Medicine and Health Sciences Commons^™

Exploration Of Latina/Hispanic Women's Experiences Living With Non-Alcoholic Fatty Liver Disease: A Qualitative Study With Patients In Houston, Natalia I Heredia, Erika Mendoza Duque, Sylvia Ayieko, Amelia Averyt, Lorna H Mcneill, Jessica P Hwang, Maria E Fernandez

Faculty, Staff and Student Publications

OBJECTIVES: A deeper understanding of the lived experiences of Hispanic patients with non-alcoholic fatty liver disease (NAFLD) can help guide the development of behavioral programs that facilitate NAFLD management. This paper explores Hispanic women's experiences living with NAFLD.

DESIGN, SETTING, PARTICIPANTS: We collected brief sociodemographic questionnaires and conducted in-depth interviews with 12 low-income (all had household income ≤USD$55 000 per year) Hispanic women with NAFLD from the Houston area. Transcripts were audio-recorded and transcribed. We developed a coding scheme and used thematic analysis to identify emergent themes, supported by Atlas.ti.

RESULTS: Participants identified physicians as their main information source on …

The Digital Transition: Are Adults Aged 65 Years Or Older Willing To Complete Online Forms And Questionnaires In Patient Portals?, Nancy P Gordon, Sherry Zhang, Joan C Lo, Christina F Li

Faculty, Staff and Student Publications

INTRODUCTION: Patients are being encouraged to complete forms electronically using patient portals rather than on paper, but willingness of older adults to make this transition is uncertain.

METHODS: The authors analyzed data for 4105 Kaiser Permanente Northern California 2020 Member Health Survey respondents aged 65-85 years who answered a question about willingness to complete online forms and questionnaires using a patient portal. Data weighted to the Kaiser Permanente Northern California membership were used to estimate percentages of older adults willing to complete patient portal forms and questionnaires. Chi-square tests and log-Poisson regression models that included sociodemographic, internet use, and patient …

An Exposome Atlas Of Serum Reveals The Risk Of Chronic Diseases In The Chinese Population, Lei You, Jing Kou, Mengdie Wang, Guoqin Ji, Xiang Li, Chang Su, Fujian Zheng, Mingye Zhang, Yuting Wang, Tiantian Chen, Ting Li, Lina Zhou, Xianzhe Shi, Chunxia Zhao, Xinyu Liu, Surong Mei, Guowang Xu

Faculty, Staff and Student Publications

Although adverse environmental exposures are considered a major cause of chronic diseases, current studies provide limited information on real-world chemical exposures and related risks. For this study, we collected serum samples from 5696 healthy people and patients, including those with 12 chronic diseases, in China and completed serum biomonitoring including 267 chemicals via gas and liquid chromatography-tandem mass spectrometry. Seventy-four highly frequently detected exposures were used for exposure characterization and risk analysis. The results show that region is the most critical factor influencing human exposure levels, followed by age. Organochlorine pesticides and perfluoroalkyl substances are associated with multiple chronic diseases, …

Close Contacts Of Xenograft Recipients: Ethical Considerations Due To Risk Of Xenozoonosis, Daniel J Hurst, Luz Padilla, Daniel Rodger, Tamar Schiff, David K C Cooper

Rowan-Virtua School of Osteopathic Medicine Departmental Research

With decades of pre-clinical studies culminating in the recent clinical application of xenotransplantation, it would appear timely to provide recommendations for operationalizing oversight of xenotransplantation clinical trials. Ethical issues with clinical xenotransplantation have been described for decades, largely centering on animal welfare, the risks posed to the recipient, and public health risks posed by potential spread of xenozoonosis. Much less attention has been given to considerations relating to potentially elevated risks faced by those who may care for or otherwise have close contact with xenograft recipients. This paper examines the ethical and logistical issues raised by the potential exposure to …

U.S. Military Veteran Identity And Civilian Adjustment, Darren A. Sosa

Pacific Journal of Health

U.S. military veterans transitioning back into the civilian sector often experience a variety of challenges and need to readjust into non-military environments. In order to examine the psychological challenges involved in the transition and readjustment processes among U. S. active military veterans, a qualitative study was conducted. For 6 months, data was collected from veterans in California, Nevada, Texas, Florida, and New York. Following an IRB approval, semi-structured open-ended self-developed interviews were developed and conducted with sixteen military veterans who have served in 4 branches of the U.S. Armed Forces: Army, Navy, Air Force, and Marine Corps. Data and information …

How To Develop A Qualitative Evaluation Plan For A Complex National Intervention: Key Steps And Reflections From The Radx-Up Program, Shelly A. Maras, Josephine Mckelvy, Kelley Milligan, Allyson Kelley, Valerie A. Lucas, Tara Carr, Abisola Osinuga, Leah Frerichs, Gaurav Dave

The Qualitative Report

This article describes the formative process of developing and implementing a Qualitative Evaluation Plan (QEP) for a large-scale, National Institute of Health (NIH) supported program: Rapid Acceleration of Diagnostics — Underserved Populations (RADx-UP). RADx-UP includes over 137 projects in the United States that aim to ensure that all Americans have access to timely, accurate diagnostics for COVID-19, with a specific focus on populations the pandemic disproportionately affects. As part of a comprehensive, mixed-methods strategic evaluation plan, our team developed the QEP. We employed qualitative methods to understand RADx-UP academic and community partners’ experiences implementing community-engaged research strategies, and to understand …

How Can Generative Ai (Genai) Enhance Or Hinder Qualitative Studies? A Critical Appraisal From South Asia, Nepal, Niroj Dahal

The Qualitative Report

Qualitative researchers can benefit from using generative artificial intelligence (GenAI), such as different versions of ChatGPT—GPT-3.5 or GPT-4, Google Bard—now renamed as a Gemini, and Bing Chat—now renamed as a Copilot, in their studies. The scientific community has used artificial intelligence (AI) tools in various ways. However, using GenAI has generated concerns regarding potential research unreliability, bias, and unethical outcomes in GenAI-generated research results. Considering these concerns, the purpose of this commentary is to review the current use of GenAI in qualitative research, including its strengths, limitations, and ethical dilemmas from the perspective of critical appraisal from South Asia, Nepal. …

Early Life Experiences As Later Life Predictors For Criminality: Examination Of Public Criminal Records., Juliana S. Bastien

College of Arts & Sciences Senior Theses

Crime's detrimental impact on society, victims, families, and the justice system is undeniable. Thus, identifying factors that contribute to the perpetration of crime is essential to reduce the public health impact of crime. Adverse Childhood Experiences (ACEs) are frequently found in community samples and are consistently associated with physical, psychological, and behavioral consequences. Research suggests that negative childhood experiences contribute to maladaptive behaviors, including delinquency and perpetration of crime later in life (Perez et al., 2018). The present study's purpose is to identify specific childhood experiences associated with criminality. The data presented on criminality and ACEs was collected from recruited …

The Adverse Childhood Experiences Identification Gap In Speech Language Pathology, Mallory Prior

College of Education and Human Sciences: Dissertations, Theses, and Student Research

Children exposed to adverse childhood experiences, a variety of potentially traumatic events occurring within the first 18 years of life, are at increased risk for speech and language disorders. Due to the high prevalence of trauma and its lasting effects, it is almost guaranteed that children who are experiencing the ongoing effects from adversity will be found on practicing Speech Language Pathologists’ caseloads. This scoping review was designed to identify current screening practices of Speech Language Pathologists (SLP) in comparison to other professionals (e.g., allied health and education), as well as additional information related to screening procedures for SLPs. The …

The Great Resignation: Narratives Of Mid-Career Teacher Burnout And Attrition, Nicole Burton

Dissertations and Doctoral Documents, University of Nebraska-Lincoln, 2023–

The COVID-19 pandemic has increased the issues of teacher attrition. According to the U.S. Bureau of Labor and Statistics, from January to November 2021, there was a 40% increase in the quit levels of teachers within the state and local education agencies (John, 2022). While prior research has examined early-career teachers leaving the profession, mid-career teachers have largely been left out of the conversation. This narrative inquiry investigates the reasons that mid-career teachers are leaving the profession. Semi-structured interviews were conducted with four mid-career teachers hailing from the Midwest region. Interviews focused on understanding how teachers have experienced stress and …

The Accuracy Of Anal Self- And Companion Exams Among Sexual Minority Men And Transgender Women: A Prospective Analysis, Alan G Nyitray, Timothy L Mcauliffe, Cameron Liebert, Michael D Swartz, Ashish A Deshmukh, Elizabeth Y Chiao, Lou Weaver, Ellen Almirol, Jared Kerman, John A Schneider, J Michael Wilkerson, Lu-Yu Hwang, Derek Smith, Aniruddha Hazra

Faculty, Staff and Student Publications

BACKGROUND: Squamous cell carcinoma of the anus (SCCA) annual incidence among sexual minority men with and without HIV is 85/100,000 and 19/100,000 persons, respectively, which is significantly higher than the overall incidence (2/100,000). Incidence may also be higher in transgender women. Since SCCA tumours average ≥30 mm at diagnosis, we assessed the accuracy of individuals to self-detect smaller anal abnormalities.

METHODS: Using convenience sampling, the study enrolled sexual minority men and transgender women, aged 25-81 years, in Chicago, Illinois and Houston, Texas, USA, during 2020-2022. Individuals were taught the anal self-examination and anal companion examination (ASE/ACE). Then, a clinician performed …

Quality Indicators In Surgical Oncology: Systematic Review Of Measures Used To Compare Quality Across Hospitals, Megan Mcleod, Kari Leung, C S. Pramesh, Peter Kingham, Miriam Mutebi, Julie Torode, Andre Ilbawi, Jade Chakowa, Richard Sullivan, Ajay Aggarwal

General Surgery, East Africa

Background: Measurement and reporting of quality indicators at the hospital level has been shown to improve outcomes and support patient choice. Although there are many studies validating individual quality indicators, there has been no systematic approach to understanding what quality indicators exist for surgical oncology and no standardization for their use. The aim of this study was to review quality indicators used to assess variation in quality in surgical oncology care across hospitals or regions. It also sought to describe the aims of these studies and what, if any, feedback was offered to the analysed groups.

Methods: A literature search …

Trends In Sleep Duration In The Us From 2004 To 2018: A Decomposition Analysis, Jiahui Xu, Liying Luo, Alyssa Gamaldo, Ashton Verdery, Melissa Hardy, Orfeu M Buxton, Qian Xiao

Faculty, Staff and Student Publications

Average sleep duration in the United States declined in recent years, and the decline may be linked with many biopsychosocial factors. We examine how a set of biopsychosocial factors have differentially contributed to the temporal trends in self-reported sleep duration across racial groups between 2004-2005 and 2017-2018. Using repeated nationally representative cross-sections from the National Health Interview Survey, we decompose the influence of biopsychosocial factors on sleep duration trends into two components. One component corresponds to coefficient changes (i.e., changes in the associations between behaviors or exposures and sleep duration) of key biopsychosocial factors, and the other part accounts for …

Integrating Primary Care, Shared Decision Making, And Community Engagement To Facilitate Equitable Access To Multi-Cancer Early Detection Clinical Trials, Cheryl L. Thompson, Adam H. Buchanan, Ronald E. Myers, David S. Weinberg

Department of Medical Oncology Faculty Papers

Effective implementation of cancer screening programs can reduce disease-specific incidence and mortality. Screening is currently recommended for breast, cervical, colorectal and lung cancer. However, initial and repeat adherence to screening tests in accordance with current guidelines is sub-optimal, with the lowest rates observed in historically underserved groups. If used in concert with recommended cancer screening tests, new biospecimen-based multi-cancer early detection (MCED) tests could help to identify more cancers that may be amendable to effective treatment. Clinical trials designed to assess the safety and efficacy of MCED tests to assess their potential for reducing cancer mortality are needed and many …

Causal Influence Of Linguistic Learning On Perceptual And Conceptual Processing: A Brain-Constrained Deep Neural Network Study Of Proper Names And Category Terms, Phuc T U Nguyen, Malte R Henningsen-Schomers, Friedemann Pulvermüller

Faculty, Staff and Student Publications

Language influences cognitive and conceptual processing, but the mechanisms through which such causal effects are realized in the human brain remain unknown. Here, we use a brain-constrained deep neural network model of category formation and symbol learning and analyze the emergent model's internal mechanisms at the neural circuit level. In one set of simulations, the network was presented with similar patterns of neural activity indexing instances of objects and actions belonging to the same categories. Biologically realistic Hebbian learning led to the formation of instance-specific neurons distributed across multiple areas of the network, and, in addition, to cell assembly circuits …

Infant Mortality Rates Vary Substantially Across Regions Of The United States, Marissa Merrifield

Population Health Research Brief Series

Infant mortality rates are higher in the United States than in its high-income peer countries. Additionally, infant mortality rates vary within the U.S., with much higher rates in some geographic regions compared to others. This data slice uses data from the U.S. Centers for Disease Control and Prevention to compare infant mortality rates by geographic region in the U.S. between 2017-2021. The results show that the infant mortality rate was the highest in the South and lowest in the Northeast and West.

Intersectional Model Of Service Use: Understanding Transgender And Nonbinary Healthcare Access, Jarrod Call, Brendon Holloway

Journal of Social, Behavioral, and Health Sciences

Transgender and nonbinary (TNB) people often have difficulty accessing healthcare services because of the systemic forces of transphobia and cisgenderism. Despite this, there is little theory specifically designed to examine healthcare access among TNB people. We conducted a literature review to identify studies examining TNB healthcare access. We screened a total of 2,050 unique articles for inclusion, resulting in a final sample of 46 articles that met the review criteria. Theories used and key findings were coded to inform the development of the Intersectional Model of Service Use (IMSU) for TNB people. The IMSU builds upon current theoretical frameworks including …

Racial Discrimination, Knowledge, And Health Outcomes: The Mediating Role Of Hepatitis B-Related Stigma Among Patients With Chronic Hepatitis B, Julia G. Katcher, Ann C. Klassen, Hie-Won Hann, Mimi Chang, Hee-Soon Juon

Department of Medical Oncology Faculty Papers

It is well described in current literature that Hepatitis B virus (HBV) affects Asian Americans more than any other racial group in the United States and that there is a stigma attached to this condition. The effects of stigma can be lasting, penetrating physiologically and psychologically, yet few studies have focused on the consequences of this phenomenon. The purpose of this study was to examine the mediating role of stigma in the effect of racial discrimination and knowledge (of HBV sequelae) on health status of Korean Americans with chronic hepatitis B (CHB). Three hundred sixty-five CHB patients were recruited and …

Empowering Spanish Heritage Learners Through A Community Informed, Online Medical Spanish Curriculum, Bonnie C. Holmes Ph.D., Kenneth Rhee Md

11th National Symposium on Spanish as a Heritage Language (Archived)

The lack of standardized medical Spanish curriculum leads to variable content and quality, often neglecting heritage language learners. Also, community engagement efforts seldom extend to curriculum development. Learn about a collaboration between Spanish faculty and a physician to create an innovative, virtual Spanish for healthcare curriculum that addresses these challenges.

What Factors Increase Risk Of Alzheimer's Disease And Related Dementia?, Elizabeth Vásquez, Kai Zhang

Population Health Research Brief Series

Alzheimer’s disease is the most common form of dementia and ranks 7th in the leading causes of death in the United States (U.S.). This data slice uses nationwide data from 3,155 counties in the U.S. to identify the factors that best predict county-level rates of Alzheimer’s Disease and Related Dementias (ADRDs) in 2018. The results indicate that insufficient sleep, consuming less than one serving of fruits and vegetables per day, having no high school diploma, Black population percentage, and social vulnerability were among the leading factors predicting county-level ADRD prevalence.

Lessons From Hospitality: Towards A Hybrid Model Of Senior Living Communities, Yunying Zhong, Tingting Zhang

Rosen Research Review

Old age gets most of us, and how we spend it should be meaningful. The hospitality sector could play a vital role in this regard. Senior living communities are big business in the U.S., but they face demands from residents, and the family and friends who visit them, for more than the traditional focus on healthcare. UCF Rosen College of Hospitality Management researchers, Dr. YunYing Zhong, Dr. Tingting Zhang, and their co-author understand the connection between the senior living community and hospitality sectors; their research is giving impetus to a hybrid model that could benefit both.

Black Women Have The Highest Maternal Mortality Rate In The United States, Tori-Ann Haywood

Population Health Research Brief Series

The U.S. maternal mortality rate is consistently higher than its high-income peer countries. Since 2018 maternal mortality rates in the U.S. have steadily increased for all ethnoracial groups. This data slice uses data from the U.S. National Center for Health Statistics to describe U.S. maternity mortality rates for women ages 15-45 across different ethnoracial groups between 2018-2022. Results show that, except for non-Hispanic (NH) Asian women, ethnoracial minority women have higher maternal death rates than NH White women.

Calming The Body, Calming The Mind: A Pilot Study On The Use Of Zero Balancing To Reduce Anxiety, Misty L. Rhoads, Mary Murphy

Journal of Transformative Touch

Background: The predominance of anxiety is currently at record levels, and the need for non-pharmaceutical approaches to help alleviate and decrease the harmful effects of anxiety on an individual and collective level is necessary. This study explored how Zero Balancing supports individuals with anxiety to manage their physical, mental, and emotional health more effectively. Researchers hypothesized that Zero Balancing would lower the perceived severity of general anxiety and lower perceived anxiety symptoms.

Methods: To honor the holistic nature of bodywork and the participants' lived experiences, the researchers utilized a concurrent mixed-methods phenomenological research design. Each participant received one Zero Balancing …

Real-World Trends, Rural-Urban Differences, And Socioeconomic Disparities In Utilization Of Narrow Versus Broad Next-Generation Sequencing Panels, Yiqing Zhao, Anastasios Dimou, Zachary C Fogarty, Jun Jiang, Hongfang Liu, William B Wong, Chen Wang

Faculty, Staff and Student Publications

UNLABELLED: Advances in genetic technology have led to the increasing use of genomic panels in precision oncology practice, with panels ranging from a couple to hundreds of genes. However, the clinical utilization and utility of oncology genomic panels, especially among vulnerable populations, is unclear. We examined the association of panel size with socioeconomic status and clinical trial matching. We retrospectively identified 9,886 eligible adult subjects in the Mayo Clinic Health System who underwent genomic testing between January 1, 2016 and June 30, 2020. Patient data were retrieved from structured and unstructured data sources of institutional collections, including cancer registries, clinical …

Barriers And Facilitators To Enhance Interprofessional Education For Rehabilitation Science Graduate Students, Mary A. Riopel, Kimberly Wynarczuk, Taylor Grube

The Qualitative Report

Interprofessional education (IPE) aims to develop healthcare practitioners who work effectively in teams, demonstrate strong communication skills, respect others, and have a working knowledge of the roles and responsibilities of other professionals. Of identified research to date, it is unclear what students perceive as important for effective IPE delivery and learning. The purpose of this study was to identify graduate students' perceptions of facilitators and barriers to learning interprofessional practice using phenomenology. Three semi-structured focus groups were conducted including athletic training, occupational therapy, or speech-language pathology students and the transcripts were analyzed using thematic analysis. Four themes emerged about IPE …

A Social Media–Delivered Melanoma Prevention Program For Young Women Engaged In Frequent Uv Tanning: Protocol For A Randomized Controlled Trial, Jerod L. Stapleton, Sharon L. Manne, Sherry L. Pagoto, Allison Leip, Kathryn Greene, Joel Hillhouse, Allison S. Merritt, Brent J. Shelton

UK CARES Faculty Publications

Background: Rates of melanoma have increased dramatically in the United States over the past 25 years, and it has become among the most prevalent cancers for young adult women. Intentional skin tanning leads to a pattern of intense and intermittent UV radiation exposure that is associated with increased risk of melanoma. Frequent tanning is most common among young women and is linked to a variety of sociocultural pressures that negatively impact body image and drive appearance control behaviors. Unfortunately, there are no established interventions designed for frequent tanners. This intervention addresses this gap with unique content informed by body image …

Racial/Ethnic Disparities In The Association Between Patient Care Experiences And Receipt Of Initial Surgical Breast Cancer Care: Findings From Seer-Cahps, Mariana Arevalo, Trevor A Pickering, Sally W Vernon, Kayo Fujimoto, Melissa F Peskin, Albert J Farias

Faculty, Staff and Student Publications

PURPOSE: We determined whether racial/ethnic differences in patient experiences with care influence timeliness and type of initial surgical breast cancer treatment for a sample of female Medicare cancer patients.

METHODS: We conducted a retrospective cohort study using the linked Epidemiology and End Results-Consumer Assessment of Healthcare Providers and Systems (SEER-CAHPS) dataset. The outcomes were: (1) time-to-initial surgical treatment, and (2) type of treatment [breast conserving surgery (BCS) vs. mastectomy]. The indicators were reports of four types of patient experiences with care including doctor communication, getting care quickly, getting needed care, and getting needed Rx. Interaction terms in each multivariable logistic …

An Increase In Food Insecurity Correlated With An Increase In Plasma Triglycerides Among Latinx Children, Keally Haushalter, Marissa Burgermaster, Erin Hudson, Matthew J Landry, Shreela V Sharma, Jaimie N Davis

Faculty, Staff and Student Publications

BACKGROUND: Food insecurity and metabolic diseases both disproportionately affect Hispanic children. Cross-sectional studies have linked food insecurity with adverse cardiometabolic markers, including elevated plasma triglycerides and glucose concentrations. However, the association between changes in food insecurity and changes in cardiometabolic markers in children remains to be explored. Furthermore, few studies have assessed the impact of school-based nutrition interventions on household food insecurity.

OBJECTIVE: The objectives of this study are to assess the effect of the TX Sprouts intervention on household food insecurity and to examine the association between changes in household food insecurity and changes in cardiometabolic markers over 1 …

Profiles Of Activity Engagement And Depression Trajectories As Covid-19 Restrictions Were Relaxed, Jonathan L. Chia, Andree Hartanto, William Tov

Research Collection School of Social Sciences

Given elevated depression rates since the onset of the pandemic and potential downstream implications, this research examined the association between activity engagement and depression among middle-aged and older adults postlockdown. This study aimed to (a) identify activity engagement profiles among middle-aged and older adults, (b) understand factors associated with profile memberships, and (c) compare depression trajectories across profiles as COVID-19 restrictions eased over 16 months in Singapore. This longitudinal study involved 6,568 middle-aged and older adults. Latent growth analysis was first conducted to obtain estimates of depression trajectories for each individual. Latent profile analysis was then conducted to identify different …

Facilitators To Cervical Cancer Screening In A Minority, Urban, Underserved Population, Noel Higgason, Linh Nguyen, Yen-Chi Le, Ogochukwu Juliet Ezeigwe, Tong Han Chung, Natalia Williams, Xochitl K Olguin, Abigail S Zamorano

Faculty, Staff and Student Publications

OBJECTIVES: Cervical cancer has markedly declined due to widespread use of screening, but Hispanic women continue to bear a disproportionate amount of the cervical cancer burden due to under-screening. Previous studies have explored barriers to screening but have failed to identify targetable facilitators in this group. We aimed to assess facilitators to cervical cancer screening among a predominantly urban, Hispanic population who presented to a no-cost, community-based clinic.

METHODS: Patients completed demographic and health information, a validated social determinants of health (SDOH) screen, and a self-reported facilitators survey on factors which enabled them to present to clinic. Descriptive statistics were …