Medicine and Health Sciences Commons^™

Enhancing Timeliness Of Drug Overdose Mortality Surveillance: A Machine Learning Approach, Patrick J. Ward, Peter J. Rock, Svetla Slavova, April M. Young, Terry L. Bunn, Ramakanth Kavuluru

Kentucky Injury Prevention and Research Center Faculty Publications

BACKGROUND: Timely data is key to effective public health responses to epidemics. Drug overdose deaths are identified in surveillance systems through ICD-10 codes present on death certificates. ICD-10 coding takes time, but free-text information is available on death certificates prior to ICD-10 coding. The objective of this study was to develop a machine learning method to classify free-text death certificates as drug overdoses to provide faster drug overdose mortality surveillance.

METHODS: Using 2017–2018 Kentucky death certificate data, free-text fields were tokenized and features were created from these tokens using natural language processing (NLP). Word, bigram, and trigram features were created …

Access To Care And Melanoma Incidence And Mortality In Nebraska, Natalia Trinidad

Capstone Experience

The purpose of this study is to determine incidence and mortality of melanoma across all counties in Nebraska in the context of access to primary care providers and dermatologists. Crude and age-adjusted incidence rates of melanoma from 2001-2016 by county were calculated for the following year intervals: 2001-2005, 2006-2010, 2011-2016. Variables for melanoma cases were obtained from the Nebraska Cancer Registry and included the case’s zip code at diagnosis, race, ethnicity, sex, age at diagnosis, year, cancer site, vital status, stage of disease, and the ICD-O code for the cancer type. Crude and age-adjusted mortality rates were calculated for the …

Heat Waves And Heat-Related Mortality In East Tennessee, Taiwo Adesoba

Electronic Theses and Dissertations

Heat waves represent a public health challenge that requires multiple responses and warnings to protect vulnerable populations. Although studies have reported an increasing trend of heat wave occurrence in many areas of the world, no clear trend exists in East Tennessee. Using data from Parameter-elevated Relationships on Independent Slope Models (PRISM), CDC WONDER and the United States Census Bureau, the relationship between mortality rates and year was estimated during heat wave events between 1999 and 2010. Five heat wave definitions were tested. Overall, 2007 and 2010 stand out as the years with the highest number of heat wave days in …

Determinants Of Disparities In The Colorectal Cancer Burden, Karen Elizabeth Callahan

UNLV Theses, Dissertations, Professional Papers, and Capstones

Colorectal cancer (CRC) is the third leading cause of cancer incidence and mortality in the United States, with an estimated 140,000 new cases and 51,000 deaths expected in 2018. Like most cancers, the burden of CRC is unequally distributed among population groups. The current dissertation included two studies filling gaps in knowledge about CRC disparities. Study 1 characterized the relationship between educational attainment and CRC mortality by race/ethnicity. Six years of CRC mortality data (2012-2017) from the diverse state of California, with 30,180 deaths were analyzed. Sex-specific mortality rate ratios (MRR) stratified by race/ethnicity as well as by educational level …

Telomeres, Nutrition And Mortality: Risk Factors For The Rate Of Telomere Length Decline And The Associations Between Telomere Length, Nutrition And Mortality, Saruna Ghimire

UNLV Theses, Dissertations, Professional Papers, and Capstones

Introduction: Telomeres are nucleoprotein structures located at the ends of eukaryotic chromosomes, thought to protect the DNA from damage. As a person experiences stressors, harmful exposures, and other diseases throughout their life, telomeres are thought to become damaged and their length shortened, decreasing their ability to protect the DNA. Nutrition is an important aspect of healthy aging. Preservation of telomere length (TL) is thought to be one of the mechanisms by which good nutrition can delay or prevent the development of chronic disease and death. Recent evidence of preservation of TL with good nutrition is promising. Thus, the aim of …

A Retrospective Study Of The Opioid Epidemic And Fentanyl Related Overdose Fatality Cases In A Florida West Coast Medical Examiner District Population, Anne Terese Powell

USF Tampa Graduate Theses and Dissertations

Opioids are scheduled by the propensity for misuse and abuse with a high rate of dependency and risk of fatal overdose. Opioids can be divided into different classes, including, natural, synthetic, and semi-synthetic. Opiates are naturally occurring and come directly from the opium poppy plant; whereas the semi synthetics opioids are chemical modifications of the poppy plant. Synthetic opioids attach to the opioid receptor but contain no part of the poppy plant. The increased variety and frequency in opioid prescriptions contributed to an opioid epidemic in the United States which is still on going.

According to the CDC, the opioid …

Identifying Predictors Of Racial Disparity In Treatment And Mortality Among Patients Diagnosed With Breast Cancer In South Carolina, Oluwole Adeyemi Babatunde

Theses and Dissertations

Introduction: Despite a lower incidence of breast cancer (BrCA) among Black women in the U.S. compared to White women, Black women experience consistently higher mortality rates. The aims of this study were 1) to assess the relationship between race and diagnosis-to-treatment times 2) to assess racial disparity in mortality among Black and White BrCA patients in SC and 3) assessment of the validity of the Mortality-to- incidence ration (MIR) as a proxy for survival and geospatial investigation of racial disparity among breast cancer (BrCA) patients.

Methods: Breast cancer cases diagnosed between 2002-2010 were obtained retrospectively from the SC Central Cancer …

Assessment Of Pneumonia Severity Indices As Mortality Predictors, Connor L. English, Thomas Chandler, Brian E. Guinn, Stephen P. Furmanek, Julio A. Ramirez

The University of Louisville Journal of Respiratory Infections

BACKGROUND

The leading cause of infectious disease death in the United States is community-acquired pneumonia (CAP). Several pneumonia severity indices exist and are widely used as tools to assist physicians regarding site of care based on risk of death. However, limited data exists that discerns which of the most commonly used severity scores is the best predictor of mortality across multiple time points. The objective of this study is to determine the best mortality predictor at different time points between four of the most commonly used pneumonia severity scores.

METHODS

This was a secondary analysis of a prospective, multicenter, population-based, …

Severity Of Disease And Mortality For Hospitalized Patients With Community-Acquired Viral Pneumonia Compared To Patients With Community-Acquired Bacterial Pneumonia, Richard Y. Kim, Thomas Chandler, Stephen P. Furmanek, Timothy Lee Wiemken, Rodrigo Cavallazzi

The University of Louisville Journal of Respiratory Infections

Background: There exists a large body of literature to help identify, diagnose, treat, and manage community-acquired pneumonia (CAP). Despite this, there is little data that directly compares the clinical syndromes and complications of pure bacterial pneumonia to pure viral pneumonia. Our study compares the clinical presentation, morbidity and mortality of viral vs. bacterial etiologies of CAP.

Methods: This was a secondary data analysis of the Community-Acquired Pneumonia Organization (CAPO) international study database. Data was collected concerning patient demographics, physical examination findings, laboratory findings, radiological findings, severity of illness, and clinical outcomes and stratified according to the two study groups, CAVP …

The Risk Of New-Onset Epilepsy And Refractory Epilepsy In Older Adult Stroke Survivors, Jorge G. Burneo, Tresah C. Antaya, Britney N. Allen, Andrea Belisle, Salimah Z. Shariff, Gustavo Saposnik

Neuroepidemiology Research Unit Project Summaries

Research Summary: Key Findings

• Stroke is a common cause of epilepsy in older adults, but little is known about stroke-related epilepsy or its outcomes in this population.
• 1.1% of older adult stroke survivors developed epilepsy in this study, of whom 12.9% developed refractory epilepsy, indicating that this population is particularly responsive to treatment.
• Over 85% of deaths in this population are not due to stroke or epilepsy.

Post-Diagnosis Quality Of Life And Mortality In Non-Hispanic White And Hispanic Women Diagnosed With Invasive Breast Cancer., Delvon T. Mattingly

Electronic Theses and Dissertations

The prevalence of breast cancer is increasing, and the health-related quality of life (HRQOL) of breast cancer survivors may help to further understand survivorship. This study evaluated HRQOL as a potential prognostic factor for mortality among Non-Hispanic White (NHW) and Hispanic women diagnosed with invasive breast cancer. Data were used from the Health, Eating, Activity, and Lifestyle (HEAL) Study. Data for 351 participants were analyzed for associations between HRQOL scores (subscale, component) and mortality. Cox proportional hazards regression was conducted to assess the relationship between HRQOL and mortality outcomes (all-cause, breast cancer-specific, non-cancer). Median follow-up time from HRQOL assessment (approximately …

Epidemiology News, Georgia Southern University

Epidemiology News (2012-2018)

• Georgia Southern Examines Muscle-Strengthening and Aerobic Activities and Mortality in Cancer Survivors

The Importance Of Person And Place In Predicting Prostate Cancer Incidence And Mortality Among United States Veterans Seeking Veterans Health Administration Care, Peter Georgantopoulos

Theses and Dissertations

T Introduction: There are several unique characteristics in the epidemiology of prostate cancer (PrCA) that make it an interesting and important cancer to study. The first is that while prostate cancer is the most common cancer that men develop, it is one of the least common cancers that men die from. This indolent nature of PrCA has led to the idiom among health scientists that “men are more likely to die with PrCA than due to PrCA”. Just like other cancers, several individual-level risk factors (e.g., family history of the disease, age, and race) are well established for both PrCA …

Spatiotemporal Variations In Coexisting Multiple Causes Of Death And The Associated Factors, Emmanuel Oluwatobi Salawu

Walden Dissertations and Doctoral Studies

The study and practice of epidemiology and public health benefit from the use of mortality statistics, such as mortality rates, which are frequently used as key health indicators. Furthermore, multiple causes of death (MCOD) data offer important information that could not possibly be gathered from other mortality data. This study aimed to describe the interrelationships between various causes of death in the United States in order to improve the understanding of the coexistence of MCOD and thereby improve public health and enhance longevity. The social support theory was used as a framework, and multivariate linear regression analyses were conducted to …

Rare Single Gene Disorders: Estimating Baseline Prevalence And Outcomes Worldwide, Hannah Blencowe, Sowmiya Moorthie, Mary Petrou, Hanan Hamamy, Alan Bittles, Stephen Gibbons, Matthew Darlison, Bernadette Modell, Congenital Disorders Expert Group .

Research outputs 2014 to 2021

As child mortality rates overall are decreasing, non-communicable conditions, such as genetic disorders, constitute an increasing proportion of child mortality, morbidity and disability. To date, policy and public health programmes have focused on common genetic disorders. Rare single gene disorders are an important source of morbidity and premature mortality for affected families. When considered collectively, they account for an important public health burden, which is frequently under-recognised. To document the collective frequency and health burden of rare single gene disorders, it is necessary to aggregate them into large manageable groupings and take account of their family implications, effective interventions and …

Moving Mountains : A Study Examining Long-Term Impacts Of Mountaintop Removal Coal Mining On Mortality In The Appalachian Region Using Geographic Information Sciences Techniques., James Howard Kent Pugh

Electronic Theses and Dissertations

Over the last hundred years, the Appalachian region has been dominated by the coal industry. It has also been and currently is one of the unhealthiest regions in the United States. Recent scholarship has examined the relationship between coal mining and health and mortality rates in the Appalachian region. The first study incorporates air quality and pollution data to examine if coal mining counties have higher levels of pollution and if this pollution contributes to mortality disadvantage. In the second study, I construct a population-based coal-exposure measure to better evaluate the relationship between coal mining and health I find that …

The Path To Health Equity Through Multidisciplinary Collaboration, Cynthia Haq

Journal of Patient-Centered Research and Reviews

The author, a guest editor for this special issue of the Journal of Patient-Centered Research and Reviews dedicated to health disparities and inequities, comments on recent studies demonstrating poorer health outcomes among various patient populations in the United States despite its having higher spending per capita than any other nation. Noting that health inequities are defined as avoidable differences, the author encourages health professionals to work to narrow these gaps.

One-Year Mortality In Patients With Community-Acquired Pneumonia, Paula Peyrani, Julio A. Ramirez

The University of Louisville Journal of Respiratory Infections

Pneumonia remains a common cause of morbidity and mortality in the US. Although, communityacquired pneumonia (CAP) has traditionally been considered an acute process, more recently, data have emerged showing that patients surviving an episode of CAP are at increased risk of death long after hospital discharged. In this descriptive review, we examine the current knowledge of long-term mortality and propose a hypothesis explaining the pathogenesis of long-term mortality in patients with CAP.

Alternative Healthy Eating Index 2010, Dietary Inflammatory Index And Risk Of Mortality: Results From The Whitehall Ii Cohort Study And Meta-Analysis Of Previous Dietary Inflammatory Index And Mortality Studies, Nitin Shivappa, James R. Hébert, Mika Kivimaki, Tasnime Akbaraly

Faculty Publications

We aimed to examine the association between the Alternative Healthy Eating Index updated in 2010 (AHEI-2010), the Dietary Inflammatory Index (DIITM) and risk of mortality in the Whitehall II study. We also conducted a meta-analysis on the DII-based results from previous studies to summarise the overall evidence. Data on dietary behaviour assessed by self-administered repeated FFQ and on mortality status were available for 7627 participants from the Whitehall II cohort. Cox proportional hazards regression models were performed to assess the association between cumulative average of AHEI-2010 and DII scores and mortality risk. During 22 years of follow-up, 1001 participants died …

The Role Of Socioeconomic Context In The Association Between Educational Attainment And Morbidity And Mortality, Jennifer Brite

Dissertations and Theses

Although the association between educational attainment and health is one of the most studied in the social science, little is known about the role of social and economic context. Fundamental Cause Theory suggests that the education-health gradient will be weakest in contexts where the better educated are unable to leverage their resources to achieve better health. This dissertation tests several different factors that may moderate the association between educational attainment and morbidity and mortality: 1. Demographic characteristics, including race, immigration status, and gender, 2. Status consistency (defined as education equivalent to that required for current occupation), 3. Unemployment rates at …

Impact Of Obesity On Mortality In Hospitalized Patients With Pneumonia Due To 2009 H1n1 Influenza A Virus Versus Other Etiologies, Martin A. Espinosa-Ginic, Ryan T. Hurt, Stephen P. Furmanek, Paula Peyrani, Julio A. Ramirez, Timothy Lee Wiemken, The Capo Investigators

The University of Louisville Journal of Respiratory Infections

Background: Reports from the 2009 H1N1 influenza A virus (2009 H1N1) pandemic indicate increased mortality in obese patients hospitalized with pneumonia. However, articles published prior to the pandemic have suggested that obesity may be a protective factor for mortality in these patients. The objective of this study was to compare the impact of obesity on mortality in hospitalized patients with pneumonia due to the 2009 H1N1 versus pneumonia due to other etiologies.

Methods: This was a secondary analysis of the CAPO international cohort study. Study groups were defined as follows: Group One, pneumonia due to 2009 H1N1: Patients hospitalized with …

Rhabdomyosarcoma Incidence And Survival In Whites, Blacks, And Hispanics From 1973-2013: Analysis From The Surveillance, Epidemiology, And End Results Program, Heather Tinsley

USF Tampa Graduate Theses and Dissertations

Purpose

Our objectives were to 1) determine the difference in Rhabdomyosarcoma (RMS) incidence and survival between different race/ethnicity groups, and 2) evaluate the difference in survival of RMS between children and adults of these race/ethnicity groups, using the Surveillance, Epidemiology, and End Results Program (SEER) database between 1973-2013.

Patients and Methods

We analyzed racial characteristic and incidence data from 4,280 patients diagnosed with RMS, between 1973-2013, that were reported to the SEER database. Survival and hazard analyses were conducted on 4,268 patients with known follow-up data, with end point being death from any cause.

Results

Over the 40-year study period …

Global, Regional, And National Life Expectancy, All-Cause Mortality, And Cause-Specific Mortality For 249 Causes Of Death, 1980-2015: A Systematic Analysis For The Global Burden Of Disease Study 2015, H Wang, M Naghavi, M Coggeshall, L Dandona, D Dicker, Sahil Khera, M Tavakkoli, Gbd 2015 Mortality And Causes Of Death Collaborators

NYMC Faculty Publications

Background Improving survival and extending the longevity of life for all populations requires timely, robust evidence on local mortality levels and trends. The Global Burden of Disease 2015 Study (GBD 2015) provides a comprehensive assessment of all-cause and cause-specific mortality for 249 causes in 195 countries and territories from 1980 to 2015. These results informed an in-depth investigation of observed and expected mortality patterns based on sociodemographic measures. Methods We estimated all-cause mortality by age, sex, geography, and year using an improved analytical approach originally developed for GBD 2013 and GBD 2010. Improvements included refinements to the estimation of child …

Intra-Ethnic Diversity In Ischemic Heart Disease And Stroke Mortality Among Hispanics In The United States, Karen Elizabeth Callahan

UNLV Theses, Dissertations, Professional Papers, and Capstones

Introduction: Hispanics are the largest racial/ethnic minority group in the United States (US), comprising 17% of the total US population in 2014, and projected to increase to 28.6% by 2060. Yet, the intra-ethnic heterogeneity for the second and fourth leading causes of death among Hispanic populations, heart disease and stroke, has never been comprehensively studied. We examined ischemic heart disease (IHD) and stroke mortality among distinct Hispanic subgroups: Caribbean Hispanics (including Puerto Ricans, Cubans, and Dominicans), Mexicans, Central Americans and South Americans, comparing their mortality with non-Hispanic whites (NHWs).

Methods: Five years (2008-2012) of death certificate data from Florida and …

Maternal Hypertension Influences Mortality And Severe Morbidity In Infants Born Extremely Preterm, Carole Anne Mcbride

Graduate College Dissertations and Theses

Worldwide, more than 1 million infants die as a result of premature birth. In the United States, where 1 in 10 births occurs preterm, premature birth is the leading cause of infant mortality. Premature infants have high rates of mortality and morbidity, with the highest rates seen in those infants born extremely preterm -- prior to 30 weeks gestation. Severe morbidity in these infants often contributes to life-long health problems. Maternal hypertension (HTN) is one contributor to preterm birth and also contributes to fetal growth restriction, resulting in birth weights which are small for gestational age (SGA, and generally within …

Roles Of Serum Lycopene In The Prevalence And Mortality Of Metabolic Syndrome In The Adult Population, Guang-Ming Han

Theses & Dissertations

Metabolic syndrome (MetS) is a cluster of metabolic disorders, including increased fasting glucose, blood pressure, plasma triglyceride, reduced high-density lipoprotein cholesterol and abdominal obesity. It leads to an increased risk of cardiovascular disease and diabetes. The growing prevalence of MetS is strongly related to the increasing prevalence of overweight/obesity. As an antioxidant, lycopene can reduce the risk of MetS. However, it is unclear whether lycopene has similar effects among overweight/obese individuals and whether lycopene can reduce the risk of mortality among individuals with MetS. The purpose of this study was to explore the roles of lycopene in the prevalence and …

Epidemiology News, Georgia Southern University

Epidemiology News (2012-2018)

• Georgia Southern Questions the Validity of Avoidable Mortality

The Revolving Door Pattern Of Jail Incarceration And Homelessness And Its Influence On Mortality And Morbidity Among New York City Adults, Sungwoo Lim

Dissertations, Theses, and Capstone Projects

Objectives

The purpose of this dissertation study was to identify timing and sequencing of jail incarceration and homelessness by utilizing sequence analysis and to test whether a particular trajectory contributes to mortality risk and discontinuity of HIV care.

Methods

The main data source was an existing matched dataset, constructed using administrative data from the New York City (NYC) Departments of Health and Mental Hygiene, Correction, and Homeless Services. The study cohort consisted of 15,620 NYC adults with recent histories of both jail incarceration and homelessness. Monthly experiences of jail incarceration, homelessness, and community-dwelling in 2001-03 were summarized into trajectory groups …

An Assessment Of Risk Factors For Early Death Among A Sample Of Previously Incarcerated Youth, Patricia A. Stoddard Dare, Miyuki Fukushima Tedor, Linda M. Quinn, Christopher A. Mallett

Social Work Faculty Publications

Most previous research regarding early death prior to, or during, young adulthood among previously detained delinquent youth has focused predominantly on males or on their cause of death. This study extends previous research by evaluating potential factors that are associated with early death in a random sample (N = 999) of formerly detained youthful offenders in New York stratified by gender (50% female). Existing case records were referenced with the National Death Index to determine if the formerly detained youth were deceased by the time they would have reached age 28. Regression analyses were run to determine if any of …

Short- And Long-Term Associations Between Widowhood And Mortality In The United States: Longitudinal Analyses, J. Robin Moon, M. Maria Glamour, Anusha M. Vable, Sze Yan Liu, S.V. Subramanian

Department of Public Health Scholarship and Creative Works

Background

Past research shows that spousal death results in elevated mortality risk for the surviving spouse. However, most prior studies have inadequately controlled for socioeconomic status (SES), and it is unclear whether this ‘widowhood effect’ persists over time.

Methods

Health and Retirement Study participants aged 50+ years and married in 1998 (n = 12 316) were followed through 2008 for widowhood status and mortality (2912 deaths). Discrete-time survival analysis was used to compare mortality for the widowed versus the married.

Results

Odds of mortality during the first 3 months post-widowhood were significantly higher than in the continuously married (odds ratio …