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Cost - Minimization Analysis Of Treprostinil Vs. Epoprostenol As An Alternate To Oral Therapy: Non - Responders For The Treatment Of Pulmonary Arterial Hypertension, Lutchmie Narine, L. Hague, J. Walker, C. Vicente

Public Health, Food Studies, and Nutrition

Idiopathic pulmonary arterial hypertension (IPAH) is associated with substantial morbidity and mortality. Treprostinil was compared to epoprostenol for the economic impact of treating IPAH patients who failed or were not candidates for bosentan. METHODS: The model was a cost-minimization analysis, assuming clinical equivalence was achieved by proper dosing of both drugs, in terms of survival and surrogate measures. Two theoretical cohorts of 270 patients were treated with subcutaneous treprostinil and intravenous epoprostenol, and were evaluated over 3 years using a spreadsheet model. Annual survival rates were estimated for the cohorts so that at endpoint 114 (42%) patients survived in both …

Genome Size And Organization In The Blacklegged Tick, Ixodes Scapularis And The Southern Cattle Tick, Boophilus Microplus, A. J. Ullmann, C. M. R. Lima, F. D. Guerrero, J. Piesman, W. C. Black Iv

United States Public Health Resources

Genome sizes and the organization of repetitive DNA were determined in the hard ticks Ixodes scapularis and Boophilus microplus using reassociation kinetics. The I. scapularis genome contains ~ 2.15 pg (2.1 × 10 ³ Mbp) of DNA and consists of no foldback (FB), 27% highly repetitive (HR), 39% moderately repetitive (MR), and 34% unique DNA. The B. microplus genome contains 7.5 pg (7.1 × 10 ³ Mbp) DNA, and consists of 0.82% FB, 31% HR, 38% MR, and 30% unique DNA. In both species, repetitive sequences occur in a mixture of long and short period interspersion but most (65–80%) of …

Evolutionary Genetics Of A New Pathogenic Escherichia Species: Escherichia Albertii And Related Shigella Boydii Strains, Katie E. Hyma, David W. Lacher, Adam M. Nelson, Alyssa C. Bumbaugh, J. Michael Janda, Nancy A. Strockbine, Vincent B. Young, Thomas S. Whittam

United States Public Health Resources

A bacterium originally described as Hafnia alvei induces diarrhea in rabbits and causes epithelial damage similar to the attachment and effacement associated with enteropathogenic Escherichia coli. Subsequent studies identified similar H. alvei-like strains that are positive for an intimin gene (eae) probe and, based on DNA relatedness, are classified as a distinct Escherichia species, Escherichia albertii. We determined sequences for multiple housekeeping genes in five E. albertii strains and compared these sequences to those of strains representing the major groups of pathogenic E. coli and Shigella. A comparison of 2,484 codon positions in 14 …

Non-O157 Shiga Toxin–Producing Escherichia Coli Infections In The United States, 1983–2002, John T. Brooks, Evangeline G. Sowers, Joy G. Wells, Katherine D. Greene Greene, Patricia M. Griffin, Robert M. Hoekstra, Nancy A. Strockbine

United States Public Health Resources

Background. Shiga toxin–producing Escherichia coli (STEC) O157:H7 is a well-recognized cause of bloody diarrhea and hemolytic-uremic syndrome (HUS). Non-O157 STEC contribute to this burden of illness but have been underrecognized as a result of diagnostic limitations and inadequate surveillance.

Methods. Between 1983 and 2002, 43 state public health laboratories submitted 940 human non-O157 STEC isolates from persons with sporadic illnesses to the Centers for Diseases Control and Prevention reference laboratory for confirmation and serotyping.

Results. The most common serogroups were O26 (22%), O111 (16%), O103 (12%), O121 (8%), O45 (7%), and O145 (5%). Non-O157 STEC infections were …

Identification And Characterization Of Shigella Boydii 20 Serovar Nov., A New And Emerging Shigella Serotype, David L. Woodward, Clifford G. Clark, Richard A. Caldeira, Rafiq Ahmed, Geoff Soule, Louis Bryden, Helen Tabor, Pasquale Melito, Roger Foster, Julie Walsh, Lai-King Ng, Georgia B. Malcolm, Nancy Strockbine, Frank G. Rodgers

United States Public Health Resources

Analysis of 163 putative Shigella isolates from Canada and the USA showed biochemical reactions consistent with Shigella species, although none of the isolates reacted with antiserum raised against any of the well-established or provisional Shigella serotypes. All these isolates, provisionally designated serotype SH108, were positive for the ipaH gene and the invasion-associated locus. All fermented mannitol, were serologically indistinguishable from each other and showed no reaction in antisera prepared against Escherichia coli serotypes O1 to O181. PCR-RFLP analysis of the genes involved in O-antigen synthesis revealed a common pattern among these isolates that was distinct from recognized Shigella serotypes and …

Evaluating Current Policy For Detecting Mosaicism In Amniotic Fluid Cultures: Implications For Current Cell Counting Practices, Samuel P. Caudill, Daniel L. Van Dyke, Andrew T. L. Chen, John A. Reidy, Paul S. Ing, Stuart Schwartz, Gail H. Vance

United States Public Health Resources

Chromosomal mosaicism is one of the most vexing problems for clinical cytogenetic laboratories and personnel time used for analysis at the microscope is one of the principle costs in cytogenetic laboratories. We use data collected from 26 cytogenetic laboratories to evaluate whether the American College of Medical Genetics guidelines for minimum number of cells to count to exclude mosaicism in amniotic fluid specimens is appropriate. An accurate estimate of the number of mosaics that are missed by current cell counting practices is an important step in this process. Thus, we present a new method for estimating the number of mosaics …

Molecular Cloning And Characterization Of A Porcine Ul16 Binding Protein (Ulbp)-Like Cdna, Carmen N. Garcia-Borges, Bounleut Phanavanh, Sarika Saraswati, Richard A. Dennis, Mark D. Crew

United States Public Health Resources

UL16 binding proteins (ULBPs) are ligands for the NK cell activating receptor NKG2D. A cDNA encoding a porcine ULBP-like protein (PULBP) was cloned and the predicted amino acid sequence exhibited 35–52% identity to human ULBPs. Southern blot analysis suggested that there is only one ULBP-like gene in the pig genome. Transcripts of PULBP and another potential NKG2D ligand, MIC2, were detected by RT-PCR in a wide range of tissues. Recombinant PULBP-Fc and human ULBP2-Fc fusion proteins were made and used to examine PULBP binding to porcine PBMCs and a human NK cell line (NKL cells). PULBP-Fc bound to a subpopulation …

Phylogenetic Analysis Of North American West Nile Virus Isolates, 2001–2004: Evidence For The Emergence Of A Dominant Genotype, C. Todd Davis, Gregory D. Ebel, Robert S. Lanciotti, Aaron C. Brault, Hilda Guzman, Marina Siirin, Amy Lambert, Ray E. Parsons, David W.C. Beasley, Robert J. Novak, Darwin Elizondo-Quiroga, Emily N. Green, David S. Young, Lillian M. Stark, Michael A. Drebot, Harvey Artsob, Robert B. Tesh, Laura D. Kramer, Alan D.T. Barrett

United States Public Health Resources

The distribution of West Nile virus has expanded in the past 6 years to include the 48 contiguous United States and seven Canadian provinces, as well as Mexico, the Caribbean islands, and Colombia. The suggestion of the emergence of a dominant genetic variant has led to an intensive analysis of isolates made across North America. We have sequenced the premembrane and envelope genes of 74 isolates and the complete genomes of 25 isolates in order to determine if a dominant genotype has arisen and to better understand how the virus has evolved as its distribution has expanded. Phylogenetic analyses revealed …

Agricultural Pesticide Use And Risk Of Glioma In Nebraska, United States, W. J. Lee, J. S. Colt, E. F. Heineman, R. Mccomb, D. D. Weisenburger, W. Lijinsky, M. H. Ward

United States Public Health Resources

Background: To evaluate the risk of the adult glioma associated with farming and agricultural pesticide use, the authors conducted a population based case control study in eastern Nebraska.
Methods: Telephone interviews were conducted with men and women diagnosed with gliomas (n = 251) between 1988 and 1993 and controls (n = 498) randomly selected from the same geographical area. Unconditional logistic regression was used to calculate adjusted odds ratios (ORs) for farming and for use of individual and chemical classes of insecticides and herbicides, including pesticides classified as nitrosatable (able to form N-nitroso compounds upon reaction with nitrite). Non-farmers were …

Role Of Elevated S-Adenosylhomocysteine In Rat Hepatocyte Apoptosis: Protection By Betaine, Kusum K. Kharbanda, David D. Rogers Ii, Mark E. Mailliard, Gerri L. Siford, Anthony J. Barak, Harriet C. Beckenhauer, Michael F. Sorrell, Dean J. Tuma

United States Public Health Resources

Previous studies from our laboratory have shown that ethanol consumption results in an increase in hepatocellular S-adenosylhomocysteine levels. Because S-adenosylhomocysteine is a potent inhibitor of methylation reactions, we propose that increased intracellular S-adenosylhomocysteine levels could be a major contributor to ethanol-induced pathologies. To test this hypothesis, hepatocytes isolated from rat livers were grown on collagen-coated plates in Williams’ medium E containing 5% FCS and exposed to varying concentrations of adenosine in order to increase intracellular S-adenosylhomocysteine levels. We observed increases in caspase-3 activity following exposure to adenosine. This increase in caspase activity correlated with increases in intracellular S-adenosylhomocysteine levels and …

Measurements Of Constraint Of Total Knee Replacement, H. Haider, P.S. Walker

United States Public Health Resources

Measurement of the constraint of total knee components in a test machine provides an objective method of describing the laxity and stability characteristics of the implant itself, independent of the knee joint into which it would be implanted. A special fixture was designed and fitted to a Bionix multi-channel loading machine. The test consisted of applying a compressive load, applying a cyclic AP force or internal-external torque, and measuring all of the displacements and rotations. Three different commonly-used TKR’s showed widely different constraint characteristics. In the cyclic AP test, along with the cyclic AP displacement, displacements and rotations occurred in …

Effect Of Cirrhosis On Antibiotic Efficacy In A Rat Model Of Pneumococcal Pneumonia, Laurel C. Preheim, Keith M. Olsen, Mei Yue, Mary U. Snitily, Martha J. Gentry-Nielsen

United States Public Health Resources

A rat model was used to study the effects of cirrhosis on antibiotic therapy of pneumococcal pneumonia. Cirrhotic and control male Sprague-Dawley rats were infected transtracheally with type 3 Streptococcus pneumonia. Treatment began 18 h later with phosphate-buffered saline (PBS), azithromycin (50 mg/kg), trovafloxacin (50 mg/kg), or ceftriaxone (100 mg/kg) injected subcutaneously twice daily for 5 days. Antibiotic concentrations were measured by high-performance liquid chromatography. Azithromycin, trovafloxacin, and ceftriaxone were all equally effective at preventing mortality in both cirrhotic and normal rats. Free fraction area under the curve to minimum inhibitory concentration ratio (AUC/MIC) and maximum calculated serum concentration …

Rat Sinusoidal Liver Endothelial Cells (Secs) Produce Pro-Fibrotic Factors In Response To Adducts Formed From The Metabolites Of Ethanol, Geoffrey M. Thiele, Michael J. Duryee, Thomas L. Freeman, Michael F. Sorrell, Monte S. Willis, Dean J. Tuma, Lynell W. Klassen

United States Public Health Resources

Previous studies with alcohol-associated malondialdehyde–acetaldehyde (MAA)-modified proteins have demonstrated an increase in the expression of adhesion molecules, and the secretion of pro-inflammatory cytokines/chemokines by rat sinusoidal liver endothelial cells (SECs). However, no studies have been initiated to examine the effects of MAA-modified proteins on the expression of the extracellular matrix (ECM) protein, fibronectin and its isoforms. For these studies, SECs were isolated from the liver of normal rats, and exposed to MAA-modified bovine serum albumin (MAA–Alb). At selected time points, the total plasma and cellular fibronectin were determined by Western blot. Injection of rat liver via the mesenteric vein with …

The Un And The Responsibility To Practice Public Health, David P. Fidler

Articles by Maurer Faculty

No abstract provided.

From International Sanitary Conventions To Global Health Security: The New International Health Regulations, David P. Fidler

Articles by Maurer Faculty

In May 2005, the World Health Organization adopted the new International Health Regulations (IHR), which constitute one of the most radical and far-reaching changes to international law on public health since the beginning of international health cooperation in the mid-nineteenth century. This article comprehensively analyses the new IHR by examining the history of international law on infectious disease control, the IHR revision process, the substantive changes contained in the new IHR and concerns regarding the future of the new IHR. The article demonstrates why the new IHR constitute a seminal event in the relationship between international law and public health …

Reducing The Transmission Of Hiv And Sexually Transmitted Infections In A Mining Community: Findings From The Carletonville Mothusimpilo Intervention Project: 1998 To 2001, Lewis Ndhlovu, Catherine Searle, Johannes Van Dam, Yodwa Mzaidume, Bareng Rasego, Solly Moema

HIV and AIDS

The Horizons program, in collaboration with the Center for Scientific and Industrial Research, the South African Institute for Medical Research, and the London School of Economics, conducted an intervention study in the mining town of Carletonville, South Africa to examine the social determinants of the HIV epidemic, and to assess the impact of a targeted program of HIV and STI prevention and service delivery. The project did not reduce STI prevalence or HIV prevalence, as changing sexual behavior is far more complex than educating individuals about HIV. The report recommends interventions to support behavioral change education, STI treatment, the role …

Graduate Public Health Education In Africa: An Innovative Distance-Learning Model, Emmanuel Rudatsikira, Patricia Johnston, Richard Hart

International Journal of Global Health and Health Disparities

This article describes the development and implementation of a distance graduate public health education program in Africa by Loma Linda University, Loma Linda, California, U.S.A. The program started in March 2000 and ended in September 2003 with formal teaching sessions on-site held twice a year at the University of Eastern Africa, Kenya. The instruction was given in English and French. Of the cohort of 67 students from 20 African countries who started the program, 57 received an M.P.H. degree and six received a certificate in public health. The experiential learning model allowed students to immediately put into practice what they …

Latinas And Breast Cancer In The Midwest: Factors Influencing Survivorship, M. Elise Radina, Daniel R. Longo, Jane M. Armer

International Journal of Global Health and Health Disparities

Latinos are the largest ethnic minority group in the U.S. and the Midwest is experiencing the fastest growth in residents of Hispanic descent. Rural health care delivery systems in these areas must therefore respond to changing demographics and provide culturally appropriate service delivery. The incidence rate of breast cancer among Latinas is lower than that among non-Hispanic women; however an increasing number of Latinas are being diagnosed with breast cancer. Despite higher mortality rates from cancer than non-Hispanic women, more Latinas are being treated for breast cancer and are now facing their own unique survivorship experiences This paper addresses factors …

The Role Of The Insecticide Ddt In Breast Cancer, Jared D. Taylor

International Journal of Global Health and Health Disparities

Breast cancer is by far the most common cancer among black and white females, with approximately 211,000 new cases expected to be diagnosed in the U.S. in 2004 (1). More importantly, incidence has been increasing. Age-adjusted breast cancer incidence in U.S. females rose from the 88.6 per 100,000 in the early 1970s to 109.8 in the early 1990s (2). This represents a 24 percent increase over that time. This trend is only partially explained by the known risk factors for breast cancer, including advancing age, early menarche, late menopause, late age at first parturition and family history. Therefore, researchers have …

Information For Authors

International Journal of Global Health and Health Disparities

No abstract provided.

Programming For Hiv Prevention In South African Schools: A Report On Program Implementation, Priscilla Reddy, Shegs James, Ann P. Mccauley

HIV and AIDS

An evaluation study conducted in KwaZulu Natal, South Africa, provides important insights into whether learners who participated in a fact-based, interactive course had more knowledge about HIV risks, prevention, and care practices; more positive attitudes toward prevention practices and people living with HIV and AIDS; and a higher prevalence of reported safe behaviors than comparable learners who did not participate in the course. Results show that the Life Skills Grade 9 Curriculum had a positive impact of students’ knowledge of HIV/AIDS, attitudes about abstinence, and intention to use condoms. There was, however, no evidence of increased adoption of such protective …

Mfit Weight Management Program: Effects On Anthropometric And Cardiovascular Measures, Lindsay L. Boik

Senior Honors Theses and Projects

Objective: Traditional approaches to address obesity typically entail severe caloric restriction and drastic alterations in activity pattern. The MFit Weight Management Program, a derivative of the University of Michigan Health System, takes a different approach to weight loss. The goal of the program is to stress the development of longterm lifestyle changes and it places less emphasis on rapid weight loss. It was the purpose of this study to determine whether the MFit Weight Management Program, a behavioral modification program, is successful for decreasing anthropometric and cardiovascular measurements of obesity. Research Methods and Procedures: This is an ongoing study with …

Saddle Height Positioning For Triathletes Ssing Road Cyclist Methods, Edith Ann Sherman

Master's Theses and Doctoral Dissertations

Triathlon is the combined sport of swimming, cycling, and running. Cycling is normally the longest portion of the race. Therefore, maintenance of comfort and efficiency while maintaining high power output is essential for success in the cycling portion. Several methods are currently used for determination of height for road cyclists. It has yet to be determined if these methods are applicable to triathletes. Because of the different geometry of a triathlon bicycle, the question remains whether road-saddle fitting techniques can be an applied and work for the triathlon bicycle.

This thesis evaluated the participant’s current saddle height in addition to …

Female Genital Cutting Among The Somali Of Kenya And Management Of Its Complications, Guyo W. Jaldesa, Ian Askew, Carolyne Njue, Monica Wanjiru

Reproductive Health

The Somali community living in Kenya (and in their native Somalia) has practiced the severest form of female genital cutting (FGC)—infibulation—for centuries. To understand the context within which the practice takes place, and how its complications are managed, the Population Council’s Frontiers in Reproductive Health Program undertook a diagnostic study that confirmed that FGC is a deeply rooted and widely supported cultural practice. Several closely related reasons are used to sustain the practice: religious obligation, family honor, and virginity as a prerequisite for marriage; an aesthetic preference for infibulated genitalia was also mentioned. The study also found that the health …

Technical Assistance And Training For Procosi Operations Research Program, Bolivia, Fernando Gonzales Salguero, Ricardo Vernon

Reproductive Health

In September 1999, PROCOSI, a Bolivian network of 24 nongovernmental organizations that provide health services, invited the Population Council Frontiers in Reproductive Health (FRONTIERS) program to provide technical assistance for designing and conducting operations research aimed at increasing the quality and impact of their reproductive health programs. In collaboration with PROCOSI, FRONTIERS conducted four training workshops on design of operations research projects, qualitative research methods, utilization and dissemination of research results, and preparing research reports. Technical assistance on other topics, such as developing research instruments, creating databases, and using EpiInfo for transcribing and analyzing data was provided on-site to each …

Enquêtes D'Acceptation De Paiment Destinées À Déterminer Les Prix Des Produits Et Services Dans Le Domaine De La Santé De La Reproduction : Manuel De L'Utilisateur, Karen G. Fleischman Foreit, James R. Foreit

Reproductive Health

Les enquêtes d’acceptation de paiement (willingness to pay—WTP) permettent aux directeurs de programmes de simuler les changements intervenant dans la demande en raison des prix sans les modifier réellement, ce qui leur donne un moyen de prendre des décisions relatives à la détermination des prix sur la base d’informations empiriques. Le présent document décrit une méthode d’enquête simple qui donne une estimation de l’acceptation de paiement par les clients pour les biens et services, ce qui permet aux directeurs de prendre des décisions rationnelles dans ce domaine. Il présente les avantages et les précautions à prendre lors d’une enquête WTP. …

Cancer Information Seeking Preferences Among Health Professionals Serving American Indians In Minnesota, North Dakota, And Wisconsin, K. Knutsen, R. Strickland, J. Matloub, P. Remington, J. Kaur

Native Health Database Full Text

This article identifies cancer information resources used by health professionals in tribal health departments or Indian Health Service clinics serving American Indian communities in Wisconsin, Minnesota and North Dakota.

Monstrous Impersonation: A Critique Of Consent-Based Justifications For Hard Paternalism, Thaddeus Mason Pope

Faculty Scholarship

Restricting a person's substantially voluntary, self-regarding conduct primarily for the sake of that person is hard paternalism. Particularly in the public health context, scholars, legislators, and judges are devoting increasing attention to discussing the conditions and circumstances under which hard paternalism is justified. One popular type of argument for the justifiability of hard paternalism takes its normative warrant from the consent of the restricted person.

In this Article, I argue that scholars and policymakers should abandon consent-based arguments for the justifiability of hard paternalism. Such arguments are torn between incoherence and lacking moral force. Very few consent-based arguments successfully resolve …

Is Public Health Paternalism Really Never Justified? A Response To Joel Feinberg, Thaddeus Mason Pope

Faculty Scholarship

n the preeminent scholarly legal treatise on paternalism, The Moral Limits of the Criminal Law: Harm to Self, Joel Feinberg argues that hard paternalism is never justified because it is superfluous; all reasonable restriction of self-regarding conduct can be justified on (more palatable) soft paternalistic grounds.

In this article, I argue that Feinberg's strategy seems to work only because he "stretches" soft paternalism to justify liberty limitation that is properly described as hard paternalism. I expose Feinberg's strained appeals, and argue for honesty and transparency regarding the bases for paternalistic liberty limitation. If the rationale for public health restrictions on …

A Pilot Randomized, Controlled Trial Of An In-Home Drinking Water Intervention Among Hiv + Persons, John M. Colford, Sona R. Saha, Timothy J. Wade, Catherine C. Wright, Mai Vu, Sandra Charles, Peter Jensen, Alan Hubbard, Deborah A. Levy, Joseph N. S. Eisenberg

Journal Articles: Epidemiology

Although immunocompromised persons may be at increased risk for gastrointestinal illnesses, no trials investigating drinking water treatment and gastrointestinal illness in such patients have been published. Earlier results from San Francisco suggested an association (OR 6.76) between tap water and cryptosporidiosis among HIV + persons. The authors conducted a randomized, triple-blinded intervention trial of home water treatment in San Francisco, California, from April 2000 to May 2001. Fifty HIV-positive patients were randomized to externally identical active (N = 24) or sham (N = 26) treatment devices. The active device contained a filter and UV light; the sham provided no treatment. …