Public Health Commons^™

Palliative Care And Life-Sustaining/Local Procedures In Colorectal Cancer In The United States Hospitals: A Ten-Year Perspective, Zahra Mojtahedi, Ja Seol Koo, Ji Yoo, Pearl Kim, Hee-Taik Kang, Jinwook Hwang, Moon Kyung Joo, Jay J. Shen

School of Medicine Faculty Research

Background: In recent years, palliative care utilization has been increasing while life-sustaining/local procedures have been declining at the end of life. Palliative care utilization widely varies based on tumor type. Limited information is available on inpatient palliative care in colorectal cancer. Aims: This study investigated inpatient palliative care utilization and its association with patient demographics, hospital charges, and procedures among colorectal cancer patients admitted to US hospitals between 2008 and 2017. Receipt of life-sustaining and local procedures and surgeries were also investigated during the ten years. Methods: Data were extracted from the National inpatient sample (NIS) database containing de-identified information …

Collegiate Athletic Trainers’ Experiences Planning For Return-To-Sports During Covid-19: A Qualitative Research Study, Eric G. Post, Justin S. Disanti, Christianne M. Eason, Hayley J. Root, Thomas E. Abdenour

Internet Journal of Allied Health Sciences and Practice

Purpose: The purpose of this study was to explore the role of intercollegiate head athletic trainers in the process of planning to resume sport, as well as their experiences across the course of the pandemic to identify key strategies, challenges, and future considerations during the Covid-19 pandemic. Method: This exploratory, descriptive qualitative study was conducted via one-on-one semi structured interviews through the Zoom video conference technology. Twenty-four head athletic trainers across NCAA Division I, II, and III institutions participated in the study. Results: Emerging themes included the development of detailed, institution-specific plans with shared elements such as policies for testing …

Introducing The Vpha Policy Forum, Benjamin P. Barber

Virginia Journal of Public Health

Data before and during the pandemic indicates Virginia's public health system needs reform. This article suggests that reform requires policy change, and it introduces the VPHA forum as a place to examine current policies and explore new ideas. Finally, it encourages policymakers, advocates, and the public to focus on fundamental questions about how public health is financed and delivered in Virginia. Answering these questions is necessary to creating better public health policies - and better health - for all Virginians.

The Influence Of The Urban Food Environment On Diet, Nutrition And Health Outcomes In Low-Income And Middle-Income Countries: A Systematic Review, Susannah Westbury, Iman Ghosh, Helen Margaret Jones, Daniel Mensah, Folake Samuel, Ana Irache, Nida Azhar, Lena Al-Khudairy, Romaina Iqbal, Oyinlola Oyebode

Community Health Sciences

Introduction: Diet and nutrition are leading causes of global morbidity and mortality. Our study aimed to identify and synthesise evidence on the association between food environment characteristics and diet, nutrition and health outcomes in low-income and middle-income countries (LMICs), relevant to urban settings, to support development and implementation of appropriate interventions.
Methods: We conducted a comprehensive search of 9 databases from 1 January 2000 to 16 September 2020 with no language restrictions. We included original peer-reviewed observational studies, intervention studies or natural experiments conducted in at least one urban LMIC setting and reporting a quantitative association between a characteristic of …

Impact Of The Covid-19 Pandemic On Loneliness And Social Isolation: A Multi-Country Study, Roger O’Sullivan, Annette Burns, Gerard Leavey, Iracema Leroi, Vanessa Burholt, James Lubben, Julianne Holt-Lunstad, Christina Victor, Brian Lawlor, Mireya Vilar-Compte, Carla M. Perissinotto, Mark A. Tully, Mary Pat Sullivan, Michael Rosato, Joanna Mchugh Power, Elisa Tiilikainen, Thomas R. Prohaska

Department of Public Health Scholarship and Creative Works

The COVID-19 global pandemic and subsequent public health social measures have challenged our social and economic life, with increasing concerns around potentially rising levels of social isolation and loneliness. This paper is based on cross-sectional online survey data (available in 10 languages, from 2 June to 16 November 2020) with 20,398 respondents from 101 different countries. It aims to help increase our understanding of the global risk factors that are associated with social isolation and loneliness, irrespective of culture or country, to support evidence-based policy, services and public health interventions. We found the prevalence of severe loneliness was 21% during …

Concerns Of Women Choosing Community Birth During The Covid-19 Pandemic: A Qualitative Study, Sharon Bernecki Dejoy, Deborah Mandel, Niamh Mcfadden, Lauren Petrecca

Public Health Sciences Faculty Publications

Introduction During the coronavirus disease 2019 (COVID-19) pandemic, midwives have reported increased demand for community birth services. The purpose of this qualitative study was to understand childbearing persons' decision-making during the pandemic and to illuminate their experiences giving birth in community settings. Methods The study was framed by the interpretive phenomenological approach. Eligible participants were recruited from midwives providing out-of-hospital birth services. Of the 26 women who agreed to an interview, 17 were able to be reached and interviewed. Interviews followed a semistructured guide. Early paradigm cases were coded by all researchers, and then the first author coded the remaining …

Covid-19 One Year On: Security And Privacy Review Of Contact Tracing Mobile Apps, Wei Yang Ang, Lwin Khin Shar

Research Collection School Of Computing and Information Systems

The ongoing COVID-19 pandemic caused 3.8 million deaths since December 2019. At the current vaccination pace, this global pandemic could persist for several years. Throughout the world, contact tracing (CT) apps were developed, which play a significant role in mitigating the spread of COVID-19. This work examines the current state of security and privacy landscape of mobile CT apps. Our work is the first attempt, to our knowledge, which provides a comprehensive analysis of 70 CT apps used worldwide as of year Q1 2021. Among other findings, we observed that 80% of them may have handled sensitive data without adequate …

Sustainable Developmental Goals Interrupted: Overcoming Challenges To Global Child And Adolescent Health, Zulfiqar Ahmed Bhutta, Kathryn M. Yount, Quique Bassat, Caitlin E. Moyer

Woman and Child Health

No abstract provided.

Study Protocol For A Prospective Process Evaluation Of A Culturally Secure Rehabilitation Programme For Aboriginal Australians After Brain Injury: The Healing Right Way Project, Rachel Skoss, Jane White, Mandy J. Stanley, Melanie Robinson, Sandra Thompson, Elizabeth Armstrong, Judith M. Katzenellenbogen

Research outputs 2014 to 2021

INTRODUCTION: Aboriginal and Torres Strait Islander (hereafter respectfully referred to as Aboriginal) people are Australia's First Peoples, having the longest continuous culture in the world and deep spiritual connections with ancestral land. Improvements in their health and well-being is a major policy goal of Australian governments, as the legacy of colonisation and disruption of cultural practices contribute to major health challenges. Lack of culturally secure services impacts participation of Aboriginal people in health services. Aboriginal people with a brain injury typically experience poor access to rehabilitation and support following hospital discharge. 'Healing Right Way' (HRW) is a randomised control trial …

Exploring Digital Health Interventions To Support Community Health Workers In Low-And-Middle-Income Countries During The Covid-19 Pandemic: A Scoping Review Protocol, Anam Shahil Feroz, Komal Valliani, Hajra Khwaja, Sehrish Karim

Community Health Sciences

Introduction: COVID-19 has significantly affected community health workers' (CHWs) performance as they are expected to perform pandemic-related tasks along with routine essential healthcare services. A plausible way to optimise CHWs' functioning during this pandemic is to couple the efforts of CHWs with digital tools. So far, no systematic evidence is available on the use of digital health interventions to support CHWs in low-middle-income countries (LMICs) amid the COVID-19 pandemic. The article describes a protocol for a scoping review of primary research studies that aim to map evidence on the use of unique digital health interventions to support CHWs during COVID-19 …

Inpatient Palliative Care Is Less Utilized In Rare, Fatal Extrahepatic Cholangiocarcinoma: A Ten-Year National Perspective, Zahra Mojtahedi, Ji Won Yoo, Karen Callahan, Neeraj Bhandari, Donghui Lou, Katayoon Ghodsi, Jay J. Shen

School of Medicine Faculty Research

Background—Extrahepatic cholangiocarcinoma (ECC) is a rare, morbid, fatal cancer with distressing symptoms. Maintaining a high quality of life while reducing hospital charges and length of stay (LOS) for the end-of-life period remains a major challenge for the healthcare system. Palliative care utilization has been shown to address these challenges; moreover, its use has increased in recent years among cancer patients. However, the utilization of palliative care in rare cancers, such as ECC, has not yet been explored. Objectives—To investigate palliative care utilization among ECC patients admitted to US hospitals between 2007 and 2016 and its association with patient demographics, clinical …

Impact Of Pulse Oximetry On Hospital Referral Acceptance In Children Under 5 With Severe Pneumonia In Rural Pakistan (District Jamshoro): Protocol For A Cluster Randomised Trial, Fatima Mir, Apsara Ali, Suhail Chanar, Amjad Hussain, Arjumand Rizvi, Imran Ahmed, Zahid Memon, Atif Habib, Sajid Bashir Soofi, Zulfiqar Ahmed Bhutta

Department of Paediatrics and Child Health

Background: Pneumonia is a leading cause of death among children under 5 specifically in South Asia and sub-Saharan Africa. Hypoxaemia is a life-threatening complication among children under 5 with pneumonia. Hypoxaemia increases risk of mortality by 4.3 times in children with pneumonia than those without hypoxaemia. Prevalence of hypoxaemia varies with geography, altitude and severity (9%-39% Asia, 3%-10% African countries). In this protocol paper, we describe research methods for assessing impact of Lady Health Workers (LHWs) identifying hypoxaemia in children with signs of pneumonia during household visits on acceptance of hospital referral in district Jamshoro, Sindh.
Methods and analysis: A …

Quality Of Inpatient Care Of Small And Sick Newborns In Pakistan: Perceptions Of Key Stakeholders, Nousheen Pradhan, Ammarah Ali, Sana Roujani, Sumera Aziz Ali, Samia Rizwan, Sarah Saleem, Sameen Siddiqi

Community Health Sciences

Background: In LMICs including Pakistan, neonatal health and survival is a critical challenge, and therefore improving the quality of facility-based newborn care services is instrumental in averting newborn mortality. This paper presents the perceptions of the key stakeholders in the public sector to explore factors influencing the care of small and sick newborns and young infants in inpatient care settings across Pakistan.
Methods: This exploratory study was part of a larger study assessing the situation of newborn and young infant in-patient care provided across all four provinces and administrative regions of Pakistan. We conducted 43 interviews. Thirty interviews were conducted …

Relationship Between Food Insecurity And Smoking Status Among Women Living With And At Risk For Hiv In The Usa: A Cohort Study, Lila A. Sheira, Edward A. Frongillo Jr., Judith Hahn, Kartika Palar, Elise D. Riley, Tracey E. Wilson, Adebola Adedimeji, Daniel Merenstein, Mardge Cohen, Eryka L. Wentz, Adaora A. Adimora, Ighovwerha Ofotokun, Lisa Metsch, Janet M. Turan, Phyllis C. Tien, Sheri D. Weiser

Faculty Publications

Objectives People living with HIV (PLHIV) in the USA, particularly women, have a higher prevalence of food insecurity than the general population. Cigarette smoking among PLHIV is common (42%), and PLHIV are 6–13 times more likely to die from lung cancer than AIDS related causes. This study sought to investigate the associations between food security status and smoking status and severity among a cohort of predominantly low-income women of colour living with and without HIV in the USA.

Design Women enrolled in an ongoing longitudinal cohort study from 2013 to 2015.

Setting Nine participating sites across the USA.

Participants 2553 …

Improving Social Justice In Covid-19 Health Research: Interim Guidelines For Reporting Health Equity In Observational Studies, Alba Antequera, Daeria O. Lawson, Stephen G. Noorduyn, Omar Dewidar, Marc Avey, Zulfiqar Ahmed Bhutta, Catherine Chamberlain, Holly Ellingwood, Damian Francis, Sarah Funnell

Woman and Child Health

The COVID-19 pandemic has highlighted the global imperative to address health inequities. Observational studies are a valuable source of evidence for real-world effects and impacts of implementing COVID-19 policies on the redistribution of inequities. We assembled a diverse global multi-disciplinary team to develop interim guidance for improving transparency in reporting health equity in COVID-19 observational studies. We identified 14 areas in the STROBE (Strengthening the Reporting of Observational Studies in Epidemiology) checklist that need additional detail to encourage transparent reporting of health equity. We searched for examples of COVID-19 observational studies that analysed and reported health equity analysis across one …

Precision Public Health Campaign: Delivering Persuasive Messages To Relevant Segments Through Targeted Advertisements On Social Media, Jisun An, Haewoon Kwak, Hanya M. Qureshi, Ingmar Weber

Research Collection School Of Computing and Information Systems

Although established marketing techniques have been applied to design more effective health campaigns, more often than not, the same message is broadcasted to large populations, irrespective of unique characteristics. As individual digital device use has increased, so have individual digital footprints, creating potential opportunities for targeted digital health interventions. We propose a novel precision public health campaign framework to structure and standardize the process of designing and delivering tailored health messages to target particular population segments using social media–targeted advertising tools. Our framework consists of five stages: defining a campaign goal, priority audience, and evaluation metrics; splitting the target audience …

An Exploration Into Public Health Experiences Of Rural Residents To Facilitate Understanding Of Chronic Poor Health Habits: A Phenomenological Study, Marybeth E. Mitcham

Doctoral Dissertations and Projects

The purpose of this hermeneutic phenomenological study was to interpret the public health education experiences of rural residents in one predominantly rural county. This county was identified by its pseudonym, Middlesex County, for the purposes of this paper. The research was done to identify causal factors contributing to the problem of non-compliance exhibited by many rural residents. The non-compliance has resulted in many of those residents choosing to not implement beneficial practices and information from public health education. The guiding behavioral theory for this study was Maslow’s behavioral theory of a hierarchy of needs. This theory describes the rationale behind …

The Histories Of Hivs : The Emergence Of The Multiple Viruses That Caused The Aids Epidemics, William H. Schneider

Ohio University Press Open Access Books

This new collection of essays on HIV viruses spans disciplines to topple popular narratives about the origins of the AIDS pandemic and the impact of the disease on public health policy.

With a death toll in the tens of millions, the AIDS pandemic was one of the worst medical disasters of the past century. The disease was identified in 1981, at the height of miraculous postwar medical achievements, including effective antibiotics, breakthrough advances in heart surgery and transplantations, and cheap, safe vaccines—smallpox had been eradicated just a few years earlier. Arriving as they did during this era of confidence in …

Exploring Community Perceptions, Attitudes And Practices Regarding The Covid-19 Pandemic In Karachi, Pakistan, Anam Shahil Feroz, Naureen Akber Ali, Ridah Feroz, Noshaba Akber, Salima Nazim Meghani

Community Health Sciences

Background: The Government of Pakistan is facing difficulty to contain the surge of COVID-19 due to the country's social, political, economical and cultural context. Experiences from the previous epidemic suggest that community perceptions, social norms and cultural practices can impede COVID-19 containment. To understand social responses towards COVID-19, the study aims to explore the understanding of COVID-19 and the acceptance of control measures among community members.
Methods: We conducted an exploratory qualitative study using a purposive sampling approach, at two communities of Karachi, Pakistan. In-depth interviews were conducted with community members including, young, middle-aged and older adults of both genders. …

Conflicts Of Interest: An Invisible Force Shaping Health Systems And Policies, Afifah Rahman-Shepherd, Priya Balasubramaniam, Meenakshi Gautham, Eleanor Hutchinson, Freddy E. Kitutu, Robert Marten, Mishal S. Khan

Community Health Sciences

No abstract provided.

Perceptions And Experiences Of Healthcare Providers During Covid-19 Pandemic In Karachi, Pakistan: An Exploratory Qualitative Study, Anam Shahil Feroz, Nousheen Pradhan, Zarak Hussain Ahmed, Mashal Murad Shah, Nargis Asad, Sarah Saleem, Sameen Siddiqi

Community Health Sciences

Objective: To explore healthcare provider's perspectives and experiences of the barriers and facilitators to treat and manage COVID-19 cases.
Design and setting: We conducted an exploratory qualitative study using a purposive sampling approach, at a private tertiary care teaching hospital in Karachi, Pakistan. Study data were analysed manually using the conventional content analysis technique.
Participants: Key-informant interviews (KIIs) were conducted with senior management and hospital leadership and in-depth interviews (IDIs) were conducted with front-line healthcare providers.
Results: A total of 31 interviews (KIIs=19; IDIs=12) were conducted, between April and May 2020. Three overarching themes emerged. The first was 'challenges faced …

Mental Preparation For The Post-Covid World, Singapore Management University

Perspectives@SMU

Embracing unpredictability will be key in navigating the new normal. Knowing what your employees are innately good at will help your organisation excel

Prevalence And Determinants Of Inappropriate Antibiotic Dispensing At Private Drug Retail Outlets In Urban And Rural Areas Of Indonesia: A Mixed Methods Study, Luh Putu Lila Wulandari, Mishal Khan, Marco Liverani, Astri Ferdiana, Yusuf Ari Mashuri, Ari Probandari, Tri Wibawa, Neha Batura, Gill Schierhout, John Kaldor

Department of Pathology and Laboratory Medicine

Introduction: The aim of this mixed-method study was to determine the extent and determinants of inappropriate dispensing of antibiotics by licensed private drug retail outlets in Indonesia.
Methods: Standardised patients (SPs) made a total of 495 visits to 166 drug outlets (community pharmacies and drug stores) between July and August 2019. The SPs presented three clinical cases to drug outlet staff: parent of a child at home with diarrhoea; an adult with presumptive tuberculosis (TB); and an adult with upper respiratory tract infection (URTI). The primary outcome was the dispensing of an antibiotic without prescription, with or without the client …

Exploring Opportunities For Prevention Of Child Sexual Abuse In A Diverse American Muslim Community., Rishtya Meena Kakar

Electronic Theses and Dissertations

Recognizing the significant mental, emotional, developmental and health consequences for victims of child sexual abuse (CSA) and sociopolitical consequences for families and communities in every cultural, ethnic, and religious group around the world, this study sought to determine key opportunities for prevention of CSA in a diverse American Muslim community using a public health socioecological lens, rooted in aspects of critical theory. While there is considerable research on situational and individual-level risk factors related to CSA cases, there is less research on the societal and community-level processes related to the primary prevention of CSA, especially among minoritized communities. Responding to …

Effectiveness Of Typhoid Conjugate Vaccine Against Culture-Confirmed Salmonella Enterica Serotype Typhi In An Extensively Drug-Resistant Outbreak Setting Of Hyderabad, Pakistan: A Cohort Study, Mohammad Tahir Yousafzai, Sultan Karim, Sonia Qureshi, Abdul Momin Kazi, Hina Memon, Amber Junejo, Zohra Khawaja, Najeeb Ur Rehman, Muhammad Sajid Ansari, Rafey Ali, Heera Mani Lohana, Farah Naz Qamar

Department of Paediatrics and Child Health

Background: Salmonella enterica serotype Typhi (S Typhi) is a major public health problem in low-income and middle-income countries. We aimed to investigate the effectiveness and impact of the typhoid conjugate vaccine Typbar-TCV against S Typhi among children in an outbreak setting of extensively drug-resistant (XDR) S Typhi in Pakistan.
Methods: This cohort study was done from Feb 21, 2018, to Dec 31, 2019. A census survey of all households located in the Qasimabad and Latifabad subdistricts of Hyderabad, Pakistan, was done at baseline, and 174 005 households were registered in the census. The Typbar-TCV immunisation campaign was initiated at temporary …

Poliovirus Excretion Among Children With Primary Immune Deficiency In Pakistan: A Pilot Surveillance Study Protocol, Asma Sadruddin Pethani, Zaubina Kazi, Ujala Nayyar, Muhammad Shafiq-Ur-Rehman, Mohammad Tahir Yousafzai, Mach Ondrej, Ali Faisal Saleem

Department of Paediatrics and Child Health

Introduction: Children with primary immunodeficiency disorders (PID) are more susceptible to developing viral infections and are at a substantially increased risk of developing paralytic poliomyelitis. Such children, if given oral polio vaccines tend to excrete poliovirus chronically that may lead to the propagation of highly divergent vaccine-derived poliovirus (VDPV). Consequently, they may act as a reservoir for the community by introducing an altered virus potentially imposing a risk to global polio eradication. However, the risks of chronic and prolonged excretion are not well characterised in the study context. This study seeks to establish a pilot surveillance system for successful identification …

Acceptance Of Covid-19 Vaccine In Pakistan: A Nationwide Cross-Sectional Study, Mohammad Aadil Qamar, Omar Irfan, Rubaid A. Dhillon, Areesh Bhatti, Mir Ibrahim Sajid, Safia Awan, Wajiha Rizwan, Ali Bin Sarwar Zubairi, Zouina Sarfraz, Javaid Ahmed Khan

Department of Paediatrics and Child Health

Introduction: The coronavirus disease 2019 (COVID-19) vaccine is available across various countries worldwide, with public-private partnerships ensuring all individuals are vaccinated through a phased approach. Irrespective of the geographical spread, several myths pertaining to the COVID-19 vaccine have stemmed, ultimately limiting the national administration of vaccines and rollouts. This study assessed the acceptance of the COVID-19 vaccine among the general public in Pakistan.
Methods: A pre-validated questionnaire was administered from January 2021 to February 2021 to assess the public attitude and acceptance of the COVID-19 vaccine. Logistic regression analyses were run to identify factors associated with the acceptance among the …

Longitudinal Pre-Exposure Prophylaxis (Prep) Acceptability, Initiation And Adherence Among Criminal Justice-Involved Adults In The Usa: The Southern Prep Cohort Study (Specs) Protocol, Katherine Lemasters, Carrie B. Oser, Mariah Cowell, Katie Mollan, Kathryn Nowotny, Lauren Brinkley-Rubinstein

Sociology Faculty Publications

INTRODUCTION: HIV prevalence among criminal justice (CJ)-involved adults is five times higher than the general population. Following incarceration, CJ-involved individuals experience multilevel barriers to HIV prevention. Pre-exposure prophylaxis (PrEP) is a widely available, daily medication efficacious in preventing HIV. Little is known about PrEP knowledge, acceptability, initiation and sustained use among CJ-involved persons or about how these outcomes vary by multilevel factors. The Southern Pre-Exposure Prophylaxis Study (SPECS) will investigate barriers and facilitators for PrEP initiation and sustained use among CJ-involved adults, building a foundation for PrEP interventions for this underserved population.

METHODS AND ANALYSIS: SPECS uses a mixed-methods sequential …

What’S In Wildfire Smoke?: A Toxicologist Explains The Health Risks And Which Masks Can Help, Luke Montrose

Public and Population Health Faculty Publications and Presentations

Smoke is turning the sky hazy across a large swath of the country as dozens of large fires burn, and a lot of people are wondering what’s in the air they’re breathing.

As an environmental toxicologist, I study the effects of wildfire smoke and how they differ from other sources of air pollution. We know that breathing wildfire smoke can be harmful. Less clear is what the worsening wildfire landscape will mean for public health in the future, but research is raising red flags.

Review Of Sexual Health Issues Linked With Cardiovascular Disease And Type 2 Diabetes Mellitus In Aboriginal And Torres Strait Islander Males, Veronica Collins, Tamara J. Swann, Jane Burns, Tim Moss, Mick Adams

Australian Indigenous HealthBulletin

There are well established links between male sexual health conditions and chronic disease, particularly cardiovascular disease (CVD) and type 2 diabetes (T2DM). Erectile dysfunction (ED) and low testosterone are two sexual health conditions that are relatively common among the wider male population. However, there is a lack of data specifically about these sexual problems among Aboriginal and Torres Strait Islander males.

One of the most important findings of research regarding the links between sexual health and chronic disease is that ED can be a risk marker for future CVD or undiagnosed T2DM. Understanding these links can lead to more holistic …