Public Health Commons^™

Health Profiles Of Newly Arriving Refugees In Kentucky, 2016: Data From The University Of Louisville Global Health Program, Ruth M. Carrico, Timothy L. Wiemken, Rahel Bosson, William A. Mattingly, Rebecca Ford, Sarah Van Heiden, Stanley Kotey, Julio A. Ramirez

Journal of Refugee & Global Health

Objectives: Refugees resettling in the United States bring with them a number of health conditions, the majority chronic. These health conditions may impact their ability to be successful with disease self-management and employment, and acculturate and thrive in their new communities. Knowledge of health conditions present in individual refugee populations can be of benefit to healthcare providers in the community and public health. The objective of this manuscript is to describe the state of health among refugees newly arriving in the US and resettling in Kentucky during 2016.

Methods: Using data from the domestic health screens, immunization clinics, and the …

Refugee-Centered Medical Home:A New Approach To Care At The University Of Louisville Global Health Center, Rahel Bosson, Ruth M. Carrico, Anupama Raghuram, Paula Peyrani, William A. Mattingly, Rebecca Ford, Stephen P. Furmanek, Julio A. Ramirez

Journal of Refugee & Global Health

Refugees arrive to the United States with a full spectrum of health conditions, many of which involve intense case management requiring significant financial investments and use of healthcare resources. Kentucky receives more than 3,000 new refugees each year and ranked 10th in the nation for numbers of new arrivals resettled during 2015. These refugees arrive from diverse countries representing different cultures and speaking different languages. In addition, they arrive with diverse health conditions and medical needs. The aims of this paper are to share experiences from the University of Louisville Global Health Center regarding conceptualization, implementation and evaluation of a …

Use Of Emergency Department For Care Access By Refugees Resettling In Kentucky, 2015: Findings From The University Of Louisville Global Health Center, Ruth M. Carrico, Carmen Mitchell, Dawn Balcom, Linda Goss, Anna Persaud, Karen Mutsch, Timothy L. Wiemken, Rahel Bosson, Julio A. Ramirez

Journal of Refugee & Global Health

Background: Kentucky is one of the largest rural resettlement areas for refugees in the US welcoming more than 3,000 refugees and other entrants during 2015. Refugees arrive with a number of chronic health conditions that require ongoing management in a healthcare system where they lack knowledge and ability to navigate. This may encourage them to seek care that is easy to access but episodic and fragmented. The objective of this study was to determine the frequency and reasons for accessing care via a local emergency department by resettling refugees during their first twelve months of resettlement.

Methods: Using data from …

Subjective Well-Being And Hiv Prevention: A Cross-Country Descriptive Study Using Multiple Indicator Cluster Survey Data, Janine Foggia, Anne Sebert Kuhlmann

Journal of Refugee & Global Health

Subjective well-being (SWB) is positively associated with improved health outcomes and, in particular, preventative behaviors. Yet, the relationship between SWB and HIV prevention is not well understood, especially in the context of developing countries. Furthermore, young females experience a high burden of HIV as well as sociodemographic factors which influence SWB. Therefore, this descriptive study sought to describe the global landscape of three constructs of SWB - happiness, life satisfaction, and life perception - and the following HIV prevention variables: comprehensive HIV knowledge, HIV testing, and condom use among young adult females aged 15-24 years. Descriptive statistics of Multiple Indicator …

Evaluating Mental Health In Cuban Refugees: The Role Of The Refugee Health Screener-15, Rahel Bosson, Victoria A. Schlaudt, Monnica T. Williams, Ruth M. Carrico, Adriana Peña, Julio A. Ramirez, Jonathan Kanter

Journal of Refugee & Global Health

The Refugee Health Screener-15 (RHS-15) is widely used in refugee populations, but the psychometric properties and clinical utility have not been evaluated in Cuban refugees and entrants. The current study explored results from the Spanish version of the RHS-15 in a sample of 53 Cuban entrants and refugees, and of these, 17.6% screened positive for a mental health concern. Analyses suggested that a positive screening was significantly related to symptoms of anxiety, depression, and posttraumatic stress disorder; however, it was not associated with demographic variables such as gender, mode of transport, or the number of countries through which a refugee …

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

Electronic Theses and Dissertations

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

Coal Ash Exposure And Asthma In Children., Jack Anthony Pfeiffer

Electronic Theses and Dissertations

This study examined the association between exposure to coal ash in the home among children aged 6-14 and asthma. Data was collected using personal modular impactors, lift tape samples, toe/finger nail samples, questionnaires, and peak flow meters. Laboratory methods used to analyze the samples included gravimetric analysis, scanning electron microscopy (SEM) / energy dispersive x-ray (EDX), and proton-induced x-ray emission (PIXE). Statistical methods used to analyze the data included the Chi Square Test of Independence, logistic regression, the Hosmer-Lemeshow Goodness of Fit test, Fisher’s Exact Test, and the Anderson-Darling Normality Test. Sample size was small, making statistical significance in calculated …

Intergenerational Music Therapy : Bridging The Generational Gap Through Community-Based Music Making., Michael R. Detmer, Petra Kern, Jill Jacobi-Vessels, Kristi M. King

Faculty and Staff Scholarship

No abstract provided.

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.

A New Journal Section: Patient Management, Forest W. Arnold, Rodrigo Cavallazzi

The University of Louisville Journal of Respiratory Infections

No abstract provided.

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 …

Short Duration Of Antibiotic Therapy In Hospitalized Patients With Community-Acquired Pneumonia: Results From The Capo International Cohort Study, Alejandro Chirino Navarta, Paula Peyrani, Timothy L. Wiemken, Marcos I. Restrepo, James D. Chalmers, Carlos M. Luna, Francesco Blasi, Julio A. Ramirez, Stefano Aliberti

The University of Louisville Journal of Respiratory Infections

Introduction: Experts suggest a short duration of antibiotic therapy (DOT) in responding patients with community-acquired pneumonia (CAP). The aim of this study was to evaluate clinical outcomes after hospital discharge among patients treated with short-course antibiotic therapy (SCT) vs. long-course antibiotic therapy (LCT) for CAP.

Methods: A secondary analysis of the Community-Acquired Pneumonia Organization (CAPO) database from January 2007 to June 2013 was performed, including hospitalized CAP patients who reached clinical stability within 5 days. Two groups were identified: patients who were treated with antibiotic therapy for a total duration of 5 days or less (SCT Group) vs. …

The Presence Of Copd Does Not Influence Clinical Outcomes In Hospitalized Patients With Community-Acquired Pneumonia, Rosemeri Maurici, Alessandra Morello Gearhart, Vanessa Viríssimo Maciel, Forest Arnold, Francisco Fernandez, Annuradha K. Persaud, Stephen Furmanek, Timothy Wiemken, Julio Ramirez, Rodrigo Cavallazzi

The University of Louisville Journal of Respiratory Infections

Introduction

Community-acquired pneumonia (CAP) is a leading cause of death worldwide. Chronic obstructive pulmonary disease (COPD) is a well-established risk factor for development of CAP. What is not as clear is the impact of COPD in the outcomes of patients with CAP. In this study, we compared the outcomes of CAP in COPD and non-COPD patients.

Methods

This was a retrospective cohort study. We conducted a secondary analysis of the Community-Acquired Pneumonia Organization (CAPO) international cohort study database, which includes patients with CAP admitted to several hospitals throughout the world. Outcomes were time to clinical stability, length of hospital stay, …

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 …

A 49-Year-Old Woman With Chronic Skin Lesions, Acute Mental Status Changes And New Pulmonary Infiltrate: Case Discussion From The University Of Louisville Hospital, Bhavani Puskur, Youssef Khafateh, Srikant Ramachandruni, Veronica Corcino, Mark Burns, Forest W. Arnold

The University of Louisville Journal of Respiratory Infections

No abstract provided.

Clinical Research: Educational Videos - The Process Of Clinical Research: Step-By-Step From Idea To Publication, Julio A. Ramirez

The University of Louisville Journal of Respiratory Infections

Clinical research can be defined as the creation and dissemination of new knowledge with the goal to improve outcomes in patients with a particular health problem. In this short video, Dr. Julio Ramirez, from the University of Louisville, offers an overview of the process of clinical research and describe how an investigator moves from the generation of an idea to the publication of study findings.

Making Sex Work For The State : The Policing Of Sex Work In The United States., Madeline A Clabough

College of Arts & Sciences Senior Theses

This thesis analyzes the ways that sex work is regulated within the United States, and analyze the ways that regulation is shaped by contemporary feminist discourse. To do so, it analyzes the ways in which sex workers have been and pathologized since the 19th century, and address the ways that these conceptualizations have been incorporated into the legal regulation of sex workers. Finally, this thesis will look to contemporary practices in the state regulation of sex workers, and argue that the relationship between neoliberalism, the carceral state, and what has come to be termed “carceral feminism” operate in conjunction to …

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

Electronic Theses and Dissertations

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

Prenatal Depression Screening Among A Diverse Healthy Start Population., Evangeline Pierce

Electronic Theses and Dissertations

Prenatal depression has been associated with adverse outcomes for both pregnant women and infants. Data was studied from Healthy Start (n=1093). Healthy Start participants were screened for depression using the Edinburgh Postnatal Depression Scale (EPDS) during pregnancy. Data reported included birthweight, gestational length, ethnicity, and sociodemographic variables. No statistically significant association was found between a positive EPDS screen and birthweight-low/normal (OR 1.02 [95% CI 0.53, 1.70]), birthweight-abnormal (OR 1.02 [95% CI 0.53, 1.70], or gestation-preterm/term (OR 1.29 [95% CI 0.68, 2.45]). An association was observed between a positive screen and race, ethnicity by region of origin, immigrant status, English as …

The Particulars About Particulates : Metal Exposure And Self-Regulation Of Children Living Near Coal Ash., Clara G. Sears

Electronic Theses and Dissertations

The use of coal combustion for electricity and the storage of coal combustion by-products known as coal ash occur across the United States and around the world. The most abundant type of coal ash, fly ash, contains small particles with metals, some of which are known neurotoxins. Fly ash is currently stored in open-air landfills and surface impoundments that allow fugitive dust to escape into surrounding communities, potentially exposing children to small neurotoxic particles. This dissertation uses preliminary data from a larger cross-sectional study to investigate the relationship between particulate matter exposure, metal exposure, and problems with self-regulation. Recruitment of …

Evaluating The Impact Of Statewide Policy Implementation On Interorganizational Collaboration At The Regional Level : An Application Of Network Analysis., Nida Moez Ali

Electronic Theses and Dissertations

One challenge to improving population health in the United States is that the systems tasked with the responsibility of providing services across the continuum of care often operate in silos, missing opportunities to provide quality, coordinated care. In 2011, Texas received approval from the Centers for Medicare and Medicaid Services (CMS) for a five-year 1115(a) Medicaid Waiver Demonstration Project. This dissertation focuses on one element of the Waiver, the Delivery System Reform Incentive Payment (DSRIP) Program, which was designed to incentivize activities that support organizations’ collaborative efforts with other organizations in addressing the Triple Aim strategies. DSRIP was implemented through …

The Effect Of Caffeine On Fecundability : Differences In Coffee, Tea, And Cola Consumption., Emily Kathleen Steinmetz

Electronic Theses and Dissertations

This study examined whether intake of caffeinated beverages (coffee, tea, and cola) was associated with fecundability (time to pregnancy) in a prospective cohort study. Data from 470 women from the Mount Sinai Study of Women Office Workers (1990-1994) were analyzed. Intake of coffee, tea, cola, and other variables were recorded in daily diaries and calculated as menstrual cycle level means for up to 20 cycles. Pregnancy was assayed using hCG and confirmed by physician diagnosis. The associations of caffeinated beverages with the probability of becoming pregnant during a given cycle were determined using discrete survival analysis, adjusted for potential confounders. …

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

Electronic Theses and Dissertations

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

Pediatric Anxiety And/Or Depression Problems : Associations With Pm10, Fly Ash, And Metal Exposure., Abby Nicole Burns Hagemeyer

Electronic Theses and Dissertations

Background: In the last several decades, the use of coal has become more prevalent in turn increasing the amount of coal ash being produced. Coal ash, the by-product of coal combustion, is composed of small particles that contain essential elements, hazardous metals, polycyclic aromatic hydrocarbons, and radioactive material. While a small proportion of coal ash is reused, the majority gets discarded in open-air landfills and ash ponds. Fly ash, the major component of coal ash, can become emitted into the air and potentially contribute to the air pollution and metal exposure in the surrounding community. Few studies, particularly in the …

Clinical & Translational Research In Pneumonia: Defining A Research Agenda For Today And Tomorrow, Julio A. Ramirez

The University of Louisville Journal of Respiratory Infections

From the Editor in Chief

The reason for this special supplement of the Journal is to inform readers of a scientific research conference supported by the National Institutes of Health (NHI). The NIH Research Conference Grant (R13) supports high quality scientific conferences in areas that are important to the NIH's mission and to the public health. We just received notification that the National Heart, Lung, and Blood Institute (NHLBI) has approved the application for an international research conference entitled: DzClinical & Translational Research in Pneumonia: Defining a Research Agenda for Today and Tomorrowdz. The conference will be held on Wednesday, …

Examining Cervical Cancer Screening Utilization Among African Immigrant Women: A Literature Review, Adebola Adegboyega, Mollie Aleshire, Ana Maria Linares

Faculty and Staff Scholarship

Background: Globally, 530,000 women per year are diagnosed with cervical cancer, and approximately 275,000 die from the disease. Routine cervical cancer screening may reduce the burden of cervical cancer morbidity and mortality through early detection and improved treatment outcome. Immigrant women in the United States (U.S.) may be disproportionately affected by cervical cancer; however, there is scarce literature addressing cervical cancer screening in African immigrants (AIs) when compared to other immigrant groups. This systematic review evaluates the state of cervical cancer screening research in AIs and identifies current gaps.

Materials and methods: Through a comprehensive literature search, we identified 16 …

Clinical Outcomes Of Community-Acquired Pneumonia In Patients With Diabetes Mellitus, Siddartha Bandhary, Bolivar Y. Contreras-Mora, Ruby Gupta, Patricia Fernandez, Patricio Jimenez, Paula Peyrani, Timothy L. Wiemken, Steven Burdette, Julio A. Ramirez, Hadi Harati, Jose Bordon

The University of Louisville Journal of Respiratory Infections

Background: Studies have found admission hyperglycemia as a predictor of poor outcomes in Community acquired Pneumonia (CAP), whereas others have not. The objective of this study was to evaluate the impact of diabetes mellitus (DM) on mortality as well as Length of stay (LOS) and Time to clinical stability (TCS) of hospitalized patients with CAP.

Materials and Methods: Adult patients hospitalized with CAP enrolled at Community-Acquired Pneumonia Organization (CAPO) database with DM were categorized as admission blood glucose ≥ 250 mg/dL (diabetes mellitus blood sugar (BG) > 250) and admission blood glucose ≤ 250 mg/dL (DM BG ≤ 250). CAP outcomes …

Why A New Journal?, Julio A. Ramirez

The University of Louisville Journal of Respiratory Infections

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