Public Health Commons^™

Health Workers’ Perspectives, Knowledge And Skills Regarding Community Case Management Of Childhood Diarrhoea And Pneumonia: A Qualitative Inquiry For An Implementation Research Project “Nigraan” In District Badin, Sindh, Pakistan, Fauziah Rabbani, Shagufta Perveen, Wafa Aftab, Aysha Zahidie, Kashif Sangrasi, Shamim Ahmad Qazi Ahmad Qazi

Community Health Sciences

BACKGROUND:

Pakistan's Lady Health Worker Programme aims to provide care to children sick with pneumonia and diarrhoea, which continues to cause 27 % under-five mortality in Pakistan. The quality of supervision received by Lady Health Workers (LHWs) in the programme influence their knowledge and skills, in turn impacting their ability to provide care.

METHODS:

This study is part of an implementation research project titled "Nigraan" (an Urdu word meaning supervisor), and explores LHW and Lady Health Supervisor (LHS) perspectives regarding the role of supervision in improving LHWs performance and motivation in district Badin, Sindh, Pakistan. Their knowledge and skills regarding …

Economic Burden Of Mental Illnesses In Pakistan., Ashar Muhammad Malik, Murad Moosa Khan

Community Health Sciences

BACKGROUND:

The economic consequences of mental illnesses are much more than health consequences. In Low and Middle Income Countries (LMIC) the economic impact of mental illnesses is rarely analyzed. This paper attempts to fill the gap in research on economics of mental health in LMIC. We provide economic burden of mental illness in Pakistan that can serve as an argument for reorienting health policy, resource allocation and priority settings.

AIM:

To estimate economic burden of mental illnesses in Pakistan.

METHODS:

The study used prevalence based cost of illnesses approach using bottom-up costing methodology. We used Aga Khan University Hospital, Psychiatry …

Abstracts From The 22nd Annual Health Care Systems Research Network Conference, April 13–16, 2016, Atlanta, Georgia

Journal of Patient-Centered Research and Reviews

This proceedings supplement includes selected abstracts presented at the 22nd annual conference of the Health Care Systems Research Network (HCSRN), held April 13–16, 2016, in Atlanta, Georgia. The HCSRN connects the resources and capabilities of research departments from its member health care systems. Collectively, the organization represents more than 1,900 scientists and research staff from an array of disciplines such as epidemiology, economics, disparities, outcomes and quality assessment, trials and genomics.

Mater: Innovative Programs For Maternal Addiction Education Treatment And Research, Meghan Gannon Phd Msph

Population Health Matters (Formerly Health Policy Newsletter)

No abstract provided.

Case Study Of Persons With Cancer Participating In A Community-Based Exercise Program: An Exploration Of Meaning And Change, Barbara K. Haas, Melinda Hermanns, Christina Melin-Johansson

The Qualitative Report

Increasingly, research supports the importance of incorporating exercise into the cancer care paradigm. While quantitative studies have substantiated the significant effects of exercise on physical functioning, the individual’s perspective of participating in an exercise program has rarely been considered. The purpose of this study was to explain the impact of a community based exercise program on the lives of persons with cancer and their caregivers. Based on Bandura’s Social Cognitive Theory, a single explanatory case study with multiple embedded units of analyses was conducted. Interviews were conducted with 10 individuals representing participants with cancer, their caregivers, and health care providers. …

Surveillance, Epidemiological, And Virological Detection Of Highly Pathogenic H5n1 Avian Influenza Viruses In Duck And Poultry From Bangladesh, Wahedul Karim Ansari, Md Safiullah Parvej, Mohamed E. El Zowalaty, Sally Jackson, Stephen A. Bustin, Adel K. Ibrahim, Md Tanvir Rahman, Han Zhang, Mohammad Ferdousur Rahman Khan, Md Mostakin Ahamd, Md. Fasiur Rahman, Marzia Rahman, Khm Nazmul H. Nazir, Sultan Ahmed, Md Liakot Hossenn, Md Abdul Kafi, Mat Yamage, Nitish C. Debnath, Graba Ahmed, Hossam Ashour, Md Masoud, Ayman Noreddin, Md B. Rahman

Pharmacy Faculty Articles and Research

Avian influenza viruses (AIVs) continue to pose a global threat. Waterfowl are the main reservoir and are responsible for the spillover of AIVs to other hosts. This study was conducted as part of routine surveillance activities in Bangladesh and it reports on the serological and molecular detection of H5N1 AIV subtype. A total of 2169 cloacal and 2191 oropharyngeal swabs as well as 1725 sera samples were collected from live birds including duck and chicken in different locations in Bangladesh between the years of 2013 and 2014. Samples were tested using virus isolation, serological tests and molecular methods of RT-PCR. …

Differences In The Carcinogenic Evaluation Of Glyphosate Between The International Agency For Research On Cancer (Iarc) And The European Food Safety Authority (Efsa)., C. J. Portier, B. Armstrong, B. Baguley, X. Baur, I. Belyaev, Melissa J. Perry, +Several Additional Authors

Environmental and Occupational Health Faculty Publications

No abstract provided.

Als Mutant Sod1 Interacts With G3bp1 And Affects Stress Granule Dynamics, Jozsef Gal, Lisha Kuang, Kelly R. Barnett, Brian Z. Zhu, Susannah C. Shissler, Konstantin V. Korotkov, Lawrence J. Hayward, Edward J. Kasarskis, Haining Zhu

Molecular and Cellular Biochemistry Faculty Publications

Amyotrophic lateral sclerosis (ALS) is a fatal neurodegenerative disease. Mutations in Cu/Zn superoxide dismutase (SOD1) are responsible for approximately 20 % of the familial ALS cases. ALS-causing SOD1 mutants display a gain-of-toxicity phenotype, but the nature of this toxicity is still not fully understood. The Ras GTPase-activating protein-binding protein G3BP1 plays a critical role in stress granule dynamics. Alterations in the dynamics of stress granules have been reported in several other forms of ALS unrelated to SOD1. To our surprise, the mutant G93A SOD1 transgenic mice exhibited pathological cytoplasmic inclusions that co-localized with G3BP1-positive granules in spinal cord motor neurons. …

Geographical Location And Stage Of Breast Cancer Diagnosis: A Systematic Review Of The Literature, Faustine Williams, Aimee S. James, Stephen Jeanetta

ETSU Faculty Works

Objective: To examine systematically the literature on the effect of geographical location variation on breast cancer stage at diagnosis, race/ethnicity, and socioeconomic status.

Methods. Eight electronic databases were searched using combination of key words. Of the 312 articles retrieved from the search, 36 studies from 12 countries were considered eligible for inclusion.

Results. This review identified 17 (47%) of 36 studies in which breast cancer patients residing in geographically remote/rural areas had more late-stage diagnosis than urban women. Ten (28%) studies reported higher proportions of women diagnosed with breast cancer resided in urban than rural counties. Nine …

Inspiring Health Worker Motivation With Supportive Supervision: A Survey Of Lady Health Supervisor Motivating Factors In Rural Pakistan, Fauziah Rabbani, Leah Shipton, Wafa Aftab, Kashif Sangrasi, Shagufta Perveen, Aysha Zahidie

Community Health Sciences

BACKGROUND:

Community health worker motivation is an important consideration for improving performance and addressing maternal, newborn, and child health in low and middle-income countries. Therefore, identifying health system interventions that address motivating factors in resource-strained settings is essential. This study is part of a larger implementation research project called Nigraan, which is intervening on supportive supervision in the Lady Health Worker Programme to improve community case management of pneumonia and diarrhea in rural Pakistan. This study explored the motivation of Lady Health Supervisors, a cadre of community health workers, with particular attention to their views on supportive supervision.

METHODS:

Twenty-nine …

Available Interventions For Prevention Of Cotton Dust-Associated Lung Diseases Among Textile Workers, Asaad Ahmed Nafees, Zafar Fatmi

Community Health Sciences

The authors reviewed literature on interventions for cotton dust-associated lung diseases among textile workers. Internet sources (PubMed, Cochrane Library, Google and Google Scholar) were accessed and interventions were categorized into: Engineering or administrative controls, or personal protective equipment (PPE). Ten relevant articles were shortlisted, five related to engineering controls (pre-processing, bactericidal treatment of cotton, improved workplace design, machinery and dust control measures). Administrative controls may involve setting standards, environmental surveillance, periodic medical examinations, and workers training. Although specific guidelines are available regarding the use of PPEs, but there was little literature on their effectiveness. It was concluded that there is …

Diabetes Is Associated With Cerebrovascular But Not Alzheimer's Disease Neuropathology, Erin L. Abner, Peter T. Nelson, Richard J. Kryscio, Frederick A. Schmitt, David W. Fardo, Randall L. Woltjer, Nigel J. Cairns, Lei Yu, Hiroko H. Dodge, Chengjie Xiong, Kamal Masaki, Suzanne L. Tyas, David A. Bennett, Julie A. Schneider, Zoe Arvanitakis

Sanders-Brown Center on Aging Faculty Publications

INTRODUCTION: The relationship of diabetes to specific neuropathologic causes of dementia is incompletely understood.

METHODS: We used logistic regression to evaluate the association between diabetes and infarcts, Braak neurofibrillary tangle stage, and neuritic plaque score in 2365 autopsied persons. In a subset of >1300 persons with available cognitive data, we examined the association between diabetes and cognition using Poisson regression.

RESULTS: Diabetes increased odds of brain infarcts (odds ratio [OR] = 1.57, P < .0001), specifically lacunes (OR = 1.71, P < .0001), but not Alzheimer's disease neuropathology. Diabetes plus infarcts was associated with lower cognitive scores at end of life than infarcts or diabetes alone, and diabetes plus high level of Alzheimer's neuropathologic changes was associated with lower mini-mental state examination scores than the pathology alone.

DISCUSSION: This study supports the conclusions that diabetes increases the risk of cerebrovascular but not Alzheimer's disease pathology, and at least some of diabetes' relationship to …

Peer Pressure And Family Smoking Habits Influence Smoking Uptake In Teenage Boys Attending School: Multilevel Modeling Of Survey Data., Shafquat Rozi, Sadia Mahmud, Gillian Lancaster, Nida Zahid

Community Health Sciences

Introduction:

Among young teens, about one in five smokes worldwide. Adolescents spend a considerable amount of their time in school, and the school environment is therefore important for child health practices and outcomes.

Objectives:

We aimed to investigate the impact on smoking behavior of the school environment and the personal characteristics of male teenage students attending schools in Pakistan, taking into account the survey sampling structure.

Methods:

A two-stage cluster sampling with stratification was employed, and we interviewed 772 male secondary school students. We adopted random effect and generalizing estimating equation models.

Results:

Peer pressure in particular had a strong …

Impact Of Lung Function On Exacerbations, Health Care Utilization, And Costs Among Patients With Copd, Xuehua Ke, Jessica Marvel, Tzy-Chyi Yu, Debra Wertz, Caroline Geremakis, Liya Wang, Judith J. Stephenson, David M. Mannino

Preventive Medicine and Environmental Health Faculty Publications

Objective: To evaluate the impact of lung function, measured as forced expiratory volume in 1 second (FEV₁) % predicted, on health care resource utilization and costs among patients with COPD in a real-world US managed-care population.

Methods: This observational retrospective cohort study utilized administrative claim data augmented with medical record data. The study population consisted of patients with one or more medical claims for pre- and postbronchodilator spirometry during the intake period (July 1, 2012 to June 30, 2013). The index date was the date of the earliest medical claim for pre- and postbronchodilator spirometry. Spirometry results were …

Maternal Age Of Menarche And Blood Pressure In Adolescence: Evidence From Hong Kong’S “Children Of 1997” Birth Cohort, Tsz Chun Lai, Gabriel Matthew Leung, C Mary Schooling

Publications and Research

Background Age of puberty has declined substantially in developed settings and is now declining in the rest of the world with economic development. Early age of puberty is associated with noncommunicable diseases in adulthood, and may be a long-term driver of population health with effects over generations. In a non-Western setting, we examined the association of maternal age of menarche with blood pressure in late childhood/adolescence.

Methods We used generalised estimating equations to estimate the adjusted association of maternal age of menarche with age-, sex- and height-adjusted blood pressure z-score from 10 to 16 years in Hong Kong’s population-representative birth …

Tricurin, A Novel Formulation Of Curcumin, Epicatechin Gallate, And Resveratrol, Inhibits The Tumorigenicity Of Human Papillomaviruspositive Head And Neck Squamous Cell Carcinoma, Longzhu Piao, Sumit Mukherjee, Qing Chang, Xiujie Xie, Hong Li, Mario R. Castellanos, Probal Banerjee, Hassan Iqbal, Ryan Ivancic, Xueqian Wang, Theodoros N. Teknos, Quintin Pan

Publications and Research

Head and neck squamous cell carcinoma (HNSCC) is the sixth most prevalent cancer worldwide with about 600,000 new cases diagnosed in the last year. The incidence of human papillomavirus-positive head and neck squamous cell carcinoma (HPV-positive HNSCC) has rapidly increased over the past 30 years prompting the suggestion that an epidemic may be on the horizon. Therefore, there is a clinical need to develop alternate therapeutic strategies to manage the growing number of HPV-positive HNSCC patients. TriCurin is a composition of three food-derived polyphenols in unique stoichiometric proportions consisting of curcumin from the spice turmeric, resveratrol from red grapes, and …

Development Of The Chronic Obstructive Pulmonary Disease Morning Symptom Diary (Copd-Msd), Gary Globe, Brooke Currie, Nancy Kline Leidy, Paul Jones, David M. Mannino, Fernando Martinez, Paul Klekotka, Sean O'Quinn, Niklas Karlsson, Ingela Wiklund

Preventive Medicine and Environmental Health Faculty Publications

Background: The morning tends to be the most difficult time of day for many patients with chronic obstructive pulmonary disease (COPD) when symptoms can limit one’s ability to perform even simple activities. Morning symptoms have been linked to higher levels of work absenteeism, thereby increasing the already substantial economic burden associated with COPD. A validated patient-reported outcome (PRO) instrument designed to capture morning symptoms will allow for a more comprehensive approach to the evaluation of treatment benefit in COPD clinical trials.

Methods: A qualitative interview study was conducted among a sample of symptomatic adults with COPD. Concept elicitation interviews ( …

Gestational Hormone Profiles Predict Human Maternal Behavior At 1-Year Postpartum, Laura M. Glynn, Elyssia Poggi Davis, Curt A. Sandman, Wendy A. Goldberg

Psychology Faculty Articles and Research

In many non-human species, including primates, gestational reproductive hormones play an essential role in the onset of maternal motivation and behaviors. We investigated the associations between prepartum estradiol and progesterone and maternal behavior at 1-year postpartum in 177 women. Blood was obtained at five gestational time points and an index of quality of maternal care was determined using a well-validated mother-child interaction protocol. Women who exhibited higher quality maternal care at 1-year postpartum were characterized by unique gestational profiles of estradiol, progesterone and the estrogen to progesterone ratio; specifically by slower accelerations and levels of these hormone trajectories beginning in …

The Carefirst Patient-Centered Medical Home Program: Cost And Utilization Effects In Its First Three Years, Alison Cuellar, Lorens A. Helmchen, Gilbert Gimm, Jay Want, Sriteja Burla, Bradley Kells, Iwona Kicinger, Len M. Nichols

Health Policy and Management Faculty Publications

Background

Enhanced primary care models have diffused slowly and shown uneven results. Because their structural features are costly and challenging for small practices to implement, they offer modest rewards for improved performance, and improvement takes time.

Objective

To test whether a patient-centered medical home (PCMH) model that significantly rewarded cost savings and accommodated small primary care practices was associated with lower spending, fewer hospital admissions, and fewer emergency room visits.

Design

We compared medical care expenditures and utilization among adults who participated in the PCMH program to adults who did not participate. We computed difference-in-difference estimates using two-part multivariate generalized …

Important Strategies For Effective Family Planning Counseling, Savera Aziz Ali, Minaz Mawani, Gulshan Bano, Sumera Aziz Ali

School of Nursing & Midwifery

No abstract provided.

Gender Differences In Concussion Reporting Among High School Athletes, Theresa Miyashita, Eleni Diakogeorgiou, Christina Vandervegt

All PTHMS Faculty Publications

Background: An athlete’s lack of concussion knowledge could lead to significant underreporting and injury mismanagement. To provide more effective management strategies of concussions in adolescent athletes, further examination of reporting behaviors is of critical importance. Hypothesis: The hypotheses for this study were as follows: (1) Girls are more likely to report concussion, (2) girls are more likely to report future concussions after an educational intervention, and (3) a difference in rationale for not reporting concussion will be found between sexes. Study Design: Cross-sectional, cohort design. Level of Evidence: Level 3. Methods: Survey answers were collected on 454 high school athletes …

Maternal Healthcare In Eastern Uganda: The Three Delays, Mothers Making Empowered Choices, And Combatting Maternal Mortality, Emma Gier

Independent Study Project (ISP) Collection

Maternal and child health has been noted as an international concern and issue. While access to maternal healthcare has improved in Uganda since 2000, maternal mortality rates have remained high in the country as of 2015. However, maternal and child healthcare are inherently important in promoting sustainable and positive development. For that reason, I have explored maternal healthcare in Uganda’s Eastern region, specifically in Mbale Town and surrounding rural areas including Kween and Manafwa districts. Specifically I have looked at what factors influence women’s decision to give birth in a health centre or hospital, versus at home. I have also …

Antenatal Glucocorticoid Treatment Is Associated With Diurnal Cortisol Regulation In Term-Born Children, M. N. Edelmann, Curt A. Sandman, Laura M. Glynn, D. A. Wing, Elyssia Poggi Davis

Psychology Faculty Articles and Research

Due to the rapid developmental changes that occur during the fetal period, prenatal influences can affect the developing central nervous system with lifelong consequences for physical and mental health. Glucocorticoids are one of the proposed mechanisms by which fetal programing occurs. Glucocorticoids pass through the blood-brain barrier and target receptors throughout the central nervous system. Unlike endogenous glucocorticoids, synthetic glucocorticoids readily pass through the placental barrier to reach the developing fetus. The synthetic glucocorticoid, betamethasone, is routinely given prenatally to mothers at risk for preterm delivery. Over 25% of the fetuses exposed to betamethasone will be born at term. Few …

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?

Total Versus Partial Splenectomy In Pediatric Hereditary Spherocytosis: A Systematic Review And Meta-Analysis, Leonardo Guizzetti

Epidemiology and Biostatistics Publications

To compare the clinical effectiveness of total (TS) or partial (PS) splenectomy in pediatric hereditary spherocytosis, a systematic review and meta-analysis was performed (PROSPERO registration CRD42015030056). There were 14 observational studies comparing pre- and post- operative hematologic parameters. Secondary outcomes include in-hospital infections, surgical complications, symptomatic recurrence and biliary disease. TS is more effective than PS to increase hemoglobin (3.6 g/dL vs 2.2 g/dL) and reduce reticulocytes (12.5% vs 6.5%) after one year; outcomes following PS are stable for at least 6 years. There were no cases of overwhelming post-splenectomy sepsis. A population-based patient registry is needed for long-term follow-up.

Lack Of An Association Or An Inverse Association Between Low-Density-Lipoprotein Cholesterol And Mortality In The Elderly: A Systematic Review, Uffe Ravnskov, Rokura Hama, Tomohito Hamazaki, Paul J. Rosch, Tore Schersten, Ralf Sundberg

NYMC Faculty Publications

OBJECTIVE: It is well known that total cholesterol becomes less of a risk factor or not at all for all-cause and cardiovascular (CV) mortality with increasing age, but as little is known as to whether low-density lipoprotein cholesterol (LDL-C), one component of total cholesterol, is associated with mortality in the elderly, we decided to investigate this issue.

SETTING, PARTICIPANTS AND OUTCOME MEASURES: We sought PubMed for cohort studies, where LDL-C had been investigated as a risk factor for all-cause and/or CV mortality in individuals ≥60 years from the general population.

RESULTS: We identified 19 cohort studies including 30 cohorts with …

Probability Of Fallopian Tube And Ovarian Detection With Transvaginal Ultrasonography In Normal Women, Jason R. Lefringhouse, Erin Neward, Frederick R. Ueland, Lauren A. Baldwin, Rachel W. Miller, Christopher P. Desimone, Richard J. Kryscio, John R. Van Nagell, Edward J. Pavlik

Obstetrics and Gynecology Faculty Publications

Objective: Some ovarian malignancies may originate in the fallopian tube. The feasibility of ultrasonographically visualizing the fallopian tube is presented. Methods: In total, 549 normal women participated in the fallopian tube visualization trial, while ovarian visualization was studied in 43,521. Chi-square analysis, t-tests and multivariate analysis determined significance and interactions. Results: Ovaries were observed in 82.7% while fallopian tubes were detected in 77.2% of women and 85.2% of the time when an ovary was detected. Age, BMI or parity was not significantly different when one or both fallopian tubes were visualized. Elevated BMI had slightly greater influence …

Cost Of Management Of Severe Pneumonia In Young Children: Systematic Analysis, Shanshan Zhang, Peter M. Sammon, Isobel King, Ana Lucia Andrade, Cristiana M. Toscano, Sheila N. Araujo, Anushua Sinha, Shabir A. Madh, Gulam Khandaker, Jiehui Kevin Yin, Robert Booy, Tanvir M. Huda, Qazi S. Rahman, Shams El Arifeen, Angela Gentile, Norberto Giglio, Mejbah U. Bhuiyan, Katharine Sturm Ramirez, Bradford D. Gessner, Mardiati Nadjib, Phyllis J. Carosone– Link, Eric Af Simões, Jason A. Child, Imran Ahmed, Zulfiqar Ahmed Bhutta, Sajid Bashir Soofi

Department of Paediatrics and Child Health

Background: Childhood pneumonia is a major cause of childhood illness and the second leading cause of child death globally. Understanding the costs associated with the management of childhood pneumonia is essential for resource allocation and priority setting for child health.
Methods: We conducted a systematic review to identify studies reporting data on the cost of management of pneumonia in children younger than 5 years old. We collected unpublished cost data on non–severe, severe and very severe pneumonia through collaboration with an international working group. We extracted data on cost per episode, duration of hospital stay and unit cost of interventions …

Partner Interfering Behaviors Affecting Cancer Quality Of Life, Ann L. Coker, Diane R. Follingstad, Lisandra S. Garcia, Heather M. Bush

Obstetrics and Gynecology Faculty Publications

Objective: Because partners are an important and unpaid resource in cancer care, understanding how destructive, controlling or interfering partner behaviors influence women's cancer care may be particularly relevant for health care providers seeking to provide cancer care and enhance recovery. Using a new measure of partner interfering behaviors in cancer care (PIB-C), we investigated whether women with a recent cancer diagnosis who additionally endorsed any PIB-C would report (a) more symptoms of depression and stress, and (b) lower Functional Assessment of Cancer Therapy (FACT-G) and lower Functional Assessment of Chronic Illness Therapy-Spiritual Well-being (FACIT-SP) scale scores indicating poorer quality of …

A Novel Point-Of-Care Testing Strategy For Sexually Transmitted Infections Among Pregnant Women In High-Burden Settings: Results Of A Feasibility Study In Papua New Guinea, Steven G. Badman, Lisa M. Vallely, Pamela Toliman, Grace Kariwiga, Bomesina Lote, William Pomat, Caroline Holmer, Rebecca Guy, Stanley Luchters, Chris Morgan

Population Health, East Africa

Background: Sexually transmitted and genital infections in pregnancy are associated with an increased risk of adverse maternal and neonatal health outcomes. High prevalences of sexually transmitted infections have been identified among antenatal attenders in Papua New Guinea. Papua New Guinea has amongst the highest neonatal mortality rates worldwide, with preterm birth and low birth weight major contributors to neonatal mortality. The overall aim of our study was to determine if a novel point-of-care testing and treatment strategy for the sexually transmitted and genital infections Chlamydia trachomatis (CT), Neisseria gonorrhoeae (NG), Trichomonas vaginalis (TV) and Bacterial vaginosis (BV) in pregnancy is …