Medicine and Health Sciences Commons^™

Evolving Availability And Standardization Of Patient Attributes For Matching, Yu Deng, Lacey P Gleason, Adam Culbertson, Xiaotian Chen, Elmer V Bernstam, Theresa Cullen, Ramkiran Gouripeddi, Christopher Harle, David F Hesse, Jacob Kean, John Lee, Tanja Magoc, Daniella Meeker, Toan Ong, Jyotishman Pathak, Marc Rosenman, Laura K Rusie, Akash J Shah, Lizheng Shi, Aaron Thomas, William E Trick, Shaun Grannis, Abel Kho

Faculty, Staff and Student Publications

Variation in availability, format, and standardization of patient attributes across health care organizations impacts patient-matching performance. We report on the changing nature of patient-matching features available from 2010-2020 across diverse care settings. We asked 38 health care provider organizations about their current patient attribute data-collection practices. All sites collected name, date of birth (DOB), address, and phone number. Name, DOB, current address, social security number (SSN), sex, and phone number were most commonly used for cross-provider patient matching. Electronic health record queries for a subset of 20 participating sites revealed that DOB, first name, last name, city, and postal codes …

Crisis Narratives In Crisis? A Comparative Investigation Into National Covid-19 Narratives, Mouse D. Bennett

Graduate Program in International Studies Theses & Dissertations

On January 31, 2020, the World Health Organization (WHO) declared a public health emergency for only the sixth time in its history. On March 11, 2020, it was stated that COVID-19 constituted a pandemic. How did countries respond? This dissertation traces the evolution of national crisis narratives in four states and assesses their relative success. The findings of this study are that pandemic crisis narratives are not generalizable to all crisis situations but require a high level of compliance to be effective in stopping the crisis. There is no formula for government success, there are no decisive variables determining outcomes. …

Microaggressions: Investigating Physical Therapy Student Perspectives During Clinical Experiences, Dakota Studley, Jocelin Friedman, Ashley H. Campbell, Laurie Shimko, Megan B. Flores

Physical Therapy Faculty Articles and Research

Purpose: Microaggressions are “brief and commonplace daily verbal, behavioral, and environmental indignities, whether intentional or unintentional, that communicate hostile, derogatory or negative racial slights and insults to the target person or group” (Gilliam & Russel, 2021). The effect of microaggressions has been explored among medical students, however, there is limited literature identifying the frequency and effect of microaggressions on Doctor of Physical Therapy (DPT) students. The purpose of this study is to explore the experiences of DPT students on clinical experiences to determine: 1) the frequency that students experience microaggressions, and 2) the impact of microaggressions on self-efficacy.

Methods: …

Supporting Tomorrow’S Innovators: Effective Collaborative Strategies For Transforming Mlis Coursework Into Valuable Career Experience, Brittany Smith

Himmelfarb Library Faculty Posters and Presentations

Presented at the Virginia Library Association Annual Meeting, October 22-24, 2023, Chantilly, VA.

Longitudinal Associations Between Cognitive Functioning And Depressive Symptoms Among Couples In The Mexican Health And Aging Study, Joan K Monin, Gail Mcavay, Katie Newkirk, Rafael Samper-Ternent

Faculty, Staff and Student Publications

OBJECTIVE: To examine the bidirectional associations between older adult spouses' cognitive functioning and depressive symptoms over time and replicate previous findings from the United States (US) in Mexico.

DESIGN: Longitudinal, dyadic path analysis with the actor-partner interdependence model.

SETTING: Data were from the three most recent interview waves (2012, 2015, and 2018) of the Mexican Health and Aging Study (MHAS), a longitudinal national study of adults aged 50+ years in Mexico.

PARTICIPANTS: Husbands and wives from 905 community-dwelling married couples (N = 1,810).

MEASUREMENTS: The MHAS cognitive battery measured cognitive function. Depressive symptoms were assessed using a modified nine-item Center …

Universal Health Coverage: A Basis For Pandemic Preparedness?, Merline Feero

Independent Study Project (ISP) Collection

Amid extensive research and reporting on the effects of COVID-19 on Universal Health Coverage (UHC) progress, this study explores an often neglected topic: the potential of UHC to contribute to the foundations of pandemic preparedness. Herein, quantitative analysis reveals that countries with higher UHC coverage tend to exhibit greater pandemic preparedness (as determined by the UHC Service Coverage Index and the Global Health Security Index). Complementary qualitative analysis is used to further illustrate and explain the correlation between UHC and pandemic preparedness using four case study countries, integrating literature reviews and relevant expert interviews. Through these methods, a clear tie …

Parent-Reported Provider Recommendation Of Hpv Vaccination Among Minority Adolescents Before And During The Covid-19 Pandemic: Findings From The National Immunization Survey-Teen, 2019-2021, Chinenye Lynette Ejezie, Paula Cuccaro, Casey Durand, Lara Savas, Ross Shegog

Faculty, Staff and Student Publications

Provider recommendation of human papillomavirus (HPV) vaccination among adolescents has steadily improved over the years, however, limited research has been conducted to examine if the COVID-19 pandemic disrupted this positive trend in parent-reported provider recommendation among minority adolescents. Therefore, we conducted the present study to determine if there is an association between the pandemic and parent-reported provider recommendation of HPV vaccine among non-Hispanic black and Hispanic adolescents. We also examined whether any changes in parent-reported provider recommendation in the years 2019, 2020, and 2021 differed by race or ethnicity. Using a cross-sectional design to examine data from the National Immunization …

Climate Change, Malnutrition, And Hiv: The Impact Of Food Insecurity On Hiv Response In Sub-Saharan Africa, Olivia Walshak

Independent Study Project (ISP) Collection

Climate change is a key driver of an unprecedented global food crisis, exacerbated by rising temperatures and the vulnerability of crop yields. Sub-Saharan Africa is particularly susceptible, and case studies demonstrate the fragility of food systems in the region, leading to severe food insecurity and famine in the face of climate shocks.

There are a variety of health implications, particularly the syndemic relationship between malnutrition and HIV. HIV interacts bidirectionally with malnutrition, creating a vicious cycle of poor clinical outcomes. Expanding access to antiretroviral therapy in Sub-Saharan Africa is hindered by rampant food insecurity, including inadequate food intake, reduced dietary …

Hidden Hurdles: Evaluating Informal Barriers To Primary Healthcare Access Among Undocumented Migrants In Switzerland, Arantxa Bonifaz Rosas

Independent Study Project (ISP) Collection

Undocumented migrants face heightened difficulties in accessing healthcare due to a combination of legal, financial, and social challenges. Informal barriers to accessing healthcare further exacerbate poor health outcomes among undocumented migrants. In Switzerland, where undocumented migrants have the right to health insurance, barriers to receiving healthcare continue to restrict their access to essential services, such as primary healthcare (PHC). Employing a meta-analysis approach, this qualitative study aimed to broaden existing research on informal barriers hindering access to PHC for undocumented migrants, with a particular focus on the Swiss context. The identified informal barriers centered around health insurance, fear of deportation, …

The Implications Of Politicizing Global Health Diplomacy In A Multipolar World, Haley Stock

Independent Study Project (ISP) Collection

This research paper is the result of an independent study project that details the implications of politicizing global health diplomacy. With a mixture of interviews, primary sources, and secondary sources, this project aims to explain how and why global health has become entrenched in politics in the world today. This paper explores the intersection between global health and foreign policy and analyzes the extent to which countries use medical interventions to achieve political and economic success. Medical interventions, like vaccines, have become increasingly significant, especially looking back at the recent pandemic. Therefore, this paper will also explore the complex nature …

Professional Virtue Of Civility And The Responsibilities Of Medical Educators And Academic Leaders, Laurence B Mccullough, John Coverdale, Frank A Chervenak

Center for Medical Ethics and Health Policy Staff Publications

Incivility among physicians, between physicians and learners, and between physicians and nurses or other healthcare professionals has become commonplace. If allowed to continue unchecked by academic leaders and medical educators, incivility can cause personal psychological injury and seriously damage organisational culture. As such, incivility is a potent threat to professionalism. This paper uniquely draws on the history of professional ethics in medicine to provide a historically based, philosophical account of the professional virtue of civility. We use a two-step method of ethical reasoning, namely ethical analysis informed by pertinent prior work, followed by identifying the implications of clearly articulated ethical …

Factors Associated With Internalizing And Externalizing Symptoms In A Clinical Sample Of Youth With Misophonia, Gabrielle M Armstrong, Rebecca L Greenberg, Orri Smárason, Renee M Frederick, Andrew G Guzick, Sophie C Schneider, Samuel D Spencer, Matti Cervin, Eric A Storch

Center for Medical Ethics and Health Policy Staff Publications

Misophonia is an often chronic condition characterized by strong, unpleasant emotional reactions when exposed to specific auditory or visual triggers. While not currently defined within existing classification systems, and not clearly fitting within the framework of extant psychiatric conditions, misophonia has historically been studied most frequently within the context of obsessive-compulsive and related disorders. Internalizing and externalizing psychiatric symptoms are common in misophonia, but specific factors that confer risk for these symptoms remain unknown. The present cross-sectional study examined whether sensory sensitivity and cognitive emotion regulation facets are associated with co-occurring internalizing and externalizing symptoms in 102 youth with misophonia …

Clinician Perspectives On Levels Of Evidence And Oversight For Deep Brain Stimulation For Treatment-Resistant Childhood Ocd, Michelle T Pham, Tiffany A Campbell, Natalie Dorfman, Laura Torgerson, Kristin Kostick-Quenet, Jennifer Blumenthal-Barby, Eric A Storch, Gabriel Lázaro-Muñoz

Center for Medical Ethics and Health Policy Staff Publications

Approximately 10-20% of children with obsessive-compulsive disorder (OCD) have treatment-resistant presentations, and there is likely interest in developing interventions for this patient group, which may include deep brain stimulation (DBS). The World Society for Stereotactic and Functional Neurosurgery has argued that at least two successful randomized controlled trials should be available before DBS treatment for a psychiatric disorder is considered "established." The FDA approved DBS for adults with treatment-resistant OCD under a humanitarian device exemption (HDE) in 2009, which requires that a device be used to manage or treat a condition impacting 8,000 or fewer patients annually in the United …

A Special Message To You From Your Mda Dental Pac Chair, Elizabeth Ralstrom Dds, Ms

The Journal of the Michigan Dental Association

This article is a message from the chair of the Michigan Dental Association’s political action committee thanking members for their contributions and encouraging them to make a contribution with their 2024 dues statement. It includes a listing of all contributors to the PAC over the past year.

Hope And Optimism In Pediatric Deep Brain Stimulation: Key Stakeholder Perspectives, Natalie Dorfman, Lilly Snellman, Ynez Kerley, Kristin Kostick-Quenet, Gabriel Lazaro-Munoz, Eric A Storch, Jennifer Blumenthal-Barby

Center for Medical Ethics and Health Policy Staff Publications

Introduction: Deep brain stimulation (DBS) is utilized to treat pediatric refractory dystonia and its use in pediatric patients is expected to grow. One important question concerns the impact of hope and unrealistic optimism on decision-making, especially in "last resort" intervention scenarios such as DBS for refractory conditions.

Objective: This study examined stakeholder experiences and perspectives on hope and unrealistic optimism in the context of decision-making about DBS for childhood dystonia and provides insights for clinicians seeking to implement effective communication strategies.

Materials and methods: Semi-structured interviews with clinicians (n = 29) and caregivers (n = 44) were conducted, …

Ethics Education For Healthcare Professionals In The Era Of Chatgpt And Other Large Language Models: Do We Still Need It?, Vasiliki Rahimzadeh, Kristin Kostick-Quenet, Jennifer Blumenthal Barby, Amy L Mcguire

Center for Medical Ethics and Health Policy Staff Publications

In this paper, we contend with whether we still need traditional ethics education as part of healthcare professional training given the abilities of chatGPT (generative pre-trained transformer) and other large language models (LLM). We reflect on common programmatic goals to assess the current strengths and limitations of LLMs in helping to build ethics competencies among future clinicians. Through an actual case analysis, we highlight areas in which chatGPT and other LLMs are conducive to common bioethics education goals. We also comment on where such technologies remain an imperfect substitute for human-led ethics teaching and learning. Finally, we conclude that the …

Rural-Urban Disparities In Video Telehealth Use During Rapid Mental Health Care Virtualization Among American Indian/Alaska Native Veterans, Isabelle S Kusters, Amber B Amspoker, Kristen Frosio, Stephanie C Day, Giselle Day, Anthony Ecker, Julianna Hogan, Jan A Lindsay, Jay Shore

Center for Medical Ethics and Health Policy Staff Publications

Importance: American Indian/Alaska Native veterans experience a high risk for health inequities, including mental health (MH) care access. Rapid virtualization of MH care in response to the COVID-19 pandemic facilitated care continuity across the Veterans Health Administration (VHA), but the association between virtualization of care and health inequities among American Indian/Alaska Native veterans is unknown.

Objective: To examine differences in video telehealth (VTH) use for MH care between American Indian/Alaska Native and non-American Indian/Alaska Native veterans by rurality and urbanicity.

Design, setting, and participants: In this cohort study, VHA administrative data on VTH use among a veteran cohort that received …

Spanish-Language Communication Of Covid-19 Information Across Us Local Health Department Websites, Isabelle S Kusters, Amanda M Gutierrez, Julianna M Dean, Mark Sommer, Anna Klyueva

Center for Medical Ethics and Health Policy Staff Publications

The COVID-19 pandemic has brought new urgency to a longstanding problem: the US health system is not well-equipped to accommodate the country's large limited English proficient (LEP) population in times of national emergency. We examined the landscape of Spanish-language COVID-19 website information compared to information in English provided by health departments of the top 10 cities by population in the USA. For each city, coders evaluated three score measures (amount of information, presentation quality, and ease of navigation) for six content types (general information, symptoms, testing, prevention, vaccines, and live statistics) across six delivery modes (print resources, website text, videos, …

Hope And Optimism In Pediatric Deep Brain Stimulation: Key Stakeholder Perspectives, Natalie Dorfman, Lilly Snellman, Ynez Kerley, Kristin Kostick-Quenet, Gabriel Lazaro-Munoz, Eric A Storch, Jennifer Blumenthal-Barby

Center for Medical Ethics and Health Policy Staff Publications

Introduction: Deep brain stimulation (DBS) is utilized to treat pediatric refractory dystonia and its use in pediatric patients is expected to grow. One important question concerns the impact of hope and unrealistic optimism on decision-making, especially in "last resort" intervention scenarios such as DBS for refractory conditions.

Objective: This study examined stakeholder experiences and perspectives on hope and unrealistic optimism in the context of decision-making about DBS for childhood dystonia and provides insights for clinicians seeking to implement effective communication strategies.

Materials and methods: Semi-structured interviews with clinicians (n = 29) and caregivers (n = 44) were conducted, …

Mda Advocacy Report: 2023 To Date, And What’S Next, Jason Mashni Dds

The Journal of the Michigan Dental Association

This article is a recap of MDA legislative advocacy accomplishments and what is on the horizon for the remainder of 2023, written by the chair of the MDA Committee on Governmental and Insurance Affairs.

Electrophysiological Responses To Emotional And Cocaine Cues Reveal Individual Neuroaffective Profiles In Cocaine Users, Heather E Webber, Constanza De Dios, Margaret C Wardle, Robert Suchting, Charles E Green, Joy M Schmitz, Scott D Lane, Francesco Versace

Faculty, Staff and Student Publications

Smokers with stronger neuroaffective responses to drug-related cues compared to non-drug-related pleasant images (C>P) are more vulnerable to compulsive smoking than individuals with the opposite brain reactivity profile (P>C). However, it is unknown if these neurobehavioral profiles exist in individuals abusing other drugs. We tested whether individuals with cocaine use disorder (CUD) show similar neuroaffective profiles to smokers. We also monitored eye movements to assess attentional bias toward cues and we further performed exploratory analyses on demographics, personality, and drug use between profiles. Participants with CUD (n=43) viewed pleasant, unpleasant, cocaine, and neutral images while we recorded electroencephalogram. …

Postoperative Pain-Related Outcomes And Perioperative Pain Management In China: A Population-Based Study, Yanhong Liu, Saisong Xiao, Huikai Yang, Xuecai Lv, Aisheng Hou, Yulong Ma, Yandong Jiang, Chongyang Duan, Weidong Mi

Faculty, Staff and Student Publications

Background: Postoperative pain poses a significant challenge to the healthcare system and patient satisfaction and is associated with chronic pain and long-term narcotic use. However, systemic assessment of the quality of postoperative pain management in China remains unavailable.

Methods: In this cross-sectional study, we analyzed data collected from a nationwide registry, China Acute Postoperative Pain Study (CAPOPS), between September 2019 and August 2021. Patients aged 18 years or above were required to complete a self-reported pain outcome questionnaire on the first postoperative day (POD1). Perioperative pain management and pain-related outcomes, including the severity of pain, adverse events caused by pain …

Examination Of Disparities In Prehospital Encounters For Pediatric Asthma Exacerbations, Lauren Riney, Sam Palmer, Erik Finlay, Andrew Bertrand, Shannon Burcham, Phyllis Hendry, Manish Shah, Kathryn Kothari, David W Ashby, Daniel Ostermayer, Olga Semenova, Benjamin N Abo, Benjamin Abes, Nichole Shimko, Emily Myers, Marshall Frank, Tim Turner, Mac Kemp, Kim Landry, Greg Roland, Jennifer N Fishe

Faculty, Staff and Student Publications

INTRODUCTION: There are disparities in multiple aspects of pediatric asthma care; however, prehospital care disparities are largely undescribed. This study's objective was to examine racial and geographic disparities in emergency medical services (EMS) medication administration to pediatric patients with asthma.

METHODS: This is a substudy of the Early Administration of Steroids in the Ambulance Setting: An Observational Design Trial, which includes data from pediatric asthma patients ages 2-18 years. We examined rates of EMS administration of systemic corticosteroids and inhaled bronchodilators by patient race. We geocoded EMS scene addresses, characterized the locations' neighborhood-based conditions and resources relevant to children using …

Predictors And Moderators Of Treatment Outcomes For Anxious Children Randomized To Computer-Assisted Cognitive Behavioral Therapy Or Standard Community Care, Orri Smárason, Andrew G Guzick, Wayne K Goodman, Alison Salloum, Eric A Storch

Faculty, Staff and Students Publications

Introduction:

Computer-assisted cognitive behavioral therapy (CCBT) for childhood anxiety disorders may aid the dissemination of CBT, while maintaining treatment fidelity. Although CCBT is an effective intervention, not everyone benefits equally from treatment. Identifying patient characteristics that predict who will benefit from treatment and to what extent can help with matching patients to suitable interventions, and allow researchers and clinicians to modify, and individualize, their treatment formats more effectively. Such predictors and moderators have not yet been examined for CCBT outcomes in anxious children and studies of more traditional treatment formats have yielded inconsistent results.

Methods:

Using data from a randomized …

Racial/Ethnic Differences Persist In Treatment Choice And Outcomes In Isolated Intervention For Coronary Artery Disease, Rodrigo Zea-Vera, Sainath Asokan, Rohan M Shah, Christopher T Ryan, Subhasis Chatterjee, Matthew J Wall, Joseph S Coselli, Todd K Rosengart, Waleed T Kayani, Hani Jneid, Ravi K Ghanta

Faculty, Staff and Students Publications

OBJECTIVE: Studies have noted racial/ethnic disparities in coronary artery disease intervention strategies. We investigated trends and outcomes of coronary artery disease treatment choice (coronary artery bypass grafting or percutaneous coronary intervention) stratified by race/ethnicity.

METHODS: We queried the National Inpatient Sample for patients who underwent isolated coronary artery bypass grafting or percutaneous coronary intervention (2002-2017). Outcomes were stratified by race/ethnicity (White, African American, Hispanic, Asian). Multivariable logistic regression evaluated associations between race/ethnicity and receiving coronary artery bypass grafting versus percutaneous coronary intervention, in-hospital mortality, and costs.

RESULTS: Over the 15-year period, 2,426,917 isolated coronary artery bypass grafting surgeries and 7,184,515 …

J Mich Dent Assoc October 2023

The Journal of the Michigan Dental Association

The October 2023 issue of the Journal of the Michigan Dental Association provides: A message from the chair of the Michigan Dental Association political action committee with a listing of donors and a report on MDA advocacy during 2023, which are this month’s cover stories. Also included is a Q&A feature on dealing with dental benefits companies. This month’s clinical article is a discussion of the management of a failing implant using guided bone regeneration and esthetic crown lengthening. Other features include a listing of 2023 MDA life members and a President’s Message on the dental workforce crisis in Michigan. …

The Prevalence Of Burnout In Saudi Arabia Dental Hygienists, Nouf Hamad Aldayel

Dental Hygiene Theses & Dissertations

Purpose: The purpose of this pilot study was to assess the prevalence of burnout in Saudi Arabian dental hygienists and identify risk factors associated with burnout. Methods: A descriptive survey design using the Copenhagen Burnout Inventory (CBI) assessed burnout among a convenience sample of n=123 Saudi dental hygienists. The survey was disseminated electronically to 1,000 Saudi Arabian dental hygienists. The CBI measures three subscales: personal, work-related, and client/patient-related burnout on a five-point Likert-type scale. The survey also included six demographic questions, two Likert-type, one “yes/no,” and one openended question, related to burnout. Descriptive statistics, one-way between subject’s ANOVA, independent samples …

Cheiloscopy Examination And Classification Of Lip Prints With And Without Parafunctional Oral Habits: A Cross-Sectional Observation Study, Emily Smith Regan

Dental Hygiene Theses & Dissertations

Problem: Lip prints are unique and have potential for use as a human identifier. The purpose of this study was to observe possible cheiloscopy differences of individuals with and without parafunctional oral habits. Additionally, inter-rater reliability (IRR) of lip print examiners was observed. Methods: This IRB approved blinded cross-sectional observational study collected lip prints from sixty-six individuals using lipstick and adhesive tape to transfer lip prints to white bond paper for viewing purposes. Each set of included lip prints was divided into quadrants and dichotomized as those with or without an oral parafunctional habit. Each quadrant sample was manually analyzed …

The Impact Of Mandatory Substance Abuse Counselor Reporting Requirements On Child Maltreatment Reporting Outcomes, Bilgé Özgé Yilmaz

Psychology Theses & Dissertations

The present study sought to examine how state-level mandatory reporting policies are associated with child maltreatment reporting through analysis of the National Data Archive on Child Abuse and Neglect (NDACAN, 2021). This study aimed: 1) to examine how the implementation of substance abuse counselor reporting requirements is associated with the reporting process, including the disposition of reports and the presence of substance abuse; and 2) to examine differences in the above outcomes based on associations between non-specific reporting requirements and specific requirements that mention substance use counselors. A quasi-experimental approach with repeated cross-sectional data was utilized, as it is a …

Incremental Validity Of The Mmpi-A-Rf And Maci In A Clinical Outpatient Setting, Madison Smart-Mccarthy

Psychology Theses & Dissertations

With the persistent rise of depression and suicide in adolescents, it is imperative that clinicians select empirically supported measures that accurately assess these conditions (Van Orman, 2022; Sellbom & Suhr, 2020). One empirical method used to evaluate measures is incremental validity. Incremental validity examines the level of improvement in predicting a phenomenon when adding a test or procedure to a combination of other instruments (APA, 2020). Experts regard the Minnesota Multiphasic Personality Inventory—Adolescent Version—Restructured Form (MMPI-A-RF; Archer et al., 2016) and the Millon Adolescent Clinical Inventory (MACI; Millon et al., 1993) as psychometrically sound measures often used in clinical practice. …