Digital Commons Network^™

Prevalence And Social Determinants Of Alcohol Use Disorders In Patients Attending Primary Care Clinics In Nairobi Kenya, Verah Kabwayi

Master of Medicine in Family Medicine

Introduction: In Kenya, studies have been conducted at community levels aiming at understanding the determinants of Alcohol-Use and heavy episodic drinking which may include healthy people. However, limited studies have been done to find out social determinants of alcohol use disorders in patients at private primary care clinics in Nairobi County. The study aimed to find out the prevalence and social determinants of alcohol use disorders in patients attending primary care clinics in Nairobi. Methods: A cross-sectional survey design was used and 389 respondents purposefully recruited into the study. Data was collected using a self-administered questionnaire adapted from the alcohol …

Effective Instructonal Strategies, While Using Experiential Learning, To Encourage Student Engagement In A Rural, Distance Learning Setting, Janelle Frank

Leadership Education Capstones

The COVID-19 pandemic forced many school districts to move all traditional face-to-face classes to distance learning settings. As a result, educators were left with the challenge of keeping students engaged from a remote location. This study determined what instructional strategies 4K-8 educators found most effective in fostering student engagement while using experiential learning in a rural, distance learning setting. 4K-8 educators were asked to complete an anonymous, confidential survey to gather information about their emergency transition to distance learning experiences and what instructional strategies they found most beneficial in fostering student engagement while using experiential learning. The study analyzed the …

Hybrid Cyclic-Linear Cell-Penetrating Peptides Containing Alternative Positive And Hydrophobic Residues As Molecular Transporters, Sorour Khayyatnejad Shoushtari

Pharmaceutical Sciences (MS) Theses

The cell membrane properties create a significant obstacle in intracellular delivery of cell-impermeable and negatively charged molecules. Amphiphilic cyclic peptides containing alternative arginine and tryptophan such as [WR]₅ have been shown to enhance the transport of cargo molecules across the cell membrane. Herein, we report the synthesis and biological evaluation of a novel series of hybrid cyclic-linear peptides containing alternative positive and hydrophobic amino acids on the ring and side-chain [(RW)₅]K(RW)_X (X=1-5) to compare their molecular transporter efficiency. The peptides were synthesized through Fmoc solid-phase peptide synthesis. Final compounds were purified by a reversed-phase HPLC (High …

Modulation Of Antibacterial Activity And Cytotoxicity In Amphipathic Cyclic Peptide [R4w4] Using Histidine Substitution, Ryan Stueber

Pharmaceutical Sciences (MS) Theses

Antibiotics have been the gold standard frontline defense against bacterial infections for decades. At the same time, these infecting bacteria have continued to evolve to resist developed antibiotics in an almost endless cycle. As such, we aim to take an alternative approach utilizing antimicrobial peptides (AMPs) as a means to end this cycle. [R4W4] is among known AMPs that demonstrated antimicrobial activity against methicillin-resistant staphylococcus aureus (MRSA) with a minimum inhibitory concentration (MIC) of 2.67 μg/mL. This peptide had notably effective antimicrobial activity, especially relative to linear (R4W4). However, it displayed a concerning level of cytotoxicity; eliciting a human embryonic …

Understanding The Impact Of Covid-19 On Agriculture And Food Supply Chains: System Dynamics Modeling For The Resilience Of Smallholder Farmers, Busra Atamer Balkan, Andreas Nicolaidis Lindqvist, Kelechi Odoemena, Robert Lamb, Monique Ann Tiongco, Stueti Gupta, Arpitha Peteru, Hector Manuel Menendez Iii

Quantitative Methods and Information Technology Faculty Publications

COVID-19 has caused severe agriculture and food supply chain disruptions; significantly affecting smallholder farmers who supply most of the world’s food; specifically their changes in vulnerability; resilience; and food loss and waste. Therefore; the objective of this study was to understand the complex causal and feedback relationships for this system by developing a dynamic hypothesis and causal loop diagrams utilizing the System Dynamics methodology. Results provide a roadmap for dialogue and a framework for case-specific model development and help to guide policy decisions for smallholder farmers’ survival during health crises.

Investigation Into Bacterial Impairment Of Greene And Polk County Water Systems, John C. Kincaid

Graduate Theses/Dissertations

Bacterial impairment of water systems is a major issue facing mankind. Bacteria that are introduced into a system have the potential to cause harmful diseases to wildlife and humans. In Greene and Polk counties, many water systems have become bacterially impaired over the years. Despite this, little is known about the contamination of known harmful bacteria in this region. To address this issue, I investigated the presence of known human pathogens across water systems in these two counties, many of which have displayed high levels of E. coli and fecal indicator microorganisms over many years. I used a high-throughput sequencing …

Examining Health Inequity In Ancient Egypt, Samantha Rose Gonzalez

Graduate Theses/Dissertations

This thesis explores the history of medicine in ancient Egypt between the Middle and New Kingdoms, and offers a case study highlighting the use of religion and magic in healing and analyzing health inequity. I am interested in medical practices, treatments, diagnosis methods, and access to healthcare in the ancient world. I seek to bridge the gaps and help unify the knowledge surrounding ancient Egyptian medical practices and contribute to the studies in the history of medicine. I explore types of diseases that commonly affected the ancient Egyptians and how they integrated religion and magic into their understanding and treatment …

Nucleotide P2y₂ Receptor-Dependent Leukocyte-Endothelial Interaction, Spencer E. Thomas

Graduate Theses/Dissertations

Extracellular nucleotides (ATP, UTP) released from cells act on nucleotide receptors to promote vascular inflammation. Increased leukocyte-endothelial interaction is a hallmark of vascular inflammation. The nucleotide P2Y₂ receptor (P2Y₂R), activated by extracellular ATP≈UTP, plays a role in cardiovascular homeostasis and immune regulation. Moreover, accumulating evidence from studies in vitro and in vivo models have implicated the P2Y₂R in the inflammatory response significantly contributing to the progression and pathogenesis of asthma, atherosclerosis, sepsis, and ischemia. I hypothesized that P2Y₂R activation by UTP, an agonist of the receptor, increased leukocyte rolling and adhesion in the microvasculature from baseline. To test the hypothesis, …

Modern Acinetobacter Baumannii Clinical Isolates Replicate Inside Spacious Vacuoles And Egress From Macrophages, Gabriela Sycz, Gisela Di Venanzio, Jesus S. Distel, Mariana G. Sartorio, Nguyen-Hung Le, Nichollas E. Scott, Wandy L. Beatty, Mario F. Feldman

Open Access Publications

Multidrug-resistant Acinetobacter baumannii infections are increasing at alarming rates. Therefore, novel antibiotic-sparing treatments to combat these A. baumannii infections are urgently needed. The development of these interventions would benefit from a better understanding of this bacterium's pathobiology, which remains poorly understood. A. baumannii is regarded as an extracellular opportunistic pathogen. However, research on Acinetobacter has largely focused on common lab strains, such as ATCC 19606, that have been isolated several decades ago. These strains exhibit reduced virulence when compared to recently isolated clinical strains. In this work, we demonstrate that, unlike ATCC 19606, several modern A. baumannii clinical isolates, including …

The Alternative Serotonin Transporter Promoter P2 Impacts Gene Function In Females With Irritable Bowel Syndrome, Sandra Mohr, Gregory Sayuk, Et Al

Open Access Publications

Irritable bowel syndrome (IBS) is a gut-brain disorder in which symptoms are shaped by serotonin acting centrally and peripherally. The serotonin transporter gene SLC6A4 has been implicated in IBS pathophysiology, but the underlying genetic mechanisms remain unclear. We sequenced the alternative P2 promoter driving intestinal SLC6A4 expression and identified single nucleotide polymorphisms (SNPs) that were associated with IBS in a discovery sample. Identified SNPs built different haplotypes, and the tagging SNP rs2020938 seems to associate with constipation-predominant IBS (IBS-C) in females. rs2020938 validation was performed in 1978 additional IBS patients and 6,038 controls from eight countries. Meta-analysis on data from …

Decreased Antiviral Immune Response Within The Central Nervous System Of Aged Mice Is Associated With Increased Lethality Of West Nile Virus Encephalitis, Kristen E Funk, Artem D Arutyunov, Pritesh Desai, James P White, Allison L Soung, Sarah F Rosen, Michael S Diamond, Robyn S Klein

Open Access Publications

West Nile virus (WNV) is an emerging pathogen that causes disease syndromes ranging from a mild flu-like illness to encephalitis. While the incidence of WNV infection is fairly uniform across age groups, the risk of lethal encephalitis increases with advanced age. Prior studies have demonstrated age-related, functional immune deficits that limit systemic antiviral immunity and increase mortality; however, the effect of age on antiviral immune responses specifically within the central nervous system (CNS) is unknown. Here, we show that aged mice exhibit increased peripheral organ and CNS tissue viral burden, the latter of which is associated with alterations in activation …

Geographic And Occupational Mobility Of Small-Scale Fishers Of Lake Malawi: An Exploratory Study Of Water, Sanitation, And Hygiene Access, Malawi., Rochelle H. Holm, Tikhala Chakalamba, Bwighane Ngasama, Fanuel Kapute

Faculty and Staff Scholarship

The livelihood of small-scale fishers on the world’s freshwater lakes cuts across the Sustainable Development Goal (SDG) 6, which covers water and sanitation, and SDG 8 on economic growth. The aim of this study was to examine the nature and extent of fishers’ mobility patterns and access to improved sanitation facilities, safe drinking water, and handwashing practices while at work and home for two fishing camps in Malawi. The study used key informant interviews, questionnaires, water quality testing, and an observational checklist, followed by interviews on fishers’ occupational migration. Many fishers (85%; 51/60) live and work in fishing camps with …

Exposure To Parasitic Infections Determines Features And Phenotypes Of Active Convulsive Epilepsy In Africa, Nelson K. Langat, Symon M. Kariuki, Gathoni Kamuyu, Angelina Kakooza-Mwesige, Seth Owusu-Agyei, Kenneth Ae-Ngibise, Anne Wang'ombe, Anthony Ngugi, Honorati Masaja, Ryan G. Wagner

Population Health, East Africa

Background: Epilepsy affects 70 million people worldwide, 80% of whom are in low-and-middle income countries (LMICs). Infections of the central nervous system (CNS) contribute considerably to the burden of epilepsy in LMICs, but the nature and presentation of epilepsy following these infections is not fully understood. We examined if epilepsy foutcomes are associated with the exposure to parasitic infections.
Methods: This was a case-comparison study nested in a cross-sectional survey of people with active convulsive epilepsy, with cases as those exposed to parasitic infections, and comparison as those unexposed. Associations of exposure to parasites with clinical and electroencephalographic …

The Impact Of Obesity On Covid-19 Outcomes In A High-Risk, Majority Hispanic Community Sample, Maxwell A. Lawlor

Capstone Experience: Master of Public Health

The novel coronavirus disease 2019 (COVID-19) pandemic has caused over 33.7 million cases and 605,000 deaths in the United States¹. Factors associated with increased odds for hospitalization, death, and other poor outcomes include age, comorbid conditions like cardiovascular disease and lung disease, and obesity. COVID-19 has also disproportionately affected Hispanic communities across the United States and in Omaha. Potential explanations for this disparity include social determinants of health, particularly occupational factors, structural challenges to access healthcare services, and increased medical comorbidities including obesity. In this retrospective cohort study, we used patient data from April to May 2020 (N=1,000) …

Documenting The Costs Of Social Behavior Change Interventions For Health In Low- And Middle-Income Countries, Avenir Health

Sexual and Reproductive Health, Rights, and Choices

Understanding the costs associated with social and behavior change (SBC) interventions for health is critical for budgeting, price setting, program planning, and economic analysis. Breakthrough RESEARCH performed a literature review and analysis to identify, classify, and synthesize published costs associated with SBC programming in low- and middle-income countries.

Standardizing New Diagnostic Tests To Facilitate Rapid Responses To The Covid-19 Pandemic, Xiao Dong

Dissertations and Theses (Open Access)

In order to enhance the data interoperability, an expeditious and accurate standardization solution is highly desirable for naming rapidly emerging novel lab tests, and thus diminishes confusion in early responses to pandemic outbreaks. This is a preliminary study to explore the roles and implementation of medical informatics technology, especially natural language processing and ontology methods, in standardizing information about emerging lab tests during a pandemic, thereby facilitating rapid responses to the pandemic. The ultimate goal of this study is to develop an informatics framework for rapid standardization of lab testing names during a pandemic to better prepare for future public …

Frequency Of Primiparous Mother Initiated Breastfeeding Earlier After Birth And Factors Associated With It In Sindh, Pakistan: A Secondary Analysis, Asma A. Bham, Sucheta Sharma, Akash Sardool, Umer F. Mujahid, Amrat Ayaz, Komal Valliani, Nawaal Maredia

Community Health Sciences

Background: Initiation of breastfeeding within one hour after delivery plays a vital role in a newborns life by not only increasing their survival rate but also reducing many life-threatening diseases in the newborn. The aim of the study was to determine frequency of early initiation of breastfeeding among primiparous mothers in a rural district of Thatta, Pakistan.
Methods: This study was conducted using survey data extracted from a cross-sectional study conducted in 2019 on prevalence of exclusive breastfeeding and factors associated with it among women in Thatta. The outcome was early initiation of breastfeeding. To determine factors associated with it, …

Multi-Assay Nutritional Metabolomics Profiling Of Low Vitamin A Status Versus Adequacy Is Characterized By Reduced Plasma Lipid Mediators Among Lactating Women In The Philippines: A Pilot Study, Catherine M. Johnson

Master's Theses

Background: A significant portion of lactating women in less developed countries have vitamin A (VA) deficiency. Lactation has substantial effects on a mother’s metabolism and VA is known to be needed in multiple biological processes, including growth, vision, immunity, and reproduction.

Objective: The objective of this pilot study was to utilize metabolomics profiling to conduct a broad, exploratory assessment of differences in plasma metabolites associated with low VA status versus adequacy in lactating women.

Methods: Plasma samples from lactating women who participated in a survey in Samar, Philippines, were selected from a cross-sectional study based on plasma retinol concentrations indicating …

Understanding Host-Pathogen Interactions, Brett E. Pickett

BYU Research Development Office Research Networking Conference

Gene Expression, Signaling Pathway Analysis, RNA-Sequencing, Drug Repurposing, Infectious Diseases, Diagnostics, Cancer, Comparative Genomics, Machine Learning

The Impact Of Daylight And Window Views On Health And Recovery: A Quash-Experimental Study Of Patients With Heart Disease In A Cardiac Icu, Roxana Jafarifiroozabadi

All Dissertations

Heart disease is the leading cause of death in the United States. Being diagnosed with heart disease can lead to depression, anxiety, sleep disruption, and delirium symptoms, which can cause prolonged hospital stays among patients. Evidence suggests that the presence of daylight and window views can influence these symptoms positively. However, no studies to date have differentiated the impact of daylight from window views on heart disease patients or addressed how window use can impact patient recovery in cardiac intensive care units (CICUs).

This IRB-approved study employed a retrospective and prospective quasiexperimental approach to investigate CICU rooms of the same …

“Old People Problems”, Uncertainty And Legitimacy: Challenges With Diagnosing Parkinson's Disease In Kenya, Natasha Fothergill-Misbah, Richard Walker, Judith Kwasa, Juzar Hooker, Kate Hampshire

Internal Medicine, East Africa

Very little is known about the experience of people living with Parkinson's disease (PD) in low- and middle-income countries, such as those in sub-Saharan Africa. The number of specialists in the region is low and awareness is limited among the population and healthcare professionals. Drawing on ten months of ethnographic fieldwork in urban and rural Kenya with 55 people living with PD (PwP), 23 family members and 22 healthcare professionals from public and private clinics, we set out to understand the experience of diagnosis among PwP in Kenya. The diagnostic journeys of our study participants were typically long, convoluted and …

Factors Associated With Mortality Among Hospitalized Adults With Covid-19 Pneumonia At A Private Tertiary Hospital In Tanzania: A Retrospective Cohort Study, Nadeem Kassam, Eric Aghan, Omar Aziz, Hanifa Mbithe, Kamran Hamid, Reena Shah, Salim Surani, James Orwa, Samina Somji

Internal Medicine, East Africa

Background: The emergence of the novel coronavirus disease 2019 (COVID-19) has caused millions of deaths worldwide. There has been paucity of data for hospitalized African patients suffering from COVID-19. This study aimed to identify factors associated with in-hospital mortality in patients suffering from COVID-19 in Tanzania.

Methods: This was a single center, retrospective, observational cohort study in adult patients hospitalized with confirmed COVID-19 infection. Demographics, clinical pattern, laboratory and radiological investigations associated with increased odds of mortality were analyzed.

Results: Of the 157 patients, 107 (68.1%) patients survived and 50 (31.8%) died. Mortality was highest in patients …

The Waste Management Of Large-Scale Recirculating Aquaculture Systems And Potential Value-Added Products From The Waste Stream, Franco R. Pilone

All Theses And Dissertations

Recirculating Aquaculture Systems (RAS) is an emerging technology that is capturing the attention of many in aquaculture due to its ability to produce high-quality seafood using sustainable models. This study explored the waste management of RAS, specifically further treatment technologies, and the potential value-added products from the RAS waste stream that can be reused. Advanced, tertiary, or down-stream treatment technologies available for RAS were investigated through a literature review. Utilizing the constant comparative method and semistructured interviews with stakeholders in RAS, opinions and attitudes were collected about advanced treatment of RAS waste and reuse opportunities presented from value-added products generated …

School Police Reform: A Public Health Imperative, Thalia González, Emma Kaeser

SMU Law Review Forum

Out of the twin pandemics currently gripping the United States­—deaths of unarmed Black victims at the hands of police and racialized health inequities resulting from COVID-19—an antiracist health equity agenda has emerged that identifies racism as a public health crisis. Likewise, calls for reform of school policing by those advocating for civil rights, racial justice, and Black Lives Matter have simultaneously intensified. Yet each remains siloed, despite the natural connection and implicit overlap between these separate movements and debates. Indeed, there are documented negative health effects of school policing for Black, Indigenous, people of color (BIPOC) youth. But these have …

Innovative Computational Methods For Pharmaceutical Problem Solving A Review Part Ii: Serious Gaming, Heather R. Campbell, Robert A. Lodder

Pharmaceutical Sciences Faculty Publications

Serious gaming has begun to take a foothold in pharmaceutical problem-solving. Companies such as Akili's Interactive are seeing success in the form of positive clinical trial results and FDA approval of digital therapeutics. Academic researchers have begun exploring novel uses for serious gaming in the way of protein design and more with promising results. This paper provides a review of such topics in addition to topics of game repurposing- repurposing a game originally intended for entertainment into a serious game-such as Minecraft and America's Army. Reviewing these topics this paper shows the utility of serious gaming as a tool for …

Relative Risks Of Covid-19 Fatality Between The First And Second Waves Of The Pandemic In Ontario, Canada, Sylvia H Hsu, Su-Hsin Chang, Cary P Gross, Shi-Yi Wang

Open Access Publications

OBJECTIVES: To examine whether the case fatality rate (CFR) of COVID-19 decreased over time and whether the COVID-19 testing rate is a driving factor for the changes if the CFR decreased.

METHODS: Analyzing COVID-19 cases, deaths and tests in Ontario, Canada, we compared the CFR between the first wave and the second wave across 26 public health units in Ontario. We also explored whether a high testing rate was associated with a large CFR decrease.

RESULTS: The first wave CFR ranged from 0.004 to 0.146, whereas the second wave CFR ranged from 0.003 to 0.034. The pooled RR estimate of …

Moral Circles And Mind Perception Shift Perceptions Of Effective Altruism, Kyle Fiore Law

Legacy Theses & Dissertations (2009 - 2024)

Across a re-analysis of an existing dataset (Study 1; N = 96) and a higher-powered new study (Study 2; N = 300), we reveal that moral valuation of environmentalism over humanitarianism predicts less favorable moral judgments of effective altruism (i.e., welfare-maximizing socially distant altruism directed at humans) that is performed at the exclusion of helping animals in need. Furthermore, this relationship is explained by tendencies in mind perception to dehumanize outgroup members and stigmatized humans, rather than tendencies to anthropomorphize animals (Study 2). These findings reveal that granular versus aggregate individual differences in moral circles and mind perception may be …

Calling The Shots: Balancing Parental And Child Rights In The Age Of Anti-Vax, Mahrukh Badar

Indiana Journal of Global Legal Studies

Vaccinations have become a contentious issue in recent times. Although there has always been opposition to vaccines, the internet has made it possible for pseudoscience and false information to spread like never before. This has led to alarming declines in vaccine confidence and adherence rates globally. High-income countries have seen the sharpest drop in vaccine confidence rates. Factors such as the complacency effect and religious objections likely explain this decline. Most countries have attempted to raise vaccine confidence levels by enacting laws that make vaccinations for children compulsory, with strict penalties for parents who refuse to comply. In addition to …

I Just Took A Dna Test—Turns Out, I'M 100% Breaching My Donor Anonymity Contract: Direct-To-Consumer Dna Testing And Parental Medical-Decision-Making, Morgan C. York

Indiana Journal of Global Legal Studies

Part I of this note provides a brief history of assisted reproductive technology and its increased use throughout the world, illustrating the growing number of donor-conceived children and the related importance of knowing genetic information. Part I also surveys regulations concerning donor anonymity in the United States and the United Kingdom to illustrate different jurisdictions' approaches to the regulation of donor anonymity. This note uses the United Kingdom as a model of countries that have prohibited sperm donor anonymity. Part II of this note discusses direct-to-consumer DNA testing, specifically 23andMe's products. This note selects 23andMe as the direct-to-consumer company for …

Calibration Study Of A Bacterial Quantification Technique Using Transport Swabs And Line Inoculations On Agar Growth Medium, Seth Larue

Honors Theses

Enumeration of bacteria has been the subject of research for over a century. Some of the techniques that have been developed include viable plate counts, the most probable number assessment, and more modern molecular techniques. Many of the newer molecular-based techniques provide little or no information about the viability of the cells being counted, and are generally not quantitative. Having quantitative data for potentially pathogenic bacteria on surfaces can be very useful in many settings, particularly in healthcare facilities. Knowing the numbers of bacterial cells present on surfaces within healthcare facilities may be important to attempt to study the cause …