Digital Commons Network^™

Medical Response For Terrorist And Public Health Threats: One Region's Experience (Pittsburgh), Eileen Salinsky, Lisa Sprague

National Health Policy Forum

This site visit, planned and convened in conjunction with the Agency for Healthcare Research and Quality’s User Liaison Program, examined the efforts underway in the greater Pittsburgh area to develop emergency medical response capabilities for mass causality events. The site visit explored efforts to improve infectious disease surveillance capabilities and looked at the Region 13 collaborative’s development of a regionalized approach to emergency management planning and response. Hospital preparedness activities were also studied, including a discussion of lessons learned from a recent drill to test response to a radiological event and an exploration of conceptual frameworks to guide hospital planning …

The Relationship Between Health Status And Hope In Individuals With Hiv Disease, Celine Meera Chohan

All-Inclusive List of Electronic Theses and Dissertations

This study examined the relationship between hope and health status over a two-year period in individuals who were HIV -infected. One hundred and three individuals completed the surveys at entry into the study, at 12 months, and at 24 months. The Health Status Questionnaire (Wu et.al., 1991) measured Cognitive Functioning, Emotional Functioning, and Physical Functioning. Additionally, the Hope Scale (Snyder, 1991) and the Client Information Form were used to collect data. Results suggested hope at entry into the study was a significant predictor of physical functioning initially, at 12 months, and at 24 months. This finding suggests a link between …

The Benefits Of Breastfeeding: An Introduction For Health Educators, Sheila G. J. Clark, Timothy J. Bungum

Environmental & Global Health Faculty Research

Currently 16% of Americans breastfeed their children for at least 12 months as recommended by the AAP, which is well below the HP 2010 goal of 25%. Breastfed infants receive benefits that can improve their health throughout their lives. The benefits of breastfeeding for children include increased resistance to infectious diseases, such as gastroenteritis, respiratory tract infections, and ear infections. Breastfed children also display lower rates of chronic diseases including diabetes, obesity, asthma, and leukemia. The choice to breastfeed results in economic benefits from lower health care costs and from reduced spending on infant formula. The Healthy People 2010 targets …

Obesity In America: A Growing Threat, Eileen Salinsky, Wakina Scott

National Health Policy Forum

This background paper seeks to clarify the nature and causes of the obesity epidemic in the United States and provides an overview of the associated economic and health costs. The paper summarizes existing federal programs and policies that address obesity and examines new and emerging policy strategies to battle the bulging American silhouette. Topics explored include population-based prevention, federal food- and nutrition-assistance programs, Medicare and Medicaid payment policies, school health initiatives, and publicly funded biomedical research.

Temporal Stability And Geographic Variation In Cumulative Case Fatality Rates And Average Doubling Times Of Sars Epidemics, Alison P. Galvani, Xiudong Lei, Nicholas P. Jewell

U.C. Berkeley Division of Biostatistics Working Paper Series

We analyze temporal stability and geographic trends in cumulative case fatality rates and average doubling times of severe acute respiratory syndrome (SARS). In part, we account for correlations between case fatality rates and doubling times through differences in control measures. We discuss factors that may alter future estimates of case fatality rates. We also discuss reasons for heterogeneity in doubling times among countries and the implications for the control of SARS in different countries and parameterization of epidemic models.

Patterns Of Cocaine Consumption: A Sub-Analysis Of The Drugnet Survey, Nivedita Seerpi

Masters Theses & Specialist Projects

The myths and misconceptions that surround cocaine use lead to the over-estimation of the prevalence of cocaine addiction in society. Health education curricula and drug policy do not differentiate between cocaine use and abuse. This study describes the cocaine consumption patterns in a nonclinical, non-incarcerated sample of cocaine users. The resulting patterns are compared to those found by Cohen (1989) and Cohen and Sas (1993, 1994, 1995). DRUGNET is an online survey of recreational drug use by nondeviant adults via the WWW. Self-selected subjects completed a survey over the Internet between February and October 1997 (N= 701). This sample was …

Association Of Borrelia Garinii And B. Valaisiana With Songbirds In Slovakia, Klara Hanincova, Veronika Taragelova, Juraj Koci, Stefanie M. Schafer, Rosie Hails, Amy J. Ullmann, Joseph Piesman, Milan Labuda, Klaus Kurtenbach

United States Public Health Resources

In Europe, 6 of the 11 genospecies of Borrelia burgdorferi sensu lato are prevalent in questing Ixodes ricinus ticks. In most parts of Central Europe, B. afzelii, B. garinii, and B. valaisiana are the most frequent species, whereas B. burgdorferi sensu stricto, B. bissettii, and B. lusitaniae are rare. Previously, it has been shown that B. afzelii is associated with European rodents. Therefore, the aim of this study was to identify reservoir hosts of B. garinii and B. valaisiana in Slovakia. Songbirds were captured in a woodland near Bratislava and investigated for engorged ticks. Questing I. ricinus ticks …

Application Of The Traditional Epidemiological Model To Predict Occupational Injury Rates In Manufacturing Industries, Gary A. Morris

Health Services Research Dissertations

This study was designed to test the usefulness of the Traditional Epidemiological Model of disease causation in modeling occupational injury rates and the presence of occupational illness in the manufacturing industry. More specifically, this research involved use of the agent, host, and environment constructs of the Traditional Epidemiological Model to examine the effects of five environmental-related workplace health and safety practices on occupational injury and illness. Data from the National Occupational Exposure Survey (NOES), conducted by the National Institute for Occupational Safety and Health (NIOSH) in 1981–1983, were used to ascertain the presence of specific workplace characteristics and to calculate …

Population Mobility High-Risk Environments And The Diffusion Of Hiv/Stds: A Community Based Study In Southwest China, Hongyun Fu

Sociology & Criminal Justice Theses & Dissertations

Globally, population migration has been associated with the spread ofHIV/STDs in many countries. A similar trend has been observed in China from the very beginning of the HIV epidemic, but empirical research is very limited. Furthermore, the previous studies mainly focused on the micro impact of migration on individual migrant's risky behaviors. The impact of population mobility on the general population, especially on non-migrant residents, has been ignored. Using data collected from a specially designed community level survey, which was conducted in a province in the Southwest of China, this study examines the macro-level association between temporary migration and the …

Transmission Of Mycobacterium Tuberculosis Associated With Failed Completion Of Treatment For Latent Tuberculosis Infection - Chickasaw County, Mississippi, June 1999-March 2002, T. Chamblee, D. Hartley, M. Holcombe, K. Parham, P. Upchurch, R. M. Webb, Alyssa G. Robillard, L. Diem, B. Metchock, N. Deluca, P. D. Mcelroy, T. Navin, W. Walton, P. K. Dewan

Faculty Publications

During June 1999-March 2002, a total of 16 tuberculosis (TB) cases were reported from Chickasaw County, Mississippi (2000 population: 19,440), corresponding to annual TB incidences of 20.5-27.6 cases per 100,000 population. In comparison, annual TB incidences for Mississippi during the same period decreased from 7.8 to 5.4 cases per 100,000 population. This report summarizes the results of an investigation of the patients and their contacts and demonstrates the need for strategies to increase the proportion of infection contacts that successfully complete treatment for latent TB infection (LTBI).

Persistence Of Virus-Reactive Serum Immunoglobulin M Antibody In Confirmed West Nile Virus Encephalitis Cases, John T. Roehrig, Denis Nash, Beth Maldin, Anne Labowitz, Denise A. Martin, Robert S. Lanciotti, Grant L. Campbell

Publications and Research

Twenty-nine laboratory-confirmed West Nile virus (WNV) encephalitis patients were bled serially so that WNV-reactive immunoglobulin (Ig) M activity could be determined. Of those patients bled, 7 (60%) of 12 had anti-WNV IgM at approximately 500 days after onset. Clinicians should be cautious when interpreting serologic results from early season WNV IgM-positive patients.

Introduction Of A Waterless Alcohol-Based Hand Rub In A Long-Term Care Facility, Lona Mody, Mcneil A. Shelly, Rongjun Sun, Bradley Suzanne, Carol A. Kauffman

Sociology & Criminology Faculty Publications

OBJECTIVE:

To examine the impact of introduction of an alcohol-based hand rub on hand hygiene knowledge and compliance and hand colonization of healthcare workers (HCWs) in a long-term-care facility (LTCF).

METHODS:

Two floors of an LTCF participated. Ward A used the hand rub as an adjunct to soap and water; ward B was the control. HCWs' hands were cultured using the bag-broth technique for Staphylococcus aureus, gram-negative bacilli (GNB), Candida, and vancomycin-resistant enterococci (VRE). HCWs completed a questionnaire at baseline and after an educational intervention and introduction of rub.

RESULTS:

Hand hygiene practices, knowledge, and opinions did not change after …

A Preliminary Linkage Map Of The Hard Tick, Ixodes Scapularis, A. J. Ullmann, J. Piesman, M. C. Dolan, W. C. Black Iv

United States Public Health Resources

Blackwell Publishing Ltd. A linkage map of the Ixodes scapularis genome was constructed, based upon segregation amongst 127 loci. These included 84 random amplified polymorphic DNA (RAPD) markers, 32 Sequence-Tagged RAPD (STAR) markers, 5 cDNAs, and 5 microsatellites in 232 F₁ intercross progeny from a single, field-collected P₁ female. A preliminary linkage map of 616 cM was generated across 14 linkage groups with one marker every 10.8 cM. Assuming a genome size of ~ 10 ⁹ bp, the relationship of physical to genetic distance was found to be ~ 300 kb/cM in the I. scapularis genome.

Absence Of Interferon-Γ–Inducible Gene Igtp Does Not Significantly Alter The Development Of Chagasic Cardiomyopathy In Mice Infected With Trypanosoma Cruzi (Brazil Strain), A. P. De Souza, B. Tang, H. B. Tanowitz, S. M. Factor, V. Shtutin, J. Shirani, G. A. Taylor, L. M. Weiss, L. A. Jelicks

United States Public Health Resources

Interferon-γ (IFN-γ) contributes to host resistance during acute infection with Trypanosoma cruzi, the causative agent of Chagas’ disease. Inducibly expressed guanosine triphosphatase (IGTP), a 48-kDa guanosine triphosphatase (GTPase), is a member of a family of GTPase proteins inducibly expressed by IFN-γ. The expression pattern of IGTP suggests that it may mediate IFN-γ–induced responses in a variety of cell types. IGTP has been demonstrated to be important for control of Toxoplasma gondii infection but not for resistance against Listeria monocytogenes. We evaluated the role of IGTP in development of chronic chagasic cardiomyopathy in IGTP null mice and C57X129sv (wild …

Estimated Risk Of Transmission Of The West Nile Virus Through Blood Transfusion In The Us, 2002, Brad J. Biggerstaff, Lyle R. Petersen

United States Public Health Resources

BACKGROUND: The West Nile virus (WNV) epidemic in 2002 in the US saw over 3300 reported human cases of WNV disease, with over 2300 reported cases of WNV encephalitis and meningitis. The first documented cases of transfusion transmission of WNV through voluntary blood donation also occurred.

STUDY DESIGN AND METHODS: Case onset dates from the 2002 WNV epidemic in the US were used to estimate the risk of transfusion-associated transmission with statistical resampling. An easily computed approximating formula for the mean risk was derived. Estimates were computed for six high-incidence states and metropolitan areas.

RESULTS: Mean and …

Racism Or Realpolitik? U.S. Foreign Policy And The Hiv/Aids Catastrophe In Sub-Saharan Africa, David P. Fidler

Articles by Maurer Faculty

No abstract provided.

Population And Development: An Introductory View, Geoffrey Mcnicoll

Poverty, Gender, and Youth

A brief overview of the relationships between population change and economic development, written for readers unfamiliar with the subject. The paper touches on the scale and pace of world development, the economic consequences of population size and rate of growth, patterns of demographic transition, and the scope for policy measures aimed at speeding that transition.

Cancer Mortality Among American Indians And Alaska Natives: Regional Differences, 1994-1998, D.K. Espey, R.E. Paisano, N. Cobb

Native Health Database Full Text

This monograph delineates cancer mortality rates among American Indians and Alaska Native within the different regions served by the Indian Health Service (IHS). The table and charts depict broader geographic regions than in previous IHS cancer mortality monographs. The estimated IHS service population for each region and the cancer mortality rates from 1994 to 1998 are presented. Comparisons are made to the general U.S. population for the same time period. The intention of this publication is to provide detailed information about thew impact of cancer among Native American peoples, with a focus on the regional variability of cancer incidence for …

The Politics Of Public Health: A Response To Epstein, Lawrence O. Gostin, Maxwell Gregg Bloche

Georgetown Law Faculty Publications and Other Works

Conservatives are taking aim at the field of public health, targeting its efforts to understand and control environmental and social causes of disease. Richard Epstein and others contend that these efforts in fact undermine people’s health and well-being by eroding people’s incentives to create economic value. Public health, they argue, should stick to its traditional task—the struggle against infectious diseases. Because markets are not up to the task of controlling the transmission of infectious disease, Epstein says, coercive government action is required. But market incentives, not state action, he asserts, represent our best hope for controlling the chronic illnesses that …

Public Health And National Security In The Global Age: Infectious Diseases, Bioterrorism, And Realpolitik, David P. Fidler

Articles by Maurer Faculty

No abstract provided.

Is It 'Too Bloody Late'? : Older People's Attitudes To Physical Activity And To The Recommendations In The National Physical Activity Guidelines, Joan Jackson

Theses: Doctorates and Masters

Participation in physical activity confers many health benefits by reducing the risk factor for a number of lifestyle related diseases such as diabetes, colon cancer, and heart disease. Other benefits include improved mental and physical well-being. For older people the benefits are even more important; engagement in physical activity extends to such health benefits as reduction in the risk of falls and related potential injuries. However the most significant benefit to older people is that physical activity enables older people to live independently for longer and with a greater sense of well-being. This study explores, through qualitative research, older people's …

U.S. Childhood Vaccine Availability: Legal, Regulatory, And Economic Complexities, Robin J. Strongin

National Health Policy Forum

Despite the vital role they play in public health, childhood vaccines travel a complicated road from laboratory to provider and patient. From the fall of 2000 until well into 2002, a combination of factors, including market dynamics, legal challenges, and regulatory hurdles, led to a shortage of some childhood vaccines. This paper examines each of these factors, focusing on the important roles of both the public and the private sectors.

Laboratory Response To Anthrax Bioterrorism, New York City, 2001, Michael B. Heller, Michel L. Bunning, Martin E.B. France, Debra M. Niemeyer, Leonard Peruski, Tim Naimi, Phillip M. Talboy, Patrick H. Murray, Harald W. Pietz, John Kornblum, William Oleszko, Sara T. Beatrice, Joint Microbiological Rapid Response Team, New York City Anthrax Investigation Working Group, Denis Nash

Publications and Research

In October 2001, the greater New York City Metropolitan Area was the scene of a bioterrorism attack. The scale of the public response to this attack was not foreseen and threatened to overwhelm the Bioterrorism Response Laboratory’s (BTRL) ability to process and test environmental samples. In a joint effort with the Centers for Disease Control and Prevention and the cooperation of the Department of Defense, a massive effort was launched to maintain and sustain the laboratory response and return test results in a timely fashion. This effort was largely successful. The development and expansion of the facility are described, as …

Current Status Data: Review, Recent Developments And Open Problems, Nicholas P. Jewell, Mark J. Van Der Laan

U.C. Berkeley Division of Biostatistics Working Paper Series

Researchers working with survival data are by now adept at handling issues associated with incomplete data, particular those associated with various forms of censoring. An extreme form of interval censoring, known as current status observation, refers to situations where the only available information on a survival random variable T is whether or not T exceeds a random independent monitoring time C. This article contains a brief review of the extensive literature on the analysis of current status data, discussing the implications of response-based sampling on these methods. The majority of the paper introduces some recent extensions of these ideas to …

Clinical And Epidemiological Correlates Of Genotypes Within The Mycobacterium Avium Complex Defined By Restriction And Sequence Analysis Of Hsp65, Sandra C. Smole, Fionnuala Mcaleese, Jutamas Ngampasutadol, C. Fordham Von Reyn, Robert D. Arbeit

Dartmouth Scholarship

Species identification of isolates of the Mycobacterium avium complex (MAC) remains a difficult task. Although M. avium and Mycobacterium intracellulare can be identified with expensive, commercially available probes, many MAC isolates remain unresolved, including those representing Mycobacterium lentiflavum as well as other potentially undefined species. PCR restriction analysis (PRA) of the hsp65 gene has been proposed as a rapid and inexpensive approach. We applied PRA to 278 MAC isolates, including 126 from blood of human immunodeficiency virus (HIV)-infected patients, 59 from sputum of HIV-negative patients with chronic obstructive pulmonary disease, 88 from environmental sources, and 5 pulmonary isolates from …

Building Jefferson's Future, Douglas J. Macmaster Jr., Paul C. Brucker

Thomas Jefferson University Administrative Documents and Reports

2002 Annual report of Thomas Jefferson University.

Will The Nation Be Ready For The Next Bioterrorism Attack? Mending Gaps In The Public Health Infrastructure, Eileen Salinsky

National Health Policy Forum

This paper provides an overview of critical weaknesses in public health preparedness capabilities and discusses policy initiatives to address these shortcomings. It examines developmental needs related to communication and coordination, information systems, laboratories, the development and distribution of vaccines and other countermeasures, emergency medical preparedness and response, and the public health workforce. The paper summarizes the status of federal and state plans to respond to these developmental needs and touches on the challenges likely to emerge as these plans are implemented.

Evaluation Of A Comprehensive Diabetes Disease Management Program: Progress In The Struggle For Sustained Behavior Change, Janice Clarke, Albert Crawford, David B. Nash

College of Population Health Faculty Papers

The successful management of diabetes with a goal of achieving near-normoglycemia requires patients to make multiple lifestyle changes as part of an intensive, complex, and coordinated therapeutic regimen aimed at reducing the risk of complications associated with the disease. The difficulty in creating and sustaining these lifestyle behavior changes is a major stumbling block in achieving the desired therapeutic goal. An underlying assumption of comprehensive disease management is that regular, personal contact with nurses and ancillary health professionals will facilitate these lifestyle behavior changes for program participants. The results of a survey of self-reported data from 750 participants in a …

Public Health Emergency Preparedness: Fundamentals Of The "System", Eileen Salinsky

National Health Policy Forum

This paper examines the existing public health infrastructure, with an emphasis on the resources and activities necessary for public health emergency preparedness and response. It provides a brief historical overview of the evolution of public health and contrasts public health interventions with medicine and health care services. The paper summarizes the broad range of activities that constitute public health practice today and provides a more detailed review of functions and services that are critical to emergency response capabilities. It explores the legal foundation for public health authorities, discussing constitutional, federal, and state public health law. The paper also summarizes how …

Bse: Risk, Uncertainty, And Policy Change, Enda Cummins, Pat Grace, Kevin Mcdonnell, Shane Ward

RISK: Health, Safety & Environment (1990-2002)

The authors discuss how, in our "risk society," a range of potential risks and uncertainties are associated with new technologies and new diseases, such as BSE. These risks bring with them worries about human health, while the ability to assess and manage new health scares is an essential skill for government and related industries.