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Public Health Officials (public + health_official)
Selected AbstractsThe effects of cigarette costs on BMI and obesityHEALTH ECONOMICS, Issue 1 2009Article first published online: 4 FEB 200, Charles L. Baum Abstract About 30% of Americans are currently obese, which is roughly a 100% increase from 25 years ago. Public health officials have consequently become alarmed because recent research indicates that societal costs of obesity now exceed those of cigarette smoking and alcoholism. Cigarette taxes may have exacerbated the prevalence of obesity. In 1964, the US Surgeon General issued its first report relating smoking and health, and since that time, federal and state governments have increased cigarette taxes in a successful effort to reduce cigarette smoking. However, because cigarette smoking and obesity seem inversely related, cigarette taxes may have simultaneously increased obesity. This paper examines the effects of cigarette costs on BMI and obesity and finds that they have significant positive effects. This paper attempts to reconcile conflicting evidence in the literature by controlling more carefully for correlation with state-specific time trends using panel data. Results indicate that the net benefit to society of increasing cigarette taxes may not be as large as previously thought, though this research in no way concludes that they should be decreased to prompt weight loss. Copyright © 2008 John Wiley & Sons, Ltd. [source] "Stains" on their self-discipline: Public health, hygiene, and the disciplining of undocumented immigrant parents in the nation's internal borderlandsAMERICAN ETHNOLOGIST, Issue 4 2009SARAH HORTON Ph.D. ABSTRACT Histories of the role of public health in nation building have revealed the centrality of hygiene to eugenic mechanisms of racial exclusion in the turn-of-the-20th-century United States, yet little scholarship has examined its role in the present day. Through ethnography in a Mexican migrant farmworking community in California's Central Valley, we explore the role of oral hygiene campaigns in racializing Mexican immigrant parents and shaping the substance of their citizenship. Public health officials perceive migrant farmworkers' children's oral disease as a "stain of backwardness," amplifying Mexican immigrants' status as "aliens." We suggest, however, that the recent concern with Mexican immigrant children's oral health blends classic eugenic concerns in public health with neoliberal concerns regarding different immigrant groups' capacity for self-governance. [source] The Spanish Influenza of 1918 in St. Louis, MissouriPUBLIC HEALTH NURSING, Issue 5 2006Irene Kalnins ABSTRACT In view of current concern about a possible pandemic of virulent avian influenza, it is timely to revisit the public health response to the "Spanish" influenza of 1918. St. Louis, Missouri, was the most successful of nine largest cities in limiting the death toll from influenza and pneumonia through the use of public health measures during the first 8 weeks of the epidemic. A second wave of cases increased the final death rate, but it remained below that of other major cities. Public health officials attributed the lower death rate to the early and rigorous ban on public gatherings. [source] Metrics in the Science of SurgeACADEMIC EMERGENCY MEDICINE, Issue 11 2006Jonathan A. Handler MD Metrics are the driver to positive change toward better patient care. However, the research into the metrics of the science of surge is incomplete, research funding is inadequate, and we lack a criterion standard metric for identifying and quantifying surge capacity. Therefore, a consensus working group was formed through a "viral invitation" process. With a combination of online discussion through a group e-mail list and in-person discussion at a breakout session of the Academic Emergency Medicine 2006 Consensus Conference, "The Science of Surge," seven consensus statements were generated. These statements emphasize the importance of funded research in the area of surge capacity metrics; the utility of an emergency medicine research registry; the need to make the data available to clinicians, administrators, public health officials, and internal and external systems; the importance of real-time data, data standards, and electronic transmission; seamless integration of data capture into the care process; the value of having data available from a single point of access through which data mining, forecasting, and modeling can be performed; and the basic necessity of a criterion standard metric for quantifying surge capacity. Further consensus work is needed to select a criterion standard metric for quantifying surge capacity. These consensus statements cover the future research needs, the infrastructure needs, and the data that are needed for a state-of-the-art approach to surge and surge capacity. [source] EVOLUTION O ANTIBIOTIC RESISTANCE BY HUMAN AND BACTERIAL NECHE CONSTRUCTIONEVOLUTION, Issue 3 2005Maciej F. Boni Abstract Antibiotic treatment by humans generates strong viability selection for antibiotic-resistant bacterial strains. The frequency of host antibiotic use often determines the strength of this selection, and changing patterns of antibiotic use can generate many types of behaviors in the population dynamics of resistant and sensitive bacterial populations. In this paper, we present a simple model of hosts dimorphic for their tendency to use/avoid antibiotics and bacterial pathogens dimorphic in their resistance/sensitivity to antibiotic treatment. When a constant fraction of hosts uses antibiotics, the two bacterial strain populations can coexist unless host use-frequency is above a critical value; this critical value is derived as the ratio of the fitness cost of resistance to the fitness cost of undergoing treatment. When strain frequencies can affect host behavior, the dynamics may be analyzed in the light of niche construction. We consider three models underlying changing host behavior: conformism, the avoidance of long infections, and adherence to the advice of public health officials. In the latter two, we find that the pathogen can have quite a strong effect on host behavior. In particular, if antibiotic use is discouraged when resistance levels are high, we observe a classic niche-construction phenomenon of maintaining strain polymorphism even in parameter regions where it would not be expected. [source] Neonatal health care costs related to smoking during pregnancyHEALTH ECONOMICS, Issue 3 2002E. Kathleen Adams Abstract Research objective: Much of the work on estimating health care costs attributable to smoking has failed to capture the effects and related costs of smoking during pregnancy. The goal of this study is to use data on smoking behavior, birth outcomes and resource utilization to estimate neonatal costs attributable to maternal smoking during pregnancy. Study design: We use 1995 data from the Center for Disease Control's (CDC) Pregnancy Risk Assessment Monitoring System (PRAMS) database. The PRAMS collects representative samples of births from 13 states (Alabama, Alaska, California, Florida, Georgia, Indiana, Maine, Michigan, New York (excluding New York City), Oklahoma, South Carolina, Washington, and West Virginia), and the District of Columbia. The 1995 PRAMS sample is approximately 25 000. Multivariate analysis is used to estimate the relationship of smoking to probability of admission to an NICU and, separately, the length of stay for those admitted or not admitted to an NICU. Neonatal costs are predicted for infants ,as is' and ,as if' their mother did not smoke. The difference between these constitutes smoking attributable neonatal costs; this divided by total neonatal costs constitutes the smoking attributable fraction (SAF). We use data from the MarketScanÔ database of the MedStatÔ Corporation to attach average dollar amounts to NICU and non-NICU nursery nights and data from the 1997 birth certificates to extrapolate the SAFs and attributable expenses to all states. Principal findings: The analysis showed that maternal smoking increased the relative risk of admission to an NICU by almost 20%. For infants admitted to the NICU, maternal smoking increased length of stay while for non- NICU infants it appeared to lower it. Over all births, however, smoking increased infant length of stay by 1.1%. NICU infants cost $2496 per night while in the NICU and $1796 while in a regular nursery compared to only $748 for non-NICU infants. The combination of the increased NICU use, longer stays and higher costs result in a positive smoking attributable fraction (SAF) for neonatal costs. The SAF across all states is 2.2%. Across the states, the SAF varied from a low of 1.3% in Texas to a high of 4.6% in Indiana. Conclusions: These results further confirm the adverse effects of smoking. Among mothers who smoke, smoking adds over $700 in neonatal costs. The smoking attributable neonatal costs in the US represent almost $367 million in 1996 dollars; these costs vary from less than a million in smaller states to over $35 million in California. These costs are highly preventable since the adverse effects of maternal smoking occur in the short-run and can be avoided by even a temporary cessation of maternal smoking. These cost estimates can be used by managed care plans, state and local public health officials and others to evaluate alternative smoking cessation programs. Copyright © 2002 John Wiley & Sons, Ltd. [source] Practical and experimental consideration of sun protection in dermatologyINTERNATIONAL JOURNAL OF DERMATOLOGY, Issue 7 2003William W. Ting MD Much is known regarding the deleterious effects of ultraviolet radiation (UV) on the skin. As more epidemiologic and basic research continues to characterize the impact of sun exposure and other sources of UV radiation upon the development of cutaneous neoplasm and a variety of photosensitive dermatoses, it is crucial for the dermatologist to promote sun protection among his/her patients as well as the primary care physician who has a greater reach of the community than the skin specialist. Practical steps to achieve optimal sun protection include avoidance of UV radiation, avoidance of photosensitizing drugs, use of photo-protective clothing, and diligent application of broad-spectrum sunscreens. In recent years, novel agents and experimental modalities with the potential to offer enhanced protective effects against deleterious sequelae of sun exposure have been elucidated, e.g. antioxidants, alpha-MSH, polyphenol in green teas, genistein, NF-kB decoy oligodeoxynucleotides, pTpT vaccination, and IL-12. As these new photo-protective tools are being developed by scientists around the world, greater concerted effort is needed to engage public health officials and the media to promote sun protection awareness throughout the general public. [source] Utility of Infectious Disease Coding Sheets for Surveillance in a State Medical Examiner's Office,JOURNAL OF FORENSIC SCIENCES, Issue 4 2008Ph.D., Sarah L. Lathrop D.V.M. Abstract:, Medical examiners are often first to recognize unusual occurrences of fatal infectious diseases. Recognition of these deaths allows public health officials to institute appropriate public health measures. Therefore, we developed a simple method of identifying and tracking infectious disease deaths in a statewide medical examiner's office. One-page infectious disease forms were completed for 1566/1949 autopsies (80%) performed at the New Mexico Office of the Medical Investigator in 2004. In 241 cases one infectious disease was identified at autopsy and 58 cases had two infectious diseases. Fourteen of the infectious-diseases caused deaths involved diseases that are notifiable conditions in New Mexico. Pneumonia was the most commonly reported infectious process (47 deaths) followed by sepsis (25 deaths). Tracking infectious disease deaths highlighted the importance of recognizing these deaths, although hand-written entries were unstandardized. Preferably, a tracking system would be built into electronic databases at medical examiner and coroner's offices, expediting the identification of these diseases and contact of public health agencies. [source] Community-specific, preventive oral health policies: preventive measures on dental cariesJOURNAL OF INVESTIGATIVE AND CLINICAL DENTISTRY, Issue 1 2010Shahrokh Esfandiari Abstract In all health fields, limited infrastructure and resources hinder the provision of basic services to low-income populations. Subsequently, oral health is often neglected, as over 90% of caries remains untreated in developing communities. In order to deliver the most cost-effective prevention methods, public health officials must assess each available strategy on an individual community basis. In this paper, examples from oral health will demonstrate the importance of community-specific determinants in the formation of preventive public health policies. These determinants include economical, cultural, social, and political elements that can assist policy makers in generating effective functional public health policies. [source] Strategies for Implementing School-Located Influenza Vaccination of Children: A Systematic Literature ReviewJOURNAL OF SCHOOL HEALTH, Issue 4 2010John Cawley PhD BACKGROUND: The Advisory Committee on Immunization Practices (ACIP) recommends influenza vaccinations for all children 6 months to 18 years of age, which includes school-aged children. Influenza immunization programs may benefit schools by reducing absenteeism. METHODS: A systematic literature review of PubMed, PsychLit, and Dissertation Abstracts available as of January 7, 2008, was conducted for school-located vaccinations, using search words "School Health Services" and "Immunization Programs"; limited to "Child" (6-12 years) and "Adolescent" (13-18 years) for PubMed and "mass or universal" and (immuniz* or immunis* or vaccin*) and (school or Child or Adolescen*) for PsychLit and Dissertation Abstracts. Fifty-nine studies met the criteria for review. RESULTS: Strategies such as incentives, education, the design of the consent form, and follow-up can increase parental consent and number of returned forms. Minimizing out-of-pocket cost, offering both the intramuscular (shot) and intranasal (nasal spray) vaccination, and using reminders can increase vaccination coverage among those whose parents consented. Finally, organization, communication, and planning can minimize the logistical challenges. CONCLUSIONS: Schools-based vaccination programs are a promising option for achieving the expanded ACIP recommendation; school-located vaccination programs are feasible and effective. Adhering to lessons from the peer-reviewed scientific literature may help public health officials and schools implement the expanded recommendation to provide the greatest benefit for the lowest cost. Given the potential benefits of the expanded recommendation, both directly to the vaccinated children and indirectly to the community, prospective, well-controlled trials to establish the cost-effectiveness of specific vaccination strategies should be high priorities for future research. [source] Identifying the Gaps Between Biodefense Researchers, Public Health, and Clinical Practice in a Rural CommunityTHE JOURNAL OF RURAL HEALTH, Issue 3 2008Jessica M. Van Fleet-Green BS ABSTRACT:,Objective:It is essential for health care professionals to be prepared for a bioterrorist attack or other public health emergency. We sought to determine how well biodefense and emerging infectious disease research information was being disseminated to rural health care providers, first responders, and public health officials. Methods: Semi-structured interviews were conducted at a federally funded research institution and a rural community in Washington state with 10 subjects, including researchers, community physicians and other health care providers, first responders, and public health officials. Results: The interviews suggest there is inadequate information dissemination regarding biodefense and emerging infectious disease research and an overall lack of preparedness for a bioterrorist event among rural clinicians and first responders. Additionally, a significant communication gap exists between public health and clinical practice regarding policies for bioterrorism and emerging infectious disease. There was, however, support and understanding for the research enterprise in bioterrorism. Conclusions: Biodefense preparedness and availability of information about emerging infectious diseases continues to be a problem. Methods for information dissemination and the relationships between public health officials and clinicians in rural communities need to be improved. [source] Case Report: Fatal Apophysomyces elegans Infection Transmitted by Deceased Donor Renal AllograftsAMERICAN JOURNAL OF TRANSPLANTATION, Issue 9 2010B. D. Alexander Two patients developed renal mucormycosis following transplantation of kidneys from the same donor, a near-drowning victim in a motor vehicle crash. Genotypically, indistinguishable strains of Apophysomyces elegans were recovered from both recipients. We investigated the source of the infection including review of medical records, environmental sampling at possible locations of contamination and query for additional cases at other centers. Histopathology of the explanted kidneys revealed extensive vascular invasion by aseptate, fungal hyphae with relative sparing of the renal capsules suggesting a vascular route of contamination. Disseminated infection in the donor could not be definitively established. A. elegans was not recovered from the same lots of reagents used for organ recovery or environmental samples and no other organ transplant-related cases were identified. This investigation suggests either isolated contamination of the organs during recovery or undiagnosed disseminated donor infection following a near-drowning event. Although no changes to current organ recovery or transplant procedures are recommended, public health officials and transplant physicians should consider the possibility of mucormycosis transmitted via organs in the future, particularly for near-drowning events. Attention to aseptic technique during organ recovery and processing is re-emphasized. [source] Prepartum Work, Job Characteristics, and Risk of Cesarean DeliveryBIRTH, Issue 1 2002Shirley Hung MPP Background:,Reducing the rate of cesarean deliveries in the United States is a high priority among public health officials and members of the medical community. Many factors known to contribute to an individual woman's risk of having a cesarean rather than a vaginal delivery are not readily altered by public policy intervention. In this study we explored the effects on type of delivery of prepartum work practices, a category of factors that has a potential to affect the likelihood of cesarean delivery and to be amenable to change. Methods:,Data are from U.S. Food and Drug Administration's Infant Feeding Practices Study, using questions on mail surveys administered prenatally and at 1 month postpartum. The sample comprised 1194 women who worked during pregnancy. The outcome measure is type of delivery. Predictor variables are characteristics of prepartum work: how far into their pregnancy the women work, number of hours worked, and occupation. Results:,For most women, maintaining employment through the third trimester, working long hours, and working in certain occupations are not independently associated with the odds of having a cesarean delivery. However, we found marginally significant evidence that those women who worked more than 40 hours a week in a sales job were more likely to have cesarean deliveries than women who worked in other occupations. Conversely, women working part-time in sales jobs were less likely to have a cesarean delivery. Conclusion:,This study provides evidence that prenatal work does not substantially increase the probability of having a cesarean delivery in most occupational categories. (BIRTH 29:1 March 2002) [source] | ||||||||||