International Public Health Commons^™

Changes In Preventive Care Utilisation And Its Influencing Factors Among Chinese Adults Before And After The Healthcare Reform: Cross-Sectional Evidence From The China Health And Nutrition Survey In 2004-2015, Tingting Wu, Wei Wei Liu, Mao Zou, Xun Lei, Qiang Yang, Manoj Sharma, Yong Zhao, Zu Min Shi

Environmental & Global Health Faculty Research

Objective China launched its health reform in 2009. This study aimed to assess changes in preventive care utilisation (PCU) and its relationship with the healthcare reform. Design A cross-sectional study using demographic characteristics, socioeconomic status, environmental factors, and lifestyle and health status data of adults from five waves (2004–2015) of the China Health and Nutrition Survey (CHNS) was conducted. Multilevel mixed-effects logistic regression models were used. Setting Data were derived from urban and rural communities of nine provinces in China. Participants Data were obtained from five waves of the CHNS, with 9960 participants in 2004, 9888 in 2006, 10 286 …

The Role Of Paraprofessionals In The Mental Health Structure Of India, Amy Abraham

Senior Theses

The mental health treatment gap in India is part of a growing public health crisis, with over 95% of those in need of services never receiving them. Over 197 million Indians suffer from at least one diagnosable mental health disorder, and this number continues to grow given the treatment gap. The treatment gap is a result of four major factors: lack of government support, stigma, limited treatment facilities, and the dearth of professionals able to provide treatment. The current study aimed to analyze several factors of paraprofessional led mental health interventions including setting, treatments delivered, treatment models, and client outcomes. …

Gastrointestinal Symptoms In Patients With Covid-19, Mohammed Abbas, Rafik Elbeblawy, Islam Gadelmoula, Suvarna Rekha, Bettina Sinanova, Jose Bordon

The University of Louisville Journal of Respiratory Infections

Introduction: Though coronavirus disease 2019 (COVID-19) is predominantly a respiratory illness, a growing number of studies reported gastrointestinal (GI) symptoms among these patients. We examined the incidence of GI symptoms in patients with COVID-19 and GI symptoms as the initial presentation of the disease.

Methods: We examined peer-reviewed studies in English of patients with COVID-19 that reported GI symptoms. We searched PubMed and Google Scholar for articles published up to June 30, 2020, by using the keywords ``COVID-19,'' ``Coronavirus,'' ``severe acute respiratory syndrome coronavirus 2,'', ``SARS-CoV-2,'' ``gastrointestinal tract,'' ``gastrointestinal diseases,'' and ``gastrointestinal symptoms and signs.'' Studies with fewer than 30 …

Midline Report: Accelerating Action To End Child Marriage In Bangladesh, Masuma Billah, Eashita Haque, Surojit Kundu, Md. Saddam Hossain, Momoe Makino, Sajeda Amin

Poverty, Gender, and Youth

This report describes results from the midline survey of Accelerating Action to End Child Marriage in Bangladesh. The objective of the program is to identify effective and scalable approaches to end child marriage by empowering girls and communities. To bring about social norms change, the program experiments with alternative means of community engagement that can be offered in conjunction with skills-development opportunities for adolescent girls. The program is being assessed in a multi-arm cluster randomized trial. This report explores the impact on the prevalence of child marriage in two districts of Bangladesh as well as on a range of other …

Availability Of Over-The-Counter Antibiotics In Guatemalan Corner Stores, Purificación Moreno, Alejandro Cerón, Karen Sosa, Marinees Morales, Laura M. Grajeda, Maria Renee Lopez, John P. Mccraken, Celia Cordón-Rosales, Guy H. Palmer, Douglas R. Call, Brooke M. Ramay

Anthropology: Faculty Scholarship

Widespread availability of antibiotics without prescription potentially facilitates overuse and contributes to selection pressure for antimicrobial resistant bacteria. Prior to this study, anecdotal observations in Guatemala identified corner stores as primary antibiotic dispensaries, where people purchase antibiotics without prescriptions. We carried out a cross sectional study to document the number and types of antibiotics available in corner stores, in four study areas in Guatemala. A total of 443 corner stores were surveyed, of which 295 (67%) sold antibiotics. The most commonly available antibiotics were amoxicillin, found in 246/295 (83%) stores, and tetracycline, found in 195/295 (66%) stores. Over the counter …

A Review Of Quarantine Period In Relation To Incubation Period Of Sars-Cov-2, Satya Rashmit Durugu, Hammad Tanzeem, Divya Menghani, Zahid Imran, Priya Krishnan

The University of Louisville Journal of Respiratory Infections

Introduction: The period from exposure to a potential pathogen to the manifestation of symptoms, i.e.  the incubation period, is time the virus spends replicating in the host. An estimation of this period and subsequent quarantine of the host can limit potential spread, particularly in asymptomatic carriers. Effective contact tracing, length of self-quarantine, repeat testing, and understanding of disease transmission are all contingent on a true estimation of this incubation period.

Methods: Articles in English published since December 1st, 2019, on Google scholar, PubMed, and Research Gate, along with bulletins from the World Health Organization and the Centers for Disease Control …

Perinatal Anxiety And Depression During The Covid 19 Pandemic, Helen Xumin Chen, Nancy Selix, Marcianna Nosek

DNP Qualifying Manuscripts

Abstract

The novel coronavirus disease 2019 (COVID-19) outbreak places perinatal women at higher risk of developing anxiety and depression. Uncertainty, fear, and confusion in medical, social, economic, occupational and political aspects of life in the US add to existing stressors that perinatal women experience. To optimize the quality of perinatal care during the pandemic, appropriate mental health interventions must be implemented to prevent and alleviate perinatal anxiety and depression and improve maternal and infant outcomes. Measures include increased screening, non-pharmacologic and/or pharmacologic interventions and the use of telehealth for care delivery.

Keywords: perinatal anxiety, perinatal depression, COVID-19, SARS CoV-2, maternal …

Covid-19 Is Associated With Increased Severity In Pregnant Women, Zahid Imran, Vidyulata Salunkhe, Ahmed A. Eladely, Ahmed Abdelhaleem, Satya Durugu, Daisy Sangroula

The University of Louisville Journal of Respiratory Infections

Introduction: The COVID-19 pandemic originated in China in late 2019; the number of cases is increasing with 2,104,346 cases and 116,140 deaths in the United States as of June 16, 2020. Pregnant women are a vulnerable population in epidemics or pandemics. This review is designed to look in detail at the severity of COVID-19 in pregnant women compared to non-pregnant women of reproductive age.

Methods: Literature searches on PubMed, Google Scholar, the Lancet, and Web of Science were conducted.

Results: We found evidence of increased risk for severe disease and distinctive symptoms among pregnant women diagnosed with COVID-19 compared …

Practice-Based Learning: Establishing Simple Monitoring Systems To Support Sgbv Programming In Refugee Settings, Chi-Chi Undie, Josephine Ngebeh, Jane Harriet Namwebya, Michael Gaitho, George Odwe, Nachela Chelwa, Harriet Birungi, Michael Mbizvo

Reproductive Health

Implementers of sexual and gender-based violence programs in refugee settings are typically eager to learn about the extent to which their programs are making a difference in the lives of those they serve. Basic monitoring information can help address this imperative without unduly burdening program implementers with time-consuming evaluations. The Sauti/VOICE project is guiding adaptation and implementation of evidence-based SGBV interventions in refugee contexts. These interventions are implemented by UNHCR partners in eight countries in the East, Horn, and Great Lakes region of Africa. Although Sauti/VOICE is primarily focused on integrating tested SGBV interventions into refugee contexts, monitoring the implementation …

Practice-Based Learning: Medico-Legal Evidence Collection As Part Of Post-Rape Care In Refugee Contexts, Michael Gaitho, Ronald Kotut, Anne Ngunjiri, Jane T. Thiomi, Josephine Ngebeh, Chi-Chi Undie

Reproductive Health

Health care providers collect an array of documentation and specimens to support criminal investigations. Such documentation and specimens are referred to as “medico-legal” or “forensic” evidence, and in the case of rape, include a survivor’s documented injuries and emotional state at the time of examination, as well as samples and specimens from the survivor’s body or clothing. For survivors of rape and defilement who want to obtain legal justice, medico-legal evidence is critical. In African countries, health providers and the police are depended upon to ensure such evidence is collected, but medico-legal evidence collection can present challenges. Evidence-based interventions are …

Looking Beyond A Rare Presentation Of Betel Nut Use In A North American Patient- An Opportunity For Lessons And Intervention In Global Health And Gender Equity, Muhammad O. Zaman, Thomas M. Park, Vikas Patel, Riley G. Jones

Journal of Refugee & Global Health

Betel nut is estimated to be the fourth most common psychoactive substance used globally behind caffeine, alcohol, and nicotine with 600 million global users. Betel nut use has a strong association with oral cancer and many other systemic effects including oral submucosal fibrosis. Although North American use is rare, its enduring effects may surface long after use posing a diagnostic challenge to practitioners caring for an increasingly global diaspora. Herein, we present a patient with severe trismus due to advanced oral submucosal fibrosis who was unexpectedly found to be importing and using Betel nut for over thirty years after immigrating. …

Guatemala: Conocimientos, Actitudes Y Prácticas Frente A La Covid-19—Perspectivas De 144 Informantes Clave En 10 Municipios Con Mayoría De Población Indígena. Resultados De La Segunda Ronda De Recolección De Datos, 21–26 Julio De 2020, Population Council

Poverty, Gender, and Youth

El Population Council tiene una asociación de larga data con las comunidades indígenas y rurales de Guatemala a través del programa Abriendo Oportunidades. Para mediados de agosto de 2020, las restricciones gubernamentales permitían la movilidad entre departamentos a nivel nacional, las clases siguen suspendidas y se permite a las empresas operar en conformidad con los protocolos de prevención de COVID-19. Para entender mejor los conocimientos perspectivas y la evolución de las necesidades relacionadas con la pandemia por la COVID-19 en Guatemala, realizamos una segunda ronda de encuestas telefónicas con 144 informantes clave en 10 municipios con mayoría de población indígena. …

Guatemala: Covid-19 Knowledge, Attitudes And Practices—Perspectives From 144 Key Informants In 10 Indigenous Municipalities. Results From The Second Round Of Data Collection, July 21–26, 2020, Population Council

Poverty, Gender, and Youth

The Population Council has a longstanding partnership with indigenous communities in rural Guatemala through the Abriendo Oportunidades program. In compliance with COVID-19 prevention protocols, as of mid-August 2020 government restrictions allowed for inter-district mobility at the national level, classes remain suspended, and businesses were allowed to operate. To better understand indigenous knowledge, perspectives, and evolution of needs related to the COVID-19 pandemic in Guatemala, we conducted a second round of phone interviews with 144 key informants in ten municipalities. The second round represents 75% (n = 108) of the cohort interviewed April 14–18, 2020. Thirty-six new informants were recruited to …

Municipios Indígenas De Guatemala: Conocimientos, Actitudes Y Prácticas Frente A La Covid-19 Resultados De La Segunda Ronda De Recopilación De Datos, Population Council

Poverty, Gender, and Youth

No abstract provided.

Gaining A “Foothold” On The Diagnosis Of Leishmaniasis, Brent M. Troy, Rebecca Hart, Navjyot Vidwan, Bethany Hodge

Journal of Refugee & Global Health

Pediatric refugees and immigrants may present with unusual diagnoses due to their extensive migration and potential harsh conditions in travel. Trauma and family separation add to the difficulty of obtaining a history of exposures. We report a case of one of the more commonly neglected tropical diseases, Leishmaniasis. A 15-year-old male refugee patient presented to the hospital with ulcerative lesions to his legs. His migration history was extensive, starting in Central Africa with travel to South America, followed by migration through Central America to Texas. The patient developed ulcerative lesions on his legs, and he was brought to the children’s …

Intensive Animal Farming Conditions Are A Major Threat To Global Health, Cynthia Schuck-Paim

Animal Sentience

Wiebers & Feigin accurately propose that reducing the risks posed by infectious disease outbreaks and other global health challenges will depend critically on transitioning away from intensive animal farming practices. Creating the right incentive structure for this transition to happen is one of the great challenges in the years to come, but a much-needed step to ensure the health and well-being of current and future generations.

Asking And Telling: An Assessment Of The Feasibility Of Screening Children For Sexual Violence In Kenyan School And Health Facility Contexts, Chi-Chi Undie, Margaret Mak'anyengo

Reproductive Health

Although sexual violence against children is increasingly prevalent in Kenya, documented and tested interventions for proactively identifying child survivors and providing them with care are currently nonexistent. This study aimed to determine the feasibility of screening children for SV in both school and health facility settings, and of providing child survivors identified through this process with access to care. The four-component intervention, implemented from January through April 2017, involved parent dialogues; student sensitization; provider training to administer a child-friendly screening tool and respond to child survivors; and SV screening, paired with SV service provision. As noted in this report, the …

Factors Associated With Binge Drinking During The Transition Into Adulthood: Exploring Associations Within Two Distinct Young Adult Age Ranges, Tamara Leech, Sarah Jacobs, Denis Watson

Department of Public Health Scholarship and Creative Works

Background:

Binge drinking among young adults aged 18-21 years has declined over the past decade, but binge drinking rates among people 22-25 years old have remained largely the same. This steady trend in later years represents a departure from the traditional course of maturing out of risky alcohol use, perhaps because young adults are delaying the transition into adulthood.

Aims:

This paper explores the relationship between binge drinking and aspects of the transition into adulthood that could inform interventions targeting these two distinct groups of young adults.

Methods:

We use survey data on 1,081 young adults aged 18-25 living in …

The Incidence Of Common Respiratory Viruses During The Covid-19 Pandemic: Results From The Louisville Covid-19 Epidemiology Study, Brian C. Bohn Pharmd, Bcidp, Ashley M. Wilde Pharmd, Bcps-Aq Id, Sarah E. Moore Pharmd, Matthew Song Pharmd, Bcidp, Clayton J. Patross Pharmd, Bcps, Alan D. Junkins Phd, D(Abmm), Paul Schulz Md, Julio A. Ramirez Md Facp

The University of Louisville Journal of Respiratory Infections

Introduction: Social distancing has been utilized during the COVID-19 pandemic to reduce the spread of SARS-CoV-2; it is also expected to reduce the spread of common respiratory viruses.

Methods: This retrospective, descriptive study assessed the rate of positivity of common respiratory viruses from a commercially available respiratory pathogen panel across a five-hospital health system during four-week periods within March to April of 2019 and 2020.

Results: During the four-week period in 2019, the percent positivity of common respiratory viruses from week 1 to week 4 decreased from 6 to 32% among the four included viruses. In the comparator period in …

Impact Of 2012 Spanish Health Care Reform On Hiv-Positive Immigrants: A Mixed Methods Approach, Megi Gogishvili

Dissertations and Theses

Background: The financial crisis of 2008 hit Spain hard. As a consequence, the government took multiple austerity measures, including reforms in the healthcare system in 2012. Specifically, the government reduced the budget for health and social services by 13.7% in 2012.The reduction was further followed with structural changes via the 2012 Royal Decree Law (RDL) and Royal Decree (RD).The 2012 RDL and RD entailed broad areas of action,but most importantly the Spanish National Health System (SNS) no longer covered undocumented immigrants. The 2012 RDL and RD excluded approximately 500,000 undocumented immigrants from SNS.

The number of immigrants in Spain has …