Public Health Commons^™

Expansion Of The Performance Capabilities Of The Usf Inhalation Challenge Chamber, Laura Riley

USF Tampa Graduate Theses and Dissertations

The purpose of this research was to evaluate the capability and performance of the University of South Florida’s (USF) Human Exposure Chamber (HEC) using aerosols in the thoracic range. The goals of this research were two-fold: to obtain an average particle size of 10 µm (thoracic-size range) inside the chamber during dust production and to test for evenness of dust concentration within the chamber. The USF HEC can be used for studies using gases and/or particulates. The chamber measurements are 4.16 ft x 2.67 ft x 6.75 ft, for a total volume of 75 ft³ or 2.13 m^{3 …}

Caution Is Needed In Designing Pharmacy Coverage., Steven A Farmer, William B Borden

Health Policy and Management Faculty Publications

Introduction

Pharmaceuticals are a critical component of modern medical care and have contributed substantially to health and quality of life. They are also expensive, accounting for ≈10% of US health care costs.1 By the end of this year, Medicare beneficiaries are expected to spend $343 billion on medications, and drug spending is projected to grow faster than both the inpatient and outpatient care categories.2Commercial and public payers use a range of mechanisms to constrain these costs, including formularies, tiered copayments, and preauthorization. These coverage policies may have potent impacts on medication usage, and their effects deserve close …

Bias In The Eyes Of Resident Physicians, Abel H. Irena, Kern A. Reid, Richard Battiola, Anthony Cáceres

Journal of Patient-Centered Research and Reviews

Background: The utilization of patient characteristics can allow health care providers to arrive at diagnosis or decide on treatment options; however, the subjective nature of patient characterization can negatively affect patient care. A 2003 Institute of Medicine report, called Unequal Treatment, recognized that bias or stereotyping may affect provider-patient communication or the care offered.

Purpose: To investigate residents’ recognition of bias in an inpatient care setting.

Methods: In order to explore the topic of bias among providers, we elected to indirectly assess its recognition among providers by asking their opinion in an anonymous manner about their fellow residents. This, we …

Proceedings Of 2016 Aurora Scientific Day

Journal of Patient-Centered Research and Reviews

This supplement includes select abstracts presented at the 42nd annual Aurora Scientific Day research symposium, held May 25, 2016, in Milwaukee, Wisconsin. Aurora Scientific Day provides a forum for original research conducted by faculty, fellows, residents, students and other allied health professionals affiliated with Aurora Health Care, a not-for-profit health system comprised of integrated hospitals and clinics across eastern Wisconsin and northeastern Illinois.

Association Between Pregnancy Intention And Maternal Characteristics, Outcomes, And Cost Of Care: A Pilot Study, Kristy M. Kelel, Kiley B. Vander Wyst, Danielle M. Greer, Danish Siddiqui

Journal of Patient-Centered Research and Reviews

Background: An estimated 51% of pregnancies in the United States are unintended. In Wisconsin, unplanned pregnancies account for 40% of all pregnancies and cost $148 million in public funds. Unintended pregnancy, which creates increased hardship for mothers and threatened well-being of infants, has been recognized as an important health, social and economic problem.

Purpose: To determine the pregnancy intentions of postpartum women and the maternal characteristics, outcomes and costs of care associated with unintended pregnancies at a large urban hospital in Milwaukee, Wisconsin.

Methods: Postpartum women were surveyed prior to discharge. The 20-item survey included whether or not the woman …

Cost-Effectiveness Of Genomic-Based Warfarin Therapy, John Weissert, Kourosh Ravvaz

Journal of Patient-Centered Research and Reviews

Background: With over 40 years of demonstrated clinical efficacy, warfarin remains the world’s most used pharmaceutical to prevent ischemic stroke in patients with atrial fibrillation (AF). However, warfarin has many challenges. Thus, despite known effectiveness, warfarin is a leading cause to drug-induced morbidity and mortality. Over 50 different warfarin therapy protocols, including a number of pharmacogenomic-based (PG) protocols, with as many as 14 independent variables, have been developed to improve safety and efficacy, thereby reducing ischemic strokes and intracranial hemorrhages (ICH).

Purpose: To conduct a preliminary cost-effectiveness study to determine the price point at which using warfarin PG dosing to …

Identifying Disparities In Colorectal Cancer Screening Rates In Milwaukee-Based Academic And Nonacademic Clinics, Jasmine Wiley, Jonathan J. Blaza, Will Lehmann, Deborah Simpson, Jeffrey A. Stearns, Shelby L. Pischke, Tracy L. Greiten

Journal of Patient-Centered Research and Reviews

Background: The Institute for Healthcare Improvement’s Triple Aim focuses on improving the patient’s experience of care, improving population health and reducing the per capita cost of health care. Health care systems and providers continuously seek to improve quality of care through understanding what percentage of their patients are achieving quality-of-care standards for various indicators, including immunizations, tobacco cessation, asthma and cancer screening. As health care moves toward reimbursing for value-based care, deepening our understanding of patient population characteristics within each of these conditions is vital to continuous quality improvement.

Purpose: To determine if there are race/ethnicity/age/preferred language (REAL) disparities in …

Evaluation Of Patient Opinions And Experiences With Electronic Cigarettes At A Family Medicine Residency Clinic, Ima D. Tanner, Breana C. Cummens, Jessica J.F. Kram, Dennis J. Baumgardner

Journal of Patient-Centered Research and Reviews

Background: Since 2003, electronic cigarettes (e-cigs) have grown in popularity. E-cigs are often marketed as a safer, healthier alternative to smoking traditional cigarettes or as an aid for smoking cessation. However, the risks and benefits of e-cig use, as well as the beliefs that influence use or avoidance, are poorly understood.

Purpose: To assess our patient population’s perception or beliefs as they relate to e-cig use.

Methods: A 13-question survey regarding nicotine and e-cig use was distributed to English-speaking adult patients at Aurora St. Luke’s Family Practice Clinic from August 2015 to January 2016. Questions assessed patient demographics and smoking …

Determining The Incidence And Factors Of Cardiotoxicity In Breast Cancer Patients Treated With Anthracycline And/Or Trastuzumab-Containing Regimen At Aurora Health Care, Stephanie Ghojallu, Matthew Rappelt, Han-Yang Chen, Ruth Perez, Lydia Garlie, Geoffrey Riddell, Yingying Gu, Jun Zhang, Rubina Qamar, Bijoy K. Khandheria, Arshad Jahangir, Yang Shi

Journal of Patient-Centered Research and Reviews

Background: Anthracycline and trastuzumab are common breast cancer treatments. While improving survival, they elevate risk of congestive heart failure. The incidence of cardiotoxicity (CTx) with these therapies varies in the literature from 10% to 59%, higher than those reported in clinical trials (4%–10%) that excluded patients with preexisting cardiovascular comorbidities. Studies have failed to establish consensus on the risk factors for CTx associated with these therapies.

Purpose: We aim to determine the incidence and risk factors of CTx in breast cancer patients treated with anthracycline and/or trastuzumab at Aurora Health Care.

Methods: A retrospective review of patients with breast cancer …

Does Travel Time To A Radiation Facility Impact Patient Decision-Making Regarding Treatment For Prostrate Cancer? A Study Of The New Hampshire State Cancer Registry, Fady Ghali, Maria Celaya, Michael Laviolette, Johann Ingimarsson, Heather Carlos, Judy R. Rees, Elias Hyams

Dartmouth Scholarship

Purpose: We sought to determine whether further distance from a radiation center is associated with lower utilization of external beam radiation therapy (XRT). Methods: We retrospectively identified patients with a new diagnosis of localized prostate cancer (CaP) within the New Hampshire State Cancer Registry from 2004 to 2011. Patients were categorized by age, D’Amico risk category, year of treatment, marital status, season of diagnosis, urban/rural residence, and driving time to the nearest radiation facility. Treatment decisions were stratified into those requiring multiple trips (XRT) or a single trip (surgery or brachytherapy). Multivariable regression analysis was performed. Results: A total of …

Continuing Development Of An All Payer Health Care System In Maryland, David P. Paul Iii, Taeko Matsumoto, Alberto Coustasse, Lama Mohammed Bakhamis, Mary Lynn Harshbarger

Management Faculty Research

The state of Maryland, in collaboration with the Centers for Medicare and Medicaid, developed the first all-payer system model in the U.S. in 1971, and some 35 years later in response to financial pressures, modernized this program. The focus of the modernized program was to improve overall per capita expenditure, quality of care, and the outcome of Marylanders’ health.

This study showed positive change in moving its healthcare delivery model from volume-driven care to value-driven coordinated care. Maryland hospitals have changed their mindsets to achieve the Triple Aim of cost reduction, health improvement, and quality of care improvement for the …

Health And Health Care In Kentucky: Variations By Region And Metro/Micro/Rural Status, Tyrone F. Borders, Keith Branham

Institute for Rural Health Policy Reports

Health policy makers and health system managers frequently make decisions to allocate and organize resources according to differences in unmet needs across geographic areas. This report describes, compares, and contrasts key health, health behavior, and health care access indicators by region and metropolitan status in Kentucky.

Sex Ed To Go- An Analysis Of Comprehensive Sexual Education Mobile Phone Applications, Kerstin M. Kalke

Communication ETDs

The United States has one of the highest teen pregnancy rates among developed countries and the numbers of STIs have increased during the last few years. Mobile phone applications constitute a promising platform to disseminate sexual health information and to reduce adverse health outcomes, particularly among teens. In order to be effective, apps have to follow a comprehensive approach to sexuality education, include concepts of behavior change theories, and adhere to health literacy principles.

This study used a mixed-methods approach consisting of a quantitative content analysis and qualitative thematic analysis to assess the quality of sexual education apps available to …

College Of Public Health News, Georgia Southern University

College of Public Health: News & Publications

• Georgia Southern Associate Dean Serves as Guest Editor for the Special Issue on Health Informatics
• Georgia Southern:Examines Estimation of P (X>Y) when X and Y are Dependent Random Variables.

Health Policy & Management News, Georgia Southern University

Health Policy & Community Health: News & Publications (2011-2018)

• Georgia Southern Associate Dean Serves as Guest Editor for the Special Issue on Health Informatics

Motor Development And Skill Acquisition In Elementary Aged Students, Joanna M. Guerrant Ms.

Posters-at-the-Capitol

Mastering physical movement occurs through motor learning and experience. Motor development is needed for successful acquisition of sport and other physical skills. A lack of motor skills has been associated with decreased physical activity later in life, which has been linked to a variety of hypokinetic diseases. This study examined motor learning and skill acquisition in elementary age children. Twenty 2^nd-5^th grade students were recruited through the local school system. Subjects did not have any injuries that would preclude them from performing three basic skills (modified squat, tree, and arm and leg raises). IRB approval, parental consent, …

Glucose-6-Phosphate Dehydrogenase Deficiency And Physical And Mental Health Until Adolescence, Man Ki Kwok, Gabriel M. Leung, C. Mary Schooling

Publications and Research

Background: To examine the association of glucose-6-phosphate dehydrogenase (G6PD) deficiency with adolescent physical and mental health, as effects of G6PD deficiency on health are rarely reported.

Methods: In a population-representative Chinese birth cohort: ªChildren of 1997º (n = 8,327), we estimated the adjusted associations of G6PD deficiency with growth using generalized estimating equations, with pubertal onset using interval censored regression, with hospitalization using Cox proportional hazards regression and with size, blood pressure, pubertal maturation and mental health using linear regression with multiple imputation and inverse probability weighting.

Results: Among 5,520 screened adolescents (66% follow-up), 4.8% boys and 0.5% girls had …

Use Of A Modified Greenscreen Tool To Conduct A Screening-Level Comparative Hazard Assessment Of Conventional Silver And Two Forms Of Nanosilver., Jennifer Sass, Lauren Heine, Nina Hwang

Environmental and Occupational Health Faculty Publications

BACKGROUND: Increased concern for potential health and environmental impacts of chemicals, including nanomaterials, in consumer products is driving demand for greater transparency regarding potential risks. Chemical hazard assessment is a powerful tool to inform product design, development and procurement and has been integrated into alternative assessment frameworks. The extent to which assessment methods originally designed for conventionally-sized materials can be used for nanomaterials, which have size-dependent physical and chemical properties, have not been well established. We contracted with a certified GreenScreen profiler to conduct three GreenScreen hazard assessments, for conventional silver and two forms of nanosilver. The contractor summarized publicly …

Use Of A Modified Greenscreen Tool To Conduct A Screening-Level Comparative Hazard Assessment Of Conventional Silver And Two Forms Of Nanosilver., Jennifer Sass, Lauren Heine, Nina Hwang

Environmental and Occupational Health Faculty Publications

BACKGROUND: Increased concern for potential health and environmental impacts of chemicals, including nanomaterials, in consumer products is driving demand for greater transparency regarding potential risks. Chemical hazard assessment is a powerful tool to inform product design, development and procurement and has been integrated into alternative assessment frameworks. The extent to which assessment methods originally designed for conventionally-sized materials can be used for nanomaterials, which have size-dependent physical and chemical properties, have not been well established. We contracted with a certified GreenScreen profiler to conduct three GreenScreen hazard assessments, for conventional silver and two forms of nanosilver. The contractor summarized publicly …

Substance Use And Psychosocial Status Among People Living With Hiv/Aids Who Encountered Hiv Stigma In China: Stratified Analyses By Socio-Economic Status, Chen Zhang, Xiaoming Li Ph.D., Yu Liu, Shan Qiao Ph.D., Yuejiao Zhou, Zhiyong Shen, Yi Chen

Faculty Publications

This study examined whether the impact of HIV stigma on psychosocial status and substance use among people living with HIV/AIDS (PLWHA) differed by their socio-economic status (SES) in a Chinese setting. A total of 2,987 PLWHA were recruited from 12 sites with the highest number of cumulative HIV incidence in Guangxi, China. Participants were asked to provide information regarding their psychosocial status (e.g., depression, anxiety), history of substance use (e.g., tobacco, alcohol and drug) and SES (e.g., education, monthly income, residence type, and job category). By employing stratified multivariate regression analyses, we assessed stratum-specific impacts of HIV stigma on PLWHA’s …

Substance Use And Psychosocial Status Among People Living With Hiv/Aids Who Encountered Hiv Stigma In China: Stratified Analyses By Socio-Economic Status, Chen Zhang, Xiaoming Li, Yu Liu, Shan Qiao, Yuejiao Zhou, Zhiyong Shen, Yi Chen

Faculty Publications

This study examined whether the impact of HIV stigma on psychosocial status and substance use among people living with HIV/AIDS (PLWHA) differed by their socio-economic status (SES) in a Chinese setting. A total of 2,987 PLWHA were recruited from 12 sites with the highest number of cumulative HIV incidence in Guangxi, China. Participants were asked to provide information regarding their psychosocial status (e.g., depression, anxiety), history of substance use (e.g., tobacco, alcohol and drug) and SES (e.g., education, monthly income, residence type, and job category). By employing stratified multivariate regression analyses, we assessed stratum-specific impacts of HIV stigma on PLWHA’s …

Cervical Cancer Infrastructure, Knowledge And Attitudes In Kabale, Uganda, Nicole Robertson

Posters-at-the-Capitol

Cervical Cancer Infrastructure, Knowledge and Attitudes in Kabale, Uganda

Nicole Robertson¹, ShaCoria Winston², Kara Miller³, Julia Hanebrink⁴

¹University of Louisville ²Washington University in St. Louis ³University of California Riverside ⁴Christian Brothers University, Department of Anthropology

Cervical cancer has increasing prevalence in southwestern Uganda and is the most common cancer among women in sub-Saharan Africa. Despite this increased prevalence, the biomedical infrastructure in Uganda lacks support for cervical cancer screening and treatment. At the same time, cervical cancer carries a stigma as an incurable sexually transmitted disease similar to the …

Albuminuria Changes And Cardiovascular And Renal Outcomes In Type 1 Diabetes: The Dcct/Edic Study., Ian H De Boer, Xiaoyu Gao, Patricia A Cleary, Ionut Bebu, John M Lachin, Mark E Molitch, Trevor Orchard, Andrew D Paterson, Bruce A Perkins, Michael W Steffes, Bernard Zinman

Epidemiology Faculty Publications

Background and objectives In trials of people with type 2 diabetes, albuminuria reduction with renin-angiotensin system inhibitors is associated with lower risks of cardiovascular events and CKD progression. We tested whether progression or remission of microalbuminuria is associated with cardiovascular and renal risk in a well characterized cohort of type 1 diabetes.

Design, setting, participants, & measurements We studied 1441 participants in the Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications study. Albumin excretion rate (AER) was quantified annually or biennially for up to 30 years. For each participant, albuminuria status was defined over time as normoalbuminuria (AER …

Creating Sustainable Models For Short-Term Volunteers Through The Global Health Service Partnership, James Scott, +Several Additional Authors

Emergency Medicine Faculty Posters and Presentations

Thirty-one countries in sub-Saharan Africa (SSA) have a critical shortage of health care professionals. Subsequently, African medical schools are increasing enrollment, thus increasing demand on limited faculty. Simultaneously, US medical residents’ interest in global health is increasing and training programs are seeking ways to provide high quality experiences while also contributing to the host country health system. Recently published guidelines outlined key factors in successful global health training partnerships: structured programs, mutual benefits, long-term relationships, on-site mentorship, and trainee preparation. Partnerships between US academic institutions, GHSP, and SSA institutions create meaningful and sustainable ways of enabling residents and faculty across …

The Association Between Environmental Factors And Scarlet Fever Incidence In Beijing Region: Using Gis And Spatial Regression Models, Gehendra Mahara, Chao Wang, Kun Yang, Sipeng Chen, Jin Guo, Qi Gao, Wei Wang, Quanyi Wang, Xiuhua Guo

Research outputs 2014 to 2021

Background:

Evidence regarding scarlet fever and its relationship with meteorological, including air pollution factors, is not very available. This study aimed to examine the relationship between ambient air pollutants and meteorological factors with scarlet fever occurrence in Beijing, China.

Methods:

A retrospective ecological study was carried out to distinguish the epidemic characteristics of scarlet fever incidence in Beijing districts from 2013 to 2014. Daily incidence and corresponding air pollutant and meteorological data were used to develop the model. Global Moran’s I statistic and Anselin’s local Moran’s I (LISA) were applied to detect the spatial autocorrelation (spatial dependency) and clusters of …

“What Matters To You?”: A Pilot Project For Implementing Patient-Centered Care, Anthony M. Digioia Md, Iii, Sarah B. Clayton, Michelle B. Giarrusso

Patient Experience Journal

This project was intended to enhance the delivery of patient-centered care by asking patients what matters to them before and after total joint replacement (TJR) surgery. In Phase I, pre-operatively, patients undergoing total joint replacement (TJR) surgery were asked, “What matters to you before surgery, during your hospital stay, and in the first 3 months following surgery?” and “What matters to you moving forward after you’ve recovered from your joint replacement?” Four weeks post-operatively they were asked, “Now that that you’ve been through the surgery and first 4 weeks of recovery, can you identify new concerns that you didn’t have …

Envisioning Mechanisms For Success: Evaluation Of Ebcd At Cheo, Kristina Rohde, Mireille Brosseau, Diane Gagnon, Jennifer Schellinck, Christine Kouri

Patient Experience Journal

To advance patient engagement (PE) and more comprehensively involve patients, families, and staff in quality improvement (QI) at the Children’s Hospital of Eastern Ontario (CHEO), the Experience Based Co-Design (EBCD) approach was piloted. Set against the backdrop of envisioning factors that would facilitate success, an evaluation was designed to assess five domains: strengthening of mutual understanding, collaboration, and partnerships between patients/families and staff; a greater involvement of patients, families, and staff in QI; satisfaction with the process; the ability of EBCD to generate clear and useful data to ascertain the patient/family and staff experience; and the ability of EBCD to …

Patient Advisors: How To Implement A Process For Involvement At All Levels Of Governance In A Healthcare Organization, Marie-Pascale Pomey, Edith Morin, Catherine Neault, Veronique Biron, Lise Houle, Louise Lavigueur, Guy Bouvette, Nicole St-Pierre, Martin Beaumont

Patient Experience Journal

Patient involvement at the operational (clinical care and services), tactical (management), and strategic (board of directors and executive management) levels of establishments is increasingly sought after. To address this specific challenge, a Canadian healthcare organization, the Centre intégré universitaire de santé et de services sociaux de la Mauricie-et-du-Centre-du-Québec, has developed an integrated strategy based on three principles: (1) shared leadership between a patient and a manager to build the strategy; (2) a clear process for recruiting, training, and coaching patient advisors (PA) so that they can participate in decision-making at the various levels of governance of the establishment; and (3) …

Using Patient Value Statements To Develop A Culture Of Patient-Centred Care: A Case Study Of An Ontario, Canada Hospital, Erica Bridge, Madelyn P. Law, Miya Narushima

Patient Experience Journal

Patient-centred care (PCC) is not a new concept; however, in recent years it has garnered increasing attention in the research literature and clinical practice. PCC in clinical practice has been found to improve clinical outcomes, resource allocation, and the patient experience. In response to the need for PCC and quality in healthcare, the Ontario, Canada government developed the Excellent Care for All Act (ECFAA) in 2010. The ECFAA imposes six obligations to Ontario hospitals, one of which is developing and publishing a Patient Declaration of Values (PDoV). The purpose of this study was to explore how a leading patient-centred Ontario …

Showcasing Patient Experience And Engagement Best Practices Through An Innovative Forum Celebrating Patients, Families, And Multidisciplinary Care Teams, Alison S. Tothy Md, Sunitha K. Sastry, Andres Valencia, Mary Kate Springman, Susan Murphy

Patient Experience Journal

A platform was designed for interdisciplinary teams to learn from colleagues, patients, and their families, about what creates and sustains positive, lasting impressions from their care team. A forum focused on positive experiences designed to highlight the relationships between patients and care teams was utilized. A Best Practices Forum was designed to share methods for generating positive patient experiences across the institution. These quarterly conferences featured patient stories and highlighted best practices such as empathic communications, collaboration, and teamwork used by caregivers throughout the institution. The patient experience team invited various well-performing departments to share best practices, as well as …