Medicine and Health Sciences Commons^™

The Challenge Of Regulating Pharmaceutical Clinical Trials In The 21st Century With A Focus On Guatemala, Alejandro Cerón, Antonio Ricafort, Carter Saccocio, Maria Delmonte, Jordan Vasquez, Amarri Bishop, Julia Atwood, Addison Bucsko, Jordan Lewis, Alexandra Welch, Itzael Garcia, Ella Wald, Selena Johnson, Crystal Jin, Talya Riciputi, Lindsey Speer, Vanessa Udo-Obong, Soren Engberg, Tessa Lindstrom

Anthropology: Undergraduate Student Scholarship

This report was prepared by the students and instructor of the "Right to Health in Theory and Practice" class taught in the fall of 2024 at the University of Denver. The report was prepared for the Vice Ministry of Health Regulation, Surveillance and Control of the Ministry of Public Health and Social Assistance of Guatemala. The work used the following guiding question: What can a country like Guatemala do to regulate international pharmaceutical clinical trials in the context of research commercialization? In other words, the work was guided by three important elements. First, the regulatory aspect of clinical trials. Second, …

Reflections From The Pandemic: Is Connectivism The Panacea For Clinicians?, Jennifer Benjamin, Tyson Pillow, Heather Macneill, Ken Masters, Anoop Agrawal, Neil Mehta

Faculty, Staff and Students Publications

The COVID-19 pandemic and the recent increased interest in generative artificial intelligence (GenAI) highlight the need for interprofessional communities' collaboration to find solutions to complex problems. A personal narrative experience of one of the authors compels us to reflect on current approaches to learning and knowledge acquisition and use solutions to the challenges posed by GenAI through social learning contexts using connectivism. We recognize the need for constructivism and experiential learning for knowledge acquisition to establish foundational understanding. We explore how connectivist approaches can enhance traditional constructivist paradigms amid rapidly changing learning environments and online communities. Learning in connectivism includes …

Estimated Vaccine Effectiveness For Pediatric Patients With Severe Influenza, 2015-2020., Kelsey M. Sumner, Leila C. Sahni, Julie A. Boom, Natasha B. Halasa, Laura S. Stewart, Janet A. Englund, Eileen J. Klein, Mary A. Staat, Elizabeth P. Schlaudecker, Rangaraj Selvarangan, Christopher J. Harrison, Geoffrey A. Weinberg, Peter G. Szilagyi, Monica N. Singer, Parvin H. Azimi, Benjamin R. Clopper, Heidi L. Moline, Emma K. Noble, John V. Williams, Marian G. Michaels, Samantha M. Olson, New Vaccine Surveillance Network Collaborators

Manuscripts, Articles, Book Chapters and Other Papers

IMPORTANCE: Increasing the understanding of vaccine effectiveness (VE) against levels of severe influenza in children could help increase uptake of influenza vaccination and strengthen vaccine policies globally.

OBJECTIVE: To investigate VE in children by severity of influenza illness.

DESIGN, SETTING, AND PARTICIPANTS: This case-control study with a test-negative design used data from 8 participating medical centers located in geographically different US states in the New Vaccine Surveillance Network from November 6, 2015, through April 8, 2020. Participants included children 6 months through 17 years of age who were hospitalized or presented to an emergency department (ED) with acute respiratory illness. …

A Latent Class Assessment Of Healthcare Access Factors And Disparities In Breast Cancer Care Timeliness, Matthew Dunn, Didong Li, Marc Emerson, Caroline Thompson, Hazel Nichols, Sarah Van Alsten, Mya Roberson, Stephanie Wheeler, Lisa Carey, Terry Hyslop, Jennifer Elston Lafata, Melissa Troester

Kimmel Cancer Center Faculty Papers

BACKGROUND: Delays in breast cancer diagnosis and treatment lead to worse survival and quality of life. Racial disparities in care timeliness have been reported, but few studies have examined access at multiple points along the care continuum (diagnosis, treatment initiation, treatment duration, and genomic testing).

METHODS AND FINDINGS: The Carolina Breast Cancer Study (CBCS) Phase 3 is a population-based, case-only cohort (n = 2,998, 50% black) of patients with invasive breast cancer diagnoses (2008 to 2013). We used latent class analysis (LCA) to group participants based on patterns of factors within 3 separate domains: socioeconomic status ("SES"), "care barriers," and …

Predictors Of Mortality In African Americans With Alzheimer’S Disease-Related Dementias, Latrice Camille Noonan

Walden Dissertations and Doctoral Studies

Alzheimer’s disease-related dementia (ADRD) is a leading cause of death worldwide. There is a need to identify the link between modifiable risk factors and the association with ADRD mortality. This study addresses the disproportionately high burden of ADRD among African Americans, aiming to inform targeted prevention strategies and promote health equity. In this study, the longitudinal relationship between ADRD mortality and the presences of diabetes, smoking, and obesity among older African Americans residing in the United States was examined, while controlling for age, gender, education, and socioeconomic status. The biopsychosocial model served as the theoretical framework for this study. The …

Adiposity Throughout Adulthood And Risk Of Young-Onset Breast Cancer Tumor Subtypes In The Young Women's Health History Study, Lydia Marcus Post, Dorothy R. Pathak, Ann S. Hamilton, Kelly A. Hirko, Richard T. Houang, Emily H. Guseman, Dan Sanfelippo, Nicole Bohme Carnegie, L. Karl Olson, Hallgeir Rui, Ann G. Schwartz, Ellen M. Velie

Department of Pharmacology, Physiology, and Cancer Biology Faculty Papers

BACKGROUND: The role of adult adiposity in young-onset breast cancer (YOBC) subtype risk is not well understood.

METHODS: In this population-based case (n = 1812)-control (n = 1,381) study of invasive YOBC (ages <50 >years), cases were identified from the Los Angeles County and Metropolitan Detroit Surveillance, Epidemiology, and End Results registries, 2010 to 2015. Area-based, frequency-matched controls were sampled from the 2010 Census. General adiposity [body mass index (BMI)] and central adiposity (waist circumference and waist-to-height ratio) across adulthood and covariates were collected from in-person interviews and measurements. ORs and 95% confidence intervals (CI) for adiposity and YOBC tumor subtypes …

Screensafefuture: A Parent-Empathetic And Pragmatic Mhealth Application For Toddlers' Brain Development Addressing Screen-Addiction Challenges, Nafisa Anjum, Md. Mehedi Hasan, Syeda Umme Salma, Liang Zhao, Maria Valero, Nazmus Sakib

Faculty Articles

The surging incidents of infants and toddlers screen addiction in the United States are becoming a pressing concern, given its compound impact on cognitive, mental, and physical growth. To address this era's critical child health and development problem, in this paper an innovative mHealth application—ScreenSafeFuture—is proposed. ScreenSafeFuture provides practical solutions that seamlessly fit into parents' busy lifestyles, acknowledging the effectiveness and convenience of smartphones as a healthcare tool. The solution includes essential features designed to enhance the experience between parents and their children under 3 years old encompassing an alternative activity advocator for a personalized parent-offspring scenario, screen time tracking …

Urinary Metal Levels, Cognitive Test Performance, And Dementia In The Multi-Ethnic Study Of Atherosclerosis, Arce Domingo-Relloso, Katlyn E Mcgraw, Susan R Heckbert, Jose A Luchsinger, Kathrin Schilling, Ronald A Glabonjat, Irene Martinez-Morata, Melanie Mayer, Yongmei Liu, Alexis C Wood, Jeff Goldsmith, Kathleen M Hayden, Mohamad Habes, Ilya M Nasrallah, R Nick Bryan, Tanweer Rashid, Wendy S Post, Jerome I Rotter, Priya Palta, Linda Valeri, Timothy M Hughes, Ana Navas-Acien

Faculty, Staff and Students Publications

IMPORTANCE: Metals are established neurotoxicants, but evidence of their association with cognitive performance at low chronic exposure levels is limited.

OBJECTIVE: To investigate the association of urinary metal levels, individually and as a mixture, with cognitive tests and dementia diagnosis, including effect modification by apolipoprotein ε4 allele (APOE4).

DESIGN, SETTING, AND PARTICIPANTS: The multicenter prospective cohort Multi-Ethnic Study of Atherosclerosis (MESA) was started from July 2000 to August 2002, with follow-up through 2018. A total of 6303 MESA participants were included. Data analysis was performed from October 12, 2023, to June 13, 2024.

EXPOSURE: Urine samples were collected at baseline …

Delinquency And Inadvertent Neglect As Byproducts Of Work-Addicted Parents, Shelley Sasser

Bridges: A Journal of Student Research

Over the past decade, discussions of work addiction throughout academic literature have increased substantially. However, the relationship between childhood outcomes and parental work addiction has yet to be explored. In this study, I set out to identify functions of parent-child relationships and comparisons of situational outcomes stemming from work addiction in relation to social determinants such as income, ethnicity, and gender, along with resulting stratification. The degree to which children benefit from features of lifestyles typically associated with high household incomes, such as financial security, health care benefits, access to educational resources, and neighborhood socioeconomic advantage, wherein parental work-addiction might …

Determining An Optimal Case Definition Using Mid-Upper Arm Circumference With Or Without Weight For Age To Identify Childhood Wasting In The Philippines, Lyle Daryll Dimaano Casas, Jhanna Uy, Eldridge Ferrer, Charmaine Duante, Paluku Bahwere, Rene Gerard Galera, Alice Nkoroi, Behzad Noubary, Mueni Mutunga, Sanele Nkomani, Roland Kupka, Valerie Gilbert Ulep

Health Sciences Faculty Publications

In resource-limited areas, where accurate weight-for-height Z-scores are hard to obtain, Mid-Upper Arm Circumference (MUAC) is a simple tool to identify wasted children. MUAC alone, however, may miss identification of many wasted children, leading to untimely intervention and potentially death. Our study aimed to identify the best-performing case definition to detect wasting by Weight-for-Height z-scores (WHZ) in Filipino children aged 6-59 months. We analyzed the 2018-2019 Expanded National Nutrition Survey to assess the diagnostic performance of MUAC cutoffs and a case definition combining MUAC and weight-for-age z-score (WAZ) in identifying moderate and severe wasting compared to the WHZ criterion. The …

Perceived Patient-Centered Care In Marching Band Artists, A L. Merrill, Z K. Winkelmann, N A. Uriegas

Bakerman Student Research Awards

Objective: Approximately 27,000 college marching band (MB) artists in the United States could benefit from access to healthcare services and patient-centered clinicians. The purpose of this study was to explore HCPs MB artists have access to and their perceptions of patient-centered care (PCC). Methods: We used a cross-sectional web-based survey of MB artists (n=751, age=20±8 years). MB directors from 242 colleges were emailed a survey link to forward to MB artists. Participants indicated which HCPs they could access. Those who reported no access or unsure were prompted to describe what they would do if an injury or illness occurred. Participants …

Association Between Teaching Clinic Structure And The Readiness Of Ophthalmology Residents To Enter Independent Practice, T. Michael Kashner, Marjorie A. Bowman, Catherine P. Kaminetzky, Andrea D. Birnbaum, John M. Byrne, Paul B. Greenberg, Steven S. Henley, Karen M. Sanders

Population and Public Health Sciences Faculty Publications

Our objective is to determine if the structure of Graduate Medical Education teaching clinics is associated with how well ophthalmology residents are prepared to meet the workload demands of independent clinical practice. Resident preparedness to enter independent practice was measured by the Readiness Index. Part of the Department of Veterans Affairs’ new Workload-based Resident Academic Performance measures (WRAP), resident readiness is computed from electronic health records for residents by clinic and service-date. The index compares resident productivity net of supervision and adjusted for care quality to the average productivity of non-supervising ophthalmologists. Readiness comprises a Workload component (ratio of resident …

A011: Effects Of Aerobic Exercise On Microbiota: Gut-Brain Axis And Hippocampal Neurotransmitters In Aging Mice, Yuqian Liu, Wenqian Yang, Haitao Wang

International Journal of Physical Activity and Health

Background/Objective: Gut flora plays an important role in host stress response, anxiety, depression and cognitive function through the gut-brain axis. Microbial diversity decreases with age, which in turn affects the function of the nervous system. The role of exercise in the prevention and treatment of age-related diseases and neurodegenerative diseases has received increasing attention. The purpose of this study was to elucidate the regulatory role of intestinal flora, gut-brain axis and nervous system function in the prevention of nervous system function decline in the elderly.

Methods: The sample consisted of 16, 52-week-old SPF C57BL/6 male mice that were randomly divided …

A067: Latent Profile Analysis Of The Development Characteristics Of Fundamental Motor Skills In Children, Qinping Xu, Xiaozan Wang

International Journal of Physical Activity and Health

Focusing on the sensitive period of motor development, the current study used TGMD-3 to assess the development level of fundamental motor skills in 4833 children aged 3-6 years in Shanghai. The potential categories of children's fundamental motor skill development characteristics and their interrelationship with demographic variables were analyzed using potential profile analysis and Chi-squared test, aiming to provide references for the construction of motor development interventions for children with different motor development levels. The results revealed that: 1) The developmental level of fundamental motor skills in 3-6-year-old children in Shanghai can be categorized into five latent categories, from low to …

Examining The Risk Of Cardiovascular Disease Among African American College Students At The University Of Texas At Arlington, Esha Kashyap

2024 Fall Honors Capstone Projects - Archive

Many studies examine the risk of cardiovascular disease in the general population of African Americans adults compared with other racial and ethnic groups; however, there is limited research that explores the risk factors, discrimination, and food behavior that impact this group. Cardiovascular disease develops over time and certain practices or experiences can increase the risk of this disease; thus, studying the behavior and perceptions of college students is important. Therefore, this research examined whether food behavior and perceived discrimination was higher in African American college students than in other racial or ethnic student groups. Utilizing a survey containing both qualitative …

Building Community Resilience Through Community Participatory Asset Mapping For Emergency Preparedness, Cassandra Y. Davila

2024 Fall Honors Capstone Projects - Archive

A community's capacity to prepare, manage, and recover from a disaster determines its level of resilience. The Federal Emergency Management Agency recommends engaging community members in resilience planning to ensure sustainable strategies are implemented. This project uses community-based asset mapping to identify how community participatory methods influence community resilience to combat emergency events. An asset map documents a community’s existing resources, highlighting its strengths. Focus group discussions in the urban area will be conducted to obtain feedback about existing assets and suggestions for additional resources to include. The expected result of this project is to build a comprehensive map of …

Genomic Analysis Of The Sars-Cov-2 Variants Circulated In The Philippines, 2020–2024, Arnie Dimaano, Kiana Dominique Carreon, Giselle Sophia Camaya, Irvin Rondolo, Jarel Elgin Tolentino

Biology Faculty Publications

Purpose

Genomic sequencing has been an invaluable tool to determine the evolution of SARS-CoV-2. In the present study, we provided a comprehensive description of the SARS-CoV-2 variants circulated in the Philippines.

Methods

The dataset from the human COVID-19 infections was acquired by downloading the sequences and their associated metadata spanning from March 2020 to April 2024. Then, we executed several filtering criteria to acquire the final dataset for the Philippine samples and performed spatial distribution analysis and phylogenetic tree construction of the reported SARS-CoV-2 sequences.

Results

A total of 16,679,203 SARS-CoV sequences were obtained, of which 17,393 (0.10 %) were …

Patient, Provider, And Health System Characteristics Leading To The Delivery Of Low Value Health Care Services And Outcomes Of An Intervention For Mitigating Low Value Care., Philip Ray Rohrer

Electronic Theses and Dissertations

The United States spends more on health care than any other country, and Medicare accounted for nearly one-quarter of total personal health care spending in 2019. Waste within the health care system in the United States is estimated to represent approximately 25% of total U.S. health care expenditures. Low value care includes health care services that provide little or no benefit to patients, have potential to cause harm, incur unnecessary costs to patients, or waste limited healthcare resources. Low value care is estimated to represent roughly 10% of total health care waste, or between $75.7 billion and $101.2 billion dollars …

Understanding Carceral Pathways And Outcomes Of Marginalized Adults Who Use Drugs., Carmen Renee Mitchell

Electronic Theses and Dissertations

This dissertation is an examination of outcomes among substance users at various stages of the incarceration process divided among five chapters. Chapter One provides an overview of substance use disorder (SUD), incarceration, and wider justice system-involvement, and explores how the political economy of health theoretical framework can be applied to examine how the criminal justice system creates and perpetuates inequality among marginalized people who use substances. Chapter Two examines post-release health outcomes among the population of incarcerated people who use substances using a scoping review and finds that people in reentry with SUD have poorer overall outcomes that without transitional …

Challenging Myths & Addressing Intimate Partner Sexual Violence In Lgbtq+ Relationships, Nora K. Whitten

SPARK Symposium Presentations

Intimate partner violence (IPV), including intimate partner sexual violence (IPSV), is a public health crisis that disproportionately affects members of the LGBTQ+ community. This paper draws upon related, though limited, research to identify the five prevalent myths surrounding IPSV in LGBTQ+ relationships, addressing the following misconceptions: 1) IPSV can only occur in heterosexual relationships, 2) IPSV in LGBTQ+ relationships is not as severe, 3) Women cannot commit acts of sexual violence, 4) The more “masculine” partner is always the perpetrator, and 5) IPSV is a “mutual fight” among partners of the same sex. These myths perpetuate victim-blaming, minimize the severity …

Exposing The Disaster Disparities And Experiences On College Campuses, Deleanor Kirkpatrick Murray

All-Inclusive List of Electronic Theses and Dissertations

Challenges in higher education continue to arise, providing administrators with insights into how prepared—or unprepared—their institutions may be for future crises. The purpose of the study is to examine how mid-level leadership, staff, and students perceived the disaster response to Hurricane Ida during the 2021–2022 academic year. Using the theoretical frameworks of the Four-Frame Model (Bolman & Deal, 2021), Critical Race Theory (Delgado & Stefancic, 2017), and Institutional Theory (Manning, 2018), this case study employed interviews with 8 participants. Data analysis resulted in the emergence of 7 major themes and 11 sub-themes. The findings from the study suggest that participants …

Personal Protective Equipment For Minoritized U.S. Agricultural Farmworkers: Community-Based Efforts During The Pandemic & Implications For Extension, Helen Trejo

Journal of Human Sciences and Extension

There are an estimated 2 million farmworkers who are essential to the food system in the United States; however, they are exposed to hazardous environmental conditions with limited access and/or use of Personal Protective Equipment (PPE). The primary purpose of this research is to evaluate community-based organizational efforts to provide farmworkers with apparel-textile basic needs, such as face masks. A primary goal is to address the research gap regarding common environmental factors that impact farmworkers, including pesticides and the pandemic, their use of available PPE, and community-based efforts to improve access to face masks as basic PPE. We consider the …

Engaging Fathers(To-Be): A Pilot Study On The Adaptation And Programme Experience Of Sms4baba Intervention In Kenya’S Informal Settlements, Vibian Angweny, Richard Fletcher, Paul Mwangi, Margaret Kabue, Rachel Odhiambo, Stephen Mulupi, Emmanuel Obulemire, Eunice Njoroge, Eunice Ombech, Mercy Mokaya, Moses Wesala, Joyce Marangu, Amina Abubakar

Institute for Human Development, East Africa

Background Engaging fathers(to-be) can improve maternal, newborn, and child health outcomes. However, father-focused interventions in low-resource settings are under-researched. As part of an integrated early childhood development pilot cluster randomised trial in Nairobi’s informal settlements, this study aimed to test the feasibility of a text-only intervention for fathers (SMS4baba) adapted from one developed in Australia (SMS4dads).

Methods A multi-phased mixed-methods study, which included an exploratory qualitative phase and pre-post evaluation of the adapted SMS4baba text-only intervention was conducted between 2019 and 2022. Three focusgroup discussions (FGDs) with 19 fathers were conducted at inception to inform SMS4baba content development; two post-pilot …

High Yield Of Congenital Hypothyroidism Among Infants Attending Children Hospital, Nairobi, Kenya. Facility Based Study In The Absence Of Newborn Screening, Menbere Kahssay, Thomas Ngwiri

Paediatrics and Child Health, East Africa

Objectives: Congenital hypothyroidism (CHT) is a treatable cause of intellectual disability. Late diagnosis and delayed initiation of treatment leads to irreversible neurodevelopmental and intellectual disability. Thus, newborn screening is crucial. However, 71 % of babies are born in an area with no established newborn screening program and Kenya is not an exception. We aimed to determine the incidence of CHT, developmental outcomes of patients in the absence of newborn screening.

Methods: A retrospective data of subjects who met the inclusion criteria, newborn and infants from 3 days to 2 years whose thyroid function test (TFT) was undertaken during well baby …

Metagenomic Sequencing For Early Detection Of Future Engineered Pandemics: Foreshadowing The Privacy Challenge, Nir Eyal, Bridget Williams, Kevin M. Esvelt, Jane R. Bambauer

UF Law Faculty Publications

In this commentary, we imagine how a global system of metagenomic sequencing could be governed in order to reap the benefits and manage the risks. Global institutional engineers and their academic partners would need to develop a new governance model to ensure that all partners involved in a global metagenomic surveillance system cooperate as needed.

Integrated Child Nutrition, Parenting, And Health Intervention In Rural Liberia: A Mixed-Methods Feasibility Study, Sejla Isanovic, Musa Sanoe, Shelbie Wooten, Edward A. Frongillo Ph.D., Aisha K. Yousafzai, Christine E. Blake Ph.D., Rd, Mufaro Kanyangarara Ph.D., Melanie Swan, Nicole Rodger, Miriam Murray, Leila M. Larson Ph.D., Mph

Faculty Publications

In Liberia, children are exposed to multiple forms of adversity which can negatively impact their health and development. Research is needed to examine the feasibility and benefits of integrated interventions that can be incorporated into existing health delivery programs to simultaneously address low responsive stimulation, undernutrition, and infection. This study assessed the feasibility of an integrated intervention promoting psychosocial stimulation and improved child feeding by the provision of eggs and fish. The integrated intervention was incorporated into an existing government health program. Thirty female caregiver-child dyads were randomly selected from two rural communities in Liberia. Participants received fortnightly group parenting …

Chronic Illness Education 2024: Incremental Diet And Activity Changes To Improve Cardiovascular Health, Carter Dunaway, Jonah Kornbluh, Kit Tran, Naya Pabla, Olivia Jeakle, Zaid Saadeh

Patient Education Projects

No abstract provided.

Lgbtq+ College Students’ Willingness To Access Campus Health Services At A Midsized, Urban Christian University: A Study On Disparities, Samual J. Piatt, Christian Williams, Frecia Gonzalez

SPARK Symposium Presentations

Introduction

LGBTQ+ college students face inequitable health outcomes in both mental health and physical health versus non-LGBTQ+ counterparts (The Trevor Project, 2023), (Brittain et Dinger, 2015). LGBTQ+ students experience higher unwillingness and disparities in care access due to negative perceptions of and experiences with UHS providers (Hood et al, 2019). Research indicates that better provider LGBTQ+ cultural awareness contributes to a more affirming space which in turn benefits LGBTQ+ healthcare (Parmenter et al, 2020), (Prasad et al, 2023).

Methods

A 2024 cross-sectional study assessed the comfort levels of LGBTQ+ college students in accessing student health services, explore how affirming healthcare …

An Innovative Community‐Led Education And Recruitment Program To Increase Clinical Research Participation Among Black Americans, Bahar Niknejad, Ethlyn Mcqueen Gibson, Travonia Brown-Hughes, Katie Mcdonough, Ebony Andrews, Deborah Hudson, Hamid Okhravi

Glennan Center for Geriatrics and Gerontology Faculty Publications

Background: Previous studies attest to a lack of awareness about Alzheimer’s Disease (AD) and limited participation of Black Americans in AD clinical trials. The AHEAD Study is a multicenter trial focused on preventing AD by evaluating the effectiveness and safety of Lecanemab in individuals with preclinical AD. The study aims to recruit at least 15% from underrepresented populations, including Black Americans. To achieve this goal, our study site utilizes a community-based participatory research (CBPR) approach and developed a Community Education and Recruitment Program (CERP) designed to increase the participation of Black individuals in the AHEAD Study.

Method: In a collaborative …

Understanding And Intervening In Children's Tick Risk Perceptions And Protective Behaviors: A Grounded Theory, Ariel Dawdy

Department of Entomology: Dissertations, Theses, and Student Research

Children, ages 8 years and younger, are at a particularly high risk of contracting a tick-borne disease. This is partially due to the misconceptions spread about tick protective behavior and a poor understanding of how antibiotic treatment can help. Because most communities and families believe that tick control is the individual’s responsibility, looking at the interaction between ticks and human children is essential to understanding the individual’s motivations to protect themselves. To help alleviate the number of individuals contracting tick-borne diseases, misconceptions must be addressed, intervention programs implemented, and a behavioral change must occur. This study used a qualitative research …