Public Health Commons^™

Identifying The Gaps Between Public Health Training And Practice: A Workforce Competencies Comparative Analysis, Osnat Bashkin, Robert Otok, Ori Kapra, Kasia Czabanowska, Paul Barach, Orna Baron-Epel, Keren Dopelt, Mariusz Duplaga, Lore Leighton, Hagai Levine, Fiona Macleod, Yehuda Neumark, Stephanie Paillard-Borg, Theodore Tulchinsky, Zohar Mor

College of Population Health Faculty Papers

Objectives: The study aimed to generate insights on how best to enhance the compatibility between Public Health training program competencies and the implementation of competencies required by employers to address current and emerging public health needs.

Methods: A survey adapted from the WHO-ASPHER Competency Framework for the Public Health Workforce was conducted online among Israeli public health managers from August to November 2021. The survey was formulated to mirror Essential Public Health Operations. Forty-nine managers participated (37.6% response rate) in an assessment of 44 public health competencies and the core organizational public health operations.

Results: Analysis of Essential Public Health …

Registry-Based Cohort Study Of Alpha-1 Antitrypsin Deficiency Prevalence, Incidence And Mortality In Denmark 2000-2018, John Acquavella, Emese Vágó, Henrik Toft Sorensen, Erzsébet Horváth-Puhó, Gregory P. Hess

College of Population Health Faculty Papers

OBJECTIVE: To estimate the prevalence of diagnosed alpha-1 antitrypsin deficiency (dAATD) in Denmark as of 31 December 2018, and dAATD incidence and mortality from 1 January 2000 to 31 December 2018.

STUDY DESIGN AND SETTING: We used the Danish National Patient Registry to identify patients with dAATD based on the International Classification of Diseases, 10th Revision (ICD-10) code E88.0A and the Danish Civil Registration System (CRS) for population counts and vital status. We estimated dAATD prevalence, incidence and mortality. We compared mortality among patients with dAATD and an age-matched and sex-matched cohort extracted from the Danish CRS. We conducted a …

Efficacy And Safety Of Pacritinib Vs Placebo For Patients With Severe Covid-19: A Phase 2 Randomized Clinical Trial, John Cafardi, Carole Miller, Howard Terebelo, Chad Tewell, Sadia Benzaquen, David Park, Pamela Egan, Daniel Lebovic, Kristen Pettit, Eric Whitman, Douglas Tremblay, Jonathan Feld, Sarah Buckley, Karisse Roman-Torres, Jennifer Smith, Adam Craig, John Mascarenhas

Einstein Health Papers

IMPORTANCE: The morbidity and mortality associated with COVID-19 remain high despite advances in standard of care therapy, and the role of anti-inflammatory agents that inhibit the interleukin 6/JAK2 pathway is still being elucidated.

OBJECTIVE: To evaluate the efficacy and safety of the oral JAK2/IRAK1 inhibitor pacritinib vs placebo in the treatment of adults with severe COVID-19.

DESIGN, SETTING, AND PARTICIPANTS: This phase 2, double-blind, placebo-controlled, randomized clinical trial enrolled hospitalized adult patients with severe COVID-19 at 21 centers across the US between June 2020 and February 2021, with approximately 1.5 months of safety follow-up per patient. Data analysis was performed …

Blood Pressure Responses Are Dependent On Call Type And Related To Hypertension Status In Firefighters, Paige J Rynne, Cassandra C Derella, Carly Mcmorrow, Rachel L Dickinson, Stephanie Donahue, Andrew A Almeida, Megan Carty, Deborah L Feairheller

College of Population Health Faculty Papers

Background: Impaired cardiovascular health is a concern for firefighters, with over 50% of line-of-duty deaths having cardiac causes. Many firefighters have hypertension and <25% have their blood pressure (BP) controlled. The alarm response could be an unidentified cardiac risk, but interestingly, the BP response to different calls and on-the-job activity is unknown.

Purpose: We aimed to measure the physiological stress resulting from different call types (fire, medical) and job activity (riding apparatus, pre-alert alarms) through ambulatory BP (ABP) monitoring in a population of firefighters.

Materials and methods: During 111 12-h work shifts firefighters wore an ABP monitor. BP was measured at 30-min intervals and manual measurements were prompted when the pager went off or whenever they felt stress.

Results: Firefighters were hypertensive (124.3 ± 9.9/78.1 ± 6.7 mmHg), overweight …

Neonate, Infant, And Child Mortality In North Africa And Middle East By Cause: An Analysis For The Global Burden Of Disease Study 2019, Sadaf G. Sepanlou, Hossein Rezaei Aliabadi, Reza Malekzadeh, Ali. A. Asadi-Pooya

Global Health Articles

Background: During the past three decades, neonate, infant, and child mortality declined in North Africa and Middle East. However, there is substantial heterogeneity in mortality rates across countries.

Methods: This study is part of the Global Burden of Diseases study (GBD) 2019. We report the number as well as mortality rates for neonates, infants, and children by cause across 21 countries in the region since 1990.

Results: Between 1990 and 2019, the neonate mortality rate in the region declined from 31.9 (29.8, 34.0) to 12.2 (11.1, 13.3) per 1000 live births. Respective figures for under 5 mortality rates (U5MRs) were …

Choosing Not To Look: Not A Solution, Rosemary Frasso

College of Population Health Faculty Papers

No abstract provided.

Methylone And Mdma Pharmacokinetics Following Controlled Administration In Humans, Lourdes Poyatos, Alfredo Fabrizio Lo Faro, Diletta Berardinelli, Giorgia Sprega, Sara Malaca, Simona Pichini, Marilyn A. Huestis, Esther Papaseit, Clara Pérez-Mañá, Francesco Paolo Busardò, Magí Farré

Institute of Emerging Health Professions Faculty Papers

The aim of this study is to define, for the first time, human methylone and HMMC plasma pharmacokinetics following controlled administration of 50–200 mg methylone to 12 male volunteers. A new LC-MS/MS method was validated to quantify methylone, MDMA, and their metabolites in plasma. The study was a randomized, cross-over, double-blinded and placebo-controlled study, with a total of 468 plasma samples collected. First, 10 µL of MDMA-d5, MDA-d5 and methylone-d3 internal standards were added to 100 µL of plasma. Two mL of chloroform and ethyl acetate 9:1 (v/v) were then added, mixed well and centrifuged. The supernatant was fortified with …

Epigenetic Regulation In Chromium-, Nickel- And Cadmium-Induced Carcinogenesis, Lei Zhao, Ranakul Islam, Yifang Wang, Xiujuan Zhang, Ling-Zhi Liu

Department of Medical Oncology Faculty Papers

Environmental and occupational exposure to heavy metals, such as hexavalent chromium, nickel, and cadmium, are major health concerns worldwide. Some heavy metals are well-documented human carcinogens. Multiple mechanisms, including DNA damage, dysregulated gene expression, and aberrant cancer-related signaling, have been shown to contribute to metal-induced carcinogenesis. However, the molecular mechanisms accounting for heavy metal-induced carcinogenesis and angiogenesis are still not fully understood. In recent years, an increasing number of studies have indicated that in addition to genotoxicity and genetic mutations, epigenetic mechanisms play critical roles in metal-induced cancers. Epigenetics refers to the reversible modification of genomes without changing DNA sequences; …

Using A Human-Centered, Mixed Methods Approach To Understand The Patient Waiting Experience And Its Impact On Medically Underserved Populations, Elizabeth N. Liao, Lara Z. Chehab, Kathryn Neville, Jennifer Liao, Devika Patel, Amanda Sammann

Department of Emergency Medicine Faculty Papers

Purpose: To use a mixed methods approach to investigate the patient waiting experience for a medically underserved population at an outpatient surgical clinic.

Methods: We used lean methodology to perform 96 time-tracked observations of the patient journey in clinic, documenting the duration of activities from arrival to departure. We also used human-centered design (HCD) to perform and analyze 43 semi-structured interviews to understand patients’ unmet needs.

Results: Patients spent an average of 68.5% of their total clinic visit waiting to be seen. While the average visit was 95.8minutes, over a quarter of visits (27%) were over 2hours. Patients waited an …

A Rapid Systemic Review Of The Significance Of Parental Awareness Of Children’S Oral Health On The Prevalence Of Dental Caries In Saudi Arabia, Nasser Albishi

Master of Public Health Capstone Presentations

Dental caries in children has been identified as a public health challenge in the Kingdom of Saudi Arabia (KSA). Among those factors associated with their presence is the role that parents play in their children’s oral hygiene practices and how much it affects their development. The knowledge and awareness levels of the parents when it comes to maintaining proper oral hygiene in their children are still limited in the KSA, and a well-rounded characterization of these levels is needed for the problem to be addressed. Hence, a rapid systematic review was conducted to synthesize the evidence from published articles and …

The Food Environment: Examining The Proximity Of Crimes To Food Stores, Nina Diamond

Master of Public Health Capstone Presentations

Food insecurity is a persistent and widespread issue in the United States. Individuals who are food insecure are more likely to develop chronic diseases due to their dietary habits, which tend to consist of ultra-processed foods. For many individuals, these habits are not by choice, but are the result of a lack of access to healthy foods. Both geographical and financial access issues often lead to these unhealthy diet choices, which increase an individual’s risk of morbidity and mortality. While the issue of food insecurity is complex, it is not often observed in the context of violence. Many food insecure …

Maternal Healthcare Utilization Among Pregnant Women Experiencing Intimate Partner Violence: A Rapid Systematic Review, Gabrielle Harb

Master of Public Health Capstone Presentations

Intimate Partner Violence (IPV) impacts millions of pregnant women every year, and IPV is associated with adverse maternal and infant health outcomes. Previous studies have suggested that women experiencing IPV during pregnancy are less likely to access maternal healthcare services. Still, no consensus has been found, particularly within understudied low-and middle-income countries. This rapid systematic review identifies and examines evidence related to maternal healthcare utilization among women experiencing IPV in studies from 2015 to the present. A literature search was conducted in PubMed and Scopus, and 1797 unique records were identified. After reviewing abstracts and full texts, 28 studies were …

Process Mapping: The "One Best Way" To Improve Public Health Interventions, Adam T. Thompson

Master of Public Health Capstone Presentations

Process mapping (PM) is a quality improvement (QI) systems-level intervention used to analyze workflows in a variety of industries. PM is a robust improvement strategy but there is poor evidence for its effectiveness within healthcare QI projects. Evidence also suggests that there is variation in the implementation of PM likely affecting the value derived from the practice. In 2021, Antonacci, et al., proposed an empirical framework to guide the implementation, reporting, and evaluating of PM within healthcare QI projects. Informed by the empirical framework for process mapping (EFPM), the aim of this capstone was to enhance the value derived from …

Fall Reduction Strategies For Older Community Dwelling Americans, Heather L. Roach

Master of Public Health Capstone Presentations

Each year millions of older adults fall, and one out of five falls result in an injury that requires medical attention. In 2015 medical costs associated with falls was over $50 billion. Falls and specifically fall related injury in the older American population is a public health burden. There are many modalities that are implemented to reduce falls including management of underlying medical conditions, exercise regimens, supplementation, medication modifications, and home modifications. This project worked to identify which modalities had the greatest impact on falls. The goal of the information obtained is to inform practitioners and public health professionals that …

The Emotional Well-Being Of Menstruating Women In South Asia: A Rapid Systematic Review, Payal Patel

Master of Public Health Capstone Presentations

In South Asia, many girls and women experience period poverty which is defined to be a lack of access to or affordability of menstrual hygiene products, washing facilities, and disposal methods. There is also a lack of education and conversation that surrounds menstruation, leading to there being stigma and taboo. With an absence of Wash, Sanitation, and Hygiene (WASH) facilities, women and girls in South Asia are unable to change their pads safely and privately, have access to clean water, and successfully manage their hygiene and health. Apart from the lack of education and WASH facilities, there are also unfair …

The Impact Of Doulas On Birth Outcomes: A Rapid Systematic Review, Heather Higgins

Master of Public Health Capstone Presentations

Although most pregnancies in the United States are uncomplicated, adverse birth outcomes are more common in the U.S. than any other developed country (CDC, n.d.). The use of doula care during labor and delivery has shown to be effective in reducing adverse birth outcomes. A rapid systematic review was conducted to consolidate information on the effectiveness doulas have on certain adverse birth outcomes. These adverse birth outcomes included, low-birth weight, preterm birth, caesarean sections, shorter laboring time, and epidural use. The review of the literature was conducted using PubMed and search terms. PRISMA guidelines were followed and out of the …

Disparities In Neighborhood Park Access Among Adults In Philadelphia, Russell K. Mcintire, Tiara Halstead, Devesh Dajee, Meghan Buckley, Kyle Mcgregor, Sharon Larson

College of Population Health Faculty Papers

Researchers have clearly identified the importance of green space to promote mental and physical health among humans. In urban areas, public parks are essential for providing access to green space for many residents. This study identified the relationships between demographics, neighborhood social capital, violent crime, and residential distance to the closest park (park proximity) with self-reported access to neighborhood parks, among a population-representative sample of adults in Philadelphia. Women, older age groups, minorities, and those with lower education levels had lower self-reported access to neighborhood parks. Those reporting high neighborhood social capital had higher self-reported access to neighborhood parks. Park …

Conducting A Supportive Oncology Clinical Trial During The Covid-19 Pandemic: Challenges And Strategies, Jie Deng, John N. Lukens, Joy C. Cohn, Erin Mcmenamin, Barbara Murphy, Bryan A. Spinelli, Niya Murphy, Alicia K. Steinmetz, Megan A. Landriau, Alexander Lin

Department of Physical Therapy Faculty Papers

The coronavirus disease 2019 (COVID-19) pandemic resulted in severe interruptions to clinical research worldwide. This global public health crisis required investigators and researchers to rapidly develop and implement new strategies and solutions to mitigate its negative impact on the progress of clinical trials. In this paper, we describe the challenges, strategies, and lessons learned regarding the continuation of a supportive oncology clinical trial during the pandemic. We hope to provide insight into the implementation of clinical trials during a public health emergency to be better prepared for future instances.

Trial registration: ClinicalTrials.gov, a service of the US National Institute of …

“I Can’T See How People Could Walk Through That Exhibit And Not Be Forever Changed”: A Qualitative Analysis Exploring The Use Of Art In Research Dissemination, Vincent M. Pepe, Allison Sowers, Michelle Pimentel, Alexa Hoffman, Cierrah Doran, Amanda Guth, Sameer Khan, Willie Baronet, Rosemary Frasso

College of Population Health Faculty Papers

Background: Art can be a strong advocacy tool; it can be used to amplify the voices of marginalized communities and can change people’s perceptions of the world and others in it. In 2018, an art exhibit at Jefferson University included the cardboard signs of people who panhandle in Philadelphia as well as excerpts from in-depth interviews with those who panhandle to highlight their lived experiences. While the team published an article about this work, the purpose of this follow-up study is to explore the lasting impact of the exhibit experience on attendees’ perceptions of people who panhandle.

Methods: Fourteen attendees …

Commentary: Examining Contextual Factors Contributing To Differentials In Covid-19 Mortality In U.S. Vs. India., Preeti Zanwar, Katrine L Wallace, Christopher Soria, Arokiasamy Perianayagam

College of Population Health Faculty Papers

No abstract provided.

Increased Incidence Of Suspected Smoke Inhalation During The Coronavirus Disease 2019 Pandemic: A National Database Study, Theodore E Habarth-Morales, Arturo J. Rios Diaz, Emily Isch, Shreyas Chandragiri, Lucy Qi, Rose Ni, Edward J. Caterson

Student Papers, Posters & Projects

The COVID-19 pandemic has forced many Americans to adapt their daily routines. In 2020, there was a significant increase in house fires according to the National Fire Prevention Association (NFPA). The objective of this study was to characterize the changes in suspected smoke inhalations (SSIs) during the first year of the pandemic in the National Emergency Medical Services Information System (NEMSIS). The NEMSIS database was queried for all EMS transports captured between 2017 and 2020. Differences in the incidences of SSIs and fire dispatches in 2020 were estimated using Poisson regression models. There was a 13.4% increase in the incidence …

A Call For Consistent Measurement Across The Social Determinants Of Health Industry Landscape., Ellen T Rudy, Kelsey C Mcnamara, Zachary N Goldberg, Andrew Parker, David B Nash

College of Population Health Faculty Papers

No abstract provided.

Assessing The Effect Of Four Types Of Direct Mail Messages To Promote The Uptake Of Residential Lead Remediation Funds, H. Okatch, B. Nkala, J. Beltrami, E. Poy, D. Parmer, J. Nkala, F. Olawole

College of Population Health Faculty Papers

Objective

To examine the efficacy of direct mailing using four types of messaging on promoting the uptake of residential lead remediation (RLR) funds in Lancaster, PA, USA.

Study design

We designed a quasi-experiment to assess the effect of 4 RLR messages sent to households in Lancaster, PA by direct mail between September and December 2020: a brief flyer (F); a detailed brochure + the flyer (BF); a health infographic + the flyer (IF); and an application form + the flyer (AFF).

Methods

Mailers were sent to addresses in four census tracts; each census tract received a different message. Both English …

Emerging Lessons From The Covid-19 Pandemic About The Decisive Competencies Needed For The Public Health Workforce: A Qualitative Study, Osnat Bashkin, Robert Otok, Lore Leighton, Kasia Czabanowska, Paul Barach, Nadav Davidovitch, Keren Dopelt, Mariusz Duplaga, Leah Okenwa Emegwa, Fiona Macleod, Yehuda Neumark, Maya Peled Raz, Theodore Tulchinsky, Zohar Mor

College of Population Health Faculty Papers

The global COVID-19 crisis exposed the critical need for a highly qualified public health workforce. This qualitative research aimed to examine public health workforce competencies needed to face COVID-19 challenges and identify the gaps between training programs and the competency demands of real-world disasters and pandemics. Through a sample of thirty-one participant qualitative interviews, we examined the perspectives of diverse stakeholders from lead public health organizations in Israel. Grounded Theory was used to analyze the data. Six themes emerged from the content analysis: public health workforce's low professional status and the uncertain future of the public health workforce; links between …

Editorial: Promising Strategies For Vaccine Messages: The Message And The Source, Bridget J. Kelly, Amy E. Leader, Nora B. Henrikson

Department of Medical Oncology Faculty Papers

No abstract provided.

Serious Hazards Of Transfusion: Evaluating The Dangers Of A Wrong Patient Autologous Salvaged Blood In Cardiac Surgery., Masashi Uramatsu, Hideyuki Maeda, Shiro Mishima, Megumi Takahashi, Jun Wada, Kagehiro Amano, Paul Barach, Tamotsu Miki

College of Population Health Faculty Papers

BACKGROUND: The past half century has seen the near eradication of transfusion-associated hazards. Intraoperative cell salvage while widely used still poses significant risks and hazards due to human error. We report on a case in which blood collected from a patient with lung cancer was mistakenly administered to a patient undergoing cardiac surgery who should have received his own collected blood. The initial investigation found that the cause of the patient harm was violations of procedures by hospital personnel. A detailed investigation revealed that not only violations were the cause, but also that the underlying causes included haphazard organizational policies, …

The Hearst Health Prize: The First Five Years, Alexa M. Waters, Alexis Skoufalos, Emily Frelick, Gregory Dorn, David B. Nash

Department of Family & Community Medicine Faculty Papers

The Hearst Health Prize is the first national annual award for excellence in population health. The prize was established "to discover, support, and showcase the work of an individual, group, organization, or institution that has successfully implemented a population health program or intervention that has made a measurable difference" in health outcomes. Now, 5 years since the award's inception, this article reflects on how submissions for the prize collectively mirror - and may even predict - changes within the field of population health. It examines how the most successful programs demonstrated genuine, measurable improvements in health outcomes and/or health behaviors. …

Implementation And Outcomes Of A Remote Hepatitis B Screening Program Designed To Overcome Covid-19 Pandemic-Related Disruptions To Community-Based Screenings For Asians In Greater Philadelphia: A Descriptive Study, Yoonhee P Ha, Yusha Sun, Jack Wilkinson, Sonia Wang, Lillian Chien, Marisa Wu, Evangeline Wang, Catherine Freeland

College of Population Health Faculty Papers

No abstract provided.

Outcomes Following Abiraterone Versus Enzalutamide For Prostate Cancer: A Scoping Review, Yash B, Shah, Amy L. Shaver, Jacob Beiriger, Sagar Mehta, Nikita Nikita, William Kevin Kelly, Stephen J. Freedland, Grace Lu-Yao

Department of Medical Oncology Faculty Papers

Abiraterone acetate (AA) and enzalutamide (ENZ) are commonly used for metastatic prostate cancer. It is unclear how their outcomes and toxicities vary with patient-specific factors because clinical trials typically exclude patients with significant comorbidities. This study aims to fill this knowledge gap and facilitate informed treatment decision making. A registered protocol utilizing PRISMA scoping review methodology was utilized to identify real-world studies. Of 433 non-duplicated publications, 23 were selected by three independent reviewers. ENZ offered a faster and more frequent biochemical response (30-50% vs. 70-75%), slowed progression (HR 0.66; 95% CI 0.50-0.88), and improved overall survival versus AA. ENZ was …

Resilience And Protection Of Health Care And Research Laboratory Workers During The Sars-Cov-2 Pandemic: Analysis And Case Study From An Austrian High Security Laboratory, Martina Loibner, Paul Barach, Stella Wolfgruber, Christine Langner, Verena Stangl, Julia Rieger, Esther Föderl-Höbenreich, Melina Hardt, Eva Kicker, Silvia Groiss, Martin Zacharias, Philipp Wurm, Gregor Gorkiewicz, Peter Regitnig, Kurt Zatloukal

College of Population Health Faculty Papers

The SARS-CoV-2 pandemic has highlighted the interdependency of healthcare systems and research organizations on manufacturers and suppliers of personnel protective equipment (PPE) and the need for well-trained personnel who can react quickly to changing working conditions. Reports on challenges faced by research laboratory workers (RLWs) are rare in contrast to the lived experience of hospital health care workers. We report on experiences gained by RLWs (e.g., molecular scientists, pathologists, autopsy assistants) who significantly contributed to combating the pandemic under particularly challenging conditions due to increased workload, sickness and interrupted PPE supply chains. RLWs perform a broad spectrum of work with …