Medicine and Health Sciences Commons^™

Lgbtq+ And Dental Education: Analyzing The Present And Recommendations For The Future, Diana V. Macri, Colin Haley Dds, Herminio Perez Dmd, Scott Schwartz Dds

Publications and Research

LGBTQ+ populations constitute increasing proportions of children, adolescents, and adults in the United States. Compared to their heterosexual counterparts, this group suffers from health inequities, including oral health. The report “Oral Health: Advances and Challenges” identified the LGBTQ+ community as an underserved population which faces significant barriers in accessing oral health care. Coverage of LGBTQ+ topics in formal education settings in both dental schools and dental hygiene programs is scarce, which contributes to inequities within this group. Increasing curriculum content related to LGBTQ+ populations is of utmost importance to promote optimal patient-provider interactions while improving oral health outcomes. Ensuring equity …

Recognizing And Disrupting Stigma In Implementation Of Hiv Prevention And Care: A Call To Research And Action, Sarit A. Golub, Rachel A. Fikslin

Publications and Research

Introduction: There is robust evidence that stigma negatively impacts both people living with HIV and those who might benefit from HIV prevention interventions. Within healthcare settings, research on HIV stigma has focused on intra-personal processes (i.e. knowledge or internalization of community-level stigma that might limit clients’ engagement in care) or inter-personal processes (i.e. stigmatized interactions with service providers). Intersectional approaches to stigma call us to examine the ways that intersecting systems of power and oppression produce stigma not only at the individual and interpersonal levels, but also within healthcare service delivery systems. This commentary argues for the importance of analysing …

Oral Anticoagulant Underutilization Among Elderly Patients With Atrial Fibrillation: Insights From The United States Medicare Database, Muhammad Bilal Munir, Patrick Hlavacek, Allison V. Keshishian, Jennifer D. Guo, Rajesh Mallampati, Mauricio Ferri, Cristina Russ, Birol Emir, Matthew Cato, Huseyin Yuce, Jonathan C. Hsu

Publications and Research

Background

Oral anticoagulants (OACs) mitigate stroke risk in patients with atrial fibrillation (AF). The study aim was to analyze prevalence and predictors of OAC underutilization.

Methods

Newly diagnosed AF patients with a CHA2DS2-VASc score ≥ 2 were identified from the US CMS Database (January 1, 2013–December 31, 2017). Patients were stratified based on having an OAC prescription versus not and the OAC prescription group was stratified by direct OAC (DOACs) versus warfarin. Multivariable logistic regression models were used to examine predictors of OAC underutilization.

Results

Among 1,204,507 identified AF patients, 617,611 patients (51.3%) were not prescribed an OAC during follow-up …

Community Engagement Education In Academic Health Centers, Colleges, And Universities, Chyke A. Doubeni, David Nelson, Elizabeth Gross Cohn, Electra Paskett, Seleshi Ayalew Asfaw, Mehek Sumar, Syed M. Ahmed, Rhonda Mcclinton-Brown, Mark L. Wieland, Anita Kinney, Sergio Aguilar-Gaxiola, Lisa G. Rosas, Cecilia M. Patino

Publications and Research

Community engagement (CE) is critical for advancing health equity and a key approach for promoting inclusive clinical and translational science. However, it requires a workforce trained to effectively design, implement, and evaluate health promotion and improvement strategies through meaningful collaboration with community members. This paper presents an approach for designing CE curricula for research, education, clinical care, and public health learners. A general pedagogical framework is presented to support curriculum development with the inclusion of community members as facilitators or faculty. The overall goal of the curriculum is envisioned as enabling learners to effectively demonstrate the principles of CE in …

Developing Standards For Cultural Competency Training For Health Care Providers To Care For Lesbian, Gay, Bisexual, Transgender, Queer, Intersex, And Asexual Persons: Consensus Recommendations From A National Panel, Mandi L. Pratt-Chapman, Kristen Eckstrand, Amorie Robinson, Lauren B. Beach, Charles Kamen, Alex S. Keuroghlian, Scott Cook, Asa Radix, Markus P. Bidell, Daniel Bruner, Liz Margolies

Publications and Research

Purpose: Lesbian, gay, bisexual, transgender, queer, intersex, and/or asexual and other sexual and gender diverse persons (LGBTQIA + or SGD persons) experience barriers to equitable health care. The purpose of this article is to describe a collaborative process that resulted in core cultural competency recommendations addressing training for those who provide health care and/or social services to LGBTQIA + patients.

Methods: In 2018 and 2019, Whitman-Walker Health, a Federally Qualified Community Health Center in Washing- ton, DC, and the National LGBT Cancer Network purposively selected leaders of community clinics and community-based organizations, cultural competency trainers, and clinicians and researchers with …

Precision Dentistry In Practice, Diana V. Macri

Publications and Research

A paradigm shift is necessary to improve healthcare delivery and outcomes. Precision medicine and precision dentistry may be able to shift the burden of disease and improve the nation’s oral and overall health.

Cmv-Responsive Cd4 T Cells Have A Stable Cytotoxic Phenotype Over The First Year Post-Transplant In Patients Without Evidence Of Cmv Viremia, Lauren E. Higdon, Ayah A. Amad, Steven Schaffert, Kenneth B. Margulies, Jonathan S. Maltzman

Publications and Research

Cytomegalovirus (CMV) infection is a known cause of morbidity and mortality in solid organ transplant recipients. While primary infection is controlled by a healthy immune system, CMV is never eradicated due to viral latency and periodic reactivation. Transplantation and associated therapies hinder immune surveillance of CMV. CD4 T cells are an important part of control of CMV reactivation. We therefore investigated how CMV impacts differentiation, functionality, and expansion of protective CD4 T cells from recipients of heart or kidney transplant in the fi rst year post-transplant without evidence of CMV viremia. We analyzed longitudinal peripheral blood samples by flow cytometry …

Student Self-Grading Form, Brett Whysel

Open Educational Resources

This is a word document that students use at the beginning, midpoint, and end of a semester to set relevant goals, measure progress towards goals, and self-grade. It is intended to build motivation, metacognition, and accountability. Instructors may use it on its own or to supplement other assessment tools, and improve the accuracy, validity, and fairness of final grades.

Impact Of The Covid-19 Pandemic On The Care Continuum Of Youth Living With Hiv: Qualitative Study Of The Scale It Up Program Clinical Sites, Tyra Dark, Sitaji Gurung, Mary Dooley, Kit N. Simpson, Seyram A. Butame, Sylvie Naar

Publications and Research

The study objective was to explore the impact of COVID-19 pandemic restrictions on the clinics’ ability to provide continuous healthcare services to youth (15–24 years) living with HIV (YLWH). One focused semi-structured interview was conducted with each HIV clinic site—resulting in ten interviews. Data were analyzed using thematic analysis techniques assisted by NVIVO coding software and themes indicating barriers and facilitators to providing uninterrupted healthcare were elicited. Six themes were identified that affected the care continuum of YLWH: Timeframe of clinic preparation to address COVID-19 restrictions; impact on treatment cascade monitoring data; impact on patient care; impact on staff and …

Investigating The Covid-19 Pandemic In Your Community, Tanzina Ahmed

Open Educational Resources

In this writing assignment, students will conduct research on statistics about COVID-19 in New York City and their embedded communities using free online databases from the New York City Department of Health (NYC DOH). For questions 1, 2, 3, and 4, students will conduct research on COVID-19 statistics within NYC and their specific neighborhood/community in New York City. In questions 5 and 6, students will analyze the data you have gathered while using your own knowledge of your community. A full set of instructions for accessing NYC DOH databases and a complete rubric for grading the assignment is included.

Is The Phq-9 A Unidimensional Measure Of Depression? A 58,272-Participant Study, Renzo Bianchi, Jay Verkuilen, Sharon Toker, Irvin Sam Schonfeld, Markus Gerber, Elmar Brähler, Kurt Kroenke

Publications and Research

The PHQ-9 has become a measure of reference in depression research and clinical practice. However, the issue of the PHQ-9’s unidimensionality has not been fully elucidated, and the usability of the PHQ-9’s total score requires clarification. In this study, we examined the dimensionality, scalability, and monotonicity properties of the PHQ-9 as well as the scale’s total-score reliability. We did so based on exploratory structural equation modeling (ESEM) bifactor analysis and Mokken scale analysis (MSA). We relied on a total of 58,272 participants (63% female; Mage = 43, SDage = 13) from 29 samples involving seven different countries (e.g., Germany, the …

Longitudinal Patterns Of Suicidality Among Heroin Users In Johannesburg, South Africa: A Need For Suicide Screening And Intervention, Nirvana Morgan, Ellen-Ge Denton, Ugasvaree Subramaney, William Daniels, Tilman Steinert

Publications and Research

Objectives: The objective of the study was to longitudinally assess the outcomes and correlates of suicidal ideation and behavior (SIB) among heroin users who attended inpatient detoxification and psychosocial rehabilitation. SIB was assessed in 300 heroin users upon entry into inpatient detoxification (baseline) as well as 3-months (t1) (n = 252; 84%) and 9-months (t2) (n = 225; 75%) post treatment. Multivariable logistic regression was used to determine the demographic, clinical and treatment related factors that increased the risk for a high SIB score.

Results: From baseline to t1 there was a significant decrease in the proportion of …

Imaging Of Transmetallation And Chelation Phenomena Involving Radiological Contrast Agents In Mineral-Rich Fruits, Subhendra Sarkar, Zoya Vinokur, Bleidis Buitrago, Lin Mousa, Hayley Sanchez, Analia Basilicata, Jodi-Ann Douglas, Seanetta Reddock

Publications and Research

Exogenous heavy metals or non-metallic waste products, for example lanthanide or iodinated contrast media for radiological procedures, may interfere with the biochemical pools in patients and in common food sources, creating an excess buildup of exogenous compounds which may reach toxic levels. Although the mechanisms are unknown, our experiments were designed to test if this toxicity can be attributed to “transmetallation” or “chelation” reactions freeing up lanthanides or chelated transition metals in acidic fruits used as phantoms representing the biologically active and mineral-rich carbohydrate matrix. The rapid breakdown of stable contrast agents have been reported at a lower pH. The …

Treatment Of Gravitational Pulling Sensation In Patients With Mal De Debarquement Syndrome (Mdds): A Model-Based Approach, Sergei B. Yakushin, Theodore Raphan, Catherine Cho

Publications and Research

Perception of the spatial vertical is important for maintaining and stabilizing vertical posture during body motion. The velocity storage pathway of vestibulo-ocular reflex (VOR), which integrates vestibular, optokinetic, and proprioception in the vestibular nuclei vestibular-only (VO) neurons, has spatio-temporal properties that are defined by eigenvalues and eigenvectors of its system matrix. The yaw, pitch and roll eigenvectors are normally aligned with the spatial vertical and corresponding head axes. Misalignment of the roll eigenvector with the head axes was hypothesized to be an important contributor to the oscillating vertigo during MdDS. Based on this, a treatment protocol was developed using simultaneous …

Recent Advances In Bone Research 2022 Edition, Jean-Philippe Berteau, Laurent Pujo-Menjouet

Publications and Research

More and more scientific and engineering applications in bone research make pivotal advances in treating patients with orthopedics issues. Hence, bone research in the 21st century combines, inter alia, biology, chemistry, mathematics, and mechanics with complementary characteristics that help a holistic approach to bone-related pathologies. Nowadays, it is hard to connect new evidence when jargoning and money remain two significant obstacles to sharing knowledge. “Recent Advances In Bone Research” is a free book – no money involved at any stage - that combines the most recent efforts in bone research from several experts with different backgrounds, every expert seeks to …

Effectiveness And Safety Of Oral Anticoagulants In Non-Valvular Atrial Fibrillation Patients With Prior Bleeding Events: A Retrospective Analysis Of Administrative Claims Databases, G. Y. H. Lip, Allison V. Keshishian, Amiee Kang, Xuemei Luo, Nipun Atreja, Yan Zhang, Patricia Schuler, Jenny Jiang, Huseyin Yuce, Steve Deitelzweig

Publications and Research

Introduction

There are a paucity of real-world data examining effectiveness and safety of non-vitamin K antagonist oral anticoagulants (NOACs) and warfarin in nonvalvular atrial fibrillation (NVAF) patients with prior bleeding.

Methods

This retrospective analysis included data from 5 insurance claims databases and included NVAF patients prescribed OACs with prior bleeding. One-to-one propensity score matching was conducted between NOACs and warfarin and between NOACs in each database. Cox proportional hazards models were used to evaluate the risk of stroke/systemic embolism (SE) and MB.

Results

A total of 244,563 patients (mean age 77; 50% female) with prior bleeding included 55,094 (22.5%) treated …

Covid-19 Vaccine Mandate, Mikhail Kun, Tatiana Ryzhakova

Publications and Research

The COVID-19 pandemic has wreaked havoc on the planet and killed millions of people. Health care workers and radiology technicians who come into direct contact with COVID-19 patients have indeed been the most affected by the virus. Since the pandemic began, the COVID-19 cases among health care workers have surged and quadrupled. COVID-19 vaccine mandate is the need of the time. Mandates have a history and are in effect for other diseases such as smallpox, measles, or mumps. But since the vaccines have come out for COVID-19, there is a public impetus to condemn these vaccines, based on the false …

Open Lab Vs. Radiologic Students Final Practical Grades, Navdeep Kaur, Safraz Harun, Katie Tam, Robert O'Brien

Publications and Research

Open Lab provides the students of the Radiologic Technology & Medical Imaging Department the opportunity outside regular class time to practice communicating effectively in a health care setting, and grants the students the freedom to craft critical thinking skills in a radiologic environment. Our research aims to analyze the correlation between hourly time spent in Open Lab, and its contributing factor to a student's overall Radiographic Procedures grade. The amount of time spent in Open Lab can additionally contribute to a student's grasp of didactic concepts, and their integration into the clinical setting. Additional time spent in the laboratory can …

Medication Assisted Treatment In Opioid Use Disorder, Catherine Paradiso

Open Educational Resources

This lesson centers on Medication Assisted Treatment, one part of the harm reduction strategy used to combat the opioid epidemic. This lesson reviews the medications that are used, and which ones can be used in a primary care setting. There are sample discussion questions and brief scenarios associated with primary care and medication.

Depression Is Associated With Myocardial Infarction Within A Two-Year Period Among Adults In China, Lydia W. Li, Greta Cheng, Hongwei Xu, Zhenmei Zhang, Jinyu Liu, Yeates Conwell

Publications and Research

We examined whether baseline depression is associated with MI within a two-year period among adults aged 45+ in China and whether the association varies by sociodemographic characteristics. Two-year longitudinal data from a nationally representative sample of people aged 45+ in China were analyzed (N = 15,226). MI within the 2-year period was coded dichotomously. Baseline depression, assessed by the 10-item Center for Epidemiological Studies Depression scale, was used as a dichotomous and a continuous variable. After adjusting for medical conditions, lifestyle and sociodemographic characteristics, the odds of having an MI within the 2-year period were 46% greater for respondents with …

Promoting Healthy Eating In Latin American Restaurants: A Qualitative Survey Of Views Held By Owners And Staff, Fuster, Melissa, Rosa Abreu, Margaret A. Handley, Donald Rose, Michelle A. Rodriguez, Emily G. Dimond, Brian Elbel, Terry T. K. Huang

Publications and Research

Background

Restaurants, particularly independently-owned ones that serve immigrant communities, are important community institutions in the promotion of dietary health. Yet, these restaurants remain under-researched, preventing meaningful collaborations with the public health sector for healthier community food environments. This research aimed to examine levels of acceptability of healthy eating promotion strategies (HEPS) in independently-owned Latin American restaurants (LARs) and identify resource needs for implementing HEPS in LARs.

Methods

We completed semi-structured, online discussions with LAR owners and staff (n = 20), predominantly from New York City (NYC), to examine current engagement, acceptability, potential barriers, and resource needs for the implementation …

Feasibility Of Using Electronic Health Records For Cascade Monitoring And Cost Estimates In Implementation Science Studies In The Adolescent Trials Network For Hiv/Aids Interventions, Tyra Dark, Kit N. Simpson, Sitaji Gurung, Amy L. Pennar, Marshall Chew, Sylvie Naar

Publications and Research

Background:One of the most difficult areas in the fight against HIV/AIDS is reaching out to youth aged 13 to 24 years. The proportion of youth living with HIV/AIDS on antiretroviral therapy (ART) and who are virally undetectable is low, highlighting significant challenges for reaching the Joint United Nations Program on HIV targets.

Objective:This study aimed to assess the feasibility of obtaining key clinical indicators and monitoring treatment, viral suppression, and retention components of the youth HIV treatment cascade in Adolescent Trials Network for HIV/AIDS Interventions clinics using electronic health record (EHR) downloads and to provide baseline characteristics for the study …

Occupational Depression In A Spanish-Speaking Sample: Associations With Cognitive Performance And Work-Life Characteristics, Bianchi Renzo, Guadalupe Manzano García, Maria Pilar Montanes, Emily A. Schonfeld, Irvin Sam Schonfeld

Publications and Research

This 386-participant study investigated the structural and psychometric properties of the Spanish version of the Occupational Depression Inventory (ODI). Exploratory structural equation modeling bifactor analysis revealed that the ODI meets the requirements for essential unidimensionality. Measurement invariance held across our sample and the English- and French-speaking samples used in the ODI’s initial validation study. Mokken scale analysis indicated that (a) the scalability of the instrument was strong, (b) no violations of monotonicity or local independence were present, and (c) invariant item ordering was sufficiently accurate. The ODI’s reliability was optimal. The ODI exhibited both convergent validity and discriminant validity vis-à-vis …

Medical Norm Of Psychiatric Misdiagnoses In Rare Disease Patients, Rachel Han

Publications and Research

Spring 2022 ENG 120 Student Final Research Paper on the medical norm of psychiatric misdiagnosis throughout the diagnostic journeys of rare disease patients. The idea of a norm was taken from Chimamanda Ngozi Adichie's Tedx Talk "The Danger of a Single Story". Paper discusses prevalence, harmful effects, and origin of this medical norm. Includes discussion of statistical data quoted relating to prevalence of rare diseases as well as anecdotal evidence of the severe ramifications of this norm. Discussion of how medically unexplained symptoms such as mysterious chronic pain often lead to the phenomenon of the psychogenic inference. Origins of this …

Lessons To Build An Educational Model For Higher Education Institutions Defined As Anchor Institutions To Tackle Public Health Crises: A Pilot Study On Covid-19 Vaccine Hesitancy Among Faculty And Students In Herbert L. College In The Bronx, Ny, Maria-Isabel Roldos, Katherine Burt, Jacob Eubank

Publications and Research

Coronavirus disease 2019 exacerbated health inequities in Bronx Communities. This study explored vaccine hesitancy among a random sample of faculty and students from Herbert Lehman College. Findings suggest faculty are largely vaccinated (87%), while 59% of students are unvaccinated. Significant gaps in information were found related to safety and complications. This suggests universities need to adopt an educational model with a multipronged social support strategy to gain students’ trust and a greater sense of belonging.

An Evaluation Of The Effect Of The Oxycontin® Reformulation On Unintentional Fatal And Non-Fatal Overdose, Daniel C. Beachler, Kelsey Hall, Renu Garg, Geetanjoli Banerjee, Ling Li, Luke Boulanger, Huseyin Yuce, Alexander M. Walker

Publications and Research

Objectives: OxyContin® was reformulated with a polyethylene oxide matrix in August 2010 to reduce the potential for intravenous abuse and for abuse by insufflation. The objective of this study was to evaluate the impact of OxyContin’s reformulation on overdose risk for individuals dispensed OxyContin in comparison to those dispensed other opioids under regular care. Methods: Three national insurance databases with National Death Index linkage identified OD in individuals with any dispensing of OxyContin or a primary comparator opioid (ER morphine, transdermal fentanyl, or methadone) between July 2008 through September 2015. A difference-in-differences design was used to compare the pre-post reformulation …

Adapting A Conceptual Framework To Engage Diverse Stakeholders In Genomic/Precision Medicine Research, Karriem S. Watson, Elizabeth G. Cohn, Alecia Fair, Usha Menon, Laura A. Szalacha, Selena M. Carpenter, Consuelo H. Wilkins

Publications and Research

Introduction: Genomic/precision medicine offers a remarkable opportunity to improve health and address health disparities. Genomic medicine is the study of genes and their interaction with health. Precision medicine is an approach to disease prevention and treatment that considers individual variability in genes, environ- ment and lifestyle. Conclusions from studies lacking diversity may hinder general- izability as genomic variation occurs within and between populations. Historical factors, such as medical mistrust, ethical issues related to decision making, and data sharing pose complex challenges that may further widen inequities in genomic/ precision medicine if not appropriately addressed. Although few biomedical studies integrate priorities …

Monitoring Sars-Cov-2 In Wastewater During New York City's Second Wave Of Covid-19: Sewershed-Level Trends And Relationships To Publicly Available Clinical Testing Data, Catherine Hoar, Francoise Chauvin, Alexander Clare, Hope Mcgibbon, Esmeraldo Castro, Samantha Patinella, Dimitrios Katehis, John J. Dennehy, Monica Trujillo, Davida S. Smyth, Andrea I. Silverman

Publications and Research

New York City's wastewater monitoring program tracked trends in sewershed-level SARS-CoV-2 loads starting in the fall of 2020, just before the start of the city's second wave of the COVID-19 outbreak. During a five-month study period, from November 8, 2020 to April 11, 2021, viral loads in influent wastewater from each of New York City's 14 wastewater treatment plants were measured and compared to new laboratory-confirmed COVID-19 cases for the populations in each corresponding sewershed, estimated from publicly available clinical testing data. We found significant positive correlations between viral loads in wastewater and new COVID-19 cases. The strength of the …

Sleep And Economic Status Are Linked To Daily Life Stress In African-Born Blacks Living In America., Zoe C. Waldman, Blayne R. Schenk, Marie Grace Duhuze Karera, Arielle C. Patterson, Thomas Hormenu, Lilian S. Mabundo, Christopher W. Dubose, Ram Jagannathan, Peter L. Whitesell, Annemarie Wentzel, Margrethe F. Horlyck-Romanovsky, Anne E. Sumner

Publications and Research

To identify determinants of daily life stress in Africans in America, 156 African-born Blacks (Age: 40 ± 10 years (mean ± SD), range 22-65 years) who came to the United States as adults (age ≥ 18 years) were asked about stress, sleep, behavior and socioeconomic status. Daily life stress and sleep quality were assessed with the Perceived Stress Scale (PSS) and Pittsburgh Sleep Quality Index (PSQI), respectively. High-stress was defined by the threshold of the upper quartile of population distribution of PSS (≥16) and low-stress as PSS < 16. Poor sleep quality required PSQI > 5. Low income was defined as groups, PSS were: 21 ± 4 versus …

Faculty’S Perception On Student Performance Using Vsim For Nursing® As A Teaching Strategy, Leighsa Sharoff

Publications and Research

During the COVID-19 pandemic, clinical nurse educators within pre-licensure baccalaureate educational programs had to quickly adapt to new ways of teaching. Hospital-based clinicals no longer permitted students to attend and some schools of nursing (SON) transitioned to virtual simulation learning environments. These alternative learning strategies were imperative for students continued progression. The first purpose of this pilot study explored nursing faculty’s perceived effectiveness of using vSim for Nursing® to replace clinical practice. A second purpose examined the effectiveness of faculty preparation. Effectiveness was evaluated using an adapted version of the Simulation Effectiveness Tool – Modified (SET-M). Mean scores indicated that …