Public Health Commons^™

Assessment Of Refugees’ Health In Montgomery County: A Case Study Of Refugees From Rwanda And Burundi, Jean De Dieu Mukunzi

Master of Public Health Program Student Publications

The purpose of this research study was to identify health needs and health problems experienced by a refugee/asylee population in Montgomery County. Montgomery County hosts a large number of refugees, asylees and asylum seekers from countries such as Iraq, Ethiopia, Eritrea, Soudan, Rwanda, Burundi and Congo.

A public health challenge is limited demographic data about this population. The scarce data on their health needs slows down not only their successful resettlement but also limits community organizations, health and human services agencies to improve the delivery of health care services and health promotion programs to refugees and immigrants in Montgomery County. …

Il Faut Manger: A Study Of Women’S Body Image And Obesity In Mali, Jennifer Denike

Independent Study Project (ISP) Collection

Africa has long been a region of the world marked by the media as one of rail thin children with distended bellies and older men and women with cracked and wrinkled skin sagging off their bones. Media outlets like BBC, CNN, and the New York Times focus entire sections of their websites to special reports entitled ‘Famine in Africa’2, ‘Food Crisis in Niger’3, and ‘East Africa Famine 2011’4. Photos of children curled up on the ground, ribs and bones protruding at every angle grace the pages of nearly every magazine and newspaper. Nongovernmental organizations plead for donations and host fundraisers …

Outcomes Of A Tailored Tobacco Treatment Approach For Individuals With Substance Use Disorders And/Or Psychiatric Disorders, Chizimuzo T.C. Okoli, Milan Khara

Nursing Presentations

Summary of Key Findings

• Smoking abstinence at end of program:
• Intent to treat analysis: 31% (167/540)
• Among program completers: 41% (167/406)

• Significant predictors of abstinence:
• Having a history of an anxiety disorder is predictive of being less likely to quit smoking when compared to having no history of a psychiatric disorder.
• Having a lower CO level at program enrolment was a significant predictor of being more likely to quit.
• Attending the TDC program for a longer duration was a significant predictor of being more likely to quit.

Effect Of School Racial Composition On Trajectories Of Depressive Symptoms From Adolescence Through Early Adulthood, Katrina M. Walsemann, Bethany A. Bell, Bridget J. Goosby

Faculty Publications

Introduction: We investigate the effect of high school racial composition, measured as percent of non-Hispanic White students, on trajectories of depressive symptoms from adolescence to early adulthood. We also explore whether the effect of school racial composition varies by respondent race/ethnicity and if adult socio-economic status mediates this relationship.

Methods: We analyzed four waves of data from the National Longitudinal Study of Adolescent Health using 3-level linear growth models. We restricted our sample to respondents enrolled in grades 9-12 in 1994/5 who were interviewed at a minimum in Waves I and IV. This resulted in 10,350 respondents enrolled in 80 …

Food Insecurity And Sexual Risk In An Hiv Endemic Community In Uganda, Cari L. Miller, David R. Bangsberg, David M. Tuller, Jude Senkungu, Annet Kawuma, Edward A. Frongillo Jr., Sheri D. Weiser

Faculty Publications

Food insecurity has been linked to high-risk sexual behavior in sub-Saharan Africa, but there are limited data on these links among people living with HIV/AIDS, and on the mechanisms for how food insecurity predisposes individuals to risky sexual practices. We undertook a series of in-depth open-ended interviews with 41 individuals living with HIV/AIDS to understand the impact of food insecurity on sexual-risk behaviors. Participants were recruited from the Immune Suppression Clinic at the Mbarara University of Science and Technology in Mbarara, Uganda. Interviews were recorded, transcribed verbatim, translated, and coded following the strategy of grounded theory. Four major themes emerged …

Mandatory Hpv Vaccination And Political Debate, Lawrence O. Gostin

Georgetown Law Faculty Publications and Other Works

Vaccinations are among the most cost-effective and widely used public health interventions, but have provoked popular resistance, with compulsion framed as an unwarranted state interference. When the FDA approved a human papillomavirus (HPV) vaccine in 2006, conservative religious groups strongly opposed a mandate, arguing it would condone pre-marital sex, undermine parental rights, and violate bodily integrity. Yet, Governor Rick Perry signed an executive order in 2007 making Texas the first state to enact a mandate — later revoked by the legislature.

Mandatory HPV vaccination reached the heights of presidential politics in a recent Republican debate. Calling the vaccine a "very …

Combined Impact Of Lifestyle Factors On Cancer Mortality In Men, Chong-Do Lee, Xuemei Sui, Steven P. Hooker, James R. Hébert, Steven N. Blair

Faculty Publications

PURPOSE - The impact of lifestyle factors on cancer mortality in the U.S. population has not been thoroughly explored. We examined the combined effects of cardiorespiratory fitness, never smoking, and normal waist girth on total cancer mortality in men.

METHODS - We followed a total of 24,731 men ages 20-82 years who participated in the Aerobics Center Longitudinal Study. A low-risk profile was defined as never smoking, moderate or high fitness, and normal waist girth, and they were further categorized as having 0, 1, 2, or 3 combined low-risk factors.

RESULTS - During an average of 14.5 years of follow-up, …

Brief: Fostering A Movement Towards Evidence-Based Screening, Assessment, And Treatment, Institute For Public Health And Justice, Evidence-Based Treatment And Services, Evidence Based Practices Dissemination Strategies

Policy & Position Papers

No abstract provided.

Youth Outcomes Study, Institute For Public Health And Justice, Data Collecting And Reporting

Policy & Position Papers

No abstract provided.

Data On Youth Service Needs In Louisiana, Institute For Public Health And Justice, Data Collecting And Reporting

Policy & Position Papers

No abstract provided.

Juvenile Detention Screening Instruments: Determining Appropriate Placement For Young Offenders, Institute For Public Health And Justice, Screening And Assessment, Stephen Phillippi, Sara Crosby Juneau, Kelsey Witmeir

Policy & Position Papers

No abstract provided.

Creating & Optimizing Children & Youth Planning Boards, Institute For Public Health And Justice, Community Participatory Work

Policy & Position Papers

No abstract provided.

Migration, Vulnerability And Xenophobia: Central African Refugee And Asylum Seekers’ Access To Health Services In Durban, South Africa, Cathy Kaplan

Independent Study Project (ISP) Collection

In 1998, South Africa passed historic legislation that bridged international conventions on refugees and asylum seekers with the protections and rights defined in the South African Constitution and Bill of Rights. The 1998 refugees act defined specific rights that refugees and asylum seekers are entitled in South Africa, the most important of which include the provision of legal and immigration documentation, employment, adequate housing, and health and social services. When asylum seekers arrive in Durban, many are in the need of immediate health services as a result of long journeys, pre-existing conditions, pregnancy, or illnesses contracted in refugee camps throughout …

Effectively Filling Gaps In Care: A Comparative Study Of Models Of Government Partnerships With Community Health Organizations In Kwazulu-Natal, South Africa, Madeline Ross

Independent Study Project (ISP) Collection

This study conducted Amatkiulu, Impendle, and Durban, KwaZulu-Natal, South Africa, utilizes three case studies to form a comparative analysisof the effectiveness of different models of public-private partnerships. Two expert interviews, three informal interviews, and many hours of observation inform this analysis of community health worker organizations employed through government clinics, tuberculosis tracer teams hired by government clinics, and independent non-governmental organizations heavily subsidized by the government. Subjective analysis found that the partnership between the Department of Health and a primary healthcare NGO, providing a wide range of comprehensive services, operated with the best efficiency and quality of care.

“La Percepción Social De Vih/Sida En Chile Y Sus Efectos”, Philip Krause

Independent Study Project (ISP) Collection

Research Question—How does the social perception of HIV/AIDs in Chile affect the country’s prevention and treatment programs?

Background-- This paper investigated the social perception of HIV/AIDs in Chile through the opinions of experts who work closely to the issue, including regional and national political professionals, medical professionals on HIV/AIDs treatment teams in hospitals, and leaders of social organizations that had a relationship to HIV/AIDs representation and prevention. The professionals were also asked how they believed this perception affected the efforts of the Chilean government and national organizations in prevention and management of the HIV/AIDs epidemic in Chile. An …

La Etnia Y Las Cesáreas En Los Partos En El Hospital Público De Arica, Chile, Marisa Westbrook

Independent Study Project (ISP) Collection

The principal objective of this project was to explore the relationship between ethnicity and the causes for Caesarean section in the regional public hospital in Arica, Chile. All births recorded in the maternity register (n=907) were analyzed over a 4-month period in 2011. The regional public hospital had a 27% caesarean section rate, higher than the WHO-recommended 15%. Last names were analyzed and deemed to be either of Aymara descent (n=275) or of European descent (n=632) based on criteria used from CONADI, the National Corporation for Indigenous Development. The overall rate of Caesarean section did not differ between Aymara and …

Effective, Efficient Health Care Reform The United States And Swiss Health Care Systems: A Comparative Analysis What Can The U.S. Learn From The Swiss Experience?, Rebecca Dittrich

Independent Study Project (ISP) Collection

Home to 45 million people without health insurance while still spending 17% of its GDP on health care expenses, the United States has been in need of a massive health care overhaul for quite some time. Some have speculated that the Swiss system may be an ideal model for health care reform, and in fact, many aspects of the newly instated Patient Protection and Affordable Care Act (ACA) do reflect areas of LAMal, Swiss health care law. This paper evaluates the Swiss and United States health care systems (under ACA), their similarities and differences, and the pros and cons of …

La Medicina Tradicional Y La Medicina Moderna En Cusco, Katelyn Scott

Independent Study Project (ISP) Collection

Cuando estaba tratando a escoger un tema para esta investigación encontré esta cita, “In the assessment of the World Health Organization (WHO), the majority of the population of most developing countries regularly use and rely on traditional medicine for their everyday healthcare needs[1]” (Bodeker 23). En hecho, WHO dice que casi 80% de la población de un país desarrollado todavía usa la medicina tradicional (Mendoza, 439). Estas citas me interesé y por eso decidí a investigar las perspectivas que las personas en Cusco tienen sobre la medicina tradicional y la medicina moderna. Quiera aprender si la medicina tradicional …

Cap Centre : L’Epicerie Sociale, Ana De Pina

Independent Study Project (ISP) Collection

Contrairement à autres study abroad programs, « The School of International Training (SIT) » donne les étudiants Américains une opportunité de découvrir la culture Française, d’apprendre la langue Française, et de s’intègre dans la société Française. Pendant notre séjour en France, nous avons fait de bénévolat dans une association que correspond à nos études aux États-Unis. Aux États-Unis j’étudie la sante publique. Je suis très intéressé pour l’administration des hôpitaux et autres institutions de santé et la relation entre la sécurité sociale et la bonne santé. Donc, pendant trois mois j’ai travaillé au CAP Centre, une épicerie sociale qui aide …

Understanding Social Marketing In A Not-For-Profit Ngo Setting: An Internship With Pace In Eastern Uganda, Veronica L. Tuerffs

Independent Study Project (ISP) Collection

The organization PACE (Programme for Accessible health, Communication and Education) focuses on generating a positive health impact throughout Uganda by the means of social marketing and other proven, evidence based techniques. An internship with the organization took place over the course of six weeks and was conducted under the A2L (Access to Life) program which is located in four of the country’s eastern districts. The focus of the health and sales communication internship was the implementation of PACE’s marketing scheme on their life-saving products and how the products and organization are perceived.

Any of the information gathered during this time …

When Mountain Bellies Grow Round: Localized Knowledge And Behaviors Facilitating Pregnancy And Childbirth In Phaphlu, Nepal, Cailin Marsden

Independent Study Project (ISP) Collection

In attempts to gain a level of understanding of a community’s localized experiences, beliefs, practices, and roles around pregnancy and childbirth, ethnographic fieldwork was conducted with the mothers and fathers of Phaphlu in the Solukhumbu district of Nepal. Aimed at the validation of diverse and localized ways of knowing revealed during the fieldwork period, this paper applies anthropologist Bridgette Jordan’s theoretical framework of authoritative knowledge to the emergent themes of subjectively understood childbirth (knowledge acquisition and flow, role of the husband, and protective behavior.)

Using Mixed-Methods To Measure The Perception Of Community Capacity In An Academic-Community Partnership For A Walking Intervention, Charkarra Anderson-Lewis, Diana Cuy-Castellanos, Arnecca Byrd, Karen Zynda, Alicia Sample, Vickie Blakely Reed, Mary Beard, Latessa Minor, Kathleen Yadrick

Faculty Publications

H.U.B. City Steps is a 5-year community-based participatory research walking intervention designed to help lower blood pressure in a majority African American population in southern Mississippi via community collaboration and capacity building, increased walking, culturally tailored health education sessions, and motivational interviewing. Building community capacity for physical activity is a key component of this intervention. Qualitative and quantitative methods have been used to assess how project stakeholders perceive the community capacity-building efforts of the project. This article illustrates the baseline results of this mixed methods approach from the perspective of three groups of stakeholders: project researchers and staff, community advisory …

Heterogeneity And Data Analysis, Peter J. Taylor

Working Papers on Science in a Changing World

This working paper is a discussion paper for a September 2011 meeting of the research group of Prof. Di Cook on data visualization and exploratory data analysis at Iowa State University. A taxonomy of eleven kinds of heterogeneity is presented, followed by a set of vignettes that illustrate some of the meanings and sketch some implications, then a series of images that illustrate the heterogeneities. Several of the vignettes speak to a broad contention about heterogeneity and control: In relation to modern understandings of heredity and development over the life course, research and application of resulting knowledge are untroubled by …

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 …

Use Of Dried-Blood-Spot Samples And In-House Assays To Identify Antiretroviral Drug Resistance In Hiv-Infected Children In Resource-Constrained Settings, Carrie Ziemniak, Yohannes Mengistu, Andrea Ruff, Ya-Hui Chen, Leila Khaki, Abubaker Bedri, Birgitte B. Simen, Paul Palumbo

Dartmouth Scholarship

Monitoring HIV drug resistance is an important component of the World Health Organization's global HIV program. HIV drug resistance testing is optimal with commercially available clinically validated test kits using plasma; however, that type of testing may not be feasible or affordable in resource-constrained settings. HIV genotyping from dried blood spots (DBS) with noncommercial (in-house) assays may facilitate the capture of HIV drug resistance outcomes in resource-constrained settings but has had varying rates of success. With in-house assays for HIV reverse transcriptase, we evaluated the yield of genotyping DBS samples collected from HIV-infected children who were enrolled in two clinical …

Florida Public Health Association 2009 Survey Of Academic Public Health Programs In Florida, Leslie Sue Lieberman, Nancy Rudner Lugo, Mary Peoples-Sheps, Melissa J. Vilaro, Claude Earl Fox

Florida Public Health Review

Preparing the public health workforce is essential to the protection ofthe health and wellbeing ofthe state and the nation. Yet, a workforce shortage is looming. It is anticipated that by 2020, the nation will be facing a shortfall ofmore than a quarter of a million public health workers. To address this impeding shortage, the Association ofSchools ofPublic Health (ASPH) has stressed the need to build public health education capacity, with emphasis on competencies and curriculum in emerging diseases, with joint degrees, and with diverse approaches to education, including certificates and distance learning. To assess Florida’s available public health professional preparation …

A Regularization Corrected Score Method For Nonlinear Regression Models With Covariate Error, David M. Zucker, Malka Gorfine, Yi Li, Donna Spiegelman

Harvard University Biostatistics Working Paper Series

No abstract provided.

Estimation Of Risk Ratios In Cohort Studies With Common Outcomes: A Simple And Efficient Two-Stage Approach, Eric J. Tchetgen

Harvard University Biostatistics Working Paper Series

No abstract provided.

Reducing Psychosocial And Behavioral Pregnancy Risk Factors: Results Of A Randomized Clinical Trial Among High-Risk Pregnant African American Women, Jill G. Joseph, Ayman El-Mohandes, Michele Kiely, M. Nabil El-Khorazaty, Marie G. Gantz, Allan A. Johnson, Kathy S. Katz, Susan M. Blake, Maryann W. Rossi, Siva Subramanian

Publications and Research

Objectives. We evaluated the efficacy of a primary care intervention targeting pregnant African American women and focusing on psychosocial and behavioral risk factors for poor reproductive outcomes (cigarette smoking, secondhand smoke exposure, depression, and intimate partner violence).

Methods. Pregnant African American women (N=1044) were randomized to an intervention or usual care group. Clinic-based, individually tailored counseling sessions were adapted from evidence-based interventions. Follow-up data were obtained for 850 women. Multiple imputation methodology was used to estimate missing data. Outcome measures were number of risks at baseline, first follow-up, and second follow-up and within-person changes in risk from baseline to the …

Highly Variable Recessive Lthal Or Nearly Lethal Mutation Rates During Germ-Line Development Of Male Drosophila Melanogaster, Jian-Jun Gao, Xue-Rong Pan, Jing Hu, Li Ma, Jian-Min Wu, Ye-Lin Shao, Sara A Barton, Ronny C Woodruff, Ya-Ping Zhang, Yun-Xin Fu

Faculty, Staff and Student Publications

Each cell of higher organism adults is derived from a fertilized egg through a series of divisions, during which mutations can occur. Both the rate and timing of mutations can have profound impacts on both the individual and the population, because mutations that occur at early cell divisions will affect more tissues and are more likely to be transferred to the next generation. Using large-scale multigeneration screening experiments for recessive lethal or nearly lethal mutations of Drosophila melanogaster and recently developed statistical analysis, we show for male D. melanogaster that (i) mutation rates (for recessive lethal or nearly lethal) are …