Digital Commons Network^™

Women's Unique Health Needs And The Sustainable Development Goals: A Meeting Report From The 79th United Nations General Assembly Science Summit, Irene Aninye, Sarah Chew, Nicole Althaus, Michele Barry, Ru-Fong Cheng, Carolyn Harris, Eleanor Nwadinobi, Beth Battaglino, Aisha Brooks, Marleen Temmerman

Centre of Excellence in Women and Child Health

Biological sex, hormones, and gender uniquely affect health and disease, often resulting in disparities for women across the lifespan and from different racial and ethnic groups, geographical locations, and socio economic backgrounds. Without intentional investment and infrastructure to support good health and wellbeing for women,half of the world’s population remains vulnerable to preventable morbidity and mortality. The Society for Women’s Health Research and ECHAlliance–The Global Health Connector convened a women’s health programas part of the 10th Annual Science Summit during the United Nations 79th General Assembly. This hybrid event was held in New York, NY, (USA) and virtually in September …

Strategies And Considerations For Forming And Managing Community Advisory Boards From Health Research With Transgender And Nonbinary Communities, Mannat Malik, Anushka Aqil, Jennifer L. Glick, Jean Michel Brevelle, Anthony Black, Kellan Baker, Arjee Restar, Molly Gribbin, Colin Flynn, Danielle German

School of Public Health Faculty Publications

Purpose: There is limited research on the use of community advisory boards (CABs) in health research with transgender and nonbinary communities. Transgender communities are navigating challenging histories of health researcher exploitation and research distrust alongside exponential research growth. We explored strategies for forming and managing CABs when conducting transgender community-informed health research. Methods: We used purposive and snowball sampling to identify key informants (KIs): research leaders, implementing staff, and community partners engaging in transgender health research. Between October 2018 and December 2020, we conducted 30 semi-structured in-depth interviews. We used coding followed byiterative thematic analysis and memoing to identify themes. …

Policy Evaluation With Nonlinear Trended Outcomes: Covid-19 Vaccination Rates In The United States, Lynn Bergeland Morgan, Peter C. B. Phillips, Donggyu Sul

Research Collection School Of Economics

This paper discusses pitfalls in two way fixed effects (TWFE) regressions when the outcome variables contain nonlinear and possibly stochastic trend components. If a policy change shifts trend paths of outcome variables, TWFE estimation can distort results and invalidate inference, especially in a context of evolving policy decisions. A robust solution is proposed by allowing for dynamic club membership empirically using a relative convergence test procedure. The determinants of respective club memberships are assessed by panel ordered logit regressions. The approach allows for policy evolution and shifts in outcomes according to a convergence cluster framework with transitions over time and …

End User Experiences Of An Electronic Health Records Platform In A Tertiary Hospital System In Kenya, Anmol Shrestha, Jasmit Shah, Zamanali Khakhar, Armando Ruiz, Zohray Talib, Sayed Karar

Internal Medicine, East Africa

Background: Electronic Health Record (EHR) systems allow health care facilities to provide better care to patients and improve overall provider efficiency. They are vital for low-and middle-income countries in achieving the United Nations Sustainable Development Goal of ensuring healthy lives and promoting the well-being of all their citizens. This study aimed to evaluate perceptions and usage of a comprehensive EHR by end-users after its deployment into a tertiary hospital system and its outpatient centers in Kenya and also aimed to understand the effectiveness of various implementation strategies deployed by the institution during their implementation process.

Methods: We conducted …

Knowledge, Attitude And Practice Of Artificial Intelligence Among Healthcare Professionals: An Online Cross-Sectional Survey, Nikhil R, Divya K L, Mahabaleshwar Mamadapur, Harshwardhan S Patil, Shashirekha B, Hema Sameera Pinnam, Purna Bansal

Digital Journal of Clinical Medicine

Background: Deep learning-powered Artificial Intelligence-driven assistance offers enormous potential to improve healthcare by facilitating administrative work, diagnosis, and the treatment of chronic diseases. The gap between clinical values and the day-to-day realities of primary care practice might widen if AI is not successfully incorporated.

Methods: A cross-sectional design was used to evaluate healthcare professionals' perceptions and understanding of AI within a clinical setting. The study was conducted among 456 Health care Workers from May to November 2024.

Results: Among 456 participants, 55.7% were MBBS students/interns, and 37.9% were postgraduates/professionals. More than 50% supported AI integration, and 62.3% of MBBS …

Cardiogenic Shock With Acute Myocardial Infarction Among Older Adults In The United States, Taha Mansoor, Ali Bin Jabbar, Mahmoud Ismayl, Dylan Yu, Kartik Gupta, Sachin Parikh, Austin Brubaker, Abdul Minhas, Dmitry Abramov, Salim S. Virani

Population Health, East Africa

Background: Characteristics and outcomes associated with cardiogenic shock (CS) with acute myocardial infarction (AMI) in older patients have not been well characterized.

Objectives: The purpose of this study was to investigate characteristics and outcomes of older patients admitted with CS with AMI.

Methods: We used the National Inpatient Sample database to evaluate clinical characteristics of hospitalizations, clinical outcomes, and health care utilization of hospitalizations of older patients ≥80 years with CS and AMI from 2003 to 2021. We also compared data from older patients with a reference relatively younger patient population (18-79 years).

Results: During the study period, …

Induction Of An Early Ifn-Γ Cellular Response And High Plasma Levels Of Sdf-1Α Are Inversely Associated With Covid-19 Severity And Residence In Rural Areas In Kenyan Patients, Perpetual Wanjiku, Benedict Orindi, John Kimotho, Shahin Sayed, Reena Shah, Mansoor Saleh, Viviane Olouch, Ann Karanu, Jasmit Shah, Zaitun Nneka

Pathology, East Africa

Introduction COVID-19 was less severe in Sub-Saharan Africa (SSA) compared with Europe and North America. It is unclear whether these differences could be explained immunologically. Here we determined levels of ex vivo SARS-CoV-2 peptide-specific IFN-γ producing cells, and plasma cytokines and chemokines over the first month of COVID-19 diagnosis among Kenyan COVID-19 patients from urban and rural areas.

Methods Between June 2020 and August 2022, we recruited and longitudinally monitored 188 COVID-19 patients from two regions in Kenya, Nairobi (urban, n=152) and Kilifi (rural, n=36), with varying disease severity – severe, mild/moderate, and asymptomatic. IFN-γ secreting cells were enumerated at …

Secretogranin 2 Binds Lilrb4 Resulting In Immunosuppression, Xing Yang, Ryan Huang, Meng Fang, Yubo He, Jingjing Xie, Xiaoye Liu, Chengcheng Zhang, Qi Lou, Mi Deng, Wei Xiong, Cheryl Lewis, Zade Sadek, Ankit Gupta, Lianqi Chen, Xuewu Zhang, Lei Guo, Lin Xu, Ningyan Zhang, Zhiqiang An, Cheng Cheng Zhang

Faculty, Staff and Student Publications

Immunosuppressive myeloid cells are important in a variety of physiological and pathological contexts, including tumor development, but how hormones might regulate their activity is unclear. Secretogranins, a family of secretory proteins in endocrine and neuronal cells, are proposed to function as prohormones or hormones, but their specific receptors are unknown. Here we show that secretogranin 2 (SCG2), a granin family member, functionally interacts with leukocyte immunoglobulin-like receptor B4 (LILRB4) on monocytic cells. Tumor-derived SCG2 promotes tumor growth in myeloid-specific LILRB4 transgenic mice in a T cell-dependent manner, whereas SCG2 deficiency in host mice impairs tumor progression and reduces infiltration of …

Optimizing Initial Screening For Colorectal Cancer Detection With Adherence Behavior, Sarah Yini Gao, Yan He, Ruijie Zhang, Zhichao Zheng, Shao Wei Lam Lam, Emile Tan

Research Collection Lee Kong Chian School Of Business

Background: Two-stage screening programs are widely adopted for early colorectal cancer (CRC) detection, where individuals receiving positive outcomes in the first-stage (initial) test are recommended to undergo a second-stage test (colonoscopy) for further diagnosis. Methods: We study the initial test design—the selection of cutoffs for reporting test outcomes—to balance the trade-off between screening effectiveness (i.e., CRC and polyp detection) and efficiency (i.e., colonoscopy costs), incorporating the fact that not all individuals follow up with a colonoscopy after receiving positive outcomes. We integrate the Bayesian persuasion framework with information avoidance to model this problem and apply it to Singapore's CRC screening …

Curing The Peasant's Disease : Frank Oldt’S Work And Research On Hookworm Disease In South China, 1905-1926, Jiaying Fu

Lingnan Theses (MPhil & PhD)

While current scholarship on “hygienic modernity” in China focuses on the construction of urban health systems and institutional infrastructures, this study proposes an alternative analytical lens by foregrounding the domain of agricultural health. It aims to investigate how early twentieth-century medical researchers uncovered public health models grounded in China’s agrarian conditions. Taking the case of Frank Oldt (1879–1976), a medical missionary living in Guangdong between 1905 and 1926, this research examines how he identified, interpreted, and sought to mitigate the problem of hookworm disease—a parasitic condition intricately linked to China’s farming practices and rural environmental conditions.

Specifically, this thesis aims …

Occupational Exposure To Diesel Particulate Matter In Western Australian Mining: A Retrospective Analysis And Challenges To Future Compliance, Matthew Oosthuizen, Kerry Staples, Adelle Liebenberg, Kiam Padamsey, Marcus Cattani, Andy Mccarthy, Jacques Oosthuizen

Research outputs 2022 to 2026

De-identified diesel particulate matter (DPM) exposure data (n = 24,459) was obtained from the Western Australian mining regulator to assess compliance with the current Workplace Exposure Standard (WES) of 0.1 mg/m³, measured as submicron elemental carbon, and a proposed limit of 0.01 mg/m³, assessed as respirable elemental carbon. R and R-Studio were used to generate summary statistics comparing compliance to the current and proposed limits, stratified by industry and occupational groups. To examine temporal trends, a zero-adjusted gamma model was used to assess whether expected sample means changed over the past ten years, using commodity and …

Tissue-Specific Distribution Of Microplastics In Human Blood And Carotid Plaques: A Paired Sample Analysis, Cancan Cui, Zheng Guo, Yanxi Liu, Ning Han, Jiayin Song, Yuanmei Chen, Yulu Zheng, Chen Sheng, Lois Balmer, Haibin Li, Rui Liu, Lin Liu, Jianshi Du, Zhiyuan Wu

Research outputs 2022 to 2026

Backgrounds: Microplastics (MPs) have been increasingly detected in human tissues, raising concerns about their role in cardiovascular disease. However, their distribution in matched blood and vascular tissues, such as atherosclerotic plaques, remains poorly understood. Methods: Paired blood and carotid plaque samples were analyzed for 12 polymer types of MPs using pyrolysis–gas chromatography–mass spectrometry among twenty patients undergoing carotid endarterectomy. Results: The mean concentration of total MPs was 75.2 μg/g in blood and 432.9 μg/g in plaque. Polyethylene (PE) dominated blood samples (46.5 %), followed by polyvinyl chloride (PVC, 16.8 %) and styrene-butadiene rubber (SBR, 16.3 %). In plaques, MPs were …

Accordance And Conflict Between Religious And Scientific Precautions Against Covid-19 In 27 Societies, T. Samore, D.M.T. Fessler, A.M. Sparks, C. Holbrook, L. Aarøe, C.G. Baeza, M.T. Barbato, P. Barclay, R. Berniūnas, J. Contreras-Garduño, B. Costa-Neves, M.P. Grazioso, P. Elmas, P. Fedor, Li, Norman P., R. Fernández-Morales, L. Garcia-Marques, P. Giraldo-Perez, P. Gul, F. Habacht

Research Collection School of Social Sciences

Meaning-making systems underlie perceptions of the efficacy of threat-mitigating behaviors. Religion and science both offer threat mitigation, yet these meaning-making systems are often considered incompatible. Do such epistemological conflicts swamp the desire to employ diverse precautions against threats? Or do individuals—particularly individuals who are highly reactive to threats—hedge their bets by using multiple threat-mitigating practices despite their potential epistemological incompatibility? Complicating this question, perceptions of conflict between religion and science likely vary across cultures; likewise, pragmatic features of precautions prescribed by some religions make them incompatible with some scientifically-based precautions. The COVID-19 pandemic elicited diverse precautions thus providing an opportunity …

Public Support For And Reactive Behavior Toward Technological Risk Interventions: An Extension Of Secondary Risk Theory, Hye Kyung Kim, Rui Gu, Fiona Goh, Sonny Rosenthal, Shirley S. Ho

Research Collection College of Integrative Studies

Project Wolbachia is a dengue control initiative in Singapore. Guided by Secondary Risk Theory, this study examined how primary (dengue) and secondary (Wolbachia) threat and coping appraisals shape public support and reactive behavior toward the project. A nationally representative survey of 1,000 Singaporeans showed that support was positively linked to the perceived primary risk, the efficacy of the project and the government, while negatively related to the perceived secondary risk. Reactive behavior was positively associated with perceptions of both primary and secondary risk. Media attention and trust in the government indirectly influenced support and behavior moderated by knowledge.

Iot Sensors As A Tool For Assessing Spatiotemporal Risk To Extreme Heat, Kijin Seong, Seung Jun Choi, Junfeng Jiao

Research Collection College of Integrative Studies

The safety of urban populations sensitive to extreme heat is under increasing threat. Few studies examine the potential benefits of deploying IoT environmental sensors in the urban context and their integration with large-scale human activity data. This paper examines the deployment of IoT sensors in high-resolution extreme heat risk assessment in the case of Seoul, South Korea. This study conducted spatiotemporal analysis on heat exposure with IoT sensors, compared it with an existing land surface temperature map for validation, combined it with human activity data for risk assessment, and finally discussed the benefits of IoTs in detecting abnormal weather events. …

Old Frames On New Media: Health Misinformation In Black Digital Communities, Merriah Croston

Brown School Graduate Student Theses and Dissertations

Growing evidence suggests that health misinformation has the potential to proliferate on social media. However, our understanding of the problem’s magnitude continues to evolve. Despite several studies on health misinformation and Black communities in the United States (U.S.), few of these studies characterize misinformation within digital settings. This dissertation seeks to address this gap by: 1) synthesizing the literature on health misinformation and Black communities to identify prevalent misinformation topics and claims, characteristics of exposure to and belief in these topics and claims, and successful intervention strategies; 2) quantifying and characterizing the volume of COVID-19 misinformation on Black Twitter during …

The Blacker The Berry: Food Environments And Intake Associated With Perinatal Depression And Secondary Breastfeeding Outcomes Among Black Americans In The St. Louis Metropolitan Area, Najjuwah S. Walden

Brown School Graduate Student Theses and Dissertations

The relationship between the food environment, intake, and health is complex. The purpose of this study was to evaluate if food environments in proximity to Black pregnant women in the St. Louis Metropolitan Area were associated with prenatal eating habits and if these eating habits were associated with the risk of developing depressive symptoms in pregnancy and postpartum. The study also aimed to understand if there was a relationship between prenatal eating habits and the decision to breastfeed and if the onset of postpartum depressive symptoms has any effect on this relationship. Due to the importance of nutrient-dense, anti-inflammatory foods …

Three Versus Six Sessions Of Problem-Solving Training With Or Without Boosters For Care Partners Of Adults With Dementia (Cades): A Randomised Controlled Optimization Trial, Shannon B. Juengst, Alexandra Holland, Kristin Wilmoth, Matthew Lee Smith, Gang Han, Charlene Supnet-Bell, Chung Lin (Novelle) Kew, Alka Khera, Gladys Maestre

School of Medicine Publications

Background: Problem-Solving Training/Descubriendo Soluciones Juntos (PST/DSJ) can improve emotional consequences of caregiving. We assessed the number of sessions and boosters needed for reducing caregiver burden and depressive symptoms among Alzheimer's disease and related dementias (ADRD) care partners.

Methods: We conducted a randomised factorial-design trial of bilingual PST/DSJ among ADRD care partners (NCT04748666). Participants were randomly assigned (blocks of 8 stratified by language) to 3 PST/DSJ sessions with (n = 19) or without (n = 21) boosters or 6 PST/DSJ sessions with (n = 28) or without (n = 29) boosters. The Zarit Burden Interview measured caregiver burden and …

A Metabolomics Study Of Cardiac Dysfunction In Hyperglycemia: Findings From The Atherosclerosis Risk In Communities (Aric) Study And The Hispanic Community Health Study/Study Of Latinos (Hchs/Sol), Yilin Yoshida, Ngoc Quynh Nguyen, Eun Hye Moon, Casey Rebholz, Hicham Skali, Victoria Arthur, Justin B Echouffo-Tcheugui, Christie Ballantyne, Elizabeth Selvin, Amil Shah, Robert Kaplan, Carlos J Rodriguez, Qibin Qi, Susan Cheng, Bing Yu

Faculty, Staff and Student Publications

Objective: Hyperglycemic states (prediabetes and diabetes) are associated with heart failure (HF) risk. We aimed to identify distinct metabolites for subclinical cardiac dysfunction, a precursor of HF, in hyperglycemic or euglycemic individuals.

Research design and methods: We conducted cross-sectional and prospective analyses of 2,492 HF-free participants from the Atherosclerosis Risk in Communities (ARIC) study visit 5, 2011-2013. A total of 1,297 participants were hyperglycemic (assessed on the basis of hemoglobin A1c >5.7%, fasting glucose >100 mg/dL, use of diabetes medication, or diagnosis), and 1,195 were euglycemic. We used logistic regression for analysis of association between 790 metabolites and cardiac dysfunction, …

Comparative Effectiveness Of Less Vs More Frequent Hydrocortisone Dosing In Septic Shock, Alan Hao, Tianshi David Wu, Keegan Collins, Danielle Guffey, Rebecca Kessinger, Meghna Vallabh, Ali Omranian

Faculty, Staff and Students Publications

Objectives: Guidelines recommend hydrocortisone as an adjunctive treatment in septic shock, but the optimal dosing regimen is unknown. A national shortage of hydrocortisone in 2023 prompted a change in institutional practice for hydrocortisone administration from 50 mg every 6 hours to 100 mg every 12 hours in an effort to reduce waste and conserve vials, creating an opportunity to evaluate the comparative effectiveness of these two regimens. The primary efficacy outcome was time to shock resolution, and secondary outcomes evaluated in this study were mortality, renal replacement therapy (RRT), medication costs, and maximum vasopressor dose attained.

Design: Single-center, retrospective cohort …

Patient-Centered Management Of Heavy Menstrual Bleeding While On Anticoagulation: A Survey Study, Benjamin Barnett, Rushad Patell, Dana Angelini, Leben Tefera, Jordan K Schaefer, Ang Li, Alejandra Gutierrez Bernal, Shruti Chaturvedi, Anjlee Mahajan, Leslie Lake, Jori May, Anna L Parks

Faculty, Staff and Students Publications

Background: Nearly three-quarters of women experience heavy menstrual bleeding (HMB) during anticoagulation treatment for venous thromboembolism (VTE). HMB can lead to medical interventions, impact school or work and diminish quality of life (QOL). While there are several management options for HMB in patients with VTE, we lack information on how patients approach HMB treatment decisions.

Objectives: We examined patients' experience with, perceptions of, and preferences for treatment of HMB while on anticoagulation.

Methods: Clinicians and patient advocates developed a web-based survey that was distributed via patient advocacy organizations and social media between May and June 2024, targeting participants 18 years …

A Fascination With Gastrointestinal Viruses, Mary Kolb Estes

Faculty, Staff and Students Publications

My arrival into this world came quickly, according to my mother, and it feels like my life has mirrored that rapid beginning. I have enjoyed a rich, varied, and stimulating life and career that have gone through several phases. I credit genetics, my family, technological advances, and many environmental factors for shaping my career. Being a virologist allowed me to be curious and creative and to make several unexpected discoveries. This has been a fun and rewarding journey, but it wasn't always easy. I am not accustomed to talking about myself, but I am happy to share some scientific achievements …

The Role Of Serum Phosphate Control In Supporting Transplant Readiness In Patients On Dialysis, Laura A Williams, Stephen Z Fadem

Faculty, Staff and Students Publications

Chronic kidney disease affects over 36 million Americans, with more than 800,000 progressing to end-stage kidney disease (ESKD). Treatment with kidney transplantation offers superior survival, quality of life, and cost-effectiveness compared with dialysis, yet access remains limited. Hyperphosphatemia is a highly prevalent and modifiable complication of ESKD that contributes to cardiovascular disease, mineral bone disorder, and potential pulmonary dysfunction. Additionally, elevated serum phosphate has been linked to transplant graft failure and adverse post-transplant outcomes. Although normal phosphate levels are not formally required for transplant eligibility, they are frequently considered as part of transplant readiness assessments. Persistent gaps between clinical guideline …

Elephant Endotheliotropic Herpesvirus 2 Infection In 5 African Elephants (Loxodonta Africana) At Multiple North American Zoological Institutions, Taylor J Willis, Anne Burgdorf-Moisuk, Maren Connolly, Jan Raines, Cameron Ratliff, Zoltan S Gyimesi, Erica Lipanovich, Genevive A Dumonceaux, Kathryn L Perrin, Lauren L Howard, Matthew E Kinney, Kirk Suedmeyer, Erin Latimer, Tiffany L Kim, Jessica R Watts, Jie Tan, Paul Ling

Faculty, Staff and Students Publications

Objective: To acknowledge that elephant endotheliotropic herpesvirus (EEHV) is a well-recognized major threat to Asian elephants (Elephas maximus) and can cause acute and often fatal hemorrhagic disease (HD). Historically, EEHV-HD has been less frequently identified in African elephants (Loxodonta africana). This case series describes 5 recent cases of EEHV2 infection in African elephants within managed care at 5 North American institutions.

Animals: 5 African elephants (L africana).

Clinical presentation: The cases involved 4-, 7-, and 10-year-old males that died despite receiving aggressive medical therapy and 4- and 14-year-old females that survived. Clinical signs included lethargy, decreased appetite, lameness, changes in …

Evaluation Of A Novel Tc-24 Recombinant Antigen Elisa For Serologic Detection Of Trypanosoma Cruzi Infection In Dogs: A Pilot Study, Rojelio Mejia, Guilherme G Verocai, Ilana A Mosley, Ashley B Saunders, Bin Zhan, Lindsey Vongthavaravat, Rachel E Busselman, Sarah A Hamer

Faculty, Staff and Students Publications

Chagas disease, caused by the protozoan Trypanosoma cruzi, is a significant challenge for canine health, with limited diagnostic tools. This study assessed the performance of a novel Tc-24 recombinant antigen ELISA compared to three commercial diagnostic tests on 70 serum samples from kennel dogs in Texas. The Tc-24 ELISA demonstrated high sensitivity (87.5%) and specificity (91.2%) compared to Indirect Fluorescent Antibody (IFA) testing, with significant differences in Tc-24 optical density (OD) between positives and negatives (0.607 vs. 0.089, p < 0.001). When compared to Chagas Stat-Pak (SP), Tc-24 ELISA showed sensitivity and specificity values of 82.1% and 86.7%, respectively (p < 0.001). For Chagas Detect Plus (IB), the assay achieved a sensitivity of 80.0% and specificity of 93.1% (p < 0.001). Spearman correlation analysis revealed significant associations between Tc-24 OD and SP (r = 1.0, p = 0.0167), IB (r = 0.9, p = 0.0833) and IFA (r = 0.6273, p = 0.044). Elevated immunochromatographic values in commercial kits (SP or IB) correlated with Tc-24 OD (1.17 vs. 0.039, p < 0.001), achieving 100% sensitivity and 95.8% specificity based on positive results from commercial kits. These findings suggest that Tc-24 ELISA is a reliable and accurate serological tool for diagnosing T. cruzi infection in dogs, with the potential to enhance diagnostic capabilities in veterinary medicine.

Access To Information On Toddler Family Development Program And Family Participation In Child Growth And Development, Dita Dhammayanti, Demsa Simbolon, Lissa Ervina, Yusran Fauzi

Kesmas

The comprehension of the Toddler Family Development (TFD) Program among families in Indonesia remains limited, likely due to insufficient access to information and low participation rates. Limited participation can negatively affect a family’s ability to support optimal child growth and development. This study examined the relationship between access to information on the TFD Program and family participation in child growth and development. Using secondary data from the 2019 Program Performance and Accountability Survey in Indonesia, the cross-sectional analysis included 21,497 respondents. The results revealed an association between access to information on the TFD Program and family participation in child growth …

Potential Biological Hazards In Health Clinics: Key Strategies For Enhancing Worker Safety In Malaysia, Subki Ahmad, Normah Awang, Ermie Abdull Hamid, Anuar Ithnin, Nurul Farahana Kamaludin, Noraizah Muhd Nor

Makara Journal of Health Research

Background: Biological hazards in health clinics may lead to acute or chronic health issues for healthcare workers. This study aims to identify potential biological hazards within health clinics, with a focus on the knowledge, attitude, and practice (KAP) of healthcare workers, in order to improve their safety.

Methods: Samples from environmental surfaces were collected and cultured to identify bacterial pathogens. A cross-sectional study involving 203 healthcare workers was conducted using a questionnaire derived from CDC-adapted guidelines. Descriptive analysis and multivariate regression were used to assess KAP.

Results: Bacterial growth was observed in all clinics. The Kruskal-Wallis Test …

Enhancing Patient Outcomes: Developing A Comprehensive Database For Tracking Post- Dural Puncture Headache Incidence And Contributing Factors, Meredith B. Auge, Brittany Bogonovich

Doctor of Nurse Anesthesia Practice (DNAP) Manuscripts

Post-dural puncture headache (PDPH) is a debilitating complication following labor analgesia, often resulting from unintentional dural puncture (UDP). While national incidence is approximately 1.5%, institutional rates may vary due to provider experience, documentation practices, and patient factors. This Doctor of Nurse Anesthesia Practice (DNAP) quality improvement project aimed to improve identification and monitoring of UDP and PDPH through a revised tracking tool, retrospective review of 2024 data, and planning for an electronic registry. A multidisciplinary team of anesthesiologists, Certified Registered Nurse Anesthetists (CRNAs), Student Registered Nurse Anesthetists (SRNAs), and IT and quality specialists revised an existing tracking tool to better …

Improved Obstetric Hemorrhage Care Through Toolkit Revision: A Quality Improvement Project, Samantha Kalkstein, Amber Woodring

Doctor of Nurse Anesthesia Practice (DNAP) Manuscripts

Obstetric hemorrhage (OBH) remains a leading cause of preventable maternal morbidity and mortality in the United States. Accurate risk identification is critical for initiating timely interventions; however, current risk assessment practices vary significantly. This quality improvement (QI) project aimed to implement the California Maternal Quality Care Collaborative (CMQCC) OBH Risk Assessment Tool on the labor and delivery (L&D) unit of a community-based hospital to standardize risk stratification and improve interdisciplinary communication. Guided by the Johns Hopkins Nursing Evidence-Based Practice model, the project involved a gap analysis, staff education, and the introduction of a paper-based CMQCC tool formatted for visibility and …

Towards A New Health Politics In Kenya: Labor Organizing And Strikes By Health Workers In The Public Health Sector, Michael Scanlon

Graduate Doctoral Dissertations

There has been insufficient attention by global health scholars to labor organizing by health workers, including when and why organizing occurs, what forms and strategies it takes and its implications for governance and policy. These questions are critical but largely absent in research on what has been called the “global health workforce crisis.” Kenya represents an important case study. A new constitution in 2010 expanded institutional spaces for labor organizing and decentralized governance of the health system. Both reforms had significant implications for the health workforce and strikes by health workers have been pervasive. In 2017, nationwide strikes by public …