Public Health Commons^™

Diagnostic Error In Mental Health: A Review, Andrea Bradford, Ashley N D Meyer, Sundas Khan, Traber D Giardina, Hardeep Singh

Faculty, Staff and Students Publications

Diagnostic errors are associated with patient harm and suboptimal outcomes. Despite national scientific efforts to advance definition, measurement and interventions for diagnostic error, diagnosis in mental health is not well represented in this ongoing work. We aimed to summarise the current state of research on diagnostic errors in mental health and identify opportunities to align future research with the emerging science of diagnostic safety. We review conceptual considerations for defining and measuring diagnostic error, the application of these concepts to mental health settings, and the methods and subject matter focus of recent studies of diagnostic error in mental health. We …

Adaptation Of The Socioecological Model To Address Disparities In Engagement Of Black Men In Prostate Cancer Genetic Testing, Amy Leader, Timothy Rebbeck, William Oh, Alpa Patel, Eric Winer, Leeann Bailey, Leonard Gomella, Crystal Lumpkins, Isla Garraway, Lisa Aiello, Monica Baskin, Heather H Cheng, Kathleen Cooney, Amanda Ganzak, Daniel George, Susan Halabi, Feighanne Hathaway, Claire Healy, Joseph W Kim, Michael Leapman, Stacy Loeb, Kara Maxwell, Christopher Mcnair, Todd Morgan, Breanne Prindeville, Howard R Soule, Whitney Steward, Sakinah Suttiratana, Mary-Ellen Taplin, Kosj Yamoah, Thierry Fortune, Kris Bennett, Joshua Blanding-Godbolt, Laura Gross, Veda Giri

Department of Medical Oncology Faculty Papers

BACKGROUND: Black men consistently have higher rates of prostate cancer (PCA)- related mortality. Advances in PCA treatment, screening, and hereditary cancer assessment center around germline testing (GT). Of concern is the significant under-engagement of Black males in PCA GT, limiting the benefit of precision therapy and tailored cancer screening despite longstanding awareness of these disparities. To address these critical disparities, the Socioecological Model (SEM) was employed to develop comprehensive recommendations to overcome barriers and implement equitable strategies to engage Black males in PCA GT.

METHODS: Clinical/research experts, national organization leaders, and community stakeholders spanning multiple regions in US and Africa …

Rethinking Health Systems Responsiveness In Low- And Middle-Income Countries: Validation Study, Meesha Iqbal, Cecilia Ganduglia Cazaban, Robert Morgan, Cici Bauer, Sameen Siddiqi

Faculty, Staff and Student Publications

BACKGROUND: Health systems responsiveness (HSR) is the ability of systems to respond to legitimate non-health expectations of the population. The concept of HSR by the World Health Organization (WHO) includes respect for dignity, individual autonomy, confidentiality, prompt attention to care, availability of basic amenities, choice of provider, access to social support networks, and clarity of communication. The WHO tool is applied globally to assess HSR in low, middle, and high-income countries.

OBJECTIVE: We have revised the conceptual framework of HSR following a rigorous systematic review and made it specific for low- and middle-income countries (L&MICs). This study is designed to …

Development Of Message Passing-Based Graph Convolutional Networks For Classifying Cancer Pathology Reports, Hong Jun Yoon, Hilda B. Klasky, Andrew E Blanchard, J. Blair Christian, Eric B Durbin, Xiao Cheng Wu, Antoinette Stroup, Jennifer Doherty, Linda Coyle, Lynne Penberthy, Georgia D Tourassi

School of Public Health Faculty Publications

Background: Applying graph convolutional networks (GCN) to the classification of free-form natural language texts leveraged by graph-of-words features (TextGCN) was studied and confirmed to be an effective means of describing complex natural language texts. However, the text classification models based on the TextGCN possess weaknesses in terms of memory consumption and model dissemination and distribution. In this paper, we present a fast message passing network (FastMPN), implementing a GCN with message passing architecture that provides versatility and flexibility by allowing trainable node embedding and edge weights, helping the GCN model find the better solution. We applied the FastMPN model to …

Association Between Non-Injection Drug Use And Hepatitis C Infection Among Hiv-Negative Men Who Have Sex With Men, Jing Zhao, Charles Green, Christine Markham, Kayo Fujimoto, Alan G Nyitray, Lu-Yu Hwang

Faculty, Staff and Student Publications

Background: Prior research predominantly examined the association between HIV-positive men who have sex with men (MSM) or those using injection drugs and hepatitis C virus (HCV) infection. However, limited attention has been given to understanding the association among HIV-negative MSM who do not inject drugs. This gap leaves apportion of the population unexamined, potentially overlooking important factor that may contribute to the transmission and prevalence of HCV. This study aims to investigate the relationship between non-injection drug use and HCV infection in this population.

Methods: In this cross-sectional study, we analyzed data on 118 MSM who reported use of non-injection …

Expanding Healthcare Access For The Undocumented Immigrant Community: The Heal For Immigrant Families Act Of 2023, Perla Torres Estrada

The Gettysburg Journal for Public Policy

When it comes to the topic of universal healthcare, most of us will readily agree that healthcare is a human right. Where this agreement usually ends, however, is on the question of who should be granted this right, and if it should be left to the free market to determine access and affordability. Specifically, the political debate on expanding healthcare access to undocumented immigrants in the United States revolve around concerns over costs, legality, and equity. Proponents maintain that it is a human right whereas opponents question the potential burden on taxpayers and the implication for immigration policy. The HEAL …

The Impact Of Hypertension On Clinical Outcomes In Moyamoya Disease: A Multicenter, Propensity Score-Matched Analysis, Basel Musmar, Joanna Roy, Hammam Abdalrazeq, Elias Atallah, Kareem El Naamani, Ching-Jen Chen, Roland Jabre, Hassan Saad, Jonathan Grossberg, Adam Dmytriw, Aman Patel, Mirhojjat Khorasanizadeh, Christopher Ogilvy, Ajith Thomas, Andre Monteiro, Adnan Siddiqui, Gustavo Cortez, Ricardo Hanel, Guilherme Porto, Alejandro Spiotta, Anthony Piscopo, David Hasan, Mohammad Ghorbani, Joshua Weinberg, Shahid Nimjee, Kimon Bekelis, Mohamed Salem, Jan-Karl Burkhardt, Akli Zetchi, Charles Matouk, Brian Howard, Rosalind Lai, Rose Du, Rawad Abbas, Georgios Sioutas, Abdelaziz Amllay, Alfredo Munoz, Nabeel Herial, Stavropoula Tjoumakaris, Michael Gooch, Robert Rosenwasswer, Pascal Jabbour

Department of Neurosurgery Faculty Papers

BACKGROUND: Moyamoya disease (MMD) is a rare cerebrovascular disorder characterized by progressive steno-occlusive changes in the internal carotid arteries, leading to an abnormal vascular network. Hypertension is prevalent among MMD patients, raising concerns about its impact on disease outcomes. This study aims to compare the clinical characteristics and outcomes of MMD patients with and without hypertension.

METHODS: We conducted a multicenter, retrospective study involving 598 MMD patients who underwent surgical revascularization across 13 academic institutions in North America. Patients were categorized into hypertensive (n=292) and non-hypertensive (n=306) cohorts. Propensity score matching (PSM) was performed to adjust for baseline differences.

RESULTS: …

A Qualitative Study Of The Knowledge Of Metabolic Syndrome, Attitudes About Lifestyle Modifications, And Preferences For Lifestyle Interventions Among Patients With Cancer And Metabolic Syndrome, Isabel Martinez Leal, Ashwathy B Pillai, Jessica T Foreman, Kimberly W Siu, Natalia I Heredia, Carmen P Escalante, Ellen F Manzullo, Aimee J Christie, Tamara E Lacourt, Zayd Adnan Razouki, Jessica P Hwang

Faculty, Staff and Student Publications

Metabolic syndrome is a group of disorders-hypertension, dyslipidemia, obesity, and insulin resistance-that together increase the risk of coronary heart disease, stroke, and diabetes. Although ~60% of cancer patients have metabolic syndrome, which increases their risk of mortality, oncology providers lack clear guidance about its management. The development of metabolic syndrome lifestyle interventions requires a better understanding of these patients' knowledge, attitudes, and intervention preferences in order to inform management. During 2022-2023, 19 adult cancer patients with metabolic syndrome engaged in semistructured interviews focused on metabolic syndrome and lifestyle interventions. Interviews were analyzed using hybrid thematic analysis involving deductive and inductive …

Effect Of Cemented Vs Uncemented On Outcomes For Hemiarthroplasty In The Elderly: A Meta-Analysis Of Randomized Clinical Trials, Yuning Feng, Jun Wan, Haidong Deng, Lvlin Chen, Yangchun Xiao, Tiangui Li, Jialing He, Peng Wang, Weelic Chong, Yang Hai, Lu Jia, Yu Zhang

Department of Medical Oncology Faculty Papers

PURPOSE: In patients undergoing hemiarthroplasty in the elderly, the choice of the cemented method remains controversial. This meta-analysis was undertaken to compare the impact of cemented vs uncemented on outcomes for hemiarthroplasty in the elderly.

METHODS: This study included randomized controlled trials comparing the postoperative effects of cemented vs uncemented in patients with hemiarthroplasty. With no language restrictions, we searched Medline (Ovid), Embase (Ovid), Cochrane Central Register of Controlled Trials (Cochrane Collaboration), Clinical Trials.gov, the ISRCTN registry, as well as gray literature with no language restrictions from January 1966 to April 2023. Data were quantitatively summarized using a random-effects model. …

Transcatheter Aortic Valve Replacement Is Ready For Most Low-Risk Patients: A Systematic Review Of The Literature, Ahmad Jabri, Anas Alameh, Gennaro Giustino, Pedro Engel Gonzalez, Brian O'Neill, Rodrigo Bagur, Pedro Cox, Tiberio Frisoli, James Lee, Dee Dee Wang, William W. O'Neill, Pedro Villablanca

School of Medicine Faculty Publications

Transcatheter aortic valve replacement (TAVR) has undergone rapid expansion, emerging as a viable therapeutic option for low-risk patients in lieu of surgical aortic valve replacement. This paper aims to provide a review of the scientific evidence concerning TAVR in low-risk patients, encompassing both observational and clinical trial data. Furthermore, a substantial proportion of low-risk patients possesses a bicuspid aortic valve, necessitating careful examination of the pertinent anatomic and clinical considerations to TAVR that is highlighted in this review. Additionally, the review expands upon some of the unique challenges associated with alternate access in low-risk patients evaluated for TAVR. Last, this …

Increasing Referrals To Local Resources For The Treatment Of Aud By Increasing Audit-C Usage By Increasing Awareness Of Aud Through Use Of Educational Materials ​, David Ortiz, Gerardo Munoz Monaco

Research Colloquium

Background: One in nine people will suffer from alcohol use disorder, if of legal drinking age. One in nine of our patients might suffer from AUD. Among those suffering from AUD, only 1.6% were found to be treated with evidence-based medications for treatment of AUD. Underdiagnosing may be a reality.

Methods: Evaluate physicians-in-training knowledge regarding AUD at time zero and after 3 months after an educational presentation is giving containing information on AUD diagnosis, treatment, and available local resources. This repeated cross-sectional data analysis aims to increase screening using the AUDIT-C tool, as well as referral/utilization to local resources. Patients …

The Burden Of Diabetes Mellitus In The Medically Underserved Rio Grande Valley, John M. Gaddis, Elias Arellano, Kassandra Pulido, Tyler Torres, Dominic Chau-Zanetti, Natasha Quailes, Andres Suarez Parraga

Research Colloquium

Introduction

Diabetes mellitus (DM) encompasses metabolic disorders characterized by elevated blood sugar. This study aimed to evaluate the prevalence and associated metrics of DM in the Rio Grande Valley (RGV), a low-income and medically underserved region in the United States, and compare these metrics to the national averages from 2012 to 2022.

Methods

A retrospective cross-sectional analysis was conducted using publicly accessible data from the Centers for Medicare and Medicaid Services (CMS). Metrics analyzed included DM prevalence, average principal cost, rates of emergency department visits, hospitalizations, screenings, and prevalence of obesity. Data from the RGV counties were compared to national …

Prevalence And Economic Impact Of Osteoarthritis And Rheumatoid Arthritis In The Medically Underserved Rio Grande Valley, John M. Gaddis, Elias Arellano, Ryan Bialaszewski, Dominic Chau-Zanetti, Tyler Torres, Joel Wells

Research Colloquium

Introduction: Osteoarthritis and rheumatoid arthritis (OA/RA), two of the most common forms of arthritis worldwide, are chronic diseases affecting joints. The Rio Grande Valley (RGV) is characterized by an abundance of health disparities with previous studies showing increased rates of multiple diseases and disorders in this region. The purpose of this study was to determine both the prevalence and the risk-adjusted average total cost of OA/RA in the RGV and compare with the national average.

Methods: This retrospective, observational study utilized publicly accessible Medicare beneficiary data from 2012 to 2022. Data on OA/RA prevalence, risk-adjusted average total cost, and stratified …

Environmental Impact Of Water And Air Contaminants On Public Health, Astrid-Ines Foamkom, Luis A. Peña Marquez, Maria Sophia Malbas, Esmeralda Rodriguez, Noe Garza, Ney Alliey-Rodriguez

Research Colloquium

Background: Established literature suggests a strong relationship between exposure to air contaminants and physical health. Similarly, numerous studies have demonstrated the effects of water pollution on public health. Texas denizens are often victims of poor air and water quality, yet there are scant studies that have integrated evidence of health tolls caused by air and water pollution across the state. In this study, we assessed the relationship between particulate matter

Methods: The study used data from the 2018 Medicare and Medicaid report which displayed chronic health conditions across all counties in Texas. Additionally, the study also includes collected data on …

Efficacy Of Thoracic Endovascular Aortic Repair Versus Medical Therapy For Treatment Of Type B Aortic Dissection, Karam Motawea, Samah Rouzan, Rowan Elhalag, Abdelrhaman Abdelwahab, Hussam Al Hennawi, Salem Elshenawy, Mai Saad Mohamed, Pensée Chébl, Mohamed Salem Madian, Mostafa Elsayed Elsayed Hewalla, Sarya Swed, Wael Hafez, Bisher Sawaf, Samer Kaspo, Naim Battikh, Mohammed Najdat Seijari, Amr Farwati, Amine Rakab

Abington Jefferson Health Papers

BACKGROUND: Techniques in endovascular therapy have evolved to offer a promising alternative to medical therapy alone for Type B aortic dissections (TBADs).

AIM: The aim of this meta-analysis was to compare mortality and overall complications between thoracic endovascular aortic repair (TEVAR) and best medical therapy (BMT) in patients with TBADs.

METHODS: We included randomized control trials and prospective or retrospective cohort studies that compared TEVAR and BMT for the treatment of type B aortic dissection. Multiple electronic databases were searched.

RESULTS: Thirty-two cohort studies including 150,836 patients were included. TEVAR was associated with a significantly lower 30-day mortality rate than …

Context-Aware Single-Cell Multiomics Approach Identifies Cell-Type-Specific Lung Cancer Susceptibility Genes, Erping Long, Jinhu Yin, Ju Hye Shin, Yuyan Li, Bolun Li, Alexander Kane, Harsh Patel, Xinti Sun, Cong Wang, Thong Luong, Jun Xia, Younghun Han, Jinyoung Byun, Tongwu Zhang, Wei Zhao, Maria Teresa Landi, Nathaniel Rothman, Qing Lan, Yoon Soo Chang, Fulong Yu, Christopher I Amos, Jianxin Shi, Jin Gu Lee, Eun Young Kim, Jiyeon Choi

Faculty, Staff and Students Publications

Genome-wide association studies (GWAS) identified over fifty loci associated with lung cancer risk. However, underlying mechanisms and target genes are largely unknown, as most risk-associated variants might regulate gene expression in a context-specific manner. Here, we generate a barcode-shared transcriptome and chromatin accessibility map of 117,911 human lung cells from age/sex-matched ever- and never-smokers to profile context-specific gene regulation. Identified candidate cis-regulatory elements (cCREs) are largely cell type-specific, with 37% detected in one cell type. Colocalization of lung cancer candidate causal variants (CCVs) with these cCREs combined with transcription factor footprinting prioritize the variants for 68% of the GWAS loci. …

The Discover In-Hospital Cardiac Arrest (Discover Ihca) Study: An Investigation Of Hospital Practices After In-Hospital Cardiac Arrest, Luke Andrea, Nathaniel S. Herman, Jacob Vine, Katherine M. Berg, Saiara Choudhury, Mariana Vaena, Jordan E. Nogle, Saleem M. Halablab, Aarthi Kaviyarasu, Jonathan Elmer, Gabriel Wardi, Alex K. Pearce, Conor Crowley, Micah T. Long, J. Taylor Herbert, Kipp Shipley, Brittany D. Bissell Turpin, Michael J. Lanspa, Adam Green, Shekhar A. Ghamande, Akram Khan, Siddharth Dugar, Aaron M. Joffe, Michael Baram, Cooper March, Nicholas J. Johnson, Alexander Reyes, Krassimir Denchev, Michael Loewe, Et Al

School of Medicine Faculty Publications

IMPORTANCE: In-hospital cardiac arrest (IHCA) is a significant public health burden. Rates of return of spontaneous circulation (ROSC) have been improving, but the best way to care for patients after the initial resuscitation remains poorly understood, and improvements in survival to discharge are stagnant. Existing North American cardiac arrest databases lack comprehensive data on the post-resuscitation period, and we do not know current post-IHCA practice patterns. To address this gap, we developed the Discover In-Hospital Cardiac Arrest (Discover IHCA) study, which will thoroughly evaluate current post-IHCA care practices across a diverse cohort. OBJECTIVES: Our study collects granular data on post-IHCA …

Birth Defect Trends Within Texas Public Health Region 11, 2000-2019: An Analysis Of Texas Department Of State Health Services Public Data, Jonathan M. Hebert, Miguel A. Lopez, Padmanabhan Rengasamy

Research Colloquium

Background: South Texas is a medically underserved area with pockets of low socioeconomic status and poor access to healthcare, including prenatal care. This paper aims to monitor the changes in prevalence for cardiac, circulatory, gastrointestinal, genitourinary, and neural tube birth defects in this region in the last two decades to monitor the effectiveness of current public health efforts.

Methods: Public data on 20 birth defects from the Texas Department of State Health Services were obtained for decades 2000-2010 and 2010-2019 in Texas Public Health Region 11 and the remaining regions of Texas. Prevalences and odds ratios for all birth defects …

Assessing The Impact Of A Comprehensive Care Model On Reducing A1c Levels Compared To Primary Care Alone: A Comprehensive Study, Hector Trejo, Lizette Ingle, Karla Soberanis

Research Colloquium

Introduction: Diabetes significantly challenges the Rio Grande Valley (RGV), especially in low-income rural areas where prevalence and mortality rates are higher than in urban regions. Limited access to routine healthcare and specialists exacerbates these issues, delaying medical attention and reducing diagnostic testing and management adherence. Early diagnosis and lifestyle modification interventions show promise, but objective evaluation of these models by local organizations in the RGV. Further analysis is needed to assess their effectiveness in reducing diabetes prevalence and improving health outcomes in the RGV.

Methods: This retrospective study aims to evaluate the Comprehensive Care Model (CCM) on Improved Health Outcomes …

Differences In Happiness And Perceived Meaning In Life Between U.S. Working-Age Adults With Versus Without A Self-Care Disability, Nastassia Vaitsiakhovich, Scott D. Landes, Shannon M. Monnat

Population Health Research Brief Series

Subjective wellbeing (SWB) - being happy or perceiving one’s life has meaning, is critical to good physical health. People who are happier and who report that their lives have meaning are healthier and live longer. In general, individuals with disabilities have worse SWB compared to those without disabilities. This brief summarizes findings from a study that used data from the National Wellbeing Survey collected in early-2021 to examine differences in happiness and perceived meaning in life between U.S. working-age adults (ages 18-64) with versus without a self-care disability (such as difficulty eating, using the toilet, or dressing without assistance) and …

Neuroinflammation And Brain Health Risks In Veterans Exposed To Burn Pit Toxins, Athena Brooks, Brian Sandri, Joshua Nixon, Timothy Nurkiewicz, Paul Barach, Janeen Trembley, Tammy Butterick

College of Population Health Faculty Papers

Military burn pits, used for waste disposal in combat zones, involve the open-air burning of waste materials, including plastics, metals, chemicals, and medical waste. The pits release a complex mixture of occupational toxic substances, including particulate matter (PM), volatile organic compounds (VOCs), heavy metals, dioxins, and polycyclic aromatic hydrocarbons (PAHs). Air pollution significantly impacts brain health through mechanisms involving neuroinflammation. Pollutants penetrate the respiratory system, enter the bloodstream, and cross the blood-brain barrier (BBB), triggering inflammatory responses in the central nervous system (CNS). Chronic environmental exposures result in sustained inflammation, oxidative stress, and neuronal damage, contributing to neurodegenerative diseases and …

Final Outcomes From A Phase 2 Trial Of Posoleucel In Allogeneic Hematopoietic Cell Transplant Recipients, Sanjeet S Dadwal, Rajat Bansal, Michael W Schuster, Jean A Yared, Gary Douglas Myers, Michelle Matzko, Sama Adnan, David Mcneel, Julie Ma, Sarah A Gilmore, Spyridoula Vasileiou, Ann M Leen, Joshua A Hill, Jo-Anne H Young

Faculty, Staff and Students Publications

Allogeneic hematopoietic cell transplantation (allo-HCT) recipients are susceptible to viral infections. We conducted a phase 2 trial evaluating the safety and rate of clinically significant infections (CSIs; viremia requiring treatment or end-organ disease) after infusion of posoleucel, a partially HLA-matched, allogeneic, off-the-shelf, multivirus-specific T-cell investigational product for preventing CSIs with adenovirus, BK virus, cytomegalovirus, Epstein-Barr virus, human herpesvirus-6, or JC virus. This open-label trial enrolled allo-HCT recipients at high risk based on receiving grafts from umbilical cord blood, haploidentical, mismatched, or matched unrelated donors; post-HCT lymphocytes of < 180/mm3; or use of T-cell depletion. Posoleucel dosing was initiated within 15 to 49 days of allo-HCT and subsequently every 14 days for up to 7 doses. The primary end point was the number of CSIs due to the 6 target viruses by week 14. Of the 26 patients enrolled, only 3 (12%) had a CSI by week 14, each with a single target virus. In vivo expansion of functional virus-specific T cells detected via interferon-γ enzyme-linked immunosorbent spot assay was associated with viral control. Persistence of posoleucel-derived T-cell clones for up to 14 weeks after the last infusion was confirmed by T-cell–receptor deep sequencing. Five patients (19%) had acute graft-versus-host disease grade 2 to 4. No patient experienced cytokine release syndrome. All 6 deaths were due to relapse or disease progression. allo-HCT recipients at high risk who received posoleucel had low rates of CSIs from 6 targeted viruses. Repeat posoleucel dosing was generally safe and well tolerated and associated with functional immune reconstitution.

สถานการณ์โรคไม่ติดต่อ และปัจจัยที่สัมพันธ์กับการใช้บริการรักษาพยาบาลในกลุ่มประชากรไทยอายุตั้งแต่ 45 ปี ที่เป็นโรคไม่ติดต่อ: ข้อค้นพบจากโครงการสำรวจด้านสุขภาพ การสูงอายุ และการเกษียณในประเทศไทย 2564 (Health, Aging, And Retirement In Thailand 2021: Hart 2021), Arnat Wannasri

Journal of Demography

บทคัดย่อ

การวิจัยนี้มีวัตถุประสงค์เพื่อการศึกษาสถานการณ์โรคไม่ติดต่อและปัจจัยที่สัมพันธ์กับการใช้บริการรักษาพยาบาลแบบผู้ป่วยนอกและผู้ป่วยใน ในประชากรไทยอายุตั้งแต่ 45 ปีขึ้นไป โดยการใช้ข้อมูลจากโครงการสำรวจด้านสุขภาพ การสูงอายุ และการเกษียณในประเทศไทย (Health, Aging, and Retirement in Thailand: HART) รอบที่ 3 ปี พ.ศ. 2564 เป็นการวิจัยเชิงวิเคราะห์แบบภาคตัดขวาง (cross-sectional analytical study) ผลการวิจัยพบว่า ปัจจัยด้านอายุ เพศ สถานภาพสมรส การศึกษา การสูบบุหรี่ สถานะสุขภาพกาย สถานะสุขภาพจิต ภูมิภาค และสิทธิหลักประกันสุขภาพ สัมพันธ์กับการเจ็บป่วยด้วยโรคไม่ติดต่อ ยกเว้นการออกกำลังกาย สำหรับการใช้บริการรักษาพยาบาล พบว่า ผู้ที่ป่วยด้วยโรคไม่ติดต่อตั้งแต่ 2 โรคขึ้นไป มีโอกาสในการใช้บริการรักษาพยาบาล จำนวนครั้ง (กรณีผู้ป่วยนอกและผู้ป่วยใน) และจำนวนวันนอนรักษาในโรงพยาบาล (กรณีผู้ป่วยใน) สูงกว่าผู้ที่ป่วยด้วยโรคไม่ติดต่อเพียง 1 โรค ปัจจัยที่สัมพันธ์กับการใช้บริการรักษาพยาบาลผู้ป่วยนอก ได้แก่ ปัจจัยด้านการออกกำลังกาย สถานะสุขภาพจิต และภูมิภาค ในขณะที่บริการรักษาพยาบาลผู้ใน พบว่า การเจ็บป่วยด้วยโรคไม่ติดต่อตั้งแต่ 2 โรคขึ้นไป อายุ และสถานะสุขภาพกาย สัมพันธ์กับการใช้บริการรักษาพยาบาลผู้ป่วยใน นอกจากนี้แล้ว การวิจัยนี้ไม่พบว่า สิทธิหลักประกันสุขภาพที่แตกต่างกันสัมพันธ์กับการใช้บริการรักษาพยาบาลทั้งผู้ป่วยนอกและผู้ป่วยในที่แตกต่างกัน ข้อค้นพบจากการวิจัยนี้สามารถนำไปใช้ประโยชน์ในการกำหนดนโยบายสาธารณสุขด้านโรคไม่ติดต่อและเพื่อพัฒนาระบบสาธารณสุขของประเทศไทยต่อไปได้

Abstract

This research aimed to study the situation on noncommunicable diseases (NCDs) and the factors associated with outpatient and inpatient care utilization among the Thai population aged 45 and older using the Health, Aging, …

Understanding And Addressing Statistics Anxiety, Hairui Liu

AI Assignment Library

This assignment is a critical first step in understanding the psychological barriers that students may face when learning statistics. It acknowledges the prevalence of statistics anxiety and its potential impact on academic success. The reflection is intended to be a safe space for students to express their concerns, with the ultimate goal of creating a more supportive and effective learning environment. By sharing their experiences, students contribute to the development of strategies that can help them and their peers navigate the challenges of statistics with greater confidence.

Pickup: Survey Of People Experiencing Homelessness In New Mexico, Summary Report, Kimberly Page, Christina E. Phillips, Annemarie Madaras, University Of New Mexico Health Sciences Center Department Of Internal Medicine

Epidemiology, Biostatistics, and Preventive Medicine

The PICKUP Project represents a comprehensive effort to ascertain the needs and conditions of unhoused populations in New Mexico, engaging a partnership network that spans academic institutions, community health services, and government bodies. The PICKUP Study aims to provide actionable data to inform targeted interventions by community and public health groups, clinical organizations, and academic institutions.

Project participants included the University of New Mexico Health Sciences Center (Dr. Kimberly Page, PI); Alianza of New Mexico, Roswell, Chavez County, NM; Interfaith Community Shelter, Santa Fe, Santa Fe County, NM; Four Corners Detox Recovery & Santa Fe Recovery Center, Gallup, McKinley County, …

Design And Implementation Of An Opioid Scorecard For Hospital System-Wide Peer Comparison Of Opioid Prescribing Habits: Observational Study, Benjamin Slovis, Soonyip Huang, Melanie Mcarthur, Cara Martino, Tasia Beers, Meghan Labella, Jeffrey Riggio, Edmund Pribitkin

Jefferson Hospital Staff Papers and Presentations

BACKGROUND: Reductions in opioid prescribing by health care providers can lead to a decreased risk of opioid dependence in patients. Peer comparison has been demonstrated to impact providers' prescribing habits, though its effect on opioid prescribing has predominantly been studied in the emergency department setting.

OBJECTIVE: The purpose of this study is to describe the development of an enterprise-wide opioid scorecard, the architecture of its implementation, and plans for future research on its effects.

METHODS: Using data generated by the author's enterprise vendor-based electronic health record, the enterprise analytics software, and expertise from a dedicated group of informaticists, physicians, and …

An Analysis Of Flavor Descriptors On Tobacco Products In The Philippines: Regulatory Implications And Lessons For Low- And Middle-Income Countries, Samantha J. Ackary, Patrick James Cabrera, Alen Josef A. Santiago, Gianna Gayle H. Amul

Ateneo School of Government Publications

Background

Historically, tobacco companies have used flavored tobacco products to enhance the appeal of tobacco consumption, encourage initiation and experimentation of tobacco use, and contribute to sustained tobacco use. While flavored tobacco products are regulated in several countries, there is no existing regulation on flavored tobacco products in the Philippines, specifically for cigarettes and cigars. This study aims to update evidence on the flavored tobacco product landscape in the Philippines by assessing both the flavor descriptors and flavor imagery featured on cigarette and cigar packaging.

Results

We collected 106 cigarette and cigar products from four major cities in the National …

A Case Demonstration Of The Open Health Natural Language Processing Toolkit From The National Covid-19 Cohort Collaborative And The Researching Covid To Enhance Recovery Programs For A Natural Language Processing System For Covid-19 Or Postacute Sequelae Of Sars Cov-2 Infection: Algorithm Development And Validation, Andrew Wen, Liwei Wang, Huan He, Sunyang Fu, Sijia Liu, David A Hanauer, Daniel R Harris, Ramakanth Kavuluru, Rui Zhang, Karthik Natarajan, Nishanth P Pavinkurve, Janos Hajagos, Sritha Rajupet, Veena Lingam, Mary Saltz, Corey Elowsky, Richard A Moffitt, Farrukh M Koraishy, Matvey B Palchuk, Jordan Donovan, Lora Lingrey, Garo Stone-Derhagopian, Robert T Miller, Andrew E Williams, Peter J Leese, Paul I Kovach, Emily R Pfaff, Mikhail Zemmel, Robert D Pates, Nick Guthe, Melissa A Haendel, Christopher G Chute, Hongfang Liu, National Covid Cohort Collaborative, Recover Initiative

Faculty, Staff and Student Publications

BACKGROUND: A wealth of clinically relevant information is only obtainable within unstructured clinical narratives, leading to great interest in clinical natural language processing (NLP). While a multitude of approaches to NLP exist, current algorithm development approaches have limitations that can slow the development process. These limitations are exacerbated when the task is emergent, as is the case currently for NLP extraction of signs and symptoms of COVID-19 and postacute sequelae of SARS-CoV-2 infection (PASC).

OBJECTIVE: This study aims to highlight the current limitations of existing NLP algorithm development approaches that are exacerbated by NLP tasks surrounding emergent clinical concepts and …

Factors Associated With Early Onset Anal Cancer And Facilitators And Barriers To Screening Among Men Living With Hiv And Their Providers In The Deep South: A Mixed Methods Investigation, Anna Junkins

All ETDs from UAB

For my dissertation work, I aimed to 1) determine the occurrence of early onset (diagnosis at <50 years) anal cancer and the impact of HIV infection and other risk factors, and 2) utilize a mixed methods research approach to identify and explain factors associated with screening among men living with HIV (MLHIV) and their providers. In Aim 1, I used logistic regression to estimate the odds of early onset cancer by sociodemographic and clinical characteristics among anal cancer patients in the Alabama cancer registry from 2012-2018. Among 519 patients, 17.7% were diagnosed at <50 years. Male sex, Black race, and HIV infection were associated with younger age at diagnosis. Black patients had a 4-fold increased odds of early onset anal cancer compared to White patients and disproportionately lived in areas with higher social vulnerability. In Aim 2, I used logistic regression to estimate the odds of anal cancer screening by sociodemographic and sexual risk characteristics among MLHIV using retrospective survey data from 1917 Clinic in 2018. Among 1,114 men, 52% had received an anal pap within one year of completing the survey. Men who were screened were more likely to have multiple sexual partners. Heterosexual men had lower odds and men who reported unprotected anal sex had higher odds of screening. Older Black men were less likely to be screened. In Aim 3, I used thematic analyses to identify themes related to health beliefs, barriers and facilitators, and perceived and evaluated need of screening using in-depth interviews among MLHIV and their providers. Benefits of screening among MLHIV were early detection and awareness about one’s body. Suggestions for overcoming barriers to screening among providers included screening guidelines, patient education, inclusion of screening into routine care, and self-collection. Among men that were aware of HPV-associated cancers, there was perceived risk and desire to receive HPV vaccination. Individuals who are male, Black, or living with HIV may be at increased risk of developing anal cancer younger. Among MLHIV, improving education about HPV-associated cancer, and offering self-collected screening as part of routine care could facilitate screening in the South.

The Association Between Social Connectedness And Opioid Reuse Among Vulnerable Groups Receiving Medication For Opioid Use Disorder, Jolanda Lynn Hudson

All ETDs from UAB

THE ASSOCIATION BETWEEN SOCIAL CONNECTEDNESS AND OPIOID REUSE AMONG VULNERABLE GROUPS RECEIVING MEDICATION FOR OPIOID USE DISORDER JOLANDA L. HUDSON PUBLIC HEALTH ABSTRACT Introduction: Opioid Use Disorder (OUD) is a serious illness that continues to persist despite the many efforts of researchers, physicians, government agencies, state, and local programs, to eliminate the mortality rate associated with this disease. Although manageable, OUD is still taking the lives of citizens due to illegal opioid misuse. Understanding the dynamics of the disease and the contributing factors in various populations may inform researchers in successful intervention outcomes. Methods: A retrospective secondary data analysis utilizing …