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Articles 391 - 420 of 5349

Full-Text Articles in Public Health

Influences And Implications Of Medical Mistrust On Healthcare Behaviors In A Low Health Outcomes County In The State Of New Jersey, Dale Johnson, Adeena Javed, Nathaniel J Byrnes, Anne C Jones, Kristin N Bertsch May 2025

Influences And Implications Of Medical Mistrust On Healthcare Behaviors In A Low Health Outcomes County In The State Of New Jersey, Dale Johnson, Adeena Javed, Nathaniel J Byrnes, Anne C Jones, Kristin N Bertsch

Rowan-Virtua School of Osteopathic Medicine Departmental Research

Medical mistrust is an ongoing concern in the United States, with patient confidence in both individual practitioners and institutions decreasing sharply in recent years. Atlantic County, New Jersey has some of the worst health outcomes in the state and is below the national average. This study sought to investigate medical mistrust by recruiting participants to complete a survey and/or health screening at 12 food pantry distribution events throughout Atlantic County (N = 124). The mean score for the Medical Mistrust Index was 19.06 (SD = 5.6) for participants who reported receiving the annual influenza vaccine and 16.05 (SD = 4.7) …


The Influence Of Compensation From Wages And Benefits On Healthcare Workers' Performance In Healthcare Services, Jiddan Azizan Hakim, Ghania Danisha Maharani, Riswandy Wasir, Alif Indah Melani, Cahya Arbitera May 2025

The Influence Of Compensation From Wages And Benefits On Healthcare Workers' Performance In Healthcare Services, Jiddan Azizan Hakim, Ghania Danisha Maharani, Riswandy Wasir, Alif Indah Melani, Cahya Arbitera

Journal of Indonesian Health Policy and Administration

This study aims to evaluate the influence of compensation, including wages, incentives, and benefits, on the performance of health workers in primary health centers and hospitals. A literature review was conducted using Google Scholar and PubMed, focusing on articles published in the last 5–10 years. From an initial search yielding 1,021 articles, nine were selected based on inclusion criteria. The results show that direct compensation (salary) and indirect compensation (benefits) have a positive impact on health worker performance. However, the effect of incentives varies depending on implementation. Motivation and job satisfaction were mediating factors that strengthened the relationship between compensation …


The Perk/Atf4 Pathway Is Required For Metabolic Reprogramming And Progressive Lung Fibrosis, Jyotsana Pandey, Jennifer L Larson-Casey, Mallikarjun H Patil, Chao He, Nisarat Pinthong, A Brent Carter May 2025

The Perk/Atf4 Pathway Is Required For Metabolic Reprogramming And Progressive Lung Fibrosis, Jyotsana Pandey, Jennifer L Larson-Casey, Mallikarjun H Patil, Chao He, Nisarat Pinthong, A Brent Carter

Faculty, Staff and Students Publications

Asbestosis is a prototypical type of fibrosis that is progressive and does not resolve. ER stress is increased in multiple cell types that contribute to fibrosis; however, the mechanism(s) by which ER stress in lung macrophages contributes to fibrosis is poorly understood. Here, we show that ER stress resulted in protein kinase RNA-like ER kinase (PERK; Eif2ak3) activation in humans with asbestosis. Similar results were seen in asbestos-injured mice. Mice harboring a conditional deletion of Eif2ak3 were protected from fibrosis. Lung macrophages from asbestosis individuals had evidence of metabolic reprogramming to fatty acid oxidation (FAO). Eif2ak3fl/fl mice had increased oxygen …


Staff Expectancies In Conducting Ship Hygiene And Sanitation Inspections: A Qualitative Study At Banten Class I Port Health Quarantine Office, Lukman Waris, Budiman Budiman, Hany Puspita Aryani May 2025

Staff Expectancies In Conducting Ship Hygiene And Sanitation Inspections: A Qualitative Study At Banten Class I Port Health Quarantine Office, Lukman Waris, Budiman Budiman, Hany Puspita Aryani

Journal of Indonesian Health Policy and Administration

Sea transport plays a vital role in the movement of goods and passengers, yet it simultaneously poses a potential risk for the transmission of infectious diseases, both nationally and internationally. Ship hygiene and sanitation inspection (HSI) is a strategic measure to control such risks, and the outcomes of these inspections are influenced by the expectations of the implementing officers. This study explores how staff expectancy at the Banten Class I Port Health Quarantine Office affects the quality of HSI. A qualitative study using the Rapid Assessment Procedure (RAP) was conducted with 80 staff members across five work units. Data were …


Strengthening Occupational Health And Safety (Ohs) In Schools To Minimize Risks For Students, Teachers, And Visitors: Policy Recommendation, Wiwik Eko Pertiwi, Hanifa Maher Denny, Yuliani Setyaningsih, Agung Dwi Laksono May 2025

Strengthening Occupational Health And Safety (Ohs) In Schools To Minimize Risks For Students, Teachers, And Visitors: Policy Recommendation, Wiwik Eko Pertiwi, Hanifa Maher Denny, Yuliani Setyaningsih, Agung Dwi Laksono

Journal of Indonesian Health Policy and Administration

Vocational schools equip students with practical skills and expose them to industry-related hazards, making Occupational Health and Safety (OHS) a crucial aspect of the school environment. This study aims to identify key factors behind the weak implementation of OHS in vocational schools. A literature review used articles published between 2017–2024 from national and international journals. The review found poor OHS implementation stems from lack of awareness, inadequate policies, insufficient infrastructure, weak safety culture, and negligence in accident prevention. To address these issues, the study recommends OHS education and training, improvement of school infrastructure, curriculum integration, formation of safety teams, and …


Exposure To Second-Hand Smoke In Homes And Respiratory Symptoms Among Non-Smoking Adults In Depok, Indonesia 2025, Faraz Ali, Budi Hartono May 2025

Exposure To Second-Hand Smoke In Homes And Respiratory Symptoms Among Non-Smoking Adults In Depok, Indonesia 2025, Faraz Ali, Budi Hartono

Journal of Indonesian Health Policy and Administration

Second-hand smoke (SHS) exposure in the home environment has become a public health emergency, especially in countries with very high smoking rates, such as Indonesia. SHS exposure has already presented evidence of symptoms of the respiratory category, like a cough and shortness of breath. This study aimed to assess the association between exposure to SHS at home and the presence of respiratory symptoms among non-smoking adults in Depok, Indonesia. Convenience sampling was adopted for enrolling 108 non-smoking adults aged 18-30 who were jointly exposed to SHS in their homes for a cross-sectional study. Data aggregations of gatherings were performed using …


Rural And Urban Disparities In Access To Glp-1 Agonists For Patients With Obesity, Christine J. Hackler-Moorman May 2025

Rural And Urban Disparities In Access To Glp-1 Agonists For Patients With Obesity, Christine J. Hackler-Moorman

MUSC Theses and Dissertations

The increasing interest in glucagon-like peptide-1 (GLP-1) agonists, such as semaglutide, which are often prescribed as a first-line treatment for managing Type II diabetes, as well as for non-diabetic purposes—such as weight management and improving metabolic health—highlights their potential in preventive care. This promise inspires hope for a future where preventive healthcare is more effective and accessible to a wider audience. Nonetheless, significant geographic disparities in access to healthcare, especially between rural and urban areas, create obstacles that prevent numerous patients from reaping the benefits of these essential medications. In rural communities, challenges like cost, availability, and awareness are often …


Observed And Reported Outcomes Following Experiential Cultural Capability And Clinical Yarning Training For Clinicians Treating Aboriginal And Torres Strait Islander People With Persistent Pain, Stuart Ekberg, Renata F. I Meuter, Ivan Lin, Roslyn Rowen, Angela Kinnell, Eva Malacova, Tania Waring, Kushla Houkamau, Marayah Taylor, Matthew Bryant, Jermaine Isua, Andrew Claus, Paul Gray, Joseph Kluver, Christina M. Bernardes, Greg Pratt May 2025

Observed And Reported Outcomes Following Experiential Cultural Capability And Clinical Yarning Training For Clinicians Treating Aboriginal And Torres Strait Islander People With Persistent Pain, Stuart Ekberg, Renata F. I Meuter, Ivan Lin, Roslyn Rowen, Angela Kinnell, Eva Malacova, Tania Waring, Kushla Houkamau, Marayah Taylor, Matthew Bryant, Jermaine Isua, Andrew Claus, Paul Gray, Joseph Kluver, Christina M. Bernardes, Greg Pratt

Journal of the Australian Indigenous HealthInfoNet

Communication is recognised as crucial to culturally safe healthcare, and poor communication remains a major reason that Aboriginal and Torres Strait Islander people do not access healthcare. This pragmatic, pre-post comparison study employed mixed methods to evaluate cultural capability and clinical yarning training delivered to 57 clinicians supporting Aboriginal and Torres Strait Islander people at three persistent pain management services in Queensland, Australia. Observable outcomes of the training were evaluated by video recording clinicians’ training experiences and seven consultations with patients that occurred either pre- or post-training. Reported outcomes were evaluated by using a modified Cultural Safety Survey (CSS), which …


Enhancing Patient Education Of Antimicrobial Side Effects At Discharge, Isaac Daudelin, Md, Phd, Bojan Lazarevic, Jordan Feingold-Link, Md, Nehar Damle, Md, Pharmd, Caroline Brugger, Crnp, Rachel Carr, Pa-C, Devin Weber, Md, Daniel Taupin, Md, Mhqs May 2025

Enhancing Patient Education Of Antimicrobial Side Effects At Discharge, Isaac Daudelin, Md, Phd, Bojan Lazarevic, Jordan Feingold-Link, Md, Nehar Damle, Md, Pharmd, Caroline Brugger, Crnp, Rachel Carr, Pa-C, Devin Weber, Md, Daniel Taupin, Md, Mhqs

Health Equity and Quality Improvement (HEQI) Summit

Background

Problem: Patients discharged from the hospital on antimicrobial agents often receive insufficient education about potential side effects that warrant medical attention(1). We identified a critical gap in patient communication and safety that occurred during discharge at a large urban academic center.

Stakeholders

  • Patients
  • Physicians
  • Nurses
  • Pharmacists
  • Outpatient providers
  • Nurse practitioners
  • Physician assistants

Objective: This project aimed to utilize a multidisciplinary team to:

  1. Quantify a gap in patient education
  2. Create an interactive navigator- which would not rely on provider memory and automatically include relevant information in patient discharge paperwork
  3. Implement within 3 months into the EPIC system
  4. Measure the effect …


Future Of Transplant Centers: Leveraging Integration Of Transplant Institutes To Mitigate The Impact Of Transplant Professional Shortages And Enhance Patient Outcomes, Kiran Goli, Prashamsa Shenoy, Paula Martinez-Cantarin, Maitreyee Gupta, Rakesh Gulati, Pooja Singh May 2025

Future Of Transplant Centers: Leveraging Integration Of Transplant Institutes To Mitigate The Impact Of Transplant Professional Shortages And Enhance Patient Outcomes, Kiran Goli, Prashamsa Shenoy, Paula Martinez-Cantarin, Maitreyee Gupta, Rakesh Gulati, Pooja Singh

Health Equity and Quality Improvement (HEQI) Summit

Background

The Increasing Organ Transplant Access (IOTA) Model introduced by the Centers for Medicare & Medicaid Services (CMS) emphasizes increasing transplant volumes, reducing disparities, and enhancing care efficiency. Transplant centers face unique challenges, including workforce shortages, growing demand for organ transplants, care delivery inefficiencies, and the need to align with the achievement, efficiency, and quality domains of the IOTA model while fostering health equity. Integration, whether through mergers, acquisitions, or strategic alliances, offers transplant centers a competitive advantage in optimizing resources, expanding access, and meeting CMS metrics.


Improving Viral Hepatitis Testing With A Clinical Scenario Based Order Set: The Viral Hepatitis Hub, Jordan Feingold-Link, Md, Elizabeth A. Braden, Md, Courtney E. Comar, Phd, Jonathan M. Fenkel, Md, Kory S. London, Md, Sean P. Moss, Md, Elizabeth Novick, Md, Matthew Pettengill, Phd, Christine Papastamelos, Md, Jeffrey M. Riggio, Md, Daniel Taupin, Md May 2025

Improving Viral Hepatitis Testing With A Clinical Scenario Based Order Set: The Viral Hepatitis Hub, Jordan Feingold-Link, Md, Elizabeth A. Braden, Md, Courtney E. Comar, Phd, Jonathan M. Fenkel, Md, Kory S. London, Md, Sean P. Moss, Md, Elizabeth Novick, Md, Matthew Pettengill, Phd, Christine Papastamelos, Md, Jeffrey M. Riggio, Md, Daniel Taupin, Md

Health Equity and Quality Improvement (HEQI) Summit

Background and Problem

Viral hepatitis disproportionately affects historically marginalized populations, with less than one-third of high-risk patients receiving appropriate screening. Racial and ethnic minoritized groups, rural residents, and PWID face significant disparities in both testing and treatment.

Paradoxically, while underserved populations remain undertested, providers frequently order inappropriate hepatitis tests, particularly acute- phase markers like HAV IgM and HBV core IgM, in clinical situations where guidelines do not indicate their use. This pattern of inappropriate testing is partly driven by provider uncertainty regarding the selection of appropriate serologic tests from a complex array of options. Clinical decision support (CDS) within computerized …


Project Proposal: The Impact Of The Septa Zero Fare Program On Healthcare Access Among Philadelphia's Refugee And Migrant Population, Emily Hashem, Bs, Paranshu Shah, Mitchell Kaminski, Md, Mba May 2025

Project Proposal: The Impact Of The Septa Zero Fare Program On Healthcare Access Among Philadelphia's Refugee And Migrant Population, Emily Hashem, Bs, Paranshu Shah, Mitchell Kaminski, Md, Mba

Health Equity and Quality Improvement (HEQI) Summit

Background

Since the 1960s, private, state sponsored, and charitable programs have attempted to increase transportation programs to improve healthcare access. Among these are the Centers for Medicare and Medicaid Services' Non-Emergency Medical Transportation (NEMT) program, Pennsylvania’s Medical Assistance Transportation Program (MATP) benefiting Medicaid recipients, Southeastern Pennsylvania Transit Association’s (SEPTA) SEPTA Access (formerly known as CCT connect) for disabled and elderly people, and ModivCare, a social services corporation that offers non-emergency medical transportation for qualifying people with low incomes. The importance of these programs is emphasized by the body of evidence surrounding healthcare metrics and transportation access. A Robert Wood Johnson …


Improving Healthcare Access Among Hunter College Students – Suggestions For A Hunter College Student Health Center, Jacob Villorente May 2025

Improving Healthcare Access Among Hunter College Students – Suggestions For A Hunter College Student Health Center, Jacob Villorente

Publications and Research

This study investigates disparities in healthcare access among students at CUNY Hunter College, an urban public university in Manhattan serving over 22,000 students. 89% of Hunter students receive financial aid, with 67% of students receiving Pell grants. Hunter College only offers limited health services, primarily short-term mental health counseling and wellness workshops. A cross-sectional survey (n = 33) assessed insurance status, coverage (dental, vision, psychiatric), access barriers (e.g., transportation), mental health symptoms, and impacts to academia. While 69.7% of respondents reported comprehensive insurance, students with public insurance (Medicaid, Medicare) experienced substantially higher access barriers than those with employer-sponsored plans and …


Advancing Remote Monitoring For Patients With Alzheimer Disease And Related Dementias: Systematic Review, Mohmmad Arif Shaik, Fahim Islam Anik, Md Mehedi Hasan, Sumit Chakravarty, Mary Dioise Ramos, Mohammad Ashiqur Rahman, Sheikh Iqbal Ahamed, Nazmus Sakib May 2025

Advancing Remote Monitoring For Patients With Alzheimer Disease And Related Dementias: Systematic Review, Mohmmad Arif Shaik, Fahim Islam Anik, Md Mehedi Hasan, Sumit Chakravarty, Mary Dioise Ramos, Mohammad Ashiqur Rahman, Sheikh Iqbal Ahamed, Nazmus Sakib

School of Nursing Faculty Publications

BACKGROUND: Using remote monitoring technology in the context of Alzheimer disease (AD) care presents exciting new opportunities to lessen caregiver stress and improve patient care quality. The application of wearables, environmental sensors, and smart home systems designed specifically for patients with AD represents a promising interdisciplinary approach that integrates advanced technology with health care to enhance patient safety, monitor health parameters in real time, and provide comprehensive support to caregivers. OBJECTIVE: The objectives of this study included evaluating the effectiveness of various remote sensing technologies in enhancing patient outcomes and identifying strategies to alleviate the burden on health care professionals …


Role Of Systemic Therapy In Localized Renal Cell Carcinoma: Where Do We Stand And Where Are We Heading?, Deepa Raghavan, Viktoriya Gibatova, Nikhil Vojjala, Nagaishwarya Moka, Aihua Edward Yen May 2025

Role Of Systemic Therapy In Localized Renal Cell Carcinoma: Where Do We Stand And Where Are We Heading?, Deepa Raghavan, Viktoriya Gibatova, Nikhil Vojjala, Nagaishwarya Moka, Aihua Edward Yen

Faculty, Staff and Students Publications

The effectiveness of immunotherapy and targeted therapy has been well established in metastatic renal cell cancer (mRCC). These therapies demonstrated higher overall response rates and led to prolonged survival. In contrast, in localized RCC, conventional treatment is either partial or complete nephrectomy. While surgery is a curative option in early stages, high recurrence rates remain a concern, with survival rates ranging from 53% to 85%, depending on the initial stage at the time of diagnosis. Given favorable outcomes with systemic therapies in the metastatic setting, there has also been an increased interest in utilizing these therapies for the localized stage …


Incorporating Latent Survival Trajectories And Covariate Heterogeneity In Time-To-Event Data Analysis: A Joint Mixture Model Approach, Fu-Wen Liang, Wenyaw Chan, Michael D Swartz, Bouthaina S Dabaja May 2025

Incorporating Latent Survival Trajectories And Covariate Heterogeneity In Time-To-Event Data Analysis: A Joint Mixture Model Approach, Fu-Wen Liang, Wenyaw Chan, Michael D Swartz, Bouthaina S Dabaja

Faculty, Staff and Student Publications

Background: Finite mixture models have been recently applied in time-to-event data to identify subgroups with distinct hazard functions, yet they often assume differing covariate effects on failure times across latent classes but homogeneous covariate distributions. This study aimed to develop a method for analyzing time-to-event data while accounting for unobserved heterogeneity within a mixture modeling framework.

Methods: A joint model was developed to incorporate latent survival trajectories and observed information for the joint analysis of time-to-event outcomes, correlated discrete and continuous covariates, and a latent class variable. It assumed covariate effects on survival times and covariate distributions vary across latent …


Theta Oscillons In Behaving Rats, M S Zobaer, Nastaran Lotfi, Carli M Domenico, Clarissa Hoffman, Luca Perotti, Daoyun Ji, Yuri Dabaghian May 2025

Theta Oscillons In Behaving Rats, M S Zobaer, Nastaran Lotfi, Carli M Domenico, Clarissa Hoffman, Luca Perotti, Daoyun Ji, Yuri Dabaghian

Faculty, Staff and Students Publications

Recently discovered constituents of the brain waves—the oscillons—provide a high-resolution representation of the extracellular field dynamics. Here, we study the most robust, highest-amplitude oscillons recorded in actively behaving male rats, which underlie the traditional θ-waves. The resemblances between θ-oscillons and the conventional θ-waves are manifested primarily at the ballpark level—mean frequencies, mean amplitudes, and bandwidths. In addition, both hippocampal and cortical oscillons exhibit a number of intricate, behavior-attuned, transient properties that suggest a new vantage point for understanding the θ-rhythms’ structure, origins and functions. In particular, we demonstrate that oscillons are frequency-modulated waves, with speed-controlled …


Opmed Seal: Engineering A Rapid-Response Biodegradable Device For Hemorrhage Control And Infection Prevention In Abdominal Trauma, Paula M. Cabrera, Wesley Stephen Murphy May 2025

Opmed Seal: Engineering A Rapid-Response Biodegradable Device For Hemorrhage Control And Infection Prevention In Abdominal Trauma, Paula M. Cabrera, Wesley Stephen Murphy

Honors Theses

Abdominal gunshot wounds are amongst the deadliest injuries encountered in combat and remote emergency settings. For military medics and first responders, the challenge lies in controlling internal bleeding and preventing infection before patients can reach surgical care-often within a narrow window of time known as the “golden hour”. Currently available field treatments are either too slow, not designed for internal wounds, or fail to provide antimicrobial protection. To address this gap, our team developed OpMed Seal: a compact, dual-syringe delivery system that deploys a biodegradable, antibiotic-infused hydrogel directly into abdominal injuries. The system is designed for rapid hemorrhage control, localized …


Let-7 Restrains An Epigenetic Circuit In At2 Cells To Prevent Fibrogenic Intermediates In Pulmonary Fibrosis, Matthew J Seasock, Md Shafiquzzaman, Maria E Ruiz-Echartea, Rupa S Kanchi, Brandon T Tran, Lukas M Simon, Matthew D Meyer, Phillip A Erice, Shivani L Lotlikar, Stephanie C Wenlock, Scott A Ochsner, Anton Enright, Alex F Carisey, Freddy Romero, Ivan O Rosas, Katherine Y King, Neil J Mckenna, Cristian Coarfa, Antony Rodriguez May 2025

Let-7 Restrains An Epigenetic Circuit In At2 Cells To Prevent Fibrogenic Intermediates In Pulmonary Fibrosis, Matthew J Seasock, Md Shafiquzzaman, Maria E Ruiz-Echartea, Rupa S Kanchi, Brandon T Tran, Lukas M Simon, Matthew D Meyer, Phillip A Erice, Shivani L Lotlikar, Stephanie C Wenlock, Scott A Ochsner, Anton Enright, Alex F Carisey, Freddy Romero, Ivan O Rosas, Katherine Y King, Neil J Mckenna, Cristian Coarfa, Antony Rodriguez

Faculty, Staff and Students Publications

MicroRNA-mediated post-transcriptional regulation of lung alveolar type 2 (AT2) and AT1 cell differentiation remains understudied. Here, we demonstrate that the let-7 miRNA family plays a homeostatic role in AT2 quiescence by preventing the uncontrolled accumulation of AT2 transitional cells and promoting AT1 differentiation. Using mouse and organoid models, we show that genetic ablation of let-7a1/let-7f1/let-7d cluster (let-7afd) in AT2 cells prevents AT1 differentiation and leads to KRT8 transitional cell accumulation in progressive pulmonary fibrosis. Integration of AGO2-eCLIP with RNA-sequencing identified direct let-7 targets within an oncogene feed-forward regulatory network, including BACH1/EZH2/MYC, which drives an aberrant fibrotic cascade. Additional CUT&RUN-sequencing analyses …


Healthcare Experiences And Pain Dismissal By Healthcare Professionals, Amanda Warren May 2025

Healthcare Experiences And Pain Dismissal By Healthcare Professionals, Amanda Warren

Honors Theses

Background. Pain dismissal by healthcare professionals has gained recent attention in popular culture as people have come forward to discuss their own experiences with this issue. Pain dismissal is prevalent within the healthcare system, and college-aged young adults may be particularly vulnerable to experiencing pain dismissal because of their age. College students may also be influenced by societal factors that may affect their attitudes towards seeking help and advocating for themselves during healthcare visits. There is limited research on college students' attitudes and behaviors on seeking help after experiencing pain dismissal by a healthcare provider. This study aims to 1) …


Development Of A Risk Score To Aid With The Diagnosis Of Infections After Spinal Cord Injury: Protocol For A Retrospective Cohort Study, Felicia Skelton, Larissa Grigoryan, Joann Pan, Ashley Collazo, Barbara Trautner May 2025

Development Of A Risk Score To Aid With The Diagnosis Of Infections After Spinal Cord Injury: Protocol For A Retrospective Cohort Study, Felicia Skelton, Larissa Grigoryan, Joann Pan, Ashley Collazo, Barbara Trautner

Faculty, Staff and Students Publications

Background: Patients with spinal cord injury (SCI) who develop urinary tract infection (UTI) present differently than the non-SCI population. UTIs can cause loss of quality of life and even lead to life-threatening complications including urosepsis. Challenges in SCI management include distinguishing symptomatic UTI from asymptomatic bacteriuria (ASB), which occurs often in patients with SCI, and the lack of standardization in UTI diagnosis in SCI.

Objective: This study aims to set the foundation for the development of a risk score to improve diagnostic accuracy of UTI after SCI.

Methods: This study will use data from the Veterans Health Administration Corporate Data …


Gut Dysbiosis Patterns In Cvid Patients With Noninfectious Complications Observed In A Germ-Free Mouse Model Through Fecal Microbiota Transplantation, Joud Hajjar, Anita Y Voigt, Margaret E Conner, Alton G Swennes, Stephanie Fowler, Chadi Calarge, Danielle D Mendonca, Dominique Armstrong, Chen-Yen Chang, Jolan E Walter, Manish J Butte, Tor Savidge, Julia Oh, Farrah Kheradmand, Joseph F Petrosino May 2025

Gut Dysbiosis Patterns In Cvid Patients With Noninfectious Complications Observed In A Germ-Free Mouse Model Through Fecal Microbiota Transplantation, Joud Hajjar, Anita Y Voigt, Margaret E Conner, Alton G Swennes, Stephanie Fowler, Chadi Calarge, Danielle D Mendonca, Dominique Armstrong, Chen-Yen Chang, Jolan E Walter, Manish J Butte, Tor Savidge, Julia Oh, Farrah Kheradmand, Joseph F Petrosino

Faculty, Staff and Students Publications

Patients with common variable immunodeficiency (CVID) who develop noninfectious complications (NIC) have worse clinical outcomes than those with infections only (INF). While gut microbiome aberrations have been linked to NIC, reductionist animal models that accurately recapitulate CVID are lacking. Our aim in this study was to uncover potential microbiome roles in the development of NIC in CVID. We performed whole-genome shotgun sequencing on fecal samples from CVID patients with NIC, INF, and their household controls. We also performed fecal microbiota transplants from CVID patients to germ-free mice. We found potentially pathogenic microbes


Examination Of Eating Disorder Risks And Body Image Dissatisfaction Among Division Iii Student-Athletes, Maddie Wisener May 2025

Examination Of Eating Disorder Risks And Body Image Dissatisfaction Among Division Iii Student-Athletes, Maddie Wisener

Masters Theses/Capstone Projects

Eating disorders (ED) and pathogenic behaviors are prevalent concerns among collegiate athletes due to performance pressures and body image expectations. This cross-sectional study examined the risk of ED among 243 student-athletes (Males: 54.9%, Females: 44.3%, Non-Binary: 0.4%) at a private institution in the Midwest. The convenience sample included student-athletes from baseball, basketball, cheerleading, cross country, football, golf, lacrosse, soccer, softball, tennis, track, volleyball, and wrestling teams. The participants were given a demographic survey, the Eating Attitudes Test-26, and Sex-Specific Figural Stimuli Silhouettes to assess eating behaviors and perceived and desired body images. Overall, 22.1% of participants were at risk for …


Behavioral Responses To The Medicare Part D Coverage Gap And Its Closure, Selene Urbatsch May 2025

Behavioral Responses To The Medicare Part D Coverage Gap And Its Closure, Selene Urbatsch

Theses and Dissertations

The author examines how exposure to the Medicare Part D coverage gap affects future prescription drug use and whether the closure of the gap under the Affordable Care Act (ACA) altered beneficiary behavior. Using 2007–2019 MEPS data, the analysis compares Part D enrollees to similarly aged, privately insured individuals, producing first-differences and difference-in-differences estimates. Before the ACA, exposure to the gap was associated with 4.9 fewer prescription fills relative to comparable non-Part D individuals. After the ACA, the effect fell to a reduction of 2.2 generic fills, with no significant decline in branded use. Sudden out-of-pocket cost increases prompted sharp …


Improving Hospital Discharges Before Noon: Implementation Of A Vida (Very Important Discharge Appointment), Nadia Paul May 2025

Improving Hospital Discharges Before Noon: Implementation Of A Vida (Very Important Discharge Appointment), Nadia Paul

Evidence-Based Practice Project Reports

Delays in hospital discharge can negatively affect hospital throughput and bed capacity, resulting in increased length of stay and boarding of patients in off-unit locations which causes concerns for patient safety and potential harm (Rutherford et al., 2017). The purpose of this DNP project was to determine if the implementation of a very important discharge appointment (VIDA) would increase the number of hospital discharges occurring before noon (DBN) each day. This project was implemented at a 350-bed academic medical center in East Central Indiana. A 25-bed, adult medical unit served as the pilot unit. In total, 538 patients were included …


Understanding The Impact Of Language Barriers And Visit Duration On Caregiver Satisfaction In Pediatric Primary Care, Gavin Miller May 2025

Understanding The Impact Of Language Barriers And Visit Duration On Caregiver Satisfaction In Pediatric Primary Care, Gavin Miller

Health, Human Performance and Recreation Undergraduate Honors Theses

Background: Children from households that speak languages other than English (LOE) face barriers in accessing healthcare, leading to poorer health outcomes. Language barriers contribute to these disparities, often resulting in diminished communication between providers and families. Visit duration may play a key role in facilitating effective communication and improving patient satisfaction.

Purpose: This study examines how language barriers affect caregiver satisfaction in pediatric primary care, and whether visit duration mediates this relationship. We hypothesized that caregivers from LOE households would have comparable visit durations to English-preferring caregivers but report lower satisfaction due to receiving less information within that time. …


Socio-Medical Factors Associated With Neurodevelopmental Disorders On The Kenyan Coast, Patricia Kipkemoi, Jeanne E. Savage, Joseph Gona, Kenneth Rimba, Martha Kombe, Paul Mwangi, Collins Kipkoech, Beatrice Mkubwa, Amina Abubakar, Charles Newton May 2025

Socio-Medical Factors Associated With Neurodevelopmental Disorders On The Kenyan Coast, Patricia Kipkemoi, Jeanne E. Savage, Joseph Gona, Kenneth Rimba, Martha Kombe, Paul Mwangi, Collins Kipkoech, Beatrice Mkubwa, Amina Abubakar, Charles Newton

Institute for Human Development, East Africa

Neurodevelopmental disorders (NDDs) are a group of conditions with their onset during the early developmental period and include conditions such as autism and intellectual disability. Occurrence of NDDs is thought to be determined by both genetic and environmental factors, but data on the role of environmental factors for NDD in Africa is limited. This study investigates environmental influences on NDDs in children from Kenya. This case-control study compared children with NDDs and typically developing children from two studies on the Kenyan coast. We included 172 study participants from the Kilifi Autism study and 151 from the NeuroDev study who had …


Implementing Early Detection Of Cognitive Impairment In Primary Care To Improve Care For Older Adults, Nicole R. Fowler, Katherine A. Partrick, James Taylor, Michael Hornbecker, Malaz Boustani, Jeffrey L. Cummings, Tim Macleod, Michelle M. Mielke, Jared R. Brosch, Chinedu Momoh May 2025

Implementing Early Detection Of Cognitive Impairment In Primary Care To Improve Care For Older Adults, Nicole R. Fowler, Katherine A. Partrick, James Taylor, Michael Hornbecker, Malaz Boustani, Jeffrey L. Cummings, Tim Macleod, Michelle M. Mielke, Jared R. Brosch, Chinedu Momoh

Brain and Mind Institute

Primary care is the ideal setting for early detection of mild cognitive impairment (MCI) and Alzheimer's disease and related dementias (ADRD), as it serves as the primary point of care for most older adults. With the growing aging population, reliance on specialists for detection and diagnosis is unsustainable, highlighting the need for primary care-led assessment. Recent research findings on successful brain health prevention strategies, AD diagnostic tools, and anti-amyloid treatments empower primary care to play a central role in early detection and intervention. Primary care-focused resources are being developed, including tools for cognitive assessments and materials designed to educate patients …


Rural Access To Certified Community Behavioral Health Clinics (Ccbhcs), Aaron P. Smith, Jeffrey Talbert May 2025

Rural Access To Certified Community Behavioral Health Clinics (Ccbhcs), Aaron P. Smith, Jeffrey Talbert

Rural & Underserved Health Research Center Publications

Overview of Key Findings

▪ The number of Certified Community Behavioral Health Clinics (CCBHCs) expanded from 2022 to 2023, increasing from 371 to 480. Most of the growth was driven by rural counties (57.9% increase, 126 to 199) while urban counties increased by 14.7% (245 to 281).

▪ The number of services offered at CCBHCs is similar in both rural and urban localities, but urban CCBHCs were more likely to offer services that cater to a diverse client base, such as speaking different languages, and nicotine cessation programs. Rural CCBHCs were more likely to have programs for minors, veterans, and …


Knowledge, Attitudes, And Practices Regarding Antimicrobial Resistance And Antimicrobial Stewardship Among Healthcare Workers In Outpatient Medical Centers In Kenya: A Qualitative Study, Mary Kaniu, Wahu Gitakah, Rupali Jain, Ann Munyare, Rodney Adam, Aliza Monroe Wise May 2025

Knowledge, Attitudes, And Practices Regarding Antimicrobial Resistance And Antimicrobial Stewardship Among Healthcare Workers In Outpatient Medical Centers In Kenya: A Qualitative Study, Mary Kaniu, Wahu Gitakah, Rupali Jain, Ann Munyare, Rodney Adam, Aliza Monroe Wise

Paediatrics and Child Health, East Africa

Objective: Antimicrobial resistance (AMR) is a major global health threat with a projected 10 million deaths globally by 2050. Antimicrobial stewardship (AMS) programs are coordinated efforts involving doctors, nurses, pharmacists, and other healthcare providers. Understanding knowledge, attitudes, and practices of health providers is pivotal for implementing strategies to curb the spread of AMR. The aim of this study was to evaluate knowledge, attitudes, and practices surrounding AMR and AMS among healthcare workers in Kenya.

Design: A qualitative study using in-depth semi-structured interviews

Setting: 12 private outpatient clinics in Kenya.

Participants: Healthcare workers including administrators and clinicians. …