Health Services Research Commons^™

A Narrative Review Of Sex And Gender Differences In Sleep Disordered Breathing: Gaps And Opportunities, Margaret Bublitz, Nour Adra, Leen Hijazi, Fidaa Shaib, Hrayr Attarian, Ghada Bourjeily

Faculty, Staff and Students Publications

Introduction: Sleep disordered breathing (SDB) is a common condition, associated with multiple comorbidities including cardiovascular and metabolic disease. It has been previously established that SDB is more prevalent in men than women, shifting the literature's focus away from the latter population. As such, underdiagnosis, and thus undertreatment, of SDB in women exists.

Methods: To establish the differences in prevalence, clinical presentation, and pathophysiology of SDB between the two sexes, a narrative review of the current literature was performed.

Results: Rates of SDB are higher among men, likely driven by differences in symptom presentation between men and women, with women presenting …

Loss Of Wnt4 In The Gubernaculum Causes Unilateral Cryptorchidism And Fertility Defects, Abhishek Seth, Juan C Bournat, Olga Medina-Martinez, Armando Rivera, Joshua Moore, Hunter Flores, Jill A Rosenfeld, Liya Hu, Carolina J Jorgez

Faculty, Staff and Students Publications

Undescended testis (UDT) affects 6% of male births. Despite surgical correction, some men with unilateral UDT may experience infertility with the contralateral descended testis (CDT) showing no A-dark spermatogonia. To improve our understanding of the etiology of infertility in UDT, we generated a novel murine model of left unilateral UDT. Gubernaculum-specific Wnt4 knockout (KO) mice (Wnt4-cKO) were generated using retinoic acid receptor β2-cre mice and were found to have a smaller left-unilateral UDT. Wnt4-cKO mice with abdominal UDT had an increase in serum follicle-stimulating hormone and luteinizing hormone and an absence of germ cells in the undescended testicle. Wnt4-cKO mice …

Effects Of Α And Β-Adrenergic Signaling On Innate Immunity And Porphyromonas Gingivalis Virulence In An Invertebrate Model, Renata Mendonça Moraes, Maíra Terra Garcia, Fabio Stossi, Patrícia Pimentel De Barros, Juliana Campos Junqueira, Ana Lia Anbinder

Faculty, Staff and Students Publications

To investigate the role of adrenergic signalling (AS) in the host immune response and Porphyromonas gingivalis virulence, we compared norepinephrine (NE) and isoproterenol (ISO) responses in Galleria mellonella. P. gingivalis infection was evaluated by survival; humoral immune responses (i.e. melanization and cecropin and gloverin mRNA expression); cellular immune responses (i.e. haemocyte count, nodulation by histology); and P. gingivalis recovery (CFU/mL). P. gingivalis was cultivated in the presence of ISO (PgISO) or NE and injected into the larvae for survival evaluation. Finally, we co-injected ISO and PgISO to evaluate the concomitant effects on the immune response and bacterial virulence. None …

Should All Car-T Therapy For Acute Lymphoblastic Leukemia Be Consolidated With Allogeneic Stem Cell Transplant?, Alejandro Marinos, Helen E Heslop

Faculty, Staff and Students Publications

Autologous T cells genetically modified with a CD19 chimeric antigen receptor are an effective therapy for children and adults with relapsed or refractory acute lymphoblastic leukemia with initial response rates ranging from 70 to 85%. Unfortunately, about half of these responding patients will subsequently relapse raising the question of whether allogeneic hemopoietic stem cell transplant should be considered as a consolidative therapy. Currently efforts are focused on defining risk factors for relapse to try and develop algorithms predicting which patients may benefit from allogenic transplant.

Human Islet Amyloid Polypeptide (Hiapp) Protofibril-Specific Antibodies For Detection And Treatment Of Type 2 Diabetes, Angelina S Bortoletto, W Vallen Graham, Gabriella Trout, Alessandra Bonito-Oliva, Manija A Kazmi, Jing Gong, Emily Weyburne, Brandy L Houser, Thomas P Sakmar, Ronald J Parchem

Faculty, Staff and Students Publications

Type 2 diabetes mellitus (T2D) is a major public health concern and is characterized by sustained hyperglycemia due to insulin resistance and destruction of insulin-producing β cells. One pathological hallmark of T2D is the toxic accumulation of human islet amyloid polypeptide (hIAPP) aggregates. Monomeric hIAPP is a hormone normally co-secreted with insulin. However, increased levels of hIAPP in prediabetic and diabetic patients can lead to the formation of hIAPP protofibrils, which are toxic to β cells. Current therapies fail to address hIAPP aggregation and current screening modalities do not detect it. Using a stabilizing capping protein, monoclonal antibodies (mAbs) can …

The Us Department Of Veterans Affairs Science And Health Initiative To Combat Infectious And Emerging Life-Threatening Diseases (Va Shield): A Biorepository Addressing National Health Threats, John B Harley, Saiju Pyarajan, Elizabeth S Partan, Lauren Epstein, Jason A Wertheim, Abhinav Diwan, Christopher W Woods, Victoria Davey, Sharlene Blair, Dennis H Clark, Kenneth M Kaufman, Shagufta Khan, Iouri Chepelev, Alexander Devine, Perry Cameron, Monica F Mccann, Mary Cloud B Ammons, Devin D Bolz, Jane K Battles, Jeffrey L Curtis, Mark Holodniy, Vincent C Marconi, Charles D Searles, David O Beenhouwer, Sheldon T Brown, Jonathan P Moorman, Zhi Q Yao, Maria C Rodriguez-Barradas, Shyam Mohapatra, Osmara Y Molina De Rodriguez, Emerson B Padiernos, Eric R Mcindoo, Emily Price, Hailey M Burgoyne, Ian Robey, Dawn C Schwenke, Carey L Shive, Ronald M Przygodzki, Rachel B Ramoni, Holly K Krull, Robert A Bonomo

Faculty, Staff and Students Publications

Background: The coronavirus disease 2019 (COVID-19) pandemic, caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has demonstrated the need to share data and biospecimens broadly to optimize clinical outcomes for US military Veterans.

Methods: In response, the Veterans Health Administration established VA SHIELD (Science and Health Initiative to Combat Infectious and Emerging Life-threatening Diseases), a comprehensive biorepository of specimens and clinical data from affected Veterans to advance research and public health surveillance and to improve diagnostic and therapeutic capabilities.

Results: VA SHIELD now comprises 12 sites collecting de-identified biospecimens from US Veterans affected by SARS-CoV-2. In addition, 2 …

Impact Of Instrumental Support From Family On Medication Adherence Among Tuberculosis Patients, Astuti Yuni Nursasi, Mega Hasanul Huda, Syifa Widya Rahmasari

Kesmas

Instrumental support is concrete and tangible, for instance, helping to provide food or accompanying patients to health care facilities. However, its impact on medication adherence among tuberculosis patients in Indonesia needs to be explored. This study aimed to examine the impact of instrumental support from family on tuberculosis patients’ adherence to medication in Bogor City, West Java Province, Indonesia. A cross-sectional study involving 106 participants with an age average of 39.7 (SD = 14.9) was conducted in 12 primary health care (PHC). The independent variables (age, sex, education, employment status, wealth index, and the distance between home and PHC) of …

Factors Associated With Depression Among Type 2 Diabetes Mellitus Patients At A Tertiary Hospital During The Covid-19 Pandemic, Muhammad Ikhsan Mokoagow, Dian Pitawati, Ditya Nona Arisandy, Nadya Magfira, Pratiwi Indah Palupi, Jerry Nasarudin, Marina Epriliawati, Ida Ayu Kshanti

Kesmas

Diabetes mellitus is a metabolic disorder characterized by chronic hyperglycemia that can cause various complications, economic burdens, and psychosocial issues that eventually lead to depression. This study aimed to describe the prevalence of depression among type 2 diabetes mellitus patients in the Internal Medicine Outpatient Clinic of a South Jakarta tertiary hospital during the COVID-19 pandemic. This cross-sectional study was conducted from May to July 2021. The data were collected consecutively from 100 patients aged 18 years or older who came for regular consultation. The instrument used for determining depression is Beck Depression Inventory-II. The prevalence of depression, a correlation …

Lessons Learned: Covid-19 In Post-Corrections Secured Behavioral Rehabilitation, Jennifer G. Jones, Maria Devalpine, Erica J. Lewis

Virginia Journal of Public Health

Background: The COVID-19 case rate on June 5, 2020, for prisoners in the United States (US) was 5.5 times higher than the US population case rate (Saloner et al., 2020). Secure facilities were challenged to mitigate the spread of COVID-19. One secure behavioral rehabilitation facility made many changes to facility and program protocols to meet this challenge.

Methods: The purpose of this program evaluation was to assess newly implemented infection control measures at a secure behavioral rehabilitation facility and to inform policy and procedure recommendations for the mitigation of COVID-19 transmission in congregate living facilities in the future. Case rates, …

Routine Immunization Coverage And Immunization Card Retention In Pakistan: Results From A Cross-Sectional National Survey, Imtiaz Hussain, Ahmad Khan, Dale A. Rhoda, Imran Ahmed, Muhammad Umer, Uzair Ansari, Muhammad Akram Shah, Soofia Yunus, Sajid Bashir Soofi, Zulfiqar Ahmed Bhutta

Department of Paediatrics and Child Health

Background: Immunization is one of the most successful public health interventions available, saving millions of lives from death and disability each year. Therefore, improving immunization coverage is a high priority for the Government of Pakistan and essential to progress toward universal health coverage. This survey reports the national and provincial/regional coverage and determinants of fully, partially, and not-vaccinated children aged 12–23 months, antigen-wise coverage, percentage of home-based vaccination records (HBR) retention, and reasons for nonretention; dropout, timeliness, and prevalence of missed opportunities for simultaneous vaccination (MOSV).
Methods: The survey was a descriptive cross-sectional national household survey carried out across Pakistan. …

Temporal Regulation Of Notch Activation Improves Arteriovenous Fistula Maturation, Qunying Guo, Guang Chen, Hunter Cheng, Ying Qing, Luan Truong, Quan Ma, Yun Wang, Jizhong Cheng

Faculty, Staff and Students Publications

Background: Arteriovenous fistula (AVF) maturation is a process involving remodeling of venous arm of the AVFs. It is a challenge to balance adaptive AVF remodeling and neointima formation. In this study we temporally controlled Notch activation to promote AVF maturation while avoiding neointima formation.

Methods: Temporal Notch activation was controlled by regulating the expression of Notch transcription factor, RBP-Jκ, or dnMAML1 (dominant negative MAML2) in vascular smooth muscle cells (VSMCs). AVF mouse model was created and VSMC phenotype dynamic changes during AVF remodeling were determined.

Results: Activated Notch was found in the nuclei of neointimal VSMCs in AVFs from uremic …

Using A Human-Centered, Mixed Methods Approach To Understand The Patient Waiting Experience And Its Impact On Medically Underserved Populations, Elizabeth N. Liao, Lara Z. Chehab, Kathryn Neville, Jennifer Liao, Devika Patel, Amanda Sammann

Department of Emergency Medicine Faculty Papers

Purpose: To use a mixed methods approach to investigate the patient waiting experience for a medically underserved population at an outpatient surgical clinic.

Methods: We used lean methodology to perform 96 time-tracked observations of the patient journey in clinic, documenting the duration of activities from arrival to departure. We also used human-centered design (HCD) to perform and analyze 43 semi-structured interviews to understand patients’ unmet needs.

Results: Patients spent an average of 68.5% of their total clinic visit waiting to be seen. While the average visit was 95.8minutes, over a quarter of visits (27%) were over 2hours. Patients waited an …

Health Services Survey, Doan (Delaney) Le, Hannah Gries, Cassandra Roy, Lesley Rabago, Franzelle Macaspac

Nursing Leadership in Community Engagement Projects

Health Services Survey

The agency we partnered with is a nonprofit organization committed to serving the needs of women and their families who are experiencing unstable or absent housing. They help to provide emergency shelter to families across five locations in the Seattle area and provide services surrounding housing, healthcare, employment, and community. They also have specialty programs aimed at providing services to children who are medically fragile and require specialized care, and families who have recently given birth and are still in the recovery and bonding stages. All this work is delivered with the values of love, equity, stewardship, …

Screening For Social Determinants Of Health To Improve Care In Pediatric Patients With Recurrent Urinary Tract Infections: A Scoping Review, Emily Gray Msn, Fnp-C, Michelle Rickard Dnp, Cpnp-Ac

Doctor of Nursing Practice Projects

Purpose: To describe what is known about how SDoH screening impacts adherence to treatment in pediatric patients with recurrent UTIs.

Exploring Stakeholders' Experiences And Perceptions Regarding Barriers To Effective Surveillance Of Communicable Diseases In A Rural District Of Pakistan: A Qualitative Study, Imran Naeem Abbasi, Sameen Siddiqi, Mmna Rehana Sididiqui, Rumina Hasan

Community Health Sciences

Objective: To explore the experiences and perceptions of health system stakeholders of a rural district of Sindh, Pakistan regarding the barriers to effective surveillance of communicable diseases.
Design: This qualitative descriptive exploratory design comprised in-depth interviews. Both inductive and deductive thematic analysis was applied to identify key themes from the data.
Settings: The study was conducted in public sector healthcare facilities and the district health office of the rural district of Thatta, in Sindh province, Pakistan.
Participants: Fifteen healthcare managers and healthcare providers working in the eight public sector primary and secondary healthcare facilities were interviewed using an open-ended in-depth …

Whistleblowing As An Anti-Corruption Strategy In Health And Pharmaceutical Organizations: A Scoping Review Protocol., Taryn Vian, Brianna Agnew Mph, Keith Mcinnes Jr

Nursing and Health Professions Faculty Research and Publications

Background

Whistleblowing can bring suspected wrongdoing to the attention of someone who is in the position to rectify the problem. Whistleblowing research can help improve effectiveness of anti-corruption efforts in the health sector.

Objective

The objective of this scoping review is to understand the extent and type of evidence on whistleblowing as an anti-corruption strategy in health and pharmaceutical organizations in low- and middle-income countries (LMICs).

Methods

This scoping review searched the PubMed, Scopus, and EMBASE databases from 2005 to 2020, limited to English language. We also searched websites of multilateral agencies or international non-governmental organizations for policy documents, guidance …

Public Satisfaction With Covid-19 Vaccination Program In Saudi Arabia, Muhammad Waseem Shahzad, Adel Al-Shabaan, Ammar Mattar, Bilal Salameh, Eman M. Alturaiki, Waleed A. Alqarni, Khalid A. Alharbi, Turki M. Alhumaidany

Patient Experience Journal

The challenges posed by the ongoing COVID-19 pandemic have required the introduction of new care delivery models and procedures. For the foreseeable future, vaccine administration will be a key part of the patient experience journey. It is important therefore to understand and evaluate experiences of individuals taking the vaccination, an area which requires considerable attention. To address this, the COVID-19 Vaccination Satisfaction survey was developed and administered at several healthcare facilities across Saudi Arabia. Between January 2021 and end of December 2021, a total of 1,699,177 completed surveys were collected. The survey results suggest high satisfaction among participants taking the …

Going From An Academic Medical Center To A Community Hospital: Patient Experiences With Transfers, Alexander Kazberouk, Nicole Boyd, Sandra Oreper, Michael Chang, James D. Harrison, Priya A. Prasad, Ari Hoffman

Patient Experience Journal

Academic medical centers (AMCs) often operate at or near full capacity, which leads to delays in care while smaller community hospitals may have excess capacity. To address this issue and to match patient needs to care acuity, patients may be transferred from an AMC emergency department for direct admission to a community hospital. We aimed to explore the experiences and perspectives of patients who were transferred. We randomly selected patients transferred between February 2019 and February 2020. We conducted structured thirty-minute interviews containing fixed response and open-ended questions focusing on the transfer rationale and experience, care quality, and patient financial …

Determinants Of Ambulatory Patients’ Satisfaction With Encounter At Core Service Stations In A Tertiary Hospital Of A Developing Country, Ndubuisi Emuka Opurum, Ogaji Samuel Daprim, Felix Emeka Anyiam

Patient Experience Journal

Patients may have different and complex convictions of what their idea of satisfaction is, which may not be addressed regarding what they perceive as satisfaction. Therefore, using the patients’ demographic and clinical characteristics could tailor the individual needs of these patients, hence, providing feedback and recommendations on improvement in services provided. This study examined the determinants of patients’ satisfaction with general outpatient department (GOPD) services of a tertiary hospital in Rivers State, Nigeria. A descriptive cross-sectional study was carried out among new and repeat patients attending the GOPD of the University of Port-Harcourt Teaching Hospital, Rivers State, Nigeria. A structured …

Patient Experience Of The Electronic Health Record (Ehr) In A Maternity Unit In Ireland, Joye Mckernan, Paul Corcoran Dr, Richard A. Greene Professor

Patient Experience Journal

The introduction of the Electronic Health Records (EHRs) for maternity services in Ireland provided an opportunity to examine patient satisfaction and to examine what patients require from an Electronic Health Record. The implementation of the EHR in Ireland started in 2016, and at present, four of the 19 maternity units are digital. Patients at antenatal booking visits in an Irish maternity unit were invited to participate in the project. The invite was taken up by 201 women. The survey took 10-15 minutes to complete. The survey was conducted nine months following the implementation of the MN-CMS. The survey was anonymous …

Secreted Fas Decoys Enhance The Antitumor Activity Of Engineered And Bystander T Cells In Fas Ligand-Expressing Solid Tumors, Pradip Bajgain, Alejandro G Torres Chavez, Kishore Balasubramanian, Lindsey Fleckenstein, Premal Lulla, Helen E Heslop, Juan Vera, Ann M Leen

Faculty, Staff and Students Publications

T-cell immunotherapy has demonstrated remarkable clinical outcomes in certain hematologic malignancies. However, efficacy in solid tumors has been suboptimal, partially due to the hostile tumor microenvironment composed of immune-inhibitory molecules. One such suppressive agent abundantly expressed in solid tumors is Fas ligand (FasL), which can trigger apoptosis of Fas-expressing effector cells such as T cells and natural killer (NK) cells. To alleviate this FasL-induced suppression of tumor-specific immune cells in solid tumors, we describe here the development of a Fas decoy that is secreted by engineered cells upon activation and sequesters the ligand, preventing it from engaging with Fas on …

Evidence Review Peer Support And Peer Delivered Service, Roxanne Marsillo, Lizzie Fussell

Articles, Abstracts, and Reports

No abstract provided.

Patterns Of Health Care Use Among Rural-Urban Medicare Beneficiaries Age 85 And Older, 2010-2017, Yvonne Jonk Phd, Heidi O'Connor Ms, Amanda Burgess Mppm, Carly Milkowski Mph

Access / Insurance

The purpose of this study was to examine rural-urban differences in health care use among Medicare beneficiaries age 85+. Understanding these differences, and the socioeconomic characteristics that contribute to them, can have important implications for Medicare policies aimed at serving the age 85+ population. Using the Medicare Current Beneficiary Survey 2010-13 Cost and Use and 2015-17 Cost Supplement Files, we examined whether and how rural and urban Medicare beneficiaries age 85+ differ in terms of their:

1. socioeconomic and health characteristics that may inform health care use;
2. trends in health care use, including use of inpatient and emergency department (ED) care; …

Choosing And Switching Biological Agents In Severe Asthma, Muhammad Adrish, Nicola A Hanania

Faculty, Staff and Students Publications

No abstract provided.

Development Of A Novel Mouse Model Of Menopause-Associated Asthma, William P Pederson, Laurie M Ellerman, Estevan C Sandoval, Scott Boitano, Jennifer B Frye, Kristian P Doyle, Heddwen L Brooks, Francesca Polverino, Julie G Ledford

Faculty, Staff and Students Publications

No abstract provided.

A Descriptive Analysis Of Patients With Attempted Suicide At A Rural Level I Trauma Center, Evelyn Coile, Tatiana Eversley-Kelso, Eric K. Shaw, Cynthia Ponir, Mickey M. Ott

HCA Healthcare Journal of Medicine

Objectives

For patients with self-harm, suicide attempt, or suicide completion, the trauma bay is often the single point of contact. Regional differences and patterns exist for suicide that should be studied to enhance preventive strategies. Our goal was to critically evaluate the suicidal population of Southeast Georgia over a 9-year period.

Methods

A retrospective review of our trauma database from January 2010 through December 2019 was conducted at a Level I Trauma Center. All ages were included. All patients arriving with attempted suicide or death due to a suicidal complication were included. Patients with deaths highly suspicious for suicide were …

The Experiences And Challenges Of Community Health Volunteers As Agents For Behaviour Change Programming In Africa: A Scoping Review, Mary Ndu, Ellena Andoniou, Sorcha Mcnally, Francisco Olea Popelka, Marisa Tippet, Elysee Nouvet

Health Studies Publications

ommunity health volunteers are considered a vital part of the community health structure in Africa. Despite this vital role in African health systems, very little is known about the community health volunteers’ day-to-day lived experiences providing services in communities and supporting other health workers. This scoping review aims to advance understanding of the day-to-day experiences of community health volunteers in Africa. In doing so, this review draws attention to these under-considered actors in African health systems and identifies critical factors and conditions that represent challenges to community health volunteers’ work in this context. Ultimately, our goal is to provide a …

Faktor-Faktor Yang Berhubungan Dengan Tingginya Rujukan Kasus Non Spesialistik Oleh Fasilitas Kesehatan Tingkat Pertama Di Era Jaminan Kesehatan Nasional: Systematic Review, I Nyoman Gede Semarajana, I Nyoman Gede Bayu Wiratama Suwedia, Maria Wahyu Daruki, Anak Agung Sri Stuti Damayanti

Jurnal ARSI : Administrasi Rumah Sakit Indonesia

The Primary Health Facility (FKTP) in the era of National Health Insurance (JKN) must behave effective and efficiently in serving patients. Referring patients as indicated is an effort to achieve this. The research shows that optimizing primary services has the potential to save on health costs from the Social Security Agency of Health (BPJS) source of 49.1 billion per year. BPJS data also shows the high number of referrals for non- specialist cases, namely 714 thousand cases during 2014-2017. This study aims to find out the factors that are related to the high number of non-specialist cases referral by FKTP …

Analisis Layanan Dan Bauran Pemasaran Klinik Telekonsultasi Gizi Rumah Sakit Izza Karawang Di Masa Pandemi Covid-19, Arif Guntur Wiryawan

Jurnal ARSI : Administrasi Rumah Sakit Indonesia

Izza Karawang Hospital Nutrition Clinic as an excellent service must adapt to the COVID-19 pandemic situation, in this case the transformation into a virtual or Nutrition Teleconsultation Clinic. The Nutrition Teleconsultation Clinic is expected to provide benefits as a means of consulting about healthy diet patterns. The research objective was to analyze the marketing of Nutrition Teleconsultation Clinic services using the STP (Segmenting, Targeting, Positioning) method and the marketing mix with the 4P concept (Product, Price, Place, Promotion). This type of research is quantitative descriptive research. Using primary data collected by questionnaire to 100 respondents, patients who seek treatment at …

Strategi Promosi Medical Check-Up Covid-19 Rsud Matraman, Vellyana Gustik, Wahyu Sulistiadi

Jurnal ARSI : Administrasi Rumah Sakit Indonesia

The community's need for health services during the Coronavirus Disease (COVID-19) pandemic has increased drastically. The need for health services at the hospital level includes examining and issuing a COVID-19 examination certificate. Responding to this, the Matraman Hospital incidentally created a new service, the COVID-19 Medical Check-Up (MCU). The management of RSUD Matraman realizes the importance of a promotional strategy to increase public interest in using the new service. This study aims to obtain an overview of the MCU COVID-19 service promotion strategy at the Matraman Hospital. The case study design in this study uses qualitative methods with in-depth interviews …