Digital Commons Network^™

The Community-Acquired Pneumonia Organization (Capo) Cloud-Based Research Platform (The Capo-Cloud): Facilitating Data Sharing In Clinical Research, William A. Mattingly, Timothy L. Wiemken, Stephen P. Furmanek, Paula Peyrani, Robert R. Kelley, Julio A. Ramirez

The University of Louisville Journal of Respiratory Infections

Background: Pneumonia is a costly and deadly respiratory disease that afflicts millions every year. Advances in pneumonia care require significant research investment and collaboration among pneumonia investigators. Despite the importance of data sharing for clinical research it remains difficult to share datasets with old and new investigators. We present CAPOCloud, a web-based pneumonia research platform intended to facilitate data sharing and make data more accessible to new investigators.

Methods: We establish the first two use cases for CAPOCloud to be the automatic subsetting and constraining of the CAPO database and the automatic summarization of the database in aggregate. We use …

Pneumonia Research And The Omics Revolution: It Is Time For Pneumomics, Julio A. Ramirez

The University of Louisville Journal of Respiratory Infections

No abstract provided.

Impact Of Temperature Relative Humidity And Absolute Humidity On The Incidence Of Hospitalizations For Lower Respiratory Tract Infections Due To Influenza, Rhinovirus, And Respiratory Syncytial Virus: Results From Community-Acquired Pneumonia Organization (Capo) International Cohort Study, Timothy L. Wiemken, William A. Mattingly, Stephen P. Furmanek, Brian E. Guinn, Connor L. English, Ruth Carrico, Paula Peyrani, Julio A. Ramirez

The University of Louisville Journal of Respiratory Infections

Abstract

Background: Transmissibility of several etiologies of lower respiratory tract infections (LRTI) may vary based on outdoor climate factors. The objective of this study was to evaluate the impact of outdoor temperature, relative humidity, and absolute humidity on the incidence of hospitalizations for lower respiratory tract infections due to influenza, rhinovirus, and respiratory syncytial virus (RSV).

Methods: This was a secondary analysis of an ancillary study of the Community Acquired Pneumonia Organization (CAPO) database. Respiratory viruses were detected using the Luminex xTAG respiratory viral panel. Climate factors were obtained from the National Weather Service. Adjusted Poisson regression models with robust …

Predicting 30-Day Mortality In Hospitalized Patients With Community-Acquired Pneumonia Using Statistical And Machine Learning Approaches, Timothy L. Wiemken, Stephen P. Furmanek, William A. Mattingly, Brian E. Guinn, Rodrigo Cavallazzi, Rafael Fernandez-Botran, Leslie A Wolf, Connor L. English, Julio A. Ramirez

The University of Louisville Journal of Respiratory Infections

Background: Predicting if a hospitalized patient with community-acquired pneumonia (CAP) will or will not survive after admission to the hospital is important for research purposes as well as for institution of early patient management interventions. Although population-level mortality prediction scores for these patients have been around for many years, novel patient-level algorithms are needed. The objective of this study was to assess several statistical and machine learning models for their ability to predict 30-day mortality in hospitalized patients with CAP.

Methods: This was a secondary analysis of the University of Louisville (UofL) Pneumonia Study database. Six different statistical and/or machine …

Inpatient & Outpatient Venous Thromboembolism: A Multifactorial Approach To Increase Mechanical And Pharmacological Prophylaxis Compliance, Suzanne E. Scheierling

Master's Projects and Capstones

Venous thromboemboli (VTEs) are a clinical and public health problem as they are commonly linked to inpatient experiences, yet frequently occur in the outpatient setting. VTEs place a significant burden on health care organizations and patients alike, as VTEs are costly, require long-term medications, and frequently reoccur. Research has identified risk factors and determined best practices for VTE prevention and prophylaxis, however little consensus exists among health care organizations and the implementation of best practices is varied. This project studied the challenges and opportunities in VTE prevention and prophylaxis at a large metropolitan hospital in California. Environmental changes were made …

Exploring The Harmful Health Effects Of Chlorpyrifos On Children: An Argument For Policy Reform, Lucia M. Ruiz

Master's Projects and Capstones

Chlorpyrifos is an organophosphate neurotoxic insecticide, which poses a significant risk to children’s health. Exposure to chlorpyrifos during childhood, infancy and pregnancy has been linked to autism, ADHD, developmental delays, and lower IQ. My internship at the Natural Resources Defense Council in San Francisco consisted of completing analyses and creating science, policy and communications materials to support health protective policies for chlorpyrifos in the market and at the federal and state levels. Information pertaining to the widespread use and harmful effects of chlorpyrifos was gathered and presented in fact sheets, spreadsheets, graphs and bulleted talking points. Data analyses and literature …

Control Policies And Sensitivity Analysis In A Cutaneous Leishmaniasis Model: A Case Study In Cusco Region, Peru., Rocio M. Caja-Rivera, Ignacio Barradas

Biology and Medicine Through Mathematics Conference

No abstract provided.

The Problem Of Suffering: Universal Health Coverage As A Partial Solution, Christen Scaggs

Dialogue & Nexus

Universal Health Coverage is evaluated from a Christian Biblical perspective and found that it meets an appropriate standard of service to the poor. Christians should consider its benefits and drawbacks compared to doing nothing. The issue of diminished access to healthcare, burdensome medical costs, reduced coverage, and discrimination against impoverished individuals with specific regards to healthcare are all conquerable challenges.

Detection Of Healthcare-Associated Infectious Disease Outbreaks With A Special Look At Clostridium Difficile Infection In Long-Term Care Facilities, Almea Matanock

Biomedical Sciences ETDs

Healthcare-associated infections (HAI) are a major cause of morbidity and mortality and a public health priority. However, standard procedures and comprehensive guidelines for HAI outbreak detection and response are still needed. This hybrid thesis describes what is known about HAI outbreaks in the introduction, reviews the HAI outbreaks reported to New Mexico Department of Health (NMDOH), in the first paper, and then in the second paper examines how established methods for detecting infectious disease outbreaks perform in identifying Clostridium difficile infection (CDI) outbreaks in long-term care facilities (LTCF) in Bernalillo County, New Mexico, and finally, it closes with our overall …

Serious Mental Illness Among Young Adult Women Who Use Drugs In The Club Scene: Co-Occurring Biopsychosocial Factors, Maayan Lawental, Hilary L. Surratt, Mance E. Buttram, Steven P. Kurtz

Center for Health Services Research Faculty Publications

Young women who regularly attend nightclubs are at risk for numerous health and social consequences, including mental distress, sexual and physical victimization and substance dependence. This paper uses a biopsychosocial framework to examine co-occurring mental health problems, victimization, substance dependence, sexual risk and physical pain among a sample of young women who use drugs (N = 222) in Miami’s club scene. The majority of women were under 24 years old, Hispanic, and identified as heterosexual. Almost all the women reported past 90-day use of alcohol, ecstasy/MDMA, marijuana, cocaine and prescription opioids and benzodiazepines; 32% of women reported being in a …

Midwives For Haiti: Process Evaluation, Denielle M. Riley

Masters Theses

The reduction of maternal mortality is a long-time international objective. One often underemphasized component of addressing complex and context-driven health problems, such as maternal mortality, is the importance of program evaluation. Program evaluation has been identified as particularly scarce among safe motherhood initiatives, which seek to reduce maternal deaths and improve the health outcomes of mothers (Freedman et al., 2007). Useful program evaluation starts with process evaluation. This study is a case study process evaluation of postpartum data collection, which utilizes interviews, observations, and document review. The purpose of this study was to evaluate, describe, and compare the intended and …

Determining The Knowledge, Attitudes And Beliefs Of Healthcare Providers In Treating Non-Specific Acute And Chronic Back Pain, Stacey L. Kale

Doctor of Nursing Practice Scholarly Project

An Abstract of the Scholarly Project by

Stacey Kale

Managing back pain has become a public health and clinical challenge (Krein et al., 2016). Incidence of back pain related complaints requiring treatment in the US is estimated at 11.2% of the adult population (Dowell, Haegerich, & Chou, 2016). New research suggests that it is the most common pain problem (Pauline, 2016). It is the third most expensive health disorder and is exceeded only by cancer and heart disease. Many health care providers lack formal pain management education and training thus leaving them at risk for failing to properly manage patients …

The Effect Of Bundled Interventions On Prevention Of Hospital Acquired Clostridium Difficile Infection, Kaitlin Kendys

Evidence-Based Practice Project Reports

Clostridium difficile infection (CDI) rates have steadily increased in hospitalized patients due to the change in epidemiology. Approximately 13 of every 1,000 inpatients are either infected or colonized with C. difficile (CDC, 2013). CDI rates continue to rise due to the hyper-virulent strain of C. difficile and length of therapy needed to treat CDI. The average cost for a single inpatient CDI is more than $35,000, and the estimated annual cost burden for the healthcare system exceeds $3 billion (Walsh, 2012). The purpose of this evidence-based project (EBP) was to reduce hospital-acquired CDI rates over a 3-month period-oftime from November …

The Skin Cancer Health Crisis And Recommended Intervention Methods, Blaire Brooks

Senior Theses

Despite the increasing research connecting UVR exposures to skin cancer, rates of skin cancer are rising. Skin cancer is now the most common form of cancer and there are significant health care costs associated with treating the cases (Balk et al., 2013). As a result, the United States needs greater initiatives to increase educational programs, physician counseling, and political action regarding ultraviolet exposure and incidence of skin cancer. Evaluation of the types of skin cancer, perceptions of tanning, and current regulations and recommendations are required in order to form the initiatives to combat the growth of skin cancer.

Environmental Health, Tessa Oliaro

Student Scholar Symposium Abstracts and Posters

There is a very important intersection between the environment, public health, and socioeconomic factors (Braveman, 2014). These include waste disposal, water use and quality, road safety, ecosystem services, and many more. Environmental health stresses, “the health impacts of physical, chemical, and biological agents in the environment and workplace, and learns to develop strategies to measure and control major environmental health problems both locally…and in settings around the globe” (UC Berkeley School of Public Health, 2017). This overarching umbrella can have emphases in environmental epidemiology, exposure science, climate change, ergonomics, home and industrial hygiene, and molecular epidemiology. Exploring each of these …

Sex And Sexuality Of Breast Cancer Survivors, Aja D. Kneip Pelster

Theses & Dissertations

With new diagnostic technologies and treatment modalities available, more people than ever are living as cancer survivors in the United States. A large group of this population consists of breast cancer survivors. The purpose of this research was to explore the intersection of breast cancer survivorship, at points beyond the termination of treatment, and sexuality, including expressions and performance of gender, relationships, and sexual behavior. The current study used semi-structured interviews, conducted with 21 Midwestern women at least 6-months post-treatment, to better understand the intersection of these two concepts. Following traditions of narrative and phenomenological qualitative research, the women’s own …

Epigenetic Modifications Of Human Placenta Associated With Preterm Birth, Drissa Toure

Theses & Dissertations

Preterm birth is a complex multifactorial process. Despite the well-known role of the placenta in supporting the fetal development and maternal-fetal tolerance, the placental epigenetic modifications and preterm birth (PTB) remains poorly understood and under investigated. Various maternal and environment factors can influence epigenetic programming during fetal development to affect the functioning and structures of organs, including the placenta, which can lead to adverse pregnancy outcomes, including PTB. The understanding of the placental epigenetic alterations and maternal determinants associated with PTB are apparently indispensable for the development of actual diagnosis and methods of prevention and treatment of premature labor. The …

Common Histories And Common Failures: How The Historical Events Of Ireland And The United States Have Led To Their Vastly Different, Equally Failing, Health Care Systems, Kimberly Narro

Senior Theses

The United States healthcare system is a constant source of debate and public interest, with the only common ground between political parties being that the current system is deeply flawed and needing improvement. Individuals often point to European single-payer systems as the answer, neglecting to mention the flaws also inherent in these systems. This thesis aims to suss out the successes and failings of the Irish and American healthcare systems through a thorough scholarly literature review, with an emphasis on the two countries’ origins and development, to lead to a discussion about why two countries with similar historical beginnings have …

Gender Disparities In Midlife Hypertension: A Review Of The Evidence On The Arab Region, Christelle Akl, Chaza Akik, Hala Ghattas Ph.D., Carla Makhlouf Obermeyer

Faculty Publications

Objective

While gender differences in hypertension and increased prevalence rates among women at midlife have been documented in multiple settings, the evidence on the Arab world has not been systematically examined. This review summarizes the evidence related to gender disparities in midlife hypertension in this region.

Methods

We searched MEDLINE and Social Sciences Citation Index (SSCI) databases for studies, published between January 2000 and August 2015, on hypertension in the 22 countries of the Arab region. We abstracted information on the prevalence of hypertension among women and men, in general populations during midlife.

Results

Nineteen studies provided data on the …

Emergency Room Overuse And Medicaid Population: Creating A Toolkit To Decrease Er Misuse By Family Resources Clients, Nicole Johanne Morrissey Ms.

Celebration of Learning

One of the biggest issues facing healthcare in the United States is excessive spending on ER visits. This issue costs the United States healthcare field about $38 billion a year to treat patients who might not necessarily need the immediate attention. The Medicaid population is one of the highest users of the ER and the most common reasons are behavioral issues and no other place to go. Family Resources, a non-profit organization in Davenport, IA, works to connect families with healthcare facilities in the area based on each family’s needs. Much of their clientele uses Medicaid and struggles with ER. …

Behavioral Determinants Of Physical Activity Across The Life Course: A "Determinants Of Diet And Physical Activity" (Dedipac) Umbrella Systematic Literature Review, Giancarlo Condello, Anna Puggina, Katina Aleksovska, Christoph Buck, Con Burns, Greet Cardon, Angela Carlin, Chantal Simon, Donatella Ciarapica, Tara Coppinger, Cristina Cortis, Sara D'Haese, Marieke De Craemer, Andrea Di Blasio, Sylvia Hansen, Licia Iacoviello, Johann Issartel, Pascal Izzicupo, Lina Jaeschke, Martina Kanning, Aileen Kennedy, Fiona Chun Man Ling, Agnes Luzak, Giorgio Napolitano, Julie Anne Nazare, Camille Perchoux, Caterina Pesce, Tobias Pischon, Angela Polito, Alessandra Sannella, Holger Schulz, Rhoda Sohun

Publications

Background: Low levels of physical activity (PA) are a global concern and increasing PA engagement is becoming a priority in current public health policies. Despite the large number of studies and reviews available, the evidence regarding the behavioral determinants of PA is still inconclusive. Thus, the aim of this umbrella systematic literature review (SLR) was to summarize the evidence on the behavioral determinants of PA across the life course. Methods: A systematic online search was conducted on MEDLINE, ISI Web of Science, Scopus, and SPORTDiscus databases. The search was limited to studies published in English from January, 2004 to April, …

Addressing Childhood Lead Poisoning Through Gis: A Proactive Approach In Scott County, Iowa, Tanner Osing

2016-2017: Scott County, Iowa and the Scott County Health Department

In June 2016, Scott County Health Department (SHCD) officially partnered with the Upper Mississippi Center (UMC) at Augustana College as part of the Sustainable Working Landscapes Initiative (SWLI). The initiative’s main goal is to address childhood lead poisoning in Scott County, Iowa. While the health department has ongoing efforts to address the problem, there are still approximately 50 children testing positive for lead poisoning every year (Tibbets, 2016). Currently, as part of the Childhood Lead Poisoning Prevention and Control Program, the health department offers case management services for children poisoned under the age of six, follow-up inspections for residences, and …

Smoking, Depression, And Hospital Costs Of Respiratory Cancers: Examining Race And Sex Variation, Baqar A. Husaini, Robert S. Levine, Phillip Lammers, Pam Hull, Meggan Novotny, Majaz Moonis

Center for Prevention Research Publications

Objective To investigate the effect of smoking and depression on hospital costs for lung cancer (LC).

Methods We extracted data on depression, smoking history, demographics, and hospital charges for patients with respiratory cancers (ICD-9 codes 161–163, 165) from the 2008 Tennessee Hospital Discharge Data System. The sample (n=6665) was mostly white (86%) and male (57%). Age-adjusted rates were developed in accordance with Centers for Disease Control and Prevention methods, and hospital costs were compared for patients with LC with versus without depression and a smoking history.

Results Three findings (P<0.001) emerged: (1) the LC rate was higher among blacks than among whites, and higher among men than among women; (2) while 66% of LC patients smoked (more men than women without racial variation), 24% had depression (more females and whites were depressed); (3) the LC hospital cost was 54% higher than the non-LC hospital cost, and this cost doubled for patients with LC with depression and smoking versus those without such characteristics.

Conclusion While LC is more prevalent among …

Adopting Children With Down Syndrome: A Qualitative Study Of Family Experiences, Emily L. Richter

Rehabilitation, Human Resources and Communication Disorders Undergraduate Honors Theses

The purpose of this study is to qualitatively investigate and compare the family beliefs, values, and perceptions of parenting of families who have adopted children with Down syndrome (DS) to parents who have biological children with DS. Participants in the study included 27 parents of biological children with DS and six parents of adopted children with DS. Participants were interviewed through a digital survey that was distributed through Qualtrics Online Survey Software. Quantitative analysis placed the participants into groups and qualitative analysis was used to identify beliefs, values, and perceptions. Results showed that while both adoptive and biological parents indicated …

Contextual Factors And Sexual Risk Behaviors Among Young, Black Men, Jamal Jones, Laura F. Salazar, Richard A. Crosby

Health, Behavior & Society Faculty Publications

Young Black men (YBM), aged 13 to 24 years, face a disproportionate burden of sexually transmitted infections (STIs). STI acquisition among YBM is due to incorrect and inconsistent condom use and is exacerbated by multiple sexual partners. Sexual and reproductive health is influenced by a complex interaction of biological, psychological, and social determinants that contribute to increased risk for STI acquisition. However, there are key social determinants of sexual health that play a major role in adolescent sexual risk-taking behaviors: gender norms, environment, peers, and families as well as a desire to impregnate a woman. Associations between contextual factors (risky …

Sugar Price Supports And Taxation: A Public Health Policy Paradox, Abby Dilk, Dennis Savaiano

Student Works

Domestic US sugar production has been protected by government policy for the past 82 years, resulting in elevated domestic prices and an estimated annual (2013) $1.4 billion dollar “tax” on consumers. These elevated prices and the simultaneous federal support for domestic corn production have ensured a strong market for high-fructose corn syrup. Americans have dramatically increased their consumption of caloric sweeteners during the same period. Consumption of “empty” calories (ie, foods with low-nutrient/high-caloric density)—sugar and high-fructose corn syrup being the primary sources—is considered by most public health experts to be a key contributing factor to the rise in obesity. There …

What’S New With The Flu?, Boriana Marintcheva

Bridgewater Review

No abstract provided.

The Development And Validation Of A Resource Kit For Use By Ngos Pertaining To The Inclusion Of People With Disabilities In Sport-Based Programmes In Developing Countries, Koffi Atitso Fiati

Theses

The current study is undertaken in relation to the recommendations of both Article 30 of the United Nations Convention on the Rights of People with Disabilities-UNCRPD, (UN, 2006) and the new Charter on Physical Education, Physical Activity and Sport (UNESCO, 2015) to serve as a building block in the improvement of the health of people with disabilities (PWDs).

The study adopted a three-phase sequential mixed method approach with a participatory action research orientation. There was a document analysis, a survey, and interviews. The first phase comprised an analysis of four documents labelled as inclusive sport and physical activities resource kits. …

Humor In Medicine: A Literature Review Of Humor’S Potential Therapeutic Value In Health Care, Weston Michael Grant

Psychological Science Undergraduate Honors Theses

Using humor and laughter within the health care field has the potential to be relevant to patients during treatment, to the patient-caregiver relationship, to the subjective well-being of health care providers, and to the environments’ (e.g., work settings) impact on group relationships (e.g., colleagues). A review of the literature examines how the psychological and physiological effects of laughter and humor within the human body impact health and well-being, how humor and laughter improve the patient-practitioner relationship, and if humor and laughter can potentially impact physician burnout. Several possible implications for these findings are discussed, such as professional medical comedians, improvements …

Hiv In New York City: An Overview Of Cultural And Social Factors Contributing To An Individual's Decision To Disclose Their Disease Status, Lindsey Riback

Public Health Undergraduate Program

will examine what effect cultural norms surrounding race and sexual orientation, as well as four specific social factors (alcohol use during sex, injection drug use, social support and the importance of religion) have on whether an HIV positive individual, specifically an urban homosexual male, chooses to disclose their disease status. This paper will discuss those cultural norms and social factors through the AIDS Risk Reduction Model, available literature, and the data collected by the National Institute of Mental Health for the Positive Connections intervention trial. The data for this paper were pulled from the larger study, and only the 171 …