Medicine and Health Sciences Commons^™

Rescue Or Divert: The Politics Of Anti-Trafficking, Carceral Reform, And Sex Work, Anjali Mahajan

CUREJ - College Undergraduate Research Electronic Journal

Calls for criminal justice reform in the United States have multiplied in recent years, yet advocates rarely discuss the role of punitive legislation surrounding the sex industry. Today’s anti-trafficking movement is one notorious for conflating human trafficking with consensual sex work, and it has seen striking success in pushing forward a narrative around the need for rescue. Pennsylvania—with the harshest laws governing the purchase and sale of sex in the country—serves as a useful case study for understanding the relationship between the anti-trafficking movement and the movement for sex workers’ rights. Through a comprehensive review of legislation ...

Substance Abuse During The Pandemic: Implications For Labor-Force Participation, Jeremy Greenwood, Nezih Guner, Karen A. Kopecky

Population Center Working Papers (PSC/PARC)

The labor-force participation rates of prime-age U.S. workers dropped in March 2020—the start of the COVID-19 pandemic—and have still not fully recovered. At the same time, substance-abuse deaths were elevated during the pandemic relative to trend indicating an increase in the number of substance abusers, and abusers of opioids and crystal methamphetamine have lower labor-force participation rates than non-abusers. Could increased substance abuse during the pandemic be a factor contributing to the fall in labor-force participation? Estimates of the number of additional substance abusers during the pandemic presented here suggest that increased substance abuse accounts for between ...

Women And Water: Lessons Learned From A Humanitarian Intervention At Igusi Clinic, Matabeleland, Zimbabwe, Rachel C. Svetanoff, Ifeoma Ilobodo

wH2O: The Journal of Gender and Water

This article highlights the disproportionate impact of water scarcity on women and girls in Matabeleland, Zimbabwe. We emphasize one Zimbabwean woman's efforts to implement a sustainable water solution for a community of 20,000 citizens. Lumbie Mlambo, Founder and President of the nonprofit JB Dondolo, Inc., took action following reports that people in the community her father was aiding were falling ill, mothers could not carry their pregnancy to full terms, and infant mortality rates were rising. Before Lumbie's intervention, the only water available was contaminated by polluted soil. Moreover, the climate change-induced droughts and floods made the ...

The Downward Spiral, Jeremy Greenwood, Nezih Guner, Karen A. Kopecky

Population Center Working Papers (PSC/PARC)

There have been more than 500,000 opioid overdose deaths since 2000. To analyze the opioid epidemic, a model is constructed where individuals, with and without pain, choose whether to misuse opioids knowing the probabilities of addiction and dying. These odds are functions of opioid use. Markov chains are estimated from the US data for the college and non-college educated that summarize the transitions into and out of opioid addiction as well as to a deadly overdose. A structural model is constructed that matches the estimated Markov chains. The epidemic's drivers, and the impact of medical interventions, are examined.

Lowering The Barriers To Medication Treatment For People With Opioid Use Disorder: Evidence For A Low-Threshold Approach, Shoshana V. Aronowitz, Czarina Navos Behrends, Margaret Lowenstein, Bruce Schackman, Janet Weiner

Issue Briefs

Overdose deaths have reached unprecedented levels in the U.S., despite effective medications to treat opioid use disorders (OUDs). Because the regulatory and administrative barriers to treatment are high, only about 11% of people with OUD receive effective medications, which include buprenorphine, methadone, and naltrexone. In response, clinicians and advocates have looked to a “low-threshold” approach that reduces the stigma surrounding effective medications and facilitates their use. This brief summarizes the barriers to treatment, the evidence on the low-threshold approach, and areas for future research. The evidence suggests that low-threshold approaches can increase access to treatment, with outcomes comparable to ...

Heterogenous Trajectories In Physical, Mental And Cognitive Health Among Older Americans: Roles Of Genetics And Earlier Ses, Cung Truong Hoang, Vikesh Amin, Jere R. Behrman, Hans-Peter Kohler, Iliana V. Kohler

Population Center Working Papers (PSC/PARC)

We investigate the roles of genetic predispositions, childhood SES and adult schooling attainment in shaping trajectories for three important components of the overall health and wellbeing of older adults -- BMI, depressive symptoms and cognition. We use the Health & Retirement Study (HRS) and group-based trajectory modelling (GBTM) to identify subgroups of people who share the same underlying trajectories over ages 50-94 years. After identifying common underlying trajectories, we use fractional multinomial logit models to estimate associations of (1) polygenic scores for BMI, depression, ever-smoked, education, cognition and subjective wellbeing, (2) childhood SES and (3) schooling attainment on the probabilities of trajectory ...

Healing The Hearts Of Healers: A Framework To Cultivate Flourishing And Combat Burnout In Healthcare, Brittany Sutton

Master of Applied Positive Psychology (MAPP) Capstone Projects

Burnout is a leading issue in the United States healthcare system today, afflicting approximately 50% of physicians. It is characterized by emotional depletion and loss of energy, a sense of depersonalization, and a reduced sense of individual accomplishment, resulting in withdrawal from occupation. While often regarded as a personal issue, it is clear that burnout arises from organizational factors and therefore, warrants organizational solutions. However, just as well-being is more than just the absence of ill-being, physician flourishing requires more than just treatment of burnout. The HEAL (Hope, Engagement, Action, Lead) model, the subject matter of ...

Pressure Injury Prevention In Cardiac Surgery Using Risk Factor Assessment And Standardization, Timothy H. Madeira

Doctor of Nursing Practice (DNP) Projects

Cardiac surgical patients are more susceptible to pressure injury (PI) than other surgical specialties, and little is known about PI prevention (PIP) in this population. How do PIP strategies, compared to standard care, affect the incidence of PI during the post-operative recovery among adult cardiac surgery patients? The aim was to reduce the incidence of UAPI in an adult CVSICU by 5% in six weeks. The conceptual framework chosen was The Iowa Model Revised, and the theoretical framework employed was the Theoretical Model for Lesion Development. Quality improvement, single-group pretest-posttest design. Sample consisted of 69 cardiac surgery, LVAD, ECMO patients ...

Does Administration Timing Of Ondansetron, A 5-Ht3 Receptor Antagonist, Affect Inhibition Of The Bezold-Jarisch Reflex In Ob C-Section Patients Receiving Spinal Anesthesia, Spenser Zaharie, Matthew Rowley

Doctor of Nursing Practice (DNP) Projects

Ondansetron (a 5HT-3 receptor antagonist) has been shown in multiple randomized controlled trials (RCT’s) and meta-analysis to inhibit activation of Bezold-Jarisch Reflex (BJR) in response to spinal anesthesia for elective cesarean section patients. Studies have not determined whether the timing of administration changes the inhibitory affect of ondansetron in this patient population. This project addressed the following question: Does administration timing of Ondansetron, a 5-HT3 receptor antagonist, affect inhibition of the Bezold-Jarisch Reflex in obstetric cesarean section patients receiving spinal anesthesia? De-identified aggregated electronic medical record data for a one-year period was obtained. Data was grouped by ondansetron administration ...

Positive Rituals For Motherhood: Pain Points And Practices For Maternal Well-Being, Kelsey Klinefelter

Master of Applied Positive Psychology (MAPP) Capstone Projects

Motherhood is both meaningful and arduous. The decades spent mothering bring with them stressors like decreased downtime, overload, high stress, fatigue, and more. As parenting takes priority, mothers often neglect their own needs for their child’s, negatively impacting their well-being. Today, many mothers in the United States face declining health and increasing burnout as a result. A variety of factors may be contributing to this: institutional invisibility, inequity, inflexibility, imbalance, isolation, and identity issues among them. Despite the multigenerational impact of a mother’s well-being, American culture and politics give comparatively little attention to the issue. In this paper ...

Peloton As A Positive Intervention: Using Values, Character Strengths, Language, And Agency To Promote Sustained Engagment, Heidi S. B. Kaufman, Pia Dalal

Master of Applied Positive Psychology (MAPP) Capstone Projects

In a world full of options of exercise platforms and modalities for individuals to choose from, what entices people to stick with a particular program? The exercise platform itself? The language the instructors use to motivate participants? Or is it the ability of a participant to choose from a menu of activities that keeps them engaged? To shed light on this topic, we analyzed physical activity as a positive intervention, using Peloton as an exemplar. Our capstone is divided into three parts. In Part I, we introduce positive psychology and the concept of positive interventions as a pathway to well-being ...

The Impact Of A Preoperative Screening Tool For Adults Ages 40 And Older On Surgical Cancellations: A Quality Improvement Project, Colleen B. Bole, Emilsy S. Herron, Allison J. Sweeney

Doctor of Nursing Practice (DNP) Projects

Patients ages 40 and older are at increased risk for postoperative complications but are often under-optimized preoperatively due to a lack of proper screening tools. The clinical question for this project was: In patients ages forty and older undergoing elective Otolaryngology (ENT) procedures, how does the use of a preoperative risk assessment tool compared to standard preoperative care influence the rate of same-day surgical case cancellations due to improper preoperative optimization? A pre- and post-implementation design was conducted at an academic medical center with ENT surgical cases. The primary outcome was the rate of same-day anesthesia-led cancellations. Eligible cases included ...

How Lagging Financial Metrics Affect Next Year Hospital Patient Metrics, Mason Gatewood

Wharton Research Scholars

This paper analyzes a dataset of 231 California general acute hospitals from 2013-2018 to determine whether there are differences between how financial metrics affect following year patient metrics in non-profit versus investor-owned hospitals. The primary patient metric used in this paper is the average length of stay, excluding long-term care. The primary financial metrics used in this paper are lagged gross patient revenue. Secondary outcomes measured include how c-section births, inpatient operating room minutes, and total discharges are affected by financial metrics from non-profit and investor-owned hospitals. The main finding of this paper is that investor-owned hospitals decrease the average ...

Incidence Of Dental Implant Failure In Academic Setting - A Clinical Retrospective Study Part One: Patient Level, Reza Hakim Shoushtari

Dental Theses

Aim: The aim of this retrospective study was to determine the implant failure rate and associated factors in the academic setting by using electronic health records (Axium) and hard copies of patients who received dental implants at in Penn Dental Medicine (PDM) and at Penn Dental Faculty Ppractices (PDFP) ofat the University of Pennsylvania from 06/01/2016 to 08/31/201920. In addition, evaluation of electronic health records and hard copies were reviewed for patients who had implants removed due to bone loss or lack of osseointegration atin PDM and Faculty practicesPDFP of the University of Pennsylvania from ...

The Effect Of Different Polishing Protocols On Surface Topography And Roughness Of Provisional And Semi-Permanent Prosthodontic Materials, Lucie Zi Xuan Yin

Dental Theses

A smooth-surface provisional restoration is necessary to reduce biofilm adhesion, periodontal inflammation, caries formation, discoloration, and wear.

This study evaluated the surface topography and roughness of a bis-acryl resin (Luxatemp), a semi-permanent composite resin (Luxacrown), a CAD/CAM composite block (Luxacam), and a polymethyl methacrylate block (Telio CAD) when polished with different protocols.

A total of thirty-six specimens were fabricated, and finished with 320-grit silicon carbide abrasive papers to simulate clinical finishing. Nine specimens for each material were divided into unpolished (control), 2-step, and 3-step polishing groups. Two-step polishing consisted of a gray polisher and a goat hair chamois brush ...

Mrgprx2 Signaling On Mast Cell-Mediated Pseudoallergy And Neuroimmune Interaction, Chalatip Chompunud Na Ayudhya

Dental Theses

In addition to high affinity IgE receptor, human mast cells (MCs) express a newly identified receptor known as Mas-related G protein-coupled receptor-X2 (MRGPRX2; mouse ortholog MrgprB2). This receptor is predominantly expressed on only one subtype of MCs and it can be activated by a diverse group of cationic agonists including host defense peptides, Food and Drug Administration (FDA)-approved drugs associated with pseudoallergy and neuropeptides secreted from sensory nerve endings. Not surprisingly, MRGPRX2 has been implicated in several MC-mediated health and disease, ranging from host defense and wound healing to drug-induced pseudoallergic reactions, neurogenic inflammation and pain. However, there is ...

The Asian Games, Air Pollution And Birth Outcomes In South China: An Instrumental Variable Approach, Xiaoying Liu, Huazhang Miao, Jere R. Behrman, Emily Hannum, Zhijiang Liang, Qingguo Zhao

Population Center Working Papers (PSC/PARC)

We estimate the causal effects of air pollution exposure on low birthweight, birthweight, and prematurity risk in South China, for all expectant mothers and by maternal age group and child sex. We do so by exploiting exogenous improvement in air quality during the 2010 Guangzhou Asian Games, when strict regulations were mandated to assure better air quality. We use daily air pollution levels collected from monitoring stations in Guangzhou, the Asian Games host city, and Shenzhen, a nearby control city, between 2009 and 2011. We first show that air quality during the Asian Games significantly improved in Guangzhou, relative to ...

A Qualitative Systematic Review Of The Association Of Sleep Disturbances With Burning Mouth Syndrome: An Overlooked Relationship, Fatmah J. Alhendi Dds, Patricia Corby Dds, Ms, Eugene Ko Dds, Laurel Graham Mls, Sunday Akintoye Bds, Dds, Ms, Takako Tanaka Dds, Fds, Rcsed

Dental Theses

Objectives: To review the relevant literature to assess if patients with burning mouth syndrome (BMS) are more prone to have sleep disturbances than general population.

Methods: The literature search for relevant articles was from July 2020 to March 2021. A systematic search of PubMed, Embase, Google Scholar, Cochrane library, Dentistry & Oral Sciences Source, and Scopus was conducted to search for relevant studies. The quality of studies was assessed in accordance with the Joanna Briggs Institute’s guidelines and using the software SUMARI – The System for the Unified Management, Assessment and Review of Information. Confidence in the findings was assessed using the GRADE‐CERQual approach.

Results: A total of 1064 studies were initially identified from the search; 6 studies, two cross-sectional and 4 case controls, met the inclusion criteria and were selected for this systematic review. Sleep disturbances was a required outcome measured in selected studies evaluating symptoms of BMS. For studies that were included in the final analyses, BMS was found to relate to several dimensions ...

Single Cell Transcriptomics Identifies Mesenchymal Stem Cell Lineage Trajectories During Maxillary Expansion, Xuefeng Zhao

Dental Theses

Skeletal transverse harmony between maxilla and mandible is essential for balanced vertical and sagittal dental and skeletal relationship, as well as facial esthetics and periodontal health. However, patients, especially adult ones, responded to maxillary expansion differently. It remains unclear why some cases fail while others succeed despite usage of miniscrews for anchorage reinforcement. A deep understanding of the biological basis underlying maxillary expansion is the fundament to answer this question. Unfortunately, the scientific evidence behind the maxillary expansion is largely missing. Cell population within mid-palatal suture and cellular and molecular mechanisms in response to mechanical expansion forces are potential factors ...

Changes In Subjective Versus Objective Well-Being In India, Vani S. Kulkarni, Veena S. Kulkarni, Katsushi S. Imai, Raghav Gaiha

Population Center Working Papers (PSC/PARC)

Although there is abundant literature on subjective well-being (SWB), there is virtually none for India. Growing recognition of the validity and accuracy of measures of SWB of well-being underlies the rapid growth of literature on SWB in recent decades but it has mainly focused on developed countries. Ours is, to our knowledge, the first study of SWB at the all-India level, and one of the few on developing countries, with a rigorous validation of the results. Applying robust OLS and ordered probit models to the India Human Development Survey (IHDS) panel data in 2005 and 2012, we assess SWB changes ...

A Healthcare System In Crisis: Assessing The Financial Impacts Of The Covid-19 Pandemic On American Hospitals, Rachel Goldstein

Wharton Research Scholars

In recent years, the number of hospital closures has steadily increased, which jeopardizes the long-term health of people residing in communities without ready access to hospitals. The onset of the COVID-19 pandemic presented a variety of challenges to hospitals across the United States, including the cessation of elective procedures. This paper compares the financial outcomes of American hospitals during the height of the pandemic and the immediately following months, as well as some hospitals’ methods of responding to the financial hardships presented by the pandemic. Through a regression analysis as well as a case study, this paper finds that there ...

Reimagining Robotic Walkers For Real-World Outdoor Play Environments With Insights From Legged Robots: A Scoping Review, Abriana Stewart-Height, Daniel E. Koditschek, Michelle J. Johnson

Departmental Papers (ESE)

PURPOSE

For children with mobility impairments, without cognitive delays, who want to participate in outdoor activities, existing assistive technology (AT) to support their needs is limited. In this review, we investigate the control and design of a selection of robotic walkers while exploring a selection of legged robots to develop solutions that address this gap in robotic AT.

METHOD

We performed a comprehensive literature search from four main databases: PubMed, Google Scholar, Scopus, and IEEE Xplore. The keywords used in the search were the following: “walker”, “rollator”, “smart walker”, “robotic walker”, “robotic rollator”. Studies were required to discuss the control ...

Character Strengths As An Antidote To Burnout Among Healthcare Trainees, Kristin Jonason, Brittany Sutton, Nicholette Kasman

Master of Applied Positive Psychology (MAPP) Service Learning Projects

Burnout among healthcare workers is a particular kind of occupational stress characterized by emotional fatigue, loss of energy and withdrawal from work. A character strengths-based intervention was designed to mitigate the effects of burnout upon medical trainees at Cincinnati Children’s Hospital and Medical Center. Over the course of a year pediatric anesthesia fellows will participate in four training sessions in character strengths with the intention of giving them increased tools for personal support and improved team dynamics. An introduction to character strengths, appreciating character strengths, mindfulness and character strengths, and character strengths at work and at home were the ...

Effect Of Adjunct Antibiotics In The Treatment Of Peri-Implant Disease: A Systematic Review And Meta-Analysis, Ya-Wei Chen

Dental Theses

Aim: The aim of this systematic review was to assess the clinical effect of adjunct antibiotics in the treatment of peri-implant diseases. Materials and Methods: An electronic systematic search was conducted by using the following databases: PubMed (Medline), Elsevier EMBASE, Web of Science, and Cochrane Central Register of Controlled Trials (CENTRAL), EBSCO-Dentistry and Oral Science Source, and WHO International Clinical Trials Registry Platform (WHOINT) from January 1980 to March 2020 (Registration in PROSPERO:CRD42018114147). Randomized controlled clinical trials with at least 10 patients with peri-implant diseases, treated with or without adjunct local or systemic antibiotics along with surgical or non-surgical ...

Public And Political Opinion On Medicaid, Jane M. Zhu, Sarah Gollust, Yuan-Chi Yang, Abeed Sarker, David Grande

Issue Briefs

Medicaid has long been a political litmus test and a target for substantial programmatic changes. But what does the public feel about Medicaid, especially during a pandemic? In this study, the authors analyze more than one million Medicaid-related tweets from December 1, 2018 to September 30, 2020. They found a high volume of political posts on Twitter around Medicaid topics, peaking in January 2020 in the context of news about Medicaid expansion and the prior administration’s Medicaid block grant proposal. As the pandemic hit, the number of Twitter posts about Medicaid and the pandemic increased, and the volume of ...

Ending The Opioid And Overdose Crisis, Shoshana Aronowitz, Molly Candon, Austin Kilaru, Margaret Lowenstein, Zachary F. Meisel, Jeanmarie Perrone, Janet Weiner

Issue Briefs

The pandemic has worsened an existing drug overdose crisis that claimed the lives of more than 81,000 people in the U.S. from May 2019-June 2020. As the Biden-Harris administration firms up and implements its proposed response to the opioid epidemic, this brief provides evidence-based recommendations to consider.

We focus our recommendations on the evidence and our experience in three areas: reducing the demand for opioids through policies that increase access to prevention, treatment, and recovery services; reducing the harms from opioid use through strategies that reduce morbidity and mortality; and reducing the supply of opioids through opioid stewardship ...

Curtailing Covid-19 On A Dollar-A-Day In Malawi: Implications For The Ongoing Pandemic, Iliana V. Kohler, Fabrice Kämpfen, Alberto Ciancio, James Mwera, Victor Mwapasa, Hans-Peter Kohler

Population Center Working Papers (PSC/PARC)

Utilizing population-based data from the COVID-19 phone survey (N=2,262$) of the Malawi Longitudinal Study of Families and Health (MLSFH) collected during June 2nd--August 17th, 2020, we investigate behavioral, economic and social responses COVID-19 and focus on the crucial role that community leadership and trust in institutions play towards shaping these responses. We argue that the effective response of Malawi to limit the spread of the virus was facilitated by the engagement of local leaders to mobilize communities to adapt and adhere to COVID-19 prevention strategies. Village heads (VHs) played pivotal role in shaping individual's knowledge about the ...

Family Companionship And Elderly Suicide: Evidence From The Chinese Lunar New Year, Hanming Fang, Ziteng Lei, Liguo Lin, Peng Zhang

Population Center Working Papers (PSC/PARC)

Mental health problems among the elderly have attracted increasing attention. The most serious mental health problems may result in suicide, and lack of family companionship is often speculated to be a major cause. In this paper, we use high-frequency suicide rate data and utilize a novel temporal variation in the lunisolar calendar to provide evidence on the protective effects of the Chinese Lunar New Year (when the elderly people receive unusually high level of family companionship) on elderly suicide. We find that elderly suicide rate decreases by 8.7% during the Chinese Lunar New Year. In addition, the protective effects ...

Water, Sanitation, And Hygiene In Healthcare Facilities In The Covid-19 Pandemic: The Case Of Water Mission Mexico, Julia C. Sherry, Kausha Dierker

wH2O: The Journal of Gender and Water

Water, sanitation, and hygiene (WASH) services in healthcare facilities (HCFs) are critical for infection prevention and control, however, these services are often lacking in hospitals and clinics around the world. Water Mission is a nonprofit that designs, builds, and implements safe water, sanitation, and hygiene solutions in various contexts, including healthcare facilities. Two staff members from the Water Mission headquarters in Charleston, SC interviewed the Water Mission Mexico country director, Johnny Bermudez, to share about the role of WASH in HCFs in Mexico and speak on Water Mission’s response to the COVID-19 pandemic.

The Health Impacts Of Eviction: Evidence From The National Longitudinal Study Of Adolescent To Adult Health, Morgan Hoke, Courtney E. Boen

Population Center Working Papers (PSC/PARC)

Eviction represents an urgent social and economic issue in the United States, with nearly two million evictions occurring annually in the U.S. Still, the population health impacts of evictions, as well as the pathways linking eviction to health, are not well documented or understood, particularly among young adults. Using nationally-representative, longitudinal data from the National Longitudinal Study of Adolescent to Adult Health (1994-2008) (n=9,029), the present study uses a combination of analytic methods—including prospective lagged dependent variable regression models, inverse probabilities of treatment weighting, longitudinal first difference models, causal mediation techniques—to comprehensively assess whether and ...