Medicine and Health Sciences Commons^™

From Past To Present: Tracing Africa’S Path To Universal Health Coverage, Evaline Chepchirchir Langat, Paul Russell Ward, Hailay Abrha Gesesew, Lillian Mwanri

Centre of Excellence in Women and Child Health

At the 58th World Health Assembly in 2005, the international community charted a course for universal health coverage (UHC), aiming to ensure access to health care for all in need, of sufficient quality, and without causing financial hardship. At the time, barriers to accessing health care were overwhelming, particularly in low-and middle-income countries like Africa. Currently, 50 of Africa’s 54 countries are in various phases of UHC implementation. Some are developing national UHC agendas, while others have made significant progress but still face gaps in meeting UHC targets. This mini review comprehensively examines the literature to understand the temporal and …

Risk Factors And Public Health Interventions Associated With Adolescent Pregnancy Prevention Among Females Aged 10–19 Years In Kenya: A Scoping Review Protocol, Kimbley Asaso Omwodo, Abdu Mohiddin, Danielle Denwood, Augustine N. Gitonga

Centre of Excellence in Women and Child Health

Background ; Adolescent pregnancy is associated with multifaceted challenges that impact countries’ health, education and economic stability. Despite ongoing interventions, in developing countries such as Kenya, adolescent pregnancy rates continue to be high. There is a need for more synthesised evidence on regional-specific risk factors to support tailored prevention strategies.

Objective; This scoping review aims to explore what is known about the risk factors and intervention strategies focused on adolescent pregnancy prevention in Kenya.

Methods and analysis; Using the Arksey and O’Malley framework combined with a three-step search strategy as recommended by the Joanna Briggs Institute, relevant articles will be …

Violence Against Healthcare Workers In Kenya: A Cross-Sectional Sub-Analysis Of The Global Vishwas Study, Reena Shah, Jasmit Shah, Rakhtan K. Qasba, Ruman K. Qasba, Annastacia Mbithi, Eric Njenga, Akshat Banga, Rahul Kashyap, Salim Surani

Institute for Educational Development, East Africa

Background: Global concern exists for workplace violence against healthcare workers (HCWs), especially in low and middle-income nations. This violence includes physical, verbal, or sexual abuse and has a significant impact despite initiatives like Occupational Safety and Health Administration (OSHA) guidelines. We conducted a study in Kenya to address this issue.

Methods: We did a cross-sectional survey that collected responses during June 6th to August 9th, 2022, focused on healthcare professionals in Kenya within the global ViSHWaS study. Violence against healthcare professionals in multiple Kenyan counties was analysed, The study reached participants through social media, emails, and other channels using a …

The Swahili Version Of The Cd-Risc 10 Resilience Scale: Psychometric Properties And Factors Associated With Resilience Among Healthcare Workers In Tanzania, Kevinson Mwangi, Sabina Odero, Gideon Mbithi, Rachel Odhiambo, Rosemary Stephen, Tumbwene Mwansisya, Eunice Pallangyo, Eunice Ndirangu, Amina Abubakar

Institute for Human Development, East Africa

Background: Despite the central role of resilience in promoting mental well-being, little is known about the resilience process among healthcare workers in East Africa, partly due to the lack of adequately standardised and psychometrically sound assessment tools for our context. This study provides the first psychometric evaluation of the Swahili version of the Connor-Davidson Resilience Scale 10 (CD-RISC 10) among nurses/midwives and community health volunteers (CHVs) in Tanzania, potentially informing the accuracy of measuring resilience in this setting. Additionally, we examine factors associated with self-reported resilience as measured by the CD-RISC 10 scale.

Methods We used cross-sectional data on nurses/midwives …

Profiles And Well-Being Of Older Adult Caregivers In Singapore, Yi Wen Tan, Rachel Wen Yi Ngu, Kenneth Choo, Lydia Ng, Wensi Lim

ROSA Research Briefs

In Singapore, the government espouses a “many helping hands” philosophy towards caregiving, where care for older adults is borne by three pillars: the family, the community, and the state (Mehta & Vasoo, 2000). Of these, the family is regarded as the “first line of support”, rendering family caregivers essential to the care of older adults (Ng et al., 2016). Many of these caregivers are themselves older adults, where the average age of caregivers was found to be 62 years (Tan, 2023). As Singapore’s population continues to age, alongside demographic trends of extended longevity and a shrinking population, many more will …

Substance Use Among Healthcare Professionals: A Cross-Sectional Study In Kenya, Jasmit Shah, Cynthia Smith, Cyprian Mostert, Linda Khakali, Zul Merali, Sayed Karar

Brain and Mind Institute

Substance use among healthcare professionals, including alcohol, tobacco, marijuana, benzodiazepines etc., is a rising concern. The immensity of substance use is not yet clear, though recently, studies conducted on medical students and physician trainees show that 10% to 15% of all healthcare professionals misuse drugs at some point in their career, and that 6% to 8% of physicians have a substance use disorder. Substance use has a direct impact on relationships, physical health, and job performance, and is associated with depression, burnout, and decreased career satisfaction. The aim of this study was to shed light on the prevalence of substance …

The Cross-Sectional Association Between Lifestyle Behaviors And Breast And Cervical Cancer Screening Among Hispanic Women Along The Texas-Mexico Border, Paul Gerardo Yeh, Audrey C Choh, Susan P Fisher-Hoch, Joseph B Mccormick, David R Lairson, Belinda M Reininger

Faculty, Staff and Student Publications

Objective: Lifestyle behaviors may influence timely cancer screening, but their relationship is unknown among Hispanic women who have low cancer screening rates.

Methods: We used Cameron County Hispanic Cohort data from 2014 to 2022 to evaluate the relationship between lifestyle and compliance with mammography and Papanicolaou (Pap) screening guidelines ("up-to-date") among Hispanic women along the Texas-Mexico border. The 2018 World Cancer Research Fund scoring system characterized cancer-preventive lifestyle adherence. Multivariable logistic regression assessed the association between lifestyle behaviors and mammography and, separately, Pap screening.

Results: Among 385 age-eligible women for mammography and 412 age-eligible women for Pap test screening, up-to-date …

"Our Vision Is That Black Mothers And Birthing People, Fathers, And Partners Are Safe, Honored, And Respected Throughout Pregnancy And Parenthood": Black Birth Workers' Agenda For Black Maternal Health In Oregon, Sarah Marguerite Applin

University Honors Theses

Black women and Birthing People (BWBP) face disproportionate rates of mortality within the United States healthcare system. BWBP are three times more likely to suffer a pregnancy-related death than White women. Therefore, addressing and consulting with BWBP about the birthing experience that BWBP sustains when they are bearing children is imperative. The inclusion and application of this key knowledge and understanding should be emphasized and at the root of further development toward reproductive justice. This participatory story was led by Dr. Roberta Hunte. Interviews and focus groups with Black birth workers, birthing people, and public health professionals were conducted in …

Inhibition Of Il-6 Trans-Signaling Promotes Post-Stroke Functional Recovery In A Sex And Dose-Dependent Manner, Cassandra Hall, Dustin T Nguyen, Kate Mendoza, Chunfeng Tan, Anjali Chauhan

Faculty, Staff and Student Publications

Introduction: Elevated circulating IL-6 levels are associated with poorer outcomes after stroke, and increased serum IL-6 levels are linked to a higher risk of stroke. IL-6 binds to soluble IL-6 receptors (sIL-6R) and subsequently to ubiquitously expressed gp130, initiating proinflammatory trans-signaling. This study tested the hypothesis that inhibiting IL-6 trans-signaling by administering soluble (s) gp130 improves long-term functional outcomes in young mice after stroke.

Methods: Recombinant mouse gp130Fc chimera (sgp130) was administered one hour after middle cerebral artery occlusion (MCAO) followed by twice-weekly administration for 2 weeks in mice (8-15 weeks old). Behavioral assessments were done on days 7 and …

A Review Of Racial Differences And Disparities In Ecg, Jianwei Zheng, Chizobam Ani, Islam Abudayyeh, Yunfan Zheng, Cyril Rakovski, Ehsan Yaghmaei, Omolola Ogunyemi

Mathematics, Physics, and Computer Science Faculty Articles and Research

The electrocardiogram (ECG) is a widely used, non-invasive tool for diagnosing a range of cardiovascular conditions, including arrhythmia and heart disease-related structural changes. Despite its critical role in clinical care, racial and ethnic differences in ECG readings are often underexplored or inadequately addressed in research. Variations in key ECG parameters, such as PR interval, QRS duration, QT interval, and T-wave morphology, have been noted across different racial groups. However, the limited research in this area has hindered the development of diagnostic criteria that account for these differences, potentially contributing to healthcare disparities, as ECG interpretation algorithms largely developed from major …

How Do Gender And Marital Status Impact High-Risk Polysubstance Use?, Kira England, Alexander Chapman

Population Health Research Brief Series

Drug overdose deaths in the United States increasingly include the use of multiple drugs, known as polysubstance use. These include opioids, cocaine, methamphetamine, tranquilizers, and sedatives. Polysubstance use is considered high risk because it can cause dangerous synergistic effects and result in the ingestion of higher amounts of drugs. This brief summarizes findings from a study that used data from the National Survey on Drug Use and Health on U.S. adults from 2002 through 2019 to examine gender and marital status differences in high-risk polysubstance use among U.S. adults ages 18 and older. The authors find that polysubstance use is …

Podcasting Towards Togetherness: Utilizing Podcasts To Improve Departmental Camaraderie And Well-Being, Michael Petrauskis, Colleen Gutman, Rosemarie Fernandez

Journal of Wellness

Introduction: Physician burnout is on the rise, and this is of particular concern in emergency medicine. Burnout is associated with medical errors, adverse events, poor professionalism, and litigation. A sense of community can build engagement and mitigate workplace stressors on well-being. Emergency physicians may have trouble connecting due to the nature of shift-work and various practice settings. Communication technology, and particularly podcasting, has the potential to help overcome these barriers and positively impact relatedness and well-being.

Approach: We developed an inward-facing podcast, “The ER Break Room” within the Department of Emergency Medicine at the University of Florida. Through the …

Religion And Attitudes Toward Xenotransplantation: Results Of A Nationwide Survey In The United States., Daniel J Hurst, Luz A Padilla, Amanda Zink, Brendan Parent, Laura L Kimberly

Rowan-Virtua School of Osteopathic Medicine Departmental Research

Religious viewpoints have been shown to influence the ways in which many persons approach medical decision-making and have been noted as a potential barrier to xenotransplantation acceptance. This study sought to explore how attitudes toward xenotransplantation differ among various religious beliefs. A national Likert-scale survey was conducted in 2023 with a representative sample in the United States. Religious belief was self-reported. Regression analysis was used to identify associations with religious belief and hesitations about xenotransplantation. Five thousand and eight individuals across the United States responded to the survey. The two biggest concerns about xenotransplantation across religious groups were the current …

Framework, Design, And Baseline Data Of A Collective Impact Initiative To Strengthen The Community Health Worker Workforce Ecosystem In Texas, Shreela V Sharma, Heidi Hagen Mcpherson, Jemima John, Rosalia Guerrero, Sisan B Tennyson, Deborah Banerjee, Nadia Siddiqui, Sheila Savannah, Peter Durand, Amanda Gao, Sean A Haley, Elisa Garcia, Jennifer Cofer, Adrick Harris

Faculty, Staff and Student Publications

BACKGROUND: The Health Equity Collective (HEC), a multi-sector systems-level collective impact coalition in the Greater Houston region, partnered with the City of Houston Health Department (HHD) to launch a 2-year effort to implement a comprehensive approach towards strengthening the regional Community Health Workers (CHW) workforce infrastructure as a pathway to advancing health equity. Our paper presents the logic model, methods, and baseline qualitative and quantitative data from this initiative.

METHODS: In the fall of 2022, the Health Equity Collective brought together a Network of CHW-employing or training organizations in the Greater Houston region. This Network was the working group of …

Inclusive Space For Everyone Door Sign (Printable 8.5 X 11 Inch), Joan H. Robinson

Open Educational Resources

This is a printable 8.5 x 11 inch door sign for faculty, staff, and administrators to let people know it is an inclusive space for everyone. For improved visibility, print with a color printer and cut along the dotted line.

See also: 11 x 17 inch door sign.

Investigating Mental Health Disparities In Rural Sexual And Gender Minority Adults: Protocol For The Rural Exploration And Approaches To Lgbtq + Mental Health (Realm) Prospective Cohort Study, Shoshanna L. Fine, Kalai Willis, Iaah L. Lucas, Kirsten F. Siebach, Jennifer L. Glick, Mariah Valentine-Graves, Savannah Winter, Michael Smith, Thomas Waltz, Gina Bailey Herring, Marissa Hannah, Holly C. Wilcox, Travis Sanchez, Stefan D. Baral, Sarah M. Murray

School of Public Health Faculty Publications

BACKGROUND: Sexual and gender minority (SGM) persons experience substantial mental health disparities throughout the life course, including increased vulnerability to depression and suicide. Few existing studies, however, have explored how pervasive experiences of SGM-related stigma, discrimination, and trauma (i.e., minority stress) contribute to adverse mental health outcomes among diverse sub-populations of SGM adults living in rural areas of the United States. This paper describes the protocol for a prospective cohort study, "Rural Exploration and Approaches for LGBTQ + Mental Health (REALM)," that will explore minority stress in relation to mental health conditions and suicidal behaviors among rural SGM adults. METHODS: …

Speech And Language Assessment Practices For Bilingual Children In The School Setting: Where Do We Go From Here?, Seijra Toogood, Raul Prezas

Journal of Human Services: Training, Research, and Practice

Abstract

The field of speech-language pathology has demonstrated growth in bilingual assessment and evaluations. However, many questions remain regarding formal and informal assessment practices, intervention recommendations, and cultural competency or responsiveness. Sixty-one SLPs in Virginia completed a survey on demographics, bilingual assessment practices, cultural competence, and language development of ELL students. Seven SLPs who work with bilingual and/or ELL students were also interviewed to ascertain bilingual assessment practices, cultural competence, and language development knowledge. Areas of concern included assessment of bilingual students, lack of developmental norms and standardized assessment tools in languages other than English, and lack of knowledge of …

Ask The Experts: Community Engagement Studios To Inform Research On Cannabis Use In Cancer Symptom Management, Brittney Greene, Grace Mckenzie, Keenan Gibbons, Salimah Meghani, Brooke Worster, Rebecca Ashare

Institute of Emerging Health Professions Faculty Papers

AIM: Despite one-third of patients with cancer using cannabis for symptom management, little is known about their access to and usage of cannabis. Community Engagement (CE) studios involving community experts with chronic health conditions were used to inform a qualitative study on access to and use of cannabis products among patients with cancer.

METHOD: We conducted two 2-hour CE studios with residents from Western NY (WNY) (N = 18). Our sample primarily included White and Black residents (56% vs. 39%). After a researcher-led 10-minute presentation, a community facilitator led the discussion, which focused on questions about challenges to cannabis …

Investigating Suicide Risk Factors Among Appalachian West Virginian Adults, Erin D. Caswell, Angela M. Dyer, Summer D. Hartley, Caroline P. Groth, Mary Christensen, Sahiti K. Tulabandu, Bryce K. Weaver, Ruchi Bhandari

Journal of Appalachian Health

Introduction: Suicide rates in the United States have increased over the past two decades, with rural areas, particularly the Appalachian Region, facing unique challenges that elevate suicide risk. These include economic hardships, social isolation, and limited access to mental health services.

Purpose: This study addresses critical gaps in understanding lifetime suicide risk in West Virginia (WV), a predominantly rural state entirely within the Appalachian Region. By identifying the factors driving urban-rural differences in suicide risk, this research seeks to inform interventions tailored to the state's distinct needs and provide insights applicable to the broader Appalachian Region

Methods: Using 2021 Mountain …

Current Attitudes And Barriers Among Appalachian Patients Towards Orthopaedic Surgery, Dylan Smith Md, Justin B. West Ms, Wade Smith Md, Micah Macaskill Md, Jonathan Lash, Matthew W. Bullock Do, Mpt

Journal of Appalachian Health

Introduction: This study explores the challenges faced by residents of rural West Virginia in accessing orthopaedic care due to geographic and socioeconomic barriers.

Purpose: This study seeks to survey rural West Virginia residents about their attitudes and experiences regarding access to orthopaedic care in southern West Virginia.

Methods: A total of 132 electronic surveys were collected from rural West Virginia residents during an appointment with their primary care provider located at an affiliated outreach clinic. The survey was designed to investigate various factors influencing their access to orthopaedic care.

Results: Delays in seeking orthpaedic care are common in rural West …

The Journal Of Appalachian Health: A Year Of Growth And Impact, Noah Wren, Bradley Firchow, Emily Wilson, Randy Wykoff

Journal of Appalachian Health

The Journal of Appalachian Health continues to grow in strength and reach, serving as a critical platform for research and discussion on the unique health challenges and opportunities in Appalachia, as well as how the challenges and opportunities Appalachia faces are local manifestations of broader regional and global phenomena. Over the past year, we have witnessed a remarkable expansion in our readership, reflecting the increasing demand for evidence-based insights into the health of our region.

Hispanic Patients Undergoing Spinal Fusion For Neuromuscular Scoliosis Sustain Health Inequalities, Armando S Martinez, David Momtaz, Travis Kotzur, Alexandra Mclennan, Abdullah Ghali, Farhan Ahmad, Ebubechi Adindu, Alan C Santiago-Rodriquez, Ali Seifi, Brian Smith

Faculty, Staff and Students Publications

INTRODUCTION: Pre- and postoperative optimization remains a complex process impacted by various demographic factors. Our study aims to identify and describe those demographic factors associated with poor outcomes after spinal fusion with instrumentation in neuromuscular scoliosis to reduce health disparities and improve postoperative outcomes.

METHODS: A retrospective analysis was conducted using Healthcare Cost and Utilization Project data from 2016 to 2020, encompassing a random sample of 20% of procedures in the United States. Data included demographic and hospital variables, including days from admission to the procedure, length of stay, recovery time, total charge, discharge disposition, and mortality rates. In addition …

The Quic-Sp: A Spanish Language Tool Assessing Unpredictability In Early Life Is Linked To Physical And Mental Health, Sabrina R. Liu, Natasha A. Bailey, Sara Romero-González, Amy Moors, Belinda Campos, Elysia P. Davis, Laura M. Glynn

Psychology Faculty Articles and Research

Accumulating evidence indicates that unpredictable signals in early life represent a unique form of adverse childhood experiences (ACEs) associated with disrupted neurodevelopmental trajectories in children and adolescents. The Questionnaire of Unpredictability in Childhood (QUIC) was developed to assess early life unpredictability, encompassing social, emotional, and physical unpredictability in a child’s environment, and has been validated in three independent cohorts. However, the importance of identifying ACEs in diverse populations, including non-English speaking groups, necessitates translation of the QUIC. The current study aims to translate and validate a Spanish language version of the QUIC (QUIC-SP) and assess its associations with mental and …

Feasibility And Acceptability Of The Mazi Umntanakho Digital Tool In South African Settings: A Qualitative Evaluation, Catherine E. Draper, Caylee J. Cook, Elizabeth A. Ankrah, Jesus A. Beltran, Franceli L. Cibrian, Kimberley D. Lakes, Hanna Mofid, Lucretia Williams, Gillian R. Hayes

Engineering Faculty Articles and Research

To address the need for interventions targeting social emotional development and mental health of young children in South Africa, the Mazi Umntanakho (‘know your child’) digital tool was co-designed, and piloted with caregivers and 3–5-year-old children involved in home visiting programmes promoting early childhood development. The aim of this study was to qualitatively evaluate the feasibility and acceptability of this tool in four urban and four rural low-income communities, from the perspective of home visitors and caregivers. Focus groups were conducted with home visitors (n = 117) and caregivers (n = 72). Issues relating to the feasibility of …

What Factors Influenced Covid-19 Vaccine Hesitancy? Evidence From Social Media, Huseyin Zeyd Koytak

Population Health Research Brief Series

Vaccine hesitancy is one of the most significant threats to global public health efforts. Despite the rapid development and deployment of effective vaccines, resistance to vaccination has persisted in many communities, undermining collective immunity and prolonging health crises, including most recently the COVID-19 pandemic. This brief summarizes findings from a study that used data from over 50 million tweets (later rebranded as X) from 2020 to 2022 to investigate the patterns, justifications, and socioeconomic roots of vaccine hesitancy in the United States. The authors find that Twitter users in states with lower levels of education, higher poverty and unemployment rates, …

Genome-Wide Association Study Reveals Shared And Distinct Genetic Architecture Of Fatty Acids And Oxylipins In The Hispanic Community Health Study/Study Of Latinos, Carolina G Downie, Heather M Highland, Mona Alotaibi, Barrett M Welch, Annie Green Howard, Susan Cheng, Nick Miller, Mohit Jain, Robert C Kaplan, Adam G Lilly, Tao Long, Tamar Sofer, Bharat Thyagarajan, Bing Yu, Kari E North, Christy L Avery

Faculty, Staff and Student Publications

Bioactive fatty acid-derived oxylipin molecules play key roles mediating inflammation and oxidative stress. Circulating levels of fatty acids and oxylipins are influenced by environmental and genetic factors; characterizing the genetic architecture of bioactive lipids could yield new insights into underlying biology. We performed a genome-wide association study (GWAS) of 81 fatty acids and oxylipins in 11,584 Hispanic Community Health Study/Study of Latinos (HCHS/SOL) participants with genetic and lipidomic data measured at study baseline (58.6% female, mean age = 46.1 years (standard deviation 13.8)). Additionally, given the effects of central obesity on inflammation, we examined interactions with waist circumference using two-degree-of-freedom …

Disrupted Relatedness And Shifting Perceptions Of Others: Changing Moods Over Time For People Diagnosed With Bipolar Disorder, Joanna Farr, Jonathan A. Smith, John E. Rhodes

The Qualitative Report

For people diagnosed with bipolar disorder, the relationship between mood episodes and interpersonal life is critical. Yet little is known about how their experience of other people changes during and between episodes of depression and mania. This longitudinal study aimed to investigate the experience of interpersonal change during depression, mania and euthymia (stability). Semi-structured interviews were conducted with three women at two time points and were analysed using longitudinal interpretative phenomenological analysis. One longitudinal theme, “Changing sense of others impacts relatedness,” demonstrates profound changes in participants’ experiences of other people within and between episodes. During depression, participants experienced other people …

Autoethnographic Action Research As A Contemplative Practice: Awareness And Transformation Of Inner And Outer Selves, Jiju Varghese, Bal Chandra Luitel, Niroj Dahal

The Qualitative Report

Contemplation as a spiritual practice has taken various forms across different religious traditions and regions worldwide. Over the years, various contemplative practices have evolved and become popular even outside religious traditions to promote the well-being of all for inner and outer selves’ transformation. In education, many scholars worldwide have expounded on the benefits of contemplative practices in the classroom for students and teachers. Contemplative practices have penetrated research practices in the form of contemplative inquiry considering performative, philosophical, and artistic transformations, where researchers enter into a deep, thoughtful, and reflective introspective journey to see the connection between what is seen …

Covid-19 Vaccine Hesitancy Among Black Women In The Us, Brittany C Slatton, Farrah G Cambrice, Serwaa S Omowale

Faculty, Staff and Student Publications

IMPORTANCE: COVID-19 vaccine hesitancy among Black women is a critical public health concern, potentially exacerbating existing health disparities and impacting community-wide vaccination efforts.

OBJECTIVE: To explore the factors associated with COVID-19 vaccine hesitancy among Black women in the US and identify the specific concerns and experiences shaping hesitant attitudes toward vaccination.

DESIGN, SETTING, AND PARTICIPANTS: Qualitative study using in-depth, semistructured interviews conducted virtually between June and November 2021. Thematic analysis was used to identify key themes from the interview data. Participants were recruited through social media platforms and word-of-mouth referrals from various regions of the US. Interviews were conducted remotely …

Suicide Exposure In The Army National Guard: A Three Manuscript Dissertation, Rebecca Willis-Nichols

Theses and Dissertations--Social Work

Between 2000-2022, the U.S. suicide rate increased 36% with one death now occurring every 11 minutes (CDC, 2024). Despite the Department of Defense making a concerted effort to curb the suicide increases in their ranks, the rates have continued to rise. Active-duty component rates have slowly increased since 2011 while reserve and guard components have held steady (U.S. Department of Defense, 2023). After adjusting for age, the suicide rate in the veteran population was 57% greater than the civilian population in 2020 (CDC, 2024). There is a need for a better understanding of the impact of these deaths and the …