PLoS Articles
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UNC-authored articles published by the Public Library of Science (PLoS)
Works (1963)
61. An emerging field: An evaluation of biomedical graduate student and postdoctoral education and training research across seven decades
- Title Tesim:
- An emerging field: An evaluation of biomedical graduate student and postdoctoral education and training research across seven decades
- Creator:
- Djorić, Dušanka, Layton, Rebekah, Hardy, LaKeya, Tetzlaff, Julie E., Wart, Audra Van, D’Silva, Natalie M., and Suelzer, Elizabeth
- Date of publication:
- 2023
- Abstract Tesim:
- Biomedical graduate student and postdoctoral education and training research has expanded greatly over the last seven decades, leading to increased publications and the emergence of a field. The goal of this study was to analyze this growth by performing a cross-sectional bibliometric analysis using a systematic approach to better understand the publishing trends (including historical vs. emerging themes and research priorities); depth, structure, and evidence-basis of content; and venues for publication. The analysis documented a dramatic increase in biomedical trainee-related publications over time and showed that this area of research is maturing into its own independent field. Results demonstrated that the most frequently published article types in this field are shorter editorial and opinion pieces, and that evidence-based articles are less numerous. However, if current trends continue, projections indicate that by the year 2035, evidence-based articles will be the dominating article type published in this field. Most frequently published topics included career outcomes and workforce characterization and professional development. In recent years, the most cited articles were publications focused on diversity, equity, and inclusion, career outcomes and workforce characterization, and wellness. This study also shows that although a small subset of journals publishes most of this literature, publications are distributed diffusely across a wide range of journals and that surprisingly 68% of these journals have published only a single article on the topic. Further, we noted that the assignment of author- and index-supplied keywords was variable and inconsistent and speculate that this could create challenges to conducting comprehensive literature searches. Recommendations to address this include establishing standard keyword assignment criteria and proposing new index-supplied keywords to improve accessibility of research findings. These changes will be important for bringing visibility of this literature to our community, institutional leaders, national trainee organizations, and funding agencies.
- Resource type:
- Article
- Affiliation Label Tesim:
- University of North Carolina at Chapel Hill
- DOI:
- https://doi.org/10.17615/nnf9-fs11
- Edition:
- Publisher
- Identifier:
- https://dx.doi.org/10.1371/journal.pone.0282262
- ISSN:
- 1932-6203
- Journal Issue:
- 7
- Journal Title:
- PLOS ONE
- Journal Volume:
- 18
- Keyword:
- Careers in research, Medicine and health sciences, Database searching, Scientific publishing, Citation analysis, Graduates, Careers, and Medical journals
- Language Label:
- English
- License Label:
- Attribution 4.0 International
- ORCID:
- Other Affiliation:
- Medical College of Wisconsin, , and Brown University
- Page Start:
- e0282262
- Person:
- Djorić, Dušanka, Layton, Rebekah, Hardy, LaKeya, Tetzlaff, Julie E., Wart, Audra Van, D’Silva, Natalie M., and Suelzer, Elizabeth
- Publisher:
- Public Library of Science
- Rights Statement Label:
- In Copyright
- Source:
- 9f7da808-36a3-4a7b-beee-36ab9d1349a8
62. A machine learning approach to explore individual risk factors for tuberculosis treatment non-adherence in Mukono district
- Title Tesim:
- A machine learning approach to explore individual risk factors for tuberculosis treatment non-adherence in Mukono district
- Creator:
- Gichuhi, Haron W., Kumar, Manish, Magumba, Mark, and Mayega, Roy William
- Date of publication:
- 2023
- Abstract Tesim:
- Despite the availability and implementation of well-known efficacious interventions for tuberculosis treatment by the Ministry of Health, Uganda (MoH), treatment non-adherence persists. Moreover, identifying a specific tuberculosis patient at risk of treatment non-adherence is still a challenge. Thus, this retrospective study, based on a record review of 838 tuberculosis patients enrolled in six health facilities, presents, and discusses a machine learning approach to explore the individual risk factors predictive of tuberculosis treatment non-adherence in the Mukono district, Uganda. Five classification machine learning algorithms, logistic regression (LR), artificial neural networks (ANN), support vector machines (SVM), random forest (RF), and AdaBoost were trained, and evaluated by computing their accuracy, F1 score, precision, recall, and the area under the receiver operating curve (AUC) through the aid of a confusion matrix. Of the five developed and evaluated algorithms, SVM (91.28%) had the highest accuracy (AdaBoost, 91.05% performed better than SVM when AUC is considered as evaluation parameter). Looking at all five evaluation parameters globally, AdaBoost is quite on par with SVM. Individual risk factors predictive of non-adherence included tuberculosis type, GeneXpert results, sub-country, antiretroviral status, contacts below 5 years, health facility ownership, sputum test results at 2 months, treatment supporter, cotrimoxazole preventive therapy (CPT) dapsone status, risk group, patient age, gender, middle and upper arm circumference, referral, positive sputum test at 5 and 6 months. Therefore, machine learning techniques, specifically classification types, can identify patient factors predictive of treatment non-adherence and accurately differentiate between adherent and non-adherent patients. Thus, tuberculosis program management should consider adopting the classification machine learning techniques evaluated in this study as a screening tool for identifying and targeting suited interventions to these patients.
- Resource type:
- Article
- Affiliation Label Tesim:
- Public Health Leadership Program
- DOI:
- https://doi.org/10.17615/4e19-5314
- Edition:
- Publisher
- Identifier:
- https://dx.doi.org/10.1371/journal.pgph.0001466
- ISSN:
- 2767-3375
- Journal Issue:
- 7
- Journal Title:
- PLOS Global Public Health
- Journal Volume:
- 3
- Keyword:
- Tuberculosis, Machine learning, Support vector machines, Drug therapy, Health care facilities, Medical risk factors, Machine learning algorithms, and Tuberculosis diagnosis and management
- Language Label:
- English
- License Label:
- Attribution 4.0 International
- ORCID:
- Other Affiliation:
- Makerere University School of Public Health, , and Makerere University College of Computing, and Information Science
- Page Start:
- e0001466
- Person:
- Gichuhi, Haron W., Kumar, Manish, Magumba, Mark, and Mayega, Roy William
- Publisher:
- Public Library of Science
- Rights Statement Label:
- In Copyright
- Source:
- 13e9d50d-c784-4f67-9996-536835685ffa
63. “My wellbeing-their wellbeing “– An eHealth intervention for managing obesity in early care and education: Protocol for the Go NAPSACC Cares cluster randomized control trial
- Title Tesim:
- “My wellbeing-their wellbeing “– An eHealth intervention for managing obesity in early care and education: Protocol for the Go NAPSACC Cares cluster randomized control trial
- Creator:
- Burney R., Clarke E.C., Ward D.S., Nezami B., Beckelheimer B., Mathews E., Tate D.F., Willis E.A., Hales D., Thompson M., Moore R.H., and Ilugbusi L.O.
- Date of publication:
- 2023
- Abstract Tesim:
- Background To fully leverage the potential of the early care and education (ECE) setting for childhood obesity prevention, initiatives must not intervene solely at the organizational level, but rather they should also address the health needs of the ECE workers. Workers suffer disproportionately high rates of obesity, and have reported low confidence in modeling and promoting healthy eating and activity behaviors. However, information regarding the effectiveness of improving ECE workers’ health behaviors or whether such improvements elicit meaningful change in the ECE environment and/or the children in their care is limited. Method The proposed study will integrate a staff wellness intervention into a nationally recognized, ECE obesity prevention initiative (Go NAPSACC). Go NAPSACC+ Staff Wellness program will be assessed using a clustered randomized controlled trial including 84 ECE centers, 168 workers, and 672 2–5-year-old children. Centers will be randomly assigned to 1) standard “Go NAPSACC” or 2) Go NAPSACC+ Staff Wellness. Outcome measures will assess impact on dietary intake and PA behaviors of 2-5-year-old children at 6 months (primary aim) and 12 months. Secondarily, we will compare the impact of the intervention on centers’ implementation of healthy weight practices and the effect on ECE workers’ diet quality and PA at 6- and 12 months. Discussion This trial expects to increase our understanding of how ECE worker’s personal health behaviors impact the health behaviors of the children in their care and the ECE environment. Trial registration ClinicalTrials.gov: NCT05656807, registered on 19 December 2022. Protocol version 1.0, 22 March 2023.
- Resource type:
- Article
- Affiliation Label Tesim:
- UNC Center for Health Promotion and Disease Prevention and Department of Nutrition
- DOI:
- https://doi.org/10.17615/2z50-5d79
- Edition:
- Publisher
- Identifier:
- https://dx.doi.org/10.1371/journal.pone.0286912
- ISSN:
- 1932-6203
- Journal Issue:
- 7-Jul
- Journal Title:
- PLoS ONE
- Journal Volume:
- 18
- Keyword:
- controlled study, Child Day Care Centers, child day care, childhood obesity, child behavior, preschool child, Pediatric Obesity, Health Promotion, wellbeing, physical activity, multicenter study, health care personnel, body weight, childhood obesity intervention, Health Behavior, clinical trial protocol, diet, Randomized Controlled Trials as Topic, health behavior, Diet, telehealth, food quality, human, outcome assessment, Humans, randomized controlled trial (topic), child nutrition, Child, Child, Preschool, health promotion, early care and education, randomized controlled trial, child, implementation science, dietary intake, procedures, and Article
- Language Label:
- English
- License Label:
- Attribution 4.0 International
- ORCID:
- Other Affiliation:
- and Drexel University
- Person:
- Burney R., Clarke E.C., Ward D.S., Nezami B., Beckelheimer B., Mathews E., Tate D.F., Willis E.A., Hales D., Thompson M., Moore R.H., and Ilugbusi L.O.
- Publisher:
- Public Library of Science
- Rights Statement Label:
- In Copyright
- Source:
- 6d6cda07-652d-4067-b23d-7e086b6a027b
64. Serologic surveillance of maternal Zika infection in a prospective cohort in Leon, Nicaragua during the peak of the Zika epidemic
- Title Tesim:
- Serologic surveillance of maternal Zika infection in a prospective cohort in Leon, Nicaragua during the peak of the Zika epidemic
- Creator:
- Zepeda, O., Blette, B., Stringer, E., Harris, E., Becker-Dreps, S., Jadi, R., Morales, M., Pérez, R., De Silva, A.M., Collins, M.H., Stringer, J., Bucardo, F., Liou, G.-J.A., and Montoya-Cruz, M.
- Date of publication:
- 2020
- Abstract Tesim:
- Background Zika virus caused thousands of congenital anomalies during a recent epidemic. Because Zika emerged in areas endemic for dengue and these related flaviviruses elicit cross-reactive antibodies, it is challenging to serologically monitor pregnant women for Zika infection. Methods A prospective cohort of 253 pregnant women was established in León, Nicaragua. Women were followed during prenatal care through delivery. Serologic specimens were obtained at each visit, and birth outcome was recorded. Established flavivirus serologic methods were adapted to determine Zika seroprevalence, and a stepwise testing algorithm estimated timing of Zika infection in relation to pregnancy. Results Zika seroprevalence was approximately 59% among women tested. Neutralization testing was highly concordant with Zika NS1 BOB results. Per study algorithm, 21% (40/187) of women were classified as experiencing Incident ZIKV infection during pregnancy. Importantly, the Incident ZIKV group included mostly women pregnant during the 2016 Zika epidemic peak and the only 3 subjects in the cohort with RT-PCR-confirmed infections. Approximately 17% of births had complications; 1.5% (3/194) manifesting clinical criteria of congenital Zika syndrome, one was RT-PCR-confirmed as a case of congenital Zika syndrome. Adverse birth outcome did not correlate with timing of Zika infection. Conclusions By leveraging prenatal care systems, we developed a simple algorithm for identifying women who were likely infected by Zika during pregnancy.
- Resource type:
- Article
- Affiliation Label Tesim:
- Department of Biostatistics, Department of Obstetrics and Gynecology, Department of Family Medicine, and Department of Microbiology and Immunology
- DOI:
- https://doi.org/10.17615/ntsv-cg91
- Edition:
- Publisher
- Identifier:
- https://dx.doi.org/10.1371/journal.pone.0230692
- ISSN:
- 1932-6203
- Journal Issue:
- 4
- Journal Title:
- PLoS ONE
- Journal Volume:
- 15
- Keyword:
- algorithm, pregnancy, Cohort Studies, Serologic Tests, seroprevalence, adult, birth, Article, obstetric delivery, serology, mother, Adolescent, Adult, adolescent, Epidemics, cohort analysis, Nicaragua, Female, prospective study, prenatal care, Mothers, pregnant woman, virus neutralization, Time Factors, young adult, human, reverse transcription polymerase chain reaction, epidemic, time factor, Prospective Studies, major clinical study, disease surveillance, adverse event, Zika fever, Epidemiological Monitoring, immunology, Zika Virus Infection, Young Adult, Humans, female, clinical feature, Pregnancy, and epidemiological monitoring
- Language Label:
- English
- License Label:
- Attribution 4.0 International
- ORCID:
- Other Affiliation:
- Universidad Nacional Autonoma de Nicaragua-Leon, , University of California, Berkeley, National Autonomous University of Nicaragua at León, Emory University, and National Autonomous University of Nicaragua, León
- Person:
- Zepeda, O., Blette, B., Stringer, E., Harris, E., Becker-Dreps, S., Jadi, R., Morales, M., Pérez, R., De Silva, A.M., Collins, M.H., Stringer, J., Bucardo, F., Liou, G.-J.A., and Montoya-Cruz, M.
- Publisher:
- Public Library of Science
- Source:
- 137a0d1b-116c-4343-9de8-9b75041791ab
65. Symptomatic malaria enhances protection from reinfection with homologous Plasmodium falciparum parasites
- Title Tesim:
- Symptomatic malaria enhances protection from reinfection with homologous Plasmodium falciparum parasites
- Creator:
- Mangeni, Judith N., Zeno, Erica E., Markwalter, Christine F., Sumner, Kelsey M., Prudhomme-O’Meara, Wendy, Petersen, Jens E. V., Freedman, Elizabeth, Abel, Lucy, Taylor, Steve M., and Obala, Andrew A.
- Date of publication:
- 2023
- Abstract Tesim:
- A signature remains elusive of naturally-acquired immunity against Plasmodium falciparum. We identified P. falciparum in a 14-month cohort of 239 people in Kenya, genotyped at immunogenic parasite targets expressed in the pre-erythrocytic (circumsporozoite protein, CSP) and blood (apical membrane antigen 1, AMA-1) stages, and classified into epitope type based on variants in the DV10, Th2R, and Th3R epitopes in CSP and the c1L region of AMA-1. Compared to asymptomatic index infections, symptomatic malaria was associated with reduced reinfection by parasites bearing homologous CSP-Th2R (adjusted hazard ratio [aHR]:0.63; 95% CI:0.45–0.89; p = 0.008) CSP-Th3R (aHR:0.71; 95% CI:0.52–0.97; p = 0.033), and AMA-1 c1L (aHR:0.63; 95% CI:0.43–0.94; p = 0.022) epitope types. The association of symptomatic malaria with reduced hazard of homologous reinfection was strongest for rare epitope types. Symptomatic malaria provides more durable protection against reinfection with parasites bearing homologous epitope types. The phenotype represents a legible molecular epidemiologic signature of naturally-acquired immunity by which to identify new antigen targets.
- Resource type:
- Article
- Affiliation Label Tesim:
- Department of Epidemiology
- DOI:
- https://doi.org/10.17615/6aqk-cd31
- Edition:
- Postprint
- Identifier:
- https://dx.doi.org/10.1371/journal.ppat.1011442
- ISSN:
- 1553-7374
- Journal Issue:
- 6
- Journal Title:
- PLOS Pathogens
- Journal Volume:
- 19
- Keyword:
- Parasitic diseases, Nucleotide sequencing, T cells, Malaria, Immunity, Malarial parasites, Plasmodium, and Medical risk factors
- Language Label:
- English
- License Label:
- Attribution 4.0 International
- ORCID:
- Other Affiliation:
- Moi University, , Duke University, and Moi Teaching and Referral Hospital
- Page Start:
- e1011442
- Person:
- Mangeni, Judith N., Zeno, Erica E., Markwalter, Christine F., Sumner, Kelsey M., Prudhomme-O’Meara, Wendy, Petersen, Jens E. V., Freedman, Elizabeth, Abel, Lucy, Taylor, Steve M., and Obala, Andrew A.
- Publisher:
- Public Library of Science
- Source:
- 8448bf74-d94d-45a6-abe5-64fc940acab6
66. Self-management of type 2 diabetes mellitus in pregnancy and breastfeeding experiences among women in Thailand: Study protocol
- Title Tesim:
- Self-management of type 2 diabetes mellitus in pregnancy and breastfeeding experiences among women in Thailand: Study protocol
- Creator:
- Baernholdt, Marianne, Hodges, Eric A., and Phonyiam, Ratchanok
- Date of publication:
- 2023
- Abstract Tesim:
- Women with type 2 diabetes mellitus are at a higher risk of pregnancy complications. Although traditional beliefs and practices influence diabetes management and breastfeeding, recommendations integrating Thai cultural beliefs in maternal care are lacking. The purpose of this study is to describe diabetes self-management in pregnancy and breastfeeding experiences in women with preexisting type 2 diabetes mellitus from Thailand. A convergent parallel mixed-methods study will be conducted. Data will be collected from 20 pregnant women with preexisting type 2 diabetes mellitus in Thailand who are either primigravida or multigravida, aged 20–44 years old, speak the Thai language, and provide consent. The National Institute on Minority Health and Health Disparities Framework’s sociocultural and behavioral domains guides the research aims. Data will be collected two times. The first time is during pregnancy (T1); study participants will complete questionnaires and engage in an interview about diabetes self-management, breastfeeding confidence, and breastfeeding intention. The second time is at 4–6 weeks postpartum (T2); study participants will be interviewed about their breastfeeding experiences. We will review and extract maternal health outcomes including body mass index, gestational weight gain, and glycated hemoglobin for T1 as well as fasting plasma glucose for T2. Qualitative data will be analyzed using directed content analysis. Quantitative data will be analyzed using descriptive statistics. Data sources will be triangulated with relative convergence in the results. This proposed study is significant because the findings will be used as a preliminary guide to developing a culturally tailored approach to enhance health outcomes of Thai women with diabetes in pregnancy and postpartum periods.
- Resource type:
- Article
- Affiliation Label Tesim:
- School of Nursing
- DOI:
- https://doi.org/10.17615/n353-fk09
- Edition:
- Publisher
- Identifier:
- https://dx.doi.org/10.1371/journal.pone.0286646
- ISSN:
- 1932-6203
- Journal Issue:
- 6
- Journal Title:
- PLOS ONE
- Journal Volume:
- 18
- Keyword:
- Type 2 diabetes, Thailand, Thai people, Infants, Pregnancy, Breast feeding, HbA1c, and Gestational diabetes
- Language Label:
- English
- License Label:
- CC0 1.0 Universal
- ORCID:
- Other Affiliation:
- University of Virginia and
- Page Start:
- e0286646
- Person:
- Baernholdt, Marianne, Hodges, Eric A., and Phonyiam, Ratchanok
- Publisher:
- Public Library of Science
- Source:
- f42da5bf-ad1e-4456-bb34-e60de546db36
67. Safe infant feeding in healthcare facilities: Assessment of infection prevention and control conditions and behaviors in India, Malawi, and Tanzania
- Title Tesim:
- Safe infant feeding in healthcare facilities: Assessment of infection prevention and control conditions and behaviors in India, Malawi, and Tanzania
- Creator:
- Phiri, Melda, Bellad, Roopa, Yogeshkumar, S., Koppad, Bhavana, Duggan, Christopher P., Kibogoyo, George C., Dhaded, Sangappa, Mvalo, Tisungane, Nyirenda, Naomie, North, Krysten, Caruso, Bethany A., A, Chaya K., LIFE Study Group, Nanda, Saumya, Sudfeld, Christopher R., Tuller, Danielle E., Nabapure, Shilpa, Kisenge, Rodrick, Hoffman, Irving, Manji, Karim, Kafansiyanji, Eddah, Semrau, Katherine E. A., Paniagua, Uriel, Vesel, Linda, Saidi, Friday, Somji, Sarah, Singh, Bipsa, Fleming, Katelyn, Vernekar, Sunil S., Bakari, Mohamed, and Young, Melissa F.
- Date of publication:
- 2023
- Abstract Tesim:
- Infants need to receive care in environments that limit their exposure to pathogens. Inadequate water, sanitation, and hygiene (WASH) environments and suboptimal infection prevention and control practices in healthcare settings contribute to the burden of healthcare-associated infections, which are particularly high in low-income settings. Specific research is needed to understand infant feeding preparation in healthcare settings, a task involving multiple behaviors that can introduce pathogens and negatively impact health. To understand feeding preparation practices and potential risks, and to inform strategies for improvement, we assessed facility WASH environments and observed infant feeding preparation practices across 12 facilities in India, Malawi, and Tanzania serving newborn infants. Research was embedded within the Low Birthweight Infant Feeding Exploration (LIFE) observational cohort study, which documented feeding practices and growth patterns to inform feeding interventions. We assessed WASH-related environments and feeding policies of all 12 facilities involved in the LIFE study. Additionally, we used a guidance-informed tool to carry out 27 feeding preparation observations across 9 facilities, enabling assessment of 270 total behaviors. All facilities had ‘improved’ water and sanitation services. Only 50% had written procedures for preparing expressed breastmilk; 50% had written procedures for cleaning, drying, and storage of infant feeding implements; and 33% had written procedures for preparing infant formula. Among 270 behaviors assessed across the 27 feeding preparation observations, 46 (17.0%) practices were carried out sub-optimally, including preparers not handwashing prior to preparation, and cleaning, drying, and storing of feeding implements in ways that do not effectively prevent contamination. While further research is needed to improve assessment tools and to identify specific microbial risks of the suboptimal behaviors identified, the evidence generated is sufficient to justify investment in developing guidance and programing to strengthen infant feeding preparation practices to ensure optimal newborn health.
- Resource type:
- Article
- Affiliation Label Tesim:
- UNC Project-Malawi
- DOI:
- https://doi.org/10.17615/8352-0g87
- Edition:
- Publisher
- Identifier:
- https://dx.doi.org/10.1371/journal.pgph.0001843
- ISSN:
- 2767-3375
- Journal Issue:
- 6
- Journal Title:
- PLOS Global Public Health
- Journal Volume:
- 3
- Keyword:
- Research facilities, Hygiene, Sanitation, Health care facilities, Water resources, Pediatrics, Medical risk factors, and Infants
- Language Label:
- English
- License Label:
- Attribution 4.0 International
- ORCID:
- Other Affiliation:
- , KLE Academy of Higher Education and Research, Boston Children’s Hospital, Muhimbili University of Health and Allied Sciences, Brigham and Women’s Hospital, Emory University, Bapuji Child Health Institute & Research Centre, Shri Jagannath Medical College and Hospital, Harvard T.H. Chan School of Public Health, Ariadne Labs, and SS Institute of Medical Sciences & Research Centre
- Page Start:
- e0001843
- Person:
- Phiri, Melda, Bellad, Roopa, Yogeshkumar, S., Koppad, Bhavana, Duggan, Christopher P., Kibogoyo, George C., Dhaded, Sangappa, Mvalo, Tisungane, Nyirenda, Naomie, North, Krysten, Caruso, Bethany A., A, Chaya K., LIFE Study Group, Nanda, Saumya, Sudfeld, Christopher R., Tuller, Danielle E., Nabapure, Shilpa, Kisenge, Rodrick, Hoffman, Irving, Manji, Karim, Kafansiyanji, Eddah, Semrau, Katherine E. A., Paniagua, Uriel, Vesel, Linda, Saidi, Friday, Somji, Sarah, Singh, Bipsa, Fleming, Katelyn, Vernekar, Sunil S., Bakari, Mohamed, and Young, Melissa F.
- Publisher:
- Public Library of Science
- Source:
- 51d069ba-be0a-44e1-b6b7-98776ddbc372
68. Qualitative evaluation of barriers and facilitators to hepatocellular carcinoma care in North Carolina
- Title Tesim:
- Qualitative evaluation of barriers and facilitators to hepatocellular carcinoma care in North Carolina
- Creator:
- Teal, Randall W., Sanoff, Hanna K., Coffman, Erin, Ray, Emily M., and Carda-Auten, Jessica
- Date of publication:
- 2023
- Abstract Tesim:
- Background Many patients with hepatocellular carcinoma (HCC) never receive cancer-directed therapy. In order to tailor interventions to increase access to appropriate therapy, we sought to understand the barriers and facilitators to HCC care. Methods Patients with recently diagnosed HCC were identified through the University of North Carolina (UNC) HCC clinic or local hospital cancer registrars (rapid case ascertainment, RCA). Two qualitative researchers conducted in-depth, semi-structured interviews. Interviews were audiotaped, transcribed, and coded. Results Nineteen interviews were conducted (10 UNC, 9 RCA). Key facilitators of care were: physician knowledge; effective communication regarding test results, plan of care, and prognosis; social support; and financial support. Barriers included: lack of transportation; cost of care; provider lack of knowledge about HCC; delays in scheduling; or poor communication with the medical team. Participants suggested better coordination of appointments and having a primary contact within the healthcare team. Limitations We primarily captured the perspectives of those HCC patients who, despite the challenges they describe, were ultimately able to receive HCC care. Conclusions This study identifies key facilitators and barriers to accessing care for HCC in North Carolina. Use of the RCA system to identify patients from a variety of settings, treated and untreated, enabled us to capture a broad range of perspectives. Reducing barriers through improving communication and care coordination, assisting with out-of-pocket costs, and engaging caregivers and other medical providers may improve access. This study should serve as the basis for tailored interventions aimed at improving access to appropriate, life-prolonging care for patients with HCC.
- Resource type:
- Article
- Affiliation Label Tesim:
- UNC Lineberger Comprehensive Cancer Center, Department of Medicine, and Gillings School of Global Public Health
- DOI:
- https://doi.org/10.17615/gq7p-db66
- Edition:
- Publisher
- Identifier:
- https://dx.doi.org/10.1371/journal.pone.0287338
- ISSN:
- 1932-6203
- Journal Issue:
- 6
- Journal Title:
- PLOS ONE
- Journal Volume:
- 18
- Keyword:
- Hepatocellular carcinoma, Transportation, Cancers and neoplasms, Oncology, Finance, Cancer treatment, Cancer detection and diagnosis, and Physicians
- Language Label:
- English
- License Label:
- Attribution 4.0 International
- ORCID:
- Other Affiliation:
- Page Start:
- e0287338
- Person:
- Teal, Randall W., Sanoff, Hanna K., Coffman, Erin, Ray, Emily M., and Carda-Auten, Jessica
- Publisher:
- Public Library of Science
- Source:
- 014de8df-0432-482f-9177-db5a5b8721df
69. Perceived stress, mental health symptoms, and deleterious behaviors during the transition to college
- Title Tesim:
- Perceived stress, mental health symptoms, and deleterious behaviors during the transition to college
- Creator:
- Mazzolenis, M. Emilia, Pepper, Mollie A., Perreira, Krista M., and Fruehwirth, Jane Cooley
- Date of publication:
- 2023
- Abstract Tesim:
- Background This study examined associations between different sources of chronic perceived stress and deleterious behaviors (eating disorder symptoms, insufficient sleep, and insufficient vigorous physical activity) among first-year college students. Methods The study used data on 885 first-year students (ages 18–20) at a large public university in North Carolina. The prevalence of deleterious behaviors was evaluated. Associations were estimated between different sources of chronic perceived stress (academic, future, peers, friendships, romantic, appearance, health, chronic illness, financial, work, family) and health behaviors after controlling for psychosocial supports and demographics. Moderating effects of gender and moderate-severe anxiety/depression symptoms were also tested. Results 19% of first-year student reported symptoms of eating disorders, 42% insufficient sleep, and 43% insufficient vigorous physical activity. Perceived chronic stress increased the odds of reporting these deleterious behaviors. These effects were not moderated by gender or moderate-severe anxiety/depression symptoms. Appearance- and health-related stress were associated with eating disorder symptoms; health- and romantic-related stress were associated with insufficient sleep; and health-related stress was associated with insufficient vigorous physical activity. Limitations Outcomes were survey-based. The study was based on cross-sectional data from a single university, so the direction of causality cannot be determined, and more work needs to be done to determine whether this would extend to other populations.
- Resource type:
- Article
- Affiliation Label Tesim:
- Department of Social Medicine and Department of Economics
- DOI:
- https://doi.org/10.17615/t9f2-3v15
- Edition:
- Publisher
- Identifier:
- https://dx.doi.org/10.1371/journal.pone.0287735
- ISSN:
- 1932-6203
- Journal Issue:
- 6
- Journal Title:
- PLOS ONE
- Journal Volume:
- 18
- Keyword:
- Sleep, Eating disorders, Psychological stress, Physical activity, Psychological and psychosocial issues, Finance, Behavior, and Behavioral and social aspects of health
- Language Label:
- English
- License Label:
- Attribution 4.0 International
- ORCID:
- Other Affiliation:
- Harvard University, Federal Reserve Bank of San Francisco, and
- Page Start:
- e0287735
- Person:
- Mazzolenis, M. Emilia, Pepper, Mollie A., Perreira, Krista M., and Fruehwirth, Jane Cooley
- Publisher:
- Public Library of Science
- Source:
- 6225f917-af99-4451-87fa-23ca3fd28333
70. Missing data approaches in longitudinal studies of aging: A case example using the National Health and Aging Trends Study
- Title Tesim:
- Missing data approaches in longitudinal studies of aging: A case example using the National Health and Aging Trends Study
- Creator:
- Faurot K.R., Kinlaw A.C., Lund J.L., Park J., Duchesneau E.D., Shmuel S., Yang Y.C., Musty A., and Stürmer T.
- Date of publication:
- 2023
- Abstract Tesim:
- Purpose Missing data is a key methodological consideration in longitudinal studies of aging. We described missing data challenges and potential methodological solutions using a case example describing five-year frailty state transitions in a cohort of older adults. Methods We used longitudinal data from the National Health and Aging Trends Study, a nationally-representative cohort of Medicare beneficiaries. We assessed the five components of the Fried frailty phenotype and classified frailty based on their number of components (robust: 0, prefrail: 1–2, frail: 3–5). One-, two-, and five-year frailty state transitions were defined as movements between frailty states or death. Missing frailty components were imputed using hot deck imputation. Inverse probability weights were used to account for potentially informative loss-to-follow-up. We conducted scenario analyses to test a range of assumptions related to missing data. Results Missing data were common for frailty components measured using physical assessments (walking speed, grip strength). At five years, 36% of individuals were lost-to-follow-up, differentially with respect to baseline frailty status. Assumptions for missing data mechanisms impacted inference regarding individuals improving or worsening in frailty. Conclusions Missing data and loss-to-follow-up are common in longitudinal studies of aging. Robust epidemiologic methods can improve the rigor and interpretability of aging-related research.
- Resource type:
- Article
- Affiliation Label Tesim:
- Department of Physical Medicine and Rehabilitation, Division of Pharmaceutical Outcomes and Policy, Department of Epidemiology, and Department of Sociology
- DOI:
- https://doi.org/10.17615/hv72-vn23
- Edition:
- Publisher
- Identifier:
- https://dx.doi.org/10.1371/journal.pone.0286984
- ISSN:
- 1932-6203
- Journal Issue:
- 6-Jun
- Journal Title:
- PLoS ONE
- Journal Volume:
- 18
- Language Label:
- English
- License Label:
- Attribution 4.0 International
- ORCID:
- Other Affiliation:
- Person:
- Faurot K.R., Kinlaw A.C., Lund J.L., Park J., Duchesneau E.D., Shmuel S., Yang Y.C., Musty A., and Stürmer T.
- Publisher:
- Public Library of Science
- Source:
- debf45a8-1bbc-41c0-8be1-c56e6cd688c3
Collection Details
- Total items
-
1963
- Size
-
unknown
- Date created
-
February 2, 2022