Medicine and Health Sciences Commons^™

Which Internal Medicine Clerkship Characteristics Are Associated With Students' Performance On The Nbme Medicine Subject Exam? A Multi-Institutional Analysis., Matthew M. Fitz, William Adams, Steven A. Haist, Karen E. Hauer, Linette P. Ross, Amanda Raff, Gauri Agarwal, T. Robert Vu, Jonathan Appelbaum, Valerie J. Lang, Chad Miller, Cyril Grum, Mark Fagan, Jennifer Foster, Hilary F. Ryder, Bruce Houghton, Ryan Nall, Amy Shaheen, Michael Elnicki, Anna Donovan, Stuart Kiken, Cynthia Ledford, Shobhina Chheda, Doug Paauw, Blake Barker, Maureen Lowery, Nina Mingioni, Deepti Rao, William Kelly

Division of Internal Medicine Faculty Papers & Presentations

PURPOSE: To identify which internal medicine clerkship characteristics may relate to NBME Medicine Subject Examination scores, given the growing trend toward earlier clerkship start dates.

METHOD: The authors used linear mixed effects models (univariable and multivariable) to determine associations between medicine exam performance and clerkship characteristics (longitudinal status, clerkship length, academic start month, ambulatory clinical experience, presence of a study day, involvement in a combined clerkship, preclinical curriculum type, medicine exam timing). Additional covariates included number of NBME clinical subject exams used, number of didactic hours, use of a criterion score for passing the medicine exam, whether medicine exam performance …

E-Cigarette Availability, Price Promotions And Marketing At The Point-Of Sale In The Contiguous United States (2014-2015): National Estimates And Multilevel Correlates, Heather D'Angelo, Shyanika W. Rose, Shelley D. Golden, Tara Queen, Kurt M. Ribisl

Behavioral Science Faculty Publications

Electronic cigarette (e-cigarette) sales and use have increased rapidly, yet point-of-sale e-cigarette availability and marketing is understudied. We estimated changes in e-cigarette availability and marketing among tobacco retailers in the U.S., and associations with neighborhood characteristics. A national sample of tobacco retailers in the Contiguous U.S. was audited in 2014 and 2015 (n = 1,905 and n = 2,126, respectively) to observe e-cigarette availability and marketing (signs, ads, displays and promotions) and generate national prevalence estimates. Store, neighborhood and state level correlates of 2015 e-cigarette availability, price promotions and exterior advertising were analyzed using multilevel mixed-effects generalized linear models. E-cigarettes …

The Application Of Drones In Healthcare And Health-Related Services In North America: A Scoping Review, Bradley Hiebert, Elysée Nouvet, Vyshnave Jeyabalan, Lorie Donelle Phd, Rn, Fcan

Publications

Using drone aircraft to deliver healthcare and other health-related services is a relatively new application of this technology in North America. For health service providers, drones represent a feasible means to increase their efficiency and ability to provide services to individuals, especially those in difficult to reach locations. This paper presents the results of a scoping review of the research literature to determine how drones are used for healthcare and health-related services in North America, and how such applications account for human operating and machine design factors. Data were collected from PubMed, CINAHL, Scopus, Web of Science, and IEEE Xplore …

Parental Intent To Initiate And Complete The Human Papillomavirus Vaccine Series In The Usa: A Nationwide, Cross-Sectional Survey, Kalyani Sonawane, Yenan Zhu, Jane R Montealegre, David R Lairson, Cici Bauer, Lindy U Mcgee, Anna R Giuliano, Ashish A Deshmukh

Faculty, Staff and Student Publications

BACKGROUND: Human papillomavirus (HPV) vaccine uptake among US adolescents is primarily dependent on the intent of their parents. to the best of our knowledge, an analysis quantifying parental intent to initiate and complete the HPV vaccine series in the USA at both the national and state level has not been done. We aim to estimate parental intent to initiate and complete the HPV vaccine series at the national-level and state-level and to identify reasons for lack of intent to initiate and complete the vaccine series.

METHODS: This cross-sectional study uses data from the adolescent component of the 2017-18 National Immunization …

Vampire Bats: Preparing For Range Expansion Into The U.S., Michael J. Bodenchuk, David L. Bergman

United States Department of Agriculture Wildlife Services: Staff Publications

The common vampire bat apparently is expanding its range northwards in Mexico and seems poised to enter the southern United States. Climate models predict suitable habitat in the U.S. in south Texas and parts of southern Arizona. While vampire bats’ northward range expansion is not unexpected, the fact that this species brings a strain of rabies that impacts livestock and people warrants a strategic response. Annual economic damages from bats are estimated between $7M and $9M, largely associated with deaths of livestock from rabies. To prepare for the emerging rabies issue, USDA Wildlife Services programs in Texas and Arizona have …

Interstage Home Monitoring For Infants With Single Ventricle Heart Disease: Education And Management: A Scientific Statement From The American Heart Association., Nancy A. Rudd, Nancy S. Ghanayem, Garick D. Hill, Linda M. Lambert, Kathleen A. Mussatto, Jo Ann Nieves, Sarah Robinson, Girish S. Shirali, Michelle M. Steltzer, Karen Uzark, Nancy A. Pike, American Heart Association Council On Cardiovascular And Stroke Nursing; Council On Lifelong Congenital Heart Disease And Heart Health In The Young; Council On Arteriosclerosis, Thrombosis And Vascular Biology; Council On Clinical Cardiology; And Council On Lifestyle And Cardiometabolic Health

Manuscripts, Articles, Book Chapters and Other Papers

This scientific statement summarizes the current state of knowledge related to interstage home monitoring for infants with shunt-dependent single ventricle heart disease. Historically, the interstage period has been defined as the time of discharge from the initial palliative procedure to the time of second stage palliation. High mortality rates during the interstage period led to the implementation of in-home surveillance strategies to detect physiologic changes that may precede hemodynamic decompensation in interstage infants with single ventricle heart disease. Adoption of interstage home monitoring practices has been associated with significantly improved morbidity and mortality. This statement will review in-hospital readiness for …

Real-World Cost Of Treatment For Multiple Sclerosis Patients Initiating And Receiving Infused Disease-Modifying Therapies Per Recommended Label In The United States., Jacqueline Nicholas, Rachel Halpern, Marina Ziehn, Jesse Peterson-Brandt, Michael Leszko, Chinmay Deshpande

Neuroscience Articles

Aims: The study evaluated the real-world cost of treatment in multiple sclerosis (MS) patients initiating infused disease-modifying-therapies (DMT) in the United States.Materials and Methods: This retrospective cohort study using administrative claims data included adult patients with MS initiating index infusion DMT (ocrelizumab (OCR), natalizumab (NTZ) or alemtuzumab (ATZ)) from April 2017-September 2018 with 6-months pre/12-months post-index continuous enrollment. The primary cohort included patients who had prescribed annual dosing visits indicated by the approved product label (PL): 3 OCR, 5 ATZ, and 12-13 NTZ infusion visits within the first year of initiation. Annual treatment cost was the sum of all …

Predicting Quality Of Clinical Performance From Cardiology Fellowship Applications, Michael W Cullen, Thomas J Beckman, Kristine M Baldwin, Gregory J Engstler, Jay Mandrekar, Christopher G Scott, Kyle W Klarich

The Texas Heart Institute Journal

Variables in cardiology fellowship applications have not been objectively analyzed against applicants' subsequent clinical performance. We investigated possible correlations in a retrospective cohort study of 65 cardiology fellows at the Mayo Clinic (Rochester, Minn) who began 2 years of clinical training from July 2007 through July 2013. Application variables included the strength of comparative statements in recommendation letters and the authors' academic ranks, membership status in the Alpha Omega Alpha Honor Medical Society, awards earned, volunteer activities, United States Medical Licensing Examination (USMLE) scores, advanced degrees, publications, and completion of a residency program ranked in the top 6 in the …

Reflections Of The Angiotensin Receptor Blocker Recall By The Fda And Repercussions On Healthcare, Michael Gillette, Addison Taylor, Djenita Butulija, Himabindu Kadiyala, Hani Jneid

Faculty, Staff and Students Publications

PURPOSE: Beginning in July of 2018, the FDA issued a voluntary recall regarding the presence of a contaminant found in the manufacturing of valsartan. What would ensue has become a largely unprecedented sequence of alarming events since the FDA began reporting public recalls, withdrawals and safety alerts on their website in 2016. Since then, the United States has been significantly impacted by drug recalls affecting angiotensin receptor blockers. This report arms clinicians with additional guidance and provides a framework for responding appropriately to future similar incidents and includes an overview of the angiotensin receptor blockers, and their effects and safety …

Prevalence Of Helicobacter Pylori Positive Non-Cardia Gastric Adenocarcinoma Is Low And Decreasing In A Us Population, Theresa H Nguyen, Niharika Mallepally, Tariq Hammad, Yan Liu, Aaron P Thrift, Hashem B El-Serag, Mimi C Tan

Faculty, Staff and Students Publications

BACKGROUND: Helicobacter pylori infection is an established causal factor for non-cardia gastric cancer. H. pylori negative gastric cancer prevalence among US patients is unclear.

METHODS: This retrospective cohort study examined H. pylori prevalence among consecutive patients with incident non-cardia gastric adenocarcinoma at the Houston VA Hospital (11/2007-10/2018). H. pylori positivity was defined by H. pylori on histopathology, positive antibody serology, stool antigen, or urea breath testing. We examined for trends in H. pylori negative gastric cancer based on year of diagnosis. Associations between histopathologic and cancer-related outcomes with H. pylori positivity were determined using regression models.

RESULTS: Of 91 patients …

Boarding Of Critically Ill Patients In The Emergency Department, Nicholas M Mohr, Brian T Wessman, Benjamin Bassin, Marie-Carmelle Elie-Turenne, Timothy Ellender, Lillian L Emlet, Zachary Ginsberg, Kyle Gunnerson, Kevin M Jones, Bridgette Kram, Evie Marcolini, Susanna Rudy

2020-Current year OA Pubs

OBJECTIVES: Emergency department boarding is the practice of caring for admitted patients in the emergency department after hospital admission, and boarding has been a growing problem in the United States. Boarding of the critically ill has achieved specific attention because of its association with poor clinical outcomes. Accordingly, the Society of Critical Care Medicine and the American College of Emergency Physicians convened a Task Force to understand the implications of emergency department boarding of the critically ill. The objective of this article is to review the U.S. literature on (1) the frequency of emergency department boarding among the critically ill, …

Health Is Wealth: The Correlation Of Wellness Programs & Productivity In Canada And The U.S., Madeline Wert

Business and Economics Summer Fellows

Does health impact the productivity of workers? Are there differences between the U.S. and Canada? Firms both in Canada and the U.S. deal with issues of presenteeism and absenteeism. Presenteeism is when an employee shows up to work but they are distracted by their own or a family member’s health issue. One response to reduce presenteeism and absenteeism are workplace wellness programs. Workplace wellness programs are facilitated programs by a firm to promote the health and wellbeing of their employees, which benefits the employer and the employees. There are additional incentives for U.S. employers to implement workplace wellness programs as …

Sociodemographic Determinants Of Physical Activity And Sport Participation Among Women In The United States, Jennifer R. Pharr, Nancy L. Lough, Angela M. Terencio

School of Public Health Faculty Research

Regular physical activity and sport participation have been shown to improve women’s health; however, research has found that better health is associated with sport participation. Little is known about the sociodemographic determinants of physical activity among women, especially among the different subcategories of physical activity (sport, conditioning exercise, recreation, and household tasks). Because of the added health benefits associated with sport participation, the purpose of this study was to examine the sociodemographic determinants among subcategories of physically active women in the United States by analyzing Behavioral Risk Factor Surveillance System (BRFSS) data. We used data from the 2017 national BRFSS …

Understanding Type 2 Diabetes Mellitus Among Haitian American Women: A Cultural Perspective, Balkys L. Bivins, Indra R Hershorin, Lonar M. Umadhay

Faculty Articles

The prevalence of type 2 diabetes mellitus (T2DM) is 19.7% in Haiti (DeGennaro et al., 2018). Haitian American women (HAW) experience difficulties with adherence to T2DM treatment and management (Bivins, 2016; Magny-Normilus et al., 2019; Vimalananda et al., 2011; Huffman et al., 2013); however, no previous study was found that focused exclusively on Haitian American women with T2DM. Van Manen's six research activities guided this phenomenological qualitative inquiry. Recruitment included 25 Haitian American women (N = 25) with T2DM from three South Florida counties. Data were collected using a vignette and audio-recorded semi-structured interviews with open-ended questions. Recordings were then …

A Health Care Comparison Of Areas In Ghana And In The United States, Lindsey Matsumoto

Honors Projects

The health care system is an important factor for the well-being of the human population all around the world, and yet, health care can differ greatly depending on a variety of factors including location and culture. When referring to health care, it is appropriate to include skilled physicians, hospitals, care clinics, and medical equipment. This article conducts a literature review that compares the health care systems of two countries, the Republic of Ghana and the United States of America. This information is relevant for not only expanding one’s knowledge, but also for travel purposes, as both countries have highly populated …

Health Insurance Coverage Disruptions And Cancer Care And Outcomes: Systematic Review Of Published Research, K Robin Yabroff, Katherine Reeder-Hayes, Jingxuan Zhao, Michael T Halpern, Ana Maria Lopez, Leon Bernal-Mizrachi, Anderson B Collier, Joan Neuner, Jonathan Phillips, William Blackstock, Manali Patel

Kimmel Cancer Center Faculty Papers

BACKGROUND: Lack of health insurance coverage is associated with poor access and receipt of cancer care and survival in the United States. Disruptions in coverage are common among low-income populations, but little is known about associations of disruptions with cancer care, including prevention, screening, and treatment, as well as outcomes of stage at diagnosis and survival.

METHODS: We conducted a systematic review of studies of health insurance coverage disruptions and cancer care and outcomes published between 1980 and 2019. We used the PubMed, EMBASE, Scopus, and CINAHL databases and identified 29 observational studies. Study characteristics and key findings were abstracted …

Highlights Of Studies In Cardiovascular Disease Prevention Presented At The 2020 American College Of Cardiology Annual Scientific Session, Xiaoming Jia, Mahmoud Al Rifai, Jing Liu, Anandita Agarwala, Martha Gulati, Salim S Virani

Faculty, Staff and Students Publications

PURPOSE OF REVIEW: The review highlights selected studies related to cardiovascular disease (CVD) prevention that were presented at the American College of Cardiology 2020 Virtual Scientific Session (ACC.20)/World Cardiology Congress (WCC).

RECENT FINDINGS: The studies reviewed include clinical trials on the efficacy and safety of alirocumab (Study in Participants with Homozygous Familial Hypercholesterolemia [ODYSSEY HoFH]) and evinacumab in the treatment of homozygous familial hypercholesterolemia (HoFH); Evaluating the Efficacy of E-cigarettes for Smoking Cessation (E3); the use of renal denervation in the treatment of hypertension (SPYRAL HTN-OFF MED PIVOTAL); and the assessment of vericiguat in the treatment of heart failure (A …

Covid-19 Medical Papers Have Fewer Women First Authors Than Expected., Jens Peter Andersen, Mathias Wullum Nielsen, Nicole L Simone, Resa E Lewiss, Reshma Jagsi

Department of Radiation Oncology Faculty Papers

The COVID-19 pandemic has resulted in school closures and distancing requirements that have disrupted both work and family life for many. Concerns exist that these disruptions caused by the pandemic may not have influenced men and women researchers equally. Many medical journals have published papers on the pandemic, which were generated by researchers facing the challenges of these disruptions. Here we report the results of an analysis that compared the gender distribution of authors on 1893 medical papers related to the pandemic with that on papers published in the same journals in 2019, for papers with first authors and last …

The Role Of Agency In Early And Unwanted Adolescent Pregnancy: A Multi Country Analysis, Katharine Mccarthy

Dissertations and Theses

Purpose. The agency to decide one’s reproductive future is paramount, yet an estimated 75 percent of adolescent girls in the United States (U.S.) and 49 percent of those in low and middle-income countries experience mistimed or unwanted pregnancy. This dissertation characterized empirical representations of agency over the course of adolescence and investigated the relationship between agency and early and unwanted pregnancy and childbearing using data from three countries (India, Zambia and the U.S.).

Methods. Using latent class and latent transition analysis, multi-dimensional profiles of adolescent agency were assessed using data from: (1) a state representative cross-sectional cohort study of adolescents …

Posterior Cortical Atrophy: Characteristics From A Clinical Data Registry., Jennifer J Olds, William L Hills, Judith Warner, Julie Falardeau, Lori Haase Alasantro, Mark L Moster, Robert A Egan, Wayne T Cornblath, Andrew G Lee, Benjamin M Frishberg, Roger E Turbin, David M Katz, John A Charley, Victoria S Pelak

Department of Neurology Faculty Papers

No abstract provided.

Shadow Standards And The Logic Of Costs: Care, Stewardship, And Data In U.S. Community Health, Margarite J. Whitten

Dissertations, Theses, and Capstone Projects

This dissertation examines the delegation of responsibility for providing health care to particular categories of marginalized populations in the United States in the absence of a uniform and universal health care system. It explores how the U.S. federal government governs patient populations at a distance by mandating that healthcare providers collect, produce, and report on patient data. Drawing from eighteen months of ethnographic research in Massachusetts clinics for the homeless and the frail elderly between 2014-2015, I argue that when marginalized patients are unable to satisfy the neoliberal ideal of self-governance to maintain their health in cost-effective ways, providers are …

The Relationship Of Span Of Control To Nurse Manager Satisfaction, Jeffrey Batcher

Master of Science in Nursing Final Projects

Purpose: The purpose of this study was to examine the relationship between span of control (SOC) and nurse manager job satisfaction for nurse managers working in a hospital system. The study may help administrators identify how wide and narrow SOC correlates to the overall job satisfaction of nurse managers.

Design: A non-experimental descriptive correlational study design was used.

Methods: Data were collected from a convenience sample of nurse managers working within an eleven-hospital healthcare system. Survey Monkey was used for data collection and included a demographic questionnaire, The Ottawa Hospital Model of Nursing Clinical Practice (TOH MoNCP) Clinical Management Span …

Promising Practices For Boating Safety Initiatives That Target Indigenous Peoples In New Zealand, Australia, The United States Of America, And Canada, Mitchell Crozier, Audrey R. Giles

International Journal of Aquatic Research and Education

Boating-related incidents are responsible for a significant number of the drowning fatalities that occur within Indigenous communities in New Zealand, Australia, the USA, and Canada. The aim of this paper was to identify promising practices for boating safety initiatives that target Indigenous peoples within these countries and evaluate past and ongoing boating safety initiatives delivered to/with Indigenous peoples within these countries to suggest the ways in which they – or programs that follow them - may be more effective. Based upon evidence from previous research, boating safety initiatives that target Indigenous peoples in New Zealand, Australia, the USA, and Canada …

Evaluating The Feasibility And Acceptability Of Internet-Based Cognitive Behavioral Therapy For Insomnia In Rural Women, Mairead Eastin Moloney, Madeline Dunfee, Matthew Rutledge, Nancy Schoenberg

Sociology Faculty Publications

Background: Insomnia, one of the most common sleep disorders among women in midlife, is associated with multiple negative health outcomes. Rural Appalachian women are disproportionately affected by insufficient sleep, but their barriers to care (e.g., health care shortages, cultural norms) may prevent intervention. This study assessed the feasibility and acceptability of Sleep Healthy Using the Internet (SHUTi) an Internet-based version of cognitive behavioral therapy for insomnia in Appalachian women ages 45+ years.

Materials and Methods: We used mixed methods to assess feasibility (through summaries of recruitment and retention data) and acceptability (quantitatively through online survey scales and qualitatively …

Drug Courts And The Following Of The Federal Guidelines, Charles James Souza

Master’s Theses and Projects

During the 1980’s, drug offense were running high within the United States. The court system along with the police and other fields were forced to form other methods of dealing with offenders who have a substance abuse problem. In 1989, the first drug court in the United States was formed in the state if Florida. The idea was to create a therapeutic method to help those who are committing non-violent criminal acts due to their addiction. The goal of drug court was to get offenders the treatment they needed so they would not resort to criminal activity. Drug court personal …

Oral Health-Related Quality Of Life In Us Adults With Type 2 Diabetes., Giang Truong Vu

Electronic Theses and Dissertations

This dissertation focused on the relationship between type 2 diabetes (T2DM) and oral health-related quality of life (OHRQoL) and the factors associated with this relationship in the US. The objectives of the dissertation research were a three-part process: (1) to understand the relationships of T2DM with poor OHRQoL, clarify risk and preventive factors that affect this association, and identify research gaps in the literature, (2) to analyze risk factors associated with poor OHRQoL in US adults with T2DM using a nationally representative random probability cluster sample, and (3) to apply structural equation modeling (SEM) to a simplified Andersen’s Behavioral Model …

Exercise As A Mitigator Of Poor Mental Health Among Lesbian, Gay, And Bisexual Adults, Jennifer R. Pharr, Jason D. Flatt, Lung-Chang Chien, Axenya Kachen, Babayemi O. Olakunde

Environmental & Global Health Faculty Research

Introduction: There is a positive association between exercise and improved mental health in the general population. Although there is a greater burden of psychological distress among lesbian, gay, and bisexual (LGB) people, little is known about the association between exercise and mental health in this population. The authors explored the association between exercise and poor mental health reported by LGB adults in the United States. Methods: Our analyses used data from the 2017 Behavioral Risk Factor Surveillance System survey. Multiple regression analyses were used to determine the association between exercising and mental health days adjusting for sociodemographic characteristics. Results: Data …

Screen Time Effects On Children And Adolescents In Both The United States And Australia, Marrisa Cox

Honors Projects

Technology and screen time have become an essential part of everyday life in many countries across the world. Children in Australia and the United States are exposed to increasing hours of technology exceeding recommendations by pediatricians in both countries. Pediatricians suggest limiting screen time due to the research indicating possible impact on social development, and unhealthy emotional and physical outcomes in children. The objective of this paper was to review the mental and physical impacts of screen time on young and adolescent children and to compare and contrast policies regulating screen time in the United States and Australia. The information …

Associations Between Breast Cancer Subtype And Neighborhood Socioeconomic And Racial Composition Among Black And White Women, Erin Linnenbringer, Arline T Geronimus, Kia L Davis, John Bound, Libby Ellis, Scarlett L Gomez

2020-Current year OA Pubs

PURPOSE: Studies of Black-White differences in breast cancer subtype often emphasize potential ancestry-associated genetic or lifestyle risk factors without fully considering how the social or economic implications of race in the U.S. may influence risk. We assess whether neighborhood racial composition and/or socioeconomic status are associated with odds of triple-negative breast cancer (TNBC) diagnosis relative to the less-aggressive hormone receptor-positive/HER2-negative subtype (HR+ /HER-), and whether the observed relationships vary across women's race and age groups.

METHODS: We use multilevel generalized estimating equation models to evaluate odds of TNBC vs. HR+ /HER2- subtypes in a population-based cohort of 7291 Black and …

Bone Marrow Concentrate (Bmc) Therapy In Musculoskeletal Disorders: Evidence-Based Policy Position Statement Of American Society Of Interventional Pain Physicians (Asipp), Laxmaiah Manchikanti, Christopher J. Centeno, Sairam Atluri, Sheri L. Albers, Shane Shapiro, Gerard A. Malanga, Alaa Abd-Elsayed, Mairin Jerome, Joshua A. Hirsch, Alan David Kaye, Steve M. Aydin, Douglas Beall, Don Buford, Joanne Borg-Stein, Ricardo M. Buenaventura, Joseph A. Cabaret, Aaron K. Calodney, Kenneth D. Candido, Cameron Cartier, Richard Latchaw, Sudhir Diwan, Ehren Dodson, Zachary Fausel, Michael Fredericson, Christopher G. Gharibo, Mayank Gupta, Adam M. Kaye, Nebojsa Nick Knezevic, Radomir Kosanovic, Matthew Lucas, Maanasa V. Manchikanti, R. Amadeus Mason, Kenneth Mautner, Samuel Murala, Annu Navani, Vidyasagar Pampati, Sarah Pastoriza, Ramarao Pasupuleti, Cyril Philip, Mahendra R Sanapati, Theodore Sand, Rinoo V Shah, Amol Soin, Ian Stemper, Bradley W Wargo, Philippe Hernigou

School of Pharmacy Faculty Articles

BACKGROUND: The use of bone marrow concentrate (BMC) for treatment of musculoskeletal disorders has become increasingly popular over the last several years, as technology has improved along with the need for better solutions for these pathologies. The use of cellular tissue raises a number of issues regarding the US Food and Drug Administration's (FDA) regulation in classifying these treatments as a drug versus just autologous tissue transplantation. In the case of BMC in musculoskeletal and spine care, this determination will likely hinge on whether BMC is homologous to the musculoskeletal system and spine.

OBJECTIVES: The aim of this review is …