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Geographic Disparities Associated With Stroke And Myocardial Infarction In East Tennessee, Ashley Pedigo Golden

Doctoral Dissertations

Stroke and myocardial infarction (MI) are serious conditions whose burdens vary by socio-demographic and geographic factors. Although several studies have investigated and identified disparities in burdens of these conditions at the county and state levels, little is known regarding their geographic epidemiology at the neighborhood level. Both conditions require emergency treatments and therefore timely geographic accessibility to appropriate care is critical. Investigation of disparities in geographic accessibility to stroke and MI care and the role of Emergency Medical Services (EMS) in reducing treatment delays are vital in improving health outcomes. Therefore, the objectives of this work were to: (i) classify …

La Etnia Y Las Cesáreas En Los Partos En El Hospital Público De Arica, Chile, Marisa Westbrook

Independent Study Project (ISP) Collection

The principal objective of this project was to explore the relationship between ethnicity and the causes for Caesarean section in the regional public hospital in Arica, Chile. All births recorded in the maternity register (n=907) were analyzed over a 4-month period in 2011. The regional public hospital had a 27% caesarean section rate, higher than the WHO-recommended 15%. Last names were analyzed and deemed to be either of Aymara descent (n=275) or of European descent (n=632) based on criteria used from CONADI, the National Corporation for Indigenous Development. The overall rate of Caesarean section did not differ between Aymara and …

Neighborhood Disparities In Stroke And Myocardial Infarction Mortality: A Gis And Spatial Scan Statistics Approach, Agricola Odoi

Agricola Odoi

Background: Stroke and myocardial infarction (MI) are serious public health burdens in the US. These burdens vary by geographic location with the highest mortality risks reported in the southeastern US. While these disparities have been investigated at state and county levels, little is known regarding disparities in risk at lower levels of geography, such as neighborhoods. Therefore, the objective of this study was to investigate spatial patterns of stroke and MI mortality risks in the East Tennessee Appalachian Region so as to identify neighborhoods with the highest risks. Methods: Stroke and MI mortality data for the period 1999-2007, obtained free …

Oral Ingestion Of Hexavalent Chromium Through Drinking Water And Cancer Mortality In An Industrial Area Of Greece - An Ecological Study, Athena Linos, Athanassios Petralias, Costas A. Christophi, Eleni Christoforidou, Paraskevi Kouroutou, Melina Stoltidis, Afroditi Veloudaki, Evangelia Tzala, Konstantinos C. Makris, Margaret R. Karagas

Dartmouth Scholarship

Background: Hexavalent chromium is a known carcinogen when inhaled, but its carcinogenic potential when orally ingested remains controversial. Water contaminated with hexavalent chromium is a worldwide problem, making this a question of significant public health importance.

Methods: We conducted an ecological mortality study within the Oinofita region of Greece, where water has been contaminated with hexavalent chromium. We calculated gender, age, and period standardized mortality ratios (SMRs) for all deaths, cancer deaths, and specific cancer types of Oinofita residents over an 11-year period (1999 - 2009), using the greater prefecture of Voiotia as the standard population.

Results: A total of …

The Effect Of Providing Skilled Birth Attendance And Emergency Obstetric Care In Preventing Stillbirths, Mohammad Yawar Yakoob, Mahrukh Ayesha Ali, Mohammad Usman Ali, Aamer Imdad, Joy E. Lawn, Nynke Van Den Broek, Zulfiqar Ahmed Bhutta

Woman and Child Health

Background:Of the global burden of 2.6 million stillbirths, around 1.2 million occur during labour i.e. are intrapartum deaths. In low-/middle-income countries, a significant proportion of women give birth at home, usually in the absence of a skilled birth attendant. This review discusses the impact of skilled birth attendance (SBA) and the provision of Emergency Obstetric Care (EOC) on stillbirths and perinatal mortality.

Methods:

A systematic literature search was performed on PubMed/MEDLINE, Cochrane Database and the WHO regional libraries. Data of all eligible studies were extracted into a standardized Excel sheet containing variables such as participants' characteristics, sample size, location, …

Neonatal Resuscitation And Immediate Newborn Assessment And Stimulation For The Prevention Of Neonatal Deaths: A Systematic Review, Meta-Analysis And Delphi Estimation Of Mortality Effect, Anne C. C. Lee, Simon Cousens, Stephen N. Wall, Susan Niermeyer, Gary L. Darmstadt, Waldemar A. Carlo, William J. Keenan, Zulfiqar Ahmed Bhutta, Christopher Gill, Joy E. Lawn

Woman and Child Health

Background: Of 136 million babies born annually, around 10 million require assistance to breathe. Each year 814,000 neonatal deaths result from intrapartum-related events in term babies (previously "birth asphyxia") and 1.03 million from complications of prematurity. No systematic assessment of mortality reduction from tactile stimulation or resuscitation has been published. Objective:To estimate the mortality effect of immediate newborn assessment and stimulation, and basic resuscitation on neonatal deaths due to term intrapartum-related events or preterm birth, for facility and home births.

Methods:

We conducted systematic reviews for studies reporting relevant mortality or morbidity outcomes. Evidence was assessed using GRADE criteria …

Social Capital And Life Satisfaction: A Cross-Sectional Study On Persons With Musculoskeletal Impairments In Hanoi, Vietnam, Kyo Takahashi, Nguyen Tm Thuy, Krishna C. Poudel, Kayako Sakisaka, Masamine Jimba, Junko Yasuoka

Krishna C. Poudel

Groundwater Uranium And Cancer Incidence In South Carolina, Sara E. Wagner, James B. Burch, Matteo Bottai, Robin C. Puett, Dwayne E. Porter, Susan Bolick-Aldrich, Tom Temples, Rebecca C. Wilkerson, John E. Vena, James R. Hébert

Faculty Publications

Objective

This ecologic study tested the hypothesis that census tracts with elevated groundwater uranium and more frequent groundwater use have increased cancer incidence.

Methods

Data sources included: incident total, leukemia, prostate, breast, colorectal, lung, kidney, and bladder cancers (1996–2005, SC Central Cancer Registry); demographic and groundwater use (1990 US Census); and groundwater uranium concentrations (n = 4,600, from existing federal and state databases). Kriging was used to predict average uranium concentrations within tracts. The relationship between uranium and standardized cancer incidence ratios was modeled among tracts with substantial groundwater use via linear or semiparametric regression, with and without stratification …

Epistemic Fault Lines In Biomedical And Social Approaches To Hiv Prevention, Barry D. Adam

Barry D Adam

This paper raises the question of how knowledge creation is organized in the area of HIV prevention and how this concatenation of expertise, resources, at-risk people and viruses shapes the knowledge used to impede the epidemic. It also seeks to trouble the discourses of biomedical pre-eminence in the fi eld of HIV prevention by examining the claim for treatment as prevention, looking at evidence constructed through the biomedical frame and through the lens of the sociology of science. These questions lie within a larger socio-historical context of lagging worldwide attention and funding to prevention in the HIV area and, in …

The Relationship Between Sunlight And Cerebrovascular Health, Shia T. Kent

All ETDs from UAB

Sunlight radiation may be related to stroke risk through increased vitamin D production. The latter has been associated with a number of conditions including stroke, cognitive function and cardiovascular disease. We performed three sets of analyses to determine whether higher levels of sunlight radiation were associated with lower rates of stroke incidence, all-cause mortality, and cognitive decline. We explored these relationships using the REasons for Geographic And Racial Differences in Stroke (REGARDS) study, a national longitudinal cohort of 30,239 participants. We merged the participants' residential histories with a ground and satellite-derived NASA dataset to characterize 15-year average sunlight radiation and …