Public Health Commons^™

Age-Dependent Chronic Lung Injury And Pulmonary Fibrosis Following Single Exposure To Hydrochloric Acid, Ruben M.L. Colunga Biancatelli, Pavel Solopov, Christiana Dimitropoulou, John D. Catravas

Bioelectrics Publications

Exposure to hydrochloric acid (HCl) represents a threat to public health. Children may inhale higher doses and develop greater injury because of their smaller airways and faster respiratory rate. We have developed a mouse model of pediatric exposure to HCl by intratracheally instilling p24 mice (mice 24 days old; 8–10 g) with 2 µL/g 0.1 N HCl, and compared the profile of lung injury to that in HCl-instilled adults (10 weeks old; 25–30 g) and their age-matched saline controls. After 30 days, alveolar inflammation was observed with increased proteinosis and mononuclear cells in the bronchoalveolar lavage fluid (BALF) in both …

Opioid Use Disorder: The Timeline For Medication Assisted Therapy, Alexander Cristofori

Capstone Showcase

Opioid Use Disorder is patterns of opioid use leading to withdrawal, giving up important life events in order to use opioids, and excessive time spent using opioids, to name a few diagnostic criteria. The clinical progression of the disorder involves periods of acute exacerbation and remission that are cyclic in nature. Treatment is most effective when it includes both pharmacological and psychosocial modalities, referred to as medication assisted therapy (MAT). Three drugs used commonly in MAT-based treatment for OUD from oldest to newest include Methadone, Buprenorphine-naloxone, and Naltrexone. Treatment program models that prioritize total abstinence from the addictive substance attached …

Effect Of Exercise On Blood Pressure And Body Mass Index In At-Risk Populations, Jared Crum, Victoria Patterson, Riley Jarvis

Williams Honors College, Honors Research Projects

Higher blood pressure and basal metabolic rate (BMI) are health problems in the United States (U.S.), but particularly in high risk minority populations, in part because of limited access to adequate resources to help themselves become healthier. This Honors Paper aimed to examine the effect of an exercise intervention on blood pressure and BMI in high risk minority populations. The honors project is a part of the Finding A Better You (FABU) project by College of Health Profession faculty Dr. Murrock, Dr. MacCracken, and Dr. Juvancic-Heltzel. The FABU project assessed at risk individuals (lower income older adults) in Summit County …

Maintaining Population Health In Low‐ And Middle‐Income Countries During The Covid‐19 Pandemic: Why We Should Be Investing In Community Health Workers, Benjamin Palafox, Alicia Renedo, Gideon Lasco, Lia M. Palileo-Villanueva, Dina Balabanova, Martin Mckee

Development Studies Faculty Publications

Community health workers in low- and middle-income country primary health care systems are well suited to perform essential functions on the frontlines of Covid-19 pandemic responses. However, clear and coordinated guidance, updated infection control training, and reliable access to personal protective equipment must be ensured in order to deploy them safely and effectively. With these additional responsibilities, community health workers must also be supported to ensure that hard-fought gains in population health, including progress on non-communicable diseases, are sustained throughout the pandemic.

Improving Human Papillomavirus Vaccination Rates Among Kentucky Adolescents, Cori Arena

DNP Projects

Background: The Human Papillomavirus (HPV) is a significant factor associated with the development of HPV-associated cancers in the United States. The administration of the HPV vaccination is a critical prevention strategy in reducing HPV-related cancers in the United States. The state of Kentucky has lower than average HPV vaccination rates compared to the national average. There is a significant amount of evidence exploring barriers and facilitators of the HPV vaccination administration. There are several multi-level barriers associated with low uptake of the HPV vaccination in adolescents. Multiple sources of evidence have indicated that parents who receive a provider recommendation are …

Population Assessment To Determine The Eligibility For Birth Center Care At University Of Kentucky Midwife Clinic, Dolores Polito

DNP Projects

Background: The COVID-19 crisis prompted patients to inquire about their options to avoid going to the hospital for birth. Outside of the hospital, birth center care has been identified as an evidence-based model for healthy women during pregnancy and birth, but it is not available in Kentucky.

Purpose The purpose of this study was to determine if there are women eligible for birth center care who have been part of a nurse midwifery service and given birth in a large, academic, tertiary care setting.

Methods: A retrospective chart review was used for this study. It involved a collection of …

More Than A Myth: The Benefits Of Incorporating Holistic Healing Methods From Native American And Mexican Cultures To Approach Opioid Use Disorder (Oud) Treatment, Juliana Favela

CMC Senior Theses

Opioid Use Disorder (OUD) is a substance use disorder that characterizes a dependence on and an addiction to opioids. Opioids attack the prefrontal cortex, the dopaminergic reward system, and the hypothalamic-pituitary-adrenal (HPA) axis which is responsible for the body’s stress response. Opioids constantly shift one’s “set point” to the point where normal actions that cause joy and excitement no longer cause those feelings, resulting in craving and dependence. The opioid epidemic is currently ravaging the United States and has disproportionately affected Native American populations specifically in the rural areas (Tipps, et.al, 2018). The current methods for addressing OUD include medicine …

2018 Statewide Child Death Report, Nevada Institute For Children’S Research And Policy, Dawn L. Davidson, Elizabeth Holka

Nevada Institute for Children's Research and Policy Reports

The purpose of this report is to provide comprehensive information regarding the circumstances by which children die in Nevada in order to prevent future child deaths and improve the health and safety of children in the state.

White Paper On Engineering Controls For Bioaerosols In Non-Industrial/ Non-Healthcare Settings, Cheri L. Marcham, American Conference Of Governmental Industrial Hygienists

Publications

The list of disease pathogens that can be transmitted in the air is extensive. This list includes the common cold, SARS, measles, Hansen's disease (leprosy), polio, influenza, Legionella (Legionnaires’ disease and Pontiac fever), and tuberculosis (TB). TB, SARSCoV-1, avian influenza, varicella, and now SARS-CoV-2 all have received public notice due not only to their known or assumed ability to be transmitted in the air rapidly from one individual to another, but also for their virulence. Other bioaerosols that can be transmitted through the air include bacteria, fungal spores and fragments, dust mites, and pollen. This document was developed to address …

Identifying Sleep-Related Factors Associated With Cognitive Function In A Hispanics/Latinos Cohort: A Dual Random Forest Approach, Li Xiaojin, Cui Licong, Wang Fei, Paul E Schulz, Guo-Qiang Zhang

Faculty, Staff and Student Publications

Disordered sleep is associated with poor cognitive function and cognitive decline. However, little is known regarding the association of sleep-related factors with cognitive function in underrepresented cohorts such as the Hispanic/Latino population. Leveraging the National Sleep Research Resource, one of the most comprehensive collections of sleep studies, we identified a Hispanic/Latino cohort of 1,031 lower cognitive function cases and 2,062 normal controls. We developed a novel dual random forest (DRF) approach to discriminate cases against controls for estimating the potential impact of sleep-related variables related to the decline of cognitive function. Several important sleep-related factors were identified which may be …

The Primary Care Provider’S Role In Screening And Intervening In The Human Trafficking Of Adolescents: A Systematic Literature Review, Brittany Schmid

All Graduate Theses, Dissertations, and Other Capstone Projects

Human trafficking (HT) is a growing concern within the United States (U.S.) and internationally. With the alarming number of HT victims presenting for medical care, primary care providers (PCPs) are in a unique and privileged position to encounter HT victims within the healthcare system. Adolescents, in particular, are vulnerable to HT because of minimal life experiences, inadequate social support, and limited coping mechanisms (Ertl et al., 2020). Failure to recognize and intervene in cases involving HT victims who are minors is detrimental to the individual’s health, wellbeing, and safety. With the assistance of education and training, community resources, guideline adoption, …

Factors Influencing Contraception Use In Sexual Minority Women: A Systematic Literature Review, Grace M. Hudson

All Graduate Theses, Dissertations, and Other Capstone Projects

Contrary to widespread beliefs that lesbian, gay, bisexual, transgender, queer, plus (LGBTQ+) women do not need contraceptive care, sexual minority women (SMW) engage in vaginal-penile sexual contact which puts them at risk for unintended pregnancy. SMW assigned female gender at birth are at higher risk for less reliable and consistent contraceptive use and thus unintended pregnancy (Everett et al., 2017). This leads to the question of factors which cause SMW to be less engaged in contraceptive services. Through synthesis of studies addressing SMW and contraceptives, four themes developed: attitudes towards contraception, obstacles to care, knowledge gaps, and ways to improve …

Understanding The Implications Of Hpv Infection: Does Parental Education Impact Hpv Vaccination Completion Rates?, Heather A. Pederson

All Graduate Theses, Dissertations, and Other Capstone Projects

Up to 80% of United States (U.S.) citizens will contract the human papillomavirus (HPV) at some point in their lives. HPV has the ability to cause multiple types of cancer, including cervical, vulvar, vaginal, penile, anal, and oropharyngeal. The most recent HPV vaccine is effective against nine strains of the virus, which account for most cases of cancer and genital warts caused by HPV. Parents are a key component in reaching Healthy People 2030’s goal to have 80% of all adolescents in the U.S. completely vaccinated against HPV. Objective: The purpose of this systematic review was to determine if …

Epigenetic Mechanisms Underlying Hiv-Infection Induced Susceptibility Of Cd4+ T Cells To Enhanced Activation-Induced Fasl Expression And Cell Death., Smita Ghare, Paula M. Chilton, Aakarsha V. Rao, Swati Joshi-Barve, Paula Peyrani, Andrea Reyes-Vega, Craig J. Mcclain, Kendall Bryant, Robert L. Cook, Mathew Freiberg, Shirish Barve

Faculty and Staff Scholarship

Background:

Chronic immune activation and CD4⁺ T cell depletion are significant pathogenic features of HIV infection. Expression of Fas ligand (FasL), a key mediator of activation-induced cell death in T cells, is elevated in people living with HIV-1 infection (PLWH). However, the epigenetic mechanisms underlying the enhanced induction of FasL expression in CD4⁺ T lymphocytes in PLWH are not completely elucidated. Hence, the current work examined the effect of HIV infection on FasL promoter-associated histone modifications and transcriptional regulation in CD4⁺ T lymphocytes in PLWH.

Method:

Flow cytometric analysis was performed to examine the Fas-FasL expression on …

Healthier Oregon Qualitative Study, Core (Center For Outcomes Research & Education)

Reports

No abstract provided.

Nursing, Physical Therapy, And Cytotechnology Graduate And Undergraduate Students' Attitudes Toward Teamwork Before And After Participation In An Interprofessional Education Experience, Shelley C. Mishoe, Muge Akpinar Elci, Rebecca Poston, Kimberly Adams Tufts, Beth Thompson

Community & Environmental Health Faculty Publications

BACKGROUND Educating health professional (HP) students in environments wherein they can learn about, from, and with each other can prepare them for interprofessional collaborative practice (IPCP), which may positively impact patient safety and satisfaction (Brashers et al., 2015; Health Professions Accreditors Collaborative [HPAC], 2019). IPCP is characterized by effective communication, shared values, respect for diverse disciplines and teamwork among health professionals (IOM, 2015). However, professional silos in practice can foster competition rather than collaboration. Knowledge of HP roles and responsibilities is a primary tenet of IPCP (Interprofessional Educational Collaborative [IPEC], 2011).

PURPOSE An interprofessional education (IPE) approach that combined book …

A Qualitative Study On The Perception Of Undergraduate Nursing Students On Online Learning During The Covid-19 Pandemic At A Public University In Malaysia, Muhammad Hibatullah Romli

Student Works (2020-2029)

The COVID-19 pandemic and Movement Control Order have restricted learning activities in traditional face-to-face classrooms. Subsequently, these learning activities have shifted to full online learning, and these activities are conducted in the student’s own environment namely dorm room and home. The present researcher conducted a meta-synthesis, and the result shows that full online learning is receiving resistance, however, it begin to gain better reception. Past studies show that online learning is a potential approach in allowing active and dynamic learning experience especially on the acquisition of theoretical knowledge, despite having limitations to developing technical skills. Therefore, the present study aimed …

Strategic Implications Of Covid-19: Considerations For Georgia’S Rural Health Providers, Bettye A. Apenteng, Linda Kimsey, Charles Owens, Samuel T. Opoku, Angela Peden, William Mase

Health Policy & Community Health: Faculty Publications

Whether rural hospitals and providers have seen a surge in COVID-19 cases or a reduction in patients seeking care since the pandemic began, their financial condition has been negatively impacted. Many providers have now received some emergency funding through the Coronavirus Aid, Relief, and Economic Security Act and the Payroll Protection Program but these are likely only short-term fixes. For many, the crisis has exacerbated already existing problems. Notable among these problems are volume declines, supply chain disruptions, and workforce concerns. While these problems require immediate action, two longer-term systemic changes to rural healthcare delivery are needed to address them. …

Syphilis Screening Among Primary Care Providers, Sarah Christian, Nikki Franklin, Seth Stuart, Casey Tramel, Sereka Walker

MSN Research Projects

Syphilis is a sexually transmitted infection (STI) that can cause lesions on various mucosal areas of the body on an infected individual. If the disease is left untreated, syphilis can progress and affect an individual’s cardiovascular, neurological, and immune systems. The STI rates are on the rise across the United States, especially in the state of Mississippi. Because of the increase in syphilis rates in Mississippi, the researchers developed this study. The purpose of this study is to determine if primary care providers (PCPs) are knowledgeable and screening according to the guidelines of the Early and Periodic Screening, Diagnostic, and …

A Survey Of Primary Care Providers’ Strategies To Affect Influenza Vaccination Rates, Jennifer Moffett, Tracy Mitchell, Vera Simmons

MSN Research Projects

Influenza is a vaccine preventable disease that affects millions of Americans and causes thousands of deaths and billions in healthcare costs. Annual influenza vaccination is regarded by researchers and healthcare governing bodies as the most effective way to prevent contracting the flu. A large body of research exists supporting primary care providers as influential in regard to patients’ healthcare decision making. However, if strategies are consistently being implemented to affect influenza vaccination rates remains unclear. The purpose of this study was to identify strategies being implemented to affect influenza vaccination rates by asking two questions: 1. Do primary care providers …

Understanding And Promoting Racial Diversity In Healthcare Settings To Address Disparities In Pandemic Crisis Management, Azza Sarfraz, Zouina Sarfraz, Alanna Barrios, Kuchalambal Agadi, Sindhu Thevuthasan, Krunal Pandav, Manish Kc, Muzna Sarfraz, Pedram Rad, George Michel

Department of Paediatrics and Child Health

Background: Health disparities have become apparent since the beginning of the COVID-19 pandemic. When observing racial discrimination in healthcare, self-reported incidences, and perceptions among minority groups in the United States suggest that, the most socioeconomically underrepresented groups will suffer disproportionately in COVID-19 due to synergistic mechanisms. This study reports racially-stratified data regarding the experiences and impacts of different groups availing the healthcare system to identify disparities in outcomes of minority and majority groups in the United States.
Methods: Studies were identified utilizing PubMed, Embase, CINAHL Plus, and PsycINFO search engines without date and language restrictions. The following keywords were used: …

Patient-Perceived Versus Actual Risk Of Cardiovascular Disease And Associated Willingness To Consider And Use Prevention Therapy, Ann Marie Navar, Tracy Y Wang, Shuang Li, Xiaojuan Mi, Zhuokai Li, Jennifer G Robinson, Salim S Virani, Eric D Peterson

Faculty, Staff and Students Publications

BACKGROUND: Cardiovascular prevention guidelines use estimated 10-year atherosclerotic cardiovascular disease (CVD) risk based on the pooled cohort equations to guide treatment decisions and engage patients in shared decision-making. We sought to determine patient perceived versus actual risk of atherosclerotic CVD and associations with willingness for preventive therapy.

METHODS: We evaluated calculated and perceived CVD risk among 4187 patients across 124 sites in the Patient and Provider Assessment of Lipid Management Registry. Ten-year risk was assessed using the pooled cohort equations; risk relative-to-peers was determined based on age-, sex-, and race-based percentiles; and patient estimates of risk were assessed using patient …

How Did We Learn About Sex? —— Sex Education And Sexual Health In Chinese Youth, Yujuan Liu

Theses and Dissertations (Comprehensive)

Attitudes toward sexuality among Chinese youth have become more liberal in recent generations, but sex education remains controversial and limited. Due to the lack of awareness of sexual risks, many Chinese youth engage in unprotected sexual activities resulting in unintended pregnancy, abortions, and STIs. Therefore, understanding successful pathways and unique challenges are crucial to develop adequate sex education for youth’s sexual health in China. The current study used semi-structured in-depth interviews and investigated 28 Chinese youths’ experiences of sex education and sexual health. The results mapped out youth’s sex education experiences by age and sources and demonstrated the impacts of …

Effect Of An Electronic Order Set On Newborn Hepatitis B Immunization Rates, Daniel Pedersen, Angelina Rodriguez, Olu Oyesanmi, Heather Schramm, Michael King

HCA Healthcare Journal of Medicine

Objective

Hepatitis B is an infectious deoxyribonucleic acid virus which can cause significant morbidity and mortality. There is no current definitive treatment, however in the United States immunization is widely available. A paper published by the Advisory Committee on Immunization Practices/Centers for Disease Control (ACIP/CDC) in 2018 made updated recommendations regarding vaccination practices in the United States. The most notable change made was that all healthy newborns weighing ≥2000 g with a negative hepatitis B-status mother should receive hepatitis B immunization within 24 hours of birth. This quality improvement project studied the effect of the electronic medical record newborn admission …

Preconceptional Lipid-Based Nutrient Supplementation In 2 Low-Resource Countries Results In Distinctly Different Igf-1/Mtor Placental Responses, Marisol Castillo-Castrejon, Ivana V. Yang, Elizabeth J. Davidson, Sarah J. Borengasser, Purevsuren Jambal, Jamie Westcott, Jennifer F. Kemp, Ana Garces, Sumera Aziz Ali, Sarah Saleem

Community Health Sciences

Background: Preconceptional maternal small-quantity lipid-based nutrient supplementation (SQLNS) improved intrauterine linear growth in low-resource countries as demonstrated by the Women First Preconception Maternal Nutrition Trial (WF). Fetal growth is dependent on nutrient availability and regulated by insulin-like growth factor 1 (IGF-1) through changes in placental transfer capacity, mediated by the mechanistic target of rapamycin (mTOR) pathway.
Objectives: Our objective was to evaluate the role of placental mTOR and IGF-1 signaling on fetal growth in women from 2 low-resource countries with high rates of stunting after they received preconceptional SQLNS.
Methods: We studied 48 women from preconception through delivery who were …

Elderly Musculoskeletal Disease Burden In Karachi, Pakistan: Associations And Implications For Developing Countries, Saniya Sabzwari, Zafar Fatmi, Adeel Ahmed Khan

Department of Family Medicine

Objective: The global rise in the older population has increased the rates of osteoporosis and osteoarthritis, conditions that impact mobility and functionality. There is limited data on musculoskeletal disease in older populations residing in developing countries.
Methods: A community-based study using multistage cluster random sampling of older individuals was conducted in Karachi. Predefined criteria were used for osteoporosis and osteoarthritis. Gait assessment was performed.
Results: More than half of the participants were females and 53% reported illiteracy. Around 30% had osteoporosis and two-thirds had osteoarthritis. Multivariate analysis showed associations of female sex, Pashtun ethnicity, illiteracy, and hypertension with the combined …

Short Term Effects Of Electronic Cigarettes On Pulmonary Function In Healthy Adult Smokers When Compared To Conventional Cigarette Use, Kayleen Lynch, Rachel Bastianelli

Physician Assistant Capstones, 2020-current

Background: Electronic cigarettes (e-cigarettes) first appeared on the U.S. market in 20071 , but to date, little is known about their safety. Concern about long term adverse effects on overall health continues to increase as we explore the potential of e-cigarettes to aid in smoking cessation practices. E-cigarettes have gained popularity and support through this idea that by using them to help patients quit smoking, the benefits of ultimately abstaining from tobacco use will outweigh the harms associated with e-cigarette use¹ . While the idea of reducing tobacco usage by any means possible remains the goal for most providers, …

Healthcare Workers Hospitalized With Covid-19: Outcomes From The Burden Of Covid-19 Study At The University Of Louisville Center Of Excellence For Research In Infectious Diseases [Cerid], Ruth Carrico, T'Shura S. Ali, Maria Hill, Lucia B. Puga Sanchez, Catherine M. Bryan, Dawn Balcom, Stephen P. Furmanek, Amr Aboelnasr, Julio A. Ramirez

The University of Louisville Journal of Respiratory Infections

Introduction: On March 6, 2020, the current ongoing pandemic of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), also known as COVID-19, reached the commonwealth of Kentucky. Within days, the first cases of infection and hospitalization were identified among healthcare workers (HCW) in Kentucky, other states in the U.S., and around the world. There is little information available regarding the impact of COVID-19 on the HCW population within this area. The objective of this study was to describe the baseline characteristics of hospitalized HCWs infected with COVID-19.

Methods: Data collection was performed as part of a retrospective study of patients hospitalized …

Open Drug Discovery Of Anti-Virals Critical For Canada’S Pandemic Strategy, Tania M. Bubela, E. Richard Gold, Vivek Goel, Max Morgan, Karen Mossman, Jason Nickerson, David Patrick, Aled Edwards

Office of the Provost

In the event of the current COVID-19 pandemic and in preparation for future pandemics, open science can support mission-oriented research and development, as well as commercialization. Open science shares skills and resources across sectors; avoids duplication and provides the basis for rapid and effective validation due to full transparency. It is a strategy that can adjust quickly to reflect changing incentives and priorities, because it does not rely on any one actor or sector. While eschewing patents, it can ensure high-quality drugs, low pricing, and access through existing regulatory mechanisms. Open science practices and partnerships decrease transaction costs, increase diversity …

Covid-19 & Pregnancy Complication During Early Pandemic: A Narrative Review, Ahmed A. Eladely, Maria Hill, Ahmed Abdelhaleem, Zahid Imran, Ahsan M. Khan, Daisy Sangroula

The University of Louisville Journal of Respiratory Infections

Background: Coronaviruses have caused three outbreaks in the past two decades. The novel one is SARS-COV-2, which causes COVID-19. Pregnant women have a somewhat altered immune state, which may make them more vulnerable to COVID-19 and its complications. Extensive research is needed to better understand the clinical course of COVID-19 in this population. This review article discusses the comparison of SARS-CoV-2 with previous coronavirus outbreaks, clinical presentations, and complications in pregnant women and newborns.

Methods: We conducted a literature search for case series and case reports about pregnancy outcomes in pregnant women with COVID-19 during the early phase of pandemic. …