Community Health and Preventive Medicine Commons^™

Spontaneous Large Volume Hemothorax Managed With A Small-Bore Chest Tube, Moiz Salahuddin, Samia Ayub

Department of Medicine

A 67-year-old male with metastatic lung cancer presented with acute shortness of breath and increasing oxygen requirements. He had a decreasing hemoglobin for which he required red blood cell transfusions. His chest x-ray showed near complete white-out of the left lung. Bedside ultrasound (Handheld Sonostar C4PL) showed a large pleural effusion with swirling echogenic material suggestive of plankton sign. The pleural effusion was aspirated and showed frank blood, after which a small-bore chest tube (SBCT) was inserted. A total of 3200ml of blood was drained with the SBCT. There was complete clearance of the pleural space, and no further blood …

Age And Racial Disparities In The Utilization Of Anticancer, Antihypertension, And Anti-Diabetes Therapies, And In Mortality In A Large Population-Based Cohort Of Older Women With Breast Cancer

Faculty, Staff and Student Publications

OBJECTIVE: This study examined the receipt of therapies for cancer, hypertension, and diabetes in association with age and racial disparities in mortality among women with breast cancer.

METHODS: This study identified 92,829 women diagnosed with breast cancer at age ≥ 65 years in 2007-2015 with follow-up to 2016 from the Surveillance, Epidemiology, and End Results (SEER)-Medicare linked database.

RESULTS: There were substantial age and racial disparities in the prevalence of hypertension and diabetes, which was higher in women ≥ 75 (86.3% and 32.0%) than younger women 65-74 (72.8% and 29.3%), and the highest in Black women (91.1% and 49.1%), followed …

Public Health Measures And Sars-Cov-2 Cases In The Juvenile Justice System: Implications For Pandemic Response In The Detention Setting, Asha Davidson, Shelley Aggarwal, Mona Eissa, Laura Benjamins, John Will, Rebecca Beyda

Faculty, Staff and Student Publications

OBJECTIVE: The purpose of this study was to examine severe acute respiratory syndrome-coronavirus-2 case positivity in juvenile justice facilities of two different states alongside institutional, local, and state public health policies during the first 6 months of the coronavirus disease 2019 pandemic.

METHODS: This retrospective chart review examined two large, urban juvenile justice centers in California and Texas. Positive intake or day 12 tests were considered suggestive of community-acquired severe acute respiratory syndrome-coronavirus-2 infection. Researchers examined state and county restrictions, closings, and openings. The study included all of the youths 10 to 18 years residing in the facilities between March …

Risks Of Mortality And Severe Coronavirus Disease 19 (Covid-19) Outcomes In Patients With Or Without Systemic Lupus Erythematosus, Sebastian Bruera, Xiudong Lei, Hui Zhao, Jinoos Yazdany, Mariana Chavez-Macgregor, Maria E Suarez-Almazor

Faculty, Staff and Student Publications

OBJECTIVES: We compared the outcomes of patients with or without systemic lupus erythematosus (SLE) who were diagnosed with coronavirus disease 19 (COVID-19) and evaluated factors within patients with SLE associated with severe outcomes.

METHODS: This retrospective cohort study used the deidentified Optum COVID-19 electronic health record dataset to identify patients with COVID-19 from 1/1/2020 to 31/12/2020. Cases with SLE were matched with general controls at a ratio of 1:10 by age, sex, race and ethnicity and COVID-19 diagnosis date. Outcomes included 30-day mortality, mechanical ventilation, hospitalisation and intensive care unit admission. We evaluated the relationship between COVID-19-related outcomes and SLE …

Investigating Stigma During The Early Stages Of A Pandemic Through The Lens Of Covid-19, Zach Thornton, Bethany Hodge, Sheridan Langford

The University of Louisville Journal of Respiratory Infections

Background: Individuals face stigma associated with numerous health conditions. Stigma can arise rapidly during the early spread of a new disease, adding to the burden felt by those affected. COVID-19 can be used as an example to study stigma during the early phases of a pandemic. This narrative review is a descriptive analysis that tracks the ways in which COVID-19 stigma was discussed in the scholarly literature during the first year of the pandemic to understand how stigma was viewed in the context of a rapidly spreading pandemic.

Methods: PubMed was used as a non-exhaustive sample of the literature. Searches …

Neighborhood Condition Prevalence Rates Correlate With Covid-19 Mortality In Milwaukee County, Wisconsin, George L. Morris Iii

Journal of Patient-Centered Research and Reviews

Purpose: We sought to determine if census tract-level (ie, neighborhood) COVID-19 death rates in Milwaukee County correlated with the census tract-level condition prevalence rates (CPRs) for individual COVID-19 mortality risk.

Methods: This study used Milwaukee County-reported COVID-19 death rates per 100,000 lives for the 296 census tracts within the county to perform a linear regression with individual COVID-19 mortality risk CPR, mean age, racial composition of census tract (by percentage of non-White residents), and poverty (by percentage within census tract), followed by multiple regression with all 7 CPRs as well as the 7 CPRs combined with the additional demographic variables. …

Racial Differences In Perceived Risk And Sunscreen Usage, Rebecca Fliorent, Alicia Podwojniak, Lianne Adolphe, Katharine Milani

Rowan-Virtua School of Osteopathic Medicine Departmental Research

Background Although White individuals have higher incidence of melanoma, clinical outcomes are worse among patients with skin of color. This disparity arises from delayed diagnoses and treatment that are largely due to clinical and sociodemographic factors. Investigating this discrepancy is crucial to decrease melanoma-related mortality rates in minority communities. A survey was used to investigate the presence of racial disparities in perceived sun exposure risks and behaviors. Methods A survey consisting of 16 questions was deployed via social media to assess skin health knowledge. Over 350 responses were recorded, and the extracted data were analyzed using statistical software. Results Of …

Impact Of Enteropathogens On Faltering Growth In A Resource-Limited Setting, Furqan Kabir, Junaid Iqbal, Zehra Jamil, Najeeha Talat Iqbal, Fatima Aziz, Adil Kalam, Sahrish Muneer, Aneeta Hotwani, Sheraz Ahmed, Fayyaz Umrani, Sana Syed, Kamran Sadiq, Syed Asad Ali

Department of Paediatrics and Child Health

Introduction: Environmental enteropathy is an important contributor to childhood malnutrition in the developing world. Chronic exposure to fecal pathogens leads to alteration in intestinal structure and function, resulting in impaired gut immune function, malabsorption, and growth faltering leading to environmental enteropathy.
Methods: A community-based intervention study was carried out on children till 24 months of age in Matiari district, Pakistan. Blood and fecal specimens were collected from the enrolled children aged 3-6 and 9 months. A real-time PCR-based TaqMan array card (TAC) was used to detect enteropathogens.
Results: Giardia, Campylobacter spp., enteroaggregative Escherichia coli (EAEC), Enteropathogenic Escherichia coli (EPEC), …

Treatment Strategies And Mechanisms Associated With The Prevention Of Nash-Associated Hcc By A Toll-Like Receptor 4 Inhibitor, Suet-Ying Kwan, Alyssa N Slayden, Aubrey R Coronado, Rosamaria C Marquez, Huiqin Chen, Michelle I Savage, Jennifer T Fox, Shizuko Sei, Dong Liang, Heather L Stevenson, Gregory K Wilkerson, Mihai Gagea, Powel H Brown, Laura Beretta

Faculty, Staff and Student Publications

UNLABELLED: We evaluated the cancer preventive efficacy of TAK-242, an inhibitor of Toll-like receptor 4 (TLR4), in a mouse model of hepatocellular carcinoma (HCC) occurring in the context of nonalcoholic steatohepatitis (NASH). We also assessed the cellular events associated with the preventive treatment efficacy. We tested oral administration of TAK-242, at clinically relevant but toxicity-reducing doses and scheduling, in mice with hepatocyte-specific deletion of Pten (HepPten-). The optimal dose and oral gavage formulation of TAK-242 were determined to be 30 mg/kg in 5% DMSO in 30% 2-hydroxypropyl-β-cyclodextrin. Daily oral administration of 30 mg/kg TAK-242 over 18 weeks was well tolerated …

Phase I Dose Escalation Study Of Topical Bexarotene In Women At High Risk For Breast Cancer, Parijatham S Thomas, Anisha B Patel, J Jack Lee, Diane D Liu, Mike Hernandez, Alejandro Contreras, Carrie Mays, Diane Weber, Lana A Vornik, Seema A Khan, Eileen Dimond, Brandy M Heckman-Stoddard, Marjorie Perloff, Powel H Brown

Faculty, Staff and Student Publications

Bexarotene is a rexinoid that has been shown to prevent mammary tumors in mouse models but oral dosing has toxicities. This phase I study evaluates topical bexarotene, as a potential chemoprevention agent, for safety and toxicity in high-risk women for breast cancer.

Comparing The Impact Of Food Insecurity, Access To Exercise Opportunities, And County Classification On Obesity Rates In Ohio, Ankur Parekh, Deborah Lee

Scholarship in Medicine - All Papers

Objective: We completed a study to determine how food insecurity, access to exercise opportunities, and county classification (rural or urban) impacted obesity rates in Ohio. We hypothesized that the county classification impacted obesity the most followed by food insecurity and access to exercise opportunities.

Methods: We obtained data on food insecurity, access to exercise opportunities, and obesity from County Health Rankings and county classification data from the United States Department of Agriculture Census. We analyzed correlations between obesity and food insecurity and obesity and access to exercise opportunities in both county types. We also analyzed changes in obesity rates in …

Hpv Vaccination In Florida: Where We Are, Where We Need To Be And How To Get There, Thanuja Neerukonda, Alexandra Witt, Neeharika Makani, Dhruv Patel

West Florida Division GME Research Day 2023

No abstract provided.

Dementia Screening At Hope Clinic, Kang-Lin Tsai, Wolf Frances, Elizabeth Suniega

Gulf Coast Division GME Research Day 2023

No abstract provided.

Patient Experience Study: Healthy Birth Initiatives & Providence, Monique Gill, Ritu Ghosal, Maggie M Hodges, Lindsay Dickey, Roberta Hunte

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No abstract provided.

Obesity During Adolescence And Feeding Practices During Infancy: Cross-Sectional Study, Reem Sharaf-Alddin, Radhia Almathkoori, Hara Kostakis, Ahmed N. Albatineh, Abdullah Al-Taiar, Muge Akpinar-Elci

Community & Environmental Health Faculty Publications

Background: Breastfeeding is proposed to play a role in reducing the risk of obesity throughout life. Kuwait has an extremely high prevalence of childhood obesity (45% of adolescents are overweight/obese) and extremely low breastfeeding indicators, particularly exclusive breastfeeding. In fact, little is known about the association between breastfeeding and obesity from Kuwait and the broader Middle East.

Aims: To estimate the prevalence of overweight/obesity in female adolescents in Kuwait and assess its association with breastfeeding during infancy.

Methods: This is a cross-sectional study that included 775 girls randomly selected from public and private high schools in Kuwait. The primary exposure …

Development Of A Community-Based Plan For An Effective Behavioral Intervention To Reduce Childhood Obesity In A Rural Appalachian Community, Jennifer Stacy Wells

Theses and Dissertations--Nutrition and Food Systems

Rural children experience increased rates of obesity and reduced access to specialized weight management facilities, which makes receiving the recommended frequency of care difficult. Clinical-community partnerships, recommended by the American Academy of Pediatrics (AAP) to expand access, have been shown to be a feasible strategy of care delivery. Examination of literature and stakeholder interviews were used to inform the development of a collaborative pediatric weight management program in a rural, Appalachian community. Screening articles as well as intervention articles were reviewed. Outcomes of screening articles reviewed included BMI measures (3), screening practices (7), and referral practices (4). Common outcomes of …

Relationships Among Pregnancy, Substance Use, Social Determinants Of Health And Assessment, Referral, And Utilization Of Treatment: A Secondary Analysis Of Nsduh Data, Heather Lynn Coddington

Graduate Theses, Dissertations, and Problem Reports (ETD)

ABSTRACT

Relationships Among Pregnancy, Substance Use, Social Determinants of Health and Assessment, Referral, and Utilization of Treatment: A Secondary Analysis of NSDUH Data

Heather Coddington

Background: Assessment and referral for substance use disorder during pregnancy is crucial to improving outcomes for mothers and newborns during the antepartum and postpartum period. Healthcare professionals are essential during the entirety of the pregnancy during each trimester to provide effective communication when assessing for substance use early and throughout each trimester of pregnancy. The purpose of this study was to determine if there was a relationship between assessment, referral, and utilization of treatment …

A Lifestyle Management Coaching Intervention For Fear Of Cancer Recurrence In Young Breast Cancer Survivors, Lisa R. Murphy

DNP Research Projects

Abstract

Objective: A significant challenge facing young breast cancer (BC) survivors is learning how to manage fear of cancer recurrence (FCR) during survivorship. Limited tailored FCR interventions and age-appropriate support exist. This Doctor of Nursing (DNP) project, based upon best practice guidelines, aimed to evaluate how a Lifestyle Management Coaching Intervention (LMCI) could help young female BC survivors learn how to decrease and manage their FCR more effectively and experience improved health outcomes.

Method: Eligible participants were female BC survivors aged 18-59 with Stage I-III BC demonstrating elevated baseline FCR screening scores during the extended survival period recruited from the …

The Effect Of An Educational Handout On Knowledge, Awareness And Attitudes Of Pre-Exposure Prophylaxis (Prep) Among Participants At A Needle And Syringe Exchange Site, Mckenzie Buckel

DNP Projects

Background: In 2018, the total number of HIV cases in the United States was 1.2 million. Almost 186,500 of these cases were attributed to intravenous drug use. With the adherence to pre-exposure prophylaxis (PrEP) there is approximately a 49% decrease in the rates of HIV among people who inject drugs and the most significant barrier to PrEP among this population is a lack of awareness and knowledge.

Objective: The purpose of this study was to determine participants’ of a needle and syringe exchange site knowledge, awareness and attitudes of PrEP after reviewing an educational handout about PrEP.

Methods: A quasi …

Addressing Breast Health Disparities Among Recent, Established African-Born Immigrant Women And Second-Generation Americans In Prince George County, Maryland, Omolola Okunromade

College of Graduate Studies: Theses & Dissertations

Background: Breast health disparities and underutilization of screening methods are major concerns in the United States (US), particularly affecting Black women who experience lower survival rates and advanced diagnoses. Despite the rapid growth of the African-born immigrant population, breast health among this group in the US is notably under-examined. This study aims to investigate the breast health knowledge and practices of first-generation African-born immigrants and second-generation immigrant women of African descent, aiming to understand the distinctive attributes of this group and the impact of acculturation on this public health issue.

Methods: Interviews were conducted among First Generation African immigrants and …

Plasma Protein Biomarkers Of Healthy Dietary Patterns: Results From The Atherosclerosis Risk In Communities Study And The Framingham Heart Study, Alice H Lichtenstein, Bing Yu, Ramachandran S Vasan, Josef Coresh, Casey M Rebholz

Faculty, Staff and Student Publications

Background: Molecular mechanisms underlying the benefits of healthy dietary patterns are poorly understood. Identifying protein biomarkers of dietary patterns can contribute to characterizing biological pathways influenced by food intake.

Objectives: This study aimed to identify protein biomarkers associated with four indexes of healthy dietary patterns: Healthy Eating Index-2015 (HEI-2015); Alternative Healthy Eating Index-2010 (AHEI-2010); DASH diet; and alternate Mediterranean Diet (aMED).

Methods: Analyses were conducted on 10,490 Black and White men and women aged 49-73 y from the ARIC study at visit 3 (1993-1995). Dietary intake data were collected using a food frequency questionnaire, and plasma proteins were quantified using …

Application Of Implementation Mapping To Develop Strategies For Integrating The National Diabetes Prevention Program Into Primary Care Clinics, Catherine Pulicken, Pierre Fwelo, Grace E White, Belinda M Reininger, John W Mcwhorter, Roshanda Chenier, Maria E Fernandez

Faculty, Staff and Student Publications

BACKGROUND: Diabetes is considered one of the most prevalent and preventable chronic health conditions in the United States. Research has shown that evidence-based prevention measures and lifestyle changes can help lower the risk of developing diabetes. The National Diabetes Prevention Program (National DPP) is an evidence-based program recognized by the Centers for Disease Control and Prevention; it is designed to reduce diabetes risk through intensive group counseling in nutrition, physical activity, and behavioral management. Factors known to influence this program's implementation, especially in primary care settings, have included limited awareness of the program, lack of standard clinical processes to facilitate …

Application Of Implementation Mapping To Develop Strategies For Integrating The National Diabetes Prevention Program Into Primary Care Clinics, Catherine Pulicken, Pierre Fwelo, Grace E White, Belinda M Reininger, John W Mcwhorter, Roshanda Chenier, Maria E Fernandez

Faculty, Staff and Student Publications

BACKGROUND: Diabetes is considered one of the most prevalent and preventable chronic health conditions in the United States. Research has shown that evidence-based prevention measures and lifestyle changes can help lower the risk of developing diabetes. The National Diabetes Prevention Program (National DPP) is an evidence-based program recognized by the Centers for Disease Control and Prevention; it is designed to reduce diabetes risk through intensive group counseling in nutrition, physical activity, and behavioral management. Factors known to influence this program's implementation, especially in primary care settings, have included limited awareness of the program, lack of standard clinical processes to facilitate …

Risk Of Depression In A Suburban Primary Care Setting Before And During The Covid-19 Pandemic

Faculty, Staff and Student Publications

INTRODUCTION: Major depression is a common disorder affecting millions of adults each year. Many population-based surveys showed an increase in the number people with symptoms of depression at the onset of the COVID-19 pandemic. Our aim was to determine and compare the prevalence of depression risk in a primary care setting before and during the COVID-19 pandemic.

METHODS: We conducted a cross-sectional study based on retrospective review of medical records from a large suburban primary care clinic. Records of adults 18 years and older, seen between January 1, 2019 and December 31, 2020 and who had also been screened for …

Cardiovascular Disease Risk Factors Among Middle-Aged And Older Adult Vietnamese American Members Of A Northern California Health Plan, Donna B Haysbert, Joan C Lo, Nirmala D Ramalingam, Nancy P Gordon

Faculty, Staff and Student Publications

OBJECTIVE: There is increasing recognition that cardiovascular disease (CVD) risk factors vary by Asian subgroups. We examined CVD risk factor prevalence among Vietnamese adults in a northern California health plan.

METHODS: We used electronic health record data to examine smoking, overweight/obesity (body mass index ≥23.0 kg/m

RESULTS: Current smoking prevalence was 20.3% for middle-aged men, 7.0% for older men, and

CONCLUSIONS: Study results suggest that more research on health conditions, lifestyle, and social factors among Vietnamese American adults is needed to develop culturally competent interventions to reduce CVD risk in this growing ethnic group.

Targeting Nuclear Hormone Receptors For The Prevention Of Breast Cancer, Cassandra L Moyer, Powel H Brown

Faculty, Staff and Student Publications

Advancements in research have led to the steady decline of breast cancer mortality over the past thirty years. However, breast cancer incidence has continued to rise, resulting in an undue burden on healthcare costs and highlighting a great need for more effective breast cancer prevention strategies, including targeted chemo preventative agents. Efforts to understand the etiology of breast cancer have uncovered important roles for nuclear receptors in the development and progression of breast cancer. Targeted therapies to inhibit estrogen receptor (ER) and progesterone receptor (PR) signaling (selective ER modulators, aromatase inhibitors and selective PR modulators) have shown great promise for …

Evaluation Of Scrub Typhus Surveillance, Alwar District, Rajasthan, India, July-August 2020, Surendra M Prajapati, Kanica Kaushal, Simmi Tiwari, Ajit Shewale, Tushar Nale

Faculty, Staff and Student Publications

INTRODUCTION: Scrub typhus is one of the most underreported and fatal illnesses accounting for 23% of all febrile illness. Rajasthan reported cases during 2018-2019 in state reporting system but did not report any case to central Integrated Disease Surveillance Programme (IDSP) unit. We evaluated the Scrub typhus surveillance system in Alwar district, Rajasthan, with the objective of describing and evaluating the system and providing evidence-based recommendations to identify gaps.

MATERIAL AND METHODS: In cross-sectional study, we reviewed records and conducted key informant interviews at district- and block-level health facilities. Using US Centers for Disease Control guidelines, we evaluated the system …

Safety Baby Shower Intervention Improves Safe Sleep Knowledge And Self-Efficacy Among Expectant Teens, Beverly K Miller

Faculty, Staff and Student Publications

INTRODUCTION: Young, minority women are less likely to follow recommendations to prevent infant sleep-related deaths putting their children at risk. This study extended the past pre/post study designs to an RCT design and included both parent report and objective observation of the sleep environment.

OBJECTIVE: This study focused on this population in a quantitative, randomized controlled trial using a low-cost, brief educational intervention, a Safety Baby Shower (SBS).

METHODS: Pregnant teens aged 13-19 (N = 147) were recruited as a dyad with a senior female caregiver and randomized to intervention or control groups.

RESULTS: Comparing self-report, safe sleep knowledge, attitudes, …

School-Based Intervention Impacts Availability Of Vegetables And Beverages In Participants’ Homes, Erin A Hudson, Marissa Burgermaster, Sophia M Isis, Matthew R Jeans, Sarvenaz Vandyousefi, Rebecca Seguin-Fowler, Jaimie Davis

Faculty, Staff and Student Publications

As rates of metabolic syndrome rise, children consume too few vegetables and too much added sugar. Because children tend to eat what is available at home, the home environment plays a key role in shaping dietary habits. This secondary analysis evaluated the effects of a school-based gardening, cooking, and nutrition education intervention (TX Sprouts) compared to control on the availability of vegetables, fruit juice, and sugar-sweetened beverages (SSBs) at home. In the TX Sprouts cluster-randomized trial, 16 schools were randomized to TX Sprouts (

Regional Disparities In Major Cancer Incidence In Korea, 1999–2018, Eun Hye Park, Mee Joo Kang, Kyu-Won Jung, Eun Hye Park, E Hwa Yun, Hyun-Joo Kong, Jeong-Soo Im, Hong Gwan Seo

Faculty, Staff and Student Publications

OBJECTIVES: This study investigated regional disparities in the incidence of 8 major cancers at the municipal level in Korea during 1999-2018 and evaluated the presence or absence of hot spots of cancer clusters during 2014-2018.

METHODS: The Korea National Cancer Incidence Database was used. Age-standardized incidence rates were calculated by gender and region at the municipal level for 4 periods of 5 years and 8 cancer types. Regional disparities were calculated as both absolute and relative measures. The possibility of clusters was examined using global Moran's I with a spatial weight matrix based on adjacency or distance.

RESULTS: Regional disparities …