Medicine and Health Sciences Commons^™

Collective Leadership, Academic Collaborations And Health Disparities: A Framework For Success, Phyllis R. Magrab, Suzanne M. Bronheim

Journal of Health Disparities Research and Practice

Implementing collaborative approaches to addressing health disparities involves multiple individuals who have leadership roles both within their own sectors and within the collaborative effort’s infrastructure. Understanding how that collective leadership operates and the skills and behaviors each member of the team brings to the collaborative process can shed light on what makes for a successful outcome. The Center of Excellence for Health Disparities in the Nation’s Capital (CEHD) was a collaborative effort between two universities and among multiple schools within the same institution, across departments and with multiple community partners. This paper presents a case example of collective leadership in …

Higher Quality At Lower Cost: Community Health Worker Interventions In The Health Care Innovation Awards, Caitlin Cross-Barnet, Sarah Ruiz, Megan Skillman, Rina Dhopeshwarkar, Rachel Singer, Rachel Carpenter, Suzanne Campanella, Maysoun Freij, Lynne Snyder, Erin Colligan

Journal of Health Disparities Research and Practice

Background: Published evidence regarding cost savings, reduced utilization, and improved quality associated with employing community health workers (CHWs) is largely lacking. This paper presents findings from the Centers for Medicare & Medicaid Services Health Care Innovation Awards (HCIA), with a focus on six diverse programs that employ CHWs. We examine outcomes associated with programs incorporating CHWs into care teams for a broad age range of patients with various health issues such as cancer, asthma, and complex conditions.

Methods: This mixed-methods study used data from claims and site visits to assess the effectiveness of CHW programs. In difference-in-differences analyses of Medicare …

Racial/Ethnic Disparities In Diabetes Care And Outcomes: A Mixed Methods Study, Yhenneko J. Taylor, Marion E. Davis, Rohan Mahabaleshwarkar, Melanie D. Spencer

Journal of Health Disparities Research and Practice

Limited research has examined racial/ethnic differences in diabetes care and outcomes among primary care patients. This study examined racial/ethnic differences in diabetes care and outcomes among an ambulatory patient population and explored patient perceptions of the patient-provider relationship to inform strategies to improve care delivery. Using data from 62,149 adults with diabetes who received care within Atrium Health in 2013, regression models assessed associations between race/ethnicity and the following outcomes: glycated hemoglobin (HbA1c) tests, low density lipoprotein (LDL) and blood pressure (BP) screening, foot and eye exams, and HbA1c, LDL, and BP control. Eleven patients with diabetes and uncontrolled hypertension …

Application Of Photovoice With Focus Groups To Explore Dietary Behaviors Of Older Filipino Adults With Cardiovascular Disease, Jane Jih, Trish La Chica, Luisa M. Antonio, Ofelia O. Villero, Mary N. Roque, Joseph R. Domingo, Joshua F. Landicho, Anna M. Napoles, Celia P. Kaplan, Tung T. Nguyen

Journal of Health Disparities Research and Practice

Filipino Americans have high rates of cardiovascular diseases (CVD). This study explored the dietary behaviors, a modifiable risk factor, of Filipinos with CVD. Filipinos with CVD were recruited and trained to do Photovoice. Participants took photos to depict their “food experience,” defined as their daily dietary activities. Participants then shared their photos during focus groups. Focus group transcripts were analyzed using an iterative, grounded theory approach. Among 38 Filipino participants, the mean age was 70 years old and all were foreign-born. Major themes included efforts to retain connection to Filipino culture through food, and dietary habits shaped by cultural health …

Blood Pressure And Job Domains Among Hotel Housekeepers, Marie-Anne Sanon Rosemberg Phd, Mn, Rn, Bidisha Ghosh Ms., John Shaver Bsn, Maria Militzer Ma, Julia Seng Phd, Cnm, Faan, Marjorie C. Mccullagh Phd, Rn, Aphn-Bc, Cohn-S, Faaohn, Faan

Journal of Health Disparities Research and Practice

Hotel housekeepers have challenging working conditions, putting them at risk for poor health such as hypertension. Despite their risks, few studies have measured their blood pressure (BP). The purpose of this study was to explore hotel housekeepers’ blood pressure and the associations between work and BP. Methods: A community engagement approach was used to recruit study participants. Data sources included questionnaires, and BP measurement. Results: Over 25% of the 39 hotel housekeepers reported hypertension diagnosis and/or antihypertensive medication used. Across the job domains, job satisfaction was correlated with diastolic BP, and workload was correlated with systolic BP. There were difference …

Effectiveness Of Community Health Workers In Healthcare Delivery: Evidence From The Field, Mohammad Shahbazi Professor, Mukesh Kumar, Anthony Mawson, Donna Antoine Lavigine, Cassandra Dove

Journal of Health Disparities Research and Practice

Evidence suggests that health care in the United States could benefit from including the services of Community Health Workers (CHW), provided through Community Health Houses, in the delivery of care. This research project evaluated the impact of three newly-established Health Houses and the services provided to patients by Community Health Workers at three locations in the Mississippi Delta. The patients were current enrollees in the Medicare administered by United Healthcare. The program began in February 2014 and continued through September 2015. After analyzing data for payments made for each enrollee, emergency room visits and hospital admissions for the years of …

Exploring H.Pylori Seropositivity As A Risk Factor For Type 2 Diabetes, Virginia Chaidez, Yumou Qiu

Journal of Health Disparities Research and Practice

Background: In the US, the percentage of adults with diagnosed diabetes are higher in members of racial and ethnic minority groups compared to non-Latino Whites. Understanding why such disparities exist has been less forthcoming.

Methods: Secondary data analysis was conducted using the National Health and Nutrition Examination Survey (NHANES) 1999-2000 cross-sectional data.

Results: H.pylori seropositivity was highest in Mexican Americans (43.7%), lowest in non-Hispanic Whites (18.1%). Diabetes was highest in non-Hispanic Blacks (5.9%); lowest in non-Hispanic whites (4.3%). H.pylori seropositivity was associated with greater likelihood of having type 2 diabetes (1.927, 95% CI 1.142, 3.257) compared to H.pylori negative in …

Alternative Financial Services And Health Status In U.S. Metropolitan Statistical Areas, Courtney Hundley, Richard W. Wilson 8520196, John Chenault

Journal of Health Disparities Research and Practice

Abstract

Alternative financial services (AFS) such as, payday lenders, pawn brokers, tax refund loans, and check cashers are more prevalent in minority and lower income neighborhoods. These are neighborhoods also found to have disparities in health, compared to more affluent neighborhoods and communities. The focus of this paper is to determine if any relationship exists between use of AFS and health disparities.

Using data from a survey performed by the Federal Deposit Insurance Corporation (FDIC), we compared four banking variables to several measures of health for 85 metropolitan statistical areas (MSA) across the nation. The four banking variables all related …

Implementing A Pre-Exposure Prophylaxis Intervention For Safer Conception Among Hiv Serodiscordant Couples: Recommendations For Health Care Providers, Mari-Lynn Drainoni, Dea L. Biancarelli, Ashley A. Leech, Meg Sullivan, Angela R. Bazzi

Journal of Health Disparities Research and Practice

Couples in HIV serodiscordant relationships frequently desire children. Although partners who are virally suppressed pose almost no risk of transmitting HIV to their partners, partners who are inconsistently on therapy may transmit HIV to their partners when attempting to conceive. Pre-exposure prophylaxis (PrEP) is an available safer conception strategy for these couples but is not consistently offered. We sought to better understand barriers to PrEP implementation for couples seeking conception and patient perceptions on what providers could do to encourage use. We conducted in-depth, qualitative interviews with 11 participants representing six couples taking PrEP for safer conception in a safety-net …

Human Papillomavirus Infections In The Southern And Other United States Regions, Dudith Pierre-Victor, Mary Jo Trepka, Dionne Stephens, Tan Li, Timothy Page, Purnima Madhivanan

Journal of Health Disparities Research and Practice

Human papillomavirus (HPV) infection is the most common sexually transmitted infection worldwide and has been linked to several cancers, including cervical cancer. In the United States, the Southern region has a disproportionate burden of cervical cancer, and research about the epidemiology of HPV in the region is scarce. This study estimates the prevalence and correlates of HPV infection among 14–59 year-old females.

Data from 4,250 females aged 14–59 years collected during the 2007–2010 National Health and Nutrition Examination Survey (NHANES) were used. We estimated the prevalence of HPV infection for the South and the rest of the country. We performed …

Medical School Watercooler Newsletter - August 5, 2018, Lindsey Lyle

Watercooler Newsletter

This is the August 5, 2018 edition of the Frederick P. Whiddon College of Medicine's newsletter - Watercooler.

Contents Include:

• Abby Perkins Named Director of Operations for Orthopaedic Surgery
• Med School Café - Expert Advice for the Community
• South Med Prep Scholars Participate in Research Day
• LoRen Burroughs Named Diversity Coordinator for USACOM

Pubh 4234 – International Development In Health, Nandi A. Marshall

College of Public Health: Faculty Syllabi (2014-2021)

This course will describe key cultural, social, and economic issues and methods in global health, and thus provide essential background for other core courses. The course is interdisciplinary, emphasizing the fields of anthropology, sociology, public health, global health, and critical global health studies. This course explores aspects of health inequalities and demonstrates how the sources of health inequalities (including globalization, the impact of social, economic, and political systems, the local and global economy, transnational organizations, culture, race, class, gender, and sexuality) are rooted in injustices that create and sustain the conditions that lead to disparities in health status and health …

Evaluation Of A Hydrogel-Based Diagnostic Approach For The Point-Of-Care Based Detection Of Neisseria Gonorrhoeae, Sumudu R. Perera, Ali Taheri, Nurul H. Khan, Rajinder P. Parti, Stephanie Stefura, Pauline Skiba, Jason P. Acker, Irene Martin, Anthony Kusalik, Jo-Anne R. Dillon

Agricultural and Environmental Sciences Faculty Research

Eleven primer pairs were developed for the identification of Neisseria gonorrhoeae. The sensitivity and specificity of these primers were evaluated by Real Time (RT)-PCR melt curve analyses with DNA from 145 N. gonorrhoeae isolates and 40 other Neisseria or non-Neisseria species. Three primer pairs were further evaluated in a hydrogel-based RT-PCR detection platform, using DNA extracted from 50 N. gonorrhoeae cultures. We observed 100% sensitivity and specificity in the hydrogel assay, confirming its potential as a point-of-care test (POCT) for N. gonorrhoeae diagnosis.

A Cadaveric Case Of A Circular Torcular Herophili., Sasha Lake, Juan J Altafulla, Joe Iwanaga, Rod J Oskouian, Marios Loukas, R Shane Tubbs

Articles, Abstracts, and Reports

The torcular Herophili is formed by the joining of the straight sinus, superior sagittal sinus, and transverse sinus. The anatomic configuration of the torcular Herophili is highly variable. In the current literature, classification systems define up to nine subtypes of the torcular Herophili. The frequency of prevalence of these anatomical variants is also variable. Herein is a case report of a circularly-shaped torcular Herophili found during cadaveric dissection.

Tendinous Inscriptions Of The Rectus Abdominis: A Comprehensive Review., Rabjot Rai, Lilian C Azih, Joe Iwanaga, Marios Loukas, Martin Mortazavi, Rod J Oskouian, R Shane Tubbs

Articles, Abstracts, and Reports

The rectus abdominis muscles are interrupted by tendinous inscriptions, which typically appear as fibrous bands crossing the muscle. The current literature on tendinous inscriptions is scarce; hence, this review will provide a detailed overview of their anatomical description, including their variation, embryology, comparative anatomy, and clinical application. Understanding the anatomy and function of the tendinous inscription assists in providing clinical relevance and in guiding reconstructive surgeons in their surgical planning and design.

Co-Use Of Tobacco And Marijuana During Pregnancy: Pathways To Externalizing Behavior Problems In Early Childhood., Stephanie A. Godleski, Shannon Shisler, Rina D. Eiden, Marilyn A. Huestis

Institute of Emerging Health Professions Faculty Papers

Use and co-use of tobacco and marijuana during pregnancy are associated with the development of social, cognitive, and behavioral problems for infants and children. However, less is known about the potential developmental impact of the use of tobacco and marijuana in tandem. The present study examined an etiological model for the development of externalizing behavior problems (EBP) in early childhood in a high risk sample (N = 247) of mother-infant dyads with prospective data from pregnancy to 36 months of child age. Co-use during pregnancy and continued maternal tobacco and marijuana use from infancy through early childhood were investigated. Although …

Pubh 4233 Topics In Global Epidemiology, Rachel D. Schwartz

College of Public Health: Faculty Syllabi (2014-2021)

This course will introduce students to the field of epidemiology as applied in a global context. Students will be introduced to basic concepts of epidemiology as well as an overview of topics across the discipline. Special emphasis will be placed on health issues in the low and middle-income countries and case studies will be used as examples to illustrate concepts and topics of epidemiology. (3 credits)

Modeling The Dynamics Of Human Liver Failure Post Liver Resection, Babita Verma, Pushpavanam Subramaniam, Rajanikanth Vadigepalli

Department of Pathology, Anatomy, and Cell Biology Faculty Papers

Liver resection is an important clinical intervention to treat liver disease. Following liver resection, patients exhibit a wide range of outcomes including normal recovery, suppressed recovery, or liver failure, depending on the regenerative capacity of the remnant liver. The objective of this work is to study the distinct patient outcomes post hepatectomy and determine the processes that are accountable for liver failure. Our model based approach shows that cell death is one of the important processes but not the sole controlling process responsible for liver failure. Additionally, our simulations showed wide variation in the timescale of liver failure that is …

Epidemiology Of Patients Presenting To A Pediatric Emergency Department In Karachi, Pakistan, Nadir Ijaz, Matthew Strehlow, N. Ewen Wang, Elizabeth Pirrotta, Areeba Tariq, Naseeruddin Mahmood, Swaminatha Mahadevan

Department of Paediatrics and Child Health

Background: There is little data describing pediatric emergencies in resource-poor countries, such as Pakistan. We studied the demographics, management, and outcomes of patients presenting to the highest-volume, public, pediatric emergency department (ED) in Karachi, Pakistan.
Methods: In this prospective, observational study, we approached all patients presenting to the 50-bed ED during 28 12-h study periods over four consecutive weeks (July 2013). Participants’ chief complaints and medical care were documented. Patients were followed-up at 48-h and 14-days via telephone. Results: Of 3115 participants, 1846 were triaged to the outpatient department and 1269 to the ED. Patients triaged to the ED had …

Pubh 4231- Health Aspects Of Aging, James Thomas

College of Public Health: Faculty Syllabi (2014-2021)

This course examines the aging process from a health education perspective. Students will become acquainted with the process of and problems associated with aging in order to effectively manage this important public health issue. Knowledge and understanding of biological, psychological, and sociological aspects of aging as related to health and wellness will also be addressed. (2018-2019, Georgia Southern University Undergraduate and Graduate Course Catalog) Access to course materials are available for up to one year after graduation.

Gamification Of Hospital Utilization: Incorporating Cost-Consciousness In Daily Practices., Peter J Tomaselli, Dimitrios Papanagnou, Md, Jonathan E Karademos, Elizabeth Teixeira, Xiao Chi Zhang

Department of Emergency Medicine Faculty Papers

Healthcare costs in the United States have skyrocketed over the past decade, contributing to an estimated $750 billion in wasteful spending annually. Despite the demand to improve residency education on value-based, cost-conscious healthcare, there is no consensus on how to best teach this practice. Traditional lectures have failed to demonstrate enduring change in clinical practice patterns, provider attitudes, and reductions in hospital expenditures. We sought to evaluate whether gamification is an effective pedagogical tool to teach cost-consciousness to emergency medicine (EM) residents by creating a 60-minute interactive session based on the popular gameshow, the Price is Right. Costs and associated …

Endorepellin Remodels The Endothelial Transcriptome Toward A Pro-Autophagic And Pro-Mitophagic Gene Signature., Thomas Neill, Eva Andreuzzi, Zi-Xuan Wang, Stephen C. Peiper, Maurizo Mongiat, Renato V. Iozzo

Department of Pathology, Anatomy, and Cell Biology Faculty Papers

Regulation of autophagy by proteolytically cleaved fragments of heparan sulfate proteoglycans is a novel and current research focus in tumor biology. Endorepellin is the C-terminal angiostatic fragment of the heparan sulfate proteoglycan perlecan and induces autophagy in endothelial cells. To further investigate this property, we used NanoString, a digital PCR platform for measuring pre-defined transcripts in biological samples to analyze a custom subset of 95 autophagy-related genes in human umbilical vein endothelial cells treated with ultrapure human recombinant endorepellin. We discovered an endorepellin-evoked pro-autophagic and pro-mitophagic gene expression signatures, which included two coordinately up-regulated mitochondrial-associated genes encoding the E3 ubiquitin …

Recurrent Cutaneous Tuberculosis In An Immunocompetent 7-Year-Old Male, Alvaro Galvis, Vidyasagar Jaiswal, Iris Pecson, Craig Nakamura, Dena Austin

School of Medicine Faculty Research

Cutaneous tuberculosis (TB) makes up a small proportion of the 10.4 million cases around the world. Although it is more commonly found in the developing world, cutaneous TB is rarely reported in the developed countries. It is fairly challenging to diagnose without histological examination. In this report, we present an immunocompetent 7-year-old male with a complex medical history diagnosed with cutaneous Mycobacterium tuberculosis after multiple ventriculoperitoneal shunt (VPS) revisions. This case of cutaneous TB in an immunocompetent patient is remarkable in its uncharacteristic presentation with no obvious source of TB infected contacts or travel history.

Prevalence Of House Dust Mites In Low-Income Homes In Utah County, Robert Graul, Dr. James Johnston

Journal of Undergraduate Research

Asthma is the leading chronic disease among children in U.S. Low-income populations, minorities, and children living in poor housing experience more emergency department visits, hospitalizations, and deaths due to asthma that the general population. HDM allergens are linked to the exacerbation of asthma and are found within homes all throughout the United States. Previous studies have shown that HDM exposure is lower in arid and semi-arid climates, such as Utah, but robust data is still lacking. Although HDM thrive in climates more humid than Utah, we have found that they are still present based on certain indoor environmental factors.

Social Issues In Nonmetropolitan Nebraska: Perceptions Of Social Stigma And Drug And Alcohol Abuse: 2018 Nebraska Rural Poll Results, Rebecca J. Vogt, Cheryl A. Burkhart-Kriesel, Randolph L. Cantrell, Bradley Lubben, L. J. Mcelravy, Timothy Meyer

Rural Futures Institute: Publications

Conclusion

Many rural Nebraskans think it brings shame upon a person to do the following: file personal bankruptcy, apply for food stamps and apply for income assistance. Most rural Nebraskans disagree that the following items bring shame to a person: go to Alcoholics Anonymous or other alcohol treatment, seek mental health care, and go to drug treatment. In general, rural Nebraskans say that residents of their community are more likely than they personally are to think doing the items brings shame upon a person.

At least one-third of rural Nebraskans think the following are a very serious problem or a …

Health In Surroundings: Application Of The Theory Of Environment In Nursing Practice, Nasreen Rafiq

School of Nursing & Midwifery

Nursing practices are guided by theoretical frameworks which provide functional basis to nursing care. This paper discusses the application of Nightingale’s theory of environment in nursing practices. The theory highlights and explains 13 environmental cannons which include ventilation, cleanliness of walls/rooms, light, noise, personal cleanliness, bed and bedding, and taking food. Florence exquisitely explains the influence of environmental health on patients wellbeing. The application of the theory in nursing practices will help to understand and reflect the direct relation of environment on patients health.

A Land Not Forgotten: Indigenous Food Security & Land-Based Practices In Northern Ontario By Michael A. Robidoux And Courtney W. Mason, Tonia L. Payne Ph.D.

The Goose

Review of Michael A. Robidoux and Courtney W. Mason's (eds.) A Land Not Forgotten: Indigenous Food Security & Land-Based Practices in Northern Ontario.

Establishing Hematology And Serum Chemistry Reference Intervals For Wild Hawaiian Monk Seals (Neomonachus Schauinslandi), Angela C. Kaufman, Stacie J. Robinson, Dori L. Borjesson, Michelle Barbieri, Charles L. Littnan

United States Department of Commerce: Staff Publications

Hematology and serum chemistry reference intervals have been previously established for the endangered Hawaiian monk seal (Neomonachus schauinslandi) as an imperative measure for health assessments. Monitoring the health of the wild population depends upon reference intervals that are context specific; hence we developed reference intervals from fresh samples, as opposed to frozen, from wild monk seals. This study builds on the number of parameters from previous efforts by using samples collected between 2004 and 2015 from wild monk seals. Blood samples were analyzed by a single veterinary diagnostic laboratory within 24 hr of collection from apparently healthy, wild …

Autotaxin-Lpa Signaling Contributes To Obesity-Induced Insulin Resistance In Muscle And Impairs Mitochondrial Metabolism, Kenneth D'Souza, Carine Nzirorera, Andrew M. Cowie, Geena P. Varghese, Purvi Trivedi, Thomas O. Eichmann, Dipsikha Biswas, Mohamed Touaibia, Andrew J. Morris, Vassilis Aidinis, Daniel A. Kane, Thomas Pulinilkunnil, Petra C. Kienesberger

Internal Medicine Faculty Publications

Autotaxin (ATX) is an adipokine that generates the bioactive lipid, lysophosphatidic acid (LPA). ATX-LPA signaling has been implicated in diet-induced obesity and systemic insulin resistance. However, it remains unclear whether the ATX-LPA pathway influences insulin function and energy metabolism in target tissues, particularly skeletal muscle, the major site of insulin-stimulated glucose disposal. The objective of this study was to test whether the ATX-LPA pathway impacts tissue insulin signaling and mitochondrial metabolism in skeletal muscle during obesity. Male mice with heterozygous ATX deficiency (ATX^+/−) were protected from obesity, systemic insulin resistance, and cardiomyocyte dysfunction following high-fat high-sucrose (HFHS) feeding. …

Mass Spectrometry Image Creator (Msic): Ion Mobility / Mass Spectrometry Imaging Workflow In Python, Stephen Creger, Julia Laskin, Daniela Mesa Sanchez

The Summer Undergraduate Research Fellowship (SURF) Symposium

Mass spectrometry (MS) is a powerful characterization technique that enables identification of compounds in complex mixtures. Acquiring mass spectra in a spatially-resolved manner (i.e. over a grid), allows the data to be used to generate images that show the spatial distribution and relative intensities of every compound in a sample. These images can be used to monitor and identify biomarkers, explore the metabolism of compounds within tissues, and much more. However, the limitations of mass spectrometry can result in ambiguous compound identifications. Another characterization tool, ion mobility spectrometry (IM) can be integrated into existing MS routines to address this problem; …