Public Health Commons^™

Public Health In The Age Of Ebola In West Africa, Michael T. Osterholm, Kristine A. Moore, Lawrence O. Gostin

Georgetown Law Faculty Publications and Other Works

The Ebola epidemic, with its fast-growing toll and real potential for spreading into much of Africa, including major cities, has the makings of a “Black Swan” event. Such events, using the term coined by Nassim Nicholas Taleb, are: 1) unpredictable, outside the realm of regular expectations; 2) have a major impact, and; 3) are rationalized after the fact as being explainable and predictable.

We have learned from this outbreak the potential for an infectious disease to be politically, economically, and socially destabilizing, and that what kills us may be very different from what frightens us or substantially affects our social …

Tougher Than Rocket Science, Or Just Messier? Using Research To Improve U.S. Public Health Delivery, Glen P. Mays

Health Management and Policy Presentations

Advances in the field of public health services & systems research (PHSSR) are incorporating complexity in theory and methods to derive strong inferences about the health and economic effects attributable to public health strategies. Opportunities for comparative international research in Canada and the U.S. promise to strengthen these avenues of inquiry.

Public Health Services Research: Informing Public Health Practice & Policy, Glen P. Mays

Health Management and Policy Presentations

Heterogeneity in the mechanisms used for organizing and financing public health strategies creates opportunities for comparative effectiveness research (CER) in public health that examine which organization and financing mechanisms work best, for whom, and under what circumstances. Findings from these types of studies have direct utility in shaping public health policy and practice decisions.

Laboratories And The Value Stream Of Next-Generation Public Health, Glen P. Mays

Health Management and Policy Presentations

Public health laboratories are the information engines for public health agencies and delivery systems. Measuring the value stream that flows from this information can support objective assessments of the health and economic benefits attributable to laboratory infrastructure and information.

Governmental Public Health And The Economics Of Adaptation To Population Health, Glen P. Mays

Health Management and Policy Presentations

Research on the organization and financing of public health strategies offers valuable insight for governmental public health agencies seeking to adapt to a population health improvement perspective under health system reform.

Effects Of Extreme Climate Events On Tea (Camellia Sinensis) Functional Quality Validate Indigenous Farmer Knowledge And Sensory Preferences In Tropical China, Selena Ahmed, John Richard Stepp, Colin M. Orians, Timothy S. Griffin, Corene Matyas, Albert Robbat, Sean Cash, Dayuan Xue, Chunlin Long, Uchenna Unachukwu, Sarabeth Buckley, Edward J. Kennelly

Publications and Research

Climate change is impacting agro-ecosystems, crops, and farmer livelihoods in communities worldwide. While it is well understood that more frequent and intense climate events in many areas are resulting in a decline in crop yields, the impact on crop quality is less acknowledged, yet it is critical for food systems that benefit both farmers and consumers through high-quality products. This study examines tea (Camellia sinensis; Theaceae), the world’s most widely consumed beverage after water, as a study system to measure effects of seasonal precipitation variability on crop functional quality and associated farmer knowledge, preferences, and livelihoods. Sampling was conducted in …

Children's Use Of Dental Care In Medicaid: Federal Fiscal Years 2000-2012, Erika Steinmetz, Brian K. Bruen, Leighton C. Ku

Health Policy and Management Faculty Publications

This report presents with national and state-specific analyses about dental services received by children ages 1 to 20 under Medicaid’s Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) benefit in federal fiscal years (FFY) 2000-2012. These analyses are based on data reported by state Medicaid agencies using Form CMS-416 (Form 416); all data reflect updates received by CMS as of April 3, 2014. This report focuses on the number of children who received any dental service, any preventive dental service (e.g., dental cleaning or application of dental sealants) and any dental treatment service (e.g., filling a cavity). The national trend …

Neglected Or Non-Compliant? Assessing The Difficulties Of Tuberculosis Patients In Salvador-Ba, Brazil, Erin Slatery

Independent Study Project (ISP) Collection

Objective: The aim of this study is to analyze how Instituto Brasileiro para Investigação da Tuberculose (IBIT), a philanthropic tuberculosis clinic in Salvador, Brazil, maintains treatment abandonment rates much lower than those of surrounding public clinics. This study also aims to evaluate how professionals conceptualize and address the difficulties faced by patients.

Methods: Interviews were conducted with 8 IBIT professionals and 16 patients in treatment for tuberculosis in the aforementioned institution via semi-structured and structured questionnaires, respectively. Participant observation guided the analysis of relationships between patients and professionals.

Results: Patients found varying aspects of treatment difficult depending on personal circumstances, …

Exploring Barriers: An Analysis Of Access To Effective Tuberculosis Care In Cape Town, Yvonne Okaka

Independent Study Project (ISP) Collection

My independent study project (ISP) examines factors that hinder access to tuberculosis (TB) healthcare and its effective implementation in Cape Town. In order to expand research on the topic, important barriers will be examined and explained. This project is relevant due to the high prevalence and mortality rates of tuberculosis in South Africa, as well as the fact that an overwhelming emphasis on HIV can lead to overlooking the serious nature of TB as a public healthcare issue. It is hoped that this study will provide more insight into improving access to TB care, and be a resource for those …

Breaking Barriers: The Influence Of Socioeconomic Status On Obesity Among Women In Salvador, Bahia, Brazil, Christina Camoriano

Independent Study Project (ISP) Collection

Obesity in Brazil has grown rapidly within the past decade, however research is conflicting in terms of who carries the burden of this disease- the economic elite or the poor. Despite the lack of clarity towards the current distribution of obesity, many studies have come to the conclusion that in developing countries, obesity is growing more rapidly among those of lower socioeconomic status.¹¹ Therefore, the purpose of my research study is to examine how socioeconomic status influences the dietary and exercise habits of lower and lower-middle income women who are obese. This study is relevant because it seeks to …

Access To Comprehensive Perinatal Services Among Pregnant Women Enrolled In Both Medi-Cal And Covered California: Aligning And Integrating Care, Sara J. Rosenbaum, Carla Hurt, Mark Dorley, Sara Rothenberg, Nancy Lopez

Health Policy and Management Faculty Publications

Medi-Cal-enrolled women who are pregnant are entitled to coverage for enriched pregnancy-related care under Medi-Cal’s Comprehensive Perinatal Services Program (CPSP), a national landmark in the care and management of pregnant women with elevated health risks due to their low economic status. This entitlement applies to all pregnant women enrolled in Medi-Cal, including women who also are enrolled in subsidized health plans purchased through Covered California. The task that jointly faces Medi-Cal and Covered California is how best to align these two sources of pregnancy care financing in order to achieve a central goal of SB 857 – ensuring that dually …

Mindful Eating: Trait And State Mindfulness Predict Healthier Eating Behavior, Christian H. Jordan, Wan Wang, Linda R. Donatoni, Brian P. Meier

Psychology Faculty Publications

Obesity and excess weight are significant societal problems. Mindfulness may encourage healthier weight and eating habits. Across four studies, we found a positive relation between mindfulness and healthier eating. Trait mindfulness was associated with less impulsive eating, reduced calorie consumption, and healthier snack choices. In addition, we found a causal effect of mindfulness on healthier eating. An experimental manipulation of state mindfulness led participants to consume fewer calories in a spontaneous eating task. We also found preliminary evidence that mindfulness affects eating behavior by encouraging attitudinal preferences for healthier foods. Taken together, these results provide strong evidence that mindfulness encourages …

A Meta-Analysis Of The Prediction Of Violence Among Adults With Mental Disorders, Hing Po Lam

Dissertations, Theses, and Capstone Projects

The study of the risk for violence among persons with mental disorders has received substantial scientific attention over the past few decades; however, many uncertainties and controversies remain due to the wide disparities in the reported results. Using the state-of-the-art perspective of public health, a meta-analysis was conducted to clarify the ambiguities by synthesizing quantitative findings from 85 research reports (completed between January 1970 and May 2010) on violence risk assessment among mentally disordered adults. Results of this meta-analytic study revealed that the estimates of the prevalence of violence among the psychiatric population varied considerably from 1.1% to 78.4% with …

“In Light Of Real Alternatives”: Negotiations Of Fertility And Motherhood In Morocco And Oman, Victoria E. Mohr

Student Publications

Many states in the Arab world have undertaken wide-ranging family planning polices in the last two decades in an effort to curb high fertility rates. Oman and Morocco are two such countries, and their policies have had significantly different results. Morocco experienced a swift drop in fertility rates, whereas Oman’s fertility has declined much more slowly over several decades. Many point to the more conservative religious and cultural context of Oman for their high fertility rates, however economics and the state of biomedical health care often present a more compelling argument for the distinct differences between Omani and Moroccan family …

A Community Conversation On Adolescent Pregnancy And Parenting Services: Networks Of Support, Gatekeepers To Care, And Non-Compulsory Fathering In A Black Urban Community, Tamara Leech, Elizabeth A. Adams, Marci Littlefield

Department of Public Health Scholarship and Creative Works

This study employed Community-Based Participatory Research (CBPR) methods to document needs and capacity around adolescent pregnancy and parenting in one predominately Black, low-income urban community. Using an iterative focus group method, we engaged 60 participants in a two-day community conversation. Quantitative data from an enrollment questionnaire and qualitative transcripts of the discussions are analyzed. Our results indicate that the community’s greatest capacity lies in a network of women. Men tend to participate in parenting more holistically once formal paternity is established. Neighborhood women typically introduce adolescents to prenatal care, so delays in revealing the pregnancy to them serve as a …

Improving Public Health Safety Nets After An Economic Recession, Sanjay Basu

Center for Policy Research

When we say ‘here’s what’s going on with our nation’s health,’ how do we know the answer? Where is the data coming from? How can we best evaluate our public health system? We’re talking about it every day on CNN given the Ebola scare. What do we mean by our ‘public health system’? I would argue that we should expand our definition to mean something more than hospitals and clinics, or doctors and nurses. In particular, I’ll argue that some of our non-health programs that we have as part of the safety net actually make a bigger health impact than …

Giving The Homeless Population A Chance To Become Healthier: An Initial Needs Assessment Of The Homeless Population Of Portland, Maine, Annarae Andresen, Oana Butnarasu, Jayme Keith, Sarah Kou, Dana Mccoy, Stephanie Sheehan, Jessica Takatsuki, Zoe Hull, Ian Imbert, Suzanne Dunn, Tara Lonneman, Marissa Prezanno, Catherine Bixby

Homeless Needs Assessment

Research poster stemming from IPEC mini-grant student project Homeless Needs Assessment. The project was designed to assess the greatest needs for people experiencing homelessness in Portland, Maine. UNE Students from several healthcare professions partnered together to provide a holistic approach to the community needs with hopes of developing and implementing intervention strategies. Goal was to conduct surveys of at least 100 homeless individuals.

Health Advocacy Intervention For Youth : A Case Study Of Metro Youth Advocates., Tiffany Monyhan, Sasha Belenky, Kristi Mcclary King

Faculty and Staff Scholarship

No abstract provided.

Conceptualization Of Autism In The Latino Community And Its Relationship With Early Diagnosis, Katharine E. Zuckerman, Brianna Sinche, Martiza Cobian, Marlene Cervantes, Angie Mejia, Thomas Becker, Christina Nicolaidis

School of Social Work Faculty Publications and Presentations

Objective—Early identification of autism spectrum disorders (ASD) has been linked to improved long-term developmental outcomes. However, Latino children are diagnosed later than white non- Latino children. We aimed to qualitatively assess the understanding and conceptualization of ASD in the Latino community in order to understand potential community barriers to early diagnosis.

Method—We conducted 5 focus groups and 4 qualitative interviews with 30 parents of typicallydeveloping Latino children in Oregon. Participants were asked structured questions concerning video vignettes that follow a Latina mother from the time she begins to worry about her 3-year-old son's behaviors to the time he receives an …

Structural Factors That Increase Hiv/Sti Vulnerability Among Indigenous People In The Peruvian Amazon, E. Roberto Orellana, Isaac E. Alva, Cesar P. Cárcamo, Patricia J. García

School of Social Work Faculty Publications and Presentations

We examined structural factors—social, political, economic, and environmental—that increase vulnerability to HIV among indigenous people in the Peruvian Amazon. Indigenous adults belonging to 12 different ethnic groups were purposively recruited in four Amazonian river ports and 16 indigenous villages. Qualitative data revealed a complex set of structural factors that give rise to environments of risk where health is constantly challenged. Ferryboats that cross Amazonian rivers are settings where unprotected sex—including transactional sex between passengers and boat crew and commercial sex work—often take place. Population mobility and mixing also occurs in settings like the river docks, mining sites, and other resource …

Agency Of The South Sudanese: Compensating For Health Care In Mungula Refugee Settlement, Lauren Schmidt

Independent Study Project (ISP) Collection

In reaction to the endemic violence, which has forced many South Sudanese to flee their homes and seek refuge within Uganda’s borders, the researcher spent the practicum interning with the Uganda Red Cross Society (URCS) in Mungula refugee settlement, under academic advisor Steven Mawa. As the organization is the leading health provider in the settlement, the researcher gained insight into the provision of social services to the population, which allowed an extensive study on the ability of the South Sudanese to compensate for shortages in care and various complications associated with doing so.

The researcher sought to entertain these inquiries …

Syrian Refugee Families’ Awareness Of The Health Risks Of Child Marriage And What Organizations Offer Or Plan In Order To Raise Awareness, Rachel Fowler

Independent Study Project (ISP) Collection

The hypothesis of the study assumes: If Syrian refugee families understood the health risks involved with child marriage and the severity of these risks, they would be less likely to choose to marry off their daughter under the age of 18. If these families had more health educational programs and had more access to these programs, these programs would influence their decision towards avoiding child marriage for their daughter(s).

According to UNICEF, one-third of registered marriages among Syrian refugees in Jordan between January and March 2014 involved girls under the age of 18. Child marriage puts girls at risk of …

Surgeon Practices And Attitudes Toward The Control Of Surgical-Site Infections In Jordan, Sara Ali Mater

Independent Study Project (ISP) Collection

The purpose of this study was to determine the attitudes and practices of Jordanian surgeons on the control of surgical-site infections, evaluated by the Center of Disease Control’s guidelines toward the prevention of surgical-site infections, in addition to gaining respondents opinions on infection control in Jordan. This study was conducted through the distribution of 75 questionnaires given to surgeons at five hospitals in Jordan. Additional insight on SSI infection control was gained through interviews with two cardiac surgeons and three infection control directors. The results of the survey were compared with the Center for Disease Control’s guide to surgical-site infection …

Hispanic Mothers' Normative Beliefs And Intentions About The Discussion Of Sex-Related Topics With Their Adolescent Daughters, Dana M. Rodriguez

Dissertations (1934 -)

Hispanic adolescent females continue to have rates of pregnancy and STIs, which exceed those of white non-Hispanic peers. When mothers engage in the discussion of sex-related topics (DSRTs) with their adolescent daughters, it has been shown to delay or decrease sexual intercourse. However, it has been found that Hispanic parents talk less with their daughters about sex-related topics (SRTs) when compared to other ethnic groups. Understanding why Hispanic mothers may or may not intend to engage in DSRTs is important in order to design culturally appropriate programs aimed at increasing their DSRTs. A sequential mixed-methods predictive correlational design framed by …

Prevalence Of Hepatitis B Virus Infection Among Barbers And Their Knowledge, Attitude And Practices In The District Of Sukkur, Sindh ., Imran Naeem Abbasi, Zafar Fatmi, Muhammad Masood Kadir, Nalini Sathiakumar

Community Health Sciences

Abstract

OBJECTIVES:

Several occupations in developing countries lag behind in ensuring the safety of their workers in occupational settings. Lack of implementation of safety guidelines at workplaces can expose workers to health risks. In Pakistan, barbers are one of the un-regulated occupational groups. Low literacy, increased frequency of direct skin contact and blade/razors use can expose barbers to body fluids including blood of the customers. We conducted this study in order to determine hepatitis B virus (HBV) prevalence among barbers and their knowledge, attitude and practices in a peri-urban district of Sindh.

MATERIAL AND METHODS:

Three hundred eighty-five barbers from …

Mainecare Health Homes Enrollment In The First Year Of Implementation, Kimberley S. Fox Mpa, Carolyn E. Gray Mph, Katherine Rosingana

Population Health & Health Policy

The MaineCare Health Homes Initiative is designed to improve care coordination for MaineCare members with complex chronic medical conditions. The program is being implemented in two stages: Health Homes (HH), which began in January 2013, focuses on members with chronic health conditions. Behavioral Health Homes (BHH), which began in April 2014, is designed to meet the needs of people with Severe Mental Illness (SMI) or Serious Emotional Disturbances (SED).

The HH first stage builds off the State’s existing multi-payer Patient Centered Medical Home (PCMH) Pilot project and Medicare Advanced Primary Care Practice (MAPCP) Demonstration by providing addon payments to qualifying …

Many Paths To Primary Care: Flexible Staffing And Productivity In Community Health Centers, Leighton C. Ku, Bianca K. Frogner, Erika Steinmetz, Patricia Pittman

Health Policy and Management Issue Briefs

No abstract provided.

Photos That Changed The World: Ted Talk Annotated Resource List, Chris Riehl

Undergraduate Research Award

No abstract provided.

Grant Application: Immigrant And Refugee Family Wellness Engagement Through Yoga And Zumba, Elizabeth Crawford, Faith Swenson, Angela Serrani, Kathleen Cassidy, Brittany Roy, Trixie Porter

Immigrant and Refugee Family Wellness Engagement Through Yoga and Zumba

IPEC Mini-grant application for funding of UNE student project Immigrant And Refugee Family Wellness Engagement Through Yoga And Zumba. Students from multiple health professions collaborated to provide Yoga and Zumba classes at the Riverton Community Center. The project aimed to increase the participants’ ability to utilize stress reducing activities through a blend of student created heath education materials and yoga and zumba classes for refugee women and children.

The Ebola Epidemic: A Public Health Emergency Of International Concern, Lawrence O. Gostin, Daniel Lucey, Alexandra Phelan

Georgetown Law Faculty Publications and Other Works

On August 8, 2014, the World Health Organization (WHO) Director-General Margaret Chan declared the West Africa Ebola crises a “public health emergency of international concern,” triggering powers under the 2005 International Health Regulations (IHR).

The most affected West African states have attempted classic public health measures with varied success, including quarantine and isolation, social distancing, risk communication, and travel restrictions. These have involved a trade off between population health and human rights; sometimes to the disadvantage of both. At the same time, the countries’ health systems and human resources are fragile, impeding an effective response.

Beyond the public health and …