Health Policy Commons^™

Actionable Tumor Alterations And Treatment Protocol Enrollment Of Pediatric And Young Adult Patients With Refractory Cancers In The National Cancer Institute-Children's Oncology Group Pediatric Match Trial, D Williams Parsons, Katherine A Janeway, David R Patton, Cynthia L Winter, Brent Coffey, P Mickey Williams, Sinchita Roy-Chowdhuri, Gregory J Tsongalis, Mark Routbort, Nilsa C Ramirez, Lauren Saguilig, Jin Piao, Todd A Alonzo, Stacey L Berg, Elizabeth Fox, Douglas S Hawkins, Jeffrey S Abrams, Margaret Mooney, Naoko Takebe, James V Tricoli, Nita L Seibel, Nci-Cog Pediatric Match Team

Center for Medical Ethics and Health Policy Staff Publications

Purpose: The National Cancer Institute-Children's Oncology Group Pediatric MATCH trial aimed to facilitate evaluation of molecular-targeted therapies in biomarker-selected cohorts of childhood and young adult patients with cancer by screening tumors for actionable alterations.

Patients and methods: Tumors from patients age 1-21 years with refractory solid tumors, lymphomas, or histiocytic disorders were subjected to cancer gene panel sequencing and limited immunohistochemistry to identify actionable alterations for assignment to phase II treatment arms. The rates of treatment arm assignment and enrollment were compared between clinical and demographic groups.

Results: Testing was completed for 94.7% of tumors submitted. Actionable alterations were detected …

Phase Ii Study Of Selumetinib In Children And Young Adults With Tumors Harboring Activating Mitogen-Activated Protein Kinase Pathway Genetic Alterations: Arm E Of The Nci-Cog Pediatric Match Trial, Olive S Eckstein, Carl E Allen, P Mickey Williams, Sinchita Roy-Chowdhuri, David R Patton, Brent Coffey, Joel M Reid, Jin Piao, Lauren Saguilig, Todd A Alonzo, Stacey L Berg, Nilsa C Ramirez, Alok Jaju, Joyce Mhlanga, Elizabeth Fox, Douglas S Hawkins, Margaret M Mooney, Naoko Takebe, James V Tricoli, Katherine A Janeway, Nita L Seibel, D Williams Parsons

Center for Medical Ethics and Health Policy Staff Publications

Purpose: The NCI-COG Pediatric MATCH trial assigns patients age 1-21 years with relapsed or refractory solid tumors, lymphomas, and histiocytic disorders to phase II studies of molecularly targeted therapies on the basis of detection of predefined genetic alterations. Patients with tumors harboring mutations or fusions driving activation of the mitogen-activated protein kinase (MAPK) pathway were treated with the MEK inhibitor selumetinib.

Methods: Patients received selumetinib twice daily for 28-day cycles until disease progression or intolerable toxicity. The primary end point was objective response rate; secondary end points included progression-free survival and tolerability of selumetinib.

Results: Twenty patients (median age: 14 …

Radiological Appearance Of Appendicular Osteosarcoma: A Case Report, Dr. Bathreenathh B, Dr. Vikram Patil, Dr. Anupama C

Radiology Teaching Files

A 42yr old male patient with complaints of on and off pain of right shoulder and arm since 3months. No e/o weight loss and loss of appetite. No e/o fever. No e/o discharging sinus/ superficial swelling over the right arm.

Assessing Smoking Status And Risk Of Sars-Cov-2 Infection: A Machine Learning Approach Among Veterans, Alice B S Nono Djotsa, Drew A Helmer, Catherine Park, Kristine E Lynch, Amir Sharafkhaneh, Aanand D Naik, Javad Razjouyan, Christopher I Amos

Center for Medical Ethics and Health Policy Staff Publications

The role of smoking in the risk of SARS-CoV-2 infection is unclear. We used a retrospective cohort design to study data from veterans' Electronic Medical Record to assess the impact of smoking on the risk of SARS-CoV-2 infection. Veterans tested for the SARS-CoV-2 virus from 02/01/2020 to 02/28/2021 were classified as: Never Smokers (NS), Former Smokers (FS), and Current Smokers (CS). We report the adjusted odds ratios (aOR) for potential confounders obtained from a cascade machine learning algorithm. We found a 19.6% positivity rate among 1,176,306 veterans tested for SARS-CoV-2 infection. The positivity proportion among NS (22.0%) was higher compared …

Older Adult Healthcare Utilization Patterns And Receptiveness Towards Healthier Sg Initiative, Micah Tan, Grace Cheong, Wensi Lim, Paulin T. Straughan

ROSA Research Briefs

The Healthier SG (HSG) initiative was launched by Health Minister Ong Ye Kung in March 2022. HSG marks a distinct departure from existing healthcare models as under this new initiative, greater emphasis is placed on preventive healthcare rather than reactive treatments. This shift in approach is envisioned to have a significant influence on the healthcare system in Singapore – for instance, by focusing on “health care” rather than on “sick care” it is hoped by some that this new model will discourage the ‘over-service’ of patients by doctors in Singapore (Lim, 2022). An integral component of the HSG initiative is …

Advocacy Spotlight: Are You An Advocate?, Vincent Benivegna Dds

The Journal of the Michigan Dental Association

Advocacy is crucial for dentists in Michigan, as they face a unique opportunity to impact Medicaid dental benefits positively. Governor Gretchen Whitmer's budget proposal for 2023 includes a substantial $240 million investment to revamp dental Medicaid benefits, a historic move for the state. The Michigan Dental Association (MDA) has actively engaged with government offices and legislators to ensure this opportunity is not missed. However, despite the MDA's efforts to mobilize members through action alerts, response rates have disappointed. The article emphasizes the importance of consistent advocacy, as it has the power to influence dental practices and the well-being of patients …

Examining Disparities In The Early Adoption Of Covid-19 Personal Mitigation Across Family Structures, Casey Harris, Kevin Fitzpatrick, Michael Nino, Priya Thelapurath, Grant Drawve

Sociology and Criminology Faculty Publications and Presentations

The United States' response to the COVID-19 pandemic has relied heavily on personal mitigation behaviors versus centralized governmental prevention strategies, especially early in the virus's outbreak. This study examines how family structure shapes mitigation, focusing on the intersectional effects of gender, marital status, and the presence of children while accounting for differences in worry about infection from the virus. Using data from a national survey of 10,368 United States adults early in the pandemic (March 2020), survey-weighted logistic regression models show important differences in the likelihood of personal mitigation adoption across family structures. Unmarried women with children were most likely …

Characterization And Assessment Of Barriers And Facilitators To The Decision-Making Process For Blood And Blood Donor Safety In The United States: A Collective Case Study, Lauren A. Crowder

Doctor of Philosophy in Translational Health Sciences Dissertations

Background: Over 16 million blood components are transfused to patients in need every year in the United States (Jones et al., 2021). Because of the reliance on human blood donors, the donation and transfusion of blood will always be associated with some level of risk for both donors and recipients; the tolerability of these risks may vary from stakeholder to stakeholder. While the U.S. Food and Drug Administration (FDA) concedes that attaining a blood supply with zero risk for transmission of infectious diseases may be unattainable (U.S. Food and Drug Administration, 2019), they continue to strive for the lowest …

Breast Cancer Diagnosis And Treatment During The Covid-19 Pandemic In A Nationwide, Insured Population, Jennifer L Caswell-Jin, Maryam N Shafaee, Lan Xiao, Mina Liu, Esther M John, Melissa L Bondy, Allison W Kurian

Center for Medical Ethics and Health Policy Staff Publications

Purpose: The early months of the COVID-19 pandemic led to reduced cancer screenings and delayed cancer surgeries. We used insurance claims data to understand how breast cancer incidence and treatment after diagnosis changed nationwide over the course of the pandemic.

Methods: Using the Optum Research Database from January 2017 to March 2021, including approximately 19 million US adults with commercial health insurance, we identified new breast cancer diagnoses and first treatment after diagnosis. We compared breast cancer incidence and proportion of newly diagnosed patients receiving pre-operative systemic therapy pre-COVID, in the first 2 months of the COVID pandemic and in …

A Validation Framework For Somatic Copy Number Detection In Targeted Sequencing Panels, Raghu Chandramohan, Jacquelyn Reuther, Ilavarasi Gandhi, Horatiu Voicu, Karla R Alvarez, Sharon E Plon, Dolores H Lopez-Terrada, Kevin E Fisher, D Williams Parsons, Angshumoy Roy

Center for Medical Ethics and Health Policy Staff Publications

Somatic copy number alterations (SCNAs) in tumors are clinically significant diagnostic, prognostic, and predictive biomarkers. SCNA detection from targeted next-generation sequencing panels is increasingly common in clinical practice; however, detailed descriptions of optimization and validation of SCNA pipelines for small targeted panels are limited. This study describes the validation and implementation of a tumor-only SCNA pipeline using CNVkit, augmented with custom modules and optimized for clinical implementation by testing reference materials and clinical tumor samples with different classes of copy number variation (CNV; amplification, single copy loss, and biallelic loss). Using wet-bench and in silico methods, various parameters impacting CNV …

Provider Perceptions Of Telehealth And In-Person Exposure And Response Prevention For Obsessive-Compulsive Disorder, Andrew D Wiese, Kendall N Drummond, Madeleine N Fuselier, Jessica C Sheu, Gary Liu, Andrew G Guzick, Wayne K Goodman, Eric A Storch

Center for Medical Ethics and Health Policy Staff Publications

Until recently, psychotherapies, including exposure and response prevention (ERP) for obsessive-compulsive disorder (OCD), have primarily been delivered in-person. The COVID-19 pandemic required OCD providers delivering ERP to quickly transition to telehealth services. While evidence supports telehealth ERP delivery, limited research has examined OCD provider perceptions about patient characteristics that are most appropriate for this modality, as well as provider abilities to identify and address factors interfering with effective telehealth ERP. In the present study, OCD therapists (N = 113) rated the feasibility of delivering telehealth ERP relative to in-person for different (1) patient age-groups, (2) levels of OCD severity, and …

The Role Of An Inpatient Hospice And Palliative Clinical Pharmacist In The Interdisciplinary Team, Jetavia Jones Moody, Ivy O Poon, Ursula K Braun

Center for Medical Ethics and Health Policy Staff Publications

Palliative care is a specialized health care service for individuals with serious illness at any stage and can be provided in any setting. Current national consensus developed by palliative care experts recommends the inclusion of pharmacists in an interdisciplinary team (IDT) to provide quality palliative care. However, national registry data report that less than 10% of inpatient palliative teams in the U.S. have a clinical pharmacist. Clinical pharmacists have an impactful role in palliative patients' quality of life by optimizing symptom management, deprescribing, and providing education to the palliative care team as well as patients and their families. In this …

A Novel, De Novo Intronic Variant In Pogz Causes White-Sutton Syndrome, Ashanta Merriweather, David R Murdock, Jill A Rosenfeld, Hongzheng Dai, Shamika Ketkar, Lisa Emrick, Sarah Nicholas, Richard A Lewis, Undiagnosed Diseases Network, Carlos A Bacino, Daryl A Scott, Brendan Lee, Vernon Reid Sutton, Lorraine Potocki, Lindsay C Burrage

Center for Medical Ethics and Health Policy Staff Publications

White-Sutton syndrome (WHSUS), which is caused by heterozygous pathogenic variants in POGZ, is characterized by a spectrum of intellectual disabilities and global developmental delay with or without features of autism spectrum disorder. Additional features may include hypotonia, behavioral abnormalities, ophthalmic abnormalities, hearing loss, sleep apnea, microcephaly, dysmorphic facial features, and rarely, congenital diaphragmatic hernia (CDH). We present a 6-year-old female with features of WHSUS, including CDH, but with nondiagnostic clinical trio exome sequencing. Exome sequencing reanalysis revealed a heterozygous, de novo, intronic variant in POGZ (NM_015100.3:c.2546-20T>A). RNA sequencing revealed that this intronic variant leads to skipping of exon 18. …

Attitudes Of Major Religious Organizations In Ukraine To Abortion And Reproductive Medicine, Kateryna Karpenko, Alla Guzhva

Occasional Papers on Religion in Eastern Europe

The attitude of the largest religions of Ukraine to reproductive medicine is determined by a variety of practical approaches, which are still in process of change between the rather strict negative official position of major religious organizations of Ukraine, on the one hand, and a rather liberal approach to reproductive medicine in secular legislation of Ukraine. The harsh negative official position of the main religious organizations of Ukraine to surrogacy and abortions is presented in a joint document adopted by the Ukrainian Council of Churches and Religious Organizations. While the diversity of practical approaches of these organizations is represented by …

Review Of Cannabis Use Among Aboriginal And Torres Strait Islander People, Julia Butt, Mandy Wilson, Jocelyn Jones, Simon Lenton

Journal of the Australian Indigenous HealthInfoNet

The health effects of cannabis use may not always be seen as a high priority for Aboriginal and Torres Strait Islander communities. However, the impact of cannabis use on physical and mental health can have significant consequences. It is known that the use of high potency cannabis has increased over the last two decades, with a corresponding increased risk to health. In particular, young people are at increased risk of experiencing harms to mental health. Physical harms to health include effects on the respiratory system, cardiovascular system, an increased risk of cancer, and in-utero effects from maternal use. The review …

The Coming Global Food Crisis, E. Wesley F. Peterson

Cornhusker Economics

Inflation driven by rising prices for food, energy, and other consumer goods has become a major concern in the United States and other high-income countries. A far more serious issue is the effect of rising food prices on low-income households in many developing countries in Africa, Asia, and Latin America. Global food prices had been rising in 2020 and 2021 as a result of supply shortages caused by adverse weather conditions exacerbated by climate change, war and civil strife in various countries, and economic shocks in the aftermath of the Covid-19 pandemic and the consequent disruption of global supply chains …

Forms Of Community Engagement In Neighborhood Food Retail: Healthy Community Stores Case Study Project, Ravneet Kuar, Megan R. Winkler, Sara John, Julia Deangelo, Rachael D. Dombrowski, Ashley Hickson, Samantha M. Sundermeir, Christina Kasprzak, Bree Bode, Alex B. Hill, Emma C. Lewis, Uriyoán Colón-Ramos, Jake Munch, Lillian L. Witting, Angela Odoms-Young, Joel Gittelsohn, Lucia A. Leone

Urban Studies and Planning Faculty Research Publications

Community engagement is well established as a key to improving public health. Prior food environment research has largely studied community engagement as an intervention component, leaving much unknown about how food retailers may already engage in this work. The purpose of this study was to explore the community engagement activities employed by neighborhood food retailers located in lower-income communities with explicit health missions to understand the ways stores involve and work with their communities. A multiple case study methodology was utilized among seven retailers in urban U.S. settings, which collected multiple sources of data at each retailer, including in-depth interviews, …

Oregon's Senate Joint Resolution 12: Understanding The Implications Of A Constitutional Right To Healthcare, Anna Starr, Mpp

Hatfield Graduate Journal of Public Affairs

Problems persist throughout the U.S. healthcare system including exorbitant costs, poor health scores, high rates of uninsured, and lack of access to services among marginalized groups. Among many proposed solutions is a constitutional provision to healthcare. Largely based in ethics, healthcare as a right is also expected by many to improve health outcomes. However, while constitutional provisions for healthcare are found in countries around the world, empirical research results are limited and mixed at best. In the wake of social justice movements and resurgence of vibrant conversations about human rights, and with international pressure mounting for the U.S. to follow …

Experiences Seeking Meaningful Employment For Individuals With Substance Use Disorder In York County Maine, Tyler Egeland Ba, Mark Richards Bs Bs, Evelyn Ali Bs, Mary Lindsey Smith Phd

Substance Use Research & Evaluation

Two focus groups and one interview conducted in November 2021 collected information from a total of six respondents regarding theiremployment experiences in York County as individuals receiving treatment for substance use disorder. The guided discussion coveredtopics related to resources and services for finding employment opportunities, experiences obtaining meaningful employment, andpotential barriers and facilitators to maintaining employment. The interview and focus groups were facilitated and analyzed byexperienced researchers from the Catherine Cutler Institute at the University of Southern Maine. For more information, please contact Lindsey Smith at [email protected]

Bringing People Back Into Public Health Data: Community Feedback On A Set Of Visualization Tools - Summary Report, Alejandro Cerón, Mia Glover, Quisi Rodriguez-Oregel, Dani Thompson, Tom Adams, Naomi Asakura, Kaela Belknap, Anna Block, Nicole Boehler, Hannah Boeve, Sarah Bomers, Sasha Borovok, Grace Bryan, Kate Buffington, Majesty Cain, Beth Carideo, Haley Chesno, Grace Connell, Jake Corbett, Camille Cruz, Chloe Dawkins, Anna Denniston, Lydia Dickens, Sophie Duplock, Samuel Dwinell, Avery Ess, Sam Ferman, Ellis Geis, Ethan Graupmann, Xander Hedrick, Angel Hernandez-Miramontes, Grant Huyghe, Sara Ibrahiem, Anna Jamieson, Ian Kang, Allie Kris, Erin Lawrence, Maddie Leake, Ryan Leary, Taylor Loh, Charlotte Monroe, Alexander Nguyen-Lopez, Henry O’Daffer, Cat Parish, Jaylee Recountre, Grace Rizzo, Noah Roseth, Grace Rothstein, Katie Sage, Marie Saltzmann, Stephen Shlain, Riley Shores, Mackenna Simson, Mark Teneza, Jack Weinmeister, Justin Weinzweig, Alison Wenman, Patch Whelan, Lea Zimmerman

Anthropology: Undergraduate Student Scholarship

This course-based study is a product of the University of Denver’s Spring 2022 The Social Determination of Health (ANTH 2424) class. The study aimed to understand how well a set of public health visualization tools tells the data stories about people in Colorado, and about important public health problems. For this, a team of almost sixty undergraduate students taking the class, coordinated by three graduate teaching assistants, and directed by the course instructor interviewed a total of fifty-six people from Colorado, qualitatively analyzed those interviews, and wrote reports that draw conclusions and recommendations.