Medicine and Health Sciences Commons^™

Neonatal Survival After Serial Amnioinfusions For Bilateral Renal Agenesis: The Renal Anhydramnios Fetal Therapy Trial, Jena L Miller, Ahmet A Baschat, Mara Rosner, Yair J Blumenfeld, Julie S Moldenhauer, Anthony Johnson, Mauro H Schenone, Michael V Zaretsky, Ramen H Chmait, Juan M Gonzalez, Russell S Miller, Anita J Moon-Grady, Ellen Bendel-Stenzel, Amaris M Keiser, Radhika Avadhani, Angie C Jelin, Jonathan M Davis, Daniel S Warren, Daniel F Hanley, Joslynn A Watkins, Joshua Samuels, Jeremy Sugarman, Meredith A Atkinson

Faculty, Staff and Student Publications

IMPORTANCE: Early anhydramnios during pregnancy, resulting from fetal bilateral renal agenesis, causes lethal pulmonary hypoplasia in neonates. Restoring amniotic fluid via serial amnioinfusions may promote lung development, enabling survival.

OBJECTIVE: To assess neonatal outcomes of serial amnioinfusions initiated before 26 weeks' gestation to mitigate lethal pulmonary hypoplasia.

DESIGN, SETTING, AND PARTICIPANTS: Prospective, nonrandomized clinical trial conducted at 9 US fetal therapy centers between December 2018 and July 2022. Outcomes are reported for 21 maternal-fetal pairs with confirmed anhydramnios due to isolated fetal bilateral renal agenesis without other identified congenital anomalies.

EXPOSURE: Enrolled participants initiated ultrasound-guided percutaneous amnioinfusions of isotonic fluid …

Addressing Resource Constraints For Alzheimer’S Dementia Patients And Caregivers In The Global South: An Interdisciplinary Approach, Zaheen Rashed '24

Student Research

There are two main focuses of this paper: to address the care that AD patients in countries with few healthcare resources receive and to explore the experiences of familial caregivers who care for these patients. This thesis will investigate issues including access to the education required to administer informed care, who is ultimately responsible for caring for AD patients in countries with few health facilities, and the lack of resources that is apparent in countries that do not have AD specialists or clinics. This paper will pinpoint the root issue in treating AD patients globally to serve as the first …

What We Know About School-Based Health Centers: Literature On Outcomes, Cost Impact, Implementation, And Sustainability, Michelle R. Coble, Valerie F. Mcdaniel

Pacific Journal of Health

Many children lack access to adequate healthcare in the United States. School Based Health Centers (SBHC) are a useful resource for accessing those needed services. The purpose of this study is to evaluate the available research for the strengths of SBHCs with improving health outcomes and health equity, cost impact of SBHCs, and best practices for implementing and sustaining an SBHC. The focus of this study was on reviewing the current literature on the impact of SBHCs on improving health equity, health outcomes, cost impact, and to establish best practices for implementing and sustaining an SBHC. Although the current literature …

Examining The Effect Of Financial Strain On Gpa In College Students​, Dayanara S. Sanchez-Nunez

[Archive] Belmont University Research Symposium (BURS)

The problem to be addressed in this study is the lack of attention to financial stress among college students. The purpose of this study was to examine the effect of financial strain on a college student’s GPA. The study had two aims: 1) to assess financial stress, including loans and the ability to pay for college, impact academic performance and 2) examine causes of financial strain including aid and loans. A cross-sectional survey assessed the effect of financial strain on academic performance among undergraduate students enrolled at Belmont University during the Fall 2023-2024 semester. The sample consisted of undergraduate students …

The Effects Of Education On Influenza Vaccination Uptake, Jazzlyn Lawson

MSN Capstone Projects

Influenza is a viral illness that occurs internationally and peaks in prevalence during the months of October to May. There are several types of influenza viruses: Influenza A, B, C, and D (CDC, 2023). Vaccines are available in the United States as early as the start of the flu season to those who wish to receive it. The influenza virus types covered by the annual flu vaccine include Influenzas A and B types (CDC, 2023). The influenza vaccine is recommended by the CDC with the intent to limit the occurrence and spread of influenza each year. Symptoms of influenza consist …

Changing The Playbook For Immigrant Health, Cheryl Bettigole, Patricia C. Henwood, Sage Myers, Maura Sammon

Department of Emergency Medicine Faculty Papers

Philadelphia’s response to welcoming Afghan evacuees during the COVID-19 pandemic suggests the need for a new approach to immigrant health care.

Duchenne Muscular Dystrophy: Age, Disease Stage, And Patient-Reported Quality Of Life, Sheila Jagers

Walden Dissertations and Doctoral Studies

No abstract provided.

Wellness Review 2023, Part 1, Brian A. Ferguson, Martin Huecker

Journal of Wellness

Introduction: The 2023 Part 1 summary reviews research on wellness in healthcare professionals published outside of JWellness from January 1, 2023 to June 30, 2023.

Methods: Editors conducted a Boolean search of titles and abstracts in PubMed utilizing keyword identifiers pairing healthcare personnel (providers, nurses, and other staff) with a well-being metric. Of 416 relevant articles, an intriguing and innovative 30 were selected for inclusion, with two additional articles manually curated.

Literature in Review: This sample of the recent literature into healthcare professional wellness included multiple targeted interventions and studies of resilience. Main themes that emerged include: positive systematic healthcare …

Enhancing Antenatal Education In Pakistan: An Audit And Recommendations, Maliha Abbas, Shelina Bhamani, Yasmin Kanjani, Lumaan Sheikh

Department of Obstetrics & Gynaecology

Background: Antenatal Education equips parents with knowledge for safe maternal health and infant care. It also reduces fear and anxiety during childbirth. ANE curriculum can vary according to country and institute. It can include classes focusing on childbirth, pain relief techniques, mode of birth, parenting, breastfeeding, breathing techniques, etc. Although ANE is widely practiced in developed countries, there is no standard program in developing countries like Pakistan. This study aims to improve antenatal education at a tertiary care hospital in Karachi, Pakistan potentially proposing an upgraded curriculum as a national standards
Methods: This multiphase study used mix-method design was conducted …

Interest In And Barriers To Online Esol Instruction For Adults During And Beyond Covid-19: Exploring Relationships With Sociodemographics And English Proficiency, Jessica G. Cox, Lauren Y. Chen, Harriet Okatch

College of Population Health Faculty Papers

Digital divides mean that marginalized groups such as adults who speak English as a second or other language (ESOL) are less likely to have access to online instruction. Higher levels of English proficiency are associated with better health and employment; therefore, access to ESOL classes is essential. We investigated how sociodemographics and English proficiency relate to adult learners' preferences for, and barriers to, online instruction of ESOL during and beyond the COVID-19 pandemic. Sixty-one adults completed a survey on their pandemic experiences, demographics, and ESOL classes. Analyses showed nonsignificant relationships between interest in online instruction and internet access, education, income, …

From Life To Life: Transitioning To Freedom After 45 Years Of Incarceration- A Single Subject Case Study, James O. Mackey, Lindsay Gietzen

Pacific Journal of Health

This case study delves into the complex process of reintegrating an elderly parolee who recently emerged from a 45-year-long incarceration within California's state prisons. The research explores this unique individual's reentry experiences and compares them with those of parolees of average age and sentence length. Factors such as family support, educational background, criminal history, health, social support, employment, access to age-appropriate resources, and recidivism rates are meticulously examined to provide valuable insights into the successful reintegration of elderly individuals back into society.

Navigating Professional Paradigms: Transactional Sex, Behavior Change, And Structural Responses In Uganda, Shelley K. White, Hugo A. Kamya

Journal of Social Work in the Global Community

Professional paradigms within social work and related social service fields have been critiqued for being behaviorally focused, thereby obscuring and perhaps excusing structural determinants of health and well-being. Recent initiatives in international social work have aimed to align theory, practice, education, and research with sustainable development, reflecting the United Nations’ Sustainable Development Goals, which aim to address structural determinants. Our qualitative research examined responses to transactional sex among Ugandan youth through in-depth interviews with 23 professionals working in social services with youth who were vulnerable to HIV. Through thematic content analysis, using deductive and inductive analysis, we examined the demographics …

The Effect Of Pesticide Spray Season And Residential Proximity To Agriculture On Glyphosate Exposure Among Pregnant People In Southern Idaho, 2021, Cynthia L. Curl, Carly Hyland, Meredith Spivak, Lianne Sheppard, Bruce Lanphear, Michael N. Antoniou, Maria Ospina, Antonia M. Calafat

Public and Population Health Faculty Publications and Presentations

Background: Glyphosate is one of the most heavily used pesticides in the world, but little is known about sources of glyphosate exposure in pregnant people living in agricultural regions.

Objective: Our objective was to evaluate glyphosate exposure during pregnancy in relation to residential proximity to agriculture as well as agricultural spray season.

Methods: We quantified glyphosate concentrations in 453 urine samples collected biweekly from a cohort of 40 pregnant people in southern Idaho from February through December 2021. We estimated each participant’s glyphosate exposure as the geometric mean (GM) of glyphosate concentrations measured in all samples (average n = 11 …

Healthcare Professionals’ Perspectives Of Barriers To Cancer Care Delivery For American Indian, Rural, And Frontier Populations, Brandon M. Varilek, Sarah Mollman Phd, Rn, Chpn, Cne

College of Nursing Faculty Publications

Objective: This descriptive qualitative study sought to understand the barriers affecting cancer care delivery from the perspective of healthcare professionals (HCPs) serving American Indian (AI), rural, and frontier populations.
Methods: One-on-one, semi-structured interviews with multidisciplinary HCPs (N = 18) who provide cancer care to AI, rural, and frontier populations were conducted between January and April 2022. Interviews were conducted via Zoom. Data were analyzed following thematic content analysis methodologies. Results: Thematic content analysis revealed three major themes: (a) Access, (b) Time, and (c) Isolation. The themes represent the HCP perspectives of the needs and barriers of persons with cancer to …

Models Of Shared Care For The Management Of Psychotic Disorder After First Diagnosis In Ontario., Joshua C. Wiener, Rebecca Rodrigues, Jennifer N S Reid, Kelly K. Anderson

Epidemiology and Biostatistics Publications

OBJECTIVE: To describe the provision of care for young people following first diagnosis of psychotic disorder.

DESIGN: Retrospective cohort study using health administrative data.

SETTING: Ontario.

PARTICIPANTS: People aged 14 to 35 years with a first diagnosis of nonaffective psychotic disorder in Ontario between 2005 and 2015 (N=39,449).

MAIN OUTCOME MEASURES: Models of care, defined by psychosis-related service contacts with primary care physicians and psychiatrists during the 2 years after first diagnosis of psychotic disorder.

RESULTS: During the 2-year follow-up period, 29% of the cohort received only primary care, 30% received only psychiatric care, and 32% received both primary and …

Assessing Social Determinants Of Health In Primary Care, Vicki Carpenter

Doctoral Projects

The social determinants of health encompass the various circumstances and environments in which individuals reside, develop, labor, and experience aging (Social Determinants of Health, 2022). These variables significantly contribute to the existence of health inequities and disparities within populations. In order to effectively mitigate health disparities, it is imperative to consider the various determinants that influence health outcomes, as this consideration is crucial for advancing the goal of achieving health equity. This public health concern encompasses multiple sectors within our society, necessitating the collaboration of various organizations and communities to effectively address and mitigate its impact.

The fundamental …

Opioid Overdose Knowledge And Attitudes Among Undergraduate College Studentsopioid Overdose Knowledge And Attitudes Among Undergraduate College Students, Kaiya Cook

Honors College Theses

No abstract provided.

Planners Vs. Non-Planners: Do Preterm Births Impact Future Contraceptive Use?, Jessie Moore

NYMC Student Theses and Dissertations

Background: In the United States, 45% of all pregnancies are unintended and occur when contraception is not used or is used inconsistently. Among those pregnancies, 1 in 10 women will experience a preterm birth, which is defined as a birth occurring before 37 weeks gestation. Women who have delivered preterm are at an increased risk for preterm birth in future pregnancies and are encouraged to wait at least 18 months between giving birth and getting pregnant again. Among women who have experienced a preterm birth, the desire to delay future pregnancy or avoiding it all together often becomes a necessity …

The Contradictory Nature Of U.S. Laws And Nutrition Programs And Their Effects On Infant Feeding, Lily Patel

Journal of Food Law & Policy

The contradictory nature of U.S. laws, including the laws concerning infant feeding, though supposedly aligned with policies to promote wellness in Americans, can exacerbate gender and race inequality and work against the National Strategy. The overarching goal of U.S. laws concerning infant feeding is to ensure that infants are fed, nourished, and receive proper nutrition. However, the laws often appear to be directly contradictory to one another in the priorities they are promoting.

Free For All: Proposing Legislation To Eliminate Food Insecurity In Arkansas Public Schools, A. Mills Bryant

Journal of Food Law & Policy

Schools serve millions of students daily as one of the largest food distribution sites in the United States. However, more than 13.1 million children in the United States, and almost 150,000 in Arkansas, are food insecure. Before the COVID-19 pandemic, most Arkansas schools offered free and reduced lunch to students at or below the poverty line through participation in the National School Lunch Program (“NSLP”). During COVID-19, Congress passed The Families First Coronavirus Response Act (“FFCRA”) and The Coronavirus Aid, Relief, and Economic Security Act (“CARES”) (hereinafter “The Acts”). This legislation effectively eliminated food insecurity in participating American public schools, …

Organizational Change In Saudi Healthcare Settings: Evaluating Organizational And Individual Readiness For Change, And The Mediating Role Of Readiness For Change Between Management Support And Commitment To Change., Sultan Alsaif

Electronic Theses and Dissertations

BACKGROUND: To respond to the constantly changing environment and developments of healthcare, leaders of healthcare organizations have been trying to introduce and implement transformations that allow their organizations to be able to operate effectively and efficiently to meet the shifts in healthcare demand and to deal with new patterns of health issues, comply with the new policies, and to enhance their present in the market. Thus, it is important for managers to determine the level of readiness for implementing organizational changes from to perspectives. These perspectives include organizational readiness for change and individual readiness for change. METHOD: This first manuscript …

Environmental Exposures And Aging., Daniel Chris Gomes

Electronic Theses and Dissertations

In recent years, research into air pollution has shown that exposure to certain components in air pollution, primarily PM2.5 can accelerate biological aging and thereby lead to increased susceptibility to multiple diseases. We hypothesize that prolonged exposure to air pollutants can result in premature aging leading to extensive tissue dysfunction and susceptibility to diseases. To examine this, we exposed mice to PM2.5 for 9, 15, and 21 days, then measured the telomere lengths, cellular senescence, and histone methylation patterns of multiple cell types. We found consistently increased telomere attrition, cellular senescence and advanced age-consistent histone methylation patterns in groups exposed …

Genetic Risk Scores For Hypertension And Chronic Kidney Disease In African Americans., Aastha Kakar

Electronic Theses and Dissertations

Hypertension (HT) and chronic kidney diseases (CKD) are complex conditions, disproportionally prevalent among African Americans (AA) and are influenced by multiple genetic as well as environmental factors. Genetic risk scores (GRS) enable the analysis of the combined effects of multiple single nucleotide polymorphisms (SNPs). This study investigates the association of blood pressure (BP) and CKD GRS with BP, hypertension (HT) and CKD; early-onset HT and CKD; and investigates interactions of the GRSs with environmental measures in AA. We observed a significant association between the BP-GRS with HT, SBP and DBP. The odds of HT for one standard deviation (s.d.) increase …

Improving Post-Discharge Engagement Of Mental Health Patients In The Veterans Affairs South Texas Healthcare System, Nneoma Lewis

Doctor of Nursing Practice

Discharge from a hospital is a high-risk period for mental health patients, as 20% experience an adverse event within 30 days of discharge. Poor discharge engagement can lead to complications for recovery, which include an increased risk for readmissions, longer length of stay, increased risk for suicide, and death. Hospital stays cost the United States $377.5 billion dollars per year; there is pressure for hospitals, health plans, and providers to examine the admission and discharge processes to improve healthcare delivery, transition of care, and patient health outcomes. At a South Texas VA, 67.66% of mental health patients attended all their …

Communication With Physicians And Family About Breast Cancer Recurrence, Kimberly M. Kelly, Pragya Rai, Jamie L. Studts, Stephanie Dickinson, Beate Henschel, Mark Dignan, Mara D. Chambers, Hannah Hazard-Jenkins

UK CARES Faculty Publications

Objective: Adequate physician-patient communication about cancer recurrence is vital to quality of life and to informed decision-making related to survivorship care. The current study was guided by a cognitive-affective framework to examine communication with family and physicians about breast cancer recurrence risk.

Methods: A survey of recently-diagnosed, early-stage breast cancer patients in Appalachia investigated physician- patient and familial communication about breast cancer recurrence risk.

Results: Over 30% of participants reported not talking to family or physicians about breast cancer recurrence risk. Younger patients reported more conversations, and speaking with physicians was associated with greater perception risk factors associated with recurrence …

A Case Study Of The Political Determinant Of Health On The Public Health Crisis Of Malaria In Nigeria, Bisola M. Olumegbon

Electronic Theses and Dissertations

Abstract

Globally, there were about 229 million cases of malaria in 2022. The sub-Saharan African region accounted for 92% of the reported cases and 94% of deaths. Nigeria had the highest number of malaria cases and deaths, representing 27% of global cases. This scholarly project was a case study guided by the political determinants of health. Triangulation of data using thematic analysis was used to identify the political determinants of malaria in Nigeria and to understand how the concept of interaction contributes to the persistence of the disease. The analysis involved a deductive and inductive approach based on the literature …

Wastewater Analysis Of Mpox Virus In A City With Low Prevalence Of Mpox Disease: An Environmental Surveillance Study, Jeremiah Oghuan, Carlos Chavarria, Scout R Vanderwal, Anna Gitter, Akpevwe Amanda Ojaruega, Carlos Monserrat, Cici X Bauer, Eric L Brown, Sara Javornik Cregeen, Jennifer Deegan, Blake M Hanson, Michael Tisza, Hector I Ocaranza, John Balliew, Anthony W Maresso, Janelle Rios, Eric Boerwinkle, Kristina D Mena, Fuqing Wu

Faculty, Staff and Student Publications

BACKGROUND: Tracking infectious diseases at the community level is challenging due to asymptomatic infections and the logistical complexities of mass surveillance. Wastewater surveillance has emerged as a valuable tool for monitoring infectious disease agents including SARS-CoV-2 and Mpox virus. However, detecting the Mpox virus in wastewater is particularly challenging due to its relatively low prevalence in the community. In this study, we aim to characterize three molecular assays for detecting and tracking the Mpox virus in wastewater from El Paso, Texas, during February and March 2023.

METHODS: In this study, a combined approach utilizing three real-time PCR assays targeting the …

Covid-19 Prevention, Testing, And Treatment Seeking Among People Who Inject Drugs (Pwid) On The Us Mexico Border, Jorge Raul Puentes

Open Access Theses & Dissertations

The outbreak of the COVID-19 pandemic exacerbated the negative social determinants of health that affect medically underserved people who inject drugs (PWID) inhibiting their access to services, promoting infectious disease acquisition such as HIV and HCV, and overdose rates. The effects of the pandemic were more pronounced among Latino PWID communities. Participants of this study are 194 PWID residing in El Paso, Texas, and Cd. Juarez, Chihuahua along the US-Mexico border. Cross-sectional surveys were administered assessing environmental risk factors that impact COVID-19 acquisition and engagement in preventive behaviors. The purpose of this secondary data analysis study was to describe the …

Traditional And Emerging Modifiable Lifestyle Risk Behaviors For Non-Communicable Diseases In A Sample Of Hispanic/Latino American Adolescents Living In The U.S.-Mexico Border Region, Silvia Salinas Lopez

Open Access Theses & Dissertations

Background: Non-communicable diseases (NCDs) pose a significant global health threat, with modifiable lifestyle risk behaviors (mLRBs) contributing substantially to their onset. This study examined traditional and emerging mLRBs and their distribution on cross-sectional health outcomes among Hispanic/Latino in-school adolescents living on the U.S.-Mexico border. Methods: This secondary data analysis used information from the cross-sectional 2019 El Paso YHBS obtained through online surveys. The secondary data analyzed the prevalence, clustering, and co-occurrence of mLRBs of 539 Hispanic/Latino high school students. Results were compared to mLRBs findings corresponding to Hispanic/Latino adolescents who participated in the national and state 2019 CDC YRBSS. An …

Barriers And Facilitators To Enrollment For Free And Reduced Price Meals In The School Nutrition Program Among Lawrence Public School Families, Emily Brinkman

Capstone Experience: Master of Public Health

Many low-income families are facing nutrition insecurity, meaning they do not have consistent and equitable access to healthy, safe, affordable foods to meet needs for optimal health and well-being. The impact of nutrition insecurity is especially concerning for children as they are more likely to face adverse outcomes that can limit physical, intellectual, and emotional potential across the lifespan. The U.S. Department of Agriculture administers the School Nutrition Programs that can help improve access to nutritious foods. Eligible families can apply for their children to receive free or reduced-price school meals based on income level and household size. However, many …