Digital Commons Network^™

Bridging Ipv And Sud For Pregnant And Postpartum Women: A Case Report Of Interdisciplinary Programming In Mississippi, Catherine Poehling, Masoumeh Karimi, Chinedu Chukwu, Jerome R. Kolbo, Xiaoshan Gordy, Saijun Zhang, Matthew Morris, Andrew Voluse, Erin Dehon, Michelle Brassfield, Danielle Lahn, Lisa Slade, Deanna Howington, Kathleen Rhodes, Tearsanee Davis, Sonja Fuqua, Mary M. Wesley, Lei Zhang

Journal of Public Health in the Deep South

Lesbian, gay, bisexual, transgender, queer, and other sexual and gender minority (LGBTQ+) adolescents in the U.S. South experience disproportionately high rates of bullying, discrimination, depression, and suicidality. Supportive and inclusive school climates are identified as key protective factors that can mitigate these risks and function as primary prevention against violence. This systematic narrative review synthesizes peer-reviewed research and high-quality survey reports published between 2015 and 2024 that assess school climate, mental health, and violence-related outcomes among LGBTQ+ youth with representation from Southern states, including Mississippi, Alabama, and Louisiana. Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, 1,167 records …

Gun Violence And Maternal Mortality In The Mississippi Delta: A Dual Public Health Crisis, Nelson Atehortua, Mary Shaw-Ridley

Journal of Public Health in the Deep South

No abstract provided.

The Mississippi Violence Injury Prevention Program (Ms-Vip): Building A Community-Driven Model For Healing And Safety, Rukia Lumumba

Journal of Public Health in the Deep South

No abstract provided.

Dampak Penerapan Integrated Care For Older People Dan Ina-Frail Dalam Menurunkan Sindroma Kerapuhan Pada Lansia, Mochamad Ramadhan Arista Pesat Eka Putra, Vetty Yulianty Permanasari

Jurnal ARSI : Administrasi Rumah Sakit Indonesia

Indonesia is facing a significant increase in its elderly population, requiring effective and sustainable integrated geriatric services, one of which is through the implementation of Integrated Care for Older People (ICOPE) to assess intrinsic capacity decline combined with the Ina-FRAIL questionnaire to measure frailty in the elderly. This study aims to assess the condition of frailty in older adults through the ICOPE approach in integrated geriatric services at Humana Prima Hospital in Bandung using a quantitative design with an experimental approach. The assessment was conducted using the ICOPE and Ina-FRAIL instruments to monitor intrinsic capacity and the level of frailty …

The Role Of Gynecologic Oncologists In Improving Survival Outcomes Of Epithelial Ovarian Cancer: A Retrospective Cohort Study, Widyorini Lh Hanafy, Bambang Dwipoyono, Asri C. Adisasmita, Yosephine E. Regina, Airine S. Lians, Oktaviani P. Rahayu, Jane G. Auwelia

Kesmas

Epithelial ovarian cancer (EOC) is a leading cause of gynecological cancer mortality and is often diagnosed at an advanced stage, resulting in poor survival outcomes. Access to specialized gynecological oncology services has been associated with improved prognosis; however, data on its impact in Indonesia remain limited. This study aimed to evaluate the association between gynecologic oncologist (GO) services and disease-free survival (DFS) in patients with EOC. This retrospective cohort study included 76 patients with EOC who were treated at a national cancer hospital in Jakarta between 2015 and 2018. Patient data were obtained from medical records and followed for three …

Achieving And Sustaining Treatment Targets In Rheumatoid Arthritis: A Retrospective Cohort Analysis In Indonesia, Fara Fauzia, Rudy Hidayat, Suryo Anggoro Kusumo Wibowo, Sumariyono Sumariyono, Faisal Parlindungan, Anna Ariane, Johanda Damanik, Abirianty Priandani Araminta, Suci Damaratri

Kesmas

Achieving and sustaining low disease activity (LDA) and remission in rheumatoid arthritis (RA) remains challenging. This study examined the rates and predictors of LDA/remission and sustained LDA/remission in an Indonesian RA cohort. A retrospective study of newly diagnosed adult patients attending a rheumatology clinic in 2020-2021 was conducted. Patients were followed for 12 months to evaluate achievement of LDA/remission, defined as DAS28-ESR ≤3.2, and those meeting the target were observed for an additional 12 months to evaluate sustained LDA/remission. Cox regression was used to identify predictors of time to LDA/remission and loss of LDA/remission. Of 166 participants, 91 (54.8%) achieved …

Urban–Rural Disparities In Metabolic Risk Factors For Hypertension Among The Elderly In Indonesia, Susiana Nugraha, Puri Wulandari

Kesmas

Hypertension remains a major public health challenge among the elderly in low- and middle-income countries. This cross-sectional study examined demographic and metabolic factors associated with hypertension among the elderly living in urban and rural areas of West and Central Java Provinces, Indonesia. This study included 1,920 adults aged ≥60 years who had resided in the study areas for at least six months, were able to communicate effectively, and provided informed consent. Data were collected between March and August 2023 using stratified multistage random sampling, structured questionnaires, and biochemical measurements. Multivariable logistic regression revealed distinct patterns of association across settings. In …

Short-Term Survival And Prognostic Factors In Cervical Cancer Patients Requiring Hemodialysis: A Retrospective Cohort Study, Muhammad Trihatmowijoyo Bundjali, Maruhum Bonar Hasiholan Marbun, Wulyo Rajabto, Ikhwan Rinaldi, Hamzah Shatri, Dwi Lestari Partiningrum, Dadang Makmun, Pringgodigdo Nugroho, Sukamto Koesnoe, Pradana Soewondo

Kesmas

Cervical cancer is a common gynecological malignancy, particularly in developing countries, where it coexists with renal impairment in over one-third of patients. This disease typically presents acutely and progresses rapidly. Consequently, kidney replacement therapy, including hemodialysis (HD), is commonly required. To assess survival rates and associated factors, this retrospective cohort study analyzed the medical records of 252 cervical cancer patients who began HD across a three-month follow-up period. Kaplan–Meier analysis indicated a median short-term survival duration of 71.5 days (range: 7–90), with 1-, 2-, and 3-month survival rates of 56%, 51%, and 49%, respectively. Multivariate Cox regression identified post-HD systolic …

Factors Associated With Antiretroviral Therapy Adherence In Patients With Hiv At A Public Hospital In Central Jakarta, Indonesia, Kareena Sari Fatimah, Laily Hanifah, Chandrayani Simanjorang, Nayla Kamilia Fithri

Kesmas

Patients with human immunodeficiency virus (HIV) are required to take antiretroviral therapy (ART) to suppress the virus. However, suboptimal adherence remains a critical barrier that can lead to treatment failure and persistent transmission risks. This study aimed to identify factors associated with ART adherence in patients with HIV. This quantitative study with a cross-sectional design consisted of patients with HIV aged >18 years who received care at the voluntary counseling and testing clinic of a public hospital in Jakarta, Indonesia. Purposive sampling was used. This study used HIV care and ART overview forms as instruments. Data were analyzed using multiple …

Factors Affecting Irritant Contact Dermatitis Among Horticulture Farmers In Semarang District, Indonesia, Maria Goretti Catur Yuantari, Haikal Haikal, Dewi Susanna

Kesmas

Irritant contact dermatitis is a common condition among farmers, but its underlying causes remain poorly understood. This study aimed to identify factors associated with irritant contact dermatitis among horticulture farmers in Semarang District, Indonesia. A cross-sectional survey was conducted among 427 farmers using a validated, reliable structured questionnaire. The results indicated complaints of dermatitis related to contact with irritants. Data were analyzed using the Chi-square test and logistic regression. Analysis revealed that sex, personal hygiene habits, education level, and the number of pesticide types used were significantly associated with irritant contact dermatitis. Female farmers were less likely to develop irritant …

Patterns Of Tobacco Marketing And User Engagement On Social Media In Indonesia: Challenges For Digital Public Health, Resti Yulianti Sutrisno, Nopryan Ekadinata, Sutantri Sutantri, Dinasti Pudang Binoriang, Enrico Aditjondro, Rachfiansyah Rachfiansyah, Yosef Rabindanata, Silvia Dini, Rebecca Perl, Riska Rachmawati, Bertha Tesma Wulandari, Dianita Sugiyo

Kesmas

Large-scale tobacco marketing on social media has resulted in widespread population-level exposure, particularly in Indonesia, which faces growing challenges in digital public health. This study aimed to assess the associations between platform type and marketing tactics and identify correlations of user engagement. An analytical cross-sectional study was conducted using secondary data from the Tobacco Enforcement and Reporting Movement (TERM), collected from January 2022 to August 2023. A total of 21,255 tobacco marketing posts from social media were analyzed. Platform–tactic associations were examined using Chi-square tests, and multivariable Poisson regression was used to identify factors associated with user engagement. The findings …

Low-Dose Prophylaxis Versus On-Demand Treatment For Children With Severe Hemophilia A In Indonesia: A Conceptual Model, Levina Chandra Khoe, Nur Atika, Dhia Ticha Pertiwi, Septiara Putri

Kesmas

Hemophilia A is a rare bleeding disorder caused by a deficiency of clotting factor VIII, leading to recurrent bleeds, joint damage, and disability. Low-dose prophylaxis has been shown to achieve better clinical outcomes than on-demand treatment in reducing bleeding frequency. However, in Indonesia, access and affordability remain key challenges. This study aimed to develop a conceptual model for conducting a health economic evaluation of low-dose prophylaxis treatment for children with severe hemophilia A in Indonesia. This study followed the ISPOR-SMDM Modeling guidelines, outlining two-stage processes: conceptualization of the clinical problem and model development. A systematic literature review was conducted to …

A Patient-Needs Assessment In The Management Of Vestibular Schwannoma, Eric Martinez, Alexandra Jackson, Gavriel Kohlberg, Andy Saultz

Pacific Journal of Health

Background: Decision aids have evolved as a tool utilizing evidence-based information to help patients understand treatment options and are nascent in the field of neurotology. Vestibular schwannoma management consists of observation, microsurgery, and / or radiation. A decision aid has the potential to help patients understand treatment options regarding vestibular schwannomas while functioning in a patient-centered environment.

Objective: To conduct a patient needs assessment in the diagnosis and management of vestibular schwannoma to inform draft decision aid development.

Setting and Participants: Eight patients between 45 and 74 years of age who received a diagnosis of a unilateral vestibular schwannoma and …

Balancing Education And Health Among Rural Schoolchildren During Prolonged Heat Wave In The Philippines, Elias Olapane

Kesmas

Intensifying heat waves disrupt learning environments in the Philippines, particularly in rural areas where schools often lack adaptive infrastructure. Many rural classrooms are built with heat-retaining materials, such as concrete, which trap excessive heat, leading to indoor temperatures exceeding safe comfort levels. These conditions lead to dehydration, fatigue, and reduced cognitive function, directly impairing students’ focus and academic performance. Schoolchildren are particularly vulnerable due to their developing thermoregulatory systems, higher metabolic demands, and potential preexisting health conditions. These risks are further amplified in rural communities with limited access to cooling, healthcare, and adaptive resources. These challenges require practical, context-specific interventions. …

Translating Community Voices To Build Meaningful Engagement: A Community Health Worker Led Study, Lauren Workman, Julie Smithwick Msw, Chw, Kimberly C. Rawlinson, Mark M. Macauda, Lashandra Morgan, Whitney Davis

Faculty Publications

Background: Understanding community perspectives on barriers and facilitators of meaningful engagement, equitable decision making, and sustainable community improvement is critical for advancing health equity. Community Health Workers can make significant contributions to research teams, as they are bridges into communities and bring unique perspectives. This study describes community voices on barriers to authentic engagement and insights on strategies to build trust, as well as the way in which these data were translated into a tangible assessment tool and a community-facilitated learning academy.

Methods: A team of Community Health Workers led a series of 24 ‘open mic’ discussions in four South …

Association Between Dietary Folate And Prostate Cancer Aggressiveness Among African Americans And European Americans, Lihchyun Joseph Su, Sarah O'Connor, Daniela Ramirez Aguilar, Minjae Lee, Harrison Wong, Hui-Yi Lin, Jeannette T. Bensen, James L. Mohler, Lenore Arab, Longgang Zhao, Ebonee N. Butler, Laura Farnan, Susan E. Steck Phd, Mph, Rd

Faculty Publications

Background: Despite the confirmed beneficial effects on preventing neural tube defects, concerns about high intakes of synthetic folate, or folic acid, in promoting cancer progression have been raised. This study evaluated the association between folate intake and prostate cancer (PCa) aggressiveness among African-American (AA) and European-American (EA) males. Methods: This study included 722 AA and 775 EA men with prostate cancer. Folate intake (dietary folate equivalent (DFE), synthetic folate, natural folate) was estimated using the National Cancer Institute Dietary History Questionnaire and detailed dietary supplement use questionnaire. Analyses included univariable comparisons of demographic and clinical characteristics of the two racial …

Evidentiary Standards For Newly Approved Antibiotics For Uncomplicated Urinary Tract Infections, Rosa Rodriguez-Monguio, Enrique Seoane-Vazquez, John H. Powers Iii

Pharmacy Faculty Articles and Research

Importance: Uncomplicated urinary tract infections (uUTIs) are among the most common bacterial infections and are typically treated with existing oral antibiotics. In 2024–2025, the FDA approved two new oral agents, sulopenem etzadroxil/probenecid and gepotidacin, via expedited review pathways, for the treatment of uUTIs. Objective: To assess the clinical significance and regulatory evidence supporting FDA approval of sulopenem/probenecid and gepotidacin for uUTI, and to analyze the adherence of pivotal phase III trials to regulatory standards for approval and FDA guidelines. Design, Setting, and Participants: Comparative descriptive analysis of publicly available data from phase 3 randomized, double-blind, active-controlled clinical …

Challenges, Stressors, And Resilience Resources Experienced By Older Black Women In Rural South Carolina Throughout The Covid-19 Pandemic, Arielle N'Diaye, Camryn Garrett, Sarah Wilcox Phd, Bankole Olatosi Ph.D., Xiaoming Li Ph.D., Shan Qiao Ph.D.

Faculty Publications

Background

Resilience has been established as a protective factor against mental health challenges (e.g., anxiety, depression). From an intersectional perspective, the stressors experienced by Black women living in rural communities are likely to have been exacerbated during the COVID-19 pandemic. This study aims to identify the challenges and stressors experienced and the resilience resources available to and relied upon by rural, Black women, during the pandemic.

Methods

Individual, in-depth, structured interviews (n = 24) were conducted among Black women living in rural South Carolina, recruited by local community health workers, from January to April of 2024. All interviews were recorded, …

Racial Disparities Among Pregnant Women Of Color And Their High Risk For Developing Periodontal Disease, Darrylnn Mayo

Pacific Journal of Health

This qualitative study explored the oral health experiences of four women of color during their pregnancies. Data was collected through interviews and presented as case studies. Although existing literature indicated that pregnant women of color are at a higher risk for developing periodontal disease, the participants in this case study reported actively engaging with their dental care providers, daily intake of prenatal vitamins with practice of self-oral care, and compliance with oral hygiene instructions. Further studies should investigate larger sample populations with broader minority ethnic groups to help explore the determinants of racial disparities and strategize ways to reduce barriers …

Trends In Self-Reported Responses To Nutrition Facts Labels Before And After Nutrition Labeling Policy Implementation: A Comparison Of Adults In The United States And Mexico, Jim Thrasher Ph.D., Ma, Ms, Victor Vilalobos, Dai Fang, Alejandra Jáuregui, Alejandra Contreras-Manzano, Rachel Davis Ph.D., Lana Vanderlee, Christine M. White, Rachel B. Acton, James W. Hardin, Edward A. Frongillo Jr. Ph.D., Simón Barquera, David Hammond

Faculty Publications

Background

Objectives

Methods

Plasma Ca125 Levels As A Predictor Of Major Adverse Cardiac Events In Patients With Acute Coronary Syndrome: A Six-Month Follow-Up Study, Nazlı Dilek Çolak, Turgut Karabağ, Onuralp Çalışkan, Songül Tezcan

Journal of the Saudi Heart Association

Objectives: Carbohydrate antigen 125 (CA125) is associated with different cardiovascular conditions. This study aimed to determine CA125 levels in patients with acute coronary syndrome (ACS) and the potential relationship between major adverse cardiac events (MACE) in the short-term following.

Methods: This prospective cohort study was conducted in a coronary care unit between May and November 2022. Plasma CA125 levels were measured only once upon hospital admission. Patients were followed for six months. All-cause mortality, recurrent acute coronary syndrome, requirement for revascularization, decompensated heart failure, cardiogenic pulmonary edema, atrial fibrillation, and stroke were recorded as MACE.

Results: A total of 127 …

Social Support And Mental Toughness As Predictors Of Perceived Stress Among College Kinesiology Students, Jianmin Guan, Wan Xiang Yao, Xiaofen D. Hamilton, Gaofeng Lu

International Journal of Physical Activity and Health

Drawing on Lazarus and Folkman’s transactional theory of stress and coping, this study examined the associations of age, gender, three types of social support (family, friends, and significant others), and mental toughness with two dimensions of perceived stress (helplessness and coping inefficacy) among 666 college students majoring in Kinesiology. Hierarchical multiple regression analysis revealed that male college students, as well as those with higher levels of mental toughness and family support, reported significantly lower levels of helplessness and coping inefficacy in managing stress. Additionally, greater support from friends was significantly associated with lower levels of coping inefficacy, while younger students …

Improving Structured Handoff Documentation In A Pediatric Emergency Department, Deborah Hammett, Rebecca Matta, Jody Kieffer, Jillian Savage, Courtney Nelson

Department of Pediatrics Faculty Papers

INTRODUCTION: The I-PASS handoff tool guides provider handoffs and reduces adverse events in the inpatient setting. Transitions of care occur frequently in the emergency department (ED), and the unpredictable environment can lead to less structured handoffs. Our goal was to increase the percentage of handoff notes that include all 4 I-PASS components by 20% within 6 months.

METHODS: We developed a handoff note template for the pediatric ED that included 4 key I-PASS elements: illness severity, patient care summary, action list, and situational awareness/contingency planning. Our primary outcome measure was the percentage of handoff notes that contained all 4 I-PASS …

Gender Differences In College Students’ Physical Activity Self-Efficacy, Social Comparison Beliefs, And External Frames Of Reference, Ken Murfay, Sarah Pyszczynski, Sarah Collins

International Journal of Physical Activity and Health

This study examined whom college-aged individuals believe observing would more likely increase their physical activity self-efficacy (PASE) for a physical skill, whom they are more likely to compare their abilities to within a physical education (PE) class, how often they compare themselves to others in PE, and what students’ PASE scores were. Based on the mean scores for each question, students were more likely to compare themselves to a student than a teacher, friend than a non-friend, and similar or higher skilled peer than a lower skilled peer. To increase students’ confidence for a physical skill, students had higher levels …

Association Between Children’S Secondhand Co-Exposure To Tobacco And Cannabis Smoke And Elevated Urinary Cotinine Levels: A Cross-Sectional Analysis, Bradley N. Collins, Stephen J. Lepore, Vincent Berardi, Renee D. Goodwin, Karen Wilson, Mona Baishya

Psychology Faculty Articles and Research

Background Cannabis use is far more common among adults who smoke tobacco than adults who do not, and its use is increasing among people who smoke tobacco with children living in the home. Given the well-established evidence that caregiver smoking is the primary source of children’s secondhand exposures to these products, the increasing trend in caregiver co-use is raising public health concerns about children’s co-exposure. Emerging data indicates that adult co-use is linked to additive health consequences, such as elevated nicotine and other tobacco-related toxicant blood levels, relative to use of only tobacco. It is unknown whether children’s co-exposure leads …

From Waitlist To Activation: Exploring Patient Barriers And Team Interactions In Kidney Transplant Readiness, Judith I. Eguzoikpe

Harrisburg University Dissertations and Theses

Kidney transplant candidates frequently experience prolonged inactive waitlist status due to incomplete readiness requirements, yet limited understanding exists regarding how patient barriers and team interactions intersect to influence activation timelines. This transcendental-phenomenological study explored how patient barriers and team dynamics contribute to delays in kidney transplant readiness, guided by Team Theory. Semi-structured interviews were conducted with 16 participants (8 patients, 8 healthcare professionals) between December 2025 and February 2026. Data were analyzed using systematic phenomenological methods to identify patterns that address patient barriers, team interaction effects, and the teamwork improvements needed for earlier activation. Five interconnected themes emerged: Navigating a …

A Transcriptional Program Associated With Neurotransmission In The Living Human Brain, Alexander W. Charney, Lora E. Liharska, Eric Vornholt, Alissa Valentine, Anina Lund, Alice Hashemi, Ryan C. Thompson, Terry Lohrenz, Jessica S. Johnson, Nicole Bussola, Esther Cheng, You Jeong Park, Salman Qasim, Alisha Aristel, Lillian Wilkins, Kimia Ziafat, Hannah Silk, Lisa M. Linares, Brendan Sullivan, Claudia Feng, Beniamino Hadj-Amar Ph.D.

Faculty Publications

At the foundation of neurotransmission, and by extension at the foundation of brain function, are coordinated programs of gene expression involving many thousands of genes. These programs are poorly defined in humans because most modern studies that characterize human brain gene expression use tissue obtained in the postmortem state when neurotransmission and brain function have ceased. Here, to advance knowledge of the gene expression programs at the foundation of neurotransmission in the human brain, gene expression was characterized in 130 prefrontal cortex (PFC) samples obtained from participants of the Living Brain Project (LBP) during neurosurgical procedures in conjunction with intracranial …

Survival On Image Regression With Application To Partially Functional Distributional Representation Of Physical Activity, Rahul Ghosal, Sunwoo Emma Cho, Marcos Matabuena

Faculty Publications

Technological advancements in wearable devices and medical imaging often lead to high-dimensional physiological signals in the form of images or surfaces. To address these data structures, we develop a novel survival on image regression model with a specific focus on partially functional distributional representation of wearable data. The existing approaches for functional data and survival outcomes have been primarily developed for uni-dimensional functional predictors. Drawing on recent developments in distributional data analysis, we model temporally varying distributional patterns of physical activity (PA) as a partially functional distributional predictor within a semiparametric Cox model framework. We use tensor product splines to …

Environmental Chemicals And Maternal Depression During And After Pregnancy: A Scoping Review, Pengfei Guo, Yunyue Shi, Cindy Nguyen, Haoran Zhuo, Tormod Rogne, Zeyan Liew

Faculty Publications

Purpose of Review

There is increasing evidence that several environmental exposures may pose a risk for depression, including maternal depression. We conducted a scoping review of epidemiological evidence regarding maternal exposure to environmental chemicals and perinatal depression.

Recent Findings

We searched PubMed, Embase, Web of Science, Dimensions, and Scopus, and summarized the findings from 27 articles that examined environmental chemical exposures and maternal depression. Studies of ambient air pollutants (N = 11) showed exposure to NO₂ and PM10 to be most consistently associated with antenatal or postnatal depression. Studies of endocrine-disrupting chemicals, including phthalates (n = 6), …

Cardiac Output-Guided Vs. Mean Arterial Pressure-Guided Hemodynamic Management In Craniotomy Patients With Cardiovascular Disease: A Randomized Trial, Na Chen, Minjing Yang, Renhua Li, Chunyan Ye, Lu Wang, Xingyang Liu, Jinghan Wu, Daniel I Sessler, E Wang

Faculty, Staff and Student Publications

We tested the primary hypothesis that cardiac output (CO)-guided versus mean arterial pressure (MAP)-guided hemodynamic management reduces the fraction of patients with 90-day Glasgow Outcome scores ≤ 4 (on a 1–5 scale, 5 better) after supratentorial brain tumor resections in adults with cardiovascular disease. 202 adults were randomized to intraoperative hemodynamic management guided by either CO or MAP. In patients assigned to CO guidance, clinicians targeted CO > 4 L/min and > 90% of baseline values using a combination of fluids and vasoactive agents. In patients assigned to MAP guidance, clinicians targeted MAP within ± 20% of baseline and ≥ 65 mmHg. …