Public Health Commons^™

Improving Maternal, Neonatal And Child Health Outcomes In Low-Resource Settings: Translating Research Evidence To Practice - Report From The Third International Conference On Maternal, Newborn And Child Health, Robert L. Goldenberg, Shivaprasad S. Goudar, Nancy F. Krebs, Richard Derman, Sarah Saleem, Elizabeth M. Mcclure

Community Health Sciences

No abstract provided.

Polygenic Risk Score Development And Validation For Early Detection And Risk Stratification Of Rheumatoid Arthritis And Osteoarthritis In Postmenopausal Women, Yingke Xu

UNLV Theses, Dissertations, Professional Papers, and Capstones

Introduction: Around one in four adults worldwide suffer from arthritis. There are more than one hundred different forms of arthritis; the two most common forms of arthritis are rheumatoid arthritis (RA) and osteoarthritis (OA). RA is an autoimmune disease that can cause joint inflammation. Around 1.3 million adults in the US suffer from RA, representing 0.6%–1% of the population. The RA diagnosis in its early stages is difficult since its signs and symptoms are similar to other arthritis. OA is the most common form of arthritis. In the US, around 30.8 million people are affected by this disease. However, OA …

Heterogeneity Of The Group B Streptococcal Type Vii Secretion System And Influence On Colonization Of The Female Genital Tract, Brady L Spencer, Alyx M Job, Clare M Robertson, Zainab A Hameed, Camille Serchejian, Caitlin S Wiafe-Kwakye, Jéssica C Mendonça, Morgan A Apolonio, Prescilla E Nagao, Melody N Neely, Natalia Korotkova, Konstantin V Korotkov, Kathryn A Patras, Kelly S Doran

Faculty, Staff and Students Publications

Type VIIb secretion systems (T7SSb) in Gram-positive bacteria facilitate physiology, interbacterial competition, and/or virulence via EssC ATPase-driven secretion of small ɑ-helical proteins and toxins. Recently, we characterized T7SSb in group B Streptococcus (GBS), a leading cause of infection in newborns and immunocompromised adults. GBS T7SS comprises four subtypes based on variation in the C-terminus of EssC and the repertoire of downstream effectors; however, the intraspecies diversity of GBS T7SS and impact on GBS-host interactions remains unknown. Bioinformatic analysis indicates that GBS T7SS loci encode subtype-specific putative effectors, which have low interspecies and inter-subtype homology but contain similar domains/motifs and therefore …

Feasibility Of Delivering A Virtual 1-Day Acceptance And Commitment Therapy Workshop To Rural Veterans Through Community Partnerships, Lilian Dindo, Angelic Chaison, Merlyn Rodrigues, Ken Woods, Alicia Mark, Derrecka Boykin

Faculty, Staff and Students Publications

Background: This single-arm, open pilot study examined the feasibility and initial efficacy of a 1-day virtual Acceptance and Commitment Therapy (ACT) group workshop for distressed veterans.

Methods: We collaborated with veteran-serving community-based organizations to enhance outreach to veterans, especially those in rural areas. Veterans completed a baseline assessment and two follow-up assessments (1 month, 3 months) after workshop participation. Feasibility outcomes included reach (workshop recruitment and completion rates; veteran characteristics) and acceptability (open-ended survey question about satisfaction). Clinical outcomes included psychological distress (Outcome Questionnaire-45), stressor-related distress (PTSD Checklist-5), community reintegration (Military to Civilian Questionnaire), and meaning and purpose (PROMIS Short …

Missense Genetic Variation Of Icam1 And Incident Heart Failure, Pedro Giro, Jonathan W Cunningham, Laura Rasmussen-Torvik, Suzette J Bielinski, Nicholas B Larson, Laura A Colangelo, David R Jacobs, Myron Gross, Alex P Reiner, Donald M Lloyd-Jones, Xiuqing Guo, Kent Taylor, Muthiah Vaduganathan, Wendy S Post, Alain Bertoni, Christie Ballantyne, Amil Shah, Brian Claggett, Eric Boerwinkle, Bing Yu, Scott D Solomon, Sanjiv J Shah, Ravi B Patel

Faculty, Staff and Student Publications

BACKGROUND: Intercellular adhesion molecule-1 (ICAM-1) is a cell surface protein that participates in endothelial activation and is hypothesized to play a central role in heart failure (HF). We evaluated associations of ICAM1 missense genetic variants with circulating ICAM-1 levels and with incident HF.

METHODS AND RESULTS: We identified 3 missense variants within ICAM1 (rs5491, rs5498 and rs1799969) and evaluated their associations with ICAM-1 levels in the Coronary Artery Risk Development in Young Adults Study and the Multi-Ethnic Study of Atherosclerosis (MESA). We determined the association among these 3 variants and incident HF in MESA. We separately evaluated significant associations in …

Blunted Adaptive Immune Responses And Acute Exacerbations Of Copd: Breaking The Code, Ken R Bracke, Francesca Polverino

Faculty, Staff and Students Publications

No abstract provided.

Development And Validation Of The Houston-Best, A Barrett's Esophagus Risk Prediction Model Adaptable To Electronic Health Records, Theresa Nguyen Wenker, Joel H Rubenstein, Aaron P Thrift, Hardeep Singh, Hashem B El-Serag

Faculty, Staff and Students Publications

No abstract provided.

Does Gender And Cultural Diversity Matter For Sustainability In Healthcare? Evidence From Global Organizations, Kylie De Klerk, Favil Singh

Research outputs 2022 to 2026

Global healthcare organizations are fundamental in addressing the healthcare needs of local and global communities. This highly regulated sector means it is under constant scrutiny for health, safety, and ethical compliance risks by federal regulatory bodies. Despite higher monitoring, an increasing number of healthcare companies receive fines for their irresponsible practices, manifesting significant questions about their corporate governance and sustainability practices. Against this backdrop, this study examines the relationship between boardroom diversity on the sustainability performance of companies operating in healthcare. Utilizing a global sample of publicly listed healthcare companies, using panel regression data and the system-GMM estimator accounting for …

Demise Of The Usmle Step-2 Cs Exam: Rationalizing A Way Forward, Francis I Achike, Jennifer G Christner, Jeremy L Gibson, Robert M Milman, Sharon Obadia, Amy L Waer, Patricia K Watson

Faculty, Staff and Students Publications

The COVID-19 pandemic has compelled rethinking and changes in medical education, the most controversial perhaps being the cancelation of USMLE Step-2 Clinical Skills exam (Step-2 CS). What started in March of 2020 as suspension of this professional licensure exam, because of concerns about infection risk for examinees, standardized patients (SPs), and administrators, soon became permanent cancelation in January 2021. Expectedly, it triggered debate in medical education circles. Positively, however, the USMLE regulatory agencies (NBME and FSMB) saw an opportunity to innovate an exam tainted with perceptions of validity deficits, cost, examinee inconvenience, and worries about future pandemics; they therefore called …

Health Information Seeking In The Digital Age: A National Survey Of Women With Disabilities, Susan Robinson-Whelen, Rosemary B Hughes, Jeanne L Alhusen, Leanne Beers, Charles G Minard, David Davidson

Faculty, Staff and Students Publications

PURPOSE: Access to high quality and accessible online health information (OHI) is critical for reducing disparities, overcoming barriers, and improving the health of women with disabilities. This study aimed to understand women with physical disabilities' use of the Internet to access OHI, most often searched health topics, perceived usefulness of OHI, and self-reported eHealth literacy and challenges in OHI seeking.

METHODS: We conducted a national online survey with 508 women with physical disabilities who used the Internet.

RESULTS: Respondents utilized a wide variety of OHI resources. They searched a broad array of health and disability-related topics, with bowel/bladder and finding …

Sideffect Gameplan: Development Of An Alcohol And Other Drug Serious Game For High School Students Using A Systematic And Iterative User-Centred Game Development Framework, Joanna Nicholas, Brennen Mills, Sara Hansen, Stephen J. Bright, Joseph Scott, Imogen Ridout, Jess Watson, Heather Boyd, Luke Brook, Luke Hopper

Research outputs 2022 to 2026

Serious games have shown to be effective in improving motivation to learn, knowledge and retention, thus are being increasingly used for alcohol and other drug (AOD) education. This paper outlines the development of an online AOD serious game for in-class use by Australian secondary school teachers for students in Years 9–10. Adapted from Edwards et al. (2018), the seven-step systematic and iterative user-centred development framework included: (1) Forming an expert multidisciplinary design team, (2) Defining the problem and establishing user preferences, (3) Incorporating the evidence base, (4) Serious game design, (5) Incorporating behavioural and psychological theory, (6) Developing a logic …

Clinical Outcomes Associated With Overestimation Of Oxygen Saturation By Pulse Oximetry In Patients Hospitalized With Covid-19, Ashraf Fawzy, Tianshi David Wu, Kunbo Wang, Kenneth E Sands, Arielle M Fisher, Shanna A Arnold Egloff, Jeffrey D Dellavolpe, Theodore J Iwashyna, Yanxun Xu, Brian T Garibaldi

Faculty, Staff and Students Publications

IMPORTANCE: Many pulse oximeters have been shown to overestimate oxygen saturation in persons of color, and this phenomenon has potential clinical implications. The relationship between overestimation of oxygen saturation with timing of COVID-19 medication delivery and clinical outcomes remains unknown.

OBJECTIVE: To investigate the association between overestimation of oxygen saturation by pulse oximetry and delay in administration of COVID-19 therapy, hospital length of stay, risk of hospital readmission, and in-hospital mortality.

DESIGN, SETTING, AND PARTICIPANTS: This cohort study included patients hospitalized for COVID-19 at 186 acute care facilities in the US with at least 1 functional arterial oxygen saturation (SaO2) …

Variation In Early Anakinra Use And Short-Term Outcomes In Multisystem Inflammatory Syndrome In Children, Joyce C Chang, Cameron C Young, Eyal Muscal, Sara K Sexson Tejtel, Margaret M Newhams, Suden Kucukak, Hillary Crandall, Aline B Maddux, Courtney M Rowan, Natasha B Halasa, Helen A Harvey, Charlotte V Hobbs, Mark W Hall, Michele Kong, Cassyanne L Aguiar, Jennifer E Schuster, Julie C Fitzgerald, Aalok R Singh, Kari Wellnitz, Ryan A Nofziger, Natalie Z Cvijanovich, Elizabeth H Mack, Adam J Schwarz, Sabrina M Heidemann, Jane W Newburger, Laura D Zambrano, Angela P Campbell, Manish M Patel, Adrienne G Randolph, Mary Beth F Son, Overcoming Covid Investigators

Faculty, Staff and Students Publications

OBJECTIVE: Evidence regarding effectiveness of interleukin-1 receptor antagonism in multisystem inflammatory syndrome in children (MIS-C) is lacking. We characterized variation in initial treatment with anakinra and evaluated cardiovascular outcomes associated with adding anakinra to standard initial therapy.

METHODS: We conducted a retrospective cohort study of MIS-C cases in a US surveillance registry from November 2020 to December 2021. Day 0 was the first calendar day of immunomodulatory treatment. Factors associated with initial anakinra use (days 0-1) were identified. We compared cases in patients ages 2-20 years receiving intravenous immunoglobulin (IVIG) and glucocorticoids versus anakinra plus IVIG and/or glucocorticoids on days …

Rounding In The Time Of Covid, Adam Cohen

Faculty, Staff and Students Publications

No abstract provided.

Avocado Consumption And Markers Of Inflammation: Results From The Multi-Ethnic Study Of Atherosclerosis (Mesa), Feon W Cheng, Nikki A Ford, Alexis C Wood, Russell Tracy

Faculty, Staff and Students Publications

Purpose

Since avocado consumption has been linked to a possible reduction in inflammation, we investigated associations between avocado consumption and markers of inflammation in a population-based multi-ethnic cohort [Multi-Ethnic Study of Atherosclerosis (MESA)].

Methods

We used a food frequency questionnaire (FFQ) at MESA exam 1 to capture avocado/guacamole consumption. To calculate daily servings of avocado/guacamole, we used both frequency and serving size data from the FFQ. We classified participants into three consumer groups: rare or never (daily serving ≤ 0.03), medium (0.03 < daily serving < 0.1), and heavy (0.1 ≤ daily serving). Inflammation was estimated by natural log-transformed inflammatory biomarkers (CRP, IL-2, IL-6, homocysteine, fibrinogen, TNF-a soluble receptors). We used multivariate general linear regression models to assess associations accounting for age, sex, race/ethnicity, educational level, income, energy intake, smoking status, physical activity, diet quality, body mass index, and diabetes type.

Results

Among 5794 MESA participants, the average age and BMI were 62.25 y ± 10.26 and 28.28 ± …

Hunger Extends Lifespan By Modulating Histone Proteins, Hailan Liu, Hongjie Li, Yong Xu

Faculty, Staff and Students Publications

No abstract provided.

Disparities In Antifibrotic Medication Utilization Among Veterans With Idiopathic Pulmonary Fibrosis, Bhavika Kaul, Joyce S Lee, Laura A Petersen, Charles Mcculloch, Ivan O Rosas, Venkata D Bandi, Ning Zhang, Alison M Dedent, Harold R Collard, Mary A Whooley

Faculty, Staff and Students Publications

Background: Two antifibrotic medications, pirfenidone and nintedanib, are approved for the treatment of idiopathic pulmonary fibrosis (IPF). Little is known about their real-world adoption.

Research question: What are the real-world antifibrotic utilization rates and factors associated with uptake among a national cohort of veterans with IPF?

Study design and methods: This study identified veterans with IPF who received care either provided by the Veterans Affairs (VA) Healthcare System or non-VA care paid for by the VA. Patients who had filled at least one antifibrotic prescription through the VA pharmacy or Medicare Part D between October 15, 2014, and December 31, …

The Benefits Of Making Peace With Pain: Chronic Pain Acceptance Moderates The Indirect Effect Of Perceived Burdensomeness Between Pain Severity And Suicidal Cognitions, Willie Hale, Sarah Vacek, Meghan Crabtree, Kaitlin Grelle, Craig J Bryan, Donald D Mcgeary, Kathryn E Kanzler

Faculty, Staff and Students Publications

Objective: The purpose of this study was (1) to examine the degree to which perceived burdensomeness mediates the relationship between pain severity and suicidal cognitions and (2) to determine whether this mediated relationship was moderated by pain acceptance. We predicted that high levels of pain acceptance would buffer relationships on both paths of the indirect effect.

Methods: Two-hundred seven patients with chronic pain completed an anonymous self-report battery of measures, including the Chronic Pain Acceptance Questionnaire, the Interpersonal Needs Questionnaire, the Suicidal Cognitions Scale, and the pain severity subscale of the West Haven-Yale Multidimensional Pain Inventory. Conditional process models were …

Improving The Diagnostic Process For Patients With Possible Bladder And Kidney Cancer: A Mixed-Methods Study To Identify Potential Missed Diagnostic Opportunities, Yin Zhou, Hardeep Singh, Willie Hamilton, Stephanie Archer, Sapphire Tan, James Brimicombe, Georgios Lyratzopoulos, Fiona M Walter

Faculty, Staff and Students Publications

Background: Patients with bladder and kidney cancer may experience diagnostic delays.

Aim: To identify patterns of suboptimal care and contributors of potential missed diagnostic opportunities (MDOs).

Design and setting: Prospective, mixed-methods study recruiting participants from nine general practices in Eastern England between June 2018 and October 2019.

Method: Patients with possible bladder and kidney cancer were identified using eligibility criteria based on National Institute for Health and Care Excellence (NICE) guidelines for suspected cancer. Primary care records were reviewed at recruitment and at 1 year for data on symptoms, tests, referrals, and diagnosis. Referral predictors were examined using logistic regression. …

Transplanting Hepatitis B Surface Antigen-Positive Livers In The United States: Outcomes And Opportunities, Anshul Bhatnagar, Sameer Prakash, Peter Lymberopoulos, Cameron Goff, Anjiya Shaikh, Donghee Kim, Aijaz Ahmed, Carl Berg, Susanna Naggie, Fasiha Kanwal, George Cholankeril, Tzu-Hao Lee

Faculty, Staff and Students Publications

Livers from donors with positive hepatitis B surface antigens (HBsAg+) have been used to expand the donor pool; however, outcome data are limited. We aim to evaluate survival following liver transplant (LT) from HBsAg+ donors. Using the United Network for Organ Sharing registry, we identified HBsAg+ donors used for LT from 2009 to 2020. We used Kaplan-Meier survival and Cox proportional hazards regression to compare post-LT survival in hepatitis B virus-negative recipients who utilized HBsAg+ donors to propensity-matched cohorts who utilized other types of donors. From 2009-2020, 70 patients received HBsAg+ livers, and 58 of them did not carry a …

Leveraging Omics To Predict Chronic Obstructive Pulmonary Disease Exacerbations: The "Immunome", Francesca Polverino, Ravi Kalhan

Faculty, Staff and Students Publications

No abstract provided.

Polymorphisms In The Nonhomologous End-Joining Dna Repair Pathway Are Associated With Hpv Integration In Cervical Dysplasia, Jennifer M Geris, E Susan Amirian, Deborah A Marquez-Do, Martial Guillaud, Laura M Dillon, Michele Follen, Michael E Scheurer

Center for Medical Ethics and Health Policy Staff Publications

Previous evidence indicates that HPV integration status may be associated with cervical cancer development and progression. However, host genetic variation within genes that may play important roles in the viral integration process is understudied. The aim of this study was to examine the association between HPV16 and HPV18 viral integration status and single nucleotide polymorphisms (SNPs) in non-homologous end-joining (NHEJ) DNA repair pathway genes on cervical dysplasia. Women enrolled in two large trials of optical technologies for cervical cancer detection and positive for HPV16 or HPV18 were selected for HPV integration analysis and genotyping. Associations between SNPs and cytology (normal, …

The Past, Present, And Future Of The Latino Paradox, Sheila Flores

University Honors Theses

The Latino/Hispanic paradox has left scholars and researchers puzzled as to how Latinos, despite facing socioeconomic challenges, show better health outcomes when compared to other racial/ethnic groups. The emergence of this phenomenon can be traced back to the 1980s/1990s when researchers first noticed Latinos in the United States having characteristics of lower mortality rates and improved health compared with non-Hispanic whites despite having a better socioeconomic status. Performing a literature review of scholars analyzing the past, present, and future of the Latino Paradox will thus allow for an understanding of its origin, current state, and the possible potential trajectories that …

High Risk Lung Nodule: A Multidisciplinary Approach To Diagnosis And Management, Babith J Mankidy, Ghasemirad Mohammad, Kelly Trinh, Anoop P Ayyappan, Quillan Huang, Steven Bujarski, Mohammad S Jafferji, Ravi Ghanta, Alexander N Hanania, Donald R Lazarus

Faculty, Staff and Students Publications

Pulmonary nodules are often discovered incidentally during CT scans performed for other reasons. While the vast majority of nodules are benign, a small percentage may represent early-stage lung cancer with the potential for curative treatments. With the growing use of CT for both clinical purposes and lung cancer screening, the number of pulmonary nodules detected is expected to increase substantially. Despite well-established guidelines, many nodules do not receive proper evaluation due to a variety of factors, including inadequate coordination of care and financial and social barriers. To address this quality gap, novel approaches such as multidisciplinary nodule clinics and multidisciplinary …

The Role Of The Women's Organization Of Nahdlatul Ulama (Nu) In Efforts To Control Cigarette Consumption In Indonesia, Salsabila Nadya, Isranalita Madelif Sihombing

Cities and Urban Development Journal

Background: The protection of the nation's next generation from the dangers of smoking cannot be separated from the role of women/mothers as educators and as influencers in creating a safe and comfortable environment from exposure to cigarette smoke for children to grow and develop healthily.

Aims: To analyze the role of the Nahdlatul Ulama (NU) women's organization, namely NU Young Women's Organization (Fatayat NU) and NU Female Student Association (IPPNU) in efforts to control tobacco in Indonesia.

Methods: This research is descriptive research with a method of collecting data on the results of activities owned by the Center for Social …

Workers’ Characteristics Of Hearing Loss At Soekarno-Hatta International Airport, Indonesia, Andrew Ebeneizer Timanta, Budi Haryanto, Ririn Arminsih Wulandari

Kesmas

This study aimed to analyze the characteristics and factors of worker behavior, including age, the use of ear protection, work duration, a record of diabetes mellitus or hypertension, work rotation, and noise hazards involved in hearing loss in PT. X at Soekarno-Hatta International Airport, Indonesia. A cross-sectional study from May 2017 to June 2017 involved 73 workers in the power service area (TZ Unit) exposed to noise levels ≥85 dBA, using an audiometry test for hearing loss and Sound Level Meter for noise hazards was conducted. The Chi-square test showed a significant correlation between age (OR 8.4, 95% Cl = …

Smallholder Farmers’ Health, Occupational Nutrition, And Sustainable Agriculture, Jen Fuk Liem

Occupational and Environmental Medicine Journal of Indonesia

Smallholder Farmers’ Health, Occupational Nutrition, and Sustainable Agriculture

Brominated Flame Retardants: A Literature Review Of The Toxicity Mechanisms, Clinical Manifestations, And Current Treatments, Yacobus Christian Prasetyo, Eti Nurwening Sholikhah

Occupational and Environmental Medicine Journal of Indonesia

Brominated flame retardants (BFRs) are organohalogen compounds that can inhibit fire formation and delay its spread in manufacturing materials. BFRs are known to be toxic for the environment and humans. BFRs could persist for years prolonging potential exposure and toxicity to living beings. Indonesia had begun to reduce the use, even though some of toxic BFRs are still illegally circulating. This review aims to describe some aspects of BFRs toxicity including the mechanism, its clinical manifestations, and the current possible treatments. Toxicity after BFRs exposure includes endocrine, neurodevelopmental, and genotoxicity. The toxicity is manifested into some clinical conditions such as …

The Vigilance Screening Tool In The Workplace: Scoping Review, Iwan Sugiarta, Dewi Yunia Fitriani, Muchtaruddin Mansyur

Occupational and Environmental Medicine Journal of Indonesia

VIGILANCE SCREENING TOOLS IN THE WORKPLACE: SCOPING REVIEW

ABSTRACT

Background: Vigilance performance examination is currently used widely in many disciplines, neurophysiology, sleep medicine, psychology to its application to workers whose daily activities require prime vigilance. A more objective inspection of vigilance has not yet become a routine screening examination for workers to detect decreased vigilance as part of a fit-to-work assessment, but only in the form of research / study using a partial sampling technique. The aim is to provide an overview of vigilance screening tools in the workplace, its terminologies and how the process of maintaining quality such …

Examining The Chelating Effectiveness Of Dimercaptosuccinic Acid And Ethylenediaminetetraacetic Acid Calcium Disodium In Patients With Lead Poisoning : An Evidence-Based Case Report, Heru Alfares, Reza A. Rafsanzani, Muchtaruddin Mansyur

Occupational and Environmental Medicine Journal of Indonesia

Evidence Based Case Report:

Examining the Chelating Effectiveness of Dimercaptosuccinic Acid and Ethylenediaminetetraacetic acid Calcium Disodium in Patients with Lead Poisoning

Heru Alfares¹, Reza A. Rafsanzani¹, Muchtaruddin Mansyur²

¹ Occupational Medicine Specialist Study Program, Faculty of Medicine, Universitas Indonesia, Jakarta,

² Dept. of Community Medicine, Faculty of Medicine, Universitas Indonesia, Jakarta,

ABSTRACT

Background: Lead environmental and occupational exposures harm workers’ health, both acute and chronic lead poisoning. Chelation therapy is one of the treatments for lead poisoning using several chelating agents available, including ethylenediaminetetraacetic acid (EDTA), dimercaptosuccinic acid (DMSA), dimercaptopropanesulfonate (DMPS), and 2,3-dimercaptopropanol …