Digital Commons Network^™

Factors Associated With Antiretroviral Therapy Adherence In Patients With Hiv At A Public Hospital In Central Jakarta, Indonesia, Kareena Sari Fatimah, Laily Hanifah, Chandrayani Simanjorang, Nayla Kamilia Fithri

Kesmas

Patients with human immunodeficiency virus (HIV) are required to take antiretroviral therapy (ART) to suppress the virus. However, suboptimal adherence remains a critical barrier that can lead to treatment failure and persistent transmission risks. This study aimed to identify factors associated with ART adherence in patients with HIV. This quantitative study with a cross-sectional design consisted of patients with HIV aged >18 years who received care at the voluntary counseling and testing clinic of a public hospital in Jakarta, Indonesia. Purposive sampling was used. This study used HIV care and ART overview forms as instruments. Data were analyzed using multiple …

Factors Affecting Irritant Contact Dermatitis Among Horticulture Farmers In Semarang District, Indonesia, Maria Goretti Catur Yuantari, Haikal Haikal, Dewi Susanna

Kesmas

Irritant contact dermatitis is a common condition among farmers, but its underlying causes remain poorly understood. This study aimed to identify factors associated with irritant contact dermatitis among horticulture farmers in Semarang District, Indonesia. A cross-sectional survey was conducted among 427 farmers using a validated, reliable structured questionnaire. The results indicated complaints of dermatitis related to contact with irritants. Data were analyzed using the Chi-square test and logistic regression. Analysis revealed that sex, personal hygiene habits, education level, and the number of pesticide types used were significantly associated with irritant contact dermatitis. Female farmers were less likely to develop irritant …

Low-Dose Prophylaxis Versus On-Demand Treatment For Children With Severe Hemophilia A In Indonesia: A Conceptual Model, Levina Chandra Khoe, Nur Atika, Dhia Ticha Pertiwi, Septiara Putri

Kesmas

Hemophilia A is a rare bleeding disorder caused by a deficiency of clotting factor VIII, leading to recurrent bleeds, joint damage, and disability. Low-dose prophylaxis has been shown to achieve better clinical outcomes than on-demand treatment in reducing bleeding frequency. However, in Indonesia, access and affordability remain key challenges. This study aimed to develop a conceptual model for conducting a health economic evaluation of low-dose prophylaxis treatment for children with severe hemophilia A in Indonesia. This study followed the ISPOR-SMDM Modeling guidelines, outlining two-stage processes: conceptualization of the clinical problem and model development. A systematic literature review was conducted to …

A Patient-Needs Assessment In The Management Of Vestibular Schwannoma, Eric Martinez, Alexandra Jackson, Gavriel Kohlberg, Andy Saultz

Pacific Journal of Health

Background: Decision aids have evolved as a tool utilizing evidence-based information to help patients understand treatment options and are nascent in the field of neurotology. Vestibular schwannoma management consists of observation, microsurgery, and / or radiation. A decision aid has the potential to help patients understand treatment options regarding vestibular schwannomas while functioning in a patient-centered environment.

Objective: To conduct a patient needs assessment in the diagnosis and management of vestibular schwannoma to inform draft decision aid development.

Setting and Participants: Eight patients between 45 and 74 years of age who received a diagnosis of a unilateral vestibular schwannoma and …

Translating Community Voices To Build Meaningful Engagement: A Community Health Worker Led Study, Lauren Workman, Julie Smithwick Msw, Chw, Kimberly C. Rawlinson, Mark M. Macauda, Lashandra Morgan, Whitney Davis

Faculty Publications

Background: Understanding community perspectives on barriers and facilitators of meaningful engagement, equitable decision making, and sustainable community improvement is critical for advancing health equity. Community Health Workers can make significant contributions to research teams, as they are bridges into communities and bring unique perspectives. This study describes community voices on barriers to authentic engagement and insights on strategies to build trust, as well as the way in which these data were translated into a tangible assessment tool and a community-facilitated learning academy.

Methods: A team of Community Health Workers led a series of 24 ‘open mic’ discussions in four South …

Association Between Dietary Folate And Prostate Cancer Aggressiveness Among African Americans And European Americans, Lihchyun Joseph Su, Sarah O'Connor, Daniela Ramirez Aguilar, Minjae Lee, Harrison Wong, Hui-Yi Lin, Jeannette T. Bensen, James L. Mohler, Lenore Arab, Longgang Zhao, Ebonee N. Butler, Laura Farnan, Susan E. Steck Phd, Mph, Rd

Faculty Publications

Background: Despite the confirmed beneficial effects on preventing neural tube defects, concerns about high intakes of synthetic folate, or folic acid, in promoting cancer progression have been raised. This study evaluated the association between folate intake and prostate cancer (PCa) aggressiveness among African-American (AA) and European-American (EA) males. Methods: This study included 722 AA and 775 EA men with prostate cancer. Folate intake (dietary folate equivalent (DFE), synthetic folate, natural folate) was estimated using the National Cancer Institute Dietary History Questionnaire and detailed dietary supplement use questionnaire. Analyses included univariable comparisons of demographic and clinical characteristics of the two racial …

Balancing Education And Health Among Rural Schoolchildren During Prolonged Heat Wave In The Philippines, Elias Olapane

Kesmas

Intensifying heat waves disrupt learning environments in the Philippines, particularly in rural areas where schools often lack adaptive infrastructure. Many rural classrooms are built with heat-retaining materials, such as concrete, which trap excessive heat, leading to indoor temperatures exceeding safe comfort levels. These conditions lead to dehydration, fatigue, and reduced cognitive function, directly impairing students’ focus and academic performance. Schoolchildren are particularly vulnerable due to their developing thermoregulatory systems, higher metabolic demands, and potential preexisting health conditions. These risks are further amplified in rural communities with limited access to cooling, healthcare, and adaptive resources. These challenges require practical, context-specific interventions. …

Evidentiary Standards For Newly Approved Antibiotics For Uncomplicated Urinary Tract Infections, Rosa Rodriguez-Monguio, Enrique Seoane-Vazquez, John H. Powers Iii

Pharmacy Faculty Articles and Research

Importance: Uncomplicated urinary tract infections (uUTIs) are among the most common bacterial infections and are typically treated with existing oral antibiotics. In 2024–2025, the FDA approved two new oral agents, sulopenem etzadroxil/probenecid and gepotidacin, via expedited review pathways, for the treatment of uUTIs. Objective: To assess the clinical significance and regulatory evidence supporting FDA approval of sulopenem/probenecid and gepotidacin for uUTI, and to analyze the adherence of pivotal phase III trials to regulatory standards for approval and FDA guidelines. Design, Setting, and Participants: Comparative descriptive analysis of publicly available data from phase 3 randomized, double-blind, active-controlled clinical …

Challenges, Stressors, And Resilience Resources Experienced By Older Black Women In Rural South Carolina Throughout The Covid-19 Pandemic, Arielle N'Diaye, Camryn Garrett, Sarah Wilcox Phd, Bankole Olatosi Ph.D., Xiaoming Li Ph.D., Shan Qiao Ph.D.

Faculty Publications

Background

Resilience has been established as a protective factor against mental health challenges (e.g., anxiety, depression). From an intersectional perspective, the stressors experienced by Black women living in rural communities are likely to have been exacerbated during the COVID-19 pandemic. This study aims to identify the challenges and stressors experienced and the resilience resources available to and relied upon by rural, Black women, during the pandemic.

Methods

Individual, in-depth, structured interviews (n = 24) were conducted among Black women living in rural South Carolina, recruited by local community health workers, from January to April of 2024. All interviews were recorded, …

Racial Disparities Among Pregnant Women Of Color And Their High Risk For Developing Periodontal Disease, Darrylnn Mayo

Pacific Journal of Health

This qualitative study explored the oral health experiences of four women of color during their pregnancies. Data was collected through interviews and presented as case studies. Although existing literature indicated that pregnant women of color are at a higher risk for developing periodontal disease, the participants in this case study reported actively engaging with their dental care providers, daily intake of prenatal vitamins with practice of self-oral care, and compliance with oral hygiene instructions. Further studies should investigate larger sample populations with broader minority ethnic groups to help explore the determinants of racial disparities and strategize ways to reduce barriers …

Navigating (M)Otherhood: Perception, Practice, & Policy Of Adolescent Pregnancy In The North Coast Of Perú, Mahir Rahman

USF Tampa Graduate Theses and Dissertations

“It’s a vicious circle”, the obstetricians of Huanchaco repeated time and time again after discussing a recently pregnant 13-year-old girl who had just moved to the North Coast of Perú. Adolescent pregnancy is an extremely stigmatized topic in global maternal and child health discourse. Pregnant adolescents are subject to educational policy, clinical protocol, and community practice. While global scholarship emphasizes adolescent pregnancy prevention, limited scholarship focuses on the conditions in which adolescent pregnancy is perceived, discussed, and managed. More importantly, these perspectives are even less documented amongst the North Coast of Perú.

This thesis serves as an ethnographic exploration of …

Trends In Self-Reported Responses To Nutrition Facts Labels Before And After Nutrition Labeling Policy Implementation: A Comparison Of Adults In The United States And Mexico, Jim Thrasher Ph.D., Ma, Ms, Victor Vilalobos, Dai Fang, Alejandra Jáuregui, Alejandra Contreras-Manzano, Rachel Davis Ph.D., Lana Vanderlee, Christine M. White, Rachel B. Acton, James W. Hardin, Edward A. Frongillo Jr. Ph.D., Simón Barquera, David Hammond

Faculty Publications

Background

Objectives

Methods

Plasma Ca125 Levels As A Predictor Of Major Adverse Cardiac Events In Patients With Acute Coronary Syndrome: A Six-Month Follow-Up Study, Nazlı Dilek Çolak, Turgut Karabağ, Onuralp Çalışkan, Songül Tezcan

Journal of the Saudi Heart Association

Objectives: Carbohydrate antigen 125 (CA125) is associated with different cardiovascular conditions. This study aimed to determine CA125 levels in patients with acute coronary syndrome (ACS) and the potential relationship between major adverse cardiac events (MACE) in the short-term following.

Methods: This prospective cohort study was conducted in a coronary care unit between May and November 2022. Plasma CA125 levels were measured only once upon hospital admission. Patients were followed for six months. All-cause mortality, recurrent acute coronary syndrome, requirement for revascularization, decompensated heart failure, cardiogenic pulmonary edema, atrial fibrillation, and stroke were recorded as MACE.

Results: A total of 127 …

Social Support And Mental Toughness As Predictors Of Perceived Stress Among College Kinesiology Students, Jianmin Guan, Wan Xiang Yao, Xiaofen D. Hamilton, Gaofeng Lu

International Journal of Physical Activity and Health

Drawing on Lazarus and Folkman’s transactional theory of stress and coping, this study examined the associations of age, gender, three types of social support (family, friends, and significant others), and mental toughness with two dimensions of perceived stress (helplessness and coping inefficacy) among 666 college students majoring in Kinesiology. Hierarchical multiple regression analysis revealed that male college students, as well as those with higher levels of mental toughness and family support, reported significantly lower levels of helplessness and coping inefficacy in managing stress. Additionally, greater support from friends was significantly associated with lower levels of coping inefficacy, while younger students …

Improving Structured Handoff Documentation In A Pediatric Emergency Department, Deborah Hammett, Rebecca Matta, Jody Kieffer, Jillian Savage, Courtney Nelson

Department of Pediatrics Faculty Papers

INTRODUCTION: The I-PASS handoff tool guides provider handoffs and reduces adverse events in the inpatient setting. Transitions of care occur frequently in the emergency department (ED), and the unpredictable environment can lead to less structured handoffs. Our goal was to increase the percentage of handoff notes that include all 4 I-PASS components by 20% within 6 months.

METHODS: We developed a handoff note template for the pediatric ED that included 4 key I-PASS elements: illness severity, patient care summary, action list, and situational awareness/contingency planning. Our primary outcome measure was the percentage of handoff notes that contained all 4 I-PASS …

Gender Differences In College Students’ Physical Activity Self-Efficacy, Social Comparison Beliefs, And External Frames Of Reference, Ken Murfay, Sarah Pyszczynski, Sarah Collins

International Journal of Physical Activity and Health

This study examined whom college-aged individuals believe observing would more likely increase their physical activity self-efficacy (PASE) for a physical skill, whom they are more likely to compare their abilities to within a physical education (PE) class, how often they compare themselves to others in PE, and what students’ PASE scores were. Based on the mean scores for each question, students were more likely to compare themselves to a student than a teacher, friend than a non-friend, and similar or higher skilled peer than a lower skilled peer. To increase students’ confidence for a physical skill, students had higher levels …

Association Between Children’S Secondhand Co-Exposure To Tobacco And Cannabis Smoke And Elevated Urinary Cotinine Levels: A Cross-Sectional Analysis, Bradley N. Collins, Stephen J. Lepore, Vincent Berardi, Renee D. Goodwin, Karen Wilson, Mona Baishya

Psychology Faculty Articles and Research

Background Cannabis use is far more common among adults who smoke tobacco than adults who do not, and its use is increasing among people who smoke tobacco with children living in the home. Given the well-established evidence that caregiver smoking is the primary source of children’s secondhand exposures to these products, the increasing trend in caregiver co-use is raising public health concerns about children’s co-exposure. Emerging data indicates that adult co-use is linked to additive health consequences, such as elevated nicotine and other tobacco-related toxicant blood levels, relative to use of only tobacco. It is unknown whether children’s co-exposure leads …

From Waitlist To Activation: Exploring Patient Barriers And Team Interactions In Kidney Transplant Readiness, Judith I. Eguzoikpe

Harrisburg University Dissertations and Theses

Kidney transplant candidates frequently experience prolonged inactive waitlist status due to incomplete readiness requirements, yet limited understanding exists regarding how patient barriers and team interactions intersect to influence activation timelines. This transcendental-phenomenological study explored how patient barriers and team dynamics contribute to delays in kidney transplant readiness, guided by Team Theory. Semi-structured interviews were conducted with 16 participants (8 patients, 8 healthcare professionals) between December 2025 and February 2026. Data were analyzed using systematic phenomenological methods to identify patterns that address patient barriers, team interaction effects, and the teamwork improvements needed for earlier activation. Five interconnected themes emerged: Navigating a …

A Transcriptional Program Associated With Neurotransmission In The Living Human Brain, Alexander W. Charney, Lora E. Liharska, Eric Vornholt, Alissa Valentine, Anina Lund, Alice Hashemi, Ryan C. Thompson, Terry Lohrenz, Jessica S. Johnson, Nicole Bussola, Esther Cheng, You Jeong Park, Salman Qasim, Alisha Aristel, Lillian Wilkins, Kimia Ziafat, Hannah Silk, Lisa M. Linares, Brendan Sullivan, Claudia Feng, Beniamino Hadj-Amar Ph.D.

Faculty Publications

At the foundation of neurotransmission, and by extension at the foundation of brain function, are coordinated programs of gene expression involving many thousands of genes. These programs are poorly defined in humans because most modern studies that characterize human brain gene expression use tissue obtained in the postmortem state when neurotransmission and brain function have ceased. Here, to advance knowledge of the gene expression programs at the foundation of neurotransmission in the human brain, gene expression was characterized in 130 prefrontal cortex (PFC) samples obtained from participants of the Living Brain Project (LBP) during neurosurgical procedures in conjunction with intracranial …

Survival On Image Regression With Application To Partially Functional Distributional Representation Of Physical Activity, Rahul Ghosal, Sunwoo Emma Cho, Marcos Matabuena

Faculty Publications

Technological advancements in wearable devices and medical imaging often lead to high-dimensional physiological signals in the form of images or surfaces. To address these data structures, we develop a novel survival on image regression model with a specific focus on partially functional distributional representation of wearable data. The existing approaches for functional data and survival outcomes have been primarily developed for uni-dimensional functional predictors. Drawing on recent developments in distributional data analysis, we model temporally varying distributional patterns of physical activity (PA) as a partially functional distributional predictor within a semiparametric Cox model framework. We use tensor product splines to …

Environmental Chemicals And Maternal Depression During And After Pregnancy: A Scoping Review, Pengfei Guo, Yunyue Shi, Cindy Nguyen, Haoran Zhuo, Tormod Rogne, Zeyan Liew

Faculty Publications

Purpose of Review

There is increasing evidence that several environmental exposures may pose a risk for depression, including maternal depression. We conducted a scoping review of epidemiological evidence regarding maternal exposure to environmental chemicals and perinatal depression.

Recent Findings

We searched PubMed, Embase, Web of Science, Dimensions, and Scopus, and summarized the findings from 27 articles that examined environmental chemical exposures and maternal depression. Studies of ambient air pollutants (N = 11) showed exposure to NO₂ and PM10 to be most consistently associated with antenatal or postnatal depression. Studies of endocrine-disrupting chemicals, including phthalates (n = 6), …

Cardiac Output-Guided Vs. Mean Arterial Pressure-Guided Hemodynamic Management In Craniotomy Patients With Cardiovascular Disease: A Randomized Trial, Na Chen, Minjing Yang, Renhua Li, Chunyan Ye, Lu Wang, Xingyang Liu, Jinghan Wu, Daniel I Sessler, E Wang

Faculty, Staff and Student Publications

We tested the primary hypothesis that cardiac output (CO)-guided versus mean arterial pressure (MAP)-guided hemodynamic management reduces the fraction of patients with 90-day Glasgow Outcome scores ≤ 4 (on a 1–5 scale, 5 better) after supratentorial brain tumor resections in adults with cardiovascular disease. 202 adults were randomized to intraoperative hemodynamic management guided by either CO or MAP. In patients assigned to CO guidance, clinicians targeted CO > 4 L/min and > 90% of baseline values using a combination of fluids and vasoactive agents. In patients assigned to MAP guidance, clinicians targeted MAP within ± 20% of baseline and ≥ 65 mmHg. …

A Qualitative Analysis Of Progress, Successes, And Challenges Among Indiana Recipients As Part Of A National Initiative To Reduce Covid-19–Related Health Disparities, Marla Winters, Lily Darbishire

Purdue Journal of Service-Learning and International Engagement

In light of the COVID-19 pandemic, the Centers for Disease Control and Prevention (CDC) provided funding to states as part of the CDC Disparities Grant initiative. The aim of the funding was to reduce chronic disease and COVID-19–related health disparities among vulnerable communities through four unique strategies. Funding was awarded to the Indiana Department of Health (IDOH) to begin an Indiana chapter of this initiative, called Indiana Healthy Opportunities for People Everywhere (I-HOPE). From 2021 to 2023, the IDOH provided I-HOPE funding to local communities (subgrantees) to support the design and implementation of programs to improve community health. For example, …

Determinasi Minimum Dietary Diversity Pada Anak Usia 6-23 Bulan: Analisis Survei Kesehatan Indonesia 2023, Elfys Ferdynan, Besral Besral

Jurnal Biostatistik, Kependudukan, dan Informatika Kesehatan

Keragaman pangan minimum atau minimum dietary diversity (MDD) merupakan indikator penting kualitas konsumsi pangan anak usia 6-23 bulan. Pemenuhan MDD berperan dalam mendukung pertumbuhan optimal dan pencegahan malnutrisi, termasuk stunting. Penelitian ini bertujuan untuk menganalisis faktor-faktor yang berhubungan dengan pemenuhan MDD pada anak usia 6-23 bulan di Indonesia. Data yang digunakan adalah data Survei Kesehatan Indonesia 2023 dengan desain potong lintang. Subjek penelitian adalah 17.991 anak usia 6-23 bulan. Analisis yang dilakukan menggunakan regresi logistik biner dengan penyesuaian desain complex samples. Hasil penelitian menunjukkan bahwa faktor yang meningkatkan peluang pemenuhan MDD secara signifikan meliputi usia anak 12-23 bulan, …

Hold Harmless For Whom? The Impact Of Covid Era Policies On School Funding, Teachers, And Students, Michah W. Rothbart, Samantha Cervantes, Amy Ellen Schwartz

Center for Policy Research

This study evaluates the fiscal and academic consequences of New York City’s hold harmless policy during COVID-19, which aimed to stabilize school expenditures amid unexpected enrollment declines by restoring schools’ funding up to initial levels. We examine how school racial composition predicts whether or when schools receive hold harmless “treatment” and assess the impact of hold harmless on financial resources, staffing, and student outcomes, exploring heterogeneity by timing of policy announcement. Although schools with higher White student shares were no more likely than those with higher Hispanic or Black shares to receive hold harmless funds, schools with higher Black shares …

Social, Political, And Economic Determinants For Hiv Prep Care Delivery Innovations, Joanne Senoga Brown

Walden Dissertations and Doctoral Studies

Pre-exposure prophylactic care delivery innovations (PCDI) are critical to the Ending the HIV Epidemic (EHE) initiative. While individual studies have examined isolated factors such as patient awareness, provider willingness to prescribe, and cost-effectiveness, few have synthesized these findings into a unified framework explaining how structural social, political, and economic determinants jointly influence PCDI. Prior literature remains fragmented, emphasizing behavioral or programmatic variables rather than systemic structures. This meta-analysis was done to examine how structural determinants independently and collectively influence PCDI across the 47 U.S. EHE jurisdictions. Guided by the consolidated framework for implementation research and Rogers’s diffusion of innovations theory, …

Psychosocial Determinants Of Hand Hygiene Practices Among Children And Adolescents Living With Hiv In The Northern City Of Malawi, Balwani Chingatichifwe Mbakaya, Maggie Zgambo, Richard Moyo, Paul Uchizi Kaseka, Obed Nkhata, Fatch Kalembo

Research outputs 2022 to 2026

Background: The common cause of death in HIV and AIDS patients are opportunistic infections such as diarrhoea, acute respiratory infections, and skin conditions. Many of these infections are spread through contaminated hands. Therefore, this study aimed at exploring hand hygiene practices among HIV positive children and adolescents in Mzuzu City, Malawi. Methodology: A cross-sectional study was used to collect data from children and adolescents living with HIV (aged between 9 and 18 years) WHO were attending teen clubs in Mzuzu City. Data were analysed using Stata 17. Chi-Square and logistic regression analysis were used to examine the association among multiple …

Operational Factors Influencing Branch Revenue In Multi-Branch Child Therapy Services, Muhammad Luthfi

Jurnal Administrasi Bisnis Terapan

The management of multi-branch child therapy services requires a strong understanding of operational factors that contribute to revenue performance. This study aims to analyze the relationship between operational days, occupancy rate, service attendance, and the number of practitioners in relation to branch revenue within a child therapy service organization operating in urban areas in Indonesia. A quantitative cross-sectional design was employed using operational data collected from 24 child therapy services. This study employed a quantitative cross-sectional design using branch-level operational data collected in December 2025 from 24 child therapy service branches. Multiple linear regression analysis was conducted to examine the …

Neurophysiological Connectomic Signatures Of Consciousness During Propofol-Induced General Anesthesia, Yuqin Li, Xiaoxiao Chen, Hui Zheng, Senqi Li, Qingyu Teng, Chengyu Wang, Fali Li, Zhongcong Xie, Daniel Sessler, Zhe Zhang, Peng Xu, Ti-Fei Yuan, Tao Xu

Faculty, Staff and Student Publications

General anesthesia induces reversible changes in consciousness through cortical activity and connectivity alterations, yet the functional connectome dynamics underlying propofol-induced unconsciousness remains unclear. We analyze high-density 128-channel electroencephalogram (EEG) from 31 surgical patients using source localization to identify neurobiological connectome signatures of propofol anesthesia. Propofol anesthesia increases delta and theta functional connectivity and decreases alpha, beta, and gamma connectivity. A classification model and dynamic analysis of consciousness loss reveals that alpha-band connectivity between parietal, occipital, and subcortical regions is critical for sustaining consciousness, with its disruption marking a key transition to unconsciousness. EEG from 46 additional patients under mild sedation …

The Relationship Between Social Determinants And Primary Care Utilization Among Medicaid Recipients In A Managed Care Community Health Worker Program, Rachel Elaine Rosensteel

Walden Dissertations and Doctoral Studies

Community health worker (CHW) programs are an increasingly important strategy for addressing social determinants of health (SDOH) within Medicaid systems. However, evidence on how specific SDOH impact healthcare utilization remains limited. In this quantitative, correlational study, the relationship between SDOH factors like housing instability, food insecurity, and transportation barriers, and primary care utilization among adult Medicaid recipients aged 18–65 who participated in a Medicaid managed care organization’s CHW program in Clark County, Nevada, during 2023 were examined. Retrospective administrative data from 441 participants were analyzed using negative binomial regression to assess associations between SDOH factors and postintervention primary care visits …