Medicine and Health Sciences Commons^™

Health And Healthcare: Designing For The Social Determinants Of Health And Blue Zones In North Nashville, Rebecca Tonguis, Honor Thomas, Olivia Hobbs

Belmont University Research Symposium (BURS)

Owned by North Nashville’s First Community Church, a now empty site in the Osage-North Fisk neighborhood of North Nashville has been identified as a potential site for a new location of The Store, in addition to a community-centric architectural development based on the social determinants of health and informed by the principles behind Blue Zones, the locations with the highest lifespans in the world. Opened by Brad Paisley and Kimberly Williams-Paisley, The Store is a free grocery store that “allow[s] people to shop for their basic needs in a way that protects dignity and fosters hope”, for which North Nashville …

Reducing Food Scarcity: The Benefits Of Urban Farming, S.A. Claudell, Emilio Mejia

Journal of Nonprofit Innovation

Urban farming can enhance the lives of communities and help reduce food scarcity. This paper presents a conceptual prototype of an efficient urban farming community that can be scaled for a single apartment building or an entire community across all global geoeconomics regions, including densely populated cities and rural, developing towns and communities. When deployed in coordination with smart crop choices, local farm support, and efficient transportation then the result isn’t just sustainability, but also increasing fresh produce accessibility, optimizing nutritional value, eliminating the use of ‘forever chemicals’, reducing transportation costs, and fostering global environmental benefits.

Imagine Doris, who is …

Drug Ideologies Of The United States, Macy Montgomery

Helm's School of Government Conference - American Revival: Citizenship & Virtue

The United States has been increasingly creating lenient drug policies. Seventeen states and Washington, the District of Columbia, legalized marijuana, and Oregon decriminalized certain drugs, including methamphetamine, heroin, and cocaine. The medical community has proven that drugs, including marijuana, have myriad adverse health side effects. This leads to two questions: Why does the United States government continue to create lenient drug policies, and what reasons do citizens give for legalizing drugs when the medical community has proven them harmful? The paper hypothesizes that the disadvantages of drug legalization outweigh its benefits because of the numerous harms it causes, such as …

Open Data Indicates That Collegedale Could Be A Bluezone, Tristan Deschamps, Alva Johnson

Campus Research Day

A blue zone is an indicator of exceptional health in a community. Adventists have a blue zone community in Loma Linda, but there has been little research into other Adventist populated areas that could be blue zones. Therefore, our goal is to show that open data suggests that a blue zone may exist near Southern Adventist University, specifically in Collegedale. This data has been gathered from different federal sources, including, the CDC, the US Census Bureau, the Tennessee Department of Health, official state records, and federal documents that are available to the public.

The Effects Of Demographics And Risk Factors On The Morphological Characteristics Of Human Femoropopliteal Arteries, Sayed Ahmadreza Razian, Majid Jadidi, Alexey Kamenskiy

UNO Student Research and Creative Activity Fair

Background: Disease of the lower extremity arteries (Peripheral Arterial Disease, PAD) is associated with high morbidity and mortality. During disease development, the arteries adapt by changing their diameter, wall thickness, and residual deformations, but the effects of demographics and risk factors on this process are not clear.

Methods: Superficial femoral arteries from 736 subjects (505 male, 231 female, 12 to 99 years old, average age 51±17.8 years) and the associated demographic and risk factor variables were used to construct machine learning (ML) regression models that predicted morphological characteristics (diameter, wall thickness, and longitudinal opening angle resulting from the …

Quality And Transparency, Christopher J. Smiley Dds

The Journal of the Michigan Dental Association

In a recent JDR Clinical & Translational Research report, the American Dental Association's clinical practice guidelines (CPGs) were determined to offer high-quality guidance for the dental profession. The study employed the AGREE II tool to validate the ADA's guidelines’ methodological rigor and transparency, ensuring their quality. This external review is promising for the profession, as it indicates that the ADA has developed reliable CPGs that support advocacy and implementation. However, the article raises questions about consumer-targeted quality scores for dentist providers, such as DentaQual by P&R Dental Strategies LLC. It suggests that for such scoring systems to be credible, they …

Intervention Time Series Analysis Of Organ Donor Transplants In The Us, Supraja Malladi

Biology and Medicine Through Mathematics Conference

No abstract provided.

Data-Driven Statin Initiation Evaluation And Optimization For Prediabetes Population, Muhenned A. Abdulsahib

Graduate Theses and Dissertations

This dissertation develops quantitative models to support medical decision making of statininitiation considering the uncertainty in disease progression for prediabetes patients. A mathematical model is built to help medical decision-makers take action of statin initiation under uncertainty in future prediabetes progressions. The association between cholesterol drug use, such as statin, and elevating glucose level attracted considerable amounts of attention in the literature. Statin effects on glucose vary with respect to different levels of glucose. The first chapter of this dissertation introduces the problem and an overview of the tools that will be used to solve it. In the second chapter …

Anti-Vaxxers: Parents Fighting Science, Katie West

Symposium of Student Scholars

Immunizing children helps protect the health of our community, especially those people who cannot be immunized. Yet, since 1996 after a study was released that linked autism to vaccinations, there has been a trend of parents refusing to vaccinate their children. What are the demographics of the parents who believe their children are better off without vaccines? By knowing where these parents live and what decisions they make for their children’s education, counties and medical professionals can provide education and address their concerns.

My research involves data on 116,141 kindergarten classes from 2000-2015 in California. The two vaccine exemption options …

Medical Marijuana And Opioids (Memo) Study: Protocol Of A Longitudinal Cohort Study To Examine If Medical Cannabis Reduces Opioid Use Among Adults With Chronic Pain, Chinazo O. Cunningham, Joanna L. Starrels, Chenshu Zhang, Marcus A. Bachhuber, Nancy L. Sohler, Frances R. Levin, Haruka Minami, Deepika E. Slawek, Julia H. Arnsten

School of Medicine Faculty Publications

Introduction In the USA, opioid analgesic use and overdoses have increased dramatically. One rapidly expanding strategy to manage chronic pain in the context of this epidemic is medical cannabis. Cannabis has analgesic effects, but it also has potential adverse effects. Further, its impact on opioid analgesic use is not well studied. Managing pain in people living with HIV is particularly challenging, given the high prevalence of opioid analgesic and cannabis use. This study's overarching goal is to understand how medical cannabis use affects opioid analgesic use, with attention to Δ9-tetrahydrocannabinol and cannabidiol content, HIV outcomes and adverse events. Methods and …

Use Of Advanced Statistical Techniques To Predict All-Cause Mortality In The Systolic Blood Pressure Intervention Trial, William Kostis, Javier Cabrera, Chun Pang Lin, John Kostis, Jennifer Wellings, Stavros Zinonos, Jeanne Dobrzynski, Daniel Blickstein

Department of Medicine Faculty Papers

Background: The Systolic Blood Pressure Intervention Trial (SPRINT) was conducted in patients with hypertension and additional risk for cardiovascular disease who were randomized to the intensive blood pressure group targeting systolic blood pressure (SBP) less than 120 mm Hg and to the standard group where the target was less than 140 mm Hg. Analyses were done in the matched group of participants with the same gender, same age (±2 years) and same SBP (±3 mm Hg) at three months of treatment regardless of initial randomization to intensive or standard group (shaded area in Figure 1). Methods and results: During 3.26 …

The Experiences Of Ncaa Student-Athletes With An Eating Disorder Or Disordered Eating, Rachel E. Taylor

Electronic Theses and Dissertations

The purpose of this study was to explore the experiences of student-athletes who had an eating disorder or disordered eating (ED/DE) while competing for the National Collegiate Athletic Association (NCAA). Integrating criticism and connoisseurship and critical evocative portraiture, four post-collegiate women who participated in cross country and track, who were either clinically diagnosed with an ED/DE or who self-diagnosed, participated in two interviews to describe their experiences with and the impact of ED/DE on their athletic pursuits, academic pursuits, as well as their relationships with coaches, teammates, and family. The analysis of these interviews showed the complexity of this topic. …

Three Essays On Health Economics And Policy Evaluation, Shishir Shakya

Graduate Theses, Dissertations, and Problem Reports

This dissertation consists of three essays on the U.S. Health care policy. Each paragraph below refers to the three abstracts for the three chapters in this dissertation, respectively. I provide quantitative evidence on how much Prescription Drug Monitoring Programs (PDMPs) affects the retail opioid prescribing behaviors. Using the American Community Survey (ACS), I retrieve county-level high dimensional panel data set from 2010 to 2017. I employ three separate identification strategies: difference-in-difference, double selection post-LASSO, and spatial difference-in-difference. I compare how the retail opioid prescribing behaviors of counties, that are mandatory for prescribers to check the PDMP before prescribing controlled substances …

Sickle Cell Disease Complications: Prevalence And Resource Utilization, Nirmish Shah, Menaka Bhor, Lin Xi, Jincy Paulose, Huseyin Yuce

Publications and Research

Objectives: This study evaluated the prevalence rate of vaso-occlusive crisis (VOC) episodes, rates of uncomplicated and complicated VOC episodes, and the primary reasons for emergency room (ER) visits and inpatient admissions for sickle cell disease (SCD) patients.

Methods: The Medicaid Analytic extracts database was used to identify adult SCD patients using claims from 01JUL2009-31DEC2012. The date of the first observed SCD claim was designated as the index date. Patients were required to have continuous medical and pharmacy benefits for .6 months baseline and .12 months follow-up period. Patient demographics, baseline clinical characteristics, the rate of uncomplicated and complicated VOC (VOC …

Comparative Clinical Outcomes Between Direct Oral Anticoagulants And Warfarin Among Elderly Patients With Non-Valvular Atrial Fibrillation In The Cms Medicare Population, Alpesh Amin, Oluwaseyi Dina, Allison Keshishian, Amol Dhamane, Anagha Nadkarni, Eric Carda, Cristina Russ, Lisa Rosenblatt, Jack Mardekian, Huseyin Yuce, Christine L. Baker

Publications and Research

Atrial fibrillation (AF) prevalence increases with age; > 80% of US adults with AF are aged ≥ 65 years. Compare the risk of stroke/systemic embolism (SE), major bleeding (MB), net clinical outcome (NCO), and major adverse cardiac events (MACE) among elderly non-valvular AF (NVAF) Medicare patients prescribed direct oral anticoagulants (DOACs) vs warfarin. NVAF patients aged ≥ 65 years who initiated DOACs (apixaban, dabigatran, and rivaroxaban) or warfarin were selected from 01JAN2013-31DEC2015 in CMS Medicare data. Propensity score matching was used to balance DOAC and warfarin cohorts. Cox proportional hazards models estimated the risk of stroke/SE, MB, NCO, and MACE. 37,525 …

Real-Time Dengue Forecasting In Thailand: A Comparison Of Penalized Regression Approaches Using Internet Search Data, Caroline Kusiak

Masters Theses

Dengue fever affects over 390 million people annually worldwide and is of particu- lar concern in Southeast Asia where it is one of the leading causes of hospitalization. Modeling trends in dengue occurrence can provide valuable information to Public Health officials, however many challenges arise depending on the data available. In Thailand, reporting of dengue cases is often delayed by more than 6 weeks, and a small fraction of cases may not be reported until over 11 months after they occurred. This study shows that incorporating data on Google Search trends can improve dis- ease predictions in settings with severely …

The Relationship Between Stryd Power And Running Economy In Well-Trained Distance Runners 2018, Casey Austin

Master's Theses

A novel running wearable called the Stryd Summit footpod attaches to a runner’s right or left shoe and measures running power output. The developers of the product purport that the footpod’s power and form power measures may correlate with metabolic data gathered in a lab. PURPOSE: Explore the relationship between power output and running economy at threshold pace. METHODS: Seventeen well-trained distance runners, 9 males and 8 females, completed a running protocol at threshold pace. Participants ran two discontinuous four-minute stages: one with their self-selected cadence (SS), and one with cadence lowered by 10% (LC). Metabolic data, power, and form …

Analysis Of Episodes Of Care In Medicare Beneficiaries Newly Diagnosed With Alzheimer’S Disease, Rezaul K. Khandker, Christopher Black, Lin Xie, M. Furaha Kariburyo, Baishali M. Ambegaonkar, Onur Baser, Huseyin Yuce, Howard Fillit

Publications and Research

OBJECTIVES: To study transitions between healthcare settings and quantify the cost burdens associated with different combinations of transitions during a 6-month period before initial Alzheimer’s disease (AD) diagnosis so as to investigate how using an episode-of-care approach to payment for specific disease states might apply in AD.

DESIGN: A retrospective observational cohort study.

SETTING: United States.

PARTICIPANTS: A random sample of 8,995 individuals aged 65 to 100 with a diagnosis of AD (International Classification of Diseases, Ninth Revision, Clinical Modification code 331.0) were identified from the Medicare database between January 1, 2011, and June 30, 2014. This analysis identified individuals …

Burden Of Rheumatoid Arthritis Among Us Medicare Population: Co-Morbidities, Health-Care Resource Utilization And Costs, Chieh-I Chen, Li Wang, Wenhui Wei, Huseyin Yuce, Kristine Phillips

Publications and Research

Objectives. The study aimed to assess the burden of RA among the US Medicare population (aged 65 years) by comparing co-morbidities, health-care resource utilization (HCRU) and costs against matched non-RA Medicare patients.

Methods. Data were obtained from the Medicare fee-for-service claims database from 2010 to 2013. RA Medicare patients were identically matched with Medicare patients without RA (controls) based on demographics. Bivariate analyses were conducted to examine differences between cohorts for comorbidities, HCRU and costs. A generalized linear model was used to test relationships between patient-level characteristics, HCRU and costs.

Results. The study population included 115 867 RA patients and …

Systematic Review And Meta-Analysis: Tuberculosis, Tnfα Inhibitors, And Crohn's Disease, Brent L. Cao

Honors Undergraduate Theses

Inflammation is often a protective reaction against harmful foreign agents. However, in many disease conditions, the mechanisms behind the inflammatory response are poorly understood. Often times, the inflammation causes adverse effects, such as joint pain, abdominal pain, fever, fatigue, and loss of appetite. Thus, many treatments aim to inhibit the inflammatory response in order to control adverse symptoms. Such treatments include TNFα inhibitors. However, a major risk associated with drugs inhibiting tumor necrosis factor alpha (TNFα) is serious infection, including tuberculosis (TB).

Anti-TNFα therapy is used to treat patients with Crohn’s disease, for which the risk of tuberculosis may be …

Long-Term Outcomes After Elective Sterilization Procedures — A Comparative Retrospective Cohort Study Of Medicaid Patients, Rachel Steward, Patricia Carney, Amy Law, Lin Xie, Yuexi Wang, Huseyin Yuce

Publications and Research

Objectives: The objectives were to compare the long-termoutcomes, including hysterectomy, chronic pelvic pain (CPP) and abnormal uterine bleeding (AUB), in women post hysteroscopic sterilization (HS) and laparoscopic tubal ligation (TL) in the Medicaid population.

Study design: This was a retrospective observational cohort analysis using data from the US Medicaid Analytic Extracts Encounters database.Women aged 18 to 49 years with at least one claimfor HS (n=3929) or TL (n=10,875) between July 1, 2009, through December 31, 2010, were included. Main outcome measures were hysterectomy, CPP or AUB in the 24 months poststerilization. Propensity score matching was used to control for patient …

Economic Burden, Mortality, And Institutionalization In Patients Newly Diagnosed With Alzheimer’S Disease, Christopher M. Black, Howard Fillit, Lin Xie, Xiaohan Hu, M. Furaha Kariburyo, Baishali M. Ambegaonkar, Onur Baser, Huseyin Yuce, Rezaul K. Khandker

Publications and Research

Background: Current information is scarce regarding comorbid conditions, treatment, survival, institutionalization, and health care utilization for Alzheimer’s disease (AD) patients.

Objectives: Compare all-cause mortality, rate of institutionalization, and economic burden between treated and untreated newly-diagnosed AD patients.

Methods: Patients aged 65–100 years with ≥1 primary or ≥2 secondary AD diagnoses (ICD-9-CM:331.0] with continuous medical and pharmacy benefits for ≥12 months pre-index and ≥6 months post-index date (first AD diagnosis date) were identified from Medicare fee-for-service claims 01JAN2011–30JUN2014. Patients with AD treatment claims or AD/ADrelated dementia diagnosis during the pre-index period were excluded. Patients were assigned to treated and untreated cohorts …

Mechanistic Mathematical Models: An Underused Platform For Hpv Research, Marc Ryser, Patti Gravitt, Evan R. Myers

Global Health Faculty Publications

Health economic modeling has become an invaluable methodology for the design and evaluation of clinical and public health interventions against the human papillomavirus (HPV) and associated diseases. At the same time, relatively little attention has been paid to a different yet complementary class of models, namely that of mechanistic mathematical models. The primary focus of mechanistic mathematical models is to better understand the intricate biologic mechanisms and dynamics of disease. Inspired by a long and successful history of mechanistic modeling in other biomedical fields, we highlight several areas of HPV research where mechanistic models have the potential to advance the …

Effects Of Ankle Weights On Metabolic Response And Muscle Activity On A Lower Body Positive Pressure Treadmill 2017, Saige Hupman

Master's Theses

Lower body positive pressure (LBPP) treadmills are growing in popularity for rehabilitative use, as the benefits of exercising at partially supported body weight may induce faster recovery. It is unknown if there are certain practices that increase exercise intensity while maintaining positive effects of LBPP. Adding ankle weights when walking or running could increase intensity of rehabilitation programs while maintaining the comfort of supported body weight. PURPOSE: To measure metabolic response (VO2, RER, HR, Caloric expenditure), RPE, and lower limb electromyography (EMG) amplitudes of LBPP treadmill walking and running with and without ankle weights. METHODS: Sixteen participants (Age: 21.94 ± …

Climate Change, Natural Disasters, And Suicide: A Systematic Review, Ans Irfan, Peter Lapuma

GW Research Days 2016 - 2020

Background.
Natural disasters are projected to increase due to climate change. Mental health is not a well-researched area in public health, particularly as it relates to environmental health and in the aftermath of natural disasters. The suicide rate is approximately 13 per 100,000 people in the US, nationally. This already high suicide rate warrants researching this area mental health. Understanding the relation between natural disasters and suicide rates might help alleviate human suffering and potentially save lives in the future, in post-disaster settings. This research will further the knowledge of the association between natural disasters and suicide and provide foundation …

Variables Associated With Overweight/Obesity Among African-American Women With Hypertension And/Or Diabetes, Monica A. Hamilton, Dnp, Rn, Acns-Bc

Doctor of Nursing Practice Projects

BACKGROUND

Obesity is the second leading cause of preventable death next to tobacco use. Although it is prevalent in all populations, it disproportionately affects AA women. Overweight/obesity increases AA women’s chances of developing chronic illnesses such as diabetes, hypertension, heart disease, and decreases their life expectancy. The purpose of this study was to explore variables associated with overweight/obese AA women with hypertension and/or diabetes.

METHODS

A secondary data analysis was conducted using a descriptive-correlational design to analyze cross-sectional data obtained from the 2013 Behavioral Risk Factor Surveillance System (BRFSS). The sample consisted of AA women (n =1823). The dependent variable …

Health Care Resource Utilization And Costs Of California Medicaid Patients With Schizophrenia Treated With Paliperidone Palmitate Once Monthly Or Atypical Oral Antipsychotic Treatment, Jacqueline A. Pesa,, Dilesh Doshi, Li Wang, Huseyin Yuce, Onur Baser

Publications and Research

Objective: To compare all-cause health care utilization and costs between patients with schizophrenia treated with once monthly paliperidone palmitate (PP1M; Invega Sustenna1) and atypical oral antipsychotic therapy (OAT).

Methods: This was a retrospective claims-based analysis among adult California Medicaid (Medi-Cal) patients with schizophrenia having 2 claims for PP1M or OAT from 1 July 2009 to 31 December 2013 and continuous health plan enrollment for 1 year pre- and post-index date (PP1M or OAT initiation date). Baseline characteristics were reported descriptively. Propensity score matching with a 1:1 greedy match method was used to create two matched cohorts. Treatment patterns, all-cause health …

Perspectives On Model Forecasts Of The 2014–2015 Ebola Epidemic In West Africa: Lessons And The Way Forward, Gerardo Chowell, Cecile Viboud, Lone Simonsen, Stefano Merler, Alessandro Vespignani

Global Health Faculty Publications

The unprecedented impact and modeling efforts associated with the 2014–2015 Ebola epidemic in West Africa provides a unique opportunity to document the performances and caveats of forecasting approaches used in near-real time for generating evidence and to guide policy. A number of international academic groups have developed and parameterized mathematical models of disease spread to forecast the trajectory of the outbreak. These modeling efforts often relied on limited epidemiological data to derive key transmission and severity parameters, which are needed to calibrate mechanistic models. Here, we provide a perspective on some of the challenges and lessons drawn from these efforts, …

Models For Hsv Shedding Must Account For Two Levels Of Overdispersion, Amalia Magaret

UW Biostatistics Working Paper Series

We have frequently implemented crossover studies to evaluate new therapeutic interventions for genital herpes simplex virus infection. The outcome measured to assess the efficacy of interventions on herpes disease severity is the viral shedding rate, defined as the frequency of detection of HSV on the genital skin and mucosa. We performed a simulation study to ascertain whether our standard model, which we have used previously, was appropriately considering all the necessary features of the shedding data to provide correct inference. We simulated shedding data under our standard, validated assumptions and assessed the ability of 5 different models to reproduce the …

Generalized Confidence Intervals And Fiducial Intervals For Some Epidemiological Measures., Ionut Bebu, G. Luta, T. Mathew, B. K. Agan

GW Biostatistics Center

For binary outcome data from epidemiological studies, this article investigates the interval estimation of several measures of interest in the absence or presence of categorical covariates. When covariates are present, the logistic regression model as well as the log-binomial model are investigated. The measures considered include the common odds ratio (OR) from several studies, the number needed to treat (NNT), and the prevalence ratio. For each parameter, confidence intervals are constructed using the concepts of generalized pivotal quantities and fiducial quantities. Numerical results show that the confidence intervals so obtained exhibit satisfactory performance in terms of maintaining the coverage probabilities …