Faculty Bibliography

Big data, that is, data that are byproducts of our lives rather than designed for research purposes, are the newest of the information highway innovations. One of the important challenges to social and behavioral science data collection, curation, and dissemination for the foreseeable future is to link diverse forms of data in a way that is cumulative, representative, meaningful, and accessible to a broad range of researchers. It is critical to explore the new questions these data can address and to develop new methods to address them, including linking persons and information about them and their environments across different data platforms while maintaining confidentiality and privacy. Linking a broad array of information-from administrative data (local and state and regional), to social media (Twitter, Facebook), to census and other surveys, to ethnographic data, and data from experiments such as randomized controlled trials-to address how humans and their communities make decisions is challenging. This issue was addressed by papers presented at a conference on New Data Linkages convened by the Social Observatories Coordinating Network in 2016; those articles are brought together in this volume.

Purpose: The purpose of this paper is to argue that police research has reached a level of acceptance such that executive management has an ethical obligation to their communities to use evidence-based practices. Design/methodology/approach: Using an Evidence-Based Medicine (EBM) framework the authors apply an ethical-based decision-making model to policing decisions. EBM does not allow physicians to ignore research when giving guidance to patients. The authors compare the two professional approaches to decision making and argue policing has reached a level of research that if ignored, just like medicine, should be considered unethical. Police interventions can potentially be harmful. Rather than do no harm, the authors argue that police managers should implement practices that are the least harmful based on the current research. Findings: The authors found policing has a substantial amount of research showing what works, what does not, and what looks promising to allow police executives to make decisions based on evidence rather than tradition, culture, or best practice. There is a deep enough fund of knowledge to enable law enforcement leadership to evaluate policies on how well the policies and procedures they enforce prevent crime with a minimum of harm to the communities they are sworn to protect and serve. Originality/value: Policing has yet to view community interventions as potentially harmful. Realigning police ethics from a lying, cheating, stealing, lens to a "doing the least harm" lens can alter the practitioner"™s view of why evidence-based policing is important. Viewing executive decision from an evidence-based ethical platform is the future of evaluating police executive decisions.

This article discusses the current state of value in the United States health care system, and the unsustainable growth trend of health care spending. Also discussed is the role of waste and its subcategories as the drivers of that cost. The key differences in the cost drivers for governmental and commercial payers are discussed. The patient-level outcomes of low-value care are addressed. In addition, hospitalists are provided with an overview of the tools that exist to help improve the value of their current practices as well as for teaching value and leading value-based projects.

Data from a cross-sectional study of a clinic-based sample of older people living with HIV (PLWH; n = 100) were used to examine associations between biomarkers of physical health and neurocognitive impairment (NCI). In this sample, anemia, chronic kidney disease (CKD) stages 4-5, and hypocalcemia were associated with impairment in executive functioning or processing speed. Furthermore, participants with anemia were more likely to have CD4+ T cell counts <200 cells/mm3 (chi2 [1] = 19.57, p < .001); hypocalcemia (chi2 [1] = 17.55, p < .001); and CKD 4-5 (chi2 [2] = 10.12, p = .006). Black and Hispanic participants were more likely to be anemic compared to other races and ethnicities (chi2 [3] = 12.76, p = .005). Common medical conditions (e.g., anemia, hypocalcemia, CKD) should be investigated as potential contributors to NCI in older PLWH. Additionally, laboratory testing in racial/ethnic minority PLWH may help inform NCI screening.

OBJECTIVE:The objective of this study was to understand predictors of hepatitis C virus (HCV) antibody positivity in a large urban jail system in New York City. METHODS:We examined demographic characteristics, risk behaviors, and HCV antibody prevalence among 10 790 jail inmates aged 16 to 86 who were screened from June 13, 2013, to June 13, 2014, based on birth cohort or conventional high-risk criteria. We used logistic regression analysis to determine predictors of HCV antibody positivity. RESULTS:Of the 10 790 inmates screened, 2221 (20.6%) were HCV antibody positive. In the multivariate analysis, HCV antibody positivity was associated most strongly with injection drug use (IDU; adjusted odds ratio [aOR] = 35.0; 95% confidence interval [CI], 28.5-43.0). Women were more likely than men to be infected with HCV (aOR = 1.3; 95% CI, 1.1-1.5). Compared with non-Hispanic black people, Hispanic (aOR = 2.1; 95% CI, 1.8-2.4) and non-Hispanic white (aOR = 1.7; 95% CI, 1.5-2.1) people were more likely to be infected with HCV. Non-IDU, recidivism, HIV infection, homelessness, mental illness, and lower education level were all significantly associated with HCV infection. The prevalence rate of HCV infection among a subset of inmates born after 1965 who denied IDU and were not infected with HIV was 5.6% (198 of 3529). Predictors of HCV infection among this group included non-IDU as well as being non-Hispanic white, Hispanic, recidivist, and homeless. CONCLUSION:These data reveal differences in HCV infection by sex, race/ethnicity, and socioeconomics in a large jail population, suggesting that a focused public health intervention is required and that universal screening may be warranted. Further sensitivity and cost-benefit analyses are needed to make this determination.

PURPOSE: The authors performed a review of 30 Accelerating Change in Medical Education full grant submissions and an analysis of the health systems science (HSS)-related curricula at the 11 grant recipient schools to develop a potential comprehensive HSS curricular framework with domains and subcategories. METHOD: In phase 1, to identify domains, grant submissions were analyzed and coded using constant comparative analysis. In phase 2, a detailed review of all existing and planned syllabi and curriculum documents at the grantee schools was performed, and content in the core curricular domains was coded into subcategories. The lead investigators reviewed and discussed drafts of the categorization scheme, collapsed and combined domains and subcategories, and resolved disagreements via group discussion. RESULTS: Analysis yielded three types of domains: core, cross-cutting, and linking. Core domains included health care structures and processes; health care policy, economics, and management; clinical informatics and health information technology; population and public health; value-based care; and health system improvement. Cross-cutting domains included leadership and change agency; teamwork and interprofessional education; evidence-based medicine and practice; professionalism and ethics; and scholarship. One linking domain was identified: systems thinking. CONCLUSIONS: This broad framework aims to build on the traditional definition of systems-based practice and highlight the need for medical and other health professions schools to better align education programs with the anticipated needs of the systems in which students will practice. HSS will require a critical investigation into existing curricula to determine the most efficient methods for integration with the basic and clinical sciences.