Health Services Research Commons^™

Global Public Health Feasibility: Digital Dentistry In Geriatric Population, Merna Amr Saleh

Theses and Dissertations

Oral health is a critical yet often overlooked determinant of well-being among older adults in Egypt, where mobility limitations, geographic barriers, and low awareness of preventive practices exacerbate dental disparities. DentalPal, a teledentistry-based mobile application, was developed to provide older adults with remote dental consultations, oral hygiene advice, and triage guidance. The platform enables users to submit oral photographs or radiographs for assessment, seek second opinions, and initiate follow-up chats directly with the healthcare provider. This flexible design allows users to access dental consultations on demand while ensuring continuity of care The question that guided this study was how older …

Safety Of Carotid Endarterectomy In The Elderly And Octogenarian Population: A Nationwide Study Including 80,000 Patients, Victor Gabriel El-Hajj, Joanna Roy, Basel Musmar, Wi Jin Kim, Michael Rizzuto, Nathaniel Ellens, Rabab Alshahrani, Victor Staartjes, Adrian Elmi-Terander, Ramachandra Tummala, Stavropoula Tjoumakaris, Michael Gooch, Robert Rosenwasswer, Ziad Khabbaz, Pascal Jabbour

Department of Neurosurgery Faculty Papers

INTRODUCTION: Carotid endarterectomy (CEA) is an established procedure for stroke prevention in patients with carotid artery stenosis. While CEA is considered safe in younger patients, perioperative risks in octogenarians remain debated, with current guidelines classifying the procedure as "high-risk" in this patient population. This study aimed to evaluate short-term outcomes of CEA across age groups and to assess whether comorbidity burden better predicts outcomes than chronological age.

METHODS: The ACS-NSQIP database (2013-2020), was used to identify patients eligible for inclusion. The cohort was stratified based on age <  60, 60-80, and > 80 years. Propensity score matching and multivariable logistic regression were used to compare …

National Landscape Of Pediatric And Adult Inpatient Sickle Cell Disease Care, Ashley M. Jenkins, Spoorthy Vangala, Matthew Mcintosh, Robert Legros, Sophie Lanzkron, Kevin Fiscella

Department of Medicine Faculty Papers

No abstract provided.

Purpuric Pityriasis Rosea In A 7-Year-Old Girl: A Rare Variant With Generalized Involvement, Ying-Ying Qian, Ya-Fen Wu, Ting Zhang, Ji-Bing Li, Si-Yuan Song, Wei Li

Faculty, Staff and Students Publications

A 7-year-old girl presented with a 10-day history of generalized purpura and petechiae. The eruption began with a solitary violaceous macule on the trunk and progressed within 1 week to multiple oval and round dark-red to violaceous purpuric macules, ecchymoses, and petechiae affecting the face, trunk, and extremities. Lesions were distributed parallel to skin cleavage lines with a characteristic “Christmas-tree” pattern on the back (Fig 1). No oropharyngeal lesions were noted on examination, and the patient denied sore throat or oral discomfort. She reported no pruritus, pain, fever, or systemic symptoms.

Private Sector Healthcare Investment In Indonesia: Leveraging Australia-Indonesia Partnerships For Health System Transformation, Susan Josephine Neuhaus

Journal of Indonesian Health Policy and Administration

Australia and Indonesia are strategic partners with expanding bilateral trade valued at AUD 26.7 billion (2022-23). Health care partnerships between the two countries offer significant opportunities for private sector engagement. Indonesia’s large population, rapidly growing middle class, and implementation of Universal Health Coverage (UHC) through the Jaminan Kesehatan Nasional (JKN) present partnership opportunities to strengthen health system capacity, address infrastructure gaps and workforce shortages, and contribute to shared economic and prosperity goals. This study explores how Australian private healthcare investment can complement government initiatives in supporting Indonesia’s UHC while advancing Australia’s regional engagement. A descriptive qualitative analysis was conducted using …

Analysis Of Coverage Of Tuberculosis Prevention Therapy (Tpt): Literature Review, Septia Rahmalina, Ede Surya Darmawan

Journal of Indonesian Health Policy and Administration

Tuberculosis Preventive Therapy (TPT) is a crucial intervention for tuberculosis (TB) control, particularly among high-risk groups such as household contacts of TB patients and people living with Human Immunodeficiency Virus (HIV). Despite being recommended by the World Health Organization (WHO), TPT implementation still faces challenges at the primary care level. This study employed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) method to review 11 articles published between 2021 and 2025 that were relevant to TPT implementation in various high-TB burden countries, including Indonesia. The main barriers identified were input (logistics, training), process (tracing, education, monitoring), and output …

Prophylactic Antibiotic Analysis In Obs-Gyn, Orthopedics, Gastrointestinal Surgery At A South Tangerang Hospital, January-March 2024, Evelina Endang Nurjaman, Helen Andriani

Journal of Indonesian Health Policy and Administration

Inappropriate use of prophylactic antibiotics (PAs) remains a primary driver of antimicrobial resistance (AMR); however, global adherence to established prescribing guidelines remains suboptimal. This study aimed to analyze the compliance and rationality of PA prescription and to evaluate the underlying causes of physician non-adherence in obstetrics, orthopedic, and gastrointestinal surgeries at a hospital in South Tangerang City, Indonesia. Adopting a mixed-methods approach, this investigation combined a quantitative assessment of 208 surgical patient records (January–March 2024) with qualitative exploratory interviews conducted with three specialist peer group heads. This design allowed the triangulation of prescribing data with underlying clinical perspectives. PA rationality …

Harmonization And Ambiguity In Regulations For Physicians With Family Medicine Competence Post-Law No. 17 Of 2023, Danar Wahyu Giwang Katon, Dumilah Ayuningtyas, Purnawan Junadi, Wahyu Sulistiadi, Roberth J. Pattiselanno, Fitria Fitria, Ika Fitri Alfiani

Journal of Indonesian Health Policy and Administration

Strengthening primary care services in Indonesia requires that community health centers, namely Pusat Kesehatan Masyarakat (Puskesmas), involve medical personnel with family medicine competence. However, the fulfillment of physicians with this competence, especially Primary Care Family Medicine Specialists or Spesialis Kedokteran Keluarga Layanan Primer (Sp.KKLP), still face significant obstacles. This qualitative research uses the integrated Easton's System Model and Buse's Policy Framework to analyze the dynamics of this policy. The findings reveal a gap between the strong legal foundation and weak implementation mechanisms on the ground. First, there is ambiguity in terminology and lack of harmonization among regulations, especially concerning the …

The Relationship Between Accessibility Factors And Post-Inpatient Control Visits Among Non-Jkn Participants At Hospital X, Putri Candaika, Desy Kartika Ningsih, Risky Kusuma Hartono

Journal of Indonesian Health Policy and Administration

The rate of post-inpatient control visits remains relatively low due to various factors, including accessibility. At Hospital X, 220 of non-Jaminan Kesehatan Nasional (JKN) participants scheduled for post-inpatient control visits between January and March 2025, 71.82% attended, and 28.18% did not. Patients who did not attend control visits were twice as likely to be readmitted. This study aimed to determine the relationship between accessibility and post-inpatient control visits for non-JKN participants at Hospital X. This quantitative study employed an analytical cross-sectional design, with a population of 220 patients and a sample of 142 patients selected using probability sampling. Bivariate …

Comparing Educational Pathways For Denturists To Become Maxillofacial Prosthetic Specialists In The Us And The Uk, Minseok Kim

Oral Health

Abstract

In the absence of formal training, licensure, and professionalism, this scientific literature review will seek to include denturists in the American maxillofacial prosthetics industry. Denturists are oral health professionals who perform oral examination, design, manufacture, and place removable oral prostheses. In other regions of the world, they are also known as clinical dental technologists and dental prosthetists. This practice is not widespread in the US. The review can also be assessed on the model mediated by PRISMA, which is concentrated on the experiences of international education in the United Kingdom, Canada, and Australia, where the concentration further revolves around …

Partial Versus Full Revision In Cementless Single-Stage Exchange For Hip Periprosthetic Joint Infection: A Multicenter Comparative Study With 10-Year Survivorship Analysis, Wenbo Mu, Atthakorn Jarusriwanna, Boyong Xu, Scot A. Brown, Xiaogang Zhang, Alexander Dawes, Javad Parvizi Md, Li Cao

Rothman Institute Papers

BACKGROUND: Periprosthetic joint infection (PJI) is one of the most challenging complications following total hip arthroplasty (THA). Traditional management typically involves full revision to ensure comprehensive infection eradication. However, for patients with well-fixed implants, partial revision in a single-stage cementless approach may provide a viable alternative, potentially preserving bone stock and reducing operative time. The relative efficacy of this approach compared with full revision remains to be fully explored. This multicenter study aims to determine whether partial revision in cementless single-stage exchange surgery offers comparable infection control outcomes to full revision for select patients with well-fixed implants.

METHODS: We conducted …

Pemodelan Regresi Logistik Spasial Pada Kejadian Demam Berdarah Dengue (Dbd) Di Provinsi Jawa Barat Tahun 2023, Valida Ulfa Septiana, Sutanto Priyo Hastono

Jurnal Biostatistik, Kependudukan, dan Informatika Kesehatan

Demam Berdarah Dengue (DBD) merupakan salah satu penyakit menular yang masih menjadi masalah kesehatan masyarakat di Indonesia, termasuk Provinsi Jawa Barat, dengan rata-rata kejadian yang lebih tinggi dari rata-rata nasional. Analisis spasial diperlukan untuk memahami pola penyebaran DBD, mengingat adanya kemungkinan pengaruh antar wilayah. Penelitian ini bertujuan untuk menganalisis pengaruh faktor sosio-demografi, faktor perilaku, serta efek spasial kedekatan geografis antar wilayah terhadap kejadian DBD di Provinsi Jawa Barat tahun 2023. Penelitian ini menggunakan desain potong lintang dengan unit analisis 27 kabupaten/kota di Jawa Barat tahun 2023. Data sekunder diperoleh dari Survei Kesehatan Indonesia 2023 dan Jawa Barat dalam Angka 2024. …

Race And Patient-Physician Communication On Blood Pressure Management: Helping Improve Care, Samar A. Nasser, Ashley Pender, Ayan Ali, Kardie Tobb, Keith C. Ferdinand

Division of Cardiology Faculty Papers

PURPOSE OF REVIEW: To provide an overview of the relationship of race and ethnicity and patient-physician/clinician communication on blood pressure management.

RECENT FINDINGS: The suboptimal interactions experienced by patients from underrepresented racial and ethnic populations may be improved by enriching relationships among clinicians, population health scientists, policymakers, and community members/leaders. Current care communication and policies for managing hypertension appear to be insufficient. Implementing and disseminating effective strategies to efficiently improve the quality of hypertension care and recognize social determinants of health among minoritized populations is intertwined with enhanced communication.

SUMMARY: Approaches such as self-affirmation—encouraging patients to reflect on their strengths …

Analisis Klaim Odc Dan Kesiapan Sistem Informasi Rumah Sakit Dalam Mendukung Pengelolaan Klaim Bpjs: Studi Kasus Di Rs. Fatmawati, Grahyta Dhamayanti, Arifin Arifin

Jurnal Biostatistik, Kependudukan, dan Informatika Kesehatan

Masalah klaim tertunda BPJS Kesehatan pada layanan rawat inap kategori one day care (ODC) masih menjadi isu strategis di Rumah Sakit (RS) Fatmawati. Hal ini menyebabkan layanan tidak efisien dan potensi kerugian finansial. Hingga saat ini, mekanisme deteksi dini yang sistematis untuk mengidentifikasi masalah potensi klaim ODC belum tersedia secara optimal. Penelitian ini bertujuan menganalisis pola klaim ODC serta menyusun model konseptual deteksi dini potensi klaim ODC berbasis data Sistem Informasi Manajemen Rumah Sakit (SIMRS). Penelitian menggunakan desain deskriptif analitik dengan pendekatan metode campuran. Analisis kuantitatif dilakukan terhadap 2.401 data klaim rawat inap periode Januari–April 2025 di RS. Fatmawati, meliputi …

Analisis Usia Awal Merokok Remaja Dan Perilaku Merokok Orang Tua Di Indonesia: Studi Gshs 2015, Cathrine Jane David, Qonita Ayunina, Janitra Larasati, Glory Soemoele

Jurnal Biostatistik, Kependudukan, dan Informatika Kesehatan

Kebiasaan merokok masih menjadi permasalahan kesehatan global, termasuk Indonesia. Tingginya prevalensi perokok usia remaja menjadi tantangan kesehatan masyarakat yang salah satu penyebabnya adalah perilaku merokok orang tua. Oleh karena itu, penelitian ini bertujuan untuk menganalisa hubungan antara perilaku merokok orang tua dengan usia awal merokok pada remaja. Penelitian ini menggunakan desain studi potong lintang berdasarkan data Global School-based Student Health Survey (GSHS) 2015. Sampel penelitian ini berjumlah 2027 responden yang dipilih secara acak sistematik. Analisis data dilakukan dengan analisis univariat dan bivariat menggunakan uji Chi-square untuk melihat hubungan antar variabel. Hasil analisis menunjukkan bahwa sebagian besar responden memulai kebiasaan merokok …

Music Therapy Versus Cognitive Behavioral Therapy Via Telehealth For Anxiety In Survivors Of Cancer: A Randomized Clinical Trial, Kevin T. Liou, Joke Bradt, M. Beatriz Currier, Raymond Baser, Katherine Panageas, Jodi Macleod, Desiree Walker, Susan Q. Li, Ana Maria Lopez, Kelly Mcconnell, Jun J. Mao

Department of Medical Oncology Faculty Papers

PURPOSE: Anxiety is prevalent, disruptive, and undertreated among survivors of cancer. Cognitive behavioral therapy (CBT) is the first-line treatment, but not all individuals have access, respond to treatment, or prefer this option because of stigma. Music therapy is effective for short-term anxiety reduction, but it is unknown whether it is noninferior to first-line CBT for long-term anxiety reduction.

METHODS: This comparative effectiveness trial randomly assigned English- or Spanish-speaking survivors of cancer to seven weekly telehealth sessions of music therapy or CBT. The coprimary end points were changes in the Hospital Anxiety and Depression Scale (HADS) anxiety score at weeks 8 …

Does Adding An Interbody Cage In L4–L5 Posterolateral Fusion For Degenerative Spondylolisthesis And Stenosis Improve Clinical Outcome?, Enrico Aimar, Lucrezia Di Stefano, Federico Longhitano, Alberto Bona, Marco Meloni, Tommaso Alfiero, Federica Valente, Roberta Bonomo, Giulio Bonomo, Flavio Tancioni, Guglielmo Iess

Department of Neurosurgery Faculty Papers

INTRODUCTION: As the population ages, L4-L5 degenerative spondylolisthesis is increasingly common. Posterolateral fusion was long standard; interbody cages are widely used for perceived higher fusion rates.

RESEARCH QUESTION: Does adding an interbody cage to posterolateral fusion improve outcomes or reduce complications in elderly patients with grade I spondylolisthesis and severe stenosis?

MATERIALS AND METHODS: We retrospectively studied 319 adults aged 60-85 who underwent single-level L4-L5 fusion (2011-2018) after failed conservative care. Patients received posterior lumbar fusion (PLIF, n = 155) or posterolateral lumbar fusion (PLF, n = 164). Primary outcomes were Oswestry Disability Index (ODI) change and complications over a …

M-O-M-S On The Bayou: Implementation Of An Intervention To Improve Mental Health After Disaster, E. W. Harville, Gloria Giarratano, M. Patterson, M. Schultheis, K. S. Dorans, S. Turner, S. Harris, S. Longo, K. Weis

School of Nursing Faculty Publications

Pregnant women are a vulnerable population after disaster. Their health may be improved through community-based support programs in addition to their standard prenatal care. We conducted a prenatal peer support program, Mentors Offering Maternal Support (M-O-M-S), focused on improving mental health in hurricane-affected areas in southern Louisiana. M-O-M-S consists of six biweekly sessions covering pregnancy acceptance, maternal role identification, family and partner relationships, preparation for labor/fears around labor, well-being/safety of self and baby, and post-delivery health and maternal-infant bonding. The program is led by a “mentor”, an experienced mother but not necessarily a clinician or social worker, who guides the …

Anti-Csf-1r Therapy With Combined Immuno-Chemotherapy Coordinate An Adaptive Immune Response To Eliminate Macrophage Enriched Triple Negative Breast Cancers, Diego A Pedroza, Xueying Yuan, Fengshuo Liu, Hilda L Chan, Christina Zhang, William Bowie, Alex J Smith, Sebastian J Calderon, Nadia Lieu, Weiguo Wu, Paul Porter, Poonam Sarkar, Na Zhao, Constanze V Oehler, Ondrej Peller, M Waleed Gaber, Qian Zhu, Charles M Perou, Xiang H-F Zhang, Jeffrey M Rosen

Faculty, Staff and Students Publications

Women diagnosed with metastatic triple negative breast cancer (mTNBC) have limited treatment options, are more prone to develop resistance and are associated with high mortality. A cold tumor immune microenvironment (TIME) characterized by low T cells and high tumor associated macrophages (TAMs) in mTNBC is associated with the failure of standard-of-care chemotherapy and immune checkpoint blockade (ICB) treatment. We demonstrate that the combination of immunomodulatory low-dose Cyclophosphamide (CTX) coupled with anti-CSF-1R antibody targeted therapy (SNDX-ms6352) and anti-PD-1 (ICB), was highly effective against aggressive metastatic Trp53 null TNBC transplantable syngeneic models that present with high macrophage infiltration. Mechanistically, CSF-1R inhibition along …

Guidelines For Community Engaged Health Research, Carrie Leach, Hayley Thompson, Alex Sass, Patricia Wren, Rodlescia Sneed, Rhonda Dailey, Elizabeth Towner, Maha Albdour, Carla Caringi, Alyssa W. Beavers, Theresa A. Hastert, Vanessa Rorai, Peter A. Lichtenberg, Angulique Outlaw, Ijeoma Nnodim Opara

Institute of Gerontology

Executive Summary:

Wayne State University’s Guidelines for Community Engaged Health Research provide a practical framework for designing, conducting, and evaluating ethical, equitable, and impactful health research that engages community experts in projects that advance health equity in Detroit.

Purpose 

Developed for WSU faculty, staff, and research teams, the guidelines support the meaningful involvement of community experts across all phases of research. They respond to common challenges in community-engaged work, including limited experience with engagement approaches, the need for reflexive and equitable practices, and the time and coordination required for authentic collaboration.

The document defines Community-Engaged Research (CEnR) as collaborative work …