Public Health Commons^™

An Analysis Of Covid-19 Stimulus Checks On Food Scarcity During Pre-Covid And Post-Covid Conditions In The United States, Edward Ning '23

External Student Research Opportunities

COVID-19 has impacted the economy on a global scale through the loss of employment and rapid decline of public health conditions, primarily with the financially vulnerable population. One aspect that has been affected by the pandemic has been food scarcity and the isolation of individuals from grocery stores and other establishments. One proposed solution has been stimulus checks from the
United States Government that were projected to provide financial relief to be used for living expenses, food, education, healthcare treatments, or other personal matters. This study aims to analyze the impact of the stimulus checks on food scarcity in the …

Global Think Tank On The Clinical Considerations And Management Of Lipoprotein(A): The Top Questions And Answers Regarding What Clinicians Need To Know, Salim S. Virani, Marlys L. Koschinsky, Lisa Maher, Anurag Mehta, Carl E. Orringer, Raul D. Santos, Michael D. Shapiro, Joseph J. Saseen

Office of the Provost

Evidence from Mendelian randomization studies suggest that lipoprotein(a) (Lp(a)) has a causal role in the development of atherosclerotic cardiovascular disease risk. However, guidelines and consensus statement recommendations vary regarding how clinicians should incorporate Lp(a) into patient care. To provide practical answers to key questions pertaining to Lp(a) that clinicians will find useful when assessing and treating patients, a global think tank was convened. Representatives from seven national and international stakeholder organizations answered questions that were focused on: Lp(a) measurement; ethnic, gender, and age considerations; factoring Lp(a) into risk assessment; and current and emerging treatment options for elevated Lp(a). This manuscript …

Health Concerns Of Kentucky's Library Workforce During The Early Covid-19 Pandemic., Anita R. Hall, Brandi Duggins

Faculty and Staff Scholarship

Although research early in the pandemic primarily emphasized libraries’ pandemic response and service to patrons, more interest has developed regarding library workers and their experiences. This study seeks to understand the impacts library workers experienced from the beginning of institutions’ initial pandemic response through the end of 2020. This article focuses on a subset of the data related to the health concerns and impacts Kentucky library workers experienced during distinct phases of the early pandemic. Responses to this survey indicate that workers required to be onsite were impacted more frequently with COVID-related health concerns while all library workers experienced significant …

“The Worst Part About My Pregnancy Was Stuff That Didn’T Have To Do With My Pregnancy”: Medicaid Beneficiaries’ Pregnancy Intentions & Experiences In South Carolina, Andrew Michael Chen

Senior Theses

Low-income women and women of color experience adverse birth outcomes at disproportionately higher rates in the United States than most people who give birth. This thesis examines individual interviews conducted with 30 low-income women whose most recent birth was covered by Medicaid, the United States’ largest means-tested public health insurance program. The aim of this thesis is to examine how the women in the study thought about pregnancy, and how they described their intentions to become or avoid becoming pregnant at various times in their life. While public health researchers often frame pregnancy as an event that is either intended …

A Comparison Of American Women's Experiences With Both Gestational Surrogate Pregnancies And Spontaneous Pregnancies, Jennifer Lahl, Kallie Fell, Kate Bassett, Frances H. Broghammer, William M. Briggs

Dignity: A Journal of Analysis of Exploitation and Violence

This article evaluates the pregnancy experiences of American women by comparing their spontaneous or non-surrogate pregnancies with their gestational surrogate pregnancies. Data were collected through structured interviews using an online video platform. In total, 96 interviews were conducted. Data revealed that a woman was more likely to have a pregnancy that was high-risk during a surrogate pregnancy than during a non-surrogate pregnancy, independent of maternal age or gravidity (OR 11.4, 3.5-36.6; p<.0001). A surrogate pregnancy had three times higher odds of resulting in a cesarean section (p<.0001) and was five times more likely to deliver at an earlier gestational age (p<.0001). Women in this study were significantly more likely to experience postpartum depression following the delivery of surrogate children than after delivering their non-surrogate children (p=.01), and overall, they were more likely to have adverse outcomes during a surrogate pregnancy. The rate of new post-surrogacy chronic health issues for women of color was significantly higher than for women identified as white (p<.0001). We found that women’s economic disadvantage was a major contributor to the decision to proceed with surrogacy. This study confirms that health disparities exist for women with surrogate pregnancies compared to non-surrogate pregnancies, which can lead to long-term complications after a surrogate pregnancy. In terms of biomedical ethics, it raises important social, economic, and political issues related to surrogacy, all requiring further exploration. Future research will build on the present work in further helping us to understand the circumstances and consequences involved for women in surrogacy.

Heart Transplant Recipient 1-Year Outcomes During The Covid-19 Pandemic, Gabriel Esmailian, Nikhil Patel, Jignesh K Patel, Lawrence Czer, Matthew Rafiei, Dominick Megna, Dominic Emerson, Danny Ramzy, Alfredo Trento, Joanna Chikwe, Fardad Esmailian, Jon A Kobashigawa

Faculty, Staff and Student Publications

The COVID-19 pandemic initially brought forth considerable challenges to the field of heart transplantation. To prevent the spread of the virus and protect immunocompromised recipients, our center made the following modifications to post-transplant outpatient management: eliminating early coronary angiograms, video visits for postoperative months 7, 9, and 11, and home blood draws for immunosuppression adjustments. To assess if these changes have impacted patient outcomes, the current study examines 1-year outcomes for patients transplanted during the pandemic. Between March and September 2020, we assessed 50 heart transplant patients transplanted during the pandemic. These patients were compared to patients who were transplanted …

Increased Rates Of Death From Unintentional Injury Among Non-Hispanic White, American Indian/Alaska Native, And Non-Metropolitan Communities, Lindsey R. Hammerslag, Jeffery Talbert, Tyrone F. Borders

Rural & Underserved Health Research Center Publications

Overview of Key Findings

• Living in a nonmetropolitan area is associated with an increase in the age-adjusted death rate from unintentional injuries, from 46.2 in metropolitan areas to 59.2 in nonmetropolitan areas in 2018, with all races/ethnicity groups affected except for non-Hispanic Black.
• The ratio of unintentional injury deaths in nonmetropolitan areas, compared to metropolitan areas, was 1.28 overall, ranging from 1.05 to 1.56 depending on race and ethnicity.
• American Indians and Alaska Natives have the highest rate of living in nonmetropolitan areas (39.5%), and this group has the greatest increase in death from unintentional injury associated with living in …

Differences In Hiv, Sti And Other Risk Factors Among Younger And Older Male Sex Workers Who Have Sex With Men In Nairobi, Kenya, Nicholas Muraguri, Jerry Okoth Okal, Marleen Temmerman, Helgar Musyoki, Peter Gichangi

Obstetrics and Gynaecology, East Africa

Introduction: Previous surveys of male sex workers (MSW) in sub-Saharan Africa have not fully documented the HIV and sexually transmitted infections (STIs) rates and vulnerabilities by age category.

Methods: The bio-behavioral survey of MSW in Nairobi, Kenya, utilized respondent-driven sampling to recruit MSW. Structured interviews captured MSW's behavioral aspects, and biological tests for HIV and other STIs.

Results: Analysis of the two age categories, 18–24 years (younger MSW) and 25 years and above (older MSW), shows that of all participants, a significantly higher proportion of younger MSW (59.6% crude, 69.6% RDS-adjusted) were recruited compared to older MSW …

A Patient Risk Minimization Model For Post-Disaster Medical Delivery Using Unmanned Aircraft Systems, Mark J. Simpson

Doctoral Dissertations and Master's Theses

The purpose of this research was to develop a novel routing model for delivery of medical supplies using unmanned aircraft systems, improving existing vehicle routing models by using patient risk as the primary minimization variable.

The vehicle routing problem is a subset of operational research that utilizes mathematical models to identify the most efficient route between sets of points. Routing studies using unmanned aircraft systems frequently minimize time, distance, or cost as the primary objective and are powerful decision-making tools for routine delivery operations. However, the fields of emergency triage and disaster response are focused on identifying patient injury severity …

Advocacy Spotlight: Are You An Advocate?, Vincent Benivegna Dds

The Journal of the Michigan Dental Association

Advocacy is crucial for dentists in Michigan, as they face a unique opportunity to impact Medicaid dental benefits positively. Governor Gretchen Whitmer's budget proposal for 2023 includes a substantial $240 million investment to revamp dental Medicaid benefits, a historic move for the state. The Michigan Dental Association (MDA) has actively engaged with government offices and legislators to ensure this opportunity is not missed. However, despite the MDA's efforts to mobilize members through action alerts, response rates have disappointed. The article emphasizes the importance of consistent advocacy, as it has the power to influence dental practices and the well-being of patients …

J Mich Dent Assoc July 2022

The Journal of the Michigan Dental Association

Monthly, The Journal of the Michigan Dental Association brings news, information, and feature articles to our state's oral health community and the MDA's 6,200+ members. No publication reaches more Michigan dentists! In this July 2022 issue, the reader will find the following original content:

• A cover feature on negotiating reimbursement rates with PPO contracts.
• A cover feature on guarding against employee embezzlement.
• A 10-Minute EBD on rampant caries management and prevention with ADHD patients taking stimulant medications.
• A Back Page look at the 2022 MDA award winners.
• News you need: an Editorial, guidance on dental practice cybersecurity, and regular department …

Evaluating The Extent Of Fall Prevention Knowledge Of Direct Care Clinicians In A Post-Acute Hospital Setting: A Quality Improvement Initiative, Joseph Henry Mitchell Jr

Doctor of Nursing Practice Projects

Background: Events, such as falls, continue to maintain permanence in countless public health settings and organizations, attributing to unnecessary resource utilization. Proven methods for mitigating fall occurrences transpire through reliable fall education and by creating programs that directly impact these incidents. These agendas are essential and can lessen undue stress, obligations, and associated fiscal liability.

Purpose: This DNP project aimed to ascertain and expand unit nurses' fall prevention strategy knowledge in a long-term acute care hospital, bringing awareness of evidence-based practices through a learning addendum.

Methods: This program, based on a descriptive, quasi-experimental, pre-, and post-analysis, strategically …

Implementation And Evaluation Of A Syphilis Screening Tool To Increase Patient Testing For Syphilis Among Adults 18 Years And Older In A Rural Primary Care Clinic, Valeria S. Wiggins

Doctor of Nursing Practice Projects

Background: Sexually transmitted infections (STIs) are an increasing epidemic in the United States (U.S.) that need immediate interventions to reverse the effects of syphilis on the sexual health of adults in rural populations. Many are unaware of the growing rate of syphilis and the overall impact it causes nationally. When syphilis is detected early, it can be easily treated and cured. Rural primary care providers are ideal candidates for implementing education, screening, testing, and treatment.

Purpose: The Doctor of Nursing Practice (DNP) project aims to increase the frequency of screening patients in rural primary care clinics for high-risk sexual behaviors. …

Project Ankle-Brachial Index: Implementation Of An Evidence-Based Peripheral Artery Disease Protocol, Melaney Banks

Doctor of Nursing Practice Projects

Background: Peripheral artery disease (PAD) is a narrowing or blocking of the arteries due to plaque buildup, which prevents oxygen, blood, and other nutrients from getting to the legs. When this buildup reaches a certain point, it becomes atherosclerosis, which is more prevalent in a smoker. Smoking intensifies the problem of plaque buildup if an individual already suffers from PAD. When an individual smokes, the nicotine causes the arteries to constrict and narrow, reducing blood flow further. The ankle-brachial index (ABI) is a simple, cost-effective diagnostic test to identify the presence of PAD which will improve patient outcomes.

Purpose: This …

Association Between Postpartum Weight Retention And The Dietary Inflammatory Index, Nyrobi Tyson

Theses and Dissertations

Objective: The objective of this thesis is to examine the relationship between the Dietary Inflammatory Index (DII), measured during the postpartum period, and postpartum weight retention.

Setting and Participants: We used the Infant Feeding Practices Study (IFPS) II (n=5000), a longitudinal study of women from late pregnancy through their infant’s first year of life conducted between 2005 and 2007. Survey topics included feeding practices, infant health, food allergies, sleeping arrangements, mother’s employment, childcare, and mother’s dietary intake.

Main Outcomes: Postpartum weight retention (PPWR) was calculated in kilograms by subtracting self-reported body weight at 3, 6, 9, and 12 months postpartum …

Clinical Experience During The Covid-19 Pandemic: Student Nurses Perspectives, Vinita Rosa Monis, Aksa Rajan David, Radhika R. R Pai, Linu Sara George

Manipal Journal of Nursing and Health Sciences

Covid 19 pandemic spread in India has affected the teaching-learning aspects of academics. (Raja & Lakshmi Priya, 2022) 290 million students out of school due to COVID-19: UNESCO releases first global numbers and mobilizes response. (UNESCO, 2020) All educational institutions in the country were immediately shut down and all students were sent back to their respective homes as soon as the rise in covid 19 cases was detected (Mid-March 2020). (Tarkar, 2020) BSc Nursing program in India has compulsory requirements for completion of practical requirements before the course completion. (Nursing Council) Clinical postings were withheld during the peak of the …

The Paradoxical Effects Of Covid-19 Event Strength On Employee Turnover Intention, Hui Deng, Wenbing Wu, Yihua Zhang, Xiaoyan Zhang, Jing Ni

All Faculty Open Access Publications

As a global pandemic, the novel coronavirus (COVID-19) has brought enormous challenges to employees and organizations. Although numerous existing studies have highlighted that the COVID-19 pandemic is a stressful event and empirically proved its detrimental effect on employee turnover intention, few scholars have noted that this pandemic can deteriorate the external economic and employment environment simultaneously, which may further complicate employees’ intentions to leave or stay in the current organization. Drawing on event system theory and social cognitive theory, this study aims to uncover two potential cognitive mechanisms of the complex impact of COVID-19 event strength on employee turnover intention. …

Improving Cancer Care Through Digital Health Coaching, Jennifer Nguyen, Pharmd, Vittorio Maio, Pharmd, Ms, Msph, Nathan Handley, Md, Mba

College of Population Health Faculty Papers

No abstract provided.

Does Public Health Start Within Jails? A New Incentive For Reform Of Wisconsin's Bail System, Mahmood N. Abdellatif

Marquette Law Review

Wisconsin’s Milwaukee and Dane Counties are among many jurisdictions in the country employing modern bail reforms, specifically the Public Safety Assessment (PSA). Most of these jurisdictions adopted the PSA before the advent of the COVID-19 pandemic in the United States, but are increasingly relevant as the virus continues to derail public health measures. Through the intersection of detainees, correctional officers, judicial officials, attorneys, and visitors, millions of Americans filter in and out of correctional facilities on an annual basis. These facilities serve as a microcosm of society and breeding ground for mass infection. The COVID-19 pandemic amplified an existing need …

Examining Disparities In The Early Adoption Of Covid-19 Personal Mitigation Across Family Structures, Casey Harris, Kevin Fitzpatrick, Michael Nino, Priya Thelapurath, Grant Drawve

Sociology and Criminology Faculty Publications and Presentations

The United States' response to the COVID-19 pandemic has relied heavily on personal mitigation behaviors versus centralized governmental prevention strategies, especially early in the virus's outbreak. This study examines how family structure shapes mitigation, focusing on the intersectional effects of gender, marital status, and the presence of children while accounting for differences in worry about infection from the virus. Using data from a national survey of 10,368 United States adults early in the pandemic (March 2020), survey-weighted logistic regression models show important differences in the likelihood of personal mitigation adoption across family structures. Unmarried women with children were most likely …

Precision Dentistry In Practice, Diana V. Macri

Publications and Research

A paradigm shift is necessary to improve healthcare delivery and outcomes. Precision medicine and precision dentistry may be able to shift the burden of disease and improve the nation’s oral and overall health.

Health Inequities As Measured By The Eq-5d-5l During Covid-19: Results From New York In Healthy And Diseased Persons, Erica I. Lubetkin, Di Long, Juanita A. Haagsma, Mathieu F. Janssen, Gouke J. Bonsel

Publications and Research

Introduction: The effects of the COVID-19 pandemic caused considerable psychological and physical effects in healthy and diseased New Yorkers aside from the effects in those who were infected. We investigated the relationship between known risk-enhancing and health-promoting factors (social and medical), comorbidity indicators, and, as the primary outcome, health-related quality of life (HRQoL).

Methods: Between April 22 and May 5, 2020, a market research agency (Dynata) administered a digital survey including the EQ-5D-5L and items related to individual characteristics, social position, occupational and insurance status, living situation, exposures (smoking and COVID-19), detailed chronic conditions, and experienced access to care to …

Sepsis: Do The Clinical Criteria Support The Medical Coding?, April M. Insco

Theses and Dissertations (ETD)

Background: Sepsis is a condition that can be very costly and very deadly. Diagnosing sepsis can be challenging as there is not one specific test that will identify whether a patient has sepsis and there are varying opinions as to the true definition of sepsis. The definition of sepsis used for this research is a combination of System Inflammatory Response Syndrome (SIRS) with an identified infection. Medical Coders must review the documentation provided in a medical record to accurately assign an ICD-10-CM code. Administrative data is then used to provide statistical information for research purposes. When coded data is not …

Rural-Urban Differences In Survival Among People With Early Onset Colorectal Cancer, Radhika Ranganathan

Theses and Dissertations

Colorectal cancer (CRC) is the third most common cancer and the second most among cancer deaths both in the US and globally. Early Onset Colorectal Cancer (EOCRC), occurring between the ages of 20 and 49, has continued to rise over the past decades. Several studies have reported a persistent increase in EOCRC incidence and mortality, especially in rural areas as compared to urban areas, despite decreases in rates for people over the age of 50 years. Increase in EOCRC may have played a role in lowering the age of screening recommendation to 45-49 age group. The objective of this study …

Hiv-Related Stigma, Sexual And Gender Minority-Related Stigma, And Health Outcomes Among Msm Living With Hiv: Measurement, Impact, And Intersectionality, Tianyue Mi

Theses and Dissertations

Background: Many men who have sex with men (MSM) living with human immunodeficiency virus (HIV) experience suboptimal health outcomes compared to nonMSM males living with HIV, including a faster decline in CD4 count before initiating antiretroviral therapy (ART), slower immune recovery after initiating ART, more mental health problems, suboptimal ART adherence, and lower retention in care. MSM living with HIV are often exposed to multiple layered stigmas, including, but not limited to, stigma related to being infected with HIV and stigma related to sexual and gender minority (SGM) status. Although various scales of HIV-related stigma have been frequently used for …

Prevalence And Clustering Of Congenital Heart Defects Among Boys With Hypospadias, Melissa A Richard, Jenil Patel, Renata H Benjamin, Emine Bircan, Stephen J Canon, Lisa K Marengo, Mark A Canfield, A J Agopian, Philip J Lupo, Wendy N Nembhard

Faculty, Staff and Student Publications

IMPORTANCE: Hypospadias is a common birth defect of the male urinary tract that may be isolated or may co-occur with other structural malformations, including congenital heart defects (CHDs). The risk for co-occurring CHDs among boys with hypospadias remains unknown, which limits screening and genetic testing strategies.

OBJECTIVE: to characterize the risk of major CHDs among boys born with hypospadias.

DESIGN, SETTING, AND PARTICIPANTS: This retrospective cohort study used data from population-based birth defect surveillance programs on all male infants born in 11 US states from January 1, 1995, to December 31, 2014. Statistical analysis was performed from September 2, 2020, …

Potential Impact Of Revised Nci Eligibility Criteria Guidance: Prior Malignancy Exclusion In Breast Cancer Clinical Trials, Matthew Perez, Caitlin C Murphy, Sandi L Pruitt, Sawsan Rashdan, Asal Rahimi, David E Gerber

Faculty, Staff and Student Publications

BACKGROUND: Many individuals with cancer have survived a prior cancer and for this reason may have been excluded from clinical trials. Recent NCI guidance recommends including these individuals, especially when the risk of the prior malignancy interfering with either safety or efficacy endpoints is very low. Using breast cancer as an example, we determined the potential effect this policy change may have on clinical trial accrual.

PATIENTS AND METHODS: We reviewed protocols of NCI-sponsored breast cancer clinical trials activated in 1991 through 2016. We quantified prevalence of prior cancer-related exclusion criteria and assessed the association with trial characteristics using Fisher's …

Cas9/Nickase-Induced Allelic Conversion By Homologous Chromosome-Templated Repair In Drosophila Somatic Cells, Sitara Roy, Sara Sanz Juste, Marketta Sneider, Ankush Auradkar, Carissa Klanseck, Zhiqian Li, Alison Henrique Ferreira Julio, Victor Lopez Del Amo, Ethan Bier, Annabel Guichard

Faculty, Staff and Student Publications

Repair of double-strand breaks (DSBs) in somatic cells is primarily accomplished by error-prone nonhomologous end joining and less frequently by precise homology-directed repair preferentially using the sister chromatid as a template. Here, a

Vaccine Hesitancy And Betrayal Aversion, Abdelaziz Alsharawy, Esha Dwibedi, Jason Aimone, Sheryl Ball

Faculty, Staff and Student Publications

The determinants of vaccine hesitancy remain complex and context specific. Betrayal aversion occurs when an individual is hesitant to risk being betrayed in an environment involving trust. In this pre-registered vignette experiment, we show that betrayal aversion is not captured by current vaccine hesitancy measures despite representing a significant source of unwillingness to be vaccinated. Our survey instrument was administered to 888 United States residents via Amazon Mechanical Turk in March 2021. We find that over a third of participants have betrayal averse preferences, resulting in an 8-26% decline in vaccine acceptance, depending on the betrayal source. Interestingly, attributing betrayal …

Covid-Associated Avascular Necrosis Of The Maxilla-A Rare, New Side Effect Of Covid-19, Victoria A Mañón, Steven Balandran, Simon Young, Mark Wong, James C Melville

Faculty, Staff and Student Publications

Purpose: The purpose of this article is to present an interesting, rare case of a patient who experienced avascular necrosis of the maxilla associated with COVID-19 infection.

Methods and results: Our team retrospectively evaluated this patient's chart after completion of surgical management. The patient is a 72-year-old male who presented to the University of Texas Health Science Center at Houston for surgical management of his infarcted maxilla, which developed as a sequela of infection with COVID-19. A literature review was completed using PubMed. Twenty-five articles are reviewed and discussed.

Conclusions: Infection with COVID-19 confers a hypercoagulable state in patients, leading …