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Factors Affecting The Adoption Of Malaria Interventions For Pregnant Women In Tanzania: Tanzania Demographic Health Survey 2022, Melisa Nyamukondiwa, Asri C. Adisasmita, Renti Mahkota, Same Betera

Jurnal Epidemiologi Kesehatan Indonesia

Tanzania is endemic to malaria and pregnant women due to their vulnerability are among the high-risk groups. The adoption of malaria interventions targeted to pregnant women is affected by a number of factors. A cross-sectional study using secondary data from Tanzania Demographic Health Survey (TDHS) for 2022 was used. A logistic regression was used for bivariate analysis to identify factors affecting the adoption of malaria interventions during pregnancy in Tanzania. Data from pregnant women between 15 to 49 years (N=1408) were analyzed in this study. Insecticide treated nets (ITNs) and intermittent preventive therapy in pregnancy using sulfadoxine-pyrimethamine (IPTp-SP) were the …

Double-Blind Randomised Trial Of Saline Solution For Gargling And Nasal Rinsing In Sars-Cov-2 Infection, Sebastian R Espinoza, Lexton Trauffler, Amir Shamshirsaz, Alireza Shamshirsaz, Andres Espinoza, Jimmy Espinoza, Alice O'Brien

Faculty, Staff and Student Publications

Background: Previous studies have shown that hypertonic saline nasal irrigation and gargling reduced the duration of symptoms in upper respiratory infections caused by coronavirus. This study aims to investigate the effects of two saline regimens on symptoms associated with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2).

Methods: Between 2020 and 2022, individuals aged 18-65 years who tested positive for SARS-CoV-2 infection via polymerase chain reaction (PCR) were randomly assigned to either low- or high-saline regimens for 14 days. The low-saline solutions contained 2.13 g of salt dissolved in eight ounces of warm water, while the high-saline solution contained six grams of …

From Surviving To Thriving: Key Considerations For Weight Control Across Diverse Cancer Survivorship Populations, Justin C. Brown, Marlyn Allicock, Carmina G. Valle, Tanya Agurs-Collins

School of Medicine Faculty Publications

BACKGROUND: Obesity is a chronic, relapsing, progressive disease of excess adiposity that increases the risk of dying from at least 16 types of cancer. The prevalence of obesity has increased more rapidly in cancer survivors compared with the general population. Tailored weight management strategies are needed to improve prognosis and health outcomes in the growing population of cancer survivors. However, certain cancer survivor population subgroups require unique consideration when developing weight management strategies. METHODS: In a symposium convened by The Obesity Society during ObesityWeek 2023 titled "From Surviving to Thriving: Key Considerations for Weight Control Across Diverse Cancer Survivorship Populations," …

Challenges And Opportunities In Implementing And Enforcing India’S Loose Cigarette Sales Ban: A Qualitative Stakeholder Analysis, Mayank Sakhuja, Daniela B. Friedman Ph.D., Mark M. Macauda Phd, Mph, James R. Hebert Scd, Mangesh S. Pednekar, Prakash C. Gupta, James F. Thrasher Ph.D., Ma, Ms

Faculty Publications

Introduction Several Indian states have banned the sale of loose cigarettes, and India is considering a national ban. This study examines the perceptions of policymakers, implementers, and law enforcement officials regarding the implementation and enforcement of this ban. Methods Between May–October 2022, we conducted in-depth interviews with 26 key stakeholders involved in tobacco control in two Indian cities, Delhi (where the ban was not implemented) and Mumbai (where the ban was in effect). Participants included representatives from various government departments such as police, municipal corporations, FDA, health, and civil society organizations / NGOs such as Vital Strategies, World Health Organization, …

Improving Pediatric Magnetic Resonance Imaging Safety By Enhanced Non-Technical Skills And Team Collaboration, Masashi Uramatsu, Hidekuni Takahashi, Paul Barach, Yoshikazu Fujisawa, Megumi Takahashi, Shiro Mishima, Gaku Yamanaka

College of Population Health Faculty Papers

BACKGROUND: Safe pediatric magnetic resonance imaging (MRI) ideally relies on non-sedative techniques, as avoiding risky sedation is inherently safer. However, in practice, sedation often becomes unavoidable, particularly for younger children or those with anxiety, to ensure motion-free, high-quality imaging. This narrative review explores the current practices and proposes strategies to enhance safety in pediatric MRI examinations.

METHODS: We identified and analyzed 247 studies addressing various aspects of pediatric MRI safety, including sedation protocols, patient monitoring, and team-based management approaches.

RESULTS: Safe sedation requires careful drug selection tailored to individual needs, continuous monitoring, and robust emergency preparedness. While efforts are underway …

Health Literacy On Physical Therapy Among Senior Citizens With Physical Disability And Community Health Workers, Kriza G. Ganotisi, Faye Angelene J. Barangay, Andrew A. Galang, Wina Frances Q. Lazaro, Christopher U. Rivera, Ryan Dean T. Sucgang

Philippine Journal of Physical Therapy

Introduction. This study was conducted to determine the health literacy on physical therapy (PT) among senior citizens with physical disability and community health workers (CHWs). Specifically, it identified the sociodemographic profile of the CHWs and senior citizens with physical disability, their extent of health literacy on PT as to prose, document and numeracy and how health policies, availability of PT programs, and available equipment and facilities for the rendition of PT services affect their health literacy.

Methods. This study employed a descriptive research design. The respondents of the study involved 18 CHWs and 29 senior citizens. It was conducted in …

From The Ocean To Our Kitchen Table: Anthropogenic Particles In The Edible Tissue Of U.S.. West Coast Seafood Species, Summer D. Traylor, Elise F. Granek, Marilyn Duncan, Susanne Brander

Environmental Science and Management Faculty Publications and Presentations

Microplastics (MPs) and other anthropogenic particles (APs) are pervasive environmental contaminants found throughout marine and aquatic environments. We quantified APs in the edible tissue of black rockfish, lingcod, Chinook salmon, Pacific herring, Pacific lamprey, and pink shrimp, comparing AP burdens across trophic levels and between vessel-retrieved and retail-purchased individuals. Edible tissue was digested and analyzed under a microscope, and a subset of suspected APs was identified using spectroscopy (μFTIR). Anthropogenic particles were found in 180 of 182 individuals. Finfish contained 0.02–1.08 AP/g of muscle tissue. In pink shrimp (Pandalus jordani), the average AP/g was 10.68 for vessel-retrieved and …

Dental Clinic Deserts In The Us: Spatial Accessibility Analysis, Md Shahinoor Rahman, Jeffrey C. Blossom, Ichiro Kawachi, Renuka Tipirneni, Hawazin W. Elani

School of Public Health Faculty Publications

IMPORTANCE: Little is known about the spatial accessibility to dental clinics across the US. OBJECTIVE: To map the spatial accessibility of dental clinics nationally and to examine the characteristics of counties and US Census block groups with dental care shortage areas. DESIGN, SETTING, AND PARTICIPANTS: Cross-sectional study of US dental clinics in 2023 using data from the IQVIA national practitioners' database, which includes 205 762 active dentists. Data were analyzed from November 2023 to April 2024. EXPOSURES: Socioeconomic characteristics of block groups and counties including rurality, area deprivation, racial and ethnic segregation, and uninsured population. MAIN OUTCOMES AND MEASURES: Enhanced …

Sparkled: Social Programming In Kids Affects Risk Of Latent Endothelial Disease, Rebecca Drakowski

Theses & Dissertations

Background: Social Health Programming (SHP) is a holistic intervention that can empower communities to address modifiable risk factors for poor cardiovascular health, including suboptimal nutrition or psychosocial stressors. SHP participation has been shown to increase dietary intake of fruits and vegetables, decrease perceived stress, and improve cardiovascular endurance. However, it is unknown how SHP participation during adolescence affects carotenoid serum levels, hair cortisol concentrations (biological marker of chronic stress), or vascular reactivity index (VRI; measure of subclinical cardiovascular health).

Methods: Adolescent girls and young adult women (12–29-year-old) were enrolled in this observational cohort study. Serum, hair, and saliva samples were …

Efficacy Of Probiotics For Treatment Of Acute Or Persistent Diarrhoea In Children From Birth Till 10 Years: Systematic Review And Meta-Analysis, Anmol Minaz, Ridwa Alam, Uswa Jiwani, Khadija Vadsaria, Ahmad Khan, Aqsa Ishaq, Samar Sultan, Marium Mohsin, Ashraf Sharif, Yasir Bin Nisar, Jai K. Das, Sajid Bashir Soofi, Shabina Ariff

Centre of Excellence in Women and Child Health

Background: Numerous studies have investigated the efficacy of probiotics in treating acute and persistent diarrhoea. However, probiotics have not been established as a recommended management option for diarrhoeal illness by the World Health Organization (WHO). Therefore, we conducted a systematic review of randomised controlled trials to assess the efficacy of probiotics for the management of acute and persistent diarrhoea in children.
Methods: A systematic search on PubMed, CINAHL, Wiley Cochrane Library, Scopus, Clinicaltrials.gov, and WHO International Clinical Trials Registry Platform (ICTRP) was performed. All studies published in the year 2000 and onwards that assessed the use of probiotics in the …

Protocol For Culturing Patient-Derived Organoids Of Cervical Cancer, Rui Wang, Timothy Harris, Dalissa Negrón-Figueroa, David Lo, Allison Judge, D'Shaunique Walters, Bo Jiang, Lauren E Colbert

Faculty, Staff and Student Publications

Herein, we present a protocol for culturing patient-derived organoids (PDOs) of cervical cancer that includes workflows for tumor biopsy/resection tissue and cytobrush-sampled cells. We describe steps for PDO culture initiation, including rinsing, gentle dissociation, Lymphoprep separation, and cell assessment, as well as seeding cells from surgical and cytobrush tissue digestion. We then provide guidance on PDO maintenance and passage and techniques for producing conditioned medium. Overall, this protocol serves as a valuable guide for establishing and maintaining cervical cancer PDOs. For complete details on the use and execution of this protocol, please refer to Colbert et al.

Deceased Donor Renal Allograft Utility In Adult Single And Multi-Organ Transplantation In The United States, Peter J. Altshuler, Adam S. Bodzin, Kenneth A. Andreoni, Pooja Singh, Anju Yadav, Jaime M. Glorioso, Ashesh P. Shah, Carlo B. Ramirez, Warren R. Maley, Adam M. Frank

Department of Surgery Faculty Papers

BACKGROUND: Deceased donor multiorgan transplants utilizing kidneys (MOTs) can improve outcomes for multiorgan recipients but reduces kidneys for chronic renal failure patients.

METHODS: We reviewed the Organ Procurement and Transplantation Network database from 2015 through 2019, for adult deceased donor kidney transplants. Recipients were classified as kidney transplant alone (KTA) (n = 62,252) or MOTs pancreas-kidney, simultaneous pancreas-kidney (n = 3,976), liver-kidney, simultaneous liver-kidney (n = 3,212), heart-kidney, simultaneous heart-kidney (n = 808), and "other"-kidney, simultaneous "other" kidney (n = 73).

RESULTS: Liver, heart, and lung-alone transplants were at least 7 times more frequent than their MOT correlate, whereas the …

Analysis Of Public Opinion Polls About Covid-19 Vaccines: Theoretical And Policy Implications For Vaccine Communication And Campaigns To Address Vaccine Hesitancy, Muhammad Ittefaq, Hong Tien Vu, Ali Zain, Tayyeb Ramazan, Gary L. Kreps

School of Communication Studies - Faculty Scholarship

This study analyzed 1432 questions asked in 19 surveys (N = 43,014) on COVID-19 vaccines between January 2020 and August 2022 using dimensions including (1) information sources about COVID-19 vaccine, (2) information about the access, effectiveness, and side effects of COVID-19 vaccine, (3) COVID-19 vaccine hesitancy (i.e. false perception, skepticism, and vaccine refusal), (4) motivations to get the COVID-19 vaccine (i.e. to perform routine activities, convenience, incentives, influences, and travel requirement), (5) false perceptions caused vaccine refusal, and (6) intentions to get vaccinated. Our results show that vaccine refusal was rampant throughout the pandemic and mostly attributed to the …

Human Papillomavirus Vaccination Coverage In Genesee County: Geographic Disparities And The Need For Community-Partnered Vaccination Efforts, Olivia G. Aspiras, Joanne Herman, Todd Lucas, Eric Adjei Boakye, Ariel Washington, Hayley S. Thompson

Michigan Journal of Public Health

There are approximately 37,000 new cases of cancer attributed to human papillomavirus (HPV) each year in the United States. The HPV vaccine is generally widely available, low cost, and highly effective in providing long-lasting protection against HPV. Yet, HPV vaccination rates remain suboptimal among children and adolescents in the United States. The present commentary spotlights HPV vaccination within Genesee County. Using data from the Michigan Department of Health and Human Services, we describe the alarmingly low HPV vaccination rates in Genesee County relative to state and national vaccination rates. We then identify potential barriers to vaccination and offer evidence-based strategies …

Pathways From Socioeconomic Factors To Major Cardiovascular Events Among Postmenopausal Veteran And Nonveteran Women: Findings From The Women's Health Initiative, Hind A Beydoun, May A Beydoun, Rebecca L Kinney, Simin Liu, Rona Yu, Matthew Allison, Robert B Wallace, Qian Xiao, Longjian Liu, Philippe Gradidge, Su Yon Jung, Hilary A Tindle, Shawna Follis, Robert Brunner, Jack Tsai

Faculty, Staff and Student Publications

BACKGROUND: Cardiovascular disease (CVD) remains a leading cause of death for women in the United States, with veterans being at potentially higher risk than their nonveteran counterparts due to accelerated aging and distinct biopsychosocial mechanisms. We examined pathways between selected indicators of socioeconomic status (SES) such as education, occupation, household income, and neighborhood SES and major CVD events through lifestyle and health characteristics among veteran and nonveteran postmenopausal women.

METHODS AND RESULTS: A total of 121 286 study-eligible WHI (Women's Health Initiative) participants (3091 veterans and 118 195 nonveterans) were prospectively followed for an average of 17 years, during which …

Large-Scale Crispr/Cas9 Deletions Within The Wfdc Gene Cluster Uncover Gene Functionality And Critical Roles In Mammalian Reproduction, Katarzyna Kent, Kaori Nozawa, Rachel Parkes, Laura Dean, Frey Daniel, Mei Leng, Antrix Jain, Anna Malovannaya, Martin M Matzuk, Thomas X Garcia

Faculty, Staff and Students Publications

Despite 96 million years of evolution separating humans and rodents, 11 closely related reproductive tract-specific genes in humans—SPINT3, WFDC6, EPPIN, WFDC8, WFDC9, WFDC10A, WFDC11, WFDC10B, WFDC13, SPINT4, and WFDC3—and the 13 reproductive tract-specific orthologous genes in mice, form highly conserved syntenic gene clusters indicative of conserved, combined critical functions. Further, despite significant progress toward a nonhormonal male contraceptive targeting the protein encoded by one of these genes, epididymal peptidase inhibitor (EPPIN), and associations found between mutations in EPPIN and an increased risk of male infertility, neither EPPIN nor …

Association Between Body Mass Index, Abdominal Obesity And Menopause-Related Symptoms In Postmenopausal Women, Brianna A. Rice, Patricia Heavey

SURE Journal: Science Undergraduate Research Experience Journal

Abstract: Existing research demonstrates a lack of data on the relationship between body mass index (BMI) and menopause-related symptoms in postmenopausal women, particularly in Ireland. This study aimed to determine whether there is an association between BMI, general abdominal obesity and menopause-related symptoms in postmenopausal women. This should help bridge the data gap regarding postmenopausal women living in Ireland and their symptoms. Introduction: Menopause is defined as the permanent cessation of a woman's menstrual cycle. This is caused by a reduction of the secretion of oestrogen and progesterone, leading to reduced ovarian function. These changes have been attributed …

Total Organic Carbon Analysis Of Residual Contaminants In Bioreactor Equipment: A Cleaning Verification Study Using Surface Swabbing, Ciara E. Fitzpatrick, James J. Roche

SURE Journal: Science Undergraduate Research Experience Journal

Contamination is a major issue in the biopharmaceutical industry. Bioreactors must be meticulously cleaned to remove residual impurities and avoid cross-contamination. Cleaning validation is necessary to ensure residual contaminants are reduced to the lowest acceptable limits. Bacterial cells represent the paramount challenge in manufacturing equipment cleaning because they are composed of insoluble organic contaminants. Total organic carbon (TOC) analysis is a fast, highly sensitive, and inexpensive analytical technique commonly used to evaluate the approximate level of organic contamination.

A study was conducted to assess the effectiveness of cleaning procedures in the removal of contaminants from bioreactor equipment by measuring the …

The Doing, Being, Becoming, And Belonging Of Intergenerational Collective Occupations, Gladys Garcia, Jazminne Orozco-Arteaga

Fall 2024 OTD Capstone Symposium

Background: Older adults have been globally recognized as a vulnerable population. Literature has indicated that intergenerational engagement can decrease social isolation for older adults, but there is a gap in understanding intergenerational co-occupational engagement and how these engagements can improve quality of life and fulfillment of self-identity. The purpose of this qualitative research study was to generate knowledge of how relationships and occupations performed with individuals from a younger generation impacted sense of well-being. Through the lens of Doing, Being, Becoming and Belonging (Wilcock, 2006), the study sought to increase understanding of this lived experience to promote intergenerational practice within …

Letter From The President, Suzanne Keep

Michigan Journal of Public Health

No abstract provided.

Reducing Detroit’S Heart Disease Risk: The Role Of Social Determinants Of Health And Health Behaviors, Caress A. Dean, Rebecca Milan, Maidah Raja, Swathi Radhakrishnan

Michigan Journal of Public Health

Introduction: The age-adjusted death rates related to heart disease have been increasing in Detroit, Michigan. Recognizing public health professionals' role in promoting and protecting community health, this study examined the relationship between cardiovascular health and health beliefs, behavior tracking, and social determinants of health among Detroit residents.

Methods: This cross-sectional study was guided by the World Health Organization's conceptual framework of social determinants of health, which classifies social determinants into structural (e.g., socioeconomic factors) and intermediary (e.g., behavioral factors) categories. From May 2019 to August 2021, 394 residents of Detroit were recruited to complete a survey about their …

Infant Mortality Data: Missing Pieces To Prevention In Lesotho, Jacinda Croissant

Master's Projects and Capstones

Lower-middle-income countries (LMICs) like Lesotho lack complete and quality infant mortality data. Without infant mortality data, it can be challenging to develop public health education, programming, and policies to address preventative infant deaths in specific populations (Rao et al., 2004). A literature review identified strategies to improve infant mortality data in LMICs. Through a community engagement model and digital storytelling, community members can gain awareness, begin an ongoing conversation about local public health issues, and participate in an improved data collection system. Infant mortality is often used as an indicator of health for a population; improved infant mortality data can …

The Evidence Is In: Breast Implants Are Making People Sick Increasingly Women Find When They Have Their Implants Removed, Their Symptoms Improve—Or Disappear., Pamela J. Appea

Capstones

Over the years, breast implants have been associated with a wide range of health issues, including cancer and autoimmune diseases, but surprisingly these issues are not well known to the public. In 1992, health concerns led the FDA to halt the use of silicone gel breast implants for cosmetic surgeries, although implants containing saline remained available (it was during this period that the Oprah segment that Gmitro remembered ran on TV). In 2006, after more research, which some experts believe was insufficient, the FDA re-approved the use of silicone implants. In 2019, a novel “textured” breast implant manufactured …

Jovial Family Farm Facilitates Intergenerational Learning Opportunities Through Urban Farming, Maera Williams

Purdue Journal of Service-Learning and International Engagement

Maera Williams is a sophomore in Environmental and Ecological Engineering at Purdue University. She joined the Engineering Projects in Community Service (EPICS) Urban Farming team as a freshman and now serves as project manager of ten undergraduate students collaborating with Jovial Family Farm to design and develop three indoor hydroponics systems for a laboratory space on their property in Broad Ripple, IN. Jovial Family Farm is a nonprofit organization founded by Drs. Bobbie and Brian Jellison with the mission to provide senior citizens, their families, and their communities with meaningful engagement opportunities on an intergenerational scale through urban agricultural activities. …

Elevated Ambient Temperature Associated With Reduced Infectious Disease Test Positivity Rates: Retrospective Observational Analysis Of Statewide Covid-19 Testing And Weather Across California Counties., Nicholas Wing-Ping Kwok, Joshua Pevnick, Keith Feldman

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: From medication usage to the time of day, a number of external factors are known to alter human body temperature (BT), even in the absence of underlying pathology. In select cases, clinical guidance already suggests the consideration of clinical and demographic factors when interpreting BT, such as a decreased threshold for fever as age increases. Recent work has indicated factors impacting BT extend to environmental conditions including ambient temperature. However, the effect sizes of these relationships are often small, and it remains unclear if such relationships result in a meaningful impact on real-world health care practices.

OBJECTIVE: Temperature remains …

The Work-Life Balance Of Higher Education Faculty In Light Of Constant Access To Technology: A Case Study, Giordana Morales-Spier

Doctoral Dissertations and Projects

The purpose of this instrumental case study was to explore the perception of constant access to technology for faculty members in the university setting. Constant access to technology was defined as the majority of work tasks taking place in front of the computer, the expectation of quick email responses, and the pressure for continual student interaction, particularly outside of regular business hours. Burnout theory guided this study, which provided views of faculty’s efficiency, stress levels, and personal time. The central research question that guided the study was: How do higher education faculty at CVU guard against burnout while experiencing constant …

The Impact Of Adverse Childhood Experiences On The Eating Behaviors Of Black American Women, Teshia Stovall Dula

Doctoral Dissertations and Projects

This dissertation explores the impact of behaviorism on understanding adverse childhood experiences (ACEs) and their effects on eating behaviors, particularly emotional overeating, and satiety responsiveness, in Black women. It highlights the importance of addressing ACEs to promote holistic well-being, especially given racial health disparities. The study investigates various factors shaping the behavior of Black women, including individual traits, environments, and behavioral patterns, focusing on an under-researched area. It calls for standardized definitions in this context and advocates for more extensive and diverse sample sizes for future research. Ultimately, the research aims to empower Black women by translating insights into effective …

Review Of Epidemiology, Prevention And Management Of Blood-Borne Viruses Experienced By Aboriginal And Torres Strait Islander Peoples, Katiska Davis, Eliza Lock, Laura Thum, Gemma Crawford, Roanna Lobo, Odette Aung Thein, Shane Kavanagh, Jonathan Hallett

Journal of the Australian Indigenous HealthInfoNet

This review examines the epidemiology, prevention, and management of blood-borne viruses (BBVs) experienced by Aboriginal and Torres Strait Islander peoples in Australia with a focus on hepatitis B, hepatitis C, and HIV. The review highlights the disproportionate burden of BBVs among Aboriginal and Torres Strait Islander peoples in Australia, influenced by historical, social, and cultural factors stemming from colonisation. Key findings include higher prevalence rates of hepatitis B and C compared to non-Indigenous Australians, with some progress in reducing new infections through vaccination and treatment programs. However, significant gaps remain in screening, linkage to care, and treatment uptake. The review …

Covid For One: Identifying Obstacles To Self-Management Of Covid-19 For Single Adults, Linda A. Treiber, Christie Emerson, Jenna Shackleford

Faculty Articles

Given the complexities of healthcare provision, it is imperative to understand how single adults experience their interactions with medical professionals and health care organizations, manage care and treatment, and navigate the barriers encountered. This study’s purpose is to understand physical and mental health experiences in consideration of social determinants of health, barriers, and coping strategies for single adults diagnosed with COVID-19. An interpretive phenomenology study design was used with 12 individuals who were single and living alone during the COVID-19 pandemic. Semi-structured, open-ended interviews revealed important aspects of the COVID-19 illness experience. Interviews were transcribed for coding and thematic analysis. …

Effect Of School Hpv Vaccination Requirements On Pediatricians' Recommendations, Ashley Hedrick Mckenzie, Lara S Savas, Ross Shegog, Dale S Mantey, Erica L Frost, Paul Gerardo Yeh, C Mary Healy, Stanley Spinner, L Aubree Shay, Sharice M Preston, Sally W Vernon

Faculty, Staff and Student Publications

Background/objectives: Pediatrician recommendations are highly influential in parents’ decisions to vaccinate their children against HPV. Unqualified, presumptive, and bundled recommendations (UPBRs) are associated with increased HPV vaccine uptake and are considered best practice. This study analyzes pediatricians’ self-reported data to assess changes in UPBR use and the psychosocial determinants of UPBR use as a result of the implementation of a multi-level intervention, the Adolescent Vaccination Program (AVP).

Methods: We surveyed pediatricians across 51 clinics in the Houston area. Baseline surveys (n = 137) were distributed in 2015, and follow-ups (n = 120) in 2019.

Results: Pediatrician UPBR use …