Browsing by Subject "Public health"

Now showing 1 - 12 of 12
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    Development And Application Of Targeted Dna Sequencing Tools To Profile Microbiome-Wide Antimicrobial Resistance And Pathogens Of Public Health Importance
    (2024-02) Slizovskiy, Ilya
    Antimicrobial resistance (AMR) poses critical health challenges as drivers of frequent and severe global outbreaks. In the U.S. alone, AMR accounts for one infection every eleven seconds, and one death every fifteen minutes. Bacterial antimicrobial resistance genes (ARGs) are the underpinning determinants of AMR, and traditionally prevention and surveillance efforts have focused on cultivating and studying resistant pathogens harboring DNA-encoded ARGs, isolated from human, animal, food, and environmental sources. However, across most compartments of the biosphere, bacteria reside as community members of complex microbial ecosystems with diverse ecological interactions and defined niche profiles. The perspective of the community-level composition and processes that lead to AMR rise and dissemination is rarely accounted for. Though culture-independent methods like PCR have been used for decades, recent advances in the field of metagenomics offers the possibility of directly sequencing the entire genetic milieu across the total microbiota within a sample (i.e. the ‘metagenome’). This technique offers an ecosystem-wide glimpse into bacterial community members, their genes, and their functional potential. However, metagenomic sequencing is rarely adopted in public health surveillance and tracking of pathogens, as well as risk assessment of AMR. The resulting sequencing data offers a low resolution and fragmented view of AMR hazard potential within microbial communities which is not conducive to motivating quality evidence-based decision-making for clinicians, public health practitioners, food producers, and policy makers. This dissertation consists of four integrated studies that attempt to: (1) Formalize the major impediments precluding informative metagenomic sequencing and data analysis in the study of AMR and its hazard potential; (2) Demonstrate an improved metagenomic approach to elucidate epidemiological trends in a major public health context of AMR; (3) Innovate and implement a novel metagenomic sequencing platform and associated bioinformatic tools to address impediments to metagenomic sequencing and enhance risk characterization of AMR; and (4) Extend technical metagenomic innovations for deployment in public health surveillance and monitoring activities. All metagenomic methods involved the use of unique human, animal, environmental, and food safety-related samples, and all studies were conducted using systems in vivo, in vitro, and / or in silico.
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    Did You Give the Government Your Baby’s DNA? Rethinking Consent in Newborn Screening
    (Minnesota Journal of Law, Science and Technology, 2014-05) Suter, Sonia
    Newborn screening (NBS) has long offered the possibility of identifying rare conditions, which can be lethal or debilitating if not detected and treated quickly in the newborn period. These screening programs, usually mandatory, have been well established in every state since the 1960s. In the last decade, the number of conditions screened for has risen exponentially to include more than fifty inborn errors of metabolism, blood disorders, genetic, or other conditions. Not surprisingly, newborn screening programs have been widely accepted for their potential to save the lives of countless children. Despite their valuable public health benefits, however, old approaches to, and more recent expansions of, NBS raise important privacy and policy concerns. NBS samples are collected in most states without affirmative, or sometimes any, consent from parents. NBS programs now screen for an ever-broadening range of diseases—sometimes without careful assessment of the risks and benefits—including conditions for which there is no treatment. NBS samples are retained for long periods or indefinitely. And finally, few, if any, limits prevent potentially invasive uses of these samples by the government or third parties. Indeed, evidence suggests that a great deal of research is being conducted on these stored blood spots, the collection and storage of which many parents are simply unaware. Only a few lawsuits and legislatures have addressed the legality of these practices. With recent expansions in the scope of NBS and increased interest in these samples for research, it is time to take a fresh look at this long-standing public-health system and to reexamine some of the underlying philosophies and practices associated with it. While NBS offers important public health benefits, it also threatens some of the civil liberties of the parents and children involved. This piece argues for the need to strike a careful balance between the public goods and private interests, and describes a methodology that allows these competing values to be recognized in policymaking. It concludes by suggesting ways to balance the important values of maximizing the well-being of newborns and promoting research, while also protecting autonomy and privacy as much as possible.
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    Exposures to Commercial Asbestos In Northeastern Minnesota Iron Miners who Developed Mesothelioma
    (2003) Minnesota Department of Health; Brunner, Wendy; Williams, Allan N; Bender, Alan P
    This is primary a public health study on the incidence of mesothelioma in northeastern Minnesota. Its value lies in pointing out human health impacts of mining, and of dumping taconite tailings into the Duluth harbor on the City's drinking water. In both cases asbestos fibers are implicated. Key points linking water resources and human health are extracted and reproduced below. "There is a long history of community concern about a possible link between the mining industry in northeastern Minnesota and the occurrence of cancers and respiratory diseases in that part of the state. In 1973, asbestos-like fibers were found in the Duluth water supply and traced to tailings that had been disposed of in Lake Superior by the Reserve Mining Company. This finding, along with litigation surrounding Reserve's disposal of tailings, prompted studies of the fibers, the effects of ingestion of the fibers, and the morbidity and mortality of iron ore miners, among many other studies. In addition, the Tri-County cancer survey was established by the Minnesota Department of Health (MDH) to monitor cancer rates in northeastern Minnesota. Because of the history of health concerns about mining and the large numbers of people historically employed in iron mining in these counties, the possible relationship between employment in the mining industry and mesothelioma was the primary focus of this study. It was recognized at the outset, however, that at least one other industry unique to northeastern Minnesota significantly contributed to the mesothelioma excess. The former Conwed Corporation plant in Carlton County employed over 5,000 workers between 1958 and 1974, during which time large quantities of commercial asbestos were used in the manufacturing of mineral board and ceiling tile."
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    From eugenics to public health genetics in mid-twentieth century Minnesota.
    (2011-05) Holtan, Neal Ross
    In the twentieth century, people in Minnesota experienced four developmental phases of human genetics in distinct organizational manifestations: the Minnesota Eugenics Society (organized in 1926), the Dight Institute for Human Genetics at the University of Minnesota (established in 1941), the Minnesota Human Genetics League (incorporated in 1945), and the Human Genetics Unit at the Minnesota Department of Health (authorized in 1959 and created in 1960). The first three phases are tied to the last, the unprecedented establishment of public health genetics that made Minnesota the first state to organize a public human genetics program. I examine the intellectual, scientific, and social roots of public health genetics and its relationship to the rest of public health practice before reaching the conclusion that the promise of public health genetics appeared to have been high for its proponents in the beginning, but because of the socio-cultural shifts of values in the 1970s and a poor fit with public health's traditional array of strategies, it did not thrive over time.
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    The Health and Transportation Nexus: A Conceptual Framework for Collaborative and Equitable Planning
    (Minnesota Department of Transportation, 2022-05) Fan, Yingling; Phua, Peiyu
    Transportation is a crucial contributor to health. It not only directly shapes the social and physical environments but also determines the type of places where people can live, learn, work, and play in their everyday lives. This project develops a conceptual framework for collaborative and equitable health and transportation planning by extending the social determinants of health framework to include three major pathways through which transportation factors operate on health and equity outcomes. The three major pathways are behavioral health, environmental health, and social exclusion, which are identified via a thorough review of the academic literature and gray resources on health and transportation connections. Of the three pathway mechanisms, social exclusion and environmental health are intrinsically linked to social equity and justice issues. We further review state-level initiatives linking transportation to health and interview six state departments of transportation that are pioneers in advocating and implementing integrated health and transportation planning. The interview results are summarized and discussed in the report. Based on the interviews, we make recommendations for the Minnesota Department of Transportation to help further its efforts on integrated health and transportation planning.
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    Interview with Lee Stauffer
    (University of Minnesota, 1999-02-22) Stauffer, Lee; Pflaum, Ann M.
    Ann Pflaum interviews Lee Stauffer, former dean and professor in the School of Public Health.
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    Now that's a good girl: discourses of African American women, HIV/AIDS, and respectability.
    (2010-08) Weekley, Ayana K.
    Now That's a Good Girl: Discourses of African American Women, HIV/AIDS, and Respectability draws upon black feminist theory, black queer studies, and HIV/AIDS cultural studies to examine discursive representations of African Americans in the HIV/AIDS epidemic. This dissertation argues that the discursive production of the HIV/AIDS epidemic takes place at multiple sites within the nation-state. Combining a analysis of biomedical discourses and African American popular discourses, this dissertation interrogates the ways these discourses have worked to support normative constructions of race, gender, and sexualities. Now That's a Good Girl illustrates both how state discourses of HIV/AIDS drew upon racist and gendered ideas of black women and men in its construction of the HIV/AIDS epidemic and how African American HIV/AIDS discourses attempted to counter these discourses. It argues that African American HIV/AIDS discourses revitalized a politics of respectability in an effort to shield African American women, families, and communities from racist stereotypes of deviancy. Finally, this dissertation attempts to read past these politics of respectability in order to question the queer possibilities these discourses attempt to repress.
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    Partners in Prevention: An Examination into the Creation, Operation and Regulation of Online HIV/STD Partner Notification Programs
    (2015-01) Weinmeyer, Richard
    Partner notification serves as a method for tracing sexually transmitted diseases and informing sexual partners about their possible exposure to a communicable disease. While much of the history and scholarly literature about partner notification has focused on its use in the offline context, considerably less work has examined the movement of this public health tool online where growing numbers of people are using social media, dating sites, and hookup apps to meet others for social and sexual purposes. This thesis documents the emergence and development of online HIV/STD partner notification, and it is the first study to critically examine the ethical underpinnings of its practice. Through its application of Nancy Kass's framework for public health ethics, the research presented here demonstrates that online partner notification can be undertaken in an ethically sound manner, yet greater research is needed to understand its effectiveness in an increasingly digitized world.
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    Providing flexible food portions in a restaurant setting: Impact on business operations, food consumption and food waste
    (2015-04) Berkowitz, Sarah Elizabeth
    Large portion sizes in restaurants have been identified as a public health risk.The objectives of this study were to assess the impact of adding reduced-portion menu items to the menu on customer selection, energy and nutrient intake, plate waste and business operations. A field experiment was conducted to examine the impact of offering flexible portion sizes in 2 food service environments: a cafeteria setting and a sit-down restaurant setting in St. Paul MN. Patrons were surveyed at the beginning and end of the study to assess current usage, dining needs and frequency of healthful behaviors. Purchasing, consumption and food waste data were collected throughout the study. Reduced sized portions were added to the menus halfway through the study in the spring of 2013. The management teams were interviewed at the completion of the study. Sales data show that reduced-portion entrees made up 10-30% of entrée sales across both food service environments. Energy and nutrient intakes decreased and food waste was reduced at both locations. The management teams both reported the added items provided higher profit margins or cost savings and improved customer satisfaction. Both locations have implemented the menu changes indefinitely. These outcomes could serve as the foundation for future work with reduced-portion sized menu items in different types of restaurant settings to promote public health.
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    Rural Transportation Safety and the Strategic Highway Safety Plan: An Examination of Select State Programs and Practices
    (University of Minnesota Center for Excellence in Rural Safety, 2008-02) Munnich, Lee Jr; More, Alec
    This first in a series of Center for Excellence in Rural Safety (CERS) research summaries examines the current state of safety planning through interviews and a comprehensive review of the newly mandated strategic highway safety plans (SHSPs) and supporting documents from six states representing different U.S. regions: Alabama, Idaho, Maryland, Minnesota, Vermont, and Washington. The researchers took several steps to develop a knowledge base of existing conditions pertaining to safety planning in the six states. During the analysis, five key themes emerged: 1. A focus on changing driver behavior; 2. The importance of state-level public policy and political leadership; 3. The use of emerging technologies; 4. The importance of sustained, collaborative approaches; and 5. The use of measurement-driven approaches, which rely on enhanced data collection and new interpretive methodologies. In addition to these findings, case studies of each state provide a synopsis of certain aspects of their SHSPs. Recommendations concerning the SHSP development process and emphasis areas include: strengthening public engagement activities and initiatives to communicate the importance of roadway safety, reviewing the development structure and safety stakeholders involved, and continuing integration across agencies contributing to safety.
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    Society, state, and infant welfare: negotiating medical interventions in colonial Tanzania, 1920--1950
    (2010-07) Masebo, Oswald
    This dissertation is a historical analysis of colonial state infant welfare initiatives from preventive programs of the 1920s and early 1930s to policies that integrated preventive and curative medicine in the late 1930s and 1940s in colonial Tanzania. It argues that the development of these medical interventions was a negotiated process between colonial government officials, peasants, local chiefs, welfare workers, African dressers, and medical missions. In the 1920s the British colonial government initiated the welfare programs to reduce high infant mortality rates. Government officials explained poor infant survival in terms of maternal ignorance and focused on advising mothers on proper infant care, feeding, and hygiene. The government trained African welfare workers who performed the actual work of advising mothers in the communities. Peasants, however, challenged the early preventive programs as narrowly conceived both because they ignored local medical knowledge and indigenous practices and because they excluded western curative medicine that would help them tackle infant diseases such as malaria. Using their local chiefs, peasants demanded that the colonial government incorporate curative medicine in its welfare policies. Their bargaining strategies to achieve these demands included boycotting government-run welfare centers and refusing to pay taxes. The government eventually incorporated curative medicine in its welfare programs in the late 1930s, and it trained African dressers in preventive and curative medicine. The evidence for this dissertation comes from oral interviews, written archival documents, ethnographic accounts, and missionary and explorers' writings. This evidence has allowed me to explore the complex problem of infant welfare, a topic that has not received adequate attention from historians writing about Africa.
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    The use of spatiotemporal analytical tools to inform decisions and policy in One Health scenarios
    (2019-02) Kanankege, Kaushi
    The use of spatiotemporal analytical tools to generate risk maps and risk scores that facilitate early detection of health and environmental threats is increasingly popular in many countries and international organizations around the world. The traditional approach of spatial epidemiology focuses on mapping and conducting tests for detection of spatial aggregation of cases, referred to as “clusters”, to determine visual and geographical relational clues, and then ecologic approaches to recognize etiologic signs of disease distribution in relation to explanatory factors. The advances in spatial epidemiology are focused on the application of spatiotemporal findings to inform mitigation measures, use of big data to improve the validity and reliability of case-data based analyses, and eventually to provide risk estimates in a timely manner to support decision and policy in preventive and control measures, while supporting the improvement of existing data collection processes. This study provided a framework for choosing spatiotemporal analytical tools, summarizing the features of tools commonly used in spatial analysis, and discussing their potential use when informing decisions related to One Health scenarios. To this end, three case studies addressing endemic conditions affecting ecosystem health, animal health, and public health in Minnesota were compared. A risk score; an estimate/characterization of the disease spread, and suggestions on risk zones were introduced, using spatiotemporal analytical tools, addressing aquatic invasive species in Minnesota waters, Johne’s disease in dairy cattle, and Anthrax, affecting wildlife, livestock, and humans, respectively. The One Health concept promotes a collaborative approach, through effective communication and cooperation across disciplines and sectors, to solve complex problems that intersect animal, human and environmental health. An essential component in the process is understanding the stakeholder perspectives of the problem. Therefore, the comparison between the case studies focused on the lessons learned through the researcher-stakeholder interactions and identification of the opportunities and challenges in the process. Overall, the work presented through this dissertation, serves as precedent for establishing a protocol of “good practices” when promoting the use of spatiotemporal analytical tools to inform the implementation of scientifically driven risk management and policy solutions to One Health scenarios.