Sharon Medcalf, MEd

Sharon Medcalf, MEd

Sharon Medcalf, MEd

Faculty Highlight – Sharon Medcalf was instrumental in the establishment of the College of Public Health’s new programs in emergency preparedness. She developed four core courses for the professional certificate and master of science programs and directs two of the courses each semester. She is pleased to observe a growth in enrollment of students who recognize the importance of a basic understanding of this field, in preparation for their careers in the health care arena. Ms. Medcalf is currently in the process of converting all four courses into online versions, which she anticipates will attract national and international students to the programs. Ms. Medcalf serves on capstone committees, where she helps to guide students who seek to blend their public health expertise with a project in the emergency preparedness arena.

Ms. Medcalf’s research focus is in two distinct areas. She evaluates hospital preparedness and the evacuation plans that are developed by hospitals in the region. The Joplin tornado and Hurricane Sandy forced all hospitals to examine their evacuation plans. Her other area of interest is smallpox. She was heavily involved in the National Smallpox Vaccination program launched in 2003. In response to a credible threat, the US vaccinated almost 40,000 health care and public health workers across the nation. Her colleagues in the laboratories also established a network of sites to test for smallpox. Her current research project is looking at smallpox vaccination in laboratory workers at smallpox testing sites across the country.  She hopes her research will inform national guidelines on the frequency with which this vaccination should be administered to lab workers.

Ms. Medcalf is the associate director of the Center for Preparedness Education, a training center established in 2002 to provide educational programs for Nebraska’s response community, which refers to anyone who would be involved in responding to a disaster. The professionals trained range from first-responders to the health care workers who would care for the casualties in a hospital.

Ms. Medcalf is serving her second term on the Board of Directors of the Public Health Association of Nebraska and values being part of an organization that is bolstering the public health infrastructure in Nebraska. She recently served an extended term on the Board of Directors of the Mid-Continental Region of the National Libraries of Medicine. She was nominated to this position based on her expertise in emergency preparedness and was pleased to serve the organization as they prepared for their role as a vital resource in times of disasters.

Sharon Medcalf, MEd, is an instructor in the UNMC COPH Department of Health Promotion, Social and Behavioral Health, and the associate director of the Center for Preparedness Education in the Center for Biopreparedness, Biosecurity, and Emerging Infectious Diseases.

Saad Alshahrani, MD

Saad Alshahrani, MD

Saad Alshahrani, MD

Student Highlight – Dr. Saad Alshahrani graduated from King Faisal University Medical School in Saudi Arabia in 2004. As a new graduate, Dr. Alshahrani was full of enthusiasm to practice medicine. He worked as a general practitioner in King Abdulaziz Hospital in Dhahran City, working closely with the management in the area of health and fitness. From that time, he began to think deeply about the health status of his community. He found that although Saudi Arabia had many modern hospitals with advanced technology, common health problems were still having a major impact on the country’s health system.

It was at that time that Dr. Alshahrani started to believe that he wanted to participate in building a stronger public health system in Saudi Arabia. He believes that such a system will improve planning for health services based on public health needs and on the most common diseases that need to be addressed. Consequently, Dr. Alshahrani decided to pursue training in public health by securing a master’s degree in health management planning and policy from Nuffield Institute at Leeds University, UK. After completing his MA degree, Dr. Alshahrani took a position in the 400-bed King Fahad Specialist Hospital in Dammam (KFSHD), working in the Corporate Strategic Planning Department, where he supported hospital management to develop the hospital’s strategic plan. By providing data on disease prevalence and referrals outside the region, Dr. Alshahrani helped identify the diseases that had the greatest impact on the health of residents in the eastern province in Saudi Arabia.

Realizing the need to further investigate the causes of the many diseases that impact the health system of Saudi Arabia, Dr. Alshahrani transferred to the epidemiology unit at the newly established research center at KFSHD. The research center plans to expand the services in all core areas of KFSHD, particularly oncology and neuroscience. This expansion of services will require more qualified and skilled personnel. To help meet that need, Dr. Alshahrani decided to enroll in the UNMC College of Public Health (COPH) epidemiology PhD program. When he returns to the Saudi Arabia, he expects to play an important role in developing a cancer registry and promoting more local epidemiologic cancer studies, in addition to supervising students in cancer research studies.

Dr. Alshahrani is excited about the learning environment at the COPH, and said that the “kindness and compassion of our college’s staff and faculty help me to feel that I am indeed a part of the college.” He feels that his educational and social experience at the COPH will “leave indelible memories” and will prepare him for a successful career.

Gleb Haynatzki, PhD: Developing Statistical Models for Disease to Prevent, Treat, and Improve Quality of Life at the Individual and Population Level

Gleb Haynatzki, PhD

Gleb Haynatzki, PhD

Spotlight on Research at COPH – Dr. Haynatzki’s research focuses on developing statistical models for disease to prevent, treat, and improve the quality of life in individuals and whole populations. Statistical modeling is currently the most accepted approach to modeling random phenomena that are studied in the biomedical and population health sciences. Dr. Haynatzki’s past research was focused on osteoporosis, bone biology, violence prevention, and glaucoma screening. He currently works with researchers on the UNMC campus on the design and analysis of research studies, both designed and observational. These studies range from explaining the causes of health disparities, peripheral arterial disease, and pancreatic cancer to Alzheimer’s disease treatment.

His statistical methodology work is developing methods for modeling hereditary and sporadic carcinogenesis, carcinogenesis, and genetic anticipation. For example, genetic anticipation can involve an earlier age at onset, greater disease severity, and/or a higher number of affected individuals in successive generations in a family with a familial disorder. Established anticipation provides clues to the nature of the disease and facilitates prediction of age of disease onset. It is important to detect true anticipation and not artifacts (which may be due to ascertainment bias, difference in length of follow-up time between generations, and effects of secular/nongenetic trends). In this type of statistical model building for time-to-event data, it is also important to control for the family-clustered structures in the dataset. There are different statistical methods to analyze this type of data, which are divided into two large classes: semiparametric and nonparametric. Dr. Haynatzki’s work focused on the comparison between these two approaches, and the conclusion was that the current nonparametric methods, as a whole, are the better approach.

Another research project developed by Dr. Haynatzki focused on the association of meat consumption, preparation, and meat-derived carcinogens with the risk of sporadic pancreatic cancer. The objective of this hospital-based study was to identify dietary meat and preparation type factors as well as meat-derived mutagens that are associated with the risk of pancreatic cancer. Data collected on 99 case-control pairs from Italy matched by age, gender, and region, and enrolled in the international Pancreatic Cancer Collaborative Registry, were analyzed. It was discovered that pancreatic cancer was associated in a nonlinear fashion with dietary intake of processed meat as well as increased intake of a certain mutagen (MeIQX) and, to a lesser extent, was associated in a nonlinear fashion with frying and increased dietary intake of the mutagen BaP.

Gleb Haynatzki, PhD, is a professor and graduate program director in the UNMC COPH Department of Biostatistics.

Do JuSTIce

Do JuSTIce

Do JuSTIce

Public Health Community Advisory – Men’s Health Month each June is celebrated across the country with screenings, health fairs, media appearances, and other health education and outreach activities (http://www.menshealthmonth.org/). National HIV Testing Day is on June 27. One in five people living with HIV in the U.S. don’t know they have it. National HIV Testing Day raises awareness about how people can take the test and take control (http://healthfinder.gov/NHO/PDFs/JuneNHOToolkit.pdf). Locally in Nebraska, Do JuSTIce (which stands for Douglas County Jail Uniting with Students to Impact the Citywide epidemic) is an innovative program, through collaboration between the jail, local health departments, public health agencies, and the Service-Learning Academy of the College of Public Health at the University of Nebraska Medical Center (UNMC). Through the program, health professions students offer sexually transmitted infection (STI) education, screening, and treatment to jail inmates, supported by jail authorities and the local and state health departments, and by UNMC faculty, who provided clinical supervision. Students coordinate all details of the program, lead and work with their peers, and use a succession leadership plan to ensure continuity and sustainability of the program that has been expanding over the past five years.

The Douglas County Department of Corrections in Omaha was the first  jail in Nebraska to be accredited by the National Commission on Correctional Health Care. Its mission statement reads as follows: ”The Douglas County Department of Corrections promotes public safety by effectively managing individuals in secure custody and Community Corrections by offering programs to prepare individuals to successfully return to society.” Douglas County, Nebraska, has seen high prevalence of STIs, with Chlamydia trachomatis and Neisseria gonorrhea rates 30% and 88% higher, respectively, than in the rest of the nation. Individuals in the criminal justice system are at disproportionately higher risk for STIs, with less access to STI education, screening, and treatment. The DoJuSTIce program was developed when leaders at the local jail saw themselves as crucial public health partners, positioned to facilitate interventions to reduce STI rates within the jail’s high-risk population, joining the effort to combat the high STI prevalence in the region. Since its beginning, the Do JuSTIce program has provided more than 2,500 inmates with education and more than 1,500 screenings. More than 400 students have participated to date, noting the following benefits to their own development—increased cultural awareness, increased self-awareness of stereotypes and biases, and increased compassion and understanding of poverty and its consequences. Strong commitment, multisectorial expertise, interprofessional practice, and effective collaboration have ensured the implementation and sustainability of the program. The program’s long-term goal is to test and disseminate best practices for universal screening in jails and assist in establishing an effective policy.

The Do JuSTIce program expanded recently to work in the youth correction facility, after winning grant support from the MTV Staying Alive Foundation (http://stayingalivefoundation.org/).

The SLA facilitates interprofessional and interdisciplinary public health learning experiences. SLA projects present an opportunity for health professions students to develop public health knowledge along with organizational, communication and leadership skills, while engaging in a real-world, hands-on experience. This is an interprofessional education and practice effort that allows students to “learn with, from, and about each other,” while serving a population in need. Students apply engagement principles and creativity to learn, serve, collaborate, and enhance their personal and professional growth. To learn more about this project and other exciting opportunities with the SLA, please contact Ruth Margalit at rmargalit@unmc.edu.

This article was written by Ruth Margalit, MD, associate professor in the UNMC COPH Department of Health Promotion, Social and Behavioral Health, and director of the UNMC COPH Service-Learning Academy.

Gluten and Health

source: niaid.nih.gov

source: niaid.nih.gov

Public Health in the National News – The relationship between gluten and health is currently receiving quite a bit of attention. Gluten is a major storage protein component in wheat, rye, and barley. Celiac disease (CD) is an autoimmune disease triggered by ingestion of gluten. It is estimated that 1% of the population in the United States is affected by CD. In this disease, the immune system reacts to gluten by attacking the lining of the small intestine (villi) in genetically susceptible individuals, leading to an inability to absorb certain nutrients and consequently to some nutrient deficiencies. Digestive symptoms of the disease include abdominal pain, indigestion, gas, diarrhea, weight loss, and tiredness. In some cases, there are nondigestive symptoms such as skin rash, tingling or numbness in the hands or feet, depression, and mood changes. A recent study revealed that the number of individuals with CD has increased in the United States. This increase has been attributed to better diagnostic methods or to environmental factors. However, the exact reason for the increase is unknown. Blood tests and intestinal biopsies are necessary to confirm the diagnosis of CD, as symptoms may vary from one person to another. In addition, some individuals may be intolerant or sensitive to gluten and have milder symptoms, but not have CD (ie, the small intestinal villi are not attacked).

A gluten-free diet is the primary treatment for CD and gluten intolerance. People with CD and gluten sensitivity should avoid wheat, rye, barley, and their derivatives. Foods that contain gluten include bread, muffins, cakes, pies, cookies, pancakes, couscous, and pasta. Wheat, rye, and barley derivatives include hydrolyzed vegetable proteins and soy sauce (wheat); artificial seafood present in sushi (wheat); soups and broth (wheat); meatballs (wheat); beer (barley); and Rice Krispies and corn flakes, which contain malt made of barley. Cross contamination with gluten-containing products can also be a problem. Examples of possible sources of contaminants include oil from frying breaded products, and shared toasters, strainers for pasta, and grills used for pancakes.

Gluten-free substitution foods include breads, cakes, pies, and muffins made of potato and rice flour. However, these food products are low in fiber, calcium, vitamin D, and iron. Therefore, gluten-free vitamin and mineral supplements are usually necessary for people with CD and gluten sensitivity. High fiber, gluten-free, whole grain products are also available. These products include brown rice, wild rice, quinoa, corn, popcorn, and gluten-free oats. Gluten-free foods that are high in fiber include fruits and vegetables, legumes, soybeans, uncoated nuts, and seeds. Calcium-rich gluten-free foods include fortified milk substitutes such as rice milk, almond milk, and soy milk. Iron-rich foods include unprocessed meat, poultry, and fish; whole grains; fortified gluten-free cereal; fortified rice; legumes; and green leafy vegetables. For optimal health, there are naturally gluten-free foods including fruits, vegetables, poultry, fish, and plain meat. Also, check the food label for the ingredients and for gluten-free products, and when in doubt, contact the food manufacturer.

Useful Resources:

http://www.celiac.nih.gov/Materials.aspx

http://www.eatright.org/Public/content.aspx?id=5542

Restaurants with gluten-free menus:

http://www.glutenfreerestaurants.org/

This article was written by Ghada Soliman, MD, PhD, RD, LMNT, an associate professor in the UNMC COPH Department of Health Promotion, Social and Behavioral Health.