Medicine and Health Sciences Commons^™

Designer Benzodiazepines: A Review Of Toxicology And Public Health Risks, Pietro Brunetti, Raffaele Giorgetti, Adriano Tagliabracci, Marilyn A. Huestis, Francesco Paolo Busardò

Institute of Emerging Health Professions Faculty Papers

The rising use of designer benzodiazepines (DBZD) is a cat-and-mouse game between organized crime and law enforcement. Non-prohibited benzodiazepines are introduced onto the global drug market and scheduled as rapidly as possible by international authorities. In response, DBZD are continuously modified to avoid legal sanctions and drug seizures and generally to increase the abuse potential of the DBZD. This results in an unpredictable fluctuation between the appearance and disappearance of DBZD in the illicit market. Thirty-one DBZD were considered for review after consulting the international early warning database, but only 3-hydroxyphenazepam, adinazolam, clonazolam, etizolam, deschloroetizolam, diclazepam, flualprazolam, flubromazepam, flubromazolam, meclonazepam, …

A Prospective, Population-Based Study Of Trends In Operative Vaginal Delivery Compared To Cesarean Delivery Rates In Low- And Middle-Income Countries, 2010-2016., Margo S. Harrison, Sarah Saleem, Sumera Ali, Omrana Pasha, Elwyn Chomba, Waldemar A. Carlo, Ana L. Garces, Nancy F. Krebs, K. Michael Hambidge, Shivaprasad S. Goudar, S. M. Dhaded, Bhala Kodkany, Richard J. Derman, Archana Patel, Patricia L. Hibberd, Fabian Esamai, Edward A. Liechty, Antoinette Tshefu, Adrien Lokangaka, Melissa Bauserman, Carl L. Bose, Fernando Althabe, Jose M. Belizan, Pierre Buekens, Janet L. Moore, Dennis D. Wallace, Menachem Miodovnik, Marion Koso-Thomas, Elizabeth M. Mcclure, Robert L. Goldenberg

Global Health Articles

OBJECTIVE: Few data are available on cesarean delivery and operative vaginal delivery trends in low- and middle-income countries. Our objective was to analyze a prospective population-based registry including eight sites in seven low- and middle-income countries to observe trends in operative vaginal delivery versus cesarean delivery rates over time, across sites.

STUDY DESIGN: A prospective population-based study, including home and facility births among women enrolled from 2010 to 2016, was performed in communities in Argentina, Democratic Republic of Congo, Guatemala, India, Kenya, Pakistan, and Zambia. Women were enrolled during pregnancy and delivery outcome data were collected.

RESULTS: We analyzed 354,287 …

A Multicountry Randomized Controlled Trial Of Comprehensive Maternal Nutrition Supplementation Initiated Before Conception: The Women First Trial., K. Michael Hambidge, Jamie E. Westcott, Ana Garcés, Lester Figueroa, Shivaprasad S. Goudar, Sangappa M. Dhaded, Omrana Pasha, Sumera A. Ali, Antoinette Tshefu, Adrien Lokangaka, Richard J. Derman, Robert L. Goldenberg, Carl L. Bose, Melissa Bauserman, Marion Koso-Thomas, Vanessa R. Thorsten, Amaanti Sridhar, Kristen Stolka, Abhik Das, Elizabeth M. Mcclure, Nancy F. Krebs

Global Health Articles

Background: Reported benefits of maternal nutrition supplements commenced during pregnancy in low-resource populations have typically been quite limited.

Objectives: This study tested the effects on newborn size, especially length, of commencing nutrition supplements for women in low-resource populations ≥3 mo before conception (Arm 1), compared with the same supplement commenced late in the first trimester of pregnancy (Arm 2) or not at all (control Arm 3).

Methods: Women First was a 3-arm individualized randomized controlled trial (RCT). The intervention was a lipid-based micronutrient supplement; a protein-energy supplement was also provided if maternal body mass index (kg/m2) was(DRC), Guatemala, India, and …

Delaware Health Sciences Alliance Global Health Symposium: Refugee And Immigrant Access To Care Locally And Globally

Global Health Events

Welcome to the 6th annual Global Health Symposium! As always, we are pleased to highlight the latest in our growing Global Health interests across the DHSA. The Delaware Health Sciences Alliance is a partnership of:

• Christiana Care Health System
• Jefferson Philadelphia University & Thomas Jefferson University
• Nemours / Alfred I. duPont Institute for Children
• University of Delaware

Aboriginal Urban Design For Health, Kate Clark, Mpa, Kirby Broadnax, Antionette Carroll, Jonathan Cha, Naomi Doerner, Allie Kast, Matthew Kennedy, Michael Mendez, Pascale C. Annoual, Carrie Martin, Wendall Nicholas

College of Population Health Lectures, Presentations, Workshops

Montreal’s Aboriginal population is growing rapidly, yet the community lacks a culturally safe and holistic health service center that is accessible to all Aboriginal people. On Friday, June 2, 2017 The Montreal Urban Aboriginal Health Centre (MUAHC) joined forces with Next City & Concordia University to co-create a 7-minute pitch for a $7,000 prize through the Vangaurd Conference Big Idea Challenge. An interdisciplinary team of 8 conference attendees worked with MUAHC leadership to design a short-term solution that would be a step in the right direction towards MUAHC’s goal to build a fully functioning and independent health center dedicated …

Barriers And Facilitators To Cervical Cancer Screening Among Iraqi Refugees Resettled In Philadelphia: A Qualitative Analysis Of Patient And Provider Perceptions, Colleen Payton, Mph, Ches, Laura Parente, Md, Dalea Al-Hawarri, Md, Philip Manasseh, Mph, Kevin Scott, Md, Marc Altshuler, Md

Department of Family & Community Medicine Presentations and Grand Rounds

Oral presentation at the 6^th Annual North American Refugee Health Conference, Niagara Falls, New York.

Research Questions:

1. What is the prevalence of cervical cancer and cervical cancer screening among recently resettled refugees seen at Jefferson's Center for Refugee Health?

2. Are patient-and provider-identified barriers to cervical cancer screening at CRH consistent with those identified in previous research efforts?

3. What are patient-and provider identified facilitators to cervical cancer screening for Iraqi refugee women?

Universal Healthcare: Costa Rica As A Model, Annie J. Ferris

CwiC-PH

What it Looks Like in Costa Rica

• Run by the Costa Rican Social Security Administration
• Financed by employers, employees, and the Ministry of Health. Employer and employee contributions together make up over 90% of contributions.
• Costa Rica is divided into 105 health areas, which are further divided up into primary care units called Basic Provision Units of Integrated Healthcare, or EBAIS. There are 947 of these primary care centers throughout Costa Rica, and everyone is assigned to one.
• The EBAIS clinics provide a wide range of services to cover the general and specific health needs of the community, including primary …

Health Care In Bolivia: A First Hand Experience, Sanchi Malhotra

CwiC-PH

This research project is based on a one month work experience in Cochabamba, Boliva through the NGO Sustainable Bolivia at Hosptial Viedma, a major public hospital and Centre de Salud Pacata, a rural outpatient health clinic. The information presented below is derived from both research and personal experience. This trip was partially funded by Jefferson Office of International Affairs with the goal of gaining experience and knowledge about the Bolivian health care system.

Globally Minded, Locally Serving: Refugee Health In Philadelphia, Sarah Jamieson, Angelica Montes, Gretchen Shanfeld, Mph, Rickie Brawer, Mph, Phd, Caryn Johnson, Ms, Otr/L, Faota, James D. Plumb, Md, Mph

CwiC-PH

Introduction

A refugee is someone who is forced to leave their country of origin due to war, violence, or persecution. The United States is the world’s top resettlement country. Out of the 50 states, Pennsylvania is 5^th in terms of the number of annually resettled refugees. Each year, Philadelphia resettles approximately 800 refugees. Bhutan, Burma, Iraq, Eritrea, Sudan, and Democratic Republic of Congo are the most frequent countries of origin in Philadelphia.

The Effect Of Peer Educators On Medication Adherence In Hiv Patients In Cochabamba, Bolivia, George Ru

CwiC-PH

BACKGROUND INFORMATION

• Bolivia is the least developed country in South America, with high levels of poverty, poor access to safe water, and low economic activity. Bolivia’s GDP, in US dollars, in 2013 was $30.60 billion and the gross national income, per capita in US dollars was $2,550, which both rank either at or near the bottom of the list for all South American countries (7).
• The Ministry of Health and Sports (MSD) is the national governing body responsible for formulating the strategy, policies, plans and programs in health. The Department of Health Services (SEDES) is the highest level of technical …

Cervical Cancer In Guatemala: Using Visual Inspection With Acetic Acid Screening To Reduce Incidence Of And Mortality From Cervical Cancer, Zachary Klock

CwiC-PH

Guatemala is a developing nation of nearly 16 million in Central America. Among the many health problems the nation suffers, cervical cancer remains a leading cause of cancer-related death. Cervical cancer, an easily detectable cancer, predominantly affects women in developing nations. Traditional cytology techniques have been used to screen women in the country for over 25 years, but less than 10% of the Guatemalan population is screened. The Visual Inspection with Acetic Acid (VIA) is a simple produce that uses acetic acid to visualize precancerous cervical lesions and has been proven to be more effective in resource-poor settings. The screening …

Alternative Income Generation For Kenyan Women: Preventing Prostitution And The Spread Of Hiv, Megan Elizabeth Lundy

CwiC-PH

HIV/AIDS in Mlolongo, Kenya

Mombasa Highway and Weigh Station

• Truckers spend 3+ days waiting to be processed, providing a costumer base for prostitution
• In Kenya, 27.6% of female sex workers are HIV positive and only 26.8% use condoms with all of their partners (Morris, Morris, and Ferguson, 2009).
• The rampant spread of HIV and lack of contraception has led to rapid growth in the population in an area that has little ability to support any residents
• Development of Slums that now line the highway

Evaluating And Responding To Medical Student Demand For Global Health Education, Angela Ugorets, Bs, Maria Montano, Mph, Michael Cafarchio, Md, Daniel Becchi, Ba, Annie Masterson, Ba, Nithin Paul, Ba, Ellen Plumb, Md

CwiC-PH

Introduction

With the constant interchange of people and diseases across continents, “the separation between domestic and international health problems is no longer useful.” (1) Look no further than the 80,000 refugees currently resettled in the United States for proof that health is a global phenomenon. The medical community needs to respond to the changing global landscape by training future healthcare leaders to think and act globally.

Medical students across the U.S. recognize this need with 68% of U.S. allopathic medical schools having an active student global or international health interest group. (2) Unfortunately, training opportunities lag behind student interest with …

Hernia Surgery In Rural Ghana, West Africa: Barriers To Health Care And Their Implications, Laura Traub

CwiC-PH

The information presented is a the product of a six week international rotation at Volta Regional Hospital and Royal Hospital through Blue-Med Africa, a non-governmental organization based out of Ho, Ghana. The goal of the rotation was to obtain an understanding of healthcare in Ghana and identify the differences between surgical procedures in West Africa and the U.S.

Partnerships For Health - Jeff Health And The Rwanda Village Concept Project – A Model Of Interdisciplinary Health Professions Student Global Education, James D. Plumb, Md, Mph, Ellen J. Plumb, Md, Komal Soin, Md-Cugh 2014, Edmond Bagazini, Md, Mph, Remy Muhire Manzi, Md, Mph, Jean Christoph Rusatira, Md

College of Population Health Lectures, Presentations, Workshops

Background

The Rwanda Health and Healing Project (RHHP)

• Started in 2006: Barefoot Artists and TJU Department of Family and Community Medicine

– Global health immersion experience

– Interdisciplinary

– Focus: team-based, sustainable public health programming,

economic development, community empowerment

• Public-Health Programming: Akarambi, Rugerero

– Hygiene and Sanitation

– Childhood Nutrition

– Helminth Prevention

– HIV Education

– Income Generation: chicken coop, rabbit rearing, mushroom farming, bee keeping, pig farming

Chronic Malnutrition In Guatemala, Nicholas Bishop, Susan Mcilvaine

CwiC-PH

Poster includes:

• What is chronic malnutrition and what causes it?
• Why address malnutrition?
• Addressing the problem

Care In Columbia: What We Can Glean From South American Medicine, Neil Flannery Haidorfer, Robert Simmons, Drph, Mph, Mches, Cph

CwiC-PH

The information presented is the product of a two month international rotation at Medellin General Hospital and the non-profit pediatric clinic, Santa Ana through an academic affiliation with La Universidad CES in Medellin, Antioquia. The goal of the rotation was to obtain an understanding of healthcare in Columbia and identify potential practices that could be utilized in the U.S.

Is The Reporting Timeliness Gap For Avian Flu And H1n1 Outbreaks In Global Health Surveillance Systems Associated With Country Transparency?, Feng-Jen Tsai, Eva Tseng, Chang-Chuan Chan, Hiko Tamashiro, Sandrine Motamed, André C Rougemont

Division of Internal Medicine Faculty Papers & Presentations

BACKGROUND: This study aims to evaluate the length of time elapsed between reports of the same incidents related to avian flu and H1N1 outbreaks published by the WHO and ProMED-mail, the two major global health surveillance systems, before and after the amendment of the International Health Regulations in 2005 (IHR 2005) and to explore the association between country transparency and this timeliness gap.

METHODS: We recorded the initial release dates of each report related to avian flu or H1N1 listed on the WHO Disease Outbreak News site and the matching outbreak report from ProMED-mail, a non-governmental program for monitoring emerging …