Public Health Commons^™

Kejadian Anemia Pada Siswa Sekolah Dasar, Saifuddin Sirajuddin, Masni Masni

Kesmas

Anemia gizi besi masih merupakan masalah kesehatan masyarakat dengan prevalensi pada anak 5 - 12 tahun sebesar 29% di Indonesia dan di Kota Makassar sebesar 37,6%. Penelitian ini bertujuan untuk mengetahui faktor determinan (status kecacingan, status seng, kebiasaan sarapan pagi, pola konsumsi makanan sumber heme dan nonheme, pola konsumsi sumber makanan pelancar dan penghambat zat besi) terhadap kejadian anemia. Desain penelitian yang digunakan adalah potong lintang yang dilaksanakan pada bulan April – Juni 2014. Penelitian ini menggunakan desain potong lintang yang dilaksanakan pada siswa kelas 3 - 5 SD Negeri Cambaya Kecamatan Ujung Tanah Kota Makassar. Sampel sebanyak 120 siswa …

Pencegahan Resurgensi Malaria Dengan Deteksi Dini Dan Pengobatan Segera Di Daerah Reseptif, Teni Supriyani, Umar Fahmi Achmadi, Dewi Susanna

Kesmas

Jawa Barat merupakan salah satu wilayah reseptif malaria di Indonesia, khususnya Kabupaten Tasikmalaya bagian selatan. Tahun 2009, 2011, dan 2012 telah terjadi kejadian luar biasa (KLB) terutama di Kecamatan Cineam. Namun, pada tahun 2013 tidak terjadi KLB serupa. Ekosistem Cineam berupa pegunungan dan perkebunan kondusif untuk penularan malaria. Selain itu, banyak penduduk Cineam yang merupakan pekerja migran. Tujuan penelitian ini untuk mengidentifikasi faktor-faktor yang berkontribusi terhadap tidak terjadinya peningkatan kasus (resurgensi) malaria di daerah reseptif. Penelitian ini merupakan penelitian deskriptif kuantitatif yang dilakukan pada bulan Juni - Desember 2014, dengan menggunakan sampel seluruh penderita malaria positif di Kecamatan Cineam tahun …

Diabetes Melitus Dan Tingkat Keparahan Jaringan Periodontal, Rikawarastuti Rikawarastuti, Eka Anggreni, Ngatemi Ngatemi

Kesmas

Penyakit periodontal merupakan masalah kesehatan gigi dan mulut dengan prevalensi cukup tinggi di Indonesia (60%). Diabetes melitus merupakan salah satu faktor predisposisi terjadinya penyakit periodontal. Tujuan penelitian adalah menganalisis hubungan diabetes melitus terhadap tingkat keparahan jaringan periodontal. Jenis penelitian observasional analitik potong lintang. Penelitian dilakukan di Puskesmas Kecamatan Jagakarsa Jakarta Selatan pada bulan Oktober - November 2014 dengan populasi penelitian adalah pengunjung Puskesmas Kecamatan Jagakarsa. Pengambilan sampel menggunakan simple random sampling sebanyak 122 orang. Status diabetes melitus didapat dari rekam medis poli penyakit tidak menular. Analisis data menggunakan kai kuadrat dan regresi logistik sederhana. Hasil penelitian menunjukkan proporsi penderita diabetes …

Asi Eksklusif Dan Persepsi Ketidakcukupan Asi, Adila Prabasiwi, Sandra Fikawati, Ahmad Syafiq

Kesmas

Persepsi ketidakcukupan air susu ibu (PKA) adalah keadaan ibu merasa ASI-nya tidak cukup untuk memenuhi kebutuhan bayinya. PKA merupakan salah satu penyebab utama kegagalan ASI eksklusif di dunia. Penelitian ini bertujuan untuk mengetahui faktor paling dominan berhubungan dengan PKA di Kecamatan Tegal Selatan dan Kecamatan Margadana, Kota Tegal tahun 2014. Penelitian ini merupakan penelitian primer dengan desain studi potong lintang. Sampel berjumlah 88 ibu dari bayi berusia 0 - 6 bulan yang dipilih secara purposive sampling. Status gizi ibu dilihat dari kenaikan berat badan ibu sewaktu hamil apakah sesuai dengan rekomendasi dari Institute of Medicine. Asupan energi ibu saat laktasi …

Tumor Necrosis Factor-Α Sebagai Prediktor Terjadinya Anemia Pada Ibu Hamil Di Wilayah Endemis Malaria, Rostika Flora, Mukni Mukni, Bina Melvia Girsang, Sigit Purwanto

Kesmas

Ibu hamil yang berada di daerah endemis malaria sangat rentan terhadap infeksi malaria selama kehamilan. Gejala malaria pada kelompok ini sering asimptomatik atau bahkan tidak terdeteksi sama sekali karena adanya efek imunitas protektif melalui infeksi yang berulang. Adanya peningkatan kadar tumor necrosis factor-alpha (TNF-α) dapat dijadikan indikator terjadinya infeksi malaria. TNF-α berperan penting dalam respons imun pada malaria akut yang menghambat terjadinya eritropoesis. Penelitian ini bertujuan untuk mengetahui hubungan antara kadar TNF-α dengan kejadian anemia pada ibu hamil didaerah endemik malaria vivax. Penelitian ini menggunakan desain potong lintang, dilakukan pada bulan Januari - Februari 2014 di lima wilayah kerja puskesmas …

Determinan Stres Pada Pegawai Kementerian Kesehatan Republik Indonesia, Besral Besral, Winne Widiantini

Kesmas

Kejadian stres pada pelbagai kelompok di Indonesia cukup tinggi dan belum banyak diketahui determinannya. Penelitian ini bertujuan untuk mengetahui determinan stres pada pegawai Kementerian Kesehatan Republik Indonesia (Kemenkes RI). Penelitian potong lintang ini dilakukan pada tahun 2013 terhadap 230 pegawai sekretariat jenderal yang dipilih secara acak. Analisis statistik menggunakan regresi logistik ganda. Responden dikatakan stres jika memiliki skor 28 atau lebih dengan menggunakan 17 pertanyaan terkait personal stress inventory. Hasil penelitian menunjukkan prevalensi stres sebesar 79% dan determinan stres adalah obesitas, usia, jabatan, suku, pendidikan, dan aktivitas fisik. Risiko stres lebih tinggi pada pegawai yang obesitas (ORadj = 1,9), pegawai …

Bioindikator Cemaran Timbal Pada Rambut Masyarakat Sekitar Kilang Minyak, Sukar Sukar, Suharjo Suharjo

Kesmas

Timbal atau Plumbum (Pb) bersifat toksik, karsinogenik, bioakumulator dan biomagnifikasi. Bioakumulasi Timbal dari media lingkungan dapat terjadi pada kuku, hati, dan rambut. Tujuan penelitian untuk mengetahui faktor risiko kejadian bioindikator timbal rambut masyarakat di kawasan industri minyak. Penelitian dilakukan pada tahun 2012 di Kota Dumai, Provinsi Riau. Rancangan penelitian khusus pencemaran lingkungan 2012 adalah type- 1 health study, yang disarankan US Agency for Toxic Substances and Drugs Registry (ATSDR). Analisis statistik bivariat dengan uji kai kuadrat. Populasi penelitian adalah penduduk Kota Dumai yang tinggal di desa Jayamukti, Tanjung Palas, Mekarsari, dan Bukit Timah. Sejumlah 110 ibu rumah tangga diambil dengan …

Efektivitas Air Perasan Kulit Jeruk Manis Sebagai Larvasida Nyamuk Aedes Aegypti, Dita Nurhaifah, Tri Wahyuni Sukesi

Kesmas

Demam berdarah dengue ditularkan nyamuk Aedes aegypti yang dapat dicegah dengan temefos. Penggunaan yang berkelanjutan berdampak pada resistensi nyamuk dan kerusakan lingkungan. Untuk itu perlu larvasida alami dengan menggunakan air perasan kulit jeruk manis. Tujuan penelitian untuk membuktikan efektivitas air perasan kulit jeruk manis dalam membunuh larva uji dilihat dari nilai LC50 dan LT50 serta perbedaan efektivitasnya dengan temefos. Sampel 25 larva Aedes aegypti setiap gelas media dengan kriteria inklusi instar III yang aktif dan kriteria eksklusi larva instar I, II dan yang telah menjadi pupa/mati. Larva uji diamati selama 24 jam dengan tiga kali pengulangan. Desain penelitian adalah eksperimental …

Law, Ethics, And Public Health In The Vaccination Debates: Politics Of The Measles Outbreak, Lawrence O. Gostin

Georgetown Law Faculty Publications and Other Works

The measles outbreak of early 2015 is symptomatic of a larger societal problem–the growing number of parents who decide against vaccinating their children. This failure is causing the resurgence of childhood diseases once eliminated from the United States.

This article explores the legal and ethical landscape of vaccine exemptions. While all states require childhood vaccinations, they differ significantly in the types of religious and/or philosophical exemptions permitted, the rigor of the application process, and available review mechanisms. States with relaxed exemption policies disproportionately experience more outbreaks of vaccine-preventable disease.

Vaccine exemptions are an illustration of the “tragedy of the commons,” …

Aca Implementation In The South: The Political Economy Of Full Participation In Kentucky, Glen P. Mays

Health Management and Policy Presentations

This analysis, conducted as part of the ACA Implementation Research Network, examines economic and political forces shaping Kentucky's early experience with implementation of the Patient Protection and Affordable Care Act.

Undergraduate Public Health Education: Is There An Ideal Curriculum?, Leonard H. Friedman, Joel M. Lee

Health Policy and Management Faculty Publications

No abstract provided.

Using Payment Reform Strategies To Strengthen Family Planning Services At Community Health Centers, Sara J. Rosenbaum, Peter Shin, Susan F. Wood, Jessica Sharac

Geiger Gibson/RCHN Community Health Foundation Research Collaborative

No abstract provided.

A Framework For Assessing The Impact Of Pharmaceutical Reimbursement Policies On Incentives To Innovate, Elizabeth Docteur, Joshua Cohen, Brian K. Bruen, Ruth Lopert, Avi Dor, Chuck Shih

Health Policy and Management Faculty Posters and Presentations

No abstract provided.

Evaluation Of Social Media Utilization By Latino Adolescents: Implications For Mobile Health Interventions, Megan Landry, Amita Vyas, Monique Turner, Sara Nelson Glick, Susan Wood

Health Policy and Management Faculty Publications

Background: Trends in social media use, including sending/receiving short message service (SMS) and social networking, are constantly changing, yet little is known about adolescent’s utilization and behaviors. This longitudinal study examines social media utilization among Latino youths, and differences by sex and acculturation.

Objectives: The purpose of this study was to examine Latino adolescents’ social media utilization and behavior over a 16-month period, and to assess whether changes in use differed by sex and acculturation.

Methods: This study included 555 Latino youths aged 13-19 who completed baseline and 16-month follow-up surveys. Prevalence of social media utilization and frequency, by sex …

Mapping Of Networks To Detect Priority Zoonoses In Jordan, Erin M. Sorrell, Mohammad El Azhari, Nezar Maswdeh, Sarah Kornblet, Claire J. Standley, Rebecca L. Katz, Ibrahim Ablan, Julie E. Fischer

Health Policy and Management Faculty Publications

Early detection of emerging disease events is a priority focus area for cooperative bioengagement programs. Communication and coordination among national disease surveillance and response networks are essential for timely detection and control of a public health event. Although systematic information sharing between the human and animal health sectors can help stakeholders detect and respond to zoonotic diseases rapidly, resource constraints and other barriers often prevent efficient cross-sector reporting. The purpose of this research project was to map the laboratory and surveillance networks currently in place for detecting and reporting priority zoonotic diseases in Jordan in order to identify the nodes …

Comparing Cost-Effectiveness Of Hiv Testing Strategies: Targeted And Routine Testing In Washington, Dc., Amanda D Castel, Sungwoog Choi, Avi Dor, Jennifer Skillicorn, James Peterson, Nestor Rocha, Michael Kharfen

Health Policy and Management Faculty Publications

BACKGROUND: Routine HIV testing is an essential approach to identifying undiagnosed infections, linking people to care and treatment, and preventing new infections. In Washington, DC, where HIV prevalence is 2.4%, a combination of routine and targeted testing approaches has been implemented since 2006.

METHODS: We sought to evaluate the cost effectiveness of the District of Columbia (DC) Department of Health's routine and targeted HIV testing implementation strategies. We collected HIV testing data from 3 types of DC Department of Health-funded testing sites (clinics, hospitals, and community-based organizations); collected testing and labor costs; and calculated effectiveness measures including cost per new …

Clash Of The Titans: Medicaid Meets Private Health Insurance, Sara J. Rosenbaum

Health Policy and Management Faculty Publications

Throughout its first forty-eight years of life, the federal Medicaid statute lacked a viable insurance pathway for most low-income adults' ineligible for employer-sponsored coverage. In what is arguably the most important public health achievement since the enactment of Medicare and Medicaid fifty years ago, the Patient Protection and Affordable Care Act (ACA) fundamentally alters this picture. Building on earlier breakthroughs for children, the ACA restructures Medicaid to cover poor adults and juxtaposes its new architecture against an affordable and accessible private insurance market for people ineligible for employer-sponsored or government insurance.

Impact Of Health Insurance Expansions On Nonelderly Adults With Hypertension., Suhui Li, Brian K. Bruen, Paula M. Lantz, David Mendez

Health Policy and Management Faculty Publications

Introduction

Hypertension is a risk factor for cardiovascular disease (CVD), the leading cause of death in the United States. The treatment and control of hypertension is inadequate, especially among patients without health insurance coverage. The Affordable Care Act offered an opportunity to improve hypertension management by increasing the number of people covered by insurance. This study predicts the long-term effects of improved hypertension treatment rates due to insurance expansions on the prevalence and mortality rates of CVD of nonelderly Americans with hypertension.

Methods

We developed a state-transition model to simulate the lifetime health events of the population aged 25 to …

Action For Dental Health Year Two Progress Report, American Dental Association

Action for Dental Health

No abstract provided.

The Core Competencies For Mental, Neurological, And Substance Use Disorder Care In Sub-Saharan Africa, Pamela Y. Collins, Seggane Musisi, Seble Frehywot, Vikram Patel

Health Policy and Management Faculty Publications

The 2010 Global Burden of Disease Study points to a changing landscape in which non-communicable diseases, such as mental, neurological, and substance use (MNS) disorders, account for an increasing proportion of premature mortality and disability globally. Despite evidence of the need for care, a remarkable deficit of providers for MNS disorder service delivery persists in sub-Saharan Africa. This critical workforce can be developed from a range of non-specialist and specialist health workers who have access to evidence-based interventions, whose roles, and the associated tasks, are articulated and clearly delineated, and who are equipped to master and maintain the competencies associated …

Should We Put Our Feet In The Water? Use Of A Survey To Assess Recreational Exposures To Contaminants In The Anacostia River., Rianna Murray, Sacoby Wilson, Laura Dalemarre, Victoria Chanse, Janet Phoenix, Lori Baranoff

Health Policy and Management Faculty Publications

The Anacostia River, a tributary of the Potomac River that flows into the Chesapeake Bay, is highly contaminated with raw sewage, heavy metals, oil and grease, trash, pathogens, excessive sediments, and organic chemicals. Despite this contamination, recreation on the river is very popular, including kayaking, canoeing, rowing, and sport fishing. There is currently no information available on the potential health risks faced by recreational users from exposure to the river’s pollutants. A total of 197 recreational users of the Anacostia River were surveyed regarding general demographic information and their recreational behavior over the previous year, including frequency and duration of …

Health Care Access Dimensions And Cervical Cancer Screening In South Africa: Analysis Of The World Health Survey., Tomi F. Akinyemiju, Jasmine A. Mcdonald, Paula M. Lantz

Health Policy and Management Faculty Publications

Background

Cervical cancer is the most commonly diagnosed cancer and the leading cause of cancer mortality among women in sub-Saharan Africa. Recent recommendations for cervical cancer primary prevention highlight HPV vaccination, and secondary prevention through screening. However, few studies have examined the different dimensions of health care access, and how these may influence screening behavior, especially in the context of clinical preventive services.

Methods

Using the 2003 South Africa World Health Survey, we determined the prevalence of cervical cancer screening with pelvic examinations and/or pap smears among women ages 18 years and older. We also examined the association between multiple …

Transforming Health Professions' Education Through In-Country Collaboration: Examining The Consortia Among African Medical Schools Catalyzed By The Medical Education Partnership Initiative., Zohray M. Talib, Elsie Kiguli-Malwadde, Hannah Wohltjen, Miliard Derbew, Yakub Mulla, David Olaleye, Nelson Sewankambo

Health Policy and Management Faculty Publications

BACKGROUND: African medical schools have historically turned to northern partners for technical assistance and resources to strengthen their education and research programmes. In 2010, this paradigm shifted when the United States Government brought forward unprecedented resources to support African medical schools. The grant, entitled the Medical Education Partnership Initiative (MEPI) triggered a number of south-south collaborations between medical schools in Africa. This paper examines the goals of these partnerships and their impact on medical education and health workforce planning.

METHODS: Semi-structured interviews were conducted with the Principal Investigators of the first four MEPI programmes that formed an in-country consortium. These …

Adapting Pharmaceutical Reimbursement Policies To Manage Spending On High-Priced Drugs, Elizabeth Docteur, Ruth Lopert

Health Policy and Management Faculty Posters and Presentations

No abstract provided.

Diagnosing An International Health Crisis: A Structural Exploration Of Ebola 2014, Maddison Zayn Jansen

Honors Program Theses

The Ebola crisis of 2014, though concentrated most heavily in three small countries in western Africa, awoke the international community to its lack of effective health crisis infrastructure. As the disease rocked the globe, multinational groups scrambled to help those directly affected and protect the overwhelming majority of people not directly affected. Most preventative measures failed, and pre-existing initiatives to stem the flow of the disease only served to open the floodgates more. After careful examination of the literature surrounding medical, cultural, financial, national, and global circumstances enabling Ebola to flourish, as well as applying individual analysis and examination, it …

Law’S Power To Safeguard Global Health: A Lancet–O’Neill Institute, Georgetown University Commission On Global Health And The Law, Lawrence O. Gostin, John T. Monahan, Mary C. Debartolo, Richard Horton

Georgetown Law Faculty Publications and Other Works

The law-–global, national, and subnational–-plays a vital, yet often underappreciated, role in safeguarding and promoting the public’s health. In this article, we launch the Lancet-O’Neill Institute, Georgetown University Commission on Global Health and the Law. Commissioners from around the world will explore the critical opportunities and challenges of using law as a tool, while evaluating the evidence base for legal interventions. The Commission aims to define and systematically describe the current landscape of law that affects global health and safety.

Commissioners were chosen from disciplines that range from health, policy, and law to economics and governance. The Commission aims …

Kenya Adolescent Sexual And Reproductive Health Policy, Ministry Of Health Kenya

Reproductive Health

This document is a review and revision of the National Adolescent Sexual and Reproductive Health Policy of Kenya, which involved in-depth consultations with a wide range of stakeholders through literature review, interviews, consultative meetings, and reviews of the various drafts. Many changes took place at the national and international levels that needed to be taken into account as the policy was reviewed, including the Constitution of Kenya (2010) with its attendant devolved governance structure as well as demographics, and social, economic, and technological environment. The government has made concerted efforts as part of Vision 2030 to respond to adolescents and …

Expanding Access To Education For Teenage Mothers In Homa Bay County: What ‘Might’ Work, Chi-Chi Undie

Reproductive Health

No abstract provided.

The Impact Of Disability: A Comparative Approach To Medical Resource Allocation In Public Health Emergencies, Katie Hanschke, Leslie E. Wolf, Wendy F. Hensel

Faculty Publications By Year

It is a matter of time before the next widespread pandemic or natural disaster hits the United States (U.S.). The international response to the 2009 H1N1 influenza stands as a cautionary tale about how prepared the world is for such an emergency. Although the pandemic fortunately proved to be less severe than initially anticipated, it nevertheless resulted in shortages of medical equipment, overburdened hospitals, and preventable patient deaths, particularly among young people.

A pandemic will inevitably lead to difficult decisions about the allocation of medical resources, such as who will have priority access to ventilators and critical care beds when …

Toward Coherent Federal Oversight Of Medicine, Patricia J. Zettler

Faculty Publications By Year

The conventional wisdom in U.S. health law and policy holds that states regulate medical practice – the activities of physicians and other health care professionals – while the federal government regulates medical products. But relying on states as the principal regulators of medical practice has, at times, driven law and policy in directions that are problematic from a public health perspective, as demonstrated by a deadly 2012 outbreak of fungal meningitis that was linked to a state-regulated practice known as drug compounding. This Article argues that the federalism concerns underlying the conventional wisdom are misplaced. It demonstrates that, contrary to …