Melinda Moore

RAND Corporation | RAND · RAND Health

Since 2010, the RAND Corporation has worked with the Ministry of Health and Ministry of Planning of the Kurdistan Regional Government to develop and implement initiatives for improving the region's health care system through analysis, planning, and development of analytical tools. This third phase of the project (reflecting work completed in 2013-2...

https://www.rand.org/pubs/research_reports/RR2112.html

Recent high-profile outbreaks, such as Ebola and Zika, have illustrated the transnational nature of infectious diseases. Countries that are most vulnerable to such outbreaks might be higher priorities for technical support. RAND created the Infectious Disease Vulnerability Index to help U.S. government and international agencies identify these coun...

Army medical professionals must maintain the high level of proficiency required to fulfill the Army's medical missions of supporting military operations and providing beneficiary care. Because beneficiary care demands in a U.S. medical treatment facility (MTF) do not mirror those in a combat setting and sometimes can exceed the MTF's capacity, some...

Objective: Using the example of surveys conducted by the American College of Emergency Physicians (ACEP) regarding the management of Ebola cases in the United States, we aimed to demonstrate how survey-based information networks can provide timely data to inform best practices in responding to public health emergencies. Methods: ACEP conducted 3...

Another Nepal earthquake magnified the importance of good disaster relief planning.Many questions arise in the aftermath of such calamities: How can disaster relief be initiated quickly and be effective? Which personnel and what expertise are needed? What supplies and equipment? What services? Even experienced disaster relief agencies can benefit f...

Background The Mekong Basin Disease Surveillance cooperation (MBDS) is one of several sub-regional disease surveillance networks that have emerged in recent years as an approach to transnational cooperation for infectious disease prevention and control. Since 2003 MBDS has pioneered a unique model for local cross-border cooperation. This study exam...

In the context of the 2012 National Strategy for Biosurveillance, the Office of Management and Budget (OMB) asked the Department of Defense (DoD) to review its biosurveillance programs, prioritize missions and desired outcomes, evaluate how DoD programs contribute to these, and assess the appropriateness and stability of the department's funding sy...

Background Exercises are increasingly common tools used by the health sector and other sectors to evaluate their preparedness to respond to public health threats. Exercises provide an opportunity for multiple sectors to practice, test and evaluate their response to all types of public health emergencies. The information from these exercises can be...

Commentary posted http://www.rand.org/blog/2014/06/an-outbreak-of-outbreaks.html

Biosurveillance provides information that improves decisions about mitigating the effects of disease outbreaks and bioterrorism. The success of biosurveillance depends on the effectiveness of at least four key processes: data collection, data analysis and interpretation, data integration from across organizations, and action (including public respo...

Study objective: Efficient management and allocation of scarce medical resources can improve outcomes for victims of mass casualty events. However, the effectiveness of specific strategies has never been systematically reviewed. We analyze published evidence on strategies to optimize the management and allocation of scarce resources across a wide...

Sub-regional disease surveillance networks are an emerging trend in global public health. The Mekong Basin Disease Surveillance cooperation (MBDS) is one such network, which despite notable successes over the past ten years faces challenges in sustainability. We created a sustainability framework comprising strategic and tactical sustainability-ena...

This systematic review sought to identify the best available evidence regarding strategies for allocating scarce resources during mass casualty events (MCEs). Specifically, the review addresses the following questions: (1) What strategies are available to policymakers to optimize the allocation of scarce resources during MCEs? (2) What strategies a...

U.S. policymakers have stepped up systematic disaster preparedness efforts sharply since the terrorist attacks of September 11, 2001, including the creation of the U.S. Department of Homeland Security and a plethora of federal initiatives. Against a backdrop of natural disasters that occur each year in the United States and heightened concern about...

The Army manages the Department of Defense Serum Repository (DoDSR) of over 43 million serum samples and the associated Defense Medical Surveillance System (DMSS) database that links individual service member characteristics to these biological samples. The main mission and use of these resources has been for military health surveillance. The Army...

Objectives: Community resilience (CR) is emerging as a major public policy priority within disaster management and is one of two key pillars of the December 2009 US National Health Security Strategy. However, there is no clear agreement on what key elements constitute CR. We examined exemplary practices from international disaster management to va...

The globalization of public health is both real and relevant throughout the United States and to Americans traveling or residing abroad. US public policy responses are evolving, but a crisper and more comprehensive global perspective is needed. I suggest four timely US actions to address today’s competing realities of globalization and economic aus...

ABSTRACT: Soon after the 2009-H1N1 virus emerged as the first influenza pandemic in 41 years, countries had an early opportunity to test their preparedness plans, protocols and procedures, including their cooperation with other countries in responding to the global pandemic threat. The Mekong Basin Disease Surveillance cooperation (MBDS) comprises...

This article presents the results of a comparative environmental risk-ranking exercise that was conducted in the United Arab Emirates (UAE) to inform a strategic planning process led by the Environment Agency-Abu Dhabi (EAD). It represents the first national-level application of a deliberative method for comparative risk ranking first published in...

Considerable resources have been invested in recent years to improve laboratory systems in resource-limited settings. We reviewed published reports, interviewed major donor organizations, and conducted case studies of laboratory systems in 3 countries to assess how countries and donors have worked together to improve laboratory services. While infr...

Long-term recovery from disasters presents a formidable challenge to affected communities, requiring sound strategies to restore the health and livelihoods of those affected. This paper examines exemplary practices related to long-term recovery and redevelopment from disasters in other countries, and identifies key themes and promising practices re...

To assess the extent to which the systems in place for prevention and control of routine annual influenza could provide the information and experience needed to manage a pandemic. The authors conducted a qualitative assessment based on key informant interviews and the review of relevant documents. Although there are a number of systems in place tha...

The devastation of the U.S. Gulf Coast by Hurricane Katrina in August 2005 sparked widespread reconsideration of U.S. disaster management practices. While most of this inquiry has drawn on U.S. disaster experiences, countries throughout the world are also struck by natural disasters. We hypothesized that the disaster management experiences in other...

Assesses the Department of Defense (DoD) response to three potential anthrax-related incidents at DoD facilities in March 2005 and recommends ways that DoD can improve its incident-response capabilities.

The International Health Regulations (IHR) 2005 present a challenge and opportunity for global surveillance and control of infectious diseases. This article examines the opportunity for regional networks to address this challenge. Two regional infectious disease surveillance networks, established in the Mekong Basin and the Middle East, are present...

Coordination and communication among community partners-including health departments, emergency management agencies, and hospitals-are essential for effective pandemic influenza planning and response. As the nation's largest integrated health care system, the US Department of Veterans Affairs (VA) could be a key component of community planning. To...

Excel file with four worksheets: (1) "Inputs" – allows user to vary input values for all variable parameters in the decision tool for both baseline and follow-up time periods, (2) "Outputs" – displays a composite summary table of output calculations, followed by a summary for each detection path that contains both input values and the calculated ou...

The current avian influenza pandemic in birds is raising widespread public concern about the emergence of a human influenza pandemic. Using data from the 1918 influenza pandemic, it is estimated that up to 62 million people worldwide could die if a similar event occurred today. In response to this threat, countries around the world are developing p...

Global pandemic influenza preparedness relies heavily on public health surveillance, but it is unclear that current surveillance fully meets pandemic preparedness needs. We first developed a conceptual framework to help systematically identify strategies to improve the detection of an early case or cluster of novel human influenza disease during th...

This After Action Review (AAR) summarizes the regional pandemic influenza tabletop exercise conducted in Siem Reap, Cambodia on March 13-14, 2007 by the Mekong Basin Disease Surveillance (MBDS) countries (Cambodia, Lao PDR, Myanmar, Thailand, Vietnam, and Yunnan-China) and their partners. This exercise culminated a project that began with individua...

The world is bracing for the next influenza pandemic. Many experts believe it will originate in Southeast Asia. To help improve the region’s preparedness for such an event, RAND began working in 2006 with a consortium of partners through the Mekong Basin Disease Surveillance (MBDS) project. An ongoing collaboration among six nations—Cambodia, Laos,...

Nearly half the world's population now lives in urban settlements. Cities offer the lure of better employment, education, health care, and culture; and they contribute disproportionately to national economies. However, rapid and often unplanned urban growth is often associated with poverty, environmental degradation and population demands that outs...

The role of voluntary HIV counseling and testing is still under debate, especially in the developing world. HIV counseling-and-testing (HIV CT) services are a major component of HIV and AIDS control programs in the industrialized world and are increasingly being advocated in the developing world. In the United States, voluntary HIV CT has been a ma...

A national random-sample survey of 4011 primary care physicians was conducted to determine the extent to which they are providing HIV prevention and clinical services, and to learn what characteristics and attitudes might impede the provision of such services. Physicians were asked about their history-taking practices for new adult and adolescent p...

Pretest and posttest counseling have become standard components of prevention-oriented human immunodeficiency virus (HIV) antibody testing programs. However, not all persons who receive pretest counseling and testing return for posttest counseling. Records of 557,967 clients from January through December 1990, representing more than 40 percent of a...

In order to identify the optimal configuration of HIV prevention programs, it is necessary to examine different theoretical models of behavior change. Cognitive/decision-making theories of human behavior change are compared to social learning theories vis-a-vis their influence on the structure of service delivery systems. Cognitive/decision-making...

To review published abstracts, journal articles, and presentations for evidence of the effects of human immunodeficiency virus (HIV) antibody counseling and testing on risk behaviors. Studies reviewed focused on homosexual men, intravenous drug users in treatment programs, pregnant women, and other heterosexuals. Peer-reviewed journals (January 198...

Objective: To review published abstracts, journal articles, and presentations for evidence of the effects of human immunodeficiency virus (HIV) antibody counseling and testing on risk behaviors. Studies reviewed focused on homosexual men, intravenous drug users in treatment programs, pregnant women, and other heterosexuals. Data sources: Peer-re...

Auvert B (INSERM U88, 91 Boulevard de l'Hôpital, 75013 Paris, France), Moore M, Bertrand W E, Beauchet A, Aegerter P, Lusamba D, Diong K T and Klinowski J. Dynamics of HIV infection and AIDS in central African cities. International Journal of Epidemiology 1990, 19: 417–428. A detailed stochastic model of HIV infection and AIDS for large cities in...

We conducted a 2-year prospective study of diarrheal illness in children ages 0 to 36 months in 22 day care centers in Maricopa County, Arizona. In 7464 child-months of observation, 465 sporadic cases and 170 outbreak-associated cases of diarrhea were identified. Enteric pathogens were identified in 20% of diarrhea episodes. Giardia lamblia, rotavi...

During the second year of a prospective study of diarrheal illness among 0- to 36-month-old children in day care centers in Maricopa County, Arizona, we concurrently studied children of the same age in 30 day care homes and 102 households not using day care. The seasonal pattern of diarrhea, frequency of pathogen isolation, and relative frequency o...

The changing an~u~l vaccination status of the population and the >1,OOO-fold drop in reported ~nnual incidence of paralytic poliomyelitis between the early 1950s and early 1970s indicate that the control of poliomyelitis in the United States must be attributed to the use of both the inactivated poliovirus vaccine and oral poliovirus vaccine. The co...

During 1978 and 1980, epidemiologists at the Centers for Disease Control investigated seven outbreaks of aseptic meningitis—like illness (AMLI) occurring in high school football players in four different states. One or more enterovirus types were isolated from affected students at all seven schools. Attack rates were highest among the varsity footb...

Kaplan, J. E. (CDC, Atlanta, GA 30333), D. A. Eliason, M. Moore, G. E. Sather, L. B. Schonberger, L. Cabrera-Coello and J. Fernandez de Castro. Epidemio-logic investigations of dengue infection in Mexico, 1980. Am J Epidemiol 1983; 117: 335–43. A binational investigation was conducted in two Mexican cities in 1980 to study epidemiologic characteris...

This is an interim report for the first phase of a larger study that aims to develop a disaster preparedness support tool for local military and civilian planners. It reflects the formative research carried out from October 2006 through May 2009. It describes the current policy context for domestic emergency preparedness, risk analysis, and capabil...

In late 2005, the U.S. Executive Branch put forth a new national policy for how the U.S. government is to plan and conduct stability and reconstruction operations. Existing military policy and doctrine were further revised, with the Army more definitively articulating its concept of "full spectrum operations," consisting of offensive, defensive, an...

The impetus for the development of a handbook to guide the assessment of military humanitarian assistance (HA) projects came from a January 2008 workshop with combatant command (COCOM) HA managers, "Monitoring and Evaluation of DoD Humanitarian Assistance Programs." Participants felt that a user-friendly handbook to clarify overall monitoring and e...

This report provides a summary of each of the three potential anthrax-related incidents that occurred within Department of Defense (DoD) mail facilities in northern Virginia and Washington, D.C., during 14-18 March 2005. Each of these incidents presented decisionmakers and responders with different challenges. The RAND Corporation was asked by DoD...