Digital Commons Network^™

Assessing Oral Health-Related Quality Of Life And The Application Of Silver Diamine Fluoride (Sdf) In Arresting Caries Among Older Adults, Palinee Detsomboonrat, Panatcha Weerapol, Sirinan Tangyusuk

Journal of Health Research

Background: This study aimed to evaluate the impact of oral health problems on oral health-related quality of life (OHRQoL) and assess the effectiveness of the application of 38% silver diamine fluoride (SDF) solution in arresting dental surface caries among the older adults.

Methods: This study assessed the oral impact on daily performance (OIDP) scores and evaluated the percentage of arrested caries and patient satisfaction levels before and after receiving SDF treatment among older, community-dwelling adults attending the Diabetes Mellitus Clinic under the care of Bangkok Public Health Center 5.

Results: In total, 42.9% of 49 participants encountered a minimum of …

“No Matter How Hot It Is, You Just Have To Do The Work”: Examining Farmworkers’ Experiences With Heat And Climate Change In Idaho, Carly Hyland, Delmy Flores, Grace Augusto, Irene Ruiz, Marielena Vega, Rulon Wood

Public and Population Health Faculty Publications and Presentations

Introduction: Farmworkers are one of the populations most vulnerable to climate change. In addition to disproportionate exposure to climate-intensified hazards such as extreme heat and wildfire smoke, many farmworkers face situational and psychosocial stressors that also impact their health.

Methods: We conducted open-ended interviews with 16 farmworkers in Southcentral Idaho during June-August 2023 as part of a digital storytelling project in partnership with the Idaho Organization of Resource Councils (IORC). Interviews assessed participants’ experiences with climate change, perceived impacts on their health, and strategies and barriers to protecting themselves. Bilingual (English/Spanish) study staff translated and transcribed all video recordings verbatim, …

Enhancing Patient Safety In Spain: Streamlining Adverse Event Detection In Occupational Healthcare Records, Diego Moya, Rafael Manzanera, Jordi Ortner, Marta Torres, Joan Carles Serfaty, Carme Sauri, Ma. Lourdes D. Jimenez, Jose Joaquin Mira

Ateneo School of Medicine and Public Health Publications

Background

Given the lack of previous studies on adverse events (AEs) in the area of occupational healthcare in Spain, it is very important to begin to understand this phenomenon in order to act on it. The objective was to accurately quantify AE occurring in occupational healthcare in MC Mutual during May 2021.

Methods

We conducted a review of a representative random sample of 250 clinical records to identify AEs through an active search audit, focused on the frequency, type, severity, and preventability of these events, categorized using standardized scales.

Results

We detected seven AEs in the sample of clinical records, …

Identifying Rural Health Clinics Within The Transformed Medicaid Statistical Information System (T-Msis) Analytic Files, Katherine Ahrens Mph, Phd, Zachariah Croll, Yvonne Jonk Phd, John Gale Ms, Heidi O'Connor Ms

Rural Health Clinics

Researchers at the Maine Rural Health Research Center describe a methodology for identifying Rural Health Clinic encounters within the Medicaid claims data using Transformed Medicaid Statistical Information System (T-MSIS) Analytic Files.

Background: There is limited information on the extent to which Rural Health Clinics (RHC) provide pediatric and pregnancy-related services to individuals enrolled in state Medicaid/CHIP programs. In part this is because methods to identify RHC encounters within Medicaid claims data are outdated.

Methods: We used a 100% sample of the 2018 Medicaid Demographic and Eligibility and Other Services Transformed Medicaid Statistical Information System (T-MSIS) Analytic Files for 20 states …

What Adolescents Say In Text Messages To Motivate Peer Networks To Access Health Care And Sexually Transmitted Infection Testing: Qualitative Thematic Analysis, Marguerita Lightfoot, Chadwick Campbell, Allysha C. Maragh-Bass, Joi Jackson-Morgan, Kelly Taylor

OHSU-PSU School of Public Health Faculty Publications and Presentations

Background:While rates of HIV and sexually transmitted infections (STIs) are extremely high among adolescents and young adults in the United States, rates of HIV and STI testing remain low. Given the ubiquity of mobile phones and the saliency of peers for youths, text messaging strategies may successfully promote HIV or STI testing among youths.

Objective:This study aimed to understand the types of messages youths believe were motivating and persuasive when asked to text friends to encourage them to seek HIV or STI testing services at a neighborhood clinic.

Methods:We implemented an adolescent peer-based text messaging intervention to encourage clinic attendance …

Voices From Grenada: An Impact Evaluation Of A Community-Academic Partnership., Sade Richardson

Doctor of Social Work Capstone Projects

The purpose of this study was to evaluate the impact of the community-academic partnership between the University of Michigan School of Public Health Office of Public Health Practice and the Grenadian community. Five key informant interviews were conducted to analyze the partnership from the perspectives of the community partners in Grenada to understand the strengths, challenges, and existing opportunities, specifically within the context of a global collaboration.

The findings highlighted the benefits of community-based collaboration, considerations for partnership design, and opportunities for education, practice, policy, research, and leadership. The organizations spoke highly of the partnership, underscoring their desire for expanded …

Why I Chose To Practice In Rural Michigan, Lisenia M. Collazo Dmd, Mph

The Journal of the Michigan Dental Association

This article explores the motivations behind dentists choosing rural practice, focusing on personal experiences and factors influencing career decisions. The narrative outlines the author’s journey from Pennsylvania to the Upper Peninsula of Michigan, emphasizing a commitment to addressing oral health disparities in underserved communities. The discussion covers training experiences, financial considerations, community engagement, and the challenges of rural health care. The author also highlights the role of mentorship and advocates for building relationships with mentors in the profession, especially in rural settings. The essay underscores rural practice’s unique advantages, including professional growth, lower living costs, and a supportive community.

A Job Satisfaction Evaluation Of Nursing In The United States And Greece Utilizing The American Nurses Association's Scope And Standards Of Practice, Audrey Narhi

Honors Projects

Nursing is a multifaceted profession that is constantly evolving with the health needs of the populations it serves. Professional organizations within the field utilize evidence-based practice to provide guidelines of what best-practice nursing is. This study aims to evaluate if the American Nurse's Association (ANA), a professional nursing organization in the United States, supports the realities of nursing in a rural US hospital. An international perspective is also considered by evaluating the same principles to a urban hospital in Athens, Greece. Categories that align with ANA Scope and Standards, including workplace environment, career development, supervisor relationships, and personal work practice, …

Association Between Medication Adherence And Asthma Among Latinos In The United States, Denisse Silva

Walden Dissertations and Doctoral Studies

Prior research has shown that Latinos in the United States face disproportionate challenges in managing their asthma symptoms. Therefore, this study aimed to identify factors that may influence medication adherence and asthma episodes among Latinos in the United States and was guided by Andersen’s health behavior theory. Data from 2020 Latinos who participated in the National Health Interview System in 2020 were analyzed. Findings indicated that nearly 23% of respondents reported an asthma episode. Approximately 25% of the sample reported an asthma episode during the last 12 months. A total of 43.6% of the sample reported not taking medication every …

Evaluation Of A Collaborative Model Between Managed Care And Affordable Housing On Acute Care Costs, Cecilia Ganduglia Cazaban

Faculty, Staff and Student Publications

Objectives: This study evaluated a collaborative service model between the largest Medicaid managed care organization (MCO) in Texas, Superior HealthPlan, and the affordable housing provider Prospera Housing Community Services.

Study design: Using a quasi-experimental 2-groups research design, we compared health care outcomes and costs between a sample of 104 participants served by the Prospera+Superior collaborative model and a group of 104 participants who had health care coverage through the Superior HealthPlan Medicaid MCO but did not live at Prospera properties (ie, Superior-only group).

Methods: Data from medical claims were analyzed to examine change in outcomes 12 months before and after …

Recognize & Resist: An Online Health Intervention To Promote Writing About Sexual Consent And Egalitarian Gender Roles Among One Direction Fanfiction Writers, Laura F Salazar

Faculty, Staff and Student Publications

This paper focuses on the development and feasibility of a digitally-based educational intervention, titled Recognize & Resist (R&R), for writers of One Direction (1D) fanfiction on Wattpad.com. The goal of R&R is to reduce the prevalence of social norms that are supportive of sexual violence within 1D fanfiction. 1D fanfictions, or fictional romance stories written by fans of this British boy band, have hundreds of millions of views on Wattpad.com. Formative research has found that social norms supportive of sexual violence are prevalent in 1D fanfictions and that some authors have internalized these norms. R&R aims to …

Relation Of Prenatal And Postnatal Pm25 Exposure With Cognitive And Motor Function Among Preschool-Aged Children, Michael Swartz, Aitana Lertxundi, Antonia Valentin, Llucia González-Safont, Martine Vrijheid, Monica Guxens

Faculty, Staff and Student Publications

The literature informing susceptible periods of exposure on children’s neurodevelopment is limited. We evaluated the impacts of pre- and postnatal fine particulate matter (PM2.5) exposure on children’s cognitive and motor function among 1303 mother-child pairs in the Spanish INMA (Environment and Childhood) Study. Random forest models with temporal back extrapolation were used to estimate daily residential PM2.5 exposures that we averaged across 1-week lags during the prenatal period and 4-week lags during the postnatal period. The McCarthy Scales of Children’s Abilities (MSCA) were administered around 5 years to assess general cognitive index (GCI) and several subscales (verbal, perceptual-performance, memory, fine …

Lifetime Traumatic Brain Injury And Risk Of Post-Concussive Symptoms In The Millennium Cohort Study, Jose-Miguel Yamal

Faculty, Staff and Student Publications

Traumatic brain injury (TBI) is prevalent among active duty military service members, with studies reporting up to 23% experiencing at least one TBI, with 10-60% of service members reporting at least one subsequent repeat TBI. A TBI has been associated with an increased risk of cumulative effects and long-term neurobehavioral symptoms, impacting operational readiness in the short-term and overall health in the long term. The association between multiple TBI and post-concussive symptoms (PCS), however, defined as symptoms that follow a concussion or TBI, in the military has not been adequately examined. Previous studies in military populations are limited by methodological …

The Relationship Of Health Literacy To Health Outcomes Among Individuals With Traumatic Brain Injury: A Traumatic Brain Injury Model Systems Study, Esther Ngan, Simon Driver, Laura E Dreer, Anthony H Lequerica

Faculty, Staff and Student Publications

OBJECTIVE: To examine the associations between health literacy and health outcomes among individuals with traumatic brain injury (TBI) at least a year post-injury.

SETTING: Community following discharge from inpatient rehabilitation.

PARTICIPANTS: A total of 205 individuals with complicated mild to severe TBI who completed a TBI Model Systems National Database follow-up interview and a web-based health literacy measure.

DESIGN: A multicenter, cross-sectional, observational study.

MAIN MEASURES: The Health Literacy Assessment Using Talking Touchscreen Technology (Health LiTT), number of comorbid conditions (Medical and Mental Health Comorbidities Interview [MMHCI]), perceived physical and mental health (PROMIS Global Physical and Mental Health subscales), Patient …

Self-Efficacy To Refuse Sex Mediates The Relationship Between Dating Violence Victimization And Sexual Risk Behavior, Melissa F Peskin, Robert C Addy, Jeff R Temple, Dennis E Reidy

Faculty, Staff and Student Publications

Purpose: While cross-sectional studies have shown that teen dating violence (TDV) victimization is linked to sexual risk behavior (SRB), the pathway between these variables is not well-understood. To address this knowledge gap, we explore the mediating role of self-efficacy to refuse sex in the longitudinal relationship between physical TDV victimization and subsequent SRB among adolescents.

Methods: Self-report data from three prior longitudinal studies were harmonized to create a single aggregated sample of primarily racial and ethnic minority adolescents (N = 4,620; 51.4% Hispanic, 38.5% Black, and 58% female) from 44 schools in the southwest U.S. Participants' physical TDV victimization at …

Emotional, Behavioral, And Cognitive Symptom Associations With Community Participation In Chronic Traumatic Brain Injury, Michael Williams, Zinat Taiwo, Luis Leon Novelo

Faculty, Staff and Student Publications

OBJECTIVES: To determine the association between self-reported emotional and cognitive symptoms and participation outcomes in chronic traumatic brain injury (TBI) and to explore the relative contribution of self-reported versus performance-based cognition to participation outcomes.

SETTING: Community.

PARTICIPANTS: Community-dwelling adults ( n = 135) with a lifetime history of mild to severe TBI.

DESIGN: Secondary analysis of a cross-sectional study on neurobehavioral symptoms in chronic TBI.

MAIN MEASURES: Behavioral Assessment Screening Tool (BAST) (Negative Affect, Fatigue, Executive Dysfunction, Impulsivity, Substance Abuse subscales) measured self-reported neurobehavioral symptoms; Participation Assessment with Recombined Tools (Productivity, Social Relations, and Out and About) measured self-reported participation …

Practical Considerations For Navigating Withdrawal From The Federal Select Agent Program, Rebecca B Kairis

Faculty, Staff and Student Publications

INTRODUCTION: Clear guidance is provided by the Federal Select Agent Program (FSAP) to assist registered entities in nearly all facets of compliance with the Federal select agent regulations (7 CFR Part 331; 9 CFR Part 121; 42 CFR Part 73). If a registered entity chooses to discontinue its registration, detailed instructions for registration withdrawal are deeply embedded within a document entitled "eFSAP Form 1 Amendment Instructions," which is found on the FSAP website within the electronic Federal Select Agent Program (eFSAP) Resource Center.

METHODS: Using the information found within the eFSAP Form 1 Amendment Instructions, as well as extensive written …

Measurement Bias In Caregiver-Report Of Early Childhood Behavior Problems Across Demographic Factors In An Echo-Wide Diverse Sample, Traci A Bekelman, Sara S Nozadi, Theresa M Bastain, Amy J Elliott, Kaja Z Lewinn, Julie A Hofheimer, Leslie D Leve, Brandon Rennie, Emily Zimmerman, Carmen A Marable, Cindy T Mcevoy, Chang Liu, Alexis Sullivan, Tracey J Woodruff, Samiran Ghosh, Bennett Leventhal, Assiamira Ferrara, Johnnye Lewis

Faculty, Staff and Student Publications

BACKGROUND: Research and clinical practice rely heavily on caregiver-report measures, such as the Child Behavior Checklist 1.5-5 (CBCL/1.5-5), to gather information about early childhood behavior problems and to screen for child psychopathology. While studies have shown that demographic variables influence caregiver ratings of behavior problems, the extent to which the CBCL/1.5-5 functions equivalently at the item level across diverse samples is unknown.

METHODS: Item-level data of CBCL/1.5-5 from a large sample of young children (

RESULTS: Items with the most impactful DIF across child and caregiver groupings were identified for Internalizing, Externalizing, and total Problems. The robust item sets, excluding …

Washington’S Ride Program: A Model Providing Rural Practitioners, Mary K. Smith Dds, Mba

The Journal of the Michigan Dental Association

The University of Washington School of Dentistry Regional Initiatives in Dental Education (RIDE) program is an award-winning dental education model that trains dentists to practice in rural and underserved areas. Its first cohort of students graduated in 2012. To date, there have been 96 graduates. More than 80% of RIDE graduates in practice are in rural and underserved areas, including those seeking specialty training. RIDE is successful because it collaborates with multiple universities, community health centers, local dental associations, and community leaders in the area where the students are located.

News You Need, David Foe Ma

The Journal of the Michigan Dental Association

The 2024 MDA Annual Session promises a range of valuable events and courses, including a free keynote by Joe Johnson, PhD, addressing career fulfillment. Additional highlights include the Gordon Christensen session, new dentist track, leadership courses, and an expansive exhibit hall. Meanwhile, the MDA House of Delegates Nominating Committee announced its candidate slate for the upcoming administrative year. The MDA also offers a free webinar on suicide prevention and celebrates communities awarded for water fluoridation quality. Additionally, ADA news covers a clinical guideline on managing dental pain, the ADA Academy's teaching program, and World Oral Health Day initiatives. Lastly, local …

J Mich Dent Assoc March 2024

The Journal of the Michigan Dental Association

Every month, The Journal of the Michigan Dental Association provides news, information, and features about Michigan dentistry to our state's oral health community and the MDA's 6,200+ members. It stands as the primary publication reaching Michigan dentists.

In the March 2024 issue, the Journal focuses on the landscape of practicing in rural settings. Original content includes:

• A cover story discussing "Market Realities for Rural and Small-Town Practices"

• A feature commentary from a new dentist in the Upper Peninsula on "Why I Chose to Practice in Rural Michigan"

• A feature article highlighting a dental education initiative, "Washington’s RIDE Program: A Model …

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A Systematic Review Of Measures Of Healthcare Workers’ Vaccine Confidence, Kofoworola Akinsola, Ayobami Bakare, Elisa Gobbo, Carina King, Claudia Hanson, Adegoke Falade, Sibylle Herzig Van Wees

Centre of Excellence in Women and Child Health

Healthcare workers (HCW) perceptions toward vaccines influence patient and community vaccine decision making. In an era of rising vaccine hesitancy, understanding HCW vaccine confidence is critical. This systematic review aims to review instruments that have been validated to measure HCW vaccine confidence. We conducted a search in five databases in June 2023. Data was descriptively synthesized. Twelve articles describing 10 different tools were included. Most tools included dimensions or items on vaccine knowledge (n = 9), safety (n = 8), vaccine usefulness (n = 8), recommendation behavior (n = 8), and self-vaccination practice (n = 7). All, except one study, …

Artificial Intelligence-Based Radiotherapy Contouring And Planning To Improve Global Access To Cancer Care, Laurence E Court, Ajay Aggarwal, Anuja Jhingran, Komeela Naidoo, Tucker Netherton, Christine Peterson, Hannah Simonds, Christoph Trauernicht, Lifei Zhang, Beth M Beadle, Radiation Planning Assistant Consortium Collaborators, Affiliations Expand

Faculty, Staff and Student Publications

PURPOSE: Increased automation has been identified as one approach to improving global cancer care. The Radiation Planning Assistant (RPA) is a web-based tool offering automated radiotherapy (RT) contouring and planning to low-resource clinics. In this study, the RPA workflow and clinical acceptability were assessed by physicians around the world.

METHODS: The RPA output for 75 cases was reviewed by at least three physicians; 31 radiation oncologists at 16 institutions in six countries on five continents reviewed RPA contours and plans for clinical acceptability using a 5-point Likert scale.

RESULTS: For cervical cancer, RPA plans using bony landmarks were scored as …

Analysis Of East Asia Subgroup In Study 309/Keynote-775: Lenvatinib Plus Pembrolizumab Versus Treatment Of Physician's Choice Chemotherapy In Patients With Previously Treated Advanced Or Recurrent Endometrial Cancer, Kan Yonemori, Keiichi Fujiwara, Kosei Hasegawa, Mayu Yunokawa, Kimio Ushijima, Ayumi Shikama, Tomoka Usami, Jae-Weon Kim, Byoung-Gie Kim, Peng-Hui Wang, Ting-Chang Chang, Keiko Yamamoto, Shirong Han, Jodi Mckenzie, Robert J Orlowski, Takuma Miura, Vicky Makker, Yong Man Kim

Faculty, Staff and Student Publications

OBJECTIVE: In the global phase 3 Study 309/KEYNOTE-775 (NCT03517449) at the first interim analysis, lenvatinib+pembrolizumab significantly improved progression-free survival (PFS), overall survival (OS), and objective response rate (ORR) versus treatment of physician's choice chemotherapy (TPC) in patients with previously treated advanced/recurrent endometrial cancer (EC). This exploratory analysis evaluated outcomes in patients enrolled in East Asia at the time of prespecified final analysis.

METHODS: Women ≥18 years with histologically confirmed advanced, recurrent, or metastatic EC with progressive disease after 1 platinum-based chemotherapy (2 if 1 given in neoadjuvant/adjuvant setting) were enrolled. Patients were randomized 1:1 to lenvatinib 20 mg orally once …

Single-Cell Transcriptomics Reveals Pre-Existing Covid-19 Vulnerability Factors In Lung Cancer Patients

Faculty, Staff and Student Publications

Coronavirus disease 2019 (COVID-19) and cancer are major health threats, and individuals may develop both simultaneously. Recent studies have indicated that patients with cancer are particularly vulnerable to COVID-19, but the molecular mechanisms underlying the associations remain poorly understood. To address this knowledge gap, we collected single-cell RNA-sequencing data from COVID-19, lung adenocarcinoma, small cell lung carcinoma patients, and normal lungs to perform an integrated analysis. We characterized altered cell populations, gene expression, and dysregulated intercellular communication in diseases. Our analysis identified pathologic conditions shared by COVID-19 and lung cancer, including upregulated TMPRSS2 expression in epithelial cells, stronger inflammatory responses …

Retrospective Cohort Study Of Pure Tone Audiometry Hearing Changes From Ototoxic Metalsand Solvents, Continuous Noise, And Impulse Noise Exposures At Hill Air Force Base From 2005 To 2019, Zachary I. Johnson

Theses and Dissertations

This retrospective cohort epidemiological study investigated the relative risks of hearing loss associated with ototoxicants in combination with noise exposure. Utilizing Department of Defense (DoD) industrial hygiene and hearing conservation data, this research expanded on a 2020 thesis conducted on Tinker Air Force Base (AFB), applying a similar methodology to Hill AFB, adding 893 evaluated individuals. Grouped into twelve exposure combinations with a minimum of three years of exposure duration, the study assessed various hearing loss indicators, including DoD Standard Threshold Shift (STS) and NIOSH STS. Ototoxic substances consistently elevated relative risk (RR) compared to noise-only exposure groups, but none …

Utilization Of The System Engineering Design Process To Design And Test A Low-Cost Infectious Aerosol Control Mechanism For Patient Aeromedical Evacuation, Sara Shaghaghi

Theses and Dissertations

The aeromedical evacuation of military patients is a critical component of care for Armed Forces members. The Air Force’s ability to transport patients relies on the technology and systems available. A vital transport responsibility is keeping the patient and medical personnel safe during transport. The historical and legacy systems provide reliable transport mechanisms for the Armed Forces’ patients infected with high-level biological agents, but drawbacks must be considered. This dissertation will discuss the development, conceptual design, and initial evaluation of a new low-cost, litter-mounted patient transport system, Biological-Mitigation in Patient Transport (B-MIPT), using the “V” model of the system engineering …

Clonal Hematopoiesis Of Indeterminate Potential Is Associated With Acute Kidney Injury, Alyssa C Parker, Hannah Poisner, Shirong Cao, Ming Jiang, Yinqiu Wang, Aolei Niu, Edward Siew, Joseph C Van Amburg, Holly J Kramer, Anna Kottgen, Nora Franceschini, Bruce M Psaty, Russell P Tracy, Alvaro Alonso, Dan E Arking, Josef Coresh, Christie M Ballantyne, Eric Boerwinkle, Ming-Zhi Zhang, Bryan Kestenbaum, Matthew B Lanktree, Michael J Rauh, Raymond C Harris, Alexander G Bick

Faculty, Staff and Student Publications

Age is a predominant risk factor for acute kidney injury (AKI), yet the biological mechanisms underlying this risk are largely unknown. Clonal hematopoiesis of indeterminate potential (CHIP) confers increased risk for several chronic diseases associated with aging. Here we sought to test whether CHIP increases the risk of AKI. In three population-based epidemiology cohorts, we found that CHIP was associated with a greater risk of incident AKI, which was more pronounced in patients with AKI requiring dialysis and in individuals with somatic mutations in genes other than DNMT3A, including mutations in TET2 and JAK2. Mendelian randomization analyses supported a causal …

Road Traffic Noise Annoyance And Cardiovascular Disease Risk In Population: A Case Series Study In Kota Bharu, Malaysia, Faridah Naim, Nurin H M Nasir

Kesmas

Noise pollution can cause annoyance, significantly threatening the population’s health and well-being. This study aimed to find an association between road traffic noise exposure and cardiovascular disease (CVD) risk among residents in Kota Bharu, Malaysia. This descriptive study used a case series approach and surveyed 34 residents in selected residential areas near main roads. An adapted questionnaire was distributed to residents using a purposive sampling method. Questions related to sociodemographic information, self-reporting about CVD, and road traffic noise assessment were asked to investigate the underlying risk factors for CVD. The average score of CVD assessment was classified as moderate risk. …

Depression Among Islamic Boarding Schools Students During The Covid-19 Pandemic In East Java, Indonesia, Yuni Asri, Dian Pitaloka Priasmoro, Muhammad Solihuddin Muhtar, Yankuba B. Manga

Kesmas

The COVID-19 pandemic significantly impacts many aspects of life, including health, economy, society, education, and mental well-being. The pandemic impact on mental health, in particular, leads to increased rates of depression, anxiety, and stress. This study aimed to determine the prevalence of depression among Islamic boarding school students in Indonesia and identify factors associated with depression symptoms. This cross-sectional study employed questionnaires for data collection. Assessment of depression levels used the DASS-21 tool. Descriptive statistics and multivariate logistic regression were applied to analyze relationships between variables. The study findings indicated that 62.4% of the students exhibited factors associated with depression. …