Health Policy Commons^™

The Risks Of Birth Defects And Childhood Cancer With Conception By Assisted Reproductive Technology, Barbara Luke, Morton B Brown, Ethan Wantman, Maria J Schymura, Marilyn L Browne, Sarah C Fisher, Nina E Forestieri, Chandrika Rao, Hazel B Nichols, Mahsa M Yazdy, Susan T Gershman, Caitlin R Sacha, Melanie Williams, Mary K Ethen, Mark A Canfield, Kevin J Doody, Michael L Eisenberg, Valerie L Baker, Carrie Williams, Alastair G Sutcliffe, Melissa A Richard, Philip J Lupo

Center for Medical Ethics and Health Policy Staff Publications

Study question: Is there an association between fertility status, method of conception and the risks of birth defects and childhood cancer?

Summary answer: The risk of childhood cancer had two independent components: (i) method of conception and (ii) presence, type and number of birth defects.

What is known already: The rarity of the co-occurrence of birth defects, cancer and ART makes studying their association challenging. Prior studies have indicated that infertility and ART are associated with an increased risk of birth defects or cancer but have been limited by small sample size and inadequate statistical power, failure to adjust for …

The Pandemic : Impact On Imo Member State Audit On The Pacific Island Member States, Shaleen Lata

World Maritime University Dissertations

No abstract provided.

Uthealth Quality Symposium 2022 Abstracts

Teaching in Clinics

No abstract

Characteristics Of Academic Anesthesiologist’S Elected To An Institutional Academy Of Master Educators, Evan G. Pivalizza, Sara Guzman-Reyes, Christopher Stephens, Rhashedah A. Ekeoduru, Omonele O. Nwokolo, Katherine C. Normand, Srikanth Sridhar, Travis H. Markham, Johanna B. Dehaan, George Williams, Gary C. Rosenfeld

Teaching in Clinics

Background. The educational experience and success of academic anesthesiologists may be elusive to quantify. We wished to examine the characteristics of a cohort of anesthesiology faculty who were inducted into a medical school master educator academy over the last decade.

Methods. After IRB approval with waiver of consent, all 10 anesthesiology faculty inductees into the academy supplied relevant data for their accomplishments at the time of induction in multiple educational domains, including teaching and assessment, mentoring and advising, evidence of scholarship and production of enduring materials, and educational leadership. These were deidentified and analyzed.

Results. The cohort had evidence of …

Teaching In Clinics: A New Perspective To Healthcare Education

Teaching in Clinics

No abstract

Influenza Vaccination Coverage Among An Urban Pediatric Asthma Population: Implications For Population Health, Sarah J. Parker, Amy M. Delaroche, Alex B. Hill, Rajan Arora, Julie Gleason-Comstock

Urban Studies and Planning Faculty Research Publications

Introduction
Asthma is the most common chronic disease in children. Children with asthma are at high risk for complications from influenza; however annual influenza vaccination rates for this population are suboptimal. The overall aim of this study was to describe the characteristics of a high-risk population of children with asthma presenting to an urban pediatric emergency department according to influenza vaccination status.

Methods
The study was a retrospective chart review of 4355 patients aged 2 to 18 years evaluated in a Michigan pediatric emergency department (PED) between November 1, 2017 and April 30, 2018 with an ICD-10-CM code for asthma …

Driving The Southern Nevada Health Economy Forward: Benefits Of A Transformational Unlv Academic Health Center, Tripp Umbach

Policy Briefs and Reports

The University of Nevada, Las Vegas (UNLV) plans to develop an integrated academic health center within the Las Vegas Medical District (LVMD). The academic health center includes UNLV’s five health science schools and mental and behavioral health, which is distributed among several colleges (medicine, liberal arts, urban affairs, and education) in the university. University Medical Center (UMC), a major teaching hospital, will also be an important driver of the academic health center. For the purposes of this report, UNLV’s medical and health science entities along with UMC are referred to collectively as the UNLV Academic Health Center. Additional academic health …

The Evolution Of The Southern Nevada Healthcare Economy: Building The Unlv Academic Health Center, The Lincy Institute

Lincy Institute Events

With the successful launch of the Kirk Kerkorian School of Medicine at UNLV and the completion of its medical education building, Southern Nevada is positioned to expand its healthcare infrastructure - and its healthcare economy - to create a comprehensive, integrated healthcare system to serve our fast-growing community. As UNLV moves forward with the development of an integrated academic health center within the Las Vegas Medical District, understanding the economic and social benefits of such a transformational project is important to stakeholders throughout the region.

The Lincy Institute hosted representatives of Tripp Umbach - the nation's leading consultant on community …

Executive Summary: Driving The Southern Nevada Health Economy Forward, Tripp Umbach

Policy Briefs and Reports

The University of Nevada, Las Vegas (UNLV) plans to develop an integrated academic health center within the Las Vegas Medical District (LVMD).1 The academic health center includes UNLV’s five health science schools and mental and behavioral health, which is distributed among several colleges (medicine, liberal arts, urban affairs, and education) in the university. University Medical Center (UMC), a major teaching hospital, will also be an important driver of the academic health center. For the purposes of this report, UNLV’s medical and health science entities along with UMC are referred to collectively as the UNLV Academic Health Center.

Resident Perceptions Of The Short- And Long-Term Impacts Of Hurricane Harvey, Amal Rammah, Sheryl Mccurdy, Melissa Bondy, Abiodun O Oluyomi, Elaine Symanski

Center for Medical Ethics and Health Policy Staff Publications

Severe storms and flooding events are expected to increase in frequency and severity, with lasting economic, social, and psychological impacts on communities in post-disaster recovery. In the first mixed methods study to focus on the experiences of Houstonians during Hurricane Harvey, which resulted in unprecedented and widespread flooding and billions of dollars in damage, we conducted five focus groups from four neighborhoods almost two years after Harvey made landfall. Our purpose was to understand how residents withstood and recovered from flooding-related stressors, what the major sources of support were and what long-term issues they were still dealing with. Residents relied …

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 …