Digital Commons Network^™

The Challenges Of Down Syndrome Screening In Primary Healthcare For Pregnant Women In Iran In 2018, Mona Zeinaloo, Mohammad Shariati, Masoud Younesian, Azita Kheiltash

Makara Journal of Health Research

Background: This study aimed to evaluate the various aspects of the implementation phase, including an economic evaluation, of Iran’s Down syndrome (DS) screening program.

Methods: Data were collected via phone interviews involving three random sample groups, with each group consisting of 1000 mothers who completed their pregnancies in 2018. To analyze the DS screening program from an economic aspect, we compared the costs related to the care of a DS individual in the country with that of finding and aborting a DS fetus based on the current screening program. In addition, to examine the financial expenses, we assessed …

Writing Effective Policy Briefs To Bridge Research And Policy, Arvie Vitente, Rolando Lazaro, Francis Clarence Chua

Rehabilitation Sciences Department Faculty Articles

No abstract provided.

Factors Influencing Graduate Students Of Diverse Backgrounds In Their Selection Of Occupational Therapy As A Career, Jeffrey T. Lucas, Scotillia Fogg, Mandie Lynch

The Journal of the Research Association of Minority Professors

The population of the United States is becoming more culturally diverse; however, the profession of occupational therapy does not reflect this change, whether examining educators, practitioners, or students. This study was designed to identify factors influencing graduate students of diverse backgrounds, and how a career in occupational therapy was determined. Participants for this study comprised first- and second-year occupational therapy students enrolled at Lenior-Rhyne University, The University of North Carolina at Chapel Hill, and Winston-Salem State University. A convenience sample was used to obtain the population. These universities were the only graduate-level occupational therapy programs willing to participate in the …

Leveraging The Science Of Early Life Predictability To Inform Policies Promoting Child Health, Laura M. Glynn, Sabrina R. Liu, Candice Taylor Lucas, Elysia Poggi Davis

Psychology Faculty Articles and Research

Addressing the tremendous burden of early-life adversity requires constructive dialogues between scientists and policy makers to improve population health. Whereas dialogues focused on several aspects of early-life adversity have been initiated, discussion of an underrecognized form of adversity that has been observed across multiple contexts and cultures is only now emerging. Here we provide evidence for “why unpredictability?”, including: 1. Evidence that exposures to unpredictability affect child neurodevelopment, with influences that persist into adulthood. 2. The existence of a translational non-human animal model of exposure to early life unpredictability that can be capitalized upon to causally probe neurobiological mechanisms. 3. …

Global Perspective Of The Risks Of Falsified And Counterfeit Medicines: A Critical Review Of The Literature, Aonghus J. Feeney, Jeffery A. Goad, Gerard T. Flaherty

Pharmacy Faculty Articles and Research

Background

Methods

The Role Of Indonesian Doctors As Content Creators In Fighting Health Hoaxes, Myths, And Stigma On Social Media, Lydia Okva Anjelia, Deddy Mulyana, Jenny Ratna Suminar

JURNAL KOMUNIKASI INDONESIA

Amidst the proliferation of disinformation and misinformation related to health on social media, the public must ensure that the sources of information are trustworthy. This research aims to explain the role of doctors in the fight against health hoaxes, myths, and stigma spread through social media. The study adopts qualitative research with a phenomenological approach to understand doctors' experiences and perceptions regarding their efforts to address health hoaxes, myths, and stigma on social media. Fifteen doctors as content creators in Jakarta and Bandung were selected as informants using purposive sampling. The data was collected through interviews, observation participation, and documentation …

Diabetes Health Literacy, Diabetes Numeracy, And Cognitive Function As Predictors Of Type 2 Diabetes Mellitus Self-Management, Twinkle Gupta

Doctoral Dissertations and Projects

The present study assessed older adults (≥ 45 years old) diabetes health literacy, diabetes numeracy, cognitive function, and its association with their Type 2 Diabetes Mellitus (T2DM) self-management outcomes. These factors are of concern as diabetes is a lifelong condition affecting the body’s conversion of food into energy and may lead to complications and comorbidities if this condition is not properly self-managed. Diabetes health literacy refers to having the necessary capabilities in finding and analyzing diabetes-related information to make informed decisions regarding their health. Numeracy in diabetes has to do with being able to compute diabetes-related math such as insulin …

Mapping Competency Profiles Of Schools Of Public Health: Implications For Public Health Workforce Education And Training In Israel, Yehuda Neumark, Jordan Hannink Attal, Naham Shapiro, Fiona Macleod, Janas Harrington, Paul Barach, Jascha De Nooijer, Keren Dopelt, Mariusz Duplaga, Lore Leighton, Hagai Levine, Zohar Mor, Robert Otok, Stephanie Paillard-Borg, Ted Tulchinsky, Shira Zelber-Sagi, Maureen Malowany

College of Population Health Faculty Papers

AIM: Competency frameworks are essential for analyzing capabilities of Schools of Public Health to adequately prepare public health (PH) professionals to address contemporary challenges. This study maps the competency profiles of PH training programs in Israel using a novel curriculum mapping tool.

METHODS: This study assessed all five Israeli Health Education Institutions (HEIs) offering MPH or Bachelors in Public Health (BPH) degrees across 57 competencies in six domains to determine the extent to which competencies were addressed in the curriculum. The competencies list was based on the Association of Schools of Public Health in the European Region (ASPHER) List of …

Phe 302 Social And Environmental Determinants Of Health, Tailisha Gonzalez

Open Educational Resources

This course is an introduction to the social, behavioral, and commercial factors that influence health. Theoretical and methodological approaches to the study of these determinants will be discussed from a social ecological perspective. Social determinants cover five domains: economic stability, education access and quality, health care access and quality, neighborhood and built environment, and social and community context. Behavioral determinants include such factors as smoking, physical activity, and alcohol use. Commercial determinants include economic and political domains with examples such as cigarette marketing and the placement of toxic waste sites in low-income communities.

Adherence To Mediterranean Diet Principles In Minority College Students, Bridgette Lorraine Barbre

Master's Theses

Every year, millions of young adults attend college. The Centers for Disease Control and Prevention (CDC) lists heart disease and diabetes as the top health concerns for minority Americans. African American and Hispanic/Latino communities could see a reduction in illness risk by promoting physical activity and healthy eating habits such as the Mediterranean Diet. Research indicates that young adults may benefit significantly from taking charge of their eating habits at the crucial point in their transition from high school to college. By determining the dietary patterns of minority college students, as related to the Mediterranean diet principles, this study intends …

Inequality, Prenatal Stress, And Infant Negative Emotionality: Pregnancy As A Marker Of Intergenerational Transmission, Özlü Aran

Electronic Theses and Dissertations

The Developmental Origins of Health and Disease (DOHaD) hypothesis suggests that pregnancy is a developmentally sensitive period during which environmental factors can have long term consequences for the pregnant individual and the fetus. This model regards pregnancy as a mechanism for the intergenerational transmission of health. The aim of the current dissertation is to identify sociocultural stressors that put pregnant individuals at risk and understand how stress-responsive hormones might impact infant emotional development after birth. The first study focuses on types of discrimination as sociocultural stressors and how they relate to markers of psychological and physiological stress among pregnant individuals. …

Addressing Patient Loyalty Through Their Commitment Influenced By Electronic Word-Of-Mouth And Hospital’S Image, Al Quadhri Upe, Alida Palilati, Sudirman Zaid, Nasrul Nasrul

Kesmas

This article explores the influence of Electronic Word of Mouth (e-WoM) and hospital image on hospital patient loyalty, emphasizing the mediating role of patient commitment. Amidst the development of the healthcare industry sector in Indonesia, this study highlighted that e-WoM and hospital image significantly enhanced patient loyalty, with patient commitment playing an important mediating role. This article suggested practical strategies for hospitals, such as improving the quality of healthcare services, leveraging positive e-WoM, and implementing loyalty programs to elevate patient commitment and loyalty. These findings underscore the importance of hospital image and e-WoM in patient retention, providing valuable insights for …

“Dead Or Alive?” Assessment Of The Binary End-Of-Event Outcome Indicator For The Nemsis Public Research Dataset, Mary E. Helander

Social Science - All Scholarship

OBJECTIVE: The broad absence of definitive patient outcomes in the NEMSIS public release data hinders research that seeks to understand the impact of pre-hospital care, operations, and overall patterns of population health – including geospatial and demographic differences. This study evaluated the recently proposed binary end-of-event outcome indicator to provide additional validity of the method, to evangelize its employment for more studies to analyze survival impact following an emergency medical event, and to identify appropriate use and interpretation given imperfection in predicted outcomes. METHODS: A recently published binary end-of-event outcome indicator was applied to datasets for each year from 2017 …

Exploring Informal Caregivers’ Perspectives On Oral Care For Stroke Patients, Haslina Rani, Saidatul Najibah Muhammad Zamzuri, Ezzah Omar, Tuti Ningseh Mohd-Dom, Aznida Firzah Abdul Aziz, Mohd Fairuz Ali

Kesmas

Stroke often results in physical disability and functional impairment, which may severely limit patients' ability to care for personal hygiene, including oral care. This study aimed to identify the challenges faced by informal caregivers in managing the oral health of stroke patients. This study conducted semi-structured individual interviews with eight home-based caregivers of stroke patients recruited from a community-based clinic facility of a public university in Malaysia. The interviews took 30-45 minutes to complete and were transcribed verbatim. Transcripts were analyzed thematically using a phenomenological approach. Relevant themes that emerged were variations in oral hygiene care, caregivers’ concerns in providing …

Determinants Of Testicular Cancer Survival Rates In American Indian/Alaska Natives, Mufaya Nganzi

Walden Dissertations and Doctoral Studies

Testicular cancer is the most common solid tumor among male young adults between 15 to 34 years old. Despite progress with the testicular cancer survival rate, American Indians or Alaskan Natives (AI/ANs) have the highest mortality rate of testicular cancer compared to all other racial groups in the United States. There is a shortage of reported studies on social-related factors that affect the survival rate of testicular cancer patients among AI/ANs. The purpose of this study was to examine the association between stage at diagnosis, treatment, insurance status, and marital status as independent variables and the survival rate (in months) …

Perceptions Of Hiv-Related Comorbidities And Usability Of A Virtual Environment For Cardiovascular Disease Prevention Education In Sexual Minority Men With Hiv: Formative Phases Of A Pilot Randomized Controlled Trial, S Raquel Ramos, Harmony Reynolds, Constance Johnson, Gail Melkus, Trace Kershaw, Julian F Thayer, Allison Vorderstrasse

Faculty, Staff and Student Publications

Background: Sexual minority men with HIV are at an increased risk of cardiovascular disease (CVD) and have been underrepresented in behavioral research and clinical trials.

Objective: This study aims to explore perceptions of HIV-related comorbidities and assess the interest in and usability of a virtual environment for CVD prevention education in Black and Latinx sexual minority men with HIV.

Methods: This is a 3-phase pilot behavioral randomized controlled trial. We report on formative phases 1 and 2 that informed virtual environment content and features using qualitative interviews, usability testing, and beta testing with a total of 25 individuals. In phase …

Needs Of Family Caregivers Of Hospitalised Adults With Dementia During Care Transitions: A Qualitative Study In A Us Department Of Veterans Affairs Hospital, Molly J Horstman, Tracy L Evans, Crystal Guo, Mandi Sonnenfeld, Aanand D Naik, Alan Stevens, Mark E Kunik

Faculty, Staff and Student Publications

OBJECTIVE: To identify the needs of caregivers of hospitalised adults with dementia in the hospital and during care transitions.

DESIGN: Pragmatic qualitative inquiry with semi-structured interviews.

SETTING: Michael E. DeBakey Veterans Affairs Medical Center in Houston, Texas, USA.

PARTICIPANTS: 12 family caregivers (family member (n=11); friend (n=1)) and 15 health professionals (hospital medicine physicians (n=4), inpatient nurse case managers (n=2), social workers (n=4), outpatient geriatrics providers (n=2), a primary care provider (n=1), geriatric psychiatrists (n=2)) were interviewed. Caregivers were recruited while their care recipient was hospitalised and were interviewed at least 2 weeks after the care recipient was discharged from …

Obese African American Women’S Perceptions Of Transition From College To Workforce, Alea Lycorish

Walden Dissertations and Doctoral Studies

The rate of obesity continues to rise among adults in the United States, and African American (AA) women are at greater risk in comparison with any other group. This matter has become an alarming public health crisis. Obese AA women also face a higher risk of discrimination in the workforce. The purpose of this qualitative, multiple case study was to increase the understanding of the perceptions and experiences of bachelor degree educated, overweight AA women during the postgraduate phase, who entered the workforce within the past 10 years. The theoretical framework used in this study was Crenshaw’s intersectionality theory. The …

Economic Behavior And Hiv Risk Behavior Among Vulnerable Women: A Prospective Randomized Control Study In Southern Uganda, Joshua Kiyingi

Brown School Graduate Student Theses and Dissertations

In sub-Saharan Africa (SSA), the estimated population of women engaged in sex work (WESW) is 2.5 million, aged 15 to 49 years (Laga et al., 2023). WESW face numerous challenges, including high-risk behaviors that expose them to HIV, sexually transmitted infections (STIs), drug and alcohol abuse, criminalization, discrimination, mental health problems, and limited healthcare access. Globally, WESW are significantly affected by HIV, with new infections continuing to rise. Recent estimates show that although 8% of all new HIV infections are among WESW, 32.8% of them are unaware of their HIV status (UNAIDS, 2021a). The risk of acquiring HIV is 30 …

Work-Related Musculoskeletal Problems: A Look At How Employers View Causes, Roger C. Jensen

Safety Health & Industrial Hygiene

Causation concepts for work-related musculoskeletal disorders vary among authors and academic disciplines. The major causation concepts are single-event and repetitive motion. The aim of this short communication is to share findings from a recent survey of United States employers conducted by the U.S. Bureau of Labor Statistics about work-related musculoskeletal cases, and, more specifically, about whether the employers regard the causes of their employees’ musculoskeletal problems as being from a single exposure or from multiple exposures. Recommendations are offered for using terminology consistent with employer understandings.

Examining Coping Mechanisms Among Teachers And Administrators After Experiencing Gun Violence At School, Tracey Yvonne Holt

Walden Dissertations and Doctoral Studies

According to recent research, gun violence at schools has become a public health issue. Teachers, administrators, students, and communities are trying to cope with the aftermath of gun violence at schools. The purpose of this qualitative phenomenological study was to identify coping mechanisms among teachers and administrators after experiencing gun violence at school. The theoretical framework was the transactional model of stress and coping, contending that a person’s capacity to cope and adjust to challenges and problems is a consequence of transactions. Data collection included Zoom interviews with 10 participants. Findings from coding and thematic analysis indicated that experiencing gun …

Teacher Implementation Profiles: A Response To Top-Down Mandate Of Movement Integration, Zack Beddoes, Jeanne Barcelona, Darla Castelli

International Journal of Physical Activity and Health

This study examined teacher implementation practices to meet a state mandate requiring 135 minutes of student physical activity (PA) weekly. Teachers were required to implement a video-based movement integration (MI) program. Using an embedded mixed-methods design, provider characteristics of 42 teachers and the organizational capacity of six schools were developed from interviews, surveys, observations, and artifacts. Data analysis revealed three teacher profiles (a) Dynamic Experientialists, (b) Coachable Constructivists, and (c) Cautious Behaviorists, and three school profiles (a) Whole Child Approach, (b) Grade Level Champions, and (c) Back to Basics. Findings suggest that school, teacher, …

Socioeconomic Status, Physical Inactivity, And Bmi In Transitional Urban China: Contextualizing The Theory Of Fundamental Causes, Jun Xu, Fang Gong, Wei Zhao

International Journal of Physical Activity and Health

Drawing insights from the theory of fundamental causes of disease, this study examined the relationships between socioeconomic status (SES) and selected risk factors in transitional urban China. Specifically, under China’s distinct institutional and sociocultural environment, we examined how contextualized SES (i.e., party membership, hukou status, housing ownership, and subjective social status) and conventional SES indicators (i.e., education, income, and occupation) were associated with physical inactivity and body mass index (BMI). Utilizing the urban subsample of the 2017 Chinese General Social Survey (CGSS), we found that individuals with higher education, income, Communist Party membership, and urban hukou status had lower risks …

Physical Activity Modifies The Risk Of Incident Cardiac Conduction Disorders Upon Inflammation: A Population-Based Cohort Study, Haiyan Zhao, Man Li, Dan Wu, Shuohua Chen, Chenrui Zhu, Yulong Lan, Hongmin Liu, Yuntao Wu, Shouling Wu

Research outputs 2022 to 2026

BACKGROUND: Emerging evidence suggests a central role for inflammation in cardiac conduction disorder (CCD). It is unknown whether habitual physical activity could modulate the inflammation-associated risks of incident CCD in the general population. METHODS AND RESULTS: This population-based cohort was derived from the China Kailuan study, including a total of 97 192 participants without prior CCD. The end points included incident CCD and its subcategories (atrioventricular block and bundlebranch block). Systemic inflammation was indicated by the monocyte-to-lymphocyte ratio (MLR). Over a median 10.91-year follow-up, 3747 cases of CCD occurred, with 1062 cases of atrioventricular block and 2697 cases of bundle-branch …

Multilevel Factors Affecting Covid-19 Vaccination Among African American Communities In South Carolina, Ran Zhang

Theses and Dissertations

Background: Persistent health disparities has led to significant public health challenges, especially for African American (AAs) communities, and have been exacerbated by the COVID-19 pandemic. Achieving high population vaccination rates are crucial to controlling the virus’ spread. However, AAs have higher rates of COVID-19 infection and mortality than Whites, yet their vaccination rates remain relatively low. The dissertation aimed to investigate the multilevel factors and mechanisms that affect AAs’ vaccination behavior. The first objective is to assess the impact of the intrapersonal level factor (i.e., perceived barriers to vaccination) on vaccination behavior. The second objective is to investigate the impact …

Challenges In Traumatic Spinal Cord Injury Care In Developing Countries - A Scoping Review, Mohammad Hosein Ranjbar Hameghavandi, Elaheh Khodadoust, Mahgol Sadat Hassan Zadeh Tabatabaei, Farzin Farahbakhsh, Zahra Ghodsi, Sabra Rostamkhani, Shahryar Ghashghaie, Mahkame Abbaszade, Arash Arbabi, Seyedeh Maede Hossieni, Mohsen Sadeghi-Naini, Rasha Atlasi, Samuel Berchi Kankam, Alexander Vaccaro, James Guest, Michael Fehlings, Vafa Rahimi-Movaghar

Department of Neurosurgery Faculty Papers

OBJECTIVE: To evaluate the leading challenges in developing countries' traumatic spinal cord injury (TSCI) care.

METHODS: We conducted a systematic search in electronic databases of PubMed, SCOPUS, Web of Science, EMBASE, and Cochrane Library on 16 April 2023. Studies that investigated challenges associated with the management of TSCI in developing countries were eligible for review. We extracted related outcomes and categorized them into four distinct parts: injury prevention, pre-hospital care, in-hospital care, and post-hospital care.

RESULTS: We identified 82 articles that met the eligibility criteria including 13 studies on injury prevention, 25 on pre-hospital care, 32 on in-hospital care, and …

Factorial Trial To Optimize An Internet-Delivered Intervention For Sexual Health After Breast Cancer: Protocol For The Wf-2202 Sexual Health And Intimacy Enhancement (Shine) Trial, Kelly M. Shaffer, Jennifer Barsky Reese, Emily V. Dressler, Jillian V. Glazer, Wendy Cohn, Shayna L. Showalter, Anita H. Clayton, Suzanne C. Danhauer, Michelle Loch, Mai Kadi, Caleigh Smith, Kathryn E. Weaver, Glenn J. Lesser, Lee M. Ritterband

School of Medicine Faculty Publications

Background: Although most survivors of breast cancer report substantial sexual concerns following treatment, few receive support for these concerns. Delivering sexual health care to survivors of breast cancer via the internet could overcome many of the barriers to in-person treatment. Even when delivered remotely, survivor time constraints remain a leading barrier to sexual health intervention uptake. Objective: Guided by the multiphase optimization strategy methodological framework, the primary objective of this study is to identify the most efficient internet-delivered sexual health intervention package that is expected to provide survivors of breast cancer the greatest benefit with the fewest (and least-intensive) intervention …

Addressing Dermatologic Concerns And Teledermatology In Undomiciled And Sheltered Populations, Kennedy Gallagher, Sahithi Talasila, Anna Bistline, Rebecca Krain, Leena Ramani, Elizabeth Jones

Student Papers, Posters & Projects

Homelessness in the United States is a significant public health issue, with dermatologic disease being the most prevalent health concern among the undomiciled and sheltered populations. Despite a growing need for dermatologic care, the supply of dermatologists remains insufficient, contributing to disparities in healthcare access for this vulnerable group. This review aims to detail the spectrum of dermatologic conditions experienced by homeless individuals, identify barriers to adequate care, and explore teledermatology as a potential solution to bridge these gaps. A comprehensive literature review was conducted, analyzing studies and reports on dermatologic issues prevalent among the homeless population and the efficacy …

What Is The Economic Benefit Of Annual Covid-19 Vaccination From The Adult Individual Perspective?, Sarah M Bartsch, Kelly J O'Shea, Colleen Weatherwax, Ulrich Strych, Kavya Velmurugan, Danielle C John, Maria Elena Bottazzi, Mustafa Hussein, Marie F Martinez, Kevin L Chin, Allan Ciciriello, Jessie Heneghan, Alexis Dibbs, Sheryl A Scannell, Peter J Hotez, Bruce Y Lee

Center for Medical Ethics and Health Policy Staff Publications

Background: With coronavirus disease 2019 (COVID-19) vaccination no longer mandated by many businesses/organizations, it is now up to individuals to decide whether to get any new boosters/updated vaccines going forward.

Methods: We developed a Markov model representing the potential clinical/economic outcomes from an individual perspective in the United States of getting versus not getting an annual COVID-19 vaccine.

Results: For an 18-49 year old, getting vaccinated at its current price ($60) can save the individual on average $30-$603 if the individual is uninsured and $4-$437 if the individual has private insurance, as long as the starting vaccine efficacy against severe …

The Role Of Telehealth And Obstetrics Capacity On Maternal Health Care: A Mixed Methods Approach, Shanikque L. Barksdale

Theses and Dissertations

Background: The United States (US) is experiencing a maternal health crisis, with rising severe maternal morbidity and mortality rates and persistent racial, ethnic, and geographic disparities. While telehealth can address access challenges, there is limited evidence of its impact on access to maternity care and outcomes among rural and minoritized communities. The overall objective of this study was to analyze the disparities in maternal outcomes and user satisfaction by hospital-based telehealth and obstetric care availability.

Methods: A convergent parallel mixed methods approach was used. A multinomial logistic regression was used to analyze whether the changes in the proportions of hospitals …