Medicine and Health Sciences Commons^™

Examining The Association Of Type 2 Diabetes Mellitus Risk Factors Between African Immigrants Living In The United States And African Americans Born In The United States, Philip Effiong

Walden Dissertations and Doctoral Studies

The purpose of the study was to investigate the risk factors for Type 2 diabetes mellitus (T2DM) among African immigrants and African Americans born in the United States to identify differences and similarities in their impact and prevalence. Variables considered as potential differentiators included alcohol consumption, income, educational levels, and smoking habits, age, and gender. The health belief model served as the theoretical framework. Utilizing data from the National Health and Nutrition Examination Survey 2015-2016, logistic regression analyses were used to test for significant factors affecting T2DM prevalence in these groups. Results indicated that country of origin did not predict …

Performance Of Stunting Reduction Acceleration Team: An Explorative-Qualitative Study In Indonesia-Timor Leste Border Area, Maria Paula Marla Nahak, Veronika Nitsae

Kesmas

Stunting is a complex issue influenced by multiple factors, including specific factors within and outside the health sector. Achieving a significant reduction in stunting needs the involvement of relevant local government offices in the Stunting Reduction Acceleration Team (SRAT). This study aimed to investigate SRAT performance in a specific context of accelerating stunting reduction in Malaka District. This qualitative study, with a phenomenological approach, was conducted in Malaka District, Indonesia, and Timor Leste Border Area from July to September 2023. This study revealed four major themes of SRAT performance to accelerate stunting reduction in Malaka District: activities to accelerate stunting …

Spatial Durbin Model On The Utilization Of Delivery At Health Facilities: A 2017 Indonesian Demographic And Health Survey Analysis, Indah Sri Wahyuni, Ira Gustina, Martya Rahmaniati Makful, Tris Eryando

Kesmas

The utilization of delivery at health facilities is a major intervention in reducing 16 to 33% of deaths. This study aimed to determine the model of utilization of delivery at health facilities in Indonesia in 2017 and its influential factors. This study used secondary data from the 2017 Indonesian Demographic and Health Survey using a Spatial Durbin Model (SDM) approach. The population was mothers aged 15 – 49 years, spread across 34 provinces of Indonesia, and had 15,321 samples. The results showed that the Moran’s I value was positive (0.146) and significant at p-value = 0.007, indicating clustered regions with …

Mapping For Tracking Sexually Transmitted Infections By Subdistricts In Surabaya, Indonesia, Destri Susilaningrum, Brodjol Sutijo Suprih Ulama, Fausania Hibatullah, Diandra Soja Anjani

Kesmas

The 2014 shutdown localization of prostitution in Surabaya City, East Java Province, Indonesia, has given rise to an illegal prostitution industry, resulting in the spread of uncontrolled sexually transmitted infections (STIs). Mapping needs to be done to track the spread of the disease. This study used secondary data on STIs in 2020 from the Surabaya City Health Office. By using biplot analysis, this study sought to offer a detailed understanding of the distribution and dynamics of STI cases in different parts of Surabaya. The early-stage syphilis was found in Tegalsari and Krembangan Subdistricts; then, gonorrheal urethritis was found in Tandes, …

Exploring The Implementation Of Safety Resilience Assessment In Industries: A Systematic Literature Review, Mufti Wirawan, Fatma Lestari, Zulkifli Djunaidi, Azka Hafia, Agra Mohamad Khaliwa, Muhammad Schehan Al Azhar

Kesmas

Safety Resilience discusses how a work process can run properly not only aims at preventing adverse events, but also increasing work productivity and effectiveness by increasing resilience. The concept of resilience has been widely suggested as safety management due to its ability to support organizations to continue operating even when facing unexpected demands or scale disruptions by improving their day-to-day performance. This study used a systematic literature review to explore the implementation of safety resilience in various industries. The results showed that 50% of articles used the Resilience Assessment Grid instrument to measure safety resilience in the workplace. In brief, …

Exploring The Multifaceted Nature Of Occupational Stress Among Nurses: A Systematic Review, Bala Murali Sundram, Suriya Kumareswaran Vallasamy, Umairah Muhadi

Kesmas

This systematic review examined occupational stress among nurses, its multifaceted nature, and its significant impact on healthcare delivery and nurse well-being globally. This study identified various stressors, including intrinsic job factors, organizational structure, role expectations, interpersonal relationships, and career development. Using the Cooper and Marshall stress model, a thorough literature search was conducted across databases like ISI Web of Knowledge, PubMed, Scopus, Ovid Medline, and Google Scholar, focusing on publications from 2010 to 2023. This rigorous approach included diverse research methodologies, emphasizing studies measuring outcomes related to occupational stress and mental health among nurses. A total of 10 studies met …

Analysis Of Factors Affecting Hospital Risk Management In Indonesia: The Sem-Pls Approach, Dihartawan Dihartawan, Fatma Lestari, Baiduri Widanarko, Besral Besral

Kesmas

Healthcare workers, especially those in hospitals, face a variety of complex hazards and exposures. One of the essential aspects of reducing risks and dangers is effective risk management. This study used a cross-sectional approach to survey the implementation of occupational health and safety management systems in Indonesian hospitals and to identify factors predisposing hospital risk management in Indonesia. A purposive sampling method was employed to select 90 hospitals distributed across 10 provinces in Indonesia. Data were analyzed using descriptive analysis, correlation, and SEM-PLS. A total of 44 hospitals (48.9%) had complete status plenary, and the majority were type C hospitals …

Vaccine Uptake And Intentions: Insights From A Texas Survey On Factors Influencing Covid-19 Vaccination Decisions, Yordanos M Tiruneh, Paula M Cuccaro, Kimberly S Elliott, Jing Xie, Journey Martinez, Mark Owens, Christian R Alvarado, Jose-Miguel Yamal

Faculty, Staff and Student Publications

The effectiveness of COVID-19 vaccines depends on widespread vaccine uptake. Employing a telephone-administered weighted survey with 19,502 participants, we examined the determinants of COVID-19 vaccine acceptance among adults in Texas. We used multiple regression analysis with LASSO-selected variables to identify factors associated with COVID-19 vaccine uptake and intentions to receive the vaccine among the unvaccinated. The prevalence of unvaccinated individuals (22%) was higher among those aged 18-39, males, White respondents, English speakers, uninsured individuals, those facing financial challenges, and individuals expressing no concern about contracting the illness. In a fully adjusted regression model, higher odds of being unvaccinated were observed …

Individual Longitudinal Changes In Dna-Methylome Identify Signatures Of Early-Life Adversity And Correlate With Later Outcome, Annabel K. Short, Ryan Weber, Noriko Kamei, Christina Wilcox Thai, Hina Arora, Ali Mortazavi, Hal S. Stern, Laura M. Glynn, Tallie Z. Baram

Psychology Faculty Articles and Research

Adverse early-life experiences (ELA) affect a majority of the world's children. Whereas the enduring impact of ELA on cognitive and emotional health is established, there are no tools to predict vulnerability to ELA consequences in an individual child. Epigenetic markers including peripheral-cell DNA-methylation profiles may encode ELA and provide predictive outcome markers, yet the interindividual variance of the human genome and rapid changes in DNA methylation in childhood pose significant challenges. Hoping to mitigate these challenges we examined the relation of several ELA dimensions to DNA methylation changes and outcome using a within-subject longitudinal design and a high methylation-change threshold. …

Multifactoral Immune Modulation Potentiates Durable Remission In Multiple Models Of Aggressive Malignancy, Matthew M Halpert, Briana A Burns, Spencer R Rosario, Henry G Withers, Akshar J Trivedi, Colby J Hofferek, Benjamin D Gephart, Haotong Wang, Jonathan Vazquez-Perez, Sharon B Amanya, Sean T Hyslop, Jianhua Yang, Jan O Kemnade, Vlad C Sandulache, Vanaja Konduri, William K Decker

Faculty, Staff and Students Publications

Tumors typically lack canonical danger signals required to activate adaptive immunity and also frequently employ substantial immunomodulatory mechanisms that downregulate adaptive responses and contribute to escape from immune surveillance. Given the variety of mechanisms involved in shielding tumors from immune recognition, it is not surprising that single-agent immunomodulatory approaches have been largely unsuccessful in generating durable antitumor responses. Here we report a unique combination of immunomodulatory and cytostatic agents that recondition the tumor microenvironment and eliminate complex and/or poor-prognosis tumor types including the non-immunogenic 4T-1 model of TNBC, the aggressive MOC-2 model of HNSCC, and the high-risk MYCN-amplified model of …

Design And Evaluation Of Scancap: A Low-Cost, Reusable Tethered Capsule Endoscope With Blue-Green Illumination Imaging For Unsedated Screening And Early Detection Of Barrett's Esophagus, Cheima Hicheri, Ahad M Azimuddin, Alex Kortum, Joseph Bailey, Yubo Tang, Richard A Schwarz, Daniel Rosen, Shilpa Jain, Nabil M Mansour, Shawn Groth, Shaleen Vasavada, Ashwin Rao, Adrianna Maliga, Leslie Gallego, Jennifer Carns, Sharmila Anandasabapathy, Rebecca Richards-Kortum

Faculty, Staff and Students Publications

Esophageal carcinoma is the sixth-leading cause of cancer death worldwide. A precursor to esophageal adenocarcinoma (EAC) is Barrett's Esophagus (BE). Early-stage diagnosis and treatment of esophageal neoplasia (Barrett's with high-grade dysplasia/intramucosal cancer) increase the five-year survival rate from 10% to 98%. BE is a global challenge; however, current endoscopes for early BE detection are costly and require extensive infrastructure for patient examination and sedation. We describe the design and evaluation of the first prototype of ScanCap, a high-resolution optical endoscopy system with a reusable, low-cost tethered capsule, designed to provide high-definition, blue-green illumination imaging for the early detection of BE …

Charting A Path To The Quintuple Aim: Harnessing Ai To Address Social Determinants Of Health, Yash Shah, Zachary Goldberg, Erika Harness, David Nash

College of Population Health Faculty Papers

The Quintuple Aim seeks to improve healthcare by addressing social determinants of health (SDOHs), which are responsible for 70-80% of medical outcomes. SDOH-related concerns have traditionally been addressed through referrals to social workers and community-based organizations (CBOs), but these pathways have had limited success in connecting patients with resources. Given that health inequity is expected to cost the United States nearly USD 300 billion by 2050, new artificial intelligence (AI) technology may aid providers in addressing SDOH. In this commentary, we present our experience with using ChatGPT to obtain SDOH management recommendations for archetypal patients in Philadelphia, PA. ChatGPT identified …

Medical Student Simulation Curriculum: A Quality Improvement Initiative, Catherine Shield, Caitlin Witt, Megan Molina, Jaclyn Locklear

Quality Improvement & Patient Safety Forum

No abstract provided.

Standardization Of Screening And Inpatient Management Of Abnormal Uterine Bleeding, Kayla Griese, Mariah Humphrey, Jantzen Collette, Heather Valdin

Quality Improvement & Patient Safety Forum

No abstract provided.

Standardizing Inpatient Anti-Emetic Management For Chemotherapy Induced Nausea And Vomiting In The Pediatric Oncology Setting: A Quality Improvement Project, Heather Valdin, Mackenzie Creamer, Cori Morrison, Zachary Leblanc

Quality Improvement & Patient Safety Forum

No abstract provided.

Standardizing And Improving Hie Management, Michael Evers, Michelle Knecht, Christy Mumphrey, Raegan Gupta

Quality Improvement & Patient Safety Forum

No abstract provided.

Improving Documentation Of Age-Appropriate Health Care Maintenance For All Adults In The Louisiana State University Health Sciences Center Of New Orleans Combined Internal Medicine/Pediatrics Continuity Clinic, Lauren Deleon, Emily Riley, Nataliya Khimitch

Quality Improvement & Patient Safety Forum

No abstract provided.

Improving Language Concordance For Discharge Instructions For Patients And Caregivers With Spanish Language Preference, Morgan Viviano, Hope Retif, Riley Jay, Caroline Roth

Quality Improvement & Patient Safety Forum

No abstract provided.

Optimizing A Remote Patient Monitoring Program For Hypertensive Disorders In Pregnancy, Stacey Holman, Christopher Raff, Angela Bradley-Byers, Tabitha Quebedeaux

Quality Improvement & Patient Safety Forum

No abstract provided.

2024 Qi Forum Agenda, Equip Program Office Ogme

Quality Improvement & Patient Safety Forum

No abstract provided.

Policy Implementation Analysis Of Antenatal Care Services At Puskesmas Negara Ratu And Puskesmas Cempaka Kabupaten Lampung Utara, Willyana Syafriyanti, Anhari Achadi

Journal of Indonesian Health Policy and Administration

The Ministry of Health has issued Minister of Health Regulation Number 21 of 2021 to strengthen maternal health services, which regulates health services during pregnancy (antenatal). The Minister of Health's regulation states that antenatal care is carried out at least six times, 2 (two) of which are examinations with a doctor using an Ultra Sonography (USG) device. Community health centers as primary services are expected to be able to provide antenatal services according to standards. The North Lampung Health Service has distributed ultrasound equipment to community health centers in the North Lampung Regency to support the implementation of antenatal services. …

Balancing Community And Individual Health Efforts By Utilizing Sub-Primary Health Care At Regions: Analysis For Policy, Rocky Setya Budi, Wiku Bakti Bawono Adisasmito, Adang Bachtiar, Elvi Rosanti

Journal of Indonesian Health Policy and Administration

Public Health Centers (PHCs) are responsible for organizing public health efforts and individual health efforts. PHCs also serve as FKTP, UPTD, sub-district supervisors, and implementers of policies and programs from the Ministry of Health. The workload of PHCs is increasing because people visit PHCs primarily for treatment, rather than seeking preventive measures to stay healthy. The PHCs have Sub-PHCs to lighten the workload of the PHCs, but there is no policy regulating Sub-PHCs to be used as FKTP. This research aims to analyze the policy of Balancing Community and Individual Health Efforts by utilizing Sub-PHCs such as FKTP. The research …

Policy Content Analysis In Minister Of Health Regulation Number 15 Of 2016 About Hajj Health Istithaah, Salman Mauluddin Idris, Atik Nurwahyuni

Journal of Indonesian Health Policy and Administration

Indonesia has the world's largest Muslim population and sends the most pilgrims to Saudi Arabia. The Hajj Health Istithaah Policy in Minister of Health Regulation Number 15 of 2016 is the government's effort to carry out health screening for pilgrims before leaving so that they can perform the Hajj in a healthy and independent condition. This research was conducted using a qualitative approach by collecting data through in-depth interviews and document reviews. In this study, Walt and Gilson's Policy Triangle Model was used as a reference for reviewing the Hajj health istithaah policy, especially in the content section of the …

A Qualitative Exploration Of Well-Being In Cancer Survivorship: Implications For Counselors, Hallie M. Sylvestro, Lindsey K. Umstead, Heather Delgado, Christopher Lawrence, Keith Mobley, Kelly L. Wester, Andrew Wood

Adultspan Journal

Adult cancer survivors represent an important–and growing–population that could benefit from counseling services. This study employed consensual qualitative research to examine the well-being experiences of eight cancer survivors. Findings suggest a broad range of changes to individual well-being following cancer diagnosis and treatment, and indicate counseling can provide an ideal setting for processing such changes. Recommendations for counseling practice and future research are provided.

Homologous Recombination Deficiency Should Be Tested For In Patients With Advanced Stage High-Grade Serous Ovarian Cancer Aged 70 Years And Over, Omali Pitiyarachchi, Peter J. Ansell, Robert L. Coleman, Minh H. Dinh, Laura Holman, Charles A. Leath, Theresa Werner, Paul Disilvestro, Mark Morgan, William Tew, Christine Lee, Mary Cunningham, Meredith Newton, Babak Edraki, Peter Lim, Joyce Barlin, Nicola M. Spirtos, Krishnansu S. Tewari, Mitchell I. Edelson, Thomas Reid, Jay Carlson, Michael Friedlander

Abington Jefferson Health Papers

OBJECTIVE: Due to limited data on homologous recombination deficiency (HRD) in older patients (≥ 70 years) with advanced stage high grade serous ovarian cancer (HGSC), we aimed to determine the rates of HRD at diagnosis in this age group.

METHODS: From the Phase 3 trial VELIA the frequency of HRD and BRCA1/2 pathogenic variants (PVs) was compared between younger (< 70 years) and older participants. HRD and somatic(s) BRCA1/2 pathogenic variants (PVs) were determined at diagnosis using Myriad myChoice® CDx and germline(g) BRCA1/2 PVs using Myriad BRACAnalysis CDx®. HRD was defined if a BRCA PV was present, or the genomic instability score (GIS) met threshold (GIS ≥ 33 & ≥ 42 analyzed).

RESULTS: Of 1140 participants, 21% were ≥ 70 years. In total, 26% (n = 298) had a BRCA1/2 PV and HRD, 29% (n = 329) were HRD/BRCA wild-type, 33% (n = 372) non-HRD, and 12% HR-status unknown (n = 141). …

Management Overview Of The Lung Tuberculosis Control Program At The Dki Jakarta Provincial Health Office In 2023, Mutiara Kiranti, Helen Andriani

Journal of Indonesian Health Policy and Administration

Tuberculosis is one of the infectious diseases that is fatal if not cured immediately. In 2022, the success rate of tuberculosis treatment in DKI Jakarta Province is 81%, while the national target is 90%. In the field, the number of cadres to carry out contact investigations is still insufficient, so that in 2022 the coverage of contact investigations in DKI Jakarta Province will only reach 25%, while the national target is 90%. To increase the scope of successful treatment, the government should try to overcome tuberculosis, which is needed. Proper program management is required to run effectively and efficiently for …

Island Health Crisis: Bridging Gaps In Indonesia's Healthcare Deserts, Joyce Mangoma, Wahyu Sulistiadi

Journal of Indonesian Health Policy and Administration

This narrative literature review examines critical healthcare challenges in Indonesia's island communities, focusing on workforce shortages, inadequate health infrastructure, and the profound impact of geographical and socioeconomic factors. Drawing from eight studies published between January 2000 and December 2023, the discussion highlights both the strengths and weaknesses of existing research. The studies were selected based on their relevance to healthcare issues in island communities, rigorous methodological approaches, and significant insights into healthcare challenges and solutions. This time frame was chosen to encompass a comprehensive evolution of healthcare challenges and responses, particularly considering the effects of the COVID-19 pandemic. Grounded in …

Tracking Population Decline In India Between 1950-2023 And Total Deaths Cases By Cause – A Case Study, Sumayya Rehaman Research Scientist

International Journal of Health and Allied Sciences

The Case study digs the facets of the India’s population decline from 1950-2023. Focusing Total fertility rate recorded 2.0 per woman in 2023 as similar as Birth Rate since 1950-2023 and found to be 16.9 births per 1000 people in 2023. Contradictorily, may surpass China’s population in Future. It focuses Population pyramid with annual Percent growth rate divulges Main cities population and exemplifies death occurrence. The median age - 28.7 years, life expectancy - 70.4 years, Infant Mortality Rate - 26.6 deaths per 1000 live births, with 3.89% in 2023.This study reveals comparative illustrative graphs of Indian Population 1950-2023.

Early Outcomes Of Mr-Guided Sbrt For Patients With Recurrent Pancreatic Adenocarcinoma, Spencer Poiset, Sophia Shah, Louis Cappelli, Rani Anné, Karen Mooney, Maria Werner-Wasik, Talya Laufer, James Posey, Daniel Lin, Atrayee Mallick, Harish Lavu, Babar Bashir, Charles Yeo, Adam Mueller

Kimmel Cancer Center Faculty Papers

BACKGROUND: Local treatment options for locally recurrent pancreatic adenocarcinoma (LR-PAC) are limited, with median survival time (MST) of 9-13 months (mos) following recurrence. MRI-guided stereotactic body radiation therapy (MRgSBRT) provides the ability to dose escalate while sparing normal tissue. Here we report on the early outcomes of MRgSBRT for LR-PAC.

METHODS: Patients with prior resection of pancreatic adenocarcinoma with local recurrence treated with MRgSBRT at a single tertiary referral center from 5-2021 to 2-2023 were identified from our prospective database. MRgSBRT was delivered to 40-50 Gy in 4-5 fractions with target and OAR delineation per institutional standards. Endpoints included local …

Latinas In The United States Facing Healthcare Access Challenges In A Mid-Size Urban Community, Nathan M. Lee, Deborah Kessler

Journal of Global Awareness

This study examines the discrepancies and underlying factors in access to healthcare resources regarding breast and cervical cancer for Latinas in a mid-sized urban midwestern community. A survey was conducted at clinics hosted by a local non-profit organization, and forty participants completed surveys for this study (n=40). Bivariate correlation analysis in SPSS determined that significant positive correlations were found between the subjects’ knowledge of the signs and symptoms of cervical cancer and their knowledge of the recommended frequency of receiving pap smears (p