Public Health Commons^™

Deployment And Travel Medicine Knowledge, Attitudes, Practices, And Outcomes Study (Kapos): Malaria Chemoprophylaxis Prescription Patterns In The Military Health System, Patrick W. Hickey, Indrani Mitra, Jamie Fraser, David Brett-Major, Mark S. Riddle, David R. Tribble

Journal Articles: Epidemiology

The Deployment and Travel Medicine Knowledge, Attitudes, Practices, and Outcomes Study (KAPOS) examines the integrated relationship between provider and patient inputs and health outcomes associated with travel and deployments. This study describes malaria chemoprophylaxis prescribing patterns by medical providers within the U.S. Department of Defense's Military Health System and its network of civilian healthcare providers during a 5-year period. Chemoprophylaxis varied by practice setting, beneficiary status, and providers' travel medicine expertise. Whereas both civilian and military facilities prescribe an increasing proportion of atovaquone-proguanil, doxycycline remains the most prevalent antimalarial at military facility based practices. Civilian providers dispense higher rates of …

Evaluation Of Mitochondrial Dna Copy Number Estimation Techniques, Ryan J Longchamps, Christina A Castellani, Stephanie Y Yang, Charles E Newcomb, Jason A Sumpter, John Lane, Megan L Grove, Eliseo Guallar, Nathan Pankratz, Kent D Taylor, Jerome I Rotter, Eric Boerwinkle, Dan E Arking

Faculty, Staff and Student Publications

Mitochondrial DNA copy number (mtDNA-CN), a measure of the number of mitochondrial genomes per cell, is a minimally invasive proxy measure for mitochondrial function and has been associated with several aging-related diseases. Although quantitative real-time PCR (qPCR) is the current gold standard method for measuring mtDNA-CN, mtDNA-CN can also be measured from genotyping microarray probe intensities and DNA sequencing read counts. to conduct a comprehensive examination on the performance of these methods, we use known mtDNA-CN correlates (age, sex, white blood cell count, Duffy locus genotype, incident cardiovascular disease) to evaluate mtDNA-CN calculated from qPCR, two microarray platforms, as well …

Longitudinal Sensitivity Of Alzheimer's Disease Severity Staging, Julia S Benoit, Wenyaw Chan, Linda Piller, Rachelle Doody

Faculty, Staff and Student Publications

Understanding Alzheimer's disease (AD) dynamics is essential in diagnosis and measuring progression for clinical decision-making; however, clinical instruments are imperfect at classifying true disease stages. This research evaluates sensitivity and determinants of AD stage changes longitudinally using current classifications of "mild," "moderate," and "severe" AD, using Mini-Mental State Examination (MMSE), Alzheimer's Disease Assessment Scale-Cognitive subscale (ADAS-Cog), and the Clinical Dementia Rating-Sum of Boxes (CDR-SB) thresholds. Age and pre-progression rate were significant determinants of AD progression using MMSE alone to stage AD, and pre-progression was found to impact disease progression with CDR-SB. Sensitivity of these instruments for identifying clinical stages of …

Coaching Women On The Impact Of Alcohol Intake On Mental Well-Being: A Systematic Literature Review, Amy Maloney

All Graduate Theses, Dissertations, and Other Capstone Projects

Alcohol intake among women has increased in recent years. Women’s bodies metabolize alcohol differently when compared to men and are at increased risk for adverse effects, both physically and mentally. The purpose of this systematic literature review is to explore the evidence related to the impact of coaching in primary care on drinking behaviors and over-all well-being of women. Four databases including PsycInfo, Academic Search Premier, CINAHL Plus with full text, and Gender Studies Database were searched using a variety of key words. Studies were included if they focused on female alcohol use and abuse, interventions specific to female alcohol …

Covid-19 Sampling From The Middle Ear And Mastoid: A Case Report, George B Wanna, Zachary G Schwam, Vivian F Kaul, Maura K Cosetti, Enrique Perez, Peter Filip, Waleed Javaid, Avi Kandel, Alberto Paniz-Mondolfi, Satish Govindaraj, Eric M Genden

Faculty, Staff and Student Publications

No abstract provided.

The Fms21 (Pila)-Fms20 Locus Encoding One Of Four Distinct Pili Of Enterococcus Faecium Is Harboured On A Large Transferable Plasmid Associated With Gut Colonization And Virulence, Louis Maximilian Buja, Dwayne A Wolf, Bihong Zhao, Bindu Akkanti, Michelle Mcdonald, Laura Lelenwa, Noah Reilly, Giulia Ottaviani, M Tarek Elghetany, Daniel Ocazionez Trujillo, Gabriel M Aisenberg, Mohammad Madjid, Biswajit Kar

Faculty, Staff and Student Publications

This paper collates the pathological findings from initial published autopsy reports on 23 patients with coronavirus disease 2019 (COVID-19) from 5 centers in the United States of America, including 3 cases from Houston, Texas. Findings confirm that COVID-19 is a systemic disease with major involvement of the lungs and heart. Acute COVID-19 pneumonia has features of a distinctive acute interstitial pneumonia with a diffuse alveolar damage component, coupled with microvascular involvement with intra- and extravascular fibrin deposition and intravascular trapping of neutrophils, and, frequently, with formation of microthombi in arterioles. Major pulmonary thromboemboli with pulmonary infarcts and/or hemorrhage occurred in …

Intervention For Cognitive Reserve Enhancement In Delaying The Onset Of Alzheimer's Symptomatic Expression (Increase), A Randomized Controlled Trial: Rationale, Study Design, And Protocol, Daniela C. Moga, Brooke F. Beech, Erin L. Abner, Frederick A. Schmitt, Riham H. El Khouli, Ashley I. Martinez, Lynne Eckmann, Mark Huffmyer, Rosmy George, Gregory A. Jicha

Pharmacy Practice and Science Faculty Publications

BACKGROUND: The course of Alzheimer's disease (AD) includes a 10-20-year preclinical period with progressive accumulation of amyloid β (Aβ) plaques and neurofibrillary tangles in the absence of symptomatic cognitive or functional decline. The duration of this preclinical stage in part depends on the rate of pathologic progression, which is offset by compensatory mechanisms, referred to as cognitive reserve (CR). Comorbid medical conditions, psychosocial stressors, and inappropriate medication use may lower CR, hastening the onset of symptomatic AD. Here, we describe a randomized controlled trial (RCT) designed to test the efficacy of a medication therapy management (MTM) intervention to reduce inappropriate …

Bone-Loading Physical Activity And Alcohol Intake But Not Bmi Affect Areal Bone Mineral Density In Young College-Aged Korean Women: A Cross-Sectional Study., Dong Jun Sung, Harshvardhan Singh, Seung-Bum Oh, Sojung Kim

College of Science & Mathematics Departmental Research

The purpose of this cross-sectional study was to determine the differences in areal bone mineral density (aBMD) based on alcohol consumption behaviors, bone-loading history as assessed by a bone-specific physical activity questionnaire (BPAQ), and the body mass index (BMI). College-aged female students (N = 112) were recruited from the universities in Seoul and Gyeonggi province, South Korea. The aBMD of the lumbar spine and non-dominant side of the proximal femur (total hip, TH; femoral neck, FN; femoral trochanter, FT) were measured using dual energy X-ray absorptiometry (DXA). Alcohol consumption was determined by the frequency and amount of alcohol intake during …

Healthcare Utilization Costs Of Emerging Adults With Mood And Anxiety Disorders In An Early Intervention Treatment Program Compared To A Matched Cohort, Ava A. John-Baptiste, Lihua Li, Wanrudee Isaranuwatchai, Elizabeth Osuch, Kelly K. Anderson

Epidemiology and Biostatistics Publications

AIM: The First Episode Mood and Anxiety Disorder Program (FEMAP) provides treatment to emerging adults with mood and anxiety disorders in an accessible, youth-friendly environment. We sought to investigate FEMAP's impact on the costs of care.

METHODS: We conducted a retrospective observational study of one-year health service costs using linked administrative datasets to compare emerging adults treated at FEMAP (FEMAP users) to propensity-score matched controls (non-users). Costs from the perspective of the Ontario Ministry of Health and Long-Term Care, included drug benefit claims, inpatient, physician and ambulatory care services. We used bootstrapping to perform unadjusted comparisons between FEMAP users and …

Post-Acquisition Processing Confounds In Brain Volumetric Quantification Of White Matter Hyperintensities, Ahmed A. Bahrani, Omar M. Al-Janabi, Erin L. Abner, Shoshana H. Bardach, Richard J. Kryscio, Donna M. Wilcock, Charles D. Smith, Gregory A. Jicha

Neurology Faculty Publications

BACKGROUND: Disparate research sites using identical or near-identical magnetic resonance imaging (MRI) acquisition techniques often produce results that demonstrate significant variability regarding volumetric quantification of white matter hyperintensities (WMH) in the aging population. The sources of such variability have not previously been fully explored.

NEW METHOD: 3D FLAIR sequences from a group of randomly selected aged subjects were analyzed to identify sources-of-variability in post-acquisition processing that can be problematic when comparing WMH volumetric data across disparate sites. The methods developed focused on standardizing post-acquisition protocol processing methods to develop a protocol with less than 0.5% inter-rater variance.

RESULTS: A series …

From Suffrage To The Senate: Expanding Inclusion In Women's Rights To Achieve Women's Health Equality., Frances Grimstad

Manuscripts, Articles, Book Chapters and Other Papers

No abstract provided.

Preliminary Development Of A Questionnaire Measuring Patient Views Of Participation In Clinical Trials, Judith Arnetz, Sukhesh Sudan, Courtney Goetz, Bengt Arnetz, Laura Gowland, Suzanne Manji, Samiran Ghosh

Faculty, Staff and Student Publications

OBJECTIVE: This study aimed to develop a questionnaire for measuring patient perceptions of participating in clinical trials. Development was based on earlier research on patient views of involvement in medical care and a literature review. Patients were recruited from an ongoing clinical trial focused on cardiovascular illness and from an outpatient psychiatry department. Factor analysis was conducted on a pilot version of the questionnaire in 2016 and on a revised version in 2017.

RESULTS: A total of 53 patients were recruited for the pilot study and 55 were recruited for the main study, substantially below the goal of 100 participants. …

Tinnitus And Self-Perceived Hearing Handicap In Firefighters: A Cross-Sectional Study, Samson Jamesdaniel, Kareem G Elhage, Rita Rosati, Samiran Ghosh, Bengt Arnetz, James Blessman

Faculty, Staff and Student Publications

Firefighters are susceptible to auditory dysfunction due to long-term exposure to noise from sirens, air horns, equipment, and tools used in forcible entry, ventilation, and extrication. In addition, they are exposed to ototoxic chemicals, particularly, during overhaul operations. Studies indicate that 40% of firefighters have hearing loss in the noise-sensitive frequencies of 4 and 6 kHz. Noise-induced hearing loss (NIHL) is often accompanied by tinnitus, which is characterized by ringing noise in the ears. The presence of phantom sounds can adversely affect the performance of firefighters. However, there has been limited research conducted on the prevalence of tinnitus in firefighters. …

Differences In Duration Of Untreated Psychosis For Racial And Ethnic Minority Groups With First-Episode Psychosis: An Updated Systematic Review And Meta-Analysis., Nicole Schoer, Chen Wei Huang, Kelly K. Anderson

Epidemiology and Biostatistics Publications

PURPOSE: Ethnic minority groups with early psychosis may have longer treatment delays, potentially leading to poorer outcomes. We updated a previous systematic review of the literature on racial and ethnic differences in duration of untreated psychosis (DUP) among people with first-episode psychosis.

RESULTS: Six of 17 studies described significant differences across aggregated racial groups; however, the pooled estimates did not show differences across groups. Additional data from this update allowed for disaggregated analyses, finding that Black-African groups have a shorter DUP, whereas Black-Caribbean groups have longer DUP, relative to White groups.

CONCLUSIONS: These findings highlight the importance of in-depth research …

Energy Balance Related Lifestyle Factors And Risk Of Endometrial And Colorectal Cancer Among Individuals With Lynch Syndrome: A Systematic Review, Adriana M Coletta, Susan K Peterson, Leticia A Gatus, Kate J Krause, Susan M Schembre, Susan C Gilchrist, Mala Pande, Eduardo Vilar, Y Nancy You, Miguel A Rodriguez-Bigas, Larkin L Strong, Patrick M Lynch, Karen H Lu, Karen Basen-Engquist

Faculty, Staff and Student Publications

Lifestyle factors related to energy balance, such as excess body weight, poor diet, and physical inactivity, are associated with risk of sporadic endometrial cancer (EC) and colorectal cancer (CRC). There are limited data on energy balance-related lifestyle factors and EC or CRC risk among individuals with lynch syndrome, who are at extraordinarily higher risk of developing EC or CRC. We conducted a systematic review of evidence related to weight status, weight change, dietary habits, and physical activity on EC and CRC risk among individuals with lynch syndrome. Findings are reported narratively. We searched Medline, EMBASE, CENTRAL, PubMed, and clinicaltrials.gov up …

Temperature, Placental Abruption And Stillbirth, Amal Rammah, Kristina W Whitworth, Inkyu Han, Wenyaw Chan, Judy Wendt Hess, Elaine Symanski

Faculty, Staff and Student Publications

BACKGROUND: Pregnant women may be vulnerable to changes in ambient temperature and warming climates. Recent evidence suggests that temperature increases are associated with placental abruption, a risk factor for stillbirth.

OBJECTIVES: We investigated the effect of acute exposures to apparent temperature on stillbirths in Harris County, Texas, 2008-2013.

METHODS: We conducted a case-crossover study to investigate the association between temperature and stillbirth among 708 women. We used data from the National Climatic Data Center to estimate maternal exposure to daily average apparent temperature over the days (lag days 1 through 6) preceding the stillbirth event. We employed symmetric bidirectional sampling …

Pm25 Metal Constituent Exposure And Stillbirth Risk In Harris County, Texas, Amal Rammah, Kristina W Whitworth, Inkyu Han, Wenyaw Chan, Elaine Symanski

Faculty, Staff and Student Publications

There is limited evidence on the role of exposure to chemical constituents of fine particulate matter (PM

Vitamin D Status And Risk Of Incident Tuberculosis Disease: A Nested Case-Control Study, Systematic Review, And Individual-Participant Data Meta-Analysis, Omowunmi Aibana, Chuan-Chin Huang, Said Aboud, Alberto Arnedo-Pena, Mercedes C Becerra, Juan Bautista Bellido-Blasco, Ramesh Bhosale, Roger Calderon, Silvia Chiang, Carmen Contreras, Ganmaa Davaasambuu, Wafaie W Fawzi, Molly F Franke, Jerome T Galea, Daniel Garcia-Ferrer, Maria Gil-Fortuño, Barbará Gomila-Sard, Amita Gupta, Nikhil Gupte, Rabia Hussain, Jesus Iborra-Millet, Najeeha T Iqbal, Jose Vicente Juan-Cerdán, Aarti Kinikar, Leonid Lecca, Vidya Mave, Noemi Meseguer-Ferrer, Grace Montepiedra, Ferdinand M Mugusi, Olumuyiwa A Owolabi, Julie Parsonnet, Freddy Roach-Poblete, Maria Angeles Romeu-García, Stephen A Spector, Christopher R Sudfeld, Mark W Tenforde, Toyin O Togun, Rosa Yataco, Zibiao Zhang, Megan B Murray

Faculty, Staff and Student Publications

BACKGROUND: Few studies have evaluated the association between preexisting vitamin D deficiency and incident tuberculosis (TB). We assessed the impact of baseline vitamins D levels on TB disease risk.

METHODS AND FINDINGS: We assessed the association between baseline vitamin D and incident TB in a prospective cohort of 6,751 HIV-negative household contacts of TB patients enrolled between September 1, 2009, and August 29, 2012, in Lima, Peru. We screened for TB disease at 2, 6, and 12 months after enrollment. We defined cases as household contacts who developed TB disease at least 15 days after enrollment of the index patient. …

Blood Leukocyte Dna Methylation Predicts Risk Of Future Myocardial Infarction And Coronary Heart Disease, Golareh Agha, Michael M Mendelson, Cavin K Ward-Caviness, Roby Joehanes, Tianxiao Huan, Rahul Gondalia, Elias Salfati, Jennifer A Brody, Giovanni Fiorito, Jan Bressler, Brian H Chen, Symen Ligthart, Simonetta Guarrera, Elena Colicino, Allan C Just, Simone Wahl, Christian Gieger, Amy R Vandiver, Toshiko Tanaka, Dena G Hernandez, Luke C Pilling, Andrew B Singleton, Carlotta Sacerdote, Vittorio Krogh, Salvatore Panico, Rosario Tumino, Yun Li, Guosheng Zhang, James D Stewart, James S Floyd, Kerri L Wiggins, Jerome I Rotter, Michael Multhaup, Kelly Bakulski, Steven Horvath, Philip S Tsao, Devin M Absher, Pantel Vokonas, Joel Hirschhorn, M Daniele Fallin, Chunyu Liu, Stefania Bandinelli, Eric Boerwinkle, Abbas Dehghan, Joel D Schwartz, Bruce M Psaty, Andrew P Feinberg, Lifang Hou, Luigi Ferrucci, Nona Sotoodehnia, Giuseppe Matullo, Annette Peters, Myriam Fornage, Themistocles L Assimes, Eric A Whitsel, Daniel Levy, Andrea A Baccarelli

Faculty, Staff and Student Publications

BACKGROUND: DNA methylation is implicated in coronary heart disease (CHD), but current evidence is based on small, cross-sectional studies. We examined blood DNA methylation in relation to incident CHD across multiple prospective cohorts.

METHODS: Nine population-based cohorts from the United States and Europe profiled epigenome-wide blood leukocyte DNA methylation using the Illumina Infinium 450k microarray, and prospectively ascertained CHD events including coronary insufficiency/unstable angina, recognized myocardial infarction, coronary revascularization, and coronary death. Cohorts conducted race-specific analyses adjusted for age, sex, smoking, education, body mass index, blood cell type proportions, and technical variables. We conducted fixed-effect meta-analyses across cohorts.

RESULTS: Among …

Information Diffusion And Social Norms Are Associated With Infant And Young Child Feeding Practices In Bangladesh, Phuong H. Nguyen, Edward A. Frongillo Jr., Sunny S. Kim, Amanda A. Zongrone, Amir Jilani, Lan Mai Tran, Tina Sanghvi, Purnima Menon

Faculty Publications

Background

Interaction within mothers’ social networks can theoretically diffuse messages from interventions and campaigns into norms and practices for infant and young child feeding (IYCF).

Objectives

We hypothesized that mothers’ social networks, diffusion of information, and social norms differed in intensive [intensive interpersonal counseling (IPC), community mobilization (CM), and mass media (MM)] compared with nonintensive (standard IPC and less-intensive CM and MM) intervention areas, were associated with IYCF practices, and partly explained practice improvement.

Methods

We conducted household surveys at endline in 2014 and follow-up in 2016 (n = ∼2000 each round). We used multiple regression to test differences …

Effectiveness Of High-Intensity Interval Training For Fitness And Mobility Post Stroke: A Systematic Review., Joshua C. Wiener, Amanda Mcintyre, Scott Janssen, Jeffrey Ty Chow, Cristina Batey, Robert Teasell

Epidemiology and Biostatistics Publications

OBJECTIVE: To evaluate the evidence on the effectiveness of high-intensity interval training (HIIT) in improving fitness and mobility post stroke. TYPE: Systematic review.

LITERATURE SURVEY: Medline, Embase, CINAHL, PsycINFO, and Scopus were searched for articles published in English up to January 2018.

METHODOLOGY: Studies were included if the sample was adult human participants with stroke, the sample size was ≥3, and participants received >1 session of HIIT. Study and participant characteristics, treatment protocols, and results were extracted.

SYNTHESIS: Six studies with a total of 140 participants met inclusion criteria: three randomized controlled trials and three pre-post studies. HIIT protocols ranged …

Do Employees From Less-Healthy Communities Use More Care And Cost More? Seeking To Establish A Business Case For Investment In Community Health., Russell K. Mcintire, Martha C. Romney, Greg Alonzo, Jill Hutt, Lauren Bartolome, Greg Wood, Gary Klein, Neil I. Goldfarb

College of Population Health Faculty Papers

INTRODUCTION: Few studies have examined the impact of community health on employers. We explored whether employed adults and their adult dependents living in less-healthy communities in the greater Philadelphia region used more care and incurred higher costs to employers than employees from healthier communities.

METHODS: We used a multi-employer database to identify adult employees and dependents with continuous employment and mapped them to 31 zip code regions. We calculated community health scores at the regional level, by using metrics similar to the Robert Wood Johnson Foundation (RWJF) County Health Rankings but with local data. We used descriptive analyses and multilevel …

Hospital Readmission Of Adolescents And Young Adults With Complex Chronic Disease., Peter Dunbar, Matt Hall, James C. Gay, Clarissa Hoover, Jessica L. Markham, Jessica L. Bettenhausen, James M. Perrin, Karen A. Kuhlthau, Morgan Crossman, Brigid Garrity, Jay G. Berry

Manuscripts, Articles, Book Chapters and Other Papers

Importance: Adolescents and young adults (AYA) who have complex chronic disease (CCD) are a growing population that requires hospitalization to treat severe, acute health problems. These patients may have increased risk of readmission as demands on their self-management increase and as they transfer care from pediatric to adult health care practitioners.

Objective: To assess variation across CCDs in the likelihood of readmission for AYA with increasing age.

Design, Setting, and Participants: Retrospective 1-year cross-sectional study of the 2014 Agency for Healthcare Research and Quality Nationwide Readmissions Database for all US hospitals. Participants were 215 580 hospitalized individuals aged 15 to …

Parenting Styles Are Associated With Overall Child Dietary Quality Within Low-Income And Food-Insecure Households, Michael P. Burke, Sonya J. Jones, Edward A. Frongillo Jr., Christine E. Blake, Maryah S. Fram

Faculty Publications

Objective: To examine the association between parenting styles and overall child dietary quality within households that are low-income and food-insecure.

Design: Child dietary intake was measured via a 24 h dietary recall. Dietary quality was assessed using the Healthy Eating Index-2005 (HEI-2005). Parenting styles were measured and scored using the Parenting Styles and Dimensions Questionnaire. Linear regressions were used to test main and interaction associations between HEI-2005 scores and parenting styles.

Setting: Non-probability sample of low-income and food-insecure households in South Carolina, USA.

Participants: Parent–child dyads (n 171). Parents were ≥18 years old and children were …

An Integrative Cross-Omics Analysis Of Dna Methylation Sites Of Glucose And Insulin Homeostasis, Jun Liu, Elena Carnero-Montoro, Jenny Van Dongen, Samantha Lent, Ivana Nedeljkovic, Symen Ligthart, Pei-Chien Tsai, Tiphaine C. Martin, Pooja R. Mandaviya, Rick Jansen, Marjolein J. Peters, Liesbeth Duijts, Vincent W. V. Jaddoe, Henning Tiemeier, Janine F. Felix, Gonneke Willemsen, Eco J. C. De Geus, Audrey Y. Chu, Daniel Levy, Shih-Jen Hwang, Jan Bressler, Rahul Gondalia, Elias L. Salfati, Christian Herder, Bertha A. Hidalgo, Toshiko Tanaka, Ann Zenobia Moore, Rozenn N. Lemaitre, Min A. Jhun, Jennifer A. Smith, Donna K. Arnett

Epidemiology and Environmental Health Faculty Publications

Despite existing reports on differential DNA methylation in type 2 diabetes (T2D) and obesity, our understanding of its functional relevance remains limited. Here we show the effect of differential methylation in the early phases of T2D pathology by a blood-based epigenome-wide association study of 4808 non-diabetic Europeans in the discovery phase and 11,750 individuals in the replication. We identify CpGs in LETM1, RBM20, IRS2, MAN2A2 and the 1q25.3 region associated with fasting insulin, and in FCRL6, SLAMF1, APOBEC3H and the 15q26.1 region with fasting glucose. In silico cross-omics analyses highlight the role of differential methylation …

Involuntary Hospitalization Among Young People With Early Psychosis: A Population-Based Study Using Health Administrative Data., Rebecca Rodrigues, Arlene G Macdougall, Guangyong Zou, Michael Lebenbaum, Paul Kurdyak, Lihua Li, Salimah Z Shariff, Kelly K Anderson

Epidemiology and Biostatistics Publications

OBJECTIVE: Early psychosis is an important window for establishing long-term trajectories. Involuntary hospitalization during this period may impact subsequent service engagement in people with newly diagnosed psychotic disorder. However, population-based studies of involuntary hospitalization in early psychosis are lacking. We sought to estimate the proportion of people aged 16 to 35 years with early psychosis in Ontario who are hospitalized involuntarily at first admission, and to identify the associated risk factors and outcomes.

METHODS: Using linked population-based health administrative data, we identified incident cases of non-affective psychosis over a five-year period (2009-2013) and followed cases for two years to ascertain …

Comparison Of Methods Used To Estimate The Global Burden Of Disease Related To Undernutrition And Suboptimal Breastfeeding, Alexander C. Mclain, Edward A. Frongillo Jr., Sonja Y. Hess, Ellen G. Piwoz

Faculty Publications

The Global Burden of Disease study (GBD) is an ambitious effort to estimate the disease burden attributable to various risk factors. The results from the GBD are used around the world to monitor the UN established Sustainable Development Goals, set health policies and research strategies, among others. The GBD along with other studies, such as those from the Maternal Child Epidemiology Estimation Group and the Lancet Breastfeeding Series Group, produce estimates of the nutrition-related global burden of disease that exhibit considerable differences. These differences are difficult to reconcile due to the estimation methods, which in recent years have substantially increased …

Pre-Operative Risk Of Medical Complications Varies By Health Insurance Carrier In Moderately Obese Women: Medicaid V Medicare V Private V Self-Pay, Paul Osterdahl, Melissa Gott, Amanda Sundling, Gus J. Slotman

Rowan-Virtua Research Day

Introduction: Clinical variation by health insurance status in mixed sex bariatric surgery populations is reported, but such variation among moderately obese women is unknown.

Objective: to identify pre-operative variation by health insurance in female surgical patients.

Conclusions: Pre-operative characteristics of moderately obese women vary by insurance. Medicare’s highest risk for cardiopulmonary problems and diabetes, and Medicaid’s highest asthma, abdominal-hepatobiliary, and psychological/behavioral complications should be considered in managing moderately obese women subscribing to these carriers.

Perspective: Challenges In Use Of Adolescent Anthropometry For Understanding The Burden Of Malnutrition, Alison Tumilowicz, Ty Beal, Lynnette M. Neufeld, Edward A. Frongillo Jr.

Faculty Publications

Improving nutritional status during adolescence is an opportunity to improve the lives of this generation and the next. Estimating the burden of malnutrition at a population level is fundamental to targeting interventions and measuring progress over time, and for adolescents, we usually depend on survey data and the 2007 WHO Growth Reference to do so. There is substantial risk of misguided conclusions regarding adolescent prevalence estimates, however, when underlying methodological limitations of the indicators and reference are not adequately considered. We use national prevalence estimates among girls and young women 10-22 y of age from the 2014 State of Food …

Evaluation Of A Tennessee Statewide Initiative To Reduce Early Elective Deliveries Using Quasi-Experimental Methods, Michael P. Thompson, Ilana Graetz, Caitlin N. Mckillop, Peter H. Grubb, Teresa M. Waters

Health Management and Policy Faculty Publications

Background: Concerted quality improvement (QI) efforts have been taken to discourage the practice of early elective deliveries (EEDs), but few studies have robustly examined the impact of directed QI interventions in reducing EED practices. Using quasi-experimental methods, we sought to evaluate the impact of a statewide QI intervention to reduce the practice of EEDs.

Methods: Retrospective cohort study of vital records data (2007 to 2013) for all singleton births occurring ≥36 weeks in 66 Tennessee hospitals grouped into three QI cohorts. We used interrupted-time series to estimate the effect of the QI intervention on the likelihood of an EED birth …