Public Health Commons^™

Pediatric In-Patient Days Predictive Model, Dana Nicholson Bledsoe

MUSC Theses and Dissertations

The study objective is to develop a predictive model for pediatric inpatient days based on ambulatory outpatient visits and emergency department visits. This model aims to study the relationship between ambulatory visits and inpatient days, and determine if in-patient days can be predicted based on sub-specialty practice. Such a model does not currently exist, and when created and validated such a model could be utilized for various important management decisions, including refined insight into inpatient capacity and operational efficiency for self-governing children’s hospitals with large sub-specialty practices. The data set was a sample of convenience from one health system in …

Colorectal Cancer Survival Rates In Ghana: A Retrospective Hospital-Based Study, Francis Agyemang-Yeboah, Joseph Yorke, Christian Obirikorang, Emmanuella Nsenbah Batu, Emmanuel Acheampong, Emmanuel Amankwaa Frimpong, Enoch Odame Anto, Bright Amankwaa

Research outputs 2014 to 2021

BACKGROUND: Colorectal cancer (CRC) is one of the commonest cancers associated with diverse prognosis times in different parts of the world. Despite medical interventions, the overall clinical outcomes and survival remains very poor for most patients in developing countries. This study therefore investigated the survival rate of colorectal cancer and its prognostic factors among patients at Komfo Anokye Teaching Hospital, Ghana.

METHODOLOGY: In this retrospective cohort study, a total of 221 patients diagnosed with CRC from 2009 to 2015 at the Surgical and Oncological units of Komfo Anokye Teaching Hospital (KATH), Kumasi, Ghana were employed. The survival graphs were obtained …

Inequities In Antenatal Care, And Individual And Environmental Determinants Of Utilization At National And Sub-National Level In Pakistan: A Multilevel Analysis, Ambreen Sahito, Zafar Fatmi

Community Health Sciences

Background: Nationally representative surveys are vital for gauging progress in health and planning health services. However, often marred with inadequate analysis to provide any guidance to health policy and planning. Most recent Pakistan Demographic and Health Survey (PDHS) 2012-2013 is an inclusive nationally representative investigation. Nonetheless, its published report offers limited evidence regarding antenatal care (ANC). Furthermore, after 18th constitutional amendment, policies are principally made at provincial level in Pakistan; therefore, it is imperative to have contextual evidence at sub-national level to feed programs and policies.
Methods: We analysed 7142 women with a recent birth, to assess the …

The Price Of Progress: Funding And Financing Alzheimer's Disease Drug Development, Jeffrey Cummings, Carl Reiber, Parvesh Kumar

School of Medicine Faculty Research

Introduction Advancing research and treatment for Alzheimer's disease (AD) and the search for effective treatments depend on a complex financial ecosystem involving federal, state, industry, advocacy, venture capital, and philanthropy funding approaches. Methods We conducted an expert review of the literature pertaining to funding and financing of translational research and drug development for AD. Results The federal government is the largest public funder of research in AD. The National Institute on Aging, National Institute of Mental Health, National Institute of General Medical Sciences, and National Center for Advancing Translational Science all fund aspects of research in AD drug development. Non-National …

A Systematic Review On The Validity Of Teledentistry, Jafar H. Alabdullah, Susan J. Daniel

Dental Hygiene Faculty Publications

Objectives: The aim of this systematic review was to evaluate the validity of using teledentistry in oral care examination and diagnosis.

Methods: In June 2016, a systematic search of the literature was conducted without time restrictions in three electronic databases (Ebscohost, Pubmed, and Scopus). Two reviewers screened the retrieved articles first by title and then by abstract to determine relevant articles for full text review. Studies included were as follows: (1) related to teledentistry, (2) available in full text and English, (3) compared teledentistry application to a gold standard, and (4) provided clear statistical tests for validity. The methodological …

Water Insecurity And Gendered Risk For Depression In Rural Uganda: A Hotspot Analysis, Christine E. Cooper-Vince, Hawk Arachy, Bernard Kakuhikire, Dagmar Vořechovská, Rumbidzai Mushavi, C. Baguma, Amy Q. Mcdonough, David R. Bangsberg, Alexander C. Tsai

OHSU-PSU School of Public Health Faculty Publications and Presentations

Background:

Water insecurity is linked to depression in low- and middle-income countries (LMICs), though it remains unclear how geospatial clustering of water insecurity in rural regions is associated with risk for depression.

Methods: We conducted a population-based survey of a rural parish in southwestern Uganda (N = 1603) to evaluate the joint geospatial clustering of water insecurity and risk for depression among men and women living in rural Uganda.

Results:

Geospatial clustering of self-reported water insecurity and depressive symptoms was found to be present among both men and women. Depression hotspots were more often observed near water insecurity hotspots among …

Development Of An Integrated Service Model To Achieve Personal Health Libraries For Consumers, Nathan Gauss

Dissertations, Master's Theses and Master's Reports

This concept paper establishes the framework for additional research regarding how medical records are stored and shared. Health Information Technology is rapidly developing, and one large barrier to true interoperability is data silos. This integrated service model proposes using Health Record Banks (HRB) to store and share data, while using open source applications to limit costs and create opportunities for the consumer to be at the center of their own medical records. This includes the authorization phase, in which patients will be able to seamlessly allow access to their records for clinicians they choose. This conceptual framework includes using eXist …

Pharmacy Driven Best Possible Admission Medication History At A Pediatric Institution, Damon Pabst, Charity Thompson, Brandon French, Brian O'Neal, Garret Matthews, Zeb Benner, Joshua Meade

Posters

No abstract provided.

The Effect Of A School-Based Health Center On Access To Care In A Rural Community, Macey Cornwell

DNP Projects

BACKGROUND: Lack of access to healthcare is a nationwide issue that affects underserved, minority, and rural populations. School-Based Health Centers (SBHCs) is one way to help increase access to care for students, staff, and family members.

PURPOSE: The purpose of this project was to provide preliminary data on the impact of a SBHC in a rural Kentucky community on access to care and school attendance.

METHODS: A univariate descriptive analysis was conducted to evaluate the perceived impact of the SBHC on access to care and demographic factors. Data was analyzed using Pearson’s Product Moment Correlation, two-sample t-tests, and The Wilcoxon …

A Bronchiolitis Study: The Overuse Of Bronchiolitis Therapies In Children Admitted Into The Hospital, Jocelyn S. Canedo

Theses and Dissertations

Bronchiolitis is prevalent among infants of 0 to 12 months, and usually caused by a variation of viruses. Signs and symptoms consist of coughing, rapid breathing, and an occasional fever in some infants. Bronchiolitis is not treated with antibiotics, but rather with proper medical examination and other procedures. Chest radiographs, steroids, and certain bronchodilators are considered ineffective treatments. This study identified the amount of ineffective procedures being used in infants admitted into the pediatric emergency room, and the effect it had on the patient’s average hospital stay. Past medical records were used in this clinical study. Statistical analyses and graphs …

Sociocultural Interactions Of Cuban Doctors Participating In The More Doctors Program In Brazil, Joaquin Molina, Carlos Eduardo Siqueira, Leonardo Cavalcanti

Gastón Institute Publications

This book focuses on a different and underexplored attribute of the More Doctors Program by surveying doctors in the feld with the purpose of identifying important answers regarding the sociocultural interactions of Cuban doctors recruited by the program and of producing knowledge, while also making improvements in the participation, still limited, of foreign doctors in the primary care services offered by SUS. It proposes to induce perceptions, memories, and possible explanations to anyone who is somehow associated with the Program’s development, especially those committed to universal health care and primary assistance as the only paths to an effective health system. …

Statistical Advances In Clinical Trials And Clinical Research, Guogen Shan, Sarah Banks, Justin B. Miller, Aaron Ritter, Charles Bernick, Joseph Lombardo, Jeffrey L. Cummings

School of Public Health Faculty Research

Introduction New treatments for neurodegenerative disease are urgently needed, and clinical trial methods are an essential component of new drug development. Although a parallel-group study design for neurological disorder clinical trials is commonly used to test the effectiveness of a new treatment as compared to placebo, it does not efficiently use information from the on-going study to increase the success rate of a trial or to stop a trial earlier when the new treatment is indeed ineffective. Methods We review some recent advances in designs for clinical trials, including futility designs and adaptive designs. Results Futility designs and noninferiority designs …

Biomedical Informatics Applications For Precision Management Of Neurodegenerative Diseases, Justin B. Miller, Guogen Shan, Joseph Lombardo, Gustavo Jimenez-Maggoria

School of Public Health Faculty Research

Modern medicine is in the midst of a revolution driven by “big data,” rapidly advancing computing power, and broader integration of technology into healthcare. Highly detailed and individualized profiles of both health and disease states are now possible, including biomarkers, genomic profiles, cognitive and behavioral phenotypes, high-frequency assessments, and medical imaging. Although these data are incredibly complex, they can potentially be used to understand multi-determinant causal relationships, elucidate modifiable factors, and ultimately customize treatments based on individual parameters. Especially for neurodegenerative diseases, where an effective therapeutic agent has yet to be discovered, there remains a critical need for an interdisciplinary …

In Case Of Emergency: Local Medical Services And Emergency Air Transportation In Southeast Alaska, Kourtney B. Johnson

Graduate Student Theses, Dissertations, & Professional Papers

Alaska, often referred to as “The Last Frontier”, is a vast, geographically diverse and sparsely settled landscape. Although many popular reality shows tend to exaggerate and dramatize life in Alaska, they do point to an important fact: when an emergency occurs, or someone experiences serious health complications, immediate access to sufficient medical services may not be available. Much of the state’s population faces barriers to accessing needed medical care due to large distances between communities and limited road networks due to coastal locations or challenging terrain.

Using Penchansky and Thomas’s five components of Access Theory (1981), this thesis explores factors …

Healthy Lifestyles And Job Performance Of Academics: A Theoretical Perspectives, Idayat Odunola Agboola Mrs, Chinyere Nkechi Ikonne Dr

Library Philosophy and Practice (e-journal)

The health related lifestyle behavior has been neglected in Nigerian Universities and as such causing deaths among the lecturers. Living a healthy lifestyle could reduce heart diseases, blood pressure and diabetes. The study adopted survey method. The population of the study was 5,310 lecturers across the six Federal Universities in South West, Nigeria. From the population, 372 were sampled. Structured questionnaire were used to collect data. From the 372 copies of questionnaire distributed; 278 were returned which gave 75% response rate. Data were analyzed using percentages, mean, standard deviation as well as relationship. Findings revealed that all information gathered on …

Speech Recognition Technology: Improving Speed And Accuracy Of Emergency Medical Services Documentation To Protect Patients, Tan T. Tran

UROP Posters

Because hospital errors, such as mistakes in documentation, cause one sixth of the deaths each year in the United States, the accuracy of health records in the emergency medical services (EMS) must be improved. One possible solution is to incorporate speech recognition (SR) software into current tools used by EMS first responders. The purpose of this research was to determine if SR software could increase the efficiency and accuracy of EMS documentation to improve the safety for patients of EMS. An initial review of the literature on the performance of current SR software demonstrated that this software was not 99% …

Factors Affecting Patient Satisfaction With Healthcare System Of Turkey, Serdar Aydin

Theses and Dissertations

The World Health Organization (WHO) defines health system as comprising of all the organizations, resources, and institutions dedicated to improving health. Health systems have a responsibility not just to improve the health of the population they serve but to provide financial protection against the costs of illness and to respond to people’s expectation with dignity. Besides, healthcare satisfaction and consumer satisfaction have become the latest trend in measuring quality to have a competitive advantage or best practice in the healthcare industry. Over the past 30 years, consumer satisfaction has gained widespread recognition as a measure of quality in many services …

Three Essays On Maternal And Child Health, Mandar V. Bodas

Theses and Dissertations

This dissertation is a collection of three separate essays on the health of women and children. In the first essay, I along with my co-authors, analyzed the impact of two large, national-level health policies (the Janani Suraksha Yojana (JSY) and the National Rural Health Mission (NRHM)) on maternal health outcomes (proportion of institutional deliveries) in India. We used data from the India Human Development Survey (IHDS) and found that the JSY and the NRHM had a greater impact on institutional deliveries in high-focus states. We also found that the conditions of the public health facilities, did not change after the …

Economic Burden Of Renal Cell Carcinoma (Rcc) And Treatment Patterns, Overall Survival And Healthcare Costs Among Older Metastatic Rcc Patients, Hrishikesh P. Kale

Theses and Dissertations

Background

Renal cell carcinoma (RCC) is the most common type of kidney cancer. Patients diagnosed with metastatic RCC (mRCC) have shorter overall survival compared to those diagnosed at earlier stages. Several targeted therapies, which cost from $7,000 - $16,000 per month have been approved since 2005 to treat mRCC. In addition, there is a growing interest in the use of cytoreductive nephrectomy (CN) with targeted therapies among mRCC patients. However, little is known regarding the economic burden of RCC and role of CN and prescribing patterns of targeted therapies among older mRCC patients.

Objectives

1) To assess the economic burden …

Family Planning And Hiv Interventions Among Women In Low-Income Settings, Steven P. Masiano

Theses and Dissertations

This dissertation examines the effectiveness of interventions related to family planning and the uptake of HIV-related preventive services among women in low-income settings. Women in low-income settings and living with HIV face many barriers to care, including limited access to services for family planning and HIV-related preventive care. At the same time, national, regional, and global efforts are looking for interventions to help control rapid population growth, create an HIV-free generation, and provide adequate preventive care for those living with HIV. This dissertation cuts across these issues and can help to inform debate and policies to address these issues.

This …

A Comparison Of Quality Indicators Between Medicare Accountable Care Organizations And Health Maintenance Organizations Using Publicly Available Data, William W. Campbell Iii

Theses and Dissertations

The purpose of this study is to explore differences in quality between Medicare Accountable Care Organizations (ACO) and Health Maintenance Organizations (HMO). Three outcomes measures reported by these plans use different methodologies but possess enough alignment to permit comparison: percent of diabetic patients with last HbA1c > 9.0%, colon cancer screening rate and ER visits per 1,000. These outcomes are the dependent variables (DV). A secondary purpose is to explore differences in quality based on the size of the beneficiary population served, using the same measures.

As the Medicare program faces threats to its solvency in coming decades, with 10,000 baby …

Queer Health Equity And Cervical Cancer: Identifying Social Determinants Of Papanicolaou Test Uptake In A Sample Of Sexual Minority Women And Gender Nonbinary Individuals, Ariella R. Tabaac

Theses and Dissertations

Sexual minority women (SMW) demonstrate lower rates of cervical cancer screening than heterosexual women. This is concerning as lesbian and bisexual women tend to engage in higher rates of substance-related cancer risk behaviors, unprotected sex, and tend to have higher body mass indices, all of which are risk factors for cancer development. Another major risk factor, screening avoidance, places SMW at increased risk for the development of high grade cervical lesions in the absence of early detection practices, which is likely to impact overall cervical cancer morbidity in this population. The aim of the present study was to utilize the …

The Impact Of The Medicaid Coverage Expansion And The Removal Of Cost-Sharing Under The Affordable Care Act On Mammography And Pap Tests, Abeer Alharbi

Theses and Dissertations

Background: The Affordable Care Act (ACA) aimed at making health care affordable and accessible including the use of preventive care services. To achieve these aims, the ACA expanded Medicaid coverage to population with income below 138% of FPL and removed cost-sharing when using preventive care services recommended by the USPSTF. This study tried to assess the impact of these provisions on the rate of mammography and Pap tests among women. Methods: Data was obtained from the Medical Expenditure Panel Survey - Household Component MEPS-HC. A difference-indifference design was used to determine the effect of Medicaid eligibility expansion on the outcomes …

Patient Characteristics, Discharge Disposition, And Hospital Factors Associated With All Cause 30-Day Hospital Readmission For Total Joint Arthroplasty In 2014, Hamad Yahya Alzamanan

Theses and Dissertations

Objective: Recent improvements in hospital care have come from a growing knowledge of factors that contribute to readmission. The objective of this work is to identify and describe the national readmission rate after Total Joint Arthroplasty, and to evaluate selected hospitals’ and patients’ factors for their association with the all-cause 30-day readmission rate after TJA in the United States in 2014. Method: Retrospective analysis of 938,504 TJA acute care hospital discharge records was performed, using a nationally representative database that is dedicated to the study of hospital readmissions, and accounts for 51% of total US hospitalizations. Logistic regression models were …

Evaluation Of A Peer Group Model Of Supervision For The Allied Health Workforce In Queensland: A Descriptive Overview, Susan C. Pager, Pim Kuipers, Karen Bell, Fiona Hall

Internet Journal of Allied Health Sciences and Practice

Purpose: An evaluation of a large scale implementation of a peer group model of professional supervision was conducted to inform service planning and guide policy and practice. A descriptive overview of the findings is presented. Method: Allied health staff trained in peer group supervision were surveyed about their experience of the model, its challenges and benefits. Interviews were also conducted with senior managers. Results: Analysis of 248 responses indicated that 72% of trained staff had participated in peer group supervision, and that these peer groups had continued for an average of 17.2 months. The majority of groups adhered …

Mchd Student Health Centers Needs Analysis - Claims Analysis, Hannah Cohen-Cline, Kristen Dulacki, Claire Devine, Megan Holtorf, Bill J. Wright

Articles, Abstracts, and Reports

No abstract provided.

Understanding Behavioral Health And Treatment Engagement With Former Users Of Prenatal Substances: A Strengths-Focused Mixed Methods Inquiry, Jennifer G. Benson, Peggy Maclean, Andrew Hsi, Sarah J. Erickson

Psychology ETDs

Accessible services for users of prenatal substances are lacking, and treatment engagement is poor with services that are available. Furthermore, legal consequences are often punitive, which ultimately damages the well-being of mother and child. Milagro and FOCUS are two New Mexico programs that provide comprehensive, coordinated care, including medication-assisted treatment, to former users of prenatal substances during pregnancy (in the Milagro Program) and for three years post-birth (in the FOCUS Program). This mixed methods study explored the lived experiences of women from this complex, high-risk population, using a high-engagement sample of women who utilized services at both Milagro and FOCUS. …

Social Marketing For A Farmer's Market In An Underserved Community: A Needs Assessment, Meg Skizim, Melinda Sothern, Ondrej Blaha, Tung-Sung Tseng, Lauren Griffiths, Jonathan Joseph, Henry Nuss

School of Public Health Faculty Publications

The aim of the present paper is to assess local residents' awareness of utilizing Supplemental Nutrition Assistance Program (SNAP) benefits to purchase fresh produce at local farmers' markets, and to determine internet use and media preferences of study participants prior to implementation of a social marketing campaign. A needs assessment was conducted to collect baseline data in an underserved neighbourhood in New Orleans (La, USA). The study was carried out August 2014-May 2015. The assessment revealed that 73% of the respondents were unaware that the SNAP benefits could be used to purchase food in farmers' markets; 63% of low-income participants …

Changes In The Utilization Of Osteoporosis Drugs After The 2010 Fda Bisphosphonate Drug Safety Communication, Bander Balkhi, Enrique Seoane-Vazquez, Rosa Rodriguez-Monguio

Pharmacy Faculty Articles and Research

Introduction

In October 2010, the US Food and Drug Administration (FDA) issued a safety communication regarding the risks of atypical fractures of the femur, with bisphosphonates drugs. This study evaluated the impact of the bisphosphonates FDA safety communication on the utilization of osteoporosis medications in Medicaid programs.

Methods

Osteoporosis drugs utilization data from the July 2006 to June 2014 were extracted from the national Summary Files from the Medicaid State Drug Utilization Data maintained by the Centers for Medicare & Medicaid Services (CMS). We performed an interrupted time series analyses to evaluate trends in utilization of osteoporosis drugs before and …

Sharing The Burden, Robert Livingston

Capstone Projects and Master's Theses

Family caregivers of hospice patients experience an increased burden due to providing ongoing care. Research on the issue produces no consensus on evidence-based programs to alleviate the burden. Respite or relief services continue to be the primary solution applied to the problem. Central Coast Visiting Nurse Association and Hospice supported a project to address caregiver burden. Hospice provides volunteers to families to reduce the caregiver burden. The project consists of outreach and recruitment to obtain new volunteers that continue to deliver respite within the community. Project duration lasted for approximately three months and was implemented by completing six tabling activities …