Digital Commons Network^™

A Randomized Controlled Trial Testing The Effects Of A Social Needs Navigation Intervention On Health Outcomes And Healthcare Utilization Among Medicaid Members With Type 2 Diabetes, Amy Mcqueen, David Von Nordheim, Charlene Caburnay, Linda Li, Cynthia Herrick, Lauren Grimes, Darrell Broussard, Rachel E Smith, Dana Lawson, Yan Yan, Matthew Kreuter

2020-Current year OA Pubs

Health systems are increasingly assessing and addressing social needs with referrals to community resources. The objective of this randomized controlled trial was to randomize adult Medicaid members with type 2 diabetes to receive usual care (

Hiv/Aids-Associated Knowledge And Attitudes Towards Treating Disadvantaged Communities Among Pre-Community-Based Dental Education Dental Students In The Us, Aditi Tomar, Hannah Balcezak, Shirley Lewis Miranda, Marie C Latortue, Richa Chinchkhandi, Lisa Wigfall

Faculty, Staff and Student Publications

This study examines HIV/AIDS-associated knowledge and attitudes towards treating disadvantaged communities among predoctoral dental students in U.S. dental schools who have not yet commenced their Community-Based Dental Education (CBDE) training. It also compares the difference in the knowledge and attitudes between students with reported community engagement with PLWHA and those without. Our study comprised 89 predoctoral dental students within their D1-D3 years of dental school who had not yet initiated their Community-Based Dental Education (referred to as pre-CBDE dental students). Their responses were collected via an online survey. The participants were 68% females, 94% heterosexual, and with a mean age …

Addressing Disparities In Pediatric Congenital Heart Disease: A Call For Equitable Health Care, Devyani Chowdhury, Pietro A Elliott, S Yukiko Asaki, Shahnawaz Amdani, Quang-Tuyen Nguyen, Christina Ronai, Seda Tierney, Victor Y Levy, Kriti Puri, Carolyn A Altman, Jonathan N Johnson, Julie S Glickstein

Faculty, Staff and Students Publications

While significant progress has been made in reducing disparities within the US health care system, notable gaps remain. This article explores existing disparities within pediatric congenital heart disease care. Congenital heart disease, the most common birth defect and a leading cause of infant death, has garnered substantial attention, revealing certain disparities within the US health care system. Factors such as race, ethnicity, insurance coverage, socioeconomic status, and geographic location are all commonalities that significantly affect health disparities in pediatric congenital heart disease. This comprehensive review sheds light on disparities from diverse perspectives in pediatric care, demonstrates the inequities and inequalities …

Vaccine-Sensitive Allocation - Another Divide To Divide Us?, Joelle Robertson-Preidler, Olivia Schuman

Faculty and Staff Publications

No abstract provided.

Black Radio’S Contribution To Collective And Cultural Memory: Personnel Perspectives Of Black Radio History In The United States, Kim Fox

Faculty Journal Articles

This interdisciplinary research investigates the significance of the community connection between Black radio personnel and their audiences through the lens of collective and cultural memory narratives. The study addresses two key research questions. First, how do Black radio personnel’s collective and cultural memories contribute to the Black public sphere? Second, what are the defining characteristics in developing parasocial relationships and interactions between Black radio personalities and their audiences? The qualitative research employs an autoethnographic methodology and a questionnaire, utilizing insights gained from the author’s experiences working at a Black-owned radio network and station. The questionnaire, distributed to key informants in …

Paying A Heavy Price: Costs Of Care For People With Severe Obesity In Nursing Homes, Luisa Fernandez, Bianca Shieu, Alison Trinkoff, Nicholas Castle, David G Wolf, Steven Handler, John A Harris

Faculty, Staff and Student Publications

Background and objectives: The prevalence of resident obesity in nursing homes has increased dramatically from 22% to 28% between 2005 and 2015. To provide care for people with obesity, nursing homes have changed their admissions, staffing, and equipment, but underlying these changes are increased resources and financial costs of care. The purpose of this study is to describe nursing home organizational aspects of caring for older adults with obesity, with a focus on economic factors, from the perspective of nursing home staff and leadership.

Research design and methods: This qualitative study used descriptive approaches; data were collected through semistructured telephone …

The Price Of Consent, Zohra Ahmed

Faculty Scholarship

This Article demonstrates how hierarchies in the international economy and in international financial institutions have facilitated the U.S.-led Global War on Terror (GWOT). Using U.S.-Pakistan relations as a case study, it shows how the United States has deployed its powerful position at the International Monetary Fund (IMF) to claim Pakistan's consent for its military activities in the region. In the GWOT's first decade, beginning in 2001, the United States openly sought forcible regime change, as in Afghanistan and Iraq; in its second and (now) third decades, the United States has waged covert counterinsurgency campaigns allegedly against militant groups in Muslim-majority …

A Risk Is Not A Harm: Abortion Exceptions In State Laws, Trevor M Bibler, Alison Suen

Center for Medical Ethics and Health Policy Staff Publications

This letter responds to the article "Beneath the Sword of Damocles: Moral Obligations of Physicians in a Post-Dobbs Landscape," by Anne Drapkin Lyerly, Ruth R. Faden, and Michelle M. Mello, in the May-June 2024 issue of the Hastings Center Report.

Implementation Of A Health Information Technology Safety Classification System In The Veterans Health Administration’S Informatics Patient Safety Office, Danielle Kato, Joe Lucas, Dean F Sittig

Faculty, Staff and Student Publications

Objective: Implement the 5-type health information technology (HIT) patient safety concern classification system for HIT patient safety issues reported to the Veterans Health Administration's Informatics Patient Safety Office.

Materials and methods: A team of informatics safety analysts retrospectively classified 1 year of HIT patient safety issues by type of HIT patient safety concern using consensus discussions. The processes established during retrospective classification were then applied to incoming HIT safety issues moving forward.

Results: Of 140 issues retrospectively reviewed, 124 met the classification criteria. The majority were HIT failures (eg, software defects) (33.1%) or configuration and implementation problems (29.8%). Unmet user …

Understanding Enterprise Data Warehouses To Support Clinical And Translational Research: Impact, Sustainability, Demand Management, And Accessibility, Thomas R Campion, Catherine K Craven, David A Dorr, Elmer V Bernstam, Boyd M Knosp

Faculty, Staff and Student Publications

OBJECTIVES: Healthcare organizations, including Clinical and Translational Science Awards (CTSA) hubs funded by the National Institutes of Health, seek to enable secondary use of electronic health record (EHR) data through an enterprise data warehouse for research (EDW4R), but optimal approaches are unknown. In this qualitative study, our goal was to understand EDW4R impact, sustainability, demand management, and accessibility.

MATERIALS AND METHODS: We engaged a convenience sample of informatics leaders from CTSA hubs (n = 21) for semi-structured interviews and completed a directed content analysis of interview transcripts.

RESULTS: EDW4R have created institutional capacity for single- and multi-center studies, democratized access …

Diverse Mentoring Connections Across Institutional Boundaries In The Biomedical Sciences: Innovative Graph Database Analysis, Toufeeq Ahmed Syed, Erika L Thompson, Zainab Latif, Jay Johnson, Damaris Javier, Katie Stinson, Gabrielle Saleh, Jamboor K Vishwanatha

Faculty, Staff and Student Publications

BACKGROUND: With an overarching goal of increasing diversity and inclusion in biomedical sciences, the National Research Mentoring Network (NRMN) developed a web-based national mentoring platform (MyNRMN) that seeks to connect mentors and mentees to support the persistence of underrepresented minorities in the biomedical sciences. As of May 15, 2024, the MyNRMN platform, which provides mentoring, networking, and professional development tools, has facilitated more than 12,100 unique mentoring connections between faculty, students, and researchers in the biomedical domain.

OBJECTIVE: This study aimed to examine the large-scale mentoring connections facilitated by our web-based platform between students (mentees) and faculty (mentors) across institutional …

The Psychological Risks Of War Between The United States And China, Eugen Koh

New England Journal of Public Policy

The relationship between the United States and China has deteriorated over the past two decades and fears of escalating risks of war are regularly reported in global media. This article explores the psychological factors that contribute to the two superpowers shifting from a collaborative relationship to a competitive relationship, seeing each other as enemies, feeling increasingly threatened by each other, failing to consider the heightened sensitivities that arise from their respective traumatic pasts, triggering the collapse of thinking and unleashing of uncontainable emotionality, escalating accidents to conflict, and escalating conflict to war. It highlights the dangers of ignoring heightened trauma-related …

Update On Outbreak Of Fungal Meningitis Among Us Residents Who Received Epidural Anesthesia At Two Clinics In Matamoros, Mexico, Dallas J Smith, Jeremy A W Gold, Tom Chiller, Nirma D Bustamante, Maria Julia Marinissen, Gabriel Garcia Rodriquez, Vladimir Brian Gonzalez Cortes, Celida Duque Molina, Samantha Williams, Axel A Vazquez Deida, Katrina Byrd, Peter G Pappas, Thomas F Patterson, Nathan P Wiederhold, George R Thompson, Luis Ostrosky-Zeichner

Faculty, Staff and Student Publications

Background: Public health officials are responding to an outbreak of fungal meningitis among patients who received procedures under epidural anesthesia at 2 clinics (River Side Surgical Center and Clinica K-3) in Matamoros, Mexico, during 1 January to 13 May 2023. This report describes outbreak epidemiology and outlines interim diagnostic and treatment recommendations.

Methods: Interim recommendations for diagnosis and management were developed by the Mycoses Study Group Research Education and Consortium (MSGERC) based on the clinical experience of clinicians caring for patients during the current outbreak or during previous outbreaks of healthcare-associated fungal meningitis in Durango, Mexico, and the United States. …

Thriving In Theory, Missing The Mark: U.S. Organic Farming IndustryʼS Systemic Malfunctions And How Danish Organic Farming Policy Could Help Solve These Issues, Bailey Webster

San Diego Journal of Climate & Energy Law

Section one of this Article explains the overall framework of the U.S. organic farming industry, including certification, labeling, education, and funding. Section two explains the background and structure of Danish organic farming, administered by the Ministry of Food, Agriculture, and Fisheries of Denmark. Section three addresses and analyzes current issues afflicting the U.S. organic farming industry. Section four explores a prominent organic farming case, Center for Food Safety v. Perdue. Additionally, this Article details the comparison between the U.S. and Danish organic farming policies that are most relevant to issues in the U.S. industry. Lastly, and most importantly, this …

Delays To Antibiotics In The Emergency Department And Risk Of Mortality In Children With Sepsis, Roni D Lane, Troy Richardson, Halden F Scott, Raina M Paul, Fran Balamuth, Matthew A Eisenberg, Ruth Riggs, W Charles Huskins, Christopher M Horvat, Grant E Keeney, Leslie A Hueschen, Justin M Lockwood, Vishal Gunnala, Bryan P Mckee, Nikhil Patankar, Venessa Lynn Pinto, Amanda M Sebring, Matthew P Sharron, Jennifer Treseler, Jennifer J Wilkes, Jennifer K Workman

Faculty, Staff and Students Publications

IMPORTANCE: Pediatric consensus guidelines recommend antibiotic administration within 1 hour for septic shock and within 3 hours for sepsis without shock. Limited studies exist identifying a specific time past which delays in antibiotic administration are associated with worse outcomes.

OBJECTIVE: To determine a time point for antibiotic administration that is associated with increased risk of mortality among pediatric patients with sepsis.

DESIGN, SETTING, AND PARTICIPANTS: This retrospective cohort study used data from 51 US children's hospitals in the Improving Pediatric Sepsis Outcomes collaborative. Participants included patients aged 29 days to less than 18 years with sepsis recognized within 1 hour …

Investor Presentation: May 2024, Fhlb Office Of Finance

Documents

No abstract provided.

Contemporary Analysis Of Reexcision And Conversion To Mastectomy Rates And Associated Healthcare Costs For Women Undergoing Breast-Conserving Surgery, Youngran Kim, Cecilia Ganduglia-Cazaban, Nina Tamirisa, Anthony Lucci, Trudy Millard Krause

Faculty, Staff and Student Publications

PURPOSE: This study was designed to provide a comprehensive and up-to-date understanding of population-level reoperation rates and incremental healthcare costs associated with reoperation for patients who underwent breast-conserving surgery (BCS).

METHODS: This is a retrospective cohort study using Merative™ MarketScan® commercial insurance data and Medicare 5% fee-for-service claims data. The study included females aged 18-64 years in the commercial cohort and females aged 18 years and older in the Medicare cohort, who underwent initial BCS for breast cancer in 2017-2019. Reoperation rates within a year of the initial BCS and overall 1-year healthcare costs stratified by reoperation status were measured. …

Escalated-Dose Radiotherapy For Unresected Locally Advanced Pancreatic Cancer: Patterns Of Care And Survival In The United States, Christopher Shi, Brian De, Hop S Tran Cao, Suyu Liu, Marcus A Florez, Ramez Kouzy, Adam J Grippin, Matthew H G Katz, Ching-Wei D Tzeng, Naruhiko Ikoma, Michael P Kim, Sunyoung Lee, Jason Willis, Sonal S Noticewala, Bruce D Minsky, Grace L Smith, Emma B Holliday, Cullen M Taniguchi, Albert C Koong, Prajnan Das, Ethan B Ludmir, Eugene J Koay

Faculty, Staff and Student Publications

INTRODUCTION: With locally advanced pancreatic cancer (LAPC), uncontrolled local tumor growth frequently leads to mortality. Advancements in radiotherapy (RT) techniques have enabled conformal delivery of escalated-dose RT (EDR), which may have potential local control and overall survival (OS) benefits based on retrospective and early prospective studies. With evidence for EDR emerging, we characterized the adoption of EDR across the United States and its associated outcomes.

METHODS: We searched the National Cancer Database for nonsurgically managed LAPC patients diagnosed between 2004 and 2019. Pancreas-directed RT with biologically effective doses (BED10) ≥39 and ≤70 Gy was labeled conventional-dose RT (CDR), and BED10 …

Use Of A Blood Biomarker Test Improves Economic Utility In The Evaluation Of Older Patients Presenting With Cognitive Impairment, William J Canestaro, Randall J Bateman, David M Holtzman, Mark Monane, Joel B Braunstein

2020-Current year OA Pubs

More than 16 million Americans living with cognitive impairment warrant a diagnostic evaluation to determine the cause of this disorder. The recent availability of disease-modifying therapies for Alzheimer's disease (AD) is expected to significantly drive demand for such diagnostic testing. Accurate, accessible, and affordable methods are needed. Blood biomarkers (BBMs) offer advantages over usual care amyloid positron emission tomography (PET) and cerebrospinal fluid (CSF) biomarkers in these regards. This study used a budget impact model to assess the economic utility of the PrecivityAD

Eisenhower, Kennedy, And America's Covert Military Operations In Laos, Russell Stevenson

The Thetean: A Student Journal for Scholarly Historical Writing

Summer 1963: Roger Hilsman's plane pierced the clouds to reveal the Plaines des Jarres, a flat area strewn with the remains of age-old rock jars. The plains below showed signs of the batterings of war: slit trenches, bunkers, and a network of roads. The weather was dry and arid, and the terrain resembled a ghost town in the American West more than the "land of a million elephants"-an allusion to the tremendous war machine of a medieval Lao king.

The Impact Of The Optn Policy Change On Patients With A Durable Left Ventricular Assist Device And Chronic Kidney Disease: Analysis Of The Unos Database, Eric D. Warner, Christopher Pritting, Sawan Dutta, Matt Bierowski, Waqas Ullah, Yevgeniy Brailovsky, Michelle Kittleson, René J. Alvarez, J. Eduardo Rame, Alexander Hajduczok, Vineeta Kumar, Danial Ahmad, Vakhtang Tchantchaleishvili, Indranee N. Rajapreyar

Division of Cardiology Faculty Papers

BACKGROUND: The Organ Procurement and Transplantation Network (OPTN) implemented modifications in 2018 to the adult heart transplant allocation system to better stratify the most medically urgent transplant candidates. We evaluated the impact of these changes on patients supported by a durable left ventricular assist device (LVAD) with chronic kidney disease (CKD).

OBJECTIVE: To evaluate the impact of the OPTN policy change on patients supported by durable left ventricular assist devices (LVAD) with chronic kidney disease (CKD).

METHODS: We performed an analysis of patients from the United Network of Organ Sharing Database supported by durable LVAD listed for a heart transplant …

Comptroller's Handbook: Liquidity, United States: Department Of The Treasury: Office Of The Comptroller Of The Currency (Occ)

Documents

No abstract provided.

Evaluation Of Trauma Informed Care For Indigenous Victims Of Human Trafficking: A Qualitative Discussion Of Best Practice, Nina Munson

University Honors Theses

Human trafficking is a major issue that every community and nation faces. Within the United States, Indigenous communities are especially at risk of victimization in relation to a history of systemic violence and consequent neglect. Therefore, the need for culturally competent care is crucial. This study seeks to address how culturally sensitive approaches to trauma-informed care can be developed and implemented by various providers to effectively support Native American victims of human trafficking in accessing assistance services. In order to evaluate the problem, a literature review was conducted, paired with qualitative interviews from relevant stakeholders. The findings demonstrated a significant …

Central Bank Liquidity Assistance: Challenges Of Franchise And Asset Values In Banking Crises, Steven Kelly

Documents

No abstract provided.

The Impact Of Purchasing Power Parity (Ppp), Infrastructure, And Decentralization On Pandemic Restrictions, Liam Hansen, Veronica Taraskina, Jennifer Weng

Working Papers Series

This research compares a country's mandate to shift to remote work between the federal and regional levels in comparison to PPP. We focus on how economic factors determine a country's ability to move to remote work and at what level of government the decision is made. The findings suggest that while there was variation in which level of government issued work-from-home requirements, there were strong trends for most mandates to come from the federal level. Moreover, an overwhelming majority of countries issued such federal mandates regardless of PPP. We then compare PPP per capita and the stringency of public transportation …

Exome Sequencing Implicates Ancestry-Related Mendelian Variation At Syne1 In Childhood-Onset Essential Hypertension, Ian Copeland, Edmond Wonkam-Tingang, Monesha Gupta-Malhotra, S Shahrukh Hashmi, Yixing Han, Aarti Jajoo, Nancy J Hall, Paula P Hernandez, Natasha Lie, Dan Liu, Jun Xu, Jill Rosenfeld, Aparna Haldipur, Zelene Desire, Zeynep H Coban-Akdemir, Daryl A Scott, Qing Li, Hsiao-Tuan Chao, Ana M Zaske, James R Lupski, Dianna M Milewicz, Sanjay Shete, Jennifer E Posey, Neil A Hanchard

Faculty, Staff and Student Publications

Childhood-onset essential hypertension (COEH) is an uncommon form of hypertension that manifests in childhood or adolescence and, in the United States, disproportionately affects children of African ancestry. The etiology of COEH is unknown, but its childhood onset, low prevalence, high heritability, and skewed ancestral demography suggest the potential to identify rare genetic variation segregating in a Mendelian manner among affected individuals and thereby implicate genes important to disease pathogenesis. However, no COEH genes have been reported to date. Here, we identify recessive segregation of rare and putatively damaging missense variation in the spectrin domain of spectrin repeat containing nuclear envelope …

Examining The Implications Of A Significant Cyberattack On U.S. Infrastructure, Jenna F. Riel

Honors Theses

In the modern era, the internet is becoming just as essential to the functioning of our everyday lives as food and water. Virtually everything we do relies on modern technology in some capacity, allowing our world to function efficiently. The technology that we have available has made our world smaller in a sense, because digital interconnectedness has allowed us to communicate with anyone no matter where they are on the globe in a matter of seconds, with the tap of a finger. This idea, once a phenomenon only possible in storybooks, has come to life but is not without its …

Boundaries Of Autonomy: Exploring Parallels Between Mental Hospitals And Prisons In The United States, Benjamin J. Boldt

The Agora

Within the United States, a prevailing perception emerges that mental health facilities and prisons are unfavorably similar. This societal sentiment is quite concerning if true, as the prison system is known for its many societal failures within the U.S. Furthermore, mental hospitals aim to help individuals; thus, a comparison to a faulty system highlights a possible issue worthy of exploration. Unfortunately, little analysis exists, within academic research, comparing both institutions. The following comparative analysis looks at available research between mental hospitals and prisons to validate this issue and explore implications. Findings indicate a shared pattern between mental hospitals and prisons …

Using Genome And Transcriptome Data From African-Ancestry Female Participants To Identify Putative Breast Cancer Susceptibility Genes, Jie Ping, Guochong Jia, Qiuyin Cai, Xingyi Guo, Ran Tao, Christine Ambrosone, Dezheng Huo, Stefan Ambs, Mollie E Barnard, Yu Chen, Montserrat Garcia-Closas, Jian Gu, Jennifer J Hu, Esther M John, Christopher I Li, Katherine Nathanson, Barbara Nemesure, Olufunmilayo I Olopade, Tuya Pal, Michael F Press, Maureen Sanderson, Dale P Sandler, Toshio Yoshimatsu, Prisca O Adejumo, Thomas Ahearn, Abenaa M Brewster, Anselm J M Hennis, Timothy Makumbi, Paul Ndom, Katie M O'Brien, Andrew F Olshan, Mojisola M Oluwasanu, Sonya Reid, Song Yao, Ebonee N Butler, Maosheng Huang, Atara Ntekim, Bingshan Li, Melissa A Troester, Julie R Palmer, Christopher A Haiman, Jirong Long, Wei Zheng

Faculty, Staff and Student Publications

African-ancestry (AA) participants are underrepresented in genetics research. Here, we conducted a transcriptome-wide association study (TWAS) in AA female participants to identify putative breast cancer susceptibility genes. We built genetic models to predict levels of gene expression, exon junction, and 3' UTR alternative polyadenylation using genomic and transcriptomic data generated in normal breast tissues from 150 AA participants and then used these models to perform association analyses using genomic data from 18,034 cases and 22,104 controls. At Bonferroni-corrected P < 0.05, we identified six genes associated with breast cancer risk, including four genes not previously reported (CTD-3080P12.3, EN1, LINC01956 and NUP210L). Most of these genes showed a stronger association with risk of estrogen-receptor (ER) negative or triple-negative than ER-positive breast cancer. We also replicated the associations with 29 genes reported in previous TWAS at P < 0.05 (one-sided), providing further support for an association of these genes with breast cancer risk. Our study sheds new light on the genetic basis of breast cancer and highlights the value of conducting research in AA populations.

That Way: An Examination Of Male Relationships In Film During The Hays Code, Jane Knudsen

Theses/Capstones/Creative Projects

The Hays Code (1934-1968) influenced the construct of United States masculinity and the discourse surrounding masculine presentation between the 1920s to the 1960s. The Hays Code and World War II affected the culture surrounding male/male relationships in the United States. Previous research done by David Lugowski (1999) and Jeffrey Suzik (1999) shows that both World Wars led to crises of masculinity in which the hegemonic ideal of masculinity was restructured to establish men as providers and warriors, and Code-era films reflected the discourse. To understand the gender roles in the 20^th century, I analyzed the Hays code, male bonds, …