Public Health Commons^™

Community Health Workers Can Effectively Provide Information And Referrals To People Living With Hiv In Their Communities, Population Council

Reproductive Health

A number of studies reported high levels of sexually transmitted infections among people living with HIV (PLHIV). Unfortunately, prevention interventions targeting PLHIV in the community are not common in Kenya, and most PLHIV who are not on ART have limited access to prevention information and risk-reduction counseling. The Population Council’s APHIA II Operations Research Project conducted a research project to address these gaps. This study was conducted in 2010 in collaboration with the International Center for Reproductive Health and the National AIDS and STI Control Programme. The findings show that the intervention had a number of positive outcomes and concludes …

Making Hiv Services More Responsive To Young Children And Infants In Nyanza, Monica Wanjiru

Reproductive Health

Health workers in Kenya often miss opportunities to discuss pediatric HIV with clients and to track exposed children in order to initiate treatment. To address this problem, the Population Council’s APHIA II Operations Research Project collaborated with the Christian Health Association of Kenya, Catholic Relief Services, and the Kendu Adventist Hospital to improve HIV testing and treatment services for children at the hospital. The project recommended that pediatric HIV services be strengthened and included as an essential service at all levels of healthcare facilities in order to reach more children, including as one of the roles of the community health …

Operationalizing And Scaling Up Hiv/Rh Referrals In Kenya: The Way Forward, Aphia Ii Or Project In Kenya

Reproductive Health

This policy brief describes the APHIA II Operations Research Project through which the Population Council and Kenya’s Ministry of Health (MOH) developed and tested an approach to systematically link HIV-positive family planning (FP) clients to treatment and care services. Key activities included provider training and testing of a referral package which showed how, where, when, and who is to make and receive referrals. This referral package consisted of a directory listing all facilities in the vicinity available for services including HIV counseling and testing, FP, STIs, tuberculosis, and well-child checks; and referral forms directing clients to appropriate receiving clinics. The …

Linking Hiv-Positive Family Planning Clients To Treatment And Care Services In Kenya, Wilson Liambila, Francis Obare, Harriet Birungi, Ruth Wayua Muia, Joyce Wanderi Maina, Mary N. Maina, Christine Awuor, Ibrahim Mohammed

Reproductive Health

A project from the Population Council’s USAID-funded FRONTIERS program found that integrating HIV counseling and testing into family planning (FP) services was feasible and acceptable to clients and providers, and led to significant improvement in the quality of care provided. However, a major limitation was that FP clients who tested HIV-positive were not actively linked to care and treatment services, including antiretroviral treatment, and screening and management of sexually transmitted infections. A new initiative aimed to design and test a referral framework for linking HIV-positive FP clients to treatment and care in selected health facilities; assess the acceptability of the …

United Airways Disease Among Florists, Muge Akpinar-Elci, Omur C. Elci, Aygul Odabasi

Community & Environmental Health Faculty Publications

Previously we observed an excess risk for occupational asthma among florists with rhinitis. To further evaluate the link between upper and lower airways, we investigated united airways disease in the same occupational group. Occupational history, symptoms and atopy were investigated among 128 florists. Age-, smoking-, and gender-adjusted risks were calculated using logistic regression models comparing symptomatic and asymptomatic individuals. The prevalence of work-related rhinitis symptoms was 13.3%, conjunctivitis symptoms and asthma-like symptoms were 14.1%. We observed an excess risk of work-related asthma symptoms among florists with work-related conjunctivitis (OR: 8.5, 95% CI: 2.4-29.9) and rhinitis (OR: 13.1, 95% CI: 3.0- …

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 …

Preventing Mother-To-Child Transmission Of Human Immunodeficiency Virus-1 (Hiv-1): Effects Of Intrapartum And Neonatal Single-Dose Nevirapine Prophylaxis And Subsequent Hiv-1 Drug Resistance At Antiretroviral Treatment Initiation, Amanda L. Harmon

CMC Senior Theses

The prevention of mother-to-child transmission is one of the most powerful tools in human immunodeficiency virus type 1 (HIV-1) prevention and has huge potential to improve both maternal and child health. In the absence of any preventative measures, infants born to and breastfed by their HIV-positive mothers have roughly a one-in-three chance of acquiring the infection themselves. HIV can be passed on from mother-to-child during pregnancy, during labor and delivery, and even after during breastfeeding.

Intrapartum and neonatal single-dose nevirapine (sd-NVP) is the foundation of preventing mother-to-child transmission in lower resource settings where it has been used alone or as …

Teen Pregnancy Prevention Program Year One Outcome Evaluation Report For The Southern Nevada Health District, Nevada Institute For Children’S Research And Policy, Southern Nevada Health District, Tara Phebus, Samantha Dawn Beecher, Alyson Baker, Taylor Oliver, Denise Tanata Ashby

Nevada Institute for Children's Research and Policy Reports

In the fall of 2010 the Southern Nevada Health District (SNHD) was awarded funding from the Federal Office of Adolescent Health to implement an evidence based teen pregnancy prevention curriculum. They have partnered with the Department of Juvenile Justice Services and the Clark County Department of Family Services to offer this curriculum to the youth in juvenile detention, probation, and life skills classes for youth aging out of the foster care system. The Nevada Institute for Children’s Research and Policy (NICRP) has been contracted to complete the outcome evaluation for this program and is collecting data to help measure the …

Estimating The Reproductive Numbers For The 2008-2009 Cholera Outbreaks In Zimbabwe, Zindoga Mukandavire, Shu Liao, Jin Wang, Holly Gaff, David L. Smith, J. Glenn Morris Jr.

Biological Sciences Faculty Publications

Cholera remains an important global cause of morbidity and mortality, capable of causing periodic epidemic disease. Beginning in August 2008, a major cholera epidemic occurred in Zimbabwe, with 98,585 reported cases and 4,287 deaths. The dynamics of such outbreaks, particularly in nonestuarine regions, are not well understood. We explored the utility of mathematical models in understanding transmission dynamics of cholera and in assessing the magnitude of interventions necessary to control epidemic disease. Weekly data on reported cholera cases were obtained from the Zimbabwe Ministry of Health and Child Welfare (MoHCW) for the period from November 13, 2008 to July 31, …

Occupational Respiratory Health Surveillance At Minara Resources, Murrin Murrin Mine Site, Martyn Cross

Theses: Doctorates and Masters

This thesis outlines the results of occupational respiratory health surveillance at Minara Resources, Murrin Murrin mine site. The research was conducted as part of a collaborative agreement between Edith Cowan University and Minara Resources, the overarching title of which was ‗Establishing best practice protocols in the management of occupational and environmental health in a high-risk mining and ore-processing environment‘. To form the basis of this research it was hypothesised that although the chemical hazards had been adequately identified, and the occupational exposures in each work area at Murrin Murrin were generally well below their respective occupational exposure levels, it was …

The Affordable Care Act, Medical Homes, And Childhood Asthma: A Key Opportunity For Progress, Meagan Lyon, Anne Rossier Markus, Sara J. Rosenbaum

Geiger Gibson/RCHN Community Health Foundation Research Collaborative

The medical homes provisions of the Affordable Care Act offer a major opportunity to advance high quality, cost-efficient health care for children with asthma. This policy brief examines evolving national medical homes policy in a childhood asthma context. Following a brief background that examines childhood asthma and explores the origins and evolution of medical homes policy (a concept developed with children in mind), the brief then describes how the Affordable Care Act can advance the implementation of medical homes policies to improve health outcomes for children with asthma.

Coronary Heart Disease Knowledge And Risk Factors Among Filipino-Americans Connected To Primary Care Services, Alona N. Dalusung-Angosta

Nursing Faculty Research

Coronary heart disease (CHD) is the leading cause of death of Filipino-Americans (FAs). Despite the growing numbers of FAs in the United States, little is known about their CHD knowledge and risk factors.

The purposes of this study were to examine the baseline knowledge and risk factors of CHD among FAs and to describe the relationships between knowledge, sociodemographic, and socioeconomic characteristic variables of FAs between the ages of 35-75 years.

The study sample consisted of 120 FAs (N = 120) who were connected to primary care services. Data were collected from three primary care clinics in Las Vegas, …

Coronary Heart Disease Mortality And Long-Term Exposure To Ambient Particulate Air Pollutants In Elderly Nonsmoking California Residents, Lie Hong Chen

Loma Linda University Electronic Theses, Dissertations & Projects

The purpose of this study is to assess the effect of long-term concentrations of ambient PM on risks of all causes, cardiopulmonary, coronary heart disease (CHD), total cancer, and any mention of nonmalignant respiratory disease (NMRD) mortality.

The health effects of long-term ambient air pollution have been studied with up to 30 years of follow-up in the AHSMOG cohort, a cohort of 6,338 nonsmoking white California adults. Monthly concentrations of ambient air pollutants [particulate matter(PMio), Ozone (O3), sulfur dioxide (SO2), nitrogen dioxide (NO2) or particulate matter

In the AHSMOG cohort, each increment of 10 |ig/m3 in PMio in two-pollutant models …

Effects Of Acculturation On Hiv/Aids Sexual Risk Behaviors Among Asian And Pacific Islander (Api) Women, Margaret Cabotage Salud

Loma Linda University Electronic Theses, Dissertations & Projects

Background. In the US women are the fastest growing group for sexually transmitted infections (STIs), including HIV and AIDS. In addition, the estimated AIDS cases among female adults and adolescents, aged 13-19, increased from 7% in 1985 to approximately 26% in 2002. Most infections occur by heterosexual transmission with 53% occurring through contact with a high-risk sexual partner. While overall HIV/AIDS rates in the Asian Pacific Islander (API) community remain low, they are rising and HIV testing rates, one of the major prevention strategies for HIV, are lower than that of other populations. Furthermore, very little is known about APIs …

Vertical Transmission Of West Nile Virus In Culex Spp. Mosquitoes Of Clark County, Nevada, Vivek K. Raman

UNLV Theses, Dissertations, Professional Papers, and Capstones

West Nile Virus (WNV) is an RNA arbovirus that cycles between mosquitoes and birds, but also infects and causes disease in humans, horses and other vertebrate species. Although most infections are asymptomatic, WNV has emerged as the most common cause of epidemic meningoencephalitis in North America and the leading cause of arboviral encephalitis in the United States.

Mosquitoes of the genus Culex are the most active vectors of WNV in North America. Approximately 85% of human WNV infections in the United States occur in late summer with a peak number of cases in August and September. Vertical transmission is defined …

The Efficacy Of Spirometry As A Screening Tool In Detection Of Air Flow Obstruction, Nabeel Manzar, A. Suleman Haque, Bushra Manzar, Muhammad Irfan

Section of Pulmonary & Critical Care

Background/Objectives: In developing countries, spirometry has not been considered a part of routine medical check-up. The purpose of the study was to establish the usefulness of spirometry as a primary screening tool in detecting air flow obstruction (AFO) during routine medical check-up (RMC). Methods: This was a hospital based, retrospective, non-randomized case series study of 3696 participants, who presented to hospital for routine medical check-up. All subjects were assisted at the Pulmonary Medicine Department, from January 2003 till December 2008 who, having met other inclusion criteria, underwent spirometry. Data were analyzed using proportion, group means, standard deviations and …

The Role Of Unrealistic Optimism In Explaining Preventive Behaviors In High Versus Low Endemic Malaria Settings In Belize, Daniel G. Handysides

Loma Linda University Electronic Theses, Dissertations & Projects

Background: Of all the diseases an individual can encounter in the world, malaria is one of the most destructive. Simple measures like sleeping under a bednet would greatly reduce the burden (Abeku, 2007). When people estimate their risk relative to others, they are most often unrealistically optimistic, which may explain why those at risk often fail to perform behaviors, such as using a bednet that will reduce their risk. However, one study showed that people at high risk for malaria held pessimistic perceptions of their risk for the disease, but the reasons for this finding are unclear (Morrison, Ager, & …

Cardiovascular Risk Assessment - From Individual Risk Prediction To Estimation Of Global Risk And Change In Risk In The Population, John A. Batsis, Francisco Lopez-Jimenez

Dartmouth Scholarship

Cardiovascular disease is the most common cause of death and risk prediction formulae such as the Framingham Risk Score have been developed to easily identify patients at high risk that may require therapeutic interventions. Using cardiovascular risk formulae at a population level to estimate and compare average cardiovascular risk among groups has been recently proposed as a way to facilitate surveillance of net cardiovascular risk and target public health interventions. Risk prediction formulas may help to compare interventions that cause effects of different magnitudes and directions in several cardiovascular risk factors, because these formulas assess the net change in risk …

Evaluating The Impact Of The Guatemalan Nursing Program On Staff, Organizational, And Clinical Outcomes, Sara Williamson Day

Theses and Dissertations (ETD)

There is great disparity between the outcome of childhood cancer in developed and developing countries. Nurses, who comprise the largest group of health care professionals globally, are essential to successful treatment. Pediatric oncology education is generally unavailable for nurses in developing countries. This lack of education is likely to contribute to the disparity in survival rates, as undereducated nurses are unable to meet the demands of pediatric cancer care. A second critical problem in developing countries is the workload of the nurse, with a patient nurse ratio reported as high as 30 patients per one nurse.

In 2006, the quality …

Pain Management In Nursing Home Residents With Cancer And Dementia With And Without Hospice Services, Todd Bryant Monroe

Theses and Dissertations (ETD)

Aims: We sought to identify differences in pain management between two groups; nursing home residents with malignant cancer and dementia with and without hospice services.

Methods: Decedent records from 2003-2009 were assessed for diagnosis of dementia and cause of death as cancer. Ten malignant cancer diagnoses were determined a priori from the CDC 2004 data on the top 10 malignant cancers for all races and genders. Fifty-five decedents from 10 nursing homes were included in the final sample. Four instruments were used: Minimum Data Set (MDS) a standardized assessment tool required of most U.S. nursing homes. A large …

Glycan Shielding Of The Influenza Virus Hemagglutinin Elicits Evasion Of The Adaptive Immune Response And T-Cell-Driven Pathology, Keith C. Wanzeck

Theses and Dissertations (ETD)

Three separate influenza pandemics have emerged in the human population since 1918, each characterized by viruses that lack N-linked glycosylation sites on the globular head of the hemagglutinin protein. In contrast, recent non-pandemic isolates have acquired such sites. Here we constructed isogenic viruses containing differing numbers of additional N-linked glycosylation sites to assess the impact on the host immune response. These studies show that mice infected with a glycosylated virus remain susceptible to challenge with a non-glycosylated virus, glycosylated viruses elicit an inferior immune response, and in this context T-cell pathology and death may occur. We conclude from these data …

Changing Po2licy: The Elements For Improving Childhood Asthma Outcomes, Anne Rossier Markus, Meagan Lyon, Sara J. Rosenbaum

Geiger Gibson/RCHN Community Health Foundation Research Collaborative

Childhood asthma is a serious and chronic health issue that affects one in seven U.S. children and their families, compromising their health and quality of life and placing a heavy financial burden on families as well as an enormous strain on the health care system. Treating, managing, and ultimately preventing and reducing the burden of asthma represents a critical test of the ability of the U.S. health system – health insurers, clinical care providers, and public health agencies – to work together. Our investigation found that, as a country, we already know enough to act and improve life for the …

Analysis Of Primary Risk Factors For Oral Cancer From Us States With Increasing Rates, Anthony Bunnell, Nathan Pettit, Nicole Reddout, Kanika Sharma, Susan O'Malley, Michelle Chino, Karl Kingsley

School of Public Health Faculty Research

Objectives

To examine the primary risk factor for oral cancer in the US, smoking and tobacco use, among the specific US states that experienced short-term increases in oral cancer incidence and mortality.

Methods

Population-based data on oral cancer morbidity and mortality in the US were obtained from the National Cancer Institute's (NCI) Surveillance, Epidemiology, and End Results (SEER) database for analysis of recent trends. Data were also obtained from the Centers for Disease Control and Prevention (CDC) Behavioral Risk Factor Surveillance System (BRFSS) to measure current and former trends of tobacco usage. To comprehensive measures of previous state tobacco use …

Modeling Super-Spreading Events For Sars, Thembinkosi P. Mkhatshwa

Theses, Dissertations and Capstones

One of the intriguing characteristics of the 2003 severe acute respiratory syndrome (SARS) epidemics was the occurrence of super spreading events (SSEs). Super-spreading events for a specific infectious disease occur when infected individuals infect more than the average number of secondary cases. The understanding of these SSEs is critical to under- standing the spread of SARS. In this thesis, we present a modification of the basic SIR (Susceptible - Infected - Removed) disease model, an SIPR (Susceptible - Regular Infected - Super-spreader - Removed) model, which captures the effect of the SSEs.

Prevention With Positives: How Do We Reach Them In The Community?, Avina Sarna, Jerry Okal, Stanley Luchters, Nzioki King'ola, Scott Geibel

HIV and AIDS

In the past, HIV prevention efforts have focused primarily on developing risk-reduction interventions for those presumed to be HIV-negative and therefore at risk of becoming infected with HIV. In recognition of the need for prevention among people living with HIV (PLHIV), programs have been initiated in Africa, but primarily in clinical settings for those who are on antiretroviral therapy (ART). There is little knowledge about how to reach those PLHIV not on ART, and therefore not in regular contact with the health system or with effective prevention messages. This diagnostic study aimed to address the gap in information on how …

Protecting Hope: Situation Analysis Of Vulnerable Children In Uganda 2009, Sam Kalibala, Lynne Elson

HIV and AIDS

The Government of Uganda has focused attention on the problem of orphaned and other vulnerable children through a number of policies, regulations, and initiatives. In 2004, the Ministry of Gender Labor and Social Development developed the National OVC Policy, aimed at improving the quality of life for poor and vulnerable children, such as children who have been orphaned, children who are living on the streets, children who are at risk of abuse, and children exposed to situations of armed conflict. However, despite the many efforts to improve the circumstances of vulnerable children in Uganda, policymakers, donors, and program managers still …

Rapids Evaluation Final Report 2005-2009 Key Findings, Louis Apicella, Katie D. Schenk, Hena Khan

HIV and AIDS

RAPIDS (Reaching HIV/AIDS Affected People with Integrated Development and Support) is an intervention funded by the United States Agency for International Development (USAID), and is designed to mitigate the impact of HIV/AIDS in Zambia. The overall goal of RAPIDS is to improve the quality of life of Zambians affected by HIV and AIDS by expanding successful community-based models of home-based care and support to orphans and vulnerable children and people who are chronically ill, as well as through interventions targeting youth with livelihood opportunities and life-skills training, focusing on initiatives supporting abstinence and being faithful.

Factors Affecting Enrolment Of Plhiv Into Art Services In India, Avina Sarna, Damodar Bachani, Mary Philip Sebastian, Ruchi Sogarwal, Madhusudana Battala

HIV and AIDS

At the end of 2007, India had an estimated 2.31 million people living with HIV, and an HIV prevalence of 0.34 percent. Despite the low HIV prevalence, these statistics place India among countries with a large number of people living with HIV (PLHIV). To address the care and support needs of PLHIV, the Ministry of Health and Family Welfare, Government of India, initiated a national program in 2004 to provide free antiretroviral therapy (ART) for PLHIV. By March 2009, there were 211 functioning Antiretroviral Treatment Centers and 254 Community Care Centers across the country, and to date 217,781 individuals are …

Monitoring And Evaluation Of The Emergency Plan Progress (Meepp): End-Of-Project Evaluation, Sam Kalibala

HIV and AIDS

This report evaluates the scope of the Monitoring and Evaluation of the Emergency Plan Progress (MEEPP) and the lessons learned from the project in Uganda, which aims to improve availability and quality of PEPFAR data.

Ischemic Stroke Care - Official Guidelines From The Pakistan Society Of Neurology, Ayeesha Kamran Kamal, Ahmed Itrat, Imama Naqvi, Maria Khan, Roomasa Channa, Ismail Khatri, Mohammad Wasay

Department of Medicine

No abstract provided.