| Research news |
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World Health & Population journal now part of MEDLINE Recently, the journal World
Health & Population (WHP) was accepted by the National Library
of
Medicine into MEDLINE. This means that citations from articles,
indexing terms
and article abstracts are now searchable using PUBMED.
Dr. Peggy Leatt, professor
and chair of the Department of
Health Policy and Management, associate dean for academic affairs
at the
Please see the “Call for Papers” from the WHP, and feel
free to forward it to others who might be interested in submitting. You
are
also welcome to identify people who might serve as reviewers for the
journal –
and encourage them to complete the online WHP Reviewer Profile
accessible from the
journal’s Web site.
Dr. John Paul, clinical associate professor of health policy and administration at the UNC School of Public Health, is the current editor-in-chief of World Health & Population. In addition to Leatt, members of the international editorial advisory board include Drs. Dean Harris and Bruce Fried (Dept. of Health Policy and Management), Dr. Peggy Bentley (professor, Dept. of Nutrition, and associate dean for global health at the School), and Dr. Sagar Jain (professor emeritus, Dept. of Health Policy and Administration and founding editor-in-chief of the journal). Posted 6/30/08 Public health departments across North Carolina stand to benefit from a new $449,590 grant from the Robert Wood Johnson Foundation aimed at improving the quality of public health programs.
The grant will go towards supporting the implementation of projects to address specific health outcomes, such as decreasing the incidence of vaccine-preventable diseases and reducing the burden of illness due to tobacco or alcohol use. It also will fund efforts to advance accreditation of public health departments under a voluntary accreditation program due to begin in 2011. To date, 34 North Carolina counties and the state itself have passed strict accreditation performance standards. For more information, visit www.sph.unc.edu/nciph/accred. School of Public Health contact: Ramona DuBose, director of communications, (919) 966-7467 or ramona_dubose@unc.edu. Posted 5/30/08 Medication-only Therapy and Combination Therapy Both Cost Effective for Treating Teens with Depression
Marisa Elena Domino, Ph.D., of the University of North Carolina at Chapel Hill, and colleagues compared costs associated with each of the trial’s three active treatment groups—fluoxetine only, cognitive behavioral therapy (CBT) only, and a combination of fluoxetine and CBT—to costs associated with a placebo (sugar pill) group during the first 12 weeks of the trial. The researchers studied direct costs of medication and CBT sessions, and other costs outside the trial, such as visits to primary care providers, school-based services, and lost wages associated with caregivers transporting the adolescent to and from services. Overall, cost was highest for participants in the combination group—a median of $2,832 per participant. Median cost per participant was $2,287 in the CBT-only group, $942 in the fluoxetine-only group, and $841 in the placebo group. Combination therapy was associated with the highest time and travel costs at $762, but medication costs were lower than those associated with the fluoxetine-only group because those in combination treatment tended to take lower doses of the medication. CBT costs for participants in the CBT-only group and participants receiving it as part of combination treatment did not differ. Combination treatment cost more, but it also was shown to be more effective than the fluoxetine-only treatment in the first 12 weeks, as reported in August 2004. By assigning a monetary value to clinical improvement, the researchers deduced that both the fluoxetine-only treatment and combination treatment were cost-effective choices. Finally, CBT was not found to be as effective or as cost effective as the other treatment groups in the first 12 weeks of the trial. However, by the end of the 36-week study, response rates in the CBT-only group had essentially caught up with the other two groups. Therefore, the researchers predicted that if long-term costs remain stable, CBT-only may become a cost-effective treatment choice as well. Reference: Domino ME, Burns BJ, Silva SG, Kratochvil CJ, Vitiello B, Reinecke MA, Mario J, March JS. Cost-effectiveness of treatments for adolescent depression: results from TADS. American Journal of Psychiatry. Published online ahead of print April 15, 2008.
Posted 5/13/08 The UNC School of Public Health has announced funding for five new Gillings Innovation Labs (GILs), ranging from water testing in developing countries to mental health services in North Carolina. Joseph Morrissey, professor of Health Policy and Management, UNC School of Public Health; professor of psychiatry, UNC School of Medicine; and Deputy Director for Research, UNC’s Sheps Center, will lead one lab designed to improve mental health care in North Carolina. See Dr. Morrissey talk more about his work at Meet the Innovators. The projects were among 36 proposals submitted earlier this year by School
faculty, in collaboration with many other individuals and organizations.
Proposals were reviewed by more than 100 subject-matter experts from around the
country. Final decisions were made by the School’s senior leadership, including
the dean, associate deans and department chairs. Funding is for a maximum two
years. “We are delighted by the strong, innovative proposals we received for these,
the first competitively awarded GILs,” Dean Barbara K. Rimer said. “They each
address high priority public health needs. All have potential for significant
impact. Three of the projects focus specifically on North Carolina, two others
on developing countries around the world. They’re all highly interdisciplinary –
within UNC as well as with universities, agencies and businesses around the
world. The projects showcase our ability to apply different skills and
perspectives to find the best solutions to big problems. That’s the true spirit
of the GILs – and our School.” GILs are funded through a generous gift to the School of Public Health by
Dennis and Joan Gillings. Each innovation lab will engage in one or more of
these areas: high-impact research, demonstration projects and teaching practices
which anticipate future public health challenges and accelerate sustainable solutions in North Carolina and around
the world. Here are all five new GILs: Mental Health System Improvement in North Carolina Caring for people who have serious mental illness, substance abuse, and/or
developmental disabilities has become one of North Carolina’s greatest public
health challenges. Problems abound, including short supply of community-based
crisis services, over-use of state psychiatric hospitals, the many people with
serious needs who do not receive the most effective services, and growing
numbers of people with mental illness who are detained in jails across the
state.
In the first year, the team will map the clinical, organizational, and
financial factors driving use of mental health services in the tri-county
Orange, Person, Chatham (OPC) and Durham County (DC) areas. These sites offer
both a predominantly rural laboratory (OPC) and an urban counterpart (DC) to
apply qualitative and quantitative methods, stakeholder participation, and
computer simulations to identify leverage points and intervention strategies for
enhancing system performance. In the second year, the team will scale up to
statewide implementation. These statewide models will allow the team to assess
financial and human impacts of alternative policies and ways to improve the
accessibility, quality, and effectiveness of public mental health services
locally and throughout North Carolina. Single-dose vaccine for multiple respiratory viruses could help
infants and children This team, led by epidemiology professor Ralph
Baric, aims to develop a single dose vaccine, delivered by the
respiratory route (not needles) for infants and children in the developing
world. The vaccine will have a shorter production cycle than current vaccines
(which can take up to a year to culture). This is critical in fighting emerging
diseases. The team wants to find a low-cost, multivalent single dose vaccine
that is stable at room temperature, all of which is important if the vaccine is
to be administered in developing countries. Worldwide, more than 5 million children under age 5 die of respiratory
infections, including pneumonia and influenza. Vaccines for these diseases in
the developing world are usually unavailable, or they are costly, don’t protect
against the right viruses, are not stable enough to be portable in many parts of
the world and require multiple dosing, all of which discourage their use in
developing countries. This project, if successful, would make the vaccines more accessible in developing countries. Also, it would revolutionize vaccine design through the use of synthetic genomics and computer-based genome design. It could also provide a novel, easily-accessible paradigm for the design and delivery of other vaccines for global health. Project partners include: UNC School of Medicine, Carolina Vaccine Institute,
Global Vaccines (a not-for-profit company in Research Triangle Park, NC). The data’s there – if only we could link the information held in many different systems, then we would have a better picture of how diseases develop and spread. With that clearer picture, we’d have a better chance of preventing disease and reducing human suffering.
Portable field tests could effectively check water for fecal contamination
The ultimate goal is to make these simple, reliable tests available
commercially to people around the world. Team members anticipate a test could be
available in about two years. This team comprises scientists from a number of
universities and organizations, including NOAA Center for Coastal Environmental
Health and Biomolecular Research; University of Puerto Rico; University of
Johannesburg; Department of Microbiology, University of Venda (South Africa);
Resource Development International - Cambodia; Seoul National University School
of Public Health. Identifying what pollutants in city air are most harmful
Studies in the School of Public Health’s rooftop environmental chamber, where
air quality is examined, have shown that pollutants are 5-10 times more harmful
when aged in sunlight. This project will use the chamber data to identify the
pollutants that are harmful to people’s lungs. Researchers also will work to
develop a portable device that uses technology similar to what is used in the
rooftop chamber. This advance would allow them to use cultured human lung cells
to study air in the field where pollution occurs. Vizuete’s team will include
scientists from the UNC School of Medicine. These GILs join two other labs named last fall – the Center for Innovative
Clinical Trials and the Carolina Global Water Partnership. Additionally, Rimer
said three other proposals submitted this spring have been identified for
accelerated review and funding. For more information on the Gillings Innovation Labs, including funding
guidelines, please see www.sph.unc.edu/accelerate. Posted 5/01/08 Content for this page provided by the Department of Health
Policy and Management. Please contact the webmaster with any questions or comments. |
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| Last updated August 06, 2008 |
Dr.
Edward L. Baker, research professor in the Department of Health Policy and
Administration at the University
of North Carolina at
Chapel Hill School of Public Health and director of the North Carolina Institute for Public Health at the School, will serve as
principal investigator of the project. 
This innovation lab, led by Joseph
Morrissey, professor of Health Policy and Management, UNC School of
Public Health; professor of psychiatry, UNC School of Medicine; and Deputy
Director for Research, UNC’s Sheps Center, will use a variety of systems
dynamics modeling tools in partnership with community representatives to address
these shortcomings. 
That’s the theory behind the Gillings Innovation Lab led by David Richardson, assistant professor of epidemiology, UNC
School of Public Health. He and a team from the UNC schools of Information and
Library Science and Medicine plan to develop innovative computer systems that
can link and analyze data collected in electronic hospital and ambulance
records. The idea is to get a clearer picture of diseases and how they are
treated. The hope is that more complete information will result in a better
understanding of the causes of disease, and more effective efforts at prevention
and/or treatment. The team will use asthma as a model, seeing who is affected
most by the disease, investigating environmental causes, and assessing the kind
of treatment patients receive, especially if attacks result in hospital or
emergency room visits. Local and state medical service providers will then have
a model to help them make better decisions about health care services, including
education.
Mark Sobsey, Kenan University
Distinguished Professor of environmental sciences and engineering, UNC School of
Public Health, will lead this Gillings Innovation Lab’s efforts to develop and
evaluate simple, portable field tests to detect fecal contamination in water.
Infectious diseases coming from fecal contamination of water include diarrhea,
dysentery, cholera, enteric fevers and infectious hepatitis, killing more than
1.6 million people per year and making billions sick. This project aims to
develop simple fecal microbe tests that are as reliable as current standard
tests, but that will not require sophisticated, expensive and fragile laboratory
equipment, infrastructure, energy (electricity) or advanced training of test
users in environmental microbiology or water quality analysis. 
Air pollution is linked to tens of thousands of deaths each
year. Yet, when scientists conduct toxicology studies in the lab, they see few
health effects from exposure to measured pollutants found in the air around us.
What is missing in these studies, says William Vizuete, is that
people breathe a mixture of pollutants that include chemicals that are only
created in the air, and are typically not measured. Vizuete will lead the
Gillings Innovation Lab that will look for easier, more effective ways of
finding and measuring these toxic pollutants that people actually breathe,
especially in cities. 