Health Policy Commons^™

How Has The Opioid Overdose Crisis Affected Child Maltreatment In The U.S.?, Alexander Chapman

Population Health Research Brief Series

This brief summarizes results from a study examining the association between U.S. county-level opioid mortality rates and child maltreatment rates from 2007 to 2017. Places with higher opioid overdose mortality rates have higher rates of child maltreatment. Poverty makes this problem worse - where the proportion of families in poverty increases, the association between fatal opioid overdose rates and child maltreatment also increases. Findings suggest that intervening in opioid use by reducing poverty has the potential to markedly decrease the incidence of child maltreatment.

The Oxycontin® Reformulation In 2010 Increased States’ Food Insecurity Rates, Colleen Heflin, Xiaohan Sun

Population Health Research Brief Series

The massive surge in opioid misuse and overdose over the past three decades has led to major family, economic, and social disruptions in the United States. OxyContin® - a highly potent, extended-release opioid was among the most commonly-abused narcotics throughout the 2000s. After reformulating OxyContin® to make it more difficult to inhale or inject, many people with opioid use disorders switched to using street drugs. The reformulation had many other unanticipated consequences. This brief shows that states with higher initial OxyContin® misuse rates had an increase in food insecurity after OxyContin® reformulation. The authors argue that public policies must consider …

Federal Medication-Assisted Treatment Expansion Grants Do Not Reduce Homelessness, Andrew Sullivan, Changwe Park

Population Health Research Brief Series

Medication-assisted treatment (MAT) is an evidence-based intervention that, combined with counseling and behavioral therapies, can effectively treat opioid use disorders. However, MAT is underused due to multiple barriers. To increase access to MAT, the U.S. government awarded grants to local governments and nonprofit organizations to increase and retain the number of people receiving MAT. This brief examined differences in homelessness and employment outcomes between places that received a MAT grant and those that did not. They found that these grants did not reduce homelessness or unemployment rates in the places that received funding and concluded that their effectiveness may have …

How Has The Opioid Crisis Affected Health, Health Care Use, And Crime In The United States?, Johanna Catherine Maclean, Justine Mallatt, Christopher J. Ruhm, Kosali Simon

Population Health Research Brief Series

The U.S. opioid crisis is the deadliest drug crisis in the nation’s history and is not abating. This brief summarizes what is known about the relationships between opioid misuse, health, healthcare use, and crime. The authors show that the opioid crisis has led to worsening health, increased mortality, increased healthcare use, and modest increases in crime. In addition, the policies designed to curb opioid misuse and its associated harms have had only limited success.

Editorial: Assessing And Addressing Health Inequities And Disparities: The Role Of Health Informatics, Gulzar H. Shah, Anjum Khurshid, Joanne Chopak-Foss

Health Policy & Community Health: Faculty Publications

No abstract provided.

Hervs And Cancer-A Comprehensive Review Of The Relationship Of Human Endogenous Retroviruses And Human Cancers, Erik Stricker, Erin C Peckham-Gregory, Michael E Scheurer

Center for Medical Ethics and Health Policy Staff Publications

Genomic instability and genetic mutations can lead to exhibition of several cancer hallmarks in affected cells such as sustained proliferative signaling, evasion of growth suppression, activated invasion, deregulation of cellular energetics, and avoidance of immune destruction. Similar biological changes have been observed to be a result of pathogenic viruses and, in some cases, have been linked to virus-induced cancers. Human endogenous retroviruses (HERVs), once external pathogens, now occupy more than 8% of the human genome, representing the merge of genomic and external factors. In this review, we outline all reported effects of HERVs on cancer development and discuss the HERV …

How Have Researchers Defined Institutions, Politics, Organizations And Governance In Research Related To Epidemic And Pandemic Response? A Scoping Review To Map Current Concepts, Laura Jane Brubacher

Faculty, Staff and Student Publications

In recent years, the literature on public health interventions and health outcomes in the context of epidemic and pandemic response has grown immensely. However, relatively few of these studies have situated their findings within the institutional, political, organizational and governmental (IPOG) context in which interventions and outcomes exist. This conceptual mapping scoping study synthesized the published literature on the impact of IPOG factors on epidemic and pandemic response and critically examined definitions and uses of the terms IPOG in this literature. This research involved a comprehensive search of four databases across the social, health and biomedical sciences as well as …

A Nationwide Study Of The “July Effect” Concerning Postpartum Hemorrhage And Its Risk Factors At Teaching Hospitals Across The United States, Zahra Shahin, Gulzar H. Shah, Bettye Apenteng, Kristie Cason Waterfield, Hani M. Samawi

Health Policy & Community Health: Faculty Publications

Objective To assess the “July effect” and the risk of postpartum hemorrhage (PPH) and its risk factors across the U.S. teaching hospitals. Method This study used the 2018 Nationwide Inpatient Sample (NIS) and included 2,056,359 of 2,879,924 single live-birth hospitalizations with low-risk pregnancies across the U.S. teaching hospitals. The International Classification of Diseases, Tenth Revision (ICD-10) from the American Academy of Professional Coders (AAPC) medical coding was used to identify PPH and other study variables. Multivariable logistic regression models were used to compare the adjusted odds of PPH risk in the first and second quarters of the academic year vs. …

Healthcare Associated Infections, Nurse Staffing, And Financial Performance, Soumya Upadhyay, Dean G. Smith

Healthcare Administration and Policy Faculty Research

Healthcare associated infections (HAIs) are a concern to patients, hospital administrators and policymakers. For over than a decade, efforts have been made to hold hospitals accountable for the costs of HAIs. This study uses contingency theory as a framework to examine the association between HAIs and hospital financial performance. We use publicly available data on 2059 hospitals in 2014 to 2016 that include HAIs, staffing financial performance, and hospital and hospital market characteristics. The key independent variables are available infection rates and nurse staffing. The dependent variables are indicators of financial performance: operating margin, total margin, and days cash on …

Determinants Of Child Stunting, Wasting, And Underweight: Evidence From 2017 To 2018 Pakistan Demographic And Health Survey, Maryam Siddiqa, Gulzar H. Shah, Tilicia Mayo-Gamble, Amber Zubair

Health Policy & Community Health: Faculty Publications

Child malnutrition persists in low-resource countries such as Pakistan, indicating an urgent need for interventions and policies aimed to address this critical population health issue. The World Health Organization Global Target 2025 includes the reduction of malnourishment in the form of stunting, wasting, and low weight. This study aims to examine the prevalence of factors associated with three measures of child malnutrition, i.e., stunting, wasting, and low weight in Pakistan. This study uses a secondary data analysis design based on data from Pakistan Demographic and Health Survey (2017-18) that used a two-stage cluster sampling approach. National level data covering urban …

Hutch Diverticulum: A Rare Congenital Urinary Bladder Diverticulum In An Elderly Male Patient., Dr Rudresh Hiremath, Dr Shwetha Poojari

Radiology Teaching Files

54 year old male patient presented with burning micturition and increased frequency of urination for the last two months. He also gives history of intermittent episodes of high grade fever with chills and rigors.

Mucocele Of The Appendix With Perforation., Sudha Kiran Das Dr., Vikram Patil Dr

Radiology Teaching Files

45 year old gentleman, presented to the Emergency Department with right iliac fossa pain & fever.

Parents’ Decision-Making Regarding Whether To Receive Adult-Onset Only Genetic Findings For Their Children: Findings From The Babyseq Project, Stacey Pereira, Amanda M Gutierrez, Jill Oliver Robinson, Kurt D Christensen, Casie A Genetti, Carrie L Blout Zawatsky, Rebecca L Hsu, Bethany Zettler, Melissa Kurtz Uveges, Richard B Parad, Alan H Beggs, Ingrid A Holm, Robert C Green, Amy L Mcguire

Center for Medical Ethics and Health Policy Staff Publications

Purpose: Most professional guidelines recommend against genetic screening for adult-onset only (AO) conditions until adulthood, yet others argue that there may be benefit to disclosing such results. We explored parents' decision-making on this issue in the BabySeq Project, a clinical trial of newborn genomic sequencing.

Methods: We conducted interviews with parents (N = 24) who were given the option to receive actionable AO results for their children. Interviews explored parents' motivations to receive and reasons to decline AO genetic disease risk information, their decision-making process, and their suggestions for supporting parents in making this decision.

Results: Parents noted several motivations …

Replication Competent Retrovirus Testing (Rcr) In The National Gene Vector Biorepository: No Evidence Of Rcr In 1,595 Post-Treatment Peripheral Blood Samples Obtained From 60 Clinical Trials, Kenneth Cornetta, Jing Yao, Kimberley House, Lisa Duffy, Prasad S Adusumilli, Rachel Beyer, Claire Booth, Malcolm Brenner, Kevin Curran, Bambi Grilley, Helen Heslop, Christian S Hinrichs, Rosandra N Kaplan, Hans-Peter Kiem, James Kochenderfer, Donald B Kohn, Sham Mailankody, Scott M Norberg, Roisin E O'Cearbhaill, Jennifer Pappas, Jae Park, Carlos Ramos, Antonio Ribas, Isabelle Rivière, Steven A Rosenberg, Craig Sauter, Nirali N Shah, Susan F Slovin, Adrian Thrasher, David A Williams, Tsai-Yu Lin

Center for Medical Ethics and Health Policy Staff Publications

The clinical impact of any therapy requires the product be safe and effective. Gammaretroviral vectors pose several unique risks, including inadvertent exposure to replication competent retrovirus (RCR) that can arise during vector manufacture. The US FDA has required patient monitoring for RCR, and the National Gene Vector Biorepository is an NIH resource that has assisted eligible investigators in meeting this requirement. To date, we have found no evidence of RCR in 338 pre-treatment and 1,595 post-treatment blood samples from 737 patients associated with 60 clinical trials. Most samples (75%) were obtained within 1 year of treatment, and samples as far …

Presidential Vote Share And Covid-19 Vaccination Rate In Indonesia: A District-Level Cross-Sectional Ecological Study, Gede Benny Setia Wirawan, Ni Luh Zallila Gustina, Ivy Cerelia Valerie, I Gusti Ayu Indah Pradnyani Rs, Muchamad Zaenal Arifin, Pande Putu Januraga

Kesmas

Political affiliation has been reported as a determinant of COVID-19 vaccine acceptance in some countries, although few studies have examined the Asian context. This study aims to fill this gap by employing an ecological study design using Indonesian regions as data points. Political affiliation was represented by incumbent President Jokowi’s vote share in the 2019 presidential election. Potential confounders included population density, human development index, availability of hospitals and primary health care, 2019–2020 economic growth, COVID-19 mortality rate, and proportion of Muslims in the population. The final analysis included 201 out of 501 districts and cities in Indonesia. Controlling for …

Oxidative Stress Levels Of Fine Particulate Matter (Pm2.5) And Urinary Glutathione Of Microbus Drivers, Purnama Sidebang, Agustin Kusumayati, Budi Haryanto

Kesmas

Urinary glutathione levels are known to be an early indicator of oxidative stress in travelers. This study analyzed the association between particulate matter (PM2.5) exposure on the road and urine glutathione levels in Jakarta’s microbus drivers. This cross-sectional study involved 96 microbuses (one of Jakarta’s public transportations) drivers of nine routes in Kampung Melayu Bus Station, Jakarta, Indonesia. An anthropometric assessment and a structured questionnaire were employed. Along with the participants driving on the road, real-time personal equipment measuring PM2.5 exposure concentrations was used. Total glutathione levels were measured using a colorimetric method. A correlation test and linear regression analysis …

Information-Motivation-Behavioral Skill In Diabetes Self-Management Using Structural Equation Modeling Analysis, Dien Kurtanty, Adang Bachtiar, Cicilya Candi, Alya Pramesti, Almira Fanny Rahmasari

Kesmas

Diabetes is the “mother” of various diseases increasing the risk of morbidity and mortality. Diabetes self-management, an effort made by patients to control blood sugar levels, is an important part of the management strategy. Therefore, this study analyzed information, motivation, and behavioral skills associated with diabetes self-management. Data were collected in the Special Capital Region of Jakarta, with 277 diabetic patients selected using a questionnaire by a systematic random sampling method. The analyzed variables were information (with indicator variables of information on physical activity, nutritional intake, drug consumption, and blood sugar monitoring); sociodemographic (age, sex, occupation, education level, and duration …

Job Satisfaction Model Of Primary Health Care Midwives Based On Indonesian Workforce Research In The Health Sector, Mieska Despitasari, Adang Bachtiar, Harimat Hendarwan, Besral Besral, Yuyun Yuniar

Kesmas

Promotive, preventive, curative, and rehabilitative efforts that are comprehensive, integrated, and sustainable are employed to enhance the health state of the global population. Within this context, however, the quality of primary health care depends on job satisfaction, which leads to the happiness of human resources in the health sector. Therefore, this study aimed to analyze and formulate a job satisfaction model among primary health care midwives in Indonesia. This study was an advanced secondary data analysis of a cross-sectional study conducted in 2017 by the National Institute of Health Research and Development, Ministry of Health of the Republic of Indonesia. …

The Determinants Of Stunting In The Under-Five In Three Municipalities In The Special Capital Region Of Jakarta, Tria Astika Endah Permatasari, Chairunnisa Chairunnisa, Hernani Djarir, Lily Herlina, Munaya Fauziah, Andriyani Andriyani, Yudi Chadirin

Kesmas

The COVID-19 pandemic has impacted the global decline in public health status. This study aimed to analyze the determinants of stunting in the under-five in three municipalities in the Special Capital Region of Jakarta, Indonesia. A cross-sectional study was conducted in August-December 2020 with 460 pairs of mothers and children selected by simple random sampling. Stunting was measured using a conventional anthropometric index (length/height-for-age), and anthropometric failure was measured using the Composite Index of Anthropometric Failure. The prevalence of stunting, underweight, and wasting was 41.5%,35%, and 19.8%, respectively, and 62% of the under-five experienced anthropometric failure. The dominant factor associated …

The Effect Of Covid-19-Related Occupational Stress And Burnout In Referral Hospital Nurses, Yulastri Arif, Masyithah Fadhani

Kesmas

Nurses' continuous contribution to patient health makes them prone to occupational stress, which has been exacerbated during the COVID-19 pandemic. Occupational stress that lasts for a long time and is not resolved may cause burnout. Burnout experienced by nurses can impact patients, hospital services, and themselves. This study aimed to determine the effect of occupational stress on the incidence of nurse burnout during the COVID-19 pandemic. It used a quantitative approach with a cross-sectional design. The study sample was 235 nurses in six COVID-19 referral hospitals in West Sumatra from a proportional random sampling technique. Data were collected using a …

Obesity And Asthma Risk In Indonesian Adults: Findings From The 2018 Indonesia Basic Health Research, Hoirun Nisa

Kesmas

Obesity and asthma are both global public health challenges. Mounting evidence suggests that obesity may increase asthma risk in adults; however, the association by sex remains uncertain. This study examined the association of obesity with asthma risk in Indonesian adult men and women. Data were obtained from the 2018 Indonesia Basic Health Research. The analysis included 299,837 men and 333,218 women aged ≥18 years. Asthma was identified by the self-report of a doctor’s diagnosis. Obesity was defined as a body mass index ≥30 kg/m2. A logistic regression was used for data analysis. Asthma prevalence was 2.7% (2.5% in men and …

Maternal And Child Health Handbook Utilization, Quantity And Quality Of Antenatal Services, And Maternal Emergency Rates In Padang City In 2022, Rena Afri Ningsih, Yusrawati Yusrawati, Joserizal Serudji

Kesmas

This study analyzed the relationship between the utilization of the Indonesian Ministry of Health’s Maternal and Child Health Handbook and the quantity and quality of antenatal care to maternal emergency levels. This study applied mixed methods with a consecutive sampling technique and included 108 mothers undergoing maternal emergencies at a central general hospital (quantitative) and eight mothers, seven midwives, and five cadres at primary health cares (qualitative) as informants. The result showed a relationship between the utilization of the Maternal and Child Health Care Handbook (p-value = 0.043), the quantity of antenatal care (p-value

Developing A New Tool For Early Detection Of The Nutritional And Health Risk Factors Of Urban Workers’ Productivity, Hildagardis Meliyani Erista Nai, Arimbi Karunia Estri, Christina Ririn Widianti

Kesmas

Nutrition and health play vital roles in work productivity. This study aimed to develop a risk self-assessment tool called Early Detection of the Nutritional and Health Risk Factors on the productivity of urban workers. This study was conducted in two stages: 1) the development of the tool to determine the nutritional and health risk factors that affect productivity based on literature reviews and scoring systems and 2) the testing of validity and reliability. Finally, the tool contained 63 items, including 28 items on nutritional risk factors and 35 on health risk factors. The validity of the tool was assessed using …

Detection And Characterization Of Constitutive Replication Origins Defined By Dna Polymerase Epsilon, Roman Jaksik, David A Wheeler, Marek Kimmel

Center for Medical Ethics and Health Policy Staff Publications

Background: Despite the process of DNA replication being mechanistically highly conserved, the location of origins of replication (ORI) may vary from one tissue to the next, or between rounds of replication in eukaryotes, suggesting flexibility in the choice of locations to initiate replication. Lists of human ORI therefore vary widely in number and location, and there are currently no methods available to compare them. Here, we propose a method of detection of ORI based on somatic mutation patterns generated by the mutator phenotype of damaged DNA polymerase epsilon (POLE).

Results: We report the genome-wide localization of constitutive ORI in POLE-mutated …

Lady Windermere Syndrome; Rare Pulmonary Infection Secondary To Voluntary Suppression Of Cough., Dr Rudresh Hiremath Dr

Radiology Teaching Files

65-year-old lady suffering from cough for the last one month with white colored scanty sputum. Past three weeks she has developed wheeze with shortness of breath. She also complains of on and off mid fever for last two weeks with evening raise of temperature. No evidence of chest pain or hemoptysis. No past history of pulmonary tuberculosis or allergic airway disease. Non diabetic and non-hypertensive.

General physical examination was normal. On auscultation there was reduced air entry with crackles in the right mid and lower zones. Rest of the systems was normal.

Esophageal Web: Unusual Cause Of Dysphagia In Middle Aged Male., Dr Rudresh Hiremath Dr, Dr Anupama C Dr

Radiology Teaching Files

45 year old male patient presents with dysphagia for solid foods and oral medications since 4 months. Dysphagia is gradual in onset and slowly progressive. Subject is recently diagnosed type II diabetes mellitus on oral medication. No significant history of weight loss. General physical examination and systemic examination were normal.

Post Covid-19 Avascular Necrosis Of Hip – A Rare Case Report., Dr Rudresh Hiremath Dr, Dr Gurumurthy B Dr, Dr Abhijith Roy Dr

Radiology Teaching Files

27 year old male diagnosed with COVID 19 got admitted in our hospital, and was treated on antibiotics, antivirals and short course of steroids. He was discharged after an uneventful course and resolution of symptoms. Three months later, patient presented with acute hip pain and was screened plain radiograph of Hip.

Inverted Papilloma: A Case Report, Dr. Abhigna S. Moudgalya Dr, Dr Vikram Patil Dr, Dr Gurumurthy B Dr

Radiology Teaching Files

A 41 year old male came with the complaints of nasal obstruction and on and off headache since 1 year. No history of epistaxis.

Repurposing Atovaquone As A Therapeutic Against Acute Myeloid Leukemia (Aml): Combination With Conventional Chemotherapy Is Feasible And Well Tolerated, Alexandra Mclean Stevens, Eric S Schafer, Minhua Li, Maci Terrell, Raushan Rashid, Hana Paek, Melanie B Bernhardt, Allison Weisnicht, Wesley T Smith, Noah J Keogh, Michelle C Alozie, Hailey H Oviedo, Alan K Gonzalez, Tamilini Ilangovan, Alicia Mangubat-Medina, Haopei Wang, Eunji Jo, Cara A Rabik, Claire Bocchini, Susan Hilsenbeck, Zachary T Ball, Todd M Cooper, Michele S Redell

Center for Medical Ethics and Health Policy Staff Publications

Survival of pediatric AML remains poor despite maximized myelosuppressive therapy. The pneumocystis jiroveci pneumonia (PJP)-treating medication atovaquone (AQ) suppresses oxidative phosphorylation (OXPHOS) and reduces AML burden in patient-derived xenograft (PDX) mouse models, making it an ideal concomitant AML therapy. Poor palatability and limited product formulations have historically limited routine use of AQ in pediatric AML patients. Patients with de novo AML were enrolled at two hospitals. Daily AQ at established PJP dosing was combined with standard AML therapy, based on the Medical Research Council backbone. AQ compliance, adverse events (AEs), ease of administration score (scale: 1 (very difficult)-5 (very easy)) …

Protocol: New York State Race, Ethnicity, And Insurance Disparities In Follow-Up Prostate Cancer Screening, Seth Greenspan, Mansi Chandra, Hyun Woo Joo, Netanel Sapir, Jonathan Gorman, Jie Yang, Xiaoning Li, Barghav Cavale, Allegra Fierro, Annie Laurie Laurie Shroyer, John P. Fitzgerald

Department of Urology Faculty Publications

Using de-identified reports from the Statewide Planning and Research Cooperative System (SPARCS) data, this descriptive study will identify the impact of socioeconomic status (SES) metrics on the follow-up prostate cancer screening care within 3 years of index prostate cancer screening test in NYS. The socioeconomic status metrics will be subclassified into race, insurance, and ethnicity and each of these sub-components will be evaluated for its impact on the follow-up cancer screening care. The exclusion criteria for this study includes patients records with unknown age, age <55 or >75, previous history of prostate cancer or radical prostatectomy, previous prostate biopsy, female sex, lives …