22484 research outputs found
Sort by
Assessing Health Communication Methods and Interventions for the Human Papillomavirus (HPV) Vaccine and the Associated Consequences Within the United States: A Literature Review
No full textHuman papillomavirus has been proven to be linked as a causative agent for anal cancer, cervical cancer, oropharyngeal cancer (head and neck), penile cancer, vaginal cancer, and vulvar cancer. Thus, HPV infection is a significant public health concern and increasing the vaccination rate within the United States is a public health necessity. Fortunately, the HPV vaccine is highly effective at mitigating the risk of transmission, infection, and an eventual cancer diagnosis. The HPV vaccine is intended for adolescents aged 9 to 17 but can be given to an individual well into adulthood. However, for the vaccine to be given in adolescence, parents, guardians, and caregivers must consent on behalf of their child. As such, when it became apparent that the HPV vaccine was struggling to increase its uptake rate in the United States was low, research needed to be done to understand the underlying reasons, and more importantly, identify strategies to improve vaccination rates nationwide. Research suggests vaccine hesitancy, stigma, and social determinants of health are the largest barriers to vaccination. Studies suggest that health communication strategies play a critical role in identifying effective methods to engage parents, guardians, and caregivers to increase vaccination rates. This literature review aims to analyze modern-day public health interventions and health communications in order to gain insight on the public’s education, understanding, attitudes, and initiation of the HPV vaccine in their children
Partitioned Conservative, Variable Step, Second-Order Method for Magneto-hydrodynamics In Elsässer Variables
No full textMagnetohydrodynamics (MHD) describes the interaction between the electrically conducting fluids and the electromagnetic fields. The report is devoted to the design and analysis of a partitioned, iterative, midpoint (PIM) algorithm of second-order convergence in time for the evolutionary MHD system in Elsässer variables. To reduce the computational costs of the non-linear solver, we partitioned the full system at each iteration and thus solve two subproblems in parallel. We prove that partitioned iterations converge to the numerical solutions of the coupled monolithic problem under certain mild time restriction. The stability of the PIM method and its error analysis show that the algorithm with arbitrary time grids is unconditionally conservative in energy, cross-helicity and magnetic helicity and numerical solutions are of second-order convergence.
Moreover, the time adaptive mechanism based on local truncation error criterion is implement into the constant time-step PIM method, which helps the variable step algorithm balance accuracy and time efficiency. Several numerical tests support the theoretical findings and verify the advantages of time adaptivity.
Moreover, we construct a partitioned, iterative DLN (Dahlquist, Liniger and Nevanlinna) algorithm for this MHD system in Elsässer variables, which also partitions the full nonlinear system at each iteration. We also analyze the conservation of the energy, cross-helicity and magnetic-helicity, followed by the variable step stability and error analysis
Voices of Langgam Jawa: Gender, Genre, and Repertoire in Javanese Popular Music
No full textThis dissertation is the first to investigate the performance style, cultural politics, and social meanings of a repertoire of songs called langgam Jawa (lit. “Javanese style”) in Central Java, Indonesia. These Javanese-language songs are constructed in a 32-bar AA’BA’ form and either imitate or directly use patterns and instruments from central Javanese gamelan. Langgam Jawa is performed in three genres, namely kroncong, campur sari, and gamelan, and women are most often featured as singers regardless of the genre. Women are largely responsible for maintaining the identity and status of pieces in langgam Jawa and, in turn, women shape the boundaries of these genres in their performances. Langgam Jawa takes on different meanings depending on the social context, which is related to but distinct from genre, in which it is performed. Musicians use sophisticated and subtle ways to elaborate what is typically a 32-bar structure and the form is equally malleable in adjusting to various social contexts. Developed in the late 1950s in the context of kroncong, langgam Jawa was considered a genre (langgam Jawa kroncong). However, musicians quickly began adapting songs to different genres, and by the early 1990s, it was considered a repertoire. I show the way that repertoires and genres are co-constitutive: a repertoire of songs forms the musical identity of a genre as much as genres shape the socio-cultural meaning of particular songs.
Drawing on ethnographic, historical, and music-analytical research in Central Java between 2014-2023, I detail four case studies regarding langgam Jawa. I attribute the durability of langgam Jawa to three factors: (1) the ingenuity of performers in reforming and repurposing this song form in different social contexts, particularly women singers who are able to cross genres; (2)the evocative power of nostalgia of langgam Jawa for Javanese listeners, whether a nostalgiafor earlier years in the listener’s own life or an idyllic past that urban listeners never experienced directly; and (3) the transition of langgam Jawa from a genre in the context of kroncong to a repertoire that is played in the contexts of kroncong, gamelan, and campur sari
Evaluating the Impact of Ultraviolet Light Disinfection on Clostridioides difficile Infections: A Study of Prevalence, Control Strategies, and Public Health Significance
No full textBackground
Clostridioides difficile (C. difficile) is a leading healthcare-associated infection (HAI), causing severe diarrhea and colitis, particularly in hospitalized patients. Controlling C. difficile is critical to improving patient outcomes and reducing healthcare costs. Despite the availability of ultraviolet (UV) light disinfection as a supplemental cleaning method, improper or inconsistent use of this technology may perpetuate reinfections. This study examines the impact of UV disinfection on C. difficile infections, barriers to protocol adherence, and strategies to enhance compliance and public health outcomes.
Methods
This observational study conducted over a year (September 1, 2023 – August 31, 2024) at an academic medical center, analyzed compliance with UV disinfection protocols in discharged rooms occupied by C. difficile patients. Live observations of Infection Prevention (IP) and Environmental Services (EVS) teams assessed compliance with hand hygiene (HH), personal protective equipment (PPE) use, and room signage, while artifact reviews cross-referenced UV light machine reports with patient discharge data. The primary outcome was compliance with the
disinfection protocols, defined as correctly using a UV disinfection device after discharge. Predictor variables included room type (Intensive Care Unit [ICU] vs. general floor), HH practices, and sporicidal cleaning agent usage. Confounding variables included staff training and equipment availability. Chi-square analysis to assess differences in compliance across room types.
Results
Among the 75 patient discharges, overall compliance with UV light protocols was 10.7%, with 0% in ICU rooms and 10.5%-11.5% on general floors. Observational data revealed systemic barriers, such as limited machine availability, high patient turnover, and communication gaps between staff. A chi-square test (p=0.770) indicated no significant differences by room type.
Conclusion
This study reveals significant non-compliance with UV disinfection protocols, driven by systemic operational inefficiencies. Targeted interventions such as enhanced training, better communication, and robust monitoring systems can mitigate C. difficile transmission risks, and optimizing measures is critical in high-risk areas (ICU), where compliance was notably absent. These findings carry significant public health implications, as strengthening infection control
practices is vital for reducing C. difficile transmission and improving patient outcomes in healthcare settings
Evaluating the Effects of NKG2A Blockade in HIV Therapeutic Vaccine Responses
No full textHIV Therapeutic vaccines are an important strategy in HIV cure research. The PENNVAX clinical study examines the efficacy of HIV vaccinations, and which HIV antigens should be included. In addition to therapeutic vaccines, another subject of interest is an inhibitor of NKG2A. NKG2A interactions with HLA-E inhibit immune cells, which hinders immunological responses. By blocking the NKG2A interaction, there could be boosting of immune responses. There have been some promising results with combining an NKG2A blockade with therapeutic cancer vaccinations; therefore, this project focuses on the combination of an HIV therapeutic vaccine (PENNVAX) and an anti-NKG2A mAb, 1B2-6. Cryopreserved PBMCs from the PENNVAX participants were co-cultured with 1B2-6 to determine the impact of the anti-NKG2A mAb on therapeutic vaccine-induced responses. Although our findings did not show significant differences as a group, there were some individuals with increased responses following vaccination and co-culture of 1B2-6. In the participants with increased responses by either vaccination or co-culture with 1B2-6, there were more robust responses with the combination of vaccination and 1B2-6. These results suggests that importance of individualized strategies to achieve HIV remission off ART
Investigating the relationships of the N400 and P600 event-related potentials to meaning integration and retrieval processes
No full textThe N400 component of the event-related potential (ERP) has long been used within the fields of reading and language comprehension to index the difficulty of semantically “integrating” newly encountered words into a reader’s current mental model of a text in a process known as word-to-text integration (WTI). However, recent research has called this understanding of the N400 into question, instead suggesting that the N400 only reflects the cognitive effort associated with retrieving the meaning of words from one’s mental lexicon, and that a different ERP known as the P600 indexes WTI. In this study, we sought to clarify the validity of using the N400 and P600 as indicators of integration and retrieval processes. We hypothesized that the research which challenged the integration account of the N400 was flawed, and that by addressing these perceived flaws in the present study, our experimental results would reaffirm the validity of this interpretation of the N400. Using electroencephalography (EEG)-based techniques, we measured the ERPs of college undergraduates who were randomly assigned to read sets of two-sentence texts split across “event-related congruent,” “event-related incongruent,” and “event-unrelated” experimental conditions. The results contradicted our hypothesis; although we observed an N400 effect between the event-unrelated condition and both event-related conditions (suggesting that the N400 is at the very least indexing retrieval processes), we failed to detect either an N400 or P600 effect between the two event-related conditions, thus providing insufficient evidence to positively identify which (if either) of these ERP components may be indexing integration processes
Snapshot: ULS Teaching & Learning 2023-2024
No full textA yearly review of teaching & learning initiatives at the Pitt Libraries
Associations of 24-Hour Activity Composition in Evaluating the Public Health Burden of Fall and Fracture Risk in Older Adults
No full textBACKGROUND: About 30% of older adults fall, and fractures are common consequences of falls that can lead to disability or death. Exercise/physical activity (PA) is the only non-pharmacologic prevention strategy that lowers fall and fracture risk. Inadequate sleep duration is an emerging risk factor for falls and is critical to bone metabolism for fracture prevention. PA, sedentary behaviors (SB), and sleep are often studied in isolation. Changes to time spent in one behavior necessitates changes to time spent in another behavior comprising a 24-hour day. OBJECTIVES: Use compositional data analysis to evaluate associations between the combined role of PA, SB, and sleep with 1) incident fall and fracture risk, and their risk factors of 2) bone structure and microarchitecture using high-resolution peripheral quantitative computed tomography, and 3) muscle strength and power. METHODS: Participants included community-dwelling older adults in the 1) Osteoporotic Fractures in Men (MrOS) study (n=2,918, age=78.9±5.1 years) and the 3) Study of Muscle, Mobility and Aging (SOMMA; n=714, age=76±5 years) and 2) Bone Ancillary (n=278) with 24-hour activity. Generalized estimating equations and cox proportional hazard regression estimated longitudinal fall and fracture risk (paper 1). Multiple linear regression was applied by sex to cross-sectional analyses in papers 2 and 3. Compositional isotemporal substitution quantified changes to each outcome if time were theoretically substituted from one behavior to another. RESULTS: Higher proportions of PA vs. remaining behaviors were associated with lower fall and fracture risk. Substituting 30 minutes SB for 30 minutes PA was associated with a modest 1-2% lower fall risk, but not fractures. Higher proportions of moderate-to-vigorous intensity PA (MVPA) vs. remaining behaviors were associated with higher compartmental bone microarchitecture and density, and higher muscle power, not strength, in men and women separately. Displacing 10-60 minutes SB for MVPA was consistently associated with higher compartmental bone microarchitecture and density and muscle power. COCNLUSIONS: Higher proportions of PA, particularly MVPA, may improve clinical outcomes and their risk factors. These results can help guide more effective exercise interventions by ensuring adequate sleep and increasing MVPA at the expense of SB to lower the public health burden of falls and fractures
Impacts of Rural Hospital Payment Reform: Evidence from the Pennsylvania Rural Health Model
No full textRural hospitals have long faced financial challenges, which increase the risk of service reductions or closures. The Pennsylvania Rural Health Model (PARHM) is a unique payment model tailored for rural hospitals. Developed through collaboration between the Center for Medicare & Medicaid Innovation and the Commonwealth of Pennsylvania, it started in 2019 with plans to continue through 2024. PARHM aims to assess if global budgets for hospitals—a fixed payment amount covering all services—combined with hospital-specific transformation plans, can sustain rural patient care access, enhance care quality, and boost financial stability for rural Pennsylvania hospitals. Sixty-five hospitals were eligible, with cohorts joining in 2019 (5 hospitals), 2020 (8 hospitals), and 2021 (5 hospitals), forming a natural policy experiment to investigate the ability of payment reform to sustain hospital services in rural areas.
This study evaluates PARHM’s impact on potentially avoidable utilization of inpatient hospital services, access to and utilization of low-margin service lines (e.g., obstetrics care), and rural hospital bypass for elective surgeries (e.g., total knee replacement). Employing a difference-in-differences approach with multiple time periods, we compare relative changes between PARHM-participating and non-participating eligible hospitals. Data sources include the Pennsylvania Health Care Cost Containment Council Database for hospitalizations, the American Community Survey for demographic data, and the American Hospital Association Annual Survey for hospital characteristics.
Overall, key study outcomes did not change differentially between participating and non-participating hospitals when pooled across cohorts. However, heterogeneous treatment effects were observed among individual PARHM cohorts. For example, we found a statistically significant differential decrease in potentially avoidable admissions among hospital service areas served by Cohort 2 hospitals. In our analysis of low-margin service lines, we found a statistically significant differential increase in substance use disorder care among Cohort 1 hospitals. Finally, we found a statistically significant differential increase in the risk of bypass of the rural hospital in a patient’s local hospital service area among patients from areas served by critical access hospitals. Our results underscore the role of rigorous evaluations in understanding state-level health policies such as PARHM, and inform the design and implementation of future alternative payment models in rural settings
Exploring Ancestry-Related Differences in Dengue Virus Infection in Human Skin
No full textDengue is the most prevalent arboviral infection in the world, and the number of clinical cases and global spread are rising. Recent data have demonstrated a link between genetic ancestry and susceptibility to dengue virus (DENV) infection; individuals with European ancestry (EA) have a higher rate of infection and inflammatory response to dengue than those of African ancestry (AA). Immunofluorescence staining of skin – the site of dengue virus transmission – has illustrated differences in cytokine expression in EA and AA donors following infection ex vivo. Single nucleotide polymorphisms (SNPs) of various innate immune genes, including RXRA, have been associated with susceptibility to DENV infections and genetic ancestry. Retinoid X receptor alpha (RXRα) is known to promote proinflammatory responses by limiting interferon production and inducing inflammatory and chemokine gene expression. This inhibits host antiviral defenses, which makes the immune system more susceptible to viral infection. The possible role of RXRα in DENV infections is unknown, but it could influence the ancestry-related differences observed in immune responses to DENV infections. This study aims to examine RXRα expression in the epidermis, as well as identify the cells responsible for production of proinflammatory and antiviral cytokines during DENV infections. To investigate this, human skin explants donated by the University of Pittsburgh Medical Center (UPMC) were infected with DENV. Chemiluminescent western blotting and flow cytometry techniques were used to identify and quantify RXRα expression within infected cells. Full-thickness cell lysates (epidermal and dermal cells) suggested a difference in RXRα expression between ancestry donors 24-hours post infection, while epidermal cell lysates showed no protein difference. Interleukin-1β (IL-1β) and interferon alpha (IFNα) concentrations were measured by ELISA to evaluate cytokine production in response to infection. Secreted cytokines were not detectable by ELISA 24-hours post infection, while preliminary data for intercellular cytokine levels showed no difference in concentration. This project was unable to identify the epidermal cells responsible for cytokine production in response to DENV infections. By understanding ancestry-related differences in DENV infections and the forces which drive the immune responses, therapeutics can be developed to modulate these responses that increase risk of disease in susceptible populations