Public Health Commons^™

Epidemiology Of Intestinal Parasite Infections And Multiparasitism And Their Impact On Growth And Hemoglobin Levels During Childhood In Tropical Ecuador: A Longitudinal Study Using Molecular Detection Methods, Rojelio Mejia, Irina Chis Ster, Martha E Chico, Irene Guadalupe, Andrea Arévalo-Cortés, Andrea Lopez, Aida Y Oviedo-Vera, Philip J Cooper

Faculty, Staff and Students Publications

Background: There are few longitudinal epidemiological studies of intestinal parasitic infections (IPI) and their health effects. We studied the epidemiology and determinants of IPI and multiparasitism during childhood using molecular methods for parasite detection and analysed their effects on growth and hemoglobin levels.

Methods: Random sample of 401 children from an Ecuadorian birth cohort followed up to 8 years of age. Data on environmental and sociodemographic characteristics were collected by questionnaires. Stool samples were collected, and weight, height, and hemoglobin levels were measured at 7 and 13 months, and 2, 3, 5, and 8 years. Stool samples were analysed using …

Protein Biomarkers Of Interstitial Lung Abnormalities In Relatives Of Patients With Pulmonary Fibrosis, Jonathan A Rose, Mark P Steele, Esteban J Kosak Lopez, Gisli Thor Axelsson, Andrea G Galecio Chao, Alan Waich, Katie Regan, Swati Gulati, Anthony H Maeda, Sharmin Sultana, Claire Cutting, Ann-Marcia C Tukpah, Andrew J Synn, Mary B Rice, Hilary J Goldberg, Joyce S Lee, David A Lynch, Rachel K Putman, Hiroto Hatabu, Benjamin A Raby, David A Schwartz, Ivan O Rosas, Gary M Hunninghake

Faculty, Staff and Students Publications

Rationale: First-degree relatives of patients with pulmonary fibrosis (referred to here as relatives) are at high risk for interstitial lung abnormalities (ILA), highlighting the need for biomarkers for risk prediction. We aimed to identify blood proteins associated with and predictive of ILA among relatives of patients with pulmonary fibrosis.

Methods: Relatives enrolled in two independent cohorts had protein levels measured using an aptamer-based proteomic platform. ILA were assessed with computed tomography scans as per Fleischner Society recommendations. Protein associations with ILA were assessed using regression. Significant proteins were used with clinical variables to detect ILA.

Results: Of 237 relatives from …

Targeting S1pr2 In Sepsis, One Fragmented Mitochondrion At A Time, Chao He, Jennifer L Larson-Casey

Faculty, Staff and Students Publications

No abstract provided.

Parp Inhibitor Response Is Enhanced In Prostate Cancer When Xrcc1 Expression Is Reduced, Kaveri Goel, Vani Venkatappa, Kimiko L Krieger, Dongquan Chen, Arun Sreekumar, Natalie R Gassman

Faculty, Staff and Students Publications

Prostate cancer (PCa) is the second most common cancer worldwide and the fifth leading cause of cancer-related deaths among men. The emergence of metastatic castration-resistant prostate cancer (mCRPC) after androgen deprivation therapy (ADT) exemplifies the complex disease management for PCa. PARP inhibitors (PARPis) are being tested to treat mCRPC in tumors with defective homologous recombination repair (HRR) to address this complexity. However, increasing resistance towards PARPi in HRR-deficient patients and the low percentage of HRR-defective mCRPC patients requires the identification of new genes whose deficiency can be exploited for PARPi treatment. XRCC1 is a DNA repair protein critical in the …

The Aging Ovary Stands On The Shoulders Of Giant Multinucleated Cells, Avery A Ahmed, Stephanie A Pangas

Faculty, Staff and Students Publications

Reproductive aging is associated with declining fertility and increasing inflammation, though these events are not well understood. An exciting new study in PLOS Biology utilizes cutting-edge technologies to characterize the role of multinucleated giant cells in ovarian aging.

Performance Of Stool-Based Molecular Tests And Processing Methods For Paediatric Tuberculosis Diagnosis: A Systematic Review And Meta-Analysis, Lucía Carratalà-Castro, Shilzia Munguambe, Belén Saavedra-Cervera, Petra De Haas, Alexander Kay, Olivier Marcy, Pamela Nabeta, Willy Ssengooba, Elisabetta Ghimenton-Walters, Sozinho Acácio, Maryline Bonnet, Joanna Ehrlich, Andrew R Dinardo, Anca Vasiliu, Christoph Lange, Sabine Hermans, Anna M Mandalakas, Elisa López-Varela, Alberto L García-Basteiro

Faculty, Staff and Students Publications

Background: There has been a global pursuit to improve the diagnosis of tuberculosis in young children by applying diagnostic methods on accessible biospecimens such as stool. We aimed to conduct a systematic review on the accuracy of stool-based molecular tests for tuberculosis diagnosis in children and to assess the impact of the available pre-processing methods and other design characteristics.

Methods: In this systematic review and meta-analysis, we evaluated studies in children younger than 16 years with presumptive tuberculosis that were published in English, Spanish, French, and Portuguese from Jan 1, 2000, to May 3, 2024, in MEDLINE, Embase, and Embase …

Characteristic Profiling Of Cho-Cell Expressed Mers-Cov Rbd-Fc, Mashal M Almutairi, Yi-Lin Chen, Jungsoon Lee, Zhuyun Liu, Ulrich Strych, Peter J Hotez, Maria Elena Bottazzi, Wen-Hsiang Chen

Faculty, Staff and Students Publications

The ongoing circulation of the Middle East Respiratory Syndrome coronavirus (MERS-CoV) in camels across Asia, the Middle East, and Africa, along with its occasional transmission to humans, demonstrates a need for a MERS vaccine. Previously, we have reported a receptor binding domain (RBD) of MERS-CoV fused with human Fc as a promising vaccine antigen (MERS-CoV RBD-Fc). We generated a stable recombinant CHO cell line expressing such a protein and developed a basic production process suitable for future technological transfer to pilot-scale manufacture. In this study, we employed various in-house analytical assays to examine the characteristics of purified RBD-Fc protein and …

The Need To Integrate Mental Health Treatment Into The Care Of Mayer-Rokitansky-Küster-Hauser, Teni Davoudian, Emily Hills

Faculty, Staff and Students Publications

This mini review examines the psychological burdens of Mayer-Rokitansky-Küster-Hauser (MRKH) and encourages collaborations between medical and mental health providers who treat this condition. The psychological comorbidities of MRKH emerge in adolescence and persist into adulthood. For several years, The American College of Obstetricians and Gynecologists and researchers in this field have called for the provision of psychological counseling for individuals with MRKH. However, referrals to qualified mental health professionals remain sparse leaving many to confront the emotional complexities of MRKH with little to no support.

Is Less More? Maximizing Outcomes By Tailoring Treatments To Patients: Oncofertility And Oncomenopause, Janice S Kwon, Marie Plante, Martha Hickey, Annabelle Huguenin, Sarah Hmaidan, Terri Lynn Woodard

Faculty, Staff and Students Publications

Notable advances have been made in improving survival outcomes in various cancers, but some have incurred undesirable costs and effects to patients with respect to fertility and menopause. Patients are living longer with cancer, and patient reported outcomes are influencing decision-making by individuals and their health care providers. It is essential to evaluate existing standards of care on an ongoing basis and prioritize quality of life and long-term survivorship, particularly for interventions in early-stage cancers and risk-reducing strategies that often yield long-term life expectancy.

Fine-Scale Population Structure Of Japanese Helicobacter Pylori Provides New Anthropological And Epidemiological Insights, Kohei Tomonari, Batsaikhan Saruuljavkhlan, Ricky Indra Alfaray, Kartika Afrida Fauzia, Osamu Matsunari, Daisuke Chinda, Tadashi Shimoyama, Phawinee Subsomwong, Nagisa Kinjo, Tetsu Kinjo, Yasuo Hanamure, Masato Shinzato, Rumiko Suzuki, Fukunori Kinjo, Shigeru Takigami, Toshio Fujioka, Takeshi Matsuhisa, Junko Akada, Takashi Matsumoto, Yoshio Yamaoka

Faculty, Staff and Students Publications

Helicobacter pylori is considered to contribute to gastric cancer and is also used as a marker to trace human migration due to its co-evolution with humans. To understand the recently proposed tripartite model suggesting three ancestral origins for the Japanese population and address the enigma of the high incidence of gastric cancer in Northeast Hondo (Hondo is mainland Japan), we conducted a fine-scale population structure analysis using a large Japanese H. pylori dataset, including 438 strains from 9 regions based on whole-genome sequences. As a result of fineSTRUCTURE analysis, it was found that H. pylori in Northeast Hondo is genetically …

Dietary Interventions To Support And Improve Sleep Disturbances And Insomnia Disorder In Menopause: From Bench To Bedside, Rosie H Musgrave, Sara Nowakowski, Tamlyn J Watermeyer, Emily J Arentson-Lantz, Greg J Elder

Faculty, Staff and Students Publications

Sleep is essential for maintaining physical and psychological health, and also cognitive health (referred to as 'brain health'). However, the transition to menopause has a direct impact upon sleep. Sleep disturbances are reported by approximately 40%-60% of menopausal women, and insomnia disorder is also prevalent. Diet-based interventions could potentially be used to improve subjective sleep quality in this population, and although there are several promising interventions which have been used in other groups that could be trialled, the evidence base is currently lacking. One particularly promising area for future research is that these interventions might be used alongside, or instead …

Core Domain Set For Chronic And/Or Recurrent Manifestations Of Calcium Pyrophosphate Deposition Disease: Omeract Delphi Survey To Establish Consensus, Yiling Zhang, Sara K Tedeschi, Abhishek Abhishek, Owen Hensey, David Grossberg, Ken Cai, Beverley Shea, Jasvinder A Singh, Robin Christensen, Teodora Serban, Edoardo Cipolletta, Konstantinos Parperis, Cesar Diaz-Torne, Geraldine M Mccarthy, Fabio Becce, Tamer A Gheita, Silvia Sirotti, Sara Nysom Christiansen, Luis Coronel, Lisa K Stamp, Yousra H Abdel-Fattah, Tristan Pascart, Georgios Filippou, Lih En Hong, John Fitzgerald, Nicola Dalbeth

Faculty, Staff and Students Publications

Objective: To agree on important domains for the Outcome Measures in Rheumatology (OMERACT) core domain set for chronic and/or recurrent manifestations of calcium pyrophosphate deposition (CPPD) disease.

Methods: Patient research partners (PRPs) and other participants (mainly clinicians and researchers) contributed to three rounds of a consensus survey using Delphi methodology. Consensus was defined if ≥70% of both patients and other participants scored the domain as 'critically important domain to include'. In a subsequent ranking exercise, all participants were asked to select and rank up to 10 of the domains reaching consensus.

Results: Fifteen domains reached consensus as critically important. Within …

Corrigendum To "Effects Of Dialysate Potassium Concentration Of 30 Mmol/L With Sodium Zirconium Cyclosilicate On Dialysis-Free Days Versus Dialysate Potassium Concentration Of 20 Mmol/L Alone On Rates Of Cardiac Arrhythmias In Hemodialysis Patients With Hyperkalemia" Kidney International 2025;107:169-179, David M Charytan, Wolfgang C Winkelmayer, Christopher B Granger, John P Middleton, Charles A Herzog, Glenn M Chertow, James M Eudicone, Jeremy D Whitson, James A Tumlin, Adapt Investigators

Faculty, Staff and Students Publications

No abstract provided.

Airway Immune Signatures In Severe And Fatal Infection With Covid-19, Naresh Doni Jayavelu, Jing Jing Qi, Slim Fourati, Farrah Kheradmand, Charles R Langelier, Lauren I R Ehrlich, Joann Diray-Arce, Annmarie Hoch, Monica Kraft, Patrice M Becker, Matthew C Altman, Ruth R Montgomery

Faculty, Staff and Students Publications

No abstract provided.

Aged Regulatory T Cells Fail To Control Autoimmune Lacrimal Gland Pathogenic Cd4+ T Cells, Kaitlin K Scholand, Laura Schaefer, Gowthaman Govindarajan, Zhiyuan Yu, Jeremias G Galletti, Cintia S De Paiva

Faculty, Staff and Students Publications

CD25KO mice are a model of Sjögren disease. CD25KO mice have severe inflammation and infiltrating lymphocytes to the lacrimal glands (LG). Whether the pathogenicity of CD25KO CD4+ T cells can be controlled in vivo by Tregs is unknown. Eight-week-old B6 and CD25KO mice LGs were submitted for RNA bulk sequencing. A total of 3481 genes were differentially expressed in CD25KO LG compared to B6. Tear washing analysis identified CD25KO mice had elevated protein levels of TNF, IFN-γ, and CCL5 and decreased protein levels of IL-12p40 and VEGF-A. Co-adoptive transfer of CD25KO CD4+ T cells with either young or aged B6 …

Stress, Employment Changes, And Psychological Distress Among Caregivers Of Patients With Head And Neck Cancer, Lama Abdurrahman, Vlad C Sandulache, Cielito Reyes-Gibby, Erich M Sturgis, Pavan Jhaveri, Hoda Badr

Faculty, Staff and Students Publications

Importance: Patients undergoing external beam radiation therapy (EBRT) for head and neck cancer (HNC) often experience adverse effects that require substantial caregiving. The burdens of caregiving can impact caregiver employment and mental health over time, yet this topic remains underexplored.

Objective: To examine the associations between caregiving for patients with HNC who undergo EBRT and caregiver stress, employment status, and psychological distress.

Design, setting, and participants: This was a secondary analysis of data from a longitudinal survey study that surveyed caregivers at baseline (ie, at initiation of EBRT) and at 4-month and 12-month follow-ups. The study was conducted at 2 …

Comparative Genotoxicological Analysis Of Occupational Pesticide Exposures: An Experimental Approach And Systematic Review, Moustafa Samy Sherif

Dissertations

This dissertation investigates the genotoxic and cytotoxic effects of pesticide exposure through three complementary research components: a systematic review of occupational pesticide exposure in Arab countries (AraSys), a systematic review on encapsulated versus conventional pesticide formulations (Encap-Sys), and experimental toxicological assessments of various pesticide formulations in human cell lines (Pyr-Ex). This experimental component includes cytotoxicity assays using propidium iodide and DNA damage assessments via alkaline comet assays in HL60 and HepG2 cell lines exposed to pyrethroid insecticides and glyphosate-based formulations.

The AraSys systematic review revealed a critical positive association between occupational pesticide exposure and DNA damage in agricultural workers in …

Epidemiology Of Shigella Species And Serotypes In Children: A Retrospective Substudy Of The Mal-Ed Observational Birth Cohort Study, Elizabeth T. Rogawski Mcquade, Jie Liu, Mustafa Mahfuz, Alexandre Havt, Furqan Kabir, Adil Kalam, Fatima Aziz, Sahrish Muneer, Najeeha Talat Iqbal, Zulfiqar Ahmed Bhutta

Department of Paediatrics and Child Health

Background: Shigellosis is a leading cause of diarrhoea in children globally. We aimed to assess the burden of specific Shigella species and Shigella flexneri serotypes, characterise their clinical syndromes and natural immunity, and evaluate their relevance as causes of diarrhoea and linear growth faltering.
Methods: In the MAL-ED birth cohort study, children younger than 17 days were enrolled from Nov 3, 2009, to Feb 29, 2012, in Bangladesh, Brazil, India, Nepal, Pakistan, Peru, Tanzania, and South Africa and were followed up for 2 years. In this retrospective substudy, we retested Shigella quantitative PCR-positive diarrhoeal and non-diarrhoeal stool samples with molecular …

Consumers' Perspectives On The Design Of A New Digital Frailty Education Course, ‘Focus On Frailty’: A Qualitative Co-Design Study, Kristiana Ludlow, Benignus Logan, Jhalak Arora, Sarah Martin, Elizabeth Miller, Ruth E. Hubbard, Nicola Warren, Olivia Gallagher, Rosemary Saunders

Research outputs 2022 to 2026

Introduction: Frailty-focused care in hospitals is hindered by systemic barriers, ageism and stereotypes about older adults and frailty. There is a need for frailty education to increase healthcare professionals' and students' understanding of frailty. Objective: As part of a larger study to co-design a new digital frailty education course, ‘Focus on Frailty’, this study aimed to explore consumers' and caregivers' perspectives on (i) how frailty and older adults should be represented in frailty education and (ii) what healthcare professionals should be taught about caring for older adults and people who are frail in hospitals. Design: This was a qualitative co-design …

Leadership And Capacity Building In International Osteopathic Research: Introducing Strengthening Osteopathy Leadership And Research (Solar) Program, Cindy Mcintyre, Gopi Anne Mcleod, Ana Paula Antunes Ferreira, Francesco Cerritelli, Jerry Draper-Rodi, Jack Feehan, Michael Fleischmann, Kesava Kovanur Sampath, Chantal Morin, Lee Muddle, Niklas Sinderholm Sposato, Oliver P. Thomson, Loïc Treffel, Nicholas Tripodi, Brett Vaughan, Amie Steel, Jon Adams

Research outputs 2022 to 2026

Research evidence has become the foundation of modern health services. Health professionals rely on sound research to provide safe and effective care for patients, for the development of innovative diagnostic and treatment practices and to develop policies supporting the provision of optimal healthcare. Osteopathy is an established profession with an emerging research evidence base. The Strengthening Osteopathic Leadership and Research (SOLAR) program is a recent international initiative aiming to further build the evidence base and research capacity of the osteopathy profession. The program was developed by The Australian Research Consortium in Complementary and Integrative Medicine (ARCCIM) at the University of …

A Farewell Message, Misty L. Rhoads

Journal of Transformative Touch

No abstract provided.

Investigating The Associations Of Cognitive Health, Health Behaviors, And Personality In Older Community-Dwelling Adults, Yan-Jhu Su

Graduate Doctoral Dissertations

Cognitive decline poses a significant public health challenge, with profound implications for aging populations. This dissertation investigates the associations between health behaviors, leisure activities, personality traits, and cognitive function in older U.S. adults, using data from the Health and Retirement Study (HRS) and the Consumption and Activities Mail Survey (CAMS). This work comprises three studies that explore both cross-sectional and longitudinal perspectives on cognitive aging.

Study 1 examines the complex interactions between personality traits, education, health behaviors, and cognitive function. The study is divided into two parts: Study 1a explores the role of health behaviors—smoking, alcohol use, and physical activity—as …

Determinants Of Teenage Pregnancy In Tanzania, Harun Yussuf Ayoub, Kemal Nazaruddin Siregar

Jurnal Biostatistik, Kependudukan, dan Informatika Kesehatan

Teenage pregnancies are among the leading public health problems in Tanzania. This was linked to limited education, socioeconomic disparities, cultural barriers, and inadequate access to healthcare centers. Thus, this study aims to explore the prevalence and predictors of teenage pregnancy among adolescent women using data from the 2022-2023 Tanzanian Demographic Health Survey (TDHS). The research design employed a cross-sectional approach and utilized TDHS data. The population for this study was female adolescents, while the sample was 7,545 adolescent women aged 15-24 years. Predictor variables were education level, socioeconomic status, place of residence, employment status, and lifestyle factors, including alcohol consumption …

High Prevalence Of Diabetes Mellitus Among Patients With Fabry Disease In Taiwan: A Cross-Sectional Study, Shih Han Hung, Sudha Xirasagar Mbbs., Ph.D, Yen Fu Cheng, Herng Ching Lin, Chin Shyan Chen

Publications

Objectives This study aimed to investigate the prevalence of diabetes mellitus in patients with Fabry disease using a nationwide population-based dataset. We hypothesised that patients with Fabry disease would have a higher prevalence of diabetes mellitus compared with the general population. Design A cross-sectional study. Setting Taiwan. Participants We identified a study sample from Taiwan's LHID2010 Database. There were 9408 sampled patients in this study, 2352 study patients with Fabry disease and 7056 propensity-score-matched comparison patients. Primary outcome measures Multiple logistic regression analyses were conducted to explore the association between diabetes mellitus and Fabry disease after taking the variables of …

Prosthesis, Alexander A. Grosek

Masters Theses

This thesis explores the hospital as a prosthetic—a structural and spatial support for the human body in moments of vulnerability. Like a crutch or cast, the hospital temporarily supports patients in their transition from horizontal (infirm) to vertical (mobile), yet its architecture often fails to contribute meaningfully to that healing process. While clinical treatment is prioritized, the spatial, emotional, and sensory dimensions of care are neglected. What supports what becomes a central question: the building holds the body, but the body also gives meaning to the building. Their relationship is reciprocal.

Rather than proving that good design improves health—an idea …

Understanding Occupational Health And Safety Regulations And The Influence On Students' Behavior In Practical Workshops, M. Yusuf, I Ketut Gde Juli Suarbawa, Ni Wayan Merda Surya Dewi, Ni Wayan Sadiyani, I Made Sudana

Kesmas

Understanding occupational health and safety (OHS) is essential for engineering students, especially in high-risk environments such as mechanical workshops, where unsafe practices can lead to accidents and injuries. Although Regulation Number 5 of 2018 from the Indonesian Ministry of Manpower mandates OHS implementation in all workplaces, students’ knowledge and behavior still fall short of the expected safety standards. This study aimed to measure students’ understanding of OHS, their basic knowledge of OHS law, and their behavior during workshop practicum activities. A cross-sectional research design was used, involving 203 students in State Polytechnic in Badung District, Indonesia. Data were collected through …

Food Hygiene And Sanitation Of The University Canteens In South Sumatra Province, Indonesia, Anita Rahmiwati, Fatmalina Febry, Fenny Etrawati, Indah Purnama Sari, Yeni Yeni, Virgina Putri Sabila, Erike Septa Prautami, Maretalinia Maretalinia

Kesmas

Food safety is a critical public health issue, especially in institutional settings such as university canteens, where large populations are served daily. Inadequate hygiene and sanitation practices by food handlers can lead to foodborne illnesses, placing students and staff at risk. This study evaluated hygiene and sanitation conditions in the canteens of a leading public university in South Sumatra Province, Indonesia, known for its active food service facilities. This study examined food handlers’ knowledge, attitudes, and practices and assessed the microbiological safety of chicken curry by testing for Escherichia coli (E. coli) contamination and total plate count. Using a cross-sectional …

Development Of Audiovisual Media For Reproductive Health Education For Parents Of Adolescents, Tanjung Anitasari Indah Kusumaningrum, Nurul Latifatul Inayati, Setia Asyanti, Ayu Khoirotul Umaroh, Wardhatul Livia, Ramadani Nur Laili, Trijaya Trijaya, Ririn Cahya Dewanti, Yuli Kusumawati, Izzatul Arifah

Kesmas

Parents are the primary source of information for adolescents, but many parents lack an understanding of health materials. For knowledge to be increased, health media, one of which is audiovisual media, are desirable. This study aimed to develop audiovisual media on adolescents’ reproductive health. Media development utilized the analyze, design, develop, implement, and evaluate (ADDIE) model. The respondents in this study were parents of adolescents aged 10–14 years, comprising 10 parents in the small group evaluation, 20 in the field evaluation, and 10 in the implementation stage. The effectiveness of the media was tested through pretests and posttests. Using a …

Social Eating Role In Ultra-Processed Food Consumption Among Urban Young Adults: The 2018 Indonesian Food Barometer, Imas Arumsari, Nabilla Ayusyah Putri, Siti Nur Lulu Lathifah, Gita Aisyah Astrid Rosalba, Helda Khusun, Judhiastuty Februhartanty, Rahmatika Nur Aini

Kesmas

This study investigated the differences in ultra-processed food (UPF), fruit, vegetable, and total fat consumption in different aspects of social eating among urban young adults. This cross-sectional study used the 2018 Indonesian Food Barometer dataset with 180 participants aged 18–25 years living in urban areas from 6 provinces in Indonesia. The data on social eating (cooking habits, eating out, and eating alone), UPF, fruits, and vegetables were obtained from an extended 24-hour food recall interview. The Mann-Whitney U test (CI 95%) was employed for data analysis. This study found that groups with less frequent cooking habits tended to have more …

Job Satisfaction Among Health Workers At Primary Health Care In Palembang City, Indonesia, Asmaripa Ainy, Merri Nurmala Sarri, Poppy Fujiyanti, Hartati Inaku, Tannia Tembo

Kesmas

Health workers at primary health care are the frontline providers of community health services. This study aimed to investigate the level of job satisfaction of health workers at primary health care in Palembang City, South Sumatra Province, Indonesia, and its influencing factors. Using a questionnaire developed by the authors' team, the study involved 257 samples. A total of 66.15% of respondents indicated high satisfaction, 21.79% reported moderate satisfaction, and 12.06% expressed dissatisfaction. A statistically significant correlation was found between knowledge, skills, income, promotion opportunities, work supervision, and relationships with colleagues and job satisfaction (p-value <0.001). The correlations were strong, with Spearman's rho of 0.822, 0.869, 0.912, 0.895, and 0.821, respectively. Statistical analysis of the Wilcoxon rank-sum and Kruskal-Wallis tests showed no significant differences in median satisfaction scores between sociodemographic groups (p-value 0.072 to 0.552>0.05). These findings showed that job …