Public Health Commons^™

Why Is The Skeleton Still In The Hospital Closet? A Look At The Complex Aetiology Of Protein-Energy Malnutrition And Its Implications For The Nutrition Care Team, Skye Marshall

Skye Marshall

Evaluation Of Progress Towards The Unaids 90-90-90 Hiv Care Cascade: A Description Of Statistical Methods Used In An Interim Analysis Of The Intervention Communities In The Search Study, Laura Balzer, Joshua Schwab, Mark J. Van Der Laan, Maya L. Petersen

Laura B. Balzer

WHO guidelines call for universal antiretroviral treatment, and UNAIDS has set a global target to virally suppress most HIV-positive individuals. Accurate estimates of population-level coverage at each step of the HIV care cascade (testing, treatment, and viral suppression) are needed to assess the effectiveness of "test and treat" strategies implemented to achieve this goal. The data available to inform such estimates, however, are susceptible to informative missingness: the number of HIV-positive individuals in a population is unknown; individuals tested for HIV may not be representative of those whom a testing intervention fails to reach, and HIV-positive individuals with a viral …

Social Identity And Substance Abuse In The Lesbian Community, Molly Kerby

Molly Kerby

The purpose of this study was to determine the degree of substance use (alcohol, tobacco, and other drugs) among members of the lesbian community. Additionally, the investigator attempted to determine if there was a relationship between negative social identity and low selfesteem that is reflected in higher rates of substance abuse. The data collection method employed in this study was a type of nonprobability sampling procedure referred to as a purposive sample. The questionnaire was derived from instruments used by other researchers and validated by an expert panel. In order to select respondents from the lesbian population to be included …

Massachusetts Healthy Aging Data Report: Community Profiles, Elizabeth Dugan, Frank Porell, Nina Silverstein, Ruth Palombo, Stacey Mann

Nina Silverstein

The Massachusetts Healthy Aging Data Report: Community Profiles was created by researchers at the Gerontology Institute of the John W. McCormack Graduate School of Policy and Global Studies at the University of Massachusetts Boston and commissioned by the Tufts Health Plan Foundation.

In this report, we have created a custom profile of nearly 100 healthy aging indicators for every city and town in Massachusetts including the 16 neighborhoods of Boston (367 Community Profiles). Each Community Profile is designed to help community residents, agencies, providers, and governments understand the older adults who live in their cities and towns – their ages, …

The Alzheimer’S Association Dementia Care Coordination Program: A Process Evaluation, Executive Summary, Nina Silverstein, Frank Porell, Pamela Nadash

Nina Silverstein

The Massachusetts/New Hampshire (MA/NH) Chapter of the Alzheimer's Association has long sought ways to systematically increase the number of families who utilize its services and support. According to the Alzheimer’s Association’s 2015 Alzheimer’s Disease Facts and Figures, there are 142,000 individuals living with Alzheimer’s disease in Massachusetts and New Hampshire, and the Alzheimer’s Association estimates that less than 30% of those individuals and their caregivers take advantage of its programs (Alzheimer’s Association, 2015). The MA/NH Chapter recognized that one major barrier to accessing services is a model that relies on families taking the initiative to seek out assistance.

In …

Massachusetts Healthy Aging Data Report: Community Profiles, Elizabeth Dugan, Frank Porell, Nina Silverstein, Ruth Palombo, Stacey Mann

Elizabeth Dugan

The Massachusetts Healthy Aging Data Report: Community Profiles was created by researchers at the Gerontology Institute of the John W. McCormack Graduate School of Policy and Global Studies at the University of Massachusetts Boston and commissioned by the Tufts Health Plan Foundation.

In this report, we have created a custom profile of nearly 100 healthy aging indicators for every city and town in Massachusetts including the 16 neighborhoods of Boston (367 Community Profiles). Each Community Profile is designed to help community residents, agencies, providers, and governments understand the older adults who live in their cities and towns – their ages, …

Clinical Topic Review 2013 - Behavioral Health Screening Among Masshealth Children And Adolescents, Judith A. Savageau, Georgianna Willis, Kathy Muhr, David M. Keller, Gideon Aweh, Elizabeth O'Connell

Judith A. Savageau

Results from the 2013 evaluation suggest that the Children’s Behavioral Health Initiative had a large impact on formal behavioral health screening and treatment utilization among children and adolescents enrolled in MassHealth.

Clinical Topic Review: Behavioral Health Screening For Children With Well Visits, Judith A. Savageau, Linda M. Cabral, Jack Gettens, Elizabeth O'Connell, Lana Miller, Susan Maguire

Judith A. Savageau

The first Clinical Topic Review was conducted in order to better understand how behavioral health screenings were occurring for children and adolescents during well visits prior to the implementation of a requirement that primary care providers perform behavioral health screening using a standardized behavioral health screening tool during every well child visit.

Report On The Community Conversation On Breastfeeding In Brookings Businesses, Sara A. Mehltretter Drury, Rebecca A. Kuehl, Jenn Anderson

Rebecca Kuehl

The Brookings Supports Breastfeeding (BSB) team hosted a Community Conversation on Breast feeding in Brookings Businesses, a public deliberation event on November 1, 2014. The deliberation focused on the question, “How can our community support the breastfeeding experience in Brookings businesses?” The event was held from 10am-2pm at the McCrory Gardens Education &Visitor Center in Brookings, SD. Background The BSB project is a community effort to promote dialogue and deliberation about supporting breastfeeding in Brookings businesses. It is funded through a Community Innovation grant from the Bush Foundation, and is a partnership between South Dakota State University (SDSU), the Brookings …

Community Conversation Guide: How Can Our Community Support The Breastfeeding Experience In Brookings Businesses, Becky Kuehl, Jenn Anderson, Sara A. Mehltretter Drury, Charlotte Bachman, Marilyn Hildreth, Jamison Lamp, Mary Schwaegerl, Lois Tschetter, Julia Yoder

Rebecca Kuehl

This forum is an opportunity for our community to come together and consider breastfeeding and support for our mothers and children with fresh eyes, fresh ideas, and a fresh conversation. Our conversation today will consider different approaches for increasing breastfeeding support in local businesses.
This guide introduces the issue, explains concerns with the breastfeeding experience in Brookings businesses, and presents three approaches to improving support. These approaches are not the only possible responses to the issue. Instead, they represent different ways that our community can take action based on our priorities.

The Double-Edged Sword Of Health Care Integration: Consolidation And Cost Control, Erin C. Fuse Brown, Jaime S. King

Erin C. Fuse Brown

The average family of four in the United States spends $25,826 per year on health care. American health care costs so much because we both overuse and overpay for health care goods and services. The Affordable Care Act's cost control policies focus on curbing overutilization by encouraging health care providers to integrate to promote efficiency and eliminate waste, but the the cost control policies largely ignore prices. This article examines this overlooked half of health care cost control policy: rising prices and the policy levers held by the states to address them. We challenge the conventional wisdom that reducing overutilization …

Unconventional Medical Practices Among Ghanaian Students : A University-Based Survey, Razak Mohammed Gyasi, Williams Agyemang-Duah, Charlotte Monica Mensah, Francis Arthur, Roselyn Torkornoo, Padmore Adusei Amoah

Mr. GYASI Razak Mohammed

Research on unconventional medical practices among students has proliferated lately in the global space, hitherto, little is known explicitly in Ghana. This paper teases out insights for recent utilisation patterns of traditional medical therapies at Kwame Nkrumah University of Science and Technology (KNUST), Ghana. A sample of 754, randomly selected undergraduates were involved in a retrospective cross-sectional survey. Data were analysed using multivariate logistic regression and Pearson's χ² test with p < 0.05 as significant. Overall prevalence of traditional therapies consumption was 89.1% in the last 12 months. Herbal-based products (67%), prayer healing (15%) and body-mind therapies (11%) were principally used and, accessed through purchases from pharmacy shops (29%) and encounter with faith healers (26%). Although students' knowledge on traditional therapies was acquired through family members (50%) and media (23%), literary materials remained significant information routes for Science related students compared to the Non-science related counterparts (p < 0.001). Pursuing Non-science-related programme [odds ratio (OR) 6.154 (95% confidence interval (CI) 3.745–10.111; p < 0.001)] and having Christian faith [OR 2.450 (95% CI 1.359–4.415; p = 0.003)] were strongly associated with students' traditional therapies use. Although students exhibited positive attitude towards unconventional therapies, there is an urgent need to validate …

Pulled In Or Pushed Out : Understanding The Complexities Of Motivation For Alternative Therapies Use In Ghana, Razak Mohammed Gyasi, Felix Asante, Joseph Yaw Yeboah, Kabila Abass, Charlotte Monica Mensah, Lawrencia Pokuah Siaw

Mr. GYASI Razak Mohammed

The impact of strong cultural beliefs on specific reasons for traditional medicine (TRM) use among individuals and populations has long been advanced in health care and spatio-medical literature. Yet, little has been done in Ghana and the Ashanti Region in particular to bring out the precise “pull” and “push” relative influences on TRM utilization. With a qualitative research approach involving rural and urban character, the study explored health beliefs and motivations for TRM use in Kumasi Metropolis and Sekyere South District, Ghana. The study draws on data from 36 in-depth interviews with adults, selected through theoretical sampling. We used the …

Do Health Beliefs Explain Traditional Medical Therapies Utilisation? Evidence From Ghana, Razak Mohammed Gyasi, Felix Asante, Kabila Abass, Joseph Yaw Yeboah, Samuel Adu-Gyamfi, Padmore Adusei Amoah

Mr. GYASI Razak Mohammed

Although the direct impact of health beliefs on unconventional medical therapies consumption are well documented, the previous empirical findings of the relationship have been much inconsistent and theoretically subtle in Ghana. Using social cognitive thesis, this paper examines how relative effects of personal health beliefs influence the use of traditional medicine in the Ashanti Region of Ghana. Drawing on a qualitative approach involving rural and urban peculiarities and 36 in-depth interviews, this research study adopts a posteriori inductive reduction model to derive broad- and sub-themes. Results suggest that health-seeking behaviour in Ghana is a socially negotiated process in which cultural …

Geographies And Traditional Therapies Utilization : A Convergence Of Health Behaviors In Rural And Urban Settings?, Padmore Adusei Amoah, Razak Mohammed Gyasi

Mr. GYASI Razak Mohammed

No abstract provided.

Health Literacy And Self-Perceived Health Status Among Street Youth In Kumasi, Ghana, Padmore Adusei Amoah, David Rosser Phillips, Razak Mohammed Gyasi, Adwoa Owusuaa Koduah, Joseph Edusei

Mr. GYASI Razak Mohammed

Street youth often have poor health. A number of studies have been commissioned across contexts to appreciate and address the problem. Conspicuously missing from extant researches about street youth in relation to their health however are those relating to health literacy. This study assesses general health literacy (GHL) and its association with self-perceived health status among street youth in Kumasi, Ghana. Two hundred and ninety street youth with an average age of 18 years (±3.1) participated in the study. The majority (78%) of street youth demonstrated limited GHL. Age, education, and acknowledging the streets as home, were significantly associated with …

Recruitment And Retention Of Community Health Center Primary Care Physicians Post Ma Health Care Reform: 2008 Vs. 2013 Physician Surveys, Judith A. Savageau, Linda J. Cragin, Warren J. Ferguson, Laura A. Sefton, Joan Pernice

Judith A. Savageau

OBJECTIVES: In 2008 and 2013, the University of Massachusetts Medical School and the Massachusetts League of Community Health Centers surveyed community health center (CHC) primary care physicians (PCPs) to identify factors related to preparedness, recruitment and retention. The survey was repeated to determine the impact of Massachusetts health care reform.

METHODS: An online survey was sent to 677 PCPs at 46 CHCs. New questions addressed patient-centered redesign, language competencies, and interprofessional care.

ESULTS: With 48% responding, PCPs were significantly more prepared in 2013 to practice in a CHC. Intent to continue practicing in a CHC was related to age, length …

Using A Network-Based Approach And Targeted Maximum Likelihood Estimation To Evaluate The Effect Of Adding Pre-Exposure Prophylaxis To An Ongoing Test-And-Treat Trial, Laura Balzer, Patrick Staples, Jukka-Pekka Onnela, Victor De Gruttola

Laura B. Balzer

The Transcriptional Response To Oxidative Stress During Vertebrate Development: Effects Of Tert-Butylhydroquinone And 2,3,7,8-Tetrachlorodibenzo-P-Dioxin, Mark E. Hahn, Andrew G. Mcarthur, Sibel I. Karchner, Diana G. Franks, Matthew J. Jenny, Alicia R. Timme-Laragy, John J. Stegeman, Bruce R. Woodin, Michael J. Cipriano, Elwood Linney

Alicia R. Timme-Laragy

Oxidative stress is an important mechanism of chemical toxicity, contributing to teratogenesis and to cardiovascular and neurodegenerative diseases. Developing animals may be especially sensitive to chemicals causing oxidative stress. The developmental expression and inducibility of anti-oxidant defenses through activation of NF-E2-related factor 2 (NRF2) affect susceptibility to oxidants, but the embryonic response to oxidants is not well understood. To assess the response to chemically mediated oxidative stress and how it may vary during development, zebrafish embryos, eleutheroembryos, or larvae at 1, 2, 3, 4, 5, and 6 days post fertilization (dpf) were exposed to DMSO (0.1%), tert-butylhydroquinone (tBHQ; 10 µM) …

Regional Initiatives For Malaria Elimination: Building And Maintaining Partnerships, Andrew A. Lover, Kelly E. Harvard, Alistair E. Lindawson, Cara Smith Gueye, Rima Shretta, Roly Gosling, Richard Feachem

Andrew Lover

• Country programs and international donors are increasingly focused on regional approaches to malaria elimination; regional initiatives have been established in southern Africa, the Arabian Peninsula, Asia Pacific, Eastern Europe, and Latin America. Despite this growing attention, there is limited information and guidance on both key activities and organizational components of regional initiatives.
• In a review conducted for this policy forum, common characteristics across existing regional initiatives emerged: building a region-specific evidence base, leveraging expertise and resources, shifting commodities or pooling procurement, developing data-sharing systems, mobilizing resources, promoting high-level accountability, and strengthening advocacy.
• Regional initiatives share key structural elements: a strategic …

Malaria Risk Factors And Care-Seeking Behaviour Within The Private Sector Among High-Risk Populations In Vietnam: A Qualitative Study, Ingrid Chen, Huong Ngo Thi Thanh, Andrew A. Lover, Phung Thi Thao, Tang Viet Luu, Hoang Nghia Thang, Ngo Duc Thang, Josselyn Neukom, Adam Bennett

Andrew Lover