bluuebunny/crossref_metadata_2025_split huggingface dataset:
Public Health Graduates and Employment in Governmental Public Health: Factors That Facilitate and Deter Working in This Setting
Authors: Yeager Valerie A. , Beitsch Leslie M. , Johnson Sarah M. , Halverson Paul K. 
Published: November 2019

Objectives:
Previous surveys of public health graduates examine where they work; however, little is known about public health graduates' employment decisions or the factors that facilitate interest or deter interest in working in governmental public health settings. The purpose of the current pilot study was to build on the information previously collected in graduate surveys by expanding questions to undergraduates and asking about decisions and factors that influence choices of employment.

Methods:
A pilot survey of graduates of public health programs was conducted. Respondents provided information about their degree programs, year of graduation, and current employment. Questions asked where they applied for jobs, factors they considered, experiences with the application processes, and so forth. Descriptive statistics were calculated using frequencies and proportions. Open-ended responses were qualitatively reviewed and general themes were extracted.

Results:
Employment preferences were ranked the highest for not-for-profit organizations (ranked first among 21 of 62, 33.9%), followed by governmental public health agencies (ranked first among 18 of 62, 29.0%). Among master of public health graduates, 54.7% sought employment within this setting, although only 17.0% of those employed full time at the time of the survey were employed within a governmental public health agency. Job security (84.7%), competitive benefits (82.2%), identifying with the mission of the organization (82.2%), and opportunities for training/continuing education (80.6%) were the most influential, positive factors garnering interest in working in governmental public health. Factors that were the biggest deterrents included the ability to innovate (19.2%), competitive salary (17.8%), and autonomy/employee empowerment (15.3%).

Conclusions:
Approximately half of the respondents applied for a job within governmental public health in anticipation of or since graduating. However, only a quarter of employed respondents are currently working within governmental public health, suggesting a missed opportunity for recruiting the other quarter who applied and were interested in governmental positions.
Assessing the Walkability Environments of Churches in a Rural Southeastern County of the United States
Authors: Bernhart John A. , Wende Marilyn E. , Kaczynski Andrew T. , Wilcox Sara , Dunn Caroline G. , Hutto Brent 
Published: November 2019

Context:
Churches can serve as important health promotion partners, especially in rural areas. However, little is known about the built environment surrounding churches in rural areas, including how these environments may impact opportunities for physical activity (PA) and may differ by neighborhood income levels.

Objective:
This study described walkability around churches in a rural county and examined differences in church walkability between high-, medium-, and low-income neighborhoods.

Design:
As part of the Faith, Activity, and Nutrition study, trained data collectors conducted a windshield survey of adjacent street segments within a half-mile of churches.

Setting:
Churches (N = 54) in a rural southeastern county in the United States.

Main Outcome Measure:
A summary walkability score (eg, presence of sidewalks, safety features, low traffic volume) was created with a possible range from 0 to 7. Analysis of variance was used to assess differences in walkability of churches by neighborhood income levels.

Results:
Walkability scores ranged from 0 to 6 (M = 2.31, SD = 1.23). Few churches had sidewalks, shoulders or buffers, or amenities nearby. In contrast, most churches had low traffic volume and no environmental incivilities. While not statistically significant, churches in low-income neighborhoods scored higher for walkability than churches in medium- and high-income neighborhoods.

Conclusions:
This study used low-cost environmental audits to analyze walkability in a sample of churches in a rural area and examined differences by neighborhood income. While churches may improve reach of people living in underserved and rural communities, a lack of environmental supports may limit effective PA promotion activities. Partnerships focused on improving existing areas or providing alternative PA opportunities for church and community members may be needed, especially in African American communities.
Life in Data Sets: Locating and Accessing Data on the Health of Americans Across the Life Span
Authors: King Jaron Hoani , Hall Mary Ann K. , Goodman Richard A. , Posner Samuel F. 
Published: November 2019

Context:
The US government manages a large number of data sets, including federally funded data collection activities that examine infectious and chronic conditions, as well as risk and protective factors for adverse health outcomes. Although there currently is no mature, comprehensive metadata repository of existing data sets, US federal agencies are working to develop and make metadata repositories available that will improve discoverability. However, because these repositories are not yet operating at full capacity, researchers must rely on their own knowledge of the field to identify available data sets.

Program or Policy:
We sought to identify and consolidate a practical and annotated listing of those data sets.

Implementation and/or Dissemination:
Creative use of data resources to address novel questions is an important research skill in a wide range of fields including public health. This report identifies, promotes, and encourages the use of a range of data sources for health, behavior, economic, and policy research efforts across the life span.

Evaluation:
We identified and organized 28 federal data sets by the age-group of primary focus; not all groups are mutually exclusive. These data sets collectively represent a rich source of information that can be used to conduct descriptive epidemiologic studies.

Discussion:
The data sets identified in this article are not intended to represent an exhaustive list of all available data sets. Rather, we present an introduction/overview of the current federal data collection landscape and some of its largest and most frequently utilized data sets.
Multidisciplinary Team Reviews of Drug Overdose Deaths and the Use of Minigrants to Advance Recommendations: A Statewide Pilot in Rhode Island
Authors: Hackman H. Holly , Koziol Jennifer A. , McCormick Meghan , McDonald James V. , Green Traci C. 
Published: November 2019

Context:
Rhode Island has been significantly impacted by the opioid epidemic, ranking 11th in unintentional drug overdose rates in the United States in 2017. Illicit fentanyl was involved in the majority of these deaths.

Program:
To enhance surveillance of this epidemic, the RI Department of Health piloted in-depth, multidisciplinary, and multiagency team reviews of drug overdose deaths. The goals were to identify gaps in policies and programming and develop recommendations to prevent future deaths. Time-sensitive minigrants were offered to nonprofit organizations as a novel way to further the recommendations put forth from these reviews.

Implementation:
Legal agreements between select state agencies and institutions enabled broad team representation and the sharing of information during each meeting. Reviews, revolving around a common theme, were conducted for up to 10 deaths each quarter. Recommendations for prevention were generated by the team and summarized in a report to the Governor's Overdose Prevention and Intervention Task Force and the public within 1 month of each meeting. Announcements of minigrant opportunities and funding to advance the community-specific recommendations were paired with each meeting.

Evaluation:
From November 2016 through May 2018, the pilot team convened 7 times, generated 78 recommendations, and distributed 31 minigrants. Early process evaluations of these grants have shown positive impact within local environments. Following the pilot phase, state legislation for these reviews was passed in June 2018.

Discussion:
The RI Department of Health was able to successfully pilot a multidisciplinary review process for overdose deaths and has recently institutionalized this process through legislation. The successful implementation of many of the team's community-oriented recommendations, supported through a minigrant process, highlights the impact that small financial investments can have to address the opioid epidemic and may be a model for other jurisdictions seeking to advance recommendations from these types of reviews.
Chronic Disease Surveillance Using Electronic Health Records From Health Centers in a Large Urban Setting
Authors: Figgatt Mary , Chen Jessica , Capper Gillian , Cohen Suzanne , Washington Raynard 
Published: November 2019

Objectives:
To assess the validity of electronic health records (EHRs) from a network of health centers for chronic disease surveillance among an underserved population in an urban setting.

Design:
EHRs from a network of health centers were used to calculate the prevalence of chronic disease among adult and child patient populations during 2016. Two population-based surveys with local estimates of chronic disease prevalence were compared with the EHR prevalences.

Setting:
A network of health centers that provides health care services to an underserved population in a large urban setting.

Participants:
A total of 187 292 patients who had at least 1 health care visit recorded in the Philadelphia health center network.

Main Outcome Measure:
Chronic disease indicator (CDI) prevalence of adult obesity, adult smoking, adult diabetes, adult hypertension, child obesity, and child asthma. Health center CDI proportions were compared with survey estimates.

Results:
Overall consistency between the health center estimates and surveys varied by CDI. With the exception of childhood obesity, all health center CDI proportions fell within the 95% CI for at least 1 comparison survey estimate. Statistically significant differences were observed and varied by CDI.

Conclusions:
This analysis presents a novel use of existing EHR data to estimate chronic disease prevalence among underserved populations. With the increased use of EHRs in health centers, data from health center networks may supplement chronic disease surveillance efforts, if used appropriately.
Practice-Based Evidence Supporting Healthy Eating and Active Living Policy and Environmental Changes
Authors: Kelly Cheryl , Clennin Morgan N. , Barela Breanne A. , Wagner Andrea 
Published: November 2019

Context:
Policy and environmental strategies have been recommended as evidence-based strategies to improve opportunities for healthy eating and active living.

Program:
A cohort of 6 coalitions in Colorado representing 5 communities was funded to implement policy and environmental strategies that support healthy eating and active living. Coalitions prioritized built environment to support active living and healthy food and beverage strategies.

Implementation:
Built environment coalitions prioritized the adoption of policies and implementation of infrastructure enhancements to improve access to walking, biking, and other physical activity at the institutional, regional, county, and/or municipal levels. Healthy food and beverage coalitions aimed to support the consumption of healthy foods and beverages in government settings, hospitals, and other public venues via policy, practice, or procedural changes.

Evaluation:
Built environment coalitions implemented change at 61 sites by implementing 16 policies and plans and 44 environmental changes. Healthy food and beverage coalitions implemented changes at 66 sites by passing 31 policies and plans and 44 environmental and practice changes. It is estimated that more than 70 000 individuals were likely exposed to these policy and environmental changes.

Discussion:
All community coalitions were successful in driving policy and environmental changes to promote healthy eating and active living. This program contributes to the practice-based evidence to demonstrate that with funding and resources, local public health coalitions and practitioners can drive policy and environmental changes in their communities. Providing funding to a dedicated coalition or group of partners can give coalitions the resources they need to drive these changes.
Role of Instruction Adherence During Highly Structured Robotic Arm Training on Motor Outcomes for Individuals After Chronic Stroke
Authors: Kim Grace J. , Chen Peii 
Published: November 2019

Abstract
The aim of this study was to examine the effects of instruction adherence on upper limb motor outcomes after highly structured intervention. A secondary data analysis was completed using mixed linear modeling design. Thirty chronic stroke survivors with moderate-to-severe arm impairment were assigned explicit movement instructions and completed 12 robotic therapy sessions for 4 wks. Instruction adherence was measured weekly using the Manipulation Check Questionnaire. Motor outcomes were measured at baseline, discharge, and at 4-wk follow-up using the Fugl-Meyer Assessment–Upper Extremity and Wolf Motor Function Test–Functional Ability Scale. There were no effects of adherence-related variables on upper limb motor outcomes (P > 0.2). Participant scores improved for both Fugl-Meyer Assessment–Upper Extremity and Wolf Motor Function Test–Functional Ability Scale from baseline to follow-up (P < 0.001). Participants improved motor function after 12 wks of robotic training; however, instruction adherence did not affect motor improvement. Adherence to explicit information may play a limited role in motor learning for stroke survivors with moderate-to-severe arm impairment during highly structured training protocols.
Disparities in Health Care for Hispanic Patients in Physical Medicine and Rehabilitation in the United States
Authors: Flores Laura E. , Verduzco-Gutierrez Monica , Molinares Diana , Silver Julie K. 
Published: November 2019

Abstract
In the United States, the number of people with Hispanic backgrounds is rapidly increasing. This growth, along with other factors, may put them at increased risk for healthcare disparities. Thus, physical medicine and rehabilitation should evaluate disparities in health services through the lens of the evidence base. To our knowledge, this is the first review describing the literature on healthcare disparities for Hispanic patients in the field of physical medicine and rehabilitation. This review explores healthcare utilization, risk factors, access, and health conditions specific to Hispanic populations. Articles used in this narrative review were collected for a 10-yr span (2009–2018) from online databases.
Our findings highlight disparities across common conditions and injuries in the physical medicine and rehabilitation literature, including poststroke rehabilitation, hip fracture treatment and rehabilitation, spinal cord injury, and traumatic brain injury. Our review suggests that Hispanic patients may be at risk for worse outcomes after these conditions, because of low access to rehabilitation services and disparities in the referral process. Similar results are reported for pain management and Parkinson disease. As we strive to provide optimal care to an increasingly diverse patient population, researchers and clinicians must consider effects of race and ethnicity on access to and utilization of rehabilitation services.
Comparison of Effective Cost and Complications after Abdominoperineal Resection: Primary Closure versus Flap Reconstruction
Authors: Billig Jessica I. , Hsu Jessica J. , Zhong Lin , Wang Lu , Chung Kevin C. , Kung Theodore A. 
Published: November 2019

Background:
Flap reconstruction is recommended for select patients undergoing abdominoperineal resection to mitigate complications. However, the clinical effectiveness and financial implications of flap reconstruction remain unknown. The authors aim to compare the costs and complications for patients undergoing abdominoperineal resection with and without flap reconstruction.

Methods:
The Truven MarketScan Databases (2009 to 2016) were used to perform retrospective population-based analysis of colorectal carcinoma patients who underwent abdominoperineal resection with and without flap reconstruction. Univariate and multivariable logistic regressions were used to study effective cost (cumulative cost/number of healthy days) and complications.

Results:
Of 2557 total abdominoperineal resection patients, 194 patients underwent flap reconstruction. Patients undergoing flap reconstruction had a higher Elixhauser Comorbidity Index (p = 0.004) and were more likely to have local invasion (p < 0.001). At 6 months postoperatively, there were no differences in complications between the two groups (p = 0.116). Flap reconstruction was protective against intraabdominal infections (OR, 0.4; 95 percent CI, 0.2 to 0.9; p = 0.033) but conferred an increased risk of wound complications (OR, 1.5; 95 percent CI, 1.0 to 2.3; p = 0.039). Total median cost of care was similar (abdominoperineal resection alone, $40,050; abdominoperineal resection with flap, $41,380; p = 0.456). Effective cost was greater for abdominoperineal resection alone ($259/healthy day) than abdominoperineal resection with flap ($186/healthy day) but was not statistically significant (p = 0.17).

Conclusions:
Patients with flap reconstruction displayed a higher comorbidity score and more extensive disease, but these unfavorable factors did not result in a higher complication rate, total cost, or effective cost. Therefore, flap reconstruction for complex perineal defects confers a benefit in select patients and is a judicious use of health care resources.

CLINICAL QUESTION/LEVEL OF EVIDENCE:
Therapeutic, III.
Mortality Risk Associated With Personality Facets of the Big Five and Interpersonal Circumplex Across Three Aging Cohorts
Authors: Chapman Benjamin P. , Elliot Ari , Sutin Angelina , Terraciano Antonio , Zelinski Elizabeth , Schaie Warner , Willis Sherry , Hofer Scott 
Published: November 2019

ABSTRACT

Objective
To address the common reliance on the global Big Five domains in the personality and longevity literature, the present study examined mortality risk associated with subdimensions of Big Five domains as well as specific traits within the interpersonal circumplex (IPC) model of personality.

Methods
Data were drawn from three major longitudinal studies of aging that administered the NEO Personality Inventory-Revised, a comprehensive measure of the Big Five, and comprised a total of 4223 participants. Item Response Theory models were used to generate latent trait scores for each of the 30 Big Five facets and eight scales from the IPC. Pooled mortality risk estimates were obtained from demographic-adjusted Cox regression models within each study.

Results
With a high degree of consistency, the vulnerability facet of neuroticism was associated with higher mortality risk and the activity facet of extraversion, with lower risk. None of the openness or agreeableness facets were associated with mortality, although the IPC scales submissiveness and hostile submissiveness were linked with elevated risk. All but one of the facets in the conscientiousness domain were robustly and consistently associated with lower mortality risk.

Conclusions
Findings indicate that specific facets of neuroticism and extraversion carry greater or lesser mortality risk. Broad composite scales averaging across all facets mask important personality risk factors. In contrast, nearly all facets within the conscientiousness domain confer protection against mortality. Finally, the IPC model may capture more nuanced interpersonal risk factors than the facets of Big Five agreeableness or extraversion. Understanding of the role of personality in longevity requires a more precise approach to conceptualization and measurement than broad, composite constructs usually provide.
Azole antifungals and new targeted therapies for hematological malignancy
Authors: Lindsay Julian , Teh Benjamin W. , Micklethwaite Ken , Slavin Monica 
Published: November 2019

Purpose of review
With the introduction of new targeted therapies for hematological malignancies comes the challenges of both assessing the risk of developing an IFD while being treated with these agents, as well as managing the drug--drug interactions between azole antifungals and the agents.

Recent findings
New targeted therapies for hematological malignancy include chimeric antigen receptor T cells (CAR T cells), Bi-specific T-cell Engager (BiTE) blinatumomab, and the antibody–drug conjugate (ADC) of calicheamicin inotuzumab ozogamicin for acute lymphoblasic leukemia (ALL) and lymphoma; the Bruton's tyrosine kinase (BTK) inhibitor ibrutinib and phosphatidylinositol 3-kinase (PI3Kδ) inhibitor idelalisib for lymphoma and graft-versus-host disease (GVHD); FMS-like tyrosine kinase 3 (FLT3) inhibitors, such as midostaurin, sorafenib and gilteritinib for acute myeloid leukemia (AML); and the BCL-2 inhibitor venetoclax for a range of hematological malignancies including lymphoma and leukemia. This review summarizes recommendations for IFD prophylaxis using these therapies and evidence for managing concomitant azole administration.

Summary
Whilst some evidence exists to guide IFD prophylaxis using new targeted therapies for hematological malignancies, there is an overall lack of descriptive, robust studies specifically describing IFD risk and management. With the emergence of novel agents, clinical judgment must be used to assess the risk of developing an IFD. Care must also be taken when administering azoles with drug--drug interactions, often requiring dose adjustment of the cancer therapies.
Structural Retinal Assessment Using Optical Coherence Tomography and Fundus Fluorescein Angiography in Systemic Lupus Erythematosus Patients
Authors: Fouad Shawky A. , Esmat Mahmoud Ali Soheir M. , Rezk Alnaggar Alshaimaa Rezk Lotfy , Mahfouz Safaa , Essam Mervat , El-Gendy Hala 
Published: November 2019

Background
Ocular manifestations in systemic lupus erythematosus (SLE) can be the presenting symptom of the disease or a sight-threatening complication.

Objectives
To detect different structural retinal changes in patients with SLE who had no ophthalmological symptoms and investigate the relationship between different retinal changes and the disease activity assessed by the Systemic Lupus Erythromatosus Disease Activity Index score.

Study Design
A descriptive pilot study from January 2016 to January 2017.

Methods
Fifty-two eyes of 26 patients diagnosed to have SLE were examined using visual acuity assessment, fundus examination, optical coherence tomography (OCT), and fundus fluorescein angiography (FFA).

Results
Fundus fluorescein angiography showed different changes in the form of venular occlusion and optic nerve leakage. There were also degenerative changes in the form of alternating hyperfluorescent and hypofluorescent areas outside the arcades as well as peripapillary areas and capillary dropout. Optical coherence tomography detected signs of degenerative thinning, incomplete posterior vitreous detachment, and epiretinal membrane. A significant correlation was found between SLE activity and the changes detected by FFA (p = 0.017). However, there was no significant correlation between disease activity and changes detected by OCT. Optical coherence tomography changes were significantly correlated with the duration of hydroxychloroquine use of more than 5 years (p = 0.032). There was no correlation between FFA or OCT changes and proteinuria or antiphospholipid antibodies.

Conclusions
Fundus fluorescein angiography is more sensitive in detecting early subclinical retinal changes in patients with SLE, which correlates with disease activity, whereas OCT is more sensitive in detecting changes resulting from hydroxychloroquine use.