SACM - United States of America
Permanent URI for this collectionhttps://drepo.sdl.edu.sa/handle/20.500.14154/9668
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Item Restricted Adult Foster Homes in an Aging America: Trends, Effects, and Operational Challenges (2017–2023)(Oregon Health and Science University, 2024) Albalawi, Wafi; Chair, Paula Carder; Tunalilar, Ozcan; Messer, Lynne; Carlson, BryantBackground: As the aging U.S. population grows, the demand for long-term care services (LTCS) is rising. Adult Foster Homes (AFHs), small residential care settings providing personalized support for older adults, play a critical role in meeting this demand. However, limited research has focused on AFHs compared to other LTCS options. This dissertation examines Oregon’s AFH holistically by assessing home characteristics, resident’s status and health needs, and the experiences of operators, particularly during the COVID-19 pandemic. Methods: Utilizing data from the Oregon Community-Based Care study (2017–2023), this mixed methods research integrates quantitative trend analyses and qualitative content analysis. It explores three key aims: (1) identifying trends in residents' health conditions, service utilization, and medication use; (2) assessing associations between AFH characteristics and healthcare outcomes; and (3) capturing operators' perspectives on rewards and challenges during the pandemic. Results: Findings reveal high prevalence rates of dementia and polypharmacy among residents, with increasing medication use and stable trends in ADL needs. Family involvement significantly declined during the pandemic but showed partial recovery post-restrictions. Operators highlighted meaningful rewards, such as resident care and autonomy, alongside challenges like regulatory burdens and low Medicaid reimbursement rates. Conclusion: By highlighting the unique attributes, resident health needs, and operational challenges of AFHs in Oregon, this study brings critical attention to an often-overlooked long-term care option19 0Item Restricted Investigating the Role of Zinc in Manganese-induced Hepatotoxicity(Florida International University, 2024) Alandanoosi, Afnan; Liuzzi, Juan; Palacios, Cristina; Narayanan Vijaya; George, FlorenceThe objective of this study was to investigate the role of zinc (Zn) status in manganese (Mn) -induced hepatotoxicity using epidemiological data and vitro experiments. First, we conducting epidemiological study using the National Health and Nutrition Examination Survey (NHANES) to determine the relationship between Zn status and blood Mn levels on enzymatic markers of liver damage. The findings indicated that without the regression interaction of Zn intake or serum Zn, blood Mn exhibits a direct (positive) association with Alkaline Phosphatase (ALP) and Aspartate Amino transferase (AST). The results however showed that with the interaction of blood Mn and Zn intake at the second quartile (Q2) (marginal low Zn intake), a negative association was found with ALP in model 1,model 2 (corrected by age and gender), and model 3 (corrected by age, gender, race, education, BMI, alcohol, smoking and diabetes ). A similar association was found between Q4 (adequate/high Zn intake) and Lactate Dehydrogenase (LDH) activity in all three models of the study. Second, the effect of Zn deficiency and adequacy on Mn toxicity and the expression level of the cellular Mn efflux transporter SCL30A10 in human hepatocytes was evaluated. Mitochondria oxidative stress, apoptosis, and cell death and proliferation studies showed that exposure to elevated levels of Mn increased oxidative stress, apoptosis, and cell death. Mn exposure also decreased cell proliferation. Noteworthy, Zn depletion was found to enhance Mn induced apoptosis and cell death. Lastly, the mRNA expression of SLC30A10 was significantly decreased by Mn exposure (p < 0.05). However, no significant difference in the protein expression level of SCL30A10 was found. This suggests that there was no compensatory regulatory response of this transporter expression to either Zn deficiency or Mn exposure for the time point analyzed. Overall, the results from the epidemiological data and in vitro studies indicate that Zn deficiency could enhance the toxic effects of Mn. The results underscore the importance of having an adequate Zn intake in mitigating Mn induced cytotoxicity.64 0Item Restricted Investigation of Existing and New Human Resources Practices on Public Health Eemployee Retention During the Covid-19 Pandemic in Saudi Arabia(Saudi Digital Library, 2023-07-30) Alattas, Mohsen Mohammed; Jang, Hee Soun; Andrew, Simon; Benavides, Abraham; Shi, KellyThis research investigates existing and new HR practices that have impacted public health employee retention in Saudi Arabia during the COVID-19 pandemic. It builds on social support theory and social exchange theory to better understand the relationships between HR practices and retention, and uses quantitative methods to examine the hypotheses based on a conceptual framework. While OLS regression is employed to analyze the relationships between HR practices and retention, path analysis (bootstrapping) is used to examine the mediator variable. Based on 417 valid questionnaires distributed to public health employees in Saudi Arabia’s central, western, and eastern regions, the analysis illustrates that while training and emphasis on work-life-balance as existing HR practices had a positive effect on retention, social support (supervisory support) and promotion of mental well-being as new HR practices also had a positive effect on retention during the COVID-19 pandemic. However, the hypothesis that compensation and occupational health and safety would improve retention was not supported. These results indicate that financial benefits and providing safety materials did not lead to employee retention. Meanwhile, safety training programs, psychosocial support, and promotion of well-being have been essential HR practices during the pandemic. Regarding the mediation hypotheses, interestingly, the results show that organizational commitment has mediated relationships between safety training and mental (psychological) well-being on one hand and public health retention on the other during the pandemic.33 0Item Restricted Investigating Ohio Health Commissoners' Perceptions and Experiences with Respect to Decision-Making During the COVID-19 Pandemic(2023-05-01) Alsaheil, Nouf; Hoornbeek, JohnBackground: Public Health (PH) leaders debate the effectiveness of their decisions on controlling the COVID-19 pandemic. Varying decisions across states and localities illustrate the difficulty of decision-making when confronted with complex and unexpected challenges in PH. Psychologists often frame decision-making as reflecting one of two systems. System 1 is based on experience and instinct. System 2 is based on data and analysis. In PH, many efforts are directed toward supporting evidence-based decision-making; however, scholars confirm that skills and experience play a substantial role in shaping decisions. Skills and experiences appear to become more influential in decisions associated with high-stakes situations, where individuals will depend more on their cognitive, interpersonal, and behavioral skills and less on data because of uncontrollable constraints, such as time, information, and uncertainty. The purpose of this study is to generate a better understanding of the decision-making processes used by Ohio local health commissioners (HCs) as they were dealing with COVID-19 high-stakes situations. Study aims include: examining the thinking styles of expert and novice Ohio HCs regarding decision-making in the context of COVID-19-associated high-stakes situations; identifying factors that impact the decision-making preferences and practices during these situations; and exploring the contextual factors that HCs consider when faced with COVID-19 decisions. Methods: The study applied a convergent mixed-method approach. Quantitative methods were applied to a cross-sectional survey data where the Rational-Experiential Inventory-40 survey was used to measure individual differences and their relationships with expressed preferences for using System 1 and 2 thinking. An ANOVA and paired t-test were used to assess differences between Public Health Officials’ (PHOs) experience levels and preferred decision-making systems. Multiple linear regression analysis was used to identify factors associated with preferred system thinking. The Critical Decision Method, a semi-structured interview protocol, was used to discover contextual factors that influence the decision-making process of HCs in COVID-19 situations. A thematic analysis was used to analyze the qualitative data. Findings: This study found that Ohio HCs prefer using rational over experiential thinking during COVID-19 situations. There were no consistent documented differences between novices and experts except for the reported status of their networks and relationships. The study also identified contextual factors that appeared to influence HCs’ decision-making processes. Themes that emerged from the interviews in relations to these factors included vagueness and uncertainty, senses of urgency, regulation and guidance, autonomy and sense of responsibility, prior experience, networks and relationships, effective communication and teamwork, cognitive skills, and personality traits. Implications: The results inform scientific knowledge and can be used to aid development of hazard-focused training programs and PH curricula. Equipping the PH workforce with necessary leadership competencies to face high-stake situations is an important protective factor to help counteract other uncontrollable factors that arise within the PH sector, including lack of information, time, and budget. The work presented here may be used to improve PHOs' performance, which can lead to better service delivery. Results from this study are also available to preparedness planners to assist in LHDs’ After-Action Reviews/Improvement Plans.9 0