Health Services Research Commons^™

Characterization Of Folic Acid, 5-Methyltetrahydrofolate And Synthetic Folinic Acid In The High-Affinity Folate Transporters: Impact On Pregnancy And Development, Ana M Palacios, Rachel A Feiner, Robert M Cabrera

Faculty, Staff and Students Publications

Folates are B vitamins that are essential for several molecular, cellular, and biological processes, including nucleotide synthesis, methylation, and methionine cycling. The physiological impacts of these processes on health also extend to cell proliferation, folate deficiency anemia, and reduction of the risk of birth defects during pregnancy. The primary objective of this study was to characterize the binding affinities of different folate forms, folic acid (FA), 5-methyltetrahydrofolate (5MTHF), and folinic acid, to the folate receptors α and β, and to the bovine milk folate binding protein. These three dietary forms of folate are found in enriched grains (FA), various fruits …

Association Between Modifiable Social Determinants And Mental Health Among Post-9/11 Veterans: A Systematic Review, Nipa Kamdar, Sundas Khan, Diana P Brostow, Lia Spencer, Sharmily Roy, Amy Sisson, Natalie E Hundt

Faculty, Staff and Students Publications

Introduction: As U.S. Veterans reintegrate from active duty to civilian life, many are at risk for negative modifiable social determinants of health. The prevalence of mental health conditions among Veterans is also high. Awareness of the associations between these two factors is growing. This systematic review provides a comprehensive analysis of the current state of knowledge of the associations between modifiable social determinants and mental health among U.S. Veterans.

Methods: The authors systematically searched four databases and identified 28 articles representing 25 unique studies that met inclusion criteria. Findings from the studies were extracted and synthesized on the basis of …

Interstitial Nephritis: Wherefrom, Wherein, And Whereto, Garabed Eknoyan

Faculty, Staff and Students Publications

Abnormalities of the renal interstitium were noted early while identifying chronic kidney disease in 1827; however, interest in glomerular and vascular lesions was then distracted from their further study. As a complication of scarlet fever, interstitial lesions attracted attention in 1859 and came to be defined as acute interstitial nephritis in 1898. The chronic form of interstitial nephritis was traditionally attributed to pyelonephritis until the advent of kidney biopsy in the 1950s, when interstitial lesions were recognized as an independent primary cause of chronic kidney disease from studies of analgesic nephropathy and vesico-ureteral reflux. The term tubulointerstitial nephritis was introduced …

Analysis Of Trustworthiness And Readability Of English And Spanish Hypo- And Hyperthyroid-Related Online Patient Education Information, Chitra Parikh, Adam M. Ostrovsky

Student Papers, Posters & Projects

This study aims to determine the readability and trustworthiness of English and Spanish hypo- and hyperthyroid-related online information. Google searches were conducted for four search terms: hypothyroidism, Hashimoto's Disease, hyperthyroidism, and Graves’ Disease. For each search term, the first 10 websites were analyzed with a total of 40 websites analyzed. Readability formulas were used to determine English and Spanish readability. Trustworthiness was determined using HONcode status, JAMA Benchmark Criteria, and NLM Trustworthy Score. Overall readability largely exceeded recommended grade levels. Only 1 website (2.5%) presented information below the eighth-grade reading level based on overall Readability Consensus score, while 31 websites …

Wound Care For Unhoused Youth, Diana Altman, Monse Villasenor, Grace Fry, Maddy Johnson, Matthew Messenger

Nursing Leadership in Community Engagement Projects

Wound Care For Unhoused Youth

Introduction

We partnered with a non-profit organization designed to serve the unhoused youth, ages 18-25, who have a day program as well as an overnight shelter. They have 30 beds and reserve 20 of those beds for individuals who are “residents,” who commit to staying for several nights and work towards finding more permanent options. The other 10 beds are for individuals to use for a single night, but these are not always guaranteed, you must sign up to save a spot. The day program has various activities ranging from painting to resume workshops and …

Preemption In State Tobacco Minimum Legal Sales Age Laws In The Us, 2022: A Policy Analysis Of State Statutes And Case Laws, Page D. Dobbs, Ginny Chadwich, Eric Crosbie, Jessica Breslin, Lisa Henriksen

Health, Human Performance and Recreation Faculty Publications and Presentations

Preemptive statutory language within tobacco minimum legal sales age (MLSA) laws has prohibited localities from enacting stricter laws than state statutes. With the recent uptake of state Tobacco 21 laws in the US, the current landscape of preempted MLSA laws is unknown. This study sought to update the status of preemption in MLSA laws enacted in US states between 2015–2022. A public health attorney reviewed state tobacco MLSA laws (n = 50) and state tobacco control codes, searching for language regarding preemption. When statutes were unclear, case law was reviewed by examining local ordinances that were invalidated by state court …

Strengthening The Marketing Of Pediatric Cardiac Surgery Services To Support The Transformation Of Health Services In Indonesia, Felicia Gunardi, Puput Oktamianti

Journal of Indonesian Health Policy and Administration

This study aims to determine the marketing strategy 7P carried out by cardiac surgery services in Indonesia and to identify actionable policy recommendations. This study is observational descriptive research. Data were collected from Cardiothoracic and Vascular surgeons and hospital websites with cardiac surgery services. Through the marketing analysis approach of 7P, this study identifies problems and policy recommendations that can be alternative solutions. The price of the service is high, but most of the patients used BPJS, and it is found that the hospital rate is higher than BPJS claims. The actionable recommendation to respond to it is that the …

Hospital Ambulance Standardization In Jakarta: Narrative Review, Roy Michael Suranta, Ascobat Gani

Journal of Indonesian Health Policy and Administration

Ambulance is one of the hospital infrastructures that must meet service standards, security, and occupational safety and health in hospital operations. Therefore, it is the obligation of every hospital to ensure the standard of ambulance service. In the DKI Jakarta area, every ambulance, including hospital ambulances, must meet the standards in accordance with regulations and have an ambulance operating license. Based on data until the end of 2021, there were 82 (34.9%) hospital ambulances in Jakarta that carried out the recommendation process for an ambulance operation license from a total of 235 hospital ambulances, meaning that most hospital ambulances in …

Implementation Analysis Of The Pariaman City Regional Regulation No. 9 Of 2015 Concerning The Drinking Water Depot Business Permit, Melia Roza

Journal of Indonesian Health Policy and Administration

To regulate the existence of Drinking Water Depots (DAM) in the city of Pariaman, the Pariaman City government issued Regional Regulation (Perda) Kota Pariaman No. 9 of 2015 concerning Business Permits for Drinking Water Depots. However, many depot owners do not implement these regulations. The purpose of this study was to analyze the implementation of Pariaman City Regional Regulation No. 9 of 2015 concerning Drinking Water Depot Business Permits. This research is a type of qualitative research. Data collection was carried out through in-depth interviews with informants involved in the implementation of Pariaman City Regional Regulation No. 9 of 2015 …

Perceptions Of Health Workers Regarding The Covid-19 Vaccine Report Application In Ogan Ilir Regency, South Sumatra, Haerawati Idris, Amrina Rosyada, Anggun Budiastuti, Nurmalia Ermi

Journal of Indonesian Health Policy and Administration

The Lapor Vaksin COVID-19 Application was developed to support a vaccination coverage surveillance database sourced from community self-report. This application provides data on vaccination coverage and allows users to view updates to educational content about vaccines and visualization of COVID-19 vaccine data in real-time. This study aims to analyze the perception among health worker about Lapor Vaksin COVID-19 application in the community. This study uses descriptive research with a case study design. This study was conducted in September 2021 through a virtual zoom meeting, in Ogan Ilir Regency, South Sumatra. The research sample was 42 health workers consisting of vaccine …

Health Care Spending For Cardiovascular Disease Under National Health Insurance Scheme In Indonesia Before And During Covid-19: Descriptive Analysis And Policyrecommendations, Atik Nurwahyuni, Prastuti Soewondo, Mardiati Nadjib, Yuli Farianti, Mazda Novi Mukhlisa, Helmi Wahyuningsih, Emmy Ridhawaty Mangunsong, Athiyah Athiyah, Yunita Yunita, Sekar Arum Handarbeni Sayekti, Kurnia Sari, Amila Megraini

Journal of Indonesian Health Policy and Administration

The Cardiovascular disease (CVD) prevalence continues to increase. This study aims to identify the CVD spending and utilization in the Indonesia National Health Insurance (JKN) scheme 2017-2021 using the JKN claims classified by Disease Accounts analyzed descriptively. The CVD spending increased by $125,4 million in 2019 compared to 2017 and mostly for the hospital (91% in 2019) with the highest spending occurring in the age above 60 years. Moreover, the hospital inpatient spending was dominated during these five years. The highest portion of spending by severity level was at mild level, followed by moderate and severe levels. Health facilities’ capacities …

Study Protocol: Type Iii Hybrid Effectiveness-Implementation Study Implementing Age-Friendly Evidence-Based Practices In The Va To Improve Outcomes In Older Adults, Kirstin Manges Piazza, Laura Ellen Ashcraft, Liam Rose, Daniel E. Hall, Rebecca T. Brown, Mary Elizabeth (Libby) Bowen, Shahrzad Mavandadi, Alison C. Brecher, Shimrit Keddem, Bruce Kiosian, Judith A. Long, Rachel M. Werner, Robert E. Burke

College of Population Health Faculty Papers

Background

Unmet care needs among older adults accelerate cognitive and functional decline and increase medical harms, leading to poorer quality of life, more frequent hospitalizations, and premature nursing home admission. The Department of Veterans Affairs (VA) is invested in becoming an “Age-Friendly Health System” to better address four tenets associated with reduced harm and improved outcomes among the 4 million Veterans aged 65 and over receiving VA care. These four tenets focus on “4Ms” that are fundamental to the care of older adults, including (1) what Matters (ensuring that care is consistent with each person’s goals and preferences); (2) …

Addressing Disparities For Gambling Treatment Service Use In The Latinx Community: Outreach, Education, Screening, And Referral By Community Health Workers, Michael D. Campos Phd, Abraham J. Caballero Bs, Hugo Ramirez Bs, Hanssel Walker Bba

International Conference on Gambling & Risk Taking

ABSTRACT

Problem gambling/gambling disorder prevalence among Latinx individuals in the U.S. is similar to that seen in the non-Latinx Caucasian community (Alegria et al., 2009). However, there are disparities in the use of State-funded treatment for such problems in California. This is true for mental health service use for ethnic/racial minorities in the US overall (Alegria et al., 2008; Dua et al., 2011; Wells et al., 2001). The California Office of Problem Gambling (OPG), the UCLA Gambling Studies Program (UGSP), and Visión y Compromiso (VyC) are conducting a 2-year pilot project using community health workers (promotores/as) to increase Latinx utilization …

The Effect Of Perceived Weight Status And Bmi Perception On Food Attitudes And Food Relationships, Sahil K. Patel, Ryan Gericke, Jaime Dougherty, Adarsh Gupta

Rowan-Virtua School of Osteopathic Medicine Departmental Research

CONTEXT: Obesity has been a national epidemic throughout the United States due to the increasingly sedentary western lifestyle, paired with calorically dense abundant low-nutritional food options. Discussing weight necessitates the conversation of not only the numerical value (body mass index [BMI]) associated with obesity but also the perceived weight or how an individual categorizes their weight, irrespective of their calculated BMI classification. Perceived weight can influence food relationships, overall health, and lifestyle habits.

OBJECTIVES: The purpose of this study was to identify differences in dietary habits, lifestyle habits, and food attitudes among three groups: those correctly identifying as "obese" with …

Shifting Gears: - The Expected Post-Transplant Survival (Epts) Usefulness In The Era Of Continuous Distribution- Examination Of The United Network Of Organ Sharing (Unos) Database 2000-2020, Vaughn Whittaker, Vaughn Easton Whittaker

NYMC Student Theses and Dissertations

The allocation of organs is a constantly evolving area of transplantation. The latest iteration of this process is a move toward continuous distribution of organs. This process considers dynamic factors instead of static constraints that box patients into certain categories. The expected post-transplant survival of patients is one of these dynamic factors that will be included in the assessment of patients' place in a continuous distribution allocation process. However, the predictive value of this construct is questionable, given that it uses only four factors (age, diabetes diagnosis, years on dialysis, and previous transplant) to represent complex patients who are on …

Facilitators And Barriers To Effective Scale-Up Of Evidence-Based Nonprofit-Level Hiv Prevention And Treatment Interventions Among Black Men Who Have Sex With Men (Msm), Ugochukwu C. Uzoeghelu

Master's Projects and Capstones

Since the scale-up of HIV/AIDS prevention evidence-based interventions (EBIs) has not been simple in nonprofit settings, it is crucial to examine processes that occur in the translation of the EBIs into practice that affect successful implementation through the lens of nonprofit principles and practices. This paper examines the facilitators and barriers to effective scale-up of evidence-based HIV prevention and treatment services for nonprofit health organizations that serve Black men who have sex with men (MSM). I interviewed nonprofit health organizations (n = 4) engaged in the global response to end the HIV epidemic, specifically those who provide HIV prevention and …

An Examination Of Dyadic Diabetes Self-Management Education For Patients And Care Partners: A Scoping Review, Jessica L. Tucker

Honors Theses

Diabetes self-management education and support (DSMES) programs are crucial in equipping individuals with the necessary knowledge and skills. Involving care partners in diabetes management acknowledges that it is a collaborative effort within a social context, emphasizing the importance of integrating care partners into educational interventions. This approach offers benefits like emotional and practical support, shared responsibility in managing diabetes, enhanced treatment adherence, and improved communication.

To understand this concept better, this review's objectives are defining dyadic relationships, exploring implementation logistics, and assessing program outcomes and limitations to inform future research and program development.

This study revealed inconsistent terminology and definitions …

Co-Clinical Imaging Metadata Information (Cimi) For Cancer Research To Promote Open Science, Standardization, And Reproducibility In Preclinical Imaging, Stephen M Moore, James D Quirk, Andrew W Lassiter, Richard Laforest, Gregory D Ayers, Cristian T Badea, Andriy Y Fedorov, Paul E Kinahan, Matthew Holbrook, Peder E Z Larson, Renuka Sriram, Thomas L Chenevert, Dariya Malyarenko, John Kurhanewicz, A Mcgarry Houghton, Brian D Ross, Stephen Pickup, James C Gee, Rong Zhou, Seth T Gammon, Henry Charles Manning, Raheleh Roudi, Heike E Daldrup-Link, Michael T Lewis, Daniel L Rubin, Thomas E Yankeelov, Kooresh I Shoghi

Faculty, Staff and Students Publications

Preclinical imaging is a critical component in translational research with significant complexities in workflow and site differences in deployment. Importantly, the National Cancer Institute's (NCI) precision medicine initiative emphasizes the use of translational co-clinical oncology models to address the biological and molecular bases of cancer prevention and treatment. The use of oncology models, such as patient-derived tumor xenografts (PDX) and genetically engineered mouse models (GEMMs), has ushered in an era of co-clinical trials by which preclinical studies can inform clinical trials and protocols, thus bridging the translational divide in cancer research. Similarly, preclinical imaging fills a translational gap as an …

Home Oxygen And Monitoring For Covid-19 Patients: A Multidisciplinary Team Approach, Mahta Salehi, Shehrose Chaudry, Rebecca B. Newman, Josette Hartnett, Suzanne J. Rose, Forugh Homayounrooz

Journal of Community Hospital Internal Medicine Perspectives

Introduction: During the initial COVID-19 pandemic peak, Stamford Hospital implemented a home oxygen program (HOP) to create a comprehensive, multi-disciplinary outpatient initiative without sacrificing a safe discharge. Primary care physicians monitored program participants, whose only indication for remaining admitted was an oxygen requirement. We retrospectively examined participant co-morbidities and outcomes, including death and readmission rates to evaluate HOP safety.

Methods: A retrospective analysis of program participants discharged between April 2020-Janurary 2021 was performed. Variables included demographics, oxygen requirement, days enrolled in the HOP, and major comorbidities such as cardiovascular disease (CVD), diabetes (DM), hypertension (HTN), obesity, chronic kidney disease, malignancies …

Perspectives On Non-Prescription Antibiotic Use Among Hispanic Patients In The Houston Metroplex, Lindsey Laytner, Patricia Chen, Susan Nash, Michael K Paasche-Orlow, Richard Street, Roger Zoorob, Barbara Trautner, Larissa Grigoryan

Faculty, Staff and Students Publications

BACKGROUND: Non-prescription antibiotic use includes taking an antibiotic without medical guidance (e.g., leftovers, from friends/relatives, or purchased without a prescription). Non-prescription use contributes to antimicrobial resistance, adverse drug reactions, interactions, superinfection, and microbiome imbalance. Qualitative studies exploring perspectives regarding non-prescription use among Hispanic patients are lacking. We used the Kilbourne Framework for Advancing Health Disparities Research to identify factors influencing patients' non-prescription use and organize our findings.

METHODS: Our study includes Hispanic primary care clinic patients with different types of health insurance coverage in the Houston metroplex who endorsed non-prescription use in a previous survey. Semistructured interviews explored the factors …

Higher Dose Corticosteroids In Patients Admitted To Hospital With Covid-19 Who Are Hypoxic But Not Requiring Ventilatory Support (Recovery): A Randomised, Controlled, Open-Label, Platform Trial, Recovery Collaborative Group

Faculty, Staff and Student Publications

BACKGROUND: Low-dose corticosteroids have been shown to reduce mortality for patients with COVID-19 requiring oxygen or ventilatory support (non-invasive mechanical ventilation, invasive mechanical ventilation, or extracorporeal membrane oxygenation). We evaluated the use of a higher dose of corticosteroids in this patient group.

METHODS: This randomised, controlled, open-label platform trial (Randomised Evaluation of COVID-19 Therapy [RECOVERY]) is assessing multiple possible treatments in patients hospitalised for COVID-19. Eligible and consenting adult patients with clinical evidence of hypoxia (ie, receiving oxygen or with oxygen saturation

FINDINGS: Between May 25, 2021, and May 13, 2022, 1272 patients with COVID-19 and hypoxia receiving no oxygen …

Cardiovascular Disease Prediction Modelling: A Machine Learning Approach, Usmaan Al-Shehab, Maduka Gunasinghe, Yousuf Elkhoga, Nimay Patel, Juliana Yang

Rowan-Virtua Research Day

The objective of this project is to utilize the UCI Heart Disease dataset to identify physiological biomarkers that are highly correlated with heart disease incidence. A predictive model can then be developed using these biomarkers to estimate the likelihood of someone having or developing a heart-related condition. This study compares the efficacy of predicting cardiovascular disease as an outcome using three machine learning algorithms: Support Vector Machine, Gaussian Naive Bayes, and logistic regression. Support Vector Machine works by creating hyperplanes between data points to conduct classification. Gaussian Naive Bayes works by using the conditional probabilities of events to classify the …

Effects Of Income And Language On Health Literacy: A Study Between A Student-Run Free Clinic And A Family Medicine Office, Sahil Parikh, Emily Forester, Alisha Basak, Arpan Bhagat, Leah Cliatt, Usmaan Al-Shehab, Rebecca Moore

Rowan-Virtua Research Day

Background: Over one-third of the US population exhibit limited health literacy, leading to negative health outcomes and lifestyle choices. By employing the NVS assessment, RCHC sought to compare the health literacy levels of uninsured patients at their facility with those of insured patients at the Rowan Family Medicine office in Hammonton, NJ. This study aimed to assess specific factors that may influence health literacy levels.

Methods: This is an IRB-approved study which surveyed patients enrolled at the RCHC and Rowan Family Medicine Office between February 2021 and March 2023. Patients were given a nutrition label and verbally answered the NVS …

A Clinician's Guide To 23andme: A Survey-Based Study On People’S Attitudes And Actions Towards Direct-To-Consumer Genetic Testing, Julia Kiffel, Rifke Anolik, Alexander Kowalski

Rowan-Virtua Research Day

Background: While direct-to-consumer (DTC) at-home genetic testing like 23andMe provides users with potentially valuable information about their genetics and health risks, consumers might not have the background or knowledge to fully comprehend and interpret the results. This concept is a pressing issue because of the rise in popularity of these DTC genetic tests.

Purpose: The goal of this study is to elucidate the beliefs and attitudes of 23andMe users and determine the relationship between their test results and likelihood for taking medical action. The results from the study will give clinicians and primary care providers (PCPs) insight into how to …

Trends In Opioid Usage And The Covid-19 Pandemic, Priya Brahmbhatt, Jeffery Powers

Rowan-Virtua Research Day

The opioid epidemic and the COVID-19 pandemic have affected individuals in the United States in various capacities, and new avenues to reduce the harmful effects of both public health crises must be explored. It has been found that those with substance use disorders have an increased risk for COVID-19 (Wang 2021). There have been more visits to emergency rooms for substance overdose during the COVID-19 pandemic compared to before the COVID-19 pandemic (Holland 2021). This research project attempted to understand the trends amongst opioid users during the COVID-19 pandemic compared to before the COVID-19 pandemic in the United States, in …

Effects Of Attention-Deficit/Hyperactivity Disorder On Patients Undergoing Percutaneous Coronary Intervention Procedure: Insights From The National Inpatient Sample, Rafail Beshai, Keri Anacker, Keith Anacker, Tony Elias, Veyola Rezkalla, Maziyar Daneshvar, Howard Weinberg

Rowan-Virtua Research Day

Introduction: Attention Deficit Hyperactivity Disorder (ADHD) is a neurodevelopmental disorder that can affect children and adults and is characterized by deficits in attention, self-regulation, and executive functioning. Symptoms can seriously affect daily functioning and may present as hyperactivity, inattentive behaviors, or a combination of both. There are data to suggest patients with ADHD suffer from increased rates of cardiovascular disease, however not much is known specifically regarding the relationship between ADHD and undergoing Percutaneous Coronary Intervention. We sought to examine this relationship in greater detail by perusing the national inpatient sample database to describe in-hospital trends and outcomes among these …

Growing Use Of Xylazine As An Adulterant In Opioids And Its Effects, Oluwapelumi Oluwo

Rowan-Virtua Research Day

Xylazine, according to the National Institutes of Health (NIH), is a non-opioid tranquilizer used in veterinary medicine. Although this drug has not been approved for human use, it can be linked to an increase in opioid overdose deaths due to its role as an adulterant in drugs like fentanyl.

Xylazine was detected in drugs involved in 41% of all opioid-involved unintentional deaths and in 44% of all unintentional overdose deaths with fentanyl involved in the year of 2021 in Philadelphia.

Factors That Influence The Decision To Get Vaccinated Against Covid-19, Rhea Bhargava, Meghan H. Foos, Brandy M. Gotti, Alexandra L. Mulvenna, Taylor O. Smith, Danielle Cooley, Venkateswar Venkataman

Rowan-Virtua Research Day

Since the start of the COVID-19 pandemic and the launch of the vaccine, healthcare workers have been encouraging people to get vaccinated to prevent the spread of the virus. However, there is a significant number of people who are vaccine hesitant, or uncertain about receiving the COVID-19 vaccine and its booster. Vaccine hesitancy represents a state of opportunity to make positive change; therefore, it is crucial for healthcare workers to identify those who are in this population. When factors contributing to the vaccine hesitancy, including gender, age, ethnicity, education level, and income were studied, it was found that women, those …

Analysis Of Implementing Best Practices For Co-Prescribing Naloxone In Your Agency Online Cme Training Module Via Pre- And Post- Knowledge Assessment., Alicia Podwojniak, Arvind Venkataraman, Richard Jermyn

Rowan-Virtua Research Day

The opioid epidemic poses substantial risk to society. Providers must ensure that their patients understand the uses and risks of both opioids and naloxone. One way to analyze this concept is via metacognition. This refers to a person’s knowledge about cognitive phenomena, and thus it regulates self-awareness abilities in decision making, such as planning and evaluating. It is not only important for providers to have knowledge on best practices, but also to have self-awareness, and confidence in their decision making to ensure optimal patient outcomes. True-false confidence weighted scoring can be utilized, whereby various levels of confidence are assessed from …

Association Of Maternal Biomarkers With Gestational Weight Gain And Pre-Eclampsia, Matthew Green, Xinhua Chen

Rowan-Virtua Research Day

Background: There is convincing evidence that excessive gestational weight gain (GWG), based on the Institute of Medicine’s (IOM) 2009 guidelines, increases the risk of both maternal and neonatal complications.1-6 Although the association between excessive GWG and pre-eclampsia is well-established, the reason why this association exists remains unclear.

Methods: Previously collected data from a cohort of pregnant women in Camden, NJ between the years of 1998-2007 was used to examine the association between maternal serum biomarkers (C-peptide, IGF-1, Insulin and Homeostatic Model Assessment for Insulin Resistance (HOMA-IR)) collected at entry (week 16) and 3rd trimester (week 28) and longitudinally assessed gestational …