Public Health Commons^™

Brighter Sights: Using Photovoice For A Process Evaluation Of A Food Co-Op Style Nutrition Intervention, Margaret P. Raber, Kimberly Kay Lopez, Mike Pomeroy, Avni Mody, Christine Markham, Shreela V. Sharma

Journal of Health Disparities Research and Practice

Access to healthy food is a critical factor impacting childhood obesity. Brighter Bites is a school-based program that addresses the issue of fresh food access among low-income families living in food deserts using a food co-op model. The aim of this study is to evaluate initial parent participant reactions to the ongoing Brighter Bites program using Photovoice. A predominately Hispanic, economically disadvantaged, urban school was chosen as the site for the Photovoice project. A total of seven Brighter Bites parent participants were enrolled and six completed the study. The participants developed research questions, took documentary photographs, completed a group analysis …

Feasibility Of A Community-Based Sickle Cell Trait Testing And Counseling Program, Ashley Housten, Regina Abel, Terianne Lindsey, Allison King

Journal of Health Disparities Research and Practice

Background: Sickle cell trait (SCT) screening is required at birth in the United States; however, adults rarely know their SCT status prior to having children.

Purpose: Assess feasibility of a community-based SCT education and testing intervention.

Methods: Participants were recruited from eight community sites to complete an educational program and offered a hemoglobin analysis. A genetic counselor met individually with participants to discuss lab results.

Results: Between July 14, 2010 and May 31, 2012, 637 participants completed the educational program. Five hundred seventy (89.5%) provided a blood sample, and 61 (10.9%) had SCT or other hemoglobinopathies. The genetic counselor met …

Using Electronic Health Record Data To Improve Community Health Assessment, Brian E. Dixon, Jian "Frank" Zou, Karen F. Comer, Marc Rosenman, Jennifer L. Craig, P Gibson

Frontiers in Public Health Services and Systems Research

Background: Community health assessments assist health departments in identifying health needs as well as disparities, and they enable linking of needs with available interventions. Electronic health record (EHR) systems possess growing volumes of clinical and administrative data, making them a valuable source of data for ongoing community health assessment.

Purpose: To produce population health indicators using data from EHR systems that could be combined and visually displayed alongside social determinants data, and to provide data sets at geographic levels smaller than a county.

Methods: Data from multiple EHR systems used by major health systems covering >90% of the population in …

A Conceptual Framework For The Study Of Hospital Interaction And Investment In Public Health Systems, Danielle M. Varda, Lisa Vanraemdonck, Gregory Tung, Rachel A. Hogg, Adam Atherly

Frontiers in Public Health Services and Systems Research

Background: Health care reform has resulted in changes throughout the health system, including the Affordable Care Act (ACA) and IRS requirements that nonprofit hospitals conduct community health needs assessments and develop implementation plans to guide greater investment in their respective communities. This has led to questions of which factors influence hospital interaction and investment in PH systems.

Purpose: This paper presents a comprehensive framework, informed by a literature review and expert panel that introduces hypothesized factors related to these outcomes.

Methods: To develop a conceptual framework that identifies hypothesized indicators of increased hospital interaction and investment in PH systems, we …

Visualizing Complex Adaptive Systems: A Case Study Of The Missouri Maternal, Infant, And Early Childhood Home Visiting Program, Julie M. Kapp, Sara Schlemper, Riyad Haq, Sofia Campos Vidal Pires, Eduardo J. Simoes

Frontiers in Public Health Services and Systems Research

Background: The Maternal, Infant, and Early Childhood Home Visiting (MIECHV) program was created by the 2010 Patient Protection and Affordable Care Act. MIECHV provides comprehensive services to at-risk families through evidence-based home visiting programs.

Purpose: The following question is addressed: Does the Missouri MIECHV system meet the definition of a complex adaptive system (CAS)?

Methods: A systematic review was conducted of documents related to MIECHV programs (federal, state, and local levels), and to affiliated programs with a home visiting and early childhood (aged birth to 5 years) scope. The organizations’ fit was identified for the scope of early childhood home …

Hazcom 2012, Cheri Marcham

Publications

This presentation reviews changes to the OSHA Standard called HazCom 2012. Old and new definitions for "health hazards" are discussed as well as labeling requirements.

Immediate Blood Draw For Cd4+ Cell Count Is Associated With Linkage To Care In Durban, South Africa: Findings From Pathways To Engagement In Hiv Care, Susie Hoffman, Theresa M. Exner, Naomi Lince-Deroche, Cheng-Shiun Leu, Jessica L. Phillip, Elizabeth A. Kelvin, Anisha D. Gandhi, Bruce Levin, Dinesh Singh, Joanne E. Mantell, Kelly Blanchard, Gita Ramjee

Publications and Research

Background Timely linkage to care by newly-diagnosed HIV+ individuals remains a significant challenge to achieving UNAIDS 90-90-90 goals. Current World Health Organization (WHO) guidelines recommend initiating anti-retroviral treatment (ART) regardless of CD4+ count, with priority given to those with CD4+/μl. We evaluated the impact of not having a day-of-diagnosis CD4+ count blood draw, as recommended by South African guidelines, on time to linkage, using data from a prospective cohort study.

Methods Individuals (N = 2773) were interviewed prior to HIV counseling and testing at three public sector primary care clinics in the greater Durban area; 785 were newly-diagnosed and eligible …

The Eco-Epidemiology Of Pacific Coast Tick Fever In California, Kerry A. Padgett, Denise L. Bonilla, Marina E. Eremeeva, Carol A. Glaser, Robert S. Lane, Charsey Cole Porse, Martin B. Castro, Sharon L. Messenger, Alex Espinosa, Jill Hacker, Anne Kjemtrup, Bonnie Ryan, Jamesina J. Scott, Renjie Hu, Melissa Hardstone Yoshimizu, Gregory A. Dasch, Vicki Kramer

Environmental Health Sciences: Faculty Publications

Rickettsia philipii (type strain “Rickettsia 364D”), the etiologic agent of Pacific Coast tick fever (PCTF), is transmitted to people by the Pacific Coast tick, Dermacentor occidentalis. Following the first confirmed human case of PCTF in 2008, 13 additional human cases have been reported in California, more than half of which were pediatric cases. The most common features of PCTF are the presence of at least one necrotic lesion known as an eschar (100%), fever (85%), and headache (79%); four case-patients required hospitalization and four had multiple eschars. Findings presented here implicate the nymphal or larval stages of D …

Defining And Targeting Health Disparities In Chronic Obstructive Pulmonary Disease, Roy A. Pleasants, Isaretta L. Riley, David M. Mannino

Preventive Medicine and Environmental Health Faculty Publications

The global burden of chronic obstructive pulmonary disease (COPD) continues to grow in part due to better outcomes in other major diseases and in part because a substantial portion of the worldwide population continues to be exposed to inhalant toxins. However, a disproportionate burden of COPD occurs in people of low socioeconomic status (SES) due to differences in health behaviors, sociopolitical factors, and social and structural environmental exposures. Tobacco use, occupations with exposure to inhalant toxins, and indoor biomass fuel (BF) exposure are more common in low SES populations. Not only does SES affect the risk of developing COPD and …

Peer Victimization And Depressive Symptoms Among Rural-To-Urban Migrant Children In China: The Protective Role Of Resilience, Zhi Ye, Lihua Chen, Sayward Harrison, Haiying Guo, Xiaoming Li, Danhua Lin

Faculty Publications

Peer victimization can have a profound effect on children’s wellbeing and is a known risk factor for depression in childhood. Migrant children experience peer victimization at higher rates than non-migrant peers; however, limited research has examined psychological factors that may serve to reduce depression risk for this group. In particular, no studies have yet investigated whether resilience, including personal characteristics, and a strong social support network, may moderate the relationship between peer victimization and depressive symptoms for migrant children. This study utilized a latent interaction model to examine the effect of resilience on the relationship between peer victimization and depressive …

Syrian Refugee Women In Jordan: Family Planning Preferences And Barriers In A Host Community, Hilary Smith

Independent Study Project (ISP) Collection

The aims of this pilot study were to research and analyze the availability of birth control and family planning resources among Syrian refugee women at a reproductive age. This study took place in the host community of Karak, Jordan. Syrian women are a vulnerable population based solely on their gender. But being refugee women makes them more vulnerable and sometimes, their needs do not get met. This study is important because it will look into reproductive health aspects for this vulnerable population to ensure that there is satisfaction among women about their own health. This cross-sectional study sought to answer …

Breast Is Best: Determinants Of Breastfeeding In Bali, Leah Hardenbergh

Independent Study Project (ISP) Collection

Breastfeeding greatly benefits the health of newborns, providing them with needed antibodies and protection from numerous diseases, including some of the leading causes of infant mortality. This paper explores breastfeeding practices in Bali, and the wide array of factors that have led to these practices. After discussing how breastfeeding fits into the larger context of maternal and newborn health, I explain factors in Bali that affect a woman’s decision to breastfeed and experience while breastfeeding. Determinants include those related to health, financial position, and social status. I explore the history of formula companies and formula as an alternative to breastmilk, …

Actually, Let’S Not Talk About Sex: The Value-Laden Sex Education Received By China’S Young Women, Allyson Tsu

Independent Study Project (ISP) Collection

No abstract provided.

Public Health Stops At The School House Door., Jerome A. Paulson, Claire L Barnett

Environmental and Occupational Health Faculty Publications

In the United States, all children of appropriate age are required to attend school, and many parents send their children to child care. Many school and day care buildings have been found to have environmental health problems that impact children’s health and diminish their ability to learn. No federal agency has the capacity or authority to identify, track, or remediate these problems. A recent meeting, coordinated by Healthy Schools Network, Inc., has developed a set of recommendations to begin to deal with the issue of environmental health problems in schools.

Continuous Care In Complex Contexts: Access To Health Services For Noncommunicable Diseases Among Syrian Refugee Women In Jordanian Host Communities, Jennifer Ostrowski

Independent Study Project (ISP) Collection

This study examines how, when and where Syrian refugee women living in a host community in central Jordan access health services related to noncommunicable diseases. Noncommunicable diseases are the leading cause of death and disability worldwide, but can be effectively managed through timely treatment. Examining access to care for these diseases in the context of humanitarian emergencies, such as war and displacement, is particularly important because they require continuous care, which may be interrupted during emergencies, and because they can cause acute complications, which may be exacerbated by emergencies (WHO, 2016).

Previous studies indicate a high burden of NCDs among …

Actually, Let’S Not Talk About Sex: The Value-Laden Sex Education Received By China’S Young Women, Allyson Tsu

Independent Study Project (ISP) Collection

This research explored China’s sex education and the values it imparts to China’s young women. Findings indicate that although young women wish to learn about safe sex and sexuality from both schools and parents, communication is restricted by both parties embarrassment, lack of preparation, and fear that open dialogue on such topics will promote sexual activity.

The study found that while sex education classes were informative on physiological topics, in participants' perceptions, they lacked information on safe sex (i.e. use of contraceptives) by sticking to the abstinence narrative, and assuming—or pretending—that China’s young people are not engaging in sex. Although …

Powerful Words: An Exploration Of Linguistic Hierarchy In Moroccan Hospitals, Ellelan Degife

Independent Study Project (ISP) Collection

Morocco is a country of distinct diversity, which exists as a result of the settling of multiple peoples and European colonization. As a result of this diversity, many languages are employed in different settings and spaces, and of these languages, French represents remnants of colonialism and continual elitism in the country. One of the spheres that French commands in Moroccan society is medicine, which creates a dichotomy between the educated health care providers and the underprivileged patients in public hospitals. The aim of this paper is to explore the effect of French on the doctor-patient relationship in urban, public Moroccan …

Sugar And Spice, Not Everything's Nice: Changing Dietary Habits In Bali, Harry Teplow

Independent Study Project (ISP) Collection

In this paper, I will explore the ways in which locals interact with new food options on the island of Bali. Specifically, I will explore dietary behaviors surrounding pre-­‐ packaged snacks and ‘fast-­‐food’ chains and determine whether the presence of these food options is affecting the Balinese’s relationship with more traditional cuisine. I will use everyday observations and conversations with locals to analyze dietary habits and the various food items that are being consumed while examining the potential dietary differentiation between two age groups. I will also consider health outcomes in Bali and discuss how changing dietary habits may be …

Your Body Language Shapes Who You Are Ted Talk Annotated Resource List, Elizabeth Hurm

Undergraduate Research Award

No abstract provided.

Multi-Sector Analysis Of The Progress And Challenges Of Soil-Transmitted Helminth Eradication In Rural Udaipur, Jessica Ellis

Independent Study Project (ISP) Collection

India is home to 240 million children currently at risk of Soil-Transmitted Helminthiasis, which is spread via unclean water, soil, and food, and causes acute pain and malnutrition. While acknowledging the research debates over WASH and mass drug administration, this study seeks to identify the systemic multidisciplinary issues affecting STH elimination efforts in rural Udaipur. Twenty-three interviews were conducted in villages, government departments, NGOs, and medical sectors to identify the challenges within each approach to deworming, and their experiences with multi-sectoral collaboration. The most recurring issues across disciplines were need for invested local leadership, increase in health literacy of adults, …

How We’Ll Fight The Next Deadly Virus Ted Talk Annotated Resource List, Susie Roy

Undergraduate Research Award

No abstract provided.

Manufacturing And Engineering [Career Paper], Mahdi Alawami

Undergraduate Research Award

No abstract provided.

Characterizing The Reproduction Number Of Epidemics With Early Subexponential Growth Dynamics., Gerardo Chowell, Cécile Viboud, Lone Simonsen, Seyed M Moghadas

Global Health Faculty Publications

Early estimates of the transmission potential of emerging and re-emerging infections are increasingly used to inform public health authorities on the level of risk posed by outbreaks. Existing methods to estimate the reproduction number generally assume exponential growth in case incidence in the first few disease generations, before susceptible depletion sets in. In reality, outbreaks can display subexponential (i.e. polynomial) growth in the first few disease generations, owing to clustering in contact patterns, spatial effects, inhomogeneous mixing, reactive behaviour changes or other mechanisms. Here, we introduce the generalized growth model to characterize the early growth profile of outbreaks and estimate …

Impact Of Economic Trends And Disparities On South Carolina Children’S Health And Well-Being: An Analysis Of The 2016 Kids Count Profile, Arelis Moore De Peralta, Bonnie Holaday

Publications

There are many approaches to conceptualizing and measuring the well-being of children. These indices vary considerably depending on the goal of the scale. However, all of these indices share similar characteristics in that they are multi-dimensional and take into account the complexity of children’s lives. One of the best known of these measures is the Annie E. Casey Foundation’s national KIDS COUNT Data Book (http://www.aecf.org/resources/the-2016-kids-countdata-book/). Each year since 1990 the Casey Foundation has released the KIDS COUNT Data Book. This data provides key information about dimensions of child well-being in the following areas: health, education, economic well-being and family and …

School Siting Near Industrial Chemical Facilities: Findings From The U.S. Chemical Safety Board's Investigation Of The West Fertilizer Explosion., Veronica A Tinney, Jerad M Denton, Lucy Sciallo-Tyler, Jerome A. Paulson

Environmental and Occupational Health Faculty Publications

BACKGROUND: The U.S. Chemical Safety and Hazard Investigation Board (CSB) investigated the April 17, 2013 explosion at the West Fertilizer Company (WFC) that resulted in 15 fatalities, more than 260 injuries and damage to more than 150 buildings. Among these structures were four nearby school buildings cumulatively housing children in grades K-12, a nursing care facility and an apartment complex. The incident occurred during the evening when school was not in session, which reduced the number of injuries.

OBJECTIVES: The goal of this paper is to illustrate the consequences of siting schools near facilities that store or use hazardous chemicals, …

Consumer Product Chemicals In Indoor Dust: A Quantitative Meta-Analysis Of U.S. Studies, Susanna D. Mitro, Robin Dodson, Veena Singla, Gary Adamkiewicz, Angelo F. Elmi, Monica Tilly, Ami R. Zota

Environmental and Occupational Health Faculty Publications

Indoor dust is a reservoir for commercial consumer product chemicals, including many compounds with known or suspected health effects. However, most dust exposure studies measure few chemicals in small samples. We systematically searched the U.S. indoor dust literature on phthalates, replacement flame retardants (RFRs), perfluoroalkyl substances (PFASs), synthetic fragrances, and environmental phenols and estimated pooled geometric means (GMs) and 95% confidence intervals for 45 chemicals measured in ≥3 data sets. In order to rank and contextualize these results, we used the pooled GMs to calculate residential intake from dust ingestion, inhalation, and dermal uptake from air, and then identified hazard …

Epigenetics Of Lipid Phenotypes, Sergi Sayols-Baixeras, Marguerite R. Irvin, Donna K. Arnett, Roberto Elosua, Stella W. Aslibekyan

Epidemiology and Environmental Health Faculty Publications

Dyslipidemia is a well-established risk factor for cardiovascular disease, the main cause of death worldwide. Blood lipid profiles are patterned by both genetic and environmental factors. In recent years, epigenetics has emerged as a paradigm that unifies these influences. In this review, we have summarized the latest evidence implicating epigenetic mechanisms—DNA methylation, histone modification, and regulation by RNAs—in lipid homeostasis. Key findings have emerged in a number of novel epigenetic loci located in biologically plausible genes (eg, CPT1A, ABCG1, SREBF1, and others), as well as microRNA-33a/b. Evidence from animal and cell culture models suggests a complex interplay …

A Preliminary Study Of Intergenerational Differences In Masxha Regarding Practice And Attitudes Towards Zulu Traditions During Pregnancy And Birth, Momoko Oyama

Independent Study Project (ISP) Collection

In the Zulu culture, several traditions and rituals are practiced during a woman’s pregnancy and perinatal period. However, as urbanization spreads and western influences strengthen, these rituals risk being lost. This project aims to capture existing knowledge of these traditions and to assess the intergenerational changes in practice and attitudes towards practicing the rituals.

Information on Zulu traditions practiced during a woman’s pregnancy and perinatal period was collected through two interviews and a focus group consisting of three elderly women in Masxha, a Black township in KwaZulu-Natal. Following the interviews and focus group, 32 Masxha residents were recruited to complete …

Regulation Of Ifn-Γ Expression, John Fenimore, Howard A. Young

United States Public Health Resources

Interferon gamma, referred to here as IFN- γ, is a major component in immunological cell signaling and is a critical regulatory protein for overall immune system function. First discovered in 1965 (Wheelock Science 149: (3681)310–311, 1965), IFN- γ is the only Type II interferon identified. Its expression is both positively and negatively controlled by different factors. In this chapter, we will review the transcriptional and post-transcriptional control of IFN-γ expression. In the transcriptional control part, the regular activators and suppressors are summarized, we will also focus on the epigenetic control, such as chromosome access, DNA methylation, and histone acetylation. The …

Chronic Expression Of Interferon-Gamma Leads To Murine Autoimmune Cholangitis With A Female Predominance, Heekyong R. Bae, Patrick S.C. Leung, Koichi Tsuneyama, Julio C. Valencia, Deborah L. Hodge, Seohyun Kim, Tim Back, Megan Karwan, Anand S. Merchant, Nobuyuki Baba, Dechun Feng, Ogyi Park, Bin Gao, Guo Xiang Yang, M. Eric Gershwin, Howard A. Young

United States Public Health Resources

In most autoimmune diseases the serologic hallmarks of disease precede clinical pathology by years. Therefore, the use of animal models in defining early disease events becomes critical. We took advantage of a “designer” mouse with dysregulation of interferon gamma (IFNγ) characterized by prolonged and chronic expression of IFNγ through deletion of the IFNγ 3′-untranslated region adenylate uridylate-rich element (ARE). The ARE-Del-/- mice develop primary biliary cholangitis (PBC) with a female predominance that mimics human PBC that is characterized by up-regulation of total bile acids, spontaneous production of anti-mitochondrial antibodies, and portal duct inflammation. Transfer of CD4 T cells from ARE-Del-/- …