Community Health and Preventive Medicine Commons^™

Sexually Transmitted Infection Prevention Perspectives In Black Men Who Have Sex With Men Taking Preexposure Prophylaxis In New Orleans, Meredith E. Clement, Jeremy Beckford, Aish Lovett, Julia Siren, Marie Adorno, Sara Legrand, Marsha Bennett, Jamilah Taylor, Emily Hanlen-Rosado, Brian Perry, Amy Corneli

School of Medicine Faculty Publications

INTRODUCTION: Profound sexual health disparities exist for Black men who have sex with men (MSM) in the US South, including a high prevalence of sexually transmitted infections (STIs). Sexually transmitted infection prevention strategies beyond condoms are needed for Black MSM taking preexposure prophylaxis (PrEP). METHODS: We conducted in-depth interviews with Black MSM taking PrEP in New Orleans, Louisiana. Informed by the Health Belief Model, we asked about participants' perceived susceptibility, severity, and concerns regarding STIs, and perceived benefits of STI prevention. We also asked about willingness to use various STI prevention strategies, including antibiotic prophylaxis. Interviews were audio-recorded and analyzed …

Injury Inequity Among Nevada Pedestrians: Assessment Using Measurements Of Community Needs, Merika Charupoom, Nicole Bacani, Emily Carter, Emily Strickler, Laura K. Gryder, Kavita Batra, Deborah A. Kuhls Md, Facs

Undergraduate Research Symposium Posters

In 2020, the National Highway Traffic Safety Administration (NHTSA) reported that Nevada was the 10th highest ranking in pedestrian fatality rates. According to a report by Zero Fatalities, in 2021, there were 84 pedestrian deaths. Underserved communities, the elderly, and low income individuals are more likely to use walking, biking, or public transportation as a primary means of transportation due to vehicle expenses. Older adults, racial/ethnic minorities and those with lower socioeconomic statuses (SES) may bear a disproportionate burden of auto-pedestrian crashes.

The Effects Of Night Shift Work On Heart, Gut, And Reproductive Health, A Systematic Review, Courtney Grayson, Preeti Oza

Pacific Journal of Health

Night shift work, a commonplace in today’s society, creates a variety of health-related challenges for individuals who participate in it. Often, the only adverse health effects discussed in relation to night shift work are sleep dysfunction and mental health issues. This systematic review examined the cardiovascular, gastrointestinal, and fertility health effects that plague individuals working night shift. The goal of this work is to illuminate these lesser known, but equally important, health effects in an effort to bring awareness to the issues. By educating night shift workers and health care providers of the acute risks associated with this type of …

A Case Report Of Myocardial Infarction In A Young Transgender Man With Testosterone Therapy: Raising Awareness On Healthcare Issues In The Transgender Community And A Call For Further Research, Paul J Connelly, Joanna Osmanska, Matthew M Y Lee, Christian Delles, Margaret B Mcentegart

Faculty, Staff and Student Publications

BACKGROUND: People who are transgender may utilize masculinizing or feminizing gender-affirming hormonal therapy. Testosterone and oestrogen receptors are expressed throughout the cardiovascular system, yet the effects of these therapies on cardiovascular risk and outcomes are largely unknown. We report the case of a young transgender man with no discernible cardiovascular risk factors presenting with an acute coronary syndrome.

CASE SUMMARY: A 31-year-old transgender man utilizing intramuscular testosterone masculinizing gender-affirming hormonal therapy presented with central chest pain radiating to the left arm. He had no past medical history of hypertension, dyslipidaemia, diabetes, or smoking. Electrocardiography demonstrated infero-septal ST depression, and high-sensitivity …

Covid-19 Severity Among American Indians And Alaska Natives In 16 States - January 1, 2020, To March 31, 2021, Jessica Arrazola, Scott Erickson, Chiao Wen Lan, Adrian Dominguez, Sujata Joshi, Andria Apostolou, Ashley Busacker, David Casey, Christiana Coyle, Kathryn Helfrich, Jennifer Kraszewski, Thomas Kim, Genelle Lamont, Richard Leman, Pamela Lemaster, Nick Lehnertz, Mike Mannell, Dakota Matson, Alex Merrill, Tracy Miller, Benjamin Schram, Ozair Naqvi, Samantha Rice, Samantha Hyde-Rolland, Alyssa Rowell, Dean Seneca, Victoria Warren-Mears, Laura Williamson

Journal of Health Disparities Research and Practice

Objective: To compare rates and risk factors of severe COVID-19-related outcomes between American Indian/Alaska Native (AI/AN) and non-Hispanic White people (NHW).

Methods: Aggregate Social Vulnerability Index (SVI), COVID-19-related risk factor, hospitalization, and mortality data were obtained from 16 states for January 1, 2020-March 31, 2021. Generalized estimating equation Poisson regression models calculated age-adjusted cumulative incidences, incidence ratios (IR), and 95% confidence intervals (CI) comparing AI/AN and NHW persons by age, sex, and county-level SVI status.

Results: Race data were missing for 42.7% of COVID-19 cases, 24.7% of hospitalizations, and 10.1% of deaths. Risk of AI/AN COVID-19 mortality …

Impact Of A Provider Flagging System On Increasing Ezetimibe Utilization In High-Cardiac Risk Adults, Janessa Creado

Student Scholarly Projects

Practice Problem: Cardiovascular disease continues to be the leading cause of mortality globally. Often, healthcare providers fail to follow evidence-based guidelines in their practice.

PICOT: In high cardiac-risk, adult patients with low-density lipoprotein cholesterol (LDL-C) levels greater than 70 milligram/deciliter (mg/dl) despite being on a maximum tolerated dose of statin (P), what was the effect of a provider flagging system to initiate ezetimibe (I) compared to standard care (C) on increasing the utilization of ezetimibe according to the 2018 American Heart Association (AHA) guidelines (O) within 8 weeks (T)?

Evidence: An extensive evidence literature review …

A Quality Improvement Initiative For Hiv Prevention In Underserved Communities, Meredith E. Clement, Angie D. Settle, Claudia T. Martorell, Jeffrey D. Carter, Melissa Rodriguez, Chelsie Anderson Chadha, Bonnie Douglas, Laura Simone, Leah Molloy

School of Medicine Faculty Publications

Infectious Diseases Week, IDWeek 2023, October 11 - 15, 2023, Boston, MA

To Screen Or Not To Screen: Prostate Cancer In Liver Transplant Candidates, Patrick Twohig, Jared Schober, Timothy Mccashland, Thoetchai Peeraphatdit

Graduate Medical Education Research Journal

Prostate cancer screening is a controversial topic in the general population and is even more contested among liver transplant candidates. Not only should transplant programs be concerned about the risk of false positive screening results but also the competing risks of death and the diagnostic and therapeutic effects of true prostate cancer, which often does not cause significant morbidity or mortality in organ transplant recipients. Our letter highlights a best-practices approach to prostate cancer screening in transplant candidates using available research and consensus guidelines.

Screening For Lung Cancer: 2023 Guideline Update From The American Cancer Society, Andrew M. D. Wolf, Kevin C. Oeffinger, Tina Ya-Chen Shih, Louise C. Walter, Timothy R. Church, Elizabeth T. H. Fontham, Elena B. Elkin, Ruth D. Etzioni, Carmen E. Guerra, Rebecca B. Perkins, Karli K. Kondo, Tyler B. Kratzer, Deanna Manassaram-Baptiste, William L. Dahut, Robert A. Smith

School of Public Health Faculty Publications

Lung cancer is the leading cause of mortality and person-years of life lost from cancer among US men and women. Early detection has been shown to be associated with reduced lung cancer mortality. Our objective was to update the American Cancer Society (ACS) 2013 lung cancer screening (LCS) guideline for adults at high risk for lung cancer. The guideline is intended to provide guidance for screening to health care providers and their patients who are at high risk for lung cancer due to a history of smoking. The ACS Guideline Development Group (GDG) utilized a systematic review of the LCS …

Perceptions Of Diabetes Distress And Counseling During The Pandemic - Rural Provider Perspectives, Ranjita Misra, Brenna O. Kirk, William D. Lewis

Marshall Journal of Medicine

Introduction

West Virginia is an Appalachian rural state that ranks highest in the nation in the prevalence of diabetes (16.2%). The COVID-19 pandemic impacted routine diabetes care. As a result, individuals experienced diabetes distress over the physical and psychological burdens of diabetes management. In rural and medically underserved counties (71%), diabetes care is often provided by primary care physicians. However, healthcare providers’ perspectives on diabetes distress and related counseling to address them are unclear. This cross-sectional study’s objective was to explore healthcare providers’ (HCP) perspectives regarding their patient’s diabetes distress and how it guided their counseling for diabetes self-care during …

Does A Program That Focuses On Lifestyle Changes Reduce Heart Disease Risk Factors In A Rural Community?, Reach Dissemination Committee, Maine, Usa

REACH: Research Evidence-to-Action for Community Health

Interventions like HeartHealth—that focus on self-care of heart disease risk factors and that are driven by collaboration with the community of interest—are effective in medically underserved, socioeconomically distressed rural areas.

El Programa Ampliado De Inmunización (Pai) Y La Confianza En La Vacunación De La Población En Argentina: Estudio De Caso En La Vacunación Contra El Virus Del Papiloma Humano (Vph). The Expanded Program On Immunization (Epi) And Vaccine Confidence In Argentina’S Population: A Case Study On The Human Papillomavirus (Hpv) Vaccine., Ana Tiscareño

Independent Study Project (ISP) Collection

En este estudio, se realizó una exploración del Programa Ampliado de Inmunización (PAI) en Argentina y como sus estrategias afectan los motivos a vacunarse o no en el país. Con un sistema de salud universal y gratuito, la gente en Argentina tiene el derecho a la salud que incluye la vacunación gratuita y obligatoria. Pero en el campo de la inmunización, no hay estudios sobre los otros factores que llevaban a las personas a adherir o no a la vacunación. Para cumplir los objetivos de la investigación, se utilizó un abordaje descriptivo cualitativo con un análisis de fuentes secundarias y …

Climate Change, Malnutrition, And Hiv: The Impact Of Food Insecurity On Hiv Response In Sub-Saharan Africa, Olivia Walshak

Independent Study Project (ISP) Collection

Climate change is a key driver of an unprecedented global food crisis, exacerbated by rising temperatures and the vulnerability of crop yields. Sub-Saharan Africa is particularly susceptible, and case studies demonstrate the fragility of food systems in the region, leading to severe food insecurity and famine in the face of climate shocks.

There are a variety of health implications, particularly the syndemic relationship between malnutrition and HIV. HIV interacts bidirectionally with malnutrition, creating a vicious cycle of poor clinical outcomes. Expanding access to antiretroviral therapy in Sub-Saharan Africa is hindered by rampant food insecurity, including inadequate food intake, reduced dietary …

Evaluation Of Inactivated Avian Influenza Virus And Newcastle Disease Virus Bivalent Vaccination Program Against Newly Circulated H5n8 And Ndv Strains, Abdelrahman Shoukry, Mohamed T El-Saadony, Khaled A El-Tarabily, Mohamed A Soliman

Faculty, Staff and Student Publications

Avian influenza virus (AIV) and Newcastle disease virus (NDV) are respiratory illness syndromes that have recently been detected in vaccinated flocks and are causing major financial losses in the chicken farming industry. The objective was to evaluate the efficacy of Valley Vac H5Plus NDVg7 vaccine in protecting chickens against the H5N8 and NDV strains that have recently been circulating in comparison with the efficacy of the commercially available bivalent H5+ND7 vaccine. In contrast to the H5+ND7 vaccine, which was made of genetically distinct H5N8/2018 clade 2.3.4.4b genotype group (G5), H9N2/2016, H5N1/2017, and genetically comparable NDV genotype VII 1.1/2019 of the …

Quality Improvement Project To Increase Hepatitis C Virus Screening For Ambulatory Gme Internal Medicine Clinic Patients, Nghia Nguyen, Karrar Al Gburi, Arturo Suplee, Jarrad Mcadams, Serag Fares, Carol Soler, Ans Albustamy, Jorge Alejandro Bernal, Sumandeep Brar, J. Paredes

Research Symposium

Background: In 2020, CDC established new guideline expanding Hepatitis C virus (HCV) screening to all adults aged 18 to 79 years. Our QI project objective is to enhance HCV screening amongst the UTRGV-DHR IM department by establishing suitable reminders and educational sessions.

Methods: We reviewed HCV screening status of all adult patients 18 to 79 years old from June 1^st 2020 to December 1^st 2020. We then provided one lecture on the new screening recommendation from CDC 2020 guideline. We also encouraged residents to educate patients on the importance of HCV screening, and to identify and overcome barriers …

Clinical Characteristics And Risk Factors For Mortality During The 'First Wave' Of Covid-19 In Reynosa, Tamaulipas, Luis G. Vargas Garcia, Francisco E. Díaz Cisneros, Antonio Gutiérrez Sierra, Juan Rosales Martínez, Manlio F. Lara Duck, Netzahualcoyotl Mayek Pérez

Research Symposium

Background: The COVID-19 pandemic has impacted public health in Mexico. As of February 2020, there have been at least four "waves" of contagion that resulted in 5.82 million positive cases and more than 325 thousand deaths. At the beginning of the COVID-19 pandemic, hospital and population-based information was available, frequently with non-specific symptoms. Little was known about the risk factors for mortality in specific conditions. We described the clinical characteristics of patients with COVID-19 in Reynosa, Tamaulipas during 2020 and identified the risk factors for mortality.

Methods: The COVID-19 cases registered from March to November 2020 in Reynosa were divided …

Obesity Management In Primary Care Medicine: A Review Of Obesity Perception And Barriers To Weight Loss, Asma Syed, Saima Siddiqui

Research Symposium

Background: This project addresses the obesity epidemic in America. According to the CDC, in 2018, the US obesity prevalence was 42.4%. Obesity is linked to many conditions including heart disease, stroke, type 2 diabetes, and certain types of cancer. Successfully treating obesity can decrease these leading causes of preventable and premature deaths. A proper understanding of the successes and failures of current obesity management in primary care medicine with the help of qualitative research through patient and provider interviews can elucidate the best practices to reduce the burden of disease in America.

Methods: A review of literature was conducted …

An Examination Of The Relationships Between The Neighborhood Social Environment, Adiposity, And Cardiometabolic Disease Risk In Adolescence: A Cross-Sectional Study, Kara D. Denstel, Robbie A. Beyl, Denise M. Danos, Maura M. Kepper, Amanda E. Staiano, Katherine T. Theall, Tung Sung Tseng, Stephanie T. Broyles

School of Public Health Faculty Publications

Background: Disadvantaged neighborhood environments are a source of chronic stress which undermines optimal adolescent health. This study investigated relationships between the neighborhood social environment, specifically, chronic stress exposures, adiposity, and cardiometabolic disease risk factors among 288 Louisiana adolescents aged 10 to 16 years. Methods: This cross-sectional study utilized baseline data from the Translational Investigation of Growth and Everyday Routines in Kids (TIGER Kids) study. Adolescent data were obtained using self-reported questionnaires (demographics and perceived neighborhood disorder), anthropometry, body imaging, and a blood draw while objective neighborhood data for the concentrated disadvantage index were acquired from the 2016 American Community Survey …

Lymphocytic Choriomeningitis Virus In Person Living With Hiv, Connecticut, Usa, 2021, Ketan Patel, Debi Cannon, Mary Choi, Inna Krapiunaya, John D Klena, Trevor Shoemaker

Faculty, Staff and Student Publications

Lymphocytic choriomeningitis virus is an underreported cause of miscarriage and neurologic disease. Surveillance remains challenging because of nonspecific symptomatology, inconsistent case reporting, and difficulties with diagnostic testing. We describe a case of acute lymphocytic choriomeningitis virus disease in a person living with HIV in Connecticut, USA, identified by using quantitative reverse transcription PCR.

Brominated Flame Retardants: A Literature Review Of The Toxicity Mechanisms, Clinical Manifestations, And Current Treatments, Yacobus Christian Prasetyo, Eti Nurwening Sholikhah

Occupational and Environmental Medicine Journal of Indonesia

Brominated flame retardants (BFRs) are organohalogen compounds that can inhibit fire formation and delay its spread in manufacturing materials. BFRs are known to be toxic for the environment and humans. BFRs could persist for years prolonging potential exposure and toxicity to living beings. Indonesia had begun to reduce the use, even though some of toxic BFRs are still illegally circulating. This review aims to describe some aspects of BFRs toxicity including the mechanism, its clinical manifestations, and the current possible treatments. Toxicity after BFRs exposure includes endocrine, neurodevelopmental, and genotoxicity. The toxicity is manifested into some clinical conditions such as …

Hypertension: Care Management Program And Medication Adherence, Courtney Montgomery

Student Scholarly Projects

Practice Problem: Medication adherence is a major concern in healthcare as it is a contributing factor to uncontrolled hypertension and resistant hypertension. Uncontrolled hypertension can lead to strokes, heart attacks, kidney failure, and even death.

PICOT: The PICOT question that guided this project was in Medicare Advantage members with hypertension located in Kansas, who were admitted to the hospital or emergency room identified by stratification (P), does care management utilization using hypertension clinical guidelines (I), compared to the stand-alone hypertension clinical practice guideline (C), improve medication adherence (O) over 10 weeks (T)?

Evidence: Hypertension is one of the leading preventable …

Neurotropic Manifestations As A Potential Risk Factor For Schizophrenia Following In Utero Exposure To Sars-Cov-2, Mir Ali R Talpur, Omar H. Elsayed, Rif S. El-Mallakh

The University of Louisville Journal of Respiratory Infections

Background: COVID-19 infection is associated with neurologic and psychiatric morbidity that suggests a direct effect of the virus or secondary effect of an inflammatory process. These neuropsychiatric consequences may increase the likelihood of schizophrenia in the offspring of women who become infected with COVID-19 during their pregnancy.

Methods: We performed a directed narrative review of the literature focusing on the proposed pathophysiological processes that lead to schizophrenia and known pathological consequences of COVID-19 infection.

Results: Schizophrenia in adult offspring has been associated with maternal infections during pregnancy by a wide range of respiratory and neurotropic pathogens. Spikes in the incidence …

Abstracts From The 2023 Health Care Systems Research Network (Hcsrn) Annual Conference, Denver, Colorado

Journal of Patient-Centered Research and Reviews

The Health Care Systems Research Network (HCSRN) is comprised of 20 learning health systems with embedded population-based research units. The network’s annual conference serves as a forum for research teams from member institutions to disseminate project findings, explore scientific collaborations, and share insights about conducting research in real-world care delivery settings. Abstracts presented at HCSRN 2023 are published in this issue supplement of Journal of Patient-Centered Research and Reviews, the journal of record for HCSRN’s annual conference proceedings.

Community Centred Co-Design Methodology For Designing And Implementing Socio-Behavioural Interventions To Counter Covid-19 Related Misinformation Among Marginalized Population Living In The Squatter Settlements Of Karachi, Pakistan: A Methodology Paper, Rubina Qasim, Waqas Ahmed Farooqui, Atiya Rahman, Rukhsana Haroon, Madiha Saleem, Muhammad Rafique, Fiza Noor, Afifa Ghani, Muhammad Yaqoob, Mohammad Tahir Yousafzai

Community Health Sciences

Background: Misinformation regarding COVID-19 pandemic and vaccination is damaging COVID-19 vaccine trust and acceptance in Low- and Middle-Income Countries (LMIC). Identification of misinformation and designing locally acceptable solutions are needed to improve COVID-19 vaccine acceptance. This study aimed to utilize community-led co-design methodology to evaluate misinformation regarding COVID-19 and develop contextual interventions to address misinformation in a marginalized peri urban slum communities of Landhi town Karachi, Pakistan.
Methods: This study was conducted between January and December 2021, in marginalized peri-urban slum dwellers of Muslimabad Colony, Landhi Town Karachi, Pakistan. We used a community-centred co-design methodology embedded within mixed study design …

Unmet Needs And Coping Strategies Of Older Underserved Veterans During The Covid-19 Pandemic, Trenton M. Haltom, Joyce Tiong, Tracy L. Evans, Nipa Kamdar, Gala True, Mark E. Kunik

School of Medicine Faculty Publications

Introduction: The COVID-19 pandemic has had profound impacts on people with diabetes, a group with high morbidity and mortality. Factors like race, age, income, Veteran-status, and limited or interrupted resources early in the COVID-19 pandemic compounded risks for negative health outcomes. Our objective was to characterize the experiences and needs of under-resourced Veterans with type 2 diabetes during the COVID-19 pandemic. Methods: We conducted semi-structured qualitative interviews (March through September 2021) with U.S. military Veterans with diabetes. Transcripts were analyzed using a team-based, iterative process of summarizing and coding to identify key themes. Participants included Veterans (n = 25) who …

On The Respiratory Syncytial Virus Vaccine, Forest W. Arnold

The University of Louisville Journal of Respiratory Infections

No abstract provided.

The Impact Of The Covid-19 Pandemic On Respiratory Syncytial Virus, Amrit Kahlon, Ravina Ramnani, Kartik Rajpal, Yusra Irshad, Sudeep Chapagain, Arushee Bhatnagar, Steven B Lippmann

The University of Louisville Journal of Respiratory Infections

No abstract provided.

Nutrition In Times Of Crisis: A Qualitative Study In Siargao Island, Philippines, During The Covid-19 Pandemic, Gideon Lasco, Vincen Gregory Yu, Julie Madelo Compra, Phetdavanh Leuangvilay, Rapeepong Suphanchaimat, Yunting Zhang, Charina Javier

Development Studies Faculty Publications

Objectives

Despite the public-health significance of both malnutrition and crises, little has been done to explore the convergence of the two domains and develop ways to improve policies and practices, especially in rural communities. This article remedies that knowledge gap by focusing on nutrition-related changes, responses, and practices during crisis situations in Siargao Island, Philippines, using the COVID-19 pandemic as a backdrop.

Methods

Forty-six (46) semi-structured interviews were conducted among parents, caregivers, local health workers, and local officials of Del Carmen, Siargao Island. Principles of thematic analysis were applied to data analysis using NVivo 12. Afterwards, the preliminary data were …

Epidemiology Of Island And Mainland Populations: How Does Culture Influence Health Risk Factors Of Non-Communicable, Chronic, And Metabolic Diseases?, Jake Thomas D. Palisoc

Honors Projects

Non-communicable diseases (NCDs), including chronic and metabolic diseases, are responsible for 74% of global mortality and are strongly influenced by health risk factors. Geographical differences in NCDs have been identified in several countries but have not been completely explained through cultural factors, specifically island and mainland cultures. This study aimed to develop an epidemiological framework for determining diseases with the highest mortality for further investigation regarding different health risk factors rooted in a specific population’s cultural foundations. Preliminary findings indicated diabetes type II (D2) and CKD caused by hypertension and D2 to have the highest risk factor and mortality percentage …

Home Oxygen And Monitoring For Covid-19 Patients: A Multidisciplinary Team Approach, Mahta Salehi, Shehrose Chaudry, Rebecca B. Newman, Josette Hartnett, Suzanne J. Rose, Forugh Homayounrooz

Journal of Community Hospital Internal Medicine Perspectives

Introduction: During the initial COVID-19 pandemic peak, Stamford Hospital implemented a home oxygen program (HOP) to create a comprehensive, multi-disciplinary outpatient initiative without sacrificing a safe discharge. Primary care physicians monitored program participants, whose only indication for remaining admitted was an oxygen requirement. We retrospectively examined participant co-morbidities and outcomes, including death and readmission rates to evaluate HOP safety.

Methods: A retrospective analysis of program participants discharged between April 2020-Janurary 2021 was performed. Variables included demographics, oxygen requirement, days enrolled in the HOP, and major comorbidities such as cardiovascular disease (CVD), diabetes (DM), hypertension (HTN), obesity, chronic kidney disease, malignancies …