Two items relevant to long COVID

One of the tricky issues in studying in long COVID is: how widely do researchers cast their net? Initial reports acknowledged that people who were hospitalized and in intensive care may take a while to get back on their feet. But the number of people who had SARS-CoV-2 infections and were NOT hospitalized, yet experienced lingering symptoms, may be greater. A recent report from the United Kingdom, published in PLOS Medicine, studied more than Read more

All your environmental chemicals belong in the exposome

Emory team wanted to develop a standard low-volume approach that would avoid multiple processing steps, which can lead to loss of material, variable recovery, and the potential for Read more

Signature of success for an HIV vaccine?

Efforts to produce a vaccine against HIV/AIDS have been sustained for more than a decade by a single, modest success: the RV144 clinical trial in Thailand, whose results were reported in 2009. Now Emory, Harvard and Case Western Reserve scientists have identified a gene activity signature that may explain why the vaccine regimen in the RV144 study was protective in some individuals, while other HIV vaccine studies were not successful. The researchers think that this signature, Read more

public health

Higher education linked to improved heart disease outcomes in richer countries

A higher level of education is associated with reduced risk of heart disease and stroke for people who live in rich countries, but not for those in low- and middle-income nations, according to the findings of a recent study led by Emory epidemiologist and cardiologist Abhinav Goyal, MD, MHS.

Abhinav Goyal, MD, MHS

The study published in the Sept. 7, 2010, issue of the journal Circulation, a publication of the American Heart Association, is one of the first international studies to compare the link between formal education and heart disease and stroke. It examined data on 61,332 people from 44 countries who had been diagnosed with heart disease, stroke, or peripheral arterial disease, or who had cardiovascular disease risk factors such as smoking or obesity.

Goyal and team found that highly educated men in high-income countries had the lowest level of cardiovascular disease. However, their findings suggest that research conducted in richer nations can’t always be applied to poorer countries.

“We can’t simply take studies that are conducted in high-income countries, particularly as they relate to socioeconomic status and health outcomes, and extrapolate them to low- and middle-income countries,” says Goyal, assistant professor of epidemiology and cardiology at Emory’s Rollins School of Public Health and Emory School of Medicine. “We need dedicated studies in those settings.”

The research team was surprised to find that despite decreased heart disease risk among the higher educated in industrialized nations, nearly half of the highly educated women from high-income countries smoked, compared with 35 percent for those with the least amount of schooling. For men, smoking rates were virtually the same across educational groups in low- and middle-income countries.

“Everyone needs to be educated about the risk of heart disease in particular, and counseled to adopt healthy lifestyles and to quit smoking,” Goyal says.

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Linking academic and public health institutions in disaster response

How can academic institutions, with their healthcare resources, faculty expertise, and students work most efficiently in responding to public health disasters along with public health agencies and non-governmental organizations (NGOs)? A conference at Emory this week explored the symbiotic relationship that, with proper planning, can turn these diverse institutions into a powerful public health response team.

The conference was co-hosted by the Southeastern Center for Emerging Biologic Threats (SECEBT) – an Emory-led partnership of academic institutions and public health agencies. Other conference sponsors were the Southeast Regional Center of Excellence for Emerging Infections and Biodefense (SERCEB), led by the University of North Carolina at Chapel Hill, Emory’s Office of Critical Event Preparedness and Response (CEPAR), and the Preparedness and Emergency Response Research Center (PERRC) at the Rollins School of Public Health.

The “Disaster Response Utilizing Academic Institutional Resources” conference brought emergency preparedness and response officers from southeastern universities together with local, state and government public health representatives, NGOs, and nonprofits.

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Gulf residents and workers face heat exhaustion, mental stress

Residents and relief workers along the oil-ravaged Gulf of Mexico could experience a host of short- and long-term health problems, including respiratory ailments, neurological symptoms, heat exhaustion and mental stress.

Emory University environmental health expert Linda McCauley, RN, PhD, is one of more than a dozen national scientists participating in a two-day Institute of Medicine (IOM) workshop in New Orleans exploring some of the potential health risks that people in the Gulf could face.

Short term, McCauley says, there could be reports of respiratory problems from people who’ve inhaled gas fumes as well as neurological issues such as dizziness, headaches, nausea and vomiting. In addition, exposure to oil may cause eye and skin irritation.

Heat stress is also a major concern for workers in the Gulf, says McCauley, dean of Emory’s Nell Hodgson Woodruff School of Nursing.

“On some of the days it’s been so hot they’ve only allowed workers to work 12 minutes out of the hour,” she says. “A lot of new workers are being brought in [to clean up the oil]. These are workers who don’t do this for a living and may never have been exposed to this type of heat before and that’s a serious issue.”

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Rollins School of Public Health describes Haiti experiences

Emory University’s Rollins School of Public Health recently collected stories of experiences that students and faculty had in Haiti after the earthquake, and the contributions were featured in the newest Emory Public Health magazine. Read excerpts and view a video below.


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Hold out your finger: Epidemiologist developing test for colon cancer risk

Years from now physicians may be able to determine whether you’re at increased risk for colorectal cancer by drawing blood from the tip of your finger.

Emory University researchers are working to identify biomarkers to detect a person’s chances of developing colon cancer. Much like blood pressure and cholesterol tests can indicate heart disease risk, researchers here hope that some day the makeup of blood and urine will be able to tell who’s at risk for colorectal cancer, why they may be at risk and what they can do to reduce their risk.

Postdoctoral fellows Joy Owen and Veronika Fedirko examine samples in Robin Bostick’s lab at the Winship Cancer Institute of Emory University.

For now, the Emory study team is analyzing the rectal tissue samples of people with colon adenomatous polyps, non-cancerous growths considered precursors to colon cancer, and comparing them to rectal tissue samples from people who don’t have polyps. They’re also looking at whether the differences they detect in rectal tissue can also be found in blood or urine. Currently, no accepted tests exist to determine whether someone may be at risk for colon cancer.

“Most people would rather provide a blood or urine sample than get a rectal biopsy,” says Robin Bostick, MD, MPH, Rollins School of Public Health epidemiology professor and study principal investigator. Bostick is also a clinical faculty member at the Winship Cancer Institute at Emory and a Georgia Cancer Coalition Distinguished Cancer Scholar.

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WHO Director Chan highlights global health changes, challenges

Dr. Margaret Chan

On World TB Day, March 16, Dr. Margaret Chan, director-general of the World Health Organization, addressed public health professionals at the Centers for Disease Control and Prevention in Atlanta at the eighth annual Jeffrey P. Koplan Global Leadership in Public Health Lecture. In introducing Chan, Koplan noted their long-term friendship, which grew from their work together in China.

While in Atlanta, Chan also visited Emory to meet with President James Wagner and Emory Global Health Institute Director Koplan. She heard presentations about global health field projects by students in public health, medicine, and theology.

Chan recalled the “lost decade for development,” the 1980s, a dismal time for public health. The 1979 energy crisis followed by a recession made for tighter public health resources and few health care improvements worldwide, she explained. Some developing countries have still not recovered.

In contrast, public health has faired better in the new millennium, when the world has benefited from financial commitments backed by substantial resources, often from innovative sources, says Chan.
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A storied look at HIV/AIDS in Africa

At a recent Emory global health seminar series, Kate Winskell showed how fiction penned by young Africans can help inform the response to HIV and AIDS. Since 1997, more than 145,000 young Africans have participated in scriptwriting contests as part of Scenarios from Africa HIV communication process.

The resulting archive of stories is a unique source of cross-cultural and longitudinal data on social representations of HIV and AIDS. The archive now spans 47 countries and a critical 12-year period in the history of the epidemic. Winskell’s presentation analyzed the stories that were part of the 2005 Scenarios contest. Six African countries were represented.

The seed for Scenarios was planted more than a decade ago–before the rise of the Internet—when Winskell, a public health educator, and her husband, Daniel Enger, were searching for innovative ways to reduce the spread of HIV/AIDS. The old ways of trying to stop the spread of the disease, focusing only on medical aspects of the epidemic or relying on educational materials that were not culturally adapted, were clearly limited.

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Chronic diseases drive up Medicare costs, study shows

A new study by Emory University public health researchers finds that outpatient treatment for chronic diseases such as diabetes, hypertension and kidney disease are to blame for the recent rise in Medicare spending. Kenneth Thorpe, PhD, chair, Health Policy and Management, Rollins School of Public Health, presented study findings today at a briefing of the National Press Club in Washington, DC.

The report, “Chronic Conditions Account for Rise in Medicare Spending from 1987 to 2006,” was published Feb. 18 by the journal Health Affairs.

Kenneth E. Thorpe, PhD

Thorpe and colleagues analyzed data about disease prevalence and about level of and change in spending on the 10 most expensive conditions in the Medicare population from 1987, 1997 and 2006.

Among key study findings:

  • Heart disease ranked first in terms of share of growth from 1987 to 1997.  However, from 1997 to 2006, heart disease fell to 10th, while other medical conditions – diabetes the most prevalent – accounted for a significant portion of the rise.
  • Increased spending on diabetes and some other conditions results from rising incidence of these diseases, not increased screening and diagnoses.

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Reducing tobacco consumption through taxes

Jeffrey Koplan, MD, MPH

In many countries, taxes on tobacco have successfully reduced its consumption. As world leaders in countries consider raising the excise tax on tobacco products in the coming year, it is vital they consider all the determinants that effectively promote health through taxation, say Emory global health experts Jeffrey Koplan, MD, MPH, and Mohammed Ali, MBChB, MSc.

Koplan and Ali discuss the complex issues of health promotion and tobacco taxation in a commentary in the current issue of the Journal of the American Medical Association, “Promoting Health Through Tobacco Taxation.”

Mohammed K. Ali, MBChB, MSc

“Effective and comprehensive tobacco control involves a broad mixture of interventions – scientific, behavioral, educational, legal, regulatory, environmental, and economic,” say Koplan, former Emory vice president for global health and former CDC director, and Ali, assistant professor, Hubert Department of Global Health at Emory’s Rollins School of Public Health.


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Experts review global health care programs for answers

A recent Knowledge@Emory article looks at a new book titled The Healing of America: A Global Quest for Better, Cheaper, and Fairer Health Care, by author and journalist T.R. Reid. The book provides an in-depth look at the health care systems in a number of Western nations, including Germany, France, the U.K, Japan and Canada. The countries he profiles offer a mix of public and semi-public health care options.

In addition to interviewing Reid, experts from Emory Healthcare, Emory’s Woodruff Health Sciences Center and the Rollins School of Public Health Department of Health Policy and Management, weigh in on the problem of U.S. health care reform and what can be learned from the examples abroad.

Joseph Lipscomb, PhD

According to Joseph Lipscomb, PhD, a Georgia Cancer Coalition Distinguished Cancer Scholar and a professor in the Department of Health Policy and Management, quality of care, outcomes and cost analysis must be factored into the reform process. Looking abroad, Lipscomb gives generally high marks to the outcome and cost analysis done by the National Health Service and the National Institute for Health and Clinical Excellence (NICE) in the U.K. He applauds NICE’s ongoing efforts to estimate the cost-effectiveness of new, expensive technologies by using decision processes that are transparent and solicit input from private citizens, providers and industry.

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