Public Health Commons^™

A Retrospective Review Of Lvhn Compliance With Diagnostic Workup For Pancreatic Cancer Per Nccn Guidelines, Caitlin Scialla, Dennis Sopka Md, Savitri Skandan Md, Melissa Kratz Rn, Msn, Aocn

Research Scholars

No abstract provided.

Hubungan Kondisi Psikologis Stress Dengan Hipertensi Pada Penduduk Usia Diatas 15 Tahun Di Indonesia, Aenaya Delavera, Kemal N. Siregar, Ryza Jazid Bahar, Tris Eryando

Jurnal Biostatistik, Kependudukan, dan Informatika Kesehatan

Stress adalah bagian normal dari kehidupan yang tidak bisa dihindari. Tetapi terlalu banyak stress dapat mempengaruhi kesehatan. Bertambahnya tingkat stress akan memungkinkan terjadinya peningkatan prevalensi hipertensi. Hipertensi adalah masalah kesehatan masyarakat global dan menjadi penyebab utama kematian dini di seluruh dunia dan memiliki tren yang selalu meningkat setiap tahunnya. Penelitian ini bertujuan untuk mengetahui hubungan antara kondisi psikologis stress dengan hipertensi pada penduduk usia ≥ 15 tahun di Indonesia. Metode penelitian dilakukan dengan analisis data sekunder Indonesian Family Life Survey 5 (IFLS 5) tahun 2014 yang memiliki desain cross sectional. Sampel berjumlah 13.667 responden yang memiliki data lengkap terkait …

Gambaran Perilaku Hidup Bersih Dan Sehat (Phbs) Di Era Pandemi Corona Virus Disease (Covid-19) Di Indonesia, Febby Anugrah Utami, Faridah Sani

Jurnal Biostatistik, Kependudukan, dan Informatika Kesehatan

Berdasarkan Riskesdas tahun 2018 proporsi anggota rumah tangga yang berperilaku benar cuci tangan dengan benar di Indonesia yaitu 49,8%, prevalensi merokok penduduk umur > 10 tahun di Indonesia sebanyak 29,3%. Jumlah kasus positif Covid-19 di Indonesia sampai tanggal 10 Januari 2021 yaitu 828.026 kasus dengan angka kematian 24.129 dan angka kesembuhan 681.024 orang. Untuk mencegah penularan Covid-19 dapat dilakukan dengan menerapkan Perilaku Hidup Bersih dan Sehat (PHBS). Tujuan dari penelitian ini yaitu menjelaskan gambaran Perilaku Hidup Bersih dan Sehat (PHBS) dalam mencegah penularan Corona Virus Disease (Covid-19) di Indonesia. Metode yang digunakan dalam penelitian ini adalah metode tinjauan kepustakaan (literatur review) …

Latihan Senam Dapat Menurunkan Kadar Glukosa Darah Pada Penderita Diabetes Melitus Tipe Ii, Rifa Fadhilah Lubis, Ramadya Kanzanabilla

Jurnal Biostatistik, Kependudukan, dan Informatika Kesehatan

Diabetes melitus tipe II adalah suatu keadaan hiperglikemia yang disebabkan gangguan pada resistensi insulin dan sekresi insulin sehingga metabolisme tubuh juga terganggu, merupakan masalah yang serius dan menjadi salah satu penyakit penyebab kematian yang cukup besar di Indonesia. Salah satu cara diabetes ini adalah dengan latihan fisik. Latihan fisik yang dianjurkan salah satunya adalah senam aerobik, yang bertujuan meningkatkan dan mempertahankan kesegaran tubuh dan dilaksanakan sesuai prinsip F.I.T.T (Frekuensi, Intensitas, Time dan Tipe). Penelitian ini bertujuan untuk menunjukkan dengan latihan senam secara rutin dapat mengontrol dan menurunkan kadar glukosa darah pada penderita diabetes melitus tipe II. Metode yang digunakan adalah …

Kajian Pustaka: Kurangnya Kualitas Tidur Dapat Meningkatkan Risiko Kejadian Diabetes Melitus, Novi Mesrina Cicionta Br Ginting, Pralampita Kori Mufidah

Jurnal Biostatistik, Kependudukan, dan Informatika Kesehatan

Diabetes melitus merupakan suatu penyakit yang ditandai dengan kadar glukosa di dalam darah tinggi karena tubuh tidak dapat melepaskan atau menggunakan insulin secara adekuat. Penderita diabetes sering kita jumpai dan tingkat insiden terus meningkat tahun demi tahun. Tidur memiliki fungsi metabolik, dan beberapa penelitian menunjukkan korelasi antara kurangnya kualitas tidur dan peningkatan risiko diabetes melitus. Penelitian ini bertujuan untuk mengetahui bahwa kurangnya kualitas tidur dapat meningkatkan risiko kejadian diabetes mellitus pada orang dewasa. Penelitian ini menggunakan metode kajian pustaka. Ada 5 jurnal yang membahas kualitas tidur dan diabetes melitus serta memenuhi kriteria inklusi yaitu kurangnya kualitas tidur meningkatkan risiko kejadian …

Analisis Penerimaan Sistem Informasi Pencatatan Dan Pelaporan Kasus Covid-19 (Aplikasi Silacak Versi 1.2.5) Menggunakan Technology Acceptance Model (Tam) Di Upt Puskesmas Cipadung Kota Bandung, Nurfatia Negari, Tris Eryando

Jurnal Biostatistik, Kependudukan, dan Informatika Kesehatan

Salah satu upaya untuk mengendalikan laju COVID-19 ialah dengan memperkuat sistem surveilans di fasilitas kesehatan tingkat dasar. Salah satu poin yang menjadi peran kunci dalam pemutusan rantai penularan COVID-19 adalah kegiatan pelacakan kontak. Kegiatan ini mengharuskan pelacak kontak untuk terus mencatat dan melaporkan kasus. Untuk itu, penggunaan sistem pencatatan dan pelaporan pelacakan kontak (Silacak) menjadi penting dalam menentukan kebijakan yang akan dibuat. Tujuan penelitian ini adalah menelaah penggunaan sistem pencatatan dan pelaporan COVID-19 dengan aplikasi Silacak serta penerimaan pengguna terhadap sistem informasi Silacak di UPT Puskesmas Cipadung Kota Bandung. Penelitian ini merupakan studi kualitatif dengan menggunakan desain studi kasus. Aplikasi …

Analisis Spasial Kasus Diare Pada Balita Di Kabupaten Banyumas Tahun 2019, Dyah Nurmarastri Sasabil Sidqi, Novia Anasta, Pralampita Kori Mufidah

Jurnal Biostatistik, Kependudukan, dan Informatika Kesehatan

Diare merupakan penyebab kematian balita terbesar kedua di seluruh dunia. Indonesia sendiri prevalensi diare untuk balita merupakan tertinggi dari seluruh kelompok umur sebesar 11,5% pada tahun 2018. Hingga tahun 2019 angka penemuan diare pada balita di Kabupaten Banyumas masih belum mencapai target yang ditentukan. Belum adanya gambaran spasial daerah yang rentan akan peningkatan kasus diare balita mempersulit upaya penemuan kasus yang penting dilakukan untuk mencegah terjadinya KLB. Tujuan penelitian ini yaitu mendeskripsikan, dan melakukan analisis spasial untuk melihat korelasi faktor risiko dengan kasus diare pada balita secara geografis melalui peta kerentanan serta menghasilkan peta buffer jangkauan pelayanan puskesmas di Kabupaten …

Physician Burnout Among West Virginia Primary Care Providers, Kevin S. Mccann, Adam Baus, Joanna Bailey, Laura Boone, Jennifer Boyd, Martha Cook-Carter, Dan Doyle

Marshall Journal of Medicine

Introduction

Work related burnout is highly prevalent in US physicians and linked to adverse effects on patients, providers and organizations. This study measures burnout in West Virginia (WV) primary care providers, allowing for comparison of results to a similar, recent study of US physicians.

Methods

Anonymous survey through email that included Maslach Burnout Inventory, demographic, workload, and practice characteristics. Responses were analyzed using JMP Pro 13. Analysis used JMP Pro 13 for descriptive statistics, chi-square and regression modeling.

Results

Subjects = 110, female/male ratio 1.4, all primary care physicians (PCP), or advanced practice registered nurses or physician assistants (APRN/PA). PCP …

Barriers And Facilitators To Promoting Resilience To Hiv/Aids: A Qualitative Study On The Lived Experiences Of Hiv-Positive, Racial And Ethnic Minority, Middle-Aged And Older Men Who Have Sex With Men From Ontario, Canada, Renato M. Liboro, Sherry Bell, Brandon Ranuschio, Lianne Barnes, Jenna Despres, Aruna Sedere, Trinity Puno, Paul A. Shuper

Psychology Faculty Research

Evidence-based research has highlighted the need for exploring factors that support the mental health of men who have sex with men living with HIV/AIDS (MSMLWH), and environmental influences that promote their resilience to HIV/AIDS. This exploratory study utilized a community-based participatory research approach to investigate barriers and facilitators to promoting resilience to HIV/AIDS, specifically among racial and ethnic minority, middle-aged and older MSMLWH, a population that continues to be significantly impacted by HIV/AIDS today. This collaborative, qualitative study recruited participants who identified as racial or ethnic minority MSMLWH, were aged 40 or older, and resided in Ontario, Canada. Participants (n …

Loneliness In Primary Care Patients: Relationships With Body Mass Index And Health Care Utilization, Tamara K. Oser, Siddhartha Roy, Jessica Parascando, Rebecca Mullen, Julie Radico, Alexis Reedy-Cooper, Jennifer Moss

Journal of Patient-Centered Research and Reviews

Purpose: Rates of loneliness and obesity have increased in recent decades. Loneliness and obesity independently have been found to be risk factors for negative physical and mental health outcomes. This study examined the rates and interrelationships of loneliness, body mass index (BMI), and health care utilization in a primary care setting.

Methods: A cross-sectional survey of adult patients presenting for outpatient care at 7 family medicine clinical practices in Pennsylvania was conducted. Survey questions included self-reported measures of loneliness, height/weight, number of health care visits, and potential confounders (eg, sociodemographic variables, health status). Bivariate and multivariable linear regression models were …

Cross-Sectional Analysis Of Patient-Centered Language Use In Journals Publishing Research Focused On Heart Failure, Vivian Pham, Benjamin Greiner, Ryan Ottwell, Matt Vassar, Micah L. Hartwell

Journal of Patient-Centered Research and Reviews

Purpose: Detrimental effects of using non–patient-centered language (nPCL) have been reported for diabetes, mental illness, and obesity, and both the American Medical Association (AMA) and International Committee of Medical Journal Editors (ICMJE) recommend using patient-centered language in medical literature. Heart failure is a common yet stigmatized disease, and nPCL may further propagate stigma. This study analyzed current use of nPCL in journals focused on heart failure research and also examined whether the journals steer authors to adhere to AMA or ICMJE guidelines regarding nPCL.

Methods: Following systematic search of PubMed for heart failure-related articles published from May 1, 2018, to …

Business Cards As A Mechanism To Encourage Patient Feedback About Trainees, Marc Atzenhoefer, Jodie Ruffin, David Parewski, Nicole Deklotz, M. Fuad Jan, Ana Cristina Perez Moreno, Suhail Q. Allaqaband

Journal of Patient-Centered Research and Reviews

This project sought to evaluate if business card distribution improved the utility of Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) surveys by serving as a feedback mechanism for trainees. Between fall 2018 and spring 2019, patient encounters for 6 cardiovascular disease fellows were tracked over two 60-day periods. Six weeks were allowed for HCAHPS surveys to be returned. Business cards were subsequently deployed and encounters similarly tracked. During the control-group monitoring period, 721 patient encounters were logged and 80 (11.1%) surveys were returned. Qualitative feedback, in the form of free-response comments, was provided in 41 (51.3%) surveys. Business …

Prevalencia Mensual De Trastorno De Ansiedad Generalizada Durante La Pandemia Por Covid-19 En México, Pablo Gaitán-Rossi, Víctor Pérez-Hernández, Mireya Vilar-Compte, Graciela Teruel-Belismelis

Department of Public Health Scholarship and Creative Works

Objective. Estimate the prevalence of generalized anxiety disorder (GAD) from April to June 2020. Materials and methods. Repeated cross-sections design based in the Encovid-19, a series of monthly mobile surveys with represen- tative samples of Mexico (N= 833-1 674).The questionnaire includes the GAD-2 scale, and, in July, the GAD-7 scale was added; we examined its internal validity with confirmatory factor analysis and its concurrent validity with sociodemo- graphic variables. Using GAD-7 as criterion, we analyzed the predictive validity of the GAD-2.We estimated the monthly prevalence with the GAD-2. Results. The GAD-7 and the GAD-2 are reliable and valid.The GAD-2 has …

Income Predicts Fpg, But Food Security Is The Mediator, Amy Blansit

eJournal of Public Affairs

This research was aimed at studying the RISE pilot program and stability factors of low socioeconomic groups. Self-sufficiency programs focus on households moving from crisis to empowerment; no longer relying on subsidies. Gaining employment and housing alone do not create socioeconomic stability. It was therefore determined that the RISE Program should be evaluated to determine the effectiveness at ending dependency. Methods: Thirty-four (30.6%) participants were included in this evaluation. Using logistic regression techniques, sixteen items on the RISE Self-sufficiency Assessment were explored. Results: RISE participants derived significant economic benefits, and that food security seemed to be the greatest mediator of …

Association Between Patient-Clinician Relationships And Adherence To Antihypertensive Medications Among Black Adults: An Observational Study Design, Teng-Jen Chang, John F.P. Bridges, Mary Bynum, John W. Jackson, Joshua J. Joseph, Michael A. Fischer, Bo Lu, Macarius M. Donneyong

All Faculty and Staff Scholarship

Background

We assessed the associations between patient‐clinician relationships (communication and involvement in shared decision‐making [SDM]) and adherence to antihypertensive medications.

Methods and Results

The 2010 to 2017 Medical Expenditure Panel Survey (MEPS) data were analyzed. A retrospective cohort study design was used to create a cohort of prevalent and new users of antihypertensive medications. We defined constructs of patient‐clinician communication and involvement in SDM from patient responses to the standard questionnaires about satisfaction and access to care during the first year of surveys. Verified self‐reported medication refill information collected during the second year of surveys was used to calculate medication …

Pattern Of Use Of Electronic Health Record (Ehr) Among The Chronically Ill: A Health Information National Trend Survey (Hints) Analysis, Rose Calixte, Sumaiya Islam, Zainab Toteh Osakwe, Argelis Rivera, Marlene Camacho-Rivera

Publications and Research

Effective patient–provider communication is a cornerstone of patient-centered care. Patient portals provide an effective method for secure communication between patients or their proxies and their health care providers. With greater acceptability of patient portals in private practices, patients have a unique opportunity to manage their health care needs. However, studies have shown that less than 50% of patients reported accessing the electronic health record (EHR) in a 12-month period. We used HINTS 5 cycle 1 and cycle 2 to assess disparities among US residents 18 and older with any chronic condition regarding the use of EHR for secure direct messaging …

Can Community Gardens With Workshops Increase Gardening Behavior? A Navajo Wellness Collaboration, Kevin A. Lombard Phd, India J. Ornelas Phd, Desiree Deschenie, Felix Nez, Sonia Bishop, Katie Osterbauer Ms, Eileen Rillamas-Sun Phd, Shirley A.A. Beresford Phd

Journal of Health Disparities Research and Practice

This paper seeks to evaluate the potential efficacy of a community gardening intervention on the Navajo Nation to increase gardening and healthy eating behaviors, which are potentially important in preventing obesity and related health conditions. Rates of obesity are high among American Indians, including those living on Navajo Nation land. Eating fresh fruits and vegetables is part of healthy eating. However, availability and access to fresh fruits and vegetables are severely limited on the Navajo Nation, due to distance and cost. One way to increase both availability and consumption of fresh fruits and vegetables is through community gardening, yet …

Lessons From The Health Care Innovation Awards: Productively Engaging Vulnerable Populations To Address Social Determinants Of Health, Maysoun Freij, Megan Skillman, Caitlin Cross-Barnet, Rachel Friedman Singer, Christina Rotondo, Michelle Dougherty, Sarah Ruiz, Adil Moiduddin, Lynne Page Snyder

Journal of Health Disparities Research and Practice

Objectives: This paper examines productive interactions—a cornerstone of the Chronic Care Model—between health care providers and vulnerable populations with chronic illnesses and/or disabilities. Methods: We conducted qualitative analysis of 16 focus groups and 29 interviews with patients and/or caregivers and 195 interviews with program leadership and providers across 15 Health Care Innovation Awards that targeted vulnerable populations. We analyzed how awardees addressed health concerns and social determinants of health (SDOH), and identified key components of productive interactions. Results: Providers achieved productive interactions through four primary strategies: establishing trust and showing respect; solving problems; building accuracy in health …

Association Between Insurance Status And Hospital Outcomes Among Acute Kidney Failure Patients, Khoa Truong, Thuan Thai, Lingling Zhang, Lu Shi, C. Jason Wang

Journal of Health Disparities Research and Practice

Objectives: To investigate the relationship between insurance status and the risk of acute kidney failure (AKF) and consequential hospitalization outcomes.

Methods: A cross-sectional regression analysis was conducted for inpatients ages 18-64 in South Carolina 2012–2013. One dichotomous dependent variable - diagnosed with AKF at hospital admission, and two continuous dependent variables of hospital outcomes - total charge and length of stay, were examined. The key explanatory variable was the patient’s insurance status. Other covariates included patient’s age, gender, and race as well as AKF risk factors - Type 2 diabetic mellitus (T2DM), chronic kidney disease (CKD), hypertension, and proteinuria.

Results: …

Examining The Use Of Immersive Clinical Experiences In Athletic Training Education, Bailey Christine Jones

Health Services Research Dissertations

Clinical experiences are an essential aspect of athletic training education that offer students opportunities to practice their skills and engage in a variety of settings. The Commission on Accreditation of Athletic Training Education (CAATE) sets accreditation standards for athletic training programs to meet, including clinical education standards. In fall 2020, new standards took effect that include a few additions to the standards surrounding clinical education; these additions require programs to afford students opportunities to engage in immersive clinical experiences (ICEs), implement behaviors associated with core competencies, and identify strategies that account for patients’ social determinants of health. Educators believe ICEs …

The Assessment Of Clinical Reasoning In Preceptors Across The Athletic Training Profession, Gary Wayne Cohen Jr.

Health Services Research Dissertations

Clinical reasoning (CR) is defined as a complex multi-factorial metacognitive process for diagnosis formulation. Clinical reasoning begins as a student and develops over a career. Students are typically taught an analytical approach defined as hypothetico-deductive reasoning (HDR). Expert clinicians use a non-analytical approach defined as the Knowledge Based Model (KBM) of CR. It is accepted that clinicians use the KBM with cases that they have more experience to streamline the evaluation process. Unfortunately, because of the nuance of CR there have been limited investigations within athletic training to evaluate CR outside of the student population.

The overarching purpose of this …

Preferred Incentives For Improving Community Health Worker Satisfaction And Retention In Bangladesh, Frontline Health Project, Johns Hopkins Bloomberg School Of Public Health

Reproductive Health

Community health workers (CHWs) are critical actors within community health systems, providing a range of reproductive, maternal, child, and primary health information, counseling, and services. To better understand factors that influence CHWs’ work motivation and satisfaction in Bangladesh, the Frontline Health project, implemented with collaborators from Johns Hopkins Bloomberg School of Public Health, and supported by the government of Bangladesh’s Directorate General of Health Services and the Directorate General of Family Planning, conducted a discrete choice experiment (DCE) study. This brief presents key qualitative findings from the DCE study in Bangladesh and implications for program and policy stakeholders.

How Ethics Committees And Requirements Are Structuring Health Research In The Philippines: A Qualitative Study, Gideon Lasco, Vincen Gregory Yu, Lia M. Palileo-Villanueva

Development Studies Faculty Publications

Background

The last few decades have seen the rising global acknowledgment of the importance of ethics in the conduct of health research. But research ethics committees or institutional review boards (IRBs) have also been criticized for being barriers to research. This article examines the case of the Philippines, where little has been done to interrogate the health research and IRB culture, and whose circumstances can serve as reflection points for other low- and middle-income countries.

Methods

Semi-structured interviews were conducted from July to October 2020 to elicit health researchers’ perspectives and experiences regarding IRBs and the ethics approval process in …

An Automated Method To Enrich And Expand Consumer Health Vocabularies Using Glove Word Embeddings, Mohammed Ibrahim

Graduate Theses and Dissertations

Clear language makes communication easier between any two parties. However, a layman may have difficulty communicating with a professional due to not understanding the specialized terms common to the domain. In healthcare, it is rare to find a layman knowledgeable in medical jargon, which can lead to poor understanding of their condition and/or treatment. To bridge this gap, several professional vocabularies and ontologies have been created to map laymen medical terms to professional medical terms and vice versa. Many of the presented vocabularies are built manually or semi-automatically requiring large investments of time and human effort and consequently the slow …

Content Analysis Of Digital Media Coverage Of The Human Papillomavirus Vaccine School-Entry Requirement Policy In Puerto Rico, Vivian Colón-López, Vilnery Rivera-Figueroa, Glizette O. Arroyo-Morales, Diana T. Medina-Laabes, Roxana Soto-Abreu, Manuel Rivera-Encarnación, Olga L. Díaz-Miranda, Ana P. Ortiz, Katelyn B. Wells, Coralia Vázquez-Otero, Pamela C. Hull

Behavioral Science Faculty Publications

BACKGROUND: In August 2018, Puerto Rico (PR) became the 4th state or territory in the United States to adopt a human papillomavirus (HPV) vaccine school-entry requirement, for students 11-12 years old. Evidence suggests that the content of media coverage may impact people's perception of HPV vaccine and their willingness to vaccinate. This study aimed to analyze the content of digital news coverage related to the implementation of the policy in PR.

METHODS: A content review was conducted of digital media published from January 2017 through December 2018. The content reviewed was carried out in two steps: 1) creating a matrix …

Vulnerability To And Protection Against Covid-19 Fear, Threat, And Worry, Marsha Kim Huh

Graduate Theses and Dissertations

Drawing from a sample of 10,368 adults living in the U.S., the current study examines the role of social and psychological resources in lowering COVID-related fear, threat, and worry, controlling for a number of social vulnerabilities (e.g. gender, race/ethnicity, and presence of children). The impact of social location, particularly in regards to race, and how one accesses and/or utilizes social and psychological resources is also examined through disaggregated regression models. Results demonstrate that some social and psychological resources impact COVID-specific distress (fear/threat/worry), but depending on the resource, relationships vary in direction and significance. The strength of social ties and mastery …

Case-Based Audit And Feedback Around A Decision Aid Improved Antibiotic Choice And Duration For Uncomplicated Cystitis In Primary Care Clinics, Larissa Grigoryan, Roger Zoorob, George Germanos, Mohamad Sidani, Matthew Horsfield, Fareed Khan, Mohammad Zare, Melanie Goebel, Robert Atmar, Barbara Trautner

Faculty, Staff and Students Publications

OBJECTIVES: The objective of our study was to evaluate the impact of a multifaceted stewardship intervention on adherence to the evidence-based practice guidelines on treatment of uncomplicated cystitis in primary care. We hypothesised that our intervention would increase guideline adherence in terms of antibiotic choice and duration of treatment.

DESIGN: A preintervention and postintervention comparison with a contemporaneous control group was performed. During the first two study periods, we obtained baseline data and performed interviews exploring provider prescribing decisions for cystitis at both clinics. During the third period in the intervention clinic only, the intervention included a didactic lecture, a …

Analisis Pemasaran Produk Layanan Homevisit Pasien Gangguan Jiwa Di Rumah Sakit Jiwa : Article Review, Ivan Paulus Gunata

Jurnal ARSI : Administrasi Rumah Sakit Indonesia

In 2018, the World Health Organization (WHO), in its report titled "Mental Health Action Plan," stated that explained that around 300 million people in the world suffer from depression, 60 million people in the world suffer from bipolar affective disorder, and 23 million people have psychosis. Meanwhile, in Indonesia, based on data from Riskesdas 2018 data on sufferers of mental disorders among the Indonesian population aged 15 years and over, there are 6.1 percent suffer from depression, and there are 9.8 percent suffer from emotional mental disorders due to stress. Stressors that are handled well will provide positive emotions. There …

Factors That Influence Enrollment In Syringe Services Programs In Rural Areas: A Qualitative Study Among Program Clients In Appalachian Kentucky, Umedjon Ibragimov, Katherine E. Cooper, Evan Batty, April M. Ballard, Monica Fadanelli, Skylar B. Gross, Emma M. Klein, Scott Lockard, April M. Young, Hannah L. F. Cooper

Epidemiology and Environmental Health Faculty Publications

BACKGROUND: Enrolling sufficient number of people who inject drugs (PWID) into syringe services programs (SSP) is important to curtail outbreaks of drug-related harms. Still, little is known about barriers and facilitators to SSP enrollment in rural areas with no history of such programs. This study's purpose was to develop a grounded theory of the role of the risk environment and individual characteristics of PWID in shaping SSP enrollment in rural Kentucky.

METHODS: We conducted one-on-one semi-structured interviews with 41 clients of 5 SSPs that were established in rural counties in Appalachian Kentucky in 2017-2018. Interviews covered PWID needs, the process …

Analisis Strategi Pemasaran Pada Pelayanan Operasi Penggantian Sendi Lutut, Nining Tri Maryani, Ni Putu Deni Adi

Jurnal ARSI : Administrasi Rumah Sakit Indonesia

Total knee replacement is a safe treatment to reduce pain and restore physical function in patients with severe osteoarthritis that cannot be treated with physical therapy. Every year there are more than 500,000 total knee replacement surgical procedures performed in the United States, it is estimated that by 2030 the volume of TKR surgical procedures will increase to more than 3.48 million per year due to premature aging and increasing obesity. With the opportunity for demand from the TKR service itself, the Karima Utama Special Surgery Hospital feels the need to establish a marketing strategy for knee joint replacement surgery …