Medicine and Health Sciences Commons^™

Least Of My Worries: Food Security, Diet Quality, And Antiretroviral Adherence Among People Living With Hiv, Charlotte Ann Noble

USF Tampa Graduate Theses and Dissertations

More than forty years into the epidemic, HIV continues to impact the health and well-being of millions of people – nearly 37 million across the globe and in excess of 1 million in the U.S. – more than 44% of which live in the Southern United States. HIV continues to disproportionally affect marginalized populations, and vast amounts of money, time, and effort have been spent to understand how to slow the rate of new infections and improve health outcomes for People Living with HIV (PLWH). This study aims to understand the experience of living with and managing HIV while on …

Mitochondrial Somatic Mutations And The Lack Of Viral Genomic Variation In Recurrent Respiratory Papillomatosis, Yuhan Hao, Ryan Ruiz, Liying Yang, Antonio Galvao Neto, Milan R Amin, Dervla Kelly, Stratos Achlatis, Scott Roof, Renjie Bing, Kasthuri Kannan, Stuart M Brown, Zhiheng Pei, Ryan C Branski

Faculty, Staff and Student Publications

Recurrent Respiratory Papillomatosis (RRP) is a rare disease of the aerodigestive tract caused by the Human Papilloma Virus (HPV) that manifests as profoundly altered phonatory and upper respiratory anatomy. Current therapies are primarily symptomatic; enhanced insight regarding disease-specific biology of RRP is critical to improved therapeutics for this challenging population. Multiplex PCR was performed on oral rinses collected from twenty-three patients with adult-onset RRP every three months for one year. Twenty-two (95.6%) subjects had an initial HPV positive oral rinse. Of those subjects, 77.2% had an additional positive oral rinse over 12 months. A subset of rinses were then compared …

Health Information Needs For The Aged In The Society, Tajudeen Temitayo Adebayo Phd, Michael Segun Omole Phd

Library Philosophy and Practice (e-journal)

The Aged are prone to a lot of challenges as they assume the latent phase of their life. These challenges include loneliness, incapacitates, and degenerative diseases among others. To adequately coop with this problems, information becomes an essential ingredients. This work reports on the importance of identify the types of information needed by the aged, sources and channels of information available to them and how the information may help in modifying their life. The general inputs expected from Librarian were also discussed.

Administration Of Health Records/Information Practitioners Of Nigeria: Requirements, Implementations, Prospects And Challenges Of Health Records Officers’ Act, Tajudeen Temitayo Adebayo Phd, Michael Segun Omole Phd, Rasaq Adetona Adio, Muyiwa Adeleke Amin, Adebayo Olayiwola Ogunniran

Library Philosophy and Practice (e-journal)

Health Records Officers’ Act was promulgated formally by Decree No. 39 of 1989 (HROA; 1989) now CAP 166 LFN1990. The Decree establishes a Board for general administration of the profession of Health Records management in Nigeria. The paper which was a desk top study discovered the constitutional requirements for the Health information practices and implementation strategies as stipulated by the Act. The study revealed the prospects and challenges associated with the implementation of the Act on the professionals. The work recommended among others, continuous education of member of the profession will aid enormously in awareness creation toward compliance with the …

Understanding Prediabetes Through Facebook: Pilot Study Protocol And Lessons Learned, Xiaomeng Xu, Michelle Litchman, Perry Gee, Se-Hee Jung, Webb Whatcott, Loni Chacon, John Holmes, Sankara Subramanian Srinivasan

Journal of Health Disparities Research and Practice

Purpose/Background: Type 2 Diabetes is a serious contributor to mortality and morbidity. Rural populations (including those in Mountain West regions) exhibit greater health disparities than their urban counterparts for many conditions, including diabetes. It is therefore vital to address this important health issue, especially among rural populations. One way to address diabetes is with prevention, starting with enhanced detection of prediabetes. According to the CDC, more than 84 millions Americans (one in three adults) has prediabetes, but nine out of ten are not aware of their condition, which hampers prevention efforts. Infodemiology has been used successfully to track health information …

“Making Do, As Best As We Can” Cancer In American Samoa: Qualitative Methods And Results, Va'atausili Tofaeono, Tyran Terada, Luana Sue Kaopua, Angela Sy, Luana Yoshikawa

Journal of Health Disparities Research and Practice

Purpose/Background: The United Nation outlines a blueprint for addressing social determinants of health (SDOH), reconciling disparities between and within countries. Indigenous people living in Small Island Developing States like the U.S. territories experience health disparities. In American Samoa (AS), SDOH involving political, social, and data limitations provide challenges to in-country research and health services delivery capacity including cancer prevention and treatment. For example, in AS less than 7% of age-eligible adults participated in colorectal cancer (CRC) screening, while the Healthy People 2020 target is 70% screened. In 2004 a cancer awareness and service needs assessment in AS funded by the …

Pre-Diabetes In The Hispanic Population: Adolescents To Adulthood, Mary Nies, Tanna Woods

Journal of Health Disparities Research and Practice

Purpose/Background: Preventing prediabetes from developing into diabetes has led to successful programs like the Diabetes Prevention Program, although translation to minority populations is not readily available. Since minorities endure a disproportionate effect from diabetes and its complications, finding tailored interventions that work for minorities and can prevent the progression of prediabetes is crucial

Materials & Methods: Searching four electronic databases yielded 1,606 articles relating to prediabetes interventions in Hispanics across the lifespan. Research had to be published during the timeframe of 2008 to 2018 and include intervention as a focus. Titles and abstracts were read to narrow results. An additional …

Knowledge And Attitudes Of Guam Residents Towards Cancer Clinical Trial Participation, Munirih R. Taafaki, Amy C. Brown, Eunjung Lim, Kevin Cassel, John J. Chen, Yvette C. Paulino

Journal of Health Disparities Research and Practice

Purpose/Background: Currently there are no cancer clinical trials conducted in Guam, but interest is growing. Limited information exists on the knowledge and attitudes of Guam’s population towards cancer clinical research, yet cancer is the second highest cause of death in Guam and among the CHamoru people, Guam’s indigenous population. CHamoru people suffer the highest rates of cancer mortality compared to other ethnic groups in Guam. The purpose of this study was to determine differences in knowledge and attitudes towards cancer clinical trials participation, and attitudes towards traditional medicine.

Materials & Methods: A telephone survey instrument was designed, pilot-tested, IRB-approved, and …

Community Assessment On Colorectal Cancer Screening Knowledge, Attitudes, Behavior, And Health Literacy In American Samoa: Methods And Results, Va'atausili Tofaeono, Angela Sy, Lana Sue Kaopua, Kathy Tong, Kevin Cassel, Luana Yoshikawa

Journal of Health Disparities Research and Practice

urpose/Background: “Weaving” Indigenous and Western knowledges are understood to advance health equity for the Indigenous community whose own knowledge and values are often subsumed. Partnerships that support Indigenous leadership and bring Indigenous knowledge to greater parity with Western knowledge are imperative. Indigenous people living in Small Island Developing States like the U.S. territories experience health disparities. The WHO has declared non- communicable diseases as a global health epidemic, including cancer disparities. In American Samoa (AS) less than 7% of age-eligible adults participated in colorectal cancer (CRC) screening, while the Healthy People 2020 target is 70% screened. CRC may be prevented …

Changes In Gender Representation In Pharmacy Research Literature, Elaine Nguyen, Renee Robinson, Rebecca Hoover

Journal of Health Disparities Research and Practice

Purpose/Background: Many health disciplines, such as pharmacy, have been historically male dominated. However, female gender representation continues to increase in health care and especially in pharmacy with women representing 57.5% of pharmacists in 2017.

Shifts in workforce gender representation have not always translated to research and publication. Limited data exist regarding women’s authorship in pharmacy research literature. The purpose of our analysis was to determine whether the percentage of women as first authors of research articles in the pharmacy literature has increased over the past decade.

Materials & Methods: We conducted a retrospective bibliometric analysis. Citations from key pharmacy practice …

Effect Of Socio-Demographics, Health-Related Problems, And Family Structure On Chronic Absenteeism Among Children, Eunjung Lim, James Davis, So Yung Choi, John J. Chen

Journal of Health Disparities Research and Practice

Purpose/Background: From 5 to 7.5 million school children are chronically absent, defined as missing ≥15 days of school within a year. Students miss schools due to various reasons such as health, socioeconomic status, and environmental factors. We examined child’s health and behavior, family structure, and socio-demographics to understand chronic absenteeism.

Materials & Methods: The population included children ages 6 to 17 years from the Medical Expenditure Panel Survey (MEPS) years 2008-2013. Multivariable logistic regressions were used to identify the risk factors of chronic absenteeism, adjusting for the complex sampling design.

Results: Among socio-demographic variables, age ≥14 years, race/ethnicity, lower-income family, …

Human Papillomavirus (Hpv) Vaccination Status Among University Freshmen In Hawai‘I, May Rose I. Dela Cruz, Myron B. Thompson, John J. Chen, Carolyn Ma

Journal of Health Disparities Research and Practice

Purpose/Background: The HPV vaccine provides immunity against nine HPV strains that cause cancer and genital warts. It is recommended for 11 to 12 year olds, and "catch-up" immunization is recommended for females 13 to 26 years old and males 13 to 21 years old. College students represent an important population for HPV vaccination due to their increased risk for HPV infection. Despite the benefits of the HPV vaccine, its coverage rates are low in Hawaii. Hawai‘i is the home of two large universities on two islands that are representative of Hawai‘i’s populations, including Native Hawaiians, Filipinos, and Pacific Islanders. The …

Changes In Knowledge Of Hpv, Cervical Cancer, Pap Smears, And Attitudes Towards Hpv Vaccination From A Community-Based Intervention For Latinas, Helen C. Tarp, Paula Phelps, Elizabeth Fore

Journal of Health Disparities Research and Practice

Purpose/Background: Latinas are 20% less likely to receive the HPV vaccine and, in Idaho, are 35% more likely to die of cervical cancer than non-Latinas -16.2/100,000 in Latinas vs. 7.6/100,000 non-Latinas-. Research indicates that this disparity is due to low health literacy, and barriers of language, culture, and poverty. This project’s purpose was to assess the efficacy of a community-based intervention designed to increase rural Idaho Latina health literacy about cervical cancer prevention and detection, about the Women's Health Check program, and to assess participant attitudes towards child HPV vaccination.

Materials & Methods: Investigators trained six bilingual Latinas from rural …

Home Base Care Approach To Reduce Disparity In Diabetes Care In Zuni Indians, Eun Hee Choi, Donica Ghahate, Jeannette Bobelu, Vernon Pankratz, Vallabh Shah

Journal of Health Disparities Research and Practice

Purpose/Background: We conducted a randomized clinical intervention trial of a home-based kidney care program to examine its efficacy in adult Zuni Indians with Chronic Kidney Disease (CKD). We evaluated the results of the study in the subset of participants with type 2 diabetes (T2DM) to determine the degree to which this intervention influenced the engagement of those with T2DM in the management of their own health circumstances.

Materials & Methods: We randomized participants by household to receive usual care or home-based care. After initial lifestyle coaching, the intervention group received frequent additional reinforcement by community health representatives (CHRs) about adherence …

Apol1 Ckd Risk Alleles In New Mexico African American And American Indian Populations: Racial Disparity, Chien-An A. Hu, Amelia Bierle, Matthew Shultz, Vallabh Shah

Journal of Health Disparities Research and Practice

Purpose/Background: Two haplotypes of human apolipoprotein L1 gene (gene: APOL1; protein: ApoL1) harboring three coding sequence mutations have been demonstrated as risk variants associated with non-diabetic chronic kidney diseases (CKD) in African Americans. The first one, termed G1, is a two non-synonymous SNP haplotype (rs73885319 (A>G; p.S342G) and rs60910145 (G>T; p.I384M). The second one, termed G2, is a two codon deletion haplotype rs71785313 (6-bp in frame deletion) These two coding-sequence variants have been discovered in CKD patients of African ancestry and linked to the pathogenesis of primary focal and segmental glomerulosclerosis (FSGS), hypertension-attributed kidney disease, and HIV-associated nephropathy …

Cytokine Registry Database Of Stroke Patients (Crisp), Atif Zafar, Fares Qeadan, Asad Ikram, Mudassir Farooqui, Sajid Suriya, Surojit Paul

Journal of Health Disparities Research and Practice

Purpose/Background: The aim of the study is to identify molecular biomarkers involve in patients who present with stroke and to determine their clinical usefulness as potential biomarkers in stroke patients as compared to patients without stroke.

Materials & Methods: All patients presenting with ischemic stroke and hemorrhagic stroke at University of New Mexico Hospital (UNMH) will be screened for potential participation in this study based on following inclusion and exclusion criteria:

Inclusion criteria: male/female of ages ≥ 18 years, patients whose standard stroke admission order sets are obtained for clinical care.

Exclusion criteria: Patients <18 year, with the history of prior stroke or any neurodegenerative or neuroinflammatory disease except multiple sclerosis (MS), pregnant women and prisoners.

Cytokines will be measured in serum …

Secondary Stroke Prevention Among Filipinos Compared With Other Racial Groups In Hawaii, Nicole Young, Kazuma Nakagawa, Sheri Tokumaru, Deborah Taira

Journal of Health Disparities Research and Practice

Purpose/Background: As the fifth leading cause of death in the United States and a main cause of disability, stroke results in immense health and economic burden. Filipinos (FI) were found to have the highest mortality due to major CVD and stroke in Hawaii, and it is unclear whether the increased stroke risk among FI might be reduced by increasing the use of guideline recommended medications for secondary stroke prevention. Additionally, the attitudes and concerns of FI patients in Hawaii regarding stroke prevention have not been studied. The purpose of this study is to utilize a mixed-method approach to elucidate health …

An Application Of A Modified Health Belief Model: Assessing Health Beliefs And Health Protective Behaviors In Mining- Impacted Communities, Chloe Wardropper, Courtney Cooper, Jeff Langman, Chantal Vella, Dilshani Sarathchandra

Journal of Health Disparities Research and Practice

Purpose/Background: Toxic metal contamination poses public health risks in many mining-impacted communities. Improved understanding of risk perception and health protective behaviors is important to sustaining public health awareness. We co-developed a research study based on the Health Belief Model (HBM; Figure 1) and facilitated through a partnership with the health district in our study area, the Silver Valley of northern Idaho. Lead contamination caused by historical mining practices continues to impact both ecological and human health and contributes to health disparities. For this study, we assess how health belief constructs (i.e., perceived threats, expectations of behavioral outcomes, and confidence in …

Compare Healthcare Utilization In The First Three Years Of Life For Infants With Prenatal Opioid Exposure Based On Type Of Neonatal Care Received, Renee Robinson, Amanda Slaunwhite, Evelyn Rider, Janet Johnson, Amanda Walch

Journal of Health Disparities Research and Practice

Purpose/Background: Infants with prenatal opioid and other drug exposure often experience withdrawal symptoms known as neonatal abstinence syndrome (NAS). Some hospitals have modified clinical environments to promote recovery (reduced stimulation, nursery-like rooms, permitting rooming-in). While existing research has demonstrated efficacy of lower-stimulation environment, there is no known research evaluating longer-term implications of clinical environment on infant health beyond immediate neonatal period in states disproportionately affected by the opioid epidemic with diverse urban-rural populations such as Alaska.

Materials & Methods: The goal of this project is to determine whether supportive care decreases the likelihood of foster care placement from birth to …

Bridging The Rural-Urban Disparity: A Mixed-Methods Analysis Of Human Papillomavirus Vaccine Uptake In Montana, Sophia Newcomer

Journal of Health Disparities Research and Practice

Purpose/Background: Since introduction of the human papillomavirus (HPV) vaccine in 2006, national efforts to increase vaccine uptake have been largely successful in urban areas, but less effective in rural settings. As of 2017, HPV vaccine series initiation rates were 10.8% percentage points lower for adolescents residing in rural versus urban areas of the U.S. This disparity leaves rural youth at higher risk of developing of HPV- caused cancers and other diseases, including cervical cancer, tongue and throat cancers, and genital warts. In Montana, a predominantly rural state, only 49% of adolescents are up-to-date on the recommended 2-dose vaccine series, well …

Augmenting Exposure Therapy For Social Anxiety With Tdcs, Cynthia L. Lancaster, Samantha J. Meckes, Mollie A. Mcdonald, Marian E. Berryhill

Journal of Health Disparities Research and Practice

Purpose/Background: Exposure therapy is one of the most potent techniques available to treat social anxiety. However, studies suggest that exposure therapy only produces full remission in 20-50% of patients. Furthermore, laboratory conditioning and extinction studies suggest that fear responses toward individuals who differ from one's own ethnicity/race may be more resistant to extinction. Because activation of the medial prefrontal cortex has been associated with facilitating fear reduction during exposure therapy, we expect that targeting activation of this region with a stimulation technique called transcranial direct current stimulation (tDCS) may improve outcomes from exposure therapy for social anxiety. The present study …

Assessment Of Risk Factors For Health Disparities Among Latina Farm Workers, Cynthia Curl, Lisa Meierotto, Rebecca Som Castellano

Journal of Health Disparities Research and Practice

Purpose/Background: Latina farm workers may experience a unique intersection of social and environmental factors that are known to affect health and well-being. The disadvantages inherent in their gender, race and social class may be compounded by their immigration status, rural location and the hazards of farm work. We propose to identify the most critical risk factors for poor health facing this underserved and understudied population.

Materials & Methods: Our study uses a mixed-methods approach that combines qualitative data from focus groups (n=3 groups of 10 participants each) and semi-structured interviews (n=15) with quantitative and qualitative survey data (n=100) and biological …

The Female Cervicovaginal Mucosa Is A Unique Site For The Production Of Autoantibodies Associated With Rheumatoid Arthritis, Brian Cherrington, Heather Rothfuss, Kristen Demoruelle

Journal of Health Disparities Research and Practice

Purpose/Background: Women have a 3-fold higher incidence of rheumatoid arthritis (RA) and a lower likelihood of remission compared to men suggesting a gender disparity in the etiology of RA. In order to devise female specific prevention and treatment strategies, it is critical to understand the mechanism initiating the production of RA autoantibodies termed anti-citrullinated protein antibodies (ACPA). ACPA target proteins that are posttranslationally modified by a family of enzymes termed peptidylarginine deiminases (PADs), which convert arginine into citrulline. Research suggests that ACPA are generated at a mucosal site years before becoming systemic and causing clinical joint disease. Mucosal sites such …

Analysis Of Knee Motion To Prevent And Treat The Increasing Incidence Of Premature Knee Oa, Tyler Brown, Micah Drew, Samantha Krammer

Journal of Health Disparities Research and Practice

Purpose/Background: Osteoarthritis (OA) is a costly, debilitating musculoskeletal disease. A disparity in OA incidence in young individuals who don body borne load while physically active, such as service members, reportedly exists. Incidence of premature OA in service members is greater than twice the general population and steadily increasing at the knee. Moreover, there is disparity in knee OA incidence for female and African-American service members, who are 15%-25% more likely to develop the disease. A service member’s physical activity directly contributes to premature knee OA development. Specific knee locomotion biomechanics indicative of joint instability, including large and/or abrupt knee adduction …

¡Yo No Estoy Loco/A! Improving Treatment Engagement For Latinos Using An E-E Video, Lorraine T. Benuto, Frances Gonzalez, Rory Newlands, Jena Casas

Journal of Health Disparities Research and Practice

Purpose/Background: Approximately 30% of Latinos experience some form of psychiatric illness in their lifetime. Despite the high prevalence rate of mood disorders among Latinos and the availability of empirically supported treatments that target anxiety and depression, Latinos underutilize behavioral health services. Perceived stigma associated with the pursuit of behavioral health services disproportionately restricts mental health care in Latinos. The research team created an Entertainment- Education (E-E) telenovela-style video (in Spanish), which acted as the experimental intervention in the proposed project. The experimental intervention is based on the E-E model which incorporates health and educational messages in an entertaining, story-telling narrative …

Mountain West Clinical Translational Research-Infrastructure Network: Introduction, Parvesh Kumar

Journal of Health Disparities Research and Practice

The Mountain West (MW) Clinical Translational Research Infrastructure Network (CTR- IN) Program represents a consortium of all of the 13 major public universities across seven Institutional Development Awards (IDeA) states with the overall goal of increasing and enhancing research capacity. The MW CTR-IN Program covers 1/3^rd the U.S. land mass and almost 1/3^rd of all IDeA states stretching across 4 time zones. The 13 major U.S. public partner universities in the 7 IDeA states are as follows: University of Alaska at Anchorage (UAA), University of Alaska at Fairbanks (UAF), University of Montana (UM), Montana State University (MSU), University …

What's Happening: November 11, 2019, Maine Medical Center

What's Happening

No abstract provided.

Abstract 13987: Underutilization Of Oral Anticoagulant Therapy In At-Risk Patients With Atrial Fibrillation—Insights From A Multistate Healthcare System, Tyler J Gluckman, Amir Ali, Mansen Wang, Howard Mun, Sally Alfred, John L. Petersen

Articles, Abstracts, and Reports

Introduction: Oral anticoagulant (OAC) therapy significantly reduces the risk of thromboembolism among at-risk patients with atrial fibrillation (AF). Current guidelines provide strong support for an OAC in men and women with AF and CHA2DS2-VASc scores of >2 and >3, respectively. In spite of this, previous data has suggested that up to 40% of these patients are not treated in accordance with guideline recommendations.

Hypothesis: We hypothesized that OAC therapy continues to remain significantly underutilized among at-risk patients with AF in real-world settings.

Methods: We sought to evaluate the prevalence of OAC underuse and contributing factors in an ambulatory population of …

Abstract 14012: Opportunities To Improve The Efficacy And Safety Of Oral Anticoagulant Therapy In Atrial Fibrillation—Insights From A Multistate Healthcare System, Tyler J Gluckman, Amir Ali, Mansen Wang, Howard Mun, Sally Alfred, John L. Petersen

Articles, Abstracts, and Reports

Introduction: Vitamin K antagonists (VKAs) effectively reduce thromboembolic risk in atrial fibrillation (AF), but are limited by a narrow therapeutic window. Patients with reduced time in the therapeutic range (TTR) also face an increased risk of bleeding and ischemic events. Based in part on this, current guidelines give preference to direct-acting oral anticoagulants (DOACs) over VKAs in AF.

Hypothesis: We hypothesized that DOACs are underutilized among those on oral anticoagulant therapy and that TTR remains suboptimal for large numbers of individuals on VKAs in real-world settings.

Methods: We sought to evaluate a) the breakdown of OAC type and b) TTR …

The Role Of Omega-3 Polyunsaturated Fatty Acids In Blood Pressure Regulation And Secondhand Smoke-Induced Vascular Dysfunction, Emily Anna Wheeler

Biomedical Sciences ETDs

Omega-3 polyunsaturated fatty acids (n-3 PUFAs) may lower cardiovascular disease risk by reducing blood pressure (BP). We hypothesized that fat-1 transgenic mice, which convert n-6 PUFAs to n-3 PUFAs, would have improved vascular function in BP regulation and following secondhand smoke (SHS) exposure, compared to wild type (WT) mice.

BP was recorded in mice fed an n-6 PUFA, or standard chow diet. On the n-6 PUFA diet fat-1 mice had a lower mean arterial pressure and a greater decrease in diastolic BP when treated with an ACE inhibitor, compared to WT mice. No differences were observed on the chow diet. …