Public Health Commons^™

The Medical Evaluation Of The Newly Resettled Female Refugee: A Narrative Review, Anne Duckles, Aba Barden-Maja, Julie Caplow

Journal of Refugee & Global Health

The number of forcibly displaced individuals worldwide is increasing each year, reaching 65 million persons by the end of 2015, half of which were women and children. As the population of displaced persons grows, it is every physician’s responsibility to understand these patients and their health needs. Refugee patients and the providers who care for them face many barriers to effective patient care, including language barriers, cultural differences, and systematic inequalities. Female refugees commonly experience gender-based violence, repetitive trauma, stigmatized mental illness, and cultural barriers to women’s healthcare. This review is intended to be a comprehensive guide for the provider …

The Brandeis Human Rights Advocacy Program: Advancing The Human Rights Of The Immigrant, Noncitizen And Refugee Community, Enid Trucios-Haynes

Journal of Refugee & Global Health

The Human Rights Advocacy Program (HRAP or the Program) at the Brandeis School of Law, University of Louisville, represents a unique collaboration of law faculty and students providing critical resources to the local immigrant, noncitizen and refugee community in Louisville, Kentucky, as well as local service providers to this community. The Program, established in Spring 2014, is distinctive because of its non-hierarchical internal model and the participatory action research and policy focus of its work. The Program is a distinguished from the typical law school clinical model in its focus on community engaged research, policy advocacy, and service, as well …

Perceptions, Careseeking, And Experiences Pertaining To Non-Cephalic Births In Rural Sarlahi District, Nepal: A Qualitative Study., Naoko Kozuki, Luke C Mullany, Subarna K Khatry, James M Tielsch, Steven C Leclerq, Caitlin E Kennedy, Joanne Katz

Global Health Faculty Publications

BACKGROUND: In low-resource settings, a significant proportion of fetal, neonatal, and maternal deaths can be attributed to intrapartum-related complications. Certain risk factors, such as non-cephalic presentation, have a particularly high risk of complications. This qualitative study describes experiences around non-cephalic births and highlights existing perceptions and care-seeking behavior specific to non-cephalic presentation in rural Sarlahi District, Nepal.

METHODS: We conducted in-depth interviews with 34 individuals, including women who recently gave birth to a non-cephalic infant and female decision-makers in their households. We also conducted two focus groups with mothers (have two or more children, with at least one child under …

Epigenome-Wide Association Study Of Metabolic Syndrome In African-American Adults, Tomi Akinyemiju, Anh N. Do, Amit Patki, Stella Aslibekyan, Degui Zhi, Bertha Hidalgo, Hemant K. Tiwari, Devin Absher, Xin Geng, Donna K. Arnett, Marguerite R. Irvin

Epidemiology and Environmental Health Faculty Publications

Background: The high prevalence of obesity among US adults has resulted in significant increases in associated metabolic disorders such as diabetes, dyslipidemia, and high blood pressure. Together, these disorders constitute metabolic syndrome, a clinically defined condition highly prevalent among African-Americans. Identifying epigenetic alterations associated with metabolic syndrome may provide additional information regarding etiology beyond current evidence from genome-wide association studies.

Methods: Data on metabolic syndrome and DNA methylation was assessed on 614 African-Americans from the Hypertension Genetic Epidemiology Network (HyperGEN) study. Metabolic syndrome was defined using the joint harmonized criteria, and DNA methylation was assessed using the Illumina HumanMethylation450K Bead …

A Mini Review Of The Zoonotic Threat Potential Of Influenza Viruses, Coronaviruses, Adenoviruses, And Enteroviruses, E. S. Bailey, J. K. Fieldhouse, J. Y. Choi, G. C. Gray

Public Health

No abstract provided.

Success And Limitations Of Hepatitis C Screening In The Inpatient Setting, Madalene Zale, Mphc, Priya Mammen, Md, Mph

College of Population Health Posters

This study evaluates the outcomes that a state level mandate for HCV screening with HCV-Antibody-only has on linkage to care and access to treatment, compared to a specific programmatic effort, which includes HCV confirmation.

Markers Of Cardiometabolic Risk And Thyroid Dysfunction In U.S. Adolescents: Nhanes Iii, Jonathan Austin

Theses and Dissertations

The global prevalence of metabolic syndrome (MetS) and its associated components (high fasting glucose, waist circumference, blood pressure, triglycerides, and low HDL) have increased over the past few decades. In addition, abnormal thyroid hormone levels have been found to manifest in a cascade of metabolic dysfunction, which may be linked to MetS in youth. PURPOSE: The purpose of the study is to investigate the association between MetS, its components, and markers of thyroid function in a nationally-representative sample of adolescents. METHODS: The National Health and Nutrition Examination Survey III (1988-1994) collected data on the components of metabolic syndrome and thyroid …

Adult Patients Living With Human Immunodeficiency Virus Hospitalized For Community-Acquired Pneumonia In The United States: Incidence And Outcomes, Leslie A. Beavin, Stephen P. Furmanek, Paula Peyrani, Anupama Raghuram, Forest W. Arnold, Mark Burns, Julio A. Ramirez

The University of Louisville Journal of Respiratory Infections

Background: Community-acquired pneumonia (CAP) is a common infectious reason for hospitalization of adults in the United States (US), including those with Human Immunodeficiency Virus (HIV). While there are studies detailing the incidence and outcomes for all adults with CAP we are not aware of a recent study detailing incidence and outcomes in adult HIV patients hospitalized with CAP. The objectives of this study were (1) to define the current incidence and outcomes of adult HIV patients hospitalized with CAP in Louisville, Kentucky, and (2) to estimate the burden of CAP in the US HIV adult population.

Methods: This was a …

A Software Tool For Automated Upload Of Large Clinical Datasets Using Redcap And The Capo Database, William A. Mattingly, Christopher Sinclair, Danna Williams, Matthew Grassman, Stephen Furmanek, Kimberley Buckner, Mohammad Tahboub

The University of Louisville Journal of Respiratory Infections

Introduction: Obtaining clinical data from healthcare sources is necessary for conducting clinical research. New technologies now allow for connecting a research database to Electronic Medical Records remotely, allowing the automatic import of clinical research data. In this paper we design and evaluate a REDCap extension to import clinical records from an external health database.

Methods: Many hospital EHRs are designed to use secure file transfer protocol (SFTP) repositories for data communication. We develop a REDCap plugin to connect to an external SFTP file repository for the import of clinical record data. We use the CAPO instance of REDCap and a …

Bacteremic Pneumococcal Pneumonia: A Longitudinal Study In 279 Adult Patients From A Single Center, Jorge H. Gentile, Claudia Hernandez, Monica D. Sparo, Edgardo M. Rodriguez, Carolina Ceriani, Florencia Bruggesser

The University of Louisville Journal of Respiratory Infections

Background: Bacteremic pneumococcal pneumonia (BPP) is the most common clinical presentation of invasive pneumococcal disease (IPD). Although it has been extensively studied, there is little knowledge in our region in relation to burden of disease, demographic and outcome features.

Methods: We conducted a prospective, longitudinal, observational study from 1989 to 2015 in adult patients with BPP, in order to deepen our knowledge of the characteristics of this disease in our community hospital in Tandil, Argentina.

Results: 279 patients were included. The mean incidence was 2.8/1000 admissions with a sharp decrease in the last two years, reaching 0.8/1000 admissions. Mean patient …

An Hiv-Positive Patient With Copd Admitted To The Icu With Respiratory Failure, Bhavani Puskur, Veronica Corcino, Srikant Ramachandruni, Viswanathan Nagarajan, Forest W. Arnold

The University of Louisville Journal of Respiratory Infections

No abstract provided.

Non-Resolving Community Acquired Pneumonia (Cap) Due To Blastomyces Dermatitidis (Pulmonary Blastomycosis): Case Report And Review Of Literature, Johnson Britto

The University of Louisville Journal of Respiratory Infections

In this case report, we describe a case of progressive acute pulmonary blastomycosis in a healthy adult living in Kentucky, initially presenting with flu like illness with a left sided consolidation, who did not respond to antibiotic therapy. Patient’s clinical condition deteriorated with development of necrotizing bronchopneumonia, mediastinal lymphadenopathy, tree-in-bud reticulonodularity and pleural effusion. A diagnosis of progressive pulmonary blastomycosis was established by radiological findings as well as transbronchial needle aspiration cytology and bronchoalveolar lavage culture demonstrating Blastomyces dermatitidis. Patient showed significant clinical improvement with resolution of pulmonary lesions on antifungal treatment. Since symptoms of blastomycosis are often similar to …

Moderate Prenatal Alcohol Exposure Impairs Performance In An Object-Place-Paired-Associate Task, Lilliana May Sanchez

Psychology ETDs

Memory impairments, including spatial and object processing, are often observed in individuals with Fetal Alcohol Spectrum Disorder. Much attention has been directed towards the hippocampus, which displays significant alterations after moderate prenatal alcohol exposure (PAE). In the present study, we tested a moderate PAE rat model in an object-place-paired-associate (OPPA) task, previously shown to require hippocampal processing. The OPPA task was composed of training rats to discriminate between an identical pair of objects presented in 180° opposite arms of a radial arm maze. Animals were given a total of 10 trials per day over 14 consecutive days of training and …

Geospatial Inequalities And Determinants Of Nutritional Status Among Women And Children In Afghanistan: An Observational Study, Nadia Akseer, Zaid Ahmad Bhatti, Taufiq Mashal, Sajid Bashir Soofi, Rahim Moineddin, Robert E Black Md, Zulfiqar Ahmed Bhutta

Department of Paediatrics and Child Health

Background: Undernutrition is a pervasive condition in Afghanistan, and prevalence is among the highest in the world. We aimed to comprehensively assess district-level geographical disparities and determinants of nutritional status (stunting, wasting, or underweight) among women and children in Afghanistan.
Methods: The study used individualised data from the recent Afghanistan National Nutrition Survey 2013. Outcome variables were based on growth and weight anthropometry data, which we analysed linearly as Z scores and as dichotomous categories. We analysed data from a total of almost 14 000 index mother–child pairs using Bayesian spatial and generalised least squares regression models accounting for the …

Effectiveness Of The Influenza Vaccine In Preventing Hospitalizations Of Patients With Influenza Community-Acquired Pneumonia, Thomas Chandler, Stephen P. Furmanek, Connor L. English, Connor Glick, Wesley Trail, Lara Daniels, Ugochukwu Owolabi, Ruth Carrico, Julio A. Ramirez, Timothy L. Wiemken

The University of Louisville Journal of Respiratory Infections

Introduction: Influenza vaccination is the primary strategy for prevention of influenza infection. Influenza infection can vary from mild or even asymptomatic illness to severe community-acquired pneumonia (CAP). Although many national and international investigators and organizations report annual estimates of influenza vaccine effectiveness for prevention of influenza infection in the community, few studies report estimates for the prevention of hospitalizations due to influenza CAP, the most severe form of the infection. The objective of this study is to determine the effectiveness of the influenza vaccine for prevention of hospitalization in patients with influenza-associated CAP.

Methods: This was a test-negative study using …

Duration Of Antibiotic Therapy For Patients With Bacteremic Staphylococcus Aureus Community-Acquired Pneumonia, Julio A. Ramirez, Thomas File, Daniel Musher

The University of Louisville Journal of Respiratory Infections

No abstract provided.

Real-Time Pcr Detection Of Mycoplasma Pneumoniae, Chlamydia Pneumoniae And Legionella Pneumophila In Respiratory Specimens Using The Aries® System, Subathra Marimuthu, Leslie A. Wolf, James T. Summersgill

The University of Louisville Journal of Respiratory Infections

Background: Mycoplasma pneumoniae (Mpn), Chlamydia pneumoniae (Cpn), and Legionella pneumophila (Lpn) can cause both epidemic and endemic occurrences of acute respiratory disease and are responsible for up to 22% of cases of community acquired pneumonia. Due to the limited availability of FDA-approved molecular diagnostic assays, we developed and evaluated a multiplexed Real-time PCR assay for the detection of these agents in two respiratory specimen types on the Luminex ARIES® instrument. The instrument provides for nucleic acid extraction plus PCR amplification and target detection in the same cassette. The ARIES® instrument generates a cycle threshold value and a confirmatory melt curve …

Communication Between Clinicians And The Hospital-Based Microbiology Laboratory: Strategies For 2018 And Beyond, Hans H. Liu

The University of Louisville Journal of Respiratory Infections

No abstract provided.

Mycobacterium Kansasii As The Primary Etiology Of Pulmonary Infections Due To Non-Tuberculous Mycobacterium (Ntm) In Patients Without Human Immunodeficiency Virus (Hiv): Experience From A Center In Buenos Aires, Argentina, Gabriel Yusti, Marcela Heres, Alejandra González, Mariano Fielli, Adrian Ceccato, Alejandra Zapata

The University of Louisville Journal of Respiratory Infections

Introduction: Pulmonary diseases due to non-tuberculous mycobacterium (NTM) lung infection in HIV-negative patients are rarely described in the literature. Currently, NTM consist of more than 150 species, and they are globally ubiquitous in both natural and man-made environments.The objective of this study was to define the most frequent species of NTM causing pulmonary disease in HIV-negative patients in the city of Buenos Aires, Argentina. The prevalence of pulmonary diseases caused by NTM is difficult to determine since the isolation of NTM does not necessarily indicate disease.

Methods: A retrospective review of all the respiratory cultures positive for NTM in the …

Research Support Infrastructure: Implementing A Clinical Research Coordinating Center, Julio A. Ramirez, Paula Peyrani, William A. Mattingly, Forest W. Arnold, Timothy L. Wiemken, Robert R. Kelley, Leslie A. Wolf, Ruth M. Carrico, The Clinical Research Coordinating Center Team

The University of Louisville Journal of Respiratory Infections

Insufficient infrastructure is one of the challenges facing investigators in the field of clinical research. At the University of Louisville (UofL) Division of Infectious Diseases, we developed a multidisciplinary coordinating center with the aim to support investigators in all aspects of the clinical research process. The objective of this article is to describe the composition and the role of the different units of the UofL Clinical Research Coordinating Center. The different components of the Center can serve as a template for institutions interested in developing a clinical research support infrastructure.

Clinical Research: From Idea To Publication, Julio A. Ramirez

The University of Louisville Journal of Respiratory Infections

Julio A. Ramirez, M.D., FACP, Professor of Medicine/Associate Professor of Microbiology and Immunology; Chief, Division of Infectious Diseases; Director, Infectious Diseases Fellowship Training Program and Founding Director, Global Health Initiative at The University of Louisville, presented "Clinical Research: From Idea to Publication" at University of Louisville Department of Medicine Grand Rounds on February 15, 2018. The talk focused on performing an overview of clinical study designs, describing the planning and performing of a clinical study, reviewing the process for statistical and clinical analysis, and presenting the structure of a Clinical Research Coordinating Center.

Disparity Of Imputed Data From Small Area Estimate Approaches – A Case Study On Diabetes Prevalence At The County Level In The U.S, Lung-Chang Chien, Ge Lin, Xiao Li, Xingyou Zhang

School of Public Health Faculty Research

This paper assesses concordance and inconsistency among three small area estimation methods that are currently providing county-level health indicators in the United States. The three methods are multi-level logistic regression, spatial logistic regression, and spatial Poison regression, all proposed since 2010. Diabetes prevalence is estimated for each county in the continental United States from the 2012 sample of Behavioral Risk Factor Surveillance System. The mapping results show that all three methods displayed elevated diabetes prevalence in the South. While the Pearson correlation coefficients among three model-based estimates were all above 0.60, the highest one was 0.80 between the multilevel and …

Research Support Infrastructure: Implementing A Clinical Research Coordinating Center, Julio A. Ramirez, Paula Peyrani, William A. Mattingly, Forest W. Arnold, Timothy L. Wiemken, Robert R. Kelley, Leslie A. Wolf, Ruth M. Carrico, Andrea Reyes-Vega

Faculty and Staff Scholarship

Insufficient infrastructure is one of the challenges facing investigators in the field of clinical research. At the University of Louisville (UofL) Division of Infectious Diseases, we developed a multidisciplinary coordinating center with the aim to support investigators in all aspects of the clinical research process. The objective of this article is to describe the composition and the role of the different units of the UofL Clinical Research Coordinating Center. The different components of the Center can serve as a template for institutions interested in developing a clinical research support infrastructure.

Amphibians And Reptiles As A Source Of Salmonella – A Review Of Salmonella Outbreaks In A Period Of Last Ten Years, Mateusz Drozdz, Gabriela Bugla-Plooskonska

Appalachian Student Research Forum

Salmonellosis is a serious problem of public health that mainly infants, young children and people with immunodeficiencies face. Human direct contact with animals is one of the possible ways of transmission of the disease. An increasing trend of keeping exotic pets, including amphibians and reptiles, has been observed for recent years in the United States and developing European countries. Most of these animals are asymptomatic carriers of Salmonella. However, in this review we introduced new and the most dangerous outbreaks of salmonellosis caused by contact with amphibians and reptiles that appeared in all continents in last ten years.

It was …

Promoting Health Education And Literacy In Rural Tennessee: The Go-Packs Pilot Project, Taylor Cox, Claire Gleadhill, William Seagrave, Coty Cooper, Alantis Hunt, Kelly Mitchell, Anthony Delucia, Randy Byington

Appalachian Student Research Forum

Little Milligan Elementary School in rural Carter County, Tennessee was provided with health literacy resources in the form of health education Go-Packs––easily implementable lessons contained in a small storage tote––as part of the community project requirement of the James H. Quillen College of Medicine Rural Primary Care Track Curriculum. These Go-Packs included detailed lesson plans and accompanying materials that were designed to facilitate health education in the classrooms by providing easily deployable lessons for the teachers to utilize. Four Go-Packs were provided for hygiene, oral health, tobacco use, and nutrition that teachers used to augment instruction during teachable moments that …

Recent Incidences And Trends Of The Top Five Cancers In Northeast Appalachian Tennessee, Adekunle Oke, Sylvester Olubolu Orimaye, Ndukwe Kalu, Faustine Williams

Appalachian Student Research Forum

Introduction: Cancer is the second leading cause of death in the United States (U.S.), after cardiovascular disease. Although there has been a continuous decline in cancer mortality rates in the U.S. over the past two decades, the Appalachian region, which extends through 13 states and 420 counties in the southeastern part of the U.S., has seen a lower decline in cancer mortality. From 1980-2014, cancer deaths decreased by almost 45%, but cancer mortality rates in rural Appalachia was 36% higher than for urban non-Appalachian counties. In terms of cancer-specific, although breast cancer mortality rates have also decreased significantly nationally, a …

The Distribution Of Hepatitis C Virus Genotypes In Us Population. Data From Nhanes 2006-2016, Hilary Elom, Shimin Zheng

Appalachian Student Research Forum

Background: Unlike other non-hepatitis c viral infection, hepatitis c viral infection is a non-vaccine preventable disease. Thus, effective treatment is an important part in the prevention of complication of chronic hepatitis c infection. The viral genotype plays a significant role in the choice of treatment regimen.

Aim: the purpose of this study is to estimate the prevalence of hepatitis c viral infection and the distribution of viral genotype in the US population.

Methods: Diagnosis of Hepatitis C viral infection was made by assaying the blood specimen collected from the study participants using Ampiclor monitor (Roche Diagnostic System, Inc Branchburg …

Characterization Of Scanning Mobility Particle Sizers For Use With Nanoaerosols, Michael R. Henderson

USF Tampa Graduate Theses and Dissertations

The purpose of this study was to evaluate the performance of scanning mobility particle sizers in the characterization of nanoaerosols. A sampling chamber was constructed from aluminum and tempered glass, had a volume of 4.6 cubic feet, and was designed for the introduction of aerosols and dilution air, maintenance of aerosol concentration, and continuous exhaust of chamber air. Penetration and aerosol distribution tests were conducted within the chamber. An aerosol generation and measurement system comprised of nitrogen gas, BGI 3 jet Collison Nebulizer, diffusion dryer, aerosol charge neutralizer, mixing chamber, critical orifice, hygrometer, condensation particle counter, scanning mobility particle sizer, …

Seroprevalence Of Anti-Polio Antibodies In Children From Polio High Risk Area Of Afghanistan: A Cross Sectional Survey 2017, Imtiaz Hussain, Ondrej Mach, Nasir A. Hamid, Zaid Bhatti, Deborah D. Moore, Shahid Khan, Hasan Khan, William C. Weldon, Zulfiqar Ahmed Bhutta, Sajid Bashir Soofi

Department of Paediatrics and Child Health

Background: Afghanistan is one of the remaining wild-poliovirus (WPV) endemic countries. We conducted a seroprevalence survey of anti-poliovirus antibodies in Kandahar Province.
Methods: Children in two age groups (6–11 months and 36–48 months) visiting Mirwais hospital in Kandahar for minor ailments unrelated to polio were enrolled. After obtaining informed consent, we collected venous blood and conducted neutralization assay to detect poliovirus neutralizing antibodies.
Results: A total of 420 children were enrolled and 409/420 (97%) were analysed. Seroprevalence to poliovirus type 1 (PV1) was 97% and 100% in the younger and older age groups respectively; it was 71% and 91% for …

Effects On Recovery And Neuroplasticity In Brain Injury Patients, Rebekkah Mclellan

Student Scholar Showcase

Abstract

According to the Centers for Disease Control, approximately 1.7 million people sustain a Traumatic Brain Injury each year, making the topic of brain plasticity and patient recovery an important area of study. An added element is understanding whether biological, social, and environmental factors can impact the recovery and plasticity of the patient’s brain.The purpose of this literature review was to evaluate if the environment surrounding an individual who has sustained a brain injury affects their recovery and neuroplasticity. The databases used for the scope of this review included LC OneSearch, Medline, EBSCOhost, and Google Scholar. Keywords included brain injury, …