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2015

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Articles 211 - 240 of 2125

Full-Text Articles in Public Health

Regulating Drug Promotion To Promote The Public Health: A Response To Bennett, Et Al., Patricia J. Zettler Nov 2015

Regulating Drug Promotion To Promote The Public Health: A Response To Bennett, Et Al., Patricia J. Zettler

Faculty Publications By Year

No abstract provided.


Necessity Of Analytics In Today’S Healthcare Revenue Cycle, Kristen N. Thomas Nov 2015

Necessity Of Analytics In Today’S Healthcare Revenue Cycle, Kristen N. Thomas

Applied Research Projects

Because of the recently growing pressures to improve quality and reduce costs, healthcare organizations are rapidly adopting IT in order to improve their operations and clinical care. As a result, an accumulation of vast amounts of data are becoming available for use. It is important for healthcare to use this data. Strome (2010) states that healthcare analytics is the application of statistical tools and techniques to healthcare-related data in order to study past situations (i.e., operational performance or clinical outcomes) to improve the quality and efficiency of clinical and business processes and performance. With the introduction of healthcare analytical tools, …


The Personal Health Record (Phr): The Effects On Patient Healthcare Outcomes?, Bonita R. Payne Nov 2015

The Personal Health Record (Phr): The Effects On Patient Healthcare Outcomes?, Bonita R. Payne

Applied Research Projects

Electronic transmission of data is on the rise, due to the Affordable Care Act and provisions to make healthcare information more accessible, complete, and transparent. The Personal Health Record (PHR) application is a tool used to provide assistance to the goal of patient-centered and patient-centric care. Its purpose is to encourage consumers to become more participatory and informed in their healthcare treatment and healthcare needs. Since its inception, it has been questionable as to whether consumers and providers are seeing any improvements in the services provided or the care rendered. Since, the development and implementation of PHR applications, there has …


Hipaa Violations On Social Media, Tamesha Helen Parris Nov 2015

Hipaa Violations On Social Media, Tamesha Helen Parris

Applied Research Projects

With the rise of social media networks such as Facebook and Twitter, healthcare professionals and students pursing healthcare careers communicate, collaborate, and network on an array of websites and apps. With the use of social media, the users can reach a large audience in a matter of seconds, with this ease; users can transmit information and has presented challenges in the form of unauthorized disclosure of patient’s health information on social media sites. The purpose of this study is to see if the number of HIPAA violations increased due to the use of social media and what steps are healthcare …


Health Literacy Improves Health Care Quality, Rebecca Cook Nov 2015

Health Literacy Improves Health Care Quality, Rebecca Cook

Applied Research Projects

A lack of knowledge about health literacy is a cause for quality healthcare concern as the world advances in health information technology. Many patients struggle to understand and navigate their health and well-being as a result of lack of understanding of the treatment plan due to low literacy skills. Several federal policy initiatives promote health literacy as the responsibility of the healthcare organization. Improving health outcomes through health literacy should be a commitment of healthcare organization through providing clear communication, simplified forms, assistance, and even follow-up calls. Three major initiatives will combat health literacy to include the Affordable Care Act; …


Maintaining The Master Patient Index: The Impact Of Patient Registration Processes On Data Integrity, Matthew Biddle Nov 2015

Maintaining The Master Patient Index: The Impact Of Patient Registration Processes On Data Integrity, Matthew Biddle

Applied Research Projects

The master patient index is one of the most important components within a healthcare system. It ensures that an individual patient is given a unique identifier that is used across the various separate clinical, financial and administrative systems and ensures that all information about that patient is organized and complete. Ensuring the MPI is accurate is critical since errors can have significant costs- both financially and in terms of patient outcomes. Patient registrars are the first line of defense when it comes to correctly identifying incoming patients and is where many errors in the MPI occur. Errors can be simple …


Occupational Exposure To Chemical And Physical Contaminants: Sex-Differentiated Analysis, France Labrèche, Aude Lacourt, Jérôme Lavoué Nov 2015

Occupational Exposure To Chemical And Physical Contaminants: Sex-Differentiated Analysis, France Labrèche, Aude Lacourt, Jérôme Lavoué

Rapports de recherche scientifique

La survenue des lésions professionnelles varie selon le sexe. Une des principales explications évoquées est l’existence de nettes différences d’exposition en milieu de travail, découlant notamment des professions occupées par les hommes et par les femmes et de la nature des tâches effectuées. Cependant, il n’existe pas de données solides pour appuyer cette assertion et les analyses traditionnelles en milieu de travail se sont le plus souvent limitées à rapporter le risque en fonction du sexe, sans identifier les raisons pouvant expliquer les différences de risque observées.

Tant le gouvernement du Québec que l’Organisation mondiale de la santé ou les …


Out-Of-Pocket Spending Among Rural Medicare Beneficiaries, Erika C. Ziller Phd, Jennifer D. Lenardson Mhs, Andrew F. Coburn Phd Nov 2015

Out-Of-Pocket Spending Among Rural Medicare Beneficiaries, Erika C. Ziller Phd, Jennifer D. Lenardson Mhs, Andrew F. Coburn Phd

Access / Insurance

The majority of Medicare beneficiaries experience gaps between the care they need and costs covered by Medicare and seek supplemental coverage to meet this gap, including private plans offered by former employers or purchased individually, or public coverage through Medicaid. Since rural beneficiaries are more likely to purchase supplemental indemnity coverage individually, to participate in Medicaid, or to go without supplemental coverage altogether, it is likely that their out-of-pocket spending differs from that of urban residents, although the magnitude and direction of these differences may vary for individual beneficiaries. This study used data from the 2006-2010 Medical Expenditure Panel Survey …


A Noise Delivery System For Multi-Animal Multi-Level Whole Body Ototoxicity Studies, John E. Stubbs, Jeremy M. Slagley, James E. Reboulet Nov 2015

A Noise Delivery System For Multi-Animal Multi-Level Whole Body Ototoxicity Studies, John E. Stubbs, Jeremy M. Slagley, James E. Reboulet

Faculty Publications

The Naval Medical Research Unit Dayton (NAMRU-D) at Wright-Patterson Air Force Base, Ohio, in conjunction with the U.S. Air Force, studied ototoxic effects of JP-8 in rats. NAMRU-D used a multi-chamber whole body exposure facility for up to 96 test animals and 32 control animals at different exposure levels. The objective was to design a noise delivery system that could provide a white noise source one octave band wide, centered at 8 kHz frequency, delivered from outside the exposure chambers. Sound pressure levels were required to be within ±2 dB at all exposure points within each chamber and within ±2 …


Associations Among Human-Associated Fecal Contamination, Microcystis Aeruginosa, And Microcystin At Lake Erie Beaches, Cheonghoon Lee, Jason Marion, Melissa Cheung, Jiyoung Lee Nov 2015

Associations Among Human-Associated Fecal Contamination, Microcystis Aeruginosa, And Microcystin At Lake Erie Beaches, Cheonghoon Lee, Jason Marion, Melissa Cheung, Jiyoung Lee

EKU Faculty and Staff Scholarship

Lake Erie beaches exhibit impaired water quality due to fecal contamination and cyanobacterial blooms, though few studies address potential relationships between these two public health hazards. Using quantitative polymerase chain reaction (qPCR), Microcystis aeruginosa was monitored in conjunction with a human-associated fecal marker (Bacteroides fragilis group; g-Bfra), microcystin, and water quality parameters at two beaches to evaluate their potential associations. During the summer of 2010, water samples were collected 32 times from both Euclid and Villa Angela beaches. The phycocyanin intergenic spacer (PC-IGS) and the microcystin-producing (mcyA) gene in M. aeruginosa were quantified with qPCR. PC-IGS and mcyA were …


The Controversy Of Rising Drug Prices: The Public’S Views, R. J. Blendon, J. M. Benson, Caitlin L. Mcmurtry, J. M. Sayde Nov 2015

The Controversy Of Rising Drug Prices: The Public’S Views, R. J. Blendon, J. M. Benson, Caitlin L. Mcmurtry, J. M. Sayde

Brown School Faculty Publications

A new poll of adults in the United States by STAT and Harvard T.H. Chan School of Public Health finds that public concerns about the unreasonableness of brand-name prescription drug prices is fueling support for major governmental action to negotiate or set brand-name drug prices in the future.


Mode Of Delivery And Risk Of Asthma In Children 5-14 Years Old In Tabriz, Iran, Roya Sahebi, Leyla Sahebi, Amir Hossein Jafari-Rouhi, Ahmad Jafari-Javid, Stanley Luchters, Chad Hughes Nov 2015

Mode Of Delivery And Risk Of Asthma In Children 5-14 Years Old In Tabriz, Iran, Roya Sahebi, Leyla Sahebi, Amir Hossein Jafari-Rouhi, Ahmad Jafari-Javid, Stanley Luchters, Chad Hughes

Population Health, East Africa

Introduction: It has been suggested that a cesarean section increases risk of developing asthma due to lack of exposure to maternal microflora during birth. To investigate the association between the mode of delivery and the risk of asthma in children aged 5-14 years in Tabriz, Iran.

Methods: A case-control study was performed on 233 (case = 81, control = 152) children aged 5-14 years referred to outpatient clinics of Tabriz Children’s Hospital and Sheikhorrais Clinic in 2014. Clinical asthma diagnosis was done according to Global Initiative for Asthma Criteria. A questionnaire was administered to obtain a demographic, environmental, and clinical …


The Experiment Must Continue: Medical Research And Ethics In East Africa, 1940–2014, Melissa Graboyes Nov 2015

The Experiment Must Continue: Medical Research And Ethics In East Africa, 1940–2014, Melissa Graboyes

Ohio University Press Open Access Books

The Experiment Must Continue is a beautifully articulated ethnographic history of medical experimentation in East Africa from 1940 through 2014. In it, Melissa Graboyes combines her training in public health and in history to treat her subject with the dual sensitivities of a medical ethicist and a fine historian. She breathes life into the fascinating histories of research on human subjects, elucidating the hopes of the interventionists and the experiences of the putative beneficiaries.

Historical case studies highlight failed attempts to eliminate tropical diseases, while modern examples delve into ongoing malaria and HIV/AIDS research. Collectively, these show how East Africans …


Building Global Capacity For Brain And Nervous System Disorders Research., Linda B. Cottler,, Joseph Zunt, Bahr Weiss, Ayeesha Kamran Kamal, Krishna Vaddipart Nov 2015

Building Global Capacity For Brain And Nervous System Disorders Research., Linda B. Cottler,, Joseph Zunt, Bahr Weiss, Ayeesha Kamran Kamal, Krishna Vaddipart

Department of Medicine

The global burden of neurological, neuropsychiatric, substance-use and neurodevelopmental disorders in low- and middle-income countries is worsened, not only by the lack of targeted research funding, but also by the lack of relevant in-country research capacity. Such capacity, from the individual to the national level, is necessary to address the problems within a local context. As for many health issues in these countries, the ability to address this burden requires development of research infrastructure and a trained cadre of clinicians and scientists who can ask the right questions, and conduct, manage, apply and disseminate research for practice and policy. This …


What Can Pakistan Do To Address Maternal And Child Health Over The Next Decade?, Zulfiqar Ahmed Bhutta, Assad Hafeez Nov 2015

What Can Pakistan Do To Address Maternal And Child Health Over The Next Decade?, Zulfiqar Ahmed Bhutta, Assad Hafeez

Department of Paediatrics and Child Health

Pakistan faces huge challenges in meeting its international obligations and agreed Millennium Development Goal targets for reducing maternal and child mortality. While there have been reductions in maternal and under-5 child mortality, overall rates are barely above secular trends and neonatal mortality has not reduced much. Progress in addressing basic determinants, such as poverty, undernutrition, safe water, and sound sanitary conditions as well as female education, is unsatisfactory and, not surprisingly, population growth hampers economic growth and development across the country. The devolution of health to the provinces has created challenges as well as opportunities for action. This paper presents …


'At-Risk' Places: Inequaties In The Distribution Of Environmental Stressors And Prescription Rates Of Mental Health Medications In Glasgow, Scotland, Juliana A. Maantay, Andrew Maroko Oct 2015

'At-Risk' Places: Inequaties In The Distribution Of Environmental Stressors And Prescription Rates Of Mental Health Medications In Glasgow, Scotland, Juliana A. Maantay, Andrew Maroko

Publications and Research

Using geospatial analytical methods, this study examines the association between one aspect of the built environment, namely, the concentration of vacant and derelict land (VDL), and the prevalence of mental health disorders (using the proxy variable of mental health medication prescription rates) in Glasgow, Scotland. This study builds on our previous research, which demonstrated the spatial correspondence between the locations of VDL in Glasgow and several physical health outcomes. Numerous studies of other locales have found similar correspondence between different elements of the built environment and various health outcomes. This is the first study of its kind to look at …


Analisis Alur Proses Penerimaan Pasien Rawat Inap Di Rumah Sakit “X” Tahun 2015 Dengan Pendekatan Lean Hospital, Pretty Kristianti Dewi Oct 2015

Analisis Alur Proses Penerimaan Pasien Rawat Inap Di Rumah Sakit “X” Tahun 2015 Dengan Pendekatan Lean Hospital, Pretty Kristianti Dewi

Jurnal ARSI : Administrasi Rumah Sakit Indonesia

Lean hospital is lean methods used in hospitals, is a continuous effort made to eliminate waste and increase value added in patient care in hospitals. This method is very appropriate to analyze the process flow of inpatient admission in "X" hospital by making Current State Value Stream Map derived from observation, interviews and review of documents. Then through the application of Lean Tools, Future State Value Stream Map was made as the idea of improvement for short and medium/long term in the process. The results showed there were 31 total events with value added time process is just 44,9% at …


Analisis Faktor-Faktor Yang Berhubungan Dengan Kepatuhan Pasien Tuberkulosis Paru Tahap Lanjutan Untuk Minum Obat Di Rs Rumah Sehat Terpadu Tahun 2015, Dewi Hapsari Wulandari Oct 2015

Analisis Faktor-Faktor Yang Berhubungan Dengan Kepatuhan Pasien Tuberkulosis Paru Tahap Lanjutan Untuk Minum Obat Di Rs Rumah Sehat Terpadu Tahun 2015, Dewi Hapsari Wulandari

Jurnal ARSI : Administrasi Rumah Sakit Indonesia

This research discussed on the This thesis aims to determine the factors that associated compliance patien lung Tuberculosis to swallowing drug at Rumah Sehat Terpadu Dompet Dhuafa Hospital 2015This research used mix methods approach with cross sectional design. This research found that there is still non compliances patient lung tuberculosis to swallowing medicine. The compliance is related on behavior (Predisposisi, Enabling, dan Reinforcing) and non behavior factor. To increase the compliance this research suggest to hospital support fot TB DOTS program, intens of counseling, support the PMO, availability of drug, and frequent recording dan reporting.


Penggunaan Konsep Lean Untuk Meningkatkan Efisiensi Pelayanan Instalasi Farmasi Rawat Jalan Di Rumah Sakit Anna Medika Bekasi, Dima Lintya Siti Karima Zahra Oct 2015

Penggunaan Konsep Lean Untuk Meningkatkan Efisiensi Pelayanan Instalasi Farmasi Rawat Jalan Di Rumah Sakit Anna Medika Bekasi, Dima Lintya Siti Karima Zahra

Jurnal ARSI : Administrasi Rumah Sakit Indonesia

The National Health Insurance which was launched on January 1, 2014, is a form of transformation and reformation of health services in Indonesia. In implementation of the JKN, Hospital Pharmacy Installation is forced to improve its quality service sustainably in order to achieve cost effective and efficient service. Lean is a management system that fully focuses on effiency with the objectives to reduce stock, service cycle time and cost. Research was conducted on outpatient pharmacy installation service at Anna Medika Bekasi Hospital in April to May 2016. It focuses on prescription process flow of non-pulvis medicine using action research method …


Analisis Kualitas Dan Kuantitas Tenaga Keperawatan Terhadap Persepsi Insiden Keselamatan Pasien Di Rs X Jakarta Tahun 2015, Evelyne Sumihar Friyanti Oct 2015

Analisis Kualitas Dan Kuantitas Tenaga Keperawatan Terhadap Persepsi Insiden Keselamatan Pasien Di Rs X Jakarta Tahun 2015, Evelyne Sumihar Friyanti

Jurnal ARSI : Administrasi Rumah Sakit Indonesia

Patient safety has become a very important issue in health care. Everyone wants to get health care that is safe and free from unwanted injuries. Through this study, analyzed the quality and quantity of nurse perceptions of patient safety incidents in the hospital X. The study was conducted on 44 nurses and midwives using cross sectional design to examine the relationship between the variables of knowledge, education, ease of use tools, work experience, discipline and the number of nurses on patient safety incidents.


Analisis Faktor Yang Berhubungan Dengan Waktu Tunggu Pemeriksaan Foto Toraks Pasien Rawat Jalan Di Instalasi Radiologi Rumah Sakit Dr. Mohammad Hoesin Palembang Tahun 2015, Muhammad Yusri Oct 2015

Analisis Faktor Yang Berhubungan Dengan Waktu Tunggu Pemeriksaan Foto Toraks Pasien Rawat Jalan Di Instalasi Radiologi Rumah Sakit Dr. Mohammad Hoesin Palembang Tahun 2015, Muhammad Yusri

Jurnal ARSI : Administrasi Rumah Sakit Indonesia

Department of Radiology Dr. Mohammad Hoesin hospital in Palembang 2014, many patients perform chest x ray examination, whom were patients radiographic outpatient. The waiting time radiographic services in RSMH not in accordance with the Standard Minimum Service Hospital less than 3 hours. This study aims to determine the factors associated with waiting time chest X-ray. This research was conducted by measuring the waiting time to 68 selected respondents The result showed radiographic waiting time 184.44 minutes. Based on statistical test found the waiting time in the reading room is the photo that most affect the length of waiting time radiographic.


Analisis Faktor-Faktor Yang Berhubungan Dengan Efektivitas Komunikasi Perawat Dan Pasien Di Ruang Rawat Inap Rumah Sakit Harapan Mulia Kabupaten Bekasi Tahun 2015, Prasetyaningtyas Agustrianti Oct 2015

Analisis Faktor-Faktor Yang Berhubungan Dengan Efektivitas Komunikasi Perawat Dan Pasien Di Ruang Rawat Inap Rumah Sakit Harapan Mulia Kabupaten Bekasi Tahun 2015, Prasetyaningtyas Agustrianti

Jurnal ARSI : Administrasi Rumah Sakit Indonesia

The study aims to determine the factors associated with the effectiveness of nurse and patient communication atinpatient unit in Harapan Mulia Hospitallocated in Bekasi Regency.It is a quantitative study with cross-sectional design.Samples are the total population amounted to 30 nurses with 60 patients as respondentsconducted in March - May 2015. The results showed that 53.3% of patients perceived that nurses’s communication was effective, further analysis with logistic regression showed no significant relationship between the characters nurses, physical and mental fatigue, language, leadership and management support for hospitals, facilities and reward with the nurses and patients communication effectiveness.


College Of Public Health News, Georgia Southern University Oct 2015

College Of Public Health News, Georgia Southern University

College of Public Health: News & Publications

  • Georgia Southern Examines Size and Power of Tests of Hypotheses
  • Georgia Southern Analyzes Awereness about Emerging Public Health Trends


Health Policy & Management News, Georgia Southern University Oct 2015

Health Policy & Management News, Georgia Southern University

Health Policy & Community Health: News & Publications (2011-2018)

  • Georgia Southern Analyzes Awareness about Emerging Public Health Trends


Analisis Besaran Biaya Obat Beberapa Penyakit Rawat Jalan Dan Faktor- Faktor Yang Mempengaruhi Di Rs. Awal Bros Bekasi Tahun 2014, Hastuti Hadiningsih Oct 2015

Analisis Besaran Biaya Obat Beberapa Penyakit Rawat Jalan Dan Faktor- Faktor Yang Mempengaruhi Di Rs. Awal Bros Bekasi Tahun 2014, Hastuti Hadiningsih

Jurnal ARSI : Administrasi Rumah Sakit Indonesia

The background of this study is the high bill outpatient drug costs when compared with the costs borne by BPJS by embracing INA CBG's tariff system. So, we need a more in-depth analysis of the factors that affect the amount of health care costs. This study uses a cross-sectional study with quantitative methods, by looking at factors of age, sex, prescription drugs, doctor and health insurance status in accordance with the secondary data obtained through medical records and bills medicine outpatient services. And based on the results of the study, factors that affect the cost of the drug is age, …


Applying Voronoi Tessellations As A Non-Orthogonal Grid Methodology To Inform Public-Private Mix Efforts In Nigeria: An Examination Of The Distribution Of Private Healthcare Providers In Six States And The Covariates Underlying Their Utilization, Trinadh Dontamsetti Oct 2015

Applying Voronoi Tessellations As A Non-Orthogonal Grid Methodology To Inform Public-Private Mix Efforts In Nigeria: An Examination Of The Distribution Of Private Healthcare Providers In Six States And The Covariates Underlying Their Utilization, Trinadh Dontamsetti

USF Tampa Graduate Theses and Dissertations

TB care and prevention is led by the public sector, but many TB symptomatics first seek care in the private sector, highlighting the importance of engaging these facilities. This report examines basic TB epidemiology (such as the gap in case finding that could be addressed in part via private sector activities), health-seeking behaviors (HSB) and diagnostic delays, the size of the private sector, activities of professional societies, and financing. It examines the potential utility of integrating Voronoi tessellations as a GIS-based method for informing and improving Public-Private Mix (PPM) efforts throughout six states in Nigeria. Further, it explores a potential …


Understanding The Value Of Multi-Sector Health System Interactions, Glen P. Mays Oct 2015

Understanding The Value Of Multi-Sector Health System Interactions, Glen P. Mays

Health Management and Policy Presentations

Recent research examines the health and economic value of multi-organizational and multi-sectoral approaches for the delivery of public health services. This presentation examines how data on these multi-organizational delivery systems and their impact can be used to solve collective action problems and stimulate collaborative solutions in public health.


Phosphorus Ingestion Improves Oral Glucose Tolerance Of Healthy Male Subjects: A Crossover Experiment, May Khattab, Christelle Abi-Rashed, Hala Ghattas Ph.D., Sani Hlais, Omar Obeid Oct 2015

Phosphorus Ingestion Improves Oral Glucose Tolerance Of Healthy Male Subjects: A Crossover Experiment, May Khattab, Christelle Abi-Rashed, Hala Ghattas Ph.D., Sani Hlais, Omar Obeid

Faculty Publications

Background:

Fasting serum phosphorus (P) was reported to be inversely related to serum glucose and insulin, while the impact of P ingestion is not well documented. The effect of P intake with or before glucose ingestion on postprandial glucose and insulin statuses was investigated.

Method:

Two cross over experiments using healthy male subjects were conducted. Experiment 1: Overnight fasted subjects (n∈=∈7) randomly received: 500 mg of P tablets, glucose (75 g) solution with placebo or 500 mg of P tablets. Experiment 2: Overnight fasted subjects (n∈=∈8) underwent similar procedures to those of experiment 1, except that placebo or 500 mg …


Disabled Women’S Attendance At Community Women’S Groups In Rural Nepal, J. Morrison, T. Colbourn, B. Budhathoki, A. Sen, D. Adhikari, J. Bamjan, S. Pathak, A. Basnet, J. F. Trani, A. Costello, D. Manandhar, N. Groce Oct 2015

Disabled Women’S Attendance At Community Women’S Groups In Rural Nepal, J. Morrison, T. Colbourn, B. Budhathoki, A. Sen, D. Adhikari, J. Bamjan, S. Pathak, A. Basnet, J. F. Trani, A. Costello, D. Manandhar, N. Groce

Brown School Faculty Publications

There is strong evidence that participatory approaches to health and participatory women’s groups hold great potential to improve the health of women and children in resource poor settings. It is important to consider if interventions are reaching the most marginalized, and therefore we examined disabled women’s participation in women’s groups and other community groups in rural Nepal. People with disabilities constitute 15% of the world’s population and face high levels of poverty, stigma, social marginalization and unequal access to health resources, and therefore their access to women’s groups is particularly important. We used a mixed methods approach to describe attendance …


The Influence Of Relationship Status On Hpv Vaccine Decision-Making Among Young Adult Women, Erika L. Thompson Oct 2015

The Influence Of Relationship Status On Hpv Vaccine Decision-Making Among Young Adult Women, Erika L. Thompson

USF Tampa Graduate Theses and Dissertations

Background: The HPV vaccine is a primary prevention method available to reduce the burden of HPV-related cancers and genital warts. The vaccine is currently approved for catch-up vaccination among women 18 to 26 years of age. Despite this recommendation, the rate of vaccine uptake among this group is considerably low (~34% uptake). One demographic characteristic that is consistently reported as a risk factor for non-vaccination is relationship status, specifically married or monogamous relationships. While the epidemiological data confirm this association, there is a lack of understanding how this risk factor operates. By elucidating the mechanism for this risk factor, …