Medicine and Health Sciences Commons^™

Hospital Variation In Costs – A Challenge To The Value Proposition, Aaron B. Caughey, Jonathan M. Snowden

OHSU-PSU School of Public Health Faculty Publications and Presentations

Mini Commentary on 2017-OG-19978R1: Hospital Variation in Cost of Childbirth and Contributing Factors: A Cross-Sectional Study. To view this article visit https://doi.org/10.1111/1471-0528.15007.

The Malaria Testing And Treatment Landscape In Kenya: Results From A Nationally Representative Survey Among The Public And Private Sector In 2016., Kathryn A. O'Connell, Vamsi Vasireddy, Megan Littrell, Andria Rusk, Actwatch Group, Anne Musuva, Waqo Ejersa, Rebecca Kiptui, Dorothy Memusi, Edward Abwao

Collected Faculty and Staff Scholarship

BACKGROUND: Since 2004, Kenya's national malaria treatment guidelines have stipulated artemisinin-based combination therapy (ACT) as first-line treatment for uncomplicated malaria, and since 2014, confirmatory diagnosis of malaria in all cases before treatment has been recommended. A number of strategies to support national guidelines have been implemented in the public and private sectors in recent years. A nationally-representative malaria outlet survey, implemented across four epidemiological zones, was conducted between June and August 2016 to provide practical evidence to inform strategies and policies in Kenya towards achieving national malaria control goals.

RESULTS: A total of 17,852 outlets were screened and 2271 …

Multiple-Modality Exercise And Mind-Motor Training To Improve Mobility In Older Adults: A Randomized Controlled Trial, Narlon Cassio Boa Sorte Silva, Dawn P. Gill, Michael A. Gregory, John Bocti, Robert Petrella

Lifestyle Research Team

Objective:

To investigate the effects of multiple-modality exercise with or without additional mind-motor training on mobility outcomes in older adults with subjective cognitive complaints.

Methods:

This was a 24-week randomized controlled trial with a 28-week no-contact follow-up. Community-dwelling older adults underwent a thrice -weekly, Multiple-Modality exercise and Mind-Motor (M4) training or Multiple-Modality (M2) exercise with an active control intervention (balance, range of motion and breathing exercises). Study outcomes included differences between groups at 24 weeks and after the no-contact follow-up (i.e., 52 weeks) in usual and dual-task (DT, i.e., serial sevens [S7] and phonemic verbal fluency [VF] tasks) gait velocity, …

When It Just Won't Go Away: Oral Artemisinin Monotherapy In Nigeria, Threatening Lives, Threatening Progress., Kathryn A. O'Connell, Vamsi Vasireddy, Megan Littrell, Andria Rusk, Actwatch Group, Chinazo Ujuju, Jennifer Anyanti, Paul N Newton, Godwin Ntadom

Collected Faculty and Staff Scholarship

BACKGROUND: Oral artemisinin monotherapy (AMT), an important contributor to multi-drug resistant malaria, has been banned in Nigeria. While oral AMT has scarcely been found for several years now in other malaria-endemic countries, availability has persisted in Nigeria's private sector. In 2015, the ACTwatch project conducted a nationally representative outlet survey. Results from the outlet survey show the extent to which oral AMT prevails in Nigeria's anti-malarial market, and provide key product information to guide strategies for removal.

RESULTS: Between August 10th and October 3rd, 2015 a total of 13,480 outlets were screened for availability of anti-malarials and/or malaria blood testing …

Social Marketing For A Farmer's Market In An Underserved Community: A Needs Assessment, Meg Skizim, Melinda Sothern, Ondrej Blaha, Tung-Sung Tseng, Lauren Griffiths, Jonathan Joseph, Henry Nuss

School of Public Health Faculty Publications

The aim of the present paper is to assess local residents' awareness of utilizing Supplemental Nutrition Assistance Program (SNAP) benefits to purchase fresh produce at local farmers' markets, and to determine internet use and media preferences of study participants prior to implementation of a social marketing campaign. A needs assessment was conducted to collect baseline data in an underserved neighbourhood in New Orleans (La, USA). The study was carried out August 2014-May 2015. The assessment revealed that 73% of the respondents were unaware that the SNAP benefits could be used to purchase food in farmers' markets; 63% of low-income participants …

Impacts Of Active School Design On Schooltime Sedentary Behavior And Physical Activity: A Pilot Natural Experiment, Jeri Brittin, Leah Frerichs, John R. Sirard, Nancy M. Wells, Beth M. Myers, Jeanette Garcia, Dina Sorensen, Matthew J. Trowbridge, Terry Huang

Interior Design Program: Faculty Scholarly and Creative Activity

Background Children spend a significant portion of their days in sedentary behavior (SB) and on average fail to engage in adequate physical activity (PA). The school built environment may influence SB and PA, but research is limited. This natural experiment evaluated whether an elementary school designed to promote movement impacted students' school-time SB and PA.

Methods Accelerometers measured SB and PA at pre and post time-points in an intervention group who moved to the new school (n = 21) and in a comparison group experiencing no school environmental change (n = 20). Difference-in-difference (DD) analysis examined SB and PA outcomes …

Hockey Fans In Training: A Pilot Pragmatic 1 Randomized Controlled Trial, Robert Petrella, Dawn P. Gill, Guangyong Zou, Ashleigh De Cruz, Brendan Riggin, Cassandra Bartol, Karen Danylchuk, Kate Hunt, Sally Wyke, Cindy M. Gray, Christopher Bunn, Merrick Zwarenstein

Lifestyle Research Team

Introduction Hockey Fans in Training (Hockey FIT) is a gender-sensitized weight loss and healthy lifestyle program. We investigated 1) feasibility of recruiting and retaining overweight and obese men into a pilot pragmatic randomized controlled trial and 2) potential for Hockey FIT to lead to weight loss and improvements in other outcomes at 12 wk and 12 months.

Methods Male fans of two ice hockey teams (35–65 yr; body mass index ≥28 kg·m−2) located in Ontario (Canada) were randomized to intervention (Hockey FIT) or comparator (wait-list control). Hockey FIT includes a 12-wk active phase (weekly, coach-led group meetings including provision of …

Albuminuria And Kidney Function As Prognostic Marker Of Left Ventricular Mass Among South Asians With Hypertension, Liang Feng, Aamir Hameed, Imtiaz Jehan, John Allen, Tazeen Jafar

Section of Cardiology

We aimed to evaluate the association of albuminuria and estimated glomerular filtration rate (eGFR) at baseline and changes in these parameters with left ventricular mass index (LVMI) at 7 years in adults with hypertension from communities in Pakistan. A nested cohort of 539 hypertensives aged 40 years and older from a community-living population in Karachi, Pakistan, followed up for 7 years in the Control of Blood Pressure and Risk Attenuation trial. Urine spot albumin-to-creatinine ratio (UACR) and serum creatinine-based eGFR were assessed at baseline and 7 years, and echocardiography at 7 years. Mean age of participants was 50.9 ± 9.1 …

Patients’ Willingness To Participate In Rapid Hiv Testing: A Pilot Study In Three New York City Dental Hygiene Clinics, Susan H. Davide, Anthony J. Santella, Winnie Furnari, Petal Leuwaisee, Marilyn Cortell, Bhuma Krishnamachari

Publications and Research

Purpose: One in eight people living with an HIV infection in the United States is unaware of their status. Rapid HIV testing (RHT) is an easily used and accepted screening tool that has been introduced in a limited number of clinical settings. The purpose of this study was to investigate patient acceptability, certainty of their decision, and willingness to pay for screening if RHT was offered in university-based dental hygiene clinics.

Methods: A cross-sectional survey was administered to 426 patients at three dental hygiene clinics in New York City over a period of four months. The survey questionnaire was based …

Optimization Of The Hockey Fans In Training (Hockey Fit) Weight Loss And Healthy Lifestyle Program For Male Hockey Fans, Wendy Blunt, Dawn P. Gill, Shannon Sibbald, Brendan Riggin, Roseanne Pulford, Ryan Scott, Karen Danylchuk, Cindy M. Gray, Sally Wyke, Christopher Bunn, Robert Petrella

Lifestyle Research Team

BACKGROUND:

The health outcomes of men continue to be poorer than women globally. Challenges in addressing this problem include difficulties engaging men in weight loss programs as they tend to view these programs as contrary to the masculine narrative of independence and self-reliance. Researchers have been turning towards sports fans to engage men in health promotion programs as sports fans are typically male, and tend to have poor health habits.

METHODS:

Developed from the highly successful gender-sensitized Football Fans in Training program, Hockey Fans in Training (Hockey FIT) recruited 80 male hockey fans of the London Knights and Sarnia Sting …

Associations Of Hiv Risk Behaviors Among Older Latinas And Their Adult Daughters, Gira J. Ravelo

FIU Electronic Theses and Dissertations

This dissertation examines the associations between adult Latina daughters’ HIV risk behaviors and that of their older Latina mothers’ HIV risk behaviors. The central hypothesis of the study is that adult Latina daughters’ influence their older mothers’ behaviors and that such behaviors interact with the level of their attachment.

Older Latinas are a vulnerable population that face cultural risk factors, health care provider bias, and engage in low rates of HIV testing. The primary mode of HIV infection for Latinas is through heterosexual contact. Yet, traditional gender norms such as marianismo belief place pressure on Latina women to be submissive …

Why Women Suffer Domestic Violence In Silence: Web-Based Responses To A Blog, Salima Farooq, Tazeen Saeed Ali, Yasmin Parpio, Nasreen Lalani, Muecke Marjorie

School of Nursing & Midwifery

Background & Aim: Domestic violence (DV) is a global socio-cultural concern faced by a majority of women. DV has a negative impact on women’s social, physical, and psychological wellbeing. Objective was to explore perceptions regarding contributing factors to domestic violence among women.
Methods & Materials: A qualitative descriptive exploratory method was applied for the study. Purposive sampling was used to select participants through emails to respond to the web based blog created for the study. 41 worldwide participants shared their perceptions through the blogs in the study. The data were collected using a web-based discussion forum on the Urban Women …

Ventricular Depolarisation Vectors In Exercise Induced Myocardial Ischaemia, Cameruddin W. Vellani, Mohammad Yusuf, Sadia Mahmud, Satwat Hashmi

Section of Cardiology

Ischaemia reduces membrane excitability and conduction of myocardial depolarisation. This would alter the synergy of electromotive forces that contribute to a resultant force at any instant. Changes in magnitude and direction of resultant forces are reflected in electrocardiographic signals. Here we show a method for obtaining the coordinates of resultant electrical forces during exercise derived from a bipolar orthogonal lead system for calculation of electrical vectors in three planes. In a trial, analysis of changes in vectors indicated that the extent of reduction in magnitude with exercise was significantly greater in groups of patients categorized by impaired effort tolerance and …

Risk Associated With E-Cigarette Use And Marketing Messages On Other Tobacco Products Use And Dependence Symptoms Among Adolescents, Rehab Auf

FIU Electronic Theses and Dissertations

E-cigarettes became available in the United States during 2007. Studies using national data have found an increase in e- cigarette use among adolescents as early as 2011. In 2014, e-cigarettes became the most commonly used tobacco product among adolescents; however, little is known about its association with other tobacco products use. Therefore, the present study aimed to: 1) Examine the association between initiating tobacco use via e-cigarettes and subsequent use of other tobacco products; 2) Examine the association between the exposure to e-cigarettes marketing messages and tobacco use; 3) Describe symptoms of nicotine dependence associated with e-cigarette use, compared with …

Pilot Test Results Of A Video-Based Hiv Intervention For Chinese College Students In The United States, Wei-Chen Tung, Minggen Lu, Rudolph Rull, Wei Yang

Faculty Publications

Background: No culturally relevant and appropriate HIV/sexually transmitted infection (STI) programs are available to Chinese college students in the United States. This study evaluated the effectiveness of a translated Center for Disease Control and Prevention (CDC) intervention, Video Opportunities for Innovative Condom Education and Safer Sex (VOICES), to change condom use intention and self-efficacy, perceived benefits and barriers, and HIV/AIDS knowledge among Chinese students in a U.S. university. The VOICES program includes video viewing and a facilitated small-group discussion.

Methods: A quasi-experimental design with single-group pretest-posttest was conducted in Chinese. Chinese students (N=67) from a local university were recruited to …

Community-Based Distribution Of Iron-Folic Acid Supplementation In Low- And Middle-Income Countries: A Review Of Evidence And Programme Implications., Justine A Kavle, Megan Landry

Prevention and Community Health Faculty Publications

The present literature review aimed to review the evidence for community-based distribution (CBD) of iron–folic acid (IFA) supplementation as a feasible approach to improve anaemia rates in low- and middle-income countries.

The literature review included peer-reviewed studies and grey literature from PubMed, Cochrane Library, LILAC and Scopus databases.

Low- and middle-income countries.

Non-pregnant women, pregnant women, and girls.

CBD programmes had moderate success with midwives and community health workers (CHW) who counselled on health benefits and compliance with IFA supplementation. CHW were more likely to identify and reach a greater number of women earlier in pregnancy, as women tended to …

Lung Cytokines And Systemic Inflammation In Patients With Copd., Alessandra Morello Gearhart, Rodrigo Cavallazzi, Paula Peyrani, Timothy L. Wiemken, Stephen P. Furmanek, Andrea Reyes-Vega, Umair Gauhar, Hiram Rivas-Perez, Jesse Roman, Julio A. Ramirez, Rafael Fernandez-Botran

Faculty Scholarship

Rationale: Chronic obstructive pulmonary disease (COPD) is characterized by lung and systemic inflammation. The role of cytokines in local and systemic inflammation in COPD is not well understood. This study aimed to compare plasma and bronchoalveolar lavage (BAL) fluid cytokine levels in COPD and non-COPD subjects with the intent of better understand their potential roles in driving local and systemic inflammation.

Methods: This cross-sectional study analyzed data from 65 subjects: 31 with COPD confirmed by spirometry and 34 non-COPD controls. All subjects underwent spirometry, plasma sample collection, and bronchoscopy/BAL. Levels of 21 inflammatory cytokines were measured in the plasma (systemic …

How Useful Is Gsv As An Environmental Observation Tool? An Analysis Of The Evidence So Far., Katherine Nesse, Leah Airt

SPU Works

Researchers in many disciplines have turned to Google Street View to replace pedestrian- or carbased in-person observation of streetscapes. It is most prevalent within the research literature on the relationship between neighborhood environments and public health but has been used as diverse as disaster recovery, ecology and wildlife habitat, and urban design. Evaluations of the tool have found that the results of GSV-based observation are similar to the results from in-person observation although the similarity depends on the type of characteristic being observed. Larger, permanent and discrete features showed more consistency between the two methods and smaller, transient and judgmental …

Managing The Cost Of Diabetes, Laressa Bethishou

Pharmacy Faculty Articles and Research

"This is of concern to health care providers because inadequate management of diabetes results in short- and long-term complications. Patients with diabetes and no health insurance have fewer physician visits and are prescribed fewer medications for management of their diabetes. Patients with diabetes make up 11.9% of all emergency department visits in the United States.Hispanic and non-Hispanic blacks are at greater risk for developing diabetes and serious associated health complications, including chronic kidney disease. This may be attributed to a combination of genetics, diet, and exercise. However, access to health care resources may also play an important role."

Marketing Strategies To Encourage Rural Residents Of High-Obesity Counties To Buy Fruits And Vegetables In Grocery Stores, Emily Liu, Tammy Stephenson, Jessica Houlihan, Alison Gustafson

Dietetics and Human Nutrition Faculty Publications

Introduction

Obesity rates in Appalachia are among the highest in the United States, and knowledge of upstream approaches to decrease prevalence among this vulnerable population is limited. The primary aim of this study was to examine the association between healthy, diet-based, social marketing interventions in grocery stores and frequency of fruit and vegetable intake.

Methods

A social marketing campaign was conducted among 17 grocery stores (N = 240 participant surveys) over 4 months in 5 rural Kentucky counties. Interventions included providing food samples, recipe cards, and promotional discounts on fruits and vegetables and moving high-calorie foods to side aisles.

Results …

Does First Sex Really “Just Happen?” A Retrospective Exploratory Study Of Sexual Debut Among American Adolescents, Lisa D. Lieberman, Eva S. Goldfarb, Samantha Kwiatkowski, Paul Santos

Department of Public Health Scholarship and Creative Works

First sex marks a significant transition for most adolescents, yet teens often report that it was unplanned. Seventy-four college students participated in exploratory focus groups about their first sex. Although initially asked whether their first sex was spontaneous or planned, many participants revealed evidence of forethought or anticipation, signifying a third option, anticipation. This study suggests that the development and timing of sexual health messages should build on the apparent, albeit often unacknowledged, planning and thought that accompany the transition to first sex. Specifically, during the time immediately preceding first sex, young people might be particularly open to such messages.

Assessing The National Cancer Institute's Smokefreemom Text-Messaging Program For Pregnant Smokers: Pilot Randomized Trial., Lorien C Abroms, Shawn Chiang, Laura Macherelli, Leah Leavitt, Margaret Montgomery

Prevention and Community Health Faculty Publications

BACKGROUND: Automated text messages on mobile phones have been found to be effective for smoking cessation in adult smokers.

OBJECTIVE: This study aims to test the acceptability and feasibility of SmokefreeMOM, a national smoking cessation text-messaging program for pregnant smokers.

METHODS: Participants were recruited from prenatal care and randomized to receive SmokefreeMOM (n=55), an automated smoking cessation text-messaging program, or a control text message quitline referral (n=44). Participants were surveyed by phone at baseline and at 1 month and 3 months after enrollment.

RESULTS: Results indicate that the SmokefreeMOM program was highly rated overall and rated more favorably than the …

Increasing Empathy And Conflict Resolution Skills Through Nonviolent Communication (Nvc) Training In Latino Adults And Youth, Marcianna Nosek, Maite Durán

Nursing and Health Professions Faculty Research and Publications

Background: Children of Latino immigrants often are torn between their native homes and new communities. Having supportive interpersonal relationships increases resilience to delinquent and violent behaviors stemming from immigration challenges. Communication fostering empathy may improve conflict resolution and supportive relationships.

Objectives: Community-based participatory research (CBPR) was conducted to evaluate the impact of nonviolent communication (NVC) trainings in Latino adults and youth.

Methods: Four sessions in NVC were provided by bilingual Latino trainers for Latino adults and youth. Pre- and post-training focus groups evaluated effectiveness of training.

Results: Three themes emerged from adult post training focus groups—enter the others’ shoes, making …

Vaccine And Cognitive Development: The Mmr Vaccine And The Supposed Effect On Autism Spectrum Disorder, Savannah Dorband

Student Writing

Autism Spectrum Disorder is being diagnosed more commonly among children today because of the constant change in parameters of the spectrum. This expansion of the spectrum has come to encompass many children, leading many parents to argue as to why their child is determined to be on the spectrum. Parents will argue that the child seems perfectly fine, or they were before they got any of their vaccines. Theories have developed that vaccines cause ASD (Autism Spectrum Disorder), specifically the Measles-Mumps-Rubella vaccine. Commonly referred to as the MMR vaccine, many parents and homeopathic professionals believe that there is a component …

Community Paramedicine Pilot Programs: Lessons From Maine, Karen B. Pearson Mlis, Ma, George Shaler Mph

Emergency Medical Services (EMS)

Community paramedicine programs are beginning to flourish across the nation, and the need to provide demonstration or pilot programs is essential to providing a consistent and high-level standard for this model of care. While the overarching goals are to align with the Triple Aim, piloting a community paramedicine program also allows each community to develop and implement a program tailored to the healthcare needs of their specific community. A successful program builds the evidence base that can then be used to create legislative change necessary to financially sustain this model of care across the healthcare delivery system. This article provides …

Hiv Harm Reduction Methods: A Comparison Between Switzerland And The United States, Erin Major

Independent Study Project (ISP) Collection

This paper explores the connections between harm reduction methods and the prevalence of HIV/AIDS in Switzerland and the United States of America, focusing primarily on the harm reduction methods of needle exchange programs, safe drug consumption spaces, and sex education. While these two countries are largely similar in their culture and geopolitical approaches, there are some key differences in how HIV is approached in each. Switzerland’s somewhat unique approach with relaxed drug policies and more pragmatic, harm reduction based response to the AIDS epidemic sets a model framework for other countries to follow, with comparatively widespread use of needle exchange …

A Comparative Study Of The Barriers To Hiv Self-Management Among Myanmar Migrant And Han Chinese Women In Yunnan, China, Anna Gaden

Independent Study Project (ISP) Collection

HIV has transitioned from high-risk populations to the general population through sexual transmission – now the primary mode of transmission in China – and is currently the biggest public health crisis in China. Those who are not directly involved with commercial sex work (CSW) or intravenous drug use (IDU) are now vulnerable to contraction. Han Chinese women, especially young women, are generally more vulnerable to transmission than their male counterparts, both physically and socially, and the virus affects their lives more deeply. Myanmar migrant women are even more vulnerable, as their migrant status leaves them without support structures or protections …

Migration And Sexual Health Among Gay Latino Migrants To Canada, Barry D. Adam

Sociology, Anthropology, and Criminology Publications

This paper enquires into the nexus of migration with sexual health among gay Latino migrants in Canada. Interviews with 25 Spanish-speaking interviewees are examined in light of models developed from studies of Latinos in the United States. Canadian immigration policy appears to result in a somewhat different selection of immigrants compared to the United States. Migrants come from a wide range of national and regional backgrounds intersected by race, generation, and social class that influence their perceptions of and adjustment to Canadian society. Pre-migration HIV knowledge varied strongly by generation with older men recalling public panic concerning HIV and younger …

Women Of Leh Town, Ladakh: An Overview Of Perceptions Of Health, Health-Seeking Behaviors, And Access To Health Care, Sophia Marion

Independent Study Project (ISP) Collection

The following study seeks to investigate access to health care services and perceptions of health care among women residing in traditional farming communities around the Ladakh region, and to analyze perspectives on health, health-seeking behavior, and access to health care. This project was prompted by the fact that health care in this region is understudied. This study also focuses on marginalized communities including local women and immigrant women. Methods used for the collection of data were qualitative interviews conducted with 24 women, as well as an amchi worker, doctors, and informal and formal conversations with people from different nongovernmental Organizations …

Retrospective Cohort Study Of The Efficacy Of Azithromycin Vs. Doxycycline As Part Of Combination Therapy In Non-Intensive Care Unit Veterans Hospitalized With Community-Acquired Pneumonia, Justin Spivey, Heather Sirek, Robert Wood, Kalpit Devani, Billy Brooks, Jonathan Moorman

ETSU Faculty Works

The IDSA Community-Acquired Pneumonia (CAP) Guideline recommends ceftriaxone in combination with doxycycline as an alternative to combination therapy with ceftriaxone and azithromycin for non-intensive care unit (ICU) patients hospitalized with CAP. This is an attractive alternative regimen due to recent concerns of increased cardiovascular risk associated with azithromycin. The objective of this study was to compare the clinical outcomes of azithromycin and doxycycline each in combination with ceftriaxone for non-ICU Veterans hospitalized with CAP.