Digital Commons Network^™

Beyond "Place Matters": Making Spatial Analysis Accessible With Dashboard-Driven Geography, Stephen Borders

Public Health

This article presents an instructional module that uses Tableau to teach spatial thinking and policy geography through an analysis of Supplemental Nutrition Assistance Program (SNAP) participation. Tableau’s ability to integrate custom spatial files with demographic and health data makes it an accessible platform for introducing geographic inquiry without requiring specialized GIS expertise. The lesson guides instructors through building maps, bullet charts, and scatterplots that highlight gaps between eligibility and enrolment, while connecting food insecurity to health outcomes. By lowering technical barriers, Tableau provides a pedagogical bridge that helps educators foster spatial literacy in diverse classroom contexts.

This article was published …

Depression, Education, And Quality Of Life In Women With Endometriosis, Ria N. Gajar

Walden Dissertations and Doctoral Studies

Endometriosis is a chronic gynecologic condition associated with substantial physical, psychological, and social burden, and depressive symptoms are consistently linked to poorer health-related quality of life (HRQoL) among affected women. However, limited population-based research has examined how depressive symptoms intersect with social factors. Guided by Engel’s biopsychosocial model, nationally representative data from the 2005–2006 National Health and Nutrition Examination Survey (NHANES)—the most recent cycle to include an item on endometriosis diagnosis—were analyzed among U.S. women with self-reported endometriosis (N = 4,137). Complex samples logistic regression models were used to examine associations between depressive symptoms and HRQoL across general, physical, and …

Asian Reference Values For Handgrip Strength, Gait Speed, Five-Times-Sit-To-Stand Test, Muscle Mass And Calf Circumference, Jozo Grgic, Siew Ling Tey, Dieu Thi Huynh, Yen Ling Low, Zeljko Pedisic, Nina Schaller, Vanessa Kristina Wazny, Weilan Wang, Yasuhiko Saito, Ravindra P. Rannan-Eliya, Hala Ghattas Ph.D., Monique Chaaya, Carlos Mendes De Leon, Preeti Gupta, Ecosse L. Lamoureux, Mythily Subramaniam, Edimansyah Abdin, Rahul Malhotra, Angelique Chan, Bayasgalan Tumenbayar, Et. Al.

Faculty Publications

Background:

Handgrip strength, gait speed, Five-Times-Sit-to-Stand Test (FTSST) performance, skeletal muscle mass and calf circumference are important health outcomes, particularly useful for diagnosing sarcopenia. The aim of this study was to establish reference (normative) values for handgrip strength, gait speed, FTSST performance, skeletal muscle mass and calf circumference by pooling individual participant data from national cohorts in Asia.

Methods:

We conducted a pooled analysis of individual participant data from 20 national cohorts representing 12 Asian countries (China, India, Indonesia, Israel, Japan, Lebanon, Malaysia, Mongolia, Philippines, Republic of Korea, Singapore and Sri Lanka). We included cohorts with data on at least …

Association Between Environmental Exposures To Perfluoroalkyl And Polyfluoroalkyl Substances And Military Veterans Cancer Determination, Stephen A. Pereira Jr

Walden Dissertations and Doctoral Studies

This study involved evaluating whether cumulative exposure to perfluoroalkyl and polyfluoroalkyl substances (PFAS) was associated with kidney cancer, bladder cancer, and adult leukemia among U.S. veterans. Pooled National Health and Nutrition Examination Survey (NHANES) data from 2005–2015 were analyzed for sample of 2,500 veterans with available serum PFAS measurements and physician-diagnosed cancer histories. This study employed a cross-sectional, correlational design grounded in a post-positivist paradigm. Inclusion required complete data for (a) serum PFAS concentrations, (b) kidney cancer, bladder cancer, and adult leukemia, and (c) covariates age, sex, race/ethnicity, smoking status, and body mass index. Cumulative PFAS was modeled as a …

Prevalence Of Premenstrual Syndrome, Premenstrual Dysphoric Disorder, And Dysmenorrhea In Nursing Students: A Systematic Review, Meta-Analysis, And Evidence-Based Recommendations, Sabyasachi Maity, Bharathi Gadad, Hansapani Rodrigo, Seham Noorani, Ayesha Usman, Chloe Lark, Mona Attarpour, Ivy Mageto, Lucas Schwartz, Nikhilesh Anand

School of Medicine Publications

Introduction: Menstrual disorders—including premenstrual syndrome (PMS), premenstrual dysphoric disorder (PMDD), and dysmenorrhea—are highly prevalent among women of reproductive age and are associated with impaired academic performance, psychological distress, and reduced social functioning. Nursing students are particularly vulnerable due to the combined demands of intensive academic schedules and clinical training, yet prevalence estimates and institutional responses remain inconsistent.

Methods: A systematic review and meta-analysis were conducted in accordance with PRISMA 2020 guidelines and registered in PROSPERO (CRD420251109363). PubMed, Scopus, Web of Science, CINAHL Ultimate, and APA PsycINFO were searched for studies published between 2016 and 2025. Eligible studies reported prevalence or …

Restoring Trust: A Fair Chance At A Bright Smile And The Human Side Of School-Based Dentistry, Rubin Sorrell Ii, Mph, Dds

Journal of the American College of Dentists

The Fair Chance at a Bright Smile (FCAABS) program represents a humanistic, community- centered approach to dentistry that redefines access, education, and dignity in oral health. Developed and refined through a year-long pilot partnership with the San Francisco Unified School District, FCAABS integrates preventive dental care, oral health education, and career exposure for students from pre-kindergarten through high school. This manuscript argues that beyond clinical outcomes, FCAABS reveals a deeper truth: oral health is intrinsically social, emotional, and moral. It examines the program through the lens of the humanities and ethics, exploring how narrative, empathy, and cultural context inform both …

Individual Characteristics And National Income Modify The Association Between Cognitive Social Capital And Food Insecurity: Evidence From The Gallup World Poll, 2014–2021, Sejla Isanovic, Kegan O'Connor, Audrey L. Richards, Edward A. Frongillo Jr. Ph.D.

Faculty Publications

Background: Food insecurity affects >2.4 billion people globally and persists across income levels. Characteristics such as low income, low education, and unstable employment do not fully explain this persistence. Social resources embedded in networks, specifically cognitive social capital involving trust, reciprocity, and support, may offset constraints and buffer characteristics associated with a higher probability of food insecurity.

Objectives: This study examined whether social capital was associated with a lower probability of food insecurity and whether this as sociation varied by individual characteristics and country contexts, consistent with buffering and compensation.

Methods: Data were drawn from the Gallup World Poll (2014–2021), …

Fathers, Futures, And Fragile Contexts: Men’S Intergenerational Perspectives On Pregnancy In A Low-Income South African Setting, Urlridge A. Thompson, Johanni Beukes, Michelle Leal, Stephanie Alcock, Stephen Lye, Shane A. Norris, Catherine Draper

Journal of Social, Behavioral, and Health Sciences

Men’s involvement in their partner’s pregnancy in low-income South African settings is influenced by a complex interplay of contextual factors that influence the nature and extent of their participation. The confluence of these factors contributes to limiting men’s adoption of an intergenerational perspective of their partner’s pregnancy. The adoption of an intergenerational perspective by men may enhance outcomes for maternal and child health, but it remains understudied. This qualitative study explored intergenerational perspectives of men in Soweto, South Africa, regarding their partners’ pregnancies. An exploratory descriptive qualitative approach was employed. We conducted in-depth individual interviews with 19 male partners (fathers …

Jefferson Heart Health (Jhh): A Successful Student-Delivered Motivational Interviewing Pilot Program To Lower Cardiovascular Disease (Cvd) Risk, Nicholas Tomasko, Bs, Cindy Cheng, Md, Phd, Rafael Hernandez, Bs, Alessandra Sapon, Bs

Alpha Omega Alpha Research Symposium Posters

Purpose: The Jefferson Heart Health (JHH) program utilizes student health coaching by trained undergraduate and medical students supporting patients to sustain lifestyle changes and subsequently determine: how can we effectively educate patients by improving adherence to lifestyle recommendations? Also, what is the effectiveness of student-delivered health coaching for reducing patient cardiovascular risk? With our unique student-delivered program, we promote cost-effective lifestyle interventions for lowering overall cardiovascular disease (CVD) burden.

Methods: We successfully completed a four-week pilot with consistent patient attendance. Certified student JHH coaches, supervised by the certified obesity-management specialist and principal investigator, met weekly with 23 patients: 82.6% female/17.4% …

Midlife Wellness: Building Healthy Lifestyle Habits To Ensure Quality Of Life, Naomi Brower, Elizabeth Davis

All Current Publications

Life expectancy has increased significantly, but women often spend their later years in poor health unless they take proactive steps to build healthy habits early. This fact sheet provides information on healthy habits women can develop to help manage hormonal changes during perimenopause and menopause and reduce long-term health risks.

Proceeding Book Of The 17th Indonesian Occupational Medicine Updates (Iomu), Perdoki .

Occupational and Environmental Medicine Journal of Indonesia

Bali, Indonesia, 16th - 18th May 2025

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.

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 …

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 …

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 …

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 …

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 …

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. …

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 …

Structural Empowerment And The Work Environment Of Nursing Home Care Workers In China, Yawen Ou

Lingnan Theses (MPhil & PhD)

China is experiencing a profound demographic transformation as its population ages rapidly, driven by declining fertility, increased longevity, and long-term effects of the One- Child policy. Traditional family-based elderly care has become increasingly unsustainable due to the pressures of the “4-2-1” family structure and the rising prevalence of empty-nest households. In this context, there is an increasing trend in institutionalized elderly care, accompanied by a growing demand for Nursing Home Care Workers (NHCWs). In spite of their vital importance, NHCWs often face heavy workloads, poor compensation, low recognition, and limited professional autonomy. This study explores the work environment and structural …

Race And Patient-Physician Communication On Blood Pressure Management: Helping Improve Care, Samar A. Nasser, Ashley Pender, Ayan Ali, Kardie Tobb, Keith C. Ferdinand

Division of Cardiology Faculty Papers

PURPOSE OF REVIEW: To provide an overview of the relationship of race and ethnicity and patient-physician/clinician communication on blood pressure management.

RECENT FINDINGS: The suboptimal interactions experienced by patients from underrepresented racial and ethnic populations may be improved by enriching relationships among clinicians, population health scientists, policymakers, and community members/leaders. Current care communication and policies for managing hypertension appear to be insufficient. Implementing and disseminating effective strategies to efficiently improve the quality of hypertension care and recognize social determinants of health among minoritized populations is intertwined with enhanced communication.

SUMMARY: Approaches such as self-affirmation—encouraging patients to reflect on their strengths …

Handling Missing Data In Copd Research, Chia-Ying Chiu

ETDs from 2020-2029

Chronic Obstructive Pulmonary Disease (COPD) remains a major global health concern and one of the leading causes of death in the United States, affecting approximately 4.6% of adults and reaching a prevalence of 9.4% in Alabama according to 2024 National Health Interview Survey. The disease imposes a substantial burden on quality of life and healthcare costs and contributes to increased disability-adjusted life years and years of life lost, as highlighted by the 2022 Lancet Commission report. Despite its im-pact, COPD is frequently diagnosed only after irreversible lung damage has occurred, largely due to under-recognized symptoms and limited diagnostic tools. Early …

Community And Individual Risk Factors Associated With Tuberculosis Treatment Outcomes: Ca, Md, And Oh, [2017-2021]., Kadiatu Banjoko

Walden Dissertations and Doctoral Studies

There are unsuccessful treatment outcomes with Tuberculosis (TB) disease, although effective therapies exist. This study aimed to identify predictors of unsuccessful treatment using the socioecological model. A quantitative cross-sectional study and multinomial logistic regression analysis were used to measure the associations between long-term care (LTC), homelessness, correctional facility, Human Immunodeficiency Virus (HIV), diabetes, excess alcohol, illicit drug use, and TB treatment outcomes of death, lost to follow-up, and treatment refusal. The sample consisted of 7,589 individuals aged 15 and older with pulmonary TB between 2017 and 2021, residing in California, Ohio, and Maryland. Findings indicated a correlation between community factors …

Multilevel Analysis Of The Food And Physical Activity Environment And Adult Obesity Across U.S. Counties And States, Ann Mary Abraham, Michael D Swartz, Alexandra E Van Den Berg, Stephen H Linder

Faculty, Staff and Student Publications

Adult obesity rates have risen steadily across the United States over the past decade, with more than 40% of adults affected. Persistent geographic and demographic disparities exist in obesity prevalence across the nation. While prior research has examined individual or environmental associated factors of obesity, limited studies have addressed both physical activity and food environments across the nation using multilevel approaches. This cross-sectional ecological study (2014-2024) used a two-level random intercept model to assess the association between county- and state-level factors and adult obesity prevalence across over 3000 U.S. counties nested within 51 states. County-level associated factors included food insecurity, …

Women With Moderate Anaemia Prior To Conception Benefited Most From Nutrition Interventions: A Secondary Analysis Of The Women First Preconception Maternal Nutrition Trial, Sumera Aziz Ali, Ka Kahe, Jeanine Genkinger, Linda Valeri, Sarah Saleem, Saleem Jessani, Robert Goldenberg, Jamie Westcott, Jennifer Kemp, Ana Garces, Lester Figueroa, Shivaprasad Goudar, Sangappa Dhaded, Richard Derman, Antoinette Tshefu Kitoto, Adrien Lokangaka, Melissa Bauserman, Elizabeth Mcclure, Marion Koso-Thomas, Louise Kuhn, Nancy Krebs

Global Health Articles

INTRODUCTION: The Women First (WF) Preconception Maternal Nutrition trial found greater benefits of small-quantity lipid-based nutrient supplements (SQ-LNS) for intrauterine growth among anaemic versus non-anaemic women at preconception. We investigated whether the benefits of SQ-LNS in improving markers of intrauterine growth occurred evenly across the mild to moderate spectrum of pre-pregnancy anaemia.

METHODS: We analysed WF data (n=2443 maternal-newborn dyads) from Pakistan, India, Guatemala and the Democratic Republic of Congo. Women received SQ-LNS either ≥3 months preconception through pregnancy (Arm 1); starting in the late first trimester (Arm 2); or not at all (Arm 3: control), with all supplementations discontinued …

Early Atopic Dermatitis And Risk Of Later Autism Spectrum Disorders, Annissa Courtney Heslope-Mathieu

Walden Dissertations and Doctoral Studies

Early-onset atopic dermatitis (AD) affects approximately 10-20% of children in the United States, and emerging evidence suggests potential links between early immune dysregulation and neurodevelopmental outcomes. Limited research has examined whether early AD serves as a specific risk factor for later ASD diagnosis. Guided by life course theory, the purpose of this study was to examine whether AD diagnosed within the first two years of life predicts later diagnosis of ASD among U.S. children younger than five years. A secondary analysis of the Fragile Families and Child Wellbeing Study was conducted using a retrospective cohort design. The sample included 2,949 …

Dietary Inflammatory Index And Risk Of Colorectal Cancer In Japanese Men, Ayaka Kotemori, Kumiko Kito, Motoki Iwasaki, Taiki Yamaji, James Hébert Scd, Junko Ishihara, Manami Inoue, Shoichiro Tsugane, Norie Sawada On The Behalf Of Jphc Study Group

Faculty Publications

Background/Objectives: Unhealthy lifestyles lead to chronic low-grade inflammation, increasing the risk of colorectal cancer. Few studies in East Asia have examined the association between the dietary inflammation potential and colorectal cancer incidence. Therefore, we aimed to investigate this association further in the Japanese population. Methods: This study included 38,807 men aged 45–74 years who participated in the Japan Public Health Center-based prospective study (JPHC Study). The energy-adjusted dietary inflammatory index (E-DII) was derived from a food frequency questionnaire. Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using Cox proportional hazards regression models. Differences in risk due to a …

Metabolome Contribution To Sex Differences In The Link Between Alcohol Consumption And Type 2 Diabetes: A Prospective Analysis In The Hispanic Community Health Study/Study Of Latinos (Hchs/Sol), Brian Wang, Kai Luo, Wenyan Ma, Yanbo Zhang, Christina Cordero, Amber Pirzada, Martha Daviglus, Krista M Perreira, Bing Yu, Eric Boerwinkle, Robert C Kaplan, Qibin Qi

Faculty, Staff and Student Publications

Background: Light-to-moderate alcohol consumption has been linked to improved insulin resistance and lower type 2 diabetes (T2D) risk predominantly in females but not males. Potential mechanisms underlying this sex difference remain unclear.

Objective: This study evaluated associations of sex-specific alcohol-associated metabolomic signatures (AMSs) with insulin resistance and T2D risk in US Hispanic/Latino adults.

Methods: We analyzed serum metabolome data in the HCHS/SOL, a prospective, multicenter, community-based study of Hispanics/Latinos, aged 18 to 74 years old, enrolled from four U.S. metropolitan areas between 2008 and 2011. Sex-specific AMSs were developed using Elastic Net to identify serum metabolites uniquely associated with alcohol …

Postdischarge Pediatric Mortality In Nigeria For Children Under 5 Years Of Age, Philomina Nwaugo Chukwudike

Walden Dissertations and Doctoral Studies

Child mortality has remained a public health issue that is prevalent among families living in Nigeria and low- and middle-income countries. Factors associated with post-discharge pediatric mortality among children under 5 have not been explored. The study involved examining associations between timely individual follow-up visits, availability of healthcare facilities for follow-up care, and likelihood of post-discharge mortality among children under 5 while adjusting for household income, geographical location, mothers’ age, and mothers’ education. The theoretical framework was the social ecological model. Data were generated from the 2018 Demographic and Health Survey. A sample size of N=21,671 was used to determine …