Community Health and Preventive Medicine Commons^™

Healthier Oregon Qualitative Study, Core (Center For Outcomes Research & Education)

Reports

No abstract provided.

Nursing, Physical Therapy, And Cytotechnology Graduate And Undergraduate Students' Attitudes Toward Teamwork Before And After Participation In An Interprofessional Education Experience, Shelley C. Mishoe, Muge Akpinar Elci, Rebecca Poston, Kimberly Adams Tufts, Beth Thompson

Community & Environmental Health Faculty Publications

BACKGROUND Educating health professional (HP) students in environments wherein they can learn about, from, and with each other can prepare them for interprofessional collaborative practice (IPCP), which may positively impact patient safety and satisfaction (Brashers et al., 2015; Health Professions Accreditors Collaborative [HPAC], 2019). IPCP is characterized by effective communication, shared values, respect for diverse disciplines and teamwork among health professionals (IOM, 2015). However, professional silos in practice can foster competition rather than collaboration. Knowledge of HP roles and responsibilities is a primary tenet of IPCP (Interprofessional Educational Collaborative [IPEC], 2011).

PURPOSE An interprofessional education (IPE) approach that combined book …

Strategic Implications Of Covid-19: Considerations For Georgia’S Rural Health Providers, Bettye A. Apenteng, Linda Kimsey, Charles Owens, Samuel T. Opoku, Angela Peden, William Mase

Health Policy & Community Health: Faculty Publications

Whether rural hospitals and providers have seen a surge in COVID-19 cases or a reduction in patients seeking care since the pandemic began, their financial condition has been negatively impacted. Many providers have now received some emergency funding through the Coronavirus Aid, Relief, and Economic Security Act and the Payroll Protection Program but these are likely only short-term fixes. For many, the crisis has exacerbated already existing problems. Notable among these problems are volume declines, supply chain disruptions, and workforce concerns. While these problems require immediate action, two longer-term systemic changes to rural healthcare delivery are needed to address them. …

How Did We Learn About Sex? —— Sex Education And Sexual Health In Chinese Youth, Yujuan Liu

Theses and Dissertations (Comprehensive)

Attitudes toward sexuality among Chinese youth have become more liberal in recent generations, but sex education remains controversial and limited. Due to the lack of awareness of sexual risks, many Chinese youth engage in unprotected sexual activities resulting in unintended pregnancy, abortions, and STIs. Therefore, understanding successful pathways and unique challenges are crucial to develop adequate sex education for youth’s sexual health in China. The current study used semi-structured in-depth interviews and investigated 28 Chinese youths’ experiences of sex education and sexual health. The results mapped out youth’s sex education experiences by age and sources and demonstrated the impacts of …

Epigenetic Mechanisms Underlying Hiv-Infection Induced Susceptibility Of Cd4+ T Cells To Enhanced Activation-Induced Fasl Expression And Cell Death., Smita Ghare, Paula M. Chilton, Aakarsha V. Rao, Swati Joshi-Barve, Paula Peyrani, Andrea Reyes-Vega, Craig J. Mcclain, Kendall Bryant, Robert L. Cook, Mathew Freiberg, Shirish Barve

Faculty and Staff Scholarship

Background:

Chronic immune activation and CD4⁺ T cell depletion are significant pathogenic features of HIV infection. Expression of Fas ligand (FasL), a key mediator of activation-induced cell death in T cells, is elevated in people living with HIV-1 infection (PLWH). However, the epigenetic mechanisms underlying the enhanced induction of FasL expression in CD4⁺ T lymphocytes in PLWH are not completely elucidated. Hence, the current work examined the effect of HIV infection on FasL promoter-associated histone modifications and transcriptional regulation in CD4⁺ T lymphocytes in PLWH.

Method:

Flow cytometric analysis was performed to examine the Fas-FasL expression on …

Understanding And Promoting Racial Diversity In Healthcare Settings To Address Disparities In Pandemic Crisis Management, Azza Sarfraz, Zouina Sarfraz, Alanna Barrios, Kuchalambal Agadi, Sindhu Thevuthasan, Krunal Pandav, Manish Kc, Muzna Sarfraz, Pedram Rad, George Michel

Department of Paediatrics and Child Health

Background: Health disparities have become apparent since the beginning of the COVID-19 pandemic. When observing racial discrimination in healthcare, self-reported incidences, and perceptions among minority groups in the United States suggest that, the most socioeconomically underrepresented groups will suffer disproportionately in COVID-19 due to synergistic mechanisms. This study reports racially-stratified data regarding the experiences and impacts of different groups availing the healthcare system to identify disparities in outcomes of minority and majority groups in the United States.
Methods: Studies were identified utilizing PubMed, Embase, CINAHL Plus, and PsycINFO search engines without date and language restrictions. The following keywords were used: …

Cardio-Pulmonary Sequelae In Recovered Covid-19 Patients: Considerations For Primary Care, Zouina Sarfraz, Azza Sarfraz, Alanna Barrios, Radhika Garimella, Asimina Dominari, Manish Kc, Krunal Pandav, Juan C. Pantoja, Varadha Retnakumar, Ivan Cherrez-Ojeda

Department of Paediatrics and Child Health

Background: Current literature lacks characterization of the post-recovery sequelae among COVID-19 patients. This review characterizes the course of clinical, laboratory, radiological findings during the primary infection period, and the complications post-recovery. Primary care findings are presented for long-COVID care.
Methods: Adhering to PRISMA guidelines, 4 databases were searched (PubMed, Embase, CINAHL Plus, Scopus) through December 5, 2020, using the keywords "COVID-19 and/or recovered and/or cardiovascular and/or long-term and/or sequelae and/or sub-acute and/or complication." We included published peer-reviewed case reports, case series, and cross-sectional studies providing the clinical course of COVID-19 infection, and cardiopulmonary complications of patients who recovered from COVID-19, …

Patient-Perceived Versus Actual Risk Of Cardiovascular Disease And Associated Willingness To Consider And Use Prevention Therapy, Ann Marie Navar, Tracy Y Wang, Shuang Li, Xiaojuan Mi, Zhuokai Li, Jennifer G Robinson, Salim S Virani, Eric D Peterson

Faculty, Staff and Students Publications

BACKGROUND: Cardiovascular prevention guidelines use estimated 10-year atherosclerotic cardiovascular disease (CVD) risk based on the pooled cohort equations to guide treatment decisions and engage patients in shared decision-making. We sought to determine patient perceived versus actual risk of atherosclerotic CVD and associations with willingness for preventive therapy.

METHODS: We evaluated calculated and perceived CVD risk among 4187 patients across 124 sites in the Patient and Provider Assessment of Lipid Management Registry. Ten-year risk was assessed using the pooled cohort equations; risk relative-to-peers was determined based on age-, sex-, and race-based percentiles; and patient estimates of risk were assessed using patient …

Effect Of An Electronic Order Set On Newborn Hepatitis B Immunization Rates, Daniel Pedersen, Angelina Rodriguez, Olu Oyesanmi, Heather Schramm, Michael King

HCA Healthcare Journal of Medicine

Objective

Hepatitis B is an infectious deoxyribonucleic acid virus which can cause significant morbidity and mortality. There is no current definitive treatment, however in the United States immunization is widely available. A paper published by the Advisory Committee on Immunization Practices/Centers for Disease Control (ACIP/CDC) in 2018 made updated recommendations regarding vaccination practices in the United States. The most notable change made was that all healthy newborns weighing ≥2000 g with a negative hepatitis B-status mother should receive hepatitis B immunization within 24 hours of birth. This quality improvement project studied the effect of the electronic medical record newborn admission …

Preconceptional Lipid-Based Nutrient Supplementation In 2 Low-Resource Countries Results In Distinctly Different Igf-1/Mtor Placental Responses, Marisol Castillo-Castrejon, Ivana V. Yang, Elizabeth J. Davidson, Sarah J. Borengasser, Purevsuren Jambal, Jamie Westcott, Jennifer F. Kemp, Ana Garces, Sumera Aziz Ali, Sarah Saleem

Community Health Sciences

Background: Preconceptional maternal small-quantity lipid-based nutrient supplementation (SQLNS) improved intrauterine linear growth in low-resource countries as demonstrated by the Women First Preconception Maternal Nutrition Trial (WF). Fetal growth is dependent on nutrient availability and regulated by insulin-like growth factor 1 (IGF-1) through changes in placental transfer capacity, mediated by the mechanistic target of rapamycin (mTOR) pathway.
Objectives: Our objective was to evaluate the role of placental mTOR and IGF-1 signaling on fetal growth in women from 2 low-resource countries with high rates of stunting after they received preconceptional SQLNS.
Methods: We studied 48 women from preconception through delivery who were …

Elderly Musculoskeletal Disease Burden In Karachi, Pakistan: Associations And Implications For Developing Countries, Saniya Sabzwari, Zafar Fatmi, Adeel Ahmed Khan

Department of Family Medicine

Objective: The global rise in the older population has increased the rates of osteoporosis and osteoarthritis, conditions that impact mobility and functionality. There is limited data on musculoskeletal disease in older populations residing in developing countries.
Methods: A community-based study using multistage cluster random sampling of older individuals was conducted in Karachi. Predefined criteria were used for osteoporosis and osteoarthritis. Gait assessment was performed.
Results: More than half of the participants were females and 53% reported illiteracy. Around 30% had osteoporosis and two-thirds had osteoarthritis. Multivariate analysis showed associations of female sex, Pashtun ethnicity, illiteracy, and hypertension with the combined …

Short Term Effects Of Electronic Cigarettes On Pulmonary Function In Healthy Adult Smokers When Compared To Conventional Cigarette Use, Kayleen Lynch, Rachel Bastianelli

Physician Assistant Capstones, 2020-current

Background: Electronic cigarettes (e-cigarettes) first appeared on the U.S. market in 20071 , but to date, little is known about their safety. Concern about long term adverse effects on overall health continues to increase as we explore the potential of e-cigarettes to aid in smoking cessation practices. E-cigarettes have gained popularity and support through this idea that by using them to help patients quit smoking, the benefits of ultimately abstaining from tobacco use will outweigh the harms associated with e-cigarette use¹ . While the idea of reducing tobacco usage by any means possible remains the goal for most providers, …

Healthcare Workers Hospitalized With Covid-19: Outcomes From The Burden Of Covid-19 Study At The University Of Louisville Center Of Excellence For Research In Infectious Diseases [Cerid], Ruth Carrico, T'Shura S. Ali, Maria Hill, Lucia B. Puga Sanchez, Catherine M. Bryan, Dawn Balcom, Stephen P. Furmanek, Amr Aboelnasr, Julio A. Ramirez

The University of Louisville Journal of Respiratory Infections

Introduction: On March 6, 2020, the current ongoing pandemic of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), also known as COVID-19, reached the commonwealth of Kentucky. Within days, the first cases of infection and hospitalization were identified among healthcare workers (HCW) in Kentucky, other states in the U.S., and around the world. There is little information available regarding the impact of COVID-19 on the HCW population within this area. The objective of this study was to describe the baseline characteristics of hospitalized HCWs infected with COVID-19.

Methods: Data collection was performed as part of a retrospective study of patients hospitalized …

Open Drug Discovery Of Anti-Virals Critical For Canada’S Pandemic Strategy, Tania M. Bubela, E. Richard Gold, Vivek Goel, Max Morgan, Karen Mossman, Jason Nickerson, David Patrick, Aled Edwards

Office of the Provost

In the event of the current COVID-19 pandemic and in preparation for future pandemics, open science can support mission-oriented research and development, as well as commercialization. Open science shares skills and resources across sectors; avoids duplication and provides the basis for rapid and effective validation due to full transparency. It is a strategy that can adjust quickly to reflect changing incentives and priorities, because it does not rely on any one actor or sector. While eschewing patents, it can ensure high-quality drugs, low pricing, and access through existing regulatory mechanisms. Open science practices and partnerships decrease transaction costs, increase diversity …

Covid-19 & Pregnancy Complication During Early Pandemic: A Narrative Review, Ahmed A. Eladely, Maria Hill, Ahmed Abdelhaleem, Zahid Imran, Ahsan M. Khan, Daisy Sangroula

The University of Louisville Journal of Respiratory Infections

Background: Coronaviruses have caused three outbreaks in the past two decades. The novel one is SARS-COV-2, which causes COVID-19. Pregnant women have a somewhat altered immune state, which may make them more vulnerable to COVID-19 and its complications. Extensive research is needed to better understand the clinical course of COVID-19 in this population. This review article discusses the comparison of SARS-CoV-2 with previous coronavirus outbreaks, clinical presentations, and complications in pregnant women and newborns.

Methods: We conducted a literature search for case series and case reports about pregnancy outcomes in pregnant women with COVID-19 during the early phase of pandemic. …

Who Are The Older Adults Who Drown In Western Australia? A Cluster Analysis Using Coronial Drowning Data., Meg Abercromby, Dr Justine E. Leavy, Lauren Nimmo, Dr Gemma Crawford

International Journal of Aquatic Research and Education

Drowning amongst older people is a growing concern. Exploring demographic and other factors associated with unintentional drowning incidents amongst older adults may assist to identify key target groups and refine prevention strategies. This study sought to examine the heterogeneity of older individuals who have drowned and identify population subgroups in Western Australia (WA). A cluster analysis was used to segment the population by examining coronial data 2001-2018 (n = 93). Analysis identified four groups; 1) ‘men who boat & fish in company’ 2) ‘affluent men with poor health’ 3) ‘non-drinkers who boat and fish’, and 4) ‘older men, who slipped …

The Case Of A Pregnant Woman With Ards Due To Covid-19 Treated With Hydroxychloroquine, Azithromycin, And Remdesivir And Delivery Of A Healthy Baby During Mechanical Ventilation Through Cesarean Section, Adria Madera-Acosta, Martin Gnoni, Bassman Tappuni, Monika Sadlak, Ravleen Grewal, Angel Mena, Yousef Ali-Ahwel

The University of Louisville Journal of Respiratory Infections

We are in the midst of a pandemic due to SARS-CoV-2. Pregnancy was identified among the risk factors for worse clinical outcomes in multiple studies. The optimal therapy in this group of patients remains to be defined. Here, we present the case of a 39-year-old Caucasian pregnant female at 31 weeks of gestation, who was treated successfully with hydroxychloroquine, azithromycin, remdesivir, prone therapy, and cesarean delivery of a healthy baby while on mechanical ventilation. She remained SARS-CoV-2-positive until the 39th day of hospitalization. We discuss the pathophysiology of the increased risk of infections during pregnancy and particularly the high risk …

Inaction On Lead Despite The Relevant Knowledge: Predictors, Covariates, And Outreach Implications, Alessandra Rossi, Bernabas Wolde, Pankaj Lal, Melissa Harclerode

Department of Biology Faculty Scholarship and Creative Works

Testing residential soil and paint for lead provides actionable information. By showing where and how much lead exists on the residence, it allows one to quantify risk and determine the best ways to reduce exposure along with the corresponding health and financial costs. For these reasons, several federal and state programs offer outreach to audiences on the benefits of testing residential soil and paint for lead. Not all individuals who know about lead’s adverse health effects, however, test their residence for lead, potentially limiting the actionable information that could have helped to reduce their exposure. Such individuals represent a challenge …

Health Insurance And The Undocumented Immigrant, Anja Diercks

Honors Theses

The purpose of this thesis is to perform a comparative analysis on how seven different countries (USA, South Africa, Germany, England, Canada, France and Singapore) organize their healthcare system to cope with the issue of undocumented immigrants and whether or not these systems in place were “fair.” The thesis will also explore the possible ways the United States could change to be more inclusive and fairer in the world of healthcare and health insurance for the undocumented immigrant. A study on what fairness means both in ethical and economical terms is done to suggest a new basis of a fair …

Hepatitis C Virus Care Cascade In Persons Experiencing Homelessness In The United States In The Era Of Direct-Acting Antiviral Agents: A Scoping Review, Aubrey Del Rosario

Biomedical Sciences ETDs

Background: The Hepatitis C Virus (HCV) care cascade has been well characterized in the general United States population and other subpopulations. However, information is limited on care cascade outcomes in persons experiencing homelessness now that highly effective medications offer the potential for cure.

Objectives: The main objective of this study is to map the available evidence on HCV care cascade outcomes in homeless and marginally housed cohorts in the United States in the era of direct-acting antiviral agents. Primary and secondary outcomes of interest include linkage to care and sustained virologic response. Exploratory outcomes include other care cascade …