Health Policy Commons^™

J Mich Dent Assoc August 2022

The Journal of the Michigan Dental Association

Monthly, The Journal of the Michigan Dental Association brings news, information, and feature articles to our state's oral health community and the MDA's 6,200+ members. No publication reaches more Michigan dentists! In this August 2022 issue, the reader will find the following original content:

• A cover story on choosing to partner with a Dental Service Organization (DSO)
• A conversation with three dentists on how and why they are involved with organized dentistry.
• A 10-Minute EBD on the efficacy of vacuum-formed removable orthodontic retainers
• News you need, an Editorial, a report from our ADA Trustee and regular department articles, Dentistry and …

Ada Trustee Report: Does The Ada Have A Long-Term Vision For Oral Health In America?, Michele Tulak-Gorecki Dds

The Journal of the Michigan Dental Association

This trustee report discusses the need for a long-term vision for oral health in America within the context of changing trends in dentistry. It highlights key questions related to evolving member value propositions, improving insurance coverage, expanding collaboration with primary care providers, and establishing dentistry as an essential part of the primary care system. A Board workgroup has been formed to explore potential actions and recommendations. The report underscores the importance of addressing these challenges. It encourages the dental profession to have meaningful conversations and work together to shape a future that aligns with new generations' evolving needs and expectations.

Meeting The Mental Health Needs Of College-Aged Young Adults: Evaluating The Value And Impact Of Digital Mental Health Interventions., Sara Atherton Choate

Electronic Theses and Dissertations

BACKGROUND: The growing prevalence of common mental health problems poses a serious hindrance to young adults, and the majority of those in need of mental health support do not seek professional psychological services. Digital mental health interventions (DMHIs) that allow for self-management of mental health symptoms could provide a useful adjunctiveto traditional one-on-one counseling or therapy and offer a useful prevention tool for students at risk for experiencing mental health crises. This dissertation explored the efficacy of self-guided DMHIs targeting college students, the factors associated with help-seeking in young adults, and the impact of implementing an evidence-based DMHI at a …

Addressing Human Trafficking As A Public Health Issue, Frances Recknor, Erica Di Ruggiero, Elsabeth Jensen

Center for Medical Ethics and Health Policy Staff Publications

Human trafficking is increasingly recognized as a significant global public health issue. Human trafficking (HT) exists in all nations, including Canada, and is estimated to impact 25 million people globally. HT is a crime that is not always visible. It is associated with a myriad of deleterious health outcomes arising from adverse living and working conditions, and the physical, sexual, and/or psychological violence often accompanying it. Human trafficking also disproportionately affects people living under vulnerable circumstances, particularly those with intersecting vulnerabilities. Public health can advance health equity for trafficked persons and add value to existing anti-trafficking (AT) efforts. Among its …

De Novo Heterozygous Variants In Slc30a7 Are A Candidate Cause For Joubert Syndrome, Monica Penon-Portmann, Mohammad K Eldomery, Lorraine Potocki, Dana Marafi, Jennifer E Posey, Zeynep Coban-Akdemir, Tamar Harel, Christopher M Grochowski, Hailey Loucks, Walter Patrick Devine, Jessica Van Ziffle, Dan Doherty, James R Lupski, Joseph T Shieh

Center for Medical Ethics and Health Policy Staff Publications

Joubert syndrome (JS), a well-established ciliopathy, is characterized by the distinctive molar tooth sign on brain MRI, ataxia, and neurodevelopmental features. Other manifestations can include polydactyly, accessory frenula, renal, or liver disease. Here, we report individuals meeting criteria for JS with de novo heterozygous variants in SLC30A7 (Chr1p21.2). The first individual is a female with history of unilateral postaxial polydactyly, classic molar tooth sign on MRI, macrocephaly, ataxia, ocular motor apraxia, neurodevelopmental delay, and precocious puberty. Exome sequencing detected a de novo heterozygous missense variant in SLC30A7: NM_133496.5: c.407 T > C, (p.Val136Ala). The second individual had bilateral postaxial polydactyly, molar …

Circulating Trophoblast Numbers As A Potential Marker For Pregnancy Complications, Brielle Crovetti, Mohamad Ali Maktabi, Hadi Erfani, Tachjaree Panchalee, Qun Wang, Liesbeth Vossaert, Ignatia Van Den Veyver

Center for Medical Ethics and Health Policy Staff Publications

Objective: To explore the potential of circulating trophoblasts (TBs) as a non-invasive tool to assess placental health and predict obstetric complications.

Methods: We retrospectively reviewed maternal characteristics and pregnancy outcomes of 369 women who enrolled in our original cell-based NIPT (cbNIPT) study. The number of circulating TBs recovered from the maternal blood samples was recorded and expressed as fetal cell concentration (FCC). We evaluated if FCC can be used to predict pregnancy outcomes such as hypertensive disorders of pregnancy (HDP), fetal growth restriction, placental abruption, preterm labor, and pregnancy loss.

Results: Receiver operating characteristic (ROC) analysis was performed to find …

Is Detection Of Relapse By Surveillance Imaging Associated With Longer Survival In Patients With Rhabdomyosarcoma?, Stephanie Fetzko, Adriana Fonseca, Mary Frances Wedekind, Abha A Gupta, Bhuvana A Setty, Jeremy Schraw, Philip J Lupo, Robert P Guillerman, Anish A Butala, Heidi Russell, Lauren Nicholls, David Walterhouse, Douglas S Hawkins, Mehmet F Okcu

Center for Medical Ethics and Health Policy Staff Publications

Background: We investigated whether surveillance imaging had an impact on post-relapse survival in patients with rhabdomyosarcoma (RMS). We hypothesized that relapse detected by imaging (group IM) would be associated with longer survival compared with relapse detected with a clinical sign or symptom (group SS).

Materials and methods: We performed an observational multi-institutional study in 127 patients with relapsed RMS comparing overall survival (OS) after relapse using Kaplan-Meier and Cox proportional hazards analyses.

Results: Relapse was detected in 60 (47%) group IM and 67 (53%) SS patients. Median follow-up in survivors was 4 years (range 1.0 to 16.7 y). Four-year OS …

Stepped Care Versus Standard Care For Children After Trauma: A Randomized Non-Inferiority Clinical Trial, Alison Salloum, Yuanyuan Lu, Henian Chen, Troy Quast, Judith A Cohen, Michael S Scheeringa, Kristen Salomon, Eric A Storch

Center for Medical Ethics and Health Policy Staff Publications

Objective: Trauma-focused cognitive-behavioral therapy (TF-CBT) is an evidence-based therapist-led treatment for children after trauma. Parents often experience barriers to treatment engagement, including cost. Stepped care TF-CBT (SC-TF-CBT) was developed as an alternative delivery system. Step One is a parent-led therapist-assisted treatment. Step Two provides therapist-led TF-CBT for children who did not benefit from Step One and require more intensive treatment. This study compared SC-TF-CBT to standard TF-CBT in a community-based non-inferiority trial.

Method: A total of 183 children (aged 4-12 years) experiencing posttraumatic stress symptoms (PTSS) and their caregivers were randomly assigned to SC-TF-CBT or standard TF-CBT within 6 community …

Outcomes Associated With Timing Of Neurologic Dysfunction Onset Relative To Pediatric Sepsis Recognition, Alicia M Alcamo, Scott L Weiss, Julie C Fitzgerald, Matthew P Kirschen, Laura L Loftis, Swee Fong Tang, Neal J Thomas, Vinay M Nadkarni, Sholeen T Nett

Center for Medical Ethics and Health Policy Staff Publications

Objectives: To compare outcomes associated with timing-early versus late-of any neurologic dysfunction during pediatric sepsis.

Design: Secondary analysis of a cross-sectional point prevalence study.

Setting: A total of 128 PICUs in 26 countries.

Patients: Less than 18 years with severe sepsis on 5 separate days (2013-2014).

Interventions: None.

Measurements and main results: Patients were categorized as having either no neurologic dysfunction or neurologic dysfunction (i.e., present at or after sepsis recognition), which was defined as Glasgow Coma Scale score less than 5 and/or fixed dilated pupils. Our primary outcome was death or new moderate disability (i.e., Pediatric Overall [or Cerebral] …

Running For Office 101, William Sullivan Jd

The Journal of the Michigan Dental Association

The pull-out section presents the MDA resources and support available from the MDA for members considering public service. It discusses the importance of having dentists in the Michigan Legislature and provides a guide to encourage dentists to run for public office. Running for public office is a significant decision, and the guide "Running for Office 101," offers information and insights for potential candidates.

Analysis Of The Utilization Of Nebraska Medicine's Price Transparency Tool, Ingrid A. Olson

Capstone Experience: Master of Public Health

Healthcare costs have become a significant concern for patients, healthcare facilities, economists, and politicians within the United States. In an effort to understand and reduce health-related costs, price transparency laws were enacted at the beginning of 2021. Because of these new laws, hospitals must provide a price transparency tool for their patients. “Price transparency in healthcare makes pricing information more readily available, defines the value of services, and enables patients and other care purchasers to identify, compare, and choose providers that offer the desired level of value” (AAMC, 2022). However, research results on price transparency tools use and efficacy is …

Sexual Health Assessment Is Vital To Whole Health Models Of Care, Alex Uzdavines, Drew A Helmer, Juliette F Spelman, Kristin M Mattocks, Amanda M Johnson, John F Chardos, Kristine E Lynch, Michael R Kauth

Center for Medical Ethics and Health Policy Staff Publications

Sexual health is the state of well-being regarding sexuality. Sexual health is highly valued and associated with overall health. Overall health and well-being are more than the absence of disease or dysfunction. Health care systems adopting whole health models of care need to incorporate a holistic assessment of sexual health. This includes assessing patients' sexual orientation and gender identity (SOGI). If health systems, including but not limited to the Veterans Health Administration (VHA), incorporate sexual health into whole health they could enhance preventive care, promote healthy sexual functioning, and optimize overall health and well-being. Assessing sexual health can give providers …

Affordable Housing: A National Crisis Fueled By The Coronavirus • A New Jersey Perspective, Latino Action Network Foundation

Center for Urban Policy Research

The Latino Action Network Foundation [LANF], its sister organization the Latino Action Network [LAN] and longtime ally, the Fair Share Housing Center [FSHC], have collaboratively monitored affordable housing issues in New Jersey for more than a decade. As part of its ongoing work, LANF sponsored a housing roundtable on September 10, 2021, to assess the affordable housing situation in the state and offer policy recommendations. At that time, a coalition of advocates, including the three organizations named above, were fresh from a legislative victory that safeguarded tenants unable to pay their rents during the pandemic and gave them a degree …

Integrated Dna Copy Number And Expression Profiling Identifies Igf1r As A Prognostic Biomarker In Pediatric Osteosarcoma, Aaron M Taylor, Jiayi M Sun, Alexander Yu, Horatiu Voicu, Jianhe Shen, Donald A Barkauskas, Timothy J Triche, Julie M Gastier-Foster, Tsz-Kwong Man, Ching C Lau

Center for Medical Ethics and Health Policy Staff Publications

Osteosarcoma is a primary malignant bone tumor arising from bone-forming mesenchymal cells in children and adolescents. Despite efforts to understand the biology of the disease and identify novel therapeutics, the survival of osteosarcoma patients remains dismal. We have concurrently profiled the copy number and gene expression of 226 osteosarcoma samples as part of the Strategic Partnering to Evaluate Cancer Signatures (SPECS) initiative. Our results demonstrate the heterogeneous landscape of osteosarcoma in younger populations by showing the presence of genome-wide copy number abnormalities occurring both recurrently among samples and in a high frequency. Insulin growth factor receptor 1 (IGF1R) is a …

A Commentary On The Healthy Community Stores Case Study Project: Implications For Retailers, Policy, And Future Research, Samantha M. Sundermeir, Megan R. Winkler, Sara John, Uriyoán Colón-Ramos, Ravneet Kuar, Ashley Hickson, Rachael D. Dombrowski, Alex B. Hill, Bree Bode, Julia Deangelo, Joel Gittelsohn

Urban Studies and Planning Faculty Research Publications

In the United States, low-income, underserved rural and urban settings experience poor access to healthy, affordable food. Introducing new food outlets in these locations has shown mixed results for improving healthy food consumption. The Healthy Community Stores Case Study Project (HCSCSP) explored an alternative strategy: supporting mission-driven, locally owned, healthy community food stores to improve healthy food access. The HCSCSP used a multiple case study approach, and conducted a cross-case analysis of seven urban healthy food stores across the United States. The main purpose of this commentary paper is to summarize the main practice strategies for stores as well as …

The Protective Effects Of Influenza Vaccination In Elderly Patients With Breast Cancer In Taiwan: A Real-World Evidence-Based Study, Szu-Yuan Wu, Ho-Jui Tung, Kuang-Hua Huang, Chiachi Bonnie Lee Lee, Tung-Han Tsai, Yu-Chia Chang

Health Policy & Community Health: Faculty Publications

In elderly patients with newly diagnosed breast cancer, clarity is lacking regarding the effects of influenza vaccines, particularly on clinical outcomes. This study conducted two nationwide, population-based, and propensity score-matched cohorts to estimate and compare the protective effects of influenza vaccine in elderly women and elderly patients with breast cancer. Data were derived from the National Health Insurance Research Database and Cancer Registry Database. Generalized estimating equations (GEEs) were used to compare outcomes between the vaccinated and unvaccinated cohorts. Adjusted odds ratios (aORs) were used to estimate the relative risks, and stratified analyses in the breast cancer cohort were performed …

Therapeutic Targeting Of Macrophage Plasticity Remodels The Tumor-Immune Microenvironment, Hee-Jin Jang, Hyun-Sung Lee, Wendong Yu, Maheshwari Ramineni, Cynthia Y Truong, Daniela Ramos, Taylor Splawn, Jong Min Choi, Sung Yun Jung, Ju-Seog Lee, Daniel Y Wang, Joel M Sederstrom, Massimo Pietropaolo, Farrah Kheradmand, Christopher I Amos, Thomas M Wheeler, R Taylor Ripley, Bryan M Burt

Center for Medical Ethics and Health Policy Staff Publications

Although the majority of patients with advanced lung adenocarcinoma (LUAD) are eligible to receive immune checkpoint blockade, approximately 80% of these tumors are resistant to this therapeutic approach. Insights at the single-cell level into mechanisms that drive LUAD tumorigenesis and the relationship of LUAD histologic heterogeneity to response to immune checkpoint blockade could help identify biomarkers and potential combinational approaches to improve immunotherapy efficacy. Here we used a genetically engineered mouse model that replicates the development of human LUAD through a spectrum of pre-invasive to invasive adenocarcinoma histologic subtypes. A systems onco-immunology approach of integrating the analytical power and unique, …

An Updated Assessment Of 43,110 Patients Enrolled In The Childhood Cancer Research Network: A Children’S Oncology Group Report, Austin L Brown, Pagna Sok, Michael E Scheurer, Karen R Rabin, Erin L Marcotte, Douglas S Hawkins, Logan G Spector, Philip J Lupo

Center for Medical Ethics and Health Policy Staff Publications

Background: The Childhood Cancer Research Network (CCRN) was established by the Children's Oncology Group (COG) as a resource for epidemiologic studies of childhood cancer. The objective of this study was to evaluate the representativeness of CCRN and identify factors associated with enrollment.

Method: The number of US childhood patients with cancer diagnosed < 20 years of age enrolled in CCRN (2008-2015) was compared to expected counts, calculated from Surveillance, Epidemiology, and End Results incidence rates and US Census population estimates. Observed-to-expected ratios and corresponding 95% confidence intervals (CI) were estimated across sex, race, diagnosis age, calendar year, and cancer diagnosis groups. Multivariable linear regression models were generated to evaluate the association between open COG phase 3 therapeutic trials and CCRN enrollment rates.

Result: The 43,110 cases enrolled in CCRN represented 36% of the expected childhood cancers diagnosed from 2008 to 2015 (N = 120,118). CCRN enrollment ratios [95% CI] were highest among males (0.38 [95% CI, 0.37-0.38]), non-Hispanics (0.35 [95% CI, 0.35-0.36]), and those diagnosed from 1 to 4 years …

Balancing Mission And Margins: What Makes Healthy Community Food Stores Successful, Sara John, Megan R. Winkler, Ravneet Kuar, Julia Deangelo, Alex B. Hill, Samantha M. Sundermeir, Uriyoán Colón-Ramos, Lucia A. Leone, Rachael D. Dombrowski, Emma C. Lewis, Joel Gittelsohn

Urban Studies and Planning Faculty Research Publications

Mission-driven, independently-owned community food stores have been identified as a potential solution to improve access to healthy foods, yet to date there is limited information on what factors contribute to these stores’ success and failure. Using a multiple case study approach, this study examined what makes a healthy community food store successful and identified strategies for success in seven community stores in urban areas across the United States. We used Stake’s multiple case study analysis approach to identify the following key aims that contributed to community store success across all cases: (1) making healthy food available, (2) offering healthy foods …

Adaptation Of Diabetes Prevention Program For Chinese Americans – A Qualitative Study, Ming-Chin Yeh, Wincy Lau, Siqian Chen, Ada Wong, Grace X. Ma, Judith Wylie-Rosett

Health Policy & Community Health: Faculty Publications

Background: Studies have demonstrated that a culturally and linguistically tailored Diabetes Prevention Program (DPP) can be effective in reducing diabetes risk in Chinese Americans. The purpose of this study was to explore the cultural and linguistic acceptability of the Centers for Disease Control and Prevention’s Prevent T2 curriculum in an online format in the Chinese American community in New York City (NYC). Methods: Three focus groups among a total of 24 Chinese Americans with prediabetes and one community advisory board (CAB) meeting with 10 key stakeholders with expertise in diabetes care and lifestyle interventions were conducted. Each focus group lasted …