Medicine and Health Sciences Commons^™

Understanding Hepatitis C Risk And Harm Reduction Needs Among People Who Smoke Drugs: A Client-Centered Qualitative Inquiry, Maxwell Gustin

Anthropology

The spread of Hepatitis C virus (HCV) via non-injectable equipment is plausible, making people who smoke drugs (PWSD) at-risk for possible infection and transmission. While much research has been conducted into injection drug use (IDU), likely due to the rising opioid epidemic, limited studies focus on the risks PWSD face. Currently, state-funded syringe service programs (SSPs) provide harm reduction education and materials to combat these risks. Safer smoking initiatives have been created and are widely used by PWSD, and have access to SSPs. To gain better insight into the HCV and non-HCV-related risks and burdens PWSD face, a qualitative study …

Identifying Barriers For Community Pharmacies As Vaccines For Children (Vfc) Providers In Rural Alabama: Opportunities For Solutions, Myra Bajwa

Honors Theses

Significant Human papillomavirus (HPV) vaccination disparities exist between rural and urban areas in the US. A primary contributor is low access to preventive care in rural areas. Among the most promising strategies to overcome this is increasing access through offering HPV vaccination in non-traditional, convenient health settings such as pharmacies. In rural areas, community pharmacies are trusted, convenient pillars of the community. In Alabama, community pharmacies are eligible for enrollment in the Vaccines for Children (VFC) Program, a federally-funded program that provides free vaccines to children and adolescents under 18 years old who are uninsured, underinsured, American Indian, or Alaska …

Best Practice Recommendations For Anesthesia Providers In Preventing Postoperative Delirium In The Geriatric Population Undergoing Non-Cardiac Surgery, Ana Primeaux, Ashanti Reed

Doctoral Projects

Postoperative delirium (POD) is a significant and preventable complication in geriatric patients undergoing non-cardiac surgery. Such complication is associated with foreseeable consequences, such as prolonged hospitalization, long-term cognitive decline, increased morbidity and mortality, and increased costs. Despite the emerging awareness of evidence-based nonpharmacologic and pharmacologic interventional strategies, POD still represents a clinical challenge for anesthesia providers.

Currently, there is a lack of clinical guidelines to guide formalized education and evidence-based interventions on POD prevention across anesthesia practice settings. Consequently, there is a critical need to raise awareness that the lack of clinical guidelines and the high incidence of POD may …

Impact In Action: Your Michigan Dental Association Foundation, Anne Berquist

The Journal of the Michigan Dental Association

The Michigan Dental Association (MDA) Foundation, a 501(c)3 non-profit, works to promote better dental health and support the future dental workforce through educational scholarships. The Foundation’s impact is increasing yearly, evidenced by a 42% increase in scholarship awards in 2024, providing $44,000 to 15 recipients. It also provides grants to statewide organizations delivering dental care to uninsured, impoverished, and underserved populations, awarding $141,500 in 2025. A high-profile program is the biannual Michigan Mission of Mercy (MOM), which provided over $1.1 million in donated care in Flint in 2024. Support is generated through various fundraisers, including the Year-End Fundraising Campaign.

Enhancing Crna's Knowledge Of Radiation Safety Through Online Education, Angela Iledan, Madeline Pousson

Doctoral Projects

Although ionizing radiation is frequently used in anesthesia-related procedures, many CRNAs receive minimal training in radiation safety principles and protective measures. This knowledge gap increases the risk of cumulative radiation exposure for providers and patients. To address the issue, this doctoral project developed and implemented an online educational intervention designed to enhance CRNAs’ understanding of radiation safety, ultimately promoting safer practices in radiation-prone environments.

The doctoral project follows a QI and EBP approach that incorporated diverse adult learning styles to enhance engagement and knowledge retention of CRNAs. The online educational module was designed and delivered to CRNAs that currently practice …

A Feasibility Study Of Sexual Organ-Dose Sparing Volumetric Modulated Arc Therapy In Female Low Rectal Cancer Patients Treated With Three-Dimensional Conformal Radiation Therapy, Margaret Downes, Victoria Olsen, Andre Williams, Rendi Sheu, Maria Thor, Lucy Greenwald, Vishruta Dumane, Kristin Hsieh, Ayesha Ali, Orly Morgan, Michael Buckstein, Deborah Marshall

Department of Radiation Oncology Faculty Papers

BACKGROUND: Sexual dysfunction is a significant toxicity of pelvic radiation therapy (RT) for female rectal cancer patients and may be more common with intensity-modulated techniques compared to three-dimensional conformal radiation therapy (3D-CRT). However, limited research has evaluated dose sparing of female sexual organs at risk (OARs), particularly erectile tissues that are critical for sexual function.

PURPOSE: This feasibility study aimed to demonstrate the practicality of contouring and sparing female sexual OARs in rectal cancer RT by generating sexual organ-sparing volumetric modulated arc therapy (SO-VMAT) plans from a small 3D-CRT cohort and comparing dose distributions to guide future planning.

METHODS: Nine …

Drought, Worry, And Preparing For The Future: The Ethnopsychology Of Climate Distress In Kilifi County, Kenya, Edna Bosire, Syed Wahid, Linda Khakali, Benjamin Oestericher, Felix Agoi, Anthony Ngugi, Rosebella Iseme, Jasmit Shah, Zul Merali, Lukoye Atwoli

Brain and Mind Institute

The impacts of climate change in sub-Saharan Africa (SSA) presents a chronic and intensifying disaster, with drought, flooding, and extreme heat, presenting unique challenges and profound disruptions. Growing evidence links such events to ecological grief, ecological anxiety, and solastalgia – negative affective states that reflects responses to climate change related destruction of nature, species, culturally significant or sacred spaces, and other ways of life. While this literature is expanding in the Global North, little is known about how communities in SSA perceive and respond to deteriorating or depleting natural ecosystems. This article explores the ethnopsychology of distress precipitated by environmental …

Community Perspectives On Factors Contributing To Resilience For Healthy Aging In Kenya, Linda Khakali, Everline Onchari, Maureen Ondire, Catherine Onyancha, Chinedu Momoh, Edna Bosire

Brain and Mind Institute

Background: The global elderly population is increasing and expected to double in thenext decade. Aging increases the likelihood of adversities, with resilience becomingan important aspect of healthy aging. Understanding how individuals conceptualizeresilience offers an opportunity to create contextually relevant interventions forpromoting healthy aging. This study aimed to explore adults’ perspectives on factorsinfluencing resilience in Kenya.

Method: Using qualitative methods, 36 adults aged 35 years and above werepurposively recruited from various communities in Nairobi County to participate ininterviews. We asked questions about their understanding of aging, adversity andresiliency. We also provided them with case scenarios of two individuals respondingdifferently to the …

Reassessing Dementia Risk: Expanding The 2024 Lancet Commission Report For A More Accurate Global Understanding, Cyprian Mostert

Brain and Mind Institute

Background: The 2024 Lancet Commission Report analyzes 14 risk factors thataccount for 45 percent of global dementia cases. However, it overlooks four criticalrisk factors: poverty, wealth shocks, income inequality, and viral infections. This isparticularly concerning given that 57 percent of the identified risk factors in theLancet report are more prevalent in men, even though dementia predominantly affectswomen worldwide.

Method: In this policy paper, we used the recent global review studies and argue that itis essential to recalibrate and expand the 2024 Lancet Commission’s list of risk factorsto include poverty, wealth shocks, income inequality, and viral infections. Our analysissuggests that these …

Understanding And Willingness To Participate In Dementia Clinical Trials In Kenya: An Ethnographic Study, Edna Bosire, Lucy Kamau, Chinedu Momoh, Jasmit Shah, Karen Blackmon, Caroline Kiio, Irene Meier, Vaibhav Narayan, Olivera Nesic Taylor,, Zul Merali

Brain and Mind Institute

Background: Advancements in dementia research are in part contingent on participation in clinical research. Clinical trials can help researchers determine if new drugs, devices, or diagnostic procedures for dementia are safe and effective. However, little is known about clinical trials for dementia in resource constrained settings such as Kenya. The aim of our research was to explore people’s understanding of dementia clinical trials, their attitudes and perceptions towards dementia clinical trials and what can be done to enhance enrollments on such clinical trials.

Method: This was an ethnographic study involving 8 focused group discussions (FGDs; age and gender stratified; n=81) …

Perceptions And Attitudes On Biospecimen Sample Collection For Dementia Research In Kenya, Lucy Kamau, Chinedu Momoh, Karen Blackmon, Caroline Kiio, Jasmit Shah, Vaibhav Narayan, Irene Meier, Olivera Nesic Taylor,, Zul Merali, Edna Bosire

Brain and Mind Institute

Background: Biospecimen sample collection is crucial in dementia diagnosis and evaluation. Limited research exists from African Countries including Kenya on people's perception on biospecimen sample collection for dementia- a disease that is largely unknown. Our aim was to understand the public perceptions towards collection of biospecimen samples for dementia research in Kenya.

Method: We conducted 8 focused group discussions (FGDs; age and gender stratified) in Nairobi to understand people's perceptions about different biospecimens (urine, saliva, blood, tears, hair, cerebrospinal fluid (CSF) and the brain samples). An open-ended FGD guide was used for the discussions, each lasting about 90 minutes.

Result: …

Tricounty Vaccine Improvement Program (Tc-Vip): Enhancing Vaccine Confidence And Uptake In Rural Utah, Aaron Hunt, Yvette Rea, Annalyz Castro

Outcomes and Impact Quarterly

The Utah State University Extension TriCounty Vaccine Improvement Program addressed low rural vaccination rates across a three-county area through bilingual social media campaigns, health fairs, training in motivational interviewing, and neuromarketing. Evaluation results showed improved skills, broad community reach, and positive participant feedback, demonstrating a replicable model to reduce vaccine hesitancy and strengthen rural health systems.

Cutting Through The Fog: Recognising Brain Fog As A Significant Public Health Concern, Darren Haywood, Susan L. Rossell, Nicolas H. Hart

Research outputs 2022 to 2026

Brain fog is a highly common condition that can have significant impacts on quality of life and functioning. Most people will experience a condition, illness, or infection that might result in the development of brain fog. We provide a call to action to minimise the impacts of brain fog.

Interventions, Programmes And Resources That Address Culturally And Linguistically Diverse Consumer And Carers’ Cancer Information Needs: A Mixed Methods Systematic Review, Lisa Whitehead, Deborah Kirk, Pelden Chejor, Weiting Liu, Minh Nguyen, Caroline Balczer, Charlene Lan, Melissa Evans

Research outputs 2022 to 2026

Background: Culturally and linguistically diverse (CaLD) consumers and carers have been identified as experiencing high levels of unmet needs relating to information and support across the cancer journey. This review identified and evaluated the effectiveness of strategies to meet the cancer information needs of consumers and carers from CaLD backgrounds. Methods: This review followed Joanna Briggs Institute (JBI) methodology for systematic reviews. Databases searched included MEDLINE, CINAHL Ultimate, PsycINFO and AMED, ProQuest Dissertations and Theses, and GreyNet. Published and unpublished studies between 2013 - May 2024 on interventions, programmes or resources developed for adults (aged 18 years and over) from …

The Importance Of Aged Care Policies In Assisting Older Adults Transition From Home To Permanent Residential Aged Care: A Focused Ethnographic Study, Stacey M. Scott, Annette J. Raynor, Julie S. Dare, Jennifer M. Grieve, Leesa N. Costello

Research outputs 2022 to 2026

Background: The Royal Commission into Aged Care Quality and Safety (RCAC) recommended a redesign of the Australian aged care system to ensure high quality care, respect, and dignity for residents. Responding to the RCAC recommendations, the Aged Care Quality Standards have been strengthened and continue to guide the delivery of safe, high quality care in Australia. This study investigated the experiences of new residents transitioning into an Australian residential care-facility, concentrating on how their experiences aligned with the core principles of the Aged Care Quality Standards. Methods: A focused ethnographic approach was used to address the aim of this study. …

Partners, Coordinators And High-Level Leaders’ Perspectives On A Consumer And Community Involvement Program In Australia: A Qualitative Evaluation Using Template Analysis, James Smith, Howard Lance, Susan Hayes

Research outputs 2022 to 2026

A Consumer and Community Involvement program located in Australia supports consumers, community members and researchers to work in partnership with health research priorities, policy and practice. The program is positioned to enhance Consumer and Community Involvement (CCI) at individual, organisational, and system levels. Partners are key to the program’s development, growth and sustainment. This study explored various partner perspectives on their involvement within the CCI program, including individuals (consumers, researchers) organisations (universities, medical research institutes) and the system level (funding organisations) alongside CCI program coordinators (delivering the program) and high-level leaders (decision-makers/executive leaders/directors). Data were collected via two focus groups …

Engaging Longitudinal Cohort Participants In A Research Priority Setting Process For The Raine Study, Michaela De Paolis, Saniya Abdul, Anne Mckenzie, Rebecca Glauert, Gracie Cayley, Romola S. Bucks, Diane Wood

Research outputs 2022 to 2026

Background: The Raine Study, one of the world’s longest-running multigenerational cohort studies, has consistently engaged participants in shaping specific research projects within the Raine Study. While participant involvement has been integral to study operations, there has not previously been an opportunity for participants to actively help shape the overall research agenda. The Participant Priority Setting Project (the Project) was developed to address this gap, providing a structured process to establish participant-led research priorities that will guide future study directions. Methods: The Project utilised a modified version of the James Lind Alliance (JLA) Priority Setting Partnerships (PSP) Framework to engage Generation …

Source-Specific Nitrate Intake And Incident Dementia In The Danish Diet, Cancer And Health Study, Catherine P. Bondonno, Pratik Pokharel, Dorit Wielandt Erichsen, Liezhou Zhong, Jörg Schullehner, Cecilie Kyrø, Kirsten Frederiksen, Peter Fjeldstad Hendriksen, Frederik Dalgaard, Lauren C. Blekkenhorst, Stephanie R. Rainey-Smith, Samantha L. Gardener, Torben Sigsgaard, Ole Raaschou-Nielsen, Anne Tjønneland, Jonathan M. Hodgson, Christina C. Dahm, Anja Olsen, Nicola P. Bondonno

Research outputs 2022 to 2026

Introduction: Dietary nitrate, through conversion to nitric oxide, which supports vascular and nervous system function, may lower dementia risk but may also form neurodegenerative N-nitrosamines, depending on the nitrate source. Methods: We investigated associations between source-specific nitrate and nitrite intake and incident and early-onset dementia (< 65 years) in 54,804 dementia-free participants from the Danish Diet, Cancer and Health Cohort Study over ∼27 years. Nitrate and nitrite intakes were derived from food frequency questionnaires and nitrate and nitrite databases. Results: Higher plant-sourced nitrate intake was non-linearly associated with lower rates of incident dementia (fifth vs first quintile hazard ratio 95% confidence interval: 0.90 [0.83, 0.98]), while increased risk was seen for higher intakes of animal-sourced, additive-permitted meat-sourced, and tap water-sourced nitrate. Similar associations were seen for source-specific nitrite intake and were more pronounced for early-onset dementia. No clear effect modification was observed. Discussion: These findings highlight the importance of nitrate source in dementia risk and warrant further investigation. Highlights: Plant nitrate is associated with a lower risk of incident and early-onset dementia. Animal and tap water nitrate are associated with an increased risk of dementia. Encouraging consumption of plant-based nitrate sources may lower risk of dementia.

Exploring And Validating Associations Between Six Systemic Inflammatory Indices And Ischemic Stroke In A Middle-Aged And Old Chinese Population, Yulu Zheng, Zheng Guo, Jingzheng Wang, Zhiyuan Wu, Xiaolin Chen, Yahong Zhu, Guangle Shan, Haifeng Hou, Xingang Li

Research outputs 2022 to 2026

Background: Inflammation and maladaptive immune mechanisms have been substantiated as integral components in the critical pathological processes of the injury cascade in ischemic stroke (IS). This study aimed to explore the associations between six systemic inflammatory indices and IS in a Chinese population. Methods: This was a case-control study based on the retrospective review of electronic medical records from two hospitals in Shandong Province, China. Systemic inflammatory indices, including the systemic inflammation response index (SIRI), systemic immune inflammation index (SII), pan-immune-inflammation value (PIV), neutrophil lymphocyte ratio (NLR), platelet lymphocyte ratio (PLR), and lymphocyte monocyte ratio (LMR), were calculated. Logistic regression …

A Cross-Sectional Audit Of The Australian Community Food Environment Highlights The Prominent Role Of Chain Food Outlets, Claire Elizabeth Pulker, Lucy Meredith Butcher, Frith Klug, Clare Whitton, Gina S.A. Trapp

Research outputs 2022 to 2026

Background: Food retail and food service outlets can be part of a chain, or independently operated. Chain food outlets are likely to have the most influence over community food environments but have not been routinely identified in studies which map and monitor access to food, highlighting an important knowledge gap. This study aimed to identify the food retail and food service outlets present within metropolitan Perth, including presence of chain and independent food outlets; and examine differences across local governments. Methods: A nutrition-focused classification framework was applied to all food businesses registered by 32 local governments in Perth, Western Australia, …

A National Survey Of Osteopaths’ Conceptions Of Practice In France: Structural Validity Of The Osteo-Taqfr And The Tendency Toward Technical Rationality, Oliver P. Thomson, Loïc Treffel, Agathe Wagner, Erwann Jacquot, Jerry Draper-Rodi, Chantal Morin, Brett Vaughan

Research outputs 2022 to 2026

Background: Despite the growing popularity of osteopathy in France, little is known about how French osteopaths conceptualise key aspects of their practice, including skills, knowledge, and decision-making. This study aimed to adapt and validate the Osteopaths' Therapeutic Approaches Questionnaire (Osteo-TAQ) for use in a French osteopathic population (Osteo-TAQfr) and to examine the professional profile and core elements of clinical practice among French osteopaths. The first objective was to establish the psychometric properties of the Osteo-TAQfr within a French osteopathic population. The second aim was to explore French osteopaths’ conceptions of practice and their approach to patient care, thereby contributing to …

Prevalence And Molecular Types Of Clostridioides (Clostridium) Difficile On Australian Retail Vegetables And Household Surfaces, Deirdre A. Collins, Su Chen Lim, Jessica Chisholm, Molly Lattin, Linda Selvey, Simon Reid, Thomas V. Riley

Research outputs 2022 to 2026

Objectives: Community-onset Clostridioides (Clostridium) difficile infection (CDI) has risen to >80 % of all CDI cases in Australia. High prevalence of C. difficile contamination has been reported in many community sources including retail root vegetables. Household surfaces may become contaminated with C. difficile when storing and handling contaminated vegetables. This study aimed to determine the prevalence and molecular types of C. difficile present on retail root vegetables and household surfaces. Methods: From April 2023 to March 2024, retail potatoes (n = 255) and onions (n = 305) were sampled at 3-monthly intervals. Environmental samples were collected from homes of householders …

Trends And Determinants Of Early Neonatal Mortality In Ethiopia: Evidence From The Ethiopian Demographic And Health Survey Data, Tsion Mulat Tebeje, Beminate Lemma Seifu, Yordanos Sisay Asgedom, Kusse Urmale Mare, Zufan Alamrie Asmare, Hiwot Altaye Asebe, Abdu Hailu Shibeshi, Afework Alemu Lombebo, Kebede Gemeda Sabo, Bezawit Melak Fente, Bizunesh Fantahun Kase

Research outputs 2022 to 2026

Background: Early neonatal mortality (ENM) accounts for three-fourths of all neonatal deaths and one-third of overall child mortality. While previous studies have primarily focused on neonatal and under-five mortality, ENM has received comparatively less attention. This study aims to address this gap by analyzing trends and identifying factors associated with ENM in Ethiopia. Methods: Data from the Ethiopian Demographic and Health Survey (EDHS) conducted between 2005 and 2016 were analyzed, comprising a total weighted sample of 22,310 participants. To account for the hierarchical structure of the EDHS data, a mixed-effects binary logistic regression model was applied to identify associated factors. …

Culturally Responsive Recommendations For Eating Disorder Prevention And Management For First Nations Peoples In Australia: A Policy Scoping Review, Zyana Gall, Hilary Smith, Gabrielle Grant, Kanita Kunaratnam, Carissa Lee, Felicity Kerslake, Alana Gall

Research outputs 2022 to 2026

Background: Evidence suggests First Nations people in Australia may experience a higher burden of eating disorders (EDs) than the broader Australian population. EDs are among the most debilitating and lethal mental health conditions; however, little is known about the unique considerations for First Nations people experiencing EDs, especially around best practices. This policy scoping review aims to map the current recommendations for managing EDs specific to First Nations peoples and to identify further research opportunities. Methods: We conducted targeted searches of electronic databases and health websites (n = 53) for policies, reports, toolkits/guidelines, and fact sheets that contained any information …

Determinants Of Utilization Of Skilled Birth Attendant Among Women Of Reproductive Age In Habeswein Ward, Wajir County, Kenya, Suada Hassan

MSc in Advanced Practice Midwifery

Background: Maternal care provided by a skilled birth attendant (SBA) during pregnancy, at delivery, childbirth, and the postpartum period is vital for reducing maternal and neonatal mortality. In sub-Saharan Africa, the overall prevalence of usage of SBA in a 2021 study was 63%. Tanzania recorded the lowest rate at 13.8%, while Kenya registered 89.3% in 2023. However, disparities exist within Kenyan counties, for instance, in Wajir County only 57% of births were assisted by skilled health providers, a disparity that could be due to socio-cultural differences.

Aim: This study aimed to determine the factors influencing the utilization of skilled …

Cultural Adaptation Of An Innovative Reproductive Health Assessment Tool For Dementia Research In Africa: Insights From The Fember-Africa Study, Alice Moraa Ondieki, Anne Njogu, Cynthia I Sabel Smith, Edna Bosire, Karen Blackmon, Harrison Kaleli, Jasmit Shah, Rachel Maina, Sheila Waa, Chinedu Momoh

Brain and Mind Institute

Background: Dementia research accounts for only 0.1% of all research in Africa,making it the lowest among all low- and middle-income country (LMIC) regions. Thedevelopment and adaptation of biological and psychosocial measures in ethnicallyand culturally diverse populations remain limited but are essential for culturallyinformed research. This is particularly critical for examining sex- and gender-basedvulnerabilities to Alzheimer’s disease and related dementias (ADRD), including factorssuch as reproductive health and fertility.

Method: We conducted a thorough review of our clinical and health questionnaires forcultural relevance and sensitivity through a series (n = 3) of focus groups discussions.These focus groups included a diverse range of …

Vitality Tracking In Kenyan Adults Using Wearable Devices And Ecological Momentary Assessments, Karen Blackmon, Benard Alaka, Catherine Onyancha, Litha Musili, Raechel Kamau, Cyprian Mostert, Mansoor Saleh, Zul Merali, Chinedu Momoh, Thomas Thesen

Brain and Mind Institute

Background: Vitality is essential to healthy aging but is elusive to define and measure.Dynamic capture of fluctuations in vitality can uncover abnormal trajectories thatcould be a harbinger of frailty in older adults. Yet, these fluctuations are missed bystatic and/or sparse sampling strategies. To address the need for dynamic and high-density capture of vitality in older adults, we developed a passive sensing and activeprobing digital platform using wearable devices and smartphones. We deployed thisparadigm in older Kenyan adults and evaluated its potential for use in research on thedynamics of accelerated aging.

Method: Cognitively unimpaired (CU) Kenyan adults ≥ 35 years of …

Predicting Accelerated And Delayed Aging In Global Settings: Biobehavioral Age Gaps And The Role Of Global Exposomes, Hernan Hernandez, Hernando Santamaria-Garcia, Sebastian Moguilne, Agustina Legaz, Pavel Prado, Jhosmary Cuadros, Liset Gonzalez, Cyprian Mostert, Chinedu Momoh, Zul Merali

Brain and Mind Institute

Background: Global health challenges like aging and dementia are shaped bysocioeconomic disparities, environmental factors, and social determinants of health.We developed a behavioral age gap (BAG), measuring the difference between expectedbehavioral age and chronological age

Method: We utilized a cross-sectional sample (n = 161,981) comprising countriesfrom Latin America, Europe, Asia, and Africa. Behavioral age was estimated usinga Gradient Boosting Regressor with 10-fold cross-validation, incorporating multiplerisk factors (hypertension, diabetes, heart disease, female sex, visual impairment andhearing impairment) and protective factors (cognition, functional ability, education)associated with healthy aging. BAG was calculated as the difference between predictedand chronological age, and adjusted gaps were derived …

Barriers To Mental Health Access Among Immigrant Populations In The U.S., Cecilia Menzinger

Capstones

No abstract provided.

Title Page Only: Nuts, Seeds, And Specific Cardiometabolic Diseases: The Adventist Health Study 2, Montry Se-Lin Suprono

Loma Linda University Electronic Theses, Dissertations & Projects

No abstract provided.