Medicine and Health Sciences Commons^™

The Impact Of Race On Pancreatic Cancer Treatment And Survival In The Nationwide Veterans Affairs Healthcare System, Natalia Khalaf, Ann Xu, Theresa Nguyen Wenker, Jennifer R Kramer, Yan Liu, Hardeep Singh, Hashem B El-Serag, Fasiha Kanwal

Faculty, Staff and Students Publications

OBJECTIVES: Among patients with pancreatic cancer, studies show racial disparities at multiple steps of the cancer care pathway. Access to healthcare is a frequently cited cause of these disparities. It remains unclear if racial disparities exist in an integrated, equal access public system such as the Veterans Affairs healthcare system.

METHODS: We identified all patients diagnosed with pancreatic adenocarcinoma in the national Veterans Affairs Central Cancer Registry from January 2010 to December 2018. We examined the independent association between race and 3 endpoints: stage at diagnosis, receipt of treatment, and survival while adjusting for sociodemographic factors and medical comorbidities.

RESULTS: …

Achieving Surgical, Obstetric, Trauma, And Anesthesia (Sota) Care For All In South Asia, Siddhesh Zadey, Shirish Rao, Isha Gondi, Natalie Sheneman, Chaitrali Patil, Anveshi Nayan, Himanshu Iyer, Arti Raj Kumar, Arun Prasad, G Allen Finley, Chellapuram Raja Krishna Prasad, Chintamani, Dhananjaya Sharma, Dhruva Ghosh, Gnanaraj Jesudian, Irum Fatima, Jogi Pattisapu, Justin Sangwook Ko, Lovenish Bains, Mashal Shah, Mohammed Shadrul Alam, Narmada Hadigal, Naveen Malhotra, Nilmini Wijesuriya, Prateek Shukla, Sadaf Khan, Sunil Pandya, Tariq Khan, Tashi Tenzin, Venkat Raja Hadiga, Daniel Peterson

Faculty, Staff and Students Publications

South Asia is a demographically crucial, economically aspiring, and socio-culturally diverse region in the world. The region contributes to a large burden of surgically-treatable disease conditions. A large number of people in South Asia cannot access safe and affordable surgical, obstetric, trauma, and anesthesia (SOTA) care when in need. Yet, attention to the region in Global Surgery and Global Health is limited. Here, we assess the status of SOTA care in South Asia. We summarize the evidence on SOTA care indicators and planning. Region-wide, as well as country-specific challenges are highlighted. We also discuss potential directions-initiatives and innovations-toward addressing these …

An Examination Of Coping Resources And Strategies Among Appalachian Transgender And Gender Nonconforming Adults And Youth, Zachary Ramsey

Graduate Theses, Dissertations, and Problem Reports (ETD)

Background. The body of literature shows that TGNC adults and youth face a multitude of health disparities (e.g., depression, anxiety, suicidal ideation, eating disorders, body dysmorphia) due to their marginalization. Neither Meyer’s Minority Stress Model nor Testa’s Gender Minority Stress and Resilience Model sufficiently examines coping and the ways it interacts with other concepts within the model. Aims. The objective of this dissertation was to examine the coping resources and strategies of Appalachian transgender and gender nonconforming individuals. The three aims of this study were to: 1) evaluate the relationship of coping resources and strategies between TGNC Youth and cisgender …

An Appalachian Perspective On Suicide: A Focus On West Virginia’S Unique Context, Erin Delaney Caswell

Graduate Theses, Dissertations, and Problem Reports (ETD)

INTRODUCTION: The Appalachian region, spanning 13 states from New York to northern Mississippi, experiences the suicide rates in the United States (U.S.), underscoring a public health crisis exacerbated by persistent socioeconomic challenges. West Virginia (WV), the only state entirely within Appalachia, serves as a focal point for understanding the broader suicide crisis in the region, as WV has the highest suicide rates in the region. Moreover, the state has several unique socioeconomic factors, like increased poverty, lower educational attainment, limited access to healthcare, and a high prevalence of chronic pain and substance that may contribute to elevated rates of suicide. …

Ecology Of Emergency Care In Lower-Tier Healthcare Providers In Ghana: An Empirical Data-Driven Bayesian Network Analytical Approach, Ebenezer Afrifa-Yamoah, Victor F. Nunfam, Bernard A. Kwanin, Kwasi Frimpong

Research outputs 2022 to 2026

The healthcare landscape in Ghana is primarily composed of lower-tier providers, which serve as the initial point of contact for most medical emergencies. This study aimed to assess the emergency care preparedness and readiness of primary healthcare providers using a robust evaluation approach. A multicentre retrospective cross-sectional study was conducted on 460 healthcare facilities using the standardised Health Facilities Emergency Preparedness Assessment Tool (HeFEPAT). Data were analysed via Bayesian Belief network. Emergency preparedness was associated with facility location, type, ownership, and in-charge personnel. Over 70% of facilities lacked specialised emergency/critical care personnel. Although 65% of in-charges reported protocol knowledge, only …

The Effects Of Alcohol Consumption On Cognitive Decline, Ashley Highland

Graduate Research Papers

The purpose of this study was to examine the relationship between alcohol use and cognitive decline among young adults. This study is a quantitative study in which secondary data was used as a means to gather information from the 2022 Behavioral Risk Factor Surveillance System (BRFSS) database. In this study, the researcher analyzed the data using descriptive statistics and inferential statistics, such as independent sample t-test, correlations analysis, ANOVA, and Chi-Square test. The findings in this research revealed that there is a significant relationship between cognitive decline and binge drinking in young adults. Meaning, young adults who binge drink are …

Patient Perceptions On The Advancement Of Noninvasive Prenatal Testing For Sickle Cell Disease Among Black Women In The United States, Shameka P Thomas, Faith E Fletcher, Rachele Willard, Tiara Monet Ranson, Vence L Bonham

Center for Medical Ethics and Health Policy Staff Publications

Background: Noninvasive prenatal testing (NIPT) designed to screen for fetal genetic conditions, is increasingly being implemented as a part of routine prenatal care screening in the United States (US). However, these advances in reproductive genetic technology necessitate empirical research on the ethical and social implications of NIPT among populations underrepresented in genetic research, particularly Black women with sickle cell disease (SCD).

Methods: Forty (N = 40) semi-structured interviews were conducted virtually with Black women in the US (19 participants with SCD; 21 participants without SCD) from June 2021 to January 2022. We employed a qualitative approach to examine the …

High-Risk Individuals And Naloxone Use: Implications For Thn Programs In Rural Appalachian Communities, Victor Garcia, Lisa Mccann, Erick Lauber, Christian Vaccaro, Melissa Swauger, Alex Daniel Heckert

Journal of Appalachian Health

Introduction: Take-home naloxone (THN) is being made available across rural Appalachia to curb opioid overdose fatalities. Despite this initiative, some opioid users do not possess naloxone, and if they do, do not administer it to others.

Purpose: Research findings on risk factors that contribute to opioid overdose are presented. These factors, identified in a sample of 16 overdose cases, are (1) early onset age of opioid use; (2) progressive opioid use; (3) a transition from pain medication to heroin and fentanyl; (4) fears of being arrested at a naloxone intervention if first responders are contacted, and (5) limited knowledge of …

Changes In Perceptions Of First Responders After Witnessing A Drug Overdose: Individual And Contextual Variations Among People Who Use Opioids In West Virginia, Kathleen L. Egan, Kelly Gurka, Alexandria Macmadu, Herb Linn

Journal of Appalachian Health

Introduction: Success of opioid overdose interventions involving first responders is dependent on the comfort level that bystanders have with first responders and their willingness to call for assistance. Positive or negative experiences with first responders following witnessing an overdose may influence a person’s willingness to call a first responder for assistance in the future.

Purpose: The objective of this study was to examine changes in bystanders’ perceptions of first responders following witnessing an overdose attended by emergency medical services or a law enforcement official. It specifically explored perception changes among a sample of individuals residing in Appalachia who use prescription …

Disparities In Mortality Between Appalachian And Non-Appalachian Regions Of Kentucky, Sonali S. Salunkhe, Sahal Alzahrani, Beatrice Ugiliweneza

Journal of Appalachian Health

Introduction: In the opioid epidemic, the U.S. faces a significant public health crisis, with some areas of the country, such as rural and Appalachian regions, suffering more than others. The differential regional impact of the crisis in Kentucky—a state with both non-metropolitan/metropolitan and Appalachian/Non-Appalachian statuses—has not yet been documented despite such knowledge being essential to the success of overdose prevention efforts.

Purpose: This study compares all-cause, drug- and opioid-related mortality between counties in different regions of Kentucky: Appalachian non-metropolitan, Appalachian metropolitan, non-Appalachian non-metropolitan, and non-Appalachian metropolitan.

Methods: Age-adjusted mortality data from the Centers for Disease Control and Prevention’s Wide-ranging Online …

Assessing And Addressing The Determinants Of Appalachian Population Health: A Scoping Review, David L. Driscoll, Hannah O'Donnell, Maitri Patel, David C. Cattell-Gordon

Journal of Appalachian Health

Introduction: Residents of Appalachia experience elevated rates of morbidity and mortality compared to national averages, and these disparities are associated with inequitable exposures to various determinants of population health. Social and environmental determinants of health are a useful lens through which to develop and evaluate programs to mitigate regional health disparities.

Methods: This 2023 scoping review was conducted of studies linking determinants of Appalachian health with leading causes of regional mortality and morbidity. The search strategy employed a keyword search that included geographic terms for the Appalachian Region and the primary adverse health outcomes in that region. Studies meeting the …

Review Of: Coal, Cages, Crisis: The Rise Of The Prison Economy In Central Appalachia, Ted Olson Phd

Journal of Appalachian Health

Ted Olson, PhD, is a professor of both Appalachian Studies and Bluegrass, Old-Time and Roots Music Studies at East Tennessee State University. In this piece, he reviews Professor Judah Schept's Coal, Cages, Crisis: The Rise of the Prison Economy in Central Appalachia and discusses the impacts of incarceration on the health of Appalachia and on its residents more broadly.

Reducing Food Scarcity: The Benefits Of Urban Farming, S.A. Claudell, Emilio Mejia

Journal of Nonprofit Innovation

Urban farming can enhance the lives of communities and help reduce food scarcity. This paper presents a conceptual prototype of an efficient urban farming community that can be scaled for a single apartment building or an entire community across all global geoeconomics regions, including densely populated cities and rural, developing towns and communities. When deployed in coordination with smart crop choices, local farm support, and efficient transportation then the result isn’t just sustainability, but also increasing fresh produce accessibility, optimizing nutritional value, eliminating the use of ‘forever chemicals’, reducing transportation costs, and fostering global environmental benefits.

Imagine Doris, who is …

The Overture! Then Is Here-And-Now: Hindsight Is Twenty, Twenty?, Elena Kydd

Music Therapy Theses

My existence and presence as a Black woman and graduate scholar in music therapy have allowed me to share my experience of racial trauma and oppression in the hallways of GCSU’s music therapy program. Autoethnography is the method I use to write my thesis on the relationships between Blackness, pedagogy, and music therapy. Thus, I perform an evocative autoethnographic study that allows me to share my personal experience of racial trauma and oppression within the culture of music therapy and to critique the larger social structures of whiteness that disenfranchise and dominate me and other Black student music therapists (SMTs). …

Bridging The Gap: Reducing Disparities In Reproductive Healthcare For Black And White Women, Emma Weiden

Population Health Research Brief Series

A woman’s reproductive healthcare experience in the United States can vary dramatically depending on her race. In 2020, the pregnancy-related mortality rate in the U.S. was 40.8 deaths per 100,000 live births for Black women, which is more than three times the rate among White women (12.7 per 100,000). This brief summarizes disparities in reproductive healthcare outcomes for Black women compared to White women in the U.S., advocates for policy changes, and provides recommendations for addressing racial disparities to create more equitable reproductive healthcare.

Study Protocol For A Randomized Controlled Trial Of Realconsent2.0: A Web‑Based Intervention To Promote Prosocial Alcohol‑Involved Bystander Behavior In Young Men, Laura F. Salazar, Dominic J. Parrott, David Dilillo, Sarah J. Gervais, Anne Marie Schipani‑Mclaughlin, Ruschelle Leone, Kevin Swartout, Lauren Simpson, Renita Moore, Tiffany Wilson, Nyla Flowers, Haley Church, Amanda Baildon

Department of Psychology: Faculty Publications

Background Sexual violence (SV) is a significant, global public health problem, particularly among young adults. Promising interventions exist, including prosocial bystander intervention programs that train bystanders to intervene in situations at-risk for SV. However, these programs suffer from critical weaknesses: (1) they do not address the proximal effect of alcohol use on bystander decision-making and (2) they rely on self-report measures to evaluate outcomes. To overcome these limitations, we integrate new content specific to alcohol use within the context of prosocial bystander intervention into an existing, evidence-based program, RealConsent1.0. The resulting program, RealConsent2.0, aims to facilitate bystander behavior …

Learning From Women Veterans Who Navigate Invisible Injuries, Caregiving, And Reintegration Challenges, Nicholas A. Rattray, Diana Natividad, Katrina Spontak, Marina Kukla, Ai Nghia L. Do, Leah Danson, Richard M. Frankel, Gala True

School of Medicine Faculty Publications

Background: As women comprise a greater proportion of military service members, there is growing recognition of how their experiences in the early phase of military to civilian transitions have an important influence on their health and reintegration outcomes. Qualitative accounts of women veterans can inform programs that support transitioning service members. Objectives: We examined narratives of civilian reintegration among women veterans to understand their experiences of adjusting to community life while coping with mental health challenges. Methods/Participants: We interviewed 16 post-911 era women who were within 5 years of separating from military service and developed a case study based on …

Reimagining A Caregiver-Friendly Society, Jodi L. Southerland

Journal of Appalachian Health

Demographic aging is accelerating in the Appalachian Region, resulting in a growing proportion of caregivers living in areas that lack services to support their needs. Strategies are urgently needed in Appalachia to address deficiencies in the region’s long-term supports and services for older adults and their caregivers. Strengthening equitable access to care and community supports for family caregivers is a policy priority for state and community leaders in Appalachia.

Moral Injury, Identity Dissonance, And Reintegration: A Compendium Of Reintegration And Survey Of United States Military Veterans, Thomas Hodges

Doctor of International Conflict Management Dissertations

How do military moral injuries affect reintegration? All service members leave the military eventually, but reintegration can be challenging, bringing changes in career, family life, and friendships, potentially prompting a loss of purpose, drive, and connection. Service members may also struggle with a crisis of identity upon separating from the military, feeling their military identity is incompatible with civilian life. While these difficulties are common for service members in reintegration, they may be worsened by moral injury, the adverse biological, social, psychological, and spiritual effects of experiencing an event that deeply offends a person’s sense of right and wrong. People …

Polisci 3210f: Feasibility Of A National Disability Insurance Plan (Ndip) In Canada, Twana Hassan, Aditi Priya, Dylan Poole, Samantha Rubin, Ethan Chen

Community Engaged Learning Final Projects

This research report presents an overview of the feasibility and reliability of a National Disability Insurance Plan (NDIP) in Canada. Several Global North countries are leading the way in disability legislation and disability funding in comparison to Canada's inaction on the matter. A National Disability Insurance Plan in Canada will have social and economic benefits for everyone in Canada. The report concluded that Canada is capable of implementing a NDIP and doing so is the right choice.

The Public Performativity Of Trust, Lynette Hammond Gerido

Faculty Scholarship

Building trust between academic medical centers and certain communities they depend on in the research process is hard, particularly when those communities consist of minoritized or historically marginalized populations. Some believe that engagement activities like the creation of advisory boards, town halls, or a research workforce that looks more like community members will establish or reestablish trust between academic medical centers and racialized communities. However, without systematic approaches to dismantle racism, those well-intended actions become public performativity, and trust building will fail. In this essay, we draw upon foundational ethical principles of trust, distrust, and trust building; apply the concept …

Poetic Representations Of Covid-19 Narratives: An Exploration Of Emotional Experiences During The Pandemic, Isha Harshe, Lindy Davidson

The Qualitative Report

In pivotal moments of history like the COVID-19 pandemic, it is critical to attend to and preserve the stories of different people experiencing the same phenomenon in their own ways. This project analyzed the public’s emotional experiences during the pandemic using methods of narrative and poetic inquiry. After reading 105 entries from the Pandemic Journaling Project, an online platform where people anonymously published journal entries reflecting on their pandemic experiences, narratives were categorized based on ten prominent emotional themes: anger, anxiety, fatigue, fear, loneliness, longing, loss, loss of control, stress, and uncertainty. Found poems were constructed for each emotion …

Insights From Obstetric Providers And Emergency Medical Technicians On Determinants Of Maternal Morbidity And Mortality Among Underserved, Rural Patients In The United States, Anna Hansen, Nancy Schoenberg, Carrie B. Oser

UK CARES Faculty Publications

Over the past two decades, individuals in the United States (US) have faced a steadily increasing risk of experiencing severe morbidities attributable to pregnancy and dying from pregnancy-related causes. The prevalence of severe maternal morbidity (SMM), defined as the occurrence of end-organ damage in the mother encompassing unexpected outcomes of labor and delivery, has nearly tripled since the turn of the 21st century (Creanga et al., 2014; Neggers, 2016). The prevalence of pregnancy related mortality (PRM), defined as the death of a woman during or within one year of pregnancy due to pregnancy-related complications or aggravated preexisting conditions, has nearly …

The Use Of Deception In Dementia-Care Robots: Should Robots Tell "White Lies" To Limit Emotional Distress?, Samuel R. Cox, Grace Cheong, Wei Tsang Ooi

ROSA Journal Articles and Publications

With projections of ageing populations and increasing rates of dementia, there is need for professional caregivers. Assistive robots have been proposed as a solution to this, as they can assist people both physically and socially. However, caregivers often need to use acts of deception (such as misdirection or white lies) in order to ensure necessary care is provided while limiting negative impacts on the cared-for such as emotional distress or loss of dignity. We discuss such use of deception, and contextualise their use within robotics.

Analysis Of Non-Kinship Foster Parent Training Needs And Their Support Of Foster Youth: An Occupational Therapy Perspective, Mackenzie King, Pam Kasyan-Howe, Kristin Domville, Amy Paul-Ward

Fall 2023 Virtual OTD Capstone Symposium

This poster discusses the training needs of non-kinship foster parents and how they support the youth in their care. A quantitative survey was used to find relationships between experience fostering and foster parent preparedness or desire for additional training. The survey also included a section for participants to write down their training needs; themes from this question are found on the poster. The poster further discusses future recommendations and implications for OT practice in working with this population.

The Impact Of The Covid-19 Pandemic On The Well-Being Of People Incarcerated In United States Prisons, Kimberly Rivera

Department of Sociology: Dissertations, Theses, and Student Research

The COVID-19 pandemic has negatively impacted the population as a whole. However, the incarcerated population (which also experiences a variety of health disparities) has been disproportionately affected by the pandemic. Due to overcrowding, poor ventilation, and lack of resources, the incarcerated population already is at a heightened risk for negative health outcomes, made worse by the recent pandemic. To adapt to the rapidly changing conditions during the pandemic in 2020 and into 2022, new safety measures were implemented, but the unintended consequences associated with the implementation of these procedures have yet to be examined empirically. I conducted a qualitative content …

Selecting Patient-Reported Outcome Measures For A Patient-Facing Technology, Priyank Raj, Youmin Cho, Yun Jiang, Yang Gong

Faculty, Staff and Student Publications

OBJECTIVE: This article provides insight into our process and considerations for selecting patient-reported outcome measures (PROMs) designed for self-reporting symptoms and quality-of-life among breast cancer (BCA) patients undergoing oral anticancer agent treatment via a patient-facing technology (PFT) platform.

METHODS: Following established guidelines, we conducted a thorough assessment of a specific set of PROMs, comparing their content to identify the most suitable options for studying BCA patients.

RESULTS: We recommend utilizing the combination of EORTC QLQ-C30 + EORTC QLQ-BR45 as the preferred instrument, especially when developing a dedicated "breast cancer-only" application.

DISCUSSION: When developing and maintaining a dashboard for a PFT …

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

Einstein Health Papers

No abstract provided.

From Vapor To Vice: Unraveling The Links Between Vaping And Traditional Substance Abuse Among Youth, Ayana Powell

Capstone Experience: Master of Public Health

ABSTRACT:

Objective: To evaluate whether vaping or using e-cigarettes is associated with the use of traditional substances, such as cigarettes, alcohol, and marijuana.

Methods: Using data from the Monitoring the Future surveys, a multivariable logistic regression model was performed, and prevalent odds ratio were calculated to evaluate the association between vaping and traditional substances.

Results: Vaping use among U.S. adolescents and teenagers was found to be an associated with use of traditional substances (cigarette use [OR]= 6.36 [CI]= 4.84, 8.38; alcohol use [OR]=5.80 [CI]= 5.28, 6.38; and marijuana use [OR]= 7.77 [CI]= 6.95, 8.70).

Conclusion: This study will assist …

Exploring The Mental Health Experience Of Perinatal Military Spouses Based In Sigonella, Italy, Lyndsey Dannenberg

Capstone Experience: Master of Public Health

The perinatal period can have a profound impact on the mental health of women, their infants, and their families, especially when it comes to depression and anxiety disorders. This study aims to delve into the experiences of perinatal mental health among military spouses stationed overseas, on Naval Air Station Sigonella, Italy, and contribute to the limited research on active-duty military spouses and their perinatal mental health while stationed overseas. The research uses a qualitative phenomenological approach, seeking to provide valuable insights into the lived experiences of military spouses and their perinatal mental health. Risk factors associated with perinatal mental illness …