Digital Commons Network^™

The Conservative Response To Transformative Disruption: Voice Or Exit 100 Years After Meyer And Pierce?, Neal Mccluskey

The Journal of Contemporary Legal Issues

In 1923 and 1925, respectively, the U.S. Supreme Court rulings in Meyer v. Nebraska and Pierce v. Society of Sisters established limits on the ability of government to constrain what children’s education contains and where it occurs. The Court recognized the “right” of parents to exercise basic control over those things. One hundred years later, we are seeing a renewed emphasis on “parental rights,” both with booming growth of “school choice” programs that allow government-connected funding to follow children to educational options their parents select and efforts to constrain what public schools do. The position of conservatives on such parental …

Prevalence Of Low Back Pain Among Office Workers During The Covid-19 Pandemic In Various Countries: A Systematic Review, Yosephine Roma Intan, Ririn Arminsih Wulandari, Popy Yuniar

Kesmas

The COVID-19 pandemic has led to the implementation of work from home policies in almost all parts of the world. This policy has increased the onset of musculoskeletal disorders in workers, such as low back pain (LBP). This study aimed to examine the prevalence of LBP among office workers during the COVID-19 pandemic after implementing WFH policies. This study was performed using data from various countries to determine the relationship between LBP and several risk factors, specifically age, sex, physical activity, ergonomic factors, as well as work environment factors such as temperature, humidity, lighting, noise, and work duration. A systematic …

Exploring Physician Well-Being: A Bibliometric Analysis Of Mental Health, Suriya Kumareswaran, Bala Murali Sundram, Vanitha Thurairasu

Kesmas

This bibliometric study examined the evolving research landscape on physician mental health from 2010 to 2023, analyzing key themes, publication trends, and global contributions. A total of 3,360 articles, including 3,137 original research and 223 reviews, were sourced from Web of Science and Scopus. Findings revealed a significant increase in research output, particularly during the COVID-19 pandemic, with burnout, depression, and anxiety emerging as dominant themes. The US accounted for most publications, while research from low- and middle-income countries remains limited, indicating a substantial global disparity. Thematic analysis highlighted variations in burnout assessment methodologies, underscoring the need for standardized evaluation …

Invasive Haemophilus Influenzae Disease At A Us Children's Hospital In The Sars-Cov-2 Era, J Chase Mcneil, David R Mcdonald, James J Dunn, Sheldon L Kaplan, Kristina G Hulten, Jesus G Vallejo

Faculty, Staff and Students Publications

Background: National data previously demonstrated an increase in invasive disease due to non-type b Haemophilus influenzae from the 2000s to the 2010s. Significant shifts in the epidemiology of respiratory pathogens in children have occurred in the post-SARS-CoV-2 era. We examined pediatric invasive H. influenzae disease in the pre- and post-SARS-CoV-2 years.

Methods: Invasive H. influenzae infections were identified from culture records of the Texas Children's Hospital microbiology laboratory from January 2011 to December 2023. Invasive cases were considered those with isolation of H. influenzae from a sterile site. The annual number of cases/1000 admissions was used as a surrogate for …

Vicarious Trauma From Covid-19 Shows Vicarious Resilience As The Best Response For Its Probative Academic Underpinnings, Anthony Hoang

Doctoral Dissertations and Projects

The purpose of this grounded theory study was to understand vicarious resilience (VR) as the best response to COVID-19 for vicarious trauma (VT) and its transition into a permanent solution via phenomenology for the general populace. At this stage in the research, VR was generally defined as overcoming adversity. Vicarious resilience was a layman’s term. The scientific name for VR was a construct called clinical theory (CT), research (R), and practice (P) (CTRP). Vicarious resilience was CTRP and vice versa. The theory guiding this study was grounded theory by Glaser and Strauss to build the CTRP construct, then by phenomenology …

Complement Activity And Autophagy Are Dysregulated In The Lungs Of Patients With Nonresolvable Covid-19 Requiring Lung Transplantation, Pooja Shivshankar, Stacey L Mueller-Ortiz, Aleksey Y Domozhirov, Weizhen Bi, Scott D Collum, Marie-Francoise Doursout, Manish Patel, Isabella N Lefebvre, Bindu Akkanti, Simon Yau, Howard J Huang, Rahat Hussain, Harry Karmouty-Quintana

Faculty, Staff and Student Publications

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-induced coronavirus disease 2019 (COVID-19) pandemic has challenged the current understanding of the complement cascade mechanisms of host immune responses during infection-induced nonresolvable lung disease. While the complement system is involved in opsonization and phagocytosis of the invading pathogens, uncontrolled complement activation also leads to aberrant autophagic response and tissue damage. Our recent study revealed unique pathologic and fibrotic signature genes associated with epithelial bronchiolization in the lung tissues of patients with nonresolvable COVID-19 (NR-COVID-19) requiring lung transplantation. However, there is a knowledge gap if complement components are modulated to contribute to tissue …

Hospitalist Use Of Point-Of-Care Ultrasound During The Covid-19 Pandemic At A Single Academic Tertiary Care Center, Emily Thunberg, Monica Thim, Kristen Barlett, Matthew Buttarazzi

Journal of Maine Medical Center

Problem: Point-of-care ultrasound (POCUS) use is limited by availability of standardized training and evaluation. Although the diagnostic accuracy of point-of-care ultrasound is superior to chest x-ray (CXR) for certain pulmonary indications, POCUS is underused.

Approach: A group of 19 hospitalists at MaineHealth Maine Medical Center participated in just-in-time training in pulmonary POCUS in mid-March 2020. The annual rate of CXRs ordered per shift was measured over a 3-year period to determine whether POCUS training resulted in a change in CXR ordering. CXR ordering rates were also evaluated among a group of 4 experienced POCUS users during the COVID-19 …

Social Work Field Education And Supervision: What A Global Pandemic Taught Us, Christie Jansing, Melissa Ketner, Lynn Shaw, Dianna Cooper-Bolinskey, Stephanie Rudd

Journal of Social Work in the Global Community

Social work field education programs have experienced changes throughout time, including adaptations to supervision of students in field education settings. Monitoring and developing field education supervision is an essential component of ensuring high-quality practicum experiences and satisfaction among both social work students and field instructors. Most recently, the COVID-19 global pandemic led most social work students and field instructors to a rapid shift in practicum placements from in-person to virtual learning; within the process, supervision changed as well. This study includes feedback from a small group of BSW students, MSW students, and field instructors regarding this transition in placement and …

Assessing The Effects Of Long-Covid On Mental Health In The United States: A Population Based Study, Anusua Datta

School of Business Faculty Papers

BACKGROUND: While most individuals recover fully from COVID-19, a significant proportion of survivors experience prolonged symptoms lasting three months or more, a condition commonly referred to as long-COVID. Long-COVID conditions have been associated with reduced quality of life. By utilizing a nationally representative sample of nearly a million Americans, this study provides insights into the prevalence and impact of long-COVID on anxiety and depression in the U.S.

METHODS: We utilize the Household Pulse Survey data, which provides the first population-based sample on the prevalence of long-COVID, beginning with its June 2022 wave. This survey also includes questions on respondents' mental …

Still Accounting For My Teacher’S Body: The Objective Body/Body As Objective In The Classroom/Classzoom, Leda M. Cooks, Jennifer A. Zenovich

Feminist Pedagogy

This critical commentary reflects on Cooks’ 2007 article, “Accounting for my Teacher’s Body: What can I teach/What can we learn?” by reconsidering power and body relations in light of the concept and pedagogy of body neutrality in the classroom in the 2023 COVID-19 era. The digital and physical classroom are spaces where the (embodied) body is never neutral. By extension, the body is never neutral anywhere regardless of the mindful body neutrality practices suggested by Pellizzer and Wade (2023). In this commentary, we first discuss how the teacher in physical and digital space communicates ideals of competence in performance of …

Supportive Programming During A Worldwide Pandemic And Beyond, Rainie B. Jueschke, Charissa Lynch, Anne Stokes, Tracy Van De Vate

GrandFamilies: The Contemporary Journal of Research, Practice and Policy

In the United States, approximately 2.4 million grandparents are the primary caregivers of their grandchildren (Annie E. Casey Foundation Kids Count Data Center, 2024). Relative caregivers provide an important opportunity to keep families together and avoid foster home placement when children are unable to safely be cared for by parents. “Parenting again” comes with its own unique set of challenges, and the COVID-19 pandemic significantly highlighted and exacerbated these difficulties. There are many organizations nationwide that work within the field of relative caregiving, providing diverse programming designed to address the needs of this unique population. Core principles include strategies to …

Learning From Experience: What Is Successful Respite During And Post-Pandemic?, Jennifer A. Crittenden, Darlene Sansone, Kristina Brant, Jennifer Odum, Caitlin O'Brien, Lisa Mccormick

GrandFamilies: The Contemporary Journal of Research, Practice and Policy

The COVID-19 pandemic had immediate and long-lasting impacts on both kinship families and the organizations that serve them. During the pandemic, as families navigated health challenges, economic consequences, and school and daycare closures, relatives as parents programs (RAPPs) were challenged to surmount staffing and programming hurdles to meet family needs. Despite the difficulties posed by the pandemic, RAPPs developed creative solutions to offer respite programming. Some of these programs continue to be used today, over four years after the start of the pandemic. This article describes the presentations and discussions that took place during a 90-minute workshop at the 2023 …

Leveraging Community Partnerships And Resources To Address Food Insecurity In A Rural County During The Covid-19 Pandemic, Kristen Johnson, Amy Elizer, Karen L. Franck, Soghra Jarvandi

Journal of Extension

Extension professionals are skilled at connecting with community partners and community members to identify needs and address challenges. This paper outlines how Extension professionals quickly responded to address rising rates of food insecurity in a rural Tennessee County during the COVID-19 pandemic. Through an extensive network of state, regional, and local partners, Extension professionals and partners planned and implemented mobile food distributions through the United States Department of Agriculture’s Farmers to Families program. These Extension-led efforts resulted in sustainable, community-driven initiatives to improve food insecurity. Lessons learned can help Extension professionals respond to emerging needs.

Counseling Students’ Perceptions Of Support During The Covid-19 Crisis: A Qualitative Study, Breahannah Hilaire, Galaxina G. Wright, Lea H, Laurie O. Campbell

Journal of Counselor Preparation and Supervision

The COVID-19 pandemic changed the counseling programs in clinical instruction, mentorship, and student’s perception of the university. The qualitative data presented in this paper identifies eight counseling students’ beliefs of support during their time in counseling program during the COVID-19 pandemic. Data was obtained through semi-structured interviews. An interpretive phenomenological analysis resulted in four themes: including higher education response, personal resources, emotions in crisis, and transitions in crisis.

Increasing Covid-19 Testing And Vaccination Uptake In The Take Care Texas Community-Based Randomized Trial: Adaptive Geospatial Analysis, Kehe Zhang, Jocelyn V Hunyadi, Marcia C De Oliveira Otto, Miryoung Lee, Zitong Zhang, Ryan Ramphul, Jose-Miguel Yamal, Ashraf Yaseen, Alanna C Morrison, Shreela Sharma, Mohammad Hossein Rahbar, Xu Zhang, Stephen Linder, Dritana Marko, Rachel White Roy, Deborah Banerjee, Esmeralda Guajardo, Michelle Crum, Belinda Reininger, Maria E Fernandez, Cici Bauer

Faculty, Staff and Student Publications

BACKGROUND: Geospatial data science can be a powerful tool to aid the design, reach, efficiency, and impact of community-based intervention trials. The project titled Take Care Texas aims to develop and test an adaptive, multilevel, community-based intervention to increase COVID-19 testing and vaccination uptake among vulnerable populations in 3 Texas regions: Harris County, Cameron County, and Northeast Texas.

OBJECTIVE: We aimed to develop a novel procedure for adaptive selections of census block groups (CBGs) to include in the community-based randomized trial for the Take Care Texas project.

METHODS: CBG selection was conducted across 3 Texas regions over a 17-month period …

Axl Signaling In Cancer: From Molecular Insights To Targeted Therapies, Monika Yadav, Akansha Sharma, Ketki Patne, Saba Tabasum, Jyoti Suryavanshi, Laxminarayan Rawat, Marc Machaalani, Marc Eid, Rana Singh, Toni Choueiri, Soumitro Pal, Akash Sabarwal

Department of Microbiology and Immunology Faculty Papers

AXL, a member of the TAM receptor family, has emerged as a potential target for advanced-stage human malignancies. It is frequently overexpressed in different cancers and plays a significant role in various tumor-promoting pathways, including cancer cell proliferation, invasion, metastasis, epithelial-mesenchymal transition (EMT), angiogenesis, stemness, DNA damage response, acquired therapeutic resistance, immunosuppression, and inflammatory responses. Beyond oncology, AXL also facilitates viral infections, including SARS-CoV-2 and Zika highlighting its importance in both cancer and virology. In preclinical models, small-molecule kinase inhibitors targeting AXL have shown promising anti-tumorigenic potential. This review primarily focuses on the induction, regulation and biological functions of AXL …

Evaluating Maternal Drug Use Disparities, Risk Factors And Outcomes In Northeast Arkansas: A Pre, During, And Post-Covid-19 Pandemic Analysis., Enrique Gomez Pomar, Johnna Berryhill, Sudeepa Bhattacharyya

Pediatrics Faculty Publications

INTRODUCTION: The use of addictive substances remains a major health problem in the U.S. An increase in drug overdose and mortality was observed during the COVID-19 pandemic, especially in underserved populations. This surge also impacted pregnant women especially with the use of marijuana (THC) and opioids.

METHODS: Retrospective study analyzing mother-infant dyads with reported Meconium Drug Screen (MDS) results, from January 2018 through April 2023 at a reference hospital serving an urban and rural area of Arkansas. Due to the absence of universal screening, the prevalence of drug use was variable during the study period. An adjusted monthly positive rate …

Evaluating Maternal Drug Use Disparities, Risk Factors And Outcomes In Northeast Arkansas: A Pre, During, And Post-Covid-19 Pandemic Analysis., Enrique Gomez Pomar, Johnna Berryhill, Sudeepa Bhattacharyya

Pediatrics Faculty Publications

INTRODUCTION: The use of addictive substances remains a major health problem in the U.S. An increase in drug overdose and mortality was observed during the COVID-19 pandemic, especially in underserved populations. This surge also impacted pregnant women especially with the use of marijuana (THC) and opioids.

METHODS: Retrospective study analyzing mother-infant dyads with reported Meconium Drug Screen (MDS) results, from January 2018 through April 2023 at a reference hospital serving an urban and rural area of Arkansas. Due to the absence of universal screening, the prevalence of drug use was variable during the study period. An adjusted monthly positive rate …

Evaluating Maternal Drug Use Disparities, Risk Factors And Outcomes In Northeast Arkansas: A Pre, During, And Post-Covid-19 Pandemic Analysis., Enrique Gomez Pomar, Johnna Berryhill, Sudeepa Bhattacharyya

Pediatrics Faculty Publications

INTRODUCTION: The use of addictive substances remains a major health problem in the U.S. An increase in drug overdose and mortality was observed during the COVID-19 pandemic, especially in underserved populations. This surge also impacted pregnant women especially with the use of marijuana (THC) and opioids.

METHODS: Retrospective study analyzing mother-infant dyads with reported Meconium Drug Screen (MDS) results, from January 2018 through April 2023 at a reference hospital serving an urban and rural area of Arkansas. Due to the absence of universal screening, the prevalence of drug use was variable during the study period. An adjusted monthly positive rate …

The Impact Of Covid-19 Pandemic On The Mental Health Of Frontline Workers Of Toronto Homeless Shelters (Csws), Isiaka Omotosho Akande

Doctoral Dissertations and Projects

The objective of this phenomenological research is to understand the impact of COVID-19 on the mental health of the client service workers (CSWs) in Toronto homeless shelters. Kolcaba's theory of comfort guides this study. This theory holds that being comfortable is one of the fundamental necessities for relief after stressful health care events or incidents. Comfort boosts health-seeking behaviors for patients, clients, and workers. In the context of the City of Toronto’s homeless shelters, Kolcaba’s theory of comfort suggests that if client service workers are given adequate resources to balance their health and mental needs, thus stabilizing their comfortabilities, then …

Neutralizing Antibody Immune Correlates For A Recombinant Protein Vaccine In The Covail Trial, Youyi Fong, Lauren Dang, Bo Zhang, Jonathan Fintzi, Shiyu Chen, Jing Wang, Nadine G Rouphael, Angela R Branche, David J Diemert, Ann R Falsey, Cecilia Losada, Lindsey R Baden, Sharon E Frey, Jennifer A Whitaker, Susan J Little, Satoshi Kamidani, Emmanuel B Walter, Richard M Novak, Richard Rupp, Lisa A Jackson, Chenchen Yu, Craig A Magaret, Cindy Molitor, Bhavesh Borate, Tara M Babu, Angelica C Kottkamp, Anne F Luetkemeyer, Lilly C Immergluck, Rachel M Presti, Martín Bäcker, Patricia L Winokur, Siham M Mahgoub, Paul A Goepfert, Dahlene N Fusco, Robert L Atmar, Christine M Posavad, Jinjian Mu, Mat Makowski, Mamodikoe K Makhene, Seema U Nayak, Paul C Roberts, Dean Follmann, Peter B Gilbert

Faculty, Staff and Students Publications

For COVAIL recipients of a coronavirus disease 2019 (COVID-19) Sanofi booster vaccine, neutralizing antibody titers were assessed as a correlate of risk (CoR) of COVID-19. Peak and exposure-proximal titers were inverse CoRs with covariate-adjusted hazard ratios (95% confidence intervals) 0.30 (0.11, 0.78) and 0.25 (0.07, 0.85) per 10-fold increase in weighted average titer.

Distributed Cross-Learning For Equitable Federated Models – Privacy-Preserving Prediction On Data From Five California Hospitals, Tsung-Ting Kuo, Rodney A Gabriel, Jejo Koola, Robert T Schooley, Lucila Ohno-Machado

Faculty, Staff and Student Publications

Quality improvement, clinical research, and patient care can be supported by medical predictive analytics. Predictive models can be improved by integrating more patient records from different healthcare centers (horizontal) or integrating parts of information of a patient from different centers (vertical). We introduce Distributed Cross-Learning for Equitable Federated models (D-CLEF), which incorporates horizontally- or vertically-partitioned data without disseminating patient-level records, to protect patients' privacy. We compared D-CLEF with centralized/siloed/federated learning in horizontal or vertical scenarios. Using data of more than 15,000 patients with COVID-19 from five University of California (UC) Health medical centers, surgical data from UC San Diego, and …

A Randomized, Double-Blind, Placebo-Controlled Trial Of Il-7 In Critically Ill Patients With Covid-19, Manu Shankar-Hari, Bruno Francois, Kenneth E Remy, Cristina Gutierrez, Stephen Pastores, Thomas Daix, Robin Jeannet, Jane Blood, Andrew H Walton, Reinaldo Salomao, Georg Auzinger, David Striker, Robert S Martin, Nitin J Anand, James Bosanquet, Teresa Blood, Scott Brakenridge, Lyle L Moldawer, Vidula Vachharajani, Cassian Yee, Felipe Dal-Pizzol, Michel Morre, Frederique Berbille, Marcel Van Den Brink, Richard Hotchkiss

Faculty, Staff and Student Publications

Background: Lymphopenia and failure of lymphocytes to mount an early IFN-γ response correlate with increased mortality in COVID-19. Given the essential role of CD4 helper and CD8 cytotoxic cells in eliminating viral pathogens, this profound loss in lymphocytes may impair patients' ability to eliminate the virus. IL-7 is a pleiotropic cytokine that is obligatory for lymphocyte survival and optimal function.

Methods: We conducted a prospective, double-blind, randomized, placebo-controlled trial of CYT107, recombinant human IL-7, in 109 critically ill, patients with lymphopenia who have COVID-19. The primary endpoint was to assess CYT107's effect on lymphocyte recovery with secondary clinical endpoints including …

A Randomized, Double-Blind, Placebo-Controlled Trial Of Il-7 In Critically Ill Patients With Covid-19, Manu Shankar-Hari, Kenneth E. Remy, Jane Blood, Andrew H. Walton, Teresa Blood, Richard Hotchkiss, Et Al.

2020-Current year OA Pubs

BACKGROUND: Lymphopenia and failure of lymphocytes to mount an early IFN-γ response correlate with increased mortality in COVID-19. Given the essential role of CD4 helper and CD8 cytotoxic cells in eliminating viral pathogens, this profound loss in lymphocytes may impair patients' ability to eliminate the virus. IL-7 is a pleiotropic cytokine that is obligatory for lymphocyte survival and optimal function.

METHODS: We conducted a prospective, double-blind, randomized, placebo-controlled trial of CYT107, recombinant human IL-7, in 109 critically ill, patients with lymphopenia who have COVID-19. The primary endpoint was to assess CYT107's effect on lymphocyte recovery with secondary clinical endpoints including …

Medicaid Unwinding: Due Process Violations And Impacts In Florida, Emma Page

University of Miami Race & Social Justice Law Review

No abstract provided.

Exploring Adolescents' Mental Health In Kampala, Uganda In The Context Of Covid-19: A Mixed Methods Study, Gideon Mbithi, Ahmed Sarki, Adam Mabrouk, Rachel Odhiambo, Mary Namuguzi, Joseph Atukwatse, Margaret Kabue, Stephen Mulupi, Amina Abubakar

Institute for Human Development, East Africa

Background: Urban areas, particularly in developing nations like Uganda, face heightened risks due to poverty, unemployment, and environmental challenges, intensifying the vulnerability of urban youth to poor mental health. This study aims to determine the psychological well-being of adolescents and to assess the risks and associated factors of mental health problems among adolescents in the context of COVID-19 pandemic in Kampala City, Uganda.

Methods: We conducted a cross-sectional survey of 500 adolescents aged 13–19 years residing within the five divisions of Kampala City, Uganda. We utilized standardized psychological assessment tools including the Patient Health Questionnaire, Generalized Anxiety Scale, …

Outcomes Of Pregnant Icu Patients With Severe Covid-19 Pneumonia In Qatar During The Three Waves Of The Covid-19 Pandemic: A Retrospective Cohort Study, Layla J.M Kily, Sohel M.G Ahmed, Tamam A.K.M Alhusban, Mohammed J. Orompurath, Marcus Lance, Mogahed I.H Hussein, Salwa M. Abuyaqoub, Huda A. Saleh, Eynas Abdalla, Santhosh Gopalakrishnan

Anaesthesiology, East Africa

Introduction: Pregnant women are considered a high-risk group for COVID-19 infection/pneumonia as they are known to be more vulnerable to viral infections. They require close monitoring and appropriate timely intervention to minimize the impact on both the mother and the fetus. Although the more prevalent Omicron variant led to fewer severe infections and fewer intensive care unit (ICU) admissions globally during the third wave, the effect on pregnant women and pregnancy outcomes was unknown. The vaccination campaign was thoroughly established by the third wave of the pandemic in Qatar. This retrospective descriptive cohort study investigates the characteristics, hospital stay, interventions, …

A Prototype Online Platform For Exploring Post-Covid Academic Recovery In U.S. Public Schools: An Example From California Public Schools, Nicole Baz

Dissertations, Theses, and Capstone Projects

This project introduces a prototype online platform designed to analyze the effects of the COVID-19 pandemic on academic achievement in public schools and districts across the United States. Leveraging data from the Stanford Education Data Archive (SEDA) and the National Center for Education Statistics (NCES), the platform enables users to examine recovery rates as measured by standardized test scores. California serves as a proof-of-concept case study, demonstrating the platform's ability to explore recovery patterns in Reading Language Arts and Mathematics between 2019 and 2023. The platform provides interactive data visualizations and dashboards that facilitate analyses based on district size, resources, …

Skin Manifestations And Related Clinical Characteristics Of Multisystem Inflammatory Syndrome In Children: A Descriptive Retrospective Cohort Study At Texas Children’S Hospital, Matthew Penna, Lauren Pupa, Grace Lee, Soo Jung Kim

Faculty, Staff and Students Publications

BACKGROUND: Little is known about the dermatologic manifestations of multisystem inflammatory syndrome in children (MIS-C) in children and adolescents.

OBJECTIVE: We sought to describe the demographic background, key clinical features, and the clinical consequences of developing rash manifestations in MIS-C patients at Texas Children's Hospital.

METHODS: Descriptive retrospective cohort study of 290 hospitalized eligible patients between May 2020 and April 2022.

RESULTS: Among MIS-C patients, 51% exhibited a rash. We found that younger children (8.62 vs 9.49 years of age,

LIMITATIONS: Rash characteristics were initially described by a variety of physicians in the pediatric primary care services.

CONCLUSION: Rash manifestations …

Implementation Of A Cascade Training Model To Enhance Emergency Care Capacity Of Healthcare Workers During The Covid-19 Outbreak In Uganda, Sulaiman Bugosera Wasukira, Carl Trevor Kambugu, Judith S. Nanyondo, Emmanuel Candia, Stephen Emmanuel Aporu, Cliff Asher Aliga

School of Nursing & Midwifery, East Africa

Introduction

Methods