Medicine and Health Sciences Commons^™

Interrupted Time Series Analysis To Evaluate The Performance Of Drug Overdose Morbidity Indicators Shows Discontinuities Across The Icd-9-Cm To Icd-10-Cm Transition, Hannah Yang, Emilia Pasalic, Peter Rock, James W. Davis, Sarah Nechuta, Ying Zhang

Peer Reviewed Articles

Introduction: On 1 October 2015, the USA transitioned from the International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM) to the International Classification of Diseases, 10th Revision (ICD-10-CM). Considering the major changes to drug overdose coding, we examined how using different approaches to define all-drug overdose and opioid overdose morbidity indicators in ICD-9-CM impacts longitudinal analyses that span the transition, using emergency department (ED) and hospitalisation data from six states’ hospital discharge data systems.

Methods: We calculated monthly all-drug and opioid overdose ED visit rates and hospitalisation rates (per 100 000 population) by state, starting in January 2010. We applied …

Impact Of Benzodiazepines And Polysubstance Status On Repeat Non-Fatal Drug Overdoses, Sarah Mayberry, Sarah Nechuta, Shanthi Krishnaswami

Peer Reviewed Articles

Research has shown that benzodiazepines and mental health disorders can increase the likelihood of repeat overdose, but researcher have not explored this association in Tennessee (TN). We examined benzodiazepines, polysubstance overdose status with/without benzodiazepines, and mental health comorbidities with repeat overdose using statewide data in TN. This study analyzed TN hospital discharge data on nonfatal overdoses for patients ages 18–64 from 2012 to 2016 for 21,066 patients with an initial inpatient visit and 36,244 patients with an initial outpatient visit. The study assessed each patient at one year after initial overdose to determine likelihood of repeat overdose. We used a …

Improving Health Care Accessibility Among Geriatric Patients In Rural Communities, Capriana Calvachi

Honors Projects

The following literature review and analysis compiles information regarding ways to improve rural geriatric healthcare accessibility through the use of interprofessional care and outreach. I also wish to bring to light the various deficiencies often seen in this realm of care, and the reasons behind the inadequate rural physician retention rates. Using this background information, I compiled various collaborative approaches which seek to ease the strain faced by the healthcare system and its elderly patients.

Improving healthcare accessibility through the use of interprofessional care and outreach is an essential facet in geriatric medicine. By exploring the deficiencies of geriactric healthcare …

Descriptive Exploration Of Overdose Codes In Hospital And Emergency Department Discharge Data To Inform Development Of Drug Overdose Morbidity Surveillance Indicator Definitions In Icd-10-Cm, Leigh M. Tyndall Snow, Katelyn E. Hall, Cody Curtis, Allison L. Rosenthal, Emilia Pasalic, Sarah Nechuta, James W. Davis, Bretta Jane Jacquemin, Sherani R. Jagroep, Peter Rock, Elyse Contreras, Barbara A. Gabella, Katherine A. James

Peer Reviewed Articles

Background: In October 2015, discharge data coding in the USA shifted to the International Classification of Diseases, 10th Revision, Clinical Modification (ICD-10-CM), necessitating new indicator definitions for drug overdose morbidity. Amid the drug overdose crisis, characterising discharge records that have ICD-10-CM drug overdose codes can inform the development of standardised drug overdose morbidity indicator definitions for epidemiological surveillance.

Methods: Eight states submitted aggregated data involving hospital and emergency department (ED) discharge records with ICD-10-CM codes starting with T36-T50, for visits occurring from October 2015 to December 2016. Frequencies were calculated for (1) the position within the diagnosis billing fields where …

A Health Care Comparison Of Areas In Ghana And In The United States, Lindsey Matsumoto

Honors Projects

The health care system is an important factor for the well-being of the human population all around the world, and yet, health care can differ greatly depending on a variety of factors including location and culture. When referring to health care, it is appropriate to include skilled physicians, hospitals, care clinics, and medical equipment. This article conducts a literature review that compares the health care systems of two countries, the Republic of Ghana and the United States of America. This information is relevant for not only expanding one’s knowledge, but also for travel purposes, as both countries have highly populated …

Comparing The Care Of Pregnant Women In Ghana And The United States, Olivia Zander

Honors Projects

During pregnancy, factors such as maternal nutrition, location of delivery, the number of antenatal care visits, maternal age, and more can all impact the health of both the mother and the developing fetus. All of these factors are subject to change based on where the mother lives and the resources that her country has to offer her. The objective of this paper was to compare and contrast the nutritional and non-nutritional care of pregnant women in Ghana and the United States and its impact on maternal/child mortality in the two countries. The information collected for this project was taken from …

Teaching Health Education Through The Development Of Student Centered Video Assignment, Heather M. Wallace, Julia Vandermolen

Peer Reviewed Articles

The purpose of this study was to explore the ways in which a student centered video assignment enhanced student learning about developing and teaching a health education plan designed to address a complex public health problem. The objectives of the assignment included (1) to explore a complex public health problem, (2) practice developing a corresponding health education plan, and (3) develop and fully execute a multimedia video to deliver high impact health education and or promotion to a diverse audience. The assignment referred to as the student centered video assignment was developed and piloted at Grand Valley State University and …

The Role Of Spirituality And 12 Step Groups In Addressing Treatment Fear And Worry Among Head And Neck Cancer Patients, Heather M. Wallace

Funded Articles

Diagnosis of head and neck squamous cell carcinoma (HNSCC) presents a multifarious problem. Because of uncertainty regarding appropriate clinical treatment, as well as the high potential for disfigurement and functional loss resulting in diminished quality of life (QOL), satisfactory patient participation in quality decision-making is critical. Previous research has consistently revealed that older adults frequently defer decisionmaking to their physician and make decisions more quickly than younger adults. Research also suggests that lay health beliefs, past experiences and various strategies of emotional regulation, based on perceptions of the quantity and quality of remaining time till death, may influence the decisionmaking …

Examining The Effect Of A Hypothetical Safe Injection Facility On Hiv And Hcv Transmission Rates In Kent County, Michigan, Trevor Ditmar

McNair Scholars Manuscripts

Previous literature has established that increases in prescription opioid misuse has resulted in similar increases in injection drug use (IDU), collectively referred to as the “opioid epidemic” in the US. Due to this surge in IDU, incidence of Hepatitis C (HCV) and Human Immunodeficiency Virus (HIV) are on the rise in many regions. Research conducted in Canada and elsewhere has supported the use of Safe Injection Facilities (SIFs) and Needle Syringe Programs (NSPs) to mollify disease incidence, but only NSPs are operating in the US despite SIFs having been in use in Canada for several decades. As little research has …

Dominican Sisters Quality Of Life Assessment, Eva Vanartsen

Other Undergraduate Research

Background: The quality of life in older women has been found to decrease with poverty, poor health, decreased access to healthcare and low education, while marriage and children can both improve or decrease the quality of life. The information on the quality of life of older women living in faith based communities is lacking.

Objectives: The purpose of this study was to explore the quality of life and factors impacting quality of life in Sisters living in an assisted living facility.

Methods: The short form 36 Health Survey Questionnaire (SF-36) was used to measure quality of life of the Dominican …

Prevalence And Risk Factors Associated With Long-Term Opioid Use After Injury Among Previously Opioid-Free Workers, Zoe Durand, Sarah Nechuta, Shanthi Kreishnaswami, Eric L. Hurwitz, Melissa Mcpheeters

Peer Reviewed Articles

Importance Using opioids for acute pain can lead to long-term use and associated morbidity and mortality. Injury has been documented as a gateway to long-term opioid use in some populations, but data are limited for injured workers.

Objective To evaluate the prevalence and risk factors of long-term opioid use after injury among workers in Tennessee who were opioid free at the time of injury.

Design, Setting, and Participants This cohort study identified injured workers aged 15 to 99 years who reported only 1 injury to the Tennessee Bureau of Workers’ Compensation from March 2013 to December 2015 and had no …

The Benefits And Accessibility Of Integrative Exercise In Geriatric Populations, Elizabeth Nisper

Honors Projects

There are many physical and mental benefits of conventional exercise and they have been well-studied. However, integrative exercise practices aim to encompass more than physical fitness. There is also a spiritual/ethical component when taking into account aspects such as meditation and mindfulness. By examining a number of different health domains, we can study whether the benefits of yoga and tai chi extend beyond the benefits of exercise more broadly. While the short-term physical fitness benefits of other cardio and strength training may exceed those of integrative practices, yoga and tai chi appear to be equally as beneficial in the long …

Testing An Implementation Strategy Bundle On Adoption And Sustainability Of Evidence To Optimize Physical Function In Community-Dwelling Disabled And Older Adults In A Medicaid Waiver: A Multi-Site Pragmatic Hybrid Type Iii Protocol, Sandra L. Spoelstra, Monica Schueller, Alla Sikorskii

Funded Articles

Background: In partnership with a state Medicaid home and community-based waiver program, this study tests implementation strategies for adoption and sustainability of an evidence-based intervention to support disabled and older adults who have difficulty with physical function and daily living tasks. A multi-level implementation strategy bundle will be directed at relationship, coalition, and team building; readiness to implement, leadership, and clinician attitude toward evidence assessments; intervention and facilitation training; interdisciplinary coordination; facilitation; and audit and feedback to support practice change.

Methods: Knowledge-to-Action model underpins this 2-arm, 3-year pragmatic mixed method randomized hybrid type III trial in 18 waiver program sites …

Food Insecurity Among College Students, Alison Hige

Honors Projects

Increasing collegiate education costs results in students today facing greater financial stress. As a result, students have to make difficult choices of how to allocate their monetary resources. Sometimes, students prioritize educational costs over nutrition and health necessities, impacting an individual’s ability to obtain adequate food resources. The purpose of this project was to explore the prevalence and impact of food insecurity among college students. The project included conducting a literature review yielding 26 pertinent articles from the keywords “food insecurity” and “college students.” Food insecurity affects a student’s physical and mental health, along with negatively impacting their scholastic abilities. …

Hiv Diagnosis Disclosure To Infected Children And Adolescents; Challenges Of Family Caregivers In The Central Region Of Ghana, Anna Hayfron-Benjamin, Dorcas Obiri-Yeboah, Stephen Ayisi-Addo, Peter Mate Siakwa, Sylvia Mupepi

Peer Reviewed Articles

Background

Disclosure of Human Immunodeficiency Virus (HIV) to infected older children and adolescents is essential for both personal health maintenance and HIV prevention within the larger population. Non-disclosure of HIV status has been identified as one of the potential barriers to optimum adherence especially in children and adolescents. Like many other countries in the SSA region, Ghana has significant number of children and adolescents infected by HIV, who have increased survival times, due to increased access to ART. However, both family caregivers and healthcare workers face an array of challenges with the disclosure process, including the timing, what information about …

Adolescent Exercise In Association With Mortality From All Causes, Cardiovascular Disease, And Cancer Among Middle-Aged And Older Chinese Women, Sarah J. Nechuta, Xiao Ou Shu, Gong Yang, Hui Cai, Yu-Tang Gao, Hong-Lan Li, Yong-Bing Xiang, Wei Zheng

Peer Reviewed Articles

Background: Little is known regarding the role of early-life exercise, a potentially modifiable factor, in long-term adult morbidity and mortality. We utilized the Shanghai Women's Health Study (SWHS) to investigate adolescent exercise in association with cancer, cardiovascular disease (CVD), and all-cause mortality among middle-aged and older women.

Methods: The SWHS is a prospective cohort of 74,941 Chinese women ages 40 to 70 years recruited from 1996 to 2000. In-person interviews at enrollment assessed adolescent and adult exercise history, medical and reproductive history, and other lifestyle and socioeconomic (SES) factors. Mortality follow-up occurs via annual linkage to the Shanghai Vital Statistics …

Energy-Related Indicators And Breast Cancer Risk Among White And Black Women, Maureen Sanderson, Loren Lipworth, David Shen-Miller, Sarah Nechuta, Alicia Beeghly-Fadiel, Martha J. Shrubsole, Wei Zheng

Peer Reviewed Articles

Energy-related indicators, including physical activity, energy intake, body mass index (BMI) and adult weight change, have been linked to breast cancer risk. Very few studies of these associations have been conducted among black women, therefore we used the Nashville Breast Health Study (NBHS) to determine whether similar effects were seen in black and white women. The NBHS is a population-based case-control study of breast cancer among women age 25 to 75 years conducted between 2001 and 2010 in and around the Nashville Metropolitan area. Telephone interviews and self-administered food frequency questionnaires were completed with 2,614 incident breast cancer cases ascertained …

Mining Mobile Datasets To Enable The Fine-Grained Stochastic Simulation Of Ebola Diffusion, Nicholas Vogel, Christopher Theisen, Jonathan P. Leidig, Jerry Scripps, Doug H. Graham, Greg Wolffe

Peer Reviewed Articles

The emergence of Ebola in West Africa is of worldwide public health concern. Successful miti- gation of epidemics requires coordinated, well-planned intervention strategies that are specific to the pathogen, transmission modality, population, and available resources. Modeling and sim- ulation in the field of computational epidemiology provides predictions of expected outcomes that are used by public policy planners in setting response strategies.

Developing up to date models of population structures, daily activities, and movement has proven challenging for developing countries due to limited governmental resources. Recent collaborations (in 2012 and 2014) with telecom providers have given public health researchers access to …

Knowledge, Practice, And Barriers Toward Cervical Cancer Screening In Elmina, Southern Ghana, Nancy Innocentia Ebu, Sylvia C. Mupepi, Mate Peter Siakwa, Carolyn M. Sampselle

Peer Reviewed Articles

Aims: The aims of this study were: 1) to assess the level of knowledge of women about Pap smear tests, 2) to determine the practices of women regarding Pap smear tests, and 3) to determine the barriers to Pap smear tests in Elmina, Ghana.

Methods: A cross-sectional study was conducted with 392 randomly selected sexually active females aged 10–74 years using structured interview questions. The Institutional Review Board of the University of Cape Coast gave ethical approval for the study and informed consent was obtained from participants. Data were analyzed with SPSS software (v19.0) using frequencies, chi-square test, and exploratory …

Marital Status And Mortality Among Middle Age And Elderly Men And Women In Urban Shanghai, Puthiery Va, Wan-Shui Yang, Sarah Nechuta, Wong-Ho Chow, Hui Cai, Gong Yang, Shan Gao, Yu-Tang Gao, Wei Zheng, Xiao-Ou Shu, Yong-Bing Xiang

Peer Reviewed Articles

Background: Previous studies have suggested that marital status is associated with mortality, but few studies have been conducted in China where increasing aging population and divorce rates may have major impact on health and total mortality.

Methods: We examined the association of marital status with mortality using data from the Shanghai Women’s Health Study (1996–2009) and Shanghai Men’s Health Study (2002–2009), two population-based cohort studies of 74,942 women aged 40–70 years and 61,500 men aged 40–74 years at the study enrollment. Deaths were identified by biennial home visits and record linkage with the vital statistics registry. Marital status was categorized …

Racial Disparities In Healthcare: Challenges Faced By Hispanic Populations, Kaitlin Mcdowell

Honors Projects

No abstract provided.

Combined Impact Of Lifestyle-Related Factors On Total And Cause-Specific Mortality Among Chinese Women: Prospective Cohort Study, Sarah Nechuta, Xiao-Ou Shu, Hong-Lan Li, Gong Yang, Yong-Bing Xiang, Hui Cai, Wong-Ho Chow, Butian Ji, Xianglan Zhang, Wanqing Wen, Yu-Tang Gao, Wei Zhang

Peer Reviewed Articles

Background: Although cigarette smoking, excessive alcohol drinking, obesity, and several other well-studied unhealthy lifestyle-related factors each have been linked to the risk of multiple chronic diseases and premature death, little is known about the combined impact on mortality outcomes, in particular among Chinese and other non-Western populations. The objective of this study was to quantify the overall impact of lifestyle-related factors beyond that of active cigarette smoking and alcohol consumption on all-cause and cause-specific mortality in Chinese women.

Methods and Findings: We used data from the Shanghai Women’s Health Study, an ongoing population-based prospective cohort study in China. Participants included …

The Effects Of Public Infrastructure And Household Characteristics On Inequality And Infant Mortality In Mexico: What Has Changed Between 1990 And 2005?, Richard S. Meindl, Jose Antonio Roldan Amaro, Cynthia Thompson, Tremaine L. Gregory, Marcela Alvarez Izazaga, Gabriel Saucedo Arteaga

Peer Reviewed Articles

The reduction of infant mortality (IM) continues to be a primary goal throughout much of the developing world, and a suite of methods have been proposed with which to achieve it. However, most attempts at IM reduction have taken place within the context of an almost bewilderingly complex regimen of simultaneous changes occurring in the physical environment, sociopolitical structure, and health care. Which of these various elements is truly causal in reducing IM and which may be merely a correlated but nonprimary agent? During the past two decades Mexico has constituted an extraordinary field laboratory with which to decipher the …

Geografía Social De Zonas Críticas En México Su Contexto Económico Político: 1982-2005, Jose Antonio Roldan Amaro, Gabriel Saucedo Arteaga, Marsela Alvarez Izazaga, Richard Meindl, Cynthia Thompson, Tremaine Gregory

Peer Reviewed Articles

Resultaría muy difícil entender los problemas sociales en México, sin ubicarlos en el contexto económico-político del que forman parte y del que son una consecuen-cia. México se encuentra inserto en el sistema económico propuesto por el bM y el fMi. El modelo neoliberal marca como prioridad el crecimiento económico, la inversión privada y la exigencia al Estado para desvincularse cada vez más de las actividades económicas, y no tiene como objetivo el bienestar social. Por consiguiente ha tenido lugar la depauperización del campo y la migración rural a las ciudades. La consecuencia más importante en el ámbito social del modelo …