International Public Health Commons^™

Can Global Health Governance Contend With Transnational Corporate Activities? A Case Study On The Chinese Tobacco Industry, Xing Gao

Geography Honors Projects

In the past two decades, China’s state-owned tobacco enterprise (CNTC) has expanded its operation and influence abroad under the “going global” strategy. These globalization activities directly and indirectly impact the Framework Convention on Tobacco Control (FCTC), the first international treaty signed under the WHO auspices. In this project, I explore how certain CNTC expansionary strategies undermine FCTC articles, as well as the ways in which FCTC articles have failed to curb the tobacco industry’s transnational growth. Using international political economy as an overarching framework for the analysis of global health governance, I argue that the FCTC fails to halt the …

Risk And Burden Of Adverse Intrapartum-Related Outcomes Associated With Non-Cephalic And Multiple Birth In Rural Nepal: A Prospective Cohort Study., Naoko Kozuki, Joanne Katz, Subarna K Khatry, James M Tielsch, Steven C Leclerq, Luke C Mullany

Global Health Faculty Publications

OBJECTIVES: Intrapartum-related complications are the second leading cause of neonatal death worldwide. We estimate the community-level risk and burden of intrapartum-related fetal/neonatal mortality and morbidity associated with non-cephalic and multiple birth in rural Sarlahi District, Nepal.

DESIGN: Community-based prospective cohort study.

SETTING: Rural Sarlahi District, Nepal.

PARTICIPANTS: Pregnant women residing in the study area.

METHODS: We collected data on maternal background characteristics, conditions during labour and delivery, fetal presentation and multiple birth during home visits. We ran log-binomial regression models to estimate the associations between non-cephalic/multiple births and fresh stillbirth, early neonatal mortality and signs of neonatal encephalopathy, respectively, and …

Building Interprofessional Global Health Infrastructure At A University And Health System: Navigating Challenges And Scaling Successes, Lucille B. Pilling, Edd,Mph, Bsn, Rn, Janice Bogen, Ma, Louis N. Hunter, Pt, Dpt, Robert Simmons, Drph, Mph, Mches, Cph, Nicholas Leon, Pharmd, Bcps, Bcacp, James D. Plumb, Md, Mph, Richard J. Derman, Md, Mph, Facog

Global Health Posters

Mission:

Global Jefferson will create sustainable programs of global distinction through collaboration that position Jefferson as a local and international destination and resource for education, research, and clinical activities.

Global Jefferson is supported by the Associate Provost for Global Affairs, part of the Office of the Provost.

Global activity at Jefferson includes:

• Global Health Initiatives Committee (GHIC)
• Service Learning
• Global Research & Exchange between institutions
• Pre-clinical, translational, clinical, and applied research

Poster presented at: 8^th Annual Global Health Conference of the Consortium of Universities for Global Health (CUGH)

Urine Electrolyte Excretion In A Hypertensive Population Of East Africans, Aiste Dobrovolskaite

Masters Theses & Specialist Projects

Chronic noncommunicable diseases (NCDs) are the largest contributor to mortality rates worldwide including in low- and middle- income countries (LMICs) which already suffer from high rates of infectious disease. Among the four major NCDs that cause 38 million deaths annually, cardiovascular disease (CVD) causes 17.5 million of these annual deaths. The primary risk factor of CVD is hypertension. Kenya, a developing country in Sub-Saharan Africa, has a high rate of hypertension with low (2.6%) management rates. Prior research from our lab has identified a population of Kenyans with a high prevalence of hypertension that is not statistically correlated with typical …

A Comparative Study On The Impact Evaluation Of World Vision’S Water, Sanitation And Hygiene Program In Malawi, Mozambique, And Zambia: Analyses Using Lives Saved Tool, Chulwoo Park, Armen Martirosyan, Erin A. Jones, Ashley Labat, Yvonne Tam, Emmanuel Opong

GW Research Days 2016 - 2020

Background

According to the World Health Organization, diarrheal disease is the second top killer of children under five years of age (U5), claiming around 760,000 young children’s lives every year, and 88% of diarrheal disease is attributed to unsafe water supply, inadequate sanitation and hygiene. The humanitarian aid organization, World Vision, launched community-based water, sanitation and hygiene (WASH) project in 76 Area Development Programs (ADPs) for 506,019 target U5 population across Southern Africa Region (SAR): Malawi, Mozambique and Zambia in 2010.

Objective

This study estimated the retrospective health impact of the project between 2010 and 2014 to measure how effectively …

Stakeholders' Perceptions Of A Hospital Based Emergency Medicine Education & Training Program: A System Change, Kate Douglass, Jay Pandya, Michael Brennan, Kyle Yoder, Janice Blanchard, Natasha Powell, Zohray Talib

GW Research Days 2016 - 2020

Background: Emergency Medicine (EM) is a new and developing specialty around the world. In India, one model for capacity building has been the development of partnerships between US academic institutions and private healthcare institutions for implementing post-graduate education and training in EM. Initiated in 2007, programs have grown both in number and scope and have continued to attract new students and partner institutions. This study was undertaken to better understand the impact of EM training programs on hospital systems.

Methods: A mixed-methods evaluation was undertaken at 5 program sites across India in the summer of 2016. Two researchers conducted onsite …

Secondary Prevention At The Aswan Heart Centre, Amira Athanasios

GW Research Days 2016 - 2020

Cardiovascular disease remains the leading cause of death globally, taking the lives of almost 18 million patients around the world each year. The overwhelming majority of cardiovascular deaths take place in low- to mid-income counties, suggesting that most cardiovascular deaths are preventable. In this study, current literature on secondary prevention of coronary artery disease was analyzed. Specific emphasis was given to preventative measures and successes in low income countries. Based on a literature review, a patient questionnaire to better understand patient adherence to preventative measures was created. This questionnaire focuses on patients receiving dual antiplatelet therapy post acute myocardial infarct …

Needs Assessment Of Pediatric Radiological Equipment And Cross-Cultural Investigation Into Parental Empowerment In Pediatric Radiology Program Development In The Kingdom Of Bhutan, Danielle Canter

GW Research Days 2016 - 2020

Background:

Bhutan is a magnificent mountainous country hugged by India to the east and west and by China to the North and South. This peaceful nestled country faces challenges in combating non-communicable diseases due to the lack of radiological equipment necessary for early diagnosis. Prior to implementation of these medical devices, it is imperative to investigate the cultural attitudes, beliefs, and infrastructure, to ensure successful integration. Bhutan is beginning to implement a pediatric radiology program for the nation with the assistance of ABAH Foundation and RAD-AID International, both of whom partnered with graduate students at George Washington University School of …

Victims Or Heroes? How Did Journalists Frame The Ebola Crisis In Liberia?, Tamah Kamlem, Nwanneamaka Ume, Skylar Lisse, Eme Udoh, Jialin Meng

GW Research Days 2016 - 2020

The Ebola Virus Disease epidemic in West Africa in 2014 with over 11,000 deaths made headlines worldwide, causing fear and posing a challenge to traditional media, entrusted with the task of reporting about the spread of the disease. Individuals and communities rely on media to obtain health information, including decisions related to disease prevention and behavior to protect their health. Therefore, frames used by the media to report about health emergencies impact public perceptions. Mass media framing during crises has been associated with emotional and behavioral responses that are consistent with the thematic depiction of unfolding events. Moreover, message frames …

Cuba’S Use Of Medical Diplomacy: Establishing Global Significance And Influence, Juan Herzberg

Independent Study Project (ISP) Collection

This research project aims to assess the importance of medical diplomacy as a foreign policy strategy for Cuba, as well as a means by which the small island nation has managed to gain geopolitical prominence in the current international political sphere. Through the analysis of Cuba’s medical internationalism, its impact on the health of populations across the world, its oil-for-doctors trade agreements with Venezuela, and its involvement in initiatives like the Bolivarian Alternative for the Americas (ALBA), it becomes easier to see the link between medical diplomacy and geopolitical power, which Cuba has been successfully garnering since its 1959 Revolution …

Equity And Community-Based Health Insurance: How Does Insurance Coverage Affect Health Seeking Behavior Among Disadvantaged Groups In India?, Hazel Hering

Independent Study Project (ISP) Collection

The objective of this study is to examine how Community-Based Health Insurance (CBHI) can promote equity by improving health seeking behavior across gender and geography. Using a CBHI scheme from the Self-Employed Women’s Association (SEWA) as a case study, trends in claims filed between October 2016 and March 2017 are compared to the distribution of memberships in order to investigate whether health insurance coverage positively impacts health seeking behavior among disadvantaged groups, and what barriers to access exist when the burden of medical costs are reduced. This study concludes that the number of male and female claims in the sample …

Improving Health Outcomes In Trafficking Survivors Through Core Skills Development In The Workplace: Experience From The Philippines, Melinda A. Gill

Dignity: A Journal of Analysis of Exploitation and Violence

Whilst an emerging body of research documents the adverse physical and mental health outcomes of victims of trafficking following rescue, there is little research or guidance regarding interventions which improve these outcomes. In this article, I describe my experience as physician involved in a computer-based social enterprise for survivors of trafficking and slavery in the Philippines, and outline my evolving understanding of the requirements for health behavior change and improved outcomes. I conclude that while meaningful vocational skills, economic security, and adequate health-related knowledge are foundational, it is necessary to develop core skills to achieve improved health outcomes and that …

Clinical & Translational Research In Pneumonia: Defining A Research Agenda For Today And Tomorrow, Julio A. Ramirez

The University of Louisville Journal of Respiratory Infections

From the Editor in Chief

The reason for this special supplement of the Journal is to inform readers of a scientific research conference supported by the National Institutes of Health (NHI). The NIH Research Conference Grant (R13) supports high quality scientific conferences in areas that are important to the NIH's mission and to the public health. We just received notification that the National Heart, Lung, and Blood Institute (NHLBI) has approved the application for an international research conference entitled: DzClinical & Translational Research in Pneumonia: Defining a Research Agenda for Today and Tomorrowdz. The conference will be held on Wednesday, …

Utilizing Three Years Of Epidemiological Data From Medical Missions In Cambodia To Shape The Mobile Medical Clinic Formulary, Jeany Kim Jun, Junia S. Koo, Amy Y. Kang, Deborah B. Chien, Albert Shim, Dale Knutson, Eda M. Kim

Pharmacy Faculty Articles and Research

Objective: The purpose of this project was to gather epidemiological data on common diseases and medications dispensed during medical mission teams to Cambodia to shape the mobile medical clinic formulary.

Methods: Data for patients seen during week-long, mobile, medical clinics was collected in Cambodia during Septembers 2012 to 2014. Patient’s gender, age, weight, blood pressure, glucose, pertinent laboratory values, diagnoses, and medications dispensed were collected. Blood pressure and glucose were measured in patients 18 years and above. Data collected onto paper intake forms were transferred onto spreadsheets without patient identifying information and analyzed for aggregate means, common diseases, and most …

Population-Based Pertussis Incidence And Risk Factors In Infants Less Than 6 Months In Nepal., Michelle M Hughes, Janet A Englund, Jane Kuypers, James M Tielsch, Subarna K Khatry, Laxman Shrestha, Steven C Leclerq, Mark Steinhoff, Joanne Katz

Global Health Faculty Publications

Background.

Pertussis is estimated to cause 2 percent of childhood deaths globally and is a growing public health problem in developed countries despite high vaccination coverage. Infants are at greatest risk of morbidity and mortality. Maternal vaccination during pregnancy may be effective to prevent pertussis in young infants, but population-based estimates of disease burden in infants are lacking, particularly in low-income countries. The objective of this study was to estimate the incidence of pertussis in infants less than 6 months of age in Sarlahi District, Nepal.

Methods.

Nested within a population-based randomized controlled trial of influenza vaccination during pregnancy, infants …

The Scoping Review Method: Mapping The Literature In “Structural Change” Public Health Interventions, Rosie Hanneke, Yuka Asada, Lisa D. Lieberman, Leah Christina Neubauer, Michael C. Fagan

Department of Public Health Scholarship and Creative Works

This case discusses how we used scoping review methodology to map the literature in an emergent area of research, “structural change” public health interventions. Scoping reviews are similar to systematic reviews in both scale and rigor; both of these literature review methodologies are comprehensive approaches to reviewing the literature on a topic. However, while a systematic review attempts to answer a specific, targeted research question, a scoping review is designed to map and categorize all of the literature on a broad topic. For this reason, it is an excellent method to employ in emergent research areas, in which researchers have …

Integrating Malaria Surveillance With Climate Data For Outbreak Detection And Forecasting: The Epidemia System, Christopher L. Merkord, Yi Liu, Abere Mihretie, Teklehaymanot Gebrehiwot, Worku Awoke, Estifanos Bayabil, Geoffrey M. Henebry, Gebeyaw T. Kassa, Mastewal Lake, Michael C. Wimberly

GSCE Faculty Publications

Background: Early indication of an emerging malaria epidemic can provide an opportunity for proactive interventions. Challenges to the identification of nascent malaria epidemics include obtaining recent epidemiological surveillance data, spatially and temporally harmonizing this information with timely data on environmental precursors, applying models for early detection and early warning, and communicating results to public health officials. Automated web-based informatics systems can provide a solution to these problems, but their implementation in real-world settings has been limited.
Methods: The Epidemic Prognosis Incorporating Disease and Environmental Monitoring for Integrated Assessment (EPIDEMIA) computer system was designed and implemented to integrate disease surveillance with …

Why A New Journal?, Julio A. Ramirez

The University of Louisville Journal of Respiratory Infections

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Time To Clinical Stability In Patients With Ventilator-Associated Pneumonia Due To Methicillin-Resistant Staphylococcus Aureus Treated With Linezolid Versus Vancomycin: Results From The Impact-Hap Study, Paula Peyrani, Timothy L. Wiemken, Marcus J. Zervos, Daniel H. Kett, Thomas M. File Jr., Gary E. Stein, Kimbal D. Ford, Julio A. Ramirez

The University of Louisville Journal of Respiratory Infections

Background: Time to clinical stability is a well-defined early clinical outcome in hospitalized patients with community-acquired pneumonia, but it has not been evaluated in patients with ventilator-associated pneumonia (VAP). The objective of this study was to compare time to clinical stability in patients with MRSA VAP treated with linezolid versus vancomycin.

Methods: This was a secondary analysis of the IMPACT-HAP study database. VAP was defined according to CDC criteria. MRSA VAP was considered when MRSA was isolated from a tracheal aspirate or bronchoalveolar lavage. A patient was considered to reach clinical stability the day that the following four criteria were …

Clinical Outcomes Of Community-Acquired Pneumonia In Patients With Diabetes Mellitus, Siddartha Bandhary, Bolivar Y. Contreras-Mora, Ruby Gupta, Patricia Fernandez, Patricio Jimenez, Paula Peyrani, Timothy L. Wiemken, Steven Burdette, Julio A. Ramirez, Hadi Harati, Jose Bordon

The University of Louisville Journal of Respiratory Infections

Background: Studies have found admission hyperglycemia as a predictor of poor outcomes in Community acquired Pneumonia (CAP), whereas others have not. The objective of this study was to evaluate the impact of diabetes mellitus (DM) on mortality as well as Length of stay (LOS) and Time to clinical stability (TCS) of hospitalized patients with CAP.

Materials and Methods: Adult patients hospitalized with CAP enrolled at Community-Acquired Pneumonia Organization (CAPO) database with DM were categorized as admission blood glucose ≥ 250 mg/dL (diabetes mellitus blood sugar (BG) > 250) and admission blood glucose ≤ 250 mg/dL (DM BG ≤ 250). CAP outcomes …