International Public Health Commons^™

Sociocultural Interactions Of Cuban Doctors Participating In The More Doctors Program In Brazil, Joaquin Molina, Carlos Eduardo Siqueira, Leonardo Cavalcanti

Gastón Institute Publications

This book focuses on a different and underexplored attribute of the More Doctors Program by surveying doctors in the feld with the purpose of identifying important answers regarding the sociocultural interactions of Cuban doctors recruited by the program and of producing knowledge, while also making improvements in the participation, still limited, of foreign doctors in the primary care services offered by SUS. It proposes to induce perceptions, memories, and possible explanations to anyone who is somehow associated with the Program’s development, especially those committed to universal health care and primary assistance as the only paths to an effective health system. …

Women's Lives In Times Of Zika, Ana Rosa Linde, Carlos Eduardo Siqueira

Gastón Institute Publications

Zika virus infection during pregnancy is a cause of congenital brain abnormalities. Its consequences to pregnancies has made governments, national and international agencies issue advices and recommendations to women. There is a clear need to investigate how the Zika outbreak affects the decisions that women take concerning their lives and the life of their families, as well as how women are psychologically and emotionally dealing with the outbreak. We conducted a qualitative study to address the impact of the Zika epidemic on the family life of women living in Brazil, Puerto Rico, and the US, who were affected by it …

Three Essays On Maternal And Child Health, Mandar V. Bodas

Theses and Dissertations

This dissertation is a collection of three separate essays on the health of women and children. In the first essay, I along with my co-authors, analyzed the impact of two large, national-level health policies (the Janani Suraksha Yojana (JSY) and the National Rural Health Mission (NRHM)) on maternal health outcomes (proportion of institutional deliveries) in India. We used data from the India Human Development Survey (IHDS) and found that the JSY and the NRHM had a greater impact on institutional deliveries in high-focus states. We also found that the conditions of the public health facilities, did not change after the …

Family Planning And Hiv Interventions Among Women In Low-Income Settings, Steven P. Masiano

Theses and Dissertations

This dissertation examines the effectiveness of interventions related to family planning and the uptake of HIV-related preventive services among women in low-income settings. Women in low-income settings and living with HIV face many barriers to care, including limited access to services for family planning and HIV-related preventive care. At the same time, national, regional, and global efforts are looking for interventions to help control rapid population growth, create an HIV-free generation, and provide adequate preventive care for those living with HIV. This dissertation cuts across these issues and can help to inform debate and policies to address these issues.

This …

Simulations For Designing And Interpreting Intervention Trials In Infectious Diseases., M Elizabeth Halloran, Kari Auranen, Sarah Baird, Nicole E Basta, Steven E Bellan, +Several Additional Authors

Global Health Faculty Publications

BACKGROUND: Interventions in infectious diseases can have both direct effects on individuals who receive the intervention as well as indirect effects in the population. In addition, intervention combinations can have complex interactions at the population level, which are often difficult to adequately assess with standard study designs and analytical methods.

DISCUSSION: Herein, we urge the adoption of a new paradigm for the design and interpretation of intervention trials in infectious diseases, particularly with regard to emerging infectious diseases, one that more accurately reflects the dynamics of the transmission process. In an increasingly complex world, simulations can explicitly represent transmission dynamics, …

Socio-Cultural Determinants Of Physical Activity Across The Life Course: A 'Determinants Of Diet And Physical Activity' (Dedipac) Umbrella Systematic Literature Review, Lina Jaeschke, Astrid Steinbrecher, Agnes Luzak, Anna Puggina, Katina Aleksovska, Christoph Buck, Con Burns, Greet Cardon, Angela Carlin, Simon Chantal, Donatella Ciarapica, Giancarlo Condello, Tara Coppinger, Cristina Cortis, Marieke De Craemer, Sara D'Haese, Andrea Di Blasio, Sylvia Hansen, Licia Iacoviello, Johann Issartel, Pascal Izzicupo, Martina Kanning, Aileen Kennedy, Fiona Chun Man Ling, Giorgio Napolitano, Julie Anne Nazare, Camille Perchoux, Angela Polito, Walter Ricciardi, Alessandra Sannella, Wolfgang Schlicht, Rhoda Sohun

Publications

Objective: Regular physical activity (PA) reduces the risk of disease and premature death. Knowing factors associated with PA might help reducing the disease and economic burden caused by low activity. Studies suggest that socio-cultural factors may affect PA, but systematic overviews of findings across the life course are scarce. This umbrella systematic literature review (SLR) summarizes and evaluates available evidence on socio-cultural determinants of PA in children, adolescents, and adults. Methods: This manuscript was drafted following the recommendations of the 'Preferred Reporting Items for Systematic reviews and Meta-Analyses' (PRISMA) checklist. The MEDLINE, Web of Science, Scopus, and SPORTDiscus databases were …

Worldwide Trends In Body-Mass Index, Underweight, Overweight, And Obesity From 1975 To 2016: A Pooled Analysis Of 2416 Population-Based Measurement Studies In 128·9 Million Children, Adolescents, And Adults, James Bentham, Mariachiara Di Cesare, Ver Bilano, Honor Bixby, Bin Zhou, Gretchen A. Stevens, Leanne M. Riley, Cristina Taddei, Kaveh Hajifathalian, Yuan Lu, Con Burns, Tara Coppinger, Janette Walton, Stefan Savin, Melanie J. Cowan, Christopher J. Paciorek, Adela Chirita-Emandi, Alison J. Hayes, Joanne Katz, Roya Kelishadi, Andre Pascal Kengne, Young Ho Khang, Avula Laxmaiah, Yanping Li, Jun Ma, J. Jaime Miranda, Aya Mostafa, Martin Neovius, Cristina Padez, Lekhraj Rampal, Aubrianna Zhu, James E. Bennett, Goodarz Danaei, Zulfiqar A. Bhutta, Majid Ezzati

Publications

Background Underweight, overweight, and obesity in childhood and adolescence are associated with adverse health consequences throughout the life-course. Our aim was to estimate worldwide trends in mean body-mass index (BMI) and a comprehensive set of BMI categories that cover underweight to obesity in children and adolescents, and to compare trends with those of adults. Methods We pooled 2416 population-based studies with measurements of height and weight on 128·9 million participants aged 5 years and older, including 31·5 million aged 5–19 years. We used a Bayesian hierarchical model to estimate trends from 1975 to 2016 in 200 countries for mean BMI …

In Liberia: A Silent Health Care Catastrophe Replaces A Viral One, Clarissa Sosin

Capstones

Underfunded and understaffed, the structural issues within the Liberian healthcare system were first exposed during the 2014 Ebola Epidemic when the system collapsed under the pressure. Its failure to respond effectively resulted in the deaths of nearly 5,000 people, the highest fatality rate out of the three countries most affected by the epidemic. Years later, despite efforts to rebuild and strengthen the system, many of the issues still remain.

http://www.clarissasosin.com/liberianhealthcare

A Novel Model Of “Remedy And Elimination Of Tuberculosis”, Akanksha Mishra

Master's Theses

Tuberculosis (TB), is one of the top ten causes of death worldwide. TB is commonly linked to poverty and creates poverty as it is the single largest cause of death in the 15-49-year-old age group in South-East Asia (WHO, 2017). It is also linked to the HIV population, and its leading cause of death. TB is effected by socio-economic factors, cultural factors, and health policy. My goal of this dissertation is to identify systematic approaches that shall support the mission set by World Health Organization (WHO): to eliminate TB globally by the year 2050. Measures might include addressing social barriers …

Global Kidney Exchange: Analysis And Background Papers From The Perspective Of Medical Anthropology, Alejandro Cerón, Kylie Dillinger, Madison Eitniear, Sophia Ernstrom, Walid Hedidar, Christiana Hellinga, Travis Himebaugh, Aaron J. Landau, Julian Nilsson, Lindsey Penn, Madison Redman, Cimmaron Retzik-Stahr, Laurel Schwartz, Isabelle Seeto, Madeline Sweet, Angelina M. R. Thomson, Margaret Wolf, Natalie Wuertz

Anthropology: Undergraduate Student Scholarship

Global Kidney Exchange (GKE) is a program aimed at facilitating trans-national kidney donation. Although its proponents aim at reducing the unmet demand of kidneys in the United States through the trans-nationalization of kidney exchange programs, the World Health Organization (WHO) and The Transplantation Society (TTS) have expressed concerns about its potential effect on black markets of organs and transnational organ trafficking, as well as on low- or middle-income countries health systems. For GKE to be implemented, it would need to be permitted to operate in at least some low- or middle-income countries. Should a low- or middle-income country allow GKE’s …

Global Kidney Exchange: Analysis And Background Papers From The Perspective Of The Right To Health, Alejandro Cerón, Kiaryce Bey, Kelly Bonk, Ellie Carson, Emilia Chapa, Louisa Cohen, Katie Crockford, Rachel Cuda, Sebastian Injac, Kajsa Kirby, Daniela Leon-Alvarez, Mackenzie Looney, Kendall Mcbeth, Winnie Pham, Rose Smith, Margarita Soltero Gutierrez, Katherine Sugura, Alexander Yu, Flinn Lazier

Anthropology: Undergraduate Student Scholarship

Global Kidney Exchange (GKE) is a program aimed at facilitating trans-national kidney donation. Although its proponents aim at reducing the unmet demand of kidneys in the United States through the trans-nationalization of kidney exchange programs, the World Health Organization (WHO) and The Transplantation Society (TTS) have expressed concerns about its potential effect on black markets of organs and transnational organ trafficking, as well as on low- or middle-income countries health systems. For GKE to be implemented, it would need to be permitted to operate in at least some low- or middle-income countries. What are the right to health implications of …

Discovery, Research, And Development Of New Antibiotics: The Who Priority List Of Antibiotic-Resistant Bacteria And Tuberculosis, Evelina Tacconelli, Elena Carrara, Alessia Savoldi, Stephan Harbarth, Marc Mendelson, Dominique L. Monnet, Celine Pulcini, Gunnar Kahlmeter, Jan Kluytmans, Yehuda Carmeli, Marc Ouellette, Kevin Outterson, Jean Patel, Marco Cavaleri, Edward M. Cox, Chris R. Houchens, M Lindsay Grayson, Paul Hansen, Nalini Singh, Ursula Theuretzbacher, Nicola Magrini, Who Pathogens Priority List Working Group

Faculty Scholarship

Summary

Background The spread of antibiotic-resistant bacteria poses a substantial threat to morbidity and mortality worldwide. Due to its large public health and societal implications, multidrug-resistant tuberculosis has been long regarded by WHO as a global priority for investment in new drugs. In 2016, WHO was requested by member states to create a priority list of other antibiotic-resistant bacteria to support research and development of effective drugs.

Methods We used a multicriteria decision analysis method to prioritise antibiotic-resistant bacteria; this method involved the identification of relevant criteria to assess priority against which each antibiotic-resistant bacterium was rated. The final priority …

Weight Management And Physical Activity Throughout The Cancer Care Continuum., Wendy Demark-Wahnefried, Kathryn H Schmitz, Catherine M Alfano, Jennifer R Bail, Pamela J Goodwin, Cynthia A Thomson, Don W Bradley, Kerry S Courneya, Christie A Befort, Crystal S Denlinger, Jennifer A Ligibel, William H Dietz, Melinda R Stolley, Melinda L Irwin, Marcas M Bamman, Caroline M Apovian, Bernardine M Pinto, Kathleen Y Wolin, Rachel M Ballard, Andrew J Dannenberg, Elizabeth G Eakin, Matt M Longjohn, Susan D Raffa, Lucile L Adams-Campbell, Joanne S Buzaglo, Sharyl J Nass, Greta M Massetti, Erin P Balogh, Elizabeth S Kraft, Anand K Parekh, Darshak M Sanghavi, G Stephen Morris, Karen Basen-Engquist

Global Health Faculty Publications

Mounting evidence suggests that weight management and physical activity (PA) improve overall health and well being, and reduce the risk of morbidity and mortality among cancer survivors. Although many opportunities exist to include weight management and PA in routine cancer care, several barriers remain. This review summarizes key topics addressed in a recent National Academies of Science, Engineering, and Medicine workshop entitled, "Incorporating Weight Management and Physical Activity Throughout the Cancer Care Continuum." Discussions related to body weight and PA among cancer survivors included: 1) current knowledge and gaps related to health outcomes; 2) effective intervention approaches; 3) addressing the …

Challenges In Delivering Refugee Health Services, Thy Vo, Fabiana Kotovicz

Journal of Patient-Centered Research and Reviews

Background: Aurora Health Care is the major health care system providing care to refugees in Milwaukee, where half of Wisconsin’s refugee population resides. Like many other institutions caring for refugee patients, Aurora faces significant challenges when trying to address refugee health needs. Even with the assistance of medical interpreters, cultural differences, language barriers and limited patient health literacy, as well as lack of knowledge of refugee patients’ backgrounds, are major obstacles encountered by health care providers in this setting.

Purpose: This quality improvement study aims to assess Aurora providers’ perceptions of the benefits and barriers to working with refugee …

Nutritional Status Of Infants At Six Months Of Age Following Maternal Influenza Immunization: A Randomized Placebo-Controlled Trial In Rural Nepal., Joanne Katz, Janet A Englund, Mark C Steinhoff, Subarna K Khatry, Laxman Shrestha, Jane Kuypers, Luke C Mullany, Helen Y Chu, Steven C Leclerq, Naoko Kozuki, James M Tielsch

Global Health Faculty Publications

Background

Maternal influenza vaccination has increased birth weight in two randomized trials in South Asia but the impact on infant growth is unknown.

Methods

A randomized placebo-controlled trial of year round maternal influenza immunization was conducted in two annual cohorts in Sarlahi District, southern plains of Nepal, from April 2011 through April 2014. Infants born to women enrolled in the trial had weight, length, and head circumference measured at birth and 6 months of age. The study was powered for the 3 primary trial outcomes but not for stunting and wasting at 6 months of age.

Results

3693 women received …

Preliminary Evaluation Of An Lyta Pcr Assay For Detection Of Streptococcus Pneumoniae In Urine Specimens From Hospitalized Patients With Community-Acquired Pneumonia, Subathra Marimuthu, James T. Summersgill, Kuldeep Ghosh, Leslie A Wolf

The University of Louisville Journal of Respiratory Infections

Community acquired pneumonia (CAP) due to Streptococcus pneumoniae still occurs in at risk populations, despite the availability of effective vaccines. Laboratory confirmation of S. pneumoniae remains challenging in cases of CAP despite advances in blood culture techniques and the availability of nucleic acid amplification tests such as PCR-based methods. Urine specimens are an attractive sample type because they are non-invasive compared to bronchial washes or whole blood specimens for patients with CAP. While urine specimens have been used successfully in antigen detection assays, they have not been extensively evaluated for PCR-based assays. In this preliminary study, we evaluated the potential …

Distributing Data And Analysis Software Containers For Better Data Sharing In Clinical Research, William A. Mattingly Phd, Stephen Furmanek, Christopher M. Sinclair, Timothy L. Wiemken Phd

The University of Louisville Journal of Respiratory Infections

Introduction: Data sharing in clinical research is critical for increasing knowledge discovery. Data and software tools should be FAIR: Findable, Accessible, Inter-operable and Re-usable. Many bottlenecks exist in the process of a clinical investigator using shared data including data acquisition and statistical analysis. The objective of this project is to develop a structure for sharing data and providing rapid automated statistical analysis through creation of a pre-packaged, open-source software container.

Methods: We use the open source software container technologies VirtualBox and Vagrant to create a template for sharing clinical data and analysis scripts as a single container. We use …

Rationale And Methods Of The Study Protocol: Streptococcus Pneumoniae Serotypes In Adults 18 Years And Older With Radiographically-Confirmed Community-Acquired Pneumonia (Cap), Ronika Alexander, Paula Peyrani, Julio A. Ramirez, Wesley H. Self Md, Mph, Carlos Grijalva, Francis Counselman, Gregory A. Volturo, Heidi Kabler, Luis Ostrosky-Zeichner, Richard Wunderink, Robert L. Sherwin, Senen Pena, Thomas File, Timothy L. Wiemken, Sharon Gray, Michael Pride, Kimbal D. Ford, Qin Jiang, Raul Isturiz

The University of Louisville Journal of Respiratory Infections

This study was an active, prospective surveillance study of adults 18 years and older hospitalized with community-acquired pneumonia (CAP) due to Streptococcus pneumoniae conducted at 21 hospitals in ten cities across the United States. This report describes the surveillance methodology applied between October 7, 2013 and September 30, 2016, including the identification and description of surveillance areas and populations at-risk for CAP hospitalization for estimation of incidence rates for selected study sites.

Streptococcus Pneumoniae Antigen, Missing Opportunities Of A Promising Point Of Care Diagnostic Test, Magdelina Słomka, Ruby Gupta, Baltej Singh, Venkatesh Gondhi, Siddartha Bhandary, Ekezie Francis, Jose Bordon

The University of Louisville Journal of Respiratory Infections

Background: The etiologic diagnosis of community acquired pneumonia (CAP) and community-acquired meningitis (CAM) are still far from optimal accuracy and turnaround time. The most common bacterial pathogen identified in both CAP and CAM is Streptococcus pneumoniae.

Methods: We reviewed the literature on S. pneumoniae antigen to highlight opportunities to optimize its use as a point of care diagnostic test to maximize quality of patient care, antimicrobial stewardship outcomes and cost saving. A PubMed search was performed using key words “S. pneumoniae antigen; rapid diagnostic tests for S. pneumoniae”. We selected articles in English and sorted into randomized …

Level Of Recall Bias Regarding Pneumococcal Vaccination History Among Adults Hospitalized With Community-Acquired Pneumonia: Results From The University Of Louisville Pneumonia Study, Sarah Van Heiden, Ruth Carrico, Timothy L. Wiemken, Ronika Alexander, John M. Mclaughlin, Qin Jiang, Paula Peyrani, William A. Mattingly, Stephen P. Furmanek, Connor L. English, Senen Pena, Raul Isturiz, Julio A. Ramirez

The University of Louisville Journal of Respiratory Infections

Background: Recall bias is likely to occur in vaccine effectiveness studies using self-reported vaccination history. The validity of patient-reported vaccination status for adults is not well defined. The objective of this study was to evaluate the validity of self-reported pneumococcal vaccination history among patients hospitalized with community-acquired pneumonia (CAP).

Methods: Prospective ancillary study of a population-based observational study of hospitalized patients with CAP in the city of Louisville. To be included in the analysis, patients had to (i) be reached by phone 30-days after discharge from the hospital and (ii) report that they remembered whether or not they received a …