Monday, January 23, 2017

Capstone 2016 – Lauren Stevens

Presented December 15, 2016, Lauren Steven’s Capstone analyzed visit severities of a level-one, urban trauma center. As a large percentage of Americans rely on emergency departments (EDs) for non-emergent or primary care visits, the misuse can lead to longer wait times, physician shortages, patient overcrowding and unnecessary increased costs of care.

With the implementation of the Affordable Care Act (ACA), many—who previously could not afford or were denied coverage—now have access to health insurance. Medicaid expansion also helped bridge some of the affordable access to care gaps.

To shed light on ED utilization situation, Lauren’s project work leveraged a New York University (NYU) Emergency Department Algorithm (EDA) for examining ED case patterns. Additionally, she studied differences in ED use pre- and post-ACA to understand how changes in affordability may have shifted utilization. Lauren observed:

  • Increased utilization of healthcare with either insurance or Medicaid coverage.
  • High levels of ED utilization for non-emergent care.
  • Higher utilization of the ED by low-income and minority populations.
  • An increase from 69% non-emergent patient visits pre-ACA to 77% post-ACA.

Lauren’s research suggests that ED misuse is a significant issue. Public health can, however, help if policy and education efforts are focused on promoting utilization of a primary care physician for treatment of non-emergent or chronic illnesses which make up the bulk of cases currently seen in the ED.

Learn more about Lauren's Capstone experience. 

Left to Right: Asra Khalid, Brittany Lee,
Lauren Stevens and Deborah Manst

Why did you choose to pursue an MPH? 

A health science studies major, I have a Bachelor’s in Education from Baylor University in Waco, TX. Wanting to be a better informed medical school applicant, I looked first to Loyola’s MPH program. I chose the epidemiology track because of my interest in human diseases as an undergraduate. I am now in the process of applying to medical schools. 

What led you to your topic?  

As an undergraduate, I scribed in an emergency room. So, when Dr. Markossian and Dr. Probst asked for help from a public health student in analyzing ER data, I knew I’d be a good fit. After the initial presentation of data, we then wanted to add additional findings that would set our project apart. My Capstone was a natural progression using the NYU EDA. Sifting through the data was definitely challenging, but also a rewarding, collaborative effort. 

What was your biggest accomplishment while in the program?

My biggest accomplishment was seeing the research I had been working with throughout the past year come together. I was also able to present a few projects at the national American Public Health Association (APHA) Conference, which was an amazing experience. Seeing so many people so passionate about numerous public health issues was eye opening. 

What did you enjoy about the project? 

I liked uncovering potential areas for public health improvement and how real world issues are addressed by the Capstone. It is not just a project, it has real potential to make contributions to public health.

A student’s Capstone project is a professional presentation, which demonstrates his/her ability to apply the program learning to a specific public health topic. Selected by the student, the project reflects a culmination of the course curriculum, field experience and independent study. This experience helps students explore their academic passions while preparing them for a competitive job market.

Thursday, January 19, 2017

New physical activity research published from the Department of Public Health Sciences.

In spite of many studies showing that for long term weight maintenance, physical activity levels may not be as important as dietary intake. In an effort to provide more evidence for the role of physical activity and weight gain, we followed 1,944 men and women enrolled in the Modeling the Epidemiologic Transition Study for 2 years. METS is a 5-country study (US, Seychelles, Jamaica, South Africa and Ghana) investigating the role of diet and physical activity in weight change.  

We measured their physical activity levels at baseline and then weighed them every year for 2 years. After the 2 years, weight gain tended to be higher in participants who were normal weight (BMI<25 kg/m) at baseline, compared to participants who were classified as obese (BMI >=30 kg/m). We also found that participants in the US and Jamaica experienced the smallest weight gains compared to participants in Ghana and South Africa. Our study confirms that baseline physical activity levels may not be associated with 2 year weight gain in participants spanning the economic transition.

The link to our study can be found here.

Tuesday, January 17, 2017

In memory of Dana Riggins - from Dr. Stephanie Kliethermes (former LUC Public Health faculty member)

In the two short years that I was lucky enough to have known and worked with Dana, she had a tremendous impact on not only me individually but also the faculty, students and department as a whole.  Dana grew into a professional right before our eyes.  Having been blessed with the opportunity to work with her both in and out of the classroom, Dana's inquisitive nature and drive to truly understand the how's and the why's of what she learned contributed immensely to her success and growth at Loyola.  For her capstone, Dana independently learned how to apply an advanced statistical technique to her data and was most concerned with understanding the merits of the procedure as opposed to simply interpreting the results at face value.  It was during these conversations that I knew Dana was a special student capable of paving a promising career path for herself.  She was so proud and excited when she learned of her acceptance into the CDC program.

But more importantly than any academic and professional success, Dana was a genuinely good and kind person.  She was a teacher to us all. Dana was constantly helping her classmates in our statistics class because she genuinely wanted to see them succeed.  She lived by the philosophy that if you win, we all win.  We need more of that in this world.  Dana always lit up a room with her wit, humor and intelligence.  She had an uncanny ability to add subtle lightness and ease to frustrating situations which reminded all of us to not take life too seriously.  We lost a bright light in this world last week, but we are all forever better for having Dana as a student and most recently, a colleague.  Her impacts on the MPH program at Loyola will have a lasting effect -- she raised the bar for those around her.  For that, and for so much more, I am forever grateful and honored to have been able to work with Dana.  Teachers are often said to inspire students, but Dana truly inspired me.   

Monday, January 16, 2017

Capstone 2016 – Asra Khalid

Presented December 15, 2016, Asra Khalid’s Capstone explored treatment utilization among patients with—the most common form of liver cancer in the U.S.—Hepatocellular Carcinoma (HCC). Over the past few decades, the incidence rate has increased over three-fold. While early detection and treatment remains the key goal in improving outcomes for patients with this form of cancer, significant racial/ethnic and socioeconomic disparities complicate progress.

Asra’s objective was to compare receipt of HCC treatment and overall mortality by race and income characteristics using a large commercial insurance database. Conducting a cross-sectional analysis, the data revealed that even when insured at the same level, significant racial and income disparities exist in treatment utilization among patients with HCC

Significant discoveries include:
  • HCC treatment is underutilized even in a large population of insured patients with a treatment rate of only 35.57%. 
  • Out of the total population, whites are more likely to receive treatment as compared to other racial groups even after adjusting for comorbidities and other patient factors.
  • Patients with high income level (i.e. 400% above the Federal Poverty Level) are 60% more likely to receive treatment than patients with low income level (i.e. at or below Federal Poverty Level)  
  • Whites and patients with high income level are more likely to receive curative treatment rather than noncurative treatment. 
While disparities in treatment selection and outcomes may be influenced by biological, health care utilization and insurance status reasons, consideration for racial/ethnic and socioeconomic differences is essential to developing successful prevention, screening and treatment initiatives in the future.

Learn more about Asra's Capstone experience. 

Asra Khalid

What led you to your topic? 

I initially started working with Dr. Steve Scaglione (Hepatologist at Loyola University Medical Center) on hepatology research. He introduced me to Leanne Metcalfe (Senior Director of the HealthCare Services Corporation’s (HCSC) Center for Collaborative Research). I was offered a graduate research fellowship at HCSC. There, I assisted in investigating the epidemiology, risk-factors and healthcare utilization of patients with chronic liver disease. My capstone project—aimed at leveraging the large employer-based, health insurance claims data to evaluate racial and income disparities in treatment utilization among patients with HCC—came almost naturally.

What did you enjoy most about completing your project? 

I enjoyed working closely with the HCSC analytical team on evaluating and reporting claims data based on the study objectives. HCSC’s dedicated analytical team works diligently to deliver valuable insights based on a lot of data. These insights are then translated into practices that improve patient’s health. The fellowship provided me with an opportunity to use my qualitative and quantitative skills for various research projects.

Why did you choose to pursue an MPH? 

I’ve always believed that an individual’s health status should not be a reflection of his or her ethnicity, income status, gender or neighborhood. Everyone, irrespective of their racial or socioeconomic background, should have equal access to adequate health care. I wanted to pursue an MPH as a means of addressing the issue of health disparities on a grand scale. During the program, I worked with various healthcare and non-profit organizations on issues of diversity, inclusion, and cultural competence. I have extensively researched healthcare disparities, focusing on diversity in clinical trials and treatment utilization. 

Where are you headed with your career? 

I accepted an Epidemiologist position with the State of Tennessee’s Health Department. I’ll be responsible for helping in data management and conducting various epidemiological evaluations and studies on population health. I’m confident the knowledge and abilities gained in my MPH program will serve me well as I hope to reduce population disparities in the future.

A student’s Capstone project is a professional presentation, which demonstrates his/her ability to apply the program learning to a specific public health topic. Selected by the student, the project reflects a culmination of the course curriculum, field experience and independent study. This experience helps students explore their academic passions while preparing them for a competitive job market.

Monday, January 9, 2017

Capstone 2016 – Demitra Runjo

Presented December 9, 2016, Demitra Runjo’s Capstone project explored whether an association exists between the duration of breastfeeding and adolescent overweight and obesity. As dietary behavior starts at birth, this important early predictor may be used in the development of health intervention strategies. Although Demitra identified research existed relating the duration of infant feeding patterns to childhood obesity outcomes, she also recognized a knowledge gap as to whether this association extends to adolescents. Demitra’s research concluded that breastfeeding for 6 months or longer may be protective against overweight and obesity.

Learn more about Demitra’s Capstone experience. 

Demtra Runjo (left) with family.

What led you to your topic? 

I was previously working with Dr. Shoham as a Research Assistant (RA) using the ALSPAC dataset. While working with him as a RA our topic was much different, we believed that the association between breastfeeding duration and obesity/overweight outcomes would be interesting to explore using the ALSPAC dataset. Working with Dr. Shoham, as my mentor, was a more engaging experience than any classroom instruction. He took the extra time to work with me until I understood not only what I was doing but also what it meant… no matter how many annoying meetings I needed!

Did you encounter any challenges? 

As the semester began, we started to dive deep into the data. I was surprised just how much time data management and cleanup takes. That was probably my biggest challenge throughout the semester.

What did you enjoy about the project? 

The capstone truly is a culmination of the entire program and I got to use knowledge and skills from almost every class. It was really rewarding to see just how many pieces and skills—from epidemiology, to biostatistics to public policy—go into a project like this.

Where are you headed with your career? 

I received my Bachelor’s in Health Sciences with a concentration in Public Health (with minors in sociology and psychology) from DePaul University. I began my school program by taking an Epidemiology of Infectious Diseases course. Displaying an interest in the subject, my professor, Dr. Layden, helped me explore it further which eventually led to me getting a position at the University of Chicago Medical Center in the Infection Control Department.

A student’s Capstone project is a professional presentation, which demonstrates his/her ability to apply the program learning to a specific public health topic. Selected by the student, the project reflects a culmination of the course curriculum, field experience and independent study. This experience helps students explore their academic passions while preparing them for a competitive job market.

Monday, January 2, 2017

Save the Date – Friday, March 24, 2017

For decades, the Ruth K. Palmer Research Symposium has been an important gathering for health care professionals. Sharing the latest research, this event addressing important matters related to nursing research, education, administration, policy and clinical practice.

Friday, March 24, 2017
Center for Translational Research and Education, Auditorium
Loyola University Chicago Health Sciences Campus
2160 S. First Ave, Maywood, IL 60153

This year, the symposium will be addressing themes related to Mobilizing Innovative Technology to Transform Research and Promote Health. Keynote speaker Ryan J. Shaw, PhD, RN (Assistant Professor at the Duke University School of Nursing in health informatics) will explore how technology is transforming the way research is designed and conducted. His research—funded by the National Institutes of Health—is uncovering how to improve health outcomes and care delivery in patients with chronic illness through the use of mobile health and sensing technologies.

Additional information and final schedule will be shared closer to the event date.

Loyola Public Health students are encouraged to plan to attend. Simply visit to register. Registration for students and faculty is free. Other attendees, the fee is $75 each attendee, but group discounts are available. Registration is open through March 17, 2017.

Researchers, educators, practitioners, administrators and students are invited to submit an abstract of completed or in progress research for a poster presentation. Poster presentations will be competitively selected on the basis of scholarship and scientific rigor. Poster topics do not need to be related to the theme of the Palmer Symposium. One person may submit multiple abstracts. Submissions are due February 3, 2017 at 5 p.m. Click for more information.

Additional questions? Email