Public Health Commons^™

Epidemiology Crucial To Cracking Elizabethkingia Crisis, Angela Tonozzi

Journal of Patient-Centered Research and Reviews

The author explains the epidemiological methods, tools and personnel required to pinpoint the source of Wisconsin’s 2016 outbreak of Elizabethkingia infections.

Is The United States Prepared For A Major Zika Virus Outbreak?, Lawrence O. Gostin, James G. Hodge Jr.

Georgetown Law Faculty Publications and Other Works

Zika virus has emerged as a global public health crisis with active transmission in the Americas and Caribbean. The World Health Organization (WHO) declared a Public Health Emergency of International Concern (PHEIC), and recently WHO reported there is a scientific consensus that Zika is a cause of microcephaly and Guillain-Barré syndrome (GBS). In the U.S. the Centers for Disease Control and Prevention (CDC) activated its emergency operations center at its highest capacity. President Obama requested $1.86 billion in emergency funding. Shamefully, Congress has yet to appropriate the funding needed for Zika preparedness, and the President has had to reallocate Ebola …

Tobacco, Alcohol, And Processed Food Industries – Why Do Public Health Practitioners View Them So Differently?, Katherine Smith, Lori Dorfman, Nicholas Freudenberg, Benjamin Hawkins, Shona Hilton, Oliver Razum, Heide Weishaar

Publications and Research

No abstract provided.

Measuring Comprehensive Public Health Delivery Systems And Their Contributions To Population Health, Glen P. Mays, Rick Ingram

Health Management and Policy Presentations

We review methods for measuring the structure of public health delivery systems using data from the National Longitudinal Survey of Public Health Systems. A growing body of research using these measures demonstrates how multiple sectors contribute to core public health functions, and how these functions influence community health status over time. We end with a summary of how the Comprehensive Public Health System measure will be used in monitoring the impact of the 21st Century Public Health System initiative.

Measuring Multi-Sector Contributions To Public Health Delivery Systems & Population Health, Glen P. Mays

Health Management and Policy Presentations

The National Longitudinal Survey of Public Health Systems has followed a nationally-representative cohort of U.S. communities since 1998 to measure the scope of public health activities implemented in each community and the range of organizations and sectors that contribute to each activity. With 16 years of follow-up observations, this survey allows us to study the effects of demographic, economic, and policy shocks on public health delivery systems, and estimate the health effects attributable to delivery system change.

Measuring Comprehensive Public Health Delivery Systems And Their Contributions To Population Health, Glen P. Mays

Health Management and Policy Presentations

Delivery and financing systems for public health services vary widely across U.S. communities, raising questions about the comparative effectiveness and efficiency of alternative structures. We summarize recent approaches for measuring alternative system configurations and estimating their health and economic effects.

An Exploration Of Core Values And Values Congruence In Local Public Health, Ross Graham, Christopher Mackie, Shannon L. Sibbald

Frontiers in Public Health Services and Systems Research

Background: Understanding and aligning staff core values with organizational values has been shown to contribute to positive work attitudes and increased organizational performance in the private sector. Little is known about the role of values in local public health.

Purpose: To identify public health staff core values, and to improve the alignment between staff values and organizational values (known as values congruence).

Methods: A Tribal Leadership exercise was used as part of a multi-stage strategic planning process at Canada’s largest autonomous local public health agency.

Results: Five sessions were held with 146 public health staff; 156 different values were reported. …

Employing The Precautionary Principle To Evaluate The Use Of E-Cigarettes, Ashley M. Bush, James W. Holsinger Jr., Lawrence D. Prybil

Health Management and Policy Faculty Publications

Electronic cigarettes (e-cigarettes) have emerged onto the public market as an alternative to tobacco cigarettes; however, science is inconclusive as e-cigarettes have not been thoroughly investigated, including their short- and long-term risks and benefits (1, 2). The question arises of whether e-cigarettes will become the future tobacco crisis. This paper connects the precautionary principle to the use of e-cigarettes in an effort to guide decision-makers in the prevention of adverse health outcomes and societal costs.

Public Health Measures Derived From The Jewish Tradition, Noam Zeffren, Tova Chein, Robert Stern

Touro College of Osteopathic Medicine (New York) Publications and Research

The authors discuss public health measures that are described in the Torah and rabbinic literature.

An Assessment Of Workplace Injury In Kentucky’S Commercial Logging Industry, Logan Ray

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Objective: To identify demographic, operational, and task-related characteristics associated with increased frequency and severity of injury in Kentucky’s commercial loggers.

Methods: Kentucky Master Loggers attending mandatory continued education courses completed a survey tool eliciting demographic and operational characteristics of their companies, and details of any on-site injury in the years 2012 through 2015 that led to medical costs, lost days or time, and/or decreased production. Associations to injury frequency and injury severity were assessed using logistic regression analysis.

Results: 86 Kentucky Master Loggers representing 66 of Kentucky’s 120 counties reported 33 accounts of non-fatal logging injury. Master Loggers were full-time …

Cross Sectional Analysis Of Patients With Alpha-1 Antitrypsin Deficiency Enrolled In A Disease Management And Prevention Program, Jordan T. Perkins

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Background: Alpha-1 antitrypsin deficiency is a heritable genetic condition that is largely underdiagnosed and has been estimated to affect 1 out of every 5,000-7,000 people in North America. The condition is characterized by a decrease in the production or activity of the alpha-1 antitrypsin protein, increasing risk for chronic lung or liver inflammation, that may lead to disease. Currently, there is no cure for the condition and augmentation therapy, which replaces the lost protein, has shown mixed results, meaning preventive measures taken by the patient are a large component of the prescribed treatment. Thus, patients with the condition are strongly …

The Association Between Latent Tuberculosis Infection And Diabetes Mellitus Control In The United States, Whitney L. Remy

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Rationale: Diabetes mellitus (DM) is recognized as a common comorbid condition for tuberculosis (TB). Those with comorbid conditions are more likely to develop active TB, to have trouble with treatment, and to have more severe symptoms.

Objective: To measure the prevalence and distribution of latent tuberculosis infection (LTBI) and DM control in the United State and test their association when measured by tuberculin skin test (TST) or QuantiFERON®-TB Gold In-Tube blood test (QFT-GIT) and by HbA1c, respectively. Literature Review: One-third of the world population is infected with TB. Ten percent of TB cases worldwide are linked to diabetes mellitus. Studies …

Occupational Risks For Recent Asthma Episodes Among Adults, Molly Reese

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Objective

Asthma affects more than 37 million Americans at some point in their lives, making it one of the most common, but costly chronic conditions. There are many known risk factors for asthma, but additional research on environmental and occupational factors is needed to better understand the association between these variables and asthma. This study investigates the associations between occupational exposures and asthma episodes among adults.

Methods

Data was obtained from the 2011-2013 Behavioral Risk Factor Surveillance System (BRFSS) Asthma Call-back Survey for adults. There was a final study population of 11,408 participants after the exclusion criteria were applied. The …

The Link Between Smoking, Lung Cancer And Socioeconomic Factors In Kentucky, Shreya Berlia

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Background and Purpose

Lung cancer is the leading cause of cancer death and the second most diagnosed cancer in both men and women in the United States. An estimated 158,080 deaths from lung cancer are expected to occur in 2016, which will account for approximately 1 in 4 of all cancer deaths. The 1- and 5-year relative survival rates for lung cancer are 44% and 17%, respectively. The incidence rate for lung cancer has been declining since the mid-1980s in men, but only since the mid-2000s in women. Tobacco smoke is the leading cause of preventable disease and death in …

Quality Improvement In The Department Of Family And Community Medicine At The University Of Kentucky, Manisha Vasishta

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

The purpose of this capstone project is to analyze the quality improvement data that was collected in order to increase the pediatric population at the University of Kentucky Department of Family and Community Medicine clinic at Turfland. There were three different patient populations that were surveyed: reproductive aged women between 18 and 40, parents of the pediatric population that the clinic saw between July 2014 and June 2015, and pregnant women between July 2014 and June 2015. The results show that continuity of care and not being able to see the provider of choice were some of the weaknesses that …

The Impact Of An Ambulatory Clinical Intervention On Viral Load Suppression And Retention In Care For Newly Diagnosed Hiv Persons, Latasha R. Jones

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Ambulatory clinical healthcare settings that serve patients infected with the human immunodeficiency virus (HIV) are critical in improving access to quality HIV care and treatment, in part due to their ability to streamline patient care along the HIV care continuum. Barriers to HIV care are significant among newly diagnosed HIV patients and in order to engage and retain these individuals in care and treatment, specific interventions must be in place to link these individuals to care. In this study, the difference in differences method was used for data analysis to measure the impact of an ambulatory clinics intervention on their …

Access For Adolescents: Multisystemic Therapy In The Juvenile Justice System, Meagan Pilar

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

In this application for funding, DC YouthLink, a non-profit organization that connects adolescents in the juvenile justice system to community resources, proposes to implement an evidence-based mental health intervention into the juvenile justice system in Washington D.C. The Director of DC YouthLink will serve as the Principal Investigator for this pilot program; she, along with five trained staff members, will be responsible for implementing multisystemic therapy (MST), an intensive form of therapy designed specifically for at-risk youth and their families. We propose to intervene at three main stages of the juvenile justice system— intake, correctional placement/probation supervision, and reentry. The …

Enough Smoke: Implementation Of An Evidence-Based Smoking Cessation Program In Owsley County, Kentucky, Meghan Fay Johnson

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

In 1964, the first United States (U.S.) Surgeon General’s Report explicitly stating the dangers of smoking, including an increased risk of lung cancer, was released. Fifty years later, the U.S. continues to carry the significant health and economic burdens for failing to heed this public health warning. Owsley County, Kentucky, located in the heart of the Appalachian is one of the most impoverished and medically underserved counties in the U.S., ranking last in almost every category of overall health outcomes in the state. The county is also entirely rural, with no major cities within an 80-mile radius. In every health …

Hurricane Sandy : Public Health Staff Perceptions Of Impact And Recommendations For Future Preparedness, New York State, Asante Shipp Hilts

Legacy Theses & Dissertations (2009 - 2024)

Abstract

Risk Factors Associated With Severe Injuries In Inland Aquaculture Farms, Amah Martin

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Objective: The main objective of this study was to analyze risk factors associated with severe occupational injuries among inland aquaculture farms.

Methods: Survey results were compiled in a data set that consisted of qualitative data from 51 farmers who were interviewed between 2008 and 2011 in 10 states and the Canadian province of British Columbia. Chi-square and Fisher’s exact test were used to assess the differences in the dichotomous level of severity among several farm and injury variables. Logistic regression was used to predict the outcome of a severe injury event.

Results: Injury observations that indicated the use of raceway …

Injuries Among Security And Law Enforcement Personnel In The Private Versus Public Sectors, William S. Witt

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Background and Objectives: Data collected through workers’ compensation may be useful for occupational injury surveillance. This study examined whether differences existed between the public and private sectors of the security and law enforcement industry in Kentucky.

Methods: Using a cross-­‐sectional design, workers’ compensation data from the Kentucky Department of Workers’ Claims was analyzed to evaluate differences in demographic and injury characteristics, as well as award outcomes, stratified by industry sector. The dataset included all workers’ compensation first reports of injury and claims filed by security and law enforcement personnel in Kentucky from 2005 to 2015. Statistical analyzes included chi-­‐square and …

Comparing The Non-Cystic Fibrosis Bronchiectasis Patients With Non-Tuberculous Mycobacteria (Ntm) And Non-Ntm Infections, Maninder Bir Singh

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Objective

The objective of the study is to compare the Non-Cystic Fibrosis Bronchiectasis patients with Non Tubercular Mycobacteria (NTM) and Non-NTM infection and determine if the NTM and Non-NTM groups are different.

Methods

Data from the COPD Foundation’s Bronchiectasis Research Registry (BRR) was used in the study (n=1660).Logistic regression, Cox proportional hazards regression, and Kaplan Meier survival analysis were used to analyze the data.

Results

The study found odds ratio for having NTM infection for age to be 1.02 and for gender to be 2.34, after adjusting for all other variables in the multivariate logistic regression, with the p-value of …

Eat Well, Keep Moving: Decreasing Childhood Obesity In Fulton County, Kentucky, Sandra Onekhena

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

With the high rates of childhood obesity in Fulton County, the Purchase District Health Department proposes the implementation of the Eat Well and Keep Moving Program in all the county’s elementary schools among fourth and fifth graders. It is an interdisciplinary, evidence-based program that will be aimed at our short-term goal of increasing knowledge about nutrition and physical activity and inspiring positive behavioral change. It works by integrating lessons and activities about proper nutrition and activity into various aspects of the children’s lives — in the classroom, cafeteria, at home and in the community. We hope to see children move …

Neurotoxic Effects Of Occupational Exposures In Agricultural Workers, Miriam Siegel

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Background: Pesticides and organic solvents are two classes of neurotoxic substances regularly used in agriculture. Pesticides have been studied in relation to a range of nervous system effects, and have been repeatedly shown to relate to depression in agricultural workers. Likewise, occupational solvent exposure is recognized as a risk factor for central nervous system effects, including mood disturbances and cognitive impairment, across various industries. Many gaps in knowledge regarding the effects of chronic exposure to these substances on mental/neurological health in agricultural workers still exist. The specific aims of the current analysis were to 1.) Estimate associations between metrics of …

Overdose Education And Naloxone Distribution By Board-Certified Pharmacists In Five Eastern Kentucky Counties, Laura Elizabeth Broughton

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

The Coalition of Kentucky Health Professionals Against Substance Abuse (CKHPASA) is a professional organization uniting members of the various health professions against a rising tide of substance abuse in the state of Kentucky. In 2013, Kentucky ranked 3rd in the United States for highest number of drug overdose fatalities. Previously under the scourge of the prescription opioid epidemic, the state of Kentucky is now seeing rising numbers of overdose deaths related to heroin use, which is an opioid that works similarly to morphine and prescription pain medications.

Naloxone is a life-saving antidote for opioid related overdoses and evidence has shown …

Improving Indoor Air Quality For Children In Rural Kentucky, Denerica L. Curry

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Community interventions directed towards improving indoor air quality for children are often implemented after exposure has occurred and focuses on parental smoking cessation. Our proposed project will intervene during the prenatal stage prior to exposure and continue to support families 6 months postpartum. Infants are at an increased risk of secondhand smoke exposure due to the amount of time they spend in the home and proximity to the smoker. We hypothesize that by enhancing care of the current home visitation model to include an early intervention we will increase the amount of smoking bans in the home and decrease maternal …

Evaluations Of Patients’ Appointment Duration By Type In An Ophthalmology Practice, Brittany U'Wren

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Objective: The Affordable Care Act expanded health care coverage and provided more access to physicians, resulting in potentially longer wait times. Large portions of ophthalmology patients are on Medicare. Two thirds of the expansion populations were Hispanic or African Americans, which have higher rates of eye disease. Another contributoring factor leading to the increase for eye care is the surge of baby boomers. More specifically, these are individuals reaching sixty-five and are beginning to utilize Medicare. Access to care has increased but the capacity of the practice has not. An important goal, therefore, is to maximize efficiency of current …

“Exchange Northern Ky”: An Evidence-Based Needle & Syringe Exchange Program Serving The Northern Kentucky Area Development District, Amanda Hunter

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Intravenous drug users (IDUs) account for nearly 16% of new HIV infections in the United States and almost one half (48%) of newly reported acute hepatitis C virus (HCV) infections have been found to be IDU related.1 Within the Northern Kentucky Area Development District, hepatitis C infections have soared with an incidence of more than 1,000 newly reported cases during 2015 alone.⁴ Rigorous scientific evidence complied by the U.S. Department of Health & Human Services has indicated that one of the most unique and effective strategies for the curtailing HIV incidence among IDUs is by ensuring users’ access to …

E-Cigarettes: Effective Cessation Tools Or Public Health Threat?, Luke Clancy, Kate Babineau

Articles

In a short time, electronic cigarettes have become a multi-billion dollar industry. Since their introduction to the market, prevalence of ever-use among smokers in the USA appears to have increased from 2% in 2010 to >30% in 2012, and the rate of increase appears to be similar in the United Kingdom, Ireland and other Western countries according to a special Eurobarometer survey in 2014.1 The e-cigarette market is estimated to be worth over $3 billion. However, there is no consensus on the role of e-cigarettes and their contribution to the provision of smoking cessation (SC) services, nor to global tobacco …

Promoting Culturally Respectful Cancer Education Through Digital Storytelling, Melany Cueva, Regina Kuhnley, Anne Lanier, Mark Dignan, Laura Revels, Nancy E. Schoenberg, Katie Cueva

Internal Medicine Faculty Publications

Cancer is the leading cause of mortality among Alaska Native people. Over half of Alaska Native people live in rural communities where specially trained community members called Community Health Aides/Practitioners (CHA/Ps) provide health care. In response to CHA/Ps’ expressed desire to learn more about cancer, four 5-day cancer education and digital storytelling courses were provided in 2014. Throughout each course, participants explored cancer information, reflected on their personal experiences, and envisioned how they might apply their knowledge within their communities. Each course participant also created a personal and authentic digital story, a methodology increasingly embraced by Indigenous communities as a …