Health Policy Commons^™

Mendelian Gene Identification Through Mouse Embryo Viability Screening, Pilar Cacheiro, Carl Henrik Westerberg, Jesse Mager, Mary E Dickinson, Lauryl M J Nutter, Violeta Muñoz-Fuentes, Chih-Wei Hsu, Ignatia B Van Den Veyver, Ann M Flenniken, Colin Mckerlie, Stephen A Murray, Lydia Teboul, Jason D Heaney, K C Kent Lloyd, Louise Lanoue, Robert E Braun, Jacqueline K White, Amie K Creighton, Valerie Laurin, Ruolin Guo, Dawei Qu, Sara Wells, James Cleak, Rosie Bunton-Stasyshyn, Michelle Stewart, Jackie Harrisson, Jeremy Mason, Hamed Haseli Mashhadi, Helen Parkinson, Ann-Marie Mallon, Damian Smedley

Center for Medical Ethics and Health Policy Staff Publications

Background: The diagnostic rate of Mendelian disorders in sequencing studies continues to increase, along with the pace of novel disease gene discovery. However, variant interpretation in novel genes not currently associated with disease is particularly challenging and strategies combining gene functional evidence with approaches that evaluate the phenotypic similarities between patients and model organisms have proven successful. A full spectrum of intolerance to loss-of-function variation has been previously described, providing evidence that gene essentiality should not be considered as a simple and fixed binary property.

Methods: Here we further dissected this spectrum by assessing the embryonic stage at which homozygous …

Measurement Of Severe Acute Respiratory Syndrome Coronavirus 2 Antigens In Plasma Of Pediatric Patients With Acute Coronavirus Disease 2019 Or Multisystem Inflammatory Syndrome In Children Using An Ultrasensitive And Quantitative Immunoassay, George B Sigal, Tanya Novak, Anu Mathew, Janet Chou, Yubo Zhang, Navaratnam Manjula, Pradeepthi Bathala, Jessica Joe, Nikhil Padmanabhan, Daniel Romero, Gabriella Allegri-Machado, Jill Joerger, Laura L Loftis, Stephanie P Schwartz, Tracie C Walker, Julie C Fitzgerald, Keiko M Tarquinio, Matt S Zinter, Jennifer E Schuster, Natasha B Halasa, Melissa L Cullimore, Aline B Maddux, Mary A Staat, Katherine Irby, Heidi R Flori, Bria M Coates, Hillary Crandall, Shira J Gertz, Adrienne G Randolph, Nira R Pollock, Overcoming Covid-19 Investigators

Center for Medical Ethics and Health Policy Staff Publications

Background: Detection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) antigens in blood has high sensitivity in adults with acute coronavirus disease 2019 (COVID-19), but sensitivity in pediatric patients is unclear. Recent data suggest that persistent SARS-CoV-2 spike antigenemia may contribute to multisystem inflammatory syndrome in children (MIS-C). We quantified SARS-CoV-2 nucleocapsid (N) and spike (S) antigens in blood of pediatric patients with either acute COVID-19 or MIS-C using ultrasensitive immunoassays (Meso Scale Discovery).

Methods: Plasma was collected from inpatients (< 21 years) enrolled across 15 hospitals in 15 US states. Acute COVID-19 patients (n = 36) had a range of disease severity and positive nasopharyngeal SARS-CoV-2 RT-PCR within 24 hours of blood collection. Patients with MIS-C (n = 53) met CDC criteria and tested positive for SARS-CoV-2 (RT-PCR or serology). Controls were patients pre-COVID-19 (n = 67) or within 24 hours of negative RT-PCR (n = 43).

Results: Specificities of N and S assays were 95-97% and 100%, respectively. In acute COVID-19 patients, N/S plasma assays …

Refining The Nutrition Environment Measures Survey (Nems) For Healthy Community Stores: Adaptations To Capture Alternative Food Retailers And Align With Dietary Guidelines, Alex B. Hill, Ravneet Kuar, Samantha M. Sundermeir, Christina Kasprzak, Megan Winkler, Sara John, Rachael D. Dombrowski, Bree Bode, Joel Gittelsohn

Urban Studies and Planning Faculty Research Publications

Inadequate consumption of healthy food is an ongoing public health issue in the United States. Food availability measures of supply versus consumption of healthy foods are disconnected in many studies. There is a need for an objective assessment of the food environment in order to assess how the food supply aligns with the Healthy Eating Index (HEI). Data were collected as part of the Healthy Community Stores Case Study Project, including a refined Nutrition Environment Measures Survey for Healthy Community Stores (NEMS-HCS) and an updated Healthy Food Availability Index that aligns with the Healthy Eating Index (HFAHEI). This paper will …

Understanding Costa Rica's Response To The Covid-19 Pandemic: Competing Explanations, Lise Charles

The Journal of International Relations, Peace Studies, and Development

As the COVID-19 pandemic continues to have major impacts on the world, careful study of successful health systems is essential. Costa Rica has been identified as a country that has responded well to the pandemic with the proportion of death rates compared to infection rates being the lowest in comparison to other countries in Central America. This paper examines Costa Rica’s relatively successful response to the COVID-19 pandemic as a case study in good public healthcare management. This study also highlights the importance of theory for addressing urgent, practical development challenges to explore what theoretical frameworks can best explain the …

Safety And Immunogenicity Of The Na-Apr-1 Hookworm Vaccine In Infection-Naïve Adults, David J Diemert, Maria Zumer, Doreen Campbell, Shannon Grahek, Guangzhao Li, Jin Peng, Maria Elena Bottazzi, Peter Hotez, Jeffrey Bethony

Center for Medical Ethics and Health Policy Staff Publications

Background: The Necator americanus hemoglobinase, aspartic protease-1 (Na-APR-1), facilitates the ability of adult hookworms to parasitize the intestine of their human hosts. A recombinant version of APR-1 protected laboratory animals against hookworm infection by inducing neutralizing antibodies that block the protein's enzymatic activity and thereby impair blood feeding. A catalytically inactive version of the wild-type hemoglobinase (Na-APR-1(M74)) was expressed by infiltrating Nicotiana benthamiana tobacco plants with an Agrobacterium tumefaciens strain engineered to express the vaccine antigen, which was adjuvanted with aluminum hydroxide adjuvant (Alhydrogel).

Methods: An open-label dose-escalation Phase 1 clinical trial was conducted in 40 healthy, hookworm-naïve adult volunteers …

Socioeconomic Status And Other Factors Associated With Hiv Status Among Ovc In Democratic Republic Of Congo (Drc), Gulzar H. Shah, Gina D. Etheredge, Lievain Maluantesa, Kristie Cason Waterfield, Osaremhen Ikhile, Elodie Engetele, Astrid Mulenga, Alice Tabala, Bernard Bossiky

Health Policy & Community Health: Faculty Publications

Background: Orphans and vulnerable children (OVC) are a high-risk group for HIV infection, particularly in Sub-Saharan Africa.

Purpose: This study aims to portray the socioeconomic profile of OVC and examine the association of household and parent/guardian characteristics with the HIV status of OVC.

Methods: For this quantitative retrospective study, we obtained data from ICAP/DRC for a total of 1,624 OVC from households enrolled for social, financial, and clinical services between January 2017 and April 2020 in two provinces of the Democratic Republic of Congo, Haut-Katanga and Kinshasa. We computed descriptive statistics for OVC and their parents' or guardians' characteristics. We …

Mainegeneral Hrsa Rcorp Grant Summary, Mary Lindsey Smith Phd, Evelyn Ali Bs, Katharine Knight, Tyler Egeland Ba

Substance Use Research & Evaluation

MaineGeneral received a Rural Communities Opioid Response Program (RCORP) Implementation grant to further the work of the Substance Use Prevention Expanded Recovery (SUPER) Consortium. Over the course of the three-year grant, the SUPER Consortium: (1) expanded harm reduction work, including naloxone distribution, and (2) increased organizational capacity to treat and prevent SUD through education efforts in healthcare organizations, first responder organizations, community organizations, and schools. The Substance Use Research and Evaluation team at the University of Southern Maine’s Catherine Cutler Institute was contracted to evaluate MaineGeneral’s RCORP grant. This grant summary presentation includes data from community outreach and training grant …

Medical Ethics: How Resource Distribution Affects The Decision Making Of Doctors In Rural India: An Explorative And Comparative Study In Jamkhed, Maharashtra, Jared Yee

Independent Study Project (ISP) Collection

Using rural Mahrasthra as a case study, I was able to explore the medical ethics and common dilemmas that occur in Rural India. Through a collection of interviews and articles, I was able to piece together my understanding of some common ethical challenges that India faces, emphasizing ones that were unique to the location and circumstance. Using observations I made through my work in the hospital, I learned that limited resources effects all sides of ethics in the medical field, with a significant effect on economics, hospital structure, and clinical protocol. In an attempt to source the aspects of Indian …

Fighting Heroin Abuse With Heroin: How Legalizing Prescription Heroin Has Changed The Way New Generations Use Drugs, Claire Ridley

Independent Study Project (ISP) Collection

In the 1980s, Switzerland was embroiled in two simultaneous crises: widespread heroin use and spreading HIV/AIDS. Zurich became the capital of heroin consumption, with groups gathering in public parks and sharing needles to inject heroin. In response to these crises, several Swiss cities started conducting randomized control trials where they offered prescription heroin to help people addicted to heroin consume the drug safely and eventually recover from their addiction. As these trials reported positive results of maintaining better health outcomes for those undergoing treatment, the Swiss people supported federally legalizing heroin-assisted treatment and expanding access to harm reduction services in …

Medical Ethics: How Resource Distribution Affects The Decision Making Of Doctors In Rural India: An Explorative And Comparative Study In Jamkhed, Maharashtra, Jared Yee

Independent Study Project (ISP) Collection

Using rural Mahrasthra as a case study, I was able to explore the medical ethics and common dilemmas that occur in Rural India. Through a collection of interviews and articles, I was able to piece together my understanding of some common ethical challenges that India faces, emphasizing ones that were unique to the location and circumstance. Using observations I made through my work in the hospital, I learned that limited resources effects all sides of ethics in the medical field, with a signficinant effect on economics, hospital structure, and clinical protocol. In an attempt to source the aspects of Indian …

The Development And Initial Validation Of The Promis®+Hf-27 And Promis+Hf-10 Profiles, Faraz S Ahmad, Kathryn L Jackson, Susan E Yount, Nan E Rothrock, Michael A Kallen, Leilani Lacson, Karl Y Bilimoria, Abel N Kho, Raja Kannan Mutharasan, Peter A Mccullough, Jeffrey Bruckel, Savitri Fedson, Stephen E Kimmel, David T Eton, Kathleen L Grady, Clyde W Yancy, David Cella

Center for Medical Ethics and Health Policy Staff Publications

Aims: Heart failure (HF) is a common and morbid condition impacting multiple health domains. We previously reported the development of the PROMIS®-Plus-HF (PROMIS+HF) profile measure, including universal and HF-specific items. To facilitate use, we developed shorter, PROMIS+HF profiles intended for research and clinical use.

Methods and results: Candidate items were selected based on psychometric properties and symptom range coverage. HF clinicians (n = 43) rated item importance and clinical actionability. Based on these results, we developed the PROMIS+HF-27 and PROMIS+HF-10 profiles with summary scores (0-100) for overall, physical, mental, and social health. In a cross-sectional sample (n = 600), we …

Incidence And 5-Year Survival Of Children And Adolescents With Hepatoblastoma In The United States, Justin A Kahla, David A Siegel, Shifan Dai, Philip J Lupo, Jennifer H Foster, Michael E Scheurer, Andras A Heczey

Center for Medical Ethics and Health Policy Staff Publications

Objective: Hepatoblastoma (HB) is the most common pediatric primary malignant liver tumor, its incidence has been increasing worldwide, but recent changes in incidence and outcomes with high population coverage are not well characterized.

Methods: We defined the incidence of HB diagnosed during 2003-2017 from United States Cancer Statistics (USCS) database, and survival during 2001-2016 from the National Program of Cancer Registries (NPCR). Data were stratified by sex, race/ethnicity, age, tumor stage, county population, and diagnosis year. Incidence trends were assessed by calculating average annual percent change (AAPC) using Joinpoint regression. Differences in overall 5-year survival were estimated using Cox regression …

Psychiatric Polygenic Risk Scores: Child And Adolescent Psychiatrists’ Knowledge, Attitudes, And Experiences, Stacey Pereira, Katrina A Muñoz, Brent J Small, Takahiro Soda, Laura N Torgerson, Clarissa E Sanchez, Jehannine Austin, Eric A Storch, Gabriel Lázaro-Muñoz

Center for Medical Ethics and Health Policy Staff Publications

Psychiatric polygenic risk scores (PRS) have potential utility in psychiatric care and prevention, but there are concerns about their implementation. We surveyed 960 US-based practicing child and adolescent psychiatrists' (CAP) about their experiences, perspectives, and potential uses of psychiatric PRS. While 23% of CAP reported that they had never heard of PRS, 10 % of respondents have had a patient/family bring PRS to them and 4% have generated PRS for patients. Though 25% stated they would request PRS if a patient/caregiver asked, 35% indicated that nothing would prompt them to request PRS. Most respondents (54%) believed psychiatric PRS are currently …

Psychiatric Polygenic Risk Scores: Child And Adolescent Psychiatrists’ Knowledge, Attitudes, And Experiences, Stacey Pereira, Katrina A Muñoz, Brent J Small, Takahiro Soda, Laura N Torgerson, Clarissa E Sanchez, Jehannine Austin, Eric A Storch, Gabriel Lázaro-Muñoz

Center for Medical Ethics and Health Policy Staff Publications

Psychiatric polygenic risk scores (PRS) have potential utility in psychiatric care and prevention, but there are concerns about their implementation. We surveyed 960 US-based practicing child and adolescent psychiatrists' (CAP) about their experiences, perspectives, and potential uses of psychiatric PRS. While 23% of CAP reported that they had never heard of PRS, 10 % of respondents have had a patient/family bring PRS to them and 4% have generated PRS for patients. Though 25% stated they would request PRS if a patient/caregiver asked, 35% indicated that nothing would prompt them to request PRS. Most respondents (54%) believed psychiatric PRS are currently …

T1 Signal Intensity Ratio Of The Pancreas As An Imaging Biomarker For The Staging Of Chronic Pancreatitis, Temel Tirkes, Anil K Dasyam, Zarine K Shah, Evan L Fogel, Santhi Swaroop Vege, Liang Li, Shuang Li, Stephanie T Chang, Carlos A Farinas, Joseph R Grajo, Kareem Mawad, Naoki Takahashi, Sudhakar K Venkatesh, Ashley Wachsman, William E Fisher, Christopher E Forsmark, Phil A Hart, Stephen J Pandol, Walter G Park, Stephen K Van Den Eeden, Yunlong Yang, Mark Topazian, Dana K Andersen, Jose Serrano, Darwin L Conwell, Dhiraj Yadav, Consortium For The Study Of Chronic Pancreatitis, Diabetes, Pancreatic Cancer (Cpdpc)

Center for Medical Ethics and Health Policy Staff Publications

Purpose: Our purpose was to validate the T1 SIR (T1 score) as an imaging biomarker for the staging of CP in a large, multi-institutional, prospective study.

Methods: The prospective study population included 820 participants enrolled in the PROCEED study from nine clinical centers between June 2017 and December 2021. A radiologist at each institution used a standardized method to measure the T1 signal intensity of the pancreas and the reference organs (spleen, paraspinal muscle, liver), which was used to derive respective T1 scores. Participants were stratified according to the seven mechanistic stages of chronic pancreatitis (MSCP 0-6) based on their …

Residence In A Latinx Enclave And End-Induction Minimal Residual Disease Positivity Among Children With Acute Lymphoblastic Leukemia, Joshua P Muñiz, John P Woodhouse, Amy E Hughes, Sandi L Pruitt, Karen R Rabin, Michael E Scheurer, Philip J Lupo, Jeremy M Schraw

Center for Medical Ethics and Health Policy Staff Publications

Racial and ethnic inequities in survival persist for children with acute lymphoblastic leukemia (ALL). In the US, there are strong associations between SES, race/ethnicity, and place of residence. This is evidenced by ethnic enclaves: neighborhoods with high concentrations of ethnic residents, immigrants, and language isolation. The Latinx enclave index (LEI) can be used to investigate how residence in a Latinx enclave is associated with health outcomes. We studied the association between LEI score and minimal residual disease (MRD) in 142 pediatric ALL patients treated at Texas Children's Hospital. LEI score was associated with end-induction MRD positivity (OR per unit increase …

Characteristics Of Graft-Versus-Host Disease (Gvhd) After Post-Transplantation Cyclophosphamide Versus Conventional Gvhd Prophylaxis, Rima M Saliba, Amin M Alousi, Joseph Pidala, Mukta Arora, Stephen R Spellman, Michael T Hemmer, Tao Wang, Camille Abboud, Sairah Ahmed, Joseph H Antin, Amer Beitinjaneh, David Buchbinder, Michael Byrne, Jean-Yves Cahn, Hannah Choe, Rabi Hanna, Peiman Hematti, Rammurti T Kamble, Carrie L Kitko, Mary Laughlin, Lazaros Lekakis, Margaret L Macmillan, Rodrigo Martino, Parinda A Mehta, Taiga Nishihori, Sagar S Patel, Miguel-Angel Perales, Hemalatha G Rangarajan, Olov Ringdén, Joseph Rosenthal, Bipin N Savani, Kirk R Schultz, Sachiko Seo, Takanori Teshima, Marjolein Van Der Poel, Leo F Verdonck, Daniel Weisdorf, Baldeep Wirk, Jean A Yared, Jeffrey Schriber, Richard E Champlin, Stefan O Ciurea

Center for Medical Ethics and Health Policy Staff Publications

Post-transplantation cyclophosphamide (PTCy) has been shown to effectively control graft-versus-host disease (GvHD) in haploidentical (Haplo) transplantations. In this retrospective registry study, we compared GvHD organ distribution, severity, and outcomes in patients with GvHD occurring after Haplo transplantation with PTCy GvHD prophylaxis (Haplo/PTCy) versus HLA-matched unrelated donor transplantation with conventional prophylaxis (MUD/conventional). We evaluated 2 cohorts: patients with grade 2 to 4 acute GvHD (aGvHD) including 264 and 1163 recipients of Haplo and MUD transplants; and patients with any chronic GvHD (cGvHD) including 206 and 1018 recipients of Haplo and MUD transplants, respectively. In comparison with MUD/conventional transplantation ± antithymocyte globulin …

Towards A Definitive Symptom Structure Of Obsessive-Compulsive Disorder: A Factor And Network Analysis Of 87 Distinct Symptoms In 1366 Individuals, Matti Cervin, Euripedes C Miguel, Ayşegül Selcen Güler, Ygor A Ferrão, Ayşe Burcu Erdoğdu, Luisa Lazaro, Sebla Gökçe, Daniel A Geller, Yasemin Yulaf, Şaziye Senem Başgül, Özlem Özcan, Koray Karabekiroğlu, Leonardo F Fontenelle, Yankı Yazgan, Eric A Storch, James F Leckman, Maria Conceição Do Rosário, David Mataix-Cols

Center for Medical Ethics and Health Policy Staff Publications

Background: The symptoms of obsessive-compulsive disorder (OCD) are highly heterogeneous and it is unclear what is the optimal way to conceptualize this heterogeneity. This study aimed to establish a comprehensive symptom structure model of OCD across the lifespan using factor and network analytic techniques.

Methods: A large multinational cohort of well-characterized children, adolescents, and adults diagnosed with OCD (N = 1366) participated in the study. All completed the Dimensional Yale-Brown Obsessive-Compulsive Scale, which contains an expanded checklist of 87 distinct OCD symptoms. Exploratory and confirmatory factor analysis were used to outline empirically supported symptom dimensions, and interconnections among the …

Longitudinal Investigation Of Suicidal Ideation And Associated Factors During Pediatric Acute Lymphoblastic Leukemia Chemotherapy, Kimberly P Raghubar, Tiffany Chambers, Ryan M Hill, Olga Taylor, Marilyn Hockenberry, M Casey Hooke, Pauline Mitby, Ida Ki Moore, Austin L Brown, Michael E Scheurer

Center for Medical Ethics and Health Policy Staff Publications

Objective: This study describes the prevalence of suicidal ideation (SI) during acute lymphoblastic leukemia (ALL) therapy and investigates the influence of clinical factors and physical symptoms on SI.

Methods: The Children's Depressive Inventory (CDI-2) was administered to ALL patients (diagnosed 2012-2017) at start of consolidation, delayed intensification (DI), maintenance cycle 1 (MC1), and maintenance cycle 2 (MC2) in a multi-site study. SI was present if patients endorsed the item "I want to kill myself." Logistic regression models evaluated associations between SI and sociodemographic factors; depressive symptoms; and below average, average, and above average symptom clusters identified using latent class analysis …

Analysis Of The Need For Legal Protection For Doctors In Teleconsultation Services Towards The Covid-19 Endemic In Indonesia, Mila Fitriana, Anhari Achadi

Journal of Indonesian Health Policy and Administration

Teleconsultation is a form of telemedicine that has developed rapidly during the COVID-19 pandemic. Clinical teleconsultation provides remote clinical consultation services to assist in establishing a diagnosis, and/or providing treatment considerations/advice. There are several issues in telemedicine, including ethical and legal issues. This study aims to find ethical and legal issues related to teleconsultation services after the COVID-19 pandemic. This research uses normative legal research methods. The laws and regulations that are reviewed by the researcher are those that are still valid in the Republic of Indonesia until June 2022. Researchers compare teleconsultation regulations and laws that were in effect …

Analysis Of Factors Related To Intention-To-Use Telemedicine Services (Teleconsultation) In Jabodetabek Residents During The Covid-19 Pandemic In 2021, Isna Mutiara Salsabila, Kurnia Sari

Journal of Indonesian Health Policy and Administration

The emergence of COVID-19 pandemic has made it difficult for people to access health services. According to JKN statistics, FKTP visits was decreased from 337.69 million (2019) to 193.03 (2021). Teleconsultation, a type of telemedicine, could be the right solution so that people can still access the health services they need and protect themselves from the spread of COVID-19. There was an increase in the use of several teleconsultation applications in Indonesia during pandemic, from 4 million to more than 15 million people. However, this rate is only 7.63% of the internet users and 5.6% of the total population of …

Analysis Of Prolanis Policy Implementation During The Covid-19 Pandemic In 2021, D.Fitria Sari Firdaus, Mardiati Nadjib

Journal of Indonesian Health Policy and Administration

Data from Basic Health Research (Riskesdas) in 2018 shows that Diabetes and Hypertension dominate chronic diseases. The Director of BPJS Kesehatan has issued Circular No. 14 of 2020 concerning health services for national health insurance participants during the COVID-19 prevention period, especially Prolanis. The policy contains an appeal to postpone the provision of services in the form of mass gathering activities such as Prolanis Gymnastics, Club Education, and and other activities. Hence, this research is needed to describe the implementation of Prolanis policies during the COVID-19 Pandemic. The study used a descriptive research design with qualitative methods and George C. …

Description Study Of Pandeglang Community Knowledge On Natural Disasters And Government Policies Related To Natural Disaster Preparedness In 2022, Novi Anggraini Ginting, Wiku Bakti Bawono Adisasmito

Journal of Indonesian Health Policy and Administration

Pandeglang Regency, which is a disaster-prone area, requires people who have sufficient knowledge to create community preparedness in dealing with disasters and can assist in the disaster mitigation process. This study aims to find out how the community's knowledge and community preparedness related to natural disasters and what efforts have been made by the government to improve the readiness of the people of Pandeglang Regency. This research method is descriptive and quantitative with 451 respondents. The results of the study showed that the people of Pandeglang Regency still did not know correctly the different types of threats or types of …

Service Of People With Psychiatric Problems (Odmk) At The Pasar Baru Health Center And Pabuaran Tumpeng Health Center In Tangerang City In 2022: A Comparative Study, Mentari Kirana Firdaus, Masyitoh Basabih

Journal of Indonesian Health Policy and Administration

Mental health is one of the global health issues with cases that continue to increase every year. In 2019, psychiatric problems were the second leading cause of disability worldwide with a total of 970 million cases. This research is a comparative study that aims to determine the difference between ODMK services at Pasar Baru Health Center and Pabuaran Tumpeng Health Center. This research uses a qualitative approach with a case study method, data collection is done through in-depth interviews and document review. The variables analyzed include input, process, and output. The results of the study found that in the input …

Observational Study Of The Clinical Performance Of A Public-Private Partnership National Referral Hospital Network In Lesotho: Do Improvements Last Over Time?, Nancy A. Scott, Jeanette L. Kaiser, Brian W. Jack, Elizabeth L. Nkholongo, Allison Juntunen, Tshema Nash, Mayowa Alade, Taryn Vian

Nursing and Health Professions Faculty Research and Publications

Public-private partnerships (PPP) may increase healthcare quality but lack longitudinal evidence for success. The Queen ‘Mamohato Memorial Hospital (QMMH) in Lesotho is one of Africa’s first healthcare PPPs. We compare data from 2012 and 2018 on capacity, utilization, quality, and outcomes to understand if early documented successes have been sustained using the same measures over time. In this observational study using administrative and clinical data, we assessed beds, admissions, average length of stay (ALOS), outpatient visits, and patient outcomes. We measured triage time and crash cart stock through direct observation in 2013 and 2020. Operational hospital beds increased from 390 …

Democratizing The Economy Or Introducing Economic Risk? Gig Work During The Covid-19 Pandemic, Daniel Auguste, Stephen Roll, Mathieu Despard

Social Policy Institute Research

Though the growth of the gig economy has coincided with increased economic precarity in the new economy, we know less about the extent to which gig work (compared with other self-employment arrangements and non-gig work) may fuel economic insecurity among American households. We fill this gap in the literature drawing on a sample of 4,756 workers from a unique national survey capturing economic hardships among non-standard workers like app-and platform-based gig and other self-employed workers during the COVID-19 pandemic. Results from generalized boosted regression modeling, utilizing machine learning to account for potential endogeneity, demonstrated that gig workers experienced significantly greater …

Considering The Genetic Architecture Of Hypoplastic Left Heart Syndrome, John W Belmont

Center for Medical Ethics and Health Policy Staff Publications

Hypoplastic left heart syndrome (HLHS) is among the most severe cardiovascular malformations and understanding its causes is crucial to making progress in prevention and treatment. Genetic analysis is a broadly useful tool for dissecting complex causal mechanisms and it is playing a significant role in HLHS research. However, unlike classical Mendelian disorders where a relatively small number of genes are largely determinative of the occurrence and severity of the disease, the picture in HLHS is complex. De novo single-gene and copy number variant (CNV) disorders make an important contribution, but there is emerging evidence for causal contributions from lower penetrance …

Usage And Impact Of Benefits Among Frontline Healthcare Workers, Mathieu Despard

Social Policy Institute Research

We completed a study about frontline healthcare workers – the benefits they get through work and how they are doing financially. This brief provides highlights from our survey to 2,321 workers and interviews with 30 workers.

“The More People’S Stories That We Learn, The More We Can Wrap Around Our Support”: How Postoperative Bariatric Surgery Patients Use Online Communities, Breisha George

Health Sciences Student Scholarship

Bariatric surgery (also called weight loss surgery) is often thought of as a one-day medical procedure. However, after surgery, there are long-term physical and psychological changes that each patient manages. The goal of this study was to gain deeper insights into how a patient navigates their postoperative experience after bariatric surgery, specifically examining their use of online bariatric communities. Ten semi-structured interviews were conducted, transcribed, and thematically analyzed. Three major themes were identified: (1) Mental Health, (2) Belonging to Community, (3) Support. Each theme incudes several sub-themes, showcasing a range of helpful and harmful experiences from engaging with these online …

Toward Informatics-Enabled Preparedness For Natural Hazards To Minimize Health Impacts Of Climate Change, Jimmy Phuong, Naomi O. Riches, Luca Calzoni, Gora Datta, Deborah Duran, Asiyah Yu Lin, Ramesh P. Singh, Anthony E. Solomonides, Noreen Y. Whysel, Ramakanth Kavuluru

Publications and Research

Natural hazards (NHs) associated with climate change have been increasing in frequency and intensity. These acute events impact humans both directly and through their effects on social and environmental determinants of health. Rather than relying on a fully reactive incident response disposition, it is crucial to ramp up preparedness initiatives for worsening case scenarios. In this perspective, we review the landscape of NH effects for human health and explore the potential of health informatics to address associated challenges, specifically from a preparedness angle. We outline important components in a health informatics agenda for hazard preparedness involving hazard-disease associations, social determinants …