Interdisciplinary Dissertation Research Among Public Health Doctoral Trainees, 2003-2015

Given the call for more interdisciplinary research in public health, the objectives of this study were to (1) examine the correlates of interdisciplinary dissertation completion and (2) identify secondary fields most common among interdisciplinary public health graduates. METHODS: We analyzed pooled cross-sectional data from 11 120 doctoral graduates in the Survey of Earned Doctorates, 2003-2015. The primary outcome was interdisciplinary dissertation completion. Covariates included primary public health field, sociodemographic characteristics, and institutional attributes. RESULTS: From 2003 to 2015, a total of 4005 of 11 120 (36.0%) doctoral graduates in public health reported interdisciplinary dissertations, with significant increases observed in recent years. Compared with general public health graduates, graduates of environmental health (odds ratio [OR] = 1.74; P < .001) and health services administration (OR = 1.38; P < .001) doctoral programs were significantly more likely to report completing interdisciplinary dissertation work, whereas graduates from biostatistics (OR = 0.51; P < .001) and epidemiology (OR = 0.76; P < .001) were less likely to do so. Completing an interdisciplinary dissertation was associated with being male, a non-US citizen, a graduate of a private institution, and a graduate of an institution with high but not the highest level of research activity. Many secondary dissertation fields reported by interdisciplinary graduates included other public health fields. CONCLUSION: Although interdisciplinary dissertation research among doctoral graduates in public health has increased in recent years, such work is bounded in certain fields of public health and certain types of graduates and institutions. Academic administrators and other stakeholders may use these results to inform greater interdisciplinary activity during doctoral training and to evaluate current and future collaborations across departments or schools

Incident Ischemic Heart Disease After Long-Term Occupational Exposure to Fine Particulate Matter: Accounting for 2 Forms of Survivor Bias.

Little is known about the heart disease risks associated with occupational, rather than traffic-related, exposure to particulate matter with aerodynamic diameter of 2.5 µm or less (PM2.5). We examined long-term exposure to PM2.5 in cohorts of aluminum smelters and fabrication workers in the United States who were followed for incident ischemic heart disease from 1998 to 2012, and we addressed 2 forms of survivor bias. Left truncation bias was addressed by restricting analyses to the subcohort hired after the start of follow up. Healthy worker survivor bias, which is characterized by time-varying confounding that is affected by prior exposure, was documented only in the smelters and required the use of marginal structural Cox models. When comparing always-exposed participants above the 10th percentile of annual exposure with those below, the hazard ratios were 1.67 (95% confidence interval (CI): 1.11, 2.52) and 3.95 (95% CI: 0.87, 18.00) in the full and restricted subcohorts of smelter workers, respectively. In the fabrication stratum, hazard ratios based on conditional Cox models were 0.98 (95% CI: 0.94, 1.02) and 1.17 (95% CI: 1.00, 1.37) per 1 mg/m(3)-year in the full and restricted subcohorts, respectively. Long-term exposure to occupational PM2.5 was associated with a higher risk of ischemic heart disease among aluminum manufacturing workers, particularly in smelters, after adjustment for survivor bias

Whole family-based physical activity promotion intervention: the Families Reporting Every Step to Health pilot randomised controlled trial protocol

Introduction : Family-based physical activity (PA) interventions present a promising avenue to promote children’s activity, however, high-quality experimental research is lacking. This paper describes the protocol for the FRESH (Families Reporting Every Step to Health) pilot trial, a child-led family-based PA intervention delivered online.  Methods and analysis : FRESH is a three-armed, parallel-group, randomised controlled pilot trial using a 1:1:1 allocation ratio with follow-up assessments at 8- and 52-weeks post-baseline. Families will be eligible if a minimum of one child in school Years 3-6 (aged 7-11 years) and at least one adult responsible for that child are willing to participate. Family members can take part in the intervention irrespective of their participation in the accompanying evaluation and vice versa. Following baseline assessment, families will be randomly allocated to one of three arms: (1) FRESH, (2) pedometer-only, or (3) no-intervention control. All family members in the pedometer-only and FRESH arms receive pedometers and generic PA promotion information. FRESH families additionally receive access to the intervention website; allowing participants to select step challenges to ‘travel’ to target cities around the world, log steps, and track progress as they virtually globetrot. Control families will receive no treatment. All family members will be eligible to participate in the evaluation with two follow-ups (8 and 52 weeks). Physical (e.g., fitness, blood pressure), psychosocial (e.g., social support), and behavioural (e.g., objectively-measured family PA) measures will be collected each time point. At 8-week follow-up, a mixed-methods process evaluation will be conducted (questionnaires and family focus groups) assessing acceptability of the intervention and evaluation. FRESH families’ website engagement will also be explored.  Ethics and dissemination : This study received ethical approval from the Ethics Committee for the School of the Humanities and Social Sciences at the University of Cambridge. Findings will be disseminated via peer-reviewed publications, conferences, and to participating families

Likelihood of Asking for Help in Caregivers of Women With Substance Use or Co-Occurring Substance Use and Mental Disorders

Family members are important to the well-being of their relatives with substance use disorders or cooccurring substance use and mental disorders. Many caregivers experience high levels of burden, negatively impacting their capacity to provide support to their ill family member. The Andersen health care utilization model (Andersen & Newman, 1973, 2005) was used to identify the impact of predisposing, enabling, and need factors hypothesized to predict caregivers’ likelihood of asking for help and support with their caregiving role. The sample include 82 women recruited from outpatient or inpatient substance abuse treatment centers and 82 family caregivers nominated by these women. Findings showed that almost half of caregivers were unlikely to ask for help. Multiple regression analysis found that two need variables were statistically significant predictors of caregivers’ likelihood to ask for help. Caregivers who had higher subject burden (worry) and caregivers who provided more assistance with daily living were more likely to ask for help. It is suggested that case managers assess the amount of worried family caregivers’ experience because their worries may provide the motivation to ask for help or to participate in help when it is offered to them

Transitioning from acute to primary health care nursing: an integrative review of the literature

Aims and objectives This paper seeks to explore the transition experiences of acute care nurses entering employment in primary health care settings. Background Internationally the provision of care in primary health care settings is increasing. Nurses are moving from acute care settings to meet the growing demand for a primary health care workforce. While there is significant research relating to new graduate transition experiences, little is known about the transition experience from acute care into primary health care employment. Design An integrative review, guided by Whittemore and Knafl\u27s (2005) approach, was undertaken. Following a systematic literature search eight studies met the inclusion criteria. Methods Papers which met the study criteria were identified and assessed against the inclusion and exclusion criteria. Papers were then subjected to methodological quality appraisal. Thematic analysis was undertaken to identify key themes within the data. Results Eight papers met the selection criteria. All described nurses transitioning to either community or home nursing settings. Three themes were identified: (1) a conceptual understanding of transition, (2) role losses and gains and (3) barriers and enablers. Conclusion There is a lack of research specifically exploring the transitioning of acute care nurses to primary health care settings. To better understand this process, and to support the growth of the primary health care workforce there is an urgent need for further well-designed research. Relevance to clinical practice There is an increasing demand for the employment of nurses in primary health care settings. To recruit experienced nurses it is logical that many nurses will transition into primary health care from employment in the acute sector. To optimise retention and enhance the transition experience of these nurses it is important to understand the transition experience

STEM Inqueery: How Belonging in STEM Might Differ Depending on LGBTQ Identities and Identity Openness

Science, technology, engineering, and mathematics (STEM) studies have investigated gender (women versus men; Kim et al., 2018), race (Latinx and Black; Unfried et al., 2015), and culture differences (Asian versus American; Brown et al., 2018); however, few studies have looked at the lesbian, gay, bisexual, transgender, and queer (LGBTQ) community (Stout & Wright, 2016). STEM has been stereotyped as a cis (same gender as birth) straight male field (Miller et al., 2020); STEM is viewed as an agentic (self-focused, achievement-oriented) field and lacking communal (other-oriented) opportunities (Diekman et al., 2010). When communal opportunities are integrated into fields that are stereotyped as being noncommunal, STEM interest is boosted (Brown et al., 2018). This raises the question: what happens to LGBTQ individuals in STEM? LGBTQ individuals may feel less open or out about their LGBTQ identity in a STEM field when it is more male-dominated (Yoder & Mattheis, 2016). Further, LGBQ students are less likely to stay in STEM compared to non-LGBQ students (Hughes, 2018); transgender students presenting feminine within STEM are not respected as much by their peers compared to other students (Kersey, 2018). This study will explore whether LGBTQ individuals’ desire for communal opportunities within STEM careers shapes their motivation to pursue STEM, their expectations for success in STEM, and their feelings of belonging in STEM. We hypothesize that LGBTQ individuals with low-openness about their LGBTQ identity will have less motivation, expectations for success, and feelings of belonging in STEM than LGBTQ individuals with high-openness and non-LGBTQ individuals

Exploring the role of pain as an early predictor of category 2 pressure ulcers: a prospective cohort study

Objective To explore pressure area related pain as a predictor of category ≥2 pressure ulcer (PU) development. Design Multicentre prospective cohort study. Setting UK hospital and community settings. Participants inclusion Consenting acutely ill patients aged ≥18 years, defined as high risk (Braden bedfast/chairfast AND completely immobile/very limited mobility; pressure area related pain or; category 1 PU). Exclusion Patients too unwell, unable to report pain, 2 or more category ≥2 PUs. Follow-up Twice weekly for 30 days. Primary and secondary outcome measures Development and time to development of one or more category ≥2 PUs. Results Of 3819 screened, 1266 were eligible, 634 patients were recruited, 32 lost to follow-up, providing a 602 analysis population. 152 (25.2%) developed one or more category ≥2 PUs. 464 (77.1%) patients reported pressure area related pain on a healthy, altered or category 1 skin site of whom 130 (28.0%) developed a category ≥2 PU compared with 22 (15.9%) of those without pain. Full stepwise variable selection was used throughout the analyses. (1) Multivariable logistic regression model to assess 9 a priori factors: presence of category 1 PU (OR=3.25, 95% CI (2.17 to 4.86), p<0.0001), alterations to intact skin (OR=1.98, 95% CI (1.30 to 3.00), p=0.0014), pressure area related pain (OR=1.56, 95% CI (0.93 to 2.63), p=0.0931). (2) Multivariable logistic regression model to account for overdispersion: presence of category 1 PU (OR=3.20, 95% CI (2.11 to 4.85), p<0.0001), alterations to intact skin (OR=1.90, 95% CI (1.24 to 2.91), p=0.0032), pressure area related pain (OR=1.85, 95% CI (1.07 to 3.20), p=0.0271), pre-existing category 2 PU (OR=2.09, 95% CI (1.35 to 3.23), p=0.0009), presence of chronic wound (OR=1.66, 95% CI (1.06 to 2.62), p=0.0277), Braden activity (p=0.0476). (3) Accelerated failure time model: presence of category 1 PU (AF=2.32, 95% CI (1.73 to 3.12), p<0.0001), pressure area related pain (AF=2.28, 95% CI (1.59 to 3.27), p<0.0001). (4) 2-level random-intercept logistic regression model: skin status which comprised 2 levels (versus healthy skin); alterations to intact skin (OR=4.65, 95% CI (3.01 to 7.18), p<0.0001), presence of category 1 PU (OR=17.30, 95% CI (11.09 to 27.00), p<0.0001) and pressure area related pain (OR=2.25, 95% CI (1.53 to 3.29), p<0.0001). Conclusions This is the first study to assess pain as a predictor of category ≥2 PU development. In all 4 models, pain emerged as a risk factor associated with an increased probability of category ≥2 PU development

Understanding Mammalian Genetic Systems: The Challenge of Phenotyping in the Mouse

Understanding mammalian genetic systems is predicated on the determination of the relationship between genetic variation and phenotype. Several international programmes are under way to deliver mutations in every gene in the mouse genome. The challenge for mouse geneticists is to develop approaches that will provide comprehensive phenotype datasets for these mouse mutant libraries. Several factors are critical to success in this endeavour. It will be important to catalogue assay and environment and where possible to adopt standardised procedures for phenotyping tests along with common environmental conditions to ensure comparable datasets of phenotypes. Moreover, the scale of the task underlines the need to invest in technological development improving both the speed and cost of phenotyping platforms. In addition, it will be necessary to develop new informatics standards that capture the phenotype assay as well as other factors, genetic and environmental, that impinge upon phenotype outcome

Looking for Distributed Star Formation in L1630: A Near-infrared (J, H, K) Survey

We have carried out a simultaneous, multi-band (J, H, K) survey over an area of 1320 arcmin^2 in the L1630 region, concentrating on the region away from the dense molecular cores and with modest visual extinctions (\leq 10 mag). Previous studies found that star formation in L1630 occurs mainly in four localized clusters, which in turn are associated with the four most massive molecular cores (Lada et al. 1991; Lada 1992). The goal of this study is to look for a distributed population of pre-main-sequence stars in the outlying areas outside the known star-forming cores. More than 60% of the pre-main-sequence stars in the active star forming regions of NGC 2024 and NGC 2023 show a near-infrared excess in the color-color diagram. In the outlying areas of L1630, excluding the known star forming regions, we found that among 510 infrared sources with the near-infrared colors ((J-H) and (H-K)) determined and photometric uncertainty at K better than 0.10 mag, the fraction of the sources with a near-infrared excess is 3%--8%; the surface density of the sources with a near-infrared excess is less than half of that found in the distributed population in L1641, and 1/20 of that in the young cluster NGC 2023. This extremely low fraction and low surface density of sources with a near-infrared excess strongly indicates that recent star formation activity has been very low in the outlying region of L1630. The sources without a near-infrared excess could be either background/foreground field stars, or associated with the cloud, but formed a long time ago (more than 2 Myrs). Our results are consistent with McKee's model of photoionization-regulated star formation.Comment: 30 pages, 10 figures To appear in ApJ Oct 1997, Vol 48