Digital Commons Network^™

Not Only How Much But How: The Importance Of Diversifying Funding Streams In A Reimagined Public Health System, J. Mac Mccullough, Umesh Ghimire, Jason M. Orr, Sezan O. Onal, Ashley Edmiston, Krishna Patel, Timothy C. Mccall, Jonathon P. Leider

Public Health and Population Science Faculty Publications and Presentations

Revenue diversification may be a synergistic strategy for transforming public health, yet few national or trend data are available. This study quantified and identified patterns in revenue diversification in public health before and during the COVID-19 pandemic. We used National Association of County and City Health Officials’ National Profile of Local Health Departments study data for 2013, 2016, 2019, and 2022 to calculate a yearly diversification index for local health departments. Respondents’ revenue portfolios changed fairly little between 2016 and 2022. Compared with less-diversified local health departments, well-diversified departments reported a balanced portfolio with local, state, federal, and clinical sources …

Public Health And Human Health Implications Of Climate Mobility, Julia Neusner, Ama Francis

Sabin Center for Climate Change Law

Climate change poses significant challenges at the intersection of human and public health, mobility, and international law. Adverse climate impacts undermine the quality of human and public health, contributing to increasing global mobility, while climate-impacted migrants and displaced people can experience severe health challenges in transit and in their receiving communities. Moreover, the nexus between climate change, human and public health, and mobility exacerbates pre-existing vulnerabilities, undermining human rights and implicating State obligations. As international and regional courts, including the International Court of Justice (ICJ), clarify states’ duty to protect people from the adverse impacts of climate change, it is …

Assessing Health Implications Of Monarch Butterfly Populations And Behaviors, Kira Goldman, Kelsey E. Fisher Dr.

Honors Scholar Theses

Pollinator populations have seen massive declines over the past decade due to anthropogenic activity and climate change posing serious threats to the health of humans and ecosystems (Ulyshen & Horn, 2023). As agents responsible for the production of about 35% of micronutrient rich food crops necessary for adequate nutrition to lead healthful lives and prevent nutrition associated diseases, pollinator decline is a public health concern (Aizen et al., 2009). Monarch butterflies (Danaus plexippus) serve as bio indicators for the health of pollinator populations because of their analogous habitat and food resources shared with many other pollinator species, including bees and …

Latent Tb Treatment Regimens In 2023: Wetmore Tb Clinic In New Orleans, Amy Wolfe, Priyanka Jadhav, Amber May, Shandrica Seymour, Angela Blanchard, Juzar Ali

School of Medicine Faculty Publications

The USPSTF has updated Latent TB Infection (LTBI) screening and treatment recommendations in 2023; describing treatment courses, side effects and benefits associated with each regimen. Overall, rifampin-containing shortened regimens are the preferred modality for LTBI treatment. A recent study in 2023 evaluated adherence and tolerance of the isoniazid(INH) + rifapentine(RPT), or “3HP” regimen and identified patient groups that may be at higher risk for non-completion of this regimen. It emphasized the need for targeted education at the beginning of treatment, to avoid early discontinuation. Our experience in New Orleans demonstrated that the 3HP is well-tolerated, with higher completion rates than …

International Students And Mental Health And Wellness, Rebecca Ramos Rosas

Capstone Research Posters

Despite concerns raised by previous literature about the undertreatment of mental health issues among international students, findings from this study suggest varied experiences during the pandemic. While some participants reported challenges accessing healthcare due to pandemic restrictions, others noted improved accessibility to healthcare services, including mental health resources. Furthermore, the study explores international students' perceptions of their college or university's supportiveness in navigating the Canadian education system. Recommendations for healthcare providers to enhance accessibility to resources for college and university students include improving communication and expanding health and wellness services. Additionally, participants highlighted financial issues and the availability of healthcare …

A Computer Vision Solution To Cross-Cultural Food Image Classification And Nutrition Logging​, Rohan Sethi, George K. Thiruvathukal

Computer Science: Faculty Publications and Other Works

The US is a culturally and ethnically diverse country, and with this diversity comes a myriad of cuisines and eating habits that expand well beyond that of western culture. Each of these meals have their own good and bad effects when it comes to the nutritional value and its potential impact on human health. Thus, there is a greater need for people to be able to access the nutritional profile of their diverse daily meals and better manage their health. A revolutionary solution to democratize food image classification and nutritional logging is using deep learning to extract that information from …

Prospective Associations Of Accelerometer-Measured Machine-Learned Sedentary Behavior With Death Among Older Women: The Opach Study., Steve Nguyen, John Bellettiere, Blake Anuskiewicz, Chongzhi Di, Jordan A. Carlson, Loki Natarajan, Michael J. Lamonte, Andrea Z. Lacroix

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: Sedentary behavior is a recognized mortality risk factor. The novel and validated convolutional neural network hip accelerometer posture algorithm highly accurately classifies sitting and postural changes compared with accelerometer count cut points. We examined the prospective associations of convolutional neural network hip accelerometer posture-classified total sitting time and mean sitting bout duration with all-cause and cardiovascular disease (CVD) death.

METHODS AND RESULTS: Women (n=5856; mean±SD age, 79±7 years; 33% Black women, 17% Hispanic or Latina women, 50% White women) in the Women's Health Initiative Objective Physical Activity and Cardiovascular Health (OPACH) Study wore the ActiGraph GT3X+ for ~7 days …

What Is The Risk Of “Captagon” And Other Pill-Pressed Stimulants In Tennessee?, Jeremy C. Kourvelas Mph

SMART Policy Briefs

• The U.S. is the world’s largest market for amphetamine-type stimulants. While “ice” methamphetamine is the predominant type seized in Tennessee, amphetamine powder, cocaine, designer stimulants like MDMA, and diverted pharmaceuticals are also encountered. In fact, non-medical use of pharmaceutical amphetamines is the most predominant type of amphetamine use in the U.S.

• The ongoing shortage of prescription stimulants like Adderall puts college-aged youth and other vulnerable populations at particular risk of encountering counterfeit prescription stimulants. Fentanyl-laced counterfeit Adderall has already been discovered on college campuses, for example.

• One potential threat is “Captagon,” which was banned in the 1980s but has since …

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Statement Of The Aspher Task Force On War And Public Health On The Conflict In Israel/Palestine, Oliver Razum, Paul Barach, Tomasz Bochenek, Colette Cunningham, Nadav Davidovitch, Polychronis Kostoulas, Jutta Lindert, Henrique Lopes, Vladimir Prikazsky, John Reid, Mirjana Kujundžić Tiljak, John Middleton

College of Population Health Faculty Papers

No abstract provided.

Indicators Of Community Physical Activity Resources And Opportunities And Variation By Community Sociodemographic Characteristics: A Scoping Review, Ann E. Rogers, Michaela A. Schenkelberg, Peter Stoepker, Danielle Westmark, Deepa Srivastava, David A. Dzewaltowski

Department of Child, Youth, and Family Studies: Faculty Publications

Objective: This scoping review synthesizes studies examining community-level variability in physical activity resource (assets) and opportunity (organized group physical activity services) availability by community sociodemographic characteristics to describe methodologies for measuring resources/opportunities, indicators characterizing availability, and associations between community-level sociodemographic characteristics and availability.

Methods: A systematic search was conducted in MEDLINE, CINAHL, PsycINFO, and Scopus for literature through 2022. Eligible studies quantitatively examined measures of physical activity resource/opportunity availability by community-level racial, ethnic, and/or socioeconomic characteristics within geospatially defined communities. Extracted data included: community geospatial definitions, sociodemographic characteristics assessed, methodologies for measuring and indicators of community physical activity …

A Dual-Angle Exploration Towards Understanding Lapses In Covid-19 Social Responsibility, Sean T. H. Lee, Jerome J. X. Mah, Angela K. Y. Leung

Research Collection School of Social Sciences

Breaking infection chains requires not just behaviours that allow individuals to stay healthy and uninfected (i.e. health protective behaviours) but also for those who are possibly infected to protect others from their harboured infection risk (i.e. socially responsible behaviours). However, socially responsible behaviours entail costs without clear, immediate benefits to the individual, such that public health-risking lapses occur from time to time. In this important yet understudied area, the current exploratory study sought to identify possible psychological factors that may affect people's likelihood of engaging in socially responsible behaviours. Assuming that self-perceived infection should provide an impetus to engage in …

Porter Et Al. V. Mccormack Et Al. - Warren Circuit Court (Sc 3717), Manuscripts & Folklife Archives

MSS Finding Aids

Finding aid and scan (Click on "Additional Files" below) for Manuscripts Small Collection 3717. Case file for L.R. Porter and Lizzie Porter v J. N. McCormack, John H. Blackburn, Henry James and Tom Potter (Warren County, Kentucky Circuit Court) relating to a restraining order secured by Luther R. Porter of Bowling Green to block the removal of his smallpox-infected daughter and the rest of the family to the local pest house. Includes affidavits of physicians, public health officials and locals familiar with the pest house. The restraining order was subsequently lifted by a Louisville judge. Also includes a 1902 Courier-Journal …

Determining The Feasibility Of A Codesigned And Personalised Intervention (Veg4me) To Improve Vegetable Intake In Young Adults Living In Rural Australian Communities: Protocol For A Randomised Controlled Trial, Katherine M. Livingstone, Jonathan C. Rawstorn, Stephanie R. Partridge, Yuxin Zhang, Eric O, Stephanie L. Godrich, Sarah A. Mcnaughton, Gilly A. Hendrie, Kate Dullaghan, Gavin Abbott, Lauren C. Blekkenhorst, Ralph Maddison, Scott Barnett, John C. Mathers, Laura Alston

Research outputs 2022 to 2026

INTRODUCTION: Diets low in vegetables are a main contributor to the health burden experienced by young adults in rural communities. Digital health interventions provide an accessible delivery model that can be personalised to meet the diverse preferences of young adults. A personalisable digital vegetable intake intervention (Veg4Me) was codesigned to meet the needs of young adults living in rural communities. This study will determine the feasibility of delivering a personalised Veg4Me programme and compare preliminary effects with a non-personalised Veg4Me (control). METHODS AND ANALYSIS: A 12-week assessor-blinded, two-arm, parallel randomised controlled trial will be undertaken from August 2023 until April …

Regional Geographies And Public Health Lessons Of The Covid-19 Pandemic In The Arctic, Sweta Tiwari, Andrey N. Petrov, Nikolay Golosov, Michele Devlin, Mark Welford, John Degroote, Tatiana Degai, Stanislav Ksenofontov

Faculty Publications

Objectives: This study examines the COVID-19 pandemic’s spatiotemporal dynamics in 52 sub-regions in eight Arctic states. This study further investigates the potential impact of early vaccination coverage on subsequent COVID-19 outcomes within these regions, potentially revealing public health insights of global significance. Methods: We assessed the outcomes of the COVID-19 pandemic in Arctic sub-regions using three key epidemiological variables: confirmed cases, confirmed deaths, and case fatality ratio (CFR), along with vaccination rates to evaluate the effectiveness of the early vaccination campaign on the later dynamics of COVID-19 outcomes in these regions. Results: From February 2020 to February 2023, the Arctic …

Machine Learning As A Tool For Early Detection: A Focus On Late-Stage Colorectal Cancer Across Socioeconomic Spectrums, Hadiza Galadima, Rexford Anson-Dwamena, Ashley Johnson, Ghalib Bello, Georges Adunlin, James Blando

Community & Environmental Health Faculty Publications

Purpose: To assess the efficacy of various machine learning (ML) algorithms in predicting late-stage colorectal cancer (CRC) diagnoses against the backdrop of socio-economic and regional healthcare disparities. Methods: An innovative theoretical framework was developed to integrate individual- and census tract-level social determinants of health (SDOH) with sociodemographic factors. A comparative analysis of the ML models was conducted using key performance metrics such as AUC-ROC to evaluate their predictive accuracy. Spatio-temporal analysis was used to identify disparities in late-stage CRC diagnosis probabilities. Results: Gradient boosting emerged as the superior model, with the top predictors for late-stage CRC diagnosis being anatomic site, …

Employers And The Privatization Of Public Health, Sharona Hoffman

Faculty Publications

This Article focuses on the role of employers in public health and argues that they constitute increasingly important actors in the U.S. public health arena. In the aftermath of the COVID-19 pandemic, a series of judicial decisions and newly enacted statutes enfeebled the public health powers of the federal and state governments. In a 2023 statement, Supreme Court Justice Neil Gorsuch clearly articulated his antagonism towards government-initiated COVID-19 interventions, describing them as “the greatest intrusions on civil liberties in the peacetime history of this country.” All too many share his views.

Employers may be highly motivated to safeguard their workers’ …

Nicotine Addiction: A Hidden Health Crisis, Macy J. Mcgrath, Andrea Walker, Anahita Mohammadkhah

Belmont University Research Symposium (BURS)

In the United States, nicotine addiction is an ongoing health crisis (U.S Food and Drug Administration, 2023). Pivotal to this crisis is the prevalence and ease of access to devices that deliver nicotine. Covering a broad spectrum, devices range from traditional forms of tobacco such as cigarettes, pipes, etc. to new nicotine devices such as e-cigarettes and vapes. Yet, even with the health crisis looming, more and more individuals are becoming addicted to nicotine (Ayers et al., 2011; Lyu et al., 2022; Pokhrel et al., 2021). In particular, research indicates that the 18-24 age demographic is significantly more likely to …

Predictive Power Of Wastewater For Nowcasting Infectious Disease Transmission: A Retrospective Case Study Of Five Sewershed Areas In Louisville, Kentucky, Fayette Klaassen, Rochelle H. Holm, Ted Smith, Ted Cohen, Aruni Bhatnagar, Nicolas A. Menzies

Faculty Scholarship

Background: Epidemiological nowcasting traditionally relies on count surveillance data. The availability and quality of such count data may vary over time, limiting representation of true infections. Wastewater data correlates with traditional surveillance data and may provide additional value for nowcasting disease trends. Methods: We obtained SARS-CoV-2 case, death, wastewater, and serosurvey data for Jefferson County, Kentucky (USA), between August 2020 and March 2021, and parameterized an existing nowcasting model using combinations of these data. We assessed the predictive performance and variability at the sewershed level and compared the effects of adding or replacing wastewater data to case and death reports. …

The Once And Future Clean Air Act: Impacts Of The Inflation Reduction Act On Epa's Regulatory Authority, Nicholas Bryner

Journal Articles

The Clean Air Act is one of Congress's greatest success stories. The major piece of legislation, passed in the context of environmental and public health crises, has driven technological change through regulation that has dramatically improved air quality even in a prolonged period of economic growth. In the context of climate change, however, despite many efforts since the 1990s, the Clean Air Act has not proven to be a successful legislative tool. Instead, the Act has faced complex obstacles in the statutory language and a trend in Supreme Court jurisprudence-leading up to and including the June 2022 decision in West …

Self-Care Practices For Common Acute Conditions In The Philippines: A Scoping Review, Arianna Maever Loreche, Veincent Christian F. Pepito, Manuel M. Dayrit

Ateneo School of Medicine and Public Health Publications

Purpose

This review aimed to identify and map published studies on self-care practices to manage common acute health conditions in the Philippines.

Design/methodology/approach

The authors conducted a scoping review in PubMed, Scopus, Cumulative Index of Nursing and Allied Health Literature (CINAHL), ProQuest Central, Journal Storage (JSTOR) and the Philippine Council for Health Research and Development – Health Research and Development Information Network (HERDIN). The authors included all studies on self-care practices to manage common acute conditions, namely low back pain, allergic rhinitis, general acute pain, cough, cold, diarrhea, constipation and stress, published up to 2021 in the Philippines. Information on …

The Importance Of Triple Panel Testing For Hepatitis B And The Burden Of Isolated Anti-Hepatitis B Core Antibodies Within A Community Sample, Catherine Freeland, Vivek Sreepathi, Richard Hass, Jonathan Fenkel, Jessie Torgersen, Kenneth Rothstein, Chari Cohen, Robert Gish

College of Population Health Faculty Papers

Within the United States (US), 2.4 million individuals are living with chronic hepatitis B, but less than 20% are diagnosed. Isolated anti-hepatitis B core (iAHBc) antibodies indicate serology in an individual that is positive for anti-HBc antibodies, while negative for surface antigen (HBsAg) and surface antibodies (anti-HBs). A result of iAHBc could indicate a chronic occult bloodstream infection, necessitating further testing. This study assesses the prevalence and risk factors associated with anti-HBc and iAHBc within community high-risk screening in Greater Philadelphia. Participants (n = 177) were screened for HBsAg, anti-HBs, and anti-HBc during community screening events in 2022. Chi-square tables …

Changing The Playbook For Immigrant Health, Cheryl Bettigole, Patricia C. Henwood, Sage Myers, Maura Sammon

Department of Emergency Medicine Faculty Papers

Philadelphia’s response to welcoming Afghan evacuees during the COVID-19 pandemic suggests the need for a new approach to immigrant health care.

Addressing Cervical Cancer Disparities In Texas: Expansion Of A Community-Based Prevention Initiative For Medically Underserved Populations, Samantha H Batman, Melissa L Varon, Maria Daheri, Tony Ogburn, Saul D Rivas, Laura Guerra, Paul A Toscano, Monica Gasca, Lori Campos, Savanah Foster, Melissa Martin, Marian Yvette Williams-Brown, Yvette Poindexter, Belinda Reininger, Mila P Salcedo, Andrea Milbourne, Bryan Fellman, Maria E Fernandez, Ellen Baker, Rose Gowen, Susan Fisher-Hoch, Ana M Rodriguez, Jessica Milan, Monica Pippin, Ernest Hawk, Kathleen M Schmeler

Journal Articles

Although cervical cancer is preventable, significant disparities exist in access to screening and prevention services. In medically underserved areas (MUAs) of Texas, these rates are 55% higher compared to the remainder of the US. In 2019, we expanded a multicomponent, comprehensive program to improve cervical cancer prevention in partnership with 13 clinics and mobile vans in MUAs of Texas. Our multicomponent intervention program consists of community education and patient navigation coupled with a training/mentoring program for local medical providers to perform diagnostic procedures and treatment for patients with abnormal screening results. Hands-on training courses to learn these skills are coupled …

Greater Traditionalism Predicts Covid-19 Precautionary Behaviors Across 27 Societies, Theodore Samore, D. M. T. Fessler, A. M. Sparks, C. Holbrook, L. Aaroe, Norman P. Li, Kai Lin Lynn Tan, Et Al

Research Collection School of Social Sciences

People vary both in their embrace of their society’s traditions, and in their perception of hazards as salient and necessitating a response. Over evolutionary time, traditions have offered avenues for addressing hazards, plausibly resulting in linkages between orientations toward tradition and orientations toward danger. Emerging research documents connections between traditionalism and threat responsivity, including pathogen-avoidance motivations. Additionally, because hazard-mitigating behaviors can conflict with competing priorities, associations between traditionalism and pathogen avoidance may hinge on contextually contingent tradeoffs. The COVID-19 pandemic provides a real-world test of the posited relationship between traditionalism and hazard avoidance. Across 27 societies (N = 7844), we …

Combat Covid-19 At National Level Using Risk Stratification With Appropriate Intervention, Xuan Jin, Kar Way Tan

Research Collection School Of Computing and Information Systems

In the national battle against COVID-19, harnessing population-level big data is imperative, enabling authorities to devise effective care policies, allocate healthcare resources efficiently, and enact targeted interventions. Singapore adopted the Home Recovery Programme (HRP) in September 2021, diverting low-risk COVID-19 patients to home care to ease hospital burdens amid high vaccination rates and mild symptoms. While a patient's suitability for HRP could be assessed using broad-based criteria, integrating machine learning (ML) model becomes invaluable for identifying high-risk patients prone to severe illness, facilitating early medical assessment. Most prior studies have traditionally depended on clinical and laboratory data, necessitating initial clinic …

Understanding The Mechanisms Of Change In The Supportive And Respectful Maternity Care Intervention In Sindh, Pakistan: Provider Perspectives, Bilal Iqbal Avan, Waqas Hameed, Bushra Khan, Muhammad Asim, Sarah Saleem, Sameen Siddiqi

Community Health Sciences

Introduction: We conducted this qualitative investigation to explore the mechanisms of change in providing respectful care resulting from the supportive and respectful maternity care intervention (S-RMC) in Sindh, Pakistan.
Methods: We applied the principles of realist evaluation methodology with a descriptive explanatory research design. We conducted in-depth interviews with 36 maternity care providers at secondary-level public health facilities where S-RMC was implemented for 6 months. The S-RMC broad components included capacity-building of maternity teams and systemic changes for improvements in governance and accountability within public health facilities. Data were analyzed using a deductive content analysis approach.
Results: We identified mechanisms …

A Two-Sample Mendelian Randomization Study Of Atherosclerosis And Dementia, Qiaoyun Zhang, Guangheng Wu, Xiaoyu Zhang, Sheng Wang, Youxin Wang

Research outputs 2022 to 2026

The causality between atherosclerosis and dementia remains unclear. This study aimed to explore the causal effect of atherosclerosis related indicators on dementia risk based on two-sample Mendelian randomization (MR) using summary statistics of genome-wide association studies (GWASs). The inverse variance weighted (IVW) method was performed as the main analysis, supplemented by different sensitivity analyses. Suggestive evidence indicated that peripheral arterial disease (PAD) (odds ratio (OR): 0.864, 95% confidence interval (CI): 0.797–0.937), coronary atherosclerosis (CoAS) (OR: 0.927, 95% CI: 0.860–0.998) and atherosclerosis, excluding cerebral, coronary, and PAD (ATHSCLE) (OR: 0.812, 95% CI: 0.725–0.909) were inversely associated with the risk of AD. …

How Does The Us Media Frame Personal Experiences Of Termination Of Pregnancy, Christina Relacion

Student Works

Limited studies have examined the lived experience of those facing termination of pregnancy due to fetal anomaly in the U.S., particularly after the 2022 ruling in Dobbs v. Jackson Women’s Health Organization. There exists a body of research elsewhere around the world studying how the media frames these experiences, but little is known about the role American media organizations play as health educators for critical reproductive healthcare topics, such as the termination of pregnancy. This critical analysis sought to understand how the U.S. media frames personal accounts of those who have experienced termination of pregnancy due to fetal anomaly, or …

Community Exercise Program Participation And Mental Well-Being In The U.S. Texas-Mexico Border Region, Alma G. Ochoa Del-Toro, Lisa A. Mitchell-Bennett, Michael Machiorlatti, Candace A. Robledo, Amanda C. Davé, Rebecca N. Lozoya, Belinda M. Reininger

School of Medicine Publications and Presentations

Hispanics are disproportionately affected by low rates of physical activity and high rates of chronic diseases. Hispanics generally and Mexican Americans specifically are underrepresented in research on physical activity and its impact on mental well-being. Some community-based interventions have been effective in increasing physical activity among Hispanics. This study examined data from a sample of low-income Hispanic participants in free community exercise classes to characterize the association between self-reported frequency of exercise class attendance, intensity of physical activity, and participant well-being. As part of two cross-sectional samples recruited from a stratified random sample of community exercise classes, 302 participants completed …

Global Variation In Diabetes Diagnosis And Prevalence Based On Fasting Glucose And Hemoglobin A1c, Ncd Risk Factor Collaboration (Ncd-Risc), Bin Zhou, Kate E. Sheffer, James E. Bennett, Edward W. Gregg, Goodarz Danaei, Rosie K. Singleton, Jonathan E. Shaw, Gladys Maestre, Jesus D. Melgarejo

School of Medicine Publications and Presentations

Fasting plasma glucose (FPG) and hemoglobin A1c (HbA1c) are both used to diagnose diabetes, but these measurements can identify different people as having diabetes. We used data from 117 population-based studies and quantified, in different world regions, the prevalence of diagnosed diabetes, and whether those who were previously undiagnosed and detected as having diabetes in survey screening, had elevated FPG, HbA1c or both. We developed prediction equations for estimating the probability that a person without previously diagnosed diabetes, and at a specific level of FPG, had elevated HbA1c, and vice versa. The age-standardized proportion of diabetes that was previously undiagnosed …