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Institute Of Public Health Newsletter- Volume 5, Issue 2, Institute Of Public Health (Iph)

Institute of Public Health Newsletter (IPHNL)

No abstract provided.

Applying An Anti-Racist Pedagogy To Develop And Deliver A Racial Microaggressions Workshop For Occupational Therapy Students, Shannon Giannitsopoulou, Jane A. Davis, Bismah Khalid, Ruheena Sangrar

Journal of Occupational Therapy Education

Many workshops about identifying, understanding, and responding to microaggressions have been designed and delivered to learners within health education. However, few workshops implement an anti-racist pedagogical approach, and none presented in the literature have been created specifically for occupational therapy students. Anti-racist pedagogical approaches explicitly link interpersonal and institutional/structural oppressions to ensure that the impacts of microaggressions are not minimized by focusing solely on interpersonal interactions. A specific workshop is needed to address the noted persistence of racial microaggressions directed at clients, families, students, and practitioners within occupational therapy contexts and due to the embeddedness of practitioners in clients’ daily …

An Explainable Artificial Intelligence Framework For The Predictive Analysis Of Hypo And Hyper Thyroidism Using Machine Learning Algorithms, Md. Bipul Hossain, Anika Shama, Apurba Adhikary, Avi Deb Raha, K. M. Aslam Uddin, Mohammad Amzad Hossain, Imtia Islam, Saydul Akbar Murad, Md. Shirajum Munir, Anupam Kumur Bairagi

Electrical & Computer Engineering Faculty Publications

The thyroid gland is the crucial organ in the human body, secreting two hormones that help to regulate the human body's metabolism. Thyroid disease is a severe medical complaint that could be developed by high Thyroid Stimulating Hormone (TSH) levels or an infection in the thyroid tissues. Hypothyroidism and hyperthyroidism are two critical conditions caused by insufficient thyroid hormone production and excessive thyroid hormone production, respectively. Machine learning models can be used to precisely process the data generated from different medical sectors and to build a model to predict several diseases. In this paper, we use different machine-learning algorithms to …

Dental Hygiene And Dental Assistant Students' Simulated Dvi Radiographic Match Accuracy: A Pilot Study, Samantha C. Vest, Brenda T. Bradshaw, Marsha A. Voelker, Ann M. Bruhn, Tara L. Newcomb, Sinjini Sikdar

Dental Hygiene Faculty Publications

Purpose Allied dental health care professionals have served on disaster victim identification (DVI) teams; however, the literature is void of statistical measures regarding transferable skills and disaster preparedness. The purpose of this study was to assess second year dental hygiene and dental assistant students’ match accuracy for simulated DVI radiographs and compare the match accuracy between the student groups.

Methods Five patient cases were chosen at random to retrospectively collect sets of digital bitewing radiographs from two time periods. The five retrospectively selected sets of images served as simulated antemortem (AM) and postmortem (PM) radiographs. A convenience sample of second …

Patterns Of Health Care Use Among Rural-Urban Medicare Beneficiaries Age 85 And Older, 2010-2017, Yvonne Jonk Phd, Heidi O'Connor Ms, Amanda Burgess Mppm, Carly Milkowski Mph

Access / Insurance

The purpose of this study was to examine rural-urban differences in health care use among Medicare beneficiaries age 85+. Understanding these differences, and the socioeconomic characteristics that contribute to them, can have important implications for Medicare policies aimed at serving the age 85+ population. Using the Medicare Current Beneficiary Survey 2010-13 Cost and Use and 2015-17 Cost Supplement Files, we examined whether and how rural and urban Medicare beneficiaries age 85+ differ in terms of their:

1. socioeconomic and health characteristics that may inform health care use;
2. trends in health care use, including use of inpatient and emergency department (ED) care; …

Executive Summary: Driving The Southern Nevada Health Economy Forward, Tripp Umbach

Policy Briefs and Reports

The University of Nevada, Las Vegas (UNLV) plans to develop an integrated academic health center within the Las Vegas Medical District (LVMD).1 The academic health center includes UNLV’s five health science schools and mental and behavioral health, which is distributed among several colleges (medicine, liberal arts, urban affairs, and education) in the university. University Medical Center (UMC), a major teaching hospital, will also be an important driver of the academic health center. For the purposes of this report, UNLV’s medical and health science entities along with UMC are referred to collectively as the UNLV Academic Health Center.

Driving The Southern Nevada Health Economy Forward: Benefits Of A Transformational Unlv Academic Health Center, Tripp Umbach

Policy Briefs and Reports

The University of Nevada, Las Vegas (UNLV) plans to develop an integrated academic health center within the Las Vegas Medical District (LVMD). The academic health center includes UNLV’s five health science schools and mental and behavioral health, which is distributed among several colleges (medicine, liberal arts, urban affairs, and education) in the university. University Medical Center (UMC), a major teaching hospital, will also be an important driver of the academic health center. For the purposes of this report, UNLV’s medical and health science entities along with UMC are referred to collectively as the UNLV Academic Health Center. Additional academic health …

Responding To Sexual Abuse In Health Care: Development Of A Guide For Patients, Tristan Mcintosh, Heidi Walsh, Meredith Parsons, Erin D. Solomon, Jessica Mozersky, James M. Dubois

Journal of Patient-Centered Research and Reviews

This report details the development of a stakeholder- and evidence-informed online resource guide for patients that provides information to raise awareness about sexual abuse in health care, the value of chaperones, and options for responding to sexual abuse. The guide was developed to reflect lessons learned from 10 years of researching physician wrongdoing (ie, sexual violations, improper prescribing, and unnecessary invasive procedures), a 5-year National Institutes of Health-funded mixed-methods study of 280 cases of egregious wrongdoing in medicine, and an expert working group. Focus groups were conducted with 22 patients from diverse backgrounds to obtain feedback on the acceptability of …

Perception Of Health Care Access In Rural Georgia: Findings From A Community Health Needs Assessment Survey, Elisa M. Childs, Tiffany R. Washington

Journal of the Georgia Public Health Association

Background: Limited access to health care services has been cited as a barrier to care for individuals who live in rural areas, contributing to significant health disparities in this population. While perception of services has been cited as a determinant of utilization of health services, it is unknown how perception of services influences health care access in rural areas. The paucity of studies specific to areas in the United States that are medically underserved, necessitated this study and its quantification of the issues that are relevant to individuals living in rural Georgia.

Methods: This study examined the perception of health …

College Of Health And Human Service Faculty’S Confidence And Inclusion Of Lgbtq+ Health Content In Curriculum, Carley S. Kanter

Honors Theses and Capstones

In the health care system, those who identify as lesbian, gay, bisexual, transgender, queer, (LGBTQ+) face discrimination and health disparities. Students who are better prepared in higher education to provide care for this population have higher levels of confidence in LGBTQ+ health content than those who have less exposure. Therefore, faculty who teach curriculum related to health and wellness have an opportunity to prepare students to provide high quality, patient centered care by teaching culturally competent care that is inclusive of LGBTQ+ populations. The aim of the study is to determine whether the degree of confidence in teaching LGBTQ+ health …

Variations In Schedule Iii Prescription Patterns In A Medicaid Population Pre- And Post-Policy, Radhakrishnan Nagarajan, Jeffery C. Talbert, Craig S. Miller, Jeffrey Ebersole

Pharmacy Practice and Science Faculty Publications

The present study investigated variations in patient movement patterns between prescribers before and after House Bill 1 (HB1) implementation in Kentucky using network abstractions (PPN: prescriber-prescriber networks) from a one-month cross-sectional Schedule III prescription data in a Medicaid population. Network characteristics such as degree centrality distribution of PPN was positively skewed and revealed Dental Practitioners to be the highly connected specialty with opioid analgesic hydrocodone-acetaminophen to be the most commonly prescribed drug. Taxonomy enrichment of the prescriber specialties in PPN using chi-square test revealed a reduction in the enriched taxonomies Post-HB1 compared to Pre-HB1 with Dental practitioners being constitutively enriched …

Seeking Care At Free Episodic Health Care Clinics In Appalachia, Malerie Lazar, Sandra Thomas, Lisa Davenport

Journal of Appalachian Health

Background: People who live in rural Appalachia experience a wide variety of problems when seeking access to health care. Health care disparities continue to be one of the most complex and prevalent problems, and many barriers exist for impoverished men and women such as a lack of education, complications with health insurance, and personal distrust of healthcare providers.

Purpose: A critical gap in the literature is the unheard voice of persons in rural underserved areas. The purpose of this study was to explore the perspectives of persons in rural Appalachia who seek healthcare services at free episodic health care clinics, …

Health Insurance Literacy Among International College Students: A Qualitative Analysis, Adebola Adegboyega, Chigozie Nkwonta, Jean Edward

Nursing Faculty Publications

In this qualitative descriptive study, we examine health insurance literacy among a group of international college students. They were recruited from a public, co-educational Southeastern university in the United States during the fall semester of 2016 to participate in semistructured interviews. Data were gathered through a demographic questionnaire, two focus group discussions, and individual interviews. Interview sessions were audio-recorded, transcribed, and analyzed using a thematic analysis approach. Three themes emerged, including knowledge of health insurance options and benefits information, affordability, and unmet expectations. These findings show the need for higher education institutions to develop a plan to integrate international students …

Improving Cultural Competency Among Healthcare Providers Working With Refugee Patients, Tena Chau

Doctor of Nursing Practice (DNP) Projects

Background: Increased diversity of the United States population has resulted in the presence of greater disparities in healthcare. One way to address factors contributing to health disparities has been to increase cultural competency in healthcare. Evidence from a review of the literature supports the idea that understanding aspects of cultural competency that are lacking among specific healthcare organizations are helpful to develop programs to address the areas of need. Purpose: The purpose was to complete a quality improvement project to evaluate if an educational intervention based on a specific model would lead to increased level of cultural competence among healthcare …

Dental Emergencies In The Current Health Care System, David Singleton, Nawar Shara, Phd

Journal of Health Disparities Research and Practice

A huge problem in the current health system is that Oral care is not currently integrated into the overall health system, given the lack of dental coverage for underserved adults, and the insufficient amount of dentists available for individuals with dental coverage.

The lack of education regarding the importance of oral health and shortage in the number of dentists and dental coverage leads to an influx of patients with mild to severe dental problems at the emergency departments (EDs) across the country. Many studies conclude that by integrating oral health into the overall health system, there would an increase in …

A Provider-Driven Approach To Preventative Oral Care In Nursing Home Facilities, Molly Anderson, Brandon Mccrossin, Kary Franchetti, Ruth Hanselman, Suneela Nayak, Stephen Tyzik, Amy Sparks

Operational Transformation

Oral care is an essential part of preventative medicine as it minimizes risk for pneumonias and other infections. In nursing home settings, often oral health care is not routinely provided due to a number of issues. A health care system that either owns or contracts nursing home facilities initiated a performance improvement plan to address this patient care concern.

The first goal of this project was to reduce the variation in oral care between nursing home facilities within the system. The second goal was 100% of their patients will have one oral health care exam documented in EPIC once a …

Exploratory Qualitative Study To Understand The Underlying Motivations And Strategies Of The Private For-Profit Healthcare Sector In Urban Bangladesh, Alayne Mary Adams, Rushdia Ahmed, Tanzir Ahmed Shuvo, Sifat Shahana Yusuf, Sadika Akhter, Iqbal Anwar

Faculty Publications

Objectives This paper explores the underlying motivations and strategies of formal small and medium-sized formal private for-profit sector hospitals and clinics in urban Bangladesh and their implications for quality and access.

Methods This exploratory qualitative study was conducted in Dhaka, Sylhet and Khulna City Corporations. Data collection methods included key informant interviews (20) with government and private sector leaders, in-depth interviews (30) with clinic owners, managers and providers and exit interviews (30) with healthcare clients.

Results Profit generation is a driving force behind entry into the private healthcare business and the provision of services. However, non-financial motivations are also emphasised …

Incorporating Oral Health Care In Pediatric Primary Care Practice, Salamatu Yusif

Evidence-Based Practice Project Reports

The most common chronic disease in childhood is dental caries and is more prevalent than asthma and hay fever (HHS, 2000). Data show that in the United States from 2011-2014, 24% of children aged 2-5 years had experienced dental caries in their primary teeth, with 11% having untreated caries (Dye et al., 2017). Primary care clinicians have an important role to play in promoting children’s oral health as much as dentists because they have more contact with children. The purpose of this evidence-based practice project was to integrate an evidence-based oral health program for children in a pediatric primary care …

Age Of First Drink, First Alcohol Intoxication, And Alcohol Abuse Behaviors Among Occupational Therapy Students, Randy P. Mccombie

The Open Journal of Occupational Therapy

The purpose of the present study was to examine alcohol use behaviors among a national sample of occupational therapy students. Survey instruments, including the AUDIT and a checklist of risky and unprofessional behaviors related to alcohol abuse, were mailed to 1,000 occupational therapy students randomly selected from membership in the American Occupational Therapy Association. Surveys were returned by 309 student members; however, 24 indicated they were not currently occupational therapy students. Of the 285 participants, 97% reported drinking alcohol at some point over the previous year, with 1 in 5 drinking two or more times a week, often consuming four …

Network Analysis Approaches To Collaborative Information Seeking In Inter-Professional Health Care Teams, J. David Johnson

Communication Faculty Publications

Introduction: It is widely believed that interprofessional health care teams can improve patient care and increase safety; however, intra-team communication has often proven to be problematic. One particularly important aspect of this problem is how teams collaborate to seek the information needed to address the issues they are confronting. Network analysis offers a rich set of concepts for tackling this problem.

Method: Review essay.

Analysis and results: Network analysis approaches offer the promise of more nuanced approaches and diagnostic tools that could address these issues by focusing on its elements: reciprocity, centrality, density, fault lines, multi-team systems, …

Health Care Priorities In Developing Countries: A Systematic Review, Heather Mckay

Senior Honors Projects, 2010-2019

Countries around the globe are struggling to find an affordable health care system. Developing countries have it particularly challenging with a lack of health care professionals and funding to spend on health care. This systematic review analyzes five developing countries’ (China, Dominican Republic, Ghana, Peru and Turkey) health care systems to find what is working well and what needs improvement. The main findings that these countries could adopt are requiring medical student graduates to do their residency in rural areas, giving more power of health care to local governments rather than the federal government, making insurance companies non-profit, and providing …

Trans, Gender Non-Conforming, And Non-Binary Experiences With The Us Health Care System, Brenna Wyffels

Honors Projects

This research aims to identify health care obstacles faced by members of the trans, gender non-conforming, and non-binary community. Through a literature review and a Qualtrics survey distributed to university students in the target community via email, obstacles to health care access and solutions to the obstacles were identified. Data collected from survey participants included demographic information, anecdotes about inclusive and exclusive health care experiences, and proposed solutions to health care obstacles. Obstacles to health care access stemmed from many sources, including from biases of health care providers. Solutions ranged from changes that individual providers could make to nation-wide education …

Understanding Haitian Women’S Health Care In Immokalee, Florida, Usa, Michele Leigh Flippo Bolduc

Theses and Dissertations--Geography

This social science research project takes a critical approach to understanding the health of a population by using the health care system as an entry point through which we can see how large-scale social processes produce a particular health care landscape in the rural, im/migrant farmworker community of Immokalee, Florida, USA. Using a multi-scalar analysis of health care, I investigate how anti-immigrant legislation and neoliberal economics influence the experience of health care for health care providers and Haitian im/migrant women navigating these processes. First, I argue that anti-immigrant and pro-market discourses have been successful in limiting the accessibility to health …

Housing Status, Patient Characteristics, And Ed Utilization Associated With Medication Prescribing At Ed Discharge Among Homeless And Nonhomeless Adults In Urban Hospitals In The United States, Lauren Cox

Theses and Dissertations

This cross-sectional study used a weighted sample of ED visits contained in the 2010-2015 years of the National Hospital Ambulatory Care Survey-Emergency Department (NHAMCS-ED) dataset. The purpose of this study was to: 1) identify differences in predisposing, enabling, and need characteristics, and ED use and medication prescribing characteristics between homeless and nonhomeless ED users; 2) assess the association between housing status and medication prescribing at ED discharge, and identify variables contributing to the disparity in medication prescribing between homeless and nonhomeless ED users; and 3) assess the predisposing, enabling, need, and ED use characteristics that predict medication prescribing at ED …

Mid-Atlantic Ethics Committee Newsletter, Fall 2017

Mid-Atlantic Ethics Committee Newsletter

No abstract provided.

Medicaid And Children With Special Health Care Needs, 2016-2017 Cohort Of New Hampshire-Maine Leadership Education In Neurodevelopmental And Related Disabilities (Nh-Me Lend) Program Trainees

Policy Analysis

Medicaid funds vital services for children and youth with special health care needs and disabilities (CYSHCN). Proposed changes to the structure of Medicaid would significantly reduce federal funding for this important program. The most concerning are the proposed structural changes including per capita caps and block grants, as well as threats to Early and Periodic Screening, Diagnostic and Treatment (EPSDT) and Medicaid Waiver services. Restructuring would have devastating effects on benefits for low-income children and individuals with disabilities, and their families, putting this very vulnerable population at additional risk.

Nonresidential Fathers Parenting Their Children Residing In Shelters: A Phenomenological Study, Karen Denise Hudson

Walden Dissertations and Doctoral Studies

This phenomenological qualitative study explored the parenting role of nonresidential fathers of children living in shelters. Special attention was paid to the perceived contributions of these fathers to the overall health and general well-being of their children residing in shelters. Often separations of nonresidential fathers from their children in shelters decreased their contributions to their children's health and well-being. Increased knowledge of these parental roles and contributions can enhance programs and policies to support these fathers in improving the health and well-being of their children. In-depth semistructured interviews were conducted with 6 demographically diverse nonresidential fathers living in Philadelphia. The …

Telehealth And Ehealth In Nurse Practitioner Training: Current Perspectives, Carolyn M. Rutledge, Karen Kott, Rebecca Poston, Christianne Fowler, Tina S. Haney

Nursing Faculty Publications

Telehealth is becoming a vital process for providing access to cost-effective quality care to patients at a distance. As such, it is important for nurse practitioners, often the primary providers for rural and disadvantaged populations, to develop the knowledge, skills, and attitudes needed to utilize telehealth technologies in practice. In reviewing the literature, very little information was found on programs that addressed nurse practitioner training in telehealth. This article provides an overview of both the topics and the techniques that have been utilized for training nurse practitioners and nurse practitioner students in the delivery of care utilizing telehealth. Specifically, this …

Decisions, Decisions: Factors That Influence A Patient's Medical Tourism Choices, Louis K. Falk, Thomas J. Prinsen

Faculty Work Comprehensive List

In the digital age, the amount of information and sources concerning Medical Tourism is overwhelming. Knowledge is power in an era of healthcare uncertainty. As health care options have grown in global proportions, it has become more difficult for potential patients to locate the material necessary to make informed decisions or to even know which factors to consider during their information search. Individual financial circumstances vary greatly. This paper suggests how medical tourism makes financial sense for many patients and payers. Proximity and culture play roles in that medical tourists may prefer locations that are not too far from home. …

Decisions, Decisions: Factors That Influence A Patient's Medical Tourism Choices, Louis K. Falk, Thomas J. Prinsen

Communication Faculty Publications and Presentations

In the digital age, the amount of information and sources concerning Medical Tourism is overwhelming. Knowledge is power in an era of healthcare uncertainty. As health care options have grown in global proportions, it has become more difficult for potential patients to locate the material necessary to make informed decisions or to even know which factors to consider during their information search. Individual financial circumstances vary greatly. This paper suggests how medical tourism makes financial sense for many patients and payers. Proximity and culture play roles in that medical tourists may prefer locations that are not too far from home. …