An Undergraduate Curriculum in Public Health Benchmarked to the Needs of the Workforce

East Tennessee State University (ETSU) has offered an undergraduate degree in public health for 60 years. Alumni survey data have documented that the majority of the graduates from this program enter the workforce [see accompanying commentary by Wykoff, et al. (1)]. To keep pace with ongoing changes in the workforce, the decision was made to completely review, and, as appropriate, revise and restructure the Bachelor of Science in Public Health (BSPH) curriculum

Overweight and Obesity in the South: Prevalence and Related Health Care Costs Among Population Groups

Overweight and obesity are leading public health concerns in the United States. Although overweight and obesity are preventable conditions in the majority of cases, their prevalence has increased significantly over the past two decades. Recent estimates indicate that 34.1 percent of Americans are classified as overweight, while 32.2 percent are classified as obese [17]. National estimates of obesity-related health care costs are alarming, yet, to date, no such estimates have been published for the Southern region overall or for population groups in the South. The Southern states have some of the highest rates of adult obesity in the nation

Breast Cancer Fatalism: The Role of Women\u27s Perceptions of the Health Care System

Cancer fatalism, which can be understood as the belief that cancer is a death sentence, has been found to be a deterrent to preventive cancer screening participation. This study examines factors associated with breast cancer fatalism among women. We analyzed data from a 2003 survey of women 40 years of age. The survey collected information about respondents\u27 knowledge and attitudes regarding breast health. Analyses compared the characteristics of women who reported and those who did not report a fatalistic attitude. Women with a fatalistic attitude were more likely to be African American, to have a family history of breast cancer, to rate their quality of care as fair or poor, to believe that not much could be done to prevent breast cancer, to believe that breast cancer could not be cured if found early, and to believe that treatment could be worse than the disease

Characteristics of Current Hospital-Sponsored and Nonhospital Birth Centers

Objectives : (1) To describe contemporary birth centers in terms of the population served, organizational and financial characteristics, services provided, mission and philosophy, and planning and marketing techniques. (2) To compare hospital-sponsored and nonhospital models with regard to the above characteristics. Method : Data from the National Survey of Women's Health Centers conducted in 1994 are analyzed using t -tests and chi-square tests. Results : Contemporary birth centers serve a diverse population of women and provide a range of clinical and nonclinical services. Birth centers are both hospital-sponsored and nonhospital, with the former growing at a faster rate. Compared to hospital-sponsored centers, nonhospital centers serve a larger proportion of uninsured women, provide a broader range of clinical services, and are more committed to women-centered care. Centers utilize different marketing methods and are involved in a number of organizational changes to better position themselves in the changing health care environment. Conclusions: Birth centers offer an attractive option to consumers and are a viable model for delivering women-centered care. Given that all “birth center” facilities do not share the same philosophy and service mix, women need to have some assurance of what a “birth center” will, and will not, provide.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/45317/1/10995_2004_Article_425315.pd

Accessibility of Federally Funded Family Planning Services in South Carolina and Alabama

This study operationalized the five dimensions of health care access in the context of contraceptive service provision and used this framework to examine access to contraceptive care at health department (HD) (Title X funded) and federally qualified health center (FQHC) (primarily non-Title X funded) clinics in South Carolina and Alabama. A cross-sectional survey was conducted in 2017/18 that assessed clinic-level characteristics, policies, and practices related to contraceptive provision. Provision of different contraceptive methods was examined between clinic types. Survey items were mapped to the dimensions of access and internal consistency for each scale was tested with Cronbach\u27s alpha. Scores of access were developed and differences by clinic type were evaluated with an independent t-test. The overall response rate was 68.3% and the sample included 235 clinics. HDs (96.9%) were significantly more likely to provide IUDs and/or Impants on-site than FQHCs (37.4%) (P \u3c 0.0001). Scales with the highest consistency were Availability: Clinical Policy (24 items) (alpha = 0.892) and Acceptability (43 items) (alpha = 0.834). HDs had higher access scores than FQHCs for the Availability: Clinical Policy scale (0.58, 95% CL 0.55, 0.61) vs (0.29, 95% CL 0.25, 0.33) and Affordability: Administrative Policy scale (0.86, 95% CL 0.83, 0.90) vs (0.47, 95% CL 0.41, 0.53). FQHCs had higher access scores than HDs for Affordability: Insurance Policy (0.78, 95% CL 0.72, 0.84) vs (0.56, 95% CL 0.53, 0.59). These findings highlight strengths and gaps in contraceptive care access. Future studies must examine the impact of each dimension of access on clinic-level contraceptive utilization

Innate Immune Cell Recovery Is Positively Regulated by NLRP12 during Emergency Hematopoiesis

With enhanced concerns of terrorist attacks, dual exposure to radiation and thermal combined injury (RCI) has become a real threat with devastating immunosuppression. NLRP12, a member of the NOD-like receptor family, is expressed in myeloid and bone marrow cells and has been implicated as a checkpoint regulator of inflammatory cytokines as well as an inflammasome activator. We show that NLRP12 has a profound impact on hematopoietic recovery during RCI by serving as a checkpoint of TNF signaling and preventing hematopoietic apoptosis. Using a mouse model of RCI, increased NLRP12 expression was detected in target tissues. Nlrp12−/− mice exhibited significantly greater mortality, inability to fight bacterial infection, heightened levels of pro-inflammatory cytokines, overt granulocyte/monocyte progenitor cell apoptosis and failure to reconstitute peripheral myeloid populations. Anti-TNF antibody administration improved peripheral immune recovery. These data suggest that NLRP12 is essential for survival after RCI by regulating myelopoiesis and immune reconstitution

Universal Iron Supplementation: A Simple and Effective Strategy to Reduce Anaemia Among Low-Income, Postpartum Women

Objective: To reduce prevalence of anaemia in low-income postpartum women. Design: A randomised, non-blind clinical trial was conducted among 959 low-income, postpartum women in eleven clinics in Mississippi. The clinics were randomised to one of three treatment groups: (i) selective anaemia screening of high-risk women as recommended currently (control); (ii) universal anaemia screening and treatment of anaemic women (group I); and (iii) universal Fe supplementation of 65 mg/d for two months to all low-income women (group II). All study participants within each clinic received the same treatment. Women were followed up at 6 months after delivery. Hb was measured at baseline and at follow-up. The primary outcome variable was the proportion of women with anaemia after treatment. Setting: Eleven health clinics in Mississippi. Subjects: Low-income, postpartum women. Results: Baseline characteristics of the three study groups were compared using one-way ANOVA and an appropriate post hoc test for continuous variables and the chi(2) test for categorical variables. Fifty-two per cent of postpartum women were anaemic (Hb, 12.0 g/dl) and the rate decreased to 33% at 6 months after the intervention. Group II women, who received universal Fe supplementation, improved their Hb status significantly (P\u3c0.001) at 6 months postpartum compared with the other groups. Prevalence of anaemia was also significantly lower among group II women (22.5%) compared with controls (34%) and group I women (43%; P\u3c0.001). Conclusions: A universal Fe supplementation strategy was effective in reducing the prevalence of anaemia among low-income postpartum women

Healthcare Costs of Methicillin Resistant Staphylococcus aureus and Pseudomonas aeruginosa Infections in Veterans: Role of Vitamin D Deficiency

Objective To reduce prevalence of anaemia in low-income postpartum women.Design A randomised, non-blind clinical trial was conducted among 959 low-income, postpartum women in eleven clinics in Mississippi. The clinics were randomised to one of three treatment groups: (i) selective anaemia screening of high-risk women as recommended currently (control); (ii) universal anaemia screening and treatment of anaemic women (group I); and (iii) universal Fe supplementation of 65 mg/d for two months to all low-income women (group II). All study participants within each clinic received the same treatment. Women were followed up at 6 months after delivery. Hb was measured at baseline and at follow-up. The primary outcome variable was the proportion of women with anaemia after treatment.Setting Eleven health clinics in Mississippi.Subjects Low-income, postpartum women.Results Baseline characteristics of the three study groups were compared using one-way ANOVA and an appropriate post hoc test for continuous variables and the χ 2 test for categorical variables. Fifty-two per cent of postpartum women were anaemic (Hb \u3c 12.0 g/dl) and the rate decreased to 33 % at 6 months after the intervention. Group II women, who received universal Fe supplementation, improved their Hb status significantly (P \u3c 0.001) at 6 months postpartum compared with the other groups. Prevalence of anaemia was also significantly lower among group II women (22.5 %) compared with controls (34 %) and group I women (43 %; P \u3c 0.001).Conclusions A universal Fe supplementation strategy was effective in reducing the prevalence of anaemia among low-income postpartum women

Evaluation of a Comprehensive Loving Support Program Among State Women, Infants, and Children (WIC) Program Breast-Feeding Coordinators

Background: Mississippi was selected as a pilot state in the national breastfeeding promotion campaign titled Loving Support Makes Breastfeeding Work (LSMBW). To reinforce the national LSMBW project, the Mississippi Women, Infants and Children (WIC) Breastfeeding Promotion Project Team developed a comprehensive program that included patient and family education, staff training, public awareness activities, health professional outreach, and partnerships with the community. The program also implemented a breastfeeding-friendly clinic environment project and a videotape project. This study was conducted to evaluate the impact of Mississippi\u27s LSMBW activities among WIC breastfeeding coordinators in the United States. Method: The cross-sectional study was performed with the use of a mailed, self-administered questionnaire. Results: Representatives of 50 state WIC agencies returned the survey. Of these 50 agencies, 36 (72%) had effectively used education materials created by the state of Mississippi. Breastfeeding coordinators reported that among the campaign activities, staff training, community outreach, and peer counseling were most beneficial. They also identified the videotape project developed by Mississippi as useful in addressing barriers to breastfeeding and in training support groups, staff, and health care professionals. Conclusion: This study showed that Mississippi\u27s outreach activities and motivational videotape had a positive impact on coordinators\u27 promotion of breastfeeding