Public Health Commons^™

2024 Qi Forum Agenda, Equip Program Office Ogme

Quality Improvement & Patient Safety Forum

No abstract provided.

A Qualitative Exploration Of Well-Being In Cancer Survivorship: Implications For Counselors, Hallie M. Sylvestro, Lindsey K. Umstead, Heather Delgado, Christopher Lawrence, Keith Mobley, Kelly L. Wester, Andrew Wood

Adultspan Journal

Adult cancer survivors represent an important–and growing–population that could benefit from counseling services. This study employed consensual qualitative research to examine the well-being experiences of eight cancer survivors. Findings suggest a broad range of changes to individual well-being following cancer diagnosis and treatment, and indicate counseling can provide an ideal setting for processing such changes. Recommendations for counseling practice and future research are provided.

Homologous Recombination Deficiency Should Be Tested For In Patients With Advanced Stage High-Grade Serous Ovarian Cancer Aged 70 Years And Over, Omali Pitiyarachchi, Peter J. Ansell, Robert L. Coleman, Minh H. Dinh, Laura Holman, Charles A. Leath, Theresa Werner, Paul Disilvestro, Mark Morgan, William Tew, Christine Lee, Mary Cunningham, Meredith Newton, Babak Edraki, Peter Lim, Joyce Barlin, Nicola M. Spirtos, Krishnansu S. Tewari, Mitchell I. Edelson, Thomas Reid, Jay Carlson, Michael Friedlander

Abington Jefferson Health Papers

OBJECTIVE: Due to limited data on homologous recombination deficiency (HRD) in older patients (≥ 70 years) with advanced stage high grade serous ovarian cancer (HGSC), we aimed to determine the rates of HRD at diagnosis in this age group.

METHODS: From the Phase 3 trial VELIA the frequency of HRD and BRCA1/2 pathogenic variants (PVs) was compared between younger (< 70 years) and older participants. HRD and somatic(s) BRCA1/2 pathogenic variants (PVs) were determined at diagnosis using Myriad myChoice® CDx and germline(g) BRCA1/2 PVs using Myriad BRACAnalysis CDx®. HRD was defined if a BRCA PV was present, or the genomic instability score (GIS) met threshold (GIS ≥ 33 & ≥ 42 analyzed).

RESULTS: Of 1140 participants, 21% were ≥ 70 years. In total, 26% (n = 298) had a BRCA1/2 PV and HRD, 29% (n = 329) were HRD/BRCA wild-type, 33% (n = 372) non-HRD, and 12% HR-status unknown (n = 141). …

Management Overview Of The Lung Tuberculosis Control Program At The Dki Jakarta Provincial Health Office In 2023, Mutiara Kiranti, Helen Andriani

Journal of Indonesian Health Policy and Administration

Tuberculosis is one of the infectious diseases that is fatal if not cured immediately. In 2022, the success rate of tuberculosis treatment in DKI Jakarta Province is 81%, while the national target is 90%. In the field, the number of cadres to carry out contact investigations is still insufficient, so that in 2022 the coverage of contact investigations in DKI Jakarta Province will only reach 25%, while the national target is 90%. To increase the scope of successful treatment, the government should try to overcome tuberculosis, which is needed. Proper program management is required to run effectively and efficiently for …

Policy Implementation Analysis Of Antenatal Care Services At Puskesmas Negara Ratu And Puskesmas Cempaka Kabupaten Lampung Utara, Willyana Syafriyanti, Anhari Achadi

Journal of Indonesian Health Policy and Administration

The Ministry of Health has issued Minister of Health Regulation Number 21 of 2021 to strengthen maternal health services, which regulates health services during pregnancy (antenatal). The Minister of Health's regulation states that antenatal care is carried out at least six times, 2 (two) of which are examinations with a doctor using an Ultra Sonography (USG) device. Community health centers as primary services are expected to be able to provide antenatal services according to standards. The North Lampung Health Service has distributed ultrasound equipment to community health centers in the North Lampung Regency to support the implementation of antenatal services. …

Balancing Community And Individual Health Efforts By Utilizing Sub-Primary Health Care At Regions: Analysis For Policy, Rocky Setya Budi, Wiku Bakti Bawono Adisasmito, Adang Bachtiar, Elvi Rosanti

Journal of Indonesian Health Policy and Administration

Public Health Centers (PHCs) are responsible for organizing public health efforts and individual health efforts. PHCs also serve as FKTP, UPTD, sub-district supervisors, and implementers of policies and programs from the Ministry of Health. The workload of PHCs is increasing because people visit PHCs primarily for treatment, rather than seeking preventive measures to stay healthy. The PHCs have Sub-PHCs to lighten the workload of the PHCs, but there is no policy regulating Sub-PHCs to be used as FKTP. This research aims to analyze the policy of Balancing Community and Individual Health Efforts by utilizing Sub-PHCs such as FKTP. The research …

Policy Content Analysis In Minister Of Health Regulation Number 15 Of 2016 About Hajj Health Istithaah, Salman Mauluddin Idris, Atik Nurwahyuni

Journal of Indonesian Health Policy and Administration

Indonesia has the world's largest Muslim population and sends the most pilgrims to Saudi Arabia. The Hajj Health Istithaah Policy in Minister of Health Regulation Number 15 of 2016 is the government's effort to carry out health screening for pilgrims before leaving so that they can perform the Hajj in a healthy and independent condition. This research was conducted using a qualitative approach by collecting data through in-depth interviews and document reviews. In this study, Walt and Gilson's Policy Triangle Model was used as a reference for reviewing the Hajj health istithaah policy, especially in the content section of the …

Island Health Crisis: Bridging Gaps In Indonesia's Healthcare Deserts, Joyce Mangoma, Wahyu Sulistiadi

Journal of Indonesian Health Policy and Administration

This narrative literature review examines critical healthcare challenges in Indonesia's island communities, focusing on workforce shortages, inadequate health infrastructure, and the profound impact of geographical and socioeconomic factors. Drawing from eight studies published between January 2000 and December 2023, the discussion highlights both the strengths and weaknesses of existing research. The studies were selected based on their relevance to healthcare issues in island communities, rigorous methodological approaches, and significant insights into healthcare challenges and solutions. This time frame was chosen to encompass a comprehensive evolution of healthcare challenges and responses, particularly considering the effects of the COVID-19 pandemic. Grounded in …

Tracking Population Decline In India Between 1950-2023 And Total Deaths Cases By Cause – A Case Study, Sumayya Rehaman Research Scientist

International Journal of Health and Allied Sciences

The Case study digs the facets of the India’s population decline from 1950-2023. Focusing Total fertility rate recorded 2.0 per woman in 2023 as similar as Birth Rate since 1950-2023 and found to be 16.9 births per 1000 people in 2023. Contradictorily, may surpass China’s population in Future. It focuses Population pyramid with annual Percent growth rate divulges Main cities population and exemplifies death occurrence. The median age - 28.7 years, life expectancy - 70.4 years, Infant Mortality Rate - 26.6 deaths per 1000 live births, with 3.89% in 2023.This study reveals comparative illustrative graphs of Indian Population 1950-2023.

Early Outcomes Of Mr-Guided Sbrt For Patients With Recurrent Pancreatic Adenocarcinoma, Spencer Poiset, Sophia Shah, Louis Cappelli, Rani Anné, Karen Mooney, Maria Werner-Wasik, Talya Laufer, James Posey, Daniel Lin, Atrayee Mallick, Harish Lavu, Babar Bashir, Charles Yeo, Adam Mueller

Kimmel Cancer Center Faculty Papers

BACKGROUND: Local treatment options for locally recurrent pancreatic adenocarcinoma (LR-PAC) are limited, with median survival time (MST) of 9-13 months (mos) following recurrence. MRI-guided stereotactic body radiation therapy (MRgSBRT) provides the ability to dose escalate while sparing normal tissue. Here we report on the early outcomes of MRgSBRT for LR-PAC.

METHODS: Patients with prior resection of pancreatic adenocarcinoma with local recurrence treated with MRgSBRT at a single tertiary referral center from 5-2021 to 2-2023 were identified from our prospective database. MRgSBRT was delivered to 40-50 Gy in 4-5 fractions with target and OAR delineation per institutional standards. Endpoints included local …

Latinas In The United States Facing Healthcare Access Challenges In A Mid-Size Urban Community, Nathan M. Lee, Deborah Kessler

Journal of Global Awareness

This study examines the discrepancies and underlying factors in access to healthcare resources regarding breast and cervical cancer for Latinas in a mid-sized urban midwestern community. A survey was conducted at clinics hosted by a local non-profit organization, and forty participants completed surveys for this study (n=40). Bivariate correlation analysis in SPSS determined that significant positive correlations were found between the subjects’ knowledge of the signs and symptoms of cervical cancer and their knowledge of the recommended frequency of receiving pap smears (p

Advancing Objective Mobile Device Use Measurement Inchildren Ages 6–11 Through Built-In Device Sensors: A Proof-Of-Concept Study, Olivia L. Finnegan, Robert Glenn Weaver Med, Phd, Hongpeng Yang, James W. White, Srihari Nelakuditi, Zifei Zhong, Rahul Ghosal Ph.D., Yan Tong, Aliye B. Cepni, Elizabeth L. Adams, Sarah Burkart Mph, Ph.D., Michael W. Beets Med, Mph, Phd, Bridget Armstrong Ph.D.

Faculty Publications

Mobile devices (e.g., tablets and smartphones) have been rapidly integrated into the lives of children and have impacted howchildren engage with digital media. The portability of these devices allows for sporadic, on-demand interaction, reducing theaccuracy of self-report estimates of mobile device use. Passive sensing applications objectively monitor time spent on a givendevice but are unable to identify who is using the device, a significant limitation in child screen time research. Behavioralbiometric authentication, using embedded mobile device sensors to continuously authenticate users, could be applied toaddress this limitation. This study examined the preliminary accuracy of machine learning models trained on iPad …

Entertainment-Education And Climate Change: Program Examples, Evidence, And Best Practices From Around The World, Suruchi Sood, Amy Henderson Riley, Lyena Birkenstock

College of Population Health Faculty Papers

Entertainment-education is a global theory-driven and evidence-based storytelling strategy that promotes social and behavioral change. A formal review of the peer-reviewed and grey literature, alongside consultations with program and industry experts, revealed several contemporary examples of entertainment-education and climate change. Late-night comedy, with the inclusion of climate change storylines within popular entertainment, is common in the Global North. In the Global South, climate adaptation and mitigation narratives are situated in formats portraying audiences’ lived experiences. Crosscutting trends relate to documentary storytelling, children’s programming, and future efforts. Recommendations include re-examining theories across the social-ecological model; placing entertainment front and center; including …

Nature Of The Evidence Base And Approaches To Guide Nutrition Interventions For Individuals: A Position Paper From The Academy Of Nutrition Sciences, Mary Hickson, Constantina Papoutsakis, Angela M Madden, Mary Anne Smith, Kevin Whelan

Faculty, Staff and Student Publications

This Position Paper from the Academy of Nutrition Sciences is the third in a series which describe the nature of the scientific evidence and frameworks that underpin nutrition recommendations for health. This paper focuses on evidence which guides the application of dietary recommendations for individuals. In some situations, modified nutrient intake becomes essential to prevent deficiency, optimise development and health, or manage symptoms and disease progression. Disease and its treatment can also affect taste, appetite and ability to access and prepare foods, with associated financial impacts. Therefore, the practice of nutrition and dietetics must integrate and apply the sciences of …

Primary Care In The University Setting After Covid-19: A Multiple Case Study Of Student Health Services In Oregon, D. Chad Johnson

Dissertations and Theses

In 2020, the COVID-19 pandemic disrupted operations across the settings of primary care and higher education institutions (HEI). HEIs faced sudden decreases in revenue because of reduced enrollments and external pressures to rapidly adapt delivery methods to accommodate the inability to provide in-person classes. Similarly, most primary care settings experienced major reductions to in-person visits and fee-for-service revenues. Student health services (SHS) exist within both primary care and higher education settings and are a unique and poorly understood aspect of primary care. This research set out to explore this under-studied primary care setting by answering the question: "How has COVID-19 …

Social/Emotional Health, Mental Health And Quality Of Life Among Adults With Comorbid Diabetes And Hypertension: A Population-Based Cross-Sectional Study, Ranjita Misra, Sara Nayeem

Journal of Appalachian Health

Introduction: West Virginia has a disproportionately large population of rural adults with diabetes and hypertension, two common chronic, comorbid conditions that represent a national economic, social, and public health burden. Anxiety, depression, and severe mental illness are associated with poor motivation to engage in coping/self-care behaviors and related increased morbidity/mortality.

Purpose: This study examines the relationship between self-reported mental health, selected social and emotional health factors, health-related quality of life (HRQoL), and clinical outcomes among adults with comorbid diabetes and hypertension.

Methods: This cross-sectional study consisted of 75 participants who participated in a diabetes and hypertension self-management program (DHSMP) in …

Fetal Brain-Derived Exosomal Mirnas From Maternal Blood: Potential Diagnostic Biomarkers For Fetal Alcohol Spectrum Disorders (Fasds), Nune Darbinian, Monica Hampe, Diana Martirosyan, Ahsun Bajwa, Armine Darbinyan, Nana Merabova, Gabriel Tatevosian, Laura Goetzl, Shohreh Amini, Michael E Selzer

Faculty, Staff and Student Publications

Fetal alcohol spectrum disorders (FASDs) are leading causes of neurodevelopmental disability but cannot be diagnosed early in utero. Because several microRNAs (miRNAs) are implicated in other neurological and neurodevelopmental disorders, the effects of EtOH exposure on the expression of these miRNAs and their target genes and pathways were assessed. In women who drank alcohol (EtOH) during pregnancy and non-drinking controls, matched individually for fetal sex and gestational age, the levels of miRNAs in fetal brain-derived exosomes (FB-Es) isolated from the mothers’ serum correlated well with the contents of the corresponding fetal brain tissues obtained after voluntary pregnancy termination. In six …

Generation Of Oviductal Glycoprotein 1 Cre Mouse Model For The Study Of Secretory Epithelial Cells Of The Oviduct, Emily A Mcglade, Jiude Mao, Kalli K Stephens, Andrew M Kelleher, Lisette A Maddison, Miranda L Bernhardt, Francesco J Demayo, John P Lydon, Wipawee Winuthayanon

Faculty, Staff and Students Publications

The epithelial cell lining of the oviduct plays an important role in oocyte pickup, sperm migration, preimplantation embryo development, and embryo transport. The oviduct epithelial cell layer comprises ciliated and nonciliated secretory cells. The ciliary function has been shown to support gamete and embryo movement in the oviduct, yet secretory cell function has not been well characterized. Therefore, our goal was to generate a secretory cell-specific Cre recombinase mouse model to study the role of the oviductal secretory cells. A knock-in mouse model, Ovgp1Cre:eGFP, was created by expressing Cre from the endogenous Ovgp1 (oviductal glycoprotein 1) locus, with enhanced green …

Barriers To Gluten-Free Diet Adherence And How They Relate To Quality Of Life And Self-Efficacy In College Students With Celiac Disease, Caitlin Elizabeth Wall

Master's Theses

Celiac disease (CD) is a chronic, autoimmune disorder with an increasing global prevalence. As the only current treatment is a strict gluten-free diet (GFD), adherence is imperative to maintain optimal health in individuals with the disease. There are many potential barriers to GFD adherence, including social, mental, and financial difficulties. College also presents a unique set of challenges for students with CD that may not be experienced by those without the disease. The purpose of this study was to determine the potential barriers to GFD adherence experienced by college students with celiac disease in the United States. This study also …

Improving Obesity And Related Chronic Disease Outcomes: Developing Nurse Practitioner Competence In Motivational Interviewing, Jodi Wilson

Doctor of Nursing Practice Final Manuscripts

Background: Despite America’s persistent focus on health, over 40% of the US population is obese. A significant obstacle to mitigating disease in those with obesity is inspiring lasting behavioral change. Motivational Interviewing (MI) is highly effective yet under-utilized for catalyzing personal change inertia. Recent meta-analyses demonstrated statistically significant improvement in BMI, A1C, and blood pressure. Objectives: This evidenced-based project (EBP) aimed to develop nurse practitioner (NP) skills in deploying fidelity-based MI, resulting in increased adherence to lifestyle interventions. Implementation: This EBP project implemented MI into routine primary care through a self-paced healthcare provider MI certification and a 45-minute skill …

“Shoes Enthused”: The Application Of An Evidence-Based Practice Podiatry Consultation And Footwear Education In Older Adults Living With Diabetes, Alissa Kathleena Gray, Razel Bacuetes Milo

Doctor of Nursing Practice Final Manuscripts

Background: Poorly fitted footwear contributes to falls in older adults living with diabetes, a population that experiences a baseline increased risk for falls in the presence of diabetic peripheral neuropathy. Despite this, baseline data reveals that 72% of older adults wear poorly fitted shoes with suboptimal shoe features¹.

Purpose of Project: Adhering to current evidence-based practice guidelines, the two goals of this project were to educate older adults with diabetes on the characteristics of properly fitted footwear and to increase access to properly fitted shoes via a podiatry consultation. Subsequently, the increased number of optimal footwear will decrease …

Assessing The Influence Of Education And The Diet Readiness Test On Self-Efficacy, Motivation And Resilience In Overweight Women, Ijeoma Iwu

Doctor of Nursing Practice Final Manuscripts

Purpose

The purpose of this evidence-based project is to assess motivation for weight loss and resilience to make lasting changes with weight management. The Diet Readiness Test (DRT) Questionnaire is a behaviorally based assessment tool used to evaluate psychological status prior to or during a weight-loss management program based on patients’ attitudes toward diet and exercise. The goal of using this survey was to identify predictive factors of successful weight changes for practitioners to implement into their approach to tackling obesity.

Background

One of the rising crises both in the United States and globally has been the topic of obesity. …

Increasing Patient Access To Mental Health Providers: Improving Depression And Anxiety Outcomes For African American Women Aged 18 Years Old And Older, Twanna Davis-Arnold, Farnaz Trasandes

Doctor of Nursing Practice Final Manuscripts

Increasing patient access to mental health providers: Improving depression and anxiety outcomes for African American women aged 18 years old and older.

Background: Depression and anxiety are growing health problems in the United States. In 2020/2021, there was a 36.4% to 41.5% increase in reported symptoms of depression and anxiety. Evidence has shown that African American women experience disproportionate increased risks and disparities in obtaining mental health care.

Purpose of Project: To improve access to African American or culturally competent mental health providers for adult African American women. Improving access to mental health care will lead to earlier diagnosis …

Avidity Maturation Of Humoral Response Following Primary And Booster Doses Of Bnt162b2 Mrna Vaccine Among Nursing Home Residents And Healthcare Workers, Oladayo A. Oyebanji, Nicholas Sundheimer, Vaishnavi Ragavapuram, Brigid M. Wilson, Jürgen Bosch, Christopher L. King, David H. Canaday

Faculty Scholarship

Infections, despite vaccination, can be clinically consequential for frail nursing home residents (NHR). Poor vaccine-induced antibody quality may add risk for such subsequent infections and more severe disease. We assessed antibody binding avidity, as a surrogate for antibody quality, among NHR and healthcare workers (HCW). We longitudinally sampled 112 NHR and 52 HCWs who received the BNT162b2 mRNA vaccine after each dose up to the Wuhan-BA.4/5-based Omicron bivalent boosters. We quantified anti-spike, anti-receptor binding domain (RBD), and avidity levels to the ancestral Wuhan, Delta, and Omicron BA.1 & 4/5 strains. The primary vaccination series produced substantial anti-spike and RBD levels …

Asymptomatic Covid-19-Associated Acquired Hemophilia A And Disseminated Intravascular Coagulation From A Bypassing Agent, Abraham Attah, Deanna Huffman, Palash Asawa, Vinay Edlukudige Keshava, Deep Shah

School of Medicine Faculty Publications

Acquired hemophilia A (AHA) is a clotting disorder characterized by the presence of neutralizing antibodies that inhibit factor VIII, resulting in increased bleeding risk. Known etiologies include malignancy, autoimmune conditions, graft-vs-host disease, and more recently coronavirus disease 2019 (COVID-19) infection. In this case report, we describe an 86-year-old female who was found to have AHA incidentally during preoperative workup for meningioma resection. She was subsequently found to have COVID-19 infection which was the likely cause of her development of AHA. She was treated with factor eight inhibitor bypassing agent (FEIBA) and recombinant factor VII (rVII) for a small hematoma on …

Review Of Treatment Of Hepatitis C Among Persons Who Are Housing Insecure And Use Substances, Kate Kelley

Faculty Scholarship

With the advent of direct-acting antiviral agents (DAA), reduction of hepatitis C infection (HCV) has become a public health priority. The World Health Organization’s goal of global elimination of HCV by 2030 has brought to light the challenges in treating certain populations. This review examines the burden of HCV infection on unhoused individuals and people who use substances in the United States in the last five years, and presents best practices in patient care and treatment.

Differences In Immigrant And U.S. Native Born Patients’ Experiences In The American Healthcare System: A Correlational Study, Betaneya W. Daniel

Virginia Journal of Public Health

Objective: To examine any perceived barriers that might exist in the United States healthcare system and gather data on how different patients experience the system.

Methods: The study utilized a correlational analysis with usage of a Likert scale survey administered to U.S.- born natives, immigrants, and healthcare providers. The survey assessed respondents of their access to healthcare services, barriers to healthcare services, healthcare provider trust/relationships, and health institutions’ relations. Another survey assessed healthcare providers’ belief in the efficacy of their services and health institutions’.

Results: No statistically significant differences were found between U.S. natives and immigrants, but notable distinctions were …

Health Equity: Communicating Impaired Water Status, Emily Potter

Virginia Journal of Public Health

Introduction: Land use changes in the Rivanna River and James River Watersheds have increased the number of impaired recreational waters, and there is a disparity in the equitable communication of these impairments to different populations. Ineffective communication contributes to inequities in access to safe, accessible, and affordable water for vulnerable populations, placing public health at risk.

Methods: This study uses secondary data from the Environmental Protection Agency’s Watershed Index Online (WSIO) Indicator Data Tables, Virginia Department of Environmental Quality (DEQ), Rivanna River Association, and James River Association. Correlations, linear regression, and percent change were used to identify statistically significant trends …

Addressing Farm Safety: Farm Safety Dinner Theaters In The Shenandoah Valley, Tammy Kiser, Michelle Seekford, Jeremy Daubert

Virginia Journal of Public Health

Statistics demonstrate that farm safety and wellness issues affect all ages in the agricultural community. However, an increased proportion of youth and older farm workers comprise the highest rates of farm-related morbidity and mortality. Engaging farmers in increasing safe practices in the agricultural community is an important, ongoing challenge.

Methodology

Farm Safety Dinner Theaters, an initiative created through community-based participatory research (CBPR) at the University of Kentucky, provide a relaxed environment where farmers and their families can identify safety and wellness issues, watch as the actors process these issues, and enjoy a meal. Seeing the situations played out in theater …

Mentorship Matters: Promising Results From Vpha’S Pilot Mentorship Program, Ashley Tharpe, Stacey B. Plichta, Anna R. Robertson, Kim Baskette

Virginia Journal of Public Health

Purpose

The Virginia Public Health Association (VPHA) Pilot Mentorship Program seeks to support public health students, early career professionals, and career switchers throughout the Commonwealth of Virginia in their growth as public health professionals. The program provides opportunities for participants to gain job-seeking and professional communication skills through live webinars, to connect with each other through online networking events, to manage stress through wellness webinars, and to interact with experienced public health professionals.

Methods

VPHA formed a volunteer committee to develop and implement the program in Fall 2022. Initially, the program was envisioned as a traditional one-to-one mentoring program; however, …