Medicine and Health Sciences Commons^™

Simplified Post Processing Of Cine Dense Cardiovascular Magnetic Resonance For Quantification Of Cardiac Mechanics, Jonathan D. Suever, Gregory J. Wehner, Christopher M. Haggerty, Linyuan Jing, Sean M. Hamlet, Cassi M. Binkley, Sage P. Kramer, Andrea C. Mattingly, David K. Powell, Kenneth C. Bilchick, Frederick H. Epstein, Brandon K. Fornwalt

Saha Cardiovascular Research Center Faculty Publications

BACKGROUND: Cardiovascular magnetic resonance using displacement encoding with stimulated echoes (DENSE) is capable of assessing advanced measures of cardiac mechanics such as strain and torsion. A potential hurdle to widespread clinical adoption of DENSE is the time required to manually segment the myocardium during post-processing of the images. To overcome this hurdle, we proposed a radical approach in which only three contours per image slice are required for post-processing (instead of the typical 30-40 contours per image slice). We hypothesized that peak left ventricular circumferential, longitudinal and radial strains and torsion could be accurately quantified using this simplified analysis.

METHODS …

The Dynamics Of Medicaid & Public Health Spending: Implications For Aca Implementation, Glen P. Mays

Health Management and Policy Presentations

We estimate the dynamics and interactions of governmental spending on Medicaid and other public health services in all 50 states over a 15 year period. Using a quasi-experimental design with instrumental variables estimation, we find evidence that increased Medicaid spending leads to reduced governmental spending on other public health services, consistent with a crowd-out effect. Over 10 years, such crowd-out has the potential to diminish the health status improvements generated through health insurance coverage expansions.

In Vivo Identification Of Eugenol-Responsive And Muscone-Responsive Mouse Odorant Receptors, Timothy S. Mcclintock, Kaylin Adipietro, William B. Titlow, Patrick Breheny, Andreas Walz, Peter Mombaerts, Hiroaki Matsunami

Physiology Faculty Publications

Our understanding of mammalian olfactory coding has been impeded by the paucity of information about the odorant receptors (ORs) that respond to a given odorant ligand in awake, freely behaving animals. Identifying the ORs that respond in vivo to a given odorant ligand from among the ∼1100 ORs in mice is intrinsically challenging but critical for our understanding of olfactory coding at the periphery. Here, we report an in vivo assay that is based on a novel gene-targeted mouse strain, S100a5-tauGFP, in which a fluorescent reporter selectively marks olfactory sensory neurons that have been activated recently in vivo. Because each …

Geographic Variation In The Delivery Of High-Value Public Health Services: Exploring Causes & Consequences, Glen P. Mays

Health Management and Policy Presentations

OBJECTIVES: A growing body of evidence indicates that the delivery of public health activities varies widely across states and communities, creating missed opportunities for prevention as well as inequities in health protection. Measures of quality in public health are needed to guide public health improvement initiatives and to support research on the comparative effectiveness of alternative public health strategies. The Multi-network Practices and Outcomes Variation Examination Study (MPROVE), uses the infrastructure of six Public Health Practice-Based Research Networks (PBRNs) across the U.S. to develop and validate a “starter set” of measures and to analyze geographic variation delivery across diverse public …

Cost Estimates Of Foundational Public Health Services: Results From Piloting An Expert Consensus Methodology, C. B. Mamaril, Glen P. Mays

Health Management and Policy Presentations

We review preliminary estimates from pilot testing a cost estimation methodology developed to identify the resources required to implement a set of Foundational Public Health Services as recommended by the Institute of Medicine and defined by the Public Health Leadership Forum.

Dear Colleagues, Readers And Authors, Maya Guglin

The VAD Journal

No abstract provided.

Medicaid Expansions & Public Health Spending: Cross-Subsidies, Complementarities, And Crowd-Out, Glen P. Mays

Health Management and Policy Presentations

In this paper we estimate the causal impact of state Medicaid enrollment expansions and expenditures on state and local resources allocated to other public health programs and services. Using a quasi-experimental design with instrumental variables estimation, we find evidence that increased Medicaid spending leads to reduced governmental spending on other public health services, consistent with a crowd-out effect. Over 10 years, such crowd-out has the potential to diminish the health status improvements generated through health insurance coverage expansions.

Aca Implementation In Kentucky: Experiences Of An Expansion State, Glen P. Mays

Health Management and Policy Presentations

Kentucky's implementation of the Affordable Care Act has included early successes with insurance coverage expansion through Medicaid and a state-operated health insurance exchange. Signals of improvements in health care accessibility and delivery of preventive services are evident in the first year after coverage expansions. Challenges associated with political opposition, delivery system transformation, and public health financing remain on the state's policy agenda.

Cost Estimates Of Foundational Public Health Services: Results From Piloting The Expert Consensus Methodology In Kentucky, C. B. Mamaril, Glen P. Mays

Health Management and Policy Presentations

We developed a methodology for estimating the resources required to deliver a set of foundational public health capabilities as recommended in the 2012 Institute of Medicine report on public health financing. The capabilities are based on IOM recommendations and defined by a national expert panel convened as part of the Public Health Leadership Forum. This paper presents preliminary estimates from a pilot test of the cost estimation methodology in Kentucky, and outlines plans for the national estimation strategy.

Exploring The Use Patterns Of A Mobile Health Application For Alcohol Addiction Before The Initial Lapse After Detoxification, Ming-Yuan Chih

Health and Clinical Sciences Faculty Publications

How patients used Addiction-Comprehensive Health Enhancement Support System (A-CHESS), a mobile health intervention, while quitting drinking is worthy exploring. This study is to explore A-CHESS use patterns prior to the initial lapse reported after discharge from inpatient detoxification programs. 142 patients with alcohol addiction from two treatment agencies in the U.S. were included. A comprehensive set of A-CHESS use measures were developed based on a three-level system use framework and three A-CHESS service categories. In latent profile analyses, three A-CHESS system use patterns-inactive, passive, and active users-were found. Compared to the passive users (with the highest chance of the initial …

Connecting Undergraduate Science Education With The Needs Of Today's Graduates, Viviane Callier, Richard H. Singiser, Nathan L. Vanderford

Markey Cancer Center Faculty Publications

Undergraduate science programs are not providing graduates with the knowledgebase and skills they need to be successful on today’s job market. Curricular changes relevant to today’s marketplace and more opportunities for internships and work experience during students’ secondary education would facilitate a smoother transition to the working world and help employers find graduates that possess both the hard and soft skills needed in the workplace. In this article, we discuss these issues and offer solutions that would generate more marketplace-ready undergraduates.

Optimizing Public Health Systems For Population Health Improvement: Institutions, Economics, And Metrics, Glen P. Mays

Health Management and Policy Presentations

This lecture reviews the evidence concerning the institutional and economic characteristics of public health delivery systems and their impact on population health. Emerging findings from these studies suggest promising pathways for transforming the U.S. public health system in ways that strengthen its effectiveness, efficiency and equity in producing health. .

Alzheimer's Therapeutics Targeting Amyloid Beta 1-42 Oligomers I: Abeta 42 Oligomer Binding To Specific Neuronal Receptors Is Displaced By Drug Candidates That Improve Cognitive Deficits, Nicholas J. Izzo, Agnes Staniszewski, Lillian To, Mauro Fa, Andrew F. Teich, Faisal Saeed, Harrison Wostein, Thomas Walko Iii, Anisha Vaswani, Meghan Wardius, Zanobia Syed, Jessica Ravenscroft, Kelsie Mozzoni, Colleen Silky, Courtney Rehak, Raymond Yurko, Patricia Finn, Gary Look, Gilbert Rishton, Hank Safferstein, Miles Miller, Conrad Johanson, Edward Stopa, Manfred Windisch, Birgit Hutter-Paier, Mehrdad Shamloo, Ottavio Arancio, Harry Levine Iii, Susan M. Catalano

Sanders-Brown Center on Aging Faculty Publications

Synaptic dysfunction and loss caused by age-dependent accumulation of synaptotoxic beta amyloid (Abeta) 1-42 oligomers is proposed to underlie cognitive decline in Alzheimer's disease (AD). Alterations in membrane trafficking induced by Abeta oligomers mediates reduction in neuronal surface receptor expression that is the basis for inhibition of electrophysiological measures of synaptic plasticity and thus learning and memory. We have utilized phenotypic screens in mature, in vitro cultures of rat brain cells to identify small molecules which block or prevent the binding and effects of Abeta oligomers. Synthetic Abeta oligomers bind saturably to a single site on neuronal synapses and induce …

Alzheimer's Therapeutics Targeting Amyloid Beta 1–42 Oligomers Ii: Sigma-2/Pgrmc1 Receptors Mediate Abeta 42 Oligomer Binding And Synaptotoxicity, Nicholas J. Izzo, Jinbin Xu, Chenbo Zeng, Molly J. Kirk, Kelsie Mozzoni, Colleen Silky, Courtney Rehak, Raymond Yurko, Gary Look, Gilbert Rishton, Hank Safferstein, Carlos Cruchaga, Alison Goate, Michael A. Cahill, Ottavio Arancio, Robert H. Mach, Rolf Craven, Elizabeth Head, Harry Levine Iii, Tara L. Spires-Jones, Susan M. Catalano

Sanders-Brown Center on Aging Faculty Publications

Amyloid beta (Abeta) 1-42 oligomers accumulate in brains of patients with Mild Cognitive Impairment (MCI) and disrupt synaptic plasticity processes that underlie memory formation. Synaptic binding of Abeta oligomers to several putative receptor proteins is reported to inhibit long-term potentiation, affect membrane trafficking and induce reversible spine loss in neurons, leading to impaired cognitive performance and ultimately to anterograde amnesia in the early stages of Alzheimer's disease (AD). We have identified a receptor not previously associated with AD that mediates the binding of Abeta oligomers to neurons, and describe novel therapeutic antagonists of this receptor capable of blocking Abeta toxic …

Melampomagnolide B Derivatives As Antileukemic And Cytotoxic Agents, Peter A. Crooks, Craig T. Jordan, Shanshan Pei, Shama Nasim

Pharmaceutical Sciences Faculty Patents

Melampomagnolide B is disclosed as a new antileukemic sesquiterpene. A biotin-conjugated derivative of melampomagnolide B was prepared to elucidate its mechanism of action. Prodrugs of Melampomagnolide B are disclosed.

A Pilot Study On The Use Of Lecture Tools To Enhance The Teaching Of Pharmacokinetics And Pharmacodynamics, Hollie I. Swanson, Michael T. Piascik

Pharmacology and Nutritional Sciences Faculty Publications

Pharmacokinetics and pharmacodynamics are essential topics contained within the medical curriculum and are highly amenable to active-learning approaches. In this pilot study, we incorporated Lecture Tools, a cloud-based audience response system, into a lecture-based graduate course. Lecture Tools was used by both the instructors and the students during peer presentations. Advantages noted by the instructors include the versatility of the questions that can be presented and the ease with which student assessment can be conducted. Student surveys revealed that, overall, the use of Lecture Tools enhanced student attentiveness and engagement and facilitated student participation in questions and answers. Some disadvantages …

Caspase-3 Mediates The Pathogenic Effect Of Yersinia Pestis Yopm In Liver Of C57bl/6 Mice And Contributes To Yopm's Function In Spleen, Zhan Ye, Amanda A. Gorman, Annette M. Uittenbogaard, Tanya Myers-Morales, Alan M. Kaplan, Donald A. Cohen, Susan C. Straley

Microbiology, Immunology, and Molecular Genetics Faculty Publications

The virulence protein YopM of the plague bacterium Yersinia pestis has different dominant effects in liver and spleen. Previous studies focused on spleen, where YopM inhibits accumulation of inflammatory dendritic cells. In the present study we focused on liver, where PMN function may be directly undermined by YopM without changes in inflammatory cell numbers in the initial days of infection, and foci of inflammation are easily identified. Mice were infected with parent and ΔyopM-1 Y. pestis KIM5, and effects of YopM were assessed by immunohistochemistry and determinations of bacterial viable numbers in organs. The bacteria were found …

Frontiers In Phssr Is On The Move, F. Douglas Scutchfield

Frontiers in Public Health Services and Systems Research

Recently, Dr. Jenine Harris and her colleagues examined the use of journals by state chronic disease prevention staff to stay up-to-date on public health evidence. We, at Frontiers in PHSSR, are pleased to be included among the journals listed in the survey. Online open-access journals are shifting the paradigm of scientific publication, allowing free and rapid exchange of information. Another illustration of Frontier’s increasing utility is a forthcoming issue of the American Journal of Public Health (AJPH). We are pleased that AJPH has agreed to publish selected abstracts from Frontiers in PHSSR in their regular issue with links to …

Qt Interval Prolongation Associated With Intramuscular Ziprasidone In Chinese Patients: A Case Report And A Comprehensive Literature Review With Meta-Analysis, Xian-Bin Li, Yi-Lang Tang, Wei Zheng, Chuan-Yue Wang, Jose De Leon

Psychiatry Faculty Publications

Intramuscular (IM) ziprasidone has been associated with QTc interval prolongations in patients with preexisting risk factors. A 23-year-old male Chinese schizophrenia patient experienced an increase of QTc interval of 83 milliseconds (ms) after receiving 20 mg IM ziprasidone (baseline and increased QT/QTc were, respectively, 384/418 and 450/501). This was rated as a probable adverse drug reaction (ADR) by the Liverpool ADR causality assessment tool. A systematic review including all types of trials reporting the effect of IM ziprasidone on the QTc interval prolongation identified 19 trials with a total of 1428 patients. Mean QTc change from baseline to end of …

Local Health Department Collaborative Capacity To Improve Population Health, Hector P. Rodriguez, Jeffrey Mac Mccullough, Charleen Hsuan

Frontiers in Public Health Services and Systems Research

Local health departments (LHDs) can more effectively develop and strengthen community health partnerships when leaders focus on building partnership collaborative capacity (PCC), including a multisector infrastructure for population health improvement. Using the 2008 National Association of County and City Health Officials (NACCHO) Profile survey, we constructed an overall measure of LHD PCC comprised of the five dimensions: outcomes-based advocacy, vision-focus balance, systems orientation, infrastructure development, and community linkages. We conducted a series of regression analyses to examine the extent to which LHD characteristics and contextual factors were related to PCC. The most developed PCC dimension was vision-focus balance, while infrastructure …

Policymakers Identify Priorities For Phssr, Katherine Froeb Papa

Frontiers in Public Health Services and Systems Research

A major goal for the health services research community is to provide evidence policymakers can use to improve the public’s health. However, it can be difficult to know what evidence policymakers want and how they decide what research to fund.

In order to understand where policymakers turn for evidence and how they make funding decisions amid fiscal and political constraints, AcademyHealth conducted a 3-part Fireside Chat series in the spring of 2014. This editorial summarizes the evidence gaps identified, and provides strategies for communicating with decision makers.

Editorial Comment: Understanding Cost Variation In Std Service Delivery As State And Federal Agencies Reduce Funding, Michael A. Preston, William W. Greenfield, Sharla A. Smith

Frontiers in Public Health Services and Systems Research

As health reform gains momentum, many changes have been seen in the way health services are delivered and financed. In an attempt to address the uncertainties and understand the costs of delivering STD prevention services, the authors examined the cost of STDs in a highly centralized public health agency system (PHAS). This commentary covers several implications that arise from this study.

Understanding Cost Variations In Std Service Delivery As State And Federal Agencies Reduce Funding, William C. Livingood, Lori Bilello, Bonita Sorensen

Frontiers in Public Health Services and Systems Research

Sexually transmitted diseases (STD) continue to be a major health problem in the U.S. Despite the persistence of STDs and the critical role of the public health sector in controlling these diseases, STD services continue to be reduced. A linear regression was performed using county demographic and cost variables. Many of these variables in county public health agencies and the populations they serve were not significantly correlated with cost of service. However, the availability of local tax funding for county health departments (CHDs), which varies extensively across counties within the state, is statistically linked to higher STD expenditure per case. …

Evidence-Informed Guidelines For Pediatric Pandemic Planning And Response, Ginny Sprang, James J. Clark, Miriam Silman, Phyllis W. Leigh, Candice M. Jackson, A. Scott Lajoie

Center on Trauma and Children Reports

From the executive summary:

Pandemic events are unpredictable and inevitable. When they occur, the impact is both all-encompassing and asymmetrical; each pandemic targets specific, vulnerable populations, but ultimately impacts individuals, families and communities throughout the world. Regardless of origin or circumstances, the next pandemic will certainly count infants, children, and adolescents among its most vulnerable targets. As evidenced by the 2009 H1N1 influenza pandemic, children may be at higher risk than populations more typically seen as susceptible to pandemic illness (the elderly, those with weakened immune systems, etc.). Children also can function as disease vectors, spreading the virus through their …

Improving Community Health Through Hospital-Public Health Collaboration: Insights And Lessons Learned From Successful Partnerships, Lawrence Prybil, F. Douglas Scutchfield, Rex Killian, Ann Kelly, Glen P. Mays, Angela Carman, Samuel Levey, Anne Mcgeorge, David W. Fardo

Health Management and Policy Faculty Book Gallery

From the introduction:

Health care expenditures in the United States currently consume over 17 percent of the nation’s gross domestic product, a much larger share than other developed nations. Yet, despite this large investment, studies by Commonwealth Fund, the Institute of Medicine, and other organizations show the USA lags behind other developed nations on multiple metrics of population health such as infant mortality and life expectancy. Moreover, there is extensive evidence of disparities in access, cost, and quality of health care services.

Thus, we are confronted by a striking paradox: the USA spends a large and growing proportion of our …

Use Of Social Media In Dental Schools: Pluses, Perils, And Pitfalls From A Legal Perspective, Joseph W. Parkinson, Sharon P. Turner

Oral Health Practice Faculty Publications

One of the ways dental education is changing the way it is preparing the next generation of learners is through efficient utilization of interactive social media. Social media, which facilitates interaction and sharing of new ideas, is being utilized to educate students, residents, and faculty. Unfortunately, as with most improvements in technology, there are growing pains. Faculty, student, and patient interaction on social media platforms, such as Facebook and Twitter, can lead to inappropriate or embarrassing situations. Striking the appropriate balance between free speech rights of students and faculty and the need for colleges and universities to have efficient operations …

"It's Just A Way Of Fitting In:" Tobacco Use And The Lived Experience Of Lesbian, Gay, And Bisexual Appalachians, Keisa Bennett, Janelle M. Ricks, Britteny M. Howell

Family and Community Medicine Faculty Publications

Lesbian, gay, and bisexual (LGB) people are affected by multiple health disparities and risk factors, including tobacco use. Few studies to date have examined tobacco use specifically in rural LGB populations, and none has investigated the intersections of identity, rural LGB culture, and tobacco. The purpose of this study was to explore the perspective of Appalachian LGB people regarding tobacco use.

METHODS: Nineteen LGB-identified Appalachian residents participated in audiotaped, semi-structured interviews. Two authors analyzed and coded transcripts through constant comparison, and determined themes through consensus.

RESULTS: Five themes emerged: the convergence of Appalachian and LGB identities, tacit awareness …

Pharmacokinetic And Pharmacodynamic Interactions Between Antiepileptics And Antidepressants, Domenico Italiano, Edoardo Spina, Jose De Leon

Psychiatry Faculty Publications

INTRODUCTION: Antiepileptic-antidepressant combinations are frequently used by clinicians; their pharmacokinetic (PK) and pharmacodynamic (PD) drug interactions (DIs) have not been well studied but are frequently likely to be clinically relevant.

AREAS COVERED: This article provides a comprehensive review of PK DIs between antiepileptics and antidepressants. In the absence of PD DI studies, PD information on pharmacological mechanisms and studies on efficacy and safety of individual drugs are reviewed.

EXPERT OPINION: The clinical relevance of the inductive properties of carbamazepine, phenytoin, phenobarbital and primidone and the inhibitory properties of valproic acid and some antidepressants are well understood; correction factors are provided …

Pharmacy Law Brief: Alternative Dispute Resolution, Joseph L. Fink Iii

Pharmacy Practice and Science Faculty Publications

No abstract provided.

The Role Of Leadership In Creating A Strategic Climate For Evidence-Based Practice Implementation And Sustainment In Systems And Organizations, Gregory A. Aarons, Mark G. Ehrhart, Lauren R. Farahnak, Marisa Sklar

Frontiers in Public Health Services and Systems Research

There is a growing impetus to effectively implement evidence-based practices (EBPs) in health and allied health settings in order to improve the public health impact of such practices. To support implementation and sustainment of EBPs, it is important to consider that health care is delivered within the outer context of public health systems and the inner context of health care organizations and work groups (3). This article identifies two relevant types of leadership for implementation and recommends steps that leaders can take in developing a strategic climate for EBP implementation and sustainment within the outer and inner contexts of health …