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In an effort to bridge the gap between public health practice and academia, the Health Resources and Services Administration–funded Tennessee Public Health Training Center (LIFEPATH) has supported establishment of an academic health department (AHD) involving the East Tennessee State University College of Public Health (COPH) and the Sullivan County Regional Health Department (SCRHD). The SCRHD identified a need to increase internal capacity to conduct ongoing community health assessment and community-centered practice. Similarly, the COPH recognized the need to expand evidence-based practice implementation and evaluation opportunities for public health students. Personnel from the SCRHD, LIFEPATH, and the COPH developed a formal AHD agreement during the summer of 2012 and launched the program the subsequent fall semester. One aspect of the COPH/SCRHD/LIFEPATH model that addresses financial barriers experienced by other AHDs is the competitive awarding of the coordinator position to a doctor of public health student from the COPH, demonstrating investment in the model by the college. The doctor of public health student gains leadership experience through project management, coordination of the local health council, and day-to-day facilitation of undergraduate and master's student interns. The SCRHD benefits from the formal academic background of graduate-level interns dedicated to working in the community. This AHD framework offers an opportunity for doctoral-level students to develop practical leadership skills in a health department while enhancing the capacity of the SCRHD and the COPH to serve their community and stakeholders.

The origin of cancer registries was to create clinical surveys and perform patient follow-up, the objective being to bring surgical patients back to the doctor periodically to identify recurrences. Over the past 60 years, cancer registries have continued to compile patient care data and perform patient follow-up. However, over the past decade, emphasis has been placed on the direct involvement of the cancer registry in monitoring quality of care. In contrast, stroke registries monitor the quality of care for patients, but do not follow them periodically to identify recurrences. The biology of these diseases is an intricate part of the different roles played by both types of registries, yet each has a page to take from the other's book. This article examines the manner in which these registries operate to improve the quality of patient care.

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The Dietary Guidelines for Americans (DGAs), established to combat the rise of chronic disease in America, serve as the primary source of current nutrition science in the U.S. These guidelines dictate nutrition policy, programming, and medical efforts nationwide. Rates of diet-related chronic disease, however, continue to increase, despite the efforts of the DGAs and subsequent programming. This is particularly prevalent in low income communities and communities of color. In examining the DGAs, we found a lack of relevant discussion regarding the impacts of cultural differences on nutritional health. Efforts to integrate culture were limited to static cultural competency discourse. Thus, we propose an alternative model to understanding cultural experiences within nutrition. An in-depth literature review revealed the importance of three elements as a part of the cultural ethnographic model: structural barriers and inequities, cultural consonance, and cultural healing methods. In an effort to apply this framework to a sample population, we looked at experiences of South Asian populations in and around the United States to create a survey format that incorporates ethnographic considerations into guidelines on nutrition.

There has been a recent expansion of community-based coalitions to address issues related to youth substance use. Research on their overall effectiveness, however, has produced mixed results. Recommendations to improve coalition success have emphasized the high-quality implementation of evidence-based programs targeting specific community needs. Coalitions vary extensively, however, in their organization and functioning. In addition, the lack of a universally accepted theoretical framework to understand coalition functioning has led to inconsistencies in the coalition research and the specific constructs used to describe coalition functioning. Purpose of the Study: To address these gaps, the current study used a case study approach to describe the organization and functioning of four local substance abuse coalitions and to identify factors related to coalition high-quality implementation of evidence-based programs. Methods: Using constructs based on Community Coalition Action Theory, the current study used coalition member surveys and key leadership interviews to produce separate case study descriptions of four participating community substance abuse coalitions. An exploratory factor analysis was conducted to examine the structure of the survey measure. Univariate statistics were used to describe coalition functioning and attitudes toward evidence-based practice and implementation. One-way analysis of variance tests were employed to examine differences across the coalitions and Pearson's product-moment correlations were used to identify coalition characteristics associated with attitudes toward evidence-based practice. A thematic analysis of interview data was conducted for an in-depth examination of coalition functioning and perceptions of evidence-based practice. Results: Coalition members and leaders reported high levels of functioning across all of the included domains. However, several differences in coalition background and structure were discussed. Community support was described as a major functioning challenge across both surveys and interviews. Interview results also revealed several different coalition belief patterns surrounding evidence-based practice and quality implementation. Coalition members and leaders generally indicated positive attitudes toward the use of evidence-based prevention programs and strategies. However, varying levels of knowledge and experience with evidence-based practices was identified across interviews. Interviews also highlighted several factors that influence coalition decision-making and identified several perceived challenges associated with the use of evidence-based practices. Results include a discussion of coalition knowledge, perceptions, and experiences with program implementation. Conclusions and Implications: Taken together, these findings form a basis for better understanding the current environment surrounding community substance abuse coalition functioning and implementation of evidence-based practices. Several factors were shown to influence coalition decision-making processes and overall functioning. In addition, the present study highlights strengths and gaps related to coalition leadership knowledge, attitudes, and implementation of evidence-based programs and strategies. These identified relationships can be used to guide future research and community practice. With their growing popularity, it is likely that community coalitions will take on a major role in future community-based prevention efforts across the country. As such, there is a need to design substance abuse prevention programming with coalitions in mind and to identify alternative avenues to disseminate information surrounding community-focused evidence-based practices. Identifying new ways to measure and build coalition processes, leadership skills, and structures could result in greater coalition capacity to plan for and support prevention activities, including use of evidence-based practices.

The purpose of this study was to determine whether participation in a Family Resource\Youth Services Center New and Expectant Parenting Series had an impact on maternal and child health knowledge of parents and their future behavior choices. The study had two components. First, a telephone survey was conducted with 40 past program participants asking them nine questions concerning behavior and lifestyle choices in regards to child safety, breast or bottle feeding, immunizations, car seat use, etc. Secondly, thirty participants were given a pretest and posttest questionnaire. As a control group, there were 25 Lamaze class participants, who also completed the pre-test and posttest questionnaires. The questionnaire was a 20 item multiple choice instrument (Learning About Parenting Survey or LAPS) which measured maternal and child health knowledge in such areas as family planning; informed parenting; maternal health; basic baby care; breast-feeding; bottle-feeding; first aid; child's health including immunizations, child safety; nutrition; child development and discipline. Analysis of covariance was performed using the LAPS raw scores from the posttests as the dependent variable, the pretest scores as the covariate and the treatment as the independent variable. The results showed no significant difference in parenting knowledge between the individuals enrolled in the Family Resource\Youth Services Center's New and Expectant Parenting Series and the comparison group who did not take the course.

Chinese people are keen on nutritional Supplements for decades. They will consume on anything that are good for their health, just like the Chinese old folk says, ¡§If we sick, we need to find the cure, but if we are not sick, we need to stay fit¡¨. Most of Chinese people who still under this traditional point of view will pay whatever it cost to acquire the supplements that are good for their health, especially on special recipe. Keeping fit is a trend in the past few years. Nowadays, functional food is acceptable in our society. But we still don¡¦t understand much about it. Besides, based from the event that occurred in 2008 which our government has changed ¡¨Centrum¡¨ from drugs into food product, we can see that The standard on distinguishing drugs, functional food and food product is still an obscure. And it left consumer in the middle of confusions. Actually, on the consumer point of view, ¡§Centrum¡¨ is a functional food to them. Hence, our study is based from consumer perspective to research the consumer recognition on functional food, and also performing a further research on consumer buying intention on functional food and the impact factors on buying the functional food products. Our Study using TPB model as our research fundamental for studying consumer acknowledgement on functional food and their buying intention. Our research sample is targeting citizen at Kaohsiung and Taichung city. We send out 120 questionnaires and 100 internet questionnaires and we manage to collect 220 samples. There are 194 effective questionnaire out of total sample of 220 that been collected, the sample effective rate is 88.19%. In-order to test the adaptability of the construct models, we use regression analysis and covariance analysis to analyze collected sample using SPSS version 14. The result of this study discovered that consumer behavior on functional food can be proved by the TPB model. But in Taiwan, the definition of functional food even though has been defined by law, but consumer still doesn¡¦t have much information about the definition of functional food. And yet has caused the irrational behavior of consumer while purchasing functional food. Though this research we suggest the government perfume action on informing its people on the definition of functional food and the proper way on differentiate and to consume the functional food. And also, the government must have started to emphasize about the preventive medical perspective to the public to ease the pressure on structural aging problem in our nation.

Health Inequalities and the Right to Healthcare of Negev Bedouin in Israel with Diabetes: A case study of a Marginalized Arab Indigenous Minority Diabetes is one of the world’s most pervasive chronic diseases and there are high rates of prevalence in the Arab world and amongst indigenous peoples. It is widespread amongst older Bedouin in the Negev, who are a marginalized Arab indigenous minority in Israel. This is a multi-method case study using non participant observation in clinic settings, analysis of medical records and semi-structured interviews in a Health Centre and Hospital Outpatient Clinic and household interviews. The fieldwork took place over eight months in 2007. Statistical analysis was done using SPSS and thematic qualitative analysis was conducted using NVIVO 7 with supplementary manual analysis. The conceptual frameworks used are the right to heath and health care approach as set out in UN Special Comment 14 in relation to the availability, accessibility acceptability and quality of health care, as well as neo materialist, materialist and socio-behavioural explanations of health inequalities linked to lay and professional explanatory models of illness. The findings show that there are limitations on the right to health care in terms of availability of clinics and clinic hours, accessibility in terms of distance, language, cost, and information, acceptability in terms of linguistic and cultural differences between staff and patients and quality in terms of medical records, monitoring and appropriate context specific lifestyle advice. The issue of non-discriminatory care needs to be addressed. Explanatory models of illness used by Bedouin and health professionals differ although both reflect awareness of changing lifestyles. These models link to explanations of health inequalities. There are gender differences in how Bedouin men and women understand and live with diabetes which is related to their social status and circumstances. Some aspects of the findings are generalisable to Bedouin in the Arab world and to indigenous peoples in relation to health care provision, health inequalities and explanatory models. However, there were specific areas of health care provision that related to the marginalized minority status and situation of this population in Israel which needs to be addressed and the rights to health and health care framework provides a potential means of monitoring improvement.

Contact structure between individuals in a population has a large impact on the spread of an epidemic within this population. Many techniques and models are used to investigate this, from heterogeneous age-age mixing matrices to the use of network models in order to quantify the heterogeneity in the populations contacts. For many diseases, the probability of infection per contact, along with the exact contact structure are unknown, compounding the difficulty of identifying accurate contact structures. In this thesis, the impact that the contact structure has on the epidemic is examined in several different ways. Analytical expressions for the variance in the spread of an epidemic in its early exponential growth phase on heterogeneous networks are derived, showing that the third moment of the degree distribution is needed to fully specify this variance. This quantifies the impact that very well connected individuals can have on the early spread of an epidemic through a network. The dependency of the potential epidemic on the heterogeneity in workplace sizes and transmission rates is examined. It is shown that large workplaces can increase the expected size of the epidemic significantly, along with increasing the effectiveness of control strategies enacted during the early stages of an epidemic. In addition to this, a synthetic population is constructed for England and Wales from available datasets, in an attempt to model the spread of an epidemic through a realistic network of comparable size to the true population. The contact structure that is derived from this is compared with that taken from two surveys of contact structure in the same population, using simple models, and qualitative differences are seen to exist between the surveyed structures and the synthetic population structure.