cases from the NVDRS. Age-specific rates showed the highest rates among male farmers over 64 at 14.03 per 100,000. Annual rates for the 15-year study period peaked during 2013 at …