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Millions of men, as a result of the natural aging process, injury, illness, and medical therapies, experience a decline in testosterone levels that necessitate a need for testosterone supplementation therapy (TST). The signs and symptoms of testosterone decline may occur gradually, and low testosterone levels may be misdiagnosed as other medical conditions. Over the past two decades, there has been an increase in testing of testosterone levels and the use of TST. With so many men now on TST, it is essential for health care professionals to know the signs and symptoms, the causes of testosterone decline, how testosterone deficiency is diagnosed, what pathological changes are associated with testosterone decline, and the benefits and risks of TST. In addition, health care providers need to be aware of the various forms of testosterone available as well as the advantages and disadvantages of each. This article provides a brief overview of testosterone deficiency, TST treatment options and guidelines, and the risks and benefits associated with of TST.

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Thesis (MPH.) --University of Limpopo, 2009 / Please refer to the document

The purpose of this study was to examine the feasibility of a behavioral health referral protocol and barriers to behavioral health care in a pediatric epilepsy clinic. A sample of 93 youth with epilepsy ages 10–17 and caregivers completed behavioral health and seizure severity measures during a routine epilepsy clinic visit. Key findings are that 47 (50.5%) of the youth screened positive for a behavioral health referral, and 35 of these youth were referred for behavioral health services. However, only 20% made and presented for the behavioral health appointment. The most commonly cited barrier for accessing and utilizing behavioral health care was stigma related- a mental health label for the child. The significance of this study lies in the revelation that solely screening for and educating caregivers about behavioral health symptoms and providing behavioral health referral information is not an ideal model. Instead, stigma related barriers point to the necessity of continued integrated physical and behavioral health care within the pediatric epilepsy visit.

Social determinants of health (SDOH) affect quality-of-life outcomes and risks.  In underserved populations, health care access and quality are often poor.  Mainstream bioethics has highlighted the importance of equity in the delivery of healthcare with a focus on the community's health disparities and inadequate access to quality healthcare. Diabetes is one of the top ten causes of death according to the World Health Organization (WHO, 2020).  Many underserved populations in the U.S. including the city of Philadelphia have a high probability of developing diabetes due to their poor diets, obesity, and sedentary lifestyle. Often it is difficult to reach the underserved population that need education and healthcare screening. After a review of the history of the prevalence of diabetes in the U.S., I discuss and analyze the development and implementation of a mobile health vehicle (MHV) World Diabetes Day event in Philadelphia. / Urban Bioethics

Breast cancer is the second leading cause of cancer death among women in the United States. Nonadherence to recommended screening guidelines and lack of screening contribute to late stage diagnosis and increased morbidity and mortality among racial and ethnic women in the United States. The purpose of this study was to assess breast cancer screening practices, knowledge, and beliefs among Cameroonian immigrant women who were 40 years and older living in the metropolitan Washington, D.C. region. This quantitative cross-sectional study was guided by the health belief model and used the revised version of Champion's health belief model scale. A convenience sample (N=267) responded to a 60-item self-administered online survey that assessed knowledge of breast cancer screening, demographic variables, constructs of the health belief model and adherence (defined as obtaining a mammogram within two years). Data analyses performed included descriptive analysis, correlational and multiple linear regression. Results of this study revealed that increased level of education and self-efficacy were associated with greater knowledge of the benefits of mammography. Additionally, women who had more self-efficacy in obtaining a mammogram, perceived less cultural barriers, lived longer in the United States, and who had a regular healthcare provider were more likely to be adherent. Study findings suggest that positive social change can be achieved by empowering women to take control of their health. Efforts promoting awareness of breast cancer screening guidelines and facilitating access to a regular healthcare provider could significantly increase uptake of screening services and lead to better health outcomes and reduced mortality.

This study examined the utility of a brief, strength-based approach to mental health screening. A strength-based based approach to mental health screening focuses on the social and emotional competencies taught and supported by the school context. As such, a strength-based approach to mental health screening is aligned with a three-tiered response to intervention model aimed at maximizing the effectiveness of universal supports and early detection of students who may benefit from additional intervention.

Group (pooled) testing, i.e., testing multiple subjects simultaneously with a single test, is essential for classifying a large population of subjects as positive or negative for a binary characteristic (e.g., presence of a disease, genetic disorder, or a product defect). While group testing is used in various contexts (e.g., screening donated blood or for sexually transmitted diseases), a lack of understanding of how an optimal grouping scheme should be designed to maximize classification accuracy under a budget constraint hampers screening efforts. We study Dorfman and Array group testing designs under subject-specific risk characteristics, operational constraints, and imperfect tests, considering classification accuracy-, efficiency-, robustness-, and equity-based objectives, and characterize important structural properties of optimal testing designs. These properties provide us with key insights and allow us to model the testing design problems as network flow problems, develop efficient algorithms, and derive insights on equity and robustness versus accuracy trade-off. One of our models reduces to a constrained shortest path problem, for a special case of which we develop a polynomial-time algorithm. We also show that determining an optimal risk-based Dorfman testing scheme that minimizes the expected number of tests is tractable, resolving an open conjecture. Our case studies, on chlamydia screening and screening of donated blood, demonstrate the value of optimal risk-based testing designs, which are shown to be less expensive, more accurate, more equitable, and more robust than current screening practices. / PHD / Group (pooled) testing, i.e., testing multiple subjects simultaneously with a single test, is essential for classifying a large population of subjects as positive or negative for a binary characteristic (e.g., presence of a disease, genetic disorder, or a product defect). While group testing is used in various contexts (e.g., screening donated blood or for sexually transmitted diseases), a lack of understanding of how an optimal grouping scheme should be designed to maximize classification accuracy under a budget constraint hampers screening efforts. We study Dorfman and Array group testing designs under subject-specific risk characteristics, operational constraints, and imperfect tests, considering classification accuracy-, efficiency-, robustness-, and equity-based objectives, and characterize important structural properties of optimal testing designs. These properties provide us with key insights and allow us to model the testing design problems as network flow problems, develop efficient algorithms, and derive insights on equity and robustness versus accuracy trade-off. We also show that determining an optimal risk-based Dorfman testing scheme that minimizes the expected number of tests is tractable, resolving an open conjecture. Our case studies, on chlamydia screening and screening of donated blood, demonstrate the value of optimal risk-based testing designs, which are shown to be less expensive, more accurate, more equitable, and more robust than current screening practices.

The diploma focuses on an assessment of welfare, technology and technological systems related to an efficiency and health condition of dairy cattle in selected farms in the Czech republic. Farming and veterinary database had been used in the process of compiling the diploma content; and screening methods to assess a welfare level in dairy cows herds. Stables for dairy cows must be in a dispositional, technical and operational compliance with the applied farm technology, in order to keep air circulation, dustiness, temperature and relative air humidity, gas concentration, lighting and noise levels within the safe limits. Any of the farm technological systems must not affect health condition and well-being of animals. Environment, providing animals conditions allowing natural behavior, rest and intake of food and water, creates a foundation for sustaining an appropriate welfare level of cattle as a significant prerequisite for reaching optimal productional a reproductional indicators. Even though there was no significant statistical difference documented (p >0,05) between monitored farms in selected indicators, an analysis of mutual dependency has been conducted between the environment level and some productional and reproductional indicators and health conditions of cattle.