Medicine and Health Sciences Commons^™

A Policy Evaluation For California’S Care Act And The Application Of The Social Determinants Of Health, Adelina Mercedes Lang

Capstone Experience: Master of Public Health

In 2022, California passed a legislative bill, SB 1338: the Community Assistance, Recovery, and Empowerment (CARE) Act, which created a new statewide procedure for treating mentally ill homeless adults diagnosed with psychotic disorders through a court-ordered CARE plan. SB 1338 intends to alleviate the mental health and homeless crisis. This capstone project provides an early assessment of SB 1338 using a modified formative policy evaluation methodology, including a scoping literature review and applying a policy assessment using the CDC's Policy Evaluation Framework. A stakeholder survey was also applied to gather stakeholders' perspectives on SB 1338. The literature review supported the …

Cancer Disparities In Southeast Asia: Intersectionality And A Call To Action, Erin Jay G. Feliciano, Frances Dominique V. Ho, Kaisin Yee, Joseph A. Paguio, Michelle Ann B. Eala, Janine Patricia G. Robredo, Kenrick Ng, Jasmine Lim, Khin Thuzar Pyone, Catherine A. Peralta, Jerickson Abbie Flores, J. Seth Yao, Patricia Mae G. Santos, Christian Daniel U. Ang, Gideon Lasco, Jeffrey Shi Kai Chan, Gary Tse, Enrico D. Tangco, T. Peter Kingham, Imjai Chitapanarux, Nirmala Bhoo-Pathy, Gerardo D. Legaspi, Edward Christopher Dee

Ateneo School of Medicine and Public Health Publications

No abstract provided.

Patient Satisfaction With Telemedicine In The Philippines During The Covid-19 Pandemic: A Mixed Methods Study, Alicia Victoria G. Noceda, Lianne Margot M. Acierto, Morvenn Chaimek C. Bertiz, David Emmanuel H. Dionisio, Chelsea Beatrice L. Laurito, Girrard Alphonse T. Sanchez, Arianna Maever Loreche

Ateneo School of Medicine and Public Health Publications

Background: The capacity to deliver essential health services has been negatively impacted by the COVID-19 pandemic, particularly due to lockdown restrictions. Telemedicine provides a safe, efficient, and effective alternative that addresses the needs of patients and the health system. However, there remain implementation challenges and barriers to patient adoption in resource-limited settings as in the Philippines. This mixed methods study aimed to describe patient perspectives and experiences with telemedicine services, and explore the factors that influence telemedicine use and satisfaction. Methods: An online survey consisting of items adapted from the Consumer Assessment of Healthcare Providers and Systems (CAHPS) Clinician & …

Global Burden Of Cardiovascular Diseases And Risks, 1990-2022, George A. Mensah, Valentin Fuster, Christopher J.L. Murray, Gregory A. Roth, Geminn Louis C. Apostol

Ateneo School of Medicine and Public Health Publications

No abstract provided.

Morphological And Metabolic Criteria Of Covid-19 Vaccine Associated Axillary Nodes On 18-Fluorodeouxyglucose Pet/Ct Imaging In Breast Cancer Patients, Nosheen Fatima, Unaiza Zaman, Areeba Zaman, Sidra Zaman, Rabia Tehseen, Maseeh Uz Zaman

Department of Radiology

Background: In the current era vaccine-associated lymphadenopathy (VAL) is not an uncommon presentation on 18F-FDG PET/CT examinations in patients inoculated with Coronavirus disease 2019 (COVID-19) vaccination. In this study, we are presenting data of VAL on 18F-FDG PET/CT regarding its prevalence, temporal response to vaccination and imaging characteristics of VAL.
Methods: Seventy-eight (78) consecutive vaccinated breast cancer (BC) patients who had 18FDG PET/CT were retrospectively analyzed. All patients had COVID-19 vaccine shots in contralateral arms and none in breast cancer site axilla (BSA). In 35 patients 18FDG avid nodes were found in vaccine site axilla (VSA). In 25 patients 18FDG …

Bridging Gaps: A Qualitative Inquiry On Improving Paediatric Rheumatology Care Among Healthcare Workers In Kenya, Angela Migowa, Sasha Bernatsky, Anthony Ngugi, Helen Foster, Peterrock Muriuki, Roselyter Riang’A, Stanley Luchters

Paediatrics and Child Health, East Africa

Background: Due to the paucity of paediatric rheumatologists in Kenya, it is paramount that we explore strategies to bridge clinical care gaps for paediatric rheumatology patients in order to promote early diagnosis, prompt referral, and optimal management.

Purpose: To identify proposed interventions which can improve the ability of non-specialist healthcare workers to care for paediatric rheumatology patients across Kenya.

Methods: We conducted 12 focus group discussions with clinical officers (community physician assistants), nurses, general practitioners and paediatricians across six regions in Kenya. Interviews were conducted, audio-recorded, transcribed verbatim, and analysed using MAXQDA 2022.2 software.

Results: A total of 68 individuals …

Associations Between Maternal Alcohol Consumption During Pregnancy And Selected Musculoskeletal Birth Defects Among Offspring In The National Birth Defects Prevention Study, Sarah Fisher

Legacy Theses & Dissertations (2009 - 2024)

Maternal alcohol consumption during pregnancy is known to be associated with poor pregnancy outcomes, including fetal alcohol spectrum disorders. However, evidence for associations between alcohol consumption during pregnancy and some major structural birth defects among offspring is conflicting or inconclusive. This dissertation used data from the National Birth Defects Prevention Study (NBDPS), a multi-site, population-based case-control study, to examine associations between maternal alcohol consumption and risk of three major musculoskeletal birth defects: gastroschisis, omphalocele, and craniosynostosis. Our analyses built upon previous analyses of these associations using NBDPS data, including larger sample sizes and more robust analytic methods to explore issues …

Prescription Opioid Misuse Among High School Students In The United States, By Sex And Race/Ethnicity, In 2019 And 2021, Deepika Reddy Kandhi

Legacy Theses & Dissertations (2009 - 2024)

Background: Drug overdose deaths in the U.S. have been increasing and are primarily related to opioid use. In 2019, an estimated 7.2% of US high school students reported misusing prescription opioids in the past 30 days. Prescription opioid misuse in adolescents may lead to development of a substance use disorder, overdose, or other serious harms. Some researchers have observed sex and race differences in prescription opioid use. This study aimed to identify patterns of prescription opioid misuse among adolescent subgroups categorized by both sex and race/ethnicity, to provide insight into intervention development and targeting.Methods: We analyzed data from the Youth …

Breastfeeding In Public: A Review Of Literature And Service Learning Experience, Taylor Jehlik, Makenzie Carney

The Eleanor Mann School of Nursing Undergraduate Honors Theses

This article explores the perceptions and beliefs of first-time expectant mothers, their family members, and their social network about breastfeeding in public places. We used experience through Tiny Tusks and reviewed literature to get a better understanding of what social factors play a role in mothers' decisions to breastfeed in public.

Providing Optimal Resident Sleep Hygiene In Assisted Living Communities; Opportunities For Design And Operation Teams To Collaborate And Share Their Unique Knowledge, Beverly B. J. Miller

Architecture Masters of Science Program: Theses

Research is emerging relating sleep hygiene to disease pathogenesis including Parkinson's, dementia, Alzheimer’s disease and increased cardiovascular risk. The application of circadian science as it relates to human wellness has intensified as a result. The quality of sleep significantly impacts the wellness of residents living in long term care, however sleep hygiene research is lacking in assisted living (AL) communities.

The thesis question inquires; How can operation and design teams collaborate to optimize sleep health for residents in assisted living communities? The research methodology utilized a two-phase process. Phase I identified three AL communities as test sites, providing case studies …

Advancing Suicide Intervention Strategies For Teens (Assist): Study Protocol For A Multisite Randomised Controlled Trial, Molly Adrian, Elizabeth Mccauley, Robert Gallop, Jack Stevens, David A. Jobes, Jennifer Crumlish, Barbara Stanley, Gregory K. Brown, Kelly L. Green, Jennifer L. Hughes, Jeffrey A. Bridge

Mathematics Faculty Publications

Introduction: Brief interventions that reduce suicide risk following youth's experience with acute care due to suicidality are needed. Methods and analysis: The study will use a three-arm randomised controlled trial designed to test the effectiveness of the Safety Planning Intervention with structured follow-up (SPI+) and the Collaborative Assessment and Management of Suicidality (CAMS) compared with enhanced usual care. The primary outcomes measure will be suicidal events, defined as death by suicide, attempted suicide, preparatory acts toward imminent suicidal behaviour or suicidal ideation resulting in a change in emergency evaluation or inpatient admission. Secondary measures will be the number of suicide …

Developing Disinfection Strategies For Controlling Human Norovirus, Sars-Cov-2, And Clostridioides Difficile Endospores In Long-Term Care Facilities, Jinge Huang

All Dissertations

Long-term care facilities (LTCFs) provide an environment favorable for the transmission of three critical human pathogens: human norovirus (HuNoV), severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), and Clostridioides difficile. Given residents in LTCFs are susceptible to infections due to their advanced ages and compromised immune systems, effective environmental surface disinfection plays a crucial role in controlling the spread of human pathogens within these settings and, therefore, mitigates the risk of infections caused by these pathogens. This dissertation aimed to assess the efficacy of various types of disinfectants against two HuNoV surrogates [feline calicivirus (FCV) and Tulane virus (TuV)], two …

Associations Between Mental Health Outcomes And Childhood Trauma And Experiences Of Violence During The First Shelter-In-Place For Covid-19 Among Sexual Minority Men Living In Texas, 2020, Sonam Deki

Open Access Theses & Dissertations

Background: The COVID-19 pandemic significantly increased mental health issues, disproportionately affecting men who have sex with men (MSM). The relationship between mental health and experiences of trauma and violence are understudied in this population. Purpose: To assess if rates of childhood trauma and COVID-19-related violence are higher for those with depression and anxiety than those without such experiences among cisgender sexual minority men in Texas. Methods: This secondary data analysis is among the cisgender sexual minority men in the COVID-19 and You Survey Study in Texas during the first shelter-in-place order. Descriptive statistics and bivariate associations between trauma and experiences …

The Iris Registry: A Novel Approach To Clinical Registry Development In Ophthalmology, John C. Lin, Leslie Hyman, Ingrid U. Scott

Wills Eye Hospital Papers

No abstract provided.

An Intersectional Approach To Quantifying The Impact Of Geographic Remoteness And Health Disparities On Quality-Adjusted Life Expectancy: Application To Australia, Peter Lee, Steven J. Bowe, Lidia Engel, Erica I. Lubetkin, Nancy Devlin, Lan Gao

Publications and Research

Objectives

Methods

Development Of A Methodology For The Quantification Of Reaerosolization Of A Biological Contaminate Surrogate Particle From A Military Uniform Fabric, George Cooksey, Jeremy M. Slagley, Casey W. Cooper, Douglas Lewis, Alisha Helm

Faculty Publications

In a mass casualty medical evacuation after a bioaerosol (BA) dispersal event, a decontamination (DC) method is needed that can both decontaminate and prevent biological particle (BP) re-aerosolization (RA) of contaminated clothes. However, neither the efficacy of current DC methods nor the risk of BP RA is greatly explored in the existing literature. The goals of this study were to develop a repeatable method to quantify the RA of a biological contaminant off military uniform fabric swatches and to test the efficacy of one DC protocol (high-volume, low-pressure water) using 1 µm polystyrene latex (PSL) spheres as a surrogate. A …

Re-Analysis And Meta-Analysis Of Summary Statistics From Gene-Environment Interaction Studies, Duy T Pham, Kenneth E Westerman, Cong Pan, Ling Chen, Shylaja Srinivasan, Elvira Isganaitis, Mary Ellen Vajravelu, Fida Bacha, Steve Chernausek, Rose Gubitosi-Klug, Jasmin Divers, Catherine Pihoker, Santica M Marcovina, Alisa K Manning, Han Chen

Faculty, Staff and Student Publications

Motivation: statistics from genome-wide association studies enable many valuable downstream analyses that are more efficient than individual-level data analysis while also reducing privacy concerns. As growing sample sizes enable better-powered analysis of gene-environment interactions, there is a need for gene-environment interaction-specific methods that manipulate and use summary statistics.

Results: We introduce two tools to facilitate such analysis, with a focus on statistical models containing multiple gene-exposure and/or gene-covariate interaction terms. REGEM (RE-analysis of GEM summary statistics) uses summary statistics from a single, multi-exposure genome-wide interaction study to derive analogous sets of summary statistics with arbitrary sets of exposures and interaction …

Type 2 Diabetes Modifies The Association Of Cad Genomic Risk Variants With Subclinical Atherosclerosis, Natalie R Hasbani, Kenneth E Westerman, Soo Heon Kwak, Han Chen, Xihao Li, Daniel Di Corpo, Jennifer Wessel, Joshua C Bis, Chloè Sarnowski, Peitao Wu, Lawrence F Bielak, Xiuqing Guo, Nancy Heard-Costa, Gregory L Kinney, Michael C Mahaney, May E Montasser, Nicholette D Palmer, Laura M Raffield, James G Terry, Lisa R Yanek, Jessica Bon, Donald W Bowden, Jennifer A Brody, Ravindranath Duggirala, David R Jacobs, Rita R Kalyani, Leslie A Lange, Braxton D Mitchell, Jennifer A Smith, Kent D Taylor, April P Carson, Joanne E Curran, Myriam Fornage, Barry I Freedman, Stacey Gabriel, Richard A Gibbs, Namrata Gupta, Sharon L R Kardia, Brian G Kral, Zeineen Momin, Anne B Newman, Wendy S Post, Karine A Viaud-Martinez, Kendra A Young, Lewis C Becker, Alain G Bertoni, John Blangero, John J Carr, Katherine Pratte, Bruce M Psaty, Stephen S Rich, Joseph C Wu, Rajeev Malhotra, Patricia A Peyser, Alanna C Morrison, Ramachandran S Vasan, Xihong Lin, Jerome I Rotter, James B Meigs, Alisa K Manning, Paul S De Vries

Faculty, Staff and Student Publications

BACKGROUND: Individuals with type 2 diabetes (T2D) have an increased risk of coronary artery disease (CAD), but questions remain about the underlying pathology. Identifying which CAD loci are modified by T2D in the development of subclinical atherosclerosis (coronary artery calcification [CAC], carotid intima-media thickness, or carotid plaque) may improve our understanding of the mechanisms leading to the increased CAD in T2D.

METHODS: We compared the common and rare variant associations of known CAD loci from the literature on CAC, carotid intima-media thickness, and carotid plaque in up to 29 670 participants, including up to 24 157 normoglycemic controls and 5513 …

Anaerobic Pathogens Associated With Osa May Contribute To Pathophysiology Via Amino-Acid Depletion, Michael Elgart, Ying Zhang, Yuan Zhang, Bing Yu, Youngmee Kim, Phyllis C Zee, Marc D Gellman, Eric Boerwinkle, Martha L Daviglus, Jianwen Cai, Susan Redline, Robert D Burk, Robert Kaplan, Tamar Sofer

Faculty, Staff and Student Publications

BACKGROUND: The human microbiome is linked to multiple metabolic disorders such as obesity and diabetes. Obstructive sleep apnoea (OSA) is a common sleep disorder with several metabolic risk factors. We investigated the associations between the gut microbiome composition and function, and measures of OSA severity in participants from a prospective community-based cohort study: the Hispanic Community Health Study/Study of Latinos (HCHS/SOL).

METHODS: Bacterial-Wide Association Analysis (BWAS) of gut microbiome measured via metagenomics with OSA measures was performed adjusting for clinical, lifestyle and co-morbidities. This was followed by functional analysis of the OSA-enriched bacteria. We utilized additional metabolomic and transcriptomic associations …

Maximizing Dietary Knowledge And Behavior Through A Teens As Teachers Approach, Anaderi Iniguez, Erica L. Doering, Elizabeth H. Weybright

Journal of Extension

The teens as teachers model is a promising approach to impact teen behavior. The current study evaluated dietary knowledge and behavior among teen teachers participating in a 4-H youth development program (N = 46; Mage = 15.5 years; 67% female; 48% Hispanic; 38% White Non-Hispanic, 14% Other). A paired sample t test was conducted on pre-and post-program surveys to identify significant improvements in dietary knowledge and behaviors. Findings suggest teens as teachers is generally effective in promoting healthy dietary knowledge and behavior. We recommend this approach be disseminated within Extension 4-H youth development healthy eating active living programming.

Evaluating Physical Activity Resources To Support Health Equity In Arizona, Kathryn M. Orzech, Theresa A. Legros, Laurel Jacobs, Gregory Goodman, Ryan Lang

Journal of Extension

We evaluated physical activity (PA) resources in lower-income Arizona communities to support the Supplemental Nutrition Assistance Program – Education (SNAP-Ed) in pursuing equitable policy, systems, and environment (PSE) interventions. In 2017, 71 PA resources across 10 counties (65% parks) were rated using the Physical Activity Resource Assessment (PARA) tool. Accessibility was high, but condition scores and attractiveness varied across resources, with no rural/urban differences. Results suggest that Extension SNAP-Ed staff can be agents of change by assessing resource condition where physical activity health inequities may exist and then convening partners to begin to address needed changes.

Patient, Provider, And Interpreter Perspectives On Interpreter Modality And Barriers To Interpreter Use In A Pediatric Inpatient Setting, Brooklyn Leitch

Capstone Experience: Master of Public Health

There are a growing number of patients and families in the United States who use a language other than English (LOE). Standard of care for best patient outcomes requires that these families receive professional interpretation for every encounter, preferably in the interpreter modality that they are most comfortable with and that provides the best communication. Unfortunately, they often do not receive this. Objectives of this research include learning how interpreter services are selected and used as well as which modality (in-person, video, or phone) is preferred by patients and families, providers, and interpreters. We aim to better understand the experiences …

Substance Use Patterns Among High School Students - A Replication Study Of The 2020 Youth Risk Behavior Survey, Haley Irons

Capstone Experience: Master of Public Health

The study selected for replication is “Prescription Opioid Misuse and Use of Alcohol and Other Substances Among High School Students” by Christopher Jones and colleagues published in the Morbidity and Mortality Weekly Report Supplement in August 2020. The original report used data from the Centers for Disease Control’s 2009-2019 Youth Risk Behavior Survey (YRBS), which is a cross-sectional survey administered every two years to a sample of public- and private-school students in 9th–12th grade in the United States. Researchers from the original report aimed to use the 2009-2019 YRBS data to examine substance use among high school students, characterize the …

Antibiotic Prescribing Patterns In The Emergency Department, Maddison Mcconnaughhay

Capstone Experience: Master of Public Health

Purpose: Antibiotic resistance is a major public health problem in the United States, resulting in significant morbidity and mortality (CDC, 2019). This study seeks to understand how antibiotic use for dental problems may contribute to antibiotic resistance and adverse drug reactions while only temporarily relieving the underlying oral health condition. Previous research suggests differences in prescribing patterns for pain management by provider type, but little is known about antibiotic prescribing patterns, especially for diverse groups of pediatric patients (Chua, et al., 2019). This study aims to characterize antibiotic prescribing patterns in a midwestern children's hospital emergency department for non-traumatic dental …

Environmental Exposure Effects To Humans And Trends Of Harmful Algal Blooms In Nebraska, Ericka Sanders

Capstone Experience: Master of Public Health

Harmful algae blooms (HAB) are becoming more of a human health concern. Humans are exposed to harmful algae blooms from freshwater bodies used for recreational activities. The presence of harmful algae blooms has been increasing across the United States. Aerosol, dermal, and ingestion routes of exposure are ways humans can develop an illness when around a HAB. Environmental exposure to humans above 8 ppb per liter of surface water can cause mild to severe symptoms and, in rare cases, may be fatal. Exposure can be acute or chronic. The Nebraska Department of Environment and Energy (NDEE) has implemented a monitoring …

The Relationship Between Self-Reported Mental Health And Body Mass Index Among Adults In The United States Using The 2021 Behavioral Risk Factor Surveillance System (Brfss), Madhur Pandey

Capstone Experience: Master of Public Health

Objective

This study investigated the link between frequent mental distress (FMD) and body mass index (BMI) in 2021 among U.S. adults, while considering sociodemographic and lifestyle factors.

Methods

Using 2021 Behavioral Risk Factor Surveillance System (BRFSS) data, we analyzed the association between BMI as the dependent variable and FMD as the independent variable, considering the sociodemographic factors and lifestyle variables. Logistic regression models were applied.

Results

In our sample, 30.7% had a normal BMI, while 69.3% were outside the normal range. Of these, 85.1% reported infrequent mental distress, whereas 14.9% reported FMD. Those with FMD were more likely to have …

Examining The Relationship Between Adverse Childhood Experiences And Covid-19 Vaccine Status Using 2022 Brfss Data: A Cross-Sectional Study, Cristhian A. Chau-Valdivia

Capstone Experience: Master of Public Health

Abstract:

Objective.To determine the association between adverse childhood experiences (ACEs) scores with COVID-19 vaccination outcomes before and after adjusting for demographic variables.

Methods. Data were from 2022 Behavioral Risk Factor Surveillance System (BRFSS) surveys regarding 13 categories of ACEs, COVID-19 vaccination, and demographic variables. Data was weight adjusted for survey respondent data. This complex design combined the core and optional modules. Participants who received at least one dose of the COVID-19 vaccine were categorized as vaccinated. The sample size is 12,514.

Results. Participants who were female (OR=1.35, 95% CI: [1.19,1.52]), greater than or equal to 65 years old (OR=4.76, 95% …

A Cross-Sectional Analysis Of Adverse Childhood Experience Exposure On Cancer Diagnosis Utilizing The 2022 Behavioral Risk Factor Surveillance Survey Data, Emma Zipperer

Capstone Experience: Master of Public Health

Objective: To determine the association between Adverse Childhood Experiences (ACEs) and cancer diagnosis based on ACE exposure levels.

Methods: We utilized data collected in the 2022 Behavioral Risk Factor Surveillance System (BRFSS) survey. The study population (n=54,148) was restricted to states that reported on the optional model of experiencing ACEs and those who responded about cancer diagnosis. A univariate analysis, bivariate analysis and a multivariate logistic regression were performed. Odds of cancer diagnosis among those with differing ACE exposure levels were calculated.

Results: High ACE exposure had 20% higher odds of cancer diagnosis when compared to low ACE exposure. White, …

Examining The Impact Of Adverse Childhood Experiences (Aces) On Breast And Colorectal Cancer Screening Behaviors In Adulthood, Meagan A. Kraft

Capstone Experience: Master of Public Health

Objective: To investigate the relationship between adverse childhood experiences (ACEs) and screening for breast and colorectal cancer in adulthood.

Methods: This cross-sectional study utilized nationwide survey data from the 2022 Behavioral Risk Factor Surveillance System (BRFSS). Data regarding ACEs and compliance with breast and colorectal cancer screening guidelines were analyzed from 12 states. Weighted logistic regression models were used to assess the relationship between ACEs and breast cancer screening compliance in a population of 18,369 women, and colorectal cancer screening compliance in a population of 30,884 men and women. Screening compliance among those with a high ACE score was compared …

School Nurses And The Sexual Health And Education Of Public-School Students In Tennessee, Amy Wake

Electronic Theses and Dissertations

Tennesseans have been experiencing increasing rates of sexually transmitted diseases since the year 2000. Those rates are highest among those 15- to 24-year-olds. At the same time, Tennessee policy requires the teaching of abstinence as the primary form of sexual health education and emphasized the use of abstinence-only curriculum. The school nurse represents an available resource in the Tennessee public schools. The purpose of the qualitative study was to explore, describe, and interpret the perceptions and experiences of public-school nurses from rural, suburban, and urban areas of Tennessee related to the sexual health and sexual health education of students. School …