Public Health Commons^™

A Nonprofit Model In A For-Profit World: A Closer Look At Sheltered Workshops And Sustainability As An Employee Run Business, Bing Jang, Mitchell Perry, Nikolin Vangjeli, Laura Ducharme

School of Professional Studies

Historically, society has tended to isolate and segregate individuals with intellectual and developmental disabilities. Despite improvements such forms of discrimination continue to be a serious social problem. On October 11, 2011, the Department of Justice began an investigation into several state’s systems of providing vocational services to individuals with intellectual and developmental disabilities. This action came about due to several states being out of compliance around Title II of the Americans with Disabilities Act (ADA). Title II of the ADA prohibits discrimination on the basis of disability for all services, programs and activities provided to the public by state and …

Why Children, Adults And The Elderly Are Living On The Streets In Moroccan Cities And What Morocco Is Doing About It., Nora Charidah

Independent Study Project (ISP) Collection

The aim of this independent study project is to explore the determinants of homelessness in the cities of Morocco, more specifically in Rabat,Casablanca and Salé, and how Non-Governmental Organizations (NGO’s) are working to eradicate this epidemic. Poverty, Dysfunctional Families, Mental Illness and Addiction can all be causes as well as results of homelessness; all of these factors have the potential of seriously affecting individuals throughout the entirety of their life. Children, Adults and the Elderly are all affected by poverty throughout Morocco yet street children and the rural impoverished are the populations of the homeless where most research predominately focuses. …

Detroit Health Department: Lead Report 2016, Abdul El-Sayed, Alex B. Hill, Haifa Haroon

Urban Studies and Planning Faculty Research Publications

The Epidemiology team at the Detroit Health Department rigorously stress- tested Detroit’s lead numbers. The findings suggest a true decline in EBLL levels rather than a decrease in lead testing or a change in the characteristics of the children who are being tested.

An Analysis Of Women’S Access To Acute Opioid Detoxification Services In Maine: Identifying The Barriers To Treatment, Karen E. Conley

Muskie School Capstones and Dissertations

The lack of treatment facilities and services for opioid use disorder in Maine, combined with an increased prevalence of addiction, creates a potential for health inequity between men and women that may be intensified by barriers in access to care. This capstone study utilized detoxification screening inquiry forms and data obtained from the Milestone Foundation’s acute opioid detoxification program to assess and categorize barriers to access by gender. A barriers model was developed based on existing literature and was to identify potential associations among and between the known barriers to accessing treatment. Barriers were described as internally or externally based, …

Inquiry Into The Implementation Of Bush’S Executive Order 13211 And The Impact On Environmental And Public Health Regulation, Elizabeth Ann Glass Geltman, Gunwant Gill, Miriam Jovanovic

Publications and Research

Executive Order 13211, promulgated in 2001, requires the federal government to consider the impact of federal action on energy independence as part of the George W. Bush’s National Energy Policy. This law review examines whether EO 13211 was used to curtail environmental protection and natural resource conservation. The article begins with a review of the procedure required of federal agencies under EO 13211 and its associated documents. The paper then examines case law and published federal rulemaking proceedings and examines how federal agencies apply tests to evaluate the potential energy effect. The study concludes that EO 13211 strikes a reasonable …

The United Nations Sustainable Development Goals: Achieving The Vision Of Global Health With Justice, Eric A. Friedman, Lawrence O. Gostin

Georgetown Law Faculty Publications and Other Works

We are resolved to free the human race from the tyranny of poverty and want and to heal and secure our planet” (UN General Assembly, 2015, September 25, preamble). So pronounces the 2030 Agenda, the United Nations declaration on the Sustainable Development Goals (SDGs), adopted on September 25, 2015, succeeding the Millennium Development Goals (MDGs). If achieved, the SDGs will secure an improved level of health, development, and global justice. However, if the international community fails to live up to its commitments, an untold number of people will likely perish prematurely, people’s opportunities to thrive will be cut off, social …

Paediatric Tuberculosis In Bhopal, Madhya Pradesh, India: Dots, Diagnosis, And Determinants, Emma Klein

Independent Study Project (ISP) Collection

Tuberculosis (TB) is one of the world’s largest public health challenges, and it has a disproportionate impact on India. In children, TB is a serious but understudied illness due to the complexity of case-notification and relative lack of public health importance. This study took place over the course of one month in Bhopal, Madhya Pradesh, India. In a mixed method study consisting of 53 quantitative patient interviews and qualitative interviews with healthcare providers, social determinants of TB in this setting were investigated as well as challenges faced at all stages of healthcare delivery. Malnutrition and housing were the most severe …

Women’S Views On The Challenges And Solutions In Preventing The Gendered Spread Of Hiv In Masxha, Cato Manor, Paige Mcmahon

Independent Study Project (ISP) Collection

Despite numerous national prevention efforts, South Africa remains at the epicenter of the HIV/AIDS epidemic. The burden of the epidemic is extremely heterogeneous, with province, race, gender, age, and socioeconomic status serving as key variables in determining HIV prevalence rates. Black African women are disproportionately affected by the epidemic, with those between the ages of 20 and 34 having an HIV prevalence rate of 31.6%, the highest in the country (Shisana et al., 2014). The purpose of this study was to engage with black African women about the challenges they believe women face in protecting themselves against HIV, and potential …

A Precarious Paradigm: Seeking Alternatives To Public-Private Partnerships In Health, A Case For The Code, Lena Mininberg

Independent Study Project (ISP) Collection

Background: Breastfeeding is an unparalleled source of nutrition for infants and young children and is recommended as the best practice universally by the World Health Organization (WHO). The benefits in human health and development that result from exclusive and sustained breastfeeding have enormous economic development potential. Because of the non-legally binding nature of the International Code of Marketing of Breastmilk Substitutes (the Code), and shifting socio-cultural norms, breastfeeding rates are at an alarming low. In order to progress towards the Sustainable Development Goals, breastfeeding practices must be protected, promoted, and supported worldwide.

Objective: This research paper explores implementing strong measures …

Developing Capacity, Skills, And Tobacco Control Networks To Address Tobacco-Related Disparities: Leadership And Advocacy Institute To Advance Minnesota’S Parity For Priority Populations (Laampp), Linda M. Bosma, Raffaele Vacca, Raymond G. Boyle, Jaime L. Martinez, Rod Lew

Journal of Health Disparities Research and Practice

Priority populations disproportionately experience tobacco-related disparities, despite population level declines in tobacco use. The Leadership and Advocacy Institute to Advance Minnesota’s Parity for Priority Populations (LAAMPP) recruits and trains African immigrants/African Americans, Asian Americans/Pacific Islanders, American Indians, Chicano/Latinos, and LGBTQ community members to develop leaders to address tobacco harms in their communities. This paper describes and evaluates the LAAMPP Institute, and discusses lessons learned through the Institute and future directions for community-based tobacco-control efforts.

The mixed-methods evaluation included qualitative key informant interviews with LAAMPP Fellows and community and project contacts, a Skills Assessment Tool, project case studies, and a social …

Reducing The Role Of The Food, Tobacco, And Alcohol Industries In Noncommunicable Disease Risk In South Africa, Peter Delobelle, David Sanders, Thandi Puoane, Nicholas Freudenberg

Publications and Research

Noncommunicable diseases (NCDs) impose a growing burden on the health, economy, and development of South Africa. According to the World Health Organization, four risk factors, tobacco use, alcohol consumption, unhealthy diets, and physical inactivity, account for a significant proportion of major NCDs. We analyze the role of tobacco, alcohol, and food corporations in promoting NCD risk and unhealthy lifestyles in South Africa and in exacerbating inequities in NCD distribution among populations. Through their business practices such as product design, marketing, retail distribution, and pricing and their business practices such as lobbying, public relations, philanthropy, and sponsored research, national and transnational …

Factors Influencing The Variation In Gms Prescribing Expenditure In Ireland, Aisling Conway Lenihan, S. Ahern, J. Cronin, N. Woods

Dept. of Management & Enterprise Publications

Background

Pharmaceutical expenditure growth is a familiar feature in many Western health systems and is a real concern for policymakers. A state funded General Medical Services (GMS) scheme in Ireland experienced an increase in prescription expenditure of 414 % between 1998 and 2012. This paper seeks to explore the rationale for this growth by investigating the composition (Anatomical Therapeutic Chemical (ATC) Group level 1 & 5) and drivers of GMS drug expenditure in Ireland in 2012.

Methods

A cross-sectional study was carried out on the Health Service Executive-Primary Care Reimbursement Service (HSE-PCRS) population prescribing database (n = 1,630,775). Three …

Aligning Delivery & Financing Systems To Advance A Culture Of Health, Glen P. Mays

Health Management and Policy Presentations

The Robert Wood Johnson Foundation's Systems for Action Research Program supports research on how best to organize, finance, and deliver the constellation of services and supports that promote health and well-being in American communities, including but extending beyond the medical care and public health sectors. This session describes work underway through the S4A program and future research priorities, building on a strong scientific foundation in the fields of health services research (HSR) and public health services & systems research (PHSSR).

Integrating Health Services & Systems: What We Know, Think We Know, And Need To Learn, Glen P. Mays

Health Management and Policy Presentations

The delivery and financing systems for medical care, public health, and social and community services pursue many common goals and serve overlapping groups of families and communities. Unfortunately, in most American communities these systems interact in complex and often poorly understood ways through fragmented funding vehicles, information flows, governance and decision-making structures, institutional relationships, implementation rules and strategies, and professional and interpersonal connections. New research approaches are required to untangle these interactions and expose novel pathways of influence that can support equitable improvements in service delivery, resource use, health impact, and wellbeing. This presentation will summarize evidence from recent studies …

Motorcycle Helmet Effectiveness In Reducing Head, Face And Brain Injuries By State And Helmet Law, Cody S. Olsen, Andrea M. Thomas, Michael Singleton, Anna M. Gaichas, Tracy J. Smith, Gary A. Smith, Justin Peng, Michael J. Bauer, Ming Qu, Denise Yeager, Timothy Kerns, Cynthia Burch, Lawrence J. Cook

Biostatistics Faculty Publications

Background: Despite evidence that motorcycle helmets reduce morbidity and mortality, helmet laws and rates of helmet use vary by state in the U.S.

Methods: We pooled data from eleven states: five with universal laws requiring all motorcyclists to wear a helmet, and six with partial laws requiring only a subset of motorcyclists to wear a helmet. Data were combined in the Crash Outcome Data Evaluation System's General Use Model and included motorcycle crash records probabilistically linked to emergency department and inpatient discharges for years 2005-2008. Medical outcomes were compared between partial and universal helmet law settings. We estimated adjusted relative …

Measuring Multi-Sector Contributions To Public Health Delivery Systems & Population Health, Glen P. Mays

Health Management and Policy Presentations

The National Longitudinal Survey of Public Health Systems has followed a nationally-representative cohort of U.S. communities since 1998 to measure the scope of public health activities implemented in each community and the range of organizations and sectors that contribute to each activity. With 16 years of follow-up observations, this survey allows us to study the effects of demographic, economic, and policy shocks on public health delivery systems, and estimate the health effects attributable to delivery system change.

Measuring Comprehensive Public Health Delivery Systems And Their Contributions To Population Health, Glen P. Mays

Health Management and Policy Presentations

Delivery and financing systems for public health services vary widely across U.S. communities, raising questions about the comparative effectiveness and efficiency of alternative structures. We summarize recent approaches for measuring alternative system configurations and estimating their health and economic effects.

Knowledge And Behavior Change Of People Living With Hiv Through Nutrition Education And Counseling, Fitri Hudayani, Ratu Ayu Dewi Sartika

Kesmas

HIV, AIDS, dan gizi saling berhubungan. Pada Unit Pelayanan Terpadu HIV Rumah Sakit Umum Pusat Nasional Dr. Cipto Mangunkusumo, layanan edukasi dan konseling gizi disediakan secara kolaboratif untuk orang yang hidup dengan HIV. Penelitian ini bertujuan untuk mengetahui pengaruh pendidikan dan konseling gizi terhadap pengetahuan dan perilaku orang yang hidup dengan HIV. Penelitian ini dilakukan dengan desain kuasi eksperimental menggunakan kelompok perlakuan dan kontrol. Kelompok perlakuan terdiri dari 25 sampel dan 29 sampel untuk kelompok kontrol, dilakukan sebelum dan setelah perlakuan. Sampel berusia dewasa antara 18 – 50 tahun dipilih dengan menerapkan kriteria inklusi dan eksklusi. Sampel uji-t berpasangan digunakan …

Influence Of Household Environment And Maternal Behaviors To Upper Respiratory Infection Among Toddlers, Reny Fahdiyani, Ardini S. Raksanagara, Hadyana Sukandar

Kesmas

Infeksi saluran pernapasan akut atas (ISPA atas) di negara berkembang menyebabkan morbiditas tinggi pada anak bawah usia lima tahun (balita). Kementerian Kesehatan Republik Indonesia melaporkan bahwa ISPAnonpneumonia meningkat 2,6% dari tahun 2007 ke 2011. Faktor risiko yang dapat berkontribusi termasuk lingkungan dan perilaku. Penelitian ini bertujuan untuk menyelidiki faktor perilaku dan lingkungan dengan ISPA atas pada balita. Studi kasus kontrol ini dilakukan dari Februari-April 2015 pada balita di Tamansari yang merupakan daerah kumuh di Kota Bandung. Kasus adalah 55 ibu dengan balita menderita ISPA atas yang datang ke puskesmas, sedangkan kontrol dua kali lebih besar dari kasus dipilih dari lingkungan …

Predisposing Factors With Complementary Feeding Practices Among 9-11 Month-Old Infants In Jakarta Urban Slum Area, Septriana Septriana, Gita Ardelia Suhartono

Kesmas

Penyebab utama kekurangan gizi selain dari penyakit infeksi adalah pola asuh yang tidak sesuai dan pemberian makan yang optimal menjadi salah satu cara untuk mengatasi konsekuensi jangka panjang dari kekurangan zat gizi. Penelitian ini bertujuan untuk mengetahui hubungan antara faktor pendukung praktik pemberian makanan pendamping air susu ibu (MPASI) pada bayi usia 9 - 11 bulan di daerah kumuh perkotaan Jakarta. Penelitian potong lintang ini melibatkan 50 orang pengasuh bayi usia 9 – 11 bulan. Data dikumpulkan melalui wawancara menggunakan kuesioner. Tidak terdapat hubungan yang bermakna antara usia pengasuh dengan praktik pemberian makan (nilai p = 0,645). Demikian juga dengan …

Residential Density, Parents’ Sexual Activity And Teenage Sexual Behavior In Yogyakarta, Luluk Rosida, Evi Martha, Besral Besral

Kesmas

Pada daerah kumuh dan padat, orangtua sering terpaksa harus berbagi ruang tidur dengan anak-anaknya sehingga anak-anaknya sudah terpapar dengan aktivitas seksual sejak dini. Penelitian ini bertujuan mengetahui kepadatan hunian, aktivitas seksual orangtua, dan efeknya terhadap perilaku seksual remaja di Yogyakarta. Penelitian ini menggunakan desain potong lintang dengan mewawancarai 268 keluarga yang memiliki anak remaja yang dipilih secara acak di daerah kumuh perkotaan dan daerah pedesaan pada bulan Maret – Mei 2015. Analisis data dilakukan menggunakan uji kai kuadrat dan regresi-cox multivariat. Hasil penelitian ini menunjukkan bahwa orangtua yang tinggal di hunian padat memiliki risiko dua kali lebih besar untuk melakukan …

Effects Of Mothers’ Attitude As Breeders And Distance Of Stockyard Toward Diarrhea Incidence Among Toddlers, Yarmaliza Yarmaliza, Sugito Sugito, Teuku Reza Ferasyi, Nurliana Nurliana, Razali Razali

Kesmas

Diare merupakan penyakit dengan perubahan bentuk dan konsentrasi tinja yang melembek sampai mencair, dan bertambahnya frekuensi buang air besar lebih dari biasanya (tiga kali atau lebih dalam sehari). Di Provinsi Aceh, terdapat kasus diare sebanyak 48/1.000 kelahiran hidup pada 2013. Di Kabupaten Aceh Barat, pada tahun 2014 terdapat 1.071 kasus, sedangkan di Kecamatan Meureubo terdapat sebanyak 70 kasus pada anak bawah lima tahun (balita). Penelitian ini bertujuan untuk mengetahui hubungan sikap ibu sebagai peternak dan jarak kandang ternak terhadap kejadian diare pada balita di wilayah kerja Puskesmas Kecamatan Meureubo. Penelitian ini dilakukan secara potong lintang pada bulan Juli – September …

Cadmium Contamination In Farmland Soil And Water Near Zinc Mining Site, Kanitta Jiraungkoorskul, Sara Arphorn, Mathuros Tipayamongholgul, Wattasit Siriwong

Kesmas

Penelitian ini merupakan penelitian potong lintang yang dilakukan di Kecamatan Phatadpaeng, Kota Mae Sod, Provinsi Tak, Thailand. Penelitian ini bertujuan untuk mengetahui konsentrasi kadmium pada air dan tanah pertanian serta pada pemukiman petani dan rumah tangga. Konsentrasi kadmium pada 48 sampel tanah dan air pemukiman petani, 12 sampel rumah tangga, enam sampel tanah pertanian, dan delapan sampel air pertanian ditelusuri menggunakan Graphite Furnace Atomic Absorption Spectrophotometer. Uji Mann-Whitney U digunakan untuk analisis perbedaan konsentrasi kadmium antara tanah pertanian dan tanah pemukiman, air pertanian dan air pemukiman. Hasil penelitian menunjukkan tidak terdapat perbedaan secara statistik pada seluruh matriks, namun air dan …

Study On Clinical, Histopathological Features And Evaluation Results Of Skin Cancer Treatment In Can Tho Oncology Hospital, Nguyen Van Qui, Phan Nguyen Ngoc

Kesmas

Kanker kulit, diagnosis kanker paling umum, cenderung mengalami peningkatan. Kondisi ini secara khusus merupakan isu penting di negara-negara maju. Penelitian ini bertujuan untuk mendeskripsikan fitur klinis, fitur hispatologis, komplikasi dan hasil pengobatan bedah awal kanker kulit di Rumah Sakit Onkologi Can Tho dari tahun 2014 sampai 2015. Penelitian deskriptif prospektif ini melibatkan seluruh pasien dengan kanker kulit nonmelanoma yang diuji dan diobati di Rumah Sakit Onkologi Can Tho dari Juli 2014 sampai Maret 2015. Terdapat 78 kasus terpilih. Kanker kulit ditemukan lebih umum pada pasien yang lebih tua. Prevalensi karsinoma sel basal ditemukan lebih tinggi dibandingkan karsinoma sel skuamosa dengan …

Communication Of Parents, Sexual Content Intake And Teenage Sexual Behavior At Senior High School In Banjarmasin City, Rusmilawaty Rusmilawaty, Yuniarti Yuniarti, Tri Tunggal

Kesmas

Perilaku seks bebas di kalangan remaja Kota Banjarmasin belakangan ini semakin mengkhawatirkan para orangtua. Kurangnya pendidikan seksologi berdampak para remaja cenderung melakukan hubungan seksual pranikah yang akan berakibat pada kehamilan yang tidak diinginkan dan pernikahan dini. Komunikasi orangtua-anak dan paparan media baik media cetak maupun elektronik merupakan cara untuk mengurangi perilaku seksual berisiko. Tujuan penelitian ini untuk mengetahui hubungan komunikasi orangtua dan asupan muatan seksual dengan perilaku seksual remaja sekolah menengah atas (SMA) di Kota Banjarmasin. Untuk mencapai tujuan tersebut, penelitian survei analitik dengan pendekatan potong lintang dilakukan pada bulan Juli – Oktober 2015 di dua sekolah negeri dan satu …

The Impact Of Reimbursement Policies And Practices On Healthcare Technology Innovation, Brian K. Bruen, Elizabeth Docteur, Ruth Lopert, Joshua Cohen, Joseph Dimasi, Avi Dor, Peter Neumann, Regina Desantis, Chuck Shih

Health Policy and Management Faculty Publications

No abstract provided.

A Public Health Framework For Screening Mammography: Evidence-Based Versus Politically Mandated Care, Lawrence O. Gostin, Kenneth W. Lin Md

Georgetown Law Faculty Publications and Other Works

This Viewpoint highlights the societal risks of politically motivated mandates relating to public health guidelines. Although the Affordable Care Act mandated insurance coverage for U.S. Preventive Services Task Force (USPSTF)-recommended preventive services, it went further for mammography screening. Instead of relying on the most recent USPSTF guidelines, Congress amended the ACA to require the Department of Health and Human Services (DHHS) to use its 2002 guidelines, which recommended screening every 1-2 years starting at age 40. The FY 2016 Consolidated Appropriations Act instructs DHHS to interpret any reference to “current” USPSTF breast cancer screening recommendations to mean those issued “before …

Use Of Pooled State Administrative Data For Mental Health Services Research., Kimberly Eaton Hoagwood, Susan Essock, Joseph Morrissey, Anne Libby, Sheila Donahue, Benjamin Druss, Molly Finnerty, Linda Frisman, Meera Narasimhan, Bradley D Stein, Jennifer P. Wisdom, Judy Zerzan

Health Policy and Management Faculty Publications

State systems are a rich, albeit challenging, laboratory for policy-relevant services research studies. State mental health authorities routinely devote resources to collect data for state planning and reporting purposes. However, these data are rarely used in cross-state comparisons to inform state or federal policy development. In 2008, in response to key recommendations from the National Institute of Mental Health (NIMH) Advisory Council’s “The Road Ahead: Research Partnership to Transform Services,” (http://www.nimh.nih.gov/about/advisory-boards-and-groups/namhc/reports/road-ahead.pdf), NIMH issued a request for applications (RFA) to support studies on the impact of state policy changes on access, cost, quality and outcomes of care for individuals …

Bridging The Divide White Paper: Long-Acting Reversible Contraception (Larc) In The United States, Julia Strasser, Liz Borkowski, Megan Couillard, Amy Allina, Susan Wood

Jacobs Institute of Women's Health

Long-acting reversible contraceptive (LARC) methods – specifically, intrauterine devices (IUDs) and subcutaneous hormone-releasing implants – demonstrate great potential in reducing unintended pregnancy. Although LARC methods have had a rocky history in the US and use rates have remained low here in comparison to other countries where the methods are available, there has been a significant increase in uptake of newer LARC products in recent years. Researchers have identified this change as a likely contributor to the declines seen in unintended pregnancy, abortion, and teen pregnancy rates.

Decades of research have shown that current LARC methods are highly safe and effective, …

Best Practices To Increase Efficacy Of Graduate School Admissions Communications At Clark University, Diana Curran, Nikki Feinberg, Mitchell Kelley, Ruiqi Li, Anning Zhou

School of Professional Studies

Within the period of time that a graduate student deposits and subsequently arrives at their academic institution, receiving timely information is important for their preparation. This process has been deemed by the Deans of the Enterprise Schools at Clark University as one that needs further investigation. As such, this Capstone looks at the array of communication that goes out to each graduate student during this four-month period. The purpose of examining this communication is to analyze its effectiveness in engaging students. To analyze the effectiveness of this communication, surveys were distributed to current students in these schools to gather data …