Medicine and Health Sciences Commons^™

Procalcitonin-Guided Duration Of Antibiotic Treatment In Children Hospitalised With Confirmed Or Suspected Bacterial Infection In The Uk (Batch): A Pragmatic, Multicentre, Open-Label, Two-Arm, Individually Randomised, Controlled Trial, Cherry-Ann Waldron, Philip Pallmann, Simon Schoenbuchner, Debbie Harris, Lucy Brookes-Howell, Céu Mateus, Jolanta Bernatoniene, Katrina Cathie, Saul N. Faust, Helen Nabwera

Centre of Excellence in Women and Child Health

Background Procalcitonin is a rapid response biomarker specific for bacterial infection, which is not routinely used in the UK National Health Service. We aimed to assess whether using a procalcitonin-guided algorithm would safely reduce the duration of antibiotic therapy compared with usual care, in which C-reactive protein is the commonly used biomarker.

Methods The BATCH trial was a pragmatic, multicentre, open-label, parallel, two-arm, individually randomised, controlled trial conducted in 15 hospitals in England and Wales. Children aged 72 h to 18 years who were admitted to hospital and were being treated with intravenous antibiotics for suspected or confirmed bacterial infection …

Engagement And Factors Associated With Annual Anal Human Papillomavirus Screening Among Sexual And Gender Minority Individuals, Jenna Nitkowski, Timothy J Ridolfi, Sarah J Lundeen, Anna R Giuliano, Elizabeth Chiao, Maria E Fernandez, Vanessa Schick, Jennifer S Smith, Paige Bruggink, Bridgett Brzezinski, Alan G Nyitray

Faculty, Staff and Student Publications

Background: Although self-sampling could help address anal cancer screening barriers, no studies have investigated annual engagement with this method or compared it with annual screening with a provider. Building on our baseline article, we compared annual anal screening engagement between home-based self-sampling and clinic-based clinician sampling.

Methods: The Prevent Anal Cancer Self-Swab Study recruited and randomized sexual and gender minority individuals 25 years and older who have sex with men to a home or clinic arm. Home-based participants were mailed an anal human papillomavirus self-sampling kit at baseline and 12 months, whereas clinic-based participants were asked to schedule and attend …

Patterns Of Substance Use Among Street-Involved Children And Youth In Kenya: The Roles Of Street-Exposure, Migratory Factors, Family Deprivation, And Geographic Sub-Location, Michael L Goodman, Sarah Seidel, Andrew Springer, Christine Markham, Aaron Godoy, Lauren Raimer-Goodman, Kelvin Munene, Stanley Gitari

Faculty, Staff and Student Publications

Substance use among street-involved children and youth (SICY) in low- and middle-income countries is common. Using data abstracted from program intake forms (2016-2022) for an intervention to reintegrate SICY with their communities, we assess which individual, family, and geographic characteristics are predictive of substance use, and specifically inhalant use and non-inhalant use among a sample of 227 SICY in Meru County, Kenya. Assessed determinants include age, geographic location of home community, years on street, family deprivation prior to street-migrating, motivation for street migrating, abuse experiences on the street, and activities on the street. Number of years lived on the street, …

Sexual Behavior Stigma Among Cisgender Gay, Bisexual, And Other Men Who Have Sex With Men In Nine Nhbs Cities Across The United States: Burden And Associations With Prep Continuum And Hiv Care Continuum Outcomes, John Mark Wiginton, Sarah M Murray, Bridget J Anderson, Kwa Sey, Yingbo Ma, Colin P Flynn, Danielle German, Emily Higgins, Timothy W Menza, E Roberto Orellana, Stephanie Sanz, Nabeeh A Hasan, Alia Al-Tayyib, Jennifer Kienzle, Garrett Shields, Zaida Lopez, Paige Wermuth, Stefan D Baral

Faculty, Staff and Student Publications

In the United States (US), sexuality-based stigma continues to undermine HIV prevention and care efforts. We assessed sexual behavior stigma burden across family, healthcare, and social domains and determined associations with HIV-related outcomes among cisgender gay, bisexual, and other men who have sex with men (MSM) in nine US metropolitan statistical areas. MSM (N = 4,086) recruited at places of MSM social congregation via venue-based, time-sampling procedures completed a survey on sexual behavior stigma, PrEP (pre-exposure prophylaxis) continuum and HIV care continuum outcomes, sociodemographic characteristics, and other measures. We calculated prevalence and overall mean stigma subscale scores (range: 0.00–1.00) …

Leucine-Rich Alpha-2-Glycoprotein 1 Promotes Metastatic Colorectal Cancer Growth Through Human Epidermal Growth Factor Receptor 3 Signaling, Moeez Rathore, Kimberly Curry, Wei Huang, Michel'le Wright, Daniel Martin, Jiyeon Baek, Derek Taylor, Masaru Miyagi, Wen Tang, Hao Feng, Yamu Li, Zhenghe Wang, Hallie Graor, Joseph Willis, Elizabeth Bryson, Christina S Boutros, Omkar Desai, Bianca N Islam, Lee M Ellis, Stephen E Moss, Jordan M Winter, John Greenwood, Rui Wang

Faculty, Staff and Student Publications

Background & aims: Therapy failure in patients with metastatic colorectal cancer (mCRC, ∼80% occur in the liver) remains an overarching challenge. Preclinical studies demonstrated that human epidermal growth factor receptor 3 (HER3) promotes colorectal cancer (CRC) cell survival, but therapies blocking the neuregulin-induced canonical HER3 signaling have made little impact in the clinic. Recent studies suggest that the liver microenvironment promotes CRC growth by activating HER3 in a neuregulin-independent fashion, thus elucidation of these mechanisms may reveal new strategies for treating patients with mCRC.

Methods: Patient-derived primary liver endothelial cells (ECs) were used to interrogate EC-CRC crosstalk. We conducted proteomic …

Vaxbot-Hpv: A Gpt-Based Chatbot For Answering Hpv Vaccine-Related Questions, Yiming Li, Jianfu Li, Manqi Li, Evan Yu, Danniel Rhee, Muhammad Amith, Lu Tang, Lara S Savas, Licong Cui, Cui Tao

Faculty, Staff and Student Publications

OBJECTIVE: Human Papillomavirus (HPV) vaccine is an effective measure to prevent and control the diseases caused by HPV. However, widespread misinformation and vaccine hesitancy remain significant barriers to its uptake. This study focuses on the development of VaxBot-HPV, a chatbot aimed at improving health literacy and promoting vaccination uptake by providing information and answering questions about the HPV vaccine.

METHODS: We constructed the knowledge base (KB) for VaxBot-HPV, which consists of 451 documents from biomedical literature and web sources on the HPV vaccine. We extracted 202 question-answer pairs from the KB and 39 questions generated by GPT-4 for training and …

Plasma Proteomic Characterization Of Motoric Cognitive Risk And Mild Cognitive Impairment, Gabriela T Gomez, Sanish Sathyan, Jingsha Chen, Myriam Fornage, Pascal Schlosser, Zhongsheng Peng, Jenifer Cordon, Priya Palta, Kevin J Sullivan, Adrienne Tin, B Gwen Windham, Rebecca F Gottesman, Nir Barzilai, Sofiya Milman, Joe Verghese, Josef Coresh, Keenan A Walker

Faculty, Staff and Student Publications

INTRODUCTION: Motoric cognitive risk (MCR) is a pre-dementia syndrome characterized by mobility and cognitive dysfunction. This study conducted a proteome-wide study of MCR and compared the proteomic signatures of MCR to that of mild cognitive impairment (MCI).

METHODS: Participants were classified as MCR using a memory questionnaire and 4-meter walk. We measured 4877 plasma proteins collected during late-life and midlife. Multivariable logistic regression related each protein to late-life MCR/MCI. MCR-associated proteins were replicated internally at midlife and in an external cohort.

RESULTS: Proteome-wide analysis (n = 4076) identified 25 MCR-associated proteins. Eight of these proteins remained associated with late-life MCR …

Development Of The Navigation Guide Evidence-To-Decision Framework For Environmental Health: Version 1.0, Nicholas Chartres, Max T. Aung, Sustan L. Norris, Courtney Cooper, Lia A. Bero, Roger Chou, Devon C. Payne-Sturges, Wendy E. Wagner, Jessica W. Reyes, Lisa M. Askie, Daniel A. Axelrad, Deysi Flores Vigo, Jill E. Johnston, Juleen Lam, Keeve E. Nachman, Eva Rehfuess, Rachel Rothschild, Patrice Sutton, Lauren Zeise, Tracey J. Woodruff

Articles

Environmental exposures, including widespread industrial pollution, impact human health and are amplified in more highly exposed communities. Policy and regulatory frameworks for making decisions and recommendations on interventions to mitigate or prevent exposures tend to narrowly focus on exposure and some health-related data related to risks. Typically, such frameworks do not consider other factors, including essentiality, health equity, and distribution of benefits and costs. Further, decisions and recommendations lack transparency regarding how they were developed. We developed the Navigation Guide Evidence-to-Decision Framework for Environmental Health (E2DFEH) to provide a structured and transparent framework incorporating a range of scientific information and …

Patient-Reported Outcomes: Comparing Functional Avoidance And Standard Thoracic Radiation Therapy In Lung Cancer, Spencer Poiset, Joseph Lombardo, Edward Castillo, Richard Castillo, Bernard Jones, Moyed Miften, Brian Kavanagh, Adam Dicker, Cullen Boyle, Nicole Simone, Benjamin Movsas, Inga Grills, Chad Rusthoven, Yevgeniy Vinogradskiy, Lydia Wilson

Department of Radiation Oncology Faculty Papers

PURPOSE: Novel methods generate functional images using image processing techniques combined with four-dimensional computed tomography (4DCT) data (4DCT-ventilation). 4DCT-ventilation was implemented in a phase II, multicenter functional avoidance clinical trial. The work compares functional avoidance patient-reported outcomes (PROs) against historical standards.

METHODS: Patients with locally advanced lung cancer undergoing curative-intent chemoradiation were accrued. 4DCT-ventilation imaging was generated and functional avoidance treatment plans created reduced dose to functional lung. PRO instruments included Functional Assessment of Cancer Therapy Lung questionnaire and accompanying subscales (including the Trial Outcome Index [TOI]), EuroQol-5 Dimension (EQ-5D), and EQ-Visual Analog Scale (EQ-VAS). The average change from baseline …

Imaging Lung Tumor Motion Using Integrated-Mode Proton Radiography-A Phantom Study Towards Tumor Tracking In Proton Radiotherapy, Ryan Fullarton, Mikaël Simard, Lennart Volz, Allison Toltz, Savanna Chung, Christoph Schuy, Daniel G Robertson, Gary Royle, Sam Beddar, Colin Baker, Christian Graeff, Charles-Antoine Collins-Fekete

Faculty, Staff and Student Publications

BACKGROUND: Motion of lung tumors during radiotherapy leads to decreased accuracy of the delivered dose distribution. This is especially true for proton radiotherapy due to the finite range of the proton beam. Methods for mitigating motion rely on knowing the position of the tumor during treatment.

PURPOSE: Proton radiography uses the treatment beam, at an energy high enough to traverse the patient, to produce a radiograph. This work shows the first results of using an integrated-mode proton radiography system to track the position of moving objects in an experimental phantom study; demonstrating the potential of using this method for measuring …

Rapidbrachyivbt: A Dosimetry Software For Patient-Specific Intravascular Brachytherapy Dose Calculations On Optical Coherence Tomography Images, Maryam Rahbaran, Jonathan Kalinowski, Joseph M Decunha, Kevin J Croce, Brian A Bergmark, James M G Tsui, Phillip M Devlin, Shirin A Enger

Faculty, Staff and Student Publications

Background: Coronary artery disease is the most common form of cardiovascular disease. It is caused by excess plaque along the arterial wall, blocking blood flow to the heart (stenosis). A percutaneous coronary intervention widens the arterial wall with the inflation of a balloon inside the lesion area and leaves behind a metal stent to prevent re-narrowing of the artery (restenosis). However, in-stent restenosis may occur due to damage to the arterial wall tissue, triggering neointimal hyperplasia, producing fibrotic and calcified plaques and narrowing the artery again. Drug-eluting stents, which slowly release medication to inhibit neointimal hyperplasia, are used to prevent …

Open-Chest Cardiac Ultrasound-Mediated Imaging With A Vacuum Coupler, Nilesh Mathuria, Krithik Vishwanath, Giorgio Brero, Blake C Fallon, Antonio Martino, Richard C Willson, Carly S Filgueira, Richard R Bouchard

Faculty, Staff and Student Publications

BACKGROUND: A fundamental obstacle for the preclinical development of ultrasound-(US) mediated cardiac imaging remains cardiac motion, which limits interframe correlation during extended acquisition periods.

PURPOSE: To address this need, we present the design and implementation of a 3D-printed vacuum coupler that stabilizes a US transducer on the epicardial surface of the heart for feasibility assessment and development of advanced, cardiac, US-mediated imaging approaches.

METHODS: The vacuum coupler was 3D printed with biocompatible resins and secured with a standard intraoperative suction aspirator. US-mediated imaging (i.e., B-mode and photoacoustic [PA] imaging) was performed in an open-chest porcine model with and without the …

On The Acceptance, Commissioning, And Quality Assurance Of Electron Flash Units, Allison Palmiero, Kevin Liu, Julie Colnot, Nitish Chopra, Denae Neill, Luke Connell, Brett Velasquez, Albert C Koong, Steven H Lin, Peter Balter, Ramesh Tailor, Charlotte Robert, Jean-François Germond, Patrik Gonçalves Jorge, Reiner Geyer, Sam Beddar, Raphael Moeckli, Emil Schüler

Faculty, Staff and Student Publications

Background and purpose: FLASH or ultra-high dose rate (UHDR) radiation therapy (RT) has gained attention in recent years for its ability to spare normal tissues relative to conventional dose rate (CDR) RT in various preclinical trials. However, clinical implementation of this promising treatment option has been limited because of the lack of availability of accelerators capable of delivering UHDR RT. Commercial options are finally reaching the market that produce electron beams with average dose rates of up to 1000 Gy/s. We established a framework for the acceptance, commissioning, and periodic quality assurance (QA) of electron FLASH units and present an …

Mid-Life Anti-Inflammatory Metabolites Are Inversely Associated With Long-Term Cardiovascular Disease Events, Anum Saeed, Chris Mckennan, Jiaxuan Duan, Yueh-Ning Yang, Kevin E Kip, David Finegold, Michael Vu, Justin Swanson, Oscar L Lopez, Ann Cohen, Mark Mapstone, Bing Yu, Christie M Ballantyne, Steven E Reis

Faculty, Staff and Student Publications

BACKGROUND: Preclinical data have shown that low levels of metabolites with anti-inflammatory properties may impact metabolic disease processes. However, the association between mid-life levels of such metabolites and long-term ASCVD risk is not known.

METHODS: We characterised the plasma metabolomic profile (1228 metabolites) of 1852 participants (58.1 ± 7.5 years old, 69.6% female, 43.6% self-identified as Black) enrolled in the Heart Strategies Concentrating on Risk Evaluation (Heart SCORE) study. Logistic regression was used to assess the impact of metabolite levels on ASCVD risk (nonfatal MI, revascularisation, and cardiac mortality). We additionally explored the effect of genetic variants neighbouring ASCVD-related genes …

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 …

Expert Clinical Management Of Inflammatory Immune-Related Arthritis In Patients With Cancer Receiving Immune Checkpoint Inhibitors, Sebastian Bruera, Mar Riveiro-Barciela, Alexa Meara, Maria E Suarez-Almazor

Faculty, Staff and Students Publications

Introduction: Treatment guidelines for immune-related inflammatory arthritis (irAE-IA) in patients with cancer receiving immune checkpoint inhibitors (ICIs) are vague with respect to the use of specific agents. Patients are usually referred to rheumatologists for treatment. We conducted a survey of expert rheumatologists to determine current practices. We also assessed experts' views on the potential deleterious effects of various agents on tumor progression.

Methods: We conducted a survey of international experts in the treatment of irAE-IA, identified as members of collaborative scientific workgroups in this area. Experts were presented with a case of a patient with moderate irAE-IA and were asked …

Analyzing The Donor Dilemma: Outcomes Of Kidney Transplant Recipients From Donors With Positive Blood Cultures Obtained At Organ Procurement, Petros A Svoronos, R Alfonso Hernandez Acosta, Prakhar Vijayvargiya, Pradeep Vaitla, James Wynn, Christopher Anderson, Jason Parham, Elena Beam, M Rizwan Sohail, Zerelda Esquer Garrigos

Faculty, Staff and Students Publications

Based on expert consensus, the American Society of Transplantation recommends 7-14 days of preventive antibiotic therapy for solid organ transplant recipients from donors with positive blood cultures. We evaluated management and outcomes of kidney transplant recipients from these donors.

Sustainable Solutions To The Continuous Threat Of Antimicrobial Resistance, Brad Spellberg, David N Gilbert, Michael Baym, Gonzalo Bearman, Tom Boyles, Arturo Casadevall, Graeme N Forrest, Sarah Freling, Bassam Ghanem, Fergus Hamilton, Brian Luna, Jessica Moore, Daniel M Musher, Travis B Nielsen, Priya Nori, Matthew C Phillips, Liise-Anne Pirofski, Andrew F Shorr, Steven Y C Tong, Todd C Lee, Emily G Mcdonald

Faculty, Staff and Students Publications

To combat antimicrobial resistance (AMR), advocates have called for passage of the Pioneering Antimicrobial Subscriptions To End Upsurging Resistance (PASTEUR) Act in the United States, which would appropriate $6 billion in new taxpayer-funded subsidies for antibiotic development. However, the number of antibiotics in clinical development, and US Food and Drug Administration approvals of new antibiotics, have already markedly increased in the last 15 years. Thus, instead of focusing on more economic subsidies, we recommend reducing selective pressure driving AMR by (1) establishing pay-for-performance mechanisms that disincentivize overprescribing of antibiotics, (2) focusing existing research and development funding on strategies that decrease …

Protocol For A Field Trial Of A Hearing And Vision Support Intervention For People Living In Long-Term Care In Australia, Carly Meyer, Najwan El-Saifi, Naomi Rose, Kasia Bail, Colette Browning, Dayna Cenin, Antonio Ahumada-Canale, Megan Campbell, Tim England, Melanie Ferguson, Yuanyuan Gu, Reema Harrison, Chyrisse Heine, Lisa Keay, Sheela Kumaran, Iracema Leroi, Gerald Liew, Angelita Martini, Ralph Martins, John Newall, Smriti Raichand, Emma Scanlan, Hamid R. Sohrabi, Melinda Toomey, Johanna Westbrook, Piers Dawes

Research outputs 2022 to 2026

Introduction: Hearing and vision impairments are prevalent among residents in long-term care settings. Hearing and vision impairments frequently go unsupported, affecting residents' quality of life and healthcare costs. This paper describes the protocol for a pre−post evaluation and process evaluation of a pragmatic sensory support intervention (SSI) that was developed with residents, informal caregivers and long-term care workers. Methods and Analysis: A prospective pre−post-intervention trial within long-term care will be conducted, including three groups: residents (n = 87), informal caregivers (n = 87) and long-term care workers (n = 40). Outcome measures include health-related quality of life and well-being measures …

Atypical Presentation Of Non-Small Cell Lung Carcinoma With Metastasis To Breast Tissue, Tylar P. Seckman, Diane Krutzler-Berry, Mohamed Ashal, Waqas Mahmud, Krista L. Denning, Logan M. Lawrence

Marshall Journal of Medicine

Malignant neoplasms of the lung commonly metastasize to lymph nodes, bone, brain, and liver via hematogenous and lymphatic routes. Much less commonly, metastasis occurs in the breast. Secondary metastatic disease of the breast is very rare, with a reported incidence ranging from 0.4-1.3%­­—with primary lung cancer being one of the most anomalous sources. This case details non-small cell lung cancer metastasis to the breast with proven primary contralateral lung origination. This atypical finding prompts medical professionals to consider these malignant cells' immunologic, histologic, and pathologic makeup to understand further and treat the neoplasm.

Does College Guarantee Economic Mobility?: Incorporating Lost In-Kind Benefits Into The Calculation, Amy S. White

Publications and Research

Average salaries of college graduates are higher than salaries of those without degrees. However, the experience of graduating and out-earning the income requirements for in-kind or entitlement benefits like Medicaid, public assistance, Supplemental Nutritional Assistance Plan, and/or Section 8 housing vouchers are not taken into consideration in any mobility calculation nor are students prepared to lose their benefits. Teaching at an urban commuter school in a financially disadvantage borough, I have identified a gap in the research literature and supportive services for these low-income students. This opinion piece further describes the problem and highlights areas for future action and research.

The Readiness For Integrated Primary Health Care (Ilp) At Puskesmas Pamulang In Tangerang Selatan City, Firda Safitri Rachmaningsih, Kurnia Sari

Journal of Indonesian Health Policy and Administration

. Integrated primary healthcare (ILP) is part of the transformation of primary healthcare aimed at improving access to quality healthcare. This study aims to analyze the readiness of Pusat Kesehatan Masyarakat (Puskesmas) and their networks to implement ILP. This research used a qualitative approach, focusing on a case study of a Puskesmas in an urban setting, specifically in the operational area of Puskesmas Pamulang in South Tangerang. Data collection methods include in-depth interviews, observations, and document reviews. This research adopts the conceptual framework of PHC monitoring based on WHO and Weiner's theory of organizational change readiness. The research findings indicate …

Analysis Of Covid-19 Prevention And Control Policy Implementation In Islamic Boarding Schools In Dki Jakarta, Dickha Adi Wibowo, Fajar Ariyanti

Journal of Indonesian Health Policy and Administration

Indonesia, as one of the countries affected by COVID-19, has implemented various efforts to prevent the transmission of COVID-19. One effort that can be implemented is the implementation of COVID-19 prevention protocols. Apart from that, according to the COVID-19 Handling Task Force, Islamic boarding schools are locations with high mobility. This research aims to determine the implementation of policies related to the prevention and control of COVID-19 in Islamic boarding schools in the DKI Jakarta Province. This research used descriptive research with a qualitative approach, with the number of respondents being three Islamic boarding school leaders and students. The results …

Contextualizing Policy Adoption: A Case Study Of Tuberculosis Control Policy In Depok City, Tri Auri Putri Ayuningtyas, Adang Bachtiar

Journal of Indonesian Health Policy and Administration

This study analyzes the formulation and implementation process of Depok Mayor Regulation No. 61 of 2023 on Tuberculosis (TB) Control using Friedman’s legal system theory (1975) and the eight General Principles of Good Governance (Asas Umum Pemerintahan yang Baik – AUPB). The regulation provides a comprehensive framework, encompassing promotive, preventive, curative, and rehabilitative aspects to support TB control. The legal structure includes the establishment of a cross-sectoral Tuberculosis Control Acceleration Team, involving government agencies and community organizations. Findings reveal that while the regulation has fulfilled several AUPB principles, such as legal certainty, utility, and public interest, there are areas …

The Relationship Between Self-Efficacy And Self-Management Behavior In Gestational Diabetes Mellitus Control, Fatimah Dwi Cahyani, Shrimarti Rukmini Devy

Journal of Indonesian Health Policy and Administration

Diabetes mellitus gestasional (DGM) merupakan kondisi kesehatan yang meningkat dalam kehamilan dan dapat menyebabkan komplikasi serius bagi ibu dan janin. Self-management yang mencakup pemahaman, penerapan, dan pemeliharaan perilaku kesehatan memiliki peran kunci dalam mengelola DGM. Health Belief Model (HBM) digunakan sebagai kerangka kerja teoretis yang membentuk dasar intervensi untuk meningkatkan self-efficacy pada ibu hamil dengan GDM. Studi ini menganalisis hubungan antara efikasi diri dan manajemen diri dalam pengendalian diabetes gestasional pada ibu hamil. Artikel ini adalah tinjauan pustaka dengan menerapkan metode pencarian literatur. Pencarian literatur dilaksanakan melalui tiga basis data yaitu PubMed, Scopus, dan Google Scholar, yang mencakup artikel-artikel yang …

Implementation Of Emr System In Indonesian Health Facilities: Benefits And Constraints – A Case Study Of Two Clinics In Central Java, Rasyid Juliansyah, Bukhori Aqid, Andien Putri Salsabila, Kurnia Nurfiyanti

Journal of Indonesian Health Policy and Administration

This paper delves into the widespread implementation of Electronic Medical Records (EMR) within healthcare facilities across Indonesia. It addresses the challenges encountered by clinic owners and healthcare providers in transitioning to these digital systems. The study is supported by empirical data collected through a mixed-method approach, combining internal data from Klinik Pintar with qualitative validation from key stakeholders responsible for clinic operations. The research focuses on two case studies: Lembaga Pemasyarakatan (LAPAS) II Purwokerto Clinic and Palang Merah Indonesia (PMI) Purbalingga Clinic, where the adoption of EMR is analyzed in terms of efficiency, compliance with regulatory standards set by the …

The Role Of Social Support In Protecting Against Perinatal Depression Among Egyptian Women, Radwa Raafat Abdelshafi

Theses and Dissertations

Perinatal Depression (PND) is a global public health issue affecting many women as they transition to motherhood, and carrying detrimental consequences for both mothers and infants. Research in low and middle-income countries shows higher PND prevalence rates than in high-income and Western countries. In addition, social support has been shown to strongly protect or reduce the impact of PND. This study aimed to address a gap in research on PND in Egypt, and to build an understanding of the social support ecological system of new mothers. A survey was conducted with 81 first-time middle-class mothers living in Greater Cairo between …

Determinants Of Physicians' Brain Drain In Egypt, Mennatallah Elbeheiry

Theses and Dissertations

Egypt is enduring a significant shortage of physicians, despite the annual graduation of approximately 10,000 medical students from its 27 medical schools. In 2016, the physician density was alarmingly low, with only one doctor per 12,285 people. This shortage is exacerbated by a physicians’ brain drain, as Egypt is a leading exporter of physicians to countries like the United Kingdom and Australia. As of 2020, the Egyptian Medical Syndicate reported 212,835 registered physicians, yet 56 percent of them work abroad, and only about 62,000 are actively employed in public hospitals, serving a population of over 110 million. The government’s efforts …

Ask The Experts: Community Engagement Studios To Inform Research On Cannabis Use In Cancer Symptom Management, Brittney Greene, Grace Mckenzie, Keenan Gibbons, Salimah Meghani, Brooke Worster, Rebecca Ashare

Institute of Emerging Health Professions Faculty Papers

AIM: Despite one-third of patients with cancer using cannabis for symptom management, little is known about their access to and usage of cannabis. Community Engagement (CE) studios involving community experts with chronic health conditions were used to inform a qualitative study on access to and use of cannabis products among patients with cancer.

METHOD: We conducted two 2-hour CE studios with residents from Western NY (WNY) (N = 18). Our sample primarily included White and Black residents (56% vs. 39%). After a researcher-led 10-minute presentation, a community facilitator led the discussion, which focused on questions about challenges to cannabis …

Peningkatan Pengetahuan Dan Sikap Siswa Sdn 146/Iv Kota Jambi Tentang Phbs Indikator Cuci Tangan Pakai Sabun Melalui Media Ular Tangga, Yulti Syaridayanti, Puspita Sari, Vinna Rahayu Ningsih

Perilaku dan Promosi Kesehatan : Indonesian Journal of Health Promotion and Behavior

Background. The lack of knowledge and attitudes among students regarding the PHBS indicator of handwashing with soap in schools can lead to various health problems, therefore, it is necessary to use engaging media such as snakes and ladders to educate students.

Objective. To determine how the snake and ladder media affects the knowledge and attitudes of SDN 146/IV Kota Jambi students regarding PHBS indicators of handwashing with soap.

Method. Quantitative research with a pre-experimental method of one group pre and post-test design. The treatment was in the form of health education intervention using snakes and ladders media. …