Digital Commons Network^™

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.

Public Health Delivery Systems And Population Health, Glen P. Mays

Health Management and Policy Presentations

Despite high overall health expenditures, the U.S. continues to fall behind other high-income countries on many measures of population health. While health care delivery systems are now studied intensively for solutions to U.S. cost and quality problems, the nation's delivery systems for public health programs and policies are only now becoming the subject of rigorous empirical study. This presentation examines recent studies of public health delivery systems and important directions for future inquiry.

New Jersey Vaccine Mandates: The Confluence Of Regulations, Rights, And Religion, Drew Harris Dpm, Mph

Population Health Matters (Formerly Health Policy Newsletter)

No abstract provided.

Diarrhea As A Risk Factor For Acute Lower Respiratory Tract Infections Among Young Children In Low Income Settings, Christa L. Fischer Walker, Jamie Perin, Joanne D. Katz, James M. Tielsch, Robert Black

Global Health Faculty Publications

Background

Diarrhea and acute lower respiratory tract infections (ALRI) are leading causes of morbidity and mortality among children under 5 years of age. We sought to quantify the correlation of diarrhea and respiratory infections within an individual child and to determine if infection with one illness increases the risk of infection with the other during the same time period.

Methods

We quantified the likelihood of an ALRI and a diarrhea episode occurring during the same week compared to the likelihood of each occurring independently in two cohorts of children under 3 years of age using a bivariate probit regression model. …

B Cell Response And Hemagglutinin Stalk-Reactive Antibody Production In Different Age Cohorts Following 2009 H1n1 Influenza Virus Vaccination, Mark Y. Sangster, Jane Baer, Felix W. Santiago, Theresa T. Fitzgerald, Natalia A. Ilyushina

Dartmouth Scholarship

The 2009 pandemic H1N1 (pH1N1) influenza virus carried a swine-origin hemagglutinin (HA) that was closely related to the HAs of pre-1947 H1N1 viruses but highly divergent from the HAs of recently circulating H1N1 strains. Consequently, prior ex- posure to pH1N1-like viruses was mostly limited to individuals over the age of about 60 years. We related age and associated dif- ferences in immune history to the B cell response to an inactivated monovalent pH1N1 vaccine given intramuscularly to subjects in three age cohorts: 18 to 32 years, 60 to 69 years, and >70 years. The day 0 pH1N1-specific hemagglutination inhibition (HAI) …

Reproductive Tract Infections Among Married Women In Peri-Urban Areas Of Karachi, Pakistan: A Population-Based Study, Neelofar Sami, Tazeen S. Ali, E. Khan

Community Health Sciences

Background: Reproductive Tract Infections (RTIs) is a major public health problem. In Pakistan, there is dearth of information about the prevalence of RTIs among women and their health seeking behavior. A study was conducted to determine the prevalence, number and types of RTIs among women residing in squatter settlements in Karachi and their health seeking behavior.
Methods: The respondents were married non-pregnant women aged 15–49 years residing in peri-urban areas of Karachi, Pakistan. The interviews with women were followed by their physical and pelvic examinations. Samples swabs collected from vagina and endocervix were tested in laboratory.
Results: Overall, 23.8% of …

Correlates Of Diarrhoea Among Children Below The Age Of 5 Years In Sudan, Seter Siziya, Adamson S. Muula, Emmanuel Rudatsikira

Faculty Publications

Background

The Millennium Development Goals recognise child health and survival as an important socio-development issue.

Objectives

To determine the correlates of diarrhoea among children aged below 5 years in north Sudan.

Methods

We conducted secondary data analysis of the Sudan Multiple Cluster Indicators Survey II.

Results

Altogether, 23,295 children were included in the survey. Half (50.0%) of the children were males, and 22.5% of them were of age less than one year. Boys were 3% (p=0.044) more likely to have diarrhoea compared to girls. Compared with the oldest age group (48–59 months), children less than 6 months of age and …

Optimizing The Value Of Public Health Services: Lessons From Research & Practice, Glen P. Mays

Health Management and Policy Presentations

Expanding the delivery of efficacious public health programs and policies holds considerable potential for improving population health and constraining the growth in health care spending. Achieving such expansions efficiently, particularly in low-resource settings, requires careful attention to interorganizational and intergovernmental relationships in public health delivery.

Significant Sequelae After Bacterial Meningitis In Niger: A Cohort Study, Jean-François Jusot, Zilahatou Tohon, Abdoul Aziz Yazi, Jean-Marc Collard

Epidemiology and Environmental Health Faculty Publications

BACKGROUND: Beside high mortality, acute bacterial meningitis may lead to a high frequency of neuropsychological sequelae. The Sahelian countries belonging to the meningitis belt experience approximately 50% of the meningitis cases occurring in the world. Studies in Africa have shown that N. meningitidis could cause hearing loss in up to 30% of the cases, exceeding sometimes measles. The situation is similar in Niger which experiences yearly meningitis epidemics and where rehabilitation wards are rare and hearing aids remain unaffordable. The aim of this study was to estimate the frequency of neuropsychological sequelae after acute bacterial meningitis in four of the …

Expanding Access To Malaria Diagnosis Through Retail Shops In Western Kenya: What Do Shop Workers Think?, Andria Rusk, Catherine Goodman, Violet Naanyu, Beatrice Koech, Andrew Obala, Wendy Prudhomme O'Meara

Collected Faculty Scholarship

Background. The common symptoms of malaria reduce the specificity of clinical diagnosis. Presumptive treatment is conventional but can lead to overdiagnosis of malaria, delay of appropriate treatment, overprescription of antimalarials, and drug resistance. Routine use of diagnostic tests can address many of these concerns. Though treatment is often procured from retailers, there is low availability of rapid diagnostic tests for malaria (MRDTs), a simple, inexpensive, and accurate diagnostic solution. We know little about the challenges to expanding access to diagnostics through these outlets. Methods. To understand the perceptions of the benefits and challenges to selling rapid diagnostic tests for malaria, …

National Estimates Of Emergency Department Visits For Pediatric Severe Sepsis In The United States, Sara Singhal, Mathias W. Allen, John-Ryan Mcannally, Kenneth S. Smith, John P. Donnelly, Henry E. Wang

Emergency Medicine Faculty Publications

Objective. We sought to determine the characteristics of children presenting to United States (US) Emergency Departments (ED) with severe sepsis.

Study design. Cross-sectional analysis using data from the National Hospital Ambulatory Medical Care Survey (NHAMCS). Using triage vital signs and ED diagnoses (defined by the International Classification of Diseases, Ninth Revision codes), we identified children(triage fever or ICD-9 infection) and organ dysfunction (triage hypotension or ICD-9 organ dysfunction).

Results. Of 28.2 million pediatric patients presenting to US EDs each year, severe sepsis was present in 95,055 (0.34%; 95% CI: 0.29-0.39%). Fever and respiratory infection were the most common indicators of …

Next Generation Public Health Delivery: Optimizing Health And Economic Impact, Glen P. Mays

Health Management and Policy Presentations

Improving population health in the context of significant policy and economic change will require governmental public health agencies to rethink their roles within the U.S. health and social services systems, giving much greater attention to "catalytic" functions intended to mobilize, direct, and coordinate the actions of others. A growing body of evidence and experience suggests that such changes are likely to be feasible, effective, and efficient.

Do User Fees Increase Tuberculosis Notifications?, Chioma Y. Chukwumah

Economics Honors Projects

Public health sectors around the world strive to provide accessible and affordable care. Tight government budgets and growing populations lead countries to consider adding or raising charges to health care consumers. These user fees may affect the quality, equity and revenue of health care. This paper investigates the impact of user fees on notifications of tuberculosis. In the panel data composed of 176 countries from 1960 to 2012, I find no evidence that suggests user fees increase tuberculosis. In contrast, I find strong and robust evidence suggesting user fees are associated with fewer new cases of tuberculosis.

Assessment Of Introduction Pathway For Novel Avian Influenza Virus Into North America By Wild Birds From Eurasia, Ryan S. Miller, Steven J. Sweeney, Judy E. Akkina, Emi K. Saito

Zoonotics and Wildlife Disease: Publications

A critical question surrounding emergence of novel strains of avian influenza viruses (AIV) is the ability for wild migratory birds to translocate a complete (unreassorted whole genome) AIV intercontinentally. Virus translocation via migratory birds is suspected in outbreaks of highly pathogenic strain A(H5N1) in Asia, Africa, and Europe. As a result, the potential intercontinental translocation of newly emerging AIV (e.g. A(H7N9) from Eurasia to North America via migratory movements of birds) remains a concern. An estimated 1.48 to 2.91 million aquatic birds, principally Anseriformes (ducks, geese, and swans) and Charadriiformes (gulls, terns, and shorebirds) move annually between Eurasia and North …

State Compliance On The Cdc Recommendations For Hepatitis C Testing, Amanda Norcott

Public Health Undergraduate Program

Last August, the CDC updated its recommendations regarding what populations are at risk and should get tested for the hepatitis C virus, adding that those born from 1945 through 1965, or “baby boomers”, should receive a one-time Hepatitis C test due to the disproportionate number of cases in the age group. My goal was to identify which states are in compliance with these recommendations, and how many include the latest update. I collected data by searching specific terms about Hepatitis C within each state’s department of health website; I found that 34% of states were fully in line with the …

Landscape Epidemiology And Machine Learning: A Geospatial Approach To Modeling West Nile Virus Risk In The United States, Sean Gregory Young

Graduate Theses and Dissertations

The complex interactions between human health and the physical landscape and environment have been recognized, if not fully understood, since the ancient Greeks. Landscape epidemiology, sometimes called spatial epidemiology, is a sub-discipline of medical geography that uses environmental conditions as explanatory variables in the study of disease or other health phenomena. This theory suggests that pathogenic organisms (whether germs or larger vector and host species) are subject to environmental conditions that can be observed on the landscape, and by identifying where such organisms are likely to exist, areas at greatest risk of the disease can be derived. Machine learning is …

Global-Health Diplomacy : The Social Determinants Perspective Of Health Approach And The Future Global Policy Agenda., Naseem Ansari

College of Arts & Sciences Senior Theses

No abstract provided.

Beliefs About Complementary And Alternative Medicine In Hiv-Infected Black Women Using The Theory Of Planned Behavior, Stephanie G. Lino

Loma Linda University Electronic Theses, Dissertations & Projects

Background. Black women make up 12% of the female population in the U.S, yet they account for 66% of new HIV infections. In 2002, AIDS was the most cited reason for death among Black women age 25-34. While prevention remains, a major effort targeting treatment efficacy and modalities for this sub-group need to be better understood.

Purpose. The purpose of this study is to assess whether HIV-positive Black women’s attitudes, subjective norms and perceived behavioral control are related to intention of dietary supplements and spiritual practices use in their HIV treatment.

Method. In phase one, Grounded Theory methods (N= …

The Presence Of Methicillin Resistant Staphylococcus Aureus (Mrsa) On Environmental Surfaces In Healthcare Facilities Pre- And Post-Cleaning, Aaron Thomas Hunt

UNLV Theses, Dissertations, Professional Papers, and Capstones

The emergence of antibiotic resistant bacteria is a serious public health issue affecting millions of people. Methicillin-resistant Staphylococcus aureus(MRSA) is a leading cause of healthcare acquired infections today. Research has shown that patients infected or colonized with MRSA shed the bacteria into the environment, where the bacteria can survive for long periods of time and become potential sources of infection. Currently, infection prevention efforts focus on active surveillance, hand hygiene, personal protective equipment use and antimicrobial stewardship, with less attention given to environmental cleaning. Nevertheless, environmental cleaning is essential to remove infectious agents from environmental surfaces and prevent transmission. The …

Food Handling, Hygiene, And Sanitation Practices In The Child-Care Environment In North Carolina And South Carolina, Xi Chen

All Theses

Introduction: Children between the ages of 37 and 54 months enrolled in child-care facilities (CCFs) are reported to be 2.3 to 3.5 times more likely to experience an acute gastrointestinal illness (AGI) than are children cared for in their own home. Identifying potential risk factors for the transmission of enteric pathogens in CCFs is essential to the prevention of AGI.
Methods: A convenience sample of CCFs in North Carolina and South Carolina was recruited to participate in this study. A survey was administered to all CCF directors to collect information about facility characteristics, meal preparation, staff training, hygiene policies and …

Public Health Aspects Of The Daugherty Water For Food Institute Strategic Plan, Eleanor G. Rogan, Bruce Grogan, Terry Huang, Alan Kolok, Risto Rautiainen, Oscar Araz, Christopher Fisher, Andrew Jameton, Ashish Joshi, Sharon Meaker-Medcalf, Jim P. Stimpson, Melissa Tibbits

Reports: College of Public Health

The University of Nebraska College of Public Health is committed to contributing to the research, service and education programs of the Daugherty Water for Food Institute. The College can offer a wide variety of expertise that can contribute to programs related to water, food and health. This document has been written to highlight the areas in which College faculty have particular interests, knowledge and experience to contribute.

Biopiracy And Vaccines: Indonesia And The World Health Organization's New Pandemic Influenza Plan, Shawn Smallman

International & Global Studies Faculty Publications and Presentations

Viral samples of avian influenza are essential to preparing pre-pandemic vaccines. In 2007, the conflicting interests of the developed and developing nations led Indonesia to briefly stop sharing viral samples. The result was a struggle in which the two blocs argued for different paradigms for viral sample sharing. The first paradigm, articulated by the developed world, depicted the issue as one of health security, in which international law mandated the sharing of viral samples. The second paradigm, advanced by the developing world, depicted viral sample sharing as a form of biopiracy, which violated countries' sovereign control of their biological resources. …

Identifikasi Vektor Malaria, Solikhah Solikhah

Kesmas

Kabupaten Kulonprogo merupakan salah satu daerah endemis malaria di Daerah Istimewa Yogyakarta dan Jawa Tengah. Lonjakan jumlah kasus malaria terjadi hampir dua kali lipat sejak tahun 2010 hingga bulan Agustus 2011. Penelitian ini bertujuan untuk mengetahui jenis Plasmodium pada penyakit malaria. Penelitian eksplorasi ini menggunakan desain studi cross sectional. Diagnosis kasus malaria diperiksa menggunakan pemeriksaan darah tebal secara mikroskopis dan untuk mengetahui faktor sosiodemografi dilakukan wawancara menggunakan kuesioner. Populasi studi adalah penduduk di wilayah Kabupaten Kulonprogo yang diambil secara proporsional pada bulan Januari sampai bulan Juni 2012. Data dianalisis secara univariat dalam bentuk grafik dan tabulasi. Hasil penelitian ini adalah …

Deskripsi Sanitasi Lingkungan, Perilaku Ibu, Dan Kesehatan Anak, Kasnodihardjo Kasnodihardjo, Elsa Elsi

Kesmas

Pada tahun 2009, dilakukan penelitian deskriptif di Kecamatan Jatibarang dan Kecamatan Kedokan Bunder untuk mengetahui faktor-faktor sanitasi lingkungan, dan perilaku ibu-ibu dan kejadian penyakit infeksi pada bayi dan anak. Data dikumpulkan menggunakan kuesioner dengan responden ibu rumah tangga yang mempunyai bayi/ anak balita berjumlah 401 orang. Penyakit diare pada bayi/anak disebabkan oleh media tercemar yang masuk ke sistem pencernaan melalui sumber air untuk minum maupun mandi, cuci, kakus (MCK) yang bukan berasal dari ledeng, keluarga yang tidak mempunyai jamban, ibu yang masih jarang mencuci tangan setelah membersihkan kotoran bayi ataupun setelah buang air besar, meminum dan memakan makanan yang tidak …

Public Health Roi: Evidence, Experience And Remaining Questions, Glen P. Mays

Health Management and Policy Presentations

Expanding the delivery of efficacious public health and prevention strategies holds considerable potential for improving health outcomes and constraining costs across the U.S. health system. Unfortunately, lingering certainties about the costs required to expand public health delivery systems and about the health and economic effects of such expansions has muted private and public support for increased public health expenditures. This lecture examines recent evidence from public health services and systems research studies that examine the health and economic value of public health delivery, and identifies remaining research needs for the field.

[Sabbatical Report], Emmanuel Iyiegbuniwe

Sabbatical Reports

The main purpose of this sabbatical leave was to provide me the opportunity to conduct relevant research and subsequently write two book chapters on environmental health and policy issues in two countries: Belize (a developing country) and Canada (a developed country). Specifically, the two book chapters were titled "Analysis of Environmental Health Policy in Belize" and "Analysis of Environmental Health and Policy Issues in Canada." As called for in my proposal, I was able to travel to Belize with a group of CHHS faculty and students during the 2013 winter term. During the leave period, I success fully conducted research …

Transport And Health: A Look At Three Latin American Cities, Janeth Mosquera Becerra, Rodrigo S. Reis, Lawrence D. Frank, Farah A. Ramirez-Marrero, Benjamin Welle, Eugenio Arriaga Cordero, Fabian Mendez Paz, Carlos J. Crespo, Veronica Dujon, Enrique Jacoby, Jennifer Dill, Lynn Weigand, Carlos M. Padin

Community Health Faculty Publications and Presentations

Transport is associated with environmental problems, economic losses, health and social inequalities. A number of European and US cities have implemented initiatives to promote multimodal modes of transport. In Latin America changes are occurring in public transport systems and a number of projects aimed at stimulating non-motorized modes of transport (walking and cycling) have already been implemented. Based on articles from peer-reviewed academic journals, this paper examines experiences in Bogota (Colombia), Curitiba (Brazil), and Santiago (Chile), and identifies how changes to the transport system contribute to encourage active transportation. Bus rapid transit, ciclovias, bike paths/lanes, and car use restriction are …

The Impact Of The Chinese Rural Healthcare System On Infectious Disease: A Study Of The History And Reform Of Chinese Healthcare, And The Global Implications Of Infectious Disease Control In China, John Barbadoro

Independent Study Project (ISP) Collection

China’s healthcare system has gone through significant changes in the 20^th and 21^st centuries. These changes have mirrored not only the political focus of the time, but also the social issues facing China. The NRCMCS for rural residents is a cheap annual fee that covers a percentage of medical costs. There are two urban equivalents, the BMIUE and BMIUR for urban employees through their job, and residency respectively. Despite the focus on cheaper healthcare for rural residents, the problems of income inequality and mistrust in the medical system are major problems that affect the health of this large …

A Passion For Saving Lives: The Motivation Of Surgically Trained Healthcare Professionals In Mozambique, Sofia Cadime

Inquiry Journal 2013

No abstract provided.

The Influences Of Climatic And Socioeconomic Variables On Cholera Incidence In India During The Seventh Pandemic, 1961-2008, Kathleen M. Henschel

Master of Public Health Program Student Publications

Background: Cholera outbreaks result in significant morbidity worldwide. Transmission of the disease may be influenced by weather fluctuations, such as El Niño-Southern Oscillation (ENSO) and excessive rainfall, and socioeconomic status (SES), including income and education. El Niño events may influence many aspects of the climate, including the amount of rainfall occurring in a given year and surface water temperature. This study aimed to assess the influences of extreme weather and SES factors on cholera incidence in India during the seventh cholera pandemic (1961-2008).

Methods: Data for all variables were obtained for 1961-2008. Indian population estimates and cholera incidence (IR) were …