Digital Commons Network^™

Prediction Of First And Multiple Antiretroviral Therapy Interruptions In People Living With Hiv: Comparative Survival Analysis Using Cox And Explainable Machine Learning Models, Donald Salami, Emily Koech, Janet Turan, Kristen Stafford, Lilly Nyagah, Stephen Ohakanu, Anthony Ngugi, Manhattan Charurat

Institute for Human Development, East Africa

Background: The Cox proportional hazards (CPH) model is a common choice for analyzing time-to-treatment interruptions in patients on antiretroviral therapy (ART), valued for its straightforward interpretability and flexibility in handling time-dependent covariates. Machine learning (ML) models have increasingly been adapted for handling temporal data, with added advantages of handling complex, nonlinear relationships and large datasets, and providing clear practical interpretations.

Objective: This study aims to compare the predictive performance of the traditional CPH model and ML models in predicting treatment interruptions among patients on ART, while also providing both global and individual-level explanations to support personalized, data-driven interventions …

Early Neonatal Admissions With Feeding Difficulties To Acute Paediatric Services At A Tertiary Paediatric Hospital In England: Sequential Audits Pre-Covid-19 And During The Covid-19 Pandemic, Kalvin Lee, Thomas Frederick Dunne, Mary Masoud, Hayley Gleig, Heidi Stott, Helen Nabwera, Halina Kamarova

Centre of Excellence in Women and Child Health

Introduction: Our objective was to describe the population of infants < 7 days of age admitted to the acute general paediatric services at Alder Hey Children’s Hospital and ascertain the proportion with feeding difficulties amenable to community-based support.

Methods: Sequential retrospective audits of all infants < 7 days of age admitted to acute paediatrics at Alder Hey Children’s Hospital, Liverpool, England, from March to September 2019 (pre-COVID-19) and March to September 2020 (during COVID-19). All the infants were born and discharged from maternity units in Merseyside, Northwest England. Anonymised data were extracted from the electronic clinical records by three members of the clinical team.

Results: Pre-COVID-19, 38.6% (93) of the 241 admissions to acute general paediatric services had feeding difficulties. 31.2% (29) presented solely with feeding difficulties and 31.2% (29) were exclusively breastfed. However, during COVID-19, although there were fewer admissions (104), more than half (51%, 54) had feeding difficulties and for 54% (29), this was the only reason for admission. Over half (53.7%, 29) were exclusively breastfed.

Conclusion: Our audits showed that at least a third of infants < 7 days of age admitted with feeding difficulties did not have any other features of severe illness. These admissions unnecessarily expose infants to hospital-acquired infections while disrupting the opportunity for families to build close and loving relationships that enhance the establishment of breastfeeding. Co-designing infant feeding strategies with the mothers and stakeholders will be a crucial next step to enhance infant feeding support, particularly in impoverished communities in the region.

Associations Between County-Level Vape-Free Air Law Coverage And E-Cigarette Use Behaviors Among U.S. Adolescents In Monitoring The Future, James H. Buszkiewicz, Yanmei Xie, Catherine A. Vander Woude, Steven Cook, Bukola Usidame, Megan E. Patrick, Michael R. Elliott, James F. Thrasher, Nancy L. Fleischer

Department of Health and Kinesiology Faculty Publications

Purpose

We examined whether workplace and hospitality vape-free air law (VAL) population coverage was associated with adolescent e-cigarette use and related disparities in the United States.

Methods

We analyzed associations between county-level workplace and hospitality VAL coverage (100% vs. < 100%) and current e-cigarette use (2014–2022) and first e-cigarette initiation (2015–2022) among US 8th, 10th, and 12th graders using nationally representative, cross-sectional Monitoring the Future data. We implemented weighted, grade-stratified, modified Poisson regression models, adjusted for individual-, county-, and state-level confounding factors, examining disparities by sex, race and ethnicity, parental education, and college educational expectations through two-way interactions.

Results

Workplace and hospitality VAL coverage was not associated with adolescent e-cigarette use or initiation overall. However, we did find that VAL coverage was associated with lower current e-cigarette use in some sociodemographic subgroups. Full (100%) hospitality VAL coverage was linked to lower e-cigarette use among male 8th and 12th graders, 12th graders with parents without a bachelor's degree, Hispanic 8th …

Assessing The Effectiveness Of A Habit Recording Tool To Improve Mental Health Of University (Auc) Students, Noran Nounou

Theses and Dissertations

Introduction: According to previous research, the mental health of university students has become an alarming public health concern worldwide. Most of the mental disorders begin among young adults, attributed to the transition to university and increased financial and societal pressure. Despite the important effect of daily habits on mental health, there still remain research gaps in Egypt in exploring their effect among university students and exploring the potential opportunities to support their well-being. Objectives: To assess depression rates among AUC students and to evaluate the effectiveness of a newly designed habit recording board, Make an Impact (MAI) to improve depression …

Essays On Public Policy And Health Outcomes: Unintended Consequences And The Cost Of Influence, Wenhan Yan

Dissertations and Theses Collection (Open Access)

This dissertation investigates the complex behavioral responses to public policy shifts and institutional cues, quantifying their intended and unintended societal impacts. Across two distinct empirical contexts, this research examines how individuals adapt their risk profiles when signals from political or legal authorities change and how these adaptations generate measurable externalities.

The first chapter, "From Punishment to Treatment: Unintended Social Impacts of Changing Drug Policies," shifts the focus to the intersection of health policy and criminal justice. This chapter evaluates the sudden transition from punitive drug enforcement to health-oriented decriminalization, utilizing the 2021 State v. Blake decision in Washington as a …

“Now That The Baby Is Out, I Can Be Vaccinated”: A Qualitative Study On Covid-19 Vaccine Hesitancy In Pregnant Women In Kilifi, Kenya, Angela Koech, Onesmus Wanje, Grace Mwashigadi, Geoffrey Katana, Richmond Mdindi, Peter Mwangome, Rachel Craik, Marianne Vidler, Mai-Lei Kinshella, Marleen Temmerman

Centre of Excellence in Women and Child Health

COVID-19 vaccines are safe and effective in pregnancy, but vaccine hesitancy limits uptake and effectiveness. This study explored COVID-19 vaccine hesitancy in pregnancy in Kilifi, coastal Kenya, to elicit reasons for vaccine hesitancy and acceptance, and to compile misconceptions around vaccination in pregnancy. Twenty-three in-depth interviews were conducted with pregnant women, mothers who had given birth in the previous 2 years and health workers (community health promoters, nurses, and supervisors). Data were analyzed using thematic template analysis based on the Vaccine Hesitancy Determinants Matrix. Concern about vaccine safety for the unborn baby was a major driver of hesitancy. Many pregnant …

Qualitative Exploration Of Factors Associated With Covid-19 Vaccination Among Pregnant Women In Kenya, Violet Naanyu, Ferdinand Okwaro, Ingrid Gichere, Mandeep Sura, Prachi Singh, Berhaun Fesshaye, Marleen Temmerman

Centre of Excellence in Women and Child Health

The COVID-19 pandemic significantly disrupted societies worldwide, and COVID-19 vaccination has been identified as instrumental in the fight against the pandemic. While studies have examined uptake of COVID-19 vaccination, more research is needed to gain a better understanding of the factors influencing pregnant women’s decisions to get vaccinated. In this study, we used a cross-sectional descriptive qualitative study to explore the attitudes, beliefs, and behaviors related to COVID-19 vaccination during pregnancy in Kenya. A total of 50 in-depth interviews were conducted between October 2023 to March 2024 with a purposively drawn sample of 25 pregnant and 25 postpartum women during …

The 2025 Accra Declaration On Upskilling And Cost-Effective Cardiac Surgery In Africa, Charles Yankah, Jonathan Nwiloh, Carlos Mestres, Abdelmalek Bouzid, Tom Mwambu, Andrew Duncan, Mohamed Debieche, Samuel Omokhodion, Uvie Onakpoya, Matthias Angres

General Surgery, East Africa

The Pan-African Society for Cardiothoracic Surgery (PASCaTS) organized the 1st Pan-African Cardiothoracic Surgery Summit on 21 to 24 February 2025 in Accra, Ghana. The summit brought together leading specialists from across Africa, China, Europe, South America and the USA to address the growing burden of cardiovascular disease, to share their vision for the fight against cardiovascular disease, to raise standards in the diagnosis, treatment, and recovery of patients thereby improving procedural safety and clinical outcomes in Africa. The experts agreed on the need for cost effectiveness in cardiac surgery, simulation skills training, an African regional cardiothoracic surgery database, African heart …

International Normative Charts For Twin Weight, Length, And Head Circumference At Birth, By Gestational Age And Sex: The Twin Neonatal Cross-Sectional Study Of The Intergrowth-21st Project, Francesca Giuliani, Sonia Deantoni, Enrico Bertino, Yasmin A. Jaffer, Manorama Purwar, Fernando C. Barros, Leila Cheikh Ismail, Wu Qingqing, Ilaria Stura, Maria Carvalho

Obstetrics and Gynaecology, East Africa

Assessing the size of twins at birth using charts developed for singletons may over diagnose small for gestational age in this sub-population. The study aimed to produce international, twin-specific, newborn size normative charts by gestational age and sex. This longitudinal observational study in eight geographically diverse settings prospectively collected data between May 2009 and August 2013 from healthy pregnant women and their newborn twins. The participants were enrolled as part of the INTERGROWTH-21st study, and recruited based on World Health Organization recommendations for evaluation of anthropometric measures. All the women met, in addition to the underlying population characteristics of low …

Genetic Architecture Of N-Terminal Pro-B-Type Natriuretic Peptide In A Multiancestry Study Population, Naman S Shetty, Akhil Pampana, Mokshad Gaonkar, Amrita Nayak, Harshvir S Bal, Nirav Patel, Nehal Vekariya, J Gustav Smith, Alanna C Morrison, Bing Yu, Bruce M Psaty, Eric Boerwinkle, James S Floyd, Jerome I Rotter, Kent D Taylor, Leslie A Lange, Marguerite R Irvin, Mary Cushman, Stephen S Rich, Ramachandran S Vasan, Thomas J Wang, Xiuqing Guo, Peng Li, Garima Arora, Pankaj Arora

Faculty, Staff and Student Publications

Background: NPs (natriuretic peptides) are bioactive hormones crucial for regulating blood pressure, glucose homeostasis, and lipid metabolism. Despite the high heritability of circulating NP levels, the genetic determinants of NP regulation, particularly across ancestries and sexes, remain poorly understood. The objective of the current study was to identify genetic variants associated with NT-proBNP (N-terminal pro-B-type NP) levels in a multiancestry study population.

Methods: Whole genome sequencing and array-based data from 81 213 individuals without heart failure were analyzed from the Trans-Omics for Precision Medicine cohorts, UK Biobank, All of Us Research Program, and REGARDS (Reasons for Geographic and Racial Differences …

Bispectral Index-Guided Anesthesia For Older Patients Having Noncardiac Surgery: A Randomized Multicenter Trial, Li Zhou, Lin Ding, Hui Yang, Chengyu Li, Zhangsheng Yu, Wei Ma, Qiuyu Chen, Yanzhuo Zhang, Yong Li, Qingxiang Mao, Minghua Cheng, Gu Gong, Enqin Wang, Cunming Liu, Wei Hao, Hong Li, Changlin Chen, Yaling Fan, Zhenbo Su, Xiaoli Cai, Xiaole Zhang, Zhi Li, Bing Zhang, Yi Li, Chunxiu Jiang, Qinqin Yin, Jiali Jiao, Daniel I Sessler, Qian Li, Jin Liu

Faculty, Staff and Student Publications

Background: Older surgical patients are at risk because of age-related physiologic decline and comorbidities. Some guidelines recommend Bispectral Index (BIS; Medtronic, USA) monitoring to optimize anesthetic depth, but robust evidence supporting improved outcomes is lacking.

Methods: A randomized, multicenter, double-blind trial was conducted across 21 tertiary-care hospitals in China (March 17, 2015, to February 5, 2022). Patients aged 65 yr or older scheduled for elective noncardiac surgery (American Society of Anesthesiologists [ASA] Physical Status I to IV) were randomized 1:1 to BIS-guided or routine anesthetic management. In patients assigned to BIS guidance, hypnotic depth was adjusted to maintain BIS between …

Examination Of Traffic Safety In Neighborhoods Associated With Active Commuting To School In Austin, Texas, Kathryn G Burford, Deborah Salvo, Harold W Kohl, Leigh Ann Ganzar, Cici X Bauer, Eugen Resendiz, Yuzi Zhang, Deanna M Hoelscher

Faculty, Staff and Student Publications

Background: Only 10% of US children participate in active commuting (walking and bicycling) to school (ACS). Parental concerns related to traffic are a primary barrier to ACS, yet no studies have assessed these concerns together with neighborhood traffic safety-related features. This study examined the associations between traffic safety-related features in neighborhoods and ACS among school-age children in Austin, Texas.

Methods: This cross-sectional analysis utilized pre-COVID-19 baseline data (2019-2020) of parent-child dyads enrolled in the Safe TRavel Environment Evaluation in Texas Schools study. ACS, traffic safety-related features in the neighborhood (sidewalk availability, safe road crossings, traffic safety, traffic speed, and safety …

Cellstaar: Incorporating Single-Cell-Sequencing-Based Functional Data To Boost Power In Rare Variant Association Testing Of Noncoding Regions, Eric Van Buren, Yi Zhang, Xihao Li, Margaret Sunitha Selvaraj, Zilin Li, Hufeng Zhou, Nicholette D Palmer, Donna K Arnett, John Blangero, Eric Boerwinkle, Brian E Cade, Jenna C Carlson, April P Carson, Yii-Der Ida Chen, Joanne Curran, Ravindranath Duggirala, Myriam Fornage, Nora Franceschini, Misa Graff, Charles Gu, Xiuqing Guo, Jiang He, Nancy Heard-Cosa, Lifang Hou, Yi-Jen Hung, Rita R Kalyani, Sharon L R Kardia, Eimear Kenny, Charles Kooperberg, Brian G Kral, Leslie Lange, Dan Levy, Changwei Li, Simin Liu, Donald Lloyd-Jones, Ruth J F Loos, Ani W Manichaikul, Lisa Warsinger Martin, Rasika Mathias, Ryan L Minster, Braxton D Mitchell, Josyf C Mychaleckyj, Take Naseri, Kari North, Jeff O'Connell, James A Perry, Patricia A Peyser, Bruce M Psaty, Laura M Raffield, Ramachandran S Vasan, Susan Redline, Alex P Reiner, Stephen S Rich, Jennifer A Smith, Brian Spitzer, Hua Tang, Kent D Taylor, Russell Tracy, Satupa'itea Viali, Lisa Yanek, Wei Zhao, Nhlbi Trans-Omics For Precision Medicine (Topmed) Consortium, Jerome I Rotter, Gina M Peloso, Pradeep Natarajan, Xihong Lin

Faculty, Staff and Student Publications

Understanding how rare genetic variants influence complex traits remains a major challenge, particularly when these variants lie in noncoding regions of the genome. The effects of variants within candidate cis-regulatory elements (cCREs) often depend on the cell type, making interpretation difficult. Here we introduce cellSTAAR, which integrates whole-genome sequencing data with single-cell assay for transposase-accessible chromatin using sequencing data to capture variability in chromatin accessibility across cell types via the construction of cell-type-specific functional annotations and regulatory elements. To reflect the uncertainty in cCRE-gene linking, cellSTAAR uses a comprehensive strategy to link cCREs to their target genes. We applied cellSTAAR …

Mapping Social Determinants Of Health Data In Sub-Saharan Africa: A Scoping Review Protocol, Felix Anyiam, Jessica Gjonaj, Ngeresa Osango, Richard Mugo, Peace Aber, Jasmit Shah, Judith Mangeni, Rajesh Vedanthan, Joseph Hogan, Ann Mwangi

Internal Medicine, East Africa

Introduction Research has increasingly underscored the impact of factors such as socioeconomic status, education, healthcare access, housing and environmental conditions in shaping population health outcomes. These factors, collectively called social determinants of health (SDOH), provide crucial context for understanding drivers of health outcomes. In sub-Saharan Africa (SSA), the study of SDOH is critical due to the region’s unique sociocultural and economic conditions. Understanding how SDOH interacts with health systems and capturing SDOH in data is crucial for informing modelling efforts and policies improving population health more effectively. This scoping review aims to map the types of data used to capture …

Real-World Prevalence Of Pd-L1 Positivity In Early-Stage/Metastatic Triple-Negative Breast Cancer: Primary Results And Pathology Insights From The Global Retrospective Observational Vanessa Study, Corrado D'Arrigo, Sitki Tuzlali, Romualdo Barroso-Sousa, Nagi El Saghir, Rebecca Dent, Nataša Medić-Milijić, Gyungyub Gong, Shahin Sayed, Tu Anh, Alisan Zirtiloglu

Pathology, East Africa

Aim To understand whether the worldwide implementation of PD-L1 testing in triple-negative breast cancer (TNBC) can be achieved in routine clinical practice.

Methods and results The multicentre retrospective observational VANESSA study consecutively and uniformly enrolled patients treated with systemic therapy for early or metastatic (e/m)TNBC diagnosed between 2014 and 2017. PD-L1 status was retrospectively assessed locally and centrally using the VENTANA PD-L1 (SP142) Assay (PD-L1 expression on tumour-infiltrating immune cells covering ≥1% of the tumour area). The primary objective was to determine the prevalence of PD-L1 positivity assessed locally on primary and/or metastatic tumour tissue. Concordance between local and central …

Demographic And Other Correlates Of Non-Prescription Drug Use Among College Students During The Covid-19 Pandemic, Subi Gandhi, Sidketa Fofana, Md Rafiul Islam, Tamer Oraby

School of Mathematical & Statistical Sciences Faculty Publications

Background and objectives: Substance use among college students in the U.S. remains a pressing concern and may have intensified during the COVID-19 pandemic due to increased stress, uncertainty, and academic disruptions. This study investigates the relationship between non-prescription drug use and various demographic, mental health, and behavioral factors among college students during the pandemic's early stages.

Methods: Data were collected through online and in-person surveys in the summer semester of 2021. Behavioral health was assessed using validated instruments: the Patient Health Questionnaire-9 (PHQ-9) for depression and the Drug Abuse Screening Test-20 (DAST-20) for substance use. Demographic and behavioral variables were …

Evaluation Of Host-Immune Biomarker Signatures As Multiplex Qpcr Diagnostic Assays: A Pilot Study Toward Meeting Who Target Product Profiles For Tb Diagnosis In India, Harriet N. Garlant, Kalaiarasan Ellappan, Noyal Mariya Joseph, Carrie Turner, Vishnukanth Govindaraj, Saka Vinod Kumar, Sanjeev Kumar, Seshadri S. Vasan, Karen Elizabeth Kempsell

Research outputs 2022 to 2026

Background: Tuberculosis (TB) remains the leading cause of death from a single infectious agent. Current diagnostic tools are limited, especially in low-resource settings. The World Health Organization's (WHO) Target Product Profiles (TPPs) call for rapid, non-sputum-based diagnostics with high sensitivity and specificity. This study evaluates our previously published TB-associated host-immune biomarkers alongside small-size signatures from other studies, in our previously published non-human primate (NHP) TB infection study dataset (GSE76703) and two previously published human datasets (GSE144127, GSE42834), which include other disease group comparators, including sarcoidosis. These were also evaluated in a small-scale, exploratory qPCR pilot study to assess the feasibility …

Purpuric Pityriasis Rosea In A 7-Year-Old Girl: A Rare Variant With Generalized Involvement, Ying-Ying Qian, Ya-Fen Wu, Ting Zhang, Ji-Bing Li, Si-Yuan Song, Wei Li

Faculty, Staff and Students Publications

A 7-year-old girl presented with a 10-day history of generalized purpura and petechiae. The eruption began with a solitary violaceous macule on the trunk and progressed within 1 week to multiple oval and round dark-red to violaceous purpuric macules, ecchymoses, and petechiae affecting the face, trunk, and extremities. Lesions were distributed parallel to skin cleavage lines with a characteristic “Christmas-tree” pattern on the back (Fig 1). No oropharyngeal lesions were noted on examination, and the patient denied sore throat or oral discomfort. She reported no pruritus, pain, fever, or systemic symptoms.

Elevated Serum Lipopolysaccharides And Intrinsic Factor Autoantibodies Correlate With Macrocytic Anemia Among People With Hiv, Daniel Amakye, Samuel Hammond, Osbourne Quaye, Upal Roy, Peter Puplampu, Vincent Ganu, Emmanuel Ayitey Tagoe

Health & Biomedical Sciences Faculty Publications

Introduction: Human immunodeficiency virus (HIV) infection is associated with various comorbidities, including macrocytic anemia, though the role of the infection is unclear. HIV has been implicated in microbial translocation and altered immune responses. This study aimed to establish the relationship between gut microbial translocation and immune response, and macrocytic anemia among people with HIV (PWH).

Materials and methods: Fifty-five PWH on combination antiretroviral therapy (cART) were age-matched with 55 HIV-negative individuals. Demographic data and blood samples were collected from February to July 2023. Hematological indices, including red blood cell (RBC) count, hemoglobin concentration, and mean corpuscular volume (MCV), were measured. …

Humanity Is Evolving Its Consciousness: The Role Of Archetypal Energies As Guides During An Unfolding Weeding Out And Alignment Process, Carroy U. Ferguson

Psychology Faculty Publication Series

Humanity is evolving its consciousness at individual and collective levels.  Given these seemingly tumultuous times, as of this writing (January 2026), to make such a statement may sound like a strange thing to say.  However, I suggest that if you are alive today and if you are reading these words, these are the very times for which you were born—to assist Humanity as it evolves its consciousness with your unique gifts, whatever they may be.  That is, this period of our individual and collective human being-ness may be characterized as an unfolding period of weeding out and alignment with the …

Private Sector Healthcare Investment In Indonesia: Leveraging Australia-Indonesia Partnerships For Health System Transformation, Susan Josephine Neuhaus

Journal of Indonesian Health Policy and Administration

Australia and Indonesia are strategic partners with expanding bilateral trade valued at AUD 26.7 billion (2022-23). Health care partnerships between the two countries offer significant opportunities for private sector engagement. Indonesia’s large population, rapidly growing middle class, and implementation of Universal Health Coverage (UHC) through the Jaminan Kesehatan Nasional (JKN) present partnership opportunities to strengthen health system capacity, address infrastructure gaps and workforce shortages, and contribute to shared economic and prosperity goals. This study explores how Australian private healthcare investment can complement government initiatives in supporting Indonesia’s UHC while advancing Australia’s regional engagement. A descriptive qualitative analysis was conducted using …

Analysis Of Coverage Of Tuberculosis Prevention Therapy (Tpt): Literature Review, Septia Rahmalina, Ede Surya Darmawan

Journal of Indonesian Health Policy and Administration

Tuberculosis Preventive Therapy (TPT) is a crucial intervention for tuberculosis (TB) control, particularly among high-risk groups such as household contacts of TB patients and people living with Human Immunodeficiency Virus (HIV). Despite being recommended by the World Health Organization (WHO), TPT implementation still faces challenges at the primary care level. This study employed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) method to review 11 articles published between 2021 and 2025 that were relevant to TPT implementation in various high-TB burden countries, including Indonesia. The main barriers identified were input (logistics, training), process (tracing, education, monitoring), and output …

Prophylactic Antibiotic Analysis In Obs-Gyn, Orthopedics, Gastrointestinal Surgery At A South Tangerang Hospital, January-March 2024, Evelina Endang Nurjaman, Helen Andriani

Journal of Indonesian Health Policy and Administration

Inappropriate use of prophylactic antibiotics (PAs) remains a primary driver of antimicrobial resistance (AMR); however, global adherence to established prescribing guidelines remains suboptimal. This study aimed to analyze the compliance and rationality of PA prescription and to evaluate the underlying causes of physician non-adherence in obstetrics, orthopedic, and gastrointestinal surgeries at a hospital in South Tangerang City, Indonesia. Adopting a mixed-methods approach, this investigation combined a quantitative assessment of 208 surgical patient records (January–March 2024) with qualitative exploratory interviews conducted with three specialist peer group heads. This design allowed the triangulation of prescribing data with underlying clinical perspectives. PA rationality …

An Impact Assessment Of The Effectiveness Of Utilizing Informal Health Communication Interventions To Spread Health Recommendations And Change Public Perception, Lina Mohamed Ezzat Ahmed Abdel Mawgoud

Theses and Dissertations

Brain health is an increasingly urgent but critically under-addressed public health priority in Egypt and the wider MENA region. Despite its centrality to aging, productivity, and overall quality of life, public understanding of brain health remains limited, and stigma continues to shape responses to dementia and cognitive decline. This study evaluates the effectiveness of informal, culturally adapted health communication as a tool to shift perception, increase awareness, and promote behavior change among non-medically trained adults in Egypt.

Grounded in global evidence on cognitive reserve, neuroplasticity, and the life-course approach to brain health, the intervention translated expert-informed brain health recommendations into …

Investigating The Risk Factors Affecting The Control Of Diabetes And Hypertension In The Refugees Living In Egypt, Noura Seada

Theses and Dissertations

Introduction: Non-Communicable Diseases (NCDs) account for 74% of global deaths, with high prevalence of Diabetes and Hypertension worldwide. Egypt hosts over 1 million registered refugees and asylum seekers, often lacking inclusion in social protection or insurance schemes. This study aimed to assess the factors affecting the control of Type 2 Diabetes (T2D) and Hypertension (HTN) among Syrian and Sudanese refugees in Egypt, focusing on healthcare access, sociodemographic characteristics, lifestyle, and health behaviours.

Methods: This study employed a cross-sectional design using a self-administered questionnaire and BMI measurement. Data were collected from 246 refugees diagnosed with type T2D and/or HTN in the …

Harmonization And Ambiguity In Regulations For Physicians With Family Medicine Competence Post-Law No. 17 Of 2023, Danar Wahyu Giwang Katon, Dumilah Ayuningtyas, Purnawan Junadi, Wahyu Sulistiadi, Roberth J. Pattiselanno, Fitria Fitria, Ika Fitri Alfiani

Journal of Indonesian Health Policy and Administration

Strengthening primary care services in Indonesia requires that community health centers, namely Pusat Kesehatan Masyarakat (Puskesmas), involve medical personnel with family medicine competence. However, the fulfillment of physicians with this competence, especially Primary Care Family Medicine Specialists or Spesialis Kedokteran Keluarga Layanan Primer (Sp.KKLP), still face significant obstacles. This qualitative research uses the integrated Easton's System Model and Buse's Policy Framework to analyze the dynamics of this policy. The findings reveal a gap between the strong legal foundation and weak implementation mechanisms on the ground. First, there is ambiguity in terminology and lack of harmonization among regulations, especially concerning the …

The Relationship Between Accessibility Factors And Post-Inpatient Control Visits Among Non-Jkn Participants At Hospital X, Putri Candaika, Desy Kartika Ningsih, Risky Kusuma Hartono

Journal of Indonesian Health Policy and Administration

The rate of post-inpatient control visits remains relatively low due to various factors, including accessibility. At Hospital X, 220 of non-Jaminan Kesehatan Nasional (JKN) participants scheduled for post-inpatient control visits between January and March 2025, 71.82% attended, and 28.18% did not. Patients who did not attend control visits were twice as likely to be readmitted. This study aimed to determine the relationship between accessibility and post-inpatient control visits for non-JKN participants at Hospital X. This quantitative study employed an analytical cross-sectional design, with a population of 220 patients and a sample of 142 patients selected using probability sampling. Bivariate …

More Than A Healthcare Issue: Understanding The Breadth Of Occupational Burnout In Our Patients, Aliza Anderson*, Julia Maniccia*, Marc Moss

Marshall Journal of Medicine

Burnout is an occupation-related condition resulting from chronic workplace stress and is associated with significant psychological and physical morbidity. This commentary recognizes burnout as a public health concern across both healthcare and non-healthcare professions, illuminates key occupational risk and protective factors, reviews the biopsychosocial impacts of burnout, and argues for the integration of occupational health screening into clinical practice. A synthesis of the literature highlighted that existing research has focused primarily on healthcare occupations; however, emerging evidence demonstrates an elevated burnout risk in numerous non-healthcare occupations. Characterized by high job demands, limited autonomy, inadequate social support, and physically demanding labor, …

Symposium Day Reflection Paper - Burnout In Medicine: Understanding The Student & Resident Experience, Souraha Longo

Introduction to Public Health

A brief summary & reflection of a Symposium Day presentation (from a public health perspective).

Youth Violence, Cyberbullying, And Mental Health Among Adolescence: A Public Health Analysis Of Netflix’S “Adolescence”, Natepy Vann

Introduction to Public Health

It is a summary of a Netflix's series about British psychological crime thriller.