Medicine and Health Sciences Commons^™

From Evidence To Action: Case For Further Investment In Family Planning For Faster Fertility Decline, Population Council Pakistan

Sexual and Reproductive Health, Rights, and Choices

For over three decades, the Population Council Pakistan has generated evidence and supported governments in designing innovative approaches to address population and reproductive health challenges. Building on evidence around fertility transition, reproductive health, and the nationally endorsed Tawazun (balance) narrative, the Population Council supported the Government of Punjab through the FCDO-funded Delivering Accelerated Family Planning in Pakistan (DAFPAK) initiative and other strategic partnerships to implement scalable solutions for strengthening family planning services. This brief outlines five high-impact, proven interventions ready for institutional scale-up and provides an actionable path forward to transform routine health encounters into sustainable health system reforms.

Lower Extremity Muscle Activation In Elite Female Field Hockey Players With And Without Low Back Pain During A Prone Hip Extension, Madison S. Cornell

Masters Theses

Context: Low back pain (LBP) is a common chronic injury seen in field hockey players and more prominent in females than males. The purpose of this study was to identify if bilateral muscle activation differences exist in erector spinae (ES), gluteus maximus (Gmax), and biceps femoris (BF) in collegiate female field hockey players with and without LBP during a prone hip extension (PHE). It was hypothesized that individuals in the LBP group would have decreased Gmax and increased BF activation. Methods: A cohort design was utilized through a convenience sample to analyze variations in the dependent variables (muscle activation, flexibility, …

Exploring Capacity For Future Sustainability Of Healthy Eating Policy, Systems, And Environmental Change Strategies Previously Implemented Through Snap-Ed Programming, Carrie L. Draper, Nicholas Younginer Ph.D.

Faculty Publications

Objective

Design

Setting

Participants

Phenomenon of Interest

Analysis

Results

Neural Correlates Of Recognition Memory And Metamemory In Breast Cancer Survivors: An Event-Related Potential Study, Dishari Zaman Azad

Dissertations, Theses, and Capstone Projects

Breast cancer survivors (BCS) often report noticeable cognitive difficulties despite showing limited impairment on standardized neuropsychological tests. Some have theorized that this is simply an insensitivity of standardized testing to subtle cognitive changes (test-insensitivity hypothesis), whereas others have suggested there are early neural changes that are detected by patients but precede detection by these tests (early signal hypothesis) or that when they achieve normal performance, it is through saliently effortful compensatory processes (compensation hypothesis). The present study tested these theories by assessing metamemory and recognition memory retrieval in BCS and non-cancer controls (NCC) using both behavioral and event-related potential (ERP) …

Practice With Purpose Policy Project: The Pediatric Ng/Og Tube Safety Hierarchy, Caitlin Roush, Christine Hajovsky, Delaney Dewolf, Elizabeth Hernandez, Giselle Daclan, Jay Barber, Kris Noel, Kristen Dickey, Lynde Craig, Madeline Herrera, Margaret Willenburg, Mckenzie Pedigo, Melynda Olguin, Myesha Vines, Rhianna Brard, Teresa Wynee

Practice With Purpose

No abstract provided.

Ebp-Rc Practive With Purpose: Blood Specimen Collection, Katelyn Clark, Sarah Ritchie, Hinal Gandhi, Brady Franklin, Hailey Holt, Melanie Hubbard, Joshua Mckay, Zan Jayroe, Beena Oommen, Dhanu Bhandari, Erin Bullock, Gabriella Wiemann, Janelle Heygster, Juli Nascimento, Olga De Leon, Sharley Magaan, Tara Gunther, Thi Phan

Practice With Purpose

No abstract provided.

Ebp-Rc Practice With Purpose: Blood Specimen Collection From Piv, Katelyn Clark, Sarah Ritchie, Hinal Gandhi, Brady Franklin, Hailey Holt, Melanie Hubbard, Joshua Mckay, Zan Jayroe, Beena Oommen, Dhanu Bhandari, Erin Bullock, Gabriella Wiemann, Janelle Heygster, Juli Nascimento, Olga De Leon, Sharley Magaan, Tara Gunther, Thi Phan

Practice With Purpose

No abstract provided.

Silk Vista Baby Versus Pipeline Embolization Device For Unruptured Distal Anterior Cerebral Artery Aneurysms: A Multicenter Propensity-Weighted Comparative Study., Valerio Da Ros, Frédéric Clarençon, Adam A. Dmytriw, Pascal Jabbour Md, Marios Psychogios, Peter Sporns, Ajit S. Puri, Ameer E. Hassan, Oktay Algin, Markus A. Möhlenbruch, Mauro Bergui, Oded Goren, Gregoire Boulouis, Takeshi Morimoto, Raoul Pop, Joanna Wk Ho, Virginia Pujol Lereis, Jared Cooper, Giancarlo Salsano, Alessandro Sgreccia, Arturo Consoli, Eytan Raz, Julien Burel, Khawaja Muhammad Baqir Hassan, Zhe Ji, Riitta Rautio, Maria Ruggiero, Federico Sabuzi, Stefania Proietti, Joseph Domenico Gabrieli, Michael Levitt, Antonio Armando Caragliano, Christophe Cognard, Gaultier Marnat, Nicola Limbucci, Mariangela Piano, Alexis Guedon, Andrea Romi, Fortunato Di Caterino, Mykola Vyval, Adrien Guenego, Mohamad Abdalkader, Thanh Nguyen, Vitor Mendes Pereira, Ocilio Ribeiro Goncalves, Erwah Kalsoum, Alessandro Pedicelli, Andrea M Alexandre, Luca Scarcia

Department of Neurosurgery Faculty Papers

BACKGROUND: Flow diversion is effective for unruptured distal anterior cerebral artery (DACA) aneurysms, yet comparative data between the Silk Vista Baby (SVB) and Pipeline Embolization Device (PED) in this challenging territory remain scarce.

METHODS: We conducted a retrospective multicenter study using the CRETA Registry, including consecutive patients with unruptured DACA aneurysms treated with SVB or PED. The primary endpoint was complete angiographic occlusion (O'Kelly-Marotta grade D). Secondary outcomes included procedural characteristics, clinical outcome (modified Rankin Scale), and complications. Overlap weighting was applied to account for non-randomized treatment allocation. Predictors of occlusion were explored using penalized logistic regression. A sensitivity analysis …

Structured Telehealth Community Health Worker-Clinician Feedback And Diabetes Outcomes: A Randomized Clinical Trial, Elizabeth Vaughan, Xiaoying Yu, Amber Amspoker, Aanand Naik, Ashok Balasubramanyam, Craig Johnston, Christi Ballantyne, Salim S. Virani, Shelton Brown, Kristina Mena

Population Health, East Africa

Importance  Community health workers (CHWs) improve chronic disease management in underserved populations, but scalable integration strategies are limited.

Objective  To evaluate whether a multidimensional intervention incorporating telementored CHWs and a structured participant-CHW-clinician feedback loop can improve diabetes outcomes.

Design, Setting, and Participants  This 12-month randomized clinical trial was conducted at 3 institutionally and geographically diverse community clinics in Texas between September 1, 2023, and April 30, 2025, and included low-income, uninsured White Hispanic adults with type 2 diabetes identified through clinic databases. Data were analyzed between May 1 and July 31, 2025.

Intervention  Individuals were randomized 1:1 to the intervention …

Family Planning Exemplar Country Selection Methodology: Time Lag And Trends Analysis, Zahid Memon, Abeer Mian, Ira Martopullo, Narjis Hussain, Zeba Sathar, Ali Mohammad Mir, Michael Mbizvo, Marleen Temmerman, Jen Drake, Zulfiqar Bhutta

Centre of Excellence in Women and Child Health

Introduction While many countries achieved notable gains in contraceptive use levels after the 1994 International Conference on Population and Development which redefined family planning (FP) as a human right, there was a long period of 15 years when contraceptive use levels did not receive due attention. It was only later that its subsequent inclusion in the Sustainable Development Goals and the 2012 London Summit on FP renewed global commitment and a focus towards FP. This paper aims to select countries that identify as ‘exemplar’ low-middle-income countries that have achieved exceptional progress in FP. Examining these outliers can uncover actionable drivers …

Mathematical Models Of Multisensory Detection And Decision-Making, Rebecca M. Brady

Doctoral

The brain seamlessly integrates signals from multiple sensory modalities to interpret the world efficiently. By using information from various senses, the brain can enhance its ability to detect and respond to stimuli more quickly and accurately. However, combining sensory cues from multiple modalities is only sometimes beneficial as it may lead to illusions and reduced behavioural performance. Behavioural and electrophysiological experiments have revealed that detection and decision-making strategies for multisensory cues evolve throughout human development and ageing. Additionally, studies have demonstrated that maladaptive multisensory processing is a key indicator of a proclivity to falls in older adults and individuals with …

New Graduate Nurses' Experiences Of Leaving The Emergency Department, Gemma John

Walden Dissertations and Doctoral Studies

No abstract provided.

From Transcriptome To Function: Multimodal Characterization Of Transcriptionally Defined Ventral Tegmental Area Dopamine Neurons, Natalie Dalton Fitzgerald

ETDs from 2020-2029

Substance use disorder is a complex neurobiological disease characterized by impaired control over drug taking and drug seeking. Drugs of abuse exert their reinforcing effects largely through dopaminergic (DAergic) projections from the ventral tegmental area (VTA) to the nucleus accumbens, where all drugs of abuse increase DA transmission. Beyond reward processing and reward learning, the VTA contributes to a range of psychiatric conditions, including schizophrenia and attention-related disorders. Although DA signaling has long been a major focus of addiction research, recent transcriptomic studies have revealed substantial heterogeneity of cell types within the VTA. Previous work from our lab identified two …

Phenome-Wide Association Study Of P2rx7 Identifies Schizophrenia And Mood Disorders As Primary Associated Phenotypes, Ling Zhu, Qiao Mao, Zhixiong Luo, Bin Chen, Yong Zhang, Xiaowei Lu, Ping Liu, Jiawu Ji, Xiaoping Wang, Kesheng Wang Phd, Ma, Bs, Xinghua Pan, Yuping Cao, Na Liu, Jennifer Luo, Lingjun Zuo, Zhiren Wang, Xingguang Luo, Xiaoyun Guo

Faculty Publications

Objectives: P2RX7 has been implicated in bipolar disorder, major depressive disorder, schizophrenia, anxiety disorders, Alzheimer's disease, and Parkinson's disease. However, the specificity and comparability of these as sociations remain unclear. This study aimed to systematically evaluate multiple neuropsychiatric disorders to identify those most robustly associated with P2RX7.

Methods: We analyzed 1861 imputed SNPs spanning the P2RX7 gene in 1,087,925 individuals from 72 inde pendent cohorts across 18 neuropsychiatric disorders. SNP-disease associations were assessed within each cohort, followed by meta-analysis and false discovery rate (FDR) correction to identify significant disease-risk variants. P2RX7 mRNA and protein expression across tissues or cells …

An Aggressive Presentation Of Anti-Melanoma Differentiation-Associated Gene 5 (Mda-5)-Positive Dermatomyositis With Rapidly Progressive Interstitial Lung Disease: A Case Report, Zamanali Khakhar, Shreedhi Patel, Rajiv Patel, Soraiya Manji, Fredrick Otieno, Sayed Karar

Internal Medicine, East Africa

Anti-melanoma differentiation-associated gene 5 (MDA-5) dermatomyositis is an uncommon condition that is frequently complicated by rapidly progressive interstitial lung disease (RP-ILD), resulting in a poor prognosis. Due to its aggressive course, management is often challenging and requires timely interventions to improve outcomes. This case of a female patient with anti-MDA-5-positive DM and RP-ILD aims to document this unique and uncommon condition, its aggressive clinical course, associated complications, diagnostic challenges, and management considerations.

Outgoing President Newman: “The Future Of The Mda Is Defined By All Of Us”, David Foe

The Journal of the Michigan Dental Association

In her final address to the MDA House of Delegates, outgoing President Dr. Cheri Newman reviews the association's progress over the past administrative year. She highlights achievements in strengthening financial stability, advocating for solutions to dental workforce shortages, and expanding community access to care. Newman also discusses the ongoing strategic review of member values and a comprehensive governance review intended to position the association for the future of dentistry. She emphasizes that the organization's strength lies in the collective engagement of its membership.

The Back Page: A Dental Road Trip To The Birthplace Of Fluoridation, Chris Smiley Dds

The Journal of the Michigan Dental Association

This historical feature details a visit by ADA and MDA leadership to the Monroe Avenue Water Filtration Plant in Grand Rapids. The plant achieved international significance on January 25, 1945, when Grand Rapids became the first city in the world to implement community water fluoridation. A subsequent 10-year study showed a 65% reduction in childhood tooth decay, establishing fluoridation as a primary public health measure of the 20th century. The article highlights the facility's legacy as the birthplace of a global health initiative.

Oral Health And Alzheimer’S Disease: The Systemic Connection, Anne O. Rice Bs, Rdh

Metro Denver Dental Society Articulator Magazine

This evidence-based article examines the research connecting oral inflammation and periodontal disease with Alzheimer’s disease and cognitive decline. The author, Anne O. Rice, explores inflammatory, vascular, microbial and airway-related pathways that may contribute to neurodegeneration. Practical applications for dental professionals are highlighted, including blood pressure screening, periodontal therapy, airway assessment and interdisciplinary collaboration. The article positions dentistry as an important contributor to preventive, whole-person healthcare and dementia risk reduction.

Leadership Revisited, Allen Vean Dmd

Metro Denver Dental Society Articulator Magazine

This Reflections examines the importance of communication, collaboration and human connection in dental practice management. Dr. Allen Vean draws parallels between healthcare teams and organizational leadership models, and discusses how trust, morale and team engagement directly impact patient care and practice culture. The article also explores the evolving role of AI and technology in dentistry while emphasizing that human interaction remains essential to long-term success. The author implores dentists to foster stronger team relationships to create patient-centered practice environments.

Screening Tools For Maternal Mental Health In Africa: A Systematic Review, Joyce Jebet, Irene Mageto, Benard Mutwiri, Abednego Ongeso, Ruth Wagathu, Rose Maina, Denis Munene, Kawira Kithuci, Peter Gatiti

School of Nursing & Midwifery, East Africa

Background:

Maternal health during pregnancy and the postnatal period encompasses mental health, which is a key aspect in enhancing a positive outcome. Despite screening for other possible complications during pregnancy and the postnatal period, very little attention has been paid to screening for mental health. Screening is a key tool in early diagnosis and, eventually, timely diagnosis and management in cases where complications arise.

Aim:

This study aimed to assess the available maternal mental health screening tools and compare the outcome on their utilization during pregnancy and postnatal periods in the African continent.

Methodology:

This was a …

Impact Of Institutional Expected Practice Guidelines On Oral And Long-Acting Intravenous Antibiotic Use For Serious Bacterial Infections, William Bradford

ETDs from 2020-2029

Expected practice interventions are a type of antimicrobial stewardship intervention in which local guidelines regarding antimicrobial prescribing are developed and released at an institutional level to establish an institutional standard of care. An expected practice intervention to encourage use of oral and long-acting IV (PO/LAIV) antibiotics for serious infections was performed at the University of Alabama at Birmingham Hospitals in November of 2022. We conducted a quasi-experimental pre/post study using a difference in differences approach to evaluate the effect of these guidelines on a primary outcome of length of stay (LOS) and secondary outcomes of inpatient antibiotic days, 3-month readmission, …

Investigating The Effects Of Increased O-Glcnaylation On Pathology In Alzheimer’S Disease, Melissa Louise Garcia

ETDs from 2020-2029

Alzheimer’s disease (AD) is currently the 7th leading cause of death, with few treatment options. It is known that AD pathology begins 20-30 years before clinical symptoms manifest. Some of the earliest pathological changes occur in glial cells of the hippocampus, causing them to become chronically reactive, as well as the accumulation of Amyloid-β (Aβ) in the hippocampus and hyperphosphorylated Tau (pTau) in the locus coeruleus, resulting in dysfunction of the noradrenergic (NA) system. Preclinical studies have shown promise in the abilities of the post-translational modification O-linked β-N-acetylglucosamine (O-GlcNAc). O-GlcNAc is a tightly regulated reversible enzymatic modification controlled by the …

The Impact Of Economic Stability On Diagnostic Timing Of Autism Spectrum Disorder In Children, Leslie Box Simms

ETDs from 2020-2029

Diagnosis of neurodevelopmental delays in children, including autism spectrum disorder, is an often lengthy and burdensome process, potentially placing children with economic instability at risk for diagnostic delay. The first aim of this dissertation was to explore the impact of economic stability on diagnostic timing of autism spectrum disorder via a scoping review of the literature. Papers were summarized by study design, data sourcing, handling of variables, statistical methodology, and the effect of economic stability factors on diagnostic timing of autism. Income and healthcare insurance were the most frequently employed measures of economic stability, with transportation, housing, and food security …

Characterizing The Role Of The Paraventricular Nucleus Of The Thalamus D2r+ Neurons In Interoceptive Predictions, Briana Machen

ETDs from 2020-2029

Interoceptive predictions are internal models through which the brain anticipates future bodily states based on past experiences and environmental cues. Under healthy conditions, these predictions allow organisms to anticipate physiological needs and proactively adjust behavior to maintain homeostasis. When these processes become dysregulated, however, environmental cues can trigger maladaptive physiological responses. Although interoceptive prediction is increasingly recognized as a key mechanism underlying adaptive behavior, the neuronal circuits responsible for generating these predictions remain poorly understood. The paraventricular nucleus of the thalamus (PVT) receives convergent inputs from brain regions involved in processing both interoceptive signals and exteroceptive cues, positioning it to …

The Association Of Motherhood And Maternal-Related Life Events And Cardiovascular-Related Health, Disease Events, And Mortality, Taishayla Mckitt

ETDs from 2020-2029

More than 40% of U.S. women have cardiovascular disease (CVD), and nearly half have at least one major risk factor. Sparse evidence exists related to the role of childrearing (regardless of prior pregnancy) on CVD. A recent literature review highlighted the influence of reproduction on CVD and health and identified opportunities for advancement. At present, it has yet to be discovered from prospective epidemiologic studies the extent to which parenting and maternal events have influence on cardiovascular health and clinical events. It has been demonstrated that parous women have greater prevalence of cardiovascular risk factors (e.g., short sleep duration and …

Exploring The Association Between Social Media Use Frequency And Violence-Related Behaviors Among U.S. High School Students: A Cross-Sectional Analysis Of The 2023 Youth Risk Behavior Survey, Luma Hammoudi

ETDs from 2020-2029

Youth violence remains a major public health concern in the United States (U.S.), with firearm injuries now the leading cause of death among children and adolescents. At the same time, social media use has become nearly universal among youth, raising concerns about how online interactions may influence violence-related behaviors. Social media platforms can facilitate peer conflict, electronic bullying, and public exposure to aggressive behaviors, which may extend into offline environments such as schools and communities. However, the relationship between social media use frequency and youth violence remains understudied. This study examined the relationship between frequency of social media use and …

Electrophysiological Retinal Changes In Aging And Its Implication In Alzheimer’S Disease, Samuel Jacob Haskins

ETDs from 2020-2029

Alzheimer’s disease remains one of the most expensive and fatal diseases facing medical practitioners to this day. According to the CDC, statistics show that it is the seventh leading cause of death worldwide. In addition to fatalities, there is a tremendous financial and emotional cost of dementia to the patient and surrounding caregivers. Improved screening techniques and new treatments for this disease are a priority of several institutes within the NIH. Early detection and early intervention are critical to improve the outcomes of patients worldwide. Amyloid beta plaques and neurofibrillary tangles (NFT) are two of the most important protein aggregates …

Comparative Evaluation Of Translucency, Fluorescence, And Structural Analysis Of 3d-Printed Vs. Conventionally Fabricated 3y, 4y And 5y Zirconia, Surabhi Chhabra

ETDs from 2020-2029

Statement of Problem: Additive manufacturing has emerged as an alternative to conventional milling for zirconia-based dental restorations because of its potential to reduce material waste and increase design flexibility. However, whether 3D-printed zirconia can provide optical and structural properties comparable with those of conventionally milled zirconia for esthetic applications remains unclear. Purpose: The purpose of this in vitro study was to compare the optical properties of 3D-printed zirconia and conventionally milled 3Y, 4Y, and 5Y zirconia, as measured by translucency and fluorescence, and to evaluate their structural characteristics, as measured by density, porosity, phase composition, and surface morphology. Materials and …

An Examination Of Physical Activity And Arterial Stiffness Among Urban And Rural Older Adults, Michael J. Hankes

ETDs from 2020-2029

Rural populations in the United States experience a disproportionate burden of cardiovas-cular disease, yet how rural‑urban context shapes physical activity (PA) and vascular health is not fully understood. Because vascular dysfunction links PA to cardiovascular risk, rural‑urban differences in movement may help explain disparities in cardiovascular health. Rurality is often treated as a static, binary exposure, which may obscure meaning-ful geographic variation and accumulated life course influences. The overarching goal of this dissertation was to examine associations among rural‑urban exposure, objectively measured PA, and vascular health using national cohort data and a pilot study. This dissertation begins with a conceptual …

Social Relationships, Mental Health, And Stigma: A Qualitative Study Of Social Networks And Hiv Disclosure In Western Kenya, Sarah Obatsa, Adel Mburia-Mwalili, Salvador Jauregui, Karla Wagner, Lukoye Atwoli, Francesca Odhiambo, Jayne Lewis-Kulzer, Suzanne Goodrich, Kara Wools-Kaloustian, Jennifer Syvertsen

Internal Medicine, East Africa

The disclosure of one’s HIV-positive status is a personal decision that can play an important role in engagement in HIV treatment and care. Social network approaches situate individuals within broader webs of social connections that influence health and wellbeing and thus hold the potential to elucidate key social factors shaping the process of disclosure. As part of a larger clinical study examining how substance use and mental health shape HIV outcomes, we recruited 61 individuals newly diagnosed with HIV at two clinics in Western Kenya to participate in an egocentric social networks study. We conducted a survey that generated a …