Digital Commons Network^™

Exploring Lgbtq+ Competency In Healthcare, Jordan Whiteman

Honors College Theses

Marginalized groups such as the LGBTQ+ community are known to face healthcare disparities that negatively affect their process of navigating healthcare systems. This project explores the perceived lack of representation and understanding of the LGBTQ+ community within healthcare settings, exposing the deficits in knowledge for unique challenges and inequalities these patients may face. By viewing the literature, a myriad of complications faced by LGBTQ+ people in clinical settings can be identified. They possess a generalized feeling of mistrust towards the healthcare system. Healthcare staff overall describe low confidence with caring for this demographic. Heteronormativity’s presence in the field of healthcare …

The Importance Of Supply Chain Management In Improving Maternal, Newborn, And Child Health, Tamah Kamlem, Katie M. Mercer

Eagles Talking About the Public’s Health

No abstract provided.

Harmonizing Healing: Integrating Traditional/Cultural Remedies And Western Medicine For Chronic Pain Management In Immigrant Populations, Doreen Ugwu, Samuel T. Opoku

Eagles Talking About the Public’s Health

No abstract provided.

Healthy Homes, Healthy Lives: An Essential Call To Action For Public Health, Samuel Mbadu, Santino Oifoh, Katie M. Mercer, Atin Adhikari

Eagles Talking About the Public’s Health

No abstract provided.

The Important Role Of Health State Departments In The Surveillance And Control Of Tick-Borne Diseases, Seun Abiola, Marina Eremeeva

Eagles Talking About the Public’s Health

No abstract provided.

The Silent Transition: Lack Of Awareness Of Perimenopause Leaves Women Unprepared, Tara Hassani Goodarzi, Joanne Chopak-Foss

Eagles Talking About the Public’s Health

No abstract provided.

Enhancing Malaria Prevention: Barriers To Expanding Vaccine Access In Sub-Saharan Africa, Nenrot Gopep, Patra Chisom Ezeamii, Ho-Jui Tung

Eagles Talking About the Public’s Health

No abstract provided.

Breaking The Cycle: Public Health Solutions For Homeless Youth And Foster Care Survivors, Alysia D. Williams, Bettye Apenteng

Eagles Talking About the Public’s Health

No abstract provided.

Bullying As A Public Health Crisis: Linking Aces To Long-Term Health Consequences, Doreen Ugwu, Dziyana Nazaruk

Eagles Talking About the Public’s Health

No abstract provided.

Buyer Be Aware: An Underutilized Tool In The Public Health Protection Toolkit, Padde Musa, Jacob Gakpo, Samuel T. Opoku, Bettye A. Apenteng

Eagles Talking About the Public’s Health

No abstract provided.

A Data-Driven Sliding-Window Pairwise Comparative Approach For The Estimation Of Transmission Fitness Of Sars-Cov-2 Variants And The Construction Of The Evolution Fitness Landscape, Md Jubair Pantho, Richard Annan, Landen Alexander Bauder, Sophia Huang, Letu Qingge, Hong Qin

Computer Science Faculty Publications

Estimating the transmission fitness of SARS-CoV-2 variants and understanding their evolutionary fitness trends are important for epidemiological forecasting. Existing methods are often constrained by their parametric natures and do not satisfactorily align with the observations during COVID-19. Here, we introduce a sliding-window data-driven pairwise comparison method, the differential population growth rate (DPGR) that uses viral strains as internal controls to mitigate sampling biases. DPGR is applicable in time windows in which the logarithmic ratio of two variant subpopulations is approximately linear. We apply DPGR to genomic surveillance data and focus on variants of concern (VOCs) in multiple countries and regions. …

Clinician Attitudes Toward Palliative Care To Enhance The Quality Of Life For Patients With Sickle Cell Disease, Eberechi Nwogu-Onyemkpa, Amber B Amspoker, Nimrah Saleem, Aanand D Naik, Elizabeth Kvale, Ifeyinwa Osunkwo

Faculty, Staff and Student Publications

Objectives: Palliative care (PC) is rare for patients with sickle cell disease (SCD). This study evaluated clinician attitudes toward PC for SCD.

Methods: A cross-sectional survey was conducted between October 2022 and February 2023. Clinicians were recruited from institutions across the United States.

Results: Eighty-six participants completed the survey. Most were physicians (90%), female (72%), had >10 years of experience (63%), and lacked prior PC training (57%). Most participants agreed (83%) that patients with SCD would benefit from PC, disagreed (99%) that PC is only for dying patients, and expressed interest (91%) in learning about PC interventions. Clinicians with prior …

Mda Foundation: Great Things Are Ahead For The Mda Foundation In 2025, Anne Berquist

The Journal of the Michigan Dental Association

The MDA Foundation expresses heartfelt gratitude to donors and volunteers who contributed to improving oral health care access and education in 2024. Efforts included funding free and reduced-cost clinics, awarding scholarships, and hosting the Mission of Mercy (MOM) free clinic in Flint. For 2025, plans include the Sparkling Smiles fundraising event during the MDA Annual Session in Detroit and laying the groundwork for next year’s MOM in Kalamazoo. The Foundation encourages applications for grants (deadline: May 1) and scholarships (applications open Aug. 1), continuing its commitment to supporting Michigan communities and dental students.

The Impact Of Insurance On Adolescent Transition To Adult Care, Diane V Murrell, Cassandra J Enzler, Lauren Bretz, Beth H Garland, Albert C Hergenroeder, Christine Markham, Constance M Wiemann

Faculty, Staff and Student Publications

Background: This study sought to examine how adolescents and young adults with special health care needs (AYA) prepare for managing medical insurance (private and public) as an adult and the role of insurance in locating an adult provider and engaging in care.

Methods: Twenty-eight AYA aged 18-24 years with renal, inflammatory bowel, or rheumatologic diseases completed individual semi-structured interviews designed to evaluate the impact of insurance (private vs. public) on their health care transition experiences. An interdisciplinary team of coders analyzed transcripts using The Framework Method.

Results: Three themes emerged: continuum of accepting health insurance responsibility; the impact of insurance …

Commentary: Impact Of Resistance Training Intensity On Body Composition And Nutritional Intake Among College Women With Overweight And Obesity: A Cluster Randomized Controlled Trial, Joshua L Keller, Sarah E Deemer, Gian Luca Di Tanna, Sherri L Pals, Kevin R Fontaine, David B Allison

Children’s Nutrition Research Center Staff Publications

No abstract provided.

Journey To Well-Being: An Exploration Of Thrivership Post-Domestic Violence, Kader Gumus

Antioch University Dissertations & Theses

Domestic violence profoundly affects multiple facets of a survivor’s life. While most existing literature on survivorship addresses the immediate aftermath of domestic violence, this study delves into the extended process following the trauma of abuse to attain “thrivership,” a new concept in the scholarly and practice literature that emphasizes enduring well-being and flourishing. This dissertation examines the journeys from surviving to thriving for 13 women who transformed themselves and their lives to achieve well-being after traumatic domestic violence. Bronfenbrenner’s ecological systems theory was applied to examine the multiple layers of environmental influences on an individual’s development, including the micro, meso, …

Stigma Of Obesity And Healthcare Utilization, Moya A. O'Leary

Antioch University Dissertations & Theses

The impact of personal factors on healthcare utilization is an essential area of research to improve overall health outcomes among the population. This study explored the relationship between perceived stigma and healthcare avoidance among men and evaluated the relationship between self-reported body mass index (BMI) and avoidance of healthcare appointments due to weight-related stigma and other reasons. This study found no significant relationship between BMI and avoidance of preventive medical appointments due to perceived stigma. However, men from all weight categories endorsed avoiding preventive healthcare appointments due to weight-related reasons and for other reasons. This study explored the reported reasons …

Post-Migration Living Distress And Suicidal Behavior In Refugee Populations Resettled In Vermont, Phoebe K. Lewis

Antioch University Dissertations & Theses

The study of refugee psychology and suicidal distress is a comparatively nascent field when compared with the body of research concerning non-refugee populations. Over the past fifty years, however, the post-migration refugee experience has been the subject of growing clinical interest. In particular, the construct of post-migration living distress (PMLD) has been identified as a salient factor contributing to psychological distress in refugee populations. This dissertation explores the relationship between PMLD and suicidality in a sample of refugees resettled in a New England city. Guided by the Interpersonal Theory of Suicide (IPTS), this dissertation considers how elements of the post-migration …

Black Birth Work As Radical Praxis: A Hermeneutic Phenomenological Inquiry Of Leadership Among Black Birth Workers, Lesa C. Clark

Antioch University Dissertations & Theses

This hermeneutic phenomenological study explores the leadership experiences of Black birth workers (BBWs), revealing critical insights into leadership dynamics within maternal healthcare. Through a theoretical framework integrating African feminism, Black feminism, and anti-racist feminism, the research examines how BBWs conceptualize and enact leadership through embodied, relational, and liberatory approaches. This study addresses a significant gap in leadership literature, particularly regarding generational knowledge and practices of BBWs, which remain understudied despite their vital role in Black maternal healthcare. This study reveals distinct leadership perspectives and methodologies through in-depth interviews with eight BBWs and a detailed interpretive analysis. The findings contribute to …

Improving Nurse Knowledge And Attitudes Through Education On Integrative Pain Management In A Medical-Surgical Unit: A Quality Improvement Project, Samantha Hamilton

Master's Theses and Capstones

Abstract

Background: Pain management in medical-surgical microsystems is complex, with many patients experiencing acute and chronic pain that can be difficult to control. Nurses often receive limited continuing education on integrative and comprehensive pain management strategies, highlighting a need to improve their knowledge and attitudes toward evidence-based, multimodal approaches.

Local Problem: Nurses in this 38-bed medical-surgical microsystem identified a gap in education related to integrative pain management strategies. This may lead to a reliance on pharmacological interventions and missed opportunities for holistic, patient-centered care

Methods: A 25-day quality improvement project was conducted using an asynchronous educational PowerPoint on integrative …

Associations Between Dietary Sodium And Potassium Intakes, Urinary Sodium And Potassium Excretion And Blood Pressure Among Adult Females In Oromia Region, Ethiopia, Fred Baffour Addo

Open Access Master's Theses

Introduction: Accurate assessment of sodium (Na) and potassium (K) intake is essential for population level monitoring of salt intake as part of global strategies to reduce salt consumption to control the increasing prevalence of high blood pressure (BP). Thus, a simple, cost-effective, and low-burden method is particularly valuable in resource-limited settings for population level monitoring of Na and K intake. This study aimed to compare the reliability of various methods of Na and K intake assessment, and their associations with blood pressure measurements.

Methods: This secondary analysis was based on a cross-sectional study of 100 non-pregnant women of …

The Association Between Obstetric Violence And Postpartum Depression Among Latina Women In The United States: An Integrative Review, Natalia Alameda

Scripps Senior Theses

Obstetric violence, a structural form of gender-based violence, involves abuse, mistreatment, or neglect by healthcare providers during obstetric care. It is often associated with childbirth trauma and may result in physical and psychological harm to mothers and children, including postpartum depression. Postpartum depression is a major depressive episode occurring during pregnancy or within four weeks following delivery. While these concepts are often studied independently, few studies examine their intersection, particularly among Latina women in the United States. To address this gap, an integrative literature review was conducted to explore the association between obstetric violence and postpartum depression among Latina women. …

Methodological And Clinical Concerns In The Study On Postpartum Hypertension Management, Takaki Tanamoto, Kyosuke Kamijo, Yusuke Tsutsumi, Tetsuya Kawakita

Department of Obstetrics & Gynecology Faculty Publications

[Introduction] We read with interest the recent study by Rosenfeld et al.¹ However, we have several clinical and methodological concerns about this study.¹

First, this study's propensity score matching (PSM) lacked key clinical confounders, including perinatal risk factors and the highest systolic/diastolic blood pressures. Smoking, alcohol use, and multifetal gestation, which influence blood pressure during pregnancy,²,³ potentially affect both primary and secondary outcomes. Additionally, the authors did not report standardized mean differences before and after PSM, which are essential for assessing balance.⁴

Racial Disparities In Maternal Mortality Before, During, And After The Covid-19 Pandemic In The United States: A Difference-In-Difference Analysis, Kyosuke Kamijo, Misa Hayasaka, Tetsuya Kawakita

Department of Obstetrics & Gynecology Faculty Publications

Background

This study aimed to examine changes in racial disparities in pregnancy-related and maternal mortality before, during, and after the COVID-19 pandemic in the United States.

Methodology

This was a cross-sectional study using the Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research (CDC WONDER) data from January 2018 to June 2024. We focused on pregnancy-related and maternal mortality among Black and White individuals to examine racial disparities. The study periods were defined as pre-pandemic (January 2018-March 2020), pandemic (April 2020-March 2022), and post-pandemic (April 2022-June 2024). We applied interrupted time series analysis and difference-in-difference (DID) models …

Association Of Maternity Care Deserts With Maternal And Pregnancy-Related Mortality, Rula Atwani, Lindsay Robbins, George Saade

Department of Obstetrics & Gynecology Faculty Publications

OBJECTIVE:

To evaluate the association between the level of maternity care access and maternal and pregnancy-related mortality.

METHODS:

This was a cross-sectional analysis of county-level data in the United States from January 2018 to December 2021. Using the level of maternity care access, we categorized counties into desert, low access, moderate access, and full access. The primary outcome of interest was maternal mortality rate per 100,000 live births. A secondary outcome was pregnancy-related mortality rate per 100,000 live births. Absolute risk differences and adjusted incidence rate ratios were calculated for maternal mortality and pregnancy-related mortality with multivariable negative binomial mixed-effects …

In Danger: Hiv Vaccine Research And Development In Europe, Roger Tatoud, Yves Lévy, Roger Le Grand, Jose Alcami, Giorgio Barbareschi, Christian Brander, Andrea Cara, Behazine Combadière, François Dabis, Sarah Fidler, Tomáš Hanke, Carolina Herrera, Gunilla B. Karlsson Hedestam, Hester Kuipers, Sheena Mccormack, Christiane Moog, Giuseppe Pantaleo, Laura Richert, Rogier W. Sanders, Robin Shattock, Hendrik Streeck, Rodolphe Thiebaut, Alexandra Trkola, Klaus Üeberla, Marit J. Van Gills, Ralf Wagner, Winfried Weissenhorn, Yazdan Yazdanpanah, Gabriella Scarlatti, Jean Daniel Lelièvre

Department of Obstetrics & Gynecology Faculty Publications

Highly effective antiretroviral-based HIV prevention plays an important role in ending the global HIV/AIDS epidemic. However, the sustainable control of the epidemic is hampered by unequal access to prevention options, including HIV testing, alongside with drug resistance and ongoing barriers to accessing sustainable HIV treatment. Therefore, an HIV vaccine, combined with effective prevention and treatment, remains an absolute necessity to control the epidemic. Yet, the recent discontinuation of four major vaccine efficacy studies is raising concerns about the future of HIV vaccine research and development globally, and particularly in the European region where funding for vaccine research and development has …

Association Between The Intensity Of Exercise In The First Trimester And Early Second Trimester And The Risk Of Gestational Diabetes, Takaki Tanamoto, Misa Hayasaka, Tetsuya Kawakita

Department of Obstetrics & Gynecology Faculty Publications

Objective

Although some studies show that exercise decreases the incidence of gestational diabetes mellitus (GDM), the optimal exercise intensity during pregnancy remains unclear. We examined GDM risk according to exercise intensity in pregnant individuals.

Methods

We analyzed data from the Nulliparous Pregnancy Outcomes Study: Monitoring Mothers‐to‐Be (nuMoM2b), a prospective study enrolling nulliparous individuals in the first trimester. Participants with pregestational diabetes or delivery before 20 weeks were excluded. Exercise intensity during the first (6–13 weeks’ gestation) and early second (16–21 weeks’ gestation) trimesters was categorized by metabolic equivalent of task hours per week (MET‐hr/week) as none, low intensity (< 7.5), moderate intensity (7.5–14.9), or high intensity (≥ 15). The primary outcome was GDM; secondary outcomes included preeclampsia, gestational hypertension, preterm birth, small‐for‐gestational‐age birth, and stillbirth. Adjusted relative risks (aRRs) with 95% confidence intervals (CIs) were calculated using a generalized linear mixed‐effects model with a Poisson distribution and robust error variance, controlling for the random effects of individuals and potential confounders.

Results …

Longitudinal Assessment Of Fetal Myocardial Performance Index In Normal Pregnancy Using Spectral Tissue Doppler, R. Horgan, E. Sinkovskaya, E. Kalafat, G. Saade, A. Abuhamad

Department of Obstetrics & Gynecology Faculty Publications

Objective

Although spectral tissue Doppler imaging is recognized as the optimal method for assessing the fetal myocardial performance index (MPI), longitudinal reference ranges for fetal MPI measured using spectral tissue Doppler have not been established. Our objective was to use spectral tissue Doppler data to establish gestational-age-specific reference ranges from 12–33 weeks for left and right ventricular fetal MPI.

Methods

This was a prospective longitudinal study of women aged 18–35 years, with a body mass index below 30 kg/m² and a singleton pregnancy conceived spontaneously. Fetal MPI measurements were obtained in the first, second and third trimesters and MPI was …

Exposure To Phthalates And Replacements During Pregnancy In Association With Gestational Blood Pressure And Hypertensive Disorders Of Pregnancy, Erin E. Mcnell, Danielle R. Stevens, Barrett M. Welch, Emma M. Rosenthal, Suzanne Fenton, Antonia M. Calafat, Julianne Cook Botelho, Elena Sinkovskaya, Ann Przybylska, George Saade, Alfred Abuhamad, Kelly K. Ferguson

Department of Obstetrics & Gynecology Faculty Publications

Exposure to endocrine-disrupting chemicals such as phthalates may increase risk of hypertensive disorders of pregnancy (HDP). Prior studies lack investigation of chemical mixtures, phthalate replacements, or key periods of susceptibility including early pregnancy. In the present study, we used a longitudinal approach to evaluate gestational exposure to phthalates and replacements, as both single-pollutants and mixtures, in association with blood pressure and diagnosis of preeclampsia or any HDP. The Human Placenta and Phthalates prospective pregnancy cohort includes 291 participants recruited from two U.S. clinics. Urinary metabolites of ten phthalates and replacements were quantified at up to 8 time points per individual …

Association Between The Social Vulnerability Index And Adverse Pregnancy Outcomes, Tetsuya Kawakita, Misa Hayasaka, Lindsay Robbins, Juliana Martins, George Saade

Department of Obstetrics & Gynecology Faculty Publications

Objective: To assess the association between the Social Vulnerability Index (SVI) and racial disparities in pregnancy outcomes across U.S. counties and to quantify these racial disparities.

Methods: This was a cross-sectional study using restricted Centers for Disease Control and Prevention data sets, including natality data sets, fetal death data sets, and all-cause mortality data sets from 2016 to 2021. We limited analyses to Black or White individuals aged 15-44 years from 3,114 U.S. counties. Participants were categorized into quartiles based on county-level SVI. The primary outcome was maternal mortality rate while pregnant or within 42 days of the end of …