Public Health Commons^™

Development Of Novel Subunit Vaccine Against H5n1 Influenza, Lu Zhang

Graduate Theses and Dissertations

Influenza is a common infectious disease resulting from a frequently mutated RNA virus. Vaccination is currently the most effective method to prevent people from seasonal or pandemic influenza. The production of traditional egg-based influenza vaccine is time-consuming and provides limited effect against new strains. Therefore, it is necessary to develop a rapid method to produce influenza vaccines. We proposed a novel influenza vaccine based on the E.coli expression system. Hemagglutinin (HA) is the major target surface protein of influenza virus for vaccine development. In this study, we sub-cloned the HAs encoding gene into an E. coli expression vector; the signal …

Public Health Research Implementation And Translation: Evidence From Practice-Based Research Networks, Glen P. Mays, Rachel A. Hogg, Doris M. Castellanos-Cruz, Anna G. Hoover, Lizeth C. Fowler

Health and Clinical Sciences Faculty Publications

BACKGROUND: Research on how best to deliver efficacious public health strategies in heterogeneous community and organizational contexts remains limited. Such studies require the active engagement of public health practice settings in the design, implementation, and translation of research. Practice-based research networks (PBRNs) provide mechanisms for research engagement, but until now they have not been tested in public health settings.

PURPOSE: This study uses data from participants in 14 public health PBRNs and a national comparison group of public health agencies to study processes influencing the engagement of public health settings in research implementation and translation activities.

METHODS: A cross-sectional network …

Development And Evaluation Of Chitosan Particle Based Antigen Delivery Systems For Enhanced Antigen Specific Immune Response, Bhanuprasanth Koppolu

Graduate Theses and Dissertations

Particle-based vaccine delivery systems are under exploration to enhance antigen-specific immunity against safe but poorly immunogenic polypeptide antigens. Chitosan is a promising biomaterial for antigen encapsulation and delivery due to its ability to form nano- and microparticles in mild aqueous conditions thus preserving the antigenicity of loaded polypeptides. The objective of this work is to develop a chitosan particle based antigen delivery system for enhanced vaccine response. Chitosan particle sizes, which ranged from 300 nm to 3 ìm, were influenced by chitosan concentration, chitosan molecular weight and addition rate of precipitant salt. The composition of precipitant salt played a significant …

Us Medical Specialty Global Health Training And The Global Burden Of Disease, Vanessa B. Kerry, Rochelle P. Walensky, Alexander C. Tsai, Regan W. Bergmark, Brian A. Bergmark, Chaturia Rouse, David R. Bangsberg

OHSU-PSU School of Public Health Faculty Publications and Presentations

Background: Rapid growth in global health activity among US medical specialty education programs has lead to heterogeneity in types of activities and global health training models. The breadth and scope of this activity is not well chronicled.

Methods: Using a standardized search protocol, we examined the characteristics of US medical residency global health programs by number of programs, clinical specialty, nature of activity (elective, research, extended curriculum based field training), and geographic location across seven different clinical medical residency education specialties. We tabulated programmatic activity by clinical discipline, region and country. We calculated the Spearman's rank correlation coefficient to estimate …

The Relationship Between Health Literacy And Health Outcomes: A Mixed-Methods Study Of African-American Adult Patients With Asthma, Courtnee Erin Melton

Theses and Dissertations (ETD)

Introduction: Asthma affects 24.6 million people in the United States, and AfricanAmericans share a disproportionate burden of the disease. African-Americans have a higher prevalence of asthma, worse asthma control, higher hospitalization rates, and higher asthma mortality rates African-Americans are also more likely to have low health literacy. Low health literacy has been linked to increased use of emergency care, increased hospitalization, decreased use of preventive services, poorer medication adherence, poorer interpretation of prescription labels, nutrition labels, and health messages, and poorer health outcomes. Consequently, health literacy is one of the modifiable individual factors that contributes to asthma disparities among African-Americans. …

Full-Gestational Exposure To Nicotine And Ethanol Results In Long-Term Dysregulation In The Ventral Tegmental Area, Emily Elizabeth Roguski

Theses and Dissertations (ETD)

Nicotine is considered a gateway drug for other drugs of abuse. The majority of smokers that begin smoking in adolescence, continue into adulthood. Multiple factors have been linked with smoking initiation, including maternal smoking. Drug exposure during pregnancy has long been suspected to exert deleterious effects on the fetal brain. Concurrent use of smoking and drinking alcohol throughout pregnancy is an all too frequent occurrence in the human population especially in disadvantaged and younger women.

The present study investigated the potential contributing factors for the enhanced nicotine selfadministration as seen in offspring with gestational exposure to nicotine and ethanol (Nic+EtOH).* …

Who Done It? Rurality Vs. Ses As Critical Factors In Evaluating The Prevalence Of Child Psychosocial Concerns In Primary Care, Robert M. Tolliver

Electronic Theses and Dissertations

The purpose of this study was to evaluate the prevalence of child psychosocial concerns in rural primary care, hypothesized to be greater than national averages due to lacking mental health services in rural areas. This study was an examination of the role of SES, various definitions of “rural,” and the interaction of SES and rurality, in predicting parent-reported child psychosocial concerns in Appalachian primary care clinics. Caregivers presenting with their child at one of 8 pediatric primary care sites (n=2,672) were recruited to complete a measure assessing demographics and the Pediatric Symptom Checklist (PSC). Results showed that while rural status …

On Head Lice And Social Interaction In Archaic Andean Coastal Populations, Bernardo Arriaza, Vivien Standen, Karl Reinhard, Aduto Araújo, Jörg Heukelbach, Katharina Dittmar

Karl Reinhard Publications

Archaic mummies from northern Chile were examined for the presence of Pediculus humanus capitis. The excellent preservation of mummies and louse nits/eggs permitted a study of the degree of head lice infestation. We studied 63 Chinchorro mummies (ca. 5000–3000 years B.P.) from the Arica-Camarones coast. An area of 2 cm × 2 cm on each mummy’s head was systematically inspected for louse nits/eggs. Hairs with nits/eggs and lice were collected and analyzed using optic and scanning electronic microscopy. About 79% (50/63) of the mummies resulted positive for pediculosis, with an average of 2.1 nits/ eggs/cm2 per positive individual. Microscopic …

Factors Associated With Parental Decision Making And Childhood Vaccination, Zuwen Qiu-Shultz

UNLV Theses, Dissertations, Professional Papers, and Capstones

In order to better understand factors affecting immunization status, logistic regression was used to assess the association of various socio-demographic factors and whether parents would have their child immunized if not a state mandate. Factors included in the study were race, household income, number of children in the household, number of adults in the household, if the child had a primary provider, if the child had a health check-up in the last twelve months, and medical insurance status of the child. The combined Nevada Kindergarten Health Survey Result of 2009-2010 (Year Two) and 2010-2011 (Year Three) conducted by the Nevada …

Quantifying Value In Public Health: Using Economic Methods To Analyze System Change, Theresa M. Green

Dissertations

In this time of economic downturn, it is becoming increasingly important for organizations, including those in public health, to “prove their worth,” to show the value in improvement strategies. Health agencies have learned to discuss impact in terms of health outcome and mortality/morbidity measures. However, it is critical that these impacts are also expressed in a way that shows cost-efficiency and economic benefit especially for promising, evidence-based public health interventions. Although several methods of economic evaluation including cost-effective analysis, cost-utility analysis, or cost-benefit analysis and return on investment (ROI) have been used in social sciences and health research, fewer examples …

Telemental Health In Today's Rural Health System, David Lambert Phd, John A. Gale Ms, Anush Yousefian Hansen Ms, Ma, Zachariah T. Croll Ba, David Hartley Phd, Mha

Mental Health / Substance Use Disorders

Telemental health has long been promoted in rural areas to address chronic access barriers to mental health care. While support and enthusiasm for telemental health in rural areas remains quite high, we lack a clear picture of the reality of telemental health in rural areas, compared to its promise. This Research & Policy Brief reports on the first part of our study—the online survey of 53 telemental health programs—and describes the organizational setting, services provided, and the staff mix of these programs. We draw from our telephone interviews with 23 of these programs to help describe the organizational context of …

Association Between In Utero Arsenic Exposure, Placental Gene Expression, And Infant Birth Weight: A Us Birth Cohort Study, Dennis Liang Fei, Devin C. Koestler, Zhigang Li, Camilla Giambelli, Avencia Sanchez-Mejias, Julie Gosse, Carmen J. Marsit, Margaret R. Karagas, David J. Robbins

Dartmouth Scholarship

Epidemiologic studies and animal models suggest that in utero arsenic exposure affects fetal health, with a negative association between maternal arsenic ingestion and infant birth weight often observed. However, the molecular mechanisms for this association remain elusive. In the present study, we aimed to increase our understanding of the impact of low-dose arsenic exposure on fetal health by identifying possible arsenic-associated fetal tissue biomarkers in a cohort of pregnant women exposed to arsenic at low levels.

Methods: Arsenic concentrations were determined from the urine samples of a cohort of 133 pregnant women from New Hampshire. Placental tissue samples collected from …

Health Service Utilization And Stigma Among Hiv-Positive Men-Who-Have-Sex-With Men (Msm) In Rural Appalachia, Roger L. Blackwell Jr

Electronic Theses and Dissertations

ABSTRACT

Health Service Utilization and Stigma among

HIV-Positive Men-Who-Have-Sex-With-Men (MSM) in Rural Appalachia

by

Roger Lee Blackwell

The world has now entered the third decade of the AIDS epidemic. Men-who-have-sex-with-men continue to be disproportionately affected by HIV/AIDS. The United States still struggles in its response to this ongoing crisis in many areas: disease prevention, treatment, and HIV related stigma, prejudice and discrimination. Much of the information reported on MSM living with HIV has come from urban population centers, but only a few studies have focused on HIV positive MSM living in rural areas. Therefore, the overall aim of this dissertation …

Diagnosis And Acute Management Of Patients With Concussion At Children's Hospitals., Jeffrey D. Colvin, Cary Thurm, Brian M. Pate, Jason G. Newland, Matt Hall, William P. Meehan Iii

Manuscripts, Articles, Book Chapters and Other Papers

Objectives: To describe the number of hospital admissions for concussion at paediatric hospitals in the USA. To describe the use of imaging and medications for acute concussion paediatric patients.

Design: Cross-sectional study.

Setting: Children's hospitals participating in the Pediatric Health Information System in the USA during a 10-year period.

Patients: All emergency department (ED) visits and inpatient admissions with the primary diagnosis of concussion, defined as International Classification of Diseases, Ninth Revision, Clinical Modification codes for: (1) concussion, (2) postconcussion syndrome or (3) skull fracture without mention of intracranial injury with concussion.

Main outcome measures: The proportion of concussion patients …

The Effect Of Marriage On Stage At Diagnosis And Survival In Women With Cervical Cancer, Sanae El Ibrahimi

UNLV Theses, Dissertations, Professional Papers, and Capstones

Marriage is associated with improved health outcomes for many conditions. Married persons enjoy financial stability, social and emotional support, and tend to have better control of health risk behaviors compared to the unmarried. The marriage scene is changing continuously. Americans are marrying less or delaying the engagement to an older age. They are divorcing more, they choose cohabitation as an alternative to marriage, or engage in premarital relationships. As a consequence, barely half of Americans were married in 2011 compared to close to three quarters of Americans were married in the sixties. With the increase of the unmarried population - …

High Hiv Incidence Among Persons Who Inject Drugs In Pakistan: Greater Risk With Needle Sharing And Injecting Frequently Among The Homeless., Rab Nawaz Samo, Arshad Altaf, Ajmal Agha, Omrana Pasha, Shafquat Rozi, Ashraf Memon, Saleem Azam, Meridith Blevins, Sten Vermund, Sharaf Ali Shah

Community Health Sciences

BACKGROUND:

The incidence of HIV among persons who inject drugs (PWIDU) has fallen in many nations, likely due to successes of clean needle/syringe exchange and substance abuse treatment and service programs. However in Pakistan, prevalence rates for PWID have risen dramatically. In several cities, prevalence exceeded 20% by 2009 compared to a 2003 baseline of just 0.5%. However, no cohort study of PWID has ever been conducted.

METHODS:

We enrolled a cohort of 636 HIV seronegative PWID registered with three drop-in centers that focus on risk reduction and basic social services in Karachi. Recruitment began in 2009 (March to June) …

Development Of A Control Banding Method For Selecting Respiratory Protection Against Bioaerosols, Jacques Lavoie, Eve Neesham-Grenon, Maximilien Debia, Yves Cloutier, Geneviève Marchand

Rapports de recherche scientifique

La sélection d’un appareil de protection respiratoire contre les bioaérosols peut s’avérer une tâche complexe compte tenu de l’absence de valeurs limites d’exposition et de données toxicologiques, ainsi que des limites des techniques d’échantillonnage actuelles et de la grande diversité des bioaérosols. Dans ces circonstances, une méthode qualitative d’évaluation et de gestion du risque fournit une alternative aux méthodes quantitatives utilisées en hygiène du travail. Ce rapport propose un modèle de gestion graduée du risque pour le choix de la protection respiratoire contre les bioaérosols infectieux et non infectieux applicable à l’ensemble des milieux de travail et s’adressant aux hygiénistes …

The Influence Of Family Dynamics On Contraceptive Use In Madagascar And The Ensuing Impact On Family Well-Being, Joel Zafitandra Hajason, Kayla Piña, Joel L. Raveloharimisy

Faculty Publications

While studies have shown a relationship between family dynamics and contraceptive use and between contraceptive use and family well-being, no empirical study has been conducted to test whether a relationship exists between family influence on contraceptive use and family wellbeing. The objective of this study is to explore whether there is such a relationship between family influence on contraceptive use and family well-being.

“Many Miles To Go …”: A Systematic Review Of The Implementation Of Patient Decision Support Interventions Into Routine Clinical Practice, Glyn Elwyn, Isabelle Scholl, Caroline Tietbohl, Mala Mann, Adrian G. K. Edwards, Catharine Clay

Dartmouth Scholarship

Two decades of research has established the positive effect of using patient-targeted decision support interventions: patients gain knowledge, greater understanding of probabilities and increased confidence in decisions. Yet, despite their efficacy, the effectiveness of these decision support interventions in routine practice has yet to be established; widespread adoption has not occurred. The aim of this review was to search for and analyze the findings of published peer-reviewed studies that investigated the success levels of strategies or methods where attempts were made to implement patient-targeted decision support interventions into routine clinical settings.

Balancing The Presentation Of Information And Options In Patient Decision Aids: An Updated Review, Purva Abhyankar, Robert J. Volk, Jennifer Blumenthal-Barby, Paulina Bravo, Angela Buchholz, Elissa Ozanne, Dale C. Vidal, Nananda Col, Peep Stalmeier

Dartmouth Scholarship

Standards for patient decision aids require that information and options be presented in a balanced manner; this requirement is based on the argument that balanced presentation is essential to foster informed decision making. If information is presented in an incomplete/non-neutral manner, it can stimulate cognitive biases that can unduly affect individuals’ knowledge, perceptions of risks and benefits, and, ultimately, preferences. However, there is little clarity about what constitutes balance, and how it can be determined and enhanced. We conducted a literature review to examine the theoretical and empirical evidence related to balancing the presentation of information and options.

Occupational Injuries On Thoroughbred Horse Farms: A Description Of Latino And Non-Latino Workers' Experiences, Jennifer E. Swanberg, Jessica M. Clouser, Susan C. Westneat, Mary W. Marsh, Deborah B. Reed

Health, Behavior & Society Faculty Publications

Animal production is a dangerous industry and increasingly reliant on a Latino workforce. Within animal production, little is known about the risks or the occupational hazards of working on farms involved in various aspects of thoroughbred horse breeding. Extant research suggests that horse workers are at risk of musculoskeletal and respiratory symptoms, kicks, and other injuries. However, limited known research has examined the experiences of the industry's workers, including immigrant workers, despite their prominence and increased vulnerability. Using data collected from thoroughbred farm representatives via a phone-administered survey, a 2-hour face-to-face semi-structured interview, and farm injury logs, this article identifies …

Comparing Papanicolau Smear, Visual Inspection With Acetic Acid And Human Papillomavirus Cervical Cancer Screening Methods Among Hiv-Positive Women By Immune Status And Antiretroviral Therapy, Michael Chung, K. P. Mckenzie, H. D. Vuyst, B. A. Richardson, Farzana Rana, R. Pamnani, J. W. Njoroge, E. Nyongesa-Malava, S. R. Sakr, G. C. John-Stewart, N. R. Mugo

Internal Medicine, East Africa

Background: A rigorous comparison of cervical cancer screening methods utilizing data on immune status, antiretroviral therapy (ART) and colposcopy-directed biopsy has not been performed among HIV-positive women.

Methods: Between June and November 2009, 500 HIV-positive women were enrolled at an HIV treatment clinic in Nairobi, Kenya, and underwent Papanicolau (Pap) smear, visual inspection with acetic acid (VIA), human papillomavirus (HPV) and colposcopydirected biopsy (gold standard). Positive Pap smear (ASCUS, LSIL, HSIL), VIA, HPV and their combinations were compared with CIN2/3+. Sensitivity, specificity and AUC (sensitivity and 1-specificity) were compared using pairwise tests and multivariate logistic regression models that included age, …

Revealing The Ubiquitous Effects Of Quantum Entanglement-Toward A Notion Of God Logic, Wen-Ran Zhang, Karl E. Peace

Biostatistics: Faculty Publications

Following Spinoza-Einstein’s interpretation of God or nature, the notion “God Logic” is proposed. This notion is to serve as an elicitation for a consistent set of necessary criteria for: 1) developing the logical foundation of quantum gravity as envisaged by Einstein, 2) revealing the ubiquitous effects of quantum entanglement as suggested by Roger Penrose, and 3) programming the universe as proposed by Seth Lloyd. An evolving set of eleven criteria is proposed for the notion. The possibility of inventing such a logical system is analyzed. A supersymmetrical candidate logic of negative-positive energy dynamic equilibrium is introduced and assessed against the …

Global Mortality Estimates For The 2009 Influenza Pandemic From The Glamor Project: A Modeling Study, Lone Simonsen, Peter Spreeuwenberg, Roger Lustig, Robert J. Taylor, Douglas M. Fleming, Madelon Kroneman, Maria D. Van Kerkhove, Anthony D. Mounts, W. John Paget

Global Health Faculty Publications

Background

Assessing the mortality impact of the 2009 influenza A H1N1 virus (H1N1pdm09) is essential for optimizing public health responses to future pandemics. The World Health Organization reported 18,631 laboratory-confirmed pandemic deaths, but the total pandemic mortality burden was substantially higher. We estimated the 2009 pandemic mortality burden through statistical modeling of mortality data from multiple countries.

Methods and Findings

We obtained weekly virology and underlying cause-of-death mortality time series for 2005–2009 for 20 countries covering ~35% of the world population. We applied a multivariate linear regression model to estimate pandemic respiratory mortality in each collaborating country. We then used …

Innovations In Evaluating Health Campaigns In Developing Countries, W. Douglas Evans, Marc Boulay, Rebecca Firestone, Rajiv N. Rimal

GW Health Communication and Marketing Symposium Series

When conducting research in resource-poor settings, what research-method textbooks prescribe often varies substantially from what actually gets implemented on the ground. Randomization often breaks down, extraneous noise often pollutes the purity of experimental designs, and other challenges emerge in the field. The panel will highlight some of those challenges and engage the audience in discussions about possible solutions. Dr. Boulay will illustrate an analytic approach that combines propensity score matching and mediation analysis to provide a more comprehensive evaluation of SBCC activities. Dr. Firestone will discuss PSI's experience using coarsened exact matching to strengthen evaluation of its behavior change communications …

Epidemiology News, Georgia Southern University

Biostatistics, Epidemiology & Environmental Health Sciences: News & Publications (2011-2018)

• Social Contacts and Depression

College Of Public Health News, Georgia Southern University

College of Public Health: News & Publications

• Social Contacts and Depression

Estimating The Costs Of Public Health Services, Glen P. Mays

Health Management and Policy Presentations

The National Academy of Sciences Institute of Medicine recommended in 2012 that the federal government undertake work to identify the components and costs of a "minimum package" of public health programs, services, and capabilities that should be available in every American community. This presentation summarizes work that is currently underway through the Robert Wood Johnson Foundation-supported Public Health Practice-Based Research Networks (PBRN) Program to estimate the costs of public health delivery.

From (Un)Willingness To Involvement: Development Of A Successful Study Brand For Recruitment Of Diverse Msm To A Longitudinal Hiv Research, Paula M. Frew, Victoria A. Williams, Eve T. Shapiro, Travis Sanchez, Eli S. Rosenberg, Vincent L. Fenimore, Patrick S. Sullivan

Environmental & Global Health Faculty Research

Background. HIV continues to be a major concern among MSM, yet Black MSM have not been enrolled in HIV research studies in proportionate numbers to White MSM. We developed an HIV prevention research brand strategy for MSM. Methods. Questionnaires and focus groups were conducted with 54 participants. Descriptive statistics and chi-square analyses were performed and qualitative data were transcribed and content analyzed to identify common themes. Results. Formative research results indicated that younger Black MSM (18–29 years) were less likely to think about joining prevention studies compared to older (≥30 years) Black MSM (, ). Qualitative and quantitative results indicate …

Truck Driver Dies When Tractor-Trailer Leaves The Road And Plunges Into A Creek-Bed, Kentucky Injury Prevention And Research Center

Fatality Case Reports--Motor Vehicle

In the early morning hours of a fall day, exact time unknown and the length of time driving unknown, a 28-year-old male truck driver was driving north on an interstate transporting 30,000 lbs. of blue plastic injection molding pellets. The truck driver exited the highway behind a guardrail and traveled 1,320 feet, striking a wire fence and several trees before plummeting into a creek bed, shearing the cab open. At 10:27 a.m., a citizen called in to the fire department to report a mysterious blue substance observed in the creek a couple of miles down from the accident. The fire …