The impact of childhood residential mobility on mental health outcomes in adolescence and early adulthood: a record linkage study.

Background Understanding the causes of poor mental health in early childhood and adolescence is important as this can be a significant determinant of mental well-being in later years. One potential and relatively unexplored factor is residential mobility in formative years. Previous studies have been relatively small and potentially limited due to methodological issues. The main aim of this study was to investigate the relationship between early residential instability and poor mental health among adolescents and young adults in Northern Ireland.

Methods A Census-based record linkage study of 28% of children aged 0–8 years in 2001 in Northern Ireland (n=49 762) was conducted, with six monthly address change assessments from health registration data and self-reported mental health status from the 2011 Census. Logistic regression models were built adjusting for socioeconomic status (SES), household composition and marital dissolution.

Results There was a graded relationship between the number of address changes and mental ill-health (adjusted OR 3.67, 95% CIs 2.11 to 6.39 for 5 or more moves). This relationship was not modified by SES or household composition. Marital dissolution was associated with poor mental health but did not modify the relationship between address change and mental health (p=0.206). There was some indication that movement after the age of five was associated with an increased likelihood of poor mental health.

Conclusions This large study clearly confirms the close relationship between address change in early years and later poor mental health. Residential mobility may be a useful marker for children at risk of poorer mental health in adolescence and early adulthood

Healthy Food, Healthy Iowans, Healthy Communities Public Health Tools to Advance Healthy, Sustainable Food Systems, June 2014

The purposes of the Healthy Food, Healthy Iowans, Healthy communities Series are to demonstrate the interconnectedness of the food system to public health issues (Part 1) and to provide tools to local public health agencies for assessing, planning, implementing and evaluating food system initiatives (Part 2).

Iowa Immunization Program Annual Report 2013, April 30, 2014

The Bureau of Immunization is part of the Division of Acute Disease Prevention and Emergency Response (ADPER) at the Iowa Department of Public Health (IDPH). The ADPER division provides support, technical assistance and consultation to local hospitals, public health agencies, community health centers, emergency medical service programs and local health care providers regarding infectious diseases, disease prevention and control, injury prevention and public health and health care emergency preparedness and response. The division encompasses the Center for Acute Disease Epidemiology (CADE), the Bureau of Immunization and Tuberculosis (ITB), the Bureau of Emergency Medical Services (EMS), the Bureau of Communication and Planning (CAP), the Office of Health Information Technology (HIT), and the Center for Disaster Operations and Response (CDOR). The Bureau of Immunization and Tuberculosis includes the Immunization Program, the Tuberculosis Control Program, and the Refugee Health Program. The mission of the Immunization Program is to decrease vaccine‐preventable diseases through education, advocacy and partnership. While there has been major advancement in expanding immunizations to many parts of Iowa’s population, work must continue with public and private health care providers to promote the program’s vision of healthy Iowans living in communities free of vaccine‐preventable diseases. Accomplishing this goal will require achieving and maintaining high vaccination coverage levels, improving vaccination strategies among under‐vaccinated populations, prompt reporting and thorough investigation of suspected disease cases, and rapid institution of control measures. The Immunization Program is comprised of multiple programs that provide immunization services throughout the state: Adolescent Immunization Program, Adult Immunization Program, Immunization Registry Information System (IRIS), Vaccines for Children Program (VFC), Perinatal Hepatitis B Program, and Immunization Assessment Program.

Health equity in all policies

Public Health England (PHE) worked with the Association of Directors of Public Health (ADPH) and the Local Government Association (LGA) to develop a masterclass to understand what PHE could do to support directors and consultants of public health to embed health and health equity in all policies at a local level. These documents provide a full report and executive summary of 2 pilot masterclasses held on: 25 February 2015 in London 17 March 2015 in Manchester The masterclasses aimed to: frame public health challenges and use appropriate language within the context of overarching local authority priorities effectively position health and wellbeing in the context of competing (and sometimes conflicting) policy agendas engage wider service and policy areas in the pursuit of health and health equity within current economic and funding contexts

Long-term community responses to droughts in the early modern period: the case study of Terrassa, Spain

New challenges posed by global environmental change have motivated scholars to pay growing attention to historical long-term strategies to deal with climate extremes. We aim to understand long-term trends in community responses to cope with droughts, to explain how many preindustrial societies coevolved with local hydro-climatic dynamics and coped with climate extremes over time. The specific goals of this work are: (1) to analyze how local communities experienced droughts over long periods of time and (2) to document the spectrum of recorded community responses to drought. Our research covers over one century (1605-1710) of responses to drought in the community of Terrassa, Barcelona, Spain. Data were collected through archival research. We reviewed and coded 2076 village council minutes. Our results show that the local community adopted a mixture of symbolic, institutional, and infrastructural responses to drought and that drought-related decisions varied through time. We discuss adaptation strategies on the basis of the distinct physical signals of drought propagation and the role of nonclimatic historical factors, such as warfare and public debt, in shaping responses. We conclude that long-term perspectives on premodern history and comparable empirical studies are fundamental to advance our understanding of past social responses to hydro-climatic extremes.

Evaluating the efficiency of community-based HIV testing and counseling strategies in sub-Saharan Africa

Thesis (Ph.D.)--University of Washington, 2016-08

Gardening for Health: Patterns of Gardening and Fruit and Vegetable Consumption on the Navajo Nation

Thesis (Master's)--University of Washington, 2016-08

What is best for Esther? Building improvement coaching capacity with and for users in health and social Care-A case study

While coaching and customer involvement can enhance the improvement of health and social care, many organizations struggle to develop their improvement capability; it is unclear how best to accomplish this. We examined one attempt at training improvement coaches. The program, set in the Esther Network for integrated care in rural Jonkoping County, Sweden, included eight 1-day sessions spanning 7 months in 2011. A senior citizen joined the faculty in all training sessions. Aiming to discern which elements in the program were essential for assuming the role of improvement coach, we used a case-study design with a qualitative approach. Our focus group interviews included 17 informants: 11 coaches, 3 faculty members, and 3 senior citizens. We performed manifest content analysis of the interview data. Creating will, ideas, execution, and sustainability emerged as crucial elements. These elements were promoted by customer focusembodied by the senior citizen trainershared values and a solution-focused approach, by the supportive coach network and by participants' expanded systems understanding. These elements emerged as more important than specific improvement tools and are worth considering also elsewhere when seeking to develop improvement capability in health and social care organizations.

Positive mental health in adults reporting sexual abuse in childhood

The purpose of this study was to investigate whether a history of child sexual abuse can impact Positive Mental Health in Canadian adults and how frequency of child sexual abuse as well as perceived social support impact Positive Mental Health scores for this population. Data was collected from the Canadian Community Health Survey- Mental Health 2012 and included a sample of 20,529 adults aged 18 and older, living across ten provinces. A one-way ANOVA showed a significant difference between Positive Mental Health scores for individuals reporting a history of child sexual abuse compared to those reporting no history of child sexual abuse. A regression analysis found that reported frequency of child sexual abuse did not significantly impact Positive Mental Health scores for individuals reporting child sexual abuse. It also found that perception of social support was positively related to Positive Mental Health scores and accounted for 25% of the variance in Positive Mental Health scores for individuals reporting child sexual abuse. The implications of these findings are discussed in this study.

Exploring Health in Military Families: Does Continuity of Care Influence Patient Satisfaction?

To ensure mission-readiness for military members, support for their families is essential. Military family health and health care satisfaction has been a neglected area of study in this population. Satisfaction can be defined in terms of patient-, provider-, and practice-level factors and is influenced by continuity of care, which is often poor in transient military populations. Using a modified patient satisfaction survey, this study found that both the number of moves and assigned providers were significantly associated with continuity of care in military spouses. Further, continuity of care was a significant predictor of satisfaction with military health care.

The relationship between health literacy and indicators of informed decision making for colorectal cancer screening among African Americans

African Americans are disproportionately affected by colorectal cancer (CRC) incidence and mortality. CRC early detection leads to better treatment outcomes and, depending on the screening test, can prevent the development of CRC. African Americans, however, are screened less often than Whites. Aspects of decision making (e.g., decisional conflict, decision self-efficacy) can impact decision making outcomes and may be influenced by social determinants of health, including health literacy. However the relationship between social determinants of health and indicators of decision making in this population is not fully understood. Additionally, individuals have a choice between different CRC screening tests and an individual’s desire to use a particular screening test may be associated with social determinants of health such as health literacy. This study aimed to examine the relationship between social determinants of health and indicators of decision making for CRC screening among African Americans. A total of 111 participants completed a baseline and 14-month follow-up survey assessing decisional conflict, decision self-efficacy, decisional preference (shared versus informed decision making), and CRC test preference. Health literacy was negatively associated with decisional conflict and positively associated with decision self-efficacy (ps < .05). Individuals who were unemployed or working part-time had significantly greater decisional conflict than individuals working full-time (ps < .05). Individuals with a first-degree family history of CRC had significantly lower decision self-efficacy than individuals without a family history (p < .05). Women were significantly more likely to prefer making a shared decision rather than an informed decision compared to men (p < .05). Lastly, previous CRC screening behavior was significantly associated with CRC test preference (e.g., individuals previously screened using colonoscopy were significantly more likely to prefer colonoscopy for their next screening test; ps < .05). These findings begin to identify social determinants of health (e.g., health literacy, employment) that are related to indicators of decision making for CRC among African Americans. Furthermore, these findings suggest further research is needed to better understand these relationships to help with the future development and improvement of interventions targeting decision making outcomes for CRC screening in this population.

An investigation on benthic macro-invertebrates species diversity as bio-indicators of environmental health in Bahrekan Bay

The purpose of this study was to evaluate benthic macro-invertebrates species diversity as bio-indicators of environmental health in Bahrekan bay (in the Northwest of Persian gulf). Seasonal sediments sampling along 5 transects, 15 stations at 4 replicates (3 replicates for macrobenthos and 1 replicate for sediment analysis) was done from November 2008 to August 2009 by 0.025 m2 Van Veen grab sampler. Physical and chemical parameters of water, grain size analysis, %TOM and Ni and Va concentrations of sediments were assessed through four seasons. Macrobenthic communities after staining and sorting, using stereomicroscope have been identified. Their density in every station and every season calculated. For using of AMBI index, identified macrobenthos according to their sensitivity to stressors and pollutants, categorized into 5 ecological groups and for using of Bentix index categorized into 3 ecological groups. The diversity indices and indicators that showing ecological status were calculated. Also, the differences between physiochemical parameters of sea water, sediments TOM% and grain size, diversity indices in stations and seasons were recorded (P=0.05). The correlation coefficient determined for all parameters. According to the results of grain size analysis, bottom grain size categorized as clay. Highest percent of TOM was belong to autumn (36.39±.075) and lowest was belong to summer (19.01±0.51). Also there was positive correlation (p=0.01) between %TOM and %Clay that showing sediments with lowest size containing highest amounts of organic matters. Ni concentrations in sediments (87.80±21.25)mg/kg showed the amounts over than standards levels but Va concentrations in sediments (53.54±17.60)mg/kg showed the amounts lower than standards level. The highest density of macrobenthos was recorded for summer (8254±485) N/m2 and the lowest density was recorded for spring (3775±172)N/m2. The highest annual density was belong to mollusca (81%) and then polycheates (13%), Others (4%) and crustaceae (2%). The highest diversity was recorded for winter (Simpson index: 0.13±0.01, H':3.47±0.06) and the lowest diversity recorded for autumn (Simpson index: 0.16±0.01, H':3.17±0.06). in all stations, the highest amount of Shanon index was belong to T2S3 station in summer (4.11± 0.32) and the lowest amount was belong to T1S1 station in autumn (2.42± 0.41). The annual mean of Simpson diversity index: (0.15 ±0.04) and Shanon diversity index (3.36±0.03), illustrated that macrobenthos in Bahrekan bay have a good variation. The results of Brilluin and N1 (Number of equally common species) indices confirm the results of Simpson index. For study on the regions that diversity has a little difference between stations, with use of Ni index, the degree of differences could be better ono recognizable. According to the results of AMBI index in all seasons (autumn: 0.46±0.03; summer: 0.22±0.01; annual mean:0.31±0.01) and standards (0.0community health: normal and ecological status: high; 0.2community health: impoverished; ecological status: high) ecological status for all seasons categorized in high status with dominant ecological groups I (sensitive species) but benthic community health were impoverished. The results of Bentix index in all seasons (autumn: 5.07±0.07; summer: 5.57±0.02; annual mean: 5.40±0.02) and standards (4.5

Resilience to Climate Change: An Ethnographic Approach

Global projections for climate change impacts produce a startling picture of the future for low-lying coastal communities. The United States’ Chesapeake Bay region and especially marginalized and rural communities will be severely impacted by sea level rise and other changes over the next one hundred years. The concept of resilience has been theorized as a measure of social-ecological system health and as a unifying framework under which people can work together towards climate change adaptation. But it has also been critiqued for the way in which it does not adequately take into account local perspective and experiences, bringing into question the value of this concept as a tool for local communities. We must be sure that the concerns, weaknesses, and strengths of particular local communities are part of the climate change adaptation, decision-making, and planning process in which communities participate. An example of this type of planning process is the Deal Island Marsh and Community Project (DIMCP), a grant funded initiative to build resilience within marsh ecosystems and communities of the Deal Island Peninsula area of Maryland (USA) to environmental and social impacts from climate change. I argue it is important to have well-developed understandings of vulnerabilities and resiliencies identified by local residents and others to accomplish this type of work. This dissertation explores vulnerability and resilience to climate change using an engaged and ethnographic anthropological perspective. Utilizing participant observation, semi-structured and structured interviews, text analysis, and cultural domain analysis I produce an in-depth perspective of what vulnerability and resilience means to the DIMCP stakeholder network. Findings highlight significant vulnerabilities and resiliencies inherent in the local area and how these interface with additional vulnerabilities and resiliencies seen from a nonlocal perspective. I conclude that vulnerability and resilience are highly dynamic and context-specific for the local community. Vulnerabilities relate to climate change and other social and environmental changes. Resilience is a long-standing way of life, not a new concept related specifically to climate change. This ethnographic insight into vulnerability and resilience provides a basis for stronger engagement in collaboration and planning for the future.

COMMUNITY KNOWLEDGE, ATTITUDE AND PRACTICES (KAP) ON FLUOROSIS AND ITS MITIGATION IN ENDEMIC AREAS OF ETHIOPIA

Optimum fluoride intake plays an essential role in the prevention of dental caries while fluoride consumption above recommended level interferes with the normal formation of tooth enamel and bones and may increase risk of dental and skeletal fluorosis. The knowledge and practices of endemic communities on etiology of fluorosis will help in its mitigation and prevention. The objective of this study was to investigate the knowledge, attitude and practices of endemic community on fluoride contamination, fluorosis and prevention practices in order to devise coordinated and targeted prevention mechanisms. Focus group discussions (FGD) and key-informant interview were conducted in three dietary areas to collect knowledge, attitude and practices (KAP) of the endemic community in July 2013.The results indicated that health consequences of fluoride contaminated water are fairly understood. None of the discussants mentioned the word “fluoride”. The knowledge and perception of the community on fluoride ingestion is poor. Health extension workers (HEWs) did not teach about fluoride and related health consequences. Dental fluorosis was reported to start at early ages and not commonly perceived as a major problem. However, adolescents worried and felt that they might be singled out when going to other areas. Older people have a skeletal fluorosis, which interferes with their day to day activities. In severely affected people, the teeth were weak and fragile and thus create difficulty in chewing hard foods like unfermented dry flat bread, sugar cane and toasted grains. People prefer rain water rather than water from borehole because of the inconvenient taste of the latter. The endemic communities have no sufficient knowledge and skills on potential sources of fluoride intake, the debilitating effect of high fluoride ingestion, and preventive and mitigatory measures to reduce fluoride intake. The effect of fluoride contamination and mitigatory methods should get sufficient attention by the community, health workers and concerned governmental bodies. The trend of harvesting and using rain water should be encouraged as it reduces fluoride intake. Future studies should focus on information communication on possible fluoride risks, intervention and evaluation studies on defluoridation, rain water harvesting and mitigatory techniques.

The two opposing impacts of heritage making on local communities : residents’ perceptions: a Portuguese case

This article examines the impact associated with the making of heritage and tourism at a destination. Special attention is paid to the residents’ perceptions of the impact. The examination is focused on the rural village of Sortelha, in Portugal, where, in recent decades, a state-led programme was implemented in order to renovate the historic buildings and built fabric and to generate benefits for the local community. Based on ethnographic materials collected in 2003, 2009 and 2013, the study demonstrates that the making of heritage may give rise to two opposing impacts simultaneously – increased social cohesion and place pride, on the one hand, and envy and competition (and, hence, social atomisation), on the other hand – and that residents are entirely cognisant of the tension between the two. The study has the potential to contribute to both the theoretical and the applied literature on heritage making.