Digital Commons Network^™

A Disparities Analysis Of Cancer Patients’ Access To Depression Treatment By Health Insurance Status And Type, Stephanie Minbiole-Snider

Walden Dissertations and Doctoral Studies

Research has demonstrated that comorbid conditions like depression in cancer patients reduce quality of life, prolong recovery, and reduce survival time of the cancer patient. Although other studies have investigated the issue of depression among cancer patients, there is a dearth of studies looking at differences in taking depression medication with health insurance as a source of disparity. Using survey data from the National Health Interview Survey (NHIS), and the health belief model as the theoretical framework, this study had two purposes. The first was to determine if there were differences in the likelihood of taking medication for depression based …

Association Between The Lack Of Health Insurance, Income, And The Severity Of Negative Perinatal Outcomes Among Native Spanish- And English-Speaking Women Living In Florida, Khadijeh Ashktorab

Walden Dissertations and Doctoral Studies

Evidence indicates that non-English-speaking mothers, particularly Spanish-only speakers, experience worse maternal health outcomes compared to their mainstream counterparts. Language barriers often hinder communication and negatively affect perinatal care. This study used data from the Centers for Disease Control and Prevention Pregnancy Risk Assessment Monitoring System from Florida (2019–2020) to examine associations between health insurance, income, and perinatal outcomes among Spanish and English-speaking women. Krieger’s eco-social theory guided this cross-sectional, quantitative analysis. Chi-square tests were used for bivariable analysis, and multivariable models were used to adjust for confounders. Results showed that native language alone significantly predicted specific outcomes such as large-for-gestational-age …

Hurricane Irma's Impact On Mortality Among The Chronically Ill Populations In Florida, Cody Ray Thornton

Walden Dissertations and Doctoral Studies

Natural disasters pose significant risks to individuals with chronic diseases, exacerbating health disparities through disruptions in healthcare access and systemic vulnerabilities. This study investigated the association between chronic disease-related mortality occurring within 2 months of Hurricane Irma, and whether demographic variables, including age, sex, race, Hispanic ethnicity, poverty, urbanicity, and educational attainment, modified this relationship. This cross-sectional study used the social-ecological model to analyze secondary mortality data from the National Vital Statistics System. Bivariate and multivariate logistic regression revealed that deaths from chronic illnesses, occurring between September 2017 and October 2017, were 2.694 times higher, compared to the same period …

1 Studying The Determinants Of Successful Aging: Diet, Lifestyle, And Social Relations In Egypt, Fayrouz Shaltout

Theses and Dissertations

Abstract

Background

The global population is aging rapidly, with projections indicating that by 2050, one in six people will be over the age of 65. In Egypt, the aging population, particularly those aged 60 and above, is expected to grow significantly, posing a growing public health concern. Unhealthful diets (that are associated with overweight and obesity), are one of the main reasons associated with non-communicable diseases (e.g., diabetes and cardiovascular diseases) are major risk factors for poor aging outcomes. Despite this, there is limited research on the specific determinants of successful aging (SA) in Egypt, especially among individuals aged 50 …

Breastfeeding Interventions And Programs Conducted In The Islamic Republic Of Iran: A Scoping Review, Patricia J. Kelly, Amrita Sidhu, Anusha Sajja, Devanshi Majeethia, Elizabeth Dodge, Basil H. Aboul-Enein

College of Nursing Faculty Papers & Presentations

The purpose of this review was to identify interventions promoting breastfeeding (BF), BF practices and their outcomes in Iran. Using the PRISMA-ScR Guidelines, we searched across 14 databases for publications published between 2010 and February 2024 to identify studies published in English or Farsi language in peer-reviewed journals, using search terms 'breastfeeding', 'lactation', 'education', 'promotion', 'intervention' and 'program'. Inclusion criteria included intervention-based studies with quantitative outcomes of pregnant women/mothers receiving education, training or other intervention that promoted BF or exclusive BF. Excluded studies were protocols, those examining Iranian communities outside of Iran publications in other languages, brief communications, gray literature …

Cervical Cancer Screening And Hpv Vaccine Intentions: An Egyptian Population Assessment Through University Channels, Rita Hany Ebeid

Theses and Dissertations

Background: Cervical cancer remains a significant global health burden, disproportionately affecting low- and middle-income countries. While HPV vaccination and cervical cancer screening programs have shown promise in reducing incidence and mortality, access to these interventions remains limited in Egypt. The purpose of this study was to analyze female and male beliefs, knowledge of, and perceptions related to cervical cancer screening and HPV vaccination, and how these factors influence women and men’s intentions to respectively undergo or promote these behaviors in Egypt. This study also aimed to develop recommendations for more effective cervical cancer prevention measures that promote greater uptake among …

Crème De La Conference: 8th World Congress Of Pediatric Cardiology And Cardiac Surgery-Wcpccs 2023, Carissa M. Baker-Smith, Liesl Zühlke, Jennifer Co-Vu, Shubhika Srivastava, Renelle George, Shelby Kutty, Ali N. Zaidi, David J. Goldberg, Erica D. Sood, Kathryn M. Dodds, David S. Cooper, Mitchel I. Cohen, Gil Wernovsky, Jeffrey P. Jacobs

Department of Medicine Faculty Papers

No abstract provided.

Allostatic Load And Incident Dementia Among Older Adults In The United States, Mohammed Usman Kabeto

Walden Dissertations and Doctoral Studies

Allostatic load (AL), the cumulative physiological burden of chronic stress, is a significant health problem, and it has been associated with adverse health outcomes, including cognitive functioning. There is a paucity of literature examining associations between AL and incident dementia in the United States. This quantitative study used data from the United States Health and Retirement Study cohort (2016-2020) to examine the association between AL quartile and incident dementia among participants who were aged 56 and older at baseline. Dementia status was determined measuring immediate and delayed recall, serial seven subtraction, and backward count, as well as self-report conditions for …

The Multifaceted Impact Of The Covid-19 Pandemic On Perceptions Of Overall Health, Krystal Robinson, Grace Godfrey, Jacob Godfrey, Carissa Salamatin, Renee Chang, Payson Broome, Dominique Gillette, Kevin Tarrio, Sherli Koshy-Chenthittayil, Karen Duus

Annual Research Symposium

The World Health Organization (WHO) defines health as a “state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.” Previous studies have indicated both mental health and overall physical health can decline due to heightened sedentary behavior. This project investigates these concepts further by analyzing individual’s perceptions of their overall physical and mental health during the pandemic using Qualtrics and R. Participants aged 18 and older (n > 200) provided pre- and post-quarantine data with subgroup comparisons by gender, ethnicity, socioeconomic status, age, residence, and coping mechanisms. Initial results revealed a significant decline in …

Residence, Education, Wealth, And Hiv/Aids Prevention Knowledge Among Nigerian Adults, Chinedu Nwaobia Nwaru

Walden Dissertations and Doctoral Studies

HIV has remained the most prevalent and deadliest epidemic affecting humanity. It is pertinent to note that, despite the number of years since the first case was reported in the early 1980s in the United States, and concerted efforts by local, national, and international governmental and nongovernmental agencies at curbing it, the level of knowledge of HIV transmission and the disease prevention, especially among Nigerians, is still not encouraging. Nigeria, the most populous country in Sub-Saharan Africa ranks second globally as the country with the highest number of people living with HIV/AIDS, which is currently estimated at 3 million. In …

Strengthening Legal Frameworks And Patient Safety: A Narrative Review Of Medical And Dental Malpractice In Indonesia, Ghulam Mustafa, Ede Surya Darmawan

Jurnal ARSI : Administrasi Rumah Sakit Indonesia

Many cases of medical and dental malpractice in Indonesia are still related to patient safety and healthcare quality. This narrative review aims to identify solutions that can be implemented. The main focus is to compare the incidence of malpractice in clinical medical and dental practice, emphasizing legal implications, coverage, and internal organizational issues. A systematic literature search was conducted through databases such as Pubmed, ScienceDirect, Google Scholar, Springer, Garuda, and other online databases. Articles published no later than 2024. Eleven studies were selected that discussed the problem of malpractice in Indonesia. Independent screening and critical appraisal were carried out to …

Perceived Healthfulness Of The Environment Of Communities With Low Income: Focus Groups And Interviews With Extension Nutrition Educators, Elder Garcia Varela, Jamie Zeldman, Jade Mcnamara, Jesse S. Morrell, Lisa Franzen-Castle, Melissa D. Olfert, Tandalayo Kidd, Kendra Kattelmann, Geoffrey Greene, Karla P. Shelnutt, Sarah Colby

Journal of Extension

This study explored Extension nutrition educators’ (NEs) perceptions of community members’ challenges and opportunities for achieving a healthy lifestyle. NEs represented various communities with low income across nine states. NEs across locations identified similar barriers (i.e., lack of access and availability of healthy and affordable foods; access to transportation; and financial insecurity) and opportunities (i.e., trustworthy and free nutrition education resources and programs; and access to food banks, food pantries, and health care professionals) that prevented or facilitated a healthful lifestyle. Future research should explore key community stakeholder and community member perceptions to guide the development of community-driven interventions.

Menstrual Poverty In Egypt: Padding The Way To Period Equity, Sara Hesham Nasr

Theses and Dissertations

With approximately 800 million women menstruating daily worldwide, a significant portion of this demographic experiences barriers to accessing sanitary products. In Egypt, despite having around third of the population in reproductive age and menstruating monthly, an economic turmoil in 2017 opted the government to label menstrual products as luxury items and the prices have increased since then.

The current study aimed to investigate menstrual poverty in Egypt, focusing on the economic and social challenges faced by women during menstruation. Key objectives include assessing the financial challenges related to menstruation, exploring existing policies aimed at alleviating these challenges, and proposing evidence-based …

Optimizing Elderly Care: A Data-Driven Ai Model For Predicting Polypharmacy Risk In The Elderly Using Share Data., Eman Ramadan

Pharmacy

Background: Aging is frequently accompanied by multimorbidity, the presence of multiple chronic conditions, which contributes to declines in both cognitive and physical function and presents complex health challenges. One such challenge is Polypharmacy (PP), defined as the concurrent use of more than five medications. Methods: We used data from participants older than 50 years who were present in wave 6 and at least one of the subsequent three waves of the SHARE study, aiming to predict PP risk at 2, 4, and 6-year intervals. We selected the predictor variables using LASSO regression and evaluated eight ML models using a rigorous …

Anesthesia And Pain Management In Conflict-Affected Regions: Addressing Global Health Barriers To Access And Quality Of Care​, Naeel Uddin, Sierra Brown, Maria Easler, Ayanda Mkhize, Marwa Hamdam, Chandu Goli, Lauren Draper

Annual Research Symposium

This poster examines how to deliver safe, effective anesthesia and pain control in areas with limited resources and ongoing security threats. Focusing on portable technology, ketamine-based protocols, and telemedicine, we highlight ethical considerations, training needs, and global collaborations. Our findings outline a pathway to reduce suffering and improve surgical outcomes in vulnerable populations by addressing challenges unique to conflict settings.

Violence Among Nigeria’S Female And Predictors Of Help-Seeking Behavior Using Technology, Abayomi Karunwi

Walden Dissertations and Doctoral Studies

The decision-making autonomy of female intimate partner violence (IPV) survivors to make financial transactions is a stronger predictor of help-seeking behavior that is not yet fully explored. Despite the plausibility of using the mobile phone for financial transactions, it is yet to be explored as a predictor of help-seeking behavior after IPV events through digital financial inclusion. The dataset from the 2018 Nigerian Demographic Health Survey was used to explore if digital financial inclusion could predict help-seeking behavior instead of the severity of abuse among ever-partnered Nigerian female IPV survivors (aged 15 to 49 years) who use their mobile phones …

The Lived Experiences Of Prediabetes And Type 2 Diabetes Among African Americans In Rural West Virginia, Orlando Craighead

Walden Dissertations and Doctoral Studies

African Americans in rural Appalachian West Virginia experience disproportionate rates of diabetes, with limited research examining their unique challenges in managing this chronic condition. This qualitative study aimed to explore how African Americans in rural Appalachia develop and utilize diabetes management skills, examining the intersections of cultural influence, healthcare access, and technological adoption. Using a hermeneutic phenomenological approach grounded in the Social Determinants of Health theory, Health Belief Model, and Social Ecological Model, semi-structured interviews were conducted with nine African American adults diagnosed with pre-diabetes or Type 2 diabetes in Kanawha County. Thematic analysis revealed four main themes: Cultural and …

Exploring The Relationship Between Psychiatric Illness And Dermatological Disorders: A Narrative Review, Alan D. Kaye, Rahib K. Islam, Abigayle M. Castine, Grace C. Wester, William T. Barham, Catherine G. Nguyen, Elena Plakotaris, Bradley Dorius, Julian Kim, Patricia Griffin, Amber Edinoff, Sahar Shekoohi, Giustino Varrassi

School of Medicine Faculty Publications

The interplay between psychiatric conditions and dermatological disorders is complex and multifaceted, often resulting in significant challenges for both diagnosis and treatment. This narrative review examines associations between specific psychiatric conditions, trichotillomania, attention deficit hyperactivity disorder, schizophrenia, bipolar disorder, and various dermatological disorders. The present investigation delves into pathophysiological mechanisms, clinical presentations, and management strategies of these comorbid conditions. Psychiatric disorders can exacerbate dermatological conditions through mechanical trauma, medication side effects, and stress-induced exacerbations, while dermatological disorders can lead to significant psychiatric morbidity. The biopsychosocial approach, emphasizing the importance of integrated care involving dermatologists and mental health professionals, is crucial …

Lifestyle Attitudes And Habits In A Case Series Of Patients With Cancer And Metabolic Syndrome, Kimberly Siu, Isabel Martinez Leal, Natalia I Heredia, Jessica T Foreman, Jessica P Hwang

Faculty, Staff and Student Publications

Metabolic syndrome (MetS) is associated with increased cancer risk and poor cancer prognosis. The current study applied a mixed methods approach to better understand attitudes about making lifestyle changes and current dietary and physical activity behaviors among cancer patients with MetS at a cancer center and to explore the suitability of brief lifestyle questionnaires to help providers understand their patients' lifestyle attitudes and habits. Qualitative interviews were used to obtain patients' perspectives about lifestyle changes, and 3 quantitative questionnaires-the Readiness Ruler, Rate Your Plate, and the International Physical Activity Questionnaire-Short Form (IPAQ-SF)-were used to measure patients' readiness for lifestyle change, …

Experiences Of Health And Mental Health Services For Immigrant Mothers From The Northern Triangle Of Central America, Lisa Dianne Vega

Doctoral Dissertations and Projects

The purpose of this phenomenological study was to describe the lived experiences of immigrant mothers from the Northern Triangle of Central America with access to health and mental health services in the Southern United States. The theory guiding this study is social constructivism developed by Lev Vygotsky in 1968, as it will seek to understand the greater contexts of the experiences of the participants, both currently, as well as the stories and experiences of their immigration journey. Central American immigrant mothers from the Northern Triangle face many types of traumatic events in their lives. These events began in their home …

Physical Health Care Use, Mental Health Care Use, And Resilience Among Formerly Incarcerated Adults In Southern California, Tamara Parker

Walden Dissertations and Doctoral Studies

Adults who have experienced incarceration face many challenges reentering society. The lack of physical and mental healthcare use has been shown to contribute to recidivism. This cross-sectional study using a multivariate linear regression examined the relationship between physical healthcare use, mental healthcare use, and resilience among formerly incarcerated adults in Southern California while controlling for age, gender and race. Physical healthcare use was defined as the frequency of appointments, having health insurance coverage, and having a usual place of care. Mental healthcare use was defined as needing and receiving mental health treatment. The study used the Resilience Theory to determine …

Investigating Mental Health Disparities In Rural Sexual And Gender Minority Adults: Protocol For The Rural Exploration And Approaches To Lgbtq + Mental Health (Realm) Prospective Cohort Study, Shoshanna L. Fine, Kalai Willis, Iaah L. Lucas, Kirsten F. Siebach, Jennifer L. Glick, Mariah Valentine-Graves, Savannah Winter, Michael Smith, Thomas Waltz, Gina Bailey Herring, Marissa Hannah, Holly C. Wilcox, Travis Sanchez, Stefan D. Baral, Sarah M. Murray

School of Public Health Faculty Publications

BACKGROUND: Sexual and gender minority (SGM) persons experience substantial mental health disparities throughout the life course, including increased vulnerability to depression and suicide. Few existing studies, however, have explored how pervasive experiences of SGM-related stigma, discrimination, and trauma (i.e., minority stress) contribute to adverse mental health outcomes among diverse sub-populations of SGM adults living in rural areas of the United States. This paper describes the protocol for a prospective cohort study, "Rural Exploration and Approaches for LGBTQ + Mental Health (REALM)," that will explore minority stress in relation to mental health conditions and suicidal behaviors among rural SGM adults. METHODS: …

Behavioral Science-Based “Nudges” Could Increase Physical Activity Among Adolescents With Adhd, Hannah Patnaik, Andrew S. London, Kevin M. Antshel

Population Health Research Brief Series

Children and adolescents with ADHD are more likely to exhibit difficulties in school, have higher rates of injuries and accidents and more family conflicts, and are at higher risk of depression and anxiety. Given the prevalence of ADHD and associated difficulties, there is a substantial need for effective ADHD treatment and symptom management. This brief summarizes findings from a recently completed pilot study testing the efficacy of behavioral interventions aimed at encouraging daily physical activity (i.e., steps measured with an activity tracker) among adolescents with ADHD in the Syracuse, NY area between March 2023 and June 2024. Results show that …

Infection-Related Hospitalization And Incident Heart Failure: The Atherosclerosis Risk In Communities Study, Rebecca L Molinsky, Amil Shah, Melana Yuzefpolskaya, Bing Yu, Jeffrey R Misialek, Bruno Bohn, David Vock, Richard Maclehose, Barry A Borlaug, Paolo C Colombo, Chiadi E Ndumele, Junichi Ishigami, Kunihiro Matsushita, Pamela L Lutsey, Ryan T Demmer

Faculty, Staff and Student Publications

Background: The immune response to infections may become dysregulated and promote myocardial damage contributing to heart failure (HF). We examined the relationship between infection-related hospitalization (IRH) and HF, HF with preserved ejection fraction, and HF with reduced ejection fraction.

Methods and results: We studied 14 468 adults aged 45 to 64 years in the ARIC (Atherosclerosis Risk in Communities) Study who were HF free at visit 1 (1987-1989). IRH was identified using select International Classification of Diseases (ICD) codes in hospital discharge records and was treated as a time-varying exposure. HF incidence was defined as the first occurrence …

Evaluating Donor-Recipient Sex Mismatch In Anterior Cruciate Ligament Reconstruction With Allograft: Outcomes At 2 Years Postoperatively, Connor Crutchfield, Natalie Lowenstein, Chilan Leite, Christian Lattermann, Elizabeth Matzkin

SKMC Student Presentations and Publications

BACKGROUND: Female patients tend to suffer a greater risk of reinjury and worse patient-reported outcome measures (PROMs) after anterior cruciate ligament reconstruction (ACLR) than male patients, regardless of the graft type used.

PURPOSE/HYPOTHESIS: This study explored the role of donor-recipient sex mismatching to help explain these sex-based dispar- ities in outcomes after ACLR with an allograft. The hypothesis was that allograft donor-recipient sex mismatch would adversely affect surgical outcomes at a 2-year follow-up, with male-to-female graft donations yielding the lowest rates of success.

STUDY DESIGN: Cohort study; Level of evidence, 3.

METHODS: Patients who underwent primary ACLR with an allograft …

Sustainable Solutions To The Continuous Threat Of Antimicrobial Resistance, Brad Spellberg, David N Gilbert, Michael Baym, Gonzalo Bearman, Tom Boyles, Arturo Casadevall, Graeme N Forrest, Sarah Freling, Bassam Ghanem, Fergus Hamilton, Brian Luna, Jessica Moore, Daniel M Musher, Travis B Nielsen, Priya Nori, Matthew C Phillips, Liise-Anne Pirofski, Andrew F Shorr, Steven Y C Tong, Todd C Lee, Emily G Mcdonald

Faculty, Staff and Students Publications

To combat antimicrobial resistance (AMR), advocates have called for passage of the Pioneering Antimicrobial Subscriptions To End Upsurging Resistance (PASTEUR) Act in the United States, which would appropriate $6 billion in new taxpayer-funded subsidies for antibiotic development. However, the number of antibiotics in clinical development, and US Food and Drug Administration approvals of new antibiotics, have already markedly increased in the last 15 years. Thus, instead of focusing on more economic subsidies, we recommend reducing selective pressure driving AMR by (1) establishing pay-for-performance mechanisms that disincentivize overprescribing of antibiotics, (2) focusing existing research and development funding on strategies that decrease …

Childhood Sexual Trauma, Substance Use, And Antiretroviral Therapy Adherence Among Older Adults Living With Hiv: A Mediational Analysis, Monique J. Brown, Josie Zhang, Prince Nii Ossah Addo, Amandeep Kaur, Daniel Amoatika, Elizabeth L. Crouch Ph.D., Steven A. Cohen

Faculty Publications

Childhood sexual abuse (CSA) is linked to substance use and lower antiretroviral therapy (ART) adherence. However, studies examining the mediational role of substance use between CSA and ART adherence are lacking. Therefore, the aim of this study was to determine the potential mediational role of substance use between CSA and ART adherence among older adults living with HIV (OALH) (n = 91). Mediation analyses assessed the direct and indirect relationships between CSA, substance use, and ART adherence. Statistically significant differences existed in substance use by gender (male vs. female: 12.3 vs. 9.97) and ART adherence by race (Black vs. …

Patterns Of Substance Use Among Street-Involved Children And Youth In Kenya: The Roles Of Street-Exposure, Migratory Factors, Family Deprivation, And Geographic Sub-Location, Michael L Goodman, Sarah Seidel, Andrew Springer, Christine Markham, Aaron Godoy, Lauren Raimer-Goodman, Kelvin Munene, Stanley Gitari

Faculty, Staff and Student Publications

Substance use among street-involved children and youth (SICY) in low- and middle-income countries is common. Using data abstracted from program intake forms (2016-2022) for an intervention to reintegrate SICY with their communities, we assess which individual, family, and geographic characteristics are predictive of substance use, and specifically inhalant use and non-inhalant use among a sample of 227 SICY in Meru County, Kenya. Assessed determinants include age, geographic location of home community, years on street, family deprivation prior to street-migrating, motivation for street migrating, abuse experiences on the street, and activities on the street. Number of years lived on the street, …

Sexual Behavior Stigma Among Cisgender Gay, Bisexual, And Other Men Who Have Sex With Men In Nine Nhbs Cities Across The United States: Burden And Associations With Prep Continuum And Hiv Care Continuum Outcomes, John Mark Wiginton, Sarah M Murray, Bridget J Anderson, Kwa Sey, Yingbo Ma, Colin P Flynn, Danielle German, Emily Higgins, Timothy W Menza, E Roberto Orellana, Stephanie Sanz, Nabeeh A Hasan, Alia Al-Tayyib, Jennifer Kienzle, Garrett Shields, Zaida Lopez, Paige Wermuth, Stefan D Baral

Faculty, Staff and Student Publications

In the United States (US), sexuality-based stigma continues to undermine HIV prevention and care efforts. We assessed sexual behavior stigma burden across family, healthcare, and social domains and determined associations with HIV-related outcomes among cisgender gay, bisexual, and other men who have sex with men (MSM) in nine US metropolitan statistical areas. MSM (N = 4,086) recruited at places of MSM social congregation via venue-based, time-sampling procedures completed a survey on sexual behavior stigma, PrEP (pre-exposure prophylaxis) continuum and HIV care continuum outcomes, sociodemographic characteristics, and other measures. We calculated prevalence and overall mean stigma subscale scores (range: 0.00–1.00) …

Vaxbot-Hpv: A Gpt-Based Chatbot For Answering Hpv Vaccine-Related Questions, Yiming Li, Jianfu Li, Manqi Li, Evan Yu, Danniel Rhee, Muhammad Amith, Lu Tang, Lara S Savas, Licong Cui, Cui Tao

Faculty, Staff and Student Publications

OBJECTIVE: Human Papillomavirus (HPV) vaccine is an effective measure to prevent and control the diseases caused by HPV. However, widespread misinformation and vaccine hesitancy remain significant barriers to its uptake. This study focuses on the development of VaxBot-HPV, a chatbot aimed at improving health literacy and promoting vaccination uptake by providing information and answering questions about the HPV vaccine.

METHODS: We constructed the knowledge base (KB) for VaxBot-HPV, which consists of 451 documents from biomedical literature and web sources on the HPV vaccine. We extracted 202 question-answer pairs from the KB and 39 questions generated by GPT-4 for training and …