Public Health Commons^™

Knowledge, Attitudes, Practices And Perceived Barriers Of Emergency Health Care Providers Regarding Sepsis And Septic Shock In A Tertiary Care Centre: A Cross-Sectional Study, Madiha Ismail, Umaira Aftab, Kiran Azizi, Badar Afzal Khan

Department of Emergency Medicine

This study aimed to assess knowledge, attitudes, practices, and perceived barriers of emergency healthcare providers regarding the management of sepsis and septic shock. This cross-sectional study was conducted in the Emergency Department of Aga Khan University Hospital, Karachi, Pakistan from August to October 2017. A total of 53 healthcare providers participated in the study. Overall, 42(79%) of the participants demonstrated correct knowledge of the sepsis bundle. The most common barrier reported in the compliance of the sepsis bundle was a shortage of staff (62%), followed by delayed presentation of patients (58%) and overcrowding (42%). Furthermore, better staffing was perceived by …

2021-02-01_Michiganoverview_Covidschooloutbreak, Michigan Department Of Health & Human Services

Michigan COVID-19 Outbreak Reports

The School Outbreak Data page was obtained from Michigan's COVID-19 data page: https://www.michigan.gov/coronavirus/0,9753,7-406-98163_98173_102480---,00.html.

This report is created by the Michigan Department of Health & Human Services from data self-reported by local health departments. Data is updated every week.

In accordance with the Council of State and Territorial Epidemiologists’ outbreak definition, schools that have been found by their local health department to have two (2) or more COVID-19 cases who may have shared exposure at the school grounds and are not from the same household (with the exception of dorms and off-campus housing) are included. If your child’s school is …

2021-02-01_Michiganoverview_Covidsymptoms, Michigan Department Of Health & Human Services

Michigan COVID-19 Syndromic Surveillance System Data

The Syndromic Surveillance System Data report was obtained from Michigan's COVID-19 dashboard, from under the link "​Coronavirus Symptoms": https://www.michigan.gov/coronavirus. Data was compiled by the Michigan Department of Health and Human Services (MDHHS). The information was updated daily.

Syndromic Surveillance System data is obtained from approximately 183 facilities participating in syndromic surveillance (132 Emergency Departments (ED), 51 Urgent Cares) across the State of Michigan. The reporting is based on individuals who present at EDs and may not be representative of the overall population. The coronavirus-like symptoms query searches visit free-text (chief complaint, triage notes, and clinical impression) for fever or …

Considerations And Guidance For Using Routine And Program Monitoring Data For Social And Behavior Change Evaluation, Breakthrough Research

Reproductive Health

This brief is intended for global, regional, and national social and behavior change program implementers, evaluators, and monitoring and evaluation teams who want to document their program impacts through routinely collected data. Use of routine and program monitoring data for evaluation presents many opportunities for evaluating program impacts on priority health outcomes, with advantages that include their greater frequency, broader geographic range, longer duration, and lower cost of acquisition. Routine and program monitoring data may not be under direct control of evaluators and thus may not always be appropriate for evaluation. Careful consideration of the appropriateness of routine data for …

The Psychosocial Well-Being Of Older Adults In Covid-19 And The 'New Normal', Micah Tan, Paulin T. Straughan, William Tov, Grace Cheong, Wensi Lim

ROSA Research Briefs

Early research into COVID-19 has focused predominantly on the immediate and direct physical health effects of the pandemic, as compared to the wider, indirect effects of the pandemic on general well-being brought about by the various measures put in place to contain the virus. In terms of policies, focus has also been placed largely on containment and broad based policies for the entire population. As experts increasingly recognize that the pandemic will be a protracted event (The Straits Times, 2021), however, there is a need for stakeholders to place greater emphasis on the indirect effects of COVID-19 that will likely …

Application Of The Breakthrough Research Social And Behavior Change Costing Guidelines To The Rise Ii Project In Niger, Nicole M. Bellows, Lori Bollinger, Rudolph Chandler

Poverty, Gender, and Youth

Breakthrough RESEARCH drafted its Guidelines for Costing Social and Behavior Change Health Interventions, in consultation with affiliate Breakthrough ACTION and other programmers, to promote quality social and behavior change program costing studies for a range of uses including budgeting, planning, economic evaluation, and advocacy. In March 2020, Breakthrough RESEARCH began applying the Guidelines to the Resilience in the Sahel (RISE) II program in Niger for a cost-effectiveness analysis through 2022. This report shares findings from application of the Breakthrough Costing Guidelines and provides an example and guidance for social and behavior change researchers and implementers on how these guidelines can …

Racial Disparities In Occupational Risks And Lung Cancer Incidence: Analysis Of The National Lung Screening Trial., Hee-Soon Juon, Alicia Hong, Marcella Pimpinelli, Madhuwani Rojulpote, Russell Mcintire, Julie A. Barta

College of Population Health Faculty Papers

The relationship between racial disparities in occupational risk and lung cancer diagnosis is not well defined. We examined occupational exposure to asbestos, silica, and other workplace chemicals, fumes, or dusts as reported in the National Lung Screening Trial (NLST). Descriptive analyses and multivariate logistic regression models were performed. Among the NLST study cohort, 3.9% were diagnosed with lung cancer. African-Americans had a higher rate of lung cancer diagnosis than White individuals (4.3% vs. 3.9%). About 28% reported at least one occupational exposure, including 6.5% exposed to silica and 4.7% to asbestos. African-Americans reported occupational exposure more frequently than White participants, …

Cervical Cancer, Human Papillomavirus (Hpv), And Hpv Vaccination: Exploring Gendered Perspectives, Knowledge, Attitudes, And Cultural Taboos Among Mexican American Adults, Daisy Y. Morales-Campos, S. A. Snipes, Edna K. Villarreal, L. C. Crocker, A. Guerrero, M. E. Fernandez

Physician Assistant Studies Faculty Publications

Background: Gendered perspectives may be particularly important in shaping norms and values around HPV and HPV vaccination, as previous research suggests that sexuality taboos (e.g. promiscuity) may contribute to low perceived risk among adolescent and young adult Hispanic females. However, research to date focuses primarily on Hispanic mothers, adolescent females, and women of HPV vaccine-eligible age. Hispanic father's perspectives are relatively unknown despite father's important role in shaping norms for their female children.

Objective: To close this gap, this study examines gendered perspectives in knowledge, beliefs, and attitudes about HPV and HPV vaccination from Hispanic parents (mothers and fathers), women …

Epidemiology And Outcomes Of Hospitalized Adults With Sars-Cov-2 Community-Acquired Pneumonia In Louisville, Kentucky, Julio A. Ramirez, T'Shura Ali, Thomas Chandler, Stephen P. Furmanek, Daniya Sheikh, Vidyulata Salunkhe, Steven Gootee, Mohammad Tahboub, William A. Mattingly, Demetra Antimisiaris, Jiapeng Huang, Jose Bordon, Rodrigo Cavallazzi, Paul Schulz, William P. Mckinney, Dawn Balcom, Mark Burns, Ruth Carrico, Forest W. Arnold, Cerid Covid-19 Study Group

The University of Louisville Journal of Respiratory Infections

Background: During the ongoing pandemic of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), SARS-CoV-2 community-acquired pneumonia (CAP) has been the primary cause of hospitalization. The objective of this study was to evaluate the clinical characteristics and outcomes of 1,013 patients hospitalized with SARS-CoV-2 CAP from September 2020 through March 2021 in Louisville, Kentucky.

Methods: This was a retrospective observational study of 1,013 patients hospitalized with SARS-CoV-2 CAP at eight of the adult hospitals in the city of Louisville from September 2020 through March 2021. Patients with 1) a positive reverse transcriptase-polymerase chain reaction (RT-PCR) for SARS-CoV-2, 2) fever, cough, or …

Everyone Matters: Eliminating Dehumanizing Practices In Physical Education, Brian Culp

Faculty Articles

Recently, discussions regarding how to create a positive school climate where all can be successful has come to the forefront. Healthy schools support student learning, well-being, time, space to be active, and opportunities for social and emotional growth. However, a host of numerous trends suggest that the school climate is becoming increasingly hostile towards students who are from immigrant, LBGTQ, and ethnic minority groups. What is often seen as disrespectful behavior toward these students is in fact actions that can be more accurately defined as dehumanization. This article overviews the practice of dehumanization, the implications for learning, and introduces proactive …

Advancements In Postpartum Hemorrhage Care (Apphc): Overview Of Portfolio Development And Research Studies In Madagascar, Breakthrough Research, Usaid's Health Evaluation And Applied Research Development

Reproductive Health

Advancements in Postpartum Hemorrhage Care (APPHC) is a catalytic investment by USAID in Malawi and Madagascar to accelerate reductions in maternal deaths. This program brief presents APPHC’s portfolio of research activities in Madagascar.

Advancing Postpartum Hemorrhage Care (Apphc): Partnership Approach And Portfolio Overview, Breakthrough Research, Usaid's Health Evaluation And Applied Research Development

Reproductive Health

USAID has reinforced its longstanding efforts to accelerate reductions in maternal deaths with a catalytic investment in Malawi and Madagascar, Advancing Postpartum Hemorrhage Care (APPHC). This brief presents APPHC investment partnership, its approach, and expected results. The APPHC Partnership’s agenda and portfolio intensify the two major health system bilateral projects funded by USAID: Organized Network of Services for Everyone (ONSE) in Malawi and Accessible Continuum of Care and Essential Services Sustained (ACCESS) in Madagascar. These large implementation investments, with existing collaborations with ministries of Health and other key figures, offer optimal opportunities for embedding APPHC activities. The APPHC Partnership seeks …

Costing Social And Behavior Change Programming: The Role Of The Denominator, Breakthrough Research

Reproductive Health

This is the first in a series of brief reports intended to complement Breakthrough RESEARCH's Costing Guidelines and support a social and behavior change community of practice by discussing important issues and practices for social and behavior change costing. Breakthrough RESEARCH is gathering, analyzing, and sharing evidence on the costs and impact of social and behavior change interventions to support social and behavior change investments, which are crucial for improving health and advancing development. A review of costing literature identified 147 studies on social and behavior change costs, methodological shortcomings, and knowledge gaps that can be addressed in new costing …

Advancements In Postpartum Hemorrhage Care (Apphc): Overview Of Portfolio Development And Research Studies In Malawi, Breakthrough Research, Usaid's Health Evaluation And Applied Research Development

Reproductive Health

Advancements in Postpartum Hemorrhage Care (APPHC) is a catalytic investment by USAID to accelerate reductions in maternal deaths in Madagascar and Malawi. This brief outlines the portfolio of research activities in Malawi.

Effectiveness Of Enrichment Programs Such As Step Up In Increasing The Matriculation Of Urim Students To Medical Schools, Jessica Amoako, Traci Trice, Md

Phase 1

Introduction: Diversity in healthcare can improve access to healthcare for racial/ethnic minorities. However, barriers such as lack of educational opportunities have hindered URiM (underrepresented in medicine) students from matriculation to medical school. Enrichment programs such as STEP UP Medicine seek to break down these barriers. It provides its participants with MCAT preparation, advising, medical skills sessions, clinical shadowing experiences, and networking opportunities. Thus, the goal of this project is to assess if this program is effective in improving the medical school matriculation rates of URiM students.

Methods: Data was collected through a self-administered online survey using Google forms. The link …

Retrospective Chart Review Of Metastatic Solid Tumor Discharges To Subacute Rehab, Sarah Svetec, Molly Hanson, Crnp, Brooke Worster, Md

Phase 1

Introduction: Regaining strength through rehabilitation as a mechanism to return cancer patients to therapy is poorly understood and therefore realistic advice cannot be given to patients when cancer-directed therapy must be stopped. This research examines what cancer patients are able to accomplish following referral to subacute rehabilitation (SAR). It was hypothesized that the majority of patients would not return to cancer-directed therapy following SAR and that a high functional status at discharge would be the best predictor of this return.

Methods: A retrospective chart review was completed for 112 metastatic solid tumor patients discharged to SAR (2018-2020). The primary outcome …

Training Toolkit For Caregivers At Residential Care Centers In Peru, Elizabeth Stratton, Stephen Didonato, Wayne Centrone

Phase 1

Introduction:

Health Bridges International (HBI) is developing a training toolkit for caregivers working with marginalized youth in residential care centers (RCCs) in Peru. The toolkit represents an amalgamation of best practices, evidence informed research, and the results of our QI survey tool. We predicted that current Peruvian caregivers will identify topics of interest that differ from current literature.

Methods:

Surveys were distributed to over 150 RCCs throughout Peru using email and WhatsApp messages in a snowball format, starting at the administration level. The survey required 20-30 minutes to complete and was completely voluntary. All preliminary data was de-identified and imputed …

Patient Evaluation Of Medication-Assisted Treatment For Opioid Dependency, Francesca Ciocco, Lara Weinstein, Md

Phase 1

Introduction: Although primary care settings are a promising setting for expansion of medication-assisted treatment (MAT) for opioid use disorder (OUD), currently there is not an established primary care model for MAT. While creating a primary care MAT model, traditional treatment success measures (TSMs), like abstinence, may not be effective for vulnerable populations. This study aims to identify patient-important TSMs and compare their relative importance to traditional TSMs.

Methods: Traditional TSMs for MAT programs were identified with a literature review, while potential patient-important TSMs were identified from qualitative analysis of intake interviews for a MAT program in Philadelphia. Traditional and …

Pattern Of Sexual Partner Violence And Health In Young Adult College Students Ages 18-24, Alice Renaud, Allison Casola, Phd

Phase 1

No abstract provided.

Identifying Health Topics For Elementary-Aged Children In Delaware, Kayla Morrell, Denise Hughes

Phase 1

Introduction: Health literacy involves understanding health-related information to make educated decisions regarding an individual’s needs. Low health literacy is associated with poorer health outcomes, which can be minimized by early introduction to accurate health information. Currently, elementary schools in Delaware have no health curriculum, leaving students at risk for low health literacy.

Methods: Interviews were conducted with Delaware elementary school teachers to identify a series of topics that would allow students to learn health information via incorporation into existing curriculum. Teachers were divided into focus groups by school and grade level. The resulting discussions were qualitatively analyzed by two independent …

Assessing The Role Of Virtual Social Networks In The Treatment Progress Of Mothers Recovering From Opiate Addiction, Marisa Wu, Meghan Gannon, Phd Msph, Diane Abatemarco, Phd, Msw

Phase 1

Introduction: Social engagement is a significant contributor to the treatment success of individuals with prior substance use. This project aims to determine if social engagement improves the progression through and experience of treatment of mothers with prior opioid use at an inpatient recovery facility. We hypothesize that increased social engagement will improve treatment progress and experience.

Methods: The project is centered on mothers seeking treatment for opioid use at an urban inpatient treatment facility. The study obtains qualitative and quantitative data through interviews and therapy sessions. The data informs the extent and quality of social engagement and individual perspectives of …

Maternal Stress And Breastfeeding Intention In Pregnant Women With Opioid Use Disorder, Yassamin Jamshidian, Vanessa Short, Phd, Mph, Diane J. Abatemarco

Phase 1

Introduction: Breastfeeding rates are low among women in treatment for opioid use disorder (OUD). Information on determinants of breastfeeding intention can help inform the design of breastfeeding promotion interventions for this population. The objective of the study was to examine associations between maternal characteristics, including stress, and breastfeeding intention among pregnant women in treatment for OUD.

Methods: Fifty-six pregnant women who were receiving treatment for OUD at Thomas Jefferson University’s Maternal Addiction Treatment Education & Research (MATER) program completed a survey, which included questions on demographics, psychosocial characteristics, breastfeeding history, and breastfeeding intention. Maternal stress was measured using the Perceived …

Immigrant Health Literacy Initiative, Yuliya Goykhman, Kelsey Salazar, Mph

Phase 1

Introduction: Low health literacy in immigrant and refugee patients contributes to reduced health access and overall poorer quality of life in these patient populations. Community-Based Organizations (CBOs) provide necessary health navigation services for immigrant populations, but their role is often overlooked by large healthcare institutions. This project aims to illustrate the unique needs of both immigrant and refugee clients in navigating the healthcare system and CBO staff in assisting them with navigation, and to demonstrate to hospital partners how their services are crucial to adequate care of these communities.

Methods: As part of the Pennsylvania Health Literacy Coalition (PAHLC), four …

Nutritional Intervention In Concussion Treatment And Analysis Using Mri And Eeg, Jideofor Okafor, Namdi Nwasike, Andrew Newberg, Md

Phase 1

Traumatic brain injuries (TBI) occur in over one million Americans annually, leading to thousands of deaths, hospitalizations, and individuals with long term disability. The most common causes of TBI which result in hospitalization primarily affect middle-aged to older adults and contribute to the annual economic burden of billions of dollars. The goal of this study is to determine if baseline EEG scans predict responsiveness to supplemental treatment in TBI patients experiencing chronic symptoms, which could improve their care.

Subjects recruited from the greater Philadelphia area were randomly separated into 3 groups—Control, N-acetylcysteine (NAC), or Nutrition—and either received standard treatment for …

Menstrual Management In Adolescent Transgender Males, Julia Eisenberg, Sarah Felleman, Benjamin Bear, Mph, Arielle Effron, Md, Anne Kazak, Phd, Abpp, Anthony Alioto, Phd, Evan Graber, Do, Vanessa Short, Phd, Mph, Meghan Gannon, Phd, Msph, Beth Schwartz, Md

Phase 1

Introduction: Gender dysphoria is associated with increased rates of anxiety, depression, and suicidal ideation in adolescents. There is anecdotal evidence that menstruation increases the occurrence of gender dysphoria in adolescent transgender males. We hypothesize that menses are distressing to transgender males and this population would benefit from menstrual management.

Methods: We conducted a retrospective chart review of all transgender male patients seen in the Nemours Gender Wellness Program (GWP) and limited our population to those who have reached menarche. Data was extracted from the encounters at the GWP clinic and recorded in REDCap. We compared self-reported symptoms of gender dysphoria …

Diabetes Distress, Daily Functioning, And Hemoglobin A1c In Older Black Individuals With Diabetes And Mild Cognitive Impairment, Navajyoti R. Barman, Robin J. Casten, Phd, Barry W. Rovner, Md

Phase 1

Objective: The purpose of the cross-sectional study was to identify associations between diabetes distress, physical functioning, and cognition with hemoglobin A1c in older Black individuals with diabetes and mild cognitive impairment.

Methods: The investigators analyzed previously collected data from 101 older Black individuals with diabetes and mild cognitive impairment. Participants were administered surveys at baseline to assess diabetes distress, physical functioning, and cognitive functioning, and had hemoglobin A1c testing.

Results: Participants with higher hemoglobin A1c showed worse self-reported daily function (r = -0.279, p < .01). Three of four diabetes distress factors were positively correlated with hemoglobin A1c – emotional (r = .276, p < .01), regimen-related (r = .330, p < .01), and interpersonal distress (r = 0.266, p <.01). In a multivariate regression with hemoglobin A1c as the dependent variable, only regimen-related diabetes distress (beta = .282, p = .012) and self-reported daily function (beta = -0.294, p = .027) were significant.

Conclusion: The main finding of this study is that regimen-related diabetes distress and self-reported daily …

Racial Discrepancies In Interpregnancy Intervals And Postpartum Contraception Receipt In Centering Pregnancy Prenatal Care, Amulya Raju, Ms, Dennis Hand, Phd

Phase 1

Non-Hispanic black women are disproportionately affected by higher rates of shorter interpregnancy intervals. The purpose of this study is to identify whether the Centering Pregnancy model of group prenatal care (GPC) can reduce this health disparity by increasing postpartum contraception receipt.

This retrospective chart analysis measures consistency in contraception intent versus actual postpartum receipt in populations of women who received either individual or GPC. The main predictors were: race, insurance type (public or private), marital status, and type of prenatal care. The main outcomes were: type of contraception received, consistency with contraception intent, and presence of a short interpregnancy interval. …

The Number And Types Of Procedures Performed At Jeffhope Clinics, Jeremy Heard, James Plumb

Phase 1

Introduction: Procedures performed as part of the urgent care medical services provided at JeffHOPE Clinics (JHCs) are common in daily operations, but the number and types of procedures performed at each JHC have not yet been reported. The goal of this research was to provide JHCs the data needed to ensure clinic-specific evidence-based training for incoming procedures committee members, and thus ensure the highest quality patient care. The inquiry question was what are the number and types of procedures performed at each JHC?

Methods: An IRB waiver of authorization was obtained. A chart review of patients 18 years or older …

Net Therapy Effect On Chronic Pain Patients: An Fmri/Pet Imaging Study, Layla Annous, Andrew Newberg

Phase 1

Chronic pain is pain that lasts longer than 3 months or lasts longer than tissue healing should naturally take, which can limit patients’ daily activities. Chronic pain impacts 20% of people worldwide, preferentially affecting vulnerable and marginalized populations. We aimed to use fMRI/PET imaging of the brain to determine the efficacy and therapeutic use of Neuro-emotional Technique (NET) therapy for chronic pain patients. We anticipated that NET Therapy would result in decreased activity in areas of the brain associated with pain and decreased perception of pain. Patients who have been suffering chronic pain conditions were used as the experimental group …

Delivering Maternal And Neonatal Health Interventions In Conflict Settings: A Systematic Review, Mariella Munyuzangabo, Michelle F. Gaffey, Dina S. Khalifa, Daina Als, Anushka Ataullahjan, Mahdis Kamali, Reena P. Jain, Sarah Meteke, Amruta Radhakrishnan, Shailja Shah, Fahad J. Siddiqui, Zulfiqar Ahmed Bhutta

Centre of Excellence in Women and Child Health

Background: While much progress was made throughout the Millennium Development Goals era in reducing maternal and neonatal mortality, both remain unacceptably high, especially in areas affected by humanitarian crises. While valuable guidance on interventions to improve maternal and neonatal health in both non-crisis and crisis settings exists, guidance on how best to deliver these interventions in crisis settings, and especially in conflict settings, is still limited. This systematic review aimed to synthesise the available literature on the delivery on maternal and neonatal health interventions in conflict settings.
Methods: We searched MEDLINE, Embase, CINAHL and PsycINFO databases using terms related to …