Digital Commons Network^™

A Case Control Study Of Environmental And Occupational Exposures Associated With Methicillin Resistant Staphylococcus Aureus Nasal Carriage In Patients Admitted To A Rural Tertiary Care Hospital In A High Density Swine Region, Leah Schinasi, Steve Wing, Kerri L. Augustino, Keith M. Ramsey, Delores L. Nobles, David B. Richardson, Lance B. Price, Maliha Aziz, Pia Macdonald, Jill R. Stewart

Environmental and Occupational Health Faculty Publications

Background

Distinct strains of methicillin resistant Staphylococcus aureus (MRSA) have been identified on livestock and livestock workers. Industrial food animal production may be an important environmental reservoir for human carriage of these pathogenic bacteria. The objective of this study was to investigate environmental and occupational exposures associated with nasal carriage of MRSA in patients hospitalized at Vidant Medical Center, a tertiary hospital serving a region with intensive livestock production in eastern North Carolina.

Methods

MRSA nasal carriage was identified via nasal swabs collected within 24 hours of hospital admission. MRSA carriers (cases) were gender and age matched to non-carriers (controls). …

Distribution Of Human Papillomavirus Genotypes Among Hiv-Positive And Hiv-Negative Women In Cape Town, South Africa, A. C. Mcdonald, A. I. Tergas, L. Kuhn, L. Denny, T. C. Wright Jr.

Journal Articles

OBJECTIVE: HIV-positive women are known to be at high-risk of human papillomavirus (HPV) infection and its associated cervical pathology. Here, we describe the prevalence and distribution of HPV genotypes among HIV-positive and -negative women in South Africa, with and without cervical intraepithelial neoplasia (CIN). METHODS: We report data on 1,371 HIV-positive women and 8,050 HIV-negative women, aged 17-65 years, recruited into three sequential studies in Cape Town, South Africa, conducted among women who had no history of cervical cancer screening recruited from the general population. All women were tested for HIV. Cervical samples were tested for high-risk HPV DNA (Hybrid …

Incidence Of Extended-Spectrum-Beta-Lactamase-Producing Escherichia Coli And Klebsiella Pneumoniae Isolates That Test Susceptible To Cephalosporins And Aztreonam By The Revised Clsi Breakpoints, C. S. Mcwilliams, S. Condon, R. M. Schwartz, C. C. Ginocchio

Journal Articles

The incidence of aztreonam and cephalosporin susceptibility, determined using the revised CLSI breakpoints, for extendedspectrum-beta-lactamase (ESBL)-producing Escherichia coli and Klebsiella pneumoniae isolates was evaluated. Our analysis showed that results for aztreonam and/or> 1 cephalosporin were reported as susceptible or intermediate for 89.2% of ESBLproducing E coli isolates (569/638 isolates) and 67.7% of ESBL-producing K. pneumoniae isolates (155/229 isolates).

Do Hiv-Positive Women Receive Depression Treatment That Meets Best Practice Guidelines?, J. A. Cook, J. K. Burke-Miller, D. D. Grey, J. Cocohoba, C. L. Liu, R. M. Schwartz, E. T. Golub, K. Anastos, P. J. Steigman, M. H. Cohen

Journal Articles

This study addressed whether psychopharmacologic and psychotherapeutic treatment of depressed HIV+ women met standards defined in the best practice literature, and tested hypothesized predictors of standard-concordant care. 1,352 HIV-positive women in the multi-center Women's Interagency HIV Study were queried about depressive symptoms and mental health service utilization using standards published by the American Psychiatric Association and the Agency for Healthcare Research and Quality to define adequate depression treatment. We identified those who: (1) reported clinically significant depressive symptoms (CSDS) using Centers for Epidemiological Studies-Depression Scale scores of a parts per thousand yen16; or (2) had lifetime diagnoses of major depressive …

Psychosocial Correlates Of Gender-Based Violence Among Hiv-Infected And Hiv-Uninfected Women In Three Us Cities, R. M. Schwartz, K. M. Weber, G. E. Schechter, N. C. Connors, Y. Gousse, M. A. Young, M. H. Cohen

Journal Articles

Gender-based violence (GBV) is common among women with and at risk for HIV, yet little is known about the GBV associated psychological factors that could be modifiable through behavioral interventions. The current study examined the associations between some of these psychological factors (i.e., hopelessness, consideration of future consequences, self esteem), mental health symptoms, substance abuse, and GBV among a sample of 736 HIV-infected and sociodemographically similar uninfected participants in the Women's Interagency HIV Study (WIHS). Results indicated high rates of lifetime GBV among the sample (58%), as well as high rates of childhood sexual abuse (CSA) (22.2%). HIV-infected women were …

High-Risk Cervical Human Papillomavirus Infections Among Human Immunodeficiency Virus-Positive Women In The Bahamas, D. N. Dames, E. Blackman, R. Butler, E. Taioli, S. Eckstein, K. Devarajan, A. Griffith-Bowe, P. Gomez, C. Ragin

Journal Articles

BACKGROUND: High-risk (HR) HPV genotypes other than 16 and 18 have been detected in a significant proportion of immunocompromised females. We aim to evaluate the frequency of HR HPV genotypes in a population of HIV-positive Caribbean women. METHODS: One hundred sixty-seven consecutive, non-pregnant, HIV-positive females >/=18 years were recruited in this study. Each participant received a vaginal examination, PAP smear, and completed a questionnaire. DNA was extracted for HPV testing in 86 patients. RESULTS: Mean age was 39.1 years for women positive for HR HPV and 43.1 years for women negative for HR HPV (P value = 0.040). 78% (130/167) …

Baseline Survey Of Nigerian Media Coverage Of Youth Sexual And Reproductive Health And Hiv And Aids Related Issues, January 1st–December 31st, 2012, Population Council

HIV and AIDS

To promote more informed public dialogue on youth vulnerabilities, responses to HIV/AIDS, and positive changes in relevant policies and programs via learning and advocacy interventions at the state and national levels in Nigeria, the Population Council commissioned a study of the print and electronic media’s coverage of HIV/AIDS and sexual and reproductive health–related issues among youth aged 15–24 years in Nigeria for the period January 1 to December 31, 2012. The study entailed a content analysis of four national and two regional newspapers, and an online forum that is one of the most frequently visited social media sites in Nigeria. …

State Zoonotic Disease Program Structure In The United States: Implications For Local Public Health, Dustin W. Ratliff

Master of Public Health Program Student Publications

Objective: The purpose of this research was to assess to current status of zoonotic disease biosurveillance in the United States.

Methods: A questionnaire was administered to 53 state zoonotic disease program representatives in the United States and Puerto Rico. The questionnaire assessed the structure of zoonotic disease biosurveillance in the respective states, current biosurveillance activities such as testing arthropods for pathogens, information provided to local public health on zoonotic disease, and opinions of the current state of zoonotic disease surveillance. A website assessment was conducted to identify fact sheets that are provided by states on vectors of diseases of public …

One Health: Veterinary Involvement And Zoonoses In Humans, Jasmine Cheeks

Master of Public Health Program Student Publications

Introduction: As veterinarians are often first to identify zoonotic disease events in animals, their involvement in One Health should be facilitated and strengthened by support from zoonotic disease surveillance systems and health regulations specific to zoonotic disease surveillance.

Objectives: To identify relatable trends between the relationship of the number of active veterinary professionals and the incidence of zoonotic diseases in the developed countries of Australia, Brazil, Czech Republic, Denmark, Ireland, Israel, Netherlands, Spain, and the United States of America. Another objective was to illustrate potential barriers current health regulations place on veterinary contributions to One Health surveillance. Methods: Data were …

The Importance Of The Young Invincibles To The Success Of The Affordable Care, Ethel K. Ishimwe

Master of Public Health Program Student Publications

Health care reform in the United States, as codified in the Affordable Care Act (ACA), includes an individual mandate to insure that all citizens are participants in public or privately funded health insurance programs. Universal participation insures that the national risk pool of insured persons will include the broadest spectrum of patient utilizers from the very healthy, who are low utilizers, to the very sick who are high utilizers of health care services. It is only through this high level of participation that the increased services and cost savings of health care reform can be realized. Key to this comprehensive …

Polish Healthcare System In Transition - Perceptions Of The Old And New Systems, Paul Puchta

Master of Public Health Program Student Publications

Poland is the largest country in central Europe. During the Second World War (WWII) Poland lost 39% of its physicians. After WWII, Poland fell under Soviet influence. Socialist parties dominated its government until 1989. Poland was the first country from the Soviet block to adopt economic reforms and turn away from centrally planned system.

Poland is presently a stable democracy with a growing economy, and was accepted to the European Union as a full –fledged member in May 2004. Startling results of the population perception of national healthcare system were published in 2013. Polish customers rated current system poorly, giving …

Is Public Health - Dayton & Montgomery County's Level One Food Safety Certification Training Effective?, Matthew M. Tyler

Master of Public Health Program Student Publications

The objective of the culminating experience was to evaluate the effectiveness of Public Health – Dayton & Montgomery County’s (PHDMC) Level One Food Safety Certification class. Pre-training and post-training quiz score data from approximately 692 participants were examined. Paired t-tests were used to evaluate change in scores, overall, on individual questions, and by job responsibility. There was significant improvements in quiz scores both aggregately (20.6%) and also by individual questions, except for question one which assessed how people could become ill from improper food safety. The temperature related questions were answered incorrectly the most but also showed the most improvement. …

Increasing Chlamydia Retesting Rates In Std Clinics, Michelle L. Bellando

Master of Public Health Program Student Publications

Background: Chlamydia is the most common STD in the United States (Mishori, McClaskey, & WinklerPrins, 2012). Due to the high reinfection rate of Chlamydia, the CDC recommends retesting three months after initial treatment (Park, Amey, Creegan, Barandas, & Bauer, 2010).

Objective: The purpose of this study is to investigate strategies that might improve STD follow-up rates in a clinic setting.

Methods: Public Health - Dayton and Montgomery County STD clinic patients 18 years and older who tested positive for NonGonococcal Urethritis (NGU) or Mucopurulent Cervicitis (MPC) and who agreed to participate were given an opinion survey.

Results: Of the 31 …

Interaction Between Climatic, Environmental, And Demographic Factors On Cholera Outbreaks In Kenya, James D. Stoltzfus, Jane Y. Carter, Muge Akpinar-Elci, Martin Matu, Victoria Kimotho, Mark J. Giganti, Daniel Langat, Omur C. Elsi

Community & Environmental Health Faculty Publications

Background:

Cholera remains an important public health concern in developing countries including Kenya where 11,769 cases and 274 deaths were reported in 2009 according to the World Health Organization (WHO). This ecological study investigates the impact of various climatic, environmental, and demographic variables on the spatial distribution of cholera cases in Kenya.

Methods:

District-level data was gathered from Kenya’s Division of Disease Surveillance and Response, the Meteorological Department, and the National Bureau of Statistics. The data included the entire population of Kenya from 1999 to 2009.

Results:

Multivariate analyses showed that districts had an increased risk of cholera outbreaks when …

Impact Of Poor Retention In Hiv Medical Care On Time To Viral Load Suppression, Timothy N. Crawford, Wayne T. Sanderson, Alice Thornton

Family Medicine Faculty Publications

Objective: The purpose of this study was to evaluate how poor retention in HIV care impacts time to viral suppression after initiating highly active antiretroviral therapy. Methods: A retrospective cohort study design, employing a medical chart review, was conducted at an academic infectious disease clinic at the University of Kentucky. Patients seeking care between 2003 and 2011 were included in the study. A log-normal model was employed to determine the factors associated with time to viral suppression. Results: Of the 532 patients in the study, 426 (80.1%) patients were virally suppressed. Controlling for insurance status, race, baseline CD4 counts, and …

Engagement With Care, Substance Use, And Adherence To Therapy In Hiv/Aids, Patrice K. Nicholas, Suzanne Willard, Clinton J. Thompson, Carol Dawson-Rose, Inge B. Corless, +20 Additional Authors

GW Biostatistics Center

Engagement with care for those living with HIV is aimed at establishing a strong relationship between patients and their health care provider and is often associated with greater adherence to therapy and treatment (Flickinger, Saha, Moore, and Beach, 2013). Substance use behaviors are linked with lower rates of engagement with care and medication adherence (Horvath, Carrico, Simoni, Boyer, Amico, and Petroli, 2013). This study is a secondary data analysis using a cross-sectional design from a larger randomized controlled trial (n = 775) that investigated the efficacy of a self-care symptom management manual for participants living with HIV. Participants were …

Hiv Testing Implementation In Two Urban Cities: Practice, Policy, And Perceived Barriers., Camden J Hallmark, Jennifer Skillicorn, Thomas P Giordano, Jessica A Davila, Marlene Mcneese, Nestor Rocha, Avemaria Smith, Stacey Cooper, Amanda D. Castel

Epidemiology Faculty Publications

BACKGROUND: Although funding has supported the scale up of routine, opt-out HIV testing in the US, variance in implementation mechanisms and barriers in high-burden jurisdictions remains unknown.

METHODS: We conducted a survey of health care organizations in Washington, DC and Houston/Harris County to determine number of HIV tests completed in 2011, policy and practices associated with HIV testing, funding mechanisms, and reported barriers to testing in each jurisdiction and to compare results between jurisdictions.

RESULTS: In 2012, 43 Houston and 35 DC HIV-testing organizations participated in the survey. Participants represented 85% of Department of Health-supported testers in DC and 90% …

Using A Theory Of Change Approach To Analyze Global Health Diplomacy Practice In Myanmar, Sangeeta Mookherji, Holly Greb, Rebecca Katz

Global Health Faculty Publications

The current picture of global health diplomacy (GHD) is one of increasing complexity, with multiple actors striving for multiple objectives, using a multitude of strategies and activities. Analysis and documentation of GHD practice is urgently needed to help identify the opportunities GHD provides for jointly improving global health and international relations, as well as possible unintended consequences. Systematic analysis of GHD practice is challenging without a conceptual framework. We identified a Theory of Change approach as one way to conceptualize GHD practice and potential impacts that could also depict its complexity and identify relationships and pathways for measuring success. We …

Impaired Hcv Clearance In Hiv/Hcv Coinfected Subjects Treated With Pegifn And Rbv Due To Interference Of Ifn Signaling By Ifnαr2a, Yu Jin Lee, Xiaozhen Zhang, Estefania Vazquez, Gayathri Shivasabesan, Howard A. Young, Alison Murphy, Honghui Wang, Anthony F. Suffredini, Ulrich Siebenlist, Shyam Kottilil

United States Public Health Resources

Enhanced endogenous interferon (IFN) stimulated gene (ISG) signature has been associated with nonresponsiveness to hepatitis C treatment using pegylated-IFNα (pegIFNα) and ribavirin (RBV) in human immunodeficiency virus/hepatitis C virus (HIV/HCV) coinfected patients. Using a proteomic approach, we identified high levels of IFNα receptor 2a (IFNαR2a) in the serum of null responders to pegIFNα/RBV. IFNαR2a inhibited antiviral activity of all formulations of IFNα in JFH/Huh7.5 cells. Furthermore, serum from null responders, but not from those who achieved sustained virologic response, suppressed IFN-signaling and ISG expression in IFNα-stimulated PBMCs of healthy donors in an IFNαR2a specific fashion. An IFNαR2a transgenic mice model …

Internet And Telephonic Ivr Mixed-Mode Survey For Longitudinal Studies: Choice, Retention, And Data Equivalency, Santosh K. Verma, Theodore K. Courtney, David A. Lombardi, Wen-Ruey Chang, Yueng-Hsiang Huang, Melanye J. Brennan, Melissa J. Perry

Environmental and Occupational Health Faculty Publications

Purpose

This study examined data equivalency and loss to follow-up rates from Internet and interactive voice response (IVR) system surveys in a prospective-cohort study.

Methods

475 limited-service restaurant workers participating in the 12-week study were given a choice to report their weekly slipping experience by either IVR or Internet. Demographic differences, loss to follow-up, self-reported rates of slipping, and selection of first and last choices were compared.

Results

Loss to follow-up rates were slightly higher for those choosing the IVR mode. Rates of slipping and selection of first and last choices were not significantly different between survey modes. Propensity to …

Synthesizing Data And Models For The Spread Of Mers-Cov, 2013: Key Role Of Index Cases And Hospital Transmission, Gerardo Chowell, Seth Blumberg, Lone Simonsen, Mark A. Miller, Cecile Viboud

Global Health Faculty Publications

The outbreak of Middle East respiratory syndrome coronavirus (MERS-CoV) has caused 209 deaths and 699 laboratory-confirmed cases in the Arabian Peninsula as of June 11, 2014. Preparedness efforts are hampered by considerable uncertainty about the nature and intensity of human-to-human transmission, with previous reproduction number estimates ranging from 0.4 to 1.5. Here we synthesize epidemiological data and transmission models for the MERS-CoV outbreak during April–October 2013 to resolve uncertainties in epidemic risk, while considering the impact of observation bias. We match the progression of MERS-CoV cases in 2013 to a dynamic transmission model that incorporates community and hospital compartments, and …

Competency-Based Medical Education In Two Sub-Saharan African Medical Schools., Elsie Kiguli-Malwadde, E Oluwabunmi Olapade-Olaopa, Sarah Kiguli, Candice Chen, Nelson K. Sewankambo, Adesola O. Ogunniyi, Solome Mukwaya, Francis Omaswa

Health Services Management and Leadership Faculty Publications

Background

Relatively little has been written on Medical Education in Sub-Saharan Africa, although there are over 170 medical schools in the region. A number of initiatives have been started to support medical education in the region to improve quality and quantity of medical graduates. These initiatives have led to curricular changes in the region, one of which is the introduction of Competency-Based Medical Education (CBME).

Institutional reviews

This paper presents two medical schools, Makerere University College of Health Sciences and College of Medicine, University of Ibadan, which successfully implemented CBME. The processes of curriculum revision are described and common themes …

Retention Of Adolescents Living With Hiv In Care, Treatment, And Support Programs In Uganda, Livingstone Ssali, Sam Kalibala, Josephine Birungi, Aggrey Egessa, Jonathan Wangisi, Joanne Lyavala Okullu, Celestin Bakanda, Stephen Okoboi, Francis Obare

HIV and AIDS

Understanding the extent to which adolescents aged 10–19 years who are living with HIV are retained in HIV care, treatment, and support is important for informing the design of effective services for this population to better meet their needs across three main areas of HIV and AIDS programming: treatment; care and support; and prevention. Retention in HIV programs is, in turn, important for positive clinical outcomes including viral suppression and survival. In 2013–2014, The AIDS Support Organization and the Population Council undertook a study to generate evidence on factors associated with retention of adolescents in HIV and AIDS programs in …

Limiting Liberty To Prevent Obesity: Justifiability Of Strong Hard Paternalism In Public Health Regulation, Thaddeus Mason Pope

Faculty Scholarship

Because of the largely self-regarding nature of obesity, many current and proposed public health regulatory measures are paternalistic. That is, these measures interfere with a person’s liberty with the primary goal of improving that person’s own welfare.

Paternalistic public health measures may be effective in reducing obesity. They may even be the only sufficiently effective type of regulation. But many commentators argue that paternalistic public health measures are not politically viable enough to get enacted. After all, paternalism is repugnant in our individualistic culture. It is "wrong" for the government to limit our liberty for our own good.

In this …

The Effects That Liquid And Solid Cattle Manure Have On The Water Quality Of Drainage Ditches In Putnam County, Ohio, Janelle Horstman

Honors Projects

Lake Erie has experienced harmful algal blooms with increased frequency since the mid-1990s due to excess nutrients from Rivers, such as the Maumee River, and largely agricultural watersheds. Nonpoint source pollution from agriculture contributes to eutrophication, algal blooms, and the degradation of water quality. This creates stress on aquatic fauna, reduced aesthetic quality, odor, and limits of the water for usage of drinking, recreation, and industry. This research paper asks what the contributions of having access to manure application records, soil records, and information about antibiotics have on what is known about manure management and antibiotic resistance, which has been …

A Feasibility Study Of Motivational Interviewing For Health Risk Behaviors Among Thai Youth Living With Hiv, Chokechai Rongkavilit, Sylvie Naar-King, Juline Koken, Torsak Bunupuradah, Xinguang Chen, Pichai Saengcharnchai, Apirudee Panthong, Jeffrey T. Parsons

Publications and Research

Thailand is among the few less-developed countries with successful HIV prevention among segments of the population (National AIDS Prevention and Alleviation Committee, 2010). However, the success of HIV prevention among Thai adolescents and young adults has been questionable. The highest percentage of Thai persons with AIDS remain in the age group of 25–34 years, indicating that the time of greatest HIV acquisition has occurred in adolescence and young adulthood (Thai Working Group on HIV/AIDS, 2010). Most Thai youth living with HIV (TYLH) acquire HIV through sexual contact (National AIDS Prevention and Alleviation Committee, 2010). In a study of TYLH, only …

Best Practices: A Network Approach Of The Mandatory Influenza Vaccination Among Healthcare Workers, Greg Attenweiler, Angie Thomure

Master of Public Health Program Student Publications

A network simulation was applied to hospital social networks improve the influenza vaccination rate of healthcare workers in a healthcare system. Social network methods can be used to develop an understanding of structures of social relations. Over 200,000 U.S. patients are hospitalized annually for influenza, which attributes to 36,000 deaths and is the sixth leading cause of death in adults. The best way to prevent influenza each year is by receiving the influenza vaccination. The typical influenza vaccination rate among healthcare workers is 40- 50%. A Healthy People 2020 objective is to increase the percentage of healthcare workers who are …

Integration Of Early Clinical Experience And Population Health In Undergraduate Medical Education, Thang N. Vu, Josephine Mensah-Dapaah

Master of Public Health Program Student Publications

Objective: In order to better prepare physicians to face the challenges in health care delivery today, educators have pushed for the integration of core population health competencies into undergraduate medical education. The goal is to equip future physicians with the necessary skills to not only improve the health of an individual, but also be able to advocate for a community and meet the health needs of a population. The purpose of this research study is to propose a plan to evaluate the pilot program Early Meaningful Clinical Experience (EMCE) at the Boonshoft School of Medicine at Wright State University.

Methods: …

Case Study: Sick On A South American Sugarcane Plantation, Kevin M. Bonney

Publications and Research

A case study is presented that was designed to be used in high school and college level courses to familiarize students with chagas disease, its transmission, and effects in Central and South America. Noted objectives of the lesson include evaluating disease symptoms, examining socioeconomic factors related to the epidemiology, and creating visual aids with public health information. Questions are provided for discussing the a case of chagas disease at a Brazilian sugarcane plantation.

Breastfeeding Knowledge, Practice, Attitudes, And Influencing Factors: Findings From A Selected Sample Of Breastfeeding Mothers In Bemidji, Minnesota, Hadeel Adnan Tanash

All Graduate Theses, Dissertations, and Other Capstone Projects

Breastfeeding is generally considered by health professionals as the ideal feeding practice for infants. It is the first communication pathway between the mother and her infant. This study was designed to describe breastfeeding knowledge, attitudes, practice and influencing factors among breastfeeding mothers in Bemidji, MN. This cross-sectional study allowed the researcher to determine trends and other information about the sample in the Bemidji area. The participants for this study were breastfeeding mothers who gave a birth at Sanford Health located in Bemidji, MN. A written data collection instrument containing forty nine questions was used to collect data. The findings of …