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The Role Of Horizontal Gene Transfer In Antibiotic Resistance Amidst Prevalent Community And Healthcare-Associated Mrsa Rates, Gabrielle Nascimento

Honors College Theses

In recent decades, cases of community-acquired MRSA (CA-MRSA) and healthcare-associated MRSA (HA-MRSA) have been on the rise. The ability of antibiotic resistance to transfer between microorganisms greatly expands its threat to the effective treatment and containment of bacterial infections. The mecA gene is found on a mobile cassette within the Staphylococcal cell and encodes for PBP2a, an alternate version of penicillin-binding protein (PBP) with less binding affinity for β-lactam antibiotics, increasing resistance to the effects of antibiotics. The goal of this research is to investigate the horizontal transfer of the mecA gene between various Staphylococcus species as well as to …

A Case Study In Program Evaluation, Kaitlyn E. Lee

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

This capstone project evaluates a fictious online MRSA education program developed by the Lexington-Fayette County Health Department and Fayette County Public Schools after a suspected outbreak among student athletes. Using the CDC’s 6-Step Framework for Program Evaluation, the project focuses on how stakeholders were engaged, how the program was described and mapped, how the evaluation questions were developed, what evidence was collected, and how conclusions were formed. The goal of the evaluation is to understand whether the program’s structure, delivery, and implementation support clear infection-control education for the different school personnel who use it. This project emphasizes the overall evaluation …

Cause Of Death? -- It's Probably Not What's Reported On The Death Certificate, Lauren R. Roth

Lewis & Clark Law Review

In the age of big data, this country has a data problem—inaccurate and incomplete information in death certificates. The problem has long been hidden by the numbers reported—as have the people whose deaths go uncounted, but the COVID-19 pandemic unveiled the scope of the issue. Since the beginning of the pandemic, “excess deaths” (i.e., any deaths above the number predicted by existing mortality models) have increased significantly. Most of these excess deaths are likely attributable to COVID-19 because the decedent was never tested for COVID-19 or it was one of multiple factors contributing to their death. Other deaths are uncounted …

Rwanda's Natural Remedies: A Fresh Look At The Fight Against Malaria, Leandre Nsabimana Ndisanze

Pomona Senior Theses

Malaria remains one of the most devastating parasitic diseases globally, disproportionately affecting sub-Saharan Africa, where Rwanda continues to face high transmission rates and rising resistance to conventional interventions. Despite decades of control efforts, the emergence of drug-resistant Plasmodium falciparum and insecticide-resistant Anopheles mosquitoes threatens to reverse recent gains. This research responds to the urgent need for sustainable and culturally relevant alternatives by exploring the therapeutic potential of Rwandan traditional medicinal plants. These indigenous remedies, long used by local healers, offer an underexplored reservoir of bioactive compounds that may provide the basis for novel antimalarial drugs.

The central hypothesis of this …

Birthing While Black: The Color Of Care And Black Women’S Lived Experiences Giving Birth In The United States, Portia Cowlings

Theses and Dissertations

Black women in the United States face disproportionate maternal health outcomes during pregnancy, childbirth, and postpartum compared to other racial and ethnic groups. Despite advancements in healthcare, the United States continues to report the highest maternal mortality rates among high-income developed nations, with Black women experiencing rates up to three times higher than their White counterparts. This phenomenological study explores the lived experiences of Black women in the United States to understand how they navigate the continuum of maternal healthcare, from preconception through postpartum. Guided by the social determinants of health (SDOH) theoretical framework, childbirth was examined through four interconnected …

The Effects Of Medical Misinformation About Vaccines On Parents Of Pediatric Patients, Mya Izabela B. Emelia

Nursing | Student Research Posters

No abstract provided.

The Impacts Of Dietary And Educational Intervention In Addressing Adult Obesity In The Mexican Population, Matthew C. Servin

CMC Senior Theses

Mexico’s obesity epidemic has been an ongoing issue for the past few decades, with multiple studies attributing this to the disparities in accessing healthy food and health education. Designing a solution to Mexico’s adult obesity crisis will focus on studying the effects of an intervention plan that addresses these obesogenic factors. This proposed study will assess how a token system and health education sessions may impact the risk of obesity in the adult Mexican population. This study also will consider any limitations that arise when only one of the two intervention methods are used. As these interventions are implemented over …

Analisis Situasi Masalah Penyakit Infeksi Menular Seksual Di Kota Bogor Tahun 2024, Wardiman Wardiman, Ratna Djuwita, Bai Kusnadi

Jurnal Epidemiologi Kesehatan Indonesia

Abstrak

Infeksi menular seksual (IMS) masih menjadi tantangan kesehatan global, termasuk di Indonesia, terutama pada kelompok usia produktif 15-49 tahun. Di Kota Bogor, angka kasus IMS mengalami peningkatan, namum belum sepenuhnya menggambarkan kondisi yang sebenarnya. Penelitian ini bertujuan untuk menganalisis situasi IMS secara mendalam dan menetapkan prioritas masalah kesehatan menggunakan metode PAHO-adapted Hanlon, yang mengacu pada pembobotan Basic Priority Rating (BPR) berdasarkan lima kriteria utama, yaitu, A=Masalah utama; B=Keseriusan masalah; C=Efektivitas intervensi; E=Ketidakadilan; F=Kapasitas institusi dalam mengatasi masalah. Penelitian ini dilaksanakan di Dinas kesehatan Kota Bogor pada Oktober 2024 hingga Januari 2025, dengan pendekatan kualitatif dan kuantitatif, serta disajikan secara …

Gambaran Putus Obat Berdasarkan Sosial-Demografi Pada Penderita Tuberkulosis Di Indonesia Tahun 2023: Cross-Sectional Study, Anindya Oktaria Yudhanti, Arina Syahida Hurva Radisan Saf, Benita Riska, Enita Fransiska Tamba

Jurnal Epidemiologi Kesehatan Indonesia

Introduction: Tuberculosis is an infectious disease that spreads through the air. Based on data at the international and national levels, there has been an increase. Most pulmonary TB patients are cured with consecutive antibiotic treatment for 6-9 months, but there are still patients who eventually drop out of treatment. This could be a challenge in achieving the international tuberculosis elimination target of 2035 and the national target of 2030. Methods: This study analyzed the socio-demographic distribution and dropout analysis of Tuberculosis patients in Indonesia in 2023 based on SKI data with a cross-sectional study type. Results: The incidence of drug …

Gambaran Kasus Gondongan Pada Sekolah Dasar Negeri 010 Makroman, Samarinda, Dwi Listiani, Ashri Budi Astuti, Jami'an Jami'an, Eko Prasetya Budi, Arif Sumarianto, Irfansyah Baharuddin Pakki

Jurnal Epidemiologi Kesehatan Indonesia

Mumps is an infectious disease caused by a viral infection, often attacking the salivary glands, especially the parotid glands. This disease is self-limiting and common in elementary school children. This study aims to describe the prevalence, symptoms, and impact of mumps in students of SD Negeri 010 Makroman, Samarinda, as well as evaluate risk factors and relevant prevention efforts. With a descriptive research design, data was obtained from a population of 307 students through secondary data from the Makroman Health Center and direct on-site investigations. An attack rate of 3.58% indicates a limited impact on at-risk populations, but it is …

Flavorful Foes: Assessing Students’ Perceptions Of Processed And Fast Food And Its Health Implications., Soumi Roy Banerjee

Theses and Dissertations

High fast-food consumption is a common public health concern due to its link to a number of non-communicable diseases and mental health, but increased consumption of processed food, rapid urbanization, and changing lifestyles have led to a shift in dietary patterns. People are consuming more foods high in energy fats and free sugars. This mixed methods study was conducted at a college campus in Georgia, to assess knowledge and understanding of the students between the ages of 18 and 22 years about highly processed Fast Food, and its effects on health. Forty student participants were chosen through convenience sampling and …

Polymeric Nanocomposites-Based Advanced Coatings For Antimicrobial And Antiviral Applications: A Comprehensive Overview, Rachid Amrhar, Jaspal Singh, Mostafa Eesaee, Pascal Carrière, Alireza Saidi, Phuong Nguyen-Tri

Revues de littérature, synthèses de connaissances

The rise in microbial infections and viral outbreaks has accelerated the development of advanced antibacterial and antiviral coating that effectively minimize infection risks. Amidst rising global health concerns due to infectious diseases, these coatings have emerged as vital solutions for surface protection across various settings. This review focuses on the recent development and in-depth analysis includes synthesis process, inactivation mechanism in photoreactive antimicrobial and antiviral bio-coatings. This review comprehensively explores the development of different nanocomposite materials, including polymers based on metal oxide nanoparticles, metal nanoparticles, graphene-based materials, and organic-inorganic composites. Their practicality and compatibility with diverse surfaces such as ceramics, …

Integrating Human And Animal Health In The Stop Spillover Outbreak Scenarios, Kathleen E. Angell, He Julia Bai, Katherine C. Prager, Janetrix H. Amuguni, Felicia B. Nutter, Jonathan D. Gass Jr, David Brett-Major

Journal Articles: Epidemiology

OBJECTIVES: To generate and employ scenarios of sentinel human and animal outbreak cases in local contexts that integrate human and animal health interests and practices and facilitate outbreak risk management readiness.

METHODS: We conducted a scoping review of past outbreaks and the strengths and weaknesses of response efforts in USAID STOP Spillover program countries. This information and iterative query-and-response with country teams and local stakeholders led to curated outbreak scenarios emphasizing One Health human:animal interfaces at sub-national levels.

RESULTS: Two core scenarios were generated adapted to each of 4 countries’ pathogen priorities and workflows in Africa and Asia, anchoring on …

Preventing Chemical And Biological Attacks: Enhanced Threats Requiring Enhanced Solutions, Alex Elliot Ottoni-Belval

Graduate Theses/Dissertations

Chemical weapons (CW) and biological weapons (BW) are becoming more dangerous for experts to employ and more accessible to amateurs. Despite CW and BW attacks throughout history that killed and maimed millions of people, the international community has failed to establish meaningful consequences to prevent them. Agreements such as the Chemical Weapons Convention and the Biological Weapons Convention vow to eliminate and reduce the effects of CWs and BWs but lack respected response precedents and capabilities. The limited and inconsistent enforcement has inadvertently allowed CWs and BWs to become plausible weapons, especially to gain asymmetric advantages, while modern developments exasperate …

Structural And Interpersonal Determinants Of Covid-19 Vaccine Uptake In Vulnerable Populations Of The United States, Alyea Wood

Capstone Showcase

Since its introduction in late 2020, the uptake of the COVID-19 vaccine has had the lowest rates in marginalized populations like minorities, elderly, and those of low socioeconomic status. Decreased rates of vaccination uptake in these groups has resulted in increased burden of disease and subsequently higher rates of hospitalization and death. Many inequities in poor COVID-19 health outcomes can be explained by examining common predictive factors that determine vaccination rates in these United States populations. This special article research aims to explore these various predictive factors with the goal to provide targeted strategies to boost COVID-19 vaccination rates, especially …

Supports For Mental Well-Being Valued By Healthcare Workers: Qualitative Analysis Of Data From A Canadian Cohort Of Healthcare Workers During The Covid-19 Pandemic, Shannon Marie Ruzycki, Anil Adisesh, Quentin Durand-Moreau, France Labrèche, Tanis Zadunayski, Erica Stroud, Nicola Cherry

Études primaires

A prospective cohort of 4964 HCWs from four Canadian provinces was established early in the COVID-19 pandemic. Participants were invited to comment about workplace mental health supports at three time points. We performed a thematic content analysis of responses from 1738 participants using the Social Support Behaviour Code framework to categorize barriers to support as informational, tangible, emotional, social, or expressing esteem. Themes were synthesized into suggestions for healthcare organizations to prepare for future crises. Formal and informal peer support, workplace mental health supports, and one-on-one counseling were most often mentioned as valued. Analysis suggested that workplace social networks as …

Antibiotic Resistance: The Growing Threats And Potential Solutions, Olisaemeka Zikora Akunne, Blessing Nkechi Emmanuel, Umar Faruk Saidu, Ayobami Sunday Akinnawo, Nasiru Ademola Adeyemi, Livia Chinaza Egoh, Malami Aishatu Muhammad, Olusegun Ayo Ade-Adekunle, Deborah Ahuoyiza Peter, Anne Amina Freitas

Department of Biomedical and Translational Sciences Faculty Publications

Antibiotic resistance (AR) has become a critical global health crisis, threatening the efficacy of antibiotics and increasing healthcare costs, morbidity, and mortality. The One Health approach, which emphasizes the interconnectedness of human, animal, and environmental health, is increasingly recognized as an essential framework for addressing the complex drivers of AR. This review explores the mechanisms of resistance, such as genetic mutations, horizontal gene transfer, and biofilm formation, along with contributing factors such as the overuse of antibiotics in healthcare and agriculture. We assess both traditional and emerging strategies to combat AR, including antimicrobial stewardship, the development of new antibiotics, and …

Genomic Epidemiology Of Staphylococcus Aureus Sequence-Type 72, Sachitaa Senthilkumar

Honors Undergraduate Theses

Staphylococcus aureus (S. aureus, SA) is a gram-positive bacterial colonizer and pathogen commonly carried on the skin and in the anterior nares of humans. SA colonization may lead to a variety of non-invasive (e.g., skin and soft tissue infections, SSTIs) and invasive (e.g., bacteremia and osteomyelitis) infections. The SA population is comprised of multiple lineages that can be delineated through multi-locus sequence typing (MLST), which compares nucleotide sequences within seven housekeeping genes. Strains belonging to an MLST share a common evolutionary history and phenotypic characteristics like antibiotic resistance or virulence. As a result, the epidemiology of lineages can be …

Archaeoparasitology Of The Colorado Plateau, Karl J. Reinhard, Morgana Caacho

Karl Reinhard Publications

Archaeoparasitology has been conducted in the Southwest for 57 years. In the first decade of the period, two pictures of parasitism emerged. Analysis of compressed organic sediments from a latrine at Elden Pueblo presented a spectrum of geohelminths not different from medieval Europe. These findings contrast pronouncedly with an analysis of coprolites from all other studies that show consistent pinworm parasitism at other sites in the Southwest. We summarize the paleoepidemiological bases for these contrasting phenomena.

Exploring Laurier Health Sciences Students’ Knowledge Of Lgbtq+ Health, Grace Emma Henry, Todd Coleman

Theses and Dissertations (Comprehensive)

In all health-related fields, the need for well-informed, holistic healthcare providers is paramount. For the heathcare field to be impactful in positive ways, providers should emerge from multifaceted academic backgrounds, equipped with an array of knowledge and skills to address the complex needs of different patients. Central to this is the idea that all aspects of an individual's identity and the intersectionality of these identities should be considered when providing care. Intersectionality recognizes that various social and personal identities, such as race, gender, sexuality, and socioeconomic status, intersect to shape individual experiences and health outcomes (Kelly et al., 2022).

Lesbian, …

Longitudinal Viral Load Clustering For People With Hiv Using Functional Principal Component Analysis, Yunqing Ma, Xueying Yang Ph.D., Jiayang Xiao, Xiaoming Li Ph.D., Bankole Olatosi Ph.D., Jiajia Zhang Ph.D.

Faculty Publications

Background: Longitudinal measures of viral load (VL) are critical in monitoring the HIV status. While multiple lab indicators exist for monitoring measures of VL, research on clustering historical/longitudinal VL measures is limited. Analyzing longitudinal VL patterns rather than aggregated measures offers deeper insights into HIV status. This study uses functional data clustering to classify longitudinal VL patterns and characterize each cluster by demographics, comorbidities, social behaviors, and CD4 count.

Methods: Adult PWH diagnosed from 2005 to 2015 in South Carolina with a 5-year minimum follow-up were included. We compared functional principal component analysis (FPCA), K-means, hierarchical clustering, and Gaussian mixture …

Harnessing Big Heterogeneous Data To Evaluate The Potential Impact Of Hiv Responses Among Key Populations In Sub-Saharan Africa: Protocol For The Boloka Data Repository Initiative, Refilwe Nancy Phaswana Mafuya, Edith Phalane, Amrita Rao, Kalai Willis, Katherine Rucinski, K. Alida Voet, Amal Abdulrahman, Claris Siyamayambo, Betty Sebati, Mohlago Seloka, Musa Jaiteh, Lerato Lucia Olifant, Katharine Journeay, Haley Sisel, Xiaoming Li Ph.D., Bankole Olatosi Ph.D., Neset Hikmet, Prashant Duhoon, Francois Wolmarans, Yegnanew A. Shiferaw, Lifutso Motsieloa, Mashudu Rampilo, Stefan Baral

Faculty Publications

Background: In South Africa, there is no centralized HIV surveillance system where key populations (KPs) data, including gay men and other men who have sex with men, female sex workers, transgender persons, people who use drugs, and incarcerated persons, are stored in South Africa despite being on higher risk of HIV acquisition and transmission than the general population. Data on KPs are being collected on a smaller scale by numerous stakeholders and managed in silos. There exists an opportunity to harness a variety of data, such as empirical, contextual, observational, and programmatic data, for evaluating the potential impact of HIV …

Longitudinal Assessments Of Viral Rebound Among People With Hiv In South Carolina: A Population-Based Cohort Study, Jiayang Xiao, Xueying Yang Ph.D., Yunqing Ma, Bankole Olatosi Ph.D., Sharon Weissman, Xiaoming Li Ph.D., Jiajia Zhang Ph.D.

Faculty Publications

Routinely monitoring viral rebound (VR) is important in the life course of people with HIV (PWH). This study examined risk factors for time to the first VR, the number of VRs and their association with VR history in men who have sex with men (MSM). It includes 8176 adult PWH diagnosed from January 2005 to December 2018, followed until July 2021. We used the Cox model for time to the first VR, the Poisson model for a number of VRs, and logistic regression for VR history in MSM. Younger individuals (50–59 years vs 18–29 years, aHR: 0.43, 95% CI: [0.34, …

Healthcare Providers’ Perspective On Hiv Testing And Hypothetical Mhealth-Connected Linkage To Care Among Men Who Have Sex With Men (Msm) In South Carolina, Tony Brown, Prince Nii Ossah Addo, Monique J. Brown Ph.D., Mph, Xiaoming Li, Oluwafemi Adeagbo

Faculty Publications

Background: HIV continues to be an important public health concern in South Carolina (SC). However, an examination of providers’ willingness to use mHealth technologies to address ongoing barriers to HIV care and prevention strategies, particularly among men who have sex with men (MSM) is currently lacking in SC. We therefore explored HIV care providers’ perceptions of HIV testing and treatment uptake among MSM, and providers’ willingness to use mHealth technology to address barriers to HIV testing and treatment in SC. Methods: Between August and December 2021, we conducted semistructured virtual interviews with 10 HIV care providers recruited purposively based on …

Sars-Cov-2 Detection And Persistence In A Remote Amazonian Settlement, Glauco M. Silva, Roberto C. Ilacqua, Franciely G. Gonçalves, Carla M. Santana, Felipe T. Jordão, Paula R. Prist, Melissa S. Nolan Ph.D., Mph, Andreia F. Brilhante, Marcia A. Sperança, Gabriel Z. Laporta

Faculty Publications

Background: COVID-19 continues to pose a major global health challenge. Despite its geographic distance from Brazil’s major urban centers, Acre state has experienced notable outbreaks. This study assessed the detection and persistence of SARS-CoV-2 in the rural settlement of Santa Luzia, located in the remote municipality of Cruzeiro do Sul, Acre state, Brazil. Methods: In July 2022, a cross-sectional survey was conducted at 40 sites from an ongoing environmental study, selected by deforestation patterns and proximity to health posts. Saliva samples were collected from residents aged 5–90 years, followed by nucleic acid extraction and multiplex RT-qPCR for SARS-CoV-2 detection. Results: …

Enhancing Research Utilization Among Health Policymakers: Lessons From An Executive Certificate Program In Liberia, Felicia Annan-Mills

Public Health Theses

Evidence-based decision-making in health policy is a systematic and transparent approach to policymaking and program design using research evidence and other similar sources. It is essential for developing effective health policies and ensuring that programs align with political priorities and community needs and have strong empirical support for their efficacy and impact. Global health agencies like the World Health Organization and the West African Health Organization have developed guidelines for evidence-based decision-making in health for organizations to use as guiding tools in their policymaking. Regardless, there is still a gap in applying research evidence to practice programs for many countries …

Assessing The Costs Of Illness Attributable To Leptospirosis, Alyssa Chetrick

Public Health Theses

Leptospirosis, caused by the spirochetes of the genus Leptospira, is a zoonotic bacterialdisease endemic to tropical regions and lower middle income countries (LMICs). Leptospirosis causes an estimated 1 million cases and more than 58,900 deaths annually.(Costa et al., 2015; Torgeson et al., 2015) In addition to human health, leptospirosis significantly impacts animal health and the livestock industry, particularly through reproductive losses, increased treatment costs, and decreased milk production, which exacerbates global insecurity.(Bennet, 2015; Torgeson et al., 2015) The estimated global cost loss to productivity due to disease is estimated at Int$ 29.3 billion. (Agampodi et al., 2023) Because of its …

Exploring Harm Reduction In Treatment: A Qualitative Study Of Methods And Perceptions Among People In Substance Use Disorder Care, Carson Francis Ferrara

Public Health Theses

Amidst the ongoing opioid epidemic and rising overdose deaths, substance use disorder (SUD) treatment has historically prioritized abstinence over harm reduction, creating gaps in patient safety. This qualitative study explores harm reduction integration in formal treatment settings and participant perceptions through 48 semi-structured interviews with individuals enrolled in Project RENEW, a larger cohort study examining factors influencing people in treatment for alcohol use across Connecticut and Georgia. Participants (79% inpatient, 51% court-mandated) described their experiences with harm reduction methods and safety strategies while in treatment. Thematic analysis revealed four key findings: 1) inconsistent access to resources like naloxone and fentanyl …

Influenza Vaccine Coverage, Effectiveness, And Disease Burden Among Pediatric Sickle Cell Patients In Connecticut From 2021-2024: A Test-Negative Case-Control Study, Precious Nchekwube

Public Health Theses

Background: Vaccination is the primary strategy to reduce influenza burden. Limited data exist on the burden of influenza, vaccine coverage, and seasonal influenza vaccine effectiveness (VE) in children and adolescents with sickle cell disease (SCD).

Aim: To evaluate influenza vaccine coverage, effectiveness, and disease burden among pediatric and adolescent patients living with SCD for the 2021-2024 influenza seasons in Connecticut, USA.

Methods: This was a retrospective, test-negative case-control study to estimate influenza VE against laboratory-confirmed influenza infections among children 6 months to 21 years of age across 2021-2022, 2022-2023, and 2023-2024 influenza seasons (August 1, 2021, to July 31, 2024) …

Effectiveness Of Wolbachia Introgression On Dengue Incidence In A Complex Urban Environment, Karthika Satyanarayanan

Public Health Theses

Dengue is an arboviral disease of increasing global public health importance for which more than half the world’s population is at risk. The burden of dengue has increased greatly in the last decade; in 2024, over 14 million cases and 10,000 dengue-related deaths were reported, marking a historical milestone. The endosymbiotic bacterium Wolbachia (wMel strain) offers a promising alternative to traditional control methods through its reduction of Aedes aegypti vector competence and introgression into wild Ae. aegypti populations. This thesis evaluated the dynamics of Wolbachia introgression and its effect on reducing dengue incidence up to 31 months after the completion …