Public Health Commons^™

Understanding Adherence To Prescribed Medical Regimen To Treat Hypertension Among African American Males, Yolanda Lucian George

Walden Dissertations and Doctoral Studies

Hypertension is referred to as the silent killer and has been for decades. African Americans have been affected disproportionately compared to Whites, leading to a significant medical and financial burden. The literature has demonstrated that even though African Americans have a similar or better awareness of hypertension, they are more likely to have poorer treatment outcomes and have their hypertension less controlled. In this study, the health belief model and the ecological social model were used as the guiding framework to understand this phenomenon. In this qualitative study, semistructured interviews were used to explore and understand the perception of adherence …

Experiences Of Women In Sierra Leone Relating To Accessing Breast Cancer Treatment, Anne Neville, Magdeline Aagard Dr.

Journal of Sustainable Social Impact

The lack of consistent access to breast cancer care and treatment remains a significant problem for women diagnosed with breast cancer in Sierra Leone. The instability of the political structure has created an environment with a high level of illiteracy and financial hardship among the female population, resulting in a significant deficiency in information relating to symptoms and the detection of breast cancer. To study the lived experience of women living in Sierra Leone who were diagnosed with breast cancer, I [the first author] used a descriptive phenomenological approach. I conducted semi-structured interviews based on Andersen and Newman’s healthcare utilization …

Editorial: Reviews And Advances In The Molecular Mechanisms Of Breast Cancer, A. Redfern, V. Agarwal, Suresh Alahari

School of Medicine Faculty Publications

No abstract provided.

Birth Defect Trends Within Texas Public Health Region 11, 2000-2019: An Analysis Of Texas Department Of State Health Services Public Data., Miguel A. Lopez, Jonathan M. Hebert, Padmanabhan Rengasamy

Research Symposium

South Texas is a predominantly Hispanic region with high rates of chronic illness, poor healthcare access, and a history of birth defect clusters. Between 1986 and 1991, 47 cases of anencephaly in Cameron County were linked to elevated fumonisins in the region’s corn-based diet, prompting a series of ongoing public health efforts. This paper aims to identify changes in prevalence for CNS defects, in addition to cardiac, circulatory, gastrointestinal, and genitourinary defects in South Texas within the last two decades. Public data on 20 birth defects from the Texas Department of State Health Services were obtained for decades 2000-2010 and …

Nigerian Nurses' Perceptions Of Caring For Women With Female Genital Mutilation, Jane-Frances Echeozo

Walden Dissertations and Doctoral Studies

There are numerous health problems associated with female genital mutilation (FGM) practice. In Nigerian healthcare, professionals need to ensure culturally sensitive care for FGM cases. However, there was a literature gap involving culturally sensitive care for Nigerian women with FGM complications, evidenced by some northern Nigerian nurses who were not able to identify FGM categories or cultural given names associated with FGM types. Thus, this qualitative study involved ascertaining the worldview of Nigerian nurses and midwives in Owerri regarding providing culturally competent nursing care for FGM complications, guided by the process of cultural competence in the delivery of healthcare services …

Enhancing Prognostic Power In Multiple Myeloma Using A Plasma Cell Signature Derived From Single-Cell Rna Sequencing, Jian-Rong Li, Shahram Arsang-Jang, Yan Cheng, Fumou Sun, Anita D'Souza, Binod Dhakal, Parameswaran Hari, Quillan Huang, Paul Auer, Yong Li, Raul Urrutia, Fenghuang Zhan, John D Shaughnessy, Siegfried Janz, Jing Dong, Chao Cheng

Faculty, Staff and Students Publications

Multiple myeloma (MM) is a heterogenous plasma cell malignancy, for which the established prognostic models exhibit limitations in capturing the full spectrum of outcome variability. Leveraging single-cell RNA-sequencing data, we developed a novel plasma cell gene signature. We evaluated and validated the associations of the resulting plasma cell malignancy (PBM) score with disease state, progression and clinical outcomes using data from five independent myeloma studies consisting of 2115 samples (1978 MM, 65 monoclonal gammopathy of undetermined significance, 35 smoldering MM, and 37 healthy controls). Overall, a higher PBM score was significantly associated with a more advanced stage within the spectrum …

Liax Is A Surrogate Marker For Cell Envelope Stress And Daptomycin Non-Susceptibility In Enterococcus Faecium, Dierdre B Axell-House, Shelby R Simar, Diana Panesso, Sandra Rincon, William R Miller, Ayesha Khan, Orville A Pemberton, Lizbet Valdez, April H Nguyen, Kara S Hood, Kirsten Rydell, Andrea M Detranaltes, Mary N Jones, Rachel Atterstrom, Jinnethe Reyes, Pranoti V Sahasrabhojane, Geehan Suleyman, Marcus Zervos, Samuel A Shelburne, Kavindra V Singh, Yousif Shamoo, Blake M Hanson, Truc T Tran, Cesar A Arias

Faculty, Staff and Student Publications

Daptomycin (DAP) is often used as a first-line therapy to treat vancomycin-resistant

Immuno-Molecular Targeted Therapy Use And Survival Benefit In Patients With Stage Ivb Cervical Carcinoma In Commission On Cancer, Collin A Sitler, Chunqiao Tian, Chad A Hamilton, Michael T Richardson, John K Chan, Daniel S Kapp, Charles A Leath, Yovanni Casablanca, Christina Washington, Nicole P Chappell, Ann H Klopp, Craig D Shriver, Christopher M Tarney, Nicholas W Bateman, Thomas P Conrads, George Larry Maxwell, Neil T Phippen, Kathleen M Darcy

Faculty, Staff and Student Publications

PURPOSE: To investigate IMT use and survival in real-world stage IVB cervical cancer patients outside randomized clinical trials.

METHODS: Patients diagnosed with stage IVB cervical cancer during 2013-2019 in the National Cancer Database and treated with chemotherapy (CT) ± external beam radiation (EBRT) ± intracavitary brachytherapy (ICBT) ± IMT were studied. The adjusted hazard ratio (AHR) and 95% confidence interval (CI) for risk of death were estimated in patients treated with vs. without IMT after applying propensity score analysis to balance the clinical covariates.

RESULTS: There were 3164 evaluable patients, including 969 (31%) who were treated with IMT. The use …

Distraction Culture: The Origin Story Of Notification Stress, Benedicte Kalonda

Symposium of Student Scholars

Long gone are the days when procrastination was the sole culprit of poor productivity through the chronic delay of task completion, which has also been linked to a range of stress-related health problems (e.g., headaches, digestive issues, and insomnia). Today’s culture has given rise to the phenomenon of pre-crastination, whereby a technological notification demands and receives immediate attention despite its level of urgency. This propensity to abandon flow and groove is becoming normalized, and the public health impact is currently unknown.

These notifications, a seemingly benign cost of technological advances, are setting the stage for a new level of stressor …

Sexual Health Questionnaire Results: Demographics And Sexual History And Risk Patterns, Veda Maany

Health Sciences Data Repository

Dataset for manuscript titled “The Sexual History Intake of the College Student: A Different Approach”

This file contains the following variables: age, sex, sexual history, and risk pattern regarding barrier methods.

Data was generated in 2023.

Sexual Health Questionnaire Results: Behavior Correlation With Test Specimen, Veda Maany

Health Sciences Data Repository

No abstract provided.

Sexual Health Questionnaire Results: Variable Correlation With Sti Diagnoses, Veda Maany

Health Sciences Data Repository

No abstract provided.

Hypertension In Pregnancy Among Immigrant And Swedish Women: A Cohort Study Of All Pregnant Women In Sweden, Per Wändell, Casey Crump, Xinjun Li, Nouha Saleh Stattin, Axel C Carlsson, Jan Sundquist, Kristina Sundquist

Faculty, Staff and Student Publications

BACKGROUND: Little is known about risks of hypertensive disorders of pregnancy in both first- and second-generation immigrant women in Europe and other Western countries; such knowledge may help elucidate the influence of genetic versus social factors on such risks. We aimed to study both first- and second-generation immigrant women for the presence of all types of hypertension (preexisting hypertension, gestational hypertension, preeclampsia, and eclampsia) during pregnancy.

METHODS AND RESULTS: A cohort study was conducted using data derived from the Swedish National Birth Register, the National Patient Register, and the total Population Register. We used Cox regression analysis to compute hazard …

Sex Differences In Revascularization, Treatment Goals, And Outcomes Of Patients With Chronic Coronary Disease: Insights From The Ischemia Trial, Harmony R Reynolds, Derek D Cyr, C Noel Bairey Merz, Leslee J Shaw, Bernard R Chaitman, William E Boden, Karen P Alexander, Yves D Rosenberg, Sripal Bangalore, Gregg W Stone, Claes Held, John Spertus, Kaatje Goetschalckx, Olga Bockeria, Jonathan D Newman, Jeffrey S Berger, Ahmed Elghamaz, Renato D Lopes, James K Min, Daniel S Berman, Michael H Picard, Raymond Y Kwong, Robert A Harrington, Boban Thomas, Sean M O'Brien, David J Maron, Judith S Hochman, Ischemia Research Group

Faculty, Staff and Student Publications

BACKGROUND: Women with chronic coronary disease are generally older than men and have more comorbidities but less atherosclerosis. We explored sex differences in revascularization, guideline-directed medical therapy, and outcomes among patients with chronic coronary disease with ischemia on stress testing, with and without invasive management.

METHODS AND RESULTS: The ISCHEMIA (International Study of Comparative Health Effectiveness with Medical and Invasive Approaches) trial randomized patients with moderate or severe ischemia to invasive management with angiography, revascularization, and guideline-directed medical therapy, or initial conservative management with guideline-directed medical therapy alone. We evaluated the primary outcome (cardiovascular death, myocardial infarction, or hospitalization for …

High Clinical Exome Sequencing Diagnostic Rates And Novel Phenotypic Expansions For Nonisolated Microphthalmia, Anophthalmia, And Coloboma, Bhavana Kunisetty, Bailey A Martin-Giacalone, Xiaonan Zhao, Pamela N Luna, Brian P Brooks, Robert B Hufnagel, Chad A Shaw, Jill A Rosenfeld, A J Agopian, Philip J Lupo, Daryl A Scott

Faculty, Staff and Student Publications

PURPOSE: A molecular diagnosis is only made in a subset of individuals with nonisolated microphthalmia, anophthalmia, and coloboma (MAC). This may be due to underutilization of clinical (whole) exome sequencing (cES) and an incomplete understanding of the genes that cause MAC. The purpose of this study is to determine the efficacy of cES in cases of nonisolated MAC and to identify new MAC phenotypic expansions.

METHODS: We determined the efficacy of cES in 189 individuals with nonisolated MAC. We then used cES data, a validated machine learning algorithm, and previously published expression data, case reports, and animal models to determine …

Addressing Educational Disparities To Improve Health In The Rio Grande Valley, Ronald A. Shaju, Alex Zuo

Research Symposium

Background. The Rio Grande Valley (RGV) has emerged as a United States region facing great hardships regarding health, with the region identified in the work with the highest rates of diabetes and obesity among the diverse mix of people that inhabit it. This extensive public health research shall seek to delve deeply into the relationships between educational disparities and health outcomes in the RGV population, as this might serve as a pivotal point for breaking down health disparities in the RGV. This comprehensive public health research endeavor seeks to delve deeply into that complicated relationship between educational disparities and the …

Exploring Imageability Through Architecture To Study Neuroscience: Preliminary Results Of A Systemic Review, Cristian Maestre, Shana Garza, Silvia Mejia-Arango, Jesus D. Melgarejo, Gladys E. Maestre

Research Symposium

Background: Neuroscience and architecture are often combined to study the impact of environment, physical spaces, colors, shapes, and buildings on brain activity and health. This is an emerging field with distinct areas examining architecture in relation to neuroscience. Among the numerous elements of architecture, imageability seems to be of particular interest. Imageability refers to the quality of a physical space that evokes strong images in people’s mind, and influence cognitive functions including visual, memory, and spatial recall. It is hypothesized that environments, spaces, and buildings with poor imageability might negatively affect cognition, behavior, and brain health. Diverse studies have been …

The Moderating Effect Of Race On The Relationship Between Perceived Supervisor Support And Burnout Amongst Public Health Workers, Douglas Diontay Gaffney, Jr

Walden Dissertations and Doctoral Studies

Recent research has shown that burnout is a prevalent problem across the public health workforce. Burnout (BO) contributes to workplace challenges in turnover, employee performance, job satisfaction, and overall quality of life, and is more prevalent among racial minorities. Not only has BO been found to differ across racial demographics, employee perceptions about their level of support from supervisors (PSS) also differ. This quantitative study, informed by Meyer’s minority stress theory, examined Black-White differences in PSS and BO, and whether race moderated the relationship between PSS and BO. Data collected by De Beaumont’s 2017 national public health workforce interest and …

Medical Home Implementation And Follow-Up Of Cancer-Related Abnormal Test Results In The Veterans Health Administration, Suja S Rajan, Shashank Sarvepalli, Li Wei, Ashley N D Meyer, Daniel R Murphy, Debra T Choi, Hardeep Singh

Faculty, Staff and Student Publications

IMPORTANCE: Lack of timely follow-up of cancer-related abnormal test results can lead to delayed or missed diagnoses, adverse cancer outcomes, and substantial cost burden for patients. Care delivery models, such as the Veterans Affairs' (VA) Patient-Aligned Care Team (PACT), which aim to improve patient-centered care coordination, could potentially also improve timely follow-up of abnormal test results. PACT was implemented nationally in the VA between 2010 and 2012.

OBJECTIVE: To evaluate the long-term association between PACT implementation and timely follow-up of abnormal test results related to the diagnosis of 5 different cancers.

DESIGN, SETTING, AND PARTICIPANTS: This multiyear retrospective cohort study …

Changes In Real-World Dispensing Of Adhd Stimulants In Youth From 2019 To 2021 In California, Anika Patel, Rishikesh Chavan, Cyril Rakovski, Richard C. Beuttler, Sun Yang

Mathematics, Physics, and Computer Science Faculty Articles and Research

Introduction: Attention-deficit/hyperactivity disorder (ADHD) is one of the most common pediatric neurobehavioral disorders in the U.S. Stimulants, classified as controlled substances, are commonly used for ADHD management. We conducted an analysis of real-world stimulants dispensing data to evaluate the pandemic’s impact on young patients (≤ 26 years) in California.

Methods: Annual prevalence of patients on stimulants per capita across various California counties from 2019 and 2021 were analyzed and further compared across different years, sexes, and age groups. New patients initiating simulants therapy were also examined. A case study was conducted to determine the impact of socioeconomic status on patient …

Prenatal, Perinatal And Postnatal Risk Factors Associated With Autism Spectrum Disorder In Palestine: A Case-Control Study, Mustafa Ghanim, Mariam Al-Tell, Samaa Staiti, Maha Rabayaa, Johnny Amer, Malik Alqub, Sameeha Atout, Nihad Al-Othman, Marwa Ismail

An-Najah University Journal for Research - B (Humanities)

Background: Autism spectrum disorder (ASD) is a multifactorial neurodevelopment disorder. Several prenatal, perinatal, and postnatal factors are suggested as risk factors for ASD. This study aimed to correlate prenatal, perinatal, and postnatal factors in a limited number of ASD cases in Palestine. Methods: A case-control study involved 120 children (60 typically diagnosed with ASD and 60 healthy matched with the ASD group). The parents of the children in both groups were asked to fill out the questionnaire. Results: The study showed a higher male-to-female ratio in the ASD group. A family history of ASD was reported in 38.3% of the …

Treatment And Mortality Following Cancer Diagnosis Among People With Non-Affective Psychotic Disorders In Ontario, Canada: A Retrospective Cohort Study, Jared C. Wootten, Lucie Richard, Melody Lam, Phillip S. Blanchette, Marco Solmi, Kelly K. Anderson

Epidemiology and Biostatistics Publications

Background and Hypothesis People with psychotic disorders have a higher risk of mortality following cancer diagnosis, compared to people without psychosis. The extent to which this disparity is influenced by differences in cancer-related treatment is currently unknown. We hypothesized that, following a cancer diagnosis, people with psychotic disorders were less likely to receive treatment and were at higher risk of death than those without psychosis. Study Design We constructed a retrospective cohort of cases of non-affective psychotic disorder (NAPD) and a general population comparison group, using Ontario Health (OH) administrative data. We identified cases of all cancers diagnosed between 1995 …

How To Develop A Qualitative Evaluation Plan For A Complex National Intervention: Key Steps And Reflections From The Radx-Up Program, Shelly A. Maras, Josephine Mckelvy, Kelley Milligan, Allyson Kelley, Valerie A. Lucas, Tara Carr, Abisola Osinuga, Leah Frerichs, Gaurav Dave

The Qualitative Report

This article describes the formative process of developing and implementing a Qualitative Evaluation Plan (QEP) for a large-scale, National Institute of Health (NIH) supported program: Rapid Acceleration of Diagnostics — Underserved Populations (RADx-UP). RADx-UP includes over 137 projects in the United States that aim to ensure that all Americans have access to timely, accurate diagnostics for COVID-19, with a specific focus on populations the pandemic disproportionately affects. As part of a comprehensive, mixed-methods strategic evaluation plan, our team developed the QEP. We employed qualitative methods to understand RADx-UP academic and community partners’ experiences implementing community-engaged research strategies, and to understand …

A Greb1-Steroid Receptor Feedforward Mechanism Governs Differential Greb1 Action In Endometrial Function And Endometriosis, Sangappa B Chadchan, Pooja Popli, Zian Liao, Eryk Andreas, Michelle Dias, Tianyuan Wang, Stephanie J Gunderson, Patricia T Jimenez, Denise G Lanza, Rainer B Lanz, Charles E Foulds, Diana Monsivais, Francesco J Demayo, Hari Krishna Yalamanchili, Emily S Jungheim, Jason D Heaney, John P Lydon, Kelle H Moley, Bert W O'Malley, Ramakrishna Kommagani

Faculty, Staff and Students Publications

Cellular responses to the steroid hormones, estrogen (E2), and progesterone (P4) are governed by their cognate receptor's transcriptional output. However, the feed-forward mechanisms that shape cell-type-specific transcriptional fulcrums for steroid receptors are unidentified. Herein, we found that a common feed-forward mechanism between GREB1 and steroid receptors regulates the differential effect of GREB1 on steroid hormones in a physiological or pathological context. In physiological (receptive) endometrium, GREB1 controls P4-responses in uterine stroma, affecting endometrial receptivity and decidualization, while not affecting E2-mediated epithelial proliferation. Of mechanism, progesterone-induced GREB1 physically interacts with the progesterone receptor, acting as a cofactor in a positive feedback …

Vulnerable Neighborhoods Had Smaller Gains In Health Insurance Coverage During Early Covid-19, Ismail Mustafa Aijazuddin, Ammar Sukari

Medical Student Research Symposium

Background:

The Covid-19 pandemic has illuminated the inequities that jeopardize health, prompting rapid interventions to promote care access. However, such efforts have had mixed success in eradicating disparities. One focus is the equity of improvements in insured rates.

Methods:

Self-reported health insurance coverage rates among adults aged 18-64 were obtained from the CDC’s PLACES datasets for collection years 2018 and 2021, at the Census Tract level. These data were merged with the CDC’s 2018 Social Vulnerability Index (SVI), which ranks Tracts on 15 measures of social determinants of health. Across Tracts nationally and by state, univariate correlations between Overall SVI …

Addressing Barriers To Black Americans Participation In Clinical Trials: A Faith-Based Community Survey, Alexandra Stone, Lydell Lettsome Md, Brian A. Stone Md, Clinical Diversity Solutions

Medical Student Research Symposium

Background: The underrepresentation of high-risk minority groups in clinical trials remains a crisis in American healthcare. Despite pressures from the NIH to increase Black-American participation in trials, recruitment and retention in this group rarely match population demographics. Our company launched an opinion survey polling 260 Blacks regarding their thoughts and awareness about clinical trial participation.

Methods: We created a web-based survey consisting of 38 items and subdivided it into three main sections: (1) cultural affinity, (2) trust, and (3) background information. The survey was conducted using Jotform, a HIPAAcompliant web-based application. Our target population was Black Americans in central Alabama. …

Natural Spaces, A Social Determinant Of Health, And Self-Rated Health Among Medical Students, Josiah P. Stryd, Anil N. F. Aranha

Medical Student Research Symposium

Background and Purpose: Natural spaces are areas which have a majority of natural ground cover such as vegetation or water. These spaces have positive effects on both physical and mental health. The purpose of this study was to investigate whether medical students who have greater accessibility and use of natural spaces have better self-rated health.

Methods: M2-M4 students from Wayne State University School of Medicine received an email link to the Qualtrics-based study. Variables evaluated included: sociodemographics, residence zip code, natural spaces access frequency, distance, and transportation method. Self-rated physical and mental health was measured using the Healthy Days measure …

Vaccine Hesitancy Among Youth Living With Hiv In Detroit, Madeline B. Simone

Medical Student Research Symposium

Vaccine hesitancy among youth with human immunodeficiency virus (HIV) was evaluated to determine if the pandemic affected vaccine acceptance. A retrospective chart review was conducted to analyze vaccine rates over a five-year (pre-post COVID) in one university-based clinic. Results indicated a variation in acceptance rates between vaccines, with the MenACWY, MenB, tetanus, and HPV having the highest acceptance rates and COVID-19 and annual flu vaccine having the lowest acceptance rates. Vaccine hesitancy did not correlate with HIV treatment hesitancy nor with aversion to needles. Negative messaging around vaccines from a variety of sources appeared to be the primary factor in …

M-Chat Implementation Strategies To Improve Autism Screening Rates In Pediatric Clinics In Metro Detroit, Karamoja Monchamp

Medical Student Research Symposium

The Modified Checklist for Autism in Toddlers (M-CHAT) is the most widely used autism screening tool. However, current practices for M-CHAT roll-outs and follow-ups are not wide-reaching, culturally sensitive, or consistent. This study aims to address the existing barriers to universal autism screenings and design a sustainable implementation strategy for a successful M-CHAT roll-out. We implemented strategies in five Henry Ford Health pediatric clinics, incorporating iPad-administered M-CHAT in waiting rooms, multilingual options, task shifting for referrals, forced choice mechanisms, and audit-and-feedback support. A Clinical Screening Dashboard tracked real-time M-CHAT data, including demographic information, collected from EPIC. Our goal is to …

Assessment Of Breastfeeding Education In Medical Training, Saranya Madan, Abigail Kuplicki

Medical Student Research Symposium

In 2019, the Academy of Breastfeeding Medicine issued a revised set of educational objectives for medical trainees at various stages of education. In this statement, objectives for medical school were broken down into preclinical and clinical training objectives. In this project, our goal is to assess the degree to which medical training at Wayne State University School of Medicine is addressing these aims.

The assessment of breastfeeding education is accomplished by surveying medical students at various stages of training (M1-M4) and eliciting their level of confidence in and understanding of the topics outlined in the objectives by the Academy of …