scholarly journals Somewhere to go: Assessing the impact of public restroom interventions on reports of open defecation in San Francisco, California from 2014 to 2020

2021 ◽  
Author(s):  
Heather Kathleen Amato ◽  
Douglas Martin ◽  
Christopher Michael Hoover ◽  
Jay Paul Graham
Keyword(s):  
Public Health ◽  
San Francisco ◽  
Fecal Contamination ◽  
The United States ◽  
Public Health Issue ◽  
Intervention Period ◽  
Interrupted Time Series Analysis ◽  
Post Intervention ◽  
Open Defecation ◽  
The Impact

Abstract Background Open defecation due to a lack of access to sanitation facilities remains a public health issue in the United States. People experiencing homelessness face barriers to accessing sanitation facilities, and are often forced to practice open defecation on streets and sidewalks. Exposed feces may contain harmful pathogens posing a significant threat to public health, especially among unhoused persons living near open defecation sites. The City of San Francisco’s Department of Public Works implemented the Pit Stop Program to provide the unhoused and the general public with improved access to sanitation with the goal of reducing fecal contamination on streets and sidewalks. The objective of this study was to assess the impact of these public restroom interventions on reports of exposed feces in San Francisco, California. Methods We evaluated the impact of various public restroom interventions implemented from January 1, 2014 to January 1, 2020 on reports of exposed feces, captured through a 311 municipal service. Publicly available 311 reports of exposed feces were spatially and temporally matched to 31 Pit Stop restroom interventions in ten San Francisco neighborhoods. We conducted an interrupted time-series analysis to compare pre- versus post-intervention rates of feces reports near the restrooms. Results Feces reports declined by 12.47 reports per week after the installation of 13 Pit Stop restrooms (p-value = 0.0002). The rate of reports per week declined from the six-month pre-intervention period to the post-intervention period (slope change=-0.024 [95% CI=-0.033, -0.014]). Reports also declined after new restroom installations in the Mission and Golden Gate Park, and after the provision of attendants in the Mission, Castro/Upper Market, and Financial District/South Beach. Conclusions Increased access to public toilets and the addition of restroom attendants reduced fecal contamination in San Francisco, especially in neighborhoods with people experiencing homelessness. Programs that improve access to public restrooms should be evaluated at the neighborhood level in order to tailor sanitation interventions to neighborhood-specific needs.

Framing Obesity: Effects of Obesity Labeling and Prevalence Statistics on Public Perceptions

2018 ◽  
Vol 46 (2) ◽  
pp. 322-328 ◽  
Author(s):  
Jiawei Liu ◽  
ByungGu Lee ◽  
Douglas M. McLeod ◽  
Hyesun Choung
Keyword(s):  
Public Health ◽  
Prevalence Rate ◽  
The United States ◽  
Reference Points ◽  
Public Health Issue ◽  
Accurate Information ◽  
Prevalence Rates ◽  
Body Type ◽  
Prevalence Of Obesity ◽  
The Impact

The rising prevalence rate of obesity in the United States has accentuated concerns about obesity-related problems as a major public health issue, which has motivated widespread efforts to increase public knowledge and to motivate individuals to change their relevant behaviors. Although health campaign messages commonly include information about prevalence rates for obesity, the impact of obesity labeling and prevalence rate descriptions in such messages has been overlooked by researchers. This online framing experiment fills the research gap by investigating the effects of obesity labeling (disease vs. body type) and prevalence statistics (prevalence rates of obesity, extreme obesity, combined overweight–obesity, or no prevalence information). Our findings suggest that obesity perceptions deviate from reality and that participants use framed cues in the health message as reference points when making judgments related to the nature and prevalence of obesity. Moreover, this study shows that even accurate information might lead to inaccurate perceptions as a result of framing, and perceptions of the nature and prevalence of obesity mediate the effects of framing on behavioral intentions. Implications for obesity framing and the design of public health messages are discussed.

scholarly journals LB-16. Association Between Universal Face Shield in a Quaternary Care Center and Reduction of SARS-COV2 Infections Among Healthcare Personnel and Hospitalized Patients

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S851-S851
Author(s):  
Vagesh Hemmige ◽  
Becky Winterer ◽  
Todd Lasco ◽  
Bradley Lembcke
Keyword(s):  
Time Series ◽  
Care Center ◽  
Interrupted Time Series ◽  
Hospitalized Patients ◽  
Healthcare Personnel ◽  
Segmented Regression ◽  
Intervention Period ◽  
Interrupted Time Series Analysis ◽  
Post Intervention ◽  
The Impact

Abstract Background SARS-COV2 transmission to healthcare personnel (HCP) and hospitalized patients is a significant challenge. Our hospital is a quaternary healthcare system with more than 500 beds and 8,000 HCP. Between April 1 and April 17, 2020, we instituted several infection prevention strategies to limit transmission of SARS-COV2 including universal masking of HCP and patients, surveillance testing every two weeks for high-risk HCP and every week for cluster units, and surveillance testing for all patients on admission and prior to invasive procedures. On July 6, 2020, we implemented universal face shield for all healthcare personnel upon entry to facility. The aim of this study is to assess the impact of face shield policy on SARS-COV2 infection among HCP and hospitalized patients. Figure 1- Interrupted time series Methods The preintervention period (April 17, 2020-July 5, 2020) included implementation of universal face masks and surveillance testing of HCP and patients. The intervention period (July 6, 2020-July 26, 2020) included the addition of face shield to all HCP (for patient encounters and staff-to-staff encounters). We used interrupted time series analysis with segmented regression to examine the effect of our intervention on the difference in proportion of HCP positive for SARS-COV2 (using logistic regression) and HAI (using Poisson regression). We defined significance as p values < 0.05. Results Of 4731 HCP tested, 192 tested positive for SARS-COV2 (4.1%). In the preintervention period, the weekly positivity rate among HCP increased from 0% to 12.9%. During the intervention period, the weekly positivity rate among HCP decreased to 2.3%, with segmented regression showing a change in predicted proportion positive in week 13 (18.0% to 3.7%, p< 0.001) and change in the post-intervention slope on the log odds scale (p< 0.001). A total of 14 HAI cases were identified. In the preintervention period, HAI cases increased from 0 to 5. During the intervention period, HAI cases decreased to 0. There was a change between pre-intervention and post-intervention slope on the log scale was significant (p< 0.01). Conclusion Our study showed that the universal use of face shield was associated with significant reduction in SARS-COV2 infection among HCP and hospitalized patients. Disclosures All Authors: No reported disclosures

scholarly journals Factors Associated with Time to Appropriate Treatment in Pertussis Cases in Georgia, 2009 to 2013

2016 ◽  
Vol 60 (5) ◽  
pp. 3051-3056 ◽  
Author(s):  
Dana Goodenough ◽  
Ebony Thomas ◽  
Jessica Tuttle ◽  
Robert A. Bednarczyk
Keyword(s):  
Public Health ◽  
Linear Regression ◽  
Antibiotic Treatment ◽  
Health Care Providers ◽  
The United States ◽  
Vaccination Status ◽  
Public Health Issue ◽  
Care Providers ◽  
Time To Treatment ◽  
The Impact

ABSTRACTPertussis is endemic in the United States, with periodic epidemics that continue to highlight its importance as a public health issue. The clinical presentation of pertussis can vary by age and vaccination status. However, little is known about the factors that affect time to antibiotic treatment of pertussis cases. We analyzed 5 years of data from the Georgia Department of Public Health to understand how factors such as age, symptoms, and vaccination status can alter the clinical picture of pertussis and affect time to treatment. We used multivariable linear regression to assess the impact of each variable on time to antibiotic treatment. There was little consistency across age groups for symptom and demographic predictors of time to antibiotic treatment. Overall, the multivariate linear regression showed that among patients ≤18 years old, none of the variables had an impact on time to antibiotic treatment greater than −0.25 to 1.47 days. Among patients >18 years old, most variables had little impact on time to treatment, though two (paroxysmal cough in >18- to 40-year-olds and hospitalization in individuals over 40) were associated with an additional 5 days in time to treatment from cough onset. This study highlights how the difficulties in pertussis diagnosis, particularly among adults, can affect time to antibiotic treatment; adults may not begin antibiotic treatment until there is an accumulation of symptoms. Health care providers need to recognize the variety of symptoms that pertussis can present with and consider confirmatory testing early.

scholarly journals Fall of Community-Acquired Pneumonia in Children Following COVID-19 Non-Pharmaceutical Interventions: A Time Series Analysis

Pathogens ◽  
2021 ◽  
Vol 10 (11) ◽  
pp. 1375
Author(s):  
Alexis Rybak ◽  
David Dawei Yang ◽  
Cécile Schrimpf ◽  
Romain Guedj ◽  
Corinne Levy ◽  
...  
Keyword(s):  
Time Series ◽  
Time Series Analysis ◽  
Pediatric Emergency ◽  
Community Acquired Pneumonia ◽  
Intervention Period ◽  
Interrupted Time Series Analysis ◽  
Post Intervention ◽  
Series Analysis ◽  
The Impact ◽  
Pharmaceutical Interventions

Non-pharmaceutical interventions (NPIs) were implemented to reduce the spread of coronavirus disease 2019 (COVID-19). A first national lockdown was decided in France on the 17 March 2020. These measures had an impact on other viral and non-viral infectious diseases. We aimed to assess this impact on community-acquired pneumonia (CAP) in children. We performed a quasi-experimental interrupted time series analysis. We used data from a French prospective surveillance system of six pediatric emergency departments (PEDs). All visits from 1 January 2017 to 31 December 2020 were included. Pre-intervention period was before 17 March 2020 and post-intervention period was after 18 March 2020. We estimated the impact on the weekly number of visits for CAP and CAP admission using quasi-Poisson regression modeling. A total of 981,782 PEDs visits were analyzed; among them, 8318 visits were associated with CAP, and 1774 of these were followed by a hospital admission. A major decrease was observed for CAP visits (–79.7% 95% CI [–84.3; –73.8]; p < 0.0001), and CAP admission (–71.3% 95 CI [–78.8; –61.1]; p < 0.0001). We observed a dramatic decrease of CAP in children following NPIs implementation. Further studies are required to assess the long-term impact of these measures.

scholarly journals Bubonic Panic: When Plague Invaded America by G. Jarrow

2017 ◽  
Vol 6 (3) ◽  
Author(s):  
Tammy Flanders
Keyword(s):  
Public Health ◽  
Hong Kong ◽  
San Francisco ◽  
Social Issues ◽  
The United States ◽  
Third Wave ◽  
Teaching Resources ◽  
Ongoing Research ◽  
Technological Developments ◽  
The Impact

Jarrow, Gail. Bubonic Panic: When Plague Invaded America. Calkins Creek, 2015.If public health seems like it would be one of those topics that would send you to sleep, then Bubonic Plague: When Plague Invaded America by Gail Jarrow will change your mind. This is the final book in her trilogy about Deadly Diseases for middle grades and higher.Jarrow is fairly succinct in presenting the history, transmission, and trajectory of various waves of plague around the world.  She briefly charts its first appearance in 541 in Turkey, then vividly describes the second wave that started in 1346 and at its most virulent was named the Black Death, killing millions in Europe and parts of Asia and North Africa. The majority of the book focuses on the third wave, when it reached North America.The third pandemic began in the mid-1800s when China became ground zero for this next wave, which spread to Hong Kong by 1894. Hong Kong was a busy port town and trade and travel on steamships allowed for rapid dispersion of the disease. Researchers from a number of countries sought feverishly to identify the source of the epidemic and learn how it was spread. By the late 1890s two of them had proven it was rat fleas. Unfortunately almost nobody believed them, which became problematic when in 1900 San Francisco saw its first deaths in Chinatown.Jarrow provides a fascinating look at the political and social climate of this period in relation to the attitudes of Americans towards Chinese immigrants and the impact quarantining San Francisco’s Chinatown would have on businesses reliant on trade and tourism. It became a complicated and fraught tug-o-war between politicians, businessmen, doctors and public health officials, fighting about whether to recognize and publicize the deaths and quarantine when the evidence seemed inconclusive as to their cause. Even after proof was offered action was surprisingly slow to follow and the disease was able to spread, although the number of deaths was comparatively low, being in the low hundreds.This well researched book also includes information about contemporary cases in the United States, ongoing research and treatments for all three strains of plague.  There are extensive source notes and bibliography, a glossary, timeline, index and an author’s note explaining her keen interest in public health and the importance it had in the past,and will have when the next global pandemic hits. Also included are numerous photographs (some a little gruesome), newspaper clippings, cartoons, posters and illustrations to engage readers’ interest.This will pair perfectly with a middle grade novel, Chasing Secrets by Gennifer Choldenko, 2015 that gives a fictional account of the outbreak in San Francisco.This is a strong finish to a fascinating series that combines history, social issues, scientific research, technological developments and culture in America, showing long term implications for today’s government policies towards health.Highly Recommended: 4 out of 4 starsReviewer: Tammy FlandersTammy is the Reference Coordinator in the Doucette Library of Teaching Resources at the University of Calgary. She also reviews juvenile resources with an eye to classroom use in her blog, Apples with Many Seeds.

scholarly journals Dual MD–MPH Degree Students in the United States: Moving the Medical Workforce Toward Population Health

2021 ◽  
pp. 003335492097842
Author(s):  
Jo Marie Reilly ◽  
Christine M. Plepys ◽  
Michael R. Cousineau
Keyword(s):  
Public Health ◽  
United States ◽  
Population Health ◽  
Health Care Policy ◽  
The United States ◽  
Extensive Literature ◽  
Master Of Public Health ◽  
Telephone Interviews ◽  
Public Health Training ◽  
The Impact

Objective A growing need exists to train physicians in population health to meet the increasing need and demand for physicians with leadership, health data management/metrics, and epidemiology skills to better serve the health of the community. This study examines current trends in students pursuing a dual doctor of medicine (MD)–master of public health (MPH) degree (MD–MPH) in the United States. Methods We conducted an extensive literature review of existing MD–MPH databases to determine characteristics (eg, sex, race/ethnicity, MPH area of study) of this student cohort in 2019. We examined a trend in the MD community to pursue an MPH career, adding additional public health and health care policy training to the MD workforce. We conducted targeted telephone interviews with 20 admissions personnel and faculty at schools offering MD–MPH degrees in the United States with the highest number of matriculants and graduates. Interviews focused on curricula trends in medical schools that offer an MD–MPH degree. Results No literature describes the US MD–MPH cohort, and available MD–MPH databases are limited and incomplete. We found a 434% increase in the number of students pursuing an MD–MPH degree from 2010 to 2018. The rate of growth was greater than the increase in either the number of medical students (16%) or the number of MPH students (65%) alone. Moreover, MD–MPH students as a percentage of total MPH students more than tripled, from 1.1% in 2010 to 3.6% in 2018. Conclusions As more MD students pursue public health training, the impact of an MPH degree on medical school curricula, MD–MPH graduates, and MD–MPH career pursuits should be studied using accurate and comprehensive databases.

scholarly journals More Than Shelter: Housing for Urban Maternal and Infant Health

2021 ◽  
Vol 18 (7) ◽  
pp. 3331
Author(s):  
Jason Reece
Keyword(s):  
Public Health ◽  
Maternal Health ◽  
Health Outcomes ◽  
City Planning ◽  
Infant Health ◽  
The United States ◽  
Housing Quality ◽  
Housing Discrimination ◽  
Maternal Health Outcomes ◽  
The Impact

Housing quality, stability, and affordability have a direct relationship to socioemotional and physical health. Both city planning and public health have long recognized the role of housing in health, but the complexity of this relationship in regard to infant and maternal health is less understood. Focusing on literature specifically relevant to U.S. metropolitan areas, I conduct a multidisciplinary literature review to understand the influence of housing factors and interventions that impact infant and maternal health. The paper seeks to achieve three primary goals. First, to identify the primary “pathways” by which housing influences infant and maternal health. Second, the review focuses on the role and influence of historical housing discrimination on maternal health outcomes. Third, the review identifies emergent practice-based housing interventions in planning and public health practice to support infant and maternal health. The literature suggests that the impact of housing on infant health is complex, multifaceted, and intergenerational. Historical housing discrimination also directly impacts contemporary infant and maternal health outcomes. Policy interventions to support infant health through housing are just emerging but demonstrate promising outcomes. Structural barriers to housing affordability in the United States will require new resources to foster greater collaboration between the housing and the health sectors.

scholarly journals The Arab region’s contribution to global COVID-19 research: Bibliometric and visualization analysis

2021 ◽  
Vol 17 (1) ◽  
Author(s):  
Sa’ed H. Zyoud
Keyword(s):  
Public Health ◽  
Saudi Arabia ◽  
Population Size ◽  
Low Income ◽  
Research Output ◽  
Arab World ◽  
The United States ◽  
Arab Countries ◽  
Public Health Issue ◽  
Global Research

Abstract Background At the global level and in the Arab world, particularly in low-income countries, COVID-19 remains a major public health issue. As demonstrated by an incredible number of COVID-19-related publications, the research science community responded rapidly. Therefore, this study was intended to assess the growing contribution of the Arab world to global research on COVID-19. Methods For the period between December 2019 and March 2021, the search for publications was conducted via the Scopus database using terms linked to COVID-19. VOSviewer 1.6.16 software was applied to generate a network map to assess hot topics in this area and determine the collaboration patterns between different countries. Furthermore, the research output of Arab countries was adjusted in relation to population size and gross domestic product (GDP). Results A total of 143,975 publications reflecting the global overall COVID-19 research output were retrieved. By restricting analysis to the publications published by the Arab countries, the research production was 6131 documents, representing 4.26% of the global research output regarding COVID-19. Of all these publications, 3990 (65.08%) were original journal articles, 980 (15.98%) were review articles, 514 (8.38%) were letters and 647 (10.55%) were others, such as editorials or notes. The highest number of COVID-19 publications was published by Saudi Arabia (n = 2186, 35.65%), followed by Egypt (n = 1281, 20.78%) and the United Arab Emirates (UAE), (n = 719, 11.73%). After standardization by population size and GDP, Saudi Arabia, UAE and Lebanon had the highest publication productivity. The collaborations were mostly with researchers from the United States (n = 968), followed by the United Kingdom (n = 661). The main research lines identified in COVID-19 from the Arab world are related to: public health and epidemiology; immunological and pharmaceutical research; signs, symptoms and clinical diagnosis; and virus detection. Conclusions A novel analysis of the latest Arab COVID-19-related studies is discussed in the current study and how these findings are connected to global production. Continuing and improving future collaboration between developing and developed countries will also help to facilitate the sharing of responsibilities for COVID-19 in research results and the implementation of policies for COVID-19.

scholarly journals Standing on the shoulders of Giants: a citation analysis of the paediatric congenital heart disease literature

2021 ◽  
pp. 1-9
Author(s):  
Daniel P. Sew ◽  
Nigel E. Drury
Keyword(s):  
Citation Analysis ◽  
San Francisco ◽  
Citation Count ◽  
Case Series ◽  
Scientific Progress ◽  
The United States ◽  
Original Research ◽  
Prolific Author ◽  
Journal Citation Reports ◽  
The Impact

Abstract Objective: The citation history of a published article reflects its impact on the literature over time. We conducted a comprehensive bibliometric analysis to identify the most cited papers on CHD in children. Methods: One-hundred and ninety journals listed in Journal Citation Reports were accessed via Web of Science. Publications with 250 or more citations were identified from Science Citation Index Expanded (1900–2020), and those relating to structural CHD in children were reviewed. Articles were ranked by citation count and the 100 most cited were analysed. Results: The number of citations ranged from 2522 to 309 (median 431, IQR 356–518), with 35 published since 2000. All were written in English, most originated from the United States (74%), and were published in cardiovascular journals, with Circulation (28%) the most frequent. There were 86 original research articles, including 50 case series, 14 cohort studies, and 10 clinical trials. The most cited paper was by Hoffman JI and Kaplan S on the incidence of CHD. Thirteen authors had 4 or more publications in the top 100, all of whom had worked in Boston, Philadelphia, San Francisco, or Dallas, and the most prolific author was Newburger JW (9 articles). Conclusions: Citation analysis provides a historical perspective on scientific progress by assessing the impact of individual articles. Our study highlights the dominant position of US-based researchers and journals in this field. Most of the highly cited articles remain case series, with few randomised controlled trials in CHD appearing in recent years.

scholarly journals High food insecurity in Latinx families and associated COVID-19 infection in the Greater Bay Area, California

BMC Nutrition ◽  
2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Milagro Escobar ◽  
Andrea DeCastro Mendez ◽  
Maria Romero Encinas ◽  
Sofia Villagomez ◽  
Janet M. Wojcicki
Keyword(s):  
Food Security ◽  
Food Insecurity ◽  
San Francisco ◽  
Employment Status ◽  
The United States ◽  
Household Food Security ◽  
Bay Area ◽  
Household Food ◽  
History Of ◽  
The Impact

Abstract Background Food insecurity impacts nearly one-in-four Latinx households in the United States and has been exacerbated by the novel coronavirus or COVID-19 pandemic. Methods We examined the impact of COVID-19 on household and child food security in three preexisting, longitudinal, Latinx urban cohorts in the San Francisco Bay Area (N = 375 households, 1875 individuals). Households were initially recruited during pregnancy and postpartum at Zuckerberg San Francisco General Hospital (ZSFG) and UCSF Benioff prior to the COVID-19 pandemic. For this COVID-19 sub-study, participants responded to a 15-min telephonic interview. Participants answered 18 questions from the US Food Security Food Module (US HFSSM) and questions on types of food consumption, housing and employment status, and history of COVID-19 infection as per community or hospital-based testing. Food security and insecurity levels were compared with prior year metrics. Results We found low levels of household food security in Latinx families (by cohort: 29.2%; 34.2%; 60.0%) and child food security (56.9%, 54.1%, 78.0%) with differences between cohorts explained by self-reported levels of education and employment status. Food security levels were much lower than those reported previously in two cohorts where data had been recorded from prior years. Reported history of COVID-19 infection in households was 4.8% (95% Confidence Interval (CI); 1.5–14.3%); 7.2% (95%CI, 3.6–13.9%) and 3.5% (95%CI, 1.7–7.2%) by cohort and was associated with food insecurity in the two larger cohorts (p = 0.03; p = 0.01 respectively). Conclusions Latinx families in the Bay Area with children are experiencing a sharp rise in food insecurity levels during the COVID-19 epidemic. Food insecurity, similar to other indices of poverty, is associated with increased risk for COVID-19 infection. Comprehensive interventions are needed to address food insecurity in Latinx populations and further studies are needed to better assess independent associations between household food insecurity, poor nutritional health and risk of COVID-19 infection.

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