Public Health Commons^™

Community-Level Factors And Their Associations With Changing Opioid Overdose Fatality Rates In Kentucky, 2019–2021, Shawn R. Nigam, Philip M. Westgate, Svetla Slavova, Rachel Vickers-Smith, Katherine L. Thompson

Journal of Appalachian Health

Introduction: Kentucky has one of the highest opioid overdose fatality rates in the United States, which has increased significantly from 2019 to 2020. The COVID-19 pandemic has caused lasting effects on mental health and health care, which have been linked with increased opioid overdose. These effects are exacerbated in Appalachian regions, where there is a lack of sufficient access to community pharmacies and adequate health care.

Purpose: In this study, we characterize changes in opioid overdose fatality rates in Kentucky from 2019 to 2021, with a specific focus on changes in Appalachian vs non-Appalachian counties. We aim to identify associations …

Characteristics Associated With Early Vs. Late Adoption Of Lung Cancer Screening, Christine S. Shusted, Jan M. Eberth, Hee-Soon Juon, Julie Barta

Division of Pulmonary, Allergy, and Critical Care Medicine Faculty Papers

Background: Although lung cancer screening (LCS) reduces lung cancer mortality among high-risk individuals, uptake overall remains low. With all cancer screening modalities, a period of diffusion among medical providers and the public is expected, with screening uptake exhibiting a distribution among early vs. late adoption. We aimed to characterize individuals undergoing LCS based upon the timeframe of screening adoption. Methods: This retrospective study examined patients who underwent LCS between January 2015 – December 2022 in a centralized LCS program. Based on United States Preventive Services Task Force (USPSTF) criteria for LCS, early and late adopters of LCS – defined by …

Hampton's Hump- A Rare Radiographic Finding In Pulmonary Embolism, Tanshi Anand

Digital Journal of Clinical Medicine

Background- Pulmonary embolism is a condition that is characterized by occlusion of the pulmonary circulation, usually originating from deep vein thrombosis in the lower extremities. This condition is difficult to diagnose as it can present with a wide spectrum of nonspecific symptoms, making it a life-threatening illness.

Case Description- A 50-year-old man with a medical history of deep vein thrombosis, ischemic heart disease, dilated cardiomyopathy with left ventricular dysfunction, diabetes, hypertension, and COPD presented with fever, cough with expectoration, orthopnea, and exertional dyspnea. A routine X-ray was done and revealed Hampton’s hump, a rare radiographic finding persistent with possible …

Ai Driven Analysis Of Mri To Measure Health And Disease Progression In Fshd, Lara Riem, Olivia Ducharme, Matthew Cousins, Xue Feng, Allison Kenney, Jacob Morris, Stephen J Tapscott, Rabi Tawil, Jeff Statland, Dennis Shaw, Leo Wang, Michaela Walker, Leann Lewis, Michael A Jacobs, Doris G Leung, Seth D Friedman, Silvia S Blemker

Faculty, Staff and Student Publications

Facioscapulohumeral muscular dystrophy (FSHD) affects roughly 1 in 7500 individuals. While at the population level there is a general pattern of affected muscles, there is substantial heterogeneity in muscle expression across- and within-patients. There can also be substantial variation in the pattern of fat and water signal intensity within a single muscle. While quantifying individual muscles across their full length using magnetic resonance imaging (MRI) represents the optimal approach to follow disease progression and evaluate therapeutic response, the ability to automate this process has been limited. The goal of this work was to develop and optimize an artificial intelligence-based image …

Comorbidity Of Disordered Eating And Depression: Examining Intersectional Inequities And Cardiometabolic Health Consequences Across The Life Course, Franklin Hunter Mcguire

Brown School Graduate Student Theses and Dissertations

Traditional epidemiologic research has often neglected the degree to which interlocking systems of oppression may (1) describe the distribution of population health inequities and (2) moderate health exposure-outcome associations. Grounded in an intersectional framework, this three-aim dissertation used an intersectional multilevel modeling approach (i.e., intersectional MAIHDA) and US nationally representative data to answer a series of intersectionality-informed research questions relevant to disordered eating, depression, and cardiometabolic health. With data from the National Health and Nutrition Examination Survey, Aim 1 quantified the population distribution of weight loss-oriented disordered eating behaviors (DEBs) among US adults across intersectional groups defined by race/ethnicity, sex/gender, …

What Constitutes Adequate Control Of High Blood Pressure? Current Considerations, Donald E. Casey, Alexander J. Blood, Stephen D. Persell, Daniel Pohlman, Jeff D. Williamson

College of Population Health Faculty Papers

An estimated 45% of adult Americans currently have high blood pressure (HBP). Effective blood pressure (BP) control is essential for preventing major adverse events from cardiovascular and other vascular-related diseases, such as chronic kidney disease, stroke and dementia. A large and growing number of medical professional societies, health care organizations, and governmental agencies have now endorsed a clinical practice guideline-based target for adequate control of HBP to a systolic BP of less than 130 mm Hg. However, adequate BP control to this goal has been recently estimated to be as low as 30%. The first and most important steps to …

Intersectional Analysis Of Vaccination Inequity Among Individuals With Disabilities In The United States During Covid-19 Pandemic, Philip Ndoki Ndoki

Walden Dissertations and Doctoral Studies

This study was an investigation of how disability status, types, sociodemographic indicators, and reasons for not receiving vaccinations influenced COVID-19 vaccination rates among individuals with disabilities in the United States. Despite efforts, vaccination disparities persisted, necessitating an understanding of barriers to uptake. Using intersectionality theory and the social determinants of health framework, this study examined the impact of marginalized identities and structural inequalities. Key questions included the association between disability status and vaccination uptake, differences among disability types moderated by sociodemographic factors, and the interaction between disability status and reasons for not vaccinating. Household Pulse Survey data from the US …

Caregiver Recruitment Strategies For Interventions Designed To Optimize Transitions From Hospital To Home: Lessons From A Randomized Trial, Allison M Gustavson, Molly J Horstman, Jodie A Cogswell, Diane E Holland, Catherine E Vanderboom, Jay Mandrekar, William S Harmsen, Brystana G Kaufman, Cory Ingram, Joan M Griffin

Faculty, Staff and Students Publications

Challenges to recruitment of family caregivers exist and are amplified when consent must occur in the context of chaotic healthcare circumstances, such as the transition from hospital to home. The onset of the COVID-19 pandemic during our randomized controlled trial provided an opportunity for a natural experiment exploring and examining different consent processes for caregiver recruitment. The purpose of this publication is to describe different recruitment processes (in-person versus virtual) and compare diversity in recruitment rates in the context of a care recipient's hospitalization. We found rates of family caregiver recruitment for in-person versus virtual were 28% and 23%, respectively …

The Protective Efficacy Of A Sars-Cov-2 Vaccine Candidate B1351v Against Several Variant Challenges In K18-Hace2 Mice, Jie Yang, Huifen Fan, Anna Yang, Wenhui Wang, Xin Wan, Fengjie Lin, Dongsheng Yang, Jie Wu, Kaiwen Wang, Wei Li, Qian Cai, Lei You, Deqin Pang, Jia Lu, Changfu Guo, Jinrong Shi, Yan Sun, Xinguo Li, Kai Duan, Shuo Shen, Shengli Meng, Jing Guo, Zejun Wang

Faculty, Staff and Student Publications

The emergence of SARS-CoV-2 variants of concern (VOCs) with increased transmissibility and partial resistance to neutralization by antibodies has been observed globally. There is an urgent need for an effective vaccine to combat these variants. Our study demonstrated that the B.1.351 variant inactivated vaccine candidate (B.1.351V) generated strong binding and neutralizing antibody responses in BALB/c mice against the B.1.351 virus and other SARS-CoV-2 variants after two doses within 28 days. Immunized K18-hACE2 mice also exhibited elevated levels of live virus-neutralizing antibodies against various SARS-CoV-2 viruses. Following infection with these viruses, K18-hACE2 mice displayed a stable body weight, a high survival …

Which Types Of People Were Least Likely To Get The Covid-19 Vaccine?, Xue Zhang, Shannon M. Monnat

Population Health Research Brief Series

Vaccine hesitancy is a long-standing challenge that worsened during the COVID-19 pandemic. Understanding the reasons behind different types of vaccine hesitancy is crucial for developing effective vaccine messaging strategies that can increase confidence in and uptake of future vaccines. This brief summarizes the findings from a study that used data from the 2022 National Wellbeing Survey on 7,612 U.S. adults aged 18-64 to identify characteristics of adults who were least likely to get the COVID-19 vaccine and the characteristics associated with different types of vaccine hesitancy. The authors considered three non-mutually exclusive types of vaccine hesitancy: 1) watchful (concerned about …

Associations Between Covid-19 Therapies And Outcomes In Rural And Urban America: A Multisite, Temporal Analysis From The Alpha To Omicron Sars-Cov-2 Variants, A. Jerrod Anzalone, William H. Beasley, Kimberly Murray, William B. Hillegass, Makayla Schissel, Michael T. Vest, Scott A. Chapman, Ronald Horswell, Lucio Miele, J. Zachary Porterfield, H. Timothy Bunnell, Bradley S. Price, Sharon Patrick, Clifford J. Rosen, Susan L. Santangelo, James C. Mcclay, Sally L. Hodder

School of Medicine Faculty Publications

Purpose: To investigate the enduring disparities in adverse COVID-19 events between urban and rural communities in the United States, focusing on the effects of SARS-CoV-2 vaccination and therapeutic advances on patient outcomes. Methods: Using National COVID Cohort Collaborative (N3C) data from 2021 to 2023, this retrospective cohort study examined COVID-19 hospitalization, inpatient death, and other adverse events. Populations were categorized into urban, urban-adjacent rural (UAR), and nonurban-adjacent rural (NAR). Adjustments included demographics, variant-dominant waves, comorbidities, region, and SARS-CoV-2 treatment and vaccination. Statistical methods included Kaplan-Meier survival estimates, multivariable logistic, and Cox regression. Findings: The study included 3,018,646 patients, with rural …

Veterans In Focus: Disability And Veterans In Rural America, Hannah W. Pepprock, Lillie Greiman, University Of Montana Rural Institute

Health and Wellness

There are an estimated 17 million Veterans living throughout the United States. Relative to the general population, Veterans are more likely to experience disability. Veterans are also disproportionately represented in rural areas across the U.S. As people with disabilities are also disproportionately represented in rural areas, it is valuable to explore the intersection between veteran status, disability, and rurality. This analysis uses publicly available date from the American Community Survey to examine service-connected disability rating status and the ACS-6 questions on functional ability as they related to U.S. regions and rurality.

Strengthening Linkages Between Health Care And Public Health: A Novel Framework For Public Health Action In Health Care Settings To Improve Cardiovascular Disease Risk, Candice Fryda, Liz Gebhart-Morgan, Mindy Anderson-Knott, Nicole Roseberry, Jamie Hahn, Kelli Niemeier, Jennifer Rutt, Debra Miller

UNL Office of Research and Innovation, Social/Behavioral Sciences Research Consortium

The Chronic Disease Prevention and Control Program (CDPCP) at the Nebraska Department of Health and Human Services developed a novel public health framework and tools to translate public health knowledge, grant work, and terminology to a health care audience in order to inform clinical practice changes in the management of hyperlipidemia and hypertension. The CDPCP piloted the tools with 2 accountable care organizations that included 19 clinics and then funded 9 independent clinics. The project sought to empower clinics to design and implement interventions for reducing high blood pressure and high blood cholesterol focused on populations disproportionately at risk for …

The Key Elements And Driving Paths Of Digital Empowerment For The Efficient Construction Of The Rural Medical And Health Service System: Based On 28 Cases Through Fsqca, Liqing Li, Ming Yu

Journal of Scientific Information Research

[Purpose/significance]This paper explores the linkage effect and improvement path of technology-organization-environment antecedents on the efficient construction of digital empowerment rural medical and health service system, in order to accelerate the research progress of digital construction of rural medical and health service. [Method/process]Based on the technology-organization-environment (TOE) framework and China's real-life scenarios, this paper constructs a theoretical analysis framework for the efficient construction of digital empowerment rural medical and health service system, Using the method of fuzzy set qualitative comparative analysis, this paper takes the rural areas of 28 provinces (autonomous regions and municipalities directly under the central government) in China …

Multicountry Spread Of Influenza A(H1n1)Pdm09 Viruses With Reduced Oseltamivir Inhibition, May 2023-February 2024, Mira C Patel, Ha T Nguyen, Philippe Noriel Q Pascua, Rongyuan Gao, John Steel, Rebecca J Kondor, Larisa V Gubareva

Faculty, Staff and Student Publications

Since May 2023, a novel combination of neuraminidase mutations, I223V + S247N, has been detected in influenza A(H1N1)pdm09 viruses collected in countries spanning 5 continents, mostly in Europe (67/101). The viruses belong to 2 phylogenetically distinct groups and display ≈13-fold reduced inhibition by oseltamivir while retaining normal susceptibility to other antiviral drugs.

Mixed-Methods Assessment Of Farmworkers’ Perceptions Of Workplace Compliance With Worker Protection Standards And Implications For Risk Perceptions And Protective Behaviors, Carly Hyland, Lisa Meierotto, Rebecca L. Som Castellano, Cynthia L. Curl

Public and Population Health Faculty Publications and Presentations

Introduction: The Environmental Protection Agency (EPA)’s Worker Protection Standards is the primary set of legislation aimed at protecting farmworkers from occupational pesticide exposure in the United States. Previous studies suggest that worker adoption of Pesticide Protective Behaviors (PPBs) promoted by WPS is associated with lower urinary pesticide concentrations. However, adoption of PPBs is often outside of the control of individual farmworkers and dependent on workplace factors such as employer provisioning of Personal Protective Equipment (PPE) and access to trainings/resources.

Methods: We conducted a mixed-method study including urinary pesticide biomonitoring, surveys, and interviews with 62 Latinx farmworkers in southwestern Idaho from …

Antenatal Care Utilisation And Receipt Of Its Components In Nigeria: Assessing Disparities Between Rural And Urban Areas—A Nationwide Population-Based Study, Emmanuel O. Adewuyi, Asa Auta, Mary I. Adewuyi, Aaron Akpu Philip, Victory Olutuase, Yun Zhao, Vishnu Khanal

Research outputs 2022 to 2026

Introduction Antenatal care (ANC) is crucial for positive pregnancy outcomes, but it is underutilised in Nigeria, suggesting unmet needs, and potentially contributing to the country’s high burden of maternal and neonatal mortalities. This study comprehensively assesses ANC utilisation and receipt of its components in Nigeria, focusing on disparities between rural and urban areas. Methods We used the data disaggregation approach to analyse the Nigeria Demographic and Health Survey 2018. We estimated ANC utilisation, assessed the receipt of ANC components, and identified factors associated with eight or more (≥ 8) ANC contacts nationally and across rural and urban residences. Results Nationwide, …

A Landscape Evaluation Of Caffeine Citrate Availability And Use In Newborn Care Across Five Low- And Middle-Income Countries, Osayame Ekhaguere, Olufunke Bolaji, Helen Nabwera, Andrew Storey, Nicholas Embleton, Stephen Allen, Zelalem Demeke, Olufunke Fasawe, Betty Wariari, Mansharan Seth

Centre of Excellence in Women and Child Health

Apnoea of prematurity (AOP) is a common complication among preterm infants (< 37 weeks gestation), globally. However, access to caffeine citrate (CC) that is a proven safe and effective treatment in high-income countries is largely unavailable in low- and-middle income countries, where most preterm infants are born. Therefore, the overall aim of this study was to describe the demand, policies, and supply factors affecting the availability and clinical use of CC in LMICs. A mixed methods approach was used to collect data from diverse settings in LMICs including Ethiopia, Kenya, Nigeria, South Africa, and India. Qualitative semi-structured interviews and focus group discussions were conducted with 107 different health care providers, and 21 policymakers and other stakeholders from industry. Additional data was collected using standard questionnaires. A thematic framework approach was used to analyze the qualitative data and descriptive statistics were used to summarize the quantitative data. The findings indicate that there is variation in in-country policies on the use of CC in the prevention and treatment of AOP and its availability across the LMICs. As a result, the knowledge and experience of using CC also varied with clinicians in Ethiopia having no experience of using it while those in India have greater knowledge and experience of using it. This, in turn, influenced the demand, and our findings show that only 29% of eligible preterm infants are receiving CC in these countries. There is an urgent need to address the multilevel barriers to accessing CC for managing AOP in Africa. These include cost, lack of national policies, and, therefore, lack of demand stemming from its clinical equivalency with aminophylline. Practical ways to reduce the cost of CC in LMICs could potentially increase its availability and use.

Perceptions Of Communities Of Practice And Sense Of Belonging: Focus Groups Of Academic Pediatric Faculty, Margaret P. Huntwork, Myo T. Myint, Emma Simon, Bonnie Desselle, Amy M. Creel

School of Medicine Faculty Publications

BACKGROUND: Providing the opportunity for collaboration around a central purpose to improve skills and exchange knowledge, the Community of Practice model can be useful for faculty development. A sense of belonging enhances the engagement in communities. Yet, the barriers and contributors to academic medicine faculty's sense of belonging in communities are not as well explored. METHODS: Through focus groups with 21 academic pediatric faculty conducted between January and March 2023, this qualitative study examined knowledge of Communities of Practice and the factors that affect sense of belonging and engagement. The authors iteratively coded transcripts to generate themes. RESULTS: Community accessibility; …

Occupational Stress And Coping During A Public Health Emergency: A Mixed-Methods Approach To Understand The Experiences Of Lactation Professionals In Clinical Settings, Mya Michele Carter

Health Services Research Dissertations

Introduction: During public health emergencies, such as the coronavirus 2019 pandemic, breastfeeding is still the recommended feeding option, and mothers and babies may need additional support to reach breastfeeding goals. Pandemic-related, clinic-level restrictions posed new challenges for postpartum mothers and their healthcare teams, including lactation professionals (LPs). The pandemic and subsequent restrictions may have impacted lactation professionals’ work-related stress and limited their ability to provide lactation support. Coping strategies to mitigate occupational stress can be useful in preventing adverse outcomes for both the provider and the patient. The need for continuous support for this profession of healthcare workers is paramount. …

The Blessed Assembly: Irreplaceable Physical Co-Presence In Worship And Healthy Hybridity Reimagined After The Pandemic In The Digital Age, Yvette, Ying Wai Lau

Doctor of Pastoral Music Projects and Theses

Because of the unprecedented and unexpected force of the pandemic since 2020, most churches around the world have experienced some online worship during the lockdown of their cities or the mandated closure of the church buildings. For many people, online worship seems to be an equivalent, if not better, alternative for gathering together—a physical co-presence in worship—even after the pandemic has ended. As necessary and vital as online worship experiences have been for Christians during the pandemic, the witness of the church from Pentecost throughout Christian history indicates that gathered worship in physical spaces is irreplaceable for faith formation and …

Distinct Genetic Liability Profiles Define Clinically Relevant Patient Strata Across Common Diseases, Lucia Trastulla, Georgii Dolgalev, Sylvain Moser, Laura T. Jiménez-Barrón, Till F. M. Andlauer, Moritz Von Scheidt, Schizophrenia Working Group Of The Psychiatric Genomics Consortium:, Douglas M. Ruderfer, Stephan Ripke, Andrew Mcquillin, Eli A. Stahl, Enrico Domenici, Rolf Adolfsson, Ingrid Agartz, Esben Agerbo, Margot Albus, Madeline Alexander, Farooq Amin, Silviu A. Bacanu, Martin Begemann, Richard A. Belliveau Jr., Judit Bene, Sarah E. Bergen, Elizabeth Bevilacqua, Tim B. Bigdeli, Donald W. Black, Douglas H. R. Blackwood, Anders D. Borglum, Nancy G. Buccola, Et Al

School of Nursing Faculty Publications

Stratified medicine holds great promise to tailor treatment to the needs of individual patients. While genetics holds great potential to aid patient stratification, it remains a major challenge to operationalize complex genetic risk factor profiles to deconstruct clinical heterogeneity. Contemporary approaches to this problem rely on polygenic risk scores (PRS), which provide only limited clinical utility and lack a clear biological foundation. To overcome these limitations, we develop the CASTom-iGEx approach to stratify individuals based on the aggregated impact of their genetic risk factor profiles on tissue specific gene expression levels. The paradigmatic application of this approach to coronary artery …

Examining Enrollment & Engagement In A Hospital-Based Violence Prevention Intervention Study At A Level 1 Trauma Center, Leigh Frederick

Electronic Theses and Dissertations

BACKGROUND: Violence is a significant healthcare issue that affects the health and well-being of individuals, families, and communities. Violence prevention and intervention programs are a powerful way to stop the revolving door of violent injury in our hospitals and communities. The Health Alliance for Violence Intervention (HAVI), develops and connects violence intervention programs, promotes equity for victims of violence globally, and is dedicated to engaging patients during the window of opportunity when they are recovering in the hospital after a violent injury to reduce the chance of retaliation (related to the injury) and recurrence. A small body of research shows …

Burnout Among Medical Residents, Coping Mechanisms And The Perceived Impact On Patient Care In A Low/ Middle Income Country, Charles Muteshi, Elizabeth Ochola, Dorothy Kamya

Obstetrics and Gynaecology, East Africa

Background: Burnout is a syndrome that result from chronic workplace stress and it characterized by emotional exhaustion, depersonalization and low personal accomplishments. Studies report higher burnout levels in medical personnel compared to the general population. Workplace burnout has been directly linked to medical errors and negative coping strategies such as substance abuse. The aims of this study were to assess the level of burnout in medical residents, evaluate their impressions about coping mechanisms and assess perceived impact on patient care in a low/ middle income country setting.

Methods: This was a cross sectional, mixed methods survey carried out at Aga …

J Mich Dent Assoc July 2024

The Journal of the Michigan Dental Association

Every month, the Journal of the Michigan Dental Association provides news, information, and features about Michigan dentistry to our state's oral health community and the MDA's 6,200+ members. It is the primary publication reaching Michigan dentists.

The July issue of the Michigan Dental Association (MDA) journal focuses on the member and public value of the association's Public Education Campaign through a cover story "Smile Brighter Michigan!". It also features articles on:

• How to get value from your MDA membership

• Joining the MDA Forensic Dental Team

• A new professional column, News you need, an editorial and regular department articles covering MDA …

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Knowledge, Attitudes And Practices Regarding Sexually Transmitted Infections In South Carolina: A Cross-Sectional Survey And Comparison To Geographically-Associated Social Determinants Of Health, Sean Patrick Sweeney

Theses and Dissertations

Sexually transmitted disease (STD) rates are on the rise in the United States. South Carolina ranks consistently among the states with the highest STD burdens, especially for the bacterial diseases gonorrhea and chlamydia. This study sought to determine the opinions, beliefs, and knowledgebase of South Carolina citizens regarding STDs and sexual health/education. In doing so, the study seeks to identify areas of improvement for educators, healthcare workers, and public health employees. Using a web-based cross-sectional survey, this study contacted approximately 900,000 South Carolina residents for participation. Participants were asked a variety of questions focused on STD knowledge, opinions, and practices. …

Baseline Assessment Of Cervical Cancer Screening And Treatment Capacity In 25 Counties In Kenya, 2022, Valerian Mwenda, David Murage, Catherine Kilonzo, Joan-Paula Bor, Patricia Njiri, Lance Osiro, Mary Nyangasi, Marc Arbyn, Philippe Tummers, Marleen Temmerman

Centre of Excellence in Women and Child Health

Background: Cervical cancer is the leading cause of cancer deaths among women in Kenya. In the context of the Global strategy to accelerate the elimination of cervical cancer as a public health problem, Kenya is currently implementing screening and treatment scale-up. For effectively tracking the scale-up, a baseline assessment of cervical cancer screening and treatment service availability and readiness was conducted in 25 priority counties. We describe the findings of this assessment in the context of elimination efforts in Kenya.

Methods: The survey was conducted from February 2021 to January 2022. All public hospitals in the target counties …

Smile Brighter, Michigan: Inside The Mda Public Education Campaign, Rich Evans

The Journal of the Michigan Dental Association

The Michigan Dental Association's (MDA) Public Education Campaign, active for over three decades, aims to improve oral health and encourage visits to MDA-member dentists across Michigan. Funded by member dues, the campaign uses digital advertising and the smilemichigan.com website to educate the public. Key initiatives include the Find-A-Dentist tool, the "Healthy Mouth, Healthy Body" program, and various community outreach efforts. Upcoming features include the "Story Behind Every Smile" campaign, highlighting personal stories about the impact of dental health. By promoting proactive oral care, the MDA supports better overall health for Michigan residents.

In Their Voices: Kenyan Women's Experiences With Cancer Treatment–Related Side Effects, Tayreez Mushani, Dinah Kassaman, Sharon Brownie, Peterson Kiraithe, Margaret Barton-Burke

School of Nursing & Midwifery, East Africa

Objective This article reports on a secondary analysis of a qualitative study conducted in Nairobi, Kenya that reported several initial themes. In this article, the authors explore the theme of treatment-related side effect management by women receiving treatment for breast or cervical cancer.

Methods Women were interviewed at three points during their active treatment trajectory. Participants were purposefully selected and saturation was reached when interviews did not yield any new themes. The interviews were transcribed and analyzed for internal consistency, frequency, extensiveness, intensity and specificity. The Nvivo pro 12 software was used in organizing and managing the data to facilitate …

Interdisciplinary Perspectives On Multimorbidity In Africa: Developing An Expanded Conceptual Model, Justin Dixon, Ben Morton, Misheck Nkhata, Alan Silman, Ibrahim Simiyu, Stephen Spencer, Myrna Van Pinxteren, Edna Bosire, Christopher Bunn, Claire Calderwood

Brain and Mind Institute

Multimorbidity is an emerging challenge for health systems globally. It is commonly defined as the co-occurrence of two or more chronic conditions in one person, but its meaning remains a lively area of academic debate, and the utility of the concept beyond high-income settings is uncertain. This article presents the findings from an interdisciplinary research initiative that drew together 60 academic and applied partners working in 10 African countries to answer the questions: how useful is the concept of multimorbidity within Africa? Can the concept be adapted to context to optimise its transformative potentials? During a three-day concept-building workshop, we …