Public Health Commons^™

Health Disparities: The Influence Of Black Celebrity Endorsers And Social Media Influencers On Consumption Habits Among African American Consumers, Dale A. Cake, Wooyang Kim

AMTP Proceedings 2024

This study examines the impact of celebrity and social media influencer endorsements on the dietary choices of African Americans, a group disproportionately affected by obesity and diabetes. It focuses on the role of limited access to healthy foods in impoverished communities and cultural influences. Using the source credibility model, the research assesses endorsements based on the endorser's attractiveness, expertise, and trustworthiness. The methodology involves a two-step approach: conducting semi-structured interviews with African American students to understand perceptions of food-related celebrity endorsements, followed by an experimental design using eye-tracking and galvanic skin response (GSR) technology. This design will evaluate reactions to …

Comments Re: Draft Guidance Considering Exercise Of March-In Rights - Docket No.: 230831-0207, Fred D. Ledley, Edward Zhou

CISI Publication

This comment focuses on criterion #3 of the march-in provisions of the Bayh Dole Act, which pertains to “…action is necessary to meet requirements for public use specified by Federal regulations and such requirements are not reasonably satisfied by the contractor, assignee, or licensees.” We recognize that the term “public use” in Bayh Dole refers not only to commercialization or availability of products representing practical applications of the inventions made with federal funding and licensed to industry under the terms of the Act, but also use of these inventions to achieve a series of socioeconomic goals (i.e., access to and …

Most Deprived Louisiana Census Tracts Have Higher Hepatocellular Carcinoma Incidence And Worse Survival, Kendra L. Ratnapradipa, Tingting Li, Mei Chin Hsieh, Laura Tenner, Edward S. Peters

School of Public Health Faculty Publications

Background: Liver cancer incidence increased in the US from 1975 through 2015 with heterogeneous rates across subpopulations. Upstream or distal area-level factors impact liver cancer risks. Objective: The aim of this study was to examine the association between area-level deprivation and hepatocellular carcinoma (HCC) incidence and survival. We also explored the association between area deprivation and treatment modalities. Methods: Louisiana Tumor Registry identified 4,151 adult patients diagnosed with malignant HCC from 2011 to 2020 and linked residential address to census tract (CT)-level Area Deprivation Index (ADI) categorized into quartiles (Q1 = least deprived). ANOVA examined the association between ADI quartile …

Covid-19 Hospital Mortality Among Patients With Invasive Mechanical Ventilation: A Comparison Between Public And Private Healthcare Services In San Luis Potosí 2020–2022, María E. Torres-Acosta, Rocío M. Cubos-Moncada, Alan Y. Martínez-Castellanos

The University of Louisville Journal of Respiratory Infections

Background: During 2019, México’s total public spending on health was 5.43% of the national gross domestic product, making it one of the countries of the Organisation for Economic Co-operation and Development that invested the least in developing public health systems. This study analyzes hospital mortality among intubated patients with laboratory-confirmed COVID-19 according to type of institution in San Luis Potosí, México, from March 18, 2020, to April 7, 2022.

Methods: This is a secondary data analysis of publicly available information about mortality among intubated patients with a laboratory-confirmed diagnosis of COVID-19 with respect to the type of hospitalization institution.

Results: …

Large-Scale Proteomics Identifies Novel Biomarkers And Circulating Risk Factors For Aortic Stenosis, Khaled Shelbaya, Victoria Arthur, Yimin Yang, Pranav Dorbala, Leo Buckley, Brian Claggett, Hicham Skali, Line Dufresne, Ta-Yu Yang, James C Engert, George Thanassoulis, James Floyd, Thomas R Austin, Anna Bortnick, Jorge Kizer, Renata C C Freitas, Sasha A Singh, Elena Aikawa, Ron C Hoogeveen, Christie Ballantyne, Bing Yu, Josef Coresh, Michael J Blaha, Kunihiro Matsushita, Amil M Shah

Faculty, Staff and Student Publications

Background: Limited data exist regarding risk factors for aortic stenosis (AS). The plasma proteome is a promising phenotype for discovery of novel biomarkers and potentially causative mechanisms.

Objectives: The aim of this study was to discover novel biomarkers with potentially causal associations with AS.

Methods: We measured 4,877 plasma proteins (SomaScan aptamer-affinity assay) among ARIC (Atherosclerosis Risk In Communities) study participants in mid-life (visit 3 [V3]; n = 11,430; age 60 ± 6 years) and in late-life (V5; n = 4,899; age 76 ± 5 years). We identified proteins cross-sectionally associated with aortic valve (AV) peak velocity (AVmax) and dimensionless …

Unsatisfactory Fecal Immunochemical Tests For Colorectal Cancer Screening: Prevalence, Reasons, And Subsequent Testing, Po-Hong Liu, Rasmi G Nair, Celette Sugg Skinner, Caitlin C Murphy, Eric J Kim, Cynthia Ortiz, Lei Wang, Ellen Hu, Jacquelyn M Lykken, Theodore R Levin, Beverly B Green, Erin E Hahn, Noel Santini, Ethan A Halm

Faculty, Staff and Student Publications

BACKGROUND: Fecal immunochemical test (FIT) is an effective colorectal cancer screening modality. Little is known about prevalence, reasons, and testing after unsatisfactory FIT, or a FIT that cannot be processed by the laboratory due to inadequate stool specimen or incomplete labeling.

METHODS: Our retrospective cohort study examined unsatisfactory FIT among average-risk individuals aged 50-74 years in a large, integrated, safety-net health system who completed an index FIT from 2010 to 2019. We determined prevalence of unsatisfactory FIT and categorized reasons hierarchically. We used multivariable logistic regression models to identify factors associated with: (i) unsatisfactory FIT; and (ii) subsequent testing within …

Education, Occupation, And Healthcare Accessibility As Predictors Of Self-Reporting Memory Rating, Ana Maria Gonzales

Walden Dissertations and Doctoral Studies

The increasing number of dementia cases in the United States, particularly among women, is a significant concern. This progressively deteriorating cognitive disease may profoundly affect talking, decision-making, and problem-solving abilities, interfere with their daily lives, and decrease their life expectancy. Although education, occupation, and healthcare access are individually associated with positive health outcomes, it was essential to explore whether their combination impacts self-reporting memory loss, an indicator of dementia. The purpose of this study was to determine the role of education, occupation, and access to health care as predictors of dementia among women in the United States. This study used …

The Association Between Cognitive Dysfunctions And Cardiovascular Disease Of Minority And Lgbtq+ Communities In The United States, Nathan G. De Shields

Walden Dissertations and Doctoral Studies

Dementia, the loss of cognitive acuity is an umbrella term of neuro-degenerative symptoms that impact an estimated 6.5 million Americans, and amid heart disease, cancers, and emerging viruses, such as COVID-19, has reportedly increased in prevalence. A cross-sectional study of secondary data from the National Health and Nutrition Examination Survey (NHANES) was conducted to analyze minority and non-heterosexual experiences of health risks found higher in prior studies of distress rates in LGBTQ+ adults. The socio-ecological framework was used to interpret the competing ecologies of social health determinants in natural and social settings. Literature reviews on cognitive dysfunction and other vascular …

It Takes A Village To Raise A Grandchild: Developing Communities Of Support For Grand-Families On Pei, Canada, Christina Murray, Laura Bain, Nora Spinks, Donald Avery

GrandFamilies: The Contemporary Journal of Research, Practice and Policy

In this practice brief, we outline our research focused on grandparents raising grandchildren in Prince Edward Island (PEI), Canada. Specifically, we highlight a series of collaborative community workshops implemented as part of our research project. Using a participatory action research approach, we worked with grandparents raising grandchildren to co-design and implement the workshops, which we titled It Takes a Village to Raise a Grandchild. These workshops brought together grandparents raising grandchildren and key community members, including clergy, educators, healthcare providers, politicians, social services, child services, and researchers. The goal of these workshops was to build awareness and increase understanding …

Real-World Trends, Rural-Urban Differences, And Socioeconomic Disparities In Utilization Of Narrow Versus Broad Next-Generation Sequencing Panels, Yiqing Zhao, Anastasios Dimou, Zachary C Fogarty, Jun Jiang, Hongfang Liu, William B Wong, Chen Wang

Faculty, Staff and Student Publications

UNLABELLED: Advances in genetic technology have led to the increasing use of genomic panels in precision oncology practice, with panels ranging from a couple to hundreds of genes. However, the clinical utilization and utility of oncology genomic panels, especially among vulnerable populations, is unclear. We examined the association of panel size with socioeconomic status and clinical trial matching. We retrospectively identified 9,886 eligible adult subjects in the Mayo Clinic Health System who underwent genomic testing between January 1, 2016 and June 30, 2020. Patient data were retrieved from structured and unstructured data sources of institutional collections, including cancer registries, clinical …

Running Biomechanics Differ During And After Pregnancy Compared To Females Who Have Never Been Pregnant, Jennifer J. Bagwell, Elizabeth Avila, Nicholas Reynolds, Jo Armour Smith, Kevin Valenzuela, Dimitrios Katsavelis

Physical Therapy Faculty Articles and Research

Background

Perinatal running participation has increased recently; however, pregnancy related symptoms can limit activity. Perinatal running biomechanics could inform interventions to help perinatal individuals maintain an active lifestyle.

Research question

Are perinatal running biomaechanics and muscle activation different compared to nulligravida females?

Methods

Sixteen pregnant participants completed self-selected velocity running during second trimester (2 T), third trimester (3 T), and postpartum (PP) and 16 matched controls completed these procedures once in this case control study. Kinematic, kinetic, and electromyography (EMG) data were collected using a motion capture system, force plates, and EMG electrodes. Peak trunk, pelvis, hip, knee, and ankle …

Teaching And Safety-Net Hospital Penalization In The Hospital-Acquired Condition Reduction Program, Jose A Serpa, Gretchen Gemeinhardt, Cesar A Arias, Robert O Morgan, Heidi Russell, Hongyu Miao, Cecilia M Ganduglia Cazaban

Faculty, Staff and Student Publications

IMPORTANCE: The Hospital-Acquired Condition Reduction Program (HACRP) evaluates acute care hospitals on the occurrence of patient safety events and health care-associated infections. Since its implementation, several studies have raised concerns about the overpenalization of teaching and safety-net hospitals, and although several changes in the program's methodology have been applied in the last few years, whether these changes reversed the overpenalization of teaching and safety-net hospitals is unknown.

OBJECTIVE: to determine hospital characteristics associated with HACRP penalization and penalization reversal.

DESIGN, SETTING, AND PARTICIPANTS: This retrospective cross-sectional study assessed data from 3117 acute care hospitals participating in the HACRP. The HACRP …

Teaching And Safety-Net Hospital Penalization In The Hospital-Acquired Condition Reduction Program, Jose A Serpa, Gretchen Gemeinhardt, Cesar A Arias, Robert O Morgan, Heidi Russell, Hongyu Miao, Cecilia M Ganduglia Cazaban

Faculty, Staff and Student Publications

IMPORTANCE: The Hospital-Acquired Condition Reduction Program (HACRP) evaluates acute care hospitals on the occurrence of patient safety events and health care-associated infections. Since its implementation, several studies have raised concerns about the overpenalization of teaching and safety-net hospitals, and although several changes in the program's methodology have been applied in the last few years, whether these changes reversed the overpenalization of teaching and safety-net hospitals is unknown.

OBJECTIVE: to determine hospital characteristics associated with HACRP penalization and penalization reversal.

DESIGN, SETTING, AND PARTICIPANTS: This retrospective cross-sectional study assessed data from 3117 acute care hospitals participating in the HACRP. The HACRP …

Fluvoxamine Inhibits Th1 And Th17 Polarization And Function By Repressing Glycolysis To Attenuate Autoimmune Progression In Type 1 Diabetes, Yuan Zou, Jing Zhang, Fei Sun, Qianqian Xu, Longmin Chen, Xi Luo, Ting Wang, Qing Zhou, Shu Zhang, Fei Xiong, Wen Kong, Ping Yang, Qilin Yu, Shiwei Liu, Cong-Yi Wang

Faculty, Staff and Student Publications

BACKGROUND: Fluvoxamine is one of the selective serotonin reuptake inhibitors (SSRIs) that are regarded as the first-line drugs to manage mental disorders. It has been also recognized with the potential to treat inflammatory diseases and viral infection. However, the effect of fluvoxamine on autoimmune diseases, particularly type 1 diabetes (T1D) and the related cellular and molecular mechanisms, are yet to be addressed.

METHOD: Herein in this report, we treated NOD mice with fluvoxamine for 2 weeks starting from 10-week of age to dissect the impact of fluvoxamine on the prevention of type 1 diabetes. We compared the differences of immune …

Health Economic Consequences Associated With Covid-19-Related Delay In Melanoma Diagnosis In Europe, Lara V Maul, Dagmar Jamiolkowski, Rebecca A Lapides, Alina M Mueller, Axel Hauschild, Claus Garbe, Paul Lorigan, Jeffrey E Gershenwald, Paolo Antonio Ascierto, Georgina V Long, Michael Wang-Evers, Richard A Scolyer, Babak Saravi, Matthias Augustin, Alexander A Navarini, Stefan Legge, István B Németh, Ágnes J Jánosi, Simone Mocellin, Anita Feller, Dieter Manstein, Alexander Zink, Julia-Tatjana Maul, Alessandra Buja, Kaustubh Adhikari, Elisabeth Roider

Faculty, Staff and Student Publications

IMPORTANCE: The COVID-19 pandemic resulted in delayed access to medical care. Restrictions to health care specialists, staff shortages, and fear of SARS-CoV-2 infection led to interruptions in routine care, such as early melanoma detection; however, premature mortality and economic burden associated with this postponement have not been studied yet.

OBJECTIVE: To determine the premature mortality and economic costs associated with suspended melanoma screenings during COVID-19 pandemic lockdowns by estimating the total burden of delayed melanoma diagnoses for Europe.

DESIGN, SETTING, AND PARTICIPANTS: This multicenter economic evaluation used population-based data from patients aged at least 18 years with invasive primary cutaneous …

Neonatal Intensive Care Unit Resource Use For Infants At 22 Weeks' Gestation In The Us, 2008-2021, Matthew A Rysavy, Monica M Bennett, Kaashif A Ahmad, Ravi M Patel, Zubin S Shah, Dan L Ellsbury, Reese H Clark, Veeral N Tolia

Faculty, Staff and Student Publications

IMPORTANCE: During the past decade, clinical guidance about the provision of intensive care for infants born at 22 weeks' gestation has changed. The impact of these changes on neonatal intensive care unit (NICU) resource utilization is unknown.

OBJECTIVE: To characterize recent trends in NICU resource utilization for infants born at 22 weeks' gestation compared with other extremely preterm infants (≤28 weeks' gestation) and other NICU-admitted infants.

DESIGN, SETTING, AND PARTICIPANTS: This is a serial cross-sectional study of 137 continuously participating NICUs in 29 US states from January 1, 2008, through December 31, 2021. Participants included infants admitted to the NICU. …

Neighborhood Environment And Poor Maternal Glycemic Control-Associated Complications Of Gestational Diabetes Mellitus, Leela V. Thomas, Claudine T. Jurkovitz, Zugui Zhang, Mitchell R. Fawcett, M. James Lenhard

Department of Medicine Faculty Papers

INTRODUCTION: Risk of complications due to gestational diabetes mellitus is increasing in the U.S., particularly among individuals from racial minorities. Research has focused largely on clinical interventions to prevent complications, rarely on individuals' residential environments. This retrospective cohort study aims to examine the association between individuals' neighborhoods and complications of gestational diabetes mellitus.

METHODS: Demographic and clinical data were extracted from electronic health records and linked to American Community Survey data from the U.S. Census Bureau for 2,047 individuals who had 2,164 deliveries in 2014-2018. Data were analyzed in 2021-2022 using Wilcoxon rank sum test and chi-square test for bivariate …

Gestational Diabetes Augments Group B Streptococcus Infection By Disrupting Maternal Immunity And The Vaginal Microbiota, Vicki Mercado-Evans, Marlyd E Mejia, Jacob J Zulk, Samantha Ottinger, Zainab A Hameed, Camille Serchejian, Madelynn G Marunde, Clare M Robertson, Mallory B Ballard, Simone H Ruano, Natalia Korotkova, Anthony R Flores, Kathleen A Pennington, Kathryn A Patras

Faculty, Staff and Student Publications

Group B Streptococcus (GBS) is a pervasive perinatal pathogen, yet factors driving GBS dissemination in utero are poorly defined. Gestational diabetes mellitus (GDM), a complication marked by dysregulated immunity and maternal microbial dysbiosis, increases risk for GBS perinatal disease. Using a murine GDM model of GBS colonization and perinatal transmission, we find that GDM mice display greater GBS in utero dissemination and subsequently worse neonatal outcomes. Dual-RNA sequencing reveals differential GBS adaptation to the GDM reproductive tract, including a putative glycosyltransferase (yfhO), and altered host responses. GDM immune disruptions include reduced uterine natural killer cell activation, impaired recruitment to placentae, …

Acceptability Of Personalized Lung Cancer Screening Program Among Primary Care Providers, Paul J Resong, Jiangong Niu, Gabrielle F Duhon, Lewis E Foxhall, Sanjay Shete, Robert J Volk, Iakovos Toumazis

Faculty, Staff and Student Publications

Current lung cancer screening (LCS) guidelines rely on age and smoking history. Despite its benefit, only 5%-15% of eligible patients receive LCS. Personalized screening strategies select individuals based on their lung cancer risk and may increase LCS's effectiveness. We assess current LCS practices and the acceptability of personalized LCS among primary care providers (PCP) in Texas. We surveyed 32,983 Texas-based PCPs on an existing network (Protocol 2019-1257; PI: Dr. Shete) and 300 attendees of the 2022 Texas Academy of Family Physicians (TAFP) conference. We analyzed the responses by subgroups of interest. Using nonparametric bootstrap, we derived an enriched dataset to …

Efficacy And Safety Of Autologous Tumor-Infiltrating Lymphocytes In Recurrent Or Refractory Ovarian Cancer, Colorectal Cancer, And Pancreatic Ductal Adenocarcinoma, Rodabe Amaria, Anne Knisely, David Vining, Scott Kopetz, Michael J Overman, Milind Javle, Mara B Antonoff, Ching-Wei D Tzeng, Robert A Wolff, Shubham Pant, Kathryn Lito, Kelly Rangel, Bryan Fellman, Ying Yuan, Karen H Lu, Donastas Sakellariou-Thompson, Cara L Haymaker, Marie-Andrée Forget, Patrick Hwu, Chantale Bernatchez, Amir A Jazaeri

Faculty, Staff and Student Publications

BACKGROUND: Tumor-infiltrating lymphocyte (TIL) therapy has shown efficacy in metastatic melanoma, non-small cell lung cancer, and other solid tumors. Our preclinical work demonstrated more robust CD8 predominant TIL production when agonistic anti-4-1BB and CD3 antibodies were used in early ex vivo TIL culture.

METHODS: Patients with treatment-refractory metastatic colorectal (CRC), pancreatic (PDAC) and ovarian (OVCA) cancers were eligible. Lymphodepleting chemotherapy was followed by infusion of ex vivo expanded TIL, manufactured at MD Anderson Cancer Center with IL-2 and agonistic stimulation of CD3 and 4-1BB (urelumab). Patients received up to six doses of high-dose IL-2 after TIL infusion. Primary endpoint was …

Covid-19 Vaccine And Survival Of Diabetes Patient On Dialysis, Luis Guillermo De Jesús Iii Vega

Walden Dissertations and Doctoral Studies

No abstract provided.

African Americans’ Nutrition And Dietary Management Experiences To Mitigate Congestive Heart Failure, Chukwuemeke Joseph Onokwai

Walden Dissertations and Doctoral Studies

No abstract provided.

Association Between Malaria Educational Message Exposure And Malaria Prevalence Among Children In Nigeria, Eberechukwu Jacob Ajiwe

Walden Dissertations and Doctoral Studies

No abstract provided.

Chronic Respiratory Symptoms Following Deployment-Related Occupational And Environmental Exposures Among Us Veterans, Eric Garshick, Carrie A Redlich, Anna Korpak, Andrew K Timmons, Nicholas L Smith, Karen Nakayama, Coleen P Baird, Paul Ciminera, Farrah Kheradmand, Vincent S Fan, Jaime E Hart, Petros Koutrakis, Ware Kuschner, Octavian Ioachimescu, Michael Jerrett, Phillipe R Montgrain, Susan P Proctor, Emily S Wan, Christine H Wendt, Cherry Wongtrakool, Paul D Blanc

Faculty, Staff and Students Publications

Objectives: Characterise inhalational exposures during deployment to Afghanistan and Southwest Asia and associations with postdeployment respiratory symptoms.

Methods: Participants (n=1960) in this cross-sectional study of US Veterans (Veterans Affairs Cooperative Study 'Service and Health Among Deployed Veterans') completed an interviewer-administered questionnaire regarding 32 deployment exposures, grouped a priori into six categories: burn pit smoke; other combustion sources; engine exhaust; mechanical and desert dusts; toxicants; and military job-related vapours gas, dusts or fumes (VGDF). Responses were scored ordinally (0, 1, 2) according to exposure frequency. Factor analysis supported item reduction and category consolidation yielding 28 exposure items in 5 categories. Generalised …

Patient Satisfaction With A Coach-Guided, Technology-Based Mental Health Treatment: Qualitative Interview Study And Theme Analysis, Ashley Helm Smith, Hilary Touchett, Patricia Chen, Terri Fletcher, Jennifer Arney, Julianna Hogan, Miryam Wassef, Marylene Cloitre, Jan A Lindsay

Faculty, Staff and Students Publications

Background: Technology-based mental health interventions address barriers rural veterans face in accessing care, including provider scarcity and distance from the hospital or clinic. webSTAIR is a 10-module, web-based treatment based on Skills Training in Affective and Interpersonal Regulation, designed to treat posttraumatic stress disorder and depression in individuals exposed to trauma. Previous work has demonstrated that webSTAIR is acceptable to participants and effective at reducing symptoms of posttraumatic stress disorder and depression when delivered synchronously or asynchronously (over 5 or 10 sessions).

Objective: This study explored factors that lead to greater patient satisfaction with webSTAIR, a web-based, coach-guided intervention.

Methods: …

Assessing Suboptimal Health Status In The Saudi Population: Translation And Validation Of The Shsq-25 Questionnaire, Mohamed A. Alzain, Collins O. Asweto, Sehar-Un-Nisa Hassan, Mohammed E. Saeed, Ahmed Kassar, Kamal E. M. Ali, Mouna Ghorbel, Rafat Zrieq, Bandar Alsaif, Wei Wang

Research outputs 2022 to 2026

Background: Suboptimal Health Status (SHS) is realised as a vital feature for improving global health. However, the Arabian world does not have a validated instrument for screening SHS in their population. Therefore, the study aimed to evaluate the psychometric properties of Arabic-translated SHS (ASHSQ-25) in the Saudi Arabian population. Methods: We conducted a cross-sectional study among the conveniently sampled 1590 participants from the Saudi population (with a 97.4% response rate). The data was gathered through an online survey and then exported into SPSS and AMOS version 26.0 for analysis. Mann-Whitney and Kruskal-Wallis tests were used to identify the median difference …

"I Live My Best Life In The Garden": Project Dig Summary Report, Tracy Boehm Barrett, University Of Montana Rural Institute

Health and Wellness

People with intellectual and developmental disabilities (IDD) are commonly overlooked in society because of a combination of social, economic, political, and cultural barriers. Due to such constraints, they also experience a wide range of health and community disparities that result in negative impact on their quality of life and well-being (Mpofu et al., 2020; Akyurek & Bumin, 2017). While many community-based organizations provide a variety of supports for people with disabilities, far less common are those providing therapeutic horticulture (TH) programs within the scope of their services. This report provides information about and recommendations for TH as an increased practice …

A Validation Study Of The Occupational Depression Inventory In Poland And Ukraine, Krystyna Golonka, Karine O. Malysheva, Dominika Fortuna, Bożena Gulla, Leon T. De Beer, Irvin Sam Schonfeld, Renzo Bianchi

Publications and Research

This study examined the psychometric and structural properties of the Polish and Ukrainian versions of the Occupational Depression Inventory (ODI). We relied on two samples of Polish employees (NSample1 = 526, 47% female; NSample2 = 164, 64% female) and one sample of Ukrainian employees (NSample3 = 372, 73% female). In all samples, the ODI exhibited essential unidimensionality and high total-score reliability (e.g., McDonald’s omegas > 0.90). The homogeneity of the scale was strong (e.g., 0.59 ≤ scale-level Hs ≤ 0.68). The ODI’s total scores thus accurately ranked individuals on a latent occupational depression continuum. We found evidence of complete measurement invariance …

Assessment Of Salivary Cadmium Levels And Breast Density In The Marin Women's Study, Michaela F. George, Shayne Paff, Jenyse Rojo, Mark Powell, Christopher Benz, Karl Pope, Karla Kerlikowske, John Shepard, Matthew Willis, Rochelle Ereman, Leeann Prebil

Global Public Health | Faculty Scholarship

Background: We aimed to determine if salivary cadmium (Cd) levels had any association with breast density, hoping to establish a less invasive cost-effective method of stratifying Cd burden as an environmental breast cancer risk factor.

Methods: Salivary Cd levels were quantified from the Marin Women's Study, a Marin County, California population composite. Volumetric compositional breast density (BDsxa) data were measured by single x-ray absorptiometry techniques. Digital screening mammography was performed by the San Francisco Mammography Registry. Radiologists reviewed mammograms and assigned a Breast Imaging-Reporting and Data System score. Early morning salivary Cd samples were assayed. Association analyses were then …

Impact Of Point-Of-Care Ultrasound Use On Patient Referral Decisions In Rural Kenya: A Mixed Methods Study., Grace Wanjiku, Gregory Bell, Sonja Kapadia, Benjamin Wachira

Emergency Medicine, East Africa

Background: Point-of-care ultrasound (POCUS) is recognized as a key imaging modality to bridge the diagnostic imaging gap in Low- and Middle-Income Countries (LMICs). POCUS use has been shown to impact patient management decisions including referral for specialist care. This study explored the impact of POCUS use on referral decisions among trained healthcare providers working in primary rural and peri-urban health facilities in Kenya.

Methods: A concurrent mixed methods approach was used, including a locally developed survey (N=38) and semistructured interviews of POCUS trained healthcare providers (N=12). Data from the survey was descriptively analyzed and interviews were evaluated through the framework …