Medicine and Health Sciences Commons^™

Zika Virus Prevention Behaviors And Knowledge Among Male Partners Of Pregnant People And Lack Of Condom Use As A Prevention Behavior From The Zika En Embarazadas Y Niños (Zen) Prospective Cohort Study, Colombia, Christina L Sancken, Ayzsa Tannis, Sandra A Amouzou, Veronica Burkel, Jeffrey M Carlson, Suzanne Newton, Suzanne M Gilboa, Maritza Gonzalez, Diana Valencia, Van T Tong, Martha Ospina

Journal Articles

Objective: Zika virus (ZIKV) infection in pregnancy can cause brain and eye abnormalities and neurodevelopmental sequelae. In the absence of medical countermeasures, behavioral interventions were recommended to prevent mosquito bites and sexual transmission of ZIKV. This report uses data from the Zika en Embarazadas y Niños (ZEN) prospective cohort study in Colombia to describe the knowledge, attitudes, and behaviors (KAB) related to ZIKV prevention in male partners compared to those of their pregnant partners at study enrollment during February 2017-2018.

Results: Most male partners reported wearing protective clothing such as long pants (97.6%) and long sleeves (72.8%), as well as …

The Effect Of Calcium Channel Blockers On Digital Ulcers In Systemic Sclerosis: Data From A Prospective Cohort Study, Laura Ross, Dylan Hansen, Nancy Maltez, Kathleen Morrisroe, Kimti Kumar, Jennifer Walker, Wendy Stevens, Joanne Sahhar, Gene-Siew Ngian, Lauren Host, Mandana Nikpour, Susanna Proudman

Journal Articles

Digital ulcers (DU) are a common, severe vascular manifestation of systemic sclerosis (SSc) with few effective treatment options. Using data from the Australian Scleroderma Cohort Study (ASCS), we sought to evaluate the effect of calcium channel blockers (CCB) on the treatment and prevention of DU.Using data from 1953 participants, with a median of 4.34 years of follow-up, we used generalised estimating equations to evaluate the clinical characteristics associated with CCB use and ascertain the risk factors for the presence of DU at subsequent study visits. A time-dependent Cox-proportional hazard model was applied to evaluate the risk of future occurrence of …

Multifactorial Exercise Intervention Decreases Falls Risk In High-Risk And Low-Risk Older Adults, Amanda Estep, Steven Morrison, Shane V. Caswell, Jatin P. Ambegaonkar, João R. Vaz, Nelson Cortes

Rehabilitation Sciences Faculty Publications

Background: Each year, 1 in 4 people over the age of 65 years of age will experience a fall. It is important to identify and address modifiable risk factors that are associated with falls in adults at high and low risk for falls.

Hypothesis: Falls risk improves in both high-risk and low-risk participants with the implementation of Stay Active and Independent for Life (SAIL).

Study Design: Cohort study.

Level of Evidence: Level 3.

Methods: Seventy-eight older adults (age, 70.9 ± 5.1 years) were included in this study and categorized into high risk and low risk for falling based on the …

Prevention Of Surgical Site Infection: A Ten-Step Approach, Saad Tarabichi, Javad Parvizi

Rothman Institute Faculty Papers

Surgical site infection (SSI) is a common cause of morbidity and mortality in patients undergoing surgery. Similarly, periprosthetic joint infection (PJI), is a major cause of failure after total joint arthroplasty (TJA). As the annual volume of TJA procedures is projected to rise, so will the rate of subsequent SSI and PJI. Currently, prevention has been identified as the single most important strategy for combating SSI/PJI. Hence, the present article will serve as a summary of an evidence-based ten-step approach for SSI/PJI prevention that may help orthopedic surgeons with their infection prevention strategies.

Exploring Modern Trends And Prevention Strategies For Childhood Obesity: A Comprehensive Literature Review, Anya E. Bogen

Honors Theses

This literature review seeks to provide an overview of the current research on childhood obesity. The study examines the prevalence and causes of childhood obesity, including genetic, environmental, and behavioral factors. The review also discusses the health consequences associated with childhood obesity, such as the increased risk for chronic diseases and psychological and social problems. Additionally, the review explores the effectiveness of interventions designed to prevent childhood obesity, including individual lifestyle modifications, education from health practitioners and school programs, and global, national, and state programs to promote wellness. The literature review concludes that childhood obesity is a complex and multifactorial …

Identification And Management Of Atherosclerotic Cardiovascular Disease Risk In South Asian Populations In The U.S., Anandita Agarwala, Priyanka Satish, Mahmoud Al Rifai, Anurag Mehta, Miguel Cainzos-Achirica, Nilay S. Shah, Alka M. Kanaya, Garima V. Sharma, Dave L. Dixon, Salim S. Virani

Office of the Provost

South Asians (SAs, individuals with ancestry from Bangladesh, Bhutan, India, Maldives, Nepal, Pakistan, and Sri Lanka) are among the fastest growing ethnic subgroups in the United States. SAs typically experience a high prevalence of diabetes, abdominal obesity, and hypertension, among other cardiovascular disease risk factors, which are often under recognized and undermanaged. The excess coronary heart disease risk in this growing population must be critically assessed and managed with culturally appropriate preventive services. Accordingly, this scientific document prepared by a multidisciplinary group of clinicians and investigators in cardiology, internal medicine, pharmacy, and SA-centric researchers describes key characteristics of traditional and …

Glucocentric Drugs In Cardiovascular Disease Protection And Heart Failure, Khawaja M. Talha, Gregg C. Fonarow, Salim S. Virani, Javed Butler

Office of the Provost

Evidence for cardiovascular outcomes with older-generation antihyperglycemic drugs in the management of type 2 diabetes is based on aggregated data from prior randomized controlled trials and observational studies that were not focused on prespecified cardiovascular end points. Newer antihyperglycemic medications have undergone a rigorous evaluation of cardiovascular outcomes through randomized controlled trials since the US Food and Drug Administration imposed a mandatory requirement for all glucose-lowering drugs in 2008. The three classes of drugs that have been most extensively studied are dipeptidyl peptidase 4 inhibitors, glucagon-like peptide 1 receptor agonists, and sodium-glucose cotransporter-2 (SGLT2) inhibitors, the latter two reporting significant …

Drug-Resistant Bacterial Infections: We Need Urgent Action And Investment That Focus On The Weakest Link, Christiane Dolecek, Sadia Shakoor, Buddha Basnyat, Tochi Okwor, Benn Sartorius

Department of Pathology and Laboratory Medicine

Despite high mortality and morbidity, drug-resistant bacterial infections remain the forgotten pandemic. We argue for strengthening of diagnostics, WASH (water, sanitation, and hygiene) and infection prevention and control to reduce drug-resistant infections, as an integral part of sustainable high-quality health services, particularly in low- and middle-income countries.

Oral N-Acetyl Cysteine Versus Rectal Indomethacin For Prevention Of Post Ercp Pancreatitis: A Multicenter Multinational Randomized Controlled Trial, Pezhman Alavinejad, Nguyen-Phuong Nhu Tran, Omid Eslami, Omar El Shaarawy, Omar El Shaarawy, Ahmad Hormati, Seied Saeed Seiedian, Abazar Parsi, Mohammed Hussien Ahmed, Amna Subhan Butt

Section of Gastroenterology

Background: This multicenter multinational RCT designed to compare the efficacy of suppository indomethacin and NAC for prevention of PEP.
Methods: During a 6-month period, all of the ERCP cases in seven referral centers were randomly assigned to receive either 1200 mg oral NAC, indomethacin suppository 100 mg, 1200 mg oral NAC plus indomethacin suppository 100 mg or placebo 2 hours before ERCP. The primary outcomes were the rate and severity of any PEP.
Results: A total of 432 patients included (41.4% male). They were originally citizens of 6 countries (60.87% Caucasian). They were randomly allocated to receive either NAC (group …

The Importance Of An Early Onset Of Migraine Preventive Disease Control: A Roundtable Discussion, Christopher Gottschalk, Anirban Basu, Andrew Blumenfeld, Bradley Torphy, Michael J. Marmura, Jelena M. Pavlovic, Paula K. Dumas, Nim Lalvani, Dawn C. Buse

Department of Jefferson Headache Center papers and presentations

Background: Newly approved migraine preventive therapies have allowed for rapid control of migraine activity, offering potential to minimize the burden of migraine. This report summarizes a roundtable discussion convened to analyze evidence for early onset of prevention, ascertain its clinical relevance, and provide guidance for healthcare professionals in crafting goals and treatment expectations for patients with migraine initiating preventive therapy.

Methods: A virtual roundtable meeting of migraine clinicians, researchers, and patient advocates convened in October 2020. Participants reviewed and discussed data summarizing patient and healthcare professional perceptions of migraine prevention and evidence from the peer-reviewed and gray literature to develop …

Identifying Differences: A Key Step In Precision Cardiovascular Disease Prevention, Mahmoud Al Rifai, Salim S. Virani, Vijay Nambi

Office of the Provost

No abstract provided.

Potential Impact Of 2017 American College Of Cardiology/American Heart Association Hypertension Guideline On Contemporary Practice: A Cross-Sectional Analysis From Ncdr Pinnacle Registry, Aliza Hussain, Salim S. Virani, Luke Zheng, Ty J. Gluckman, William B. Borden, Frederick A. Masoudi, Thomas M. Maddox

Office of the Provost

Background Clinical implications of change in the 2017 American College of Cardiology (ACC)/American Heart Association (AHA) guideline on the diagnosis and management of hypertension, compared with recommendations by 2014 expert panel and Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC7), are not known. Methods and Results Using data from the NCDR (National Cardiovascular Data Registry) PINNACLE (Practice Innovation and Clinical Excellence) Registry (January 2013-Decemver 2016), we compared the proportion and clinical characteristics of patients seen in cardiology practices diagnosed with hypertension, recommended antihypertensive treatment, and achieving blood pressure (BP) goals …

An Opportunity For Primary Prevention Research In Psychotic Disorders, Elliot S. Gershon, S. Hong Lee, Xuan Zhou, John A. Sweeney, Carol Tamminga, Godfrey A. Pearlson, Brett A. Clementz, Matcheri S. Keshavan, Ney Alliey-Rodriguez, Matthew Hudgens-Haney

School of Medicine Publications and Presentations

An opportunity has opened for research into primary prevention of psychotic disorders, based on progress in endophenotypes, genetics, and genomics. Primary prevention requires reliable prediction of susceptibility before any symptoms are present. We studied a battery of measures where published data supports abnormalities of these measurements prior to appearance of initial psychosis symptoms. These neurobiological and behavioral measurements included cognition, eye movement tracking, Event Related Potentials, and polygenic risk scores. They generated an acceptably precise separation of healthy controls from outpatients with a psychotic disorder.

Methods

The Bipolar and Schizophrenia Network on Intermediate Phenotypes (B-SNIP) measured this battery …

Suicide Prevention In Bangladesh: The Role Of Family, S M Yasir Arafat, Tamkeen Saleem, Todd M. Edwards, Syeda Ayat-E-Zainab Ali, Murad M. Khan

Department of Psychiatry

Background: Suicide is a public health problem that gets little attention in Bangladesh especially in prevention aspects. Recent studies revealed that a significant portion of risk factors is closely related to family events. However, potential prevention strategies considering the family structure and involving family dynamics of Bangladesh have not been discussed.
Objectives: We aim to highlight areas of family vulnerability and resilience when the threat of suicide is present, as well as the potential roles of family in suicide prevention in Bangladesh.
Methods: We conducted a thorough narrative and focused literature search and synthesized evidence based on available articles discussing …

Viral Hepatitis - The Road Traveled And The Journey Remaining, Ghulam Fareed Malik, Noval Zakaria, Muhammad Ibrahim Majeed, Faisal Wasim Ismail

Section of Gastroenterology

Hepatitis is defined as inflammation of the liver and is commonly due to infection with The hepatotropic viruses - hepatitis A, B, C, D and E. Hepatitis carries one of the highest disease burdens globally and has caused significant morbidity and mortality among different patient populations. Clinical presentation varies from asymptomatic or acute flu-like illness to acute liver failure or chronic liver disease, characterized by jaundice, hepatomegaly and ascites among many other signs. Eventually, this can lead to fibrosis (cirrhosis) of the liver parenchyma and carries a risk of development into hepatocellular carcinoma. Hepatitis B and C are most notorious …

Optimizing Prevention And Community-Based Management Of Severe Malnutrition In Children, Zulfiqar Ahmed Bhutta

Department of Paediatrics and Child Health

Zulfiqar A. Bhutta discusses prevention and treatment strategies for optimization of community-based management of severe acute malnutrition in children

Characterisation Of Lung Function Trajectories And Associated Early-Life Predictors In An Australian Birth Cohort Study, Francesca Sanna, Francesca Locatelli, Peter D. Sly, Elisha White, Jane Heyworth, Graham L. Hall, Rachel E. Foong, David Blake

Research outputs 2022 to 2026

Background There is growing evidence that lung function in early-life predicts later lung function. Adverse events over the lifespan might influence an individual’s lung function trajectory, resulting in poor respiratory health. The aim of this study is to identify early-life risk factors and their impact on lung function trajectories to prevent long-term lung impairments. Methods Our study included participants from the Raine Study, a prospective pregnancy cohort, with at least two spirometry measurements. Lung function trajectories from the 6-to 22-year follow-ups were characterised using finite mixture modelling. Multinomial logistic regression analyses were used to evaluate the association between early-life predictors …

The Effectiveness Of The More Than Sad School Based Gatekeeper Training Program, Guy Diamond, Lawrence Ogunkua, Matthew B. Wintersteen, Tita Atte, Perri Rosen, Robert Gallop

Department of Psychiatry and Human Behavior Faculty Papers

Schools have the unique opportunity to identify and refer youth at risk for suicide. School-based gatekeeper training programs aim to improve staff’s ability to talk to students about mental health concerns and refer them for an assessment. Unfortunately, progress in evaluating the available programs has been limited. In fact, the popular and widely used More Than Sad program has received no rigorous evaluation to date. This study sets out to evaluate the effectiveness of the More Than Sad program in a quasi-experimental, wait-list control design with a large number of school personnel, across geographically diverse communities. Fourteen school districts with …

Hypertension Guidelines And Coronary Artery Calcification Among South Asians: Results From Masala And Mesa, Jaideep Patel, Anurag Mehta, Mahmoud Al Rifai, Michael J. Blaha, Khurram Nasir, John W. Mcevoy, Ambarish Pandey, Alka M. Kanaya, Namratha R. Kandula, Salim S. Virani

Office of the Provost

Untreated hypertension may contribute to increased atherosclerotic cardiovascular disease (ASCVD) risk in South Asians (SA). We assessed HTN prevalence among untreated adults free of baseline ASCVD from the MASALA & MESA studies. The proportion of participants who received discordant recommendations regarding antihypertensive pharmacotherapy use by the 2017-ACC/AHA and JNC7 Guidelines across CAC score categories in each race/ethnic group was calculated. Compared with untreated MESA participants (n = 3896), untreated SA (n = 445) were younger (55±8 versus 59±10 years), had higher DBP (73±10 versus 70±10 mmHg), total cholesterol (199±34 versus 196±34 mg/dL), statin use (16% versus 9%) and …

Uptake And Outcomes Of A Novel Community-Based Hiv Post-Exposure Prophylaxis (Pep) Programme In Rural Kenya And Uganda, James Ayieko, Maya L. Petersen, Jane Kabami, Florence Mwangwa, Fred Opel, Marilyn Nyabuti, Edwin D. Charlebois, James Peng, Catherine A. Koss, Laura B. Balzer

Biostatistics and Epidemiology Faculty Publications Series

Introduction Antiretroviral-based HIV prevention, including pre-exposure prophylaxis (PrEP), is expanding in generalized epidemic settings, but additional prevention options are needed for individuals with periodic, high-risk sexual exposures. Non-occupational post-exposure prophylaxis (PEP) is recommended in global guidelines. However, in Africa, awareness of and access to PEP for sexual exposures are limited. We assessed feasibility, acceptability, uptake and adherence in a pilot study of a patient-centred PEP programme with options for facility- or community-based service delivery. Methods After population-level HIV testing with universal access to PrEP for persons at elevated HIV risk (SEARCH Trial:NCT01864603), we conducted a pilot PEP study in five …

Implementing Nudges For Suicide Prevention In Real-World Environments: Project Inspire Study Protocol, Molly Davis, Courtney Benjamin Wolk, Shari Jager-Hyman, Rinad S Beidas, Jami F Young, Jennifer A Mautone, Alison M Buttenheim, David S Mandell, Kevin G Volpp, Katherine Wislocki, Anne Futterer, Darby Marx, E L Dieckmeyer, Emily M Becker-Haimes

College of Life Sciences Faculty Papers

Background: Suicide is a global health issue. There are a number of evidence-based practices for suicide screening, assessment, and intervention that are not routinely deployed in usual care settings. The goal of this study is to develop and test implementation strategies to facilitate evidence-based suicide screening, assessment, and intervention in two settings where individuals at risk for suicide are especially likely to present: primary care and specialty mental health care. We will leverage methods from behavioral economics, which involves understanding the many factors that influence human decision making, to inform strategy development.

Methods: We will identify key mechanisms that limit …

You Don’T Have To Get Diabetes, Mitch Kaminski, Md, Mba, Nevaneva White, Dnp, Crnp, Cdces

Department of Family & Community Medicine Presentations and Grand Rounds

The goal is to streamline the steps required to make referrals to and enroll in the National Diabeties Prevention Program (DPP).

Risk Factors Of Recurrent Falls Among Older Adults Admitted To The Trauma Surgery Department., William Curran-Groome, Gary Klein, Stanton Miller, Azor Hui, Jordan S Wilson, Chol Kuoiloi, Venkata Masarapu, Andre Alabd, Toni Mascaro, Gideon Logan, Jonathan Lubeck

Department of Surgery Faculty Papers

Falls affect more than 29 million American adults ages ≥65 years annually. Many older adults experience recurrent falls requiring medical attention. These recurrent falls may be prevented through screening and intervention. In 2014 to 2015, records for 199 older adult patients admitted from a major urban teaching hospital’s emergency department were queried. Open-ended variables from clinicians’ notes were coded to supplement existing closed-ended variables. Of the 199 patients, 52 (26.1%) experienced one or more recurrent falls within 365 days after their initial fall. Half (50.0%) of all recurrent falls occurred within the first 90 days following discharge. A large proportion …

Vaccines, Children, And The Public Health Trust, Christopher Chambers, Md

Department of Family & Community Medicine Presentations and Grand Rounds

Objectives

1. Review the impact of immunizations on the public health over the past 50 years.
2. Childhood Vaccines Now
3. Describe the challenges associated with trying to eliminate “immunizable” diseases. Examples: Invasive Pneumoccal Disease, Neisseria meningitis
4. The Future

Current Strategies In Prevention Of Postoperative Infections In Spine Surgery., Kivanc Atesok, Efstathios Papavassiliou, Michael J Heffernan, Danny Tunmire, Irina Sitnikov, Nobuhiro Tanaka, Sakthivel Rajaram, Jason Pittman, Ziya L Gokaslan, Alexander Vaccaro, Steven Theiss

Rothman Institute Faculty Papers

Study Design: Narrative review.

Objectives: Postoperative surgical site infections (SSIs) are among the most common acute complications in spine surgery and have a devastating impact on outcomes. They can lead to increased morbidity and mortality as well as greater economic burden. Hence, preventive strategies to reduce the rate of SSIs after spine surgery have become vitally important. The purpose of this article was to summarize and critically analyze the available evidence related to current strategies in the prevention of SSIs after spine surgery.

Methods: A literature search utilizing Medline database was performed. Relevant studies from all the evidence levels have …

Mentoring Multi-College Bystander Efficacy Evaluation – An Approach To Growing The Next Generation Of Gender-Based Interpersonal Violence Intervention And Prevention (Vip) Researchers, Ann L. Coker, Danielle Davidov, Heather M. Bush, Emily R. Clear

Obstetrics and Gynecology Faculty Publications

The Centers for Disease Control and Prevention provided funding (U01 CE002668) to evaluate bystander program efficacy to reduce gender-based violence on college campuses (Aim 1) and to create a mentoring network (Aim 2) for young campus-based researchers interested in violence intervention or prevention (VIP). While an evaluation of this mentoring program is ongoing, our purpose here was to document the strategies used to create, implement, and begin evaluation of this national multi-college mentoring network. As each public college was recruited into this evaluation named multi-college Bystander Efficacy Evaluation (mcBEE), each college was invited to nominate a researcher interested in receiving …

Prophylaxis Of Food Allergen Sensitivity, Dustin Gottfeld

Physician Assistant Studies | Student Articles

Food allergies can have a severe and drastic effect on a person’s lifestyle, while prevention of allergic disease can help to ensure others do not have to live with this burden. There are a variety of differing hypotheses that offer explanations for the early development of food allergies, particularly peanut allergies. Two of the foremost hypotheses are the Hygiene Hypothesis and the Dual-Allergen Hypothesis. The Hygiene Hypothesis claims that the diversity of a child’s microbiota creates a beneficial balance of microorganisms which can help prevent the development of allergic disease. Alternatively, the Dual-Allergen Hypothesis states that early environmental exposure to …

Guide To Mask Wearing 101, Laiquannah Hason, Jeremiah Kinsey, Kevin O'Connor

Foundations of Public Health - Infographics

No abstract provided.

The Use Of Probiotics To Prevent Ventilator-Associated Pneumonia In Adults, Michael Roper, Paige Douthett

Physician Assistant Capstones, 2016 to 2019

Objective: To assess the efficacy and safety of preventing the acquisition of ventilator- associated pneumonia with the use of probiotic supplementation, as compared to a placebo, among hospitalized adult men and women receiving more than 24 hours of mechanical ventilation. Design: Systematic Literature Review. Methods: Systematic searches were conducted through PubMed and Scopus using the search terms “ventilator”, “probiotics”, and “prevention”. Records were excluded from the analysis if they were published before 2015, full text was not available, studies other than randomized control trial or cohort studies, and if the study population was less than 18 years old. Results: Of …

Feasibility Pilot Outcomes Of A Mammography Decision Support And Navigation Intervention For Women With Serious Mental Illness Living In Supportive Housing Settings., Lara Weinstein, Marianna Lanoue, Katelyn Hurley, Colleen Payton, Randa Sifri, Ronald Myers

Department of Family & Community Medicine Faculty Papers

Objective: People with serious mental illness (SMI) experience significant disparities in morbidity and mortality from preventable and treatable medical conditions. Women with SMI have low mammography screening rates. SMI, poverty, and poor access to care can have a significant effect on a woman’s opportunity to learn about and discuss breast cancer screening with health care providers. This study examines the feasibility pilot outcomes of mammography decision support and patient navigation intervention (DSNI) for women with SMI living in supportive housing settings. The primary research question was: Does the DSNI increase knowledge, promote favorable attitudes, and decrease decisional conflict relating to …