Public Health Commons^™

Healthconnect Hub Report Long Term Impact Of Pathways, Hannah Cohen-Cline, Taylor Doren, Kyle G Jones, Jb Rinaldi, Sarah E Roth

Articles, Abstracts, and Reports

No abstract provided.

Healthconnect Long-Term Impact Of The Healthconnect Hub By County, Hannah Cohen-Cline, Taylor Doren, Kyle G Jones, Katherine Marsi, Jb Rinaldi, Sarah E Roth

Articles, Abstracts, and Reports

No abstract provided.

Blood Pressure Responses Are Dependent On Call Type And Related To Hypertension Status In Firefighters, Paige J Rynne, Cassandra C Derella, Carly Mcmorrow, Rachel L Dickinson, Stephanie Donahue, Andrew A Almeida, Megan Carty, Deborah L Feairheller

College of Population Health Faculty Papers

Background: Impaired cardiovascular health is a concern for firefighters, with over 50% of line-of-duty deaths having cardiac causes. Many firefighters have hypertension and <25% have their blood pressure (BP) controlled. The alarm response could be an unidentified cardiac risk, but interestingly, the BP response to different calls and on-the-job activity is unknown.

Purpose: We aimed to measure the physiological stress resulting from different call types (fire, medical) and job activity (riding apparatus, pre-alert alarms) through ambulatory BP (ABP) monitoring in a population of firefighters.

Materials and methods: During 111 12-h work shifts firefighters wore an ABP monitor. BP was measured at 30-min intervals and manual measurements were prompted when the pager went off or whenever they felt stress.

Results: Firefighters were hypertensive (124.3 ± 9.9/78.1 ± 6.7 mmHg), overweight …

An Evaluation Of Injurious Falls And Fall-Risk-Increasing-Drug (Frid) Prescribing In Ambulatory Care In Older Adults, Taylor R. Elliott, Susan Westneat, Shama D. Karanth, Erin L. Abner, Anna M. Kucharska‑Newton, Daniela C. Moga

Epidemiology and Environmental Health Faculty Publications

Background: Falls are a major public health problem afecting millions of older adults each year. Little is known about FRID prescribing behaviors after injurious falls occur. The primary objective of this study was to investigate whether an injurious fall is associated with being prescribed a new FRID.

Methods: We conducted a cross-sectional analysis using data from the National Ambulatory Medical Care Survey (2016). We included visits from patients age≥65 years and classifed visits based on presence of an injurious fall. The outcome of interest was prescription of new FRID between those with and without an injurious fall. Multivari‑ …

Substance Use Treatment And Providers For Sexual And Gender Minority Populations In A Texas-Mexico Border City, Diana Laura Barraza

Open Access Theses & Dissertations

Sexual and gender minority (SGM) is an umbrella term that refers to lesbian, gay, bisexual, transgender, and gender-diverse populations. These populations face challenges and barriers when accessing health services that further lead to negative health outcomes and an increase in health disparities. For example, rates of substance use are higher among SGM communities compared to heterosexual/cisgender people. Risk factors for substance use problems include lack of social support, Adverse Childhood Experiences (ACEs), rejection and discrimination, and solitary drug use. Various efforts in Texas and the U.S.-Mexico border region have been made to close the gap in health inequalities. In El …

A Thematic Analysis Of Resilient Experiences Of People Who Use Drugs And Are Living With Hiv Adhering To Hiv Medicine, Valeria Duenas

Open Access Theses & Dissertations

Human immunodeficiency virus (HIV) is a disease acquired through sex, from mother to child, sharing needles, and open wound exposure to the blood-borne virus. The disease leads to the rapid weakening of the immune system which renders the individual vulnerable to various opportunistic infections, cancer, disease progression into acquired immunodeficiency virus (AIDS), and possibly death. Unfortunately, US Latinos are disproportionately affected by HIV as they account for nearly 30% of all new HIV infections. A subpopulation disproportionately affected also are people who inject drugs (PWID) which account for 1 in 10 HIV diagnosis in the U.S. Modern medicine has allowed …

Exploration And Analysis Of Attitudes And Determinants Toward Undetectable Equals Untransmittable (U=U) Among Minority Women, Roberta Marie Thimbriel

Open Access Theses & Dissertations

Purpose: To explore and assess awareness of and attitudes toward "undetectable equals untransmittable" (U=U) and associations with social-ecological factors among minority women. Population: Ethnic minority women 18 years and older residing in the El Paso, TX, US - Juarez, Mexico border region. Methods: A cross-sectional convergent parallel mixed methods study using in-depth interviews and a survey instrument was conducted among a purposive sample. Thematic analysis was done on qualitative data, and descriptive, bivariate and binary logistic regression analyses were done on quantitative data. Results: The majority of the participants (66.7% interviewees and 50.7% survey) were Hispanic, in their early-mid thirties, …

Safety And Efficacy Of Hsp90 Inhibitor Ganetespib For Neoadjuvant Treatment Of Stage Ii/Iii Breast Cancer, Julie E Lang, Andres Forero-Torres, Douglas Yee, Christina Yau, Denise Wolf, John Park, Barbara A Parker, A Jo Chien, Anne M Wallace, Rashmi Murthy, Kathy S Albain, Erin D Ellis, Heather Beckwith, Barbara B Haley, Anthony D Elias, Judy C Boughey, Rachel L Yung, Claudine Isaacs, Amy S Clark, Hyo S Han, Rita Nanda, Qamar J Khan, Kristen K Edmiston, Erica Stringer-Reasor, Elissa Price, Bonnie Joe, Minetta C Liu, Lamorna Brown-Swigart, Emanuel F Petricoin, Julia D Wulfkuhle, Meredith Buxton, Julia L Clennell, Ashish Sanil, Scott Berry, Smita M Asare, Amy Wilson, Gillian L Hirst, Ruby Singhrao, Adam L Asare, Jeffrey B Matthews, Michelle Melisko, Jane Perlmutter, Hope S Rugo, W Fraser Symmans, Laura J Van 'T Veer, Nola M Hylton, Angela M Demichele, Donald A Berry, Laura J Esserman

Faculty, Staff and Student Publications

HSP90 inhibitors destabilize oncoproteins associated with cell cycle, angiogenesis, RAS-MAPK activity, histone modification, kinases and growth factors. We evaluated the HSP90-inhibitor ganetespib in combination with standard chemotherapy in patients with high-risk early-stage breast cancer. I-SPY2 is a multicenter, phase II adaptively randomized neoadjuvant (NAC) clinical trial enrolling patients with stage II-III breast cancer with tumors 2.5 cm or larger on the basis of hormone receptors (HR), HER2 and Mammaprint status. Multiple novel investigational agents plus standard chemotherapy are evaluated in parallel for the primary endpoint of pathologic complete response (pCR). Patients with HER2-negative breast cancer were eligible for randomization to …

Adjuvant Therapy In Women With Early Stage Uterine Serous Carcinoma: A Multi-Institutional Study, Katherine C Kurnit, Silvana Pedra Nobre, Bryan M Fellman, David A Iglesias, Kristina Lindemann, Anuja Jhingran, Ane Gerda Z Eriksson, Beyhan Ataseven, Gretchen E Glaser, Jennifer J Mueller, Shannon N Westin, Pamela T Soliman

Faculty, Staff and Student Publications

OBJECTIVE: Uterine serous carcinoma is a rare but aggressive subtype of endometrial adenocarcinoma. Our objective was to compare adjuvant treatment strategies for patients with early stage uterine serous carcinoma.

METHODS: This multi-institutional, retrospective cohort study evaluated patients with early stage uterine serous carcinoma. Patients with FIGO Stage IA-II disease after surgery, whose tumors had serous or any mixed serous/non-serous histology were included. Patients with carcinosarcoma were excluded. Clinical data were abstracted from local medical records. Summary statistics, Fisher's exact, and Kruskal-Wallis tests were used to analyze demographic and clinical characteristics. Univariable and multivariable analyses were performed for recurrence-free and overall …

Cell-Free Dna Screening Positive For Monosomy X: Clinical Evaluation And Management Of Suspected Maternal Or Fetal Turner Syndrome, Tazim Dowlut-Mcelroy, Shanlee Davis, Susan Howell, Iris Gutmark-Little, Vaneeta Bamba, Siddharth Prakash, Sheetal Patel, Doris Fadoju, Nandini Vijayakanthi, Mary Haag, Deborrah Hennerich, Lorraine Dugoff, Roopa Kanakatti Shankar

Faculty, Staff and Student Publications

Initially provided as an alternative to evaluation of serum analytes and nuchal translucency for the assessment of pregnancies at high risk of trisomy 21, cell-free DNA screening for fetal aneuploidy, also referred to as noninvasive prenatal screening, can now also screen for fetal sex chromosome anomalies such as monosomy X as early as 9 to 10 weeks of gestation. Early identification of Turner syndrome, a sex chromosome anomaly resulting from the complete or partial absence of the second X chromosome, allows medical interventions such as optimizing obstetrical outcomes, hormone replacement therapy, fertility preservation and support, and improved neurocognitive outcomes. However, …

Estimating The Distribution Of Ratio Of Paired Event Times In Phase Ii Oncology Trials, Li Chen, Mark Burkard, Jianrong Wu, Jill M. Kolesar, Chi Wang

Markey Cancer Center Faculty Publications

With the rapid development of new anti-cancer agents which are cytostatic, new endpoints are needed to better measure treatment efficacy in phase II trials. For this purpose, Von Hoff (1998) proposed the growth modulation index (GMI), that is, the ratio between times to progression or progression-free survival times in two successive treatment lines. An essential task in studies using GMI as an endpoint is to estimate the distribution of GMI. Traditional methods for survival data have been used for estimating the GMI distribution because censoring is common for GMI data. However, we point out that the independent censoring assumption required …

Correctional Career Pathways: A Reentry Program For Incarceration, Taylor M. Dula

Electronic Theses and Dissertations

For the past several decades, the United States led the world in incarceration rates. With nearly 2.3 million people being held in state or federal prisons or local jails in 2019, incarceration rates in the United States are over four times higher than in other developed countries. Disparities exist by gender, race, ethnicity, and other special populations. Males are 13 times more likely to be incarcerated than females. Additionally, black males are 5.7 times and Hispanic males are 2.8 times more likely to be incarcerated than white males. Individuals who experience incarceration have poorer mental and physical health outcomes. People …

10-Minute Ebd: Are Hearing Protective Devices Effective For Protecting Clinicians From Noise Exposure In Clinical Practice?, Julie Frantsve-Hawley Phd

The Journal of the Michigan Dental Association

This Ten-Minute Evidence-Based Dentistry Article provides an example of implementing the evidence-based dentistry search process with trusted search engines and identifying the best literature through critical appraisal to answer the clinical question: Are Hearing Protective Devices Effective for Protecting Clinicians from Noise Exposure in Clinical Practice? This article examines the effectiveness of hearing protective devices for safeguarding clinicians from noise exposure in dental practice. The clinical environment, exacerbated by COVID-19 aerosol-reducing devices, exposes oral health providers to elevated sound levels. While there's no conclusive evidence regarding the impact of handpieces on hearing, occupational noise exposure in dental settings can affect …

Bayesian Methods For Graphical Models With Neighborhood Selection., Sagnik Bhadury

Electronic Theses and Dissertations

Graphical models determine associations between variables through the notion of conditional independence. Gaussian graphical models are a widely used class of such models, where the relationships are formalized by non-null entries of the precision matrix. However, in high-dimensional cases, covariance estimates are typically unstable. Moreover, it is natural to expect only a few significant associations to be present in many realistic applications. This necessitates the injection of sparsity techniques into the estimation method. Classical frequentist methods, like GLASSO, use penalization techniques for this purpose. Fully Bayesian methods, on the contrary, are slow because they require iteratively sampling over a quadratic …

The Impact Of Volatile Organic Compound Exposure On Subclinical Biomarkers Of Cardiovascular Injury., Breandon Taylor

Electronic Theses and Dissertations

Pollution has been identified as the leading environmental cause of non-communicable disease and premature deaths globally. Volatile organic compounds (VOCs) are gaseous chemical constituents of pollution derived from a variety of sources, including industrial solvents and byproducts, automobile exhaust, tobacco smoke, cleaning supplies, and personal care products. VOCs are also abundant at various Superfund and Hazardous Waste Sites. Emerging data suggest that VOC exposure is associated with several adverse health outcomes, including cardiovascular disease (CVD). VOCs and their metabolites can potentially damage the endothelial lining of blood vessels, resulting in perturbed vascular function and vascular inflammation. We hypothesize that VOC …

A Mixed Methods Assessment Of Menstrual Hygiene Management And School Attendance Among Schoolgirls In Edo State, Nigeria., Madeline Tomlinson

Electronic Theses and Dissertations

Menstrual hygiene in lower-middle-income countries (LMICs) is limited and has been linked to many health, educational and social effects. However, the prevalence, details, and impact of menstrual hygiene management have not been well characterized in rural and peri-urban settings across Nigeria. The overall purpose of this research was to investigate menstrual hygiene management (MHM) among adolescent schoolgirls in peri-urban areas of Edo State, Nigeria; and to determine the educational consequences associated with poor MHM. MHM was measured using previously validated questions that were adapted after a formative assessment of MHM within the Edo State community. We used a mixed methods …

Forgetting Ourselves: Alzheimer's In Women, Jasmine Mortero

Research Briefs

Women are 3x more likely to develop Alzheimer's disease than their male counterparts. Two thirds of Americans with Alzheimer's are women. Women in their 60s are twice as likely to develop Alzheimer's during the rest of their life than they are to develop breast cancer.

Is Nevada A Reproductive Resource Desert?, Tsion Mekonnen

Research Briefs

In 2018, 52.4% of Nevada adult women reported ever receiving an HPV test. Women made up 63% of all chlamydia cases and 38% of all gonorrhea cases in Nevada. 18.4% of women in Nevada reported not receiving health care at some point in the last year due to cost. While there were 180 pregnancy-associated deaths in Nevada from 2016 to 2021. Of the 180, 79 pregnancy-associated deaths were from January 2020 to December 2021 alone. Of the drug overdoses associated with pregnancy-associated deaths, 95.7% were coded as unintentional overdoses.

Is Nevada A Reproductive Resource Desert?, Tsion Mekonnen

Research Publications

Nevada's reproductive health issues is specified in a list of statistical data. The data ranges from issues concerning women living in poverty, the uninsured population of men and women in Nevada, and the amount of women enrolled/eligible for benefits.

Increasing The Prescribing Of Pre-Exposure Prophylaxis (Prep) With A Pre-Exposure Prophylaxis Screening Tool, Cassey Hall

Student Scholarly Projects

Practice Problem: Human Immunodeficiency Virus (HIV) is one of the leading pandemics in the world. In 2019, 38 million people were living with HIV around the world. Of those, roughly 87% were aware of their HIV status.

PICOT: In patients with high risk for HIV, how does implementing a pre-exposure (PrEP) screening tool compared to randomly screening for pre-exposure prophylaxis (PrEP) affect the prescribing of pre-exposure prophylaxis (PrEP) within eight weeks?

Evidence: In 2015, the World Health Organization (WHO) recommended PrEP for the prevention of HIV in high-risk individuals. The patients include men who have sex with …

Malnutrition Vaccines For An Imminent Global Food Catastrophe, Peter J Hotez

Center for Medical Ethics and Health Policy Staff Publications

Together with climate change, both the geopolitical events in Ukraine and social disruptions in supply chains from the COVID-19 pandemic could produce global food shortages or even mass starvation events. Promising new interventions include vaccines to prevent infectious causes of malnutrition or infections disproportionately causing death among the malnourished.

Social Networks, High-Risk Anal Hpv And Coinfection With Hiv In Young Sexual Minority Men, Kayo Fujimoto, Alan G Nyitray, Jacky Kuo, Jing Zhao, Lu-Yu Hwang, Elizabeth Chiao, Anna R Giuliano, John A Schneider, Aditya Khanna

Faculty, Staff and Student Publications

OBJECTIVES: Young sexual minority men (SMM) exhibit a high prevalence and incidence of high-risk genotypes of human papillomavirus (hrHPV) anal infections and a confluence of a high prevalence of HIV and rectal STIs. Social determinants of health (SDOHs) are linked to social network contexts that generate and maintain racial disparities in HIV and STIs. A network perspective was provided to advance our knowledge of drivers of genotype-specific hrHPV infection and coinfection with HIV. The study also examined whether socially connected men are infected with the same high-risk HPV genotypes and, if so, whether this tendency is conditioned on coinfection with …

Incidence Of An Insulin-Requiring Hyperglycemic Syndrome In Sars-Cov-2-Infected Young Individuals: Is It Type 1 Diabetes?, Massimo Pietropaolo, Peter Hotez, Nick Giannoukakis

Center for Medical Ethics and Health Policy Staff Publications

Pancreatic ACE2 receptor expression, together with increased prevalence of insulin-requiring hyperglycemia in patients with coronavirus disease 2019 (COVID-19), suggested that severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pancreatic infection might trigger a β-cell-selective inflammation precipitating autoimmune type 1 diabetes (T1D). We examined T1D incidence in patients with COVID-19 inside a large, global population using a "big data" approach. The incidence in 0-30-year-old patients with confirmed COVID-19 over an ∼15-month period from the beginning of the COVID-19 pandemic was compared with an age-matched population without COVID-19 inside the TriNetX COVID-19 Research Network (>80 million deidentified patient electronic medical records globally). …

Identification Of A Novel Large Multigene Deletion And A Frameshift Indel In Pde6b As The Underlying Cause Of Early-Onset Recessive Rod-Cone Degeneration, Riccardo Sangermano, Pooja Biswas, Lori S Sullivan, Emily M Place, Shyamanga Borooah, Juerg Straubhaar, Eric A Pierce, Stephen P Daiger, Kinga M Bujakowska, Radha Ayaggari

Faculty, Staff and Student Publications

A family, with two affected identical twins with early-onset recessive inherited retinal degeneration, was analyzed to determine the underlying genetic cause of pathology. Exome sequencing revealed a rare and previously reported causative variant (c.1923_1969delinsTCTGGG; p.Asn643Glyfs*29) in the

A Randomized, Sham-Controlled, Quintuple-Blinded Trial To Evaluate The Net Device As An Alternative To Medication For Promoting Opioid Abstinence, Mark K Greenwald, Samiran Ghosh, Joe R Winston

Faculty, Staff and Student Publications

BACKGROUND: There is an unmet need for non-medication approaches to illicit opioid discontinuation and relapse prevention. The NET (NeuroElectric Therapy) Device is a non-invasive, battery-operated, portable, re-useable device designed to deliver bilateral transcranial transcutaneous alternating current electrical stimulation, and is intended to treat opioid use disorder (OUD) without medication. The device is a CE-marked Class IIa, non-significant risk, investigational medical device.

OBJECTIVE: This prospective trial (NRC021) tests the hypothesis that the NET Device provides safe and effective neurostimulation treatment for persons with OUD who express a desire to be opioid abstinent without medications for opioid use disorder (MOUD).

METHODS: NRC021 …

Sex-Related Differences In Violence Exposure, Neural Reactivity To Threat, And Mental Health, Heather E Dark, Nathaniel G Harnett, Danielle R Hurst, Muriah D Wheelock, Kimberly H Wood, Adam M Goodman, Sylvie Mrug, Marc N Elliott, Susan Tortolero Emery, Mark A Schuster, David C Knight

Faculty, Staff and Student Publications

The prefrontal cortex (PFC), hippocampus, and amygdala play an important role in emotional health. However, adverse life events (e.g., violence exposure) affect the function of these brain regions, which may lead to disorders such as depression and anxiety. Depression and anxiety disproportionately affect women compared to men, and this disparity may reflect sex differences in the neural processes that underlie emotion expression and regulation. The present study investigated sex differences in the relationship between violence exposure and the neural processes that underlie emotion regulation. In the present study, 200 participants completed a Pavlovian fear conditioning procedure in which cued and …

Effect Of The Environment On Home-Based Self-Sampling Kits For Anal Cancer Screening, Jenna Nitkowski, Anna Giuliano, Tim Ridolfi, Elizabeth Chiao, Maria E Fernandez, Vanessa Schick, Michael D Swartz, Jennifer S Smith, Ellen A Schneider, Bridgett Brzezinski, Alan G Nyitray

Faculty, Staff and Student Publications

BACKGROUND: Anal cancer incidence has increased in Western countries in recent decades and currently there are no consensus screening guidelines. Home-based self-sampling kits might facilitate screening for anal precancer/cancer but could require travel through postal mail where they may experience extreme temperatures or long transport times.

OBJECTIVE: To determine the effect of the environment on specimen adequacy for HPV genotyping of a mailed home-based self-sampling anal cancer screening kit.

STUDY DESIGN: The Prevent Anal Cancer (PAC) Study in Milwaukee, Wisconsin recruited men who have sex with men (MSM) and transgender persons 25 years of age and older. Participants were randomized …

Infrastructure Development For Personalized Risk Prediction To Reduce Cardiovascular Disease In Childhood Cancer Survivors, Suman Shrestha

Dissertations and Theses (Open Access)

Although childhood cancer survivors have lengthy life expectancies, they run the risk of experiencing long-term health issues as a result of their treatment. The most frequent non-cancerous cause of morbidity and mortality for these survivors is cardiac disease. Radiation therapy (RT) has been linked in numerous cohort studies to a higher chance of developing a late cardiac disease in these survivors, and this risk rises with higher mean heart doses and increased RT exposure to larger cardiac volumes. Since, the heart is a heterogeneous organ made up of several distinct substructures, RT dose received by the entire heart does not …

Clinical Outcomes Associated With Co-Infection Of Carbapenem-Resistant Enterobacterales And Other Multidrug-Resistant Organisms, Bekana K Tadese, Stacia M Desantis, Osaro Mgbere, Kayo Fujimoto, Charles Darkoh

Faculty, Staff and Student Publications

BACKGROUND: Infections with carbapenem-resistant Enterobacterales (CRE) are associated with increased risk of death. Polymicrobial infections with antimicrobial-resistance may add to the burden of clinical care and patients' clinical prognosis.

AIM: to examine the impact of CRE co-infection with other multi-drug resistant organisms (MDRO) on patient clinical outcomes.

STUDY DESIGN: A retrospective observational study was conducted to compare the clinical outcomes of CRE patients who were co-infected with carbapenem-resistant

RESULTS: A total of 224 CRPA and 209 MDRA co-infections with CRE were identified from 4,236 cases from 2015-2020. The overall 90-day all-cause mortality was 21.6% but increased to 35.0% and 33.5% …

Adverse Drug Events Related To Common Asthma Medications In Us Hospitalized Children, 2000-2016, Luyu Xie, Andrew Gelfand, Matthew S Mathew, Folefac D Atem, Nimisha Srikanth, George L Delclos, Sarah E Messiah

Faculty, Staff and Student Publications

BACKGROUND: The reduction in adverse drug events is a priority in healthcare. Medications are frequently prescribed for asthmatic children, but epidemiological trends of adverse drug events related to anti-asthmatic medications have not been described in hospitalized children.

OBJECTIVE: The objective of this study was to report incidence trends, risk factors, and healthcare utilization of adverse drug events related to anti-asthmatic medications by major drug classes in hospitalized children in the USA from 2000 to 2016.

METHODS: A population-based temporal analysis included those aged 0-20 years who were hospitalized with asthma from the 2000 to 2016 Kids Inpatient Database. Age-stratified weighted …