Medicine and Health Sciences Commons^™

How Early Nutrition And Foundational Cognitive Skills Interconnect? Evidence From Two Developing Countries, Alan Sánchez, Marta Favara, Margaret Sheridan, Jere R. Behrman

Population Center Working Papers (PSC/PARC)

We use unique data collected in Ethiopia and Peru as part of the Young Lives Study to investigate the relationship between early undernutrition and four foundational cognitive skills, the first two of which measure executive functioning: working memory, inhibitory control, long-term memory, and implicit learning. We exploit the rich longitudinal data available to control for potential confounders at the household level and for time-invariant community characteristics. We also exploit the availability of data for paired-siblings to obtain household fixed-effects estimates. Overall, we find robust evidence that stunting is negatively related with the development of executive functions, predicting reductions in working …

Effect Of Nudges To Clinicians, Patients, Or Both To Increase Statin Prescribing: A Cluster Randomized Clinical Trial, Chris Tachibana

Research Briefs

Nudges — which present information or set choices to achieve desired behavior — increased guideline based statin prescribing over usual care. Clinician nudges alone had a small effect, patient nudges alone had no effect, and combined clinician and patient nudges had the greatest effect, increasing prescribing by 7.2 percentage points. The interventions employed a common electronic health record (EHR) system, making them generalizable and scalable.

Collation Model For Ms. Codex 1162: Annotata In Libellos Aristotelis Parva Naturalia Appellatos., Dot Porter

Collation Models

Lecture notes on Aristotle's Parva naturalia, in many cases indicating the date of the lecture. Each section begins with a summary of its argument, followed by running commentary on the Greek text. Greek headings indicate the text currently under consideration. In between De divinatione ex insomniis and De longa et brevi vita, there also appears a commentary on De motu animalium dated to the same time, which employs the same structure as the other sections. However, the heading follows a different pattern, and the whole work is contained within its own three gatherings. Table of contents the title page (f. …

Global Age Patterns Of Under-5 Mortality (Gapu5m) Site Profiles Series: Maternal And Child Health Surveillance System (Mchss), China, Francisco Villavicencio, Li Liu, Andrea Verhulst, Michel Guillot

Global Age Patterns of Under-5 Mortality (GAPU5M) Site Profiles Series

No abstract provided.

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.

The Impact Of The Juntos Conditional Cash Transfer Programme On Foundational Cognitive Skills: Does Age Of Enrollment Matter?, Douglas Scott, Jennifer Lopez, Alan Sánchez, Jere R. Behrman

Population Center Working Papers (PSC/PARC)

This paper studies the relationship between the age of enrolment in Peru’s conditional cash transfer programme, JUNTOS, and the foundational cognitive skills of a sample of children aged between 5 and 12 years old. Using a difference-in-differences approach and exploiting within-household variation, we show that younger siblings in recipient households display significantly higher levels of inhibitory control than their older counterparts (0.11 standard deviations), having benefited from the programme for the first time at a relatively earlier age. In high-income countries, this behavioural trait has been linked to later-life outcomes such as job success, physical health, and even reduced risk …

The Effect Of Different Surface Treatments On The Bond Strength Of Zirconia, Kushaldeep Fnu

Dental Theses

Objectives: The purpose of the study was to evaluate the influence of various surface treatment methods on the resin bond durability of zirconia.

Methods: Hundred KATANA Zirconia STML (n=20) specimens were sectioned and sintered in an induction furnace (CEREC SpeedFire, Dentsply Sirona, Germany). Specimen surfaces were ground finished with 800 grit silicon carbide abrasive with cooling water and cleaned in an alcohol bath ultrasonically before cementation for 5 min, and thoroughly washed again with running distilled water. Specimens in Group 1 had no surface treatment, Group 2 was air-abraded with 50 μm aluminum oxide, Group 3 was air …

Collation Model For Ljs 195: [Medical Miscellany], Dot Porter

Collation Models

Medical compilation with a particular focus on the plague, but also including information on diseases of different parts of the body, urine, medicines, laxatives, water and wine, and the making of pigments for painting and inks for writing (f. 209r-215r).

Psychedelics, Positive Psychology, And Positive Humanities, Hamide Eygoren

Master of Applied Positive Psychology (MAPP) Capstone Projects

Public and scientific interest in the effect of psychedelic drugs on wellbeing has risen significantly. Preliminary data show that psychedelic drugs, specifically classic psychedelics (DMT, psilocybin, mescaline, and LSD), may have the potential to treat mood disorders and increase wellbeing through their acute subjective effects. The acute subjective effects and enduring effects of psychedelics on wellbeing seem to relate to positive psychological frameworks (e.g., resilience factors and PERMA) considerably. Moreover, optimizing acute subjective effects indicates the importance of set (individual’s internal (mental) factors) and setting (individual’s external factors) in psychedelics administration as moderating factors. A new subfield in positive psychology, …

Organizations As Agents For Well-Being: How An Organizational Orientation To “Do Good” Could Lead To Flourishing, Andrew Frick

Master of Applied Positive Psychology (MAPP) Capstone Projects

It has been proposed that flourishing individuals enable flourishing organizations which leads to a flourishing world. However, is it also possible that by focusing on building a flourishing world a reciprocal elevation of organizational flourishing and individual flourishing can occur? This paper discusses well-being, the progression of research regarding organizational orientation to do good, and mirror flourishing. The amplification effect of virtuousness, along with the heliotropic effect, provide support to the theorized concept of mirror flourishing. In addition, this paper proposes a study design using appreciative inquiry to conduct interviews to better understand how an organization’s orientation to do good …

A Prescription Of Positive Psychology: Bridging The Intention-Behavior Gap In Social Prescribing In The Uk, Jill Rzym

Master of Applied Positive Psychology (MAPP) Capstone Projects

Although people have intentions to change their behavior, many do not take any action, and this discrepancy is called the intention-behavior gap. Studies estimate the gap is as high as 50%, a figure of some significance in health behavior change. This paper explores the intention-behavior gap in the context of social prescribing in the UK. It looks at the current problems of measurement and evaluation within social prescribing and the potential impact of the intention-behavior gap. The paper also considers the current research addressing the gap and proposes an alternative solution based on a positive psychology framework and positive psychology …

Improving Residents’ Well-Being Through Mindful Interventions And Character Strength Amplification, Hasan Mabry

Master of Applied Positive Psychology (MAPP) Capstone Projects

Abstract

This paper offers a new approach that aims to improve the well-being of nursing home residents through implementing positive psychology. Developing care plans that include mindful practices as positive interventions may help improve cognition, mood stabilization, and amplification of character strengths. Specifically, residents engaging in the positive interventions may help improve their ability to live in the moment, while also learning to amplify certain character strengths as needed. Through improving mindfulness and learning to rely on their strengths, nursing home residents may become more self-sufficient during times of change. These care plans also inspire a sense of mattering within …

Communitas: Building Community Through Leisure And Collective Joy, Louise Wo

Master of Applied Positive Psychology (MAPP) Capstone Projects

Relationships and belonging are fundamental needs for well-being. At the same time, our culture is becoming increasingly individualistic and loneliness is pervasive. Our traditional community and relational frameworks, such as religious institutions and associations, are also diminishing. This capstone explores leisure as a possible pathway for building social capital and community well-being. We will look at why leisure activities based in recreation, play and the humanities have the capacity to build community and enduring connections with others, while also having individual well-being benefits. This capstone features some exemplary groups that utilize leisure activities and have built strong communities through positive …

In Vitro Comparative Study Between Full-Arch Conventional Implant Impressions And Full-Arch Digital Implant Impressions With Snap-On Scan Bodies, Thomas H. Yoo

Dental Theses

Statement of Problem: Digital impression techniques are widely used in everyday cases. There is sufficient evidence to support this technique in partially edentulous patients but the evidence supporting the use of intraoral scanners (IOS) in restorative digital workflows for edentulous patients is still limited.

Purpose: The aim of the present in vitro study was to measure and compare the accuracy of full- arch conventional implant impressions with open and closed-trays, full-arch digital implant impressions with intraoral scanners (IOS), and three-dimensional (3D) printed casts from the full-arch digital implant impressions.

Material and methods: Six implants were placed into a mandibular model. …

18f-Fdg-Pet/Ct In Radiation Therapy-Induced Cerebellar Inflammation, Mohammad Abu Kar, Abass Alavi, Johnathan M. Korostoff, Joseph P. Fiorellini, Yu-Cheng Chang

Dental Theses

ABSTRACT

Background

18F-fluorodeoxyglucose-positron emission tomography/computed tomography (¹8FDG- PET/CT) is used in the clinical diagnosis and management of oncologic and inflammatory pathologies. It may also have utility in detecting tissue damage induced by radiotherapy (RT) used to treat various types of cancer. The aim of the present study was to use ¹8FDG-PET/CT to evaluate the effect of RT on the uptake of ¹8FDG by the cerebellum.

Methods Thirty patients with head and neck cancer (HNC) were included in this retrospective study. The patients were treated with photon, proton, or combined photon/proton RT, in addition to chemotherapy. All …

Preliminary Analysis Of Transcriptomic Variations In Esrp1/Sox2 Double Transgenic Mouse Embryo Facial Prominences In Search Of Esrp1 Targets Responsible For Cleft Lip And/Or Palate Pathogenesis, Grace Lee

Dental Theses

Cleft lip and/or palate (CL/P) is a highly prevalent craniofacial deformation worldwide, that is challenging to treat. Despite the series of reconstructive surgeries, orthodontic treatments, and functional rehabilitation therapies, patients can not fully recover from the esthetic and functional defect they were born with. A paradigm-shift in treatment approach is needed to lift the medical, psychosocial, and financial burdens from the patients and their families, one that would intercept the malformation in utero and recapitulate normal development of the lip and the palate before birth. A necessary first step towards this goal is to decipher the intricate molecular mechanisms underlying …

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 9 and 26 …

Deep Margin Elevation: A Literature Review, Theodora Kalliopi Samartzi, Dimokritos Papalexopoulos, Panagiotis Ntovas, Christos Rahiotis, Markus Blatz

Departmental Papers (Dental)

A conservative approach for restoring deep proximal lesions is to apply an increment of composite resin over the preexisting cervical margin to relocate it coronally, the so-called “deep margin elevation” (DME). A literature search for research articles referring to DME published from January 1998 until November 2021 was conducted using MEDLINE (PubMed), Ovid, Scopus, Cochrane Library and Semantic Scholar databases applying preset inclusion and exclusion criteria. Elevation material and adhesive system employed for luting seem to be significant factors concerning the marginal adaptation of the restoration. This technique does not affect bond strength, fatigue behavior, fracture resistance, failure pattern or …

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 potable water hard …

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 high-barrier, …

Changing Care Paradigms: A Pilot Study On User-Interface And Design Implications On The Efficacy Of Medical Record Systems In Low-Resource Settings, Raveen S. Kariyawasam

Wharton Research Scholars

Electronic Medical Record Systems (EMRS) has quickly become the backbone of the healthcare delivery ecosystem in developed countries. Their reaches range from insurance to billing to physician charting. Despite the mainstream use of EMRS in developed countries, their implementation in low-resource settings has faced more barriers and challenges. During the development of EMRS, the concerns, hurdles, and considerations of developed nations are what were used as inspiration when designing these systems. This thesis explores the use of effective User Interface and User Experience (UI/UX) design to help lower the accessibility barriers associated with EMRS implementation and usage in low-resource settings. …

The Impact Of Value-Based Reimbursement On Patient Care, Samarth Sharma

Wharton Research Scholars

This paper aims to perform initial research on the impact of value-based reimbursement on the quality of patient care. I will apply descriptive and exploratory data analysis methods on patient claims data to understand the change in length of stay over time as value-based payment models became a larger proportion of reimbursement structures. I also provide descriptive evidence of the obstacles to the implementation of value-based reimbursement based on physician perspectives. Initial findings show that diagnoses related to pregnancies decreased in mean and standard deviation of length of stay, which points to increased patient quality. There may be some correlation …

Racialized Patterns Of Inequality In United States Birth Outcomes, 1990-2018, Hannah Olson

Publicly Accessible Penn Dissertations

Low birthweight is a pernicious public health problem that has seen little to no improvement in the United States for over 50 years. Being born low birth weight carries an increased risk of a broad range of adverse health and development outcomes and has been identified as a likely mechanism through which health and socioeconomic inequality is reproduced across generations. Racial disparities in birth weight are particularly stark. However, despite considerable attention to the issue, existing research fails to fully explain the social, institutional, and historical processes that operate to uphold racialized inequality in adverse birth outcomes. In light of …

Blimp1 And Nr4a3 Transcription Factors Reciprocally Regulate Antitumor Car T-Cell Stemness And Exhaustion, Inyoung Jung

Publicly Accessible Penn Dissertations

Chimeric antigen receptor (CAR) T-cells have not induced meaningful clinical responses in solid tumor indications. Loss of T-cell stemness, poor expansion capacity and exhaustion during prolonged tumor antigen exposure are major causes of CAR T-cell therapeutic resistance. scRNA-sequencing analysis of CAR T-cells from a first-in-human trial in metastatic prostate cancer identified two distinct and independently validated cell states associated with antitumor potency or lack of efficacy. Low levels of the PRDM1 gene encoding the BLIMP1 transcription factor defined highly potent TCF7+CD8+ CAR T-cells, while enrichment of TIM3+CD8+ T-cells with elevated PRDM1 expression predicted poor outcome. PRDM1 single knockout promoted TCF7-dependent …

Dismantling The System: Unpacking Racism's Impact On Inequities In Behavioral Health, Healthcare Utilization, And Access To Care, Nana Akosua Adjeiwaa-Manu

Publicly Accessible Penn Dissertations

Identifying how the many elements of structural racism affect racial and ethnic health inequities remains an ongoing challenge. Although a growing body of work primarily focuses on structural racism's impact on population health outcomes, this dissertation examines structural racism's role in shaping inequities in behavioral health outcomes, behavioral healthcare use, and behavioral healthcare access. I argue that the complex features of structural racism work together to produce health inequities. First, I explore the relationship between self-reported racial and ethnic classification – which I conceptualize as placement in the racial hierarchy relative to whiteness – and inequities in behavioral health outcomes …

Optimizing The Design And Implementation Of Peer Support Interventions For Adolescents Living With Hiv In Sub-Saharan Africa, Charisse Victoria Ahmed

Publicly Accessible Penn Dissertations

Adolescents living with HIV (ALHIV) in sub-Saharan Africa (SSA) face multiple challenges which exacerbate their risks for treatment failure and poor psychosocial outcomes. Peer support interventions can be a mechanism to potentially improve their health outcomes. The purpose of this dissertation was to use innovative approaches to design and evaluate peer support interventions for ALHIV in sub-Saharan Africa, which were explored in three ways. First, an integrated review was conducted to understand the state of the science regarding the efficacy of peer support interventions in improving psychosocial and treatment outcomes among ALHIV in SSA. Second, a hybrid inductive-deductive thematic approach …

Comparing The Mental Health Care Policies And Economic Effects In Australia And The United States: Implementing The “Headspace” Centre Model, Catherine J. Michelutti

Social Impact Research Experience (SIRE)

The prevalence of mental and behavioral health problems is currently high in most, if not all, countries. In the U.S. and elsewhere we have seen the impact of an increasingly stressful time, as we live through the pandemic, social unrest, war, and divisive politics. Costs of mental health problems include not only the direct expense of treatment but also indirect costs of loss of productivity and the impacts on society, including substance abuse, family dysfunction, homelessness, crime, etc. The headspace model, which originated in Australia, is a new approach for addressing mental health issues for adolescents and young adults. After …

An Examination Of Clinical Decision Support For Discharge Planning: Systematic Review, Simulation, And Natural Language Processing To Elucidate Referral Decision Making, Erin Elizabeth Kennedy

Publicly Accessible Penn Dissertations

Statement of the Problem: As healthcare data becomes increasingly prolific and older adult patient needs become more complex, there is opportunity for evidence-based technology such as clinical decision support systems (CDSS) to improve decision making at the point of care. Although CDSS for discharge planning is available, few published tools have been translated to new settings. Existing studies have not explored discordance between recommended and actual discharge disposition. Understanding the reasons why patients do not receive optimal post-acute care referrals is critical to improving the discharge planning process for older adults and their families. Methods: Three-paper dissertation examining CDSS. Paper …

Inequalities In The Structure And Delivery Of U.S. Health Care, Rebecca Anna Schut

Publicly Accessible Penn Dissertations

Although healthcare inequalities by race-ethnicity and nativity have been widely explored, more research is needed to investigate how these inequalities result from structures of racial stratification and immigrant exclusion operating within U.S. health care. My dissertation employs hand coded restricted-access medical record data, linked survey data, and rich administrative data to examine the factors generating healthcare inequalities experienced by both patients and physicians. I contextualize these inequalities within a broader U.S. landscape characterized by structural racism and nativism. In the first chapter, I examine the impact of state immigration policy contexts on healthcare access of U.S. agricultural workers representing various …

Observational Data With A Continuous Exposure: Study Design And Outcome Analysis, Bo Zhang

Publicly Accessible Penn Dissertations

Subclassification and matching are often used in empirical studies to adjust for observed covariates; however, they are largely restricted to relatively simple study designs with a binary exposure and less developed for designs with a continuous exposure. This thesis contains three papers discussing aspects of study design and outcome analysis with a continuous exposure. The first paper presents a new full match methodology for data with a continuous exposure that achieves good subclass homogeneity, preservation of all study units, dose separation when desired, and control over the size of subclasses. There are two types of empirical studies where matching with …