Public Health Commons^™

Middle East Respiratory Syndrome: A Global Health Challenge, Lawrence O. Gostin, Daniel Lucey

Georgetown Law Faculty Publications and Other Works

Beginning in May 2015, Middle-East respiratory syndrome (MERS) experienced its first publicly reported “super-spreading” event in South Korea. By mid-June, more than 120 cases and 11 deaths in South Korea had been linked to a businessman returning from travel to Bahrain, United Arab Emirates, the Kingdom of Saudi Arabia and Qatar. Globally more than 1200 had been infected of whom more than 450 died—a high fatality rate of 37%.

What are the most effective legal, social, and public health responses to MERS and other emerging diseases? First, the World Health Organization’s International Health Regulations (IHR) did not effectively guide the …

Maximizing The Impact Of Training Initiatives For Health Professionals In Low-Income Countries: Frameworks, Challenges, And Best Practices, Corrado Cancedda, Paul E. Farmer, Vanessa Kerry, Tej Nuthulaganti, Kirstin W. Scott, Eric Goosby, Agnes Binagwaho

Dartmouth Scholarship

Corrado Cancedda and colleagues outline a framework for health professional training initiatives in low-income countries.

Historical Differences In School Term Length And Measured Blood Pressure: Contributions To Persistent Racial Disparities Among Us-Born Adults, Sze Yan Liu, Jennifer M. Manly, Benjamin Capistrant, M Maria Glymour

Department of Public Health Scholarship and Creative Works

Abstract

Introduction

Legally mandated segregation policies dictated significant differences in the educational experiences of black and white Americans through the first half of the 20^th century, with markedly lower quality in schools attended by black children. We determined whether school term length, a common marker of school quality, was associated with blood pressure and hypertension among a cohort of older Americans who attended school during the de jure segregation era.

Methods

National Health and Nutrition Examination Survey I and II data were linked to state level historical information on school term length. We used race and gender-stratified linear regression …

Using Network Analysis To Understand Public Health Delivery Systems & Community Health Initiatives, Glen P. Mays

Health Management and Policy Presentations

The increasingly connected world of health care delivery relies on an expanding frontier of multi-stakeholder structures and processes, from interdisciplinary patient-centered care teams, to virtual accountable care organizations (ACOs), to complex community-level interventions. This session highlights recent advances in applying social network analysis (SNA) methods to study the implementation and impact of these types of innovations. This methods workshop examines the benefits and limits of novel SNA applications based on the expanding availability of large, linkable electronic clinical and administrative data sources with dependent data structures. This paper profiles examples of using SNA principles and methods to study the implementation …

Learning From Network Analysis: Care Transitions, Market Competition, & Community Interventions, Glen P. Mays

Health Management and Policy Presentations

The increasingly connected world of health care delivery relies on an expanding frontier of multi-stakeholder structures and processes, from interdisciplinary patient-centered care teams, to virtual accountable care organizations (ACOs), to complex community-level interventions. This methods workshop highlights recent advances in applying social network analysis (SNA) methods to study the implementation and impact of these types of innovations. This session will examine the benefits and limits of novel SNA applications based on the expanding availability of large, linkable electronic clinical and administrative data sources with dependent data structures.

Mobilisation Of Public Support For Policy Actions To Prevent Obesity, Terry T-K Huang, John H. Cawley, Marice Ashe, Sergio Costa, Leah M. Frerichs, Lindsey Zwicker, Juan A. Rivera, David Levy, Ross A. Hammond, Estelle V. Lambert, Shiriki K. Kumanyika

Publications and Research

Public mobilisation is needed to enact obesity prevention policies and to mitigate backlash against their implementation. However, current approaches in public health focus primarily on dialogue between public health professionals and political leaders. Strategies to increase popular demand for obesity prevention policies include refining and streamlining public information, identifying effective frames for each population, enhancing media advocacy, building citizen protest and engagement, and developing a receptive political environment with change agents embedded across organisations and sectors. Long-term support and investment in collaboration among diverse stakeholders to create shared value is also important. Each actor in an expanded coalition for obesity …

Learning From Delivery System Behavior, Dynamics & Interactions To Advance A Culture Of Health, Glen P. Mays

Health Management and Policy Presentations

A new "Systems for Action" national research program flows directly from the Robert Wood Johnson Foundation's Culture of Health action framework. This program will build evidence on how best to align the delivery and financing systems for medical care, public health, and community services & supports so as to promote wellbeing and resiliency, realize efficiencies in resource use, and reduce inequities in health.

Changes In Public Health System Capital And Long-Run Health And Economic Outcomes: 1998 To 2014, Glen P. Mays, Cezar B. Mamaril

Health Management and Policy Presentations

Research Objective: The Affordable Care Act created new resources and incentives for hospitals, insurers, public health agencies, and others to contribute to disease prevention and health promotion activities, potentially changing the structure of public health delivery systems and expanding the implementation of strategies that improve population health. This study uses data from the 1998-2014 National Longitudinal Survey of Public Health Systems to examine: (1) the extent and nature of change in inter-organizational contributions to public health activities, which we use as indicators of public health “system capital”; and (2) the effects of these changes on preventable mortality and resource use. …

Portrait Des Pratiques De Prévention Primaire Et Secondaire En Bureautique Au Québec Chez Les Intervenants Et Dans Les Milieux De Travail, Marie Saint-Vincent, Sylvie Montreuil, Georges Toulouse, Roselyne Trudeau

Rapports de recherche scientifique

Dans la perspective de stimuler la prévention des troubles musculo-squelettiques (TMS) dans le domaine de la bureautique au Québec, et de préparer un guide de bonnes pratiques, une première étape nous est apparue incontournable : documenter les pratiques de praticiens et celles mises en œuvre dans les milieux de travail au Québec. Il s’agissait de décrire ce qui se fait au Québec, de déterminer les approches les plus prometteuses, de décrire les difficultés rencontrées et, inversement, les conditions de succès.

L’étude a été réalisée en deux temps. D’abord, 25 praticiens ont été interrogés, 23 seuls et quatre en binômes pour …

Staying Sharp: The Cutting Edge Of Research On Cognition And Aging, Regula H. Robnett

Occupational Therapy Faculty Presentations

Workshop PowerPoint presentation given June 11, 2015, for the 25th Maine Geriatrics Conference in Bar Harbor, Maine. Presentation reviews the latest evidence on cognition and aging. While there is an overwhelming amount of data out there, it is crucial to be informed consumers so the information can be used to enhance one's own life and the lives of others. As people age, changes occur in the brain that can impact learning, memory, and overall daily performance. However, techniques based on promoting preserved skills, embracing new learning, and providing contextual adaptations can be used to improve overall performance. Workshop presentation included …

A Rapid Assessment Of Post-Disclosure Experiences Of Urban Hiv-Positive And Hiv-Negative School-Aged Children In Kenya, Grace Gachanja

Walden Faculty and Staff Publications

There has been limited involvement of HIV-negative children in HIV disclosure studies; most studies conducted on the effects of disclosure on children have been with HIV-positive children and HIV-positive mother-child dyads. Seven HIV-positive and five HIV-negative children participated in a larger study conducted to understand the lived experiences of HIV-positive parents and their children during the disclosure process in Kenya. In this study, the experiences of these 12 children after receiving disclosure of their own and their parents’ illnesses respectively are presented. Each child underwent an in-depth qualitative semi-structured digitally recorded interview. The recorded interviews were transcribed and loaded into …

The Impact Of Free Trial Acceptance On Demand For Alternative Nicotine Products: Evidence From Experimental Auctions, Matthew C. Rousu, Richard J. O'Connor, Maans Bansal-Travers, James M. Pitcavage, Jim Thrasher

Faculty Publications

Objectives: This study explored the relationship between product trials and consumer demand for alternative nicotine products (ANP).

Methods: An experimental auction was conducted with 258 adult smokers, wherein participants were randomly assigned to one of four experimental conditions. The participants received the opportunity to try, but did not have to accept, one of three relatively novel ST products (i.e., snus, dissolvable tobacco, or medicinal nicotine), or they were placed into a control group (i.e., no trial). All the participants then bid on all three of these products, as well as on cigarettes. We assessed interest in using ANP based on …

High-Risk Travel Distance And Number Of Primary Care Visits In A North Carolina Medicaid Population, Justin Allred, Christopher Duffrin, Jason Brinkley, John Jones

Frontiers in Public Health Services and Systems Research

Background: With nearly 20% of the U.S. population in rural areas, a lack of access to primary care may cause rural residents to forego recommended preventive care procedures, and suffer higher morbidity rates than their urban counterparts.

Methods: Medicaid billing data from 2009 to 2011 were analyzed to calculate the distance and duration that a Medicaid patient population had to travel when seeking primary care in the 29 rural counties of eastern North Carolina. Primary care codes were analyzed to detect any differences in access patterns for various complexity levels of physician visits. Data were also used to evaluate health …

The Associations Between Environmental Quality And Preterm Birth In The United States, 2000–2005: A Cross-Sectional Analysis, Kristen M. Rappazzo, Lynne C. Messer, Jyotsna S. Jagai, Christine L. Gray, Shannon C. Grabich, Danelle T. Lobdell

Community Health Faculty Publications and Presentations

Background: Many environmental factors have been independently associated with preterm birth (PTB). However, exposure is not isolated to a single environmental factor, but rather to many positive and negative factors that co-occur. The environmental quality index (EQI), a measure of cumulative environmental exposure across all US counties from 2000—2005, was used to investigate associations between ambient environment and PTB.

Methods: With 2000–2005 birth data from the National Center for Health Statistics for the United States (n = 24,483,348), we estimated the association between increasing quintiles of the EQI and county-level and individual-level PTB; we also considered environmental domain-specific (air, …

The National Health Security Preparedness Index: National Advisory Committee Meeting, Glen P. Mays, Michael Childress, Anna Goodman Hoover, Chris Bollinger

Health Management and Policy Presentations

This meeting of the National Advisory Committee for the National Health Security Preparedness Index program discussed strategies for improving the theoretical framework, measures, and analytic methodologies used in assessing and comparing preparedness levels across U.S. states and the nation as a whole.

College Of Public Health News, Georgia Southern University

College of Public Health: News & Publications

• Georgia Southern Models the Effect of School Closures
• Georgia Southern Researcher Examines Racial Differences in the Utilization of Bone Marrow Transplantation and Participation in Survey and Biospecimen Research

Epidemiology News, Georgia Southern University

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

• Georgia Southern Models the Effect of School Closures

Community Health News, Georgia Southern University

Health Policy & Community Health: News & Publications (2011-2018)

• Georgia Southern Researcher Examines Racial Differences in the Utilization of Bone Marrow Transplantation and Participation in Survey and Biospecimen Research

Cost Estimation In Public Health Services & Systems Research, Glen P. Mays

Health Management and Policy Presentations

Considerable uncertainty persists about the resources required to implement public health programs and policies, and about the factors that drive variation in resource needs and utilization across community and institutional settings. This paper reviews several alternative approaches to cost estimation that we have used in the field of public health services & systems research (PHSSR). This review was prepared for an expert panel meeting convened as part of a study commissioned by the U.S. Assistant Secretary for Planning and Evaluation (ASPE) to estimate the costs associated with public health emergency preparedness capabilities.

Know Your Status: Alleviating Stigma From The Hiv Positive Community Of San Luis Obispo California, Mario Alberto Viveros Espinoza

Ethnic Studies

The purpose of this project is to alleviate stigma from the HIV community in San Luis Obispo, CA by creating an outreach program, “Know Your Status,” that raises awareness of HIV education and prevention. Research on HIV stigma and on ideologies for program development and implementation shows that HIV positive individuals face both internalized and externalized stigma. Program development and implementation can be effective by assessing and addressing the specific needs of those living within the community. This project includes the data needed for program development and implementation, collected through anonymous surveys from HIV positive community members, interviews with professionals …

How Will Texas’ Affordable Care Act Implementation Decisions Affect The Population? A Closer Look, Sara J. Rosenbaum, Sara Rothenberg, Sara Ely

Geiger Gibson/RCHN Community Health Foundation Research Collaborative

The Affordable Care Act (ACA) gives states two key choices: Whether to expand Medicaid to cover poor uninsured adults; and whether to establish a state Exchange. No population stands to gain more from these choices than residents of Texas, who experience the nation’s highest uninsured rate. National estimates show that by not expanding Medicaid, the state has foregone coverage for 1.5 million people. County‐level estimates show that in 249 out of 254 counties, the proportion of uninsured adults exceeds 20 percent of the total adult county population. In 31 counties, the proportion of low income uninsured adults exceeds 60 percent …

Medical Education Departments: A Study Of Four Medical Schools In Sub-Saharan Africa, Elsie Kiguli-Malwadde, Zohray Talib, Hannah Wohltjen, Susan C. Connors, Jonathan Gandari, Sekelani S. Benda, Lauren A. Maggio, Susan C. Van Schalkwyk

Health Policy and Management Faculty Publications

Background

Many African countries are investing in medical education to address significant health care workforce shortages and ultimately improve health care. Increasingly, training institutions are establishing medical education departments as part of this investment. This article describes the status of four such departments at sub-Saharan African medical schools supported by the Medical Education Partnership Initiative (MEPI). This article will provide information about the role of these institutional structures in fostering the development of medical education within the African context and highlight factors that enable or constrain their establishment and sustainability.

Methods

In-depth interviews were conducted with the heads or directors …

Iarc Monographs: 40 Years Of Evaluating Carcinogenic Hazards To Humans, Neil Pearce, Aaron Blair, Paolo Vineis, Wolfgang Ahrens, Aage Andersen, Melissa J. Perry, +Several Additional Authors

Environmental and Occupational Health Faculty Publications

Background: Recently, the International Agency for Research on Cancer (IARC) Programme for the Evaluation of Carcinogenic Risks to Humans has been criticized for several of its evaluations, and also for the approach used to perform these evaluations. Some critics have claimed that failures of IARC Working Groups to recognize study weaknesses and biases of Working Group members have led to inappropriate classification of a number of agents as carcinogenic to humans.

Objectives: The authors of this Commentary are scientists from various disciplines relevant to the identification and hazard evaluation of human carcinogens. We examined criticisms of the IARC classification process …

Adipokine Levels During The First Or Early Second Trimester Of Pregnancy And Subsequent Risk Of Gestational Diabetes Mellitus: A Systematic Review, Wei Bao, Aileen Baecker, Yiqing Song, Michele Kiely, Simin Liu, Cuilin Zhang

Publications and Research

Objective—We aimed to systematically review available literature linking adipokines to gestational diabetes mellitus (GDM) for a comprehensive understanding of the roles of adipokines in the development of GDM.

Methods—We searched PubMed/MEDLINE and EMBASE databases for published studies on adipokines and GDM through October 21, 2014. We included articles if they had a prospective study design (i.e., blood samples for adipokines measurement were collected before GDM diagnosis). Random-effects models were used to pool the weighted mean differences comparing levels of adipokines between GDM cases and non-GDM controls.

Results—Of 1,523 potentially relevant articles, we included 25 prospective studies relating …

Penile Microbiota And Female Partner Bacterial Vaginosis In Rakai, Uganda, Cindy M. Liu, Bruce A. Hungate, Aaron A.R. Tobian, Jacques Ravel, Lance B. Price, +8 Additional Authors

Environmental and Occupational Health Faculty Publications

Bacterial vaginosis (BV) is a common vaginal bacterial imbalance associated with risk for HIV and poor gynecologic and obstetric outcomes. Male circumcision reduces BV-associated bacteria on the penis and decreases BV in female partners, but the link between penile microbiota and female partner BV is not well understood. We tested the hypothesis that having a female partner with BV increases BV-associated bacteria in uncircumcised men. We characterized penile microbiota composition and density (i.e., the quantity of bacteria per swab) by broad-coverage 16S rRNA gene-based sequencing and quantitative PCR (qPCR) in 165 uncircumcised men from Rakai, Uganda. Associations between penile community …

Factors Affecting Hispanic Women’S Participation In Screening For Cervical Cancer, Arelis Moore De Peralta, Bonnie Holaday, James R. Mcdonell

Publications

Hispanic women’s cervical cancer rates are disproportionately high. The Health Belief Model (HBM) was used as a theoretical framework to explore beliefs, attitudes, socio-economic, and cultural factors influencing Hispanic women’s decisions about cervical cancer screening. A cross-sectional survey was conducted among Hispanic women 18–65 years old (n = 205) in the Upstate of South Carolina. Generalized Linear Modeling was used. Across all models, perceived threats (susceptibility and severity), self-efficacy, and the interaction of benefits and barriers were significant predictors. Significant covariates included age, marital status, income, regular medical care, and familism. A modified HBM was a useful model for examining …

Sex Differences In Morbidity And Care-Seeking During The Neonatal Period In Rural Southern Nepal, Summer Rosenstock, Joanne Katz, Luke C. Mullany, Subarna K. Khatry, Steven C. Leclerq, James M. Tielsch, Et Al.

Global Health Faculty Publications

Background

South Asian studies, including those from Nepal, have documented increased risk of neonatal mortality among girls, despite their early biologic survival advantage. We examined sex differences in neonatal morbidity and care-seeking behavior to determine whether such differences could help explain previously observed excess late neonatal mortality among girls in Nepal.

Methods

A secondary analysis of data from a trial of chlorhexidine use among neonates in rural Nepal was conducted. The objective was to examine sex differences in neonatal morbidity and care-seeking behavior for ill newborns. Girls were used as the reference group.

Results

Referral for care was higher during …

Cronobacter Sakazakii Bacteremia In A 76-Year-Old Woman: A Case Report, Amy Y. Kang, Nancy Garcia, Bhanu Sud, Lee Nguyen

Pharmacy Faculty Articles and Research

Cronobacter sakazakii, commonly found in contaminated infant formula and thereby causes infantile bacteremia, is rarely associated with adult bacteremia. We present the tenth case of C. sakazakii bacteremia in adults. The patient is a 76-year-old woman who resides in a skilled nursing facility and presents with risk factors including bullous pemphigoid, Type II diabetes mellitus, hypertension, hyperlipidemia, chronic kidney disease, and anemia. The therapy was started with intravenous ciprofloxacin and vancomycinempirically. After consultation with an Infectious Diseases specialist, ciprofloxacin and vancomycin was replaced with meropenem based on the patient’s extensive bullous lesions, history of ESBL infections, and possible pneumonia. Later, …

Intensive Transition Team - Analysis Of Program Impacts, Bill J. Wright, Keri B Vartanian, Megan Holtorf

Articles, Abstracts, and Reports

No abstract provided.

Alcohol Consumption, Depression, Insomnia And Colorectal Cancer Screening: Racial Differences, Daniel Owusu, Megan Quinn, Ke Sheng Wang

ETSU Faculty Works

Background: Mortality from colorectal cancer (CRC) can be reduced drastically by early detection and early treatment. However, uptake of CRC screening is relatively low, about 50% for those whom the test is highly recommended.

Objectives: We examined the influence of and racial differences in depression, insomnia, alcohol use, and tobacco use on CRC screening uptake in the US.

Patients and Methods: Analysis of the 2012 National Health Information Survey data was conducted. Both weighted univariate and multiple logistic regression analyses were performed in SAS to estimate the odds ratios (ORs) and their 95% confidence intervals (CIs). A total …