Digital Commons Network^™

Lean Six Sigma Body Of Knowledge For Healthcare Industry Administrators: Implementation Of Lessons Learned In Applied Engineering, Mohammed Ali

Technology Faculty Publications and Presentations

The purpose of this paper is to propose a Lean Six Sigma (LSS) course curriculum for healthcare administration and management majors. It identifies the relevant opportunities and challenges for the application of LSS within the healthcare industry. The paper also discusses the cultural changes necessary to provide an appropriate climate for its long-term success. This work contains a comprehensive description of the body of knowledge in LSS, which were successful in applied engineering. Additionally, the paper describes how LSS may be applied in the hospital setting to improve processes in patient-care services. Upon successful completion of the course, the healthcare …

The Effectiveness Of Disinfection Protocols In Osteopathic Family Medicine Offices, Riley Phyu, Harrison A Patrizio, Thomas Boyle, Todd Schachter

Rowan-Virtua School of Osteopathic Medicine Departmental Research

CONTEXT: Healthcare-associated infections (HAIs) pose a substantial public health threat. Despite significant strides to curb HAIs in hospital environments, outpatient settings have not received the same degree of attention. Given their emphasis on holistic, patient-centered care, osteopathic family medicine offices are pivotal in both disease prevention and comprehensive patient treatment. The importance of simple yet effective disinfection protocols, such as thorough cleaning between patient appointments, cannot be overstated in these settings because they are integral to minimizing disease transmission.

OBJECTIVES: This study aims to assess the effectiveness of the current disinfection protocols in osteopathic family medicine offices.

METHODS: A cross-sectional …

"I Believe More In The Ability Of The Small Person To Make Big Changes": Innovation And Social Entrepreneurship To Promote Public Health In Israel., Keren Dopelt, Nila Mordehay, Shir Goren, Aviya Cohen, Paul Barach

College of Population Health Faculty Papers

Social entrepreneurship has grown worldwide in recent decades as it attempts to create and implement innovative solutions to social and environmental issues through business strategies. The aim of this study was to explore what motivates public health social entrepreneurs to act, the challenges and barriers they face, achievements, and competencies required for success. As such, we interviewed 15 social entrepreneurs in Israel. Budget issues, regulatory barriers, and struggles against powerful companies were the frequent barriers to success. The interviewees indicated several achievements at the health policy level by positioning and becoming an authority in the field, positively influencing other people's …

Pathogen-Driven Crispr Screens Identify Trex1as A Regulator Of Dna Self-Sensing During Influenza Virus Infection, Cason R King, Yiping Liu, Katherine A Amato, Grace A Schaack, Clayton Mickelson, Autumn E Sanders, Tony Hu, Srishti Gupta, Ryan A Langlois, Judith A Smith, Andrew Mehle

Faculty, Staff and Student Publications

Host:pathogen interactions dictate the outcome of infection, yet the limitations of current approaches leave large regions of this interface unexplored. Here, we develop a novel fitness-based screen that queries factors important during the middle to late stages of infection. This is achieved by engineering influenza virus to direct the screen by programming dCas9 to modulate host gene expression. Our genome-wide screen for pro-viral factors identifies the cytoplasmic DNA exonuclease TREX1. TREX1 degrades cytoplasmic DNA to prevent inappropriate innate immune activation by self-DNA. We reveal that this same process aids influenza virus replication. Infection triggers release of mitochondrial DNA into the …

The Effect Of Long Covid Syndrome On Physical Activity, Patrisha Hanna Villarmea

Master of Science in Kinesiology

Long covid syndrome is a condition where individuals experience persistent symptoms and functional limitations that can last about three months to two years after the initial Covid-19 infection. While long-term health consequences of Covid-19 have garnered significant attention,the impact of long covid syndrome symptoms is poorly understood. The purpose of the study is to explore the effect of long covid syndrome symptoms to an individual’s physical activity. Furthermore, this research aims to provide an overview of the existing literature on the effect of long covid syndrome symptoms on physical activity. The research would invite participants to answer two surveys that …

Innovations In Health-Care Service Delivery During The Pandemic, Taryn Vian, Ankita Meghani Phd

Nursing and Health Professions Faculty Research and Publications

The COVID-19 pandemic disrupted health service delivery as countries implemented lockdowns and issued stay-at-home orders. Despite attempts to make essential health services available throughout, the pandemic strained health systems and resulted in rampant shortages of health commodities, beds and health-care staff. There were concomitant declines in tuberculosis screening, HIV testing, and maternal and child health services.2 However, the global pandemic also accelerated the pace of innovation. Some initiatives served as stopgap measures implemented to maintain health services, whereas others helped leapfrog progress in the areas of health information systems, telemedicine, and regulatory policy, bringing efficiencies that could be applied even …

Social Inequalities And The Adoption Of Health Misinformation In Cameroon: Implications On Health Behaviour, Eugene Nche Che

Library Philosophy and Practice (e-journal)

Public health restrictions in response to the COVID-19 pandemic resulted in an increase in the reliance on social media for peer interactions. This resulted in the proliferation of medical misinformation and conspiracy theories that undermined public support for disease control measures, and influenced negative health attitudes such as vaccine denial. The aim of this study was to determine how social inequalities influence the adoption of health related misinformation, and the extent to which the adoption of health misinformation results in poor health behaviours. The study employed an exploratory survey design, and relied on both quantitative and qualitative methods to collect …

The Public Health Impact Of Paxlovid Covid-19 Treatment In The United States, Yuan Bai, Zhanwei Du, Lin Wang, Eric H. Y. Lau, Isaac Fung, Petter Holme, Ben Cowling, Alison Galvani, Robert Krug, Lauren Ancel Meyers

Biostatistics, Epidemiology & Environmental Health Sciences: Faculty Publications

The antiviral drug Paxlovid has been shown to rapidly reduce viral load. Coupled with vaccination, timely administration of safe and effective antivirals could provide a path towards managing COVID-19 without restrictive non-pharmaceutical measures. Here, we estimate the population-level impacts of expanding treatment with Paxlovid in the US using a multi-scale mathematical model of SARS-CoV-2 transmission that incorporates the within-host viral load dynamics of the Omicron variant. We find that, under a low transmission scenario (Re∼1.2) treating 20% of symptomatic cases would be life and cost saving, leading to an estimated 0.26 (95% CrI: 0.03, 0.59) million hospitalizations averted, 30.61 (95% …

A Pre-Medical Student’S Reconciliation Of Feminist Narratives Regarding Women’S Health: A Consideration Of Perspectives On Childbirth In The U.S., Laura Clayton

sprinkle: an undergraduate journal of feminist and queer studies

Many feminists argue that one major negative aspect of reproductive healthcare in the U.S. is the common over-medicalization of women during childbirth, including potentially unnecessary procedures such as cesarean-section and episiotomy. As a solution, they advocate for increased involvement of midwives in childbirth practices, as midwives allow women to give birth at home with minimal medical intervention. This paper analyzes the benefits of midwifery as well as the current increased risk associated with homebirth in the U.S. Additionally, it questions the damaging stigma associated with assumptions of cesarean-section as a suboptimal outcome. A false dichotomy has developed in our culture …

Adaptability In Community-Based Participatory Research: Comparisons Of Coalitions In The Deep South, Candace Forbes Bright Phd

Journal of Public Health in the Deep South

Background: Health inequities in the Gulf states are complex issues to resolve, and no single solution or strategy can improve the health rankings in each state. Yet, using grassroots approaches and building community partnerships are promising strategies to identify important health issues and opportunities for policy change. Purpose: This paper illustrates how the Gulf States Health Policy Center coalitions in four different locations used the same community-based participatory research model, but with distinct differences in processes, across nine projects to address issues that negatively affected population health. Methods: Recognizing that communities have unique needs, resources, and complementary health efforts, we …

Rural Medical Scholars Program: Filling The Gap For Health-Care And Public Health Leaders In Mississippi, Ann Sansing, David R. Buys, Marion W. Evans Phd, Mches, Laura Downey, Jasmine Harris-Speight

Journal of Public Health in the Deep South

The Rural Medical & Science Scholars program aims to help rising high school seniors determine if they want to pursue health-related careers. The program shapes students’ interest in and understanding of medicine, health-related disciplines, and other science, technology, engineering, and mathematics (STEM) fields. The program combines didactic, observational, and practical learning during a summer semester. Participants earn seven college credits to jumpstart a health or STEM career. We report on descriptive statistics since the program’s inception in 1998. The program has matriculated 401 students, of whom approximately 71% have chosen health-related careers in nursing, physical or occupational therapy, dentistry, pharmacy, …

Policies On Hand-Held Mobile Device Use While Driving: Considerations For Mississippi, Amy Radican-Wald

Journal of Public Health in the Deep South

Background: Mississippi enacted a texting/accessing social networking sites ban for all drivers in 2015; this ban is due for reauthorization in 2018. Purpose: Examine state policies prohibiting mobile device use while driving and changes in behaviors, attitudes, and opinions over time for Mississippi adults regarding distracted driving. Methods: Review literature and enacted policies. Analyze traffic, death, and survey data statewide from 2010 to 2017. Results: Mississippi’s crash death rate rose significantly (22.7 to 25.6 per 100,000; p < .01) from 2010 to 2015. Mississippi adults surveyed said they had talked on a mobile device (75.4%), texted (45.5%), or emailed (10.1%) while driving in 2017. Each reported risky driving behavior increased significantly (p < 0.05) from 2010. Most Mississippians support bans on texting (95%) and hand-held device use (89%) while driving. Support for these types of bans significantly (p < 0.05) increased from 2010 to 2017. Enacted policies vary among states and include mobile device use bans for novice drivers (n = 38) and texting (n = 47) and hand-held (n = 14) bans for all drivers. While safety campaigns coupled with aggressive enforcement are found effective, officials cite enforcement difficulties. Only three texting citations were issued to Mississippi drivers during 2016. Conclusions: Enforcement of policies addressing drivers’ mobile device use is a key factor to consider in reducing crash-related deaths.

Maternal, Child, And Parenting Factors Associated With Obesity Among Pre-Kindergarten Children In Mississippi, Jerome R. Kolbo

Journal of Public Health in the Deep South

Background: Obesity among children and youth has been consistently assessed among public school students in Mississippi since 2005. Significant declines in the prevalence of obesity among elementary students over the past decade suggest that changes may be occurring prior to entry into public school. Purpose: The purpose was to collect anthropometric data on a weighted, representative sample of children ages 3 to 5 years in licensed childcare facilities across Mississippi, and to correlate maternal, child, and parenting characteristics to obesity. Methods: The Body Mass Index was calculated using measured height and weight data. Results: A total of 14.12% of the …

Development Of A Culturally Adapted Dietary Intervention To Reduce Alzheimer's Disease Risk Among Older Black Adults, Ashley R Shaw, Mickeal N Key, Samantha Fikru, Saria Lofton, Debra K Sullivan, Jannette Berkley-Patton, Crystal M Glover, Jeffrey M Burns, Eric D Vidoni

Faculty, Staff and Student Publications

The objective of this study is to identify and understand knowledge and attitudes that influence dietary practices among older Black adults using a community-engaged approach. This is a non-interventional mixed methods study designed to inform the development of an adapted brain-healthy soul food diet intervention. A purposive sampling approach was used to conduct seven semi-structured focus group discussions and an online quantitative survey. In total, 39 participants who self-identified as Black, aged 55 years and older, English speaking, and who were cognitively normal with an AD8 < 2; (25.6% men; 74.4% women) participated in the online survey and one of the seven 60 min virtual focus group discussions (5-7 per focus group). Quantitative frequency data from the online surveys were analyzed using descriptive statistics. Qualitative focus group data were analyzed using a 6-step thematic analysis process. Five themes emerged: dementia awareness; practices shaping food choices and consumption; barriers to eating healthy; instrumental support; and elements of a culturally adapted brain-healthy dietary intervention. Older Black adults perceived an adapted MIND dietary model as the most acceptable with the incorporation of salient cultural characteristics and strategies within both the design and delivery phases.

Chronic Illness Education 2023: Do You Know Your Mental Health? A Board Game, Katie Clark, Amjad El Othmani, Bethany Lyche, Nikhil Navathe, Hafsah Umerani, Alyssa Kalsbeek

Patient Education Projects

No abstract provided.

Acceptance Of Communication Technology, Emotional Support And Subjective Well-Being For Chinese Older Adults Living Alone During Covid-19: A Moderated Mediation Model, Ze Ling Nai, Woan Shin Tan, William Tov

Research Collection School of Social Sciences

Stringent social distancing measures implemented to control the spread of COVID-19 affected older adults living alone by limiting their social interaction beyond their households. During these restrictions, interactions beyond the household could be facilitated by communication technology (CT) such as voice calls, instant messages. Our study provides evidence on how CT acceptance could influence the emotional support and in turn, subjective well-being (SWB) of older adults living alone. We did a cross-sectional survey with 293 community-dwelling Chinese older adults. Participants were surveyed from September to November 2020 and had completed measures on CT acceptance (competency), emotional support, and SWB. PROCESS …

Chronic Illness Education 2023: Investigating The Association Between Increased Social Media Use And The Risk Of Pediatric Psychiatric Disorders, Alexander Eskandarian, Hamza Ali, Sesilia Kammo, Sonja Klumpp, Grace Markey, Michael Wang

Patient Education Projects

No abstract provided.

Chronic Illness Education 2023: Available Mental Health Resources For Students With Anxiety And Depression, Carline Dugue, Lauren Fleckenstein, Ethan Mathew, Alexander Minos, Katherine Sommers, Peter Zakaria, Anna Kang

Patient Education Projects

No abstract provided.

Chronic Illness Education 2023: The Impact Of Food Deserts On Adult Diabetes Mellitus, Stephanie Barna, Blaise Deschamps, Jack Mao, Armaan Naghdi, Anjani Raja, Noor Sulieman, Anneliese Rademacher

Patient Education Projects

No abstract provided.

Current Curricular Trends After The Covid-19 Pandemic: A National Survey Of Psychiatry Residency Programs, Jeff Wang Jin, Kacy Smith, Amanda Helminiak, Vineeth John, Hanjing Emily Wu

Faculty, Staff and Student Publications

OBJECTIVES: During the COVID-19 pandemic, many psychiatry residencies (academic, community, and hybrid programs) have adopted different learning modalities to preserve a high quality of educational training. There is minimal data on specific program adaptations, related change perspectives, and program type stratification. This study sought to examine trends in curriculum changes in accredited psychiatry residency programs in the United States.

METHODS: Program directors of accredited general psychiatry programs in the United States were surveyed to assess both general program details and changes in educational content, delivery, and perspectives with regard to program curricula.

RESULTS: A total of 63 program directors out …

Global Blood Pressure Screening During The Covid-19 Pandemic: Results From The May Measurement Month 2021 Campaign, Thomas Beaney, Wei Wang, Markus P Schlaich, Aletta E Schutte, George S Stergiou, Luis Alcocer, Jafar Alsaid, Alejandro Bimbo Diaz, Rafael Hernandez-Hernandez, Mohammad Ishaq, Jacek Jozwiak, Nadia Khan, Gaia Kiru, Harsha Mccardle, Augustine Nonso Odili, Wook Bum Pyun, Cesar A Romero, Jiguang Wang, Neil R Poulter, Mmm Investigators

Faculty, Staff and Student Publications

BACKGROUND: Raised blood pressure (BP) remains the biggest risk factor contributing to the global burden of disease and mortality, despite the COVID-19 pandemic. May Measurement Month (MMM), an annual global screening campaign aims to highlight the importance of BP measurement by evaluating global awareness, treatment and control rates among adults with hypertension. In 2021, we assessed the global burden of these rates during the COVID-19 pandemic.

METHODS: Screening sites were set up in 54 countries between May and November 2021 and screenees were recruited by convenience sampling. Three sitting BPs were measured, and a questionnaire completed including demographic, lifestyle and …

Gross Hematuria And Lower Urinary Tract Symptoms Associated With Military Burn Pits Exposures In Us Veterans Deployed To Iraq And Afghanistan, Mosammat M. Perveen, Henry E. Mayo-Malasky, Mary F. Lee-Wong, Julie M. Tomaska, Edward Forsyth, Amy Gravely, Mark A. Klein, Janeen H. Trembley, Tammy A. Butterick, Robert A. Promisloff, Pamela K. Ginex, Paul Barach, Anthony M. Szema

College of Population Health Faculty Papers

OBJECTIVE: The aim of the study is to describe rates of hematuria and other lower urinary tract symptoms, including self-reported cancer rates, among veterans postburn pits emissions exposure during deployment to Iraq and Afghanistan.

METHODS: US post-9/11 veterans with burn pits emissions exposure confirmed via DD214 forms in the Burn Pits360.org Registry were sent a modified survey. Data were deidentified and anonymously coded.

RESULTS: Twenty-nine percent of the 155 respondents exposed to burn pits self-reported seeing blood in their urine. The average index score of our modified American Urological Association Symptom Index Survey was 12.25 (SD, 7.48). High rates of …

Epigenome-Wide Association Study Using Peripheral Blood Leukocytes Identifies Genomic Regions Associated With Periodontal Disease And Edentulism In The Atherosclerosis Risk In Communities Study, Naisi Zhao, Flavia Teles, Jiayun Lu, Devin C Koestler, James Beck, Eric Boerwinkle, Jan Bressler, Karl T Kelsey, Elizabeth A Platz, Dominique S Michaud

Faculty, Staff and Student Publications

AIM: To investigate individual susceptibility to periodontitis by conducting an epigenome-wide association study using peripheral blood.

MATERIALS AND METHODS: We included 1077 African American and 457 European American participants of the Atherosclerosis Risk in Communities (ARIC) study who had completed a dental examination or reported being edentulous at Visit 4 and had available data on DNA methylation from Visit 2 or 3. DNA methylation levels were compared by periodontal disease severity and edentulism through discovery analyses and subsequent testing of individual CpGs.

RESULTS: Our discovery analysis replicated findings from a previous study reporting a region in gene ZFP57 (6p22.1) that …

Cancer Patients' Preferences And Perceptions Of Advantages And Disadvantages Of Telehealth Visits During The Covid-19 Pandemic, Deepika Kumar, Nancy Gordon, Constanza Zamani, Tammy Sheehan, Ernesto Martin, Olga Egorova, Jessica Payne, Tatjana Kolevska, Elad Neeman, Raymond Liu

Faculty, Staff and Student Publications

PURPOSE: We aimed to ascertain oncology patients' perceptions of telehealth versus in-person (IP) visits for different types of clinical encounters.

METHODS: We surveyed adults undergoing cancer treatment at Kaiser Permanente Northern California infusion centers between November 2021 and May 2022 using a self-administered questionnaire. Patients were asked about visit modality preferences (video, phone, and IP) for six types of clinical discussions, overall advantages and disadvantages of telehealth (video or phone) versus IP modalities, and barriers to video visit use.

RESULTS: The 839 patients who completed surveys in English were 63% female; median age 63 years; 64% White; and 73% college-educated …

Evaluating The Knowledge, Attitudes, And Practices Of Healthcare Workers Regarding High-Risk Nosocomial Infections: A Global Cross-Sectional Study, Elham M Khatrawi, Priyadarshi Prajjwal, Muhammad Farhan, Pugazhendi Inban, Shraddha Gurha, Saud M S Al-Ezzi, Mohammed D M Marsool, Prerna Ahuja, Mohammed A Mateen, Felix O Aina, Omniat A Hussin

Faculty, Staff and Student Publications

BACKGROUND: Healthcare workers (HCWs) play a vital role in delivering care and are frequently exposed to the risk of acquiring infections within the hospital setting. Around 15% of hospitalized patients suffer from these infections globally. However, the role and awareness of HCWs in the transmission of hospital-acquired infections (HAIs) or nosocomial infections is still unclear. This study aimed to evaluate the knowledge, attitude, and practices (KAP) toward high-risk microbial infections among HCWs on a global scale to identify measures to address this problem.

METHOD: A cross-sectional descriptive study was conducted between 2022 and 2023, with HCWs selected as the study …

Risk Factors Associated With Occupational Stress Among Malaysian Construction Professionals, Nur Syafiqah Fauzan, Nur Alia Farahanin Mohd Tajuddin, Neroshini Thanarejee, Dayana Hazwani Mohd Suadi Nata, Ezrin Hani Sukadarin, Mirta Widia

Makara Journal of Health Research

Background: Construction industries that focus on project-based nature, pressure, and long hours may lead to job-related stress among workers. In many emerging nations, robust economic growth plans generate occupational depression, anxiety, and stress among construction industry personnel. This study aims to determine the relationship between these items and the risk factors (demographic) among Malaysian construction professionals.

Methods: A cross-sectional study was carried out among 173 Malaysian construction professionals. A DASS-21 questionnaire is used to survey eligible respondents.

Results: Findings show that construction professionals have a high level of stress (54.9%), anxiety (48.5%), and depression (37%). Gender is …

Self-Reported Consumption Of Bottled Water V. Tap Water In Appalachian And Non-Appalachian Kentucky, Jason W. Marion

Journal of Appalachian Health

Introduction: Quantitative studies on drinking water perceptions in Appalachia are limited. High-profile water infrastructure failures in the U.S. and Eastern Kentucky, coupled with human-made and natural disasters in the Appalachian Region, have likely impacted opinions regarding tap water.

Purpose: To use existing unexplored data to describe baseline tap water v. bottled water consumption in Kentucky.

Methods: Telephone-based cross-sectional data were obtained from the 2013 Kentucky Health Issues Poll (KHIP) directed by the Foundation for a Healthy Kentucky. Among many items in KHIP, self-reported consumption of bottled water over tap water, reasons for bottled water use, and demographic data were obtained. …

Evaluation Of A Faculty Fellows Program In Science Communication, Stacy Stanifer, Beverly Delidow, Kathy Rademacher, Luz Huntington-Moskos, Kelly Kennoy, Amanda Thaxton-Wiggins, Craig Wilmhoff, Ellen J. Hahn

Journal of Appalachian Health

Introduction: Science communication plays a crucial role in tackling pressing regional, national, and global health issues. Effective communication with various audiences is integral to dissemination of science findings.

Purpose: This study evaluates changes in self-efficacy and attitudes toward science communication skills over time and also assesses program outcomes and satisfaction with a Faculty Fellows in Science Communication (FFSC) program among faculty (N = 30) with interest in environmental health science and/or education in Appalachia Kentucky.

Methods: A mixed methods program evaluation was employed using longitudinal data on behaviors, attitudes, and program outcomes from three cohorts of Faculty Fellows who participated …

Development Of A Medication Compliance Determinant Instrument For Low-Middle Literate Patients With Type 2 Diabetes Mellitus, Ivans Panduwiguna, Rani Sauriasari, Ratu Ayu Dewi Sartika, Woro Riyadina, Fransiskus Samuel Renaldi

Kesmas

Diabetes, a leading cause of 6.7 million deaths in 2021, poses a significant challenge despite existing interventions. Non-adherence to treatment remains a barrier to diabetes management. However, a comprehensive instrument to assess medication adherence determinants in diabetes patients’ population in Indonesia with low-medium literacy levels and following the sociocultural characteristics of Indonesian society has been lacking. This study aimed to develop and evaluate a valid and reliable instrument for measuring medication adherence in type 2 diabetes mellitus patients based on the Borg and Gall model. Through the input of an expert panel, a valid and reliable instrument was developed, which …

Workload And Stress Level In Non-Covid-19 Zoning Nurses At National Central Public Hospital Jakarta, Zakiyah Zakiyah, Ulfah Nuraini Karim, Aliana Dewi, Siti Nuraini, Aan Sutandi, Rony Darmawansyah Alnur

Kesmas

The COVID-19 pandemic has increased the workload for nurses directly handling COVID-19 patients and those working in non-COVID-19 zones. As the number of COVID-19 cases rises, nurses face psychological problems, including stress. This study aimed to determine the relationship between workload and stress levels in a non-COVID-19 zoning ward using a cross-sectional approach and Spearman’s correlation test conducted on 94 nurses at one hospital in Jakarta, Indonesia, selected through simple random sampling. The workload questionnaire with 15 items and the DASS 42 questionnaire were used to measure stress levels. The results indicated that most nurses (73.4%) experienced a heavy workload. …