Digital Commons Network^™

A New Health Informatics Course: A Funded Collaboration, Xinyu Yu

SLIS Connecting

Information access is considered critical to the public health workforce, which involves informatics, communication, analytic assessment, and health education (NN/LM Public Health Training Workgroup, 2004). Information-oriented outreach to the public health workforce is challenging to libraries because the public health workforce is made up of diverse health professions and public health personnel are not aware if key information resources are available to them (Cogdill, 2007). The National Library of Medicine (NLM) funded information outreach to the public health workforce projects in different periods of time, which altogether reflect challenges of providing public health professionals with access to electronic health information …

Multi-Criteria Decision Analysis As An Innovative Approach To Managing Zoonoses: Results From A Study On Lyme Disease In Canada, Cécile Aenishaenslin, Valérie Hongoh, Hassane D. Cissé, Anne Gatewood Hoen

Dartmouth Scholarship

ackground: Zoonoses are a growing international threat interacting at the human-animal-environment interface and call for transdisciplinary and multi-sectoral approaches in order to achieve effective disease management. The recent emergence of Lyme disease in Quebec, Canada is a good example of a complex health issue for which the public health sector must find protective interventions. Traditional preventive and control interventions can have important environmental, social and economic impacts and as a result, decision-making requires a systems approach capable of integrating these multiple aspects of interventions. This paper presents the results from a study of a multi-criteria decision analysis (MCDA) approach for …

Comparison Of Hpv Dna Testing In Cervical Exfoliated Cells And Tissue Biopsies Among Hiv-Positive Women In Kenya, Hugo De Vuyst, Michael Chung, Lacopo Baussano, Nelly R. Mugo, Vanessa Tenet, Folkert J. Van Kemenade, Farzana S. Rana, Samah R. Sakr, Chris J.L.M. Meijer, Peter J.F. Snijders, Silvia Franceschi

Pathology, East Africa

HIV-positive women are infected with human papillomavirus (HPV) (especially with multiple types), and develop cervical intraepithelial neoplasia (CIN) and cervical cancer more frequently than HIV-negative women. We compared HPV DNA prevalence obtained using a GP5+/6+ PCR assay in cervical exfoliated cells to that in biopsies among 468 HIV-positive women from Nairobi, Kenya. HPV prevalence was higher in cells than biopsies and the difference was greatest in 94 women with a combination normal cytology/normal biopsy (prevalence ratio, PR = 3.7; 95% confidence interval, CI: 2.4-5.7). PR diminished with the increase in lesion severity (PR in 58 women with high-grade squamous intraepithelial …

Accreditation And Standardization In Local Public Health, Glen P. Mays

Health Management and Policy Presentations

Reducing harmful, wasteful, and inequitable variation in public health delivery is a central objective for administrative and policy decision-makers in public health, and is embedded in the national accreditation movement. The challenge lies in accomplishing this objective while preserving the benefits of customization in public health delivery that accrue through tailoring and targeting of resources to unique community needs and risks. Public health services and systems research (PHSSR) can help determine the optimal balance between standardization and customization in public health delivery.

Strengthening The Evidence Base For Accreditation: Progress In Phssr And Pbrns, Glen P. Mays

Health Management and Policy Presentations

With the launch of a voluntary national accreditation program for public health agencies, the field requires an expanding evidence base concerning which public health strategies work best, for which populations, and under what circumstances. The field of public health services and systems research (PHSSR) and practice-based research networks (PBRNs) are producing applied studies that can inform the future development and implementation of accreditation standards, and evaluate the impact of accreditation on the field of practice.

Public Health Practice-Based Research Networks: Creating Evidence For Practice, Glen P. Mays

Health Management and Policy Presentations

Powerful opportunities for learning from variation and change in public health delivery now exists across the U.S. health system. Practice-based research networks (PBRNs) provide the vehicles for harvesting evidence from applied, comparative studies -- and for feeding this information back into the delivery system.

Public Health Services & Systems Research: Concepts, Methods, And Emerging Findings, Glen P. Mays

Health Management and Policy Presentations

The field of public health services & systems research (PHSSR) increasingly is addressing the question of how to assess the value of investments in public health programs, infrastructure, and delivery systems. Progress in quasi-experimental research designs, measurement, estimation techniques, and data sources are yielding important insight.

Up North They’Re Talking Sex: A Collaborative And Community Driven Model For Sexual Health Knowledge Mobilization, Karen Edwards, Steve Mitchell Phd, Nancy Gibson Phd, Cecilia Zoe-Martin, Anita Daniels, Jim Martin, Patrick Wansbrough Rn

Journal of Health Disparities Research and Practice

To address high STI rates in their aboriginal communities, the Tłı̨chǫ of the Northwest Territories adopted a collaborative participatory research approach to sexual health based on four key stages of development. First was community initiation and engagement, where local leaders identified a priority need and began community discussions around sexual health. Secondly, identifying that existing government statistics did not provide them with adequate information, the Tlicho Community Services Agency partnered with the University of Alberta and CIETcanda to conduct a baseline study in all four Tlicho communities, designed and administered by community-based researchers. Third, a community action research team (CART) …

Racial/Ethnic Disparities In Infectious Disease Hospitalizations In Arizona, Laura Callinan, Robert Holman, Douglas Esposito, Marian Mcdonald

Journal of Health Disparities Research and Practice

Infectious disease (ID) hospitalizations in Arizona, a diverse population with nearly complete race/ethnicity data, were analyzed using the State Inpatient Database for 2005-2008. ID hospitalizations rates were calculated and compared by ID group, race/ethnicity, age, and sex. During 2005-2008, there were 383,597 ID hospitalizations reported in Arizona, resulting in an age-adjusted rate of 1498.1 per 100,000 persons. A range of racial/ethnic disparities in ID hospitalization rates were noted. Persons of Native American and black race/ethnicity had overall ID hospitalization rates higher than the rate for persons of white race/ethnicity; persons of Asian or Pacific Islander race/ethnicity had a lower rate. …

Développement D'Un Modèle De Gestion Graduée Du Risque Pour Le Choix De La Protection Respiratoire Contre Les Bioaérosols, Jacques Lavoie, Eve Neesham-Grenon, Maximilien Debia, Yves Cloutier, Geneviève Marchand

Rapports de recherche scientifique

La sélection d’un appareil de protection respiratoire contre les bioaérosols peut s’avérer une tâche complexe compte tenu de l’absence de valeurs limites d’exposition et de données toxicologiques, ainsi que des limites des techniques d’échantillonnage actuelles et de la grande diversité des bioaérosols. Dans ces circonstances, une méthode qualitative d’évaluation et de gestion du risque fournit une alternative aux méthodes quantitatives utilisées en hygiène du travail. Ce rapport propose un modèle de gestion graduée du risque pour le choix de la protection respiratoire contre les bioaérosols infectieux et non infectieux applicable à l’ensemble des milieux de travail et s’adressant aux hygiénistes …

Does Comorbidity Increase The Risk Of Mortality Among Children Under 3 Years Of Age?, Christa L. Fischer Walker, Jamie Perin, Jodi L. Liu, Joanne Katz, James M. Tielsch, Robert Black

Global Health Faculty Publications

Objectives Diarrhoea and pneumonia remain leading causes of morbidity and mortality in children under 5 years of age. Little data is available to quantify the burden of comorbidity and the relationship between comorbid diarrhoea and pneumonia infections and mortality. We sought to quantify the relationship between comorbidity and risk of mortality among young children in two community-based studies conducted among South Asian children.

Design Secondary data analysis of two cohort studies.

Participants We identified two cohort studies of children under 3 years of age with prospective morbidity at least once every 2 weeks and ongoing mortality surveillance.

Outcome measures We …

Diffusion Of Innovation Across A National Local Health Department Network: A Simulation Approach To Policy Development Using Agent-Based Modeling, Mark Orr, Jacqueline Merrill

Frontiers in Public Health Services and Systems Research

The network that local health officials use to communicate about professional issues is sparsely connected, which may limit the spread of innovative practices. We used agent-based simulation modeling to find out if a policy to promote more connections improved the network’s capability to diffuse innovation. We found that unanticipated effects could result, depending on the requirements of the policy and the proportion of health officials involved. With carefully crafted assumptions and reliable data it is possible to untangle complex processes using simulation modeling. The results represent how the world might actually work which may provide useful decision support for policymakers …

Correlates Of Hiv Acquisition In A Cohort Of Black Men Who Have Sex With Men In The United States: Hiv Prevention Trials Network (Hptn) 061, Beryl A. Koblin, Kenneth H. Mayer, Susan H. Eshleman, Lei Wang, Sharon B. Mannheimer, Carlos Del Rio, Steve Shoptaw, Manya Magnus, Susan Buchbinder, Leo Wilton, Ting-Yuan Liu, Vanessa Cummings, Estelle Piwowar-Manning, Sheldon D. Fields, Sam Griffith, Vanessa Elharrar, Darrell Wheeler

Epidemiology Faculty Publications

Background

Black men who have sex with men (MSM) in the United States (US) are affected by HIV at disproportionate rates compared to MSM of other race/ethnicities. Current HIV incidence estimates in this group are needed to appropriately target prevention efforts.

Methods

From July 2009 to October 2010, Black MSM reporting unprotected anal intercourse with a man in the past six months were enrolled and followed for one year in six US cities for a feasibility study of a multi-component intervention to reduce HIV infection. HIV incidence based on HIV seroconversion was calculated as number of events/100 person-years. Multivariate proportional …

Population Cancer Risks Associated With Coal Mining: A Systematic Review, Wiley D. Jenkins, W. Jay Christian, Georgia Mueller, K. Thomas Robbins

Epidemiology and Environmental Health Faculty Publications

BACKGROUND: Coal is produced across 25 states and provides 42% of US energy. With production expected to increase 7.6% by 2035, proximate populations remain at risk of exposure to carcinogenic coal products such as silica dust and organic compounds. It is unclear if population exposure is associated with increased risk, or even which cancers have been studied in this regard.

METHODS: We performed a systematic review of English-language manuscripts published since 1980 to determine if coal mining exposure was associated with increased cancer risk (incidence and mortality).

RESULTS: Of 34 studies identified, 27 studied coal mining as an occupational exposure …

Livestock-Associated Methicillin And Multidrug Resistant Staphylococcus Aureus Is Present Among Industrial, Not Antibiotic-Free Livestock Operation Workers In North Carolina, Jessica L. Rinsky, Maya Nadimpalli, Steve Wing, Devon Hall, Dothula Baron, Lance B. Price, Jesper Larsen, Marc Stegger, Jill Stewart, Christopher D. Heaney

Environmental and Occupational Health Faculty Publications

Objectives

Administration of antibiotics to food animals may select for drug-resistant pathogens of clinical significance, such as methicillin-resistant Staphylococcus aureus (MRSA). In the United States, studies have examined prevalence of MRSA carriage among individuals exposed to livestock, but prevalence of multidrug-resistant S. aureus (MDRSA) carriage and the association with livestock raised with versus without antibiotic selective pressure remains unclear. We aimed to examine prevalence, antibiotic susceptibility, and molecular characteristics of S. aureus among industrial livestock operation (ILO) and antibiotic-free livestock operation (AFLO) workers and household members in North Carolina.

Methods

Participants in this cross-sectional study were interviewed and provided a …

Integrated Health Care Systems: A Holistic Approach To Medicine, Tatiana Kaehler

Independent Study Project (ISP) Collection

This paper examines how the strengths of both allopathic and traditional medical systems are harnessed in integrated health care systems – a system which “consciously targets and harnesses people’s links with biodiversity for health care reasons” (Quansah, personal communication, July 1, 2013). It uses examples of integrated health care in Madagascar to prove that integrated health care systems offers health care in an affordable and accessible manner, while also promoting cultural sustainability and conservation of biodiversity. By recognizing and establishing integrated health care systems throughout the world, global health disparities can be addressed and various health goals can be accomplished.

Maribel Gamon - Multidrug-Resistant Tuberculosis In India: Solving A Problem By Reconstructing The Public Health Infrastructure, Maribel Gamon

Ronald E. McNair Scholars Program 2013

Mycobacterium tuberculosis, commonly referred to as TB, is responsible for causing about 630,000 cases per year of infectious diseases worldwide. Recently, multidrug resistant tuberculosis (MDR-TB) has become an alarming public health concern. In addition, many developing countries lack effective treatment programs. India is one of those countries with a high prevalence of TB, seemingly affected by disconnectedness in their public health infrastructure. India, although a developing country, is still burdened with both chronic and infectious diseases, and there is a reactive public health system that must place focus on long-term effects of emerging resistant strains of TB. It is important …

Preventative Care And Culture, Anna Wagman

Independent Study Project (ISP) Collection

This paper explores the intersection between culture and health. The similarities and differences between methods for preventative medicine employed by traditional and allopathic systems are discussed. These ostensibly disparate systems, in reality, display many parallels in regards to their delivery. The effects of industrial progress, and therefore cultural change, on the health of the inhabitants of rapidly urbanizing African cities are examined. Historical information from studies of Great Britain, the first area to undergo a full industrial revolution is also drawn on. These analyses essentially predict the societal issues that come with urbanization, such as the amalgamation of preexisting pollutants …

National And Regional Estimates Of Term And Preterm Babies Born Small For Gestational Age In 138 Low-Income And Middle-Income Countries In 2010, Anne C.C. Lee, Joanne D. Katz, Hannah Blencowe, Simon Cousens, Naoko Kozuki, James M. Tielsch, +30 Additional Authors

Global Health Faculty Publications

Background

National estimates for the numbers of babies born small for gestational age and the comorbidity with preterm birth are unavailable. We aimed to estimate the prevalence of term and preterm babies born small for gestational age (term-SGA and preterm-SGA), and the relation to low birthweight (<2500 >g), in 138 countries of low and middle income in 2010.

Methods

Small for gestational age was defined as lower than the 10th centile for fetal growth from the 1991 US national reference population. Data from 22 birth cohort studies (14 low-income and middle-income countries) and from the WHO Global Survey on Maternal …

The Epidemiology Of Human Herpesvirus-8: Transmission Of Infection To Children In Zambian Households, Kay L. Crabtree

School of Biological Sciences: Dissertations, Theses, and Student Research

Human Herpes virus-8 (HHV-8) is the known etiologic agent for several malignant pathologies, including Kaposi’s sarcoma (KS), the most common tumor in children in sub-Saharan Africa. Saliva is implicated as the culprit of transmission; however there is a paucity of information regarding transmission to young children. In this study, we investigated the hypothesis that household behaviors exposing the susceptible child to saliva increase the risk of transmission of HHV-8 to that child.

To test our hypothesis a large prospective cohort study in Lusaka, Zambia, enrolling 464 young children and their households, was followed for 48 months. Socio-demographics, health histories, feeding …

Needle Stick Injuries--Risk And Preventive Factors: A Study Among Health Care Workers In Tertiary Care Hospitals In Pakistan., Asad Ali Khan Afridi, Ameet Kumar, Raza Sayani

Community Health Sciences

BACKGROUND:

Health care workers (HCWs) are at substantial risk of acquiring blood borne infections such as HIV, Hepatitis-B and Hepatitis-C through needle stick injuries (NSIs). This study aimed to assess the proportion of NSIs and their associated factors among HCWs and also to identify the areas in which preventive efforts might be directed to protect against this occupational hazard.

METHODOLOGY:

A cross-sectional study was conducted in two tertiary care hospitals of Pakistan representing both private and public health sector. A total of 497 HCWs (doctors and nurses) were interviewed using a structured questionnaire. Data was collected from January to May …

The Effect Of The Sphere Standards On The Incidence Of Communicable And Infectious Diseases In A Complex Humanitarian Emergency, Masashi Rotte

Master of Public Health Capstone Presentations

The purpose of this study was to determine what effect achieving the Sphere Standards relating to water and sanitation had on the incidence of communicable diseases in a returnee camp in South Sudan during a complex humanitarian emergency. The water and sanitation infrastructure of the returnee camp was tracked over time until it met the Sphere Standards. The total camp population was also tracked over the same period of time and compared to daily counts of diseases diagnosed in a medical clinic at the camp. A daily incidence of disease was then calculated for each communicable disease that was tracked. …

Local Public Health In Financial Crises: Common Decision Drivers For Changes In Services Due To Economic Downturn, Gulzar H. Shah

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

We measured the impact of the 2008-2010 economic recession on local health departments (LHDs) across the United States. Between 2008 and 2010, we conducted 3 Web-based, cross-sectional surveys of a nationally representative sample of LHDs to assess cuts to budgets, workforce, and programs. By early 2010, more than half of the LHDs (53%) were experiencing cuts to their core funding. In excess of 23 000 LHDs jobs were lost in 2008-2009. All programmatic areas were affected by cuts, and more than half of protecting the health of the public, such as monitoring health status to identify and solve community health …

To Bear Witness: A Journey Of Healing And Solidarity, Updated, Revised, And Expanded Edition, Kevin M. Cahill, M.D.

International Affairs

For more than fifty years, Dr. Cahill has been helping to heal the world, as a leading specialist in tropical medicine and as a driving force in humanitarian assistance and relief efforts around the globe. In this revised and expanded edition, he chronicles extraordinary achievements of compassion and commitment. Bringing together a rich selection of writings, he crafts a fascinating memoir of a life devoted to others. The book includes front-line reports from places under siege—Lebanon, Somalia, Sudan, Nicaragua, Gaza, and Ireland; there are also visionary essays from the origins of the AIDS epidemic and landmine crises, and no less …

Early Detection Of Zoonotic Emerging Infectious Diseases, Thomas Cotter, Earl Stoddard Iii

Homeland Security Publications

No abstract provided.

Maximizing The Delivery Performance Of Point-Of-Care Cd4+ T-Cell Counting Tests In Resource-Limited Settings - A Policy Brief, Nan Kong, J. Paul Robinson, Fenggang Yang

Purdue Policy Research Institute (PPRI) Policy Briefs

Managing HIV/AIDS presents challenges to public health policymakers, frontline workers, and researchers worldwide. A key strategy in the disease management is early diagnosis and rapid treatment initiation. While the technological field of point‐of‐care HIV/AIDS diagnostics has advanced significantly in the past two decades, several critical issues remain that hinder the deployment of point‐of‐care testing devices in resource‐deprived settings. In this policy brief, we discuss these issues, including technological specifics of point‐of‐care CD4⁺ T‐cell counting approaches and requirements of deploying them. We also discuss cultural and religious concerns on the deployment. At the end of the brief, we propose a …

When To Start Antiretroviral Therapy: The Need For An Evidence Base During Early Hiv Infection, James D. Lundgren, Abdel G. Babiker, Fred M. Gordin, Alvaro H. Borges, James D. Neaton

Epidemiology Faculty Publications

Background

Strategies for use of antiretroviral therapy (ART) have traditionally focused on providing treatment to persons who stand to benefit immediately from initiating the therapy. There is global consensus that any HIV+ person with CD4 counts less than 350 cells/μl should initiate ART. However, it remains controversial whether ART is indicated in asymptomatic HIV-infected persons with CD4 counts above 350 cells/μl, or whether it is more advisable to defer initiation until the CD4 count has dropped to 350 cells/μl. The question of when the best time is to initiate ART during early HIV infection has always been vigorously debated. The …

The Public Health Pbrn Program: Building The Science Of Public Health Delivery, Glen P. Mays, Anna Goodman Hoover

Health Management and Policy Presentations

This session describes public health practice-based research networks (PBRNs) and emerging opportunities for collaboration with injury control research centers to advance the science of injury prevention practice.

Research Fatigue Among Injecting Drug Users In Karachi, Pakistan, Aysha Zahidie, Arshad Altaf, Adeel Ahsan, Tanzil Jamali

Community Health Sciences

Background

Karachi is the largest metropolis of Pakistan and its economic hub attracting domestic migrants for economic opportunities. It is also the epicenter of HIV epidemic in the country. Since 2004, one pilot study and four behavioral and biological surveillance rounds have been conducted in Karachi. In addition many student research projects have also focused on key risk groups including injection drug users (IDUs). As a result of this extra ordinary exposure of same kind of questions, IDUs know how to respond to high value questions related to sharing of needles or unsafe sexual practices. The purpose of the study …

Harnessing The Power Of Public Health Systems For Injury Prevention & Control, Glen P. Mays

Health Management and Policy Presentations

Efforts to improve population health hinge on a vast yet diffuse constellation of government agencies, health care providers, and community organizations that assume responsibilities in implementing prevention programs and policies across the U.S. Realizing the full health and economic benefits of injury prevention and control initiatives requires mobilizing and managing these complex and heterogeneous public health delivery systems. This session will explore the emerging science of public health delivery systems and what it tells us about improving injury prevention and control amid policy and economic change.