Digital Commons Network^™

Inhibition Of Mirna Associated With A Disease-Specific Signature And Secreted Via Extracellular Vesicles Of Systemic Lupus Erythematosus Patients Suppresses Target Organ Inflammation In A Humanized Mouse Model, Nicholas A Young, Emily Schwarz, Braden M Zeno, Shane Bruckner, Rosana A Mesa, Kyle Jablonski, Lai-Chu Wu, Elisha D O Roberson, Wael N Jarjour

2020-Current year OA Pubs

INTRODUCTION: Distinct, disease-associated intracellular miRNA (miR) expression profiles have been observed in peripheral blood mononuclear cells (PBMCs) of systemic lupus erythematous (SLE) patients. Additionally, we have identified novel estrogenic responses in PBMCs from SLE patients and demonstrated that estrogen upregulates toll-like receptor (TLR)7 and TLR8 expression. TLR7 and TLR8 bind viral-derived single-stranded RNA to stimulate innate inflammatory responses, but recent studies have shown that miR-21, mir-29a, and miR-29b can also bind and activate these receptors when packaged and secreted in extracellular vesicles (EVs). The objective of this study was to evaluate the association of EV-encapsulated small RNA species in SLE …

Covid-19 Two Years On: A Review Of Covid-19-Related Empirical Research In Major Tourism And Hospitality Journals, Songshan (Sam) Huang, Xuequn Wang

Research outputs 2022 to 2026

Purpose: This study aims to provide a timely review of the COVID-19-related empirical research published in 19 quartile one (Q1) and quartile two (Q2) tourism and hospitality journals in social science citation index (SSCI).

Design/methodology/approach: A total of 407 COVID-19-related empirical papers were collected from the 19 SSCI Q1 and Q2 tourism and hospitality journals via Scopus database. Thematic content analysis was supplemented with Leximancer software to identify the research themes/subthemes, research methods and countries/regions of research.

Findings: The study found studies of COVID-19’s impact on consumer behaviour predominate in number, followed by studies on response actions and recovery strategies, …

Spore-Forming Clostridium (Clostridioides) Difficile In Wastewater Treatment Plants In Western Australia, Jessica M. Chisholm, Papanin Putsathit, Thomas V. Riley, Su-Chen Lim

Research outputs 2022 to 2026

There is growing evidence that shows Clostridium (Clostridioides) difficile is a pathogen of One Health importance with a complex dissemination pathway involving animals, humans, and the environment. Thus, environmental discharge and agricultural recycling of human and animal waste have been suspected as factors behind the dissemination of Clostridium difficile in the community. Here, the presence of C. difficile in 12 wastewater treatment plants (WWTPs) in Western Australia was investigated. Overall, C. difficile was found in 90.5 % (114/126) of raw sewage influent, 48.1 % (50/104) of treated effluent, 40 % (2/5) of reclaimed irrigation water, 100 % (38/38) of untreated …

Overview Of Aboriginal And Torres Strait Islander Health Status 2022, Australian Indigenous Healthinfonet

Research outputs 2022 to 2026

The main purpose of the Overview of Aboriginal and Torres Strait Islander health status (Overview) is to provide a comprehensive summary of the most recent indicators of the health and current health status of Australia’s Aboriginal and Torres Strait Islander people. The Overview has been prepared by HealthInfoNet staff as part of our contribution to supporting those who work in the Aboriginal and Torres Strait Islander health sector. The Overview is a key indicator of the HealthInfoNet’s commitment to authentic and engaged knowledge development and exchange. The initial sections of this Overview provide information about the context of Aboriginal and …

Summary Of Aboriginal And Torres Strait Islander Health Status - Selected Topics 2022, Australian Indigenous Healthinfonet

Research outputs 2022 to 2026

The Summary of Aboriginal and Torres Strait Islander health status - selected topics 2022 (Summary) is a useful resource for those working or studying in the Aboriginal and Torres Strait Islander health sector. It provides general information regarding the health status of Aboriginal and Torres Strait Islander people covering the following topics:

• the Aboriginal and Torres Strait Islander population
• determinants of health
• information pertaining to births and pregnancy, deaths and hospitalisation
• burden of disease
• chronic conditions including cardiovascular disease, cancer, diabetes, kidney and respiratory health
• social and emotional wellbeing (including mental health)
• selected sexually transmissible infections
• environmental health
• tobacco and …

The Plasma Virome In Longitudinal Samples From Pregnant Patients, Molly J Stout, Anoop K Brar, Brandi N Herter, Ananda Rankin, Kristine M Wylie

2020-Current year OA Pubs

INTRODUCTION: Nucleic acid from viruses is common in peripheral blood, even in asymptomatic individuals. How physiologic changes of pregnancy impact host-virus dynamics for acute, chronic, and latent viral infections is not well described. Previously we found higher viral diversity in the vagina during pregnancy associated with preterm birth (PTB) and Black race. We hypothesized that higher diversity and viral copy numbers in the plasma would show similar trends.

METHODS: To test this hypothesis, we evaluated longitudinally collected plasma samples from 23 pregnant patients (11 term and 12 preterm) using metagenomic sequencing with ViroCap enrichment to enhance virus detection. Sequence data …

Leveraging Machine Learning To Analyze Sentiment From Covid-19 Tweets: A Global Perspective, Md Mahbubar Rahman, Nafiz Imtiaz Khan, Iqbal H. Sarker, Mohiuddin Ahmed, Muhammad Nazrul Islam

Research outputs 2022 to 2026

Since the advent of the worldwide COVID-19 pandemic, analyzing public sentiment has become one of the major concerns for policy and decision-makers. While the priority is to curb the spread of the virus, mass population (user) sentiment analysis is equally important. Though sentiment analysis using different state-of-the-art technologies has been focused on during the COVID-19 pandemic, the reasons behind the variations in public sentiment are yet to be explored. Moreover, how user sentiment varies due to the COVID-19 pandemic from a cross-country perspective has been less focused on. Therefore, the objectives of this study are: to identify the most effective …

Staff Perceptions Of The Effectiveness Of Managerial Communication During The Covid-19 Pandemic: A Cross-Sectional Study, Gemma Doleman, Linda Coventry, Amanda Towell-Barnard, Manonita Ghosh, Lucy Gent, Rosemary Saunders, Beverly O'Connell

Research outputs 2022 to 2026

Aims: This work aims to explore staff perceptions of (1) the effectiveness of organizational communication during the COVID-19 pandemic and (2) the impact of organizational communication on staff well-being and ability to progress their work and patient care. Background: Effective coordination and communication are essential in a pandemic management response. However, the effectiveness of communication strategies used during the COVID-19 pandemic is not well understood. Design: An exploratory cross-sectional research design was used. A 33-item survey tool was created for the study. Methods: The study was conducted at a tertiary teaching hospital in Western Australia. Convenience sampling was used to …

Summary Of Gynaecological Cancer Among Aboriginal And/Or Torres Strait Islander People In Australia, Australian Indigenous Healthinfonet

Research outputs 2022 to 2026

This publication, in plain language, is based on information presented in the Review of gynaecological cancer among Aboriginal and/or Torres Strait Islander people in Australia (2023). This short, visual report summarises the key findings and concepts from the review to provide a holistic picture of gynaecological cancer among Aboriginal and/or Torres Strait Islander women. It is a quick source of information covering:

• the social, cultural and historical contexts that contribute to inequitable gynaecological cancer rates among Aboriginal and/or Torres Strait Islander women
• the extent of gynaecological cancer, specifically cervical cancer, ovarian cancer and uterine cancer, including the incidence, mortality, …

Urinary Tract Infection And Associated Factors Among Pregnant Women Receiving Antenatal Care At A Primary Health Care Facility In The Northern Region Of Ghana, Ezekiel K. Vicar, Samuel E. K. Acquah, Williams Wallana, Eugene D. Kuugbee, Emmanuel K. Osbutey, Abigail Aidoo, Emmanuel Acheampong, Gloria I. Mensah

Research outputs 2022 to 2026

Urinary tract infection (UTI) is frequently encountered during pregnancy and is associated with adverse maternal, fetal, and neonatal effects. However, very little information is available on the prevalence of UTI among pregnant women in the northern part of Ghana, a region with a high birth rate. This study employed a cross-sectional analysis of the prevalence, antimicrobial profile, and risk factors associated with UTI in 560 pregnant women attending primary care for antenatal check-ups. Sociodemographic obstetrical history and personal hygiene information were obtained using a well-structured questionnaire. Afterward, clean catch mid-stream urine samples were collected from all participants and subjected to …

Tourism Experiences Reduce The Risk Of Cognitive Impairment In The Chinese Older Adult: A Prospective Cohort Study, Qian Li, Zheng Guo, Fangli Hu, Mengfei Xiao, Qiang Zhang, Jun Wen, Tianyu Ying, Danni Zheng, Youxin Wang, Song Yang, Haifeng Hou

Research outputs 2022 to 2026

Background: Given the etiological complexity of cognitive impairment, no effective cure currently exists for precise treatment of dementia. Although scholars have noted tourism’s potential role in managing cognitive impairment and mild dementia, more robust empirical investigation is needed in this area. This study aimed to examine the associations between tourism and cognitive impairment and dementia in older Chinese adults. Method: From a nationwide community-based cohort, 6,717 individuals aged ≥ 60 were recruited from 2011 to 2014, of whom 669 (9.96%) had had at least one tourism experience in the 2 years prior to enrollment. All the participants were then prospectively …

Externalizing Traits: Shared Causalities For Covid-19 And Alzheimer's Dementia Using Mendelian Randomization Analysis, Haotian Wang, Mingyang Cao, Yingjun Xi, Weijie Cao, Xiaoyu Zhang, Xiaoni Meng, Deqiang Zheng, Lijuan Wu, Wei Wang, Di Liu, Youxin Wang

Research outputs 2022 to 2026

Externalizing traits have been related with the outcomes of coronavirus disease 2019 (COVID-19) and Alzheimer's dementia (AD); however, whether these associations are causal remains unknown. We used the two-sample Mendelian randomization (MR) approach with more than 200 single-nucleotide polymorphisms (SNPs) for externalizing traits to explore the causal associations of externalizing traits with the risk of COVID-19 (infected COVID-19, hospitalized COVID-19, and severe COVID-19) or AD based on the summary data. The inverse variance–weighted method (IVW) was used to estimate the main effect, followed by several sensitivity analyses. IVW analysis showed significant associations of externalizing traits with COVID-19 infection (odds ratio …

Invisible Women: Gender Representation In High School Science Courses Across Australia, Kathryn Ross, Shanika Galaudage, Tegan Clark, Nataliea Lowson, Andrew Battisti, Helen Adam, Alexandra K. Ross, Nici Sweaney

Research outputs 2022 to 2026

The visibility of female role models in science is vital for engaging and retaining women in scientific fields. In this study, we analyse four senior secondary science courses delivered across the states and territories in Australia: Biology, Chemistry, Environmental Science, and Physics. We compared male and female representation within the science courses by examining the mentions of male and female scientists along with the context of their inclusions in the syllabuses. We find a clear gender bias with only one unique mention of a female scientist. We also find a clear Eurocentric focus and narrow representation of scientists. This bias …

Australian Highlevel Public Policy Preparedness For Population-Based Triage During The Pandemic, Zachary Horn, Lily Gapp Duckett, Kaitlin Webber

Research outputs 2022 to 2026

The COVID-19 pandemic brought attention to scarce clinical resource allocation via secondary population-based triage (S-PBT) throughout the international healthcare community. Experiences overseas highlighted the importance of coordinated and consistent approaches to allocating resources when facing overwhelming demand, particularly for critical care. Noting the importance of consistency and the system of devolved governance deployed in Australia, this study aimed to identify and analyse sources of high-level policy that affect Australia’s health system preparedness for the operationalisation of S-PBT. Of the 39 documents reviewed, 17 contained potential references to S-PBT. There was a lack of clear recommendations and guidance to inform S-PBT …

Genomic Epidemiology And Transmission Dynamics Of Recurrent Clostridioides Difficile Infection In Western Australia, Daniel R. Knight, Korakrit Imwattana, Deirdre A. Collins, Su-Chen Lim, Stacey Hong, Papanin Putsathit, Thomas V. Riley

Research outputs 2022 to 2026

Recurrent cases of Clostridioides difficile infection (rCDI) remain one of the most common and serious challenges faced in the management of CDI. The accurate distinction between a relapse (caused by infection with the same strain) and reinfection (caused by a new strain) has implications for infection control and prevention, and patient therapy. Here, we used whole-genome sequencing to investigate the epidemiology of 94 C. difficile isolates from 38 patients with rCDI in Western Australia. The C. difficile strain population comprised 13 sequence types (STs) led by ST2 (PCR ribotype (RT) 014, 36.2 %), ST8 (RT002, 19.1 %) and ST34 (RT056, …

Identification And Validation Of Igg N-Glycosylation Biomarkers Of Esophageal Carcinoma, Huiying Pan, Zhiyuan Wu, Haiping Zhang, Jie Zhang, Yue Liu, Zhiwei Li, Wei Feng, Guiqi Wang, Yong Liu, Deli Zhao, Zhiyi Zhang, Yuqin Liu, Zhe Zhang, Xiangtong Liu, Lixin Tao, Yanxia Luo, Xiaonan Wang, Xinghua Yang, Feng Zhang, Xia Li, Xiuhua Guo

Research outputs 2022 to 2026

Introduction: Altered Immunoglobulin G (IgG) N-glycosylation is associated with aging, inflammation, and diseases status, while its effect on esophageal squamous cell carcinoma (ESCC) remains unknown. As far as we know, this is the first study to explore and validate the association of IgG N-glycosylation and the carcinogenesis progression of ESCC, providing innovative biomarkers for the predictive identification and targeted prevention of ESCC. Methods: In total, 496 individuals of ESCC (n=114), precancerosis (n=187) and controls (n=195) from the discovery population (n=348) and validation population (n=148) were recruited in the study. IgG N-glycosylation profile was analyzed and an ESCC-related glycan score was …

Biofilm Formation On The Surface Of Monazite And Xenotime During Bioleaching, Arya Van Alin, Melissa K. Corbett, Homayoun Fathollahzadeh, M. Christian Tjiam, William D. A. Rickard, Xiao Sun, Andrew Putnis, Jacques Eksteen, Anna H. Kaksonen, Elizabeth Watkin

Research outputs 2022 to 2026

Microbial attachment and biofilm formation is a ubiquitous behaviour of microorganisms and is the most crucial prerequisite of contact bioleaching. Monazite and xenotime are two commercially exploitable minerals containing rare earth elements (REEs). Bioleaching using phosphate solubilizing microorganisms is a green biotechnological approach for the extraction of REEs. In this study, microbial attachment and biofilm formation of Klebsiella aerogenes ATCC 13048 on the surface of these minerals were investigated using confocal laser scanning microscopy (CLSM) and scanning electron microscopy (SEM). In a batch culture system, K. aerogenes was able to attach and form biofilms on the surface of three phosphate …

Approach To Vaccinating The Pediatric Solid Organ Transplant Candidate And Recipient, Carol M Kao, Marian G Michaels

2020-Current year OA Pubs

Solid organ transplantation (SOT) candidates and recipients are at increased risk for morbidity and mortality from vaccine-preventable infections. Children are at particular risk given that they may not have completed their primary immunization series at time of transplant or have acquired natural immunity to pathogens from community exposures. Multiple society guidelines exist for vaccination of SOT candidate and recipients, although challenges remain given limited safety and efficacy data available for pediatric SOT recipients, particularly for live-vaccines. After transplant, individual patient nuances regarding exposure risks and net state of immunosuppression will impact timing of immunizations. The purpose of this review is …

Corrigendum: Evolution, Ecology, And Zoonotic Transmission Of Betacoronaviruses: A Review, Herbert F. Jelinek, Mira Mousa, Eman Alefishat, Wael Osman, Ian Spence, Dengpan Bu, Samuel F. Feng, Jason Byrd, Paola A. Magni, Shafi Sahibzada, Guan K. Tay, Habiba S. Alsafar

Research outputs 2022 to 2026

In the published article, there was an error in the legend for Figure 1 as published. The figure legend did not indicate that it has been adapted from Plowright et al. (2017). Copyright permission was obtained from Springer Nature to adapt Figure 1 from Plowright et al. (2017). The corrected legend appears below. Figure 1. Zoonotic risk distribution, pathway to spillover, and the multimodal role of the determinants of spillover. The zoonotic risk is demonstrated by the accumulated distribution of reservoir hosts and vectors that play a role in the pathway to spillover. The risk of spillover is determined by …

Changes In Parental Anxiety And Intention To Demand Antibiotics: A Longitudinal Study Among Parents During The Covid-19 Pandemic, Aaron L. Alejandro, Mieghan Bruce, Wei W. C. Leo

Research outputs 2022 to 2026

Aims: Assessing the effects of the COVID-19 pandemic on parental anxiety and preferences for antibiotic treatment can help inform antibiotic stewardship strategies. Therefore, this study aimed to examine COVID-19 pandemic-related changes in parental anxiety levels, their intentions to demand antibiotics and frequencies of practising preventative behaviours. Design: This longitudinal quantitative study compared two groups of parents, those from Victoria and Western Australia, who experienced high and low COVID-19 risk, respectively. Methods: Participants were recruited through an online panel to complete three waves of surveys between October 2020 and August 2021. Anxiety scores and frequency of preventative behaviours were analysed using …

A Scoping Review Of Nurse-Led Randomised Controlled Trials, Marion Eckert, Kate Kennedy, Kim Neylon, Claire M. Rickard, Samantha Keogh, Richard Gray, Sandy Middleton, Caroline Homer, Lisa Whitehead, Greg Sharplin

Research outputs 2022 to 2026

Background: Nurses comprise the largest portion of the healthcare workforce worldwide. However, nurse representation in the leadership of clinical research and research funding is largely unknown. The Australasian Nursing and Midwifery Clinical Trials Network was established to provide a coordinated network, focussed on building research capacity in nursing and midwifery. To support this work, this scoping review of nurse-led randomised controlled trials was conducted to summarise research activity, as well as highlight future research directions, gaps and resources. Midwife-led trials will be reported elsewhere. Aim: To quantify number, type and quality of nurse-led randomised controlled trials registered between 2000–2021. Design: …

Hand Hygiene Knowledge And Demonstrated Technique Among Malawian Kindergarten Children: A Quasi-Experimental Study, Balwani Chingatichifwe Mbakaya, Maggie Zgambo, Fatch Welcome Kalembo

Research outputs 2022 to 2026

Aim: To evaluate hand hygiene knowledge and demonstrated technique before and after implementation of the hand hygiene programme and its sustainability among Malawian kindergarten students. Design: Quasi-experimental design, utilizing a repeated measure at three points, namely, before intervention (T0), soon after intervention (T1) and follow-up (T2). Methods: The hand hygiene programme consisted of integrating hand hygiene protocol into the school health curriculum, setting up proper handwashing facilities, training school teachers, health talks and developing reminders on hand hygiene. Fifty-three kindergarten children aged 3–6 years were enrolled in the programme. Data were collected at 3 months' intervals (T0, T1, and T2). …

The Servant Of God As A Proactive Manager: A Team Service Solution Model For Meeting Covid-19 Challenges In Indonesia, Muner Daliman, Jonathan James

Research outputs 2022 to 2026

Hundreds of thousands of people from all walks of life have died in Indonesia from Covid−19; work practices have been disrupted and various changes have occurred, including the sphere of service in churches, foundations, schools, and universities. The study aims to understand the concept of the proactive manager as a servant of God: a representative and spokesman for God who is obliged to plan, implement, and evaluate what he/she is doing in carrying out what God wills during the challenges of the Covid−19 era in Indonesia. The research method used was content analysis from secular and biblical texts. The results …

A Novel Approach For Assessing Bias During Team-Based Clinical Decision-Making, Natalie Pool, Megan Hebdon, Esther De Groot, Ryan Yee, Kathryn Herrera-Theut, Erika Yee, Larry A Allen, Ayesha Hasan, Joann Lindenfeld, Elizabeth Calhoun, Molly Carnes, Nancy K Sweitzer, Khadijah Breathett

2020-Current year OA Pubs

Many clinical processes include multidisciplinary group decision-making, yet few methods exist to evaluate the presence of implicit bias during this collective process. Implicit bias negatively impacts the equitable delivery of evidence-based interventions and ultimately patient outcomes. Since implicit bias can be difficult to assess, novel approaches are required to detect and analyze this elusive phenomenon. In this paper, we describe how the de Groot Critically Reflective Diagnoses Protocol (DCRDP) can be used as a data analysis tool to evaluate group dynamics as an essential foundation for exploring how interactions can bias collective clinical decision-making. The DCRDP includes 6 distinct criteria: …

Enhancing The Therapeutic Activity Of Hyperimmune Igg Against Chikungunya Virus Using Fcγriiia Affinity Chromatography, Julie M Fox, Vicky Roy, Bronwyn M Gunn, Glen R Bolton, Daved H Fremont, Galit Alter, Michael S Diamond, Austin W Boesch

2020-Current year OA Pubs

INTRODUCTION: Chikungunya virus (CHIKV) is a re-emerging mosquito transmitted alphavirus of global concern. Neutralizing antibodies and antibody Fc-effector functions have been shown to reduce CHIKV disease and infection in animals. However, the ability to improve the therapeutic activity of CHIKV-specific polyclonal IgG by enhancing Fc-effector functions through modulation of IgG subclass and glycoforms remains unknown. Here, we evaluated the protective efficacy of CHIKV-immune IgG enriched for binding to Fc-gamma receptor IIIa (FcγRIIIa) to select for IgG with enhanced Fc effector functions.

METHODS: Total IgG was isolated from CHIKV-immune convalescent donors with and without additional purification by FcγRIIIa affinity chromatography. The …

Jiann-Ping Hsu College Of Public Health Magazine, Georgia Southern University

College of Public Health: News & Publications

• Message from the Dean: Stuart H. Tedders, PhD
• Remembering Dr. Evans Afriyie-Gyawu
• Exploring Research Focus Areas
• Alumni Feature: Overcoming Hurdles
• Research Feature: It's a weighted issue.
• Research Feature: The effectiveness of lactation cookies
• Period Equity Movement Earns National Recognition
• Leaving Her Mark
• Georgia on Our Mind
• Center for Addiction Recovery: Transforming Lives through Comprehensive Support
• Center for Public Health Practice and Research: The LEAD Academy: A Hospital Leadership Training Program
• Office of Practice and Research: Continued Engagement in Practice and Research
• Office of Teaching and Learning
• Office of Health Equity and Community: Engagement Continued Engagement in Practice and Research
• Awards, …

Advancing Racial Justice Through Civil And Criminal Academic Medical-Legal Partnerships, Yael Cannon, Vida Johnson

Georgetown Law Faculty Publications and Other Works

The medical-legal partnership (MLP) model, which brings attorneys and healthcare partners together to remove legal barriers to health, is a growing approach to addressing unmet civil legal needs. But MLPs are less prevalent in criminal defense settings, where they also have the potential to advance both health and legal justice. In fact, grave racial health inequities are deeply intertwined with both civil and criminal injustice. In both spheres, health justice is racial justice. Building on the experiences of the authors in their respective civil and criminal law school clinics at Georgetown University in Washington, D.C., this Article argues that academic …

Perceptions Of Florida Victim Advocates During The Covid-19 Pandemic, Katarina Renee Hamburg

Theses and Dissertations

In December of 2019, a new virus known as COVID-19 emerged out of Wuhan, China. COVID-19 is a respiratory virus which is highly contagious and, in some cases, lethal. By January 20th, 2020, the United States reported its first case of COVID-19. Between January and December of 2020 there were 18.7 million cases and 329,000 deaths in the United States alone. Globally, during that time frame, there were 79.8 million cases and 1.75 million deaths. Due to the highly contagious and dangerous nature of COVID-19, countries across the world have attempted to promote public health by enacting social distancing measures. …

Human Trafficking: The Impact Of Covid-19 On Labor Trafficking In The Us, Anthony A. Mottola

Theses and Dissertations

Human trafficking is a global phenomenon where traffickers prey upon their victims without discriminating against age, gender, ethnic background, or nationality. The United States (US) is not immune to the human rights violations of human trafficking. The victims of human trafficking are coerced into a life of exploitation through forced labor or sexual exploitation. Many victims are migrants from disadvantaged countries that travel to the US seeking employment but end up the victims of abuse, both physically and mentally, at the hands of traffickers. In 2020, the COVID-19 pandemic devastated the global economy, forcing quarantines, travel bans, and social distancing. …

A Mixed-Method Study On Social Media’S Role In The Health Decision-Making Practices Of Black Millennial Women In South Florida, Sashah Damier

Theses and Dissertations

The purpose of this research study was to examine health care decision-making practices of Black millennial women in South Florida, based on their social media use. The study contributed to understanding of how cultural components contribute to health care disparities for people of color because health care providers lacked information on how to reach Black millennial women with accurate and helpful information through social media.

The design for the study included a convergent parallel mixed-methods design using a web-based quantitative cross-sectional survey along with embedded qualitative telephone interviews and NVivo software. This mixed-methods methodology provided rich data and new understandings …