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Unraveling The Drivers Of Inequality In Maternal Healthcare Utilization In Indonesia: A Decomposition Analysis, Wji Wahyuningsih, Kemal N. Siregar, Syifa Nurhakiki

Jurnal Ekonomi Kesehatan Indonesia

This study assessed socioeconomic inequalities in maternal healthcare utilization in Indonesia and identifies key factors driving these inequalities. We used data from 2013 and 2023 Indonesian Health Surveys, comprised of a total unweighted sample of 15,638 and 9,923 women aged 15-49 in the 2013 and 2023, respectively. Concentration index (CI) measured wealth-based inequality, and decomposition analysis identified primary drivers of inequalities in maternal healthcare access. Overall maternal healthcare service utilization has increased, but significant inequalities persist. Antenatal care showed minimal improvement, with the CI rising from 0.059 to 0.079, indicating a persistent higher socioeconomic distribution. Facility-based deliveries improved, with the …

Implementation And Outcomes Of A Digital Onboarding Taskforce In The Acute Care Setting, Julianna Lenoir, Alexzandra Gentsch, Akshay Krishnan, Jeffrey Ndubisi, Marissa Witmer, Kristin L. Rising, Brooke Worster, Angela M. Gerolamo

Jefferson Center for Connected Care Faculty Papers

INTRODUCTION: Use of digital health technology can improve patient health outcomes; however, not all patients have the knowledge and skills to download a health app and access a patient portal. Providing digital onboarding support to hospitalized patients has potential to overcome some barriers to accessing needed education in the community, including both having the time and a location to receive education. To address this, our team developed the Jefferson Digital Onboarding Taskforce (JeffDOT), a group of staff and students who approach hospitalized patients and provide one-on-one teaching on how to sign up for and use a patient portal.

METHODS AND …

Analysis Of The Health Access Initiatives Available For Newly Resettled Immigrants And Refugees In Charlotte, North Carolina, Yetunde Akinyelu

Doctoral Dissertations and Projects

The Health Access Initiative for Newly Arrived Immigrants and Refugees in Charlotte, North Carolina addresses the major obstacles which prevent these populations from obtaining vital healthcare services (P Iqbal., et al 2022). The research investigated healthcare difficulties faced by immigrant and refugee populations after their arrival in the United States while developing solutions to enhance their healthcare accessibility and results. The research employed qualitative methods to gather data through semi-structured interviews with immigrants and refugees who resided in Charlotte (Alkhawaldeh, et al., 2023). The research took place in community-based locations to create an environment where participants could freely discuss their …

Is Ai Replacing Human Mental Health Professionals?, Michiko Ueda

Population Health Research Brief Series

An increasing number of people are turning to generative artificial intelligence (AI) tools and AI-assisted chatbots to manage mental health concerns. This data slice presents findings from a national survey of U.S. adults aged 18-49 (N = 1,805) conducted in October 2025. Among respondents, 35.2% reported using AI tools more than once a week for mental health support. Among those who had ever seen a human mental health professional, 28.4% reported visiting human providers less often since beginning to use AI for the same purpose. The findings suggest that a subset of users may be using AI to replace, rather …

Addressing Challenges In Accessing Secondary And Tertiary Healthcare Services For Migrants And Refugees In Egypt, Noura Seada, Nehal El-Bakhshawangy, Heba Semary, Fatma Alzahraa Hassan, Ahmed Hammad

Papers, Posters, and Presentations

The growing number of vulnerable migrants and refugees worldwide presents a significant challenge to host countries, particularly in terms of accessing healthcare services. Egypt hosts over 9 million migrants and refugees, with 1.5 million in a vulnerable situation. Despite the country’s efforts in providing adequate healthcare to these vulnerable groups, some challenges persist. This paper addresses the barriers that vulnerable migrants and refugees face when seeking secondary and tertiary healthcare services in Egypt, analyzing the legal, economic, social, and health system factors that contribute to this problem.

In 2018, the Egyptian government began an ambitious journey to reform its healthcare …

Violence Between Residents In Nursing Homes Is An Enduring Problem. The Agencies, Nursing Homes, And Residents Are Playing Hot Potato With The Responsibility, Cindy Marchionda, Rafael Escalara Montoto

Capstones

Resident-to-resident aggression in nursing homes is a persistent issue, far more common than the general public realizes. While many of these violent situations can be managed, some tragically escalate to fatal outcomes, leaving families mourning the loss of their loved ones at the hands of a facility that was meant to provide safety and care during their final years. Experts agree that this issue is largely driven by chronic understaffing and insufficient training for employees on how to manage patients with dementia and aggression issues.

Future-Ready Physicians: Exploring Medical Students’ Readiness, Attitudes, And Perceptions Of Healthcare Artificial Intelligence In Saudi Arabia, Hassan Abdulaziz Moria, Amirah Alatawi, Sharifah Alzahrani, Hyder Mirghani, Hisham Al Shadfan

Makara Journal of Health Research

Background: While the integration of artificial intelligence (AI) in healthcare has advanced globally, there is limited research on the preparedness of medical students in the Tabuk region of Saudi Arabia, particularly regarding their specific educational needs and cultural context. This study assessed medical students’ knowledge, attitudes, readiness, and confidence toward AI integration at the University of Tabuk, providing the first comprehensive analysis of AI readiness in this underrepresented northern region of Saudi Arabia.

Methods: A cross-sectional study was conducted among 261 medical students and interns across all academic years (1–6) at the Faculty of Medicine, University of Tabuk, …

A Cross-Sectional Study On Patient Safety Attitudes And Their Determinants Among Medical Staff In Malaysian Public Specialist Hospitals, Sharifah Balqis Sayed Abdul Hamid, Aniza Ismail, Saperi Sulong

Makara Journal of Health Research

Introduction: This study aimed to assess the baseline level and mean scores of patient safety attitude domains among doctors and nurses in Malaysian public hospitals and to identify determinants associated with these attitudes across six domains: teamwork, safety climate, working conditions, job satisfaction, stress recognition, and perception of management.

Methods: A cross-sectional study was conducted using the Safety Attitudes Questionnaire (SAQ) among 142 doctors and 231 nurses from three public tertiary hospitals. Participants were selected through proportionate stratified random sampling. Data were analyzed using descriptive, bivariate, and multivariate methods.

Results: The study achieved an 81% response rate. …

Exploring The Prevalence And Determinants Of Self-Medication During Pregnancy Among Women From South Punjab, Pakistan, Madiha Madiha, Sehar Jabbar, Imran Masood

Makara Journal of Health Research

Background: For developing countries with high neonatal and maternal mortality rates, any practice that may threaten the maternal-fetal health must be gauged. This study evaluated the prevalence and contributing factors of self-medication during pregnancy among women opting for antenatal or postnatal care in South Punjab, Pakistan.

Methods: A cross-sectional study design was used. Data was collected from 424 women, selected through multi-stage sampling, who visited health care facilities located in six randomly selected cities of South Punjab. Outcomes reported by descriptive and inferential statistics (p < 0.05). Binary logistic regression analysis was performed to determine the association of self-medication with different factors.

Results: Most of the women were involved in self-medication practice (38.9%) …

Knowledge, Attitudes, And Practices Concerning Water, Sanitation, And Hygiene And Related Diseases Among University Students In Malaysia, Renee Ng Jeffrey, Aida Soraya Shamsuddin, Farah Diyana Ariffin, Aziemah Zulkifli

Makara Journal of Health Research

Background: Water, sanitation, and hygiene (WASH) practices are fundamental components of public health, being crucial in preventing disease transmission and promoting healthy living environments. In this context, university students play an essential role as future professionals and community advocates in fostering proper hygiene behaviors and preventing disease outbreaks. Understanding knowledge, attitudes, and practices (KAP) in regard to WASH among individuals, particularly university students, is crucial for promoting proper hygiene behaviors. This study aimed to assess the KAP in regard to WASH and related diseases among undergraduate students from the Faculty of Health Sciences, Universiti Kebangsaan Malaysia (UKM).

Methods: …

Impact Of Postoperative Intraocular Pressure Spikes On Outcomes Following Goniotomy: A Comparative Study Of Surgical Techniques, Wesam S. Shalaby, Steven L. Chang, Julia Yu, Teresa Horan, Sagar Shah, Shahin Hallaj, Marlene Moster, Reza Razeghinejad, Daniel Lee, Michael Pro, Aakriti Shukla, Ping Huang, Jonathan S. Myers, Tina Xia, Dilru Amarasekera

Wills Eye Hospital Papers

AIM AND BACKGROUND:To compare postoperative intraocular pressure (IOP) spikes and 1-year surgical success among goniotomy procedures: Kahook Dual Blade (KDB), OMNI, bent ab interno needle goniotomy (BANG), and gonioscopy-assisted transluminal trabeculotomy (GATT).

MATERIALS AND METHODS: This single-center, retrospective chart review included glaucoma patients ≥18 years, who underwent goniotomy from January 2021 to December 2022 with ≥3 months of follow-up. Primary outcomes were IOP spikes (≥10 mm Hg increase within 3 months) and 12-month surgical success (≥20% IOP and/or ≥1 medication reduction without further surgery). Secondary outcomes included IOP and medication changes.

RESULTS: Among 247 eyes (107 KDB, 63 OMNI, 77 …

Mapping Climatic And Environmental Determinants Of Parasitic Helminth Prevalence In Southeast Asia, Angelica Avisado

UNLV Theses, Dissertations, Professional Papers, and Capstones

Climate change is reshaping environmental conditions across Southeast Asia (SEA) through rising temperatures, altered precipitation patterns, and increased droughts. These changes alter transmission dynamics of neglected tropical diseases (NTDs) by shifting spatial distribution, increasing larval development rates, faster pathogen growth development, and increasing transmission rates. NTDs are a group of preventable and treatable infections that disproportionately affect more than 1 billion people globally, specifically in tropical and subtropical regions. A subgroup of NTDs, parasitic helminth infections (PHIs) - particularly schistosomiasis, soil-transmitted helminths, and lymphatic filariasis remains a public health concern in the Southeast Asian region. PHIs and their ecological responses …

Behind The Badge: Effects Of Stress And Trauma In Policing -- Understanding The Importance Of Evidence-Based Prevention, Early Intervention, And Wellness Programs, Jessica Rolshouse

Master of Arts in Human Services

Law enforcement officers are exposed to occupational stress and trauma routinely and at rates that far exceed the general population. This chronic exposure places them at risk for physical and psychological injury and negative outcomes to include mental health disorders including burnout, anxiety, depression, and PTSD. Prolonged exposure to occupational stress and trauma also increases the risk of suicidal ideation and dying by suicide, the most tragic outcome of the stress law enforcement officers face. This literature review focuses on individual risk factors, occupational stress, and trauma, and the development of mental health disorders in law enforcement officers. It also …

Lycopene, Race And Periodontitis: Disparities In Older Adults, Katherine Kwong, You Lu, Zhuo Huan Li, Susu Luo, Zhaoyu Huang, Zhong Chen, Na Zhao, Tung Sung Tseng

School of Public Health Faculty Publications

Background Periodontitis is a severe gum disease that can be an indicator of other health conditions such as cardiovascular disease and diabetes. Lycopene has been suggested as an adjunct therapy for periodontitis. This study aims to investigate the association between insufficient lycopene intake and the risk of Periodontitis among non-Hispanic White (NHW) and non-Hispanic Black (NHB) older adults. Methods The study included 1,227 adults aged 65–79 years from the National Health and Nutritional Examination Survey (2009–2014). Total lycopene intake from daily diet was studied with age, race, marital status, smoking status, BMI, diabetes, sex, and education as independent variables in …

What’S That Smell? It’S Climate Change!, Perry Gregory

Capstones

Climate change is going to make New York City smell worse. Reporter Perry Gregory breaks down the process of olfaction and explains how heat affects what we smell. The piece features a collage of voices of New Yorkers describing the current smell profile of the city. The report features insight from several Atmospheric Scientists into why New York City is getting hotter and more humid, and how those climate changes will make the existing smells of the city stronger, and worse. The most economically vulnerable New Yorkers, who cannot afford air conditioning to buffer them from heat, will be the …

Health Implications Of Heavy Metal Contamination In Commercially Available Deodorant And Antiperspirant Products Sold In Benghazi, Libya, Maysson Yaghi, Khaled Elsherif

Al-Bahir

The extensive usage of deodorants and antiperspirants raises concerns about the potential health risks posed by heavy metal content. This study quantified the levels of five heavy metals: Aluminum, Zirconium, Lead, Cadmium, and Chromium in 22 commercial products widely used in Benghazi, Libya, and assessed the associated health risks. Samples, categorized into gel, stick, and roll-on formulations, were analyzed using iCAP TQ ICP-MS. Al and Zr showed the widest concentration ranges, reflecting their intentional use as active ingredients. Al levels ranged from trace amounts (0.032 mg/kg) up to a maximum of 99.10 mg/kg, while Zr was found exclusively in gel …

Disaster Exercise: Evaluating Mci Triage Training, Michael J. Steflovich Jr, Jodie Stobierski, Alexis Davis, Natasha Pavlinetz, Nela Isic, Nicole Roberson, Earl Best Md

Florida Journal of Emergency Medicine (FJEM)

Abstract

Study Objectives

The primary objective of this study was to evaluate the effectiveness of a didactic lecture-based training on mass casualty incident (MCI) triage performance among first- and second-year medical students. Specifically, the study aimed to measure improvements in overall triage accuracy, as well as reductions in over-triage and under-triage rates for both adult and pediatric patients.

Methods

This study employed a pre-test/post-test design involving 31 participants. Participants completed an electronic pre-test consisting of 30 patient scenarios (20 adult and 10 pediatric) before attending a 40-minute didactic lecture on MCI triage principles. The lecture covered the identification of MCI …

A Quality Improvement Initiative To Streamline Flu Vaccine Documentation And Increase Staff Engagement, Carla E. Giron

Master's Projects and Capstones

Objective: This quality improvement project was implemented in an urban community health clinic primarily serving low-income and Latinx patients. Factors such as demographics, socioeconomic status, health, and transportation contribute to low U.S. influenza vaccination rates (Chen et al., 2020), while EHR training can improve provider satisfaction and efficiency (DiAngi et al., 2019). This microsystem faced inconsistent workflow processes, limited EHR training, and documentation errors that contributed to low staff satisfaction rates and influenza vaccination rates. An average of 11.4% of patients received a flu vaccine in October 2023 and 2024. Medical assistants (MAs) completed a pre-intervention survey indicating that 35% …

From Fear To Familiar: Reducing Technology-Induced Anxiety In Seniors, Justin Kyle V. Manalang

Master's Projects and Capstones

Abstract

This quality improvement project focuses on reducing the average technology-induced anxiety score among senior community members through 1:1 mentorship sessions. Aim During an eight-week period from September 10, 2025, to November 5, 2025, this project will reduce the severity of technology-induced anxiety by 25% from the established baseline. Methods: A 5P Microsystem assessment was conducted alongside an initial questionnaire to gauge the residents’ interests and concerns regarding technology use. From the results, focused mentorship sessions were conducted once a week and pertained to the chief complaint the resident had for eight weeks. The mentorship sessions were one-to-one and individualised …

From Fear To Familiar: Alleviating Technology Anxiety In Older Adults Through A Community-Based Mentorship Program, Inyoung Jang

Master's Projects and Capstones

This quality improvement project was implemented in a senior residential facility in Richmond, California, catering to older low-income adults who frequently experience elevated levels of technology anxiety. Aim This project aims to reduce the mean modified technology-anxiety score among residents aged 65 and older by at least 25% from baseline by November 5, 2025. Methods The Abbreviated Technology Anxiety Scale (MTAS) was modified to consider the cognitive, linguistic, and experiential differences among target population. The original 11-item instrument, which was validated primarily within college-aged populations, used terms and repeated items irrelevant to older people. The adapted tool included five simplified …

Exploring The Association Between Nurse Characteristics And Intent To Leave Their Current Position In Counties With Rural Hospital Closures, Caroline A. King

2025 Fall Honors Capstones Projects - Archive

Increased rural hospital closures and nursing burnout may lead to greater morbidity/mortality for rural residents. Current literature fails to capture whether rural hospital closures influence nurses’ intent to leave their current position. In this cross-sectional study, descriptive and correlational statistical analyses were conducted on survey responses from a sample of nurses who lived in a rural county that experienced a hospital closure. 66% of nurses stated that, at one point, they had considered leaving their primary nursing position. Logistic regression model results revealed that nurse-reported age and gender were significant predictors of a nurse’s intention to leave their current position. …

Factors Influencing The Re-Emergence Of Vaccine-Preventable Diseases Using The Social Ecological Model: A Scoping Review, Glenda Dorina Rodriguez Lenarduzzi

Master's Projects and Capstones

Abstract

Background.

Several factors contribute to the resurgence of vaccine-preventable diseases, affecting coverage rates and vaccine uptake during recent outbreaks. The pandemic has underscored how crucial it is to comprehend vaccine literacy, as this understanding influences people's perspectives and behaviors toward vaccination, particularly in their approaches to problem-solving and decision-making.

Objective.

The present study conducts a scoping review of research on the impact of vaccine literacy and vaccine uptake on the re-emergence of vaccine-preventable diseases in the United States, framed by the social ecological model (SEM).

Design.

PubMed and Google Scholar were utilized as online databases to identify papers published …

Emergency Preparedness Education And Simulation Training For Nursing Students In Southern India, Kevin C. Cameron, Taryn Mccoy, Laura Gray, David Phillippi

DNP Projects

Introduction

To address the identified gap in emergency preparedness education and training among nursing students at a teaching hospital in southern India, a private university in the southeastern United States partnered with the site to develop a quality improvement initiative aimed at strengthening these skills. Nursing students at the partner hospital have limited access to simulation-based training opportunities due to constraints in both curriculum and availability of simulation resources. This lack of exposure may hinder the development of critical emergency preparedness competencies

Methods

Educational content focused on triage and basic life support (BLS). One hundred twenty-four students participated in the …

Standardizing The Use Of The Sinc Screening Tool In A Rural Clinic, Madison Foss

DNP Projects

Unmet contraceptive need represents a persistent quality gap in rural primary care, where reproductive health discussions are often inconsistently addressed. A rural primary care clinic in Shelbyville, Tennessee lacked a standardized, evidence-based process for screening women of childbearing age (15–44 years) for contraceptive needs. This quality improvement project evaluated the feasibility and effectiveness of implementing the Self-Identified Need for Contraception (SINC) screening tool to support routine, patient-centered care. The SINC tool consists of a single validated question designed to identify patients who wish to discuss contraception or pregnancy prevention during clinical visits. Plan–Do–Study–Act cycles were used to integrate the tool …

Improving Staff Satisfaction And Flu Vaccine Uptake Through Standardized Workflow Tools, Salma Adriana Blanco

Master's Projects and Capstones

Objective: Insufficient workflows can cause documentation to be confusing, which ultimately

limits staff engagement. This has led to staff dissatisfaction and a low vaccination uptake in

outpatient clinics. The implementation of a standardized workflow tool and proper staff

education and training can improve staff satisfaction and vaccination adherence, as indicated by

a review of literature. Aim: The purpose of this quality improvement project is to implement a

change in workflow in the electronic health record and staff training in an urban community

health clinic primarily serving low income and Latino patients. This intervention seeks to

increase medical assistant user satisfaction …

Safety And Feasibility Of Talimogene Laherparepvec In Peritoneal Surface Malignancies: Results From The Tempo Trial, John H. Stewart, Donna Niedzwiecki, Melissa Lowe, Ashley Moyer, Emily Bolch, Shannon Diane Maclaughlan, Edward A. Levine, Omeed Moaven, Niharika Mettu, John H. Strickler, Dan G. Blazer

School of Medicine Faculty Publications

Peritoneal surface malignancies (PSMs) remain a therapeutic challenge, particularly in patients with unresectable disease who cannot benefit from cytoreductive surgery and hyperthermic intraperitoneal chemotherapy. The Talimogene Laherparepvec for the Treatment of Peritoneal Surface Malignancies (TEMPO) trial (NCT03663712) is the first phase 1, multicenter, open-label study to evaluate intraperitoneal (i.p.) administration of talimogene laherparepvec (T-VEC), an FDA-approved oncolytic virus, in this setting. Nineteen patients with unresectable PSMs from appendiceal, ovarian, small bowel, and peritoneal carcinomas were enrolled; 18 received treatment across three escalating dose cohorts (4 × 10-4×10 PFU). The primary endpoint was safety and tolerability, with secondary endpoints assessing viral …

Application Of Augmented Reality Technology As A Dietary Monitoring And Control Measure Among Adults: A Systematic Review, Gabrielle Victoria Gonzalez, Bingjing Mao, Ruxin Wang, Wen Liu, Chen Wang, Tung Sung Tseng

School of Public Health Faculty Publications

Background/Objectives: Traditional dietary monitoring methods such as 24 h recalls rely on self-report, leading to recall bias and underreporting. Similarly, dietary control approaches, including portion control and calorie restriction, depend on user accuracy and consistency. Augmented reality (AR) offers a promising alternative for improving dietary monitoring and control by enhancing engagement, feedback accuracy, and user learning. This systematic review aimed to examine how AR technologies are implemented to support dietary monitoring and control and to evaluate their usability and effectiveness among adults. Methods: A systematic search of PubMed, CINAHL, and Embase identified studies published between 2000 and 2025 that evaluated …

Concurrent Tb And Hiv Therapies Control Tb Reactivation During Co-Infection But Not Chronic Immune Activation, Riti Sharan, Yi Zou, Bindu Singh, Vinay Shivanna, Edward J Dick, Shannan Hall-Ursone, Xi Luo, Guanlin Guo, Shabaana A Khader, Xavier Alvarez, Jyothi Rengarajan, Zhao Lai, Smriti Mehra, Hulin Wu, Deepak Kaushal

Faculty, Staff and Student Publications

Most HIV-negative individuals exposed to Mycobacterium tuberculosis (Mtb) control infection as latent TB infection (LTBI), but HIV co-infection greatly increases progression to tuberculosis (TB), the leading cause of death in people living with HIV (PLHIV). Although combination antiretroviral therapy (cART) reduces LTBI reactivation, immune control of Mtb is not fully restored, as shown by persistent TB incidence in PLHIV on cART. In macaques, skewed pulmonary effector memory CD4⁺ T-cell (TEM) responses and new TB lesions persist despite cART. We hypothesize that concurrent anti-TB therapy with cART would improve bacterial control and immune restoration compared to cART alone. Using …

Food, Fitness, And Filipino Culture: Evaluating And Reimagining Chronic Disease Interventions For Filipino Americans Through The Pen-3 Framework, Juliana Mastro

Master's Projects and Capstones

Filipino Americans experience high rates of chronic diseases such as diabetes and hypertension. This paper reviews nutrition and exercise interventions targeting this population through the strengths-based PEN-3 cultural framework, focusing on cultural identity, relationships and expectations, and cultural values. It identifies effective strategies that engage these cultural components, and highlights gaps such as limited research on Filipino-American health outcomes. Recommendations include family-centered approaches, culturally relevant activities like tinikling dance, and community-driven online healthy recipe archives to promote positive health behaviors. These culturally informed strategies aim to improve self-efficacy, support lasting health behavior change and reduce chronic disease prevalence nationwide.

Implementation Factors For Wearable Fall Injury Mitigation Technology: A Framework For Technology Adoption, Richard G. Stefanacci, Rebecca J. Tarbert, Nicole Hemenover

College of Population Health Faculty Papers

OBJECTIVES: To identify implementation factors influencing the adoption of wearable fall injury mitigation technology in long-term care (LTC) settings and develop a practical framework for technology implementation success.

DESIGN: Mixed-methods assessment of a multicenter evaluation examining organizational, staff, and resident factors affecting technology adoption.

SETTING AND PARTICIPANTS: Ten LTC facilities implementing the Tango Belt, a wearable airbag device for hip protection during falls. Analysis included 134 intervention participants (mean age 87.3 years, 76% female, 93% with fall history in past year) and comprehensive stakeholder feedback from staff, leadership, residents, and families.

METHODS: Quantitative measures included device adherence rates, training attendance, …