Digital Commons Network^™

Make Your Wishes Known: Understanding The Challenges And Barriers For Providing Effective Ethics Consults To Low-Income African American Men, Ruth Nwefo

Symposium of Student Scholars

The distrust of the U.S. health care system is prevalent, especially within the African American (AA) community. This distrust is largely based on infamous cases such as the Tuskegee Syphilis Experiment and experiments conducted by James Marion Sims on slave women without anesthesia. While these experiments along with many others further advanced medicine, they severed trust between health care institutions and the African American community, bringing upon repercussions still felt today. Although many steps have been taken to rebuild trust in the health care system by establishing effective ethical guidelines, more needs to be done in terms of rebuilding the …

Food Deserts: Hungry For Answers, Lawren Cumberbatch

Symposium of Student Scholars

In 2010, the United States Department of Agriculture (USDA) reported that 23.5 million people in the United States live in food deserts. As defined by the USDA, a “food desert” is a neighborhood that lacks healthy food sources. This can be measured by distance to a store, number of stores in an area, individual-level resources such as family income or vehicle availability, and neighborhood-level resources such as availability of public transportation. Past research provides evidence that food deserts are especially likely to occur in communities heavily populated by minorities. As a Black Indian pre-med student aiming to join the world …

Impact Of Covid-19 On Health Disparities In The United States - A Preliminary Study, Alina Panjwani

Symposium of Student Scholars

Health disparities are the differences in health outcomes and health status among people belonging to different groups. This means that people with low socioeconomic status, old age, racial and ethnic minorities, who are often those with limited access to healthcare may often face a higher disease burden and experience worse health outcomes. The current pandemic of Coronavirus 2019 (COVID-19), caused by the novel coronavirus SARS-CoV-2, provides a painful reminder of why inequities harm all of us as the devastating impact of the pandemic is apparent. This paper examines the differences in and possible cause of the rates of COVID infections, …

The Hidden Child: Analyzing The Cyclical Nature Of Statelessness And Violations Of Reproductive Autonomy, Simone Lieban Levine, Kelsey J. Peden

The Journal of International Relations, Peace Studies, and Development

Statelessness is a reproductive justice issue. When states explicitly or implicitly regulate or restrict reproduction, it results in children being born into statelessness. When there is a risk that a child will be born into statelessness, it both impacts the parents’ ability to parent with dignity and can have a chilling effect on the parents’ decision to have a child in the first place. In this way, statelessness results both in and from violations of reproductive autonomy. To combat statelessness, the international human rights community must use a reproductive justice lens to examine the ways that policies related to regulating …

Multi-Stage Stochastic Optimization And Reinforcement Learning For Forestry Epidemic And Covid-19 Control Planning, Sabah Bushaj

Dissertations

This dissertation focuses on developing new modeling and solution approaches based on multi-stage stochastic programming and reinforcement learning for tackling biological invasions in forests and human populations. Emerald Ash Borer (EAB) is the nemesis of ash trees. This research introduces a multi-stage stochastic mixed-integer programming model to assist forest agencies in managing emerald ash borer insects throughout the U.S. and maximize the public benets of preserving healthy ash trees. This work is then extended to present the first risk-averse multi-stage stochastic mixed-integer program in the invasive species management literature to account for extreme events. Significant computational achievements are obtained using …

Association Between Self-Reported Fatigue And Sarcopenia Measures Among Elderly In Selangor, Malaysia, Maria Justine, Aliff Latir, Nadhirah Noor, Angelbeth Joanny, Izzaty Iskandar, Maisarah Sakinah Amirul Faizi, Dzulhelmi Edinan

Kesmas

The association between fatigue and sarcopenia is not well understood, therefore, this study aimed to compare the sarcopenia measures among elderly with mild and severe fatigue and to determine whether fatigue severity is associated with sarcopenia measures. This was a cross-sectional study conducted on201 elderly (age = 68.45±6.30 years). The elderly was classified into either mild or severe fatigue based on the Fatigue Severity Scale (FSS), meanwhile, sarcopenia measures include SARC-F score, muscle mass (ASM/height2), calf circumference (CC), upper (handgrip) and lower limb muscle strength, as well as physical performance (gait speed). Data were analyzed using independent t-tests and logistic …

Effects Of Hydroxyurea Treatment On Haemolysis In Patients With Sickle Cell Disease At Muhimbili National Hospital, Tanzania, Azra Gangji, Upendo Masamu, Josephine Mgaya, Joyce Ndunguru, Agnes Jonathan, Irene Kida Minja, Julie Makani, Emmanuel Balandya, Paschal Ruggjao, Siana Nkya

Tanzania Journal of Science

Tanzania is one of the countries with a high burden of sickle cell disease (SCD). Haemolytic anaemia is a clinical feature of SCD, and has been linked to major complications leading to morbidity and mortality. Treatment with hydroxyurea (HU) has shown to induce foetal haemoglobin (HbF) which in turn decreases haemolysis in patients. This study aimed to investigate the effects of HU on haemolysis in SCD patients attending Muhimbili National Hospital, Tanzania by comparing their haemolytic parameters before and after therapy. Patients meeting the criteria were initiated on HU therapy for 3 months. Two haemolytic biomarkers: unconjugated plasma bilirubin levels …

Accelerating The Provision Of Safe Water Supply In Urban And Rural Areas Of Indonesia, Sumengen Sutomo, Salord Sagala, Bebi Sutomo, Sri Winarti, Gelant Sanjaya

Kesmas

Over the past 100 years, the provision of a safe water supply to drink in Indonesia has been slowly progressed with low coverage. The majority of the population does not have access to safe water. Morbidity and mortality of water-related diseases, including diarrhea, are very high. The provision of safe water is not a technological issue but good water management that comprises content, institutional, and communication layer. This paper provided information for strategic and operational decisions to accelerate the provision of safe water services in urban and rural areas. Benchmarking good water management with the characteristics of the water supply …

Strategy For Diagnosing Breast Cancer In Indonesia During The Covid-19 Pandemic: Switching To Ultrasound-Guided Percutaneous Core Needle Biopsy, Farida Briani Sobri, Adang Bachtiar, Sonar Soni Panigoro, Juwita Cresti Rahmaania, Patria Wardana Yuswar, Ening Krisnuhoni, Nelly Tandiari

Kesmas

In this era of COVID-19, suspected breast cancer patients experience delay in diagnosis due to the fear of contracting the virus and reduction of non-COVID-19 health services. Furthermore, it may lead to potential increase in the incidence of advanced cancers in the future. Ultrasound-guided (US-guided) percutaneous core needle biopsy (CNB) is a great option for the diagnosis of cancer but it is poorly utilized. This study aimed to prove that the US-guided CNBis accurate when performed in a local setting and a potential solution for diagnosing breast cancer patients in this pandemic. In addition, it was a single health center …

Correlation Between Dental Environment And Perceived Stress Scale Among Dental Students During The Covid-19 Pandemic In Indonesia, Tri Erri Astoeti, Howis Josephine, Armelia Sari Widyarman, Widijanto Sudhana

Kesmas

Academic stressors in a medical educational environment are related to two factors. This study was carried out in order to analyze the correlation between the dental environment and perceived stress among dental students during the COVID-19 pandemic. The respondents were 422 undergraduate dental students and the validated Modified Dental Environmental Stress (DES) and Perceived Stress Scale (PSS) questionnaires were used. Furthermore, the Spearman correlation analysis was used to measure the correlation between DES and PSS score. The result showed that five dental stressors were noted to have the strongest correlations with PSS (p-value >0.40). They include expectation towards dental school …

Covid-19 Preparedness And The Anxiety Of Thai Citizens, Afifi Lateh, Prasopchai Pasunon, Kiflan Dolah, Panida Kongjam, Saminee Chemae, Phanupong Panomwan, Alawee Lateh

Kesmas

The outbreak of COVID-19 has brought sickness and fatality to Thai citizens. In addition, it left a tremendous psychological impact on mental health as they experienced panic and anxiety about controlling situations and preserving their physical and mental well-being. This study aimed to analyze the factors influencing COVID-19 preparedness and anxiety based on groups of Thai citizens. Online questionnaires were employed to collect data from 2,768 respondents selected through convenience sampling and snowball sampling on Facebook, having shared questionnaires with 190 other users. Data were collected from March 29 to April 3, 2020. The acquired data were analyzed using percentage …

Dietary Diversity And Social Determinants Of Nutrition Among Late Adolescent Girls In Rural Pakistan, Jo-Anna B. Baxter, Yaqub Wasan, Muhammad Islam, Simon Cousens, Sajid Bashir Soofi, Imran Ahmed, Daniel W. Sellen, Zulfiqar Ahmed Bhutta

Centre of Excellence in Women and Child Health

The conditions in which adolescent girls mature shape their health, development and nutrition. Nutrient requirements increase to support growth during adolescence, but gaps between consumption and requirements exist in low- and middle-income countries. We aimed to identify and quantify the relationship between dietary intake and diverse social determinants of nutrition (SDN) among a subset of adolescent girls 15-18.9 years (n = 390) enrolled within the Matiari emPowerment and Preconception Supplementation (MaPPS) Trial. The primary outcome, dietary diversity score (DDS), was derived by applying the Minimum Dietary Diversity for Women 10-item scale to 24-h dietary recall data collected three times per …

Unintended Consequences Of Air Cleaning Chemistry, Douglas B. Collins, Delphine K. Farmer

Faculty Journal Articles

Amplified interest in maintaining clean indoor air associated with the airborne transmission risks of SARS-CoV-2 have led to an expansion in the market for commercially available air cleaning systems. While the optimal way to mitigate indoor air pollutants or contaminants is to control (remove) the source, air cleaners are a tool for use when absolute source control is not possible. Interventions for indoor air quality management include physical removal of pollutants through ventilation or collection on filters and sorbent materials, along with chemically reactive processes that transform pollutants or seek to deactivate biological entities. This perspective intends to highlight the …

Variation Of Igg N-Linked Glycosylation Profile In Diabetic Retinopathy, Zhiyuan Wu, Huiying Pan, Di Liu, Di Zhou, Lixin Tao, Jie Zhang, Xiaonan Wang, Xia Li, Youxin Wang, Wei Wang, Xiuhua Guo

Research outputs 2014 to 2021

Background: The relationship of immunoglobulin G (IgG) glycosylation with diabetes and diabetic nephropathy has been reported, but its role in diabetic retinopathy (DR) remains unclear. We aimed to investigate and validate the association of IgG glycosylation with DR.

Methods: We analyzed the IgG N-linked glycosylation profile and primarily selected candidate glycans by lasso (least absolute shrinkage and selection operator) regression analysis in the discovery population. The findings were validated in the replication population using a binary logistics model. The association between the significant glycosylation panel and clinical features was illustrated with Spearman's coefficient. The results were confirmed by sensitivity analyses. …

A Susceptible Exposed Infected Recovered Susceptible (Seirs) Model For The Transmission Of Tuberculosis, Latifat M Erinle-Ibrahim, Waheed O Lawal, Olukayode Adebimpe, Gbemisola R Sontan

Tanzania Journal of Science

In this paper, a deterministic mathematical model was proposed and analyzed to understand the dynamics of tuberculosis based on the SEIRS model. The disease-free equilibrium, the endemic equilibrium, and their stabilities were examined. The R0 (basic reproduction number) was derived using the Next Generation Matrix method and its sensitivity analysis showed that the birth rate and infectious rate were the most sensitive parameters of R0. The behaviour of exposed individuals at the latent period with varied treatment rates were examined through numerical simulation. From the analysis carried out, the effect of variations of the treatments of latent TB shows that …

An Age-Structured Model For Transmission Dynamics Of Malaria With Infected Immigrants And Asymptomatic Carriers, Asha S Kalula, Eunice Mureithi, Theresia Marijani, Isambi Mbalawata

Tanzania Journal of Science

Abstract An age-structured (children and adults) model for the transmission dynamics of malaria with asymptomatic carriers and infected immigrants has been analyzed. We first analyze a model without infected immigrants. It shows that the disease-free equilibrium exists and is stable when and unstable for . Also, we compute the sensitivity indices of the basic reproduction number. The basic reproduction number is most sensitive to the mosquito biting rate. Besides, the sensitivity of the basic reproduction number shows that the children's class parameters are more sensitive than those of adults. In the presence of infected immigrants, the model does not admit …

County And Demographic Differences In Drug Arrests And Controlled Substance Use In Maine, Trajan F. Hyde, Amadea D. Bekoe-Tabiri, Amalie K. Kropp Lopez, Luis G. Devia, Belsy D. Gutierrez, Matthew C. Lara, Anthony R. Soto, Daniel E. Kaufman, Matthew T. Moran, Kevin J. Simpson, Dipam T. Shah, Michelle Foster, Clare E. Desrosiers, John Hebert, Stephanie D. Nichols, Kenneth Lee Mccall, Brian J. Piper

Journal of Maine Medical Center

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Introduction: The Diversion Alert Program (DAP) was established to curb misuse of drugs and help identify people who may need treatment for substance use disorder (SUD). Law enforcement compiled arrest data into a database accessible by health care providers. Our objectives were to identify regional and demographic differences in drug use and misuse in Maine.

Methods: All arrests (N = 11 234) reported to the DAP from 2013 to 2018 were examined by county and arrestee demographics, and classified into families (opioids, stimulants, sedatives). The Drug Enforcement Administration’s Automation of Reports and Consolidated Orders System (ARCOS) tracks the distribution …

Breathing Wildfire Smoke Can Affect The Brain And Sperm, As Well As The Lungs, Luke Montrose, Adam Schuller

Public and Population Health Faculty Publications and Presentations

Wildfires burning in the western U.S. are sending smoke into communities far from the fires themselves, creating hazardous air for days or weeks at a time. A lot of people are wondering: What does breathing all that smoke do to our bodies?

Wildfire smoke is a mix of chemicals and tiny particles that are small enough to evade the body’s defenses and directly affect the lungs. But the damage may not stop there.

As environmental toxicologists, we have been investigating the health effects of wildfire smoke on humans, including on parts of the body that you might not expect: sperm …

Determination Of The Nutritional Habits And Anxiety Levels In Individuals With Covid-19 In Turkey, Hatice Iskender, Eda Dokumacioglu, Osman Yalap

Makara Journal of Health Research

Background: Coronavirus disease 2019 (COVID-19), which has spread worldwide since December 2019, has infected and claimed the lives of millions of people. This study aimed to investigate the relationship between anxiety levels and nutritional habits of patients with COVID-19.

Methods: This cross-sectional study enrolled patients diagnosed with COVID-19 between February 1, 2021 and May 1, 2021. The study population included a total of 108 individuals with COVID-19 residing in Artvin, Turkey. This study used a self-administered online questionnaire, containing 40 questions from the State and Trait Anxiety Scale.

Results: The state anxiety score was 37.26, and the …

A 10-Year Post-Analysis Of The Maya Health Toolkit For Medical Providers, Lorenna Garcia-Bochas

Master of Science in Integrative Biology Theses

Researchers have often overlooked America's Indigenous community when conducting health disparities research. In Central and South America, The World Bank 2015 report identifies 774 indigenous groups living today (Davis-Castro, n.d.). One of the oldest known is the Maya people. The Maya have been through various cultural struggles, from the Spanish conquistadors of the past to current anti-indigenous discrimination, violence, and rhetoric. The historical conflict and prejudice have contributed to why many Maya migrate north to the United States for a better opportunity and a more peaceful life for their families. In doing so, they face many health risks to their …

Dependence On Humidity And Aerosol Composition Of The Gas-Particle Partitioning Of Weakly And Moderately Polar Vocs, Jeonghyeon Ahn, Guiying Rao, Eric P. Vejerano

Faculty Publications

Volatile organic compounds (VOCs) dominate the class of pollutants that accumulate in the atmosphere and indoors. Assessing the gas-particle partitioning of VOCs is important to determine their fate, transport, and adverse health impacts. This work is a companion to our earlier study on the temperature dependence of VOC partitioning. Here, we report our measurement of the gas-particle partition coefficient (Kp) for weakly polar (trichloroethylene, TCE) and moderately polar (n-butanol, n-BuOH) VOCs under varying relative humidity (RH) levels onto organic and inorganic aerosols. Kp of TCE was four to five orders of magnitude lower than those …

Whole-Genome Association Analyses Of Sleep-Disordered Breathing Phenotypes In The Nhlbi Topmed Program, Brian E Cade, Jiwon Lee, Tamar Sofer, Heming Wang, Man Zhang, Han Chen, Sina A Gharib, Daniel J Gottlieb, Xiuqing Guo, Jacqueline M Lane, Jingjing Liang, Xihong Lin, Hao Mei, Sanjay R Patel, Shaun M Purcell, Richa Saxena, Neomi A Shah, Daniel S Evans, Craig L Hanis, David R Hillman, Sutapa Mukherjee, Lyle J Palmer, Katie L Stone, Gregory J Tranah, Gonçalo R Abecasis, Eric A Boerwinkle, Adolfo Correa, L Adrienne Cupples, Robert C Kaplan, Deborah A Nickerson, Kari E North, Bruce M Psaty, Jerome I Rotter, Stephen S Rich, Russell P Tracy, Ramachandran S Vasan, James G Wilson, Xiaofeng Zhu, Susan Redline

Faculty, Staff and Student Publications

BACKGROUND: Sleep-disordered breathing is a common disorder associated with significant morbidity. The genetic architecture of sleep-disordered breathing remains poorly understood. Through the NHLBI Trans-Omics for Precision Medicine (TOPMed) program, we performed the first whole-genome sequence analysis of sleep-disordered breathing.

METHODS: The study sample was comprised of 7988 individuals of diverse ancestry. Common-variant and pathway analyses included an additional 13,257 individuals. We examined five complementary traits describing different aspects of sleep-disordered breathing: the apnea-hypopnea index, average oxyhemoglobin desaturation per event, average and minimum oxyhemoglobin saturation across the sleep episode, and the percentage of sleep with oxyhemoglobin saturation < 90%. We adjusted for age, sex, BMI, study, and family structure using MMSKAT and EMMAX mixed linear model approaches. Additional bioinformatics analyses were performed with MetaXcan, GIGSEA, and ReMap.

RESULTS: We identified a …

Disparities In Covid-19 Rates Among Various Demographics And Lack Of Racial Representation In Medical Texts, Diangelo Gonzalez

Celebration of Learning

The 2019 novel coronavirus (COVID-19) outbreak, which originated in Wuhan, China in December of 2019, has impacted nations all over the globe. Given the health disparities which existed within the United States prior to the COVID-19 pandemic, this pandemic continued to pose a significant challenge to the health of the public. The aims of this research study were twofold: (1) to analyze the incidence rates of COVID-19 among different racial and ethnic groups within the United States and (2) to describe the occurrence of diversity within medical texts. Overall, the COVID-19 pandemic exacerbated health disparities within the United States. Understanding …

Cohort Profile: The Alliance For Maternal And Newborn Health Improvement (Amanhi) Biobanking Study, Fahad Aftab, Salahuddin Ahmed, Aneeta Hotwani, Muhammad Ilyas, Mohammad Javaid, Fyezah Jehan, Farah Khalid, Usma Mehmood, Muhammad Imran Nisar, Muhammad Sajid

Department of Paediatrics and Child Health

No abstract provided.

Suicide Attempts In Us Veterans With Chronic Headache Disorders: A 10-Year Retrospective Cohort Study, X. Michelle Androulakis, Siyuan Guo, Jiajia Zhang Ph.D., Jason Sico, Peter Warren, Alec Giakas, Xiaoming Li Ph.D., B Lee Peterlin, Roy Mathew, Deborah Reyes

Faculty Publications

Objectives: A large-scale retrospective analysis of veterans with chronic pain was con-ducted to examine (1) the annual incidence of suicide attempts (SA) in veterans with chronic headache and other chronic pain conditions, and (2) the risk of SA in men and women with chronic headache and chronic headache concurrent with traumatic brain injury (TBI) as compared to non-headache chronic pain.

Methods: This retrospective study (N=3,247,621) analyzed National Veterans Affair Health Administrative data of patients diagnosed with chronic head, neck, back and other chronic pain from 2000 to 2010. Multivariable Poisson regression was used to explore the relative risks of SA …

Drivers Of Food Choice Among Children And Caregivers In Post-Earthquake Nepal, Pepijn Schreinemachers, Rachana Manadhar Sherestha, Bishal Gole, Dhruba Raj Bhattarai, Puspa Lal Ghimire, Bhishm P. Subedi, Tilman Brück, Ghassan Baliki, Ishwori P. Gautam, Christine E. Blake

Faculty Publications

Food systems in many countries are experiencing a shift from traditional foods toward processed foods high in sugar, fat and salt, but low in dietary fiber and micronutrients. There is an urgent need to better understand drivers of changing food behavior, particularly for lower-income countries. This study analyzes drivers of food choice among children and parents in rural Nepal. It uses qualitative data collected through key informant interviews and focus group discussions with school children, parents and teachers. The study reveals substantial changes in food behavior during the past decade with increased consumption of rice, meat, and highly processed snack …

Recognising The Pitfalls Of The Past: Community Health Workers In The Time Of Covid-19, Sam Brakarsh

The Yale Undergraduate Research Journal

Since their formal inception in the 1960s, Community Health Worker (CHW) programs have been revered as a panacea by some and critiqued as a delusion by others (R. N. Labonte et al., 2017; R. Labonte & Saunders, 2015). CHW programs can yield up to a 10:1 return on investment, mobilising communities to take preventative actions to tackle some of the most overwhelming diseases of our time (Earth Institute at Columbia University, 2013; WHO, 2015). However, when carried out without appropriate support or integration into broader health systems, CHW programs cease to be comprehensive tools for resilient preventative health and, instead, …

The Double Burden Of Malnutrition And Associated Factors Among South Asian Adolescents: Findings From The Global School-Based Student Health Survey, Sara Estecha Querol, Romaina Iqbal, Laura Kudrna, Lena Al-Khudairy, Paramijit Gill

Community Health Sciences

The health and nutrition of the global adolescent population have been under-researched, in spite of its significant size (1.2 billion). This study investigates the prevalence and associated factors of malnutrition (stunting, thinness and overweight) among adolescents living in South Asia. The sample analysed was 24,053 South Asian schooled adolescents aged 12-15 years that participated in the cross-sectional Global School-Based Student Health Survey (GSHS) between 2009 and 2016. The prevalence of stunting, thinness and overweight was calculated using the World Health Organization (WHO) Child Growth Reference 2007. Associations between the three forms of malnutrition and their possible associated factors were assessed …

Strongyloides Stercoralis Hyperinfection And Disseminated Tuberculosis, Hernan Terroba, Alejandra González, Diana Vera Gonzalez, Roxana Mariela Godoy, Analia Santos, Marisol Arrojo

The University of Louisville Journal of Respiratory Infections

No abstract provided.

The Histories Of Hivs : The Emergence Of The Multiple Viruses That Caused The Aids Epidemics, William H. Schneider

Ohio University Press Open Access Books

This new collection of essays on HIV viruses spans disciplines to topple popular narratives about the origins of the AIDS pandemic and the impact of the disease on public health policy.

With a death toll in the tens of millions, the AIDS pandemic was one of the worst medical disasters of the past century. The disease was identified in 1981, at the height of miraculous postwar medical achievements, including effective antibiotics, breakthrough advances in heart surgery and transplantations, and cheap, safe vaccines—smallpox had been eradicated just a few years earlier. Arriving as they did during this era of confidence in …