Digital Commons Network^™

Tackling The Global Ncd Crisis: Innovations In Law And Governance, Bryan P. Thomas, Lawrence O. Gostin

Georgetown Law Faculty Publications and Other Works

35 million people die annually of non-communicable diseases (NCDs), 80% of them in low- and middle-income countries—representing a marked epidemiological transition from infectious to chronic diseases and from richer to poorer countries. The total number of NCDs is projected to rise by 17% over the coming decade, absent significant interventions. The NCD epidemic poses unique governance challenges: the causes are multifactorial, the affected populations diffuse, and effective responses require sustained multi-sectorial cooperation. The authors propose a range of regulatory options available at the domestic level, including stricter food labeling laws, regulation of food advertisements, tax incentives for healthy lifestyle choices, …

Rediscovering The Core Of Public Health, Steven Teutsch, Jonathan E. Fielding

Frontiers in Public Health Services and Systems Research

The success of public health has been its ability to understand contemporary health problems, to communicate the needs successfully, to identify solutions, and to implement them through programs and policies. In the past 50 years, those successes can be attributed largely to control of infectious disease, improved maternal and child health, delivery of other personal health care services, and changes in behaviors, particularly smoking. Yet health is primarily a product of our social, cultural, and physical environments. To continue to improve the nation’s health and reduce disparities, public health needs to return to its historical roots and engage with other …

Type Ii Diabetes And Dietary Preferences In A Rapidly Urbanizing Region Of West Africa, Megan Doherty

Master of Public Health Capstone Presentations

This study aims to identify themes in food preferences, knowledge, attitudes and behaviors (KAB) among a mix of rural and urban Ghanaians in the greater Kumasi region; to inform health interventions targeting better patient management of type II diabetes in a rapidly urbanizing region of Ghana; and to inform social marketing strategies by providing insight into consumption patterns. Urban centers in Sub-Saharan Africa have been especially impacted by the persistence of infectious disease and accompanying rise in non-communicable disease prevalence, including type II diabetes. In fact, type II diabetes recently registered as tenth among top causes of death in Kumasi, …

Sweet Freedom: Smokers’ Rights & The Rebranding Of Philip Morris, Amy Dipierro

Annual Undergraduate Conference on Health and Society

This paper discusses how Philip Morris invoked strong American values to defend its own corporate speech as well as “smoker’s rights.” In particular, it examines Philip Morris Company’s Bill of Rights advertising campaign of the early 1990s, especially focusing on an advertisement featuring Everett Alvarez, a prisoner of war during Vietnam. This strategy reveals how Philip Morris was able to manipulate the public conversation about smoking from one about health and disease to one about human rights and freedoms.

Pit Latrines And Their Impacts On Groundwater Quality: A Systematic Review, Jay P. Graham, Matthew L. Polizzotto

Environmental and Occupational Health Faculty Publications

Background: Pit latrines are one of the most common human excreta disposal systems in low-income countries, and their use is on the rise as countries aim to meet the sanitation-related target of the Millennium Development Goals. There is concern, however, that discharges of chemical and microbial contaminants from pit latrines to groundwater may negatively affect human health.

Objectives: Our goals were to a) calculate global pit latrine coverage, b) systematically review empirical studies of the impacts of pit latrines on groundwater quality, c) evaluate latrine siting standards, and d) identify knowledge gaps regarding the potential for …

Aids: An Overview, Loretta Mclaughlin

New England Journal of Public Policy

"We stand nakedly in front of a very serious pandemic, as mortal as any pandemic there ever has been," said Halfdan Mahler, director-general of the World Health Organization (WHO). "I don't know of any greater killer than AIDS, not to speak of its psychological, social and economic maiming. Everything is getting worse and worse with AIDS and all of us have been underestimating it, and I in particular. We're running scared. I cannot imagine a worse health problem in this century." When asked to compare AIDS to other epidemics, such as smallpox, that have infected and killed over the course …

A Global Health Framework Based On Competencies And Learning Opportunities In Graduate Health Education, Robert Simmons, Drph, Mph, Mches, Cph, James D. Plumb, Md, Mph

College of Population Health Lectures, Presentations, Workshops

Poster covers:

• What is Global Health?
• The Changing Global Landscape
• Why Invest in Global Health Education?
• Growth of Global Health Education Programs
• What is Covered in Graduate Education?
• Future Challenges and Opportunities

Building The Science Of Public Health Delivery: Advances In Public Health Services And Systems Research, Glen P. Mays

Health Management and Policy Presentations

Efforts to improve the health and economic performance of the U.S. health system require evidence about how best to deliver public health strategies that protect health and prevent disease and injury on a population-wide basis. The field of public health services and systems research is building a "science of delivery" in public health that complements the evidence-based practice movement in medical care.

The Last Page: The Other Sars Epidemic, John Hughes

Colby Magazine

In the weeks before I left for my job teaching English in Wuhan, in central China’s Hubei province, I worried about whether I would be a good teacher, how I would cope with spicy Sichuan cuisine every day and even whether Chinese girls would like me. I didn’t, however, give a thought to the possibility that a deadly disease—and the even more invasive rumors that accompanied it—would consume my life so fully that, in the end, I would count masks as I walked down the street, trying to time my breathing so I exhaled as I passed large groups of …

Foodborne Urinary Tract Infections: A New Paradigm For Antimicrobial-Resistant Foodborne Illness, Lora Nordstrom, Cindy M. Liu, Lance B. Price

Environmental and Occupational Health Faculty Publications

Urinary tract infections (UTIs) are among the most common bacterial infections worldwide. Disproportionately affecting women, UTIs exact a substantial public burden each year in terms of direct medical expenses, decreased quality of life, and lost productivity. Increasing antimicrobial resistance among strains of extraintestinal pathogenic Escherichia colichallenges successful treatment of UTIs. Community-acquired UTIs were long considered sporadic infections, typically caused by the patients’ native gastrointestinal microbiota; however, the recent recognition of UTI outbreaks with probable foodborne origins has shifted our understanding of UTI epidemiology. Along with this paradigm shift come new opportunities to disrupt the infection process and possibly quell …

First Steps Phase I Initiative: Improving Immunizations For Children And Adolescents, Kimberley S. Fox Mpa, Carolyn E. Gray Mph

Population Health & Health Policy

This evalution report, authored by research staff at the USM Muskie School, assesses the change in immunization rates in participating pediatric and family practices that serve a high volume of children insured by MaineCare (Maine's Medicaid system). The authors also summarize lessons learned in implementing changes in practices and challenges in using the immunization measures at the practice-level to inform quality improvement.

Kondisi Sanitasi Lingkungan Perumahan Dan Kontaminasi Escherichia Coli Pada Penyajian Makanan Pendamping Air Susu Ibu Lokal, Aria Kusuma, Haryoto Kusnoputranto, I Made Djaja, Rizal Syarief

Kesmas

Bayi sangat rentan terhadap penyakit yang disebabkan oleh Makanan Pendamping Air Susu Ibu lokal (MP-ASI lokal). Sampai saat ini belum diketahui keamanan penyajiannya dari kontaminasi mikrobiologi. Penelitian ini bertujuan mengetahui kontaminasi Escherichia coli (E. coli) pada penyajian MP-ASI lokal dan mengamati hubungan antara kondisi sanitasi rumah, seperti Sarana Air Bersih (SAB), tempat mencuci peralatan makan bayi, kondisi Saluran Pembuangan Air Limbah (S PAL), kondisi tempat sampah dan keberadaan hewan berkeliaran di dalam rumah terhadap kontaminasi E. coli pada penyajian. Desain penelitian ini adalah potong lintang yang mengamati penyajian MP-ASI lokal bagi bayi usia 6-12 bulan pada 138 rumah. Lokasi penelitian …

Evidence-Based Decision Making To Improve Public Health Practice, Ross C. Brownson, Jonathan E. Fielding, Christopher M. Maylahn

Frontiers in Public Health Services and Systems Research

Despite the many accomplishments of public health, greater attention on evidence-based approaches is warranted. This article reviews the concepts of evidence-based public health (EBPH), on which formal discourse originated about 15 years ago. Key components of EBPH include: making decisions based on the best available scientific evidence, using data and information systems systematically, applying program planning frameworks, engaging the community in decision making, conducting sound evaluation, and disseminating what is learned. Core competencies for EBPH are emerging, including not only technical skills but also attention to administrative practices in public health agencies. To better bridge evidence and practice, the concepts …

Progress Realized: Trends In Hiv-1 Viral Load And Cd4 Cell Count In A Tertiary-Care Center From 1999 Through 2011, Howard B. Gale, Manuel D. Rodriguez, Heather J. Hoffman, Debra A. Benator, Fred M. Gordin, Ann M. Labriola, Virginia L. Kan

Epidemiology Faculty Publications

Abstract

Accumulating evidence suggests that alterations in immune function may be important in the etiology of papillary thyroid cancer (PTC). To identify genetic markers in immune-related pathways, we evaluated 3,985 tag single nucleotide polymorphisms (SNPs) in 230 candidate gene regions (adhesion-extravasation-migration, arachidonic acid metabolism/eicosanoid signaling, complement and coagulation cascade, cytokine signaling, innate pathogen detection and antimicrobials, leukocyte signaling, TNF/NF-kB pathway or other) in a case-control study of 344 PTC cases and 452 controls. We used logistic regression models to estimate odds ratios (OR) and calculate one degree of freedom P values of linear trend (PSNP-trend) for the association …

Impact Of The Tohoku Earthquake And Tsunami On Pneumonia Hospitalisations And Mortality Among Adults In Northern Miyagi, Japan: A Multicentre Observational Study, Hisayoshi Daito, Motoi Suzuki, Jun Shiihara, Paul E. Kilgore, Hitoshi Ohtomo, Konosuke Morimoto, Masayuki Ishida, Taro Kamigaki, Hitoshi Oshitani, Masahiro Hashizume, Wataru Endo, Koichi Hagiwara, Koya Ariyoshi, Shoji Okinaga

Department of Pharmacy Practice

Background On 11 March 2011, the Tohoku earthquake and tsunami struck off the coast of northeastern Japan. Within 3 weeks, an increased number of pneumonia admissions and deaths occurred in local hospitals.

Methods A multicentre survey was conducted at three hospitals in Kesennuma City (population 74000), northern Miyagi Prefecture. All adults aged ≥18 years hospitalised between March 2010 and June 2011 with community-acquired pneumonia were identified using hospital databases and medical records. Segmented regression analyses were used to quantify changes in the incidence of pneumonia.

Results A total of 550 pneumonia hospitalisations were identified, including 325 during the pre-disaster period …

Public Health Delivery Systems And Population Health: What We Know And Need To Learn, 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.

Latitudinal Variations In Seasonal Activity Of Influenza And Respiratory Syncytial Virus (Rsv): A Global Comparative Review, Kimberly Bloom-Feshbach, Wladimir J. Alonso, Vivek Charu, James Tamerius, Lone Simonsen, Mark A. Miller, Cecile Viboud

Global Health Faculty Publications

Background

There is limited information on influenza and respiratory syncytial virus (RSV) seasonal patterns in tropical areas, although there is renewed interest in understanding the seasonal drivers of respiratory viruses.

Methods

We review geographic variations in seasonality of laboratory-confirmed influenza and RSV epidemics in 137 global locations based on literature review and electronic sources. We assessed peak timing and epidemic duration and explored their association with geography and study settings. We fitted time series model to weekly national data available from the WHO influenza surveillance system (FluNet) to further characterize seasonal parameters.

Results

Influenza and RSV activity consistently peaked during …

Faktor Risiko Diare Shigellosis Pada Anak Balita, A. Zulkifli Abdullah, A. Arsunan Arsin, Lidyawati Dahlan

Kesmas

Diare shigellosis pada balita merupakan masalah serius sebab dapat menyebabkan kematian. Untuk mengetahui faktor-faktor risiko kejadian shigellosis pada anak balita dilakukan studi kasus kontrol di beberapa rumah sakit di Kota Makassar dengan 68 kasus dan 136 kontrol. Data mengenai jenis kelamin dan status gizi anak balita, pemberian air susu ibu (ASI) eksklusif, status ekonomi, pendidikan ibu, kebiasaan ibu mencuci tangan memakai sabun, kepadatan hunian rumah, sarana air bersih, danjamban keluarga dikumpulkan dengan wawancara dan observasi serta dikategorikan dan disaring (screening) dengan uji chi square. Enam variabel dengan nilai p < 0,25 dimasukkan dalam uji regresi logistik yang menghasilkan variabel dengan nilai p < 0,05 (gizi rendah, ASI tidak eksklusif, dan status ekonomi rendah). Uji regresi logistik tahap kedua dengan 3 variabel ini menghasilkan model shigellosis = 1,47 gizi rendah + 1,471 ASI tidak eksklusif + 1,022 status ekonomi rendah - 2,546 dengan nilai oddsratio (OR) = 4,352 (gizi rendah), 4,353 (ASI tidak eksklusif), dan 2,779 (status ekonomi rendah). Studi ini menyimpulkan bahwa gizi balita yang rendah, pemberian ASI yang tidak eksklusif, dan status ekonomi ibu yang rendah merupakan faktor-faktor risiko penting kejadian diare shigellosis pada balita.

Shigellosis diarrhea is a serious issue to children under five years …

Changes In Natural Killer Cell Activation And Function During Primary Hiv-1 Infection, Vivek Naranbhai, Marcus Altfeld, Salim S. Abdool Karim, Thumbi Ndung’U, Quarraisha Abdool Karim, William H. Carr

Publications and Research

Background: Recent reports suggest that Natural Killer (NK) cells may modulate pathogenesis of primary HIV-1 infection. However, HIV dysregulates NK-cell responses. We dissected this bi-directional relationship to understand how HIV impacts NK-cell responses during primary HIV-1 infection.

Methodology/Principal Findings: Paired samples from 41 high-risk, initially HIV-uninfected CAPRISA004 participants were analysed prior to HIV acquisition, and during viraemic primary HIV-1 infection. At the time of sampling post-infection five women were seronegative, 11 women were serodiscordant, and 25 women were seropositive by HIV-1 rapid immunoassay. Flow cytometry was used to measure NK and T-cell activation, NK-cell receptor expression, cytotoxic and cytokine-secretory functions, …

2012 Southern Nevada Existing Conditions Report, Southern Nevada Regional Planning Coaltion, Lincy Institute, Unlv Urban Sustainability Initiative, Unlv School Of Community Health Sciences, Jennifer Pharr Phd, Courtney Coughenour

Lincy Institute Reports and Briefs

No abstract provided.

Prevalence Of Antibiotic-Resistant E. Coli In Retail Chicken: Comparing Conventional, Organic, Kosher, And Raised Without Antibiotics, Jack M. Millman, Kara Waits, Heidi Grande, Ann R. Marks, Jane C. Marks, Lance B. Price, Bruce A. Hungate

Environmental and Occupational Health Faculty Publications

Retail poultry products are known sources of antibiotic-resistant Escherichia coli, a major human health concern. Consumers have a range of choices for poultry, including conventional, organic, kosher, and raised without antibiotics (RWA) – designations that are perceived to indicate differences in quality and safety. However, whether these categories vary in the frequency of contamination with antibiotic-resistant E. coli is unknown. We examined the occurrence of antibiotic-resistant E. coli on raw chicken marketed as conventional, organic, kosher and RWA. From April – June 2012, we purchased 213 samples of raw chicken from 15 locations in the New York City metropolitan …

Modeling The Impact And Costs Of Semiannual Mass Drug Administration For Accelerated Elimination Of Lymphatic Filariasis, Wilma A. Stolk, Quirine A. Ten Bosch, Sake J. De Vlas, Peter U. Fischer, Gary J. Weil, Ann S. Goldman

Epidemiology Faculty Publications

The Global Program to Eliminate Lymphatic Filariasis (LF) has a target date of 2020. This program is progressing well in many countries. However, progress has been slow in some countries, and others have not yet started their mass drug administration (MDA) programs. Acceleration is needed. We studied how increasing MDA frequency from once to twice per year would affect program duration and costs by using computer simulation modeling and cost projections. We used the LYMFASIM simulation model to estimate how many annual or semiannual MDA rounds would be required to eliminate LF for Indian and West African scenarios with varied …

Enhancing Communication Between Scientists, Government Officials, And The Lay Public: Advancing Science And Protecting The Public's Welfare Through Better Multi-Stakeholder Interfacing, Clark J. Lee, Patrick P. Rose, Earl Stoddard Iii

Homeland Security Publications

No abstract provided.

Air Force Demographics Of Sexually Transmitted Infections 2007 To 2012, Daniel R. Shea

Master of Public Health Program Student Publications

In the United States there is a significant gap between Sexually Transmitted Infection (STI) rates of Caucasians and African Americans. This disparity is attributed to many causes including access to health care, socioeconomic status, and social dynamics. The objective of this research is to describe the racial demographics of STI infections in the Air Force and explore possible disparities based on military pay grades. The military enforces many of the recommendations on how to limit STI health disparities by offering easy access to free health care and mandatory regular checkups. Despite these policies, the data reveals significant disparities based on …

Patent Landscape Of Helminth Vaccines And Related Technologies, Jon R. Cavicchi, Stanley P. Kowalski, John Schroeder, Rayna Burke, Jillian Michaud-King

Law Faculty Scholarship

Executive Summary This report focuses on patent landscape analysis of technologies related to vaccines targeting parasitic worms, also known as helminths. These technologies include methods of formulating vaccines, methods of producing of subunits, the composition of complete vaccines, and other technologies that have the potential to aid in a global response to this pathogen. The purpose of this patent landscape study was to search, identify, and categorize patent documents that are relevant to the development of vaccines that can efficiently promote the development of protective immunity against helminths. The search strategy used keywords which the team felt would be general …

Critical Analysis Of Contemporary Public Health Genomics And Needs Assessment For Public Health Genomics Course Curriculum, Kim London

Master of Public Health Program Student Publications

Objective: To analyze the need for increased content on genomics in Public Health (PH) academic curriculum.

Methods: A literature synthesis was performed of various genetic science studies. Results were assessed with regard to the number and type of genomic studies published, cost to perform genetic analyses, health care provider and the public’s use and understanding of genetic testing capabilities. A search was conducted and assessment performed of public health genomics curriculum at accredited public health educational programs.

Results: The cost to sequence a single genome declined from $10 million in 2007 to under $10 thousand in 2012. This cost reduction …

What Are Parents' Perceptions On Immunizations Causing Autism Spectrum Disorders?, Shanae Nicole Blake

Theses Digitization Project

The purpose of this study was to identify parental perceptions on immunizations causing Autism Spectrum Disorders (ASDs), and identify whether or not these perceptions influenced whether or not a parent vaccinated their child. If parents are educated on vaccinations, and understand that numerous studies have been conducted proving immunizations do not cause autism, it may prevent a host of possible problems that may arise in the future.

Molecular Epidemiology Of Early And Acute Hiv Type 1 Infections In The United States Navy And Marine Corps, 2005–2010, Richard A. Heipertz, Eric Sanders-Buell, Gustavo Kijak, Shana Howell, Michelle Lazzaro, Linda L. Jagodzinski, John Eggleston, Sheila Peel, Jennifer Malia, Adam Armstrong, Nelson L. Michael, Jerome H. Kim, Robert J. O'Connell, Paul T. Scott, David Brett-Major, Sodsai Tovanabutra

Journal Articles: Epidemiology

The U.S. military represents a unique population within the human immunodeficiency virus 1 (HIV-1) pandemic. The last comprehensive study of HIV-1 in members of the U.S. Navy and Marine Corps (Sea Services) was completed in 2000, before large-scale combat operations were taking place. Here, we present molecular characterization of HIV-1 from 40 Sea Services personnel who were identified during their seroconversion window and initially classified as HIV-1 negative during screening. Protease/reverse transcriptase (pro/rt) and envelope (env) sequences were obtained from each member of the cohort. Phylogenetic analyses were carried out on these regions to determine relatedness within the cohort and …

Combating Sti Epidemic: Community Perspectives Learned From Mixed-Gender Focus Group Study, K. M. M. Islam, Laura C. Vinson, Sherri Nared, Ira Combs, Melissa Tibbits, Shinobu Watanabe-Galloway, Ruth Margalit

Journal Articles: Epidemiology

Background. Since 2004, Douglas County in Nebraska has been experiencing higher rates of sexually transmitted infections (STIs) than the rest of the state. Northern Omaha has been considered to be one of the “hot spots” for STIs in the county. In 2011-2012, a focus group study was conducted to investigate the community’s perception of STIs and to identify strategies to increase the testing and treatment of STIs. Methods. Fourteen young adults were recruited to participate in two mixed-gender focus group sessions, each lasting 1.5 hours. Sessions covered various topics on STIs. Audio-recorded sessions were transcribed and analyzed by …

Documentation Of Hiv Prevention Research And Programmatic Learnings From India—Selected Peer-Reviewed Journal Publications From The Knowledge Network Project (Volume 1), Population Council

HIV and AIDS

Over the past decade (2000–11), India has achieved dramatic successes in reversing the HIV epidemic. These successes are largely due to the implementation of upscaled HIV-prevention interventions by the National AIDS Control Organization, two other donors, and nongovernmental organizations, under the National AIDS Control Program III. As the epidemic in India is concentrated in vulnerable subpopulations, these interventions were focused on high-risk groups. It is important to understand the lessons learned from the implementation of HIV-prevention programs and the vulnerabilities that need to be addressed to reach the goal of zero new infections. To support this understanding, the Population Council …