Public Health Commons^™

Hiv Preventive Care Services For Pregnant Women In Kenya Before And During The Covid-19 Pandemic, Modesta Vesonder

Walden Dissertations and Doctoral Studies

The COVID-19 pandemic significantly affected access to prenatal and postnatal care services for pregnant women living with HIV (PWLHIV) in counties in the Central, Eastern, and Rift Valley regions of Kenya. Many PWLHIV in some counties in Kenya faced challenges in accessing treatment services. In urban counties such as those in the Central region, HIV preventive care services were accessed with minimal disruption. Counties in the semi-arid of Eastern and Central regions experienced some disruptions in the provision of HIV preventive care services for PWLHIV. The periods under consideration were before the COVID-19 pandemic (2019) and during the COVID-19 pandemic …

C-Terminal Binding Protein 2 Is A Novel Tumor Suppressor Targeting The Myc-Irf4 Axis In Multiple Myeloma, Coty Hing Yau Cheung, Chi Keung Cheng, Kam Tong Leung, Chi Zhang, Chi Yan Ho, Xi Luo, Angel Yuet Fong Kam, Tian Xia, Thomas Shek Kong Wan, Herbert Augustus Pitts, Natalie Pui Ha Chan, Joyce Sin Cheung, Raymond Siu Ming Wong, Xiao-Bing Zhang, Margaret Heung Ling Ng

Faculty, Staff and Student Publications

Multiple myeloma (MM) cells are addicted to MYC and its direct transactivation targets IRF4 for proliferation and survival. MYC and IRF4 are still considered "undruggable," as most small-molecule inhibitors suffer from low potency, suboptimal pharmacokinetic properties, and undesirable off-target effects. Indirect inhibition of MYC/IRF4 emerges as a therapeutic vulnerability in MM. Here, we uncovered an unappreciated tumor-suppressive role of C-terminal binding protein 2 (CTBP2) in MM via strong inhibition of the MYC-IRF4 axis. In contrast to epithelial cancers, CTBP2 is frequently downregulated in MM, in association with shortened survival, hyperproliferative features, and adverse clinical outcomes. Restoration of CTBP2 exhibited potent …

Multiple Job Holding, Job Changes, And Associations With Gestational Diabetes And Pregnancy-Related Hypertension In The National Birth Defects Prevention Study, Amel Omari, Miriam R Siegel, Carissa M Rocheleau, Kaori Fujishiro, Kristen Van Buren, Dallas Shi, A J Agopian, Suzanne M Gilboa, Paul A Romitti

Faculty, Staff and Student Publications

We used National Birth Defects Prevention Study data to investigate associations between working patterns shortly before and during pregnancy and gestational diabetes and pregnancy-related hypertension. We analyzed working patterns (multiple-job holders, job changers, single-job holders) during the three months before and during pregnancy for 8140 participants who delivered a live-born child without a birth defect. "Multiple-job holders" worked more than one job simultaneously, "job changers" worked more than one job with no overlap, and "single-job holders" (referent) worked one job. We used multivariable logistic regression to estimate associations between working pattern and each outcome, adjusting for maternal age and educational …

Characterization Of Nationally Reported Pediatric Deaths Involving Fentanyl Ingestions In Missouri, Margaret Campbell, Mary Moffatt, Emily Killough, Terra Frazier

Research Days

There has been a dramatic rise in pediatric deaths associated with synthetic opioid use, with the most prominent being Fentanyl. This is a retrospective cohort study using data from the National Center for Fatality Review and Prevention with the goal of identifying risk factors that increase the vulnerability of children to Fentanyl ingestion. Ultimately this research may help lead to improved identification of at risk children with the goal of implementation of targeted prevention programming.

Understanding The Needs Of Georgia’S Hispanic/Latinx Population Regarding Adolescent Health, Aylin Diaz, Evelina W. Sterling

Symposium of Student Scholars

Georgia’s Department of Public Health’s Adolescent Health and Youth Development (AHYD) Program is based on the Positive Youth Development Approach as recommended by the Centers for Disease Control and Prevention. This approach engages youth within their communities, schools and organizations, peer groups, and families in a productive and constructive manner. Overall, the AHYD program aims at preventing HIV, STIs, and pregnancy among all youth. In Georgia, the Hispanic/Latino population has grown to over 10% of our total population. However, adolescent health programs within Georgia have not specifically focused on the cultural differences among the large Hispanic/Latino community. This study takes …

Pour Une Diffusion Éthique Des Connaissances De La Médecine Traditionnelle: L’Intersection De La Culture Yoruba Et Des Besoins Médicaux, Isabel Sala

CISLA Senior Integrative Projects

No abstract provided.

High All-Cause Mortality And Increasing Proportion Of Older Adults With Tuberculosis In Texas, 2008–2020, Belinda A Medrano, Miryoung Lee, Gretchen Gemeinhardt, Lana Yamba, Blanca I Restrepo

Faculty, Staff and Student Publications

Pulmonary tuberculosis (PTB) elimination efforts must consider the global growth of the ageing population. Here we used TB surveillance data from Texas, United States (2008-2020; total n = 10656) to identify unique characteristics and outcomes in older adults (OA, ≥65 years) with PTB, compared to young adults (YA, 18-39 years) or middle-aged adults (40-64 years). We found that the proportion of OA with PTB increased from 15% in 2008 to 24% in 2020 (trend p < 0.05). Diabetes was highly prevalent in OA (32%) but not associated with adverse outcomes. Death was 13-fold higher in OA compared to YA and was 7% at the time of diagnosis which suggests diagnostic delays. However, once TB was suspected, we found no differences in culture, smear, or nucleic acid detection of mycobacteria (although less lung cavitations) in OA. During treatment, OA had less drug-resistant TB, few adverse reactions and adhered with TB treatment. We recommend training healthcare workers to 'think TB' in OA, for prompt treatment initiation to diminish deaths. Furthermore, OA should be added as a priority group to the latent TB treatment guidelines by the World Health Organization, to prevent TB disease in this highly vulnerable group.

Unrestricted Versus Regulated Open Data Governance: A Bibliometric Comparison Of Sars-Cov-2 Nucleotide Sequence Databases, Nathanael Sheehan, Federico Botta, Sabina Leonelli

Copyright, Fair Use, Scholarly Communication, etc.

Two distinct modes of data governance have emerged in accessing and reusing viral data pertaining to COVID-19: an unrestricted model, espoused by data repositories part of the International Nucleotide Sequence Database Collaboration and a regulated model promoted by the Global Initiative on Sharing All Influenza data. In this paper, we focus on publications mentioning either infrastructure in the period between January 2020 and January 2023, thus capturing a period of acute response to the COVID-19 pandemic. Through a variety of bibliometric and network science methods, we compare the extent to which either data infrastructure facilitated collaboration from different countries around …

Exploring Social Workers Potential Role In Mitigating Maternal Mortality Through Coordinated Care, Jena Brown-Talib

Honors Theses

Maternal health disparities persist as a significant challenge in Mississippi, particularly for African American women. This thesis explores the intersection of coordinated care models and social work interventions in addressing maternal mortality. Coordinated care involves collaboration among physicians, nurses, practitioners, social workers, community health workers, and other support services, aiming to maximize pregnant patients' overall health outcomes.

Analyzing strategies of social workers within coordinated care models is important for improving maternal health outcomes within this study. A qualitative approach was chosen to delve beyond statistics and illuminate the reality of maternal health disparities and the efforts to resolve them. Data …

The Impact Of School-Based Education Program On Body Image In Middle School Students, Elizabeth Hendon

Honors Theses

Body dissatisfaction is an emerging public health concern and carries significant health-related consequences. These implications encompass mental health challenges, eating disorders, unhealthy weight management practices, adverse effects on self-esteem, and potential physical health consequences. Because adolescence is a critical period for healthy body image development due to age-related transitions occurring at this time, it is essential to implement an education program to promote positive body image. Educational programs focused on protective factors designed to enhance self-compassion can potentially improve body image, eating attitudes, and body satisfaction. School-based body image education programs aim to provide adolescents with the knowledge, skills, and …

Impact Of An Electronic Human Papillomavirus Vaccination Catch-Up Module For Women With Criminal-Legal System Involvement, Shawana Moore

Electronic Theses and Dissertations

Introduction: Cervical cancer can often be prevented with targeted strategies such as Pap smear screenings and the human papillomavirus (HPV) vaccination, now also recommended for those aged 27-45 who have not received the vaccine previously. However, women involved in the criminal-legal system often miss out on primary and secondary prevention measures and are at increased risk for the development of cervical cancer caused by HPV. Purpose: The purpose of this study was to examine the feasibility and acceptability of an electronic HPV catch-up module for women in the criminal-legal system aged 27-45. The study, guided by the Health Belief Model, …

Parental Factors Associated With Covid-19 Vaccine Uptake For Children Over 5 Years Of Age In Texas, Paula M Cuccaro, Jihye Choi, Yordanos M Tiruneh, Journey Martinez, Jing Xie, Michelle Crum, Mark Owens, Jose-Miguel Yamal

Faculty, Staff and Student Publications

The COVID-19 vaccine is safe and effective for children, yet parental hesitancy towards vaccinating children against the virus persists. We conducted a telephone-administered weighted survey in Texas to examine parents' sociodemographic factors and medical conditions associated with COVID-19 vaccination intention for parents with unvaccinated children ages 5-17 years. We collected responses from 19,502 participants, of which 4879 were parents of children ages 5-17 years. We conducted multiple logistic regression with Lasso-selected variables to identify factors associated with children's vaccination status and parents' intention to vaccinate their children. From the unweighted sample, less than half of the parents (46.8%) had at …

An Analysis Of Professional Education For Future Physicians To Address Implicit Racial Bias In Black Maternal Health, Jasmine Butler

Honors Theses

The history of medicine in the United States is littered with incidences of racism and exploitation of Black Americans. The extensive history of medical racism has continued to be perpetuated in healthcare today. Within the field of maternal health, the dark history of medicine shows its face with the treatment of black mothers. Black maternal health is a current public health crisis currently being exacerbated through discrimination in the form of implicit bias. Implicit bias is a current issue in our healthcare system that needs to be addressed through adequate training of both medical students and physicians. This qualitative research …

Revisiting Snack-Time: Analyzing How A Food Prescription Program In Charleston, Ms Affects The Children Of Participating Parents And Caregivers, Aubrey Bethay

Honors Theses

This study examines how Food Rx programs impact the children of enrolled families. Currently, research in this area is limited to data that focuses on produce consumption rates and BMI; however, there are other measures of physical and mental well-being that require evaluation. Consequently, this paper takes a more comprehensive approach, looking into childrens’ sense of security and perception of healthy food. 10 parents (representing 23 children) were interviewed and participated in recorded focus groups in order to gather information. From here, their responses were organized into domains in order to categorize the data.

Many parents reported that their children …

Methods And Variability In Physician Associate Student Advocacy Education, Jason P. Prevelige, Lindsay Gietzen

Pacific Journal of Health

Objective: To assess the current practices of PA programs pertaining to how advocacy education is taught to their students and to determine differences among the programs.

Methods: PA program directors were interviewed about advocacy education including time allotted, when it is provided, learning objectives, source materials, teaching methods, determination of competency, and tracking of student advocacy participation after graduation.

Results: All noted that advocacy education is important, however meaningful, in-depth, instruction can be limited for a variety of reasons. Such reasons include limited educational time to ensure that a sizeable set of standards is met, limited access …

Improving Access To Mainehealth Care At Home, Amanda Kunkel, Mhcah Intake Department, Mhcah Scheduling Department, Mhcah Clinical Leadership Team

Operations Transformation

It is known that there are capacity limitations at MaineHealth Care at Home caused by a decrease in staffing. This leads to limited availability of home health services to patients in the community and can also contribute to increased length of stay for patients in acute care hospitals. MaineHealth Care at Home needs a way to measure current capacity to accept referrals and improved systems for communicating with referral sources.

Gut Microbiota, Blood Metabolites, And Left Ventricular Diastolic Dysfunction In Us Hispanics/Latinos, Kai Luo, Alkis Taryn, Eun-Hye Moon, Brandilyn A Peters, Scott D Solomon, Martha L Daviglus, Mayank M Kansal, Bharat Thyagarajan, Marc D Gellman, Jianwen Cai, Robert D Burk, Rob Knight, Robert C Kaplan, Susan Cheng, Carlos J Rodriguez, Qibin Qi, Bing Yu

Faculty, Staff and Student Publications

BACKGROUND: Left ventricular diastolic dysfunction (LVDD) is an important precursor of heart failure (HF), but little is known about its relationship with gut dysbiosis and microbial-related metabolites. By leveraging the multi-omics data from the Hispanic Community Health Study/Study of Latinos (HCHS/SOL), a study with population at high burden of LVDD, we aimed to characterize gut microbiota associated with LVDD and identify metabolite signatures of gut dysbiosis and incident LVDD.

RESULTS: We included up to 1996 Hispanic/Latino adults (mean age: 59.4 years; 67.1% female) with comprehensive echocardiography assessments, gut microbiome, and blood metabolome data. LVDD was defined through a composite criterion …

Extension-Clinical Approach To Covid-19 Testing And Vaccination, Camden Bryan, Rhonda Matthews, Kapri Kreps, David Thornal, Danielle Mcfall, David Sudduth, Michelle Parisi

Journal of Extension

Vaccination rates against COVID-19 are lower in rural areas across the country, including SC. This paper highlights the work conducted by Clemson Cooperative Extension Service in SC to increase rural access to COVID-19 testing and vaccine services. Extension Agents engaged in clinical and community partnerships to coordinate COVID-19 vaccine and testing clinics in rural and underserved communities. Agents established 204 test clinics and 220 vaccination clinics. The total number of people tested and vaccinated was 9,331 and 2,037, respectively. The success of this project shows Extension agents can be instrumental in bridging the gap between clinical resources and rural communities.

Pregnancy-Related Maternal Deaths In The State Of Georgia According To Timing And Causes Of Death, Anthony Kondracki, Wei Li, Mitch Mokhtari, Bhuvaneshwari Muchandi, John A. Ashby, Jennifer L. Barkin

Georgia Public Health Association Annual Meeting & Conference

BACKGROUND: This study examines pregnancy-related maternal deaths in the State of Georgia according to timing and causes of death in association with maternal sociodemographic characteristics. METHODS: Maternal mortality data from 2016 to 2019 were obtained from the Georgia Department of Public Health and the study sample was restricted to pregnancy-related deaths. Descriptive analyses compared timing and six leading underlying causes of maternal death in association with basic sociodemographic characteristics. A distribution of the leading underlying causes of death was conducted among the four time-points, i.e., during pregnancy, 0 to 60 days, 61 to 180 days, and 181 to 365 days …

Trends In Substance Use And Mental Health Among Adolescents In Georgia, 2002-2022, Saumya S. Palipudi, Bangaru Talli Palipudi, Murty Komanduri

Georgia Public Health Association Annual Meeting & Conference

Background: While substance use and absence of mental health disorders among youth in the United States (US) have declined over the past two decades, post COVID-19 pandemic, these conditions have increased significantly with notable disparities, and witnessed a crisis in public health. In 2022, 24.7% or 6.1 million adolescents aged 12 to 17 in the US had either Major Depressive Episodes (MDE) or Substance Use Disorder (SUD) and 3.7 percent had both in the prior year². Increased stress, lack of peer connections, parental abuse, and poor mental health conditions were attributed to this increase in substance use^{3-7 …}

Perception Of African Immigrants Living In The United States Towards Latent Tuberculosis Infection Treatment Hesitancy, Akinwale O. Obatayo

Walden Dissertations and Doctoral Studies

About 80% of active tuberculosis (TB) cases are caused by untreated latent tuberculosis infection (LTBI), with most being foreign-born United States residents. Despite the availability of preventive therapies, African immigrants living in the United States are hesitant to accept LTBI treatment. Although researchers have explored LTBI treatment hesitancy among foreign-born United States citizens, no study has explored the perspectives of African immigrants living in the United States. This generic qualitative study explored the perception of African immigrants living in the United States on LTBI treatment hesitancy. Participants’ inclusion criteria include those 18 years and older with a positive TB test, …

Type 2 Diabetes As A Risk Factor For The Development Of Cognitive Dysfunction In U.S. Adults, Bobbi Johnson

Walden Dissertations and Doctoral Studies

There is no consensus as to whether having type 2 diabetes increases an individual’s risk for developing cognitive dysfunction. Though cognitive dysfunction is considered a risk factor for type 2 diabetes, it is also classified as a newly formed diabetes-related complication. The purpose of the study was to evaluate if self-reported healthcare – diagnosed diabetes has any association in the risk of the development of cognitive dysfunction in individuals living with type 2 diabetes. Self-determination theory served as the theoretical framework. The research questions concerned whether (a) an association exists between diabetes and cognitive dysfunction, (b) ethnicity plays a vital …

Forgotten Clientele: A Systematic Review Of Patient-Centered Pathology Reports, Eric Steimetz, Elmira Mostafidi, Carolina Castagna, Raavi Gupta, Rosemary Frasso

College of Population Health Faculty Papers

CONTEXT: Patient portals, designed to give ready access to medical records, have led to important improvements in patient care. However, there is a downside: much of the information available on portals is not designed for lay people. Pathology reports are no exception. Access to complex reports often leaves patients confused, concerned and stressed. We conducted a systematic review to explore recommendations and guidelines designed to promote a patient centered approach to pathology reporting.

DESIGN: In consultation with a research librarian, a search strategy was developed to identify literature regarding patient-centered pathology reports (PCPR). Terms such as "pathology reports," "patient-centered," and …

The Relationship Between Social Risk Factors And Pre-Term Births In Hawai’I, Rina Therese Ramos Amposta

Walden Dissertations and Doctoral Studies

Premature birth remains the leading cause of neonatal death and is associated with birth defects and long-term health morbidities. Hawai’i, with dominant Pacific Islander, Asian, and White populations, ranks 18th amongst the states with the highest rate of preterm birth. Guided by the social ecological model, the purpose of this quantitative, cross-sectional research study was to determine the extent of the association of social risk factors and preterm birth in the state of Hawai’i for the years 2012-2015 using the Hawai’i Pregnancy Risk Assessment and Monitoring Systems (PRAMS). Preterm birth in Hawai’i from 2012- 2015 was found to be 17% …

How Financial Beliefs And Behaviors Influence The Financial Health Of Individuals Struggling With Opioid Use Disorder, James R Langabeer, Francine R Vega, Marylou Cardenas-Turanzas, A Sarah Cohen, Karima Lalani, Tiffany Champagne-Langabeer

Faculty, Staff and Student Publications

The surge in opioid use disorder (OUD) over the past decade escalated opioid overdoses to a leading cause of death in the United States. With adverse effects on cognition, risk-taking, and decision-making, OUD may negatively influence financial well-being. This study examined the financial health of individuals diagnosed with OUD by reviewing financial beliefs and financial behaviors. We evaluated quality of life, perceptions of financial condition during active use and recovery, and total debt. We distributed a 20-item survey to 150 individuals in an outpatient treatment program for OUD in a large metropolitan area, yielding a 56% response rate. The results …

Physical Activity In Underserved Preadolescents: Characterization Of Accumulation And Patterns, Alma I. Behar, Matthew T. Mahar, Gregory Norman, John P. Elder, Michael Pratt, Patricia Dionicio, Noe C. Crespo

International Journal of Physical Activity and Health

Objectives: The increasing rates of physical inactivity and sedentary behaviors among youth are a significant public health concern. The greatest disparities in physical activity (PA) are experienced by underserved (racial/ethnic minority, low-income) youth. This study aimed to characterize accelerometer-measured PA behaviors in a sample of low-income, predominantly Latino, preadolescents. Methods: Participants wore wrist worn GENEActiv accelerometers for 7 days. PA levels were classified as sedentary (< 50 mg), light (50-150 mg), moderate (> 150-500 mg), vigorous (> 500 mg), and MVPA (≥ 150 mg). Time spent in PA levels and sedentary time (ST), prevalence of meeting MVPA guidelines, and PA volume were estimated from accelerometer data. Three-way …

A Case Study On The Effects Of Pregnancy On Expiratory Flow Limitation (Efl) And Operating Lung Volumes During Exercise, Hannah Young

Masters Theses, 2020-current

The purpose of this study was to examine the effects of pregnancy on expiratory flow limitation (EFL) and operating lung volumes (end expiratory lung volume and end inspiratory lung volume; EELV and EILV) during exercise, with an exploratory aim to assess differences in the above measures between exercise modalities. EFL has been shown to occur in several other subgroups but has never been studied in pregnant individuals. We followed one 35-year-old pregnant subject throughout her pregnancy, completing exercise and pulmonary testing every other week from 8 weeks gestation to 38 weeks gestation, and once again ~8 weeks postpartum. Testing was …

Assessing The Effectiveness Of Treatment Programs Among Veterans With Opioid Use Disorder In New York State, Olatoye Oluwaseyi Itaniyi

Walden Dissertations and Doctoral Studies

New York State (NYS) is home to millions of veterans and has the fifth-largest veteran population in the country. Veterans represent a vulnerable population and are at higher risk for mental and physical health struggles. The focus of this quantitative study was to assess if there is any significant difference between pre- and post-OUD 24-hour detoxification treatment services, residential/rehabilitation treatment services, ambulatory outpatient treatment services, frequency of opioid use at discharge, and mental disorder among veterans with opioid use disorder in NYS when controlling for age, gender, race, and marital status. The study utilized the harm reduction framework and the …

A Bioinformatic Analysis Of T-Cell Epitope Diversity In Sars-Cov-2 Variants: Association With Covid-19 Clinical Severity In The United States Population, Grace J. Kim, Jacob H. Elnaggar, Mallory Varnado, Amy K. Feehan, Darlene Tauzier, Rebecca Rose, Susanna L. Lamers, Maya Sevalia, Najah Nicholas, Elizabeth Gravois, Daniel Fort, Judy S. Crabtree, Lucio Miele

School of Graduate Studies Faculty Publications

Long-term immunity against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) requires the identification of T-cell epitopes affecting host immunogenicity. In this computational study, we explored the CD8+ epitope diversity estimated in 27 of the most common HLA-A and HLA-B alleles, representing most of the United States population. Analysis of 16 SARS-CoV-2 variants [B.1, Alpha (B.1.1.7), five Delta (AY.100, AY.25, AY.3, AY.3.1, AY.44), and nine Omicron (BA.1, BA.1.1, BA.2, BA.4, BA.5, BQ.1, BQ.1.1, XBB.1, XBB.1.5)] in analyzed MHC class I alleles revealed that SARS-CoV-2 CD8+ epitope conservation was estimated at 87.6%–96.5% in spike (S), 92.5%–99.6% in membrane (M), and 94.6%–99% in …

Construction And Mutagenesis Of Ssv1 Mutants In Extreme Viruses, Lou Ann F. O'Connor, Jono Abshier, Kenneth M. Stedman

Student Research Symposium

Archaeal viruses with unique structures such as spindle-shaped virions are found abundantly in extreme environments like geothermal hot springs around the world. Among all spindle-shaped viruses, the model Sulfolobus Spindle-shaped Virus 1 (SSV1) is best studied. Creating the lemon-shaped or spindle-shaped virion structure are two proteins, VP1 as the major capsid protein, and VP3 as the minor capsid protein. The primary structure of VP1 consists of a proteolytic cleavage site at position 66 that is believed to be necessary for virus evolution. Recent studies showed that genetic mutation of the amino acid, glutamate (E) at position 66 in VP1 which …