Public Health Commons^™

Genome Analysis Of Staphylococcus Aureus St291, A Double Locus Variant Of St398, Reveals A Distinct Genetic Lineage, Marc Stegger, Maliha Aziz, Tomsz Chroboczek, Lance B. Price, Troels Ronco, Kristoffer Kiil, Robert L. Skov, Frederic Laurent, Paal S. Andersen

Environmental and Occupational Health Faculty Publications

Staphylococcus aureus ST291 has been reported as a homologue recombinant double locus variant of the livestock associated S. aureus ST398. However, whole genome sequencing show that ST291 is a unique genetic lineage with highly variable content within its accessory genome compared to both human and livestock associated genome sequenced CC398s.

Linking And Retaining Hiv Patients In Care: The Importance Of Provider Attitudes And Behaviors, Manya Magnus, Jane Herwehe, Michelli Murtaza-Rossini, Petera Reine, Damien Cuffie, Deann Gruber, Michael Kaiser

Epidemiology Faculty Publications

Retention in HIV treatment may reduce morbidity and mortality, as well as slow the epidemic. Myriad barriers to retention include stigma, homophobia, structural barriers, transportation, and insurance. The purpose of this study was to evaluate patient perceptions of provider attitudes among HIV-infected persons within a state-wide public hospital system in Louisiana. A convenience sample of patients attending HIV clinics throughout the state participated in an anonymous interview. Factors associated with negative perceptions of care were evaluated in conjunction with a validated stigma measure. Factors associated with having a delayed entry into or break in care were evaluated in conjunction with …

Male Circumcision Significantly Reduces Prevalence And Load Of Genital Anaerobic Bacteria, Cindy M. Liu, Bruce A. Hungate, Aaron A.R. Tobian, David Serwadda, Jacques Ravel, Richard Lester, Godfrey Kigozi, Maliha Aziz, Ronald M. Galiwango, Fred Nalugoda, Tania L. Contente-Cuomo, Maria J. Wawer, Paul Keim, Ronald H. Gray, Lance B. Price

Environmental and Occupational Health Faculty Publications

Male circumcision reduces female-to-male HIV transmission. Hypothesized mechanisms for this protective effect include decreased HIV target cell recruitment and activation due to changes in the penis microbiome. We compared the coronal sulcus microbiota of men from a group of uncircumcised controls (n= 77) and from a circumcised intervention group (n = 79) at enrollment and year 1 follow-up in a randomized circumcision trial in Rakai, Uganda. We characterized microbiota using16S rRNA gene-based quantitative PCR (qPCR) and pyrosequencing, log response ratio (LRR), Bayesian classification, nonmetric multidimensional scaling (nMDS), and permutational multivariate analysis of variance (PerMANOVA). At baseline, men …

The Association Of Caregivers' Educational Level And Their Knowledge Of Children's Nutrition And Exercise Behavior, Hauwa Okorie, Bersabeh Medmim, Nazrat Mirza

GW Research Days 2013

BACKGROUND:

Parents play an instrumental role in modeling their children's health behaviors and exposing them to new foods, and engaging them in physical activities.

OBJECTIVE:

To assess the association of parents' educational level on their nutritional and physical activity knowledge.

METHODS:

This is a cross-sectional study of 72 participants from a nutrition and wellness program targeting parents of African American preschoolers. Socio-demographic, child's nutritional and physical exercise habit survey and anthropometric data were collected from all participants at baseline.

RESULTS:

77% of the participants were grandmothers or mothers; the mean age was 44.8 and 13% of participants were college graduates. …

Factors Associated With Early Sexual Debut Among Ghanaian Women From The Manya – Krobo District, – Ghana, 2011, Omoro Faye Omoighe, Amanda D. Castel, Jeffrey Bingenheimer

GW Research Days 2013

Affiliation: Department of Epidemiology and Biostatistics GW, School of Public Health and Health Services

Title: "Factors associated with early sexual debut among Ghanaian women from the Manya – Krobo district, – Ghana, 2011"

Background: The dipo, a Krobo puberty initiation rite practiced annually among an estimated 2,000 Ghanaian females ages 2–20, is a cultural rite of passage into womanhood that is intended to promote abstinence from sexual activity until marriage.

Objectives: This study examined the risk of early sexual debut among dipo-initiated Krobo females versus uninitiated Krobo females. This study also assessed Manya–Krobo societal opinions regarding the sexual health outcomes …

Justification Of Intimate Partner Violence In Egypt, Amira A. Roess, Esther L. Aranda

GW Research Days 2013

Background: Intimate Partner Violence (IPV) is an important problem in developing countries and associated with poor reproductive health outcomes.

Objectives: To describe trends and justification of IPV in Egypt.

Methods: We used the 2008 Egypt Demographic Health Surveys (EDHS). Information on IPV was drawn from 16,527 women in 2008. We performed bivariate analyses to examine trends in and risk factors for justification of IPV.

Results: 39.5% of respondents reported that IPV is justifiable. Logistic regression suggests that age, education, wealth and female autonomy are associated with respondents not justifying IPV. In contrast respondents who supported the continuation of female circumcision …

The Characteristics Of Women Seeking Funding From The Dc Abortion Fund, Karin Elizabeth Bleeg

GW Research Days 2013

Objectives: To determine whether the population DCAF serves, based on current research, are those most in need of its financial services. Describe the population that DCAF is supports by age, race and ethnicity, poverty, educational attainment, union status, contraceptive method used, referral source, and number of prior pregnancies.

Methods: An adapted version of The Guttmacher Institute's National Patient Survey will be used to collect data from women who contact DCAF for financial assistance for their abortion (n=150). The data will be collected for one month and then analyzed in SPSS.

Results: Between January and March 2013 approximately 400 women contacted …

Developing Standardized Language For Use In Lgbt Health Research, Vaibhav Jain, Marisa Workman, Sara Mostafa, Abigail Wolfe, Stefania Davia, Natalie Terens, Keith Li, Blaine Parrish

GW Research Days 2013

BACKGROUND: In the past two decades, the LGBT community in the United States has been more visible, active, and positively accepted by society. As acceptance progresses, research interests on the LGBT population have increased, driving the need for standard language for researchers to share for comparative and community-based participatory research. "What term is right?" is often the question researchers ask a very diverse LGBT community. In August 2012, the District of Columbia's Office of LGBT Affairs identified incongruent language in a number of published reports commissioned by the Mayor's Office. The Office realized the importance of standardized language for health …

Infrastructure For Health: Empowering Village Health Teams In Uganda, Daniel C. Mays

GW Research Days 2013

BACKGROUND: The Ugandan National Health System, primarily organized by the Ministry of Health, utilizes community health workers which are structured as Village Health Teams (VHTs). Omni Med, a Boston-based NGO, works with the Ministry of Health to train and mobilize VHTs in the Mukono District.

OBJECTIVES: Understanding how VHTs are empowered to improve health in their communities, educating VHTs in health and medicine, mobilizing VHTs by providing motivation and oversight, and understanding VHT-member experiences through focus groups.

METHODS: Omni Med works with community chairpersons to organize VHT elections. Subsequently, Omni Med holds a training course on health topics like hygiene …

Fall Safety Assessment At The New School Of Public Health And Health Services Building, Amanda Mcqueen, Seung-Sup Kim, Melissa J. Perry

GW Research Days 2013

Objective: Falls are one of the leading causes of workplace death, lost work time, and costs to industry, particularly in construction. The public health burden of falls is significant, as approximately 25% of nonfatal injuries and 38% of fatalities in the general construction industry are due to falls. The goal of this study is to develop an assessment tool to evaluate fall safety in general construction and to evaluate fall safety among five skilled construction trades (i.e. electricians, painters, carpenters, welders, and roofers) throughout different stages of a new building construction project. The project is the new School of Public …

Examining The Impact Of International Volunteer Service And Village Health Teams On Community Health In Uganda's Mukono District, Caitlin M. Sherman, Anne E. Nichols

GW Research Days 2013

In many third world countries there is a dramatic shortage of doctors available for the countries' growing population. Similarly, the countries' infrastructure lacks adequate public transportation at an affordable cost. This is especially true throughout the continent of Africa. As a result, many people do not seek care until it is too late and do not receive basic medical education on how to keep their family and themselves healthy. To try to alleviate this issue many countries have begun training community health workers. In Uganda, they are called Village Health Teams (VHT). VHTs are people selected by their community to …

Guardian Engagement Learning Community 2012-2013, Ebony Allen, Paige Kulie, Risa Nakajima, Sarah Scheinfeld, Jordanna Snyder, Julia Song, Zachary Spoehr-Labutta, Kelly Worden

ISCOPES Posters and Presentations

No abstract provided.

Healthy Teen Scholars, Tanya Abraham, Katherine Boretsky, Shari Boyce, Nikita Desai, Odera Ekwunife, Rachel Glassford, Ahimsa Govender, Dolores Prudent, Anna Yakovleva

ISCOPES Posters and Presentations

No abstract provided.

Transitioning Veterans Collaborative, Suzanne Arnott, Kiara Baginski, Geoff Ball, Elizabeth Buchanan, Jay Choi, Courtney Gieber, Jackie Lussier, Nigel Madden, Satya Piccioni-Grenna, Nellie Trenga-Schein, Paul Tschudi, Heidi Wolff

ISCOPES Posters and Presentations

No abstract provided.

Senior Wellness Learning Community: Young At Heart, Amna Vahidy, Brook Simopoulos, Caitlin Bove, Julia Zamarchi, Kathleen Pormento, Megan Dormond, Meghana Vijaysimha, Sarah Jones

ISCOPES Posters and Presentations

No abstract provided.

Annual Report 2012, Forum Staff

National Health Policy Forum

This annual report describes the activities of the Forum during the 2012 calendar year, and provides a snapshot of our resources.

Access To Chemical Data Used In Regulatory Decision Making, Lynn R. Goldman, Ellen K. Silbergeld, Randall Lutter, Craig Barrow, Christopher J. Borgert, James W. Conrad Jr., Debra Edwards, Allan Felsot

Environmental and Occupational Health Faculty Publications

No abstract provided.

Pit Latrines And Their Impacts On Groundwater Quality: A Systematic Review, Jay P. Graham, Matthew L. Polizzotto

Environmental and Occupational Health Faculty Publications

Background: Pit latrines are one of the most common human excreta disposal systems in low-income countries, and their use is on the rise as countries aim to meet the sanitation-related target of the Millennium Development Goals. There is concern, however, that discharges of chemical and microbial contaminants from pit latrines to groundwater may negatively affect human health.

Objectives: Our goals were to a) calculate global pit latrine coverage, b) systematically review empirical studies of the impacts of pit latrines on groundwater quality, c) evaluate latrine siting standards, and d) identify knowledge gaps regarding the potential for …

Open-Source Collaboration For Global Health: Science And Practice, Ariel Pablos-Méndez, Michael Klag, Lynn R. Goldman

Environmental and Occupational Health Faculty Publications

No abstract provided.

The Work Environment Disability-Adjusted Life Year For Use With Life Cycle Assessment: A Methodological Approach, Kelly A. Scanlon, George M. Gray, Royce A. Francis, Shannon M. Lloyd, Peter Lapuma

Environmental and Occupational Health Faculty Publications

Background

Life cycle assessment (LCA) is a systems-based method used to determine potential impacts to the environment associated with a product throughout its life cycle. Conclusions from LCA studies can be applied to support decisions regarding product design or public policy, therefore, all relevant inputs (e.g., raw materials, energy) and outputs (e.g., emissions, waste) to the product system should be evaluated to estimate impacts. Currently, work-related impacts are not routinely considered in LCA. The objectives of this paper are: 1) introduce the work environment disability-adjusted life year (WE-DALY), one portion of a characterization factor used to express the magnitude of …

Assessing The Potential Impact Of Sequestration On Community Health Centers, Patients, And Medically Underserved Communities, Peter Shin, Jessica Sharac, Carmen Alvarez, Sara J. Rosenbaum

Geiger Gibson/RCHN Community Health Foundation Research Collaborative

A new report by the Peter Shin, Jessica Sharac, Carmen Alvarez, and Sara Rosenbaum examines the potential impact of sequestration on community health centers and their patients and communities. "Assessing the Potential Impact of Sequestration on Community Health Centers, Patients, and Medically Underserved Communities" estimates that the nation's 1,200 federally funded health centers will lose $120 million in grant funding, and that this funding drop can be expected to translate into 900,000 fewer patients served and 3 million fewer visits. The analysis shows that the cuts will disproportionately impact the poorest Americans, children, young families, and members of ethnic and …

Community Health Centers In An Era Of Health Reform: An Overview And Key Challenges To Health Center Growth, Peter Shin, Jessica Sharac, Carmen Alvarez, Sara J. Rosenbaum

Geiger Gibson/RCHN Community Health Foundation Research Collaborative

Today, over 1,100 federally funded community health centers play a vital role in ensuring access to health care for a predominantly low-income population in medically underserved communities. Health centers’ ability to provide comprehensive primary care and improve access to high-quality care while holding down health care cost growth has been well-documented. As health reform spurs coverage expansion and efforts to improve quality, the nation’s reliance on health centers is likely to grow.

In the Affordable Care Act (ACA), Congress invested $11 billion over five years to expand the health center program, to broaden access to care in lower-income communities as …

Foodborne Urinary Tract Infections: A New Paradigm For Antimicrobial-Resistant Foodborne Illness, Lora Nordstrom, Cindy M. Liu, Lance B. Price

Environmental and Occupational Health Faculty Publications

Urinary tract infections (UTIs) are among the most common bacterial infections worldwide. Disproportionately affecting women, UTIs exact a substantial public burden each year in terms of direct medical expenses, decreased quality of life, and lost productivity. Increasing antimicrobial resistance among strains of extraintestinal pathogenic Escherichia colichallenges successful treatment of UTIs. Community-acquired UTIs were long considered sporadic infections, typically caused by the patients’ native gastrointestinal microbiota; however, the recent recognition of UTI outbreaks with probable foodborne origins has shifted our understanding of UTI epidemiology. Along with this paradigm shift come new opportunities to disrupt the infection process and possibly quell …

Improving Access To Children's Mental Health Care: Lessons From A Study Of Eleven States, Donna Behrens, Julia Graham Lear, Olga Acosta Price

Center for Health and Health Care in Schools

Implementation of the Patient Protection and Affordable Care Act (ACA) is well underway, creating long-overdue opportunities for growing the capacity of child and adolescent mental health systems and meeting children’s pressing needs. The good news is that as of January 1, 2014, coverage of mental health conditions and substance use disorders will be required as part of the broad Essential Benefits package of services under the ACA. While states will determine specific benefits, it is widely accepted that mental health and substance abuse coverage will substantially increase, though the details remain to be determined.1 Additionally, as a result of this …

Improving Access To Children's Mental Health Care: Lessons From A Study Of Eleven States, Donna Behrens, Julia Graham Lear, Olga Acosta Price

Prevention and Community Health Faculty Publications

No abstract provided.

Progress Realized: Trends In Hiv-1 Viral Load And Cd4 Cell Count In A Tertiary-Care Center From 1999 Through 2011, Howard B. Gale, Manuel D. Rodriguez, Heather J. Hoffman, Debra A. Benator, Fred M. Gordin, Ann M. Labriola, Virginia L. Kan

Epidemiology Faculty Publications

Abstract

Accumulating evidence suggests that alterations in immune function may be important in the etiology of papillary thyroid cancer (PTC). To identify genetic markers in immune-related pathways, we evaluated 3,985 tag single nucleotide polymorphisms (SNPs) in 230 candidate gene regions (adhesion-extravasation-migration, arachidonic acid metabolism/eicosanoid signaling, complement and coagulation cascade, cytokine signaling, innate pathogen detection and antimicrobials, leukocyte signaling, TNF/NF-kB pathway or other) in a case-control study of 344 PTC cases and 452 controls. We used logistic regression models to estimate odds ratios (OR) and calculate one degree of freedom P values of linear trend (PSNP-trend) for the association …

The "Coopetition" Model: Caring For San Diego's Low-Income Population, Lisa Sprague, Jessamyn Taylor

National Health Policy Forum

This site visit explored aspects of health care delivery for Medicaid beneficiaries and the uninsured in a California county marked by a diverse population, dominant managed care, and stakeholder dedication to solving problems in a spirit of "coopetition." The program looked at the impact of California's Bridge to Reform (the state's Medicaid section 1115 waiver) on federally qualified health centers and the people they serve. Eligibility and enrollment expansions in the Low Income Health Program and Medi-Cal, health information technology adoption and its use to improve care delivery and health, and patient-centered medical homes and care coordination were discussed. The …

Latitudinal Variations In Seasonal Activity Of Influenza And Respiratory Syncytial Virus (Rsv): A Global Comparative Review, Kimberly Bloom-Feshbach, Wladimir J. Alonso, Vivek Charu, James Tamerius, Lone Simonsen, Mark A. Miller, Cecile Viboud

Global Health Faculty Publications

Background

There is limited information on influenza and respiratory syncytial virus (RSV) seasonal patterns in tropical areas, although there is renewed interest in understanding the seasonal drivers of respiratory viruses.

Methods

We review geographic variations in seasonality of laboratory-confirmed influenza and RSV epidemics in 137 global locations based on literature review and electronic sources. We assessed peak timing and epidemic duration and explored their association with geography and study settings. We fitted time series model to weekly national data available from the WHO influenza surveillance system (FluNet) to further characterize seasonal parameters.

Results

Influenza and RSV activity consistently peaked during …

Assuring Access To Data For Chemical Evaluations, Lynn R. Goldman, Ellen K. Silbergeld

Environmental and Occupational Health Faculty Publications

Background: A database for studies used for U.S. Environmental Protection Agency (EPA) pesticide and chemical reviews would be an excellent resource for increasing transparency and improving systematic assessments of pesticides and chemicals. There is increased demand for disclosure of raw data from studies used by the U.S. EPA in these reviews.

Objectives: Because the Information Quality Act (IQA) of 2001 provides an avenue for request of raw data, we reviewed all IQA requests to the U.S. EPA in 2002–2012 and the U.S. EPA’s responses. We identified other mechanisms to access such data: public access databases, the Freedom of Information Act …

Assisted Living: Facilities, Financing, And Oversight, Carol O'Shaughnessy

National Health Policy Forum

This publication briefly describes assisted living facilities that provide long-term services and supports to people with functional or cognitive impairments who do not need the level of skilled nursing care offered in nursing homes but cannot live independently. It also describes selected resident characteristics, reviews cost and financing arrangements, and reviews state responsibilities for regulation and oversight of assisted living facilities.