International Public Health Commons^™

Barriers, Challenges And Fears From Immigrants In Access To Healthcare: A Proposal For Undocumented Immigrants To Being Insured, Jose Gonzalez-Ibarra

Community Engagement Student Work

Access to healthcare is a global issue that needs to be addressed. Worldwide organizations have put efforts in place to overcome this problem and offer solutions and recommendations to various countries. However, these efforts have not been entirely successful. Receiving the highest attainable standard of health or only receiving care is extremely difficult or impossible for individuals who are considered vulnerable such as immigrants, especially those who are undocumented immigrants. Through the recognition of barriers, challenges and fears from immigrants accessing healthcare and a shape of social determinants of health, institutions of government, nonprofit sector and community members organized could …

Improving Sepsis Bundle Compliance In The Emergency Department, Meredith Burkhart

The Eleanor Mann School of Nursing DNP Capstone Projects

Sepsis is one of the leading causes of death in hospitals across the nation. It is also the costliest condition a patient can be admitted to the hospital for. This proposal discussed the significance of sepsis in the local, national, and international level. It also covered the SEP-1 guidelines given by the Centers for Medicare and Medicaid. Prior to project implementation, the clinical site had at least one sepsis bundle fall out every month, meaning that a portion of the SEP-1 guideline was not met. This project introduced an alert system for the emergency department to respond to patients with …

The Policy Of Substance Abuse In Liberia: Analysis And Recommendations, Yamah Dolo

Community Engagement Student Work

Countries all over the globe are affected by substance abuse. Substance abuse is a traumatic issue that people around the world battle. Substance use has occurred for many years and seems to keep increasing. According to Parekh, “Substance use disorder (SUD) is complex a condition in which there is uncontrolled use of a substance despite harmful consequence.” (Parekh, 2017). Substance abuse has a significant effect on health, an individual’s well-being, families, relationships, and the post-war community. However, with the information on Liberia, little is known about the substance abuse cases. Liberia is a country that has no health, and there …

Limitations And Consequences Of Migrant And Refugee Healthcare- An Analysis Of The Current State Of Migrant Health, Meghan Herilla

Senior Theses

Migrants and refugees are an often-neglected specialized population in the field of healthcare, although making up over 14% of the world’s population.

The following paper examines the current state of migrant healthcare, including but not limited to ease of access, quality of care, and the accompanying stigmatization of immigrants in general. It then analyzes current policies, both national and global, influencing the healthcare of immigrants in both the United States and abroad. Finally, a comparison of migrant healthcare in the United States versus Thailand shows how the current U.S. healthcare system can be improved to better accommodate migrants and refugees. …

The Financing Need For Expanding Paid Maternity Leave To Support Breastfeeding In The Informal Sector In The Philippines, Valerie Gilbert Ulep, Paul Zambrano, Janice Datu-Sanguyo, Mireya Vilar-Compte, Graciela Materuel Belismelis, Rafael Pérez-Escamilla, Grace J. Carrol, Roger Mathisen

Department of Public Health Scholarship and Creative Works

In low- and middle-income countries, almost three-fourths of women in the labour force lack maternity protection. In the Philippines, current laws do not guarantee paid maternity leave to workers in the informal economy. A non-contributory maternity cash transfer to informal sector workers could be used to promote social equity and economic productivity and could provide health benefits by helping mothers meet their breastfeeding goals. The objective of the study is to provide a realistic cost estimate and to assess the financial feasibility of implementing a publicly financed, non-contributory maternity cash transfer programme to the informal sector in the Philippines. Using …

Emergent Trends In The Chinese Counterfeit Pharmaceutical Supply Chain And Opportunities For Public-Private Reform, Mary Monk

Senior Theses

This research seeks to identify and analyze emerging trends in the Chinese counterfeit pharmaceutical trade, extending from the supply chain’s point of origin to domestic and overseas retail dispensary. To aid readability, Chapter 1 of this thesis opens with key conclusions and policy recommendations for various Chinese and U.S. stakeholders based on the shortcomings identified in Chapter 5. Chapter 2 begins with a review of international roadblocks to diagnosing the issue, such as lack of consensus on working definitions and cross-border discrepancies in pharmaceutical oversight regulation. This section also provides a general overview of existing factors driving demand for counterfeit …

International Respiratory Infections Society Covid Research Conversations: Podcast 3 With Dr. Antoni Torres, Julio A. Ramirez, Antoni Torres

The University of Louisville Journal of Respiratory Infections

Section(s) Topics

1–4 Introductions

5 “Spanish” influenza

6–9 Dr. Torres’ personal thoughts and experiences

10 COVID-19 hospitalizations in Barcelona

11 A threatening phone call

12–13 Origin of the CIBERESUCICOVID project

14 Baseline characteristics

15 Bloodwork at hospital admission; ICU admission vs. day 3

16 Treatments

17 Complications

18 Outcomes related to interventions

19 Viral RNA load in plasma associated with critical illness and dysregulated response

20 Follow-up with health care workers

21 Medical education

22 Conclusions

23–26 Interleukin 6

27–29 Ventilatory approach

30–33 Post-COVID syndrome

34–38 Impact on health care workers

39–41 Holidays and COVID-19 infection

42–43 New paradigm for …

A New Chapter In The Life Of The Journal, Julio A. Ramirez

The University of Louisville Journal of Respiratory Infections

No abstract provided.

A Transition Of Uljri Leadership, Forest W. Arnold, Jose Bordon

The University of Louisville Journal of Respiratory Infections

No abstract provided.

Slowing The Spread Of Covid-19: Review Of “Social Distancing” Interventions Deployed By Public Transit In The United States And Canada, Camille Kamga, Penny Eickemeyer

Publications and Research

This paper presents a review of social distancing measures deployed by transit agencies in the United States and Canada during the COVID-19 pandemic and discusses how specific operators across the two countries have implemented changes. Challenges and impacts on their operations are also provided.

Social distancing is one of the community mitigation measures traditionally implemented during influenza pandemics and the novel coronavirus pandemic. Research has shown that social distancing is effective in containing the spread of disease. This is applicable to the current situation with the novel coronavirus, given the lack of effective vaccines and treatments in the United States …

International Respiratory Infections Society Covid Research Conversations: Podcast 2 With Dr. Michael S. Niederman And Dr. Edward J. Schenck, Julio A. Ramirez, Michael S. Niederman, Edward J. Schenck

The University of Louisville Journal of Respiratory Infections

Section(s) Topics

1–4 Introductions

5 COVID-19 in New York City

6–7 Telemedicine, long-term sequelae

8 Development of a multi-disciplinary ICU team

9–10 Treatment of ARDS, COVID-19 pathogenesis

11–12 Prioritizing treatment at research

13 Challenges in tracing the natural history of severe COVID-19

14–15 Experience with mechanically ventilated patients; non-pulmonary organ failure

16–17 Mapping COVID-19 trajectories by SOFA score

18–20 Findings: additive organ dysfunction, improving vs. worsening trajectory

21 ARDS therapeutic approaches

22 Clinical trials involving Cornell

23–25 Lessons learned: patient care, research, education, caring for critical care workers

26–30 2021 predictions: improved therapies and research, endemic COVID-19, vaccines

31–33 Prioritizing …

Defining Early And Late Clinical Outcomes In Patients With Sars-Cov-2 Pneumonia, Julio A. Ramirez, Jose Bordon, Rodrigo Cavallazzi, Stephen P. Furmanek, Jiapeng Huang, Timothy L. Wiemken, Forest W. Arnold

The University of Louisville Journal of Respiratory Infections

No abstract provided.

H1n1 Influenza Virus (Swine Flu): A Comprehensive Insight Into Escalating Catch-22 Scenarios, Muhammad Shahzaib, Ehsan Ul Haq

The University of Louisville Journal of Respiratory Infections

Introduction: Viruses have always been a major cause of various disastrous pandemics in mankind’s history. H1N1 became a threat when its original strain was first discovered back in the swine flu pandemic of 2009. It became highly catastrophic on a large scale because none of the therapeutic interventions and methodologies that were already present at the time were effective against the virus.

Methods: A vast amount of literature and research is available regarding H1N1 influenza from different reputable sources online. The data were gathered with the contrasting and relative situations of 1918 and 2009 pandemics in mind. The overall extracted …

Factors Associated With Chronic Kidney Disease Of Non-Traditional Causes Among Children In Guatemala, Alejandro Cerón, Brooke M. Ramay, Luis Pablo Méndez-Alburez, Randall Lou-Meda

Anthropology: Faculty Scholarship

Objective. To identify factors associated with chronic kidney disease of non-traditional causes among children in Guatemala. Methods. A cross-sectional survey was conducted. The study population was all pediatric patients with stage 5 chronic kidney disease active in FUNDANIER’s pediatric nephrology unit (N = 156). Simple random sampling led to a total of 100 participants. Data collection consisted of a questionnaire addressing individual and household characteristics, access and utilization of health care, and place of residence when the disease began. Chronic kidney disease etiology was obtained from medical records. Municipality-level secondary data were collected. Descriptive statistics were estimated. Logistic regression was …

International Respiratory Infections Society Covid Research Conversations: Podcast 1 With Dr. Francesco Blasi, Julio A. Ramirez Md, Francesco Blasi Md, Phd

The University of Louisville Journal of Respiratory Infections

Section(s) Topics

1–2 Introductions

3 Foundations of best practice

4 COVID-19 as stimulus for innovation

5 Adapting and evolving therapeutic approach

6 Age and comorbidities as risk factors

7 Over-capacity ICU

8 Adapting the ER for COVID-19

9 Training personnel for COVID-19

10 Psychological support, healthcare heroes, and COVID fatigue

11 Increased oxygen requirement

12–13 Milan’s multi-disciplinary unit

14 Standardizing respiratory support measures

15 Nutrition, sedation, and life support

16 CPAP successes and failures

17 Prone and lateral positioning of patients on CPAP

18 Different COVID-19 phenotypes?

19 Thromboembolism risk score, age, and comorbidities

20 Cardiorespiratory considerations: hypertension, echocardiography

21 …

An Update On The Leading Covid-19 Vaccines, Ahmed A. Eladely, Javaria Anwer Mbbs, Ashwini Gotimukul Mbbs, Manish Kc Mbbs, Jessica Petrey Msls, Alex Glynn Ma, Ruth M. Carrico Phd, Dnp, Julio A. Ramirez Md

The University of Louisville Journal of Respiratory Infections

We reviewed the COVID-19 vaccines that reached phase III of clinical development. For each of the 10 vaccines identified, we described the technology used for vaccine development, the available data from phase III clinical trials, data on vaccine safety, and the role of new SARS-CoV-2 variants on vaccine efficacy.

Cities, Covid-19, And The New Normal, Singapore Management University

Perspectives@SMU

As cities recover and reorganise post-pandemic, policymakers should take into consideration how communities’ mobility, livability, security and sociability are affected

Predictive Modeling And Estimation Of The Doubling Time Of Confirmed Cases Of Covid-19 In Niger, Ibrahim Sidi Zakari, Hadiza Galadima

Community & Environmental Health Faculty Publications

Modeling is increasingly used to assess scenarios and make projections on the future course of new coronavirus disease. This allows for better planning of care as well as a relaxation or tightening of the restrictive measures decreed by the government and the health authorities. The data analyzed in this study covers the period from March 19 to June 05, 2020 and allowed predictions of new cases of COVID-19 based on a growth model with a growth rate that changes linearly over time. In addition, we calculated and predicted the doubling time of the number of positive cases in each region …

Mortalidad Por Infarto Agudo De Miocardio En Guatemala 2018: Patrones E Inequidades, Alejandro Cerón, Gila Goldstein

Anthropology: Faculty Scholarship

El presente estudio busca analizar la mortalidad por infarto agudo de miocardio (IAM) en Guatemala con el propósito de identificar posibles criterios epidemiológicos que orienten la priorización de acciones de salud pública. El riesgo de morir de IAM en Guatemala muestra marcadas desigualdades por departamento, las que son aún más marcadas al comparar por municipio. El riesgo de morir es también más alto en personas mestizas o ladinas, en niveles educativos bajos, y en personas que se dedican a ocupaciones elementales. Deberían implementarse medidas de salud pública orientadas a los municipios y grupos en mayor riesgo de morir de IAM. …

Sars-Cov-2 Early Infection Signature Identified Potential Key Infection Mechanisms And Drug Targets, Yue Li, Ashley Duche, Michael R. Sayer, Don Roosan, Farid G. Khalafalla, Rennolds S. Ostrom, Jennifer Totonchy, Moom Roosan

Pharmacy Faculty Articles and Research

Background

The ongoing COVID-19 outbreak has caused devastating mortality and posed a significant threat to public health worldwide. Despite the severity of this illness and 2.3 million worldwide deaths, the disease mechanism is mostly unknown. Previous studies that characterized differential gene expression due to SARS-CoV-2 infection lacked robust validation. Although vaccines are now available, effective treatment options are still out of reach.

Results

To characterize the transcriptional activity of SARS-CoV-2 infection, a gene signature consisting of 25 genes was generated using a publicly available RNA-Sequencing (RNA-Seq) dataset of cultured cells infected with SARS-CoV-2. The signature estimated infection level accurately in …

A Comparative Analysis Of The Knowledge And Stigmatizing Attitude Of Ghanaians And Nigerians Towards Covid-19 Survivors, Emmanuel Lamptey, Dorcas Serwaa, Maxwell Hubert Antwi, Theckla Ikome Ms, Nkechi Odogwu

Journal of Refugee & Global Health

Introduction: In Africa, COVID-19 associated stigmatization still remains the contextual factor that poses a challenge for the mitigation and suppression of COVID-19 spread, especially among the illiterate populations. This comparative study was therefore conducted to assess the knowledge and willingness of Ghanaians and Nigerians to associate with COVID-19 survivors.

Methods: A cross-sectional study was conducted to collect information from 290 Ghanaian and 220 Nigerian nationals aged 18 years and above between 11th July-30th October 2020. An electronic-based questionnaire was developed to collect information on the public. The data were analyzed with SPSS v 22 and factors influencing knowledge and willingness …

Human Rights Education In Humanitarian Settings: Opportunities And Challenges, Megan Devonald, Nicola Jones, Silvia Guglielmi, Jennifer Seager, Sarah Baird

Global Health Faculty Publications

Human rights education in humanitarian settings provides an opportunity for adolescent refugees to understand and exercise their human rights, respect the rights of others, and gain active citizenship skills. This paper examines non-formal education programmes and the extent to which they embed education about, through and for human rights; it draws on mixed method data from two diverse contexts–Rohingya refugees in Bangladesh and Syrian refugees in Jordan. We find stark differences in how human rights are reflected in non-formal education programming for refugees. In Jordan, the Makani programme integrates human rights across subjects and teacher pedagogy, and fosters skills …

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 …

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 …

"There Is Always Violence": An Exploratory Study Of Phnom Penh, Cambodia, Street-Involved Children, Jarrett D. Davis, Glenn M. Miles, Sean Blackburn, Erika Mosebach-Kornelsen

Dignity: A Journal of Analysis of Exploitation and Violence

As the economic center of Cambodia, Phnom Penh has long been a hotspot for street-involved children and families. While violence is a common facet of life on the street, risk and vulnerability among children is notoriously difficult to measure. Most large-scale surveys tend to sample children within homes and schools, which overlook street-involved children who are commonly unregistered, irregularly attend school, and live outside of houses. This research paper is one of a series of studies on such groups in Southeast Asia. The study conducted 94 semi-structured interviews with street-involved children eight to 18 years of age in Phnom Penh. …

Malaria In Southern Venezuela: The Hottest Hotspot In Latin America, Maria Eugenia Grillet, Jorge E. Moreno, Juan V. Hernández-Villena, Maria F. Vincenti-González, Oscar Noya, Adriana Tami, Alberto Paniz-Mondolfi, Martin Llewellyn, Rachel Lowe, Ananias A. Escalante, Jan E. Conn

Harold W. Manter Laboratory of Parasitology: Library Materials

Malaria elimination in Latin America is becoming an elusive goal. Malaria cases reached a historical ~1 million in 2017 and 2018, with Venezuela contributing 53% and 51% of those cases, respectively. Historically, malaria incidence in southern Venezuela has accounted for most of the country’s total number of cases. The efficient deployment of disease prevention measures and prediction of disease spread to new regions requires an in-depth understanding of spatial heterogeneity on malaria transmission dynamics. Herein, we characterized the spatial epidemiology of malaria in southern Venezuela from 2007 through 2017 and described the extent to which malaria distribution has changed country-wide …

Community As Medicine: A Trauma-Informed Yoga Program For Multi-Cultural Female Immigrants Identified In The Primary Care Setting, Katherine Rizzolo, Sean Lena, Maha Jaber, Jessica Schaumburg, Kiana Vakil-Gilani, Nicole Rebusi, Dianna Stade, Adriana Nadeau, Nicoleta Toma, Brian King, Lesley Gordon

Journal of Maine Medical Center

Introduction: The immigrant population in Maine represents a unique group of patients with complicated health care needs due to cultural, linguistic, and systemic barriers. We sought to bridge gaps in health access for immigrant women by expanding and integrating community resources through the development and evaluation of a trauma-informed yoga class.

Methods: A needs assessment via a focus group with immigrant women revealed barriers to care and community health needs. Health partners of the immigrant community were identified via word of mouth and a Google search. Yoga participants were recruited in the primary care clinic and by community outreach. Participants …

Antibiotics And Antimicrobial Resistance In The Covid-19 Era: Perspective From Resource-Limited Settings, Mentor Ali Ber Lucien, Michael F. Canarie, Paul E. Kilgore, Gladzin Jean-Denis, Natael Fénélon, Manise Pierre, Mauricio Cerpa, Gerard A. Joseph, Gina Maki, Marcus J. Zervos, Patrick Dely, Jacques Boncy, Hatim Sati, Ana Del Rio, Pilar Ramon-Pardo

Department of Pharmacy Practice

The dissemination of COVID-19 around the globe has been followed by an increased consumption of antibiotics. This is related to the concern for bacterial superinfection in COVID-19 patients. The identification of bacterial pathogens is challenging in low and middle income countries (LMIC), as there are no readily-available and cost-effective clinical or biological markers that can effectively discriminate between bacterial and viral infections. Fortunately, faced with the threat of COVID-19 spread, there has been a growing awareness of the importance of antimicrobial stewardship programs, as well as infection prevention and control measures that could help reduce the microbial load and hence …

Impact Of Heavy Metals In Ambient Air In Insulin Resistance Of Shipyard Welders In Northern Taiwan, Ting-Yao Su, Hueiwang Anna Jeng, Yuan-Ting Hsu, Ching-Huang Lai, Chih-Hong Pan

Community & Environmental Health Faculty Publications

Exposure to metals poses potential health risks, including insulin resistance (IR), to those exposed to them in excess. Limited studies have examined such risks in occupational workers, including welders, and these have yielded inconsistent results. Thus, we examined the associations between exposure to welding metals and IR in welders. We recruited 78 welders and 75 administrative staff from a shipyard located in northern Taiwan. Personal exposure to heavy metals, including chromium (Cr), manganese (Mn), iron (Fe), nickel (Ni), copper (Cu), zinc (Zn), and cadmium (Cd), was monitored through particulate matter with an aerodynamic diameter of less than 2.5 μm (PM …

Corruption: An Impediment To Delivering Pathology And Laboratory Services In Resource-Limited Settings, Emily H. Glynn Md, Timothy Amukele, Taryn Vian

Nursing and Health Professions Faculty Research and Publications

OBJECTIVES

Corruption is a widely acknowledged problem in the health sector of low- and middle-income countries (LMICs). Yet, little is known about the types of corruption that affect the delivery of pathology and laboratory medicine (PALM) services. This review is a first step at examine PALM corruption risks.

METHODS

We performed a critical review of medical literature focused on health sector corruption in LMICs. To provide context, we categorized cases of lab-related fraud and abuse in the U.S.

RESULTS

Forms of corruption in LMICs that may impact the provision of PALM services include informal payments, absenteeism, theft and diversion, kickbacks, …