Reducing Disparities in Vaccination Rates Between Different Racial/Ethnic and Socioeconomic Groups- The Potential of Community-based Multilevel Interventions

There are well-documented disparities in vaccination rates between different socioeconomic and racial/ethnic groups in the United States. These disparities persist in spite of an overall increase in vaccination rates during the last decade and the implementation of several interventions that have aimed to increase vaccination rates in disadvantaged groups. Although many interventions are efficacious at improving vaccination rates under trial conditions, these interventions when extended to the general population frequently do not appreciably improve its health. Explanations for this limited intervention efficiency include poor adherence to protocols in real life versus idealized trial situations, changes in baseline so that the trial conditions are no longer replicable, and the contribution of other community-level factors that make it difficult to extend the trial methods to other communities. Multilevel community intervention trials recognize and address the multiple competing forces that shape the health of the population in cities and have the potential to increase vaccination rates among minorities and marginalized groups.http://deepblue.lib.umich.edu/bitstream/2027.42/40332/2/Galea_Reducing Disparities in Vaccination Rates Between_2005.pd

Project VIVA: A multi-level community-based intervention to increase influenza vaccination rates among hard-to-reach populations in New York City

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/60340/1/coady_project viva_2008.pd

Exposure to the World Trade Center Disaster and 9/11-Related Post-Traumatic Stress Disorder and Household Disaster Preparedness

Objective In a population with prior exposure to the World Trade Center disaster, this study sought to determine the subsequent level of preparedness for a new disaster and how preparedness varied with population characteristics that are both disaster-related and non-disaster-related. Methods The sample included 4496 World Trade Center Health Registry enrollees who completed the Wave 3 (2011-2012) and Hurricane Sandy (2013) surveys. Participants were considered prepared if they reported possessing at least 7 of 8 standard preparedness items. Logistic regression was used to determine associations between preparedness and demographic and medical factors, 9/11-related post-traumatic stress disorder (PTSD) assessed at Wave 3, 9/11 exposure, and social support. Results Over one-third (37.5%) of participants were prepared with 18.8% possessing all 8 items. The item most often missing was an evacuation plan (69.8%). Higher levels of social support were associated with being prepared. High levels of 9/11 exposure were associated with being prepared in both the PTSD and non-PTSD subgroups. Conclusions Our findings indicate that prior 9/11 exposure favorably impacted Hurricane Sandy preparedness. Future preparedness messaging should target people with low social support networks. Communications should include information on evacuation zones and where to find information about how to evacuate

Mental Health Status Among Ethnic Albanians Seeking Medical Care in an Emergency Department Two Years After the War in Kosovo: A Pilot Project

Study objective: The long-term psychological effects of war are underappreciated in clinical settings. Describing the postwar psychosocial burden on medical care can help direct public health interventions. We performed an emergency department (ED)–based assessment of the mental health status of ethnic Albanian patients 2 years after the North Atlantic Treaty Organization–led bombing of Serbia and Kosovo in 1999. Methods: This study was conducted July 30, 2001, to August 30, 2001, in the ED of a hospital in Pristina, Kosovo. Investigators collected data through systematic sampling of every sixth nonacute ED patient presenting for care; 87.7% of patients agreed to participate. Respondents completed a structured questionnaire, including demographic characteristics, the Short Form-36, and the Harvard Trauma Questionnaire. Results: All 306 respondents were ethnic Albanians; mean age was 39 years (SD 17.9 years). Of respondents, 58% had become refugees during the war. Two hundred ninety-six (97%) reported experiencing at least one traumatic event during the war; the average number of traumatic events encountered by participants was 6.6. Fortythree (14%) reported symptoms that met Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition criteria for posttraumatic stress disorder; mean Short Form- 36 Mental Component Summary score was 42.1 (SD 12.5). Separate multivariable linear regression models confirmed our belief that older age, female sex, less than a high school education, and having experienced a greater number of traumatic events would be associated with more posttraumatic stress disorder symptoms and lower Mental Component Summary scores. Conclusion: Mental health problems among ED patients in Kosovo, particularly among specific vulnerable populations, are a significant public health concern 2 years after the conflict.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/40378/2/Fernandez_Mental Health Status Among Ethnic Albanians_2004.pd

Determinants of influenza vaccination in hard-to-reach urban populations

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/40392/1/bryant_determinants of influenza vaccination_2006.pd

Predictors of influenza vaccination in an urban community during a national shortage

http://deepblue.lib.umich.edu/bitstream/2027.42/61292/1/phillips caesar e, coady mh, blaney s, ompad dc, galea s, predictors of influenza vaccination in an urban community during a national shortage.pd

War-related psychological sequelae among emergency department patients in the former Republic of Yugoslavia

Background: Residents of the Republic of Serbia faced civil war and a NATO-led bombing campaign in 1999. We sought to assess the burden of metal health dysfunction among emergency department (ED) patients presenting for care three years post-war in Serbia. Methods: This study was conducted during July and August 2002 at two sites: a university hospital ED in Belgrade, Serbia and an ED in a remote district hospital serving a Serbian enclave in Laplje Selo, Kosovo. Investigators collected data on a systematic sample of non-acute patients presenting to the ED. All respondents completed a structured questionnaire assessing demographics and symptoms of post-traumatic stress disorder (PTSD) (using the Harvard Trauma Questionnaire), and major depression (using the Center for Epidemiologic Studies Depression Scale). Results: A total of 562 respondents participated (310 in Belgrade, 252 in Laplje Selo); the response rate was 83.8%, 43% were female, and mean age was 37.6 years (SD = 13.4). Overall, 73 (13.0%) participants had symptoms consistent with PTSD, and 272 (49.2%) had symptoms consistent with depression. Sixty-six respondents had both disorders (11.9%). In separate multivariable logistic regression models, predictors of PTSD were refugee status and residence in Laplje Selo, and predictors of depression were older age, current unemployment, and lower social support. Conclusions: Three years post-war, symptoms of PTSD and major depression in Serbia remained a significant public health concern, particularly among refugees, those suffering subsequent economic instability, and persons living in rural, remote areas

Extending the Climate Data Initiative to GeoPlatform.gov

No abstract availabl

War-related psychological sequelae among emergency department patients in the former Republic of Yugoslavia

Background Residents of the Republic of Serbia faced civil war and a NATO-led bombing campaign in 1999. We sought to assess the burden of metal health dysfunction among emergency department (ED) patients presenting for care three years post-war in Serbia. Methods This study was conducted during July and August 2002 at two sites: a university hospital ED in Belgrade, Serbia and an ED in a remote district hospital serving a Serbian enclave in Laplje Selo, Kosovo. Investigators collected data on a systematic sample of non-acute patients presenting to the ED. All respondents completed a structured questionnaire assessing demographics and symptoms of post-traumatic stress disorder (PTSD) (using the Harvard Trauma Questionnaire), and major depression (using the Center for Epidemiologic Studies Depression Scale). Results A total of 562 respondents participated (310 in Belgrade, 252 in Laplje Selo); the response rate was 83.8%, 43% were female, and mean age was 37.6 years (SD = 13.4). Overall, 73 (13.0%) participants had symptoms consistent with PTSD, and 272 (49.2%) had symptoms consistent with depression. Sixty-six respondents had both disorders (11.9%). In separate multivariable logistic regression models, predictors of PTSD were refugee status and residence in Laplje Selo, and predictors of depression were older age, current unemployment, and lower social support. Conclusions Three years post-war, symptoms of PTSD and major depression in Serbia remained a significant public health concern, particularly among refugees, those suffering subsequent economic instability, and persons living in rural, remote areas

Distribution and Foraging Ecology of Hardhead (Ariopsis Felis) and Gafftopsail (Bagre Marinus) Catfishes in The Florida Coastal Everglades

Distribution of the sea catfishes Ariopsis felis and Bagre marinus were investigated using long-term data collected from May 2005–December 2017 in Tarpon Bay, a mangrove estuary that is part of the Everglades National Park. A total of 332 catfish were caught during 452 longlines deployed from May 2005 to December 2017 in Tarpon Bay. Of those, 44 were identified as A. felis, 184 as B. marinus, while the remaining 104 were unidentified. Using a multiple regression approach and multi-model inference, I found that salinity, temperature, and year all showed a positive relationship with the catch rate of both species of catfish. Using a combination of stomach content and stable isotope analysis, I compared δ13C and δ15N with known stomach contents to assess trophic position. Stomach contents of B. marinus (n = 8) were consistent with previous studies that indicate a dominance of crustaceans and teleosts, which was supported by δ15N levels in both fin and muscle tissues. Further, stable isotope analysis indicated that A. felis and B. marinus are feeding within the same trophic level. The movements of these large-bodied fish, particularly in relation to their breeding season, should be further investigated, as they likely represent a temporal prey pulse for larger predators in this sub-tropical estuary