Publications by authors named "Schaffer K"

Little is known about how to develop public health workforce capacity for health equity work. We explored associations of individual and organizational characteristics of local public health departments (LHDs) with competencies essential for advancing health equity. Data included responses of 29,751 staff from 742 LHDs in 48 states to the 2021 Public Health Workforce Interests and Needs Survey, plus LHD characteristics and county demographics.

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Reaching is a common daily activity requiring a range of humeral elevation that contributes to rotator cuff compression. The purpose of this study was to estimate supraspinatus and infraspinatus tendon compression risk relative to the acromion and coracoacromial ligament during reaching by manual wheelchair users with spinal cord injury. A cross-sectional design was used to evaluate 8 participants (7 males, median [range] age 36 y [23-61]).

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Background: Social media influencers have revolutionized information, gaining viewers, retention, and interest with short videos. Medical teams could potentially benefit from this medium for educating patients. Defining success in this endeavor remains unclear.

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  • The study examines the impact of illicit substance use during pregnancy, noting a 4-fold increase over two decades and its negative effects on mothers and fetuses.
  • A multicenter retrospective analysis from 2016 to 2021 included 852 pregnant trauma patients (PTPs), with 9.8% testing positive for substances, primarily THC and methamphetamine.
  • Findings showed that PTPs with positive urine toxicology had higher rates of blunt head injuries, extremity injuries, domestic violence incidents, and uterine contractions, but similar maternal complication rates compared to those who tested negative.
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  • Scientists studied the kinematic Sunyaev-Zel'dovich (kSZ) effect using data from two telescopes, the South Pole Telescope and Herschel-SPIRE, covering a large area in the sky.
  • They found a strong signal indicating that there is a trispectrum, which is a kind of pattern in the data, but it had contributions from other sources too, like cosmic microwave background lensing and foregrounds.
  • By analyzing the data, they couldn't find just the kSZ signal alone, but they set limits on how long the reionization period lasted in the early universe, which helps us understand its history better.
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  • Hospitalized patients need goals of care (GOC) and Advance Health Care Planning (ACP), which can drain healthcare providers emotionally and time-wise; thus, a specialized nursing team was created to assist in these discussions.
  • The nursing team, trained to consult with patients facing illnesses or geriatric issues, conducted an average of three visits per patient to establish long-term care goals and document essential aspects of their healthcare journey using structured templates.
  • The study, involving 3,342 patients mostly aged 65 and older over nine months, found that 30% of older adults changed their resuscitation orders by discharge, indicating that a focused nursing approach can effectively facilitate conversations around care preferences and often lead to more conservative treatment plans.
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Objective: To summarize and examine data collected from the first-ever Public Health Workforce Interests and Needs Survey Maternal and Child Health (MCH) module.

Design, Setting, And Participants: Responses from MCH governmental public health employees in 47 state health departments and 288 local health departments (LHDs) in the United States.

Main Outcome Measure: Demographic characteristics; 4 measures from the MCH module: the importance of and skill level in 5 MCH competencies in daily work, growth and leadership development opportunities, and additional workforce development needs.

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Azobenzene analogues of the tubulin polymerisation inhibitor combretastatin A4 (PSTs) were previously developed to optically control microtubule dynamics in living systems, with subsecond response time and single-cell spatial precision, by reversible photoswitching of their bioactivity with near-UV/visible light. First-generation PSTs were sufficiently potent and photoswitchable for use in live cells and embryos. However, the link between their seconds-scale and hours-scale bioactivity remained untested.

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Background: Maternal mortality in the United States is rising and many deaths are preventable. Emergencies, such as postpartum hemorrhage, occur less frequently in non-teaching, rural, and urban low-birth volume hospitals. There is an urgent need for accessible, evidence-based, and sustainable inter-professional education that creates the opportunity for clinical teams to practice their response to rare, but potentially devastating events.

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  • The study investigates the genetic factors influencing levels of prostate-specific antigen (PSA), which could enhance its effectiveness for prostate cancer screening among men.
  • Researchers conducted a transcriptome-wide association study (TWAS) using data from nearly 100,000 prostate cancer-free men, identifying 173 unique genes associated with PSA levels, with 151 resembling findings in another large dataset.
  • Further analysis revealed 20 genes that influenced PSA levels independently from identified genetic variants, with several showing a potential causal relationship and the need for additional research to understand these genetic influences better.
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Background: The abdominal seat belt sign (SBS) is associated with an increased risk of hollow viscus injury (HVI). Older age is associated with worse outcomes in trauma patients. Thus, older trauma patients ≥65 years of age (OTPs) may be at an increased risk of HVI with abdominal SBS.

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Background: Blunt traumatic abdominal wall hernias (TAWHs) are rare but require a variety of operative techniques to repair including bone anchor fixation (BAF) when tissue tears off bony structures. This study aimed to provide a descriptive analysis of BAF technique for blunt TAWH repair. Bone anchor fixation and no BAF repairs were compared, hypothesizing increased hernia recurrence with BAF repair.

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  • This study compares two surgical methods, Hartmann's procedure (HP) and resection with primary anastomosis (RPA), for treating acute left-sided colonic emergencies among 1215 patients from 204 centers globally.
  • Results showed that while HP was the more common treatment (57.3%), RPA was favored for younger patients with fewer health issues and those needing surgery sooner.
  • The study concluded that although HP is still widely used, RPA might be the better option, emphasizing the importance of patient characteristics and surgeon experience in determining treatment choice.
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  • Almost 10% of pregnant women experience serious injuries, but how serious injuries affect them and their babies isn’t well understood.
  • A study looked at 950 pregnant women with injuries and found that about 3.4% had severe injuries, which led to more complications and higher risks for both the mother and baby.
  • Severely injured women had more surgeries and a higher chance of losing their baby, so doctors need to be very careful when taking care of them.
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This article is one of 3 research briefs that highlight valuable experiences and opportunities that can be thought of as "bright spots" of the governmental public health workforce's pandemic response. Using PH WINS 2021 data, we qualitatively examined responses to an open-ended survey question about workforce experiences during the pandemic response. On-the-job learning was emphasized as a critical component of employees' experiences.

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The public health emergency response following the outbreak of COVID-19 necessitated greater internal public health agency teamwork and external collaboration. Building on previous research, this article is the third of 3 research briefs that highlight "bright spots" or valuable experiences and opportunities from the COVID-19 response. Using PH WINS 2021 data, we qualitatively examined responses to a question about pandemic workforce experiences.

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The protracted nature of the COVID-19 pandemic demanded extraordinary efforts and innovation from public health agencies and their leaders. This is the first of 3 research briefs that highlight valuable experiences and opportunities that can be thought of as "bright spots" of the public health workforce's pandemic response. Using Public Health Workforce Interests and Needs Survey 2021 data, we qualitatively examined responses to an open-ended question about pandemic workforce experiences.

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  • Doctors often use CT scans to check for injuries after car accidents, but for pregnant women, these scans can be risky for the baby.
  • A study looked at how often pregnant women involved in car crashes got CT scans at 12 different hospitals from 2016 to 2021.
  • The results showed a big difference in the number of scans given at each hospital, suggesting there should be clearer rules to keep both moms and babies safe while still finding any injuries.
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Background: Considering resources for comprehensive geriatric care, it would be beneficial for geriatric trauma patients (GTPs) and medical patients to be comanaged in one program focusing on ancillary therapeutics (AT): physical therapy, occupational therapy, speech language pathology, respiratory therapy, and sleep wake hygiene. This pilot study describes outcomes of GTPs in a hospital-wide program focused on geriatric-specific AT.

Methods: Geriatric trauma patients and geriatric patients were screened by program coordinator for enrollment at one Level II trauma center from August 2021 to December 2022.

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Prostate cancer is one of the most common cancers among men in the United States and a leading cause of cancer-related death in men. Treatment options for patients with advanced prostate cancer include hormone therapies, chemotherapies, radioligand therapies, and immunotherapies. Provenge (sipuleucel-T) is an autologous cancer-vaccine-based immunotherapy approved for men with asymptomatic or minimally symptomatic metastatic castration-resistant prostate cancer (mCRPC).

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Background: Blunt traumatic abdominal wall hernias (TAWH) occur in <1 % of trauma patients. Optimal repair techniques, such as mesh reinforcement, have not been studied in detail. We hypothesize that mesh use will be associated with increased surgical site infections (SSI) and not improve hernia recurrence.

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Penile squamous cell carcinoma is a rare disease with very limited data to guide treatment decisions. In particular, there is minimal evidence for effective therapies in the metastatic setting. Here, we present a case of metastatic penile squamous cell carcinoma with response to the Nectin-4 inhibitor enfortumab-vedotin-ejfv (EV).

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We conducted a multi-ancestry genome-wide association study of prostate-specific antigen (PSA) levels in 296,754 men (211,342 European ancestry; 58,236 African ancestry; 23,546 Hispanic/Latino; 3,630 Asian ancestry; 96.5% of participants were from the Million Veteran Program). We identified 318 independent genome-wide significant (p≤5e-8) variants, 184 of which were novel.

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Introduction: The Brain Injury Guidelines (BIG) stratify patients by traumatic brain injury (TBI) severity to provide management recommendations to reduce health care resource burden but mandates that patients on anticoagulation (AC) are allocated to the most severe tertile (BIG 3). We sought to analyze TBI patients on AC therapy using a modified BIG model to determine if this population can offer further opportunity for safe reductions in health care resource utilization.

Methods: Patients 55 years or older on AC with traumatic intracranial hemorrhage (ICH) from two centers were retrospectively stratified into BIG 1 to 3 risk groups using modified BIG criteria excluding AC as a criterion.

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