Health Policy Commons^™

Large-Scale Genotype Prediction From Rna Sequence Data Necessitates A New Ethical And Policy Framework, Mary A Majumder, Jeffrey T Leek, Kasper D Hansen, Afrooz Razi, Amy L Mcguire

Center for Medical Ethics and Health Policy Staff Publications

Genotype prediction from RNA-seq data has become widespread. RNA-seq data, unlike DNA-seq data, are available as raw reads for many projects, with related protocols and consent terms typically inaccessible. However, there is a lack of clarity in current policy and inconsistency in practice with regard to the handling of these data. Here, we call for a framework for management of RNA-seq data and the predicted genotypes that includes registered access for RNA-seq data, controlled access for predicted genotypes, and a code of conduct for data access and use, as well as enhanced downstream protections.

Passive Smoking And Its Correlation With Stunting In Children: A Systematic Review, Anita Rahmiwati, Karlinda Karlinda, Hamzah Hasyim, Febriyansyah Febriyansyah

Kesmas

Passive smoking is a significant risk factor for stunting in children, highlighting the urgent need for effective public health measures. This study aimed to investigate the association between passive smoking and stunting in children aged 0 months-7 years. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, a comprehensive literature search was conducted across multiple online databases, including PubMed, ProQuest, Science Direct, Willey Online Library, Sage Journal, Cambridge University Press, and Oxford Academic. The quality of included articles reporting observational studies was assessed using the Critical Appraisal Skill Programme (CASP) checklist, presenting data through narrative synthesis. Findings …

The Correlation Of Age With Thrombocytes And D-Dimer Values In Covid-19 Patients At Hospital X In Jakarta, Indonesia, Nanik Prasetyoningsih, Ascobat Gani

Kesmas

Coronavirus disease (COVID-19), caused by the SARS-CoV-2 virus, spread globally, with research indicating that prognosis severity can be assessed by thrombocyte and D-dimer levels; while, patient age serves as a mortality predictor. This study aimed to analyze the relationship between age with thrombocytes and D-dimer in COVID-19 patients. This cross-sectional study used laboratory testing samples from 667 COVID-19 patients at Hospital X in Jakarta, Indonesia, collected from August 2020 until May 2021. The data was collected using cluster random sampling and analyzed using descriptive statistics and the Chi square test (95% CI). The results showed that age and thrombocytes positively …

Capitation Management Through Performance-Based Capitation Mechanism Of Primary Health Care In Malang, Indonesia, Ayu Tyas Purnamasari, Herlinda Dwi Ningrum, Anggi Ardhiasti, Asri Hikmatuz Zahroh

Kesmas

Primary health care (PHC) has one of the largest funding sources, capitation, which BPJS Healthcare Security transfers monthly. Capitation fund receipts were frequently insufficient due to failure to meet performance-based capitation/Kapitasi Berbasis Kinerja (KBK) targets, including for PHC in Malang City, Indonesia. This study aimed to examine the management and utilization of capitation funds through a KBK mechanism. This descriptive study used a qualitative approach supported by quantitative data. This study was conducted from July to August 2023 and purposely selected nine informants from BPJS Healthcare Security, the local health office, and PHC. The interviews were transcribed verbatim and analyzed …

Data Mining Analysis With Orange In The Development Of Tuberculosis Among Diabetes Mellitus Patients, Malahayati Rusli Bintang, Adang Bachtiar, Cicilya Candi

Kesmas

Prevention and treatment of diabetes will have a positive influence on tuberculosis (TB) since people may get TB because they have diabetes mellitus (DM). Recording and reporting through the TB Information System are not run optimally because of many factors. The information system must be strengthened to be used by private health facilities. This study used secondary data from the 2013 and 2018 Indonesian Basic Health Research (IBHR). The data was analyzed univariately and analyzed further using Orange Data Mining Tools to test the screening tool model used to predict TB in diabetic individuals. The total sample in this study …

New Approach To Mapping Regional Vulnerability In Controlling Tuberculosis Disease In Indonesia, Maria Holly Herawati, Asep Hermawan, Dasuki Dasuki, Hadi Supratikta, Al Asyary, M Rokhis Khomarudin, Muhammad Priyatna, Raflizar Raflizar, Kristina Kristina, Noer Endah Pracoyo, Dina Bisara, Cahya Tri Purnami, Mentari Nur Farida Suteja, Yusrial Bachtiar, Noor Edi Widya Sukoco, Doni Lasut

Kesmas

Tuberculosis (TB) in Indonesia is still a health problem. The TB prevalence in Indonesia ranks second in the world after India in 2023. Regional factors, inadequate healthcare facilities, and limited resources (financial, human, and infrastructure) are challenges requiring innovation to help the government control TB. TB eradication efforts need to be made with a comprehensive and effective approach. One method used is to look at the vast territory of Indonesia, therefore, mapping the TB disease vulnerability is a highly recommended method. The use of a Geographic Information System is expected to help map the TB vulnerability areas in Indonesia. Given …

Double Burden Of Persons With Disabilities: Are Those More Likely To Suffer From Chronic Disease?, Salsabila Kusumawardani, Hardiyani Puspitasari, Muhammad Ciro Danuza, Yusuf Faisal Martak

Masyarakat: Jurnal Sosiologi

This study examines the likelihood of persons with disabilities experiencing chronic diseases compared to those without disabilities, emphasizing the role of demographic characteristics. Prior research shows that individuals with disabilities have a higher risk of chronic diseases due to pre-existing health conditions, secondary complications, healthcare access barriers, and limited health education. Beyond these factors, we argue that demographic characteristics—such as age, gender, insurance status, and living environment—also shape daily habits and lifestyles that influence long-term health outcomes. Using probit regression analysis, this study quantifies the probability of chronic disease among persons with disabilities. Our findings indicate that individuals with disabilities …

Smoking Habit At Home And Upper Respiratory Infection In Infants Aged 6-12 Months, Musfardi Rustam, Nur Pelita Sembiring, Taswir Effendy

Kesmas

Upper Respiratory Tract Infection (URI) is an acute infection caused by viruses, fungi, and bacteria. Smoking habit at home is a risk factor for URI in infants. This study aimed to determine a relationship between smoking at home and the incidence of URI in infants. This study was conducted the fourth week of February 2010 until the third week of April 2010 in Kampar District, Indonesia. This analytical study used a case-control design and cluster random sampling. The samples comprised 162 cases and 162 controls, infants aged 6-12 months. The cases were 162 infants aged 6-12 months suffering from URI …

Trust Criteria For Artificial Intelligence In Health: Normative And Epistemic Considerations, Kristin Kostick-Quenet, Benjamin H Lang, Jared Smith, Meghan Hurley, Jennifer Blumenthal-Barby

Center for Medical Ethics and Health Policy Staff Publications

Rapid advancements in artificial intelligence and machine learning (AI/ML) in healthcare raise pressing questions about how much users should trust AI/ML systems, particularly for high stakes clinical decision-making. Ensuring that user trust is properly calibrated to a tool's computational capacities and limitations has both practical and ethical implications, given that overtrust or undertrust can influence over-reliance or under-reliance on algorithmic tools, with significant implications for patient safety and health outcomes. It is, thus, important to better understand how variability in trust criteria across stakeholders, settings, tools and use cases may influence approaches to using AI/ML tools in real settings. As …

Nevada Medical Residencies, 2024, Annie Vong, Caitlin J. Saladino, William E. Brown Jr.

Health

This fact sheet highlights medical residency data for the 2021, 2022, 2023, and 2024 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 data on residency program matches at the Kirk Kerkorian School of Medicine at UNLV and the UNR School of Medicine and reveals where Nevada medical school graduates pursue their residencies, and updates findings from a 2023 fact sheet exploring 2021, 2022, and 2023 graduating class data.

Illegal Dumping: Prevention, Abatement, And Compliance Strategies For Cities, Ingrid Self

Certified Public Manager® Applied Research

Illegal dumping, with its many monikers and negative impacts, is a prevailing issue challenging Texas local government. Whether driven by malicious intent or stemming from ignorance of policies and laws, illegal dumping creates health and safety risks for Texans, degrades wildlife areas, impedes economic development and becomes an expensive burden on city budgets. The growing amount of e-waste and the proliferation of improper tire disposal exacerbate the issue, compelling Texas cities to find ways to quickly abate junk piles and deter future dumping crimes.

Across Texas, programs to combat illegal dumping are gaining momentum. These initiatives establish methods for immediate …

Chimeric Antigen Receptor-Induced Antigen Loss Protects Cd5cart Cells From Fratricide Without Compromising On-Target Cytotoxicity, Royce Ma, Mae Woods, Phillip Burkhardt, Noah Crooks, Dayenne G Van Leeuwen, Daniil Shmidt, Jacob Couturier, Alexandre Chaumette, Divya Popat, Laquisa C Hill, Rayne H Rouce, Sachin Thakkar, Aaron F Orozco, Alexandre F Carisey, Malcolm K Brenner, Maksim Mamonkin

Center for Medical Ethics and Health Policy Staff Publications

Chimeric antigen receptor T cells (CART) targeting lymphocyte antigens can induce T cell fratricide and require additional engineering to mitigate self-damage. We demonstrate that the expression of a chimeric antigen receptor (CAR) targeting CD5, a prominent pan-T cell antigen, induces rapid internalization and complete loss of the CD5 protein on T cells, protecting them from self-targeting. Notably, exposure of healthy and malignant T cells to CD5.CART cells induces similar internalization of CD5 on target cells, transiently shielding them from cytotoxicity. However, this protection is short-lived, as sustained activity of CD5.CART cells in patients with T cell malignancies results in full …

Developing Public-Private R&D Consortia To Accelerate Alzheimer’S Disease Drug Development, Joel West, Paul Olk

Management: Faculty Scholarship

Efforts to accelerate Alzheimer's disease (AD) drug development have been spurred on by the creation of open science, public-private R&D consortia. An R&D consortium provides an improved structure for generating and disseminating AD knowledge across a range of organizations while also aligning their interests. Drawing from archival and interview data collected on 46 public-private R&D consortia focused wholly or in part on AD, we uncover two important innovations: the creation of novel consortium types that facilitate coordination beyond the individual consortium, and the practice of organizations joining multiple consortia. Collectively these innovations provide member organizations with different pathways for advancing …

Impact Of Efavirenz On Hormone-Positive Breast Cancer Survival In Women Living With Hiv, Arthur T Johnson, Taolo Ntloedibe, Jose Euberto Mendez Reyes, Mogomotsi S Matshaba, Scott L Dryden-Peterson, Elizabeth Y Chiao

Center for Medical Ethics and Health Policy Staff Publications

Women living with HIV and breast cancer have poorer survival than HIV-negative women. Efavirenz-estrogen interactions are documented; however, the survival impact is unknown. Survival between women with estrogen-receptor positive breast cancer taking efavirenz (n = 38) and nonefavirenz regimens (n = 51) were compared. The 5-year overall-survival was 48.9% [95% confidence interval (CI) 33.0-72.2 and 51.1% (95% CI 34.0-76.8)] in the efavirenz and nonefavirenz groups, respectively suggesting efavirenz is unlikely driving poorer survival in women living with HIV and estrogen-receptor positive breast cancer.

The Impact Of Clinical Genome Sequencing In A Global Population With Suspected Rare Genetic Disease, Erin Thorpe, Taylor Williams, Chad Shaw, Evgenii Chekalin, Julia Ortega, Keisha Robinson, Jason Button, Marilyn C Jones, Miguel Del Campo, Donald Basel, Julie Mccarrier, Laura Davis Keppen, Erin Royer, Romina Foster-Bonds, Milagros M Duenas-Roque, Nora Urraca, Kerri Bosfield, Chester W Brown, Holly Lydigsen, Henry J Mroczkowski, Jewell Ward, Fabio Sirchia, Elisa Giorgio, Keith Vaux, Hildegard Peña Salguero, Aimé Lumaka, Gerrye Mubungu, Prince Makay, Mamy Ngole, Prosper Tshilobo Lukusa, Adeline Vanderver, Kayla Muirhead, Omar Sherbini, Melissa D Lah, Katelynn Anderson, Jeny Bazalar-Montoya, Richard S Rodriguez, Mario Cornejo-Olivas, Karina Milla-Neyra, Marwan Shinawi, Pilar Magoulas, Duncan Henry, Kate Gibson, Samuel Wiafe, Parul Jayakar, Daria Salyakina, Diane Masser-Frye, Arturo Serize, Jorge E Perez, Alan Taylor, Shruti Shenbagam, Ahmad Abou Tayoun, Alka Malhotra, Maren Bennett, Vani Rajan, James Avecilla, Andrew Warren, Max Arseneault, Tasha Kalista, Ali Crawford, Subramanian S Ajay, Denise L Perry, John Belmont, Ryan J Taft

Center for Medical Ethics and Health Policy Staff Publications

There is mounting evidence of the value of clinical genome sequencing (cGS) in individuals with suspected rare genetic disease (RGD), but cGS performance and impact on clinical care in a diverse population drawn from both high-income countries (HICs) and low- and middle-income countries (LMICs) has not been investigated. The iHope program, a philanthropic cGS initiative, established a network of 24 clinical sites in eight countries through which it provided cGS to individuals with signs or symptoms of an RGD and constrained access to molecular testing. A total of 1,004 individuals (median age, 6.5 years; 53.5% male) with diverse ancestral backgrounds …

Employees Speak Up: Engaging Voices From The Human Services Field, Henry J. Davis, Janna C. Heyman, Linda White-Ryan, Dana Marlowe

The Journal of Values-Based Leadership

This qualitative study aims to understand the perceptions and experiences of human services professionals working within urban communities with respect to their work experiences, compensation, and work-life balance. Focus groups were used to collect data from direct service staff and executive leadership from diverse agencies. This study examined the words and stories, generating the following overarching themes: (1) dedication to agency model and communities served; (2) compensation and responsibilities; (3) reality of work-life balance; and (4) desire for professional growth and personal growth. The results show that while employees expressed personal fulfillment with their work, the issues of compensation, workload, …

Olaparib For Childhood Tumors Harboring Defects In Dna Damage Repair Genes: Arm H Of The Nci-Cog Pediatric Match Trial, Julia L Glade Bender, Kerice Pinkney, Paul M Williams, Sinchita Roy-Chowdhuri, David R Patton, Brent D Coffey, Joel M Reid, Jin Piao, Lauren Saguilig, Todd A Alonzo, Stacey L Berg, Nilsa C Ramirez, Elizabeth Fox, Brenda J Weigel, Douglas S Hawkins, Margaret M Mooney, Naoko Takebe, James V Tricoli, Katherine A Janeway, Nita L Seibel, Donald W Parsons

Center for Medical Ethics and Health Policy Staff Publications

Background: The National Cancer Institute-Children's Oncology Group Pediatric Molecular Analysis for Therapy Choice (MATCH) precision oncology platform trial enrolled children aged 1-21 years with treatment-refractory solid tumors and predefined actionable genetic alterations. Patients with tumors harboring alterations in DNA damage repair (DDR) genes were assigned to receive olaparib.

Methods: Tumor and blood samples were submitted for centralized molecular testing. Tumor and germline sequencing were conducted in parallel. Olaparib was given twice daily for 28-day cycles starting at a dose 30% lower than the adult recommended phase 2 dose (RP2D). The primary endpoint was the objective response.

Results: Eighteen patients matched …

York County Rural Communties Opioid Response Implementation Iv Grant: Interim Evaluation Report, Katie Rosingana Ba, Evelyn Ali Bs, Gordon Mcintire Ba, Sarah Mclaughlin Mph, Mary Lindsey Smith Phd

Substance Use Research & Evaluation

This interim evaluation report has been developed for the York County Rural Communities Opioid Response Program, an RCORP-Implementation IV grant awarded to MaineHealth and funded by the Health Resources & Services Administration (HRSA). A main goal of this grant project is to understand the needs of individuals impacted by substance use disorders who have faced structural inequalities to access, in both correctional and heath care settings. The project utilizes a collaborative coalition that is community based, the Rural York Community Coalition (RYCC). For more information, please contact Lindsey Smith at [email protected]

Mental Health In Price: A Report On Community Perspectives, Kristen Koci, Jessica Ulrich-Schad

Publications

This report is from a research project conducted at the end 2022 that focuses on mental health in Price. Dr. Kristen Koci conducted interviews in Price to understand community members’ perspectives on and factors affecting mental health in the area. Community leaders from government and local organizations were interviewed along with general community residents, for a total of 27 interviews. The report that follows summarizes themes and perspectives gathered during these interviews.

Healthy Acadia Prosper: Year 2 Interim Evaluation Report, Mary Lindsey Smith Phd, Evelyn Ali Bs, Gordon Mcintire Ba, Sarah Mclaughlin Mph

Substance Use Research & Evaluation

The PROSPER initiative is a collaborative effort of Healthy Acadia and its regional healthcare and nonprofit partners designed to support pregnant women, mothers, and families with Substance Use Disorder (SUD). The project is funded by a four-year HRSA Outreach grant from 2021 to 2025. Through grant funding, PROSPER provides personal care planning, navigation support, and parenting and life skills training to clients at no cost to them. The partners also work to alleviate regional barriers to care and reduce stigma and discrimination of women seeking treatment to benefit their families.This report includes findings from the year 2 evaluation of the …