Public Health Commons^™

Clash Of The Titans: Medicaid Meets Private Health Insurance, Sara J. Rosenbaum

Health Policy and Management Faculty Publications

Throughout its first forty-eight years of life, the federal Medicaid statute lacked a viable insurance pathway for most low-income adults' ineligible for employer-sponsored coverage. In what is arguably the most important public health achievement since the enactment of Medicare and Medicaid fifty years ago, the Patient Protection and Affordable Care Act (ACA) fundamentally alters this picture. Building on earlier breakthroughs for children, the ACA restructures Medicaid to cover poor adults and juxtaposes its new architecture against an affordable and accessible private insurance market for people ineligible for employer-sponsored or government insurance.

Improving Newborn Care Practices Through Home Visits: Lessons From Malawi, Nepal, Bangladesh, And Uganda., Deborah Sitrin, Tanya Guenther, Peter Waiswa, Sarah Namutamba, Gertrude Namazzi, Srijana Sharma, K. C. Ashish, Sayed Rubayet, Subrata Bhadra, Reuben Ligowe, Emmanuel Chimbalanga, Elizabeth Sewell, Kate Kerber, Allisyn Moran

Pediatrics Faculty Publications

Background: Nearly all newborn deaths occur in low- or middle-income countries. Many of these deaths could be prevented through promotion and provision of newborn care practices such as thermal care, early and exclusive breastfeeding, and hygienic cord care. Home visit programmes promoting these practices were piloted in Malawi, Nepal, Bangladesh, and Uganda.

Objective: This study assessed changes in selected newborn care practices over time in pilot programme areas in four countries and evaluated whether women who received home visits during pregnancy were more likely to report use of three key practices.

Design: Using data from cross-sectional surveys …

Evaluating The Effectiveness Of A Heart Improvement Toolkit Program: A Pilot Project, Cheryl L. Mitchell

Doctor of Nursing Practice Projects

Heart failure (HF) is a chronic, debilitating disease resulting in over one million hospitalizations with an estimated 30.7 million dollars in total health care cost per year (Go et al., 2014). Evidence shows that HF education programs that promote adherence to pharmacological and non-pharmacological provider recommendations are effective in reducing 30-day HF recidivism rates, increasing self-care behavior, and decreasing adverse clinical events. The purpose of this evidence-based project was to implement the Heart Improvement Toolkit (HIT) Program which is a one-on-one, comprehensive HF-specific education program, for patients with a HF diagnosis who have been admitted to non-cardiac specialty units. Program …

Loneliness And Drinking In An Hiv Positive Population, Erica Kiernan, Krishna Chhabria

Public Health Collection

Background: Loneliness is a common outcome in the HIV+ community due to the stigma associated with it leading to social isolation. Studies show HIV+ individuals who experience significant loneliness do engage in risky sexual behaviors. Alcohol use also has adverse consequences in this population, interfering with antiretroviral medication adherence thus an increased likelihood of further risky sexual behaviors.

Hypothesis: HIV+ individuals who experience an increase in loneliness will have an increase in hazardous drinking behaviors.

Methods: 100 patients from an HIV treatment clinic in Jacksonville, Florida were administered the AUDIT scale to measure drinking habits and UCLA loneliness scale. …

The Evidence Does Not Speak For Itself: The Role Of Research Evidence In Shaping Policy Change For The Implementation Of Publicly Funded Syringe Exchange Programs In Three Us Cities, Sean T. Allen, Monica S. Ruiz, Allison O'Rourke

Prevention and Community Health Faculty Publications

BACKGROUND:

A breadth of literature exists that explores the utilization of research evidence in policy change processes. From this work, a number of studies suggest research evidence is applied to change processes by policy change stakeholders primarily through instrumental, conceptual, and/or symbolic applications, or is not used at all. Despite the expansiveness of research on policy change processes, a deficit exists in understanding the role of research evidence during change processes related to the implementation of structural interventions for HIV prevention among injection drug users (IDU). This study examined the role of research evidence in policy change processes for the …

Chhs January 2015 E-Newsletter, Dr. John Bonaguro, Dean, Vashon S. Wells, Editor, Wku College Of Health & Human Services

College of Health & Human Services Publications

No abstract provided.

Metformin And Myocardial Injury In Patients With Diabetes And St-Segment Elevation Myocardial Infarction: A Propensity Score Matched Analysis, S. Basnet, A. Kozikowski, A. N. Makaryus, R. Pekmezaris, R. Zeltser, M. Akerman, M. Lesser, G. Wolf-Klein

Journal Articles

No abstract provided.

Tlr7 Influences Germinal Center Selection In Murine Sle, A. Boneparth, W. Huang, R. Bethunaickan, M. Woods, R. Sahu, S. Arora, M. Akerman, M. Lesser, A. Davidson

Journal Articles

TLR7 enhances germinal center maturation and migration of B cells to the dark zone where proliferation and somatic hypermutation occur. Our goal was to determine how Tlr7 dose influences selection of the autoreactive B cell repertoire in NZW/BXSB. Yaa mice bearing the site-directed heavy chain transgene 3H9 that encodes for the TLR7 regulated anti-CL response. To create a physiologic setting in which autoreactive B cells compete for survival with non-autoreactive B cells, we generated bone marrow chimeras in which disease onset occurred with similar kinetics and the transferred 3H9+ female non-Yaa, male Yaa or male TLR7(-/Yaa) cells could be easily …

Effectiveness Of Fecal-Derived Microbiota Transfer Using Orally Administered Capsules For Recurrent Clostridium Difficile Infection, B. E. Hirsch, N. Saraiya, K. Poeth, R. M. Schwartz, M. E. Epstein, G. Honig

Journal Articles

BACKGROUND: Clostridium difficile infection (CDI), a complication of antibiotic-induced injury to the gut microbiome, is a prevalent and dangerous cause of infectious diarrhea. Antimicrobial therapy for CDI is typically effective for acute symptoms, but up to one third of patients later experience recurrent CDI. Fecal-derived microbiota transplantation (FMT) can ameliorate the underlying dysbiosis and is highly effective for recurrent CDI. Traditional methods of FMT are limited by patient discomfort, risk and inefficient procedures. Many individuals with recurrent CDI have extensive comorbidities and advanced age. Widespread use of FMT requires strategies that are non-invasive, scalable and applicable across healthcare settings. METHODS: …

Seasonal Variations Of Complete Blood Count And Inflammatory Biomarkers In The Us Population - Analysis Of Nhanes Data, B. Liu, E. Taioli

Journal Articles

BACKGROUND: Recent studies reported seasonal differences in gene expression in white blood cells, adipose tissue, and inflammatory biomarkers of the immune system. There is no data on the seasonal variations of these biomarkers in the US general population of both children and adults. Then aim of this study is to explore the seasonal trends in complete blood count (CBC), and C-reactive protein (CRP) in a large non-institutionalized US population. METHODS: Seven cross-sectional data collected in the National Health and Nutrition Examination Survey (NHANES) during 1999-2012 were aggregated; participants reporting recent use of prescribed steroids, chemotherapy, immunomodulators and antibiotics were excluded. …

Determinants Of Survival In Malignant Pleural Mesothelioma: A Surveillance, Epidemiology, And End Results (Seer) Study Of 14,228 Patients, E. Taioli, A. S. Wolf, M. Camacho-Rivera, A. Kaufman, D. S. Lee, D. Nicastri, K. Rosenzweig, R. M. Flores

Journal Articles

INTRODUCTION: Left untreated, malignant pleural mesothelioma (MPM) is associated with uniformly poor prognosis. Better survival has been reported with surgery-based multimodality therapy, but to date, no trial has demonstrated survival benefit of surgery over other therapies. We evaluated whether cancer-directed surgery influenced survival independently from other predictors in a large population-based dataset. METHODS: The SEER database was explored from 1973 to 2009 to identify all cases of pathologically-proven MPM. Age, sex, race, year of diagnosis, histology stage, cancer-directed surgery, radiation, and vital status were analyzed. The association between prognostic factors and survival was estimated using Cox regression and propensity matched …

Frequency Of Surgery In Black Patients With Malignant Pleural Mesothelioma, E. Taioli, A. S. Wolf, J. Moline, M. Camacho-Rivera, R. M. Flores

Journal Articles

Introduction. Malignant Pleural Mesothelioma (MPM) is a rare disease, even less frequently described in minority patients. We used a large population-based dataset to study the role of race in MPM presentation, treatment, and survival. Methods. All cases of pathologically proven MPM were identified in the Surveillance, Epidemiology, and End Results (SEER) database. Age, sex, diagnosis year, stage, cancer-directed surgery, radiation, and vital status were analyzed according to self-reported race (black or white). Results. There were 13,046 white and 688 black MPM patients (incidence: 1.1 per 100,000 whites; 0.5 per 100,000 blacks; age-adjusted,P = 0.01). Black patients were more likely to …

Remote Video Auditing With Real-Time Feedback In An Academic Surgical Suite Improves Safety And Efficiency Metrics: A Cluster Randomised Study, F. J. Overdyk, O. Dowling, S. Newman, D. Glatt, M. Chester, D. Armellino, B. Cole, G. S. Landis, D. Schoenfeld, J. F. Dicapua

Journal Articles

IMPORTANCE: Compliance with the surgical safety checklist during operative procedures has been shown to reduce inhospital mortality and complications but proper execution by the surgical team remains elusive. OBJECTIVE: We evaluated the impact of remote video auditing with real-time provider feedback on checklist compliance during sign-in, time-out and sign-out and case turnover times. DESIGN, SETTING: Prospective, cluster randomised study in a 23-operating room (OR) suite. PARTICIPANTS: Surgeons, anaesthesia providers, nurses and support staff. EXPOSURE: ORs were randomised to receive, or not receive, real-time feedback on safety checklist compliance and efficiency metrics via display boards and text messages, followed by a …

Mining Mobile Datasets To Enable The Fine-Grained Stochastic Simulation Of Ebola Diffusion, Nicholas Vogel, Christopher Theisen, Jonathan P. Leidig, Jerry Scripps, Doug H. Graham, Greg Wolffe

Peer Reviewed Articles

The emergence of Ebola in West Africa is of worldwide public health concern. Successful miti- gation of epidemics requires coordinated, well-planned intervention strategies that are specific to the pathogen, transmission modality, population, and available resources. Modeling and sim- ulation in the field of computational epidemiology provides predictions of expected outcomes that are used by public policy planners in setting response strategies.

Developing up to date models of population structures, daily activities, and movement has proven challenging for developing countries due to limited governmental resources. Recent collaborations (in 2012 and 2014) with telecom providers have given public health researchers access to …

Body Composition Of Reserve Officers Training Corps (Rotc) Cadets: A Comparison Across Three Techniques Of Measurement, Namrata J. Dave

Master of Public Health Program Student Publications

Background: Physical fitness is imperative for the Army Reserves Officers’ Training Corps (ROTC) cadets to be commissioned for active duty. This project compared the standard anthropometric assessment of ROTC cadets using tape measurement to body composition measurements using Air Displacement Plethysmography (ADP) from the Bod Pod and the seven- site Pollock Skin Fold Thickness (SFM) measurement. These results were compared to the norms established by the Army Physical Fitness Test (APFT), recommending to improve ROTC body measurement method.

Method: Thirteen ROTC cadets were recruited from Central State and Cedarville Universities. Cadets were measured using the ADP (BODPOD) and SFM method. …

Detecting Signals Of Seasonal Influenza Severity Through Age Dynamics, Elizabeth C Lee, Cécile Viboud, Lone Simonsen, Farid Khan, Shweta Bansal

Global Health Faculty Publications

BACKGROUND: Measures of population-level influenza severity are important for public health planning, but estimates are often based on case-fatality and case-hospitalization risks, which require multiple data sources, are prone to surveillance biases, and are typically unavailable in the early stages of an outbreak. To address the limitations of traditional indicators, we propose a novel severity index based on influenza age dynamics estimated from routine physician diagnosis data that can be used retrospectively and for early warning.

METHODS: We developed a quantitative 'ground truth' severity benchmark that synthesizes multiple traditional severity indicators from publicly available influenza surveillance data in the United …

Quit4baby: Results From A Pilot Test Of A Mobile Smoking Cessation Program For Pregnant Women, Lorien C. Abroms, Pamela R. Johnson, Christina L. Heminger, Judith M. Van Alstyne, Leah E. Leavitt, Jennifer M. Schindler-Ruwisch, Jessica A. Bushar

Prevention and Community Health Faculty Publications

Background: Text messaging (short message service, SMS) programs have been shown to be effective in helping adult smokers quit smoking. This study describes the results of a pilot test of Quit4baby, a smoking cessation text messaging program for pregnant smokers that was adapted from Text2quit.

Objective: The study aimed to demonstrate the feasibility and acceptability of Quit4baby for women currently enrolled in Text4baby, a perinatal health text messaging program.

Methods: Pregnant women enrolled in Text4baby and who were current smokers or had quit within the last 4 weeks (n=20) were enrolled in Quit4baby. Those under the age of 18, not …

The Inclusion Of Women’S Health In Sustainable Medical Mission Trip Models: A Pa Student’S Perspective, Jillian G. Goles

VA Engage Journal

Like many disadvantaged countries around the world, Nicaragua is visited by numerous medical missions each year. The efficacy of these missions relies on the organization’s relationship with the communities they serve. Although the general goal of all medical missions is to ultimately help underserved populations, many missions inadvertently do harm. Two critical causes of such inadvertent harm are lack of sustainable practices and failure to form a long-term relationship with the communities. Shenandoah University’s Physician Assistant Program has worked tirelessly to form an ideal medical mission model and relationship with El Ayudante, a local non-government humanitarian organization, and the local …

Geographic Trends Of Tobacco-Related Cancers In Cyprus, Evi A. Farazi, Lina Lander, Pavlos Pavlou, Katherine Watkins, Lynne Le, Amr Soliman

Journal Articles: Epidemiology

BACKGROUND: Causal relationships have been previously established between smoking and various cancers. In Cyprus, 39 % of men and 14 % of women reported daily smoking in 2008. The objective of this study was to compare the incidence of tobacco-related cancers to all other cancers by district and rural-urban classification to understand the impact of tobacco in Cyprus.

METHODS: Data on lung, urinary bladder, oral, pharyngeal, head/neck, and laryngeal cancers were obtained from the Cyprus Cancer Registry (1998-2008). There were 3,635 patients with tobacco-related cancers and 18,780 with non-tobacco cancers. Univariate analysis comparing tobacco-related cancers and all other cancers were …

Comparison Of Individual And Pooled Urine Samples For Estimating The Presence And Intensity Of Schistosoma Haematobium Infections At The Population Level, Abraham Degarege, Berhanu Erko, Zeleke Mekonnen, Mengistu Legesse, Yohannes Negash, Jozef Vercruysse, Bruno Levecke

Journal Articles: Epidemiology

BACKGROUND: There is a lack of cost-effective diagnostic strategies to evaluate whether mass drug administration (MDA) programmes to control Schistosoma haematobium progress as anticipated. The purpose of this study is to provide a proof-of-principle for examination of pooled urine samples as a strategy for rapid assessment of presence and intensity of Schistosoma haematobium infections at the population level.

METHODS: A total of 640 urine samples were collected from 520 school-aged children (520 at baseline and 120 at follow-up) during a clinical trial that was designed to assess the efficacy of praziquantel against Schistosoma haematobium infections in Ethiopia. Individual and pooled …

Realizing Improved Patient Care Through Human-Centered Design In The Operating Room, Volume 1, Clemson Center For Health Facilities Design & Testing

Center for Health Facilities Design and Testing

This 4-year grant from the Agency for Healthcare Research and Quality supports the development of a learning lab focused on designing a safer, more ergonomic operating room. Sponsor: Agency Agency for Healthcare Research Quality Project period: 9/1/15 to 8/31/19 Project Description: The overarching goal of the learning lab titled “Realizing Improved Patient Care through Human-Centered Design in the Operating Room (RIPCHD.OR) is to develop an evidence-based framework and methodology for the design and operation of operating rooms such that it impacts improved perioperative outcomes including surgical site infections, surgical errors and staff injuries.

Factors Associated With Induced Abortion Among Female Entertainment Workers: A Cross-Sectional Study In Cambodia, Siyan Yi, Sovannary Tuot, Pheak Chhoun, Khuondyla Pal, Khimuy Tith, Carinne M. Brody

Objective: To explore risk factors associated with induced abortion among sexually active female entertainment workers (FEWs) in Cambodia.

Design: Cross-sectional study. Setting: Phnom Penh and Siem Reap, Cambodia.

Participants: This study included 556 FEWs aged 18–47 years randomly selected from entertainment establishments in the two cities in 2014 using a two-stage cluster sampling method. Data were collected through face-to-face interviews using a structured questionnaire.

Primary outcome measure: History of induced abortion during the time working as a FEW.

Results: Of the total sample, 45.6% reported currently using a contraceptive method with condom (42.4%) being the …

Breast Cancer Risk In Metabolically Healthy But Overweight Postmenopausal Women, M. J. Gunter, X. Xie, X. Xue, G. C. Kabat, T. E. Rohan, S. Wassertheil-Smoller, G. Y. Ho, J. Wylie-Rosett, J. Beasley, H. D. Strickler, +2 Additional Authors

Journal Articles

Adiposity is an established risk factor for postmenopausal breast cancer. Recent data suggest that high insulin levels in overweight women may play a major role in this relationship, due to insulin's mitogenic/antiapoptotic activity. However, whether overweight women who are metabolically healthy (i.e., normal insulin sensitivity) have elevated risk of breast cancer is unknown. We investigated whether overweight women with normal insulin sensitivity [i.e., homeostasis model assessment of insulin resistance (HOMA-IR) index, or fasting insulin level, within the lowest quartile (q1)] have increased breast cancer risk. Subjects were incident breast cancer cases (N = 497) and a subcohort (N = 2,830) …

Differential Expression Of Circulating Micrornas According To Severity Of Colorectal Neoplasia, G. Y. Ho, H. J. Jung, R. E. Schoen, T. Wang, J. Lin, Z. Williams, J. L. Weissfeld, J. Y. Park, O. Loudig, Y. Suh

Journal Articles

There is a need to develop a colorectal cancer (CRC) screening test that is noninvasive, cost effective, and sensitive enough to detect preneoplastic lesions. This case-control study examined the feasibility of using circulating extracellular microRNAs (miRNAs) to differentiate a spectrum of colorectal neoplasia of various severity and hence for early detection of colorectal neoplasia. Archived serum samples of 10 normal controls and 31 cases, including 10 with nonadvanced adenoma, 10 with advanced adenoma, and 11 with CRC, were profiled for circulating miRNAs using next-generation sequencing. Multiple linear regression, adjusting for age, gender, and smoking status, compared controls and the 3 …

Oral Bisphosphonate Use And Risk Of Postmenopausal Endometrial Cancer, P. A. Newcomb, M. N. Passarelli, A. I. Phipps, G. L. Anderson, J. Wactawski-Wende, G. Y. Ho, M. J. O'Sullivan, R. T. Chlebowski

Journal Articles

PURPOSE: Bisphosphonates are common medications used for the treatment of osteoporosis and are also used to reduce metastases to bone in patients with cancer. Several studies, including the Women's Health Initiative (WHI), have found that use of bisphosphonates is associated with reduced risk of developing breast cancer, but less is known about associations with other common malignancies. This study was aimed at examining the effects of bisphosphonates on the risk of endometrial cancer. METHODS: We evaluated the relationship between use of oral bisphosphonates and endometrial cancer risk in a cohort of 89,918 postmenopausal women participating in the WHI. A detailed …

Association Between Respiratory Syncytial Virus Activity And Pneumococcal Disease In Infants: A Time Series Analysis Of Us Hospitalization Data., Daniel M. Weinberger, Keith P. Klugman, Claudia A. Steiner, Lone Simonsen, Cécile Viboud

Epidemiology Faculty Publications

BACKGROUND:

The importance of bacterial infections following respiratory syncytial virus (RSV) remains unclear. We evaluated whether variations in RSV epidemic timing and magnitude are associated with variations in pneumococcal disease epidemics and whether changes in pneumococcal disease following the introduction of seven-valent pneumococcal conjugate vaccine (PCV7) were associated with changes in the rate of hospitalizations coded as RSV.

METHODS AND FINDINGS:

We used data from the State Inpatient Databases (Agency for Healthcare Research and Quality), including >700,000 RSV hospitalizations and >16,000 pneumococcal pneumonia hospitalizations in 36 states (1992/1993-2008/2009). Harmonic regression was used to estimate the timing of the average seasonal …

What The Obesity Prevention Field Can Learn From The Gay Marriage Movement, Sergio Costa, Emily Ferris, Terry T-K Huang

Publications and Research

In the US, two-thirds of adults and one-third of children continue to be affected by overweight or obesity despite two decades and billions of dollars' spent in public health efforts. In the last decade, public health has stepped up its call for greater emphasis on environmental and policy interventions, including active designs in urban planning and restrictions on food marketing to children, to incentivize healthy behaviors and disincentivize less healthy ones. However, there has been little success in policy change to prevent obesity. Voters in Berkeley, CA recently passed a one-cent-per-ounce soda tax, but a similar measure was defeated by …

Graduate Certificate In Public Health Informatics Brochure, Nova Southeastern University

Health Professions Divisions Course Catalogs and Course Descriptions

No abstract provided.

Community Dental Health Coordinator Program Overview And Planning For Communities, American Dental Association

Action for Dental Health

No abstract provided.

Developing A Long-Term Care Dental Training Program: A Maryland Experience, American Dental Association

Action for Dental Health

No abstract provided.