Digital Commons Network^™

Super Learner Analysis Of Electronic Adherence Data Improves Viral Prediction And May Provide Strategies For Selective Hiv Rna Monitoring, Maya L. Petersen, Erin Ledell, Joshua Schwab, Varada Sarovar, Robert Gross, Nancy Reynolds, Jessica E. Haberer, Kathy Goggin, Carol E. Golin, Julia Arnsten, Marc Rosen, Robert H. Remien, David Etoori, Ira B. Wilson, Jane M. Simoni, Judith A. Erlen, Mark J. Van Der Laan, Honghu Liu, David Bangsberg

OHSU-PSU School of Public Health Faculty Publications and Presentations

Objective—Regular HIV RNA testing for all HIV positive patients on antiretroviral therapy (ART) is expensive and has low yield since most tests are undetectable. Selective testing of those at higher risk of failure may improve efficiency. We investigated whether a novel analysis of adherence data could correctly classify virological failure and potentially inform a selective testing strategy.

Design—Multisite prospective cohort consortium.

Methods—We evaluated longitudinal data on 1478 adult patients treated with ART and monitored using the Medication Event Monitoring System (MEMS) in 16 United States cohorts contributing to the MACH14 consortium. Since the relationship between adherence and virological failure is …

Connecticut's Elderly Population: An In-Depth Analysis Of Current And Future Trends In Elder Care, With A Focus On Dementia And Cognitive Decline, Emily J. Snodgrass

Honors Scholar Theses

The aging population in Connecticut currently represents ~15% of the state’s population but is anticipated to rapidly increase over the next 20 years. My thesis is an examination of the types of interventions and programs currently available for elderly persons with memory impairment and cognitive decline, as well as the challenges associated with caring for a larger elderly population. Data collected from interviews with CT healthcare and research professionals representative of the diverse specialties of aging together with an analysis of current research literature are used to demonstrate the importance of continued research and expansion of appropriate and accessible services …

Statement And Action Agenda From The Girls In Emergencies Collaborative, Omar Robles, Judith Bruce, Holly G. Atkinson, Dale Buscher, Karen Scriven, Kristin Kim Bart, Shelby French, Judithe Registre, Audrey Anderson

Publications and Research

Many adolescent girls—the poorest girls in the poorest communities—already live in an “emergency.” Humanitarian crises only amplify the call on their coping and caring capacities, while exacerbating their vulnerabilities. The frequency and intensity of emergencies, including natural disasters, conflicts, and infectious disease outbreaks such as Ebola, appear to be growing. These emergencies threaten entire communities and whole countries, often with global implications. Many become virtually permanent.

Effect Of Sensory Cues On Hand Hygiene Habits Among A Diverse Workforce In Food Service, Robert Pellegrino

Graduate Theses and Dissertations

Poor hand hygiene is a leading cause of foodborne illnesses in the foodservice industry. A series of complex motivational interventions must be employed to permanently change the behavior of workers, to increase their compliance and sustain appropriate levels of proper hand hygiene. Unlike the healthcare industry, which uses large, costly multi-modal behavior modification strategies, the foodservice industry must deploy rapid, cost-efficient strategies that are focus on accommodating these goals with the constraints of high employee turnover rates and diverse demographics. This research was twofold, 1) examining differences in emotions and hand hygiene behavior among participants of two cultures when handling …

The Role Of Social Relationship In Hiv Healing And Its Implications In Hiv Cure In China, Shan Qiao Ph.D., Jing-Bao Nie, Joseph Tucker, Stuart Rennie, Xiao-Ming Li

Faculty Publications

HIV is both a biomedical disease and a social phenomenon that is constructed in particular cultural contexts. A successful and humane HIV cure requires not only the science of eradicating pathogens, but also the art of healing to restore harmony between mind and body. Healing in the context of HIV cure will be both personal and interpersonal, biological and social, and will involve rebuilding connections between HIV patients and their social environment. Social conceptions of healing have been highlighted in many regions with rich non-biomedical healing traditions, including China. Based on an adapted theoretical model on social relationships and health, …

The Girl With The Peanut Necklace: Experiences Of Infertility And In Vitro Fertilization In China, Ruoxi Yu

Student Work

A 2014-2015 William Prize for best essay in East Asian Studies was awarded to Ruoxi Yu (Berkeley College '15) for her essay submitted to the Department of Anthropology, “The Girl with the Peanut Necklace: Experiences of Infertility and in vitro Fertilization in China.” (Marcia Inhorn, William K. Lanman Jr. Professor of Anthropology, advisor; Susan Brownell, Professor of Anthropology at USML, secondary reader.)

Ruoxi Yu’s essay, “The Girl with the Peanut Necklace: Experiences of Infertility and in vitro Fertilization in China,” situates original research within the history of the one-child birth control policy and the tension between the …

Occupational Health Risk Factors For Schistosomiasis: Systematic Review And Analysis, Sarah Grace Sawyer, Amira Roess, Gisela Butera

GW Research Days 2015

Schistosomiasis is a neglected tropical disease caused by a parasitic flatworm which afflicts over 200 million people in the poorest regions of Africa. Carried by snails living in fresh, stagnant water, the parasite penetrates human skin upon contact, causing the victim to suffer a range of symptoms including diarrhea, blood in the urine, and eventual death. Despite its prevalence, schistosomiasis is preventable, treatable, and curable once a control program is implemented. Substantial reduction of schistosomiasis would relieve suffering and produce many socio-economic benefits, including higher productivity and higher school attendance rates. Disease transmission is directly tied to the environment, and …

Perceptions Of School And Health Department Emergency Preparedness Collaboration, Kaitlin A. O'Keefe, Katharine D. Arrington, Michael Prelip, Kimberley I. Shoaf

Frontiers in Public Health Services and Systems Research

Background: School systems often have the vital responsibility of protecting students during emergency situations. Collaborations with the local health department (LHD) can be invaluable in helping schools effectively fulfill this responsibility.

Purpose: An evaluation of existing organizational collaborations is needed to describe attitudes toward current efforts and to form recommendations for enhancing the effectiveness of future joint programs.

Methods: Questionnaires regarding perceptions of existing collaborations were distributed to a sample of LHDs and schools districts in spring and summer 2011. Participant responses from each organization were paired on jurisdictional area, forming 25 paired observations. Analyses were conducted in …

Chronic Physical Health Conditions Among Homeless, Nooshin Nikoo, Marjan Motamed, Mohammad Ali Nikoo, Verena Strehlau, Erika Neilson, Sahoo Saddicha, Michael Krausz

Journal of Health Disparities Research and Practice

ABSTRACT

Objective: Morbidity and mortality among homeless individuals is higher than the general population. This study aims to determine the prevalence of current self-reported, chronic physical health conditions in a large sample of homeless people with sub-samples from shelters and street in British Columbia, Canada. Methods: Cross-sectional survey applying modified version of the ‘National Survey of Homeless Assistance Providers and Clients (NSHAPC)’ questionnaire in multiple sites in Vancouver, Victoria and Prince George, British Columbia, Canada. Sample: Five hundred homeless individuals were surveyed between May and September of 2009. A person was defined as homeless if he/she had a …

Accuracy Of Highly Sexually Active Gay And Bisexual Men’S Predictions Of Their Daily Likelihood Of Anal Sex And Its Relevance For Intermittent Event-Driven Hiv Pre-Exposure Prophylaxis, Jeffrey T. Parsons, H. Jonathon Rendina, Christian Grov, Ana Ventuneac, Brian Mustanski

Publications and Research

Objective: We sought to examine highly sexually active gay and bisexual men’s accuracy in predicting their sexual behavior for the purposes of informing future research on intermittent, event-driven HIV Pre-Exposure Prophylaxis (PrEP).

Design: For 30 days, 92 HIV-negative men completed a daily survey about their sexual behavior (n = 1,688 days of data) and indicated their likelihood of having anal sex with a casual male partner the following day.

Method: We utilized multilevel modeling to analyze the association between self-reported likelihood of and subsequent engagement in anal sex.

Results: We found a linear association between men’s reported likelihood …

Ulaanbaatar’S Ger District Issues: Changes And Attitudes, David Engel

Independent Study Project (ISP) Collection

Several of Ulaanbaatar’s current issues are directly related to Ulaanbaatar’s sprawling Ger District. The Ger District is home to approximately 736,000 residents, 61% of Ulaanbaatar’s population (Galimbyek, 2015). The significant growth in Ulaanbaatar is shown by its 52.8% of residents who were born outside of the city, the majority of migrants moving into the Ger District due to a lack of housing. (Chilkhaasuren & Baasankhuu, 2012). The development of Ulaanbaatar has not kept up with the rapid growth leading to inadequate infrastructure in much of the Ger District. In turn, inadequate infrastructure has lead to high pollution levels, negatively affecting …

Geographic Variation In The Delivery Of Public Health Services: Understanding Causes And Consequences, Glen P. Mays

Health Management and Policy Presentations

The implementation and reach of evidence-based prevention and public health programs varies widely across the U.S., as does the availability of cross-cutting infrastructure and foundational capabilities required to support these interventions. This talk profiles ongoing research to uncover the causes and consequences of variation in public health delivery. This research points to policy and administrative strategies that can reduce inequities and inefficiencies in public health protections.

Whom Do You Trust? Doubt And Conspiracy Theories In The 2009 Influenza Pandemic, Shawn Smallman

International & Global Studies Faculty Publications and Presentations

The 2009 pandemic of H1N1 influenza led people around the globe to create narratives about the epidemic defined by the question of trust; these narratives ranged from true conspiracy theories to simply accounts in which mistrust and betrayal formed a motif. In particular, most of these narratives reflected a fear of capitalism and globalization, although in specific regions, other issues—such as religion—played a more central role. These stories were not unique to the H1N1 pandemic but rather have appeared with every contemporary outbreak of infectious disease. This paper will examine conspiracy theories and moral panics related to the H1N1 pandemic …

Ebola: Working Through Fear, Brenda Fitzgerald

Journal of the Georgia Public Health Association

Ebola: Working Through Fear

Surviving Hiv And Dying For A Smoke: Implications For Tobacco Use Among People Living With Hiv, Rachel Culbreth, Jane Kelly, David Maggio, Pascale M. Wortley, Cherie Drenzek

Journal of the Georgia Public Health Association

Background: Since the advent of highly active antiretroviral therapy in the mid-nineties, deaths among persons living with HIV (PLWH) have declined nationally. Now a controllable condition, HIV has become a chronic disease, highlighting the importance of tobacco cessation in lowering morbidity and premature mortality. Current smoking is approximately twice as high among PLWH compared with the general population. PLWH who smoke experience higher rates of cardiovascular disease, AIDS-defining illnesses, and cancer than PLWH who do not smoke. Loss of life-years associated with smoking among PLWH is greater than life-years lost from HIV.

Methods: Data on current smoking, derived from the …

Immunization Policies For Employees Of Childcare Facilities Within The North Central Health District Of Georgia, Paula Kamara, Brad Lian, Jimmie H. Smith, Judy Mcchargue

Journal of the Georgia Public Health Association

Background: Since the early 1980s, vaccinations have generally been required for children in licensed daycare and school settings. In these settings, vaccinations have reduced disease rates. Adults occupy these settings as well, and ensuring they are vaccinated should also reduce the potential for disease and disease transmission. Yet, there are few vaccination requirements for adults employed at daycare facilities, although such requirements have been recommended (CDC Adult immunization schedule, 2015; ACIP General Recommendations, 2011). The objective of this study was to examine current vaccination policies among childcare facilities within Georgia’s North Central Health District (District 5-2) and the climate for …

Perceptions Of Hiv/Aids Testing Among Urban And Rural African American Church Members, Roblena E. Walker

Journal of the Georgia Public Health Association

Background: The prevalence of the human immunodeficiency virus (HIV) continues to affect African Americans (AA) disproportionately. The purpose of this mixed methods study, guided by the health belief model, was to examine associations linking church and ambient social environment with knowledge and perceptions of HIV/AIDS testing amongst urban and rural AA church members.

Methods: Multiple regressions and t tests were used to compare perceptions of HIV/AIDS testing and knowledge of HIV/AIDS among 236 participants selected from two AA churches located in a large city (n = 122) and in a rural town (n =114) in the Southern U.S.

Results: The …

Envh 7232a - Water Quality, Asli Aslan

College of Public Health: Faculty Syllabi (2014-2021)

This course is designed for graduate students and it will provide students with an introduction and overview of the key areas of water quality and health. Students will gain an understanding of the physical, chemical and biological principles of water quality, the potential impact on health of water pollution, and local, national and international environmental policies pertinent to water issues along with current treatment and remediation strategies to ameliorate pollution. The major topics include introduction to water quality and health; physical and chemical agents in water, emerging infectious diseases related to water quality, drinking and recreational water quality criteria, drinking …

Pubh 7090 A - Selected Topics In Public Health: Advanced Infectious Disease Epidemiology, Isaac Chun-Hai Fung

College of Public Health: Faculty Syllabi (2014-2021)

This course covers the use of mathematical and computational approaches to study infectious diseases. We will discuss models that address both the dynamics of infectious disease spread through populations and the dynamics of pathogens inside an infected individual. Students will learn how to build and analyze models for a variety of human and animal diseases. We will look at the impact of interventions on disease outcomes. Students will learn how to interpret results of modeling studies to make informed public health policy decisions.

Pubh 6532 - Environmental Health (Online), Atin Adhikari

College of Public Health: Faculty Syllabi (2014-2021)

Survey of specific environmental conditions and factors that contribute to the development of health problems in communities. Health effects, policy issues, intervention strategies and control programs for community environmental health protection are discussed.

Epid 7233 - Public Health Surveillance Methods, Jian Zhang

College of Public Health: Faculty Syllabi (2014-2021)

This course will provide students with a strong foundation in public health surveillance of both health conditions and risk factors. The course will teach the theory and practice of surveillance supported by many examples of surveillance systems from the developed and developing world. The class will build on and reinforce basic epidemiologic concepts. Students will be given the opportunity to design and evaluate a surveillance system.

Pubh 6532 - Environmental Health, Evans Afriyie-Gyawu

College of Public Health: Faculty Syllabi (2014-2021)

Survey of specific environmental conditions and factors that contribute to the development of health problems in communities. Health effects, policy issues, intervention strategies and control programs for community environmental health protection are discussed.

The Care Continuum For People Living With Hiv In Georgia: How Can We Raise The Bar?, Jane Kelly, Deepali Rane, C. Drenzek

Journal of the Georgia Public Health Association

Background: Viral suppression (VS) improves quality of life and longevity for people living with HIV (PLWH) and reduces viral transmission, but is achieved by only a minority of PLWH in Georgia.

Methods: By use of the Georgia HIV/AIDS surveillance database, the HIV Care Continuum was stratified by age.

Results: Retention in care and VS generally increased with increasing age, with the exception of adolescents (aged 13-18 years), who had the highest retention and VS. Differences by sex, race and transmission category persisted across age groups. Among persons retained in care, the proportion achieving VS also generally increased with age. Linkage …

Factors Driving Local Health Department’S Collaboration With Other Organizations In The Provision Of Personal Healthcare Services, Huabin Luo, Nancy L. Winterbauer, Ashley Tucker, Gulzar H. Shah

Health Policy & Management: Faculty Presentations (2008-2022)

Background: Recent work has highlighted the necessity of integrating primary care services and public health to improve quality and reduce the cost of healthcare.

Research Objectives: To describe levels of partnership between local health departments (LHD) and other organizations in the community in the provision of personal healthcare services; and to assess LHD organizational characteristics and community factors that contribute to partnerships.

Data Sets and Sources: Data were drawn from the 2013 NACCHO Profile Study (Module 1) and the Area Health Resource File. A total of 490 LHDs responded to Module 1, where LHDs were asked to describe the level …

Investigating Barriers To Early Cancer Detection For Rural Indian Women: A Qualitative Analysis Of Cancer Outreach In Dehradun, Uttarakhand, Blair Burnett

Independent Study Project (ISP) Collection

This study examines barriers to early detection for women’s specific cancers in rural India in and around Dehradun, Uttarakhand, within the framework of existing health outreach programs from tertiary hospitals in the state. The burden of cancer mortality within India is disproportionately affecting women living in rural populations considering the current health education and health care infrastructure in place. Barriers of knowledge, access to knowledge, economic condition, geography, and cultural norms are all examined within this study in the context of early cancer detection. National Indian health policy is currently framed to address the burden of cancer within India; however, …

Confronting Cultural Challenges For Migrant Healthcare In Switzerland, Rebecca Weiss

Independent Study Project (ISP) Collection

Switzerland is home to many migrants, and migration exacerbates health risks. In addition to physical health problems, migrants are more likely than Swiss nationals to face mental health challenges and cultural barriers, which complicate their experiences seeking healthcare. Similarly, clinicians encounter numerous challenges related to the special circumstances of migrant patients. As a response to the specific health needs of migrants, hospital networks and migrant support organizations promote the migrant health situation. However, these services are not ubiquitous in Switzerland, partly due to the partial freedoms of each canton to create its own health policy. This paper explores the barriers …

Fighting The Obesity Epidemic: Challenges And Ethics, Grace Brown

Independent Study Project (ISP) Collection

In recent decades, a double burden of disease has emerged that requires public health workers to fight both hunger and obesity. The obesity epidemic is unlike other epidemics in that it is largely man-made and dependent on social factors and industry influences, making it difficult to fight. The high global prevalence of obesity is partially a result of globalization, which has encouraged development and the liberalizing of economies all around the world, which in turn has increased the marketing and consumption of obesogenic products. Policy solutions have been proposed and implemented in some countries, but an international solution has yet …

Babies First: Ensuring Proper Infant Nutrition During Emergencies, Abigail M. Alonso

Independent Study Project (ISP) Collection

Background: Breastfeeding is the best source of nutrition for an infant, living in all regions and cultures. Recommendations apply across the board, from developed nations to refugee camps, from women with HIV to those with time constraints regarding feeding. There also exists a complex relationship between corporations that provide BMS and the NGOs working to promote breastfeeding in emergency situations amongst vulnerable populations.

Objective: The objective of this paper is to expose breastfeeding promotion, using the Dadaab camps in Northeastern Kenya as a case study of IYCF programs and support of breastfeeding among low-literacy populations with an emphasis on women …

Melding Data Collection Methodology With Community Assistance: Benefits To Both Researchers And The Indigenous Groups They Study, Douglas S. London

Journal of Ecological Anthropology

I present a description of a model of melding data collection with community aid in the form of health educator training that emerged in the process of research collaboration during 2009-2011 with the Kawymeno Waorani foragers of Amazonian Ecuador. Some guidelines are suggested as to how benefits to both parties might be achieved when collecting data with indigenous populations. In this article I describe some of the advantages and pitfalls of melding data collection and community aid with research when collaborating with vulnerable indigenous groups.

Informal Child Care And Adolescent Psychological Well-Being: Hong Kong’S “Children Of 1997” Birth Cohort, Cherry Y. Leung, Gabriel M. Leung, Mary Schooling

Publications and Research

Background
Informal child care (child care by untrained family members, relatives or employees in the home) in Western populations is often associated with poorer psychological well-being, which may be confounded by socioeconomic position. We examined the association of informal child care, common in non-Western settings, with adolescent psychological wellbeing, using Hong Kong’s Chinese “Children of 1997” birth cohort.

Methods
Multivariable linear regression was used to examine the adjusted associations of informal child care (at 0.5, 3, 5 and 11 years) with parent-reported Rutter score for child behavior at 11 years, self-reported Culture-Free Self-Esteem Inventories score at 11 years and selfreported …