Public Health Commons^™

Chemical Reprogramming Takes The Fast Lane, Emily J Park, Srikanth Kodali, Bruno Di Stefano

Faculty, Staff and Students Publications

Small molecule-induced cell fate transitions are characterized by low efficiency and slow kinetics. An optimized chemical reprogramming approach now facilitates the robust and rapid conversion of somatic cells to pluripotent stem cells, unlocking exciting avenues to study and manipulate human cell identity.

Pattern Dynamics And Stochasticity Of The Brain Rhythms, Clarissa Hoffman, Jingheng Cheng, Daoyun Ji, Yuri Dabaghian

Faculty, Staff and Students Publications

Our current understanding of brain rhythms is based on quantifying their instantaneous or time-averaged characteristics. What remains unexplored is the actual structure of the waves—their shapes and patterns over finite timescales. Here, we study brain wave patterning in different physiological contexts using two independent approaches: The first is based on quantifying stochasticity relative to the underlying mean behavior, and the second assesses “orderliness” of the waves’ features. The corresponding measures capture the waves’ characteristics and abnormal behaviors, such as atypical periodicity or excessive clustering, and demonstrate coupling between the patterns’ dynamics and the animal’s location, speed, and acceleration. Specifically, we …

Early Lead Extraction For Infected Implanted Cardiac Electronic Devices: Jacc Review Topic Of The Week, Dhanunjaya R Lakkireddy, Douglas S Segar, Ami Sood, Maryann Wu, Archana Rao, M Rizwan Sohail, Sean D Pokorney, Carina Blomström-Lundqvist, Jonathan P Piccini, Christopher B Granger

Faculty, Staff and Students Publications

Infection remains a serious complication associated with the cardiac implantable electronic devices (CIEDs), leading to substantial clinical and economic burden globally. This review assesses the burden of cardiac implantable electronic device infection (CIED-I), evidence for treatment recommendations, barriers to early diagnosis and appropriate therapy, and potential solutions. Multiple clinical practice guidelines recommended complete system and lead removal for CIED-I when appropriate. CIED extraction for infection has been consistently reported with high success, low complication, and very low mortality rates. Complete and early extraction was associated with significantly better clinical and economic outcome compared with no or late extraction. However, significant …

Oral Health In Relation To The Covid-19 Pandemic, Anika L. Gram

Honors Thesis

Oral health has seen significant changes through the Covid-19 pandemic. Many people experienced the lifestyle alteration of wearing a mask for a major portion of their day-to-day life, and some went to the dentist significantly less than they did pre-pandemic. The literature review explores dental practices during the Covid-19 pandemic. It also examines mask-wearing behaviors both before and during the pandemic and the research that has been conducted previously regarding the potential effects of mask-wearing. Despite the decrease in use of masks post-pandemic, many healthcare professionals continue to wear masks daily. Additionally, in the event of future disease outbreak, it …

Fear Of Recurrence, Emotional Well-Being And Quality Of Life Among Long-Term Advanced Ovarian Cancer Survivors, Kathryn Osann, Lari Wenzel, Chelsea Mckinney, Lynne Wagner, David Cella, Giulia Fulci, Mary J Scroggins, Heather A Lankes, Victoria Wang, Kenneth P Nephew, George L Maxwell, Samuel C Mok, Thomas P Conrads, Austin Miller, Michael Birrer

Faculty, Staff and Student Publications

OBJECTIVE: Although advanced stage epithelial ovarian cancer is widely considered life-threatening, 17% of women with advanced disease will survive long-term. Little is known about the health-related quality of life (QOL) of long-term ovarian cancer survivors, or how fear of recurrence might affect QOL.

METHODS: 58 long-term survivors with advanced disease participated in the study. Participants completed standardized questionnaires to capture cancer history, QOL, and fear of recurrent disease (FOR). Statistical analyses included multivariable linear models.

RESULTS: Participants averaged 52.8 years at diagnosis and had survived >8 years (mean:13.5); 64% had recurrent disease. Mean FACT-G, FACT-O, and FACT-O-TOI (TOI) scores were …

Advancing Diagnostic Equity Through Clinician Engagement, Community Partnerships, And Connected Care, Traber D Giardina, Lechauncy D Woodard, Hardeep Singh

Faculty, Staff and Students Publications

No abstract provided.

Accuracy Of Therapeutic Drug Monitoring In Vancomycin And The Pharmacist Role: A Retrospective Case-Series, Kateryna Parkhomenko

Senior Theses

Vancomycin is a mainstay of therapy for treating virulent and resistant infections, especially methicillin-resistant Staphylococcus aureus (MRSA). However, vancomycin requires therapeutic drug monitoring (TDM) for optimal dosing and treatment. This requires pharmacists to calculate a dosing regimen that correlates to appropriate goal vancomycin concentrations in the blood. Dosing vancomycin can be difficult, as it varies on a patient’s weight, renal function, age, etc. Doses may have to be adjusted in response to out-of-range concentrations, which requires further pharmacy calculations. Inaccurate dosing poses a risk to patient safety and places a resource and time burden on pharmacists. If vancomycin dosing methods …

Paving The Road For Chimeric Antigen Receptor T Cells: American Society For Transplantation And Cellular Therapy 80/20 Task Force Consensus On Challenges And Solutions To Improving Efficiency Of Clinical Center Certification And Maintenance Of Operations For Commercially Approved Immune Effector Cell Therapies, Sarah Nikiforow, Matthew J Frigault, Noelle V Frey, Rebecca A Gardner, Krishna V Komanduri, Miguel-Angel Perales, Partow Kebriaei, Phyllis Irene Warkentin, Marcelo Pasquini, Joy Lynn Aho, Bruce L Levine, Helen E Heslop, Tracey L Hlucky, Karen Habucky, Mecide Gharibo, Madan Jagasia, Frederick L Locke

Faculty, Staff and Students Publications

As the number and type of regulatory authority-approved cellular therapies grow, clinical treatment centers face a heavy burden of duplicative documentation around initial qualification, ongoing auditing, and reporting, with overlapping requirements from each manufacturer to ensure safe use of their specific product, which in the United States are stipulated under individual Food and Drug Administration (FDA) Biologic License Applications. The American Society for Transplantation and Cellular Therapy (ASTCT) convened the 80/20 Task Force to consider challenges and potential solutions to these issues. The Task Force proposed that 80% of manufacturers' requirements for onboarding and ongoing operations of commercially available products …

Telemental Health In Emergency Care Settings: A Qualitative Analysis Of Considerations For Sustainability And Spread, Mckenzie K Roddy, Patricia Chen, Alvin D Jeffery, Jeydith Gutierrez, Melissa Rubenstein, Corey Campbell, Eric Blake, Michael J Ward

Faculty, Staff and Students Publications

Objectives: Following rapid uptake of telehealth during the COVID-19 pandemic, we examined barriers and facilitators for sustainability and spread of telemental health video (TMH-V) as policies regarding precautions from the pandemic waned.

Methods: We conducted a qualitative study using semistructured interviews and observations guided by RE-AIM. We asked four groups, local clinicians, facility leadership, Veterans, and external partners, about barriers and facilitators impacting patient willingness to engage in TMH-V (reach), quality of care (effectiveness), barriers and facilitators impacting provider uptake (adoption), possible adaptations to TMH-V (implementation), and possibilities for long-term use of TMH-V (maintenance). Interviews were recorded, transcribed, and analyzed …

Lung Volume Reduction In Copd: Scope Or Surgery, Francesca Polverino, Frank Sciurba

Faculty, Staff and Students Publications

No abstract provided.

Cancer Patient And Provider Responses To Companion Scales Assessing Experiences With Lgbtqi-Affirming Healthcare, Mandi L. Pratt-Chapman, Yan Wang, Gwendolyn P. Quinn, Sylvia Shirima, Sarah Adler, Ruta Brazinskaite, Asa Radix, Barbara Warren, Kristen Eckstrand, Ana Maria Lopez

Department of Medical Oncology Faculty Papers

Background: Sexual and gender minority (SGM) persons are at a higher risk for some cancers and may have poorer health outcomes as a result of ongoing minority stress, social stigma, and cisnormative, heteronormative healthcare environments. This study compared patient and provider experiences of affirming environmental and behavioral cues and also examined provider-reported knowledge, attitudes, behaviors, and clinical preparedness in caring for SGM patients among a convenience sample.

Methods: National convenience samples of oncology providers (n = 107) and patients (n = 88) were recruited separately via snowball sampling. No incentives were provided. After reverse coding of appropriate items for unidirectional …

Functional Effects Of Disease-Associated Variants Reveal That The S1-M1 Linker Of The Nmda Receptor Critically Controls Channel Opening, Lingling Xie, Miranda J Mcdaniel, Riley E Perszyk, Sukhan Kim, Gerarda Cappuccio, Kevin A Shapiro, Beatriz Muñoz-Cabello, Pedro A Sanchez-Lara, Katheryn Grand, Jing Zhang, Kelsey A Nocilla, Rehan Sheikh, Lluis Armengol, Roberta Romano, Tyler Mark Pierson, Hongjie Yuan, Scott J Myers, Stephen F Traynelis

Faculty, Staff and Students Publications

The short pre-M1 helix within the S1-M1 linker (also referred to as the pre-M1 linker) between the agonist-binding domain (ABD, S1) and the M1 transmembrane helix of the NMDA receptor (NMDAR) is devoid of missense variants within the healthy population but is a locus for de novo pathogenic variants associated with neurological disorders. Several de novo variants within this helix have been identified in patients presenting early in life with intellectual disability, developmental delay, and/or epilepsy. In this study, we evaluated functional properties for twenty variants within the pre-M1 linker in GRIN1, GRIN2A, and GRIN2B genes, including six novel missense …

Exploring Communication In Healthcare Through Decision-Making Interventions And A Novel Measure Of Clinician Spoken Plain Language, Renata W. Yen

Dartmouth College Ph.D Dissertations

Statement of the Problem

Good communication in clinical encounters is a key component of quality healthcare. Improving clinician communication would benefit all populations, however patients with lower health literacy or who are socially disadvantaged stand to benefit the most due to the complex content in clinical encounters. Shared decision-making can improve outcomes, but shared decision-making cannot occur without good clinician communication. In this dissertation, I reviewed interventions for facilitating shared decision-making for socially disadvantaged patients. Then, I examined the use of spoken plain language, or clinician use of familiar, clear verbal language when communicating with patients, and developed a prototype …

Effects Of The Needle Exchange Program And Its Current Status In West Virginia, Thomas Norton, Amber Graves, Anthony Uriarte, Katherine Duty, Alberto Coustasse

Management Faculty Research

Excerpt:

One of the main problems that have impacted the state of healthcare in West Virginia has been the rising costs of treatments for bloodborne infections (Bates et al., 2019). Bloodborne pathogens and their resulting diseases have commonly spread by exchanging contaminated needles (Denault & Gardner, 2021). In West Virginia, Needle Exchange Programs (NEPs) have been implemented to reduce the transmission of certain infections, such as HIV, hepatitis B, and hepatitis C, which have been more common among drug users (Beck & Kersey, 2018). In 2015, West Virginia had the second-highest rate of cases of hepatitis C Virus (HCV) in …

Rural Working-Age Adults Report More Cost Barriers To Health Care, Erika C. Ziller Phd, Carly Milkowski Mph, Amanda Burgess Mppm, Mph

Access / Insurance

Using the 2019-2020 National Health Insurance Survey, researchers at the Maine Rural Health Research Center examined rural-urban differences in affordability of care and cost-saving strategies among working-age adults. Rural adults (18-64) were more likely than their urban counterparts to report problems paying, or being unable to pay, their medical bills. They were also more likely to delay or go without needed care because of the cost. Compared with urban adults, those in rural areas were more likely to engage in prescription drug cost-saving measures such as skipping doses, delaying refills, or taking less medication than prescribed. For all affordability measures, …

Sexual Behaviors, Contraception Use And Barriers Among Adolescents And Young Adults In Rural Haiti., Abbey R. Masonbrink, Emily A. Hurley, Nikolaus Schuetz, Jonathan Rodean, Emily Rupe, Kemi Lewis, Marie Daphnée Boncoeur, Melissa K. Miller

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: Adolescents and young adults (AYAs) in Haiti experience a high unintended pregnancy rate, in part due to unmet contraception needs. Little is known about AYA opinions of and experiences with contraception that may explain remaining gaps in coverage. We aimed to describe barriers and facilitators to contraception use among AYAs in Haiti.

METHODS: We conducted a cross-sectional survey and semi-structured qualitative interviews with a convenience sample of AYA females aged 14-24 in two rural communities in Haiti. The survey and semi-structured interviews assessed demographics, sexual health and pregnancy prevention behaviors and explored contraception opinions and experiences according to Theory …

Exploration Of Data Science Toolbox And Predictive Models To Detect And Prevent Medicare Fraud, Waste, And Abuse, Benjamin P. Goodwin, Adam Canton, Babatunde Olanipekun

SMU Data Science Review

The Federal Department of Health and Human Services spends approximately $830 Billion annually on Medicare of which an estimated $30 to $110 billion is some form of fraud, waste, or abuse (FWA). Despite the Federal Government’s ongoing auditing efforts, fraud, waste, and abuse is rampant and requires modern machine learning approaches to generalize and detect such patterns. New and novel machine learning algorithms offer hope to help detect fraud, waste, and abuse. The existence of publicly accessible datasets complied by The Centers for Medicare & Medicaid Services (CMS) contain vast quantities of structured data. This data, coupled with industry standardized …

Impact Of A Health Fair On Student Organizations Providing Care To The Detroit Hispanic/Latinx Community And Barriers Affecting Patients Of A Student-Run Clinic Primarily Serving This Population, Amanda Rodriguez Bs, Lucas Edgren Bs, Sanjana Rao Bsph, Diane L. Levine Md, Jennifer Mendez Phd, Joel Appel Do

Medical Student Research Symposium

Current literature shows Hispanic/Latinx populations in the U.S. face health inequities. Amigos Medicos (AM) Clinic, located in Southwest Detroit, is a student-run free clinic that addresses these issues through preventive health screenings. We hosted a health fair in 2022 and invited other student organizations in efforts to connect the community to resources. Our aim is to identify specific barriers faced by our population in receiving health care and to identify the impact of participation in the fair on those organizations. One survey was administered to patients attending clinic that identified health barriers they face. The other survey was administered to …

The Role Of Vigorous And High Intensity Interval Training Physical Activity Counseling In Prenatal Care, Emily Lau, Brendan T. Lynch, Sonia Hassan

Medical Student Research Symposium

Background: Physical activity is becoming a more common component of preventative medicine and patient counseling; however, the prevalence of physical activity counseling and specific social determinants of health have prevented women, namely prenatal patients, from receiving this counseling from their providers¹. Physical activity, including high intensity interval training (HIIT), has been shown to be feasible for implementation in patient counseling³ and shown to be safe for pregnant women, even into the third trimester². We hypothesize that the current percentage of patients, including prenatal patients, being counseled on physical activity is lacking. In addition, we hypothesize …

Gambaran Kematian Maternal Di Kota Depok Sebelum Dan Sesudah Pandemi Covid-19, Dhora Yufita, Milla Herdayati

Jurnal Biostatistik, Kependudukan, dan Informatika Kesehatan

Pandemi COVID-19 menimbulkan tantangan baru bagi kematian ibu yang berdampak pada seluruh aspek. Kematian ibu perlu menjadi perhatian khusus dikarenakan Angka Kematian Ibu (AKI) merupakan salah satu indikator yang menggambarkan kesejahteraan suatu bangsa. Tujuan penelitian ini adalah untuk mengetahui gambaran kematian ibu sebelum dan setelah pandemi COVID-19 di Kota Depok. Penelitian ini merupakan penelitian deskriptif kuantitatif yang menggambarkan isi suatu variabel dalam penelitian dan tidak dimaksudkan untuk menguji hipotesis tertentu. Hasil penelitian didapatkan bahwa kematian ibu di Kota Depok terbanyak terjadi pada tahun 2021 dengan jumlah kematian 65 kasus, dan penyebab tertinggi adalah COVID-19. Tingginya kematian ibu akibat COVID-19 dikarenakan …

Pemodelan Statistik Hubungan Antara Persalinan Sesar Dengan Inisiasi Menyusu Dini Di Provinsi Dki Jakarta (Analisis Data Sdki 2017), Amanda Widlanisia, Kemal N. Siregar

Jurnal Biostatistik, Kependudukan, dan Informatika Kesehatan

Pemberian ASI merupakan usaha dan investasi yang mudah dilakukan untuk menekan angka morbiditas dan mortalitas pada bayi dan anak. Keterlambatan pemberian ASI pertama dapat diakibatkan oleh metode kelahiran yang dipilih seperti secara pervaginam atau persalinan sesar. Penelitian ini dilakukan secara cross sectional dan pendekatan kuantitatif menggunakan data SDKI 2017 untuk mengetahui hubungan antara persalinan sesar dengan Inisiasi Menyusu Dini (IMD) di Provinsi DKI Jakarta. Sampel yang digunakan adalah wanita usia subur 15-49 tahun saat survei di Provinsi DKI Jakarta yang memiliki anak terakhir yang lahir dalam 2 tahun terakhir sebanyak 236 responden. Dilakukan analisis statistik univariat, bivariat menggunakan chi-square (CI …

Analisis Faktor Risiko Kejadian Stunted, Underweight, Dan Wasted Pada Balita Di Wilayah Kerja Puskesmas Rangkapan Jaya, Kota Depok, Jawa Barat Tahun 2022, Anggi Tria Abimayu, Nurul Dina Rahmawati

Jurnal Biostatistik, Kependudukan, dan Informatika Kesehatan

Menurut UNICEF, status gizi pada anak secara langsung dipengaruhi oleh asupan makanan dan infeksi penyakit. Namun, banyak faktor secara tidak langsung yang mempengaruhi tumbuh kembang anak, diantaranya berat lahir, panjang lahir, jenis kelamin, usia dan status kenaikan berat badan. Maka dari itu penelitian ini bertujuan untuk menganalisis hubungan antara faktor risiko tersebut dengan kejadian stunted, underweight dan wasted. Metode yang digunakan adalah cross sectional dengan menggunakan data sekunder dari website Elektronik Pencatatan dan Pelaporan Gizi Berbasis Masyarakat (E PPGBM). Hasil dari penelitian ini adalah adanya hubungan berat lahir, panjang lahir, jenis kelamin, usia dan status kenaikan berat badan dengan …

Faktor-Faktor Terjadinya Kematian Neonatal Di Indonesia: Analisis Data Sdki 2017, Mochtar Ghaffar Ramadhan, Ulya Qoulan Karima, Terry Yuliana, Chahya Kharin Herbawani

Jurnal Biostatistik, Kependudukan, dan Informatika Kesehatan

Kematian neonatal merupakan masalah yang harus diselesaikan dalam SDGs. Sama halnya di Indonesia, masih adanya ketimpangan antara target RPJMN 2020-2024 untuk menurunkan angka kematian neonatal menjadi 10 per 1000 kelahiran hidup. Penelitian ini bertujuan untuk mengetahui faktor-faktor terjadinya kematian neonatal di Indonesia sebagai salah satu cara untuk mencapai target RPJMN. Penelitian ini menggunakan desain studi potong lintang dengan analisis data sekunder SDKI 2017. Sampel yang digunakan penelitian ini adalah 34.972 wanita usia subur usia 15-49 tahun yang pernah melahirkan di Indonesia. Analisis menggunakan pembobotan dan analisis yang digunakan adalah analisis spasial, Chi-Square, dan regresi logistik ganda. Hasil analisis bivariat menunjukkan …

Pengelompokan Provinsi Di Indonesia Berdasarkan Faktor Risiko Perilaku Penyakit Tidak Menular Dengan Metric Multidimensional Scaling, Syafira Maulidia, Rahmi Susanti, Ismail Ab

Jurnal Biostatistik, Kependudukan, dan Informatika Kesehatan

Angka kasus penyakit tidak menular (PTM) di Indonesia terus mengalami peningkatan. Faktor pendorong utama terjadinya peningkatan PTM adalah dari faktor risiko perilaku yaitu, pengunaan tembakau, penggunaan alkohol, aktivitas fisik, dan diet tidak sehat. Berdasarkan hal tersebut diperlukan pengelompokan provinsi di Indonesia berdasarkan faktor risiko perilaku PTM. Menghasilkan kelompok-kelompok provinsi di Indonesia berdasarkan faktor risiko perilaku PTM. Jenis penelitian ini adalah non-reactive research. Pengelompokan provinsi di Indonesia menggunakan analisis Metric Multidimensional Scaling dan analisis One Way MANOVA sebagai analisis lanjutan untuk memvalidasi perbedaan kelompok yang dibentuk. Data yang digunakan merupakan data sekunder dari publikasi laporan Riset Kesehatan Dasar Indonesia tahun …

Relationship Between Treatment Comorbidities And Hiv Viral Suppression Among People Who Live With Aids In Johannesburg., Nwogo Immaculata Ekeji, Tolulope A. Osoba, Hebatullah Tawfik, Mehdi Agha

Journal of Social, Behavioral, and Health Sciences

HIV has globally infected over 37.9 million people, of which 28.2 million (73%) are on antiretroviral treatment, and 66% of those on treatment are virally suppressed. In South Africa, however, low rate of viral suppression (47%) among people living with HIV is a major health problem that has continued to fuel HIV prevalence. A cross-sectional quantitative research design was used to investigate the relationship between treatment comorbidities and viral suppression among HIV-infected adults aged 18–49 who were diabetic, had cancer, or tuberculosis in Johannesburg. HIV Care Continuum formed the theoretical framework for this research. An existing HIV-infected patient de-identifiable dataset …

Public Health Officers’ Capability, Opportunity, Motivation, And Behavior After Covid-19 Vaccination In Thailand, Uyen Thi To Nguyen, Charuai Suwanbamrung, Cua Ngoc Le, Wichaya Janhom, Yanika Ratjaran, Alisara Khwansri

Journal of Health Research

Background: Public health officers (PHOs) are the frontline health workforce against the Coronavirus disease 2019 (COVID-19) and therefore need high immunity for protection. The application of the capability, opportunity, motivation, and behavior (COM-B) model aimed to 1) explore the level of COM-B for prevention and control of COVID-19, and 2) analyze the association between factors and behaviors for prevention and control of COVID-19 among PHOs at primary care units (PCUs) of seven provinces in southern Thailand.

Methods: The study design performed an analytical cross-sectional study using information from primary care units from July to September 2021. Data collection used multi-stage …

Logic Model And Data System Recommendations, Claire Devine, Natalie Royal Kenton, Kristen Lacijan, Maggie Weller

Articles, Abstracts, and Reports

No abstract provided.

Multimorbidity Research In Sub-Saharan Africa: Proceedings Of An Interdisciplinary Workshop, Gift T. Banda, Edna Bosire, Christopher Bunn, Clare I.R. Chandler, Edith Chikumbu, Jonathan Chiwanda, Justin Dixon, Rashida A. Ferrand, Andre-Pascal Kengne, Felix Limbani

Brain and Mind Institute

As life expectancies rise globally, the number of people living with multiple chronic health conditions – commonly referred to as ‘multimorbidity’ – is rising. Multimorbidity has been recognised as especially challenging to respond to in countries whose health systems are under-funded, fragmented, and designed primarily for acute care, including in sub-Saharan Africa. A growing body of research in sub-Saharan Africa has sought to better understand the particular challenges multimorbidity poses in the region and to develop context-sensitive responses. However, with multimorbidity still crystallising as a subject of enquiry, there remains considerable heterogeneity in conceptualising multimorbidity across disciplines and fields, hindering …

Logic Model And Data System Recommendations, Kristen Lacijan, Claire Devine, Natalie Royal Kenton, Maggie Weller

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No abstract provided.

Ferroptosis In Life: To Be Or Not To Be, Ling Xu, Yu'e Liu, Xi Chen, Hua Zhong, Yi Wang

Faculty, Staff and Students Publications

Ferroptosis is a novel type of programmed cell death, characterized by a dysregulated iron metabolism and accumulation of lipid peroxides. It features the alteration of mitochondria and aberrant accumulation of excessive iron as well as loss of the cysteine-glutathione-GPX4 axis. Eventually, the accumulated lipid peroxides result in lethal damage to the cells. Ferroptosis is induced by the overloading of iron and the accumulation of ROS and can be inhibited by the activation of the GPX4 pathway, FS1-CoQ10 pathway, GCH1-BH4 pathway, and the DHODH pathway, it is also regulated by the oncogenes and tumor suppressors. Ferroptosis involves various physiological and pathological …