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Healthcare Disparities And Noncompliance In Children And Young Adults With Crohn’S Disease, Robert McLoughlin 2019 University of Massachusetts Medical School

Healthcare Disparities And Noncompliance In Children And Young Adults With Crohn’S Disease, Robert Mcloughlin

GSBS Dissertations and Theses

Objective:

Treatment compliance in children with Crohn’s disease is associated with higher levels of symptom remission. We hypothesized that the management, comorbidities, and complications for children with Crohn’s disease would differ based on a diagnosis of noncompliance.

Methods:

Using the Kids’ Inpatient Database for 2006-2012, we identified young patients (<21 >years) with a diagnosis of Crohn’s disease. Diagnoses and procedures were analyzed according to a recorded diagnosis of noncompliance. Multivariable logistic regression analysis was performed to examine the association between noncompliance and the outcomes of interest.

Results:

There were 28,337 pediatric Crohn’s disease hospitalizations identified with ...


Changes In Anticoagulant Utilization Among United States Nursing Home Residents With Atrial Fibrillation From 2011 To 2016, Matthew Alcusky, David D. McManus, Anne L. Hume, Marc Fisher, Jennifer Tjia, Kate L. Lapane 2019 University of Massachusetts Medical School

Changes In Anticoagulant Utilization Among United States Nursing Home Residents With Atrial Fibrillation From 2011 To 2016, Matthew Alcusky, David D. Mcmanus, Anne L. Hume, Marc Fisher, Jennifer Tjia, Kate L. Lapane

Open Access Publications by UMMS Authors

Background: Nursing home residents with atrial fibrillation are at high risk for ischemic stroke and bleeding events. The most recent national estimate (2004) indicated less than one third of this high-risk population was anticoagulated. Whether direct-acting oral anticoagulant ( DOAC ) use has disseminated into nursing homes and increased anticoagulant use is unknown.

Methods and Results: A repeated cross-sectional design was used to estimate the point prevalence of oral anticoagulant use on July 1 and December 31 of calendar years 2011 to 2016 among Medicare fee-for-service beneficiaries with atrial fibrillation residing in long-stay nursing homes. Nursing home residence was determined using Minimum ...


Segmental Distribution Of Hepatocellular Carcinoma Correlates With Microvascular Invasion In Liver Explants Undergoing Transplantation, Yasir Al-Azzawai, Eva Rouanet, Ryan J. Hendrix, Lidia Spaho, Hesham Malik, Deepika Devuni, Gyongyi Szabo, Graham Barnard 2019 University of Massachusetts Medical School

Segmental Distribution Of Hepatocellular Carcinoma Correlates With Microvascular Invasion In Liver Explants Undergoing Transplantation, Yasir Al-Azzawai, Eva Rouanet, Ryan J. Hendrix, Lidia Spaho, Hesham Malik, Deepika Devuni, Gyongyi Szabo, Graham Barnard

Open Access Publications by UMMS Authors

Introduction: Microvascular invasion (MVI) in hepatocellular carcinoma (HCC) patients is a poor prognostic factor after liver transplantation and/or resection. Any correlation between MVI and segmental location of HCC has yet to be studied. Our aim is to evaluate the segmental location of HCC and any correlation with the presence of MVI, portal vein thrombosis (PVT) in explanted livers, and the recurrence of HCC after transplantation. Another objective of the study is to assess the treatment history (ablation or transarterial chemoembolization (TACE)) and size of the tumor with respect to the risk of MVI.

Methods: A single center, retrospective chart ...


A Cross-Sectional Analysis Of Factors Associated With Detection Of Oncogenic Human Papillomavirus In Human Immunodeficiency Virus-Infected And Uninfected Kenyan Women, A. Ermel, P. Tonui, M. Titus, Y. Tong, N. Wong, J. Ong'echa, K. Muthoka, S. Kiptoo, Ann M. Moormann, J. Hogan, A. Mwangi, S. Cu-Uvin, P. J. Loehrer, O. Orang'o, D. Brown 2019 Indiana University

A Cross-Sectional Analysis Of Factors Associated With Detection Of Oncogenic Human Papillomavirus In Human Immunodeficiency Virus-Infected And Uninfected Kenyan Women, A. Ermel, P. Tonui, M. Titus, Y. Tong, N. Wong, J. Ong'echa, K. Muthoka, S. Kiptoo, Ann M. Moormann, J. Hogan, A. Mwangi, S. Cu-Uvin, P. J. Loehrer, O. Orang'o, D. Brown

Open Access Publications by UMMS Authors

BACKGROUND: Cervical cancer is caused by oncogenic human papillomaviruses (HPV) and is one of the most common malignancies in women living in sub-Saharan Africa. Women infected with the human immunodeficiency virus (HIV) have a higher incidence of cervical cancer, but the full impact on HPV detection is not well understood, and associations of biological and behavioral factors with oncogenic HPV detection have not been fully examined. Therefore, a study was initiated to investigate factors that are associated with oncogenic HPV detection in Kenyan women.

METHODS: Women without cervical dysplasia were enrolled in a longitudinal study. Data from enrollment are presented ...


Lipoprotein(A) Plasma Levels, Bone Mineral Density And Risk Of Hip Fracture: A Post Hoc Analysis Of The Women's Health Initiative, Usa, Bernhard Haring, Carolyn J. Crandall, Laura Carbone, Simin Liu, Wenjun Li, Karen C. Johnson, Jean Wactawski-Wende, Aladdin H. Shadyab, Margery L. Gass, Victor Kamensky, Jane A. Cauley, Sylvia Wassertheil-Smoller 2019 University of Würzburg

Lipoprotein(A) Plasma Levels, Bone Mineral Density And Risk Of Hip Fracture: A Post Hoc Analysis Of The Women's Health Initiative, Usa, Bernhard Haring, Carolyn J. Crandall, Laura Carbone, Simin Liu, Wenjun Li, Karen C. Johnson, Jean Wactawski-Wende, Aladdin H. Shadyab, Margery L. Gass, Victor Kamensky, Jane A. Cauley, Sylvia Wassertheil-Smoller

Open Access Publications by UMMS Authors

OBJECTIVES: Elevated Lipoprotein(a) (Lp[a]) is a well-known risk factor for cardiovascular disease. However, its roles in bone metabolism and fracture risk are unclear. We therefore investigated whether plasma Lp(a) levels were associated with bone mineral density (BMD) and incident hip fractures in a large cohort of postmenopausal women.

DESIGN: Post hoc analysis of data from the Women's Health Initiative (WHI), USA.

SETTING: 40 clinical centres in the USA.

PARTICIPANTS: The current analytical cohort consisted of 9698 white, postmenopausal women enrolled in the WHI, a national prospective study investigating determinants of chronic diseases including heart disease, breast ...


Protocol For Serious Fall Injury Adjudication In The Strategies To Reduce Injuries And Develop Confidence In Elders (Stride) Study, David A. Ganz, Jerry H. Gurwitz 2019 University of California, Los Angeles

Protocol For Serious Fall Injury Adjudication In The Strategies To Reduce Injuries And Develop Confidence In Elders (Stride) Study, David A. Ganz, Jerry H. Gurwitz

Open Access Publications by UMMS Authors

Background: This paper describes a protocol for determining the incidence of serious fall injuries for Strategies to Reduce Injuries and Develop Confidence in Elders (STRIDE), a large, multicenter pragmatic clinical trial with limited resources for event adjudication. We describe how administrative data (from participating health systems and Medicare claims) can be used to confirm participant-reported events, with more time- and resource-intensive full-text medical record data used only on an "as-needed" basis.

Methods: STRIDE is a pragmatic cluster-randomized controlled trial involving 5451 participants age > /= 70 and at increased risk for falls, served by 86 primary care practices in 10 US health ...


Quantifying The Invisible: A Literature Review And History Of Research On The Health Effects Of Wildfire Smoke, Lily A. Cook MA 2019 Oregon Health & Science University

Quantifying The Invisible: A Literature Review And History Of Research On The Health Effects Of Wildfire Smoke, Lily A. Cook Ma

OHSU-PSU School of Public Health Annual Conference

The objective of this scoping review is to provide an overview of issues affecting the results of studies on the health effects of non-occupational wildfire exposure. Although it is well established that wildfire smoke is harmful to people with chronic respiratory conditions, research on other health impacts have often found inconsistent results or small effect sizes. These results are often misinterpreted to mean that wildfire smoke has a negligible effect on non-respiratory outcomes such as cardiovascular health or mortality. However, what these results actually reflect is the complexity of determining public exposure to wildfire smoke, as well as variations in ...


U.S. Prevalence Of Endocrine Therapy-Naive Locally Advanced Or Metastatic Breast Cancer, Anthony P. Nunes, C. Liang, W. J. Gradishar, T. Dalvi, J. Lewis, N. Jones, E. Green, M. Doherty, J. D. Seeger 2019 University of Massachusetts Medical School

U.S. Prevalence Of Endocrine Therapy-Naive Locally Advanced Or Metastatic Breast Cancer, Anthony P. Nunes, C. Liang, W. J. Gradishar, T. Dalvi, J. Lewis, N. Jones, E. Green, M. Doherty, J. D. Seeger

Open Access Publications by UMMS Authors

Background: Variations in treatment choice, or late stage at first diagnosis, mean that, despite guideline recommendations, not all patients with hormone receptor (hr)-positive locally advanced or metastatic breast cancer (la/mbca) will have received endocrine therapy before disease progression. In the present study, we aimed to estimate the proportion of women with postmenopausal hr-positive la/mbca in the United States who are endocrine therapy-naive.

Methods: Women in the Optum Electronic Health Record (ehr) database with a breast cancer (bca) diagnosis (January 2008-March 2015) were included. Patient and malignancy characteristics were identified using structured data fields and natural-language processing of ...


Are We Optimizing The Use Of Dual Antiplatelet Therapy In Patients Hospitalized With Acute Myocardial Infarction?, Essa H. Hariri 2019 University of Massachusetts Medical School

Are We Optimizing The Use Of Dual Antiplatelet Therapy In Patients Hospitalized With Acute Myocardial Infarction?, Essa H. Hariri

GSBS Dissertations and Theses

Background: Dual antiplatelet therapy (DAPT) is a mainstay treatment for hospital survivors of an acute myocardial infarction (AMI). However, there are extremely limited data on the prescribing patterns of DAPT among patients hospitalized with AMI.

Objective: To examine decade-long trends (2001-2011) in the use of DAPT versus antiplatelet monotherapy and patient characteristics associated with DAPT use.

Methods: The study population consisted of 2,389 adults hospitalized with an initial AMI at all 11 central Massachusetts medical centers on a biennial basis between 2001 and 2011. DAPT was defined as the discharge use of aspirin plus either clopidogrel or prasugrel. Logistic ...


Religiosity And Patient Activation And Health Outcomes Among Hospital Survivors Of An Acute Coronary Syndrome, Hawa Ozien Abu 2019 University of Massachusetts Medical School

Religiosity And Patient Activation And Health Outcomes Among Hospital Survivors Of An Acute Coronary Syndrome, Hawa Ozien Abu

GSBS Dissertations and Theses

Background: Religious involvement is widespread and may influence patient engagement with their healthcare (patient activation) and health outcomes. This dissertation examined the association between religiosity and patient activation, changes in health-related quality of life (HRQOL), readmissions, and survival after hospitalization for acute coronary syndrome (ACS).

Methods: We recruited 2,174 patients hospitalized for ACS in Georgia and Central Massachusetts (2011-2013) in a prospective cohort study. Participants self-reported three items assessing religiosity – strength/comfort from religion, petition prayers for health, and awareness of intercessory prayers by others. Patient activation was measured using the 6-item Patient Activation Measure. Generic HRQOL was assessed ...


Minimal Associations Between Clinical Data And Children's Self-Reported Health-Related Quality Of Life In Children With Chronic Conditions-A Cross-Sectional Study, Kathrin I. Fischer, Dana Barthel, Christiane Otto, Ulrike Ravens-Sieberer, Ute Thyen, Marcus Klein, Otto Walter, Matthias S. F. Rose, Sandra Nolte 2019 Humboldt University of Berlin

Minimal Associations Between Clinical Data And Children's Self-Reported Health-Related Quality Of Life In Children With Chronic Conditions-A Cross-Sectional Study, Kathrin I. Fischer, Dana Barthel, Christiane Otto, Ulrike Ravens-Sieberer, Ute Thyen, Marcus Klein, Otto Walter, Matthias S. F. Rose, Sandra Nolte

Open Access Publications by UMMS Authors

Introduction: The improvement-or at least maintenance-of health-related quality of life (HRQoL) in children and adolescents is one of the main aims of chronic disease care. This study examines HRQoL of children and adolescents with three different chronic conditions (i.e., diabetes mellitus, asthma, juvenile arthritis) using the computer-adaptive test Kids-CAT, comprising five HRQoL domains: physical well-being, psychological well-being, parent relations, social support and peers, and school well-being. Further, associations between HRQoL and distinct clinical data and medical assessments are investigated to explore how much variability of the five domains can be explained by these variables.

Methods: Cross-sectional data of the ...


Determinants Of Severe Maternal Morbidity And Its Racial/Ethnic Disparities In New York City, 2008–2012, Renata E. Howland, Meghan Angley, Sang Hee Won, Wendy Wilcox, Hannah Searing, Sze Yan Liu, Emily White Johansson 2019 New York City Department of Health and Mental Hygiene

Determinants Of Severe Maternal Morbidity And Its Racial/Ethnic Disparities In New York City, 2008–2012, Renata E. Howland, Meghan Angley, Sang Hee Won, Wendy Wilcox, Hannah Searing, Sze Yan Liu, Emily White Johansson

Department of Public Health Scholarship and Creative Works

Objectives Severe maternal morbidity (SMM) is an important indicator for identifying and monitoring efforts to improve maternal health. Studies have identified independent risk factors, including race/ethnicity; however, there has been limited investigation of the modifying effect of socioeconomic factors. The study aims were to quantify SMM risk factors and to determine if socioeconomic status modifies the effect of race/ethnicity on SMM risk. Methods We used 2008–2012 NYC birth certificates matched with hospital discharge records for maternal deliveries. SMM was defined using an algorithm developed by the Centers for Disease Control and Prevention. Mixed-effects logistic regression models estimated ...


Introduction To Redcap, Troy Moon 2019 Vanderbilt University Medical Center

Introduction To Redcap, Troy Moon

PEER Liberia Project

This presentation provides an overview of REDCap, which is web-based software used to create and manage research databases and participant surveys effectively and responsibly. Topics include: history and background; project setup; using surveys, and applications and tools.


Update On Prevail Vaccine Studies, Mark Kieh 2019 University of Massachusetts Medical School

Update On Prevail Vaccine Studies, Mark Kieh

PEER Liberia Project

This presentation provides an overview of the PREVAIL vaccine study and the Partnership for Research on Ebola VACcination (PREVAC) study, the goals of which are to develop a safe and effective Ebola vaccine to prevent future outbreaks.


Cohort Studies And Relative Risks, Richard Ssekitoleko 2019 Yale University

Cohort Studies And Relative Risks, Richard Ssekitoleko

PEER Liberia Project

This presentation provides an overview of cohort studies and relative risk. The learning objectives are to be able to: Define a cohort study and the steps for the study; Understand the populations in a cohort study; Understand timing in a cohort study and the difference between retrospective, prospective and ambi-directional cohort studies; Understand the selection of the cohort population and the collection of exposure and outcome data; Understand the sources of bias in a cohort study; Understand the calculation and interpretation of the relative risk; and, Understand use of the new-castle Ottawa quality assessment score for cohort studies.


Prevail Viii: A Cohort Clinical, Viral, And Immunologic Monitoring Study Of People Living With Retroviral Infection In Liberia (Honor), J. Soka Moses, Ian Wachekwa, Stephen A. Migueles 2019 University of Massachusetts Medical School

Prevail Viii: A Cohort Clinical, Viral, And Immunologic Monitoring Study Of People Living With Retroviral Infection In Liberia (Honor), J. Soka Moses, Ian Wachekwa, Stephen A. Migueles

PEER Liberia Project

This presentation provides an overview of the PREVAIL VIII HONOR study, the goals of which are to: provide a clearer understanding of the HIV epidemic in Liberia, improve health and clinical follow-up of people living with AIDS/HIV, support policy and care through collaborative research, and improve capabilities for independent research.


Association Between Asthma And Dental Caries Amongst 12 - 15 Years Old Children: A School-Based Cross-Sectional Study In Karachi, Pakistan, Wajeeha Zahid, Shafquat Rozi, Farhan Raza Khan, Nida Zahid, Muhammad Masood Kadir 2019 Aga Khan University

Association Between Asthma And Dental Caries Amongst 12 - 15 Years Old Children: A School-Based Cross-Sectional Study In Karachi, Pakistan, Wajeeha Zahid, Shafquat Rozi, Farhan Raza Khan, Nida Zahid, Muhammad Masood Kadir

Community Health Sciences

Objective: The study aimed to determine an association between dental caries and asthma among 12 to 15 years old children.
Methods: This is a school-based cross-sectional study conducted from January to February 2016. A random sample of 544 children aged 12 - 15 years were enrolled from five private schools of Karachi. Dental caries was assessed using DMFT Index (Decayed, Missing, Filled teeth). The main exposure variable was asthma and information on it was collected through the International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire.
Results: The data was analyzed using Cox Proportional Hazard algorithm. Crude and adjusted prevalence ...


Understanding The Experience And Evaluating The Occurrence Of Depression In A Sample Of Pregnant Veterans, Aimee R. Kroll-Desrosiers 2019 University of Massachusetts Medical School

Understanding The Experience And Evaluating The Occurrence Of Depression In A Sample Of Pregnant Veterans, Aimee R. Kroll-Desrosiers

GSBS Dissertations and Theses

Background: The Veterans Health Administration (VHA) encourages depression screening and treatment for pregnant veterans; however, rates of depression symptoms and treatment utilization during pregnancy have not been well-studied.

Methods: We used data from the Maternity Care Coordination for Women Veterans cohort study. Specifically, our aims were to: 1) examine rates and correlates of depression symptoms in a sample of pregnant veterans; 2) understand mental health care treatment utilization and explore the experiences of veterans accessing mental health care at the VHA during pregnancy; and 3) examine VHA mental health provider's perspectives on depression screening and treatment in the perinatal ...


Patient Perceptions Of Planned Organ Removal During Hysterectomy, Zeinab Kassem, Chad M. Coleman, Andrew S. Bossick, Wan-Ting Su, Roopina Sangha, Ganesa Wegienka 2019 Henry Ford Health System

Patient Perceptions Of Planned Organ Removal During Hysterectomy, Zeinab Kassem, Chad M. Coleman, Andrew S. Bossick, Wan-Ting Su, Roopina Sangha, Ganesa Wegienka

Journal of Patient-Centered Research and Reviews

Purpose: Previous reports indicate many women may not have a firm grasp on likely outcomes of different hysterectomy procedures. This study aimed to assess women’s self-reported expectations of how they think their anatomy will change after hysterectomy.

Methods: Women scheduled for hysterectomy at a tertiary care hospital, for non-oncological reasons, reported their planned procedure type and the organs they understood would be removed 2 weeks prior to surgery. Patient reports and electronic medical records were reviewed, and kappa statistics (κ) were calculated to assess agreement for all women and within subgroups.

Results: Most of the 456 study participants (mean ...


Disparities In Access To Primary Care And Emergency Department Utilization In A Large Medicaid Program, Natasha Parekh, Marian Jarlenski, David Kelley 2019 University of Pittsburgh

Disparities In Access To Primary Care And Emergency Department Utilization In A Large Medicaid Program, Natasha Parekh, Marian Jarlenski, David Kelley

Journal of Health Disparities Research and Practice

Identifying and eliminating disparities are priorities for State Medicaid programs, especially in the context of increased enrollment through Medicaid expansion. We assessed racial, ethnic, regional, and managed care organization (MCO) differences, as well as time trends before and after Medicaid expansion, in primary care and emergency department (ED) utilization in a large Medicaid program. We performed a cross-sectional evaluation of data from Pennsylvania Medicaid from 2011-2015. Three primary care outcomes included: 1) adult access to primary care; 2) adolescent access to primary care; and 3) pediatric access to dental care. Our fourth outcome reflected ED utilization. We observed significant racial ...


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