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The Effect Of Prenatal Care And Other Factors On Preterm Births In Montgomery County 2007-2009, Leslie A. Schmieder

Master of Public Health Program Student Publications

Introduction Preterm birth is defined as a baby who is born before 37 weeks of pregnancy. Problems with preterm birth include an increased risk for health complications throughout life as well as having significantly more medical expenses compared to a full term infant. Prenatal care has shown to decrease the risk for preterm birth nationally. The objective of this project was to analyze prenatal care and other risk and demographic factors to determine their association with preterm birth in Montgomery County.

Method Data used included the 2007-2009 Montgomery County Birth Certificate Data for mothers who had singleton births. The Kessner …

Pertussis In Ohio: A Descriptive Analysis Of The 2010 Columbus Outbreak And Patterns Of A Reemerging Childhood Disease, Christopher Rohde

Master of Public Health Program Student Publications

Objective: In 2010, Columbus, Ohio experienced the largest outbreak of pertussis that it has had in the past 25 years. Similar outbreaks are occurring across the nation on an increasing basis. This descriptive study examines the 2010 outbreak and describes the demographics of the affected population. Comparison is made to previous and current pertussis incidence in Ohio and outbreaks elsewhere in the United States. Contributing factors to the increasing occurrence of pertussis outbreaks are discussed.

Methods: Raw data was obtained from the Columbus Public Health epidemiology department and is gathered through the Ohio Disease Reporting System (ODRS). Pertussis cases are …

Gaps And Strengths In Us Policies On Infant And Young Child Feeding: An Analysis Based On The Global Strategy On Infant And Young Child Feeding, Linda J. Smith

Master of Public Health Program Student Publications

This research project reviews the evidence on the significance of infant and young child feeding to public health goals, analyzes US policy documents in relationship to the Global Strategy using the World Breastfeeding Trends Initiative (WBTi) to quantify the findings into a national score, and then summarizes the gaps and strengths in US policies and makes recommendations. Using the WBTi scoring system, strengths for the US exist in national policy, Baby-Friendly Hospital Initiative, monitoring and evaluation, and complementary feeding. Mother support and community outreach, information and support were moderate. Gaps exist in policies on infant feeding in emergencies and for …

Determining Evidence-Based Practices In Asthma Management, Erin Smiley

Master of Public Health Program Student Publications

Objective: One aim of this study will focus on determining what are evidence-based studies in asthma control. A second aim focuses on determining which asthma interventions, self-monitoring tools and asthma management programs have shown to be the most significant in improving outcomes in patients with asthma. Recommendations will be made to future asthma self-management programs based on the findings.

Methodology: The review of 15 evidence-based research studies is used to identify and analyze the best asthma self-management practices to be implemented in a community health education program. Using the Brownson framework a weighting schema was created based on the level …

Mathematical Model To Assess The Relative Effectiveness Of Rift Valley Fever Countermeasures, Holly Gaff, Colleen Burgess, Jacqueline Jackson, Tianchan Niu, Yiannis Papelis, David Hartley

Biological Sciences Faculty Publications

Mathematical modeling of infectious diseases is increasingly used to explicate the mechanics of disease propagation, impact of controls, and sensitivity of countermeasures. The authors demonstrate use of a Rift Valley Fever (RVF) model to study efficacy of countermeasures to disease transmission parameters. RVF is a viral infectious disease that propagates through infected mosquitoes and primarily affects animals but also humans. Vaccines exist to protect against the disease but there is lack of data comparing efficacy of vaccination with alternative countermeasures such as managing mosquito population or destroying infected livestock. This paper presents a compartmentalized multispecies deterministic ordinary differential equation model …

Restoring Health To Health Reform: Integrating Medicine And Public Health To Advance The Population's Wellbeing, Lawrence O. Gostin, Peter D. Jacobson, Katherine L. Record, Lorian E. Hardcastle

Georgetown Law Faculty Publications and Other Works

The Patient Protection and Affordable Care Act is a major achievement in improving access to health care services.  However, evidence indicates that the nation could achieve greater improvements in health outcomes, at a lower cost, by shifting its focus to public health.  By focusing nearly exclusively on health care, policy makers have chronically starved public health of adequate and stable funding and political support.  The lack of support for public health is exacerbated by the fact that health care and public health are generally conceptualized, organized, and funded as two separate systems.  In order to maximize gains in health status …

Disease, Medicine And Health, Diego Armus, A. López Denis

History Faculty Works

This article focuses on three overlapping trends in the historical study of human responses to illness, labeled as “new history of medicine, history of public health, and sociocultural history of disease.” The topics range from colonial epidemiology and pharmacopoeia to twentieth-century public health institutions and urban hygiene. But a consistent focus on the social, cultural, and symbolic components of diseases and cures unifies this historiography and distinguishes it from the narrower scope of the long-established field of the history of medicine.

In Re Miguel M., Jonathan Weinstein

NYLS Law Review

No abstract provided.

Reforming The World Health Organization, Devi Sridhar, Lawrence O. Gostin

Georgetown Law Faculty Publications and Other Works

Director-General Margaret Chan recently called the WHO overextended and unable to respond with speed and agility to today’s global health challenges. Given the importance of global health cooperation, few would dispute that a stronger, more effective WHO would benefit all. In this commentary, we offer 5 proposals for re-establishing WHO’s leadership.
 
(1) Give Real Voice to Multiple Stakeholders
The WHO would be more effective by giving real voice and representation to key stakeholders, including philanthropies, businesses, public/private partnerships, and civil society. Meaningful stakeholder engagement would instill confidence, and spark investment, in the agency.
 
(2) Improve Transparency, Performance and Accountability
Stakeholders …

Influenza Vaccine Given To Pregnant Women Reduces Hospitalization Due To Influenza In Their Infants, Isaac Benowitz

Yale Medicine Thesis Digital Library

The aim of this study was to determine whether giving influenza vaccine to pregnant women can reduce the incidence of hospitalization due to influenza in their infants in the first year of life. This was a matched, hospital-based case-control study at Yale-New Haven Children's Hospital. Case and control subjects were all aged hospitalization, matched to cases by date of birth and date of hospitalization (both within 4 weeks before or after). We contacted parents of all subjects to collect information on the subjects' health and home setting and to get permission to review subjects' and mothers' hospital records and outpatient …

Norovirus Epidemiology And Duration Of Shedding In Michigan, 2007-2008, Nodira A. Abdujamilova, David Dixon, Laura Mosher, Patricia Somsel, Anthony Muyombwe, Patricia A. Clark, Jeffrey Massey, Brenda Brennan, Paul C. Bartlett

Michigan Journal of Public Health

Background: In the United States, an estimated 23 million cases of norovirus (NoV) are reported each year, and although mortality is low, the morbidity and economic impact are substantial. Methods: RT-PCR and sequencing were used for identification of NoV genotypes obtained from outbreak and sporadic cases. RT Quant PCR was used to determine the viral load in fecal specimens. In order to rule out bacterial infection as the cause for acute gastroenteritis (AGE), bacterial culture for Salmonella, E.coli O157, Shigella, Campylobacter and Clostridium difficile was performed by standard laboratory procedures. The duration of NV shedding was investigated with longitudinal sampling …

Biosafety Concerns Involving Genetically Modified Mosquitoes To Combat Malaria And Dengue In Developing Countries, Graciela R. Ostera, Lawrence O. Gostin

Georgetown Law Faculty Publications and Other Works

Malaria and dengue are the most prevalent mosquito-borne infections worldwide. Because traditional vector control methods have proven to be insufficient to control mosquito populations in endemic areas, scientists are actively working in the design of new strategies, such as genetically modified (GM) mosquitoes, to reduce disease transmission. The replacement of natural populations with GM mosquitoes is becoming a tangible possibility, however, many fear that the release of these organisms into the environment could constitute a significant risk to biodiversity and may cause the unintended spread of GM organisms across national borders.

The Cartagena Protocol on Biosafety, an international agreement originally …

Critical Hermeneutic Inquiry In Kagaa, Kenya : Refiguring Village Health Education Through Community Inquiry, Peninah N. Kaniu

Doctoral Dissertations

unavailable

Evaluating The Get Into Fitness Today (Gift) Program: Weight Loss And The Roles Of Education And Empowerment, Emily Koby Novicki

USF Tampa Graduate Theses and Dissertations

This study investigated the effects of Get Into Fitness Today (GIFT), a health program for adults that promotes balanced nutrition, physical activity, and weight loss through weekly meetings that provide education and social support. In addition to investigating the effects of GIFT, this evaluation sought to better understand explanatory models used by participants and program staff, and the roles of education and empowerment in weight loss and health education. This mixed methods, case study evaluation consisted of quantitative analysis of existing program records for 664 participants, 40 hours of participant observation of class sessions with ten GIFT groups, and follow-up …

Environmental Health In The Latin American And Caribbean Region: Use Of Water Storage Containers, Water Quality, And Community Perception, Erlande Omisca

USF Tampa Graduate Theses and Dissertations

Water quality and availability are important issues in many developing countries where portions of populations still lack access to potable water. Throughout the English-speaking Caribbean and parts of Latin America, households and businesses invest in water supply systems even when they are connected to and pay for water services from a private or state owned provider. Inconsistent supplies of water from the water companies have led many people to invest in storage tanks which, if operated correctly, can provide water throughout the day even when the supply from the main is low or zero. While these individual systems help to …

The Virginia Gardasil Law: A Constitutional Analysis Of Mandated Protection For Schoolchildren Against The Human Papillomavirus, Christina O. Hud

Washington and Lee Journal of Civil Rights and Social Justice

No abstract provided.

Latin America And The Caribbean: Assessment Of The Advances In Public Health For The Achievement Of The Millennium Development Goals, Amal K. Mitra, Gisela Rodriguez-Fernandez

Faculty Publications

To improve health and economy of the world population, the United Nations has set up eight international goals, known as Millennium Development Goals (MDGs), that 192 United Nations member states and at least 23 international organizations have agreed to achieve by the year 2015. The goals include: (1) eradicating extreme poverty and hunger; (2) achieving universal primary education; (3) promoting gender equality; (4) reducing child mortality; (5) improving maternal health; (6) combating HIV/AIDS, malaria and other diseases; (7) ensuring environmental sustainability; and (8) developing a global partnership for development. Having been in the midway from the 2015 deadline, the UN …

Assessment Of Support Service Needs Of Primary Caregivers Of Hiv And Aids Infected Children: A Review Of Literature And Suggestions For Practice, Barry Eneh

Master of Public Health Program Student Publications

Summary: With the advent of highly active antiretroviral treatment, routine screening and treatment options for pregnant women for perinatally acquired HIV and AIDS, infection is on dramatic decline in the U.S. In spite of the declines and the medical advances, primary and informal caregivers of infected children continue to face innumerable challenges with regard to the availability, access and utilization of non-medical supportive service care needs. HIV/AIDS continues to create unique challenges for infected children and the non-infected family caregivers at multiple levels; impacting their relationships, resources and resilience.

Objective: This literature review identifies and assesses the unique and critical …

The Public Health Impacts Of Concentrated Animal Feeding Operations On Local Communities, Michael Greger, Gowri Koneswaran

Environment Collection

Large-scale farm animal production facilities, also known as concentrated animal feeding operations (CAFOs), release a significant amount of contaminants into the air and water. Adverse health effects related to exposure to these contaminants among CAFO workers have been welldocumented; however, less is known about their impact on the health of residents in nearby communities. Epidemiological research in this area suggests that neighboring residents are at increased risk of developing neurobehavioral symptoms and respiratory illnesses, including asthma. Additional research is needed to better understand community-scale exposures and health outcomes related to the management practices and emissions of CAFOs.

Barriers To Accessing Primary Dental Care For The Uninsured/ Underinsured Population In The City Of Cincinnati, Kiana R. Trabue

Master of Public Health Program Student Publications

Despite federal, state and local efforts to provide access to dental services to vulnerable populations such as the uninsured and underinsured, many people still do not receive adequate dental care. This study seeks to identify barriers to primary dental care in the City of Cincinnati. The Cincinnati Health Department (CHD) operates five safety net health centers which provide dental care for the citizens of the Cincinnati service area. Surveys conducted in these centers found that cost was the main reason individuals do not see the dentist regularly. Even in those with dental insurance cost was a major barrier, although most …

The Relationship Of Maternal Age, Trimester Of Entry Into Prenatal Care, Maternal Postpartum Depression, And Race With Birth Weight Of Infants Born In Cincinnati, Ohio, Kelli Kohake

Master of Public Health Program Student Publications

Healthcare, resources, and technology in the United States (U.S.) has improved, yet the U.S. ranks 29th in the world for the highest infant mortality rates – behind other less developed countries. Within the U.S., Ohio (and Hamilton County in particular) has high rates of infant mortality. Low birth weight and preterm births are a major cause of infant mortality. Data analysis was done consisting of descriptive statistics and Analysis of Variance of the prenatal patients served at the Cincinnati Health Department health centers who delivered in 2009, with dependent variables of birth weight and postpartum depression. Independent variables included maternal …

Unmet Medical Need Of Underserved Population In A Safety-Net Organization, Leslie Clem

Master of Public Health Program Student Publications

Background: Safety net providers serve a large proportion of America’s uninsured and low income population. The purpose of this study is to determine if differences in unmet medical needs exist between the provisional and clinic populations, age groups, and sex and race categories. This research study provides information about the population that receives services from Good Neighbor House, a non-profit social service organization in Dayton, Ohio.

Methods: GNH created a survey to assess the unmet medical need of their clients. The instrument contains questions about routine medical care, unmet medical care in the last 12 months, medical bills, and demographic …

Socioeconomic And Environmental Causes For Respiratory Infection Death In Alaska Native Villages, Sarah Mcbeth

Master of Public Health Program Student Publications

Objectives. This ecological study evaluates the association between community characteristics and death rates from pneumonia/influenza, tuberculosis, and infectious diseases in 196 Alaska Native villages.

Methods. Ecological variables studied included percentage of Natives in the population, age distribution, latitude, average household size, socioeconomic status, percentage of homes with complete plumbing and/or kitchens, type of heating fuel used, community alcohol restrictions, level of healthcare access, and residence in specific regions of Alaska. These data come from the 2000 U.S. Census, the Alaska Alcohol Beverage Control Board, and the Alaska Native Tribal Health Consortium. A stepwise analysis of variance using the Proc GLM …

Zoonotic Disease In Ohio: Surveillance, Preparation, And Response, Erik B. Balster

Master of Public Health Program Student Publications

This paper examines the state of public health preparation and response capacity to zoonotic infectious disease in the state of Ohio. A comprehensive literature review of zoonotic disease emergence and re-emergence, the National Veterinary Stockpile (NVS), the One Health Initiative, emergency response, and Ohio policy was performed in conjunction with telephone interviews. This study shows that responsibilities and systems integral to disease preparedness, such as sentinel surveillance and reporting, vary significantly between two key departments: the Ohio Department of Health (ODH) and the Ohio Department of Agriculture (ODA). Consistency and standardization of agency, mirroring the One Health Initiative, must be …

Viral Gastroenteritis In Charleston, West Virginia, In 2007: From Birth To 99 Years Of Age, Carolyn M. Wilhelm, Samantha L. Hanna, Christine A. Welch, Haider Shahid, Linda L. Minnich, Shane B. Daly, John N. Udall

Faculty & Staff Scholarship

No abstract provided.

Mapping The Issues: Public Health, Law And Ethics, Lawrence O. Gostin

Georgetown Law Faculty Publications and Other Works

The field of public health is typically regarded as a positivistic pursuit and, undoubtedly, our understanding of the etiology and response to disease is heavily influenced by scientific inquiry. Public health policies, however, are shaped not only by science but also by ethical values, legal norms, and political oversight. Public Health Law and Ethics: A Reader (expanded and updated 2nd ed., 2010) probes and seeks to illuminate this complex interplay, through a careful selection of government reports, scholarly articles, and court cases together with discussion and analysis of critical problems at the interface of law, ethics, and public health. The …

The O’Neill Institute For National And Global Health Law: Discovering Innovative Solutions For The Most Pressing Health Problems Facing The Nation And The World, Lawrence O. Gostin, Oscar A. Cabrera, Susan C. Kim

Georgetown Law Faculty Publications and Other Works

The connection between health and an individual’s ability to function in society, as well as the importance of health to a society’s economic, political, and social wellbeing necessitates finding innovative solutions to the world’s most pressing health problems. The O’Neill Institute for National and Global Health Law at Georgetown University seeks to demonstrate the role that academia can play in addressing complex national and global health problems in a comprehensive, evidence-based, intellectually-rigorous, and nonpartisan manner. The O’Neill Institute currently has three research programs: global health law, national health law, and the center for disease prevention and outcomes. Projects within these …

Redressing The Unconscionable Health Gap: A Global Plan For Justice, Lawrence O. Gostin

Georgetown Law Faculty Publications and Other Works

Consider two children—one born in sub-Saharan Africa and the other in the United States. The African child is twenty-five times more likely to die in the first five years of life; if she lives to child-bearing age, she is a two hundred times more likely to die in labor; and overall, she will die thirty years earlier than the American child. The international community is deeply resistant to taking bold remedial action—more concerned with their geostrategic interests than the health of the poor. The scale of foreign aid is both insufficient and unsustainable and fails to address the key determinants …

The Legal Ecology Of Resistance: The Role Of Antibiotic Resistance In Pharmaceutical Innovation, Kevin Outterson

Faculty Scholarship

Antibiotic effectiveness is a common pool resource that can be prematurely depleted through resistance. Some experts warn that we may face a global ecological collapse in antibiotic effectiveness. Conventional wisdom argues for more intellectual property rights to speed the creation of new antibiotics. Recent theoretical literature suggests that conservation-based approaches may yield superior results. This Article describes a novel typology for organizing these emerging theories, and provides an early empirical test of these models, using proprietary data on the sales of vancomycin, an important hospital antibiotic for the last three decades.

The results challenge the assumptions in several models, and …

Pharmacy & Therapeutics Update: Drug Information For Health Care Professionals, November/December 2009, Medical University Of South Carolina, Heather Kokko, Kelli Garrison, Jason Cooper, Chris Wisniewski, James New

Pharmacy & Therapeutics Update: Drug Information for Health Care Professionals

No abstract provided.