Browsing by Author "Scales, Sarah Elizabeth"

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    Burnout among public health workers during the COVID-19 response: Results from a follow-up survey
    (PLOS Mental Health, 2024-08-07) Scales, Sarah Elizabeth; Kintziger, Kristina W.; Stone, Kahler W.; Jagger, Meredith A.; Horney, Jennifer A.
    The public health workforce began the response to the COVID-19 pandemic with a critical workforce deficit, losing 20% of staff between 2018 and 2019. This study assesses changes in burnout among a cohort of 80 public health workers in the U.S. who completed multiple assessments during the ongoing COVID-19 response via Qualtrics. Self-reported burnout was assessed using a 5-point, validated, non-proprietary single-item measure. A binary burnout variable (1,2 = No; 3,4,5 = Yes) was created based on responses. Burnout direction (e.g., decreased, same, increased) was derived from changes in five-level work-related burnout scores. Factors indicating work-related exhaustion was higher among individuals reporting burnout in the follow-up survey compared to those without burnout. Baseline burnout, hours worked per week, and sleep quality were significant predictors of burnout at follow-up. A higher proportion of respondents reported burnout at follow-up than at the baseline survey. The ubiquitous nature of burnout among public health workers is a threat to the wellbeing of individuals in the workforce and the population’s health at large. Investments in expanding and supporting the public health workforce are needed.
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    Chickenpox Outbreaks in Three Refugee Camps on Mainland Greece, 2016-2017: A Retrospective Study
    (Prehospital and Disaster Medicine, 2023-12-18) Scales, Sarah Elizabeth; Park, Jee Won; Nixon, Rebecca; Guha-Sapir, Debarati; Horney, Jennifer A.
    Introduction: Displaced populations face disproportionately high risk of communicable disease outbreaks given the strains of travel, health care circumstances in their country of origin, and limited access to health care in receiving countries. Study Objective: Understanding the role of demographic characteristics in outbreaks is important for timely and efficient control measures. Accordingly, this study assesses chickenpox outbreaks in three large refugee camps on mainland Greece from 2016 – 2017, using clinical line-list data from Médecins du Monde (MdM) clinics. Methods: Clinical line-list data from MdM clinics operating in Elliniko, Malakasa, and Raidestos camps in mainland Greece were used to characterize chickenpox outbreaks in these camps. Logistic regression was used to compare the odds of chickenpox by sex, camp, and yearly increase in age. Incidences were calculated for age categories and for sex for each camp outbreak. Results: Across camps, the median age was 19 years (IQR: 7.00 - 30.00 years) for all individuals and five years (IQR: 2.00 - 8.00 years) for cases. Males were 55.94% of the total population and 51.32% of all cases. There were four outbreaks of chickenpox across Elliniko (n = 1), Malakasa (n = 2), and Raidestos (n = 1) camps. The odds of chickenpox when controlling for age and sex was lower for Malakasa (OR = 0.46; 95% CI, 0.38 - 0.78) and Raidestos (OR = 0.36; 95% CI, 0.24 - 0.56) when compared Elliniko. Odds of chickenpox were comparable between Malakasa and Raidestos (OR = 1.49; 95% CI, 0.92 - 2.42). Across all camps, the highest incidence was among children zero-to-five years of age. The sex-specific incidence chickenpox was higher for males than females in Elliniko and Malakasa, while the incidence was higher among females in Raidestos. Conclusion: As expected, individuals five years of age and under made up the majority of chickenpox cases. However, 12% of cases were teenagers or older, highlighting the need to consider atypical age groups in vaccination strategies and control measures. To support both host and displaced populations, it is important to consider risk-reduction needs for both groups. Including host communities in vaccination campaigns and activities can help reduce the population burden of disease for both communities.
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    Civil war and death in Yemen: Analysis of SMART survey and ACLED data, 2012–2019
    (PLOS Global Public Health, 2022-08-08) Guha Sapir, Debarati; Ogbu, Jideofor Thomas; Scales, Sarah Elizabeth; de Almeida, Maria Moitinho; Donneau, Anne-Francoise; Diep, Anh; Bernstein, Robyn; al-Masnai, Akram; Rodriguez-Llanes, Jose Manuel; Burnham, Gilbert
    Conflict in Yemen has displaced millions and destroyed health infrastructure, resulting in the world’s largest humanitarian disaster. The objective of this paper is to examine mortality in Yemen to determine whether it has increased significantly since the conflict began in 2015 compared to the preceding period. We analysed 91 household surveys using the Standardized Monitoring and Assessment of Relief and Transitions methodology, covering 2,864 clusters undertaken from 2012–2019, and deaths from Armed Conflict Location & Event Data Project database covering the conflict period 2015–2019. We used a Poisson-Gamma model to estimate pre-conflict (μp, baseline value) and conflict period (μc) mean death rates using household survey data from 2012–2019. To analyse changes in the distribution of deaths and estimate nationwide excess deaths, we applied pre- and post-conflict death rates to total population numbers. Further, we tested for association between excess death and security levels by governorate. The national estimated crude death rate/10,000 in the conflict period was 0.20 (95% CI: 0.17, 0.24), which is meaningfully higher than the estimated baseline rate of 0.19 (95% CI: 0.17, 0.22). Applying the conflict period rate to the Yemeni population, we estimated 168,212 excess deaths that occurred between 2015 and 2019. There was an 17.8% increase in overall deaths above the baseline during the conflict period. A large share (67.2%) of the excess deaths were due to combat-related violence. At the governorate level, posterior crude death rate varied across the country, ranging from 0.03 to 0.63 per 10,000 per day. Hajjah, Ibb, and Al Jawf governorates presented the highest total excess deaths. Insecurity level was not statistically associated with excess deaths. The health situation in Yemen was poor before the crisis in 2015. During the conflict, intentional violence from air and ground strikes were responsible for more deaths than indirect or non-violent causes. The provision of humanitarian aid by foreign agencies may have helped contain increases in indirect deaths from the conflict.