Public Health Commons^™

Latent Tb Treatment Regimens In 2023: Wetmore Tb Clinic In New Orleans, Amy Wolfe, Priyanka Jadhav, Amber May, Shandrica Seymour, Angela Blanchard, Juzar Ali

School of Medicine Faculty Publications

The USPSTF has updated Latent TB Infection (LTBI) screening and treatment recommendations in 2023; describing treatment courses, side effects and benefits associated with each regimen. Overall, rifampin-containing shortened regimens are the preferred modality for LTBI treatment. A recent study in 2023 evaluated adherence and tolerance of the isoniazid(INH) + rifapentine(RPT), or “3HP” regimen and identified patient groups that may be at higher risk for non-completion of this regimen. It emphasized the need for targeted education at the beginning of treatment, to avoid early discontinuation. Our experience in New Orleans demonstrated that the 3HP is well-tolerated, with higher completion rates than …

Implementation Of Psychiatric Collaborative Care Management In Rural Primary Care Practices, Ryan Dean Kruis

MUSC Theses and Dissertations

Behavioral health (BH) disorders are highly prevalent in the United States and especially concerning in rural communities which disproportionately lack access to BH services. While models for integrating BH into primary care, such as psychiatric collaborative care management (CoCM), have shown promise in mitigating the BH crisis, implementation in rural communities has proved challenging.
This dissertation examines implementation of CoCM nationally and in rural settings through three distinct aims. First, a claims-based retrospective cohort study was used to determine whether commercially insured patients receiving CoCM had lower acute BH care utilization and cost as compared to similar patients not receiving …

Dismantling Barriers To Hepatitis B And Delta Screening, Prevention, And Linkage To Care Among The Pwud Community In Philadelphia, Beatrice Zovich, Catherine Freeland, Holly Moore, Kara Sapp, Anousha Qureshi, Rachel Holbert, Jason Zambrano, Daljinder Bhangoo, Chari Cohen, Richard W. Hass, Amy Jessop

College of Population Health Faculty Papers

The prevalence of hepatitis B and delta viruses (HBV/HDV) among people who use drugs (PWUD) remains largely unknown. In the context of one Philadelphia-based harm reduction organization (HRO), this study aimed to assess HBV/HDV prevalence and facilitate linkage to care. Participants completed a demographic HBV/HDV risk factor survey and were screened for HBV and reflexively for HDV if positive for HBV surface antigen or isolated core antibody. Fisher's exact tests and regression were used to understand relationships between risks and HBV blood markers. Of the 498 participants, 126 (25.3%) did not have hepatitis B immunity, 52.6% had been vaccinated against …

A Population Health Approach To Workplace Mental Health: Rationale, Implementation And Engagement, Kaylee T. Woodard, Allison M. Bailey, Aaron I. Esagoff, Maren S. Fragala, Joanna I. Hayward, Jennifer L. Hunter, Yea Jen Hsu, Paul M. Kim, Matthew E. Peters, Susan M. Carr

School of Medicine Faculty Publications

Objectives: To describe a population health-based program to support employee and dependent mental health and learn from engagement trends. Methods: Retrospective analysis of a program utilizing an assessment of mental health risk. For scoring “at risk,” a Care Concierge is offered to connect users with resources. Results: Participation was offered to 56,442 employees and dependents. Eight thousand seven hundred thirty-one completed the assessment (15%). Of those, 4,644 (53%) scored moderate or higher. A total of 418 (9%) engaged the Care Concierge. Factors that negatively influenced the decision to engage care included bodily pain, financial concerns. Positive influences were younger age, …

The King Hygiene Project: Addressing Hygiene Poverty In College Students, Krislynn King

Honors Projects

For my Honors Project, I seek to shine a light on the topic of hygiene insecurity and investigate how it impacts the modern-day college student. In addition, I have taken physical action through a hygiene drive, marketing, and volunteering to better the lives of those who struggle with this issue regardless of whether they are a student at Bowling Green State University.

Somatic Mutations Of Esophageal Adenocarcinoma: A Comparison Between Black And White Patients, Hyeyeun Lim, Marie-Claude Gingras, Jing Zhao, Jinyoung Byun, Patricia D Castro, Spiridon Tsavachidis, Jianhong Hu, Harshavardhan Doddapaneni, Yi Han, Donna M Muzny, Richard A Gibbs, Christopher I Amos, Aaron P Thrift

Faculty, Staff and Students Publications

Esophageal adenocarcinoma is the most common histological subtype of esophageal cancer in Western countries and shows poor prognosis with rapid growth. EAC is characterized by a strong male predominance and racial disparity. EAC is up to fivefold more common among Whites than Blacks, yet Black patients with EAC have poorer survival rates. The racial disparity remains largely unknown, and there is limited knowledge of mutations in EAC regarding racial disparities. We used whole-exome sequencing to show somatic mutation profiles derived from tumor samples from 18 EAC male patients. We identified three molecular subgroups based on the pre-defined esophageal cancer-specific mutational …

Protocols For Postpartum Hemorrhage, Nicole A. Mitchell, Wilbur Greene, Samantha Claxton, Lydia Lester

Student Scholar Showcase

The purpose of this study was to examine the relationship between the protocols for postpartum hemorrhage and lack of implementation, how race may play a role in care, the different effect on maternal lives; physically and mentally, and more effective treatment options. Many women all over the world struggle with postpartum hemorrhaging as it is a life-threatening complication that can follow giving birth. There are standard protocols set in place for different facilities that relay how the healthcare professionals should act in that situation. The PICOT question, “In child-bearing women, how do protocols for postpartum hemorrhage compared with a lack …

Evidenced-Based Strategies To Increase Cervical Cancer Screening Rates, Tuong Cat Vo Bsn-Rn, Nada Salloukh Bsn-Rn, Tatiana Elena Swanson Bsn-Rn, Xiao Mie Cindy Zhu Bsn-Rn, Laura Taylor Reed Dnp, Aprn, Fnp-Bc

Doctor of Nursing Practice Projects

Purpose/Background

Cervical cancer is the fourth leading cause of cancer affecting women worldwide (Staley et al., 2021). With cervical cancer being a preventable disease, an effective method of reducing healthcare costs and mortality is primary prevention, such as screenings. Financial burdens and barriers to accessing medical care may result due to the lack of proper cervical cancer screenings. Detecting cervical cancer includes screening women 21 to 65 years old with a Papanicolaou (PAP) test every three years. Women aged 30 to 65 years old can extend the screening of cervical cancer by having a Human Papillomavirus (HPV) test along with …

Preparatory Program For Women During Pregnancy/Postpartum And Transitioning Back To Work Or School, Bria Runnels, Rebecca King

Spring 2024 Virtual OTD Capstone Symposium

Despite the importance of maternal health during the prenatal, postnatal, and parenting stages, there is a lack of research on the role of occupational therapists (OTs) in addressing the occupational challenges faced by women during this transitional phase. This dissertation aims to develop a program that raises awareness of the role of occupational therapy in maternal health and promotes occupational therapists as part of an interdisciplinary team within the scope of maternal health care. By adapting co-occupation for mothers, occupational therapists can play an important role in individualizing occupations for enhanced transitioning and overall quality of life. The study highlights …

Old Dog, New Tricks? Applying The Causal Hazard Chain Model To Burn Prevention And Injuries, Randy D. Kearns, Jeffrey E. Carter, Ernest Grant, W.L. Hickerson

School of Medicine Faculty Publications

56th Annual Meeting of the American Burn Association, 2024; April 9 - April 12, 2024; Chicago, IL

Exploring The Experience Of Healthcare-Related Epistemic Injustice Among People With Myalgic Encephalomyelitis / Chronic Fatigue Syndrome, Joanne Hunt, Jessica Runacres, Daniel Herron, David Sheffield

The Qualitative Report

Myalgic encephalomyelitis / chronic fatigue syndrome (ME/CFS) is a chronic, disabling yet clinically “contested” condition, previously theorised through a lens of epistemic injustice. Phenomena conceptually close to epistemic injustice, including stigma, are known to have deleterious consequences on a person’s health and life-world. Yet, no known primary studies have explored how people with ME/CFS experience healthcare through a lens of epistemic injustice, whilst a dearth of research explicitly exploring healthcare-related injustice from a patient perspective has been noted. This qualitative study seeks to address this gap. Semi-structured interviews and interpretative phenomenological analysis (IPA) were used to explore the experiences of …

Eye Infection Risks From Pseudomonas Aeruginosa Via Hand Soap And Eye Drops, Anna Gitter, Kristina D Mena, Karla S Mendez, Fuqing Wu, Charles P Gerba

Faculty, Staff and Student Publications

Eye infections from bacterial contamination of bulk-refillable liquid soap dispensers and artificial tear eye drops continue to occur, resulting in adverse health outcomes that include impaired vision or eye enucleation. Pseudomonas aeruginosa (P. aeruginosa), a common cause of eye infections, can grow in eye drop containers and refillable soap dispensers to high numbers. To assess the risk of eye infection, a quantitative microbial risk assessment for P. aeruginosa was conducted to predict the probability of an eye infection for two potential exposure scenarios: (i) individuals using bacteria-contaminated eye drops and (ii) contact lens wearers washing their hands with …

Gut Symbionts Alleviate Mash Through A Secondary Bile Acid Biosynthetic Pathway, Qixing Nie, Xi Luo, Kai Wang, Yong Ding, Shumi Jia, Qixiang Zhao, Meng Li, Jinxin Zhang, Yingying Zhuo, Jun Lin, Chenghao Guo, Zhiwei Zhang, Huiying Liu, Guangyi Zeng, Jie You, Lulu Sun, Hua Lu, Ming Ma, Yanxing Jia, Ming-Hua Zheng, Yanli Pang, Jie Qiao, Changtao Jiang

Faculty, Staff and Student Publications

The gut microbiota has been found to play an important role in the progression of metabolic dysfunction-associated steatohepatitis (MASH), but the mechanisms have not been established. Here, by developing a click-chemistry-based enrichment strategy, we identified several microbial-derived bile acids, including the previously uncharacterized 3-succinylated cholic acid (3-sucCA), which is negatively correlated with liver damage in patients with liver-tissue-biopsy-proven metabolic dysfunction-associated fatty liver disease (MAFLD). By screening human bacterial isolates, we identified Bacteroides uniformis strains as effective producers of 3-sucCA both in vitro and in vivo. By activity-based protein purification and identification, we identified an enzyme annotated as β-lactamase in B. …

Reducing Sexually Transmitted Infection In African American Teenage Adolescents: Developing A Culturally Competent Health Program For Underserved Communities, Brandolyn I. Burks

Doctoral Dissertations and Projects

Proper education and programming can help reduce Sexually transmitted infections (STIs) among adolescents. This research aimed to help lay the framework for determining ways to ensure African American young adult adolescents aged 18–19 years have the necessary information and resources to make healthy decisions regarding their sex lives and experiences. The purpose of this grounded theory study was to understand what lived experiences and gaps of knowledge contribute to the contracting of STIs to develop a culturally competent health program to reduce the high rate of infections among African American 18–19-year-old adolescents living in underserved communities. The theory guiding this …

Uterine Adenosarcoma Presenting As Uterine Inversion: A Case Study, Caitlin Witt, Chelsey Vranes, Leslie H. Clark

School of Medicine Faculty Publications

No abstract provided.

Lai Antipsychotics Vs. Oral Antipsychotics: Treatment Adherence, Relapses, And Readmissions, Natalie N. Lewis Bsn, Rn, Mallory F. Johnson Bsn, Rn-Bc, Tyler N. Halle-Todd Bsn, Rn, Natalie N. Ragland Bsn, Rn, Sharon H. Little Dnp, Aprn, Fnp-Bc, Jacqueline Sharp Dnp, Aprn,Pmhnp-Bc

Doctor of Nursing Practice Projects

Purpose/Background

Schizophrenia is a lifelong illness with recurrent and often debilitating symptoms that may impair daily functioning, cognition, behaviors, socialization, emotions, and expression. It is recognized as a global mental health burden that affects the individual, their family, and society. Medication nonadherence and resulting relapse detrimentally affect the patient’s physical and mental health and quality of life. They are associated with increased hospitalization and emergency room visits, substance use, suicide, and homelessness. Current guidelines endorse second-generation antipsychotics such as Risperidone and Aripiprazole as the first-line treatment for most cases of psychosis. However, long-acting injectable (LAIs) atypical antipsychotics are a promising …

Identifying Multilevel Predictors Of Behavioral Outcomes Like Park Use: A Comparison Of Conditional And Marginal Modeling Approaches, Marilyn E. Wende, S. Morgan Hughey, Alexander C. Mclain, Shirelle Hallum, J. Aaron Hipp, Jasper Schipperijn, Ellen W. Stowe, Andrew T. Kaczynski Ph.D.

Faculty Publications

This study compared marginal and conditional modeling approaches for identifying individual, park and neighborhood park use predictors. Data were derived from the ParkIndex study, which occurred in 128 block groups in Brooklyn (New York), Seattle (Washington), Raleigh (North Carolina), and Greenville (South Carolina). Survey respondents (n = 320) indicated parks within one half-mile of their block group used within the past month. Parks (n = 263) were audited using the Community Park Audit Tool. Measures were collected at the individual (park visitation, physical activity, sociodemographic characteristics), park (distance, quality, size), and block group (park count, population density, age structure, racial …

Playing It Sun Safe: A Quality Improvement Project, Sarah P. Tarr, Kathryn K. Dambrino, R. David Phillippi, Ashley Karpinos

DNP Projects

Background: Athletes who play outdoor sports have multiple risk factors for the development of skin cancer. Literature highlights the need for the use of evidence-based strategies to improve the knowledge and utilization of sun protection practices in this high-risk population. Methods: Playing it Sun Safe was a multifaceted skin cancer prevention initiative implemented in a population of collegiate soccer athletes in collaboration with a university athletic department and campus health clinic. Evidence-based interventions were designed through application of the Health Belief Model (HBM) and were implemented using the Institute for Healthcare Improvement (IHI) quality improvement framework. Purpose: The two-fold aim …

Emerging Variants Develop Total Escape From Potent Monoclonal Antibodies Induced By Ba4/5 Infection, Chang Liu, Raksha Das, Aiste Dijokaite-Guraliuc, Daming Zhou, Alexander J Mentzer, Piyada Supasa, Muneeswaran Selvaraj, Helen M E Duyvesteyn, Thomas G Ritter, Nigel Temperton, Paul Klenerman, Susanna J Dunachie, Neil G Paterson, Mark A Williams, David R Hall, Elizabeth E Fry, Juthathip Mongkolsapaya, Jingshan Ren, David I Stuart, Gavin R Screaton

Faculty, Staff and Student Publications

The rapid evolution of SARS-CoV-2 is driven in part by a need to evade the antibody response in the face of high levels of immunity. Here, we isolate spike (S) binding monoclonal antibodies (mAbs) from vaccinees who suffered vaccine break-through infections with Omicron sub lineages BA.4 or BA.5. Twenty eight potent antibodies are isolated and characterised functionally, and in some cases structurally. Since the emergence of BA.4/5, SARS-CoV-2 has continued to accrue mutations in the S protein, to understand this we characterize neutralization of a large panel of variants and demonstrate a steady attrition of neutralization by the panel of …

Assessment Of Condylar Morphology In Various Facial Types-Cbct Study, Dr.Shruti Patil

Annual Research Symposium

Mandibular condyle being part of the TMJ complex, its volume and shape play a pivotal role in treatment stability and outcomes in orthodontic and orthognathic patients over long term periods. Different loading patterns would result in different morphology of the TMJ. The association with different facial types and understanding the relationship between condylar position, morphology and jaw base divergence is limited. This study’s objective is to assess the condylar structure which includes condylar height, width and height of the fossa in different jaw base divergences.

A cross-sectional study was conducted in which 90 patients undergoing Orthodontic treatment were selected and …

Adolescent Perceptions Of Weighted Blankets And Quality Of Sleep: A Mixed Method Design, Tara D. S. Summers

The Open Journal of Occupational Therapy

Background: The purpose of this mixed methods case study was to describe the perceived sleep quality experience of an adolescent, without a pre-identified sleep need, when they used a weighted blanket during sleep.

Method: Adolescents (n = 5) 11 to 16 years of age completed a sleep diary for 7 days, sleeping with a self-selected weighted blanket for at least 3 days. A semi-structured individual interview was held after Day 7.

Results: The majority of the participants would like to continue using a weighted blanket for sleep. Eighty percent of the adolescents choose to sleep with a …

Multi-Omics Analysis Reveals Immune Features Associated With Immunotherapy Benefit In Patients With Squamous Cell Lung Cancer From Phase Iii Lung-Map S1400i Trial, Edwin Roger Parra, Jiexin Zhang, Dzifa Yawa Duose, Edgar Gonzalez-Kozlova, Mary W Redman, Hong Chen, Ganiraju C Manyam, Gayatri Kumar, Jianhua Zhang, Xingzhi Song, Rossana Lazcano, Mario L Marques-Piubelli, Caddie Laberiano-Fernandez, Frank Rojas, Baili Zhang, Len Taing, Aashna Jhaveri, Jacob Geisberg, Jennifer Altreuter, Franziska Michor, James Provencher, Joyce Yu, Ethan Cerami, Radim Moravec, Kasthuri Kannan, Rajyalakshmi Luthra, Gheath Alatrash, Hsin-Hui Huang, Hui Xie, Manishkumar Patel, Kai Nie, Jocelyn Harris, Kimberly Argueta, James Lindsay, Roshni Biswas, Stephen Van Nostrand, Seunghee Kim-Schulze, Jhanelle E Gray, Roy S Herbst, Ignacio I Wistuba, Scott Gettinger, Karen Kelly, Lyudmila Bazhenova, Sacha Gnjatic, J Jack Lee, Jianjun Zhang, Cara Haymaker

Faculty, Staff and Student Publications

PURPOSE: Identifying molecular and immune features to guide immune checkpoint inhibitor (ICI)-based regimens remains an unmet clinical need.

EXPERIMENTAL DESIGN: Tissue and longitudinal blood specimens from phase III trial S1400I in patients with metastatic squamous non-small cell carcinoma (SqNSCLC) treated with nivolumab monotherapy (nivo) or nivolumab plus ipilimumab (nivo+ipi) were subjected to multi-omics analyses including multiplex immunofluorescence (mIF), nCounter PanCancer Immune Profiling Panel, whole-exome sequencing, and Olink.

RESULTS: Higher immune scores from immune gene expression profiling or immune cell infiltration by mIF were associated with response to ICIs and improved survival, except regulatory T cells, which were associated with worse …

Surgical Intervention For Diffuse Dermal Angiomatosis Of The Breast, Caroline E. Savoie, Bethany S. Acosta, Harley J. Davis, G. William Poche

School of Medicine Faculty Publications

No abstract provided.

Clearing The Air: Innovations In Imaging For Early Detection And Management Of Chronic Obstructive Pulmonary Disease, Francesca Polverino

Faculty, Staff and Students Publications

No abstract provided.

Proportion Of Cancer Cases And Deaths Attributable To Potentially Modifiable Risk Factors In Peru, Jhony A De La Cruz-Vargas, Willy Ramos, Willer Chanduví, Lucy E Correa-López, Nadia Guerrero, Joan Loayza-Castro, Irene Tami-Maury, Diego Venegas

Faculty, Staff and Student Publications

BACKGROUND: Limited evidence exists on the population attributable fraction (PAF) of cancer cases and deaths in Latin America. In Peru several studies have been published regarding the PAF of various risk factors and their associated diseases. The objective of this study was to estimate the fraction of cancer cases and deaths attributable to potentially modifiable risk factors in Peru in 2018, before the COVID-19 pandemic in the population of 15 years old and older.

METHODS: An ecological study was conducted using the prevalence of exposure of the Peruvian population to modifiable risk factors for cancer, the relative risk associated with …

Longitudinal Regression Of Covariance Matrix Outcomes, Yi Zhao, Brian S Caffo, Xi Luo

Faculty, Staff and Student Publications

In this study, a longitudinal regression model for covariance matrix outcomes is introduced. The proposal considers a multilevel generalized linear model for regressing covariance matrices on (time-varying) predictors. This model simultaneously identifies covariate-associated components from covariance matrices, estimates regression coefficients, and captures the within-subject variation in the covariance matrices. Optimal estimators are proposed for both low-dimensional and high-dimensional cases by maximizing the (approximated) hierarchical-likelihood function. These estimators are proved to be asymptotically consistent, where the proposed covariance matrix estimator is the most efficient under the low-dimensional case and achieves the uniformly minimum quadratic loss among all linear combinations of the …

Effects Of Family Dignity Interventions Combined With Standard Palliative Care On Family Adaptability, Cohesion, And Anticipatory Grief In Adult Advanced Cancer Survivors And Their Family Caregivers: A Randomized Controlled Trial, Nannan Wang, Kun Wang, Xinyu Lu, Shuyu Zhang, Xuhan Sun, Yuxi Zhang

Faculty, Staff and Student Publications

BACKGROUND: Family involvement and comfort are equally important in palliative care. Dignity undertook a new meaning and novel challenges as a result of restrictions on visits and companionship during the pandemic. Family-centered family dignity interventions have been shown to be effective in increasing patients' sense of dignity, increasing levels of hope, and reducing psychological distress; however, the effectiveness in enhancing family adaptability and intimacy in the survivor-caregiver binary and reducing expected grief have been inconclusive.

OBJECTIVES: The primary objective of this study was to assess the efficacy of family dignity interventions on family adaptability and cohesion. The secondary objective was …

Icariin Accelerates Bone Regeneration By Inducing Osteogenesis-Angiogenesis Coupling In Rats With Type 1 Diabetes Mellitus, Sheng Zheng, Guan-Yu Hu, Jun-Hua Li, Jia Zheng, Yi-Kai Li

Faculty, Staff and Student Publications

BACKGROUND: Icariin (ICA), a natural flavonoid compound monomer, has multiple pharmacological activities. However, its effect on bone defect in the context of type 1 diabetes mellitus (T1DM) has not yet been examined.

AIM: to explore the role and potential mechanism of ICA on bone defect in the context of T1DM.

METHODS: The effects of ICA on osteogenesis and angiogenesis were evaluated by alkaline phosphatase staining, alizarin red S staining, quantitative real-time polymerase chain reaction, Western blot, and immunofluorescence. Angiogenesis-related assays were conducted to investigate the relationship between osteogenesis and angiogenesis. A bone defect model was established in T1DM rats. The …

Relationship Between Knowledge, Years Of Licensure, And Attitudes Of Midwives About Female Genital Mutilation And Its Prevalence Among Their Patients In Bawku, Ghana, Frank Debrah

Walden Dissertations and Doctoral Studies

Female genital mutilation (FGM) is one of the hindrances to girls' development. FGM is often a rite of passage between childhood and adulthood. This cross-sectional study examined the relationship between the knowledge, years of licensure, and attitudes of midwives regarding FGM and the prevalence of FGM among their patients in Bawku, Ghana. Bronfenbrenner's social ecological model served as the theoretical framework to describe the link between midwives' knowledge, attitude, years of licensure, and FGM prevalence. The knowledge and attitude of midwives were classified as exosystem factors. Hence, their direct interaction with patients is likely to affect the patient's practice of …

Implementation Of A Standardized Suicide Screening Process In A University Student Health Clinic: A Quality Improvement Project, Addie Grace Strong, Kathryn Dambrino, R. David Phillippi, Linda Wofford

DNP Projects

Background: Suicide is a leading cause of death among college age students, prompting the need for evidence-based screening tools like the Columbia Suicide Severity Rating Scale (C-SSRS) to enable early detection and timely intervention. Inconsistencies in suicide screening may pose a risk of missed intervention opportunities. This Doctor of Nursing Practice project specifically aimed to improve the quality and consistency of suicide screening in a university student health clinic by implementing the C-SSRS tool into the clinic workflow during mental health appointments. Methods: Employing a quality improvement framework, this scholarly project followed the Institute for Healthcare Improvement Model for Improvement …