Public Health Commons^™

The Dissemination And Implementation Of N95 Fit Testing Capacities For Nebraska Long-Term Care Facilities: A Mixed-Methods Analysis Using The Re-Aim Framework, Anthony Blake

Theses & Dissertations

Background: Ensuring the proper fit of N95 respirators used by healthcare workers in long-term care facilities (LTCF) is essential for their safety. The Nebraska Department of Health and Human Services launched a LTCF strike team project (STP) in the summer of 2022, focused on increasing the number of staff trained in infection control and building internal capacity for LTCFs to fit test their employees. This study describes the N95 fit-testing initiative for Nebraska LTCFs.

Methods: Staff from all 19 local health departments (LHD) received “train-the-trainer” training to prepare LTCF staff to perform qualitative fit testing. LTCF administrators were requested to …

Agnotology Of The E-Cigarette Industry: How The E-Cigarette Industry Continues The Tobacco Industry's Legacy Of Creating Controversy And Confusion Within The Scientific Community And The General Population, Calvin Lewis

University Honors Theses

The purpose of this paper is to determine the extent to which the e-cigarette industry follows in the footsteps of the tobacco industry's attempts to disrupt science and cause controversy. Four tactics are described that the tobacco industry uses to disrupt science: funding research that is designed to show results that support their position, criticizing and suppressing research that goes against their position, changing risk assessment and scientific research standards to fit their aims, and spreading data created by their interest groups to politicians and the nonacademic press. Evidence is found to show that both the tobacco industry and e-cigarette …

Improving Patient Care: Expansion Of Access To Free Clinics, Anahis H. Davidian, Gail M. Bloom

Patient Experience Journal

Free clinics provide free or reduced-fee healthcare services for uninsured, underserved, and marginalized populations. Free clinics may be the only source of primary care for socioeconomically disadvantaged individuals lacking health insurance. However, consistently understaffed and underfunded free clinics are struggling to meet growing needs. The demand for services results in long waitlists with long wait times. Most free clinics rely on volunteer providers and staff due to limited financial resources. This case study proposes recommendations that can address the challenges of funding limitations while improving free clinics' ability to offer more accessible and equitable care to serve a greater proportion …

Foundational Patient Experience: Analyzing 10 Years Of Patient Experience Research, Geoffrey A. Silvera Phd, Mha, Courtney Haun Phd, Mph, Varun Natarajan

Patient Experience Journal

In this study, we seek to provide a critical examination of the field of Patient Experience (PX) by using citation analysis to determine the foundational keystones of the PX knowledge base. This study will employ a systematic citation analysis to evaluate the articles published in the Patient Experience Journal (PXJ), focusing on citation frequency as evidence of impact on the field. To achieve this, we examine the entire corpus of article citations published in the PXJ from 2014–2023 (Volumes 1–10). By examining a corpus consisting of 515 independent articles (N=515) that include over 12,000 references (n=12,712) over the course of …

Patient Experience And Virtual Reality: The Use Of An Mri Exam Simulator, Jaqueline Maria Da Silva Jms, Marcus Antonio Medeiros De Souza Mams, Mônica Augusta Reis Dos Santos Mars, Milena Loureiro De Melo Mlm, Lorena De Fátima Lucena Almeida Lfla, Alayde Ricardo Da Silva Ars, Êmilly Vitória Dos Santos Vieira Evsv, Alessandra Nascimento Pontes Anp, Jandson De Oliveira Soares Jos

Patient Experience Journal

Magnetic resonance (MR) imaging is a safe diagnostic method of high accuracy detection and characterization of various pathological conditions. However, due to the very closed aspect of the apparatus, the high sound amplitude emitted and the need to remain motionless for a significant time, some patients experience discomfort and high levels of anxiety, compromising time and image quality management that can impair the clinical outcome of the patient or even give up the performance of this procedure. Therefore, this study aimed to validate, with patients, the use of Virtual Reality (VR) as a humanized practice of exposure to magnetic resonance …

Accompanying People Affected By Cancer In Their Return To Life After Treatment: A Report On An Experiment Conducted In Canada, Christine Arsenault, Saskia Hazout, John Calogerinis, Françoise Poirier, Louise Normandin, Cécile Vialaron, Monica Iliescu Nelea, Marie-Pascale Pomey

Patient Experience Journal

This study aims to assess family doctors' perceived needs for improved patient follow-up post-acute treatment in oncology departments, specifically focusing on the Patient Oriented Discharge Summary (PODS) for individuals living with cancer. A cross-sectional quantitative survey targeted family doctors, and a before/after exploratory study was conducted with patients to measure their needs pre- and post-PODS implementation. Twenty-one out of 42 family doctors participated in the survey (50%). Patient data was collected at three points in time: prior to PODS implementation (T1, n = 20/30; 77%), one month later (T2, n = 20/26; 77%), and six months later (T3, n = …

Investigating The Perceived Impact Of Surgeons' Burnout On Surgical Physician Associates' Wellness In United States Ambulatory Surgery Centers, Rhionna J. Smith, Lihua Dishman, John W. Fick, Kathleen M. Thomas

Patient Experience Journal

Surgeons are the de facto leaders of surgical teams with surgical physician associates (SPAs) as integral members who function in all areas of the peri-operative environment. Surgeons often supervise SPAs. Ambulatory surgery centers (ASCs) provide patients with same-day diagnostic and preventive procedures as more convenient alternatives to hospital-based outpatient procedures. This qualitative, national, and cross-sectional study explored the perceived impact of surgeons' burnout on SPAs' wellness in U.S. ASCs during global health crises. Primary demographic and qualitative data were collected using a self-developed, three-section survey instrument: (1) information regarding informed consent; (2) 10 short demographic questions; and (3) two open-ended …

Primary Care Productivity And Patient Satisfaction Community Practice: What Is The Relationship?, Thomas G. Howell Jr.

Patient Experience Journal

Research has shown a consistent positive association between patient and provider experience and improved patient outcomes and safety. There is a belief that patient satisfaction and physician productivity are competing interests. The relationship for primary care physicians, in a Midwest Health system was evaluated as part of this project. Data from Press Ganey patient satisfaction surveys on likelihood of recommending the practice and the physician were compared between primary care physicians in the top quartile of average monthly patient visits and those that were in the three lower quartiles. A secondary analysis of patient satisfaction scores related to continuous years …

The Perceived Usefulness Of Patient Narrative Feedback In Primary Care Settings, Sasmira Matta, Yuna S.H. Lee, Rachel Grob, Mark Schlesinger, Ingrid Nembhard

Patient Experience Journal

Research suggests that insights from patient narratives – stories about care experiences in patients' own words – contain information that can be used to improve care. However, assessments of narratives reported by clinical personnel have been mixed. This is the first study, to our knowledge, to systematically measure how useful personnel in primary care perceive patient narratives to be. We surveyed 276 clinical and administrative personnel in nine primary care clinics in a large health system in the United States. We found that perceived usefulness of patient narratives is generally high, but varies by individual characteristics such as level of …

Research Imitates Life: Researching Within Your Lived Experience, Bethany Donaghy, Delane Linkiewich

Patient Experience Journal

This personal narrative article seeks to bring awareness to and provide an overview of the various aspects that come with being a lived experience researcher including the host of benefits and challenges that come with conducting research within one's own area of lived experience. Throughout this narrative, we (Bethany Donaghy, an autistic person, and Delane Linkiewich a person living with chronic pain) share our perspectives on what it is like to be lived experience researchers. Our narratives discuss how the many identities we hold both improve the impact and relevance of our research while also posing challenges for us like …

A Commitment To Experience Must Reach Across The Continuum Of Care, Jason A. Wolf Phd

Patient Experience Journal

A conversation on patient experience is not restricted to one care setting, nor should it be. People's healthcare journeys are not singular instances, but most often a series of encounters that while perhaps separate operationally from the delivery side of care, all weave together to frame one experience for a patient, their family members and care partners. This special issue purposefully takes us outside the traditional conversation space for experience, looking at segments of the care continuum including primary care, ambulatory care, free clinics and even dental care and the use of non-traditional care methods such as telehealth and app-based …

Five A Day, The Rainbow Way: A Nutrition Education Toolkit For Elementary School Aged Children, Sasha Menard

Department of Nutrition Student Projects

Learning Outcome: Develop a nutrition educational toolkit based on Social Cognitive Theory (SCT) for obesity prevention among elementary school-aged children by improving determinants of fruit and vegetable intake.

Background: Poor consumption of fruits and vegetables is a major contributing factor to childhood obesity, increasing the risk for chronic diseases later in life. There is a need for multicomponent nutrition educational tools to influence children to improve their eating behavior by increasing their awareness and self-efficacy. The current project describes the development of a 3-component toolkit for improving participants’ knowledge and values related to fruit and vegetable intake among 6-11-year-olds.

Methods: …

Syphilitic Gumma Presenting As Squamous Cell Carcinoma Of Vulva: A Case Report, R.M. Nuss, A.J. Lazenby, Holly C. Provost, Tara Castellano

School of Medicine Faculty Publications

Introduction: Tertiary syphilis, a late form of the disease with neurologic, cutaneous, and cardiovascular manifestations, is rarely seen in the United States in modern times. Also called the “great imitator,” syphilis tends to mimic other disease processes, which can lead to a delay in proper diagnosis and treatment. Case: We present the case of a 59-year-old woman who presented for evaluation of possible squamous cell carcinoma of the vulva. After multiple inconclusive biopsies and extensive workup with multiple providers, she was instead found to have cutaneous and neurologic tertiary syphilis. A correct diagnosis was delayed in this patient due to …

Pan-Cancer Proteogenomics Expands The Landscape Of Therapeutic Targets, Sara R Savage, Xinpei Yi, Jonathan T Lei, Bo Wen, Hongwei Zhao, Yuxing Liao, Eric J Jaehnig, Lauren K Somes, Paul W Shafer, Tobie D Lee, Zile Fu, Yongchao Dou, Zhiao Shi, Daming Gao, Valentina Hoyos, Qiang Gao, Bing Zhang

Faculty, Staff and Students Publications

Fewer than 200 proteins are targeted by cancer drugs approved by the Food and Drug Administration (FDA). We integrate Clinical Proteomic Tumor Analysis Consortium (CPTAC) proteogenomics data from 1,043 patients across 10 cancer types with additional public datasets to identify potential therapeutic targets. Pan-cancer analysis of 2,863 druggable proteins reveals a wide abundance range and identifies biological factors that affect mRNA-protein correlation. Integration of proteomic data from tumors and genetic screen data from cell lines identifies protein overexpression- or hyperactivation-driven druggable dependencies, enabling accurate predictions of effective drug targets. Proteogenomic identification of synthetic lethality provides a strategy to target tumor …

Variability And Error In Measurement Of Infant Formula Powder And Water: An Experimental Study, Richard R. Rosenkranz, Ana Gonzalez-Alvarez, Chris Acosta, Andrew Hooyman, Jose R. Hidalgo, Cindyromina Ballasteros-Paniagua, Sara K. Rosenkranz

Physical Therapy Faculty Articles and Research

Introduction: Formula feeding is the only viable nutrition alternative for infants 0–6mos who cannot breastfeed. Among the drawbacks of formula feeding, however, is potential dilution or concentration errors in the formula during preparation that may lead to infant health issues. The present study aimed to investigate the accuracy of caregiver measurements as they prepared infant formula under multiple conditions, compared with manufacturer specifications.

Methods: A diverse sample of caregivers (N = 84) participated in this cross-over experimental study. Participants hand-scooped infant formula powder and poured water to prepare 4oz. and 7oz. feedings, using both a standardized set of …

Disparities And Protective Factors In Pandemic-Related Mental Health Outcomes: A Louisiana-Based Study, Ariane L. Rung, Evrim Oral, Tyler Prusisz, Edward S. Peters

School of Public Health Faculty Publications

Introduction: The COVID-19 pandemic has had a wide-ranging impact on mental health. Diverse populations experienced the pandemic differently, highlighting pre-existing inequalities and creating new challenges in recovery. Understanding the effects across diverse populations and identifying protective factors is crucial for guiding future pandemic preparedness. The objectives of this study were to (1) describe the specific COVID-19-related impacts associated with general well-being, (2) identify protective factors associated with better mental health outcomes, and (3) assess racial disparities in pandemic impact and protective factors. Methods: A cross-sectional survey of Louisiana residents was conducted in summer 2020, yielding a sample of 986 Black …

Exploring Lived Experiences Of Mothers Raising Children With Down Syndrome In Western Nigeria, Vivian N. Aruwajoye

Walden Dissertations and Doctoral Studies

Having a child with Down syndrome (DS) negatively impacts mothers’ health and well-being. Families raising a child or children with DS encounter significant financial burdens, inadequate support services, and cultural influences, which have adverse effects on the families. The purpose of this phenomenological qualitative study was to understand the accessibility and utilization of support services through the lived experiences of Western Nigerian mothers raising children with DS. The study involved 10 mothers who were recruited using a purposive sampling technique. Data were collected through semi-structured interviews via Zoom and observational notes. Thematic analysis was guided by Bronfenbrenner's ecological model. NVivo …

Evaluating The Effectiveness Of Hiv/Aids Interventions In Lesotho, Maya Gomez Velardez

Master's Projects and Capstones

Lesotho faces a severe HIV/AIDS epidemic, with one of the highest prevalence rates globally, impacting its public health, economy, and society. Despite numerous efforts, the country continues to struggle with persistently high infection rates, highlighting the need to thoroughly evaluate current interventions. This review examines the effectiveness of various HIV/AIDS interventions in Lesotho, focusing on multi-level strategies within the Social Ecological Model. The paper synthesizes literature from 2013 to 2023, concentrating on antiretroviral therapy (ART) coverage, community initiatives, and efforts targeting high-risk groups. Key strategies involve expanding ART coverage, strengthening community-based healthcare through community health workers (CHWs), and enhancing initiatives …

Health For All: Evaluating The Impact Of Equity-Centered Approaches On U.S. Healthcare Delivery, A Review Of Literature, Angela Leung

Master's Projects and Capstones

This literature review examines the impact of equity-centered approaches on issues affecting U.S. healthcare delivery—multiple databases to identify relevant literature that discussed equity-centered care, associated health disparities, and implementation strategies. Of the 490 search results, ten articles remained after refining the search results to include papers published between 2014-2024 and fit the specific inclusion and exclusion criteria. The key findings highlight the benefits of equity-centered approaches in improving the quality and accessibility issues affecting the U.S. healthcare system. Presently, the status of equity work is siloed between healthcare systems in the U.S., creating an unprecedented roadblock. Nonetheless, the findings suggest …

Effects Of Misinformation And Disinformation On Vaccine Hesitancy And Routine Vaccine Uptake, Cindy Chen

Master's Projects and Capstones

This literature review was conducted to identify the role misinformation and disinformation plays on the rates of vaccine hesitancy and vaccine uptake for routine immunization among the child and adult populations of the United States. Fifteen articles between 2018-2024 were extracted from PubMed and Google Scholar databases. As shelter-in-place and social distancing protocol wanes, the risk of common vaccine preventable diseases (VPDs) reemerges, especially in populations that have not kept up with routine immunization schedules. Current efforts to restore mass vaccination campaigns are underway, but do not provide the necessary modifications to include social, behavioral, and cultural factors that influence …

The Michigan Procedure: Mass Extraction From The Heart Facilitated By Onocor Global Embolic Protection Device, Hussam Al Hennawi, Shaurya Srivastava, Ahmad Abulshamat, Mohammed Qintar

Abington Jefferson Health Papers

Intracardiac masses present a challenging diagnostic and therapeutic dilemma and are associated with an increased risk of complications, such as embolic events and obstructive symptoms. We report a novel procedure using an ŌNŌCOR device through subclavian access that acted as a full-body protection device as well as a retrieval device.

Developing Project Management Success Criteria For Public Health Response Programs, Priyanka Dutta

Harrisburg University Dissertations and Theses

This study addresses an existing gap in the project management literature in regards to the limited research on its application in public health settings. Specifically, this study intends to identify and develop success criteria to help measure the performance of project management methodologies used for public health response programs. Using a qualitative research design in the form of a case study review, the study will consolidate findings and propose a success criteria by which project management methodologies for public health programs can be evaluated. The criteria will contribute to future research and the development of a standardized measure that will …

Effects Of E-Cigarettes On The Lung And Systemic Metabolome In People With Hiv, Aline Zaparte, Courtney J. Christopher, Connie Arnold, Lauren Richey, Adairre Castille, Kyle Mistretta, Christopher M. Taylor, Huiyi Lin, Steve Nelson, John P. Kirwan, John W. Apolzan, Shawn R. Campagna, David A. Welsh

School of Medicine Faculty Publications

The popularity of e-cigarettes (vaping) has soared, creating a public health crisis among teens and young adults. Chronic vaping can induce gut inflammation and reduce intestinal barrier function through the production of the proinflammatory molecule hydrogen sulfide (H2S). This is particularly concerning for people with HIV (PWH) as they already face impaired immune function and are at a higher risk for metabolic dysregulation, diabetes, and chronic liver disease. Furthermore, PWH experience unhealthy behaviors, making it crucial to understand the systemic metabolic dysregulation and pathophysiological mechanisms associated with vaping in this population. Here, we employed liquid chromatography–mass spectrometry (LC-MS)-based metabolomics to …

Prostate Specific Antigen-Based Cancer Screening In The United States, Treves M. Dennis

Walden Dissertations and Doctoral Studies

In 2012, the U.S. Preventive Services Task Force revised its prostate cancer screening recommendations to advocate against the routine use of prostate-specific antigen-based testing. This cross-sectional study of a large dataset from the Surveillance, Epidemiology, and End Results Program compared PSA-based diagnoses made from 2006 to 2011 to those from 2013 to 2018. The study aimed to address the impact of the change in recommendation on survival and stage at diagnosis in prostate cancer patients. The socioecological model was used as the theoretical foundation for the study. A total of 205,129 men diagnosed with prostate cancer comprised the study population. …

Pregnancy Intention, Perinatal Depression, Birth Weight, And Premature Delivery Among Black Women, Chantay Philease Mcneil

Walden Dissertations and Doctoral Studies

Perinatal depression among Black women results in significant public health burdens, interacting with systemic disparities to create disproportionate risks of adverse birth outcomes. The present study explored the moderating effect of pregnancy intention on the relationship between perinatal depression and adverse birth outcomes such as low birth weight and preterm delivery among Black women living in the southern United States. Using secondary data from the 2016-2020 Pregnancy Risk Assessment Monitoring System (PRAMS), data were analysed from 9825 black women across eight southern states including Alabama, Arkansas, Florida, Georgia, Louisiana, Mississippi, Tennessee, and Virginia. The statistical approach included chi-square tests and …

The Bench To Community Initiative: Community-Based Participatory Research Model For Translating Research Discoveries Into Community Solutions, Jazma L. Tapia, Abigail Lopez, D. Bing Turner, Tonya Fairley, Tiah Tomlin-Harris, Maggie Hawkins, Pastor Rhonda Holbert, Lindsey S. Treviño, Dede K. Teteh-Brooks

Health Sciences and Kinesiology Faculty Articles

Methods: Community-based participatory research (CBPR) is an effective methodology for translating research findings from academia to community interventions. The Bench to Community Initiative (BCI), a CBPR program, builds on prior research to engage stakeholders across multiple disciplines with the goal of disseminating interventions to reduce breast cancer disparities and improve quality of life of Black communities.

The BCI program was established to understand sociocultural determinants of personal care product use, evaluate the biological impact of endocrine disrupting chemicals, and develop community interventions. The three pillars of the program include research, outreach and engagement as well as advocacy activities. The research …

Non-Receptor Tyrosine Kinases: Their Structure And Mechanistic Role In Tumor Progression And Resistance, Abdulaziz M. Eshaq, Thomas W. Flanagan, Sofie Yasmin Hassan, Sara A. Al Asheikh, Waleed A. Al-Amoudi, Simeon Santourlidis, Sarah Lilly Hassan, Maryam O. Alamodi, Marcelo L. Bendhack, Mohammed O. Alamodi, Youssef Haikel, Mossad Megahed, Mohamed Hassan

School of Graduate Studies Faculty Publications

Protein tyrosine kinases (PTKs) function as key molecules in the signaling pathways in addition to their impact as a therapeutic target for the treatment of many human diseases, including cancer. PTKs are characterized by their ability to phosphorylate serine, threonine, or tyrosine residues and can thereby rapidly and reversibly alter the function of their protein substrates in the form of significant changes in protein confirmation and affinity for their interaction with protein partners to drive cellular functions under normal and pathological conditions. PTKs are classified into two groups: one of which represents tyrosine kinases, while the other one includes the …

Evaluating Attitudes On Health-Seeking Behavior Among A Network Of People Who Inject Drugs, Ayako Shimada, Ashley Buchanan, Natallia Katenka, Benjamin Skov, Gabrielle Lemire, Stephen Kogut, Samuel Friedman

Department of Pharmacology, Physiology, and Cancer Biology Faculty Papers

People who inject drugs (PWID) are often members of HIV/AIDS risk networks, where individuals engage in sexual and injection risk behavior. Engagement in HIV care is important for this population. Low socioeconomic status, stigmatization, and lack of access to medical care often complicate successful engagement in the HIV cascade of care for PWID. This study investigates how individual’s attitudes about how much control they have over HIV/AIDS risk in their life (i.e., locus of control and self-blame) affect health-seeking behavior in PWID participants and their community members. We applied causal inference methodology to PWID HIV risk networks ascertained from the …

Population-Level Trends In Self-Reported Healthcare Utilization Among Older Adults In Mexico With And Without Cognitive Impairment, José Eduardo Cabrero Castro, Rebeca Wong, Rafael Samper Ternent, Brian Downer

Faculty, Staff and Student Publications

BACKGROUND: Older adults with cognitive impairment exhibit different patterns of healthcare utilization compared to their cognitively healthy counterparts. Despite extensive research in high-income countries, similar studies in low- and middle-income countries are lacking. This study aims to investigate the population-level patterns in healthcare utilization among older adults with and without cognitive impairment in Mexico.

METHODS: Data came from five waves (2001-2018) of the Mexican Health and Aging Study. We used self-reported measures for one or more over-night hospital stays, doctor visits, visits to homeopathic doctors, and dental visits in the past year; seeing a pharmacist in the past year; and …

Staff Perspectives Of Deaf And Hard Of Hearing College Students’ Alcohol Use, Christine L. Gannon, Theresa H. Gibble, Retta Evans

Journal of Social, Behavioral, and Health Sciences

A predominant health issue at colleges and universities is alcohol use. This is also true for deaf and hard of hearing college students. Key stakeholders who observe and witness this alcohol dynamic are staff. Researchers used a semi-structured qualitative guide to interview Gallaudet University staff (N = 26) to learn about their perspectives on and experiences with student alcohol use. Through thematic analysis, they identified several dominant themes that were then grouped into the three levels of the social-ecological model. First, they identified intrapersonal factors, including fear of missing out and coping strategies. Second, they identified interpersonal factors such …