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Association Of Covid-19 Coinfection With Increased Mortality Among Patients With Pseudomonas Aeruginosa Bloodstream Infection In The Veterans Health Administration System, Leila S. Hojat, Brigid M. Wilson, Federico Perez, Maria F. Mojica, Mendel E. Singer, Robert A. Bonomo Dec 2023

Association Of Covid-19 Coinfection With Increased Mortality Among Patients With Pseudomonas Aeruginosa Bloodstream Infection In The Veterans Health Administration System, Leila S. Hojat, Brigid M. Wilson, Federico Perez, Maria F. Mojica, Mendel E. Singer, Robert A. Bonomo

Faculty Scholarship

Objective: Pseudomonas aeruginosa bloodstream infection (PA-BSI) and COVID-19 are independently associated with high mortality. We sought to demonstrate the impact of COVID-19 coinfection on patients with PA-BSI. Design: Retrospective cohort study. Setting: Veterans Health Administration. Patients: Hospitalized patients with PA-BSI in pre-COVID-19 (January 2009 to December 2019) and COVID-19 (January 2020 to June 2022) periods. Patients in the COVID-19 period were further stratified by the presence or absence of concomitant COVID-19 infection. Methods: We characterized trends in resistance, treatment, and mortality over the study period. Multivariable logistic regression and modified Poisson analyses were used to determine the association between COVID-19 …


Feasibility Of Using Podcasts For Knowledge Dissemination To Reduce Health Disparities For Women Targeting Preventative Initiatives And Lifestyle Medicine Interventions, Kristin Stovern Dec 2023

Feasibility Of Using Podcasts For Knowledge Dissemination To Reduce Health Disparities For Women Targeting Preventative Initiatives And Lifestyle Medicine Interventions, Kristin Stovern

Doctor of Nursing Practice Scholarly Project

The purpose of this feasibility project was to look at podcasts to shed light on the issues that affect the well-being of women with gender-based disparities in healthcare. Women face persistent obstacles when it comes to the quality of healthcare they receive. One of the barriers that has been ever-present is with failure of the medical system to rigorously study the effects of diseases and drugs on women or to fund studies on women’s health conditions. Implicit biases and lack of access to care inhibit the quality of healthcare. Collectively, these issues result in unnecessary sickness, disability, and decreased quality …


Give Love With Lovenox: Improving Nurse Education On Lovenox Prophylaxis To Reduce Pulmonary Embolism Risk On The Postpartum Unit, Jennifer G. Domingo Rn Dec 2023

Give Love With Lovenox: Improving Nurse Education On Lovenox Prophylaxis To Reduce Pulmonary Embolism Risk On The Postpartum Unit, Jennifer G. Domingo Rn

Master's Projects and Capstones

This quality improvement project aims to improve nurse education about Lovenox prophylaxis to reduce the risk of pulmonary emboli – post-discharge – amongst high-risk postpartum women who underwent vaginal and cesarean deliveries on the family baby unit. This project took place in a Family Baby/Postpartum Unit at Hospital SC. This unit has a total of 25 beds with an increased prevalence of pulmonary embolism following cesarean delivery. Nurses were given anonymous pre- and post-survey questionnaires and provided educational sessions with distributed handouts. A unit needs assessment was conducted using the 5 P’s. Out of the 72 nurses on the staff …


Childcare License Not Necessary, Jean C. Brannum Dec 2023

Childcare License Not Necessary, Jean C. Brannum

Capstones

Most childcare centers need a license to operate, but many states have loopholes that allow fitness center daycares to forego traditional licensing. The variation in rules lets some kids play in dangerous situations.


Inequality In Opportunities And Outcomes: Indicators To Inform Data-Driven Community Systems For Youth Physical Activity, Ann Essay Dec 2023

Inequality In Opportunities And Outcomes: Indicators To Inform Data-Driven Community Systems For Youth Physical Activity, Ann Essay

Theses & Dissertations

Indicators illuminating whole-of-community and setting system physical activity (PA) outcomes and drivers are needed to inform population health improvement efforts. This multi-study dissertation examines inequalities in PA resources, opportunities, and outcomes and the factors influencing inequalities across multiple temporal and geospatial scales (e.g., community, setting). First, a scoping review examined community-level variability in PA resource and opportunity availability by community sociodemographic characteristics (e.g., race). Across 46 included studies, 41 unique indicators characterizing community PA systems were identified, and 29.8% of relationships assessed indicated greater resource/opportunity availability in communities of higher socioeconomic status or lower minority population prevalence. The indicators synthesized …


Towards A Mode Of Action For The Anti-Schistosomal Aryl Hydantoins, Thomas Schulze Dec 2023

Towards A Mode Of Action For The Anti-Schistosomal Aryl Hydantoins, Thomas Schulze

Theses & Dissertations

Schistosomiasis is a significant human disease caused by the helminth parasite Schistosoma mansoni. Praziquantel remains the only clinically used treatment, yet it is rapidly metabolized and only effective against the adult stage worm infection. Ro 13-3978 (AR02) is a potent antischistosomal compound with activity against multiple S. mansoni life stages; however, it manifests anti-androgenic activity. Additionally, the mechanism of action for worm clearance remains unknown. The structure of Ro 13-3979 was used to generate optimized derivatives, including AR102, that show increased potency towards worms, reduced off-target anti-androgen effects, and extended half-life thereby increasing the feasibility for a single-dose curative treatment. …


Applications Of The Re-Aim Framework In Health Promotion, Emiliane L. Pereira Dec 2023

Applications Of The Re-Aim Framework In Health Promotion, Emiliane L. Pereira

Theses & Dissertations

This dissertation applied a variety of methods under the RE-AIM (Reach, Effectiveness, Adoption, Implementation, and Maintenance) framework and provided a valuable and relevant contribution to the field of the dissemination and implementation (D&I) science. In the first study, we applied the RE-AIM framework to evaluate interventions and summarize the literature on breastfeeding promotion programs on the Black population (Chapter 1). The study results provide meaningful findings by bridging the gap on the literature of reporting breastfeeding supporting services and resources available to ensure breastfeeding continuation, as well as the need for a better reporting on the individual-level and setting representativeness, …


A Community-Based Participatory Research Approach To Addressing Pediatric Asthma Disparities In Douglas County, Nebraska, Aislinn Rookwood Dec 2023

A Community-Based Participatory Research Approach To Addressing Pediatric Asthma Disparities In Douglas County, Nebraska, Aislinn Rookwood

Theses & Dissertations

Pediatric asthma is the leading chronic disease among children in the United States, and the incidence of pediatric asthma is increasing every year. Nebraska has an asthma prevalence comparable to the United States average; however, the state has significant disparities by county, race, and geographic location, with prevalence rates much higher than the national average. Douglas County is a hot spot for increased pediatric asthma rates, with further differences in rates by race and geographic location within the county. The University of Nebraska Medical Center, in partnership with Healthy Housing Omaha and the Nebraska Asthma Coalition, collaborated to conduct this …


Lifestyle Behaviors Before And After Diagnosis Of Type 2 Diabetes: Findings From The Nurses’ Health Studies, Amelia E. Roebuck Dec 2023

Lifestyle Behaviors Before And After Diagnosis Of Type 2 Diabetes: Findings From The Nurses’ Health Studies, Amelia E. Roebuck

Dissertations and Theses (Open Access)

Short- and long-term changes in diet or physical activity in relation to type 2 diabetes mellitus (T2DM) and factors associated with behavior change with adequate inclusion of relevant confounding and effect-modifying variables have been minimally explored. The objective of this research was to examine changes in diet and physical activity following a diagnosis of T2DM and identify sociodemographic, medical, psychosocial, and lifestyle factors associated with changes in dietary or physical activity behaviors. This dissertation utilized two prospective cohorts of U.S. female nurses participating in the Nurses’ Health Study (1976-2016) and Nurses’ Health Study II (1989-2017). Linear mixed effects modeling was …


Dna Methylation-Based Epigenetic Biomarkers In Cell-Type Deconvolution And Tumor Tissue Of Origin Identification, Ze Zhang Dec 2023

Dna Methylation-Based Epigenetic Biomarkers In Cell-Type Deconvolution And Tumor Tissue Of Origin Identification, Ze Zhang

Dartmouth College Ph.D Dissertations

DNA methylation is an epigenetic modification that regulates gene expression and is essential to establishing and preserving cellular identity. Genome-wide DNA methylation arrays provide a standardized and cost-effective approach to measuring DNA methylation. When combined with a cell-type reference library, DNA methylation measures allow the assessment of underlying cell-type proportions in heterogeneous mixtures. This approach, known as DNA methylation deconvolution or methylation cytometry, offers a standardized and cost-effective method for evaluating cell-type proportions. While this approach has succeeded in discerning cell types in various human tissues like blood, brain, tumors, skin, breast, and buccal swabs, the existing methods have major …


Quality Of Life And Unmet Needs Of Late-Stage And Metastatic Colorectal Cancer Survivors, Krista Brown Dec 2023

Quality Of Life And Unmet Needs Of Late-Stage And Metastatic Colorectal Cancer Survivors, Krista Brown

Theses & Dissertations

Colorectal cancer (CRC) is the third leading cause of cancer-related deaths in both men and women and is the second leading cause of cancer deaths when men and women are combined. CRC survivors are living longer with an increase in 5-year survival, rising from 52% in the 1980s to 62% in the 2000s. The objective of this dissertation was to explore the QoL and unmet needs of stage III and IV CRC survivors and contribute to the field of survivorship research through an integrative literature review of the state of the science and a sequential, explanatory mixed methods study.

The …


Improving Intimate Partner Violence Screening In A Women’S Health Practice Through Implementation Of An Evidence-Based Screening Tool, Jasmine Weber Dec 2023

Improving Intimate Partner Violence Screening In A Women’S Health Practice Through Implementation Of An Evidence-Based Screening Tool, Jasmine Weber

Doctor of Nursing Practice Projects: College of Nursing

The purpose of this quality improvement project was to implement intimate partner violence screening in an outpatient women’s health clinic with no prior screening process in place. Current recommendations are to screen all reproductive age women for intimate partner violence 6 . During a three-month period 170 patients out of 260 eligible patients were screened using the HARK screening tool, 7 of those patients screened positive and were offered referrals to social work. While universal IPV screening was not achieved, a screening rate of 64% is a remarkable improvement from an apparent absence of screening prior to project implementation.


Acceptability And Use Of An Online Health Priorities Self-Identification Tool For Older Adults: A Qualitative Investigation, Emily L Mroz, Kizzy Hernandez-Bigos, Jessica Esterson, Eliza Kiwak, Aanand Naik, Mary E Tinetti Dec 2023

Acceptability And Use Of An Online Health Priorities Self-Identification Tool For Older Adults: A Qualitative Investigation, Emily L Mroz, Kizzy Hernandez-Bigos, Jessica Esterson, Eliza Kiwak, Aanand Naik, Mary E Tinetti

Faculty, Staff and Student Publications

OBJECTIVE: To examine the use of a web-based, self-directed health priorities identification tool for older adults with multiple chronic conditions (MCCs).

METHODS: We recruited a gender- and racially-diverse, highly educated sample of older adults with MCCs to engage with our My Health Priorities tool, then complete a semi-structured interview. Thematic analysis was used to examine interview transcripts.

RESULTS: Twenty-one participants shared perspectives on the acceptability and use of the tool. Three themes (with eleven subthemes) were generated to describe: website

CONCLUSION: Participants found this tool acceptable and easy to use, describing a variety of benefits of the priorities self-identification process …


Plants As Vectors For Environmental Prion Transmission, Christina M Carlson, Samuel Thomas, Matthew W Keating, Paulina Soto, Nicole M Gibbs, Haeyoon Chang, Jamie K Wiepz, Annabel G Austin, Jay R Schneider, Rodrigo Morales, Christopher J Johnson, Joel A Pedersen Dec 2023

Plants As Vectors For Environmental Prion Transmission, Christina M Carlson, Samuel Thomas, Matthew W Keating, Paulina Soto, Nicole M Gibbs, Haeyoon Chang, Jamie K Wiepz, Annabel G Austin, Jay R Schneider, Rodrigo Morales, Christopher J Johnson, Joel A Pedersen

Faculty, Staff and Student Publications

Prions cause fatal neurodegenerative diseases and exhibit remarkable durability, which engenders a wide array of potential exposure scenarios. In chronic wasting disease of deer, elk, moose, and reindeer and in scrapie of sheep and goats, prions are transmitted via environmental routes and the ability of plants to accumulate and subsequently transmit prions has been hypothesized, but not previously demonstrated. Here, we establish the ability of several crop and other plant species to take up prions via their roots and translocate them to above-ground tissues from various growth media including soils. We demonstrate that plants can accumulate prions in above-ground tissues …


Unravelling The Potential Mortality Benefits Of Mass Drug Administration With Azithromycin In Niger, Zulfiqar Ahmed Bhutta Dec 2023

Unravelling The Potential Mortality Benefits Of Mass Drug Administration With Azithromycin In Niger, Zulfiqar Ahmed Bhutta

Centre of Excellence in Women and Child Health

No abstract provided.


“Nadie Nunca Me Habló De Riesgos”: Madres Subrogantes En Eeuu Reclaman Protección, Carla Gloria Colomé Santiago Dec 2023

“Nadie Nunca Me Habló De Riesgos”: Madres Subrogantes En Eeuu Reclaman Protección, Carla Gloria Colomé Santiago

Capstones

Commercial surrogacy is a growing industry. In the United States, the Centers for Disease Control and Prevention (CDC) reported that by 2020, 90 percent of clinics in the country were offering gestational carrier services. In this report, several surrogate mothers speak of inefficient contracts, poor pay and lack of support, amid a landscape where business takes precedence over the treatment of women.

https://preview.shorthand.com/dN8XSDPrI83UIc8P


Validity And Reliability Of The Persian Version Of The Suboptimal Health Status Questionnaire Among University Staff In Iran, Erfan Ayubi, Salman Khazaei, Shiva Borzouei, Ali R. Soltanian, Samereh Ghelichkhani, Fatemeh Karbin, Yuxiang Yan, Manshu Song, Cuihong Tian, Wei Zhang, Jing Sun, Wei Wang Dec 2023

Validity And Reliability Of The Persian Version Of The Suboptimal Health Status Questionnaire Among University Staff In Iran, Erfan Ayubi, Salman Khazaei, Shiva Borzouei, Ali R. Soltanian, Samereh Ghelichkhani, Fatemeh Karbin, Yuxiang Yan, Manshu Song, Cuihong Tian, Wei Zhang, Jing Sun, Wei Wang

Research outputs 2022 to 2026

Background: Suboptimal Health Status Questionnaire-25 (SHSQ-25) is an established tool for measuring a precision health state between health and illness. The present study aims to assess the validity and reliability of a Persian version of SHSQ-25 (P-SHSQ-25) in a university staff Iranian population. Methods: A sample of 316 academic and supporting staff (163 males, age range from 23 to 64 years old) from Hamadan University of Medical Sciences, Hamadan, Iran was recruited in this population-based cross-sectional study with a questionnaire validation from Apri1 to October 2022. Forward-backward translation method was performed for the SHSQ-25 translation from English to Persian. Internal …


Test Event Example 12/14/23, Metzalli Demolastname Dec 2023

Test Event Example 12/14/23, Metzalli Demolastname

Annual Research Symposium

No abstract provided.


The Pima County Jail In A “State Of Full-Blown Crisis”: Inmate Deaths Four Times The National Average, Natalie Robbins Dec 2023

The Pima County Jail In A “State Of Full-Blown Crisis”: Inmate Deaths Four Times The National Average, Natalie Robbins

Capstones

Last year, 12 inmates died in custody at the Pima County Jail in Tucson, Arizona. With a 10-year average jail population of 1,827, that is a per capita rate of 656.8 deaths per 100,000 inmates.

According to the most recent data from the Bureau of Justice Statistics, the 2019 national local jail mortality rate was 167 deaths for every 100,000 inmates, making the Pima County Jail’s 2022 per capita death rate nearly four times as high as the national average in 2019.

In a December 2022 memo to the Pima County Board of Supervisors, Pima County Sheriff Chris Nanos wrote …


Développement De Méthodes Analytiques Pour Les Composés Organiques Volatils Microbiens (Covm) Dans Les Matrices Biologiques : Vers L’Évaluation Des Covm Comme Biomarqueurs D’Exposition Aux Moisissures, Badr El Aroussi, Sarah Tabbal, Wissam Berkane, Michèle Bouchard, Geneviève Marchand, Sami Haddad Dec 2023

Développement De Méthodes Analytiques Pour Les Composés Organiques Volatils Microbiens (Covm) Dans Les Matrices Biologiques : Vers L’Évaluation Des Covm Comme Biomarqueurs D’Exposition Aux Moisissures, Badr El Aroussi, Sarah Tabbal, Wissam Berkane, Michèle Bouchard, Geneviève Marchand, Sami Haddad

Rapports de recherche scientifique

Préalablement, vingt composés organiques volatils microbiens (COVM), avec un potentiel d’être utilisés comme biomarqueurs de contamination et d’exposition aux moisissures en milieu de travail, avaient été identifiés, en considérant plusieurs paramètres, comprenant l’intérêt pour la santé des espèces de moisissures, l’occurrence d’émission ainsi que les paramètres physicochimiques et pharmacocinétiques.

Dans la présente étude, de nouvelles méthodes analytiques, pour mesurer simultanément 21 COVM incluant ceux identifiés préalablement dans les matrices biologiques et l’air ambiant, en se basant sur les techniques H-SPME-GC-MS/MS (sang et urine) et TD-GCMS/MS (exhalât et air ambiant), ont été développées et validés. Celles-ci ont exhibé des performances analytiques …


Policy Review And Recommendation For Secondary Education Np-Led Clinics In The Southeastern United States, Shiney Alex Jacob Dec 2023

Policy Review And Recommendation For Secondary Education Np-Led Clinics In The Southeastern United States, Shiney Alex Jacob

Student Scholarly Projects

Secondary-level education involves adolescent children aged 11-12 years to 18-19 with unique healthcare needs. Their healthcare is of significant importance as they are transitioning to adulthood, and a majority of them lack access to primary healthcare needs. Advanced Practice Registered Nurses/Nurse Practitioners (APRNs/NPs) provide high-quality, cost-effective, and evidence-based care to people across the lifespan, and there is minimal utilization of their services in meeting the primary care needs of adolescents at the secondary school level. The purpose of the policy project was to determine if current policies and practices related to school health services in three southeastern states of the …


The Next Phase Of Public Health: Innovations From The Private Sector To Build Health Equity, Collaborations, And Resilience, Susan Garfield, Amy S. White, Frances Garfield, Rick B. Siegrist, Natasha Eslami Dec 2023

The Next Phase Of Public Health: Innovations From The Private Sector To Build Health Equity, Collaborations, And Resilience, Susan Garfield, Amy S. White, Frances Garfield, Rick B. Siegrist, Natasha Eslami

Publications and Research

The Covid-19 pandemic highlighted foundational challenges in managing the public's health and the persistent health inequities in our communities. Within the private sector, companies witnessed how adverse health events impact the economy at large, their employees, and their customers. As a result, many companies have begun to see that they have a critical role in improving the long-term well-being of the communities in which they work and how health equity can build resilience. This recognition has driven many to action. Either on their own or in collaboration with established public health players, companies are deploying private sector points of view …


Postmortem Minimally Invasive Tissue Sampling In Communities: Exploring Perceptions Of Families, Funeral Workers, Religious And Community Leaders And Healthcare Providers From Pakistan, Nazia Ahsan, Fauzia Aman Malik, Waliyah Mughis, Rawshan Jabeen, Shaheen Mehboob, Raheel Allana, Syeda Quratulain, Saima Jamal Saima Jamal, Christina R. Paganelli, Abdul Momin Kazi Dec 2023

Postmortem Minimally Invasive Tissue Sampling In Communities: Exploring Perceptions Of Families, Funeral Workers, Religious And Community Leaders And Healthcare Providers From Pakistan, Nazia Ahsan, Fauzia Aman Malik, Waliyah Mughis, Rawshan Jabeen, Shaheen Mehboob, Raheel Allana, Syeda Quratulain, Saima Jamal Saima Jamal, Christina R. Paganelli, Abdul Momin Kazi

Department of Paediatrics and Child Health

Background: Minimally invasive tissue sampling (MITS) has increasingly been used to improve the diagnosis of disease and identification of the cause of death, particularly in underserved areas. However, there are multiple barriers to accessing those who die within the community, our study aimed to explore the perceptions and insights of community members and healthcare providers regarding the feasibility of implementing MITS in community settings.
Methods: A qualitative exploratory study was conducted. A total of twenty one in-depth interviews were conducted with deceased infants' parents, elders of the family, religious leaders, community leaders, and funeral workers. Focus group discussions were conducted …


Where Did All The Bed Bugs Go?, Lauren Friedman Dec 2023

Where Did All The Bed Bugs Go?, Lauren Friedman

Capstones

In the early 2000s in New York City, everyone was talking about bed bugs. The disc-shaped, bloodsucking pests had been a common domestic nuisance up to the World War II era, but in the decades since, they’d mostly faded into obscurity. That was until bed bug infestations, which are often psychologically distressing and sometimes impossible to overcome, suddenly became routine across the five boroughs, driving people from their apartments and stoking fear about everything from upholstered theater seats to thrift stores.

But then, just as quickly as bed bugs had invaded, they seemed to fade away. In a 2022 study …


Identifying Locations Of Drug Overdose In Las Vegas To Implement The Cardiff Violence Prevention Model, John Girard, Shikha Pandey, Zack Bunn, Chris Papesh, Jacquelyn Cheun Phd, Ying Zhang Dec 2023

Identifying Locations Of Drug Overdose In Las Vegas To Implement The Cardiff Violence Prevention Model, John Girard, Shikha Pandey, Zack Bunn, Chris Papesh, Jacquelyn Cheun Phd, Ying Zhang

SMU Data Science Review

This paper will provide an innovative approach to drug overdose prevention programs. Using data from Las Vegas emergency departments, this paper will analyze geospatial trends of drug overdoses. Leveraging the Cardiff Violence Prevention Model, the information is shared with local law enforcement agencies and decision makers to empower them to make evidence-based strategies. This paper highlights the efficacy of a data-driven model in addressing public health issues and underscoring its ability for even broader implementation in urban settings. Findings will suggest significant implications for policymaking, crime prevention, and public health initiatives, demonstrating a step towards a safer Las Vegas.


Analisis Hubungan Tingkat Pencahayaan, Reflektansi, Dan Kekontrasan Area Kerja Terhadap Keluhan Eye Strain Pada Karyawan Office Di Pt. X Tahun 2023, Afni Fadhila, Mila Tejamaya Dec 2023

Analisis Hubungan Tingkat Pencahayaan, Reflektansi, Dan Kekontrasan Area Kerja Terhadap Keluhan Eye Strain Pada Karyawan Office Di Pt. X Tahun 2023, Afni Fadhila, Mila Tejamaya

National Journal of Occupational Health and Safety

Eye strain is a condition where the eyes are strained due to prolonged overuse, especially in computer-based activities. NIOSH states that about 75 - 90% of computer users who spend three hours or more complaining of visual impairment. A study by Kowalska et al (2011) on office workers who use computers intensely stated that the prevalence of eye strain in female workers was 50,7% and in men was 32,6%. This study aims to determine the relationship between illuminance, reflectance, and work area contrast on eye strain complaints in office employees at PT. X. This research was conducted from April - …


Bridging The Gap: Reducing Disparities In Reproductive Healthcare For Black And White Women, Emma Weiden Dec 2023

Bridging The Gap: Reducing Disparities In Reproductive Healthcare For Black And White Women, Emma Weiden

Population Health Research Brief Series

A woman’s reproductive healthcare experience in the United States can vary dramatically depending on her race. In 2020, the pregnancy-related mortality rate in the U.S. was 40.8 deaths per 100,000 live births for Black women, which is more than three times the rate among White women (12.7 per 100,000). This brief summarizes disparities in reproductive healthcare outcomes for Black women compared to White women in the U.S., advocates for policy changes, and provides recommendations for addressing racial disparities to create more equitable reproductive healthcare.


Patterns And Predictors Of Racial/Ethnic Disparities In Hiv Care Continuum In The Southern Usa: Protocol For A Population-Based Cohort Study, Xueying Yang Ph.D., Jiajia Zhang Ph.D., Bankole Olatosi Ph.D., Zhenlong Li, Sharon Weissman, Xiaoming Li Ph.D. Dec 2023

Patterns And Predictors Of Racial/Ethnic Disparities In Hiv Care Continuum In The Southern Usa: Protocol For A Population-Based Cohort Study, Xueying Yang Ph.D., Jiajia Zhang Ph.D., Bankole Olatosi Ph.D., Zhenlong Li, Sharon Weissman, Xiaoming Li Ph.D.

Faculty Publications

Introduction Health disparities exist at every step of the HIV care continuum (HCC) among racial/ethnic minority population. Such racial/ethnic disparities may have significantly delayed the progress in HCC in the Southern US states that are strongly represented among geographic focus areas in the 2019 federal initiative titled 'Ending the HIV Epidemic: A Plan for America'. However, limited efforts have been made to quantify the long-term spatiotemporal variations of HCC disparities and their contributing factors over time, particularly in the context of COVID-19 pandemic. This project aims to identify the spatiotemporal patterns of racial disparities of each HCC outcome and then …


Oral Lactoferrin Administration Does Not Impact The Diversity Or Composition Of The Infant Gut Microbiota In A Peruvian Cohort, Luis González, Jose Luis Paredes Sosa, Susan Mosquito, Yesenia Filio, Pedro E Romero, Theresa J Ochoa, Pablo Tsukayama Dec 2023

Oral Lactoferrin Administration Does Not Impact The Diversity Or Composition Of The Infant Gut Microbiota In A Peruvian Cohort, Luis González, Jose Luis Paredes Sosa, Susan Mosquito, Yesenia Filio, Pedro E Romero, Theresa J Ochoa, Pablo Tsukayama

Faculty, Staff and Student Publications

Previous studies have suggested that oral lactoferrin enhances diversity in the gut microbiota in infants while inhibiting the growth of opportunistic pathogens. However, the effect of lactoferrin on infant gut microbiota over time has yet to be thoroughly studied. Our study suggests that lactoferrin oral treatment in infants aged 12-18 months does not affect gut microbiome diversity and composition over time. to our knowledge, this is the first study to report the effect of lactoferrin on infant gut microbiome composition over time and helps elucidate its impact on infant health and its therapeutic potential.


A Multilevel Mhealth Intervention Boosts Adherence To Hydroxyurea In Individuals With Sickle Cell Disease, Jane S Hankins, Donald Brambilla, Michael B Potter, Abdullah Kutlar, Robert Gibson, Allison A King, Ana A Baumann, Cathy Melvin, Victor R Gordeuk, Lewis L Hsu, Chinonyelum Nwosu, Jerlym S Porter, Nicole M Alberts, Sherif M Badawy, Jena Simon, Jeffrey A Glassberg, Richard Lottenberg, Lisa Dimartino, Sara Jacobs, Maria E Fernandez, Hayden B Bosworth, Lisa M Klesges, Nirmish Shah Dec 2023

A Multilevel Mhealth Intervention Boosts Adherence To Hydroxyurea In Individuals With Sickle Cell Disease, Jane S Hankins, Donald Brambilla, Michael B Potter, Abdullah Kutlar, Robert Gibson, Allison A King, Ana A Baumann, Cathy Melvin, Victor R Gordeuk, Lewis L Hsu, Chinonyelum Nwosu, Jerlym S Porter, Nicole M Alberts, Sherif M Badawy, Jena Simon, Jeffrey A Glassberg, Richard Lottenberg, Lisa Dimartino, Sara Jacobs, Maria E Fernandez, Hayden B Bosworth, Lisa M Klesges, Nirmish Shah

Faculty, Staff and Student Publications

Hydroxyurea reduces sickle cell disease (SCD) complications, but medication adherence is low. We tested 2 mobile health (mHealth) interventions targeting determinants of low adherence among patients (InCharge Health) and low prescribing among providers (HU toolbox) in a multi-center, non-randomized trial of individuals with SCD ages 15-45. We compared the percentage of days covered (PDC), labs, healthcare utilization, and self-reported pain over 24 weeks of intervention and 12 weeks post-study with a 24-week preintervention interval. We enrolled 293 patients (51% male; median age 27.5 years, 86.8% HbSS/HbSβ0-thalassemia). The mean change in PDC among 235 evaluable subjects increased (39.7% to 56.0%; P < 0.001) and sustained (39.7% to 51.4%, P < 0.001). Mean HbF increased (10.95% to 12.78%; P = 0.03). Self-reported pain frequency reduced (3.54 to 3.35 events/year; P = 0.041). InCharge Health was used ≥1 day by 199 of 235 participants (84.7% implementation; median usage: 17% study days; IQR: 4.8-45.8%). For individuals with ≥1 baseline admission for pain, admissions per 24 weeks declined from baseline through 24 weeks (1.97 to 1.48 events/patient, P = 0.0045) and weeks 25-36 (1.25 events/patient, P = 0.0015). PDC increased with app use (P < 0.001), with the greatest effect in those with private insurance (P = 0.0078), older subjects (P = 0.033), and those with lower pain interference (P = 0.0012). Of the 89 providers (49 hematologists, 36 advanced care providers, 4 unreported), only 11.2% used HU toolbox ≥1/month on average. This use did not affect change in PDC. Tailoring mHealth solutions to address barriers to hydroxyurea adherence can potentially improve adherence and provide clinical benefits. A definitive randomized study is warranted. This trial was registered at www.clinicaltrials.gov as #NCT04080167.