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Convenient Care Clinics: The Future Of Accessible Health Care, Tine Hansen-Turton, Sandra Ryan, Ken Miller, Mona Counts, David B. Nash

College of Population Health Faculty Papers

The need for accessible, affordable, quality health care in the United States has never been greater. In response to this need, convenient care clinics (CCCs) are being launched across the country to help provide care to meet the basic health needs of the public. In CCCs, highly qualified health care providers diagnose and treat common health problems, triage patients to the appropriate level of care, advocate for a medical home for all patients, and reduce unnecessary visits to emergency rooms and Urgent Care Clinics. CCCs have been called a "disruptive innovation" because they are consumer driven. They serve as a …

Overdose Prevention For Injection Drug Users: Lessons Learned From Naloxone Training And Distribution Programs In New York City, Tinka Markham Piper, Sasha Rudenstine, Sharon Stancliff, Susan Sherman, Vijay Nandi, Allan Clear, Sandro Galea

Publications and Research

Background: Fatal heroin overdose is a significant cause of mortality for injection drug users (IDUs). Many of these deaths are preventable because opiate overdoses can be quickly and safely reversed through the injection of Naloxone [brand name Narcan], a prescription drug used to revive persons who have overdosed on heroin or other opioids. Currently, in several cities in the United States, drug users are being trained in naloxone administration and given naloxone for immediate and successful reversals of opiate overdoses. There has been very little formal description of the challenges faced in the development and implementation of large-scale IDU naloxone …

Final Report Technical Assistance To Improve Quality Oversight Of The Oklahoma Advantage Waiver, Maureen Booth, Louise Olsen

Disability & Aging

No abstract provided.

Estimating The Empirical Lorenz Curve And Gini Coefficient In The Presence Of Error, Chaya S. Moskowitz, E. S. Venkatraman, Elyn Riedel, Colin B. Begg

Memorial Sloan-Kettering Cancer Center, Dept. of Epidemiology & Biostatistics Working Paper Series

The Lorenz curve is a graphical tool that is widely used to characterize the concentration of a measure in a population, such as wealth. It is frequently the case that the measure of interest used to rank experimental units when estimating the empirical Lorenz curve, and the corresponding Gini coefficient, is subject to random error. This error can result in an incorrect ranking of experimental units which inevitably leads to a curve that exaggerates the degree of concentration (variation) in the population. We explore this bias and discuss several widely available statistical methods that have the potential to reduce or …

A Quality Assurance Initiative For Emergency Medical Services, Melissa Anne Howell

Master of Public Health Program Student Publications

Ohio Revised Code 4765.12 mandates the implementation of ongoing peer review and quality assurance (QA) programs for all emergency medical service (EMS) organizations in the State of Ohio. The purpose of implementing QA programs for EMS is to ensure delivery of quality care to the public. Public health core strategies are to assess systems and assure the implementation of policies and processes that improve community health. Involving public health in the development of a QA program provides technical assistance in developing valid methods that can be used to measure the performance of an EMS system. This study will use a …

Risk Reduction Strategies: Past, Present, And Future, Roger C. Jensen

Safety Health & Industrial Hygiene

Several respected authors have proposed short lists of all strategies for controlling hazards or reducing risks from hazards. This article reviews those attempts and proposes an improved list of nine risk reduction strategies.

Fusion, 2007, George Washington University, William H. Beaumont Medical Research Honor Society

Fusion

No abstract provided.

An Administrator's Guide To Implementing Effective Dual Immersion Programs, Melanie Dawn Mcgrath

Theses Digitization Project

This project fills a void in the area of dual immersion program implementation. Although there are general guidelines that exist, there is a paucity of specific guidelines that explicitly delineate the implementation of these critical components in the current accountability climate. We need to move beyond general categories and tailor them to the unique needs program models within situated contexts.

A Feasibility Study For Establishing A Dedicated Breast Magnetic Resonance Imaging Center In The City Of Redlands, Hans Philip Saaty

Theses Digitization Project

This study is intended to determine the feasiblity of establishing a high-quality, free-standing MR imaging center dedicated to the breast in or about the City of Redlands.

Routes Of Exposure For Leptospirosis, Catherine C. Schmidt

International Journal of Global Health and Health Disparities

Leptospirosis was once a common zoonotic disease affecting most mammalian species. While it was once a very prevalent disease, it had tailored off only affecting humans with certain occupational hazards in developed countries. Recently, there has been an increase in the incidence of leptospirosis associated with recreational exposures and travel to tropical climates. Humans become infected with the disease through either direct or indirect contact with infected animal urine. Since leptospirosis has a longer survival period in wet, humid and warm conditions it is more prevalent in tropical and temperate climates and exposure peaks in the summer. There are a …

A Review Of Case-Control And Cohort Studies Examining Pesticides And The Risk Of Parkinson's Disease, Ruth Moytca Parks

International Journal of Global Health and Health Disparities

Parkinson's disease (PD) is the second most common neurodegenerative disease after Alzheimer disease, having an annual incidence of approximately 20 per 100,000 people (Schapira 2004, Fischer 1999). An estimated one million persons in the United States have PD, and this prevalence is likely to rise as the population ages (Schapira 2004). This disorder is characterized pathologically by a loss of dopamine neurons in the substantia nigra pars compacta that produces the neurotransmitter dopamine. The clinical features of PD are motor function abnormalities including tremor, rigidity, slowness of movement, and difficulty with balance. In the early stages of PD, treatments may …

Demographic Factors Associated With Prevalence Of Antibody To Sin Nombre Virus In Deer Mice In The Western United States, Charles Calisher, Kent Wagoner, Brian Amman, J. Jeffrey Root, Richard J. Douglass, Amy Kuenzi, Ken Abbott, Cheryl Parmenter, Terry Yates, Thomas Ksiazek, Barry J. Beaty, James N. Mills

United States Public Health Resources

We used long-term data collected for up to 10 yr (1994–2004) at 23 trapping arrays (i.e., webs and grids) in Arizona, Colorado, Montana, and New Mexico to examine demographic factors known or suspected to be associated with risk of infection with Sin Nombre virus (SNV) in its natural host, the deer mouse (Peromyscus maniculatus). Gender, age (mass), wounds or scars, season, and local relative population densities were statistically associated with the period prevalence of antibody (used as a marker of infection) to SNV in host populations. Nevertheless, antibody prevalence and some of the risk factors associated with antibody …

Annual Report To The Nation On The Status Of Cancer, 1975–2004, Featuring Cancer In American Indians And Alaska Natives, David K. Espey, Xiao-Cheng Wu, Judith Swan, Charles Wiggins, Melissa A. Jim, Elizabeth Ward, Phyllis A. Wingo, Holly L. Howe, Lynn A. G. Ries, Barry A. Miller, Ahmedin Jemal, Faruque Ahmed, Nathaniel Cobb, Judith S. Kaur, Brenda K. Edwards

United States Public Health Resources

BACKGROUND. The American Cancer Society, the Centers for Disease Control and Prevention, the National Cancer Institute, and the North American Association of Central Cancer Registries collaborate annually to provide updated information on cancer occurrence and trends in the U.S. The 2007 report features a comprehensive compilation of cancer information for American Indians and Alaska Natives (AI/AN).

METHODS. Cancer incidence data were available for up to 82% of the U.S. population. Cancer deaths were available for the entire U.S. population. Long-term (1975 through 2004) and fixed-interval (1995 through 2004) incidence and mortality trends were evaluated by annual percent change …

Social Capital And Rates Of Gonorrhea And Syphilis In The United States: Spatial Regression Analyses Of State-Level Associations, Salaam Semaan, Maya Sternberg, Akbar Zaidi, Sevgi O. Aral

United States Public Health Resources

We conducted spatial regression analysis to account for spatial clustering of sexually transmitted diseases (STDs) and to examine the state-level association between social capital (using Putnam’s public use data set) and rates of gonorrhea and syphilis. We conducted the analysis for the 48 contiguous states of the United States for 1990, 1995, and 2000 and controlled for the effects of regional variation in STD rates, and for state variation in poverty, income inequality, racial composition, and percentage aged 15–34 years. We compared the results of the spatial regression analysis with those of ordinary least squares (OLS) regression. Controlling for all …

The Straight Talk Campaign In Uganda: Impact Of Mass Media Initiatives—Summary Report, Susan E. Adamchak, Karusa Kiragu, Cathy Watson, Medard Muhwezi, Tobey C. Nelson, Ann Akia-Fiedler, Richard Kibombo, Milka Juma

HIV and AIDS

This Horizons study in Uganda found that exposure by adolescents to Straight Talk, a mass media initiative focused on adolescent sexual and reproductive health (ASRH), was associated with greater ASRH knowledge, a greater likelihood of having been tested for HIV, and more communication with parents about ASRH issues.

Community-Based Approaches To Prevention Of Mother-To-Child Transmission Of Hiv: Findings From A Low-Income Community In Kenya, Susan Kaai, Carolyn Baek, Scott Geibel, Peter Omondi, Benson Ulo, Grace Muthumbi, Carol Nkatha, Naomi Rutenberg

HIV and AIDS

The Horizons program, in partnership with International Medical Corps and Steadman Research Services International, conducted an intervention study in Kibera, an urban slum in Nairobi, Kenya to determine what effect three different community-based activities had on utilization of key prevention of mother-to-child transmission (PMTCT) services. The interventions included moving services closer to the population via mobile clinics, as well as increasing psychosocial support through the use of traditional birth attendants and peer counselors as PMTCT promoters. Data from the study showed that there were positive trends during the study period in most of the PMTCT indicators, including knowledge of MTCT, …

Beacon Of Hope: Evaluation Of The Kenya Girl Guides Association Hiv/Aids Program For School Children, Karusa Kiragu, George Odingo, Milka Juma, Jane Mbugua, Magdalen Waweru, Wamuyu Mahinda, Beatrice Mwaniki, Charity Muturi, Simon Ochieng, Tobey C. Nelson, Ann P. Mccauley

HIV and AIDS

This Horizons report presents findings from an evaluation of the Kenya Girl Guides Participatory Peer Education Program for HIV and AIDS Prevention. The objective of the program was to train Girl Guide patrol leaders as peer educators, who in turn would communicate key information and concepts about such topics as HIV prevention, relationships, and self-esteem to other Girl Guides, and ultimately to their school peers. The results demonstrate that peer education conducted by Girl Guides is a feasible strategy for imparting HIV and AIDS education to school-going youth; however, such a program would need to be branded, strengthened, and appropriately …

Beyond Compensation: Using Torts To Promote Public Health, Elizabeth A. Weeks

Journal of Health Care Law and Policy

No abstract provided.

Medicine And Public Health: Crossing Legal Boundaries, Wendy K. Mariner

Journal of Health Care Law and Policy

No abstract provided.

The Human Papillomavirus Vaccine: Should It Be Mandatory Or Voluntary?, Carrie A. Roll

Journal of Health Care Law and Policy

No abstract provided.

Current Research And Good Practice In Hiv And Aids Treatment Education, Avina Sarna, Ellen Weiss

HIV and AIDS

This report was prepared by UNESCO and WHO for presentation at the HIV and AIDS Treatment Education Technical Consultation in Paris, November 22–23, 2005. There is a growing realization among program managers and donors that merely providing antiretroviral therapy (ART) and training health providers is not sufficient and that unless efforts are made to engage communities and individuals to improve their knowledge and understanding of HIV, AIDS, and ART, programs will not meet the targets set by these initiatives and will fall short of contributing to the goal of attaining universal access to treatment. This report describes current research and …

Key Findings From An Evaluation Of The Mothers2mothers Program In Kwazulu-Natal, South Africa, Carolyn Baek, Vuyiswa Mathambo, Sibongile Mkhize, Irwin Friedman, Louis Apicella, Naomi Rutenberg

HIV and AIDS

The Horizons program of Population Council, in collaboration with Health Systems Trust, completed the first evaluation of mothers2mothers (m2m) as part of its introduction in KwaZulu-Natal Province, South Africa. It is the first external evaluation that provides quantitative evidence about the role of the well-known m2m program in complementing services to prevent mother-to-child transmission of HIV (PMTCT). m2m is a peer support program that aims to provide education and psychosocial support to HIV-positive pregnant women and new mothers, help women access existing health care, and follow up with mothers and babies to ensure they receive appropriate medical care after delivery. …

Our Stories: Women Speak Out Against Hiv And Aids—An Interactive Communication Package For Rural Low-Literate Women, Vijaya Nidadavolu, Moumita Saha, Vijaya Usha Rani

HIV and AIDS

The National AIDS Control Organisation (NACO) estimates that there are over 5.1 million people living with HIV and AIDS in India. Among new infections reported in 2006, 88 percent were reported in the reproductive age group (15–49 years). The virus is spreading rapidly among women, including married and monogamous women, and adolescent girls. Existing literature shows that women's vulnerability is compounded due to their gendered disadvantage in information access, literacy, and decision-making. This disadvantage is particularly acute in the case of married women in rural India. NACO has indicated the need to develop audience-appropriate strategies for communicating HIV-related information. To …

Bullying, Depression, And Suicidality In Adolescents, Anat Brunstein-Klomek, Frank Marrocco, Marjorie Kleinman, Irvin Sam Schonfeld, Madelyn S. Gould

Publications and Research

Objective: To assess the association between bullying behavior and depression, suicidal ideation, and suicide attempts among adolescents. Method: A self-report survey was completed by 9th- through 12th-grade students (n = 2342) in six New York State high schools from 2002 through 2004. Regression analyses were conducted to examine the association between being victimized and bullying others with depression, ideation, and attempts. Results: Approximately 9% of the sample reported being victimized frequently, and 13% reported bullying others frequently. Frequent exposure to victimization or bullying others was related to high risks of depression, ideation, and suicide attempts compared with adolescents not involved …

Poverty And Fertility: Evidence And Agenda, Sajeda Amin, John B. Casterline, Laura Spess

Poverty, Gender, and Youth

This paper explores how poverty affects childbearing patterns in the contemporary developing world. In considering the association between poverty and fertility, we explore one measure of economic status, household asset holdings, in Demographic and Health Surveys conducted in 51 countries since 1990. The results show that the association between poverty and fertility differs according to the measure of fertility considered. We conclude there is much to be gained from distinguishing between the impact of poverty on fertility aspirations and the implementation of those aspirations.

Emergency Contraception, Female Condoms And Iuds In Kenya's Public Sector: Findings From A National Diagnostic Assessment, Jill Keesbury, Benter Owino, Spike Bradford

Reproductive Health

In 2005, the Kenya Ministry of Health, Department of Reproductive Health (DRH), began an initiative to strengthen the provision of emergency contraception (EC) in the public sector. As a first step, 700,000 units of the dedicated EC product Postinor 2 were procured by UNFPA for use in government facilities and select providers were trained on its administration. In 2006, the DRH requested assistance from ECafrique, the African Forum on Emergency Contraception, to expand access to the product. This report documents the results of a diagnostic assessment conducted at the outset of this initiative. It examines the provision and utilization of …

Evaluation Of Berhane Hewan: A Pilot Program To Promote Education And Delay Marriage In Rural Ethiopia, Annabel Erulkar, Eunice N. Muthengi

Poverty, Gender, and Youth

The Berhane Hewan Program pilot-tested in rural Ethiopia from 2004–06 was developed to sensitize community members to the dangers of child marriage, prevent early marriage among unmarried adolescents, and provide support for girls who are already married. The program included social mobilization of girls aged 10–19 into groups led by female mentors; support to stay in school or convening of groups outside of school including nonformal education and livelihoods skills; and community-wide conversations on early marriage and reproductive health issues affecting girls. Economic incentives were provided to families who did not marry off their daughters during the project period. Population-based …

The Experience Of Married Adolescent Girls In Northern Nigeria, Annabel Erulkar, Mairo Bello

Poverty, Gender, and Youth

Programs for young people in sub-Saharan Africa have been directed largely toward unmarried adolescents, neglecting the fact that a large proportion of adolescents—especially girls—are married in some settings. Early marriage is a common feature of girls’ adolescence in Northern Nigeria, yet few programs are in place to support this sizable and vulnerable group. To suggest directions for future programming, Adolescent Health and Information Projects (AHIP) and the Population Council examined the lives of married and unmarried girls in two geopolitical regions of Nigeria, North West and North East. The study, as described in this report, consisted of secondary analysis of …

Teacher Absence As A Factor In Gender Inequalities In Access To Primary Schooling In Rural Pakistan, Sharon Ghuman, Cynthia B. Lloyd

Poverty, Gender, and Youth

This paper examines the case of Pakistan, where primary school enrollment among girls in rural areas is substantially lower than among children in urban areas and boys in rural areas, owing to lack of access to government girls’ schools. The focus is on teacher absence as a further barrier to schooling for girls. Using data from a panel study of primary schooling in rural Punjab and NWFP in 1997 and 2004, the report examines trends in teacher absence, examine the factors correlated with teacher absence in the government and private sector, and assesses the implications of these absence levels for …

Biodosepr-2006 Consensus Committee Report On Biodosimetric Methods To Evaluate Radiation Doses At Long Times After Exposure, Steven L. Simon, Ian Bailiff, André Bouville, Paola Fattibene, Ruth A. Kleinerman, David C. Lloyd, Stephen W.S. Mckeever, Alexander Romanyukha, Alexander V, Sevan’Kaev, James D. Tucker, Albrecht Wieser

Uniformed Services University of the Health Sciences

The requirements for biodosimetric techniques used at long times after exposure, i.e., 6 months to more than 50 years, are unique compared to the requirements for methods used for immediate dose estimation. In addition to the fundamental requirement that the assay measures a physical or biologic change that is proportional to the energy absorbed, the signal must be highly stable over time to enable reasonably precise determinations of the absorbed dose decades later. The primary uses of these biodosimetric methods have been to support long-term health risk (epidemiologic) studies or to support compensation (damage) claims. For these reasons, the methods …