Public Health Commons^™

Healthcare Reform In The U.S. Must Be Driven By Policy And Data, Not Politics And Idealogy, Teresa M. Waters, Michael Karpf

Health Management and Policy Faculty Publications

Background U.S. healthcare spending will reach 20% of GDP by 2026. Despite this spending, almost 14% of our under-65 population still lacks health insurance and out-of-pocket healthcare spending is high. To date, much of the healthcare reform debate has focused on who pays—the government, employers or individuals. Objective To review current healthcare reform issues and evidence. Method We address the questions of how much we pay, how we pay and what we receive for the money as a potential foundation for constructive dialogue. Results U.S. healthcare spending continues to exceed that of other countries, without offering universal coverage. Notwithstanding coverage …

Examining Integration And Sense Of Belonging Among Undergraduate Students Participating In Stem Support Programs, Mackenzie J. Gray

University Honors Theses

National calls have been made to strengthen our nation’s Science, Technology, Engineering, and Mathematics (STEM) workforce by improving student preparation and increasing retention rates. A sense of belonging in STEM fields is thought to be key for persistence in STEM, but many students face academic, social, and financial barriers that can impede this sense of belonging. These barriers can be more pronounced for students underrepresented in STEM. In response, many federal and non-governmental agencies have invested in the future STEM workforce by funding STEM support programs. Such programs aim to support student persistence by providing academic, social, and financial resources …

Anti-Corruption, Transparency And Accountability In Health: Concepts, Frameworks, And Approaches, Taryn Vian

Nursing and Health Professions Faculty Research and Publications

Background: As called for by the Sustainable Development Goals, governments, development partners and civil society are working on anti-corruption, transparency and accountability approaches to control corruption and advance Universal Health Coverage.

Objectives: The objective of this review is to summarize concepts, frameworks, and approaches used to identify corruption risks and consequences of corruption on health systems and outcomes. We also inventory interventions to fight corruption and increase transparency and accountability.

Methods: We performed a critical review based on a systematic search of literature in PubMed and Web of Science and reviewed background papers and presentations from two …

Promoting Anti-Corruption, Transparency And Accountability To Achieve Universal Health Coverage, Theadora Koller, David Clarke, Taryn Vian

Nursing and Health Professions Faculty Research and Publications

Anti-corruption, transparency and accountability measures are often missing from efforts to promote universal health coverage. Yet, if unchecked, corruption represents a significant drain on domestic health resource and a major barrier to achieving universal health coverage and the sustainable development goals. The World Health Organization is promoting a coordinated public health approach to anti-corruption, transparency and accountability, working with global partners to create new internal control and assurance models, increase monitoring and evaluation; develop capacity for multiple stakeholders to address corruption; and strengthen normative guidance to integrate anti-corruption, transparency and accountability into WHO’s work on health systems strengthening. The articles …

A Review Of The Literature On Corruption In Healthcare Organizations, Vincenzo Sforza, Riccardo Cimini, Alessandro Mechelli, Taryn Vian

Nursing and Health Professions Faculty Research and Publications

This paper provides a systematic and bibliometric review of 80 research articles on corruption in healthcare published in peer-reviewed journals between 2006 and 2017. Findings suggest that the number of studies has increased over time with a focus on low- and middle-income countries; academic researchers have published papers in a large variety of journals and have investigated different types of corruption with various methodologies. The interest is especially focused on low- and middle-income countries where corrupt behaviors are more common. The paper suggests future research directions to a dynamic research community to facilitate anticorruption actions by public authorities.

2020-03-09 A Message From Chancellor Roth, Paul B. Roth

HSC Messages from the Chancellor

No abstract provided.

Migrant Health Policies In The European Union: A Comparative Policy Analysis, Jessica Joanne Currier

Dissertations and Theses

There is an undeniable relationship between migration and health. Despite the fact that the concept of health as a fundamental human right has been enshrined in numerous international and supranational policy instruments, health disparities between migrants and host nation populations persist. Inequities in health are perpetuated by several factors that include, but are not limited to, immigration status, lack of knowledge of health system access points, appropriateness of health care services, language barriers, and unique health profiles of migrants. The literature firmly positions migrants as a vulnerable population due to their collective risk of poor health outcomes in multiple areas. …

Medicaid Home Visitation And Maternal And Infant Care And Health: A Reassessment Of Program Effectiveness, Cristian Meghea, Zhiying You, Jennifer E. Raffo, Lee Anne Roman

Michigan Journal of Public Health

Introduction: The Maternal Infant Health Program, MIHP, is Michigan's largest home visiting program for Medicaid-eligible pregnant women and infants. Prior quasi-experimental propensity score matched MIHP evaluations were limited by the possibility of selection bias due to the limited available baseline characteristics. The purpose of this study was to assess the effectiveness of MIHP including previously unobserved baseline characteristics to mitigate the possibility of selection bias.

Methods: We analyzed health care and outcomes of mothers and their infants using linked administrative and screening data. All Medicaid pregnant women with a singleton birth in Michigan between 2009 and 2012 who were prenatally …

Development Of A Diabetes Self-Management + Mhealth Program: Tailoring The Intervention For A Pilot Study In A Low-Income Setting In Mexico, Robin Whittemore, Mireya Vilar-Compte, Soraya Burrola-Méndez, Annel Lozano-Marrufo, Roberta Delvy, Mariana Pardo-Carrillo, Selene De La Cerda, Ninfa Pena-Purcell, Rafael Pérez-Escamilla

Department of Public Health Scholarship and Creative Works

Background: Type 2 diabetes (T2D) is a public health pandemic disproportionately affecting low- and middle-income countries. The purpose of this formative research was to adapt evidence-based diabetes self-management education programs to the context of Seguro Popular clinics in Mexico. A theory-based mHealth (pictorial text messaging) component was developed.

Method: Our formative research and development of the program protocol consisted of six phases: (1) interviews and focus groups with stakeholders on the challenges to T2D management, curriculum content needs, and the use of mHealth as a supplement to a DSME program; (2) review of the theoretical underpinning, curriculum, and interactive strategies …

2020-02-04 A Message From Chancellor Roth, Paul B. Roth

HSC Messages from the Chancellor

No abstract provided.

The Implementation Of Indonesian Navy Victim Identification Policy In Ladokgi R.E. Martadinata, Sugeng Winarno, Suhardjo Sitam, Bambang Hidayat Hidayat, Yuli Subiyakto

Journal of Indonesian Health Policy and Administration

Soldier is a death-risk profession; thus, identification to have their exact identity is a fundamental right. The Presidential Regulation Number 107 of 2013 mandates Ladokgi RE. Martadinata as the investigator of victim identification activities for Indonesian Navy Soldiers. This study analyzes the implementation of the policy with a qualitative descriptive approach using the Edward III model analysis. Retrieval of primary informant data through in depth interviews and secondary data, including observation and review of the literature, documents, and related laws and regulations. Data validation is done by triangulating data sources, theories, and methodologies. The results of the study indicate that …

The Implementation Of Enhancing Male Participation On Family Planning Policy In Bandung Barat Regency, Dadang Suhenda, Evalina Franciska Hutasoit

Journal of Indonesian Health Policy and Administration

This study aims to analyze the conduct implementation of the increasing male contraception policy in Bandung Barat Regency. The study is using qualitative methods with case studies approachment. Qualitative data were gained from 16 informants which consist of implementor group as program managers, and partnership and community group as the targeted group. This study was conducted at three locations: district of Cililin, Batu Jajar, and Parongpong. The study shows that the decision process to decide PPM as the standard and goals of the family planning program has been understood by all of its administrators and resources available for this program …

Policy Implementation In Achieving Basic Complete Immunization And Universal Child Immunization Indicators In Kapuas District In 2018, Lia Rosi Vela, Amal Chalik Sjaaf

Journal of Indonesian Health Policy and Administration

Completing the basic immunization and implementing Universal Child Immunization (UCI) are the objectives for the Immunization Program according to the Ministry of Health of Republic Indonesia Strategic Planning. In 2017, Kapuas district achieved 66,6% of the Completed Basic Immunization target and 32,2% of the Universal Child Immunization (UCI) target. There is still a 26,4% gap and a 62,8% gap, respectively, from the 95% target of Strategic Plan Ministry of Health 2015-2019. This study aims to discuss the performance of policy implementation of Completed Basic Immunization (CBI) and Universal Child Immunization (UCI) in 2018 at Kapuas Regency, using qualitative research with …

Policy Of Patient Safety Governance For Hospitalized Patient At The Koja Public Hospital In 2019, Tiara Fani Yolanda, Masyitoh Basabih

Journal of Indonesian Health Policy and Administration

Clinical governance is a structured organizational framework to improve the quality and safety of patients in the hospital which made by the NHS into seven pillars and adjusted to RI Law No. 44 of 2009. The evaluation results from the quality and patient safety team of Koja Public Regional Hospital in 2018, showed that there is Fall Patient incidents (6 events), KTD and KNC (13 events) which is not following the 0 % of the target from Patient Safety Goals by the Ministry of Health. The study was conducted to analyze patient safety governance for hospitalized patients at the Koja …

The Impact Of National Health Insurance Policy On Outpatient Visit In Maluku And Papua: Logit Model, Rira Wahdani Martaliza, Pujiyanto Pujiyanto

Journal of Indonesian Health Policy and Administration

The National Health Insurance (JKN) is one manifestation of the National Social Security System program which aims to provide benefits for health care and protection. This study uses secondary data from the 2017 National Socio-Economic Survey (Susenas) which aims to prove that JKN ownership has an influence on outpatient visits. The research respondents were all people who were registered as JKN participants in the Maluku and Papua Islands regions as many as 77.307 people. This study uses the econometric approach with the Logit regression model. The results showed that JKN was positively associated with outpatient visits, with coefficients of PBI …

Increasing Access To Sti Services In The Medicaid Program, Naomi Seiler, Katie Horton, Darla Bishop, Madina Adil, Claire Heyison

Health Policy and Management Informal Communications

The United States is undergoing an epidemic of sexually transmitted infections (STIs), including chlamydia, gonorrhea, and syphilis. All three bacterial infections are detectable and treatable, yet they often go diagnosed. Untreated chlamydia and gonorrhea can lead to serious pelvic infections and infertility; untreated syphilis can result in severe complications, including death. Congenital syphilis is increasing as well, with a concurrent rise in stillbirth and newborn deaths.

Increased resources and heightened attention are urgently needed to supplement the work of the public health infrastructure, for which STI funding has remained stagnant for two decades. Fortunately, the Medicaid program is well situated …

Survival Of A Serotype 4b Strain And A Serotype 1/2a Strain Of Listeria T Monocytogenes, Isolated From A Stone Fruit Outbreak Investigation, On Whole Stone Fruit At 4 °C, Antonio J. De Jesus, Ishani Sheth, Hee Jin Kwon, Zhujun Gao, Jessica Palmer, Minji Hur, Thomas S. Hammack, Dumitru Macarisin, Yi Chen

United States Food and Drug Administration: Publications

In the summer of 2014, a multistate outbreak of listeriosis associated with contaminated stone fruit (peach and nectarine) was reported. A serotype 4b variant Listeria monocytogenes (Lm) strain of singleton Sequence Type (ST) 382 was isolated from clinical samples and stone fruit associated with the outbreak. A serotype 1/2b Lm strain of ST5, Clonal Complex 5 was isolated only from outbreak-associated stone fruit, not from clinical samples. Here we investigated the fate of the serotype 4b and 1/2b strains, at two inoculation levels (high level at 3.7 logCFU/fruit and low level at 2.7 logCFU/fruit), on the surfaces of white peach, …

Adult Perceptions Of The Relative Harm Of Tobacco Products And Subsequent T Tobacco Product Use: Longitudinal Findings From Waves 1 And 2 Of The Population Assessment Of Tobacco And Health (Path) Study, Tara Elton-Marshall, Pete Driezen, Geoffrey T. Fong, K. Michael Cummings, Alexander Persoskie, Olivia Wackowski, Kelvin Choi, Annette Kaufman, David Strong, Shannon Gravely, Kristie Kristie, Jonathan Kwan, Maansi Bansal-Travers, Mark Travers, Andrew Hyland

United States Food and Drug Administration: Publications

Objectives: To examine: (1) How perceptions of harm for seven non-cigarette tobacco products predict sub- sequent use; (2) How change in use is associated with changes in perceptions of product harm; (3) Whether sociodemographic variables moderate the association between perceptions and use.

Methods: Data are from the adult sample (18+) of the Population Assessment of Tobacco and Health (PATH) Study, a nationally representative longitudinal cohort survey conducted September 2013-December 2014 (Wave 1 (W1) n = 32,320) and October 2014-October 2015 (Wave 2 (W2) n = 28,362).

Results: Wave 1 users and non-users of e-cigarettes, filtered cigars, cigarillos, and pipes, who …

An Evaluation Of The Usda's Policy To Reduce Listeria Illnesses In Ready‐To‐Eat Meat And Poultry Products, Travis Minor, Matt Parrett

United States Food and Drug Administration: Publications

Using 1998–2008 data collected by the Centers for Disease Control and Prevention on foodborne illnesses and outbreaks, we examine the economic impact of the United States Department of Agriculture's proposed and final rules to reduce the incidence of Listeria monocytogenes (Lm) in ready‐to‐ eat meat and poultry products. Using a difference‐in‐ differences approach, we find that these rules together reduced meat‐related Lm illnesses by about 60 per year, which we attribute to reductions in both the number and average size of meat‐related Lm outbreaks. We then monetize this illness reduction using an underreporting and underdiagnosis multiplier of 2.3 and an …

Genomics-Based Re-Examination Of The Taxonomy And Phylogeny Of Human And Simian Mastadenoviruses: An Evolving Whole Genomes Approach, Revealing Putative Zoonosis, Anthroponosis, And Amphizoonosis, June Kang, Ashrafali Mohamed Ismail, Shoaleh Dehghan, Jaya Rajaiya, Marc W. Allard, Haw Chuan Lim, David W. Dyer, James Chodosh, Donald Seto

United States Food and Drug Administration: Publications

With the advent of high-resolution and cost-effective genomics and bioinformatics tools and methods contributing to a large database of both human (HAdV) and simian (SAdV) adenoviruses, a genomics-based re-evaluation of their taxonomy is warranted. Interest in these particular adenoviruses is growing in part due to the applications of both in gene transfer protocols, including gene therapy and vaccines, as well in oncolytic protocols. In particular, the re-evaluation of SAdVs as appropriate vectors in humans is important as zoonosis precludes the assumption that human immune system may be na€ıve to these vectors. Additionally, as impor- tant pathogens, adenoviruses are a model …

The Impact Of The Abuse-Deterrent Reformulation Of Extended-Release T Oxycontin On Prescription Pain Reliever Misuse And Heroin Initiation, Carolyn Wolff, William N. Dowd, Mir M. Ali, Chandler Mcclellan, Angelica Meinhofer, Lukas Glos, Ryan Mutter, Matthew Rosenberg, Andreas Schikc

United States Food and Drug Administration: Publications

The introduction of abuse-deterrent OxyContin in 2010 was intended to reduce its misuse by making it more tamper resistant. However, some studies have suggested that this reformulation might have had unintended consequences, such as increases in heroin-related deaths. We used the 2005–2014 cross-sectional U.S. National Survey on Drug Use and Health to explore the impact of this reformulation on intermediate outcomes that precede heroin-related deaths for individuals with a history of OxyContin misuse. Our study sample consisted of adults who misused any prescription pain reliever prior to the reformulation of OxyContin (n = 81,400). Those who misused OxyContin prior to …

Development Of A Nicotinic Acetylcholine Receptor Nachr Α7 Binding Activity Prediction Model, Sugunadevi Sakkiah, Carmine Leggett, Bohu Pan, Wenjing Guo, Luis G. Valerio Jr., Huixiao Hong

United States Food and Drug Administration: Publications

Despite the well-known adverse health effects associated with tobacco use, addiction to nicotine found in tobacco products causes difficulty in quitting among users. Nicotinic acetylcholine receptors (nAChRs) are the physiological targets of nicotine and facilitate addiction to tobacco products. The nAChR-α7 subtype plays an important role in addiction; therefore, predicting the binding activity of tobacco constituents to nAChR-α7 is an important component for assessing addictive potential of tobacco constituents. We developed an α7 binding activity prediction model based on a large training data set of 843 chemicals with human α7 binding activity data extracted from PubChem and ChEMBL. The model …

Long-Term Negative Emotional Outcomes Of Warzone Tbi, Jennifer J. Vasterling, Mihaela Aslan, Susan P. Proctor, John Ko, Xenia Leviyah, John Concato

United States Food and Drug Administration: Publications

Objective: Many veterans of the Iraq and Afghanistan Wars have experienced traumatic brain injury (TBI). Although prior work has examined associations between TBI and development of psychi- atric syndromes, less is known about associations between TBI and component emotions constituting these syndromes, especially in the long term. The purpose of this study was to examine the long-term emotional consequences of deployment-related TBI.

Methods: As part of VA Cooperative Studies Program #566, we assessed a sample of n1⁄4456US Army soldiers prior to an index deployment to Iraq, and again an average of 8.3 years (SD1⁄42.4years) after their deployment for a long-term …

Association Between Usage Of An App To Redeem Prescribed Food Benefits And Redemption Behaviors Among The Special Supplemental Nutrition Program For Women, Infants, And Children Participants: Cross-Sectional Study, Qi Zhang, Junzhou Zhang, Kayoung Park, Chuanyi Tang

Community & Environmental Health Faculty Publications

BACKGROUND: The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) is one of the most important food assistance programs in the United States, serving 6.4 million low-income, eligible women, infants, and children under 5 years of age in 2019. In the program, participants are prescribed a list of food benefits, which can be redeemed in WIC-authorized stores. However, there are multiple behavioral barriers in the program and the stores that prevent participants from redeeming the benefits fully.

OBJECTIVE: This study aims to examine the relationship between the use of a widely used mobile phone app, WICShopper, and the …

Impact On Hospital Profitability Due To Covid Safety Guidelines, Khaja Umair Shariff, Anna Noel Franklin

Theses, Dissertations and Capstones

Introduction: The pandemic of COVID 19 presented a unique challenge to hospitals and healthcare systems that they have been struggling to function in. Operating costs had increased with new protocols, planning, operating space, supplies, and staffing. This coupled with the loss of revenue has led to approximately 10% - 20% salary reductions, furloughs, and loss of benefits such as PTO and vacation days to employees. Hospital’s cash reserves are being depleted due to increased operations costs and reduced revenue. Government funding, such as the CARES Act provided by the sanction of the Department of Health and Human Services Office, …

Tolerance Intervals For Time Series Models And Specifying Trimming/Winsorizing Cutoffs, Kedai Cheng

Theses and Dissertations--Statistics

Confidence intervals are used to capture a parameter of interest, usually a mean or a quantile, at a specified confidence level. Prediction intervals are another practical interval that aim at making sound predictions of future values with some confidence. Although these are useful inference tools, neither of them gives people a plausible range of the sampled population. Tolerance intervals are such an inference tool that captures a specified proportion of the sampled population at a predetermined confidence level. In this dissertation, tolerance intervals for an autoregressive process with order p are constructed. In addition, a method of utilizing tolerance interval …

A Descriptive Case Study On Patient Flow At A Medical Center In A Resource-Limited Setting, Salman Moti

MUSC Theses and Dissertations

Medical centers operating in resource-limited settings face unique challenges associated with a scarcity of resources, expertise, and infrastructure. While inefficiencies can be identified in any organization, they can be particularly problematic for health care facilities that seek to expand the scope of their operations in resource-limited areas as resources that are already in short supply are utilized to fuel non-value-added activities. In this descriptive case study of a newly built medical center in Khorog, Tajikistan, we consider a medical center’s patient flow and the underlying systemic factors that contribute to the current state of affairs as well as interventions that …

Association Between Breastfeeding And Child Stunting In Mexico, Ana Paola Campos, Mireya Vilar-Compte, Summer Sherburne Hawkins

Department of Public Health Scholarship and Creative Works

Background: Globally, the prevalence of child stunting has been decreasing over the past decades. How-ever, in low-and middle-income countries such as Mexico, stunting is still the most prevalent form of undernutrition affecting a large number of children in the most vulnerable conditions. Breastfeeding has been identified as one of the key affordable and modifiable maternal health behaviors protecting against child stunting. Objective: To examine the association between breastfeeding (defined as never breastfed, any breast-feeding for <6 months, and any breastfeeding for ≥6 months) and other individual-, household-, and area-level factors with child stunting (defined as length/height-for-age-z-score for sex under –2 standard deviations of the World Health Organization child growth standards’ median) in Mexico. Methods: Secondary data analysis using the 2012 Mexican Health and Nutrition Survey, which allowed representativeness of rural and urban areas at national level and among 4 regions in Mexico. Our subset included data on 2,089 singleton Mexican children aged 6–35 months with information on previously identified risk and protective factors for stunting. We conducted fixed-and mixed-effects logistic regression models sequentially controlling for each level of factors. Findings: Overall, 12.3% of children were stunted and 71.1% were breastfed for ≥6 months. Any breast-feeding and being female were consistent protective factors against child stunting across all models. In contrast, child low birthweight, maternal short stature, higher number of children aged <5 years per household, and moderate to severe food insecurity were consistent risk factors for child stunting across all models. Conclusions: According to our findings, efforts to reduce child stunting in Mexico should include prenatal strategies aiming to prevent low birthweight offspring particularly among short-stature women, moderate to severe food insecure households, families with a higher number of children aged <5 years, and indigenous communities. Postnatal components should include multilevel strategies to support breastfeeding.

Assessing The Efficiency Of Sub-National Units In Making Progress Towards Universal Health Coverage: Evidence From Pakistan, Faraz Khalid, Maria Petro Brunal, Abdul Sattar, Samia Laokri, Matthew Jowett, Wajeeha Raza, David R. Hotchkiss

Community Health Sciences

The World Health Report 2010 encourages countries to reduce wastage and increase efficiency to achieve Universal Health Coverage (UHC). This research examines the efficiency of divisions (sub-provincial geographic units) in Pakistan in moving towards UHC using Data Envelop Analysis. We have used data from the Pakistan National Accounts 2011-12 and the Pakistan Social Living and Measurement Survey 2012-13 to measure per capita pooled public health spending in the divisions as inputs, and a set of UHC indicators (health service coverage and financial protection) as outputs. Sensitivity analysis for factors outside the health sector influencing health outcomes was conducted to refine …

Anaphylaxis Diagnosis And Management In The Emergency Department Of A Tertiary Hospital In The Philippines, Michelle Joy De Vera, Iris Conela Tagaro

Ateneo School of Medicine and Public Health Publications

Background:
In the Emergency Department (ED), diagnosis and management of anaphylaxis are challenging with at least 50% of anaphylaxis episodes misdiagnosed when the diagnostic criteria of current guidelines are not used.

Objective:
Objective of our study was to assess anaphylaxis diagnosis and management in patients presenting to the ED.

Methods:
Retrospective chart review conducted on patients presenting to The Medical City Hospital ED, the Philippines from 2013–2015 was done. Cases were identified based on International Statistical Classification of Diseases, 10th revision coding for either anaphylaxis or other allergic related diagnosis. Cases fitting the definition of anaphylaxis as identified by the …