Public Health Commons^™

Early Marriage And Reproductive Health Outcomes Among Women In South Asia, Sameen Kazmi

Annual Research Symposium

No abstract provided.

Association Of Asthma With Oral Health In Different Age Groups, Jody Chiang, Amir Mohajeri, Joseph Cheever, Frank Licari, Man Hung

Annual Research Symposium

No abstract provided.

Covid-19 Safety Protocol Communication From School: Dental Students' Experience, Daniel Yevseyevich

Annual Research Symposium

Survey of Dental students' experience of COVID-19 Safety protocols

Determining The Proportionality Of Ischemic Stroke Risk Factors To Age, Elizabeth Hunter, John D. Kelleher

Articles

While age is an important risk factor, there are some disadvantages to including it in a stroke risk model: age can dominate the risk score and lead to over-or under-predictions in some age groups. There is evidence to suggest that some of these disadvantages are due to the non-proportionality of other risk factors with age, eg, risk factors contribute differently to stroke risk based on an individual’s age. In this paper, we present a framework to test if risk factors are proportional with age. We then apply the framework to a set of risk factors using Framingham heart study data …

Not A Waste: Wastewater Surveillance To Enhance Public Health, Anna Gitter, Jeremiah Oghuan, Anuja Rajendra Godbole, Carlos A. Chavarria, Carlos Monserrat, Tao Hu, Yun Wang, Anthony W. Maresso, Blake M. Hanson, Kristina D. Mena, Fuqing Wu

Pharmacy Faculty Articles and Research

Domestic wastewater, when collected and evaluated appropriately, can provide valuable health-related information for a community. As a relatively unbiased and non-invasive approach, wastewater surveillance may complement current practices towards mitigating risks and protecting population health. Spurred by the COVID-19 pandemic, wastewater programs are now widely implemented to monitor viral infection trends in sewersheds and inform public health decision-making. This review summarizes recent developments in wastewater-based epidemiology for detecting and monitoring communicable infectious diseases, dissemination of antimicrobial resistance, and illicit drug consumption. Wastewater surveillance, a quickly advancing Frontier in environmental science, is becoming a new tool to enhance public health, improve …

Characterization Of Food Chain Clostridioides Difficile Isolates In Terms Of Ribotype And Antimicrobial Resistance, Pilar Marcos, Aoife Doyle, Paul Whyte, Thomas R. Rogers, Maire Mcelroy, Seamus Fanning, Jesus Maria Frias, Declan Bolton

Articles

The aim of this study was to characterize C. difficile isolates from the farm, abattoir, and retail outlets in Ireland in terms of ribotype and antibiotic resistance (vancomycin, erythromycin, metronidazole, moxifloxacin, clindamycin, and rifampicin) using PCR and E-test methods, respectively. The most common ribotype in all stages of the food chain (including retail foods) was 078 and a variant (RT078/4). Less commonly reported (014/0, 002/1, 049, and 205) and novel (RT530, 547, and 683) ribotypes were also detected, but at lower frequencies. Approximately 72% (26/36 tested) of the isolates tested were resistant to at least one antibiotic, with the majority …

Prevention Research Center For Healthy Neighborhoods, Madeline Panus

Celebration of Scholarship 2023

No abstract provided.

Massachusetts Prevalence Of Opioid Use Disorder Estimation Revisited: Comparing A Bayesian Approach To Standard Capture-Recapture Methods, Jianing Wang, Nathan Doogan, Katherine L. Thompson, Dana Bernson, Daniel Feaster, Jennifer Villani, Redonna Chandler, Laura F. White, David Kline, Joshua A. Barocas

Statistics Faculty Publications

Background: The National Survey on Drug Use and Health (NSDUH) estimated the prevalence of opioid use disorder (OUD) among the civilian, noninstitutionalized people aged 12 years or older in Massachusetts as 1.2% between 2015 and 2017. Accurate estimation of the prevalence of OUD is critical to the success of treatment and resource planning. Various indirect estimation approaches have been used but are subject to data availability and infrastructure-related issues.

Methods: We used 2015 data from the Massachusetts Public Health Data Warehouse (PHD) to compare the results of two approaches to estimating OUD prevalence in the Massachusetts population. First, we used …

Turnover, Covid-19, And Reasons For Leaving And Staying Within Governmental Public Health, Jonathan P. Leider, Gulzar H. Shah, Valerie A. Yeager, Jingjing Yin, Kusuma Madamala

Biostatistics, Epidemiology & Environmental Health Sciences: Faculty Publications

Background and Objectives:

Public health workforce recruitment and retention continue to challenge public health agencies. This study aims to describe the trends in intention to leave and retire and analyze factors associated with intentions to leave and intentions to stay.

Design:

Using national-level data from the 2017 and 2021 Public Health Workforce Interests and Needs Surveys, bivariate analyses of intent to leave were conducted using a Rao-Scott adjusted chi-square and multivariate analysis using logistic regression models.

Results:

In 2021, 20% of employees planned to retire and 30% were considering leaving. In contrast, 23% of employees planned to retire and 28% …

The Daily Patterns Of Emergency Medical Events, Mary Elizabeth Helander, Margaret K. Formica, Dessa K. Bergen-Cico

Social Science - All Scholarship

This study examines population level daily patterns of time-stamped emergency medical service (EMS) dispatches to establish their situational predictability. Using visualization, sinusoidal regression, and statistical tests to compare empirical cumulative distributions, we analyzed 311,848,450 emergency medical call records from the U.S. National Emergency Medical Services Information System (NEMSIS) for years 2010 through 2022. The analysis revealed a robust daily pattern in the hourly distribution of distress calls across 33 major categories of medical emergency dispatch types. Sinusoidal regression coefficients for all types were statistically significant, mostly at the p < 0.0001 level. The coefficient of determination ($R^2$) ranged from 0.84 and 0.99 for all models, with most falling in the 0.94 to 0.99 range. The common sinusoidal pattern, peaking in mid-afternoon, demonstrates that all major categories of medical emergency dispatch types appear to be influenced by an underlying daily rhythm that is aligned with daylight hours and common sleep/wake cycles. A comparison of results with previous landmark studies revealed new and contrasting EMS patterns for several long-established peak occurrence hours--specifically for chest pain, heart problems, stroke, convulsions and seizures, and sudden cardiac arrest/death. Upon closer examination, we also found that heart attacks, diagnosed by paramedics in the field via 12-lead cardiac monitoring, followed the identified common daily pattern of a mid-afternoon peak, departing from prior generally accepted morning tendencies. Extended analysis revealed that the normative pattern prevailed across the NEMSIS data when re-organized to consider monthly, seasonal, daylight-savings vs civil time, and pre-/post- COVID-19 periods. The predictable daily EMS patterns provide impetus for more research that links daily variation with causal risk and protective factors. Our methods are straightforward and presented with detail to provide accessible and replicable implementation for researchers and practitioners.

Climate Change And The Law Of National Security Adaptation, Mark P. Nevitt

Faculty Articles

The Department of Defense (DoD) is the largest employer in the world, owns and operates an enormous global real estate portfolio, and emits more Greenhouse Gases (GHGs) than many nations. Entrusted with the national security, the DoD is now threatened by a new enemy—climate change. Climate change imperils national security infrastructure while undermining the military’s capacity to respond to climate-driven disasters at home and abroad. However, legal scholarship has yet to address what I call “the law of national security adaptation” and related questions. For example, how do environmental and climate change laws apply to the U.S. military? What laws …

Modeling The Spread Of Covid-19 In Spatio-Temporal Context, S.H. Sathish Indika, Norou Diawara, Hueiwang Anna Jeng, Bridget D. Giles, Dilini S.K. Gamage

Mathematics & Statistics Faculty Publications

This study aims to use data provided by the Virginia Department of Public Health to illustrate the changes in trends of the total cases in COVID-19 since they were first recorded in the state. Each of the 93 counties in the state has its COVID-19 dashboard to help inform decision makers and the public of spatial and temporal counts of total cases. Our analysis shows the differences in the relative spread between the counties and compares the evolution in time using Bayesian conditional autoregressive framework. The models are built under the Markov Chain Monte Carlo method and Moran spatial correlations. …

Using Wastewater-Based Epidemiology To Study Chlamydia Occurrence On A College Campus, Jessie E. Chin Quee

Honors Undergraduate Theses

Chlamydia is a sexually transmitted disease caused by Chlamydia trachomatis, commonly affecting sexually active college-aged adults. Presently, opportunistic testing, self-testing, and information campaigns are methods to screen vulnerable populations and raise awareness about chlamydia. Chlamydia remains underdiagnosed and undertested due to a lack of participation by individuals who may have been exposed to it. Wastewater-based epidemiology is a rising biomonitoring tool that detects the presence of disease- and drug-specific biomarkers in a community's wastewater. In this study, wastewater-based epidemiology was used to detect the presence of C. trachomatis on the University of Central Florida campus. Wastewater samples were collected …

Nutrient Pollution And Chlorophyll-A As A Precursor To Harmful Algal Blooms And Cyanotoxins In Rehabilitated Machado Lake, California, Michael E. Shiang

Walden Dissertations and Doctoral Studies

Algal blooms result in the formation of cyanotoxic conditions in a freshwater lake causing severe detrimental impacts to community and public health. Nitrogen, phosphorous, and ammonia stimulate the growth of phytoplankton biomass and algae, as measured by chlorophyll. This retrospective quantitative research study, grounded in the socioecological model, examined the relationship between nutrient pollutants and chlorophyll-a (Chl-a) that forecast harmful algal blooms, a precursor to cyanotoxins. A former impaired lake, Machado Lake in California, provided an ideal setting to assess relationships among nutrient indicators and Chl-a post-lake rehabilitation. Correlation and multiple regression analyses were performed to determine if a relationship …

Striving For Appropriate Antibiotic Use: A Biomarker Initiative, And Outcomes Associated With Azithromycin Exposure, Amanda Gusovsky

Theses and Dissertations--Pharmacy

The introduction of antibiotics into clinical practice is considered the greatest medical breakthrough of the 20^thcentury. However, the use of antibiotics can contribute to the development of resistance. In the United States (U.S.), approximately 2.8 million people are infected with antibiotic-resistant bacteria each year, and more than 35,000 people die as a result. Moreover, some antibiotics are known to cause cardiac side effects including QT prolongation, hypotension, and ventricular arrythmias. The U.S. Centers for Disease Control and Prevention (CDC) defines appropriate antibiotic use as the effort to use “the right antibiotic, at the right dose, for the right …

Clustering Hospital Performance Using Group-Based Multi-Trajectory Modeling With Singular Bayesian Information Criterion, Gaixin Du

Theses and Dissertations--Epidemiology and Biostatistics

Hospital performance is complex and patient-experience oriented. Currently, the Centers for Medicare and Medicaid Services (CMS) evaluate hospitals yearly with a single score of one to five ("Star Rating") using composite measures from five domains. However, a single composite score cannot fully describe it, and alternative measures should be considered. Healthcare quality improvement needs long-term data to validate effectiveness. Group-based multi-trajectory modeling (GBMTM) estimates probabilities of latent group membership based on longitudinal profiles from multiple outcomes. We use GBMTM to identify groups of hospitals with similar performance in SAS PROC TRAJ.

We downloaded Medicare-eligible hospitals (N=5,111) that provided patient care …

The Effect Of Land-Cover/Land-Use And Habitat Fragmentation On Spatial Patterns Of Lyme Disease In The Eastern United States, Maria Elizabeth Topmiller

Theses and Dissertations--Forestry and Natural Resources

Lyme disease has been of national concern for the past few decades. As our understanding of the role of landscape structure in epidemiology expands, it is essential to apply the principles of landscape ecology to the research of vector-borne and zoonotic disease. This study examined the strength of the relationship between land-cover class, degree of habitat fragmentation and county-level Lyme disease cases. Forest, agricultural, and urban land cover types were the categories of interest, while percent cover, edge density, and patch density were the landscape metric used to measure habitat amount and fragmentation. The general linear trends were modelled with …

Covidanno, Covid-19 Annotation In Human, Yuzhou Feng, Mengyuan Yang, Zhiwei Fan, Weiling Zhao, Pora Kim, Xiaobo Zhou

Faculty, Staff and Student Publications

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the etiologic agent of coronavirus disease 19 (COVID-19), has caused a global health crisis. Despite ongoing efforts to treat patients, there is no universal prevention or cure available. One of the feasible approaches will be identifying the key genes from SARS-CoV-2-infected cells. SARS-CoV-2-infected in vitro model, allows easy control of the experimental conditions, obtaining reproducible results, and monitoring of infection progression. Currently, accumulating RNA-seq data from SARS-CoV-2 in vitro models urgently needs systematic translation and interpretation. To fill this gap, we built COVIDanno, COVID-19 annotation in humans, available at http://biomedbdc.wchscu.cn/COVIDanno/. The aim …

Deposited Cigarette Smoke As A Driver Of Oxidation And Partitioning Processes On Indoor Surfaces, April Hurlock

Honors Theses

Despite the large amount of time that individuals spend indoors during their lives, very little attention was paid to the chemistry that occurs on indoor surfaces until recently. Although not visible to the naked eye, physical and chemical processes, such as partitioning and oxidation, are occurring on virtually every indoor surface in a typical household. Indoor pollutants, ranging from skin oils to environmental cigarette smoke, drive a lot of these processes. The transformation of indoor surfaces by indoor pollutants can increase chemical exposure risks as new irritants or carcinogens can be introduced to the surfaces. In this thesis, I describe …

Nutrient Pollution And Chlorophyll-A As A Precursor To Harmful Algal Blooms And Cyanotoxins In Rehabilitated Machado Lake, California, Michael E. Shiang

Walden Dissertations and Doctoral Studies

Algal blooms result in the formation of cyanotoxic conditions in a freshwater lake causing severe detrimental impacts to community and public health. Nitrogen, phosphorous, and ammonia stimulate the growth of phytoplankton biomass and algae, as measured by chlorophyll. This retrospective quantitative research study, grounded in the socioecological model, examined the relationship between nutrient pollutants and chlorophyll-a (Chl-a) that forecast harmful algal blooms, a precursor to cyanotoxins. A former impaired lake, Machado Lake in California, provided an ideal setting to assess relationships among nutrient indicators and Chl-a post-lake rehabilitation. Correlation and multiple regression analyses were performed to determine if a relationship …

Sun Exposure And Protective Behaviors Among U.S. Hispanic Farmworkers, Claudia Marie Delgado Cebollero

Walden Dissertations and Doctoral Studies

Sun exposure increases the risk of sun-related illnesses and skin cancer among U.S. Hispanic farmworkers. Reinforced by the health belief model, the purpose of this study was to determine the association between socio-demographic factors (i.e., age, educational attainment, gender, income, and marital status) and skin cancer with the level of sun exposure (sun’s effect on skin, sunburn reported) and protective behaviors (use of cap/visor, use of sunscreen) among adult Hispanic farmworkers in the United States. The study included Hispanic farmworkers aged 21 or older (N = 112) who responded to the 2015 National Health Interview Survey. Ordinal logistic regression showed …

Lessons Learned From Interdisciplinary Efforts To Combat Covid-19 Misinformation: Development Of Agile Integrative Methods From Behavioral Science, Data Science, And Implementation Science, Sahiti Myneni, Paula Cuccaro, Sarah Montgomery, Vivek Pakanati, Jinni Tang, Tavleen Singh, Olivia Dominguez, Trevor Cohen, Belinda Reininger, Lara S Savas, Maria E Fernandez

Faculty, Staff and Student Publications

BACKGROUND: Despite increasing awareness about and advances in addressing social media misinformation, the free flow of false COVID-19 information has continued, affecting individuals' preventive behaviors, including masking, testing, and vaccine uptake.

OBJECTIVE: In this paper, we describe our multidisciplinary efforts with a specific focus on methods to (1) gather community needs, (2) develop interventions, and (3) conduct large-scale agile and rapid community assessments to examine and combat COVID-19 misinformation.

METHODS: We used the Intervention Mapping framework to perform community needs assessment and develop theory-informed interventions. To supplement these rapid and responsive efforts through large-scale online social listening, we developed a …

Poisson Regression Model With Application To Wastewater Surveillance Under A Threshold Linear Mixed Model For Covid-19 Sensitivity Rates, Norou Diawara, Hueiwang Anna Jeng, Kyle Curtis, Raul Gonzalez, Nancy Welch, Cynthia Jackson, Rekha Singh, David Jurgens, Sasanka Adikari, Omotomilola Jegede

Mathematics & Statistics Faculty Publications

A Threshold Linear Mixed Model (TLMM) has been developed to identify specific thresholds based on wastewater SARS-CoV-2 viral concentrations, which reflect COVID-19 cases. The thresholds can guide decisions regarding public health responses and prevention measures. To assess the practical application of TLMM, a simple simulation was conducted using a sample size of 100 and 500 replications. The simulation allowed for comparing parameter estimators by assessing bias and standard deviation and the root of the mean square error. The model and estimation procedures were applied to reported wastewater and clinic data to test its application for real-world scenarios. Our results demonstrated …

Annotation And Information Extraction Of Consumer-Friendly Health Articles For Enhancing Laboratory Test Reporting, Zhe He, Shubo Tian, Arslan Erdengasileng, Karim Hanna, Yang Gong, Zhan Zhang, Xiao Luo, Mia Liza A Lustria

Faculty, Staff and Student Publications

Viewing laboratory test results is patients' most frequent activity when accessing patient portals, but lab results can be very confusing for patients. Previous research has explored various ways to present lab results, but few have attempted to provide tailored information support based on individual patient's medical context. In this study, we collected and annotated interpretations of textual lab result in 251 health articles about laboratory tests from AHealthyMe.com. Then we evaluated transformer-based language models including BioBERT, ClinicalBERT, RoBERTa, and PubMedBERT for recognizing key terms and their types. Using BioPortal's term search API, we mapped the annotated terms to concepts in …

Modeling The Bidirectional Relationship Between Shared-Patient Physician Networks And Patient Longitudinal Treatment Patterns: Application To Physician Risky-Prescribing, Xin Ran

Dartmouth College Ph.D Dissertations

Risky-prescribing is a pressing public health concern in the United States. Opioids, benzodiazepines, and non-benzodiazepine sedative-hypnotics (sedative-hypnotics) are three commonly-prescribed but potentially risky drug groups, prescribed alone or in combination. Physician shared-patient networks provide a unique perspective in studying physician network characteristics and structures, as well as their association with the delivery of health care. Understanding how physician shared-patient networks are related to their prescribing may inform network-based interventions targeting risky-prescribing, which is yet to be fully studied.

We investigated patient receipt of risky prescriptions and physician risky-prescribing intensity through the scope of shared-patient networks. We used retrospective Medicare insurance …

Exploring The Evolution Of Trypanosoma Cruzi And The Emergence Of Chagas Disease In The Context Of Environmental Change: Applying The Stockholm Paradigm To Archaeoparasitology, Part I, Aida Romera Barbera, Daniel R. Brooks, T. Michael Fink, Karl J. Reinhard

Karl Reinhard Publications

The Stockholm Paradigm is an evolutionary synthesis that explains the emergence of novel pathogens in the context of environmental disturbances. Considering the urgent climate change situation, anticipation stands as key to prevent and mitigate the effects that climate change can have in the emergence of pathogens. However, the success of preventive measures is hindered by a limited knowledge of the interplaying dynamics between biology, environment, and culture leading to emerging infectious diseases. For many decades, bioarchaeologists have been gathering data on past human-environment interactions, therefore contributing to the conversation. Archaeoparasitology, at the intersection between pathology, bioarchaeology, and biology, is uniquely …

Occupational Risk Perceptions Among Foreign-Born Construction Workers In Central Florida, Matthew Edison Law

Walden Dissertations and Doctoral Studies

Hispanic and Latino foreign-born construction workers in the United States experience higher rates of serious injuries and fatalities in the workplace than their native-born peers. Previous research has pointed to specific vulnerabilities among this population, including birthplace, age of the worker, language barriers, and education level, but little to no research has examined addressable risk factors, such as occupational risk perceptions, among this population. The purpose of this quantitative study was to determine the relationship between birthplace, number of years working in the United States, and occupational risk perceptions while controlling for age of the worker, language barriers, and education …

Forest Bathing Increases Adolescent Mental Well-Being And Connection To Nature: A Transformative Mixed Methods Study, Jennifer Keller

Antioch University Dissertations & Theses

Previous research has demonstrated that practicing forest bathing has significant positive effects on well-being. However, few studies have investigated whether forest bathing increases adolescent well-being despite the growing adolescent mental health crisis in the United States. Similarly, few studies have explored forest bathing’s impacts on connectedness to nature. Considering the ongoing environmental crisis, determining if forest bathing increases connectedness to nature is a critical expansion of forest bathing research, as connectedness to nature is linked to environmental care and concern. This study investigated the possibility that forest bathing, a nature-based mindfulness practice, could increase adolescent mental well-being and connectedness to …

Laboratory Practices And Antimicrobial Resistance In A Florida Hospital, Crispina Marie Sy-Trias

Walden Dissertations and Doctoral Studies

Antibiotic resistance is a health threat affecting millions of Americans. Microorganisms develop resistance to antibiotics, rendering them useless for treating infections. The purpose of this quantitative study was to assess the associations between sample processing time and antibiotic resistance and is based on the health belief model. A retrospective specimen tracking activity of data from November 2019 to November 2020 was obtained by random sampling of 246 bacterial cultures. One hundred ninety-six (80%) samples were processed on time, and 50 (20%) were delayed; 167 (68%) samples were determined to have the presence of antimicrobial resistance (AMR), and 79 (32%) with …

Occupational Risk Perceptions Among Foreign-Born Construction Workers In Central Florida, Matthew Edison Law

Walden Dissertations and Doctoral Studies

Hispanic and Latino foreign-born construction workers in the United States experience higher rates of serious injuries and fatalities in the workplace than their native-born peers. Previous research has pointed to specific vulnerabilities among this population, including birthplace, age of the worker, language barriers, and education level, but little to no research has examined addressable risk factors, such as occupational risk perceptions, among this population. The purpose of this quantitative study was to determine the relationship between birthplace, number of years working in the United States, and occupational risk perceptions while controlling for age of the worker, language barriers, and education …