SPH news

Posted Date: November 16, 2017


Thirty-eight years ago, Dr. Lilly Ramphal-Naley received a special gift on her medical school graduation day, and now she has passed it on to a UNTHSC public health graduate who will soon be caring for patients himself.

The gift- a doctor’s bag – is probably over 100 years old.

It was presented to Nnamdi Maduabum, who recently passed his medical board exams and is applying for a residency position.

Dr. Ramphal-Naley served as Maduabum’s faculty mentor while he was studying for his MPH in Environmental and Occupational Health Sciences at the UNTHSC School of Public Health (class of ’15).

After graduation, he went to work for Catholic Charities in Fort Worth as a Data and Research Specialist, and now he’s on to the next step in his career.

“This bag was given to me in 1979 by a 90-year-old doctor. He was barely standing. He brought it to my graduation. If was full of his thoughts, hopes and wishes for my future,” Dr. Ramphal-Naley said during the presentation. “I was young, but I knew it was a precious gift. So now I am passing this gift on to you.”

She advised Maduabum to “stay humble and grounded.”

“This bag is full of the voices of patients who have been cared for by a doctor before me, then by me, and now will be cared for by you,” she said. “Stay focused on them. Always apply your knowledge to do good for the most – to heal a village.”

The gift carries special meaning for Maduabum, who said, “I am honored to know that Dr. Ramphal-Naley thinks so highly of me and my desire to provide excellent medical care to the community.”

Posted Date: November 15, 2017


When Dr. Thad Miller introduced a different kind of course project to his Health Insurance and Managed Care class, he knew it would be interesting, but he had no idea that it would result in one of the university’s largest and most collaborative Grand Rounds in many years.

How did a unique teaching experiment go so far and have such an impact?

“I know that when I’m personally learning new information or a new subject, it really comes alive for me if I have a chance to use the concepts in practice,” Dr. Miller said. “I wanted to give the class that kind of hands-on opportunity, to dig deeper into a very complex topic that would take them beyond the more traditional path of lectures and exams, so they could learn by doing.”

Dr. Miller challenged the class to engage across the UNTHSC campus, community and health care industry to plan and produce a Grand Rounds continuing education presentation for students, faculty, health professionals and others in the fields of medicine and public health.

In addition to a standing-room-only crowd on campus, an online audience from eight states tuned in to the webcast for Continuing Medical Education (CME) credit, viewing from Texas, California, Arizona, Utah, Alabama, Michigan, South Carolina and Pennsylvania.

Dr. Miller first connected the class with Leslie Herman, MLS, MBA, CHCP, Program Manager for INCEDO UNT Health Science Center, a nationally-accredited provider for continuing education activities and programs both live and online. The idea proposed was to explore the challenges of today’s health care environment with a panel of insurance and provider experts.

INCEDO liked the proposal for its educational value and because it fit accreditation guidelines for including students in the planning process.

“It was a valuable experience for the class to work with panelists from diverse health care business settings to examine how the payer/provider/regulatory sectors connect, and to gain a firsthand look ‘behind the curtain’ to see what goes into planning a continuing education activity where specific goals and desired outcomes align to inform a targeted audience,” Herman said. “This was the first time in my three years with UNTHSC that I’ve worked with students developing a Grand Rounds as part of a class project.”

Herman met regularly with the students, and Dr. Miller provided guidance along the way, connecting the class with leads on speakers and others within the university who could help.

“The Office of Brand Communication advised on messaging to present the story of ‘Insurance in a Dynamic Marketplace,’ and UNTHSC media spokesperson Jeff Carlton coached our moderators on effective panel interview techniques,” Dr. Miller said.

The School of Public Health agreed to underwrite costs for event, which was provided free to participants.

“The funding commitment from the Dean demonstrated confidence in what our students are doing. This is consistent with the mission of connecting our students with the community and the professional world,” Dr. Miller said.

The class broke into teams to start, electing an executive committee and sub-groups who would reach out to speakers, coordinate with INCEDO, develop questions for the panelists in line with CME guidelines, and plan hospitality and after-event follow up.

Dr. Miller’s active role minimized once the class took the lead. He advised the teams to avoid saying they were working on a class project, so they could take a higher-level approach in their conversations with speakers and others involved.

UNT Health’s Chief Medical Officer, Eric H. Beck, D.O., M.P.H., was recruited as a panelist, along with Paul Hain, MD, Blue Cross and Blue Shield of Texas, North Texas Market President, and William (Doug) Wallace, JD, Fraud Prosecutor with the Texas Department of Insurance, Fort Worth.

Student Laci Sherman (MHA candidate, class of ’18), who coordinated with Blue Cross Blue Shield as one of the class team leads, said the experience “brought the whole topic to light,” taking it a step beyond what’s presented in class.

“It gave us a great opportunity to network with professionals in the industry, learn more about the future of health care, and gain valuable project management and organizational skills that will help in our careers,” she said.

Dr. Miller said a big benefit to this teaching tool has been the new relationships formed with industry leaders, as well as increased awareness of what UNTHSC students can do.

Dr. Beck agreed, calling the event “a wonderful proof point for the value of One University and how UNTHSC is uniquely positioned as the producer of contemporary practitioners for the health care delivery system of the future – one focused on improving health for populations and communities.”

Posted Date: November 7, 2017

Within two months of graduating from the UNTHSC School of Public Health (MHA ’16), Harleen Singh took on a highly selective administrative residency with Baylor Scott & White Health (BS&W), one of the largest not-for-profit health care systems in the United States.

This two-year postgraduate program – which helps prepare future health care leaders so they will be ready to assume a key management role within a complex health care organization – placed Singh with BS&W’s Health Texas Provider Network physicians group.

Her focus is on outpatient operations management, and the job takes her to different locations around Dallas-Fort Worth, where she spends several months in rotation learning about outpatient services, finance, human resources, physician-administrator relationships and other aspects of the business.

After completing her bachelor’s degree in Human Development and Family Sciences with a Business Certificate, Singh worked two years for Hilton Worldwide, where she was involved in revenue management and analysis for all of the company’s brands.

“It was during that time that I developed an interest in health care administration,” she said. “I have always had a passion for helping people, and being married to a physician, I was inspired to explore ways that I could apply my skills to the field and be able to serve others as well.”

She decided to pursue an MHA program where she could build on her revenue management background as a transition into health care leadership.

“I liked that the UNTHSC program is accredited by CAHME, the Commission on the Accreditation of Healthcare Management Education. This was very important to me when selecting my school, as it means that the program has met all the guidelines for having a robust and effective curriculum,” she said.

“Additionally, the program requires a 12-week, hands-on experiential internship where students are asked to incorporate, synthesize and apply their knowledge within both an operational and a community context. The program overall provided me with an excellent education and skillset to succeed in the health care industry,” she said.

As Singh took courses in health care finance, strategy, operations management and leadership development, she studied with health industry leaders who brought their real-world experiences into the classroom, “making it more relatable,” she said.

She also found a career mentor when she connected with Jack DuFon, her MHA internship preceptor at the VA Health Care System Dallas/Fort Worth, whose guidance helped Singh move toward her current administrative resident position.

“His advice helped me realize that practice management is a strong fit for my skills,” she said. “I believe it’s very important to connect with a mentor early on in your career, and in this field, organizations like the American College of Healthcare Executives (ACHE) are quite helpful with that process.”

Singh said she sees important work for outpatient health leadership in the future.

“As health care policies evolve and change, marketplace incentives are encouraging health systems to find ways of managing chronic disease care outside the traditional hospital setting. This signals a new trend for outpatient clinics, and it will be an important learning experience for me as I begin my career,” she said.

Posted Date: November 3, 2017


UNT Health Science Center public health students celebrated Halloween 2017 in healthy style.

As part of a community-wide “Public Health in Action Series,” the School of Public Health was treated to a nutritious, tasty cooking demonstration courtesy of the Blue Zones Project Fort Worth.

Vahista Ussery, known locally as “Chef V,” boiled the pot to create a black bean and sweet potato Spooktacular Chili recipe and shared helpful tips on preparing vegetables, including her own techniques for chopping onions, peeling potatoes and slicing bell peppers.

A registered dietitian, Chef V is co-founder of the consulting and education company To Taste: A Culinary Nutrition Experience. To Taste works to help bridge the gap between medical advice, healthy eating and cooking.

“The chili was delicious, and Chef V received applause several times throughout the demonstration for her great kitchen tips and nutritional advice,” said Dr. Emily Spence-Almaguer, Associate Dean for Community Engagement and Health Equity.

SPH students in the Health Insurance and Managed Care class added a different touch to Halloween with their presentation for the weekly Tuesday Interlude cohort session.

Dr. Thad Miller’s classes have been involved in teaching others as a way to reinforce their own learning experience, so this semester’s group decided on a “Family Feud Halloween” theme for their program on Medicaid and Politics. The group was graded on their presentation, which was well received by the audience.

 

Posted Date: October 24, 2017

UNTHSC students, faculty and staff are invited to the 2nd Annual Zoonotic Disease Fair from noon to 3 p.m. on November 21, to learn about some of the common diseases found in Texas that can be passed from animals to humans.

“It pays to be aware,” said public health student Emily Blankenship, who is helping to organize the event with fellow Environmental and Occupational Health classmates.

“Typhus, once considered almost eradicated in the U.S., is back on the rise in Texas. This potentially fatal disease transmitted by fleas joins the growing list of tropical infections impacting the state,” Blankenship said. “In August, a Texas dairy issued recalls on raw milk found to contain drug-resistant Brucella bacteria. And Listeria outbreaks in Texas food production have made news over the last several years. With climate change, we also expect to see more and different zoonotic disease threats moving in.”

The theme of the event is “In Our Backyard,” featuring games, food, prizes and brief presentations by speakers from the Tarrant County Public Health Department and UNTHSC School of Public Health.

UNTHSC Assistant Professor Katherine Fogelberg, DVM, PhD, will speak from noon to 12:20 p.m. on One Health, a global initiative recognizing the interconnectedness of the health of people, animals and the environment. One Health promotes an interdisciplinary approach to population health among veterinarians, physicians, public health officials and other health professions.

From 12:20 to 12:40 p.m., Dr. Vinny Taneja, Director, Tarrant County Public Health, will talk about Re-emerging Diseases from Developing Countries.

Russell W. Jones, MPH, Tarrant County Public Health Chief Epidemiologist, will speak on Brucellosis Exposure in Hospitals from 12:40 to 1 p.m.

Come-and-go games and activities are scheduled from 1 to 3 p.m.

The event will be held in MET 109-111.

For more information, contact Emily Blankenship at eb0219@my.unthsc.edu or 817-901-4040.

Posted Date: October 12, 2017

Lead author Melvin D. Livingston, PhD, with Tracey E. Barnett, PhD

UNT Health Science Center researchers and colleagues have released findings from a new study, published in the American Journal of Public Health, showing a reduction in opioid-related deaths following legalized recreational marijuana in Colorado.

Illegal and legally prescribed opioids now account for nearly 30,000 deaths a year in the United States, and the CDC says that 91 Americans die every day from an opioid overdose.

CDC data shows that opioid deaths from prescription drugs, heroin and synthetics like fentanyl have more than quadrupled since 1999.

In a July 31, 2017, interim report to the White House, the U.S. Commission on Combating Drug Addiction and the Opioid Crisis emphasized the severity of the problem, calling America “a nation in crisis.”

“As policy makers continue to grapple with both the growing opioid crisis and the rapidly changing landscape of marijuana laws in the U.S., scientific evidence is needed to help inform policy decisions to combat this disturbing upward trend in opioid-related deaths,” said Melvin D. Livingston, PhD, lead author of the study.

The researchers analyzed Colorado data covering a 15-year period from 2000 to 2015 to compare changes in the number of opioid-related deaths before and after recreational marijuana sale and use was legalized.

Findings showed that opioid deaths fell more than 6 percent in the following two years after the state’s marijuana legalization, reversing the previous upward trend.

“As of 2016, eight states and Washington DC have legalized recreational marijuana. While we found an apparent public health benefit in short-term reduction of opioid-related deaths following Colorado’s legalization, it’s important to note that expanded, legalized marijuana can also be associated with significant potential harms,” Dr. Livingston said.

“For policymakers to weigh decisions balancing potential beneficial and detrimental effects of these laws, researchers must continue to examine the full range of health outcomes through further study,” he said.

Dr. Livingston is Assistant Professor of Biostatistics and Epidemiology at the UNTHSC School of Public Health.

Co-authors of the study were Tracey E. Barnett, PhD, Associate Professor and Associate Dean for Academic Affairs, also with the UNTHSC School of Public Health; Chris Delcher, PhD, from the University of Florida; and Alex C. Wagenaar, PhD, from Emory University.

Posted Date: October 4, 2017

Helena Sung, who received her MPH in Health Management and Policy from the UNTHSC School of Public Health in 2014, has been awarded the Benjamin B. Ferencz Fellowship in Human Rights and Law from the World Without Genocide organization at Mitchell Hamline School of Law in St. Paul, Minnesota.

Ferencz fellowships are named for one of the world’s leading advocates of human rights, justice and peace, who prosecuted and received convictions at the 1947 Nuremberg, Germany, trials.

The fellowships provide financial support through World Without Genocide for work on core areas of human rights, including research, policy development and action at local, state, national and international levels.

A second-year law student, Ms. Sung was selected as a reporter for the American NGO Coalition of the International Criminal Court and will attend the Court’s annual Assembly of State Parties at the United Nations in New York.

Dr. Rohit Ojha, who received his DrPH from the UNTHSC School of Public Health in 2010, was published in the September 2017 issue of CANCER, a peer-reviewed journal of the American Cancer Society.

A team led by Washington University researchers in St. Louis and Dr. Ojha examined whether insurance status may affect survival rates of children diagnosed with cancer.

The team looked at data on cancers diagnosed among children under 15 years old for the time period 2007-2009. Among 8,219 childhood cancer patients (131 without insurance; 2,838 with Medicaid; and 4,297 with private insurance) who were followed for five years, the study found that children who were uninsured had a 26 percent higher risk of cancer death than those who were privately insured at diagnosis; the risk for those with Medicaid was similar to those with private insurance.

Dr. Ojha serves as Director for the JPS Health Network’s Center for Outcomes Research in Fort Worth, working toward improved patient outcomes in treatment and prevention of cancer, diabetes, infectious diseases like HIV and Hepatitis C, and maternal/child health.

 

Posted Date: October 2, 2017

Collaboration between TCOM, the UNTHSC School of Public Health, the CDC and Tarrant County Public Health resulted in a research publication and presentation at a national meeting for student Patrick Crowley, TCOM class of 2018.

Crowley has been published in the Texas Journal of Public Health for his work with Dr. Thad Miller, Associate Professor of Health Behavior and Health Systems, who leads UNTHSC’s role as one of 10 sites selected nationally for the CDC’s Tuberculosis Epidemiologic Studies Consortium (TBESC).

UNTHSC has served as a TBESC site since 2001, with a second 10-year funding commitment received for the project in 2011.

Crowley was matched with Dr. Miller through the TCOM summer research fellowship program in 2015 and spent six weeks collecting data on TB at Tarrant County Public Health.

“TB is considered to be a preventable disease, so if someone ends up at the health department with TB, it’s because somewhere along the way, there was a breakdown in the system,” Dr. Miller said. “Prevention efforts work very well, but still people get sick, so the question is, why and what can we do differently?”

Working under Dr. Miller’s guidance and in cooperation with Jeremy Gallups, RN, BSN, Tarrant County Public Health TB Division Manager, and Dr. George Samuel, UNTHSC Assistant Professor of Medicine and Tarrant County Public Health Pulmonary Medicine and Infectious Disease specialist, Crowley’s task as graduate research assistant was to personally interview TB patients to look for risk factors that might have been missed along the way.

Most patients were more than willing to share their records and information, Dr. Miller said, and the resulting presentations on Crowley’s work demonstrated that personal interviews could be an important research tool to aid in TB prevention.

Since then, Crowley has shared his research at UNT Health Science Center’s Research Appreciation Day and was invited to Atlanta to speak at a national CDC meeting.

The CDC Consortium is now exploring this methodology for future TB studies.

“It is very exciting to be able to contribute to the scientific progress toward TB elimination,” Crowley said. “As I talk to other medical students from around the state and across the country, I realize how fortunate UNTHSC students are to have so many great mentors and researchers from diverse fields to work with.”

A key element to making this effort work was the collaboration that began at UNTHSC, extended into the community and has now moved onto a broader scope with the CDC.

“It’s a great win-win and a perfect example of what can be accomplished when we all work together as one team,” Dr. Miller said.

Posted Date: September 27, 2017


Incoming School of Public Health graduate students participated in their first Interprofessional Education and Practice (IPE) event of the year to discuss the summer’s common reading exercise for Saving Gotham: A Billionaire Mayor, Activist Doctors, and the Fight for Eight Million Lives, the bestselling book that tells the tale of how New York City launched one of the country’s most important and controversial public health campaigns in 2002.

With the help of then mayor Michael Bloomberg, the city’s new health commissioner Dr. Thomas Frieden ambitiously tackled smoking in bars, outlawed trans fats in restaurants and lobbied to set limits on the size of soda, among other groundbreaking actions toward healthier eating and lifestyle.

While the initiatives drew criticism, by 2011 the results were clear: 450,000 people had quit smoking, childhood obesity rates were falling, and life expectancy was growing.

Lessons from the book were used to provide students in this IPE exercise with an example of the broad, defining principles of public health and the different pros and cons involved in leading a city to positive public health outcomes.

Students worked in groups with SPH faculty and staff to identify how different influences can contribute to or challenge public health initiatives. Second-year SPH graduate students also served as event co-facilitators, using their experiences from 2016-17 IPE activities to help inform the roundtable conversations.

IPE provides an opportunity for students to work together in a collaborative setting as they learn from real-world examples and case studies, sharing ideas, gaining perspective from others and outlining solutions for healthier communities.

In addition to the roles, responsibilities and abilities of public health and health administration professions, students in this exercise looked at the issues impacting collaboration among a diverse public when goals may not always be the same, funding may not be available and politics, special interests and personal values may differ.

“This showed me that public health is not a single issue,” said graduate research assistant Brandon Hoff, “and that collaboration is key as we step into this field.”

In the spring, the book’s author, Dr. Thomas A. Farley, who succeeded Dr. Frieden as health commissioner and continued the efforts to transform the city’s health, will Skype with SPH students and faculty to further discuss the book and its important takeaways.

Posted Date: September 21, 2017

Perhaps the main reason that UNT Health Science Center student Shivani Goswami was selected as this year’s Barbara Starfield Medical Scholar by the American Public Health Association (APHA) is because of her desire to build a better healthcare system.

As a future healthcare leader selected for this prestigious national honor, she will be involved in planning and assisting with Medical Section activities for the November APHA Annual Conference in Atlanta.

Seven years ago, Shivani found the road she wanted to take.

Interning as a clinical language assistant with autistic patients, she met 9-year-old Sarah.

Sarah suffered from complicated speech and motor impairments that intensified when she became nervous or excited.

The person that Shivani said she connected with was not a child labeled as autistic but a “bright-eyed young girl with a contagious smile,” individual in her own way.

The experience with Sarah and other children like her moved Shivani to want to learn more about the healthcare delivery system in order to change it.

“I wanted to have impact on what I saw as a very complex system with intricacies that sometimes lose sight of the fact that healthcare delivery is really about caring for people, and in this case, the children,” she said.

“As an intern, I was very limited in my capacity to help Sarah. It was a wonderful feeling to connect with her and make her laugh, but still needing knowledge and training, I couldn’t alleviate her complications or guide her health in the future,” she said.

“As I watched this child fight through challenges every day, I found myself drawn toward a Master’s in Health Administration, where I could develop as a leader and use my experience to manage and enhance the quality of healthcare programs in the future.”

On course now to complete her MHA in May 2018 from the UNTHSC School of Public Health, Shivani took her first leap into health leadership when she co-established a non-profit regional organization called Health Connect South five years ago. The organization, based in Georgia, builds collaborations among health leaders and innovators in the field to advance healthcare in the Southeast.

“Caring for a patient really involves an interdisciplinary focus and a values-based approach,” she said. “With a team of health professionals working together to cover every aspect of a patient’s needs, so much more can be addressed than when one person alone tries to make a difference.”

The UNTHSC public health program has helped Shivani broaden this idea beyond inpatient care services to “communities of care” that partner the patient and family with clinicians and community services addressing nutrition and healthy food access, safe housing, transportation, literacy, employment, education, work training and job opportunities.

“A pediatrician once told me that absolute compassion with humility is the best service a physician can provide. I realized this is also true in public health,” Shivani said.

“To tell the health community what you are working on is easy, but to tell them that you need help involves the humility that can lead to groundbreaking collaborations for advancing healthcare and healthier lives at a faster pace.”

In her role as APHA’s Barbara Starfield Medical Care Scholar, Shivani will be involved in sessions and programs tackling solutions for healthcare challenges like these.