Digital Commons Network^™

Evaluating The American Society Of Hematology Quality Measure On Timeliness Of Analgesics For Sickle Cell Disease Pain Crisis, Ibrahim Gwarzo, Harish Chandra Dega, Paula Tanabe, Robin Miller, David C. Brousseau

Department of Medicine Faculty Papers

The American Society of Hematology (ASH) proposed the median time to first emergency department (ED) administration of pain medication for patients with sickle cell disease (SCD) vaso-occlusive pain episodes (VOE) as a site-level quality measure. Generalizable studies assessing current guideline adherence recommending pain medications within 60 minutes are lacking. We leveraged multisite electronic health record data from Epic's Cosmos research platform to analyze ED encounters for SCD VOE from 1 January 2019 to 31 December 2024, with administration of at least 1 pain medication. We calculated the quality measure (median time to first pain medication) and ranked sites based on …

The Relationship Between Social Determinants And Primary Care Utilization Among Medicaid Recipients In A Managed Care Community Health Worker Program, Rachel Elaine Rosensteel

Walden Dissertations and Doctoral Studies

Community health worker (CHW) programs are an increasingly important strategy for addressing social determinants of health (SDOH) within Medicaid systems. However, evidence on how specific SDOH impact healthcare utilization remains limited. In this quantitative, correlational study, the relationship between SDOH factors like housing instability, food insecurity, and transportation barriers, and primary care utilization among adult Medicaid recipients aged 18–65 who participated in a Medicaid managed care organization’s CHW program in Clark County, Nevada, during 2023 were examined. Retrospective administrative data from 441 participants were analyzed using negative binomial regression to assess associations between SDOH factors and postintervention primary care visits …

Metformin Exposure After Glioblastoma Diagnosis And Mortality: A Large Population-Based Study, Vittorio Maio, Roshani Shah, Manisha Lin, Patrick J. Moeller, Iyad Alnahhas, Richard Hass, Wenyin Shi, Scott W Keith

College of Population Health Faculty Papers

BACKGROUND: Glioblastoma (GBM) is an aggressive primary brain malignancy with limited therapeutic options and poor survival outcomes. Recent real-world studies and early-phase clinical trials evaluating metformin have yielded mixed findings. This study assessed the association between post-diagnosis metformin exposure and all-cause mortality in a large population-based cohort of older adults with GBM.

METHODS: A retrospective cohort study was conducted utilizing the Surveillance, Epidemiology, and End Results (SEER)-Medicare linked database. Adults aged ≥66 years diagnosed with GBM between 2007 and 2018 were included, excluding those with other malignancies or diagnoses made by autopsy or death certificate. Metformin exposure was modeled as …

Stumping The Federal Effort: Southern States’ Contributions To The United States’ Leading Maternal Mortality Rate, Natalie A. Snook

Arkansas Law Review

Maternal care has reached a terrifying deficit in the United States. Masses of women throughout this nation are dying preventable deaths resulting from extremely lacking prenatal, birthing, delivery, and postnatal care. This is a silent epidemic. Why is the United States failing so miserably in comparison to its fellow developed countries? Why does the gap appear to be widening more and more each day? Various factors lend themselves to an explanation: general factors like the overall shortage of maternal care providers, as well as specific ones such as the not-so surprising fact that the United States is the only developed …

Prephiral Bacterial Infectious Agent Triggers Neuroinflammatory Responses And Neurobehavioral Impairment In Wild-Type Mice, Hadeer Atalah

Theses and Dissertations

Neurodegenerative diseases, including Alzheimer's and Parkinson's, present an increasing global challenge, with chronic neuroinflammation identified as a principal factor alongside genetic, environmental, and infectious influences (Boyd et al., 2022).  Epidemiological data associate bacterial infections with a 40% heightened risk of Parkinson's disease; however, the mechanisms—especially the direct connection between peripheral sepsis and the silent onset of central nervous system pathology absent acute meningitis—are inadequately investigated (Smeyne et al., 2021), particularly concerning common pathogens like Klebsiella pneumoniae in high-burden areas such as Egyptian ICUs, where it constitutes 30% of cases (Alkompoz et al., 2023). This study filled the gap by creating …

Global Public Health Feasibility: Digital Dentistry In Geriatric Population, Merna Amr Saleh

Theses and Dissertations

Oral health is a critical yet often overlooked determinant of well-being among older adults in Egypt, where mobility limitations, geographic barriers, and low awareness of preventive practices exacerbate dental disparities. DentalPal, a teledentistry-based mobile application, was developed to provide older adults with remote dental consultations, oral hygiene advice, and triage guidance. The platform enables users to submit oral photographs or radiographs for assessment, seek second opinions, and initiate follow-up chats directly with the healthcare provider. This flexible design allows users to access dental consultations on demand while ensuring continuity of care The question that guided this study was how older …

Facebook Interaction As A Potential Marker Of Cognitive Decline: Pilot Study, Esraa M. Qansuwa

Theses and Dissertations

One of the critical challenges in brain disorder research is the early identification of individuals with mild cognitive impairment (MCI) who may later develop Alzheimer’s disease (AD) or other dementias. MCI in older adults is frequently associated with diminished social engagement and observable behavioral changes. With the rapid expansion of social media platforms and advances in Machine Learning (ML), digital traces from online activity present a novel and scalable avenue for mental health screening. In particular, predictive ML approaches have demonstrated strong potential in building reliable classifiers for early detection of neurocognitive decline. This study introduces an innovative framework that …

Perceptions Of Healthcare Access Barriers Among Eritrean, Sudanese, And Somali Refugees And Asylum Seekers In Cairo., Ayan Musa Mohamed

Theses and Dissertations

As the world witnesses an increase in different displacements of individuals for various reasons, ranging from wars, civil conflicts, human rights violations, and natural disasters, refugees and asylum seekers, who are among those forcibly displaced, continue to face challenges in access to health care services in host countries. The topic of barriers to health care has been widely researched, with a large body of literature on refugees' interactions with health care systems. However, there is limited literature on the perceptions of Eritrean, Sudanese, and Somali refugees and asylum seekers' experience with healthcare access in host countries. Therefore, this thesis aims …

Hubungan Marketing Mix Dan Hospital Brand Image Dengan Minat Kunjungan Ulang Pasien Di Rsi Sultan Agung Banjarbaru, Fitriani Fitriani, M. Noor Ifansyah, Zubaidah Zubaidah

Jurnal ARSI : Administrasi Rumah Sakit Indonesia

Hospitals are required to provide high-quality services to increase patient visits. Over the past six months, RSI Sultan Agung Banjarbaru has experienced a decline in the number of patient visits. This study aimed to analyze the relationship between the marketing mix and hospital brand image with revisit intention. The study employed a correlational analytic design, involving an outpatient population of 107,146 patients. A total of 100 respondents were selected using purposive sampling, and data were collected through questionnaires. Data analysis was conducted using the Spearman’s Rho test. The results showed that the marketing mix and hospital brand image variables were …

Investigating Tau Pathology In The Retina And Anterior Segment Structures Of The Eye In A 3-Nitropropionic Acid–Induced Tauopathy Mouse Model, Mohamed Sayed Ahmed Abdel-Kader Qasem

Theses and Dissertations

Background and Objectives: Alzheimer's disease, the most prevalent neurodegenerative disorder in older adults, is characterized by accumulation of hyperphosphorylated tau and amyloid-beta (Aβ) plaques in the central nervous system. Given the retina's shared embryological origin with the brain, its direct neural connectivity via the optic nerve, and similarities in vasculature and age-related degeneration patterns, retinal pathology may serve as an early, non-invasive biomarker for Alzheimer's disease. This study employed 3-nitropropionic acid (3NP) as a pathway-specific tauopathy model driven by mitochondrial dysfunction. The study particularly aimed to investigate whether retinal and corneal tau pathology reflects underlying tau-related neurodegeneration triggered by …

Efektivitas Pertemuan Tim Multidisiplin Dalam Meningkatkan Outcome Tata Laksana Kanker Di Rumah Sakit: Literature Review, Ngakan Putu Daksa Ganapati, Wahyu Sulistiadi

Jurnal ARSI : Administrasi Rumah Sakit Indonesia

Optimal cancer management requires a multidisciplinary approach to improve the quality of patient care. Multidisciplinary teams (MDTs) enable interprofessional collaboration in designing comprehensive, patient-centered care. However, the implementation of MDTs in Indonesia still faces various challenges, necessitating a systematic review to understand their effectiveness in improving cancer management outcomes. This systematic review employed the PRISMA method, searching articles from the ScienceDirect, Semantic Scholar, and PubMed databases, published between 2014 and 2024. Ten scientific articles were analyzed from 745 articles retrieved to understand the effectiveness of MDTs in improving cancer management outcomes. The results indicate that MDTs improve the quality of …

Safety Of Carotid Endarterectomy In The Elderly And Octogenarian Population: A Nationwide Study Including 80,000 Patients, Victor Gabriel El-Hajj, Joanna Roy, Basel Musmar, Wi Jin Kim, Michael Rizzuto, Nathaniel Ellens, Rabab Alshahrani, Victor Staartjes, Adrian Elmi-Terander, Ramachandra Tummala, Stavropoula Tjoumakaris, Michael Gooch, Robert Rosenwasswer, Ziad Khabbaz, Pascal Jabbour

Department of Neurosurgery Faculty Papers

INTRODUCTION: Carotid endarterectomy (CEA) is an established procedure for stroke prevention in patients with carotid artery stenosis. While CEA is considered safe in younger patients, perioperative risks in octogenarians remain debated, with current guidelines classifying the procedure as "high-risk" in this patient population. This study aimed to evaluate short-term outcomes of CEA across age groups and to assess whether comorbidity burden better predicts outcomes than chronological age.

METHODS: The ACS-NSQIP database (2013-2020), was used to identify patients eligible for inclusion. The cohort was stratified based on age <  60, 60-80, and > 80 years. Propensity score matching and multivariable logistic regression were used to compare …

The State Of Mental Health In The Mountain West, 2025, Cason Noll, Anirudh Polagani, Taylor Volk, Olivia K. Cheche, Caitlin J. Saladino, William E. Brown Jr.

Health

This fact sheet presents data on the mental health of youth and adults, as well as the availability of mental health care, across the five Mountain West states of Arizona, Colorado, Nevada, New Mexico, and Utah in 2025. The data are derived from "The State of Mental Health in America 2025,” originally published by Mental Health America (MHA).

Penguatan Pengendalian Persediaan Obat Melalui Integrasi Abc-Ven, Eoq, Dan Rop Di Rumah Sakit Rujukan Nasional, Rasendah Rasendah, Helen Andriani, Dendhi Bagus Andriyanto

Jurnal ARSI : Administrasi Rumah Sakit Indonesia

Drug inventory control is a critical component of pharmaceutical management in referral hospitals with high service complexity. This study aimed to evaluate pharmaceutical inventory control performance at the Pharmacy Installation of RSUP Persahabatan and to formulate improvement strategies using an Operational Research approach. A mixed-methods design with a sequential explanatory approach was applied. Quantitative analysis was conducted on 2,291 drug items recorded in the inventory system during October 2025 using ABC-VEN classification to identify priority medicines, followed by calculations of Economic Order Quantity (EOQ) and Reorder Point (ROP). Qualitative data were obtained through in-depth interviews with key informants to strengthen …

Analisis Pengaruh Patient-Perceived Hospital Service Quality Terhadap Customer Satisfaction Dan Behavioral Intention Pelayanan Rawat Inap, Launa Inayati Arlina, Dwiky Yuanasika, Mochammad Bagus Qomaruddin, Djazuly Chalidyanto

Jurnal ARSI : Administrasi Rumah Sakit Indonesia

The Bed Occupancy Rate (BOR) of inpatient rooms at Mitra Sehat Mandiri Hospital Sidoarjo during 2019-2023 has not reached the ideal standard. The BOR values were 22%, 28%, 37%, 25%, and 20%, with an average of 26.4%, remaining below the ideal range of 60-85%. One of the most influential factors contributing to the low BOR is suboptimal service quality. This study aims to analyze the relationship between Patient-Perceived Hospital Service Quality, customer satisfaction , and behavioral intention among inpatients at Mitra Sehat Mandiri Hospital Sidoarjo. This study employed a quantitative method with an analytical approach and a cross-sectional design. The …

Perceptions Of Ischaemic Heart Disease Risk Among Indian Migrants In Australia: A Qualitative Study, Kunwar Kaur, Ma'en Zaid Abu-Qamar, Amineh Rashidi, Nilufeur Mckay, Rosemary Saunders

Research outputs 2022 to 2026

Background: Ischaemic heart disease (IHD) is a global health issue, with people of Indian origin facing earlier onset and more severe cases, leading to higher mortality at younger ages compared to Western countries. Indian migrants maintain similar risks post-migration. Managing modifiable risk factors and improving risk knowledge and health-seeking behaviours are essential, but research on IHD risk perceptions among Indian migrants is limited. Aim: This study explores how first-generation Indian migrants perceive their IHD risk and the factors influencing these perceptions. Methods: As a component of a mixed- method study, a qualitative descriptive study design was employed to examine study …

Beyond "Place Matters": Making Spatial Analysis Accessible With Dashboard-Driven Geography, Stephen Borders

Public Health

This article presents an instructional module that uses Tableau to teach spatial thinking and policy geography through an analysis of Supplemental Nutrition Assistance Program (SNAP) participation. Tableau’s ability to integrate custom spatial files with demographic and health data makes it an accessible platform for introducing geographic inquiry without requiring specialized GIS expertise. The lesson guides instructors through building maps, bullet charts, and scatterplots that highlight gaps between eligibility and enrolment, while connecting food insecurity to health outcomes. By lowering technical barriers, Tableau provides a pedagogical bridge that helps educators foster spatial literacy in diverse classroom contexts.

This article was published …

The Enduring Legacy Of Nuclear Tests: Barriers To Managing Type 2 Diabetes Among Marshallese Pacific Islanders In The United States, Bernard A. Muriithi

Occupational Therapy Faculty Scholarship

Introduction / Rationale: Nuclear tests conducted by the United States caused significant damage to the environment and traditional food sources in the Marshall Islands. The Marshall Islanders began to depend on imported processed food, but the change of diet resulted in significant increases in chronic diseases, in addition to cancers and birth defects associated with nuclear radiation. Since the 1986 Compact of Free Association, over 15,000 Marshallese have relocated to the United States, and the majority live in one U.S. state. This community of Marshallese has the highest prevalence rate for type 2 diabetes in the world.

Objectives: identify the …

A Rare And Challenging Polymicrobial Pleural Infection Involving Cupriavidus Pauculus In A Patient With Rheumatoid Arthritis And Multiple Complications, Moiz Ahmed Khan, Syeda Samiya Kamal, Muhammad Muneeb, Summaya Zafar

The University of Louisville Journal of Respiratory Infections

A 58-year-old female with a 15-year history of rheumatoid arthritis (RA) and a history of treatment consisting of methotrexate, hydroxychloroquine, leflunomide, and chronic prednisolone therapy, presented with fever, productive cough, dyspnea, and left leg cellulitis. She developed septic shock complicated by tension pneumothorax requiring emergency thoracostomy and non-ST-elevation myocardial infarction (NSTEMI). Pleural fluid culture grew Cupriavidus pauculus, a rare environmental gram-negative bacillus, alongside Burkholderia cepacia and Candida parapsilosis, indicating polymicrobial infection which was most likely predisposed by patient's immunosuppressed state from RA and prolonged steroid use. Treatment consisted of trimethoprim/sulfamethoxazole, meropenem, fluconazole, and cardiopulmonary support, and culminated in …

Menopause 101, Stephanie Carlson, Emma Parkhurst, Ashley Yaugher, Cris Meier

All Current Publications

This fact sheet provides women with basic information about perimenopause, menopause, and postmenopause, along with helpful tips and resources to better prepare for or manage these phases of life.

A Pilot Study Evaluating Child Resistant Closures In Pharmaceuticals In The Developing Nation Of Ghana: Informing Global Paediatric Safety And Usability Standards, Samuel Ofosu, Kojo Agyapong Afrifah, Laura Bix

Journal of Applied Packaging Research

Despite their proven effectiveness in preventing unintentional paediatric medication poisoning in high-income countries, the performance and usability of Child Resistant Closures (CRCs) remain underexplored in low and middle-income countries (LMICs).

To provide pilot data regarding the potential efficacy of using CRCs in LMICs, we conducted a study of the approach in a low-resourced region (Ghana, West Africa) by adapting testing protocols utilized in the United States (16 CFR Part 1700.20). The study utilized a convenience sample of children (n=50; 42-51 months) and adults (n=50; 50-70 years) to develop preliminary data related to the efficacy of a single design of CRC …

Depression, Education, And Quality Of Life In Women With Endometriosis, Ria N. Gajar

Walden Dissertations and Doctoral Studies

Endometriosis is a chronic gynecologic condition associated with substantial physical, psychological, and social burden, and depressive symptoms are consistently linked to poorer health-related quality of life (HRQoL) among affected women. However, limited population-based research has examined how depressive symptoms intersect with social factors. Guided by Engel’s biopsychosocial model, nationally representative data from the 2005–2006 National Health and Nutrition Examination Survey (NHANES)—the most recent cycle to include an item on endometriosis diagnosis—were analyzed among U.S. women with self-reported endometriosis (N = 4,137). Complex samples logistic regression models were used to examine associations between depressive symptoms and HRQoL across general, physical, and …

Asian Reference Values For Handgrip Strength, Gait Speed, Five-Times-Sit-To-Stand Test, Muscle Mass And Calf Circumference, Jozo Grgic, Siew Ling Tey, Dieu Thi Huynh, Yen Ling Low, Zeljko Pedisic, Nina Schaller, Vanessa Kristina Wazny, Weilan Wang, Yasuhiko Saito, Ravindra P. Rannan-Eliya, Hala Ghattas Ph.D., Monique Chaaya, Carlos Mendes De Leon, Preeti Gupta, Ecosse L. Lamoureux, Mythily Subramaniam, Edimansyah Abdin, Rahul Malhotra, Angelique Chan, Bayasgalan Tumenbayar, Et. Al.

Faculty Publications

Background:

Handgrip strength, gait speed, Five-Times-Sit-to-Stand Test (FTSST) performance, skeletal muscle mass and calf circumference are important health outcomes, particularly useful for diagnosing sarcopenia. The aim of this study was to establish reference (normative) values for handgrip strength, gait speed, FTSST performance, skeletal muscle mass and calf circumference by pooling individual participant data from national cohorts in Asia.

Methods:

We conducted a pooled analysis of individual participant data from 20 national cohorts representing 12 Asian countries (China, India, Indonesia, Israel, Japan, Lebanon, Malaysia, Mongolia, Philippines, Republic of Korea, Singapore and Sri Lanka). We included cohorts with data on at least …

Association Between Environmental Exposures To Perfluoroalkyl And Polyfluoroalkyl Substances And Military Veterans Cancer Determination, Stephen A. Pereira Jr

Walden Dissertations and Doctoral Studies

This study involved evaluating whether cumulative exposure to perfluoroalkyl and polyfluoroalkyl substances (PFAS) was associated with kidney cancer, bladder cancer, and adult leukemia among U.S. veterans. Pooled National Health and Nutrition Examination Survey (NHANES) data from 2005–2015 were analyzed for sample of 2,500 veterans with available serum PFAS measurements and physician-diagnosed cancer histories. This study employed a cross-sectional, correlational design grounded in a post-positivist paradigm. Inclusion required complete data for (a) serum PFAS concentrations, (b) kidney cancer, bladder cancer, and adult leukemia, and (c) covariates age, sex, race/ethnicity, smoking status, and body mass index. Cumulative PFAS was modeled as a …

Group Antenatal Care Model As An Innovative And Sustainable Maternal And Child Health Service Delivery In A Northern Nigerian State, Pius I. Christopher-Izere, Abiola Ajibola, Abimbola Phillips, Dorcas Magbadelo, Ibidun Jolaoso, Obioma Azurunwa, Francis Ogirima, Collins Imarhiagbe, Anthony Onwuegbusi, David Udanwojo, Emmanuel Udeh, Victor Obagunlu, Adebola Adekogbe, Sunday Joseph, Hamza Abubakar, Neyu Iiyasu, Adetosoye Adebanjo, Barlarbe Gaya, Olayiwola Jaiyeola, Damilola Olaniyan, Bankole Olatosi Ph.D., Deborah Lynn Billings Ph.D., Et. Al.

Faculty Publications

The maternal and child health situation in developing countries remains critical and deeply concerning, These regions account for 99% of global maternal and under-five deaths. In Nigeria, uptake of critical life-saving maternal, neonatal and child health (MNCH) services, delivered through antenatal care (ANC), are sub-optimal, leading to poor outcomes. Group antenatal care (G-ANC) is an evolving antenatal care delivery model in low and medium-income countries. G-ANC models can improve quality and uptake of maternal health services.G-ANC model was implemented across 255 primary health facilities (PHFs) to ensure pregnant women receive components of a well-defined package of MNCH services at regular …

“My Heart Was In My Stomach”: Texas-Based Obstetricians’ And Gynecologists’ Experiences Post Anti-Abortion Legislation, Chelsey Kanipe, Precious Chiamaka Anunobi, Anupria D Davenport, Sheryl A Mccurdy, Marie A Brault

Faculty, Staff and Student Publications

Background

The purpose of this study is to investigate the downstream effects of anti-abortion legislation on the practice of obstetrics and gynecology in urban Texas.

Methods

We conducted semi-structured interviews until saturation with eleven obstetricians/gynecologists (OBGYNs) to explore the effects of Texas’s abortion laws. Analysis consisted of inductive and deductive approaches.

Results

We identified three main themes regarding the downstream effects of Texas abortion laws: the conflicting role of colleagues as a support system and a source of frustration and distrust for OBGYNs, the lowered standard of care for those with a desired pregnancy, and concerns that anti-abortion legislation will …

Prevalence Of Premenstrual Syndrome, Premenstrual Dysphoric Disorder, And Dysmenorrhea In Nursing Students: A Systematic Review, Meta-Analysis, And Evidence-Based Recommendations, Sabyasachi Maity, Bharathi Gadad, Hansapani Rodrigo, Seham Noorani, Ayesha Usman, Chloe Lark, Mona Attarpour, Ivy Mageto, Lucas Schwartz, Nikhilesh Anand

School of Medicine Publications

Introduction: Menstrual disorders—including premenstrual syndrome (PMS), premenstrual dysphoric disorder (PMDD), and dysmenorrhea—are highly prevalent among women of reproductive age and are associated with impaired academic performance, psychological distress, and reduced social functioning. Nursing students are particularly vulnerable due to the combined demands of intensive academic schedules and clinical training, yet prevalence estimates and institutional responses remain inconsistent.

Methods: A systematic review and meta-analysis were conducted in accordance with PRISMA 2020 guidelines and registered in PROSPERO (CRD420251109363). PubMed, Scopus, Web of Science, CINAHL Ultimate, and APA PsycINFO were searched for studies published between 2016 and 2025. Eligible studies reported prevalence or …

Forward Momentum

DePaul Magazine

Mission: Forward, the most ambitious philanthropic campaign in DePaul’s history, is fueling purpose-driven education to solve society’s biggest challenges. Learn and watch videos about DePaul programs and initiatives that exemplify the campaign through academic innovation, interdisciplinary collaboration, service-oriented community partnership and activist scholarship.

Experiences Of Care-Seeking Parents With Children With Autism Spectrum Disorder In India, Yash Navnit Patel

Walden Dissertations and Doctoral Studies

Autism spectrum disorder (ASD) affects approximately 18 million individuals in India, yet the factors influencing parental care-seeking behavior were not well understood. Guided by the health belief model, the purpose of this basic qualitative study was to explore how parents’ perceived severity of a child’s symptoms, parental beliefs about the causes of autism, and perceived mental and physical health outcomes of caregiving influence parents’ intention to seek services for children aged 1–10 years diagnosed with ASD in India. Data were collected using semistructured interviews with 10 mothers of autistic children. Data were analyzed using Braun and Clarke’s six-step thematic analysis. …

Abortions In The Mountain West, 2022-2025, Olivia K. Cheche, Caitlin J. Saladino, William E. Brown Jr.

Health

This fact sheet presents data on the number of abortions provided annually in the Mountain West states of Arizona, Colorado, Nevada, New Mexico, and Utah between July 2022 and June 2025. The data are retrieved from the Society of Family Planning’s #WeCount report,  which includes data on abortion volume across all 50 U.S. states and Washington, D.C. This fact sheet focuses on the administration of both in-person and telehealth abortions in the Mountain West.