Digital Commons Network^™

A Mixed Methods Exploration Of Young Women's Agency And Mental Health During Covid-19 In Low-Income Communities In Mumbai, India, Marie A Brault, Melissa F Peskin, Anastasia N Jones, Amrita Saikia, Rinchen O Bhutia, Sai Sammitha Cheruvu, Vaishali M Jagtap, Rajendra Singh, Poornima Nair, Rajesh Vedanthan, Sten H Vermund, Shubhada Maitra

Faculty, Staff and Student Publications

Introduction: Adolescent girls and young women (AGYW) in India face additional health inequities compared to their male peers, as gender norms constrain agency for prevention and self-care. The onset of the COVID-19 pandemic and associated lockdowns deepened health inequities and often worsened mental health, but the impacts on agency are unclear. This exploratory sequential mixed methods paper examined mental health and COVID-19 elements that exacerbated or mitigated adverse consequences for AGYW in low-income communities in Mumbai.

Methods: We conducted semi-structured interviews with AGYW (aged 15-25 years; N = 60) and adults (parents, healthcare providers, community-based organization representative; N = 30). …

Abstract Book Of The 16th Indonesian Occupational Medicine Update (Iomu)

Occupational and Environmental Medicine Journal of Indonesia

Jakarta, Indonesia, 2nd March to 4th March 2024

Mckenzie Exercise For Reducing Low Back Pain Complaints In Office Worker: An Evidence-Based Case Report, Bonnie Medana Pahlavie, Dewi S. Soemarko, Indah Suci Widyahening

Occupational and Environmental Medicine Journal of Indonesia

Background:

Low back pain (LBP) is pain that is felt in the lower back area, namely between the corners of the lowest ribs and the lower buttocks (lumbar or lumbo-sacral area) and can be local pain or radiate to the upper thighs/legs or both. Low back pain is a 10% debilitating condition that results in a change in life expectancy due to disability. Low back pain is not a malignancy and is a self-limiting condition, but patients always seek treatment to reduce the severity of their symptoms. Chronic Low Back Pain can alter lifestyle and increase the rate of prolonged …

Multidrug-Resistant Organisms Infection On Mortality Of Burn Patients At Public Hospital X In Jakarta: A Retrospective Study, Raja Merlinda Veronica, July Kumalawati, Cleopas Martin Rumende, Leonard Nainggolan, Marcellus Simadibrata, Hamzah Shatri, Em Yunir, Aditya Wardhana, Erni Juwita Nelwan, Musfardi Rustam

Kesmas

Susceptibility to infection and increasing antibiotic resistance put burn patients at risk of developing infections caused by multidrug-resistant organisms (MDRO). This condition can progress to sepsis, increasing morbidity and mortality. This retrospective cohort study employed the medical record data of patients treated at Public Hospital X in Jakarta, Indonesia, from January 2020 to June 2022. Of 160 subjects, most were aged <60 years (82.5%) and had comorbidities (16.88%). The most common cause of burns was fire (86.25%). The use of medical devices was 90.63%, with a 14-day median length of stay. The most common gram-negative MDRO pathogens were K. pneumoniae (29.91%), Enterobacter sp (22.32%), and Acinetobacter (20.54%); 45% of patients infected with MDRO died. The bivariate analysis found an increased risk of death due to MDRO infection in burn patients (RR 1.103; 95%CI 1.004-1.211, p-value = 0.046). After adjusting for role variables (age, comorbidities, total body surface area, use of medical devices, length of stay) and from multivariate analysis, the confounding variables for MDRO infection and mortality were length of stay and age. MDRO infection increases the mortality rate in burn patients. Mortality in burn patients due to MDRO infection is greater than non-MDRO.

Passive Smoking And Its Correlation With Stunting In Children: A Systematic Review, Anita Rahmiwati, Karlinda Karlinda, Hamzah Hasyim, Febriyansyah Febriyansyah

Kesmas

Passive smoking is a significant risk factor for stunting in children, highlighting the urgent need for effective public health measures. This study aimed to investigate the association between passive smoking and stunting in children aged 0 months-7 years. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, a comprehensive literature search was conducted across multiple online databases, including PubMed, ProQuest, Science Direct, Willey Online Library, Sage Journal, Cambridge University Press, and Oxford Academic. The quality of included articles reporting observational studies was assessed using the Critical Appraisal Skill Programme (CASP) checklist, presenting data through narrative synthesis. Findings …

Epigenetic Age Acceleration And Disparities In Posttraumatic Stress In Women In Southeast Louisiana: Nimhd Social Epigenomics Program, Alicia K. Smith, Seyma Katrinli, Dawayland O. Cobb, Evan G. Goff, Michael Simmond, Grace M. Christensen, Tyler Prusisz, Sierra N. Garth, Meghan Brashear, Anke Hüls, Erika J. Wolf, Edward J. Trapido, Ariane L. Rung, Nicole R. Nugent, Edward S. Peters

School of Medicine Faculty Publications

IMPORTANCE: Disasters experienced by an entire community provide opportunities to understand individual differences in risk for adverse health outcomes over time. DNA methylation (DNAm) differences may help to distinguish individuals at increased risk following large-scale disasters. OBJECTIVE: To examine the association of epigenetic age acceleration with probable posttraumatic stress disorder (PTSD) and PTSD symptom severity in women. DESIGN, SETTING, AND PARTICIPANTS: This prospective cohort study examined data from participants in the Women and Their Children's Health cohort, who were characterized longitudinally following the Deepwater Horizon oil spill (DHOS) in 2010 and through numerous hurricanes in the Gulf Coast region of …

Impacts Of Social Media Use On The Wellbeing Of Older Adults : Evidence From China During The Covid-19 Pandemic, Xuying Dong

Lingnan Theses (Doctoral degree)

Given the trend of increasing use of information and communication technologies among Chinese elder population, more attention should be drawn on the relationship between social media use and wellbeing of older adults. This research explores the social media use situation among older adults in mainland China as well as its influences on their wellbeing, and employs a mixed approach including quantitative questionnaire distributed via WeChat social media platform and qualitative interview among Chinese older adults who are over 60 years of age in Jingzhou, Hubei Province. Generally speaking, social media use can improve the wellbeing of Chinese older adults, more …

Development And Implementation Of An Emergency Preparedness Policy And Procedure, Educational Intervention, And In-Situ Simulation In A Pediatric Primary Care Office: A Quality Improvement Project, Kaitlin Patel

Doctor of Nursing Practice Scholarly Projects

Background. Pediatric primary care offices are frequently unprepared to respond to clinical emergencies that may present to or occur at their site. The purpose of this project was to improve office emergency preparedness at a pediatric primary care office to align with the American Academy of Pediatrics policy statement for pediatric office emergency preparedness.

Methods. A PRISMA-guided literature review found support for both educational interventions and in-situ simulation to improve aspects of emergency preparedness. The aim of this project was to develop a practice-specific emergency preparedness policy and procedure and implement a training and in-situ simulation to increase medical and …

Sociocultural Effects On Suicidal Ideation Among South Asian Immigrants, Rezwana Ahmed Choudhury

Walden Dissertations and Doctoral Studies

With the growing South Asian immigrant population in the West, it is necessary to conduct suicide-related studies among this population to understand the reasons behind suicidal ideation faced by this population. This quantitative cross-sectional survey design study aimed to examine sociocultural factors that may be associated to the risk level of suicidal ideation among South Asian immigrants in the United States. A survey questionnaire was developed using a combination of demographic questions and existing instruments: the Suicide Ideation Attributes Scale, Religious Belief Salience Scale, Suinn-Lew Asian Self-Identity Acculturation Scale, and Rapid Eating Assessment for Participants—S. Data were collected from a …

Influence Of Adiposity And Sex On Sars-Cov-2 Antibody Response In Vaccinated University Students: A Cross-Sectional Esfuerso Study, Adriana L. Perales-Torres, Lucia M. Perez-Navarro, Esperanza M. Garcia-Oropeza, Alvaro Diaz-Badillo, Yoscelina Estrella Martinez-Lopez, Marisol Rosas-Diaz, Octelina Castillo-Ruiz, Laura Yanneth Ramirez-Quintanilla, Leonel Vela, Beatriz Tapia, Juan C. Lopez-Alvarenga

School of Medicine Publications

Prior studies have identified various determinants of differential immune responses to COVID-19. This study focused on the Ig-G anti-RBD marker, analyzing its potential correlations with sex, vaccine type, body fat percentage, metabolic risk, perceived stress, and previous COVID-19 exposure. In this study, data (available in S1 Data) were obtained from 108 participants from the ESFUERSO cohort, who completed questionnaires detailing their COVID-19 experiences and stress levels assessed through the SISCO scale. IgG anti-RBD concentrations were quantified using an ELISA assay developed by UNAM. Multiple regression analysis was employed to control for covariates, including sex, age, body fat percentage, body …

Setting Up An Ambulatory Gi Endoscopy Suite In The Usa-Anesthesia And Sedation Challenges, Basavana Goudra

Department of Anesthesiology Faculty Papers

Gastrointestinal endoscopy units, both freestanding and associated with ambulatory surgical centers, are on the increase, and the trend is likely to continue. The concept is relatively new, and there are insufficient guidelines and a general dearth of information for prospective planners and physicians. Debate continues in areas such as the selection of patients, appropriateness of procedures, and access to tertiary care. Leaders often scramble to address both critical and non-critical issues, often after the center has opened to the public. They often encounter issues which were not anticipated. In this review, we have provided comprehensive and concise information on the …

Improving Patient Awareness And Compliance With Telephone Follow-Up Calls Post Visit, Ajibola Kutti

Student Scholarly Projects

Practice Problem: In a high-volume clinic without current follow up practices post visit, a telephone follow-up (TFU) intervention was implemented within three days of patient outpatient appointments.

PICOT: The PICOT question that guided this project was: In adult patients in a high-volume clinic (P), does the implementation of telephone follow-up calls by nurses (I) compared to current practices (C) improve patient compliance and post-office follow-up visits (O) over 10-weeks (T)?

Evidence: The literature provided recommendations and evidence that supported the effectiveness of following up with patients within three days of leaving the healthcare clinic. TFU’s are a cost-effective intervention that …

Psychological Impact Of Ebola Disease On Survivors: A West Africa Study, Babatunde Moses Irinoye

Walden Dissertations and Doctoral Studies

Survivors of Ebola virus disease often experience social isolation. Understanding the psychological impact of Ebola virus disease on these survivors was the focus of this study. The study encompasses assessment of experiences in re-integration back into communities, and psychological implications (post-recovery), among Ebola infection survivors (EIS) in Republic of Liberia. The purpose of the study was to explore the psychological impact of Ebola as the EIS continue their re-integration journey in their communities in Liberia. The conceptual framework for this study was based on principles of system theory, based on interrelatedness of the biopsychological experience of the EIS, and the …

Relationship Between Geographic Location, Race, And Socioeconomic Status On Adolescent Male Hpv Vaccination In The United States, Stacy Herb

Walden Dissertations and Doctoral Studies

Human papillomavirus (HPV) represents the most prevalent sexually transmitted infection in the United States. Despite readily available safe and effective vaccines and established knowledge of influencing factors, HPV vaccination rates in the United States remain suboptimal, particularly among adolescent males. This quantitative study addressed this gap by investigating the association between geographic location, race, and socioeconomic status with HPV vaccination uptake in adolescent males. A secondary data analysis was conducted using the 2022 National Immunization Survey (NIS)—Teen, comprised of 22,667 adolescent males. The fundamental cause theory served as the theoretical framework, guiding the exploration of why a safe and effective …

Relationship Between Sports Participation, Weight Intentions, And Insufficient Sleep On E-Cigarette Use Among U.S. High School Students, Stephanie Deivert

Walden Dissertations and Doctoral Studies

Despite public health efforts, e-cigarette use among youths persists, posing risks due to high nicotine content and the potential for transitioning to traditional cigarette smoking. Although sports participation has shielded individuals from traditional cigarette use, recent studies revealed a higher susceptibility to e-cigarette use among young athletes, though influencing factors were unexplored. Using the socioecological model, this retrospective cross-sectional study examined the relationship between sports participation, weight intentions, insufficient sleep, and e-cigarette use among U.S. high school students by analyzing 2021 National Youth Risk Behavior Survey data. Binary logistic regression assessed associations between variables. An interaction term examined the moderating …

Hybrid Inferior Pedicle Reduction Mammaplasty With Free Nipple Grafts In A Patient With Gigantomastia, Devin M. Melancon, Harel G. Schwartzberg, Genevieve E. Messa, Jonathan C. Boraski

School of Medicine Faculty Publications

Gigantomastia presents a unique set of challenges for preservation of the nipple-areola complex in patients undergoing reduction mammaplasty. Historically an indication for breast amputation and free nipple graft (FNG), gigantomastia is now commonly treated using pedicle-based reconstruction. We present a case combining these two surgical techniques, using an inferior-pedicle reduction with an FNG in the management of extreme breast hypertrophy with 11,300g in total resected. This case report shows that such a technique for gigantomastia reductions can combine the aesthetic benefits of a pedicled reduction with the reliability of FNGs. These benefits make the hybrid inferior pedicle reduction a useful …

Optimizing Adherence To Antiretroviral Therapy Among Adolescents Living With Hiv In Low And Middle-Income Settings, Samuel Kizito

Brown School Graduate Student Theses and Dissertations

Globally, 1.8 million adolescents are living with HIV (ALHIV), of whom 89% (1.5 million) are in Sub-Saharan Africa (SSA) (UNAIDS, 2021b). Unfortunately, despite advances in prevention—such as the prevention of mother to child transmission (PMTCT) and pre-exposure prophylaxis—new infections continue to occur. For example, in 2021 alone, the number of new HIV infections among adolescents aged 10 to 19 was 160,000 cases. Moreover, the rate of HIV-related deaths among adolescents has only declined by 10% in the last decade, which is not fast enough to meet the 2030 global targets. Despite antiretroviral therapy (ART) playing a crucial role in controlling …

Caregiver Attitudes Toward Sexual Behavior And Sex Education For Children With Down Syndrome, Shawna Urban

Walden Dissertations and Doctoral Studies

This quantitative correlational study investigates caregivers’ attitudes toward sexual behavior and sex education for children with Down syndrome, drawing upon the theories of reasoned action and planned behavior. Data was collected from a convenience sample of 112 caregivers. The analysis revealed significant positive associations between caregivers’ attitudes toward sexuality and their perspectives on sex education. Binary logistic regression indicated that higher POS scores predict increased likelihood of endorsing sexual behavior and supporting sex education for children with Down syndrome. Notably, demographic factors such as gender, age, and educational level did not significantly influence caregivers’ decisions regarding sex education support. The …

Association Between Psychological Distress And Diabetic Retinopathy Among U.S. Adults, Claret Ijeoma Onukogu

Walden Dissertations and Doctoral Studies

Diabetes can lead to diabetic retinopathy, an eye disease that causes damaged blood vessels and the growth of abnormal ones, leading to vision loss. The two stages of the disease are non-proliferative and proliferative diabetic retinopathy. In the non-proliferative stage, diabetics develop macular edema and ischemia with shortage of blood in the macula region of the eye, and the vision eventually becomes blurry. However, the proliferative stage is the advanced stage of the disease involves neovascularization and retinal detachment. The quantitative study employed the socioecological model as the theoretical framework to examine the relationship between psychological distress and diabetic retinopathy …

Dietary Acculturation Is Associated With Altered Gut Microbiome, Circulating Metabolites, And Cardiovascular Disease Risk In Us Hispanics And Latinos: Results From Hchs/Sol, Yi Wang, Guo-Chong Chen, Zheng Wang, Kai Luo, Yanbo Zhang, Yang Li, Amanda C Mcclain, Marta M Jankowska, Krista M Perreira, Josiemer Mattei, Carmen R Isasi, Maria M Llabre, Bharat Thyagarajan, Martha L Daviglus, Linda Van Horn, David Goldsztajn Farelo, Luis E Maldonado, Steven R Levine, Bing Yu, Eric Boerwinkle, Rob Knight, Robert D Burk, Robert C Kaplan, Qibin Qi, Brandilyn A Peters

Faculty, Staff and Student Publications

Background: Dietary acculturation, or adoption of dominant culture diet by migrant groups, influences human health. We aimed to examine dietary acculturation and its relationships with cardiovascular disease (CVD), gut microbiota, and blood metabolites among US Hispanic and Latino adults.

Methods: In the HCHS/SOL (Hispanic Community Health Study/Study of Latinos), US exposure was defined by years in the United States (50 states and Washington, DC) and US nativity. A dietary acculturation pattern was derived from 14 172 participants with two 24-hour dietary recalls at baseline (2008-2011) using least absolute shrinkage and selection operator regression, with food groups as predictors of US …

Breastfeeding As Co-Occupation: Occupational Therapy’S Role In Promoting Health And Well-Being, Lisa Joelle Sutton, Julie D. Kugel, Dragana Krpalek, Arezou Salamat

The Open Journal of Occupational Therapy

Background: Even with efforts to encourage mothers to breastfeed exclusively for the first 6 months, the majority of women are not able to undertake breastfeeding as the sole means of infant nutrition provision for various reasons. The role of occupational therapists working with mothers who breastfeed is complex and not strongly supported in the literature. Therefore, this qualitative study was designed to examine the role that occupational therapists may engage in supporting mothers and infants in the co-occupation of breastfeeding.

Method: A qualitative phenomenological study design was applied and included 11 occupational therapists working with breastfeeding dyads. The …

East African Refugee Women Seeking Health Care After Government Assistance Ends, Sylivia Chelimo

Walden Dissertations and Doctoral Studies

East African refugee women arrive as a vulnerable population in their host country. Before coming to the United States, refugee women may have experienced varying levels of trauma due to civil wars, genocide, sexual assault, deaths of loved ones, terrorist attacks, being taken hostage, and torture in their home country. The purpose of this generic qualitative study was to explore the experiences of refugee women from East African countries seeking health care in the Central United States when government assistance ends. The framework of the behavioral model of health was the guide for examining the experiences of the participant refugee …

Framing The Path To Fitness: Age Differences In Response To Framed Exercise Messages, Iliya Sherif, David B. Taullahu, Alyssa R. Minton, Joseph A. Mikels

DePaul Discoveries

Physical activity is one of the most protective health behaviors one can engage in, yet 75% of active adults in the US, meaning those who exercise regularly, fall short of the recommended levels of physical activity, with an even greater percentage of older adults living inactive lives, meaning they exercise minimally and engage in prolonged sedentary behavior (CDC, 2019). The goal of the current study was to explore different types of message framing targeted at encouraging older and younger adults to exercise. We recruited older adults (n = 184; Mage = 69.45 years, age range: 65- 80 years) and younger …

Community-Based Participatory Obesity Prevention Interventions In Rural Communities: A Scoping Review, Saagar Dhanjani, Haley Allen, Beatriz Varman, Chishinga Callender, Jayna M Dave, Debbe Thompson

Library Staff Publications

Child obesity is a worldwide public health concern. In America, children from rural areas have greater odds of obesity in comparison to those from urban areas. Community-engaged research is important for all communities, particularly under-represented communities. This paper reports the results of a scoping review investigating community-engaged research in obesity prevention programs tested with school-aged children in rural America. A literature search of Medline Ovid was conducted to identify interventions reporting the results of obesity prevention interventions that promoted a healthy diet or physical activity (PA) behaviors to school-age children in rural communities of the United States (US). After title …

Discordant Prenatal Cell-Free Dna Screening Vs. Diagnostic Results Of Sex Chromosome Aneuploidies: Implications For Newborn Screening And Genetic Counseling, Susan Howell, Shanlee M. Davis, Billie Carstens, Mary Haag, Judith L. Ross, Nicole R. Tartaglia

Department of Pediatrics Faculty Papers

Sex chromosome aneuploidies (SCAs) collectively occur in 1 in 500 livebirths, and diagnoses in the neonatal period are increasing with advancements in prenatal and early genetic testing. Inevitably, SCA will be identified on either routine prenatal or newborn screening in the near future. Tetrasomy SCAs are rare, manifesting more significant phenotypes compared to trisomies. Prenatal cell-free DNA (cfDNA) screening has been demonstrated to have relatively poor positive predictive values (PPV) in SCAs, directing genetic counseling discussions towards false-positive likelihood rather than thoroughly addressing all possible outcomes and phenotypes, respectively. The eXtraordinarY Babies study is a natural history study of children …

Perceived Stress, Social Media Usage, And Sleep Quality In United States Adults, Justine P. Scott

Walden Dissertations and Doctoral Studies

The purpose of this quantitative study was to explore the intricate connections among perceived stress, sleep quality, and social media usage metrics, challenging prior assumptions by highlighting social media as a noteworthy stress coping mechanism. The research aimed to understand the relationship between sleep quality, perceived stress, and the frequency and quality of social media use, guided by the biopsychosocial model as the theoretical framework.The study involved adults aged 20-65. A questionnaire incorporated four validated instruments to assess these variables: the Epworth Sleepiness Scale (ESS), Internet Addiction Diagnostic Questionnaire (IADQ), Perceived Stress Scale (PSS), and Social Media Quality Measure (SMQM). …

Socioeconomic Status On The Management Of Type-2 Diabetes Among African Americans (Aged 26–64) In Rural Pennsylvania, Mariejo Joyce Constant

Walden Dissertations and Doctoral Studies

There is a lack of knowledge on hardly-reached patients’ socioeconomic status (SES). This quantitative study examined the extent to which SES moderated or impacted the relationships of African American status, rural status, or insurance status with type-2 diabetes mellitus (T2DM) management outcomes (testing for elevated glucose levels, patient education, and regular doctor visits) for African American individuals of low SES living in rural areas. The theoretical foundation for this study was the ecological systems theory (EST). Secondary data were from the publicly available Behavioral Risk Factor Surveillance System (BRFSS) 2021 dataset. Binary and linear regression analyses showed insufficient results to …

Community-Level Factors And Their Associations With Changing Opioid Overdose Fatality Rates In Kentucky, 2019–2021, Shawn R. Nigam, Philip M. Westgate, Svetla Slavova, Rachel Vickers-Smith, Katherine L. Thompson

Journal of Appalachian Health

Introduction: Kentucky has one of the highest opioid overdose fatality rates in the United States, which has increased significantly from 2019 to 2020. The COVID-19 pandemic has caused lasting effects on mental health and health care, which have been linked with increased opioid overdose. These effects are exacerbated in Appalachian regions, where there is a lack of sufficient access to community pharmacies and adequate health care.

Purpose: In this study, we characterize changes in opioid overdose fatality rates in Kentucky from 2019 to 2021, with a specific focus on changes in Appalachian vs non-Appalachian counties. We aim to identify associations …

Hampton's Hump- A Rare Radiographic Finding In Pulmonary Embolism, Tanshi Anand

Digital Journal of Clinical Medicine

Background- Pulmonary embolism is a condition that is characterized by occlusion of the pulmonary circulation, usually originating from deep vein thrombosis in the lower extremities. This condition is difficult to diagnose as it can present with a wide spectrum of nonspecific symptoms, making it a life-threatening illness.

Case Description- A 50-year-old man with a medical history of deep vein thrombosis, ischemic heart disease, dilated cardiomyopathy with left ventricular dysfunction, diabetes, hypertension, and COPD presented with fever, cough with expectoration, orthopnea, and exertional dyspnea. A routine X-ray was done and revealed Hampton’s hump, a rare radiographic finding persistent with possible …

Comorbidity Of Disordered Eating And Depression: Examining Intersectional Inequities And Cardiometabolic Health Consequences Across The Life Course, Franklin Hunter Mcguire

Brown School Graduate Student Theses and Dissertations

Traditional epidemiologic research has often neglected the degree to which interlocking systems of oppression may (1) describe the distribution of population health inequities and (2) moderate health exposure-outcome associations. Grounded in an intersectional framework, this three-aim dissertation used an intersectional multilevel modeling approach (i.e., intersectional MAIHDA) and US nationally representative data to answer a series of intersectionality-informed research questions relevant to disordered eating, depression, and cardiometabolic health. With data from the National Health and Nutrition Examination Survey, Aim 1 quantified the population distribution of weight loss-oriented disordered eating behaviors (DEBs) among US adults across intersectional groups defined by race/ethnicity, sex/gender, …