Medicine and Health Sciences Commons^™

Methodological And Clinical Concerns In The Study On Postpartum Hypertension Management, Takaki Tanamoto, Kyosuke Kamijo, Yusuke Tsutsumi, Tetsuya Kawakita

Department of Obstetrics & Gynecology Faculty Publications

[Introduction] We read with interest the recent study by Rosenfeld et al.¹ However, we have several clinical and methodological concerns about this study.¹

First, this study's propensity score matching (PSM) lacked key clinical confounders, including perinatal risk factors and the highest systolic/diastolic blood pressures. Smoking, alcohol use, and multifetal gestation, which influence blood pressure during pregnancy,²,³ potentially affect both primary and secondary outcomes. Additionally, the authors did not report standardized mean differences before and after PSM, which are essential for assessing balance.⁴

Disparities In Cardiovascular Disease Outcomes And Economic Burdens Among Minorities In Southeastern Virginia, Ismail El Moudden, Asra Amidi, Reem Sharaf Alddin, Michael Bittner, Qi Zhang

Department of Obstetrics & Gynecology Faculty Publications

Background

Cardiovascular diseases are the leading cause of mortality in the United States, presenting significant public health challenges and financial burdens, particularly in Southeastern Virginia, where African American and Hispanic (AA&H) populations are disproportionately affected.

Methods

This retrospective observational study analyzed data from 30,855 hospital discharges of AA&H patients across Southeastern Virginia from 2016 to 2020, focusing on individuals aged 18 to 85 with cardiovascular diseases. Utilizing the Virginia Health Information database, we examined demographic information, clinical data, and healthcare utilization patterns through hypothesis tests and regression models to explore associations between these variables and the economic impacts of cardiovascular …

Association Between The Intensity Of Exercise In The First Trimester And Early Second Trimester And The Risk Of Gestational Diabetes, Takaki Tanamoto, Misa Hayasaka, Tetsuya Kawakita

Department of Obstetrics & Gynecology Faculty Publications

Objective

Although some studies show that exercise decreases the incidence of gestational diabetes mellitus (GDM), the optimal exercise intensity during pregnancy remains unclear. We examined GDM risk according to exercise intensity in pregnant individuals.

Methods

We analyzed data from the Nulliparous Pregnancy Outcomes Study: Monitoring Mothers‐to‐Be (nuMoM2b), a prospective study enrolling nulliparous individuals in the first trimester. Participants with pregestational diabetes or delivery before 20 weeks were excluded. Exercise intensity during the first (6–13 weeks’ gestation) and early second (16–21 weeks’ gestation) trimesters was categorized by metabolic equivalent of task hours per week (MET‐hr/week) as none, low intensity (< 7.5), moderate intensity (7.5–14.9), or high intensity (≥ 15). The primary outcome was GDM; secondary outcomes included preeclampsia, gestational hypertension, preterm birth, small‐for‐gestational‐age birth, and stillbirth. Adjusted relative risks (aRRs) with 95% confidence intervals (CIs) were calculated using a generalized linear mixed‐effects model with a Poisson distribution and robust error variance, controlling for the random effects of individuals and potential confounders.

Results …

Longitudinal Assessment Of Intravillous Arterioles In Normal Pregnancy Using Superb Microvascular Imaging, R. Horgan, E. Sinkovskaya, G. Saade, E. Kalafat, A. Heeze, A. Abuhamad

Department of Obstetrics & Gynecology Faculty Publications

Objective

To use superb microvascular imaging (SMI) to longitudinally evaluate blood flow in intravillous arterioles (IVA) in pregnancy, and to develop reference ranges for IVA pulsatility index (PI) and peak systolic velocity (PSV) from 12 to 38 weeks' gestation.

Methods

The data for this study were obtained from the National Institutes of Health-funded Human Placenta Project. Eligible for inclusion were women aged 18-35 years, with a body mass index of <  30 kg/m², without comorbidities, with a singleton pregnancy conceived spontaneously and a gestational age of ≤ 13 + 6 weeks. Exclusion criteria were maternal or neonatal complications, fetal or umbilical cord anomalies, abnormal placental implantation and delivery <  37 weeks. Each participant underwent eight ultrasound examinations during pregnancy. Using SMI technology, the total number of IVA identified was recorded in a sagittal placental section at the level of cord insertion. The PI and PSV were measured in a total of six IVA (two in the central portion of the placenta, two peripherally towards the uterine fundal portion and two peripherally towards the lower uterine segment). Umbilical artery (UA)-PI was also obtained. Multilevel regression models were used to create reference ranges for IVA-PI and IVA-PSV at 12-38 weeks' gestation.

Results

A total of 90 women fulfilled the study criteria. IVA-PI decreased throughout pregnancy from a mean ± SD of 1.04 ± 0.23 in the first trimester (at 12-13 weeks) …

Mobile Health Intervention Tools Promoting Hiv Pre-Exposure Prophylaxis Among Adolescent Girls And Young Women In Sub-Saharan Africa: Scoping Review, Alex Emilio Fischer, Homaira Hanif, Jacob B. Stocks, Aimee E. Rochelle, Karen Dominguez, Eliana Gabriela Armora Langoni, H. Luz Mcnaughton Reyes, Gustavo F. Doncel, Kathryn E. Muessig

Department of Obstetrics & Gynecology Faculty Publications

Background:

In 2022, 3100 adolescent girls and young women in sub-Saharan Africa experienced new HIV infections each week. HIV pre-exposure prophylaxis (PrEP) is effective at preventing HIV but has limited uptake and persistence. Mobile health (mHealth) interventions can improve medication adherence; however, their utility to improve PrEP adherence among adolescent girls and young women is not well established.

Objective:

This scoping review synthesizes evidence supporting mHealth for PrEP among adolescent girls and young women in sub-Saharan Africa and identifies strategies for further evaluation.

Methods:

We searched PubMed and Google Scholar databases, expert referrals, and reference lists using the following eligibility …

Association Of Mean Arterial, Systolic, And Diastolic Blood Pressure Trends In Early Pregnancy With Superimposed Preeclampsia With Severe Features In Pregnancies Complicated By Chronic Hypertension, Tetsuya Kawakita, Justin M. Leach, George R. Saade, Kim Boggess, Lorraine Dugoff, Brenna L. Hughes, Joseph Bell, Kjersti Aagaard, Rodney K. Edwards, Kelly Gibson, David M. Haas, Lauren Plante, Torri Metz, Brian Casey, Sherri Longo, Matthew K. Hoffman, Kara K. Hoppe, Methodius Tuuli, Michelle Y. Owens, Heather Frey, Todd Rosen, Uma M. Reddy, Wendy Kinzler, Emily Su, Iris Krishna, Mary E. Norton, Daniel Skupski, Yasser Y. El-Sayed, Ronald Librizzi, Mounira Habli, Shauna Williams, Gabriella Pridjian, David S. Mckenna, Sarah Osmundson, Joanne Quinones, Zorina Galis, Lorie Harper, Namasivayam Ambalavanan, Jeff M. Szychowski, Alan T.N. Tita

Department of Obstetrics & Gynecology Faculty Publications

OBJECTIVE: To evaluate the association of longitudinal systolic blood pressure (SBP), diastolic blood pressure (DBP), and mean arterial pressure (MAP) in early pregnancy with later development of superimposed preeclampsia with severe features in pregnancies complicated by mild chronic hypertension.

METHODS: This secondary analysis used data from the CHAP (Chronic Hypertension and Pregnancy) trial, a multicenter randomized controlled trial that involved pregnant individuals with chronic hypertension. Participants were categorized based on the development of superimposed preeclampsia with severe features. Longitudinal blood pressure measurements from enrollment to the development of superimposed preeclampsia with severe features or delivery were assessed using regression models. …

Racial Disparities In Maternal Mortality Before, During, And After The Covid-19 Pandemic In The United States: A Difference-In-Difference Analysis, Kyosuke Kamijo, Misa Hayasaka, Tetsuya Kawakita

Department of Obstetrics & Gynecology Faculty Publications

Background

This study aimed to examine changes in racial disparities in pregnancy-related and maternal mortality before, during, and after the COVID-19 pandemic in the United States.

Methodology

This was a cross-sectional study using the Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research (CDC WONDER) data from January 2018 to June 2024. We focused on pregnancy-related and maternal mortality among Black and White individuals to examine racial disparities. The study periods were defined as pre-pandemic (January 2018-March 2020), pandemic (April 2020-March 2022), and post-pandemic (April 2022-June 2024). We applied interrupted time series analysis and difference-in-difference (DID) models …

Longitudinal Assessment Of Fetal Myocardial Performance Index In Normal Pregnancy Using Spectral Tissue Doppler, R. Horgan, E. Sinkovskaya, E. Kalafat, G. Saade, A. Abuhamad

Department of Obstetrics & Gynecology Faculty Publications

Objective

Although spectral tissue Doppler imaging is recognized as the optimal method for assessing the fetal myocardial performance index (MPI), longitudinal reference ranges for fetal MPI measured using spectral tissue Doppler have not been established. Our objective was to use spectral tissue Doppler data to establish gestational-age-specific reference ranges from 12–33 weeks for left and right ventricular fetal MPI.

Methods

This was a prospective longitudinal study of women aged 18–35 years, with a body mass index below 30 kg/m² and a singleton pregnancy conceived spontaneously. Fetal MPI measurements were obtained in the first, second and third trimesters and MPI was …

American Heart Association Blood Pressure Classification And Subsequent Risk Of Preeclampsia, Rebecca Horgan, Erkan Kalafat, Elena Sinkovskaya, Alfred Abuhamad, George Saade

Department of Obstetrics & Gynecology Faculty Publications

Background: In 2017, the American Heart Association (AHA) and American College of Cardiology updated their hypertension guidelines for the nonpregnant population, lowering the diagnostic thresholds to systolic blood pressure ≥130 mmHg or diastolic blood pressure ≥80 mmHg. This reclassification has raised important questions regarding whether blood pressure (BP) values previously considered within the normal range in pregnancy may, in fact, confer an increased risk for hypertensive disorders of pregnancy (HDPs).

Objective: To evaluate the association between first-trimester BP classified by AHA thresholds and the subsequent development of HDPs.

Study design: This was a secondary analysis of a prospective, multicenter cohort …

Timing Of Delivery In Preeclampsia: Time To Reconsider?, Rebecca Horgan, Ahmed S. Z. Moustafa, Mackenzie Mchugh, Tetsuya Kawakita, Baha Sibai, George Saade

Department of Obstetrics & Gynecology Faculty Publications

The article discusses the need to reassess the timing of delivery in cases of preeclampsia, a condition affecting 2%–8% of pregnancies and linked to significant maternal and neonatal risks. It highlights that existing guidelines, primarily based on older studies, may not adequately reflect current clinical practices and advancements in neonatal care. The authors suggest that planned delivery at 34–36 weeks of gestation may offer maternal benefits without increasing short-term neonatal morbidity, while also emphasizing the importance of considering long-term outcomes for both mothers and infants. They advocate for further research, including large-scale randomized trials, to better understand the implications of …

A Rare Complication Of Dilation And Evacuation: Unrecognized Extrauterine Retained Products Of Conception, Aviana Terschueren, Lauren Siewertsz Van Reesema, Joseph Hudgens

Department of Obstetrics & Gynecology Faculty Publications

Introduction: Surgical abortions, including dilation and evacuation, are among the safest gynecological procedures, with complication rates ranging from 0.5–4.0%. Uterine perforation, though rare (0.2–0.8%), can result in serious sequela, including translocation of retained products of conception into the abdominal cavity. We present a rare case of abdominal retained products of conception following a second-trimester dilation and evacuation.

Case Report: A 29-year-old G3P1112 underwent an elective surgical abortion at 17 weeks’ gestation, complicated by hemorrhage necessitating transfer to an outside hospital. She was treated with uterotonics and a blood transfusion and was discharged after a 6-day hospitalization. Initial transvaginal ultrasound showed …

Association Between Adverse Pregnancy Outcomes And Awareness Of Cardiovascular Risk Factors: A Numom2b-Hhs Secondary Analysis, Elizabeth M. Wendl, Amanda A. Allshouse, Ashley Goodwin, Bri Hobbs, Philip Greenland, Lisa Levine, William Grobman, George R. Saade, Natalie Cameron, C. Noel Bairey Merz, Caroline Rouse, Sarah Rogan, Judith H. Chung, Lauren H. Theilen, National Heart, Lung, And Blood Institute Numom2b Heart Health Study Network

Department of Obstetrics & Gynecology Faculty Publications

Background

Adverse pregnancy outcomes (APOs) affect 10%-20% of pregnancies and are associated with increased risk of cardiovascular disease.

Objective

To determine whether the history of APO is associated with a person's awareness of their cardiovascular risk factors (CRF) 2-7 years postpartum.

Methods

This is a secondary analysis of a multicenter cohort study in which nulliparous pregnant people were enrolled in the first trimester and followed prospectively. Participants with a CRF (hypertension, dyslipidemia, and/or prediabetes/diabetes) at follow-up were included. We excluded participants with: pre-gestational diabetes, chronic hypertension, dyslipidemia during the index pregnancy or subsequent pregnancy, and non-fasting blood draws. The exposure …

Maternal Mortality According To State Abortion Legislative Climate Following The Us Supreme Court's Dobbs V. Jackson Women's Health Organization Ruling, Emily Nuss, Mari Iwasaki, Lindsay Robbins, Peggy Ye, Misa Hayasaka, George Saade, Tetsuya Kawakita

Department of Obstetrics & Gynecology Faculty Publications

Objective

We aimed to evaluate how maternal mortality rates have evolved across US states following the Dobbs ruling, while accounting for the confounding influence of the coronavirus disease 2019 (COVID-19) pandemic.

Study Design

We conducted a retrospective analysis of publicly available data from the Centers for Disease Control and Prevention Wide-ranging ONline Data for Epidemiologic Research (CDC WONDER) database from January 2018 to December 2024. This study period was divided into three intervals: (1) pre-COVID (January 2018 to February 2020), (2) pandemic (March 2020 to September 2022), and (3) post-Dobbs (October 2022 to December 2024). Using the Kaiser Family Foundation …

Online Learning-Driven Human Intent Estimation And Control For Human-Robot Interaction, Irfan Ganie, S. Jagannathan

Electrical and Computer Engineering Faculty Research & Creative Works

This paper presents a novel Stackelberg-game theoretic multilayer-online learning framework for cooperative control of nonlinear Physical Human-Robot Interaction (pHRI), where the human is modeled as the leader guiding a robot follower. This hierarchical interaction is captured as a dynamic Stackelberg game, with the human's intention estimated in real-time through online multilayer neural networks (MNNs). We introduce SVD-based weight update laws for actor-critic MNNs, which approximate value functions and control inputs for both human and robot, eliminating the need for predefined basis functions. In this framework, the human objective is first inferred and used to guide the robot actions by shaping …

Improved Optimal Tracking Of Uncertain Nonlinear Discrete-Time Systems Using Experience Replay, Maxwell Geiger, Sarangapani Jagannathan

Electrical and Computer Engineering Faculty Research & Creative Works

This paper addresses the infinite horizon optimal tracking control problem for partially uncertain control-affine nonlinear discrete-time (DT) systems, where the control input dynamics are known. Multi-layer critic and actor neural networks (MNNs) are utilized for online estimation of the infinite horizon value function and optimal control input. The NN weights are tuned online using a direct temporal difference error (TDE)-driven learning approach, which modifies the singular values of the gradient with respect to the NN weights to accelerate their convergence. The critic NN uses a novel experience replay technique to improve sample efficiency without introducing biased TDEs and guarantee the …

Multi-Model Safe Neuro-Optimal Output Tracking Control Of Autonomous Surface Vessels With Explainable Ai, Behzad Farzanegan, S. Jagannathan

Electrical and Computer Engineering Faculty Research & Creative Works

This paper presents a safety-aware deep reinforcement learning (DRL)-based trajectory tracking control of autonomous surface vessels (ASVs). A multilayer neural network (MNN) observer estimates the ASV's state and uncertain dynamics. By utilizing the estimate state vector from the observer, a safety-aware DRL-based optimal policy is formulated using control barrier function (CBF) and Karush-Kuhn-Tucker (KKT) conditions. An actor-critic MNN with singular value decomposition (SVD)-based update mitigates vanishing gradients. To enhance adaptability, an online safe lifelong learning (SLL) scheme counters catastrophic forgetting across varying ASV dynamics. The Shapley Additive Explanations (SHAP) method identifies key features influencing the control policy. Simulations on an …

Reinforcement Learning-Based Nonlinear Optimal Discrete-Time Control Of Power Systems, Vijay Kumar Singh, Behzad Farzanegan, S. Jagannathan

Electrical and Computer Engineering Faculty Research & Creative Works

This paper presents a partially model-free adaptive optimal tracking control method for power systems, specifically targeting a synchronous generator connected through a reactive transmission line. By integrating the tracking error dynamics with reference trajectory dynamics, an augmented system is created. A discounted performance function is introduced to address the nonlinear tracking problem optimally. Unlike traditional methods that compute feedforward and feedback terms separately, the proposed approach calculates both simultaneously by minimizing the discounted performance function. The discrete-time tracking Bellman and Hamilton-Jacobi-Bellman (HJB) equations are derived, and a reinforcement learning (RL)-based technique is employed to solve the optimal policy online without …

Enhanced Continual Reinforcement Learning-Based Output Feedback Control Of Heterogeneous Quadrotors Formation, Ehsan Soleimani, S. Jagannathan

Electrical and Computer Engineering Faculty Research & Creative Works

This paper presents a unified framework for the safe and optimal control of heterogeneous quadrotor unmanned aerial vehicles (QUAVs) in formation, enabling multitask missions without requiring precise system dynamics. To address partial state observability, a multilayer neural network (MNN) observer is designed to estimate unmeasured states. Reinforcement learning (RL) is employed for optimal control utilizing an MNN ensuring adaptability. Barrier Lyapunov Functions (BLFs) are integrated into the RL framework to enforce safety by maintaining QUAVs within predefined constraints. An enhanced continual learning (ECL) method is proposed to improve the adaptability of MNNs. This method enables effective multitask learning while mitigating …

Resilience As Accusation: A Critical Examination Of Individual Resilience Training For Burnout Mitigation, Jacqueline Christianson, Bonnie Sommers-Olson, Jessica Leiberg, Dana Kaminstein

College of Nursing Faculty Research and Publications

Burnout, a syndrome of work-related exhaustion and cynicism, is prevalent among nurses and is associated with workplace stressors. Resilience training programs are a prevalent method of burnout mitigation employed by healthcare institutions that aim to improve or alter how individuals respond to chronic stressors. Through the lens of General Systems Theory, we describe resilience training as a method of individualizing a systemic problem by problematizing a response to chronic stress exposure. Resilience training may furthermore serve as a mechanism which allows subversion of institutional responsibility for nurses’ well-being in the workplace. We describe several suggestions for nurses to resist being …

Rapid Implementation Of Open-Access Pandemic Education For Global Frontline Healthcare Workers, Jacqueline Christianson, Erica Frank, Stacen Keating, Susan Boyer, Miriam Chickering

College of Nursing Faculty Research and Publications

Background

The recent global pandemic posed extraordinary challenges for healthcare systems. Frontline healthcare workers required focused, immediate, practical, evidence-based instruction on optimal patient care modalities as knowledge evolved around disease management.

Objective

This course was designed to provide knowledge to protect healthcare workers; combat disease spread; and improve patient outcomes.

Methods

A team of global healthcare workers responded by rapidly creating a competency-based online course. To promote transcultural applicability, the course was developed by an international team of more than 45 educators from over 20 countries. Course delivery included a built-in language translation tool, routine updates, and several innovative course …

Nurse Perspectives On Labor Union Participation Prior To Implementation Of A Collective Bargaining Agreement: A Qualitative Study, Jacqueline Christianson, Bonnie Sommers-Olson, Cathleen Fox, Norah L. Johnson

College of Nursing Faculty Research and Publications

Background: Patient advocacy is a duty for professional nurses; however, not all nurses are empowered to advocate for meeting patients’ needs. Participation in labor unions may serve as a venue for nurses with limited institutional decision-making authority to advocate for patient needs; however, unionization can be a time-intensive and fraught process.

Purpose: This study examined how nurses participating in a new union in an urban United States hospital described their reasons for participating in a labor union during collective bargaining.

Methods: Content analysis of participant's interviews that took place between January and March 2023, after the nurses voted to unionize …

Evaluating Nurse Conscientious Objection: Application Of A Novel Framework, Maya Zumstein-Shaha, Lucia D. Wocial, Vicki D. Lachman, Norah Louise Johnson, Cynda Hylton Rushton, Pamela J. Grace

College of Nursing Faculty Research and Publications

Certain moral beliefs and/or values about what is good or harmful can cause nurses and other healthcare professionals to object to participating in some clinical actions. Such objections are also called conscientious objections. Invocation of a conscientious objection (CO) can produce complexities in patient care and health care delivery and must be mindfully evaluated for its soundness. In this manuscript, a recently developed framework, The Ethical Evaluation of a Nurse’s Conscientious Objection (EENCO), is applied to expose hidden elements and nuances in a proposed or actual CO by nurses or other healthcare professionals, thereby illuminating strategies that can lessen associated …

Critical Care Advanced Practice Providers As Partners In Advancing Pediatric Intensive Care Unit Nursing Knowledge: A Needs Assessment., Mary Seidl, Meghan Roller, Whitney Seul, Laura Rose, Christine A. Schindler

College of Nursing Faculty Research and Publications

Background

Critical care advanced practice providers (APPs) are frontline providers in many pediatric intensive care units (PICUs). From 2020 to 2022, there was a significant downward shift in nursing experience level in the PICU at the authors’ institution. APPs may help provide additional in situ education.

Methods

Data were collected using role-specific needs assessment of PICU nursing staff and providers, assessing concept related to knowledge and job stress.

Results

Findings overwhelmingly demonstrated desire for more APP-led education. Overall, 27% of nurse respondents strongly agreed that current knowledge was adequate to provide safe and best care for their patients, and 47% …

Reversible Degradation Of Peptidoglycan By Lytic Transglycosylases, Aaron Devereaux

Theses and Dissertations (Comprehensive)

Antimicrobial resistance continues to be a burden on the global healthcare system with an estimated cost of billions of dollars and millions of deaths each year. Recently, there has been little to no development on new antibiotics to treat bacterial infection, and any that are developed become resisted to within a few years. Both Gram-positive and Gram-negative bacteria contain a mesh-like layer called peptidoglycan (PG) that surrounds their cells providing strength, cell shape, and protection from their environments. This layer is a polymer of N-acetylmuramic acid (MurNAc) and N-acetylglucosamine (GlcNAc) connected via a b-1,4-glycosidic bond, with each strand being cross-linked …

“It Is Tiny And It Is Everything”: Exploring The Effects Of Arts-Integrated Gardening On Experiences Of Ecological Grief Through Autoethnographic Research, Christina Kingsbury

Theses and Dissertations (Comprehensive)

This study explores how arts-integrated gardening affects experiences of ecological grief through autoethnography and draws on my personal experiences as a survivor of environmentally linked cancer and artist working with gardens through social practice. My research builds on two areas of emergent scholarship—investigations of ecological grief and gardens as sites for social work practice—to explore how social work may address ecological grief through arts-integrated gardening. I use a quilting autoethnography as a method of inquiry to foreground my subjective knowledge and analyze it through intersectional feminist, disability and decolonizing theories. By incorporating narrative analysis and arts-based inquiry—writing in place, poetic …

Weight Stigma In Health-Related Undergraduate Programs, Alicia Rodney

Theses and Dissertations (Comprehensive)

Health-related undergraduate programs are common pathways for future health care providers and play a critical role in shaping attitudes toward weight, as biases formed during training often carry over into professional practice. While weight stigma (WS) has been examined among practicing professionals and medical students, little is known about how it is experienced by undergraduate students in different health-related programs, particularly across the weight spectrum. This qualitative study contributes to closing this gap by exploring and comparing how students in one kinesiology and one health sciences program experience WS within an academic setting.

Using Reflexive Thematic Analysis, open-ended survey responses …

Development Of A Stress Response Framework For Understanding Sogie Refugee Health, Arooran Saravanan Ananthavel Murugan

Theses and Dissertations (Comprehensive)

As an increasing number of individuals flee persecution on the basis of sexual orientation and gender identity expression (SOGIE), Canada has become a prominent destination for SOGIE refugees. The chronic stressors encountered by this marginalized population remain insufficiently studied, particularly in relation to physical health outcomes. This qualitative study investigates the cumulative health impacts of chronic stress among SOGIE refugees through the application of a cell-to-society framework, underpinned by Minority Stress Theory (MST). The study seeks to develop a SOGIE-specific stress response framework that theorizes the processes by which social and environmental stressors become biologically embedded, thereby contributing to elevated …

Neighbourhood Resilience Planning With Renters In Hamilton, Ontario, Canada, Anna Do

Theses and Dissertations (Comprehensive)

This sequential mixed-methods study demonstrates the co-production of knowledge between academic researchers and local communities. Guided by the resilience planning framework, the study engaged 48 renters from the Beasley neighbourhood of Hamilton, Ontario, Canada in identifying stressful and supportive locations using a participatory mapping tool called the “Place Report.” A total of 74 Place Reports were submitted, with most reporting supportive places in or near Beasley. Thematic analysis revealed three overarching domains, and 13 themes related to the use and function of these locations. Places pertaining to food, housing, and physical activity emerged as the most frequently discussed topics. The …

Exploring Laurier Health Sciences Students’ Knowledge Of Lgbtq+ Health, Grace Emma Henry, Todd Coleman

Theses and Dissertations (Comprehensive)

In all health-related fields, the need for well-informed, holistic healthcare providers is paramount. For the heathcare field to be impactful in positive ways, providers should emerge from multifaceted academic backgrounds, equipped with an array of knowledge and skills to address the complex needs of different patients. Central to this is the idea that all aspects of an individual's identity and the intersectionality of these identities should be considered when providing care. Intersectionality recognizes that various social and personal identities, such as race, gender, sexuality, and socioeconomic status, intersect to shape individual experiences and health outcomes (Kelly et al., 2022).

Lesbian, …

Limiting H1n1 Replication Via The Dsrnai Pathway Using Sequence-Specific Ldsrna, Shawn Marie Sharon Carr, Stephanie Dewitte-Orr

Theses and Dissertations (Comprehensive)

The seasonal influenza virus causes a common respiratory illness that can be life threatening to the immunocompromised, the very young, and the elderly. The current strategies for avoiding a serious influenza virus infection are good hygiene practices and the annual influenza vaccine. Unfortunately, last year’s influenza virus vaccine effectiveness ranged between 32-60% for children and adolescents and 46-54% for adults. These low efficacy rates are due to the vaccine often targeting hemagglutinin, a highly variable surface protein. This thesis seeks to create a prophylactic treatment via the RNA interference (RNAi) response that targets the virus’s conserved genes that are integral …