Global Health

The analysis of population health in a global context in order to understand and reduce disparities and protect against global threats such as infectious diseases

The Impact Of Global Budget Payment Reform On Systemic Overuse In Maryland

Oct. 4, 2020

Allison H. Oakes, Aditi P. Sen, Jodi B. Segal

Abstract [from journal]

Background: Medical overuse is a leading contributor to the high cost of the US health care system and is a definitive misuse of resources. Elimination of overuse could improve health care efficiency. In 2014, the State of Maryland placed the majority of its hospitals under an all-payer, annual, global budget for inpatient and outpatient hospital services. This program aims to control hospital use and spending.

Objective: To assess whether the Maryland global budget program was associated with

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Effect Of Neighborhood Food Environment And Socioeconomic Status On Serum Phosphorus Level For Patients On Chronic Dialysis

Sep. 11, 2020

Vishnu S. Potluri, Deirdre Sawinski, Vicky Tam, Justine Shults, Jordana B. Cohen, Douglas J. Wiebe, Siddharth P. Shah, Jeffrey S. Berns and Peter P. Reese

Abstract [from journal]

Background: Elevated blood phosphorus levels are common and associated with a greater risk of death for patients receiving chronic dialysis. Phosphorus-rich foods are prevalent in the American diet, and low-phosphorus foods, including fruits and vegetables, are often less available in areas with more poverty. The relative contributions of neighborhood food availability and socioeconomic status to phosphorus control in patients receiving dialysis are unknown.

Methods: Using longitudinal data

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COVID-19 Pandemic Significantly Decreases Acute Surgical Complaints

Aug. 29, 2020

John S. Riley, Valerie L. Luks, Luis Filipe de Pina, Ziad Al Adas, Jordan B. Stoecker, Benjamin M. Jackson, Benjamin M. Braslow, Daniel N. Holena

Abstract [from journal]

Background: The coronavirus disease 2019 (COVID-19) pandemic significantly reduced elective surgery in the United States, but the impact of COVID-19 on acute surgical complaints and acute care surgery is unknown.

Study design: A retrospective review was performed of all surgical consults at the Hospital of the University of Pennsylvania in the 30 days prior to and 30 days following confirmation of the first COVID-19 patient at the institution. Consults to all divisions within general surgery

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Welfare Chauvinism, Populist Radical Right Parties and Health Inequalities Comment on "A Scoping Review of Populist Radical Right Parties' Influence on Welfare Policy and its Implications for Population Health in Europe"

Julia Lynch head shot
Aug. 10, 2020

Clare Bambra and Julia Lynch

Abstract [from journal]

In this short commentary, we examine the implications of the welfare chauvinism of the populist radical right (PRR) for health inequalities by examining the international evidence about the impact of previous periods of welfare state contraction on population health and health inequalities. We argue that parties from various political traditions have in fact long engaged in stigmatisation of welfare recipients to justify welfare state retrenchment, a technique that the PRR have now 'weaponised.' We conclude by reflecting on

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Psychological Reactance Is A Novel Risk Factor For Adolescent Antiretroviral Treatment Failure

Robert Gross, MD, MSCE
Aug. 4, 2020

Elizabeth Lowenthal, Mitchelle Matesva, Tafireyi Marukutira, One Bayani, Jennifer Chapman, Ontibile Tshume, Mogomotsi Matshaba, Meredith Hickson, Robert Gross

Abstract [from journal]

Psychological reactance is an aversive response to perceived threats against personal agency. For adolescents receiving HIV treatment in Botswana, we utilized a two-question, medication-specific reactance tool to assess whether: (1) verbal reminders to take medicines made adolescents want to avoid taking them, and, (2) whether adolescents felt anger when reminded to take medicines. Reactant adolescents had 2.05-fold (95% CI 1.23, 3.41) greater odds of treatment failure than non-reactant adolescents (p = 0.03). Adjusted risk of

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The Psychological Benefits Of Marriage And Children In Rural Malawi

Iliana Kohler
Jul. 27, 2020

Shelley Clark, Cassandra Cotton, Rachel Margolis, Hans-Peter Kohler

Abstract [from journal]

Despite an extensive literature on the psychological rewards of marriage and children in high-income countries, research on these relationships in low-income countries remains limited. This paper draws on data from 4,133 adult women and men interviewed in the Malawi Longitudinal Study of Families and Health to examine how marital status, categorized as never, formerly, monogamously, and polygynously married, and number of children are associated with psychological well-being. With respect to marital status, we find that women in

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Sexually Transmitted Infections Among Kenyan Adolescent Girls and Young Women With Limited Sexual Experience

Tiffany Yuh
Jul. 14, 2020

Tiffany Yuh, Murugi Micheni, Stacy Selke, Lynda Oluoch, Catherine Kiptinness, Amalia Magaret, Bhavna Chohan, Kenneth Ngure, Anna Wald, Nelly R. Mugo,  Alison C. Roxby

Abstract [from journal] 

Objectives: Globally, the highest rates of sexually transmitted infections (STIs) are among the 15-24 age group. Studying adolescent girls and young women (AGYW) pre-sexual debut could identify risk factors for STI acquisition.

Methods: We recruited a prospective cohort of low-risk AGYW aged 16-20 in Kenya. Participants were HIV and HSV-2 seronegative and reported no history of sexual intercourse or reported sex with one partner. Participants underwent genital exams, nucleic acid testing of vaginal swabs for ...

Perioperative Point-of-Care Ultrasound And Transesophageal Echocardiography In Resource- Limited Settings-A Focus On Nepal And Bangladesh

Jul. 11, 2020

Jesse Raiten, Nahreen Ahmed, Ashish Amyata, Apurb Sharma, Subhash Acharya, Jill Lanahan, Hazel Werlhof, Hanjo Annie Ko, Cindy Tsui, Tariq Reza, Smriti Bajracharya, Ove Hagen, Gentle Shrestha

Abstract [from journal]

The use of point-of-care ultrasound (POCUS) and transesophageal echocardiography (TEE) in the perioperative and critical care setting is increasing worldwide. This increase has been driven by increasing educational opportunities and technologic advances. Nepal and Bangladesh are resource-limited countries where concerted efforts have been made to increase training in POCUS or TEE in the perioperative and critical care settings. This paper's focus is to present the current state of use and international efforts to improve education and

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Assessing The Effects Of Maternal HIV Infection On Pregnancy Outcomes Using Cross-Sectional Data In Malawi

Dylan S. Small, PhD
Jun. 22, 2020

Halima S. Twabi, Samuel O. Manda, Dylan S. Small

Abstract [from journal]

Background: Several studies have shown that maternal HIV infection is associated with adverse pregnancy outcomes such as low birth weight and perinatal mortality. However, the association is conflicted with the effect of antiretroviral therapy (ART) on the pregnancy outcomes and it remains unexamined. If the association is confirmed then it would guide policy makers towards more effective prevention of mother to child HIV transmission interventions. Using methods for matching possible confounders, the objectives of

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Practices And Perspectives Of Traditional Bone Setters In Northern Tanzania

Neil Sheth, MD
Jun. 16, 2020

Elizabeth B. Card, Joy E. Obayemi, Octavian Shirima, Matayo Lazaro, Honest Massawe, John W. Stanifer, Ajay Premkumar, Neil P. Sheth

Abstract [from journal]

Background: Traditional health practitioners remain a critical source of care in Tanzania, more than 50% of Tanzanians frequently using their services. With a severe shortage of orthopaedic surgeons (1:3.3 million Tanzanians) traditional bone setters (TBSs) could potentially expand access to musculoskeletal care and improve outcomes for morbidity as a result of trauma.

Objective: We sought to identify the advantages and disadvantages of traditional bone setting in Tanzania and to assess

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Comparison of Medical Comorbidities in Medicare Patients Treated by Orthopaedic Surgeons and Neurosurgeons Throughout the USA

Jun. 12, 2020

Alexander Beschloss, John Mueller, Jon-Michael E. Caldwell, Alex Ha, Joseph M. Lombardi, Ali Ozturk, Ronald Lehman, Comron Saifi

Abstract [from journal]

Aims: Medical comorbidities are a critical factor in the decision-making process for operative management and risk-stratification. The Hierarchical Condition Categories (HCC) risk adjustment model is a powerful measure of illness severity for patients treated by surgeons. The HCC is utilized by Medicare to predict medical expenditure risk and to reimburse physicians accordingly. HCC weighs comorbidities differently to calculate risk. This study determines the prevalence of medical comorbidities and the average HCC

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Evaluating The Impact Of Oncology Care Model Reporting Requirements On Biomarker Testing And Treatment

Jun. 4, 2020

Emily H Castellanos, Abigail Orlando, Xinran Ma, Ravi B Parikh, Gillian O'Connell, Neal J Meropol, James Hamrick, Blythe J S Adamson

Abstract [from journal]

Purpose: The Oncology Care Model (OCM) is Medicare's first alternative payment model program for patients with cancer. As of October 2017, participating practices were required to report biomarker testing of patients with advanced non-small-cell lung cancer (aNSCLC). Our objective was to evaluate the effect of this OCM reporting requirement on quality of care.

Methods: We selected patients with aNSCLC receiving care in practices in a nationwide de-identified electronic health record-derived

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Maximum Daily Temperature, Precipitation, Ultra-Violet Light And Rates Of Transmission Of SARS-Cov-2 In The United States

May. 30, 2020

Shiv T. Sehra, Justin D. Salciccioli, Douglas J. Wiebe, Shelby Fundin, Joshua F. Baker

Abstract [from journal]

Background: Previous reports have suggested that transmission of SARS-CoV-2 is reduced by higher temperatures and higher humidity. We analyzed case-data from the United States to investigate effects of temperature, precipitation, and UV Light on community transmission of SARS-CoV-2.

Methods: Daily reported cases of SARS-CoV-2 across the United States from 01/22/2020 to 04/03/2020 were analyzed. We used negative binomial regression modelling to investigate whether daily maximum

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Maximum Daily Temperature, Precipitation, Ultra-Violet Light And Rates Of Transmission Of SARS-Cov-2 In The United States

Douglas Wiebe, PhD, University of Pennsylvania
May. 30, 2020

Shiv T. Sehra, Justin D. Salciccioli, Douglas J. Wiebe, Shelby Fundin, Joshua F. Baker

Abstract [from journal]

Background: Previous reports have suggested that transmission of SARS-CoV-2 is reduced by higher temperatures and higher humidity. We analyzed case-data from the United States to investigate effects of temperature, precipitation, and UV Light on community transmission of SARS-CoV-2.

Methods: Daily reported cases of SARS-CoV-2 across the United States from 01/22/2020 to 04/03/2020 were analyzed. We used negative binomial regression modelling to investigate whether daily maximum temperature,

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