Public Health Commons^™

Is It Time To Consider The "Burnout Syndrome" A Distinct Illness?, Renzo Bianchi, Irvin Sam Schonfeld, Eric Laurent

Publications and Research

The "burnout syndrome" has been defined as a combination of emotional exhaustion, depersonalization, and reduced personal accomplishment caused by chronic occupational stress. Although there has been increasing medical interest in burnout over the last decades, it is argued in this paper that the syndrome cannot be elevated to the status of diagnostic category, based on (1) an analysis of the genesis of the burnout construct, (2) a review of the latest literature on burnout-depression overlap, (3) a questioning of the three-dimensional structure of the burnout syndrome, and (4) a critical examination of the notion that burnout is singularized by its …

Fy 2015 Community Benefit Summary, Children's Mercy Hospital

Community Benefits

Fiscal year report on the community benefits provided by Children's Mercy Kansas City to the communities in the Kansas City region.

Dominicanas Redefining Hiv In San Pedro De Macorís, Emily Frances Surico

Master of Public Health Program Student Publications

This study explored the social support among women impacted by human immunodeficiency virus (HIV) living in the Province of San Pedro de Macorís, República Dominicana. Social support is one way that social networks can influence health status. Social networks impact health behaviors and overall health outcomes which include infectious diseases, morbidity rates, and mortality rates. Social networks can promote health and minimize risky behavior: “cohesive, supportive networks may themselves blunt stressful experiences and enable people to resist risky behavior and maintain healthier choices” (Berkman, Kawachi, & Krishna, 2014, p. 248). Qualitative methods were used to explore how social support systems …

Experiential Learning: Using Virtual Simulation In An Online Rn-Bsn Program, Henny Breen, Melissa Jones

Faculty Publications

This article highlights the innovative experiential learning used by an online RN-BSN program through the use of simulation that takes place in an online classroom. Three experiential learning activities using a virtual community are described. These learning activities engage the students in thinking about social justice and health policy as well as teaching concepts that include community, leadership, influence, advocacy, networking, collaboration, and vulnerable populations. These concepts are critical to the learning needs of diploma and associate degree-prepared nurses who wish to continue their education to be better prepared to meet the complex needs of today’s health care environment.

Building On Social Capital To Improve Health: The Interactional Approach To Community Development, Matthew Charles Tomlin Mr

Student Research – Stevenson Center

Since political scientist, Robert Putnam, (1995) brought the concept of social capital into popular discourse, there has been a surge in debate over its definition, causes, and consequences in a range of social science disciplines. While social capital has been found to support self-rated overall health at the state level (Kawachi et al, 1999), there is still a dearth of data and research on localities in different regions of the country. This study analyzes survey data collected in the United Way of McLean County’s 2014 Community Assessment to better understand the dynamic between social capital and health in one Central …

Quit4baby: Results From A Pilot Test Of A Mobile Smoking Cessation Program For Pregnant Women, Lorien C. Abroms, Judy M. Van Alstyne, Christina L. Heminger, Leah E. Leavitt, Jennifer M. Schindler-Ruwisch

GW Research Days 2015

Background: Text messaging programs have been shown to be effective in helping adult smokers quit smoking. This study describes the results of a pilot test of Quit4baby, a smoking cessation text messaging program for pregnant smokers that was adapted from Text2quit.

Objective: The study aimed to demonstrate the feasibility and acceptability of Quit4baby for women currently enrolled in Text4baby, a perinatal health text messaging program.

Methods: Pregnant women enrolled in Text4baby and who were current smokers or had quit within the last 4 weeks (N=20) were enrolled in Quit4baby. Those under age 18, not pregnant, not current smokers, …

Bundled Payments For Care Improvement Initiative – Insights From The Test Pilots Of Payment Reform, Jason M. Sutherland, William B. Borden

Medicine Faculty Publications

Background: The Medicare Bundled Payments for Care Improvement (BPCI) pilot program aims to reward high-value providers by setting a global payment target for particular episodes of care. The representativeness of BPCI participants will influence the ability of this pilot to inform policy decisions. Methods: We linked the Medicare lists of participants in the risk-bearing portion of BPCI Model 2, encompassing acute and post-acute care, to the American Hospital Association resource file and the 2013 Hospital Value-Based Purchasing quality performance data. We classified episode-initiating hospitals by the number of bundles in which they were participating into “narrow”, “medium” and “comprehensive”. The …

Serum Cotinine And Chronic Pain: Nhanes 2003-2004, R Constance Wiener

Faculty & Staff Scholarship

Purpose—Tobacco smoke exposure continues to be the leading preventable risk factor for many diseases and has the potential to be a risk factor for chronic pain. The purpose of this study is to determine the relationship of chronic pain with smoking, secondhand smoke exposure and nonsmoking using serum cotinine (and self-report of living with someone who smokes in the home) to identify the tobacco exposure groups. Methods—The National Health and Nutrition Examination Survey (NHANES) 2003–2004 was used for this study. Participants were queried about pain duration and had serum cotinine levels determined during the course of the NHANES examination/survey. Participants, …

A History Of Undergraduate Education For Public Health: From Behind The Scenes To Center Stage., Richard Kenneth Riegelman, Susan Albertine, Randy Wykoff

GW Biostatistics Center

No abstract provided.

Scaling Down To Scale Up: A Health Economic Analysis Of Integrating Point-Of-Care Syphilis Testing Into Antenatal Care In Zambia During Pilot And National Rollout Implementation., Katharine D. Shelley, Éimhín M. Ansbro, Alexander Tshaka Ncube, Sedona Sweeney, Colette Fleischer, Grace Tembo Mumba, Michelle M. Gill, Susan Strasser, Rosanna W. Peeling, Fern Terris-Prestholt

GW Biostatistics Center

Maternal syphilis results in an estimated 500,000 stillbirths and neonatal deaths annually in Sub-Saharan Africa. Despite the existence of national guidelines for antenatal syphilis screening, syphilis testing is often limited by inadequate laboratory and staff services. Recent availability of inexpensive rapid point-of-care syphilis tests (RST) can improve access to antenatal syphilis screening. A 2010 pilot in Zambia explored the feasibility of integrating RST within prevention of mother-to-child-transmission of HIV services. Following successful demonstration, the Zambian Ministry of Health adopted RSTs into national policy in 2011. Cost data from the pilot and 2012 preliminary national rollout were extracted from project records, …

Treatment-Induced Changes In Plasma Adiponectin Do Not Reduce Urinary Albumin Excretion In The Diabetes Prevention Program Cohort., Kieren J. Mather, Qing Pan, William C. Knowler, Tohru Funahashi, George A. Bray, Et Al.

GW Biostatistics Center

BACKGROUND AND OBJECTIVES: Molecular data suggests that adiponectin may directly regulate urinary albumin excretion. In the Diabetes Prevention Program (DPP) we measured adiponectin and albuminuria before and after intervention, and we previously reported increases in adiponectin with interventions. Here we have used the DPP dataset to test the hypothesis that treatment-related increases in adiponectin may reduce albuminuria in obesity.

DESIGN, SETTING, PARTICIPANTS AND METHODS: We evaluated cross-sectional correlations between plasma adiponectin and urinary albumin excretion at baseline, and the relationship of treatment-related changes in adiponectin and albuminuria. Baseline and follow-up urine albumin to creatinine ratios (ACR (albumin to creatinine ratio)) …

The Cost-Effectiveness Of Diabetes Prevention: Results From The Diabetes Prevention Program And The Diabetes Prevention Program Outcomes Study, William H. Herman

GW Biostatistics Center

Background

The Diabetes Prevention Program (DPP) was a randomized, controlled clinical trial. It demonstrated that among high-risk individuals with impaired glucose tolerance, diabetes incidence was reduced by 58 % with lifestyle intervention and 31 % with metformin compared to placebo. During the Diabetes Prevention Program Outcomes Study (DPPOS), all DPP participants were unmasked to their treatment assignments, the original lifestyle intervention group was offered additional lifestyle support, the metformin group continued metformin, and all three groups were offered a group-implemented lifestyle intervention. Over the 10 years of combined DPP/DPPOS follow-up, diabetes incidence was reduced by 34 % in the lifestyle …

Skin Collagen Advanced Glycation Endproducts (Ages) And The Long-Term Progression Of Sub-Clinical Cardiovascular Disease In Type 1 Diabetes, Vincent M. Monnier, Wanjie Sun, Xiaoyu Gao, David R. Sell, Patricia Cleary, John M. Lachin, Saul Genuth, The Dcct/Edic Research Group

GW Biostatistics Center

BACKGROUND:

We recently reported strong associations between eight skin collagen AGEs and two solubility markers from skin biopsies obtained at DCCT study closeout and the long-term progression of microvascular disease in EDIC, despite adjustment for mean glycemia. Herein we investigated the hypothesis that some of these AGEs (fluorescence to be reported elsewhere) correlate with long-term subclinical cardiovascular disease (CVD) measurements, i.e. coronary artery calcium score (CAC) at EDIC year 7-9 (n = 187), change of carotid intima-media thickness (IMT) from EDIC year 1 to year 6 and 12 (n = 127), and cardiac MRI outcomes at EDIC year 15-16 (n …

Quality Control Measures Over 30 Years In A Multicenter Clinical Study: Results From The Diabetes Control And Complications Trial / Epidemiology Of Diabetes Interventions And Complications (Dcct/Edic) Study., Gayle M Lorenzi, Barbara H Braffett, Valerie L Arends, Ronald P Danis, Lisa Diminick, Kandace A Klumpp, Anthony D Morrison, Elsayed Z Soliman, Michael W Steffes, Patricia A Cleary

GW Biostatistics Center

No abstract provided.

The Cost-Effectiveness Of Diabetes Prevention: Results From The Diabetes Prevention Program And The Diabetes Prevention Program Outcomes Study, William Herman

GW Biostatistics Center

Background

The Diabetes Prevention Program (DPP) was a randomized, controlled clinical trial. It demonstrated that among high-risk individuals with impaired glucose tolerance, diabetes incidence was reduced by 58 % with lifestyle intervention and 31 % with metformin compared to placebo. During the Diabetes Prevention Program Outcomes Study (DPPOS), all DPP participants were unmasked to their treatment assignments, the original lifestyle intervention group was offered additional lifestyle support, the metformin group continued metformin, and all three groups were offered a group-implemented lifestyle intervention. Over the 10 years of combined DPP/DPPOS follow-up, diabetes incidence was reduced by 34 % in the lifestyle …

Multiplexed Loop-Mediated Isothermal Amplification Of The 16s Rrna Gene For The Diagnosis Of Neonatal Sepsis In Resource-Limited Environments, Griffin T. Sonaty

Inquiry: The University of Arkansas Undergraduate Research Journal

Sepsis, or dysregulated inflammation caused by bacterial infection, places a disproportionately high burden on newborns in developing countries. This is due in part to a lack of diagnostic tools suitable for sustainable use in resource-limited nurseries. One potential vehicle for a new diagnostic assay is loop-mediated isothermal amplification (LAMP), a high-yield DNA amplification method. LAMP has previously been used to detect genes from single species of bacteria in blood serum samples to aid in sepsis diagnosis. LAMP could be adapted to detect a broad set of bacteria, while retaining a degree of specificity that allows clinicians to begin directed antimicrobial …

Providing Monthly Health And Wellness Presentations In A Patient Library: Program Development And Brief Assessment, Dana Ladd

VCU Libraries Faculty and Staff Presentations

Objectives: To describe the development, implementation, and brief assessment of a lunch time health and wellness series of presentations on a variety of consumer health related topics. The presentations were held in the Community Health Education Center, a patient library located inside a large academic medical center and were open to patients, their families, community members, and academic and health care employees.

Methods: We collaborated with marketing to identify topics and potential speakers. Topics included: stress, diabetes, healthy eating, care giving, depression, cancer, and others. Presentations were advertised via mass mail and flyers were posted in the library and relevant …

Knowledge, Attitudes, Beliefs, And Behaviors Of Diabetes Among Afro-Caribbeans Living Near Brooklyn, Sophia I. Allen

2010-2016 Archived Posters

Literature has found Afro-Caribbeans with diabetes have a negative perception of medical professionals. Using a cross-sectional design, Afro-Caribbeans with type 2 diabetes were recruited across 7 churches to determine whether shared knowledge and beliefs about diabetes screening and complications exist and whether they would attend a workshop at their church.

Pregnant And Postpartum Women’S Experiences And Perspectives On The Acceptability And Feasibility Of Copackaged Medicine For Antenatal Care And Pmtct In Lesotho, Michelle M. Gill, Heather J. Hoffman, Appolinaire Tiam, Florence M. Mohai, Mokone Majoalane, Anthony Isavwa, Laura Guay, +4 Additional Authors

Epidemiology Faculty Publications

Objective. To improve PMTCT and antenatal care-related service delivery, a pack with centrally prepackaged medicine was rolled out to all pregnant women in Lesotho in 2011. This study assessed acceptability and feasibility of this copackaging mechanism for drug delivery among pregnant and postpartum women.

Methods. Acceptability and feasibility were assessed in a mixed method, cross-sectional study through structured interviews (SI) and semistructured interviews (SSI) conducted in 2012 and 2013.

Results. 290 HIV-negative women and 437 HIV-positive women (n=727) participated. Nearly all SI participants found prepackaged medicines acceptable, though modifications such as size reduction of the pack were …

Association Between Dietary Patterns During Pregnancy And Birth Size Measures In A Diverse Population In Southern Us, Uriyoan Colón-Ramos, Susan B. Racette, Jody M. Ganiban, Thuy G. Nguyen, Mehmet Kocak, Kecia N. Carroll, Eszter Volgyi, Frances A. Tylavsky

Global Health Faculty Publications

Despite increased interest in promoting nutrition during pregnancy, the association between maternal dietary patterns and birth outcomes has been equivocal. We examined maternal dietary patterns during pregnancy as a determinant of offspring’s birth weight-for-length (WLZ), weight-for-age (WAZ), length-for-age (LAZ), and head circumference (HCZ) Z-scores in Southern United States (n = 1151). Maternal diet during pregnancy was assessed by seven dietary patterns. Multivariable linear regression models described the association of WLZ, WAZ, LAZ, and HCZ with diet patterns controlling for other maternal and child characteristics. In bivariate analyses, WAZ and HCZ were significantly lower for processed and processed-Southern compared to healthy …

Co2 And H2o: Understanding Different Stakeholder Perspectives On The Use Of Carbon Credits To Finance Household Water Treatment Projects., Sarah K. Summers, Rochelle Rainey, Maneet Kaur, Jay P. Graham

Global Health Faculty Publications

Background

Carbon credits are an increasingly prevalent market-based mechanism used to subsidize household water treatment technologies (HWT). This involves generating credits through the reduction of carbon emissions from boiling water by providing a technology that reduces greenhouse gas emissions linked to climate change. Proponents claim this process delivers health and environmental benefits by providing clean drinking water and reducing greenhouse gases. Selling carbon credits associated with HWT projects requires rigorous monitoring to ensure households are using the HWT and achieving the desired benefits of the device. Critics have suggested that the technologies provide neither the benefits of clean water nor …

Challenges And Opportunities Associated With Neglected Tropical Disease And Water, Sanitation And Hygiene Intersectoral Integration Programs., E. Anna Johnston, Jordan Teague, Jay P. Graham

Global Health Faculty Publications

BACKGROUND:

Recent research has suggested that water, sanitation, and hygiene (WASH) interventions, in addition to mass drug administration (MDA), are necessary for controlling and eliminating many neglected tropical diseases (NTDs).

OBJECTIVES:

This study investigated the integration of NTD and WASH programming in order to identify barriers to widespread integration and make recommendations about ideal conditions and best practices critical to future integrated programs.

METHODS:

Twenty-four in-depth, semi-structured interviews were conducted with key stakeholders in the global NTD and WASH sectors to identify barriers and ideal conditions in programmatic integration.

RESULTS:

The most frequently mentioned barriers to WASH and NTD integration …

Tracking Global Fund Hiv/Aids Resources Used For Sexual And Reproductive Health Service Integration: Case Study From Ethiopia, Sangeeta Mookherji, Samantha Ski, Dale Huntington

Global Health Faculty Publications

Objective/Background

The Global Fund to Fight AIDS, Tuberculosis & Malaria (GF) strives for high value for money, encouraging countries to integrate synergistic services and systems strengthening to maximize investments. The GF needs to show how, and how much, its grants support more than just HIV/AIDS, TB and malaria.

Sexual and Reproductive Health (SRH) has been part of HIV/AIDS grants since 2007. Previous studies showed the GF PBF system does not allow resource tracking for SRH integration within HIV/AIDS grants. We present findings from a resource tracking case study using primary data collected at country level.

Methods

Ethiopia was the study …

Factors Associated With Recent Hiv Testing Among High-Risk Men Who Have Sex With Men: A Cross-Sectional Study In Cambodia, Siyan Yi, Sovannary Tuot, Pheak Chhoun, Carinne M. Brody, Khuondyla Pal, Sopheap Oum

Background: Despite remarkable success in the fight against HIV, HIV prevalence in many countries remains high among key populations including men who have sex with men (MSM), and HIV testing rates is relatively low among this hard-to-reach population. This cross-sectional study explores factors associated with recent HIV testing among MSM in Cambodia.

Methods: This study was conducted in 2014 and included 384 MSM randomly selected from two provinces of Battembang and Siem Reap, using a two-stage cluster sampling method. A structured questionnaire was used for face-to-face interviews to collect data on socio-demographic characteristics, HIV testing history, sexual behaviors, …

Improving Education Opportunity, Health, And Quality Of Life Of Orphans And Vulnerable Children: The Sustainable Action Against Hiv And Aids In Communities (Sahacom), Siyan Yi, Pheak Chhoun, Samantha Brant, Kelley Kita, Sovannary Tuot

Aims: This study evaluated the impact of the Sustainable Action against HIV and AIDS in Communities (SAHACOM) project in improving education opportunity, health, and quality of life of orphans and vulnerable children (OVC) in Cambodia.

Study Design: Operational intervention study.

Place and Duration of the Study: Five provinces in Cambodia, from 2010 to 2014.

Methodology: A two-stage cluster sampling method was used to select 756 OVC at midterm and 785 OVC at end line for face-to-face interviews. Outcome indicators from end line (2014) were compared to those obtained at midterm (2012). Where possible, the data were also compared with data …

Aids-Related Stigma And Mental Disorders Among People Living With Hiv: A Cross-Sectional Study In Cambodia, Siyan Yi, Pheak Chhoun, Samedy Suong, Carinne M. Brody, Sovannary Tuot

Background: AIDS-related stigma and mental disorders are the most common conditions in people living with HIV (PLHIV). We therefore conducted this study to examine the association of AIDS-related stigma and discrimination with mental disorders among PLHIV in Cambodia.

Methods: A two-stage cluster sampling method was used to select 1,003 adult PLHIV from six provinces. The People Living with HIV Stigma Index was used to measure stigma and discrimination, and a short version of general health questionnaire (GHQ-12) was used to measure mental disorders. Multivariate logistic regression analysis was conducted.

Results: The reported experiences of discrimination in communities …

Factors Associated With Inconsistent Condom Use Among Men Who Have Sex With Men In Cambodia, Siyan Yi, Sovannary Tuot, Pheak Chhoun, Khuondyla Pal, Khimuy Tith, Carinne M. Brody

Background: Compared to the general population, men who have sex with men (MSM) are at greater risk for HIV and less understood due to their more hidden and stigmatized nature. Moreover, the discrepancy in findings in the literature merits further investigations in MSM populations from different cultures and settings. We therefore conducted this study to explore factors associated with inconsistent condom use among high-risk MSM in Cambodia.

Methods: This cross-sectional study was conducted in 2014 among 367 MSM randomly selected from Battembang and Siem Reap using a two-stage cluster sampling method. A structured questionnaire was used for face-to-face interviews to …

Mosquito-Borne Diseases In Mississippi, Ryan J. Rodriguez

Department of Entomology: Distance Master of Science Projects

Life Cycle:
Egg Must be exposed to water to hatch
Larvae Live in aquatic habitats
Pupa Stay near the surface of water to breath
Adults: Only females feed on blood; Males feed on nectar

Public Health •Besides being a nuisance, they cause numerous health hazards to humans (and other animals) •In some cases, they may cause severe allergic reactions •Diseases they transmit: •Eastern Equine Encephalitis •Japanese Encephalitis •La Crosse Encephalitis •St. Louis Encephalitis •West Nile Virus •Western Equine Encephalitis •Dengue Fever •Malaria •Rift Valley Fever •Yellow Fever

Mosquito-Borne Diseases in Mississippi and its Vectors •Chikungunya Virus •Aedes species •Eastern Equine …

Clinical Significance Of Left Atrial Anatomic Abnormalities Identified By Cardiac Computed Tomography, Ara V. Vehian, Brian G. Choi, Satinder Rekhi, Heather A. Young, Raman S. Dusaj, Robert K. Zeman

Epidemiology Faculty Publications

Purpose: The clinical significance of newly identified left atrial anatomic abnormalities (LAAA)— accessory appendages, diverticula, septal pouches—by multidetector CT (MDCT) remains unclear. Similar anatomical outpouchings, i.e., the left atrial appendage, have been associated with cardioembolisms and arrhythmia. To test the hypothesis that LAAA are also associated with increased risk of these events, we performed a retrospective analysis to examine the association of LAAA in patients undergoing CT with embolic events and arrhythmia.

Methods: 242 patients (mean age 56 SD 12 years, 41% female) were selected who had CT coronary angiography performed with 64-row MDCT between 2007 and 2012 if complete …

Parity And Diabetes Risk Among Hispanic Women From Colombia: Cross-Sectional Evidence, Pablo Cure, Heather J. Hoffman, Carlos Cure-Cure

Epidemiology Faculty Publications

Objective

The association between parity and type 2 diabetes has been studied in developed countries and in Singapore and Chinese women but not in Hispanics. Herein we evaluated the association between parity (number of live births) with diabetes in a group of Hispanic postmenopausal women from Colombia.

Research design and methods

Herein we evaluated the association between parity and diabetes in a population of 1,795 women from Colombia. Women were divided in birth categories (0 [referent], 1 or 2, 3–5, 6 or > births). Medical history of diabetes and anthropometric characteristics were recorded. Logistic regressions were performed in order to find …