Public Health Commons^™

Safety Of Daily Low-Dose Aspirin Use During Pregnancy In Low-Income And Middle-Income Countries, Vanessa L. Short, Matthew Hoffman, Mrityunjay Metgud, Avinash Kavi, Shivaprasad S. Goudar, Jean Okitawutshu, Antoinette Tshefu, Carl L. Bose, Saleem Jessani, Sarah Saleem

Community Health Sciences

Background: The daily use of low-dose aspirin may be a safe, widely available, and inexpensive intervention for reducing the risk of preterm birth. Data on the potential side effects of low-dose aspirin use during pregnancy in low- and middle-income countries are needed.
Objective: This study aimed to assess differences in unexpected emergency medical visits and potential maternal side effects from a randomized, double-blind, multicountry, placebo-controlled trial of low-dose aspirin use (81 mg daily, from 6 to 36 weeks' gestation).
Study design: This study was a secondary analysis of data from the Aspirin Supplementation for Pregnancy Indicated Risk Reduction In Nulliparas …

Strategically Rational Risk Taking By Age In Covid-19, And The Heterogeneous Agent Behavioral Sir Model, Siamak Javadi, Elena Quercioli, Lones Smith

School of Economics and Finance Faculty Publications

Given the dramatic age variation in COVID death rates, we create a heterogeneous agent version of the Behavioral SIR contagion model of Engle et al. (2020). The Bayes Nash equilibrium of our infection avoidance game yields a simple new log-linear relationship between the case fatality rate (CFR) and COVID incidence: Everyone knows that everyone optimizes vigilance both for the prevalence and their CFR. We explain 2020 CDC incidence data for the USA north-east in terms of the CFR to age-specific COVID death data for Massachusetts. Our model is statistically significant: A 10% higher CFR reduces incidence by about 1%.

Building Healthy Communities: Executive Summary - Policy, Systems, And Physical Changes, Core (Center For Outcomes Research & Education)

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No abstract provided.

Education Of Infectious Diseases Fellows During The Covid-19 Pandemic Crisis: Challenges And Opportunities, Lisa M Chirch, Wendy S Armstrong, Gayle P Balba, Prathit A Kulkarni, Constance A Benson, Victoria Konold, Vera P Luther, Obinna N Nnedu, Sarah Perloff, Raymund R Razonable, Wendy Stead, George R Thompson, Michael T Melia

Faculty, Staff and Students Publications

One of the many challenges that has befallen the Infectious Diseases and Graduate Medical Education communities during the coronavirus disease 2019 (COVID-19) pandemic is the maintenance of continued effective education and training of the future leaders of our field. With the remarkable speed and innovation that has characterized the responses to this pandemic, educators everywhere have adapted existing robust and safe learning environments to meet the needs of our learners. This paper will review distinct aspects of education and training of the Infectious Diseases fellows we believe the COVID-19 pandemic has impacted most, including mentoring, didactics, and wellness. We anticipate …

Food Insecurity Measurement And Prevalence Estimates During The Covid-19 Pandemic In A Repeated Cross-Sectional Survey In Mexico, Pablo Gaitán-Rossi, Mireya Vilar-Compte, Graciela Teruel, Rafael Pérez-Escamilla

Department of Public Health Scholarship and Creative Works

Objective: To validate the telephone modality of the Latin American and Caribbean Food Security Scale (ELCSA) included in three waves of a phone survey to estimate the monthly household food insecurity prevalence during the COVID-19 pandemic in Mexico. Design: We examined the reliability and internal validity of the ELCSA scale in three repeated waves of cross-sectional surveys with Rasch models. We estimated the monthly prevalence of food insecurity in the general population and in households with and without children and compared them with a national 2018 survey. We tested concurrent validity by testing associations of food insecurity with socio-economic status …

Maternal And Newborn Health Risks Of Climate Change: A Call For Awareness And Global Action, Nathalie Roos, Sari Kovats, Shakoor Hajat, Veronique Filippi, Matthew Chersich, Stanley Luchters, Fiona Scorgie, Britt Nakstad, Olof Stephansson, Chamnha Consortium

Population Health, East Africa

Climate change represents one of the largest global health threats of the 21st century with immediate and long‐term consequences for the most vulnerable populations, especially in the poorest countries with the least capacity to adapt to climate change. Pregnant women and newborns are increasingly being recognized as vulnerable populations in the context of climate change. The effects can be direct or indirect through heat stress, extreme weather events and air pollution, potentially impacting both the immediate and long‐term health of pregnant women and newborns through a broad range of mechanisms. In 2008, the World Health Organization passed a resolution during …

Distribution And Antibiotic Resistance Profiles Of Salmonella Enterica In Rural Areas Of North Carolina After Hurricane Florence In 2018, Yuqing Mao, Mohamed Zeineldin, Moiz Usmani, Sital Uprety, Joanna Shisler, Antarpreet Jutla, Avinash Unnikrishnan, Thanh H. Nguyen

Civil and Environmental Engineering Faculty Publications and Presentations

The frequency and magnitude of extreme events are increasing globally (Arnell & Gosling, 2016). Inundation, as a result of massive flooding, has the potential to change environmental conditions abruptly, and as a result, add pressure to the metabolism and proliferation of microorganisms (Furtak et al., 2020). The resulting overland flows and additional burden from domestic sewer and septic tank systems during an extreme flood event can introduce pathogens into ecologically unstable water bodies. For example, Yu et al. (2018) reported elevated levels of Escherichia coli and antibiotic resistance genes (ARGs) in river water samples 6 months after flooding in Houston, …

Public Perceptions Of Opioid Use Disorder (Oud) In Rural Pennsylvania: Opportunities, Challenges, And Barriers, Josiah Miller, Duane Donmoyer, Md, James Plumb, Md, Mph

Phase 1

Introduction:

Opioid Use Disorder (OUD) has significantly impacted rural communities nation-wide. This study adds information to what is currently known about OUD and its effects on small towns through examining how OUD has, and is currently, affecting a rural community (~7,000 population) in central Pennsylvania. The main aim of this study was to better understand how OUD affects this small town through interviewing individuals involved in local public health.

Methods:

This qualitative study consisted of key stakeholder interviews with ten individuals involved in local government, law enforcement, or healthcare. Questions centered around how OUD affects the local area, how current …

Improving The Implementation Of Home Blood Pressure Monitoring, Joshua Mairose, Geoffrey Mills, Md

Phase 1

Introduction: Home blood pressure monitoring (HBPM) has been shown to outperform traditional office readings in its association with cardiovascular disease (CVD) risk and ability to identify patients with white coat or masked hypertension. For these reasons, the 2017 ACC/AHA Guidelines included HBPM as part of its recommendations for hypertension management. Our project focused on improving the implementation of HBPM in an urban primary care practice with an end goal of increasing the number of patients that actively use home blood pressure cuffs and have access to them for future telemedicine visits.

Methods: A patient outreach process to increase HBPM uptake …

Medicaid Expansion’S Importance To Mental Health Care, Cameron Blazoski, Vittorio Maio, Pharmd, Ms, Msph

Phase 1

Introduction: The 2010 Patient Protection and Affordable Care Act established the Medicaid expansion, which incentivized states to expand their Medicaid programs to include individuals with incomes up to 138% of the federal poverty level. A significant population that stood to benefit from this health care expansion were Americans who suffer from a mental health disorder. This study was conducted to analyze the impact of Medicaid expansion on individuals with mental health and substance abuse disorders.

Methods: This political commentary was based on statistics on mental health in the United States derived from research studies and publications from federal …

Attitudes And Practices Of Providers Towards Continuity Of Care With Patients Prescribed Contraception, Jennifer Sachs, Grace Styklunas, Caroline King, Rebecca Mercier, Md

Phase 1

Introduction: The primary objective of this study is to evaluate provider attitudes and practices for follow-up counseling regarding patients prescribed contraception at women's health and primary care offices. As prescription contraception (oral contraceptive pills (OCPs), the patch, NuvaRing) are the most widely used reversible form of birth control in the United States, understanding provider practices and attitudes towards the necessity of follow-up for prescription contraception management is crucial.

Methods: An anonymous 16-item cross-sectional online Qualtrics survey queries providers for specialty and position, years in practice, as well as attitudes and practices regarding follow-up counseling for prescription contraception. The study cohort …

Differences In Hypertension And Obesity Levels Between High School Students In Philadelphia Urban And Suburban Areas, Joseph Gonnella, Jeremy Close, Md, Michael Bozzi, Md, Peri Levey, Kyle Prochno

Phase 1

Introduction: The prevalence of childhood obesity remains high, putting millions of children at risk of developing certain illnesses, such as diabetes and cardiovascular diseases. Therefore, it is vital to determine the true scope of the issue and reveal the risk factors associated with this condition. Since the objective of this study is to compare the obesity and hypertension levels between adolescents in Philadelphia urban and suburban high schools, these risk factors can be highlighted and analyzed.

Methods: Biometric and demographic data of Philadelphia urban students was collected from the Athlete Health Organization (AHO) pre-participation evaluations (PPEs) from 2016-2018. It was …

Comparing The Quality Of An In-Person Versus Virtual Diabetes Education Course Due To Covid 19 Pandemic, Allie Hamilton, Rickie Brawer, Phd

Phase 1

Introduction: Group diabetes education courses are proven to improve patients’ diabetes knowledge and metabolic control. Due to the COVID19 pandemic, Stephen Klein Wellness Center (SKWC) shifted their diabetes education course to an online format over Zoom. This study aimed to investigate difference in patient experience and course effectiveness between the in-person and online courses.

Methods: The population for this study includes 89 patients at SKWC that completed either the in-person or online diabetes education course. Participant satisfaction was measured with phone interviews and a survey. Course effectiveness was measured using surveys to assess the change in patients’ weight, amount of …

The Impact Of Doula-Supported Care On Stress Levels Of Women Receiving Opioid Addiction Treatment, Mariel Becker, Meghan Gannon, Phd, Msph

Phase 1

Introduction: Mothers suffering from opioid addiction are at high risk for experiencing extreme stress levels which prevents them from providing a healthy and nurturing environment for their family. The aim of this project is to explore if a doula-supported care team alleviates the parenting stress of new mothers participating in opioid addiction rehabilitation.

Methods: A total of 35-40 women in treatment at the Montair program for substance use disorder rehabilitation were recruited to participate in the City of Philadelphia’s Community Doula project. The Parenting Stress Index Score (PSI) was recorded and compared to a control group composed of women …

An Assessment Of Quality Improvement Strategies For The Implementation Of Certified Recovery Specialists In Treating Opioid Use Disorder At The Emergency Department At Jefferson, A. Cosmo Annese, Rickie Brawer, Phd, Mph, Ches

Phase 1

Introduction: Opioid overdose mortality rate in the U.S. has seen a staggering upward trend lately, more than tripling between the years 2000-2017. Although the use of Certified Recovery Specialists (CRSs) has been shown to improve overdose rates, relapse rates, and treatment completion rates for people with opioid use disorder (OUD), the optimal specialization of CRSs in healthcare settings has yet to be clearly defined. This project seeks the perspectives of CRSs and healthcare workers to gain insight into how CRSs can be most effectively implemented in the ED at Jefferson to treat OUD.

Methods: The study population includes CRSs and …

Pediatric Group Well Care Within The Maternal Treatment Education & Research (Mater) Program, Elizabeth Franko, Neera Goyal, Vanessa Short, Aditi Kale

Phase 1

Introduction:

This project aims to develop and implement group well care for mothers and infants receiving care for opioid use disorder (OUD). Groups would be composed of 5-7 mothers and infants of similar age with extension of sessions to allow group activities and parenting discussions. To evaluate acceptability and feasibility of this care model, we sought to examine attitudes and beliefs from these mothers, in particular the impacts of the COVID-19 pandemic.

Methods:

A qualitative interview study of women receiving treatment for OUD at Maternal Addiction Treatment Education and Research at Thomas Jefferson University from October – December 2020 was …

Impact Of Long-Term Doula Services On Maternal And Fetal Health Outcomes In Women In Treatment For Opioid Use Disorder, Saloni Parikh, Meghan Gannon, Phd, Msph

Phase 1

This study analyzed the impact of doula services on maternal and fetal health outcomes in pregnant women seeking treatment for opioid use disorder. Understanding the impact of doula services is critical in reducing inequities in health outcomes experienced by this vulnerable population. Retrospective and prospective data was collected from surveys, focus groups, and maternal and infant birth data from 100 women in treatment for opioid use disorder, with fifty utilizing doulas and fifty not utilizing doulas. Standardized data abstraction of quantitative and qualitative measures were collected into an SPSS database and Nvivo, respectively, and analyzed using SPSS. Measures of importance …

Race And Disordered Eating: A Narrative Review Of Current Literature, Casey Swann, Msed, Lee Pachter, Do, Elizabeth Liveright, Md, Meghan Gannon, Phd, Msph

Phase 1

Research Problem: Eating disorder literature has well-established a correlation between childhood trauma and development of eating disorder symptomology. One type of trauma that is often overlooked in eating disorder research is that of racial stress faced by ethnic minorities. The literature on racism and eating disorders tends to focus on the transdiagnostic construct of disordered eating behavior rather than specific DSM-5 diagnoses. As such, the current literature review examined the findings regarding associations between racial stressors and disordered eating behavior.

Methods: The current literature review between Nov 2007 and August 2020 searched 3 databases, PubMed, CINAHL, and PsycInfo for …

Seeking Control During Uncontrollable Times: Control Abilities And Religiosity Predict Stress During Covid-19, Shi Ann Shuna Khoo, Wei Xing Toh, Hwajin Yang

Research Collection School of Social Sciences

The COVID-19 pandemic has created an urgent need to understand the protective factors that can buffer individuals against psychological distress. We employed a latent-variable approach to examine how control-related factors such as religiosity, self-control, cognitive control, and health locus of control can act as resilience resources during stressful periods. We found that cognitive control emerged as a protective factor against COVID-19-related stress, whereas religiosity predicted a heightened level of stress. These results provide novel insights into control factors that can safeguard individuals' psychological well-being during crises such as a pandemic.

Digital News Media Coverage On Sexual And Gender-Based Violence In Kenya: Scoping The Impact Of The Covid-19 Pandemic, Clara Broekaert, Ceri-Lune Renneboog, Ferdinand Okwaro, Abdu Mohiddin, Marleen Temmerman

Obstetrics and Gynaecology, East Africa

Background: Sexual and gender-based violence (SGBV) in Kenya is frequently covered in digital news media. As a powerful influencer of public opinion, news media coverage can have a significant societal impact. This scoping review identifies the extent, nature, and themes of all available digital news media coverage on SGBV in Kenya from June 2019 to July 2020. It analyzes changes in coverage since the start of the COVID-19 pandemic.

Method: The methodological framework for scoping reviews developed by Arksey and O’Malley (2005) guided the scoping review. The selected articles were analyzed using NVivo.

Results: Analysis of the 340 …

Association Of Long-Term Trajectories Of Neighborhood Socioeconomic Status With Weight Change In Older Adults, Dong Zhang, Cici Bauer, Tiffany Powell-Wiley, Qian Xiao

Faculty, Staff and Student Publications

IMPORTANCE: Studying long-term changes in neighborhood socioeconomic status (SES) may help to better understand the associations between neighborhood exposure and weight outcomes and provide evidence supporting neighborhood interventions. Little previous research has been done to examine associations between neighborhood SES and weight loss, a risk factor associated with poor health outcomes in the older population.

OBJECTIVE: to determine whether improvements in neighborhood SES are associated with reduced likelihoods of excessive weight gain and excessive weight loss and whether declines are associated with increased likelihoods of these weight outcomes.

DESIGN, STUDY, AND PARTICIPANTS: This cohort study was conducted using data from …

Understanding The Impacts Of Emerging Infectious Disease (Eid) Media Exposure: The Case Of U.S. Ebola Virus Disease (Evd), Alicia Mason, Kevin Wright, Laura Lambert

Faculty Submissions

Introduction: Using the Extended Parallel Processing Model (EPPM) as a theoretical framework this study examines the impact of Ebola virus disease (EVD) media exposure on U.S. audience perceptions of the threat severity, personal susceptibility, and behavioral intentions to respond to the 2014 Ebola virus disease (EVD) threat.

Methods: Respondents included (n = 255) residents from the Midwest and Southern regions of U.S. Participants completed an online survey between 28 October and 3 December 2014 during the height of Ebola-related media coverage.

Results: Findings reveal that increased exposure to EVD media content was associated with increased threat severity and personal susceptibility. …

Acute Respiratory Distress Syndrome, George W Williams, Nathaniel K Berg, Alexander Reskallah, Xiaoyi Yuan, Holger K Eltzschig

Faculty, Staff and Student Publications

Acute Respiratory Distress Syndrome (ARDS) is defined as the rapid onset of non-cardiogenic pulmonary edema resulting in respiratory failure and hypoxemia. Efforts over the past 25 years, such as those of the ARDS and Prevention and Early Treatment of Acute Lung Injury (PETAL) Networks, have demonstrated a praiseworthy collaboration to further optimize the management of ARDS. However, improvements have been only moderate and ARDS remains a leading cause of mortality in the perioperative and critical care setting. Recently, the significant morbidity and mortality of ARDS have been emphasized by its high incidence in Coronavirus Disease 2019 (COVID-19) patients. A major …

2021 Final Butte Reduction Works (Brw) Phase I Quality Assurance Project Plan (Qapp) Revision 3. February 2021, Pioneer Technical Services, Inc.

Silver Bow Creek/Butte Area Superfund Site

No abstract provided.

Disparities In Sars-Cov-2 Positivity Rates: Associations With Race And Ethnicity, Harvey W Kaufman, Justin K Niles, David B. Nash

College of Population Health Faculty Papers

Numerous reports indicate that African Americans and Latinos are being affected disproportionately by coronavirus disease 2019 (COVID-19). Positivity rates have not been analyzed on scale because only 4 states report race/ethnicity as part of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) testing. Previous studies also have had little ability to control for many known risk factors to better identify the effects of COVID-19 on racial and ethnic communities. Using test results from a large national reference laboratory database that included patients from all 50 states and the District of Columbia, this study compared positivity rates for SARS-CoV-2 nucleic acid amplification …

The Quest For Conquering Covid-19: Updates From The Laboratory, David B. Nash

College of Population Health Faculty Papers

No abstract provided.

A Comparison Of Safety, Health, And Well-Being Risk Factors Across Five Occupational Samples, Ginger C. Hanson, Anjali Rameshbabu, Todd Bodner, Leslie Hammer, Diane S. Rohlman, Ryan Olson, Nancy Perrin, Bradley Wipfli, Kuehl S. Kerry, Lindsey Alley, Multiple Additional Authors

OHSU-PSU School of Public Health Faculty Publications and Presentations

Objective: The aim of this study was to present safety, health and well-being profiles of workers within five occupations: call center work (N = 139), corrections (N = 85), construction (N = 348), homecare (N = 149), and parks and recreation (N = 178).

Methods: Baseline data from the Data Repository of Oregon’s Healthy Workforce Center were used. Measures were compared with clinical healthcare guidelines and national norms.

Results: The prevalence of health and safety risks for adults was as follows: overweight (83.2%), high blood pressure (16.4%), injury causing lost work (9.9%), and reported pain (47.0%). Young workers were least …

Thematic Content Analysis Of Newspaper Coverage Of The Causes Of The Opioid Crisis, Joseph Daniel Eichenlaub, Essma Nasher

Sociology Faculty Publications and Presentations

This nation pioneered modern life. Now epic numbers of Americans are killing themselves with opioids to escape it”[1]. According to the CDC, In 2017 alone, 47,600 people died from opioid-related overdoses [2]. The current opioid epidemic has developed in three distinct waves. Initially there was a sharp rise in opioid overdoses after doctors began prescribing drugs such as Oxycontin, which they were assured by pharmaceutical companies were less addictive than traditional opiates. The second wave began around 2010, when a rapid …

Constructing Curriculum: Centering Identities In Sex Education, Jozette Belmont

Dissertations, Theses, and Capstone Projects

Sex education (sex ed) is a state-by-state and school-by-school issue, and there are no federal laws which mandate medically accurate education. In New York, schools only offer one semester of health education which often happens in the last semester of twelfth grade. Further, LGBTQIA+ people’s sexual health and identities are rarely mentioned. Therefore, this project asks: What are the ways sex ed curricula and policies in New York address the needs of LGBTQIA+ youth? To answer this question, I use a critical policy analysis to compare curriculum from the New York City Department of Education (NYCDOE) and Peer Health Exchange …

Corneal Disease And Air Pollution Levels In Detroit: Preliminary Results And Future Directions​, Sachin Ketkar, Matthew Silbergleit, Vaama Patel

Medical Student Research Symposium

Purpose: To determine if Detroit zip codes with elevated air pollution levels demonstrate increased incidence of corneal disease.

Background: 82 million people in the United States live in counties with air quality concentrations above the National Ambient Air Quality Standards. Air pollution’s detrimental effects on an individual’s health has been well documented. Much of this research has focused on the pulmonary system. The eye, another mucous membrane exposed to the external environment, has been largely ignored

Methods: After an initial literature review of similar studies, 14 corneal diseases and 5 pollutants were selected to be evaluated. Kresge Eye Institute’s patient …