Digital Commons Network^™

Palliative Medicine Integration In The Usa: Cancer Centre Executives’ Attitudes, Joseph Chen, Allison De La Rosa, Dejian Lai, Rony Dev, Frances Lee Revere, David Lairson, Paige Wermuth, Eduardo Bruera, David Hui

Faculty, Staff and Student Publications

OBJECTIVES: To compare cancer centre (CC) executives' attitudes towards palliative care between National Cancer Institute-designated CCs (NCI-CCs) and non-NCI-designated CCs (non-NCI-CCs) in 2018 and to examine the changes in attitudes and beliefs between 2009 and 2018.

METHODS: CC chief executives at all NCI-CCs and a random sample of non-NCI-CCs were surveyed from April to August 2018. Twelve questions examined the executives' attitudes towards palliative care integration, perceived barriers and self-assessments. The primary outcome was agreement on the statement 'a stronger integration of palliative care services into oncology practice will benefit patients at my institution.' Survey findings from 2018 were compared …

Considerations In Selecting Venues For The American Thoracic Society International Conference: Balancing Competing Priorities Of The Society's Diverse Membership, Gregory P. Downey, M. Patricia Rivera, Lynn M. Schnapp, Irina Petrache, Jesse Roman, Karen J. Collishaw

Division of Pulmonary, Allergy, and Critical Care Medicine Faculty Papers

No abstract provided.

Risk Factors For Non-O157 Shiga Toxin-Producing Escherichia Coli Infections, United States, Ellyn P. Marder, Zhaohui Cui, Beau B. Bruce, Latonia Clay Richardson, Michelle M. Boyle, Paul R. Cieslak, Nicole Comstock, Sarah Lathrop, Katie Garman, Suzanne Mcguire, Danyel Olson, Duc J. Vugia, Siri Wilson, Patricia M. Griffin, Carlota Medus

Pathology Research and Scholarship

Shiga toxin-producing Escherichia coli (STEC) causes acute diarrheal illness. To determine risk factors for non-O157 STEC infection, we enrolled 939 patients and 2,464 healthy controls in a case-control study conducted in 10 US sites. The highest population-attributable fractions for domestically acquired infections were for eating lettuce (39%), tomatoes (21%), or at a fast-food restaurant (23%). Exposures with 10%-19% population attributable fractions included eating at a table service restaurant, eating watermelon, eating chicken, pork, beef, or iceberg lettuce prepared in a restaurant, eating exotic fruit, taking acid-reducing medication, and living or working on or visiting a farm. Significant exposures with high …

The Impact Of The Covid-19 Lockdown On Retinopathy Of Prematurity Screening And Management In The United States: A Multicenter Study, Shefali Sood, Mina M Naguib, David S Portney, Cagri G Besirli, Cole A Martin, C Armitage Harper, Maria P Fernandez, Audina M Berrocal, Polly A Quiram, Peter Belin, Noreen Clarke, Aaron Nagiel, Melissa Chandler, Christopher Bair, M Elizabeth Harnett, Vaidehi S Dedania

Faculty, Staff and Student Publications

Purpose: To study the effect of the pandemic-related lockdown (physical distance measures and movement restrictions) on the characteristics and management of retinopathy of prematurity (ROP).

Methods: In this controlled, multicenter cohort study, the medical records of patients born prematurely and screened for ROP in the neonatal intensive care unit during four time periods were reviewed retrospectively: (1) November 1, 2018, to March 15, 2019; (2) March 16, 2019, to August 2, 2019 (lockdown control period); (3) November 1, 2019, to March 15, 2020; and (4) March 16, 2020-August 2, 2020.

Results: A total of 1,645 patients met inclusion criteria. Among …

National Institutes Of Health Diversity Supplement Awards: Experience Of Radiation Oncology Principal Investigators And Trainees, Afua A Yorke, Michael K Rooney, Jillian Rigert, Amy C Moreno, Clifton D Fuller, Eric C Ford

Faculty, Staff and Student Publications

No abstract provided.

2021 Aapm Equity, Diversity, And Inclusion Climate Survey Executive Summary, Kristi R G Hendrickson, Stephen M Avery, Richard Castillo, Laura Cervino, Ashley Cetnar, Nolan L Gagne, Wendy Harris, Amirh Johnson, Megan E Lipford, Nadia Octave, Kelly C Paradis, Angélica Pérez-Andújar, Surendra Prajapati, Julianne Pollard-Larkin

Faculty, Staff and Student Publications

Purpose: The American Association of Physicists in Medicine (AAPM) shares the results, conclusions, and recommendations from the initial Equity, Diversity, and Inclusion Climate Survey conducted in 2021.

Methods and materials: The climate survey targeted medical physicists who are full members of the AAPM and included demographic inquiries and questions intended to assess the working environmental climate in terms of a sense of belonging and inclusion, experiences of discrimination and harassment, and obstacles to participation within the AAPM. The survey invitation was sent to 5,500 members. Responses were collected from 1385 members (response rate of 25%) between January and February 2021. …

Learning Through Doing: Comprehensive Programming For A Training Program In Cancer Disparities, Kayce D Solari Williams, Kamisha Hamilton Escoto, Crystal Roberson, Kathy Le, Lorraine R Reitzel, Lorna H Mcneill, Shine Chang

Faculty, Staff and Student Publications

In the United States, preparing researchers and practitioners for careers in cancer requires multiple components for success. In this reflection article, we discuss our approach to designing a comprehensive research training program in cancer disparities. We focused on elements that provide students and early career scientists a deep understanding of disparities through first-hand experiences and skills training necessary to build a research career in the area. Our Educational Program sits within the framework of an NCI P20 program, "UHAND (University of Houston/MD Anderson Cancer Center)", jointly established by an NCI-designated comprehensive cancer center and a minority-serving university as a collaborative …

Real-World Safety Of Neurohormonal Antagonist Initiation Among Older Adults Following A Heart Failure Hospitalization, Parag Goyal, Andrew R Zullo, Barbara Gladders, Chukwuma Onyebeke, Min Ji Kwak, Larry A Allen, Emily B Levitan, Monika M Safford, Lauren Gilstrap

Faculty, Staff and Student Publications

AIMS: To optimize guideline-directed medical therapy for heart failure, patients may require the initiation of multiple neurohormonal antagonists (NHAs) during and following hospitalization. The safety of this approach for older adults is not well established.

METHODS AND RESULTS: We conducted an observational cohort study of 207 223 Medicare beneficiaries discharged home following a hospitalization for heart failure with reduced ejection fraction (HFrEF) (2008-2015). We performed Cox proportional hazards regression to examine the association between the count of NHAs initiated within 90 days of hospital discharge (as a time-varying exposure) and all-cause mortality, all-cause rehospitalization, and fall-related adverse events over the …

Contributions From Medical Geneticists In Clinical Trials Of Genetic Therapies: A Points To Consider Statement Of The American College Of Medical Genetics And Genomics (Acmg), Loren D M Peña, Lindsay C Burrage, Gregory M Enns, Edward D Esplin, Cary Harding, Jerry R Mendell, Zhiyv Neal Niu, Curt Scharfe, Timothy Yu, Dwight D Koeberl

Faculty, Staff and Students Publications

No abstract provided.

Dementias Among Older Males And Females In The U.S. Medicare System With And Without Hiv, Xiaoying Yu, Yong-Fang Kuo, Mukaila A Raji, Abbey B Berenson, Jacques Baillargeon, Thomas P Giordano

Faculty, Staff and Students Publications

Background: Despite the growing concern that people with HIV (PWH) will experience a disproportionate burden of dementia as they age, very few studies have examined the sex-specific prevalence of dementia, including Alzheimer disease and related dementias (AD/ADRD) among older PWH versus people without HIV (PWOH) using large national samples.

Methods: We constructed successive cross-sectional cohorts including all PWH aged 65+ years from U.S. Medicare enrollees and PWOH in a 5% national sample of Medicare data from 2007 to 2019. All AD/ADRD cases were identified by ICD-9-CM/ICD-10-CM diagnosis codes. Prevalence of AD/ADRD was calculated for each calendar year by sex-age strata. …

Epidemiology Of Cancer-Associated Venous Thromboembolism In Patients With Solid And Hematologic Neoplasms In The Veterans Affairs Health Care System, Kylee L Martens, Ang Li, Jennifer La, Sarah B May, Kaitlin N Swinnerton, Hannah Tosi, Danne C Elbers, Nhan V Do, Mary T Brophy, J Michael Gaziano, Saran Lotfollahzadeh, Vipul Chitalia, Katya Ravid, Nathanael R Fillmore

Faculty, Staff and Students Publications

IMPORTANCE: Identifying changes in epidemiologic patterns of the incidence and risk of cancer-associated thrombosis (CAT), particularly with evolving cancer-directed therapy, is essential for risk stratification.

OBJECTIVE: To assess the incidence of CAT over time and to determine pertinent patient-specific, cancer-specific, and treatment-specific factors associated with its risk.

DESIGN, SETTING, AND PARTICIPANTS: This longitudinal, retrospective cohort study was conducted from 2006 to 2021. Duration of follow-up was from the date of diagnosis until first venous thromboembolism (VTE) event, death, loss of follow-up (defined as a 90-day gap without clinical encounters), or administrative censoring on April 1, 2022. The study took place …

The Impact Of Covid-19 On A Large Pragmatic Clinical Trial Embedded In Primary Care, Sarah M Leatherman, Cynthia Hau, Alison Klint, Peter A Glassman, Addison A Taylor, Ryan E Ferguson, William C Cushman, Areef Ishani

Faculty, Staff and Students Publications

INTRODUCTION: The COVID-19 pandemic had significant impact on clinical care and clinical trial operations, but the impact on decentralized pragmatic trials is unclear. The Diuretic Comparison Project (DCP) is a Point-of Care (POC) pragmatic trial testing whether chlorthalidone is superior to hydrochlorothiazide in preventing major cardiovascular (CV) events and non-cancer death. DCP utilized telephone consent, data collection from the electronic health record and Medicare, forwent study visits, and limited provider commitment beyond usual care. We assessed the impact of COVID-19 on recruitment, follow-up, data collection, and outcome ascertainment in DCP.

METHODS: We compared data from two 8-month periods: Pre-Pandemic (July …

Racial/Ethnic Disparities In Cervical Cancer Stage At Diagnosis: Mediating Effects Of Neighborhood-Level Socioeconomic Deprivation, Itunu O Sokale, Abiodun O Oluyomi, Jane R Montealegre, Aaron P Thrift

Faculty, Staff and Students Publications

BACKGROUND: Mortality from cervical cancer has declined steadily in the United States over the past several decades due to widespread screening for precancerous and early-stage cervical cancer (ECC), which are significantly easier to treat compared with late-stage cervical cancer (LCC). Unequal screening access continues to cause significant racial/ethnic disparities in cervical cancer diagnosis stage. This study examined the underlying role of neighborhood-level socioeconomic disadvantage as a potential mediator of the association between race/ethnicity and cervical cancer diagnosis stage.

METHODS: We analyzed Texas Cancer Registry data for cervical cancer cases diagnosed among women ages 18 or older from 2010 to 2018. …

Reviewing Internal Medicine Clerkship Grading Through A Proequity Lens: Results Of A National Survey, Cindy J Lai, Irene Alexandraki, Nadia Ismail, Diane Levine, Chavon Onumah, Amber T Pincavage, Jackcy Jacob, Melissa Osborn Jenkins, Amulya Nagarur, Michael Kisielewski, Nora Y Osman

Faculty and Staff Publications

Purpose: Equity in assessment and grading has become imperative across medical education. Although strategies to promote equity exist, there may be variable penetrance across institutions. The objectives of this study were to identify strategies internal medicine (IM) clerkship directors (CDs) use to reduce inequities in assessment and grading and explore IM CDs' perceptions of factors that impede or facilitate the implementation of these strategies.

Method: From October to December 2021, the Clerkship Directors in Internal Medicine of the Alliance for Academic Internal Medicine conducted its annual survey of IM core CDs at 137 U.S. and U.S. territory-based medical schools. This …

American Academy Of Orthopaedic Surgeons Clinical Practice Guideline Summary: Management Of Anterior Cruciate Ligament Injuries, Robert H. Brophy, Kent Jason Lowry

2020-Current year OA Pubs

Management of Anterior Cruciate Ligament Injuries : Evidence-based Clinical Practice Guideline is based on a systematic review of published studies for the treatment of anterior cruciate ligament injurie in both skeletally mature and immature patients. This guideline contains eight recommendations and seven options to assist orthopaedic surgeons and all qualified physicians managing patients with ACL injuries based on the best current available evidence. It is also intended to serve as an information resource for professional healthcare practitioners and developers of practice guidelines and recommendations. In addition to providing pragmatic practice recommendations, this guideline also highlights gaps in the literature and …

Emily Sohn, Oral History Interview, 2023, You Li

Collective Memory of Women Journalists in COVID-19

Emily Sohn, based in the U.S., is a freelance journalist with 20 years of experience. She explores issues in science, health, and the environment. Her work has been published in Nature, the Washington Post, the Los Angeles Times, Discovery News, Science News for Kids, U.S. News & World Report, and National Geographic News, among others.

Sohn tried to explain the science of COVID guidance and the pandemic's psychological and behavioral impacts on children and adults. She reminded the public that science is an evolving process, and journalism plays an important role in analyzing, documenting, and conveying evidence-based information to the …

Transmission Of Mycobacterium Tuberculosis To Healthcare Personnel Resulting From Contaminated Bone Graft Material, United States, June 2021–August 2022, Ruoran Li, Molly Deutsch-Feldman, Tamasin Adams, Michelle Law, Chinpar Biak, Erika Pitcher, Marci Drees, Alfonso C Hernandez-Romieu, Thomas D Filardo, Tracina Cropper, Angelica Martinez, W Wyatt Wilson, Sandy P Althomsons, Sapna Bamrah Morris, Jonathan M Wortham, Isaac Benowitz, Noah G Schwartz, Kelly White, Maryam B Haddad, Janet B Glowicz, Bone Allograft Tuberculosis Investigators

Faculty, Staff and Student Publications

A nationwide tuberculosis outbreak linked to a viable bone allograft product contaminated with Mycobacterium tuberculosis was identified in June 2021. Our subsequent investigation identified 73 healthcare personnel with new latent tuberculosis infection following exposure to the contaminated product, product recipients, surgical instruments, or medical waste.

May 2023 Debt Limit Analysis, Shai Akabas, Rachel Snyderman, Arianna Fano

Documents

No abstract provided.

Education And Welfare: Their Impact On The Experience Of Poverty In India And The United States, Anushka Rajani

Senior Theses

The experience of poverty and chances of upward mobility is drastically different in India and the United States. The following thesis contends that this is largely due to the current educational and welfare policies in place in these two nations. Education allows for a higher possibility of financial upward mobility by allowing students to learn skills that prepare them for higher-paying career paths. High-quality welfare gives recipients aid for their necessities while providing them time for growth to pursue financial independence. The following thesis investigates these policies and how accessible they make education and welfare to poor populations in India …

Integrating Tobacco Treatment Into Oncology Care: Reach And Effectiveness Of Evidence-Based Tobacco Treatment Across National Cancer Institute-Designated Cancer Centers, Sarah D Hohl, Alex T Ramsey, Li-Shiun Chen, Et Al.

2020-Current year OA Pubs

PURPOSE: Quitting smoking improves patients' clinical outcomes, yet smoking is not commonly addressed as part of cancer care. The Cancer Center Cessation Initiative (C3I) supports National Cancer Institute-designated cancer centers to integrate tobacco treatment programs (TTPs) into routine cancer care. C3I centers vary in size, implementation strategies used, and treatment approaches. We examined associations of these contextual factors with treatment reach and smoking cessation effectiveness.

METHODS: This cross-sectional study used survey data from 28 C3I centers that reported tobacco treatment data during the first 6 months of 2021. Primary outcomes of interest were treatment reach (reach)-the proportion of patients identified …

The Evolution Of Primary Care Telehealth Disparities During Covid-19: Retrospective Cohort Study, Rachel D'Amico, Patrick M Schnell, Randi Foraker, J Nwando Olayiwola, Daniel E Jonas, Seuli Bose Brill

2020-Current year OA Pubs

BACKGROUND: Telehealth has become widely used as a novel way to provide outpatient care during the COVID-19 pandemic, but data about telehealth use in primary care remain limited. Studies in other specialties raise concerns that telehealth may be widening existing health care disparities, requiring further scrutiny of trends in telehealth use.

OBJECTIVE: Our study aims to further characterize sociodemographic differences in primary care via telehealth compared to in-person office visits before and during the COVID-19 pandemic and determine if these disparities changed throughout 2020.

METHODS: We conducted a retrospective cohort study in a large US academic center with 46 primary …

Low Educational Attainment Is Associated With Higher All-Cause And Cardiovascular Mortality In The United States Adult Population, Najah Khan, Zulqarnain Javed, Isaac Acquah, Kobina Hagan, Madiha Khan, Javier Valero-Elizondo, Ryan Chang, Umair Javed, Mohamad B Taha, Michael J Blaha, Salim S Virani, Garima Sharma, Ron Blankstein, Martha Gulati, Elias Mossialos, Adnan A Hyder, Miguel Cainzos Achirica, Khurram Nasir

Faculty, Staff and Students Publications

Introduction: Educational attainment is an important social determinant of health (SDOH) for cardiovascular disease (CVD). However, the association between educational attainment and all-cause and CVD mortality has not been longitudinally evaluated on a population-level in the US, especially in individuals with atherosclerotic cardiovascular disease (ASCVD). In this nationally representative study, we assessed the association between educational attainment and the risk of all-cause and cardiovascular (CVD) mortality in the general adult population and in adults with ASCVD in the US.

Methods: We used data from the 2006-2014 National Death Index-linked National Health Interview Survey for adults ≥ 18 years. We generated …

Living Between Two Worlds: Learning About High School Immigrant Students’ Experiences In The United States: A Phenomenological Qualitative Study, Xixellonje Nebihu

Masters Theses, 2020-current

This phenomenological qualitative research study examined the experiences of two immigrant high school students in terms of adaptation, integration, academic performance, and challenges they encountered in U.S. schools. These participants have been in the United States for three years and come from Jordan and Honduras. Semi-structured interviews and the researcher’s journal served as the study’s primary data sources. Two interview sessions were conducted with the participants at their school. The findings revealed that a variety of elements, including school support, such as counselors and the option to select courses, teacher support, and a diverse student body had a positive impact …

Dynamic Frailty Risk Assessment Among Older Adults With Multiple Myeloma: A Population-Based Cohort Study, Hira Mian, Tanya M Wildes, Ravi Vij, Matthew J Pianko, Ajay Major, Mark A Fiala

2020-Current year OA Pubs

Multiple myeloma (MM) is a cancer of older adults and those who are more frail are at high risk of poor outcomes. Current tools for identifying and categorizing frail patients are often static and measured only at the time of diagnosis. The concept of dynamic frailty (i.e. frailty changing over time) is largely unexplored in MM. In our study, adults with newly-diagnosed MM who received novel drugs between the years 2007-2014 were identified in the Surveillance, Epidemiology, and End Results (SEER)-Medicare linked databases. Using a previously published cumulative deficit approach, a frailty index score was calculated at diagnosis and each …

Medication For Opioid Use Disorder During Pregnancy - Maternal And Infant Network To Understand Outcomes Associated With Use Of Medication For Opioid Use Disorder During Pregnancy (Mat-Link), 2014-2021, Kathryn Miele, Shin Y. Kim, Rachelle Jones, Juneka H. Rembert, Elisha M. Wachman, Hira Shrestha, Michelle L. Henninger, Teresa M. Kimes, Patrick D. Schneider, Vaseekaran Sivaloganathan, Katherine A. Sward, Vikrant G. Deshmukh, Pilar M. Sanjuan, Jessie R. Maxwell, Neil S. Seligman, Sarah Caveglia, Judette M. Louis, Tanner Wright, Carolyne Cody Bennett, Caitlin Green, Nisha George, Lucas Gosdin, Emmy L. Tran, Dana Meaney-Delman, Suzanne M. Gilboa

Pediatrics Research and Scholarship

PROBLEM: Medication for opioid use disorder (MOUD) is recommended for persons with opioid use disorder (OUD) during pregnancy. However, knowledge gaps exist about best practices for management of OUD during pregnancy and these data are needed to guide clinical care.

PERIOD COVERED: 2014-2021.

DESCRIPTION OF THE SYSTEM: Established in 2019, the Maternal and Infant Network to Understand Outcomes Associated with Medication for Opioid Use Disorder During Pregnancy (MAT-LINK) is a surveillance network of seven clinical sites in the United States. Boston Medical Center, Kaiser Permanente Northwest, The Ohio State University, and the University of Utah were the initial clinical sites …

Gestational Diabetes Among The South Asian Diaspora In The United States Of America: A Scoping Review, Anudeep Deevi, Mariam Sharobeem, Gabrianna Andrews, Rahul Ubrani, Venkateswar Venkataraman

Rowan-Virtua Research Day

Aim: The scoping review was conducted to review the current knowledge base regarding gestational diabetes mellitus (GDM) among South Asians in the United States. In addition, the review was meant to identify any gaps in knowledge, specifically about the current care received by South Asians as well as the associated adverse health outcomes.

Methods: A systematic search of PubMed, Web of Science, Embase, and Scopus was conducted. Key words ""gestational diabetes South Asians in the United States" were used as search terms. Search was restricted to U.S. articles published on or after 01/01/2013 with key words. Articles were screened by …

The Correlation Between Traumatic Brain Injury And Incarceration Among Adult Males In The United States, Shadi Shams

Rowan-Virtua Research Day

The United States has one of the largest growing prison populations in the world. A large amount of social and economic resources go towards the cost and maintenance of correctional facilities each year. Additionally, the current correctional programs are insufficient in assisting inmates with getting back to society; especially those with traumatic brain injury (TBI) who often remain undiagnosed and are usually treated unfairly in the prison system instead of receiving the appropriate help. Prior scholarly work has shown that patients in the post-TBI stage are more likely to enter the judicial system. In the recent population-based cohort study, the …

What The United States Could Learn From Norway: Training Police Officers To Be Social Workers, Not Warriors, Liana Brown

University of Miami International and Comparative Law Review

This note compares the training of police officers and its consequential effects in the United States versus that of Norway. In the United States, the lack of national training standards, in conjunction with an emphasis on technical skills and weaponry, has further perpetuated the “Warrior mindset.” The “Warrior mindset” reflects the rhetoric that officers are akin to combatants in a war, in which they have a duty to safeguard the rest of civilization against criminals that can strike at any moment. Contrastingly, the training programs for police officers in Norway include a consolidated and robust three-year education program that emphasizes …

Emergency Powers: Understanding The Benefits While Mitigating The Consequences, Savannah Valentine

University of Miami International and Comparative Law Review

This note compares the short-term benefits and long-term consequences of emergency powers using examples from several countries and offers solutions to mitigate those consequences. Historically, emergency powers were only granted in times of true crises. In those circumstances, emergency powers can serve an important purpose: to help the government run smoothly and efficiently. Unfortunately, permanent power grabs are now more common and the standard for what constitutes an emergency has weakened severely, often resulting in civil rights infringements. Possible solutions to this problem include understanding the negative effects of sunset clauses in emergency acts, increased awareness of manufactured emergencies, encouraging …

Household Heroes: An Examination Of Domestic Workers' Rights In The United States And Mexico, Kaitlyn Sutton

Honors College Theses

Since 2018, worker's rights have become a forefront in the battle to developing a more equitable nation in Mexico, specifically regarding domestic employees. In my honors thesis I compare the rights of domestic workers in both the United States and Mexico using elements set forth in the SA8000 Standard formed by the Social Accountability International Organization in order to analyze which country grants more access to these liberties. I then examine different cross-cultural management styles in the countries as a method for explaining the differences in right. I also discuss advocacy groups still fighting for more freedom as well as …