Community Health and Preventive Medicine Commons^™

Effectiveness Of Antibiotic Stewardship For Healthcare Providers At Urgent Care Clinics, Helen T. Adewole

Electronic Theses and Dissertations

Antibiotics have revolutionized modern medicine; however, the overuse in urgent care and primary care significantly contributes to the global burden of infections resistant to available antimicrobial medicines. Approximately 30% of the antimicrobials prescribed in acute care settings are unnecessary. Patient demand for antibiotics has seemingly skyrocketed following the recent COVID-19 pandemic. Practitioners must be knowledgeable about antibiotic stewardship initiatives, such as the wait-and-see approach, to reduce antibiotic overuse and improve the trajectory of antibiotic resistance and patient health outcomes. The gap in practice was the limited awareness of scientific evidence-based tools to partner with patients and improve antibiotic prescription patterns. …

Ethnic Minorities And Family Health History: An Autoethnography Of Guyanese Americans And Kidney Disease, Dhaneesha R. Bahadur

Dissertations, Theses, and Capstone Projects

Exploring family health histories (FHHs) has emerged in recent years as an inexpensive genomic tool in public health. Families and clinicians can also use them to uncover family histories and experiences, which could inform better lifestyle choices to prevent or delay the onset of diseases. Exploring family health histories focuses on an individual’s genetic makeup and considers differences in lifestyle and environment. Despite national campaigns, it is an underutilized tool that could lead to engagement in effective strategies and better health outcomes. One important and serious condition that families should be more aware of is chronic kidney disease (CKD). One …

Veterans Health Administration Enrollees’ Choice Of Care Setting Relates To The Expansion Of Care Options: Evidence From Screening Colonoscopies Before And After The Mission Act, Chase S Eck, Cheng Jiang, Laura A Petersen

Center for Medical Ethics and Health Policy Staff Publications

Objective: To estimate whether those enrolled in the Veterans Health Administration (VHA) were less likely to use VHA-delivered colorectal cancer screening colonoscopies after the MISSION Act.

Data sources and study setting: Secondary data were collected on VHA-enrolled Veterans from FY2017-FY2021.

Study design: This retrospective cross-sectional study measured the volume and share of screening colonoscopies that were VHA-delivered over time and by drive time eligibility-defined as living more than 60 min away from the nearest VHA specialty-care clinic. We used a multivariable logistic regression to adjust for patient and facility factors.

Data extraction: Data were extracted for VHA enrollees (n = …

Implementation And Evaluation Of A Mhealth-Based Community Health Worker Feedback Loop For Hispanics With And At Risk For Diabetes, Elizabeth M Vaughan, Victor J Cardenas, Wenyaw Chan, Amber B Amspoker, Craig A Johnston, Salim S Virani, Christie M Ballantyne, Aanand D Naik

Faculty, Staff and Student Publications

BACKGROUND: Gaps in accessibility and communication hinder diabetes care in poor communities. Combining mobile health (mHealth) and community health workers (CHWs) into models to bridge these gaps has great potential but needs evaluation.

OBJECTIVE: To evaluate a mHealth-based, Participant-CHW-Clinician feedback loop in a real-world setting.

DESIGN: Quasi-experimental feasibility study with intervention and usual care (UC) groups.

PARTICIPANTS: A total of 134 participants (n = 67/group) who were all low-income, uninsured Hispanics with or at-risk for type 2 diabetes.

INTERVENTION: A 15-month study with a weekly to semimonthly mHealth Participant-CHW-Clinician feedback loop to identify participant issues and provide participants monthly diabetes …

Human Zoo Healthcare At The 1904 World’S Fair, Angel Blake

Undergraduate Research Symposium

Human Zoo Healthcare at the 1904 World’s Fair

Were precautions taken or put into place for the Human Zoo performers at the 1904 World’s Fair? This topic has been overlooked and understudied by historians, there are few articles written and we do not know the true death toll which shows the racism towards these indigenous peoples. The research for this project was conducted at the State Historical Society of Missouri, the St. Louis Mercantile Library, Newspapers.com, Archives.com, St. Louis Public Library, and the Missouri Historical Society, including research on primary sources such as official World’s Fair committee meeting minutes, hospital …

Prognosis Of Covid-19 On Workers With History Of Asthma: An Evidence-Based Case Report, Parmitasari Parmitasari, Dewi Yunia Fitriani, Indah S. Widyahening

Occupational and Environmental Medicine Journal of Indonesia

Background. As the COVID-19 pandemic occurs, those with asthma were thought to have an increased risk of infection. Question arisen whether special preparation for severe clinical outcomes might be needed for remote site workers. Method. A literature search was conducted through PubMed, Scopus and ProQuest databases, as well as hand searched. The inclusion criteria were systematic review, cohort study, retrospective study, cross sectional study, COVID-19, asthma, and ICU. Then, they were critically appraised based on Center of Evidence-Based Medicine, Oxford University, Critical Appraisal for Prognostic Studies and Systematic Reviews. Result. Three systematic review studies and three retrospective cohort studies were …

Factors Affecting Superoxide Dismutase Activity In Railway Workers In Jakarta, Indonesia, Vera Winata, Muhammad Ilyas, Aria Kekalih, Suryo Wibowo, Muchtaruddin Mansyur

Occupational and Environmental Medicine Journal of Indonesia

Introduction. Railway workers are exposed to many occupational health risk factors that may cause oxidative stress. Superoxide dismutase (SOD) activity is one of the response biomarkers of oxidative stress.

Methods. A cross-sectional study was conducted from July-October 2021. Eighty-four participants were included in this study. Data about participants’ characteristics, physical activity intensity as measured by the Global Physical Activity Questionnaire (GPAQ) version 2, and stress levels as measured by Holmes-Rahe Stress Inventory were collected using Google Forms. The physical examination yielded data on blood pressure, ear condition, and waist circumference. Blood Superoxide dismutase activity and HbA1c levels were determined using …

Validity And Reliability Of The Indonesian Version Of Expanded Nursing Stress Scale (Enss) As A Job-Stress Assessment Tool For Nurses, Hasto Harsono, Herqutanto Herqutanto, Suryo Wibowo, Aria Kekalih, Astrid Sulistomo

Occupational and Environmental Medicine Journal of Indonesia

ABSTRACT

Background: Job stress is a serious health problem in the 21st century because of its high incidence and impact. Nurses are known as a profession that has high risks of stress, has distinctive characteristics, and hence requires a work stress assessment instrument that suits its peculiarities. The Expanded Nursing Stress Scale (ENSS) is a nurse-specific stress assessment instrument that has high validity and reliability (Cronbach's alpha = 0.96) and is widely used in many countries but is not yet available in Indonesian. This study aims to obtain the Indonesian version of ENSS and evaluate its reliability and validity.

Method: …

The Association Between Mental Workload And Nonspecific Chronic Low Back Pain Among Operators Of An On Shore Oil And Gas Company In South Sumatera, Ardi Artanto, Suryo Wibowo, Nuri Purwito Adi

Occupational and Environmental Medicine Journal of Indonesia

Background: Work location influences the proportion of operators with low back pain (LBP) at a South Sumatera onshore oil and gas company. This study aimed to determine the prevalence of nonspecific chronic LBP among the company's operators, as well as the association between quantitative and qualitative mental workload and nonspecific chronic LBP.

Methods: This study was cross-sectional in design, with 96 samples collected through purposive sampling. Questionnaires and physical examinations were used to collect data.

Results: Nonspecific chronic LBP was found in 32.3 percent of people. According to the multivariate analysis, moderate-heavy qualitative mental workload (OR: 5.14; 95 percent CI: …

The Effectiveness Of Education Through Web-Based Seminar In Increasing Knowledge About The Early Detection And Reporting Of Occupational Diseases, Keyne Christa Monintja, Dewi Sumaryani Soemarko, Dewi Yunia Fitriani, Herqutanto Herqutanto, Suryo Wibowo

Occupational and Environmental Medicine Journal of Indonesia

Background: In 2022, the Indonesian Occupational Medicine Association (IOMA) collaborated with oil and gas companies and conducted a web-based seminar (webinar) to enable participants to recognize occupational disease earlier and enhance reporting in companies. We aimed to investigate the effectiveness of the webinar in increasing the intended knowledge.

Method: The webinar was separated into three batches, with different participants per batch. Using a one-group pretest-posttest design, we utilized secondary data from IOMA. The effectiveness of the webinar was determined by participants' satisfaction and knowledge as measured by pre-test and post-test. After performing item analysis, we removed poor discriminating items in …

Analysis Of Knowledge Of Hospital Manager About Occupational Tuberculosis And Associated Factors, Aditya Agung Prasetyo, Suryo Wibowo, Muhammad Ilyas, Ahmad Fuady, Feni Fitriani Taufik

Occupational and Environmental Medicine Journal of Indonesia

Introduction.Knowledge of hospital managers about occupational tuberculosis can affect occupational tuberculosis services in the hospital. This study aims was to identify associated factors with knowledge of hospital manager about occupational tuberculosis in order to improve occupational tuberculosis services in hospitals as seen in the four management functions.

Method.Concurrent embedded mixed approaches are used in this cross-sectional study. Focus group discussions (FGD) are used in qualitative research, whereas questionnaires are used in quantitative research. The questionnaire was evaluated using the difficulty level and discriminating index tests. The ten questions were examined both univariate and bivariate. Thematic analysis was used …

Psychosocial Factors In The Workplace, Suryo Wibowo

Occupational and Environmental Medicine Journal of Indonesia

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A Case Study To Investigate Factors Influencing The Santa Clara County Getting To Zero Initiative’S Collective Impact Model, Harit Agroia, Rebecca Reno, Jenette Spezeski, Leyla Mousli, Richard Sarabia, Erin Starzyk

Journal of Social, Behavioral, and Health Sciences

Our objective was to explore how factors, such as backbone organization changes and COVID-19, affected a collective impact (CI) initiative’s progression through the five CI phases and its components of success. We conducted a case study using semistructured interviews with 17 representatives from the action committee, community-based organization, and health department between January and February 2023 in Santa Clara County, California. Participants were asked how internal and external factors affected their engagement and experiences with the CI initiative. We analyzed the data using structural and holistic coding. Results showed that the initiative’s progression was impacted by intersecting factors; overall findings …

Self-Efficacy, Grit, And Rural Career Aspirations Among Early Career Nurses: A Repeated Cross-Sectional Study, Daniel Terry, Blake Peck, Ed Baker, David Schmitz

Public and Population Health Faculty Publications and Presentations

Background Global nursing workforce shortage represents an impediment to the delivery of safe, evidence-based healthcare. Despite collective efforts, a consistent stream of nurses leaving the profession remains, particularly within the first five years of practice, which is exacerbated in rural communities. The aim of the study was to compare self-efficacy, grit, and rural career aspirations among nursing graduates between their second and fourth year of their nursing profession.

Methods As part of a longitudinal investigation, a repeated cross-sectional design was utilised. Participants included, 117 (response rate 52.2%) who completed an online questionnaire 18–24 months after graduating, and 32 participants (response …

Polygenic Scores For Tobacco Use Provide Insights Into Systemic Health Risks In A Diverse Ehr-Linked Biobank In Los Angeles, Vidhya Venkateswaran, Kristin Boulier, Yi Ding, Ruth Johnson, Arjun Bhattacharya, Bogdan Pasaniuc

Faculty, Staff and Student Publications

Tobacco use is a major risk factor for many diseases and is heavily influenced by environmental factors with significant underlying genetic contributions. Here, we evaluated the predictive performance, risk stratification, and potential systemic health effects of tobacco use disorder (TUD) predisposing germline variants using a European- ancestry-derived polygenic score (PGS) in 24,202 participants from the multi-ancestry, hospital-based UCLA ATLAS biobank. Among genetically inferred ancestry groups (GIAs), TUD-PGS was significantly associated with TUD in European American (EA) (OR: 1.20, CI: [1.16, 1.24]), Hispanic/Latin American (HL) (OR:1.19, CI: [1.11, 1.28]), and East Asian American (EAA) (OR: 1.18, CI: [1.06, 1.31]) GIAs but …

Alternative Dosing Regimen Of Exemestane In A Randomized Presurgical Trial: The Role Of Obesity In Biomarker Modulation, Harriet Johansson, Aliana Guerrieri-Gonzaga, Sara Gandini, Bjørn-Erik Bertelsen, Debora Macis, Davide Serrano, Gunnar Mellgren, Matteo Lazzeroni, Parijatham S Thomas, Katherine D Crew, Nagi B Kumar, Irene Maria Briata, Viviana Galimberti, Giuseppe Viale, Lana A Vornik, Valentina Aristarco, Tania Buttiron Webber, Stefano Spinaci, Powel H Brown, Brandy M Heckman-Stoddard, Eva Szabo, Bernardo Bonanni, Andrea Decensi

Faculty, Staff and Student Publications

In a 3-arm presurgical trial, four-six weeks exemestane 25 mg three times/week (TIW) was non-inferior to 25 mg/day (QD) in suppressing circulating estradiol in postmenopausal women with ER-positive breast cancer. Since obesity may decrease exemestane efficacy, we analyzed changes in sex steroids, adipokines, Ki-67, and drug levels in relation to obesity. Postmenopausal women with early-stage ER-positive breast cancer were randomized to either exemestane 25 mg QD (n = 57), 25 mg TIW (n = 57), or 25 mg/week (QW, n = 62) for 4-6 weeks before breast surgery. Serum and tissue pre- and post-treatment biomarkers were stratified by body mass …

Modeling The Health Impact And Cost-Effectiveness Of A Combined Schoolgirl Hpv Vaccination And Cervical Cancer Screening Program In Guangdong Province, China, Yating Huang, Dantao Zhang, Lihua Yin, Jianguo Zhao, Zhifeng Li, Jing Lu, Xiaoming Zhang, Chenggang Wu, Wei Wu

Faculty, Staff and Student Publications

Low human papillomavirus (HPV) vaccine uptake is a key barrier to cervical cancer elimination. We aimed to evaluate the health impact and cost-effectiveness of introducing different HPV vaccines into immunization programs and scaling up the screening program in Guangdong. We used a dynamic compartmental model to estimate the impact of intervention strategies during 2023-2100. We implemented the incremental cost-effectiveness ratio (ICER) in costs per averted disability-adjusted life year (DALY) as an indicator to assess the effectiveness of the intervention. We used an age-standardized incidence of 4 cases per 100,000 women as the threshold for the elimination of cervical cancer. Compared …

Barriers To Care For Children With Cerebral Palsy In The Rural State Of Maine: A Mixed-Methods Study, Rayne L. Whitten, Anya K. Cutler, Alexa K. Craig

Journal of Maine Medical Center

Introduction: Guidelines on orthopedic hip surveillance in children with cerebral palsy have been published to minimize the effects of cerebral palsy and maximize quality of life. Researchers aimed to identify barriers to cerebral palsy care and to assess adherence to national hip-surveillance guidelines among a small subset of children with cerebral palsy who live in a rural state.

Methods: Parents of children with cerebral palsy were interviewed, and thematic analyses were performed on the recorded transcripts. Patient-specific data about imaging and demographics were manually extracted from the electronic health record to perform a mixed-methods analysis.

Results: Twenty-one parents were interviewed, …

A Life-Threatening Emergency Exacerbated By Untreated Mental Illness In A Low-Barrier Health Center, Brendan J. Prast, Byron Marshall

Journal of Maine Medical Center

Introduction: We report on a patient with untreated severe mental illness who presented with a life-threatening emergency: retained products of conception and hemorrhage.

Clinical Findings: A female patient experiencing homelessness developed life-threatening hemorrhage. Her mental illness impaired effective communication and treatment.

Clinical Course: The patient presented with fatigue, vaginal bleeding, and known retained products of conception. Her active mental illness complicated the situation as it limited effective communication and treatment due to delusions. She requested only treatment for an infectious cause of her symptoms. She refused most interventions and had a self-directed discharge from the hospital. Throughout this process, we …

A Conceptual Analysis Of Sbirt Implementation Alongside The Continuum Of Prep Awareness: Domains Of Fit And Feasibility., Lesley M. Harris, Kerr C. Jelani, Blake D. Skidmore, Smita Ghare, Andrea Reyes-Vega, Vania Remenik-Zarauz, Harideep Samanapally, Rana U. Anwar, Rishikesh Rijal, Kendall Bryant, Martin T. Hall, Shirish Barve

Faculty and Staff Scholarship

Screening, Brief Intervention, and Referral to Treatment (SBIRT) is a supplementary intervention that can be incorporated into the Pre-Exposure Prophylaxis (PrEP) Care Continuum, complementing initiatives and endeavors focused on Human Immunodeficiency Virus (HIV) prevention in clinical care and community-based work. Referencing the Transtheoretical Model of Change and the PrEP Awareness Continuum, this conceptual analysis highlights how SBIRT amplifies ongoing HIV prevention initiatives and presents a distinct chance to address identified gaps. SBIRT's mechanisms show promise of fit and feasibility through (a) implementing universal Screening (S), (b) administering a Brief Intervention (BI) grounded in motivational interviewing aimed at assisting individuals in …

County-Level Trends And Potential Disparities In The Suicide Rates In Virginia, 2020 – 2022, Sharon A. Olowoyo, Oluwatosin M. Oduneye, Glodi B. Bokanya, Ayooluwa G. Olowoyo, Coralie E. Mugenga, Yuhan Yan, Robyn L. Anderson

Montview Journal of Research & Scholarship

Abstract

Objectives

This study aims to investigate the influence of social determinants of health (SDH) on suicide patterns in the state of Virginia.

Methods

A secondary statistical analysis was conducted using publicly accessible data from the County Health Rankings & Roadmaps database for Virginia. Data from 2020 to 2022 were analyzed, focusing on age-adjusted suicide rates and SDH factors, including % rural, mental health provider rate, median household income, high school completion, and unemployment rates. Multiple regression analysis and visualizations were employed for data interpretation.

Results

The analysis revealed that SDH factors significantly predicted suicide rates across the study period. …

Experiences Of Family Communication And Cascade Genetic Testing For Hereditary Cancer In Medically Underserved Populations-A Qualitative Study, Erica M Bednar, J Alejandro Rauh-Hain, Jose J Garcia, Norma De Aguinaga, Mary Anne Powell, Sylvia L Peral, Roni Nitecki, Kirsten Jorgensen, Natasha L Rudy, Karen H Lu, Charles A Leath, Isabel C Scarinci

Faculty, Staff and Student Publications

UNLABELLED: We sought to explore the intrafamilial communication and cascade genetic testing (CGT) experiences of patients with hereditary cancer from diverse, medically underserved populations and their relatives. Participants included patients receiving oncology care at an urban, safety net hospital in Texas or comprehensive cancer center in Alabama and their first-degree relatives. In-depth semi-structured qualitative interviews were completed wherein patients shared their experiences with genetic counseling (GC), genetic testing (GT), and communicating their results to relatives. Relatives shared their experiences receiving information from the patient and considering CGT. Interviews were transcribed, coded, and themes were identified. Of 25 participating patients, most …

Health Systems Partnership For Collaborative Anti-Racist Perinatal Care: A Case Study Of Black Community Based Perinatal Care, Roberta Hunte, Monique Gill, Kevin Cherry, Desha Reed-Holden

Reports

No abstract provided.

Addressing The Big Picture As A Community-Engaged Linguist: Community-Engaged Scholarship And Applied Learning For Systemic Change, Rachel E. Showstack

International Journal of the Linguistic Association of the Southwest

Through a narrative about the formation and advancement of Wichita State University’s community-based health equity initiative Alce su Voz (‘Speak Out’), this article presents a reflection on the author’s role as a community-engaged scholar and the multiple levels of work in which linguists can engage to support linguistic social justice. The paper begins with a discussion of the role of the applied linguist in social change and a discussion of community-engaged scholarship, including community-based learning and community-based research. Then, using Alce su Voz’s approach to improving health equity for speakers of Spanish and Indigenous languages as an example, the author …

Husr 336: Human Sexuality Undergraduate Course, Four Units, Emily Darrell, Rose Grace Grose

Open Course Materials

This brief Human Sexuality curriculum, offered as part of an undergraduate elective in the Human Services department, encompasses four units that collectively provide a comprehensive exploration of sexuality education in the U.S., the intersection of sex and disability, contraception, and variations in sexual behavior including kink and paraphilias. This curriculum provides varied, current, and accessible information about these topics using resources that students can continue to access for free after the end of the semester.

• Unit 1: Introduction to Human Sexuality & Sexual Education in the U.S. introduces students to the history of sex education in the United States, facilitating …

Climate Change And Mental Health: An Interactive Educational Session, Andrea Costin, Daniel Fisher, Bethany Harper, Ramzi W. Nahhas, John Sullenbarger

Population and Public Health Sciences Faculty Publications

Introduction: Climate change is the single biggest health threat facing humanity, with direct and indirect impacts on mental health, yet health impacts of climate change remain notably absent from most medical school curricula. We describe a timely interactive educational session on climate change and mental health that was implemented and studied on a medical student clinical psychiatry rotation. Methods: We developed a 1-hour introductory session on the mental health impacts of climate change and potential solutions. The session was delivered to third-year medical students on their 4-week clinical psychiatry rotation and included pre- and postsession survey questions assessing their knowledge, …

Assessing Lung Cancer Screening Protocols And Outcomes: A Comparative Analysis Between Indonesia And The United States, Priscilla Sitorus

Nursing | Senior Theses

Background/Significance: Social inequity is a large problem within the healthcare system, especially in third-world countries, like Indonesia. Poor access to healthcare and screening protocols can contribute to delayed diagnoses, poorer outcomes, and increasing mortality rates. Purpose: This study aims to assess the effectiveness of lung cancer screening protocols in Indonesia compared to California and help identify potential barriers and factors in lung cancer screening in both regions. This will later help reform policy interventions and decisions to improve community access. Methods: The study will be divided into two portions using a mixed method approach. The qualitative component will include lung …

A Quality Improvement Study On Increasing Rates Of Lung Cancer Screening, Arpit Arora, Crystal Bharat, Sophia Zia, Pooja Paunikar, Dana Simpson

South Atlantic Division GME Research Day 2024

No abstract provided.

Primary Care Physician Trust: The Importance Of Early Medical Intervention For African American Children With Asthma, Harrish Ganesh

AUCTUS: The Journal of Undergraduate Research and Creative Scholarship

Asthma is a prevalent condition characterized by an individual’s airway becoming inflamed, constricted, and leads to the formation of mucus and difficulty breathing. Nearly 27 million individuals are currently diagnosed with Asthma in the United States, and African Americans are 40% more likely to be diagnosed with asthma than Caucasians. This literature review analyzed multifaceted barriers that restrict African American asthmatic children from gaining consistent asthma treatment. Some of these barriers range from historical racial discrimination that leads to parental mistrust to financial and educational barriers that result in inconsistent pediatric care for asthmatic children. The combination of the above …

Qualitative Study Of Hiv-Related Stigma In The Dental Care Setting, Sania A. Pullen, Dr. Dina T. Garcia

UROP Posters

Objectives: People living with HIV (PLWH) are susceptible to developing a variety of oral conditions that if left untreated can lead to sore gums, painful chewing, and tooth loss as well as compromise HIV management and viral suppression. Despite the increased risk of developing oral conditions, it is estimated that up to 58% of PLH do not receive regular dental care. This study aimed to examine HIV-related stigma and discrimination in the dental care setting.

Methods: Adults living with HIV who receive care through the Ryan White HIV/AIDS Program at the VCU Infectious Disease (ID) clinic were recruited to participate. …