Digital Commons Network^™

Rapid Recovery Of Peripheral Oxygen Saturation In Hypoxic Covid-19 Patients With Ivermectin/Doxycycline/Zinc Multidrug Therapy, Sabine Hazan, Adriana C. Vidal, Eleftherios Gkioulekas, Anoja W. Gunaratne, Sibaish Dolai, Robert L. Clancy, Peter A. Mccullough, Thomas J. Borody

School of Mathematical & Statistical Sciences Faculty Publications

Several combination therapies for the early outpatient treatment of COVID-19 were proposed by independent research groups at the onset of the pandemic during 2020 and 2021. In this observational study, we report on the outcomes of an off-label triple combination therapy, consisting of ivermectin, doxycycline, and zinc, with adjunct vitamin C and D3 supplementation, which was used on high-risk COVID-19 patients. These patients refused an initial recommendation to seek inpatient care, despite a high-risk presentation compounded with one or more comorbidities and/or severe hypoxia. Telemedicine was used to administer personalized treatment to patients at home, who did not have access …

Behavioral Intentions And Use Of Telehealth Among Afro-Caribbean Immigrants In Florida, Patsy Patricia Lindo-Wood

Walden Dissertations and Doctoral Studies

Many researchers have documented the benefits of telehealth in managing cardiovascular disease and its risk factors. However, acceptance and use of telehealth among immigrants in the United States were low compared to other users, and little is known about Afro-Caribbean immigrants and their telehealth acceptance and use. Guided by the unified theory of acceptance and use of technology, this study explored how performance expectancy, effort expectancy, social influence, and facilitating conditions shape behavioral intentions and telehealth use among Afro-Caribbean immigrants in Port St. Lucie, Florida. A generic qualitative design with a purposive sampling strategy was used to interview 17 Afro-Caribbean …

Leadership-Mediated Retention Strategies To Sustain Workforce Capacity And Performance In Public Health, Meredith Winslow Wilkins

Walden Dissertations and Doctoral Studies

Workforce retention challenges continue to affect public health leaders by contributing to staffing shortages, reduced organizational capacity, and disruptions in service delivery. Public health leaders are concerned with employee turnover because it affects workforce stability, organizational performance, and the ability to meet community health needs. Grounded in Herzberg’s motivation-hygiene theory, the purpose of this qualitative pragmatic inquiry was to explore effective workforce retention strategies used by public health leaders to retain skilled staff and strengthen organizational capacity and revenue. The participants were eight public health leaders in the Northeast region of the United States with responsibility for workforce management and …

Caregiving And Mental Health Among Mothers During The Covid-19 Pandemic, Makayla Elise Techentine

Walden Dissertations and Doctoral Studies

The 2019 coronavirus (COVID-19) pandemic led to reliance on family members or friends to care for the sick, resulting in a burden of informal caregiving stressors and relationship to mental health. Guided by the stress process model, this quantitative, cross-sectional study aimed to assess the relationship between caregiving stressors and the mental health of mothers of children aged 18 years or younger who were serving as informal caregivers. Secondary data from the 2020-2021 Behavioral Risk Factor Surveillance System (N = 1,772) considered the independent variables related to caregiving stressors, including hours spent caregiving, time since becoming a caregiver, personal care …

Peer-Peer Mentoring In Undergraduate Medical Education (Ume): Scoping Review Of Us-Based Medical Schools, Sakshi Sehgal, Jordon Brinkley, Andrea Kadima, Sydney Wright, Nicole Winston Ms, Pharmd, Edd

Journal of the Georgia Public Health Association

Background: Mentorship plays a formative role in undergraduate medical education (UME) From shaping professional outcomes to developing longitudinal personal relationships, various forms of mentorship can influence student progress meaningfully, particularly for students from underrepresented or marginalized backgrounds. Though faculty-student mentorship has been readily investigated, limited knowledge exists regarding peer-peer mentorship structures, particularly within UME in the American medical education model. This scoping review sought to investigate existing peer-peer mentorship models, as well as report on the need for further mentorship within this realm in UME.

Methods: This scoping review employed Arksey and O’Malley’s framework. We conducted a systematic and comprehensive …

The Role Of Social Determinants Of Health In Hydroxyurea Adherence Among Persons With Sickle Cell Disease: A Systematic Review, Doreen O. Ugwu, Lori L. Vick, Terika Williams, Aurela Nikaj, Seyi Omeh, Benjamin Becerra Dr., Tilicia Mayo-Gamble

Journal of the Georgia Public Health Association

Objective: Georgia has one of the highest prevalences of sickle cell disease (SCD). For Georgians living with SCD, inadequate medication adherence is associated with important clinical outcomes. One important area that is understudied in SCD is the impact of social determinants of health (SDoH) on medication adherence. A foundational understanding of SDoH is needed to introduce, inform and carry out programs and interventions designed to facilitate hydroxyurea adherence through the state of Georgia.

Method: We conducted a systematic literature review to synthesize the literature on SDoH addressed in studies to improve hydroxyurea adherence in persons with SCD. SDoH were based …

Reducing Stress Through Low-Carbohydrate Nutrition Education In Emergency Department Staff – A Quality Improvement Project, Hassan Oman Gomar

Loma Linda University Electronic Theses, Dissertations & Projects

Introduction and Background

Emergency department staff often face job-related stress, which can lead to burnout, reduced compassion satisfaction, and adverse effects on patient care. Loma Linda University Health (LLUH) offers support programs, including Care for the Caregiver (C4C) and the Living Whole Employee Wellness program, that provide emotional and general wellness resources. While these programs are helpful, they do not offer practical solutions for everyday stress. There is a need for simple, lasting, and food-based ways to help staff manage stress and perform better. Recent research shows that eating patterns, especially high intake of processed carbohydrates, can alter energy and …

Cyberbullying Perpetration: A Systematic Review Of Global Prevalence, Profiles, Antecedents, Consequences, And Interventions, Ysabel A. Guevarra, K. T. A. Sandeeshwara Kasturiratna, Charlotte K. Y. Lee, Andree Hartanto

Research Collection School of Social Sciences

The anonymity afforded by cyberspace enables individuals to engage in harmful online behaviours, most notably cyberbullying perpetration, which has become a pressing social and psychological concern worldwide. Despite extensive research on its antecedents, outcomes and interventions, insights into cyberbullying perpetration remain scattered, highlighting the value of a comprehensive synthesis to capture its multifaceted nature. This systematic review synthesised findings from 54 meta-analyses, comprising 314 effect sizes (Sample size: Range = 3273–1,479,614, Mdn = 46,604) across diverse populations worldwide. Results indicate that approximately one in ten individuals engage in peer cyberbullying, with even higher prevalence in partner-directed forms such as cyber …

Assessing Hpv And Hpv Vaccine Awareness And Perception Amongst Undergraduate Students, Maura Hawkins

Honors Theses

Human Papillomavirus (HPV) is one of the most common sexually transmitted infections in the United States. Vaccination rates remain low among college-aged students despite an effective vaccine being available. This study investigates HPV and HPV vaccination-related knowledge, beliefs, and perceptions among undergraduate students to inform targeted intervention strategies. Participants included undergraduate students (n = 19) who attended one of three focus groups conducted in April 2025 at the University of South Alabama. Structured interview guides explored HPV knowledge, perceived risk and severity, attitudes towards vaccination, autonomy in health decision-making, trust in health information sources, and preferred educational strategies. Discussions were …

Neighbourhood Social Vulnerability And Preterm Birth Risk Among Infants With Trisomy 21: A Statewide Analysis, Fatima R Sheriff, Renata H Benjamin, Qian Xiao, Jenil Patel, Charles Shumate, Alejandra Fernandez, A J Agopian

Faculty, Staff and Student Publications

Background: Residing in socioeconomically vulnerable areas is known to be associated with increased preterm birth (PTB) risk in the general population. However, the relationship between social vulnerability and PTB remains unexplored among infants with trisomy 21, who experience more than twice the PTB rate of the general population.

Objectives: The primary objective was to examine the association between maternal socioeconomic vulnerability, as measured by the SVI, and PTB among infants with trisomy 21.

Methods: We conducted a retrospective cohort study among infants with trisomy 21 born in Texas (1999-2018). We examined the association between neighbourhood vulnerability, measured by Social Vulnerability …

Social Phobia, Coping Strategies, And Socio-Demographic Associations Among Late Adolescents: A Cross-Sectional Study, Ezhilan B U, Jesymol Joy, Smitha Chandrashekarappa Dr.

Digital Journal of Clinical Medicine

Background: Adolescence is a transitional period from childhood to adulthood, often marked by psychological challenges such as social anxiety, also known as social phobia. It is characterized by excessive fear of social interactions and can lead to impaired functioning or depression. Globally, its prevalence ranges from 6-10% in developed countries and 10-44% in developing countries. Coping strategies play a crucial role in managing social phobia, varying by individual characteristics. This study aimed to determine the prevalence of social phobia, identify coping strategies, and evaluate their association with socio-demographic factors among late adolescents.

Methodology: A cross-sectional study was conducted …

Just Opt For Caesarean Section And Pick The Birthdate': A Qualitative Study Exploring Women's Delivery Preferences After Caesarean Section In Urban Tanzania, Daudi Gidion, Columba Mbekenga, Miriam Mgonja, Marleen Temmerman, Muzdalfat Abeid

Obstetrics and Gynaecology, East Africa

Objectives To explore perspectives, preferences and decision-making regarding mode of delivery after a previous caesarean section among women in urban Tanzania.

Design A descriptive qualitative study using semi-structured in-depth interviews. Data were analysed using thematic analysis.

Setting A private tertiary hospital in Dar es Salaam, Tanzania.

Participants 11 women with one previous caesarean section who delivered at the study site were interviewed on the third day after delivery. Participants were purposively sampled to include both modes of delivery: five women underwent repeat caesarean section and six attempted a trial of labour after caesarean (TOLAC).

Results Thematic analysis identified four key …

Global Prevalence Of Internet Gaming Disorder: An Umbrella Review Of Meta-Analytic Evidence And Implications For Child And Adolescent Psychiatry, Elisabeth C. S. Poon, Xun Ci Soh, Trina J. H. Poh, Andre C. S. Tan, Andree Hartanto

Research Collection School of Social Sciences

Background/Objectives: Internet gaming has become a widespread global activity, raising concerns about the prevalence of Internet Gaming Disorder (IGD). However, existing meta-analyses report highly variable prevalence estimates. This umbrella review aims to clarify the prevalence and variability of IGD by synthesizing evidence from meta-analyses to provide a comprehensive overview of IGD prevalence across populations, age groups, and regions. Methods: Following PRISMA guidelines, systematic searches were carried out across five published literature databases and two supplementary search sources. Title and abstract screening, followed by full-text eligibility assessment, were conducted independently by three authors. The same three authors then performed data extraction …

Perceptions Of Research Participation Among Underrepresented Groups: Insights Using Freelisting Methodology, Tamar Klaiman, Jasmine Silvestri, Emma Britez Ferrante, Dorothy Sheu, Adina Lieberman, Erich Dress, Modele Ogunniyi, Neal Dickert, Meghan Lane-Fall, Rosemary Frasso, Rachel Kohn

College of Population Health Faculty Papers

BACKGROUND: Low enrollment and retention in clinical research disproportionately impact Black, Hispanic or Latinx, women, and rural populations, undermining generalizability and perpetuating health disparities. However, few studies have compared mechanisms driving underrepresentation across populations. Freelisting is a qualitative methodology that elicits lists of terms, explores perspectives about domains, and identifies common themes within groups with shared characteristics; however, it has not been systematically applied to understand research participation across underrepresented populations.

OBJECTIVE: To explore perspectives on clinical research participation across underrepresented populations using freelisting methodology to ultimately inform culturally-responsive recruitment strategies.

METHODS: We conducted a web-based freelisting survey among adults …

Exploring Primary Care Providers’ Compassionate Care And Their Evidence-Based Practice With Death, Grief, And Loss: Patient Experience And Perspective, Kathryn Krzykala

Dissertations

Research on primary care providers’ (PCPs) education regarding Death, Grief, and Loss (DGL) remains limited. Specifically, data is lacking regarding patients' perceptions and opinions on what they need and expect from their PCPs regarding grief and loss. This exploratory mixed-method study comprised 146 participants who had experienced death and non-death loss. It examined participants' perceptions of 1) PCP compassion, 2) PCP utilization of evidence-based grief and loss practices, 3) their own level of comfort discussing DGL with their PCPs during medical visits, and 4) their personal grief and loss experiences. The findings revealed that PCPs' grief-informed evidence-based treatment, as reflected …

Diversity And Inclusivity In Australian Dementia Prevention Research: A Mixed Methods Review, Olivia E. Giameos, Maddison L. Mellow, Diana Karamacoska, Aaron Davis, Paul A. Gardiner, Eddy Roccati, Kaarin J. Anstey, Nicolas Cherbuin, Jessica M. Adsett, Nikki Anne Wilson, Kylie Radford, Louise Lavrencic, Perminder S. Sachdev, Simone Reppermund, Suraj Samtani, Annabel P. Matison, Zara A. Page, Philip J. Batterham, Sophie C. Andrews, Alex Bahar-Fuchs, Michelle K. Lupton, Andrew Pipingas, Adrienne Withall, Belinda M. Brown, Helen Macpherson, Hannah A.D. Keage, Britt Burton, James C. Vickers, David W. Dunstan, Ashleigh E. Smith

Research outputs 2022 to 2026

Minoritized communities are disproportionately impacted by modifiable dementia risk factors but are underrepresented in dementia research globally. In Australia, the number of dementia prevention cohort and intervention studies has rapidly increased in the past two decades, yet the representation of minoritized groups has not been synthesized. The aims of this mixed-methods review were to summarize the demographic characteristics of participants involved in Australian dementia prevention-focused cohort and intervention studies. A systematic search of published literature, funded grant outcomes, and clinical trial registrations was conducted in October 2023 and updated in February 2025 to identify any Australia-based cohort or intervention studies …

Time For A New Whole-Person Care Pathway For Chest Pain Admissions, Dana Kajan, Sabbir Mirza, Alexander M. Ruiz, Anthony Degennaro, Mohamad S. Saad

HCA Healthcare Journal of Medicine

Background

Emergency department (ED) visits for chest pain are common and costly, and ED workup often shows no clear cardiac etiology in low-risk patients. Emerging evidence suggests that social determinants of health (SDOH) such as loneliness, social isolation, and food insecurity contribute to cardiovascular outcomes and chest pain presentations.

Methods

We interviewed 114 patients (>18 years) presenting with chest pain and a thrombolysis in myocardial infarction (TIMI) score less than 4 at our community teaching hospital ED. Structured questionnaires assessed the SDOH triad of loneliness, social isolation, and food insecurity. Dependent variables included systolic blood pressure (SBP) at admission, …

Association Of Lifestyle, Nutritional Status, And Eating Habits With Academic Performance Among Adolescents, Lulu'ul Badriyah, Farah Paramita, Rachmy Rosyida Ro'is, Shanica Yohana Veronica, Alifia Meida Indrayati, Randy Gustawan

Preventia: The Indonesian Journal of Public Health

Health is an important factor in determining academic performance. This study aims to analyze the relationships between lifestyle, nutritional status, eating habits, and academic achievement among high school students. The study used a cross-sectional design with a sample of 131 students from four schools in Malang City, Malang Regency, Batu City, and Pasuruan Regency. Data were collected through interviews, anthropometric measurements, and the SQ-FFQ and IPAQ questionnaires. Analysis was performed using the Chi-Square test. The results showed that most respondents slept less than 8 hours (58.8%), used smartphones for ≥ 8 hours per day (50.4%), had moderate physical activity (52.7%), …

Respectful Maternity Care: A Narrative Review Of Current Evidence And Clinical Implications, Hadeel Rasheed Seger, Nada Abd Ali Mohammed, Khalid Alyodawi

Preventia: The Indonesian Journal of Public Health

Respectful Maternity Care (RMC) is key to improving quality maternity care and has also been recognized as a foundational approach to quality maternity services. The framework has been developed around respect and promotion of dignified care, confidentiality and privacy, and autonomy of a woman, along with her right to freedom from neglect, discrimination, physical and verbal abuse, during pregnancy and childbirth. Despite worldwide acknowledgment and promotion of RMC, disrespect and abuse during childbirth have been observed among women in maternity settings, especially in low- and middle-income countries. This narrative review summarizes the current evidence and clinical implications of RMC. The …

Activities Of Daily Living Limitations In Middle-Aged And Older Adults With Joint Disorders And Osteoporosis: Indonesia Longitudinal Aging Survey 2023, Desfalina Aryani, Mufti As Siddiq As Siddiq M. Irzal, Agustina Sianipar

Jurnal Epidemiologi Kesehatan Indonesia

Population ageing is associated with an increasing prevalence of limitations in activities of daily living. Joint disorders and osteoporosis are common health problems among older adults and may begin to emerge during middle age, potentially accelerating functional decline. However, studies examining the association between these conditions and limitations in activities of daily living in Indonesia remain limited. This study aimed to analyse the association between joint disorders and osteoporosis and limitations in activities of daily living among middle-aged and older adults in Indonesia. This study employed a cross-sectional design using data from the Indonesia Longitudinal Aging Survey (ILAS) 2023. The …

Associated Factors Of Quality Of Life In Hypertensive Patients: A Cross-Sectional Study In Riau Province, Indonesia, Dhimas Maybelliano, Rajunitrigo Rajunitrigo, Lita Lita, Abdurrahman Hamid, T Abdur Rasyid

Jurnal Epidemiologi Kesehatan Indonesia

Hypertension is a chronic condition that adversely affects quality of life (QoL). Identifying factors associated with QoL is essential for improving hypertension management. This study aimed to identify factors associated with QoL among hypertensive patients in Riau Province, Indonesia. A cross-sectional study was conducted from December 2024 to January 2025 at two public health centers in Riau Province: Puskesmas Rejosari in Pekanbaru City and Puskesmas Bagansiapi-api in Rokan Hilir Regency. A total of 150 hypertensive patients aged 25-59 years were enrolled. QoL was assessed using the WHOQOL-BREF questionnaire. Independent variables included sociodemographic characteristics, comorbidities, dietary patterns, and physical activity. Data …

African Americans’ Perceptions And Experiences Of Aesthetic Environments As A Determinant Of Stress, Clarence Gardener

Walden Dissertations and Doctoral Studies

No abstract provided.

Physical Activity Mediation In Perceived Emotional Support And Type 2 Diabetes Among African American Older Adults, Don Scott Mendes

Walden Dissertations and Doctoral Studies

No abstract provided.

Kelelahan Kerja, Kualitas Tidur, Dan Pengetahuan Mengemudi Defensif Sebagai Faktor Risiko Perilaku Defensive Driving Pada Pengemudi Grabcar Malang, Elisa Lutfiyah Azizah, Dian Puspitaningtyas Laksana, Marji Marji, Agung Kurniawan

National Journal of Occupational Health and Safety

Online transportation activities contribute to the increasing volume of vehicles, particularly GrabCar drivers in Malang City, which has the potential to worsen traffic congestion. Identification results showed that GrabCar drivers experienced drowsiness while driving and work fatigue due to the habit of working at night and for more than eight hours per day, accompanied by limited understanding related to defensive driving. This study aimed to determine the effect of work fatigue and knowledge, as well as differences in sleep quality scores, on defensive driving behavior. This study employed an observational analytic design with a cross-sectional approach involving 87 GrabCar drivers …

Maternal Mental Health: What Utahns Need To Know, Brie Sparks, Susan R. Madsen

Marketing and Strategy Faculty Publications

Pregnancy and the transition to motherhood are often portrayed as joyful and fulfilling experiences, yet many women face significant emotional and psychological challenges. Maternal mental health conditions, including depression and anxiety, are among the most common complications of pregnancy and the postpartum period. Despite growing awareness, stigma, screening gaps, and limited access to care persist. In Utah, where rates are similar to or higher than national averages, expanding screening and resources will create a clearer path to better support mothers and families.

Faktor Yang Berhubungan Dengan Keaktifan Pelaporan Bahaya K3 Pada Pekerja Pelabuhan Batu Bara: Studi Cross-Sectional, Samuel Adi Kristiawan, Dewi Puspito Sari, Nur Ani, Wartini Wartini

National Journal of Occupational Health and Safety

Active hazard reporting is a key indicator in preventing workplace accidents and strengthening safety culture, particularly in high-risk industries such as coal port services. This study aimed to analyze internal and external factors associated with active hazard reporting among workers in the coal port services industry. A quantitative cross-sectional study with total sampling was conducted involving all workers (N = 130). Data were collected using a structured questionnaire measuring accident history, unsafe actions, unsafe conditions, supervisor support, performance appraisal, risk level, and hazard reporting activity. Univariate and bivariate analyses were performed using the Chi-Square test. The results showed that 66.2% …

Marshallese Female Caregivers’ Intention To Seek Pediatric Care For Their Children, Ages 2–5, With A Body Mass Index At Or Above The 95th Percentile, Living In Northwest Arkansas, Madicyn Huddleston Freeman

Walden Dissertations and Doctoral Studies

No abstract provided.

Racial Differences In Hiv Testing And Hiv Infection Among Adults With Seborrheic Dermatitis In Atlanta, Georgia, Olivia Elizabeth Collins

Walden Dissertations and Doctoral Studies

No abstract provided.

Refining Of An Online Rotator Cuff Related Pain Screening Tool (Orcs): A Mixed Methods Refinement Study, Andrew J. Smythe, Rhiannon Whale, Melanie Farlie, Peter Malliaras

Internet Journal of Allied Health Sciences and Practice

Purpose: The purpose of this study is to refine an online rotator cuff related shoulder pain screening tool. Method: A mixed methods item-refinement study was used. The original tool was designed through expert opinion and informal literature review. In this study the original tool was refined over three rounds of cognitive interviews totalling 39 participants. The screening tool consisted of two sections, red flag screening followed by rotator cuff related shoulder pain differential diagnostic items. Results from each round of interviews were summarised and informed a nominal group research panel review process to modify items and develop a finalised version …

The Roots Of Sexual Violence In Utah: A Framework For Understanding Harm, Susan R. Madsen

Marketing and Strategy Faculty Publications

Sexual violence in Utah is not an anomaly, a private tragedy, or the result of individual deviance. It is a patterned, predictable outcome of cultural norms, social systems, and power structures that shape how people understand gender, authority, and worth. Despite Utah’s reputation for strong families, close‑knit communities, and deep religious commitment, the state continues to report higher‑than‑national‑average rates of rape, child sexual abuse, and other forms of gender‑based harm. These realities demand a deeper understanding of why violence persists—and what can be done to prevent it.

This white paper synthesizes decades of national and international research, Utah‑specific data, and …