Public Health Commons^™

Facing Covid-19: Knowledge, Attitudes, Practices, And Challenges Of Healthcare Providers, Population Council

Reproductive Health

This research brief describes findings from the Population Council study Reproductive Healthcare in the Time of COVID-19: Perspectives of Poor Women and Service Providers from Rahim Yar Khan, Punjab with the support of the United Nations Population Fund (UNFPA). During this study, 60 health care providers that represented 60 unique health facilities in Punjab’s Rahim Yar Khan district were interviewed by telephone, to evaluate how much they know about COVID-19 symptoms, prevention, and treatment, as well as their individual attitudes, practices, and challenges during the ongoing pandemic. To assess how the situation evolved during the critical first three months of …

Poor Women's Reproductive Health And Family Planning Challenges And Needs During The Covid-19 Pandemic, Population Council

Reproductive Health

This research brief describes findings from the Population Council study Reproductive Healthcare in the Time of COVID-19: Perspectives of Poor Women and Service Providers from Rahim Yar Khan, Punjab with the support of the United Nations Population Fund (UNFPA). The study conducted 164 interviews by telephone with beneficiaries of the Benazir Income Support Programme (BISP) in Rahim Yar Khan, Pakistan, previously surveyed in 2019, to determine how much those most vulnerable to the effects of COVID-19 know about the disease and its effects, in addition to understanding the pandemic’s effects on their lives, including their mental health and well-being as …

Reflections On A Post-Covid World: Lessons From The Surge., David B. Nash, Mark D Smith, Anand K Parekh, Byron C Scott, Kavita Patel, Karen Murphy, Karen B Desalvo

College of Population Health Faculty Papers

This conversation was held on June 16, 2020, and the resulting transcript reflects the events that were current as of the time of the original discussion. Changes to policies, events, and data may have changed between the time of the discussion and its publication.

Changes In Health Care Following Covid-19., David B. Nash, Thomas H Lee, Leana Wen, Bruce A Meyer, Judd E Hollander, Susan Skochelak

College of Population Health Faculty Papers

This conversation was held on June 17, 2020, and the resulting transcript reflects the events that were current as of the time of the original discussion. Changes to policies, events, and data may have changed between the time of the discussion and its publication.

Household And Personal Air Pollution Exposure Measurements From 120 Communities In Eight Countries: Results From The Pure-Air Study, Matthew Shupler, Perry Hystad, Aaron Birch, Daniel Miller-Lionberg, Matthew Jeronimo, Raphael E. Arku, Yen Li Chu, Rehman Khawaja, Romaina Iqbal, Khawar Kazmi

Community Health Sciences

Background: Approximately 2·8 billion people are exposed to household air pollution from cooking with polluting fuels. Few monitoring studies have systematically measured health-damaging air pollutant (ie, fine particulate matter [PM_2·5] and black carbon) concentrations from a wide range of cooking fuels across diverse populations. This multinational study aimed to assess the magnitude of kitchen concentrations and personal exposures to PM_2·5 and black carbon in rural communities with a wide range of cooking environments.
Methods: As part of the Prospective Urban and Rural Epidemiological (PURE) cohort, the PURE-AIR study was done in 120 rural communities in eight countries …

The Hypercoagulable State In Covid-19: Incidence, Pathophysiology, And Management, Mouhamed Yazan Abou-Ismail, Akiva Diamond, Yasmin Arafah, Lalitha Nayak

Faculty Scholarship

The 2019 coronavirus disease (COVID-19) presents with a large variety of clinical manifestations ranging from asymptomatic carrier state to severe respiratory distress, multiple organ dysfunction and death. While it was initially considered primarily a respiratory illness, rapidly accumulating data suggests that COVID-19 results in a unique, profoundly prothrombotic milieu leading to both arterial and venous thrombosis. Consistently, elevated D-dimer level has emerged as an independent risk factor for poor outcomes, including death. Several other laboratory markers and blood counts have also been associated with poor prognosis, possibly due to their connection to thrombosis. At present, the pathophysiology underlying the hypercoagulable …

Haiti's Hiv Surveillance System: Past, Present, And Future, Chris Delcher, Ermane G. Robin, Daniella Myriam Pierre

Pharmacy Practice and Science Faculty Publications

No abstract provided.

Public Health Implications Of Early Marriage, Prachi Joshi, Tilicia Mayo-Gamble

Health Policy & Community Health: Faculty Publications

Work published by Georgia Southern University Press.

Optimal Pregnancy Outcomes And Subsequent Postnatal Development, Maria Sevoyan

Theses and Dissertations

Optimal pregnancy outcomes and subsequent postnatal development in childhood are important contributors for health in adulthood. Some contributors to pregnancy outcomes include interpregnancy interval (IPI) and gestational age. Postnatal growth patterns also contribute to neurodevelopment and metabolic health outcomes later in life.

Several systematic reviews consistently show that short and long IPIs are associated with increased risk of subsequent adverse perinatal outcomes. Recent studies demonstrate that previously observed consistent positive associations between short and long IPIs and adverse perinatal outcomes might be due to unmeasured confounding rather than the length of the IPI. We used the National Institute of Child …

Caregiver Experience And Perceived Acceptability Of A Novel Near Point-Of-Care Early Infant Hiv Diagnostic Test Among Caregivers Enrolled In The Pmtct Program, Myanmar: A Qualitative Study, Win Lei Yee, Kyu Kyu Than, Yasmin Mohamed, Hla Htay, Htay Htay Tin, Win Thein, Latt Latt Kyaw, Win Win Yee, Moe Myat Aye, Stanley Luchters

Population Health, East Africa

Background: The majority of HIV infection among children occurs through mother-to-child transmission. HIV exposed infants are recommended to have virological testing at birth or 4–6 weeks of age but challenges with centralized laboratory-based testing in Myanmar result in low test- ing rates and delays in result communication and treatment initiation. Decentralized point- of-care (POC) testing when integrated in prevention of mother-to-child transmission of HIV (PMTCT) services, can be an alternative to increase coverage of early infant diagnosis (EID) and timely engagement in HIV treatment and care.

Aim: This paper aims to explore experiences of caregivers of HIV-exposed infants enrolled …

Early Breastfeeding Practices Contribute To Exclusive Breastfeeding In Bangladesh, Vietnam And Ethiopia, Phuong Hong Nguyen, Sunny S. Kim, Lan Mai Tran, Purnima Menon, Edward A. Frongillo Jr.

Faculty Publications

Limited evidence exists on the complex relationship among interventions, early initiation of breastfeeding (EIBF), prelacteal feeding and exclusive breastfeeding (EBF). We examined whether early breastfeeding practices are associated with EBF and how much improving EIBF and non-prelacteal feeding contributes to increased prevalence of EBF. Survey data were collected in 2010 and 2014 as part of impact evaluations of Alive & Thrive (A&T) interventions to improve infant and young child feeding (IYCF) practices in Bangladesh, Vietnam and Ethiopia. Multivariable logistic regression analyses were used to examine effects of interventions and early breastfeeding practices on EBF. Structural equation modelling quantified the direct …

Effect Of Female Sex Work-Targeted Community-Based Interventions Along The Hiv Treatment Cascade In Sub-Saharan Africa: A Systematic Review Protocol, Lydia Atuhaire, Olatunji Adetokunboh, Constance Shumba, Peter S. Nyasulu

School of Nursing & Midwifery, East Africa

Introduction: Female sex workers (FSWs) are a known high-risk group that are at increased risk of HIV transmission due to exposure to multiple sexual partners and inability to negotiate safe sex attributed to challenging economic circumstances. Previous systematic reviews have examined the effectiveness of HIV interventions prioritising FSWs and have shown that targeted interventions improve access to HIV prevention and treatment services. Interventions that increase FSWs’ uptake of services are well documented; however, evidence on specific interventions aimed at improving FSWs’ continuity in HIV care along the treatment cascade is lacking. This systematic review aims to document the performance of …

Changes In Preventive Care Utilisation And Its Influencing Factors Among Chinese Adults Before And After The Healthcare Reform: Cross-Sectional Evidence From The China Health And Nutrition Survey In 2004-2015, Tingting Wu, Wei Wei Liu, Mao Zou, Xun Lei, Qiang Yang, Manoj Sharma, Yong Zhao, Zu Min Shi

Environmental & Global Health Faculty Research

Objective China launched its health reform in 2009. This study aimed to assess changes in preventive care utilisation (PCU) and its relationship with the healthcare reform. Design A cross-sectional study using demographic characteristics, socioeconomic status, environmental factors, and lifestyle and health status data of adults from five waves (2004–2015) of the China Health and Nutrition Survey (CHNS) was conducted. Multilevel mixed-effects logistic regression models were used. Setting Data were derived from urban and rural communities of nine provinces in China. Participants Data were obtained from five waves of the CHNS, with 9960 participants in 2004, 9888 in 2006, 10 286 …

Positive Parenting Approaches And Their Association With Child Eating And Weight: A Narrative Review From Infancy To Adolescence, Katherine N. Balantekin, Stephanie Anzman-Frasca, Lori A. Francis, Alison K. Ventura, Jennifer O. Fisher, Susan L. Johnson

Kinesiology and Public Health

Parents play a critical role in the development of children's eating behaviours and weight status, serving as providers, models and regulators of the food environment. Many research reviews have focused on the robust body of evidence on coercive control in feeding: how parenting practices such as restriction and pressure to eat increase children's risk for developing undesirable eating behaviours and unhealthy weight outcomes. Fewer reviews adopt a strengths-based perspective focusing on the ways that parents can actively support the development of healthy eating behaviours and weight trajectories. Emerging research on such positive parenting styles and practices offers solutions beyond the …

The Post Hurricane Harvey Respiratory Protection Training Program, Yiyao Li, Christine Bakos-Block, Amal Rammah, Rotem Magal, Joel Adekanye, Shari Esquenazi, Michelle R Mcdaniel, Kai Zhang, Elaine Symanski, William B Perkison

Faculty, Staff and Student Publications

OBJECTIVES: This study evaluated the effectiveness of an outreach program which included safety training and the distribution of personal protection kits in the Houston area in the aftermath of Hurricane Harvey.

METHODS: Outreach: 71 volunteers conducted training sessions at 19 different sites and distributed a total of 1187 kits. Follow-up study: We conducted telephonic interviews to collect data on respiratory symptoms and obtain perceptions of the quality of the safety training provided among 83 participants.

RESULTS: Participants reported an increase in airway symptoms four weeks after Hurricane Harvey. Outreach efforts were felt to be effective by a majority of participants. …

Between Lives And Economy: Optimal Covid-19 Containment Policy In Open Economies, Wen-Tai Hsu, Hsuan-Chih Luke Lin, Yang Han

Research Collection School Of Economics

This paper studies optimal containment policy for combating a pandemic in an open-economy context. It does so via quantitative analyses using a model that incorporates a standard epidemiological compartmental model in a multi-country, multi-sector Ricardian model of international trade with full-fledged input-output linkages. We devise a novel approach in computing optimal national policies in the long run, and contrast these policies with a baseline in which countries maintain their current policies until vaccine availability. The welfare gains under optimal policies are asymmetric as the gains for the set of countries which should tighten up the containment measures are much larger …

Law And Covid-19, Aurelio Gurrea-Martinez, Yihan Goh, Mark Findlay

Research Collection Yong Pung How School Of Law

This book is a collection of essays from scholars at Singapore Management University School of Law analysing the challenges and implications of COVID-19 from the perspective of different areas of law, including private law, corporate law, insolvency law, data protection, financial laws, public law, privacy law, commercial law, constitutional law, law and technology, and dispute resolution. It also analyses how the COVID-19 pandemic will affect the judicial system, the study of law, and the future of the legal profession. Beyond considerations of the pandemic’s influence on law and legal service delivery the authors consider how law can help facilitate the …

Tort Liability In A Pandemic Environment: Exploratory Thoughts, Kee Yang Low

Research Collection Yong Pung How School Of Law

In a matter of months, the emergence and spread of the coronavirus has massively disrupted and radically changed life, causing untold suffering and staggering losses. It will be some time before the pandemic ends and the world returns to normal or, more likely, move to a new normal. Since the beginning of 2020, health authorities and governments worldwide have devoted huge amounts of resources studying the science surrounding the coronavirus – its origin, spread, mutation, symptoms, treatment, containment and the like – and taking regulatory action to manage the crisis. The outbreak of the virus and the attendant governmental measures …

Social Determinants Of Health-Related Needs During Covid-19 Among Low-Income Households With Children, Shreela V Sharma, Ru-Jye Chuang, Melinda Rushing, Brittni Naylor, Nalini Ranjit, Mike Pomeroy, Christine Markham

Faculty, Staff and Student Publications

INTRODUCTION: Little is known about the social needs of low-income households with children during the coronavirus-2019 (COVID-19) pandemic. Our objective was to conduct a cross-sectional quantitative and qualitative descriptive analysis of a rapid-response survey among low-income households with children on social needs, COVID-19-related concerns, and diet-related behaviors.

METHODS: We distributed an electronic survey in April 2020 to 16,435 families in 4 geographic areas, and 1,048 responded. The survey asked families enrolled in a coordinated school-based nutrition program about their social needs, COVID-19-related concerns, food insecurity, and diet-related behaviors during the pandemic. An open-ended question asked about their greatest concern. We …

We Know Health Is Not Elective: Impacts Of Covid-19., David B. Nash, Mark Angelo, Esther J Nash, Jonathan L Gleason, Bruce A Meyer

College of Population Health Faculty Papers

Several months into the impact of the global COVID-19 pandemic, the authors use the framework of "radical uncertainty" and specific regional health care data to understand current and future health and economic impacts. Four key areas of discussion included are: (1) How did structural health care inequality manifest itself during the closure of all elective surgeries and visits?; (2) How can we really calculate the so-called untold burden that resulted from the closure, with a special emphasis on primary care?; (3) The Pennsylvania experience - using observations from the population of one major delivery ecosystem (Jefferson Health), a major accountable …

Effect Of Lifestyle, Medical School Culture And Income On Medical Students' Decision To Pursue A Primary Care Career In Saudi Arabia, Ahmed Abdullah Alhussain

Theses and Dissertations

This study aims to examine the relationship of medical school students who select primary care as their career specialty. Based on extensive literature review, we focused on the three main factors that influence students to consider career specialty: lifestyle, income, and medical school culture. With a paper questionnaire of a cross-sectional study survey at ten medical schools, we were able to collect 1,006 participants from fourth and fifth year students. The clear majority of students considered lifestyle characteristics to be a significant influence in their career decision (PP<.05). Also, we found there was a significant relationship between students’ specialty choices and income variables. The result showed us that medical school culture played a notable role in terms of forming the students’ decisions in different ways. First, specialty characteristics were strongly correlated with career consideration. Second, having advising and mentoring within the medical school enhanced the probability of choosing primary care specialty. Finally, the effect of the primary care course was significant and closely related to the choice of the primary care specialty. In conclusion, the study demonstrated the impact of lifestyle, income, and medical school culture on student career selection. These results are in parallel with previous studies conducted in many countries around the world.

Policies And Practices Of Shea Research Network Hospitals During The Covid-19 Pandemic., Michael S. Calderwood, Valerie M. Deloney, Deverick J. Anderson, Vincent Chi-Chung Cheng, Shruti Gohil, Jennie H. Kwon, Lona Mody, Elizabeth Monsees, Valerie M. Vaughn, Timothy L. Wiemken, Matthew J. Ziegler, Eric Lofgren

Manuscripts, Articles, Book Chapters and Other Papers

To understand hospital policies and practices as the COVID-19 pandemic accelerated, the Society for Healthcare Epidemiology of America (SHEA) conducted a survey through the SHEA Research Network (SRN). The survey assessed policies and practices around the optimization of personal protection equipment (PPE), testing, healthcare personnel policies, visitors of COVID-19 patients in relation to procedures, and types of patients. Overall, 69 individual healthcare facilities responded in the United States and internationally, for a 73% response rate.

Canakinumab To Reduce Deterioration Of Cardiac And Respiratory Function In Sars-Cov-2 Associated Myocardial Injury With Heightened Inflammation (Canakinumab In Covid-19 Cardiac Injury: The Three C Study), Calvin C Sheng, Debasis Sahoo, Siddharth Dugar, Robier Aguillon Prada, Tom Kai Ming Wang, Ossama K Abou Hassan, Danielle Brennan, Daniel A Culver, Prabalini Rajendram, Abhijit Duggal, A Michael Lincoff, Steven E Nissen, Venu Menon, Paul C Cremer

Faculty, Staff and Student Publications

BACKGROUND: In patients with Covid-19, myocardial injury and increased inflammation are associated with morbidity and mortality. We designed a proof-of-concept randomized controlled trial to evaluate whether treatment with canakinumab prevents progressive respiratory failure and worsening cardiac dysfunction in patients with SARS-CoV2 infection, myocardial injury, and high levels of inflammation.

HYPOTHESIS: The primary hypothesis is that canakiumab will shorten time to recovery.

METHODS: The three C study (canakinumab in Covid-19 Cardiac Injury, NCT04365153) is a double-blind, randomized controlled trial comparing canakinumab 300 mg IV, 600 mg IV, or placebo in a 1:1:1 ratio in hospitalized Covid-19 patients with elevations in troponin …

Reorganising For Covid-19 Pandemic: A Review Of Structural Modifications By The Department Of Internal Medicine In Low To Middle-Income Countries, Shakeel Ur Rehman, Muhammad Arslan Ahmed, Ghufran Adnan, Maria Ali Khan

Department of Medicine

Scientists classified the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) as a novel coronavirus on January 7, 2020. The World Health Organization (WHO) acknowledged the SARS-CoV-2 outburst a public health emergency of international concern on January 30, 2020. Since its origin, this virus has disrupted the best healthcare systems, economies, and strained financial resources; and for underdeveloped countries' healthcare systems, the virus has become a crisis. To tackle the potential hazards from this virus, our Department restructured the services that not only helped us to cope with the pandemic, but also provided an example to copy for other contemporary institutes. …

Regulation, Quality Reporting And Third-Party Certification Of Healthcare Providers, Amir Jahan Khan, Muhammad Ashar Malik

Community Health Sciences

The newly established provincial healthcare commissions in Pakistan have started certification of healthcare providers. The policy-makers perceive that without third-party certification or licencing the healthcare quality will be suboptimal in the country. This paper reviews the current literature on third-party certification and studies objectives and progress of the largest healthcare commission in Pakistan. It analyses the certification role of the Punjab Healthcare Commission and draw lessons for future regulation and strengthening of the quality reporting process. It also documents the short-term and long-term trade-off resulting from the enforcement of quality certification in the absence of appropriate alternative investment in medical …

Human Genes Differ By Their Uv Sensitivity Estimated Through Analysis Of Uv-Induced Silent Mutations In Melanoma, Ivan P Gorlov, Christopher I Amos, Spiridon Tsavachidis, Colin Begg, Eva Hernando, Chao Cheng, Ronglai Shen, Irene Orlow, Li Luo, Marc S Ernstoff, Joel Parker, Nancy E Thomas, Olga Y Gorlova, Marianne Berwick

Faculty, Staff and Students Publications

We hypothesized that human genes differ by their sensitivity to ultraviolet (UV) exposure. We used somatic mutations detected by genome-wide screens in melanoma and reported in the Catalog Of Somatic Mutations In Cancer. As a measure of UV sensitivity, we used the number of silent mutations generated by C>T transitions in pyrimidine dimers of a given transcript divided by the number of potential sites for this type of mutations in the transcript. We found that human genes varied by UV sensitivity by two orders of magnitude. We noted that the melanoma-associated tumor suppressor gene CDKN2A was among the top …

Aaim Recommendations For The 2020-2021 Internal Medicine Residency Application Cycle In Response To The Covid-19 Pandemic, Katherine C Chretien, Jaya M Raj, Reeni A Abraham, Paul Aronowitz, Donna J Astiz, Shobhina G Chheda, Ernie L Esquivel, Maria M Garcia, Nadia Ismail, Susan Lane, Suzanne E Mclaughlin, Anne Pereira, Amy W Shaheen, Abby L Spencer, Kimberly M Tartaglia, Lisa L Willett

Faculty, Staff and Students Publications

This statement was released in June 2020 by the Alliance for Academic Internal Medicine to provide guidance for the 2020-2021 residency application cycle in light of the COVID-19 pandemic. While many of the recommendations are specific to this cycle, others, such as the Department Summary Letter of Evaluation, are meant to be an enduring change to the internal medicine residency application process. AAIM realizes that some schools may not yet have the tools or resources to implement the template fully this cycle and look toward collaboration within the internal medicine education community to facilitate adoption in the cycles to come.

The Role Of Paraprofessionals In The Mental Health Structure Of India, Amy Abraham

Senior Theses

The mental health treatment gap in India is part of a growing public health crisis, with over 95% of those in need of services never receiving them. Over 197 million Indians suffer from at least one diagnosable mental health disorder, and this number continues to grow given the treatment gap. The treatment gap is a result of four major factors: lack of government support, stigma, limited treatment facilities, and the dearth of professionals able to provide treatment. The current study aimed to analyze several factors of paraprofessional led mental health interventions including setting, treatments delivered, treatment models, and client outcomes. …

An Analysis Of How Stress Impacts Dietary Habits In First-Year Students, Matthew Telfer

Senior Theses

The majority of students will experience stress during their first year at college. Stress can have many ill effects on the well-being of a first-year student and can even be a significant factor in weight gain – hence the term “The Freshman 15”. Sixty seven first-year students at the University of South Carolina were recruited to participate in a sixteen-item questionnaire focused on analyzing the relationship between stress and dietary habits. It was hypothesized that first -year students who had higher levels of stress would have significantly more unhealthy eating habits than first-year students who had lower levels of stress. …

Application Of Human Factors Methods To Understand Missed Follow-Up Of Abnormal Test Results, Deevakar Rogith, Tyler Satterly, Hardeep Singh, Dean F Sittig, Elise Russo, Michael W Smith, Don Roosan, Viraj Bhise, Daniel R Murphy

Faculty, Staff and Students Publications

OBJECTIVE: This study demonstrates application of human factors methods for understanding causes for lack of timely follow-up of abnormal test results ("missed results") in outpatient settings.

METHODS: We identified 30 cases of missed test results by querying electronic health record data, developed a critical decision method (CDM)-based interview guide to understand decision-making processes, and interviewed physicians who ordered these tests. We analyzed transcribed responses using a contextual inquiry (CI)-based methodology to identify contextual factors contributing to missed results. We then developed a CI-based flow model and conducted a fault tree analysis (FTA) to identify hierarchical relationships between factors that delayed …