Public Health Commons^™

Determinants Of Multimorbidity Among Stroke Patients For Epidemiological Management In Indonesia's Agro-Coastal Communities, Krish Naufal Anugrah Robby, Isa Ma'rufi, Farida Wahyu Ningtyias, Latifatul Izzah, Nurjazuli Nurjazuli, Suhartono Suhartono, Muchlis Achsan Udji Sofro, Ida Srisurani Wiji Astuti, Olivia Listiowati Prawoto, Dedek Sutinbuk, Taufik Kurrohman, Elhoussin Ouassou

Kesmas

Multimorbidity remains a major public health challenge among stroke patients, particularly in agro-coastal communities characterized by socioeconomic vulnerability, limited healthcare access, and lifestyle changes. This study aimed to analyze the determinants of multimorbidity among stroke patients in agro-coastal communities. A quantitative observational analytical design was employed, involving 45 stroke patients selected through total sampling in Jember District, Indonesia. Data were collected through structured interviews, anthropometric measurements, and secondary health records. The model included biological, socioeconomic, healthcare access, and lifestyle as exogenous variables, with multimorbidity as the endogenous variable. Data were analyzed using PLS-SEM, including evaluation of measurement and structural models …

Covid-19 Case Study, Armando Olmeda

Distinguished Student Scholarship Collection

Coronavirus disease 2019 (COVID-19), caused by SARS-CoV-2, continues to affect healthcare systems and public health worldwide. This case study examines COVID-19 from an epidemiological perspective by looking at how the disease spreads, the populations most affected, the major risk factors, and the impact on healthcare systems. It also analyzes key epidemiological measures, including incidence, prevalence, hospitalization, and mortality trends, to better understand how the pandemic has changed over time. The findings show that older adults, individuals with chronic medical conditions, and socially disadvantaged populations continue to experience the greatest burden of disease, with social determinants of health playing an important …

Examining The Link Between Adenomas And Early-Onset Colorectal Cancer In Adults Aged 20–44, Ijeoma F. Erondu

Doctoral Dissertations and Projects

Early-onset colorectal cancer (EOCRC) has increased among adults younger than 50 years, raising concerns regarding risk identification and screening practices in younger populations. This study examined the association between colorectal adenomas and EOCRC among adults aged 20–44 years in the United States and evaluated whether this relationship was influenced by selected demographic and behavioral factors. A cross-sectional analytic design was used to examine medical claims data from the Optum Partner Health database. The study population included 186,790 individuals aged 20–44 years who underwent colonoscopy procedures. Demographic variables included age group, sex, race/ethnicity, and body mass index (BMI). Smoking status was …

Global Health Financing Of Diagonal Interventions: Building Resilient And Sustainable Health Systems In Sub-Saharan Africa, Lucy Kim

Master in Public Policy Theses

Background: Global health financing has historically prioritized disease-specific “vertical” programs over broader “horizontal” strengthening of general health systems. Vertical programs in HIV have led to unprecedented reductions in mortality worldwide, but HIV remains a significant public health threat in sub-Saharan Africa, where vertical strategies have long been criticized for creating fragmented health systems. In response, global health strategies have shifted towards combining vertical investments with broader horizontal activities, commonly referred to as “diagonal” programming. While evidence suggests that diagonal programming has the potential to create more resilient and sustainable health systems, evaluating its value for money is challenging due to …

Stochastic Invasion And Extinction In Environmentally Transmitted Diseases, Mahmudul Bari Hridoy, Lauren M. Childs

Biology and Medicine Through Mathematics Conference

No abstract provided.

Group B Streptococcus In Pregnant Women: Universal Guidelines And Protocols, Dania Presteguin

Undergraduate Honors Thesis Collection

Background: Group B Streptococcus (GBS) is a leading cause of maternal sepsis and neonatal mortality globally. Variability in screening and treatment guidelines influences global disease burden.

Objective: This study uses a cross-national analysis to compare screening and treatment guidelines and their impact on prevalence, screening, intrapartum antibiotic prophylaxis (IAP), and maternal-neonatal clinical manifestations Methodology: A systematic review of secondary literature was conducted using PubMed, Scopus, and CINAHL (2010-2025). Inclusion criteria include maternal GBS colonization and one or more measures of interventions and neonatal infection rates. No geographic or demographic restrictions were applied. A total of 67 studies were screened, and …

Occupational Epidemiology Of Acral Lentiginous Melanoma, Lily Guo, Robin Kikuchi, April W. Armstrong, Suephy C. Chen

Department of Dermatology and Cutaneous Biology Faculty Papers

Acral lentiginous melanoma (ALM) classically presents in glabrous skin. Some studies suggest an association between mechanical stress and ALM development. People working jobs with long periods of standing/walking may be exposed to near-daily mechanical stress. To investigate the relationship between occupation type and ALM development, we performed a retrospective cohort study using Optum’s Clinformatics Database (2007—2023). We compared the risk of ALM in adults with occupational data (n = 9,270,935). Retired patients had the highest prevalence (0.081) and incidence per 1,000,000 person-years (0.514, 95% confidence interval = 0.487—0.542) of ALM. We performed multivariate logistic regression, adjusted for demographics and insurance, …

Metformin Exposure After Glioblastoma Diagnosis And Mortality: A Large Population-Based Study, Vittorio Maio, Roshani Shah, Manisha Lin, Patrick J. Moeller, Iyad Alnahhas, Richard Hass, Wenyin Shi, Scott W Keith

College of Population Health Faculty Papers

BACKGROUND: Glioblastoma (GBM) is an aggressive primary brain malignancy with limited therapeutic options and poor survival outcomes. Recent real-world studies and early-phase clinical trials evaluating metformin have yielded mixed findings. This study assessed the association between post-diagnosis metformin exposure and all-cause mortality in a large population-based cohort of older adults with GBM.

METHODS: A retrospective cohort study was conducted utilizing the Surveillance, Epidemiology, and End Results (SEER)-Medicare linked database. Adults aged ≥66 years diagnosed with GBM between 2007 and 2018 were included, excluding those with other malignancies or diagnoses made by autopsy or death certificate. Metformin exposure was modeled as …

Dietary Inflammatory Index And Risk Of Colorectal Cancer In Japanese Men, Ayaka Kotemori, Kumiko Kito, Motoki Iwasaki, Taiki Yamaji, James Hébert Scd, Junko Ishihara, Manami Inoue, Shoichiro Tsugane, Norie Sawada On The Behalf Of Jphc Study Group

Faculty Publications

Background/Objectives: Unhealthy lifestyles lead to chronic low-grade inflammation, increasing the risk of colorectal cancer. Few studies in East Asia have examined the association between the dietary inflammation potential and colorectal cancer incidence. Therefore, we aimed to investigate this association further in the Japanese population. Methods: This study included 38,807 men aged 45–74 years who participated in the Japan Public Health Center-based prospective study (JPHC Study). The energy-adjusted dietary inflammatory index (E-DII) was derived from a food frequency questionnaire. Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using Cox proportional hazards regression models. Differences in risk due to a …

On Burden Of Diseases, Prevention, Medical Research And Health Service Delivery: Grampian Case Study, Seshadri S. Vasan, Sudarshan Anand, Miae Lee, Nicholas C. Fluck

Research outputs 2022 to 2026

Burden of diseases measured as disability-adjusted life years (DALYs) per 100,000 people can be mined from public domain data, when they are made available by population health surveillance systems. This can be analysed to allow insightful comparisons with the national average, and to understand differences in trends between the sexes, age groups, time periods, geographic regions, and sub-regions. In this illustrative case study, we have analysed the Scottish burden of disease database to understand what ailed the population of the Grampian region before the COVID-19 pandemic. We have identified that selected cancers, ischaemic heart disease, Alzheimer’s disease and other dementias …

Combined Effects Of Cumulative Triglyceride-Glucose And Blood Pressure On Stroke In Middle-Aged And Older Chinese Adults: A Longitudinal Analysis, Xinyue Wang, Wen Zheng, Xiangqian Jin, Hongzhi Liu, Jiheng Hao, Liyong Zhang, Yuanyuan Gu, Haifeng Hou, Wei Wang

Research outputs 2022 to 2026

Background: The triglyceride-glucose (TyG) index has increasingly been recognised an indicator for stroke risk. We aimed to explore the relationship between TyG and blood pressure (BP) and the combined effects of cumulative TyG (CumTyG) and cumulative BP (CumBP) on stroke risk in a cohort of Chinese middle-aged and older adults. Methods: We enrolled 5138 participants from the 2011–2018 waves of the China Health and Retirement Longitudinal Study. Cumulative TyG and BP exposures were recorded between 2011 and 2015, and stroke incidence was then followed up until 2018. We conducted a cross-lagged panel analysis to address the temporal and directional relationships …

Cannabinoid Impacts On Ethnic Modulation Of Atrial Septal Defect Prevalence Usa, Albert Stuart Reece, Gary Kenneth Hulse

Research outputs 2022 to 2026

Objective: To conduct a detailed epidemiological exploration of the relative contributions of cannabis and ethnicity to US atrial septal defect (ASD) rates (ASDR). Study design: State-based ASDR data from the US National Births Defects Prevention Network, substance use, income and ethnicity data analyzed in RStudio. Results: Ethnic effects were significant with relative risks amongst African Americans and American Indians and Alaskan Natives of 2·40 (95%C.I. 2·27, 2·54) and 2·31 (2·19, 21·43), Cohen’s D of 1·44 and 1·46 and P values of 2·94 × 10⁻¹⁶⁸ and 3·01 × 10⁻¹⁷² compared to others, respectively. In general, additive models inclusion of …

Evaluating Differences In Nonsyndromic Orofacial Clefts By Infant Sex: National Birth Defects Prevention Study, 1997-2011, Victoria A Salinas, Natalie P Archer, Layla R Lustri, Katherine L Ludorf, Timothy Ihongbe, Wei Yang, Eva M Williford, Marilyn L Browne, Adrian M Michalski, Lindsay A Williams, Wendy Nembhard, Eirini Nestoridi, Gary M Shaw, Andrew F Olshan, A J Agopian, National Birth Defects Prevention Study

Faculty, Staff and Student Publications

Objective: To investigate nongenetic factors that may contribute to observed differences in nonsyndromic orofacial clefts by infant sex.

Study design: Using data for 1997-2011 deliveries from the National Birth Defects Prevention Study, a case-control study, we separately examined associations between 23 maternal factors and cleft lip with or without cleft palate (CL/P) and cleft palate alone (CP) using multivariable logistic regression stratified by infant sex.

Results: We compared 2986 infants with CL/P and 1557 with CP to 11 271 control infants without birth defects. After adjusting for maternal age at conception and education, lower odds of nonsyndromic orofacial clefts were …

Global, Regional, And National Burden Of Epilepsy, 1990–2021: A Global Burden Of Disease Study, Jinqing Zhao, Qiannan Chen, Jiahan Dong, Meng Gao, Siqi Ge, Anxin Wang

Research outputs 2022 to 2026

Background: Epilepsy is a common neurological disorder characterised by spontaneous seizures without an identifiable cause, leading to high morbidity and a significant public health burden. Understanding trends in its incidence, prevalence, mortality, and disability-adjusted life years (DALYs) is essential for developing effective prevention and treatment strategies. We aim to describe global trends in epilepsy over the past 32 years and explore the impact of sociodemographic index (SDI) levels on disease burden using the Global Burden of Disease 2021 data. Methods: We analysed the global burden of epilepsy (1990–2019) using age-standardised rates (ASRs) and their 95% uncertainty intervals (UI). We assessed …

Trends In Hypertension Prevalance And Control In The United States Over 25 Years, Omar Saleh, Neda Rehan, Saleh Mostafa, Rehan Qayyum

Department of Medicine Faculty Publications

Despite sustained public health efforts, hypertension remains highly prevalent in the United States, with persistent disparities across demographic and socioeconomic groups. We examined 25-year trends in hypertension prevalence, undiagnosed hypertension, and on-treatment uncontrolled hypertension in the United States using nationally representative National Health and Nutrition Examination Survey (NHANES) data from adults aged ≥18 years. Hypertension was defined as systolic BP ≥130 mmHg, diastolic BP ≥80 mmHg, or current antihypertensive use. Undiagnosed hypertension was defined as elevated BP without prior diagnosis or treatment, while on-treatment uncontrolled hypertension was defined as diagnosed hypertension with BP ≥130/80 mmHg despite treatment. Survey-weighted generalized linear …

An Analysis Of Heart Failure Among Cancer Patients In The United States Between 1999 And 2020, Abes A. Bautista Neughebauer, Deepak Talreja, Apostolos Gaitanidis

Department of Medicine Faculty Publications

Background: Cancer and heart failure (HF) are highly prevalent in the population and can co-exist, due to shared risk factors and an aging population. The HF-related mortality burden in cancer patients across in the United States (US) remains poorly understood. The goal of this study is to evaluate the patterns of HF-related deaths among cancer patients in the United States.

Methods: A retrospective analysis was performed using the Centers for Disease Control and Prevention (CDC) WONDER Multiple Cause of Death database between years 1999 and 2020. HF-related deaths were defined as death certificates listing HF as a contributing cause of …

Association Between Neighborhood Social Determinants Of Health And Stillbirth, Tetsuya Kawakita, Misa Hayasaka, Ann M. Harper, John Brush, George Saade

Department of Obstetrics & Gynecology Faculty Publications

OBJECTIVE:

To examine the association between neighborhood-level social determinants of health and stillbirth.

METHODS:

We performed a retrospective cohort study of deliveries that occurred at a gestational age of at least 20 weeks within a five-hospital system (2012-2022). Electronic health record data mapped to the Observational Medical Outcomes Partnership Common Data Model were geocoded using addresses at the time of delivery and linked to neighborhood health indices, which included the Area Deprivation Index (ADI), Maternal Vulnerability Index (MVI), and Social Vulnerability Index (SVI) at the Census tract level. Stillbirths were adjudicated by medical record review. Modified Poisson regression generated relative …

Dietary Acculturation, Dietary Inflammatory Potential, And Metabolic Syndrome Among Immigrants In The United States: A Mixed-Methods Approach Using Nhanes And Qualitative Data, Esse G. Foka Nzaha

Theses and Dissertations

Background and Objectives: Immigrants in the United States undergo acculturation — a process of sociocultural and behavioral adaptation to the host country. Increasingly, behavioral adaptations have been associated with cardiometabolic health and chronic disease risk. Metabolic syndrome (MetS), a cluster of conditions including abdominal obesity, elevated blood pressure, impaired fasting glucose, elevated triglycerides, and reduced HDL cholesterol, is a major risk factor for type 2 diabetes mellitus, cardiovascular diseases and other chronic diseases, including cancer. Despite the growing immigrant population in the U.S., the role of diet and dietary acculturation in MetS development remains poorly understood in this population. This …

Epidemiology, Presentation, And Diagnosis Of Type 2 Diabetes Mellitus In Children And Adolescents, Bisher Alsabbagh, Whard Alsabbagh

School of Integrative Biological & Chemical Sciences (Formerly Dept. of Biology)

The prevalence of type 2 diabetes mellitus (T2DM) in children and adolescents has increased substantially over recent decades, paralleling rising rates of pediatric obesity and metabolic risk. Youth-onset T2DM is characterized by significant insulin resistance accompanied by an inadequate compensatory insulin response, resulting in progressive hyperglycemia and early beta-cell dysfunction. Incidence varies widely among racial and ethnic groups, with the highest rates observed in non-Hispanic Black, Hispanic, Native American, Asian American, and Pacific Islander youth. Risk factors include obesity, family history, high-risk ethnicity, pubertal insulin resistance, prenatal metabolic exposures, and comorbid conditions such as polycystic ovary syndrome. Clinical presentation ranges …

Behçet's Disease Unraveled: Insights Into Clinical Manifestations, Diagnosis, And Management, Mansour Alghamdi, Stephen Lindsey

School of Medicine Faculty Publications

Behçet's disease is a rare and recurrent multisystem inflammatory disorder, primarily distinguished by systemic vasculitis that affects veins and arteries of various sizes. Clinically, Behçet's disease is characterized by the presence of recurrent oral and genital ulcers, skin lesions, and uveitis. The prevalence of this condition is significantly elevated along the historical Silk Road, particularly in Turkey; however, epidemiological data indicate variations across different regions and ethnic groups. The diagnosis of Behçet's disease is typically established during the third decade of life, with a more severe prognosis noted when the onset occurs before the age of 25. This review aims …

A Randomized Controlled Trial Combining House Screening And Insecticide-Treated Nets Reduces Malaria Transmission In Northwestern Ethiopia, Aklilu K. Belay, Abebe Asale, Catherine L. Sole, Abdullahi A. Yusuf, Baldwyn Torto, Zewdu Abro, Menale Kassie, Clifford M. Mutero, David P. Tchouassi

All Peer-Reviewed Publications

House screening (HS) of doors, eaves, and windows using wire-mesh has demonstrated potential in the integrated vector management of malaria. However, limited epidemiological data are available to guide its implementation across different ecological settings. In a 16-month randomized controlled trial (follow-up period) conducted across three agroecological areas (dry mountain, plateau highland, and semi-arid) in Jabi Tehnan district, northwestern Ethiopia, treatment houses were equipped with HS combined with insecticide-treated nets (ITNs), while control houses received ITNs only. The intervention led to a significant 2.3-fold reduction in indoor malaria vector density, the primary entomologic outcome, largely influenced by An. gambiae s.l. mosquitoes. …

Human Plasma Proteomic Profile Of Clonal Hematopoiesis, Zhi Yu, Amélie Vromman, Ngoc Quynh H Nguyen, Art Schuermans, Linke Li, Thiago Rentz, Tetsushi Nakao, Shamsudheen K Vellarikkal, Md Mesbah Uddin, Abhishek Niroula, Gabriel Griffin, Michael C Honigberg, Amy E Lin, Christopher J Gibson, Daniel H Katz, Usman A Tahir, Shi Fang, Jacqueline S Dron, Michael Pan, Sara Haidermota, Shriienidhie Ganesh, Tajmara Antoine, Joshua Weinstock, Thomas R Austin, Ramachandran S Vasan, Gina M Peloso, Whitney Hornsby, Peter Ganz, Joann E Manson, Bernhard Haring, Charles Kooperberg, Alexander P Reiner, Joshua C Bis, Bruce M Psaty, Yuan-I Min, Adolfo Correa, Leslie A Lange, Wendy S Post, Jerome I Rotter, Stephen S Rich, James G Wilson, Benjamin L Ebert, Bing Yu, Christie M Ballantyne, Josef Coresh, Vijay G Sankaran, Alexander G Bick, Siddhartha Jaiswal, Robert E Gerszten, Nhlbi Trans-Omics For Precision Medicine, Peter Libby, Rajat M Gupta, Pradeep Natarajan

Faculty, Staff and Student Publications

Plasma proteomic profiles associated with subclinical somatic mutations in blood cells may offer insights into downstream clinical consequences. Here we explore these patterns in clonal hematopoiesis of indeterminate potential (CHIP), which is linked to several cancer and non-cancer outcomes, including coronary artery disease (CAD). Among 61,833 participants (3881 with CHIP) from TOPMed and UK Biobank (UKB) with blood-based DNA sequencing and proteomic measurements (1,148 proteins by SomaScan in TOPMed and 2917 proteins by Olink in UKB), we identify 32 and 345 proteins from TOPMed and UKB, respectively, associated with CHIP and most prevalent driver genes (DNMT3A, TET2, and ASXL1). These …

Epidemiology Of Metabolic Syndrome In Patients With Inflammatory Bowel Disease: A Population-Level Cohort Study From The United States, Aakash Desai, Himsikhar Khataniar, Jana G. Hashash, Priya Sehgal, Francis A. Farraye, Gursimran S. Kochhar

Division of Gastroenterology and Hepatology Faculty Papers

BACKGROUND: Epidemiological data on metabolic syndrome (MetS) in patients with inflammatory bowel disease (IBD) are limited.

METHODS: A retrospective cohort study was conducted using the United States (US) Collaborative Network (TriNetX) to obtain data for patients with IBD between 2010 and 2023. The primary aim of the study was to estimate the prevalence of MetS in ulcerative colitis (UC) and Crohn's disease (CD). Prevalence was further characterized by age, sex, race, disease location, IBD medications, history of surgery, and IBD phenotype.

RESULTS: Among 100,890 patients with IBD, metabolic syndrome (MetS) affected 34.4% overall (UC 32.4%, CD 34.3%). Prevalence rose sharply …

The Association Between Physical Activity, Sedentary Time, And Sleep With Risk Of Hepatocellular Carcinoma In Patients With Cirrhosis, Samuel Ma, Yossef Alsabawi, Fasiha Kanwal, Hao Duong, Laith Elserag, Amit G. Singal, Nicole E. Rich, Saira Khaderi, Sumeet K. Asrani, Hashem B. El-Serag, Aaron P. Thrift

School of Medicine Publications

Background: The majority of hepatocellular carcinoma (HCC) cases arise in patients with cirrhosis, with known major risk factors of hepatitis B (HBV) or C (HCV) infection, metabolic dysfunction-associated steatotic liver disease (MASLD), and alcohol-associated liver disease (ALD). However, the impact of additional risk factors that act independently or jointly on the pathogenesis of HCC in cirrhosis patients is unknown. The aim of this study was to determine whether sleep, sedentariness, or physical activity levels play a role in the progression of cirrhosis to HCC.

Methods: We systematically collected data on sleep, sedentary time, and physical activity from the ongoing prospective …

Global, Regional, And National Burden Of Cardiovascular Diseases And Risk Factors In 204 Countries And Territories, 1990-2023, Global Burden Of Cardiovascular Diseases And Risks 2023 Collaborators, Mohammadreza Abbasian

Department of Orthopaedic Surgery Faculty Papers

BACKGROUND: Cardiovascular diseases (CVDs) are the leading cause of mortality and are among the foremost causes of disability globally. CVD burden has continued to increase in most countries since 1990, with trends driven by changing exposures to harmful risk factors, population growth, and population aging.

OBJECTIVES: We report estimates of global, national, and subnational CVD burden, including 18 subdiseases and 12 associated modifiable risk factors. We analyzed change in CVD burden from 1990 to 2023 and identified drivers of change including population growth, population aging, and risk factor exposure.

METHODS: The Global Burden of Disease (GBD) 2023 study, a multinational …

Postpartum Conversion Type 2 Diabetes In African American Women With Gestational Diabetes, Guerino Tondreau

Walden Dissertations and Doctoral Studies

Type 2 diabetes mellitus (T2DM) remains a significant public health concern in the United States, with non-Hispanic Black women bearing a disproportionately high burden of the disease. Although this group has a lower overall prevalence of gestational diabetes mellitus (GDM), those who develop GDM face an increased risk of progressing to T2DM. The purpose of this quantitative, correlational study was to explore the relationship between GDM, physical activity, weight status, and T2DM development among non-Hispanic Black women. Secondary data from the National Health and Nutrition Examination Survey, collected from 2017 through March 2020, were analyzed. The health belief model served …

Inter- And Intra-Observer Agreement In Ultrasound Diagnosis Of Steatotic Liver Disease: Implications For Screening In Resource-Limited Settings, Maria Spencer-Sandino, Maya Balakrishnan, David Wynne, Ilona Argirion, Paz Cook, Vanessa Van De Wyngard, Noldy Mardones, Ruth Pfeiffer, Allan Hildesheim, Catterina Ferreccio, Jill Koshiol

Faculty, Staff and Students Publications

Steatotic liver disease (SLD), which is associated with increased risk of cancer-related mortality, needs timely and cost-effective detection. Although liver biopsy remains the diagnostic gold standard, its invasiveness and high-cost limit widespread use. Ultrasound is a practical and affordable alternative. We evaluated inter- and intra-observer agreement for ultrasound-based diagnosis of SLD using images from the Chile Biliary Longitudinal Study (Chile BiLS), a cohort of women with gallstones. These women have a high burden of obesity and related metabolic disorders, putting them at higher risk for SLD. A radiologist (observer 1) reviewed a randomly selected subset of 425 baseline images and …

Associations Between Social Drivers Of Health And Breast Cancer Stage At Diagnosis Among U.S. Black Women, Mollie Barnard, Bo Qin, Marc Emerson, Etienne Holder, Matthew Dunn, Shromona Sarkar, Nuo Xu, Yutong Li, Christine Ambrosone, Elisa Bandera, Julie Palmer, Melissa Troester, Terry Hyslop

Department of Pharmacology, Physiology, and Cancer Biology Faculty Papers

U.S. Black women have disproportionately high breast cancer mortality, partly due to later-stage diagnoses. We examined how social drivers of health (SDOH) relate to stage at diagnosis by analyzing data from 4,995 breast cancer survivors in the Black Women's Health Study, Carolina Breast Cancer Study, and Women's Circle of Health Studies. SDOH were self-reported and stage was ascertained from medical records. We used polytomous logistic regression to estimate odds ratios (ORs) for diagnosis at stages III/IV or II versus stage I (referent), adjusting for age, insurance status, and income. Meta-analyzed results indicated that underutilization of screening mammography (OR = 3.21, …

If Alcohol Consumption Were Eliminated, Which Us Counties Would Still Experience High Rates Of Breast Cancer Among Women?, Hina Javed

Boise State University Theses and Dissertations

Background

Breast cancer is the most prevalent cancer among women in the United States, accounting for roughly one-third of all newly diagnosed female cancers (American Cancer Society, 2024). The risk factors for breast cancer include both non-modifiable and modifiable factors. Non-modifiable factors include age at menarche, early menstrual cycles and late menopause. Modifiable factors include smoking, diabetes, obesity and environmental factors such as air pollution. The interplay between lifestyle factors and environmental exposures in cancer development has long been debated. While alcohol consumption is widely recognized as a major breast cancer risk factor, the role of environmental exposure such as …

Chance Or Strategy? Assessing The Unanticipated Policy Window For Active Transportation During The Covid-19 Pandemic: A Systematic Review, Katja Siefken, Michael Pratt, Juliana Mejía-Grueso, Adrian Bauman, Deborah Salvo, Catherine B Woods, Wanda Wendel-Vos, Justin Richards, J Jaime Miranda, Pedro C Hallal, Andrea Ramírez Varela

Faculty, Staff and Student Publications

Physical activity (PA) policy is essential for promoting population-level PA by coordinating efforts across various sectors. Global crises like the COVID-19 pandemic can open policy windows, enabling rapid implementation of innovative policies. This study examined how policy windows shaped active transportation (AT) policies during the pandemic, resulting in infrastructural changes.

Methods: A systematic review using PubMed, Scopus, ProQuest-Coronavirus Research Database, Web of Science, WHO COVID-19 Research Database, PsycInfo, and SPORTDiscus conducted to characterize AT policy during the pandemic (2020-2023). Descriptive analyses were conducted in Stata. PROSPERO registration number: CRD42025644930.

Results: The search retrieved 3879 articles; 1162 were duplicates, leaving 2716 …