Digital Commons Network^™

Cancer In Louisiana: 2017-2021, Volume 39, Louisiana Tumor Registry, Ingrid Wagner, Lauren Maniscalco, Mei-Chin Hsieh, Christina Lefante, Yong Yi, Lisa Pareti, Brent Mumphrey, Mary Anne Lynch, Xiao-Cheng Wu, Tommy Ngyuen

Policy & Position Papers

Mission:

To collect and report complete, high-quality, and timely population-based cancer data in Louisiana to support cancer research, control, and prevention.

Vision:

To reduce suffering and death from cancer using information collected by the Louisiana Tumor Registry.

History:

Cancer registration in Louisiana began in 1947 at the Charity Hospital Tumor Registry in New Orleans. In 1974, as part of its Surveillance, Epidemiology and End Results (SEER) Program, the National Cancer Institute provided funds for a population-based cancer incidence and survival registry covering Jefferson, Orleans, and St. Bernard parishes. Five years later, the Louisiana Tumor Registry (LTR) was transferred to the …

The Impact Of Digital Inequities On Salivary Gland Cancer Disparities In The United States, David M. Bruss, David J. Fei-Zhang, Helena Kim, Daniel C. Chelius, Anthony M. Sheyn, John P. Maddalozzo, Jeffrey C. Rastatter, Jill N. D'Souza

School of Medicine Faculty Publications

Introduction: Technology and internet access have become increasingly integrated into healthcare as the primary platform for health-related information and provider-patient communication. Disparities in access to digital resources exist in the United States and have been shown to impact health outcomes in various head and neck malignancies. Our objective is to evaluate the associations of digital inequity on health outcomes in patients with salivary gland cancer (SGC). Methods: The Digital Inequity Index (DII) was developed using 17 census-tract level variables obtained from the American Community Survey and Federal Communications Commission. Variables were categorized as digital infrastructure or sociodemographic (e.g., non-digital) and …

Considerations Of Medicare Telehealth Services With Older Adults, Sonah Kho, Amanda Dediego

Adultspan Journal

The onset of the COVID-19 pandemic set in motion a rapid expansion of mental health services offered via telehealth. With this rapid expansion came the need to examine how policy and practice should be shaped in a future where telehealth is considered common in counseling practice. For counselors to understand how to support older adult clients in using telehealth services, they must understand telehealth policy. Following the eligibility of licensed counselors to participate in Medicare, counselors need to stay abreast of regulatory changes regarding restrictions and regulations on use of telehealth for mental and behavioral health services, including video and …

The Association Between Race And Obesity After Controlling For Dietary Behaviors Among Adolescents, Jasmine Nicole Williams

Walden Dissertations and Doctoral Studies

Childhood obesity has become a critical global public health concern due to its significant, long-term impact on overall quality of life and physical health. Despite efforts, there is a lack of information that includes all races and ages to combat childhood obesity. This study addressed the association between race and obesity after controlling for dietary behaviors among adolescents in Georgia, using quantitative cross-sectional data from the 2021 Youth Risk Behavior Surveillance System (YRBSS). Guided by the social ecological model, the research investigated how demographic factors and dietary behaviors influence obesity rates. Specifically, the study explored the association between age, race, …

Design And Implementation Of An Opioid Scorecard For Hospital System-Wide Peer Comparison Of Opioid Prescribing Habits: Observational Study, Benjamin Slovis, Soonyip Huang, Melanie Mcarthur, Cara Martino, Tasia Beers, Meghan Labella, Jeffrey Riggio, Edmund Pribitkin

Jefferson Hospital Staff Papers and Presentations

BACKGROUND: Reductions in opioid prescribing by health care providers can lead to a decreased risk of opioid dependence in patients. Peer comparison has been demonstrated to impact providers' prescribing habits, though its effect on opioid prescribing has predominantly been studied in the emergency department setting.

OBJECTIVE: The purpose of this study is to describe the development of an enterprise-wide opioid scorecard, the architecture of its implementation, and plans for future research on its effects.

METHODS: Using data generated by the author's enterprise vendor-based electronic health record, the enterprise analytics software, and expertise from a dedicated group of informaticists, physicians, and …

Changes In Drug And Alcohol Behaviors Before And After An Educational Intervention Among At-Risk Adults And Youth, Isabel Cuellar Acker

All ETDs from UAB

Introduction: Substance abuse is defined as the excessive use of a drug in a way that is detrimental to oneself, society, or both. Gender is important to examine because it is becoming more common for females to develop substance use disorders and for their substance use to be more severe. This study will address the role of an education-based intervention on substance abuse in an area that is at the intersection of rural and urban geography with a unique pool of participants. Methods: This is a longitudinal cohort study that has a pre-post intervention design. A linear model was used …

The Foodpunk City: Advancing Portland's Food Security Through A Shared Ideology Of Adaptation & Resistance, Nickolas Hash

Dissertations and Theses

Food injustice is a form of violence perpetrated by state and corporate actors against a constituency under their governing power, particularly impacting marginalized and impoverished communities. It denies individuals access to nutritious food, perpetuating cycles of poverty, inequality, physical health risks, and social exclusion. Grassroots movements have emerged to challenge dominant paradigms and advocate for food sovereignty, agroecology, and food anarchy. In Portland, the movement represents a nontraditional approach to food security that closely resembles the reactionary ideology of urban "punk" culture. Both groups prioritize community autonomy over food systems, sustainable agricultural practices, and resistance to oppressive structures that perpetuate …

A Cross Cultural Comparison Of Adolescent Sexual Socialization In Family Settings In Four Thai Regions: A Cross Sectional Survey, Ampornpan T้Heeranut, Pongdech Sarakarn, Donlagon Jumparway, Arina Abdulloh, Piches Ruangsuksud, Chaiyun Sakulsriprasert, Bhunyabhadh Chaimay, Linda L. Shield, Alison Hutton, Kesinee Saranrittichai

Journal of Health Research

Background: Sexual socialization is different across cultural contexts due to norms and values including adolescents’ growth & development and characteristics. Patterns of sexual socialization across different cultural contexts and adolescents in Thailand are still unknown. This analytical cross-sectional study aimed to explain and compare 5 patterns of adolescent sexual socialization in Thailand (SSFA): trust, strict, exhaust, review, and general patterns.

Methods: The sample included 1,050 parents living in the same house with their adolescent offspring aged 13-19 years. Stratified cluster randomized sampling was performed to access participants. The instrument used for measuring adolescent sexualization in families with adolescents was …

An Analysis Of Suspected Microplastics In The Muscle And Gastrointestinal Tissues Of Fish From Sarasota Bay, Fl: Exposure And Implications For Apex Predators And Seafood Consumers, Eric Conger, Miranda Dziobak, Elizabeth J Berens Mccabe, Tita Curtin, Ayushi Gaur, Randall S Wells, John E Weinstein, Leslie B Hart

Faculty, Staff and Student Publications

Microplastics have been found in the gastrointestinal (GI) fluid of bottlenose dolphins (Tursiops truncatus), inhabiting Sarasota Bay, FL, suggesting exposure by ingestion, possibly via contaminated fish. To better understand the potential for trophic transfer, muscle and GI tissues from 11 species of dolphin prey fish collected from Sarasota Bay were screened for microplastics (particles <5 mm diameter). Suspected microplastics were found in 82% of muscle samples (n=89), and 97% of GI samples (n=86). Particle abundance and shapes varied by species (p<0.05) and foraging habit (omnivore vs. carnivore, p<0.05). Pinfish (Lagodon rhomboides) had the highest particle abundance for both tissue types (muscle: 0.38 …

Dementia-Focused Programs In Older Adult Centers And Health Care Use Among Individuals With Dementia, Ayse Akincigil, Divya Bhagianadh, Clara J. Scher, Ceara Somerville, Caytln Coyle, Natalie E. Pope, Emily Greenfield

Health, Human Performance and Recreation Faculty Publications and Presentations

There is growing attention to community-based services for preventing adverse health care outcomes among people aging with dementia. We explored whether the availability of dementia-centered programming within older adult centers (ie, senior centers)—specifically, adult day services (ADS), social adult day centers (SADCs), memory cafes, and caregiver support—is associated with reduced hospitalization, emergency room use, and total Medicare costs for community-dwelling individuals ages 75 and older with Alzheimer's disease and related dementias (ADRD), and whether associations differ by the relative size of the local jurisdiction. We used a novel dataset that links Medicare claims data with data from an organizational census …

Predicting Poor Mental Health Among Older Syrian Refugees In Lebanon During The Covid-19 Pandemic: A Nested Cross-Sectional Study, Berthe Abi Zeid, Leen Farouki, Tanya El Khoury, Abla M. Sibai, Carlos Mendes F. De Leon, Marwan F. Alawieh, Zeinab Ramadan, Sawsan Abdulrahim, Hala Ghattas Ph.D., Stephen J. Mccall

Faculty Publications

Background: Post-term pregnancy, defined as reaching or exceeding 42 + 0 weeks of gestation, is known to be associated with unfavourable birth outcomes. High-income countries have responded to this risk by widely adopting labour induction protocols in late-term, but many low- and middle-income countries have not. However, understanding underlying mechanisms linking post-term births to adverse newborn and infant outcomes remains limited.

Objective:To investigate the (a) prevalence of post-term, (b) the risk factors associated with post-term (c) the association between post-term births and the risk of smallfor-gestational-age (SGA) neonates and of infant mortality in middle-income settings.

Methods:We used existing …

The Influence Of Individual Characteristics On Human Immunodeficiency Virus Testing In Puerto Rico, Jose Au Lay

Walden Dissertations and Doctoral Studies

In 2016, there were 17,072 people living with HIV in Puerto Rico. Most HIV cases were among men, with the primary mode of transmission identified as men who have sex with other men followed by heterosexual contact. Among women, heterosexual contact was the primary mode of HIV transmission. The rise in the numbers of individuals infected with HIV through heterosexual contact suggest the prevalence of high-risk sexual behaviors including multiple sexual partners and unprotected vaginal and anal sex. Guided by the health belief model, the purpose of this study was to explore the relationship between the likelihood of HIV testing …

A Systematic Review: Longevity And Quality Of Life In Blue Zones, Salmaan Mulla

Theses and Graduate Projects

Ikaria, Loma Linda, Sardinia, Okinawa, and Nikoya. These 5 cities around the world are famed for their increased longevity and quality of life and are termed “Blue Zones”. Blue zones are areas around the world noted for their population of centenarians, overall long life expectancy and high quality of life compared to the average population. Studying these communities offer insights into the commonalities they share to better understand the unique aspects of living a healthy, fulfilling and long life. A comprehensive literature review was conducted using Google Scholar, with the search terms “Ikaria, Greece longevity; Loma Linda, California longevity; Sardinia, …

Chronic Obstructive Pulmonary Disease Hot Spots In Mississippi, Taylor Jansen, Elizabeth Dugan

Journal of Public Health in the Deep South

Abstract

Introduction. Chronic obstructive pulmonary disease (COPD) is the sixth leading cause of death in the US and approximately 10% of people 65 years and older have COPD. This study examines the association of geographic-level risk factors with chronic obstructive pulmonary disease (COPD) prevalence using spatial-based analyses with the goal of identifying risk factors associated with county-level COPD and to identify communities at risk.

Methods. The study sample consisted of all N=82 counties in Mississippi and all data is reported at the county level. All measures were drawn from the 2023 Mississippi Healthy Aging Data Report. A hot spot …

Evaluating The Effectiveness Of Hiv/Aids Interventions In Lesotho, Maya Gomez Velardez

Master's Projects and Capstones

Lesotho faces a severe HIV/AIDS epidemic, with one of the highest prevalence rates globally, impacting its public health, economy, and society. Despite numerous efforts, the country continues to struggle with persistently high infection rates, highlighting the need to thoroughly evaluate current interventions. This review examines the effectiveness of various HIV/AIDS interventions in Lesotho, focusing on multi-level strategies within the Social Ecological Model. The paper synthesizes literature from 2013 to 2023, concentrating on antiretroviral therapy (ART) coverage, community initiatives, and efforts targeting high-risk groups. Key strategies involve expanding ART coverage, strengthening community-based healthcare through community health workers (CHWs), and enhancing initiatives …

Evaluating Stormwater Erosion Prevention And Sediment Control Best Management Practices Using High-Resolution Rainfall Monitoring And Field-Based Assessment Tools, Brittany Pekara

Masters Theses & Specialist Projects

Advancing stormwater management methods and technology is critical as runoff from impermeable surfaces increases with urbanization and development. Stormwater runoff is highly susceptible to contamination from non-point source pollution and causing flood impacts following rain events, which varies spatially and temporally in an urban landscape. To counteract the impacts of contamination and drainage issues, Best Management Practices (BMPs) are implemented to reduce the effects of stormwater runoff; however, the unpredictable nature of storm events can make methods for effectively monitoring impacts difficult in trying to capture first flush inputs, flood threats, and sedimentation sources. This research utilizes a highresolution rainfall …

Perceptions And Visual Awareness Of Urban Karst Flooding To Inform Preparedness Planning And Management Actions, Grace Hermann

Masters Theses & Specialist Projects

Awareness and perception of flooding can heavily affect how an individual or community prepares for flooding. Flood awareness can be affected by factors like past flood experience and demographics. Flood experience and demographics can affect flood awareness differently based on factors including the types and cause of flooding. Flooding in karst landscapes can vary from other types of flooding and neither perception nor awareness of karst flooding has been directly studied before. This study explored both expert and non-expert flood awareness and perception and flood policies in a karst landscape through interviews with experts, surveys, and cognitive mapping activities. The …

Associations Of Natural Vegetation In Relation To Colorectal Cancer Hotspots And Colorectal Cancer Survival., Johnnie Newton

Electronic Theses and Dissertations

Background: Across Kentucky, county-level geographic disparities in colorectal cancer (CRC) incidence and outcomes exist. Given the heterogeneity of lifestyle, socioeconomic (SES), and environmental factors within a county, more granular approaches should be used to identify local areas with a high CRC burden and identify the area-level factors that may contribute to geographic disparities. Studies reported that living in greener areas is associated with beneficial health outcomes, including lower mortality. Despite growing evidence that natural vegetation (greenness) exposure is associated with increased physical activity and obesity, two well-known CRC risk factors, epidemiological studies investigating the association of residential greenness exposure with …

Environmental Factors (Rurality, Distribution Of Prescribers, And Altitude) Of People Who Died By Suicide In Montana, 2013- 2022, Anne N. Brown

Electronic Theses and Dissertations

Introduction: Suicide is increasingly prevalent in rural areas across the United States, especially in the western Rocky Mountain states. The connection between suicide and rural residency is not well understood, nor is the relationship between the distribution of prescribers, altitude, and suicide. Purpose: This retrospective quantitative study aimed to describe the characteristics of individuals who died by suicide in Montana and investigate the associations among rurality, distribution of prescribers, altitude, and suicide rate. Methods: Montana suicide mortality data for 2013-22 was used to describe individual characteristics. A second dataset was created for each Zip Code Tabulation Area (ZCTA) level in …

A Descriptive Study: Aging In Place In The Rural Southeastern United States, Dama G. Cooley

Electronic Theses and Dissertations

Older Americans will soon outnumber children and younger adults. In 2022, there were 58 million older adults. By 2050, older adult numbers will grow to 82 million, and by 2060, 100 million. The National Institute on Aging calls for ongoing research on the impact that a historically large aging population will have on health, well-being, and quality of life. A key concern is how to meet needs while decreasing costs associated with institutional long-term care.

Most of these elders reside in the community and wish to live in their homes throughout their lives, but they will experience an increased need …

The Impact Of The Covid-19 Pandemic On Device-Associated Healthcare-Associated Infections In Nevada, Gabriela Bran

UNLV Theses, Dissertations, Professional Papers, and Capstones

Healthcare-associated infections or hospital-acquired infections (HAIs) have remained prevalent despite the growth of infection control programs in healthcare facilities and are a large cause of morbidity and mortality. Device-associated HAIs (DA-HAIs) make up a large portion of HAIs. The devices include central line-associated bloodstream infections (CLABSIs), catheter-associated urinary tract infections (CAUTIs), and ventilator-associated events (VAEs). DA-HAIs became a large concern during the COVID-19 pandemic as many healthcare facilities became overwhelmed by the influx of COVID-19 cases, illuminating the importance of studies to examine these changes. Therefore, this study aimed to evaluate how DA-HAI rates have changed during and after the …

Effect Of Male Partners' Involvement And Support On Reproductive, Maternal And Child Health And Well-Being In East Africa: A Scoping Review, Richard Fletcher, Faye Forbes, Abel Fekadu Dadi, Getachew Mullu Kassa, Casey Regan, Anna Galle, Addisu Beyene, Rebecca Liackman, Marleen Temmerman

Centre of Excellence in Women and Child Health

Background and Aims: East African countries have high rates of maternal and childmortality and morbidity. Studies have shown that the involvement of male partners inreproductive health can benefit maternal and child health (MCH). This scoping reviewaims to provide an overview of the evidence across East Africa that describes malepartner involvement and its effect on maternal, reproductive, and child well‐being.

Methods: Ten databases were searched to identify quantitative data on male'sinvolvement in East Africa. Studies reporting qualitative data, “intention to use” dataor only reporting on male partner's education or economic status were excluded.Studies were organized into five a priori categories: antenatal …

A Comparison Of Maxent Models For Aedes Aegypti Species Distribution In South America Utilizing Different Bioclimatic And Environmental Variables, Matthew Beer

Electronic Theses and Dissertations

Aedes aegypti is the principal vector for dengue transmission across large areas of the world. Understanding where this critically important vector lives is paramount to preventing the continued expansion of dengue globally. Using 1981-2010 bioclimatic (bioclim) variables, as well as additional environmental variables and elevation data, multiple MaxEnt models were constructed for Ae. aegypti within the South American continent to identify ecologically important variables and areas of persistent high suitability. All models had acceptable AUC scores (> 0.70), indicating accurate model fitting. Annual mean precipitation and temperature were found to be important model variables; however, when added, humidity became the …

Covering The Care: Most Prevalent Health Conditions And Their Associated Costs Among Nh’S Insured Population – Behavioral Health And Cardiovascular Disease Top The List, Bethany Swanson, Erica Plante, Deborah Fournier

Faculty Publications

This data brief presents an analysis of available claims data from New Hampshire’s commercial, Medicaid, and Medicare insured populations. Specifically, the study identifies the top ten most prevalent health conditions, the cost of treatment for those conditions, and the overall medical cost for those with one of the identified conditions. The analysis is based on the most recent calendar year of available claims data (January – December 2022).

Dengue And Climate Change: Assessing Potential Future Areas Of Concern For Transmission In The United States, Matthew Beer

Electronic Theses and Dissertations

Background: Global climate change severely impacts human life, particularly health, as rising temperatures and extreme weather affect physical and mental well-being. Climate change can also alter the risk factors and epidemiology of infectious diseases, notably vector-borne diseases (VBDs), including those transmitted by mosquitoes. The Aedes mosquito, responsible for dengue, poses a significant threat due to its prevalence vector. Dengue prevention lacks effective methods beyond vector control, and the current vaccine has limitations, emphasizing the need for intensified research and prevention strategies to mitigate the expanding dengue burden worldwide. The goal of these studies was to establish a novel risk index …

Residential Street Trees And Cardiovascular Disease Among Urban-Dwelling Mexican Adults, Christine Campbell

Walden Dissertations and Doctoral Studies

Cardiovascular diseases (CVDs) are a significant public health burden in Mexico despite national efforts to address traditional risk factors. With growing evidence that elements of nature can improve physical and mental health of people living in cities, this quantitative epidemiological study of secondary data examined the relationship between the presence of street trees in Mexican metropolitan areas and self-reported CVD in adults over age 40. The integrated socio-environmental model of health and well-being provided the conceptual framework for the study. A secondary data analysis was performed using combined individual health data from Mexico’s 2012 National Health and Nutrition Survey and …

New Approach To Mapping Regional Vulnerability In Controlling Tuberculosis Disease In Indonesia, Maria Holly Herawati, Asep Hermawan, Dasuki Dasuki, Hadi Supratikta, Al Asyary, M Rokhis Khomarudin, Muhammad Priyatna, Raflizar Raflizar, Kristina Kristina, Noer Endah Pracoyo, Dina Bisara, Cahya Tri Purnami, Mentari Nur Farida Suteja, Yusrial Bachtiar, Noor Edi Widya Sukoco, Doni Lasut

Kesmas

Tuberculosis (TB) in Indonesia is still a health problem. The TB prevalence in Indonesia ranks second in the world after India in 2023. Regional factors, inadequate healthcare facilities, and limited resources (financial, human, and infrastructure) are challenges requiring innovation to help the government control TB. TB eradication efforts need to be made with a comprehensive and effective approach. One method used is to look at the vast territory of Indonesia, therefore, mapping the TB disease vulnerability is a highly recommended method. The use of a Geographic Information System is expected to help map the TB vulnerability areas in Indonesia. Given …

A Mixed Methods Exploration Of Young Women's Agency And Mental Health During Covid-19 In Low-Income Communities In Mumbai, India, Marie A Brault, Melissa F Peskin, Anastasia N Jones, Amrita Saikia, Rinchen O Bhutia, Sai Sammitha Cheruvu, Vaishali M Jagtap, Rajendra Singh, Poornima Nair, Rajesh Vedanthan, Sten H Vermund, Shubhada Maitra

Faculty, Staff and Student Publications

Introduction: Adolescent girls and young women (AGYW) in India face additional health inequities compared to their male peers, as gender norms constrain agency for prevention and self-care. The onset of the COVID-19 pandemic and associated lockdowns deepened health inequities and often worsened mental health, but the impacts on agency are unclear. This exploratory sequential mixed methods paper examined mental health and COVID-19 elements that exacerbated or mitigated adverse consequences for AGYW in low-income communities in Mumbai.

Methods: We conducted semi-structured interviews with AGYW (aged 15-25 years; N = 60) and adults (parents, healthcare providers, community-based organization representative; N = 30). …

Bayesian Beta-Binomial Mixed Models For Longitudinal, Clustered, And Spatiotemporal Data, Chun-Che Wen

MUSC Theses and Dissertations

Overdispersed binomial data arise in many clinical and public health research studies. Examples include timeline followback data (TLFB), which are used in addiction research to monitor recent substance use. This dissertation proposes novel beta-binomial (BB) mixed models to address the challenges associated with overdispersed binomial data, including zero-inflation, heterogenous effects, and spatiotemporal correlation. Motivated by a 12-week randomized controlled trial evaluating the efficacy of varenicline tartrate for smoking cessation among adolescents, Aim 1 develops a Bayesian zero-inflated beta-binomial (ZIBB) model to analyze longitudinal and bounded TLFB data — namely, the number of abstinent days in the past week. Because treatment …

How The Cahps Clinician And Group Patient Experience Survey Data Have Been Used In Research: A Systematic Review, Denise D. Quigley, Marc N. Elliott, Nabeel Qureshi, Zachary Predmore, Ron D. Hays

Journal of Patient-Centered Research and Reviews

Purpose: Patient experience is a key aspect of care quality. The Consumer Assessment of Healthcare Providers and Systems Clinician and Group (CG-CAHPS®) survey measures experiences with ambulatory care providers to inform public reporting, pay-for-performance initiatives, interventions, patient choice of physicians/practices, and quality improvement. Since the survey’s 2007 release, no systematic review of its use in research has been published.

Methods: We reviewed English-language, peer-reviewed articles published since 2008 using CG-CAHPS survey data in the U.S. We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and used the Checklist for Analytical Cross-Sectional Studies.

Results: We examined 126 articles …