Diseases Commons^™

The Connection Between Medicaid And Obesity In Northeast Ohio, Emmie Kelley, Sophie Kheder

Williams Honors College, Honors Research Projects

Obesity is a major public health concern in the United States that is projected to increase exponentially over the next few years. Obesity is commonly associated with a lower socioeconomic status. Lower-income individuals tend to be supported by Medicaid, a federal insurance program for low-income Americans. Prior studies have shown a positive correlation between income status and obesity prevalence. Our goal was to find if there was a correlation between Medicaid patients and obesity in Northeast Ohio, to provide physicians with a set of characteristics to better combat obesity, since preventative and treatment guidelines are tailored to national trends. We …

Neighborhood Socioeconomic Deprivation And Physical Activity Associate With Extracellular Vesicle Size And Cargo In A Community-Based Cohort Of Women, Yvonne Baumer, Elizabeth M. Aquino Peterson, Matthew R. Bavuso, Noel Miller, Cristhian A. Gutierrez-Huerta, Nithya P. Vijayakumar, Sam J. Neally, Kaveri Curlin, Valerie M. Mitchell, Billy S. Collins, Neelam R. Redekar, Subrata Paul, Anca D. Dobrian, Tiffany M. Powell-Wiley

Department of Biomedical and Translational Sciences Faculty Publications

African American (AA) women face disproportionate cardiovascular disease (CVD) risk due to adverse social determinants of health (SDoH), including lower socioeconomic status (SES). Physical activity (PA) and plasma extracellular vesicles (EVs) modulate CVD risk, but their relationships with SDoH remain unclear. This study examines associations between SDoH, PA, and plasma EVs in a Washington, DC-based cohort of at-risk AA women. Participants (N = 24, Age: 57 ± 12, BMI: 35 ± 6, ASCVD: 9 ± 5) joined the Step It Up Community-Engaged, Digital Health Physical Activity Intervention pilot study. EVs were isolated from fasting plasma samples. Multivariable regression, adjusted for …

Politics Of A Silent Pandemic: Antimicrobial Resistance And State Capacity In India And Nigeria, Mia Kelly

CMC Senior Theses

Antimicrobial Resistance (AMR) has emerged as one of the most pressing yet widely underestimated health threats of the 21st century; this thesis explores the potentially devastating global impact of this “silent pandemic”, exposing how deeply health outcomes depend on political choices, regulatory capacity, and economic constraints. Although the danger of spreading drug-resistant pathogens is now widely acknowledged in both the scientific and political communities, states differ in their abilities to contain the issue, with low- and middle-income countries facing the greatest obstacles to national action plan implementation. This thesis investigates these disparities through a comparison of India and Nigeria, two …

Aging With A Chronic Illness: Symptom Burden, Everyday Challenges, And Quality Of Life Among Older Adults With Multiple Sclerosis, Swasati Handique

Social Work Dissertations

This three-article study examined the quality of life and everyday lived experience of older adults living with multiple sclerosis (MS). The first article is a scoping review of 14 peer-reviewed studies published between 2012 and 2025, conducted in accordance with Arksey and O’Malley’s five-stage framework and the PRISMA checklist. The second article is a cross-sectional study using the Aging Concerns, Challenges, and Everyday Solution Strategies (ACCESS) Phase II data set of 60 older adults living with MS. Multiple linear regression and moderation analysis was conducted to examine the association between physical symptom burden and quality of life, and whether participation …

Incorporating New Guidelines Into School-Based Asthma Management, Jessica Michala Jindra, Angela Duff Hogan

Department of Pediatrics Faculty Publications

Purpose of the Review

The aim of this review is to identify barriers and provide solutions to the implementation of inhaled corticosteroid-formoterol as rescue therapy within schools.

Recent findings

GINA guidelines in 2019 and NAEPP in 2020 recommended inhaled corticosteroids combined with formoterol for a rescue inhaler over the traditional short-acting beta-agonist.

Summary

The findings discussed in this article describe the barriers to the implementation of inhaled corticosteroids combined with formoterol for a rescue inhaler in school systems. Traditional asthma action plans, school nursing and parental education, and differences in dosing are some barriers identified. This paper provides solutions for …

A Scoping Review To Conceptualize Social Privilege For Studying Patients' Health Outcomes And Health Disparities, Elizabeth A. Brown, Priyanka Patel, Esther May B. Sarino, Vladimir Markovic, Carles Muntaner

Health Behavior, Policy & Management Faculty Publications

Background

The continued reliance on single-category self-reported demographic data (e.g., race/ethnicity) reflects conceptual limitations that hinder the study and understanding of health outcomes research. There is a pressing need for more precise measures of social privilege that conceptualize privilege and oppression while enabling the examination of their effects on health outcomes in the United States (US) healthcare system.

Objective

The purpose of this scoping review was to review the literature, determine how researchers have measured aspects of privilege and oppression, and develop a conceptual framework to study patients' social privilege in the US healthcare system and public health research.

Methods …

Criterion Validity Of The Functional Status And Pain Assessment Scale Versus Pain And Length Of Stay In Hospitalized Adults With Scd, Wally R. Smith, Daniel M. Sop, Yue May Zhang, Margaret S. Guy, Rehan Qayyum

Department of Medicine Faculty Publications

Objectives

In prior research we demonstrated face, construct, discriminant, and preliminary convergent validity of the newly developed, 10-item Functional Status Pain Assessment (FSPA) scale (0-50) in adult SCD patients hospitalized with VOC. We aimed in this study to further demonstrate criterion validity of the FSPA.

Methods

This was a prospective observational study of 561 daily functional and pain assessments from 91 hospitalized adults with SCD from January 2018 to June of 2019. Principal Component Analysis (PCA) Partial Least Squares (PLS) models determined the relationship between LOS, pain intensity, and FSPA. A Generalized Linear Model (GLM) to quantified the impact of …

Insurance Disparities In Hidradenitis Suppurativa: A Comprehensive Review Of Demographics, Outcomes, And Access To Care, Alim Osman, Alexandra R. Nigro, Michael C. Povelaitis, Marc Z. Handler

Department of Medicine Faculty Publications

Background: Hidradenitis suppurativa (HS) is a chronic inflammatory skin condition that disproportionately affects women, African Americans, and individuals of biracial descent. It is associated with substantial physical and psychiatric morbidity, reducing quality of life.

Objective: This review analyzed disparities in treatment outcomes, disease progression, and healthcare access among HS patients based on insurance type.

Methods: Using PRISMA guidelines, a comprehensive literature search identified 7 studies meeting inclusion criteria. Owing to data heterogeneity, studies were qualitatively analyzed.

Results: Findings consistently demonstrated that Medicaid patients experienced worse outcomes than those with private insurance or Medicare. Medicaid patients had higher rates of comorbid …

Regional Pain Is Associated With Functional Performance In People With Parkinson's Disease, Ryan P. Duncan, Monica R. Hendricksen, Luke Ekdahl, Kevin Smaller, Benjamin Friedman, Miriam R. Rafferty

Department of Medicine Faculty Publications

Background and Purpose:

Little is known about how pain influences physical function in people with mild Parkinson disease (PwPD). The purpose of this study was to investigate the association between physical function and pain presence, location, and intensity in PwPD who were evaluated in an early physical therapy program.

Methods:

Retrospective cross-sectional analysis of electronic medical records from patients with PD evaluated at a single center (2016-2023). Pain presence, location, and intensity (0-10 scale) were recorded at the initial physical therapy evaluation. Functional outcomes included 5-time sit-to-stand, 10-meter walk test, 6-minute walk test, timed up and go, mini-BESTest, and Functional …

State Social Benefit Schemes For Women In Continuity Of Psychiatric Care: A Case Report, Mathumitha A, Kishor M. Manohar Rao Professor

Digital Journal of Clinical Medicine

Mental health disorders are a major global public health challenge. The disorders affect over a billion people worldwide, while depressive and bipolar spectrum disorders also contribute substantially to disability and reduced quality of life. According to the World Health Organization, major depression alone affects more than 300 million people globally and is considered a leading cause of years lived with disability. Beyond clinical morbidity, mental illnesses exert a profound economic impact, with depression and anxiety accounting for an estimated USD 1 trillion annually in lost productivity worldwide, while the overall global economic burden of mental disorders is projected to reach …

What’S Sleep Got To Do With It? A Mixed Methods Exploration Of The Feasibility, Acceptability, And Initial Outcomes Of Group Cbt For Insomnia In Parkinson’S Disease, Claire M. Williams

Theses and Dissertations

Parkinson’s disease is a progressive neurodegenerative disease that is commonly associated with sleep disturbances, affecting up to 80 percent of individuals with Parkinson’s. Effective and accessible treatments for sleep problems in Parkinson’s disease remain limited. Cognitive Behavioral Therapy for Insomnia (CBTi) is a well-established, non-pharmacological treatment for insomnia but has been minimally studied in Parkinson’s populations. This study evaluated the feasibility, acceptability, and preliminary outcomes of a group-based CBTi intervention adapted for individuals with Parkinson’s disease. Participants engaged in a six-week group intervention that incorporated Parkinson’s-specific adaptations. Preliminary findings indicated that the adapted group CBTi intervention was generally feasible and …

The Interplay Between Loneliness, Cortisol, And Nk Cell Function: The Role Of Cortisol In Nk Cell Dysfunction, Abhinav Saurabh, Yvonne Baumer, Laurel G. Mendelsohn, Elizabeth M. Aquino Peterson, Dana Sadler, Shirley J. Lopez De Leon, Ayushi Dave, Andrew S. Baez, Lola R. Ortiz-Whittingham, Mario A. Pita, Manuel A. Cintron, Hannatu A. Tarfa, Sandy T. Reynolds, Shelby R. Hicks, Sonal Sharda, J. Eleanor Seo, Maria Lopez-Ocasio, Pradeep K. Dagur, Skyler A. Kuhn, Neelam R. Redekar, James F. Troendle, Ayanna L. Wells, Marie Marah, Katherine J. Tolentino, Michael J. Corley, Alika K. Maunakea, Lynnette K. Nieman, Marcus R. Andrews, Tiffany M. Powell-Wiley

Department of Biomedical and Translational Sciences Faculty Publications

Chronic psychosocial stressors contribute to cardiovascular disease (CVD) and related risk factors, particularly in under-resourced communities. Psychosocial stressors activate the hypothalamic-pituitary-adrenal (HPA) axis, leading to sustained cortisol action on immune cells. Natural killer (NK) cells are altered in distribution and function in cardio-metabolic diseases; however, pathways linking cortisol as a marker of chronic stress to NK cell dysfunction remain understudied. We recruited 186 African American women from the Step It Up Community-Engaged, Digital Health Physical Activity Intervention study and collected cortisol, NK cell measures, and psychosocial stress measures using validated questionnaires, including chronic stress and loneliness. Plasma cortisol levels were …

Assessing Access To Orthopaedic Care For Patients With Osteogenesis Imperfecta, Annemarie K. Leonard, Kara Ayers, Lauren Faokunla, Kaeli Samson, Erika Carter, Tracy Hart, Maegen Wallace

Graduate Medical Education Research Journal

Background. Osteogenesis Imperfecta (OI) is a rare disorder caused by variations in collagen. Clinical manifestations include multiple fractures, short stature, scoliosis, blue sclera, hearing loss, and opalescent teeth. Patients often need many different medical providers frequently, which may place financial burdens on families. This study sought to identify and understand barriers to care for children with OI.

Methods. We utilized an Institutional Review Board (IRB)-approved survey for primary caregivers of children with OI. Questions included demographic data, type of health insurance, history of and reasons for insurance denials, access to multidisciplinary OI care, and travel to receive OI care. The …

Evaluating The Effect Of Ethnicity And Amyloid On Gait Speed In The Healthy Aging Brain Study-Health Disparities Study, Alexandra M. Reed, Andrew Hooyman, Edward Ofori, Sydney Y. Schaefer

Physical Therapy Faculty Articles and Research

Background

Many novel Alzheimer's disease (AD) biomarkers have been studied in non-Hispanic White populations, despite Hispanic/Latino adults being 1.5 times more likely to develop AD and receiving a later diagnosis. Equitable, accessible assessments are needed to identify individuals at risk earlier. While cognitive screening monitors early AD signs, neuropsychological tests are often inequitable across ethnicity, race, and other social determinants of health. However, we have shown that performance-based motor assessments may be less susceptible to demographic factors than memory tests, and may be more equitable for screening older adults. Gait speed has been linked to elevated amyloid in non-Hispanic White …

Developing A Tool To Measure Resistance To Sustainable Food Choices: A Pilot Study In Ireland And The Netherlands, Kate Flanagan, Bart Sinteur, Patricia J. Bulsing, John M. Kearney

SURE Journal: Science Undergraduate Research Experience Journal

Consumer uptake of a sustainable diet is critical for addressing environmental challenges and promoting public health. Understanding why consumers resist adopting sustainable eating habits can inform targeted interventions and policies. This pilot study examines whether a newly developed scale can effectively detect consumer resistance to a sustainable diet. Currently, there is a lack of research on a tool to measure consumer resistance to a sustainable diet, highlighting the need for a reliable instrument.

The aim of this study is to develop a scale, based on existing literature, to measure consumer resistance to a sustainable diet. Additionally, the study aims to …

Editorial-Sure Journal Volume 7, Issue 2, Geraldine M. Dowling, Eva Campion, Sinead Loughran, Ariane Perez-Gavilan, Josephine Treacy

SURE Journal: Science Undergraduate Research Experience Journal

No abstract provided.

Filling The Gap: Integrating Hiv Into The Counselor Education Curriculum, J. Richelle Joe, Roseina D. Britton, Tiffany Hairston

Teaching and Supervision in Counseling

People living with HIV (PLWH) are vulnerable to mental health conditions including depression, anxiety, and substance use disorders, which in turn, often affect their health outcomes. Multiple, overlapping structural and social determinants of health exacerbate the physical and mental health concerns of PLWH, presenting a need for services that are responsive to the unique implications of the illness. Professional counselors have the potential to provide such services but must be adequately prepared to do so. In response to the lack of HIV-related professional development for counselors and the minimal preparation of counselors-in-training to serve clients with HIV, this article uses …

Enhancing Public Health Strategies: Addressing The Rsv Burden In Alabama Through Clinical Treatment, Community Prevention, And Surveillance Approaches, Martha K. Findley Roper, Jennifer S. Dawson

Journal of Public Health in the Deep South

Introduction: Respiratory Syncytial Virus (RSV) is a highly contagious pathogen driving morbidity, hospitalizations, and economic burden. This review uses the epidemiological triad and National Wastewater Surveillance System data to assess transmission, viral load spikes in Alabama, and strategies for treatment and prevention.

Methods: A review of literature on supportive care, vaccination, monoclonal antibodies, and emerging nanomedicine was reviewed to evaluate strategies for reducing viral burden and complications.

Results: Trends from December 2024–January 2025 were assessed with National Wastewater Surveillance System data. Primary prevention includes immunization, hygiene, air quality maintenance, and early diagnostics. Tertiary care addresses complications such as secondary …

Lycopene, Race And Periodontitis: Disparities In Older Adults, Katherine Kwong, You Lu, Zhuo Huan Li, Susu Luo, Zhaoyu Huang, Zhong Chen, Na Zhao, Tung Sung Tseng

School of Public Health Faculty Publications

Background Periodontitis is a severe gum disease that can be an indicator of other health conditions such as cardiovascular disease and diabetes. Lycopene has been suggested as an adjunct therapy for periodontitis. This study aims to investigate the association between insufficient lycopene intake and the risk of Periodontitis among non-Hispanic White (NHW) and non-Hispanic Black (NHB) older adults. Methods The study included 1,227 adults aged 65–79 years from the National Health and Nutritional Examination Survey (2009–2014). Total lycopene intake from daily diet was studied with age, race, marital status, smoking status, BMI, diabetes, sex, and education as independent variables in …

Identification Of Predictive Pretreatment Biomarkers For Neoadjuvant Chemotherapy Response In Latino Invasive Breast Cancer Patients, Hedda Michelle Guevara-Nieto, Rafael Parra-Medina, Carlos A. Orozco, Sandra Diaz-Casas, Jone Garai, Jovanny Zabaleta, Liliana López-Kleine, Alba L. Combita

School of Medicine Faculty Publications

Background: Breast cancer (BC) exhibits significant heterogeneity in incidence and mortality worldwide. Neoadjuvant chemotherapy (NAC) is the standard treatment for locally advanced BC; however, its efficacy varies by subtype. This study examined the gene expression profiles associated with NAC response in Colombian women with invasive BC. Methods: RNA sequencing of pre-treatment tissues from 58 patients (29 responders and 29 non-responders) identified differentially expressed genes (DEGs) for each molecular subtype, and prognostic performance was evaluated using risk scores. Results: Functional enrichment analysis highlighted the immune system pathways in non-responders. Changes in cytokine target activity and immune cell populations were analyzed to …

Travel Time To Treating Facility And Mortality In Men With Prostate Cancer, Stephan M. Korn, Filippo Dagnino, Danesha Daniels, Zhiyu Qian, Hanna Zurl, Klara K. Pohl, Mei Chin Hsieh, Brenda Y. Hernandez, Andrea Piccolini, Alexander P. Cole, Amanda J. Reich, Joel S. Weissman, Quoc Dien Trinh, Hari S. Iyer

School of Public Health Faculty Publications

IMPORTANCE Geographic access to prostate cancer care may influence outcomes but is often measured using straight-line distance, which may not accurately capture the travel burden experienced by patients. OBJECTIVE To evaluate the association between estimated travel time from patients’ residence to treatment facilities and all-cause and prostate cancer–specific mortality. DESIGN, SETTING, AND PARTICIPANTS This retrospective cohort study used data from the Multilevel Epidemiologic Tumor Registry for Oncology, a nationally representative, investigatorinitiated, population-based cancer registry that integrates geomasked residential and treatment facility information from multiple US state cancer registries. The study included patients aged 40 to 99 years from Hawaii, Louisiana, …

Diabetes And Hypertension Frequencies And Trends In The Health Districts Of Sololá, Alejandro Cerón, Sophie Perfetto, Ana Textor, Sidona Alemayehu, Emilia Alvear Escobar, Adele Beard, Sarah Berson, Rachel Bryant, Jennifer Calzontzi, Rylee Castro, Eva Cress Palencia, Jake Czarnecki, Jordyn Epstein, Nikki Harris, Patience Hinojos, Max Hippisley, Erin House, Jackson Hullett, Nathan Johnson, Amelie King, Saule Lankelyte, Juan Loya, Ashley Mackenzie, Ilana Mighdoll, Molly Morrill, Maria De Jesus Ramos Jimenez, Lilly Teklemedhin, Joseph Trujillo, Lauren Verachtert, Nathan Verachtert, Violet Vreeland, Alex Welch, Jada Wright

Anthropology: Undergraduate Student Scholarship

This report was prepared by the students, Graduate Teaching Assistants, and instructor of “The Social Determination of Health” class taught in the fall of 2025 at the University of Denver. The report was prepared for Dr. Luis Pablo Méndez, of the Vice Ministry of Health Regulation, Surveillance and Control, of the Ministry of Public Health and Social Assistance of Guatemala. The work used the following guiding question: How can available data about service production can be used to inform the planning process for the implementation of the Global Hearts Initiative’s HEARTS technical package in the Distrito de Redes Integradas de …

Gender Differences In Healthy Eating Index As Informed By The Awareness Of Diagnosis Of Metabolic Dysfunction-Associated Steatotic Liver Disease, Wei Ting Lin, Madeline Novack, Suthat Liangpunsakul, Chiung Kuei Huang, Hui Yi Lin, Po Hung Chen, Tung Sung Tseng, Peng Sheng Ting

School of Public Health Faculty Publications

Background/Objectives: Dietary quality is a driver of metabolic dysfunction-associated steatotic liver disease (MASLD). Men and women often have different levels of adherence to medical advice, but the effect of gender on adherence to dietary advice as a function of awareness of MASLD is understudied. We aim to investigate the differences in diet quality between men and women who are aware of their diagnosis of MASLD compared to their undiagnosed counterparts. Methods: We utilized the National Health and Nutrition Examination Survey 2017–2020 to identify a nationally representative sample of subjects with MASLD, 127 of whom reported a diagnosis of MASLD (diagnosed …

High Prevalence And Atypical Genotype Distribution Of Oral Human Papillomavirus In An East African Hiv Cohort: A Cross-Sectional Study, Ian G. Munabi, Adriane Kamulegeya, Dunstan Kalanzi, David P. Kateete, Fred Collins Semitala, Catherine-Lutalo Mwesigwa, Samuel Kalungi, Jennifer E. Cameron, Kimon Divaris, William Buwembo

School of Medicine Faculty Publications

BACKGROUND: Globally, Human Papillomavirus type 16 (HPV-16) is the predominant genotype associated with oropharyngeal cancers. However, little is known about the prevalence and type distribution of Oral Human Papillomavirus (OHPV) in people living with HIV (PLWHIV) in the East African region. The objective of this study was to document the prevalence and circulating genotypes of OHPV infection in a large cohort of PLWHIV attending an urban HIV clinic in Eastern Africa METHODS: This was a cross-sectional study among 1,715 participants of the Makerere University Joint AIDS Program clinic, located in Kampala, Uganda, in East Africa. A salivary sample was collected …

Characterizing Global Dermatologic Engagement And Needs: A Cross-Sectional Study From 83 Countries, Alexis G. Strahan, Christine Li, Maud Guérin, Tom Allison, Gene Colón, Jehireh Peraza-Williams, Olyvia Zarchin, Morvarid Zehtab, Ann M. Pacheco, Jadesola Akinwuntan, Shivani Jain, Marlous L. Grijsen, Wendemagegn Enbiale, Wingfield Rehmus, L. Claire Fuller, Karolyn Wanat, Esther E. Freeman

School of Medicine Faculty Publications

No abstract provided.

Shape: Spatial Health And Population Estimator, Emma M. Von Hoene, Aanya Gupta, Hamdi Kavak, Amira Roess, Taylor Anderson

Annual Symposium on Biomathematics and Ecology Education and Research

No abstract provided.

Losing Focus In The Age Of Tik Tok: Clinical Evidence For Policy Action On Social Media Use, Megan Conefrey, Robert Griffin

SURE Journal: Science Undergraduate Research Experience Journal

No abstract provided.

Tracking Livestock Heart Rate & Location Using Long-Range Radio Networks. An Immediate Solution For Farms Without Reliable Wi-Fi, Dermott Harkin, Martin Bradley

SURE Journal: Science Undergraduate Research Experience Journal

No abstract provided.

Voices Matter: Tackling Accentism In Ireland. A Study Addressing Accent-Based Discrimination Awareness In Education, Sadhbh Reddington, Victoria Graham, Holly Jordan, Mairead Moriarty

SURE Journal: Science Undergraduate Research Experience Journal

No abstract provided.

Income Inequality And Attitudes Towards Immigrants – How Increased Inequality Drives Division, Niamh Anderson, Vincent O'Sullivan

SURE Journal: Science Undergraduate Research Experience Journal

No abstract provided.