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Integrated Primary Care and Mental Health in Rural Communities: A Comprehensive Literature Review to Understand Barriers
No full textThis comprehensive literature review capstone project identifies structural barriers to integrating primary care and mental health services in rural areas. It examined reliable literature and validated research articles to determine challenges and barriers to the adoption and expansion of integrating primary care and mental health services in rural communities. The hypothesis of this work is that the issues of workforce shortages, financial constraints, technological limitations, and stigma in a society limits the development and viability of integrated healthcare models. These structural limitations must be addressed to address issues related to access to health care, costs and patient well-being. As it contributes to public health discourse, the study suggests sustainable strategies for overcoming barriers to care integration and fostering a more effective rural healthcare system
Navigating Nutrition Between Cultures: A Mixed Methods Study of Dietary Acculturation and Generational Status in Mexican-American Populations
No full textBackground. This mixed-methods dissertation explores how acculturation influences dietary behaviors among Hispanics of Mexican origin. As acculturation progresses, traditional dietary patterns may shift toward Westernized eating habits, increasing chronic disease risk. This research draws on the NIMHD Research Framework to examine how cultural, behavioral, and structural factors shape diet across generational lines.
Methods. Study 1 was a rapid review of 89 peer-reviewed articles (2014–2024) using PRISMA and JBI guidelines. Study 2 analyzed dietary and demographic data from 2,057 adults in NHANES 2017–March 2020. Acculturation was operationalized through a composite index based on nativity, years in the U.S., and language use. HEI-2020 scores were calculated using NCI scoring macros. Study 3 involved semi-structured interviews with 20 Mexican-origin adults in Nebraska (10 first-generation, 10 second-generation), analyzed using theoretical content analysis.
Results. Study 1 found that higher acculturation was associated with lower dietary quality and fewer healthy behaviors. In Study 2, Mexican Americans had lower HEI-2020 scores (51.61) than Other Hispanics (54.11; p = 0.006), and highly acculturated Mexican Americans scored lower (50.68) than their low acculturation counterparts (53.14; p = 0.006). Study 3 revealed that first-generation participants retained traditional cooking practices tied to identity and disease prevention, while second-generation participants described blending cultural foods with health trends and emotional eating patterns.
Conclusion. Across all three studies, higher acculturation was consistently linked to less favorable dietary patterns. Findings underscore the importance of culturally grounded, generation-specific interventions to support healthy eating in Mexican-origin populations
Extracellular Adherence Proteins Reduce Matrix Porosity and Enhance Staphylococcus aureus Biofilm Survival during Prosthetic Joint Infection
Get PDFBiofilms are a cause of chronic, non-healing infections. Staphylococcus aureus is a proficient biofilm-forming pathogen commonly isolated from prosthetic joint infections that develop following primary arthroplasty. Extracellular adherence protein (Eap), previously characterized in planktonic or non-biofilm populations as being an adhesin and immune evasion factor, was recently identified in the exoproteome of S. aureus biofilms. This work demonstrates that Eap and its two functionally orphaned homologs EapH1 and EapH2 contribute to biofilm structure and prevent macrophage invasion and phagocytosis in these communities. Biofilms unable to express Eap proteins demonstrated increased porosity and reduced biomass. We describe the role of Eap proteins in vivo using a mouse model of S. aureus prosthetic joint infection. The Results suggest that the protection conferred to biofilms by Eap proteins is a function of biofilm structural stability that interferes with the leukocyte response to biofilm-associated bacteria
Gratitude: Reflecting on Mentors and Mission Work and Facial Aging and midfacial fat grafting techniques
Get PDFThe Effect of Travel Load on MiLB Injuries Part 2: Injury Frequency By Position
Get PDFhttps://digitalcommons.unmc.edu/com_fam_pres/1033/thumbnail.jp
Lung Disease in Relation to Unique Monocyte-Macrophage Subpopulations Induced by Combined Inhalant Endotoxin and Collagen-Induced Arthritis
Get PDFBACKGROUND: Lung disease is the most overrepresented cause of death in rheumatoid arthritis (RA). Animal studies have demonstrated potentiated autoimmunity, arthritis, and profibrotic/inflammatory lung disease with a combination of airborne exposures and collagen-induced arthritis (CIA), a model that recapitulates features of RA-associated interstitial lung disease (RA-ILD). As patients with RA-ILD demonstrate unique circulating monocyte subpopulations, this study aims to characterize lung infiltrating monocytes/macrophages in a mouse model of RA-ILD and determine whether reducing these cells mitigates the development of lung disease.
METHODS: Autoimmune-prone DBA/1J mice received intranasal inhalation of lipopolysaccharide (LPS) daily for up to 5 weeks and CIA induction. Experimental groups included Sham (saline injection/saline inhalation), CIA (CIA/saline), LPS (saline/LPS), and CIA+LPS (CIA/LPS). Lung disease was assessed by longitudinal imaging, lung function measurements, bronchoalveolar lavage fluid, lung tissues, and lung histopathology. Cell subpopulations were analyzed by single cell RNA-sequencing and flow cytometry. Intravenous clodronate liposome administration was employed to reduce circulating monocytes.
RESULTS: Longitudinal imaging demonstrated increased lung volume and tissue density in CIA+LPS mice. Lung function assessment showed reduced compliance and increased airway resistance with dual exposure. Unsupervised clustering revealed 16 discrete clusters among the experimental groups with robust clusters of monocytes/macrophages of overlapping characteristics for both CIA+LPS and CIA. By flow cytometry, dual CIA+LPS exposure induced activated CD11c
CONCLUSION: The interaction of inhalation-induced airway inflammation and autoimmune arthritis results in lung disease associated with uniquely activated infiltrating inflammatory interstitial macrophages. Moreover, depletion of circulating monocytes attenuated lung disease. Whereas the induced interstitial macrophage immunophenotype is more aligned to CIA than endotoxin exposure, co-exposure modeling renders unique features that potentially inform the pathogenesis and treatment of RA-ILD
Characteristics and Educational Background of Current Deans of Medicine
Get PDFBackground. Medical school leadership demographics have been examined previously, but there has not been a study investigating the educational background of the current Deans of Medicine (DOMs). The purpose of this report is to examine the demographics, as well as the educational and training background, of the current DOMs to determine how medical school leadership can continue to be diversified across various attributes, such as gender and specialty type.
Methods. The current DOMs at 159 Doctor of Medicine (MD) and 41 Doctor of Osteopathic (DO) programs were identified using medical school websites. Information about the DOM’s background, including pronouns used in biography, years since completion of residency, and specialty type, was collected from school website biographies, US News Health, or LinkedIn.
Results. 71.50% of DOMs have male pronouns in their biography, 28.50% have female pronouns, and none used other pronouns. DOMs completed their residency training an average of 31.83 years ago. The three most common specialties among DOMs at MD programs are internal medicine, general surgery, and pediatrics, while the three most common specialties among DOMs at DO programs are family medicine, internal medicine, and emergency medicine. About 44% of DOMs at MD programs completed a fellowship, as compared to just 7.50% of DOMs at DO programs.
Conclusion. To further diversify the DOM position, more female DOMs are needed, and MD programs will need to hire more DOMs specializing in family medicine
