Digital Commons Network^™

Outcomes Of The “Brca Quality Improvement Dissemination Program”: An Initiative To Improve Patient Receipt Of Cancer Genetics Services At Five Health Systems, Erica M Bednar, Minxing Chen, Michael T Walsh, Amanda L Eppolito, Molly H Klein, Kelly Teed, Brittany Hodge, Jordan Hunter, Han Gill Chao, Dillon Davis, Wilshauna Serchion, Cara Yobbi, Rebekah Krukenberg, Sandra B Jenkinson, Jennifer J Moore, Cassandra Garcia, Fatimaeliza Gonzalez, Towanna Murray, Linda D Nielsen, Brenda Ho, Megan Haas, Sarah B Greenzweig, Abby Anderson, Christina Johnson, Nichole A Morman, Elizabeth Bowdish, Emaline Wise, Julia N Cooper, Pauline Kefalas Russ, Katelyn Tondo-Steele, Buonarotti F De Gracia, Brooke Levin, Kristin Mattie, Kathryn Zarnawski, Molly Kalasinski, Jennifer Stone, Caitlin O'Brien, Alexa Bream, Aidan M Kennedy, Rachel A Paul, Michelle Bilbao, Maureen Romero, Rebecca L Carr, Jennifer M Siettmann, Anna K Vercruyssen, Kaycee Leon, Banu K Arun, Andrew V Grainger, David P Warshal, Erin Bowman, Timothy A Goedde, Deepa Halaharvi, Kellie Rath, Generosa Grana, Lida Mina, Karen H Lu

Faculty, Staff and Student Publications

OBJECTIVE: A quality improvement initiative (QII) was conducted with five community-based health systems' oncology care centers (sites A-E). The QII aimed to increase referrals, genetic counseling (GC), and germline genetic testing (GT) for patients with ovarian cancer (OC) and triple-negative breast cancer (TNBC).

METHODS: QII activities occurred at sites over several years, all concluding by December 2020. Medical records of patients with OC and TNBC were reviewed, and rates of referral, GC, and GT of patients diagnosed during the 2 years before the QII were compared to those diagnosed during the QII. Outcomes were analyzed using descriptive statistics, two-sample t-test, …

An Evaluation Of Hospital-Based Health Technology Assessment Processes In The United States., Scott Skinner

Electronic Theses and Dissertations

This research study explored the practices of hospital-based health technology assessment (HTA) in the U.S., as experienced by healthcare technology management (HTM) professionals. HTA can play an important role in helping to evaluate health technologies at both the macro (e.g., policy) level as well as at the micro (e.g., institutional) level of the public health ecosystem (C. S. Goodman, 2004). HTA seeks to broadly evaluate the effects, properties, and other impacts of various health technologies (C. S. Goodman, 2004). Common goals of HTA are to evaluate the safety, effectiveness, and cost-benefit of health technologies. A primarily phenomenological approach was used …

Lesbian, Gay, Bisexual, Transgender, Queer (Lgbtqia+) Health Disparities In Sexual Health And Sexual Education, Cole T. Mcbride

Curriculum and Instruction Undergraduate Honors Theses

Background: Comprehensive sex education instills knowledge and promotes the health of all youth, however, most sex education remains heteronormative. School-based programs in the United States (US) emphasize monogamous, heterosexual relationships. In 2021, only 7.4% of students received sex education that included positive representations of both LGB and transgender people and nonbinary topics, while 72% of programs across the US omit LGBTQ+ topics. Most new HIV diagnoses occur in gay and bisexual men aged 13-34, but the sex education environment for this group is increasingly hostile as more states prohibit addressing these topics in public schools.

Purpose: The purpose …

Klebsiella Aerogenes Adhesion Behaviour During Biofilm Formation On Monazite, Arya Van Alin, Melissa K. Corbett, Homayoun Fathollahzadeh, M. Christian Tjiam, Andrew Putnis, Jacques Eksteen, Anna H. Kaksonen, Elizabeth Watkin

Research outputs 2022 to 2026

The adsorption behaviour of micro-organisms during the initial attachment stage of biofilm formation affects subsequent stages. The available area for attachment and the chemophysical properties of a surface affect microbial attachment performance. This study focused on the initial attachment behaviour of Klebsiella aerogenes on monazite by measuring the ratio of planktonic against sessile subpopulations (P:S ratio), and the potential role of extracellular DNA (eDNA). eDNA production, effects of physicochemical properties of the surface, particle size, total available area for attachment, and the initial inoculation size on the attachment behaviour were tested. K. aerogenes attached to monazite immediately after exposure to …

Does Antibiotic Awareness Campaigns Exposure Decrease Intention To Demand Antibiotic Treatment? Testing A Structural Model Among Parents In Western Australia, Aaron Lapuz Alejandro, Wei Wei Cheryl Leo, Mieghan Bruce, Kaymart Gimutao

Research outputs 2022 to 2026

Antimicrobial resistance (AMR) is one of the key public health concerns the world is facing today. The effect of antibiotic awareness campaigns (AACs) on consumer behaviour has been documented in the literature with mixed results. Understanding the mechanism for how AACs affect target populations is vital in designing effective and tailored campaigns. Using structural equation modelling our study examined the relationships among people's exposure to antibiotic awareness campaigns, knowledge of AMR prevention, AMR risk perception, and intention to seek antibiotic treatment. This study also tested the moderating effect of anxiety and societal responsibility on preventing AMR, and on their intention …

Examining The Marketing Strategies Of Campus Mental Health On A Minority Student Population, Rochelle Bernarte

Electronic Theses, Projects, and Dissertations

Background: Public health, particularly mental health services aimed at making a positive impact can be difficult to market to populations. Promoting mental health services to a target demographic of predominantly minority students at a university comes with its own set of unique variables making the task especially tough. This can be concerning as studies have shown that minority students experience greater amounts of stress than their White counterparts but are less likely to seek mental health services (DeFreitas et al., 2018; Duffy, 2019; Lipson, et al., 2022). The purpose of this study was to gauge the Attitudes and Practices …

Meeting, Moving, Mastering - A Text Analysis Of The Aesthetic Attractions Of 'Wild Swimming', Dagmar Dahl, Åsa I. Bäckström

International Journal of Aquatic Research and Education

Why are people fascinated by swimming in nature? This article addresses the aesthetic experiences of wild swimming as expressed by five wild swimming authors in their books. Drawing from aesthetic philosophy, we analyze the ways in which the appeal of wild swimming is described on three levels: the allure of water in the environment, the sensory encounter between water and the body, and the experience of moving in water. Furthermore, with reference to Seel’s concept of nature aesthetics (1996), the experience of wild swimming is analyzed in terms of contemplation, correspondence, and imagination. We can conclude that the special intensity …

Aquatics For Individuals With Disabilities: An Analysis Of Publication Trends, Susan J. Grosse

International Journal of Aquatic Research and Education

This study investigates the published literature in the field of aquatics with disabilities; more specifically, it examines literature published during the most recent two decades, 2000 through 2019. Considerations include the content focus of published articles relating to aquatics with disabilities, distribution of articles over the specified time period, publication opportunities for authors, barriers as well as enhancements to development of literature in the field, and summary recommendations.

Health And Nutritional Status Among Internally Displaced Children Under Five Years, During The Civil War: Sri Lankan Experience, Madhuka Ambagahage

Indonesian Journal of Public Health Nutrition (IJPHN)

Around the globe, 1 in 6 children become vulnerable to grave physical and mental violence, hunger, sexual assaults, and exploitation of human rights due to war. These adversities are multi-dimensional, synergistic, and often subtle. This study attempted to evaluate the health and nutritional status of children aged under five years and living in the war zone of Sri Lanka, in view of improving the health services delivered to them. The study used a descriptive cross-sectional design. The study sample, 400, was based on probability proportionate and then systematic sampling drawn from IDP camps located in the Vavuniya district. Validated instruments …

Sars-Cov-2 Serostatus And Covid-19 Illness Characteristics By Variant Time Period In Non-Hospitalized Children And Adolescents, Sarah E Messiah, Michael D Swartz, Rhiana A Abbas, Yashar Talebi, Harold W Kohl, Melissa Valerio-Shewmaker, Stacia M Desantis, Ashraf Yaseen, Steven H Kelder, Jessica A Ross, Lindsay N Padilla, Michael O Gonzalez, Leqing Wu, David Lakey, Jennifer A Shuford, Stephen J Pont, Eric Boerwinkle

Faculty, Staff and Student Publications

OBJECTIVE: to describe COVID-19 illness characteristics, risk factors, and SARS-CoV-2 serostatus by variant time period in a large community-based pediatric sample.

DESIGN: Data were collected prospectively over four timepoints between October 2020 and November 2022 from a population-based cohort ages 5 to 19 years old.

SETTING: State of Texas, USA.

PARTICIPANTS: Participants ages 5 to 19 years were recruited from large pediatric healthcare systems, Federally Qualified Healthcare Centers, urban and rural clinical practices, health insurance providers, and a social media campaign.

EXPOSURE: SARS-CoV-2 infection.

MAIN OUTCOME(S) AND MEASURE(S): SARS-CoV-2 antibody status was assessed by the Roche Elecsys

RESULTS: Over half …

The Application Of An Extracellular Vesicle-Based Biosensor In Early Diagnosis And Prediction Of Chemoresponsiveness In Ovarian Cancer, Meshach Asare-Werehene, Robert A Hunter, Emma Gerber, Arkadiy Reunov, Isaiah Brine, Chia-Yu Chang, Chia-Ching Chang, Dar-Bin Shieh, Dylan Burger, Hanan Anis, Benjamin K Tsang

Faculty, Staff and Student Publications

BACKGROUND: Ovarian cancer (OVCA) is the most fatal gynecological cancer with late diagnosis and plasma gelsolin (pGSN)-mediated chemoresistance representing the main obstacles to treatment success. Since there is no reliable approach to diagnosing patients at an early stage as well as predicting chemoresponsiveness, there is an urgent need to develop a diagnostic platform for such purposes. Small extracellular vesicles (sEVs) are attractive biomarkers given their potential accuracy for targeting tumor sites.

METHODS: We have developed a novel biosensor which utilizes cysteine-functionalized gold nanoparticles that simultaneously bind to cisplatin (CDDP) and plasma/cell-derived EVs, affording us the advantage of predicting OVCA chemoresponsiveness, …

The Effectiveness Of Nem (Nutrizone Educational Media) Compared With Knowledge And Attitudes In Early Adults In The West Jakarta Region, Daniel Hartanto, Laras Sitoayu, Lintang Purwara Dewanti, Harna Harna, Mertien Sa’Pang

Indonesian Journal of Public Health Nutrition (IJPHN)

Metabolic syndrome is a disease that often occurs in early adulthood. Maintaining a good lifestyle to prevent non-communicable diseases is very important to maintain a good quality of life. In early adulthood, most of them are still not exposed to information related to metabolic syndrome, so it is necessary to provide interventions associated with it. This study uses the Nutrizone gameboard intervention media. Good early adults’ knowledge and attitude about Metabolic Syndrome may lead to a good lifestyle that prevents them from suffering from NCDs. An intervention media may improve their knowledge and attitude. The research design used was pre-experimental …

Associated Food Parenting Practices And Other Factors With Fruit And Vegetable Consumption In Students In Jakarta, Indonesia, Gina Amalia Chaerunnisa, Triyanti Triyanti

Indonesian Journal of Public Health Nutrition (IJPHN)

The increased risk of non-communicable diseases is still a problem in Indonesia, one of which is the lack of consumption of fruits and vegetables. The available data shows that although fruits and vegetables have a protective/protective effect on the incidence of non-communicable diseases but in real life, the average consumption of fruits and vegetables is still below the recommended intake. Thus, the protective effect cannot be seen clearly. This study aims to describe the consumption of fruits and vegetables and determine the factors of food parenting practices and other factors related to the consumption of fruits and vegetables in students …

The Impact Of Nutrition On The Mental And Physical Health Of Young Adults, Dareena El-Far

WRIT: Journal of First-Year Writing

Upon close examination by nutritional professionals, concern has arisen regarding the typical contents of a young adult diet. In terms of the rate at which young adults choose to consume nutritionally-dense food items, the rate at which nutrition-deficient junk food items are chosen over the former is significantly higher. Among further examinations of this issue by researchers, it has become evident that the nutritional decisions made by young adults are increasingly associated with several social, commercial, mental, educational, and economic influences. As a consequence of these factors, research has uncovered a connection between the consumption of a poor diet and …

Unmet Need For Family Planning In Indonesia And Its Associated Factors, Dewi Nuryana, Restu Adya Cahyani, Sukma Rahayu, Nohan Arum Romadlona, Elvira Liyanto, Lovely Daisy, Wira Hartiti, Maria Evi Ratnawati, Budi Utomo, Robert Joseph Magnani

Makara Journal of Health Research

Background: The unmet need for family planning in Indonesia has been stagnant since the early 2000s in the 10%–12% range with substantial socioeconomic and geographic disparities. This study sought to better understand the factors underlying the nonuse of contraceptives among women with an apparent need for family planning so that evidence-based corrective actions can be taken.

Methods: Three sources of quantitative data were used in the study—the 2017 Indonesia Demographic Health Survey, the 2018 Village Potential Survey, and the National Population and Family Planning Board service statistics. Further insights were obtained from online focus group discussions and in-depth …

Pfas: A Threat To Public Health And Safety, Ibrahim Qazi, Adriana Carrillo, Alexa Guloy [email protected], Emily Moon, Rayan Muneer, Hien Tran, Raiden Wadsworth

Undergraduate Research Symposium Posters

Nonstick pots and pans, takeout containers, waterproof clothes: these are items that people use in their daily lives. A common denominator in all of these items lies PFAS, or Per- and Poly-Fluoroalkyl Substances. Our exposure to these chemicals has proven to be toxic and carcinogenic to human health. Despite the evidence of their harmful effects, many companies still continue to incorporate these forever chemicals into their products, thus prolonging their exposure to humans.

The Intersection Of Herbicide Policy, Exposure, And Health At The University Of Connecticut, Katherine Hayward

Honors Scholar Theses

Pesticides play an extremely complicated role in our everyday lives. From the water you use to make your coffee, to the breastmilk your neighbor provides for their child, to the lake your dog swims in, chemical pesticides or their byproducts have been found in nearly every corner of our lives. The chemicals used in synthetic herbicides, a subcategory of pesticides, have far reaching negative impacts on human health, biodiversity, and water quality. Despite there being numerous published studies on the relationships between pesticide exposures and health, there is still ongoing discord and controversy surrounding their role in our lives. After …

Living With Covid-19 In The Community During The First Wave Of The Pandemic: Lessons From Patients For Healthcare Providers And Policy Makers, Linda Rozmovits, Michelle Marcinow, Ilja Ormel, Terence Tang, Elizabeth Mansfield, Kerry Kuluski, Seema Marwaha, Susan Law Dr

Patient Experience Journal

This qualitative descriptive study explores patients’ experiences of living with COVID-19, in the community, during the early stages of the pandemic. Between October 2020 and April 2021, fifteen semi-structured, video-recorded interviews were conducted, via Zoom, with participants in five Canadian provinces. Participants self-identified as having had a confirmed or suspected case of COVID-19. The constant comparative method was used to produce a thematic analysis of findings. Key findings include 1) PCR tests were not widely available in Canada, during the first wave, so many participants lacked a confirmed diagnosis and, subsequently, encountered challenges accessing specialist medical care; 2) Rapidly changing …

A Concept Analysis Of The Patient Experience, Tanja Avlijas Rn, Mscn, Janet E. Squires Rn, Phd, Michelle Lalonde Rn, Phd, Chantal Backman Rn, Phd

Patient Experience Journal

Patient experience, an essential indicator of quality patient care, is of increasing importance to hospitals that want to improve and maintain strong patient experience metrics to remain competitive in the business of healthcare. The aim of this study was to clarify the concept of the patient experience by identifying its existing definitions, methods of measurement, and underlying themes and attributes, to differentiate it from similar concepts and propose an operational and theoretical definition to guide valid and reliable development of future assessment tools. Walker and Avant’s eight-step methodology served as the framework for this concept analysis. A literature search, using …

Socio-Demographic, Maternal, And Infant Characteristics Associated With Pacifier Use Among Six-Months Old Infants In Clark County, Nevada, Kaelia Lynn Saniatan, Smriti Neupane, Chad L. Cross, Gabriela S. Buccini

Epidemiology & Biostatistics Faculty Research

Background

Pacifier use can interfere with nurturing care practices such as breastfeeding, soothing, and sleeping. Due to contradicting beliefs, recommendations, and the high frequency of pacifier use, understanding its associations may support shaping equitable public health recommendations. This study explored the socio-demographic, maternal, and infant characteristics associated with pacifier use among six-months old infants in Clark County, Nevada.

Method

Cross-sectional survey was conducted in 2021 with a sample of mothers (n = 276) of infants under six months old in Clark County, Nevada. Participants were recruited through advertisements in birth, lactation, pediatric care centers, and social media. We used binomial …

Building An Infrastructure For Down Syndrome Care, Kate E. Martin

Instructional Design Capstones Collection

People with intellectual disabilities experience greater obstacles in attaining their full health potential. The most common identifiable cause of intellectual disability is Down syndrome. Established in September 2021, the Down Syndrome Program at The Kirk Kerkorian School of Medicine at the University of Nevada, Las Vegas (UNLV) aims to meet the healthcare needs of members of the Southern Nevada community with Down syndrome and their families. However, there is currently no infrastructure in place in Southern Nevada to provide Down syndrome care, or clinical services dedicated to individuals with the condition. This work discusses options that were explored to develop …

Communicating Health: Misinformation And Mistrust In The Age Of Coronavirus, Chris Anstead

Undergraduate Theses

With one of the most advanced medical systems in the world, the Untied States still experienced an exceedingly high COVID-19 death rate per capita. Because biomedical therapies for COVID-19 were available, the focus of this review is on the social aspects of the COVID-19 response. By observing how Americans reacted to vaccination, masking, and social distancing guidelines, as well as how those guidelines were communicated to the general population from the public and private sectors, this thesis argues that the social and political aspects of the COVID-19 pandemic played a significant role in the outcome of the pandemic response. Additionally, …

Possible Effects Of Sexual Health Education On Health Behaviors And Indicators, Chloe Lafosse

Honors Scholar Theses

Sexual health education has long been evolving, and while a mountain of research has built a compelling case for continuing its improvement, the authors of the present paper were interested in evaluating the efficacy of state education standards in 2009, 2014, and 2019 on a multitude of sexual health outcomes in 2019. We concluded that throughout all three years, states with higher educational requirements could in fact produce better health outcomes, but those outcomes were heavily targeting delaying pregnancy. The educational requirements appeared to have neglected all other aspects of sexual health, including STD prevention, even though STD-based education was …

Review Of: Appalachian Health: Culture, Challenges, And Capacity, Danielle M. Davidov

Journal of Appalachian Health

The Journal of Appalachian Health is committed to reviewing published media that relates to contemporary concepts affecting the health of Appalachia. This is a review of the text Appalachian Health: Culture, Challenges, and Capacity. This book is an ideal starting point for anyone interested in Appalachian history, public health, and health disparities research.

A Better Life: Factors That Help And Hinder Entry And Retention In Mat From The Perspective Of People In Recovery, Adam D. Baus, Martha Carter, Jennifer Boyd, Erin Mcmullen, Trey Bennett, Alexandra Persily, Danielle M. Davidov, Christa Lilly

Journal of Appalachian Health

Introduction: Opioid addiction and opioid-related overdoses and deaths are serious public health problems nationally and in West Virginia, in particular. Medication-assisted treatment (MAT) is an effective yet underutilized treatment for opioid use disorder (OUD).

Purpose: Research examining factors that help individuals succeed in MAT has been conducted from provider and program perspectives, but little research has been conducted from the perspective of those in recovery.

Methods: This study, co-developed with individuals in recovery, took place in West Virginia-based MAT programs using an exploratory sequential mixed methods approach. The survey was open February through August 2021. Data were analyzed late 2021 …

Prevalence And Factors Of Self-Medication With Antibiotics In Claiborne County, Tennessee, Kimberly A. Carney, Lauren Wisnieski, Tristan Lackey, Donald Noah

Journal of Appalachian Health

Introduction: Antimicrobial resistance (AMR) is a serious concern to public health, causing an estimated 35,000 deaths annually in the U.S. Misuse of antimicrobials increases the rate of AMR. Self-medication with antibiotics (SMA) is a primary contributor to AMR that can be addressed through education. SMA has been reported at rates of 3% to 66% in the U.S. but has not been evaluated in Appalachia.¹ Low health literacy and barriers to accessing care have been correlated with SMA and are common in many areas of Appalachia.

Purpose: This study aims to assess factors associated with SMA, demographic differences in knowledge …

Factors Associated With Physical Activity Increases And Decreases Among A Sample Of Appalachian Residents During The Covid-19 Pandemic: A Cross-Sectional Study, Christiaan G. Abildso, Angela M. Dyer, Shay M. Daily, Christa Lilly, Emily A. Sarkees, Samantha I. Moyers, Thomas K. Bias

Journal of Appalachian Health

Introduction: Physical activity (PA) can prevent and reduce the deleterious physical and mental health effects of COVID-19 and associated lockdowns. Research conducted early in the pandemic demonstrates that a greater proportion of adults in the U.S. have decreased than increased PA, and the effects vary by sociodemographic factors. Ongoing evidence is important to identify patterns in PA changes during the pandemic.

Purpose: This study aims to identify factors associated with increases and decreases in PA during the COVID-19 pandemic in a convenience sample of adults residing in Appalachia.

Methods: Surveys were collected from a convenience sample of adults from eight …

An Analysis Of Burnout And Wellness Of Healthcare Workers Based On Patient Population And Healthcare Worker Location, Spencer Brandenburg

Undergraduate Theses

Healthcare workers, even with all of the positive work that they do, often suffer from increased burnout and decreased wellness/quality of life. This problem is not new and has been steadily worsening for many years, however, there are factors which impact burnout and wellness that have not been analyzed or have produced mixed results in prior burnout and wellness literature. There has been little to no research done on the impact of patient population demographics on burnout and wellness in healthcare workers, and the research analyzing the impacts of demographic healthcare worker location has consistently produced mixed results often based …

Building Before: Community Resiliency As Emergency Management, Alexandria Rinne

Honors Program: Senior Projects (Public)

This project seeks to address gaps in emergency preparedness education related to tornado response. Through an examination of current research about best practices for tornado emergency management response and an examination of the needs of FEMA Regions 7 and 8, the author has identified key strategies and stakeholders to increase positive outcome through building community engagement and resiliency. Three presentations were created for delivery to key community stakeholders—local government officials; non-governmental organizations, social networks, and associations; and individual private citizens. The project offers an overview of background research and provides presentation slide decks, scripts, and discussion guides, all created with …

Patient And Provider Experience With Artificial Intelligence Screening Technology For Diabetic Retinopathy In A Rural Primary Care Setting, Brian M. Nolan, Emma R. Daybranch, Kerri Barton, Neil Korsen

Journal of Maine Medical Center

Introduction: The development of autonomous artificial intelligence for interpreting diabetic retinopathy (DR) images has allowed for point-of-care testing in the primary care setting. This study describes patient and provider experiences and perceptions of the artificial intelligence DR screening technology called EyeArt by EyeNuk during implementation of the tool at Western Maine Primary Care in Norway, Maine.

Methods: This non-randomized, single-center, prospective observational study surveyed 102 patients and 13 primary care providers on their experience of the new screening intervention.

Results: All surveyed providers agreed that the new screening tool would improve access and annual screening rates. Some providers also identified …