Public Health Commons^™

The Perspectives Of Men In Mexico City About Vasectomy—Brief, Isabel Vieitez Martínez, Adriana Ramos

Reproductive Health

On November 17, 2017, Mexico City took part in the global World Vasectomy Day campaign promoting men’s participation in family planning, especially through no-scalpel vasectomy (NSV). During the event the Population Council Mexico conducted an exploratory study to better understand the reasons men chose NSV, as well as their concerns before and after the procedure. The study found that the principal reason for seeking NSV among men surveyed was their achievement of a desired family size, for themselves and their partners. The study further reveals the need to disseminate information through mass media, social networks, and all levels of the …

Penalized Mixed-Effects Ordinal Response Models For High-Dimensional Genomic Data In Twins And Families, Amanda E. Gentry

Theses and Dissertations

The Brisbane Longitudinal Twin Study (BLTS) was being conducted in Australia and was funded by the US National Institute on Drug Abuse (NIDA). Adolescent twins were sampled as a part of this study and surveyed about their substance use as part of the Pathways to Cannabis Use, Abuse and Dependence project. The methods developed in this dissertation were designed for the purpose of analyzing a subset of the Pathways data that includes demographics, cannabis use metrics, personality measures, and imputed genotypes (SNPs) for 493 complete twin pairs (986 subjects.) The primary goal was to determine what combination of SNPs and …

Immunoglobulin Therapy And Primary Immunodeficient Patients' Health-Related Quality Of Life And Well-Being, Niedre Heckman

Walden Dissertations and Doctoral Studies

Individuals born with primary immune deficiency diseases (PIDD) have a dysfunctional immune system, and many are treated by lifelong injections of immunoglobulin therapy. Studies have shown that these patients have low health-related quality of life (HRQOL) and well-being (WB) and that these outcomes might be improved by the availability of therapy innovated according to preferences for fewer needle sticks or a shorter infusion time. Regulators at the U.S. Food and Drug Administration (FDA) have approved therapies innovated per these preferences. However, there is limited data demonstrating how these innovations impact HRQOL and WB. Using the biopsychosocial model, the purpose of …

Rare Single Gene Disorders: Estimating Baseline Prevalence And Outcomes Worldwide, Hannah Blencowe, Sowmiya Moorthie, Mary Petrou, Hanan Hamamy, Alan Bittles, Stephen Gibbons, Matthew Darlison, Bernadette Modell, Congenital Disorders Expert Group .

Research outputs 2014 to 2021

As child mortality rates overall are decreasing, non-communicable conditions, such as genetic disorders, constitute an increasing proportion of child mortality, morbidity and disability. To date, policy and public health programmes have focused on common genetic disorders. Rare single gene disorders are an important source of morbidity and premature mortality for affected families. When considered collectively, they account for an important public health burden, which is frequently under-recognised. To document the collective frequency and health burden of rare single gene disorders, it is necessary to aggregate them into large manageable groupings and take account of their family implications, effective interventions and …

Sedentary Time And The Cumulative Risk Of Preserved And Reduced Ejection Fraction Heart Failure: From The Multi-Ethnic Study Of Atherosclerosis, Brandi Scot Rariden

UNF Graduate Theses and Dissertations

ABSTRACT

Purpose: The purpose of this study was to examine the relationship between self-reported sedentary time (ST) and the cumulative risk of preserved ejection fraction heart failure (HFpEF) and reduced ejection fraction heart failure (HFrEF) using a diverse cohort of U.S. adults 45-84 years of age.

Methods: Using data from the Multi-Ethnic Study of Atherosclerosis (MESA), we identified 6,814 subjects (52.9% female). All were free of baseline cardiovascular disease. Cox regression was used to calculate the hazard ratios (HR) associated with baseline ST and risk of overall heart failure (HF), HFpEF, and HFrEF. Weekly self-reported ST was dichotomized …

Metabolic Dysregulation And Cancer Mortality In A National Cohort Of Blacks And Whites, Tomi Akinyemiju, Justin Xavier Moore, Suzanne Judd, Susan Lakoski, Michael Goodman, Monika M. Safford, Maria Pisu

Epidemiology and Environmental Health Faculty Publications

Background: We examined the association between metabolic dysregulation and cancer mortality in a prospective cohort of Black and White adults.

Methods: A total of 25,038 Black and White adults were included in the analysis. Metabolic dysregulation was defined in two ways: 1) using the joint harmonized criteria for metabolic syndrome (MetS) and 2) based on factor analysis of 15 variables characterizing metabolic dysregulation. We estimated hazards ratios (HRs) and 95% confidence intervals (CIs) for the association of MetS and metabolic dysregulation with cancer mortality during follow-up using Cox proportional hazards models.

Results: About 46% of Black and 39% of White …

Medical Sciences 4300: London-Middlesex Suicide Prevention Council, Harshith Bhaskar, Adnan Husein, Ramin Javaheri-Poya, Sabrina Jetly, Christopher Nguyen, Serena Tejpar

Community Engaged Learning Final Projects

Suicide is an issue that affects people of all backgrounds, and takes the lives of many individuals every year. The London-Middlesex Suicide Prevention Council (LMSPC), an organization established in 1990, seeks to provide suicide prevention training to members of the community. They seek to engage community members in prevention and intervention by recognizing warning signs that may exist among the London-Middlesex region. The three main programs that strive to deliver these skills are ASIST, ASK, and safeTALK, each with a slightly different focus. LMSPC’s current goal is to increase access to these services through external grants and potential partnerships. Our …

Combinational Sirna Delivery Using Hyaluronic Acid Modified Amphiphilic Polyplexes Against Cell Cycle And Phosphatase Proteins To Inhibit Growth And Migration Of Triple-Negative Breast Cancer Cells, Manoj B. Parmar, Daniel Nisakar Meenakshi Sundaram, Remant Bahadur Kc, Robert Maranchuk, Hamidreza Montazeri Aliabadi, Judith C. Hugh, Raimar Löbenberg, Hasan Uludağ

Pharmacy Faculty Articles and Research

Triple-negative breast cancer is an aggressive form of breast cancer with few therapeutic options if it recurs after adjuvant chemotherapy. RNA interference could be an alternative therapy for metastatic breast cancer, where small interfering RNA (siRNA) can silence the expression of aberrant genes critical for growth and migration of malignant cells. Here, we formulated a siRNA delivery system using lipid-substituted polyethylenimine (PEI) and hyaluronic acid (HA), and characterized the size, ζ-potential and cellular uptake of the nanoparticulate delivery system. Higher cellular uptake of siRNA by the tailored PEI/HA formulation suggested better interaction of complexes with breast cancer cells due to …

Proposed Method For Measuring The Let Of Radiotherapeutic Particle Beams, Stephen D. Bello

Physics & Astronomy ETDs

The Bragg peak geometry of the depth dose distributions for hadrons allows for precise and effective dose delivery to tumors while sparing neighboring healthy tissue. Further, compared against other forms of radiotherapeutic treatments, such as electron beam therapy (EBT) or photons (x and \(\gamma\)-rays), hadrons create denser ionization events along the particle track, which induces irreparable damage to DNA, and thus are more effective at inactivating cancerous cells. The measurement of radiation's ability to inactivate cellular reproduction is the relative biological effectiveness (RBE). A quality related to the RBE that is a measurable physical property is the linear energy transfer …

Variations In Practice Of Apnea Test For Brain Death: Review From A Multihospital Health Care System, Jeffrey Stein, Marvi V. Rijhwani, Ernesto Brauer

Journal of Patient-Centered Research and Reviews

Background: Ventilation encompasses both active and passive processes. Air is initially drawn into the lungs due to a negative intrathoracic pressure created using the respiratory muscles, most importantly the diaphragm. In contrast, expiration is the passive relaxation of the respiratory muscles. Oxygenation occurs when oxygen diffuses across the alveolar-capillary membrane. The ability to oxygenate without ventilation has been termed apneic diffusion oxygenation or apneic oxygenation. We believe it is crucial to keep alveoli open in order for adequate oxygenation to occur. This can be achieved with the aid of positive end-expiratory pressure (PEEP). We investigated this concept in patients who …

Relative Associations Of Age, Height, And Weight On Sinus Of Valsalva And Mid-Ascending Aorta: An Imaging And Epidemiology Study, Mirza Nubair Ahmad, Syed Haris Pir, Mirza Mujadil Ahmad, Sharmeen Hussaini, Bijoy K. Khandheria, A. Jamil Tajik, Khawaja Afzal Ammar

Journal of Patient-Centered Research and Reviews

Background: Prior studies show ascending aorta diameter varies with age, height and weight, but they did not evaluate relative influence of these variables on aortic diameter. Since height is genetically determined, and genetic disorders like Marfan syndrome are predominantly associated with sinus of Valsalva (SOV) dilation, we hypothesized height may have stronger association with SOV.

Purpose: Based on anecdotal observation, since age, weight and obesity are acquired attributes, we hypothesized age, weight and body mass index may have greater association with mid-ascending aorta (MAA) diameter, even in normal patients.

Methods: We evaluated echocardiographic studies of patients ≥ 15 years old …

College Students, Experiences On Smart Phone Technology Usage: A Qualitative Content Analysis Study, Fatemeh Jafarzadeh-Kenarsari, Parand Pourghane

The Qualitative Report

Besides many benefits of the cell phone technology, numerous arguments are raised on the different and important negative effects of such a technology. This qualitative content analysis study explored the common usages of smart phone technology, its challenges, and benefits among Iranian college students. Participants were 32 bachelor degree students who were recruited using purposive sampling method with maximum variation. Data were collected through 11 individual semi-structured interviews and 3 focus group discussions (5-8 students in each group). Data analysis was done based on a conventional content analysis approach. Data analysis resulted in 3 main themes and 12 sub-themes. The …

Cesarean Scar Defects And Placental Abnormalities – A 3 Year Survey Study, Denisa Oana Bălălău, Nicolae Bacalbașa, Anca D. Stănescu

Journal of Mind and Medical Sciences

The placenta is an essential organ for embryonic and fetal development, ensuring nutrient uptake, gas exchange (via the mother's blood supply), waste elimination, thermo-regulation, immunological and hormonal factors, etc. The most common placental abnormalities are represented by placenta previa, and a morbidly adherent placenta (in the form of accreta, increta, and percreta placenta). This study was performed on a sample of 99 patients diagnosed with abnormalities of placentation who underwent cesarian delivery during a period of 3 years in Bucur Maternity Hospital. Seven patients were diagnosed with morbidly adherent placenta (5 accreta and 2 percreta subtypes), the others having placenta …

Caring For Caregivers: Challenges Facing Informal Palliative Caregivers In Western Kenya, Hartlee Johnston

Independent Study Project (ISP) Collection

Chronic illnesses like cancer, HIV, and other non-communicable disease are increasing globally, especially in developing countries, necessitating development of palliative care and symptom management systems. In Kenya, the burden of care for chronically ill patients often falls to unpaid, informal caregivers like family members or friends. Thirty-five current or past informal caregivers from Kisumu, Kenya were interviewed about their experience, challenges they faced, and interventions they felt would be helpful. Major challenges identified included lack of finances for treatment and other living expenses; inadequate, unaffordable, or interrupted medical care; emotional stress exacerbated by juggling many responsibilities, pressure to emotionally support …

Characterization Of Different Molecular Markers For Identification Of Salmonella Enterica Serovar Typhi In Pakistani Population, Faizan Muttiullah, Fida Muhammad Khan, Fakhar-I- Abbas, Sabiha Shamim

Journal of Bioresource Management

Typhoid is caused by Salmonella enterica serovar Typhi that is usually diagnosed by using serologic and immuno-chromatographic techniques in developing counties including Pakistan, which is thought to be an unreliable diagnostic method. For accurate diagnosis we used molecular techniques to amplify 204 bp StyR-36 and 498 bp flagellin gene for the identification of Salmonella enterica serovar Typhi. This study was done on 58 individuals diagnosed positive of typhoid via serologic tests and 50 healthy individuals as a control group. Success rate of amplification for flagellin gene was 77.58% while that for StyR-36 gene was 68.97% showing that flagellin gene primer …

A Validated Measure For Fertility Awareness: An Essential Step Toward Informed Reproductive Decision-Making, Brennan Peterson

Marriage and Family Therapy Faculty Articles and Research

"The efforts by Kudesia and colleagues (1) to create and validate a fertility awareness survey is a vital development in the field of reproductive health care. The 29-item Fertility and Infertility Treatment Knowledge Score (FIT-KS) was created to measure fertility awareness and infertility treatment knowledge in the general population and among medical trainees. Using a combination of existing questionnaires, consultation with specialists in test construction, and clinical recommendations of an expert panel of 15 reproductive endocrinologists, the FIT-KS is the first of its kind in the United States. The authors should be commended for their foresight and attempts to address …

Relationship Between Self-Efficacy And Patient Knowledge On Adherence To Oral Contraceptives Using The Morisky Medication Adherence Scale (Mmas-8), Daniel M. Tomaszewski, Benjamin D. Aronson, Margarette L. Kading, Donald E. Morisky

Pharmacy Faculty Scholarship

Background
Preconception care, including family planning, is a vital component of healthcare for women of reproductive age. An average female spends the majority of her reproductive life trying to prevent a pregnancy. In order to prevent unintended pregnancy, women often rely on the use of hormonal contraceptives. In the United States, the majority of hormonal contraceptive users are prescribed oral contraceptive pills (OCPs). Reduced adherence to OCPs decreases their ability to prevent pregnancy. The study aimed to measure OCP adherence among female college students, and explore the relationship between OCP adherence, knowledge, and self-efficacy.

Methods
This cross-sectional study recruited a …

Web Resources For Physician Wellness, Elizabeth C. Lawrence

Office of Physician and Student Wellness (OPSW)

A current listing of websites, TED talks, and podcasts related to physician wellness and resiliency.

Current Prospects Of Type Ii Interferon Γ Signaling & Autoimmunity, Daniel S. Green, Howard A. Young, Julio C. Valencia

United States Public Health Resources

Interferon γ (IFNγ) is a pleiotropic protein secreted by immune cells. IFNγ signals through the IFNγ receptor, a protein complex that mediates downstream signaling events. Studies into IFNγ signaling have provided insight into the general concepts of receptor signaling, receptor internalization, regulation of distinct signaling pathways, and transcriptional regulation. Although IFNγ is the central mediator of the adaptive immune response to pathogens, it has been shown to be involved in several non-infectious physiological processes. This review will provide an introduction into IFNγ signaling biology and the functional roles of IFNγ in the autoimmune response.

Aligning Opioid Prescribing Pathways, Andrea Lai, Outpatient Pharmacy, Haley Pelletier, Suneela Nayak, Stephen Tyzik, Ruth Hanselman

MaineHealth Maine Medical Center

There is a drug epidemic sweeping the State of Maine and it continues to worsen each passing year. In 2017, the Maine legislature passed Public Law Chapter 488 to strengthen the controlled substance prescription monitoring program. An outpatient pharmacy, located in a large acute care hospital, created a performance improvement project to clarify opioid prescription and resolve any non-compliance with Chapter 488.

After a root cause analysis, several KPIs were established to include tracking the number of phone calls made by pharmacists to non-compliant providers to clarify scripts, provide one on one education and ultimately resolve non-compliance. Repeat offenders were …

Multiple Myeloma Baseline Immunoglobulin G Level And Pneumococcal Vaccination Antibody Response, Michael A. Thompson, Martin K. Oaks, Maharaj Singh, Karen M. Michel, Michael P. Mullane, Husam S. Tarawneh, Angi Kraut, Kayla J. Hamm

Journal of Patient-Centered Research and Reviews

Infections are a major cause of morbidity and mortality in multiple myeloma (MM), a cancer of the immune system. Vaccination clinical efficacy endpoints have not been demonstrated, and there are limited data on surrogate markers of efficacy. This pilot study evaluated sequential immunologic markers after standard pneumococcal vaccination (PV) in patients with MM and non-MM controls. Vaccination was standard for PV (PCV13 or PPV23), with laboratory testing at baseline and at 2, 4, 12 and 24 weeks after vaccination. Immunoglobulin G (IgG) antibodies to pneumococcal antigens were detected by ELISA. Prevaccination total IgG levels and IgG subclass levels were also …

Bibliography Of Physician Wellness Resources, Elizabeth C. Lawrence

Office of Physician and Student Wellness (OPSW)

Current list of articles and books on physician wellness.

Prediktor Kejadian Tb Pada Odha Di Salah Satu Rs Pemerintah Bogor, Tahun 2014-2016, Ulya Qoulan Karima, Mondastri Korib Sudaryo, Nuning Maria Kiptiyah

Jurnal Epidemiologi Kesehatan Indonesia

TB merupakan tantangan bagi pengendalian Acquired Immunodeficiency Syndrome (AIDS) karena merupakan infeksi oportunistik terbanyak pada orang dengan HIV/AIDS (ODHA). TB dapat meningkatkan progresivitas HIV dan meningkatkan risiko kematian bagi penderita HIV. Tujuan penelitian ini adalah untuk mengetahui prediktor yang berhubungan dengan kejadian TB pada ODHA di salah satu RS tahun 2014-2016. Desain studi yang digunakan adalah cross sectional dengan menggunakan data register ART dan Rekam Medis. Sampel berjumlah 817 pasien HIV. Analisis data dilakukan dengan menggunakan multiple cox regression. Hasil analisis multivariat menunjukkan adanya peningkatan risiko TB pada kelompok dengan anemia (PR=1,54, 95% CI: 1,17-2,03) dibandingkan kelompok tanpa anemia, adanya …

Determinant Of Timely First-Shot Hepatitis B Immunization In East Lombok, West Nusa Tenggara, Indonesia, Putri Bungsu Machmud, Dwi Gayatri, Tri Yunis Miko Wahyono

Jurnal Epidemiologi Kesehatan Indonesia

Hepatitis B remains as one of health problems in the world. The results of several studies related to factors in predicting of the timely first-shot hepatitis B immunization were still inconsistent. Aim of this study is to identify determinant factors of the timely first-shot hepatitis B immunization in East Lombok, Indonesia. We used a cross sectional design study, and data derived from immunization coverage survey at six districts/ cities in 2013. A Total of 227 children aged 12 to 23 months who already got immunization of a first-shot hepatitis B vaccineand well documented were included as samples in this study. …

Feeding Problems Sebagai Prediktor Kejadian Obestitas Pada Anak Autis, Qisty Afifah Noviyanti

Jurnal Epidemiologi Kesehatan Indonesia

Latar belakang: Obesitas merupakan masalah yang dapat terjadi pada anak autis. Hal ini disebabkan adanya perubahan perilaku dan pola makan akibat kondisi autisme. Akan tetapi, belum banyak studi yang menjelaskan hubungan perilaku makan bermasalah (feeding problems) dengan kejadian obesitas pada anak autis. Tujuan: Penelitian ini untuk melihat hubungan antara masalah perilaku makan (feeding problem) dengan kejadian obesitas anak autis. Metode: Peninjauan artikel dilakukan dengan kata kunci autism OR autism spectrum disorder AND feeding problem OR food selectivity dan autism AND childhood obesity. Dua studi ditemukan sesuai dengan kriteria inklusi yang dibuat Anak autis memiliki perilaku makan bermasalah yang lebih tinggi …

Hubungan Obesitas Dengan Kejadian Hipertensi Derajat 1 Di Pos Pembinaan Terpadu Penyakit Tidak Menular (Posbindu Ptm) Kantor Kesehatan Pelabuhan Bandung Tahun 2016, Teguh Dhika Rohkuswara, Syahrizal Syarif

Jurnal Epidemiologi Kesehatan Indonesia

Hipertensi sampai saat ini masih menjadi masalah kesehatan di dunia termasuk Indonesia. Prevalensi hipertensi di Indonesia, cukup tinggi yaitu sebesar 25,8% (Riskesdas, 2013). Sebagian besar penderita hipertensi termasuk dalam kelompok hipertensi derajat 1 dan separuhnya tidak menyadari sebagai penderita. Hipertensi bukan penyakit kausal tunggal, ada berbagai faktor yang berkontribusi terhadap munculnya hipertensi, salah satunya yang sering ditemukan adalah obesitas. Penelitian ini bertujuan untuk mengetahui besarnya hubungan antara obesitas dengan kejadian hipertensi derajat 1 di Posbindu PTM Kantor Kesehatan Pelabuhan Bandung. Desain penelitian adalah cross sectional, menggunakan data sekunder kegiatan Posbindu PTM KKP Bandung tahun 2016. Subjek penelitian adalah pegawai instansi …

Pengaruh Konsumsi Fruktosa Pada Minuman Kemasan Terhadap Toleransi Glukosa Terganggu Pada Kelompok Usia Muda Di Perkotaan Di Indonesia, Nicolaski Lumbuun, Nasrin Kodim

Jurnal Epidemiologi Kesehatan Indonesia

Peningkatan konsumsi minuman kemasan (soft drinks/ bevereges) tampak nyata di dunia, termasuk Indonesia. Peningkatan ini terutama terjadi di kelompok usia muda. Konsumsi minuman tersebut berkaitan dengan gangguan metabolik, antara lain obesitas, toleransi glukosa terganggu (TGT) dan diabetes melitus. Hal ini disebabkan penggunaan pemanis tinggi fruktosa (high fructose corn syrup, HFCS). TGT terutama menjadi masalah kesehatan serius karena umumnya tidak menunjukkan gejala dan terlambat untuk dideteksi sehingga sering kali telah berprogresi menjadi diabetes mellitus. Penelitian ini bertujuan untuk melihat hubungan konsumsi tinggi fruktosa dengan kejadian TGT pada usia muda, serta prevalensi kekerapan mengkonsumsi minuman tinggi fruktosa, baik secara nasional maupun pada …

Hubungan Pengetahuan Hiv/Aids Dengan Stigma Terhadap Orang Dengan Hiv/Aids Di Kalangan Remaja 15-19 Tahun Di Indonesia (Analisis Data Sdki Tahun 2012), Berliana Situmeang, Syahrizal Syarif, Renti Mahkota

Jurnal Epidemiologi Kesehatan Indonesia

Stigma terhadap ODHA menjadi salah satu hambatan paling besar dalam pencegahan, perawatan, pengobatan, dan dukungan HIV/AIDS. Pengetahuan tentang HIV/AIDS mempengaruhi terjadinya stigma terhadap ODHA. Tujuan penelitian ini untuk mengetahui hubungan pengetahuan tentang HIV/AIDS dengan stigma terhadap ODHA di kalangan remaja usia 15-19 tahun di Indonesia. Penelitian ini menggunakan data Survei Demografi dan Kesehatan Indonesia (SDKI) Tahun 2012 dengan disain cross-sectional. Sampel penelitian sebanyak 8.316 orang. Hasil studi menunjukkan 71,63% remaja mempunyai stigma terhadap ODHA, 49,10% remaja mempunyai pengetahuan yang kurang tentang HIV. Pengetahuan yang kurang tentang HIV/AIDS berhubungan dengan stigma terhadap ODHA (PR= 1,210 95% CI: 1,149-1,273) setelah dikontrol oleh …

Pengaruh Jarak Kelahiran Terhadap Kematian Bayi Di Indonesia, Filipina, Dan Kamboja (Analisis Data Survei Demografi Kesehatan), Adelina Fitri, Asri Adisasmita, Renti Mahkota

Jurnal Epidemiologi Kesehatan Indonesia

Kematian bayi didefinisikan sebagai kematian yang terjadi pada tahun pertama kehidupan. Angka kematian bayi di Indonesia dan Kamboja sendiri masih berada diatas AKB Asia Tenggara, sedangkan Filipina sudah sama dengan AKB Asia Tenggara. Jarak kelahiran merupakan salah satu faktor yang memegang peran penting pada kematian bayi. Tujuan penelitian ini adalah untuk mengetahui pengaruh jarak kelahiran terhadap kematian bayi di Indonesia, Filipina dan Kamboja. Penelitian menggunakan data dari Demographic Health Survey (DHS). Desain penelitian adalah cross sectional dan sampel pada masing-masing negara berjumlah 10.162, 4.741 dan 4.330 bayi. Hasil penelitian memperlihatkan, jarak kelahiran < 18 bulan memiliki risiko paling besar terhadap kematian bayi di Indonesia (OR = 2,43: 95% CI 1,26 - 4,70), Kamboja (OR = 4,39: 95% CI 1,76 - 10,94) dibandingkan jarak kelahiran 18 - 23 bulan, 24 - 35 bulan dan > 36 bulan. Sedangkan di Filipina jarak kelahiran 18 …

Optimizing Heart Failure Outcomes Through Diet: A Review, Farley B. Neasman Iii

Marshall Journal of Medicine

Heart failure is a growing epidemic that will add significant monetary and human costs to an already overtaxed health-care system. Though promising new medications have recently been approved, this complex condition is largely preventable through aggressive risk factor modification, with diet being shown to have a greater effect than exercise. An underrated component of a healthy diet is the simple addition of nuts – the anti-inflammatory fatty acids, healthy proteins, and general availability have been shown to improve survival and reduce the primary risk factors contributing to heart failure, making the addition of nuts and legumes to the diet an …