Digital Commons Network^™

Pediatric Diarrhea Patients Living In Urban Areas Have A Higher Incidence Of Clostridioides Difficile Infection, Ayodele T Adesoji, Osaro Mgbere, Charles Darkoh

Faculty, Staff and Student Publications

Clostridioides difficile infection (CDI) is a major cause of antibiotic-associated diarrhea and an unappreciated contributor to child mortality in low- and middle-income countries where the diagnosis may be difficult. There is little information about the prevalence of CDI among infants, children, and adolescents in Africa. Using a cross-sectional design, seventy-six samples were collected from pediatric patients presenting with diarrhea, including infants (≤ 2 years old), children (2-12 years), and adolescents (13 ≤17 years) from three hospitals between January and December 2019. Demographic data, medical history, and prior antibiotic use were recorded. Toxigenic culture and PCR were used to detect and …

Population-Based Assessment Of The Burden Of Covid-19 Infection In African Countries: A First-Year Report Card And Public Health Implications, Osaro Mgbere, Ogbonna Collins Nwabuko, Olajumoke A Olateju, Omolola E Adepoju, Winston Liaw, Charles Darkoh, Ekere James Essien

Faculty, Staff and Student Publications

BACKGROUND: The COVID-19 pandemic constitutes a global health threat and poses a major burden on the African continent. We assessed the real-world burden of COVID-19 infection in African Union (AU) member states to determine the distributional patterns of epidemiological measures during the first 1 year of the pandemic.

METHODS: This retrospective cross-sectional study utilized COVID-19 data from publicly available data repositories of the African Center for Disease Control and Prevention and

RESULTS: A total of 3.21 million cases were reported during the 1-year period, with 2.6 million recoveries, 536,784 cases remaining active, and 77,486 deaths. Most countries (49.1%,

CONCLUSION: Understanding …

The Nih-Moderna Vaccine: Public Science, Private Profit, And Lessons For The Future, Christopher J. Morten

Faculty Scholarship

This commentary highlights the scientific history of the NIH-Moderna COVID-19 vaccine and corroborates Sarpatwari’s theme of private capture of value created by the public. The commentary also identifies missteps by the Trump and Biden Administrations and offers policy recommendations: better contracts with and incentives for pharmaceutical manufacturers and a not-for-profit “public option” for pharmaceutical development.

Fostering A High-Functioning Team In Cancer Care Using The 4r Oncology Model: Assessment In A Large Health System And A Blueprint For Other Institutions, Raymond Liu, Christine B Weldon, Elizabeth Linehan, Nancy Gordon, Thea Abbe, Marti Hennings, Henie James, Jed Katzel, Chun Ng, Megumi Tomita, Jeffrey B Velotta, Stephanie Ossowski, Lori C Sakoda, Sharon Likely Sprague, Anna Dowling, Kimberly Beringer, Arliene Ravelo, Elaine Yu, Julia R Trosman

Faculty, Staff and Student Publications

PURPOSE: Delivering cancer care by high-functioning multidisciplinary teams promises to address care fragmentation, which threatens care quality, affects patient outcomes, and strains the oncology workforce. We assessed whether the 4R Oncology model for team-based interdependent care delivery and patient self-management affected team functioning in a large community-based health system.

METHODS: 4R was deployed at four locations in breast and lung cancers and assessed along four characteristics of high-functioning teams: recognition as a team internally and externally; commitment to an explicit shared goal; enablement of interdependent work to achieve the goal; and engagement in regular reflection to adapt objectives and processes. …

Evaluation Of Scrub Typhus Surveillance, Alwar District, Rajasthan, India, July-August 2020, Surendra M Prajapati, Kanica Kaushal, Simmi Tiwari, Ajit Shewale, Tushar Nale, Tanzin Dikid

Faculty, Staff and Student Publications

INTRODUCTION: Scrub typhus is one of the most underreported and fatal illnesses accounting for 23% of all febrile illness. Rajasthan reported cases during 2018-2019 in state reporting system but did not report any case to central Integrated Disease Surveillance Programme (IDSP) unit. We evaluated the Scrub typhus surveillance system in Alwar district, Rajasthan, with the objective of describing and evaluating the system and providing evidence-based recommendations to identify gaps.

MATERIAL AND METHODS: In cross-sectional study, we reviewed records and conducted key informant interviews at district- and block-level health facilities. Using US Centers for Disease Control guidelines, we evaluated the system …

A Student-Designed Multimodal Sex- And Gender-Based Women's Health Elective Program: Advocacy Curriculum For Medical Students, Lauren M Conroy, Danna Ghafir, Maitreyi Narayan, Hunter Mcspedden, Samuel Neher, S Shahrukh Hashmi, Rebecca Lunstroth

Faculty, Staff and Student Publications

OBJECTIVES: The objective of this article is to describe the design and implementation of a multimodal, student-driven, sex- and gender-based women's health (SGBWH) elective with a curricular focus on patient and legislative advocacy. In this single arm, pre/post design, interventional study, we detail and evaluate the use of social media, newsletters, and round-table discussions in conjunction with a traditional lecture-based educational format to engage medical students in a virtual learning environment.

METHODS: We developed a 22-week SGBWH curriculum for pre-clinical and clinical medical students, which included a series of lectures on multi-specialty and gender-inclusive topics related to SGBWH, small group …

Trem-1, Trem-2 And Their Association With Disease Severity In Patients With Covid-19, Ruyue Fan, Zuowang Cheng, Zhisheng Huang, Ying Yang, Na Sun, Bin Hu, Peibin Hou, Bo Liu, Chuanjun Huang, Shuai Liu

Faculty, Staff and Student Publications

BACKGROUND: Delayed diagnosis and inadequate treatment caused by limited biomarkers are associated with the outcomes of COVID-19 patients. It is necessary to identify other promising biomarkers and candidate targets for defining dysregulated inflammatory states.

METHODS: The triggering receptors expressed on myeloid cell (TREM)-1 and TREM-2 expression from hospitalized COVID-19 patients were characterized using ELISA and flow cytometry, respectively. Their correlation with disease severity and contrast with the main clinical indicators were evaluated.

RESULTS: Increased expression of soluble TREM-1 and TREM-2 in the plasma of COVID-19 patients was found compared to the control group. Moreover, membrane-bound TREM-1 and TREM-2 expression was …

A Comparison By Ethnicity Of Usage Of Medication, Intubation Use, And Mortality Rates Of Covid-19 Patients In An Urban Hospital, Howard Rubin Baruch

Walden Dissertations and Doctoral Studies

Evidence from an urban hospital initially revealed that ethnicity had no bearing on treatment modalities or mortality among patients admitted and diagnosed with COVID-19 symptoms from January 1, 2020 to January 1, 2021. The purpose of this study was focused on answering three principal research questions concerning evidence at one hospital of differences in medication used, whether intubation was used, and mortality by ethnicity for those treated for COVID-19 while controlling for age, gender, and co-morbidities. The health belief model served as the theoretical framework. Data was collected from 1188 patient charts, and binary logistic regression was used to test …

Tuberculosis-Associated Knowledge, Stigma, And Health Seeking Behavior Among Traders In Onitsha Main Market, Anambra State, Nigeria, Benedeth N. Ezeosim

Walden Dissertations and Doctoral Studies

The utilization of tuberculosis (TB) health care services in a Nigerian state has not been optimal. Many residents do not utilize available health care resources when they experience symptoms of TB. Although much is known about the determinants of health seeking behavior (HSB), there is a gap on how TB knowledge and TB related stigma among traders in one main market contribute to HSB. This study examined the effect of TB knowledge and TB related stigma on HSB among traders. The health stigma and discrimination and health belif models served as the theoretical foundation. A quantitative cross-sectional analytical survey design …

Evaluation Of Recovery Level And Surgical Site Infection For Hip Replacement Surgeries, Misha Foster

Walden Dissertations and Doctoral Studies

Surgical site infection (SSI) is one of the most common healthcare associated infections and is a major cause of morbidity and mortality. Existing studies have focused primarily on perioperative intervention strategies to reduce infection risks following total joint replacement (TJA) procedures. However, postoperative (post-op) SSI risk factors may account for a significant percentage of hospital readmissions due to infections at the surgical site. Therefore, the purpose of this study was to examine the association between post-op recovery level and SSI among patients who underwent primary hip arthroplasty procedures. Using the social ecological model, which conceptualizes health broadly and focuses on …

A Comparison By Ethnicity Of Usage Of Medication, Intubation Use, And Mortality Rates Of Covid-19 Patients In An Urban Hospital, Howard Rubin Baruch

Walden Dissertations and Doctoral Studies

Evidence from an urban hospital initially revealed that ethnicity had no bearing on treatment modalities or mortality among patients admitted and diagnosed with COVID-19 symptoms from January 1, 2020 to January 1, 2021. The purpose of this study was focused on answering three principal research questions concerning evidence at one hospital of differences in medication used, whether intubation was used, and mortality by ethnicity for those treated for COVID-19 while controlling for age, gender, and co-morbidities. The health belief model served as the theoretical framework. Data was collected from 1188 patient charts, and binary logistic regression was used to test …

A Real-Time Infodemiology Study On Public Interest In Mpox (Monkeypox) Following The World Health Organization Global Public Health Emergency Declaration, Akshaya Srikanth Bhagavathula, Jacques E. Raubenheimer

Health, Human Performance and Recreation Faculty Publications and Presentations

Google Trends (GT) is a useful real-time surveillance tool for epidemic outbreaks such as monkeypox (Mpox). GT provides hour-by-hour (real-time) data for the last seven days of Google searches. Non-real-time data are a random sample that encompasses search trends from 2004 and up to 72 h. Google Health Trends (GHT) API extracts daily raw search probabilities relative to the time period and size of the underlying population. However, little is known about the utility of GT real-time surveillance and GHT API following the public health announcements. Thus, this study aimed to analyzed Mpox GT real-time, non-real-time, and GHT API data …

Experiences Of Older Adults With Hiv/Aids Enrolled In Case Management Programs In Northwest Indiana, Antoinette Cardenas

Walden Dissertations and Doctoral Studies

AbstractIn 2016, more than half of those infected with HIV/AIDS were age 50 years or older. Since the introduction of antiretroviral therapy, the survival rate of HIV patients has been on the rise with a predicted increase by 2030, but this has also contributed to early onset of comorbidities such as cardiovascular disease, osteoporosis, and kidney failure. The purpose of this generic qualitative study, driven by ecological systems theory, was to explore the experiences of older adults (age 50 and older) with HIV/AIDS who were enrolled in case management programs in Northwest Indiana. Data were collected from semi structured interviews …

Extreme Temperatures And Sickness Absence In The Mediterranean Province Of Barcelona: An Occupational Health Issue, Mireia Utzet, Amaya Ayala-Garcia, Fernando G Benavides, Xavier Basagaña

Faculty, Staff and Student Publications

OBJECTIVES: This study aims to assess the association between daily temperature and sickness absence episodes in the Mediterranean province of Barcelona between 2012 and 2015, according to sociodemographic and occupational characteristics.

METHODS: Ecological study of a sample of salaried workers affiliated to the Spanish social security, resident in Barcelona province between 2012 and 2015. The association between daily mean temperature and risk of new sickness absence episodes was estimated with distributed lag non-linear models. The lag effect up to 1 week was considered. Analyses were repeated separately by sex, age groups, occupational category, economic sector and medical diagnosis groups of …

Association Of Income, Education, Employment And Covid-19 Mortality In Brazil, Marcelina Machado

Walden Dissertations and Doctoral Studies

The increased mortality rates from COVID-19 in Brazil have adversely affectedvulnerable populations and placed a severe burden on its public health system as compared to other nations. Focusing on socioeconomic status as a risk factor in this retrospective cohort study, I investigated the association between Brazilian COVID-19 mortality rate, income, school enrollment rate, and employment rate after controlling for the demographics and immunization rate. This is an important issue as an increase in incidence and mortality rates affects how governmental and public health leaders can effectively control and prevent disease spread. Using the fundamental causes of disease theory as the …

The Relationship Between Chlamydia, Gonorrhea, Syphilis And Race, Gender, And Age, Johnny James Mcgrew

Walden Dissertations and Doctoral Studies

The purpose of this quantitative correlational design using secondary data from Colorado Department of Public Health and Environment was to examine the relationship between different types of sexually transmitted infections (STIs), specifically, chlamydia, gonorrhea, and syphilis, and race, gender, and age in the United States. This study is significant because it could assist medical personnel to focus on more personally-based STI treatments. This study could also lead to a call for more research regarding sexual health programs across the nation, individuals’ willingness to share personal information regarding STIs, and how sexual health programs could increase testing for STIs. The study …

Optimizing Sample Collection And Data Interpretation For Effective Wastewater-Based Epidemiology In Combined Sewer Systems, Christopher Allen Anderson

Graduate Theses, Dissertations, and Problem Reports (ETD)

COVID-19 has spurred growth in the science surrounding wastewater-based epidemiology (WBE) pertaining to the detection of severe acute respiratory virus 2 (SARS-CoV-2) in waste streams as an early warning signal for public health. However, the highly variable wastewater environment has made it difficult to standardize an approach for sampling and analysis, especially in locations using combined sewer infrastructure. This study addresses knowledge gaps of WBE via three specific aims: (1) to compare diurnal fluctuations of SARS-CoV-2 and the human fecal indicator, pepper mild mottle virus (PMMoV) in wastewater treatment plant (WWTP) influent samples collected during dry versus wet weather conditions; …

Risk Factors Of Human Papillomavirus Positive Oropharyngeal Cancer In Men, Kentress Davison

Walden Dissertations and Doctoral Studies

The human papillomavirus (HPV) is a leading domestic and global sexually transmitted disease. The purpose of this secondary quantitative, cross-sectional study is to investigate if there is an relationship between the rate of oral HPV-oropharyngeal squamous cell carcinoma (OPSCC) and race, exposure to smoking cigarettes (tobacco), risky sexual behavior, and participation in oral sex of male-to-male contact vs. male-to-female contact. The social cognitive theory grounded this study. The University of Alabama at Birmingham cancer database population supplied the study’s sample size of 337 males greater than 18 years of age with a diagnosis of OPSCC. I conducted descriptive analyses using …

Association Of Income, Education, Employment And Covid-19 Mortality In Brazil, Marcelina Machado

Walden Dissertations and Doctoral Studies

The increased mortality rates from COVID-19 in Brazil have adversely affectedvulnerable populations and placed a severe burden on its public health system as compared to other nations. Focusing on socioeconomic status as a risk factor in this retrospective cohort study, I investigated the association between Brazilian COVID-19 mortality rate, income, school enrollment rate, and employment rate after controlling for the demographics and immunization rate. This is an important issue as an increase in incidence and mortality rates affects how governmental and public health leaders can effectively control and prevent disease spread. Using the fundamental causes of disease theory as the …

Risk Factors Influencing Poliomyelitis Seroprevalence In Polio High Risk Areas Of Afghanistan, Wasan Abdulaziz Al-Tamimi

Walden Dissertations and Doctoral Studies

Afghanistan is one of the remaining polio endemic countries in the world. Nearly one million children under 5 years of age have missed polio vaccination in Afghanistan from May 2018 until January 2021. This quantitative study used the socioecological model as the theoretical framework and secondary data analysis of the 2020 polio serosurvey (N = 1384) to investigate various risk factors such as gender, parental education, family origin (language/location), wealth, distance to nearest health facility, and number of polio vaccine doses on the level of antibodies (i.e., seroprevalence) against all three types of polioviruses in children of two age groups, …

Study Of Barrier Face Coverings And Respirator Exhalation Filtration Efficiency And Exhaled Air Velocity During Wear, Weihua Yang

Graduate Theses, Dissertations, and Problem Reports (ETD)

This study aimed to assess the effectiveness of different types of respiratory protection, including National Institute for Occupational Safety and Health (NIOSH) Approved respirators and surgical masks in healthcare settings, as well as barrier face coverings (BFCs) used by the public as source control. The assessment was based on three components: total outward leakage (TOL), particle size distribution, and exhalation airflow velocity. To achieve this, the study utilized headform testing systems to measure TOL and airflow velocity. Specifically, a hard surface headform was used for NIOSH Approved respirators and surgical masks, while two soft surface headforms of different sizes were …

Issues Encountered By Parents In Continuing School-Based Obesity Prevention Programs At Home, Prenu Skaria

Walden Dissertations and Doctoral Studies

Childhood obesity is a public health problem that can lead to various chronic health diseases such as cardiovascular disease and diabetes later in life. School-based obesity prevention programs are a public health recommendation to reduce and prevent obesity in schools through increased physical activity and better nutritional habits. This qualitative research involved exploring the reason for the discontinuation of school-based interventions at home using multi-theory model (MTM) constructs for health behavior change. A convenience sample of three focus groups of consenting parents whose children participated in the Wolf Pack Coaches Challenge (WPCC), a school-based obesity prevention program in Nevada, was …

Laboratory Practices And Antimicrobial Resistance In A Florida Hospital, Crispina Marie Sy-Trias

Walden Dissertations and Doctoral Studies

Antibiotic resistance is a health threat affecting millions of Americans. Microorganisms develop resistance to antibiotics, rendering them useless for treating infections. The purpose of this quantitative study was to assess the associations between sample processing time and antibiotic resistance and is based on the health belief model. A retrospective specimen tracking activity of data from November 2019 to November 2020 was obtained by random sampling of 246 bacterial cultures. One hundred ninety-six (80%) samples were processed on time, and 50 (20%) were delayed; 167 (68%) samples were determined to have the presence of antimicrobial resistance (AMR), and 79 (32%) with …

Community Perceptions Of Syringe Service Programs In Charleston, West Virginia: A Qualitative Socioecological Perspective, Kenya M. Burton

Walden Dissertations and Doctoral Studies

In rural areas of the United States, people who inject drugs (PWID) experience an array of obstacles to accessing adequate healthcare. Locations with high rates of drug use normally offer more healthcare options, including needle exchange programs but, in some communities, there is resistance to providing this kind of care. This increases mortality, morbidity, cost, and adds to the stigma experienced by this vulnerable group. The experiences of people with substance dependency, including PWID, has been widely explored throughout studies that reflect a need for increased support. However, the perspectives of the community, especially in rural areas, though equally important, …

Internal Population Displacement And Vaccination Completion, Malnutrition, And Respiratory Infections Among Children In The Central African Republic, Francois Xavier Batalingaya

Walden Dissertations and Doctoral Studies

Forced displacement in fragile and conflict-affected countries has the potential to disrupt access to basic primary healthcare services such as immunization. The purpose of this study was to assess the association between internal population displacement and vaccination completion, malnutrition, and acute respiratory infections (ARIs) while controlling for maternal characteristics of wealth index, education level, and residence status in the Central African Republic. The socioecological model underpinned this cross-sectional study that used a secondary dataset collected in 2018 – 2019 and maintained by UNICEF. Descriptive statistics and logistic regression tests were used to analyze the data. The findings of this study …

The Application Of Time Series Analysis To Injury Epidemiology Data, Eric Wayne Lundstrom

Graduate Theses, Dissertations, and Problem Reports (ETD)

Introduction: Injury fatality rates in the United States (US) decreased throughout the majority of the 20th century, mostly due to declining rates of occupational and motor vehicle injuries. However, near the beginning of the 21st century, fatal injury rates in the US began to increase. This is principally due to the nation’s opioid epidemic, which has been characterized by different epidemic “waves”, each driven by overdoses associated with specific substances. Given the temporally dynamic nature of US injury trends, this study aimed to explore the application of time series analysis to injury data in the US. First, rates of non-fatal …

Anxiety Risk Factors And Social Isolation Among Young Adults, Jennifer Clancy

Walden Dissertations and Doctoral Studies

The COVID-19 pandemic is a public health concern that impacted the world. Increased feelings of loneliness and social isolation during the pandemic were reported to be associated with those seeking help for symptoms of anxiety and depression. Though symptoms of anxiety have been associated with social isolation, research is limited on the association between the anxiety risk factors and social isolation among young adults in the United States. Using the socioecological model, the association between social isolation (dependent variable) with financial stress, health anxiety, and perceived impact of COVID-19 (independent variable), and the influence of gender, race, and household status …

Real-World Experience With Cefiderocol Therapy For Pseudomonas Aeruginosa And Other Multidrug Resistant Gram-Negative Infections Within The Veterans Health Administration, 2019–2022, Andrew Chou, David Ramsey, Eva Amenta, Barbara W Trautner

Faculty, Staff and Students Publications

OBJECTIVE: Single-center and regional studies have reported outcomes after treatment with cefiderocol, a novel siderophore cephalosporin. We report on real-world use, clinical outcomes, and microbiological outcomes with cefiderocol therapy within the Veterans' Health Administration (VHA).

DESIGN: Prospective, observational descriptive study.

SETTING: Veterans' Health Administration, 132 sites across the United States, during 2019-2022.

PATIENTS: This study included patients admitted to any VHA medical center who received cefiderocol for ≥2 days.

METHODS: Data were obtained from the VHA Corporate Data Warehouse and through manual chart review. We extracted clinical and microbiologic characteristics and outcomes.

RESULTS: In total, 8,763,652 patients received 1,142,940,842 prescriptions …

Bacteriuria In Older Adults Triggers Confusion In Healthcare Providers: A Mindful Pause To Treat The Worry, Eva M Amenta, Robin L P Jump, Barbara W Trautner

Faculty, Staff and Students Publications

The evidence base for refraining from screening for or treating asymptomatic bacteriuria (ASB) in older adults is strong, but both practices remain prevalent. Clinical confusion over how to respond to a change from baseline, when to order a urinalysis and urine culture, and what to do with a positive urine culture fuels unnecessary antibiotic use for ASB. If the provider can take a mindful pause to apply evidenced-based assessment tools, the resulting increased clarity in how to manage the situation can reduce overtreatment of ASB.

The Small Intestinal Microbiome: Vibing With Intestinal Stem Cells, Victoria Poplaski, Faith Sawyer, Sarah E Blutt

Faculty, Staff and Students Publications

The epithelial lining of the small intestine mediates its absorptive and secretory function and thus is a critical component of human health. Regeneration and renewal of the epithelium is the result of proliferation of intestinal stem cells (ISCs). Many cell types and molecular factors are known to regulate the ability of ISCs to proliferate, including adjacent neighboring epithelial cells and the underlying, supportive stromal cells. The microbiome resides in the lumen of the small intestine and is in close contact with the epithelium. Due to its proximity to ISCs, it has been hypothesized that species within the microbiome have the …