Medicine and Health Sciences Commons^™

Differences In Bilinguals And Multilinguals Diagnosed With Alzheimer's Disease, Nathalie Rios Carreon

University Honors Theses

Alzheimer’s Disease does not have a cure but there are different things that can be done to manage the disease. Keeping your brain healthy is important to keep cognitive reserve (CR) strong and intact. One way to keep CR intact is to speak more than one language. Previous research done shows that monolinguals typically get diagnosed with Alzheimer's disease 4 to 5 years earlier than bilinguals and multilinguals. Using existing articles it was found that this new research was similar to research already done. Speaking more than one language keeps the brain healthy in many different ways. Research suggests that …

Neuroscience-Based Harm Reduction Education For College Students In Portland, Or, Catriona Swallow

University Honors Theses

Harm reduction (HR) is a movement focused on reducing the harms of the opioid overdose crisis through education, advocacy, and community engagement. A key component of HR is naloxone, a medication which reverses opioid overdoses when administered. Due to increased fentanyl contamination, opioid overdose deaths have been on the rise among adolescents in the U.S and HR practices are crucially important at this point in time. In recent years, alternative curricula of HR education have included a neuroscience-based approach to the topic of substance use. While both traditional and alternative programs have had success increasing substance use literacy among adolescents, …

Effortless Mindfulness Toolkit: Easy Meditation Scripts To Begin Each Class., Brett Whysel

Open Educational Resources

The Effortless Mindfulness in the Classroom Toolkit is an open educational resource designed to create happier classrooms, boost student engagement, and foster a sense of community through brief, effective mindfulness exercises. This comprehensive toolkit provides educators with everything they need to seamlessly integrate mindfulness practices into their teaching routines, regardless of prior experience. The toolkit includes introductory slides, 15 ready-to-use meditation scripts, and accompanying audio recordings, covering a variety of mindfulness techniques such as focused breathing, body scans, and loving-kindness meditations. Each meditation is paired with a reflective prompt to deepen student engagement and reinforce the benefits of mindfulness. Additionally, …

Vaccines At The Intersection Of Religion And Politics, Charles Downey

Master's Theses

Vaccine hesitancy – a delay in acceptance or refusal of vaccines despite their availability – is a rising threat to global health and has increased in recent years in higher income countries. This is a complex phenomenon with the potential to undo decades of progress toward eradicating communicable diseases. The recent COVID-19 pandemic introduced a new wave of vaccine hesitancy, with evangelical Christians as leading actors in the movement away from vaccines in the United States. The present study investigated factors related to vaccine hesitancy and sources of health-related information among members of evangelical Christian churches in and around Hattiesburg, …

Cognitive Behavioral Therapy Factors Related To Outcomes In Depression Among Youth With Hiv, Betsy D Kennard, Larry K Brown, Kristin Baltrusaitis, Miriam Chernoff, Graham J Emslie, Jessica Jones, Sarah Buisson, Jaime Deville, Megan Wilkins, Amber Bunch, Chivon Mcmullen Jackson, Christy Beneri, David E Shapiro

Faculty, Staff and Students Publications

PURPOSE: This is a secondary analysis of a multi-site, cluster (site) randomized trial of the efficacy of a combined Health and Wellness Cognitive Behavior Therapy (H&W CBT) and medication management approach for depression in youth with HIV (YWH) compared to standard care. In this study, we explored the association between H&W CBT factors and depression outcomes after 24 weeks of treatment to discover treatment elements associated with symptom reduction.

METHODS: Participants (12-24 years of age) were YWH in the United States (US) diagnosed with moderate to severe depression [Quick Inventory of Depressive Symptomatology (QIDS), Clinician-Rated score ≥ 11]. Thirteen US …

Measuring Perceived Utility Of Genomic Sequencing: Development And Validation Of The Genetic Utility (Gene-U) Scale For Pediatric Diagnostic Testing, Hadley Stevens Smith, Caryn Kseniya Rubanovich, Jill Oliver Robinson, Ariel N Levchenko, Sarah A Classen, Janet Malek, Barbara Biesecker, Kyle B Brothers, Benjamin S Wilfond, Christine Rini, Sara J Knight, Amy L Mcguire, Cinnamon S Bloss

Center for Medical Ethics and Health Policy Staff Publications

Purpose: Measuring the effects of genomic sequencing (GS) on patients and families is critical for translational research. We aimed to develop and validate an instrument to assess parents' perceived utility of pediatric diagnostic GS.

Methods: Informed by a 5-domain conceptual model, the study comprised 5 steps: (1) item writing, (2) cognitive testing, (3) pilot testing and item reduction, (4) psychometric testing, and (5) evaluation of construct validity. Parents of pediatric patients who had received results of clinically indicated GS participated in structured cognitive interviews and 2 rounds of surveys. After eliminating items based on theory and quantitative performance, we conducted …

Large-Scale Genotype Prediction From Rna Sequence Data Necessitates A New Ethical And Policy Framework, Mary A Majumder, Jeffrey T Leek, Kasper D Hansen, Afrooz Razi, Amy L Mcguire

Center for Medical Ethics and Health Policy Staff Publications

Genotype prediction from RNA-seq data has become widespread. RNA-seq data, unlike DNA-seq data, are available as raw reads for many projects, with related protocols and consent terms typically inaccessible. However, there is a lack of clarity in current policy and inconsistency in practice with regard to the handling of these data. Here, we call for a framework for management of RNA-seq data and the predicted genotypes that includes registered access for RNA-seq data, controlled access for predicted genotypes, and a code of conduct for data access and use, as well as enhanced downstream protections.

Governing With Public Engagement: An Anticipatory Approach To Human Genome Editing, Dorit Barlevy, Eric Juengst, Jeffrey Kahn, Jonathan Moreno, Lauren Lambert, Alta Charo, Hervé Chneiweiss, Mahmud Farooque, David H Guston, Insoo Hyun, Paul S Knoepfler, Cynthia Selin, Rebecca Wilbanks, Manar Zaghlula, Christopher Thomas Scott

Center for Medical Ethics and Health Policy Staff Publications

In response to calls for public engagement on human genome editing (HGE), which intensified after the 2018 He Jiankui scandal that resulted in the implantation of genetically modified embryos, we detail an anticipatory approach to the governance of HGE. By soliciting multidisciplinary experts’ input on the drivers and uncertainties of HGE development, we developed a set of plausible future scenarios to ascertain publics values—specifically, their hopes and concerns regarding the novel technology and its applications. In turn, we gathered a subset of multidisciplinary experts to propose governance recommendations for HGE that incorporate identified publics’ values. These recommendations include: (1) continued …

Generating Clinical-Grade Gene-Disease Validity Classifications Through The Clingen Data Platforms, Matt W Wright, Courtney L Thaxton, Tristan Nelson, Marina T Distefano, Juliann M Savatt, Matthew H Brush, Gloria Cheung, Mark E Mandell, Bryan Wulf, T J Ward, Scott Goehringer, Terry O'Neill, Phil Weller, Christine G Preston, Ingrid M Keseler, Jennifer L Goldstein, Natasha T Strande, Jennifer Mcglaughon, Danielle R Azzariti, Ineke Cordova, Hannah Dziadzio, Lawrence Babb, Kevin Riehle, Aleksandar Milosavljevic, Christa Lese Martin, Heidi L Rehm, Sharon E Plon, Jonathan S Berg, Erin R Riggs, Teri E Klein

Center for Medical Ethics and Health Policy Staff Publications

Clinical genetic laboratories must have access to clinically validated biomedical data for precision medicine. A lack of accessibility, normalized structure, and consistency in evaluation complicates interpretation of disease causality, resulting in confusion in assessing the clinical validity of genes and genetic variants for diagnosis. A key goal of the Clinical Genome Resource (ClinGen) is to fill the knowledge gap concerning the strength of evidence supporting the role of a gene in a monogenic disease, which is achieved through a process known as Gene-Disease Validity curation. Here we review the work of ClinGen in developing a curation infrastructure that supports the …

Expanding A Behavioral View On Digital Health Access: Drivers And Strategies To Promote Equity, Maura M Kepper, Lauren A Fowler, Isabelle S Kusters, Jean W Davis, Manal Baqer, Sara Sagui-Henson, Yunyu Xiao, Adati Tarfa, Jean C Yi, Bryan Gibson, Kristin E Heron, Nicole M Alberts, Marissa Burgermaster, Veronica Ps Njie-Carr, Lisa M Klesges

Center for Medical Ethics and Health Policy Staff Publications

The potential and threat of digital tools to achieve health equity has been highlighted for over a decade, but the success of achieving equitable access to health technologies remains challenging. Our paper addresses renewed concerns regarding equity in digital health access that were deepened during the COVID-19 pandemic. Our viewpoint is that (1) digital health tools have the potential to improve health equity if equitable access is achieved, and (2) improving access and equity in digital health can be strengthened by considering behavioral science-based strategies embedded in all phases of tool development. Using behavioral, equity, and access frameworks allowed for …

Genomic Sequencing Research In Pediatric Cancer Care: Decision Making, Attitudes, And Perceived Utility Among Adolescents And Young Adults And Their Parents, Amanda M Gutierrez, Jill O Robinson, Hadley S Smith, Lauren R Desrosiers-Battu, Sarah R Scollon, Isabel Canfield, Rebecca L Hsu, Nicole M Schneider, D Williams Parsons, Sharon E Plon, Wendy Allen-Rhoades, Mary A Majumder, Janet Malek, Amy L Mcguire

Center for Medical Ethics and Health Policy Staff Publications

Purpose: Professional guidelines recommend engaging adolescents and young adults (AYAs) in medical decision making (DM), including whether to undergo genomic sequencing (GS). We explored DM around GS and attitudes after return of GS results among a diverse group of AYAs with cancer and their parents.

Methods: We surveyed AYAs with cancer (n = 75) and their parents (n = 52) 6 months after receiving GS results through the Texas KidsCanSeq study. We analyzed AYAs' DM role in GS research enrollment and their satisfaction with that role. We compared AYAs' and parents' self-reported understanding of, attitudes toward, and perceived utility of …

How To Design Equitable Digital Health Tools: A Narrative Review Of Design Tactics, Case Studies, And Opportunities, Amy Bucher, Beenish M Chaudhry, Jean W Davis, Katharine Lawrence, Emily Panza, Manal Baqer, Rebecca T Feinstein, Sherecce A Fields, Jennifer Huberty, Deanna M Kaplan, Isabelle S Kusters, Frank T Materia, Susanna Y Park, Maura Kepper

Center for Medical Ethics and Health Policy Staff Publications

With a renewed focus on health equity in the United States driven by national crises and legislation to improve digital healthcare innovation, there is a need for the designers of digital health tools to take deliberate steps to design for equity in their work. A concrete toolkit of methods to design for health equity is needed to support digital health practitioners in this aim. This narrative review summarizes several health equity frameworks to help digital health practitioners conceptualize the equity dimensions of importance for their work, and then provides design approaches that accommodate an equity focus. Specifically, the Double Diamond …

Smoking Habit At Home And Upper Respiratory Infection In Infants Aged 6-12 Months, Musfardi Rustam, Nur Pelita Sembiring, Taswir Effendy

Kesmas

Upper Respiratory Tract Infection (URI) is an acute infection caused by viruses, fungi, and bacteria. Smoking habit at home is a risk factor for URI in infants. This study aimed to determine a relationship between smoking at home and the incidence of URI in infants. This study was conducted the fourth week of February 2010 until the third week of April 2010 in Kampar District, Indonesia. This analytical study used a case-control design and cluster random sampling. The samples comprised 162 cases and 162 controls, infants aged 6-12 months. The cases were 162 infants aged 6-12 months suffering from URI …

Passive Smoking And Its Correlation With Stunting In Children: A Systematic Review, Anita Rahmiwati, Karlinda Karlinda, Hamzah Hasyim, Febriyansyah Febriyansyah

Kesmas

Passive smoking is a significant risk factor for stunting in children, highlighting the urgent need for effective public health measures. This study aimed to investigate the association between passive smoking and stunting in children aged 0 months-7 years. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, a comprehensive literature search was conducted across multiple online databases, including PubMed, ProQuest, Science Direct, Willey Online Library, Sage Journal, Cambridge University Press, and Oxford Academic. The quality of included articles reporting observational studies was assessed using the Critical Appraisal Skill Programme (CASP) checklist, presenting data through narrative synthesis. Findings …

The Correlation Of Age With Thrombocytes And D-Dimer Values In Covid-19 Patients At Hospital X In Jakarta, Indonesia, Nanik Prasetyoningsih, Ascobat Gani

Kesmas

Coronavirus disease (COVID-19), caused by the SARS-CoV-2 virus, spread globally, with research indicating that prognosis severity can be assessed by thrombocyte and D-dimer levels; while, patient age serves as a mortality predictor. This study aimed to analyze the relationship between age with thrombocytes and D-dimer in COVID-19 patients. This cross-sectional study used laboratory testing samples from 667 COVID-19 patients at Hospital X in Jakarta, Indonesia, collected from August 2020 until May 2021. The data was collected using cluster random sampling and analyzed using descriptive statistics and the Chi square test (95% CI). The results showed that age and thrombocytes positively …

Capitation Management Through Performance-Based Capitation Mechanism Of Primary Health Care In Malang, Indonesia, Ayu Tyas Purnamasari, Herlinda Dwi Ningrum, Anggi Ardhiasti, Asri Hikmatuz Zahroh

Kesmas

Primary health care (PHC) has one of the largest funding sources, capitation, which BPJS Healthcare Security transfers monthly. Capitation fund receipts were frequently insufficient due to failure to meet performance-based capitation/Kapitasi Berbasis Kinerja (KBK) targets, including for PHC in Malang City, Indonesia. This study aimed to examine the management and utilization of capitation funds through a KBK mechanism. This descriptive study used a qualitative approach supported by quantitative data. This study was conducted from July to August 2023 and purposely selected nine informants from BPJS Healthcare Security, the local health office, and PHC. The interviews were transcribed verbatim and analyzed …

Data Mining Analysis With Orange In The Development Of Tuberculosis Among Diabetes Mellitus Patients, Malahayati Rusli Bintang, Adang Bachtiar, Cicilya Candi

Kesmas

Prevention and treatment of diabetes will have a positive influence on tuberculosis (TB) since people may get TB because they have diabetes mellitus (DM). Recording and reporting through the TB Information System are not run optimally because of many factors. The information system must be strengthened to be used by private health facilities. This study used secondary data from the 2013 and 2018 Indonesian Basic Health Research (IBHR). The data was analyzed univariately and analyzed further using Orange Data Mining Tools to test the screening tool model used to predict TB in diabetic individuals. The total sample in this study …

New Approach To Mapping Regional Vulnerability In Controlling Tuberculosis Disease In Indonesia, Maria Holly Herawati, Asep Hermawan, Dasuki Dasuki, Hadi Supratikta, Al Asyary, M Rokhis Khomarudin, Muhammad Priyatna, Raflizar Raflizar, Kristina Kristina, Noer Endah Pracoyo, Dina Bisara, Cahya Tri Purnami, Mentari Nur Farida Suteja, Yusrial Bachtiar, Noor Edi Widya Sukoco, Doni Lasut

Kesmas

Tuberculosis (TB) in Indonesia is still a health problem. The TB prevalence in Indonesia ranks second in the world after India in 2023. Regional factors, inadequate healthcare facilities, and limited resources (financial, human, and infrastructure) are challenges requiring innovation to help the government control TB. TB eradication efforts need to be made with a comprehensive and effective approach. One method used is to look at the vast territory of Indonesia, therefore, mapping the TB disease vulnerability is a highly recommended method. The use of a Geographic Information System is expected to help map the TB vulnerability areas in Indonesia. Given …

Double Burden Of Persons With Disabilities: Are Those More Likely To Suffer From Chronic Disease?, Salsabila Kusumawardani, Hardiyani Puspitasari, Muhammad Ciro Danuza, Yusuf Faisal Martak

Masyarakat: Jurnal Sosiologi

This study examines the likelihood of persons with disabilities experiencing chronic diseases compared to those without disabilities, emphasizing the role of demographic characteristics. Prior research shows that individuals with disabilities have a higher risk of chronic diseases due to pre-existing health conditions, secondary complications, healthcare access barriers, and limited health education. Beyond these factors, we argue that demographic characteristics—such as age, gender, insurance status, and living environment—also shape daily habits and lifestyles that influence long-term health outcomes. Using probit regression analysis, this study quantifies the probability of chronic disease among persons with disabilities. Our findings indicate that individuals with disabilities …

Maternal Decision Making And Children’S Nutritional Status: Evidence From Indonesia, Nadia Roswita, Teguh Dartanto

Jurnal Ekonomi Kependudukan dan Keluarga

Indonesia is encountering consecutive health problems caused by malnutrition. The latter poses long-term effects on children’s development. As this issue continue its prominence, using linear regression and binary logistic with time lag to analyze data from Indonesia Family Life Survey (IFLS) in 2007 and 2014 shall support the analysis of issue. Previous results from the models indicated that maternal decision-making in their share of food expenditure has a weak correlation for stunted children's experience. However, this study revealed different results. It suggested that involvement in from men in nutritional knowledge, skills, and financial backing to advance women's roles contributes to …

Pengaruh Karakteristik Rumah Tangga Terhadap Kejadian Kematian Maternal Di Pulau Papua, Intan Putri Utami, Yuliagnis Transver Wijaya

Jurnal Ekonomi Kependudukan dan Keluarga

Maternal health and life during pregnancy, childbirth, and the postpartum period are very important in determining the growth and future development of the birth generation. SDG indicators express the global seriousness of this effort, aiming to reduce the maternal mortality ratio (MMR) to less than 70 per 100,000 live births by 2030. However, according to the Long Form SP2020, Indonesia still has 189 deaths per 100,000 live births. Papua and West Papua are the two provinces with the worst MMR achievements, with 565 and 343 deaths per 100,000 live births, respectively. Therefore, this research will provide general overview and identify …

Associations Between Coping Style And Perceptions Of Web-Delivered Physical Activity Messages Among Women In Midlife With Cardiovascular Health Risks, Kristen Pasko

Theses and Dissertations

Midlife women are at unique risk for cardiovascular disease (CVD) and benefit from increasing physical activity (PA). Many PA interventions involve social support, though fail to address related processes such as social comparison. Desire for specific types of social support and comparison may represent emotion-focused versus problem-solving coping, though little is known about women’s preferences for/responses to these coping opportunities. The present study examined women’s selections of PA content in a digital environment. Over 7 days, women in midlife ≥1 CVD risk factor (N = 60, MAge = 50.70, SD = 5.89) wore a PA monitor and visited a proprietary …

Developing A Fair And Interpretable Representation Of The Clock Drawing Test For Mitigating Low Education And Racial Bias., Jiaqing Zhang, Sabyasachi Bandyopadhyay, Faith Kimmet, Jack Wittmayer, Kia Khezeli, David J. Libon, Catherine C Price, Parisa Rashidi

Rowan-Virtua School of Osteopathic Medicine Departmental Research

The clock drawing test (CDT) is a neuropsychological assessment tool to screen an individual's cognitive ability. In this study, we developed a Fair and Interpretable Representation of Clock drawing test (FaIRClocks) to evaluate and mitigate classification bias against people with less than 8 years of education, while screening their cognitive function using an array of neuropsychological measures. In this study, we represented clock drawings by a priorly published 10-dimensional deep learning feature set trained on publicly available data from the National Health and Aging Trends Study (NHATS). These embeddings were further fine-tuned with clocks from a preoperative cognitive screening program …

Application Of An Opioid Risk Assessment Tool For Patients With Pain Presenting To The Emergency Department With Drug-Seeking Behaviors, Darian L. Stephens

Doctor of Nursing Practice Final Project Abstract

PURPOSE The purpose of this quality improvement project was to introduce the Screener and Opioid Assessment for Patients with Pain- Revised (SOAPP-R) tool to identify patients in the emergency department (ED) at risk for opioid abuse.

BACKGROUND The project was implemented in a 13-bed freestanding ED that can treat medical emergencies as well as provide substance abuse detoxification services.

METHODOLOGY A systematic approach that combined quantitative and qualitative data was used during the pre-implementation and implementation periods. The clinical staff was educated on the process of implementing the SOAPP-R tool. Those who were identified as at risk for opioid abuse …

Impacts Of Social Media Use On The Wellbeing Of Older Adults : Evidence From China During The Covid-19 Pandemic, Xuying Dong

Lingnan Theses (Doctoral degree)

Given the trend of increasing use of information and communication technologies among Chinese elder population, more attention should be drawn on the relationship between social media use and wellbeing of older adults. This research explores the social media use situation among older adults in mainland China as well as its influences on their wellbeing, and employs a mixed approach including quantitative questionnaire distributed via WeChat social media platform and qualitative interview among Chinese older adults who are over 60 years of age in Jingzhou, Hubei Province. Generally speaking, social media use can improve the wellbeing of Chinese older adults, more …

Using Item Response Theory To Identify Key Symptoms Of Insomnia In A Sample Of University Students With Probable Eating Disorders, Kara A. Christensen Pacella, Brianne N. Richson, Nicole A. Short, Angeline R. Bottera, Leah A. Irish, Victoria L. Perko, Kelsie T. Forbush

Psychology Faculty Research

Purpose

Researchers have theorized that interactions between appetitive and circadian disruptions result in increased eating disorder (ED) symptoms and insomnia. However, it is unclear how specific insomnia symptoms present among people with EDs and if the latent structure of insomnia in this population is similar to that of people with insomnia disorder.

Methods

We conducted a secondary analysis of data collected on ED and insomnia symptoms using a subset of students with probable EDs at a large Midwestern American university. Item response theory (IRT) for polytomous items was performed to identify item difficulty, discrimination, and information parameters for the Insomnia …

Modeling The Effect Of Human Behavior On Disease Transmission, Katie Yan

Rose-Hulman Undergraduate Mathematics Journal

Many infectious disease models build upon the classic Susceptible-Infected-Recovered (SIR) model, a compartmental system that is used to simulate disease transmission in a population. The SIR model focuses on the transmission of disease but rarely includes behavioral or informational components that explore how disease perception influences transmission. In this paper, we propose a six-compartment behavioral SIR model that further segments the classic SIR system based on knowledge of information about the disease, and we explore how sharing information affects disease transmission. We designate two states as aware and unaware based on whether the relevant information is known by the population. …

The College Campus, A Place Of Learning, And A Place Of Healing, Huma Bashir, Joshua Francis

Human Services Faculty Publications

The COVID-19 pandemic and its aftermath have precipitated a marked increase in mental health needs among college students. Lockdowns, the sudden shift to remote learning, and social distancing mandates have compounded existing challenges, highlighting a trend that has evolved over the past two decades. Despite heightened demand for mental health support, colleges struggle to meet these needs amid the emotional aftermath of COVID-19 effectively. Recognizing the pivotal role of higher education institutions in shaping future leaders and addressing and enhancing the mental well-being of the college community is imperative to foster an environment conducive to learning and healing. This paper …

Nutrition And Dietetics Educators’ Experiences Using Systems Thinking In Teaching, Erin E. Bergquist, Lyndi Buckingham-Schutt, Scott Smalley, Christina G. Campbell, Awoke Dollisso, Shuyang Qu

Journal of Dietetic Education

Objective: Describe educator experiences teaching systems thinking in nutrition and dietetics education. Design: Qualitative, semi-structured, online interviews. Setting: Educators teaching in accredited nutrition and dietetics programs. Participants: Purposive sample of thirteen Registered Dietitian Nutritionists (92% female, 77% with > 6 years teaching experience) from each U.S. census region and accredited program type. Phenomenon of Interest: Educators described experiences teaching systems thinking in accredited programs, including benefits. Analysis: Transcribed interviews were analyzed using qualitative grounded theory iterative coding. Excel was used for data organization and thematic coding analysis. Results: Educators described four themes when teaching systems thinking: (1) a holistic approach to …

Student Exposure To Andhii Improves Confidence With Applying The Nutrition Care Process, Casey Colin, Tad Campbell, Michel Harris, Avalon Mustafa, Lindsay Woodcock

Journal of Dietetic Education

The objective of this study was to explore if using ANDHII improves NCP confidence and documentation quality. This quasi-experimental trial was conducted with n = 43 undergraduate dietetic students. NCP confidence was measured before and after a traditional case study, and after an ANDHII case study. Documentation quality was measured using a validated quality audit tool. Confidence increased from time 1 to time 2 (p = 0.008), and from time 2 to time 3 (p = 0.003). Documentation quality was higher for the ANDHII documentation compared to the non-ANDHII documentation (p < 0.001) but lower when compared to the traditional ADIME (p = 0.03). Familiarizing students with ANDHII improved NCP confidence. Opportunities exist to improve ANDHII functionality and positively impact documentation quality.