Medicine and Health Sciences Commons^™

The Hazard Prediction Problem, Mary E. Helander, Brendan Smith, Sylvia Charchut, Erika Swiatowy, Calvin Nau, Gregory Cavaretta, Timothy Schuler, Adam Schunk, Héctor Ortiz-Peña

Social Science - All Scholarship

This work formulates the hazard prediction problem while addressing the research question: Can machine learning create a model to automatically recognize patterns that correspond to hazard state conditions during a mission-critical operation? Supervised learning models were trained and tested on data observed from mission simulators, which allowed for safe observation of dynamic system states and undesirable casualty events. The prediction task was formulated as a binary classification problem, producing the probability of being in a hazard state at time t and providing situational awareness of a possible imminent loss. Several modeling architectures were investigated: neural networks, logistic regression, a support …

The Bradley-Terry Model In Binary Outcome Driven Rankings: An Apllication In Amateur Hockey, Connor Meissner, Jeremy M. Losak

Sport Management - All Scholarship

Ranking systems serve critical roles in sport settings, most notably in determining playoff participants and seeding. Numerous ranking methodologies exist that incorporate many input measures and produce models that are highly predictive of game outcomes. However, there are circumstances—especially for amateur sport leagues—in which more complex inputs are either unavailable or not desirable, as they may lead to adverse performance incentives. Therefore, the goal of this paper is to highlight a ranking methodology that only considers binary game outcomes, i.e., wins and losses. Specifically, we consider the efficacy of the Bradley-Terry Model to rank sport teams for playoff consideration. We …

The Impact Of Technological Innovation On Deaf And Hard Of Hearing Communities, Mickayla Cooper Kwakye-Ndlovu

Honors College Theses

Over the past couple of decades, significant shifts have occurred in technological development. Among these advancements, the smartphone has emerged as an integral part of people’s daily lives, serving as a powerful tool for accessibility and global connectivity. This literature review explores the ways in which everyday communication technology is utilized by Deaf and Hard of Hearing (DHH) individuals and examines the impact of its development on these communities. The goal of the work is to investigate how the evolution of modern smartphones contributes to breaking down communication barriers for DHH communities. This review focuses on smartphone features that enhance …

Comparisons Of Unilateral And Limb Symmetry Indexes Between Fixed Dynamometry Testing Modes, Emily E. Frizzell

Honors College Theses

Hamstring muscles strains are extremely common and can vary in severity. The biarticular structure of the hamstring groups is one reason that they are more susceptible to injuries. The recurrence of these injuries is also common even after they have been through a rehabilitation phase in their recovery. This project aims to compare and associate knee flexion and extension muscle performance characteristics between isometric, isotonic, and isokinetic assessment modes. These different modes of assessment will test analyze muscle performance under varying muscle lengths, movement velocities and biomechanical load modes. The data collected from this testing will be analyzed to see …

Physicians And The Holocaust: Book Of Responses, Quotes, Reflections, Yanil Ramirez

Physicians and the Holocaust Student Books

A book of responses, quotes, and reflections written for Physicians and the Holocaust course.

Postpartum Abdominal Binder Use For Pain Management After Vaginal Delivery – A Randomized Controlled Trial, Laura A. Bute, Elena Fuell-Wysong, Vijay K. Rings, Samantha M. Younglove, Rose A. Maxwell, Sheela Barhan

Obstetrics and Gynecology Faculty Publications

Objective: To investigate the impact of abdominal binder plus usual care versus usual care alone 26 after spontaneous vaginal delivery on pain severity scores. 27 28 Methods: A prospective randomized study was performed, recruiting patients on a Labor and 29 Delivery unit who were anticipating spontaneous vaginal delivery from 2019 to 2022. Patients 30 were randomly assigned to receive an abdominal binder plus usual care or usual care alone 31 within two hours postpartum. Primary outcomes were patient-reported immediate postpartum 32 pain score and average daily pain scores on days 0 and 1 postpartum (using a scale from 0 to …

The Impact Of Mental Healthcare Access On Community Safety, David Buchinsky, Caroline Watts

Scholarship in Medicine - All Papers

Mental health illness is a pressing American public health concern. Approximately one in five Americans is diagnosed with a mental health condition.1 While cost, location, and physician shortage play a role in one’s access to mental healthcare, research is still determining the effects of mental healthcare access on community safety. Using County Health Rankings (CHR), we analyze the changes in mental health providers between 2016 and 2022 in Alabama and Massachusetts, two states with differing rankings in access to mental healthcare and firearm legislation. We then investigate how access to mental health providers affects community safety (firearm fatalities, suicide rates, …

Insufficient Sleep In Ohio And Its Complication In Risky Behaviors, James Dai, Jackson Mitchell

Scholarship in Medicine - All Papers

Background Insufficient sleep is a major public health concern in the United States. Lack of sufficient sleep causes impaired decision making that can increase the chance of participating in risky behavior. Methods County Health Rankings data from Ohio in 2016 and 2022 were reviewed for percentage of insufficient sleep and risky behaviors. We identified excessive alcohol use, driving deaths due to alcohol, drug overdose mortality, and percentage of smokers as risky behaviors. Urban and rural counties were identified via HRSA. Results: There was a significant increase in insufficient sleep from 2016 to 2022 in Ohio. Smoking and drug overdose mortality …

Positive Correlation Of Smoking Percentage And Mentally Unhealthy Days In Ohio 2016-2022, Kevin Williams, Matt Crudele

Scholarship in Medicine - All Papers

There is substantial research regarding the negative physical side effects of smoking, such as increased risk of developing hypertension or chronic obstructive pulmonary disease. Smoking rates are substantially higher among those with a pre-existing mental illness (such as schizophrenia or generalized anxiety disorder)1. Additionally, second-hand smoke exposure among non-smokers has been attributed to an increased risk of developing symptoms of poor mental health (such as anxiety or depression)2,3. It has also been shown that smoking cessation leads to improved mental health4. However, there is limited research regarding the negative effects of smoking on mental health, especially in the state of …

The Relationship Between Being Uninsured And Having Poor Health Outcomes And Experiences In Eastern Kentucky, Danielle Adams, Amber Todd

Scholarship in Medicine - All Papers

Objective: To examine health insurance and health outcome disparities in Eastern Kentucky since Kentucky’s implementation of the Affordable Care Act. Methods: Using data from County Health Rankings and Roadmap, rates of uninsurance will be compared before and a decade after implementation of the ACA in Kentucky (2013 and 2023). In addition, prevalence of certain health outcomes in Eastern Kentucky will be compared from 2013 and 2023 and correlation established between uninsured rates and particular health outcomes for 2023. Results: Since 2013, the percentage of those uninsured in Eastern Kentucky has seen a significant decline. While there is no correlation between …

Regional Disparities In Hispanic/Latino Health Outcomes: A Comparative Analysis Of The Midwest And Top Hispanic Population States, Julian Aviles, Marcelo Hyczy Dacosta Neto

Scholarship in Medicine - All Papers

Background: Hispanic/Latino communities in the United States face significant health disparities and poorer health outcomes compared to non-Hispanic whites. While previous research has documented these inequalities at the national level, it is unclear whether certain regions exhibit more substantial disparities than others. Hypothesis/Research Question: This study aims to investigate whether counties in Midwest states with higher rates of health inequalities and unfavorable outcomes have compared to counties in the top 3 states by Hispanic/Latino population percentage. Methods: Using County Health Rankings, we examined counties in Midwest states (Ohio, South Dakota, and North Dakota) and counties within high Latino population states …

A Systematic Study Of Freezing Behavior In Earthworms In Response To Auditory And Vibratory Stimuli, Navjot Singh, A. Burton, Dragana Ivkovich Claflin

Celebration of Undergraduate & Graduate Research, Scholarship, and Creative Activities Materials

This study examined the parameters needed to reliably induce a freezing fear response to a predator-like auditory stimulus in the earthworm species Eisenia Fetida. Previous work from our lab found that a grunting noise was more reliable in causing freezing compared to a mole sound, i.e. artificial versus natural predators of E. Fetida (Worthen et al., 2024). In the present study, 8 amplitude levels of grunting sound were presented in either serial or random order. The speaker location was varied so that it either did or did not touch the apparatus, thus producing a mechanical vibration in addition to the …

A Case Study In Prospective Program Evaluation, Sarai Rosemary Combs

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Evaluation is a helpful tool in public health to provide transparency about community interventions and programs. The following is a prospective evaluation of a case study, looking at a recently designed program by the Lexington-Fayette County Health Department, as a capstone project for the Health Management and Policy concentration of the Masters in Public Health program of the College of Public Health. The health department developed a series of online training modules to increase knowledge of Methicillin-resistant staphylococcus aureus (MRSA) and other similar organism outbreaks and how to respond to these outbreaks. The program targets were Fayette County Public School …

Characteristics Of Congenital Syphilis Cases In Kentucky 2019-2023, Ines Roy

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Abstract:

Background: The incidence of congenital syphilis (CS) has increased both in the United States (US) and globally and remains a public health concern. In Kentucky alone, there has been a significant increase in CS cases, from 9 cases in 2019 to 27 cases in 2023. CS is a preventable disease, but testing and immediate treatment are critical to prevent its spread. We have limited knowledge regarding Kentucky’s characteristics and behavioral factors that may be associated with this rise. The goal of this study is to identify characteristics and potential risk factors that contribute to the rise of CS in …

The Distribution Of Cp-Cre Cases From 2013-2020 In The Commonwealth Of Kentucky, Hannah Hiscox

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Multidrug-resistant organisms (MDROs), particularly Carbapenem-Resistant Enterobacterales (CRE), pose a significant threat to public health due to their resistance to multiple antibiotics, including carbapenems. CRE infections, especially those producing carbapenemases (CP-CRE), are associated with high morbidity and mortality rates, making them a growing concern in healthcare settings. Despite the prevalence of CRE infections in the United States, limited data exist on the incidence and distribution of CP-CRE infections in specific regions, such as the Appalachian counties of Kentucky.

This study aimed to investigate the cumulative incidence and distribution of CP-CRE cases in Appalachian and non-Appalachian counties of Kentucky, as well as …

A Case Study In Program Evaluation, Iantha Wright

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

The framework for program evaluation is a systematic way of improving and accounting for public health actions by providing practical, feasible, ethical, and accurate information. As a practical, non-prescriptive tool, it guides public health professionals through the essential steps in program evaluation. The framework uses the six steps to understand how to improve and conduct assessments effectively. Additionally, it emphasizes integrating stakeholders and using ongoing evaluation strategies to plan effective interventions, improve existing programs, and demonstrate the efficient use of resources.

Demographic And Behavioral Characteristics Of People Who Help Others Inject Drugs: A Study Of People Who Inject Drugs In Appalachia Kentucky, Ryli Hockensmith

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Aim: This study aims to understand the demographic and behavioral characteristics of people who inject drugs (PWID) who assist others with injection, hereafter “injection assistors,” and assess the characteristics of injection assistors compared to PWID who do not assist others with injection in Appalachian Kentucky.

Methods: A cross sectional secondary data analysis of data collected from 433 PWID enrolled in the ongoing Kentucky Outreach Service (KyOSK) was performed. Logistic regression analyses were performed to compare injection assistors to those who do not assist others on demographic, behavioral, service usage, and harm reduction characteristics.

Results: In total, 128 (29%) PWID reported …

Mail-Based Or Home Delivery Services: Preferences Among People Who Inject Drugs In Appalachian Kentucky, Su Su Zin

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Aim: To explore acceptability of delivery-based syringe services program (SSP) among people who inject drug (PWID) in Eastern Kentucky and compare those who wanted to participate in delivery-based SSP to those who did not.

Methods: This was a cross-sectional analysis of data from PWID who injected drugs to get high in the past 30 days (n=246) collected during the baseline assessment administered to the Gateway2Health cohort. Chi-square tests, t-tests, univariate and multivariable logistic regressions were calculated between independent variables and the outcome variable (likelihood of participating in a delivery-based SSP).

Results: 52.9% of PWID reported being likely to participate in …

Human Papilloma Virus Type 16 Seroprevalence Among Men Living With Hiv, Ashley Duff

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Objectives: Individuals living with HIV are at a higher risk for developing human papillomavirus-driven oropharyngeal cancer (HPV-OPC). There are no methods for early detection; however, HPV16 E6 antibodies have been identified as a promising early marker. The objective of this study was to evaluate seroprevalence and predictors of HPV16 E6 seropositivity among men living with HIV.

Methods:2,334 men aged 40+ living with HIV with blood specimens banked within the Tennessee Center for AIDS Research (TN-CFAR) biorepository were evaluated using HPV multiplex serology. Seroprevalence of HPV16 antibodies was calculated for all HPV16 proteins analyzed (L1, E1, E2, E4, E6, E7). …

A Case Study In Program Evaluation, Sierra L. Williams

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

The Lexington-Fayette County Health Department (LFCHD) developed an education program targeted toward infectious disease outbreaks. The program ensures timely reporting and action during an infectious disease outbreak within the Fayette County Public Schools (FCPS) system. I have been tasked with evaluating the program and its implementation of training modules through pre and post-surveys to determine if the program is significantly increasing the overall knowledge of program participants and make recommendations for how program aspects can be improved.

Program Evaluation Case Study, Grace Mullikin

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Program evaluation case study utilizing Center for Disease Control and Prevention's Case Evaluation Framework.

Survey Of Pain Curriculum Among Entry-Level Occupational Therapy Programs In The United States, John V. Rider, Vicki Khau, Kristin A. Valdes

Journal of Occupational Therapy Education

Occupational therapy practitioners address pain management across settings, populations, and the lifespan. Occupational therapy practitioners offer unique contributions to pain management through biopsychosocial approaches, targeting supported self-management and occupational engagement. Comprehensive pain education is necessary to prepare entry-level occupational therapy practitioners to address pain in practice, yet no standards exist in entry-level occupational therapy education. This survey describes the status of pain-related education in entry-level occupational therapy programs across the United States. A total of 41 entry-level occupational therapy programs completed the survey. Total instructional time for pain content was reported to be an average of 9.68 hours, ranging from …

The Influence Of Music On The Performance Of Graduate Occupational Therapy Students During Practical Examinations, Chris Mulligan, Marybeth Hoefs, Bonnie Fischer-Camara, Donald F. Graves

Journal of Occupational Therapy Education

Test anxiety is alarmingly rising and has been shown to correlate with academic performance and affect occupations and well-being. Graduate occupational therapy (OT) students encounter a rigorous workload and pressure to become entry-level practitioners. Higher levels of baseline graduate student anxiety is correlated with increased test anxiety. Practical examinations are essential for assessing graduate OT students' higher learning and entry-level clinical skills. Educators are often challenged with identifying coping strategies to assist graduate OT students in reducing their test anxiety. Substantial research supports the use of music to reduce anxiety in adults. Seventy-five OT graduate students participated in this quasi-experimental …

Enhancing Health Professions Students’ Attitudes And Self-Efficacy To Care For Unhoused Populations, Jacob T. Greenfield, Brad Phillips, Kathryn L. Hoffman, Gina M. Baugh

Journal of Occupational Therapy Education

Health professions students, including occupational therapy students, often have limited exposure to unhoused populations, which may alter their attitudes and self-efficacy to participate in their care. In turn, this could reduce access and quality of care for these marginalized groups. The purpose of this study was to evaluate the impact of a phased multimodal learning approach on interprofessional health sciences students’ attitudes and self-efficacy in providing care to unhoused individuals. A pre-posttest single group design was used to evaluate a didactic presentation, poverty simulation, and street-based experiential learning experience. Findings revealed significant differences in students’ (N=257) attitudes and self-efficacy in …

Occupational Balance And Temporal Satisfaction With Life Among Occupational Therapy Students Amid Transitioning To In-Campus Classes In The Philippines, Paolo Miguel P. Bulan, Nikki Y. Pestaño, John Ray O. Suerte

Journal of Occupational Therapy Education

As students transitioned back to on-campus classes, challenges affecting occupational balance (OB) and temporal satisfaction with life (TSWL) influenced their overall health and well-being. This study aimed to assess OB and TSWL among 171 occupational therapy (OT) students in the Philippines and examine the correlation between them. Participants completed the Occupational Balance Questionnaire (OBQ11) and the Temporal Satisfaction with Life Scale (TSWLS). The mean OBQ11 score was 16.71 ± 6.87, with a median score of 17. Based on this median score, nearly half of students 43.90% (n = 75) were classified as having low OB. The TSWLS scores indicated that …

Operationalizing Power In Health Law: The Hospital Abolition Hypothesis, Matthew B. Lawrence

Faculty Articles

This symposium Article describes how prison abolitionist arguments also support the hypothesis that a defining goal of health law should be the abolition of hospitals. Like prison abolitionism, the hospital abolition hypothesis can provide a constructive way to shift the focus of legal analysis from substantive dimensions (in health law — cost, quality, access, and equity) to the dimension of power.

Rethinking Health Law Architecture, Ani B. Satz

Faculty Articles

Neither the individualistic regulatory health paradigm nor the vulnerable populations approach of public health can provide the legal structure necessary to address the most pressing problems in health care today. These approaches fail to address conflicts between individuals and populations as well as challenges to qualifying for care and are in inherent conflict with each other, sometimes within the same statute. As health concerns become more global, it is necessary to move past a vulnerable populations approach to a broader population approach that respects individual choice but does not sacrifice community health for liberty interests.

The Influence Of Drd2 Polymorphism Exon 8 C/T (Rs6276) On Manifestations Of Delirium Tremens & Alcohol Withdrawal Seizures, Naomi Schneider

Honors Theses and Capstones

This study explores the correlation between the DRD2 Polymorphism exon 8 C/T (rs6276) and manifestations of delirium tremens (DT). DT is a condition that is clinically diagnosed utilizing two characteristic symptom manifestations: the presence of delirium and severe alcohol withdrawal. It is not entirely understood why DT can occur in some patients, but evidence has suggested that genetic predisposition can play a role. Utilizing the National Institutes of Health (NIH) All of Us Research database and performing a secondary analysis of existing genomic data, this candidate gene association study aims to determine the genotype frequencies within three cohorts: a healthy …

การศึกษาผลของน้ำมันปลาต่อประสิทธิศักย์และผลข้างเคียงของยาไอโซเตรทติโนอินขนาดต่ำ ในการรักษาสิวปานกลางถึงรุนแรง เปรียบเทียบกับการรับประทานยาไอโซเตรทติโนอินอย่างเดียว, ปานเพชร สังขสัญญา

Chulalongkorn University Theses and Dissertations (Chula ETD)

ไอโซเตรทติโนอินเป็นยารักษาสิวชนิดปานกลางถึงรุนแรง แต่มีข้อจำกัดจากผลข้างเคียง ปัจจุบันพบว่า น้ำมันปลาช่วยลดผลข้างเคียงของยาได้ และการละลายในไขมันได้ดียังอาจช่วยเพิ่มการดูดซึมของยา ทำให้ผลการรักษาสิวดีขึ้น การศึกษานี้มีวัตถุประสงค์เพื่อประเมินประสิทธิศักย์ของยาไอโซเตรทติโนอินขนาดต่ำที่รับประทานร่วมกับน้ำมันปลาในการรักษาสิวปานกลางถึงรุนแรง และผลต่อผลข้างเคียงของยา โดยเป็นการศึกษาแบบสุ่ม เปรียบเทียบแบบปกปิดสองฝ่าย และออกแบบเพื่อพิสูจน์ความไม่ด้อยกว่า (ขอบเขตความไม่ด้อยกว่า = 5) ผู้เข้าร่วมวิจัยอายุ 18–25 ปี ซึ่งมีสิวปานกลางถึงรุนแรง (Investigator Global Assessment; IGA ≥ 3) จะถูกสุ่มให้รับยาไอโซเตรทติโนอิน ขนาด 10 มิลลิกรัม ร่วมกับน้ำมันปลา 1 กรัม หรือยาหลอก รับประทานวันละครั้ง เป็นระยะเวลา 3 เดือน ตัวชี้วัดประสิทธิศักย์ ได้แก่ จำนวนสิว และคะแนน IGA ส่วนผลข้างเคียง ได้แก่ ระดับไตรกลีเซอไรด์ในเลือด ค่าเอนไซม์ตับ และผลข้างเคียงทางผิวหนังและเยื่อเมือก จากผู้เข้าร่วมวิจัยทั้งหมด 75 คน (กลุ่มน้ำมันปลา = 37 คน; กลุ่มยาหลอก = 38 คน) พบว่ากลุ่มที่ได้รับน้ำมันปลาสามารถลดจำนวนสิวทั้งหมดได้ไม่ด้อยกว่ากลุ่มยาหลอก (-6.4; 95%CI: -17.5 ถึง 4.6) และมีการสูญเสียความชุ่มชื้นของผิวน้อยกว่า (ค่าความแตกต่างของ corneometer เฉลี่ย = 8.97; 95% CI: 2.76 ถึง 15.18) นอกจากนี้ ระดับไตรกลีเซอไรด์ในเลือดของกลุ่มน้ำมันปลายังเพิ่มขึ้นน้อยกว่าอย่างมีนัยสำคัญ (–12.6 มก./ดล.; 95% CI: –23.0 ถึง –2.1) สรุป: การใช้น้ำมันปลาร่วมกับยาไอโซเตรทติโนอินขนาดต่ำให้ผลไม่ด้อยกว่ายาเพียงอย่างเดียวในการรักษาสิว อีกทั้งยังมีประโยชน์ในการควบคุมระดับไตรกลีเซอไรด์ในเลือดและรักษาความชุ่มชื้นของผิว จึงสนับสนุนบทบาทของน้ำมันปลาเป็นการรักษาเสริม โดยเฉพาะในผู้ป่วยกลุ่มเสี่ยงที่มีแนวโน้มจะเกิดไตรกลีเซอไรด์ในเลือดสูง

ความตั้งใจมีบุตร บุคลิกภาพ และปัจจัยที่เกี่ยวข้องในผู้หญิงทำงานที่ยังไม่มีบุตร ในกรุงเทพมหานคร, ปิยาภัสร์ แผ่นทอง

Chulalongkorn University Theses and Dissertations (Chula ETD)

การวิจัยครั้งนี้เป็นการวิจัยเชิงพรรณนา ณ จุดเวลาใดเวลาหนึ่ง มีวัตถุประสงค์เพื่อศึกษาความชุกของความตั้งใจมีบุตร ความสัมพันธ์ระหว่างบุคลิกภาพกับความตั้งใจมีบุตร และปัจจัยที่สามารถทำนายความตั้งใจมีบุตร กลุ่มตัวอย่างคือผู้หญิงทำงานที่ยังไม่มีบุตร อายุ 18–49 ปี ในกรุงเทพมหานคร จำนวน 110 คน โดยตอบแบบสอบถามออนไลน์เครื่องมือที่ใช้ ได้แก่ แบบสอบถามข้อมูลพื้นฐาน ทัศนคติเรื่องคุณค่าของบุตร อิทธิพลทางสังคม ลำดับความสำคัญของปัจจัยสนับสนุน และแบบวัดบุคลิกภาพ IPIP-NEO ฉบับภาษาไทย จำนวน 30 ข้อ ซึ่งครอบคลุมบุคลิกภาพห้าองค์ประกอบ การวิเคราะห์ข้อมูลใช้สถิติเชิงพรรณนา และสถิติเชิงอนุมาน ได้แก่ Chi-square, t-test และ Logistic Regressionผลการวิจัยพบว่า กลุ่มที่ตั้งใจไม่มีบุตรหรือน่าจะไม่มีบุตรมีความชุกสูงที่สุด (ร้อยละ 55.5) บุคลิกภาพทั้ง 5 ด้านไม่สามารถทำนายความตั้งใจมีบุตรได้อย่างมีนัยสำคัญ อย่างไรก็ตาม พบว่า อายุ ทัศนคติว่าบุตรทำให้ครอบครัวสมบูรณ์ และอิทธิพลจากบุคคลรอบข้าง สามารถทำนายความตั้งใจมีบุตรได้อย่างมีนัยสำคัญสำหรับปัจจัยสนับสนุนกลุ่มที่ตั้งใจจะมีบุตรให้ความสำคัญสูงสุดกับ นโยบายของที่ทำงาน รองลงมาคือ บริการดูแลเด็ก ขณะที่กลุ่มที่ตั้งใจจะไม่มีบุตรให้ความสำคัญกับ ปัจจัยอื่น ๆ เช่น ความกังวลด้านสิ่งแวดล้อมและเศรษฐกิจ และ นโยบายของที่ทำงานผลการศึกษานี้สะท้อนความซับซ้อนของการตัดสินใจมีบุตรในกลุ่มผู้หญิงทำงาน และสามารถใช้เป็นแนวทางในการวางแผนเชิงนโยบายด้านครอบครัวและแรงงานในอนาคต