Medicine and Health Sciences Commons^™

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. …

A Logistics Approach To Improve Medication Reconciliation In The Outpatient Clinic Setting, Aysha Khan, Demetra Antimisiaris, Madison Perkins, Luz Fernandez

The Cardinal Edge

Medication reconciliation (MR) is the process of determining the most accurate account of medication the patient is taking. Although MR seems simple, research has shown that 25% of medical errors are related to lack of medication reconciliation [1]. In the community clinic setting, the task of medication reconciliation falls on the Medical Assistants (MAs). A preliminary study of MR accuracy in an outpatient clinic found an average of 5.8 discrepancies in the chart medication list [2]. The most notable were incomplete directions, wrong directions, or wrong frequency of dosing. Unoptimized medication use is estimated to result in 275,869 deaths per …

Food Insecurity And Residential Segregation Among Adults In The United States: The National Health And Nutrition Examination Survey 2017- March 2020 Pre-Pandemic Data., Chandre' L. Chaney

Electronic Theses and Dissertations

Food insecurity is when a household has insufficient food supply due to limited economic resources. It is a public health issue that continues to persist. The health, social, and economic impact affects millions of people nationwide. Residential segregation is a primary cause of inequities and health disparities. It shapes the differences in socio-economic conditions between Blacks and Whites living in the U.S. This country is segregated across racial lines in many of our most populated metropolitan cities. Americans worship in different churches, learn in disparate schools, and live in separate neighborhoods. Residential segregation has consequences that impact the economy, professional …

The Detection Of Periodic Reemergence Events Of Sars-Cov-2 Delta Strain In Communities Dominated By Omicron, Claire E. Westcott, Kevin J. Sokoloski, Eric C. Rouchka, Julia H. Chariker, Rochelle H. Holm, Ray A. Yeager, Joseph B. Moore Iv, Erin M. Elliott, Daymond Talley, Aruni Bhatnagar

Faculty Scholarship

Despite entering an endemic phase, SARS-CoV-2 remains a significant burden to public health across the global community. Wastewater sampling has consistently proven utility to understanding SARS-CoV-2 prevalence trends and genetic variation as it represents a less biased assessment of the corresponding communities. Here, we report that ongoing monitoring of SARS-CoV-2 genetic variation in samples obtained from the wastewatersheds of the city of Louisville in Jefferson county Kentucky has revealed the periodic reemergence of the Delta strain in the presence of the presumed dominant Omicron strain. Unlike previous SARS-CoV-2 waves/emergence events, the Delta reemergence events were geographically restricted in the community …

Wastewater-Informed Public Health Intervention Playbook

Sustain Magazine

As the SARS-CoV-2 pandemic quickly spread from country to country and continent to continent in 2020, governments and scientists needed a way to track COVID-19 through populations in order to position public health interventions in the most impactful locations. Having a decision-based risk framework may help to guide policy creation that could minimize or prevent possible outbreaks and surges of infection within communities. The University of Louisville in partnership with Louisville’s Department of Public Health and Wellness tested this strategy in 2021 and 2022. This Wastewater-Informed Public Health Intervention Playbook describes the decisions and actions of that academic and public …

Exploring Opportunities For Prevention Of Child Sexual Abuse In A Diverse American Muslim Community., Rishtya Meena Kakar

Electronic Theses and Dissertations

Recognizing the significant mental, emotional, developmental and health consequences for victims of child sexual abuse (CSA) and sociopolitical consequences for families and communities in every cultural, ethnic, and religious group around the world, this study sought to determine key opportunities for prevention of CSA in a diverse American Muslim community using a public health socioecological lens, rooted in aspects of critical theory. While there is considerable research on situational and individual-level risk factors related to CSA cases, there is less research on the societal and community-level processes related to the primary prevention of CSA, especially among minoritized communities. Responding to …

Looking Beyond A Rare Presentation Of Betel Nut Use In A North American Patient- An Opportunity For Lessons And Intervention In Global Health And Gender Equity, Muhammad O. Zaman, Thomas M. Park, Vikas Patel, Riley G. Jones

Journal of Refugee & Global Health

Betel nut is estimated to be the fourth most common psychoactive substance used globally behind caffeine, alcohol, and nicotine with 600 million global users. Betel nut use has a strong association with oral cancer and many other systemic effects including oral submucosal fibrosis. Although North American use is rare, its enduring effects may surface long after use posing a diagnostic challenge to practitioners caring for an increasingly global diaspora. Herein, we present a patient with severe trismus due to advanced oral submucosal fibrosis who was unexpectedly found to be importing and using Betel nut for over thirty years after immigrating. …

“Pissing In The Wind”: Racially Discriminatory Economic Policies’ Impact On Today’S Banking Status, Use Of Alternative Financial Services And Health Outcomes., Gaberiel Jones Jr

Electronic Theses and Dissertations

Centuries of discriminatory policies and practices in the United States have created racially segregated, resource-poor urban communities. Differential benefits of banking and housing legislation were among the consequences of these policies as they contributed to drastic racial inequities in wealth. Today, racial differences in banking status and financial practices persist. However, a void exists in the literature exploring what alternative financial services (AFS) are used in lieu of banks by Black Americans, why those services are used, the thoughts and beliefs of Black Americans about the use of those services, the impact of bank locations on financial behavior patterns, and …

Kentucky's Environmental Future, Fall/Winter 2004, Issue 9

Sustain Magazine

No abstract provided.

Vitamin Deficiencies Among Resettled Refugees In Buffalo, Ny, Tyler B. Evans, Myron Glick Md

Journal of Refugee & Global Health

Background

Vitamin deficiency in the developing world is a considerable public health issue that is often overlooked. Refugees are some of the most vulnerable populations, since they rely almost exclusively on the nutrition provided by refugee camps. Buffalo, NY resettles the fourth largest number of refugees per capita among cities in the United States (US).

Objective

We examined the prevalence of vitamin A, B2, B12, and D deficiencies among refugees who had been recently resettled to Buffalo, NY and referred to our practice for assessment. Our exploratory objective was to examine potential differences in the prevalence of vitamin deficiencies among …

Polydrug Use Among People Who Use Opioids, National Survey On Drug Use And Health 2002 To 2017., Diana Kuo Stojda

Electronic Theses and Dissertations

Introduction: Mortality due to overdose has been increasing since 2010 in the U.S., with an increase in the reported use of heroin and co-use of heroin and prescription opioids. Trends and correlates of polydrug use need to be analyzed to propose policies to reduce overdose risk. The overall objective of this study is to characterize high-risk polydrug groups among people who use opioids (PWUO) to understand the patterns of co-used substances and overdose risk factors. Methods: Publicly available data from the 2002-2017 National Survey on Drug Use and Health were analyzed to obtain weighted prevalence rates and trends …

Research Support Infrastructure: Implementing A Clinical Research Coordinating Center, Julio A. Ramirez, Paula Peyrani, William A. Mattingly, Forest W. Arnold, Timothy L. Wiemken, Robert R. Kelley, Leslie A. Wolf, Ruth M. Carrico, Andrea Reyes-Vega

Faculty Scholarship

Insufficient infrastructure is one of the challenges facing investigators in the field of clinical research. At the University of Louisville (UofL) Division of Infectious Diseases, we developed a multidisciplinary coordinating center with the aim to support investigators in all aspects of the clinical research process. The objective of this article is to describe the composition and the role of the different units of the UofL Clinical Research Coordinating Center. The different components of the Center can serve as a template for institutions interested in developing a clinical research support infrastructure.

Attending To Systemic Racism : Advancing Public Health's Approach To Youth Violence Prevention., Billie Faith Castle

Electronic Theses and Dissertations

This dissertation examines how the field of public health addresses the impact of systemic racism on health and how that informs public health’s approach to youth violence prevention. Beginning with an overview of youth violence, it breaks down the concepts of race and racism and how they are addressed within the science. It also reviews concepts that contribute to risk and protective factors of youth violence. The dissertation is written from a Critical Race Theory approach, argues that the social environment contributes to why youth violence is pervasive in certain neighborhoods, and promotes action from a macro-level approach. Seven chapters …

Reducing Tobacco-Related Health Disparities : Exploring The Barriers And Facilitators To Smoking Cessation Among Individuals Experiencing Homelessness., Bernadette Guzman Antoon

Electronic Theses and Dissertations

Although the prevalence of smoking has declined in the U.S., vulnerable populations continue to suffer from tobacco-related health disparities. An estimated 68.0-80.0% of homeless adults are current cigarette smokers compared to 15.1% in the general population. The large gap in smoking rates suggests that current tobacco cessation programs designed to reduce smoking have little impact among individuals experiencing homelessness. The purpose of this study was to explore the barriers and facilitators to smoking cessation among the homeless. The second aim of this study was to explore if the barriers and facilitators to tobacco cessation differed among male smokers experiencing homelessness …

Colorectal Cancer Fit Screening In The Hope Vi Population Of Jefferson County, Kentucky., Jeffrey D. Stone

Electronic Theses and Dissertations

Using pre-post survey data collected from 209 randomly selected African American people from the population of former residents of Clarksdale and Sheppard Square public housing areas, this study explores the relationship between individual characteristics and colorectal cancer screening behavior, measured by the uptake of the Fecal Immunochemical Test (FIT) and by prior colorectal screening, while controlling for neighborhood factors and geographic proximity to healthcare facilities. This particular public housing population is of interest because of their relocation from the downtown area, where healthcare facilities are within walking distances, to other public housing units either in large apartment complexes or scattered …