Health Policy Commons^™

Park Access And Quality In Mountain West Cities, 2023, Maryam Raja, Julia Salangsang, Vanessa M. Booth, Caitlin J. Saladino, William E. Brown Jr.

Environment

This fact sheet presents data from a 2023 publication from The Trust for Public Land ParkScore® Index1 which provides data on public parks for the 100 largest cities in the United States. The fact sheet includes park scores for the cities in the Mountain West states of Nevada, Arizona, Colorado, and New Mexico. This fact sheet expands upon a previously published fact sheet on park access and quality from 2020.

Nevada Medical Residencies, 2023, Annie J. Vong, Emily J. Daclan, Caitlin J. Saladino, William E. Brown Jr.

Health

This fact sheet highlights medical residency data for the 2021, 2022, 2023 graduating classes of the Kirk Kerkorian School of Medicine at the University of Nevada, Las Vegas (UNLV) and the University of Nevada, Reno (UNR) School of Medicine. This fact sheet presents the number of residency program matches at the Kirk Kerkorian School of Medicine at UNLV and the UNR School of Medicine and reveals where Nevada medical school students pursue their residencies, and updates findings from a 2022 fact sheet exploring 2021 and 2022 graduating class data.

Firearm Deaths In The Mountain West, 2020, Lana Kojoian, Annie Vong, Caitlin J. Saladino, William E. Brown Jr.

Criminal Justice

This fact sheet examines data from the RAND Corporation report “Understanding Firearm Deaths by State—and How to Reduce Them,” which provides data on state and national rates of firearm related deaths, including suicides and homicides for 2020 This fact sheet includes firearm death data for five Mountain West states: Arizona, Colorado, Nevada, New Mexico, and Utah.

Women’S Leadership And Covid-19 Pandemic: Navigating Crises Through The Application Of Connective Leadership, Chris Taylor Cartwright, Maura Harrington, Sarah Smith Orr, Tessa Sutton

International & Global Studies Faculty Publications and Presentations

International and national crises often highlight behavioral patterns in the labor market that illustrate women’s courage and adaptability in challenging times. The COVID-19 pandemic and resulting changes in the workplace due to social distancing, remote work, and tele-communications protocols showcased women’s power of authenticity and accessibility (interpersonal and personalized experiences) to engage with their constituents effectively. The catalyzed this research was our desire to underscore the importance of studying the impact of COVID-19 on women leaders. The COVID-19 pandemic brought to light specific challenges and disparities women faced in the workplace. It has been asserted that women leaders substantially benefit …

Applying Structural Equation Modeling To Better Understand The Relationship Between Stressors, Social Support And Wellbeing In The Lives Of Spouse Dementia Caregivers, Craig Holden

Dissertations, Theses, and Capstone Projects

Applying Structural Equation Modeling to Better Understand the Relationship Between Stressors, Social Support and Wellbeing in the Lives of Spouse Dementia Caregivers considers the utility of Pearlin et al.’s (1990) stress process model in understanding the needs of spouse caregivers. Data were drawn from eight biennial waves of the University of Michigan Health and Retirement Study (HRS) and analyzed using structural equation modeling. The final study sample comprised 774 spouses, average age 73, who were categorized based on Alzheimer’s Disease and Related Dementia (ADRD) and non-ADRD caregiver status. Results showed that for the study sample as a whole, social support …

Poverty And Commercial Surrogacy In India: An Intersectional Analytical Approach, Sheela Suryanarayanan

Dignity: A Journal of Analysis of Exploitation and Violence

The destination and source countries for commercial surrogacy match world patterns of inequality. India, Nepal, Thailand, Mexico, and Cambodia banned commercial surrogacy, moving the market to other less-developed countries in South Africa and South America. India had a commercial surrogacy boom until exploitative factors led to the passage of the Surrogacy (Regulation) Bill in 2019, which banned the practice. This paper examines surrogacy's monetary, health, and emotional effects on 45 surrogate mothers in Gujarat State, India. The study revealed that a majority (63%) of the very poor women remained very poor post-surgery. Surrogate mothers in poor households had to do …

The Promise Of Universalism Deferred: Political Economy Of Social Policy In 21st Century Latin America, Juan C. Ferre

Dissertations, Theses, and Capstone Projects

In the first decade and half of the 21st century, most Latin American countries experienced a long-overdue reduction in income inequalities and significant social policy expansion. While this welfare expansion has been widely documented, scholars have paid less attention to the persistent or increasing segmentation: inequalities in transfers and in the quality of services across population groups continued unabated. This dissertation employs mixed-methods to respond to the following questions: have governments in Latin America, and Left governments in particular, made significant progress toward universal social policy?

For 17 Latin American countries in the period 2000-2020, I measure three dimensions …

Cell-Based Noninvasive Prenatal Testing (Cbnipt)-A Review On The Current Developments And Future Prospects, Mohamad Ali Maktabi, Liesbeth Vossaert, Ignatia B Van Den Veyver

Center for Medical Ethics and Health Policy Staff Publications

Considering the diagnostic limitations of cfDNA-based noninvasive prenatal testing (NIPT), scientists have long been interested in isolating and analyzing rare intact fetal and trophoblast cells from maternal blood or endocervical samples to diagnose fetal genetic conditions. These cells may be scarce and difficult to isolate, but they are a direct source of pure fetal genetic material. In this review, we summarize the history of cell-based NIPT, present an updated review on its current developments, evaluate its genetic diagnostic potential, and discuss its future prospects for clinical use.

Common Rituals In Obsessive-Compulsive Disorder And Implications For Treatment: A Mixed-Methods Study, Caitlin M Pinciotti, Nyssa Z Bulkes, Brenda E Bailey, Eric A Storch, Jonathan S Abramowitz, Leonardo F Fontenelle, Bradley C Riemann

Center for Medical Ethics and Health Policy Staff Publications

Obsessive-compulsive disorder (OCD) is characterized by engagement in rituals that serve to obtain certainty and prevent feared outcomes. Exposure and response prevention is most effective when rituals are resisted, yet existing self-report measures of OCD limit identification of the full range of possible rituals, and little is known about how rituals might cluster together and predict worsened severity and poorer treatment outcomes. In a retrospective sample of 641 adult patients who received intensive OCD treatment, the present study used a mixed-methods approach to (a) identify and validate treatment provider-identified rituals using the Yale-Brown Obsessive-Compulsive Scale, (b) identify clustering patterns of …

Closing The Gap For Children With Ocd: A Staged-Care Model Of Cognitive Behavioural Therapy With Exposure And Response Prevention, Lara J Farrell, Allison M Waters, Eric A Storch, Gabrielle Simcock, Iain E Perkes, Jessica R Grisham, Katelyn M Dyason, Thomas H Ollendick

Center for Medical Ethics and Health Policy Staff Publications

Childhood obsessive-compulsive disorder (OCD) is among the most prevalent and disabling mental health conditions affecting children and adolescents. Although the distress and burden associated with childhood OCD are well documented and empirically supported treatments are available, there remains an unacceptable "treatment gap" and "quality gap" in the provision of services for youth suffering from OCD. The treatment gap represents the large number of children who never receive mental health services for OCD, while the quality gap refers to the children and young people who do access services, but do not receive evidence-based, cognitive behavioural therapy with exposure and response prevention …

International Society For Cell & Gene Therapy Position Paper: Key Considerations To Support Evidence-Based Cell And Gene Therapies And Oppose Marketing Of Unproven Products, Laertis Ikonomou, Natividad Cuende, Miguel Forte, Bambi J Grilley, Aaron D Levine, Megan Munsie, John E J Rasko, Leigh Turner, Hamid R Bidkhori, Rachele Ciccocioppo, Felix Grignon, Alok Srivastava, Daniel J Weiss, Patricia Zettler, Bruce L Levine

Center for Medical Ethics and Health Policy Staff Publications

The field of regenerative medicine, including cellular immunotherapies, is on a remarkable growth trajectory. Dozens of cell-, tissue- and gene-based products have received marketing authorization worldwide while hundreds-to-thousands are either in preclinical development or under clinical investigation in phased clinical trials. However, the promise of regenerative therapies has also given rise to a global industry of direct-to-consumer offerings of prematurely commercialized cell and cell-based products with unknown safety and efficacy profiles. Since its inception, the International Society for Cell & Gene Therapy Committee on the Ethics of Cell and Gene Therapy has opposed the premature commercialization of unproven cell- and …

Childhood Exposure To Parental Threatening Behaviors And Anxiety In Emerging Adulthood: Indirect Effects Of Perceived Stress, Erika S Trent, Andres G Viana, Elizabeth M Raines, Haley E Conroy Busch, Karina Silva, Eric A Storch, Michael J Zvolensky

Center for Medical Ethics and Health Policy Staff Publications

Background: Although childhood exposure to parental threatening behaviors is associated with elevated anxiety in emerging adulthood, the underlying mechanisms remain unexplored. Perceived stress-a subjective experience comprised of feelings of helplessness (being unable to cope or exert control) and poor self-efficacy (confidence in one's ability to manage stressors)-is one candidate mechanism. The present investigation examined the underlying role of perceived stress in the association between childhood exposure to parental threatening behaviors and anxiety symptom severity in a sample of emerging adults.

Methods: Participants (N = 855; Mage = 18.75 years, SD = 1.05, range 18-24; 70.8% female) were recruited from a …

High Foxa1 Levels Induce Er Transcriptional Reprogramming, A Pro-Metastatic Secretome, And Metastasis In Endocrine-Resistant Breast Cancer, Xiaoyong Fu, Resel Pereira, Chia-Chia Liu, Carmine De Angelis, Martin J Shea, Sarmistha Nanda, Lanfang Qin, Tamika Mitchell, Maria L Cataldo, Jamunarani Veeraraghavan, Vidyalakshmi Sethunath, Mario Giuliano, Carolina Gutierrez, Balázs Győrffy, Meghana V Trivedi, Ofir Cohen, Nikhil Wagle, Agostina Nardone, Rinath Jeselsohn, Mothaffar F Rimawi, C Kent Osborne, Rachel Schiff

Center for Medical Ethics and Health Policy Staff Publications

Aberrant activation of the forkhead protein FOXA1 is observed in advanced hormone-related cancers. However, the key mediators of high FOXA1 signaling remain elusive. We demonstrate that ectopic high FOXA1 (H-FOXA1) expression promotes estrogen receptor-positive (ER+) breast cancer (BC) metastasis in a xenograft mouse model. Mechanistically, H-FOXA1 reprograms ER-chromatin binding to elicit a core gene signature (CGS) enriched in ER+ endocrine-resistant (EndoR) cells. We identify Secretome14, a CGS subset encoding ER-dependent cancer secretory proteins, as a strong predictor for poor outcomes of ER+ BC. It is elevated in ER+ metastases vs. primary tumors, irrespective of ESR1 mutations. Genomic ER binding near …

Association Between Chronic Disease And Substance Use Among Older Adults In Tennessee, Manik Ahuja, Jessica Stamey, Johanna Cimilluca, Kawther Al Skir, Mary K. Herndon, Kathleen Baggett, Thiveya Sathiyasaleen, Praveen Fernandopulle

ETSU Faculty Works

Background:

Design and methods:

Covid-19 Mortality Rates Were Higher In States That Limited Governments From Enacting Public Health Emergency Orders, Xue Zhang, Mildred E. Warner, Gen Meredith

Population Health Research Brief Series

State and local governments enacted various public health emergency policies during the COVID-19 pandemic, resulting in lower infection and death rates than would have occurred without these policies. However, some states limited the emergency public health authority of state executives, state governors, and other state and local officials during the pandemic. This brief summarizes the results of a study that used data from the Center for Public Health Law Research and Oxford COVID-19 Government Response Tracker to explore which states passed laws that limited emergency public health authority during the COVID-19 pandemic and the effects of those limits on COVID-19 …

The Effect Of An Intersectionality Elective On The Perceived Self-Efficacy Of Medical Students In Addressing Health Inequity, Patrick Rollo, Noel Higgason, Kaitlyn Stark, Amina Aslam, Mason Motakef, Olivia Kerr, Asia Mccleary-Gaddy

Teaching in Clinics

Background: Intersectionality is a theoretical framework that contextualizes an individual’s experience as more than the sum of their cultural identifiers.

Aims: The current study investigates the effect of a 10-week intersectionality curriculum supplemented with student-led discussions on medical students’ self-efficacy in addressing bias and health inequity.

Methods: First- and second-year medical students volunteered to participate in a ten-week pilot elective entitled “Intersectionality in Medicine.” Participants enrolled in the course were required to complete a ten-minute online pre-elective and post-elective survey.

Results: Results showed that after completing the elective, medical students were significantly more confident in identifying their personal biases, assessing …

Uthealth Quality Symposium 2023 Abstracts-2, Salih Selek

Teaching in Clinics

UTHealth Quality Symposium 2023 Abstracts

Uthealth Quality Symposium 2023 Abstracts-1, Salih Selek

Teaching in Clinics

UTHealth Quality Symposium 2023 Abstracts

A Review Of Recent Update In Acgme Faculty Qualifications, Salih Selek

Teaching in Clinics

A Review on Update of ACGME Faculty Qualifications

Emotional Distress During Covid-19 By Mental Health Conditions And Economic Vulnerability: Retrospective Analysis Of Survey-Linked Twitter Data With A Semisupervised Machine Learning Algorithm, Michiko Ueda-Ballmer, Kohei Watanabe, Hajime Sueki

Center for Policy Design and Governance

The brief summarizes "Emotional Distress During COVID-19 by Mental Health Conditions and Economic Vulnerability: Retrospective Analysis of Survey-Linked Twitter Data With a Semisupervised Machine Learning Algorithm," co-authored by Michiko Ueda-Ballmer, Kohei Watanabe, and Hajime Sueki in the Journal of Medical Internet Research.

Utilization And Costs Of Home Hemodialysis, In-Center Hemodialysis, And Peritoneal Dialysis Among Patients With End-Stage Renal Disease (Esrd) In The United States, Andres Mauricio Garcia Sierra

Electronic Theses and Dissertations, 2020-2023

Chronic kidney disease (CKD) is a condition that requires access to renal replacement therapies (RRTs) to enable patients to live. The use of such therapies has been continuously researched due to the high cost to payers and their patients. This dissertation aimed to analyze the incidence, prevalence, and mortality of renal replacement therapies in patients with end-stage renal disease (ESRD), and document cost trends and analyze possible inequalities in access to these therapies. Based on an integrated health risk management (IHRM) model, this study examined patient characteristics associated with renal replacement therapies in ESRD patients through a pooled cross-sectional study …

An Exploration Of Policies, Equity, And Emerging Threats To The Traffic Safety Environment In The U.S., Sachi Verma

Theses & Dissertations

Road traffic crashes are among one of the leading causes of death around the globe. Additionally, it also causes long-term physical disabilities, mental trauma, and financial pressure. By implementing road safety guidelines such as speed limits, drug and alcohol checkpoints, restraints, and penalties, motor vehicle crashes can be reduced. Road traffic crash survival primarily depends on emergency medical service's timely triaging. Rapid triaging and reduced response times can help road traffic crash morbidities and mortalities. However, several factors can be responsible for EMS delays in responding to a fatal crash. This dissertation aims to observe multiple factors related to EMS …

Indigenous Water Rights: Navigating Sovereign Waters, Cynthia N. Pina

Master's Projects and Capstones

The issue of Native American water rights and the sovereignty of their land on reservations is gaining increasing prominence, making it the focal point of this thesis as an environmental justice concern. Native Americans face disproportionate public health challenges related to water accessibility, contamination, sanitation, outdated infrastructure, and other social determinants of health. The legal framework that governs the coexistence of Native Americans in the United States is rooted in a settler colonial perspective. Consequently, this has created a dependent relationship between Native Americans and the United States federal government. Despite the long-standing advocacy of Tribes for sovereignty since the …

A Consensus Panel Approach To Estimating The Start-Up And Annual Service Costs For Rural Ambulance Agencies, Yvonne Jonk Phd, Gary Wingrove Facpe, Cp-C, Nikiah Nudell Ms, Mphil, Nrp, Facpe, Kevin Mcginnis Mps

Emergency Medical Services (EMS)

This brief serves to fill the information void on the costs of running ambulance services for three population-based service tiers and establishes a minimum access standard for ambulances servicing a 25-minute travel time radius from the ambulance station. The model enables policymakers and community stakeholders to develop strategic plans for the financing and provision of ambulance services. Key Highlights: An expert panel established that ambulances could reasonably serve a maximum 25-minute travel time from the ambulance station that accounts for road conditions. A minimum access standard was defined as a single resource consisting of one full-time staffed ambulance, with a …

Greater Portland Health Homeless Opioid User Service Engagement Program: Final Evaluation Report, Mary Lindsey Smith Phd, Evelyn Ali Bs, Tyler Egeland Ba, Katharine Freund Mph, Thomas Chalmers Mclaughlin Msw, Phd, Katie Rosingana Ba

Substance Use Research & Evaluation

Given the high rates of overdoses in the Bayside area of Portland, Maine, as well as the shortage of providers and services to meet the complex medical and social determinant of health (SDOH) needs of individuals who are experiencing homlessness (IWAEH), with funds from the State of Maine, Greater Portland Health and Preble Street collaborated to implement the HOUSE Program. The HOUSE Program was implemented in the Greater Portland metropolitan area with a specific focus on expanding the continuum of care at Greater Portland Health’s Bayside Homeless site to include comprehensive SUD treatment, case management and housing services to IWAEH. …

Trends Of Azole Antifungal Prescription In The United States: Medicare Part D Provider Utilization And Payment Data Analysis, Mohanad M Al-Obaidi, Luis Ostrosky-Zeichner, David E Nix

Faculty, Staff and Student Publications

BACKGROUND: Invasive fungal infections carry a substantial risk of mortality and morbidity. Azole antifungals are used in the treatment of such infections; however, their extensive use can lead to the emergence of antifungal resistance and increased costs to patients and healthcare systems. The aim of this study is to evaluate trends in these antifungals use and costs.

METHODS: The secular and regional trends of outpatient azole antifungals were analyzed using Medicare Part D Prescriber Public Use Files for the years 2013-2020. The total days supply (TDS), total drug cost (TDC) per 100 000 enrollees, and cost per day (CPD) were …

Clinical And Demographic Attributes Of Patients With Diabetes Associated With The Utilization Of Telemedicine In An Urban Medically Underserved Population Area, Lisa Ariellah Ward, Gulzar H. Shah, Kristie C. Waterfield

Health Policy & Community Health: Faculty Publications

Marginalized populations often experience health disparities due to the significant obstacles to care associated with social, economic, and environmental inequities. When compared with advantaged social groups, these populations frequently experience increased risks, poorer health outcomes, and reduced quality of life (QoL). This research examines the clinical and demographic characteristics—age, gender, and race—related to patients with varying stages of type 2 diabetes mellitus (T2DM), comparing the utilization of telemedicine (TM) with traditional healthcare face-to-face (F2F) appointments in an urban medically underserved population area (UMUPA). A logistic regression model, was used to analyze retrospective electronic patient health records (EHRs) from 1 January …

Polymorphisms In The Nonhomologous End-Joining Dna Repair Pathway Are Associated With Hpv Integration In Cervical Dysplasia, Jennifer M Geris, E Susan Amirian, Deborah A Marquez-Do, Martial Guillaud, Laura M Dillon, Michele Follen, Michael E Scheurer

Center for Medical Ethics and Health Policy Staff Publications

Previous evidence indicates that HPV integration status may be associated with cervical cancer development and progression. However, host genetic variation within genes that may play important roles in the viral integration process is understudied. The aim of this study was to examine the association between HPV16 and HPV18 viral integration status and single nucleotide polymorphisms (SNPs) in non-homologous end-joining (NHEJ) DNA repair pathway genes on cervical dysplasia. Women enrolled in two large trials of optical technologies for cervical cancer detection and positive for HPV16 or HPV18 were selected for HPV integration analysis and genotyping. Associations between SNPs and cytology (normal, …

Intraoperative Predictors Of In-Hospital Mortality After Open Repair Of Ruptured Abdominal Aortic Aneurysms, Nicola Troisi, Giulia Bertagna, Athanasios Saratzis, Simone Guadagni, Fabrizio Minichilli, Daniele Adami, Mauro Ferrari, Raffaella Berchiolli

Center for Medical Ethics and Health Policy Staff Publications

Background: Several models and scores have been released to predict early mortality in patients undergoing surgery for a ruptured abdominal aortic aneurysm (rAAA). These scores included above all preoperative factors and they could be useful to deny surgical repair. The aim of the study was to evaluate intraoperative predictors of in-hospital mortality in patients undergoing open surgical repair (OSR) for a rAAA.

Methods: Between January 2007 and December 2020, 265 patients were admitted at our tertiary referral hospital for a rAAA. Two-hundred-twenty-two patients underwent OSR. Intra-operative factors were analyzed by means of univariate analysis (step 1). Associations of procedure variables …

Editorial, Al Asyary

Kesmas

No abstract provided.