Digital Commons Network^™

Needs Of Family Caregivers Of Hospitalised Adults With Dementia During Care Transitions: A Qualitative Study In A Us Department Of Veterans Affairs Hospital, Molly J Horstman, Tracy L Evans, Crystal Guo, Mandi Sonnenfeld, Aanand D Naik, Alan Stevens, Mark E Kunik

Faculty, Staff and Student Publications

OBJECTIVE: To identify the needs of caregivers of hospitalised adults with dementia in the hospital and during care transitions.

DESIGN: Pragmatic qualitative inquiry with semi-structured interviews.

SETTING: Michael E. DeBakey Veterans Affairs Medical Center in Houston, Texas, USA.

PARTICIPANTS: 12 family caregivers (family member (n=11); friend (n=1)) and 15 health professionals (hospital medicine physicians (n=4), inpatient nurse case managers (n=2), social workers (n=4), outpatient geriatrics providers (n=2), a primary care provider (n=1), geriatric psychiatrists (n=2)) were interviewed. Caregivers were recruited while their care recipient was hospitalised and were interviewed at least 2 weeks after the care recipient was discharged from …

Sustainable Campus Landscapes In The United States And China: A Comparative Analysis, Zhaofang Zhang, Jing Zhou, Deanna Schmidt, Kathleen Garland

The Geographical Bulletin

This paper explores landscapes of sustainability. Universities across the world have incorporated sustainability into their curriculum, research, infrastructure operation, and resource management. However, campus landscapes are relatively unexplored assets to promote university sustainability. As the physical embodiment of university values as well as an enduring legacy, campus landscapes offer the potential to integrate sustainability into the fabric of universities for generations to come. The paper presents findings from an empirical study of two universities: China T hree Gorges University, Yinchang City, Hubei province, China, (CTGU) and the University of Houston, Clear Lake, Texas, United States (UHCL). The research utilizes landscape …

Addressing Dermatologic Concerns And Teledermatology In Undomiciled And Sheltered Populations, Kennedy Gallagher, Sahithi Talasila, Anna Bistline, Rebecca Krain, Leena Ramani, Elizabeth Jones

Student Papers, Posters & Projects

Homelessness in the United States is a significant public health issue, with dermatologic disease being the most prevalent health concern among the undomiciled and sheltered populations. Despite a growing need for dermatologic care, the supply of dermatologists remains insufficient, contributing to disparities in healthcare access for this vulnerable group. This review aims to detail the spectrum of dermatologic conditions experienced by homeless individuals, identify barriers to adequate care, and explore teledermatology as a potential solution to bridge these gaps. A comprehensive literature review was conducted, analyzing studies and reports on dermatologic issues prevalent among the homeless population and the efficacy …

Internalizing Mental Health Symptoms And Nicotine Use Among Adolescents In Canada, England, And The Us From 2020-2022, Emily E. Hackworth

Theses and Dissertations

Background: There is a well-established bi-directional relationship between cigarette smoking and internalizing mental health (IMH) symptoms (e.g., symptoms of depression, symptoms of anxiety). However, it is unclear whether IMH symptoms are associated with using different types of nicotine products among adolescents, as adolescents are using a variety of nicotine products, including combustible products (cigarettes), non-combustible products (e-cigarettes), or combinations of both types of products. This dissertation examines associations between IMH symptoms and current use of various types of nicotine products across three countries from 2020-2022.

Methods: Data come from the 2020-2022 waves of the International Tobacco Control (ITC) Adolescents Tobacco …

Detection And Analysis Of Solid-Phase Nutrients In Complex Benthic Cyanobacterium Communities, Cassidy Ann Crandell

Theses and Dissertations

Eutrophication is one of the most serious water quality issues affecting aquatic systems in the United States. Densely populated urban areas as well as mining and agriculture are major sources of anthropogenic nutrient loading into lakes and rivers. Excess loading of nutrients like phosphorus (P) into these ecosystems can cause native algal species to be outcompeted by harmful algal bloom (HAB) species. Increases in these HAB events are a growing public health concern as contact with excreted toxins can be harmful for human, aquatic, and land species. Remediation techniques like total maximum daily loads (TMDLs) have been implemented to reduce …

Impacts Of Covid-19 And Taliban Takeover On U.S. Afghan Refugee Women’S Mental Health: A Socio-Ecological Approach To Resilience Resources, Atefeh Aghaei

Theses and Dissertations

In response to the escalating global refugee crisis, intensified by ongoing conflicts and environmental changes, this dissertation research focuses on the mental health of Afghan refugee women in the United States (U.S.), particularly in the context of the COVID-19 pandemic and the 2021 Taliban takeover. With over 114 million people displaced globally, Afghan refugees, notably women, encounter heightened mental health risks due to violence, deprivation, systemic persecution, and the challenges of migration. This vulnerability is exacerbated by recent mass traumatic events, including the pandemic and political upheaval in Afghanistan. Our study, conducted through semi-structured interviews with Afghan refugee women and …

Stroke Severity, Caregiver Feedback, And Cognition In The Regards-Cares Study, Jason A Blake, D Leann Long, Amy J Knight, Burel R Goodin, Michael Crowe, Suzanne E Judd, J David Rhodes, David L Roth, Olivio J Clay

2020-Current year OA Pubs

BACKGROUND: Cognitive impairment after stroke is common and is present in up to 60% of survivors. Stroke severity, indicated by both volume and location, is the most consequential predictor of cognitive impairment, with severe strokes predicting higher chances of cognitive impairment. The current investigation examines the associations of 2 stroke severity ratings and a caregiver-report of poststroke functioning with longitudinal cognitive outcomes.

METHODS AND RESULTS: One hundred fifty-seven caregivers and stroke survivor dyads participated in the CARES (Caring for Adults Recovering From the Effects of Stroke) project, an ancillary study of the REGARDS (Reasons for Geographic and Racial Differences in …

Potential Us Health Care Savings Based On Clinician Views Of Feasible Site-Of-Care Shifts, Nikhil R Sahni, Crosbie Marine, David M Cutler, Laura N Medford-Davis, Melvin Mezue, Omar Kattan, Ed Levine, Karen E Joynt Maddox

2020-Current year OA Pubs

IMPORTANCE: Shifting care to alternative sites when clinically appropriate may be associated with reduced US health care spending, improved access, and, in some cases, improved care outcomes.

OBJECTIVE: To fill 2 main gaps in the current literature on site-of-care shifts: (1) understanding the clinician perspective on appropriateness of alternative care sites, given the central role they play in referrals and patient trust and (2) considering all potential sites where care could shift and calculating net savings potential.

DESIGN, SETTING, AND PARTICIPANTS: In this survey study, physicians (MDs and DOs), nurse practitioners, physician assistants, nurse anesthetists, radiology and imaging technicians, and …

Pediatric Mental Health Emergency Department Visits From 2017 To 2022: A Multicenter Study, Jennifer A Hoffmann, Camille P Carter, Cody S Olsen, David Ashby, Kamali L Bouvay, Susan J Duffy, James M Chamberlain, Sofia S Chaudhary, Nicolaus W Glomb, Jacqueline Grupp-Phelan, Maya Haasz, Erin P O'Donnell, Mohsen Saidinejad, Bashar S Shihabuddin, Leah Tzimenatos, Neil G Uspal, Joseph J Zorc, Lawrence J Cook, Elizabeth R Alpern

Faculty, Staff and Students Publications

Background: The COVID-19 pandemic adversely affected children's mental health (MH) and changed patterns of MH emergency department (ED) utilization. Our objective was to assess how pediatric MH ED visits during the COVID-19 pandemic differed from expected prepandemic trends.

Methods: We retrospectively studied MH ED visits by children 5 to < 18 years old at nine U.S. hospitals participating in the Pediatric Emergency Care Applied Research Network Registry from 2017 to 2022. We described visit length by time period: prepandemic (January 2017-February 2020), early pandemic (March 2020-December 2020), midpandemic (2021), and late pandemic (2022). We estimated expected visit rates from prepandemic data using multivariable Poisson regression models. We calculated rate ratios (RRs) of observed to expected visits per 30 days during each pandemic time period, overall and by sociodemographic and clinical characteristics.

Results: We identified 175,979 pediatric MH ED visits. Visit length exceeded 12 h for 7.3% prepandemic, 8.4% early pandemic, 15.0% midpandemic, and 19.2% late pandemic visits. During the early pandemic, observed visits per 30 days decreased relative to expected rates (RR 0.80, 95% confidence interval [CI] 0.78-0.84), were similar to expected …

2023 American College Of Rheumatology (Acr)/American College Of Chest Physicians (Chest) Guideline For The Screening And Monitoring Of Interstitial Lung Disease In People With Systemic Autoimmune Rheumatic Diseases, Sindhu R Johnson, Elana J Bernstein, Marcy B Bolster, Jonathan H Chung, Sonye K Danoff, Michael D George, Dinesh Khanna, Gordon Guyatt, Reza D Mirza, Rohit Aggarwal, Aberdeen Allen, Shervin Assassi, Lenore Buckley, Hassan A Chami, Douglas S Corwin, Paul F Dellaripa, Robyn T Domsic, Tracy J Doyle, Catherine Marie Falardeau, Tracy M Frech, Fiona K Gibbons, Monique Hinchcliff, Cheilonda Johnson, Jeffrey P Kanne, John S Kim, Sian Yik Lim, Scott Matson, Zsuzsanna H Mcmahan, Samantha J Merck, Kiana Nesbitt, Mary Beth Scholand, Lee Shapiro, Christine D Sharkey, Ross Summer, John Varga, Anil Warrier, Sandeep K Agarwal, Danielle Antin-Ozerkis, Bradford Bemiss, Vaidehi Chowdhary, Jane E Dematte D'Amico, Robert Hallowell, Alicia M Hinze, Patil A Injean, Nikhil Jiwrajka, Elena K Joerns, Joyce S Lee, Ashima Makol, Gregory C Mcdermott, Jake G Natalini, Justin M Oldham, Didem Saygin, Kimberly Showalter Lakin, Namrata Singh, Joshua J Solomon, Jeffrey A Sparks, Marat Turgunbaev, Samera Vaseer, Amy Turner, Stacey Uhl, Ilya Ivlev

Faculty, Staff and Students Publications

Objective: We provide evidence-based recommendations regarding screening for interstitial lung disease (ILD) and the monitoring for ILD progression in people with systemic autoimmune rheumatic diseases (SARDs), specifically rheumatoid arthritis, systemic sclerosis, idiopathic inflammatory myopathies, mixed connective tissue disease, and Sjögren disease.

Methods: We developed clinically relevant population, intervention, comparator, and outcomes questions related to screening and monitoring for ILD in patients with SARDs. A systematic literature review was performed, and the available evidence was rated using the Grading of Recommendations, Assessment, Development, and Evaluation methodology. A Voting Panel of interdisciplinary clinician experts and patients achieved consensus on the direction and …

Trends In Central Nervous System-Active Polypharmacy Among People With Multiple Sclerosis, Hayden Naizer, Joseph Wozny, Trudy Millard Krause, Ethan Huson, Leorah Freeman

Faculty, Staff and Student Publications

BACKGROUND: People with multiple sclerosis (pwMS) are at risk of concurrently using multiple central nervous system (CNS)-active drugs, yet the prevalence of CNS-active polypharmacy remains unmeasured in pwMS.

OBJECTIVE: The objective is to measure the prevalence of CNS-active polypharmacy in pwMS.

METHODS: This serial, cross-sectional study measured CNS-active polypharmacy in people with MS in the United States from 2008 to 2021 using insurance claims data. CNS-active polypharmacy was defined as the concurrent prescription of ⩾3 CNS-active drugs for >30 continuous days. CNS-active drugs included antidepressants, antiepileptics, antipsychotics, benzodiazepines, nonbenzodiazepine benzodiazepine receptor agonist hypnotics, opioids, and skeletal muscle relaxants.

RESULTS: The …

Associations Of Mid-To-Late-Life Inflammation With Late-Life Mobility And The Influences Of Chronic Comorbidities, Race, And Social Determinants Of Health: The Atherosclerosis Risk In Communities Study, Kirby G Parker, B Gwen Windham, Chad Blackshear, Keenan A Walker, Sara B Parker, Ron C Hoogeveen, Christie M Ballantyne, Anna Kucharska-Newton, Priya Palta, Elizabeth Selvin, Maria Vassilaki, Thomas H Mosley, Michael E Griswold

Faculty, Staff and Students Publications

Background: Relationships of midlife inflammation with late-life mobility and influences of chronic health conditions, race, and social determinants of health (SDoH) on these relationships are poorly understood.

Methods: Among 4758 community-dwelling participants (41% men, 20% Black), high-sensitivity C-reactive protein (hsCRP) was measured over 20+ years: in midlife at study visit 2 (V2: 1990-1992, 47-68 years); at V4 (1996-1998, 53-74 years); and with concurrent late-life 4-m gait speed at V5 (2011-2013, 67-88 years, mean 75 years). SDoH measures included race, the national-rank area deprivation index, education, and income. We examined associations of late-life gait speed with midlife hsCRP (V2 continuous and …

Care Fragmentation, Social Determinants Of Health, And Postoperative Mortality In Older Veterans, Carly A Duncan, Michael A Jacobs, Yubo Gao, Michael Mader, Susanne Schmidt, Heather Davila, Katherine Hadlandsmyth, Paula K Shireman, Leslie R M Hausmann, Robert A Tessler, Andrea Strayer, Mary Vaughan Sarrazin, Daniel E Hall

Faculty, Staff and Student Publications

Introduction: Veterans Affairs Surgical Quality Improvement Program (VASQIP) benchmarking algorithms helped the Veterans Health Administration (VHA) reduce postoperative mortality. Despite calls to consider social risk factors, these algorithms do not adjust for social determinants of health (SDoH) or account for services fragmented between the VHA and the private sector. This investigation examines how the addition of SDoH change model performance and quantifies associations between SDoH and 30-d postoperative mortality.

Methods: VASQIP (2013-2019) cohort study in patients ≥65 y old with 2-30-d inpatient stays. VASQIP was linked to other VHA and Medicare/Medicaid data. 30-d postoperative mortality was examined using multivariable logistic …

African American Patients Have A Higher Probability Of Cognitive Impairment After Incident Stroke: An Analysis Of National Electronic Health Record Data, Alicia Zha, Chenguang Zhang, Gen Zhu, Xinran Huang, Sahar Anjum, Yashar Talebi, Sean Savitz, Hulin Wu

Faculty, Staff and Student Publications

Background: Cognitive impairment (CI) and stroke are diseases with significant disparities in race and geography. Post stroke cognitive impairment (PSCI) can be as high as 15-70 % but few studies have utilized large administrative or electronic health records (EHR) to evaluate trends in PSCI. We utilized an EHR database to evaluate for disparities in PSCI in a large sample of patients after first recorded stroke to evaluate for disparities in race.

Methods: This is a retrospective cohort analysis of Cerner Health Facts® EHR database, which is comprised of EHR data from hundreds of hospitals/clinics in the US from 2009-2018. We …

Posttraumatic Stress Disorder And Type 2 Diabetes Outcomes In Veterans, Jeffrey F Scherrer, Joanne Salas, Wenjin Wang, Kenneth E Freedland, Patrick J Lustman, Paula P Schnurr, Beth E Cohen, Allan S Jaffe, Matthew J Friedman

2020-Current year OA Pubs

IMPORTANCE: Posttraumatic stress disorder (PTSD) symptom reduction is linked with lower risk of incident type 2 diabetes (T2D), but little is known about the association between PTSD and comorbid T2D outcomes. Whether PTSD is a modifiable risk factor for adverse T2D outcomes is unknown.

OBJECTIVE: To determine whether patients with PTSD who improved and no longer met diagnostic criteria for PTSD had a lower risk of adverse T2D outcomes compared with patients with persistent PTSD.

DESIGN, SETTING, AND PARTICIPANTS: This retrospective cohort study used deidentified data from US Veterans Health Administration (VHA) historical medical records (from October 1, 2011, to …

Parkinson’S Disease Variant Detection And Disclosure: Pd Generation, A North American Study, Lola Cook, Jennifer Verbrugge, Tae-Hwi Schwantes-An, Jeanine Schulze, Tatiana Foroud, Anne Hall, Karen S Marder, Ignacio F Mata, Niccolò E Mencacci, Martha A Nance, Michael A Schwarzschild, Tanya Simuni, Susan Bressman, Anne-Marie Wills, Hubert H Fernandez, Irene Litvan, Kelly E Lyons, Holly A Shill, Carlos Singer, Thomas F Tropea, Nora Vanegas Arroyave, Janfreisy Carbonell, Rossy Cruz Vicioso, Linn Katus, Joseph F Quinn, Priscila D Hodges, Yan Meng, Samuel P Strom, Cornelis Blauwendraat, Katja Lohmann, Cynthia Casaceli, Shilpa C Rao, Kamalini Ghosh Galvelis, Anna Naito, James C Beck, Roy N Alcalay

Faculty, Staff and Students Publications

Variants in seven genes (LRRK2, GBA1, PRKN, SNCA, PINK1, PARK7 and VPS35) have been formally adjudicated as causal contributors to Parkinson's disease; however, individuals with Parkinson's disease are often unaware of their genetic status since clinical testing is infrequently offered. As a result, genetic information is not incorporated into clinical care, and variant-targeted precision medicine trials struggle to enrol people with Parkinson's disease. Understanding the yield of genetic testing using an established gene panel in a large, geographically diverse North American population would help patients, clinicians, clinical researchers, laboratories and insurers better understand the importance of genetics in approaching Parkinson's …

The Association Between Prolonged Sars-Cov-2 Symptoms And Work Outcomes, Arjun K Venkatesh, Huihui Yu, Caitlin Malicki, Michael Gottlieb, Joann G Elmore, Mandy J Hill, Ahamed H Idris, Juan Carlos C Montoy, Kelli N O'Laughlin, Kristin L. Rising, Kari A Stephens, Erica S Spatz, Robert A Weinstein

Department of Emergency Medicine Faculty Papers

While the early effects of the COVID-19 pandemic on the United States labor market are well-established, less is known about the long-term impact of SARS-CoV-2 infection and Long COVID on employment. To address this gap, we analyzed self-reported data from a prospective, national cohort study to estimate the effects of SARS-CoV-2 symptoms at three months post-infection on missed workdays and return to work. The analysis included 2,939 adults in the Innovative Support for Patients with SARS-CoV-2 Infections Registry (INSPIRE) study who tested positive for their initial SARS-CoV-2 infection at the time of enrollment, were employed before the pandemic, and completed …

American Sanctions On China's Space Program: Effective Economic Statecraft?, Paul J. Bolt

Space and Defense

American economic statecraft as a tool to manage competition with China’s Space Program is likely to remain contentious as it amplifies enduring debates in U.S. foreign policy: i) the tension between international realism and American liberalism; ii) the questionable benefit of government involvement in picking winners and losers from the private sector; and iii) the difficulty of defining long-term success in foreign policy outcomes.

Development And Implementation Of A Digital Quality Measure Of Emergency Cancer Diagnosis, Paarth Kapadia, Andrew J Zimolzak, Divvy K Upadhyay, Saritha Korukonda, Riyaa Murugaesh Rekha, Umair Mushtaq, Usman Mir, Daniel R Murphy, Alexis Offner, Gary A Abel, Georgios Lyratzopoulos, Luke T A Mounce, Hardeep Singh

Faculty, Staff and Students Publications

PURPOSE: Missed and delayed cancer diagnoses are common, harmful, and often preventable. Automated measures of quality of cancer diagnosis are lacking but could identify gaps and guide interventions. We developed and implemented a digital quality measure (dQM) of cancer emergency presentation (EP) using electronic health record databases of two health systems and characterized the measure's association with missed opportunities for diagnosis (MODs) and mortality.

METHODS: On the basis of literature and expert input, we defined EP as a new cancer diagnosis within 30 days after emergency department or inpatient visit. We identified EPs for lung cancer and colorectal cancer (CRC) …

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 (

Accuracy, Thoroughness, And Quality Of Outpatient Primary Care Documentation In The U.S. Department Of Veterans Affairs., Michael Weiner, Mindy E Flanagan, Katie Ernst, Ann H Cottingham, Nicholas A Rattray, Zamal Franks, April W Savoy, Joy L Lee, Richard M Frankel

Health Services and Informatics Research

BACKGROUND: Electronic health records (EHRs) can accelerate documentation and may enhance details of notes, or complicate documentation and introduce errors. Comprehensive assessment of documentation quality requires comparing documentation to what transpires during the clinical encounter itself. We assessed outpatient primary care notes and corresponding recorded encounters to determine accuracy, thoroughness, and several additional key measures of documentation quality.

METHODS: Patients and primary care clinicians across five midwestern primary care clinics of the US Department of Veterans Affairs were recruited into a prospective observational study. Clinical encounters were video-recorded and transcribed verbatim. Using the Physician Documentation Quality Instrument (PDQI-9) added to …

Dietary Acculturation Is Associated With Altered Gut Microbiome, Circulating Metabolites, And Cardiovascular Disease Risk In Us Hispanics And Latinos: Results From Hchs/Sol, Yi Wang, Guo-Chong Chen, Zheng Wang, Kai Luo, Yanbo Zhang, Yang Li, Amanda C Mcclain, Marta M Jankowska, Krista M Perreira, Josiemer Mattei, Carmen R Isasi, Maria M Llabre, Bharat Thyagarajan, Martha L Daviglus, Linda Van Horn, David Goldsztajn Farelo, Luis E Maldonado, Steven R Levine, Bing Yu, Eric Boerwinkle, Rob Knight, Robert D Burk, Robert C Kaplan, Qibin Qi, Brandilyn A Peters

Faculty, Staff and Student Publications

Background: Dietary acculturation, or adoption of dominant culture diet by migrant groups, influences human health. We aimed to examine dietary acculturation and its relationships with cardiovascular disease (CVD), gut microbiota, and blood metabolites among US Hispanic and Latino adults.

Methods: In the HCHS/SOL (Hispanic Community Health Study/Study of Latinos), US exposure was defined by years in the United States (50 states and Washington, DC) and US nativity. A dietary acculturation pattern was derived from 14 172 participants with two 24-hour dietary recalls at baseline (2008-2011) using least absolute shrinkage and selection operator regression, with food groups as predictors of US …

Nrg Oncology And Particle Therapy Co-Operative Group Patterns Of Practice Survey And Consensus Recommendations On Pencil-Beam Scanning Proton Stereotactic Body Radiation Therapy And Hypofractionated Radiation Therapy For Thoracic Malignancies, Wei Liu, Hongying Feng, Paige A Taylor, Minglei Kang, Jiajian Shen, Jatinder Saini, Jun Zhou, Huan B Giap, Nathan Y Yu, Terence S Sio, Pranshu Mohindra, Joe Y Chang, Jeffrey D Bradley, Ying Xiao, Charles B Simone, Liyong Lin

Faculty, Staff and Student Publications

Stereotactic body radiation therapy (SBRT) and hypofractionation using pencil-beam scanning (PBS) proton therapy (PBSPT) is an attractive option for thoracic malignancies. Combining the advantages of target coverage conformity and critical organ sparing from both PBSPT and SBRT, this new delivery technique has great potential to improve the therapeutic ratio, particularly for tumors near critical organs. Safe and effective implementation of PBSPT SBRT/hypofractionation to treat thoracic malignancies is more challenging than the conventionally fractionated PBSPT because of concerns of amplified uncertainties at the larger dose per fraction. The NRG Oncology and Particle Therapy Cooperative Group Thoracic Subcommittee surveyed proton centers in …

Community-Based Participatory Obesity Prevention Interventions In Rural Communities: A Scoping Review, Saagar Dhanjani, Haley Allen, Beatriz Varman, Chishinga Callender, Jayna M Dave, Debbe Thompson

Library Staff Publications

Child obesity is a worldwide public health concern. In America, children from rural areas have greater odds of obesity in comparison to those from urban areas. Community-engaged research is important for all communities, particularly under-represented communities. This paper reports the results of a scoping review investigating community-engaged research in obesity prevention programs tested with school-aged children in rural America. A literature search of Medline Ovid was conducted to identify interventions reporting the results of obesity prevention interventions that promoted a healthy diet or physical activity (PA) behaviors to school-age children in rural communities of the United States (US). After title …

Urban-Rural Disparities In Food Insecurity And Weight Status Among Children In The United States, Jayna M Dave, Tzuan A Chen, Alexandra N Castro, Mamie A White, Elizabeth A Onugha, Sloane Zimmerman, Debbe Thompson

Children’s Nutrition Research Center Staff Publications

Place of residence (urban versus rural) is a contextual determinant of health that has received less attention in the food insecurity literature. The purpose of this study was to assess the urban–rural disparity in the prevalence of food insecurity and weight status among US children. Using data from the National Health and Nutrition Examination Survey (NHANES) 2013–2016 with three age groups of children (2–5, 6–11, and 12–17 years old), the associations of weight status and child and household food security status by urban–rural residence were examined using Rao–Scott Chi-square tests. Statistical significance was set at p < 0.05. Children living in urban areas were significantly more likely to experience household food insecurity (29.15%) compared to their rural counterparts (19.10%), among those aged 6–11 years. The associations between children’s weight status and child and household food security status were significant for children living in urban areas overall and different age groups but not for children living in rural areas. These trends were more pronounced in older age groups. Given the link between food insecurity and higher obesity rates, particularly among urban children, this study highlights the importance of incorporating food security interventions into future obesity prevention programs.

A/B Testing Of User Enrollment Forms To Enhance Diversity In The Biomedical Workforce Via The National Research Mentoring Network: User-Centered Design Case Study, Toufeeq Ahmed Syed, Erika L Thompson, Jason Johnson, Zainab Latif, Nan Kennedy, Damaris Javier, Katie Stinson, Jamboor K Vishwanatha

Faculty, Staff and Student Publications

BACKGROUND: The National Research Mentoring Network (NRMN) is a National Institutes of Health-funded program for diversifying the science, technology, engineering, math, and medicine research workforce through the provision of mentoring, networking, and professional development resources. The NRMN provides mentoring resources to members through its online platform-MyNRMN.

OBJECTIVE: MyNRMN helps members build a network of mentors. Our goal was to expand enrollment and mentoring connections, especially among those who have been historically underrepresented in biomedical training and the biomedical workforce.

METHODS: To improve the ease of enrollment, we implemented the split testing of iterations of our user interface for platform registration. …

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.

Myalgic Encephalomyelitis/Chronic Fatigue Syndrome After Sars-Cov-2 Infection, Elizabeth R. Unger, Jin-Mann S. Lin, Lauren E. Wisk, Huihui Yu, Michelle L'Hommedieu, Helen Lavretsky, Juan Carlos C. Montoy, Michael A. Gottlieb, Kristin L. Rising, Nicole L. Gentile, Michelle Santangelo, Arjun K. Venkatesh, Robert M. Rodriguez, Mandy J. Hill, Rachel E. Geyer, Efrat R. Kean, Sharon Saydah, Samuel A. Mcdonald, Ryan Huebinger, Ahamed H. Idris, Jocelyn Dorney, Bala Hota, Erica S. Spatz, Kari A. Stephens, Robert A. Weinstein, Joann G. Elmore

Department of Emergency Medicine Faculty Papers

IMPORTANCE: Chronic symptoms reported following an infection with SARS-CoV-2, such as cognitive problems, overlap with symptoms included in the definition of myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS).

OBJECTIVE: To evaluate the prevalence of ME/CFS-like illness subsequent to acute SARS-CoV-2 infection, changes in ME/CFS symptoms through 12 months of follow-up, and the association of ME/CFS symptoms with SARS-CoV-2 test results at the acute infection-like index illness.

DESIGN, SETTING, AND PARTICIPANTS: This prospective, multisite, longitudinal cohort study (Innovative Support for Patients with SARS-CoV-2 Infections Registry [INSPIRE]) enrolled participants from December 11, 2020, to August 29, 2022. Participants were adults aged 18 to 64 …

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 …

Genetic Correlations Between Liver Fat Content, Metabolic Health, And Adiposity Distribution In The Fels Longitudinal Study, Ariana L Garza, Miryoung Lee, John Blangero, Cici X Bauer, Stefan A Czerwinski, Audrey C Choh

Faculty, Staff and Student Publications

Background and aims: Hepatic steatosis is known to be heritable, but its genetic basis is mostly uncharacterized. Steatosis is associated with metabolic and adiposity features; recent studies hypothesize that shared genetic effects between these traits could account for some of the unexplained heritability. This study aimed to quantify these genetic associations in a family-based sample of non-Hispanic white adults.

Methods and results: 704 participants (18-95 years, 55.8% female) from the Fels Longitudinal Study with an MRI assessment of liver fat were included. Quantitative genetic analyses estimated the age- and sex-adjusted heritability of individual traits and the genetic correlations within trait …