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The Journal Of Appalachian Health: A Year Of Growth And Impact, Noah Wren, Bradley Firchow, Emily Wilson, Randy Wykoff

Journal of Appalachian Health

The Journal of Appalachian Health continues to grow in strength and reach, serving as a critical platform for research and discussion on the unique health challenges and opportunities in Appalachia, as well as how the challenges and opportunities Appalachia faces are local manifestations of broader regional and global phenomena. Over the past year, we have witnessed a remarkable expansion in our readership, reflecting the increasing demand for evidence-based insights into the health of our region.

The Adiponectin-Pparγ Axis In Hepatic Stellate Cells Regulates Liver Fibrosis, Shangang Zhao, Qingzhang Zhu, Wang-Hsin Lee, Jan-Bernd Funcke, Zhuzhen Zhang, May-Yun Wang, Qian Lin, Bianca Field, Xue-Nan Sun, Guannan Li, Mbolle Ekane, Toshiharu Onodera, Na Li, Yi Zhu, Christine M Kusminski, Terry D Hinds, Philipp E Scherer

Faculty, Staff and Students Publications

Hepatic stellate cells (HSCs) are key drivers of local fibrosis. Adiponectin, conventionally thought of as an adipokine, is also expressed in quiescent HSCs. However, the impact of its local expression on the progression of liver fibrosis remains unclear. We recently generated a transgenic mouse line (Lrat-rtTA) that expresses the doxycycline-responsive transcriptional activator rtTA under the control of the HSC-specific lecithin retinol acyltransferase (Lrat) promoter, which enables us to specifically and inducibly overexpress or eliminate genes in these cells. The inducible elimination of HSCs protects mice from methionine/choline-deficient (MCD) diet-induced liver fibrosis, confirming their causal involvement in fibrosis development. We generated …

Sex-Specific Astrocyte Regulation Of Spinal Motor Circuits By Nkx61, Navish A Bosquez Huerta, Zhung-Fu Lee, Eun-Ah Christine Song, Junsung Woo, Yi-Ting Cheng, Debosmita Sardar, Ozlem Sert, Ehson Maleki, Kwanha Yu, Ekin Su Akdemir, Kaitlyn Sanchez, Juyeon Jo, Matthew N Rasband, Hyun Kyoung Lee, Akdes Serin Harmanci, Benjamin Deneen

Faculty, Staff and Students Publications

Astrocytes exhibit diverse cellular and molecular properties across the central nervous system (CNS). Recent studies identified region-specific transcription factors (TF) that oversee these diverse properties; how sex differences intersect with region-specific transcriptional programs to regulate astrocyte function is unknown. Here, we show that the TF Nkx6.1 is specifically expressed in ventral astrocytes of the spinal cord and that its deletion results in sex-specific effects on astrocyte morphology. Astrocytes from males exhibit enhanced morphological complexity, accompanied by increased motor function and cholinergic synapses. In contrast, female astrocytes exhibit reduced complexity and no changes in motor function. Mechanistically, we found that Nkx6.1 …

Efektivitas Full Body Stretching Dan Edukasi Manual Handling Digital Terhadap Keluhan Musculoskeletal Disorders Pekerja Yantek, Nadia Rosalinda, Anita Sulistyorini, Marji Marji, Supriyadi Supriyadi, Tika Dwi Tama

National Journal of Occupational Health and Safety

Occupational Diseases (PAK) in the form of pain complaints in the skeletal system that cause the work process are called Musculoskeletal Disorders (MSDs). PT. PLN Yantek workers are at risk of experiencing MSDs complaints because the work is done manually and the work posture is less ergonomic. This study aimed to analyze the effect of implementing full-body stretch and digital-based manual handling education and to assess its effectiveness on MSDs. The study used a quasi-experimental method with a one-group pretest-posttest design involving 26 Yantek workers. The intervention was given at 10 meetings, MSDs complaints were measured using the Nordic Body …

Virginia Academy Of Sleep Medicine Position Statement On School Start Times In Virginia, Sean Hesselbacher, Mariana Szklo-Coxe, Sachin Relia, Jonathan Gellman, Nicole Mcintyre

Eastern Virginia Medical Journal

The VASM endorses the 2017 AASM position statement that middle and high schools should begin no earlier than 8:30 a.m. The existing and updated scientific literature repeatedly identifies the detrimental impact of early high school start times, and the benefits of delaying start times, on the safety and well-being of students in Virginia. The adverse effects of early school start times on Virginia’s students have been demonstrated, with regards to academic performance, mental health, and driving risks. Data published since the AASM position paper highlight these dangers further. Importantly, recent studies also demonstrate some of the benefits that can come …

Sex Differences In Response To Diet Enriched With Glutathione Precursors In The Aging Heart, Aude Angelini, Grecia Garcia Marquez, Anna Malovannaya, Marta L Fiorotto, Alexander Saltzman, Antrix Jain, Joann Trial, George E Taffet, Katarzyna A Cieslik

Faculty, Staff and Students Publications

Common features of the aging heart are dysregulated metabolism, inflammation, and fibrosis. Elevated oxidative stress is another hallmark of cardiac aging that can exacerbate each of these conditions. We hypothesize that by increasing natural antioxidant levels (glutathione), we will improve cardiac function. Twenty-one-month-old mice were fed glycine and N-acetyl cysteine (GlyNAC; glutathione precursors)-supplemented or control diets for 12 weeks. Heart function was monitored longitudinally, and the exercise performance was determined at the end of the study. We found that the GlyNAC diet was beneficial for old male but not old female mice, leading to an increase of Ndufb8 expression (a …

Nourishing Change In Houston, Texas: Exploring Grocery Shopping Behaviours And Fruit And Vegetable Consumption Among Low-Income Families In The Brighter Bites Program, Victoria Kwentua, Allison Marshall, Ru-Jye Chuang, Jessica Chen, Christine Markham, Mallika Mathur, Mike Pomeroy, Megan Hall, Shreela Sharma

Faculty, Staff and Student Publications

OBJECTIVE: We qualitatively examine the grocery shopping behaviours and fruit and vegetable consumption of low-income families participating in the Brighter Bites program in Houston, Texas.

DESIGN: We used a single-group observational study design. We used (1) purposive sampling of schools and (2) convenience sampling of parents/caregivers to recruit participants. Research staff conducted three face-to-face qualitative focus groups in Spanish and English. Transcripts were coded using deductive and inductive reasoning.

SETTING: Three elementary schools serving low-income families in Houston, Texas, in February-May of 2022.

PARTICIPANTS: Brighter Bites parents/caregivers from the 2021-2022 school year.

RESULTS: Three primary themes emerged: (1) child involvement …

The Wright Brothers And Their Genetic Susceptibility To Typhoid Fever, John D. Bullock, H Bradford Hawley

Population and Public Health Sciences Faculty Publications

Importance: Typhoid fever gravely sickened Orville Wright in 1896 and the disease killed his older brother, Wilbur, in 1912. The occurrence of typhoid fever among other Wright family members has never been explored.

Objective: To investigate the number of cases of typhoid fever in the Wright brothers’ family and determine if they had a predisposition to typhoid fever that might have had a genetic basis.

Methods: Biographical information concerning the Wright brothers was examined and a family tree was constructed. Using an estimated untreated case fatality rate of 20%, typhoid fever mortality data from decennial U.S. censuses (1850-1920) was converted …

Can Clinical Findings At Admission Allow Withholding Of Antibiotics In Patients Hospitalized For Community Acquired Pneumonia When A Test For A Respiratory Virus Is Positive?, Ryan Ward, Alejandro J Gonzalez, Justin A Kahla, Daniel M Musher

Faculty, Staff and Students Publications

BACKGROUND: Current guidelines recommend empiric antibiotic therapy for patients who require hospitalization for community-acquired pneumonia (CAP). We sought to determine whether clinical, imaging or laboratory features in patients hospitalized for CAP in whom PCR is positive for a respiratory virus enable exclusion of bacterial coinfection so that antibiotics can be withheld.

METHODS: For this prospective study, we selected patients in whom an etiologic diagnosis was likely to be reached, namely those who provided a high-quality sputum sample at or shortly after admission, and in whom PCR was done to test for a respiratory virus. We performed quantitative bacteriologic studies on …

Improving Health Literacy Related To Hypertension In A Minority Faith-Based Population, Kasaundra M. Beverly-Marshall, Kasaundra M. Beverly-Marshall

Doctor of Nursing Practice Scholarly Projects

Background: Insufficient research on health literacy related to cardiovascular disease highlights a gap in healthcare. Healthy People 2030 and local community health programs acknowledge gaps in research with future goals to improve health literacy.

Local Problem: The health literacy rate for Winnebago County, IL (41%) is higher than both the State of Illinois and national health literacy rates, which aligns with the results of a community needs assessment survey.

Methods: A community-based health promotion project using a pre-post study design uses the health promotion model to engage participants in advancing cardiovascular health outcomes.

Interventions: DNP student assisted participants in creating …

Understanding The Impact Of Language Barriers And Visit Duration On Caregiver Satisfaction In Pediatric Primary Care, Gavin Miller, Liz Vazquez, Joyce Ho, Emma Maynor, Emily L. Allen, Marley F. Fradley, Julian Ruiz, Ana J. Bridges

2025 Honors Symposium

Abstract:

Problem. Children from households that speak languages other than English (LOE) face significant challenges in accessing healthcare, which can lead to poorer health outcomes and inadequate medical care (Flores et al., 2005). Language barriers contribute to these disparities, often resulting in diminished communication between healthcare providers and families (Ramirez et al., 2023). In pediatric primary care, visit duration—defined as the amount of time between when a patient is checked into and out of the clinic—may play a crucial role in facilitating effective communication and improving patient satisfaction (Tsiga et al., 2013). Physicians experience significant time pressure and productivity expectations, …

Neurosurgical Praxis Guidelines During The Covid-19 Outbreak. Consensus-Based On Currently Available Literature., José Antonio Soriano Sánchez, Bárbara Nettel Rueda, José Alberto Israel Romero Rangel, Armando Alpizar Aguirre, Miguel Ángel Andrade-Ramos, Ulises García Dr., Diego Mendez Rosito, Jorge A. Santos, Sara Patricia Pérez Reyes, Julian Eduardo Soto Abraham, Jose E. Valerio Pascua, Marco Antonio Barajas Romero, Eduardo Díaz Juárez, Alma Griselda Ramírez Reyes, Maria Elena Gonzalez, Claudia Katiutska González Valdez, Félix Domínguez Cortinas, Noé Santiago Ramírez, Tenoch Herrada Pineda, Manuel Eduardo Soto García, Edgar Nathal Vera, Gustavo Melo Guzmán

Archives of Neurosurgery

INTRODUCTION: The World Health Organization recommended several strategies to contain the COVID-19 pandemic, including optimization of care for all patients, especially the seriously ill. Given the strain, the pandemic has posed on healthcare systems around the world, many neurosurgical associations have provided triage recommendations for patients to save resources for the pandemic. We aimed to provide practical recommendations based on specific illnesses requiring surgical procedures commonly performed by neurosurgeons on a life-threatening basis of patient illness. We consider this guideline will help neurosurgeons for the appropriate triage of patients on a daily-situation basis during this pandemic.

METHODS: The Mexican Society …

Nsu Outreach, Nova Southeastern University

NSU Digital: Communiversity

No abstract provided.

Nsu Communiversity Outreach, Nova Southeastern University

NSU Digital: Communiversity

No abstract provided.

Navigating The Way To Colonoscopy Completion: A Quality Improvement Study, Jessica Duncan

Doctor of Nursing Practice Scholarly Projects

Abstract

Background: Colonoscopies are a highly effective method of colorectal cancer screening, yet their value is hindered by frequent last-minute cancellations and patient no-shows. The absence of a consistent, evidence-based pre-procedural education tool to address patient-level barriers remains a critical gap in healthcare delivery.

Local Problem: At a hospital-based medical practice in Kane County, Illinois, 7% of colonoscopy cancellations occur last minute, primarily due to preventable factors.

Methods: This quality improvement project compared last-minute cancellation and no-show rates between a control group receiving standard care and an intervention group provided with enhanced education and regularly scheduled follow-up contact through patient …

Improving Knowledge And Confidence Of Family Nurse Practitioners In Offering The Hpv Vaccine, Leni Terano Fisher

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Abstract

Introduction

Despite the recommendations of the United States Advisory Committee on Immunization Practices, HPV immunization lags behind other routine vaccines by up to 31%. Although there are many reasons for the low vaccine rate, provider hesitancy and lack of confidence significantly contribute to suboptimal HPV vaccine uptake.

Objectives

This project aimed to utilize evidence-driven interventions to increase family nurse practitioners' (FNPs) knowledge and confidence in offering the HPV vaccine.

Methods

Participants were given pre- and post-questionnaire surveys. The Wilcoxon Rank Test was used to compare, quantify, and measure the results of the eight-week data collection.

Results

The subjects were …

Would Exercise, Household Income, Nutritional Education, Or Transportation Play A Pivotal Role In Decreasing Prevalence Of Obesity In Hidalgo County, Chijoke Anyaehie

Gulf Coast Division GME Research Day 2025

No abstract provided.

Facility-Based Uptake Of Colorectal Cancer Screening In 45-49-Year-Olds After U.S. Guideline Changes, Alyssa H. Harris, Hannah Murphy, Madeleine Mcdowell, Margaret E. Wright, M. Courtney Hughes

Faculty Articles, Papers, and Other Scholarship

No abstract provided.

Strategies To Enhance Involvement In Research And The Use Of Hiv Prevention Services In Black Men Who Have Sex With Men (Bmsm): The Voices Of Bmsm, Chijoke Anyaehie, Brittany L. Gardner, Paris Green, John Bonelli, Hong Van Tieu, Melonie Walcott

Gulf Coast Division GME Research Day 2025

No abstract provided.

A Case Study In Program Evaluation: Evaluation Of A Community Program To Increase Rates Of Physical Activity, Emma Hughes

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Bourbon County faces rates of obesity and levels of physical inactivity that are at, or worse, than the Kentucky state average. The Bourbon County Health Department (BCHD) has prioritized addressing these issues and received funding from a private foundation to do so. Collaboration with the University of Kentucky and additional funding from UK Healthcare (UKHC) will support these efforts to improve the rates of regular physical activity, raise awareness of the negative health impacts of inactivity, and increase access to safe places to exercise. The BCHD developed a 6-month program that involves several interventions aimed at increasing the percent of …

How To Create A Self-Sustaining Meditation Garden, Heather Salazar, Lydia Barrett-Miller, Kaitlyn Parisan

Honors in Practice Online Archive

This essay presents the creation and maintenance of a campus meditation garden as an outgrowth of four successive philosophy classes in honors. The authors describe the garden’s inception, execution, curricular advantages, and administration, with specific examples of the impact on student health and well-being. The authors observe the ways in which honors students attained skills in transformational leadership by collaborating to develop projects and lead events, suggesting that a meditation garden may be appropriate for any learning environment emphasizing cooperation, creativity, mindfulness, and well-being.

Engaging The Community, Providing Hopes, Mackenzie Peeke, Margaret West, Alyssa Wilkinson, Matthew Serrata, Michael Baroody, Conner Tembe, Chrisney Yerena

HOPES Free Clinic Publications

Founded in the 1970s as a grassroots effort to provide care to the underserved population of Hampton Roads, Eastern Virginia Medical School (EVMS) has long been committed to community-centered care. The HOPES Free Clinic is a manifestation of that mission. Launched in 2011 as a student-run phone triage service, the Health Outreach Partnership of EVMS Students (HOPES) later transitioned to provide direct clinical services—becoming the first student-run free clinic in the Commonwealth of Virginia. In 2014, HOPES integrated into Community Engaged Learning to enhance and solidify its efforts. Since its inception, medical and health professions students have partnered with volunteer …

Resilience And Reality: Exploring The Lived Experiences Of People Living With Hiv In Texas During The Covid-19 Pandemic – A Qualitative Study., Ahmed F. Alanazi

Social Work Dissertations - Archive

This study investigated the lived experiences of individuals living with HIV (PLWH) in the Dallas-Fort Worth (DFW) area of Texas during the COVID-19 pandemic, using an Interpretative Phenomenological Analysis (IPA) framework. The research examined the intersection of health, social dynamics, and psychological resilience among PLWH, who faced compounded vulnerabilities due to systemic inequities and the dual public health crises of HIV and COVID-19. Through semi-structured interviews with ten participants from diverse backgrounds, the study captured the profound impacts of disrupted healthcare systems, heightened stigma, and social isolation on this marginalized population. The findings reveal that the pandemic exacerbated existing inequities …

The Impact Of Health Promotion Home Visits On Loneliness In An Older Adult Population, Jean M. Herb

West Chester University Doctoral Projects

Loneliness among older adults is a significant public health concern associated with adverse physical, emotional, and cognitive outcomes. Despite widespread recognition of the issue, effective interventions remain limited in clinical practice. This Doctor of Nursing Practice (DNP) project implemented and evaluated a Health Promotion Home Visit (HPHV) intervention designed to reduce loneliness in community-dwelling adults aged 65 and older. A quality improvement initiative using a pre-post design was conducted at a community outreach division of a home health agency. Patients received HPHV every other week over an eight-week period. The UCLA Loneliness Scale (Version 3) was used to assess loneliness …

Adolescents Sexual Health Education Disparities: A Comparative Study Of Inclusion, Cultural Barriers, Access, Policy In Relation To Health And Long Term Outcomes​, Sofia Vega

Nursing | Student Research Posters

Currently, across the different states, sexual health education varies in a range of comprehensive sexual health education to limited sexual health education. These differences in curriculum are not only different from each other but also within themselves. This creates disparities in the knowledge and access among adolescents within their sexual health, which then creates a range of complications involving confidence in knowledge, pregnancy, STIs, and overall inclusion. When granting access to contraceptives on an educational campus, along with education on contraceptives, it allows students to access these tools in a safe environment and increases usage of condoms, lowering the risk …

Prepared To Protect: Improving Cardiac Emergency Response Through Education And Action Planning In Youth Club Sports, Melissa Garcia

Nursing | Senior Theses

Sudden cardiac arrest (SCA) is the leading cause of death in youth sports, illuminating the essential demand for adequate emergency response, including cardiopulmonary resuscitation (CPR), automated external defibrillator (AED) usage, and comprehensive emergency action plans (EAPs). Research shows that despite the importance of prompt intervention, the majority of youth club sports programs outside of the school setting lack the training and resources needed to respond effectively to SCA incidents. This study will evaluate the effectiveness of an educational seminar that includes CPR/AED training and EAP simulation exercises in improving participants’ knowledge, skills, and confidence in managing cardiac emergencies. A quasi-experimental …

Awareness Of The Physiological Changes Occurring In Older Adults Can Reduce Dehydration And Electrolyte Imbalances, Lisa Isley

Nursing | Senior Theses

Background: Individuals over 65 years are at an increased risk of dehydration. The physiological changes that occur with age and medication consumption can cause fluid and electrolyte imbalances that can physically and mentally impair individuals over 65 years old. Objective: By providing education to individuals 65 years and older regarding the significance of drinking water and consuming electrolytes daily, older adults can reduce their dehydration symptoms and improve their quality of life. Method: The proposed research is a quasi experimental study geared towards individuals 65 years and older. The quasi-experimental study will include two pre-surveys and then two post-surveys. The …

Mistrust Among Injured Immigrant Workers: A Conceptual Framework, Maude Arsenault, Daniel Côté, Jessica Dubé

Revues de littérature, synthèses de connaissances

Background

In Quebec, injured workers have access to medical assistance, wage replacement indemnities, and rehabilitation measures, with most injuries resolved easily. However, a small percentage of cases require a lengthy rehabilitation process, which is particularly complex when involving immigrants. The therapeutic alliance is at the heart of the process, involving mutual trust and confidence and a degree of consensus about the therapeutic interventions to be used and, ultimately, the return to work.

Objective

This article delves into the concept of mistrust as more than the absence of trust, and sheds light on its role in the rehabilitation process of immigrant …

Enablers And Barriers To The Use Of Portable Ultrasound Devices For Antenatal Care In Rural Health Centers In The Philippines, Jacob Anthony Batuhan, Reynan Hernandez, Florentina Villanueva, Airen Sigue, Kevyn Yu, Kate Wad-Asen, Beatriz Carandang, Jeremie Bartelheimer

Ateneo School of Medicine and Public Health Publications

Objectives

This qualitative study aims to examine the enablers and barriers to portable ultrasound device utilization for antenatal care in rural Philippine health centers, with the goal of improving maternal outcomes and reducing maternal mortality.

Methods

We conducted focus group discussions with 18 healthcare workers (midwives, a nurse, and a radiologic technician) and 20 pregnant women across 5 rural health centers. We used inductive thematic analysis to identify system-related, provider-related, and client-related enablers and barriers.

Results

Enablers included free ultrasound services, hospital policies requiring prenatal scans, provider training, awareness creation, patient interest and acceptance, and confidence in HCWs’ capabilities. Barriers …

The Process And Significance Of Convening A Community Advisory Board With Individuals With Severe Mental Illness, Jacelyn Biondo, Nia Johnson

Department of Medicine Faculty Papers

Individuals with lived experience of being diagnosed with severe mental illness and/or substance use disorders have deep and profound knowledge regarding the culture and needs of their community. Historically, these and other vulnerable populations have been excluded from care access, treatment insights, research development and participation, and often society in general. In this paper, we share our experience of convening a community advisory board with vulnerable populations and highlight the expertise these community members provide. We outline our processes of convening the community advisory board, engaging in collaborative meetings, revising the research protocol, and exploring future research needs. Using meeting …