• C the light! Exploring dynamic changes in hepatitis C epidemiology, screening, and treatment

      Miller, Lesley; Travis, Natasha; Lom, Jennifer; Fluker, Shelly-Ann; Emory University, Grady Memorial Hospital (Georgia Public Health Association, 2017)
      Background: Hepatitis C is common, deadly and curable. A major public health epidemic, it affects close to 4 million Americans, and kills more Americans than HIV, hepatitis B and tuberculosis combined. New all-oral therapies for hepatitis C can cure over 90% of those treated with few side effects and with a short 12-week course. However, many people with hepatitis C are unaware of their infection and access to curative therapy remains limited, especially for underserved populations. Methods: Our workshop will focus on areas of dynamic change in hepatitis C. We will discuss the changing epidemiology, focusing on the epidemic of new infections among young injection drug users. We will discuss hepatitis C screening recommendations and how these are applied in medical and public health settings, including barriers and facilitators to screening and linkage to care. We will describe current available therapies for hepatitis C and challenges to accessing these medications. Results: We will present results of our screening and linkage to care cascade, as well as the impact of our primary care-based hepatitis C clinic on antiviral treatment outcomes. We will focus on ways that workshop attendees can apply these principles to hepatitis C screening in their individual settings throughout the state of Georgia. Conclusions: We will conclude by making the compelling argument that combining public awareness of the disease, screening, linkage to care and treatment can lead to hepatitis C elimination in an unexpectedly short time frame.
    • Can summer camp improve childhood asthma management? Outcomes from Augusta Area Asthma Camp

      Flakes, Terrill; Augusta University (Georgia Public Health Association, 2017)
      Background: Childhood asthma is the most common chronic condition in the U.S., affecting 8.6% of children.1 Asthma is particularly an issue in Georgia where 16.2% of children have been diagnosed with this condition.2 Research suggests an association between pediatric asthma education and a decrease in emergency room visits and hospitalizations, and improved quality of life (QOL).3,4 The Augusta Area Asthma Camp, a free week-long educational day camp, was created to address a critical need for asthma education in the community by increasing parent and child knowledge and self-management of asthma symptoms while providing typical summer camp activities in a safe environment. Yet camp effectiveness has not been evaluated. This study explored differences in parent and child related asthma outcomes before and after attending Asthma Camp. Methods: In summer 2016, children attending Asthma Camp along with their parents/legal guardian were consented and asked to complete pre- and post-camp surveys that collected information about asthma control, education, self-management of symptoms, and physical activity. Paired samples t-tests were used to determine pre- and post-camp differences. Results: Children (n=43) ranged from 6-13 years (M=8.53, SD=1.80) with the majority Black (65.1%), male (62.8%), from single parent (41.5%), low-income (73.1%), and nonsmoking households (84.65%). Child asthma education scores were low both before (65%, SD=0.22) and after (69%,SD=0.11) camp. Children reported a significant increase in the number of physically active days/week pre (M=3.66, SD=1.99) to post (M=5.48,SD=1.33) camp t(28)=-4.14,p=0.00. While we noticed slight improvement in child symptoms (preM=5.38,SD=1.30; postM=5.66,SD=1.24), activity limitations (preM=5.90,SD=1.16; postM=6.01,SD=1.13), emotional function (preM=5.57,SD=1.68; postM=5.68,SD= 1.84), and total QOL (preM=5.47,SD=1.25; postM=5.76,SD=1.24) and parent management strategies (preM=3.19,SD=0.52; postM=3.31,SD=0.92) and support (preM=0.50,SD=0.57; postM=0.55,SD=0.59), differences were not statistically significant. Conclusions: Asthma camp can increase child physical activity and shows promise for improving asthma education, self-management, and parental support. A larger sample and more sensitive measures may improve our ability to detect changes in the participants.
    • Capital and technical assistance needs of Georgia’s health-related nonprofits: An exploratory study

      Daniel, Jerry B.; Green-Caldwell, Cherysh; Albany State University, Turner County Connection-Communities In Schools of Turner County, Inc. (Georgia Public Health Association, 2016)
      Background: Nonprofit organizations, particularly those related to health and human services, are involved in addressing needs of the American population. They provide an array of services in small and large communities throughout the United States. Compared to for-profit organizations, health-related nonprofits are increasing in number. Despite having a substantial share of the health care market, nonprofit organizations face difficulties delivering services to those in need. The difficulties faced by rural nonprofits may be greater than those for their urban counterparts. The impetus for this study came from Healthcare Georgia Foundation’s goal of strengthening nonprofits to address the burgeoning health inequities in Georgia. The purpose was to gain a better understanding of the capital and technical assistance needs of health-related nonprofits. The specific aim was to answer a set of exploratory questions. Methods: This study utilized exploratory, descriptive methodology to examine the capital and technical assistance needs of health-related nonprofits in the state of Georgia. Organizational management staff was used as the unit of analysis. A cross-sectional, correlational design was used to gauge participants’ views about their organization’s current needs. The sample consisted of 48 rural and 45 urban/metropolitan nonprofits. Results: The findings provide information related to the capital and technical assistance needs of rural and urban health-related nonprofits in Georgia and reveal specific needs of nonprofits focusing on health and social services. Conclusions: The results have public health implications for a state that currently faces various public health challenges. Nonprofits located in rural areas could use more technical assistance in reaching their funding goals.
    • The care continuum for people living with HIV in Georgia: How can we raise the bar?

      Kelly, Jane; Rane, Deppali; Wortley, Pascale; Drenzek, Cherie; Georgia Department of Public Health (Georgia Public Health Association, 2015)
      Background: Viral suppression (VS) improves quality of life and longevity for people living with HIV (PLWH) and reduces viral transmission, but is achieved by only a minority of PLWH in Georgia Methods: By use of the Georgia HIV/AIDS surveillance database, the HIV Care Continuum was stratified by age. Results: Retention in care and VS generally increased with increasing age, with the exception of adolescents (aged 13-18 years), who had the highest retention and VS. Differences by sex, race and transmission category persisted across age groups. Among persons retained in care, the proportion achieving VS also generally increased with age. Linkage to care within 3 months of HIV diagnosis was lower among young adults (aged 19-24 years) (54%); young Black, non-Hispanic (NH) males (49%); and young Black NH men who have sex with men (MSM) (49%) as compared to those among adolescents (66%, 58%, and 57%). Conclusions: Retention in care and VS decreases with the transition from adolescence to young adulthood, possibly reflecting loss of support systems and competing priorities. At the other end of the age spectrum, health care and social support systems will be confronted with increasing numbers of older PLWH in Georgia. Challenges in HIV treatment and prevention include (a) the need for integrated medical care for aging PLWH with co-morbid conditions, and (b) the changing social environment of young PLWH.
    • Care Quality for Adult Medicaid Beneficiaries with Type 2 Diabetes Varies by Primary Care Provider Subspecialty

      Mayberry, Robert M.; Finley, Rita; Alema-Mensah, Ernest; Davis, Trobiand A.; Baylor Health Care System; Morehouse College (Georgia Public Health Association, 2006)
      The Georgia Medicaid primary care case management (PCCM) program, phased in over the 1994- 1997 period, has now given way to a capitated managed care model of regional care management organizations (CMOs). Using Georgia Medicaid eligibility and provider claim data for 1996-1998, this study investigated diabetes care quality and whether it varied by primary care provider subspecialty in a longitudinal follow-up of newly diagnosed adults with type 2 diabetes during the early phase of the PCCM program. Results indicated that the quality of diabetes care was suboptimal and varied significantly by PCP subspecialty, with patients seen by generalists least likely to have their HbA1c monitored as recommended during office visits (odds ratio = 0.34, (95% confidence interval 0.16- 0.73). No PCP subspecialty consistently performed better or worse on all diabetes care quality indicators investigated. The lessons learned from this investigation are that variations in Medicaid care quality by PCP subspecialty is likely to remain and the new CMO model of care will unlikely demonstrate immediate improvement in diabetes care quality.
    • CBD Analysis in Oils and Foods

      Foley, Joanna; Chemistry and Physics (Augusta University Libraries, 2020-05-05)
      This item presents the abstract for an oral presentation at the 21st Annual Phi Kappa Phi Student Research and Fine Arts Conference.
    • A Central Georgia asthma prevalence assessment of school-age children and compliance with Senate Bill 472

      Gaddis, Cheryl; Smith, Jimmie (Georgia Public Health Association, 2016)
      Background: A common theme among the counties of the North Central Health District is the disparity between the number of asthma-related visits of African-American and white children ages 1-14 to the emergency department. In 2013, 858 children ages 1-14 in the district had emergency room visits related to asthma. The purpose of this study was to assess North Central Health District (NCHD) schools to determine the prevalence of self-reported asthma by parents and school age children and the adequacy of students’ access to maintenance inhalers at school, and to identify schools that qualify for Asthma Friendly School Recognition. Methods: The “Asthma School Policy Assessment” from the 2015 Georgia Asthma-Friendly Schools Toolkit and Recognition Guidance was used to assess policies and practices for addressing asthma with school staff, parents, and children within the NCHD schools. The Lead School Nurses in each of the 13 counties were contacted in the fall of 2015 via email to request their participation in the assessment. Each was sent a link via email to complete the consent and assessment online; Lead Nurses then sent the link to their team nurses. Data were analyzed using descriptive statistics. IRB approval was obtained from Mercer University. Results: The findings from the study indicate that 75% of the reporting schools have asthmatic students enrolled. The number of students with asthma ranged from 5 to 79 per school. However, only two reporting schools could identify a medication policy that allows children to possess and self-administer asthma medication. Furthermore, none of the schools reported having all five policies necessary to obtain Asthma Friendly School recognition. Conclusions: The results indicate a need for school health nurse training to ensure schools implement and adhere to policies to reduce asthma disparities among school age children as outlined in the 2015 Georgia Asthma-Friendly Schools Toolkit and Recognition Guidance.
    • Chaotic Dripping

      Park, Taejung; Guerrero-Millan, Josefa; Department of Chemistry and Physics (Augusta University Libraries, 2021-05-18)
      This item presents the abstract for a presentation at the 2021 Annual Phi Kappa Phi Student Research and Fine Arts Conference at Augusta University.
    • Characteristics of reported symptoms among confirmed and suspect cases of Zika virus in Georgia, 2016

      Thompson, Ashton; Georgia Department of Public Health (Georgia Public Health Association, 2017)
      Background: In May 2015, Zika virus was detected in Brazil. The virus has since spread through several countries in the Americas. Knowledge of the major symptoms of Zika virus infection was based on historic data from two previous outbreaks in the Pacific Islands. Currently-known Zika-specific symptoms include rash, conjunctivitis, arthralgia, and fever. Epidemiologists at the Georgia Department of Public Health (GDPH) began surveillance for travel-related Zika virus infections in January 2016. Surveillance data from GDPH contributes to better characterization of the current Zika clinical picture and more efficient triage of suspect cases for laboratory testing and prevention measures. Methods: For each patient approved for Zika testing, GDPH epidemiologists created an entry in the Zika Active Monitoring System (ZAMS) within the State Electronic Notifiable Disease Surveillance System (SendSS). Patients are categorized as “asymptomatic” or “symptomatic” and reported symptoms are noted. For symptomatic patients, clinical data are compared to determine differences in the distribution of symptoms in Zika negative and positive patients. Results: GDPH has approved testing for 383 symptomatic suspect Zika patients as of October 19, 2016; 88 (23%) were confirmed Zika infections. Among symptomatic positive patients, the most common Zika-specific symptom was maculopapular rash (95%); other common symptoms were headache and myalgia (27%). Among symptomatic Zika-negative patients, the most common Zika specific symptom was fever (62%), and the most common non-Zika specific symptom was headache (19%). Conclusions: Maculopapular rash is the most suggestive symptom of a true Zika virus infection, with 95% of symptomatic Zika positive patients in Georgia exhibiting the symptom. These data can be taken into consideration when updating the testing criteria for Zika virus. GDPH currently does not approve a patient for testing based on fever or non-Zika specific symptoms alone, and that guideline is reaffirmed by these results.
    • Characteristics of rural users of emergency medical services in Georgia: A populationbased study

      Turner, Nannette; Chen, Huey; Morosanu, Liliana; Mercer University (Georgia Public Health Association, 2016)
      Background: Emergency medical services (EMS) are an essential part of health care. Appropriate information about EMS usage in rural areas will allow effective utilization of EMS resources for their intended purpose, and at the state level, drive the adoption of better EMS policies to ensure and maintain equitable access to these health services in rural areas. Methods: The present study, performed by analyzing data from the Georgia Emergency Medical Services Information System (GEMSIS), describes the population using EMS in rural Georgia. Distributions of rural EMS transports are reported, along with usage for selected population groups based on race, gender, age groups, and primary impressions recorded by emergency medical personnel (EMP). Results: The groups with the highest rates of EMS use were African Americans, females, and the elderly. In 2014, about twice as many African Americans used EMS as compared to Whites. Rural use of EMS increased with age, with the elderly having the highest percentage of users. About 31% of all transports were for emergency conditions; the remaining 69% were for non-emergencies. The most frequent health complaints were those for altered physical conditions and traumatic injuries. Conclusions: The findings of this study can guide decision in planning future services and ensuring appropriate access to EMS in rural Georgia.
    • Characterization of Protein Sensitive G-Protein Coupled Receptors

      Nam, Alisha; Okashah, Najeah; Biological Sciences, Pharmacology & Toxicology, Chemistry & Physics (Augusta University Libraries, 2020-05-05)
      This item presents the abstract for a poster presentation at the 21st Annual Phi Kappa Phi Student Research and Fine Arts Conference.
    • Characterizing discrepancies in school recovery after disasters

      Shah, Hazel; Georgia State University (Georgia Public Health Association, 2019-01-30)
      Background: Academic institutions provide consistency and routine to children. When disasters damage schools, students often suffer in a variety of ways, and racial minority students are often impacted disproportionately. However, minimal research exists exploring these discrepancies. This presentation examines racial disparities in school systems affected by Hurricane Ike (2008). Methods: This study, funded by the National Science Foundation, uses publicly available Texas Education Agency data from approximately 600 schools affected by Hurricane Ike. Schools were included in the study based on two criteria: if they were declared “disaster areas” by FEMA and if they were closed for at least 10 school days after Hurricane Ike. Results: Descriptive analyses were conducted comparing school characteristics and pass rates for all students in grades 3-11 on the Texas Assessment of Knowledge and Skills (TAKS) standardized test during pre- and post-hurricane school years (i.e., 2003 – 2011). Mean pass rates on the TAKS varied greatly by race/ethnicity and other factors. Of African American students, 60.7% (SD=17.4) passed the TAKS in 2004 compared to 69.9% in 2011 (SD=15.0); 68.0% (SD=15.7) of Hispanic students passed in 2004 as opposed to 76.23% (SD=12.2) in 2011; 78.8% (SD=14.8) of White students passed in 2004 versus 83.1% in 2011. Further analyses will explore various other determinants influencing academic performance. Conclusions: Preliminary findings show discrepancies at baseline in academic outcomes between racial/ethnic groups. These discrepancies persisted post-hurricane, though all groups saw an increase in pass-rates. Further research utilizing advanced statistical approaches and geographic information system (GIS) analysis could yield insights on variation of academic performance between schools and school districts, as well as physical exposure and risk factors. These insights can inform strategies for improving schools’ academic trajectories after disasters and optimizing community recovery as a whole.
    • Characterizing the NADPH Oxidase 1-Evoked Pancreatic Stellate Cell Secretome

      Chakraborty, Ananya; Mondal, Souravi; Zhi, Wenbo; Csanyi, Gabor; Sabbatini, Maria; Department of Biological Sciences; Center for Biotechnology and Genomic Medicine; Department of Pharmacology and Toxicology (Augusta University Libraries, 2021-05-18)
      This item presents the abstract for a presentation at the 2021 Annual Phi Kappa Phi Student Research and Fine Arts Conference at Augusta University.
    • Childhood cancer incidence in Georgia: Descriptive epidemiology, geographic trends, and disparities in insurance coverage and health care access

      Kanu, Florence; Robb, Wagner Sara; Corriero, Rosemary; University of Georgia (Georgia Public Health Association, 2015)
      Background: Limited research has been conducted concerning childhood cancer (CC) incidence in Georgia, which is a leading cause of death for children in the US. The purpose of this study was to determine if county-level CC incidence rates differed by geography or race and if health care access disparities exist. Methods: Incidence data were obtained from the Georgia Comprehensive Cancer Registry for 2000-2011. Age-adjusted incidence rates per 100,000 were analyzed by sex, race, and county. Hotspots and coldspots of CC incidence were analyzed using the Getis-Ord GI* statistic. Health care access data for children under 19 were obtained using US Census Bureau’s Small Area Health Insurance Estimates for 2011. Georgia’s three children’s oncology group (COG) treatment facilities with 40-mile buffer zones were geographically overlaid with CC incidence rate maps and health insurance maps using Geographic Information Systems (GIS). Results: For leukemia and central nervous system cancers, incidence rates were significantly different between Whites [7.8, 95% confidence interval (CI) (7.4, 8.2)] and Blacks [5.2, 95% CI (4.8, 5.6)]. Statistical hotspots of CC were observed in north Georgia. A lower percentage of insurance coverage among children was observed in southeast GA. Approximately 25% of Georgia counties that were not within a COG buffer had a higher percentage of children who were uninsured (mean ± SD: 10.28% ± 1.86%). Conclusion: Higher CC incidence rates and disparities in access to care were evident in north Georgia. Future research is needed in these geographies to investigate potential risk factors associated with CC incidence patterns and racial differences in Georgia.
    • Children, Philosophy, and Early Education

      Garrett, Elyse M.; Maynard, Lee; Department of English and World Languages (Augusta University Libraries, 2021-05-18)
      This item presents the abstract for a presentation at the 2021 Annual Phi Kappa Phi Student Research and Fine Arts Conference at Augusta University.
    • Chronic disease prevention as an adaptive leadership problem

      O'Connor, Jean; Georgia Department of Public Health (Georgia Public Health Association, 2017)
    • Civilizing with a Krag: U.S. Counter-Insurgency in Vietnam and Iraq

      Ritchie, George (Augusta University Libraries, 2018-04)
    • A clinical trial to increase the identification, genetic counseling referral and genetic testing of women at risk for hereditary breast and/or ovarian cancer

      Bellcross, Cecelia; Stanislaw, Christine; Hermstad, April (Georgia Public Health Association, 2017)
      Background: Approximately 1/300 individuals in the general population are at risk for hereditary breast and ovarian cancer due to an inherited mutation in the BRCA1/BRCA2 genes. BRCA mutations are associated with dramatically increased risks for breast cancer, especially at younger ages, in addition to ovarian cancer. Enhanced screening and risk reduction strategies can significantly reduce associated morbidity and mortality. The United States Preventive Services Task Force (USPSTF) recommends identifying women at-risk for BRCA mutations for receipt of genetic counseling and if appropriate, testing. The Breast Cancer Genetics Referral Screening Tool (B-RST) is a validated screen endorsed by USPSTF to facilitate this process. This implementation study seeks to evaluate the most effective means of follow-up for screen-positive women to maximize the number who are referred to, and receive, cancer genetic counseling (CGC) services. Methods: B-RST (v3.0) was used in three Emory Healthcare breast-imaging centers. Screen-positive women were randomized into three methods of follow-up (patient initiated, physician notification, or staff phone call). Primary outcomes were to compare the number of screen positive individuals who were referred for, scheduled, and completed a CGC appointment among the three groups. Results: Of 3,419 women approached, 63% participated and 579 (27%) screened positive. Appointments were scheduled by 7% of Group 1 participants, 17% of Group 2 individuals, and 11% of Group 3 (p<0.001). Scheduling challenges included physician non-response to notification and unsuccessful direct contact. Of those scheduled, 73% completed the CGC appointment. Conclusions: Genomic medicine is receiving increased attention in the public health arena. Screening with B-RST 3.0 in mammography settings can improve identification of individuals at-risk for BRCA mutations and facilitate referral to CGC services. Despite B-RST’s ability to easily and accurately identify individuals appropriate for CGC, additional strategies are needed to facilitate completion of CGC in routine clinical practice.
    • Clinicians’ Perception of Inmates’ Satisfaction with Mental Health Services

      Daniel, Jerry B.; Korr, Wynne S.; Mercer University; University of Illinois at Urbana-Champaign (Georgia Public Health Association, 2007)
      A growing body of literature addresses the mental health needs of prison inmates; however, very little research has examined mental health services among this population. Based on the Behavioral Model of Health Services Use (Andersen Model), the current study examined clinicians’ perception of inmates’ satisfaction with mental health services. The study’s main objective was to identify the effect of three major groups of predictor variables (predisposing, enabling, and need) on clinicians’ perception with inmates’ satisfaction with mental health services. The study utilized an exploratory, survey methodology. Although only a few variables were found to be statistically significant in the multivariate analyses, the findings of the study are a significant step in beginning to understand satisfaction of mental health services by inmates. The link between satisfaction and treatment outcome has great significance in the correctional environment, where staff and inmates may tend to see each other as adversaries.
    • Coastal septic tank inventory: data resources for future wastewater management planning

      Alcorn, Jessica; University of Georiga (Georgia Public Health Association, 2017)
      Background: The US Environmental Protection Agency estimates that more than one in five homes are served by decentralized wastewater treatment systems—commonly known as septic tanks. In coastal areas where it is impossible to extend sewer service due to either financial or hydrogeological constraints, septic tanks are an integral part of wastewater treatment. When maintained adequately and installed under appropriate conditions, septic tanks remove excess nutrients and dangerous pathogens from wastewater. As coastal infrastructure is increasingly threatened by recurrent flooding, extreme weather events, and future sea level rise, coastal communities will need to assess the adequacy of their wastewater management systems and plan for future changes. Methods: Through funding from the Coastal Resource Division of the Department of Natural Resources, UGA’s Marine Extension has completed digitization of historic septic tank records into the Digital Health Department database in five coastal counties. This presentation will discuss how septic tank records have been linked to unique parcel identification numbers; the methodology for identification of potential undocumented septic tanks; and online, interactive GIS mapping features to allow expanded access and applications of the data. The septic tank inventory offers two primary benefits. First, digitization of septic tank records increases the efficiency of local public health departments in fulfilling information requests. Second, mapping the septic tank data allows for identification of areas in the county where septic tanks might be at the highest risk of failure or where targeted water sampling might be beneficial. Results and Conclusions: This presentation will focus on enhancing awareness of the data resource that has been created and potential uses in local wastewater management planning that incorporates climate considerations. This presentation will also demonstrate how other relevant GIS datasets can be integrated with the septic tank inventory.