Medicine and Health Sciences Commons^™

Registry-Based Cohort Study Of Alpha-1 Antitrypsin Deficiency Prevalence, Incidence And Mortality In Denmark 2000-2018, John Acquavella, Emese Vágó, Henrik Toft Sorensen, Erzsébet Horváth-Puhó, Gregory P. Hess

College of Population Health Faculty Papers

OBJECTIVE: To estimate the prevalence of diagnosed alpha-1 antitrypsin deficiency (dAATD) in Denmark as of 31 December 2018, and dAATD incidence and mortality from 1 January 2000 to 31 December 2018.

STUDY DESIGN AND SETTING: We used the Danish National Patient Registry to identify patients with dAATD based on the International Classification of Diseases, 10th Revision (ICD-10) code E88.0A and the Danish Civil Registration System (CRS) for population counts and vital status. We estimated dAATD prevalence, incidence and mortality. We compared mortality among patients with dAATD and an age-matched and sex-matched cohort extracted from the Danish CRS. We conducted a …

Identifying The Gaps Between Public Health Training And Practice: A Workforce Competencies Comparative Analysis, Osnat Bashkin, Robert Otok, Ori Kapra, Kasia Czabanowska, Paul Barach, Orna Baron-Epel, Keren Dopelt, Mariusz Duplaga, Lore Leighton, Hagai Levine, Fiona Macleod, Yehuda Neumark, Stephanie Paillard-Borg, Theodore Tulchinsky, Zohar Mor

College of Population Health Faculty Papers

Objectives: The study aimed to generate insights on how best to enhance the compatibility between Public Health training program competencies and the implementation of competencies required by employers to address current and emerging public health needs.

Methods: A survey adapted from the WHO-ASPHER Competency Framework for the Public Health Workforce was conducted online among Israeli public health managers from August to November 2021. The survey was formulated to mirror Essential Public Health Operations. Forty-nine managers participated (37.6% response rate) in an assessment of 44 public health competencies and the core organizational public health operations.

Results: Analysis of Essential Public Health …

Blood Pressure Responses Are Dependent On Call Type And Related To Hypertension Status In Firefighters, Paige J Rynne, Cassandra C Derella, Carly Mcmorrow, Rachel L Dickinson, Stephanie Donahue, Andrew A Almeida, Megan Carty, Deborah L Feairheller

College of Population Health Faculty Papers

Background: Impaired cardiovascular health is a concern for firefighters, with over 50% of line-of-duty deaths having cardiac causes. Many firefighters have hypertension and <25% have their blood pressure (BP) controlled. The alarm response could be an unidentified cardiac risk, but interestingly, the BP response to different calls and on-the-job activity is unknown.

Purpose: We aimed to measure the physiological stress resulting from different call types (fire, medical) and job activity (riding apparatus, pre-alert alarms) through ambulatory BP (ABP) monitoring in a population of firefighters.

Materials and methods: During 111 12-h work shifts firefighters wore an ABP monitor. BP was measured at 30-min intervals and manual measurements were prompted when the pager went off or whenever they felt stress.

Results: Firefighters were hypertensive (124.3 ± 9.9/78.1 ± 6.7 mmHg), overweight …

Choosing Not To Look: Not A Solution, Rosemary Frasso

College of Population Health Faculty Papers

No abstract provided.

Disparities In Neighborhood Park Access Among Adults In Philadelphia, Russell K. Mcintire, Tiara Halstead, Devesh Dajee, Meghan Buckley, Kyle Mcgregor, Sharon Larson

College of Population Health Faculty Papers

Researchers have clearly identified the importance of green space to promote mental and physical health among humans. In urban areas, public parks are essential for providing access to green space for many residents. This study identified the relationships between demographics, neighborhood social capital, violent crime, and residential distance to the closest park (park proximity) with self-reported access to neighborhood parks, among a population-representative sample of adults in Philadelphia. Women, older age groups, minorities, and those with lower education levels had lower self-reported access to neighborhood parks. Those reporting high neighborhood social capital had higher self-reported access to neighborhood parks. Park …

“I Can’T See How People Could Walk Through That Exhibit And Not Be Forever Changed”: A Qualitative Analysis Exploring The Use Of Art In Research Dissemination, Vincent M. Pepe, Allison Sowers, Michelle Pimentel, Alexa Hoffman, Cierrah Doran, Amanda Guth, Sameer Khan, Willie Baronet, Rosemary Frasso

College of Population Health Faculty Papers

Background: Art can be a strong advocacy tool; it can be used to amplify the voices of marginalized communities and can change people’s perceptions of the world and others in it. In 2018, an art exhibit at Jefferson University included the cardboard signs of people who panhandle in Philadelphia as well as excerpts from in-depth interviews with those who panhandle to highlight their lived experiences. While the team published an article about this work, the purpose of this follow-up study is to explore the lasting impact of the exhibit experience on attendees’ perceptions of people who panhandle.

Methods: Fourteen attendees …

Commentary: Examining Contextual Factors Contributing To Differentials In Covid-19 Mortality In U.S. Vs. India., Preeti Zanwar, Katrine L Wallace, Christopher Soria, Arokiasamy Perianayagam

College of Population Health Faculty Papers

No abstract provided.

A Call For Consistent Measurement Across The Social Determinants Of Health Industry Landscape., Ellen T Rudy, Kelsey C Mcnamara, Zachary N Goldberg, Andrew Parker, David B Nash

College of Population Health Faculty Papers

No abstract provided.

Assessing The Effect Of Four Types Of Direct Mail Messages To Promote The Uptake Of Residential Lead Remediation Funds, H. Okatch, B. Nkala, J. Beltrami, E. Poy, D. Parmer, J. Nkala, F. Olawole

College of Population Health Faculty Papers

Objective

To examine the efficacy of direct mailing using four types of messaging on promoting the uptake of residential lead remediation (RLR) funds in Lancaster, PA, USA.

Study design

We designed a quasi-experiment to assess the effect of 4 RLR messages sent to households in Lancaster, PA by direct mail between September and December 2020: a brief flyer (F); a detailed brochure + the flyer (BF); a health infographic + the flyer (IF); and an application form + the flyer (AFF).

Methods

Mailers were sent to addresses in four census tracts; each census tract received a different message. Both English …

Emerging Lessons From The Covid-19 Pandemic About The Decisive Competencies Needed For The Public Health Workforce: A Qualitative Study, Osnat Bashkin, Robert Otok, Lore Leighton, Kasia Czabanowska, Paul Barach, Nadav Davidovitch, Keren Dopelt, Mariusz Duplaga, Leah Okenwa Emegwa, Fiona Macleod, Yehuda Neumark, Maya Peled Raz, Theodore Tulchinsky, Zohar Mor

College of Population Health Faculty Papers

The global COVID-19 crisis exposed the critical need for a highly qualified public health workforce. This qualitative research aimed to examine public health workforce competencies needed to face COVID-19 challenges and identify the gaps between training programs and the competency demands of real-world disasters and pandemics. Through a sample of thirty-one participant qualitative interviews, we examined the perspectives of diverse stakeholders from lead public health organizations in Israel. Grounded Theory was used to analyze the data. Six themes emerged from the content analysis: public health workforce's low professional status and the uncertain future of the public health workforce; links between …

Serious Hazards Of Transfusion: Evaluating The Dangers Of A Wrong Patient Autologous Salvaged Blood In Cardiac Surgery., Masashi Uramatsu, Hideyuki Maeda, Shiro Mishima, Megumi Takahashi, Jun Wada, Kagehiro Amano, Paul Barach, Tamotsu Miki

College of Population Health Faculty Papers

BACKGROUND: The past half century has seen the near eradication of transfusion-associated hazards. Intraoperative cell salvage while widely used still poses significant risks and hazards due to human error. We report on a case in which blood collected from a patient with lung cancer was mistakenly administered to a patient undergoing cardiac surgery who should have received his own collected blood. The initial investigation found that the cause of the patient harm was violations of procedures by hospital personnel. A detailed investigation revealed that not only violations were the cause, but also that the underlying causes included haphazard organizational policies, …

Implementation And Outcomes Of A Remote Hepatitis B Screening Program Designed To Overcome Covid-19 Pandemic-Related Disruptions To Community-Based Screenings For Asians In Greater Philadelphia: A Descriptive Study, Yoonhee P Ha, Yusha Sun, Jack Wilkinson, Sonia Wang, Lillian Chien, Marisa Wu, Evangeline Wang, Catherine Freeland

College of Population Health Faculty Papers

No abstract provided.

Resilience And Protection Of Health Care And Research Laboratory Workers During The Sars-Cov-2 Pandemic: Analysis And Case Study From An Austrian High Security Laboratory, Martina Loibner, Paul Barach, Stella Wolfgruber, Christine Langner, Verena Stangl, Julia Rieger, Esther Föderl-Höbenreich, Melina Hardt, Eva Kicker, Silvia Groiss, Martin Zacharias, Philipp Wurm, Gregor Gorkiewicz, Peter Regitnig, Kurt Zatloukal

College of Population Health Faculty Papers

The SARS-CoV-2 pandemic has highlighted the interdependency of healthcare systems and research organizations on manufacturers and suppliers of personnel protective equipment (PPE) and the need for well-trained personnel who can react quickly to changing working conditions. Reports on challenges faced by research laboratory workers (RLWs) are rare in contrast to the lived experience of hospital health care workers. We report on experiences gained by RLWs (e.g., molecular scientists, pathologists, autopsy assistants) who significantly contributed to combating the pandemic under particularly challenging conditions due to increased workload, sickness and interrupted PPE supply chains. RLWs perform a broad spectrum of work with …

Social Determinants Of Health In Pulmonary Arterial Hypertension Patients In The United States: Clinician Perspective And Health Policy Implications, Vijay R. Nadipelli, Jean M. Elwing, Willie H. Oglesby, Karim El-Kersh

College of Population Health Faculty Papers

Social determinants of health (SDoH) can impact the vulnerable pulmonary arterial hypertension (PAH) population, especially during the COVID-19 pandemic. Providers' understanding of SDoH at the point of care and their impact is unknown. We conducted semi-structured virtual interviews with US clinicians at 17 pulmonary hypertension (PH) centers and one patient advocate from the Pulmonary Hypertension Association. We sought participants' perspective on SDoH in PAH and their impact. Transcripts were developed and analyzed for key themes to assess potential policy implications. Participants served a large PAH population and demonstrated high awareness of SDoH and its impact on treatment and outcomes. They …

Improving Cancer Care Through Digital Health Coaching, Jennifer Nguyen, Pharmd, Vittorio Maio, Pharmd, Ms, Msph, Nathan Handley, Md, Mba

College of Population Health Faculty Papers

No abstract provided.

Patient-Reported Outcome Measures-Challenges And Opportunities For China., Donald E Casey

College of Population Health Faculty Papers

No abstract provided.

Overcrowded Housing Increases Risk For Covid-19 Mortality: An Ecological Study, Karan Varshney, Talia Glodjo, Jenna R Adalbert

College of Population Health Faculty Papers

Objectives: Overcrowded housing is a sociodemographic variable associated with increased infection and mortality rates from communicable diseases. It is not well understood if this association exists for COVID-19. Our objective was hence to determine the association between household overcrowding and risk of mortality from COVID-19, and this was done by performing bivariable and multivariable analyses using COVID-19 data from cities in Los Angeles County.

Results: Bivariate regression revealed that overcrowded households were positively associated with COVID-19 deaths (standardized β = 0.863, p < 0.001). COVID-19 case totals, people aged 60+, and the number of overcrowded households met conditions for inclusion in the backwards stepwise linear regression model. Analysis revealed all independent variables were positively associated with mortality rates, primarily for individuals 60 + (standardized β1 = 0.375, p = 0.001), followed by overcrowded households (standardized β2 = 0.346, p = 0.014), and total COVID-19 cases (standardized β3 = 0.311, p < 0.001). Our findings highlight that residing in overcrowded households may be an important risk factor for COVID-19 mortality. Public health entities should consider this population when allocating resources for prevention and control of COVID-19 mortality and future disease outbreaks.

Overcrowded Housing Increases Risk For Covid-19 Mortality: An Ecological Study., Karan Varshney, Talia Glodjo, Jenna Adalbert

College of Population Health Faculty Papers

OBJECTIVES: Overcrowded housing is a sociodemographic variable associated with increased infection and mortality rates from communicable diseases. It is not well understood if this association exists for COVID-19. Our objective was hence to determine the association between household overcrowding and risk of mortality from COVID-19, and this was done by performing bivariable and multivariable analyses using COVID-19 data from cities in Los Angeles County.

RESULTS: Bivariate regression revealed that overcrowded households were positively associated with COVID-19 deaths (standardized β = 0.863, p < 0.001). COVID-19 case totals, people aged 60+, and the number of overcrowded households met conditions for inclusion in the backwards stepwise linear regression model. Analysis revealed all independent variables were positively associated with mortality rates, primarily for individuals 60 + (standardized β

Patient And Provider Experiences With Cbt-I Administered In-Person Or Via Telemedicine: A Randomized Non-Inferiority Trial, Rachel E. Granberg, Arianna Heyer, Philip R. Gehrman, Paul W. Gunter, Nathan A. Hoff, Amanda Guth, Matthew S. Kayser, Samuel Kuna, Rosemary Frasso

College of Population Health Faculty Papers

Cognitive behavioral therapy for insomnia (CBT-I) is an effective treatment in adults. However, access to care is limited. One potential solution is telemedicine. Though synchronous video-based telemedicine CBT-I has been shown to be non-inferior to in-person treatment, there is no study to date that evaluates patient and provider experiences with video-based treatment. Our study team evaluated patient and provider perceptions of CBT-I delivered via telemedicine versus an in-person format. As part of a larger randomized control trial, we interviewed patients and providers in both arms of the study (in-person and via telemedicine). 20 minute interviews were conducted over the phone …

Angiotensin Blockade Therapy And Survival In Pancreatic Cancer: A Population Study, Scott W Keith, Vittorio Maio, Hwyda A Arafat, Matthew Alcusky, Thomas Karagiannis, Carol Rabinowitz, Harish Lavu, Daniel Z. Louis

College of Population Health Faculty Papers

Background: Pancreatic cancer (PC) is one of the most aggressive and challenging cancer types to effectively treat, ranking as the fourth-leading cause of cancer death in the United States. We investigated if exposures to angiotensin II receptor blockers (ARBs) or angiotensin I converting enzyme (ACE) inhibitors after PC diagnosis are associated with survival.

Methods: PC patients were identified by ICD-9 diagnosis and procedure codes among the 3.7 million adults living in the Emilia-Romagna Region from their administrative health care database containing patient data on demographics, hospital discharges, all-cause mortality, and outpatient pharmacy prescriptions. Cox modeling estimated covariate-adjusted mortality hazard ratios …

A Focus On The Future Of Opioid Prescribing: Implementation Of A Virtual Opioid And Pain Management Module For Medical Students, Jenna R Adalbert, Asif M. Ilyas

College of Population Health Faculty Papers

Background: The United States opioid epidemic is a devastating public health crisis fueled in part by physician prescribing. While the next generation of prescribers is crucial to the trajectory of the epidemic, medical school curricula designated to prepare students for opioid prescribing (OP) and pain management is often underdeveloped. In response to this deficit, we aimed to investigate the impact of an online opioid and pain management (OPM) educational intervention on fourth-year medical student knowledge, attitudes, and perceived competence.

Methods: Graduating students completing their final year of medical education at Sidney Kimmel Medical College of Thomas Jefferson University were sent …

Rehabilitation Care At The Time Of Coronavirus Disease-19 (Covid-19) Pandemic: A Scoping Review Of Health System Recommendations, Ahmed M Negm, Adrian Salopek, Mashal Zaide, Victoria J Meng, Carlos Prada, Yaping Chang, Preeti Zanwar, Flavia H Santos, Elena Philippou, Emily R Rosario, Julie Faieta, Jason R Falvey, Amit Kumar, Timothy A Reistetter, Vanina Dal Bello-Haas, Jonathan F Bean, Mohit Bhandari, Patricia C Heyn

College of Population Health Faculty Papers

Purpose: The coronavirus disease-19 (COVID-19) was declared a pandemic by the World Health Organization in March 2020. COVID-19, caused by SARS-CoV-2 has imposed a significant burden on health care systems, economies, and social systems in many countries around the world. The provision of rehabilitation services for persons with active COVID-19 infection poses challenges to maintaining a safe environment for patients and treating providers. Materials and Methods: Established frameworks were used to guide the scoping review methodology. Medline, Embase, Pubmed, CINAHL databases from inception to August 1, 2020, and prominent rehabilitation organizations' websites were searched. Study Selection: We included articles and …

How To Hospital: Barriers To Developing A Patient 'Hospital Survival Guide' To Support Information Transfer During Ward-Rounds On The Patient Journey From Admission To Hospital To Discharge, Swyn Lewis, Gwenlli Mai Jones, Paul Barach, Hawys Tomos, Mari Davies, Buddug Eckley, Hannah Rebecca Dowell, Christian Peter Subbe

College of Population Health Faculty Papers

Clinicians can enable patients to actively participate in their care but communication with patients is often poor and highly variable. The aim of this study was to explore patients' understanding of their current illness while in hospital and using a codesign process to create prototype tools to facilitate better communication during ward rounds. A mixed-methods, multistep design with step 1: Application of a questionnaire addressing domains of care in the acute medical unit; step 2: Development of communication aids that were codesigned with active help of patients, students and a specialist in user centric design to address patient needs and …