Health Services Research Commons^™

Validation Of The Jefferson Health-Related Social Needs Screener, Sara Beachy, Kristin L. Rising, Richard W. Hass, Terry Hyslop, Isabella Muti, Mackenzie Kemp, Rhea E. Powell, Cara Martino, Baligh R. Yehia, Joseph G. Cacchione, Patricia C. Henwood

Jefferson Hospital Staff Papers and Presentations

INTRODUCTION: Screening for health-related social needs (HRSN) is a growing national health priority. While multiple HRSN screening tools currently exist, none to our knowledge have been evaluated using robust statistical analyses. The goal of this work is to provide results from a validation study of the Jefferson HRSN screener conducted across inpatient and outpatient settings.

METHODS: This retrospective cross-sectional psychometric study included HRSN assessments conducted across inpatient and outpatient settings with adult patients from March 2023 to May 2024. The study was conducted across a 17-hospital academic health system serving a diverse community in a 9-county area crossing two states …

Obesity Severity And Cancer Screening In Us Adults, Florina Corpodean, Michael Kachmar, Shengping Yang, Michael W. Cook, Philip R. Schauer, Vance L. Albaugh

School of Medicine Faculty Publications

No abstract provided.

Artificial Intelligence In Head And Neck Cancer: Towards Precision Medicine, Jacob Hagen, Logan Hornung, William Barham, Supratik Mukhopadhyay, Adam Bess, Kevin Contrera, Devraj Basu, Vlad Sandulache, Guillaume Spielmann, Sagar Kansara

Faculty, Staff and Students Publications

Over the past 20 years, the capabilities of artificial intelligence (AI) have gained significant interest. While AI has been implemented to various degrees in several disciplines, its unique applications in head and neck cancer (HNC) remain underdeveloped. This narrative review examines the existing body of literature regarding the use of AI in HNC. Studies to date have demonstrated AI’s utility across multiple phases of the HNC treatment continuum. Despite its promise, integrating AI into clinical practice faces several challenges, including concerns about system integrity, generalizability, privacy, and bias. In this review, we address these challenges and offer insights into future …

Investigation Of The Optimal Length Of Discharge Summaries In Care Transitions: A Cross-Sectional Study, Taku Harada, Shintaro Kosaka, Aki Morishima, Seitaro Iguchi

Journal of Community Hospital Internal Medicine Perspectives

Introduction

Discharge summaries are essential documents that support continuity of care during patient transitions between inpatient and outpatient settings. They help ensure that crucial clinical information is conveyed accurately and completely. However, while their clinical significance is well established, there is little consensus on the optimal format, particularly in terms of length and structural clarity. Excessively brief summaries may omit key details, while overly lengthy ones can hinder efficient information transfer. Despite varied suggestions in the literature—ranging from half a page to four pages—empirical data on physician preferences are limited.

Methods

We conducted a cross-sectional, web-based survey among physicians who …

Role Of Addiction Medicine Consultation Service In A Community Hospital: Evaluation Of The Novel Service, Srikrishna Varun Malayala, Wesley Cervantes Perez, Rukshar Thapa, Archie Madan, Kushagar Singla, Pragyat Singh, Pelash Kumar, Akshay Thaper

Journal of Community Hospital Internal Medicine Perspectives

Objectives: Fewer than 2,500 physicians nationwide are certified in addiction medicine. Inpatient addiction hospitalist services have been shown to improve patient outcomes, but their capabilities and impact are underexplored in community hospitals. This study evaluates the role of an addiction medicine hospitalist service in enhancing patient outcomes in two community-based hospitals.

Methods: A retrospective chart review was conducted on patients who received care from addiction medicine service in two hospitals. The data were collected within the first 120 days of the establishment of service. The reason for consultation, substances used, types of management, impact on transition of care, readmissions and …

Barriers And Timely Postoperative Radiation Therapy In Head And Neck Cancer, Megan T Nguyen, Emily Kistner-Griffin, Reid Demass, Bhisham S Chera, Chanita Hughes Halbert, Katherine R Sterba, Elizabeth G Hill, Brian Nussenbaum, Anthony J Alberg, Vlad C Sandulache, David J Hernandez, Ryan S Jackson, Sidharth V Puram, Russel Kahmke, Nosayaba Osazuwa-Peters, Gail Jackson, Sue S Yom, Evan M Graboyes

Faculty, Staff and Students Publications

Importance: Initiation of postoperative radiation therapy (PORT) within 6 weeks of surgery is associated with improved outcomes among patients with head and neck squamous cell carcinoma. However, the relationship of barriers to care with timely PORT is unknown.

Objective: To categorize barriers to timely PORT, evaluate the association of barriers to care with initiation of timely PORT, and describe the primary reason for delay among patients without timely PORT.

Design, setting, and participants: This prospective cohort study at a US academic medical center included adults with head and neck squamous cell carcinoma undergoing curative-intent surgery with an indication for PORT. …

Predicting Weaning Failure From Invasive Mechanical Ventilation: The Promise And Pitfalls Of Clinical Prediction Scores, Maneesh Gaddam, Dedeepya Gullapalli, Zayaan A Adrish, Arnav Y Reddy, Muhammad Adrish

Faculty, Staff and Students Publications

Prediction of weaning success from invasive mechanical ventilation remains a challenge in everyday clinical practice. Several prediction scores have been developed to guide success during spontaneous breathing trials to help with weaning decisions. These scores aim to provide a structured framework to support clinical judgment. However, their effectiveness varies across patient populations, and their predictive accuracy remains inconsistent. In this review, we aim to identify the strengths and limitations of commonly used clinical prediction tools in assessing readiness for ventilator liberation. While scores such as the Rapid Shallow Breathing Index and the Integrative Weaning Index are widely adopted, their sensitivity …

Detection Of Heterogeneous Resistance Mechanisms To Tyrosine Kinase Inhibitors From Cell-Free Dna, Heather A Parsons, Conor Messer, Katheryn Santos, Jakob Weiss, David Merrell, Brian P Danysh, Melissa E Hughes, Gregory J Kirkner, Ashka Patel, Julian Hess, Kerry Sendrick, Chip Stewart, Elizabeth Grant, Kristy Schlueter-Kuck, Albert Grinshpun, Nikhil Wagle, Jamunarani Veeraraghavan, Jose Pablo Leone, Rachel A Freedman, Otto Metzger, Rachel Schiff, Eric P Winer, Sara M Tolaney, Mothaffar Rimawi, Ian E Krop, Gad Getz, Nancy U Lin

Faculty, Staff and Students Publications

Though there has been substantial progress in the development of anti-human epidermal growth factor receptor 2 (HER2) therapies to treat HER2-positive metastatic breast cancer (MBC) within the past two decades, most patients still experience disease progression and cancer-related death. HER2-directed tyrosine kinase inhibitors can be highly effective therapies for patients with HER2-positive MBC; however, an understanding of resistance mechanisms is needed to better inform treatment approaches. We performed whole-exome sequencing on 111 patients with 73 tumor biopsies and 120 cell-free DNA samples to assess mechanisms of resistance. In 11 of 26 patients with acquired resistance, we identified alterations in previously …

Overview Of A Hospital Management Information System Using The Hot-Fit Method In Medan Hospitals In 2025, Grace Putri Laia, Hotmarina Lumban Gaol, Jev Boris

Journal of Indonesian Health Policy and Administration

Hospital Management Information System (SIMRS/HMIS) is crucial in ensuring efficiency and quality in hospital services by integrating clinical and administrative functions. This study aims to evaluate the implementation of HMIS at Medan Adventist Hospital in 2025 using the Human-Organization-Technology Fit (HOT-Fit) framework. A descriptive design with total sampling was employed, involving 70 respondents comprising medical records staff, inpatient and outpatient registration staff, and ward officers. Data were collected through a structured questionnaire adapted from a validated instrument (validity 0.690–0.900; reliability 0.841–0.911) and analyzed using descriptive statistics. The results showed a high level of implementation in all HOT-Fit domains: system use …

A Scoping Review Of Epilepsy Care In Low-Resource Settings: Addressing Stigma, Healthcare Disparities, And Socioeconomic Barriers, Michael Mncedisi Willie

Journal of Indonesian Health Policy and Administration

Epilepsy affects around fifty million people worldwide, with stigma and limited healthcare access posing significant challenges, especially in low-resource settings. This scoping review aimed to identify key barriers to epilepsy care, focusing on stigma, healthcare access, and socioeconomic factors in sub-Saharan Africa and similar contexts. Using the Arksey and O’Malley framework, a systematic search was conducted across online databases for peer-reviewed studies published. The review found that stigma significantly delayed diagnosis, increased social isolation, and reduced treatment adherence. Healthcare barriers included a lack of trained professionals and inadequate treatment protocols. Socioeconomic challenges, such as poverty and rural residency, were linked …

African Swine Fever In Indonesia: Insights From Southeast Asia’S Policy Response Through The One Health Approach, Niken Salindri, Wachyu Sulistiadi

Journal of Indonesian Health Policy and Administration

African Swine Fever (ASF) seriously threatens pig production systems, food security, and rural livelihoods across Southeast Asia. This study employs an analysis of secondary national data from Indonesia using a quantitative descriptive analysis approach, complemented by regional policy responses to ASF from 2019 to 2024. To contextualize regional findings, this study also integrates official statistics from Statistics Indonesia (BPS) covering provincial pork production trends (2021–2023), the number of ASF-affected pigs per province (2020–2024), and per capita pork consumption by district. Quantitative data show that ASF outbreaks have been disproportionately concentrated in specific provinces such as East Nusa Tenggara and North …

The Effects Of Input And Characteristic Factors On Contact Rate Achievement Among Puskesmas In Indonesia, Iqbal Andri Makarim, Pujiyanto Pujiyanto

Journal of Indonesian Health Policy and Administration

The contact rate is the lowest-performing indicator in the Performance-Based Capitation Payment system initiated by BPJS Kesehatan. Analysis of the 2019 National Health Facility Research (Rifaskes) data showed that less than half of Puskesmas in Indonesia achieved the target. This cross-sectional study analyzed 5,384 Puskesmas from the 2019 Rifaskes to examine the effect of input and characteristic factors on achieving the contact rate. Independent variables included health worker ratios (doctors, nurses, midwives per 5,000 participants), completeness of essential medical equipment, communication facilities, P-Care application use, and Puskesmas characteristics. Multivariate logistic regression identified four significant factors: doctor ratio (OR=1.06; p<0.0001), midwife ratio (OR=1.01; p=0.033), completeness of essential medical equipment (OR=1.16; p=0.029), and BLUD-based financial management (OR=1.13; p=0.029). These factors explained only 2.6% of the variance (Nagelkerke R²=0.026), suggesting other unmeasured influences. Policy implications include equitable distribution of health personnel, targeted procurement of essential equipment, strengthening financial autonomy through BLUD, and optimizing P-Care data utilization to improve service accessibility and performance.

Results Of Tor001: An Open-Label Single Patient Study Using Targeted Bacteriophage Therapy For The Treatment Of A Chronic Urinary Tract Infection, Jonathan D Cook, Payton B Hooey, Keiko C Salazar, Justin R Clark, Umesh Jain, Carlos Fernando, Hanjeong Harvey, Alexander Cervantes, Stephanie Omagari, Udi Blankstein, Andrew M Kropinski, Alan R Davidson, Karen L Maxwell, Lori L Burrows, Austen L Terwilliger, Anthony W Maresso, Greg J German

Faculty, Staff and Students Publications

Chronic urinary tract infections are persistent bacterial infections with the potential to drive antibiotic resistance. Like other persistent bacterial infections, intracellular bacterial reservoirs and biofilm formation hinder the clearance of pathogens despite long courses of antibiotic therapy. New strategies for treatment of these persistent infections are needed. Here we describe the results of an open-label individual patient study using bacteriophage therapy to treat a chronic urinary tract infection in an immunocompetent 72-year-old woman without underlying urolithiasis or indwelling devices. We co-administered HP3.1, HP3, and ES19 bacteriophages with demonstrated in vitro activity via bladder instillation, orally, and as a topical formulation. …

Prevalence Of Screening Patients For Alcohol Use In West Virginia: A Cross-Sectional Observational Study, Bayan Abuhalimeh, Christopher Waters, R. Constance Wiener

Journal of Appalachian Health

Introduction: Consequences of alcohol consumption are well-established and compounded by physiological changes of aging (increased sensitivity; medication interactions; etc.). Alcohol screening for all ages is recommended, especially as most Americans believe moderate drinking is acceptable. Screening is important in high alcohol use regions, such as rural areas where isolation is more likely, especially for older adults. The Appalachian Region has a significant rural population of older adults. West Virginia (WV) is representative of Appalachia. It is a rural state, has many older adults, and all counties are Appalachian.

Purpose: The purpose of this cross-sectional study is to determine the likelihood …

Upper Gastrointestinal Symptoms And Gulf War Illness In A Clinical Cohort Of Us Veterans: A Retrospective, Cross-Sectional Study, Abdelrahman Yousef, Sarah T Ahmed, Theresa H Nguyen Wenker, Alice B S Nono-Djotsa, Stephen H Boyle, Elizabeth J Gifford, Deeksha Malhotra, Helena Chandler, Sandhya Bandi, Drew A Helmer

Faculty, Staff and Students Publications

Objective: Approximately 30% of the 700 000 US Gulf War Veterans (GWVs) report symptoms collectively termed Gulf War Illness (GWI), a multisymptom illness of uncertain pathophysiology. Prior studies in GWI focus on overlap with irritable bowel syndrome. This study examines the associations between upper gastrointestinal (UGI) symptoms, GWI and specialty GI care.

Methods: This cross-sectional study analysed GWVs referred to a Veterans Health Administration clinical War-Related Illness and Injury Study Center (2008-2020). Symptoms, demographics, military service and clinical history were obtained from self-reported intake packets. GWI was defined by the Centers for Disease Control and Prevention criteria requiring moderate-to-severe symptoms …

Establishing Best Practices Guidelines For Collaborative Research In Global Surgery: Developing A Delphi Survey, Ramitha Eshan Ruwanpathirana, Swati Deshpande, Sophia Abdulhai, Mathilde Djeneba Billau, Sumeja Catic, Theresa L Chin, Julia N Harrison, Pratyush Kumar, Maria Cecilia T Leyson, Helen W Li, Katayoun S Madani, Arthur Serumaga, Margaret Tarpley, Grayson Wright, Nia N Zalamea, Joshua S Ng-Kamstra

Faculty, Staff and Students Publications

Background: Collaborative research in global surgery has resulted in the rapid development of the field via knowledge creation and dissemination, research capacity building, and direct improvements in the delivery of clinical care. Yet the establishment and maintenance of trans-boundary collaborations carries significant risk to health systems, clinicians, patients, and researchers, particularly if such collaborations are not developed thoughtfully and with appropriate guardrails. In recent years, there has been significant growth in the literature on the pervasiveness and impact of neocolonialism on global health research.

Methods: To harness the benefits of global surgery research collaboration while mitigating these risks, we reviewed …

Amoxicillin Vs Ceftriaxone To Treat Pneumonia Caused By Amoxicillin-Non-Susceptible Streptococcus Pneumoniae, Daniel M Musher

Faculty, Staff and Students Publications

Although the article by J Càmara, I Grau, A González-Díaz, N Santos, et al. (Antimicrob Agents Chemother 69:e00237-25, 2025, https://doi.org/10.1128/aac.00237-25) suggests that ceftriaxone is greatly superior to amoxicillin in treating pneumonia due to pneumococci with an MIC > 2 mg/L, much of the difference in efficacy of the two drugs may have been due to dosage, route, and times of administration of the amoxicillin.

Improving The Reporting On Health Equity In Observational Research (Strobe-Equity): Extension Checklist And Elaboration, Omar Dewidar, Larissa Shamseer, G J. Melendez-Torres, Elie A. Akl, Jacqueline Ramke, Xiaoqin Wang, Oyekola Oloyede, Taryn Young, Stuart G. Nicholls, Zulfiqar Ahmed Bhutta

Institute for Global Health and Development

Data on health equity to inform societally relevant evidence based decisions and policy making are lacking in the research literature. Observational studies have the potential to provide data on health equity. Yet, guidance on how to report health equity data and considerations in observational research is inadequate. The STROBE-Equity extension addresses this gap by providing a structured set of criteria to enhance the reporting of health equity data and considerations.

Encapsulation Of Disease-Causing And Commensal Mitis Group Non-Pneumococcal Streptococci, Daniel M Musher, Mathias Müsken, M John Hicks, Lesley Mcgee, Bernard Beall

Faculty, Staff and Students Publications

Background: Mitis group non-pneumococcal streptococci (MGNPS), specifically Streptococcus mitis, Streptococcus infantis and Streptococcus oralis, have recently been shown to cause pneumonia and/or bacteremia. These organisms often have capsular (cps) operons resembling those in pneumococci, and some express cps-generated polysaccharides that antigenically cross-react with pneumococcal capsular serotypes. But, to date, a series of MGNPS isolates has not been studied by electron microscopy (EM) for the presence of a capsule.

Methods: We studied 21 MGNPS; 11 were isolated from sputum and determined to have caused pneumonia, 3 were isolated from blood, and 7 were commensal isolates cultured …

Commensal Colonization Of Candida Albicans In The Mouse Gastrointestinal Tract Is Mediated Via Expression Of Candidalysin And Adhesins, Kelsey E Mauk, Pedro Miramón, Michael C Lorenz, Léa Lortal, Julian R Naglik, Bernhard Hube, Lynn Bimler, Farrah Kheradmand, David B Corry

Faculty, Staff and Students Publications

The ubiquitous fungal pathogen Candida albicans has the potential to either asymptomatically colonize the gastrointestinal (GI) tract or become an invasive pathogen through mechanisms that remain incompletely understood. Here we explored the fungal, host, and environmental factors that influence the ability of C. albicans to colonize the mouse GI tract using a representative clinical strain, CLCA10. After a single gavage challenge (5 × 106 CFU C. albicans), specific pathogen-free (SPF) mice remained colonized with C. albicans strain CLCA10, but not other Candida species, for at least 58 days with the fungus confined largely to the gut luminal …

Strategies And Considerations For Forming And Managing Community Advisory Boards From Health Research With Transgender And Nonbinary Communities, Mannat Malik, Anushka Aqil, Jennifer L. Glick, Jean Michel Brevelle, Anthony Black, Kellan Baker, Arjee Restar, Molly Gribbin, Colin Flynn, Danielle German

School of Public Health Faculty Publications

Purpose: There is limited research on the use of community advisory boards (CABs) in health research with transgender and nonbinary communities. Transgender communities are navigating challenging histories of health researcher exploitation and research distrust alongside exponential research growth. We explored strategies for forming and managing CABs when conducting transgender community-informed health research. Methods: We used purposive and snowball sampling to identify key informants (KIs): research leaders, implementing staff, and community partners engaging in transgender health research. Between October 2018 and December 2020, we conducted 30 semi-structured in-depth interviews. We used coding followed byiterative thematic analysis and memoing to identify themes. …

Elephant Endotheliotropic Herpesvirus 2 Infection In 5 African Elephants (Loxodonta Africana) At Multiple North American Zoological Institutions, Taylor J Willis, Anne Burgdorf-Moisuk, Maren Connolly, Jan Raines, Cameron Ratliff, Zoltan S Gyimesi, Erica Lipanovich, Genevive A Dumonceaux, Kathryn L Perrin, Lauren L Howard, Matthew E Kinney, Kirk Suedmeyer, Erin Latimer, Tiffany L Kim, Jessica R Watts, Jie Tan, Paul Ling

Faculty, Staff and Students Publications

Objective: To acknowledge that elephant endotheliotropic herpesvirus (EEHV) is a well-recognized major threat to Asian elephants (Elephas maximus) and can cause acute and often fatal hemorrhagic disease (HD). Historically, EEHV-HD has been less frequently identified in African elephants (Loxodonta africana). This case series describes 5 recent cases of EEHV2 infection in African elephants within managed care at 5 North American institutions.

Animals: 5 African elephants (L africana).

Clinical presentation: The cases involved 4-, 7-, and 10-year-old males that died despite receiving aggressive medical therapy and 4- and 14-year-old females that survived. Clinical signs included lethargy, decreased appetite, lameness, changes in …

Comparative Effectiveness Of Less Vs More Frequent Hydrocortisone Dosing In Septic Shock, Alan Hao, Tianshi David Wu, Keegan Collins, Danielle Guffey, Rebecca Kessinger, Meghna Vallabh, Ali Omranian

Faculty, Staff and Students Publications

Objectives: Guidelines recommend hydrocortisone as an adjunctive treatment in septic shock, but the optimal dosing regimen is unknown. A national shortage of hydrocortisone in 2023 prompted a change in institutional practice for hydrocortisone administration from 50 mg every 6 hours to 100 mg every 12 hours in an effort to reduce waste and conserve vials, creating an opportunity to evaluate the comparative effectiveness of these two regimens. The primary efficacy outcome was time to shock resolution, and secondary outcomes evaluated in this study were mortality, renal replacement therapy (RRT), medication costs, and maximum vasopressor dose attained.

Design: Single-center, retrospective cohort …

Patient-Centered Management Of Heavy Menstrual Bleeding While On Anticoagulation: A Survey Study, Benjamin Barnett, Rushad Patell, Dana Angelini, Leben Tefera, Jordan K Schaefer, Ang Li, Alejandra Gutierrez Bernal, Shruti Chaturvedi, Anjlee Mahajan, Leslie Lake, Jori May, Anna L Parks

Faculty, Staff and Students Publications

Background: Nearly three-quarters of women experience heavy menstrual bleeding (HMB) during anticoagulation treatment for venous thromboembolism (VTE). HMB can lead to medical interventions, impact school or work and diminish quality of life (QOL). While there are several management options for HMB in patients with VTE, we lack information on how patients approach HMB treatment decisions.

Objectives: We examined patients' experience with, perceptions of, and preferences for treatment of HMB while on anticoagulation.

Methods: Clinicians and patient advocates developed a web-based survey that was distributed via patient advocacy organizations and social media between May and June 2024, targeting participants 18 years …

Evaluation Of A Novel Tc-24 Recombinant Antigen Elisa For Serologic Detection Of Trypanosoma Cruzi Infection In Dogs: A Pilot Study, Rojelio Mejia, Guilherme G Verocai, Ilana A Mosley, Ashley B Saunders, Bin Zhan, Lindsey Vongthavaravat, Rachel E Busselman, Sarah A Hamer

Faculty, Staff and Students Publications

Chagas disease, caused by the protozoan Trypanosoma cruzi, is a significant challenge for canine health, with limited diagnostic tools. This study assessed the performance of a novel Tc-24 recombinant antigen ELISA compared to three commercial diagnostic tests on 70 serum samples from kennel dogs in Texas. The Tc-24 ELISA demonstrated high sensitivity (87.5%) and specificity (91.2%) compared to Indirect Fluorescent Antibody (IFA) testing, with significant differences in Tc-24 optical density (OD) between positives and negatives (0.607 vs. 0.089, p < 0.001). When compared to Chagas Stat-Pak (SP), Tc-24 ELISA showed sensitivity and specificity values of 82.1% and 86.7%, respectively (p < 0.001). For Chagas Detect Plus (IB), the assay achieved a sensitivity of 80.0% and specificity of 93.1% (p < 0.001). Spearman correlation analysis revealed significant associations between Tc-24 OD and SP (r = 1.0, p = 0.0167), IB (r = 0.9, p = 0.0833) and IFA (r = 0.6273, p = 0.044). Elevated immunochromatographic values in commercial kits (SP or IB) correlated with Tc-24 OD (1.17 vs. 0.039, p < 0.001), achieving 100% sensitivity and 95.8% specificity based on positive results from commercial kits. These findings suggest that Tc-24 ELISA is a reliable and accurate serological tool for diagnosing T. cruzi infection in dogs, with the potential to enhance diagnostic capabilities in veterinary medicine.

The Role Of Serum Phosphate Control In Supporting Transplant Readiness In Patients On Dialysis, Laura A Williams, Stephen Z Fadem

Faculty, Staff and Students Publications

Chronic kidney disease affects over 36 million Americans, with more than 800,000 progressing to end-stage kidney disease (ESKD). Treatment with kidney transplantation offers superior survival, quality of life, and cost-effectiveness compared with dialysis, yet access remains limited. Hyperphosphatemia is a highly prevalent and modifiable complication of ESKD that contributes to cardiovascular disease, mineral bone disorder, and potential pulmonary dysfunction. Additionally, elevated serum phosphate has been linked to transplant graft failure and adverse post-transplant outcomes. Although normal phosphate levels are not formally required for transplant eligibility, they are frequently considered as part of transplant readiness assessments. Persistent gaps between clinical guideline …

A Fascination With Gastrointestinal Viruses, Mary Kolb Estes

Faculty, Staff and Students Publications

My arrival into this world came quickly, according to my mother, and it feels like my life has mirrored that rapid beginning. I have enjoyed a rich, varied, and stimulating life and career that have gone through several phases. I credit genetics, my family, technological advances, and many environmental factors for shaping my career. Being a virologist allowed me to be curious and creative and to make several unexpected discoveries. This has been a fun and rewarding journey, but it wasn't always easy. I am not accustomed to talking about myself, but I am happy to share some scientific achievements …

Experiences Of Elderly Living With Noncommunicable Diseases In Utilizing Health Services In Myanmar During The Covid-19 Pandemic, Nway Eint Chei, Kwanjai Amnatsatsue, Natkamol Chansatitporn, Ariya Bunngamchairat

Kesmas

The COVID-19 pandemic and armed conflicts in Myanmar have intensified the challenges in accessing and utilizing health services, particularly for noncommunicable diseases (NCDs) among older adults. This qualitative study explored the experiences of the elderly with NCDs regarding health service accessibility and utilization in secure areas with fully operational health facilities by conducting in-depth interviews with 20 eligible older adults in Myanmar; data were analyzed using content analysis. Four key themes emerged: NCD service utilization patterns; unmet needs; preferences and hesitancy toward NCD services; and disparities, barriers, and opportunities. The findings revealed widespread underutilization of NCD services due to several …

Government Health Spending And Life Expectancy: Evidence From Cities And Districts In Indonesia, Kurnia Sari, Budi Hidayat, Amal Chalik Sjaaf, Mardiati Nadjib

Kesmas

Life expectancy is widely recognized as a fundamental indicator of population health, and its improvement is often linked to government health spending, particularly in decentralized health systems. This study aimed to investigate the relationship between local government health expenditures and life expectancy in decentralized Indonesia. Data from 492 cities and districts, spanning from 2015 to 2019, were analyzed using a two-way fixed effects regression model to control for time-invariant district characteristics and common temporal shocks. The findings indicated that a 10% increase per capita in government health expenditure was associated with a 0.01% increase in life expectancy. This association was …

A Modern Analytical Method To Forecast Cerebrovascular Diseases (Cd), And Heart Diseases (Hd) Using Multivariate Time Series Model Utilizing The Cdc Provisional Mortality Data, Aditya Chakraborty, Mohan Pant

Cardiovascular Research Symposium

Background: In this study, a new analytical approach was introduced to answer specific questions related to mortalities due to cerebrovascular diseases, heart diseases, and the association of these mortalities with twelve other causes of death (COD).

Methods: A multivariate time series forecasting model was developed utilizing each of the CODs by taking the weekly and yearly seasonality into account, and the mortality counts were forecasted using the most recent CDC weekly mortality count data. A new COD data matrix was structured for all CODs as a function of weeks by combining the observed and predicted values of the mortality counts. …