Public Health Commons^™

Environmental Drivers Of Ross River Virus In South-East Tasmania, Australia: Towards Strengthening Public Health Interventions, Angela Werner, Sarah Goater, Scott Carver, Greg Robertson, Philip Weinstein

Global Health Faculty Publications

In Australia, Ross River virus (RRV) is predominantly identified and managed through passive health surveillance. Here, the proactive use of environmental datasets to improve community-scale public health interventions in southeastern Tasmania is explored. Known environmental drivers (temperature, rainfall, tide) of the RRV vector Aedes camptorhynchus are analysed against cumulative case records for five adjacent local government areas (LGAs) from 1993 to 2009. Allowing for a 0- to 3-month lag period, temperature was the most significant driver of RRV cases at 1-month lag, contributing to a 23. 2% increase in cases above the long-term case average. The potential for RRV to …

Effect Of Nutrition Changes On Foods Selected By Students In A Middle School-Based Diabetes Prevention Intervention Program: The Healthy Experience, Connie Mobley, Diane D. Stadler, Myrlene A. Staten, Laure El Ghormli, Bonnie Gillis, Jill Hartstein, Anna Maria Siega-Riz, Amy Virus, Healthy Study Group

GW Biostatistics Center

No abstract provided.

Repeat Prenatal Corticosteroid Prior To Preterm Birth: A Systematic Review And Individual Participant Data Meta-Analysis For The Precise Study Group (Prenatal Repeat Corticosteroid International Ipd Study Group: Assessing The Effects Using The Best Level Of Evidence) - Study Protocol, Caroline A. Crowther, Fariba Aghajafari, Lisa M. Askie, Elizabeth V. Asztalos, Peter Brocklehurst, Elizabeth A. Thom, +22 Additional Authors

GW Biostatistics Center

Background

The aim of this individual participant data (IPD) meta-analysis is to assess whether the effects of repeat prenatal corticosteroid treatment given to women at risk of preterm birth to benefit their babies are modified in a clinically meaningful way by factors related to the women or the trial protocol.

Methods/Design

The Prenatal Repeat Corticosteroid International IPD Study Group: assessing the effects using the best level of Evidence (PRECISE) Group will conduct an IPD meta-analysis. The PRECISE International Collaborative Group was formed in 2010 and data collection commenced in 2011. Eleven trials with up to 5,000 women and 6,000 infants …

Association Of Hexachlorobenzene (Hcb), Dichlorodiphenyltrichloroethane (Ddt), And Dichlorodiphenyldichloroethylene (Dde) With In Vitro Fertilization (Ivf) Outcomes., Shruthi Mahalingaiah, Stacey A. Missmer, Arnab Maity, Paige L. Williams, John D. Meeker, Katharine Berry, Shelley Ehrlich,, Melissa J. Perry, Daniel W. Cramer, Russ Hauser

Environmental and Occupational Health Faculty Publications

Background: Hexachlorobenzene (HCB), dichlorodiphenyltrichloroethane (DDT), and dichlorodiphenyldichloroethylene (DDE) are persistent chlorinated pesticides with endocrine activity that may adversely affect the early stages of human reproduction.

Objective: Our goal was to determine the association of serum levels of HCB, DDT, and DDE with implantation failure, chemical pregnancy, and spontaneous abortion in women undergoing in vitro fertilization (IVF) from 1994 to 2003.

Methods: Levels of HCB and congeners of DDT and DDE were measured in serum collected during the follicular phase. Multivariable-adjusted statistical models accommodating multiple outcomes and multiple cycles per woman were used to estimate the relation between serum pesticide levels …

Multi-Person Sex Among A Sample Of Adolescent Female Urban Health Clinic Patients, Emily F. Rothman, Michele R. Decker, Elizabeth Miller, Elizabeth Reed, Anita Raj, Jay G. Silverman

Prevention and Community Health Faculty Publications

Adolescent sexual activity involving three or more people is an emerging public health concern. The goal of this exploratory, cross-sectional study was to describe the prevalence, correlates, and context of multiple-person sex among a sample of adolescent females seeking health care from an urban clinic. Because sex involving multiple people may either be consensual (i.e., “three-ways” or “group sex”) or forced (i.e., “gang rape”), we use the term “multi-person sex” (MPS) to encompass these experiences. Subjects were 328 females, ages 14–20 years old, who utilized a Boston-area community- or school-based health clinic between April and December of 2006, and completed …

Alternate Estrogen Receptors Promote Invasion Of Inflammatory Breast Cancer Cells Via Non-Genomic Signaling, Kazufumi Ohshiro, Arnold M. Schwartz, Paul H. Levine, Rakesh Kumar

Epidemiology Faculty Publications

Although Inflammatory Breast Cancer (IBC) is a rare and an aggressive type of locally advanced breast cancer with a generally worst prognosis, little work has been done in identifying the status of non-genomic signaling in the invasiveness of IBC. The present study was performed to explore the status of non-genomic signaling as affected by various estrogenic and anti-estrogenic agents in IBC cell lines SUM149 and SUM190. We have identified the presence of estrogen receptor α (ERα) variant, ERα36 in SUM149 and SUM190 cells. This variant as well as ERβ was present in a substantial concentration in IBC cells. The treatment …

Association Between Interpersonal Trust, Reciprocity, And Depression In South Korea: A Prospective Analysis, Seung-Sup Kim, Yeonseung Chung, Melissa J. Perry, Ichiro Kawachi, V. S. Subramanian

Environmental and Occupational Health Faculty Publications

Background

A growing body of empirical evidence indicates that low-level social capital is related to poor mental health outcomes. However, the prospective association between social capital and depression remains unclear, and no published studies have investigated the association with longitudinal data in East-Asian countries.

Methods

We analyzed data from the ongoing Korean Welfare Panel Study to prospectively investigate association between social capital and depression. Social capital was measured at the individual level by two items specific to interpersonal trust and reciprocity. Depression was annually assessed as a dichotomous variable using the Center for Epidemiologic Studies Depression Scale. After excluding participants …

Perceived Discrimination And Self-Rated Health In South Korea: A Nationally Representative Survey, Seung-Sup Kim, David R. Williams

Environmental and Occupational Health Faculty Publications

Background

There is mounting evidence that discriminatory experiences can harm health. However, previous research has mainly focused on the health effects of racial discrimination in U.S. or European countries although there is pervasive discrimination by gender, age, education and other factors in Asian countries.

Methods

We analyzed the data from the 7th wave of Korean Labor and Income Panel Study to investigate the association between perceived discriminatory experience and poor self-rated health in South Korea. Perceived discriminatory experiences were measured in eight situations through a modified Experience of Discrimination questionnaire. In each of eight situations, the lifetime prevalence of perceived …

Patient Engagement: Patients As Partners In Their Own Health Care, Nancy L. Falk, Mary Jean Schumann

Nursing Faculty Posters and Presentations

No abstract provided.

Impact Of Antiviral Treatment And Hospital Admission Delay On Risk Of Death Associated With 2009 A/H1n1 Pandemic Influenza In Mexico, Gerardo Chowell, Cecile Viboud, Lone Simonsen, Mark A. Miller, Santiago Echevarría-Zuno, Margotx González-León, Víctor H. Borja Aburto

Global Health Faculty Publications

Background

Increasing our understanding of the factors affecting the severity of the 2009 A/H1N1 influenza pandemic in different regions of the world could lead to improved clinical practice and mitigation strategies for future influenza pandemics. Even though a number of studies have shed light into the risk factors associated with severe outcomes of 2009 A/H1N1 influenza infections in different populations (e.g., [1-5]), analyses of the determinants of mortality risk spanning multiple pandemic waves and geographic regions are scarce. Between-country differences in the mortality burden of the 2009 pandemic could be linked to differences in influenza case management, underlying population health, …

Fusion, 2012, George Washington University, William H. Beaumont Medical Research Honor Society

Fusion

No abstract provided.

Reasons For Low Pandemic H1n1 2009 Vaccine Acceptance Within A College Sample, Russell D. Ravert, Linda Y. Fu

Pediatrics Faculty Publications

This study examined health beliefs associated with novel influenza A (H1N1) immunization among US college undergraduates during the 2009-2010 pandemic. Undergraduates (ages 18–24 years) from a large Midwestern University were invited to complete an online survey during March, 2010, five months after H1N1 vaccines became available. Survey items measured H1N1 vaccine history and H1N1-related attitudes based on the health belief literature. Logistic regression was used to identify attitudes associated with having received an H1N1 vaccine, and thematic analysis of student comments was conducted to further understand influences on vaccine decisions. Among the 296 students who participated in the survey, 15.2% …

Aspirin But Not Ibuprofen Use Is Associated With Reduced Risk Of Prostate Cancer: A Plco Study, F. M. Shebl, L. C. Sakoda, A. Black, J. Koziol, G. L. Andriole, R. Grubb, T. R. Church, D. Chia, Cindy Zhou, +8 Additional Authors

GW Biostatistics Center

Background:

Although most epidemiological studies suggest that non-steroidal anti-inflammatory drug use is inversely associated with prostate cancer risk, the magnitude and specificity of this association remain unclear.

Methods:

We examined self-reported aspirin and ibuprofen use in relation to prostate cancer risk among 29 450 men ages 55–74 who were initially screened for prostate cancer from 1993 to 2001 in the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial. Men were followed from their first screening exam until 31 December 2009, during which 3575 cases of prostate cancer were identified.

Results:

After adjusting for potential confounders, the hazard ratios (HRs) of …

Developing A Business Plan For Sustaining School Mental Health Services: Three Success Storiess, Donna Behrens, Julia Graham Lear, Olga Acosta Price

Center for Health and Health Care in Schools

No abstract provided.

Urban Governance Of Disease, Rebecca Katz, Sangeeta Mookherji, Morgan Kaminski, Vibhuti Haté, Julie E. Fischer

Global Health Faculty Publications

Rapid population growth, urbanization, and the growing challenges faced by the urban poor require redefining the paradigm for public health interventions in the 21st century, creating new approaches that take urban determinants of health into consideration. The widening disparity between the urban poor and the urban rich further exacerbates health inequities. Existing tools for global governance of urban health risks fall short, particularly in the lack of formal mechanisms to strengthen collaboration and communication among national and municipal agencies and between their local and international non-governmental partners. There is also a clear disconnect between governance strategies crafted at the international …

Smoking Susceptibility And Its Predictors Among Adolescents In China: Evidence From Ningbo City, Cheng Huang, Jeffrey Koplan, Jing Liu, Changwei Li, Jessica Silvaggio, Amanda K. Macgurn, Tao Zhang, Michael P. Erikson, Pam Redmon

Global Health Faculty Publications

Susceptibility to smoking is a risk factor of actual adolescent smoking behaviors. This study aimed to estimate the rate of smoking susceptibility and its predictors in China with a sample of 4,695 junior high school students in Ningbo, China. Core questions from the Global Youth Tobacco Survey (GYTS) were adapted to the China context and administered to these students. The rate of smoking susceptibility, measured by “Do you foresee yourself taking up smoking in the next 12 months”, is 6.1%. Results from logistic regression suggested that among boys, adolescents’ health knowledge that smoking can cause lung cancer (OR=2.73), the belief …

Measuring Discrimination In South Korea: Underestimating The Prevalence Of Discriminatory Experiences Among Female And Less Educated Workers?., Seung-Sup Kim, Yeonseung Chung, David R. Williams

Environmental and Occupational Health Faculty Publications

Objectives

To investigate the possibility that Koreans show different patterns in reporting discriminatory experiences based on their gender and education level, we analyzed the participants who answered “Not Applicable” for the questions of discriminatory experiences that they were eligible to answer.

Methods

Discriminatory experiences in eight social situations were assessed using the 7th wave of Korean Labor and Income Panel Study. After restricting the study population to waged workers, a logistic regression model was constructed to predict the probability that an individual has experienced discrimination based on the observed covariates for each of eight situations, using the data of participants …

The Aging Services Network: Serving A Vulnerable And Growing Elderly Population In Tough Economic Times, Carol O'Shaughnessy

National Health Policy Forum

In 1965, Congress enacted the Older Americans Act, establishing a federal agency and state agencies to address the social services needs of the aging population. The mission of the Older Americans Act is broad: to help older people maintain maximum independence in their homes and communities and to promote a continuum of care for the vulnerable elderly. In successive amendments, the Act created area agencies on aging and a host of social support programs. The "aging services network," broadly described, refers to the agencies, programs, and activities that are sponsored by the Older Americans Act. The Act’s funding for services …

Results From The 2010-11 Readiness For Meaningful Use Of Hit And Patient Centered Medical Home Recognition Survey, Merle Cunningham, Anthony Lara, Peter Shin

Geiger Gibson/RCHN Community Health Foundation Research Collaborative

This brief describes the status of health centers with respect to Electronic Health Record (EHR) adoption, readiness to meet the health information technology (HIT) meaningful use (MU) standards, and readiness to achieve Patient-Centered Medical Home (PCMH) recognition.

A Natural Fit: Collaborations Between Community Health Centers And Family Planning Clinics, Rachel Benson Gold, Marcie Zakheim, Jillanne M. Schulte, Susan F. Wood, Tishra Beeson, Sara J. Rosenbaum

Geiger Gibson/RCHN Community Health Foundation Research Collaborative

Federally Qualified Health Centers (FQHCs) and family planning clinics funded through Title X of the Public Health Service Act are critical components of the health care safety net in urban and rural medically underserved communities. Although they share the common mission of serving vulnerable and low-income populations, health centers and Title X clinics possess different, but complementary, strengths. The Patient Protection and Affordable Care Act (Affordable Care Act) will expand coverage to an additional 32 million people while leaving 23 million uninsured. Most of the newly insured and the remaining uninsured will be residents of medically-underserved communities, and thus, positioning …

Individual And Small-Group Market Health Insurance Rate Review And Disclosure: State And Federal Roles After Ppaca, Kathryn Linehan

National Health Policy Forum

Oversight of private insurance, including health insurance, is primarily a state responsibility. Each state establishes its own laws and regulations regarding insurer activities, including premium increases for the insurance products within its purview. The authority that state regulators have to review and deny requests for premium changes varies from state to state, as do the amount of resources available to state insurance departments for reviewing premium changes. In some markets where insurers have proposed or implemented steep increases, such changes have received considerable attention from the press, state regulators, and policymakers. The Patient Protection and Affordable Care Act (PPACA) requires …

Community Health Centers And The Economy: Assessing Centers' Role In Immediate Job Creation Efforts, Sara J. Rosenbaum, Peter Shin

Geiger Gibson/RCHN Community Health Foundation Research Collaborative

Federal investment in community health centers not only creates health care access but, based on previous studies, generates an estimated 8:1 return for medically underserved communities while creating thousands of jobs. Since our earlier 2008 economic impact study, Congress has made two major program investments: $2 billion under the American Reinvestment and Recovery Act (ARRA) of 2009; and $11 billion under the Affordable Care Act (ACA). This analysis measures the economic and jobs-creation benefits of this cumulative investment in health centers, as well as the impact of legislation enacted in April, 2011, which reduced the first year of new …

Aligning Graduate Medical Education With Public Policy, Rob Cunningham

National Health Policy Forum

In late May–early June 2011, the Forum sponsored a site visit to Denver, Colorado, to observe innovative efforts to improve the health of Coloradans and reduce the cost of health care. The three-day agenda was designed to convey the breadth and interconnectedness of the efforts underway in Denver and to highlight both successes and challenges. The exploration concentrated on how three themes of national interest are unfolding in Denver: building and sustaining a robust and effective safety net in an evolving health care market; improving the health of people and their communities to prevent and reduce the need for health …

Bending The Health Care Cost Curve In North Carolina: The Experience Of Community Health Centers, Patrick Richard, Peter Shin, Kristina Vasilkovska, Sara J. Rosenbaum

Geiger Gibson/RCHN Community Health Foundation Research Collaborative

North Carolina is known for innovative practices in primary care delivery and education, and accordingly one might expect to see greater efficiencies overall in care delivery, and less direct, measurable impact by community health centers on cost and outcome. Of interest is whether community health centers (CHCs) are cost effective providers in states with a sophisticated primary care infrastructure and focus on the needs of medically underserved communities. Building on the large body of health services research literature that has documented the quality and cost-effectiveness of federally-funded primary health centers nationwide, as well as estimates of national savings that are …

The Situation Analysis Of Children And Women In Belize 2011: An Ecological Review, Mark C. Edberg, C. Chambers, D. Shaw

Center for Social Well-Being and Development

No abstract provided.

Influenza Vaccination Of The Healthcare Workforce: Developing A Model State Law, Alexandra M. Stewart, Marisa A Cox

Health Policy and Management Faculty Publications

No abstract provided.

Addressing The Challenges Of Reporting On Childhood Asthma In A Changing Health Care System: Building Better Evidence For High Performance, Meagan Lyon, Anne Rossier Markus, Maya Tuchman Gerstein, Sara J. Rosenbaum

Geiger Gibson/RCHN Community Health Foundation Research Collaborative

Childhood asthma is a serious and costly chronic disease that burdens children and families as well as the health care systems that serve them. A key element to improving asthma outcomes is access to timely and useful data that can improve the quality of care and inform programs and policies to best serve those communities most burdened by asthma. This Policy Brief examines the nation’s data collection framework for childhood asthma and considers steps that might be taken to strengthen it, including the development, collection and refinement of community-level data to inform local health care systems. Through a review of …

Rocky Mountain Highs And Lows: Efforts To Improve Health And Reduce Costs In Denver, Michele J. Orza, Jessamyn Taylor

National Health Policy Forum

In late May–early June 2011, the Forum sponsored a site visit to Denver, Colorado, to observe innovative efforts to improve the health of Coloradans and reduce the cost of health care. The three-day agenda was designed to convey the breadth and interconnectedness of the efforts underway in Denver and to highlight both successes and challenges. The exploration concentrated on how three themes of national interest are unfolding in Denver: building and sustaining a robust and effective safety net in an evolving health care market; improving the health of people and their communities to prevent and reduce the need for health …

Home, But Not Alone: Evidence-Based Maternal, Infant, And Early Childhood Home Visitation, Eileen Salinsky

National Health Policy Forum

Home visitation services for young and expectant families have the potential to improve child and parent outcomes in a broad variety of ways, but the effectiveness of home visits may depend on the nature, frequency, and duration of these services. The Patient Protection and Affordable Care Act of 2010 (PPACA) created a new federal funding stream to promote the development and implementation of evidence-based home visiting programs. This issue brief provides an overview of the newly established Maternal, Infant, and Early Childhood Home Visiting program, describes existing approaches to home visitation, and discusses the implications of federal funding for state …

Medicare's Accountable Care Organization Regulations: How Will Medicare Beneficiaries Who Reside In Medically Underserved Communities Fare?, Sara J. Rosenbaum, Peter Shin

Geiger Gibson/RCHN Community Health Foundation Research Collaborative

On March 31, 2011, the Centers for Medicare and Medicaid Services (CMS) released proposed regulations implementing the Medicare Shared Savings Program (MSSP). The thrust of the MSSP is to promote savings to Medicare as well as the greater clinical integration of health care through incentive payments to accountable care organizations (ACOs) that meet Medicare standards for structure, performance, and health care outcomes. The effort to spur greater clinical integration through the MSSP was part of a broader set of reforms contained in the Affordable Care Act (ACA) whose aim was to improve health care quality and efficiency. Among these reforms …