University of Colorado Denver

Michael Hambidge, MD, ScD, Professor Emeritus, Department of Pediatrics, University of Colorado School of Medicine, is the principal investigator of this project. The objective of this project is to determine Zn absorption from bio fortified maize meal at different levels of fortification, the determine the effect of milling on bioavailability, to compare increase in Zn absorption for each group, and to utilize data derived from these studies to develop a trivariate model which will predict the effect of dietary Zn and phyate on the total quantity of Zn absorbed each day. This project is being conducted between May 2009 and April 2011.

 

Gretchen Heinrichs, MD, DTMH, Assistant Professor of Obstetrics and Gynecology at the University of Colorado School of Medicine and Denver Health, as Director of Maternal Health Initiatives for the Center for Global Health has formulated the maternal health objectives for the ongoing Guatemala Trifinio project being conducted by Center for Global Health.

 

Susan Niermeyer, MD, MPH, FAAP, Professor of Pediatrics, Section of Neonatology at the University of Colorado School of Medicine and Professor of Epidemiology at the Colorado School of Public Health is Co-Director of the Center for Global Heatlh's Maternal and Child Health Initiative along with Eric Simoes, MB, BS, DCH, MD, Professor of Pediatrics, Section of Pediatric Infectious Disease at the University of Colorado School of Medicine and Professor of Epidemiology at the Colorado School of Public Health.

 

Together they will work on current projects beginning in Guatemala in birth attendant training and rural obstetric care health provision access. The Guatemala Trinifio Project started in 2011 and is planned to conclude in 2017.

This project is being conducted by Lorann Stallones, MPH, PhD, Professor of Psychology, Director of the Graduate Degree program in Public Health at Colorado State University. The project investigates the relationship between organophosphate pesticide (OP) exposures, agression, impulsivity, and attempted suicides. Although previous studies have suggested an association between suicide and OP exposure, no studies have assessed the relationship between suicide attempts and OP exposures.

 

This project ran from 2010-2011.

Nancy Krebs, MD, FAAP, Professor, Department of Pediatrics, University of Colorado School of Medicine is working as Co‐PI on the NICHD/NIH supported Global Network for Women’s and Children’s Health Research. She works at the lead site for a multi‐country efficacy trial on complementary feeding.  She is also working on projects related to interventions of micronutrient supplements, biofortification and plant breeding, and dietary diversification in Guatemala, China, India, Pakistan, Kenya, Zambia and Democratic Republic of Congo.  An investigation of iron interventions in a malaria‐endemic area of Kenya and the impact on the gut microbiome is also underway.

Susan B Rifkin, PhD, adjunct faculty at the Colorado School of Public Health and a Senior Research Fellow, Institute of Social Psychology, at the London School of Economics, has been building on the results of a symposium held in Washington, DC in April 2010 with the Department of Preventive Medicine, University of Geneva, and analyzing experiences from countries that have evidence of improved health outcomes from including policies of community participation.

 

Elizabeth Shick, DDS, MPH, Assistant Professor, Department of Pediatric Dentistry, University of Colorado, School of Dental Medicine, is working on the Trifinio project to provide dental services to patients of the future clinic. She plans to provide comprehensive care to patients by travelling multiple times per year to the Trifinio Clinic, and creating an elective rotation for 3rd and 4th year dental students. Students will travel to the clinic to provide dental care with an attending faculty member from the University of Colorado School of Dental Medicine. Shick is investigating possible funding opportunities to cover costs of dental chairs, instruments and materials. Another goal of this project is to collaborate with the local dental school at University of Francisco Marroqin to encourage their involvement in providing dental care at the Trifinio clinic to provide long-term sustainability and increased scope of services offered. The final objective is collaboration with the faculty of the dental school at University of Francisco Marroqin to provide education and training in the area of pediatric dentistry and encourage an exchange program between their school and University of Colorado School of Dental Medicine.

Blair Gifford, PhD, Professor, International Health Management, Business School, University of Colorado Denver, is currently working on this four-year project. Funding for this project will be used to develop midwifery auxilliare vocational training at the Ecole Professional CAMEJO (EPC) in Leogane, Haiti.  Midwife auxilliare training is needed to combat the very high maternal and infant mortality rates in Haiti.  Recent efforts to develop midwife assistants and other health human resources, by organizations like Partners in Health in Haiti, have helped lessen maternal and infant mortality rates by up to 50% since 1999 in specified work areas. Haiti has the worst maternal health statistics of any country (630 deaths per 100,000 live births) in the Western hemisphere and among the worst in the world.  Prior to the quake, only a quarter of births were attended by trained personnel, compared with 98% of births in the neighboring Dominican Republic.  Experiences from Afghanistan and Partners in Health work areas in central Haiti have shown that investing in midwifery can significantly reduce maternal mortality, even under the harshest conditions.  Midwives are significantly less expensive to train and maintain than doctors; they can be drawn from local populations with low educational levels and as “local daughters;” and, they are more likely to be accepted and trusted by, and continue to serve, hard-to-reach rural communities.

Global health electives have gained considerable popularity in the last decade among medical students wishing to travel, improve physical exam skills, enhance cultural knowledge and sensitivity, and gain clinical experience not always available at home institutions. Many students report these electives as positive experiences, however, true effects of these electives both on students and the patients they serve are unknown. Jennifer Whitfield Bellows, MD, MPH, Assistant Professor, Department of Emergency Medicine at the University of Colorado School of Medicine and Denver Health  is in the process of literature review of studies that evaluate the effect of these electives, with the goal of creating a more rigorous, standardized evaluation method of evaluation.

Jennifer Whitfield Bellows, MD, MPH, Assistant Professor, Department of Emergency Medicine at the University of Colorado School of Medicine and Denver Health is collaborating, with Deborah Thomas, PhD, Associate Professor,Department of Geography and Environmental Sciences at the University of Colorado Denver  and David Richards, MD,  Department of Emergency Medicine at the University of Colorado School of Medicine, to create a GIS-based map of the locations of penetrating trauma events whose victims  presented to a tertiary care center in Cape Town, South Africa. The map can potentially help inform further research into emergency medical and transfer systems, determinants and cofactors of interpersonal violence, and policy creation intended to address and reduce this violence in the Western Cape.

Jose Castillo-Mancilla, MD, Department of Medicine at the University of Colorado School of Medicine has worked for the past several years with the foreign-born population in Denver. His work has confirmed that migration is a risk factor for acquiring HIV infection in any given population around the world. Other factors that immigrants face and that increase their risk of acquiring HIV infection are discrimination and racism, language barriers, modifications in the sexual identity after moving to the United States and lack of social support. Despite the extensive research produced in many areas of HIV/AIDS over the last 25 years, the HIV epidemic among immigrants in the United States has not been fully studied. This is due in part to the difficulty in accounting for immigrants in general (i.e. undocumented immigrants) and to the limited resources available to study this population. Some isolated studies have calculated the prevalence of HIV infection in different immigrant groups with a wide range of results (13% in Hispanic immigrants, up to 20% in African immigrants). The extent to which HIV among immigrants in the United Sates reflects infections acquired outside the United States versus ongoing transmission within the United States is uncertain and requires further research. We are interested in better understanding the HIV epidemic, the reasons for delayed diagnosis and the limitations in access to care that this population faces. We consider that the foreign-born individuals constitute a "nation within a nation," which requires special attention.

Susan Niermeyer, MD, MPH, FAAP, Professor, Department of Pediatrics, Section of Neonatology at the University of Colorado School of Medicine collaborates in the ongoing development of “Helping Babies Breathe,” an evidence-based educational program in neonatal resuscitation for resource-limited settings. The global curriculum is designed to be used by birth attendants at the first levels of the health system (from district hospital to the community) who are responsible for the care of both the pregnant woman and the newborn infant at delivery.  The program emphasizes prompt action in the first minute after birth, The Golden Minute®, to help a baby breathe.  The basic steps of drying, providing warmth, clearing the airway, stimulation to breathe and if necessary, ventilation with bag and mask, are sufficient to establish and support spontaneous breathing in more than 98% of newborns.  
The educational program covers the following topics:
a.      Preparation for birth
b.      Routine care
c.      Initial steps of help to breathe
d.      Ventilation with bag and mask
e.      Continued ventilation with normal and slow heart rate
 
The learning materials emphasize graphic, pictorial presentation of an action plan and hands-on learning of skills using a low-cost, high-fidelity neonatal simulator. Active learning occurs through practice of discrete resuscitation skills, combination of a series of skills into exercises, integration of skills and decision-making in case scenarios and group discussion to identify potential barriers and solutions to actual implementation of the practices learned. 

 

Gretchen Heinrichs, MD, DTMH, Assistant Professor of Obstetrics and Gynecology at the University of Colorado School of Medicine and Denver Health, is presently an Obstetrics and Gynecology Consultant to Village Health Partnership. In this capacity she plans screening assessments of women with Fistula and Prolapse, plans hospital assessments of Obstetric and OR facilities at the Dembi Dollo Regional Hospital, and planned an assessment of barriers and facilitators to Facility-based Obstetric care that will be carried out in December 2011-January 2012.  Village Health Partnership is a 501c3 pending non-governmental organization focused on Vesico-vaginal Fistula, Pelvic Organ Prolapse screening and treatment, and improving maternal mortality in rural western Ethiopia.  For more information, please visit www.villagehealthpartnership.org

Wayne Sullender, MD, FAAP, Visiting Professor of Pediatrics, Section of Pediatric Infectious Disease at the University of Colorado School of Medicine, is the principal investigator for this study. Influenza viruses are significant causes of human illness and death in developed and developing countries. This study will measure the ability of influenza vaccine given to children in India to protect both the children and unimmunized persons around them from influenza. It will also determine whether the best time to immunize in a country like India that has both summer and winter outbreaks of influenza is in the fall, as is done now, or whether immunization should be in the spring to protect against influenza infections in the summer. This study will run from 10/1/2011 to 9/30/2014.

Eric A F Simões, MB, BS, DCH, MD, Professor of Pediatrics, Section of Pediatric Infectious Disease at the University of Colorado School of Medicine. Dr. Simões carried out many of the studies that provide the scientific foundation for the World Health Organization’s Integrated Case Management of Childhood Illness. He has been involved with this program for many years, initially with development of algorithms for acute respiratory infections and later on with helping develop the current Integrated Case Management of Childhood Illnesses algorithm and refining it.

 

Co-collaborators Deborah Thomas, PhD, Associate Professor, Department of Geography and Environmental Sciences at the University of Colorado Denver, and Renee King, MD, MPH, Assistant Professor, Department of Emergency Medicine at the University of Colorado School of Medicine, are working with other investigators to conduct a case study centered on the two main hospitals that serve the northern region of Haiti. Using semi-structured interviews and an analysis of organizational networks, the research: 1) examines what local health-related resources were available during and after the devastating earthquake of January 2010, 2) how these were, or were not, made use of in response efforts, and 3) the level of coordination and collaboration among health delivery groups with a particular focus on preparedness and recovery. This project is funded by the National Science Foundation.