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The purpose of this study is to determine if the ActiPed Pedometer Intervention Program would sustain or improve aerobic capacity or body composition scores over a 12-week period for students ages 8-12 in a school system in East Tennessee. Obesity is an epidemic in Tennessee and in the United States. In fact, Tennessee has the 5th highest obesity rates for youth in the United States. National and State Legislations with physical activity and wellness mandates are being passed at an alarming rate as the need to combat the obesity epidemic is astonishing. The responsibility to decrease the obesity rates in children is falling on schools systems, administrators, school nutrition personnel, and teachers. Therefore, the search for effective programs to fight the "battle of the bulge" in a school setting is becoming increasingly popular. This study focused on the ActiPed Pedometer Program and its effort to increase activity levels of students in a school setting. The local Young Men's Christian Association (YMCA) composed and received a grant from Wellmont Health System to help Activate Bristol and get students moving. The YMCA partnered with the Bristol Tennessee City School System in the fight against inactivity and childhood diabetes implementing the ActiPed Pedometer Intervention Program in January of 2008. Secondary data were collected by the investigator which included pretest and posttest Fitness Tests measures for body composition and aerobic capacity scores for both a treatment and a control group to determine success of the program. There were 310 students in the treatment group and 295 students in the control group for the body composition analysis for students at a healthy weight. The body composition analysis for overweight students included 83 students in the treatment group and 82 students in the control group. The aerobic capacity analysis for students at a healthy weight included 371 students in the treatment group and 323 students in the control group. The aerobic capacity analysis for overweight students included 78 students in the treatment group and 79 students in the control group. Population numbers differed because of missing or incomplete data on students. Base level findings revealed mixed results. Because a successful score is dependent on age and gender, students' scores were analyzed accordingly using Chi Square and Independent t tests. Statistically, the ActiPed Intervention Program did not appear to have a great impact on aerobic capacity scores or body mass index scores for students for the 12-week period. However, all groups had positive mean gains. A significant difference was found for 9-year-old girls in aerobic capacity gains between the control and treatment group. Eight-year-olds, 9-year-olds, and 10-year-olds tended to have more positive results and higher gains than 11 and 12-year-olds.

The theory of shattered assumptions proposes that experiencing traumatic events can change how people view themselves and the world. Most adults experience a traumatic event during their lifetime, and some subsequently develop post-traumatic stress disorder (PTSD). However, the current conceptualization of trauma (i.e., Criterion A PTSD) may be too narrow to adequately capture the range of potentially traumatizing events that People of Color experience, including racial discrimination and neighborhood disadvantage. This study investigated the association of racial discrimination and neighborhood disadvantage with core beliefs about the world being safe and predictable (i.e., world assumptions) among a sample of Black, Latine, and Asian young adults. Multi-step analyses of covariance tested associations between racial discrimination and neighborhood disadvantage with world assumptions and whether these held in the context of other traumatic exposures. Results indicated that racial discrimination negatively impacted world assumptions among Asian young adults only and this effect remained in the context of trauma. In addition, low neighborhood support negatively impacted world assumptions across all racial groups and neighborhood violence negatively impacted world assumptions among Latine young adults only; however, this effect did not remain in the context of trauma. This study indicates it is worthwhile to consider other adverse events in the conceptualization of trauma, such as racial discrimination and neighborhood disadvantage, that may impact world assumptions and contribute to subsequent post-trauma psychopathology.

This research study quantifies and describes suicide among South Asian Americans (SAAs), an emerging population that are underrepresented group in suicide research. The purpose of this study was to examine key characteristics of suicide deaths among SAAs. Data were employed from DuPage County, IL, a county with a large SAA population. Following federal recommendations for disaggregating Asian American data at a granular level, four SAA researchers used name recognition to identify all SAA cases classified as suicide in the DuPage County coroner’s database from 2001 to 2017 (N = 38). Coroner’s reports were analyzed for contextual details and correlating factors specific to each suicide. Overall, 76.3% of victims were male and 45.0% were married. An analysis of the coroner reports established that 71.1% of decedents showed behavioral disorders that were predisposing risk factors for suicide including mental health diagnoses (57.9%), and a reported prior suicide attempt (21.1%). Among these decedents only 34.2% had received any prior psychiatric care. Significant errors in racial classification of SAAs, lead to a gross undercount of SAA deaths by suicide with 55% of South Asian suicides assigned to a different race or ethnic group. Future studies must increase the scope of this research to other geographic locations with high concentrations of SAAs and examine the risk factors for suicide among SAAs, one of the fastest growing ethnic populations in the U.S.

Background: The utilization of telehealth has had a substantial impact on transforming and enhancing the methods by which healthcare is presently delivered. The potential benefits of telehealth in improving the health of vulnerable populations and underserved communities are substantial. The aims of this study were to examine the association between social determinants of health and patient perceptions of their experiences with telehealth. We will analyze how perceptions differ across specialization, race, gender, and other key determinants; examine how patient’s self-rated physical health and mental health influences perceptions and attitudes about telehealth utilization; and evaluate differences in perceptions and attitudes, experience with patient interactions and overall telehealth experiences between mental health providers and non-mental health providers. Methods: A scoping review was completed to explore literature regarding telehealth administration and underserved populations following the PRIMSA-ScR guidelines. Multivariable logistic regression was then conducted to assess the relationship between self-rated mental health and self-rated physical health and the primary predictor variables telehealth usability, telehealth satisfaction, and telehealth experiences. Finally, a mixed-methods study was conducted to evaluate differences in perceptions and attitudes, experience with patient interactions and overall telehealth experiences mental health-care providers and non-mental healthcare providers. Results: The scoping literature review highlights how telehealth is used in diverse settings, but more research needs to be done to determine best practices for both healthcare providers and patients utilizing telehealth. The study focused on self-reported health found significant associations between high mean scores on telehealth usability, telehealth satisfaction, and telehealth experiences and good self-reported mental and physical health. Lastly, the study looking at provider differences highlighted that the reliability of the telemedicine platform, the ability to trust the telemedicine application, and video visits being a convenient form of healthcare delivery was greater for mental healthcare providers than non-mental healthcare providers. Implications: These findings highlight the need for studies examining telehealth satisfaction, telehealth usability and telehealth experiences amongst providers and patients in underserved areas. Further research is needed to gain a deeper understanding of the telehealth access requirements of underserved communities and can aid in the development of evidence-based guidelines for the delivery of telehealth services.

As nearly one third of the world's population lives in an area that is in some way touched by war, researchers have long been interested in the varied impacts of conflict on civilians. Many indicators, measuring both physical and mental constructs, have been assessed in war-torn populations from around the world, one of which is health-related quality of life (HRQoL). The occupied Palestinian Territories (oPt) are one region in which copious research on health indicators has been undertaken in an effort to understand how long-term conflict manifests itself in noncombatant populations. However, existing studies focus primarily on indicators within the Palestinian population itself that impact HRQoL, and not on the extent to which the presence of the conflict and its consequences disturb physical and mental health outcomes compared to areas without conflict. The purpose of this study is to evaluate the impact of long-term conflict by comparing HRQoL in the oPt and the neighboring country of Jordan, as well as to assess how demographic factors such as socioeconomic status and household size can moderate or aggravate this impact. The potential mediating factors of insecurity and perceived stress will also be assessed. This study found that the presence of conflict was not the most significant predictor of low HRQoL. The mitigating factor of a traditional foundation of mental resilience in Palestinian culture is addressed as a potential explanation for this result. The implications of this study are wide-ranging, particularly in their ability to contribute to healthcare policy recommendations in war-affected areas, and to bolster our understanding of the health status and needs of those living in these areas.

Although Radio Frequency Identification (RFID) and Real-Time Location System (RTLS) technologies for inventory tracking have been growing in popularity, the healthcare industry has been reluctant to adopt these technologies. One of the primary reasons for this lack of enthusiasm has been the risk associated with electromagnetic interference between RFID/RTLS systems and medical equipment functionality. The other reason has been the substantial cost and complexity of implementing RFID/RTLS in healthcare organizations. In this study, we show that there are several ways to safely install RFID/RTLS systems to improve the inventory management processes of hospitals and clinics. We then analyze the inventory shrinkage (loss and theft) data of the Veterans Health Administration VISN 10 (the Veterans Integrated Service Network of Ohio) using a mathematical model to estimate the annual shrinkage. Finally, we develop an economic cost/benefit analysis database system in Microsoft Access that can be used to calculate the breakeven point of RFID/RTLS implementations, as well as calculate the expected reduction in inventory- related operating costs. This system can be adapted for cost/benefit analyses in similar inventory-intensive environments.

Hintergrund Es existieren keine Studien zur Inanspruchnahme psychoonkologischer Angebote durch Weichteilsarkompatienten in Deutschland. Ziel war es deshalb, die Häufigkeit der Inanspruchnahme psychoonkologischer Angebote im Krankenhaus in dieser Gruppe zu ermitteln und damit assoziierte Faktoren zu untersuchen. Methode Die Kohortenstudie PROSa (Krankheitslast und Versorgungssituation bei Sarkomen) wurde zwischen 2017 und 2020 in 39 deutschen Studienzentren durchgeführt. Für die vorliegende Analyse wurden Querschnittsdaten von erwachsenen Weichteilsarkompatienten ausgewertet. Faktoren auf Patienten- wie auf Einrichtungsebene wurden als mögliche Prädiktoren der Inanspruchnahme psychoonkologischer Beratung mittels logistischer Regression in einem verallgemeinerten linearen gemischten Modell exploriert. Resultate Bei 910 teilnehmenden Patienten lagen von 576 (63,3 %) Angaben zur Inanspruchnahme vor. 212 Patienten (unter Einbeziehung der fehlenden Angaben 23,3 %, ohne diese 36,7 %) nahmen psychoonkologische Angebote in Anspruch. Negativ mit der Inanspruchnahme assoziiert waren männliches (vs. weibliches) Geschlecht (Odds Ratio [OR] 0,62) und höheres Alter (18–< 40 Jahre vs. 65–< 75 Jahre: OR 0,32; 18–< 40 Jahre vs. ≥ 75 Jahre: OR 0,19). Positiv assoziiert waren Bildungsgrad (Abitur vs. Haupt‑/Volksschulabschluss [OR 2,01]) und Grading (High-grade-Tumoren vs. „low-grade“ [OR 4,41]). Wenn Psychoonkologen am Tumorboard beteiligt waren, war die Inanspruchnahme deutlich höher (OR 6,69). Konklusion Frauen, jüngere Personen, Patienten mit höherer Bildung und fortgeschrittenem Krankheitsstadium nehmen häufiger psychoonkologische Versorgung in Anspruch. Ein struktureller Faktor für eine erhöhte Inanspruchnahme ist die Beteiligung der Psychoonkologie am Tumorboard.

Purpose To report contemporary epidemiological data and treatment trends for upper tract urothelial carcinoma (UTUC) in Germany over a 14-year period. Methods We analyzed data from the nationwide German hospital billing database and the German cancer registry from 2006 to 2018/2019. The significance of changes over time was evaluated via regression analysis. Survival outcomes were calculated using the Kaplan–Meier method. Results There was a non-significant increase in the age-standardized incidence rate from 2.5/100,000 in 2006 to 2.9/100.000 in 2018. 13% of patients presented with lymph node metastasis and 7.6% of patients presented with distant metastasis at primary diagnosis. The 5-year overall survival was estimated at 45% and the 10-year overall survival at 32%. Endoscopic biopsies of the renal pelvis and ureter as well as ureteroscopies with excision/destruction of UTUC all increased significantly over the study period. The number of radical nephroureterectomies (RNU) for UTUC steadily increased from 1643 cases in 2006 to 2238 cases in 2019 (p < 0.005) with a shift from open surgery towards minimally invasive surgery. Complex reconstructive procedures like ileal ureter replacement or autotransplantation are rarely performed for urothelial carcinoma of the ureter. Conclusion Diagnostic and therapeutic procedures for UTUC have increased and minimally invasive nephroureterectomy is the predominant approach concerning radical surgery in 2019.

The 21st century experienced several health crises, especially in the form of infectious disease outbreaks such as the SARS outbreak in 2003, the H1N1 in 2009, and Ebola outbreaks in 2013. However, none has produced a worldwide socio-economic and health impact compared to the recent pandemic, known as COVID-19. As of October 4, 2022, more than 614 million cases with 6 million deaths have been reported worldwide. The United States is currently in the leading position with more than 98 million cases and 1 million deaths. The pandemic, however, did not impact the entire region similarly, and the infections and intensity varied with geographical and socio-economic characteristics. In this project, I used a multi-method approach to analyze the relationship between health disparities and COVID-19-related health outcomes in the USA and examine the influence of health disparities reporting on newspaper coverage of COVID-19. This assessment was performed in three ways. First, I have explored the relationship between Mississippi’s county-level COVID-19-related cases and deaths with the Center for Disease Control and Preventions’s Social Vulnerability Index (CDC SVI). Second, I have investigated the spatial pattern of COVID-19 in the USA and its associations with Social Determinants of Health (SDoH) by utilizing the County Health Rankings & Roadmaps (CHRR) dataset.Finally, I analyzed how news media reporting of key health determinants (i.e., age, race, income and gender) is framed, including the role of different stakeholders in the context of COVID-19. Findings revealed a statistical relationship between CDC’s Social Vulnerability Index (SVI) and Mississippi’s county-level COVID-19 cases and deaths. I also found that COVID-19 infections showed considerable spatial heterogeneity as the distribution of COVID-19 cases and deaths varies across the US counties and among the three largest waves. The multiple regression results also exhibited a temporal association between social determinants of health (SDH) indicators and COVID-19-related health outcomes across the USA. Finally, I found that the NYT coverage of COVID-19 dealt more with human interest, responsibility, and conflict than economic and morality frames. The findings revealed the vital role social determinants of health play during a health crisis, such as the COVID-19 pandemic.