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The Role And Challenges Of Cluster Randomised Trials For Global Health, Louis Dron, Monica Taljaard, Yin Bun Cheung, Rebecca Grais, Nathan Ford, Kristian Thorlund, Fyezah Jehan, Etheldreda Nakimuli-Mpungu, Denis Xavier, Zulfiqar Ahmed Bhutta, Jay J H. Park, Edward J. Mills

Department of Paediatrics and Child Health

Evaluating whether an intervention works when trialled in groups of individuals can pose complex challenges for clinical research. Cluster randomised controlled trials involve the random allocation of groups or clusters of individuals to receive an intervention, and they are commonly used in global health research. In this paper, we describe the potential reasons for the increasing popularity of cluster trials in low-income and middle-income countries. We also draw on key areas of global health research for an assessment of common trial planning practices, and we address their methodological shortcomings and pitfalls. Lastly, we discuss alternative approaches for population-level intervention trials …

Urgently Seeking Efficiency And Sustainability Of Clinical Trials In Global Health, Jay J H. Park, Rebecca F. Grais, Monica Taljaard, Etheldreda Nakimuli-Mpungu, Fyezah Jehan, Jean B. Nachega, Nathan Ford, Denis Xavier, Andre P. Kengne, Zulfiqar Ahmed Bhutta

Department of Paediatrics and Child Health

This paper shows the scale of global health research and the context in which we frame the subsequent papers in the Series. In this Series paper, we provide a historical perspective on clinical trial research by revisiting the 1948 streptomycin trial for pulmonary tuberculosis, which was the first documented randomised clinical trial in the English language, and we discuss its close connection with global health. We describe the current state of clinical trial research globally by providing an overview of clinical trials that have been registered in the WHO International Clinical Trial Registry since 2010. We discuss challenges with current …

Covid-19 And Challenges To The Traditional Understanding Of Individual Medical Autonomy, Callon A. Green

Honors Theses

Throughout history, vaccines have provided the human population with the ability to combat dangerous illnesses and avoid preventable suffering. Despite the benefits vaccines provide to the public health of the United States, anti-vaccination sentiment and resistance to vaccine uptake are still prevalent in the modern day. As the COVID-19 pandemic has developed into a major public health crisis that can be controlled through vaccination, the issues underlying vaccine resistance are becoming more critical to return to normal life. Using COVID-19 as a case study, it is evident that the individual choice to deny vaccination can have consequences on the health …

Preferred Narratives And Their Impact On Historical Memory: An Examination Through Comparison Of Twentieth Century Pandemics, Renee Semple

Honors Scholar Theses

Societal response to a crisis and the narratives that emerge from the event(s) often vary and oppose one another. A narrative can be considered a point of view or a lens that is often cultivated through experiences and carries its own tone while telling events. This thesis compares the narratives that emerged from both the 1918 and 1957 influenza pandemics. Examining the 1918 influenza pandemic reveals both a public and a private narrative, in which the public narrative is the preferred out of the two. Filled with optimism, the preferred public narrative focused on moving forward and furthering scientific research—a …

Tuberculosis And Poor Health Among Migrant And Seasonal Farmworkers In The United States, Lucy Cummins

Health Studies Capstones

The following paper will explore the prevalence of TB among migrant and seasonal farmworkers in the United States, and the systemic forces that contribute to that prevalence. Cyclical of poverty, dangerous working conditions, and barriers to healthcare overall have all led to increased risk of TB infection for farmworkers and their families. Moreover, structural violence traps these farmworkers in conditions of increased risk that have a major impact on their general health. Thus, the issue of TB is not a single issue, but one that relates to a range of social, economic, and political factors. Improving TB outcomes for farmworkers …

How Do Canadian Public Health Agencies Respond To The Covid-19 Emergency Using Social Media: A Protocol For A Case Study Using Content And Sentiment Analysis, Anita Kothari, Lyndsay Foisey, Lorie Donelle Phd, Rn, Fcan, Michael Bauer

Publications

INTRODUCTION: Keeping Canadians safe requires a robust public health (PH) system. This is especially true when there is a PH emergency, like the COVID-19 pandemic. Social media, like Twitter and Facebook, is an important information channel because most people use the internet for their health information. The PH sector can use social media during emergency events for (1) PH messaging, (2) monitoring misinformation, and (3) responding to questions and concerns raised by the public. In this study, we ask: what is the Canadian PH risk communication response to the COVID-19 pandemic in the context of social media? METHODS AND ANALYSIS: …

2014 Health Demographics Of A Rural Nicaraguan Community, Andrew Guymon, Brianna Mcgowen, Emma Foster

Research Symposium

In December 2014, a team of church members and associated healthcare workers from Owasso First Assembly in Owasso, Oklahoma, provided a free, two-day clinic and health assessment to the rural community of La Ceiba Dudu in Nicaragua. Services included medical exams, basic medications, dental extractions, and over the counter reading glasses. This report is a retrospective review of the patient records documented at that clinic. We analyzed the prevalence of parasites across five age cohorts and searched for correlations between parasite diagnosis and various patient metrics, including BMI, age, and gender. We searched for a relationship between occupants per household …

Institute Of Public Health Newsletter- Volume2, Issue1, Institute Of Public Health (Iph) - Cmhs

Institute of Public Health Newsletter (IPHNL) and Other Publications

No abstract provided.

Laboratory Techniques In Public Health: Bi-520 Introduction To Public Health Lab Manual, Anuradha Srivastava

Open Educational Resources

This laboratory manual for a foundations course Public Health is unique in the sense that very rarely, a foundations course in the field has a lab component offered with the lecture. This lab manual provides basic laboratory exercises that could be useful to introduce undergraduate students to the basics of public health laboratory practices.

Quarantine, Isolation, And Metaphorical Takings: Balancing Individual Rights And Public Health Responses To Disease Outbreaks, Thomas Williams

Scholarly Articles in Law Reviews & Journals

Quarantine and isolation are methods employed by public health officials to control the spread of dangerous disease pathogens through physical isolation of those exposed or symptomatic. While use of these methods has declined in the last century through advances in medical knowledge and treatment, emerging disease threats will likely require increased reliance on them. Despite this, quarantine statutes and related regulations fail to provide compensation to those subject to them, and little recourse exists to make those individuals whole for losses incurred, though the pandemic has highlighted a need for work in this area. One means of shifting the burden …

Feasibility, Usability And Acceptability Of Paediatric Lung Ultrasound Among Healthcare Providers And Caregivers For The Diagnosis Of Childhood Pneumonia In Resource-Constrained Settings: A Qualitative Study, Atif Riaz, Olga Cambaco, Laura Elizabeth Ellington, Jennifer L. Lenahan, Khatia Munguambe, Usma Mehmood, Sana Qaisar, Benazir Baloch, Muhammad Imran Nisar, Fyezah Jehan

Department of Paediatrics and Child Health

Objectives: Paediatric pneumonia burden and mortality are highest in low-income and middle-income countries (LMIC). Paediatric lung ultrasound (LUS) has emerged as a promising diagnostic tool for pneumonia in LMIC. Despite a growing evidence base for LUS use in paediatric pneumonia diagnosis, little is known about its potential for successful implementation in LMIC. Our objectives were to evaluate the feasibility, usability and acceptability of LUS in the diagnosis of paediatric pneumonia.
Design: Prospective qualitative study using semistructured interviews SETTING: Two referral hospitals in Mozambique and Pakistan PARTICIPANTS: A total of 21 healthcare providers (HCPs) and 20 caregivers were enrolled.
Results: HCPs …

The Public Good, Bad Policies, And Tough Times: When Profit And Public Interests Collide, Austin Mcneill Brown, Shannon M. Monnat

Population Health Research Brief Series

Privatization of public goods maximizes corporate profits while providing minimal benefits or protections to public health. When calamities such as infectious disease pandemics, natural disasters, and severe weather strike, privatized systems often fail to respond adequately. This issue brief describes how privatization of public goods undermines public health, damages public trust, and erodes democracy and provides suggestions for how we can rethink policies to value people over profits instead of valuing profits over people.

Mapping The Literature On Health Literacy Related To Covid-19 Pandemic: A Scientometric Analysis, Rozeen Shaukat, Nusrat Ali, Muhammad Asif Naveed

Library Philosophy and Practice (e-journal)

This study intended to carry out a scientometric analysis of the literature on health literacy related to Covid-19 pandemic and infodemic to determine its periodic growth, publication format dispersion, core journals, authorship patterns, geographic origin, keywords patterns, and core institutions. Two general bibliographic databases such as Scopus and Web of Science were searched using keywords such as ‘health literacy, health education, health communication, health promotion, combining with Covid-19 using AND to identify related citations. The data set of 620 citations were analyzed and visualized for several bibliographic characteristics using ScientoPy and VOSviewer. The results revealed that there is a phenomenal …

Post-Pandemic, Translational Research, And Indigenous Communities, Rodney C. Haring, Laticia Mcnaughton, Dean S. Seneca, Whitney Ann E. Henry, Donald Warne

Journal of Indigenous Research

It is well documented that American Indian/Alaska Native/Native Hawaiian/First Nations, known as Indigenous Peoples, have among the most significant health disparities in the world. Clinical services for these populations are typically underfunded, and Indigenous Peoples often have preexisting and co-occurring health conditions. These factors combined with a multitude of social inequities make Indigenous communities extremely susceptible to infectious diseases, including COVID- 19. This paper discusses perspectives on the post-pandemic frameworks and policies toward translational science as an approach to advance health promotion for community-based interventions, dissemination, and sustainability. The importance of exercising Indigenous self-determination, public health authority, and population health …

Consequences Of Covid-19 Crisis For Persons With Hiv: The Impact Of Social Determinants Of Health, Kristie Cason Waterfield, Gulzar H. Shah, Gina D. Etheredge, Osaremhen Ikhile

Health Policy & Community Health: Faculty Publications

Background

With the indiscriminate spread of COVID-19 globally, many populations are experiencing negative consequences such as job loss, food insecurity, and inability to manage existing medical conditions and maintain preventive measures such as social distancing and personal preventative equipment. Some of the most disadvantaged in the COVID-19 era are people living with HIV/AIDS and other autoimmune diseases.

Discussion

As the number of new HIV infections decrease globally, many subpopulations remain at high risk of infection due to lack of or limited access to prevention services, as well as clinical care and treatment. For persons living with HIV or at higher …

Capacity Of Rural Counties To Address An Hiv Or Hepatitis C Outbreak, Jennifer Lenardson Mhs, Jaclyn Janis Rn, Mph, Amanda Burgess Mppm, Karen Pearson Mlis, Ma, Martha Elbaum Mpa

Population Health

HIV and hepatitis C (HCV) are major public health concerns in the United States and are a focus of significant federal health policy attention. Rural counties may be potentially vulnerable to an HIV or HCV outbreak among persons who inject drugs due to greater prevalence of high-risk injection practices as well as limited public health capacity to prevent, prepare for, and respond to an HIV or HCV outbreak. This study identified states potentially at risk for an HIV or HCV outbreak and used data from the 2016 Association of State and Territorial Health Officials (ASTHO) Profile Survey, 2016 National Association …

Understanding The Impacts Of Emerging Infectious Disease (Eid) Media Exposure: The Case Of U.S. Ebola Virus Disease (Evd), Alicia Mason, Kevin Wright, Laura Lambert

Faculty Submissions

Introduction: Using the Extended Parallel Processing Model (EPPM) as a theoretical framework this study examines the impact of Ebola virus disease (EVD) media exposure on U.S. audience perceptions of the threat severity, personal susceptibility, and behavioral intentions to respond to the 2014 Ebola virus disease (EVD) threat.

Methods: Respondents included (n = 255) residents from the Midwest and Southern regions of U.S. Participants completed an online survey between 28 October and 3 December 2014 during the height of Ebola-related media coverage.

Results: Findings reveal that increased exposure to EVD media content was associated with increased threat severity and personal susceptibility. …

Modes Of Transmission Of Severe Acute Respiratory Syndrome-Coronavirus-2 (Sars-Cov-2) And Factors Influencing On The Airborne Transmission: A Review, Mahdieh Delikhoon, Marcelo I. Guzman, Ramin Nabizadeh, Abbas Norouzian Baghani

Chemistry Faculty Publications

The multiple modes of SARS-CoV-2 transmission including airborne, droplet, contact, and fecal–oral transmissions that cause coronavirus disease 2019 (COVID-19) contribute to a public threat to the lives of people worldwide. Herein, different databases are reviewed to evaluate modes of transmission of SARS-CoV-2 and study the effects of negative pressure ventilation, air conditioning system, and related protection approaches of this virus. Droplet transmission was commonly reported to occur in particles with diameter >5 µm that can quickly settle gravitationally on surfaces (1–2 m). Instead, fine and ultrafine particles (airborne transmission) can stay suspended for an extended period of time (≥2 h) …

Nonpharmaceutical Interventions In Turkey And Worldwide During Covid-19 Pandemic, Mustafa Necmi̇ İlhan, Hakan Tüzün, Rahmi̇ Kiliç, Nuran Yildirim

Turkish Journal of Medical Sciences

Nonpharmaceutical interventions (NPIs) are actions apart from getting vaccinated and medications, in order to promote deceleration of the spread of illness among people and communities during pandemic. In this article, we aim to examine NPIs applied in Turkey and worldwide due to the COVID-19 pandemic. Some of the NPIs such as isolation, quarantine, and contact tracing were maintained with updates of the Ministry of Health guidelines in Turkey. Some NPIs including travel and partial or full curfew mobilization restrictions were set in accordance with the various periods by the number of cases. Periods of restrictions at autumn 2021 to summer …

Post-Pandemic Privacy Law, Tiffany C. Li

Law Faculty Scholarship

COVD-19, the global pandemic that began in 2019, altered how we live our lives in just about every way imaginable. Some of those changes were obvious-for example, those who were fortunate enough to be able to work from home began working online-while other changes were more subtle. The latter category included unprecedented levels of data collection by governments and organizations purporting to collect information that would help stop the pandemic's spread. Given the deadly nature of COVID-19, few would question any public health efforts, no matter their impact on privacy. However, the lack of attention to privacy issues during the …

Privacy In Pandemic: Law, Technology, And Public Health In The Covid-19 Crisis, Tiffany C. Li

Law Faculty Scholarship

The COVID-19 pandemic has caused millions of deaths and disastrous consequences around the world, with lasting repercussions for every field of law, including privacy and technology. The unique characteristics of this pandemic have precipitated an increase in use of new technologies, including remote communications platforms, healthcare robots, and medical Al. Public and private actors alike are using new technologies, like heat sensing, and technologically influenced programs, like contact tracing, leading to a rise in government and corporate surveillance in sectors like healthcare, employment, education, and commerce. Advocates have raised the alarm for privacy and civil liberties violations, but the emergency …

Voices From The Field: A Qualitative Study Of The Challenges And Promising Practices Of Rural Public Health In Addressing Hiv And Hepatitis C, Martha Elbaum Williamson Mpa, Karen B. Pearson Mlis, Ms, Amanda R. Burgess Mppm, Jennifer D. Lenardson Mhs, Erika C. Ziller Phd

Population Health

Rural areas of the United States may be vulnerable to an HIV or hepatitis C (HCV) outbreak among persons who inject drugs. Researchers at the University of Southern Maine’s Rural Health Research Center examined the capacity of rural public health systems to prepare for, identify, control, and respond to an HIV or HCV outbreak. Through semi-structured interviews with 36 state and local public health professionals from six rural states, we sought to understand the challenges related to HIV, HCV, and serving rural persons who inject drugs and to identify strategies to address those challenges. Challenges limiting the public health capacity …

Improving Contact Tracing In Minority Communities By Combating Misinformation And Distrust, Jason G. Randall, Dev Dalal, Aileen Dowden

Understanding and eliminating minority health disparities in a 21st-century pandemic: A White Paper Collection

The COVID-19 pandemic continues to challenge the global population as infection rates climb, and officials struggle to balance the need to slow the spread of COVID-19 but also open economies safely. The disproportionate impact of COVID-19 on minority communities has raised questions about the unique experiences of these communities in terms of not only becoming infected with COVID-19, but also mitigating its spread. Although contact tracing has been identified as an invaluable tool for managing community spread and supporting economic reopening, this is contingent, in part, upon compliance with contact tracer requests. In this study, we investigated how misinformation and …

Phased Return Of Students To 77 Transitional Kindergarten-8th Grade Schools With Cohesive Mitigation Strategies Serving As Protective Factors Against The Increase Of Covid-19 Cases In Marin County: September 2020-January 2021, Shayne Q. Paff, Rochelle Ereman, Lisa Santora, Bethany Dominik, Alana Mcgrath, Jasmine Soriano, Charis Baz, Matthew Willis, Michaela George

Global Public Health | Faculty Scholarship

Background and objective

Earlier uncertain implications of the coronavirus disease 2019 (COVID-19) pandemic on the pediatric population prompted the authorities to close schools worldwide under the premise that school settings would serve as drivers of an increase in the cases of COVID-19. Safe and equitable full-in-person school instruction is a critical factor in the continued educational gains of children and for their general well-being. The objective of this study was to report epidemiological trends related to the increasing percentage of students returning to in-person instruction, the suspected in-school transmission of severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2), the virus that …

Implementing Cardiac Testing To Mitigate The Risk Of Sudden Cardiac Death: An Evidence-To-Practice Review, Victoria J. Simpson, Zachary K. Winkelmann

Clinical Practice in Athletic Training

In the United States, sudden cardiac death (SCD) is the leading cause of fatality in young athletes during exercise. Allied healthcare professionals have used screening tools such as the 12-Element American Heart Association recommendations, the European Society of Cardiology (ESC) recommendations, and the International Olympic Committee guidelines to screen for cardiovascular abnormalities in athletes. Although each of these protocols consist of personal and family history questions complemented with a physical examination, a uniform screening strategy to identify athletes at risk of SCD does not exist. The purpose of this evidence to practice review is to summarize a systematic review regarding …

Health Care Sanctuaries, Medha D. Makhlouf

Faculty Scholarly Works

It is increasingly common for noncitizens living in the United States to avoid seeing a doctor or enrolling in publicly funded health programs because they fear surveillance by immigration authorities. This is the consequence of a decades-long shift in the locus of immigration enforcement activities from the border to the interior, as well as a recent period of heightened immigration enforcement. These fears persist because the law incompletely constrains immigration surveillance in health care.

This Article argues that immigration surveillance in health care is a poor choice of resource allocation for immigration enforcement because it has severe consequences for health …

Sleep Education For Elders Program (Sleep): Promising Pilot Results Of A Virtual, Health Educator-Led, Community-Delivered Sleep Behavior Change Intervention, Robin M. Tucker, Dawn A. Contreras, Breanne R. Carlson, Anita Carter, Christopher L. Drake

Sleep Medicine Articles

Purpose: Sleep problems pose serious public health concerns, and evidence suggests that the problem is worsening. Both sufficient sleep quantity and quality are needed for optimal health, particularly among older adults, but access to sleep care can be difficult. This study examined the efficacy of a six-week sleep behavior change program designed for older adults that was delivered virtually by health educators.

Participants and Methods: This quasi-experimental pilot study (intervention n = 22; control n = 31) explored the effects of the Sleep Education for Elders Program (SLEEP) on sleep outcomes, which included: 1) sleep quality, measured by the Pittsburgh …

At A Covid Crossroads : Public Health, Patient Privacy, And Health Information Confidentiality, Stacey A. Tovino

Faculty Articles

This essay summarizes and assesses the various bulletins, guidance documents, and notices of enforcement discretion released by the federal Department of Health and Human Services regarding the application of the HIPAA Privacy Rule to the COVID-19 pandemic. Among other topics and actions, these authorities address the application of the HIPAA Privacy Rule to the use and disclosure of protected health information for public health activities, waive the application of certain HIPAA Privacy Rule requirements during the COVID-19 pandemic, and announce enforcement discretion regarding certain covered entities’ non-compliance with particular provisions within the HIPAA Privacy Rule. These authorities overwhelmingly, and appropriately, …

Covid-19 Vaccine Acceptance: We Need To Start Now, Krutika Kuppalli, David Brett-Major, Tara C. Smith

Journal Articles: Epidemiology

In this perspective, we discuss the importance of developing a vaccine to help curb transmission of severe acute respiratory syndrome coronavirus 2. The question remains: Once a safe and effective vaccine is developed, will the public be willing to get it? We present information from one of the first tracking polls to assess public attitudes and perceptions toward a possible coronavirus disease 2019 vaccine that suggests public hesitancy over a potential vaccine, concern regarding accelerating clinical trials, and unease over the vaccine approval process. Public health experts, government officials, advocates, and others in the scientific community should respect the signals …

A 'Public' Journey Through Covid-19: Donald Trump, Twitter, And The Secrecy Of U.S. Presidents’ Health, Mark Fenster

UF Law Faculty Publications

Donald Trump ignored numerous governance norms in his one term as U.S. President, especially those that prescribe disclosure of official and personal financial information. His brief period of illness from COVID-19, which he broadcast to the world via his Twitter account, revealed the complexity of Trump’s relationship to the concept and norms of transparency that presume information’s necessity for a functional and accountable state. At the same time that Trump offered little in the way of coherent and authoritative information about his health, he also provided an enormous amount of seemingly “inside” and direct accounts of the progress of his …