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Editorial - Sure Journal Vol 6, Anne M. Friel, Eva Campion, Sinead Loughran

SURE Journal: Science Undergraduate Research Experience Journal

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Effectiveness Of An Improved Leprosy Lakar Training On Knowledge And Skills Among Healthcare Workers In Primary Healthcare In Pahang Malaysia., Nuraihan Zafirah Zainal Abidin

Student Works (2020-2029)

Leprosy, a neglected chronic tropical disease caused by Mycobacterium leprae, poses significant health challenges due to its potential for irreversible disabilities and disfigurement. Adequate leprosy training for healthcare workers (HCWs) is crucial for early detection and prompt treatment, thereby preventing complications and reducing transmission risks. This study aimed to revise and evaluate the effectiveness of leprosy LaKAR* training on knowledge and skills of leprosy among HCWs in primary healthcare in Pahang, Malaysia. The study employed a sequential exploratory, mixed-method design consisting of two phases. Phase 1a was a qualitative study identifying gaps in current LaKAR training among HCWs at …

Infant Mortality Data: Missing Pieces To Prevention In Lesotho, Jacinda Croissant

Master's Projects and Capstones

Lower-middle-income countries (LMICs) like Lesotho lack complete and quality infant mortality data. Without infant mortality data, it can be challenging to develop public health education, programming, and policies to address preventative infant deaths in specific populations (Rao et al., 2004). A literature review identified strategies to improve infant mortality data in LMICs. Through a community engagement model and digital storytelling, community members can gain awareness, begin an ongoing conversation about local public health issues, and participate in an improved data collection system. Infant mortality is often used as an indicator of health for a population; improved infant mortality data can …

The Evidence Is In: Breast Implants Are Making People Sick Increasingly Women Find When They Have Their Implants Removed, Their Symptoms Improve—Or Disappear., Pamela J. Appea

Capstones

Over the years, breast implants have been associated with a wide range of health issues, including cancer and autoimmune diseases, but surprisingly these issues are not well known to the public. In 1992, health concerns led the FDA to halt the use of silicone gel breast implants for cosmetic surgeries, although implants containing saline remained available (it was during this period that the Oprah segment that Gmitro remembered ran on TV). In 2006, after more research, which some experts believe was insufficient, the FDA re-approved the use of silicone implants. In 2019, a novel “textured” breast implant manufactured …

Elevated Ambient Temperature Associated With Reduced Infectious Disease Test Positivity Rates: Retrospective Observational Analysis Of Statewide Covid-19 Testing And Weather Across California Counties., Nicholas Wing-Ping Kwok, Joshua Pevnick, Keith Feldman

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: From medication usage to the time of day, a number of external factors are known to alter human body temperature (BT), even in the absence of underlying pathology. In select cases, clinical guidance already suggests the consideration of clinical and demographic factors when interpreting BT, such as a decreased threshold for fever as age increases. Recent work has indicated factors impacting BT extend to environmental conditions including ambient temperature. However, the effect sizes of these relationships are often small, and it remains unclear if such relationships result in a meaningful impact on real-world health care practices.

OBJECTIVE: Temperature remains …

Multidisciplinary Travel Health Education: Current Status And Rationale For Standardized Competencies, Karl M Hess, Sheila M Seed, Eva H Clark, Tara Lombardo, Francesca F Norman, Gerard Flaherty

Faculty, Staff and Students Publications

This perspective highlights the inconsistent integration of travel health education across medical, nursing and pharmacy educational programmes globally and calls for standardized travel health competencies based on the International Society of Travel Medicine’s (ISTM) Body of Knowledge to help improve patient care outcomes as global travel returns to pre-pandemic levels.

Covid For One: Identifying Obstacles To Self-Management Of Covid-19 For Single Adults, Linda A. Treiber, Christie Emerson, Jenna Shackleford

Faculty Articles

Given the complexities of healthcare provision, it is imperative to understand how single adults experience their interactions with medical professionals and health care organizations, manage care and treatment, and navigate the barriers encountered. This study’s purpose is to understand physical and mental health experiences in consideration of social determinants of health, barriers, and coping strategies for single adults diagnosed with COVID-19. An interpretive phenomenology study design was used with 12 individuals who were single and living alone during the COVID-19 pandemic. Semi-structured, open-ended interviews revealed important aspects of the COVID-19 illness experience. Interviews were transcribed for coding and thematic analysis. …

Effect Of School Hpv Vaccination Requirements On Pediatricians' Recommendations, Ashley Hedrick Mckenzie, Lara S Savas, Ross Shegog, Dale S Mantey, Erica L Frost, Paul Gerardo Yeh, C Mary Healy, Stanley Spinner, L Aubree Shay, Sharice M Preston, Sally W Vernon

Faculty, Staff and Student Publications

Background/objectives: Pediatrician recommendations are highly influential in parents’ decisions to vaccinate their children against HPV. Unqualified, presumptive, and bundled recommendations (UPBRs) are associated with increased HPV vaccine uptake and are considered best practice. This study analyzes pediatricians’ self-reported data to assess changes in UPBR use and the psychosocial determinants of UPBR use as a result of the implementation of a multi-level intervention, the Adolescent Vaccination Program (AVP).

Methods: We surveyed pediatricians across 51 clinics in the Houston area. Baseline surveys (n = 137) were distributed in 2015, and follow-ups (n = 120) in 2019.

Results: Pediatrician UPBR use …

Antibiotics For Acute Watery Or Persistent With Or Without Bloody Diarrhoea In Children: A Systematic Review And Meta-Analysis, Syeda Kanza Naqvi, Mustafa Bin Ali Zubairi, Ayesha Arshad Ali, Ashraf Sharif, Rehana Abdus Salam, Zain Hasnain, Sajid Bashir Soofi, Shabina Ariff, Yasir Bin Nisar, Jai K. Das

Institute for Global Health and Development

Background: The use of antibiotics in the treatment of acute and persistent watery diarrhoea has long been a subject of contention. While the advantages of using antimicrobials are acknowledged, concerns remain regarding potential adverse effects and antibiotic resistance. Therefore, we conducted a systematic review and meta-analysis to assess the efficacy of antibiotics compared to placebos for the treatment of diarrhoea.
Methods: We searched PubMed, CINAHL, the Cochrane Library, ClinicalTrials.gov, the World Health Organization (WHO) International Clinical Trials Registry Platform, and Scopus from inception until 20 July 2023 for studies published after the year 2000 assessing antibiotics vs placebo in acute …

Spatial Dynamics Of Culex Quinquefasciatus Abundance: Geostatistical Insights From Harris County, Texas, Morgan Jibowu, Melissa S Nolan, Ryan Ramphul, Heather T Essigmann, Abiodun O Oluyomi, Eric L Brown, Maximea Vigilant, Sarah M Gunter

Faculty, Staff and Students Publications

Mosquito-borne diseases pose a significant public health threat, prompting the need to pinpoint high-risk areas for targeted interventions and environmental control measures. Culex quinquefasciatus is the primary vector for several mosquito-borne pathogens, including West Nile virus. Using spatial analysis and modeling techniques, we investigated the geospatial distribution of Culex quinquefasciatus abundance in the large metropolis of Harris County, Texas, from 2020 to 2022. Our geospatial analysis revealed clusters of high mosquito abundance, predominantly located in central Houston and the north-northwestern regions of Harris County, with lower mosquito abundance observed in the western and southeastern areas. We identified persistent high mosquito …

Review Of The Diagnosis, Pathophysiology, And Treatment Of Naegleria Fowleri-Induced Primary Amoebic Meningoencephalitis, Terrance Zhang

MCB Articles

Naegleria fowleri is a thermophilic, ubiquitous, free-living amoeba, but is also known as the “brain-eating” amoeba. This is the etiological agent of a rare and fulminant waterborne disease known as Primary Amoebic Meningoencephalitis (PAM) that is acutely fatal in 90-99% of reported cases. Those who come into contact with infested waters are at risk of introducing the amoeba into their upper nasal canal, whence the trophozoite form is known to migrate along the olfactory nerve, through the cribriform plate, and enter the central nervous system. Although the exact pathogenesis of N. fowleri is not known, studies have demonstrated contact-dependent and …

Reflections From The Pandemic: Is Connectivism The Panacea For Clinicians?, Jennifer Benjamin, Tyson Pillow, Heather Macneill, Ken Masters, Anoop Agrawal, Neil Mehta

Faculty, Staff and Students Publications

The COVID-19 pandemic and the recent increased interest in generative artificial intelligence (GenAI) highlight the need for interprofessional communities' collaboration to find solutions to complex problems. A personal narrative experience of one of the authors compels us to reflect on current approaches to learning and knowledge acquisition and use solutions to the challenges posed by GenAI through social learning contexts using connectivism. We recognize the need for constructivism and experiential learning for knowledge acquisition to establish foundational understanding. We explore how connectivist approaches can enhance traditional constructivist paradigms amid rapidly changing learning environments and online communities. Learning in connectivism includes …

Estimated Vaccine Effectiveness For Pediatric Patients With Severe Influenza, 2015-2020., Kelsey M. Sumner, Leila C. Sahni, Julie A. Boom, Natasha B. Halasa, Laura S. Stewart, Janet A. Englund, Eileen J. Klein, Mary A. Staat, Elizabeth P. Schlaudecker, Rangaraj Selvarangan, Christopher J. Harrison, Geoffrey A. Weinberg, Peter G. Szilagyi, Monica N. Singer, Parvin H. Azimi, Benjamin R. Clopper, Heidi L. Moline, Emma K. Noble, John V. Williams, Marian G. Michaels, Samantha M. Olson, New Vaccine Surveillance Network Collaborators

Manuscripts, Articles, Book Chapters and Other Papers

IMPORTANCE: Increasing the understanding of vaccine effectiveness (VE) against levels of severe influenza in children could help increase uptake of influenza vaccination and strengthen vaccine policies globally.

OBJECTIVE: To investigate VE in children by severity of influenza illness.

DESIGN, SETTING, AND PARTICIPANTS: This case-control study with a test-negative design used data from 8 participating medical centers located in geographically different US states in the New Vaccine Surveillance Network from November 6, 2015, through April 8, 2020. Participants included children 6 months through 17 years of age who were hospitalized or presented to an emergency department (ED) with acute respiratory illness. …

Predictors Of Mortality In African Americans With Alzheimer’S Disease-Related Dementias, Latrice Camille Noonan

Walden Dissertations and Doctoral Studies

Alzheimer’s disease-related dementia (ADRD) is a leading cause of death worldwide. There is a need to identify the link between modifiable risk factors and the association with ADRD mortality. This study addresses the disproportionately high burden of ADRD among African Americans, aiming to inform targeted prevention strategies and promote health equity. In this study, the longitudinal relationship between ADRD mortality and the presences of diabetes, smoking, and obesity among older African Americans residing in the United States was examined, while controlling for age, gender, education, and socioeconomic status. The biopsychosocial model served as the theoretical framework for this study. The …

Public Health Implications Of State-Level Public Health Organizational And System Structures, Cameron Ferguson Hays

Dissertations

Public health thought leaders such as the Institute of Medicine and National Academies of Science, Engineering, and Medicine have long been concerned about the lack of standardization among state-level public health systems (IOM, 1988; NASEM, 2023). However, little research studies these systems, their structures, and whether structural constructs affect population health outcomes.

This study attempted to examine the structural constructs that make up these systems and the impact of those constructs using an exploratory sequential mixed-methods design. Variables from management science were qualitatively extracted from materials describing all 50 state-level public health systems. Those variables were then analyzed using a …

Genomic Analysis Of The Sars-Cov-2 Variants Circulated In The Philippines, 2020–2024, Arnie Dimaano, Kiana Dominique Carreon, Giselle Sophia Camaya, Irvin Rondolo, Jarel Elgin Tolentino

Biology Faculty Publications

Purpose

Genomic sequencing has been an invaluable tool to determine the evolution of SARS-CoV-2. In the present study, we provided a comprehensive description of the SARS-CoV-2 variants circulated in the Philippines.

Methods

The dataset from the human COVID-19 infections was acquired by downloading the sequences and their associated metadata spanning from March 2020 to April 2024. Then, we executed several filtering criteria to acquire the final dataset for the Philippine samples and performed spatial distribution analysis and phylogenetic tree construction of the reported SARS-CoV-2 sequences.

Results

A total of 16,679,203 SARS-CoV sequences were obtained, of which 17,393 (0.10 %) were …

Metagenomic Sequencing For Early Detection Of Future Engineered Pandemics: Foreshadowing The Privacy Challenge, Nir Eyal, Bridget Williams, Kevin M. Esvelt, Jane R. Bambauer

UF Law Faculty Publications

In this commentary, we imagine how a global system of metagenomic sequencing could be governed in order to reap the benefits and manage the risks. Global institutional engineers and their academic partners would need to develop a new governance model to ensure that all partners involved in a global metagenomic surveillance system cooperate as needed.

Integrated Child Nutrition, Parenting, And Health Intervention In Rural Liberia: A Mixed-Methods Feasibility Study, Sejla Isanovic, Musa Sanoe, Shelbie Wooten, Edward A. Frongillo Ph.D., Aisha K. Yousafzai, Christine E. Blake Ph.D., Rd, Mufaro Kanyangarara Ph.D., Melanie Swan, Nicole Rodger, Miriam Murray, Leila M. Larson Ph.D., Mph

Faculty Publications

In Liberia, children are exposed to multiple forms of adversity which can negatively impact their health and development. Research is needed to examine the feasibility and benefits of integrated interventions that can be incorporated into existing health delivery programs to simultaneously address low responsive stimulation, undernutrition, and infection. This study assessed the feasibility of an integrated intervention promoting psychosocial stimulation and improved child feeding by the provision of eggs and fish. The integrated intervention was incorporated into an existing government health program. Thirty female caregiver-child dyads were randomly selected from two rural communities in Liberia. Participants received fortnightly group parenting …

The Learning Crisis: Three Years After Covid-19, Tomasz Gajderowicz, Maciej Jakubowski, Alec Kennedy, Christian Christrup Kjeldsen, Harry Anthony Patrinos, Rolf Strietholt

Education Reform Faculty and Graduate Students Publications

The COVID-19 pandemic caused widespread disruptions to education, with school closures affecting over one billion children. These closures, aimed at reducing virus transmission, resulted in significant learning losses, particularly in mathematics and science. Using data from TIMSS 2023, which assesses fourth and eighth-grade achievements across 71 education systems, this study analyzes the impact of school closure duration on learning outcomes. Mixed-effect models estimate deviations from pre-pandemic trends, adjusting for demographic factors. Results show a global average decline of 0.11 standard deviations (SD) in student achievement, with longer closures linked to more severe losses. The effects on low performers, girls, and …

Knowledge, Attitudes, And Behaviors Regarding Water Quality, Nitrate Contamination, And Related Health Issues Among Nebraska Healthcare Professionals, Jessenia Hincapie

Capstone Experience: Master of Public Health

Background: Nitrate contamination in drinking water is a public health concern, particularly in agricultural regions. Healthcare professionals often address water quality issues but may lack sufficient knowledge regarding the health effects of nitrate contamination. This study evaluates whether Nebraska healthcare professionals' knowledge and attitudes about nitrate contamination predict their behaviors in addressing this issue.

Methods: A survey was administered to healthcare professionals across Nebraska to assess their knowledge, attitudes, and behaviors regarding nitrate contamination in drinking water. A total of 462 respondents participated. Generalized linear regression analysis was employed to assess the impact of knowledge and attitudes regarding nitrate contamination …

Exploring The Contribution Of Mobile Money To The Well-Being Of Rural Tanzanian Villagers And Assessing Their Readiness To Adopt A Similar Model To Advance Their Healthcare Access An Exploratory Study, Sr. Magdalena P. Chubwa

Seton Hall University Dissertations and Theses (ETDs)

Background: Healthcare for rural villages in Tanzania has always been rudimentary. Lack of the infrastructure and poverty are among the many obstacles facing this population’s access to healthcare. While, the rise of telehealth has improved access to healthcare in many parts of the world, its use in rural Tanzania has been extremely limited to poor internet access. However, given the availability of non-internet connected mobile phones in rural Tanzania, the potential to use this devise to improve healthcare access exists. Individuals using mobile phones for financial transactions may be motivated to access healthcare via telehealth by using their non-internet connected …

Bst2 Facilitates Activation Of Hematopoietic Stem Cells Through Erk Signaling, Marcus A Florez, Apoorva Thatavarty, Duy T Le, Holly A Hill, Youngjae Jeong, Brian M Ho, Pawel Kus, Trisha K Wathan, Bailee N Kain, Shixia Huang, Dongsu Park, Katherine Y King

Faculty, Staff and Students Publications

The proinflammatory cytokine interferon-gamma (IFNγ) is upregulated in a variety of infections and contributes to bone marrow failure through hematopoietic stem cell (HSC) activation and subsequent exhaustion. The cell surface protein, bone marrow stromal antigen 2 (BST2), is a key mediator of this process, as it is induced upon interferon stimulation and required for interferon-dependent HSC activation. To identify the mechanism by which BST2 promotes interferon-dependent HSC activation, we evaluated its role in niche localization, immune cell function, lipid raft formation, and intracellular signaling. Our studies indicated that knock out (KO) of BST2 in a murine model does not disrupt …

Discrimination, Sexual Orientation, And Alcohol Amongst Latine, Brian Juarez

Electronic Theses, Projects, and Dissertations

Existing research acknowledges the influence of discrimination on alcohol use, this study emphasizes the equally significant role of sexual orientation on alcohol use. Associations between these factors and alcohol consumption demonstrate the necessity for ongoing research to analyze their intricate relationships and subsequent health outcomes. This study highlights the crucial need for an in-depth exploration of discrimination as well as marginalized identities as contributing factors in alcohol consumption.

Using a quantitative approach to assess secondary data gathered from the National Alcohol Surveys (NAS), this paper underscores the importance of a comprehensive and timely approach to research the multifaceted impact of …

Service Provider Perceptions Of Systems Serving Individuals Experiencing Homelessness: A Needs Assessment And Strategic Plan In Johnson City, Tn, Opal Frye-Clark

Electronic Theses and Dissertations

This Integrated Learning Experience (ILE) investigates service providers' perceptions of Johnson City, Tennessee's homelessness services, aiming to inform a city-wide strategic plan for reduction. Employing a mixed-methods approach, the study gathered qualitative data through in-depth interviews with service providers in 2022 and quantitative data via a 2024 survey. The research focused on those directly involved in serving or significantly influencing the lives of individuals experiencing homelessness (IEH). Three key aims guided the investigation: (1) To analyze provider perspectives to identify community assets, opportunities, barriers, and unmet needs, informing a comprehensive needs assessment; (2) To refine these findings through SWOT analysis …

Sexual Orientation, Gender Identity And Virologic Failure Among People With Hiv: A Cohort Study In All Of Us Research Program, Fanghui Shi, Ruilie Cai, Buwei He, Xiaoming Li Ph.D., Xueying Yang Ph.D., Sharon Weissman, Bankole Olatosi Ph.D., Jiajia Zhang Ph.D.

Faculty Publications

Background: Sexual and gender minorities (SGMs) are at higher risk of HIV incidence compared to their heterosexual cisgender counterparts. Despite the high HIV disease burden among SGMs, there was limited data on whether they are at higher risk of virologic failure, which may lead to potential disease progression and increased transmission risk. The All of Us (AoU) Research Program, a national community-engaged program aiming to improve health and facilitate health equity in the United States by partnering with one million participants, provides a promising resource for identifying a diverse and large volunteer TGD cohort. Leveraging various data sources available through …

Navigating Physical Activity Promotion And Policy In The Post-Covid-19-Pandemic Era, Justin Richards, Katja Siefken, Michael Pratt, Adrian Bauman, Juliana Mejía-Grueso, Catherine B Woods, Wanda Wendel-Vos, Erica Hinckson, Deborah Salvo, Pedro C Hallal, Andrea Ramírez Varela

Faculty, Staff and Student Publications

Background: There is limited evidence on the priorities and opportunities associated with promoting population physical activity (PA) participation for the post-COVID-19-pandemic future.

Purpose: This study assessed government-led PA promotion efforts before and during the COVID-19 pandemic, along with post-COVID-19-pandemic priorities and recommendations.

Methods: Two separate cross-sectional surveys conducted in 2023. Survey 1 was targeted at the Global Observatory for Physical Activity (GoPA!) Country Contacts. Survey 2 also included key international informants representing influential stakeholders in PA policy implementation.

Results: There were 68 respondents to Survey 1, collectively representing 61 countries. An additional 37 people, including representatives from 14 key international …

Covid-19 Risk Assessment Among Vulnerable Small Business Owners In El Paso County, Texas, Sadie H Conway, Denise Vasquez, Kristina D Mena, Louis D Brown, Soyoung Kwon, Janelle Rios

Faculty, Staff and Student Publications

Background: Our objective was to deliver actionable, worksite-specific COVID-19 risk assessments and mitigation strategies tailored to vulnerable workers in one of the highest-risk areas in the US.

Methods: Four trained, bilingual (English/Spanish) community health workers (CHWs) recruited small businesses (ie, ≤20 employees) across various industries and executed novel on-site infectious disease risk assessment surveys of at least one employer and one employee.

Results: Of 102 participating businesses (95% Hispanic-owned), 96% were characterized as "high risk" or "very high risk" for disease transmission. All businesses reported implementing at least one practice to reduce disease transmission; however, almost half of businesses lacked …

Effectiveness Of Enhanced Care For Treatment Of Acute Or Persistent Diarrhea In Malnourished Children Aged 0 Months To 10 Years: A Systematic Review, Ridwa Alam, Khadija Vadsaria, Ahmad Khan, Uswa Jiwani, Aqsa Ishaq, Anmol Minaz, Ashraf Sharif, Jai K. Das, Sajid Bashir Soofi, Shabina Ariff

Centre of Excellence in Women and Child Health

Background: Diarrhea poses a significant public health challenge, particularly affecting children under five. The link between malnutrition and diarrhea is well established, with diarrhea being a primary cause of malnutrition in young children and malnutrition exacerbating the severity of diarrhea. While the World Health Organization (WHO) recommends a comprehensive approach to both diarrhea and malnutrition management, including oral rehydration, continuous feeding, zinc supplementation, and antibiotics for specific strains, it does not adequately address the complex needs of malnourished children with diarrhea who may benefit from enhanced care in the form of follow-up and monitoring beyond initial treatment. We aimed to …

Promoting Adolescent Mental And Physical Health: Initiatives Focused On Connecting Public Health And Social Services To The Health Sector In Nebraska, Theresa Nguyen

Capstone Experience: Master of Public Health

This capstone focuses on the second recommendation of improving access to comprehensive, coordinated health services from the National Academies of Sciences, Engineering, and Medicine report The Promise of Adolescence: Realizing Opportunity for All Youth (2019). This proposal uses secondary data from the research project, Moving Evidence-Based Recommendations to Practice to Strengthen the Health Care System in Nebraska. Key stakeholders (n=28) were interviewed from the health care, public health, social services, and policy sectors. Each subject was asked to participate in a semi-structured interview by a trained interviewer. The interview was 1 hour long and conducted via phone call or Zoom. …

The Informal, Non-Prescribed Use Of Antiretroviral Medications For Prep Among A National Us-Based Sample Of Gay, Bisexual, And Other Men Who Have Sex With Men: A Cross-Sectional Study, Mance E. Buttram, Matthew S. Ellis, Krishen D. Samuel, Matthew Hayhurst

Health, Human Performance and Recreation Faculty Publications and Presentations

This brief report presents findings on informal, non-prescribed PrEP use among an online sample of gay, bisexual and other men who have sex with men (n = 196). Mean age was 33.4. Participants were Hispanic (13.3%), African American (15.8%), white (63.8%), and other race/ethnicity (6.6%). Informal PrEP users (11%) more frequently reported past year sexually transmitted infections (p < 0.001), group sex (p < 0.001), sex in public (p < 0.01), transactional sex (p < 0.001), ever receiving a formal PrEP prescription (p < 0.05), and ease of finding diverted HIV medications on gay dating/sex apps (p < 0.05). Formal PrEP uptake should be encouraged to mitigate potential negative consequences of informal use.