Public Health Commons^™

Quantifying The Public Health Impact Of Lyme Disease In Minnesota: A Simulation Analysis Of Reported And Unreported Cases, Kathleen Angell, M. Jana Broadhurst, Jianghu James Dong, Tzeyu L. Michaud, Abraham Degarege, Roberto Cortinas, David Brett-Major

Journal Articles: Epidemiology

Background: Lyme disease, the most common vector-borne disease in Minnesota, is estimated to be underreported by a factor of 10. Delayed diagnosis and misdiagnosis may lead to health complications and increased personal and societal costs. Environmental factors can help to predict high disease years, allowing for early intervention to decrease disease burden. Objective: To estimate the health and cost burdens of Lyme disease and the extent to which they could be diminished by public health intervention when high-incidence Lyme disease years are forecasted. Methods: We used 5 two-dimensional Monte Carlo simulations to estimate (1) average annual expected burden of Lyme …

Strategies To Enhance Involvement In Research And The Use Of Hiv Prevention Services In Black Men Who Have Sex With Men (Bmsm): The Voices Of Bmsm, Chijoke Anyaehie, Brittany L. Gardner, Paris Green, John Bonelli, Hong Van Tieu, Melonie Walcott

Gulf Coast Division GME Research Day 2025

No abstract provided.

Planned Out Of Hospital Birth Maternal And Neonatal Outcomes In A Single Institution, Priyanka Vuppala, Juhi Singhal, Linda Haddox

Central & West Texas and San Antonio GME Research Day 2025

No abstract provided.

Lower Electronic Health Record Adoption And Interoperability In Rural Versus Urban Physician Participants: A Cross-Sectional Analysis From The Cms Quality Payment Program, Alfred J. Anzalone, Carol R. Geary, Ran Dai, Shinobu Watanabe-Galloway, James C. Mcclay, James Campbell

Journal Articles: Epidemiology

BACKGROUND: The Health Information Technology for Economic and Clinical Health Act of 2009 introduced the Meaningful Use program to incentivize the adoption of electronic health records (EHRs) in the U.S. This study investigates the disparities in EHR adoption and interoperability between rural and urban physicians in the context of federal programs like the Medicare Access and CHIP Reauthorization Act of 2015 and the 21st Century Cures Act.

METHODS: A cross-sectional analysis was conducted using the 2021 Quality Payment Program Experience Report Public Use File to compare EHR adoption and Promoting Interoperability scores (PISs) between urban and rural physician participants. Data …

Occupational Exposures To Chemicals In Dentistry: A Scoping Review, Geneviève Picard, Tisha Prakash, France Labrèche, Sabrina Gravel

Revues de littérature, synthèses de connaissances

The dental workforce comprises a variety of professions, most of which are predominantly occupied by women. Dental workers can be exposed to numerous toxic chemicals such as mercury, methacrylate polymers, and silica. This scoping review aims to synthesize the scientific literature on quantified chemical exposures and to identify research gaps in occupational chemical hazards faced by dental professionals. This review followed the Joanna Briggs Institute approach and PRISMA-ScR guidelines, using three concepts to search PubMed, Embase, and Web of Science: workers, dental care, and chemicals. Studies from high-income countries, published in French or English between 2000 and 2024 and reporting …

Global, Regional, And National Burden Of Cardiovascular Diseases And Risk Factors In 204 Countries And Territories, 1990-2023, Global Burden Of Cardiovascular Diseases And Risks 2023 Collaborators, Benjamin A. Stark, Nicole K. Decleene, Emily C. Desai, Johnathan M. Hsu, Catherine O. Johnson, Laura Lara-Castor, Kate E. Legrand, Prof Bhoomadevi A., Mohammad Amin Aalipour, Nasir Abbas, Madineh Abbasi, Mohammadreza Abbasian, Hedayat Abbastabar, Abdallah H. A. Abd Al Magied, Samar Abd Elhafeez, Gregory A. Roth, Et Al.

Epidemiology, Biostatistics, & Environmental Health Faculty Publications

Background

Cardiovascular diseases (CVDs) are the leading cause of mortality and are among the foremost causes of disability globally. CVD burden has continued to increase in most countries since 1990, with trends driven by changing exposures to harmful risk factors, population growth, and population aging.

Objectives

We report estimates of global, national, and subnational CVD burden, including 18 subdiseases and 12 associated modifiable risk factors. We analyzed change in CVD burden from 1990 to 2023 and identified drivers of change including population growth, population aging, and risk factor exposure.

Methods

The Global Burden of Disease (GBD) 2023 study, a multinational …

Environmental Health Priorities In Rural Public Health Departments: Perspectives From Health Agency Directors, Michelle Rastegar

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Rural communities are staffed by environmental health practitioners with less formal public health training and fewer years of public health experience. The literature on environmental health program implementation in rural communities is incomplete and specifically misses the perspectives of those charged with developing and fielding such programs. The purpose of this paper is to gather and report the insights of three rural local public health department leaders regarding the challenges, opportunities and stakeholders for implementing environmental health programs. Using purposive sampling of faculty community partners, three rural Kentucky local health department directors were recruited to participate in the study. After …

Promoting Physical Activity (Pa) Among Latinas In Fayette County, Ky, Vanessa Diaz Mph

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

In the United States, the prevalence of overweight and obesity continues to rise at a disproportionate rate that is greatly affecting Latinas. This paper outlines the implementation of an adapted version of Fe en Acción, a faith-based evidence-based physical activity (PA) intervention that was initially implemented in San Diego, CA. The program targets Latinas in Fayette County, KY through culturally tailored, faith-based PA classes held at local Catholic churches. By using promotoras– health promoters– the program works to increase self-efficacy and social support while promoting sustainable behavior change. Key adaptations include a reduction in class frequency (four times a week), …

Pathways To Green River District Health Department, Gracelyn P. Bush

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

In an effort to decrease Neonatal Abstinence Syndrome (NAS) in the Green River District of Western Kentucky, this grant proposes the expansion of the evidence-based University of Kentucky PATHways program to the Green River District Health Department (GRDHD). To protect the health of both women and children, this program will specifically target pregnant women with substance use disorder (SUD). This program will deliver a group-based prenatal and postpartum curriculum with the integration of Peer Recovery Support Specialists, specifically modeled on Social Cognitive Theory and the adoption of whole-person care. The proposed program spans a three-year time frame, beginning with program …

A Case Study In Program Evaluation: Evaluation Of A Community Program To Increase Rates Of Physical Activity, Emma Hughes

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Bourbon County faces rates of obesity and levels of physical inactivity that are at, or worse, than the Kentucky state average. The Bourbon County Health Department (BCHD) has prioritized addressing these issues and received funding from a private foundation to do so. Collaboration with the University of Kentucky and additional funding from UK Healthcare (UKHC) will support these efforts to improve the rates of regular physical activity, raise awareness of the negative health impacts of inactivity, and increase access to safe places to exercise. The BCHD developed a 6-month program that involves several interventions aimed at increasing the percent of …

Increasing Pediatric Asthma Follow-Up Visits And Decreasing Emergency Department Visits In A Primary Care Setting, Rima M. Basal

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

The implementation of the asthma follow-up visits bundle in the pediatric primary care setting is an evidence-based practice project aimed at improving pediatric asthma management. This manuscript discusses the deployment of the bundle, which includes pre- and post- knowledge assessment for parents/caregivers, asthma education through a short video and handout, administration of the asthma control test (ACT), completion of a written asthma action plan (WAAP), and education about the patient portal and telehealth. The goal is to improve parent/caregiver knowledge, treatment adherence, follow-up visit compliance (in-person or virtual) and reduce emergency department (ED) utilization. Parent/caregiver knowledge increased by 23%, ACT …

Association Of State Cannabis Legalization With Cannabis Use Disorder And Cannabis Poisoning, Jayani Jayawardhana, Jialin Hou, Patricia Freeman, Jeffery C. Talbert

Health Management and Policy Faculty Publications

IMPORTANCE Whether state implementation of medical and recreational cannabis laws is associated with increased cannabis use disorder (CUD) and/or cannabis poisoning among adults is not evident.

OBJECTIVE To examine state-level medical and recreational cannabis laws’ associations with CUD and cannabis poisoning, overall and by sex and age subgroups.

DESIGN, SETTING, AND PARTICIPANTS In this longitudinal cohort study, state-level CUD and cannabis poisoning diagnoses from January 2011 to December 2021 were examined across all 50 US states and the District of Columbia before and after the implementation of medical and recreational cannabis laws (MCLs and RCLs, respectively) using a staggered adoption …

Demographic Variation In Continuous Glucose Monitoring Utilisation Among Patients With Type 1 Diabetes From A Us Regional Academic Medical Centre: A Retrospective Cohort Study, 2018–2021, Omer Atac, Kory R. Heier, Daniela Moga, John L. Fowlkes, Min-Woong Sohn, Aaron J. Kruse-Diehr, Teresa M. Waters, Mary E. Lacy

Health Management and Policy Faculty Publications

Objective: While continuous glucose monitoring (CGM) utilisation has been increasing among patients with type 1 diabetes (T1D), few studies have examined patterns of use across age, race/ethnicity and insurance status together. In this study, we examine CGM utilisation among patients with T1D from a regional academic medical centre across all insurance types.

Design and Setting: This is a retrospective cohort study including both paediatric and adult patients with T1D who visited a regional academic medical centre between 1 January 2018 and 31 December 2021.

Methods: Patients were followed from the date of their first T1D encounter during the study period …

Rural Hospital Closure And Medicaid Expansion, Jason White

Theses, Dissertations and Capstones

Introduction: In the United States, hospitals in rural areas have been under financial pressure and have been closing at an increasing rate.  This reduces access to care for rural citizens.  The Affordable Care Act of 2010 was passed in order to increase access to medical care, partially through an optional expansion of Medicaid coverage to a larger percentage of the population.  As some states adopted the expansion and some states did not, an opportunity was created to examine the policy’s effect on rural hospital stability.

Purpose of the Study:  This study was designed to examine the effect of …

Effect Of Wildfire Smoke Pm2.5 On Preterm Birth Outcomes: A Generalized Synthetic Control Analysis Of Preterm Births In The Contiguous United States From 2006 To 2020, Alexandra Maria Nechaev

Public Health Theses

Wildfire activity has intensified across the United States due to climate change, contributing to rising levels of smoke-attributable fine particulate matter (PM2.5) in ambient air. Wildfire-specific PM2.5 is linked to adverse health outcomes, including increased risk of preterm birth, a leading cause of infant morbidity and mortality. Despite growing concern, few studies have applied quasi-experimental methods to evaluate the causal effects of wildfire-attributable PM2.5 on preterm birth across large, diverse populations and geographical areas. This study estimated the effect of wildfire-specific PM2.5 exposure on preterm birth rates across all counties in the contiguous United States from 2006 to 2020 using …

Social Media Influences On Youth Substance Use, Sexual Health, And Mental Health In Paterson, New Jersey: A Rapid Qualitative Analysis, Nimisha Srikanth

Public Health Theses

Introduction: Social media use among youth has become a topic of concern among public health professionals and policymakers. Youth have grown to rely on social media for communication and entertainment, but are exposed to negative health behaviors with the potential to model them in their lives. In this study, we investigated youth’s perspectives on social media content and the impact it has on their health and lives.Methods: We conducted a rapid qualitative analysis of individual interviews of youth from Paterson, New Jersey. Among the sample (n=20), the mean age was 16 years, 80% identified as male, and 30% were justice-involved. …

The Role Of Climate Change In The Pandemic Agreement Negotiations, Cristina Arnes Sanz

Public Health Theses

Introduction: For over three years, Member States of the World Health Organization (WHO) have been negotiating a treaty to prevent, prepare for, and respond to future pandemics. The Pandemic Agreement is anticipated to be adopted at the World Health Assembly in May 2025. Growing scientific evidence underscores the effects of climate change on infectious diseases, including those that could lead to pandemics. This thesis examines how climate change has been addressed in the drafting and negotiations of the Pandemic Agreement.

Methods: All the references related to climate change in the transcripts of the publicly broadcast Intergovernmental Negotiating Body (INB) meetings …

Exploring The Link Between Low-Income Communities And Increased Cancer Risk From Nitrate Contamination In Drinking Water: A Review, Anna Wiggins, Rena Phillips, Michael L. Phillips, Wei-Hsiung Yang

South Atlantic Division GME Research Day 2025

No abstract provided.

Ambient Air Pollution And Survival Among Black Women With Epithelial Ovarian Cancer Across Diverse Geographical Regions Of The United States, Ekaterina Chirikova, Courtney E. Johnson, Anke Huels, Pushkar P. Inamdar, Elisa V. Bandera, Lawrence H. Kushi, Jennifer A. Doherty, Joellen M. Schildkraut, Hari S. Iyer, Melissa Bondy, Edward S. Peters, Kendra L. Ratnapradipa, Jeffrey Marks, Christopher Pierson, Theresa Hastert, Kristin Haller, Grace Christensen, Salma Shariff-Marco, Scarlett L. Gomez, Andrew Lawson

Journal Articles: Epidemiology

Background: Ovarian cancer is a leading cause of gynecologic cancer mortality, with Black women experiencing 5-year survival rates of only 41%. Disproportionate air pollution exposure may impact survival. We evaluated associations of fine particulate matter (PM_2.5) and nitrogen dioxide (NO₂) exposure with survival among Black women with epithelial ovarian cancer using data from the California Cancer Registry (CCR, n = 540) and the multi-state African American Cancer Epidemiology Study (AACES, n = 766).

Methods: Annual PM_2.5 and NO₂ levels were estimated at a 1 km resolution using well-validated ensemble-based prediction models derived from the …

Preliminary Evaluation Of A Brief Intervention To Enhance Trauma-Informed Attitudes Among Educators And School Mental Health Counselors, Cheri Shapiro, Kara Lee, Courtnie Collins, Tristan Collier, Carl Sorensen

Publications

Professional development training designed to advance knowledge of the impacts of trauma and trauma-responsive practices for educators and counselors in schools and mental health settings have become common. Given the popularity of these training approaches, it is important to understand the potential impact on trauma-informed attitudes and beliefs. This descriptive, exploratory study examined changes in traumainformed care attitudes as a function of participating in a novel intervention designed to support trauma-informed practices in a sample of elementary school educators, administrators, and school mental health counselors (n=194) from one state in the Southeastern US. Positive changes in trauma-informed attitudes from pre …

Why The Museum Matters To Honors, Mimi Killinger

Honors in Practice Online Archive

Using classroom displacement and pandemic pivoting during COVID as a touchstone, author presents ways in which museums complement and reinforce pedagogical goals in honors. Community and campus museums offer immediate and innovative teaching opportunities that require minimal technology, present diverse viewpoints and cultural perspectives, and foster visual and cultural literacies. Demonstrating how teaching within a museum aligns with the educational mission of her home institution, author suggests that these spaces can be creative, collaborative, and engaging learning locations for honors colleges and programs throughout the country. Detailed descriptions of curated collections are provided.

Building Place-Based Experiential Learning Into The Honors Curriculum At Ohio University, Geoffrey L. Buckley, Nicole Finnicum, Michelle O'Malley, Jennifer Bowie, Yolonda Youngs

Honors in Practice Online Archive

Observing the demand for interdisciplinary experiential learning opportunities post-COVID, authors present a place-based curriculum in honors. Workshop-style special topics classes provide students with an immersive and flexible learning environment, energize faculty, and engage alumni and community partners. Coursework, fieldwork, internships, and study abroad opportunities all contribute to the development of an informed and engaged citizenry. Authors address challenges in funding, access, and equity, and they suggest ways these challenges might be met.

Hemifacial Spasm Due To Dolichoectasia Of Vertebral And Basilar Arteries, Meena Iyer, Shasthara Paneyala Dr.

Digital Journal of Clinical Medicine

Dolichoectasia refers to the non-focal dilatation and tortuosity of arteries, primarily affecting the vertebral and basilar arteries due to severe tunica intima degeneration. It is associated with genetic predisposition and atherosclerosis, leading to vessel wall weakening. Patients may remain asymptomatic or develop neurological deficits due to mass effect. We report a case of a 60-year-old male presenting with hemifacial spasm secondary to vertebral artery dolichoectasia. Magnetic Resonance Angiography (MRA) revealed ectatic and tortuous basilar and vertebral arteries, with the left vertebral artery compressing the left facial nerve complex. Using Smoker’s criteria, a diagnosis of dolichoectasia was confirmed. Dolichoectasia-induced hemifacial spasm …

Comparison Of The Effectiveness Of Preoperative Dexmedetomidine Nebulization Versus Lignocaine Nebulization In Attenuation Of Stress Response During Direct Laryngoscopy And Endotracheal Intubation In Elective Surgeries Under General Anaesthesia: A Randomised Control Study At A Tertiary Care Hospital, Mandya, Sumayya E., Kiran A V., Santhosh M C B., Shivakumar G

Digital Journal of Clinical Medicine

Introduction: Direct laryngoscopy and tracheal intubation are known to provoke harmful stimuli that can lead to transient, unpredictable, and variable hemodynamic alterations, primarily due to heightened sympathoadrenal activity.¹ Various pharmacological agents have been explored to mitigate this stress response; however, none have emerged as optimal.²

Aim: This study aims to compare the effects of nebulized dexmedetomidine in comparison to nebulized lignocaine on the hemodynamic stress response during direct laryngoscopy and tracheal intubation, including any adverse effects in patients undergoing general endotracheal anesthesia.

Materials and Methods: Informed consent was obtained from 60 patients aged 18 to …

Felt Need For Psychiatry Clubs In Medical Colleges To Enhance Teaching-Learning, Aditya Rao, Sheryl Agarwal, Sharanya Bose, M Kishor

Digital Journal of Clinical Medicine

Mental health competence is critical for medical graduates, yet in India the treatment gap for common mental disorders remains substantial, with prevalence estimates indicating up to 80.4% of unmet need. Recent reforms under the Competency-based Medical Education (CBME) curriculum have expanded psychiatry training; however, deficiencies in applied skills, preventive psychiatry, and communication remain. Psychiatry clubs have been proposed as supplementary, student-led platforms to address these limitations. This cross-sectional study assessed the perceived need for psychiatry clubs among undergraduate medical students and explored their potential role in enhancing teaching–learning. A structured online survey was administered to 94 students across different phases …

Prevalence Of Depression Among Type 2 Diabetes Mellitus Patients In Urban Mysuru – A Cross-Sectional Study, Jesymol Joy, Renuka M, Chiranjeevi G S

Digital Journal of Clinical Medicine

Background: Depression is a significant comorbidity among individuals with Type 2 Diabetes Mellitus (T2DM) adversely affecting disease management and overall quality of life. Diabetes and depression have a bidirectional relationship, where poorly managed diabetes increases the risk of depression, and depression exacerbates diabetes-related complications. Depression contributes to poor glycemic control, decreased adherence to treatment, increased risk of diabetes-related complications, and higher healthcare utilization.

Objectives: To determine the prevalence of depression and its associated factors among Type 2 Diabetes Mellitus patients in urban Mysuru.

Methods: A community-based cross-sectional study was conducted among 300 Type 2 Diabetes mellitus patients >18 years of …

Allergic Bronchopulmonary Aspergillosis In Pediatric Asthma : A Diagnostic Challenge Mimicking Tuberculosis, Praveen Das, Santosh Kondekar, Surbhi Rathi

Digital Journal of Clinical Medicine

Allergic bronchopulmonary aspergillosis (ABPA) is a rare hypersensitivity reaction to Aspergillus fumigatus, more commonly observed in adults and patients with cystic fibrosis. It can, however, present in pediatric asthmatics with refractory symptoms, leading to diagnostic challenges due to overlapping features with other pulmonary diseases, including tuberculosis. ABPA should be considered in children with uncontrolled asthma and atypical radiologic features, especially when unresponsive to standard therapies. Early recognition and appropriate management are critical to prevent irreversible lung damage and improve quality of life.

Pregnancy-Related Delusional Beliefs In Midlife And Late-Life Women: A Case Series, Dyuksha Arora, Ashita Adarsh, Kishor M. Manohar Rao, Anand R, Soumya Rajshekar Patil, Akshatha Cj

Digital Journal of Clinical Medicine

Pseudocyesis and delusional pregnancy represent rare but clinically significant presentations across psychiatric practice. While pseudocyesis involves a false belief of pregnancy accompanied by physical manifestations, delusion of pregnancy refers to a fixed belief of being pregnant despite clear contrary evidence. Both conditions pose considerable challenges as they involve close consultation and liaison between Obstetrics & Gynaecology and Psychiatry. There are a few studies from tertiary care general hospitals in India. Here we report two case series.

Case 1: A 43-year-old married woman from a rural background with an 8-year history of recurrent depressive disorder and dysthymia, presented with 3 months …

One Airway, One Disease In Pregnancy: A Prospective Observational Study On The Correlation Between Upper And Lower Airway Inflammation In Pregnant Women, Durga K, Yuvarajan S

Digital Journal of Clinical Medicine

Background: The well-established "One Airway, One Disease" concept recognizes the deep physiological and pathological connections between conditions affecting both the upper and lower respiratory tracts, most notably allergic rhinitis and asthma. During pregnancy, a woman's body undergoes significant immunological, hormonal, and physiological changes, which can profoundly influence and modulate existing or emerging airway inflammation.

Objective: This prospective observational study was designed with the primary objective of meticulously evaluating the correlation between upper and lower airway inflammation in pregnant women. We aimed to achieve this by assessing a range of clinical symptoms, objective functional parameters, and specific inflammatory markers.

Methods: We …

Comparision Of Buprenorphine Versus Butorphanol As An Adjuvant To Intrathecal Hyperbaric Bupivacaine For Elective Infraumbilical Surgeries : A Randomised Control Study At A Tertiary Care Hospital, Mandya, Surabhi C A, Dr. Kiran A V. Associate Professor, Dr. Shivakumar G Pofessor And Hod, Umesh N P

Digital Journal of Clinical Medicine

Introduction: Spinal anaesthesia is the most popularly performed procedure in the field of anaesthesiology. Hyperbaric bupivacaine, the local anaesthetic most commonly used, has limitation as its effect lasts only for 1.5-2 hours. Hence a lot of adjuvants have been tried to enhance the analgesic effect of bupivacaine.^[2] Opioids remain the mainstay among the various adjuvants to local anesthetics in spinal anaesthesia primarily by virtue of its various properties such as reducing the dose of local anaesthetic, minimizing side effects, and prolonging the duration of anaesthesia.^[3]

Aim: This study aims to compare the sensory and motor characteristics …