Digital Commons Network^™

Contextual Factors Associated With County-Level Suicide Rates In The United States, 1999 To 2016, Danielle L. Steelsmith, Cynthia A. Fontanella, John V. Campo, Jefferey A. Bridge, Keith L. Warren, Elisabeth D. Root

Faculty & Staff Scholarship

Importance Understanding geographic and community-level factors associated with suicide can inform targeted suicide prevention efforts.

Objectives To estimate suicide rates and trajectories, assess associated county-level contextual factors, and explore variation across the rural-urban continuum.

Design, Setting, and Participants This cross-sectional study included all individuals aged 25 to 64 years who died by suicide from January 1, 1999, to December 31, 2016, in the United States. Spatial analysis was used to map excess risk of suicide, and longitudinal random-effects models using negative binomial regression tested associations of contextual variables with suicide rates as well as interactions among county-level contextual variables. Data …

Zika And Flavivirus Shell Disorder: Virulence And Fetal Morbidity, Gerard Kian-Meng Goh, A. Keith Dunker, James A. Foster, Vladimir N. Uversky

Molecular Medicine Faculty Publications

Zika virus (ZIKV) was first discovered in 1947 in Africa. Since then, sporadic ZIKV infections of humans have been reported in Africa and Asia. For a long time, this virus was mostly unnoticed due to its mild symptoms and low fatality rates. However, during the 2015–2016 epidemic in Central and South America, when millions of people were infected, it was discovered that ZIKV causes microcephaly in the babies of mothers infected during pregnancy. An examination of the M and C proteins of the ZIKV shell using the disorder predictor PONDR VLXT revealed that the M protein contains relatively high disorder …

Descriptive And Risk Factor Analysis Of Infantile Cataracts, Marine Nalbandyan

Legacy Theses & Dissertations (2009 - 2024)

Infantile cataract is a lens opacity diagnosed by 12 months of age. It is a major cause of childhood blindness, with about 200,000 children worldwide being blind because of bilateral cataracts. Blindness has a negative impact on the quality of a child’s life and is associated with increased healthcare costs. While reduction/elimination of childhood blindness is a priority issue in public health, risk factors remain unknown for about two-thirds of infantile cataract cases. The primary aims of this dissertation were to (1) identify, evaluate, and summarize observational studies investigating non-genetic risk factors for infantile cataracts, (2) estimate birth prevalence and …

Investigating Neurogenesis As A Veritable Epigenetic Endophenotype For Alzheimer's Disease, Layne Wells

Scripps Senior Theses

Alzheimer's disease (AD) is the most common neurodegenerative disease, characterized by progressive amyloid plaque aggregation, neurofibrillary tangles, and cortical tissue death. As the prevalence of AD is projected to climb in coming years, there is a vested interest in identifying endophenotypes by which to improve diagnostics and direct clinical interventions. The risk for complex disorders, such as AD, is influenced by multiple genetic, environmental, and lifestyle factors. Significant strides have been made in identifying genetic variants linked to AD through the genome-wide association study (GWAS). It has been estimated in more recent years, however, that GWAS-identified variants account for limited …

Evaluation By Geospatial And Spatiotemporal Distribution Of Tularemia Cases In Arkansas, Toni Kathleen Beavers

Walden Dissertations and Doctoral Studies

Tularemia is a vector-borne disease of global concern with diverse regional foci. Arkansas is an endemic state with differences in case distribution and land suitability supporting host and vector sustainment. The aim of this study was to conduct a geospatial and spatiotemporal assessment of factors associated with case distribution and timeliness and completeness of public reporting. Guided with direction from spatial epidemiology and nidality, referring to the association of ecology, climate, and proximity of disease, analysis included secondary data collected from the Arkansas Department of Health between 1995 and 2018. Using Poisson-based software, 2 clusters were found: a high-risk cluster …

Cannabis Consumption Patterns Explain The East-West Gradient In Canadian Neural Tube Defect Incidence: An Ecological Study, Albert Stuart Reece, Gary Kenneth Hulse

Research Datasets

While a known link between prenatal cannabis exposure and anencephaly exists, the relationship of prenatal cannabis exposure with neural tube defects (NTDs) generally has not been defined. Published data from Canada Health and Statistics Canada were used to assess this relationship. Both cannabis use and NTDs were shown to follow an east-west and north-south gradient. Last year cannabis consumption was significantly associated (P < .0001; cannabis use–time interaction P < .0001). These results were confirmed when estimates of termination for anomaly were used. Canada Health population data allowed the calculation of an NTD odds ratio) of 1.27 (95% confidence interval = 1.19-1.37; P < 10−11) for high-risk provinces versus the remainder with an attributable fraction in exposed populations of 16.52% (95% confidence interval = 12.22-20.62). Data show a robust positive statistical association between cannabis consumption as both a qualitative and quantitative variable and NTDs on a background of declining NTD incidence. In the context of multiple mechanistic pathways these strong statistical findings implicate causal mechanisms.

Understanding The Utilization Of Community-Based Services In Late Old Age: A Participatory Approach For Connecting Through The Communication Ecology, Carrie Leach

Wayne State University Dissertations

As the pool of eligible recipients continues to grow, understanding service system utilization and barriers can help ensure very old adults can access support from their communities when needed. Mounting research demonstrates that investment in community-based services to ensure seniors remain independent translates to saved government dollars. As a contributing researcher of a multi-year county-wide older adult needs assessment in Monroe County, Michigan, data collected from 1,870 people revealed a communication disjuncture between seniors and service providers. In response, officials convened a post assessment working group that focused on communication and outreach. Along with members of the Community Advisory Group …

Viral Emergence In Marine Mammals In The North Pacific May Be Linked To Arctic Sea Ice Reduction, Elizabeth Vanwormer, J. A.K. Mazet, A. Hall, V. A. Gill, P. L. Boveng, J. M. London, T. Gelatt, B. S. Fadely, M. E. Lander, J. Sterling, V. N. Burkanov, R. R. Ream, P. M. Brock, L. D. Rea, B. R. Smith, A. Jeffers, M. Henstock, M. J. Rehberg, K. A. Burek-Huntington, S. L. Crosby, J. A, Hammond, T. Goldstein

School of Veterinary and Biomedical Sciences: Faculty Publications

Climate change-driven alterations in Arctic environments can influence habitat availability, species distributions and interactions, and the breeding, foraging, and health of marine mammals. Phocine distemper virus (PDV), which has caused extensive mortality in Atlantic seals, was confirmed in sea otters in the North Pacific Ocean in 2004, raising the question of whether reductions in sea ice could increase contact between Arctic and sub-Arctic marine mammals and lead to viral transmission across the Arctic Ocean. Using data on PDV exposure and infection and animal movement in sympatric seal, sea lion, and sea otter species sampled in the North Pacific Ocean from …

Multi-State Analysis Of Unconventional Oil And Gas Development And Rates Of Sexually Transmitted Infections In The United States, Nicholaus Peter Johnson

Public Health Theses

Background

Advances in unconventional oil and gas development (UOGD), including hydraulic fracturing and horizontal drilling, have helped position the United States as a world leader in the production of both crude oil and natural gas hydrocarbons. This significant increase in production would not have been possible, however, without the assemblage of a workforce that is predominantly young, male, and mobile. This is significant given that a number of studies have associated similar types of mobile workforces – especially those employed by resource extractive industries – with impacts on the sexual health of the host communities in which these workers operate …

Harnessing Population Genetics For Pest Management: Theory And Application For Urban Rats, Matthew Combs, Kaylee Byers, Chelsea Himsworth, Jason Munshi-South

Human–Wildlife Interactions

Effective management of rodent pests requires an ecological understanding of how they move through their environment and how those movements influence the invasion, persistence, or reinvasion of problematic colonies. Traditional methodologies used to describe rodent movement patterns, such as mark-recapture, are hindered by their time-consuming nature and limited geographic scope. As such, our understanding of how rodents interact with urban environments remains limited. Population genetic principles and tools have the capacity to greatly increase our understanding of rodent population dynamics, ecological relationships, and movements across space, but this field is often unapproachable to non-scientist pest management professionals (PMPs). In this …

Hazardous Waste Site Proximity And Type 2 Diabetes: From Youths To Adults, Theresa Ann Johnson

Walden Dissertations and Doctoral Studies

Type 2 diabetes has reached epidemic proportions in adults and youths. Persistent organic pollutants and endocrine-disrupting chemicals (EDCs), such as pesticides, dioxins, and organochlorines, are omnipresent and persist in the environment with potential for human exposure via contaminated air, waterways, soil, and human food supply. EDCs have been correlated with diabetes incidence and risks. Residential proximity to hazardous waste sites (HWS) has been correlated with increased hospital admission rates for diabetes. The study used a sample population (N = 1,724), ages ≥ 12 years from the 2005-2012 Continuous NHANES and HWS data from the National Priorities List of Superfund Sites. …

Association Between Sanitary Toilet Coverage Rate And Intestinal Infectious Disease In Jiangsu Province, China, Tingting Chen

Chulalongkorn University Theses and Dissertations (Chula ETD)

Intestinal infectious diseases are one of the most common disease group prevalent worldwide. It is also the commonly report acute infectious diseases in Jiangsu Province, China. This problem may result from the use of unhygienic toilet. Chinese government had announced the China's toilet improvement campaign for more than decades. The purpose of this ongoing campaign is to improve the hygiene and promote health. However, there is limited study evaluating the effect of toilet improvement and the incidence of intestinal infectious diseases. This study aims to determine the association of the increasing of sanitary toilets and intestinal infectious diseases in Jiangsu …

Treatment, Prevention And Public Health Management Of Impetigo, Scabies, Crusted Scabies And Fungal Skin Infections In Endemic Populations: A Systematic Review, Philippa J. May, Steven Y.C Tong, Andrew C. Steer, Bart J. Currie, Ross M. Andrews, Jonathan R. Carapetis, Asha C. Bowen

Health Sciences Papers and Journal Articles

We conducted a systematic review of the treatment, prevention and public health control of skin infections including impetigo, scabies, crusted scabies and tinea in resource-limited settings where skin infections are endemic. The aim is to inform strategies, guidelines and research to improve skin health in populations that are inequitably affected by infections of the skin and the downstream consequences of these. The systematic review is reported according to the PRISMA statement. From

1759 titles identified, 81 full text studies were reviewed and key findings outlined for impetigo, scabies, crusted scabies and tinea. Improvements in primary care and public health management …

Relationship Of Sociodemographic Factors With Serum Levels Of Vitamin D In A Healthy Population Of Pakistan, Khalida Iqbal, Najmul Islam, Naseema Mehboobali, Ali Asghar, Saleem Perwaiz Iqbal, Mohammad Perwaiz Iqbal

Department of Biological & Biomedical Sciences

High prevalence of vitamin D deficiency has been reported from Pakistan. Association of sociodemographic factors with vitamin D status has received little attention in this region. Therefore, we embarked on investigating the relationship of sociodemographic factors with vitamin D levels in a healthy Pakistani population. Venous blood from 226 healthy participants (age range 19-69 years) was collected and analyzed for serum concentrations of 25(OH) vitamin D [25(OH)D] and other related biomarkers. Demographic characteristics of the study participants were collected. Vitamin D deficiency (25(OH)D levels less than 20 ng/ml) was found to be 75% in this cohort. Gender, sunlight exposure and …

Cannabis Consumption Patterns Explain The East-West Gradient In Canadian Neural Tube Defect Incidence: An Ecological Study, Albert Stuart Reece, Gary Kenneth Hulse

Research outputs 2014 to 2021

While a known link between prenatal cannabis exposure and anencephaly exists, the relationship of prenatal cannabis exposure with neural tube defects (NTDs) generally has not been defined. Published data from Canada Health and Statistics Canada were used to assess this relationship. Both cannabis use and NTDs were shown to follow an east-west and north-south gradient. Last year cannabis consumption was significantly associated (P < .0001; cannabis use–time interaction P < .0001). These results were confirmed when estimates of termination for anomaly were used. Canada Health population data allowed the calculation of an NTD odds ratio) of 1.27 (95% confidence interval = 1.19-1.37; P < 10⁻¹¹) for high-risk provinces versus the remainder with an attributable fraction in exposed populations of 16.52% (95% confidence interval = 12.22-20.62). Data show a robust positive statistical association between cannabis consumption as both …

Genomic Delineation Of Zoonotic Origins Of Clostridium Difficile, Daniel R. Knight, Thomas V. Riley

Research outputs 2014 to 2021

Clostridium difficile is toxin-producing antimicrobial resistant (AMR) enteropathogen historically associated with diarrhea and pseudomembranous colitis in hospitalized patients. In recent years, there have been dramatic increases in the incidence and severity of C. difficile infection (CDI), and associated morbidity and mortality, in both healthcare and community settings. C. difficile is an ancient and diverse species that displays a sympatric lifestyle, establishing itself in a range of ecological niches external to the healthcare system. These sources/reservoirs include food, water, soil, and over a dozen animal species, in particular, livestock such as pigs and cattle. In a manner analogous to human infection, …

Lead And Crime: An Ecological Study Between Lead Contaminated Topsoil And Violent Crime., Brian Guinn

Electronic Theses and Dissertations

Lead is a known neurotoxicant. Human exposure to lead comes primarily through environmental exposures, including remnant lead paint, lead contaminated topsoil and lead contaminated water. Prenatal and early life lead exposure has been associated with numerous neurocognitive and neuropsychiatric disorders. This dissertation presents findings from an ecological study which evaluated the geospatial association between topsoil lead content and the incidence of FBI designated violent crime in Jefferson County, Kentucky. A total of 412 topsoil samples were collected along roadways (n=300) and from Louisville Metro Parks (n=112). Jefferson County crime data was obtained from the Louisville Metro Police Department – Crime …

Effects Of Extreme Precipitation On Gastrointesitnal Related Hospital Admissions In Texas, Sharmila Giri

Dissertations and Theses (Open Access)

Extreme precipitation has been implicated in more than 51% of the waterborne disease outbreaks in the United States between 1948-1994. With increased incidence of extreme precipitation projected to be more likely due to ongoing climate change, the burden of waterborne disease is expected to rise even in the United States where drinking water is considered to be one of the safest in the world. In this study we aim to quantify the risk of extreme precipitation on gastrointestinal (GI) related hospital admissions by using meteorological and emergency hospital data from twelve major metropolitan statistical areas (MSA) of Texas from year …

Exposure To Ambient Air Pollution And Fetal Death In Harris County, Texas, Amal Rammah

Dissertations and Theses (Open Access)

The evidence from studies of maternal ambient air pollutant exposure (including O3, fine particulate matter (PM2.5) and PM2.5 metal constituents) and stillbirth is limited and equivocal. There is also limited evidence of the acute effect of temperature increases in the week preceding delivery and stillbirth. In the first investigation of ambient air pollution, temperature and stillbirth among a large cohort of women in Harris County, Texas, we obtained birth and fetal death records from 2008-2013 and estimated weekly residential levels of apparent temperature and ozone (O3), fine particulate matter (PM2.5), nitrogen dioxide (NO2) and PM2.5 metals from the local monitoring …

Factors Associated With Civilian And Police Officer Injury During 10 Years Of Officer-Involved Shooting Incidents: A Cross-Sectional Analysis, Ellen Paddock

Dissertations and Theses (Open Access)

Purpose. Law enforcement officer-involved shootings are uncommon events in the context of encounters with the public, but extreme situations which have the potential to pose immense harm to individuals and communities. Previous research demonstrates that a large proportion of such incidents result in injury or death, most commonly to civilians, but in some cases to officers as well. However, there has been little study of what factors are associated with injury during such incidents, and whether these factors might differ for civilians compared to officers. This study examined the factors associated with both civilian and officer injury and/or fatality during …

Mapping Maternal Mortality Rate Via Spatial Zero-Inflated Models For Count Data: A Case Study Of Facility-Based Maternal Deaths From Mozambique, Osvaldo Loquiha, Niel Hens, Leonardo Chavane, Marleen Temmerman, Nafissa Osman, Christel Faes, Marc Aerts

Obstetrics and Gynaecology, East Africa

Maternal mortality remains very high in Mozambique, with estimates from 2015 showing a maternal mortality ratio of 489 deaths per 100,000 live births, even though the rates tend to decrease since 1990. Pregnancy related hemorrhage, gestational hypertension and diseases such as malaria and HIV/AIDS are amongst the leading causes of maternal death in Mozambique, and a significant number of these deaths occur within health facilities. Often, the analysis of data on maternal mortality involves the use of counts of maternal deaths as outcome variable. Previously we showed that a class of hierarchical zero-inflated models were very successful in dealing with …

Tramadol: A Valuable Treatment For Pain In Southeast Asian Countries, Ramani Vijayan, Gauhar Afshan, Khalid Bashir, Mary Cardosa, Madhur Chadha, Pongparadee Chaudakshetrin, Khin Myo Hla, Muralidhar Joshi, Francis O. Javier, Asif Gul Kayani

Department of Anaesthesia

Background: The supply of controlled drugs is limited in the Far East, despite the prevalence of health disorders that warrant their prescription. Reasons for this include strict regulatory frameworks, limited financial resources, lack of appropriate training amongst the medical profession and fear of addiction in both general practitioners and the wider population. Consequently, the weak opioid tramadol has become the analgesic most frequently used in the region to treat moderate to severe pain.
Methods: To obtain a clearer picture of the current role and clinical use of tramadol in Southeast Asia, pain specialists from 7 countries in the region were …

Birth Outcomes And Water: A Multidisciplinary Study, Moses New-Aaron, Jane L. Meza, Patrick J. Shea, Martha Rhoades

Posters and Presentations: College of Public Health

Evidence that agrichemicals are associated with the incidence of birth defects is inconsistent. We examined whether nitrate and nitrosatable agrichemicals present in well water are associated with birth defect rates in Nebraska counties. Birth defect data from the Nebraska Department of Health and Human Services, 2005-2014, were merged with well data obtained from the Quality-Assessed Agrichemical Contaminant Database for Nebraska Ground Water (1977-2014). Nebraska counties with higher rates of birth defects had a greater prevalence of agrichemicals in well water. Of the 33 contaminants sampled from different well types, nitrate and atrazine were of interest. Birth defect rates were negatively …

Male-Female Differences In The Prevalence Of Non-Hodgkin Lymphoma And Residential Proximity To Superfund Sites In Kentucky, Ramona Stone, W. Brent Webber

Public Health Sciences Faculty Publications

Non-Hodgkin lymphoma (NHL) is a category of cancers that arise from lymphocytes. Previous work by the authors demonstrated a significant association between residential proximity to Superfund sites in Kentucky and cumulative incidence rates of NHL. In both the U.S. and Kentucky, age-adjusted NHL rates in males consistently exceed rates in females, despite NHL often arising later in the lifespan when females outnumber males. The current investigation sought to determine whether the NHL rate difference by sex is associated with proximity to environmental toxicants. Cancer data for a period of 18 years were obtained from the Kentucky Cancer Registry. Superfund geospatial …

Short-Term Association Between Black Carbon Exposure And Cardiovascular Diseases In Pakistan’S Largest Megacity, Daniel Malashock, Haider Khwaja, Zafar Fatmi, Azhar Siddique, Yi Lu, Shao Lin, David Carpenter

Community Health Sciences

This study investigated the association between black carbon (BC) exposure and hospital admissions (HAs) and outpatient department/emergency room (OPD/ER) visits for cardiovascular diseases (CVD) among residents of Karachi, the largest city in Pakistan. We measured daily concentrations of BC in fine particulate matter (PM2.5) and collected records of HAs and OPD/ER visits for CVD from 2 major tertiary care hospitals serving Karachi for 6 weeks continuously during each quarter over 1 year (August 2008–August 2009). We subsequently analyzed daily counts of hospital and BC data over 0–3 lag days. Daily mean BC concentrations varied from 1 to 32 µg/m3 . …

Pathophysiology Of Environmental Enteric Dysfunction And Its Impact On Oral Vaccine Efficacy, Chelsea Marie, Syed Asad Ali, Kanta Chandwe, William Petri Jr A, Paul Kelly

Department of Paediatrics and Child Health

Environmental enteric dysfunction (EED) refers to a subclinical disorder of intestinal function common in tropical countries and in settings of poverty and economic disadvantage. The enteropathy that underlies this syndrome is characterized by mucosal inflammation and villus blunting mediated by T cell activation. Epithelial cell disruption and microbial translocation drive systemic inflammation. EED in young children is associated geographically with growth failure, malnutrition, and greatly impaired responses to oral vaccines, notably rotavirus and poliovirus vaccines. In this review, we describe the pathophysiology of EED and examine the evidence linking EED and oral vaccine failure. This evidence is far from conclusive. …

Effectiveness Of Community Health Workers In Healthcare Delivery: Evidence From The Field, Mohammad Shahbazi Professor, Mukesh Kumar, Anthony Mawson, Donna Antoine Lavigine, Cassandra Dove

Journal of Health Disparities Research and Practice

Evidence suggests that health care in the United States could benefit from including the services of Community Health Workers (CHW), provided through Community Health Houses, in the delivery of care. This research project evaluated the impact of three newly-established Health Houses and the services provided to patients by Community Health Workers at three locations in the Mississippi Delta. The patients were current enrollees in the Medicare administered by United Healthcare. The program began in February 2014 and continued through September 2015. After analyzing data for payments made for each enrollee, emergency room visits and hospital admissions for the years of …

An Approach To Identify A Minimum And Rational Proportion Of Caesarean Sections In Resource-Poor Settings: A Global Network Study, José M. Belizán, Nicole Minckas, Elizabeth M. Mcclure, Sarah Saleem, Janet L. Moore, Shivaprasad S. Goudar, Fabian Esamai, Archana Patel, Elwyn Chomba, Ana L. Garces

Community Health Sciences

Background: Caesarean section prevalence is increasing in Asia and Latin America while remaining low in most African regions. Caesarean section delivery is effective for saving maternal and infant lives when they are provided for medically-indicated reasons. On the basis of ecological studies, caesarean delivery prevalence between 9% and 19% has been associated with better maternal and perinatal outcomes, such as reduced maternal land fetal mortality. However, the specific prevalence of obstetric and medical complications that require caesarean section have not been established, especially in low-income and middle-income countries (LMICs). We sought to provide information to inform the approach to …

An Approach To Identify A Minimum And Rational Proportion Of Caesarean Sections In Resource-Poor Settings: A Global Network Study., José M. Belizán, Nicole Minckas, Elizabeth M. Mcclure, Sarah Saleem, Janet L. Moore, Shivaprasad S. Goudar, Fabian Esamai, Archana Patel, Elwyn Chomba, Ana L. Garces, Fernando Althabe, Margo S. Harrison, Nancy F. Krebs, Richard Derman, Waldemar A. Carlo, Edward A. Liechty, Patricia L. Hibberd, Pierre M. Buekens, Robert L. Goldenberg

Global Health Articles

BACKGROUND: Caesarean section prevalence is increasing in Asia and Latin America while remaining low in most African regions. Caesarean section delivery is effective for saving maternal and infant lives when they are provided for medically-indicated reasons. On the basis of ecological studies, caesarean delivery prevalence between 9% and 19% has been associated with better maternal and perinatal outcomes, such as reduced maternal land fetal mortality. However, the specific prevalence of obstetric and medical complications that require caesarean section have not been established, especially in low-income and middle-income countries (LMICs). We sought to provide information to inform the approach to the …

Lung Cancer Risk And Low (≤50 Μg/L) Drinking Water Arsenic Levels For Us Counties (2009⁻2013)-A Negative Association., Steven H Lamm, Isabella J Boroje, Hamid Ferdosi, Jaeil Ahn

Pediatrics Faculty Publications

While epidemiologic studies clearly demonstrate drinking water with high levels of arsenic as a significant risk factor for lung cancer, the evidence at low levels (≤50 μg/L) is uncertain. Therefore, we have conducted an ecological analysis of recent lung cancer incidence for US counties with a groundwater supply of <50 μg/L, the historical limit for both the EPA and WHO. Data sources used included USGS for arsenic exposure, NCI for lung cancer outcome, and CDC and US Census Bureau forcovariates. Poisson log-linear models were conducted for male, female, and total populations using for exposure median county arsenic level, maximum arsenic level ≤50 μg/L, and ≥80% population groundwater dependency. Statistically significant negative associations were found in each of the six models in which the exposure was limited to those who had major exposure (≥80% dependency) to low-levels of arsenic (≤50 μg/L). This is the first large ecological study of lung cancer risk from drinking water arsenic levels that specifically examined the dose-response slope for populations whose exposure was below the historical limit of ≤50 μg/L. The models for each of the three populations (total; male; female) demonstrated an association that is both negative and statistically significant.