Public Health Commons^™

Expanding The Care Continuum For Hiv/Aids: Bringing Carers Into Focus, Jessica Ogden, Simel Esim, Caren Grown

HIV and AIDS

This review by the International Center for Research on Women explores the specific issues that cluster around the provision of care in the context of the global HIV/AIDS pandemic. With the support of the Population Council’s Horizons program, this review applies the care economy lens to two key sectors, health and social protection, and finds that while important strides are being made, much more needs to be known and done to enable individuals, families, and households to survive in a world shaken by AIDS. The report documents the challenges faced by family care providers, who are primarily women and unlinked …

Expanding Care And Support In South India: Scaling Up Yrg Care's Patient-Centered Approach, Yrg Care, Horizons Program, International Hiv/Aids Alliance

HIV and AIDS

This study examines the experiences of YRG CARE, a Chennai-based NGO, which provides an integrated continuum of prevention, care, and support services for PLHA in South India. In this Horizons report, the authors examine the process of scaling up YRG CARE’s patient-centered approach and how this led to the enhanced provision of care and support services at four selected sites. Networking and collaboration among providers at all sites were essential parts of the strategy. At the end of project workshop, scale-up participants and YRG CARE affirmed their intention to continue collaboration in order to build on the successes of the …

Succession Planning In Uganda: Early Outreach For Aids-Affected Children And Their Families, Horizons Program, Makerere University Department Of Sociology, Plan Uganda

HIV and AIDS

This publication reports on an intervention study that evaluated the effectiveness of a succession planning (SP) program in Uganda. Unlike most other programs for AIDS-affected children, succession planning reaches children and their families while their HIV-positive parents are still living and in a position to plan for their children’s long-term well-being. Research carried out by the Department of Sociology at Makerere University (Kampala) and the Population Council Horizons program suggests that succession planning is a promising approach: despite AIDS-related stigma and cultural resistance to acknowledging illness and death, qualitative research indicates that the approach met with a high degree of …

Combining Community Approaches And Government Policy To Prevent Hiv Infection In The Dominican Republic, Deanna Kerrigan, Luis Moreno, Santo Rosario, Bayardo Gomez, Hector Jerez, Ellen Weiss, Johannes Van Dam, Eva Roca, Clare Barrington, Michael D. Sweat

HIV and AIDS

A recent Horizons study conducted jointly with two Dominican NGOs assessed the impact of two environmental-structural models in reducing HIV-related risk among female sex workers in the Dominican Republic and compared their cost-effectiveness. In the two cities studied, there were improvements from pre- to post-intervention in the key outcome variables, however the type and level of these changes varied by intervention approach. Based on our findings, program planners and policymakers involved in the study in the Dominican Republic agree that the integrated solidarity and policy model in conjunction with ongoing peer education and community mobilization activities is an appropriate, cost-effective, …

Involving Young People In The Care And Support Of People Living With Hiv/Aids In Zambia, Eka Esu-Williams, Katie D. Schenk, Joseph Motsepe, Scott Geibel, Anderson Zulu

HIV and AIDS

The Population Council, in collaboration with CARE International and Family Health Trust, conducted a study in Zambia to determine which care and support needs of people living with HIV and AIDS and their families could be met by trained youth, and to establish whether youth engaged in formalized care and support activities would increase their adoption of protective behaviors or reduce the stigma faced by members of AIDS-affected households. Discussions with caregivers and clients demonstrated that trained youth are able to meet a range of the needs of clients and orphans and vulnerable children, and that their efforts may be …

A Rapid Situation Analysis Of The Access To Care Project In Northern Thailand, Ratana Panpanich

HIV and AIDS

A rapid situation analysis (RSA) study, supported by the Horizons program, was undertaken to understand the strengths and weaknesses of the Thai government’s Access to Care (ATC) project in northern Thailand. The ultimate aim of the study was to make recommendations for action that will improve the quality of the antiretroviral (ARV) therapy that clients receive and to enhance their adherence to HAART. The RSA has shown high levels of support for the ATC project from health providers, HAART clients, their relatives, and even those who had dropped out of the program. However, the RSA has also shown that there …

Transitions To Adulthood In The Context Of Aids In South Africa: The Impact Of Exposure To Life Skills Education On Adolescent Knowledge, Skills, And Behavior, The Transitions To Adulthood Study Team

HIV and AIDS

This study is a collaborative research project of the University of Natal-Durban, the Horizons program, and Tulane University. One objective of the study was to contribute to understanding the effectiveness of life skills education in changing behavior in South Africa. The findings indicate substantial short-to-medium-term effects of exposure to life skills education on certain areas of sexual and reproductive health-related knowledge, confidence to use condoms, and condom use behavior. Further research is needed to assess whether the observed effects are transitory or long-term in nature, whether the observed behavioral changes have an impact on HIV infection rates among youth, and …

Using Incentives To Encourage Aids Programs And Policies In The Workplace: A Study Of Feasibility And Impact In Thailand, Simon Baker, Srisuman Sartsara, Patchara Rumakom, Philip Guest, Katie D. Schenk, Anthony Pramualratana, Suparat Suksakulwat, Surachai Panakitsuwan, Sikarat Moonmeung

HIV and AIDS

A recently completed Horizons study in Thailand examined the question of how to encourage the private sector to become actively involved in developing and improving workplace HIV/AIDS programs. The study found that the AIDS-response Standard Organization (ASO) initiative mobilized a moderate proportion of different types of companies to develop and improve HIV/AIDS workplace policies and programs. The data also reveal that companies that were eligible for the insurance discount made the greatest improvements. Thus a financial incentive combined with efforts to tap into managers’ willingness to respond to the epidemic can be important motivators for certain companies to improve their …

Optimization Of Breast Cancer Screening Modalities, Yu Shen, Giovanni Parmigiani

Johns Hopkins University, Dept. of Biostatistics Working Papers

Mathematical models and decision analyses based on microsimulations have been shown to be useful in evaluating relative merits of various screening strategies in terms of cost and mortality reduction. Most investigations regarding the balance between mortality reduction and costs have focused on a single modality, mammography. A systematic evaluation of the relative expenses and projected benefit of combining clinical breast examination and mammography is not at present available. The purpose of this report is to provide methodologic details including assumptions and data used in the process of modeling for complex decision analyses, when searching for optimal breast cancer screening strategies …

Ua61/6 Newsletter, Issue 2, Wku Institute For Rural Health Development & Research

WKU Administration Documents

Newsletter created by and about the Institute for Rural Health Development & Research. This issue contains:

• College of Health & Human Services Has New Dean – John Bonaguro
• Simpson, Staci. Institute Aims to Improve Oral Health of Children
• Whitfield, Beth. WKU Mobile Unit KICS Off Dental Event with Webster County – Kentucky Interdisciplinary Community Screening
• Stone, Glynda. TEACH KY: Teachers Exploring & Advocating Careers in Health in Kentucky
• Institute Sponsors Hispanic Health Fair
• HIV Prevention Counseling & Testing Training Program Initiated at WKU
• New Web-based Course Offered Through Communications Disorders Department at WKU
• Lashley, Donita. Child Passenger Safety Training
• Handy, …

Multiple Psychosocial Factors As Predictors In The Progression Of Hiv-1 To Aids, Robert Louis Dutile

Loma Linda University Electronic Theses, Dissertations & Projects

Nearly 3.1 million individuals have died of AIDS as of December 2002 and more than 38.6 million individuals were identified as being infected with HIV (Joint United Nations Programme on HIV/AEDS (UNAIDS) and World Health Organization (WHO) 2002). Psychoneuroimmunology is a discipline that increases our understanding of the relationships between psychosocial factors, the central nervous system, the immune system, and disease. From this perspective, this study reviews the biopsychosocial medical model and components of the stress-immunity-health (SET) model. The constructs of stress and social support are discussed and defined referencing current theory and research. In addition, physiological mechanisms of stress …

Cross-Calibration Of Stroke Disability Measures: Bayesian Analysis Of Longitudinal Ordinal Categorical Data Using Negative Dependence, Giovanni Parmigiani, Heidi W. Ashih, Gregory P. Samsa, Pamela W. Duncan, Sue Min Lai, David B. Matchar

Johns Hopkins University, Dept. of Biostatistics Working Papers

It is common to assess disability of stroke patients using standardized scales, such as the Rankin Stroke Outcome Scale (RS) and the Barthel Index (BI). The Rankin Scale, which was designed for applications to stroke, is based on assessing directly the global conditions of a patient. The Barthel Index, which was designed for general applications, is based on a series of questions about the patient’s ability to carry out 10 basis activities of daily living. As both scales are commonly used, but few studies use both, translating between scales is important in gaining an overall understanding of the efficacy of …

On David Koplow's Smallpox: The Fight To Eradicate A Global Scourge, Lisa Donovan, David Alan Sapp

Reconstruction: Studies in Contemporary Culture

[First paragraph]

The world is free from the variola virus, more commonly known to us as the virus responsible for smallpox -- or at least it is almost free from it. Since the World Health Organization's (WHO) successful eradication campaign ended officially on December 9, 1979, smallpox no longer exists in its natural state, yet it does remain in securely isolated freezers in two locations: the Centers for Disease Control and Prevention facility in Atlanta, Georgia, and the Russian State Research Center of Virology and Biotechnology near Novosibirsk. In Smallpox: The Fight to Eradicate a Global Scourge, David Koplow …

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.

Reproductive Health Services In Kwazulu Natal, South Africa: A Situation Analysis Study Focusing On Hiv/Aids Services, Lewis Ndhlovu, Catherine Searle, Robert A. Miller, Andrew A. Fisher, Ester Snyman, Nancy L. Sloan

HIV and AIDS

This Horizons report examines the readiness of reproductive health services in South Africa, which are primarily geared to women, to deliver HIV and AIDS treatment, care, and prevention services. The goal of the study was to obtain information from a representative sample of provincial health care facilities offering reproductive health services in KwaZulu Natal to meet the growing demand for HIV/AIDS-related services. Ninety-eight hospitals, community health centers, and clinics participated in the situation analysis that identified gaps in service delivery and determined priorities for service integration. Results of the study were presented to a large audience of Department of Health, …

Empowering Communities To Respond To Hiv/Aids: Ndola Demonstration Project On Maternal And Child Health: Operations Research Final Report, Hope Humana, Linkages, National Food And Nutrition Commission, Ndola District Health Management Team, Horizons Program, Zambia Integrated Health Project

HIV and AIDS

A pre–post intervention study conducted in Zambia by Horizons and local NGOs and governmental organizations demonstrated that HIV voluntary counseling and testing (VCT) and infant feeding counseling (IFC) to mothers attending maternal and child health (MCH) clinics are vital components of any mother-to-child transmission (MTCT) reduction strategy, whether or not antiretrovirals (ARVs) are available. These interventions enable mothers to make informed and healthy decisions. Data from the Ndola Demonstration Project yielded encouraging results from efforts to improve the capacity of mothers to make informed decisions about their own health and the health of their infant. The interventions succeeded in raising …

Microfinance And Households Coping With Hiv/Aids In Zimbabwe: An Exploratory Study, Carolyn Barnes, Erica Keogh, Nontokozo Nemarundwe, Loveness Nyikahadzoi, Ellen Weiss

HIV and AIDS

This study, conducted in Zimbabwe, sought to better understand the relationship between a microfinance program, Zambuko Trust, and how microentrepreneurs’ households cope with the impact of HIV/AIDS. The study examined how HIV/AIDS is affecting Zambuko’s operations and what microfinance institutions (MFIs) can do to lessen the impact of HIV/AIDS on their clients and operations. The findings indicate several small yet important ways that MFI programs help microentrepreneurs and their families respond to these impacts through access to credit and business management training. Participation in a microfinance program led to income smoothing and better financial management, which can help households mitigate …

How Should Governments Address High Levels Of Natural Radiation And Radon--Lessons From The Chernobyl Nuclear Accident And Ramsar, Iran, S. M. Javad Mortazavi, M. Ghiassi-Nejad, Azam Niroomand-Rad, P. Andrew Karam, John R. Cameron

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

The authors discuss the high levels of natural background radiation in Ramsar, Iran, and offer data indicating that this has had little effect on the health of Ramsar's inhabitants. The authors then examine the implications their research could have for public health policy.

The Precautionary Principle And Radiation Protection, Kenneth L. Mossman, Gary E. Marchant

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

The authors examine the application of the precautionary principle through a case study of ionizing radiation control and suggest a reevaluation of current radiation safety standards and practices.

Integrating Hiv Prevention And Care Into Maternal And Child Health Care Settings: Lessons Learned From Horizons Studies, Naomi Rutenberg, Sam Kalibala, Charles Mwai, James Rosen

HIV and AIDS

Many women in the developing world still lack access to high-quality HIV/AIDS prevention and care services. To address this problem, Horizons has undertaken a range of operations research efforts that examine the integration of HIV-related care in the maternal-child health setting. At a workshop held in Kenya in July 2001, participants discussed the experience to date and formulated practical strategies for improving the integration. This consultation report summarizes that discussion according to the following seven key program components: Training and Motivation to Improve the Performance of Health Workers; Supervision of HIV Services and Quality Assurance of HIV Testing; Caring for …

Meeting The Sexual Health Needs Of Men Who Have Sex With Men In Senegal, Cheikh Ibrahima Niang, Moustapha Diagne, Youssoupha Niang, Amadou Moreau, Dominique Gomis, Maye Diouf, Karim Seck, Abdoulaye Sidibe Wade, Placide Tapsoba, Christopher Castle

HIV and AIDS

A study conducted in Dakar, Senegal by researchers from the National AIDS Council, Cheikh Anta Diop University, and the Horizons program obtained information on the needs, behaviors, knowledge, and attitudes of men who have sex with men (MSM). This study offers important insights into the sexuality of MSM, their vulnerability to STI/HIV, and the role of violence and stigma in their lives. The results also highlight the lack of sexual health services and information available to cover the specific needs of MSM. The results of this study were summarized during a meeting held in April 2001 in Dakar and raised …

Estimating The Cost And Effectiveness Of Different Sti Management Strategies For Sex Workers In Madagascar, Horizons Program

HIV and AIDS

In Madagascar, the prevalence of sexually transmitted infections (STIs) is a serious public health problem, particularly among sex workers. A Horizons study conducted in 2000 found approximately two-thirds of female sex workers had an STI, although few were infected with HIV. Since the link between STIs and transmission of HIV has been well established, affordable strategies to manage STIs among sex workers need to be developed. Study investigators also assessed STI management practices in health facilities in two urban areas of Madagascar. Health practitioners were using a syndromic approach, which may be appropriate for managing certain STIs in the general …

Peer Nutrition Education: A Model For Nutrition Education Among Spanish-Language Participants Of The Special Supplemental Nutrition Program For Women, Infants And Children (Wic), Maximino Alfredo Mejía

Loma Linda University Electronic Theses, Dissertations & Projects

Despite the steady improvement in the health status of Americans, Hispanics are a minority in the United States with greater prevalence of several infectious and chronic diseases and less health knowledge than the average citizen. Nearly half of the Hispanics living in this country die of preventable nutrition-related conditions, with heart disease and cancer being the leading causes. Since this minority has limited access to health care and preventive services, there is a need for an inexpensive, viable model of health education for this underserved segment of the population in order to lower the excess of preventable diseases. We trained …

Psychosocial Stress And Prostate Cancer: A Theoretical Model, Gary L. Ellison, Ann L. Coker, James R. Hebert, Maureen Sanderson, Charmaine D. Royal, Sally P. Weinrich

CRVAW Faculty Journal Articles

African-American men are more likely to develop and die from prostate cancer than are European-American men; yet, factors responsible for the racial disparity in incidence and mortality have not been elucidated. Socioeconomic disadvantage can lead to psychosocial stress and may be linked to negative lifestyle behaviors. Regardless of socioeconomic position, African-American men routinely experience racism-induced stress. We propose a theoretical framework for an association between psychosocial stress and prostate cancer. With the context of history and culture, we further propose that psychosocial stress may partially explain the variable incidence of prostate cancer between these diverse groups. Psychosocial stress may negatively …

Workplace Pollution: Nuclear Safety, Ethics, And The Exploitation--Avoidance Argument, Kristin Shrader-Frechette

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

The author reviews evidence of poor worker health and safety practices in United States Department of Energy nuclear facilities in contending that less protective standards for workplace hazards constitute an environmental injustice not rectified by a hazard pay premium.

Acquired Immuno-Deficiency Syndrome (Aids) And Human Immuno-Deficiency Virus (Hiv) In Nevada – Annual Surveillance Report (1999), Mary Guinan, Nancy Kreher, Drew Mather, Wei Yang

School of Public Health Faculty Research

Background:

Acquired Immuno-Deficiency Syndrome (AIDS) is the most severe manifestation of Human Immunodeficiency Virus (HIV) infection. AIDS was first reported in the world in 1981 by the Centers for Disease Control and Prevention. Statewide surveillance for AIDS was begun in 1982. Because the cause of AIDS was unknown at that time, the surveillance case definition included many opportunistic infections and tumors. Persons with AIDS were noted to have abnormalities in their immune system that left them susceptible to certain infections. As more information became available, the AIDS surveillance case definition was modified.

In 1984, HIV was found to be the …

Trends. The Privileged Status Of The Physical In Health Ideology: The Security Consequences Of Aids, Ibpp Editor

International Bulletin of Political Psychology

The author discusses the importance of recognizing both physical and psychological factors of the AIDS (Acquired Immune Deficiency Syndrome) pandemic on security.

Special Report On Children Born To Hiv Positive Parents In Nevada, 1991-1999, Drew Mather, Mary Guinan, Richard Whitley, Wei Yang

School of Public Health Faculty Research

Background:

This report encompasses an effort to look at the number of children born to HIV (Human Immunodeficiency Virus) and/or AIDS (Acquired Immunodeficiency Syndrome) infected parents during the years 1991 to 1999 in Nevada.

According to the Healthy People 2000 (HP 2000) Review for the years 1998- 1999, infants of untreated or undetected HIV positive women have been identified as a distinct population at risk for contracting the virus that causes AIDS.

The State of Nevada’s Bureau of Disease Control and Intervention Services in collaboration with the Bureau of Health Planning and Statistics has taken the initial step to “cross …

Contrasting Treatments Of Recall Bias In Two Epidemiological Settings, Daniel Barry

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

The author contrasts the treatment of recall bias in the literature on induced abortions and breast cancer, and on environmental tobacco smoke and lung cancer.

Over A Decade Of Comparative Risk Analysis: A Review Of The Human Health Rankings, David M. Konisky

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

The author reviews a method for undertaking a cross-project comparison of comparative risk analyses to understand which environmental problem areas have been cited most as often posing the severest risks.